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https://www.readbyqxmd.com/read/27909134/what-is-the-morbidity-of-a-non-invasive-growing-prosthesis
#1
M M Gilg, C L Gaston, M C Parry, L Jeys, A Abudu, R M Tillman, S R Carter, R J Grimer
AIMS: Extendible endoprostheses have been available for more than 30 years and have become more sophisticated with time. The latest generation is 'non-invasive' and can be lengthened with an external magnetic force. Early results have shown a worryingly high rate of complications such as infection. This study investigates the incidence of complications and the need for further surgery in a cohort of patients with a non-invasive growing endoprosthesis. PATIENTS AND METHODS: Between 2003 and June 2014, 50 children (51 prostheses) had a non-invasive growing prosthesis implanted for a primary bone sarcoma...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27903472/-endovascular-treatment-of-poplital-artery-aneurysms-a-word-of-caution-after-long-term-follow-up
#2
Cosimo Maraglino, Gianluca Canu, Renzo Ambrosi, Franco Briolini, Riccardo Gotti, Pietro Cefalì, Fabio Calliari, Paolo Ferrero, Franco Terraneo
PURPOSE: The aim of this work was to evaluate the long-term patency of endo-grafting in the treatment of popliteal artery aneurysms (Paa) and to identify which factors may be predictor of graft occlusion. METHODS: All the patients that underwent endovascular repair of Paa were analyzed from 2006 until 2014 on the basis of symptoms, comorbidities, limb salvage and long-term patency. The predictive value of the different variables was assessed in univariate analysis for primary patency and, for factors resulted significant, a multivariate analysis was performed...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27901322/risk-factors-analysis-of-thromboembolectomy-for-acute-thromboembolic-lower-extremity-ischemia-in-native-arteries
#3
Gabriele Piffaretti, Alessandro Angrisano, Marco Franchin, Massimo Ferrario, Nicola Rivolta, Alessandro Bacuzzi, Patrizio Castelli, Matteo Tozzi
BACKGROUND: Aim of this study is to report the results of thromboembolectomy (ThEmb) for acute thromboembolic lower limb ischemia (ATLI) in native arteries and to create a predictive score for amputation-free survival (AFS) at 30 days. METHODS: It is a single center, retrospective analysis of a four years period. All patients had ThEmb: adjunctive procedures included femoral and/or popliteal endarterectomy in 30 (18.3%) cases, PTA- stent in 24 (14.6%), and femoral endarterectomy plus PTA-stent in 12 (7...
November 30, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27898155/balance-confidence-and-activity-of-community-dwelling-patients-with-transtibial-amputation
#4
Alena Mandel, Kailan Paul, Ruby Paner, Michael Devlin, Steve Dilkas, Tim Pauley
The purpose of this study was to examine the relationship between balance confidence and community-based physical activity. Twenty-two community-dwelling patients with right or left unilateral transtibial amputation who reported no falls in the past 6 mo completed the Activities-Specific Balance Confidence Scale (ABC) and wore a StepWatch Activity Monitor for 7 consecutive d in the community. Subjects were subsequently stratified as low ( <3,000 steps/d) or high (>/=3,000) steps/d) activity groups. Balance confidence was significantly lower among the low activity weekday group (LAG, 70...
2016: Journal of Rehabilitation Research and Development
https://www.readbyqxmd.com/read/27897381/pathologic-fracture-in-childhood-and-adolescent-osteosarcoma-a-single-institution-experience
#5
Lindsay Haynes, Sue C Kaste, Kirsten K Ness, Jianrong Wu, Lucia Ortega-Laureano, Michael Bishop, Michael Neel, Bhaskar Rao, Israel Fernandez-Pineda
PURPOSE: Pathologic fractures occur in 5-10% of pediatric osteosarcoma (OS) cases and have historically been considered a contraindication to limb salvage. Our purpose was to describe the radiographic features of pathologic fracture and examine its impact on local recurrence rates, functional outcomes, and overall survival. METHODS: We retrospectively analyzed patients at our institution from 1990 to 2015 with pathologic fracture at diagnosis or during neoadjuvant chemotherapy...
