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Limb preservation

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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
#1
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/29145473/suppression-and-resolution-of-autoimmune-arthritis-by-rhesus-%C3%AE-defensin-1-an-immunomodulatory-macrocyclic-peptide
#2
Justin B Schaal, Dat Q Tran, Akshay Subramanian, Reshma Patel, Teresina Laragione, Kevin D Roberts, Katie Trinh, Prasad Tongaonkar, Patti A Tran, Dmitriy Minond, Gregg B Fields, Paul Beringer, André J Ouellette, Percio S Gulko, Michael E Selsted
θ-defensins constitute a family of macrocyclic peptides expressed exclusively in Old World monkeys. The peptides are pleiotropic effectors of innate immunity, possessing broad spectrum antimicrobial activities and immunoregulatory properties. Here we report that rhesus θ-defensin 1 (RTD-1) is highly effective in arresting and reversing joint disease in a rodent model of rheumatoid arthritis (RA). Parenteral RTD-1 treatment of DA/OlaHsd rats with established pristane-induced arthritis (PIA) rapidly suppressed joint disease progression, restored limb mobility, and preserved normal joint architecture...
2017: PloS One
https://www.readbyqxmd.com/read/29138919/low-re-rupture-rate-with-bptb-autograft-and-semitendinosus-gracilis-autograft-with-preserved-insertions-in-acl-reconstruction-surgery-in-sports-persons
#3
Ravi Gupta, Munish Sood, Anubhav Malhotra, Gladson David Masih, Anil Kapoor, Mukta Raghav, Mehar Dhillon
PURPOSE: To compare the results of bone-patellar tendon-bone graft (BPTB), semitendinosus-gracilis graft with preserved insertions (STGPI) and semitendinosus-gracilis-free graft (STGF) in terms of graft failure, objective mechanical stability, functional outcome, and return to sports in elite and recreational sports persons. It was hypothesized that the STGPI graft provided superior outcome as compared to the other two grafts. METHODS: Two hundred and forty-nine elite and recreational players who underwent ACL reconstruction surgery, with BPTB graft (N = 80), STGPI graft (N = 85), and STGF graft (N = 84) with a minimum follow-up of 2 years, were assessed using clinical tests, knee arthrometer (KT 1000™), single-leg hop test, Lysholm knee score, Tegner's activity scale, and return to sports...
November 14, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29133708/demonstration-of-autonomic-dysfunction-in-traumatic-brachial-plexus-injury-using-quantitative-sudomotor-axon-reflex-test-preliminary-results
#4
Satyakam Baruah, Akhil Deepika, Dhaval Shukla, Bhagavatula Indira Devi, Veeramani Preethish-Kumar, Talakad N Sathyaprabha
OBJECTIVE: To objectively document autonomic dysfunction in the affected arm with traumatic brachial plexus injury (TBPI) using quantitative sudomotor axon reflex test (QSART). MATERIALS AND METHODS: Patients with TBPI presenting to the neurosurgical outpatient department from August 2013 to November 2014 were included in the study. The QSART was administered to each patient with prior informed consent detailing the procedure. A total of 20 patients with TBPI were included in the study...
November 2017: Neurology India
https://www.readbyqxmd.com/read/29124342/connections-between-radial-and-ulnar-nerve-at-high-humeral-level-in-cadavers-incidence-topography-and-literature-review
#5
Konstantinos Natsis, A Giannakopoulou, M Piagkou, N Lazaridis, T Tegos, M R Colonna
PURPOSE: Although communications between branches and cords of the brachial plexus have been extensively published, there is a scarcity of reports concerning radial and ulnar nerve (RN-UN) communication in the arm. The current study aims to demonstrate the incidence, topography, and length of communicating branches between RN and UN. Any additional coexisted variations were also recorded. MATERIALS AND METHODS: Two hundred and sixty-six upper limbs collected from one hundred and thirty-three (81 males and 52 females) Greek cadavers were dissected...
