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https://www.readbyqxmd.com/read/29148242/infrapopliteal-peripheral-arterial-disease-and-critical-limb-ischemia-the-time-has-come-for-collaborative-streamlined-diagnostic-and-treatment-paradigms
#1
EDITORIAL
Michael S Levy
The diagnosis, surveillance, and management of infrapopliteal critical limb ischemia remain inconsistent among clinicians. This study demonstrates that using an absolute ankle pressure of >73 mm Hg or an absolute toe pressure increase of 1 mm Hg or greater post endovascular intervention in patients with infrapopliteal critical limb ischemia may be predictive of a reduction in target limb revascularization, amputation, and death. This study highlights the need for vascular societies to come together to promote standardized screening, surveillance, and treatment paradigms for this complex population...
November 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29148070/growth-factors-for-diabetic-foot-ulcers-mixed-treatment-comparison-analysis-of-randomized-clinical-trials
#2
Kannan Sridharan, Gowri Sivaramakrishnan
AIMS: Topical growth factors accelerate wound healing in patients with diabetic foot ulcers (DFU). Due to the absence of head to head comparisons, we carried out Bayesian network meta-analysis to compare the efficacy and safety of growth factors. METHODS: Using an appropriate search strategy, randomized controlled trials on topical growth factors compared with standard of care in patients with DFU, were included. Proportion of patients with complete healing was the primary outcome...
November 17, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29147171/recent-progress-of-bypass-surgery-to-the-dialysis-dependent-patients-with-critical-limb-ischemia
#3
Nobuyoshi Azuma, Shinsuke Kikuchi, Hiroko Okuda, Keisuke Miyake, Atsuhiro Koya
According to expansion of dialysis-dependent population, more than half of patients with critical ischemic limbs are dialysis-dependent in Japan. Although patients with end-staged renal disease are well-known as poor life prognosis, well-managed dialysis patients in Japan can survive much longer compared to dialysis patients in the United States and Europe. Therefore, some dialysis patients can enjoy the long-term benefits of bypass surgery. To decide the indication of bypass surgery, patient's general condition, nutrition status, and vein availability are more important rather than arterial disease anatomy...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29147167/validation-of-the-risk-score-of-the-mortality-and-lower-limb-loss-considering-ambulatory-status-after-surgical-revascularization-in-maintaining-patients-with-dialysis
#4
Haruto Yamazaki, Hisae Hayashi, Morio Kawamura, Ayana Sasaki, Eriko Kondo, Shinya Ito, Kenji Wakai
Surgical revascularization is performed to preserve limb and to maintain functional status of patients with critical limb ischemia (CLI). The PREVENT III risk score helps to predict the postoperative course of CLI. However, this score is not available to estimate the risk of amputation or death properly in patients with hemodialysis (HD) and tissue loss (HD: 4 points, Tissue loss: 3 points), because they are classified as a high-risk group. Therefore, we investigated 213 patients with revascularized HD for CLI and proposed prognosis amputation or death for patients with HD risk score (PAD for HD risk score)...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29147164/a-series-of-210-peripheral-arterial-disease-below-knee-amputations-and-predictors-for-subsequent-above-knee-amputations
#5
Jing Ting Wu, Maggie Wong, Zhiwen Joseph Lo, Wei-En Wong, Sriram Narayanan, Glenn Wei Leong Tan, Sadhana Chandrasekar
Objective: To review patient characteristics and outcomes after peripheral arterial disease (PAD)-related below-knee amputation (BKA), and identify risk factors predicting subsequent above-knee amputation (AKA). Materials and Methods: A retrospective study of 210 BKAs between May 2008 and December 2015. Results: The mean age of the study population was 66 years. Most of the patients had cardiovascular comorbidities, and 33% had end-stage renal failure (ESRF); 89% were American Society of Anesthesiologists 3 or 4...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29145857/treatment-of-charcot-neuroarthropathy-and-osteomyelitis-of-the-same-foot-a-retrospective-cohort-study
#6
Martin Berli, Lazaros Vlachopoulos, Sabra Leupi, Thomas Böni, Charlotte Baltin
BACKGROUND: We evaluated treatment of osteomyelitis in the foot in the presence of Charcot neuroarthropathy, a devastating condition with progressive degeneration and joint destruction. We hypothesized that there was a difference in (1) amputation rate, (2) amputation level, (3) duration of antibiotic therapy, and (4) duration of immobilization for treatment of osteomyelitis within versus outside the Charcot zone. METHODS: Forty patients (43 ft) diagnosed with Charcot neuroarthropathy and osteomyelitis of the same foot were retrospectively analyzed...
