skin diseases, necrobiosis lipoides, granuloma etc

necrobiosis lipoidica (diabeticorum)
- affects both diabetic and non-diabetic pts
- predominantly lower extremities
- mostly cosmetic disease of unknown aetiology but skin cancer may evolve in the place of

granuloma annulare
- benign, self limited
- localised, generalized, subcutaneous
- mainly head neck, upper extremities,
- mainly children, young adults


granuloma pyogenes /a misnomer as it is a benign tumour - no granuloma, not pyogenic/
- benign tumour
- mainly children
- mainly head, oral mucosa, may be


bullous disease of diabetes
- bullae appearing predominantly on lower extremities
- in DM lower treshold for suction-induced blister formation

-

stable CAD: BARI 2D: No difference in mortality, CVD: revascularisation vs medical therapy, COURAGE

BARI 2D in Type 2 diabetics n=2000+ pts
FU 5 years
treated with revascularisation (CABG or PCI) or intensive medical therapy.
no difference between revasc vs medical therapy
lower MI in CABG
no benefit of PCI

cf analogous to results of the COURAGE trial

- second randomization strategy
insulin provision vs senzitization.

best outcome in CABG+insulin senzitization .(least prone to hypo?)

PCI vs CABG for complex CAD, SYNTAX, CARDIA

PCI vs CABG in multivessel disease
2 year results from SYNTAX, (TaxuxDES)
- CABG better endpoint, however more strokes (mostly in the first year BEFORE surgery)
- aim of PCI nonineriority not reached /but still often interpreted that PCI feasible in high-risk multivessel disease
- PCI - more revascularisations,
pending - detailed analysis of composite endpoint

CARDIA - similar question in diabetics (
ongoing - FREEDOM