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Limb amputation

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https://www.readbyqxmd.com/read/28428904/salvage-of-necrotic-appearing-limb-after-in-utero-endoscopic-lysis-of-constriction-bands
#1
M Abdel-Sattar, A Chon, B Chen, W Burkhalter, R H Chmait
We report a case of amniotic band syndrome complicated by constriction bands and marked distal swelling of both lower extremities. Color Doppler interrogation of the right lower extremity revealed complete lack of blood flow below the level of the constriction. Upon fetoscopic survey, the right lower extremity beyond the constriction band appeared dusky red and discolored with desquamation, consistent with a necrotic appearance. The constriction bands were cut in utero using endoshears, thereby allowing restoration of blood flow on postoperative day 1...
April 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28427290/a-real-time-method-for-decoding-the-neural-drive-to-muscles-using-single-channel-intra-muscular-emg-recordings
#2
Saeed Karimimehr, Hamid Reza Marateb, Silvia Muceli, Marjan Mansourian, Miguel Angel Mañanas, Dario Farina
The neural command from motor neurons to muscles - sometimes referred to as the neural drive to muscle - can be identified by decomposition of electromyographic (EMG) signals. This approach can be used for inferring the voluntary commands in neural interfaces in patients with limb amputations. This paper proposes for the first time an innovative method for fully automatic and real-time intramuscular EMG (iEMG) decomposition. The method is based on online single-pass density-based clustering and adaptive classification of bivariate features, using the concept of potential measure...
March 20, 2017: International Journal of Neural Systems
https://www.readbyqxmd.com/read/28424223/low-dose-paclitaxel-coated-versus-uncoated-percutaneous-transluminal-balloon-angioplasty-for-femoropopliteal-peripheral-artery-disease-1-year-results-of-the-illumenate-european-randomized-clinical-trial
#3
Henrik Schroeder, Martin Werner, Dirk-Roelfs Meyer, Peter Reimer, Karsten Krüger, Michael R Jaff, Marianne Brodmann
Background -Numerous studies have reported favorable outcomes using drug-coated balloons (DCBs) for treatment of symptomatic peripheral artery disease (PAD) of the superficial femoral and popliteal arteries. However, the treatment effect compared to an uncoated balloon has differed greatly amongst the randomized trials with better outcomes observed with higher-dose DCBs. This European trial was designed to assess the safety and effectiveness of a next-generation low dose (2 µg/mm(2) surface dose of paclitaxel) DCB...
April 19, 2017: Circulation
https://www.readbyqxmd.com/read/28424173/association-between-estimated-glomerular-filtration-rate-and-outcomes-in-patients-with-diabetic-foot-ulcers-a-3-year-follow-up-study
#4
Yang He, Hongjie Qian, Lei Xu, Shanshan Zhang, Xueming Gu, Junyi Gu, Jianyuan Shi, Yaping Shen, Jian-Min Liu, Zhengyi Tang
OBJECTIVE: End stage renal disease and dialysis have been proven to be associated with poor prognoses in diabetic foot ulcers (DFU). However, it has rarely been reported whether and to what extent milder renal insufficiency effects the prognosis. The purpose of this study was to investigate the categorized impact of estimated glomerular filtration (eGFR) on the outcomes of patients with DFU. DESIGN AND METHODS: Three hundred and sixty-six DFU patients hospitalized in a Chinese tertiary hospital were recruited and classified into 4 groups according to the eGFRs as follows: normal (≥90), mildly reduced (60-89), moderately reduced (30-59), and severely reduced (<30)...
April 19, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28422912/vascular-complications-from-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-life-over-limb
#5
John R Taylor, John A Harvin, Clay Martin, John B Holcomb, Laura J Moore
BACKGROUND: Vascular complications from resuscitative endovascular balloon occlusion of the aorta (REBOA) have been reported as high as 13% with some patients requiring lower extremity amputation. We sought to review our institutions series of REBOA and assess our vascular complications. METHODS: Retrospective review of all patients undergoing REBOA from October 2011 through July 2016. Data was gathered from the Memorial Hermann Trauma registry and the hospital electronic medical records...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422865/crystalglobulinemia-manifesting-as-chronic-arthralgia-and-acute-limb-ischemia-a-clinical-case-report
#6
Nobuya Abe, Tomoko Tomita, Miyuki Bohgaki, Hideki Kasahara, Takao Koike
RATIONALE: Crystalglobulinemia is a rare disease caused by monoclonal immunoglobulins, characterized by irreversible crystallization on refrigeration. It causes systemic symptoms including purpura, arthralgia, and vessel occlusive conditions to be exacerbated by exposure to cold. We report a patient with crystalglobulinemia associated with monoclonal gammopathy of undetermined significance (MGUS) manifesting as chronic arthralgia and recurrent acute arterial occlusion. PRESENTING CONCERNS: A 61-year-old man, who had been diagnosed with MGUS and who had arthralgia of unknown origin, presented with recurrent acute limb ischemia after surgical thromboembolectomy...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28422399/dorsal-root-ganglion-stimulation-for-complex-regional-pain-syndrome-crps-recurrence-after-amputation-for-crps-and-failure-of-conventional-spinal-cord-stimulation
#7
Andreas Goebel, Sarah Lewis, Rhodri Phillip, Manohar Sharma
Limb amputation is sometimes being performed in long-standing complex regional pain syndrome (CRPS), although little evidence is available guiding management decisions, including how CRPS recurrence should be managed. This report details the management of a young soldier with CRPS recurrence 2 years after midtibial amputation for CRPS. Conventional spinal cord stimulation did not achieve paraesthetic coverage, or pain relief in the stump, whereas L4 dorsal root ganglion stimulation achieved both coverage and initially modest pain relief, and over time, substantial pain relief...
