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https://www.readbyqxmd.com/read/28722354/risk-factors-for-amputation-in-patients-with-diabetic-foot-infection-a-prospective-study
#1
Serhat Uysal, Bilgin Arda, Meltem I Taşbakan, Şevki Çetinkalp, Ilgın Y Şimşir, Anıl M Öztürk, Ayşe Uysal, İlgen Ertam
There is a variety of diagnostic and therapeutic algorithms for diabetic foot infections (DFIs). Some of them are too difficult to be applied in routine clinical approach. In the routine clinical approach, it is necessary to find new risk factors and end up with a quick and easy assessment of DFIs. In this study, we aimed to evaluate the independent risk factors for osteomyelitis, amputation and major amputation in patients with DFI using standard scoring procedures. We prospectively studied 379 patients with DFI...
July 19, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28712488/staged-reconstruction-of-diaphyseal-fractures-with-segmental-defects-surgical-and-patient-reported-outcomes
#2
S D Zoller, L A Cao, R A Smith, W Sheppard, E L Lord, C D Hamad, J H Ghodasra, C Lee, D Jeffcoat
INTRODUCTION: Two-stage limb reconstruction is an option for patients with critical size segmental bone defects following acute trauma or non-union. Reconstruction is technically demanding and associated with a high complication rate. Current protocols for limb reconstruction have well-documented challenges, and no study has reported on patient outcomes using a validated questionnaire. In this study, we aimed to examine the clinical and patient-centered outcomes following our surgical protocol for two-stage limb reconstruction following critical size segmental defects...
June 23, 2017: Injury
https://www.readbyqxmd.com/read/28673381/biomarkers-of-necrotising-soft-tissue-infections-aspects-of-the-innate-immune-response
#3
Marco Bo Hansen
Necrotising soft tissue infection (NSTI) is a life-threatening and rapidly progressing bacterial infection involving one or more layers of the soft tissue compartments causing necrosis. The amputation and mortality rates remain high despite increased focus on the patients. Timely treatment, including surgical intervention, reduces the risk of severe disability and death. However, the lack of pathognomonic signs impedes early diagnosis and treatment. Moreover, the rarity of the disease makes it difficult to conduct large prospective studies, thus prospective research is almost non-existent in this group of patients...
July 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28629292/increased-blood-pressures-in-veterans-with-post-traumatic-stress-disorder
#4
Ehsan Moazen-Zadeh, Alireza Khoshdel, Farhad Avakh, Arash Rahmani
Objective Veterans of war affected by posttraumatic stress disorder (PTSD) are at increased risk for cardiovascular diseases. We aimed to compare brachial and central blood pressures between veterans with PTSD and controls. Method In this case-control study on veterans of Iran-Iraq war, 50 veterans with PTSD and 50 veterans as controls were selected from an outpatient clinic and matched for age ±3 years. Exclusion criteria were malignancies, severe anatomical defects such as amputated extremities, history of PTSD before serving in war, comorbid psychiatric disorders other than anxiety or depressive disorders...
August 2016: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/28580658/improvement-in-perioperative-care-in-pediatric-cardiac-surgery-by-shifting-the-primary-focus-of-treatment-from-cardiac-output-to-perfusion-pressure-are-beta-stimulants-still-needed
#5
Amir-Reza Hosseinpour, Mathieu van Steenberghe, Marc-André Bernath, Stefano Di Bernardo, Marie-Hélène Pérez, David Longchamp, Mirko Dolci, Yann Boegli, Nicole Sekarski, Javier Orrit, Michel Hurni, René Prêtre, Jacques Cotting
OBJECTIVE: An important aspect of perioperative care in pediatric cardiac surgery is maintenance of optimal hemodynamic status using vasoactive/inotropic agents. Conventionally, this has focused on maintenance of cardiac output rather than perfusion pressure. However, this approach has been abandoned in our center in favor of one focusing primarily on perfusion pressure, which is presented here and compared to the conventional approach. DESIGN: A retrospective study...