November 9, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/29121964/muscle-force-distribution-of-the-lower-limbs-during-walking-in-diabetic-individuals-with-and-without-polyneuropathy
#6
Aline A Gomes, Marko Ackermann, Jean P Ferreira, Maria Isabel V Orselli, Isabel C N Sacco
BACKGROUND: Muscle force estimation could advance the comprehension of the neuromuscular strategies that diabetic patients adopt to preserve walking ability, which guarantees their independence as they deal with their neural and muscular impairments due to diabetes and neuropathy. In this study, the lower limb's muscle force distribution during gait was estimated and compared in diabetic patients with and without polyneuropathy. METHODS: Thirty individuals were evaluated in a cross-sectional study, equally divided among controls (CG) and diabetic patients with (DNG) and without (DG) polyneuropathy...
November 9, 2017: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/29119592/orthopedic-complications-of-linear-morphea-implications-for-early-interdisciplinary-care
#7
REVIEW
Jennifer J Schoch, Bradley S Schoch, Jean David Werthel, Amy L McIntosh, Dawn M R Davis
Linear morphea of the limb primarily affects children, and extracutaneous manifestations are common. Orthopedic surgeons are often essential in the care of patients with linear morphea, yet there are few reports outlining specific orthopedic complications in this population. We sought to improve the understanding of orthopedic complications in linear morphea of the limb. Between 1999 and 2014, 51 children were evaluated for linear morphea of an extremity. Twenty-six (51%) had documented orthopedic manifestations...
November 9, 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/29117811/a-new-endovascular-technique-for-the-treatment-of-dialysis-associated-steal-syndrome
#8
Enrico Ascher, Jacob E Mandel, Natalie A Marks, Anil P Hingorani
Background Dialysis access-associated steal syndrome is a major complication of arteriovenous fistula creation whereby the low-resistance venous conduit shunts arterial inflow through the anastomosis, resulting in clinically significant distal artery insufficiency. Herein, we describe a case of severe steal phenomenon with gangrene of a digit following placement of an arteriovenous fistula that was treated with a novel, entirely endovascular technique. To our knowledge, this was the first totally endovascular approach to dialysis access-associated steal syndrome...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/29113159/treatment-of-osteosarcoma-around-the-knee-in-skeletally-immature-patients
#9
Weitao Yao, Qiqing Cai, Jiaqiang Wang, Songtao Gao
Limb sparing surgery in growing young patients with malignant tumors is difficult as invasion of the physis by the tumor or surgical resection through the metaphysis may cause significant limb discrepancy following surgery. At present, hinged tumor prosthesis or biological reconstructions are the main methods following tumor resection in these patients. The aim of the present study was to assess different procedures for the treatment of osteosarcoma around knee joints in immature patients. A retrospective study of 56 patients (<15 years old, open physis) who had been treated for osteosarcoma around the knee joint between January 2007 and December 2015 was performed...
November 2017: Oncology Letters
https://www.readbyqxmd.com/read/29108513/reconstruction-of-traumatic-external-iliac-artery-dissection-due-to-vascular-clamping
#10
Mahir Kırnap, Ümit Özçelik, Aydıncan Akdur, Ebru H Ayvazoğlu Soy, İclal Işıklar, Feza Yarbuğ Karakayalı, Gökhan Moray, Mehmet Haberal
Traumatic external iliac artery dissection after renal transplant is a rare complication, but it should be urgently managed due to its devastating effects on graft and lower limb circulation. External iliac artery dissection is seen more in recipients with diabetes mellitus and comorbid disease. Recipients with external iliac artery dissection should be treated immediately by percutaneus angioplasty or surgical reconstruction. In this study, we reported the management of 2 kidney transplant cases with external iliac artery dissection due to vascular clamping of the artery...
October 31, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29104110/pseudomyogenic-hemangioendothelioma-of-skin-bone-and-soft-tissue-a-clinicopathological-immunohistochemical-and-fluorescence-in-situ-hybridization-study
#11
Dinesh Pradhan, Karen Schoedel, Richard L McGough, Sarangarajan Ranganathan, Uma N M Rao
Pseudomyogenic hemangioendothelioma (PHE) is an uncommon neoplasm with propensity for local recurrence. The tumor mimics epithelioid hemangioendothelioma and epithelioid sarcoma, representing a possible diagnostic pitfall. We investigated the clinicopathological, immunohistochemical and fluorescence in situ hybridization features of PHEs. Eight cases of PHE were retrieved from our pathology archives. The clinical and outcome information was available in six patients. In six cases the tumors were located in the lower limb while the upper limb was involved in two cases...
