2,033 results
Search Results
2. Toddlers at Risk for Paper Shredder Injury in the Home: Easy Access and Severe Injury.
- Author
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Warren, Ramona C. and Foltin, George L.
- Subjects
- *
PAPER-cutting machines , *CHILDREN'S injuries , *CHILDREN'S accidents , *PEDIATRIC emergencies , *HOUSEHOLD appliances , *SAFETY - Abstract
A 2-year-old girl sustained severe injury to 2 fingers from a home paper shredder. This case illustrates the risk of injury from paper shredders, which are increasingly common household items. Toddlers are at risk of finger injury and amputation. The US Consumer Product Safety Commission performed an investigation of reported injuries and the characteristics of paper shredders that might have contributed to the injuries, and we summarize their findings. [ABSTRACT FROM AUTHOR]
- Published
- 2006
- Full Text
- View/download PDF
3. Urgent need to clarify the definition of chronic critical limb ischemia – a position paper from the European Society for Vascular Medicine
- Author
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D. Olinic, Isabelle Quéré, Joël Constans, Jill J. F. Belch, Juraj Madaric, Lucia Mazzolai, Adriana Visonà, Marianne Brodmann, Alessandra Bura-Rivière, Pierre Abraham, Sabine Steiner, CHU Bordeaux [Bordeaux], Hôpital de Rangueil, CHU Toulouse [Toulouse], Medical University Graz, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), CHU Saint-Eloi, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), and University of Dundee
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Ischemia ,MEDLINE ,030204 cardiovascular system & hematology ,Amputation, Surgical ,03 medical and health sciences ,0302 clinical medicine ,oxygen transcutaneous pressure ,peripheral arterial disease ,toe pressure ,medicine ,Humans ,definition ,030212 general & internal medicine ,Prospective Studies ,Intensive care medicine ,Prospective cohort study ,Vascular Medicine ,Gangrene ,Peripheral Vascular Diseases ,business.industry ,Critical limb ischemia ,Extremities ,medicine.disease ,ankle pressure ,3. Good health ,Europe ,body regions ,Treatment Outcome ,Amputation ,Position paper ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
Abstract. Chronic critical lower limb ischemia (CLI) has been defined as ischemia that endangers the leg. An attempt was made to give a precise definition of CLI, based on clinical and hemodynamic data (Second European Consensus). CLI may be easily defined from a clinical point of view as rest pain of the distal foot or gangrene or ulceration. It is probably useful to add leg ulcers of other origin which do not heal because of severe ischemia, and to consider the impact of frailty on adverse outcome. From a hemodynamic viewpoint there is no consensus and most of the existing classifications are not based upon evidence. We should thus propose a definition and then validate it in a prospective cohort in order to define the patients at major risk of amputation, and also to define the categories of patients whose prognosis is improved by revascularisation. From today’s available data, it seems clear that the patients with a systolic toe pressure (STP) below 30 mmHg must be revascularised whenever possible. However other patients with clinically suspected CLI and STP above 30 mmHg must be evaluated and treated in specialised vascular units and revascularisation has to be discussed on a case by case basis, taking into account other data such as the WiFi classification for ulcers.In conclusion, many useful but at times contradictory definitions of CLI have been suggested. Only a few have taken into account evidence, and none have been validated prospectively. This paper aims to address this and to give notice that a CLI registry within Europe will be set up to prospectively validate, or not, the previous and suggested definitions of CLI.
- Published
- 2019
4. Managing the interface between acute care and rehabilitation - can utilisation review assist? [Peer-reviewed paper. Paper in: Australian Healthcare Association Biennial Health Conference (2006: Sydney): Exploring and Debating Acute Care Provision.]
- Author
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Poulos, Roslyn G., Poulos, Christopher, and Eagar, Kathy
- Published
- 2007
5. The AROC annual report: the state of rehabilitation in Australia 2005. [A summary of this paper was presented at the Biennial Health Conference (2006). Paper in: Australian Healthcare Association Biennial Health Conference (2006: Sydney): Exploring and Debating Acute Care Provision.]
- Author
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Simmonds, Frances and Stevermuer, Tara
- Published
- 2007
6. Grandmother who had to have four limbs amputated after tiny paper cut shares ordeal; Marguerite Henderson, 57, from Fife, who was left fighting for her life, has written about her harrowing experience in the hope that she can help others suffering the same fate
- Subjects
Amputation ,General interest ,News, opinion and commentary - Abstract
Byline: By, Vivienne Aitken A grandmother who had to have all four of her limbs amputated after getting blood poisoning from a tiny paper cut has written a book about [...]
- Published
- 2020
7. SIAMOC position paper on gait analysis in clinical practice: General requirements, methods and appropriateness. Results of an Italian consensus conference
- Author
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Tommaso Leo, Anna Castagna, Zimi Sawacha, Marco Rabuffetti, Fabiola Spolaor, L. Piccinini, L. Cavazzuti, M. Manca, Andrea Giovanni Cutti, Federica Verdini, Antonio De Tanti, Maurizio Petrarca, Giuseppe Vannozzi, Andrea Ravaschio, Ugo Della Croce, Maurizio Ferrarin, Rita Stagni, Ettore Beghi, P. Marchi, Andrea Cereatti, Marco Gasperi, Valentina Camomilla, Martina Del Maestro, Nino Basaglia, Maria Grazia Benedetti, Isabella Campanini, Luigi Tesio, Claudia Mazzà, Aurelio Cappozzo, Silvia Fantozzi, Isabella Visintin, Benedetti, Maria Grazia, Beghi, Ettore, De Tanti, Antonio, Cappozzo, Aurelio, Basaglia, Nino, Cutti, Andrea Giovanni, Cereatti, Andrea, Stagni, Rita, Verdini, Federica, Manca, Mario, Fantozzi, Silvia, Mazzã , Claudia, Camomilla, Valentina, Campanini, Isabella, Castagna, Anna, Cavazzuti, Lorenzo, Del Maestro, Martina, Croce, Ugo Della, Gasperi, Marco, Leo, Tommaso, Marchi, Pia, Petrarca, Maurizio, Piccinini, Luigi, Rabuffetti, Marco, Ravaschio, Andrea, Sawacha, Zimi, Spolaor, Fabiola, Tesio, Luigi, Vannozzi, Giuseppe, Visintin, Isabella, and Ferrarin, Maurizio
- Subjects
030506 rehabilitation ,Kinematics ,Operations research ,Process (engineering) ,Gait analysi ,media_common.quotation_subject ,Biophysics ,Context (language use) ,Amputation ,Amputee ,Brain injuries ,Cerebral pulsy ,Clinics ,Consensus conference ,EMG ,Force plate ,Gait analysis ,Human movement ,Stereophotogrammetry ,Orthopedics and Sports Medicine ,Rehabilitation ,Brain injurie ,Scientific evidence ,NO ,03 medical and health sciences ,0302 clinical medicine ,Gait (human) ,Jury ,Humans ,Medicine ,Quality (business) ,Gait ,Biomechanical Phenomena ,Italy ,Movement Disorders ,Practice Guidelines as Topic ,Clinic ,media_common ,Medical education ,business.industry ,Kinematic ,Work (electrical) ,Biophysic ,Position paper ,0305 other medical science ,business ,030217 neurology & neurosurgery - Abstract
Gait analysis is recognized as a useful assessment tool in the field of human movement research. However, doubts remain on its real effectiveness as a clinical tool, i.e. on its capability to change the diagnostic-therapeutic practice. In particular, the conditions in which evidence of a favorable cost-benefit ratio is found and the methodology for properly conducting and interpreting the exam are not identified clearly. To provide guidelines for the use of Gait Analysis in the context of rehabilitation medicine, SIAMOC (the Italian Society of Clinical Movement Analysis) promoted a National Consensus Conference which was held in Bologna on September 14th, 2013. The resulting recommendations were the result of a three-stage process entailing i) the preparation of working documents on specific open issues, ii) the holding of the consensus meeting, and iii) the drafting of consensus statements by an external Jury. The statements were formulated based on scientific evidence or expertsâ opinion, when the quality/quantity of the relevant literature was deemed insufficient. The aim of this work is to disseminate the consensus statements. These are divided into 13 questions grouped in three areas of interest: 1) General requirements and management, 2) Methodological and instrumental issues, and 3) Scientific evidence and clinical appropriateness. SIAMOC hopes that this document will contribute to improve clinical practice and help promoting further research in the field.
- Published
- 2017
8. OSHA CITES PAPER PRODUCT MANUFACTURER FOR LACKING SAFETY PROCEDURES AFTER WORKER SUFFERS AMPUTATION; PROPOSES $68K IN PENALTIES
- Subjects
United States. Occupational Safety and Health Administration -- Safety and security measures ,AJM Packaging Corp. -- Safety and security measures ,Amputation ,Paper products industry ,Packaging ,Employers ,News, opinion and commentary - Abstract
WASHINGTON -- The following information was released by the Occupational Safety and Health Administration: AJM Packaging Corp. cited in October 2015 for same violation Employer name: AJM Packaging Corp. Inspection [...]
- Published
- 2016
9. FOR THE 4TH TIME IN A YEAR, OSHA CITES BURROWS PAPER FOOD BOX MANUFACTURER REPEATEDLY EXPOSES WORKERS TO AMPUTATION, OTHER HAZARDS
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United States. Department of Labor ,United States. Occupational Safety and Health Administration ,Burrows Paper Corp. ,Amputation ,Food industry ,Food and beverage production/distribution software ,News, opinion and commentary - Abstract
FRANKLIN, Ohio -- The following information was released by the Occupational Safety and Health Administration: Mere months after two employees were injured by dangerous machines, Burrows Paper Corp. again put [...]
- Published
- 2015
10. THOMSON, GA., PAPER MANUFACTURER CITED BY US LABOR DEPARTMENT'S OSHA FOR WILLFUL, SERIOUS SAFETY VIOLATIONS FOLLOWING AMPUTATION OF WORKER'S FINGERS
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United States. Occupational Safety and Health Administration -- Safety and security measures ,Paper industry ,Amputation ,News, opinion and commentary - Abstract
THOMSON, Ga. -- The following information was released by the Occupational Safety and Health Administration: The U.S. Department of Labor's Occupational Safety and Health Administration has cited McDuffie Box Co. [...]
