Browsing by Author "Nedeljkovic-Beleslin, Biljana (6701355427)"

Wound healing is a complex and well coordinated biologic process that involves inflammatory, proliferative and maturation or remodeling phases. A chronic wound results when the normal process of wound healing is interrupted. Diabetic foot ulcer is also a chronic nonhealing wound resulting as a consequence of peripheral neuropathy, local trauma and ischemia. Current research and clinical evidence revealed a fundamental role of growth factors in the biology of wound healing process. Among them one of the most important is the platelet derived growth factor active in the all phases of healing process. Becaplermin (0.01%) is the recombinant human platelet derived growth factor. The biologic activity of becaplermin is similar to native human platelet derived growth factor-BB. Promotion of chemotactic recruitment, as well as the proliferation of cells involved in the wound repair, are the common characteristics of becaplermin and the indigenous human platelet derived growth factor-BB. Becaplermin, topically applied, once daily for 20 weeks or complete healing successfully stimulates the incidence of complete wound closure and decreases the time of complete wound closure of neuropathic diabetic foot ulcer. To ensure that efficacy and healing of diabetic foot ulcers using becaplermin it is essential to ensure adequate peripheral circulation (transcutaneous partial pressure of oxygen pressure at least or more than 30mmHg on the foot dorsum or at the margin of ulcer), sharp debridment, pressure relief and local infection control. Topical becaplermin has no serious local or systemic unwonted effects. The systemic absorption appears to be minimal, it does not produce cancer at the site of application and fibrosis and it does not worsen diabetic neuropathy.

Background: Although thyroid hormones have significant effect on cardiovascular system, the impact of subtle thyroid dysfunction such as subclinical hypothyroidism (SCH) remains to be determined. We investigated coronary flow reserve (CFR) in patients with subclinical hypothyroidism. Methods: Thirty two subjects with SCH and eighteen control subjects with normal serum thyroid hormones and thyroid-stimulating hormone (TSH) levels were included in the study. TSH, free thyroxine, free triiodothyronine, glucose, insulin, HbA1c, cholesterol, triglyceride and plasma levels of C-reactive protein were measured. Coronary diastolic peak flow velocities in left anterior descending coronary artery were measured at baseline and after adenosine infusion. CFR was calculated as the ratio of hyperemic to baseline diastolic peak velocity. Results: CFR values were not significantly different between the two groups (SCH 2.76±0.35 vs controls 2.76±0.42). There was a significant correlation of CFR with waist to hip ratio, hypertension, smoking habits, markers of glucose status (glucose level, HbA1c, insulin level, HOMA IR), cholesterol, LDL-cholesterol and triglyceride levels in SCH group, whereas only cholesterol level showed significant correlation with CFR in controls. There was no correlation between CFR and thyroid hormones. Conclusions: We concluded that there is a different impact of cardiovascular risk factors on CFR in SCH patients compared to healthy control and that these two groups behave differently in the same circumstances under the same risk factors. The basis for this difference could be that the altered thyroid axis»set point« changes the sensitivity of the microvasculature in patients with SCH to known risk factors. © 2022 Sciendo. All rights reserved.

Background: Although thyroid hormones have significant effect on cardiovascular system, the impact of subtle thyroid dysfunction such as subclinical hypothyroidism (SCH) remains to be determined. We investigated coronary flow reserve (CFR) in patients with subclinical hypothyroidism. Methods: Thirty two subjects with SCH and eighteen control subjects with normal serum thyroid hormones and thyroid-stimulating hormone (TSH) levels were included in the study. TSH, free thyroxine, free triiodothyronine, glucose, insulin, HbA1c, cholesterol, triglyceride and plasma levels of C-reactive protein were measured. Coronary diastolic peak flow velocities in left anterior descending coronary artery were measured at baseline and after adenosine infusion. CFR was calculated as the ratio of hyperemic to baseline diastolic peak velocity. Results: CFR values were not significantly different between the two groups (SCH 2.76±0.35 vs controls 2.76±0.42). There was a significant correlation of CFR with waist to hip ratio, hypertension, smoking habits, markers of glucose status (glucose level, HbA1c, insulin level, HOMA IR), cholesterol, LDL-cholesterol and triglyceride levels in SCH group, whereas only cholesterol level showed significant correlation with CFR in controls. There was no correlation between CFR and thyroid hormones. Conclusions: We concluded that there is a different impact of cardiovascular risk factors on CFR in SCH patients compared to healthy control and that these two groups behave differently in the same circumstances under the same risk factors. The basis for this difference could be that the altered thyroid axis»set point« changes the sensitivity of the microvasculature in patients with SCH to known risk factors. © 2022 Sciendo. All rights reserved.