November 5, 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27893784/circadian-variation-of-plasminogen-activator-inhibitor-1-levels-in-children-with-meningococcal-sepsis
#6
Navin P Boeddha, Gertjan J Driessen, Marjon H Cnossen, Jan A Hazelzet, Marieke Emonts
OBJECTIVE: To study whether the circadian variation of plasminogen-activator-inhibitor-1 (PAI-1) levels, with high morning levels, is associated with poor outcome of children with meningococcal sepsis presenting in the morning hours. DESIGN: Retrospective analysis of prospectively collected clinical and laboratory data. SETTING: Single center study at Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands. SUBJECTS: 184 patients aged 3 weeks to 18 years with meningococcal sepsis...
2016: PloS One
https://www.readbyqxmd.com/read/27884648/dipeptidyl-peptidase-4-inhibitors-peripheral-arterial-disease-and-lower-extremity-amputation-risk-in-diabetic-patients
#7
Chun-Chin Chang, Yung-Tai Chen, Chien-Yi Hsu, Yu-Wen Su, Chun-Chih Chiu, Hsin-Bang Leu, Po-Hsun Huang, Jaw-Wen Chen, Shing-Jong Lin
BACKGROUND: Recent studies have elucidated the vascular protective effects of dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors). However, to date no large-scale studies have been carried out to determine the impact of DPP-4 inhibitors on the occurrence of peripheral arterial disease, and lower extremity amputation risk in patients with type 2 diabetes mellitus. METHODS: We conducted a retrospective registry analysis using Taiwan's National Health Insurance Research Database to investigate the correlation between the use of DPP-4 inhibitors and risk of peripheral arterial disease in patients with type 2 diabetes mellitus...
November 21, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27843849/a-study-of-risk-factors-and-foot-care-behavior-among-diabetics
#8
Mackson Nongmaithem, Arjinder Pal Singh Bawa, Abhilash Kumar Pithwa, Simran Kaur Bhatia, Gurjit Singh, Somnath Gooptu
BACKGROUND: Diabetic foot results in considerable morbidity and mortality in developing countries and the prevalence of diabetes is expected to increase further in the next decades in these countries. Diabetic ulcers are the most common foot injuries leading to lower extremity amputation. Family physicians have a pivotal role in the prevention or early diagnosis of diabetic foot complications. Patient education regarding foot hygiene, nail care and proper footwear is crucial to reducing the risk of an injury that can lead to ulcer formation...
April 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/27803235/a-comparison-of-necrotising-fasciitis-in-diabetics-and-non-diabetics-a-review-of-127-patients
#9
J H Tan, B T H Koh, C C Hong, S H Lim, S Liang, G W H Chan, W Wang, A Nather
AIMS: Diabetes mellitus is the most common co-morbidity associated with necrotising fasciitis. This study aims to compare the clinical presentation, investigations, Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) score, microbiology and outcome of management of this condition in diabetic and non-diabetic patients. PATIENTS AND METHODS: The medical records of all patients with surgically proven necrotising fasciitis treated at our institution between 2005 and 2014 were reviewed...
November 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27783183/association-of-sudomotor-function-with-peripheral-artery-disease-in-type-2-diabetes
#10
Simran Chahal, Kanchan Vohra, Ashit Syngle
Peripheral artery disease (PAD) is the major risk factor for cardiovascular disease and lower extremity amputation in patients with diabetes. Autonomic neuropathy is a risk factor for cardiovascular-related morbidity and mortality. Sudomotor dysfunction is well established in type 2 diabetes mellitus (T2DM) and reflects small fibre neuropathy, cardiovascular autonomic neuropathy and peripheral sympathetic autonomic neuropathy. However, the relationship between sudomotor dysfunction and PAD remains unexplored...
