Adjunct methods of the standard diabetic foot ulceration therapy.

The outcome of management of diabetic foot ulceration (DFU) is poor and insufficient. DFU therapy includes the standard management as debridement of the wound, revascularization procedures, off-loading of the ulcer and antibacterial actions, and supplementation of growth factors and cytokines, leading to stimulation of granulation, epidermization, and angiogenesis. The aim of the present review is to summarize the adjunct methods of the standard DFU therapy as hyperbaric oxygen therapy (HBOT), maggot therapy (MT), and platelet-rich plasma therapy (PRPT). The results of preclinical and clinical trials indicated that the methods may reduce time of therapy, short-term morbidity, and the risk of major amputation.

Serum insulin levels in patients with colorectal cancer.

INTRODUCTION: Insulin regulates metabolic processes and is an important growth factor, which is able to stimulate cell proliferation and transformation and to inhibit apoptosis. OBJECTIVES: The aim of the study was to analyze the fasting serum insulin level in patients with colorectal cancer in relation to the clinical stage of the disease, patients' overweight and obesity, and the localization of a tumor (in the colon and rectum). PATIENTS AND METHODS: Seventy patients with colorectal cancer, including 41 men and 29 women (at an average age of 65 years) were enrolled into the study. Patients with diabetes, other forms of cancer, or used hormones were excluded from the study. Medical records of the patients was evaluated. Glucose and insulin levels in blood serum were analyzed. All the patients were divided into groups according to the body mass index (BMI), the clinical stage of the disease (including TNM) and tumor localization. RESULTS: Ten patients (14.29%) were obese, 31 patients (44.29%) were overweight, and 29 patients had normal weight (41.43%). The average BMI was 25.98 +/- 5.38 kg/m2. The mean glucose serum level was 5.49 +/- 1.0 mmol/l and the mean insulin serum level was 18.93 +/- 14.67 microlU/ml. There were no significant differences in glucose and insulin levels in relation to the stage of the disease, tumor localization and BMI. CONCLUSIONS: Overweight and obesity were observed in most of the colorectal cancer patients. No statistical associations were observed between serum insulin levels and tumor localization.

Genetic disregulation of TNF alpha and TNF alpha type II receptors in colon cancer at the II and III stage of disease.

The expression of the genes coding TNFalpha and TNF RII receptors (TNF RII: TNFR2 membrane and soluble domain, TNFR2/R7 soluble domain) was analysed in colon cancer at the II and III stage of disease, by estimation of mRNA expression. The study included 80 patients with histopathologically confirmed adenocarcinoma. The number of TNFalpha mRNA, TNFR2 mRNA and TNFR2/R7 mRNA copies were estimated in tumour and healthy tissue. The highest number of mRNA TNF-alpha copies were investigated in all samples of tissue and independently of the stage of disease. Simultaneously, we noticed the largest number of mRNA copies for TNFalpha and TNF R2/R7 in healthy cells at stage III of the disease. It is possible to draw a hypothetical line separating the anti-cancer activity of TNFalpha and its influence on cancer progression.

[Impaired fasting glucose and silent myocardial ischemia]. / Nieprawidlowa tolerancja glukozy a nieme niedokrwienie miesnia sercowego.

The present study was designed to reveal the incidence of silent myocardial ischemia in asymptomatic elderly patients with impaired fasting glucose. Abnormal perfusion pattern was found in 13 of 48 (27.1%), who were finally considered to have a SMI. The evidence suggests that early and intensive detection may be needed as a part of routine care for this group.