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Int J Gen Med ; 15: 5599-5607, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35712059


Background and Aim: Deep venous thrombosis (DVT) of the lower extremities is common in Covid-19 patients. Interleukin (IL)-6 and P-selectin were found to be elevated in Covid-19 patients. The current study aimed to evaluate P-selectin and IL6 in Covid-19 patients with DVT and to explore its relation to clinical and laboratory parameters in those patients. Patients and methods: The present retrospective study included 150 hospitalized COVID-19 patients diagnosed on the basis of a positive result of reverse-transcriptase polymerase chain reaction (RT-PCR) test. Laboratory assessments were included for IL-6 and P selectin assessments via enzyme-linked immunosorbent assay. The primary outcome of the present study was the development of DVT detected by Doppler ultrasound (DU) evaluation of the lower extremities during the admission. Results: The present study included 150 hospitalized Covid-19 patients. DVT was developed in 59 patients (39.3%). DVP patients had significantly higher levels of P selectin [76.0 (63.0-87.0) versus 63.0 (54.3-75.0), p < 0.001] and IL-6 [37.0 (27.0-49.0) versus 18.5 (13.5-31.5), p < 0.001]. ROC curve analysis revealed good performance of P selectin [AUC (95% CI): 0.72 (0.64-0.81)] and IL-6 [AUC (95% CI): 0.79 (0.71-0.86)] in identification of DVT. Logistic regression analysis identified the presence of severe disease [OR (95% CI): 9.016 (3.61-22.49), p < 0.001], elevated P selectin [OR (95% CI): 1.032 (1.005-1.059), p = 0.018] and elevated IL-6 [OR (95% CI): 1.062 (1.033-1.091), p < 0.001] as significant predictors of DVT development in multivariate analysis. Conclusion: The present study identified a probable role of elevated P-selectin and IL-6 levels in the DVT development in hospitalized Covid-19 patients.

Diabetes Metab Syndr Obes ; 14: 1897-1908, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33958881


BACKGROUND: The link between immune system and type 2 diabetes mellitus (T2DM) pathogenesis attracted attention to demonstrate the role of immune cells and their secreted cytokines in T2DM development and its subsequent foot complications. OBJECTIVE: To investigate the relation between T Natural killer cell (TNK) %, Interleukin 4 (IL4) and Interferon gamma (IFN-γ) and diabetic foot infection (DFI) development in patients with diabetic foot ulcer (DFU). PATIENTS AND METHODS: Ninety patients with diabetes were included in this work, divided as T2DM group (n=30), DFU group (n=30), and DFI group (n=30). TNK% was detected using flow cytometry. Serum IL4 and IFN-γ were measured by ELISA. Diabetes biochemical parameters were also analyzed. RESULTS: Significant decrease was detected in TNK% and IFN-γ in DFI group compared to other 2 groups (P<0.001). Significant decrease was detected in serum levels of IL4 in DFI group compared to T2DM group (P=0.006). IFN-γ/IL4 was significantly decreased in DFI compared to DFU group (P=0.020). There was a significant correlation of TNK% with both IL4 and IFN-γ (r=0.385, P<0.001; r=0.534, P<0.001, respectively). Significant negative correlation of TNK% with HbA1c and LDL was revealed (r=-0.631, P<0.001; and r=-0.261, P=0.013, respectively), while a positive correlation was seen with HDL (r=0.287, P=0.006). A significant negative correlation of IL4 with HbA1c  was found (r=-0.514, P<0.001;. As for IFN-γ, a significant negative correlation with HbA1c and LDL was detected (r=-0.369, P< 0.001; r=-0.229, P=0.030). TNK % and IFN-γ level showed negative correlations with disease duration/year (r=-0.546, P< 0.001; r=-0.338, P=0.001,respectively). CONCLUSION: Decline in TNK frequency has essential role in T2DM pathogenesis and subsequent foot complications. Downregulation of TNK% and IFN-γ level have potential roles in predicting infection of diabetic ulcer and are correlated with disease duration.

