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https://www.readbyqxmd.com/read/28724039/treatment-of-digital-ulcers-in-systemic-sclerosis-case-series-study-of-thirteen-patients-and-discussion-on-outcome
#1
Yahia Abuowda, Raquel Sousa Almeida, Ana Alves Oliveira, Petra Pego, Cristina Santos, João Matos-Costa
Introduction: In systemic sclerosis (SSc), digital ulcers (DU) are debilitating and recurrent. They are markers of prognosis and are associated with disability and mortality. Treatment strategies have been developed to block the proposed mechanisms of this complication. Objective: Clinical description of a population of SSc patients with DU, treatment, complications and outcome. Method: Analysis of 48 SSc patients meeting 2013 ACR-EULAR criteria, followed between 1999-2015; 13 patients had DU...
May 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28722354/risk-factors-for-amputation-in-patients-with-diabetic-foot-infection-a-prospective-study
#2
Serhat Uysal, Bilgin Arda, Meltem I Taşbakan, Şevki Çetinkalp, Ilgın Y Şimşir, Anıl M Öztürk, Ayşe Uysal, İlgen Ertam
There is a variety of diagnostic and therapeutic algorithms for diabetic foot infections (DFIs). Some of them are too difficult to be applied in routine clinical approach. In the routine clinical approach, it is necessary to find new risk factors and end up with a quick and easy assessment of DFIs. In this study, we aimed to evaluate the independent risk factors for osteomyelitis, amputation and major amputation in patients with DFI using standard scoring procedures. We prospectively studied 379 patients with DFI...
July 19, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28720187/experiences-with-regional-anesthesia-for-analgesia-during-prolonged-aeromedical-evacuation
#3
Jeffrey M Carness, Melissa A Wilson, Mark J Lenart, Danny E Smith, Susan F Dukes
INTRODUCTION: There is much debate regarding the appropriate analgesic management of patients undergoing medical evacuation following combat trauma. Our primary objective was to review the utility of regional anesthetic techniques in patients undergoing aeromedical evacuation following surgical limb amputation as treatment for combat trauma. METHODS: This study was conducted as an observational retrospective cohort whereby acutely injured amputee patients were identified via the U...
August 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28720057/use-of-integra-in-the-management-of-complex-hand-wounds-from-cancer-resection-and-nonburn-trauma
#4
Michael Reynolds, David A Kelly, Nicholas J Walker, Clayton Crantford, Anthony J Defranzo
BACKGROUND: Despite extensive use of Integra in burn reconstruction, little has been published regarding its utility in complex hand wounds from nonburn trauma or cancer resection. This study aimed to review outcomes following Integra use for hand reconstruction following cancer resection or nonburn trauma with exposed bone, joints, and/or tendons. METHODS: Retrospective review was performed of patients undergoing hand reconstruction with Integra for exposed bones, joints, or tendons over a 6-year period at a single institution...
February 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28720047/ring-avulsion-injuries-a-systematic-review
#5
Ravinder Bamba, Gautam Malhotra, Reuben A Bueno, Wesley P Thayer, R Bruce Shack
BACKGROUND: Ring avulsion injuries can range from soft tissue injury to complete amputation. Grading systems have been developed to guide treatment, but there is controversy with high-grade injuries. Traditionally, advanced ring injuries have been treated with completion amputation, but there is evidence that severe ring injuries can be salvaged. The purpose of this systematic review was to pool the current published data on ring injuries. METHODS: A systematic review of the English literature published from 1980 to 2015 in PubMed and MEDLINE databases was conducted to identify patients who underwent treatment for ring avulsion injuries...
February 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28719994/giant-cell-tumor-of-the-metacarpal-case-report
#6
Laura W Lewallen, Eric R Wagner, Steven L Moran
BACKGROUND: Giant cell tumor (GCT) of bone is a benign, though locally aggressive tumor, classically described as an eccentric lytic lesion, often with cortical expansion and destruction. It typically involves the metaphysis or epiphysis of long bones in skeletally mature patients, with a slight female predominance. The incidence in the small bones of the hand has been reported to be 2% to 5%. METHODS: Treatment options have evolved in recent years, and currently include intralesional curettage with or without adjuvant therapy, wide resection, and occasionally amputation...
March 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28719989/table-saw-injuries-are-our-safety-features-really-keeping-us-safe
#7
Sarah E Smith, Ian Kendrick, Thomas Huntsman
BACKGROUND: Currently, table saws sold in the United States have 3 safety features (riving knife, blade guard, and antikickback device) designed to prevent personal injury; however, these features can hinder the user's movements and are often disabled or removed. Despite the frequency of table saw injuries, there is relatively limited literature regarding them. METHODS: We performed a retrospective, observational study of characteristics associated with injuries incurred while using a table saw...
