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Lower limb claudication

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https://www.readbyqxmd.com/read/29790570/-%C3%A2-man-in-the-barrel%C3%A2-syndrome-atypical-manifestation-of-giant-cell-arteritis
#1
Y Calle-Lopez, A F Fernandez-Ramirez, E Franco-Dager, J G Gomez-Lopera, A L Vanegas-Garcia
INTRODUCTION: «Man-in-the-barrel» syndrome refers to diplegia of the upper extremities in which mobility of the head and lower limbs is preserved. Brachial plexitis that presents as «man-in-the-barrel» syndrome is an unusual manifestation of giant cell arteritis. We report a case of C5-C6 plexitis as part of the clinical features of a patient with giant cell arteritis. CASE REPORT: A 70-year-old male with a two-month history of weight loss, headache, facial pain and jaw claudication, associated with a persistent elevation of acute phase reactants and bilateral brachial plexopathy, with no evidence of neck or brain injuries or occult neoplasm and with negative autoimmunity tests...
June 1, 2018: Revista de Neurologia
https://www.readbyqxmd.com/read/29777849/non-invasive-diagnostic-methods-for-better-screening-of-peripheral-arterial-disease
#2
REVIEW
Neelamshobha Nirala, R Periyasamy, Awanish Kumar
BACKGROUND: Peripheral arterial disease (PAD) is a common circulatory problem in which narrowed arteries reduce blood flow to extremities usually legs. It does not receive enough blood flow to keep up with demand. This causes symptoms, most notably leg pain while walking which is known as claudication. It is a common manifestation of type II Diabetes, but the relationship between other vascular diseases and lower limb (LL)-PAD has been poorly understood and investigated. METHODS: When assessing a patient with clinically LLPAD, two questions are in order to establish a diagnosis: one is non-invasive testing and other is invasive...
May 16, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29777842/nationally-representative-readmission-factors-in-patients-with-claudication-and-critical-limb-ischemia
#3
Rennier A Martinez, Michelle Shnayder, Joshua Parreco, Lukas Gaffney, Marcus Eby, Nicholas Cortolillo, Michael Lopez, Jack Zeltzer
INTRODUCTION: Hospital readmissions are not only associated with increased mortality, morbidity and costs but also, with current healthcare reform, tied to significant financial and administrative penalties. Some studies show that patients undergoing vascular surgery may have higher than average readmission rates. The recently released Nationwide Readmission Database (NRD) is the most comprehensive national source of readmission data, gathering discharge information from 22 geographically dispersed states, accounting for 51...
May 16, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29732427/do-intra-operative-neurophysiological-changes-predict-functional-outcome-following-decompressive-surgery-for-lumbar-spinal-stenosis-a-prospective-study
#4
Krzysztof Piasecki, Gerit Kulik, Katarzyna Pierzchala, Etienne Pralong, Prashanth J Rao, Constantin Schizas
Background: To analyse the relation between immediate intraoperative neurophysiological changes during decompression and clinical outcome in a series of patients with lumbar spinal stenosis (LSS) undergoing surgery. Methods: Twenty-four patients with neurogenic intermittent claudication (NIC) due to LSS undergoing decompressive surgery were prospectively studied. Intra operative trans-cranial motor evoked potentials (tcMEPs) were recorded before and immediately after surgical decompression...
