2,904 results
Search Results
2. Toddlers at Risk for Paper Shredder Injury in the Home: Easy Access and Severe Injury.
- Author
-
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
-
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. Paper shredder machines: a danger to little fingers. A case of triple finger amputation in a 2-year-old boy
- Author
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Laura J Clifton, Ian McNab, and Clare R. Langley
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,MEDLINE ,030208 emergency & critical care medicine ,General Medicine ,Surgery ,03 medical and health sciences ,Finger amputation ,0302 clinical medicine ,Amputation ,030225 pediatrics ,Medicine ,Surgical Flaps ,business - Published
- 2018
9. 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
10. Feasibility testing of smart tablet questionnaires compared to paper questionnaires in an amputee rehabilitation clinic
- Author
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Michael W.C. Payne, Eric Earl, Ricardo Viana, Shannon Janzen, and Barry Deathe
- Subjects
Adult ,Male ,medicine.medical_specialty ,Computers handheld ,medicine.medical_treatment ,Artificial Limbs ,Health Professions (miscellaneous) ,Amputation, Surgical ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Rehabilitation clinic ,Surveys and Questionnaires ,medicine ,Humans ,030212 general & internal medicine ,Aged ,Aged, 80 and over ,business.industry ,030503 health policy & services ,Rehabilitation ,Patient Preference ,Middle Aged ,Amputee clinic ,Amputation ,Computers, Handheld ,Physical therapy ,Feasibility Studies ,Female ,0305 other medical science ,business - Abstract
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.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.Observational study.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.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.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.
- Published
- 2016
11. Discussion. A position paper in support of hand transplantation in the blind
- Author
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Tae W. Chong
- Subjects
Male ,medicine.medical_specialty ,Transplantation ,business.industry ,General surgery ,medicine.medical_treatment ,Alternative medicine ,MEDLINE ,Hand Transplantation ,Blindness ,Surgery ,Amputation ,Amputation, Traumatic ,medicine ,Position paper ,Humans ,Female ,business ,Hand transplantation - Published
- 2011
12. FOR THE 4TH TIME IN A YEAR, OSHA CITES BURROWS PAPER FOOD BOX MANUFACTURER REPEATEDLY EXPOSES WORKERS TO AMPUTATION, OTHER HAZARDS
- Subjects
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
13. War-Related Dermatoses
- Author
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Firooz, Alireza, Nassiri-Kashani, Mansour, Davoudi, S. Masoud, Emadi, S. Naser, Smoller, Bruce, editor, and Bagherani, Nooshin, editor
- Published
- 2022
- Full Text
- View/download PDF
14. State of the art papers Advances in the diagnosis and management of diabetic distal symmetric polyneuropathy
- Author
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Jacek Kasznicki
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,General Medicine ,medicine.disease ,Asymptomatic ,Distal symmetric polyneuropathy ,Surgery ,Clinical trial ,Vibration perception ,Amputation ,Diabetes mellitus ,Internal medicine ,medicine ,medicine.symptom ,Foot Injury ,Complication ,business - Abstract
Distal symmetric polyneuropathy (DSPN) is the most common chronic complication of diabetes mellitus. The pathogenesis of DSPN is not fully elucidated, but it is certainly multifactorial in nature and attributable to metabolic and microvessel disorders related to chronic hyperglycemia, diabetes duration, and several cardiovascular risk factors. Early diagnosis and appropriate management are extremely important, since up to 50% of DSPN cases may be asymptomatic, and patients are unaware of foot injury leading to foot ulcers and amputation. Simple, validated tests such as the Neuropathy Disability Score and/or Vibration Perception Threshold may be used to diagnose DSPN. Similarly, neurological dysfunction screening questionnaires should be used to assess the quality and severity of DSPN symptoms. Using both methods enables prediction of the prognosis of diabetic patients with DSPN. No causative treatment of DSPN is known, but the results of clinical trials indicate that several treatment options are highly effective in symptomatic treatment of painful DSPN. The appropriate treatment of DSPN may improve the outcome, preventing or delaying the development of numerous diabetic complications.
