Podiatry Commons^™

Comparative Effectiveness Of Conservative Versus Early Surgical Treatments On Wound Healing Outcomes Of Diabetic Foot Ulcers: A Literature Review, Paul Tran, Yasim Zafar, Andrea Piña, Stephanie N. Campbell

School of Podiatric Medicine Publications

Diabetic foot ulcers (DFUs) are a severe complication of diabetes mellitus and the leading cause of lower extremity amputations worldwide. Peripheral neuropathy and peripheral arterial disease secondary to complications of diabetes mellitus may result in ulcers going unnoticed, increasing the risk of severe osteomyelitis, necrotizing infection, hospitalization, amputation, and sepsis. While conservative management of DFUs remains the first-line approach—emphasizing wound care, infection control, glycemic management, and offloading—there is growing debate about whether delaying simple surgical interventions worsens long-term outcomes. Surgeries such as tenotomy, digital amputation, and tendo-Achilles lengthening are minimally invasive options that can correct deformities, prevent recurrence, and promote …

New Vs. Reprocessed: A Scoping Review On Ilizarov Frame Reuse, James Hughes, Nicholas Obias, Dustin Prins, Amanda Killeen

School of Podiatric Medicine - Student Research

This review examines current literature regarding the viability of reused/reprocessed Ilizarov External Fixation (IEF) – with the end-goal of improving surgical options for complex limb pathologies in austere environments. We hypothesize this review will find no statistically significant difference between clinical outcomes of reused vs. new IEFs

IEF is an important but costly modality for complex limb pathologies, such as trauma, deformity, and nonunion (Chironga et al., 2023). Though effective, the cost of IEF is exacerbated by its single-use deployment (Chironga et al., 2023). A proposed cost-control measure is IEF reuse/reprocessing via (1) antiseptic pre-treatment, (2) structural stability assessment, (3) …

Lipid Discovery Enabled By Sequence Statistics And Machine Learning, Priya M. Christensen, Jonathan Martin, Aparna Uppuluri, Luke R. Joyce, Yahan Wei, Ziqiang Guan, Faruck Morcos, Kelli L. Palmer

School of Podiatric Medicine Publications

Bacterial membranes are complex and dynamic, arising from an array of evolutionary pressures. One enzyme that alters membrane compositions through covalent lipid modification is MprF. We recently identified that Streptococcus agalactiae MprF synthesizes lysyl-phosphatidylglycerol (Lys-PG) from anionic PG, and a novel cationic lipid, lysyl-glucosyldiacylglycerol (Lys-Glc-DAG), from neutral glycolipid Glc-DAG. This unexpected result prompted us to investigate whether Lys-Glc-DAG occurs in other MprF-containing bacteria, and whether other novel MprF products exist. Here, we studied protein sequence features determining MprF substrate specificity. First, pairwise analyses identified several streptococcal MprFs synthesizing LysGlc-DAG. Second, a restricted Boltzmann machine-guided approach led us to discover an …

Randomized Clinical Trial To Compare Cryopreserved And Lyopreserved Umbilical Cord Tissue To Treat Complex Diabetic Foot Wounds, Lawrence A. Lavery, Mehmet A. Suludere, Matthew J. Johnson, Amanda Killeen, Katherine M. Raspovic, Peter A. Crisologo, Arthur Tarricone

School of Podiatric Medicine Publications

To compare the incidence of infection, wound closure and time to wound closure in patients treated with cryopreserved (CPUT) and lyopreserved umbilical tissue (LPUT) in complex diabetic surgical wounds. This single-blinded 12-week randomized clinical trial compared cryopreserved and lyopreserved amniotic cord tissue to treat complex diabetic foot wounds. LPUT or CRAT was applied at baseline and again after four weeks. We enrolled subjects with UT2A-D and 3A-D wounds (depth to tendon, muscle, or bone with infection and/or PAD) and excluded subjects with ABI < 0.5 or TBI < 0.3, untreated osteomyelitis, and autoimmune diseases. We used a 3-D camera to evaluate wound area and volume. The mean baseline wound areas were 12.9 ± 10.7 cm2 for CPUT and 11.7 ± 7.0 cm2 for LPUT. The mean baseline wound volume was 7.5 ± 8.1 for CPUT and 9.2 ± 10.2 cm3 for LPUT. There was no difference between CPUT and LPUT in wound closure (36.8% vs 19.0%, P = .21) or infection (10.5% vs 4.8%, P = .60). There was no difference in mean …

Successful Limb Salvage In A Severe Diabetic Foot Infection: A Case Study Of Aggressive Surgical Intervention And Grafting Technique, Stephanie N. Campbell, Heather V. Tran, Nikita V. Gambhir

School of Podiatric Medicine Publications

No abstract provided.

