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Limb amputation

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https://www.readbyqxmd.com/read/29792018/predictive-factors-of-a-poor-outcome-following-revascularization-for-critical-limb-ischemia-implications-for-practice
#1
Mireia Martínez, Claudia Sosa, Alina Velescu, Carme Llort, Roberto Elosua, Albert Clarà
BACKGROUND/OBJECTIVE: Advancements in open and endovascular techniques have brought a widespread indication of revascularization in the majority of patients with critical limb ischemia (CLI). However, some cases still have a dismal short-term outcome. Identifying preoperative variables that characterize these patients could be important to prevent futile decisions. The aim of this study was to define predictive risk factors of mortality and/or major amputation after revascularization for CLI...
May 23, 2018: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/29790720/recanalization-of-ctos-with-soundbitetm-active-wire
#2
Marianne Brodmann, Eric Thérasse, Andrew Benko, Louis-Philippe Riel, Steven Dion, Philippe Généreux, Martin Brouillette
BACKGROUND: The aim of this study was to examine the safety and efficacy of the SoundBite™ Crossing System for the recanalization of infrainguinal chronic total occlusion (CTO) lesions. CTOs are frequent among patients with severe claudication or critical limb ischemia. Failure to recanalize CTOs remains common and is associated with poor prognosis. The SoundBite™ Crossing System (SoundBite Medical Solutions Inc., Montreal, Canada) is a newly developed device that uses a 0.018-inch wire (SoundBite™ Active Wire) to deliver acoustic shock waves to the distal tip of a steerable guidewire to facilitate directed penetration of the proximal cap and crossing of the occlusion...
May 23, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29789188/fractures-after-multimodality-treatment-of-soft-tissue-sarcomas-with-isolated-limb-perfusion-and-radiation-likely-to-occur-and-hard-to-heal
#3
J M Seinen, P C Jutte, L B Been, E Pras, H J Hoekstra
OBJECTIVES: Treatment associated fractures (TAFs) are known severe side effects after surgery and radiotherapy for soft tissue sarcoma (STS). There is no literature about TAF after multimodality treatment with isolated limb perfusion (ILP) for locally advanced STS. This study aimed to analyze predictive factors, treatment and outcome for TAF after multimodality treatment with ILP. METHOD: Out of 126 consecutive patients undergoing ILP after 1991 till now, 25 patients were excluded due to no surgery or direct amputation at initial surgery...
April 24, 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29787549/long-term-patient-centered-outcomes-of-lower-extremity-vascular-trauma
#4
Zane B Perkins, Barbaros Yet, Simon Glasgow, William Marsh, Nigel R M Tai, Todd E Rasmussen
OBJECTIVE: To describe the long-term outcomes of military lower extremity vascular injuries, and the decision-making of surgeons treating these injuries. BACKGROUND: Lower extremity vascular trauma is an important cause of preventable death and severe disability, and decisions on amputation or limb salvage can be difficult. Additionally, the complexity of the condition is not amenable to controlled study, and there is limited data to guide clinical decision-making and establish sensible treatment expectations during rehabilitation...
May 4, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29787536/a-meta-analysis-of-the-incidence-of-complications-associated-with-groin-access-after-the-use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-trauma-patients
#5
Ramiro Manzano-Nunez, Claudia P Orlas, Juan P Herrera-Escobar, Samuel Galvagno, Joseph DuBose, Juan J Melendez, Jose J Serna, Alexander Salcedo, Camilo A Peña, Edison Angamarca, Tal Horer, Camilo J Salazar, Valeria Lopez-Castilla, Juan Ruiz-Yucuma, Fernando Rodriguez, Michael W Parra, Carlos A Ordoñez
BACKGROUND: Serious complications related to groin access have been reported with the use of resuscitative endovascular balloon occlusion of the aorta (REBOA). We performed a systematic review and meta-analysis to estimate the incidence of complications related to groin access from the use of REBOA in adult trauma patients. METHODS: We identified articles in MEDLINE and EMBASE. We reviewed all studies that involved adult trauma patients that underwent the placement of a REBOA and included only those that reported the incidence of complications related to groin access...