June 5, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28566407/pelvic-reconstruction-following-resection-of-malignant-bone-tumours-using-a-stemmed-acetabular-pedestal-cup
#6
C Hipfl, C Stihsen, S E Puchner, A Kaider, M Dominkus, P T Funovics, R Windhager
AIMS: Pelvic reconstruction after the resection of a tumour around the acetabulum is a challenging procedure due to the complex anatomy and biomechanics. Several pelvic endoprostheses have been introduced, but the rates of complication remain high. Our aim was to review the use of a stemmed acetabular pedestal cup in the management of these patients. PATIENTS AND METHODS: The study involved 48 patients who underwent periacetabular reconstruction using a stemmed pedestal cup (Schoellner cup; Zimmer Biomet Inc...
June 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28562573/predictors-of-secondary-amputation-in-patients-with-grade-iiic-lower-limb-injuries-a-retrospective-analysis-of-35-patients
#7
Wenhao Song, DongSheng Zhou, Jinlei Dong
The aim of this study was to identify risk factors for failure of limb salvage surgery in grade IIIC lower extremity injuries.A single-institution, retrospective review was performed of all patients with grade IIIC lower limb injuries presenting from January 2009 to April 2014. We gathered the data on each patient who underwent limb salvage and analyzed the final outcome for these patients (limb salvage vs secondary amputation).Grade IIIC lower limb injuries were identified in 41 patients. Primary amputation was performed in 6 patients (15%) as the initial procedure...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28552192/long-term-outcome-of-knee-arthroplasty-in-the-setting-of-pigmented-villonodular-synovitis
#8
Matthew T Houdek, Maurizio Scorianz, Cody C Wyles, Robert T Trousdale, Franklin H Sim, Michael J Taunton
BACKGROUND: Pigmented villonodular synovitis (PVNS) is a rare, benign proliferation of the synovium, commonly affecting the knee. Arthroplasty can successfully manage arthrosis in this population; however, outcome data is limited. The purpose of this study was to investigate the oncologic and functional outcome of patients undergoing total knee arthroplasty (TKA) in the setting of PVNS. METHODS: 48 patients were identified at our institution with histologically confirmed PVNS that subsequently received TKA...
May 25, 2017: Knee
https://www.readbyqxmd.com/read/28502355/how-to-diagnose-and-treat-infection-in-total-ankle-arthroplasty
#9
REVIEW
Yousef Alrashidi, Ahmed E Galhoum, Martin Wiewiorski, Mario Herrera-Pérez, Raymond Y Hsu, Alexej Barg, Victor Valderrabano
Periprosthetic infection after total ankle arthroplasty (TAA) is a serious complication, often requiring revision surgery, including revision arthroplasty, conversion to ankle arthrodesis, or even amputation. Risk factors for periprosthetic ankle infection include prior surgery at the site of infection, low functional preoperative score, diabetes, and wound healing problems. The clinical presentation of patients with periprosthetic ankle joint infection can be variable and dependent on infection manifestation: acute versus chronic...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28483190/acupuncture-treatment-of-diabetic-peripheral-neuropathy-in-an-american-indian-community
#10
Anne Bailey, Deborah Wingard, Matthew Allison, Priscilla Summers, Daniel Calac
Diabetic peripheral neuropathy (DPN) develops in 30% of type 2 diabetes patients, increases the risk for foot ulcers and amputation, and is a significant source of disability and medical costs. Treatment remains challenging, propelling research to focus on therapeutic methods that aim to improve blood circulation or ameliorate oxidative stress that drives development of DPN. The aim of this study was to assess the effectiveness of acupuncture treatment for DPN symptoms and lower extremity arterial circulation in people with type 2 diabetes...
