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Toe amputation

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https://www.readbyqxmd.com/read/29658630/lumbar-sympathectomy-versus-prostanoids-for-critical-limb-ischaemia-due-to-non-reconstructable-peripheral-arterial-disease
#1
REVIEW
Indrani Sen, Sunil Agarwal, Prathap Tharyan, Rachel Forster
BACKGROUND: Peripheral arterial disease (PAD) is a common circulatory problem that can lead to reduced blood flow to the limbs, which may result in critical limb ischaemia (CLI), a painful manifestation that occurs when a person is at rest. The mainstay of treatment for CLI is surgical or endovascular repair. However, when these means of treatment are not suitable, due to anatomical reasons or comorbidities, treatment for pain is limited. Lumbar sympathectomy and prostanoids have both been shown to reduce pain from CLI in people who suffer from non-reconstructable PAD, but there is currently insufficient evidence to determine if one treatment is superior...
April 16, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29655809/acute-limb-ischemia-in-an-8-year-old-patient-case-report
#2
Young Erben, Samuel M Miller, Brandon J Sumpio, Brian J Dillon, Alfred I Lee, Peter Blume, Bauer E Sumpio, Carlos Mena-Hurtado
We report the case of an 8-year-old patient with a history of nephrotic syndrome (NS), who presented to the emergency department (ED) with right foot pain. The patient's mother described intermittent pain that woke her son from sleep and was accompanied by the foot turning purple and becoming cold to touch. Physical exam revealed capillary refill of over ten seconds in the right and less than two seconds in the left foot. Ankle-brachial indices (ABI) were 0.0 on the right and 0.96 on the left. The patient was admitted and started on therapeutic intravenous heparin...
April 12, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29644884/prospective-analysis-of-surgical-bone-margins-after-partial-foot-amputation-in-diabetic-patients-admitted-with-moderate-to-severe-foot-infections
#3
Brian M Schmidt, Jonathan B McHugh, Rajiv M Patel, James S Wrobel
BACKGROUND: Osteomyelitis is common in diabetic foot infections and medical management can lead to poor outcomes. Surgical management involves sending histopathologic and microbiologic specimens which guides future intervention. We examined the effect of obtainment of surgical margins in patients undergoing forefoot amputations to identify patient characteristics associated with outcomes. Secondary aims included evaluating interobserver reliability of histopathologic data at both the distal-to and proximal-to surgical bone margin...
April 1, 2018: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/29644037/obstructive-hydrocephalus-secondary-to-odontoid-pannus-case-report-and-review-of-literature
#4
Wai Cheong Soon, Gopiga Thanabalasundaram, Kyaw Zayar Thant, Ebere Sunny Ogbonnaya, Stuart Edward Harrisson
Odontoid pannus or periodontoid pseudotumour is associated with a variety of rheumatological conditions. We report a case of an 80-year old man who presented with acute hydrocephalus following an emergency operation to amputate his infected left big toe. Imaging revealed a large tissue mass causing severe compression at the cervico-medullary junction and obstruction of CSF flow. The acute hydrocephalus was presumed to be related to neck manoeuvring during general anaesthesia. Following an initial emergency CSF diversion through external ventricular drainage catheter insertion, the patient subsequently underwent ventriculo-peritoneal insertion and posterior spinal decompression and fixation...
April 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29614465/running-at-submaximal-speeds-the-role-of-the-intact-and-prosthetic-limbs-for-trans-tibial-amputees
#5
Siobhan C Strike, Daniela Acrone, Michael Orendurff
BACKGROUND: Dynamic Elastic Response prostheses are designed absorb and return strain energy in running. Past research has focused on running prostheses with a single toe spring designed for high speeds. RESEARCH QUESTION: To determine how runners with amputation modulate the ground reaction force of each limb to run at different speeds using a general-purpose dynamic prosthesis which has a heel spring. METHODS: Overground running data were collected in 16 recreational runners (8 transtibial amputee using their own BladeXT prosthesis and 8 controls) using Vicon Nexus V...
