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https://www.readbyqxmd.com/read/28087118/open-lower-limb-fractures-in-major-trauma-centers-a-loss-leader
#1
Elizabeth K Tissingh, Arman Memarzadeh, Joseph Queally, Peter Hull
PURPOSE: Open lower limb fractures are resource intensive injuries. Regardless of the financing model, the cost of treatment is an important consideration for any healthcare provider. METHODS: Open lower limb fractures treated at our centre were identified over a six-month period. Isolated open femur or tibia fractures were included as well as cases with multiple fractures. Direct inpatient care costs were calculated and income was reviewed for each case according to 'Healthcare Resource Group' (HRG) cost codes...
December 28, 2016: Injury
https://www.readbyqxmd.com/read/28086828/subjective-and-objective-assessment-of-physical-activity-in-multiple-sclerosis-and-their-relation-to-health-related-quality-of-life
#2
Theresa Krüger, Janina R Behrens, Anuschka Grobelny, Karen Otte, Sebastian Mansow-Model, Bastian Kayser, Judith Bellmann-Strobl, Alexander U Brandt, Friedemann Paul, Tanja Schmitz-Hübsch
BACKGROUND: Physical activity (PA) is frequently restricted in people with multiple sclerosis (PwMS) and aiming to enhance PA is considered beneficial in this population. We here aimed to explore two standard methods (subjective plus objective) to assess PA reduction in PwMS and to describe the relation of PA to health-related quality of life (hrQoL). METHODS: PA was objectively measured over a 7-day period in 26 PwMS (EDSS 1.5-6.0) and 30 matched healthy controls (HC) using SenseWear mini® armband (SWAmini) and reported as step count, mean total and activity related energy expenditure (EE) as well as time spent in PA of different intensities...
January 13, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28086758/toxoplasmosis-associated-iris-involving-the-cns-a-case-report-with-longitudinal-analysis-of-t-cell-subsets
#3
Rita Rb-Silva, Claudia Nobrega, Eugénia Reiriz, Soraia Almeida, Rui Sarmento-Castro, Margarida Correia-Neves, Ana Horta
BACKGROUND: HIV-infected patients may present an unforeseen clinical worsening after initiating antiretroviral therapy known as immune reconstitution inflammatory syndrome (IRIS). This syndrome is characterized by a heightened inflammatory response toward infectious or non-infectious triggers, and it may affect different organs. Diagnosis of IRIS involving the central nervous system (CNS-IRIS) is challenging due to heterogeneous manifestations, absence of biomarkers to identify this condition, risk of long-term sequelae and high mortality...
January 13, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28081030/ultrasound-findings-of-young-and-traumatic-amputees-with-lower-extremity-residual-limb-pain-in-turkey
#4
Koray Aydemir, Yasin Demir, Ümüt Güzelküçük, Kutay Tezel, Bilge Yilmaz
OBJECTIVE: The current study was designed to document clinical and ultrasound (US) findings of patients with residual limb pain (RLP) after amputation and to investigate the relationship between these findings. MATERIALS AND METHODS: A chart review was performed to identify demographic and clinical data including the age (current and at the time of injury), time since amputation, gender, reason for amputation, affected limb number, side and level of limb loss, and ultrasonographic findings of young and traumatic amputees with RLP...
January 9, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28079855/acute-sarcoid-myopathy-a-case-report-and-literature-review
#5
José Miguel Gómez-Verdú, Salvador Valero Cifuentes, Francisco Pastor Quirante, Francisco Román López-Andreu
Sarcoidosis is a worldwide spread disease with brad clinical spectrum, in which the pulmonary involvement is the main manifestation (more than 90% of cases); nevertheless, extrathoracic symptoms can predominate in the clinical picture and they may even be the first manifestation. One of them is the skeletal muscle involvement that normally is chronic and silent, with poor response to treatment with glucocorticoids. However, in some cases, it has an acute presentation. We present a case of a 61-year-old man with diagnosis of sarcoidosis whe were evaluated for proximal lower limb weakness within few days of evolution...
