A systematic review of the effectiveness of revascularization of the ulcerated foot in patients with diabetes and peripheral arterial disease.

In several large recent observational studies, peripheral arterial disease (PAD) was present in up to 50% of the patients with a diabetic foot ulcer and was an independent risk factor for amputation. The International Working Group on the Diabetic Foot therefore established a multidisciplinary working group to evaluate the effectiveness of revascularization of the ulcerated foot in patients with diabetes and PAD. A systematic search was performed for therapies to revascularize the ulcerated foot in patients with diabetes and PAD from 1980-June 2010. Only clinically relevant outcomes were assessed. The research conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and the Scottish Intercollegiate Guidelines Network methodological scores were assigned. A total of 49 papers were eligible for full text review. There were no randomized controlled trials, but there were three nonrandomized studies with a control group. The major outcomes following endovascular or open bypass surgery were broadly similar among the studies. Following open surgery, the 1-year limb salvage rates were a median of 85% (interquartile range of 80-90%), and following endovascular revascularization, these rates were 78% (70.5-85.5%). At 1-year follow-up, 60% or more of ulcers had healed following revascularization with either open bypass surgery or endovascular revascularization. Studies appeared to demonstrate improved rates of limb salvage associated with revascularization compared with the results of medically treated patients in the literature. There were insufficient data to recommend one method of revascularization over another. There is a real need for standardized reporting of baseline demographic data, severity of disease and outcome reporting in this group of patients.

[Diabetic foot: new insights into pathophysiology and treatment]. / Diabetische voet: nieuwe inzichten in pathofyrsiologie en behandeling.

A foot ulcer is a complication that is difficult to treat in people with diabetes mellitus. Over the past few years, both clinicians and scientists have been showing more interest in this condition. A number of factors are involved in the development and maintenance of a diabetic foot ulcer, including: polyneuropathy, mechanical overload, peripheral arterial disease and infection. The cornerstones of treatment are: relief of pressure, the restoration of perfusion ofthe foot, treatment of infection, wound care, optimum glucose regulation and education. New and effective methods of treatment have become available. These include a non-removable plaster cast that is modelled to the form of the foot (a 'total contact cast'), endovascular revascularisation procedures in the lower leg, and topical application of negative pressure.

Valuating other people's emotional face expression: a combined functional magnetic resonance imaging and electroencephalography study.

Reading the facial expression of other people is a fundamental skill for social interaction. Human facial expressions of emotions are readily recognized but may also evoke the same experiential emotional state in the observer. We used event-related functional magnetic resonance imaging and multi-channel electroencephalography to determine in 14 right-handed healthy volunteers (29+/-6 years) which brain structures mediate the perception of such a shared experiential emotional state. Statistical parametric mapping showed that an area in the dorsal medial frontal cortex was specifically activated during the perception of emotions that reflected the seen happy and sad emotional face expressions. This area mapped to the pre-supplementary motor area which plays a central role in control of behavior. Low resolution brain electromagnetic tomography-based analysis of the encephalographic data revealed that the activation was detected 100 ms after face presentation onset lasting until 740 ms. Our observation substantiates recently emerging evidence suggesting that the subjective perception of an experiential emotional state-empathy-is mediated by the involvement of the dorsal medial frontal cortex.

Comparative quantification of the in vitro activity of veterinary fluoroquinolones.