- Published
- 2010
11. WORKERS EXPOSED TO AMPUTATION HAZARDS AT CLEARWATER PAPER NEENAH OSHA CITES 9 SERIOUS VIOLATIONS, PROPOSES FINES OF $49K
- Subjects
Workers ,Amputation ,Locks (Security devices) ,News, opinion and commentary - Abstract
WASHINGTON -- The following information was released by the Occupational Safety and Health Administration: Employer name: Cellu Tissue Neenah operating as Clearwater Paper Neenah Investigation site: 249 North Lake Street, [...]
- Published
- 2015
12. Generalized class of factor type exponential imputation techniques for population mean using simulation approach.
- Author
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Yadav, Vinay Kumar and Prasad, Shakti
- Subjects
MULTIPLE imputation (Statistics) ,MISSING data (Statistics) ,AMPUTATION ,COMPUTER simulation ,MATHEMATICS - Abstract
This article introduces some efficient generalized class of factor-type exponential imputation techniques and their corresponding estimators using auxiliary information. Generalized ratio, product, and dual to ratio type exponential estimators are the special cases of our suggested imputation techniques. Biases and mean squared error expressions are derived up to the first order of large sample approximations. The proposed imputation techniques can be viewed as efficient extensions of the work of Singh and Horn [Compromised imputation in survey sampling. Metrika. 2000;51(3):267–276. doi: 10.1007/s001840000054], Singh and Deo [Imputation by power transformation. Statist Papers. 2003;44(4):555–579. doi: 10.1007/BF02926010], Toutenburg and Srivastava [Amputation versus imputation of missing values through ratio method in sample surveys. Statist Papers. 2008;49(2):237–247. doi: 10.1007/s00362-006-0009-4], Kadilar and Cingi [Estimators for the population mean in the case of missing data. Commun Stat Theory Methods. 2008;37(14):2226–2236. doi: 10.1080/03610920701855020], Singh [A new method of imputation in survey sampling. Statistics. 2009;43(5):499–511. doi: 10.1080/02331880802605114], Gira [Estimation of population mean with a new imputation methods. Appl Math Sci. 2015;9(34):1663–1672] and Singh et al. [An improved alternative method of imputation for missing data in survey sampling. J Stat Appl Probab. 2022;11(2):535–543. doi: 10.18576/jsap]. Our proposed estimators are compared with these estimators, including the mean, ratio, and regression imputation techniques. Thereafter, a numerical illustration and simulation study are conducted for a comparative study using real and simulated data sets, and the demonstration shows that our suggested estimators are the most efficient estimators. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
13. Feasibility testing of smart tablet questionnaires compared to paper questionnaires in an amputee rehabilitation clinic.
- Author
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Payne, Michael, Janzen, Shannon, Earl, Eric, Deathe, Barry, and Viana, Ricardo
- Subjects
AMPUTEE rehabilitation ,QUESTIONNAIRES ,TABLET computers ,AMPUTATION ,PROSTHETICS ,MEDICAL quality control - Abstract
Background: Capturing the variability that exists among patients attending an amputee clinic using standardized paper-based questionnaires is time-consuming and may not be practical for routine clinical use. Electronic questionnaires are a potential solution; however, the benefits are dependent on the feasibility and acceptance of this mode of data collection among patients.Objective: To determine the feasibility and patient preference/comfort in using a tablet-based questionnaire for data collection in an outpatient amputee rehabilitation clinic compared to a traditional paper-based questionnaire.Study Design: Observational study.Methods: In all, 48 patients with major extremity amputations completed both tablet and paper questionnaires related to their amputation and prosthetic use. Both trials were timed; patients then completed a semi-structured questionnaire about their experience.Results: In all, 20.5% of patients needed hands-on assistance completing the paper questionnaire compared to 20.8% for the tablet. The majority of participants (52.1%) indicated a preference for the tablet questionnaire; 64.6% of patients felt the tablet collected a more complete and accurate representation of their status and needs. In all, 70.8% of participants described themselves as comfortable using the tablet.Conclusion: Despite comorbidities, patients with amputations demonstrated excellent acceptance of the electronic tablet-based questionnaire. Tablet questionnaires have significant potential advantages over paper questionnaires and should be further explored. Clinical relevance A custom electronic questionnaire was found to be beneficial for routine clinic use and was well received by patients in an amputee rehabilitation clinic. Development of such questionnaires can provide an efficient mechanism to collect meaningful data that can be used for individual patient care and program quality improvement initiatives. [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF
14. Free Papers.
- Subjects
ARTHROPLASTY ,BONE fractures ,AMPUTATION ,FASCIOTOMY ,MEDICAL care - Published
- 2018
- Full Text
- View/download PDF
15. Successful replantation of a bitten-off vermilion of the lower lip
- Author
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Wei, Ching-Yueh
- Subjects
- *
REIMPLANTATION (Surgery) , *TISSUE paper , *ORTHOPEDIC surgery , *PLASTIC surgery , *OPERATIVE surgery , *TRANSPLANTATION of organs, tissues, etc. - Abstract
Summary: Amputation of facial tissue presents difficult management problems, including cosmetic, functional, and psychological effects for the patient. A case of successful microsurgical replantation of a bitten-off vermilion of the lower lip is hereby reported. The outcome in this case was both functionally and cosmetically acceptable. A comprehensive review of the literature on the subject of lip replantation is also made in this communication. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
16. Evaluating the Usability and Equivalence of Electronic Patient-Reported Outcome Measures for Individuals with a Lower-Limb Amputation.
- Author
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Maronati, Rachel, Rigot, Stephanie K., Mummidisetty, Chaithanya K., Jayaraman, Chandrasekaran, Hoppe-Ludwig, Shenan, and Jayaraman, Arun
- Subjects
- *
PROSTHETICS , *CROSS-sectional method , *MEDICAL quality control , *RESEARCH funding , *QUESTIONNAIRES , *PATIENT care , *AMPUTEES , *DESCRIPTIVE statistics , *MANN Whitney U Test , *ELECTRONIC health records , *LEG amputation , *INTRACLASS correlation , *PSYCHOMETRICS , *HEALTH outcome assessment , *COMPARATIVE studies , *RELIABILITY (Personality trait) , *EVALUATION ,RESEARCH evaluation - Abstract
Introduction: Electronic versions of patient-reported outcome measures (PROMs) seem to have a clear administrative logging advantage to traditional paper versions. However, most of them have not been formally evaluated for their suitability to replace paper outcome measures for assessment of individuals with lower-limb amputations. The aim of this study is to examine the usability and equivalence of electronic to paper versions of PROMs suitable for use in prosthetic clinical care and research for persons with lower-limb loss. Methods: In this cross-sectional study, 10 participants remotely completed the following PROMs online and then on paper: Orthotic and Prosthetic User Survey (OPUS), Modified Falls Efficacy Scale (MFES), Prosthetic Evaluation Questionnaire (PEQ), Patient Health Questionnaire–9 (PHQ-9), and Community Participation Indicators (CPI). Participants also answered open-ended and standardized questions regarding the usability of the electronic surveys. Wilcoxon signed rank tests, comparisons to minimum detectable change, intraclass correlation coefficients, and Bland-Altman plots were used to evaluate differences between the two survey versions, meaningful changes in scores, reliability, and systematic biases, respectively. Results: Electronic surveys had fewer missing or ambiguous responses than paper surveys; however, the PEQ Social Burdens subscale could not be evaluated due to error in the creation of the electronic survey. No significant differences were found between scores of the two versions for any of the measures, but multiple participants had meaningful changes in the Appearance and Sounds PEQ subscales. All measures demonstrated acceptable reliability between versions, except the Appearance, Perceived Response, and Sounds subscales of the PEQ. No systematic biases in scores or usability concerns were found for any measures. Conclusions: This study analysis showed that most of the electronic PROMs studied are easily used and demonstrate equivalence to the paper versions. However, the PEQ Appearance, Perceived Response, Sounds, and Social Burden subscales require further evaluation. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
17. SIAMOC position paper on gait analysis in clinical practice: General requirements, methods and appropriateness. Results of an Italian consensus conference.