May 21, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29786412/the-use-of-scoring-balloons-in-the-superficial-femoral-artery
#6
Simon Bays
Percutaneous transluminal angioplasty and stenting is becoming increasingly the first line treatment for patients with both claudication and critical limb ischaemia instead of surgery, with the aim of returning the patient's quality of life in the former and preventing amputation. Drug eluting technologies have seen a large surge in popularity in recent years, and significant patient benefits have been seen with the use of drug eluting stents and balloons over the use of plain balloon angioplasty. Unfortunately in many patients with arterial disease there is significant vessel wall calcification - this can theoretically be a barrier to drug delivery, and can also be a contributing factor to flow limiting dissection and the subsequent need for bail out stenting...
May 22, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29786410/percutaneous-deep-venous-arterialization-in-patients-with-critical-limb-ischemia-a-technical-note
#7
Steven Kum, Eline Huizing, Michiel A Schreve, Çagdas Ünlü, Roberto Ferraresi, Lasitha B Samarakoon, Daniel A van den Heuvel
Critical limb ischemia (CLI) is the presentation of end stage peripheral arterial disease and typically presents with rest pain, ulceration and gangrene. The outcome of conservative treatment is poor and often leads to amputations. Arterial revascularization plays an important role in amputation prevention. Unfortunately, a significant percentage of CLI patients cannot be revascularized and subsequently end up with a palliative amputation. This has led to the need and exploration of new treatment options in this no option subgroup of CLI...
May 22, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29782037/multiloculated-solitary-unicameral-bone-cyst-in-a-young-dog
#8
Sarah C Roode, Heather R Shive, Willemijn Hoorntje, Jennifer Bernard, Devorah M Stowe, Roy R Pool, Carol B Grindem
A 20-month-old female spayed Staffordshire Terrier (22.3 kg) presented to the Orthopedic Surgery Service at North Carolina State University Veterinary Teaching Hospital for evaluation of a 6-week history of toe-touching to nonweight-bearing lameness in the right hind limb. Radiographs of the right stifle revealed a multiloculated lytic lesion of the distal femur, with a large open lytic zone centrally, numerous osseous septations peripherally, and focal areas of cortical thinning and loss. An aspirate of the right distal femoral lesion yielded mildly cloudy serosanguineous fluid...
May 21, 2018: Veterinary Clinical Pathology
https://www.readbyqxmd.com/read/29779466/a-systematic-review-of-shock-attenuating-componentry-for-lower-limb-amputees
#9
Mitchell Farrar, Emma Thomas
BACKGROUND: Shock-attenuating pylons are commonly fitted to prostheses in order to compensate for the anatomical and biomechanical shock-absorbing features of the lower limb removed upon amputation. However, studies concerning their shock-attenuating capacity are highly variable and, to date, have not yet been reviewed, making them difficult to interpret and apply in clinical practice. OBJECTIVES: To synthesise and appraise the available literature examining the effectiveness of shock-attenuating pylons in attenuating shock upon limb loading compared to rigid pylons among lower limb amputees...
May 1, 2018: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/29777849/non-invasive-diagnostic-methods-for-better-screening-of-peripheral-arterial-disease
#10
REVIEW
Neelamshobha Nirala, R Periyasamy, Awanish Kumar
BACKGROUND: Peripheral arterial disease (PAD) is a common circulatory problem in which narrowed arteries reduce blood flow to extremities usually legs. It does not receive enough blood flow to keep up with demand. This causes symptoms, most notably leg pain while walking which is known as claudication. It is a common manifestation of type II Diabetes, but the relationship between other vascular diseases and lower limb (LL)-PAD has been poorly understood and investigated. METHODS: When assessing a patient with clinically LLPAD, two questions are in order to establish a diagnosis: one is non-invasive testing and other is invasive...