March 2018: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29701415/antiphospholipid-syndrome-and-acute-postpartum-limb-ischemia
#5
Inês Antunes, Carlos Pereira, Rui Machado, Duarte Rego, Vitor Ferreira, João Gonçalves, Gabriela Teixeira, Carlos Veiga, Daniel Mendes, Rui Almeida
INTRODUCTION: The diagnosis of Antiphospholipid syndrome (APS) implies the identification of antiphospoholipid antibodies and arterial/venous thrombosis or pregnancy loss. During pregnancy, there is an increased risk of thrombotic complications. METHODS: Present a case of acute lower limb ischemia in a patient with APS during postpartum period Materials/ Methods: review of a clinical case and available literature Results: Patient diagnosed with APS (triple antibody positive and antecedent of 3 previous abortions) underwent cesarean at 29 weeks of gestation...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701412/functional-popliteal-artery-entrapment-syndrome
#6
Luis Gamas, João Rocha Neves, Luís Machado, Ricardo Ferreira, Pedro Paz Dias, José Teixeira
INTRODUCTION: Popliteal artery entrapment is an uncommon syndrome, caused by extrinsic compression of the popliteal artery by muscular or tendinous structures. It occurs mainly in young individuals, with no atherosclerostic risk factors, and a mean age of presentation of 20 to 40 years, and has higher prevalence in males (83% of patients). Clinical presentation depends on the degree of arterial lesion, the most common being intermittent claudication, with critical ischemia being frequent...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29691863/population-based-study-of-mortality-and-major-amputation-following-lower-limb-revascularization
#7
K Heikkila, I M Loftus, D C Mitchell, A S Johal, S Waton, D A Cromwell
BACKGROUND: The aim of this study was to estimate separate risks of major lower limb amputation and death following revascularization for peripheral artery disease (PAD) using competing risks analysis. METHODS: Routinely collected data from Hospital Episode Statistics (HES) were used to identify patients who underwent endovascular or open lower limb revascularization for PAD in England from 2005 to 2015. The primary outcomes were major lower limb amputation and death within 5 years of revascularization...
April 25, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29625411/joint-moment-strategies-during-stair-descent-in-patients-with-peripheral-arterial-disease-and-intermittent-claudication
#8
Stephanie L King, Natalie Vanicek, Thomas D O'Brien
OBJECTIVE: To determine the lower limb joint kinetic strategies during stair descent in claudicants with peripheral arterial disease (PAD-IC). DESIGN: Cross-sectional observation study. SETTING: University laboratory. PARTICIPANTS: A total of 22 participants; 10 healthy controls and 12 patients diagnosed with PAD-IC. MAIN OUTCOME MEASURES: Between-group comparisons of ground reaction force (GRF) and, hip, knee and ankle kinetics during steady-state stair descent...
March 26, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29622821/the-burden-and-characteristics-of-peripheral-arterial-disease-in-patients-undergoing-amputation-in-korle-bu-teaching-hospital-accra-ghana
#9
Antoinette Aa Bediako-Bowan, George O Adjei, Joe N Clegg-Lamptey, Simon B Naaeder
Background: To determine the prevalence of Peripheral Arterial Disease (PAD) and associated risk factors in patients undergoing amputation at the Korle Bu Teaching Hospital (KBTH), Accra, Ghana. Objectives: A cross- sectional study of all patients undergoing lower extremity amputation at the Department of Surgery, KBTH. Materials: A coded questionnaire was used to ascertain risk factors for PAD. The Edinburgh Claudication Questionnaire was used to determine symptomatic PAD and a 5 mmHz hand held Summit® Doppler together with an Accoson ® sphygmomanometer was used to determine PAD and its severity...
September 2017: Ghana Medical Journal
https://www.readbyqxmd.com/read/29615349/assessment-of-extracellular-matrix-related-biomarkers-in-patients-with-lower-extremity-artery-disease
#10
Anna Hernández-Aguilera, Signe Holm Nielsen, Cristina Bonache, Salvador Fernández-Arroyo, Vicente Martín-Paredero, Montserrat Fibla, Morten A Karsdal, Federica Genovese, Javier A Menendez, Jordi Camps, Jorge Joven
BACKGROUND: The prevalence of lower extremity artery disease (LEAD) is high (20%-25%) in the population older than 65 years, but patients are seldom identified until the disease is advanced. Circulating markers of disease activity might provide patients with a key opportunity for timely treatment. We tested the hypothesis that measuring blood-specific fragments generated during degradation of the extracellular matrix (ECM) could provide further insight into the pathophysiologic mechanism of arterial remodeling...
