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https://www.readbyqxmd.com/read/29158692/pulsed-radiofrequency-of-brachial-plexus-under-ultrasound-guidance-for-refractory-stump-pain-a-case-report
#1
Bixin Zheng, Li Song, Hui Liu
The post-amputation (pain) syndrome, including stump pain, phantom limb sensation, and phantom limb pain is common but difficult to treat. Refractory stump pain in the syndrome is an extremely challenging and troublesome clinical condition. Patients respond poorly to drugs, nerve blocks, and other effective treatments like spinal cord stimulation and surgery. Pulsed radiofrequency (PRF) technique has been shown to be effective in reducing neuropathic pain. This report describes a patient with persistent and refractory upper limb stump pain being successfully relieved with PRF of brachial plexus under ultrasound guidance after a 6-month follow-up period, suggesting that PRF may be considered as an alternative treatment for refractory stump-neuroma pain...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29157737/predicting-successful-prosthetic-rehabilitation-in-major-lower-limb-amputation-patients-a-15-year-retrospective-cohort-study
#2
Inés Fajardo-Martos, Olga Roda, Ramón Zambudio-Periago, Aurora Bueno-Cavanillas, Fidel Hita-Contreras, Indalecio Sánchez-Montesinos
OBJECTIVE: To determine and compare specific factors that could be associated and predictive with successful prosthetic rehabilitation in major lower-limb amputations. METHODS: A 15-year long (2000-2014) retrospective observational cohort study was conducted. Two different criteria were used to define successful prosthetic rehabilitation: (1) the ability to walk at least 45m, regardless of assistive devices; and (2) walking >45m without other ambulatory aids than one cane (if required)...
November 7, 2017: Brazilian Journal of Physical Therapy
https://www.readbyqxmd.com/read/29157680/immediate-and-late-outcomes-of-endovascular-therapy-for-lower-extremity-arteries-in-buerger-disease
#3
Dae-Hoon Kim, Young-Guk Ko, Chul-Min Ahn, Dong-Ho Shin, Jung-Sun Kim, Byeong-Keuk Kim, Donghoon Choi, Myeong-Ki Hong, Yangsoo Jang
OBJECTIVE: Buerger disease is a rare inflammatory vasculopathy presenting with severe claudication or critical limb ischemia. In this study, we sought to evaluate the feasibility and clinical outcomes of endovascular therapy for Buerger disease involving arteries in the lower extremities. METHODS: Between January 2006 and May 2016, there were 44 Buerger disease patients (43 men; mean age, 40.4 ± 9.6 years) with 50 target limbs treated by endovascular therapy at the Severance Cardiovascular Hospital...
November 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29153044/the-modular-socket-system-in-a-rural-setting-in-indonesia
#4
Bob Giesberts, Liezel Ennion, Olle Hjelmstrom, Agusni Karma, Knut Lechler, Edsko Hekman, Arjen Bergsma
BACKGROUND: Prosthetic services are inaccessible to people living in rural areas. Systems like the modular socket system have the potential to be fabricated outside of the prosthetic workshop. OBJECTIVES: This study aimed to evaluate the patient's performance and satisfaction with the use of the modular socket system, and the technical feasibility of its implementation in a rural setting. STUDY DESIGN: A quantitative longitudinal descriptive study design was followed...
November 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/29153043/effectiveness-of-mirror-therapy-motor-imagery-and-virtual-feedback-on-phantom-limb-pain-following-amputation-a-systematic-review
#5
Laura Herrador Colmenero, Jose Manuel Perez Marmol, Celia Martí-García, María de Los Ángeles Querol Zaldivar, Rosa María Tapia Haro, Adelaida María Castro Sánchez, María Encarnación Aguilar-Ferrándiz
BACKGROUND: Phantom limb pain is reported in 50%-85% of people with amputation. Clinical interventions in treating central pain, such as mirror therapy, motor imagery, or virtual visual feedback, could redound in benefits to amputee patients with phantom limb pain. OBJECTIVES: To provide an overview of the effectiveness of different techniques for treating phantom limb pain in amputee patients. STUDY DESIGN: Systematic review. METHODS: A computerized literature search up to April 2017 was performed using the following databases: PubMed, Scopus, CINAHL, MEDLINE, ProQuest, PEDro, EBSCOhost, and Cochrane Plus...
November 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/29150148/-family-socioeconomic-status-and-health-services-clues-to-health-care-in-diabetic-patients-with-lower-limb-amputations-in-andalusia-a-qualitative-study
#6
Gabriel Jesús Rodríguez, Juan Antonio Córdoba-Doña, Antonio Escolar-Pujolar, Manuel Aguilar-Diosdado, Isabel Goicolea
AIM: To examine the experience of diabetic care in patients undergoing lower limb amputation. DESIGN: A qualitative study using the phenomenological approach. SETTING: Cadiz Health District. PARTICIPANTS: A total of 16 patients (11 men and 5 women) diagnosed with diabetes mellitus type 2 and with non-traumatic lower limb amputation. METHODS: Semi-structured interviews were performed, followed by a content analysis according Graneheim and Lundman...
November 14, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/29148242/infrapopliteal-peripheral-arterial-disease-and-critical-limb-ischemia-the-time-has-come-for-collaborative-streamlined-diagnostic-and-treatment-paradigms
#7
EDITORIAL
Michael S Levy
The diagnosis, surveillance, and management of infrapopliteal critical limb ischemia remain inconsistent among clinicians. This study demonstrates that using an absolute ankle pressure of >73 mm Hg or an absolute toe pressure increase of 1 mm Hg or greater post endovascular intervention in patients with infrapopliteal critical limb ischemia may be predictive of a reduction in target limb revascularization, amputation, and death. This study highlights the need for vascular societies to come together to promote standardized screening, surveillance, and treatment paradigms for this complex population...
November 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29148070/growth-factors-for-diabetic-foot-ulcers-mixed-treatment-comparison-analysis-of-randomized-clinical-trials
#8
Kannan Sridharan, Gowri Sivaramakrishnan
AIMS: Topical growth factors accelerate wound healing in patients with diabetic foot ulcers (DFU). Due to the absence of head to head comparisons, we carried out Bayesian network meta-analysis to compare the efficacy and safety of growth factors. METHODS: Using an appropriate search strategy, randomized controlled trials on topical growth factors compared with standard of care in patients with DFU, were included. Proportion of patients with complete healing was the primary outcome...
November 17, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29147171/recent-progress-of-bypass-surgery-to-the-dialysis-dependent-patients-with-critical-limb-ischemia
#9
Nobuyoshi Azuma, Shinsuke Kikuchi, Hiroko Okuda, Keisuke Miyake, Atsuhiro Koya
According to expansion of dialysis-dependent population, more than half of patients with critical ischemic limbs are dialysis-dependent in Japan. Although patients with end-staged renal disease are well-known as poor life prognosis, well-managed dialysis patients in Japan can survive much longer compared to dialysis patients in the United States and Europe. Therefore, some dialysis patients can enjoy the long-term benefits of bypass surgery. To decide the indication of bypass surgery, patient's general condition, nutrition status, and vein availability are more important rather than arterial disease anatomy...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29147167/validation-of-the-risk-score-of-the-mortality-and-lower-limb-loss-considering-ambulatory-status-after-surgical-revascularization-in-maintaining-patients-with-dialysis
#10
Haruto Yamazaki, Hisae Hayashi, Morio Kawamura, Ayana Sasaki, Eriko Kondo, Shinya Ito, Kenji Wakai
Surgical revascularization is performed to preserve limb and to maintain functional status of patients with critical limb ischemia (CLI). The PREVENT III risk score helps to predict the postoperative course of CLI. However, this score is not available to estimate the risk of amputation or death properly in patients with hemodialysis (HD) and tissue loss (HD: 4 points, Tissue loss: 3 points), because they are classified as a high-risk group. Therefore, we investigated 213 patients with revascularized HD for CLI and proposed prognosis amputation or death for patients with HD risk score (PAD for HD risk score)...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29147164/a-series-of-210-peripheral-arterial-disease-below-knee-amputations-and-predictors-for-subsequent-above-knee-amputations
#11
Jing Ting Wu, Maggie Wong, Zhiwen Joseph Lo, Wei-En Wong, Sriram Narayanan, Glenn Wei Leong Tan, Sadhana Chandrasekar
Objective: To review patient characteristics and outcomes after peripheral arterial disease (PAD)-related below-knee amputation (BKA), and identify risk factors predicting subsequent above-knee amputation (AKA). Materials and Methods: A retrospective study of 210 BKAs between May 2008 and December 2015. Results: The mean age of the study population was 66 years. Most of the patients had cardiovascular comorbidities, and 33% had end-stage renal failure (ESRF); 89% were American Society of Anesthesiologists 3 or 4...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29145179/phantom-sensations-supernumerary-phantom-limbs-and-apotemnophilia-three-body-representation-disorders
#12
Laurent Tatu, Julien Bogousslavsky
Body representation disorders continue to be mysterious and involve the anatomical substrate that underlies the mental representation of the body. These disorders sit on the boundaries of neurological and psychiatric diseases. We present the main characteristics of 3 examples of body representation disorders: phantom sensations, supernumerary phantom limb, and apotemnophilia. The dysfunction of anatomical circuits that regulate body representation can sometimes have paradoxical features. In the case of phantom sensations, the patient feels the painful subjective sensation of the existence of the lost part of the body after amputation, surgery or trauma...
2018: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/29144392/design-and-development-of-a-novel-upper-limb-cycling-prosthesis
#13
Akira Tiele, Shivam Soni-Sadar, Jack Rowbottom, Shilen Patel, Edward Mathewson, Samuel Pearson, David Hutchins, John Head, Stephen Hutchins
The rise in popularity of the Paralympics in recent years has created a need for effective, low-cost sports-prosthetic devices for upper-limb amputees. There are various opportunities for lower-limb amputees to participate in cycling; however, there are only few options for those with upper-limb amputations. If the individual previously participated in cycling, a cycling-specific prosthesis could allow these activities to be integrated into rehabilitation methods. This article describes the processes involved with designing, developing and manufacturing such a prosthesis...
November 16, 2017: Bioengineering
https://www.readbyqxmd.com/read/29144105/motor-imagery-ability-of-patients-with-lower-limb-amputation-exploring-the-course-of-rehabilitation-effects
#14
Elodie Saruco, Aymeric Guillot, Arnaud Saimpont, Franck DI Rienzo, Anne Durand, Catherine Mercier, Francine Malouin, Philip Jackson
BACKGROUND: Amputation of a lower-limb results in a severe decrease of functional mobility that deeply alters independent living. Motor imagery (MI) refers to the mental representation of an action without engaging its actual execution. The repetitive use of MI has been shown to contribute to promote motor recovery and phantom-limb pain alleviation. AIM: Given the importance of invoking accurate images to benefit from MI practice, and considering the link between motor capacities and MI, the present study investigated the effect of a rehabilitation program on MI ability in patients with lower-limb amputation...
November 16, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29133605/low-density-lipoprotein-cholesterol-lowering-with-evolocumab-and-outcomes-in-patients-with-peripheral-artery-disease-insights-from-the-fourier-trial-further-cardiovascular-outcomes-research-with-pcsk9-inhibition-in-subjects-with-elevated-risk
#15
Marc P Bonaca, Patrice Nault, Robert P Giugliano, Anthony C Keech, Armando Lira Pineda, Estella Kanevsky, Julia Kuder, Sabina A Murphy, J Wouter Jukema, Basil S Lewis, Lale Tokgozoglu, Ransi Somaratne, Peter S Sever, Terje R Pedersen, Marc S Sabatine
BACKGROUND : The PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitor evolocumab reduced low-density lipoprotein cholesterol and cardiovascular events in the FOURIER trial (Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk). We investigated the efficacy and safety of evolocumab in patients with peripheral artery disease (PAD) as well as the effect on major adverse limb events. METHODS : FOURIER was a randomized trial of evolocumab versus placebo in 27 564 patients with atherosclerotic disease on statin therapy followed for a median of 2...
