Author: "Aristidis Veves" - Searchworks@Jio Institute Digital Library Search Results

267 results on '"Aristidis Veves"'

151. Prolonged mechanical noise restores tactile sense in diabetic neuropathic patients

Author: Christina Lima, Susan E. D’Andrea, Jason D. Harry, Rachel Cloutier, James B. Niemi, Aristidis Veves, and Samuel Horr
Subjects: Male, medicine.medical_specialty, Stimulation, Sensory system, Audiology, Vibration, Vibration perception, Diabetic Neuropathies, Diabetes mellitus, Physical Stimulation, Medicine, Humans, Aged, Stochastic Processes, business.industry, Null (mathematics), General Medicine, Stochastic resonance (sensory neurobiology), Equipment Design, Tactile perception, Middle Aged, medicine.disease, Diabetic Foot, Surgery, medicine.anatomical_structure, Treatment Outcome, Touch Perception, Sensory Thresholds, Female, business, Sensory nerve
Abstract: Acute application of stochastic resonance (SR), defined as a subsensory level of mechanical noise presented directly to sensory neurons, improves the vibration and tactile perception in diabetic patients with mild to moderate neuropathy. This study examined the effect of 1 hour of continuous SR stimulation on sensory nerve function. Twenty diabetic patients were studied. The effect of stimulation was measured at 2 time points, at the beginning and after 60 minutes of continual SR stimulation. This effect was measured using the vibration perception threshold (VPT) at the big toe under 2 conditions: a null (no SR) condition and active SR, defined as mechanical noise below the subject's own threshold of perception. The measurements under null and active conditions were done randomly and the examiner was blinded regarding the type of condition. Immediately after SR application, the VPT with SR in null condition was similar to baseline (32.2 ± 13.1, P = nonsignificant) but was significantly lower during active SR (27.4 ± 11.9) compared with both baseline ( P = .018) and off position ( P = .045). The 60 minutes VPT with active SR (28.7 ± 11.1) reached significance comparing the baseline when one outlier was removed from the analysis ( P = .031). It may be concluded that SR for a continuous 60-minute period can sustain the VPT improvement in diabetic patients with moderate to severe neuropathy. These results permit the conclusion that there is no short-term adaptation to the stimulation signal. Long-term application of this technique, perhaps in the form of a continually vibrating shoe insert, or insole, may result in sustained improvement of nerve function.
Published: 2009

152. Diabetes and Exercise

Author: Kerry J. Stewart, Judith G. Regensteiner, Aristidis Veves, and Jane E.B. Reusch
Subjects: Part iii, medicine.medical_specialty, Exercise program, Health science, Diabetes mellitus, Family medicine, Exercise performance, medicine, medicine.disease, Exercise prescription, Psychology
Abstract: PART I: Epidemiology and Prevention Chapter 1 The Epidemic of Type 2 Diabetes Mellitus: Its Links to Obesity, Insulin Resistance and Lipotoxicity Kenneth Cusi, MD The University of Texas Health Science Center at San Antonio Chapter 2 Prevention of Type 2 Diabetes Jonathan E. Shaw, MD International Diabetes Institute and Monash University Richard W. Simpson, DM Monash University Chapter 3 The Metabolic Syndrome Aoife M. Brennan, MD Beth Israel Deaconess Medical Center Laura Sweeney, MD Beth Israel Deaconess Medical Center Christos S. Mantzoros. MD DSc Beth Israel Deaconess Medical Center PART II: Physiology Effects of type 2 diabetes Physiological Effects of Exercise in diabetes Chapter 4 Exercise Performance and Effects of Exercise Training In Diabetes Irene Schauer, MD University of Colorado Denver Timothy Bauer, PhD University of Colorado Denver Peter Watson, PhD University of Colorado Denver Judith C. Regensteiner, PhD University of Colorado Denver Jane EB Reusch, MD University of Colorado Denver Chapter 5 The Cardiovascular Consequences of T2DM Mellitus Sherita Hill Golden, MD, MHS Johns Hopkins University School of Medicine Chapter 6 Endothelial Dysfunction, Inflammation, and Exercise John Doupis, MD Joslin Diabetes Center Jordan C. Schramm, BA Beth Israel Deaconess Medical Center Aristidis Veves, MD, D.Sc. Beth Israel Deaconess Medical Center Chapter 7 Exercise, Adiposity, and RegionalFat Distribution Kerry Stewart, EdD, FAACVPR, FACSM, FSGC Johns Hopkins School of Medicine Chapter 8 Diabetes Mellitus and Exercise Physiology in the Presence of Diabetic Co-morbidities Amy Huebschmann, MD University of Colorado Denver Judith C. Regensteiner, PhD University of Colorado Denver PART III: Management and Treatment Chapter 9 Prescribing Exercise as Therapy for Patients with Diabetes (Exercise Prescription for Diabetics) Dalynn T. Badenhop, PhD, FACSM University of Toledo Medical Center Chapter 10 Behavior Change Strategies for Increasing Exercise in Diabetes Brent Van Dorsten, PhD University of Colorado Denver Chapter 11 Nutritional Management of Diabetes Norica Tomuta, MD Albert Einstein College of Medicine Nichola Davis, MD, MS Albert Einstein College of Medicine/Montefiore Medical Center Judith Wylie-Rosett, EdD, RD Albert Einstein College of Medicine/Montefiore Medical Center Carmen Isasi, MD, PhD Albert Einstein College of Medicine/Bronx-Lebanon Hospital Center Vlad Tomuta, MD Albert Einstein College of Medicine Chapter 12 Exercise Precautions/Guidelines for Exercise Testing in Diabetics Starting an Exercise Program Barry A. Franklin, PhD William Beaumont Hospital Wendy M. Miller, MD William Beaumont Hospital Katherine Nori, MD William Beaumont Hospital Peter A. McCullough, MD, MPH William Beaumont Hospital PART IV: Special Considerations for Exercise in persons with Diabetes Chapter 13
Published: 2009
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153. Inflammation and neuropeptides: the connection in diabetic wound healing

Author: Christoph S. Nabzdyk, Frank W. LoGerfo, Aristidis Veves, Leena Pradhan, and Nicholas D. Andersen
Subjects: Nervous system, medicine.medical_specialty, Angiogenesis, Inflammation, Bioinformatics, Article, Immune system, Diabetic Neuropathies, Diabetes mellitus, Diabetes Mellitus, medicine, Animals, Humans, Molecular Biology, Wound Healing, integumentary system, business.industry, Neuropeptides, Cell migration, medicine.disease, Surgery, medicine.anatomical_structure, Peripheral neuropathy, Molecular Medicine, Inflammation Mediators, medicine.symptom, business, Wound healing
Abstract: This article provides a broad overview of the interaction between neuropeptides and inflammatory mediators as it pertains to diabetic wound healing. Abnormal wound healing is a major complication of both type I and type II diabetes and is the most frequent cause of non-traumatic lower limb amputation. Wound healing requires the orchestrated integration of complex biological and molecular events. Inflammation, proliferation and migration of cells followed by angiogenesis and re-epithelization are essential phases of wound healing. The link between wound healing and the nervous system is clinically apparent as peripheral neuropathy is reported in 30–50% of diabetic patients and is the most common and sensitive predictor of foot ulceration. The bidirectional connection between the nervous and the immune systems and the role it plays in wound healing has emerged as one of the focal features of the wound healing dogma. The mediators of this connection include neuropeptides and the cytokines released from different cells including immune and cutaneous cells. Therefore, to develop successful wound healing therapies, it is vital to understand in depth the signaling pathways in the neuro-immune axis and their implication in diabetic wound healing.
Published: 2009
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154. Conditions That May Interfere with Exercise

Author: Susan Herzlinger Botein, Aristidis Veves, and Edward S. Horton
Subjects: medicine.medical_specialty, Exercise program, Diabetes management, business.industry, Weight maintenance, medicine, Cardiorespiratory fitness, Disease, Intensive care medicine, business, Healthcare providers, Foot problems, Glycemic
Abstract: Exercise often has many positive effects on diabetes management, including improved glycemic control, assistance with weight maintenance, increases cardiorespiratory fitness, and general sense of well-being. However, as diabetic patients can also have other conditions that can be invest affected by exercise, such as cardiovascular disease and neuropathy that makes them vulnerable to foot problems and retinopathy, exercise should be carefully monitored by the health provider, especially during the initiation period. Therefore, careful evaluation of patients for complications that may present incremental risks or interfere with the capacity for exercise is an important first step in planning an appropriate exercise program. This chapter will review the currently available guidelines and will provide practical information regarding the implementation of exercise programs in all diabetic patients, including those with conditions that may interfere with exercise and will need additional attention.
Published: 2009
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155. The Relationship Between Sural Nerve Morphometric Findings and Measures of Peripheral Nerve Function in Mild Diabetic Neuropathy

Author: W. Schady, A. J. M. Boulton, R. H. Lye, A. K. Sharma, Aristidis Veves, Rayaz A. Malik, and E. A. Masson
Subjects: Male, medicine.medical_specialty, Diabetic neuropathy, Biopsy, Endocrinology, Diabetes and Metabolism, Neural Conduction, Urology, Sural nerve, Sensory system, Nerve Fibers, Myelinated, Nerve conduction velocity, Endocrinology, Diabetic Neuropathies, Sural Nerve, Reference Values, Peripheral nerve, Diabetes mellitus, Internal Medicine, medicine, Humans, Peripheral Nerves, business.industry, Peroneal Nerve, Anatomy, Middle Aged, medicine.disease, Electrophysiology, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Sensory Thresholds, Female, Complication, business
Abstract: The morphological findings in sural nerve biopsy specimens from 15 diabetic patients with mild neuropathy were compared with control biopsies from eight non-neuropathic, non-diabetic subjects, and correlations were sought with electrophysiological studies and quantitative sensory tests for vibration, thermal, and current perception thresholds. Myelinated fibre density was reduced compared with control biopsies (4042 +/- 2090 (+/- SD) vs 6800 +/- 1100 mm-2; p less than 0.01). A strong correlation existed between myelinated fibre density and sural sensory conduction velocity (r = 0.84, p less than 0.001), sural action potential amplitude (r = 0.74, p less than 0.001), peroneal motor conduction velocity (r = 0.58, p less than 0.02), and median sensory amplitude (r = 0.64, p less than 0.01) but there was no correlation between myelinated fibre density and any quantitative sensory test. We conclude that conventional electrophysiological tests in the lower limb are reliable surrogate measures for structural abnormalities in early diabetic neuropathy.
Published: 1991
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156. A team approach to diabetic foot care—the Manchester experience

Author: F.J. Thomson, Ajm Boulton, E.A. Knowles, J. Gem, M. G. Walker, Aristidis Veves, H. Ashe, and P. Hirst
Subjects: medicine.medical_specialty, business.industry, Diabetic foot care, Physical therapy, Medicine, Orthopedics and Sports Medicine, Podiatry, business
Published: 1991
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157. A study of plantar pressures in a diabetic clinic population

Author: D.J.S. Fernando, Ajm Boulton, Aristidis Veves, and P. Walewski
Subjects: medicine.medical_specialty, education.field_of_study, business.industry, Internal medicine, Population, medicine, Orthopedics and Sports Medicine, Podiatry, education, business, Foot (unit), Surgery
Abstract: It is now well established that high foot pressures in diabetic patients are associated with foot ulceration. Using the optical pedobarograph, dynamic foot pressures were measured during walking in 135 diabetic patients and 69 healthy, age-matched controls. Diabetic subjects were clinically subdivided to those with neuropathy (83 patients) and without neuropathy (52 patients). Mean peak foot-pressure in the diabetic group was significantly higher than the controls (10.1 kg.cm −2 ±4.2 SD versus 8.3±4.0, p 12.3 kg.cm −2 ), compared to non-neuropathic (15%, p
Published: 1991
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158. Semmes-Weinstein monofilaments: a simple, effective and inexpensive screening device for identifying diabetic patients at risk of foot ulceration

Author: Ajm Boulton, Sudhesh Kumar, D.J.S. Fernando, Aristidis Veves, E.A. Knowles, and Matthew J Young
Subjects: Adult, Male, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Urology, Vibration, Vibration perception, Endocrinology, Diabetic Neuropathies, Risk Factors, Diabetes mellitus, Internal Medicine, medicine, Humans, Foot ulcers, Risk factor, Foot Ulcer, business.industry, Medical screening, General Medicine, Middle Aged, medicine.disease, Surgery, Peripheral neuropathy, Touch, Sensory Thresholds, Female, business, Foot (unit)
Abstract: Both vibration perception threshold (VPT) by biothesiometry and pressure perception using Semmes-Weinstein monofilaments (filaments) have been proposed to identify diabetic patients at risk of foot ulceration. The two methods were compared in 182 subjects attending a national patients conference. Both measures were made over the great toe. Filaments of three calibres were used: 4.17, 5.07 and 6.10 bending with 1, 10 and 75 g force, respectively. Pressure perception was normal (4.17) in 122 patients (group 1) whereas in 45 patients it was grade 5.07 (group 2) and 6.10 or greater in 15 (group 3). The corresponding mean VPT (+/- SD) for the three groups were 10.6 (+/- 6.7), 22.8 (+/- 12.7) and 32 (+/- 14.3), respectively. The mean VPT for the 3 groups were significantly different (P less than 0.001). The filaments were more sensitive (100%) but less specific (77.7%) in identifying patients who had foot ulcers compared to biothesiometry which was less sensitive (78.6%) but more specific (93.4%). The filaments are therefore reliable and may be superior to biothesiometry in screening for patients at risk of foot ulceration since sensitivity is the more important parameter. In addition, they are inexpensive (12 pounds) compared to the biothesiometer (400 pounds) and are simple and easy to use.
Published: 1991
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159. Relationship of Limited Joint Mobility to Abnormal Foot Pressures and Diabetic Foot Ulceration