November 2, 2017: Human Pathology
https://www.readbyqxmd.com/read/29099893/acute-shortening-versus-bridging-plate-for-highly-comminuted-olecranon-fractures
#12
Meir Marmor, Keiko Amano, Akira Yamamoto, David Friedberg, Erik McDonald, Eric Meinberg
Severely comminuted olecranon fractures, for which elbow stability becomes the main goal of surgery, remain a challenge for surgeons. We conducted a study to determine the percentage loss of articular surface at which a bridge plating (BP) construct becomes too unstable and an acute shortening (AS) construct is required. The olecranon process of 8 fresh-frozen cadaveric upper limbs was serially resected. At each resection, the simulated fracture was fixed first with BP and then with AS. Stability was tested by performing valgus and varus stress tests at various angles under fluoroscopy...
September 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29097038/impact-of-the-calcium-form-of-%C3%AE-hydroxy-%C3%AE-methylbutyrate-upon-human-skeletal-muscle-protein-metabolism
#13
D J Wilkinson, T Hossain, M C Limb, B E Phillips, J Lund, J P Williams, M S Brook, J Cegielski, A Philp, S Ashcroft, J A Rathmacher, N J Szewczyk, K Smith, P J Atherton
BACKGROUND & AIMS: β-hydroxy-β-methylbutyrate (HMB) is purported as a key nutritional supplement for the preservation of muscle mass in health, disease and as an ergogenic aid in exercise. Of the two available forms of HMB (calcium (Ca-HMB) salt or free acid (FA-HMB)) - differences in plasma bioavailability have been reported. We previously reported that ∼3 g oral FA-HMB increased muscle protein synthesis (MPS) and reduced muscle protein breakdown (MPB). The objective of the present study was to quantify muscle protein metabolism responses to oral Ca-HMB...
October 6, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29069141/intra-arterial-fibrinolysis-for-the-management-of-acute-ischemia-on-a-below-knee-amputation-stump-case-report
#14
Breno Boueri Affonso, Joaquim Maurício da Motta Leal, Rafael Noronha Cavalcante, Priscila Mina Falsarella, Francisco Leonardo Galastri, Rodolfo Souza Cardoso, Felipe Nasser
Preservation of the knee joint has enormous advantages in terms of mobility and rehabilitation of an amputee. Any cause of breakdown requiring revision to an above-knee amputation is a major setback because it reduces the patient's rehabilitative potential. We report a case of intra-arterial thrombolysis use to save a below-knee amputation stump with acute ischemia. A 56-year-old man who sought the emergency department with 1-day history of acute pain on his right below-knee stump. The angiography confirmed popliteal artery occlusion...
October 23, 2017: Einstein
https://www.readbyqxmd.com/read/29065790/surgical-and-endovascular-venous-arterialization-for-treatment-of-critical-limb-ischaemia
#15
Michael Lichtenberg, Michiel A Schreve, Roberto Ferraresi, Daniel A F van den Heuvel, Çagdas Ünlü, Vincent Cabane, Steven Kum
Patients with critical limb ischaemia have a poor life expectancy. Aggressive revascularization is accepted in order to preserve their independence in the final phase of their lives. Bypass surgery and more recently endovascular interventions with angioplasty and stenting have become the treatment of choice to prevent amputation and to resolve pain. However, as many as 20 % of patients with critical limb ischaemia are unsuitable candidates for a vascular intervention because of extensive occlusions of outflow in the crural and pedal vessels...
