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arterial leg ulcers

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https://www.readbyqxmd.com/read/27798353/the-effects-of-intermittent-negative-pressure-on-the-lower-extremities-peripheral-circulation-and-wound-healing-in-four-patients-with-lower-limb-ischemia-and-hard-to-heal-leg-ulcers-a-case-report
#1
Øyvind H Sundby, Lars Ø Høiseth, Iacob Mathiesen, Jørgen J Jørgensen, Jon O Sundhagen, Jonny Hisdal
Peripheral circulation is severely compromised in the advanced stages of peripheral arterial disease. Recently, it was shown that the application of -40 mmHg intermittent negative pressure (INP) to the lower leg and foot enhances macro- and microcirculation in healthy volunteers. In this case report, we describe the effects of INP treatment on four patients with lower limb ischemia and hard-to-heal leg and foot ulcers. We hypothesized that INP therapy may have beneficial hemodynamic and clinical effects in the patients...
October 2016: Physiological Reports
https://www.readbyqxmd.com/read/27774697/livedoid-vasculopathy-and-popliteal-artery-occlusion-in-a-patient-with-protein-s-deficiency
#2
Takayuki Nakayama, Kentaro Mizutani, Ichiro Hanamura, Hidefumi Kato, Akiyoshi Takami, Kyosuke Takeshita, Daisuke Watanabe
Livedoid vasculopathy (LV) is a chronic disease with recurrent reticularis and ulcers, mainly affecting the feet and lower legs. The pathogenesis of LV has not been yet thoroughly understood, but thrombosis is thought to play a major role because fibrin deposition within both the wall and lumen of affected vessels is pathologically detected. A 68-year-old woman first presented to our hospital in 2004 with a 6-year history of a reticular rash and ulceration on the lower legs. Screening tests for vasculitis and collagen disease were mostly normal, leading to diagnosis of LV...
October 24, 2016: Journal of Dermatology
https://www.readbyqxmd.com/read/27771120/-retrospective-study-of-hypertensive-leg-ulcers-at-reims-university-hospital-epidemiological-clinical-disease-progression-data-effects-of-vitamin-k-antagonists
#3
P Nicol, P Bernard, P Nguyen, A Durlach, G Perceau
BACKGROUND: Hypertensive leg ulcers (HLU) are a form of necrotic leg ulcer. Their physiopathology is not well known and in these patients, no venous or arterial insufficiency is detected. The primary objective of this study was to evaluate the association between HLU severity and the presence or absence of concomitant vitamin K antagonist (VKA) medication. We furthermore aimed to describe the epidemiology of this entity and the prevalence of thrombophilia factors in this population. PATIENTS AND METHODS: This was a retrospective study in 54 patients hospitalized in the dermatology department of Reims University Hospital between 01/01/2007 and 31/12/2013: 23 patients were included in the "without VKA" group, and 30 were included in the "with VKA" group...
October 19, 2016: Annales de Dermatologie et de Vénéréologie
https://www.readbyqxmd.com/read/27767288/tricenter-analysis-of-cofactors-and-comorbidity-in-patients-with-pyoderma-gangrenosum
#4
Finja Jockenhöfer, Katharina Herberger, Jörg Schaller, Katja Christina Hohaus, Maren Stoffels-Weindorf, Philipp Al Ghazal, Matthias Augustin, Joachim Dissemond
INTRODUCTION: Pyoderma gangrenosum (PG) is a rare neutrophilic, ulcerative skin disease of largely unknown pathophysiology. MATERIAL AND METHODS: In this study, potentially relevant cofactors and comorbidities in patients with PG from three dermatological wound care centers in Germany were evaluated. RESULTS: Of the 121 patients assessed, women (66.9 %) were more frequently affected than men. Patient age ranged from 18 to 96 years (mean 59...
