A5048728346- Diabetic Foot Ulcer Assessment and Management
- Wound Healing and Treatments
- Pain Mechanisms and Treatments
- Pressure Ulcer Prevention and Management
- Botulinum Toxin and Related Neurological Disorders
- Thermoregulation and physiological responses
- Cardiovascular Health and Disease Prevention
- Skin Diseases and Diabetes
- Peripheral Artery Disease Management
- Neurological Disorders and Treatments
- Diagnosis and Treatment of Venous Diseases
- Adipokines, Inflammation, and Metabolic Diseases
- Obstructive Sleep Apnea Research
- Tendon Structure and Treatment
- Heart Rate Variability and Autonomic Control
- Cardiovascular Disease and Adiposity
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Parkinson's Disease Mechanisms and Treatments
- Cardiovascular Function and Risk Factors
- Mesenchymal stem cell research
- Adipose Tissue and Metabolism
- Laser Applications in Dentistry and Medicine
- Advanced Glycation End Products research
- Effects of Vibration on Health
- Autophagy in Disease and Therapy
Beth Israel Deaconess Medical Center
2016-2025
Harvard University
2014-2024
Center for Neuroscience and Regenerative Medicine
2020-2024
Gentofte Hospital
2024
Capital Region of Denmark
2024
Massachusetts General Hospital
2023
British Microcirculation Society
2020
Boston University
2001-2016
HyperMed (United States)
2016
Hadassah Medical Center
2003-2013
OBJECTIVE— We assessed in a randomized prospective trial the effectiveness of Graftskin, living skin equivalent, treating noninfected nonischemic chronic plantar diabetic foot ulcers. RESEARCH DESIGN AND METHODS— In 24 centers U.S., 208 patients were randomly assigned to ulcer treatment either with Graftskin (112 patients) or saline-moistened gauze (96 patients, control group). Standard state-of-the-art adjunctive therapy, which included extensive surgical debridement and adequate...
Abnormalities in vascular reactivity the micro- and macrocirculation are well established type 2 diabetes. However, little is known about changes those at risk for developing To address this situation, both was studied four age sex comparable groups: 30 healthy normoglycemic subjects with no history of diabetes a first-degree relative (controls), 39 one or parents (relatives), 32 impaired glucose tolerance (IGT), 42 patients without complications (diabetes). Laser Doppler perfusion imaging...
OBJECTIVE: Diabetic foot ulceration is a preventable long-term complication of diabetes. A multicenter prospective follow-up study was conducted to determine which risk factors in screening have high association with the development ulceration. RESEARCH DESIGN AND METHODS: total 248 patients from 3 large diabetic centers were enrolled study. Neuropathy symptom score, neuropathy disability score (NDS), vibration perception threshold (VPT), Semmes-Weinstein monofilaments (SWFs), joint...
OBJECTIVE To assess the ability of vibration perception threshold (VPT) to predict development diabetic foot ulceration. RESEARCH DESIGN AND METHODS A prospective follow-up study consecutive patients with measured by biothesiometry from April 1988 March 1989. Patients were stratified in various risk groups. RESULTS a VPT <15 V had cumulative incidence ulceration 2.9% compared 19.8% >25 V, odds ratio (OR) 7.99 (3.65–17.5, 95% confidence intervals), P < 0.01. The increased...
OBJECTIVE—To assess the ability of 4-week healing rate to predict complete over a 12-week period in large prospective multicenter trial diabetic patients with foot ulceration. RESEARCH DESIGN AND METHODS—We examined change ulcer area as predictor wound within 12 weeks who were seen weekly prospective, randomized controlled trial. RESULTS—Wound measurements at baseline and after 4 performed 203 patients. The midpoint between percentage reduction from healed versus those not was found be 53%....
High plantar foot pressures in association with peripheral neuropathy have been ascertained to be important risk factors for ulceration the diabetic foot. Most studies investigating these parameters limited by their size and homogeneity of study subjects. The objective this was therefore ascertain associated high a large diverse population.We studied cross-sectional group 251 patients Caucasian (group C) (n=121), black B) (n=36), Hispanic H) (n=94) racial origins an overall age 58.5+/-12.5...
OBJECTIVE—Adiponectin and resistin, two recently discovered adipocyte-secreted hormones, may link obesity with insulin resistance and/or metabolic cardiovascular risk factors. We performed a cross-sectional study to investigate the association of adiponectin resistin inflammatory markers, hyperlipidemia, vascular reactivity an interventional whether atorvastatin mediates its beneficial effects by altering or levels. RESEARCH DESIGN AND METHODS—Associations among reactivity, were assessed...
