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  • 1
    In: Diabetes, American Diabetes Association, Vol. 69, No. Supplement_1 ( 2020-06-01)
    Abstract: Diabetic foot is a common complication of diabetes mellitus and requires specialized treatment. Cold plasma has demonstrated beneficial effects on wound infection and healing in case reports. The “Kaltplasma Wund (KPW)-Trial” aimed to analyse whether the application of cold plasma accelerates wound healing in diabetic foot compared to standard care therapy. It was a prospective, randomized, placebo-controlled, patient-blinded, bi-center trial. People with diabetes mellitus and diabetic foot WA 1B or 2B were eligible. Each wound was randomized separately. Wounds were treated additionally with cold plasma generated from inert argon gas in an atmospheric pressure plasma jet or placebo. Primary endpoints were reduction in wound size, in clinical infection and microbial load compared to beginning. Important secondary endpoints were time to significant wound reduction ( & gt;10%), and to reduction of infection. Ad hoc we analysed the time to 20% wound reduction. In addition, wound dressings from 15 patients per group were analysed for expression of VEGF via ELISA. In total 65 cases were included in the study and 62 were considerable for final evaluation. Plasma therapy yielded in a significant increase of wound healing, both in total area reduction (-26.31±11.72, p=0.0248 vs. placebo) as well as time to significant wound area reduction (10% from baseline, -1.60±0.58, p=0.0085 vs. placebo). The effect was even more significant, if the reduction level was set to 20% (p & lt;0.0001). Reduction of infection and microbial load was not significantly pronounced in plasma therapy. Regarding the expression of VEGF wounds in the plasma group presented throughout the study with at most visits significant higher levels of baseline corrected VEGF than wounds randomized to placebo therapy. Cold plasma therapy revealed beneficial effects in chronic wound treatment in terms of wound surface reduction and time to wound closure independent from background infection. Disclosure B. Stratmann: Speaker’s Bureau; Self; AstraZeneca, Neoplas Tools GmbH. T. Costea: Other Relationship; Self; Merck Sharp & Dohme Corp. C. Nolte: None. J. Hiller: None. J. Schmidt: None. J. Reindel: None. K. Masur: None. W.H. Motz: None. J. Timm: None. W. Kerner: None. D. Tschoepe: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim International GmbH. Research Support; Self; AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, Neoplas tools GmbH.
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2020
    detail.hit.zdb_id: 1501252-9
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  • 2
    In: Diabetes Care, American Diabetes Association, Vol. 39, No. 10 ( 2016-10-01), p. e171-e173
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2016
    detail.hit.zdb_id: 1490520-6
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  • 3
    In: Diabetes Care, American Diabetes Association, Vol. 38, No. 5 ( 2015-05-01), p. 767-775
    Abstract: This study compared the long-term efficacy of a diabetes-specific cognitive behavioral group therapy (CBT) with sertraline in patients with diabetes and depression who initially responded to short-term depression treatment. RESEARCH DESIGN AND METHODS A randomized controlled single-blind trial was conducted in 70 secondary care centers across Germany comparing 12 weeks of CBT with sertraline in 251 patients with type 1 or 2 diabetes (mean HbA1c 9.3%, 78 mmol/mol) and major depression (Structured Clinical Interview for DSM-IV [SCID]). After 12 weeks, treatment responders (≥50% reduction Hamilton Depression Rating Scale [HAMD-17] ) were included in the 1-year study phase where CBT patients were encouraged to use bibliotherapy and sertraline patients received continuous treatment. We analyzed differences for HbA1c (primary outcome) and reduction (HAMD-17) or remission (SCID) of depression from baseline to the 1-year follow-up using ANCOVA or logistic regression analysis. RESULTS After 12 weeks, 45.8% of patients responded to antidepressant treatment and were included in the 1-year study phase. Adjusted HbA1c mean score changes from baseline to the end of the long-term phase (−0.27, 95% CI −0.62 to 0.08) revealed no significant difference between interventions. Depression improved in both groups, with a significant advantage for sertraline (HAMD-17 change: −2.59, 95% CI 1.15–4.04, P & lt; 0.05). CONCLUSIONS Depression improved under CBT and sertraline in patients with diabetes and depression, with a significant advantage for sertraline, but glycemic control remained unchanged. CBT and sertraline as single treatment are insufficient to treat secondary care diabetes patients with depression and poor glycemic control.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2015
    detail.hit.zdb_id: 1490520-6
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  • 4
    Online Resource
    Online Resource
    American Diabetes Association ; 1991
    In:  Diabetes Vol. 40, No. 1 ( 1991-01-01), p. 134-140
    In: Diabetes, American Diabetes Association, Vol. 40, No. 1 ( 1991-01-01), p. 134-140
    Abstract: In inbred streptozocin-induced diabetic rats, the long-term function of different endocrine pancreatic isografts was compared. Isolated islets transplanted into the portal vein showed a progressive deterioration of function over time. In contrast, islets under the kidney capsule sustained a constant long-term function controlling all clinical signs of diabetes. Recipients of kidney subcapsular islets displayed normal growth rate, peripheral serum glucose and insulin levels, and metabolic parameters. However, their functional reserve was markedly reduced as revealed by diminished glucose tolerance and reduced insulin-secreting capacity after an intravenous glucose challenge. Vascularized whole-organ pancreatic grafts with portal venous drainage led to complete normalization of all parameters determined in this study. This study showed that the long-term function of islets transplanted under the kidney capsule is superior compared with islets transplanted into the portal vein.
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 1991
    detail.hit.zdb_id: 1501252-9
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  • 5
    Online Resource
    Online Resource
    American Diabetes Association ; 1993
    In:  Diabetes Vol. 42, No. 1 ( 1993-01-01), p. 90-97
    In: Diabetes, American Diabetes Association, Vol. 42, No. 1 ( 1993-01-01), p. 90-97
    Abstract: In a model of congenic and intra-MHC recombinant rat strains, the differential role of various histocompatibility antigens in renal subcapsular transplantation of purified islets of Langerhans isevaluated. Class I MHC antigens of the RT1.A region, expressed on the endocrine cells of the islets themselves, do not induce graft rejection on their own. MHC class I antigens as encoded by the RT1.C region do not induce rejection either. MHC class II antigens as encoded by the RT1.B/D region are not expressed on the endocrine pancreas, not even during rejection. Although interstitial dendritic cells situated within the islets expess these antigens, an isolated RT1. B/D incompatibility of islets is associated with prolonged survival in contrast to rapid rejection of fully MHC-mismatched grafts. Unlike other organs, islets matched for all MHC antigens, but incompatible at minor histocompatibility antigens, undergo rejection early after transplantation.
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 1993
    detail.hit.zdb_id: 1501252-9
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