Author: E. A. Masson, D.J.S. Fernando, Andrew J.M. Boulton, and Aristidis Veves
Subjects: Male, Metatarsophalangeal Joint, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Metatarsophalangeal joints, Foot Diseases, Metacarpophalangeal Joint, Diabetic Neuropathies, Internal medicine, Diabetes mellitus, Skin Ulcer, Pressure, Internal Medicine, Humans, Medicine, Range of Motion, Articular, Pedobarography, Gait, Advanced and Specialized Nursing, Diabetic Retinopathy, Foot, business.industry, Middle Aged, medicine.disease, Limited joint mobility, Electrophysiology, medicine.anatomical_structure, Evaluation Studies as Topic, Physical therapy, Female, business, Diabetic foot ulceration, Range of motion, Ankle Joint, Foot (unit), Retinopathy
Abstract: Objective To investigate the role of limited joint mobility (LJM) in causing abnormal foot pressures and foot ulceration. Research Design and Methods The subjects were recruited from a general diabetes clinic where patients were screened for neuropathy, retinopathy, and elevated plantar foot pressure. Sixty-four patients in five groups were matched by age and sex in the following groups: group 1, patients with LJM and neuropathy; group 2, nonneuropathic diabetic patients with LJM; group 3, patients with neuropathy and no LJM; group 4, diabetic control subjects; and group 5, nondiabetic control subjects. Joint mobility was assessed in the foot at subtalar and metatarsophalangeal joints; plantar foot pressures were assessed by optical pedobarography and neuropathic status by a Biothesiometer and electrophysiology. Results Joint mobility was reduced at both sites in groups 1 and 2 compared with groups 3, 4, and 5 (P < 0.001). Plantar foot pressures were significantly higher in groups 1 and 2 compared with groups 3, 4, and 5 (P < 0.001). No differences in plantar foot pressures were observed between groups 1 and 2. There were strong correlations between plantar foot pressures and joint mobility in the foot (r = −0.7, P < 0.001). Previous foot ulceration was present in 65% of patients in group 1, none in group 2, and 5% in group 3. Conclusions 1) LJM may be a major factor in causing abnormally high plantar foot pressures, 2) abnormal plantar foot pressures alone do not lead to foot ulceration, and 3) LJM contributes to foot ulceration in the susceptible neuropathic foot.
Published: 1991
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160. Painful diabetic neuropathy: epidemiology, natural history, early diagnosis, and treatment options

Author: Rayaz A. Malik, Miroslav Backonja, and Aristidis Veves
Subjects: medicine.medical_specialty, Diabetic neuropathy, Physical medicine and rehabilitation, Diabetic Neuropathies, Pain assessment, Diabetes mellitus, Epidemiology, medicine, Animals, Humans, Intensive care medicine, Pain Measurement, Analgesics, business.industry, General Medicine, medicine.disease, Clinical trial, Natural history, Anesthesiology and Pain Medicine, Peripheral neuropathy, Early Diagnosis, Treatment Outcome, Neuropathic pain, Transcutaneous Electric Nerve Stimulation, Neurology (clinical), business
Abstract: Objective. To facilitate the clinician’s understanding of the basis and treatment of painful diabetic neuropathy (PDN). Background. PDN is one of several clinical syndromes in patients with diabetic peripheral neuropathy (DPN) and presents a major challenge for optimal management. Methods. A systematic review of the literature was undertaken for articles specific to PDN, using Medline databases between 1966 and 2007. Results. The epidemiology of PDN has not been well established and on the basis of available data the prevalence of pain is 10% to 20% in patients with diabetes and from 40% to 50% in those with diabetic neuropathy. It has a significant impact on the quality of life and health care costs. Pathophysiologic mechanisms underlying PDN are similar to other neuropathic pain disorders and are broadly characterized as peripheral and central sensitization. The natural course of PDN is variable, with many patients experiencing spontaneous improvement and resolution of pain. Hyperglycemia-induced pathways result in nerve dysfunction and damage, which lead to hyperexcitable peripheral and central pathways of pain. Glycemic control may prevent or partially reverse DPN and modulate PDN. Quantifying neuropathic pain is difficult, especially for clinical trials, although this has improved recently with the development of neuropathic pain-specific tools, such as the Neuropathic Pain Questionnaire and the Neuropathic Pain Symptom Inventory. Current therapeutic options are limited to symptomatic treatment and are similar to other types of neuropathic pain. Conclusions. A better understanding of the peripheral and central mechanisms resulting in PDN is likely to promote the development of more targeted and effective treatment.
Published: 2008

161. Effect of valsartan on left ventricular anatomy and systolic function and aortic elasticity

Author: Christina Lima, Aoife M. Brennan, Aristidis Veves, Jean L. Chan, Peter G. Danias, Lalita Khaodhiar, Christos S. Mantzoros, and Warren J. Manning
Subjects: Adult, Blood Glucose, Male, medicine.medical_specialty, endocrine system diseases, Endocrinology, Diabetes and Metabolism, Tetrazoles, Blood Pressure, Ventricular Function, Left, Young Adult, Endocrinology, Double-Blind Method, Internal medicine, medicine.artery, Ascending aorta, medicine, Humans, Prospective Studies, Aorta, Aged, Aged, 80 and over, Glycated Hemoglobin, Cross-Over Studies, Chemistry, Abdominal aorta, nutritional and metabolic diseases, Valine, Middle Aged, Angiotensin II, Crossover study, Magnetic Resonance Imaging, medicine.anatomical_structure, Blood pressure, Valsartan, Diabetes Mellitus, Type 2, cardiovascular system, Female, Angiotensin II Type 1 Receptor Blockers, Diabetic Angiopathies, Artery, medicine.drug
Abstract: The objective of the study was to examine the effect of a 6-month daily treatment with 160 mg valsartan, an angiotensin II receptor blocker, on the left ventricular systolic function and aortic elasticity of patients with type 2 diabetes mellitus (T2DM) and healthy subjects. This was a prospective, randomized, double-blind, placebo-controlled crossover study. Thirteen healthy control subjects and 11 patients with T2DM were enrolled in the study. Eight control subjects and 4 T2DM patients completed the study. Cardiovascular magnetic resonance was used to evaluate the effect of valsartan on the left ventricular function and aortic elasticity. At baseline, T2DM patients had increased left ventricular mass (P = .006) when compared with the healthy controls. In the T2DM patients, treatment with valsartan, in comparison with receiving placebo, resulted in a reduction of aortic radius (P = .026) and wall thickness (P = .032) of the ascending aorta. In the abdominal aorta, valsartan treatment, when compared with placebo treatment, reduced the arterial compliance (P = .014) in the T2DM patients. Valsartan treatment for 6 months decreased the diameter and wall thickness of the ascending aorta in patients with T2DM, but may decrease AC of the abdominal aorta.
Published: 2008

162. Micro- and Macrovascular Disease in Diabetic Neuropathy

Author: Antonella Caselli and Aristidis Veves
Subjects: medicine.medical_specialty, Diabetic neuropathy, Vascular disease, business.industry, Vasodilation, Blood flow, medicine.disease, Microcirculation, Diabetes mellitus, Internal medicine, medicine, Cardiology, sense organs, Endothelial dysfunction, business, Macrovascular disease
Abstract: Diabetes is often defined a “vascular disease” because of the early and extensive involvement of the vascular-tree observed in patients with diabetes and even in those at risk of developing diabetes. Both the micro- and macrocirculation are affected. Changes in the micro- and macrocirculation, both anatomical and functional, contribute to the development of diabetic neuropathy. On the other hand, the development of diabetic neuropathy also affects the vasodilatory capacity of the microcirculation. Thus, the interaction between changes in the vasculature and peripheral nerves is bidirectional and results in changes in both blood flow and neuronal function. The possible links between diabetic micro- and macrovascular alterations and nerve damage will be the focus of this chapter.
Published: 2008
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163. Aldose Reductase Inhibitors for the Treatment of Diabetic Neuropathy

Author: Aristidis Veves
Subjects: High rate, Aldose reductase, Diabetic neuropathy, business.industry, Pharmacology, medicine.disease, Aldose reductase inhibitor, Tissue penetration, respiratory tract diseases, Clinical trial, Enzyme inhibition, Diabetes mellitus, medicine, business, medicine.drug
Abstract: It has been more than 30 years since the first aldose reductase inhibitor (ARI) was tested in diabetic and galactosemic rats and found to control the polyol accumulation. Since then, a considerable number of ARIs have been tested in experimental and human diabetes. Despite the initial encouraging results from tests that were conducted for the past 20 years, ARIs have not been established for the treatment of diabetic neuropathy yet. The main reasons for this are inconsistent results and the unacceptable high rate of side-effects associated with the initially tested compounds. The lack of well-defined end points and the inability to produce an inhibitor that achieves satisfactory tissue penetration and enzyme inhibition are other major contributing factors for this failure. This chapter focuses on the clinical trials that have examined the effect of all tested ARIs on human diabetic neuropathy.
Published: 2008
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164. Living Skin Equivalents for the Diabetic Foot Ulcer

Author: Aristidis Veves and Thanh Dinh
Subjects: Chronic wound, medicine.medical_specialty, education.field_of_study, business.industry, medicine.medical_treatment, Population, medicine.disease, Diabetic foot, digestive system diseases, Indirect costs, Diabetic foot ulcer, Amputation, Diabetes mellitus, Medicine, medicine.symptom, business, Intensive care medicine, education, health care economics and organizations, Foot (unit)
Abstract: Foot ulceration remains the leading diabetic complication requiring hospitalization (1). Treatment of the diabetic foot ulcer is often a complex process that involves a multidisciplinary approach. Despite best efforts, failure to heal a diabetic foot ulcer can lead to amputation (2). As the incidence of diabetes in the general population is expected to rise, the prevalence of ulcerations and amputations will follow. The resulting cost to society can be measured in direct costs attributed to treatment, as well as indirect costs in lost productivity. The total cost of diabetic foot ulcerations in the United States has been estimated to approach $4 billion annually, as extrapolated from the costs of ulcer care and amputations (3). However the costs are measured, diabetic foot ulcerations represent a major public health challenge of growing proportions.
Published: 2007
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165. Abstract 3687: Microcirculatory Changes in Diabetic Subjects

Author: Jenny Freeman, Aksone Nouvong, Emile Mohler, Brian Davis, Elizabeth Medenilla, Azita Tajaddini, Martha Cornejo, Wendy Arriga, Svetlana Panasyuk, Kevin Schomacker, and Aristidis Veves
Subjects: Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract: INTRODUCTION: Hyperspectral Technology cutaneous Oxygenation Monitoring (HTcOM) quantifies oxyhemoglobin (HT-Oxy) & deoxyhemoglobin (HT-Deoxy) on a pixel by pixel basis, providing a scan that shows microcirculatory patterns of tissue oxygenation. Here, we test the use of HTcOM to define patients at higher risk of diabetic complications based on systemic microcirculatory changes. METHODS: Data were extracted from an ongoing NIH/NIDDK study, following 210 type 1 & type 2 diabetic subjects at high risk for foot ulceration & 66 with ulcers for 18 months. HTcOM values were measured from volar forearm, palm & foot dorsum. Subjects with diabetic foot ulcers during the study were compared to high risk diabetics without ulcers. HT-Oxy and HT-Deoxy data was used as the primary basis for determining systemic microvascular disease in diabetic subjects. RESULTS: Interim data was analyzed from 162 type 1 & 2 diabetics. Subjects with ulcers were compared to those without ulcers. Diastolic blood pressure, HbA1c, HDL & neuropathy disability scores were different between the 2 groups. Lower HT-Oxy was found in forearms & palms for the ulcer group when compared to the group without ulcers. Significant differences were also seen for the dorsum, but only when analyzing paired difference. CONCLUSIONS: Previous work demonstrated that HTcOM could differentiate between subjects without diabetes, low risk diabetics & high risk diabetics. The current work demonstrates additional capabilities of HTcOM to discriminate even within the high risk group. Subjects with poorer systemic microcirculation as manifested by lower HTcOM readings on the forearm were significantly more likely to have or develop a foot ulcer than other subjects considered at high risk by standard clinical assessment. HTcOM provides for the first time, the possibility to perform a non-invasive assessment of the severity of systemic microvascular disease associated with diabetes progression. Linear Regression Mixed Effects Model Results
Published: 2007
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166. Foot Care in Older Adults with Diabetes Mellitus

Author: Aristidis Veves and Thomas E. Lyons
Subjects: Pediatrics, medicine.medical_specialty, business.industry, Diabetes mellitus, Medicine, business, medicine.disease, Foot care
Published: 2007
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167. Guidelines for the treatment of diabetic ulcers

Author: Thomas Serena, Michael G. Franz, Christopher E. Attinger, David L. Steed, Hans Moosa, Andrew Alan Johnson, Peter Sheehan, Laurel Wiersma-Bryant, Martin C. Robson, Lawrence B. Harkless, Mary C. Crossland, Theodore Colaizzi, and Aristidis Veves
Subjects: Gerontology, Blood Glucose, medicine.medical_specialty, Orthotic Devices, Hyperbaric oxygenation, Dermatology, Occlusive Dressings, Diabetic ulcers, Achilles Tendon, Necrosis, Ischemia, Health science, Secondary Prevention, Medicine, Humans, University medical, Secondary prevention, Platelet-Derived Growth Factor, Hyperbaric Oxygenation, Wound Healing, Evidence-Based Medicine, business.industry, Foot, Foot Bones, University hospital, Orthotic device, Diabetic Foot, St louis, Debridement, Family medicine, Cytokines, Surgery, business
Abstract: 1. Chaired this panel2. University of Pittsburgh/UPMC, Pittsburgh, PA3. Georgetown University Hospital, Washington, DC4. Colaizzi Pedorthic Center, Pittsburgh, PA5. HCA Richmond Retreat Hospital, Richmond, VA6. University of Michigan Hospital, Ann Arbor, MI7. University of Texas Health Science Center, San Antonio, TX8. Covance, Princeton, NJ9. St Joseph’s Hospital, Belleville, IL10. University of South Florida, Tampa, FL11. Penn North Centers for Advanced Wound Care, Warren, PA12. Cabrini Medical Center, NY, NY13. Beth Israel Deaconess Medical Center, Boston, MA, and14. Barnes-Jewish Hospital at Washington University Medical Center, St Louis, MO
Published: 2007

