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https://www.readbyqxmd.com/read/28619973/marjolin-s-squamous-cell-carcinoma-of-the-hallux-following-recurrent-ingrown-toenail-infections
#1
Wahid Abdul, Barry James O'Neill, Anthony Perera
Marjolin's squamous cell carcinoma (SCC) affecting the toe is rare. Due to resemblance with benign conditions it can often result in misdiagnosis. We report a case of Marjolin's SCC affecting the proximal hallux in a patient with recurrent ingrown toenail infections. A 58-year-old woman with a background of wedge resections for ingrown toenail and distal phalanx amputation for osteomyelitis presented with pain and hyperkeratotic raised ulcer around the proximal phalanx. MRI scan revealed soft tissue mass infiltrating the proximal phalanx with biopsies confirming a SCC...
June 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28609554/digit-preserving-surgery-of-subungual-melanoma-a-case-series-using-vacuum-assisted-closure-and-full-thickness-skin-grafting
#2
D Crisan, J Gülke, C Janetzko, S Kastler, N Treiber, K Scharffetter-Kochanek, L A Schneider
Acrolentiginous melanoma (ALM) is the second most common nail organ tumour and frequently, affects the thumb or the great toe.(1,2) Digit amputation is still the gold standard for many surgeons;(3) it does, however, not protect against local recurrence. An alternative represents complete tumour resection with distal phalanx preservation, which has proven valuable, especially for well demarcated thinner tumours.(4,5) This article is protected by copyright. All rights reserved.
June 13, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28606622/reconstruction-of-combined-thumb-amputation-at-the-metacarpal-base-level-and-index-amputation-at-the-metacarpal-level-with-pollicization-and-bilateral-double-toe-composite-transfer
#3
Zhenglin Chi, Da Jiang Song, Lin Tian, Fu Hua Hu, Xiao Fang Shen, Harvey Chim
BACKGROUND: This study aimed to describe the technique and report our experience with the reconstruction of combined proximal thumb amputations at the metacarpal base level and index finger amputation at the metacarpal level with pollicization and bilateral double toe composite transfer. METHODS: The technique consists of pollicization of the remnant index ray. Then a contralateral composite medial great toe pulp and vascularized second toe proximal interphalangeal joint flap are harvested to reconstruct the metacarpophalangeal joint of the thumb...
May 20, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28606058/risk-factors-of-lower-limb-cellulitis-in-a-level-two-healthcare-facility-in-cameroon-a-case-control-study
#4
Tsi Njim, Leopold Ndemnge Aminde, Valirie Ndip Agbor, Louise Daniele Toukam, Sara Saheb Kashaf, Eric O Ohuma
BACKGROUND: Cellulitis is a common infection of the skin and subcutaneous tissues. It is associated with significant morbidity from necrosectomies and amputations especially in sub-Saharan Africa. We aimed at identifying the risk factors and burden of lower limb cellulitis to inform preventive strategies in Cameroon. METHODS: This was a hospital-based case-control study carried out in the Bamenda Regional Hospital (BRH) between September 2015 and August 2016. Cases were defined as consenting adults admitted to the surgical unit who presented with a localised area of lower limb erythema, warmth, oedema and pain, associated with fever (temperature ≥ 38 °C) and/or chills of sudden onset...
June 12, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28605608/canagliflozin-and-cardiovascular-and-renal-events-in-type-2-diabetes
#5
Bruce Neal, Vlado Perkovic, Kenneth W Mahaffey, Dick de Zeeuw, Greg Fulcher, Ngozi Erondu, Wayne Shaw, Gordon Law, Mehul Desai, David R Matthews
Background Canagliflozin is a sodium-glucose cotransporter 2 inhibitor that reduces glycemia as well as blood pressure, body weight, and albuminuria in people with diabetes. We report the effects of treatment with canagliflozin on cardiovascular, renal, and safety outcomes. Methods The CANVAS Program integrated data from two trials involving a total of 10,142 participants with type 2 diabetes and high cardiovascular risk. Participants in each trial were randomly assigned to receive canagliflozin or placebo and were followed for a mean of 188...
