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https://www.readbyqxmd.com/read/28340359/diabetic-foot-ulcer-development-risk-classifications-validation-a-multicentre-prospective-cohort-study
#1
M Monteiro-Soares, R Ribas, C Pereira da Silva, T Bral, A Mota, S Pinheiro Torres, A Morgado, R Couceiro, R Ribeiro, V Dias, M Moreira, P Mourão, M J Oliveira, M Madureira, V Paixão-Dias, M Dinis-Ribeiro
AIMS: To prospectively validate the existing classifications to stratify subjects with diabetes mellitus (DM) by their risk of diabetic foot ulcer (DFU), in high and low risk settings. METHODS: A prospective multicentre cohort study was conducted, including 446 subjects with DM without active DFU followed in the hospital or primary care setting. Demographic, clinical characterization variables, and those included in the classifications were collected at baseline...
March 9, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28337820/selective-radiofrequency-stimulation-of-the-dorsal-root-ganglion-drg-as-a-method-for-predicting-targets-for-neuromodulation-in-patients-with-post-amputation-pain-a-case-series
#2
Corey W Hunter, Ajax Yang, Tim Davis
OBJECTIVE: While spinal cord stimulation (SCS) has established itself as an accepted and validated treatment for neuropathic pain, there are a number of conditions where it has experienced less, long-term success: post amputee pain (PAP) being one of them. Dorsal root ganglion (DRG) stimulation has shown great promise, particularly in conditions where traditional SCS has fallen short. One major difference between DRG stimulation and traditional SCS is the ability to provide focal stimulation over targeted areas...
March 23, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28336738/single-stage-osseointegrated-reconstruction-and-rehabilitation-of-lower-limb-amputees-the-osseointegration-group-of-australia-accelerated-protocol-2-ogaap-2-for-a-prospective-cohort-study
#3
Munjed Al Muderis, William Lu, Kevin Tetsworth, Belinda Bosley, Jiao Jiao Li
INTRODUCTION: Lower limb amputations have detrimental influences on the quality of life, function and body image of the affected patients. Following amputation, prolonged rehabilitation is required for patients to be fitted with traditional socket prostheses, and many patients experience symptomatic socket-residuum interface problems which lead to reduced prosthetic use and quality of life. Osseointegration has recently emerged as a novel approach for the reconstruction of amputated limbs, which overcomes many of the socket-related problems by directly attaching the prosthesis to the skeletal residuum...
March 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28336529/toe-imaging-of-a-large-aortic-mass-an-unusual-cause-of-systemic-embolization-in-a-septic-patient
#4
Sarah R Blake, Jamal Khan, Adrian Chenzbraun
A 72-year-old woman presented with sepsis and lower limb ischaemia. Transoesophageal echocardiography (TOE) for suspected endocarditis revealed no cardiac pathology or source of emboli but a large thrombus-like mass was noted in a normal size descending aorta (Fig. 1A, Video 1). Repeat TOE after two weeks of anticoagulation showed two new masses and no change in the size of the original one (Fig. 1B). The patient died following bilateral leg amputation. There was no PM to provide pathology confirmation but the most likely diagnosis was of a thrombus, possibly infected...
March 23, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28336419/scarf-related-injuries-at-a-major-trauma-center-in-northern-india
#5
Pritish Singh, Ashok Kumar, Vishal Shekhawat
PURPOSE: Scarf is a long loose piece of cloth worn around the neck and shoulder. Despite cultural association of this apparel, it is part of numerous injury episodes of varying enormity. Entanglement of loose scarf in spoke wheels of bike, tricycle, belt driven machines like sugarcane juice machine, thresher, grinding machines, etc is observed both in social and industrial milieu. This study aims to investigate the scarf-related injuries at a major trauma center in northern India. METHODS: From June 2013 to May 2015, a hospital-based prospective observational study was done in patients who presented to a level 1 trauma center in northern India with the mode of injury involving scarf around the neck...
March 9, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28336044/flexor-tenosynovitis
#6
REVIEW
Brad T Hyatt, Mark R Bagg
For patients with suspected flexor tenosynovitis, the mainstay of diagnosis is a thorough history and physical examination. The examination is guided by evaluating the patient for Kanavel's four cardinal signs. Empiric antibiotics should be started immediately on diagnosis covering skin flora and gram-negative bacteria. Typically, surgery is required. Appropriate exposure is required for adequate treatment and incisions should be tailored to preserve areas of skin compromised from draining sinuses and abscess pressure...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28332168/pulp-bleeding-color-is-an-indicator-of-clinical-and-histohematologic-status-of-primary-teeth
#7
Naser Asl Aaminabadi, Marziyeh Parto, Parya Emamverdizadeh, Zahra Jamali, Sajjad Shirazi
OBJECTIVES: This study was carried out to investigate whether the changes in hematologic characteristic and color of pulpal bleeding is associated with clinical and histologic status of the pulp in primary teeth. MATERIALS AND METHODS: A total of 211 primary molars in 103 patients, 3-6 years old, were treated. One hundred eight teeth had pulpectomy, 57 teeth had pulpotomy after pulp exposure during caries excavation, and 46 teeth had pulpotomy after accidental pulp exposure in sound dentin...