168. Microvascular changes in the diabetic foot

Author: Thanh Dinh, Jordan C. Schramm, and Aristidis Veves
Subjects: medicine.medical_specialty, Vascular smooth muscle, Endothelium, Population, 030209 endocrinology & metabolism, Vasodilation, Microcirculation, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Laser-Doppler Flowmetry, Humans, Endothelial dysfunction, education, education.field_of_study, Wound Healing, business.industry, Foot, General Medicine, medicine.disease, Diabetic foot, Diabetic Foot, Surgery, medicine.anatomical_structure, Cardiology, Axon reflex, Endothelium, Vascular, business, Blood Gas Monitoring, Transcutaneous
Abstract: Impairment of the microcirculation of diabetic patients may contribute to secondary complications in the lower extremity, such as foot infections and ulcerations. These microcirculatory changes, which are mainly functional rather than structural, are responsible for the impaired ability of the microvasculature to vasodilate in response to injury. Dysfunction of vascular endothelial cells and vascular smooth muscle cells both contribute to the reduction in vasodilation that is observed in diabetic patients. Nerve-axon reflex related microvascular vasodilation is also impaired in the diabetic population, and there is a growing belief that both the failure of the vessels to dilate and the impairment of the nerve axon reflex are major causes for impaired wound healing in diabetic patients. Further studies are necessary to clarify the precise etiology of endothelial and smooth muscle dysfunction in diabetic patients so that potential therapeutic interventions may be identified.
Published: 2006

169. Percent change in wound area of diabetic foot ulcers over a 4-week period is a robust predictor of complete healing in a 12-week prospective trial

Author: Peter B. Jones, Peter Sheehan, John M. Giurini, Antonella Caselli, and Aristidis Veves
Subjects: medicine.medical_specialty, Time Factors, Endocrinology, Diabetes and Metabolism, law.invention, Randomized controlled trial, Predictive Value of Tests, Healing rate, law, Diabetes mellitus, Multicenter trial, Internal Medicine, Humans, Medicine, Prospective Studies, Prospective cohort study, Advanced and Specialized Nursing, Wound Healing, business.industry, Prognosis, medicine.disease, Diabetic foot, Diabetic Foot, Surgery, Clinical trial, Wound area, Prospective trial, Complication, business, Foot (unit)
Abstract: OBJECTIVE—To assess the ability of the 4-week healing rate to predict complete healing over a 12-week period in a large prospective multicenter trial of diabetic patients with foot ulceration. RESEARCH DESIGN AND METHODS—We examined the change in ulcer area over a 4-week period as a predictor of wound healing within 12 weeks in patients who were seen weekly in a prospective, randomized controlled trial. RESULTS—Wound area measurements at baseline and after 4 weeks were performed in 203 patients. The midpoint between the percentage area reduction from baseline at 4 weeks in patients healed versus those not healed at 12 weeks was found to be 53%. Subjects with a reduction in ulcer area greater than the 4-week median had a 12-week healing rate of 58%, whereas those with reduction in ulcer area less than the 4-week median had a healing rate of only 9% (P < 0.01). The absolute change in ulcer area at 4 weeks was significantly greater in healers versus nonhealers (1.5 vs. 0.8 cm2, P < 0.02). The percent change in wound area at 4 weeks in those who healed was 82% (95% CI 70–94), whereas in those who failed to heal, the percent change in wound area was 25% (15–35; P < 0.001). CONCLUSIONS—The percent change in foot ulcer area after 4 weeks of observation is a robust predictor of healing at 12 weeks. This simple tool may serve as a pivotal clinical decision point in the care of diabetic foot ulcers for early identification of patients who may not respond to standard care and may need additional treatment.
Published: 2006

170. The efficacy of Apligraf in the treatment of diabetic foot ulcers

Author: Thanh Dinh and Aristidis Veves
Subjects: Chronic wound, medicine.medical_specialty, Cost-Benefit Analysis, Biocompatible Materials, Diabetic ulcers, Risk Factors, Diabetes mellitus, medicine, Poor wound healing, Humans, Growth Substances, Skin, Artificial, Wound Healing, business.industry, medicine.disease, Diabetic foot, Diabetic Foot, Surgery, Peripheral neuropathy, Treatment Outcome, Quality of Life, Cytokines, Collagen, medicine.symptom, business, Complication, Foot (unit)
Abstract: Diabetic foot ulcerations can be a devastating complication of diabetes, causing prolonged hospitalization and significant morbidity. Previously identified risk factors include peripheral neuropathy, foot deformities, and poor wound healing due to an altered wound environment. Despite appropriate treatment, many diabetic ulcers fail to heal. Bioengineered tissue, such as Apligraf (Graftskin; Organogenesis Inc., Canton, Mass.), has been effectively and safely used to increase the incidence of complete wound closure and decrease the healing time. Studies have demonstrated that Apligraf works through the delivery of growth factors and cytokines to the chronic wound environment.
Published: 2006

171. Cutaneous Blood Flow, Doppler Measurement of

Author: Aristidis Veves and Lalita Khaodhiar
Subjects: Pathology, medicine.medical_specialty, business.industry, Laser probe, Blood flow, Laser Doppler velocimetry, Microcirculation, symbols.namesake, Doppler flowmetry, Doppler frequency, cardiovascular system, symbols, medicine, Plethysmograph, business, Doppler effect, circulatory and respiratory physiology, Biomedical engineering
Abstract: The necessity for measuring the skin blood flows occurs in many areas of physiology, pharmacology, and clinical medicine. Although the measurement of blood flow in the large blood vessels in the human body has been performed for centuries, the use of techniques to explore microcirculation have just evolved over the past 30 years. Available tests for assessing the skin microcirculation include tissue pH measurement, radioactive isotope clearance, capillary microscopy, plethysmography, transcutaneous oxygen tension, ultrasonic Doppler flowmetry, and laser Doppler flowmetry. Keywords: doppler flowmetry; doppler principle; doppler frequency; laser probe; atherosclerosis
Published: 2006
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172. Microcirculation in the diabetic foot: an update

Author: Aristidis Veves and Thanh Dinh
Subjects: medicine.medical_specialty, business.industry, 030209 endocrinology & metabolism, General Medicine, medicine.disease, Diabetic foot, Microcirculation, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, medicine, Surgery, business
Published: 2005

173. Diabetic Neuropathy

Author: Rayaz A. Malik and Aristidis Veves
Published: 2005
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174. Therapeutic Interventions to Improve Endothelial Function in Diabetes

Author: Aristidis Veves and Lalita Khaodhiar
Subjects: medicine.medical_specialty, Type 1 diabetes, business.industry, Type 2 diabetes, medicine.disease, Gestational diabetes, Impaired glucose tolerance, Internal medicine, Diabetes mellitus, medicine, Microalbuminuria, Endothelial dysfunction, Metabolic syndrome, business
Abstract: Endothelial dysfunction often marks an early stage in the development atherosclerosis and can be observed in coronary and peripheral arterial beds (1,2). Endothelial dysfunction has been documented in patients with type 2 diabetes (3, 4, 5) and also type 1 diabetes particularly those who have microalbuminuria (6). Recent data also showed its existence in individuals at high risk for developing diabetes (7) (e.g., impaired glucose tolerance [IGT], first-degree relatives of patients with type 2 diabetes and metabolic syndrome) and in women with pervious gestational diabetes (8).
Published: 2005
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175. Research profile. Foot ulcer risk. The role of circulation

Author: Aristidis, Veves
Subjects: Biomedical Research, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Risk Factors, Blood Circulation, Humans, History, 21st Century, Diabetic Foot, Boston
Published: 2004

176. Kidney oxygenation during water diuresis and endothelial function in patients with type 2 diabetes and subjects at risk to develop diabetes

Author: Chun S. Zuo, Caitlin Sparks, Nicholas Katsilambros, Aristidis Veves, Lalita Khaodhiar, Edward S. Horton, Panayiotis A. Economides, and Antonella Caselli
Subjects: Male, medicine.medical_specialty, Kidney Cortex, Brachial Artery, Endocrinology, Diabetes and Metabolism, Diuresis, Type 2 diabetes, Kidney, Impaired glucose tolerance, Endocrinology, Oxygen Consumption, Risk Factors, Diabetes mellitus, Internal medicine, medicine.artery, Medicine, Humans, Brachial artery, Aged, Skin, Kidney Medulla, business.industry, Microcirculation, Water, Oxygenation, Glucose Tolerance Test, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Oxygen, Vasodilation, medicine.anatomical_structure, Diabetes Mellitus, Type 2, Regional Blood Flow, Female, Sodium nitroprusside, Endothelium, Vascular, business, medicine.drug
Abstract: The aim of the present study was to examine the relationship among water diuresis-induced changes in renal oxygenation, endothelial function, and various metabolic parameters in type 2 diabetic patients and healthy subjects at risk of type 2 diabetes. Thirty-eight subjects with type 2 diabetes (D: age, 54 ± 10 years, mean ± SD, 24 men) and 7 healthy subjects with parental history of type 2 diabetes or with impaired glucose tolerance (IGT) (relatives [R]: age 46 ± 11 years, 4 men) were included. Laser Doppler imaging scanning was used to measure vasodilatation in the forearm skin in response to iontophoresis of 1% acetylcholine (Ach) and 1% sodium nitroprusside (SNP), and ultrasound was used to measure the flow-mediated dilation (FMD) and nitroglycerin-induced dilation (NID) in the brachial artery. Renal oxygenation was assessed by magnetic resonance imaging (MRI) before and during water diuresis. A decrease in the magnetic parameter R2∗ implies an increase in oxygenation. Renal medullary oxygenation did not improve with diuresis in either group (D: −0.5 ± 1.9, R: −0.4 ± 2.1, P = not significant [NS]). The renal cortical oxygenation showed a small, but statistically significant, improvement after diuresis in the 2 groups (D: −0.6 ± 1.1, R: −0.5 ± 0.5, P < .05). There were no correlations between the change in cortical R2∗ (R2∗ post-minus R2∗ prewater diuresis) and the micro- and macrovascular reactivity. The postdiuresis renal cortical R2∗ was negatively correlated with both the Ach- and SNP-induced skin vasodilation (% change over baseline)(r = −.40, P < .01 and r = − .39, P < .05, respectively), while no correlation existed with the FMD and NID. The baseline renal cortical oxygenation was also negatively correlated with the SNP-induced skin vasodilation (r = −.36, P < .05) and positively correlated with the fasting plasma glucose, total cholesterol, and vascular cell adhesion molecule (VCAM) concentrations (r = .34, P < .05, r = .31, P < .05 and r = .37, P < .05, respectively). These preliminary findings suggest an association between the kidney cortical oxygenation and the skin microvascular reactivity, glycemia, and lipidemia. Water diuresis failed to produce an improvement in renal medullary oxygenation in both patients with diabetes and subjects at risk for diabetes.
Published: 2004

177. The effects of atorvastatin on endothelial function in diabetic patients and subjects at risk for type 2 diabetes

Author: Elizabeth Tiani, Lalita Khaodhiar, Edward S. Horton, Aristidis Veves, Panayiotis A. Economides, and Antonella Caselli
Subjects: Adult, Male, medicine.medical_specialty, Percentile, Endothelium, Brachial Artery, Endocrinology, Diabetes and Metabolism, Atorvastatin, Vasodilator Agents, Clinical Biochemistry, Type 2 diabetes, Biochemistry, Endothelial activation, Nitroglycerin, Endocrinology, Forearm, Double-Blind Method, Risk Factors, Internal medicine, medicine.artery, Diabetes mellitus, medicine, Humans, Pyrroles, Brachial artery, Skin, Inflammation, business.industry, Microcirculation, Biochemistry (medical), Middle Aged, medicine.disease, Vasodilation, medicine.anatomical_structure, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Heptanoic Acids, Regional Blood Flow, Female, Endothelium, Vascular, Hydroxymethylglutaryl-CoA Reductase Inhibitors, business, Biomarkers, medicine.drug
Abstract: We have investigated the effect of atorvastatin on the endothelial function of patients with diabetes and subjects at risk for type 2 diabetes in a 12-wk, prospective, randomized, placebo-controlled, double-blind clinical trial. The flow- mediated dilation (FMD; endothelium dependent) and nitroglycerin-induced dilation (endothelium independent) in the brachial artery and the vascular reactivity at the forearm skin were measured. FMD improved in the atorvastatin-treated, at-risk subjects [median (25-75 percentile), 7.2% (2.9-9.6%) at exit visit vs. 6.6% (2.9-9.5%) at baseline; P < 0.05]. A similar improvement of FMD was found in atorvastatin-treated diabetic patients [median (25-75 percentile), 5.6 (3.9-7.9) at exit visit vs. 4.2 (3.2-7.2) at baseline; P = 0.07]. No changes were observed in nitroglycerin-induced dilation and the microcirculation reactivity measurements in either group. In the at-risk group, there was a decrease in the C-reactive protein [median (25-75 percentile), 0.12 mg/dl (0.07-0.27 mg/dl) at exit visit vs. 0.24 mg/dl (0.07-0.35 mg/dl) at baseline; P < 0.05] and TNF alpha [median (25-75 percentile), 2.6 pg/ml (1.8-4.1 pg/ml) at exit visit vs. 4.4 pg/ml (3.6-6.0 pg/ml) at baseline; P < 0.05] in the atorvastatin-treated patients, whereas in the diabetes group, a decrease in endothelin-1 (mean +/- SD, 0.97 +/- 0.29 pg/ml at exit visit vs. 1.19 +/- 0.42 pg/ml at baseline; P < 0.05) and plasminogen activator inhibitor-1 [median (25-75 percentile), 18 ng/ml (9-24 ng/ml) at exit visit vs. 27 ng/ml (7-41 ng/ml) at baseline; P < 0.05] were observed. We conclude that atorvastatin improves endothelial function and decreases levels of markers of endothelial activation and inflammation.
Published: 2004

178. 40(th) EASD Annual Meeting of the European Association for the Study of Diabetes : Munich, Germany, 5-9 September 2004