June 12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28513212/an-optical-fiber-based-smart-textile-smart-socks-to-manage-biomechanical-risk-factors-associated-with-diabetic-foot-amputation
#6
Bijan Najafi, Hooman Mohseni, Gurtej S Grewal, Talal K Talal, Robert A Menzies, David G Armstrong
OBJECTIVE: This study aimed to validate a smart-textile based on fiber-optics for simultaneous measurement of plantar temperature, pressure, and joint angles in patients with diabetic peripheral neuropathy (DPN). METHODS: After in-vitro validation in the laboratory, 33 eligible subjects with DPN were recruited (age: 58 ± 8 years, BMI: 31.5 ± 8 kg/m(2)) for assessing plantar pressure and temperature during habitual gait-speed in a clinical-setting. All participants were asked to walk at their habitual speed while wearing a pair of sensorized socks made from highly flexible fiber optics (SmartSox)...
May 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28509696/on-top-index-pollicization-after-a-partial-amputation-of-a-syndactylized-hypoplastic-thumb-in-a-patient-with-townes-brocks-syndrome
#7
Mia Lorencin, Kresimir Bulic
Townes-Brocks syndrome is a rare autosomal dominant syndrome characterized by multiple malformations, including thumb anomalies. Thumb hypoplasia poses a specific problem, where a deficient thumb creates a significant handicap in hand function. The treatment goal is enabling pinch and grip activity, and the preferred procedure for a severely hypoplastic thumb is index finger pollicization. We present a case of on-top index pollicization in a 10-year-old, after a partial amputation of a previously syndactylized hypoplastic thumb, with a well-formed first carpometacarpal joint...
May 15, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28508973/phlegmasia-cerulean-dolens-complication-of-femoral-vein-catheterization
#8
M Hari Krishna Reddy, B Sangeetha, M Aruna, V Sarat Chandra, Anil C Venkata Kumar, R Ram, V Sivakumar
There are three less frequent manifestations of acute massive venous thrombosis and obstruction of the venous drainage of an extremity. They are phlegmasia alba dolens, phlegmasia cerulean dolens (PCD), and venous gangrene. The term PCD differentiates ischemia-associated massive venous thrombosis from phlegmasia alba dolens, which describes fulminant venous thrombosis without ischemia. We present a 55-year-old hypertensive, who presented with paedal oedema and breathlessness at rest. About a month prior to this admission, she suffered dislocation of left patella...
November 2016: CEN Case Reports
https://www.readbyqxmd.com/read/28495496/aggressive-digital-papillary-adenocarcinoma-a-clinicopathological-study-of-19-cases
#9
Noëlle Weingertner, Anne Gressel, Maxime Battistella, Bernard Cribier
BACKGROUND: Aggressive digital papillary adenocarcinomas (ADPA) are malignant tumors of sweat glands having recurrence/metastatic potential. OBJECTIVE: We sought to describe the clinical/histopathological characteristics of a series of ADPA. METHODS: This is a retrospective case series of 19 ADPA. RESULTS: The tumors occurred in 17 men and 2 women (mean age: 47 years). They involved digits (15), big toe (3), and palm (1), and measured from 3 to 30 mm...
May 9, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28487741/regeneration-and-regrowth-potentials-of-digit-tips-in-amphibians-and-mammals
#10
REVIEW
Yohan Choi, Fanwei Meng, Charles S Cox, Kevin P Lally, Johnny Huard, Yong Li
Tissue regeneration and repair have received much attention in the medical field over the years. The study of amphibians, such as newts and salamanders, has uncovered many of the processes that occur in these animals during full-limb/digit regeneration, a process that is highly limited in mammals. Understanding these processes in amphibians could shed light on how to develop and improve this process in mammals. Amputation injuries in mammals usually result in the formation of scar tissue with limited regrowth of the limb/digit; however, it has been observed that the very tips of digits (fingers and toes) can partially regrow in humans and mice under certain conditions...
2017: International Journal of Cell Biology
https://www.readbyqxmd.com/read/28481632/severe-hypernatremic-dehydration-and-lower-limb-gangrene-in-an-infant-exposed-to-lamotrigine-aripiprazole-and-sertraline-in-breast-milk
#11
Caroline Morin, Isabelle Chevalier
BACKGROUND: Hypernatremic dehydration is well described in exclusively breastfed neonates, although life-threatening complications are rarely reported. MATERIALS AND METHODS: The present article describes a case of severe hypernatremic dehydration in a previously healthy term neonate. Other published cases of severe complications of hypernatremic dehydration are discussed. RESULTS: The exclusively breastfed neonate described had severe hypernatremic dehydration because of inadequate milk intake, with disseminated intravascular coagulation and right lower limb gangrene that required amputation of all five toes and surgical debridement of the metatarsals...
May 8, 2017: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
https://www.readbyqxmd.com/read/28476397/cryoglobulinemia-a-rare-cause-of-digital-gangrene-after-elective-foot-surgery
#12
Catherine L Churchill, James R Polowczyk
The development of gangrene after elective digital surgery is a rare complication. We present a case of a patient with normal preoperative vascular examination findings and a history significant for untreated hepatitis C. The patient underwent revisional second toe arthrodesis and plantar plate repair with pin fixation. After surgery, she developed gangrene and ultimately required partial digital amputation. The wound at the amputation site worsened postoperatively, warranting a rheumatologic evaluation that revealed previously undiagnosed cryoglobulinemia...
May 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28476393/is-it-worth-discriminating-against-patients-who-smoke-a-systematic-literature-review-on-the-effects-of-tobacco-use-in-foot-and-ankle-surgery
#13
REVIEW
Jason H Kim, Sandeep Patel
Although numerous studies have linked smoking with lower extremity wound and bone healing complications, a comprehensive study on the effects of smoking in foot and ankle surgery has not yet been reported. The purpose of the present study was to report the results of our systemic literature review, identifying the effects of tobacco use on common foot and ankle procedures. The systematic literature review was performed according to guidelines set by the PRIMSA statement (Preferred Reporting Items for Systematic Review and Meta-Analyses)...
May 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28475445/outcomes-after-foot-surgery-in-people-with-a-diabetic-foot-ulcer-and-a-12-month-follow-up
#14
E Lenselink, S Holloway, D Eefting
OBJECTIVE: The aim of this study was to retrospectively measure the outcomes of foot-sparing surgery at one year follow-up for patients with diabetic foot ulcers (DFUs). We assessed wound healing and the need for further surgery in relation to the variables that influence healing. METHOD: Data were retrospectively collected by reviewing the electronic files of patients attending the Wound Expert Clinic (WEC). Outcomes of surgical debridement, toe, ray and transmetatarsal amputations were assessed...
May 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28464014/analgesic-effect-of-perineural-magnesium-sulphate-for-sciatic-nerve-block-for-diabetic-toe-amputation-a-randomized-trial
#15
Jiehao Sun, Xiaona Feng, Qihan Zhu, Wendong Lin, Hailei Guo, Emmanuel Ansong, Le Liu
BACKGROUND AND OBJECTIVES: High concentrations of local anesthetics may be neurotoxic for diabetic patients. Additive perineural administration of magnesium was reported to decrease the consumption of local anesthetics for nerve block. It was hypothesized that MgSO4 added to dilute ropivacaine was equianalgesic to more concentrated ropivacaine for toe amputations in diabetic patients. METHODS: Seventy diabetic patients were allocated into 3 groups: 1) perineural 200 mg MgSO4 added to 0...