October 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/27729055/gaps-in-awareness-of-peripheral-arterial-disease-in-sri-lanka-a-cross-sectional-study
#5
Janaka Weragoda, Manuj C Weerasinghe, Rohini Seneviratne, S M Wijeyaratne
BACKGROUND: Peripheral arterial disease (PAD) is an emerging problem in Sri Lanka, particularly with the ageing population. A considerable number of patients are detected at a late stage with severe limb ischemia or chronic non-healing leg ulceration. Public awareness about PAD is important in developing preventive strategies. METHODS: A cross sectional study was conducted to assess awareness of PAD among adults aged 40-74 years in a district in Sri Lanka. In total, 2912 adults were selected for the study using a multistage probability proportionate to size sampling technique...
October 12, 2016: BMC Public Health
https://www.readbyqxmd.com/read/27723012/poorly-designed-research-does-not-help-clarify-the-role-of-hyperbaric-oxygen-in-the-treatment-of-chronic-diabetic-foot-ulcers
#6
EDITORIAL
Mesut Mutluoglu, Gunalp Uzun, Michael Bennett, Peter Germonpré, David Smart, Daniel Mathieu
Diabetic foot ulcers (DFUs) are one of the most common indications for hyperbaric oxygen treatment (HBOT). The role of HBOT in DFUs is often debated. Recent evidence based guidelines, while recommending its use, urge further studies to identify the patient subgroups most likely to benefit from HBOT. A recent study in Diabetes Care aimed to assess the efficacy of HBOT in reducing the need for major amputation and improving wound healing in patients with chronic DFUs. In this study, patients with Wagner grade 2-4 diabetic foot lesions were randomly assigned to have HBOT (30 sessions/90 min/244 kPa) or sham treatment (30 sessions/90 min/air/125 kPa)...
September 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/27707633/long-term-results-of-inframalleolar-bypass-for-critical-limb-ischaemia
#7
E Saarinen, P Kauhanen, M Söderström, A Albäck, M Venermo
INTRODUCTION: As the population ages and the incidence of diabetes increases, the expected number of patients with critical limb ischaemia (CLI) requiring distal revascularization will remain high or even increase. The aim of this study was to investigate the long-term results of inframalleolar bypass. MATERIAL AND METHODS: A total of 352 inframalleolar bypasses for CLI performed between 2002 and 2013 were included. Risk factors were evaluated and patency (both clinical and imaging based), leg salvage, survival, and amputation free survival (AFS) assessed...
December 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27681589/effectiveness-of-hyaluronic-acid-and-its-derivatives-on-chronic-wounds-a-systematic-review
#8
A Shaharudin, Z Aziz
OBJECTIVE: Hyaluronic acid (HA) and its derivatives are used for chronic wounds, but evidence of their effectiveness remains unclear. The aim of this study was to provide more updated evidence for the effectiveness of HA (or its derivatives) compared with placebo or other agents for promoting healing in chronic wounds. METHOD: The Cochrane Central Register of Controlled Trials, MEDLINE via Ovid Online, CINAHL and the EMBASE via EBSCO host databases were searched...
October 2, 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27666801/pulsatile-varicose-veins-secondary-to-severe-tricuspid-regurgitation-report-of-a-case-successfully-managed-by-endovenous-laser-treatment
#9
Shingo Chihara, Kentaro Sawada, Hiroshi Tomoeda, Shigeaki Aoyagi
We report a case of pulsatile varicose veins successfully managed by endovenous laser treatment (EVLT) of the great saphenous vein (GSV). A 77-year-old woman taking an anticoagulant was transferred to our hospital for pulsatile varicose veins complicated with repeated venous bleeding from an ulcer of her left lower leg. Doppler echocardiography showed severe tricuspid regurgitation, and duplex ultrasonography revealed an arterial-like pulsating flow in the saphenofemoral junction and along the GSV, but an arteriovenous fistula, obstruction of the deep veins, and the distal incompetent perforators were not detected...
September 22, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27649406/comparing-the-efficacy-of-viable-cryopreserved-placental-membrane-for-the-treatment-of-wounds-of-diverse-etiologies
#10
Derek S Anselmo, Marc Karpo, Ebony Love, Tracey Vlahovic
INTRODUCTION AND OBJECTIVES: The benefits of using amniotic tissue in skin regeneration are well documented. Today, cryopreservation technology allows for better availability and maintenance of mesenchymal stem cells. This is of particular interest in treating the diabetic foot ulcer as this population has fewer mesenchymal stem cells. The objective of this case series investigation was to compare the efficacy of cryopreserved human amniotic stem cells in treating foot wounds of different etiologies...
