Limb preservation

Pierre Lafère, Yann Gatzoff, François Guerrero, Steven Provyn, Costantino Balestra
BACKGROUND: Ocean racing has become increasingly demanding, both physically and psychologically. The aim of the study was to assess global changes after a transoceanic race. MATERIALS AND METHODS: Eight male sailors were evaluated pre- and post-race through anthropometric measurements (weight, skinfold, girth at different level and estimated body fat percentage), multifrequency tetrapolar bioelectrical impedance, muscular performance, visual analogic scale for perceived fatigue and Critical Flicker Fusion Frequencies for cerebral arousal...
2020: International Maritime Health
Lee C Rogers, Lawrence A Lavery, Warren S Joseph, David G Armstrong
The COVID-19 pandemic is driving significant change in the healthcare system and disrupting the best practices for diabetic limb preservation, leaving large numbers of patients without care. Patients with diabetes and foot ulcers are at increased risk for infections, hospitalization, amputations, and death. Podiatric care is associated with fewer diabetes-related amputations, ER visits, hospitalizations, length-of-stay, and costs. But podiatrists must mobilize and adopt the new paradigm of shifts away from hospital care to community-based care...
March 25, 2020: Journal of the American Podiatric Medical Association
Gustavo de Sousa Arantes Ferreira, André Luis Conde Watanabe, Natália de Carvalho Trevizoli, Fernando Marcus Felippe Jorge, Ana Virginia Ferreira Figueira, Carolina de Fatima Couto, Laura Viana de Lima, Deborah Roberta Liduario Raupp
Psychotic disorders are a group of psychiatric disorders characterized by the presence of delusions, hallucinations, bizarre behavior, and disorganized speech. There are several possible causes for the occurrence of psychotic disorders in patients who underwent solid organ transplant, including pre-existing mental illness, electrolyte disturbances, infections of the central nervous system, and adverse reaction to drugs. Calcineurin inhibitors are a class of immunosuppressive drugs, such as tacrolimus and cyclosporine, that are currently considered the mainstay in the immunosuppressive drug regimen of patients who underwent solid organ transplant...
March 17, 2020: Transplantation Proceedings
Marcus D'Souza, Caspar E P Van Munster, Jonas Dorn, Alexis Dorier, Christian P Kamm, Saskia Steinheimer, Frank Dahlke, Bernard M J Uitdehaag, Ludwig Kappos, Matthew Johnson
BACKGROUND: In chronical neurological diseases, especially in multiple sclerosis (MS), clinical assessment of motor dysfunction is crucial to monitor patients' disease. Traditional scales are not sensitive enough to detect slight changes. Video recordings of patient performance are more accurate and increase reliability in severity ratings. With these recordings automated, quantitative disability assessments by machine learning algorithms (MLA) may be created. Creation of these algorithms involves non-healthcare professionals, which is a challenge for keeping data privacy...
March 19, 2020: Journal of Medical Internet Research
Amol Gupta, Akinsansoye K Dosekun, Vinod Kumar
Patients with peripheral arterial disease (PAD) and critical limb ischemia are at risk for limb amputation and require urgent management to restore blood flow. Patients with PAD often have several comorbidities, including chronic kidney disease, diabetes mellitus, and hypertension. Diagnostic and interventional angiography using iodinated contrast agents provides excellent image resolution but can be associated with contrast-induced nephropathy (CIN). The use of carbon dioxide (CO2 ) as a contrast agent reduces the volume of iodine contrast required for angiography and reduces the incidence of CIN...
February 26, 2020: World Journal of Cardiology
G Duhil de Bénazé, M Vigan, N Corradini, V Minard-Colin, A Marie-Cardine, C Verite, A S Defachelles, E Thebaud, M P Castex, N Sirvent, D Bodet, L Mansuy, A Rome, A Petit, D Plantaz, A Jourdain, P Mary, M Carton, D Orbach
BACKGROUND: With recent conservative strategies, prognosis of patients with desmoid-type fibromatosis (DTF) is about function preservation. We analyzed the long-term quality of life (QoL) of pediatric patients with DTF. METHODS: All French young patients (<21years) treated between 2005 and 2016 for a DTF in the EpSSG NRSTS-05 study were analyzed. A first wait-and-see strategy was recommended. Patients' QoL was analyzed with the internationally validated Child Health Questionnaire (CHQ)...
February 29, 2020: European Journal of Surgical Oncology
Valentin Haug, Branislav Kollar, Sotirios Tasigiorgos, Yori Endo, Martin Kauke, Ali-Farid Safi, Anamika Veeramani, Obada Abdulrazzak, Bruce Bausk, David Walt, Bohdan Pomahac
BACKGROUND: Machine perfusion (MP) has evolved as a promising approach for the ex situ preservation in organ transplantation. However, the literature on the use of MP in human vascularized composite allografts (VCA) is scarce. The aim of this study was to evaluate the effects of hypothermic MP with an acellular perfusate in human upper extremities and compare with the current gold standard of static cold storage (SCS). METHODS: Six upper extremities were assigned to either MP (n=3) or SCS (n=3) conditions for 24 hours...