- Author
-
Benedetti, Maria Grazia, Beghi, Ettore, De Tanti, Antonio, Cappozzo, Aurelio, Basaglia, Nino, Cutti, Andrea Giovanni, Cereatti, Andrea, Stagni, Rita, Verdini, Federica, Manca, Mario, Fantozzi, Silvia, Mazzà, Claudia, Camomilla, Valentina, Campanini, Isabella, Castagna, Anna, Cavazzuti, Lorenzo, Del Maestro, Martina, Croce, Ugo Della, Gasperi, Marco, and Leo, Tommaso
- Subjects
- *
HUMAN locomotion , *CEREBRAL palsy , *AMPUTATION , *BRAIN injuries , *PHOTOGRAMMETRY , *MOVEMENT disorders , *GAIT in humans , *KINEMATICS , *MEDICAL protocols , *DIAGNOSIS - Abstract
Gait analysis is recognized as a useful assessment tool in the field of human movement research. However, doubts remain on its real effectiveness as a clinical tool, i.e. on its capability to change the diagnostic-therapeutic practice. In particular, the conditions in which evidence of a favorable cost-benefit ratio is found and the methodology for properly conducting and interpreting the exam are not identified clearly. To provide guidelines for the use of Gait Analysis in the context of rehabilitation medicine, SIAMOC (the Italian Society of Clinical Movement Analysis) promoted a National Consensus Conference which was held in Bologna on September 14th, 2013. The resulting recommendations were the result of a three-stage process entailing i) the preparation of working documents on specific open issues, ii) the holding of the consensus meeting, and iii) the drafting of consensus statements by an external Jury. The statements were formulated based on scientific evidence or experts' opinion, when the quality/quantity of the relevant literature was deemed insufficient. The aim of this work is to disseminate the consensus statements. These are divided into 13 questions grouped in three areas of interest: 1) General requirements and management, 2) Methodological and instrumental issues, and 3) Scientific evidence and clinical appropriateness. SIAMOC hopes that this document will contribute to improve clinical practice and help promoting further research in the field. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
18. Five-year outcomes after revascularization of superficial femoral artery occlusion using Ocelot catheter
- Author
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Adam Janas, Stefan R. Kiesz, Piotr P. Buszman, Paweł Buszman, and Przemysław Nowakowski
- Subjects
medicine.medical_specialty ,Percutaneous ,medicine.medical_treatment ,Population ,lcsh:Medicine ,030204 cardiovascular system & hematology ,Revascularization ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Restenosis ,superficial femoral artery occlusion ,medicine ,Deep Femoral Artery ,education ,Original Paper ,education.field_of_study ,optical coherence tomography ,medicine.diagnostic_test ,business.industry ,lcsh:R ,medicine.disease ,Surgery ,Catheter ,Amputation ,Angiography ,revascularization ,Cardiology and Cardiovascular Medicine ,business - Abstract
Introduction The population of patients with lower limb atherosclerosis includes a considerable proportion of individuals with long superficial femoral artery (SFA) lesions. Chronic total occlusions (CTOs) represent the "last frontier" of percutaneous interventions. While open strategies are considered earlier as standard management for these lesions, the results of a number of trials indicate that endovascular management might become an effective alternative to surgery. Material and methods This paper presents 5-year outcomes of a first-in-man (FIM) study (before CE mark) and the registry of OCT Guided Ocelot Catheter (Avinger) for chronic total occlusions of the superficial femoral artery. The study group comprised 10 patients with Rutherford 3 lower limb ischemia including nine men and one woman. Results The efficacy of the primary intervention was 90%. Angiography performed at 6 months of the procedure, according to the study protocol, revealed 3 and 1 cases of restenosis and reocclusion, respectively, repaired using PTA and open common and deep femoral artery patch plasty. Doppler ultrasound performed at 1, 2 and 5 years after the primary intervention did not reveal significant target vessel restenosis. The primary and primary-assisted patency was 89%. During a 5-year follow-up, four peripheral percutaneous interventions and one femoropopliteal bypass surgery were performed in non-target limbs. There were no cardiovascular deaths, myocardial infarction or stroke and no amputation was required. Conclusions This is a first-in-man study reporting long-term follow-up after SFA CTO revascularization using the Ocelot catheter. The catheter proved to have a satisfactory safety profile and a high proportion of CTO crossings. A 5-year follow-up revealed high primary and primary-assisted patency rates.
- Published
- 2019
19. Development of a Smart Fuzzy-PID Active Control System Without the need for Direct muscle or Brain Command Signals.
- Author
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Alzaydi, Ammar
- Subjects
INTELLIGENT control systems ,ARTIFICIAL knees ,USER experience ,AMPUTATION ,PROSTHETICS - Abstract
In an innovative approach to active prosthetic management, this paper introduces a method for intelligent control that circumvents the necessity of expensive sensory systems directly linked to user brain activity, such as muscle signals. The prosthesis autonomously determines the appropriate timing and nature of its movements, showcasing a unique control technique. The study also involves the development and evaluation of an advanced control system, alongside the establishment of a test platform for an Active Prosthetic Knee (APK). The scope of this research spans mechanical design, sensor integration, and motor control tailored to the APK. A noteworthy outcome of this study is the ability to fabricate a durable and cost-effective active prosthetic suitable for individuals with above-the-knee amputations. The resulting prosthetic demonstrates an enhanced capability to mimic the movement of a healthy limb with greater precision, all the while minimizing the physical strain on the patient's muscles. In terms of movement decision-making, the APK relies on analyzing the motion of the unaffected leg, thus eliminating the requirement for high-priced sensory systems traditionally connected to human brain signals. The intelligent control system has shown a significant improvement in movement precision compared to conventional models, and a reduction in the strain experienced by the user, marking significant strides in active prosthetic technology. [ABSTRACT FROM AUTHOR]
- Published
- 2023
20. War surgery in Afghanistan: a model for mass causalities in terror attacks?
- Author
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F. Wichlas, G. Strada, Christian Deininger, and V Hofmann
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Amputation, Surgical ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Low-income country ,Laparotomy ,medicine ,Humans ,War surgery ,Orthopedics and Sports Medicine ,Retrospective Studies ,Original Paper ,business.industry ,General surgery ,Afghanistan ,030208 emergency & critical care medicine ,Mean age ,Trauma surgery ,Causality ,Mass-casualty incident ,Amputation ,030220 oncology & carcinogenesis ,Orthopedic surgery ,Female ,Surgery ,Body region ,business - Abstract
Purpose The aim of the study was to identify solution strategies from a non-governmental (NGO) hospital in a war region for violence-related injuries and to show how high-income countries (HIC) might benefit from this expertise. Methods NGO trauma hospital in Lashkar Gah, Afghanistan. Four hundred eighty-four war victims admitted in a three month period (February 2016–May 2016) were included. Patients´ characteristics were analyzed. Results The mean age was 23.5 years. Four hundred thirty-four (89.9%) were male, and 50 (10.1%) were female. The most common cause of injury was bullet injuries, shell injuries, and mine injuries. The most common injured body region was the lower extremity, upper extremity, and the chest or the face. Apart from surgical wound care and debridements, which were performed on every wound in the operation theatre, laparotomy was the most common surgical procedure, followed by installation of a chest drainage and amputation. Conclusion The surgical expertise and clear pathways outweigh modern infrastructure. In case of a mass casualty incident, fast decision-making with basic diagnostic means in order to take rapid measurements for life-saving therapies could make the difference.
- Published
- 2020
21. Desirability of Difference: Georges Canguilhem and Body Integrity Identity Disorder.
- Author
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Gibson, Richard B
- Subjects
MEDICAL practice ,AMPUTATION ,PROSTHETICS - Abstract
Opponents of the provision of therapeutic, healthy limb amputation in Body Integrity Identity Disorder cases argue that such surgeries stand in contrast to the goal of medical practice – that of health restoration and maintenance. This paper refutes such a conclusion via an appeal to the nuanced and reflective model of health proposed by Georges Canguilhem. The paper examines the conceptual entanglement of the statistically common with the normatively desirable, arguing that a healthy body can take multiple forms, including that of an amputee, provided that such a form enables the continuing ability to initiate new norms of existence. It concludes that the practice of healthy limb amputation in cases of Body Integrity Identity Disorder is not only compatible with the goal of medicine but is potentially the only method of achieving this goal in the face of a complex and often mischaracterized disorder. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
22. Sexual functioning and self-esteem in women after mastectomy – a single-centre, non-randomised, cross-sectional study
- Author
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Agata Gastecka, Ewelina Monastyrska-Waszak, Aleksander Goch, Iwona Głowacka-Mrotek, Tomasz Nowikiewicz, Magdalena Tarkowska, and Wojciech Zegarski
- Subjects
medicine.medical_specialty ,sexual functioning ,Cross-sectional study ,medicine.medical_treatment ,media_common.quotation_subject ,Human sexuality ,Orgasm ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Internal medicine ,Medicine ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,media_common ,self-esteem ,Original Paper ,business.industry ,Self-esteem ,mastectomy ,medicine.disease ,Sexual dysfunction ,Oncology ,Amputation ,030220 oncology & carcinogenesis ,medicine.symptom ,business ,Mastectomy - Abstract
Aim of the study The goal of our study was to assess the sexual functioning of patients undergoing mastectomy, five years after surgery, compared to a control group. Material and methods A cross-sectional study included 170 patients five years post mastectomy (group A1) and 149 healthy women (group A2) who had never been diagnosed with breast cancer. The study was conducted at the Oncology Centre in Bydgoszcz, at the Amazon Clubs, and at the University of the Third Age by the University of Economy in Bydgoszcz. Standardised questionnaires: the Female Sexual Function Index (FSFI) and Rosenberg's SES (self-esteem scale) were used. Results Our study results show significantly worse sexual functioning in the domains pertaining to desire (p = 0.0015), arousal (p = 0.0052), lubrication (p = 0.0026), ability to reach orgasm (p = 0.0417), sexual satisfaction (p = 0.0142), and the presence of clinically significant sexual dysfunction (p = 0.0028) among patients after amputation of the mammary gland. On the scale of pain relating to sexuality, there were no significant differences between the two groups (p> 0.05). The overall score in the FSFI questionnaire was also lower (p = 0.0066) among women after mastectomy. Highly statistically significant (p < 0.0001) differences in self-esteem were also noted between the two groups, with worse results observed in patients after mastectomy. Conclusions Diagnosis of sexual dysfunction in patients treated for breast cancer allows timely implementation of counselling and interventional therapy depending on the causal factors and individual preferences of patients.
- Published
- 2020
23. Comparative analysis of the effect of tricalcium silicate cement and mineral trioxide aggregate on the cellular composition of the pulp after the vital amputation in experimental animals
- Author
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Khotimska Yu., Kovach I., Buniatian Kh., Kravchenko L., and Varzhapetian S.
