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Lower extremity

Alexander P Decilveo, Bartlomiej W Szczech, Jacob Topfer, James C Wittig
Expandable endoprostheses have become an acceptable modality to address the issue of limb-length inequality in limb-sparing procedures for skeletally immature patients afflicted with lower extremity bone sarcomas. This study retrospectively analyzed postoperative outcomes and complications for 7 patients (8 limbs) who underwent minimally invasive or noninvasive reconstruction during a 12-year period. Musculoskeletal Tumor Society (MSTS) scores and complication rates were reported. Mean functional outcome (MSTS scores) at final follow-up was 93...
October 25, 2016: Orthopedics
Simran Chahal, Kanchan Vohra, Ashit Syngle
Peripheral artery disease (PAD) is the major risk factor for cardiovascular disease and lower extremity amputation in patients with diabetes. Autonomic neuropathy is a risk factor for cardiovascular-related morbidity and mortality. Sudomotor dysfunction is well established in type 2 diabetes mellitus (T2DM) and reflects small fibre neuropathy, cardiovascular autonomic neuropathy and peripheral sympathetic autonomic neuropathy. However, the relationship between sudomotor dysfunction and PAD remains unexplored...
October 25, 2016: Neurological Sciences
Joseph A Ricci, Kayva Crawford, Olivia A Ho, Bernard T Lee, Ketan M Patel, Matthew L Iorio
BACKGROUND: Venous thromboembolism encompasses a spectrum of disease, ranging from asymptomatic deep vein thrombosis to fatal pulmonary embolism. As microsurgical techniques increase in complexity, the overriding benefit from a microsurgical versus a venous thromboembolism prophylactic regimen remains unclear. This study evaluated the current recommendations and procedure-specific strategies for venous thromboembolism prophylaxis with a focus on the utility of prophylaxis in microsurgical procedures...
November 2016: Plastic and Reconstructive Surgery
Nick A van Alphen, Mohamed Morsy, Alexis T Laungani, Assaf Kadar, Andrew J Vercnocke, Nirusha Lachman, Erik L Ritman, Steven L Moran
BACKGROUND: The purpose of this study was to use micro-computed tomography to demonstrate the intraosseous vascularity of the lunate within a three-dimensional orientation to identify areas of greatest perfusion and define vascular "safe zones" for surgical intervention. METHODS: Fourteen upper extremities were injected with a lead-based contrast agent. The lunates were harvested and scanned using a micro-computed tomography scanner. The intraosseous vascularity was incorporated into a three-dimensional image...
November 2016: Plastic and Reconstructive Surgery
I Raška, M Rašková, V Zikán, J Škrha
Type 2 diabetes mellitus (T2DM) is associated with increased fracture risk; the underlying mechanism remains unexplained. This study aimed to investigate the relationships between body composition and bone and glucose metabolism in postmenopausal women with T2DM. Dual-energy X-ray absorptiometry was used to measure bone mineral density (BMD) and body composition. A total of 68 postmenopausal women with T2DM and 71 controls were eligible for the study. In contrast to normal BMD in T2DM, a similar prevalence of low-trauma fractures was observed in both groups...
October 26, 2016: Physiological Research
Anja H Greif, Peter Hrobárik, Jochen Autschbach, Martin Kaupp
Previous relativistic quantum-chemical predictions of unusually large (1)H and (13)C NMR chemical shifts for ligand atoms directly bonded to a diamagnetic uranium(vi) center (P. Hrobárik, V. Hrobáriková, A. H. Greif and M. Kaupp, Angew. Chem., Int. Ed., 2012, 51, 10884) have been revisited by two- and four-component relativistic density functional methods. In particular, the effect of the exchange-correlation response kernel, which had been missing in the previously used two-component version of the Amsterdam Density Functional program, has been examined...
October 26, 2016: Physical Chemistry Chemical Physics: PCCP
Ryan Kunjal, Rabie Adam-Eldien, Raafat Makary, Francois Jo-Hoy, Charles W Heilig
We report the case of a 22-year-old African American female who presented to another facility for routine follow-up in the 34th week of pregnancy with lower extremity swelling and nephrotic-range proteinuria. Although she was normotensive, it was initially thought that she had preeclampsia. She was monitored carefully and delivery was induced at 37 weeks of gestation. She was transferred to our hospital, where she was diagnosed with systemic lupus erythematosus (SLE) based on clinical and laboratory criteria...
