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Joseph Christensen, Sean Spence, David Watson, Anjan Shah, Benjamin Maxson, Anthony Infante, Roy Sanders, Hassan R Mir
OBJECTIVE: To review the orthopaedic injuries from watercraft treated surgically at our institution and report the mechanisms, fractures, and complications encountered. DESIGN: Retrospective case series. SETTING: Level I trauma center. PATIENTS/PARTICIPANTS: There were 216 fractures from watercraft in 146 patients. Average age was 33 years (range 4-78 years), there were 68% males (99/146), and 16% of the injuries occurred in children...
April 2018: Journal of Orthopaedic Trauma
Daniel Freund, Silke Brilloff, Tamer Ghazy, Stephan Kirschner, Gabor Gäbel, Irene Hinterseher, Norbert Weiss, Adrian Mahlmann
BACKGROUND: Microarray analysis has been carried out in this pilot study to compare delineated gene expression profiles in the biopsies of skeletal muscle taken from patients with chronic critical limb ischaemia (CLI) and non-ischaemic control subjects. PATIENTS AND METHODS: Biopsy of gastrocnemius muscle was obtained from six patients with unreconstructed CLI referred for surgical major amputation. As control, biopsies of six patients undergoing elective knee arthroplasty without evidence of peripheral arterial occlusive disease were taken...
March 20, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Xiao-Shuai Han, Chen Wang, Fang-Hao Guo, Shuang Huang, Yong-Wen Qin, Xian-Xian Zhao, Qing Jing
Regeneration, relying mainly on resident adult stem cells, is widespread. However, the mechanism by which stem cells initiate proliferation during this process in vivo is unclear. Using planarian as a model, we screened 46 transcripts showing potential function in the regulation of local stem cell proliferation following 48 h regeneration. By analyzing the regeneration defects and the mitotic activity of animals under administration of RNA interference (RNAi), we identified factor for initiating regeneration 1 (Fir1) required for local proliferation...
March 20, 2018: Protein & Cell
Marina Dias-Neto, Manuela Matschuck, Yvonne Bausback, Ursula Banning-Eichenseher, Sabine Steiner, Daniela Branzan, Holger Staab, Ramon L Varcoe, Dierk Scheinert, Andrej Schmidt
PURPOSE: To report midterm results of the "pave-and-crack" technique to facilitate safe and effective scaffolding of heavily calcified femoropopliteal lesions in preparation for delivery of a Supera interwoven stent. METHODS: Data were collected retrospectively on 67 consecutive patients (mean age 71±8 years; 54 men) treated with this technique between November 2011 and February 2017 at a single center. A third (22/64, 34%) of the patients had critical limb ischemia (CLI)...
March 1, 2018: Journal of Endovascular Therapy
Dogus Hemsinli, Gokalp Altun, Safiye Tuba Kaplan, Furkan Yildirim, Gamze Cebi
INTRODUCTION: Wounds refractory to standard treatment in patients with thromboangiitis obliterans (TAO, Buerger's disease) are associated with amputation, other morbidity and mortality. The purpose of this study was to investigate the effect of hyperbaric oxygen treatment (HBOT) in patients with TAO. MATERIALS AND METHODS: Ninety-seven patients with TAO with ischaemic wounds treated between January 2007 and July 2016 were included in this dual-centre, non-randomised, retrospective study...
March 31, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
S J M Kamphuis, A R Jandali, F J Jung, J Sproedt
A drug-addicted patient injected himself intra-arterially with a mixture of methadone, flunitrazepam, saliva and water. The resulting compartment syndrome could be treated by fasciotomy and multiple debridement, with which a major amputation could be prevented. The course of the treatment and the resulting functional results are described, as well as a brief overview of the literature and a treatment proposal for similar cases.
March 19, 2018: Der Unfallchirurg
Wei Xi Li, Yong Kun Li, Hai Tao Lin
The curative effect of minimally invasive surgery on palmar and foot hyperhidrosis and its influence on serum-related cytokines and immunoglobulins were investigated. Seventy-six patients with palmar and foot hyperhidrosis admitted to Yunnan University Hospital from August 2014 to July 2016 were selected and randomly divided into control group (n=38) and observation group (n=38) using a random number table. Patients in control group received drug therapy, while those in observation group underwent laparoscopic thoracic-4 sympathetic chain combined with thoracic-3 branch amputation...
April 2018: Experimental and Therapeutic Medicine
Xi Liu, Hui Zhang, Shiqiang Cen, Fuguo Huang
BACKGROUND: Though several systematic reviews concerned have been published, controversy still exists. The current systematic review was designed to clarify the detailed advantages and disadvantages of the negative pressure wound therapy (NPWT) in treatment of open fractures in comparison with the conventional wound dressings. METHODS: A systematic search was performed in Pubmed, Cochrane Library, Embase, and Google Scholar for the published relevant clinical studies...