October 25, 2016: Neurological Sciences
https://www.readbyqxmd.com/read/27737513/pharmacologic-interventions-for-treating-phantom-limb-pain
#11
REVIEW
Maria Jenelyn M Alviar, Tom Hale, Monalisa Dungca
BACKGROUND: This is an updated version of the original Cochrane review published in Issue 12, 2011. Phantom limb pain (PLP) is pain that arises in the missing limb after amputation and can be severe, intractable, and disabling. Various medications have been studied in the treatment of phantom pain. There is currently uncertainty in the optimal pharmacologic management of PLP. OBJECTIVES: This review aimed to summarise the evidence of effectiveness of pharmacologic interventions in treating PLP...
October 14, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27723246/comparison-of-five-systems-of-classification-of-diabetic-foot-ulcers-and-predictive-factors-for-amputation
#12
Byung-Joon Jeon, Hwan Jun Choi, Jin Seok Kang, Min Sung Tak, Eun Soo Park
Diabetes mellitus is a common metabolic disorder. Among various complications, diabetic neuropathy and peripheral vascular disorders are closely associated with diabetic foot ulcers (DFUs). Lower extremity ulcers and amputations are ongoing problems among individuals with diabetes. There are several classification systems for DFUs; however, no prognostic system has to date been accepted as the gold standard or the optimum prediction tool for amputations. A retrospective study was designed. Demographic data and baseline laboratory data were gathered and scored or evaluated using five representative DFU classification systems...
October 10, 2016: International Wound Journal
https://www.readbyqxmd.com/read/27692110/necrotising-fasciitis-of-the-extremities-implementation-of-new-management-technologies
#13
Pablo S Corona, Frank Erimeiku, Maria Mercedes Reverté-Vinaixa, Francisco Soldado, Carles Amat, Lluis Carrera
INTRODUCTION: Necrotising fasciitis (NF) is potentially life-threatening soft-tissue infection. Early diagnosis and aggressive surgical debridement are critical to decrease mortality and morbidity. The impacts of new management technologies such as hydro-bisturi-assisted debridement (HAD) and negative pressure wound therapy (NPWT) are not yet clear with respect to treatment of NF. The objective of this study was to describe laboratory (including LRINEC score), clinical and microbiological factors, treatment methods and outcomes related to managing necrotising fasciitis, focusing on the implementation of new treatment methods in our centre...
September 2016: Injury
https://www.readbyqxmd.com/read/27670570/arterial-injuries-associated-with-blunt-fractures-in-the-lower-extremity
#14
Jamie J Coleman, Saharnaz Tavoosi, Ben L Zarzaur, Brian L Brewer, Grace S Rozycki, David V Feliciano
Problems related to the combination of an arterial injury and a blunt fracture in the lower extremity are well known-delayed diagnosis, damaged soft tissue, and high amputation rate. The actual incidence of this injury pattern is, however, unknown. The purposes of this study were to determine the current incidence of named arterial injuries in patients with blunt fractures in the lower extremities and assess potential associated risk factors. This was a 7-year (2007-2013) retrospective review of patients ≥18 years with blunt lower extremity fractures at a Level I trauma center...
September 2016: American Surgeon
https://www.readbyqxmd.com/read/27612355/dismounted-blast-injuries-in-patients-treated-at-a-role-3-military-hospital-in-afghanistan-patterns-of-injury-and-mortality
#15
John S Oh, Creighton C Tubb, Thomas P Poepping, Paul Ryan, Jonathan C Clasper, Adrian R Katschke, Caroline Tuman, Michael J Murray
BACKGROUND: The purposes of this study are to define the pattern of injuries sustained by dismounted troops exposed to improvised explosive devices blasts treated at a Role 3 combat support hospital and to assess injury patterns and mortality associated with the mechanism. Our hypothesis was that mortality is associated with pelvic fracture, massive transfusion, high Injury Severity Score (ISS), multiple limb amputations, and transfer from a Role 2 facility. STUDY DESIGN: Retrospective study of 457 patients...
September 2016: Military Medicine
https://www.readbyqxmd.com/read/27587520/fluoroscopy-guided-reduction-and-fibular-nail-fixation-to-manage-unstable-ankle-fractures-in-patients-with-diabetes-a-retrospective-cohort-study
#16
B D Ashman, C Kong, K J Wing, M J Penner, K E Bugler, T O White, A S E Younger
AIMS: Patients with diabetes are at increased risk of wound complications after open reduction and internal fixation of unstable ankle fractures. A fibular nail avoids large surgical incisions and allows anatomical reduction of the mortise. PATIENTS AND METHODS: We retrospectively reviewed the results of fluoroscopy-guided reduction and percutaneous fibular nail fixation for unstable Weber type B or C fractures in 24 adult patients with type 1 or type 2 diabetes...