November 16, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29145756/micronutrients-and-natural-compounds-status-and-their-effects-on-wound-healing-in-the-diabetic-foot-ulcer
#7
Kanokwan Kulprachakarn, Sakaewan Ounjaijean, Jukkrit Wungrath, Raj Mani, Kittipan Rerkasem
The diabetic foot ulcer (DFU) is an invariably common complication of diabetes mellitus, it is also a significant cause of amputation as well as extended hospitalization. As most patients with DFU suffer from malnutrition, which has been related to improper metabolic micronutrients status, alterations can affect impaired wound healing process. Micronutrients and herbal remedies applications present a wide range of health advantages to patients with DFU. The purpose of this review is to provide current evidence on the potential effect of dietary supplementations such as vitamins A, C, D, E, magnesium, zinc, copper, iron, boron, and such naturally occurring compounds as Aloe vera, Naringin, and Radix Astragali (RA) and Radix Rehmanniae (RR) in the administration of lower extremity wounds, especially in DFU, and to present some insights for applications in the treatment of DFU patients in the future...
November 1, 2017: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/29145179/phantom-sensations-supernumerary-phantom-limbs-and-apotemnophilia-three-body-representation-disorders
#8
Laurent Tatu, Julien Bogousslavsky
Body representation disorders continue to be mysterious and involve the anatomical substrate that underlies the mental representation of the body. These disorders sit on the boundaries of neurological and psychiatric diseases. We present the main characteristics of 3 examples of body representation disorders: phantom sensations, supernumerary phantom limb, and apotemnophilia. The dysfunction of anatomical circuits that regulate body representation can sometimes have paradoxical features. In the case of phantom sensations, the patient feels the painful subjective sensation of the existence of the lost part of the body after amputation, surgery or trauma...
2018: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/29144392/design-and-development-of-a-novel-upper-limb-cycling-prosthesis
#9
Akira Tiele, Shivam Soni-Sadar, Jack Rowbottom, Shilen Patel, Edward Mathewson, Samuel Pearson, David Hutchins, John Head, Stephen Hutchins
The rise in popularity of the Paralympics in recent years has created a need for effective, low-cost sports-prosthetic devices for upper-limb amputees. There are various opportunities for lower-limb amputees to participate in cycling; however, there are only few options for those with upper-limb amputations. If the individual previously participated in cycling, a cycling-specific prosthesis could allow these activities to be integrated into rehabilitation methods. This article describes the processes involved with designing, developing and manufacturing such a prosthesis...
November 16, 2017: Bioengineering
https://www.readbyqxmd.com/read/29144105/motor-imagery-ability-of-patients-with-lower-limb-amputation-exploring-the-course-of-rehabilitation-effects
#10
Elodie Saruco, Aymeric Guillot, Arnaud Saimpont, Franck DI Rienzo, Anne Durand, Catherine Mercier, Francine Malouin, Philip Jackson
BACKGROUND: Amputation of a lower-limb results in a severe decrease of functional mobility that deeply alters independent living. Motor imagery (MI) refers to the mental representation of an action without engaging its actual execution. The repetitive use of MI has been shown to contribute to promote motor recovery and phantom-limb pain alleviation. AIM: Given the importance of invoking accurate images to benefit from MI practice, and considering the link between motor capacities and MI, the present study investigated the effect of a rehabilitation program on MI ability in patients with lower-limb amputation...
