endothelin-1 and Diabetic-Foot

Mineral metabolism is dysregulated within days of acute renal injury in critically ill patients. On univariate analysis, high levels of calcitriol were associated with adverse clinical outcome in AKI. This association was not apparent after adjusting for age and APACHE II. Large controlled studies are needed to confirm these results, and determine if higher 1,25(OH). Los genotipos C/C y C/T en Colombia son tan variables como en otros grupos sanos en otras poblaciones. Los sujetos de nuestra población podrían tener riesgo para el desarrollo de enfermedades asociadas al polimorfismo del genMTHFR y con genotipos de riesgo de presentar toxicidad y efectos adversos del MTX, lo cual sugiere la necesidad de evaluar alternativas terapéuticas con estudios farmacogenéticos.

Topics: Acetaminophen; Administration, Oral; Adolescent; Adult; Advanced Oxidation Protein Products; Aged; Aged, 80 and over; Analgesics, Opioid; Animals; Antibodies, Monoclonal; Antioxidants; ATP Binding Cassette Transporter, Subfamily B, Member 1; Automation; Benzaldehydes; Bromates; Calcifediol; Calcitriol; Carcinoma, Squamous Cell; Catalase; Chromatography, Liquid; Coloring Agents; Cross-Over Studies; Cross-Sectional Studies; Cytochrome P-450 CYP3A; Cytokines; Diabetic Foot; Diabetic Neuropathies; Diagnostic Self Evaluation; Diosmin; DNA Damage; Double-Blind Method; Drug Combinations; Electrodes; Endothelin-1; Esophageal Neoplasms; Esophageal Squamous Cell Carcinoma; Esophagectomy; Exercise; Female; Follow-Up Studies; Gene Expression Regulation; Glutathione; Hesperidin; Humans; Illicit Drugs; Indians, North American; Injections, Intravenous; Interferometry; Interleukin-1beta; Interleukin-6; Interviews as Topic; Ions; Jejunum; Kidney; Leukocyte Count; Lipid Peroxidation; Lithium; Liver; Luminescent Measurements; Male; Mice; Middle Aged; Monocytes; Nanostructures; Oklahoma; Organ Specificity; Oxidative Stress; Oxycodone; Photochemistry; Predictive Value of Tests; Pregnane X Receptor; Preoperative Period; Prescription Drugs; Receptors, Steroid; Reference Values; Reproducibility of Results; Retinoid X Receptor alpha; Retrospective Studies; RNA, Messenger; Rumen; Sheep, Domestic; Shoes; Solar Energy; Superoxide Dismutase; Survival Rate; Tandem Mass Spectrometry; Titanium; Treatment Outcome; Tumor Necrosis Factor-alpha; Varicose Veins; Vitamin D; Water Pollutants, Chemical; Weight-Bearing; Young Adult

Critical limb ischemia (CLI) is a severe manifestation of peripheral artery disease characterized by ischemic pain, which is frequently associated with diabetes and non-healing lesions to inferior limbs. The clinical management of diabetic patients with CLI typically includes percutaneous transluminal angioplasty (PTA) to restore limb circulation and surgical treatment of diabetic foot ulcers (DFU). However, even after successful treatment, CLI patients are prone to post-procedure complications, which may lead to unplanned revascularization or foot surgery. Unfortunately, the factors predicting adverse events in treated CLI patients are only partially known. This study aimed to identify potential biomarkers that predict the disease course in diabetic patients with CLI. For this purpose, we measured the circulating levels of a panel of 23 molecules related to inflammation, endothelial dysfunction, platelet activation, and thrombophilia in 92 patients with CLI and DFU requiring PTA and foot surgery. We investigated whether these putative biomarkers were associated with the following clinical endpoints: (1) healing of the treated DFUs; (2) need for new revascularization of the limb; (3) appearance of new lesions or relapses after successful healing. We found that sICAM-1 and endothelin-1 are inversely associated with DFU healing and that PAI-1 and endothelin-1 are associated with the need for new revascularization. Moreover, we found that the levels of thrombomodulin and sCD40L are associated with new lesions or recurrence, and we show that the levels of these biomarkers could be used in a decision tree to assign patients to clusters with different risks of developing new lesions or recurrences.