September 2016: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/27623758/ankle-brachial-index-for-the-diagnosis-of-lower-limb-peripheral-arterial-disease
#11
Fay Crawford, Karen Welch, Alina Andras, Francesca M Chappell
BACKGROUND: Peripheral arterial disease (PAD) of the lower limb is common, with prevalence of both symptomatic and asymptomatic disease estimated at 13% in the over 50 age group. Symptomatic PAD affects about 5% of individuals in Western populations between the ages of 55 and 74 years. The most common initial symptom of PAD is muscle pain on exercise that is relieved by rest and is attributed to reduced lower limb blood flow due to atherosclerotic disease (intermittent claudication). The ankle brachial index (ABI) is widely used by a variety of healthcare professionals, including specialist nurses, physicians, surgeons and podiatrists working in primary and secondary care settings, to assess signs and symptoms of PAD...
September 14, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27622980/-when-to-worry-about-before-a-vascular-chronic-leg-ulcer
#12
I Lazareth
Leg ulcers are a chronic condition. Healing can be long for venous ulcers and the risk of complications is significant. Infection is the most severe complication and can occur in the form of easily diagnosed acute bacterial dermohypodermitis that generally responds well to antibiotic treatment if given at an appropriate dose or in the form of localized infection that is more difficult to diagnosis. Indeed, no consensus has been reached in the literature on the clinical criteria to retain for the diagnosis of localized infection...
September 2016: Journal des Maladies Vasculaires
https://www.readbyqxmd.com/read/27622522/calciphylaxis-and-martorell-hypertensive-ischemic-leg-ulcer-same-pattern-one-pathophysiology
#13
Jürg Hafner
This review presents a closer look at four diseases which are probably closely related to one another pathophysiologically: (a) calciphylaxis (distal pattern); (b) calciphylaxis (proximal pattern); (c) Martorell hypertensive ischemic leg ulcer; (d) calciphylaxis with normal renal and parathyroid function (synonym: eutrophication). The four diseases have largely the same risk factors: (1) arterial hypertension, (2) diabetes mellitus (types 1 and 2), (3) secondary or tertiary hyperparathyroidism (in end-stage kidney disease) and (4) oral anticoagulation with vitamin K antagonists...
September 14, 2016: Dermatology: International Journal for Clinical and Investigative Dermatology
https://www.readbyqxmd.com/read/27604676/lateral-genicular-artery-flap-for-reconstruction-of-a-large-knee-defect-following-oncological-resection-case-report
#14
Andrei Zbuchea
This article presents the case of a 53 years old patient, with ulcerated and infected dermatofibrosarcoma, extended on the anterolateral side of the left knee. The postexcisional defect, exposing patella, was covered through a regional cutaneous flap of the distal third of the thigh, upper lateral genicular artery-based, measuring 20/10 cm, together with expanded free skin split grafts, applied in proximal third of the leg and distal third of the left thigh. Surgical stages and favorable postoperative evolution are exposed...
July 2016: Chirurgia
https://www.readbyqxmd.com/read/27598919/-dangerous-mimikry-cutaneous-tumours-appearing-as-ulcus-cruris
#15
Cora Scheerer, Helene Tsoupis, Cornelia Erfurt-Berge
HISTORY AND CLINICAL FINDINGS: We report on a 83-year-old female patient which suffered from a chronic ulcer of the right leg for several years. She has been treated with standard wound dressings under the diagnosis of an ulcer due to chronic venous insufficiency. INVESTIGATIONS AND DIAGNOSIS: A first biopsy showed a lower leg dermatitis and dermatosclerosis due to the chronic venous insufficiency. Not till a second biopsy was taken in the course of the disease, a sqamous cell carcinoma could be diagnosed...