- Subjects
Cement ,Mineral trioxide aggregate ,mineral trioxide aggregate ,Cellular composition ,experiment ,Chemistry ,medicine.medical_treatment ,lcsh:R ,lcsh:Medicine ,General Medicine ,Pulp and paper industry ,histology ,pulpitis ,pulpitis, tricalcium silicate, mineral trioxide aggregate, histology, experiment ,Amputation ,stomatognathic system ,tricalcium silicate ,medicine ,Pulp (tooth) ,Tricalcium silicate - Abstract
The purpose of the study was to determine the effect of tricalcium silicate cement on the protective process of pulp in the treatment of reversible pulpitis. There was carried out an experiment on 3-month-old male rabbits to study morphofunctional changes in the pulp tissue with modeling of reversible pulpitis followed by vital amputation with coating of the pulp with tricalcium silicate (8 animals, study group) and mineral trioxide aggregate (MTA) (8 animals, comparison group). In 2 and 6 weeks dental tissues were fixed by 10% formalin solution and after decalcification and done routine procedures, histological sections were made, stained with hematoxylin and eosin. After the application of tricalcium silicate cement in 2 weeks, the odontoblast density changed to 3.92±1.03×103/mm2from 8.3±1.02×103/mm2of cell density in the intact group. The number of neutrophils also plays a big role in the regeneration of inflamed pulp. Thus, in 2 weeks the number of neutrophils made up 6.39±2.61x102per 1mm2, which is 3 times less than after mineral trioxide aggregate usage – 19.49±2.85x102per 1mm2. It was established that the processes of rheological disorders with impaired lymph circulation are replaced by the restoration of the cellular component. In such a way the proposed vital amputation was examined for reversible pulpitis and it revealed similar clinical and pathological effectiveness with a positive regenerative process with formation of a sufficient number of odontoblasts (7.98±1.51×103/mm2) for the subsequent formation of a hard tissue bridge, which consists of collagen fibers in the form of a frame. The main goal of vital amputation procedure is regeneration (proliferation) of the pulp with a short-term signs of alteration and exudation, which is provided by the choice of material for the pulp covering. Thus, after the vital amputation of the pulp, followed by the use of tricalcium silicate cement 6 weeks after, the number of neutrophils was 1.39±0.72x102per 1mm2, which is 5 times less than after using mineral trioxide aggregate.
- Published
- 2019
24. Long-term follow-up in adults with extremity osteosarcoma: comparison of different surgical procedures – single-center experience
- Author
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Marcin Zdzienicki, Piotr Rutkowski, Tomasz Goryń, Iwona Ługowska, Bartłomiej Szostakowski, and Andrzej Pieńkowski
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medicine.medical_specialty ,medicine.medical_treatment ,limb reconstruction ,lcsh:Medicine ,Single Center ,03 medical and health sciences ,0302 clinical medicine ,osteosarcoma ,amputation ,Medicine ,combined treatment ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Stage (cooking) ,Original Paper ,business.industry ,Standard treatment ,Gold standard ,lcsh:R ,Cancer ,medicine.disease ,Surgery ,Oncology ,Amputation ,030220 oncology & carcinogenesis ,Localized disease ,Osteosarcoma ,business - Abstract
Introduction Osteosarcoma is the most common primary malignant bone tumor in adults and is usually located in long bones. Standard treatment consists of perioperative chemotherapy and radical surgical resection. In the case of the extremity location, the gold standard is limb-sparing surgery (LSS) using a variety of reconstructive techniques. Aim of the study To assess long-term results of adults patients treated for limb osteosarcoma in our referral center depending on the method of surgical treatment. Material and methods In our study, we analyzed 175 adult patients with localized disease (American Joint Committee on Cancer [AJCC] stage I-III) treated for extremity osteosarcoma at our institution between 2000 and 2017. The median observation time was 41 months (3-225 months). 111 patients were treated with LSS (80 patients had tumor resection followed by endoprosthetic reconstruction, 31 patients had local resection without reconstruction) and 64 patients underwent amputation. Results 5-year overall survival (OS) and progression-free survival (PFS) in the study group were 62% and 52% and the life expectancy was on average 136 months. In the group of patients treated with LSS, 5-year OS and PFS were 66% and 59%, respectively, and life expectancy was 147 months, while in the group of patients undergoing amputation 5-year OS, PFS and life expectancy were 55%, 42% and 117 months. Conclusions The best results in the treatment of extremity osteosarcoma were achieved in a group of patients without distant metastases at the time of diagnosis, treated with perioperative chemotherapy and radical resection followed by endoprosthetic reconstruction.
- Published
- 2019
25. Towards Starting a Hand Transplant Unit and Achieving Success in a Hand Transplant: The Standard Operating Procedure.
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Puri, Vinita, Venkateshwaran, Narasiman, Shrotriya, Raghav, and Chalwade, Chandrashekhar
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STANDARD operating procedure ,SUCCESS ,FACIAL transplantation - Abstract
Vascularized Composite Tissue Allotransplantation (VCA) allows replacement of lost body parts from brain-dead donors. These surgeries are laborious, time-intensive, and require vast planning. With the advent of better immunosuppressants, VCA will increasingly play an important role in the reconstructive field. In this paper, the authors share their standard operating protocol created after much deliberation. [ABSTRACT FROM AUTHOR]
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- 2024
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26. Ageing with (and into) assistive technology: an exploration of the narratives of amputees and polio survivors.
- Author
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Johnstone, Lewis, Almukhtar, Ali, DePasquale, Rebecca, Warren, Narelle, and Block, Pamela
- Subjects
- *
PSYCHOLOGICAL aspects of aging , *PATIENT autonomy , *POLIO patients , *INTERVIEWING , *AMPUTEES , *DESCRIPTIVE statistics , *PSYCHOLOGICAL adaptation , *DECISION making , *ASSISTIVE technology , *THEMATIC analysis , *BIOGRAPHY (Literary form) , *PATIENTS' attitudes , *SELF-perception - Abstract
Assistive technologies (AT) perform an important social role, interacting with cultural systems to produce or hinder accessibility to biosocial environments. This interaction profoundly shapes not only how an individual body can be experienced by users but also produce and hinder accessibility to biosocial environments. AT users have historically been viewed through a medical model, which deems them disabled by their impairments and by dominant ableist narratives. Therefore, this paper serves to provide an insight into the importance of ageing with and into AT. This paper aims to investigate polio survivors' and diabetic amputees' experiences of assistive technologies in order to better understand impacts upon narrative and identity. By applying an anthropological and sociological lens, a holistic view of the experiences of polio survivor and amputee AT users is developed. This paper draws on 16 in-depth interviews with polio survivors and diabetic amputees in the United States (US) and Australia, which were analysed using an experience-centered narrative approach. Both projects were approved by ethics boards. All participants provided written consent. Five themes were identified: a) disruption to biographies, which reflected AT impact on how narratives become altered; b) impacts to autonomy, which reflected the importance of regaining previous daily activities; c) re-engaging with community life, which highlighted how AT supported participation in valued activities; d) self-perceptions of assistive technologies, which act in opposition to external perspectives and challenge ableist narratives; and e) an intergenerational comparison of new and older AT users highlights the importance of temporalities. This paper offers new perspectives on ageing with assistive technologies, with a focus on identity and narrative. The importance of this paper is to contribute to the existing literature that demonstrates the cultural implications that arise through embodiment and assistive technologies. The use of assistive technology can help individuals regain function, but the individual circumstances require consideration The use of assistive technology is a complex entanglement of bodies, environments, biographies, and imagined futures. The use of assistive technology can provide participants autonomy over their narratives and assist with maintaining their identities [ABSTRACT FROM AUTHOR]
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- 2024
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27. Amputation of the upper extremity due to chronic, refractory CRPS: a case report.
- Author
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Żyluk, Andrzej
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ARM amputation ,RESIDUAL limbs ,COMPLEX regional pain syndromes ,LITERATURE reviews ,REFRACTORY materials ,AMPUTATION - Abstract
Chronic refractory complex regional pain syndrome (CRPS) is the severest form of this condition characterised by acute pain, other painful phenomena (hyperpathia, allodynia), severe functional impairment of the affected extremity and non-responsiveness to standard treatments. This paper presents a case of a 40-year-old man suffering from this form of CRPS, in whom all treatment options, including non-standard appeared ineffective. The patient suffered from intractable pain and a completely disabled extremity was considered by him a burden, additionally affecting his daily living. After a review of the literature and informing the patient about the potential benefits and the potential risk of failure of surgery, at the request of the patient an amputation of the upper extremity was performed at the level of 1/3 distal arm. The postoperative course was uneventful, but amputation did not result in cessation of the pain which persisted in the residual limb. The presented case shows that limb amputation for chronic refractory CRPS may not give expected beneficial effect. [ABSTRACT FROM AUTHOR]
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- 2024
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28. Efficacy of mirror therapy, motor imagery, and visual feedback in the treatment of phantom limb pain after amputation: an updated systematic review.
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Junus Huwae, Thomas Erwin Christian, Sananta, Panji, Lestari, Dwi Indriani, Santoso, Agung Riyanto Budi, and Dhamayanti, Aulia Syavitri
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MOTOR imagery (Cognition) ,PHANTOM limbs ,AMPUTATION ,MIRRORS ,QUALITY of life - Abstract
Introduction: Phantom limb pain affects 50 percent to 85 percent of patients who have had their limbs amputated, lowering their quality of life. Clinical therapies for central pain, such as mirror therapy, motor imagery, or visual feedback, might help amputee patients suffering from phantom limb pain. Objectives: To provide a general review of the efficacy of various approaches for treating phantom limb discomfort in amputee patients. Methods: The following databases were used for a computerized literature search up to March 2022: PubMed, ScienceDirect, and Google Scholar. The modified Jadad score is utilized to measure study quality in this research. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines were followed while conducting this systematic review. Results: In all, 15 papers matched our inclusion criteria, with 5 receiving a low study quality rating and 10 receiving a good study quality rating. All the studies revealed a considerable decrease in pain; however, the patients and techniques varied. Conclusion: Mirror therapy, motor imagery, and visual feedback can alleviate phantom limb pain. However, there is a lack of scientific data to support their efficacy. Future studies should use more powerful research methodologies to investigate these medicines' short- and long-term advantages. [ABSTRACT FROM AUTHOR]
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- 2024
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29. Modified Tibial Tuberosity Advancement Rapid in a Dog with One Contralateral Amputated Limb.
