Обзор местных медикаментозных средств, применяемых в лечении гнойно-некротических осложнений синдрома диабетической стопы

The article provides  an overview of local medicines used in wounds’ treatment  for patients with purulo-necrotic complications of diabetic foot syndrome (DFS) and the requirements  for these preparations  at the present-day stage of wound healing process development and also the principles of monitoring  of  wounds of different etiology. The above material also allows you to get acquainted with the classification of local medicines groups, their brief characteristics with highlighting the peculiarity of each group, strengths and weaknesses, indications, contraindications and possible mistakes of their using. Here is given the detailed description of  main groups modern wound coverings based on alginates, hydrocolloids, hydrogels and histo-equivalent-bioplastic material of hyaluronic acid. There were made conclusions about the lack of information on the real clinical effectiveness of modern dressings and about  numerous and not systematic approaches for measuring the course of the wound healing process using various biological models. This explains the urgency to improving the modern diagnostic algorithm for measuring the course of the wound healing process and the need to develop an universal model that allows to identify its peculiarities and regularities, including efficiency assessment for local treatment of DFS purulo-necrotic complications.В статье представлены обзор местных медикаментозных средств, применяемых для лечения ран пациентов с гнойнонекротическими осложнениями синдрома диабетической стопы (СДС), требования, предъявляемые к этим препаратам на современном этапе развития учения о раневом процессе и принципах ведения ран различной этиологии. В приведенном материале можно также ознакомиться с классификацией групп местных медикаментозных средств, их краткой характеристикой с выделением особенностей каждой группы, сильных и слабых сторон, показаниями, противопоказаниями и возможными ошибками их использования. Дано подробное описание основных групп современных раневых покрытий на основе альгинатов, гидроколлоидов, гидрогелей и гистоэквивалент-биопластического материала гиалуроновой кислоты. Сделаны выводы о дефиците информации по поводу реальной клинической эффективности современных средств для местного медикаментозного лечения, о многочисленных и не всегда системных подходах к оценке течения раневого процесса с использованием различных биологических моделей. Этим объясняется актуальность совершенствования современного диагностического алгоритма при оценке течения раневого процесса и необходимость создания универсальной модели, позволяющей выявлять его особенности и закономерности, в том числе для оценки эффективности средств местного лечения гнойно-некротических осложнений СДС

Lipoprotein Lipase Links Dietary Fat to Solid Tumor Cell Proliferation

Many types of cancer cells require a supply of fatty acids (FA) for growth and survival, and interrupting de novo FA synthesis in model systems causes potent anticancer effects. We hypothesized that, in addition to synthesis, cancer cells may obtain pre-formed, diet-derived fatty acids by uptake from the bloodstream. This would require hydrolytic release of FA from triglyceride in circulating lipoprotein particles by the secreted enzyme lipoprotein lipase (LPL), and the expression of CD36, the channel for cellular FA uptake. We find that selected breast cancer and sarcoma cells express and secrete active LPL, and all express CD36. We further demonstrate that LPL, in the presence of triglyceride-rich lipoproteins, accelerates the growth of these cells. Providing LPL to prostate cancer cells, which express low levels of the enzyme, did not augment growth, but did prevent the cytotoxic effect of FA synthesis inhibition. Moreover, LPL knockdown inhibited HeLa cell growth. In contrast to the cell lines, immunohistochemical analysis confirmed the presence of LPL and CD36 in the majority of breast, liposarcoma, and prostate tumor tissues examined (n = 181). These findings suggest that, in addition to de novo lipogenesis, cancer cells can use LPL and CD36 to acquire FA from the circulation by lipolysis, and this can fuel their growth. Interfering with dietary fat intake, lipolysis, and/or fatty acid uptake will be necessary to target the requirement of cancer cells for FA

Metabolic Regulation of Invadopodia and Invasion by Acetyl-CoA Carboxylase 1 and De novo Lipogenesis