Topics: Amputation, Surgical; Biomarkers; Chronic Limb-Threatening Ischemia; Diabetes Mellitus; Diabetic Foot; Endothelin-1; Humans; Inflammation; Ischemia; Plasminogen Activator Inhibitor 1; Retrospective Studies; Thrombomodulin; Treatment Outcome

to evaluate the role of clinical characteristics, functional markers of vasodilation, inflammatory response, and atherosclerosis in predicting wound healing in diabetic foot ulcer.. a cohort study (February - October 2010) was conducted from 40 subjects with acute diabetic foot ulcer at clinical ward of Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia. Each subject underwent at least two variable measurements, i.e. during inflammatory phase and proliferation phase. The studied variables were clinical characteristics, complete peripheral blood count (CBC) and differential count, levels of HbA1c, ureum, creatinine, lipid profile, fasting blood glucose (FBG), marker of endothelial dysfunction (asymmetric dimethylarginine/ADMA, endothelin-1/ET-1, and flow-mediated dilation/FMD of brachial artery), and marker of vascular calcification (osteoprotegerin/OPG).. median of time achieving 50% granulation tissue in our study was 21 days. There were nine factors that contribute in the development of 50% granulation tissue, i.e. family history of diabetes mellitus (DM), previous history of wound, wound area, duration of existing wound, captopril and simvastatin medications, levels of ADMA, ET-1, and OPG. There were three out of the nine factors that significantly correlated with wound healing, i.e. wound area, OPG levels, and simvastatin medications.. in acute diabetic foot ulcers, wound area and OPG levels had positive correlation with wound healing, whereas simvastatin medications had negative correlation with wound healing.

Topics: Aged; Biomarkers; Cohort Studies; Diabetes Mellitus, Type 2; Diabetic Foot; Endothelin-1; Female; Humans; Indonesia; Kaplan-Meier Estimate; Linear Models; Male; Middle Aged; Multivariate Analysis; Osteoprotegerin; Tertiary Care Centers; Vascular Calcification; Wound Healing

In recent years, scientists have become increasingly interested in the role of the endothelium in the pathogenesis of vascular lesions of various origins, including diabetic patients. Therefore, the aim of the study was to investigate the expression of endothelial dysfunction in patients with diabetic foot syndrome (DFS), by examining the levels of nitric oxide, endothelin-1 levels in the serum, as well as lower limb microcirculation by laser doppler flowmetry.. It was examined 72 patients with diabetic foot syndrome with I-IV degree of lesion (by Meggit- Wagner classification). Neuropathic form was diagnosed in 32 people, ischemic--40 patients. The function of endothelium was studied on the basis of the determination of enzyme-linked immunosorbent NO and endothelin-1 in peripheral blood serum, as well as to assess the state of the microcirculation of the lower limbs by laser doppler flowmetry, using apparatus LACK-02 (Russia).. Patients with DFS are marked with endothelial dysfunction, the severity of which depends on the type of diabetes, glycemic level and pathogenic forms of destruction. This is manifested by secretion reducing of vasodilators (NO) and increased synthesis of vasoconstrictors (endothelin-1), which leads to disruption of peripheral hemodynamic. Characteristic changes in the microcirculation are a dramatic violation of endothelium-dependent regulation mechanism, the redistribution of blood towards the nutritional circulation. Also it is showed a significant reduction in reserve capacity of the capillary bed in response to the sample and the occlusal restoration of blood flow during reactive hyperemia.. Development of endothelial dysfunction and changes in peripheral hemodynamic in patients with DFS contributes to the emergence and prolongation of necrotic lesions, as well as violation of reparative processes.

Topics: Diabetic Foot; Endothelin-1; Endothelium, Vascular; Female; Humans; Laser-Doppler Flowmetry; Lower Extremity; Male; Microcirculation; Middle Aged; Nitric Oxide; Severity of Illness Index; Wound Healing