September 2016: Case Reports in Nephrology and Dialysis
Elena Maggi, Mario Cappiello, Antonella Del Corso, Francesca Lenzarini, Eleonora Peroni, Lisandro Benedetti-Cecchi
BACKGROUND: Organisms are facing increasing levels of environmental stress under climate change that may severely affect the functioning of biological systems at different levels of organization. Growing evidence suggests that reduction in body size is a universal response of organisms to global warming. However, a clear understanding of whether extreme climate events will impose selection directly on phenotypic plastic responses and how these responses affect ecological interactions has remained elusive...
2016: PeerJ
Elizabeth H Bradley, Heather Sipsma, Lauren A Taylor
BACKGROUND: for decades, U.S. taxpayers have been lamenting the high cost of health care. Since the mid-1980s, Americans have had double-digit spending on health care. Despite this investment, Americans are less healthy than their European and Scandinavian counterparts across an array of health measures. AIM: We sought to explore how inadequate attention to the social, behavioral, and environmental determinants of health may contribute to the American health care paradox of high health care spending and poor health outcomes...
October 24, 2016: QJM: Monthly Journal of the Association of Physicians
Luai Al Rabadi, Raymond Bergan
As cells progress through carcinogenesis, the associated exponential expansion of genetic and molecular aberrations and resultant heterogeneity make therapeutic success increasingly unattainable. Therapeutic intervention at early stages of carcinogenesis that occur within the primary organ and in the face of a lower burden of molecular aberrations, constitutes a basic tenet of cancer chemoprevention, and provides a situation that favors a greater degree of therapeutic efficacy compared to that of advanced cancer...
October 25, 2016: Cancer Prevention Research
F Hernández-Alfaro, M J Nieto, V Ruiz-Magaz, A Valls-Ontañón, I Méndez-Manjón, R Guijarro-Martínez
Increasing experience with alternative timing protocols in orthognathic surgery has given way to new surgical and orthodontic techniques to shorten treatment times, reduce biological costs, and improve the final outcome. A prospective evaluation of class III patients who received an inferior segmental osteotomy (ISO) for decompensation of significantly retroclined lower incisors in the context of 'surgery-first' (SF) or 'surgery-early' (SE) timing protocols was performed. Treatment was planned virtually. A thorough periodontal assessment was performed at baseline and periodically until debonding...
October 22, 2016: International Journal of Oral and Maxillofacial Surgery
Li-Feng Jiang, Hang Li, Zeng-Feng Xin, Li-Dong Wu
Acute compartment syndrome of the lower extremity is a serious postinjury complication that requires emergency treatment. Early diagnosis is of paramount importance for a good outcome. Four muscle compartments in the calf (anterior, lateral, deep posterior, and superficial posterior) may be individually or collectively affected. Acute segmental single-compartment syndrome is an extremely rare condition characterized by high pressure in a single compartment space with threatening of the segmental tissue viability...
October 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Ryan C Johnson, Michael W Ellis, Carey D Schlett, Eugene V Millar, Patrick T LaBreck, Deepika Mor, Emad M Elassal, Jeffrey B Lanier, Cassie L Redden, Tianyuan Cui, Nimfa Teneza-Mora, Danett K Bishop, Eric R Hall, Kimberly A Bishop-Lilly, D Scott Merrell
: Military trainees are at high risk for skin and soft-tissue infections (SSTIs). Although Staphylococcus aureus is associated with purulent SSTI, it is unclear to what degree this pathogen causes nonpurulent cellulitis. To inform effective prevention strategies and to provide novel insights into SSTI pathogenesis, we aimed to determine the etiology of SSTI in this population. We conducted a prospective observational study in US Army Infantry trainees with SSTI (cutaneous abscesses and cellulitis) from July 2012 through December 2014...