J Cosmet Dermatol ; 20(10): 3257-3263, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33880860


BACKGROUND: Chronic venous leg ulcer reduces the patients' activities and their overall quality of life. Platelet-rich plasma (PRP) was previously investigated as promising less invasive management for leg ulcers. THIS STUDY AIMS: To re-assess the efficacy and safety of PRP in the management of chronic leg ulcers due to venous factors. PATIENTS/METHODS: RCT enrolled 80 patients who clinically presented with chronic venous leg ulcers. Forty patients were allocated randomly for the treatment with autologous platelet-rich plasma (PRP). Intradermal and subdermal injection of PRP by 27guage syringe weekly, in all edges and in the granular floor of the ulcer for 4-6 sessions. Another 40 patients managed by conventional treatment by compression and dressing for the same period were allocated as Group B. Objective assessment achieved by the percentage of reduction of the size of the ulcer area, rate of healing, incidence of recurrence, and if side effects have been reported. RESULTS: PRP therapy showed better results and high p value significance when compared to conventional therapy. CONCLUSION: This study shows that PRP is effective and significant in promoting the wound healing process in chronic leg venous ulcers. PRP is simple, safe, and has a short learning curve technique.

Úlcera da Perna , Plasma Rico em Plaquetas , Úlcera Varicosa , Bandagens , Humanos , Úlcera da Perna/etiologia , Úlcera da Perna/terapia , Qualidade de Vida , Úlcera Varicosa/terapia
J Res Med Sci ; 24: 48, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31160915


Background: Deep venous thrombosis (DVT) is associated with significant morbidity and mortality. Thus, there is a great need to demonstrate a more efficient biomarker that would confirm the diagnosis of DVT. Our work aimed to evaluate the role of platelet-derived growth factor-beta (PDGF-B) as a new marker of DVT and its correlation with other radiological and laboratory tools used for the diagnosis. Materials and Methods: A case-control study enrolled forty patients selected from our university hospital between April 2018 and August 2018, who divided into two groups: Group I (n = 20) consisted of patients diagnosed with acute venous thrombosis and Group II (n = 20) consisted of patients diagnosed with chronic venous thrombosis. Twenty samples were collected from age- and gender-matched apparently healthy controls to be used as a control. Venous duplex ultrasonography, routine laboratory investigations, D-dimer (DD), and protein expression of PDGF-B were performed on all patients. Results: There was a highly significant increase in a protein expression of PDFG-B in all cases of acute and chronic venous thrombosis compared to the control group with P < 0.001; furthermore, it was more specific than DD for the detection of DVT (specificity 95% and 90%, respectively). Conclusion: Our study submits a novel association of PDGF-B plasma levels with DVT, and PDGF-B is considered to be a more specific indicator for DVT than is DD.

Ann Vasc Surg ; 54: 146-151, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30092419


BACKGROUND: The goals of surgical treatment of traumatic femoral artery aneurysm (FAA) are to isolate and excise the aneurysm, prevent distal embolization, and allow effective revascularization. During recent years, endovascular surgery has become a valid alternative to open repair. We aimed to compare early outcomes of the stent graft in the treatment of traumatic FAA and open surgical procedures. METHODS: This was a prospective study on 20 patients admitted to our hospital during the period from April 2016 to September 2017 with specific criteria of traumatic FAA. The patients were randomly divided into 2 groups with a one to one ratio between open repair (group I) and endovascular therapy (group II). We used the duplex scan in early follow-up 1 week and 1 month and 3 months postoperatively. RESULTS: Twenty FAAs were treated as follows: Excision of the aneurysm in patients of group I and repair by primary sutures or bypass with no graft failure occurred intraoperatively. Ten stents were placed in ten FAAs in group II. An early patency rate of 100% in 1 week was found in both groups, and thrombosis in 1 stent graft occurred after 1 month and 3 months (95%). The mean time of surgical operations was 107.5 min, and the mean time of endovascular procedures was 85 min. The group I had a significantly longer mean hospital stay time (8 days) than group II (4.25 days); P value < 0.05. CONCLUSIONS: FAA treatment can be performed easily and safely by surgery or endovascular procedures. Although the endovascular approach has several advantages, the incidence of thrombosis and high cost of stent grafts should be considered.

Falso Aneurisma/cirurgia , Implante de Prótese Vascular , Procedimentos Endovasculares , Artéria Femoral/cirurgia , Lesões do Sistema Vascular/cirurgia , Adulto , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Prótese Vascular , Implante de Prótese Vascular/efeitos adversos , Implante de Prótese Vascular/instrumentação , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/instrumentação , Feminino , Artéria Femoral/diagnóstico por imagem , Artéria Femoral/lesões , Humanos , Tempo de Internação , Masculino , Duração da Cirurgia , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Fatores de Risco , Stents , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia Doppler Dupla , Grau de Desobstrução Vascular , Lesões do Sistema Vascular/diagnóstico por imagem , Lesões do Sistema Vascular/etiologia , Adulto Jovem