March 27, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29611173/the-relationship-between-pulse-waveform-analysis-indices-endothelial-function-and-clinical-outcomes-in-patients-with-peripheral-artery-disease-treated-using-percutaneous-transluminal-angioplasty-during-a-one-year-follow-up-period
#6
Paweł S Kaczmarczyk, Paweł Maga, Rafał Niżankowski, Rafał Januszek, Marzena Frołow, Mikołaj Maga, Jolanta Kościelniak, Andrzej Belowski
BACKGROUND: The aim of the current study was to assess the relationship between potential predictors of clinical outcomes after percutaneous transluminal angioplasty (PTA) of peripheral arteries during a one-year follow-up. Indices of endothelial function (EF), arterial pulse waveform analysis (aPWA) and markers of peripheral arteries ischemia were among those mostly examined. METHODS: The study comprised of 72 individuals with PAD who underwent PTA of the peripheral arteries...
April 3, 2018: Cardiology Journal
https://www.readbyqxmd.com/read/29608373/cold-susceptibility-of-digit-stumps-resulting-from-amputation-after-freezing-cold-injury-in-elite-alpinists
#7
Jurij Gorjanc, Shawnda A Morrison, Rok Blagus, Igor B Mekjavic
Gorjanc, Jurij, Shawnda A. Morrison, Rok Blagus, and Igor B. Mekjavic. Cold susceptibility of digit stumps resulting from amputation after freezing cold injury in elite alpinists. High Alt Med Biol. 16: 000-000, 2018. AIM: The aim of the study was to assess whether previous freezing cold injury in fingers and/or toes might predispose alpinists to greater risk of further freezing cold injury, primarily due to a greater vasoconstrictor response to cold, resulting in a lower perfusion, reflected in lower skin temperature...
April 2, 2018: High Altitude Medicine & Biology
https://www.readbyqxmd.com/read/29602374/-venolymphatic-malformation-with-bone-erosion-an-unusual-affectation-in-these-lesions
#8
Ana Teijo, Felipe Sacristán, Jesús Del Pozo, Tania Pérez, Laura López, Ana Reguera, Pilar Casteleiro, Ángeles Vázquez-Barro, Ángel Concha
A 30 year old male presented with a cutaneous lesion on the distal area of the 5th toe with involvement of the outer edges. Macroscopically, it was a 1cm violaceous and keratotic lesion. Radiography showed an increase in soft tissue, possibly due to a vascular lesion. MRI showed a hyper-intense signal with erosion of the distal phalanx compatible with a low-flow vascular malformation. The distal phalanx was amputated. Histopathology revealed a lesion formed by venous and D2-40 positive lymphatic vessels. This case highlights the fact that even minimal skin involvement in vascular malformations may conceal an important deeper lesion, such as erosion of the cortical bone...
April 2018: Revista Española de Patología
https://www.readbyqxmd.com/read/29576595/therapeutic-efficacy-of-autologous-non-mobilized-enriched-circulating-endothelial-progenitors-in-patients-with-critical-limb-ischemia-the-scelta-trial
#9
Francesco Liotta, Francesco Annunziato, Sergio Castellani, Maria Boddi, Brunetto Alterini, Giovanni Castellini, Benedetta Mazzanti, Lorenzo Cosmi, Manlio Acquafresca, Filippo Bartalesi, Beatrice Dilaghi, Walter Dorigo, Gabriele Graziani, Benedetta Bartolozzi, Guido Bellandi, Giulia Carli, Alessandro Bartoloni, Aaron Fargion, Filippo Fassio, Paolo Fontanari, Giancarlo Landini, Eleonora A M Lucente, Stefano Michelagnoli, Carolina Orsi Battaglini, Grazia Panigada, Clara Pigozzi, Valentina Querci, Veronica Santarlasci, Paola Parronchi, Nicola Troisi, Cristiana Baggiore, Paola Romagnani, Edoardo Mannucci, Riccardo Saccardi, Carlo Pratesi, Gianfranco Gensini, Sergio Romagnani, Enrico Maggi
BACKGROUND: The therapeutic efficacy of bone marrow mononuclear cells (BM-MNC) autotransplantation in critical limb ischemia (CLI) has been reported. Variable proportions of circulating monocytes express low levels of CD34 (CD14+ CD34low cells) and behave in vitro as endothelial progenitor cells (EPCs). The aim of the present randomized clinical trial was to compare the safety and therapeutic effects of enriched circulating EPCs (ECEPCs) with BM-MNC administration.Methods and Results:ECEPCs (obtained from non-mobilized peripheral blood by immunomagnetic selection of CD14+ and CD34+ cells) or BM-MNC were injected into the gastrocnemius of the affected limb in 23 and 17 patients, respectively...