Author: S. Artigas, A V Dreval, Mark I. McCarthy, C Watson, Peter H. Bennett, M Quint, Y Ikeda, E Alpert, F Schiele, H Sekihara, Erik Gylfe, P Lowe, J Kuhlmann, Alain Golay, V Longo, Shahidul Alam Khan Akm., L G Mantovani, M Zawodniak-Szalapska, G Winkler, T Harrity, L Virág, U Johne, Kuo S-W., Linda C Tapsell, J Rodriguez, Michel Komajda, K Kankova, Carole A. Cull, M Sporna, E Estilles, U Ribel, M C Spruce, E Buzzigoli, T Prazak, J K McLaughlin, M K Lingohr, M Lim, F Calara, A Siebenhofer, G Meregalli, Roberto Anichini, A D Baron, R Kurashvili, P C Butler, G I Fantus, T. E. De Gooyer, Park Y-M., R. Walther, S Heinrich, Agnieszka Zawiejska, S Mukherjee, Nikolaos Papanas, G Wong, Ian D. Caterson, David M. Maahs, Shuichi Kaneko, Alexandra E. Butler, Francisco Javier Ampudia-Blasco, O N Kong, Attali J-R., C A Hedman, K Oshinyemi, Nicolle Müller, I C Cranston, N Okumus, M V Vlaiculescu, Balasubramanian Ravikumar, W W Cheatham, K Mukasa, K B Biswas, Annunziata Lapolla, Phil McEwan, G Mader, Gilles Chassot, Dragi Anevski, Werner A. Scherbaum, M Donath, C Hesselmann, R A Gandhi, David E. Moller, Ezio Bonifacio, C Garcia, V Ifandi, P Hornnes, Nieuwenhoven Fav., C Puech, S Pérez-Del-Pulgar, Kim S-R., G Hines, C Rubio Terrés, Michael Gaster, N. Hosszufalusi, A Scholze, Andrew A. Young, Stavros Liatis, F Hariri, S Tan, Paul Valensi, Allan E. Karlsen, J Kim, E. Moberg, J Kaiser, L Berman, G Nelson, A Altkrüger, P Kothare, D B Cook, S Doran, G. van Dijk, Shahnaz Shahinfar, Kim C-S., P Stahl, M Manousaki, S Sigrist, S K Lim, M. P. Stern, A Guberti, C Rezzani, J McKenney, Karl Thomaseth, Sofia Carlsson, M Julia, R Brillante, I Rubesova, T Darkow, E Matsumoto, Wendy M. Macfarlane, M Di Martino, G Bardini, Rossella Menghini, D Duhot, E Farcasiu, Annalisa Natalicchio, I Lindner, J Buvat, Christian L. Brand, Harry Dorchy, Iwona Pietrzak, Z T Luo, P Home, M Ekelund, Jesper Gromada, Kristine Færch, F Piarulli, H Kim, R Mentel, Zsuzsanna K. Zsengellér, Dullaart Rpf., Anton Luger, Thomas A. Pearson, V Manicardi, P Rösen, Feng Y-M., R Morganti, Lars Hansen, Demuth H-U., Haruo Kasai, A Shostak, Rudi Steffensen, G Taylor, Markolf Hanefeld, C Santini, E Hamaguchi, Roberto Miccoli, F Storms, M Cooper, Y Lee, Allison E. Aiello, P Smith, T Suehiro, K Treece, M Waluś, Timothy A Welborn, Simone Baltrusch, E Kontela, S Chai, J Crean, H Yokoyama, Johan G. Eriksson, Rafael Hernández Hernández, J Rodríguez-Saldaña, M P Tornero, G Formoso, D. Lovell, E Bingham, A Mylonakis, M Manteghetti, D Fedele, Antonio Martín-Duce, Ralph A. DeFronzo, D Salcedo, Kurt Højlund, Antonio Petrone, Sheu Whh., C Gutierrez, Flavia Pricci, S Kurita, Z G Abbas, M M Benedetti, Philippe A. Halban, Daniel J. Cox, O Ljungkvist, Justine Davies, J Palsgaard, Lars Sjöström, E Bosi, L Janin-Manificat, W. F. Kelly, M. Fernandez, E Colak, O V Mulyarchik, B Kronshage, F Lang, M Erfurth, Takashi Kadowaki, N Jendrike, U Walter, J Wishart, Y. Neye, D Kim, N Furuhashi, M Barsotti, D Florow, L Ke, L Borgquist, N C Jackson, Ffolliott M. Fisher, V Baskar, K Yoshioka, Bryan A. Wolf, G Chabrier, R Skoumal, Livio Luzi, H Kose, I Pharisien, B. Klein, H Winiarska, M C Johnson, L Griffiths, Nonna Kravchun, C Combe, Baptist Gallwitz, J Zdychova, L Skorda, Jorma Ilonen, W Gao, I N Steen, A Terrinoni, P D Ambery, W Kern, C M Kusminski, Cho M-H., Paolo Pozzilli, Louise G. Grunnet, E Schönle, David R Matthews, Robert W. Taylor, Y Cohen, Kim H-S., M P Eccles, N B Tutuncu, D McDowell, Richard M. Bergenstal, K Takamatsu, T Steiner, Jaan Palgi, Valdemar Grill, N Niculescu, G Federici, S Lehto, P. M. McKeigue, M Barone, Michael E. Trautmann, S Smirnov, J Mannion, M Eto, C Rousseau, M Conti, C S Ernest, Antonio Ceriello, D H Schweitzer, Jung E-D., Andreas Festa, Avijit Lahiri, A Shepelkevich, A Murro, A Kollmann, Jonathan R.S. Arch, R Landgraf, Son H-Y., I Engelsberger, E Agardh, S Rodríguez-Mulero, P J Kraml, K Lee, D. F. Du Toit, E Kim, G Fadini, Williams Ajk., Philip Home, M B Antcieferov, C Perlemoine, D Perrea, Song X-L., D Ruggieri, Krister Bokvist, Heidi Sørensen, Bilbao, G Yoshino, J P Taylor, Shen H-M., S M Furier, R Urquhart, J Wohlgelernter, Jianping Weng, T. Baba, Q Hong, C Silva, Castaigne J-P., M Felaco, X X Zhang, M Jaroň, Milla Rosengård-Bärlund, J G Papp, Toshio Miyata, Lervang H-H., Park M-K., I Kinalska, A Long, Oomen Phn., N Kogawa, Ippolita Patrizia Patera, S. Karadeniz, Dinesh Selvarajah, D S Chung, A Wensaas, Richard Imrich, M Recasens, J Ruxer, O Buchea, E Wilpart, S P Stepanenko, Le Ttd., H Ohgawara, Mariaconsuelo Valentini, A Mondok, M Peltonen, Marianne O. Larsen, K Chatzianagnostou, Agneta Ståhle, A L Ferrari, L Bordier, F Maingrette, A Matsuda, G Vukomanovic, Jakob D. Wikstrom, T Yamakita, E Gorostiaga, J Jin, B Gopalan, Heinz Drexel, S Hewitt, Rury R. Holman, C Dieterle, T L Ruchti, N Asatiani, M Sidira, A Iezzi, A J Sommerfield, D Châtenet, M L Olsen, R Bergemann, C Koehler, T L Kuraeva, B Balas, Christian Berne, E Santos-Mazo, G Smith, A Siejka, R Kožnarová, A Mattina, S Sheikh, A Adomeit, M Rasmussen, J. Fagerudd, N Busciantella Ricci, Nuria Vilarrasa, E Hammar, T L Thoms, L Aydın, Ron G. Rosenfeld, A Nikolajuk, R Gos, C L Morgan, H L Yu, D Dheelchand, S Ramrath, N Boudriga, Jerome I. Rotter, C Jahannault, W M Weston, Folke Lindgärde, M Hertlova, D Knight, A Monroy-Mayorga, E Pardini, A Chamson-Reig, B Franke, Janie McCluskey, Joseph Bryan, C Nikolopoulou, Christie M. Ballantyne, Fausto Santeusanio, L Pegoraro, M Lee, A Klimenko, S Jaiveer, K. Pettersson-Fernholm, Michael A. Nauck, A Ekbom-Schnell, G Deferrari, Riccardo Schiaffini, S. Pampanelli, Khan Aka., David Hopkins, Maija Wessman, M Kamarinos, Noh J-H., O Ebisui, K McCarroll, Jeppe Sturis, Peter Nowotny, N Gorbenko, Åke Sjöholm, David G. Maggs, A E Halseth, B Cresci, A A Ortiz-Gress, A Korakovouni, O Matejkova, C E Mogensen, C J Lin, Ramon Gomis, H Seaman, C Granier, Yang C-H., F Assah, O Sanchez, Fausto Machicao, Peter G. Morris, Alberto Ortiz, A Giardinelli, D Bracaglia, A Gonzalo, S Pavlatos, Andreas Lechner, F Canovic, L Sjolind, Allan Vaag, Birgitte Bruun Nielsen, David A. Ziegler, Vito Lampasona, R Gershoni-Baruch, A. Dei Cas, H Renz, E Mena, Matthew Waltham, Kim D-M., H Levanen, D D Mick, Valentina Alexandrovna Peterkova, E Meskhishvili, Sarah Nutland, R Bustani, John R. Lindsay, M Christoforidou, A Abicht, E Harno, K Cyganek, A Fitchet, S Neelotpol, P Nikishin, P Serradas, J Hinrichsen, M Halvorson, M Chovatia, B Voet, Jinny Willis, E Parretti, M Haslbeck, M Wellard, L Teng, Julio Wainstein, J S Fischer, K. Lalic, D Roggenland, I Gich, R Anwar, Maurizio Cassader, D Serota, X J Li, R J Schotzinger, Vilmundur Gudnason, Björn Zethelius, S A Wootton, W Andrzejewski, R Rezsohazy, R Gao, T Klimentova, T Mazurek, I Bruckner, C Dohrmann, R E James, G daSilva Xavier, Kim S-Y., A Dorca, Stuart J. Pocock, Terri J. Allen, I Giovos, P B Parab, N H Andersen, P Fotinakis, Miriam Cnop, H Lee, Norbert Tennagels, Omorodola I. Abatan, F Ailett, I. Lager, D Manzella, H Hut, Larry A. Distiller, G Lip, Lim S-K., Rong Zhang, T Tsuno, Steen Knudsen, M. Bajardi, Manuel Benito, Dai Sugimoto, Melvin J. Prince, D W Dunstan, D Rankins, K A Majali, G Ozansoy, Isabella Russo, S Uçak, G Annuzzi, R Talar-Wojnarowska, K Lange, S Neugebauer-Baba, Campbell H. Thompson, Eric Renard, P. D. Mountjoy, Z Morrison, Elizabeth A. Davis, Franco Cavallo, C Corvaja, R Antuña, Craig John Currie, H Linnebjerg, He Y-L., A J Palmer, Mariola R. Chacón, H Malinska, M. Jones, R Lichnovská, K Mandes, Paolo Tessari, T Mokhort, A Laina, H. L. Y. Chan, I Schmidt, R Banks, Richard G. IJzerman, L Ksinantova, G Setti, H Vaudry, A Gallo, V Spallone, Chen J-W., Thomas Danne, A Chong, M Hallschmid, S Aczel, S Hulme, N Islam, M Hosoi, P M Ternan, P Di Bartolo, N Bishara, T Shibasaki, Martin A. Osterhoff, Im S-S., M Jecht, T Hamaguchi, S Mattera, K Ways, Elizabeth Northam, U Rajala, Reinhard W. Holl, L Yang, S Panaiotopoulos, K Horvath, R Kluge, Thora B. Bodvarsdottir, Y Dong, Irene Alemanno, C McDougall, Reimar W. Thomsen, M Campbell, W Rabl, John Öhrvik, Yuichiro Yamada, Paola Ungaro, W Benzer, Mike Sampson, Roberto Trevisan, R G Radu, Aas A-M., P E Lobo, Ricardo Scott, S M Son, Josephine M. Forbes, T A Hillier, K L Wyne, Louis L. Nguyen, J Farmer, M H Tan, Kwon H-S., J Yang, L Sandvik, Franco Folli, A K Jenum, M Nguyen, W Pratipanawatr, A L Frederiksen, Rebecca Smith, Lee H-J., A Schäfer, C Manuelli, G S Denver, T Vukovich, B Maceira, K Matsumoto, K. Chokkalingam, Nurcan Üçeyler, P Modi, Timothy M. Morgan, S Mertens, B M Singh, Michaela Riedl, K Iso, C Cucurullo, G. F. Bottazzo, M Calvani, K Hur, J Wetzels, Kazuhiro Takahashi, Y Aso, H Stammer, M G Masding, Fitsum Guebre-Egziabher, J L González-Sánchez, L Armstrong, Alberto Maran, Peter G.F. Swift, S S Popovic, J Starczynski, E Vitacolonna, Luigi Laviola, R W Gelling, Marina Cardellini, D Barilla, Rosa de Diego Martínez, W H Landschulz, Anne Mette Rosenfalck, R K Wong, Kevin E. Schneider, K Peros, Giuseppe Nanni, F Zhang, I Rákóczi, T Iburi, M Nakhjavani, X Q Zhang, S Tournis, Per Lav Madsen, Graham A. Hitman, A. Tura, K Laubner, N D Kostic, Lawrence M. Dolan, R. Sinha Roy, J A Wagner, J. Tuomilehto, J Hauptman, M Abdel-Ghany, D Lacombe, Toralph Ruge, Johannes A Maassen, Triantafyllos Didangelos, K Sasaki, I Argüelles, Klaus Levin, C Popow, Emanuel Christ, R Chetty, L Baillet-Blanco, Jo-Ann Salmon, T Mine, James L. Trevaskis, I Franke, J Gorski, E A Andrianova, A Dayan, A Caballero, Aleksandra Gilis-Januszewska, M Yasujima, Z Kasalová, C.D.A. Stehouwer, F. K. Gorus, G A Nichols, A Glowania, David P. Strachan, P Fredlund, N. F. da Silva, P Reboldi, M Sausbier, K H Groenier, G Stuccio, N Guttman, K R Ahmed, A D Ristic, T Kapellen, J Coutcher, Aldo V. Greco, Oswald Wagner, A Zagayko, Maria Alevizaki, B B Zhang, W F Ferris, Jenny Fredriksson, Lois Jovanovic, J Hänninen, R De Giglio, Kazuo Yagui, O Potterat, P Hamliton, R E Scranton, B Mankovsky, A Stylianou, B Fellström, Abdel-Wahab Yha., M Kitagawa, Katherine L. Baldock, F R Johnson, F Baigts, S D'Addato, F J Sanz, A Mistry, S D Wise, T Pratipanawatr, U R Fölsch, James R.C. Parkinson, Claudia Sommer, C Park, F E Griffiths, M L Martí, R Demirtunc, S Taniguchi, J Lundkvist, T Siegmund, Juan Sztajzel, C Dienesch, F Baumgartner, L Scalone, T M Mckolanis, K Otake, Ullrik Pedersen-Bjergaard, T M Vriesendorp, Michael B. Wheeler, Henry Schmitt, Peter Hovind, S Lange, Stephane Roze, L. Van Gaal, B Klaproth, Anthony E. Civitarese, D Eckland, A Dagar, D F Hopkins, Kari Stefansson, C Gonzalez-Yanes, B Meyboom-de Jong, D. J. Betteridge, K Buhling, M Crepaldi, Ana M. Wägner, L Renna, L Volpe, R McBride, V Corbo, E O Brennesvik, R P Hayes, R Abdollahnia, G Viviani, C F Liew, Francisco Pérez-Bravo, Jeffrey Baron, Brian M. Frier, H H Samira, D Szentendrei, K. J. Schjoedt, W K Waldhäusl, D Gniuli, D Zou, G Tschank, V Urbančič, A L Nolan, Albertini J-P., J Malcomson, M Larbig, C Cheyssac, K Aurich, C M Kesson, S Heller, Maija E. Miettinen, R F Luco, Adrian J. Cameron, Luigi Mattiello, Z. Metelko, X E Zhang, M Parramón, I. G. Obrosova, J Fruchart, M Ilic, Björn Eliasson, Gilles Chatellier, M A Martín, D M Kendall, Holger Luthman, V F Varillas, D Maccubbin, Jang S-A., Amalia Gastaldelli, E Salzsieder, P. de Mol, A Yoshida, H D Lindner, D Gostiljac, M Just, Pan C-Y., J M Fujitaki, G Eiermann, K Bergenheim, A D Frick, A Agacdiken, K Varytimiadis, K Cseh, D A Jackson, S Calderari, Dena G. Hernandez, H M Liebich, K Min, F. de Zegher, Bernd Kulzer, K Han, Ulrich A. Müller, D Marrero, H Hatakeyama, René Koopman, Doo H-K., Petr Wohl, P. Sharp, P Forder, Thor Aspelund, N Meneveau, R M Schmülling, R Aubert, Thom Sam., H Youshikawa, M Ankelo, D Bowden, I Kelly, Frédéric Fumeron, M Sartini, Robert S. Sherwin, L Varadhan, A Criscimanna, John Betteridge, V Jelic, M Bartnik, N Lemke, B Ursø, A Bertoldo, A M Owona, H Okochi, L Pérez-Tamajó, S L Monfre, Daniel Brandhorst, K T Legg, Andries J. Smit, Veronica Sancho, Masashi Hirai, C Klein, Paul J. Thornalley, A Chaidaroglou, K Miura, B Zinman, O M Dvoynishnikova, J Plank, Jan Bolinder, C Lush, B Rubi, R Pozzilli, M Bashir, S A Shtandel, F Mosca, A Naskalska, Josef Vcelak, U Sausbier, P Cavaiani, T U Baehring, Michele Solimena, P Formisano, M Rastaldi, Bernard Thorens, J Ruzzin, E Arbit, M. Hori, Torkel B. Brismar, E Soltes Rak, A Filo, P Heinke, Matthew P. Coghlan, M Masotti, I Perevozskaya, K Ahn, I Moules, K Van Dyck, I Goldstein, Z Mathe, G Z Zhao, S Fajardo, J Taylor, S Chrul, J C Pareja, D Hadjidakis, A J Scheen, N Siddiqua, D C Cavan, R Grella, Krabbe S, H J Rochlitz, A E Hinkkanen, W Wilpshaar, Richard Stevens, M Dreyer, S Hara, X Wang, Melania Manco, D Gillen, Magalie A. Ravier, Olli Simell, John C. Lawrence, Kohnert K-D., Agardh C-D., A Berghold, L Kristensen, Grant Sfa., N Gursoy, Leif Groop, N Freemantle, Anja Schweizer, L Pala, Legros J-J., C. Di Pietro, N. Yamamoto, J Magyar, B Nikolovski, H Ikeda, D Lee, Bruce A. 