- Published
- 2014
15. Prace Oryginalne Original Papers Why Women Who Have Mastectomy Decide Not to Have Breast Reconstruction?
- Author
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Katarzyna Lorenc-Podgórska, Tomasz Zieliński, and Bogusław Antoszewski
- Subjects
medicine.medical_specialty ,Reconstructive surgery ,business.industry ,medicine.medical_treatment ,General surgery ,Cancer ,General Medicine ,medicine.disease ,Radiation therapy ,Breast cancer ,Amputation ,medicine ,Surgery ,Hormone therapy ,Breast reconstruction ,business ,Mastectomy - Abstract
Breast cancer is the most common malignancy occurring in women. The treatment of breast cancer is a complex, multistep process involving surgical treatment, chemotherapy, radiotherapy, hormone therapy, targeted therapy, and very often rehabilitation. After the treatment of the underlying disease, or still in its course, there remains a problem of deformation of the chest. Although the number of women opting for breast reconstructive surgery increases every year, the number of such procedures in Poland is low.was to investigate the reasons why women after amputation of the breast due to cancer are not likely to undergo breast reconstructive surgery.The study comprised 73 women, residents of the province of Silesia, aged between 37 and 79 years, who had undergone mastectomy for malignancy in the years 1987-2013.From all of the reasons given by women for refraining from breast reconstruction, the most frequently pointed was the fear of being subjected to further surgery (38.3%). 23 women (31.5%) admitted that they were also afraid of postoperative pain. Similarly, a common response (35.6%) was that it is not essential for their mental state, and 30% of respondents fully accepted their appearance after mastectomy. Concern about the effect of failed reconstruction was reported by 24.6% of the women, and the fear that the surgery could negatively affect the process of cancer treatment by 27.4% of respondents. Lack of information about the capabilities and knowledge of breast reconstruction methods was not an important factor in decision-making.Most of the surveyed women who abandon breast reconstruction surgery, make this decision on the basis of more than one reasons. Fear of undergoing a second surgical procedure and pain related to it were the most important reasons for the refusal of breast reconstruction. An important factor in the decision to desist from breast reconstruction is the age of the patients.
- Published
- 2015
16. THOMSON, GA., PAPER MANUFACTURER CITED BY US LABOR DEPARTMENT'S OSHA FOR WILLFUL, SERIOUS SAFETY VIOLATIONS FOLLOWING AMPUTATION OF WORKER'S FINGERS
- Subjects
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
17. Toddlers at risk for paper shredder injury in the home: easy access and severe injury
- Author
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George L. Foltin and Ramona C. Warren
- Subjects
medicine.medical_specialty ,Consumer Product Safety ,Severe injury ,business.industry ,medicine.medical_treatment ,Poison control ,Human factors and ergonomics ,Suicide prevention ,Occupational safety and health ,Surgery ,Amputation ,Accidents, Home ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Injury prevention ,Finger Injuries ,Medicine ,Humans ,Female ,business ,Intensive care medicine - 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.
- Published
- 2006
18. Review paper: basic concepts to novel therapies: a review of the diabetic foot
- Author
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Aonghus O'Loughlin, Timothy O'Brien, Caroline McIntosh, and Sean F. Dinneen
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Anti-Inflammatory Agents ,Amputation, Surgical ,Diabetic Neuropathies ,Ischemia ,Risk Factors ,Diabetes mellitus ,medicine ,Humans ,Intensive care medicine ,Inflammation ,Hyperbaric Oxygenation ,Tissue Engineering ,business.industry ,Vascular disease ,Foot ,General Medicine ,medicine.disease ,Diabetic foot ,Bandages ,digestive system diseases ,Diabetic Foot ,Clinical trial ,Peripheral neuropathy ,Amputation ,Debridement ,Physical therapy ,Etiology ,Surgery ,business ,Foot (unit) ,Stem Cell Transplantation - Abstract
Diabetes mellitus is a global epidemic. Peripheral neuropathy and peripheral vascular disease are complications of diabetes mellitus and the primary causative factors for foot ulceration. Foot ulceration is the leading cause of hospitalization in people with diabetes mellitus. The burden of foot ulceration on health care systems and individual patients is immense. Despite conventional treatment, there persists a high incidence of amputation. A multidisciplinary approach is required to prevent ulcers. This review describes the etiology and risk factors for diabetic foot ulceration and a system for evaluating the diabetic foot. The assessment of neuropathy and the grading of foot ulcers are critically examined. This is important to allow for standardization in clinical trials. The management of diabetic foot syndrome is reviewed. The treatments to ensure vascular supply to the lower limb and control of infection as well as novel therapies, which are becoming available to treat nonhealing, “no-option” diabetic ulcers, are discussed.