September 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27596566/-interest-of-punch-skin-grafting-for-the-treatment-of-painful-ulcers
#16
C Fourgeaud, G Mouloise, U Michon-Pasturel, S Bonhomme, I Lazareth, S Meaume, P Priollet
INTRODUCTION: Skin leg ulcers are chronic painful wounds. The treatment of these ulcers is crucial for patients because pain has a significant impact on their daily lives. The analgesic effect of punch skin grafting (PSG) for the treatment of painful ulcers is not well described. The objective of the study is to assess the level of pain in patients with an ulcerated wound and to see if there is an analgesic effect of PSG. PATIENT AND METHODS: It was a single-center, non-interventional study conducted in hospitalized patients with one or several ulcer(s) of any type and which has been painful for more than six weeks...
September 2016: Journal des Maladies Vasculaires
https://www.readbyqxmd.com/read/27596565/interest-of-punch-skin-grafting-for-the-treatment-of-painful-ulcers
#17
C Fourgeaud, G Mouloise, U Michon-Pasturel, S Bonhomme, I Lazareth, S Meaume, P Priollet
UNLABELLED: Skin leg ulcers are chronic painful wounds. The treatment of these ulcers is crucial for patients because pain has a significant impact on their daily lives. The analgesic effect of punch skin grafting (PSG) for the treatment of painful ulcers is not well described. The objective of the study is to assess the level of pain in patients with an ulcerated wound and to see if there is an analgesic effect of PSG. PATIENT AND METHODS: A single-center, non-interventional study conducted in hospitalized patients with one or several ulcer(s) of any type and which has been painful for more than six weeks...
September 2016: Journal des Maladies Vasculaires
https://www.readbyqxmd.com/read/27575813/the-accuracy-and-cost-effectiveness-of-strategies-used-to-identify-peripheral-artery-disease-among-patients-with-diabetic-foot-ulcers
#18
Neal R Barshes, Everardo Flores, Michael Belkin, Panos Kougias, David G Armstrong, Joseph L Mills
BACKGROUND: Patients with diabetic foot ulcers (DFUs) should be evaluated for peripheral artery disease (PAD). We sought to estimate the overall diagnostic accuracy for various strategies that are used to identify PAD in this population. METHODS: A Markov model with probabilistic and deterministic sensitivity analyses was used to simulate the clinical events in a population of 10,000 patients with diabetes. One of 14 different diagnostic strategies was applied to those who developed DFUs...
August 26, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27527566/-leg-ulcers-occurring-under-tyrosine-kinase-inhibitor-therapy-sunitinib-nilotinib
#19
A Roger, M-L Sigal, P Bagan, C Sin, P Bilan, B Dakhil, C Fargeas, J-C Couffinhal, E Mahé
BACKGROUND: Certain anticancer drugs are known to induce leg ulcers, mainly chemotherapy agents such as hydroxyurea. We report 2 cases of leg ulcers in cancer patients treated with the tyrosine kinase inhibitors, sunitinib and nilotinib, and we discuss the role of these treatments in the pathogenesis of leg ulcers. PATIENTS AND METHODS: Case 1. A 62-year-old patient on sunitinib for intrahepatic cholangiocarcinoma developed a lesion on her right foot. The vascular evaluation was negative...
August 12, 2016: Annales de Dermatologie et de Vénéréologie
https://www.readbyqxmd.com/read/27476154/recalcitrant-venous-leg-ulcers-may-heal-by-outpatient-treatment-of-venous-disease-even-in-the-presence-of-concomitant-arterial-occlusive-disease
#20
G Mosti, A Cavezzi, G Massimetti, H Partsch
OBJECTIVE/BACKGROUND: Peripheral arterial occlusive disease (PAOD) is reported in about 15-20% of patients with venous leg ulcers (VLU). In such cases arterial recanalization is often recommended, and compression therapy is considered a contraindication when the ankle brachial pressure index (ABPI) is < 0.8. The aim of this study was to compare the outcome of patients with recalcitrant VLU, both without any arterial impairment ("pure venous recalcitrant leg ulcer" [pvRLU]) and with associated PAOD ("mixed arterial and venous recalcitrant leg ulcer" [mavRLU]), by treating only the venous disease...
September 2016: European Journal of Vascular and Endovascular Surgery
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