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Ahmann, E Jebens, J Keiding, Elena Henkel, Mark Fineman, J F McRae, Carol Forsblom, S Martemucci, Lourdes Ibáñez, P G Prieto, L Ringholm Nielsen, S Pratas, B von Stritzky, Julio Rosenstock, Lee K-W., J Stocks, L J Strow, I Samarguliani, L Wennekes, R Cheung, Abhishek Nag, Roberto Gambino, Y Suleymanoglu, E Murphy, T T Durck, M F Peyrot, Y Unno, Alexander Mayorov, Eleuterio Ferrannini, D. C. Rao, D Neely, H Karunajeewa, J Palmisano, Julia B. Lewis, M Ravid, G Pons, E Junca, P Vexiau, S Sailesh, D K Miloslavskiy, O N Bondarenko, U Smith, S Torri, Constantine Tsigos, Cesario Bianchi, Mattia Locatelli, D Jaquet, Virpi Lindi, M Moroi, M E Tushuizen, P Pelicci, R Scognamiglio, Pal Pacher, S M Thyssen, A Péterfalvi, Y Ho, S Guntram, L Romics, T Nakagami, Clive S. Cockram, Irina Kowalska, K Brodbeck, Gojka Roglic, J. Dörig, Lise Tarnow, Therese Tillin, A López-Alba, Martin Krššák, Moses Elisaf, S Hata, D P Snoeck, D Schmoll, O V Udovichenko, A Scaramuzza, J Paul, John H. 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Lyu, G Rizzo, V V Bogomolov, N Krasova, G M McGuire, Tina Parkner, A Timi, Johann Bauersachs, S Foussas, S A Schreiber, T Monauni, Schwarz Peh., Allenberg, J D Lee, S Dewan, Y G Zheng, D Carroll, E Sarti, C Wollheim, Anna Kaminski, C Menneila, P Bucher, Xu Jyu., Vincent Rigalleau, A Schöpfer, Hans Jörnvall, A Ben Drief, X Jeunemaitre, E Schuster, Chan Slf., S Bilgic, J Coverly, K Szafraniec, Stalenhoef Afh., H Bergert, David I. W. Phillips, J Maksimovic Pavlovic, Sergio E. Starkstein, E Chaim, T Lehmann-Lintz, P Salacone, Tim Armstrong, Ingrid Klöting, C M Frampton, Franco Cavalot, A.K.Azad Khan, H Rose, Marta Letizia Hribal, Jette Kolding Kristensen, H Gröbe, M Nishi, A Vanderplas, Howlett Hsc., L E Bowen, R Malik, A Wu, Charles C. Richardson, Y Li, P G McNally, Yoon K-H., A Baleydier, M J Murphy, P. M. Nilsson, U Lindblad, Sten Madsbad, T Bíró, Riitta Veijola, Charlotte Glümer, Assunta Pandolfi, Lydia Aguilar-Bryan, M Namba, C Franzen, S Lopatriello, David Russel Jones, S. 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Jeffcoate, J Pariès, K Huoponen, Anne Jörns, G Shanmugam, A Tsiavou, S Yoshida, Kim M-J., Annapaula Giulietti, S Paillasson, K Tsuchiya, Divyen K Shah, P Saar, S S Juarez, Stefanie Maxion-Bergemann, J Briody, V Schmitz, C M Pena, J Fernádez-Real, S Naruse, M Kalis, A P Klimenko, X H Chen, H.H. Lervang, G Bock, Mirja Tiikkainen, J Potockova, N Pekcanli, George Dragicevic, Timothy M. Rose, David C. Goff, H Komori, V Vasseur-Delannoy, S Hanley, P Hajos, C W Ahn, Matsuoka T-A., J Burns, Petar M. Seferovic, Yuki Kita, K Lyons, K Kohri, Eleftheria Zeggini, Y Ding, G Belcher, Steven V. Edelman, N Dinççaǧ, Christopher J. Rhodes, Manders Rjf., S Giveon, Dario Iafusco, L Li, M C Ribaudo, Kang S-K., Laurie J. Goodyear, L Martinez, C Vermigli, H Dabire, R Raymond, J de Haan, Christopher J. Groves, Å Norberg, H Jahr, M Gloster, Christopher D. 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Leon, Alberti Gkm., A Opel, S Kokkoris, S B Hong, Philippe Courtois, L Haque, Maria Sörhede Winzell, M C Beauvois, A Szypowska, D Yu, M Gutniak, D Petzinna, B Isomaa, K S Prickett, Maria Felice Brizzi, Pavel Hamet, P J Hammond, K. F. Michelmore, Yumie Takeshita, N Hariharan, Corrado M. Cilio, G Pogatsa, W G Jerome, E Bartley, K Schlembacher, G Blohmó, Guy A. Rutter, Kyung Mook Choi, S. C Tamer, Felix K. Assah, K A Jandeleit-Dahm, M Chan, H Darius, Jørgen F. P. Wojtaszewski, A Papazisi, M Amaya, A Knopff, M Tadayyon, I J Kim, W Russ, T Myrnäs, M. Tryon, S Poonsatha, Noel Cameron, Kim M-H., Alejandra Tomas, F Homo-Dekarche, G. Di Cianni, M Stotzka, C Solimine, Mikhail Borisovich Antsiferov, H Naserke, M Bianchi-Biscay, J I Lara, Moon C-K., Alain Ktorza, Alison N. Jeffery, V Lilla, Eun Seok Kang, Hanley Ajg., J Widder, R Ratner, C Goretti, P J Weston, J Perkins, V Rasmussen, M Evans, T M Gibson, A Jaffe, S I Chisalita, C Owman, L Hiltunen, E Kakishita, C M Mack, H C Potter, M Femerling, M Desai, M Soinio, K Yang, Patricia L. Brubaker, M Meyer, V Dy, J Berden, R Komers, Milos Adamec, R Petzoldt, Alan G. Robinson, R Stevens, A Doi, A Leunda, Eduard Montanya, Alessandra K Cardozo, N Kraenkel, Claudio Cobelli, U A Mueller, S Yamashiro, B R Gedulin, G Francisco, J Dennenmoser, Lesch K-P., Martin G. Bischof, M Ichita, C Fernandes, Jochen Hampe, S Kern, D Kelly, E Zeender, P Perna, J D Best, A C Calkin, Vivian Fonseca, J Prestle, D G Parkes, Satish K. Garg, T Burrell, B M Fischer, D Kruger, J S Skinner, Lin T-M., Jozef Ukropec, Maria Jeziorska, K Arii, David D. D’Alessio, M B Gomes, L Quandt, I Fragaki, M C Brindisi, A Gladkih, E Kitsou, S Di Cola, T Iwasaki, Peter Diem, T Lakka, V V Popova, G Lee, Hannah J. 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Cavanagh, Allen Taylor, M Balabolkin, G Schreier, E Stern, J Lips, V Serban, G Sparacino, Roser Casamitjana, Aine McKillop, I Groza, E Bernal, Kathleen M Gillespie, T Ledet, A Garzaniti, F Hawkins, K M Tushaus, C Renaudin, Christina Maier, A Dormi, A Ubertalli, Inge Tetens, M Ostojic, E Pierre-Justin, A Bhushan, E Ur, L I Jeltova, Tilo Moede, E Tibiriça, Zoran Gucev, Knoch K-P., G Pizzolanti, A M Şengül, T P Degenhardt, Cristina Lencioni, M Fitchet, E Santini, E Devangelio, C Panaite, Y I Karachentsev, S B Solerte, Christos Manes, M Lipka, C H Teng, P Mrak, G Fegan, R C Milton, M Negrean, Astrid Plamboeck, L Patti, M Houk, Ritva Kauppinen-Mäkelin, Christoph F Ebenbichler, O Sysoyeva, Frantisek Saudek, H Wysocki, Robert A. Rizza, J Altirriba, Bjørn Richelsen, L. Lam, Rémy Burcelin, A Antsaklis, G Galimberti, R. de Vries, A Lewin, Marcia A. 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Vingrys, S Habu, Mariella Trovati, H Sobajima, Pierre Lecomte, Kim T-H., D Virsaladze, M Oprean, F Pullen, A Rußmann, G J Bruining, Martina Düfer, Wen Xu, Min Y-K., Norman E Cameron, Gianfranco Pagano, K Harley, M Su, J P Le Berre, Sian Ellard, S Howard, D Russell-Jones, Z Li, S Carpenter, E L Thomas, W Tang, Lee M-S., N Ubrich, M. M. McMahon, G Vassilikos, N Brossa, M S Joergensen, S Smith, A Vania, Y Laurent, S Basir, A Freudenthaler, Sally M. Marshall, D Niedermayer, V I Pankiv, J Mentel, S Pruna, J M Pou Torelló, Y Ito, G Chrysos, Werner Kramer, Hironori Yamasaki, L Bowman, F Palumbo, P Ruth, G Lankas, Z H Liao, D Park, W Otter, C Montrone, Sevasti Zervou, Jennifer L. Wilkinson-Berka, Bo Feldt-Rasmussen, I Banu, Paolo Sbraccia, Bani Mukhopadhyay, Mark E. Cooper, M Kidron, Pål R. Njølstad, A M Jonsdottir, M R Burge, G Valpiani, Yutaka Oiso, David J. 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Paulin, S, Marcu, S, Tauveron, I, Zimmermann, C, Schiele, F, Seronde, M, Vautrin, P, Lusson, J, Thieblot, P, Bernard, Y, Mistry, A, Pye, M, Peovska, I, Maksimovic Pavlovic, J, Vavlukis, M, Pop Gorceva, D, Bosevski, M, Scognamiglio, R, Negut, C, De Kreutzenberg, S, Madonna, R, De Caterina, R, Willerson, J, Geng, Y, Vahsen, S, Ledwig, D, Ramrath, S, Frantz, S, Schmidt, I, Calvillo, L, Dienesch, C, Elbing, I, Bischoff, H, Ertl, G, Bauersachs, J, Davydov, A, Mkrtum'Yan, A, Baranova, L, Ikeda, Y, Suehiro, T, Osaki, F, Ota, K, Arii, K, Kumon, Y, Hashimoto, K, Doney, A, Morris, A, Palmer, C, Byun, S, Doo, H, Pagnin, E, Calo, L, Fadini, G, Kubaszek, A, Chai, S, Chai, Q, Rasmussen, L, Ledet, T, Wogensen, L, Lengyel, C, Varró, A, Virág, L, Magyar, J, Bíró, T, Jost, N, Skoumal, R, Nánási, P, Tóth, M, Horkay, F, Papp, J, Zacharopoulou, O, Athanaselis, S, Tsokos, N, Doupis, J, Psallas, M, Cokkinos, D, Pavlatos, S, Liatis, S, Akhobadze, T, Dzneladze, L, Samarguliani, I, Taskiran, M, Rasmussen, V, Jensen, G, Fisher, A, Petrovsky, N, Srikusalanukul, W, Budge, M, Trifunovic zamaklar, D, Zivkovic, M, Jelic, V, Vukomanovic, G, Ristic, A, Seferovic, P, Costa, J, Duarte, S, Manley, S, Sailesh, S, Venkataraman, A, Haider, Y, Groza, I, Oprean, M, Ardelean, A, Morosanu, A, Darkow, T, Vanderplas, A, Mamas, M, Mcelduff, P, Burns, J, Edwards, R, Fitchet, A, Young, R, Gibson, J, Lichiardopol, R, Niculescu, N, Totora, A, Pencea, C, Tomescu, I, Cinteza, M, Manicardi, V, Coscelli, C, Navazio, A, Catellani, E, Michelini, M, Dall'Asta, D, Guberti, A, Piazza, A, Gasparini, E, Pantaleoni, M, Guiducci, U, Manari, A, Sejil, S, Janand delenne, B, Avierinos, J, Habib, G, Labastie, N, Vague, P, Lassmann vague, V, Luźniak, P, Tatoń, J, Wojciechowska Luźniak, A, Zairis, M, Lyras, A, Patsourakos, N, Tsirimbis, V, Foussas, S, Lupón, J, Urrutia, A, Herreros, J, González, B, Coll, R, Altimir, S, Prats, M, Valle, V, Abreu padí, C, Rábago, G, Ivanova, L, Brasacchio, D, Harno, E, Keenan, A, Li, H, Lu, Z, Ke, L, Liu, H, Jeong, I, Chae, M, Choi, M, Yoo, H, Kim, C, Yun, M, Na, M, Kang, Y, Kong, O, Son, S, Kim, I, Tanaka, N, Hosoi, M, Matsuyama, Y, Fukumoto, M, Yamakita, T, Yoshioka, K, Ishii, T, Sato, T, Fujii, S, Aoki, T, Shibata, T, Mizutani, N, Suzuki, J, Fowelin, J, Samuelsson, P, Brandrup wogsen, G, Okumura, K, Tokmakova, A, Staroverova, D, Antcieferov, M, Shutichina, I, Kuntchevich, G, Vriesendorp, T, Morélis, Q, Legemate, D, Schaper, F, Mainas, E, Gkioulmpasanis, I, Panagiotou, I, Vassilikos, G, Skorda, L, Sidira, M, Christoforidou, M, Alaveras, A, Artikis, V, Evdemon, E, Lechleitner, M, Koch, T, Ebenbichler, C, Sturm, W, Moretti, L, Moruzzo, D, Boldrini, E, Pandolfo, C, Kameyama, M, Iwasa, R, Cho, M, Nam, J, Huh, K, Kaplar, M, Paragh, G, Erdei, A, Csongradi, E, Garai, I, Varga, J, Galuska, L, Udvardy, M, Higa, M, Kaneko, Y, Hiroi, N, Koziarska, D, Nowacki, P, Majkowska, L, Luzniak, P, Wojciechowska luźniak, A, Tushuizen, M, Nieuwland, R, Snoeck, D, Sturk, A, Diamant, M, Aguiar, L, Bahia, L, Villela, N, Laflor, C, Conde, C, Bottino, D, Dorigo, D, Bouskela, E, Pu, S, Luo, Z, Lam, K, Dan, Q, Xu, A, Shen, J, Cheng, K, Xu, J, Thamer, C, Stefan, N, Haap, M, Heller, E, Tschritter, O, De Prado, A, Ortiz, A, Ybarra, J, Gich, I, Pou, J, Ehren, M, Roggenland, D, Reinsen, B, Klein, H, Rittig, K, Stock, J, Kocher, B, Balletshofer, B, Shon, H, Chung, D, Nakatani, Y, Matsuhisa, M, Kaneto, H, Hatazaki, M, Yoshiuchi, K, Katakami, N, Kawamori, D, Ohtoshi, K, Sakamoto, K, Matsuoka, T, Ozawa, K, Ogawa, S, Hori, M, Yamasaki, Y, Zitouni, K, Harry, D, Nourooz zadeh, J, Earle, K, Olesen, P, Franco, L, Corvaja, C, Semplicini, A, Ceylan işık, A, Arı, N, Rösen, P, Lee, I, Park, K, Jung, E, Shin, D, Jo, S, Obuobie, K, Prakash, P, Hanna, F, Lazarus, J, Varadhan, L, Gurushankar, J, James, D, Sheikh, S, Gaede, P, Zou, D, Vilarrasa, N, Perez maraver, M, Mena, E, Perez, D, Setti, G, Buckingham, R, Urbančič, V, Stefanovska, A, Bernjak, A, Ažman juvan, K, Kocijančič, A, Glowania, A, Filters, T, Fosmark, D, Torjesen, P, Kilhovd, B, Berg, T, Sandvik, L, Hanssen, K, Mentink, C, Donchenko, G, Stepanenko, S, Maingrette, F, Deng, H, Lindenmair, A, Freudenthaler, A, Baumgartner parzer, S, Nizheradze, K, Khoruzhenko, A, Tronko, N, Sheu, W, Ou, H, Shen, H, Lin, T, Wu, H, Yang, C, Mogylnytska, L, Schmoelzer, I, Davies, J, Band, M, Struthers, A, Prázný, M, Škrha, J, Kasalová, Z, Neelotpol, S, Jahan, P, Kauschke, S, Harrop, C, Schäfer, A, Widder, J, Eigenthaler, M, Walter, U, Uchimura, I, Ikebukuro, M, Kaibara, M, Hirata, M, Helal, R, Pervin, F, Yang, X, Jansson, P, Nagaev, I, Jack, M, Carvalho, E, Sunnerhagen, K, Cam, M, Cushman, S, Smith, U, Creely, S, Farmer, J, Gustafson, B, Kusminski, C, Krusinova, E, Wohl, P, Klementova, M, Lanska, V, Mcdougall, C, Kelly, I, Abbas, Z, Lutale, J, Archibald, L, Karunajeewa, H, Stingemore, N, Stuccio, G, Mcgechie, D, Muller, L, Hak, E, Goudzwaard, W, Montorsi, F, Homering, M, Sprenger, K, Goldstein, I, Asnaghi, V, Ferrari, G, Rastaldi, M, Gabellini, D, Dell'Antonio, G, Maestroni, A, Ruggieri, D, Luzi, L, Piemonti, L, Zerbini, G, Anafaroglu, I, Tutuncu, N, Sultana, M, Siddiqua, N, Iwasaki, T, Nakajima, A, Yoneda, M, Mukasa, K, Tanaka, S, and Sekihara, H
Subjects: 0303 health sciences, medicine.medical_specialty, business.industry, EASD, Endocrinology, Diabetes and Metabolism, Human physiology, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, Family medicine, Internal Medicine, Medicine, business, 030217 neurology & neurosurgery, 030304 developmental biology
Published: 2004

