Отдаленные результаты комплексной терапии больной сахарным диабетом 2 типа и двусторонней нейроостеоартропатией

Diabetic neuroosteoarthropathy (DNOAP) is a serious diabetes melitus complication leading to the limb loss. There was developed several ways for surgical correction of foot deformation at DNOAP in recent years, however, there is no much known about their use long-term results. This article presents the successful complex treatment and 10-years outcomes results in patient with type 2 diabetes and both feet deformation due to the DNOAP.Диабетическая нейроостеоартропатия (ДНОАП) – тяжелое осложнение сахарного диабета (СД), которое может привести к потере конечности. В последние годы было разработано несколько вариантов хирургической коррекции деформаций стопы при ДНОАП, однако об отдаленных результатах их использования пока что известно мало. В данной статье мы представляем результаты 10-летнего наблюдения и успешного комплексного лечения пациентки с СД 2 типа и деформацией обеих стоп на фоне ДНОАП

Методы оценки размеров раневого дефекта при синдроме диабетической стопы

Object. The study of the informativeness by various methods of visualizing the dimensions of wound defects and the dynamics of their healing in patients with diabetic foot syndrome (DFS).Materials and Methods. The descriptive research analyzed various methods for determining the size of wounds in 77 patients with DFS. 63 (81.8 %) patients (1st group) were performed classical planimetry by film using. The wound size at 6 (7.8 %) patients (2nd group) was estimated by using a computer program, 8 (10.4 %) patients (3d group) underwent magnetic resonance imaging (MRI) their feet.Results. In the course of the study, the median area of wounds in Group 1 patients were 25.0 [16.2; 44.5] cm2, median depth — 3.3 [1.5; 6.5] cm. It was required about 15–20 minutes of the expert work. The median area of wounds by patients Group 2, measured with the mobile application V2F, was 8.95 [6.8; 10.6] cm2. The depth determined by the same method was 0.25 [0.2; 0.5] cm. The study duration amount to 5 minutes approximately. The 3d patients Group that was measured with MRI had wound defects depth equal to 3.2 [2.6; 4.5] cm, wound area - 23.5 [12.3; 55.3] cm2. This study duration was similar to the standard MRI protocol.Conclusion. The planimetric method of wound size analysis is a routine way for assessing the dynamics of the wound defects state, its size and depth. Determining the size of wounds with special software is rather quick and simple method, but it allows to evaluate only the planar characteristics of the wound and has a high error. The MRI procedure of a wound with an alginate dressing allows to reliably estimate the volume of wound defect and exclude the presence of a hidden infection focus.Цель. Изучение информативности различных методов визуализации размеров раневых дефектов и динамики их заживления у пациентов с синдромом диабетической стопы (СДС).Материалы и методы. В описательном исследовании были проанализированы различные методы определения размеров ран у 77 пациентов с СДС. 63 (81,8 %) пациентам (группа 1) провели классическую планиметрию с использованием пленки. У 6 (7,8 %) человек (группа 2) размеры раны оценивали с помощью компьютерной программы. 8 (10,4 %) больным (группа 3) проводили МРТ стопы. Результаты. В ходе проведенного исследования медиана площади ран у пациентов группы 1 составляла 25,0 [16,2; 44,5] см2, медиана глубины — 3,3 [1,5; 6,5] см. На проведение данного исследования в среднем требовалось около 15–20 минут специалиста. У пациентов группы 2 медиана площади ран, измеренная с помощью мобильного приложения V2F, составляла 8,95 [6,8; 10,6] см2. Глубина, определенная аналогичным методом, – 0,25 [0,2; 0,5] см. Длительность исследования составляла около 5 минут. У больных группы 3 медиана глубины раневых дефектов, измеренная при помощи МРТ, составляла 3,2 [2,6; 4,5] см, площадь раны — 23,5 [12,3; 55,3] см2. Продолжительность данного исследования аналогична стандартному протоколу МРТ.Заключение. Исследование размеров ран планиметрическим методом является рутинным способом оценки динамики состояния раневого дефекта, его размеров и глубины. Определение размеров ран при помощи специального программного обеспечения – достаточно быстрый и простой метод, однако он позволяет оценить лишь плоскостные характеристики раны и отличается высокой погрешностью. Методика проведения МРТ раны с альгинатной повязкой позволяет достоверно оценить объем раневого дефекта и исключить наличие скрытого очага инфекции.