April 18, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28421855/midterm-outcomes-after-infrapopliteal-interventions-in-patients-with-critical-limb-ischemia-based-on-the-tasc-ii-classification-of-below-the-knee-arteries
#8
Gagan D Singh, Ellen K Brinza, Justin Hildebrand, Stephen W Waldo, T Raymond Foley, John R Laird, Ehrin J Armstrong
PURPOSE: To analyze the relationship between the new TransAtlantic Inter-Society Consensus (TASC II) infrapopliteal classification and limb outcomes among patients with critical limb ischemia (CLI). METHODS: A single-center retrospective study was performed on 166 consecutive CLI patients (mean age 71 years; 113 men) undergoing endovascular treatment of 244 infrapopliteal lesions from 2006 to 2013. Patient, procedural, angiographic, and limb outcomes were compared for the new TASC A/B vs C/D classification for infrapopliteal lesions...
April 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28420036/dedifferentiated-chondrosarcoma-a-survival-analysis-of-159-cases-from-the-seer-database-2001-2011
#9
Patrick K Strotman, Taylor J Reif, Stephanie A Kliethermes, Jasmin K Sandhu, Lukas M Nystrom
BACKGROUND AND OBJECTIVES: Dedifferentiated chondrosarcoma is a rare malignancy with reported 5-year overall survival rates ranging from 7% to 24%. The purpose of this investigation is to determine the overall survival of dedifferentiated chondrosarcoma in a modern patient series and how it is impacted by patient demographics, tumor characteristics, and surgical treatment factors. METHODS: This is a retrospective review of the Surveillance, Epidemiology, and End Results (SEER) database from 2001 to 2011...
April 18, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28417873/trends-in-the-incidence-of-lower-limb-amputation-after-implementation-of-a-multidisciplinary-diabetic-foot-unit
#10
Sara Jiménez, José Antonio Rubio, Julia Álvarez, Fernando Ruiz-Grande, Carlos Medina
BACKGROUNDS AND OBJECTIVE: Incidence of lower extremity amputations (LEA) in the population with and without diabetes mellitus (DM) was assessed after implementation of a Multidisciplinary Diabetic Foot Unit (MDFU) during 2008. MATERIAL AND METHODS: Non-traumatic LEA were analyzed, and those performed before (2001-2007) and after (2008-2014) introduction of the MDFU were compared. LEA were grouped by age and sex. Their incidence was expressed as a rate per 100,000 population per year, adjusted to the standard European population...
April 2017: Endocrinol Diabetes Nutr
https://www.readbyqxmd.com/read/28411244/long-term-follow-up-of-the-padi-trial-percutaneous-transluminal-angioplasty-versus-drug-eluting-stents-for-infrapopliteal-lesions-in-critical-limb-ischemia
#11
Marlon I Spreen, Jasper M Martens, Bob Knippenberg, Lukas C van Dijk, Jean-Paul P M de Vries, Jan Albert Vos, Gert Jan de Borst, Evert-Jan P A Vonken, Okker D Bijlstra, Jan J Wever, Randolph G Statius van Eps, Willem P Th M Mali, Hendrik van Overhagen
BACKGROUND: Clinical outcomes reported after treatment of infrapopliteal lesions with drug-eluting stents (DESs) have been more favorable compared with percutaneous transluminal angioplasty with a bailout bare metal stent (PTA-BMS) through midterm follow-up in patients with critical limb ischemia. In the present study, long-term results of treatment of infrapopliteal lesions with DESs are presented. METHODS AND RESULTS: Adults with critical limb ischemia (Rutherford category ≥4) and infrapopliteal lesions were randomized to receive PTA-BMS or DESs with paclitaxel...
April 14, 2017: Journal of the American Heart Association
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
#12
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)...
April 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28408154/outcomes-for-critical-limb-ischemia-are-driven-by-lower-extremity-revascularization-volume-not-distance-to-hospital
#13
Ankit N Medhekar, Doran S Mix, Christopher T Aquina, Lauren E Trakimas, Katia Noyes, Fergal J Fleming, Roan J Glocker, Michael C Stoner
OBJECTIVE: The objective of this study was to identify relationships among geographic access to care, vascular procedure volume, limb preservation, and survival in patients diagnosed with critical limb ischemia (CLI). METHODS: Using New York State administrative data from 2000 to 2013, we identified a patient's first presentation with CLI defined by International Classification of Diseases, Ninth Revision diagnosis and procedure codes. Distance from the patient's home to the index hospital was calculated using the centroids of the respective ZIP codes...
