povidone-iodine and Diabetes-Mellitus--Type-2

To determine the effects of applying a natural polymer solution (shellac) to dry gangrene, and thereby prevent infection and progression to wet gangrene, in diabetic patients.. This randomized, controlled, pilot study included patients with type 2 diabetes mellitus who had unreconstructable peripheral vascular disease and were awaiting autoamputation. Eligible patients were contraindicated for surgery, had a limited life expectancy and/or had refused surgical amputations. All patients received the best possible medical treatment and were randomized to receive either topical shellac or antiseptic application of 10% povidone-iodine (PVP-I) solution to gangrenous areas.. A total of 26 diabetic patients were eligible for inclusion, of whom 23 completed the study: 13 were treated with shellac and 10 with PVP-I. The amputation rate was higher in the conventional treatment group versus the shellac group (60.0% versus 46.2%, respectively), although this difference was not statistically significant.. Shellac is a natural solution that may be used to embalm gangrenous tissue in selected diabetic patients. More studies are needed to assess the long-term outcomes of this technique.

Topics: Administration, Cutaneous; Aged; Aged, 80 and over; Amputation, Surgical; Anti-Infective Agents, Local; Diabetes Mellitus, Type 2; Diabetic Foot; Female; Gangrene; Humans; Male; Middle Aged; Pilot Projects; Povidone-Iodine; Resins, Plant; Treatment Outcome

Periodontal disease is a common infection-induced inflammatory disease among individuals suffering from diabetes mellitus. The purpose of this study was to assess the effects of treatment of periodontal disease on the level of metabolic control of diabetes. A total of 113 Native Americans (81 females and 32 males) suffering from periodontal disease and non-insulin dependent diabetes mellitus (NIDDM) were randomized into 5 treatment groups. Periodontal treatment included ultrasonic scaling and curettage combined with one of the following antimicrobial regimens: 1) topical water and systemic doxycycline, 100 mg for 2 weeks; 2) topical 0.12% chlorhexidine (CHX) and systemic doxycycline, 100 mg for 2 weeks; 3) topical povidone-iodine and systemic doxycycline, 100 mg for 2 weeks; 4) topical 0.12% CHX and placebo; and 5) topical water and placebo (control group). Assessments were performed prior to and at 3 and 6 months after treatment and included probing depth (PD), clinical attachment level (CAL), detection of Porphyromonas gingivalis in subgingival plaque and determination of serum glucose and glycated hemoglobin (HbA1c). After treatment all study groups showed clinical and microbial improvement. The doxycycline-treated groups showed the greatest reduction in probing depth and subgingival Porphyromonas gingivalis compared to the control group. In addition, all 3 groups receiving systemic doxycycline showed, at 3 months, significant reductions (P < or = 0.04) in mean HbA1c reaching nearly 10% from the pretreatment value. Effective treatment of periodontal infection and reduction of periodontal inflammation is associated with a reduction in level of glycated hemoglobin. Control of periodontal infections should thus be an important part of the overall management of diabetes mellitus patients.

Topics: Adult; Aged; Anti-Bacterial Agents; Anti-Infective Agents, Local; Arizona; Blood Glucose; Chlorhexidine; Dental Plaque; Dental Scaling; Diabetes Mellitus, Type 2; Doxycycline; Female; Glycated Hemoglobin; Humans; Indians, North American; Iodophors; Male; Middle Aged; Mouthwashes; Periodontal Attachment Loss; Periodontal Diseases; Periodontal Pocket; Periodontitis; Placebos; Porphyromonas gingivalis; Povidone-Iodine; Subgingival Curettage; Ultrasonic Therapy

Here, a clinician compares 4 weeks of treatment with Prontosan Wound Gel with a subsequent 4 weeks of octenilin Wound Gel on a complex diabetic foot ulcer prone to recurrent infection. The data show that, following the switch to octenilin, the previously static wound started to heal.

Topics: Adult; Anti-Infective Agents, Local; Biguanides; Diabetes Mellitus, Type 2; Diabetic Foot; Disinfectants; Humans; Imines; Male; Povidone-Iodine; Pyridines; Treatment Outcome; Wound Healing

Examined 22 patients with diabetes mellitus (DM) type II of neuropathic form of diabetic foot syndrome (DFS). In 12 patients (comparison group) local povidone-iodine was used main in 10 (study group), except povidone-iodine, in the phase of exudation used tyrothricin in gel form, the granulation and epithelization phase, after cleaning the wounds, were injected intradermally 1 ml of injecting material for skin regeneration Lacerta. Trophic defects in 9 (90%) patients of the main group during the observation period healed completely, in the comparison group complete healing of the ulcer reached in 2 (16.7%) patients, the rest-wounds, although purified, however, were lethargic granulation, epithelization occurred very slowly. Consequently, the use of the proposed method allows to achieve more rapid healing of trophic ulcers that do not heal continued in patients of neuropathic forms of DFS.

Topics: Anti-Bacterial Agents; Anti-Infective Agents, Local; Biological Factors; Diabetes Mellitus, Type 2; Diabetic Foot; Diabetic Neuropathies; Female; Humans; Male; Middle Aged; Povidone-Iodine; Protamines; Re-Epithelialization; Skin; Treatment Outcome; Tyrothricin

Infectious complications of spinal or epidural anaesthesia are rare, particularly after spinal anaesthesia. Most of them consist of a meningitis. We report a case of epidural abscess due to Staphylococcus aureus following spinal anaesthesia in a 62-year-old diabetic patient, diagnosed 45 days after the puncture with bacterial samples and magnetic resonance imaging. The pejorative neurological outcome required a laminectomy in spite of an efficient anti-staphylococcal treatment.

Topics: 4-Quinolones; Abscess; Amikacin; Anesthesia, Spinal; Anti-Infective Agents; Diabetes Mellitus, Type 2; Disease Susceptibility; Drainage; Drug Therapy, Combination; Epidural Space; Fluoroquinolones; Humans; Laminectomy; Lumbar Vertebrae; Magnetic Resonance Imaging; Male; Middle Aged; Oxacillin; Pefloxacin; Postoperative Complications; Povidone-Iodine; Punctures; Quinolones; Spinal Diseases; Staphylococcal Infections