ABSTRACT
OBJECTIVE: To evaluate prognostic significance of tissue oximetry in healing of trophic defects in patients with diabetic foot syndrome (DFS) after endovascular revascularization. MATERIAL AND METHODS: In 42 patients with DFS, tissue oximetry was performed in angiosome projection with the FORE-SIGHT MC-2000 (CASMED) device before and the next day after revascularization of lower limb arteries. The 1st group included 30 patients with wound healing throughout 3 months, the 2nd group included 12 patients with amputation or no healing of trophic defects. RESULTS: Direct revascularization was more common in the 1st group (p=0.001). On the day after intervention, oxygen saturation (StO2) increased in all angiosomes in both groups (p<0.05). StO2 increment differed significantly between groups in all angiosomes except for point I (p<0.05). According to ROC analysis, StO2 increment by 4.5% in absolute values and 7.9% in percentage leads to trophic defect healing within 3 months (sensitivity and specificity were 76.7% and 66.7% for absolute values, 80% and 58.3% for percentage, respectively). CONCLUSION: Evaluation of StO2 in target angiosome may be valuable to predict trophic defect healing after endovascular surgery.
Subject(s)
Diabetic Foot , Oximetry , Wound Healing , Humans , Diabetic Foot/surgery , Diabetic Foot/diagnosis , Diabetic Foot/physiopathology , Male , Female , Middle Aged , Oximetry/methods , Wound Healing/physiology , Aged , Endovascular Procedures/methods , Prognosis , Oxygen Saturation/physiology , Treatment Outcome , Spectroscopy, Near-Infrared/methods , Lower Extremity/blood supplyABSTRACT
The number of patients with diabetes mellitus has steadily been increasing. This disease is associated with the risk for the development of micro- and macroangiopathies. One of the variants of macroangiopathy is Mönkeberg's sclerosis characterized by the presence of calcification of the media of the arterial wall. This article is a literature review reflecting the role of calcification in arterial lesions in patients with diabetes mellitus, also covering the historical aspect of studying Mönkeberg's sclerosis. Special attention is paid to its morphological forms, aetiopathogenetic mechanisms of development, taking into account contemporary studies, demonstrating mechanisms of the effect of medial arterial calcification on haemodynamics and the risk for the development of cardiovascular complications. Also presented herein are the main non-invasive and invasive methods of its diagnosis.
Subject(s)
Arteriosclerosis , Calcinosis , Diabetes Mellitus , Vascular Calcification , Arteries/pathology , Calcinosis/diagnosis , Calcinosis/etiology , Humans , Risk Factors , Sclerosis/pathology , Vascular Calcification/diagnosis , Vascular Calcification/etiology , Vascular Calcification/pathologyABSTRACT
Computer simulation of the electrical activity in sinoatrial node cells interacting via gap junctions with fibroblasts revealed that interaction with fibroblasts results in greater oscillation frequency of sinoatrial node cells. We have found out that fibroblasts also decrease the oscillation amplitude of the intrinsic central cells or completely suppress their spontaneous activity, while weakly affect the oscillation amplitude of peripheral cells.
Subject(s)
Computer Simulation , Fibroblasts/chemistry , Models, Theoretical , Sinoatrial Node/chemistry , Connective Tissue/chemistry , Fibroblasts/cytology , Gap Junctions/chemistry , Gap Junctions/physiology , Humans , Membrane Potentials , Models, Cardiovascular , Myocytes, Cardiac/chemistry , Myocytes, Cardiac/cytology , Sinoatrial Node/cytologySubject(s)
Anemia, Hypochromic/etiology , Cystadenoma, Mucinous , Melena/etiology , Pancreatectomy , Pancreatic Pseudocyst/etiology , Anemia, Hypochromic/physiopathology , Female , Humans , Melena/physiopathology , Middle Aged , Pancreatic Neoplasms/complications , Pancreatic Neoplasms/pathology , Pancreatic Neoplasms/physiopathology , Pancreatic Neoplasms/surgery , Pancreatic Pseudocyst/physiopathology , Treatment OutcomeSubject(s)
Cholecystectomy/methods , Common Bile Duct , Hepatic Duct, Common , Inflammation/etiology , Mirizzi Syndrome/complications , Cholangiopancreatography, Endoscopic Retrograde , Constriction, Pathologic/diagnosis , Constriction, Pathologic/etiology , Constriction, Pathologic/surgery , Diagnosis, Differential , Female , Follow-Up Studies , Humans , Inflammation/diagnosis , Inflammation/surgery , Middle Aged , Mirizzi Syndrome/diagnosisABSTRACT
The work deals with the features of the course of gastric and duodenal ulcers in diabetes mellitus and the frequency and pattern of the complications. The authors recommend criteria for preparation for surgical treatment, methods for compensation of the disturbances of carbohydrate metabolism, and the methods of postoperative management of such patients. The late-term results and analysis of treatment are discussed briefly. The coexistence of peptic ulcer and diabetes mellitus is a rare occurrence. During a 20-year period 31 patients were treated at the clinic, 21 of them underwent operation, in 5 patients an operation was considered inexpedient, another 5 patients refused to be operated on. The postoperative period was free of complications in 19 patients, there were no fatal outcomes.
Subject(s)
Diabetes Complications , Peptic Ulcer/complications , Diabetes Mellitus/drug therapy , Gastric Acid/metabolism , Humans , Insulin/therapeutic use , Peptic Ulcer/physiopathology , Peptic Ulcer/surgery , Postoperative PeriodABSTRACT
The results of 96 simultaneous operations for peptic ulcer are discussed. The indications for their performance are substantiated and the principles of their conduction in various diseases aggravating one another are determined. The low incidence of postoperative complications (4.2%) and lethality (1.04%) are evidence of the expediency of the suggested tactics.