March 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28718253/psychological-adjustment-to-amputation-variations-on-the-bases-of-sex-age-and-cause-of-limb-loss
#8
Shaista Ali, Syeda Kaniz Fatima Haider
BACKGROUND: Amputation is the removal of a limb or part of a limb by a surgical procedure in order to save the life of a person. The underlying reasons behind the occurrence of this tragic incidence may be varied. However, irrespective of its cause limb loss is associated with wide range of life challenges. The study was done to investigate the psychological sequel of an individual after losing a limb and to know the level of strain and pressure they experience after this traumatic event...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28718237/accidental-intra-arterial-injection-and-limb-ischemia
#9
Abdul Malik, Ikramullah, Muhammad Gibran Khan, Syed Murad Ali Shah, Muhammad Ilyas
BACKGROUND: Accidental intra-arterial drug injections usually occur as an iatrogenic complication but it is also found in drug abusers as a result of attempted intravenous (IV) injections. It is estimated that accidental intra-arterial injections are found in 1:3500-1:56000 patients visiting emergency department. METHODS: This was cross sectional study performed in cardiovascular department Lady reading Hospital Peshawar from 1.1.2013 to 31.8.2015. Accidental intra-arterial injection was defined as intravenous injection in upper limb for any illness which is followed by sudden severe pain in limb followed by bluish discoloration of any part of limb...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28717067/barthel-index-and-outcome-of-open-bypass-for-critical-limb-ischemia
#10
Shinsuke Mii, Atsushi Guntani, Eisuke Kawakubo, Hirofumi Shimazoe
BACKGROUND: Daily activity should be an important factor to consider when deciding on a treatment strategy for critical limb ischemia (CLI), and we hypothesized that there was a close relationship between activities of daily living (ADL) and prognosis. The aim of this study was to investigate the association between ADL and outcomes of open bypass for CLI.Methods and Results:A total of 226 patients undergoing infrainguinal bypass for CLI between January 2005 and December 2015 were reviewed...
July 15, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28716631/measures-of-chronic-kidney-disease-and-risk-of-incident-peripheral-artery-disease-a-collaborative-meta-analysis-of-individual-participant-data
#11
Kunihiro Matsushita, Shoshana H Ballew, Josef Coresh, Hisatomi Arima, Johan Ärnlöv, Massimo Cirillo, Natalie Ebert, Jade S Hiramoto, Heejin Kimm, Michael G Shlipak, Frank L J Visseren, Ron T Gansevoort, Csaba P Kovesdy, Varda Shalev, Mark Woodward, Florian Kronenberg
BACKGROUND: Some evidence suggests that chronic kidney disease is a risk factor for lower-extremity peripheral artery disease. We aimed to quantify the independent and joint associations of two measures of chronic kidney disease (estimated glomerular filtration rate [eGFR] and albuminuria) with the incidence of peripheral artery disease. METHODS: In this collaborative meta-analysis of international cohorts included in the Chronic Kidney Disease Prognosis Consortium (baseline measurements obtained between 1972 and 2014) with baseline measurements of eGFR and albuminuria, at least 1000 participants (this criterion not applied to cohorts exclusively enrolling patients with chronic kidney disease), and at least 50 peripheral artery disease events, we analysed adult participants without peripheral artery disease at baseline at the individual patient level with Cox proportional hazards models to quantify associations of creatinine-based eGFR, urine albumin-to-creatinine ratio (ACR), and dipstick proteinuria with the incidence of peripheral artery disease (including hospitalisation with a diagnosis of peripheral artery disease, intermittent claudication, leg revascularisation, and leg amputation)...
July 14, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28716552/is-heterotopic-ossification-getting-nervous-the-role-of-the-peripheral-nervous-system-in-heterotopic-ossification
#12
Eleanor L Davis, Alan R Davis, Zbigniew Gugala, Elizabeth A Olmsted-Davis
Heterotopic ossification (HO), or de novo bone formation in soft tissue, is often observed following traumatic injury. Recent studies suggest that peripheral nerves may play a key functional role in this process. The results supporting a neurological basis for HO are examined in this article. Evidence supports the fact that BMPs released from bone matrix possess the capacity to induce HO. However, the process cannot be recapitulated using recombinant proteins without extremely high doses suggesting other components are required for this process...
July 14, 2017: Bone
https://www.readbyqxmd.com/read/28715342/quantitative-evaluation-of-rehabilitation-effect-on-peripheral-circulation-of-diabetic-foot
#13
Yao-Kuang Huang, Chang-Cheng Chang, Pin-Xing Lin, Bor-Shyh Lin
Diabetics may encounter different foot problems, which easily lead to infection, ulcers, and increased risk of amputation due to nerve or vascular injury. In order to reduce the risk of amputation, Buerger's exercise is one of the frequently used rehabilitation to improve the blood circulation in the lower limbs. However, it is difficult to evaluate the rehabilitation efficiency of Buerger's exercise objectively. In this study, a novel non-invasively optical system was developed to non-invasively monitor the change of the foot blood circulation before and after long-term Buerger's exercise...