December 23, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
https://www.readbyqxmd.com/read/28079852/ichthyosiform-sarcoidosis-report-of-three-cases-from-japan-and-literature-review
#6
Takako Miura, Yasunobu Kato, Toshiyuki Yamamoto
Cutaneous lesions of sarcoidosis present with various manifestations including specific and non-specific cutaneous lesions. Ichthyosiform sarcoidosis is a rare form of cutaneous sarcoidosis, presenting with asymptomatic, adherent, polygonal scales, mainly appearing on the lower limbs.  Ichthyosiform sarcoidosis has a predilection for dark-skinned races, and cases affecting Japanese patients have rarely been reported in English literature.  We herein describe three Japanese cases of ichthyosiform sarcoidosis on the lower limbs...
December 23, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
https://www.readbyqxmd.com/read/28079740/venous-thromboembolism-among-pediatric-orthopedic-trauma-patients-a-database-analysis
#7
Daniel Guzman, Samir Sabharwal, Caixia Zhao, Sanjeev Sabharwal
Using the 2012 Kids Inpatient Database, we assessed records of pediatric patients (<21 years old) with fractures of the upper limb, lower limb, spine, pelvis, and multiple locations and calculated the overall prevalence of venous thromboembolism (VTE) and associated potential risk factors. 387 (0.68%) of 57 183 patients with one or more fractures were diagnosed with VTE. Children sustaining fractures of the axial skeleton and those with multiple fractures had a higher prevalence of VTE than those with isolated extremity fractures...
January 10, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28079509/excellent-balance-skills-despite-active-and-inactive-juvenile-idiopathic-arthritis-unexpected-results-of-a-cross-sectional-study
#8
Josephine Merker, Matthias Hartmann, Florian Kreuzpointner, Ansgar Schwirtz, Johannes-Peter Haas
OBJECTIVES: Postural control (PC) is fundamental for human movements. Different factors, such as injuries or diseases, can adversely affect PC. The purpose of this study was to evaluate PC in juvenile idiopathic arthritis (JIA) patients with different disease activity levels in comparison to healthy peers. METHODS: JIA patients with active and inactive lower limb joints (n=36 each group) were examined. Both groups have been on medication and have had physiotherapy for at least 5 years...
January 5, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28079427/effect-of-functional-electrical-stimulation-on-cardiovascular-outcomes-in-patients-with-chronic-heart-failure
#9
Nikolaos Pe Kadoglou, Christina Mandila, Apostolos Karavidas, Dimitrios Farmakis, Vasiliki Matzaraki, Christos Varounis, Sofia Arapi, Anastasia Perpinia, John Parissis
Background/design Functional electrical stimulation of lower limb muscles is an alternative method of training in patients with chronic heart failure (CHF). Although it improves exercise capacity in CHF, we performed a randomised, placebo-controlled study to investigate its effects on long-term clinical outcomes. Methods We randomly assigned 120 patients, aged 71 ± 8 years, with stable CHF (New York Heart Association (NYHA) class II/III (63%/37%), mean left ventricular ejection fraction 28 ± 5%), to either a 6-week functional electrical stimulation training programme or placebo...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28078071/electrical-stimulation-to-reduce-the-overload-in-upper-limbs-during-sitting-pivot-transfer-in-paraplegic-a-preliminary-study
#10
Ana Claudia G Lopes, Claudia Ochoa-Diaz, Roberto S Baptista, Lucas O Fonseca, Charles Fattal, Christine Azevedo Coste, Antônio P L Bó, Emerson Fachin-Martins
Transfer is a key ability and allows greater interact with the environment and social participation. Conversely, paraplegics have great risk of pain and injury in the upper limbs due to joint overloads during activities of daily living, like transfer. The main goal of this study is to verify if the use of functional electrical stimulation (FES) in the lower limbs of paraplegic individuals can assist the sitting pivot transfer (SPT). The secondary objective is to verify if there is a greater participation of the lower limbs during lift pivot phase...
