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Keywords = PEDIS staging

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14 pages, 357 KB  
Article
Discriminative Ability and Clinical Associations of Serum SIRT1, SIRT3, Apelin, and ELA in Patients with Diabetic Foot Infection
by Revşa Evin Canpolat-Erkan, Recep Tekin, Aysun Ekinci and Fırat Aşır
Life 2026, 16(5), 804; https://doi.org/10.3390/life16050804 - 12 May 2026
Viewed by 521
Abstract
Background: Diabetic foot infection (DFI) is a serious complication of diabetes mellitus associated with chronic inflammation, impaired wound healing, endothelial dysfunction, and oxidative stress. Sirtuin (SIRT) signaling and the apelinergic system have been implicated in these processes. This study aimed to evaluate serum [...] Read more.
Background: Diabetic foot infection (DFI) is a serious complication of diabetes mellitus associated with chronic inflammation, impaired wound healing, endothelial dysfunction, and oxidative stress. Sirtuin (SIRT) signaling and the apelinergic system have been implicated in these processes. This study aimed to evaluate serum SIRT1, SIRT3, apelin, and elabela (ELA) levels in patients with DFI and to examine their cross-sectional associations with clinical indicators, inflammatory markers, osteomyelitis, and glycemic control. Methods: This cross-sectional study included 47 patients with DFI and 42 healthy controls. Serum biomarker levels were measured using enzyme-linked immunosorbent assay (ELISA). Clinical and laboratory data, including the infection component of the PEDIS classification, were recorded. Group comparisons, Spearman correlation analyses, receiver operating characteristic (ROC) curve analysis, and logistic regression were performed. Results: Patients with DFI exhibited higher inflammatory and glycemic markers and lower hemoglobin and lipid levels compared with controls (p < 0.05). Serum SIRT1, SIRT3, apelin, and ELA levels were significantly lower in the DFI group and showed inverse correlations with HbA1c, PEDIS stage, disease duration, osteomyelitis, and inflammatory markers. Among these biomarkers, SIRT1 showed the highest discriminative ability within this cohort (AUC = 0.820). In an exploratory multivariable model, age and SIRT1 were independently associated with the presence of DFI. Conclusions: Serum SIRT1, SIRT3, apelin, and ELA levels were lower in patients with DFI and were associated with clinical and biochemical indicators of disease burden. Among these biomarkers, SIRT1 demonstrated the strongest discriminative ability within this cohort. These findings suggest that sirtuin signaling and the apelinergic system may be relevant in the biological context of DFI; however, they should be interpreted cautiously. The observed differences may reflect not only DFI but also underlying diabetes, glycemic burden, age, and systemic inflammation. Further prospective studies including appropriate diabetic comparator groups are required to clarify the clinical relevance and potential utility of these biomarkers. Full article
(This article belongs to the Special Issue Advanced Interventions in Diabetic Foot Ulcers)
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11 pages, 499 KB  
Article
Evaluation of Neutrophil-to-Lymphocyte Ratio and CRP-to-Albumin Ratio in the Risk Stratification of Diabetic Foot Infection Severity
by Revşa Evin Canpolat-Erkan, Recep Tekin and Aysun Ekinci
Medicina 2026, 62(2), 393; https://doi.org/10.3390/medicina62020393 - 17 Feb 2026
Cited by 3 | Viewed by 1401
Abstract
Background: Diabetic foot ulceration represents one of the most severe diabetic complications, with 50–60% progressing to diabetic foot infection (DFI). All diabetic wounds and diseases originate from peripheral vasculopathy and neuropathy, which are caused by oxidative stress and inflammatory processes. We investigated [...] Read more.
Background: Diabetic foot ulceration represents one of the most severe diabetic complications, with 50–60% progressing to diabetic foot infection (DFI). All diabetic wounds and diseases originate from peripheral vasculopathy and neuropathy, which are caused by oxidative stress and inflammatory processes. We investigated the utility of neutrophil-to-lymphocyte ratio (NLR) and CRP-to-albumin ratio (CAR) as cost-effective inflammatory biomarkers in DFI. Methods: The study included 58 DFI patients and 45 healthy controls. Disease severity was assessed using PEDIS staging. Routine laboratory parameters, NLR, derived NLR (d-NLR), and CAR were measured and compared. Results: In DFI patients, statistically significant increases (p < 0.001) were observed in NLR (3.12 vs. 1.99, p < 0.001), d-NLR (2.13 vs. 1.49, p = 0.003), CAR (0.91 vs. 0.03, p < 0.001), CRP (30.5 vs. 1.3 mg/L, p < 0.001) and PCT (0.1 vs. 0.02 μg/L, p < 0.001) values compared to the control group. Strong correlations existed between NLR, CAR and disease severity markers (CRP, PCT, HbA1c, osteomyelitis, PEDIS stage). ROC analysis revealed excellent discriminatory power for CAR (AUC = 0.915), PCT (AUC = 0.952), and CRP (AUC = 0.902), while NLR showed moderate performance (AUC = 0.702). Conclusions: NLR/CAR demonstrate excellent discrimination vs. healthy controls (AUC 0.915/0.702). The proposed workflow (NLR screening → CAR severity → PCT confirmation) requires prospective validation against with guidelines. Full article
(This article belongs to the Section Infectious Disease)
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10 pages, 1238 KB  
Article
Can Clinical Assessment of Postural Control Explain Locomotive Body Function, Mobility, Self-Care and Participation in Children with Cerebral Palsy?
by Blanka Vlčkova, Jiří Halámka, Markus Müller, Jose Manuel Sanz-Mengibar and Marcela Šafářová
Healthcare 2024, 12(1), 98; https://doi.org/10.3390/healthcare12010098 - 1 Jan 2024
Cited by 2 | Viewed by 3173
Abstract
Trunk control may influence self-care, mobility, and participation, as well as how children living with cerebral palsy (CP) move around. Mobility and Gross Motor performance are described over environmental factors, while locomotion can be understood as the intrinsic ontogenetic automatic postural function of [...] Read more.
