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diabetic foot ulcers. A prospective randomized trial. J Diabetes Complications. 2007 Nov-

Dec;21(6):387-91 DOI:10.1016/j.jdiacomp.2007.03.006 PMID: 17967712 [PubMed] [Scopus]

Abstract: This study tests the hypothesis that addition of a protease-modulating matrix
enhances the efficacy of autologous growth factors in diabetic ulcers. Fifty-one

patients with chronic diabetic foot ulcers were managed as outpatients at the

Democritus University Hospital of Alexandroupolis and followed up for 8 weeks. All
target ulcers were > or = 2.5 cm in any one dimension and had been previously treated

only with moist gauze. Patients were randomly allocated in three groups of 17 patients

each: Group A was treated only with the oxidized regenerated cellulose/collagen
biomaterial (Promogran, Johnson & Johnson, New Brunswick, NJ), Group B was

treated only with autologous growth factors delivered by Gravitational Platelet

Separation System (GPS, Biomet), and Group C was managed by a combination of

both. All ulcers were digitally photographed at initiation of the study and then at
change of dressings once weekly. Computerized planimetry (Texas Health Science

Center ImageTool, Version 3.0) was used to assess ulcer dimensions that were

analyzed for homogeneity and significance using the Statistical Package for Social
Sciences, Version 13.0. Post hoc analysis revealed that there was significantly greater

reduction of all three dimensions of the ulcers in Group C compared to Groups A and B

(all P<.001). Although reduction of ulcer dimensions was greater in Group A than in

Group B, these differences did not reach statistical significance. It is concluded that
protease-modulating dressings act synergistically with autologous growth factors and

enhance their efficacy in diabetic foot ulcers.

6. Efremidou E, Papageorgiou M, Kouklakis G, Karanikas M, Liratzopoulos N, Manolas KJ. Acute

abdomen due to perforation of cecal metastasis from ductal breast carcinoma: Case report
and review of the literature. Chirurgia April 2008;21(2): 115-117 Index EMBASE, [Scopus]

Abstract: We report an unusual case of a perforated, previously unknown cecal metastasis

from a primary site of ductal breast carcinoma after 9 years, presenting as acute abdomen.
The patient was not receiving at that time any chemotherapy agents, so the issue of tumor

melting must be excluded. The patient was subjected to emergency laparotomy, where right
hemicolectomy was performed. It is essential for the clinician, and especially the surgeon, to
include complications of metastatic GI disease in the differential diagnosis of acute abdomen

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