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Amputation risk score

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https://www.readbyqxmd.com/read/28090010/long-term-outcomes-after-percutaneous-lower-extremity-arterial-interventions-with-atherectomy-vs-balloon-angioplasty%C3%A3-propensity-score-matched-registry
#1
Adam Janas, Piotr P Buszman, Krzysztof P Milewski, Szymon Wiernek, Ksenia Janas, Maciej Pruski, Wojciech Wojakowski, Aleksandra Błachut, Wojciech Picheta, Pawel Buszman, Stefan Kiesz
BACKGROUND: The impact of endovascular revascularization of the lower extremity arteries with atherectomy (AT) compared with percutaneous transluminal angioplasty (PTA) is still unclear. Therefore, the aim of the study was to compare long-term outcomes after percutaneous PTA and AT in patients requiring endovascular revascularization.Methods and Results:This was a single-center, retrospective registry of obstructive and symptomatic PAD patients who underwent endovascular revascularization...
January 14, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28073665/predictive-ability-of-the-society-for-vascular-surgery-wound-ischemia-and-foot-infection-wifi-classification-system-after-first-time-lower-extremity-revascularizations
#2
Jeremy D Darling, John C McCallum, Peter A Soden, Raul J Guzman, Mark C Wyers, Allen D Hamdan, Hence J Verhagen, Marc L Schermerhorn
OBJECTIVE: The Society for Vascular Surgery (SVS) Wound, Ischemia and foot Infection (WIfI) classification system was proposed to predict 1-year amputation risk and potential benefit from revascularization. Our goal was to evaluate the predictive ability of this scale in a real-world selection of patients undergoing a first-time lower extremity revascularization for chronic limb-threatening ischemia (CLTI). METHODS: From 2005 to 2014, 1336 limbs underwent a first-time lower extremity revascularization for CLTI, of which 992 had sufficient data to classify all three WIfI components (wound, ischemia, and foot infection)...
January 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28071959/tenfold-risk-increase-of-major-cardiovascular-events-after-high-limb-amputation-with-non-compliance-for-secondary-prevention-measures
#3
Evgeniya V Shalaeva, Hugo Saner, Bakhtiyor B Janabaev, Aleksandra V Shalaeva
Background The aim of the study was to evaluate the impact of compliance with lifestyle recommendations and medication on 1-year prevention of major adverse cardiovascular events (MACE) in patients with type 2 diabetes (T2D) after trans-femoral amputation (TFA). Methods In this prospective single-center interventional cohort study, 179 consecutive T2D patients with symptomatic coronary artery disease (CAD) underwent 1-year follow-up examination after TFA in 2013. Lower limb and coronary artery CT angiography were provided before surgery; physical examination and laboratory tests were performed at baseline and every month after TFA for 1 year...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28066525/the-effect-of-transfemoral-interface-design-on-gait-speed-and-risk-of-falls
#4
Jason T Kahle, Tyler D Klenow, William J Sampson, M Jason Highsmith
Falls and diminished walking capacity are impairments common in persons with transfemoral amputation (TFA). Reducing falls and optimizing walking capacity through such means as achieving a more normal gait speed and community ambulation should be considered when formulating the prosthetic prescription. Because walking capacity and balance confidence are compromised with TFA, these outcomes should be considered when evaluating interfaces for transfemoral prosthetic users. The purpose of this study was to compare the effect of TFA interface design on walking capacity and balance confidence A retrospective cohort design was utilized involving unilateral TFA patients who used ischial ramus containment (IRC) and High-Fidelity (HiFi) interfaces (independent variables)...
September 2016: Technology and Innovation
https://www.readbyqxmd.com/read/28059972/endovascular-versus-open-revascularization-for-peripheral-arterial-disease
#5
Jason T Wiseman, Sara Fernandes-Taylor, Sandeep Saha, Jeffrey Havlena, Paul J Rathouz, Maureen A Smith, K Craig Kent
OBJECTIVE: The aim of this study was to determine whether endovascular or open revascularization provides an advantageous approach to symptomatic peripheral arterial disease (PAD) over the longer term. SUMMARY OF BACKGROUND DATA: The optimal revascularization strategy for symptomatic lower extremity PAD is not established. METHODS: We evaluated amputation-free survival, overall survival, and relative rate of subsequent vascular intervention after endovascular or open lower extremity revascularization for propensity-score matched cohorts of Medicare beneficiaries with PAD from 2006 through 2009...
February 2017: Annals of Surgery
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
#6
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/28032037/surgical-apgar-score-predicts-early-complication-in-transfemoral-amputees-retrospective-study-of-170-major-amputations
#7
Christian Wied, Nicolai B Foss, Morten T Kristensen, Gitte Holm, Thomas Kallemose, Anders Troelsen
AIM: To assess whether the surgical apgar score (SAS) is a prognostic tool capable of identifying patients at risk of major complications following lower extremity amputations surgery. METHODS: This was a single-center, retrospective observational cohort study conducted between January 2013 and April 2015. All patients who had either a primary transtibial amputation (TTA) or transfemoral amputation (TFA) conducted at our institution during the study period were assessed for inclusion...
December 18, 2016: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28002371/polymicrobial-periprosthetic-joint-infections-outcome-of-treatment-and-identification-of-risk-factors
#8
Timothy L Tan, Michael M Kheir, Dean D Tan, Javad Parvizi
BACKGROUND: The treatment outcomes of periprosthetic joint infection are frequently dependent on characteristics of the causative organism. The objective of this comparative study was to investigate the prevalence of and risk factors for development of polymicrobial periprosthetic joint infection, and the outcome of surgical treatment of these patients. METHODS: All patients with polymicrobial, monomicrobial, or culture-negative periprosthetic joint infection treated from 2000 to 2014 were identified at a single institution...
December 21, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27996340/geographic-variation-as-a-risk-factor-for-digital-ulcers-in-systemic-sclerosis-patients-a-multicentre-registry
#9
Ejr Souza, C S Muller, Amc Horimoto, R A Rezende, I Guimarães, H A Mariz, A T Dantas, I P Da Costa, Apt Del-Rio, J Sekiyama, C B Kahwage, C Kayser
OBJECTIVE: To evaluate the influence of geographic variation on the risk of digital ulcer (DU) development in systemic sclerosis (SSc) patients. METHODS: This cross-sectional, multicentre study evaluated patients with SSc from centres located in different geographic regions of Brazil (subtropical and tropical climate zones). Demographic and clinical data were collected. RESULTS: The study included 141 patients with SSc (26 from the subtropical and 115 from the tropical zone)...
December 20, 2016: Scandinavian Journal of Rheumatology
https://www.readbyqxmd.com/read/27909134/what-is-the-morbidity-of-a-non-invasive-growing-prosthesis
#10
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-popliteal-artery-aneurysms-a-word-of-caution-after-long-term-follow-up
#11
Cosimo Maraglino, Gianluca Canu, Renzo Ambrosi, Franco Briolini, Riccardo Gotti, Pietro Cefalì, Fabio Calliari, Paolo Ferrero, Franco Terraneo
BACKGROUND: The aim of this work was to evaluate the long-term patency of endografting in the treatment of popliteal artery aneurysms (PAAs) and to identify which factors may be predictors of graft occlusion. METHODS: All the patients who 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 27, 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
#12
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
#13
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
#14
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
#15
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
#16
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 (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 22, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27843849/a-study-of-risk-factors-and-foot-care-behavior-among-diabetics
#17
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
#18
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
#19
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
#20
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
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