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Limb preservation

Robert M Van Haren, Lee J Goldstein, Omaida C Velazquez, Jagajan Karmacharya, Arash Bornak
OBJECTIVE: Aortobifemoral bypass has been the gold standard treatment for extensive aortoiliac occlusive disease. Endovascular therapy and stenting of aortic and iliac occlusive lesions has proven to be efficacious, especially when dealing with short segment lesions. Endovascular treatment of TransAtlantic Inter-Society Consensus II (TASC) D aortoiliac occlusive lesions remains a challenge, but a valuable treatment option in poor surgical candidates. We present our operative technique and midterm results in treating TASC D aortoiliac occlusive disease using unibody bifurcated endografts...
October 17, 2016: Journal of Vascular Surgery
Bala Ramanan, Ayman Ahmed, Bian Wu, Marlin W Causey, Warren J Gasper, Shant M Vartanian, Jade S Hiramoto, Michael S Conte
No abstract text is available yet for this article.
August 2016: Journal of Vascular Surgery
Igor A Zolotukhin, Evgeny I Seliverstov, Elena A Zakharova, Alexander I Kirienko
OBJECTIVE: To establish an effect of isolated phlebectomy in patients with incompetent great saphenous vein (Ambulatory Selective Varices Ablation under Local anesthesia (ASVAL) procedure) on the reflux and diameter of the trunk and to assess recurrence rate of varicose veins at one year. MATERIAL AND METHODS: We conducted a prospective study on patients with primary varicose veins and with C2 or C2,3 or C2,3,4 or C2,4 classes of chronic venous disease and great saphenous vein incompetence...
October 19, 2016: Phlebology
Cheng-Wei Lin, Brend Ray-Sea Hsu, Jir-Shiong Tsai, Hui-Mei Yang, Jr-Rung Lin, Chia-Hung Lin, Chung-Huei Huang, Shih-Yuan Hung, Yu-Yao Huang
AIMS: To evaluate the effect of limb preservation status and body mass index (BMI) on the survival of patients with diabetic foot ulcers (DFUs). METHODS: A total of 1346 patients treated for limb-threatening DFUs at a major diabetic foot center in Taiwan from 2002 to 2009 were tracked until December 2012. The patients were classified into three groups: limb-preserved (n=858), minor lower-extremity amputation (LEA) (n=249), and major LEA (n=239). Clinical data during treatment were used for survival analysis...
September 30, 2016: Journal of Diabetes and its Complications
Madathipat Unnikrishnan, Sidharth Viswanathan, K Balasubramaniam, C V Muraleedharan, Arthur Vijayan Lal, P V Mohanan, Meera Mohanty, Tirur Raman Kapilamoorthy
BACKGROUND & OBJECTIVES: Vascular illnesses are on the rise in India, due to increase in lifestyle diseases and demographic transition, requiring intervention to save life, organ or limbs using vascular prosthesis. The aim of this study was to develop indigenous large diameter vascular graft for treatment of patients with vascular pathologies. METHODS: The South India Textile Research Association, at Coimbatore, Tamil Nadu, India, developed seamless woven polyester (Polyethylene terephthalate) graft at its research wing...
June 2016: Indian Journal of Medical Research
Major Vishal Arora, Mohammad Zafeer Khan, Major Sanjay Choubey, Mohammad Asim Rasheed, Arindam Sarkar
CONTEXT: Various adjuvants are being used with local anesthetics for prolongation of intraoperative and postoperative analgesia. The α2-adrenergic agonist clonidine and potent opioid buprenorphine have the ability to potentiate the effects of local anesthetics. AIMS: The purpose of this prospective, double-blind study was to compare onset, duration of sensory and motor block, effect on hemodynamics, level of sedation, duration of postoperative analgesia, and any adverse effects of clonidine and buprenorphine...
September 2016: Anesthesia, Essays and Researches
Shimpei Miyamoto, Masahide Fujiki, Fumihiko Nakatani, Eisuke Kobayashi, Masanobu Sakisaka, Minoru Sakuraba
BACKGROUND: Complex groin defects after sarcoma resection require reconstruction of multiple vital structures that can include the major vessels, the overlying skin, the abdominal wall, and the hip joint. We investigated the feasibility of limb preservation after complex groin reconstruction. METHODS: The subjects were 12 consecutive patients who underwent complex groin reconstruction after sarcoma resection. In all patients, the defect included a major artery (external iliac or femoral) and overlying skin...