November 16, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29142485/unexpected-inflammation-in-the-sympathetic-ganglia-in-thromboangiitis-obliterans
#11
Mahdi Farzadnia, Hassan Ravari, Mitra Masoudian, Narges Valizadeh, Bahare Fazeli
The aim of this study was to inspect more closely the microscopic and molecular sympathetic ganglia histology in thromboangiitis obliterans (TAO). The paraffin block and frozen RNAlater-treated tissue of the lumbar sympathetic ganglia of 19 TAO Caucasian male patients were evaluated. The gene expression of cluster of differentiation 4 (CD4) and cluster of differentiation 8 (CD8) markers in the frozen RNAlater-treated sympathetic ganglia tissues were evaluated by real-time polymerase chain reaction. Unexpectedly, lymphocyte infiltration was observed in all of the histological sections, ranging from scattered to moderate lymphocyte infiltration...
December 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/29141468/predictive-laboratory-findings-of-lower-extremity-amputation-in-diabetic-patients-meta-analysis
#12
Jong-Lim Kim, Jin Yong Shin, Si-Gyun Roh, Suk Choo Chang, Nae-Ho Lee
Lower extremity amputation is a source of morbidity and mortality among diabetic patients. This meta-analysis aimed to identify significant laboratory data in patients with diabetic foot ulcer with high rates of lower extremity amputation. We performed a systematic literature review and meta-analysis using MEDLINE, EMBASE, and Cochrane databases. We extracted and evaluated 11 variables from the included studies based on amputation rates. This study used the Newcastle-Ottawa Scale to assess the quality of the studies...
November 1, 2017: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/29140635/emergency-department-visits-for-hand-and-finger-injuries-associated-with-the-use-of-log-splitters
#13
Bart Hammig, Ches Jones
The purpose of this study was to examine patients treated in an emergency department (ED) for injuries related to the use of log splitters. Data were obtained from the National Electronic Injury Surveillance System for the years 2011-2014. National estimates of ED visits for injuries associated with the use of log splitters were obtained, and descriptive epidemiological characteristics are presented. An estimated 37,000 ED visits for injuries related to the use of log splitters occurred during the study period...
April 26, 2017: Journal of Agricultural Safety and Health
https://www.readbyqxmd.com/read/29138198/norwegian-trends-in-numbers-of-lower-extremity-revascularisations-and-amputations-including-regional-trends-in-endovascular-treatments-for-peripheral-arterial-disease-a-retrospective-cross-sectional-registry-study-from-2001-to-2014
#14
Kjersti Wendt, Ronny Kristiansen, Kirsten Krohg-Sørensen, Fredrik Alexander Gregersen, Erik Fosse
OBJECTIVE: The numbers of lower extremity revascularisations and amputations are insufficiently reported in Norway. To support future policy decisions regarding the provision of vascular treatment, knowledge of such trends is important. METHODS: This retrospective cross-sectional study from 2001 to 2014 used data from the Norwegian Patient Registry. The revascularisation treatments were categorised in multilevel, aortoiliac, femoral to popliteal and popliteal to foot levels and sorted as open, endovascular and hybrid...
November 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29138072/preoperative-assessment-of-craniopharyngioma-adherence-mri-findings-correlated-with-the-severity-of-tumor-attachment-to-the-hypothalamus
#15
Ruth Prieto, José M Pascual, Maria Rosdolsky, Laura Barrios
BACKGROUND: Craniopharyngioma (CP) adherence represents a heterogeneous pathological feature that critically influences the potentially safe and radical resection. OBJECTIVE: To define the MRI predictors of CP adherence severity. METHODS: This study retrospectively investigated a cohort of 200 surgically treated CPs with their corresponding preoperative conventional MRI scans. MRI findings related to the distortions of anatomical structures along the sella turcica-third ventricle axis caused by CPs, in addition to the tumor's shape and calcifications were analyzed and correlated with the definitive type of CP adherence observed during the surgical procedures...
November 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29137466/evaluation-of-extremity-injuries-presented-to-emergency-department
#16
Ali Karakus, Guven Kuvandik, Ezgi Atalay
OBJECTIVE: In this study, we aimed to review cases with firearms injury of extremities presented to our hospital. METHODS: After approval by Institutional Board, electronic database was retrospectively screened for firearms injury of extremities between 2012 and 2015. Overall, 600 cases with firearms injury of extremities were included in the study. Cases were assessed for demographic and clinical characteristics, Mangled extremity severity score (MESS), Glasgow Coma Scale (GCS), costs and outcomes...