Methylobacterium Genome Sequences: A Reference Blueprint to Investigate Microbial Metabolism of C1 Compounds from Natural and Industrial Sources

Methylotrophy describes the ability of organisms to grow on reduced organic compounds without carbon-carbon bonds. The genomes of two pink-pigmented facultative methylotrophic bacteria of the Alpha-proteobacterial genus Methylobacterium, the reference species Methylobacterium extorquens strain AM1 and the dichloromethane-degrading strain DM4, were compared. Methodology/Principal Findings The 6.88 Mb genome of strain AM1 comprises a 5.51 Mb chromosome, a 1.26 Mb megaplasmid and three plasmids, while the 6.12 Mb genome of strain DM4 features a 5.94 Mb chromosome and two plasmids. The chromosomes are highly syntenic and share a large majority of genes, while plasmids are mostly strain-specific, with the exception of a 130 kb region of the strain AM1 megaplasmid which is syntenic to a chromosomal region of strain DM4. Both genomes contain large sets of insertion elements, many of them strain-specific, suggesting an important potential for genomic plasticity. Most of the genomic determinants associated with methylotrophy are nearly identical, with two exceptions that illustrate the metabolic and genomic versatility of Methylobacterium. A 126 kb dichloromethane utilization (dcm) gene cluster is essential for the ability of strain DM4 to use DCM as the sole carbon and energy source for growth and is unique to strain DM4. The methylamine utilization (mau) gene cluster is only found in strain AM1, indicating that strain DM4 employs an alternative system for growth with methylamine. The dcm and mau clusters represent two of the chromosomal genomic islands (AM1: 28; DM4: 17) that were defined. The mau cluster is flanked by mobile elements, but the dcm cluster disrupts a gene annotated as chelatase and for which we propose the name “island integration determinant” (iid).Conclusion/Significance These two genome sequences provide a platform for intra- and interspecies genomic comparisons in the genus Methylobacterium, and for investigations of the adaptive mechanisms which allow bacterial lineages to acquire methylotrophic lifestyles.Organismic and Evolutionary Biolog

Biology of moderately halophilic aerobic bacteria

The moderately halophilic heterotrophic aerobic bacteria form a diverse group of microorganisms. The property of halophilism is widespread within the bacterial domain. Bacterial halophiles are abundant in environments such as salt lakes, saline soils, and salted food products. Most species keep their intracellular ionic concentrations at low levels while synthesizing or accumulating organic solutes to provide osmotic equilibrium of the cytoplasm with the surrounding medium. Complex mechanisms of adjustment of the intracellular environments and the properties of the cytoplasmic membrane enable rapid adaptation to changes in the salt concentration of the environment. Approaches to the study of genetic processes have recently been developed for several moderate halophiles, opening the way toward an understanding of haloadaptation at the molecular level. The new information obtained is also expected to contribute to the development of novel biotechnological uses for these organisms

The morphological characteristic of tissue repair in patients with neuropathic and neuroischemic forms of diabetic foot syndrome

Aim. To evaluate the morphological and immunohistochemical features of granulation tissue formation in patients with diabetic foot syndrome. Materials and methods. We analysed the histological (light microscopy) and immunohistochemical (CD31, CD68, osteopontin, MMP-9 and TIMP-1) features of tissue repair processes in patients with diabetes mellitus. The study involved 63 patients with diabetic foot syndrome after surgical debridement. Results. We found severe intercellular oedema, poorly organised extracellular matrix, small amounts of fibroblast-like cells and expressed inflammatory infiltration, along with the presence of young granulation tissue. According to the results of the immunohistochemical studies, there were a moderate number of macrophages (immunopositive with antibodies to CD68), intense staining of MMP-9 and weak staining of TIMP-1 and osteopontin. Conclusion. According to the findings of the histological and immunohistochemical studies, tissue repair processes in patients with diabetes mellitus are decelerated