Prevalence of Diabetic Foot Disease in Patients with Diabetes Mellitus under Renal Replacement Therapy in Lleida, Spain

Aim. To assess the prevalence of diabetic foot and other associated conditions in patients with diabetes mellitus under renal replacement in the region of Lleida, Spain. Methods. This was an observational, cross-sectional study of 92 dialysis-treated diabetic patients. Besides a podiatric examination, we explored the presence of cardiovascular risk factors, late diabetes complications, including peripheral neuropathy, atherosclerotic disease, and peripheral artery disease. We assessed risk factors for foot ulceration and amputation by logistic regression. Results. Prevalent diabetic foot was found in 17.4% of patients, foot deformities were found in 54.3%, previous ulcer was found in 19.6%, and amputations were found in 16.3%; and 87% of them had some risk of suffering diabetic foot in the future. We observed a high prevalence of patients with peripheral neuropathy and peripheral artery disease (89.1% and 64.2%, resp.). Multivariable analysis identified diabetic retinopathy and advanced atherosclerotic disease (stenosing carotid plaques) as independent risk factors for foot ulceration (p=0.004 and p=0.023, resp.) and diabetic retinopathy also as an independent risk factor for lower-limb amputations (p=0.013). Moreover, there was a temporal association between the initiation of dialysis and the incidence of amputations. Conclusion. Diabetic patients receiving dialysis therapy are at high risk of foot complications and should receive appropriate and intensive foot care

Port-hamiltonian based optimal power flow algorithm for multi-terminal DC networks

In this paper an algorithm for solving the Optimal Power Flow problem for multi-terminal DC networks based on the gradient method is proposed. The aim is seeking the optimal point subject to voltage, current and power constraints. The algorithm is described by a continuous-time port-Hamiltonian model, and the inequality constrains are included by the use of barrier functions. The dynamics of the algorithm is studied and stability conditions are obtained. Finally, the method is used for the offshore wind integration grid in the North Sea and the interconnection with the network dynamics is tested by means of numerical simulations.Peer Reviewe

Ileocistoplastia em cães (Canis familiaris). Descrição da técnica cirúrgica

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