September 15, 2016: European Journal of Translational Myology
https://www.readbyqxmd.com/read/28077661/characterizing-differential-post-stroke-corticomotor-drive-to-the-dorsi-and-plantarflexor-muscles-during-resting-and-volitional-muscle-activation
#11
Jacqueline Ann Palmer, Ryan Zarzycki, Susanne M Morton, Trisha M Kesar, Stuart A Binder-Macleod
Imbalance of corticomotor excitability between the paretic and nonparetic limbs has been associated with the extent of upper extremity motor recovery post-stroke, is greatly influenced by specific testing conditions such as the presence or absence of volitional muscle activation, and may vary across muscle groups. However, despite its clinical importance, post-stroke corticomotor drive to lower extremity muscles has not been thoroughly investigated. Additionally, while conventional gait rehabilitation strategies for stroke survivors focus on paretic limb foot drop and dorsiflexion impairments, most contemporary literature has indicated that paretic limb propulsion and plantarflexion impairments are the most significant limiters to post-stroke walking function...
January 11, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28077014/factors-associated-with-reduced-functional-outcome-and-quality-of-life-in-patients-having-limb-sparing-surgery-for-soft-tissue-sarcomas-a-national-multicenter-study-of-128-patients
#12
Casper Saebye, Hanna M Fugloe, Tine Nymark, Akmal Safwat, Michael M Petersen, Thomas Baad-Hansen, Anders Krarup-Hansen, Johnny Keller
BACKGROUND: Limb-sparing surgery for sarcomas has become possible in most cases. However, the impact of the procedure on the functional outcome has only been investigated in a few studies. The aim of this study has been to identify tumor- and patient-related factors associated with reduced functional outcome and quality of life after limb-sparing surgery in soft tissue sarcoma patients. MATERIAL AND METHODS: In total, 128 patients (mean age = 58, female/male = 54/74) who were treated with limb-sparing surgery without bone resection for soft tissue sarcomas in Denmark during the period 1 January 2009 to 31 December 2011 were included...
January 12, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28075499/long-term-outcome-following-remote-ischemic-postconditioning-during-percutaneous-coronary-interventions-the-rip-pci-trial-long-term-follow-up
#13
Shahar Lavi, Nour Abu-Romeh, Sabrina Wall, Mistre Alemayehu, Ronit Lavi
The clinical value of ischemic conditioning during percutaneous coronary intervention (PCI) and mode of administration is controversial. Our aim was to assess the long-term effect of remote ischemic postconditioning among patients undergoing PCI. We randomized 360 patients undergoing PCI who presented with a negative troponin T at baseline into 3 groups: 2 groups received remote ischemic postconditioning (with ischemia applied to the arm in 1 group and to the thigh in the other group), and the third group acted as a control group...
January 11, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28074808/demonstration-of-blood-flow-by-color-doppler-in-the-femoral-artery-distal-to-arterial-cannula-during-peripheral-venoarterial-extracorporeal-membrane-oxygenation
#14
K G Suresh Rao, T Muralikrishna, K R Balakrishnan
In spite of distal perfusion of the limb using a cannula, the limb can have ischemic events if there is an undetected kink or clot anywhere in the line or thrombus in the artery. There are several ways to monitor and assess the limb ischemia. Monitoring for clinical signs of limb ischemia like temperature change and pallor is reliable and mandatory. We report a method where we used color Doppler to document the blood flow. Curvilinear vascular probe of an echo machine is used to identify the flow in the distal femoral artery of the lower limb...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074445/intrathoracic-tumor-of-the-chest-wall-a-case-of-castleman-s-disease-mimicking-myositis-of-the-lower-extremities
#15
Athanasios Tampakis, Ekaterini Christina Tampaki, Thomas Daikeler, Didier Lardinois
Castleman's disease refers to a group of uncommon lymphoproliferative disorders which exhibit common lymph-node histological features. A 72-year-old male patient presented with signs of lower limb myositis. Detailed work-up focused initially on evaluating hematological malignancies, the presence of a solid tumor, autoimmune diseases and degenerative disorders of the peripheral nerves. Finally, a PET-CT scan was performed to exclude paraneoplastic manifestations of a primary tumor, revealing  however a tumor of the thoracic wall...