Investing In Limb Preservation: A Case Report In Avoiding Bilateral Amputation In A Vasculopathy Patient, Nikita Gambhir, Heather V. Tran, Craig J. Verdin, Stephanie N. Campbell, Cyaandi Dove

School of Podiatric Medicine Publications

Limb salvage and prosthetics play vital roles in restoring function and mobility for patients with severe injuries or metabolic conditions. Limb salvage involves surgical techniques aimed at preserving a limb rather than resorting to amputation, while prosthetics provide artificial devices to replace lost limbs. Key considerations for limb salvage include restoring a functional foot, maintaining patient independence, minimizing hospitalizations, and avoiding bilateral lower limb amputations. Aggressive measures in wound care and surgery are needed for patients already at single-limb status with PAD and coronary artery disease (CAD).

Enterococcus Faecium: Evolution, Adaptation, Pathogenesis And Emerging Therapeutics, Yahan Wei, Dennise Palacios Araya, Kelli L. Palmer

School of Podiatric Medicine Publications

The opportunistic pathogen Enterococcus faecium colonizes humans and a wide range of animals, endures numerous stresses, resists antibiotic treatment and stubbornly persists in clinical environments. The widespread application of antibiotics in hospitals and agriculture has contributed to the emergence of vancomycin-resistant E. faecium, which causes many hospital-acquired infections. In this Review, we explore recent discoveries about the evolutionary history, the environmental adaptation and the colonization and dissemination mechanisms of E. faecium and vancomycin-resistant E. faecium. These studies provide critical insights necessary for developing novel preventive and therapeutic approaches against vancomycin-resistant E. faecium and also reveal the intricate interrelationships …

Shooter’S Abscess: Foot Infections In People Who Inject Drugs, Amanda L. Killeen, Randi Heming, Peter A. Crisologo, Michael C. Siah, Lawrence A. Lavery

School of Podiatric Medicine Publications

Musculoskeletal infections are common among people who inject drugs. Little is known about the prevalence and characteristics of skin and soft-tissue infections in this patient population, especially in the lower extremity. The aim of this study is to describe the clinical characteristics, bacterial pathogens, and clinical outcomes in adults with foot infections due to intravenous drug use. Nine patients for whom the podiatric service was consulted for lower-extremity abscess secondary to intravenous drug use were included in this study. Most infections (66.7%) were located on the dorsal foot. Two of the abscesses (22.2%) resulted in amputation, with one toe amputation …

Management Of Group B Streptococcus Necrotizing Fasciitis Secondary To Puncture Wound In Diabetic Patient Using Xenograft* Therapy, Nikita V. Gambhir, Heather V. Tran, Stephanie N. Campbell

School of Podiatric Medicine Publications

Necrotizing soft tissue infection (NSTI) is a rapidly progressive skin and soft tissue infection that primarily affects deeper layers of adipose tissue, fascia and muscle. Once a patient becomes symptomatic, the disease typically progresses within hours. The standard treatment consists of broad-spectrum IV antibiotics, serial debridement and supportive care. However, long-term goals should include prevention of atherosclerotic disease, cardiovascular and cerebrovascular events, and ultimately, a reduction in mortality rates. Following debridement for NSTI, it is not uncommon for patients to require multiple surgeries and secondary wound healing given the extent of soft tissue loss.

Use Of A Borate-Based Bioactive Glass Matrix On Infected, Exposed Hardware, Stephanie N. Campbell, Cyaandi Dove, Connor V. Krolikowski

School of Podiatric Medicine Publications

A dreaded complication of implanting surgical hardware is a wound dehiscence resulting in hardware exposure; which places the wound at risk for infection and biofilm formation. Once established, biofilms are difficult to eradicate, with a high rate of recurrence even after surgical debridement. As such, there exists a significant need for novel technologies that can help us expedite healing in wounds with exposed hardware. Here we evaluate a borate-based bioactive glass matrix* in this challenging setting.