Invadopodia are membrane protrusions that facilitate matrix degradation and cellular invasion. Although lipids have been implicated in several aspects of invadopodia formation, the contributions of de novo fatty acid synthesis and lipogenesis have not been defined. Inhibition of acetyl-CoA carboxylase 1 (ACC1), the committed step of fatty acid synthesis, reduced invadopodia formation in Src-transformed 3T3 (3T3-Src) cells, and also decreased the ability to degrade gelatin. Inhibition of fatty acid synthesis through AMP-activated kinase (AMPK) activation and ACC phosphorylation also decreased invadopodia incidence. The addition of exogenous 16∶0 and 18∶1 fatty acid, products of de novo fatty acid synthesis, restored invadopodia and gelatin degradation to cells with decreased ACC1 activity. Pharmacological inhibition of ACC also altered the phospholipid profile of 3T3-Src cells, with the majority of changes occurring in the phosphatidylcholine (PC) species. Exogenous supplementation with the most abundant PC species, 34∶1 PC, restored invadopodia incidence, the ability to degrade gelatin and the ability to invade through matrigel to cells deficient in ACC1 activity. On the other hand, 30∶0 PC did not restore invadopodia and 36∶2 PC only restored invadopodia incidence and gelatin degradation, but not cellular invasion through matrigel. Pharmacological inhibition of ACC also reduced the ability of MDA-MB-231 breast, Snb19 glioblastoma, and PC-3 prostate cancer cells to invade through matrigel. Invasion of PC-3 cells through matrigel was also restored by 34∶1 PC supplementation. Collectively, the data elucidate the novel metabolic regulation of invadopodia and the invasive process by de novo fatty acid synthesis and lipogenesis

Person-to-Person Electronic Funds Transfers: Recent Developments and Policy Issues

The paper investigates the reasons why person-to-person electronic funds transfers are still not very common in the United States compared with practices in many other countries. The paper also describes recent enhancements to online and mobile banking that provide account holders with low-cost interfaces to manage person-to-person electronic funds transfers via automated clearing house (ACH). On the theoretical side, the paper characterizes the critical mass levels needed for payment instruments to become widely adopted. Given the Fed's long-term heavy involvement in check clearing, the paper concludes with policy discussions of whether intervention is needed

Évaluation radiologique de l’envahissement mandibulaire dans les carcinomes épidermoïdes de cavité buccale et d’oropharynx

International audienceContexteL’évaluation préopératoire de l’envahissement osseux mandibulaire dans les carcinomes épidermoïdes de la cavité buccale et de l’oropharynx est déterminante afin d’optimiser le type de résection osseuse. Cette étude a pour objectif l’évaluation de la valeur diagnostique de l’imagerie par TDM et par IRM pour le diagnostic de l’envahissement osseux mandibulaire par rapport à l’examen de référence histologique. De plus nous avons évalué l’impact de l’envahissement osseux dans l’analyse de la survie de notre cohorte.Patients et méthodesIl s’agit d’une étude rétrospective mono centrique ayant inclus tous les patients consécutifs pris en charge chirurgicalement pour un carcinome épidermoïde de la cavité buccale ou de l’oropharynx avec réalisation d’une résection osseuse interruptrice.RésultatsSoixante-huit patients ont été inclus. La prévalence de l’envahissement osseux histologique était de 43 %. Les valeurs de sensibilité, spécificité, VPP et VPN étaient respectivement de 70 %, 71 %, 66 % et 76 % pour la TDM contre 83 %, 50 %, 59 % et 78 % pour l’IRM et 83 %, 62 %, 62 %, 83 % pour l’association TDM et IRM. Les deux tests avaient une bonne concordance avec un indice de kappa égal à 0,69 IC 95 % (0,49–0,89) (p 0,70) entre le groupe avec et sans envahissement osseux.ConclusionLa TDM et l’IRM restent complémentaires pour l’évaluation préopératoire de l’envahissement osseux mandibulaire, qu’il soit cortical et/ou médullaire et devraient permettre dans certains cas une épargne osseuse mandibulaire