Background:Studies investigating the nutritional status of patients with leprosy and plantar ulcers are sparse.Therefore,the objective of this study was to describe the protein profile of leprosy patients with plantar...Background:Studies investigating the nutritional status of patients with leprosy and plantar ulcers are sparse.Therefore,the objective of this study was to describe the protein profile of leprosy patients with plantar ulcers from the Eastern Amazon region.Methods:A case record form was created for 75 patients with leprosy(31 with plantar ulcers and 44 without plantar ulcers)with the following data:sociodemographic characteristics,clinical form of leprosy,presence or absence of plantar ulcers,and nutritional assessment using anthropometry consisting of the measurement of body mass index,arm circumference,arm muscle circumference,and triceps skinfold.Levels of blood albumin,transferrin,and C-reactive protein(CRP)were also measured.Data regarding protein intake were obtained using a Food Frequency Questionnaire.Results:Plantar ulcers occurred more frequently in male patients(67.7%),patients aged 40-49 years(mean±SD:47.3±8.0 years),and patients receiving 300 or 600 USD(71.0%).The mean weight and height of patients were 71.6±11.4 kg and 1.62±0.1 m,respectively.High levels of CRP were detected in 51.6%of leprosy patients with plantar ulcers and only 9.1%of patients without plantar ulcers(P<0.001).Nutritional depletion of transferrin was observed in 14.3%of patients with paucibacillary leprosy and 44.3%of patients with multibacillary leprosy(P=0.0447).Most patients had normal levels of serum albumin(74.2%with plantar ulcers and 77.3%without plantar ulcers).Conclusions:Most leprosy patients with plantar ulcers have normal levels of serum albumin and transferrin and high CRP levels,which indicates the presence of an inflammatory process.Our findings suggest the need to monitor patients with leprosy to prevent the occurrence of plantar ulcers and to provide adequate treatment for patients with existing plantar ulcers.展开更多
BACKGROUND Diabetic foot ulcers(DFUs)are common in patients with diabetes,especially those undergoing hemodialysis.In severe cases,these ulcers can cause damage to the lower extremities and lead to amputation.Traditio...BACKGROUND Diabetic foot ulcers(DFUs)are common in patients with diabetes,especially those undergoing hemodialysis.In severe cases,these ulcers can cause damage to the lower extremities and lead to amputation.Traditional treatments such as flap transposition and transfemoral amputation are not always applicable in all cases.Therefore,there is a need for alternative treatment methods.CASE SUMMARY This report describes a 62-year-old female patient who was admitted to the hospital with plantar and heel ulcers on her left foot.The patient had a history of renal failure and was undergoing regular hemodialysis.Digital subtraction angiography showed extensive stenosis and occlusion in the left superficial femoral artery,left peroneal artery and left posterior tibial artery.Following evaluation by a multidisciplinary team,the patient was diagnosed with type 2 DFUs(TEXAS 4D).Traditional treatments were deemed unsuitable,and the patient was treated with endovascular surgery in the affected area,in addition to supportive medical treatment,local debridement,and sequential repair using split-thickness skin and tissue-engineered skin grafts combined with negative pressure treatment.After four months,the wound had completely healed,and the patient was able to walk with a walking aid.CONCLUSION This study demonstrates a new treatment method for DFUs was successful,using angioplasty,skin grafts,and negative pressure.展开更多
基金National Council for Scientific and Technological Development-Brazil(CNPq),grant number 481020/2012-8.
文摘Background:Studies investigating the nutritional status of patients with leprosy and plantar ulcers are sparse.Therefore,the objective of this study was to describe the protein profile of leprosy patients with plantar ulcers from the Eastern Amazon region.Methods:A case record form was created for 75 patients with leprosy(31 with plantar ulcers and 44 without plantar ulcers)with the following data:sociodemographic characteristics,clinical form of leprosy,presence or absence of plantar ulcers,and nutritional assessment using anthropometry consisting of the measurement of body mass index,arm circumference,arm muscle circumference,and triceps skinfold.Levels of blood albumin,transferrin,and C-reactive protein(CRP)were also measured.Data regarding protein intake were obtained using a Food Frequency Questionnaire.Results:Plantar ulcers occurred more frequently in male patients(67.7%),patients aged 40-49 years(mean±SD:47.3±8.0 years),and patients receiving 300 or 600 USD(71.0%).The mean weight and height of patients were 71.6±11.4 kg and 1.62±0.1 m,respectively.High levels of CRP were detected in 51.6%of leprosy patients with plantar ulcers and only 9.1%of patients without plantar ulcers(P<0.001).Nutritional depletion of transferrin was observed in 14.3%of patients with paucibacillary leprosy and 44.3%of patients with multibacillary leprosy(P=0.0447).Most patients had normal levels of serum albumin(74.2%with plantar ulcers and 77.3%without plantar ulcers).Conclusions:Most leprosy patients with plantar ulcers have normal levels of serum albumin and transferrin and high CRP levels,which indicates the presence of an inflammatory process.Our findings suggest the need to monitor patients with leprosy to prevent the occurrence of plantar ulcers and to provide adequate treatment for patients with existing plantar ulcers.
文摘BACKGROUND Diabetic foot ulcers(DFUs)are common in patients with diabetes,especially those undergoing hemodialysis.In severe cases,these ulcers can cause damage to the lower extremities and lead to amputation.Traditional treatments such as flap transposition and transfemoral amputation are not always applicable in all cases.Therefore,there is a need for alternative treatment methods.CASE SUMMARY This report describes a 62-year-old female patient who was admitted to the hospital with plantar and heel ulcers on her left foot.The patient had a history of renal failure and was undergoing regular hemodialysis.Digital subtraction angiography showed extensive stenosis and occlusion in the left superficial femoral artery,left peroneal artery and left posterior tibial artery.Following evaluation by a multidisciplinary team,the patient was diagnosed with type 2 DFUs(TEXAS 4D).Traditional treatments were deemed unsuitable,and the patient was treated with endovascular surgery in the affected area,in addition to supportive medical treatment,local debridement,and sequential repair using split-thickness skin and tissue-engineered skin grafts combined with negative pressure treatment.After four months,the wound had completely healed,and the patient was able to walk with a walking aid.CONCLUSION This study demonstrates a new treatment method for DFUs was successful,using angioplasty,skin grafts,and negative pressure.