Effects Of Supervised Exercise Therapy On Muscle Function During Walking In Patients With Peripheral Artery Disease, Cody P. Anderson, Iraklis Pipinos, Jason M. Johanning, Sara A. Myers, Hafizur Rahman

School of Podiatric Medicine Publications

Background: Although supervised exercise therapy (SET) is a primary treatment for peripheral artery disease (PAD), the current literature is limited regarding the mechanisms contributing to increased walking distances, including how lower extremity muscle function is altered after SET. This study aimed to investigate the effects of SET on lower extremity muscle function during walking in patients with PAD. Methods: Twelve patients with PAD participated in a 6-month SET program consisting of three weekly exercise sessions (a total of 72 sessions) and adhered to the American College of Sports Medicine’s (ACSM) recommendations. Each session started with a 5 min warm-up of …

From Crisis To Closure: Use Of Kerecis© Omega3 And Negative Pressure Wound Therapy In Treating Necrotizing Soft Tissue Infection, Nikita Gambhir, Heather V. Tran, Stephanie N. Campbell, Mihir Panchal

School of Podiatric Medicine Publications

The aim of this case study was to evaluate the effectiveness of Kerecis© Omega3 MariGen Micro for the treatment of a necrotizing soft tissue infection (NSTI) in a diabetic patient, including wound healing progress and closure outcomes post-application.

The application of acellular dermal micromatrix allograft in conjunction with NPWT and STSG, facilitated significant wound healing in a patient with NSTI, without amputation. This case highlights the unique properties of Kerecis Omega3, a fish-derived skin substitute rich in omega-3 fatty acids, significantly contributed to tissue regeneration and wound healing, even in a high-risk patient with multiple comorbidities, including diabetes and obesity. …

Trajectories Of Diabetes-Related Sequelae For Identifying Transition Probabilities, And Optimal Timepoints For Prevention Of Ulceration, Infection, And Amputation, Daniel C. Jupiter, Yuanyi Zhang, Naohiro Shibuya

School of Podiatric Medicine Publications

To reduce diabetes-related complications and to avoid futile procedures, foot and ankle surgeons need to understand the relative timings of catastrophic events, their incidence, and probabilities of transitions between disease states in diabetes in different patient populations. For this study, we tracked medical events (including an initial diagnosis of diabetes, ulcer, wound care, osteomyelitis, amputation, and reamputation, in order of severity) and the time between each such event in patients with diabetes, stratifying by sex, race, and ethnicity. We found that the longest average duration between the different lower extremity states was a diagnosis of diabetes to the occurrence of …

Does The Use Of Dacc-Coated Dressings Improve Clinical Outcomes For Hard To Heal Wounds: A Systematic Review, Saskia Schwarzer, Jose Luis Lazaro-Martinez, Amanda L. Killeen, Paulo Alves, Andrea Gledhill, Erik Nygren, Lawrence A. Lavery, Matthew Malone

School of Podiatric Medicine Publications

Reports of overuse and antimicrobial resistance have fuelled some clinicians to adopt alternative wound dressings termed to be non-medicated or non-antimicrobials, which still claim antimicrobial or antibacterial activity. In this PROSPERO-registered systematic review, we evaluated the in vivo clinical evidence for the effectiveness of DACC-coated dressings in chronic, hard to heal wound-related outcomes. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Framework was adopted as the template in constructing this systematic review. The PICO format (Population [or patients], Intervention, Comparison [control], Outcome/s) was used to identify key clinical questions in determining patient outcomes under two domains (infection control and …

Navigating The Uncommon: Providencia Rettgeri In Diabetic Foot Ulcers, Nikita Gambhir, Heather V. Tran, Stephanie N. Campbell, Mihir Panchal

School of Podiatric Medicine Publications

A case study presents with a rare microorganism, Providencia rettgeri, as a pathogen identified in a non-healing diabetic foot ulcer with osteomyelitis. P. rettgeri remains an emerging pathogen with documented drug-resistant hospital associated infections. Given the rarity of this organism in such wounds and its intrinsic resistance to multiple antibiotics, this study aims to understand the pathogen’s role in diabetic foot infections and improve clinical management practices.

