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Claudication

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https://www.readbyqxmd.com/read/29045738/the-proposed-role-of-ultrasound-in-the-management-of-giant-cell-arteritis-in-routine-clinical-practice
#1
Sara Monti, Alberto Floris, Cristina B Ponte, Wolfgang A Schmidt, Andreas P Diamantopoulos, Claudio Pereira, Sophie Vaggers, Raashid A Luqmani
Objective: To develop and explore a protocol for using colour duplex sonography (CDS) in the routine care of GCA. Methods: We tested CDS of temporal arteries and axillary arteries (AXs) on consecutive patients with suspected or established GCA, between July 2014 and September 2016. Results: We assessed 293 patients [age 72 (10), female/male 196/97], of whom 118 had clinically confirmed GCA. Seventy-three percent of patients had already received high-dose glucocorticoids (GCs) for 17 (33) days...
October 16, 2017: Rheumatology
https://www.readbyqxmd.com/read/29037346/contemporary-outcomes-of-elective-iliocaval-and-infrainguinal-venous-intervention-for-post-thrombotic-chronic-venous-occlusive-disease
#2
Johnathon C Rollo, Steven M Farley, Juan Carlos Jimenez, Karen Woo, Peter F Lawrence, Brian G DeRubertis
BACKGROUND: Patients with iliofemoral deep venous thrombosis are at risk for development of post-thrombotic syndrome. Iliac vein stenting has been shown to significantly improve clinical outcomes in patients with venous outflow obstruction, although many studies include a heterogeneous population with several different venous pathologic processes. Our objective was to evaluate the results of iliocaval and infrainguinal venous intervention for venous outflow obstruction due to post-thrombotic chronic venous occlusive disease...
November 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29033576/lumbar-spinal-stenosis-attributable-to-tophaceous-gout-case-report-and-review-of-the-literature
#3
Wei Wang, Qingbo Li, Lei Cai, Weijun Liu
OBJECTIVES: Tophaceous gout seldom affects the axial skeleton. Symptoms vary according to the differential localization of urate deposits and the diagnosis is often delayed. Here, we report an unusual case of lumbar spinal stenosis caused by extradural tophaceous deposits. METHODS: We retrospectively reviewed a case of a patient with tophaceous gout of the lumbar spine and reviewed the relevant literature. RESULTS: A 62-year-old man with a 2-year history of lower back pain and a 3-month history of lower limb radiation pain and intermittent claudication was admitted...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29031994/clinical-classification-criteria-for-neurogenic-claudication-caused-by-lumbar-spinal-stenosis-the-n-class-criteria
#4
Stéphane Genevay, Delphine S Courvoisier, Kika Konstantinou, Francisco M Kovacs, Marc Marty, James Rainville, Michael Norberg, Jean-François Kaux, Thomas D Cha, Jeffrey N Katz, Steven J Atlas
BACKGROUND CONTEXT: Since imaging findings of lumbar spinal stenosis (LSS) may not be associated with symptoms, clinical classification criteria based on patient symptoms and physical examination findings are needed. PURPOSE: To develop clinical classification criteria that identify patients with neurogenic claudication (NC) caused by LSS. STUDY DESIGN: Two stage process. Phase 1: Delphi process; Phase 2: cross-sectional study. PATIENT SAMPLE: Outpatients recruited from spine clinics in 5 countries...
October 12, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29021670/preliminary-experience-with-lumbar-facet-distraction-and-fixation-as-treatment-for-lumbar-spinal-stenosis
#5
Giovanni Grasso, Alessandro Landi
OBJECTIVES: To assess the properties of facet fixation with the Facet Wedge system in patients affected by lumbar spinal stenosis (LSS). SUMMARY OF BACKGROUND DATA: Implant of intra-articular spacers is an emerging technique for lumbar degenerative disease. METHODS: This study included forty patients (Group 1) with symptomatic LSS in whom intra-articular spacers have been implanted along with microdecompression (MD) of the neural structures...