March 10, 2020: Transplantation
Michael Kennefick, Chris J McNeil, Joel S Burma, Paige V Copeland, Paul van Donkelaar, Brian H Dalton
During destabilizing, voluntary arm movements, the vestibular system provides sensory cues related to head motion that are necessary to preserve upright balance. Although sensorimotor processing increases in accordance with task complexity during the preparation phase of reaching, it is unclear whether vestibular signals are also enhanced when maintaining postural control prior to the execution of a voluntary movement. To probe whether vestibular cues are a component of complexity-related increases in sensorimotor processing during movement preparation, vestibular-evoked responses to stochastic (0-25 Hz; root mean square = 1 mA) binaural, bipolar electrical vestibular stimulation (EVS) were examined...
March 11, 2020: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
Marius Baguma, Maral Yeganeh Doost, Audrey Riga, Patrice Laloux, Benoît Bihin, Yves Vandermeeren
Recovery is dynamic during acute stroke, but whether new motor skills can be acquired with the paretic upper limb (UL) during this recovery period is unknown. Clarifying this unknown is important, because neurorehabilitation largely relies on motor learning. The aim was to investigate whether, during acute stroke, patients achieved motor skill learning and retention with the paretic UL. Over 3 consecutive days (D1-D3), 14 patients practiced with their paretic UL the CIRCUIT, a motor skill learning task with a speed/accuracy trade-off (SAT)...
March 9, 2020: Acta Neurologica Belgica
Jie Cui, Chase W Kessinger, Harkamal S Jhajj, Madeleine S Grau, Sanjay Misra, Peter Libby, Jason R McCarthy, Farouc A Jaffer
BACKGROUND: Arteriovenous fistulas placed surgically for dialysis vascular access have a high primary failure rate resulting from excessive inward remodeling, medial fibrosis, and thrombosis. No clinically established pharmacologic or perisurgical therapies currently address this unmet need. Statins' induction of multiple anti-inflammatory and antithrombotic effects suggests that these drugs might reduce arteriovenous fistula failure. Yet, the in vivo physiologic and molecular effects of statins on fistula patency and maturation remain poorly understood...
March 9, 2020: Journal of the American Society of Nephrology: JASN
Xiangdong Tian, Changxiao Han, Jian Wang, Yetong Tan, Guangyu Zhu, Ming Lei, Sheng Ma, Yuanyi Hu, Shuwen Li, Handong Chen, Ye Huang
OBJECTIVE: To observe the efficacy of distal tibial tuberosity high tibial osteotomy in treating medial compartment osteoarthritis of the knee. In the experiment, a medical image enhancement algorithm based on shear wave domain improved Gamma correction was implemented to process medical images in order to diagnose patients more effectively. METHODS: Sixty-five patients (13 males and 52 females) were included in the study who were treated with distal tibial tuberosity high tibial osteotomy, and the mean age of the patients was 63±6 years (range 49-73)...
January 22, 2020: Computer Methods and Programs in Biomedicine
Sumiya Shibata, Yukihiro Yamao, Takeharu Kunieda, Rika Inano, Takuro Nakae, Sei Nishida, Taku Inada, Yuki Takahashi, Takayuki Kikuchi, Yoshiki Arakawa, Kazumichi Yoshida, Riki Matsumoto, Akio Ikeda, Tatsuya Mima, Susumu Miyamoto
OBJECTIVE: To propose a method for intraoperative mapping and monitoring of the medial frontal motor areas (MFMA). METHODS: We estimated the location of the MFMA using the cortico-cortical evoked potential (CCEP) provoked by electrical stimuli to the primary motor area (M1) of the upper limb. We localized or defined the MFMA by recording the motor evoked potentials (MEPs) provoked by electrical stimuli to the medial frontal cortex around the estimated area. We monitored the patients' motor function during awake craniotomy and sequentially recorded the MEPs of the upper and/or lower limbs...
March 4, 2020: World Neurosurgery
Hajar Almoajil, Helen Dawes, Sally Hopewell, Francine Toye, Crispin Jenkinson, Tim Theologis
INTRODUCTION: Musculoskeletal deformities and gait deviations are common features in ambulatory cerebral palsy (CP). Deformity correction through lower limb orthopaedic surgery is the standard form of care aimed at improving or preserving motor function. Current research on CP care does not always take into account individual patients' expectations and needs. There is a wide range of outcome domains and outcome measures used to assess outcome from treatment. This can lead to reporting bias and make it difficult to compare and contrast studies...
