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Biofilms play a central role in the chronicity of non-healing lesions such as venous leg ulcers and diabetic foot ulcers. Therefore, biofilm management and treatment is now considered an essential part of wound care. Many antimicrobial treatments, whether topical or systemic, have been shown to have limited efficacy in the treatment of biofilm phenotypes. The antimicrobial properties of iodine compounds rely on multiple and diverse interactions to exert their effects on microorganisms. An expert panel, held in Las Vegas during the autumn Symposium on Advanced Wound Care meeting in 2018, discussed these properties, with the focus on iodine and iodophors and their effects on biofilm prevention and treatment.

Objective:To assess the safety and efficacy of a surfactant-based technology for the management of burns.Method:In a retrospective review, paediatric patients with different types of burns were treated with the gel technology. In some patients, the treatment was combined with a topical antimicrobial agent. Primary objectives of the review were the assessment of healing, healing times and ease of use of the material.Results:The wounds of 15 paediatric patients with different types of burns, particularly with regard to depth and anatomical location, were evaluated using a retrospective chart review. It was found that the surfactant gel technology, with or without the topical antimicrobial agent, assisted in autolytic debridement, and that time to re-epithelialisation was short and within the range of those obtained with other established treatments.Conclusion:The number of patients and wounds in this evaluation is small but the study indicates that the gel technology provides a safe and effective way to treat smaller burns in paediatric patients.

ABSTRACTIntroduction: Glycated hemoglobin (A1c) is the measurement of choice to estimate the glycemic exposure over the last 3 months prior to sampling. The Free Style Libre® is a continuous glucose monitoring device which provides an estimated A1c(eA1c) from average interstitial glucose using Nathan’s ADAG equation. The objective of this study was to compare eA1c and A1cin type 1 diabetes patients (T1D) over a period of 3 months.Materials and methods: Data were collected from patient charts between July 2016 and October 2017. 3-months recordings with >70% of data available were analyzed. eA1c was recorded at each visit and the corresponding A1cvalue measured by high performance liquid chromatography in a single reference lab.Results: A total of 344 reports from 170 T1D were studied, 3 categories were identified: eA1c = A1c: 13% of reports. eA1c > A1c: 57% of reports, positive difference (eA1c – A1c) of +0.74 ± 0.5% (P < 0.0001). eA1c < A1c: 30% of reports, negative difference (eA1c – A1c) of −0.5 ± 0.3% (P < 0.0001).Conclusion: eA1c value was generally overestimated compared to measured A1cin this T1D cohort. This lesser concordance may result from differences in measured glucose source and/or frequency to calculate eA1c compared to ADAG, but also from using the reverse equation which is a source of potential bias. Another explanation could be a different rate of hypoglycemia between groups, or an asymmetric distribution of A1c patients’ phenotypes with differential hyper- or hypoglycation intrinsic propensity.

ABSTRACTObjectives: To document the frequency and predictors of low-density lipoprotein cholesterol (LDL-C) target value attainment among patients with coronary heart disease (CHD) in Belgium.Methods: The second Dyslipidemia International Study (DYSIS II) was an observational study of the prevalence of dyslipidemias and lipid target value attainment. Patients in this analysis were aged ≥ 18, had documented CHD, and had a full lipid profile. Use of lipid-lowering therapy (LLT), lipid profile, and LDL-C target value attainment (< 70 mg/dL) were assessed cross-sectionally at the enrollment visit. The distribution of LLTs was assessed among treated patients. Multivariate logistic regression was used to identify variables predictive of LDL-C target value attainment in treated patients.Results: We identified 409 patients with CHD in Belgium, 387 (94.6%) of whom were on LLT at the time of the lipid profile. Among treated patients, the rate of LDL-C target value attainment was 40.6%, and statin monotherapy was the most commonly used LLT (79.3%). Among users of statin monotherapy or combination therapy, simvastatin was the most commonly used treatment (41.6% of patients). Diabetes was associated with higher odds of LDL-C target value attainment (OR 2.29, 95% CI 1.33–3.93), and female gender was associated with lower odds (OR 0.48, 95% CI 0.24–0.97).Conclusion: Rates of LDL-C target value attainment are low in patients with CHD in Belgium. Intensifying statin therapy or combining it with non-statins is essential in Belgian patients for optimal LDL-C reduction.