Providencia has been classified as Critical Priority 1 on World Health Organization’s global priority pathogen list for the need of new antibiotics, highlighting its international significance. P. rettgeri tends to grow in nosocomial …

Effect Of A Potent Nitrogenous Bisphosphonate On Cell Viability In Diabetic Conditions: An In Vitro Study On Human Fibroblasts And Pre-Osteoblasts, Denae Cantu, Bryan Liu, Deborah Rocha Seixas, Claudia Biguetti

School of Podiatric Medicine - Student Research

Introduction Zoledronate (Zol) is a nitrogenous bisphosphonate (nBP) used to treat osteoporosis, bone metastases, and Charcot foot. Despite its efficacy in preventing fractures, concerns exist about its side effects on mesenchyme-origin cells and impaired wound healing. We hypothesize that Zol may impair the responses of human fibroblasts (hF) and pre-osteoblasts (MC3T3), potentially compromising tissue healing in the lower extremities of patients with diabetes.

Methodology: MC3T3 cells and hF were cultured in 96-well plates at a density of 2.5 x 10³ cells for 48 and 72 hours, respectively. Cells were subjected to normal glucose, high glucose, and high oxidative stress conditions …

Return To Play Time After Achilles Tendon Rupture In Professional Soccer Players, Oyinkansola Mudasiru, Amanda Killeen

School of Podiatric Medicine - Student Research

Introduction: Achilles tendon ruptures are severe injuries that drastically affect the careers of athletes. These ruptures typically occur during matches, often due to dorsiflexion of the ankle during passes or when tackling. Professional athletes tend to have surgical repair quickly with the goal of returning to their sport as fast as possible.

Objective: To present a scoping review to identify the return to play (RTP) rates following Achilles tendon rupture and whether these athletes achieve functional outcomes comparable to their pre- operative conditions.

Methods: 2 databases were queried; Google Scholar and PubMed using the search terms "Achilles tendon rupture" AND …

A Systematic Review Of Diabetic Foot Infections: Pathogenesis, Diagnosis, And Management Strategies, Sabyasachi Maity, Noah Leton, Narendra Nayak, Ameet Jha, Nikhilesh Anand, Kamala Thompson, Danielle Boothe, Alexandra Cromer, Yaliana Garcia, Aliyah Al-Islam

School of Medicine Publications

Background: Diabetic foot infection represents a significant complication of diabetes mellitus, contributing substantially to morbidity, mortality, and healthcare expenditure worldwide. Accurate diagnosis relies on a comprehensive assessment integrating clinical evaluation, imaging studies, and microbiological analysis. Management necessitates a multidisciplinary approach, encompassing surgical intervention, antimicrobial therapy, and advanced wound care strategies. Preventive measures are paramount in reducing the incidence and severity, emphasizing patient education, regular foot screenings, and early intervention.

Methods: The researchers performed a systematic review of literature using PUBMED MESH keywords. Additionally, the study was registered in the International Prospective Register of Systematic Reviews at the Center for Reviews …

Evaluating Hmgb1 As A Biomarker For Metabolic Dysregulation And Progression Of Diabetes In A Mexican American Cohort, Peter Elvin, Walid Fakhouri, Craig Hanis, Cláudia Cristina Biguetti

School of Podiatric Medicine - Student Research

Aim/Hypothesis: This study focuses on HMGB1 to evaluate its association with the development and progression of diabetes within a Mexican American cohort of non-diabetic (ND), pre-diabetic (Pre-D), and diabetic (D) individuals.

Methods: Data from a cohort of 40 individuals, standardized by age (61.76±11.77), BMI (32.52±7.02), and sex (58% male, 42% female) was analyzed. We assessed several immunological markers utilizing ELISA assays from buffy coats. After excluding out of range samples, the remaining 20 individuals displayed statistical significance in HMGB1. Pearson's correlation coefficient examined the relationship between HMGB1 levels and glycemic changes (HOMA-IR, HOMA-B, HOMA-IS², and HbA1c). Statistical significance …

Co-Localization Of Osteoclasts Differentiation Markers In An Implant Model In Diabetic Mice, Diego Adobbati, Deborah Rocha Seixas, Danieli Rodrigues, Claudia C. Biguetti

School of Podiatric Medicine - Student Research

Introduction and Hypothesis: Diabetes can impair implant osseointegration and impact implant functionality. While significant research has focused on osteogenesis during the osseointegration, little attention has been given to pre-osteoclast differentiation. We hypothesize that diabetes increases pre-osteoclast activity potentially leading to implant failure. This study aims to identify and localize osteoclast markers, specifically DC-STAMP (Dendritic Cell-Specific Transmembrane Protein) and NFATc2 (Nuclear Factor of Activated T-cells, cytoplasmic 2), in diabetic (D) and non-diabetic (ND) mice.