November 13, 2017: Circulation
https://www.readbyqxmd.com/read/29132880/rivaroxaban-with-or-without-aspirin-in-patients-with-stable-peripheral-or-carotid-artery-disease-an-international-randomised-double-blind-placebo-controlled-trial
#16
Sonia S Anand, Jackie Bosch, John W Eikelboom, Stuart J Connolly, Rafael Diaz, Peter Widimsky, Victor Aboyans, Marco Alings, Ajay K Kakkar, Katalin Keltai, Aldo P Maggioni, Basil S Lewis, Stefan Störk, Jun Zhu, Patricio Lopez-Jaramillo, Martin O'Donnell, Patrick J Commerford, Dragos Vinereanu, Nana Pogosova, Lars Ryden, Keith A A Fox, Deepak L Bhatt, Frank Misselwitz, John D Varigos, Thomas Vanassche, Alvaro A Avezum, Edmond Chen, Kelley Branch, Darryl P Leong, Shrikant I Bangdiwala, Robert G Hart, Salim Yusuf
BACKGROUND: Patients with peripheral artery disease have an increased risk of cardiovascular morbidity and mortality. Antiplatelet agents are widely used to reduce these complications. METHODS: This was a multicentre, double-blind, randomised placebo-controlled trial for which patients were recruited at 602 hospitals, clinics, or community practices from 33 countries across six continents. Eligible patients had a history of peripheral artery disease of the lower extremities (previous peripheral bypass surgery or angioplasty, limb or foot amputation, intermittent claudication with objective evidence of peripheral artery disease), of the carotid arteries (previous carotid artery revascularisation or asymptomatic carotid artery stenosis of at least 50%), or coronary artery disease with an ankle-brachial index of less than 0·90...
November 10, 2017: Lancet
https://www.readbyqxmd.com/read/29132264/leg-amputation-side-determines-performance-in-curve-sprinting-a-case-study-on-a-paralympic-medalist
#17
Johannes Funken, Kai Heinrich, Steffen Willwacher, Ralf Müller, Jonas Böcker, Hiroaki Hobara, Gert-Peter Brüggemann, Wolfgang Potthast
The lower limb kinetics of curve sprinting in amputees are not well described in the literature, particularly with respect to the effect of the side of amputation. This is an issue due to the importance of the knowledge for prosthetic design and classification of athletes. Thus, the aim of this study was to investigate the influence of side of amputation on curve sprinting performance in athletes with a unilateral leg amputation. A three-dimensional motion analysis system (Vicon), four force plates (Kistler) and a modified mathematical human model (ALASKA) were used to compare clockwise and counter clockwise curve sprinting lower limb kinematics and kinetics of a Paralympic medalist with a left-sided knee exarticular amputation...
November 13, 2017: Sports Biomechanics
https://www.readbyqxmd.com/read/29127251/looking-beyond-the-indication-bone-scan-for-trauma-providing-unsuspected-initial-diagnosis-of-acute-critical-lower-limb-arterial-compromise
#18
Fathima Fijula Palot Manzil, Samuel E Almodovar, Pradeep Bhambhvani
We report a case of rare incidental initial detection of unsuspected arterial supply compromise to the right lower extremity on a bone scan done to rule out fracture in a patient with right hip pain following a fall. Follow up CT angiogram confirmed near complete occlusion of right lower extremity arteries for which patient underwent above knee amputation.
November 10, 2017: Journal of Nuclear Medicine Technology
https://www.readbyqxmd.com/read/29126767/the-quality-of-life-analysis-of-knee-prosthesis-with-complete-microprocessor-control-in-trans-femoral-amputees
#19
Yavuz Saglam, Baris Gulenc, Fevzi Birisik, Ali Ersen, Ebru Yilmaz Yalcinkaya, Onder Yazicioglu
OBJECTIVE: The aim of this study was to analyze the patient demographics, etiology of limb loss as well as reporting SF-36 scores for microprocessor prosthesis users in Turkish population. METHODS: We reviewed 72 patients (61 male and 11 female; mean age: 37.7 ± 10.7) with uni-lateral, above knee amputation and a history of regular and microprocessor prosthesis use. All patients were called back for a last follow-up and they were asked to fill a self-administered general health status questionnaire (SF-36)...
November 7, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/29125416/gamma-oscillations-in-the-somatosensory-thalamus-of-a-patient-with-a-phantom-limb-case-report
#20
Diellor Basha, Jonathan O Dostrovsky, Suneil K Kalia, Mojgan Hodaie, Andres M Lozano, William D Hutchison
The amputation of an extremity is commonly followed by phantom sensations that are perceived to originate from the missing limb. The mechanism underlying the generation of these sensations is still not clear although the development of abnormal oscillatory bursting in thalamic neurons may be involved. The theory of thalamocortical dysrhythmia implicates gamma oscillations in phantom pathophysiology although this rhythm has not been previously observed in the phantom limb thalamus. In this study, the authors report the novel observation of widespread 38-Hz gamma oscillatory activity in spike and local field potential recordings obtained from the ventral caudal somatosensory nucleus of the thalamus (Vc) of a phantom limb patient undergoing deep brain stimulation (DBS) surgery...
November 10, 2017: Journal of Neurosurgery
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