April 2017: Journal of Acupuncture and Meridian Studies
https://www.readbyqxmd.com/read/28433336/the-association-of-postoperative-glycemic-control-and-lower-extremity-procedure-outcomes
#11
Todd R Vogel, Jamie B Smith, Robin L Kruse
OBJECTIVE: The effect of postoperative hyperglycemia in patients undergoing open and endovascular procedures on the lower extremities has not been fully characterized with regard to associated admission diagnoses, hospital complications, mortality, and 30-day readmission. This study evaluated the relationship of postoperative hyperglycemia on outcomes after lower extremity vascular procedures for peripheral artery disease. METHODS: Patients with peripheral artery disease admitted for elective lower extremity procedures between September 2008 and March 2014 were selected from the Cerner Health Facts (Cerner Corporation, Kansas City, Mo) database using International Classification of Diseases, Ninth Edition, Clinical Modification diagnosis and procedure codes...
April 19, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28419034/complications-and-functional-outcomes-after-pantalar-dislocation
#12
Kaeleen A Boden, Douglas S Weinberg, Heather A Vallier
BACKGROUND: Pantalar dislocations without associated talar fracture are rare and have high risks of complications, including infection, osteonecrosis, and posttraumatic osteoarthrosis. Limited information on later function exists. This study evaluated complications and outcomes following pantalar dislocation without talar fracture. METHODS: Nineteen patients were identified with open (n = 14) or closed (n = 5) pantalar dislocations without talar fracture. Ten male and 9 female patients with a mean age of 39...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28410924/society-for-vascular-surgery-wound-ischemia-foot-infection-wifi-score-correlates-with-the-intensity-of-multimodal-limb-treatment-and-patient-centered-outcomes-in-patients-with-threatened-limbs-managed-in-a-limb-preservation-center
#13
William P Robinson, Lorraine Loretz, Colleen Hanesian, Julie Flahive, John Bostrom, Nicholas Lunig, Andres Schanzer, Louis Messina
OBJECTIVE: The Society for Vascular Surgery Wound, Ischemia, foot Infection (WIfI) system aims to stratify threatened limbs according to their anticipated natural history and estimate the likelihood of benefit from revascularization, but whether it accurately stratifies outcomes in limbs undergoing aggressive treatment for limb salvage is unknown. We investigated whether the WIfI stage correlated with the intensity of limb treatment required and patient-centered outcomes. METHODS: We stratified limbs from a prospectively maintained database of consecutive patients referred to a limb preservation center according to WIfI stage (October 2013-May 2015)...
August 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28398564/statin-therapy-reduces-future-risk-of-lower-limb-amputation-in-patient-with-diabetes-and-peripheral-artery-disease
#14
Chien-Yi Hsu, Yung-Tai Chen, Yu-Wen Su, Chun-Chin Chang, Po-Hsun Huang, Shing-Jong Lin
Context: Although there is evidence to support the beneficial effects of statins on major cardiovascular events, few studies address the protection effect of statins on limb outcome. Objective: To investigate whether the use of statin is associated with a risk reduction in lower extremity amputation in type 2 diabetes (DM) patients with peripheral artery disease (PAD). Design: Observational cohort study. Setting: Using a nationwide DM database in Taiwan from 2000 to 2011...
April 7, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28396853/prevalence-of-metabolic-syndrome-and-health-related-quality-of-life-in-war-related-bilateral-lower-limb-amputees
#15
Hanieh-Sadat Ejtahed, Mohammad-Reza Soroush, Shirin Hasani-Ranjbar, Pooneh Angoorani, Batool Mousavi, Mehdi Masumi, Farhad Edjtehadi, Mahmood Soveid
BACKGROUND: Lower limb amputation is correlated with considerable impairments in health-related quality of life (HRQOL) in veterans. The aim of this study is to determine the prevalence of metabolic syndrome (MetS) in veterans with bilateral lower limb amputation and to identify its association with HRQOL. METHODS: This cross-sectional study was conducted on 235 Iranian male veterans with bilateral lower limb amputation. Demographics, anthropometrics, and biochemical measurements were assessed and MetS was defined by National Cholesterol Education Program Adult Treatment Panel III definition...
