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https://www.readbyqxmd.com/read/28926380/osseointegrated-transtibial-implants-in-patients-with-peripheral-vascular-disease-a-multicenter-case-series-of-5-patients-with-1-year-follow-up
#1
Robin Atallah, Jiao Jiao Li, William Lu, Ruud Leijendekkers, Jan Paul Frölke, Munjed Al Muderis
BACKGROUND: Osseointegration is an alternative treatment for amputees who are unable to wear or have difficulty wearing a socket prosthesis. Although the majority of limb amputations are due to vascular disease, such amputations have been perceived as a contraindication to osseointegration surgery. We report the outcomes of osseointegrated reconstruction in a series of 5 patients with limb amputation due to peripheral vascular disease. METHODS: Five patients with transtibial amputation and a history of peripheral vascular disease who received an osseointegration implant from 2014 to 2015 were followed for 12 months...
September 20, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28924874/predictive-parameters-for-clinical-outcome-in-patients-with-critical-limb-ischemia-who-underwent-percutaneous-transluminal-angioplasty-pta-a-systematic-review
#2
Sanne M Schreuder, Yvette M G A Hendrix, Jim A Reekers, Shandra Bipat
PURPOSE: To identify possible risk factors in predicting clinical outcome in critical limb ischemia (CLI) patients undergoing percutaneous transluminal angioplasty (PTA). MATERIALS AND METHODS: PubMed and EMBASE were searched for studies analyzing CLI and clinical outcome after PTA from January 2006 to April 2017. Outcome measures were ulcer healing, amputation free survival (AFS)/limb salvage and overall survival. Data on predictive factors for ulcer healing, AFS/limb salvage and survival were extracted...
September 18, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28924102/microrna-483-5p-modulates-the-expression-of-cartilage-related-genes-in-human-chondrocytes-through-down-regulating-tgf-%C3%AE-1-expression
#3
Ronghua Xu, Jiayi Li, Bo Wei, Weiling Huo, Liming Wang
Transforming growth factor-β1 (TGF-β1) has been reported to improve chondrocytes phenotype and function. The expression levels of microRNA-483-5p (miR-483-5p), a potential regulator of TGF-β signaling pathway, were elevated in chondrocytes of patients with osteoarthritis. In this study, we aimed to explore the role of miR-483-5p for the expression of cartilage-related genes in chondrocytes. Human chondrocytes were harvested from femoral condyle and tibial plateau of different donors (n = 10) following amputation due to sarcomas not involving the joint space...
2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28922325/metacarpal-like-hand-classification-and-treatment-guidelines-for-microsurgical-reconstruction-with-toe-transplantation
#4
Fu-Chan Wei, Nidal F Al Deek, Yu-Te Lin, Chung-Chen Hsu, Cheng-Hung Lin
The metacarpal-like hand is a severe hand injury, never addressed before. It describes a hand that lost a significant degree of prehension through a wide array of amputations, involving all digits proximal to the functional length except in one finger or in two digits, including the thumb.Thumb condition can be used to differentiate between two types.In type I, the thumb is intact or amputated at/or distal to the interphalangeal joint (functional length); and therefore, the reconstruction is focused on fingers mainly...
September 14, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28922142/reduced-amputation-rate-with-isovolemic-hemodilution-in-critical-limb-ischemia-patients
#5
Doosang Kim, Daniel J Cho, Young I Cho
AIMS: Critical limb ischemia (CLI) patients are characterized by intractable pain in spite of medication, non-healing ulcers, and gangrene. The objective of this study was to investigate whether or not isovolemic hemodilution treatment can reduce the rate of major amputations in CLI. METHODS: 28 patients were studied who had tissue loss on Rutherford Grade III, Category 5 or 6. The subjects were divided into two arms: standard-of-care, conventional therapy (CT) (n = 15) as a control group and hemodilution therapy (HT) (n = 13) as a study group...
September 11, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28921926/inhibition-of-vascular-endothelial-growth-factor-receptor-decreases-regenerative-angiogenesis-in-axolotls
#6
Angela M Ritenour, Renee Dickie
Angiogenesis is crucial for tissue growth and repair in mammals, and is chiefly regulated by Vascular Endothelial Growth Factor (VEGF) signaling. We evaluated the effect of chemical inhibition of VEGF receptor signaling in animals with superior regenerative ability, axolotl salamanders, to determine the impact on vascularization and regenerative outgrowth. Following tail amputation, treated animals (100nM PTK787) and controls were examined microscopically and measured over the month-long period of regeneration...
September 16, 2017: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
https://www.readbyqxmd.com/read/28921474/origins-of-phantom-limb-pain
#7
Damien P Kuffler
Phantom limb pain (PLP) is a chronic neuropathic pain occurring in 45-85% of patients who undergo major amputations of the upper and lower extremities. Chronic pain is physically and mentally debilitating, affecting an individual's potential for self-care and the performance of daily living activities essential for personal and economic independence. In addition, chronic pain may lead to depression and feelings of hopelessness. A National Center for Biotechnology Information study found that in the USA alone, the annual cost of dealing with neuropathic pain is more than $600 billion, with an estimated 20 million people in the USA suffering this condition...