March 4, 2020: BMJ Open
Vahe Fahradyan, Sayf Al-Deen Said, Carlos Ordenana, Edoardo Dalla Pozza, Russell Frautschi, Eliana F R Duraes, Maria Madajka-Niemeyer, Frank A Papay, Antonio Rampazzo, Bahar Bassiri Gharb
Ischemia and reperfusion injury remains a significant limiting factor for the successful revascularization of amputated extremities. Ex vivo normothermic perfusion is a novel approach to prolong the viability of the amputated limbs by maintaining physiologic cellular metabolism. This study aimed to evaluate the outcomes of extended ex vivo normothermic limb perfusion (EVNLP) in preserving the viability of amputated limbs for over 24 hours. A total of 10 porcine forelimbs underwent EVNLP. Limbs were perfused using an oxygenated colloid solution at 38°C containing washed RBCs...
March 4, 2020: Artificial Organs
Giulia Lioi, Simon Butet, Mathis Fleury, Elise Bannier, Anatole Lécuyer, Isabelle Bonan, Christian Barillot
Traditional rehabilitation techniques present limitations and the majority of patients show poor 1-year post-stroke recovery. Thus, Neurofeedback (NF) or Brain-Computer-Interface applications for stroke rehabilitation purposes are gaining increased attention. Indeed, NF has the potential to enhance volitional control of targeted cortical areas and thus impact on motor function recovery. However, current implementations are limited by temporal, spatial or practical constraints of the specific imaging modality used...
2020: Frontiers in Human Neuroscience
Nicholas S Powers, Roberto A Brandao, Jason M St John, Patrick R Burns
Retrograde intramedullary nails are often used for tibiotalocalcaneal arthrodesis to correct severe hindfoot deformities in high-risk patient populations. The purposes of the current study are to report outcomes of patients undergoing staged management of infection after intramedullary nail fixation for tibiotalocalcaneal arthrodesis and to review the surgical approach to management of this limb-threatening complication. The authors reviewed patients who underwent hindfoot intramedullary nailing with subsequent revision for infection between January 2006 and December 2016...
March 2020: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
S Christopher Bennett
The six known specimens of Scleromochlus taylori and casts made from their negative impressions were examined to reassess the osteological evidence that has been used to interpret Scleromochlus' s locomotion and phylogenetic relationships. It was found that the trunk was dorsoventrally compressed. The upper temporal fenestra was on the lateral surface of skull and two-thirds the size of the lower, the jaw joint posteriorly placed with short retroarticular process, and teeth short and subconical, but no evidence of external nares or antorbital fossae was found...
2020: PeerJ
Joshua A Gabel, Christian Bianchi, Isabella Possagnoli, Udochukwu E Oyoyo, Theodore H Teruya, Sharon C Kiang, Ahmed M Abou-Zamzam, Vicki Bishop, Diana Eastridge
OBJECTIVE: The Wound, Ischemia, and foot Infection classification system has been validated to predict benefit from inmediate revascularization and major amputation risk among patients with peripheral arterial disease. Our primary goal was to evaluate wound healing, limb salvage, and survival among patients with ischemic wounds undergoing revascularization when intervention was deferred by a trial of conservative wound therapy. METHODS: All patients with peripheral arterial disease and tissue loss are prospectively enrolled into our Prevention of Amputation in Veterans Everywhere limb preservation program...
February 18, 2020: Journal of Vascular Surgery
Ying Yang, Dao-Min Zhu, Cun Zhang, Yu Zhang, Chunli Wang, Biao Zhang, Wenming Zhao, Jiajia Zhu, Yongqiang Yu
Background: Sleep disturbance is common in patients with major depressive disorder (MDD), but the exploration of its neural underpinnings is limited by subjective sleep measurement and single-modality neuroimaging analyses. Methods: Ninety six patients with MDD underwent polysomnography examinations and multi-modal magnetic resonance imaging (MRI) scans. According to sleep efficiency, patients were subdivided into well-matched normal sleep efficiency (NSE, N = 42; 14 men; aged 43 ± 10 years) and low sleep efficiency (LSE, N = 54; 23 men; aged 45 ± 12 years) groups...
2020: Frontiers in Neuroscience
M Leeman, R P M Gadiot, J M A Wijnand, E Birnie, J A Apers, L U Biter, M Dunkelgrun
Laparoscopic Roux-en-Y Gastric Bypass (RYGB) is considered the gold standard for surgical treatment of morbid obesity. It is hypothesized that reducing the length of the common limb positively affects the magnitude and preservation of weight loss, but may also impose a risk of malnutrition. The aim of this study was to compare patients' nutrient and vitamin deficiencies in standard RYGB with a Very Long Roux Limb RYGB (VLRL-RYGB). This study was part of the multicenter randomized controlled trial (DUCATI), including 444 patients undergoing a RYGB or a VLRL-RYGB...
February 20, 2020: British Journal of Nutrition
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