The role of the dermis is essential for the proper orchestration of all phases of the normal wound healing process. Wounds with seriously damaged or even absent dermis consistently show seriously impaired wound healing and/or long-term complications such as hypertrophic scarring. Replacing a damaged dermis requires a dermal matrix that is compatible with, or even stimulates, the process of wound healing. Hyaluronic acid (HA), in an esterified form, is among the many matrices that are available. HA has been used in a number of indications, such as ulcers (ie, diabetic foot ulcers and venous leg ulcers), trauma, including burns, and for the repair of contractures and hypertrophic scars. The shorter healing time and the decrease of recurring hypertrophy demonstrate the efficiency of HA-derived matrices. Biopsies, taken up to 12 months post-reconstruction show a neodermis that histologically is largely comparable to normal skin, which probably is a function of HA playing such a pivotal role in normal, unwounded skin, as well as in the process of healing.

Metabolic syndrome is characterized by a constellation of comorbidities that predispose individuals to an increased risk of developing cardiovascular pathologies as well as type 2 diabetes mellitus1. The gut microbiota is a new key contributor involved in the onset of obesity-related disorders2. In humans, studies have provided evidence for a negative correlation between Akkermansia muciniphilaabundance and overweight, obesity, untreated type 2 diabetes mellitus or hypertension3–8. Since the administration of A. muciniphilahas never been investigated in humans, we conducted a randomized, double-blind, placebo-controlled pilot study in overweight/obese insulin-resistant volunteers; 40 were enrolled and 32 completed the trial. The primary end points were safety, tolerability and metabolic parameters (that is, insulin resistance, circulating lipids, visceral adiposity and body mass). Secondary outcomes were gut barrier function (that is, plasma lipopolysaccharides) and gut microbiota composition. In this single-center study, we demonstrated that daily oral supplementation of 1010A. muciniphilabacteria either live or pasteurized for three months was safe and well tolerated. Compared to placebo, pasteurized A. muciniphilaimproved insulin sensitivity (+28.62 ± 7.02%, P= 0.002), and reduced insulinemia (−34.08 ± 7.12%, P= 0.006) and plasma total cholesterol (−8.68 ± 2.38%, P= 0.02). Pasteurized A. muciniphilasupplementation slightly decreased body weight (−2.27 ± 0.92 kg, P= 0.091) compared to the placebo group, and fat mass (−1.37 ± 0.82 kg, P= 0.092) and hip circumference (−2.63 ± 1.14 cm, P= 0.091) compared to baseline. After three months of supplementation, A. muciniphilareduced the levels of the relevant blood markers for liver dysfunction and inflammation while the overall gut microbiome structure was unaffected. In conclusion, this proof-of-concept study (clinical trial no. NCT02637115) shows that the intervention was safe and well tolerated and that supplementation with A. muciniphilaimproves several metabolic parameters.

Relationship to macroangiopathy, nephropathy, and insulin resistance OBJECTIVE -- The aim of this study was to determine the distribution of plasma total homocysteine (tHcy) concentrations in type 2 diabetic patients [...]

We analyzed insulin schemes, lipid lowering and anti-hypertensive therapy as well as quality of glycaemic, blood lipid (BL) and blood pressure (BP) control achieved in 400 type 1 diabetic patients [...]

Due to its favourable effects on lipid profile, postmenopausal hormone replacement therapy (HRTh) is increasingly advocated in cardiovascular protection. Considering the association between menopause and decreased insulin sensitivity, HRTh could [...]

Adequate comparisons of the relative performance of different tests of Β-cell function are not available. We compared discrimination of commonly used in vivo tests of Β-cell function across a range [...]