April 10, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28407473/trimodal-rescue-of-hind-limb-ischemia-with-growth-factors-cells-and-nanocarriers-fundamentals-to-clinical-trials
#14
Rajesh Laksmanan, Gopi Ukani, Muhammad Tipu Rishi, Nilanjana Maulik
Peripheral Artery Disease is a severe medical condition commonly characterized by critical or acute limb ischemia. Gradual accumulation of thrombotic plaques in peripheral arteries of the lower limb may lead to intermittent claudication or ischemia in muscle tissue. Ischemic muscle tissue with lesions may become infected, resulting in a non-healing wound. Stable progression of the non-healing wound associated with severe ischemia might lead to functional deterioration of the limb, which, depending on the severity, can result in amputation...
April 13, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28406877/scapulothoracic-dissociation-evaluation-and-management
#15
Andrew M Choo, Patrick C Schottel, Andrew R Burgess
Scapulothoracic dissociation is a rare, potentially limb- and life-threatening injury of the shoulder girdle. The injury is characterized by lateral displacement of the scapula resulting from traumatic disruption of the scapulothoracic articulation. The typical physical examination findings consist of substantial swelling of the shoulder girdle, along with weakness, numbness, and pulselessness in the ipsilateral upper extremity. Radiographic evaluation includes measurement of the scapular index on a nonrotated chest radiograph and assessment for either a distracted clavicle fracture or a disrupted acromioclavicular or sternoclavicular joint...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28406651/perceived-social-support-moderates-the-relationship-between-activities-of-daily-living-and-depression-after-lower-limb-loss
#16
Derek R Anderson, Danielle S Roubinov, Aaron P Turner, Rhonda M Williams, Daniel C Norvell, Joseph M Czerniecki
OBJECTIVE: This study examined the moderating influence of perceived social support on the prospective relationship between baseline levels of activities of daily living (ADL) and depressive symptoms during the 1st year following amputation. METHOD: Participants included 73 veterans with new/first unilateral lower extremity amputation due to vascular disease or diabetes. Baseline levels of perceived social support, ADL function, and mobility were assessed by retrospective recall 6 weeks after amputation...
April 13, 2017: Rehabilitation Psychology
https://www.readbyqxmd.com/read/28403880/lower-limb-function-and-quality-of-life-after-ilp-for-soft-tissue-sarcoma
#17
Lars Erik Podleska, Nevda Kaya, Farhad Farzaliyev, Christoph Pöttgen, Sebastian Bauer, Georg Taeger
BACKGROUND: Isolated limb perfusion with TNF-alpha and melphalan (TM-ILP) in combination with complete tumor resection is an effective treatment option for non-resectable soft-tissue sarcoma of the extremities, with limb salvage rates greater than 80%. The aim of this study was to assess quality of life (QoL) after TM-ILP, also with regard to long-term survival. METHODS: We retrospectively examined 27 patients who had primarily non-resectable soft-tissue sarcoma of the leg and who had undergone TM-ILP and complete tumor resection (with limb-sparing intent) during their follow-up examinations using the Quality of Life Questionnaire (QLQ-C30) and the German Short Musculoskeletal Function Assessment (SMFA-D)...
April 13, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28400667/epidemiology-of-lower-limb-musculoskeletal-trauma-with-associated-vascular-injuries-in-a-tertiary-care-institute-in-india
#18
Nirmal Raj Gopinathan, Siva Swaminathan Santhanam, Balaji Saibaba, Mandeep Singh Dhillon
BACKGROUND: Vascular trauma associated with bony injuries is an orthopaedic emergency. Lack of timely intervention can lead to loss of limb or even life. Inspite of the rising incidence of high speed road traffic accidents in India, there is paucity of literature regarding the demographic pattern, clinical morbidity, management strategies and outcome of arterial injuries associated with lower limb trauma. The aim of this study is to describe the epidemiology and outcome of lower extremity musculoskeletal trauma with associated vascular injuries in a tertiary care institute in India...
March 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28400218/outcomes-of-the-japanese-multicenter-viabahn-trial-of-endovascular-stent-grafting-for-superficial-femoral-artery-lesions
#19
Takao Ohki, Kimihiko Kichikawa, Hiroyoshi Yokoi, Masaaki Uematsu, Terutoshi Yamaoka, Koji Maeda, Yuji Kanaoka
OBJECTIVE: The objective of this study was to assess 1-year safety, efficacy, and invasiveness outcomes of endovascular stent grafting of symptomatic long lesions (≥10 cm) in the superficial femoral artery (SFA) as a substitute for above-knee open bypass surgery. METHODS: This prospective, multicenter (15 hospitals) study assessed heparin-coated stent grafts for the treatment of long SFA lesions in Japanese subjects with peripheral arterial disease. Inclusion criteria were Rutherford category 2 to 5 symptoms (grade 5 without active infection), ankle-brachial index ≤0...
April 8, 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
#20
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
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