January 10, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28073669/reoperation-rates-after-open-and-endovascular-abdominal-aortic-aneurysm-repairs
#16
Conor F Hynes, Kendal M Endicott, Sina Iranmanesh, Richard L Amdur, Robyn Macsata
OBJECTIVE: This study compared reoperation rates associated with open abdominal aortic aneurysm (AAA) repair (OR) outcomes vs endovascular AAA repair (EVAR). METHODS: A retrospective review of the Veterans Affairs Surgical Quality Improvement Project data was performed with inclusion criteria defined as all patients who underwent AAA repair from October 1, 2007, to October 1, 2013. The primary outcome was the incidence of reoperations. Reoperations included subsequent OR or EVAR procedures performed on the abdominal aorta or iliac arteries, surgical treatment of temporally related bowel obstruction, as well as treatment of abdominal or groin wound complications ≤6 months and treatment of bowel or lower limb ischemia ≤10 days...
January 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28073668/drug-eluting-stenting-for-femoropopliteal-lesions-followed-by-cilostazol-treatment-reduces-stent-restenosis-in-patients-with-symptomatic-peripheral-artery-disease
#17
Kan Zen, Mitsuyoshi Takahara, Osamu Iida, Yoshimitsu Soga, Daizo Kawasaki, Shinsuke Nanto, Hiroyoshi Yokoi, Satoaki Matoba
BACKGROUND: Cilostazol improves clinical endovascular therapy outcomes for femoropopliteal (FP) lesions in patients with symptomatic peripheral arterial disease, but whether it also has clinical benefits for patients after drug-eluting stent implantation remains unclear. METHODS: This study is a subanalysis of the ZilvEr PTX for tHe Femoral ArterY and Proximal Popliteal ArteRy (ZEPHYR) study, a prospective multicenter study investigating FP lesions treated with the Zilver (Cook Medical, Bloomington, Ind) paclitaxel-eluting stent...
January 7, 2017: Journal of Vascular Surgery
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
#18
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/28073316/clinical-implications-of-the-anatomical-variation-of-deep-venous-thrombosis
#19
Ayman El-Menyar, Mohammad Asim, Gaby Jabbour, Hassan Al-Thani
Introduction Little is known about the anatomic variation and its implication in patients with lower limb deep venous thrombosis (DVT). We studied the clinical presentation, site of thrombosis and risk factors based on the anatomic distribution of lower limb DVT. Methods A retrospective analysis of clinically suspected DVT cases was conducted between 2008 and 2012. DVT was categorized by the location of the thrombosed segment and limb involved. The DVT anatomic segments were assessed according to left-to-right ratio, predisposing factors and clinical presentations...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28073084/reliability-and-minimum-detectable-change-of-the-gait-deviation-index-gdi-in-post-stroke-patients
#20
Katren Pedroso Correa, Gisele Francini Devetak, Suzane Ketlyn Martello, Juliana Carla de Almeida, Ana Carolina Pauleto, Elisangela Ferretti Manffra
The Gait Deviation Index (GDI) is a summary measure that provides a global picture of gait kinematic data. Since the ability to walk is critical for post-stroke patients, the aim of this study was to determine the reliability and Minimum Detectable Change (MDC) of the GDI in this patient population. Twenty post-stroke patients (11 males, 9 females; mean age, 55.2±9.9years) participated in this study. Patients presented with either right- (n=14) or left-sided (n=6) hemiparesis. Kinematic gait data were collected in two sessions (test and retest) that were 2 to 7days apart...
December 23, 2016: Gait & Posture
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