To investigate the role of limited joint mobility (LJM) in causing abnormal foot pressures and ulceration.The subjects were recruited from a general diabetes clinic where patients screened for neuropathy, retinopathy, elevated plantar pressure. Sixty-four five groups matched by age sex following groups: group 1, with LJM neuropathy; 2, nonneuropathic diabetic LJM; 3, neuropathy no 4, control subjects; 5, nondiabetic subjects. Joint was assessed at subtalar metatarsophalangeal joints; optical...
Somatosensory function declines with diabetic neuropathy and often stroke, resulting in diminished motor performance. Recently, it has been shown that input noise can enhance human sensorimotor function. The goal of this study was to investigate whether subsensory mechanical applied the soles feet via vibrating insoles be used improve quiet-standing balance control 15 patients stroke. Sway data 12 healthy elderly subjects from a previous on were added for comparison.Five traditional sway...
We examined the role of vascular function and inflammation in development failure to heal diabetic foot ulcers (DFUs). followed 104 patients for a period 18.4 ± 10.8 months. At beginning study, we evaluated reactivity serum inflammatory cytokines growth factors. DFUs developed 30 (29%) patients. DFU had more severe neuropathy, higher white blood cell count, lower endothelium-dependent -independent vasodilation macrocirculation. Complete ulcer healing was achieved 16 (53%) patients, whereas...
Abstract Diabetic foot ulceration (DFU) is a devastating complication of diabetes whose pathogenesis remains incompletely understood. Here, we profile 174,962 single cells from the foot, forearm, and peripheral blood mononuclear using single-cell RNA sequencing. Our analysis shows enrichment unique population fibroblasts overexpressing MMP1, MMP3, MMP11, HIF1A, CHI3L1 , TNFAIP6 increased M1 macrophage polarization in DFU patients with healing wounds. Further, spatially separated samples same...
Abstract Implanted biomaterials and devices face compromised functionality efficacy in the long term owing to foreign body reactions subsequent formation of fibrous capsules at implant–tissue interfaces 1–4 . Here we demonstrate that an adhesive interface can mitigate capsule diverse animal models, including rats, mice, humanized mice pigs, by reducing level infiltration inflammatory cells into compared non-adhesive interface. Histological analysis shows does not form observable on organs,...
Hypothesis: Promogran, a wound dressing consisting of collagen and oxidized regenerated cellulose, is more effective that standard care in treating chronic diabetic plantar ulcers.Design: Randomized, prospective, controlled
We studied endothelial-mediated microvascular blood flow in neuropathic diabetic patients to determine the association between endothelial regulation of microcirculation and expression constitutive nitric oxide synthetase (ecNOS) skin. Vasodilation on dorsal foot response heating iontophoresis acetylcholine (endothelium-dependent) sodium nitroprusside (endothelium-independent) were measured using single-point laser Doppler imaging with neuropathy (DN), vascular disease (DI), Charcot...
OBJECTIVE—Endothelial dysfunction has been reported in type 2 diabetic patients and obese subjects with insulin resistance syndrome (IRS). This study evaluates the effects of weight reduction exercise on vascular reactivity macro- microcirculation IRS. RESEARCH DESIGN AND METHODS—We studied 24 (9 men 15 women, age 49.3 ± 1.9 years, BMI 36.7 0.94 kg/m2, mean SEM) IRS at baseline after 6 months exercise. Brachial artery flow-mediated dilation (FMD) response to sublingual glyceryltrinitrate...
Diabetic foot ulcers are a significant health care problem. Complications of leading cause hospitalization and amputation in patients with diabetes mellitus. In response to request from the Wound Healing Society, panel advisers, including physicians academia private practice, nurses, podiatrist, pedorthist, representative industry, was selected develop guidelines for treatment diabetic lower extremity. The approach used similar that by Venous Ulcer Panel, also convened at Society. Those were...
We have previously demonstrated that high plantar pressures can predict foot ulceration in diabetic patients. The aim of the present study was to evaluate both relationship between forefoot and rearfoot pressure patients with different degrees peripheral neuropathy their role ulcer development.Diabetic a 30-month prospective were classified according disability score: scores 0, 1-5, 6-16, 17-28 are defined as absent (n = 20), mild 66), moderate 95), severe 57) neuropathy, respectively....