March 23, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/28331020/isolated-lower-limb-hypoplasia-secondary-to-congenital-varicella-syndrome-a-rare-occurrence-and-management-of-its-complications
#8
Sneha Mehta, Willem Schenk, Stephen Kirker, Amit Atrey
Isolated lower limb hypoplasia is a rare consequence of maternal congenital varicella syndrome (CVS). The hypoplastic limb is susceptible to multiple injuries, including fractures, especially if there is associated muscle weakness and lack of sensation. We describe a unique index case of a woman aged 26 years with a background of CVS who presented with a distal femur fracture following a fall onto her insensate, hypoplastic right leg. This report highlights the complexities involved in the diagnosis and management of fractures in patients with an anaesthetic limb, and in particular describes limb amputation as a successful treatment modality for distal femur fractures...
March 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28330992/localized-hepatic-lobular-regeneration-by-central-vein-associated-lineage-restricted-progenitors
#9
Jonathan M Tsai, Pang Wei Koh, Ania Stefanska, Liujing Xing, Graham G Walmsley, Nicolas Poux, Irving L Weissman, Yuval Rinkevich
The regeneration of organ morphology and function following tissue loss is critical to restore normal physiology, yet few cases are documented in mammalian postnatal life. Partial hepatectomy of the adult mammalian liver activates compensatory hepatocyte hypertrophy and cell division across remaining lobes, resulting in restitution of organ mass but with permanent alteration of architecture. Here, we identify a time window in early postnatal life wherein partial amputation culminates in a localized regeneration instead of global hypertrophy and proliferation...
March 22, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28329874/long-term-health-related-quality-of-life-outcomes-in-digital-replantation-versus-revision-amputation
#10
Oren Tessler, Matthew J Bartow, Marie P Tremblay-Champagne, Alex M Lin, Geneviève Landes, Sarah Sebbag, Andreas Nikolis
Background Earlier, digit viability judged the success of digital replantation. Now, utility health-related quality of life (HRQOL) measures can better assess the impact of digital replantation. Methods Overall, 264 digital injury patients were sent a regimen of utility measures: Disabilities of the Arm, Shoulder and Hand (DASH) score, European Quality of Life 5 Dimensions, visual analog scale (VAS), time trade-off (TTO), and standard gamble (SG). Overall, 51 patients responded completely to all of these-36 replantation patients and 15 revision amputation patients...
March 22, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28328683/surgical-support-during-the-terrorist-attacks-in-paris-13-november-2015-experience-at-b%C3%A3-gin-military-teaching-hospital
#11
Olivier Barbier, Brice Malgras, Camille Choufani, Antoine Bouchard, Didier Ollat, Gilbert Versier
BACKGROUND: Recent conflicts have allowed the French Army Health Service to improve management quality for wartime-injured people during military operations. On 13 November 2015, it was in Paris that France was directly attacked and Bégin Military Teaching Hospital, like several hospitals in Paris, had to face a large number of gunshot victims. Thanks to our operational experience, injured people hospitalized in military hospitals benefited from a management based on triage and damage control (DC) principles...
March 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28328661/microangiography-to-monitor-treatment-outcomes-following-severe-frostbite-injury-to-the-hands
#12
Thomas Masters, Steven Omodt, Jon Gayken, Christopher Logue, Bjorn Westgard, Stephen Hendriksen, Joseph Walter, Rachel Nygaard
Frostbite injury causes direct damage to tissues following exposure to temperatures below their freezing point causing tissue death potentially leading to serious amputations. After rewarming, a variety of treatment options have been employed to avoid amputation. This case report details the use of indocyanine green fluorescence microangiography to monitor the clinical progression of perfusion following hyperbaric oxygen therapy (HBOT) for severe frostbite injury. We present a case report of a man with deep frostbite of the bilateral hands treated with thrombolytics and HBOT...
March 15, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28328632/use-of-processed-nerve-allografts-to-repair-nerve-injuries-greater-than-25-mm-in-the-hand
#13
Brian Rinker, Jozef Zoldos, Renata V Weber, Jason Ko, Wesley Thayer, Jeffrey Greenberg, Fraser J Leversedge, Bauback Safa, Gregory Buncke
Processed nerve allografts (PNAs) have been demonstrated to have improved clinical results compared with hollow conduits for reconstruction of digital nerve gaps less than 25 mm; however, the use of PNAs for longer gaps warrants further clinical investigation. Long nerve gaps have been traditionally hard to study because of low incidence. The advent of the RANGER registry, a large, institutional review board-approved, active database for PNA (Avance Nerve Graft; AxoGen, Inc, Alachua, FL) has allowed evaluation of lower incidence subsets...