Methodology: Twenty-four 16-week-old male 129 Sv mice (12 diabetic and 12 non-diabetic) underwent implantation with a 0.5x1.5 mm commercially pure titanium screw in the right maxillary bone. …

A Microtomographic And Histopathological Evaluation Of Dental Cements As Late-Stage Peri-Implant Complication In A Rat Model, Bhuvana Lakkasetter Chandrashekar, Cláudia Cristina Biguetti, Alexandra Arteaga, Andres J. Miramontes, Evelin Rios, Danieli C. Rodrigues

School of Podiatric Medicine Publications

Cement mediated peri-implantitis accounts for 1.9–75% of dental implant failures associated with peri-implant diseases. This study evaluated the biological impact of dental cements on osseointegrated implants using Lewis rats. Twenty-two rats were distributed into 6 groups: negative control (NC) soft diet (SD), and hard diet (HD); positive control SD and HD (n = 3); Implant + bio-ceramic Cement (BC) SD and HD which included contralateral Sham sites (n = 5). Titanium implants were placed on either side of the maxillae and allowed to heal for 14 days. Later, both sides of experimental groups underwent a re-entry surgery to simulate clinical …

The Effect Of Limb Salvage Efforts In Different Age Groups: Relationships Between Major And Minor Amputations, Wenye Song, Javier La Fontaine, Naohiro Shibuya, John Prochaska, Daniel C. Jupiter

School of Podiatric Medicine Publications

“Limb salvage” efforts, such as performing minor amputations before infections spread proximally from the foot to decrease major lower extremity amputation, are an important part of healthcare today. It is unclear whether these efforts are preventing the number of major amputations and improving patients’ quality of life and the cost-effectiveness of the U.S. healthcare system. Rates of non-traumatic lower extremity amputation (NLEA) among patients with diabetes decreased in the early 2000s but rebounded in the 2010s. We analyzed the proportion of major amputations and differences in amputation rates between age groups in Texas. Patient data was extracted from the Texas …

A Proposed Addition To The Modified Wells Criteria: Exploring Thrombosis In The E-World, Nidhin John, Amanda Kileen

School of Podiatric Medicine - Student Research

The advancement of technology and over-reliance on electronics have led to "e-thrombosis." This review investigates the link between prolonged sedentary behavior due to extensive electronic use and the risk of venous thromboembolism (VTE) and deep vein thrombosis (DVT). The term "e-thrombosis" was introduced in 2003 by Beasley et al., highlighting the risk of immobility associated with electronics. E-thrombosis is particularly relevant post-COVID-19, with increased remote working and online learning. This review evaluates recent studies to determine if e-thrombosis should be considered in updated screening tools like the Wells Score.

A systematic literature review was conducted using PubMed, Direct Science, and …

Peripheral Artery Disease Causes Consistent Gait Irregularities Regardless Of The Location Of Leg Claudication Pain, Hafizur Rahman, Todd Leutzinger, Mahdi Hassan, Molly Schieber, Panagiotis Koutakis, Matthew A. Fuglestad, Holly Despiegelaere, G. Matthew Longo, Philippe Malcolm, Jason M. Johanning

School of Podiatric Medicine Publications

Highlights

• Peripheral artery disease (PAD) is a multi-level disease.

• PAD diffusely impairs the performance of leg muscles.

• PAD causes similar irregularities in gait biomechanics regardless of where claudication pain is located in the leg.

Abstract

Background

The most common symptom of peripheral artery disease (PAD) is intermittent claudication that involves the calf, thigh, and/or buttock muscles. How the specific location of this leg pain is related to altered gait, however, is unknown.

Objectives

We hypothesized that because the location of claudication symptoms uniquely affects different leg muscle groups in people with PAD, this would produce distinctive walking patterns.

Methods

A …

A Rare Occurrence Of Digital Fibromyxoma To The Hallux Distal Phalanx, Heather V. Tran, Nikita Gambhir, Craig J. Verdin, Luis Caporusso, Stephanie N. Campbell

School of Podiatric Medicine Publications

A paucity of literature exists for superficial acral fibromyxoma, which typically affects the acral regions of the hands and feet. Because of its indolent nature and clinical mimicry of other ungual and periungual tumors, delays in diagnosis are common. This report aims to augment our understanding of this pathology and improve recognition for prompt diagnosis, as well as provide an addition to the literature.