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Ober, Ciprian, Dragomir, Mădălina, Aștilean, Andreea, McCartney, William, Yiapanis, Christos, and Milgram, Joshua
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ANTERIOR cruciate ligament ,DOG breeds ,STIFLE joint ,DOGS ,HINDLIMB ,DOG walking ,DOG breeding - Abstract
Simple Summary: Cranial cruciate ligament disease is a very common source of pelvic limb lameness in dogs, and many techniques have been used to resolve this condition. Tibial tuberosity advancement (TTA) rapid technique is a new simplified option with very good results reported. Adding a small Steinmann pin distal to the cage prevents avulsion of the tibial tuberosity by quadriceps mechanism. In this report, we describe the first modified TTA rapid technique in a dog with a contralateral amputated limb. The dog was a five-year-old mixed breed with amputated right pelvic limb and difficulty walking. The dog started to walk unassisted second day postoperative, and at three months follow-up evaluation it showed no lameness and the osteotomy was completely healed. Cranial cruciate ligament disease (CCLD) is one of the most frequent causes of hindlimb lameness in dogs. Tibial tuberosity advancement (TTA) is a common surgery performed for CCLD. A modified, simplified technique (TTA Rapid) is also reported to have very good clinical outcomes. In this paper, we report a modified TTA Rapid technique to treat a CCLD in a dog with an amputated contralateral hindlimb. A 5-year-old mixed breed dog presented with amputated right hindlimb and difficulty walking. Pain and positive drawer sign were present at manipulation of left stifle joint. Radiographic findings of the stifle joint confirmed the presence of moderate osteoarthritis associated with CCLD, and modified TTA Rapid procedure was performed. Recovery from surgery was uneventful, and the dog was able to stand by his own by the second day postoperative. At three months follow-up evaluation, the dog was free of lameness and the osteotomy site was completely healed. This paper describes the first modified TTA rapid osteotomy technique performed in a dog with a contralateral amputated hindlimb. [ABSTRACT FROM AUTHOR]
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- 2022
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30. Thirtieth Anniversary Issue of Clinical Rehabilitation: an introductory editorial.
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Wade, Derick T.
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AGE distribution ,AMPUTATION ,COGNITION disorders ,EMOTIONS ,GOAL (Psychology) ,REHABILITATION ,SERIAL publications ,SPECIAL days ,LUMBAR pain - Abstract
An introduction is presented which discusses various topics within the issue which discusses various topics within the issue including use of goal setting in the rehabilitation of people, clinical rehabilitation and healthcare activity in rehabilitation of people.
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- 2016
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31. Partial Hand Amputation: A Case Study.
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Powell, Victoria
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AFRICAN Americans ,AMPUTATION ,AMPUTEES ,PROSTHETICS ,ABILITY testing ,PAPER mills ,WOUNDS & injuries - Abstract
The article presents a case study of an African-American woman whose three middle fingers on the right hand were cut after being crushed by rollers at a paper mill where she works. She was stabilized in the emergency room and underwent partial amputation of the index and long fingers at the metacarpal joint and of the ring finger at the proximal interphalangeal joint. The skills testing assessment used to identify what her specific deficits without the prosthesis is explored.
- Published
- 2009
32. Daily socket comfort in transtibial amputee with a vacuum-assisted suspension system: study protocol of a randomized, multicenter, double-blind multiple N-of-1 trial.
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Klotz, Rémi, Emile, Guilhem, Daviet, Jean-Christophe, De Sèze, Mathieu, Godet, Julien, Urbinelli, Renaud, and Krasny-Pacini, Agata
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RESIDUAL limbs ,MOTOR vehicle springs & suspension ,RESEARCH protocols ,SCIENTIFIC method ,REHABILITATION centers ,AMPUTEES - Abstract
Background: The main aim of this paper is to present the feasibility of rigorously designed multiple N-of-1 design in prosthetics research. While research of adequate power and high quality is often lacking in rehabilitation, N-of-1 trials can offer a feasible alternative to randomized controlled group trials, both increasing design power at group level and allowing a rigorous, statistically confirmed evaluation of effectiveness at a single patient level. The paper presents a multiple N-of-1 trial protocol, which aim is to evaluate the effectiveness of Unity, a prosthetic add-on suspension system for amputees, on patient-reported comfort during daily activities (main outcome measure), prosthesis wearing time, perception of limb-prosthesis fitting and stump volume and functional walking parameters. Methods: Multicenter, randomized, prospective, double-blind multiple N-of-1 trial using an introduction/withdrawal design alternating Unity connected/disconnected phases of randomized length on twenty patients with unilateral transtibial amputation. The primary outcome measure is the Prosthetic Socket Comfort Score (SCS), a validated measure of comfort, administered daily by an phone app designed for the study. Secondary outcomes measures will be collected during the 50 days period of the N-of-1 trial: (1) by the same app, daily for patient-reported limb-prosthesis fitting, stump volume variation, and daily wearing time of the prosthesis; (2) by a pedometer for the number of steps per day; (3) by blind assessors in the rehabilitation center during adjustment visits for functional walking parameter (L-Test, 6-minute walk test), and by the patient for the QUEST, and ABC-S. Effectiveness of the Unity system regarding SCS and daily secondary outcome measures will be tested by randomization test. The secondary outcome measures assessed during visits in the rehabilitation center will be analyzed by Non Overlap of All pairs. An estimate of the effect on the amputee population will be generated by aggregating each individual clinical trial (N-of-1 trial) by Hierarchical Bayesian methods. Discussion: This study protocol was designed to answer the question "which device is best for THIS patient" and to conclude at a group level on the effectiveness of a new devic, using a Multiple N-of-1 trial, which is promising but underused in prosthetics research so far. Trial registration: N° ID-RCB 2020-A01309-30 Clintrial.gov : NCT04804150 - Retrospectively registered March 20th 2021. Keys messages: Multiple N-of-1 trials represent a switch in the rationale behind the choice of a medical device. Instead of selecting prosthetics based on the mean response to the device of a group of participants, multiple N-of-1 trials allow to answer the question "which device is best for THIS patient", using a rigorous, recognized, scientific methodology allowing individual results as well as group analysis. This Multiple N-of-1 trials is an approach in an ecological environment and with daily measures that will provide data closer to daily prosthetic use than trials testing device effectiveness outside of daily life; [ABSTRACT FROM AUTHOR]
- Published
- 2023
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33. Suicide and accidental deaths among patients with primary malignant bone tumors
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Renpeng Peng, Feng Li, Ying Chen, Kehan Song, Yimin Dong, Bian Wu, Honglei Kang, and Kaixu Yu
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0301 basic medicine ,medicine.medical_specialty ,Population ,Diseases of the musculoskeletal system ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Epidemiology ,Medicine ,Amputation ,education ,RC254-282 ,education.field_of_study ,business.industry ,Proportional hazards model ,Hazard ratio ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Cancer ,medicine.disease ,Confidence interval ,Suicide ,030104 developmental biology ,Standardized mortality ratio ,RC925-935 ,Oncology ,030220 oncology & carcinogenesis ,Accidental ,business ,Malignant bone tumors ,Psychological disorders ,Research Paper - Abstract
Highlights • This is the first study about suicide and accident death in patients with bone tumors. • Patients had higher risk of suicide and accident death than all residents. • Amputation increased suicidal risk but did not increase the risk of accident death. • Clinicians should pay more attention to the psychological status in these survivors., Background It has been recognized that cancer is associated with a higher risk of suicide or accidental death. Earlier studies have evidenced that patients with malignant bone tumors usually experience psychological dysfunction and physical disability following surgery, which are shared risk factors between suicidal and accidental deaths. To our knowledge, there is no large population-based study on the risk of suicide or accidental death among patients with malignant bone tumors. Questions/purposes This study aimed to determine whether patients with primary malignant bone tumors are at a higher risk of suicide and accidental death than the general population and to identify the demographic and tumour-related characteristics and type of surgery associated with a higher risk of suicide and accidental death among these patients. Methods Overall, 50,817 patients diagnosed with primary malignant bone tumors between 1973 and 1975 were identified from the Surveillance, Epidemiology, and End Results database. The standardised mortality ratio (SMR) was calculated based on the general population’s mortality data, gathered by the National Center for Health Statistics. The Cox regression model was developed to determine risk factors associated with a higher risk of suicide and accidental death. Results Patients with primary malignant bone tumors had a higher risk of suicide and accidental death than the general population in the United States (US) (SMR = 2.17; 95% confidence interval (CI) [1.80–2.62] and SMR = 1.73; 95% CI [1.54–1.95]). Compared with limb salvage, amputation significantly increased the risk of suicide (SMR = 3.99; 95% CI [2.52–6.34], hazard ratio (HR) = 2.32; 95% CI [1.31–4.09]; P
- Published
- 2021
34. All-Cause Mortality Amongst Patients Undergoing Above and Below Knee Amputation in a Regional Vascular Centre within 2014-2015
- Author
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Kennedy, GEM, McGarry, K, Bradley, G, and Harkin, DW
- Subjects
Adult ,Aged, 80 and over ,Male ,Peripheral Vascular Diseases ,Vascular Surgery ,Kaplan-Meier Estimate ,Northern Ireland ,Venous Thromboembolism ,Middle Aged ,Amputation, Surgical ,All-Cause Mortality ,Deep Vein Thrombosis ,Diabetes Complications ,Postoperative Complications ,Treatment Outcome ,Lower Extremity ,Cause of Death ,Clinical Paper ,Humans ,Female ,Amputation ,Pulmonary Embolism ,Aged ,Retrospective Studies - Abstract
Background Major lower limb amputation remains a common treatment for patients with peripheral vascular disease (PVD) in whom other measures have failed. It has been associated with high morbidity and mortality, including risks from venous thromboembolism (VTE). Methods A two-year retrospective cohort study was conducted involving 79 patients who underwent major lower limb amputation (below- or above-knee amputation) between January 2014 and December 2015 in a single tertiary referral centre. Amputation procedures were performed for reasons relating to complications of PVD and/or diabetes mellitus. Patients were followed-up to investigate all-cause mortality rates and VTE events using the Northern Ireland Electronic Care Record database (mean follow-up time 17 months). Results Of the 79 patients, there were 52 male and 27 female. Mean age at time of surgery was 72 years (range 34-99 years). Forty-six patients (58%) suffered from diabetes mellitus, 29 (35%) heart failure, 31 (39%) chronic kidney disease (CKD) and 10 (13%) chronic obstructive pulmonary disease (COPD). Twenty patients (25%) were on anticoagulant therapy, and 53 (67%) were on antiplatelet therapy. Thirty-five patients (44%) died during follow-up; mean age at death was 74 years. No statistically significant association was found between mortality rate and the level of amputation (p=0.3702), gender (p=0.3507), or comorbid diabetic mellitus (p=0.1127), heart failure (p=0.1028), CKD (p=0.0643) or COPD (p=0.4987). Two patients experienced radiologically-confirmed non-fatal pulmonary emboli and two patients developed radiologically-confirmed deep vein thrombosis. Conclusions The results are in agreement with current literature that amputation is associated with significant mortality, with almost half of the study population dying during follow-up. Further work should explore measures by which mortality rates may be reduced.