March 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28326825/role-of-biomarkers-in-predicting-diabetes-complications-with-special-reference-to-diabetic-foot-ulcers
#14
Sivakamasundari Pichu, Bhoomika M Patel, Subbu Apparsundaram, Ramesh K Goyal
Diabetic foot ulcer (DFU) is one of the major complications of diabetes and about 1% of people with diabetes have to go for lower limb amputation. With better understanding of the pathological basis of DFU, number of biomarkers like atrial natriuretic peptides, galectin-3, and cardiac troponins for diabetic cardiomyopathy, cystatin C for diabetics nephropathy and C-reactive protein for infection and procalcitonin could aid in early and noninvasive diagnosis especially when clinical signs are misleading. Predictive role of novel biomarkers in primary prevention however, requires additional studies considering sex, age and multiple complications in DFU...
March 14, 2017: Biomarkers in Medicine
https://www.readbyqxmd.com/read/28326682/nervous-system-development-and-regeneration-in-freshwater-planarians
#15
REVIEW
Kelly G Ross, Ko W Currie, Bret J Pearson, Ricardo M Zayas
Planarians have a long history in the fields of developmental and regenerative biology. These animals have also sparked interest in neuroscience due to their neuroanatomy, spectrum of simple behaviors, and especially, their almost unparalleled ability to generate new neurons after any type of injury. Research in adult planarians has revealed that neuronal subtypes homologous to those found in vertebrates are generated from stem cells throughout their lives. This feat is recapitulated after head amputation, wherein animals are capable of regenerating whole brains and regaining complete neural function...
March 22, 2017: Wiley Interdisciplinary Reviews. Developmental Biology
https://www.readbyqxmd.com/read/28326399/total-knee-replacement-for-tricompartmental-arthritis-in-a-patient-with-a-below-knee-amputation-after-a-previous-closing-wedge-high-tibial-osteotomy
#16
Mark A Fleming, Michael C Dixon
This is a report of a 64-year-old man who had undergone a high tibial osteotomy (HTO) 17 years ago of his right knee for medial compartment osteoarthritis; 5 days later, he received a below-knee amputation owing to a missed popliteal artery injury at the time of the HTO. We elected to perform a total knee replacement (TKR) for progressive arthritis of the ipsilateral knee 17 years after the transtibial amputation. Although there is a plethora of literature regarding TKR in the contralateral knee of amputees, there is a paucity of data of TKR in the ipsilateral knee...
June 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326157/partial-calcanectomy-and-ilizarov-external-fixation-may-reduce-amputation-need-in-severe-diabetic-calcaneal-ulcers
#17
Mehmet Orçun Akkurt, Ismail Demirkale, Ali Öznur
Objective: The treatment of diabetic hindfoot ulcers is a challenging problem. In addition to serial surgical debridements, hyperbaric oxygen therapy and local wound care play important roles in the surgeon's armamentarium, for both superficial infection and gangrene of the soft tissue, often complicated by osteomyelitis of the calcaneus. The purpose of this study was to evaluate the results of an aggressive approach from diagnosis to treatment of calcaneal osteomyelitis in foot-threatening diabetic calcaneal ulcers...
2017: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/28325624/clinical-outcomes-for-primary-molars-treated-by-different-types-of-pulpotomy-a%C3%A2-retrospective-cohort-study
#18
Heng-Yeh Kuo, Jr-Rung Lin, Wen-Hsi Huang, Meng-Ling Chiang
BACKGROUND/PURPOSE: Pulpotomy is the amputation of coronally infected pulp tissue to maintain the vitality and function of the radicular pulp. This study was designed to assess the clinical and radiographic success rates of primary molars treated by pulpotomy using diode laser, sodium hypochlorite, or no medication after a follow-up period of 24 months. METHODS: A retrospective study was conducted by evaluating the success rates of primary molars treated by pulpotomy with diode laser, sodium hypochlorite, or no medication according to the clinical symptoms and signs and radiographic features...
March 18, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28324949/muscle-synergy-analysis-in-transtibial-amputee-during-ramp-ascending-activity
#19
P Mehryar, M S Shourijeh, H F Maqbool, M Torabi, A A Dehghani-Sanij
In developed countries, the highest number of amputees are elderly with transtibial amputation. Walking on inclined surfaces is difficult for amputees due to loss of muscle volume and strength thereby transtibial amputees (TA) rely on the intact limb to maintain stability. The aim of this study was to use the concatenated non-negative matrix factorization (CNMF) technique to calculate muscle synergy components and compare the difference in muscle synergies and their associated activation profiles in the healthy and amputee groups during ramp ascending (RA) activity...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28323804/transtibial-amputation-outcomes-study-taos-comparing-transtibial-amputation-with-and-without-a-tibiofibular-synostosis-ertl-procedure
#20
Michael J Bosse, Saam Morshed, Lisa Reider, William Ertl, James Toledano, Reeza Firoozabadi, Rachel B Seymour, Eben Carroll, Daniel O Scharfstein, Barbara Steverson, Ellen J MacKenzie
The optimal technique for a transtibial amputation in a young, active, and healthy patient is controversial. Proponents of the Ertl procedure (in which the cut ends of the tibia and fibula are joined with a bone bridge synostosis) argue that the residual limb is more stable which confers better prosthetic fit and improved function especially among high-performing individuals. At the same time, the Ertl procedure is associated with longer operative and healing time and may be associated with a higher complication rate compared with the standard Burgess procedure...
April 2017: Journal of Orthopaedic Trauma
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