July 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/29020715/diagnosis-and-management-of-polymyalgia-rheumatica
#6
Olwyn Jones, Fraser Birrell
Polymyalgia rheumatica (PMR) is a common inflammatory condition of unknown aetiology with a prevalence of 1 in 133 in the over 50s, and a female to male ratio of 2:1. Symptoms develop over a matter of weeks; typically bilateral shoulder or pelvic girdle pain and stiffness, that is worse in the mornings. Associated symptoms include low-grade fever, malaise, fatigue, low mood, poor appetite, and weight loss. There is no specific diagnostic test for PMR but the usual pattern is a commensurate rise in CRP and ESR...
December 2016: Practitioner
https://www.readbyqxmd.com/read/29019641/spine-conditions-lumbar-spinal-stenosis
#7
Steven D Trigg, Zachary Devilbiss
Lumbar spinal stenosis (LSS) is a frequent cause of chronic low back and lower extremity pain in older patients. Symptomatic LSS typically is described as neurogenic claudication consisting of pain, weakness, numbness, and/or fatigue arising in the back and radiating into the buttock, thigh, or lower leg. The diagnosis is complicated by lack of reliable clinical or x-ray criteria. North American Spine Society guidelines recommend magnetic resonance imaging study without contrast to confirm anatomic narrowing of the spinal canal or nerve root impingement...
October 2017: FP Essentials
https://www.readbyqxmd.com/read/29019109/automatic-delineation-of-functional-lung-volumes-with-68-ga-ventilation-perfusion-pet-ct
#8
Pierre-Yves Le Roux, Shankar Siva, Jason Callahan, Yannis Claudic, David Bourhis, Daniel P Steinfort, Rodney J Hicks, Michael S Hofman
BACKGROUND: Functional volumes computed from (68)Ga-ventilation/perfusion (V/Q) PET/CT, which we have shown to correlate with pulmonary function test parameters (PFTs), have potential diagnostic utility in a variety of clinical applications, including radiotherapy planning. An automatic segmentation method would facilitate delineation of such volumes. The aim of this study was to develop an automated threshold-based approach to delineate functional volumes that best correlates with manual delineation...
October 10, 2017: EJNMMI Research
https://www.readbyqxmd.com/read/28992768/peripheral-artery-disease-what-the-orthopaedic-physical-therapist-needs-to-know
#9
Matthew K Walsworth, Rob de Bie, Stephen Figoni, Jessica O'Connell
Synopsis Claudication from peripheral artery disease (PAD) may mimic or coexist with musculoskeletal conditions and represents an important diagnostic consideration in patients over 50. Physical therapists are optimally positioned to recognize this condition by incorporating a vascular history and physical examination in appropriately selected patients. Recognition of PAD is important both from the standpoint of addressing the ischemic risk to the limb and because PAD associated with high cerebrovascular and cardiovascular risk...
October 9, 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28987851/effect-of-single-level-transforaminal-lumbar-interbody-fusion-on-segmental-and-overall-lumbar-lordosis-in-patients-with-lumbar-degenerative-disease
#10
Xiaofei Cheng, Feng Zhang, Kai Zhang, Xiaojiang Sun, Changqing Zhao, Hua Li, Yan Michael Li, Jie Zhao
OBJECTIVE: This study investigated the ability of transforaminal lumbar interbody fusion (TLIF) to improve lumbar lordosis (LL). METHODS: Ninety-two patients receiving single-level TLIF due to lumbar degenerative disease were divided into low back pain, radiculopathy and neurogenic claudication group according to their symptoms. Preoperative and postoperative measures including segmental LL (SLL), whole LL (WLL), pelvic incidence (PI), pelvic tilt (PT), thoracic kyphosis (TK), sagittal vertical axis (SVA), visual analog scale (VAS) for back and leg pain and Oswestry Disability Index (ODI) were used for evaluation of radiographic and clinical outcomes...