October 6, 2016: Annals of Plastic Surgery
Dooin Lee, Jae Hoon Lee, Dongho Choi, Chang Moo Kang, Jae Uk Chong, Song-Chul Kim, Kyeong Geun Lee
BACKGROUND: Stomach cancer is the second most commonly diagnosed cancer in Korea. Although the long-term survival outcome has improved, secondary primary tumors from periampullary regions are increasing inevitably and pancreaticoduodenectomy (PD) following gastrectomy is challenging. This study evaluates the surgical outcomes of PD following gastrectomy and suggests the optimum method for reconstruction. METHODS: Patients who underwent curative PD with a history of gastric resection between 2005 and 2015 were assessed retrospectively...
October 11, 2016: World Journal of Surgery
Erwin E Argueta, Alvaro Rosales, Jose A Suarez
OBJECTIVES: To describe our single center experience with the use of laser endartherectomy assisted balloon angioplasty in popliteal and infrapopliteal arterial disease. BACKGROUND: Peripheral arterial disease (PAD) carries significant morbidity to patients. Some patients may have multiple comorbid conditions potentially limiting therapeutic options for PAD. Endovascular interventions are aimed at decreasing arterial disease symptoms, improve wound healing and ultimately limb salvage...
October 1, 2016: International Journal of Cardiology
Sarah H White, Mary M McDermott, Robert L Sufit, Kate Kosmac, Alex W Bugg, Marta Gonzalez-Freire, Luigi Ferrucci, Lu Tian, Lihui Zhao, Ying Gao, Melina R Kibbe, Michael H Criqui, Christiaan Leeuwenburgh, Charlotte A Peterson
BACKGROUND: Patients with lower extremity peripheral artery disease (PAD) have decreased mobility, which is not fully explained by impaired blood supply to the lower limb. Additionally, reports are conflicted regarding fiber type distribution patterns in PAD, but agree that skeletal muscle mitochondrial respiration is impaired. METHODS: To test the hypothesis that reduced muscle fiber oxidative activity and type I distribution are negatively associated with walking performance in PAD, calf muscle biopsies from non-PAD (n = 7) and PAD participants (n = 26) were analyzed immunohistochemically for fiber type and size, oxidative activity, markers of autophagy, and capillary density...
September 29, 2016: Journal of Translational Medicine
Laura A Davis, Firas Dandachli, Robert Turcotte, Oren K Steinmetz
BACKGROUND: The standard of care for lower extremity soft tissue sarcoma (STS) is limb-sparing surgery. A small subset of these patients will require concomitant vascular reconstruction to ensure adequate resection and to preserve limb viability and function. The aim of this study was to evaluate outcomes in these patients with respect to wound healing and postoperative functional status. METHODS: Outcomes for a total of 154 patients treated for malignant lower extremity STS during an 8-year period between 2005 and 2013 were entered in a prospective registry...
September 26, 2016: Journal of Vascular Surgery
Peter Onody, Peter Aranyi, Zsolt Turoczi, Rita Stangl, Andras Fulop, Emese Dudas, Gabor Lotz, Attila Szijarto
AIMS AND OBJECTIVES: Acute renal failure is a severe complication of lower extremity major arterial reconstructions, which could even be fatal. Levosimendan is a dual-acting positive inotropic and vasodilatory agent, which is suspected to have protective effects against cardiac ischemia. However, there is no data available on lower limb or remote organ ischemic injuries therefore the aim of the study was to investigate the effect of levosimendan on lower limb ischemia-reperfusion injury and the corollary renal dysfunction...
2016: PloS One
Olívia G S Araújo, Célio F B Haddad, Hélio R DA Silva, Lourdes A Pugener
Pipa is a Neotropical genus of frogs that dwell in freshwater environments. It includes four species that lack free-swimming larvae (P. aspera, P. arrabali, P. pipa, and P. snethlageae) and three with tadpoles (P. carvalhoi, P. myersi, and P. parva). Developmental tables such as the one proposed by Nieuwkoop and Faber might be useful for Pipa species with tadpoles. However, for the other Pipa species, to determine stages by this table or by any of the tables already prepared for frogs without tadpoles (e.g...
