NPunto

7

Authors: Serrano Rosúa, C

This is a clinical case that refers to complex wounds and the management of these cases. She is a 68-year-old woman who has a superficial trophic lesion on the distal lateral outer face of the lower left extremity (near the malleolus) since a month and a half ago when she appeared and consulted her CAP doctor. Due to a poor diagnosis initially made at the time of the onset of her ulcer or due to a poorly suited treatment pattern for the type of wound, the patient presents a poor evolution of her treated lesion from the beginning to the primary care level. Due to the poor evolution of the ulcer is decided its transfer to hospital level. After being revalued by a team of experts in complex wounds, a correct diagnosis of your ulcer is made and a new treatment schedule adapted to your needs and characteristics of your wound at that time is applied. Our patient is diagnosed with a hypertensive Martorell ulcer. Probably related to its history of poorly controlled hypertension of years of evolution and the type of ulcer it presents. For this reason the need for a team of professionals trained in complex wounds and specialized in cures. Hence the importance of making a correct and early diagnosis to be able to adapt the subsequent treatment and avoid complications in the patient’s health, higher costs in healthcare, greater results in cures...

22

Authors: Álvarez Muñiz, N

Diabetes Mellitus is a chronic disease characterized by chronic hyperglycemia. In this disease lifestyle is very important, so bad habits such as sedentarism, poor eating habit or obesity favor the appearance of this or the development of complications. One of the most important complications of diabetes and, in turn, of peripheral arterial disease and neuropathy that it produces, is diabetic foot. Diabetic foot consists of ulceration, infection, or gangrene in the foot. The first step in the treatment of diabetic foot is to treat the cause for which it occurs, as is the case with revascularization when it is caused by peripheral arterial disease. Although initially this lesion is treated in primary care, it may need to be referred to other more specialized services and end with serious consequences such as loss of the limb. The consequences of the development of diabetic foot can be devastating, for this reason, it is important to make good prevention. It is vital to have a good health education for both diabetes disease and foot self-care in these patients.

23

Authors: Morilla Martín, A

Introduction and justification: Diabetes includes pathologies due to metabolic disorders that have in common hyperglycemia. The International Diabetes Federation, in 2019, indicates that 463 million adults had diabetes, and the deaths were 4.2 million. The Human Genome Project identified polymorphisms that can determine the genotype and phenotype, and therefore the probability of suffering from a certain disease. Objectives: To examine the effect of possible interactions between diet and genetics on glucose homeostasis, insulin resistance and risk of type 2 diabetes mellitus (DM2). Methodology: A review of the last 10 years at Pubmed is carried out using an electronic search strategy, after which articles are screened according to previously defined inclusion and exclusion criteria. The search formula used in the Pubmed database is: "(gene OR SNP OR polymorphism) AND interaction AND (nutrient OR diet OR fat OR carbohydrate OR protein) AND (type 2 diabetes OR insulin resistance OR glucose OR insulin OR HOMA-IR OR HOMA beta OR HbA1C)". Results: After the identification, screening and suitability phases, 25 articles were included in the literature review. Lipids interact with genes related to the metabolism of fatty acids producing effects on DM2, whereas the interaction observed with carbohydrates (HC), are related to the synthesis and regulation of insulin. In the study of gene-nutrient interactions with effect on insulin response (IR), genes have very different functions and the results obtained are very diverse. Conclusion: Different dietary nutrients such as lipids, HC, proteins, fiber and zinc, modify the relationship with TCF7L2, PPAR-γ, ACE, APOA2, SLC30A8, IRS1, ACC2, PPM1K, ELOVL6, PIK3CA-KCNMB3, IRS1, PLIN, S100A9, DHCR7, LPL ADIPOQ and FTO genes with the risk of DM2, insulin resistance or glucose homeostasis markers.