179. Genome-wide DNA methylation analysis identifies a metabolic memory profile in patient-derived diabetic foot ulcer fibroblasts

Author: Lara K Park, Anna G Maione, Avi Smith, Behzad Gerami-Naini, Lakshmanan K Iyer, David J Mooney, Aristidis Veves, Jonathan A Garlick, Lara K Park, Anna G Maione, Avi Smith, Behzad Gerami-Naini, Lakshmanan K Iyer, David J Mooney, Aristidis Veves, and Jonathan A Garlick
Published: 2014
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180. Diabetes and Exercise

Author: Judith G. Regensteiner, Jane E. B. Reusch, Kerry J. Stewart, Aristidis Veves, Judith G. Regensteiner, Jane E. B. Reusch, Kerry J. Stewart, and Aristidis Veves
Subjects: Diabetes--Exercise therapy
Abstract: Diabetes is a major public health problem in the United States. This collection, Diabetes and Exercise, discusses the extent of the problem of diabetes and sedentary lifestyle and presents a compelling rationale for the importance of increased physical activity and exercise in persons with diabetes. The concept of exercise as medicine has a strong but underappreciated scientific basis for the prevention and treatment of diabetes. Diabetes and Exercise, compiled by a team of experts in the field, focuses on both the physiological and practical aspects of the beneficial effects of exercise. This thorough collaboration provides the why's and how's to implementing the physical activity and exercise changes so important in diabetes prevention and disease management.
Published: 2009

181. The Diabetic Foot

Author: Thanh L. Dinh and Aristidis Veves
Published: 2003
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182. Foot Pressure Abnormalities in the Diabetic Foot

Author: Aristidis Veves, Barry I. Rosenblum, and Thomas E. Lyons
Subjects: medicine.medical_specialty, Diabetic neuropathy, business.industry, Plantar pressure, Orthotics, medicine.disease, Diabetic foot, Physical medicine and rehabilitation, Medicine, Metatarsal head, Foot pressure, business, Foot (unit), Computer technology
Abstract: For decades, foot pressure measurements have been used to evaluate many medical conditions. Early techniques to assess plantar foot pressure were simple, yet innovative, methods that provided investigators with semiquantitative data. The introduction of the optical pedobarograph significantly improved the accuracy of foot pressure measurements. Measurement of foot pressures has advanced over the years and now includes computer technology that allows for accurate and reproducible measurements.
Published: 2003
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183. Living Skin Equivalents for Diabetic Foot Ulcers

Author: Hau T. Pham, Thanh L. Dinh, and Aristidis Veves
Published: 2003
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184. Vascular Abnormalities in the Prediabetic State

Author: A. Enrique Caballero, Su Chi Lim, Edward S. Horton, and Aristidis Veves
Published: 2003
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185. Microcirculation of the Diabetic Foot

Author: Osama Hamdy, K. Abuelenin, and Aristidis Veves
Published: 2003
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186. Diabetic neuropathy and microcirculation

Author: Chantel Hile and Aristidis Veves
Subjects: medicine.medical_specialty, Diabetic neuropathy, Endothelium, Nitric Oxide Synthase Type III, Endocrinology, Diabetes and Metabolism, Vasodilation, Microcirculation, Diabetic Neuropathies, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, Humans, Neurons, Kidney, business.industry, Blood flow, medicine.disease, Diabetic foot, Axons, Diabetic Foot, Endocrinology, medicine.anatomical_structure, Cardiology, Endothelium, Vascular, Nitric Oxide Synthase, Poly(ADP-ribose) Polymerases, business
Abstract: The microcirculation in diabetic and neuropathic feet is subject to the same changes found in other end organs of diabetic patients, such as the retina or the kidney. Complications such as foot ulceration lead to further morbidity and hospitalizations. Research into the causes of microcirculatory dysfunction has revealed an interplay of numerous factors. The most prominent findings are impaired endothelium-dependent and -independent vasodilation and reduced or absent nerve-axon reflex-related vasodilation. This renders the diabetic foot unable to mount a vasodilatory response under conditions of stress, such as injury, and makes it functionally ischemic even in the presence of satisfactory blood flow under normal conditions.
Published: 2003

187. Lifestyle modification improves endothelial function in obese subjects with the insulin resistance syndrome

Author: Antonella Caselli, Catherine Jarema, Kerry Ovalle, A. Enrique Caballero, Panayiotis A. Economides, Satoko Porter, Cathy Mullooly, Amr Moussa, Aristidis Veves, Sarah Ledbury, Edward S. Horton, and Osama Hamdy
Subjects: Male, medicine.medical_specialty, Brachial Artery, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Blood Pressure, Body Mass Index, Endothelial activation, Nitroglycerin, Insulin resistance, Weight loss, Internal medicine, Diabetes mellitus, Weight Loss, Internal Medicine, medicine, Humans, Obesity, Endothelial dysfunction, Exercise, Life Style, Skin, Advanced and Specialized Nursing, Metabolic Syndrome, business.industry, Insulin, Microcirculation, Middle Aged, Intercellular adhesion molecule, medicine.disease, Endocrinology, Female, Endothelium, Vascular, medicine.symptom, business, Plasminogen activator, Blood Flow Velocity
Abstract: OBJECTIVE—Endothelial dysfunction has been reported in type 2 diabetic patients and in obese subjects with insulin resistance syndrome (IRS). This study evaluates the effects of weight reduction and exercise on vascular reactivity of the macro- and the microcirculation in obese subjects with IRS. RESEARCH DESIGN AND METHODS—We studied 24 obese subjects (9 men and 15 women, age 49.3 ± 1.9 years, BMI 36.7 ± 0.94 kg/m2, mean ± SEM) with IRS at baseline and after 6 months of weight reduction and exercise. Brachial artery flow-mediated dilation (FMD) and response to sublingual glyceryltrinitrate (GTN) were assessed by high-resolution ultrasound. Microvascular reactivity was evaluated by the laser-Doppler perfusion imaging after iontophoresis of acetylcholine and sodium nitroprusside. We also measured plasma levels of soluble intercellular adhesion molecule (sICAM), vascular adhesion molecule, von Willebrand factor, plasminogen activator inhibitor-1 (PAI-1) antigen, and tissue plasminogen activator antigen. RESULTS—This intervention resulted in 6.6 ± 1% reduction in body weight (P < 0.001) and significant improvement of insulin sensitivity index (2.9 ± 0.36 vs. 1.9 ± 0.33 [10−4 · min−1 · (μU ml−1)], P < 0.001). FMD significantly improved (12.9 ± 1.2% vs. 7.9 ± 1.0%, P < 0.001), whereas response to GTN and microvascular reactivity did not change. Similar observations were seen when the subjects were subclassified according to their glucose tolerance to normal glucose tolerance, impaired glucose tolerance, and type 2 diabetes. sICAM and PAI-1 significantly decreased (251.3 ± 7.7 vs. 265.6 ± 9.3 ng/ml, P = 0.018 and 36.2 ± 3.6 vs. 48.6 ± 3.9 ng/ml, P = 0.001, respectively). The relationship between percentage weight reduction and improved FMD was linear (R2 = 0.47, P = 0.001). CONCLUSIONS—We conclude that 6 months of weight reduction and exercise improve macrovascular endothelial function and reduces selective markers of endothelial activation and coagulation in obese subjects with IRS regardless of the degree of glucose tolerance.
Published: 2003

