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Factors leading to improvement of survival in patients with peripheral arterial disease and diabetes mellitus
Austria (AMSA) - University of Vienna, Vienna
Department of Internal Medicine II, Division of Angiology, Medical University & General Hospital Vienna
Ao. Univ. Prof-Dr. Renate Koppensteiner
Ao. Univ. Prof. Dr. Gerit-Holger Schernthaner
English (required) German (accepted)
Type of Research Project
- Clinical Project without Laboratory work
What is the background of the project?
Important progress was achieved in the field of peripheral arterial disease (PAD) and type 2 diabetes mellitus (T2DM). A provocative study was published in 2009 (1) advocating for the education of patients and relatives in the treatment of diabetic foot syndrome. Additionally, dual antiplatelet therapy, aggressive treatment for all other cardiovascular risk factors (diabetes, hypertension, hyperlipidaemia), and rapid open or endovascular revascularization were performed. This multimodal aggressive approach resulted in tremendous improvement in limb salvage and survival. However, mortality of PAD patients still remains high compared to other clinical forms of atherosclerosis.
What is the aim of the project?
To evaluate whether the intensified patient care (methods stated below) might increase adherence to medical management and benefit the survival of PAD patients.
What techniques and methods are used?
A multifactorial approach combining adequate drug prescription, accomplishment of agreed goals and repetitive training to initiate, implement, and persist treatment adaptations, is being applied and evaluated. In this study, two patient cohorts are compared in a longitudinal prospective follow-up. 400 PAD patients will be included in the intensified center-based vascular medicine (VMC) group and 400 PAD patients will be treated by their usual primary care physician (PCP). Survival in both groups will be compared by Kaplan-Meier and Cox-regression analyses after 5 years.
What is the role of the student?
What are the tasks expected to be accomplished by the student?
- Recruiting patients at the outpatient vascular medicine center of Vienna General Hospital according to inclusion/exclusion criteria, which will be explained to the student upon arrival - Clinical examination of the patients under supervision as well as on his/her own after mastering, including blood pressure oscillography and ankle-brachial index, duplex ultrasonography, feet inspection, thorough clinical evaluation - Blood drawing and determining standard laboratory parameters, and collecting urinary samples under supervision - Statistical analysis using the statistical software package SPSS 23 (IBM, Chicago, IL): student’s unpaired t-test, χ2 test, Kaplan-Meier survival curves, log-rank test for between-group differences, cox-regression analysis; risk-factor modification under supervision - Getting acquainted with hospital computer systems
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
Scientific papers, mentioned below; some further learn materials will be sent prior to student's arrival (e.g. book on statistics).
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- No specific outcome is expected
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
Knowledge on medical statistics (especially multivariate analysis, SPSS, Kaplan-Meier curves) not obligatory, but advantageous. Knowledge on clinical examination obligatory.
Are there any legal limitations in the student’s involvement
Upon arrival, a form for personnel management has to be signed. This is required in the case of dealing with patients. The local AMSA (Austrian Medical Students Association) takes care of that.
Type of students accepted
This project accepts: - Medical students - Graduated students (less than 6 months)
- (1) Faglia E; Clerici G; Clerissi J; Gabrielli L; Losa S; Mantero M; et al. Long-term prognosis of diabetic patients with critical limb ischemia: a population-based cohort study. Diabetes Care. 2009;32:822–7.
- (2) Höbaus C; Herz CT; Obendorf F; Howanietz MT; Wrba T; Koppensteiner R; Schernthaner GH. Center-based patient care enhances survival of elderly patients suffering from peripheral arterial disease. Ann Med. 2016;12:1-8.
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