September 18, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28921418/coping-with-phantom-limb-pain
#8
Damien P Kuffler
Phantom limb pain is a chronic neuropathic pain that develops in 45-85% of patients who undergo major amputations of the upper and lower extremities and appears predominantly during two time frames following an amputation: the first month and later about 1 year. Although in most patients the frequency and intensity of pain diminish over time, severe pain persists in about 5-10%. It has been proposed that factors in both the peripheral and central nervous systems play major roles in triggering the development and maintenance of pain associated with extremity amputations...
September 18, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28920529/surgical-interventions-for-organ-and-limb-ischemia-associated-with-primary-and-secondary-antiphospholipid-antibody-syndrome-with-arterial-involvement
#9
Carlos A Hinojosa, Javier E Anaya-Ayala, Karla Bermudez-Serrato, Ramón García-Alva, Hugo Laparra-Escareno, Adriana Torres-Machorro, Rene Lizola
OBJECTIVE: The association of antiphospholipid antibody syndrome (APS) and hypercoagulability is well known. Arterial compromise leading to ischemia of organs and/or limbs in patients with APS is uncommon, frequently unrecognized, and rarely described. We evaluated our institutional experience. METHODS: Retrospective review was conducted. From August 2007 to September 2016, 807 patients with diagnosis of APS were managed in our Institution. Patients with primary and secondary APS who required interventions were examined...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28919807/effect-of-nerve-injury-on-the-number-of-dorsal-root-ganglion-neurons-and-autotomy-behavior-in-adult-bax-deficient-mice
#10
Chuang Lyu, Gong-Wei Lyu, Aurora Martinez, Tie-Jun Sten Shi
BACKGROUND: The proapoptotic molecule BAX, plays an important role in mitochondrial apoptotic pathway. Dorsal root ganglion (DRG) neurons depend on neurotrophic factors for survival at early developmental stages. Withdrawal of neurotrophic factors will induce apoptosis in DRG neurons, but this type of cell death can be delayed or prevented in neonatal Bax knockout (KO) mice. In adult animals, evidence also shows that DRG neurons are less dependent upon neurotrophic factors for survival...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28918873/use-of-ganga-hospital-open-injury-severity-scoring-for-determination-of-salvage-versus-amputation-in-open-type-iiib-injuries-of-lower-limbs-in-children-an-analysis-of-52-type-iiib-open-fractures
#11
K Venkatadass, Tarani Sai Prasanth Grandhi, S Rajasekaran
INTRODUCTION AND AIMS: Open injuries in children are rare compared to adults. In children with major open injuries, there is no specific scoring system to guide when to amputate or salvage the limb. The use of available adult scoring systems may lead to errors in management. The role of Ganga Hospital Open Injury Severity Scoring (GHOISS) for open injuries in adults is well established and its applicability for pediatric open injuries has not been studied. This study was done to analyse the usefulness of GHOISS in pediatric open injuries and to compare it with MESS(Mangled Extremity Severity Score)...
September 12, 2017: Injury
https://www.readbyqxmd.com/read/28918266/nanomedicine-for-safe-healing-of-bone-trauma-opportunities-and-challenges
#12
REVIEW
Shahed Behzadi, Gaurav A Luther, Mitchel B Harris, Omid C Farokhzad, Morteza Mahmoudi
Historically, high-energy extremity injuries resulting in significant soft-tissue trauma and bone loss were often deemed unsalvageable and treated with primary amputation. With improved soft-tissue coverage and nerve repair techniques, these injuries now present new challenges in limb-salvage surgery. High-energy extremity trauma is pre-disposed to delayed or unpredictable bony healing and high rates of infection, depending on the integrity of the soft-tissue envelope. Furthermore, orthopedic trauma surgeons are often faced with the challenge of stabilizing and repairing large bony defects while promoting an optimal environment to prevent infection and aid bony healing...
September 4, 2017: Biomaterials
https://www.readbyqxmd.com/read/28918185/isolated-limb-perfusion-for-locally-advanced-angiosarcoma-in-extremities-a-multi-centre-study
#13
E A Huis In 't Veld, D J Grünhagen, C Verhoef, H G Smith, A C J van Akkooi, R Jones, F van Coevorden, A J Hayes, W J van Houdt
BACKGROUND: Angiosarcomas are rare and aggressive soft-tissue sarcomas. The only potential curative treatment is complete surgical excision. This study reports the outcome of isolated limb perfusion (ILP) with high-dose melphalan and tumour necrosis factor α for locally advanced angiosarcoma. MATERIAL AND METHODS: All patients who underwent an ILP for angiosarcomas between 1991 and 2016 in three tertiary referral centres were identified from prospectively maintained databases...
