ABSTRACT
This study was designed to describe the presence of calcifications according to the clinical features of the diabetic patient and the hemodynamics of the calcified arteries. With this purpose, 197 lower limbs from diabetic patients (type I and II) and carbon-hydrate intolerant patients, were studied. In all of the patients, the pressure ratio leg/arm was measured. On the same way, the arterial flow velocity was recorded using the Doppler ultrasonography on the pedia and postero-tibial arteries. The arterial calcifications, evident on the radiography of the foot, were more frequent between the type I patients and the neuro-infections diabetic foot. According to the hemodynamics point of view, we found a trend of association of more pathologic arterial flow velocity curves with the presence of calcifications (specially on the intima layer). It was also remarkable that an arterial incomprensibility was always associated with arterial calcifications.
Subject(s)
Arterial Occlusive Diseases/physiopathology , Calcinosis/physiopathology , Diabetic Angiopathies/physiopathology , Adult , Arterial Occlusive Diseases/diagnostic imaging , Arterial Occlusive Diseases/epidemiology , Calcinosis/diagnostic imaging , Calcinosis/epidemiology , Chi-Square Distribution , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 2/complications , Diabetic Angiopathies/diagnostic imaging , Diabetic Angiopathies/epidemiology , Diabetic Foot/diagnostic imaging , Diabetic Foot/epidemiology , Diabetic Foot/physiopathology , Female , Hemodynamics , Humans , Leg/blood supply , Male , Middle Aged , RadiographyABSTRACT
In order to improve the early diagnosis of arterial occlusions, we tried to establish the basis of an automatized system that allowed the study of the hemodynamic features of diabetic patients in the different stadii of their disease. Fifty-four patients with Diabetes Mellitus Type II were included in the study. In all of them, arterial flow curves were carried out at different levels: femoral, popliteal, pedia and tibial posterior arteries of both lower limbs. In the distal arteries of patients with hemodynamic injury, normal values of Maximal Systolic Velocity (Max A), Maximal Diastolic Velocity (Max D), Peurcelot's resistance (PR), pulsatility index (PI) and spectral band (SB), were found.
Subject(s)
Arterial Occlusive Diseases/physiopathology , Diabetes Mellitus, Type 2/complications , Diabetic Angiopathies/physiopathology , Hemodynamics , Peripheral Vascular Diseases/physiopathology , Arterial Occlusive Diseases/diagnostic imaging , Arterial Occlusive Diseases/etiology , Diabetic Angiopathies/diagnostic imaging , Diabetic Angiopathies/etiology , Humans , Leg , Middle Aged , Peripheral Vascular Diseases/diagnostic imaging , Peripheral Vascular Diseases/etiology , UltrasonographyABSTRACT
In order to improve in the early diagnosis of an arterial occlusion, we proposed the bases of an automatized system that allows to recognize the hemodynamic features of diabetic patients in different stadiums of their disease. Fifty-four patients with type-II diabetes were studied. We recorded the arterial flow curves in the bilateral femoral, popliteal, pedia and tibial-posterior arteries from all of our patients. In the distal arteries from patients with hemodynamics disturbances, we found normal values of the variants measured: maximal systolic speed flow (Max A), maximal diastolic speed flow (Max D), Peurcelot's resistance (RP), pulsatility index (PI) and spectral band (SB).
Subject(s)
Arterial Occlusive Diseases/physiopathology , Diabetic Angiopathies/physiopathology , Peripheral Vascular Diseases/physiopathology , Analysis of Variance , Arterial Occlusive Diseases/epidemiology , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/physiopathology , Diabetic Angiopathies/epidemiology , Hemodynamics , Humans , Middle Aged , Peripheral Vascular Diseases/epidemiologyABSTRACT
Thirty diabetic patients submitted to a major amputation were tested by humo-celullar assays (retarded hypersensibility assays). Reactive patients were subdivided into two groups: one group was treated postoperatively with antibiotics, and the other group was not treated. Both groups were homogeneous in age, hemoglobin concentrations, hematocrit, total proteins, glucemy and history of sepsis or leukocytosis. Five patients treated with antibiotics (33.3%) presented sepsis, one patient was reamputated and one patient died. Between the not treated patients, only three presented sepsis (20%) without any other complications. Authors conclude that the development of sepsis in reactive, diabetic, amputated patients is independent of antibiotic treatment.
Subject(s)
Amputation, Surgical , Anti-Bacterial Agents/therapeutic use , Diabetes Mellitus/surgery , Foot Diseases/surgery , Foot/blood supply , Ischemia/surgery , Surgical Wound Infection/prevention & control , Amputation, Surgical/statistics & numerical data , Antibody Formation , Chi-Square Distribution , Diabetes Complications , Diabetes Mellitus/immunology , Foot Diseases/etiology , Foot Diseases/immunology , Humans , Immunity, Cellular , Ischemia/etiology , Ischemia/immunology , Postoperative Care , Surgical Wound Infection/epidemiologyABSTRACT
Se realiza un estudio en 192 arteriografias e igual numero de expedientes clinicos correspondentes a pacientes diabeticos que presentan pie isquemico o neuroinfeccioso. Se establecen patrones arteriograficos para cada uno de los niveles habituales de amputacion. Se concluye, ademas, que la arteriografia tiene valor pronostico y gran importancia en cuanto a la decision del nivel de amputacion