October 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28987704/the-role-of-colour-doppler-ultrasonography-of-facial-and-occipital-arteries-in-patients-with-giant-cell-arteritis-a-prospective-study
#11
Rok Ješe, Žiga Rotar, Matija Tomšič, Alojzija Hočevar
OBJECTIVE: Colour Doppler Sonography (CDS) in giant cell arteritis (GCA) allows the study of involvement of cranial arteries other than the temporal arteries, which are inconvenient to biopsy, such as the facial (FaA), and occipital (OcA) arteries. We aimed to estimate the frequency of the FaA, and OcA involvement in GCA; and to explore the clinical characteristics of these subgroups of patients. METHODS: From 1 January 2014 to 31 December 2016 we prospectively performed a CDS of the FaA, and OcA in addition to the temporal (TA), and the extracranial supra-aortic arteries in all newly diagnosed patients suspected of having GCA...
October 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28985707/simultaneous-pain-intensity-rating-and-quantification-of-ischemia-throughout-exercise-and-recovery-in-proximal-versus-distal-arterial-claudication
#12
Alban Fouasson-Chailloux, Pierre Abraham, Christophe Colas-Ribas, Mathieu Feuilloy, Bruno Vielle, Samir Henni
Data on simultaneous hemodynamic changes and pain rating estimation in arterial claudication while walking are lacking. This study was conducted to determine if a difference in transcutaneous oxygen pressure (tc pO2) exists between proximal and distal localization at pain appearance (PAINapp), maximal pain (PAINmax) and pain relief (PAINrel) in proximal or distal claudication and if a relationship exists between tc pO2 changes and pain intensity. We analyzed the pain rating (Visual Analog Scale (VAS)) to lower limb ischemia, measured with the decrease from rest of oxygen pressure (DROP) tc pO2 index during constant-load treadmill tests in patients with calf ( n = 41) or buttock ( n = 19) claudication...
October 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28982943/effects-of-exercise-training-on-calf-muscle-oxygen-extraction-and-blood-flow-in-patients-with-peripheral-artery-disease
#13
Wesley B Baker, Zhe Li, Steven S Schenkel, Malavika Chandra, David R Busch, Erin Kristine Englund, Kathryn H Schmitz, Arjun G Yodh, Thomas F Floyd, Emile R Mohler
We employed near-infrared optical techniques, diffuse correlation spectroscopy (DCS) and frequency-domain near-infrared spectroscopy (FD-NIRS), to test the hypothesis that supervised exercise training increases skeletal muscle microvascular blood flow and oxygen extraction in patients with peripheral artery disease (PAD) who experience claudication. PAD patients (n=64) were randomly assigned to exercise and control groups. Patients in the exercise group received three months of supervised exercise training...
October 5, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28980380/safety-and-feasibility-of-same-day-early-discharge-after-endovascular-revascularization-of-lower-extremities-in-elderly-senior-er-registry
#14
Adam Janas, Krzysztof Milewski, Piotr P Buszman, Ksenia Janas, Aleksandra Blachut, Maciej Pruski, Szymon Wiernek, Aleksander Zurakowski, Pawel E Buszman, Stefan R Kiesz
OBJECTIVE: The aim of the study was to assess safety and feasibility of one-day early discharge (ODD) after endovascular revascularization (ER) of lower extremities in elderly. BACKGROUND: Safety and feasibility of ODD after ER have never been investigated in the elderly, despite the PAD rate has been rising in well-developed countries as their populations are getting older. METHODS: The consecutive data of 477 patients after ER who were intended to ODD were reviewed...