The aim of this study was to compare the in vitro antimicrobial activity of the veterinary fluoroquinolones against a panel of recently isolated porcine and bovine bacterial pathogens. The study used enrofloxacin as a benchmark against which other agents were compared, being the most common fluoroquinolone used in treatment of bovine and porcine infections. The activity of ciprofloxacin was also assessed as it is the main metabolite of enrofloxacin in cattle. Enrofloxacin and ciprofloxacin generally showed higher antibacterial activity, in terms of MIC(50) values, for most pathogen species when compared with marbofloxacin, difloxacin, danofloxacin and norfloxacin. Ciprofloxacin showed significantly greater in vitro antibacterial activity than enrofloxacin against M. haemolytica, P. multocida and E. coli, whereas enrofloxacin showed greater activity than ciprofloxacin against S. aureus. Marbofloxacin was significantly more active than enrofloxacin against M. haemolytica, E. coli and B. bronchiseptica but less active against P. multocida, S. aureus, coagulase negative Staphylococci, S. dysgalactiae, S. uberis, A. pleuropneumoniae and S. suis. Danofloxacin was significantly less active than enrofloxacin against P. multocida, E. coli, S. uberis, A. pleuropneumoniae and S. suis. Enrofloxacin and its metabolite ciprofloxacin showed the highest in vitro activities against most bovine pathogens tested and the porcine pathogens also showed a high degree of sensitivity to enrofloxacin. These data facilitate further pharmacokinetic/pharmacodynamic comparison of fluoroquinolones currently used in veterinary medicine.

Expression of a VEGF-like protein from Parapoxvirus ovis in the yeasts Saccharomyces cerevisiae and Schizosaccharomyces pombe.

We report on the expression of a VEGF-like protein encoded by Parapoxvirus ovis in the yeasts Saccharomyces cerevisiae and Schizosaccharomyces pombe. We show that a lysine residue at amino acid position 2 (K2) is an important determinant for the stability of this protein in S. cerevisiae. Replacement of K2 by an arginine results in stabilization of the protein. This observation suggests that this lysine may be a target for ubiquitinylation, which is a prerequisite for proteasome-mediated protein degradation. Interestingly, in S. pombe the lysine (K2) has no influence on the stability of the protein. This result indicates that the two yeast species exhibit significant differences in their protein degradation pathways.

[Helical computed tomography of the liver: evaluation of the different circulatory phases]. / Tomografia computada helicoidal de higado: evaluación de las diferentes fases circulatorias.

With Helical CT development it is possible to examine the entire liver during one breath hold, marking difficult to miss any piece of parenchyma, and besides the speed of this method makes it capable to evaluated the different phases of the hepatic circulation after i.v. administration of contrast material. Both sensitivity and specificity of CT have improved since the use of this new device. Another advantage of the technique is the factibility of multidirectional and tridimensional reconstruction. We present in this paper our records of patients having hepatic lesions examined with this new methodology.

Tomografia computada helicoidal de higado: evaluacion de las diferentes fases circulatorias / Helical computed tomography of the liver: evaluation of the different circulatory phases

Con el desarrollo de los nuevos Tomógrafos Computados Helicoidales es posible explorar todo el hígado en una sola apnea por lo cual no existen áreas sin evaluar, siendo posible además la valoración de las diferentes fases de circulación luego de la inyección de la sustancia de contraste endovenoso, obteniendo imágenes durante las tres fases circulatorias hepáticas, la arterial, la portal y la de equilibrio. Con esta nueva modalidad la sensibilidad y especificidad del método han aumentado considerablemente. Otra ventaja es la posibilidad de estudiar en forma multidireccional o tridimensional las imágenes obtenidas. Presentamos nuestra casuística en pacientes portadores de lesiones hepáticas o posibles portadores de las mismas. (AU)

Tomografia computada helicoidal de higado: evaluacion de las diferentes fases circulatorias / Helical computed tomography of the liver: evaluation of the different circulatory phases

Con el desarrollo de los nuevos Tomógrafos Computados Helicoidales es posible explorar todo el hígado en una sola apnea por lo cual no existen áreas sin evaluar, siendo posible además la valoración de las diferentes fases de circulación luego de la inyección de la sustancia de contraste endovenoso, obteniendo imágenes durante las tres fases circulatorias hepáticas, la arterial, la portal y la de equilibrio. Con esta nueva modalidad la sensibilidad y especificidad del método han aumentado considerablemente. Otra ventaja es la posibilidad de estudiar en forma multidireccional o tridimensional las imágenes obtenidas. Presentamos nuestra casuística en pacientes portadores de lesiones hepáticas o posibles portadores de las mismas.