2017: PloS One
https://www.readbyqxmd.com/read/28441640/lack-of-association-between-limb-hemodynamics-and-response-to-infrapopliteal-endovascular-therapy-in-patients-with-critical-limb-ischemia
#16
J A Mustapha, Larry J Diaz-Sandoval, George Adams, Michael R Jaff, Robert Beasley, Theresa McGoff, Sara Finton, Larry E Miller, Mohammad Ansari, Fadi Saab
BACKGROUND: Non-invasive limb hemodynamics may aid in diagnosis of critical limb ischemia (CLI), although the relationship with disease severity and response to endovascular therapy is unclear. METHODS AND RESULTS: This prospective, single-center study enrolled 100 CLI patients (Rutherford class 4-6) who underwent infrapopliteal endovascular revascularization (175 lesions) in the Peripheral RegIstry of Endovascular Clinical OutcoMEs (PRIME) registry. Hemodynamic measures included ankle-brachial index (ABI), toe-brachial index (TBI), and toe pressure (TP)...
May 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28435579/peripheral-gangrene-complicating-systemic-lupus-erythematosus-in-a-patient-with-spina-bifida-a-case-report
#17
S Vijay, V K Imthiaz, S Hitesh
An adolescent girl, a known case of spina bifida with systemic lupus, presented with bluish discolouration of three toes of the right foot. She had thrombosis of bilateral popliteal arteries. She underwent percutaneous transluminal angioplasty (PTA) of both legs and Chopart amputation of the right foot. Systemic lupus erythematosus (SLE) occurring in a patient with spina bifida has not been previously reported. Weakness, sensory loss, lack of normal ambulation, endarteritis, antiphospholipid antibody syndrome are common contributory factors for peripheral gangrene in patients with spina bifida with systemic lupus erythematosus...
March 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28390770/rationale-and-design-of-the-marrowstim-pad-kit-for-the-treatment-of-critical-limb-ischemia-in-subjects-with-severe-peripheral-arterial-disease-mobile-trial-investigating-autologous-bone-marrow-cell-therapy-for-critical-limb%C3%A2-ischemia
#18
RANDOMIZED CONTROLLED TRIAL
S Keisin Wang, Linden A Green, Raghu L Motaganahalli, Michael G Wilson, Andres Fajardo, Michael P Murphy
OBJECTIVE: Critical limb ischemia (CLI) continues to place a significant encumbrance on patients and the health care system as it progresses to limb loss and long-term disability. Traditional methods of revascularization offer a significant benefit; however, for one-third of CLI patients, these surgical options are not technically possible or patency is severely limited by disease burden (deemed "poor-option" for revascularization). In a previous phase I trial, we demonstrated intramuscular injection of concentrated bone marrow aspirate (cBMA) via MarrowStim (Zimmer Biomet, Warsaw, Ind) harvest is safe and may decrease major amputation in patients with CLI unfit for surgical revascularization...
June 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28363293/cold-injuries
#19
REVIEW
Deana S Shenaq, Lawrence J Gottlieb
New treatments of frostbite have led to unprecedented salvage of extremities including fingers and toes. Success is predicated on prompt institution of time-sensitive protocols initiated soon after rewarming, particularly the use of thombolytics. Unfortunately, in the urban setting, most patients are not candidates for these treatment modalities. Triple-phase bone scans have allowed for early determination of devitalized parts that need amputation. Reconstructive surgical techniques are typically used to salvage limb length in these devastating injuries...
May 2017: Hand Clinics
https://www.readbyqxmd.com/read/28346194/case-report-diabetic-foot-ulcer-infection-treated-with-topical-compounded-medications
#20
Kelechi E Agbi, Maria Carvalho, Ha Phan, Cristiane Tuma
An adult diabetic male with three toes amputated on his right foot presented with an ulcer infection on his left foot, unresponsive to conventional antifungal oral medication for over two months. The ulcerated foot wound had a large impairment on the patient's quality of life, as determined by the Wound-QoL questionnaire. The compounding pharmacist recommended and the physician prescribed two topical compounded medicines, which were applied twice a day, free of charge at the compounding pharmacy. The foot ulcer infection was completely resolved following 13 days of treatment, with no longer any impairment on the patient's quality of life...
January 2017: International Journal of Pharmaceutical Compounding
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