Effectiveness Of Concurrent Ankle Arthroscopy During Open Reduction And Internal Fixation Of Malleolar Fractures In Prevention Of Common Short-Term Complications, Naohiro Shibuya, Daniel C. Jupiter

School of Podiatric Medicine Publications

Rotational malleolar fractures result in a high prevalence of intra-articular pathologies; therefore, routine arthroscopic assessment may be beneficial in the surgical treatment of ankle fractures. However, the clinical studies regarding the effectiveness of arthroscopy thus far have mixed results. We investigated the efficacy of concurrent arthroscopy during the treatment of malleolar fractures using a large U.S. healthcare data set. Those who had arthroscopy were compared with those who did not, during the surgical treatment of malleolar fractures, while adjusting for covariates of clinical relevance. The analysis showed that concurrent arthroscopy is protective against postoperative repeat surgery (OR = 0.13, 95CI …

Bioengineered Skin For Diabetic Foot Ulcers: A Scoping Review, Nathaniel R. Primous, Peter Elvin, Kathleen V. Carter, Hagner L. Andrade, Javier La Fontaine, Naohiro Shibuya, Cláudia Cristina Biguetti

School of Podiatric Medicine Publications

Diabetic foot ulcers (DFUs) pose a significant threat to individuals with diabetes mellitus (DM), such as lower limb amputation and severe morbidity. Bioengineered skin substitutes (BSS) are alternatives to traditional interventions for treating DFUs, but their efficacy compared to standard wound care (SWC) or other treatment types, such as allografts, remains unknown. A scoping review of human studies was conducted to identify current approaches in the treatment of DFUs using BSS as compared with other treatment options. Systematic searches in PubMed, Cochrane Library, and Web of Science were conducted to identify comparative studies that enrolled 10 or more patients and …

Use Of A Borate-Based Bioactive Glass Martix On Infected, Exposed Hardware, Stephanie N. Campbell, Cyaandi V. Dove, Connor Krolikowski

School of Podiatric Medicine Publications

Hardware exposure is a challenging complication following foot and ankle surgery due to the high risk of infection, biofilm formation, and delayed healing. In two consecutive cases, the bioactive glass matrix combined with particulate micromatrix successfully eradicated the wound infection and biofilm, resulting in full granulation of the wound and successful wound closure. Here we present a novel bioactive glass matrix that successfully managed exposed hardware in an infected foot, providing a promising treatment strategy for managing these complications and preventing further morbidity.

Public Perceptions Of Peripheral Nerve Surgery On Social Media: A Narrative Review, Nicholas Obias, James Hughes

School of Podiatric Medicine - Student Research

Objective: The intent of this study is to conduct a Narrative review of the Public Perceptions of Peripheral Nerve Surgery on Social Media.

Introduction: Peripheral nerve surgery is an effective therapeutic modality for difficult diagnoses such as peripheral neuropathy, neuromas, and complex regional pain syndrome. This study aims to explore public perceptions of peripheral nerve surgery on Instagram, a popular social media site. Information on posts such as authorship, relevance, accuracy, and purpose were collected. Conclusions from this study may direct efforts to enhance medical advice and improve patient education for extremity nerve surgeons.

Methods: Searches were conducted in September …

Comparative Effect Of Zoledronic Acid, High Glucose Levels, And Oxidative Stress On Macrophage Viability, Bryan Liu, Denae Cantu, Deborah Seixas, Cláudia Cristina Biguetti

School of Podiatric Medicine - Student Research

Introduction and Hypothesis: Zoledronate (Zol) is an antiosteoclastic drug widely utilized for osteoporosis and bone metastases, and it may be used off-label for managing diabetic Charcot neuroarthropathy¹. Since macrophages share common precursors with osteoclasts, their function may also be affected by Zol. Herein, we hypothesize that Zol impairs macrophage responses, potentially hindering their viability and host defense in diabetic conditions.

Methodology: Raw 264.7 macrophages were seeded at 2.5 x 10³ in 96-well plates for viability assays. Cells were tested under normal glucose (25 mM), high glucose (ranging from 45 to 70 mM), and high oxidative stress (ranging …