October 25, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29063283/-prosthesis-replacement-in-periprosthetic-humeral-fractures
#16
REVIEW
M Jaeger, D Maier, K Izadpanah, N P Südkamp
OBJECTIVE: Stabilization of the humerus with preservation or restoration of the shoulder function. INDICATIONS: Always in the presence of a loose prosthesis. It may become necessary in conditions of poor bone stock and if osteosynthesis is not possible. CONTRAINDICATIONS: Noncompliant patients due to alcohol or drugs. Local infections. SURGICAL TECHNIQUE: The loose implant is removed using an extended anterior deltopectoral approach...
October 23, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/29060411/influence-of-trans-spinal-magnetic-stimulation-in-electrophysiological-recordings-for-closed-loop-rehabilitative-systems
#17
Ainhoa Insausti-Delgado, Eduardo Lopez-Larraz, Carlos Bibian, Yukio Nishimura, Niels Birbaumer, Ander Ramos-Murguialday
Recent studies have shown the feasibility of spinal cord stimulation (SCS) for motor rehabilitation. Currently, there is an increasing interest in developing closed-loop systems employing SCS for lower-limb recovery. These closed-loop systems are based on the use of neurophysiological signals to modulate the stimulation. It is known that electromagnetic stimulation can introduce undesirable noise to the electrophysiological recordings. However, there is little evidence about how electroencephalographic (EEG) or electromyographic (EMG) activities are corrupted when a trans-spinal magnetic stimulation is applied...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29054354/strategies-to-reduce-ischemia-reperfusion-injury-in-vascularized-composite-allotransplantation-of-the-limb
#18
REVIEW
Kavit R Amin, Jason K F Wong, James E Fildes
An important and often underinvestigated contributor to solid organ transplant rejection is ischemia reperfusion injury. This pathophysiological response releases damaging reactive oxygen species and cell stress signals that initiate inflammation, which has a critical role in priming the immune system for allorecognition. In time, this renders graft dysfunction and how this response is mediated in composite tissues remains unknown. Current protocols are drawn from solid organ transplantation with little scientific basis as to how this informs current hand transplantation practices...
October 18, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29044029/determining-residual-adipose-tissue-characteristics-with-mri-in-patients-with-various-subtypes-of-lipodystrophy
#19
Canan Altay, Mustafa Seçil, Tevfik Demir, Tahir Atik, Gülçin Akıncı, Nilüfer Özdemir Kutbay, Ela Keskin Temeloğlu, Ilgın Yıldırım Şimşir, Seçil Özışık, Leyla Demir, Erdal Eren, Emine Burçin Tuna, Hasibe Aytaç, Hüseyin Onay, Barış Akıncı
PURPOSE: We aimed to investigate residual adipose tissue with whole-body magnetic resonance imaging to differentiate between subtypes of lipodystrophy. METHODS: A total of 32 patients (12 with congenital generalized lipodystrophy [CGL], 1 with acquired generalized lipodystrophy [AGL], 12 with familial partial lipodystrophy [FPLD], and 7 with acquired partial lipodystrophy [APL]) were included. RESULTS: Despite generalized loss of metabolically active adipose tissue, patients with CGL1 caused by AGPAT2 mutations had a significant amount of residual adipose tissue in the scalp, earlobes, retro-orbital region, and palms and soles...
November 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/29043460/longitudinal-assessment-of-the-impact-of-adapted-physical-activity-on-upper-limb-disability-and-quality-of-life-in-breast-cancer-survivors-from-an-italian-cohort
#20
Daniela Mirandola, Guido Miccinesi, Maria Grazia Muraca, Stefania Belardi, Roberta Giuggioli, Eleonora Sgambati, Mirko Manetti, Marco Monaci, Mirca Marini
PURPOSE: The purpose of this study was to evaluate the effectiveness of a specific adapted physical activity (APA) protocol on upper limb disability and quality of life in breast cancer survivors and to assess longitudinally the possible role of APA on long-term benefits. METHODS: Breast cancer survivors from an Italian cohort were assessed by fitness tests (shoulder-arm mobility, range of motion, and back flexibility) before and after 8-week APA. Quality of life and back and surgical shoulder pain intensity were evaluated by Short Form-12 and numerical rating scale questionnaires, respectively...
October 17, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
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