Calcium-based antibiotic delivery effectiveEfficacy and safety of a bio-absorbable antibiotic delivery in calcium sulphate granules for the treatment of osteomyelitis in patients with diabetic foot: A randomized, double blinded, controlled clinical study The BIG D-FOOT study.
We conducted a randomized, double-blind, placebo-controlled trial to investigate the effectiveness of calcium-sulphate granules as a local delivery system for antibiotics in treating diabetic foot osteomyelitis (DFO). This condition poses significant risks, including severe infections, potential amputations, and even death. Our goal was to determine whether this innovative treatment could reduce post-surgical infectious complications in patients suffering from DFO.
The trial included adult participants with diabetes and specifically targeted Texas grade 3 ulcers that were complicated by osteomyelitis and deep tissue infections. We monitored the primary outcomes over a period of 12 weeks, focusing on the percentage of patients experiencing various infectious complications like wound dehiscence, recurrence of DFO, and the emergence of new infections in nearby areas.
Remarkably, our findings revealed that the use of antibiotic-impregnated calcium-sulphate granules showed promising results. Out of the first 20 cases, only 25% developed the primary composite end-point of infection complications. All post-surgical complications were confined to the placebo group, highlighting a significant difference in outcomes based on the treatment administered.
This study stands out in demonstrating the potential benefits of using calcium-sulphate granules to improve the prognosis for patients with DFO, while also being economically sustainable.
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Calcium's uncertain effect on ulcersDigital Ulcers and Microvascular Abnormalities Presenting As the Initial Manifestations of Pre-scleroderma.
We observed a unique case involving a healthy 42-year-old woman who presented with recent monophasic Raynaud's phenomenon (RP) and digital ulcers. Despite the absence of other classic signs of systemic autoimmune disease, we found that the diagnosis of preclinical systemic sclerosis was possible due to abnormalities detected through capillaroscopy.
The treatment regimen included hydroxychloroquine, a statin, and a calcium antagonist. While calcium was part of this trio, it is important to note that the specific impact of calcium on ulcer healing couldn't be isolated since it was administered with other medications.
Ultimately, four years after starting the treatment, the patient had no further instances of digital ulcers and experienced notable improvement in her RP. This case illustrates how pre-scleroderma can unfold without the typical clinical or immunological markers and highlights the need for awareness of microvascular changes in diagnosing early stages of systemic sclerosis.
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Calcium accelerates ulcer healingDegree of sulfation of freeze-dried calcium alginate sulfate scaffolds dramatically influence healing rate of full-thickness diabetic wounds.
Addressing the challenge of diabetic foot ulcers (DFUs) is critical, as these chronic wounds affect individuals of all ages and can lead to severe complications. In our exploration, we investigated the potential of calcium alginate sulfate scaffolds as a new biomaterial for promoting wound healing in a diabetic mouse model.
We created alginate sulfate solutions with varying degrees of sulfation and then transformed them into scaffolds suitable for use as wound dressings. These scaffolds demonstrated favorable properties in terms of swelling, porosity, and mechanical strength, indicating they could effectively manage exudate while enhancing healing.
After confirming their safety and compatibility through testing, we applied these calcium alginate sulfate scaffolds to treat full-thickness ulcers. The results were promising; wounds treated with these scaffolds healed significantly faster than those treated with traditional alginate or untreated wounds. Histological analysis revealed that the healed skin tissue had regenerative properties similar to healthy tissue, with normal layer structure and collagen deposition.
Overall, the study suggests that calcium in the form of alginate sulfate plays a crucial role in wound healing in diabetic mice, potentially paving the way for new treatment options for DFUs.
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Vidofludimus calcium shows promiseVidofludimus Calcium in Patients With Moderate-to-Severe Ulcerative Colitis: A Randomized, Placebo-Controlled, Phase 2 Trial.
We conducted a study to understand the effects of vidofludimus calcium, a dihydroorotate dehydrogenase inhibitor, on patients suffering from moderate to severe ulcerative colitis (UC). The research involved a randomized, placebo-controlled trial where participants received either varying doses of vidofludimus calcium or a placebo over a period of ten weeks. Our goal was to determine the effectiveness of this treatment in achieving clinical remission from UC symptoms.
In our findings, 14% of the patients taking vidofludimus calcium achieved clinical remission at the end of the ten-week treatment period. Interestingly, among patients not on corticosteroids, 12% reached remission compared to just 4% in the placebo group. Furthermore, we noticed improvements in various secondary endpoints like endoscopic healing and steroid-free remission over a longer follow-up period.
While these results indicate a potential benefit of vidofludimus calcium in treating UC, it's essential to note that side effects were present but similar between the treatment and placebo groups. Common adverse events included headaches and hypertension, with one notable treatment-related issue—hematuria—observed only in higher doses of vidofludimus calcium.
Overall, we saw initial evidence supporting the use of this calcium derivative for ulcerative colitis treatment, but it’s crucial to remember that further studies are needed to fully understand its efficacy and safety profile.
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Calcium's role in ulcer healingEffect of aspirin on platelet-rich plasma of diabetes mellitus with lower extremity atherosclerosis.
We explored the effects of calcium, particularly when paired with thrombin, on platelet-rich plasma (PRP) and its role in treating diabetic foot ulcers (DFUs). Through our study, we analyzed PRP derived from diabetic patients—some taking aspirin and others not—and compared it to that from healthy volunteers.
Our findings showed that the growth factor levels in activated PRP were lower in diabetic patients than in healthy individuals, although there was no significant difference between the two diabetic groups regarding those levels. While we observed that PRP from healthy volunteers facilitated better wound healing compared to that of diabetic patients, the calcium used in activation did not seem to affect the outcome significantly.
Essentially, while calcium, when combined with thrombin, plays a role in preparing PRP, it doesn't significantly enhance ulcer healing in diabetic patients. Thus, our study suggests that while calcium treatment is safe for use with PRP therapy, it might not offer any added benefit for promoting healing in diabetic ulcers. The PRP from healthy volunteers appears to be a more effective alternative for aiding in the repair of DFUs.
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