May 16, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29777842/nationally-representative-readmission-factors-in-patients-with-claudication-and-critical-limb-ischemia
#11
Rennier A Martinez, Michelle Shnayder, Joshua Parreco, Lukas Gaffney, Marcus Eby, Nicholas Cortolillo, Michael Lopez, Jack Zeltzer
INTRODUCTION: Hospital readmissions are not only associated with increased mortality, morbidity and costs but also, with current healthcare reform, tied to significant financial and administrative penalties. Some studies show that patients undergoing vascular surgery may have higher than average readmission rates. The recently released Nationwide Readmission Database (NRD) is the most comprehensive national source of readmission data, gathering discharge information from 22 geographically dispersed states, accounting for 51...
May 16, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29777713/development-and-psychometric-validation-of-capacity-assessment-of-prosthetic-performance-for-the-upper-limb-cappful
#12
Nathan T Kearns, Jennifer K Peterson, Lisa Smurr Walters, Warren T Jackson, John M Miguelez, Tiffany Ryan
OBJECTIVES: (1) Develop a performance-based measure for adult upper limb (UL) prosthetic functioning through broad (i.e. overall performance) and functional domain-specific (e.g., control skills) assessment of commonplace activities; (2) conduct initial psychometric evaluation of the Capacity Assessment of Prosthetic Performance for the Upper Limb (CAPPFUL). DESIGN: Internal consistency of CAPPFUL and interrater reliability for task, functional domain, and full scale (sub)scores among three independent raters were estimated...
May 16, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29776439/concurrence-of-symmetrical-peripheral-gangrene-and-venous-limb-gangrene-following-polytrauma-a-case-report
#13
Jih Huei Tan, Yuzaidi Mohamad, Chor Lip Henry Tan, Mahazir Kassim, Theodore E Warkentin
BACKGROUND: Symmetrical peripheral gangrene is characterized as acral (distal extremity) ischemic limb injury affecting two or more extremities, without large vessel obstruction, typically in a symmetrical fashion. Risk factors include hypotension, disseminated intravascular coagulation, and acute ischemic hepatitis ("shock liver"). In contrast, venous limb gangrene is characterized by acral ischemic injury occurring in a limb with deep vein thrombosis. Both symmetrical peripheral gangrene and venous limb gangrene present as acral limb ischemic necrosis despite presence of arterial pulses...
May 19, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29776002/the-chaos-of-hospitalisation-for-patients-with-critical-limb-ischaemia-approaching-major-amputation
#14
Susan Monaro, Sandra West, Jana Pinkova, Janice Gullick
AIMS AND OBJECTIVES: To illuminate the hospital experience for patients and families when major amputation has been advised for critical limb ischaemia (CLI). BACKGROUND: CLI creates significant burden to the health system and the family, particularly as the person with CLI approaches amputation. Major amputation is often offered as a late intervention for CLI in response to the marked deterioration of an ischaemic limb, and functional decline from reduced mobility, intractable pain, infection and/or toxaemia...
May 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29772973/evaluation-of-metronomic-cyclophosphamide-chemotherapy-as-maintenance-treatment-for-dogs-with-appendicular-osteosarcoma-following-limb-amputation-and-carboplatin-chemotherapy
#15
Arata Matsuyama, Courtney R Schott, Geoffrey A Wood, Danielle Richardson, J Paul Woods, Anthony J Mutsaers
OBJECTIVE To determine the effectiveness of metronomic cyclophosphamide (MC) chemotherapy (primary treatment of interest) with adjuvant meloxicam administration as maintenance treatment for dogs with appendicular osteosarcoma following limb amputation and carboplatin chemotherapy. DESIGN Retrospective case series with nested cohort study. ANIMALS 39 dogs with a histologic diagnosis of appendicular osteosarcoma that underwent limb amputation and completed carboplatin chemotherapy from January 2011 through December 2015...