Trunk control may influence self-care, mobility, and participation, as well as how children living with cerebral palsy (CP) move around. Mobility and Gross Motor performance are described over environmental factors, while locomotion can be understood as the intrinsic ontogenetic automatic postural function of the central nervous system, and could be the underlying element explaining the relationship between these factors. Our goal is to study the correlation among Trunk Control Measurement Scale (TCMS) and Pediatric Evaluation of Disability Inventory (PEDI) domains, as well as Locomotor Stages (LS). Methods: A feasibility observational analysis was designed including 25 children with CP who were assessed with these scales. Results: The strong correlation confirms higher levels of trunk control in children with better self-care, mobility and participation capacities. Strong correlations indicate also that higher LS show better levels of PEDI and TCMS domains. Conclusions: Our results suggest that more mature LS require higher levels of trunk control, benefitting self-care, mobility and social functions. Full article
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21 pages, 1967 KB  
Article
Transcriptome Dynamics of an Oyster Larval Response to a Conspecific Cue-Mediated Settlement Induction in the Pacific Oyster Crassostrea gigas
by Mary Grace Sedanza, Jalal Alshaweesh, Yi-Li Gao, Asami Yoshida, Hee-Jin Kim, Kenichi Yamaguchi and Cyril Glenn Satuito
Diversity 2022, 14(7), 559; https://doi.org/10.3390/d14070559 - 12 Jul 2022
Cited by 12 | Viewed by 5729
Abstract
The molecular mechanisms underlying the conspecific cue-mediated larval settlement in Crassostrea gigas is not yet fully understood. In this study, we described and compared the transcriptomes of competent pediveligers (Pedi) and conspecific cue-induced postlarvae (PL). A total of 2383 candidate transcripts were identified: [...] Read more.
The molecular mechanisms underlying the conspecific cue-mediated larval settlement in Crassostrea gigas is not yet fully understood. In this study, we described and compared the transcriptomes of competent pediveligers (Pedi) and conspecific cue-induced postlarvae (PL). A total of 2383 candidate transcripts were identified: 740 upregulated and 1643 downregulated transcripts, after settlement. Gene Ontology analysis revealed active chitin binding, calcium ion binding, and extracellular region processes in both stages. Results showed that the differential expression trend of six candidate transcripts were consistent between the quantitative real-time PCR and transcriptome data. The differential transcript expression related to shell formation showed closely linked dynamics with a gene regulatory network that may involve the interplay of various hormone receptors, neurotransmitters, and neuropeptide receptors working together in a concerted way in the Pedi and PL stages. Our results highlight the transcriptome dynamics underlying the settlement of oysters on conspecific adult shells and demonstrate the potential use of this cue as an attractant for wild and hatchery-grown oyster larval attachment on artificial substrates. It also suggests the possible involvement of an ecdysone signal pathway that may be linked to a neuroendocrine-biomineralization crosstalk in C. gigas settlement. Full article
(This article belongs to the Section Marine Diversity)
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13 pages, 2341 KB  
Article
Treponema spp. Isolated from Bovine Digital Dermatitis Display Different Pathogenicity in a Murine Abscess Model
by Rakel Arrazuria, Cameron G. Knight, Priyoshi Lahiri, Eduardo R. Cobo, Herman W. Barkema and Jeroen De Buck
Microorganisms 2020, 8(10), 1507; https://doi.org/10.3390/microorganisms8101507 - 30 Sep 2020
Cited by 13 | Viewed by 4600
Abstract
Digital dermatitis (DD) causes lameness in cattle with substantial negative impact on sustainability and animal welfare. Although several species of Treponema bacteria have been isolated from various DD stages, their individual or synergistic roles in the initiation or development of lesions remain largely [...] Read more.
Digital dermatitis (DD) causes lameness in cattle with substantial negative impact on sustainability and animal welfare. Although several species of Treponema bacteria have been isolated from various DD stages, their individual or synergistic roles in the initiation or development of lesions remain largely unknown. The objective of this study was to compare effects of the three most common Treponema species isolated from DD lesions in cattle (T. phagedenis, T. medium and T. pedis), both as individual and as mixed inoculations, in a murine abscess model. A total of 109 or 5 × 108Treponema spp. were inoculated subcutaneously, and produced abscess was studied after 7 days post infection. There were no synergistic effects when two or three species were inoculated together; however, T. medium produced the largest abscesses, whereas those produced by T. phagedenis were the smallest and least severe. Treponema species were cultured from skin lesions at 7 days post infection and, additionally, from the kidneys of some mice (2/5), confirming systemic infection may occur. Taken together, these findings suggest that T. medium and T. pedis may have more important roles in DD lesion initiation and development than T. phagedenis. Full article
(This article belongs to the Section Medical Microbiology)
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