Diabetes
* Monochromatic infrared energy. A study published in the December 2005 issue of Diabetes Care investigated the effects of monochromatic infrared energy (MIRE) on plantar sensation in patients with diabetic peripheral neuropathy. The 39 patients enrolled in this randomized, double-blind, placebo-controlled, 8-week study received 30 minutes of active or placebo MIRE 3 times a week for 4 weeks. The investigators tested plantar sensation with a 5.07 monofilament at the start of the study (M1), after 4 weeks of treatment (M2), and after 4 more weeks of nontreatment (M3). They then totaled the number of sites at which patients could sense the monofilament for each of the 3 study stages.
The average number of sites at which the monofilament could be sensed increased for the active and the placebo groups. Both groups reported significant gains from M1 to M2 (P< .002) and from M1 to M3 (P<.002). The researchers concluded that 30 minutes of active MIRE applied 3 days per week for 4 weeks was no more effective than placebo MIRE in increasing sensation in individuals with diabetic peripheral neuropathy.
Source: Clifft JK, Kasser RJ, Newton TS, Bush AJ. The effect of monochromatic infrared energy on sensation in patients with diabetic peripheral neuropathy. Diabetes Care. 2005;28:2896-2900.
* Swab cultures vs percutaneous bone biopsy. A study published in the January 2006 issue of Clinical Infectious Diseases evaluated the efficacy of superficial swab cultures versus percutaneous bone biopsy in identifying bone bacteria in patients with diabetic foot osteomyelitis. Results indicated that cultures are not reliable and that the biopsy method seems to be a safe method to diagnose patients with this condition.
To determine these results, researchers in France reviewed the medical charts of 76 patients with foot osteomyelitis who underwent a surgical percutaneous bone biopsy during an 8-year period at a single diabetic foot clinic. The 76 patients studied had 81 episodes of foot osteomyelitis with positive results of culture bone biopsy specimens. The patients had not received antibiotic therapy for at least 4 weeks before the biopsy. Results of bone and swab cultures were identical for 12 of 69 (17.4%) patients, and bone bacteria were isolated from the corresponding swab culture in 21 of 69 (30.4%) patients.
Source: Senneville E, Melliez H, Beltrand E, et al. Culture of percutaneous bone biopsy specimens for diagnosis of diabetic foot osteomyelitis: concordance with ulcer swan cultures. Clin Infect Dis. 2006;42:57-62.
* Investigational drug study.King Pharmaceuticals, Inc, Bristol, TN, has begun a Phase II clinical trial program evaluating the safety and efficacy of its topical investigational drug, MRE0094, in patients with chronic, neuropathic, diabetic foot ulcers.
MRE0094 is a novel adenosine A2A receptor agonist that favorably affects the inflammation associated with these wounds by regulating the response of inflammatory cells and mediators and by enhancing the tissue proliferation phase of wound healing, according to the company. In a Phase I study, no safety issues related to MRE0094 were observed; positive effects on the rate of wound closure were noted.
The Food and Drug Administration has not yet evaluated the safety or efficacy of MRE0094.
[black up pointing small triangle]Information:http://www.kingpharm.com
* Reducing microbial load.Dr Luca Dalla Paola, a surgeon with the diabetic foot unit of the Abano Terme Hospital in Italy, recently presented the results of a 218-patient controlled clinical study that assessed the safety and efficacy of Microcyn Technology(Oculus Innovative Sciences, Inc, Petaluma, CA) versus povidone-iodine (10%) in treating diabetic foot ulcers. Results of the clinical study were presented at the Stuttgart2005 conference.
In the study, the Microcyn Technology proved superior in reducing the number of bacterial strains, local adverse effects, surgical dehiscence, and healing time, according to the manufacturer. The key end point of the study was microbial load reduction at both entry and at surgery (or follow-up). Patients in the Microcyn Technology group showed a significantly improved rate of reduction of microbial load and healing time in open wounds as compared with the povidone-iodine group.
[black up pointing small triangle]Information:http://www.oculusis.com
Venous Ulcers
Pine tree bark extract, known as Pycnogenol, may be an important new finding in the treatment of venous ulcers, according to a study published in the November/December 2005 issue of Angiology. Conducted in Italy, the double-blind, placebo-controlled study investigated the healing of venous ulcers in 3 groups of 6 patients (16 of the initial 18 patients completed the trial). One group received 50-mg Pycnogenol tablets 3 times a day, another group received the oral Pycnogenol tablets 3 times a day combined with a local topical treatment of Pycnogenol powder, and the third group received placebo tablets. All participants received compression stockings to treat edema, and they had their ulcers cleansed and disinfected.
The combination of oral and local treatments resulted in a faster reduction of ulcerated areas compared with oral treatment only. The researchers said that Pycnogenol appears to have an important role in improving healing and signs and symptoms of venous ulcers.
Source: Belcaro G, Cesarone MR, Errichi BM, et al. Venous ulcers: microcirculatory improvement and faster healing with local pycnogenol. Angiology. 2005;56:699-705.