March 16, 2018: International Journal of Surgery
M Iglesias, M Ramírez-Berumen, P Butrón, J Alberú-Gómez, F Salazar-Hernández, J Macias-Gallardo, R P Leal-Villalpando, J Zamudio-Bautista, V Acosta, L Jauregui, A Hernández-Campos, V Espinosa-Cruz, J Vázquez-Lamadrid, J González-Sánchez, J Cuellar-Rodriguez, J G Sierra-Madero, R Gaytan-Cervantes, S Contreras-Barbosa, A Navarro-Lara, J Guzman-Gonzalez, J Domínguez-Cherit, M Vilatoba, S Toussaint-Caire, F Vega-Boada, F J Gómez-Pérez, M Mayorquin-Ruiz
BACKGROUND: The function reported after arm transplantation is deemed beneficial relative to the marked disability that upper arm amputation causes. OBJECTIVE: We report a 51-year-old man with a Disabilities of the Arm, Shoulder and Hand (DASH) score of 75.83 who underwent bilateral arm transplantation in October 2015. PROCEDURE: The right arm was transplanted at the glenohumeral joint level, including transplantation of the humeral head, joint capsule, and rotator cuff ligaments and tendons...
March 16, 2018: Transplantation Proceedings
Jacqueline J Blank, Abby E Rothstein, Cheong Jun Lee, Michael J Malinowski, Brian D Lewis, Timothy J Ridolfi, Mary F Otterson
Aortic graft infections are a rare but devastating complication of aortic revascularization. Often infections occur due to contamination at the time of surgery. Iatrogenic misplacement of the limbs of an aortobifemoral graft is exceedingly rare, and principles of evaluation and treatment are not well defined. We report 2 cases of aortobifemoral bypass graft malposition through the colon. CASE REPORT: Case 1 is a 54-year-old male who underwent aortobifemoral bypass grafting for acute limb ischemia...
January 1, 2018: Vascular and Endovascular Surgery
Minna M Wieck, Aaron J Cunningham, Brandon Behrens, Erika T Ohm, Bryan G Maxwell, Nicholas A Hamilton, M Christopher Adams, Frederick J Cole, Mubeen A Jafri
BACKGROUND: Expediting evaluation and intervention for severely injured patients has remained a mainstay of advanced trauma care. One technique, direct to operating room (DOR) resuscitation, for selective adult patients has demonstrated decreased mortality. We sought to investigate the application of this protocol in children. METHODS: All DOR pediatric patients from 2009-2016 at a pediatric Level I Trauma Center were identified. DOR criteria included penetrating injury, chest injuries, amputations, significant blood loss, cardiopulmonary resuscitation, and surgeon discretion...
March 16, 2018: Journal of Trauma and Acute Care Surgery
Kathrin R Blume, Juliane Racz, Marcel Franz, Caroline Dietrich, Christian Puta, Reinhard Friedel, Gunther O Hofmann, Wolfgang H R Miltner, Thomas Weiss
A comprehensive functional recovery is one of the criteria for successful replantation of an amputated limb. Functionality of a replanted limb is strongly dependent on its regained sensibility. In previous studies concerning the sensibility of replanted limbs, only a few somatosensory submodalities were examined in small samples. The purpose of the present study is to provide a full pattern of somatosensory symptoms following replantation. Quantitative Sensory Testing (QST) was carried out according to a standardized protocol in a sample of 15 patients who underwent replantation of their upper limb proximal to the radiocarpal joint (macroreplantation)...
March 15, 2018: Pain
Lisa Gamsjaeger, Munashe Chigerwe
OBJECTIVE To characterize indications for and clinical outcomes of limb amputation in goats and sheep. DESIGN Retrospective case series and observational study. ANIMALS Goats (n = 15) and sheep (7) that underwent partial or complete limb amputation at the University of California-Davis Veterinary Medical Teaching Hospital from January 1, 1985, through December 31, 2015. PROCEDURES Medical records of qualifying goats and sheep were reviewed and data extracted regarding signalment, use of animal, characteristics of the amputated limb, duration of hospitalization, outcome, and surgery-associated complications...