October 2017: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/29133607/cardiovascular-outcomes-and-risks-after-initiation-of-a-sodium-glucose-co-transporter-2-inhibitor-results-from-the-easel-population-based-cohort-study
#17
Jacob A Udell, Zhong Yuan, Toni Rush, Nicholas M Sicignano, Michael Galitz, Norman Rosenthal
Background : Clinical trials have shown cardiovascular benefits and potential risks from sodium glucose co-transporter 2 inhibitors (SGLT2i). Trials may have limited ability to address individual endpoints or safety concerns. Methods : We performed a population-based cohort study among type 2 diabetes patients with established cardiovascular disease newly initiated on antihyperglycemic agents (AHAs) within the US Department of Defense Military Health System between 4/1/2013 and 12/31/2016. Incidence rates, hazard ratios (HRs), and 95% confidence intervals (CIs) for time to first composite endpoint of all-cause mortality (ACM) and hospitalization for heart failure (HHF) event, major adverse cardiovascular events (MACE; defined as ACM, nonfatal myocardial infarction, and nonfatal stroke), and individual endpoints were evaluated using conditional Cox models comparing new SGLT2i users with other AHAs...
November 13, 2017: Circulation
https://www.readbyqxmd.com/read/29133605/low-density-lipoprotein-cholesterol-lowering-with-evolocumab-and-outcomes-in-patients-with-peripheral-artery-disease-insights-from-the-fourier-trial-further-cardiovascular-outcomes-research-with-pcsk9-inhibition-in-subjects-with-elevated-risk
#18
Marc P Bonaca, Patrice Nault, Robert P Giugliano, Anthony C Keech, Armando Lira Pineda, Estella Kanevsky, Julia Kuder, Sabina A Murphy, J Wouter Jukema, Basil S Lewis, Lale Tokgozoglu, Ransi Somaratne, Peter S Sever, Terje R Pedersen, Marc S Sabatine
BACKGROUND : The PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitor evolocumab reduced low-density lipoprotein cholesterol and cardiovascular events in the FOURIER trial (Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk). We investigated the efficacy and safety of evolocumab in patients with peripheral artery disease (PAD) as well as the effect on major adverse limb events. METHODS : FOURIER was a randomized trial of evolocumab versus placebo in 27 564 patients with atherosclerotic disease on statin therapy followed for a median of 2...
November 13, 2017: Circulation
https://www.readbyqxmd.com/read/29133604/canagliflozin-for-primary-and-secondary-prevention-of-cardiovascular-events-results-from-the-canvas-program-canagliflozin-cardiovascular-assessment-study
#19
Kenneth W Mahaffey, Bruce Neal, Vlado Perkovic, Dick de Zeeuw, Greg Fulcher, Ngozi Erondu, Wayne Shaw, Elisa Fabbrini, Tao Sun, Qiang Li, Mehul Desai, David R Matthews
BACKGROUND : Canagliflozin is a sodium glucose cotransporter 2 inhibitor that significantly reduces the composite of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke in patients with type 2 diabetes mellitus and elevated cardiovascular risk. The comparative effects among participants with and without a history of cardiovascular disease (secondary versus primary prevention) were prespecified for evaluation. METHODS : The CANVAS Program (Canagliflozin Cardiovascular Assessment Study) randomly assigned 10 142 participants with type 2 diabetes mellitus to canagliflozin or placebo...
November 13, 2017: Circulation
https://www.readbyqxmd.com/read/29133201/diabetes-related-amputations-create-considerable-public-health-burden-in-the-uk
#20
REVIEW
Heather Graz, Vijay K D Souza, David E C Alderson, Michael Graz
AIMS: The main aim of this study was to assess the cost of diabetic amputation (both direct and indirect) to the National Health Service from the point of amputation onwards. METHODS: This systematic review involved searches of published literature between January 2007 and March 2017 mainly using the bibliographic databases, the Cochrane Library, EMBASE via Ovid(®), MEDLINE via Ovid(®), as well as grey literature, both in print and in electronic formats published through non-commercial publications, which reported the cost of amputation due to diabetic foot ulcers RESULTS: The studies included in this review varied considerably in estimating the cost including cost elements and how those costs were categorised...
November 10, 2017: Diabetes Research and Clinical Practice
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