September 14, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28917058/lineage-tracing-of-genome-edited-alleles-reveals-high-fidelity-axolotl-limb-regeneration
#14
Grant Parker Flowers, Lucas D Sanor, Craig M Crews
Salamanders are unparalleled among tetrapods in their ability to regenerate many structures, including entire limbs, and the study of this ability may provide insights into human regenerative therapies. The complex structure of the limb poses challenges to the investigation of the cellular and molecular basis of its regeneration. Using CRISPR/Cas, we genetically labelled unique cell lineages within the developing axolotl embryo and tracked the frequency of each lineage within amputated and fully regenerated limbs...
September 16, 2017: ELife
https://www.readbyqxmd.com/read/28915308/mutilating-purpura-fulminans-in-an-adult-with-meningococcal-sepsis
#15
María Elena Arnáiz-García, Ana María Arnáiz-García, Francisco Gutierrez-Diez, Juan Francisco Nistal, Jose María González-Santos, Ivana Pulitani, Carlos Amado-Diago, Javier Arnáiz
We report a dramatic case of meningococcal sepsis manifesting as purpura fulminans in an elderly diabetic woman. Hemodynamic instability and severe bilateral cutaneous lesions involving her hands and feet developed rapidly. Specific antibiotic therapy and the administration of inotropic and vasopressor drugs were initiated. The severity and extension of the cutaneous lesions (attributed to purpura fulminans) worsened because of the need for vasoconstrictors for the treatment of septic shock. Bilateral transmetatarsal and metacarpal amputations were required to stabilize the patient...
September 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/28912015/stem-cell-based-peripheral-vascular-regeneration
#16
Yasuyuki Fujita, Atsuhiko Kawamoto
Chronic critical limb ischemia (CLI) represents an end-stage manifestation of peripheral arterial disease (PAD). CLI patients are at very high risk of amputation and cardiovascular complications, leading to severe morbidity and mortality. Because many patients with CLI are ineligible for conventional revascularization procedures, it is urgently needed to explore alternative strategies to improve blood supply in the ischemic tissue. Although researchers initially focused on gene/protein therapy using proangiogenic growth factors/cytokines, recent discovery of somatic stem/progenitor cells including bone marrow (BM)-derived endothelial progenitor cells (EPCs) and mesenchymal stem cells (MSCs) has drastically developed the field of therapeutic angiogenesis for CLI...
September 11, 2017: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/28911921/using-data-to-tackle-the-burden-of-amputation-in-diabetes
#17
William Jeffcoate, Emma Barron, John Lomas, Jonathan Valabhji, Bob Young
No abstract text is available yet for this article.
September 11, 2017: Lancet
https://www.readbyqxmd.com/read/28911840/compartmental-resection-of-peripheral-nerve-tumours-with-limb-preservation-in-16-dogs-1995-2011
#18
L van Stee, S Boston, E Teske, B Meij
Peripheral nerve tumours (PNTs) affecting the limbs may lead to chronic pain, lameness and/or monoparesis that is refractory to medical treatment. The most common radical therapy for PNTs has been surgical excision with limb amputation. However, compartmental resection with preservation of the limb has been performed by the authors with favourable clinical results and therefore this bi-institutional retrospective study was undertaken to assess limb function, survival and recurrence. Sixteen dogs that had been diagnosed with PNTs between 1995 and 2011 met the inclusion criteria for this study...
August 2017: Veterinary Journal
https://www.readbyqxmd.com/read/28910469/prehospital-administration-of-tranexamic-acid-by-ground-forces-in-afghanistan-the-prehospital-trauma-registry-experience
#19
Steven G Schauer, Michael D April, Jason F Naylor, Jonathan Wiese, Kathy L Ryan, Andrew D Fisher, Cord W Cunningham, Noah Mitchell, Mark A Antonacci
BACKGROUND: Tranexamic acid (TXA) was shown to reduce overall mortality and death secondary to hemorrhage in a large prospective study. This intervention is time sensitive. As such, the Tactical Combat Casualty Care (TCCC) guidelines recommend use of this low-cost, safe intervention among patients with possible hemorrhagic shock, penetrating trauma to the thorax or trunk, or extremity amputation. OBJECTIVE: Prehospital administration of TXA by ground forces in the Afghanistan combat theater is described...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28910466/surgical-instrument-sets-for-special-operations-expeditionary-surgical-teams
#20
Diane F Hale, Justin C Sexton, Linda C Benavides, Jerry M Benavides, Jonathan B Lundy
BACKGROUND: The deployment of surgical assets has been driven by mission demands throughout years of military operations in Iraq and Afghanistan. The transition to the highly expeditious Golden Hour Offset Surgical Transport Team (GHOST- T) now offers highly mobile surgical assets in nontraditional operating rooms; the content of the surgical instrument sets has also transformed to accommodate this change. METHODS: The 102nd Forward Surgical Team (FST) was attached to Special Operations assigned to southern Afghanistan from June 2015 to March 2016...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
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