March 23, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29561340/validation-of-the-healthy-foot-screen-a-novel-assessment-tool-for-common-clinical-abnormalities
#10
Reneeka Persaud, Patricia M Coutts, Alisa Brandon, Luvneet Verma, James A Elliott, R Gary Sibbald
GENERAL PURPOSE: The purpose of this learning activity is to provide information about the Healthy Foot Screen, a new tool for assessment of common foot abnormalities. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing education activity, you should be able to:1...
April 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29554857/aortic-graft-infection-secondary-to-iatrogenic-transcolonic-graft-malposition
#11
Jacqueline J Blank, Abby E Rothstein, Cheong Jun Lee, Michael J Malinowski, Brian D Lewis, Timothy J Ridolfi, Mary F Otterson
Aortic graft infections are a rare but devastating complication of aortic revascularization. Often infections occur due to contamination at the time of surgery. Iatrogenic misplacement of the limbs of an aortobifemoral graft is exceedingly rare, and principles of evaluation and treatment are not well defined. We report 2 cases of aortobifemoral bypass graft malposition through the colon. CASE REPORT: Case 1 is a 54-year-old male who underwent aortobifemoral bypass grafting for acute limb ischemia...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29503004/ethnic-minorities-with-critical-limb-ischemia-derive-equal-amputation-risk-reduction-from-autologous-cell-therapy-compared-with-whites
#12
S Keisin Wang, Linden A Green, Ashley R Gutwein, Natalie A Drucker, Clifford M Babbey, Alok K Gupta, Andres Fajardo, Raghu L Motaganahalli, Michael G Wilson, Michael P Murphy
OBJECTIVE: Ethnic minorities (nonwhites) with critical limb ischemia (CLI) have historically performed worse compared with whites with regard to major amputation risk reduction and amputation-free survival (AFS) after peripheral vascular intervention. This post hoc analysis was completed to determine whether this precedent also extended to treatment of CLI without a suitable revascularization option with intramuscular injections of concentrated bone marrow aspirate (cBMA). METHODS: The treatment arm of the randomized, double-blind, multicenter MarrowStim PAD Kit for the Treatment of Critical Limb Ischemia in Subjects with Severe Peripheral Arterial Disease (MOBILE) trial was stratified by ethnicity and evaluated for demographics, comorbidities, and outcomes...
March 1, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29471870/autologous-bone-marrow-derived-mononuclear-cell-therapy-in-chinese-patients-with-critical-limb-ischemia-due-to-thromboangiitis-obliterans-10-year-results
#13
Jianming Guo, Lianrui Guo, Shijun Cui, Zhu Tong, Alan Dardik, Yongquan Gu
BACKGROUND: For patients with thromboangiitis obliterans (TAO), revascularization with bypass or angioplasty is frequently not feasible due to the poor outflow of the distal small vessels. We evaluated the long-term results of our experience treating patients with TAO with autologous bone marrow-derived mononuclear cells (ABMMNCs) to determine the safety and efficacy of ABMMNC therapy in patients with critical limb ischemia due to TAO. METHODS: This was a retrospective chart review from a single university hospital vascular surgery center between January 2005 and July 2006...
February 22, 2018: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/29469768/a-novel-association-of-pseudoainhum-and-epidermolytic-ichthyosis-successfully-treated-with-full-thickness-skin-graft-after-failed-z-plasty-repair
#14
David Simkin, Jonathan D Ho, Daren J Simkin, Kevin Tomany
Pseudoainhum is a rare constriction band variant thatmay progress to spontaneous digital strangulationand auto-amputation. Although its association withpalmoplantar keratodermas is well established, ithas not been reported in conjunction with classicepidermolytic ichthyosis. We describe the first suchcase in a 25-year-old woman who presented witha painful constricting band of the fifth toe. We alsodescribe her treatment course, which consisted ofa failed z-plasty, the traditional therapeutic optionfor acute pseudoainhum, and report the success ofsubsequent full thickness skin graft, suggesting thebenefit of this procedure as a therapeutic alternativefor patients with pseudoainhum...
January 15, 2018: Dermatology Online Journal
https://www.readbyqxmd.com/read/29430814/sglt-2-inhibitors-and-the-risk-of-lower-limb-amputation-is-this-a-class-effect
#15
Charles Khouri, Jean-Luc Cracowski, Matthieu Roustit
Inhibitors of the sodium-glucose co-transporter-2 (SGLT-2) are a novel class of glucose-lowering agents that show promising results. However, the use of canagliflozin has been associated with an increased risk of lower-limb amputation. Whether this risk concerns other SGLT-2 inhibitors is unclear, and our objective was to address this issue. We performed a disproportionality analysis using the WHO global database of individual case safety reports (VigiBase). Among the 8 293 886 reports available between January 2013 and December 2017, we identified 79 reports of lower-limb amputation that were associated with SGLT-2 inhibitors...
