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https://www.readbyqxmd.com/read/28638953/-chronic-leg-ulcers
#1
REVIEW
J Dissemond
Chronic wounds often manifest as ulcers on the lower legs. The main causes of chronic leg ulcers are chronic venous insufficiency and/or peripheral arterial occlusive disease in approximately 80% of all patients. However, there are also numerous other potentially relevant factors which can cause or almost impede the healing of chronic leg ulcers. Therefore, disease such as vasculitis, livedo vasculopathy, pyoderma gangrenosum, necrobiosis lipoidica, Martorell hypertensive leg ulcer, calciphylaxis, infectious diseases, neoplasms, drugs, cutaneous artefacts and genetic defects are exemplarily presented...
June 21, 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/28602045/compression-therapy-for-venous-leg-ulcers-risk-factors-for-adverse-events-and-complications-contraindications-a-review-of-present-guidelines
#2
A Andriessen, J Apelqvist, G Mosti, H Partsch, C Gonska, M Abel
INTRODUCTION: The adequate use of compression in venous leg ulcer treatment is equally important to patients as well as clinicians. Currently there is a lack of clarity on contra-indications, risk factors, adverse events and complications, when applying compression therapy for venous leg ulcer patients. METHODS: The project aimed to optimize prevention, treatment and maintenance approaches by recognizing contra-indications, risk factors, adverse events and complications, when applying compression therapy for venous leg ulcer patients...
June 11, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28502548/lifelong-limb-preservation-a-patient-centered-description-of-lower-extremity-arterial-reconstruction-outcomes
#3
Katie E Shean, Peter A Soden, Marc L Schermerhorn, Sara L Zettervall, Sarah E Deery, Jeremy D Darling, Allen Hamdan, Frank W LoGerfo
BACKGROUND: Life expectancy is short for patients with critical limb ischemia (CLI), many of whom may fear amputation more than death. In light of the reduced life expectancy of these patients, the traditional 5-year freedom from amputation (FFA) statistic may not accurately address their concern. We developed a more relevant patient-centered calculation of major amputation risk during a patient's remaining lifetime to better answer the question, Will I ever lose my leg? METHODS: We identified all limbs undergoing first-time intervention for CLI in a large institutional database from 2005 to 2013...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28440519/-prevention-diagnosis-and-treatment-of-perioperative-complications-of-bariatric-and-metabolic-surgery
#4
Haifu Wu, Ming Zhong, Di Zhou, Chenye Shi, Heng Jiao, Wei Wu, Xinxia Chang, Jing Cang, Hua Bian
Surgical operation in treating obesity and type 2 diabetes is popularizing rapidly in China. Correct prevention and recognition of perioperation-related operative complications is the premise of ensuring surgical safety. Familiar complications of the operation include deep venous thrombosis, pulmonary artery embolism, anastomotic bleeding, anastomotic fistula and marginal ulcer. The prevention of deep venous thrombosis is better than treatment. The concrete measures contain physical prophylaxis (graduated compression stocking and intermittent pneumatic compression leg sleeves) and drug prophylaxis (unfractionated heparin and low molecular heparin), and the treatment is mainly thrombolysis or operative thrombectomy...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28287292/-long-term-results-after-invasive-treatment-of-critical-limb-ischemia
#5
Zoltán Ruzsa, Ferenc Kuti, Balázs Berta, Károly Tóth, Zoltán Bánsághi, Zoltán Vámosi, Kálmán Hüttl
INTRODUCTION AND AIM: Surgical tibial bypass for critical limb ischemia is associated with significant morbidity, mortality, and graft failure, whereas percutaneous angioplasty and stenting has promising results. The objective of this study was the investigation of the long term results of below-knee percutaneous angioplasty for restoring straight inline arterial flow in patients with critical limb ischemia. METHOD: The clinical and angiographic data of 281 consecutive patients with critical limb ischemia treated by PTA between 2008 and 2011 was evaluated in a prospective register...
March 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28248201/intravascular-hemolysis-and-the-pathophysiology-of-sickle-cell-disease
#6
REVIEW
Gregory J Kato, Martin H Steinberg, Mark T Gladwin
Hemolysis is a fundamental feature of sickle cell anemia that contributes to its pathophysiology and phenotypic variability. Decompartmentalized hemoglobin, arginase 1, asymmetric dimethylarginine, and adenine nucleotides are all products of hemolysis that promote vasomotor dysfunction, proliferative vasculopathy, and a multitude of clinical complications of pulmonary and systemic vasculopathy, including pulmonary hypertension, leg ulcers, priapism, chronic kidney disease, and large-artery ischemic stroke. Nitric oxide (NO) is inactivated by cell-free hemoglobin in a dioxygenation reaction that also oxidizes hemoglobin to methemoglobin, a non-oxygen-binding form of hemoglobin that readily loses heme...
March 1, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28231377/evidence-based-s3-guidelines-for-diagnostics-and-treatment-of-venous-leg-ulcers-answer-to-dr-bertolini
#7
LETTER
M Neumann
No abstract text is available yet for this article.
