Incidence and Risk Factors of Diabetic Foot Syndrome in Patients Early After Pancreas or Kidney/Pancreas Transplantation and its Association with Preventive Measures.

Diabetic foot (DF) can develop in diabetic patients after organ transplantation (Tx) due to several factors including peripheral arterial disease (PAD), diabetic neuropathy and inappropriate DF prevention. Aim: To assess the occurrence of DF and associated risk factors in transplant patients. Methods: Fifty-seven diabetic patients were enrolled as part of this prospective study. All patients underwent organ Tx (01/2013-12/2015) and were followed up for minimum of 12 months up to a maximum of 50 months. Over the study period we evaluated DF incidence and identified a number of factors likely to influence DF development, including organ function, presence of late complications, PAD, history of DF, levels of physical activity before and after Tx, patient education and standards of DF prevention. Results: Active DF developed in 31.6% (18/57) of patients after organ Tx within 11 months on average (10.7 ± 8 months). The following factors significantly correlated with DF development: diabetes control (p = .0065), PAD (p<0.0001), transcutaneous oxygen pressure (TcPO2;p = .01), history of DF (p = .0031), deformities (p = .0021) and increased leisure-time physical activity (LTPA) before Tx (p = .037). However, based on logistic stepwise regression analysis, the only factors significantly associated with DF during the post-transplant period were: PAD, deformities and increased LTPA. Education was provided to patients periodically (2.6 ± 2.5 times) during the observation period. Although 94.7% of patients regularly inspected their feet (4.5 ± 2.9 times/week), only 26.3% of transplant patients used appropriate footwear. Conclusions: Incidence of DF was relatively high, affecting almost 1/3 of pancreas and kidney/pancreas recipients. The predominant risk factors were: presence of PAD, foot deformities and higher LTPA before Tx. Therefore, we recommend a programme involving more detailed vascular and physical examinations and more intensive education focusing on physical activity and DF prevention in at-risk patients before transplantation.

[The effect of aryloxyaminopropanol substances on the photosynthetic activity of chloroplasts in Spinacia oleracea L]. / Vplyv látok typu aryloxyaminopropanolov na fotosyntetickú aktivitu chloroplastov Spinacia oleracea L.

The effect of 18 compounds of the aryloxyaminopropanol type--potential beta-adrenolytics (differing each from other by modifications in the hydrophilic and lipophilic part of the molecule) on the inhibition of oxygen evolution rate in spinach chloroplasts has been investigated. The compounds with n-octyloxymethyl and n-nonyloxymethyl group in position 3 of aromatic ring were found to exhibit the highest inhibitory activity (IC50 = 67, resp. 120 mumol dm-3). The compounds containing a heterocycle or the dimethylamino group in the hydrophilic part of the molecule and with propoxymethyl group on the aromatic ring were not active. Using EPR spectroscopy it was found that the studied compounds interact with Z+/D+ intermediates, i.e. tyrosine radicals TyrZ and TyrD situated in D1 and D2 proteins on the donor side of photosystem 2. Higher concentrations of the studied inhibitors cause release of Mn2+ ions from the oxygen evolving complex which is situated in photosystem 2. The interaction of the tested compounds with chlorophyll occurring in the photosynthetic centres has been confirmed by fluorescence measurements as well.

Catecholamine heart muscle disease in pheochromocytoma.

Many clinical symptoms and signs in patients with pheochromocytoma are evoked by the influence of catecholamines on the heart muscle and on the coronary circulation. In our work besides clinical features the ECG pictures of the patients were studied where the elevation of the ST segment with a negative coronary T wave but without a Q wave were observed. In the echocardiographic picture our patients showed a rather hyperkinetic heart action in the florid phase of the illness. For several years after surgery a nonhomogenous structure of the interventricular septum persisted. Hypertrophy of the septum was a less frequent finding. In patients with pheochromocytoma we suppose the signs mentioned above to be the manifestation of the catecholamine heart muscle disease (CHMD).