July 13, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28713639/a-prospective-nonrandomized-no-placebo-controlled-phase-i-ii-clinical-trial-assessing-the-safety-and-efficacy-of-intramuscular-injection-of-autologous-adipose-tissue-derived-mesenchymal-stem-cells-in-patients-with-severe-buerger-s-disease
#14
Jeong Chan Ra, Euicheol C Jeong, Sung Keun Kang, Seog Ju Lee, Kyoung Ho Choi
Buerger's disease is a rare and severe disease affecting the blood vessels of the limbs. Adipose tissue-derived mesenchymal stem cells (ADSCs) have the potential to cure Buerger's disease when developed as a stem cell drug. In the present study, we conducted a prospective, nonrandomized, no placebo-controlled, phase I/II clinical trial with a 2-year follow-up questionnaire survey. A total of 17 patients were intramuscularly administered autologous ADSCs at a dose of 5 million cells/kg. The incidence of adverse events (AEs), adverse drug reaction (ADR), and serious adverse events (SAEs) was monitored...
2017: Cell Medicine
https://www.readbyqxmd.com/read/28713565/chronic-postoperative-pain-recent-findings-in-understanding-and-management
#15
REVIEW
Darin Correll
Chronic postoperative pain is a poorly recognized potential outcome from surgery. It affects millions of patients every year, with pain lasting for months to years, resulting in patient suffering and ensuing economic consequences. The operations with the highest incidence of chronic postoperative pain are amputations, thoracotomies, cardiac surgery, and breast surgery. Other risk factors include preoperative pain, psychological factors, demographics, and the intensity of acute postoperative pain. Attempts to prevent chronic postoperative pain have often led to debatable results...
2017: F1000Research
https://www.readbyqxmd.com/read/28712989/is-amputation-a-viable-treatment-option-in-lower-extremity-trauma
#16
Manuela Barla, Bertrand Gavanier, Mickaël Mangin, Joffrey Parot, Camille Bauer, Didier Mainard
INTRODUCTION: There is currently no consensus on how to treat patients with lower extremity trauma. Should amputation be performed early on to avoid complications or should the limb be saved at any price?The goal of this study was to show that early amputation is a viable treatment option in lower extremity trauma cases. MATERIAL AND METHODS: Twenty patients who underwent early amputation and 16 patients who underwent limb-salvage were included with a minimum follow-up of 1 year...
July 13, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28712629/the-prime-diabetes-model-novel-methods-for-estimating-long-term-clinical-and-cost-outcomes-in-type-1-diabetes-mellitus
#17
William J Valentine, Richard F Pollock, Rhodri Saunders, Jay Bae, Kirsi Norrbacka, Kristina Boye
BACKGROUND: Recent publications describing long-term follow-up from landmark trials and diabetes registries represent an opportunity to revisit modeling options in type 1 diabetes mellitus (T1DM). OBJECTIVES: To develop a new product-independent model capable of predicting long-term clinical and cost outcomes. METHODS: After a systematic literature review to identify clinical trial and registry data, a model was developed (the PRIME Diabetes Model) to simulate T1DM progression and complication onset...
July 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28712488/staged-reconstruction-of-diaphyseal-fractures-with-segmental-defects-surgical-and-patient-reported-outcomes
#18
S D Zoller, L A Cao, R A Smith, W Sheppard, E L Lord, C D Hamad, J H Ghodasra, C Lee, D Jeffcoat
INTRODUCTION: Two-stage limb reconstruction is an option for patients with critical size segmental bone defects following acute trauma or non-union. Reconstruction is technically demanding and associated with a high complication rate. Current protocols for limb reconstruction have well-documented challenges, and no study has reported on patient outcomes using a validated questionnaire. In this study, we aimed to examine the clinical and patient-centered outcomes following our surgical protocol for two-stage limb reconstruction following critical size segmental defects...
June 23, 2017: Injury
https://www.readbyqxmd.com/read/28711979/acute-kidney-injury-and-critical-limb-ischaemia-associated-with-the-use-of-the-so-called-legal-high-3-fluorophenmetrazine
#19
Michael Fawzy, Wei San Wong-Morrow, Anthony Beaumont, Chris K T Farmer
Until the law in the United Kingdom (UK) changed in May 2016 so called "legal highs" or "new psychoactive substances" were freely available in high street shops across the UK. Following prohibition these drugs are still easily purchased illegally via the internet. We report a case of a patient who self-administered 3-fluorophenmetrazine intravenously with catastrophic consequences. Adverse effects were almost immediate with symptoms of malaise and tachycardia. Two days post administration he was transferred to the intensive therapy unit with acute kidney injury and irreversible four limb ischaemia...
July 15, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28711652/dual-task-walking-over-a-compliant-foam-surface-a-comparison-of-people-with-transfemoral-amputation-and-controls
#20
Sara J Morgan, Brian J Hafner, Valerie E Kelly
People with lower limb amputation are unable to reliably sense ground characteristics due to compromised sensory inputs from the missing limb. As a result, they may rely on compensatory strategies, such as use of cognitive resources, when walking over complex surfaces. This study examined interactions between cognition and walking over a compliant surface in 14 people with transfemoral amputation (TFA) and 14 controls using a dual-task paradigm. Walking was assessed with quantitative motion analysis in both single-task (walking alone) and dual-task (walking while performing a cognitive task) conditions over a compliant foam surface...
July 10, 2017: Gait & Posture
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