October 5, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28976393/-approach-to-peripheral-arterial-disease-in-the-elderly
#15
Ozan Onur Balkanay, Suat Nail Ömeroğlu
The prevalence of peripheral arterial disease, which usually develops on the basis of atherosclerosis and develops as a result of chronic arterial occlusive pathology, increases with age. Peripheral artery disease in the elderly patient population may be asymptomatic due to restrictive conditions associated with immobilization. Concurrent cerebrovascular disease and coronary artery disease risk and mortality rates are higher in elderly patients with peripheral artery disease. The life expectancy in patients with peripheral arterial disease is worse than in prostate cancer patients...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28974486/combined-dietary-nitrate-and-exercise-intervention-in-peripheral-artery-disease-protocol-rationale-and-design
#16
Mary N Woessner, Mitch D VanBruggen, Carl F Pieper, Erin K O'Reilly, William E Kraus, Jason D Allen
BACKGROUND: Peripheral artery disease (PAD) is caused by atherosclerotic occlusions in the legs. It affects approximately 8-12 million people in the United States alone, one-third of whom suffer from intermittent claudication (IC), defined as ischemic leg pain that occurs with walking and improves with rest. Patients with IC suffer a markedly impaired quality of life and a high perception of disability. Improving pain-free walking time is a primary goal of rehabilitation in this population...
October 3, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28973638/percutaneous-interspinous-spacer-vs-decompression-in-patients-with-neurogenic-claudication-an-alternative-in-selected-patients
#17
Bernhard Meyer, Adad Baranto, Frederic Schils, Frederic Collignon, Bjorn Zoega, Leong Tan, Jean-Charles LeHuec
BACKGROUND: Standalone interspinous process devices (IPDs) to treat degenerative lumbar spinal stenosis with neurogenic intermittent claudication (NIC) have shown ambiguous results in the literature. OBJECTIVE: To show that a minimally invasive percutaneous IPD is safe and noninferior to standalone decompressive surgery (SDS) for patients with degenerative lumbar spinal stenosis with NIC. METHODS: A multicenter, international, randomized, controlled trial (RCT) was con- ducted...
June 26, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28967728/evolution-of-surgical-techniques-for-a-progressive-risk-reduction
#18
Bruno Amato, Mario Santoro, Raffaele Izzo, Giuseppe Servillo, Rita Compagna, Lorenza Di Domenico, Veronica Di Nardo, Giuseppe Giugliano
Advanced age is a strong predictor of high perioperative mortality in surgical patients and patients aged 75 years and older have an elevated surgical risk, much higher than that of younger patients. Progressive advances in surgical techniques now make it possible to treat high-risk surgical patients with minimally invasive procedures. Endovascular techniques have revolutionized the treatment of several vascular diseases, in particular carotid stenosis, aortic pathologies, and severely incapacitating intermittent claudication or critical limb ischemia...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28966827/spontaneous-pseudomeningocele-associated-with-lumbar-spondylolisthesis-a-case-report-and-review-of-the-literature
#19
Gonçalo Novais, Bernardo Ratilal, Lia Pappamikail, Pedro Branco, Nuno Reis
BACKGROUND: Pseudomeningocele, an extradural collection of cerebrospinal fluid (CSF), has only been rarely reported to occur spontaneously in conjunction with isthmic spondylolisthesis (with lysis) in the lumbar spine. CASE DESCRIPTION: A 68-year-old male presented with low back pain and neurogenic claudication of several years duration without any history of trauma, epidural spine injections, or spine surgery. Lumbosacral magnetic resonance imaging (MRI) revealed a grade-I L4-L5 isthmic spondylolisthesis with spinal canal narrowing and a posterior paravertebral collection consistent with CSF...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28965800/short-and-long-term-readmission-rates-after-infrainguinal-bypass-in-a-safety-net-hospital-are-higher-than-expected
#20
Brianna M Krafcik, Sevan Komshian, Kimberly Lu, Lauren Roberts, Alik Farber, Jeffrey A Kalish, Denis Rybin, Jeffrey J Siracuse
OBJECTIVE: Readmission rates are expected to have an increasing effect on both the hospital bottom line and physician reimbursements. Safety net hospitals may be most vulnerable. We examined readmissions at 30 days, 90 days, and 1 year in a large safety net hospital to determine the magnitude and effect of short and long-term readmission rates after lower extremity infrainguinal bypass in this setting. METHODS: All nonemergent extremity infrainguinal bypass performed at a large safety net hospital between 2008 and 2016 were identified...
September 28, 2017: Journal of Vascular Surgery
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