2016: PloS One
H Susan J Picavet, Nina Berentzen, Ninotsjka Scheuer, Raymond W J G Ostelo, Bert Brunekreef, Henriette A Smit, Alet Wijga
For musculoskeletal complaints (MSCs) among adults, several risk factors are known, but the most important determinant is an earlier episode of MSCs. Research has shifted to younger ages, showing a high prevalence of MSCs among children and adolescents. Our purpose was to evaluate the prevalence of MSCs among those growing up from age 11 to 14 and to explore the role of several sociodemographic, growth and development, psychosocial, and lifestyle factors. Data collected at age 11 (n = 2651) and age 14 (n = 2522) in the ongoing Dutch Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort study were used...
September 15, 2016: Pain
Xuan-Binh D Pham, Jerry J Kim, Aaron B Parrish, Cynthia Tom, Ezinne J Ihenachor, David Mina, Christian de Virgilio
Prior studies have shown racial and gender differences with respect to maturation of arteriovenous fistulas. Women and minorities have lower maturation rates for unclear reasons. Small arterial diameter and high brachial artery bifurcation (HBB) are also implicated in reduced maturation rates. We sought to correlate differences in upper extremity arterial anatomy to race and gender. All upper extremity vascular mapping ultrasounds from 2013 to 2014 were retrospectively reviewed. A total of 509 arms in 284 patients were evaluated...
October 2016: American Surgeon
Karen E Burtt, Alexis D Rounds, Hyuma A Leland, Ram K Alluri, Ketan M Patel, Joseph N Carey
Infections in the traumatized lower extremity are a significant source of morbidity and expense. Outcomes after vascularized soft tissue reconstruction were analyzed to determine impact on infection rates. A retrospective review of a prospectively maintained database was performed, including 114 trauma patients requiring soft tissue reconstruction of lower extremity injuries at an urban Level I tertiary referral center from 2008 to 2015. Patient characteristics and perioperative outcomes were analyzed. After trauma, 39 (34...
October 2016: American Surgeon
Yoonja Kang, Ying-Zhong Tang, Gordon T Taylor, Christopher J Gobler
To date, the life stages of pelagophytes have been poorly described. This study describes the ability of Aureoumbra lagunensis to enter a resting stage in response to environmental stressors including high temperature, nutrient depletion, and darkness as well as their ability to revert from resting cells back to vegetative cells after exposure to optimal light, temperature, and nutrient conditions. Resting cells became round in shape and larger in size, filled with red accumulation bodies, had smaller and fewer plastids, more vacuolar space, contained lower concentrations of chlorophyll a and RNA, displayed reduced photosynthetic efficiency, and lower respiration rates relative to vegetative cells...
October 25, 2016: Journal of Phycology
Thiru M Annaswamy, Jared Worchel
We report a patient with a previously undiagnosed spinal dural arteriovenous fistula (SDAVF) who became acutely paraplegic following a lumbar epidural steroid injection for lumbar spinal stenosis. Magnetic resonance imaging showed multiple flow voids and serpentine vessels on the cord surface with cord edema extending from T3 through the conus. Spinal angiography confirmed an SDAVF fed by the left lateral sacral artery, which was subsequently endovascularly embolized, and the patient had a partial return of function...
October 22, 2016: American Journal of Physical Medicine & Rehabilitation
Franck Leclère, Emilie Desnouveaux, Vincent Casoli
INTRODUCTION: The goal of lower extremity reconstruction after trauma is the coverage of defects to give patients a healed wound and to let them resume their life, ambulate, and return to work while preventing amputation. In this article we describe an innovative use of Integra® for free flap pedicle coverage in lower extremity reconstruction. MATERIALS AND METHODS: Between January 2011 and December 2015, ten patients, 4 women and 6 men, underwent a lower limb reconstruction with an association of free flap and integra® to cover the flap pedicle...
October 25, 2016: Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology
M van der Gaag, H Ising, J Lokkerbol, F Smit
Diagnoses have heterogeneous outcomes, varying from good to extremely poor. There is a need to single out an ultra-high-risk group of individuals who have illnesses that might well end unfavourably or who might later develop serious psychopathology.<br/> AIM: To devise a screening instrument that can identify a group of individuals who run a very high risk of developing a first-episode psychosis, and to create a type of intervention that can modify the course of the illness.<br/> METHOD: We developed a short screening instrument (PQ-16) and were able to ascertain its predictive value...
2016: Tijdschrift Voor Psychiatrie
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