[Factors associated with amputation in diabetic patients with foot ulcer]. / Estudio de factores asociados con amputación, en pacientes diabéticos con ulceración en pie.

OBJECTIVE: To analyse risk factors for amputation in diabetic foot ulcers. METHOD: We have studied 152 diabetic patients (in 14 food ulcers treatment was amputation) who were attendance between January 1996 and June 1998 in the diabetic foot Unit. Subjects with gangrene were excluded. RESULTS: Risk factors for amputation were: previous history of amputation (odds ratio 3.7; 1.0113.7), proliferative retinopathy, osteomielitis, and independently clinical signs of peripheral vasculopathy (7.1; 1.88-27.2) and severe infection (14.4; 2.92-71.2). CONCLUSION: Diabetic subjects with foot ulcers and previous history of amputation, proliferative retinopathy, osteomielitis, clinical signs of peripheral vasculopathy and/or severe infection were a high risk group for amputation and in this group aggressive therapeutical and preventive approaches should be done in order to prevent amputation.

Estudio de factores asociados con amputación en pacientes diabéticos con ulceración en pie / Study of factors associated with amputation in diabetic patients with foot ulceration

Objetivo: Analizar factores asociados con amputación en pacientes diabéticos que presentan úlceras en sus pies, con el fin de identificar sujetos con alto riesgo para amputación.Método: Hemos estudiado 152 diabéticos que acudieron a la Unidad del pie diabético desde enero de 1996 hasta junio de 1998 con úlceraciones en sus pies. En 14 de ellos fue necesaria la amputación. Se excluyeron sujetos con gangrena.Resultados: Los factores asociados con amputación fueron: antecedentes personales de amputación previa (odds ratio 3,7; 1,01-13,7), retinopatía proliferativa, osteomielitis y, de forma independiente, la presencia de vasculopatía (7,1; 1,88-27,2) e infección grave (14,4; 2,92-71,2).Conclusión: Los pacientes diabéticos con úlceras en pie que presenten antecedentes de amputación, signos clínicos de vasculopatía periférica, infección grave, osteomielitis o retinopatía avanzada son de alto riesgo para la amputación y en ellos se deben instaurar precozmente medidas terapéuticas y preventivas intensas. (AU)

[Nutritional status assessment in diabetes mellitus secondary to chronic alcoholic pancreatitis]. / Valoración del estado nutricional en la diabetes mellitus secundaria a pancreatitis crónica alcohólica.

BACKGROUND: Diabetes mellitus secondary to alcoholic chronic pancreatitis (DM-ACP) represents 0.5-2% of all cases of diabetes mellitus (DM) and shows predominantly symptoms related to malnutrition instead of cardinal clinical signs of diabetes. The aim of this study was to try to further characterize the features of the malnutrition in patients with pancreatic insufficiency. PATIENTS MATERIAL AND METHODS: We selected 40 patients (39 males and 1 female) meeting clinical, functional and morphological diagnostic criteria of DM-ACP which received a nutritional assessment that included estimation on fat and proteic body compartments being classified as caloric, proteic or mixed malnutrition. RESULTS: 29 patients (72.5%) showed some kind of malnutrition. The most frequent type was mixed (proteic-caloric) malnutrition found in 19 of them (47.5%). Caloric malnutrition was present in 6 (15%) and mainly proteic in 4 (10%). Only 11 patients with DM-ACP in our series showed a normal nourishment state. CONCLUSIONS: Large prevalence of mixed malnutrition in DM-ACP patients may be related to malabsorption of macronutrients (especially proteins and fat) due to exocrine insufficiency and misuse of nutrients as a result of the characteristic hypoinsulinemia showed by these patients.

[Cardiovascular risk factors in patients surviving a myocardial infarction]. / Factores de riesgo cardiovascular en pacientes sobrevivientes a infarto de miocardio.

We studied the risk factors of coronary disease in 52 patients (46 male and 6 female) survivors of myocardial infarction (MI). We found that a group of patients under 40 years old had predominant lipid alteration (100%) being hypercholesterolemia (CT greater than or equal to 260 mg/dl), the decrease of HDL-C levels (less than or equal to 35 mg/dl) and the increase of the atherogenic index (CT/HDL-C greater than or equal to 6) being the most frequent. At the same time, we observed an important association between several risk factors, such as tobacco consumption (58.5%), sedentary life (56.1%), lipid alterations (hypercholesterolemia: 46.3%, decrease of HDL-C: 41.4%, increase of atherogenic index: 60.9%) in the group of patients under 40 years old. These data show that the alterations of lipid metabolism are risk factors frequently observed in young patients with ischemic cardiac disease.