September 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27568125/effectiveness-of-the-multidisciplinary-risk-assessment-and-management-program-for-patients-with-diabetes-mellitus-ramp-dm-for-diabetic-microvascular-complications-a-population-based-cohort-study
#17
F Jiao, C S C Fung, Y F Wan, S M McGhee, C K H Wong, D Dai, R Kwok, C L K Lam
AIM: To evaluate the effectiveness of the multidisciplinary Risk Assessment and Management Program for Patients with Diabetes Mellitus (RAMP-DM) in reducing the risks of microvascular complications. METHODS: This prospective cohort study was conducted with 29,670 propensity-score-matched RAMP-DM participants and diabetes patients under the usual primary care (14,835 in each group). Study endpoints were the first occurrence of any diabetic microvascular complications, non-proliferative diabetic retinopathy/preproliferative diabetic retinopathy (NPDR/prePDR), sight-threatening diabetic retinopathy (STDR) or blindness, nephropathy, end-stage renal disease (ESRD), neuropathy and lower-limb ulcers or amputation...
December 2016: Diabetes & Metabolism
https://www.readbyqxmd.com/read/27539890/osteoarthritis-related-difficulty-walking-and-risk-for-diabetes-complications
#18
G A Hawker, R Croxford, A S Bierman, P Harvey, B Ravi, T Kendzerska, I Stanaitis, L K King, L Lipscombe
OBJECTIVES: To examine the effect of Osteoarthritis (OA)-related difficulty walking on risk for diabetes complications in persons with diabetes and OA. DESIGN: A population cohort aged 55+ years with symptomatic hip and knee OA was recruited 1996-98 and followed through provincial administrative data to 2015 (n = 2,225). In those with confirmed OA (examination and radiographs) and self-reported diabetes at baseline (n = 359), multivariate Cox regression modeling was used to examine the relationship between baseline difficulty walking (Health Assessment Questionnaire (HAQ) difficulty walking score; use of walking aid) and time to first diabetes-specific complication (hospitalization for hypo- or hyperglycemia, infection, amputation, retinopathy, or initiation of chronic renal dialysis) and cardiovascular (CV) events...
August 16, 2016: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/27487677/-preventive-measures-of-diabetic-foot-complications
#19
Sarah Malacarne, Bernhard Chappuis, Marc Egli, Isabelle Hagon-Traub, Katrin Schimke, Claude Schönenweid, Bettina Peter-Riesch
Diabetic foot complications are a public health challenge and preventive measures although simple are often not enforced, as evidenced by the lack of decrease in the rate of ulcers and amputation in Switzerland. This article proposes a risk score to grade individual risk of the diabetic patient and an individualized prevention measures as this risk. We discuss the importance of collaboration of various specialists. Two areas are important, first the early involvement of specialists in revascularization because the diabetic population with feet at risk of ulcération risk nowadays primarily has neuro-ichemic ulcerations and also the close collaboration with podiatrists and orthopedic shoemakers who are full partners of the multidisciplinary team...
June 1, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/27485674/risk-factors-for-falls-in-people-with-a-lower-limb-amputation-a-systematic-review
#20
Susan W Hunter, Frances Batchelor, Keith D Hill, Anne-Marie Hill, Shylie Mackintosh, Michael Payne
OBJECTIVE: To review the evidence connecting risk factors to falls in adults with a lower limb amputation (LLA) across the continuum of care settings. DESIGN: Systematic review. LITERATURE SURVEY: Electronic database searches were conducted in MEDLINE, Pubmed, CINAHL and EMBASE covering 01/1988 and 01/2016. Non-interventional studies, including cohort and cross-sectional studies were included. Two reviewers independently completed data extraction and quality evaluation...
July 30, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
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