June 1, 2018: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/29772326/thrombolysis-in-acute-lower-limb-ischemia-review-of-the-current-literature
#16
REVIEW
Panagiotis G Theodoridis, Constantinos H Davos, Ilias Dodos, Nikolaos Iatrou, Anastasios Potouridis, Georgios M Pappas, Dimitrios Staramos, Paul Antoniadis, Vasilios Argitis, Konstantinos Dervisis
INTRODUCTION: Catheter directed thrombolysis (CDT) is a therapeutic option with acceptable results in patients with acute limb ischaemia (ALI) but with severe systemic or intracranial bleeding being the most significant clinical complication. The aim of the study is to collect and present direct results of CDT in patients treated for ALI. MATERIALS AND METHODS: Reports on CDT treatment in ALI until December 2016 searched in PubMed using the key words catheter direct thrombolysis, acute lower limb ischemia and any combination of these...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772308/prostheses-as-extensions-of-the-body-progress-and-challenges
#17
REVIEW
Maria Niedernhuber, Damiano G Barone, Bigna Lenggenhager
Recent years have seen a surge of interest in the incorporation of artificial limbs. This research promises to provide individuals with sensorimotor disorders such as amputations with prostheses which feel like their own body part. While neuroscience made a leap towards uncovering the basic neurocognitive mechanisms of bodily self-consciousness, the development of incorporated prosthetic limbs still faces substantial challenges in basic neuroscience and in clinical reality. Here we critically examine recent findings on prosthesis incorporation to aid patient rehabilitation in the context of advances in cognitive and applied neuroscience as well as technology...
May 14, 2018: Neuroscience and Biobehavioral Reviews
https://www.readbyqxmd.com/read/29771620/self-reported-functional-mobility-balance-confidence-and-prosthetic-use-are-associated-with-daily-step-counts-among-individuals-with-a-unilateral-transtibial-amputation
#18
Jaclyn Megan Sions, Elisa Sarah Arch, John Robert Horne
BACKGROUND: Adults postamputation are not meeting physical activity recommendations. Physical activity is an important consideration in prosthetic prescription. The objective of this study was to determine if functional mobility, balance confidence, and prosthetic use are associated with physical activity among adults with a lower-limb amputation. METHODS: This study recruited patients aged 18-85 years with unilateral transtibial amputations. The Cumulative Illness Rating Scale was used to determine comorbidity burden...
June 1, 2018: Journal of Physical Activity & Health
https://www.readbyqxmd.com/read/29769391/infrared-laser-mediated-gene-induction-at-the-single-cell-level-in-the-regenerating-tail-of-xenopus-laevis-tadpoles
#19
Riho Hasugata, Shinichi Hayashi, Aiko Kawasumi-Kita, Joe Sakamoto, Yasuhiro Kamei, Hitoshi Yokoyama
We describe a precise and reproducible gene-induction method in the amphibian, Xenopus laevis Tetrapod amphibians are excellent models for studying the mechanisms of three-dimensional organ regeneration because they have an exceptionally high regenerative ability. However, spatial and temporal manipulation of gene expression has been difficult in amphibians, hindering studies on the molecular mechanisms of organ regeneration. Recently, however, development of a Xenopus transgenic system with a heat-shock-inducible gene has enabled the manipulation of specific genes...
May 16, 2018: Cold Spring Harbor Protocols
https://www.readbyqxmd.com/read/29768578/-work-accidents-and-automatic-circuit-reclosers-in-the-electricity-sector-beyond-the-immediate-causes
#20
Alessandro Jose Nunes da Silva, Ildeberto Muniz de Almeida, Rodolfo Andrade de Gouveia Vilela, Renata Wey Berti Mendes, Sandra Lorena Beltran Hurtado
The Brazilian electricity sector has recorded high work-related mortality rates that have been associated with outsourcing, used to cut costs. In order to decrease the power outage time for consumers, the industry adopted the automatic circuit recloser as the technical solution. The device has hazardous implications for maintenance workers. The aim of this study was to analyze the origins and consequences of work accidents in power systems with automatic circuit recloser, using the Accident Analysis and Prevention (AAP) model...
May 10, 2018: Cadernos de Saúde Pública
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