March 31, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29560004/avoiding-the-trap-of-misdiagnosis-valuable-teaching-points-derived-from-a-case-of-longstanding-popliteal-artery-entrapment-syndrome
#11
Heitham Wady, Zain Badar, Zerwa Farooq, Palma Shaw, Katsuhiro Kobayashi
Popliteal artery entrapment syndrome (PAES), a condition predominantly affecting young individuals, is a rare clinical entity that can result in significant morbidity. The presence of lower limb pain and claudication in young, physically active individuals should prompt consideration for PAES. Early diagnosis and management is crucial to prevent long-term complications; however, diagnosis is fraught with challenges due to the rarity of the disease and its similar clinical presentation with more common conditions...
2018: Case Reports in Medicine
https://www.readbyqxmd.com/read/29534412/-revision-of-schatzker-type-%C3%A2-tibial-plateau-fracture-failure-focus-on-the-recovery-of-lower-limb-alignment
#12
R J Cong, J F Liu, Y Jiang, Duolikun Dilixiati, X D Hou, L P Zheng
Objective: To explore the influence of the lower extremity abnormal alignment and the joint surface, and to explore the surgical skills. Methods: Twenty-two cases of tibial plateau Schatzker Ⅵ fracture internal fixation failure revision from January 2012 to January 2017 in Department of Orthopedics, Shanghai 10(th) Hospital.One year follow-up after initial surgery to make sure of failure.Three-dimensional CT scan, radiography, infection index, gait analysis, knee joint ROM, femur tibia angle, tibial plateau tibial shaft angle and posterior slope if tibial plateau were observed...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29516399/lumbar-sympathectomy-can-improve-symptoms-associated-with-ischaemia-vasculitis-diabetic-neuropathy-and-hyperhidrosis-affecting-the-lower-extremities-a-single-centre-experience
#13
Sean C Maguire, Christina A Fleming, Gavin O'Brien, Gerald McGreal
BACKGROUND: Lumbar sympthectomy (LS) was traditionally performed for intermittent claudication but is now eclipsed by revascularisation for that indication. However, it retains a role in the management of critical limb ischaemia and other conditions causing lower limb pain with or without ischaemia. We report the role of LS in modern surgical practice when revascularisation and pain management options have been exhausted. METHODS: A medical chart review was performed on all patients who underwent LS in our unit from 2005 to 2016 (inclusive)...
March 7, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29503002/retrograde-popliteal-access-to-treat-femoropopliteal-artery-occlusive-disease
#14
Sevan Komshian, Thomas W Cheng, Alik Farber, Marc L Schermerhorn, Jeffrey A Kalish, Denis Rybin, Douglas W Jones, Jeffrey J Siracuse
OBJECTIVE: Retrograde popliteal artery (RPA) access to treat superficial femoral artery and popliteal artery disease is an option when treatment through common femoral artery (CFA) access is not possible. Our goal was to compare the safety and efficacy of RPA access with CFA access for treatment of femoral and popliteal artery lesions. METHODS: The Vascular Quality Initiative was queried for all patients undergoing RPA access from 2010 to 2016 for symptomatic peripheral arterial disease...
March 1, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29484959/chronic-total-occlusion-crossing-approach-based-on-plaque-cap-morphology-the-ctop-classification
#15
Fadi Saab, Michael R Jaff, Larry J Diaz-Sandoval, Gwennan D Engen, Theresa N McGoff, George Adams, Ashraf Al-Dadah, Philip P Goodney, Farhan Khawaja, Jihad A Mustapha
PURPOSE: To present the chronic total occlusion (CTO) crossing approach based on plaque cap morphology (CTOP) classification system and assess its ability to predict successful lesion crossing. METHODS: A retrospective analysis was conducted of imaging and procedure data from 114 consecutive symptomatic patients (mean age 69±11 years; 84 men) with claudication (Rutherford category 3) or critical limb ischemia (Rutherford category 4-6) who underwent endovascular interventions for 142 CTOs...