September 22, 2016: Anais da Academia Brasileira de Ciências
Marjorie Kerzoncuf, Laurent Bensoussan, Jean Michel Viton, Alain Delarque, Christiane Rossi Durand
OBJECTIVE: The therapeutic effects of intramuscular injections of botulinum toxin-type A on spasticity can be largely explained by its blocking action at the neuromuscular junction. BTx-A is assumed also to have a central action by affecting the functional organization of the CNS. The objective was to assess its action on spinal motor networks by investigating the post-activation depression (post-AD) of the soleus H-reflex in post-stroke patients. Post-AD that is a presynaptic mechanism controlling the synaptic efficacy of Ia-motoneuron transmission is involved in the pathophysiology of spasticity...
September 2016: Annals of Physical and Rehabilitation Medicine
Jacques Griffet
Amputation of a limb is always perceived as a catastrophe. The principles underlying creation of a stump adapted to modern prosthetic fittings must be fully understood and the patient managed by a multidisciplinary team. In paediatric patients, preserving residual limb length is a crucial point that should be assessed according to the expected growth potential. Advances in prosthetic fittings have led to changes in the overall concept of socket design, which seeks to achieve three objectives: to maximise the weight-bearing surface area, to eliminate friction of the skin on the socket, and to eliminate lever-arm effects...
September 2016: Annals of Physical and Rehabilitation Medicine
Cecilia Guerra, Ezequiel Aráoz
Agricultural landscapes support large amphibian populations because they provide habitat for many species, although agriculture affects amphibians through various mechanisms. Pollution with agrochemicals is the major threat to amphibian populations after habitat loss, as chemicals alter the ecophysiology of amphibians, putting their health and survival at risk. We aimed to assess the effect of different environments, sites, width of forest buffers and sampling years on the health of amphibians, which was estimated through the prevalence of malformations and body condition...
September 26, 2016: Diseases of Aquatic Organisms
Che Norma Mat Taib, Siti Nur Aisyah Hassan, Nurhidayah Esa, Mohamad Aris Mohd Moklas, Aye Aye San
Formation, distribution and possible communication of the median nerve are essential to know in treatment and surgeries of various conditions of injuries eg. repair or reconstruction of median nerve in traumatic accident. In the present study, forty four upper limbs were dissected. Root forming of median nerve, median nerve in relation with axillary artery and communication of median nerve with other nerve were noted.
September 26, 2016: Folia Morphologica (Warsz)
Julian Aliste, Prangmalee Leurcharusmee, Phatthanaphol Engsusophon, Aida Gordon, Giuliano Michelagnoli, Chonticha Sriparkdee, Worakamol Tiyaprasertkul, Dana Q Tran, Tom C R V Van Zundert, Roderick J Finlayson, De Q H Tran
BACKGROUND: This randomized double-blinded trial compared the effect of intravenous and perineural dexamethasone (8 mg) on the duration of motor block for ultrasound (US)-guided axillary brachial plexus block (AXB). METHODS: Patients undergoing upper limb surgery with US-guided AXB were randomly allocated to receive preservative-free dexamethasone (8 mg) via intravenous (n = 75) or perineural (n = 75) administration. The local anesthetic agent, 1% lidocaine -0...
September 23, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Rachel H Dunn, Kenneth D Rose, Rajendra S Rana, Kishor Kumar, Ashok Sahni, Thierry Smith
The oldest primates of modern aspect (euprimates) appear abruptly on the Holarctic continents during a brief episode of global warming known as the Paleocene-Eocene Thermal Maximum, at the beginning of the Eocene (∼56 Ma). When they first appear in the fossil record, they are already divided into two distinct clades, Adapoidea (basal members of Strepsirrhini, which includes extant lemurs, lorises, and bushbabies) and Omomyidae (basal Haplorhini, which comprises living tarsiers, monkeys, and apes). Both groups have recently been discovered in the early Eocene Cambay Shale Formation of Vastan lignite mine, Gujarat, India, where they are known mainly from teeth and jaws...
October 2016: Journal of Human Evolution
Kyle J Hackney, Meghan E Downs, Lori Ploutz-Snyder
BACKGROUND: Bed rest studies have shown that high load (HL) resistance training can mitigate the loss of muscle size and strength during musculoskeletal unloading; however, not all individuals are able to perform HL resistance exercise. Blood flow restricted (BFR) resistance exercise may be a novel way to prevent maladaptation to unloading without requiring HL exercise equipment. This study evaluated the muscular training adaptations to HL and BFR resistance training during unilateral lower limb suspension (ULLS), a human limb unloading model...
August 2016: Aerospace Medicine and Human Performance
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