February 12, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29395424/rationale-and-design-of-the-clinical-and-histologic-analysis-of-mesenchymal-stromal-cells-in-amputations-champ-trial-investigating-the-therapeutic-mechanism-of-mesenchymal-stromal-cells-in-the-treatment-of-critical-limb-ischemia
#16
S Keisin Wang, Linden A Green, Natalie A Drucker, Raghu L Motaganahalli, Andres Fajardo, Michael P Murphy
OBJECTIVE: Currently, there are no accepted nonsurgical therapies that improve the delivery of blood-derived nutrients to patients with critical limb ischemia. Here, we describe the ongoing phase 1/2 Clinical and Histologic Analysis of Mesenchymal Stromal Cells in AmPutations (CHAMP) trial, which will provide crucial evidence of the safety profile of mesenchymal stromal cells (MSCs) and explore their therapeutic mechanisms in the setting of critical limb ischemia requiring below-knee amputation (BKA)...
January 30, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29389217/foot-kinetics-and-kinematics-profile-in-type-2-diabetes-mellitus-with-peripheral-neuropathy-a-hospital-based-study-from-south-india
#17
Animesh Hazari, Arun G Maiya, Shivashankara K N
BACKGROUND: A kinetic change in thefoot like altered plantar pressure is the most common etiological risk factor for causing foot ulcers among people with diabetes mellitus. Kinematic alterations in joint angle and spatiotemporal parameters of the gait have also been frequently observed in participants with diabetes peripheral neuropathy. Diabetes peripheral neuropathy is the most common long-term standing complication of type 2 diabetes mellitus. It leads to various micro and macrovascular related complication of the foot...
February 1, 2018: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/29384887/a-rare-large-cutaneous-chondroid-syringoma-involving-a-toe-a-case-report
#18
Hui Lu, Li-Feng Chen, Qiang Chen, Hui Shen, Zhenfeng Liu
RATIONALE: Chondroid syringoma (CS) occurs mostly on the face and neck, and rarely occurs in the toe. Malignant CS is invasive, grows quickly, and has a high recurrence rate. The presence of a bilobed CS in 1 toe has never been reported in the literature. PATIENT CONCERNS: A 72-year-old male patient presented with a mass in a third toe of his right foot. The mass had slowly grown in 2 years. He felt mild pain and the mass occupied most of the tip of the toe. DIAGNOSES: Radiographs showed a large soft-tissue mass in the third toe of his right foot without any bone destruction...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29359675/consistency-of-toe-systolic-pressures-brachial-systolic-pressures-and-toe-brachial-indices-in-people-with-and-without-diabetes
#19
Robert Trevethan
BACKGROUND & AIMS: Toe systolic blood pressures (TSPs) and toe-brachial indices (TBIs) have been identified as useful adjuncts in the identification of pedal ischemia, peripheral artery occlusive diseases, and risk for either nonhealing of lower extremity wounds or for amputation. Valid measurement of TSPs and TBIs is therefore essential. However, it could be jeopardized by rater, instrument, and intratestee inconsistency. These three sources of inconsistency were examined in this research...
January 22, 2018: Current Diabetes Reviews
https://www.readbyqxmd.com/read/29350089/a-comparative-analysis-of-internal-bone-remodelling-concepts-in-a-novel-implant-for-direct-skeletal-attachment-of-limb-prosthesis-evaluation-a-finite-element-analysis
#20
Piotr Prochor, Eugeniusz Sajewicz
Nowadays, numerous internal bone remodelling concepts are under development, in order to estimate long-term functionality of implants by evaluating the intensity of stress-shielding effect. This effect is also analysed for the implants for direct skeletal attachment, considered as a better exoprosthesis fixation method than prosthetic sockets. Most of bone remodelling approaches are based on basic concepts, differing with certain assumptions, which may affect the accuracy of the results. This article compares commonly used internal bone remodelling concepts and evaluates the functionality of the proposed Limb Prosthesis Osseointegrated Fixation System for direct skeletal attachment of limb prosthesis in comparison with two currently available implants: the Intraosseous Transcutaneous Amputation Prosthesis and the Osseointegrated Prostheses for the Rehabilitation of Amputees...
March 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
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