April 1, 2018: Journal of the American Veterinary Medical Association
Hanne Heszlein-Lossius, Yahya Al-Borno, Samar Shaqoura, Nashwa Skaik, Lasse Melvær Giil, Mads Gilbert
BACKGROUND: During four separate Israeli military attacks on Gaza (2006, 2009, 2012, and 2014), about 4000 Palestinians were killed and more than 17 000 injured (412 killed and 1264 injured in 2006; 1383 killed and more than 5300 injured in 2009; 130 killed and 1399 injured in 2012; and 2251 killed and 11 231 injured in 2014). An unknown number of people had traumatic amputations of one or more extremities. Use of unmanned Israeli drones for surveillance and armed attacks on Gaza was evident, but exact figures on numbers of drone strikes on Gaza are not available...
February 21, 2018: Lancet
Mikkel Thøgersen, John Hansen, Lars Arendt-Nielsen, Herta Flor, Laura Petrini
The purpose of the present study was to assess changes in body perception when visual feedback was removed from the hand and arm with the purpose of resembling the visual deprivation arising from amputation. The illusion was created by removing the visual feedback from the participants' own left forearm using a mixed reality (MR) and green screen environment. Thirty healthy persons (15 female) participated in the study. Each subject experienced two MR conditions, one with and one without visual feedback from the left hand, and a baseline condition with normal vision of the limb (no MR)...
March 15, 2018: Behavioural Brain Research
Marieke A Hillaert, Hester M den Ruijter, Imo E Hoefer, Eef G Lentjes, Gert J de Borst, Jean-Paul P M de Vries, Pieter A Doevendans, Gerard Pasterkamp, Leo Timmers
BACKGROUND: The renin-angiotensin-aldosterone system is increasingly being recognized to play an important role in the development and clinical course of cardiovascular diseases. Renin-angiotensin-aldosterone system activation is associated with clinical outcome in various populations of cardiovascular patients, such as patients with coronary artery, peripheral artery, and cerebrovascular disease. In this study, we investigated the associations between plasma renin and aldosterone concentrations and atherosclerotic plaque characteristics and secondary vascular events in patients undergoing carotid endarterectomy...
March 13, 2018: Journal of Vascular Surgery
Claire E Webster, Jon Clasper, Daniel J Stinner, Joseph Eliahoo, Spyros D Masouros
Background: Throughout history, traumatic amputation of the lower extremity has been a notable feature of all conflicts involving explosive incidents. Even at the close of the recent conflicts in Afghanistan, there were deaths that were deemed "potentially survivable." The purpose of this study is to characterize lower extremity blast injury and to determine if their amputation levels and associated injury characteristics correlate with a higher risk of mortality. Methods: the UK Joint Theatre Trauma Registry (JTTR) was interrogated to identify all lower extremity traumatic amputations sustained in both Iraq and Afghanistan between January 2003 and the end of UK operations in August 2014...
March 14, 2018: Military Medicine
Christine A DeForest, Virginia Blackman, John E Alex, Lauren Reeves, Alejandra Mora, Crystal Perez, Joseph Maddry, Domenique Selby, Benjamin Walrath
Introduction: Military prehospital and en route care (ERC) directly impacts patient morbidity and mortality. Provider knowledge and skills are critical variables in the effectiveness of ERC. No Navy doctrine defines provider choice for patient transport or requires standardized provider training. Frequently, Search and Rescue Medical Technicians (SMTs) and Navy Nurses (ERC RNs) are tasked with this mission though physicians have also been used. Navy ERC provider training varies greatly by professional role...
March 14, 2018: Military Medicine
Laurent Mathieu, Michel Levadoux, Emmanuel Soucany de Landevoisin, Tarun J McBride Windsor, Sylvain Rigal
INTRODUCTION: Noncombat-related hand injuries are common in current theatres of operations. Crushing is one of the most frequent mechanisms that may cause traumatic amputations of digits. In the military setting, management of these digital amputations is challenging regarding limitation in microsurgical means in medical treatment facilities and aeromedical evacuation delays out of the combat zone. METHODS: Two cases of digital replantation performed in French forward surgical units are described...
2018: SICOT-J
Kerim Sariyilmaz, Ilker Eren, Okan Ozkunt, Mustafa Sungur, Onder I Kilicoglu, Fatih Dikici
BACKGROUND: Gout is a purine metabolism disease. Tophaceous gout may cause joint destruction and other systemic problems and sometimes may be complicated by infection. Infection and sinus with discharge associated with tophaceous gout are serious complications, and treatment is difficult. We present a patient with tophaceous gout complicated by infection and discharging sinus treated by bilateral amputation at the level of the first metatarsus. METHODS: A 43-year-old man previously diagnosed as having gout, and noncompliant with treatment, presented with tophaceous gout associated with discharging sinus and infection on his left first metatarsophalangeal joint...
January 2018: Journal of the American Podiatric Medical Association
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