2017: Journal of Diabetes and Metabolic Disorders
https://www.readbyqxmd.com/read/28389759/risk-factors-for-amputation-in-periprosthetic-knee-infection
#16
Alan Giovanni Polanco-Armenta, Adrián Miguel-Pérez, Adrián Huetzemani Rivera-Villa, Manuel Ignacio Barrera-García, María Guadalupe Sánchez-Prado, Alberto Vázquez-Noya, Fernando Vidal-Cervantes, José de Jesús Guerra-Jasso, José Manuel Pérez-Atanasio
Treatment for prosthetic knee replacement is becoming more common. Infection is an arthroplasty-related complication leading to prolonged hospitalization, multiple surgical procedures, permanent loss of the implant, impaired function, impaired quality of life and even amputation of the limb. Previous studies have evaluated the risk factors associated with periprosthetic knee infection, but scarce information related to risk factors associated with amputation in this group of patients is available. The purpose of this study was to identify risk factors for amputation in periprosthetic infected knee through a case-control study, analyzing patients treated from January 2012 to November 2016 in a hospital with a high incidence of this diagnosis...
April 7, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28388835/clinical-outcomes-in-a-cohort-of-patients-with-heparin-induced-thrombocytopenia
#17
David J Kuter, Barbara A Konkle, Taye H Hamza, Lynne Uhl, Susan F Assmann, Joseph E Kiss, Richard M Kaufman, Nigel S Key, Bruce S Sachais, John R Hess, Paul Ness, Keith R McCrae, Cindy Leissinger, Ronald G Strauss, Janice G McFarland, Ellis Neufeld, James B Bussel, Thomas L Ortel
BACKGROUND: Heparin-induced thrombocytopenia (HIT) is a thrombotic disorder usually prompting treatment with non-heparin anticoagulants. The benefits and risks of such treatments have not been fully assessed. METHODS: We analyzed data for 442 patients having a positive heparin-platelet factor 4 antibody test and recent heparin exposure. The primary outcome was a composite endpoint (death, limb amputation/gangrene, or new thrombosis). Secondary outcomes included bleeding and the effect of anticoagulation...
August 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28367692/operative-wound-complications-following-total-ankle-arthroplasty
#18
Christopher E Gross, Kamran S Hamid, Cynthia Green, Mark E Easley, James K DeOrio, James A Nunley
BACKGROUND: Wound complications following total ankle replacement (TAR) potentially lead to devastating consequences. The aim of this study was to compare the operative and demographic differences in patients with and without major wound problems which required operative management. We hypothesized that increased tourniquet and operative time would negatively influence wound healing. METHODS: We identified a consecutive series of 762 primary TARs performed between December 1999 and April 2014 whose data were prospectively collected...
April 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28342514/angiosome-directed-revascularization-in-patients-with-critical-limb-ischemia
#19
REVIEW
Hidde Jongsma, Joost A Bekken, George P Akkersdijk, Sanne E Hoeks, Hence J Verhagen, Bram Fioole
OBJECTIVE: Direct revascularization (DR), according to the angiosome concept, provides direct blood flow to the site of tissue loss in patients with critical limb ischemia (CLI). DR may lead to improved outcomes; however, evidence for this is controversial. This systematic review and meta-analysis investigated the outcomes of surgical and endovascular DR compared with indirect revascularization (IR) in patients with CLI. METHODS: A systematic review was undertaken using the Cochrane Collaboration specified tool, and a meta-analysis was done according to the MOOSE (Meta-analysis of Observational Studies in Epidemiology) criteria...
April 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28261156/a-decision-tree-analysis-of-diabetic-foot-amputation-risk-in-indian-patients
#20
Prasad Umesh Kasbekar, Pranay Goel, Shailaja Prakash Jadhav
AIM: The aim of this study is to create an evidence-based tool that guides the risk of amputation in diabetic foot patients. MATERIALS AND METHODS: Hospital records of 301 diabetic foot patients were examined retrospectively for explanatory variables of foot amputation decisions. The study included all patients with a lower limb ulcer with a known history of diabetes mellitus or those diagnosed post-admission. The dataset was analyzed, and a risk scoring system was constructed using the decision tree algorithm, C5...
2017: Frontiers in Endocrinology
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