February 23, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28222435/extracorporal-shock-waves-activate-migration-proliferation-and-inflammatory-pathways-in-fibroblasts-and-keratinocytes-and-improve-wound-healing-in-an-open-label-single-arm-study-in-patients-with-therapy-refractory-chronic-leg-ulcers
#8
Ilknur Aschermann, Seema Noor, Sascha Venturelli, Tobias Sinnberg, Christian Busch, Christian D Mnich
BACKGROUND/AIMS: Chronic leg ulcers (CLUs) are globally a major cause of morbidity and mortality with increasing prevalence. Their treatment is highly challenging, and many conservative, surgical or advanced therapies have been suggested, but with little overall efficacy. Since the 1980s extracorporal shock wave therapy (ESWT) has gained interest as treatment for specific indications. Here, we report that patients with CLU showed wound healing after ESWT and investigated the underlying molecular mechanisms...
2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28182532/healing-of-an-arterial-leg-ulcer-by-compression-bandaging-a-case-report
#9
C Sanchez, H Partsch
This case report demonstrates that arterial ulcers may heal with compression therapy. The patient was a 72-year-old woman with elevated blood pressure and type II diabetes mellitus, who underwent angiography because of a painful, non-healing ulcer over the shin. The angiography showed multisegment arterial occlusive disease, not amenable to surgical revascularisation. After 4 months of wearing inelastic bandages, with increased pressure over the ulcer area and hypertension and diabetes under control, the patient was pain-free and the ulcer had healed...
February 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28166662/-ischemic-origin-of-diabetic-foot-disease-epidemiology-difficulties-of-diagnosis-options-for-prevention-and-revascularization
#10
Endre Kolossváry, Zoltán Bánsághi, Gábor Viktor Szabó, Zoltán Járai, Katalin Farkas
"Diabetic foot" as definition covers a multifactorial clinical condition. According to the recent epidemiological data, the role of lower limb ischemia is getting more influential over other pathological causes, like neuropathy, infections and bone or soft tissue deformity. In diabetes, vascular disease leads to increased risk for leg ulcers and minor or major amputations. The traditional diagnostic tools for recognition of peripheral arterial disease have limited value because of diabetes specific clinical manifestations...
February 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28153676/a-model-to-estimate-cost-savings-in-diabetic-foot-ulcer-prevention-efforts
#11
Neal R Barshes, Samira Saedi, James Wrobel, Panos Kougias, O Erhun Kundakcioglu, David G Armstrong
BACKGROUND: Sustained efforts at preventing diabetic foot ulcers (DFUs) and subsequent leg amputations are sporadic in most health care systems despite the high costs associated with such complications. We sought to estimate effectiveness targets at which cost-savings (i.e. improved health outcomes at decreased total costs) might occur. METHODS: A Markov model with probabilistic sensitivity analyses was used to simulate the five-year survival, incidence of foot complications, and total health care costs in a hypothetical population of 100,000 people with diabetes...
April 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28092221/tuberculosis-mimicking-primary-systemic-vasculitis-not-to-be-missed
#12
Ankit Jain, Durga Prasanna Misra, A Ramesh, Debdatta Basu, Vikramraj K Jain, Vir Singh Negi
Infections are an important differential diagnosis in patients presenting with features of systemic vasculitis. We report a young lady with constitutional features, leg ulcers, digital gangrene and absent peripheral pulses with cervical adenopathy. Chest imaging revealed multiple necrotic lung lesions and involvement of left subclavian artery at its origin from the aorta, Histopathology from cervical lymph nodes showed multiple caseated lymph nodes, which in the context of a positive Mantoux test led us to diagnose tuberculosis and institute appropriate therapy...
April 2017: Tropical Doctor
https://www.readbyqxmd.com/read/28060003/clinical-characteristics-of-mixed-arteriovenous-leg-ulcers-a-descriptive-study
#13
Joseph A Marin, Kevin Y Woo
PURPOSE: The purpose of this study was to identify the clinical characteristics of mixed arteriovenous leg ulcers (MLU) that differentiated them from venous leg ulcers (VLU). DESIGN: Secondary analysis of data from larger electronic database. SUBJECTS AND SETTING: The sample comprised 1007 persons with lower extremity ulcers. Two hundred sixty three individuals with MLU were compared to 744 individuals with VLU; their ankle brachial indices were 0...
January 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28054925/the-wound-trend-scale-a-retrospective-review-of-utility-and-predictive-value-in-the-assessment-and-documentation-of-lower-leg-ulcers
#14
Noreen A Campbell, Donna L Campbell, Andrea Turner
Wound assessment is essential to manage wound care. The Wound Trend Scale (WTS) is a paper-and-pen instrument comprised of 14 parameters designed to guide assessment of findings relevant to lower leg ulcer management and includes an infection screen and cues for physician consultation. To determine its clinical utility, predictive value, and reliability, data were retrospectively analyzed from a random sampling of medical records of patients seen at a Foot and Leg Clinic between January 1, 2007 and December 31, 2008...
December 2016: Ostomy/wound Management
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
#15
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
#16
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...
February 2017: 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
#17
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...
January 2017: Annales de Dermatologie et de Vénéréologie
https://www.readbyqxmd.com/read/27767288/tricenter-analysis-of-cofactors-and-comorbidity-in-patients-with-pyoderma-gangrenosum
#18
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
#19
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
#20
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
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