188. Role of C-nociceptive fibers in the nerve axon reflex-related vasodilation in diabetes

Author: Aristidis Veves, Jeremy N. Rich, Antonella Caselli, T. Hanane, and Luigi Uccioli
Subjects: Male, peripheral neuropathy, Vasodilation, Settore MED/13 - Endocrinologia, Nerve Fibers, Diabetic Neuropathies, Reference Values, Laser-Doppler Flowmetry, endothelium cell, forearm, nociception, Anesthetics, Local, Unmyelinated, Skin, clinical article, adult, nerve fiber C, article, Iontophoresis, Middle Aged, vasodilatation, medicine.anatomical_structure, Nociception, female, priority journal, Local, Anesthesia, controlled study, diabetes mellitus, diabetic nephropathy, disability, foot, human, male, measurement, microcirculation, vascular endothelium, Acetylcholine, Axons, Blood Flow Velocity, Diabetes Mellitus, Female, Foot, Forearm, Humans, Linear Models, Nerve Fibers, Unmyelinated, Reflex, Sodium nitroprusside, medicine.drug, Topical anesthetic, medicine, Anesthetics, business.industry, Neurology (clinical), business
Abstract: To evaluate the role of the C-nociceptive nerve fibers in nerve axon reflex-related vasodilation.Skin vascular reactivity, in response to iontophoresis of acetylcholine and sodium nitroprusside, was evaluated at both the forearm and the foot levels in 13 diabetic neuropathic (DN),11 nonneuropathic (D), and 9 healthy control (C) subjects. The total and nerve axon reflex-related vasodilation were measured by two single-point laser probes. A topical anesthetic was applied on the contralateral forearm and foot, and all the measurements were repeated.Dermal anesthesia resulted in a reduction of the nerve axon reflex-related vasodilation at the forearm in all three groups (C 70.7 +/- 12%, D 59.7 +/- 7%, and DN 73.5 +/- 14%; percentage of reduction over preanesthesia response, mean +/- SEM; p0.001) and at the foot in the two nonneuropathic groups (C 74 +/- 10% and D 68.9 +/- 9%; p0.001 versus before anesthesia). This reduction was absent at the foot of the neuropathic patients (DN -4 +/- 21%; p = NS versus before anesthesia). A correlation was found between the nerve axon reflex-related response and measurements of nerve function (neuropathy disability score, r = -0.425, p0.017; vibration perception threshold, r = -0.527, p0.002; Semmes-Weinstein monofilament perception, r = -0.619, p0.001).The nerve axon reflex-related vasodilation is directly related to the function of the C-nociceptive fibers and is significantly associated with other nerve function measurements. As this is an objective measurement, it has the potential to be used as an alternative to currently employed techniques to evaluate small-fiber function.
Published: 2003

189. A randomized, controlled trial of Promogran (a collagen/oxidized regenerated cellulose dressing) vs standard treatment in the management of diabetic foot ulcers

Author: Aristidis Veves, Peter Sheehan, and Hail T. Pham
Subjects: Adult, Male, medicine.medical_specialty, Randomization, Hemostatics, law.invention, Randomized controlled trial, law, Multicenter trial, Statistical significance, medicine, Humans, Cellulose, Oxidized, Prospective Studies, Prospective cohort study, Aged, Aged, 80 and over, Wound Healing, business.industry, Standard treatment, Middle Aged, medicine.disease, Diabetic foot, Bandages, Diabetic Foot, Surgery, Diabetic foot ulcer, Treatment Outcome, Female, Collagen, business
Abstract: 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 multicenter trial. Setting University teaching hospitals and primary care centers. Patients A total of 276 patients from 11 centers were enrolled in the study. The mean age of the patients was 58.3 years (range, 23-85 years). All patients had at least 1 diabetic foot ulcer. Interventions Patients were randomized to receive Promogran (n = 138) or moistened gauze (control group; n = 138) and a secondary dressing. Dressings were changed when clinically required. The maximum follow-up for each patient was 12 weeks. Main Outcome Measure Complete healing of the study ulcer (wound). Results After 12 weeks of treatment, 51 (37.0%) Promogran-treated patients had complete wound closure compared with 39 (28.3%) control patientss, but this difference was not statistically significant ( P = .12). The difference in healing between treatment groups achieved borderline significance in the subgroup of patients with wounds of less than 6 months' duration. In patients with ulcers of less than 6 months' duration, 43 (45%) of 95 Promogran-treated patients healed compared with 29 (33%) of 89 controls ( P = .056). In the group with wounds of at least 6 months' duration, similar numbers of patients healed in the control (10/49 [20%]) and the Promogran (8/43 [19%]; P = .83) groups. No differences were seen in the safety measurements between groups. Patients and investigators expressed a strong preference for Promogran compared with moistened gauze. Conclusions Promogran was comparable to moistened gauze in promoting wound healing in diabetic foot ulcers. It showed an additional efficacy for ulcers of less than 6 months' duration that was of marginal statistical significance. Furthermore, Promogran had a safety profile that was similar to that of moistened gauze, with greater user satisfaction. Therefore, Promogran may be a useful adjunct in the management of diabetic foot ulceration, especially in ulcers of less than 6 months' duration.
Published: 2002

190. A prospective, randomized, controlled double-blind study of a moisturizer for xerosis of the feet in patients with diabetes

Author: Hau Trung, Pham, Lois, Exelbert, Arlynn Carole, Segal-Owens, and Aristidis, Veves
Subjects: Foot Dermatoses, Male, Double-Blind Method, Emollients, Humans, Urea, Female, Lactic Acid, Prospective Studies, Middle Aged, Diabetic Foot, Statistics, Nonparametric, Aged
Abstract: Xerosis is frequently noted in the feet of people with diabetes. The presence of xerosis increases the risk of complications, including infection and ulceration, making it imperative to counteract its effects. A prospective, randomized, controlled double-blind study was conducted to compare the efficacy of a test moisturizer containing 10% urea and 4% lactic acid versus its emulsion base vehicle in the treatment of xerosis of the feet in patients with diabetes. Forty patients (mean age 62 +/- 11 years) with diabetes and moderate-to-severe xerosis of both feet were enrolled. Xerosis severity was assessed using a nine-point Xerosis Assessment Scale. The tested moisturizer was applied to one foot and the vehicle to the other, twice a day, for 4 weeks. The regression of xerosis also was evaluated 2 weeks following discontinuation of the treatments. Progress was noted weekly with photographs and examination. Feet treated with the vehicle cream (control) had an initial mean xerosis grading of 6.17 (+/- 0.79) and a final xerosis grading of 4.38 (+/- 2.20). In the treatment group, mean xerosis grading diminished from 6.13 (+/- 0.73) to 3.19 (+/- 2.23) after 4 weeks (P0.01). The difference between control and treatment remained statistically significant following discontinuation of cream application. In this study, regular use of a moisturizer was found to be beneficial in the treatment of moderate-to-severe xerosis of the feet in patients with diabetes. The cream containing 10% urea and 4% lactic acid provided faster and better improvement with significantly less xerosis regression.
Published: 2002

191. The forefoot-to-rearfoot plantar pressure ratio is increased in severe diabetic neuropathy and can predict foot ulceration

Author: David G. Armstrong, John M. Giurini, Antonella Caselli, Aristidis Veves, and Hau Pham
Subjects: Adult, Male, Metatarsophalangeal Joint, medicine.medical_specialty, Diabetic neuropathy, Heel, Endocrinology, Diabetes and Metabolism, Motor Activity, Severity of Illness Index, Diabetic Neuropathies, Diabetes mellitus, Internal medicine, Internal Medicine, medicine, Pressure, Humans, Tibial nerve, Prospective cohort study, Foot Ulcer, Advanced and Specialized Nursing, business.industry, Forefoot, Forefoot, Human, medicine.disease, Prognosis, Surgery, body regions, Peripheral neuropathy, medicine.anatomical_structure, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Cardiology, Female, Tibial Nerve, business, Foot (unit)
Abstract: OBJECTIVE—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 the relationship between forefoot and rearfoot plantar pressure in diabetic patients with different degrees of peripheral neuropathy and their role in ulcer development. RESEARCH DESIGN AND METHODS—Diabetic patients of a 30-month prospective study were classified according to the neuropathy disability score: scores of 0, 1–5, 6–16, and 17–28 are defined as absent (n = 20), mild (n = 66), moderate (n = 95), and severe (n = 57) neuropathy, respectively. The F-Scan mat system was used to measure dynamic plantar pressures. The peak pressures under the forefoot and the rearfoot were selectively measured for each foot, and the forefoot-to-rearfoot ratio (F/R ratio) was calculated. RESULTS—Foot ulcers developed in 73 (19%) feet. The peak pressures were increased in the forefoot of the severe and moderate neuropathic groups compared with the mild neuropathic and nonneuropathic groups (6.2 ± 4.5 and 3.8 ± 2.7 vs. 3.0 ± 2.1 and 3.3 ± 2.1 kg/cm2 [mean ± SD], respectively; P < 0.0001). The rearfoot pressures were also higher in the severe and moderate neuropathic groups compared with the mild neuropathic and nonneuropathic groups (3.2 ± 2.0 and 3.2 ± 1.9 vs. 2.5 ± 1.3 and 2.3 ± 1.0, respectively; P < 0.0001). The F/R ratio was increased only in the severe group compared with the moderate and mild neuropathic and nonneuropathic groups (2.3 ± 2.4 vs. 1.5 ± 1.2, 1.3 ± 0.9, and 1.6 ± 1.0, respectively; P < 0.0001). In a logistic regression analysis, both forefoot pressure (odds ratio 1.19 [95% CI 1.11–1.28], P < 0.0001) and the F/R ratio (1.37 [1.16–1.61], P < 0.0001) were related to risk of foot ulceration, whereas rearfoot pressure was not. CONCLUSIONS—Both the rearfoot and forefoot pressures are increased in the diabetic neuropathic foot, whereas the F/R ratio is increased only in severe diabetic neuropathy, indicating an imbalance in pressure distribution with increasing degrees of neuropathy. This may lend further evidence toward the concept that equinus develops in the latest stages of peripheral neuropathy and may play an important role in the etiology of diabetic foot ulceration.
Published: 2002

192. Effect of diabetes on renal medullary oxygenation during water diuresis

Author: Franklin H. Epstein, Aristidis Veves, and Pottumarthi V. Prasad
Subjects: Adult, Male, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Diuresis, Blood Pressure, Oxygen Consumption, Reference Values, Diabetes mellitus, Internal medicine, Internal Medicine, medicine, Renal medulla, Diabetes Mellitus, Humans, Aged, Advanced and Specialized Nursing, Kidney Medulla, medicine.diagnostic_test, Vascular disease, business.industry, Body Weight, Water, Magnetic resonance imaging, Oxygenation, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Body Height, Blood pressure, Endocrinology, medicine.anatomical_structure, Creatinine, Cardiology, Female, business, Kidney disease
Abstract: OBJECTIVES—To study the effect of water diuresis on renal medullary and cortical oxygenation in patients with diabetes using blood oxygenation level–dependent magnetic resonance imaging (BOLD MRI). RESEARCH DESIGN AND METHODS—Nine mild diabetic subjects (48 ±2.7 years of age, six women) and nine nondiabetic subjects of similar age and sex, all without known vascular or renal disease, were studied noninvasively by MRI before and during water diuresis. RESULTS—Water diuresis induced an increase in medullary oxygenation in control subjects, producing a decrease in R2* (apparent spin-spin relaxation time) of 1.89 ±0.27 (P < 0.01), but no significant change in the group of diabetic subjects. CONCLUSIONS—These findings in middle-aged diabetic subjects, which resembled those previously described in elderly subjects >65 years of age, suggest early impairment of adaptive vasodilatation within the renal medulla in diabetes.
Published: 2002

193. Diabetic Foot, The

Author: Frank W. LoGerfo, Aristidis Veves, and John M. Giurini
Subjects: medicine.medical_specialty, business.industry, Ophthalmology, Medicine, business, medicine.disease, Diabetic foot
Published: 2002
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194. Effects of Thiazolidinediones on Vascular Reactivity and Endothelial Dysfunction

Author: Rola Saouaf, A. Enrique Caballero, Aristidis Veves, and Edward S. Horton
Subjects: medicine.medical_specialty, business.industry, Insulin, medicine.medical_treatment, Type 2 diabetes, medicine.disease, Impaired glucose tolerance, Insulin resistance, Diabetes mellitus, Internal medicine, medicine, Cardiology, Hyperinsulinemia, business, Dyslipidemia, Macrovascular disease
Abstract: Type 2 diabetes frequently leads to the development of micro- and macrovascular complications [1]. Coronary heart disease (CHD) is particularly relevant in diabetes as its frequency is two to four times higher than in people without diabetes and represents the main cause of death [1]. In fact, diabetes has been recently recognized as equivalent to preexisting cardiovascular disease as a risk factor for a coronary event [2]. People with impaired glucose tolerance (IGT), a preceding stage to the development of Type 2 diabetes, also have an increased risk for the development of CHD. Therefore, hyperglycemia per se represents only one of many factors in the development of macrovascular disease. It is well recognized that people in the prediabetic state usually exhibit the insulin resistance syndrome that includes multiple metabolic abnormalities such as dyslipidemia, hypertension, obesity, and coagulation/fibrinolysis disturbances [3]. The presence of these factors contributes to the increase in cardiovascular risk even before Type 2 diabetes appears [4]. Since the hallmark in the insulin resistance syndrome is the existence of a decreased effect of insulin to regulate metabolic processes, a significant amount of work has focused on understanding its relationship to the development of atherosclerosis and cardiovascular disease. Hyperinsulinemia, a surrogate marker for the presence of insulin resistance, was found to be an independent risk factor for cardiovascular disease in nondiabetic individuals in the Quebec Cardiovascular Study [5].
Published: 2002
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195. Discussion: Bioengineered Skin Constructs and Their Use in Wound Healing