- Published
- 2019
35. Non-Invasive Sensory Input Results in Changes in Non-Painful and Painful Sensations in Two Upper-Limb Amputees.
- Author
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Lontis, Eugen Romulus, Yoshida, Ken, and Jensen, Winnie
- Subjects
ARTIFICIAL limbs ,SENSORIMOTOR integration ,PAIN measurement ,PHANTOM limbs ,REGENERATION (Biology) ,PERIPHERAL nervous system ,ARM ,AMPUTEES ,ELECTRIC stimulation ,VIBRATION (Mechanics) ,RESEARCH funding ,PROSTHESIS design & construction ,AMPUTATION - Abstract
Designs of active prostheses attempt to compensate for various functional losses following amputation. Integration of sensory feedback with the functional control re-enables sensory interaction with the environment through the prosthetic. Besides the functional and sensory loss, amputation induces anatomical and physiological changes of the sensory neural pathways, both peripherally and centrally, which can lead to phantom limb pain (PLP). Additionally, referred sensation areas (RSAs) likely originating from peripheral nerve sprouting, regeneration, and sensory reinnervation may develop. RSAs might provide a non-invasive access point to sensory neural pathways that project to the lost limb. This paper aims to report on the sensory input features, elicited using non-invasive electrical stimulation of RSAs that over time alleviated PLP in two upper-limb amputees. The distinct features of RSAs and sensation evoked using mechanical and electrical stimuli were characterized for the two participants over a period of 7 and 9 weeks, respectively. Both participants received transradial and transhumeral amputation following traumatic injuries. In one participant, a relatively low but stable number of RSAs provided a large variety of types of evoked phantom hand (PH) sensations. These included non-painful touch, vibration, tingling, stabbing, pressure, warmth/cold as well as the perception of various positions and movements of the phantom hand upon stimulation. Discomforting and painful sensations were induced with both mechanical and electrical stimuli. The other participant had a relatively large number of RSAs which varied over time. Stimulation of the RSAs provided mostly non-painful sensations of touch in the phantom hand. Temporary PLP alleviation and a change in the perception of the phantom hand from a tight to a more open fist were reported by both participants. The specificity of RSAs, dynamics in perception of the sensory input, and the associated alleviation of PLP could be effectively exploited by designs of future active prostheses. As such, techniques for the modulation of the sensory input associated with paradigms from interaction with the environment may add another dimension of protheses towards integrating personalized therapy for PLP. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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36. Body Integrity Dysphoria and "Just" Amputation: State-of-the-Art and Beyond.
- Author
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Loriga, Leandro
- Abstract
This paper presents the foundation upon which the contemporary knowledge of body integrity dysphoria (BID) is built. According to the World Health Organisation's International Classification of Diseases, 11th edition (ICD-11), the main feature of BID is an intense and persistent desire to become physically disabled in a significant way. Three putative aetiologies that are considered to explain the insurgence of the condition are discussed: neurological, psychological and postmodern theories. The concept of bodily representation within the medical context is highlighted, with the concept of dysphoria, which was brought to the fore with the introduction of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), and the ICD-11. Contemporary issues of "justice" are addressed to identify ethically relevant distinctions between BID and sex reassignment surgery. It is argued that there is no ethically relevant difference between the BID actor's desire for invasive surgical intervention and the wish of gender dysphoric individuals to undergo sex reassignment surgery procedures. Some BID actors self-mutilate, and this presents medical professionals with difficult choices regarding whether or not to intervene in order to satisfy the BID patient's desire. Both abstention and intervention may lead to severe ethical complications for doctors and patients despite the positive outcomes in terms of quality of life for BID individuals who manage to undergo such procedures. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
37. Design trends in actuated lower-limb prosthetic systems: a narrative review.
- Author
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Sun, Haoran, He, Chaoming, and Vujaklija, Ivan
- Subjects
BRAIN-computer interfaces ,MOTOR vehicle springs & suspension ,RESEARCH personnel ,PROSTHETICS ,MEDICAL personnel - Abstract
Actuated lower limb prostheses, including powered (active) and semi-active (quasi-passive) joints, are endowed with controllable power and/or impedance, which can be advantageous to limb impairment individuals by improving locomotion mechanics and reducing the overall metabolic cost of ambulation. However, an increasing number of commercial and research-focused options have made navigating this field a daunting task for users, researchers, clinicians, and professionals. The present paper provides an overview of the latest trends and developments in the field of actuated lower-limb prostheses and corresponding technologies. Following a gentle summary of essential gait features, we introduce and compare various actuated prosthetic solutions in academia and the market designed to provide assistance at different levels of impairments. Correspondingly, we offer insights into the latest developments of sockets and suspension systems, before finally discussing the established and emerging trends in surgical approaches aimed at improving prosthetic experience through enhanced physical and neural interfaces. The ongoing challenges and future research opportunities in the field are summarized for exploring potential avenues for development of next generation of actuated lower limb prostheses. In our opinions, a closer multidisciplinary integration can be found in the field of actuated lower-limb prostheses in the future. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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38. Response—Forty-Seven Years Later: Further Studies in Disappointment?
- Author
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Loughlin, Michael
- Subjects
LENGTH of stay in hospitals ,PERIPHERAL vascular diseases ,DISABILITY evaluation ,AMPUTEES ,PHILOSOPHY of medicine ,AMPUTATION ,ECONOMIC aspects of diseases - Abstract
This paper provides a commentary on "Vascular amputees: A study in disappointment" (Little et al. 1974) and its significance in the development of the disability rights movement, as well as the movements for values-based medicine and person-centred health and social care. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
39. Effectiveness of Frontal Plane Adaptability in a Novel Foot Prosthesis
- Author
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United States Department of Defense and Murray Maitland, Professor-Associate: Department of Rehabilitation Medicine
- Published
- 2024
40. RESEARCH ON OPTIMIZING THE CONSTRUCTION OF TROUSERS FOR PEOPLE WITH AMPUTATIONS USING 3D SIMULATION.
- Author
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Elena, FLOREA-BURDUJA, Aliona, RARU, Daniela, FARÎMA, and Marcela, IROVAN
- Subjects
PROSTHETICS ,LEG amputation ,AMPUTATION ,PANTS - Abstract
The construction features of waist support products depend on current fashion trends, the specific requirements imposed on the products by potential wearers and the characteristics of the materials used and of course the methodology for developing the basic construction. In the case of people with lower limb amputations, the construction also depends on the type of prosthesis and its size. The paper presents the results of the study to optimize the construction of trousers for men with amputations in the leg. The topicality of the theme is determined by the alarming increase in the number of amputations and the increased interest of specialists in creating clothing for people with disabilities. The paper aims to identify the methodology for improving the construction of the product of trousers for people with amputations of the lower limbs, using 3D simulation. The general objective of this paper is to propose a succession of optimization of the basic pattern in order to be able to be customized according to the type of amputation. The paper presents the initial data necessary in the elaboration of a customized construction. Also presented are the stages of optimizing the construction of the pants and the simulations on the body of the avatar of the pattern, even after performing the optimization. The use of 3D software allows obtaining the wearer's avatar and assigning unique features, which are taken into account when designing custom clothing products. They also allow you to check the position of the products on the body of the avatar and modify them according to the requirements. [ABSTRACT FROM AUTHOR]
- Published
- 2022
41. Clinical characteristics and risk factors analysis of lung metastasis from benign giant cell tumor of bone☆
- Author
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Yongkun Yang, Weifeng Liu, Hairong Xu, Xiaohui Niu, Yuan Li, and Zhen Huang
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medicine.medical_specialty ,lcsh:Diseases of the musculoskeletal system ,medicine.medical_treatment ,lcsh:RC254-282 ,Metastasis ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Stage (cooking) ,Survival rate ,030222 orthopedics ,Lung ,business.industry ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,Primary tumor ,Curettage ,Surgery ,medicine.anatomical_structure ,Oncology ,Amputation ,030220 oncology & carcinogenesis ,lcsh:RC925-935 ,business ,Giant-cell tumor of bone ,Research Paper - Abstract
Pulmonary metastasis of benign giant cell tumor of bone is very rare, and its biological behavior is difficult to predict. In the present study, we analyzed the clinical characteristics of and related risk factors for pulmonary metastasis from this tumor. Forty-six patients with lung metastasis were analyzed. In total, 60.9% of the primary tumors were located around the knee joint. The Campanacci stage of all tumors was stage 3. Surgery of the primary tumor included curettage in 37 patients, resection in 8, and amputation in 1. Local recurrence after the primary surgery occurred in 34 patients. The recurrence rate, Campanacci stage, and surgical method were significant risk factors for lung metastasis. The median postoperative metastasis times in the lower limbs, upper limbs, and axial skeleton were 20.1, 7.9, and 1.4 months, respectively (p=0.010). The median metastasis times in patients with and without recurrence were 13.7 and 43.2 months, respectively (p=0.018). Eighteen patients had unilateral metastasis and 28 had bilateral metastasis. Most lesions (n=38) were located in the peripheral lung. Nineteen patients received treatment, and 12 of them underwent tumor resection. The 5-year overall survival rate was 94.4%. This study showed that local recurrence, a high Campanacci stage, and curettage were possible high-risk factors for pulmonary metastasis. The primary lesion site and local recurrence may be related to the metastasis time. The survival rate of patients with pulmonary metastasis was high.
