Cultura

THE EFFECT OF USING MODERN TECHNOLOGY IN DETECTING AND EXAMINING INTESTINAL MICROBE

VOLUME 21, 2024

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Esraa Saleh Almalki, Nisrin Saad Ali Alruqi, Ahmad Saeed Onayzan Alharbi, Mohammad Khulaif Al Fuhaidi, Abdulaziz Abdullah Ali Althebyani
Mohammed Nasser Althobaiti, Maram Owayidh Algethami, Rafat Fareed Mohammad Dahwah, Mansour Alshamrani

Abstract

Infectious gastroenteritis is a diagnosis that depends greatly on traditional culture, which has a slow turnaround time and is unable to detect viruses, parasites, or fastidious bacteria, thus creating a serious ethiological gap in knowledge. The goal of the study was to determine the impact of shotgun metagenomic next -generation sequencing (mNGS) on the detection and analysis of intestinal microbes comparatively to its diagnostic capability, rapidity, and overall yield against the standard of care. A prospective, lab-based study where 200 stool samples were subjected to a conventional culture and a standardized mNGS workflow and compared statistically in terms of sensitivity, specificity and turnaround time, was conducted on patients with acute gastroenteritis. Findings indicated that mNGS was far better than culture, having a sensitivity of 96.7 -1 (95 CI: 88.7-99.1-1) and a 33.2 -hour improvement in average time-to-result (35.2 vs. 68.4-1 hours, p = 0.001). Moreover, mNGS added significant diagnostic information to the other tests by detecting viral and parasitic pathogens in 29.4% of culture-negative samples and antimicrobial resistance genes in 44.5% of all samples. We conclude that contemporary metagenomic technology is a revolutionary, more holistic method of detecting intestinal pathogens with the potential to provide rapid, true, and comprehensive diagnosis which is essential in enhancing the management and antimicrobial stewardship of patients.

Keywords : Diagnostic Yield, Metagenomics, Microbiome, Pathogen Detection, Turnaround Time.
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty