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Papers by Aristidis Veves

Journal of Vascular Surgery, 2006

Objective: To examine the effect of a 12-week daily treatment with 160 mg of valsartan, an angiot... more Objective: To examine the effect of a 12-week daily treatment with 160 mg of valsartan, an angiotensin II receptor blocker, on the microcirculation and macrocirculation of type 2 diabetic patients (T2DM) and healthy subjects. Methods: This was a prospective, randomized, double-blind, placebo-controlled crossover study. Thirteen T2DM with no severe complications and 13 healthy subjects completed the trial. Results: Treatment with valsartan in T2DM improved the resting forearm skin blood flow and increased the resting brachial artery diameter but had no effects on arterial blood pressure, large vessel vascular reactivity, or carotid intima-media thickness. Resting skin blood flow increased by 60% (2%-90%; median and 25th-75th percentiles) during valsartan treatment and by only 2% (؊22% to 27%) during placebo treatment (P < .05). No changes were observed in the nondiabetic subjects. Immunostaining studies of forearm skin biopsy samples from T2DM and healthy subjects showed that valsartan reduced poly(adenosine diphosphate-ribose) polymerase (PARP) activity in 50% (6/12) of the subjects. PARP activity remained unchanged in placebo-treated subjects (P < .02). In addition, valsartan treatment increased CD31 staining in 33% (4/12) of the subjects, whereas no change was noted in sequential skin biopsy samples of placebo-treated subjects (P ‫؍‬ .057). Valsartan had no effect on the biochemical markers of endothelial cell activation and other cytokines, including CAMs, interleukin 6, tumor necrosis factor ␣, C-reactive protein, adiponectin, and plasma activator inhibitor 1.

Advances in wound care: the journal for prevention and healing

Efficacy and safety of a collagen-alginate topical wound dressing (FIBRACOL Collagen-Alginate Wou... more Efficacy and safety of a collagen-alginate topical wound dressing (FIBRACOL Collagen-Alginate Wound Dressing) in the treatment of diabetic foot ulcers was compared with that of regular gauze moistened with normal saline. Seventy-five patients with foot ulcers were assigned randomly in a 2:1 ratio to the collagen-alginate test dressing or the gauze dressing. At the end of the study, the mean percent reduction of the wound area was 80.6% +/- 6% in the collagen-alginate dressing group and 61.1% +/- 26% in the gauze dressing group (p = .4692). Thirty-nine (78%) patients treated with the collagen-alginate dressing achieved > or = 75% wound area reduction, compared with 15 (60%) of gauze-treated patients. Complete healing was achieved in 24 (48%) of the collagen-alginate dressing group and 9 (36%) of the gauze dressing group. Wound size, when averaged over the 8-week period and with the duration of the ulcer taken into account, was reduced significantly in the collagen-alginate dressing group, as compared with the gauze dressing group (df = 1, p = .0049). It is concluded that the collagen-alginate test dressing is as or more effective and safe as the currently used treatment.

The Journal of investigative dermatology, Jan 24, 2015

Occupational and environmental medicine

Particulate air pollution has been associated with several adverse cardiovascular health outcomes... more Particulate air pollution has been associated with several adverse cardiovascular health outcomes, and people with diabetes may be especially vulnerable. One potential pathway is inflammation and endothelial dysfunction-processes in which cell adhesion molecules and inflammatory markers play important roles. To examine whether plasma levels of soluble intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1) and von Willebrand factor (vWF) were associated with particle exposure in 92 Boston area residents with type 2 diabetes. Daily average ambient levels of air pollution (fine particles (PM2.5), black carbon (BC) and sulphates) were measured approximately 500 m from the patient examination site and evaluated for associations with ICAM-1, VCAM-1 and vWF. Linear regressions were fit to plasma levels of ICAM-1, VCAM-1 and vWF, with the particulate pollutant index, apparent temperature, season, age, race, sex, glycosylated haemoglobin, cholesterol, smoking ...

Clinical science (London, England : 1979), 1996

1. In order to determine whether rheological changes occur in neuropathic diabetic patients in th... more 1. In order to determine whether rheological changes occur in neuropathic diabetic patients in the absence of smoking, proteinuria, retinopathy or other factors thought to influence haemorheology, three groups of subjects were studied; 24 non-diabetic control subjects (C), 24 non-neuropathic (D) and 24 neuropathic (N) diabetic patients. The groups were matched for age, sex, type and duration of diabetes. No patient or control was a current smoker. No patient had clinically detectable retinopathy or microalbuminuria. Neuropathy was defined as a peroneal conduction velocity < 40 ms-1. All subjects were tested resting semi-recumbent after a light breakfast. 2. There were no significant differences in rheological or microvascular parameters between uncomplicated diabetic patients and non-diabetic control subjects, although peroneal nerve motor conduction velocity was significantly reduced in otherwise uncomplicated diabetic patients [C 51.7 +/- 6.0 ms-1 (mean +/- SD) versus D 45.1 +/...

Acta neuropathologica, 2001

Nerve fibre pathology is poorly described in diabetic patients with mild neuropathy and has not b... more 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 < 0.01) reduction in myelinated fibre density, but no change in fibre/axonal area, or g-ratio, compared to control subjects. Unmyelinated fibre degeneration was evidenced by an increase in the percentage of unassociated Schwann cell profiles (P < 0.0001) and a reduction in axon density (P < 0.0008) in diabetic patients. This was associated with a significant reduction in unmyelinated axon diameter (P < 0.001) with a shift of the size frequency distribution to the left (P < 0.02). Neuroph...

Advances in wound care : the journal for prevention and healing

The Western journal of medicine, 1993

Ostomy/wound management, 2002

Xerosis is frequently noted in the feet of people with diabetes. The presence of xerosis increase... more 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 gradin...

Recent Patents on Endocrine, Metabolic & Immune Drug Discovery, 2007

Diabetic foot ulceration stands as one of the most costly and debilitating complications of diabe... more Diabetic foot ulceration stands as one of the most costly and debilitating complications of diabetes and remains the leading cause of nontraumatic lower extremity amputation in the United States. Traditionally, ischemia, neuropathy, trauma, and infection were considered the culprits of the recurring chronic wound and treatment revolved largely around wound debridement and revascularization. However, recent investigations have uncovered an impaired cutaneous wound healing process in diabetes caused by cellular and molecular alterations in the diabetic microenvironment and have subsequently identified an array of potential molecular targets for intervention. Here, we review recent patents describing upcoming molecular technologies at various stages of development for treating foot ulceration in the diabetic patient. Target classes reviewed include immunomodulators, neuropeptides, and growth factors, and targets reviewed include lactoferrin, thymosin beta 4, T cell immune response cDNA 7, substance P, neuropeptide Y, vascular endothelial growth factor, fibroblast growth factor, nerve growth factor, connective tissue growth factor, hepatocyte growth factor, homeobox genes, and treprostinil. In the course of this presentation, the biology of wound healing and the pathobiology of impaired wound healing in diabetes are emphasized to illustrate how these future molecular therapeutics are intended to counteract disease pathology and promote normal wound repair.