- Published
- 2017
42. Efficacy of Antibiotic Suppressive Therapy in Patients with a Prosthetic Joint Infection
- Author
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Greetje A. Kampinga, Sander van Assen, Paul C Jutte, Marjan Wouthuyzen-Bakker, Jasperina M Nijman, Man, Biomaterials and Microbes (MBM), Public Health Research (PHR), and Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE)
- Subjects
medicine.medical_specialty ,medicine.drug_class ,medicine.medical_treatment ,Arthrodesis ,Antibiotics ,antibiotic suppressive therapy ,Prosthesis ,03 medical and health sciences ,0302 clinical medicine ,lcsh:Orthopedic surgery ,Journal Article ,medicine ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,prosthetic joint infection ,030222 orthopedics ,business.industry ,Clindamycin ,Surgery ,side effects ,lcsh:RD701-811 ,Infectious Diseases ,Tolerability ,Amputation ,Joint pain ,Implant ,medicine.symptom ,business ,Research Paper ,medicine.drug - Abstract
Introduction: For chronic prosthetic joint infections (PJI), complete removal of the infected prosthesis is necessary in order to cure the infection. Unfortunately, a subgroup of patients is not able to undergo a revision surgery due to high surgical risk. Alternatively, these patients can be treated with antibiotic suppressive therapy (AST) to suppress the infection. Aim: To evaluate the efficacy and tolerability of AST. Methods: We retrospectively collected data (period 2009-2015) from patients with a PJI (of hip, knee or shoulder) who were treated with AST at the University Medical Center Groningen, the Netherlands. AST was defined as antibiotic treatment for PJI that was started after the usual 3 months of antibiotic treatment. The time of follow-up was defined from the time point AST was started. Treatment was considered as failed, when the patient still experienced joint pain, when surgical intervention (debridement, removal, arthrodesis or amputation) was needed to control the infection and/or when death occurred due to the infection. Results: We included 21 patients with a median age of 67 years (range 21 - 88) and with a median follow-up of 21 months (range 3 - 81). Coagulase negative staphylococci (CNS) (n=6), S. aureus (n=6) and polymicrobial flora (n=4) were the most frequently found causative pathogens. Most patients with CNS and S. aureus were treated with minocycline (67%) and clindamycin (83%) as AST, respectively. Overall, treatment was successful in 67% of patients. Failure was due to persistent joint pain (n=1), surgical intervention because of an uncontrolled infection (n=3), and death due the infection (n=3). We observed a treatment success of 90% in patients with a 'standard' prosthesis (n=11), compared to only 50% in patients with a tumor-prosthesis (n=10). Also, treatment was successful in 83% of patients with a CNS as causative microorganism for the infection, compared to 50% in patients with a S. aureus. Patients who failed on AST had a higher ESR in comparison to patients with a successful treatment (mean 73 ± 25SD versus 32 ± 19SD mm/hour (p = 0.007), respectively. 43% of patients experienced side effects and led to a switch of antibiotic treatment or a dose adjustment in almost all of these patients. Conclusions: Removal of the implant remains first choice in patients with chronic PJI. However, AST is a reasonable alternative treatment option in a subgroup of patients with a PJI who are no candidate for revision surgery, in particular in patients with a 'standard' prosthesis and/or CNS as the causative micro-organism.
- Published
- 2017
43. Development of predictive nomograms for clinical use to quantify the risk of isolating resistance prone organisms in patients with infected foot ulcers
- Author
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J. C. Lantis, Arsheena Yassin, C. F. Stavropoulos, F. Liu, K. Bui, F. Lin, A. Pakholskiy, Andras Farkas, and G. L. An
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0301 basic medicine ,Male ,medicine.medical_specialty ,Epidemiology ,medicine.medical_treatment ,030106 microbiology ,Population ,MRSA ,Risk Assessment ,resistance ,03 medical and health sciences ,0302 clinical medicine ,stewardship ,Risk Factors ,Internal medicine ,Drug Resistance, Bacterial ,medicine ,Prevalence ,Humans ,030212 general & internal medicine ,Risk factor ,education ,Aged ,Retrospective Studies ,Gangrene ,education.field_of_study ,Original Paper ,Bacteria ,business.industry ,Diabetes ,Retrospective cohort study ,Odds ratio ,Bacterial Infections ,Middle Aged ,medicine.disease ,Confidence interval ,foot ulcer ,United States ,Nomograms ,Infectious Diseases ,Amputation ,Pseudomonas aeruginosa ,Female ,business ,Empiric therapy - Abstract
Pseudomonas aeruginosaand methicillin-resistantStaphylococcus aureus(MRSA) have been considered prevalent pathogens in foot infections. However, whether empiric therapy directed against these organisms is necessary, and in whom to consider treatment, is rather unclear. The aim of this study was to develop predictive algorithms for forecasting the probability of isolating these organisms in the infected wounds of patients in a population where the prevalence of resistant pathogens is low. This was a retrospective study of regression model-based risk factor analysis that included 140 patients who presented with infected, culture positive foot ulcers to two urban hospitals. A total of 307 bacteria were identified, most frequently MRSA (11.1%).P. aeruginosaprevalence was 6.5%. In the multivariable analysis, amputation (odds ratio (OR) 5.75, 95% confidence interval (CI) 1.48–27.63), renal disease (OR 5.46, 95% CI 1.43–25.16) and gangrene (OR 2.78, 95% CI 0.82–9.59) were identified as risk factors associated with higher while diabetes (OR 0.07, 95% CI 0.01–0.34) and Infectious Diseases Society of America infection severity >3 (OR 0.18, 95% CI 0.03–0.65) were associated with lower odds ofP. aeruginosaisolation (Cstatistic 0.81). Similar analysis for MRSA showed that amputation was associated with significantly lower (OR 0.29, 95% CI 0.09–0.79) risk, while history of MRSA infection (OR 5.63, 95% CI 1.56–20.63) and osteomyelitis (OR 2.523, 95% CI 1.00–6.79) was associated with higher odds of isolation (Cstatistic 0.69). We developed two predictive nomograms with reasonable to strong ability to discriminate between patients who were likely of being infected withP. aeruginosaor MRSA and those who were not. These analyses confirm the association of some, but also question the significance of other frequently described risk factors in predicting the isolation of these organisms.
- Published
- 2019
44. Mechanical rotational thrombectomy with Rotarex system augmented with drug-eluting balloon angioplasty vs. stenting for the treatment of acute thrombotic and critical limb ischaemia in the femoropopliteal segment
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Marian Simka, Paweł Latacz, Marek Piwowarczyk, Tadeusz Popiela, and Paweł Brzegowy
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medicine.medical_specialty ,Acute limb ischaemia ,Urology ,medicine.medical_treatment ,lcsh:Medicine ,030204 cardiovascular system & hematology ,Balloon ,03 medical and health sciences ,mechanical thrombectomy ,0302 clinical medicine ,acute limb ischaemia ,Angioplasty ,medicine ,030212 general & internal medicine ,critical ischaemia ,Original Paper ,business.industry ,Mortality rate ,lcsh:R ,Gastroenterology ,Obstetrics and Gynecology ,Stent ,Thrombolysis ,medicine.disease ,Surgery ,Dissection ,drug-eluting balloon ,Amputation ,stent ,business - Abstract
Introduction Mechanical thrombectomy is an alternative to local thrombolysis for the treatment of severe ischaemia in the femoropopliteal segment, but stent implantation is usually required after this procedure. The use of drug-eluting balloons (DEBs) may overcome long-term problems associated with stents, but it remains unclear how often such a treatment is technically feasible and efficient. Aim This post hoc single-centre study was aimed at assessment of the feasibility, safety and efficacy of mechanical thrombectomy followed by application of DEBs. Material and methods Fifty-one patients, aged 69.1 ±11.6 years, were managed for acute thrombotic or chronic critical ischaemia in the femoropopliteal segment using the Rotarex device. Following mechanical thrombectomy, on condition that there was no significant residual stenosis or dissection, lesions were managed with paclitaxel-coated DEBs, which was a desired strategy (24 patients). The remaining 25 patients underwent stent implantations, which was regarded as bailout treatment. Final follow-up was scheduled 12 months after the procedure. Results The primary-assisted patency rate after mechanical rotational thrombectomy with additional balloon angioplasty and/or stenting was 97.1% (49 patients). The early mortality rate was 2.0% (1 patient) and the amputation rate was 4.1% (2 patients). There were no late mortalities or limb amputations at 12-month follow-up, but significant restenoses occurred in 13 (27.1%) patients. These restenoses were more frequent in patients who underwent stent implantation (45.5%) than those managed with DEBs (12.5%), and in patients managed for secondary lesions. Conclusions In selected patients mechanical rotational thrombectomy in the femoropopliteal segment followed by application of DEB is a safe, effective and long-lasting method of revascularisation.
- Published
- 2019
45. Body integrity dysphoria and medical necessity: Amputation as a step towards health.
- Author
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Gibson, Richard B
- Subjects
- *
AMPUTATION , *PROSTHETICS , *DIABETIC foot , *NANOMEDICINE - Abstract
Interventions are medically necessary when they are vital in achieving the goal of medicine. However, with varying perspectives comes varying views on what interventions are (un)necessary and, thus, what potential treatment options are available for those suffering from the myriad of conditions, pathologies and disorders afflicting humanity. Medical necessity's teleological nature is perhaps best illustrated in cases where there is debate over using contentious medical interventions as a last resort. For example, whether it is appropriate for those suffering from body integrity dysphoria to receive healthy limb amputations. This paper explores how one's perception of medicine's goal underpins whether interventions are necessary or unnecessary, using the controversial topic of therapeutic amputation as an example. By contrasting 'classical' amputations with their more contentious counterparts, it highlights how the idea of medical necessity influences and restrains clinical decision-making. The paper starts by giving an account of body integrity dysphoria, focusing on the debate concerning elective amputation's justifiability. It then introduces Georges Canguilhem's vitalist theory of health, paying particular attention to his emphasis on adaptability. Then, this paper uses his theory as a lens through which to evaluate the appropriateness of therapeutic amputation as a medically necessary procedure. Ultimately, the paper highlights how the label of medical necessity is withheld from potential therapeutic interventions because they fail to conform to pre-established ideas of medicine's purpose and that by doing so, potential harm befalls those who are left with no effective treatments and must look for solutions in the non-clinical world. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
46. RESEARCHES ON THE FUNCTIONAL CLOTHES USAGE DESTINED FOR PERSONS WITH LIMB AMPUTATIONS.
- Author
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Elena, FLOREA-BURDUJA, Aliona, RARU, Daniela, FARÎMA, and Marcela, IROVAN
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LEG amputation ,AMPUTATION ,SOCIAL integration ,GROUP products (Mathematics) ,TEXTILE products ,COINTEGRATION - Abstract
Recently, the issue of designing special clothing for people with disabilities attracts the attention of specialists in various fields. This topic is very current, important and requires in-depth studies. The need for functional products for people with lower limb amputations is quite high, but they can only be found in specialized workshops. At the moment, local companies do not make clothing for people with special needs, which leads to a shortage of products on the market. The paper presents the results of a study that shows us the need for specialized products for people with lower limb amputations and their use in everyday life. The topicality of the theme is determined by the increase in the number of people with lower limb amputations and the increased interest of specialists in creating clothing for people with disabilities. The paper aims to establish the range of textile products for people with amputations of the lower limbs, necessary during the rehabilitation period and the period of social integration. The general objective of this paper is to analyze the assortment present in the wardrobe of people with amputations of the lower limbs and identify the need in product types. The paper presents the results of a survey of a group of prisoners with lower limb amputations. There is also a tendency to establish the group of clothing products, which would satisfy the wearer, but also those around. [ABSTRACT FROM AUTHOR]
- Published
- 2021
47. Free versus vascularized regenerative peripheral nerve interfaces in upper limb neuromas: a systematic review.
- Author
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Satkunabalan, Maduri, Tay, Jing Qin, and Ng, Zhi Yang
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- *
PERIPHERAL nervous system , *NEUROMAS , *POSTOPERATIVE period , *SURGICAL complications , *COMPUTER software , *PAIN management - Abstract
Background: The treatment of neuromas with regenerative peripheral nerve interfaces (RPNI) has gained much attention in recent years. This systematic review compared the clinical outcomes of upper limb neuromas treated with free (fRPNI) versus vascularized RPNI (vRPNI). Methods: This systematic review was performed in accordance with PRISMA guidelines. The PubMed database was searched for relevant studies published between August 2016 and May 2023. The search term "RPNI" was used. Data including patient demographics, type of RPNI performed, mean pain duration prior to RPNI, post-operative follow-up period, the reduction in neuroma pain scores after RPNI and post-operative complications were extracted independently by two authors and recorded using standard computer software for data processing. Results: Of 43 papers identified, only four fulfilled the inclusion criteria. This provided data for upper limb neuromas in 32 patients where a total of 83 RPNIs (22 vascularized) were performed. The means for patient age, duration of neuroma pain, length of reported postoperative follow-up, and reduction in neuroma pain scores were 44.0 years, 3.6 years, 12.2 months and 86% respectively. Conclusions: The current evidence suggests that either fRPNI or vRPNI may be useful for treating upper extremity neuromas, both prophylactically and secondarily. However, the heterogeneity and inconsistencies in data reporting are such that further studies are required to compare clinical outcomes between fRPNI and vRPNI to determine if one is superior to the other. Level of Evidence: Not gradable. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
48. Comparison of Bone Preserving and Radical Surgical Treatment in 32 Cases of Calcaneal Osteomyelitis
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Ireneusz Babiak, Paweł Małdyk, M. Kulig, J. Janowicz, and Piotr Pędzisz
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medicine.medical_specialty ,Heel ,calcanectomy, collagen-gentamicin sponge ,medicine.medical_treatment ,Bone Infection ,03 medical and health sciences ,0302 clinical medicine ,Patient satisfaction ,lcsh:Orthopedic surgery ,medicine ,Infection control ,Orthopedics and Sports Medicine ,Debridement ,business.industry ,Osteomyelitis ,chronic calcaneal osteomyelitis ,medicine.disease ,Surgery ,lcsh:RD701-811 ,Infectious Diseases ,medicine.anatomical_structure ,Amputation ,030220 oncology & carcinogenesis ,local antibiotic application ,Radiology ,Calcaneus ,business ,030217 neurology & neurosurgery ,Research Paper - Abstract
Introduction. Radical procedures like calcanectomy and amputation performed for calcaneal osteomyelitis are regarded as effective in eradication of infection even though potentially functionally disabling. Bone sparing procedures offer better functional result at the expense of potentially worse infection control. The aim of the study has been to assess the influence of the surgical radicalism as much as the extent of bone infection on the final outcome in the surgical therapy of chronic calcaneal osteomyelitis (CO). Material and method. 32 patients with chronic CO have comprised the group under study: 8 with superficial type, 12 localised type and 12 with diffuse type according to Cierny-Mader classification. The aim of the treatment was to heal infection, preserve the heel shape and achieve good skin coverage over the calcaneus. The therapy consisted of 9 debridement surgeries with or without flaps, 8 drilling-operations of the calcaneus with application of collagen-gentamicin-sponge in bore holes, 15 partial and 2 total calcanectomies, and 4 below-the knee amputations. Results. The healing of infection and wound has been achieved after 7 of 9 debridements, 6 of 8 drilling-operations, 13 of 15 partial and all total calcanectomies. Conclusion. Bone preserving operations in chronic calcaneal osteomyelitis provided inferior infection control (76,47% vs 88,24%) and worse patient satisfaction (88,24% vs 100%) and almost camparable ambulation (100% vs 93,33%). Drilling of the calcaneus with application of collagen sponge containing gentamicin performed in chronic diffuse calcaneal osteomyelitis seems to offer a viable alternative to partial or radical calcanectomy. Level of evidence: V.
- Published
- 2016
49. Elective amputation and neuroprosthetic limbs.
- Author
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Gibson, Richard B.
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AMPUTATION ,DISABILITY studies - Abstract
This paper explores the impact that developments in the field of neuroprosthetics will have on the ethical viability of healthy limb amputation, specifically in cases of Body Integrity Identity Disorder (BIID). Developments in the field have meant that the prospect of such artificial components matching the utility of their biological counterparts is now a possibility. As such, arguments against the provision of therapeutic, healthy limb amputation, which are grounded in the perceived resultant harm of disability, need to be reconsidered. Drawing on philosophical insights, as well as the field of disability studies and BIID research, this paper argues that such neuroprosthetics presents a challenge for the fundamental dichotomy between the disabled and non-disabled, including the latter's perceived superiority. It goes on to suggest that healthy limb amputation, for those with BIID, should not be dismissed simply because of the distastefulness of the procedure, but rather be evaluated based upon its own merits. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
50. Amputees and Sports.
- Author
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Bragaru, Mihail, Dekker, Rienk, Geertzen, Jan H. B., and Dijkstra, Pieter U.
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RESEARCH methodology evaluation ,AMPUTATION ,ANALYSIS of variance ,ATHLETIC ability ,BIOMECHANICS ,CARDIOPULMONARY system physiology ,CINAHL database ,CONFIDENCE intervals ,EXERCISE ,EXERCISE physiology ,EXPERIMENTAL design ,INFORMATION storage & retrieval systems ,MEDICAL information storage & retrieval systems ,LIFE skills ,MEDLINE ,ONLINE information services ,ATHLETES with disabilities ,QUALITY of life ,SPORTS ,SPORTS injuries ,STATISTICS ,EVIDENCE-based medicine ,INTER-observer reliability ,SPORTS participation ,EVALUATION ,PSYCHOLOGY - Abstract
Amputation of a limb may have a negative impact on the psychological and physical well-being, mobility and social life of individuals with limb amputations. Participation in sports and/or regular physical activity has a positive effect on the above mentioned areas in able-bodied individuals. Data concerning participation in sports or regular physical activity together with its benefits and risks for individuals with limb amputations are scarce. No systematic review exists that addresses a wide range of outcomes such as biomechanics, cardiopulmonary function, psychology, sport participation and sport injuries. Therefore, the aim of this article is to systematically review the literature about individuals with limb amputations and sport participation. MEDLINE (PubMed), EMBASE, CINAHL® and SportDiscus® were searched without time or language restrictions using free text words and MeSH terms. The last search date was 31 March 2010. Books, internet sites and references of included papers were checked for papers relevant to the topic under review. Papers were included if the research topic concerned sports and a minimum of ten individuals with limb amputations were part of the study population. Papers were excluded if they included individuals with amputations of body parts other than upper or lower limbs or more distal than the wrist or ankle, or if they consisted of case reports, narrative reviews, books, notes or letters to the editor. Title, abstract and full-text assessments were performed by two independent observers following a list of preset criteria. Of the 3689 papers originally identified, 47 were included in the review. Most of the included studies were older than 10 years and had cross-sectional designs. Study participants were generally younger and often had more traumatic amputations than the general population of individuals with limb amputations. Heterogeneity in population characteristics, intervention types and main outcomes made data pooling impossible. In general, sports were associated with a beneficial effect on the cardiopulmonary system, psychological well-being, social reintegration and physical functioning. Younger individuals with unilateral transtibial amputations achieve better athletic performance and encounter fewer problems when participating in sports compared with older individuals with bilateral transfemoral amputations. Regardless of their amputation level, individuals with limb amputations participate in a wide range of recreational activities. The majority of them were not aware of the sport facilities in their area and were not informed about available recreational activities. Sport prosthetic devices were used mostly by competitive athletes. For football, the injury rate and pattern of the players with an amputation were similar to those of able-bodied players. Individuals with limb amputations appear to benefit both physically and psychologically from participation in sports and/or regular physical activity. Therefore, sports should be included in rehabilitation programmes, and individuals with limb amputations should be encouraged to pursue a physically active life following hospital discharge. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
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