Author: Aristidis Veves
Subjects: Skin, Artificial, Wound Healing, Tissue Engineering, business.industry, MEDLINE, Bioengineering, Bioinformatics, Bioengineered skin, Chronic disease, Tissue engineering, Chronic Disease, Humans, Wounds and Injuries, Medicine, Surgery, business, Wound healing
Published: 2011
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196. Role of Experimental Socks in the Care of the High-Risk Diabetic Foot: A multicenter patient evaluation study

Author: D. H. Richie, H. J. Murray, Aristidis Veves, Andrew J.M. Boulton, and Matthew J Young
Subjects: Advanced and Specialized Nursing, Research design, medicine.medical_specialty, business.industry, Vascular disease, computer.internet_protocol, Endocrinology, Diabetes and Metabolism, medicine.disease, Diabetic foot, Patient satisfaction, SOCKS, Diabetes mellitus, Internal Medicine, Physical therapy, medicine, Complication, business, computer, Foot (unit)
Abstract: OBJECTIVE To assess the acceptability of specially designed socks to provide satisfactory pressure relief in the insensitive, high-risk, diabetic foot. We have conducted a longitudinal multicenter patient evaluation study to assess the acceptability of such hosiery in neuropathic diabetic patients. RESEARCH DESIGN AND METHODS A group of 86 neuropathic diabetic patients (69 males, 14 with type I diabetes) with a mean age of 63 yr (range 34–85 yr), and a diabetes duration of 16 yr (range 1–45 yr) participated in the study. Peripheral vascular disease was present in 28 (33%) patients, previous foot ulceration in 39 (44%) patients, and active ulceration was present in 11 (13%) patients. All patients were provided with three pairs of specially designed socks and 80 patients with extra-depth shoes. Evaluation and foot examination were performed at 3 and 6 mo. RESULTS Socks were worn for a mean of 6 days/wk (range 1–7 days/wk). Patient satisfaction evaluated at both visits was good or very good in 85%, average in 12%, and poor in 3% of patients. Ten ulcers healed during this period, and seven new ulcers occurred. Intention to continue wearing the socks, most or all of the time, was expressed by 84% of patients. CONCLUSIONS We conclude that the experimental socks have a high level of patient satisfaction when worn with suitable shoes, and may be an acceptable and inexpensive addition to existing methods of protecting the high-risk insensitive diabetic foot.
Published: 1993
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197. A comparison of the Musgrave Footprint and optical pedobarograph systems for measuring dynamic foot pressures in diabetic patients

Author: Aristidis Veves, Ajm Boulton, Matthew J Young, and H. J. Murray
Subjects: medicine.medical_specialty, business.industry, medicine, Orthopedics and Sports Medicine, Mean age, In patient, Podiatry, Foot pressure, Nuclear medicine, business, Foot (unit), Large size, Surgery
Abstract: The dynamic foot pressures of 21 diabetic patients mean age 55.4 (range 50–68) years, duration of diabetes 21 (9–40) years, 16 with clinical neuropathy, 5 with no evidence of peripheral neuropathy, were measured on the optical pedobarograph (OPG) and Musgrave foot pressure systems. The results were; OPG versus Musgrave in each region: Great toe (mean±sem) 6.16±0.80 kg cm −2 vs 6.44±0.83 kg cm −2 (p=NS), r=0.64 p −2 vs 5.9±0.36 kg cm −2 (p −2 vs 4.75±0.54 kg cm −2 (p= −2 vs 5.2±0.63 kg cm −2 (p=NS), r=0.42 p −2 compared with pressures of over 25 kg cm −2 measured with the OPG, and the Musgrave has a load measuring element of a relatively large size. In conclusion, both systems have relative advantages and disadvantages and can be recommended for routine clinical use but the Musgrave may have limitations in patients with very high foot pressures.
Published: 1993
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198. Diabetes and Cardiovascular Disease

Author: Michael T. Johnstone and Aristidis Veves
Subjects: medicine.medical_specialty, Heart disease, Vascular disease, business.industry, medicine.disease, Diabetic foot, Polycystic ovary, Diabetic nephropathy, Endocrinology, Insulin resistance, Internal medicine, Diabetes mellitus, medicine, Metabolic syndrome, business
Abstract: Part I. Pathophysiology Effects of Insulin on the Vascular System Helmut O. Steinberg Effects of Diabetes and Insulin Resistance on Endothelial Functions Zhiheng He, Keiko Naruse, and George L. King Diabetes and Advanced Glycoxidation End-Products Melpomeni Peppa, Jaime Uribarri, and Helen Vlassara The Renin-Angiotensin System in Diabetic Cardiovascular Complications Edward P. Feener PPARs and Their Emerging Role in Vascular Biology, Inflammation, and Atherosclerosis Jorge Plutzky Diabetes and Thrombosis David J. Schneider and Burton E. Sobel Role of Estrogens in Vascular Disease in Diabetes: Lessons Learned From the Polycystic Ovary Syndrome Agathocles Tsatsoulis and Panayiotis Economides Poly(ADP-Ribose) Polymerase Activation and Nitrosative Stress in the Development of Cardiovascular Disease in Diabetes Pal Pacher and Csaba Szabo Adiponectin and the Cardiovascular System Suketu Shah, Alina Gavrila, and Christos S. Mantzoros Nitric Oxide and Its Role in Diabetes Mellitus Michael T. Johnstone and Eli Gelfand Diabetes and Atherosclerosis Maria F. Lopes-Virella and Gabriel Virella The Use of Animal Models to Study Diabetes and Atherosclerosis and Potential Anti-Atherosclerotic Therapies Peter D. Reaven and Wulf Palinski Part II. Clinical A. Risk Factors The Metabolic Syndrome and Vascular Disease S. J. Creely, Aresh J. Anwar, and Sudhesh Kumar Diabetes and Hypertension Samy I. McFarlane, Amal F. Farag, David Gardner, and James R. Sowers Diabetes and Dyslipidemia Asha Thomas-Geevarghese, Catherine Tuck, and Henry N. Ginsberg B. Microcirculation Diabetic Retinopathy Lloyd Paul Aiello and Jerry Cavallerano Diabetic Nephropathy Richard J. Solomon and BijanRoshan Diabetic Neuropathy Rayaz A. Malik and Aristidis Veves Microcirculation of the Diabetic Foot Chantel Hile and Aristidis Veves C. Cardiovascular System: Peripheral Vascular System Epidemiology of Peripheral Vascular Disease Stephanie G. Wheeler, Nicholas L. Smith, and Edward J. Boyko Noninvasive Methods to Assess Vascular Function and Pathophysiology Peter G. Danias and Rola Saouaf Peripheral Vascular Disease in Patients With Diabetes Mellitus Bernadette Aulivola, Allen D. Hamdan, and Frank W. LoGerfo Therapeutic Interventions to Improve Endothelial Function in Diabetes Lalita Khaodhiar and Aristidis Veves D. Cardiovascular System: Cardiac Preoperative Assessment and Perioperative Management of the Surgical Patient With Diabetes Mellitus Alanna Coolong and Mylan C. Cohen Diabetes and Percutaneous Interventional Therapy David P. Lorenz, Joseph P. Carrozza, and Lawrence Garcia Cardiac Surgery and Diabetes Mellitus Tanveer A. Khan, Pierre Voisine, and Frank W. Sellke Heart Failure and Cardiac Dysfunction in Diabetes Lawrence H. Young, Raymond R. Russell, III, and Deborah Chyun Diabetes Mellitus and Heart Disease Michael T. Johnstone and George P. Kinzfogl Index
Published: 2001
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199. Sural nerve fibre pathology in diabetic patients with mild neuropathy: relationship to pain, quantitative sensory testing and peripheral nerve electrophysiology

Author: I. Siddique, Aristidis Veves, Wolfgang Schady, Ajm Boulton, D Walker, Rayaz A. Malik, and R. H. Lye
Subjects: Adult, Male, Pathology, medicine.medical_specialty, Neural Conduction, Schwann cell, Action Potentials, Pain, Sensory system, Sural nerve, Nerve fiber, Vibration, Pathology and Forensic Medicine, Cellular and Molecular Neuroscience, Diabetic Neuropathies, Sural Nerve, Diabetes mellitus, Medicine, Humans, Axon, Myelin Sheath, Cell Size, business.industry, Middle Aged, medicine.disease, Axons, Electrophysiology, medicine.anatomical_structure, Peripheral neuropathy, Sensory Thresholds, Nerve Degeneration, Female, Neurology (clinical), Schwann Cells, business, Complication
Abstract: Nerve fibre pathology is poorly described in diabetic patients with mild neuropathy and has not been adequately related to clinical evaluation, quantitative sensory examination and neurophysiology. Sural nerve myelinated and unmyelinated fibre pathology was morphometrically quantified and related to the presence of pain and conventional measures of neuropathic severity in 15 diabetic patients with mild neuropathy and 14 control subjects. Diabetic patients demonstrated a significant (P
Published: 2001

200. Can VEGF reverse diabetic neuropathy in human subjects?

Author: George L. King and Aristidis Veves
Subjects: Vascular Endothelial Growth Factor A, medicine.medical_specialty, Diabetic neuropathy, Vasa Nervorum, Endothelial Growth Factors, Streptozocin, Diabetes Mellitus, Experimental, Rats, Sprague-Dawley, Polyol pathway, Neurotrophic factors, Internal medicine, Diabetes mellitus, Vasa nervorum, medicine, Laser-Doppler Flowmetry, Animals, Diabetic Nephropathies, Lymphokines, business.industry, Vascular Endothelial Growth Factors, Gene Transfer Techniques, Peripheral Nervous System Diseases, General Medicine, Genetic Therapy, Hypoxia (medical), medicine.disease, Sciatic Nerve, Rats, Endocrinology, Nerve growth factor, Peripheral neuropathy, Commentary, Female, Rabbits, medicine.symptom, Tibial Nerve, business
Abstract: Peripheral polyneuropathy is a common complication of diabetes that can clinically affect 30% of all diabetic patients and is the most common form of diabetic neuropathy. The main symptoms are numbness, tingling, burning, and shooting pain in the legs, whereas the physical findings include reduced pain, touch, and vibratory perception in a symmetrical stocking glove distribution (1, 2). Loss of protective sensation allows unperceived trauma and pressures of daily ambulation to cause foot ulcers, which can lead to prolonged immobilization or even amputation of the lower limb. The main histologic changes of diabetic polyneuropathy are loss of myelinated and unmyelinated fibers and segmental demyelination. Changes in the myelinated fibers can be measured functionally in vivo by quantitating nerve conduction velocities and amplitudes of evoked responses, which are objective techniques and can assess nerve function without relying solely on the patient’s subjective responses. In contrast, testing of small fibers is more difficult, as it is subjective and dependent on the patients’ active participation (3). Hyperglycemia, which has emerged as a major risk factor for the development of diabetic neuropathy, may affect the peripheral sensory nerves through several mechanisms (2). Several of the current hypotheses are shown in Figure Figure1.1. First, the increased flux through the polyol pathway in hyperglycemic patients may lead to intracellular sorbitol accumulation and, potentially, to osmotic increase or changes in the NAD/NADH ratio induced by the flux through the aldose reductase pathway. These changes can cause direct neuronal damage or decrease neuronal blood flow, indirectly leading to peripheral nerve hypoxia. Second, the activation of protein kinase C (PKC) in response to increased diacylglycerol levels via the de novo synthesis pathway can affect the Na, K ATPase, and other enzymes that are important for maintaining cellular membrane potential and nerve conduction. In addition, PKC activation can induce vasoconstriction and reduce neuronal blood flow. Third, the auto-oxidation of glucose causes increased production of reactive oxygen species and the formation of advanced glycation end products (AGEs) by nonenzymatic glycation of proteins. AGEs then bind to a cell-surface receptor and cause activation of the NF-κB, which is associated with endothelial dysfunction and reduced nerve blood flow. Finally, diabetes impairs the hepatic Δ-6 desaturation of dietary linolenic acid to γ-linolenic acid and results in reduced synthesis of vasoactive prostanoid in the vasa nervorum. This defect leads to reduced endoneurial blood flow and nerve hypoxia. Each of these models finds some support in the various biochemical abnormalities seen in peripheral nerves and vasculature of diabetic patients. Figure 1 Pathogenesis of diabetic neuropathy. Factors implicated in the pathogenesis of diabetic neuropathy include the activation of the polyol pathway, the activation of protein kinase C (PKC), increased oxidative stress, the impaired N-6 fatty acid metabolism, ... Other physiological changes that accompany the onset of diabetes may also contribute to peripheral neuropathy. In particular, decreased blood flow to these nerves is one of the earliest functional findings in the development or induction of diabetes. The resulting local hypoxia in the peripheral nerves is believed to be a major pathogenic factor, although impaired mitochondrial functions and apoptosis of neurons and Schwann cells also occurs with similar timing and may act independently of hypoxia to induce peripheral nerve dysfunction. In addition, reduction in neurotrophic factors such as nerve growth factor availability (including neurotrophin-3 [NT-3], brain-derived neurotrophic factor, and neurotrophin-4/5 [NT-4/5]) and aberrant phosphorylation of the neurofilaments that are responsible for the structural nerve axon integrity have also been implicated in the pathogenesis of diabetic neuropathy.
Published: 2001

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