February 1, 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29481920/reversal-of-lower-extremity-intermittent-claudication-and-rest-pain-by-hydration
#16
Samuel Fernández, Juan Carlos Parodi, Fabián Moscovich, Camilo Pulmari
BACKGROUND: Medical treatment of disabling intermittent claudication or critical limb-threatening ischemia causing rest pain often fails or has partial response. METHODS: In this pilot study, 36 patients (12 females) affected by disabling intermittent claudication or rest pain of the lower extremities were exposed to a daily 3-L water intake for up to 6 weeks. Cutaneous foot temperature, ankle/brachial index, time and distance of claudication, and pain intensity were recorded before and at the completion of the hydration period...
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29458301/measurement-of-peripheral-blood-flow-in-patients-with-peripheral-artery-disease-methods-and-considerations
#17
Dereck L Salisbury, Rebecca Jl Brown, Ulf G Bronas, Laura N Kirk, Diane Treat-Jacobson
Peripheral artery disease (PAD) is a manifestation of generalized atherosclerosis which results in hemodynamic compromise of oxygen and substrate delivery to the lower extremity skeletal muscles. Hemodynamic assessments are vital in PAD diagnosis and in the evaluation of strategies aimed at treating claudication (i.e. exercise training, revascularization, and pharmacological agents). Venous occlusion plethysmography (VOP) is a century-old, non-invasive technique used to quantify limb blood flow and has been used to evaluate hemodynamic compromise in patients with PAD...
April 2018: Vascular Medicine
https://www.readbyqxmd.com/read/29449058/-epidemiology-of-lower-extremity-artery-disease
#18
REVIEW
Victor Aboyans, Marie-Antoinette Sevestre, Ileana Désormais, Philippe Lacroix, Gerry Fowkes, Michael H Criqui
It is estimated that more than 200 million individuals are affected by lower extremity artery disease (LEAD) worldwide. This prevalence has increased between 2000 and 2010 by 25%, especially in low/middle income countries. In France, about one million people are affected by this condition. Almost two-thirds of patients with LEAD are asymptomatic. This explains the interest of the measurement of the ankle-brachial index (ABI), an objective and harmless diagnostic tool. An ABI≤0.90 is considered as diagnostic for LEAD...
January 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29432708/diagnostic-accuracy-of-the-postexercise-ankle-brachial-index-for-detecting-peripheral-artery-disease-in-suspected-claudicants-with-and-without-diabetes
#19
Peta Ellen Tehan, Alex Louise Barwick, Mathew Sebastian, Vivienne Helaine Chuter
The postexercise ankle-brachial index (ABI) is recommended in patients with normal resting ABI when peripheral artery disease (PAD) is suspected. The aims of this study were to determine the comparative diagnostic accuracy of the resting and postexercise ABI for detecting PAD, and, the effect of the presence of diabetes on these. Three methods of interpretation currently in use were also investigated: a reduction in postexercise ABI by >20% compared to resting ABI, an ABI value of ≤0.90 postexercise, or a reduction in systolic ankle pressure of >30 mmHg postexercise...
April 2018: Vascular Medicine
https://www.readbyqxmd.com/read/29352625/unilateral-repetitive-tibial-nerve-stimulation-improves-neurogenic-claudication-and-bilateral-f-wave-conduction-in-central-lumbar-spinal-stenosis
#20
Noritsuna Nakajima, Toshikazu Tani, Katsuhito Kiyasu, Masashi Kumon, Shinichirou Taniguchi, Ryuichi Takemasa, Nobuaki Tadokoro, Kazuya Nishida, Masahiko Ikeuchi
BACKGROUND: Repetitive electrical nerve stimulation of the lower limb may improve neurogenic claudication in patients with lumbar spinal stenosis (LSS) as originally described by Tamaki et al. We tested if this neuromodulation technique affects the F-wave conduction on both sides to explore the underlying physiologic mechanisms. METHODS: We studied a total of 26 LSS patients, assigning 16 to a study group receiving repetitive tibial nerve stimulation at the ankle (RTNS) on one leg, and 10 to a group without RTNS...
March 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
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