- Published
- 2010
19. 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
20. 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
21. Feasibility testing of smart tablet questionnaires compared to paper questionnaires in an amputee rehabilitation clinic.
- Author
-
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
22. Free Papers.
- Subjects
ARTHROPLASTY ,BONE fractures ,AMPUTATION ,FASCIOTOMY ,MEDICAL care - Published
- 2018
- Full Text
- View/download PDF
23. Successful replantation of a bitten-off vermilion of the lower lip
- Author
-
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
24. 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
25. An Intensive Care Nursing Experience of a Vibrio Vulnificus Infection Patient due to Above Knee Amputation Because Self-Use Ointment Dressing.
- Author
-
Chin-Yuan Lin and Hsin-Mei Wu
- Subjects
VIBRIO infections ,HEALTH self-care ,INTENSIVE care nursing ,OINTMENTS ,BANDAGES & bandaging ,MUSIC therapy ,REHABILITATION ,RADIO (Medium) ,NURSING ,FAMILIES ,LEG amputation ,INTENSIVE care units ,PAIN ,SURGICAL dressings ,MASSAGE therapy ,VIDEO recording - Abstract
This paper presents a vibrio vulnificus Infection Patient due to above knee amputation because self-use ointment dressing admitted to the intensive care unit. From December 21, 2021 to January 21, 2022, three health problems were identified in the course of care: acute pain, body image disturbance, and a self-care deficit. Nursing care included: listening to radio music, massage to relieve acute pain; caring and asking the patient to express his thoughts; sharing the medical process of the same case through video; help with acceptance, care for the amputation wound and facing the change of body appearance; with family members and rehabilitation team to design and participate in limb rehabilitation improve self-care ability after amputation. The nursing experience described hope for providing clinical care to similar case patients. [ABSTRACT FROM AUTHOR]
- Published
- 2024
26. 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
27. Five-year outcomes after revascularization of superficial femoral artery occlusion using Ocelot catheter
- Author
-
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
28. Predictive prosthetic socket design: part 2—generating person-specific candidate designs using multi-objective genetic algorithms
- Author
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Steer, J. W., Grudniewski, P. A., Browne, M., Worsley, P. R., Sobey, A. J., and Dickinson, A. S.
- Subjects
030506 rehabilitation ,Computer science ,Process (engineering) ,media_common.quotation_subject ,0206 medical engineering ,Artificial Limbs ,02 engineering and technology ,Prosthesis Design ,Residual limb ,Evolutionary computation ,law.invention ,Automation ,03 medical and health sciences ,law ,Pressure ,Humans ,Optimisation ,Amputation ,Function (engineering) ,FEA ,media_common ,Original Paper ,Prosthetist ,Focus (computing) ,Iterative and incremental development ,Bearing (mechanical) ,Mechanical Engineering ,fictional_universe.character_occupation ,fictional_universe ,020601 biomedical engineering ,Reliability engineering ,Modeling and Simulation ,0305 other medical science ,Engineering design process ,Algorithms ,Biotechnology - Abstract
In post-amputation rehabilitation, a common goal is to return to ambulation using a prosthetic limb, suspended by a customised socket. Prosthetic socket design aims to optimise load transfer between the residual limb and mechanical limb, by customisation to the user. This is a time-consuming process, and with the increase in people requiring these prosthetics, it is vital that these personalised devices can be produced rapidly while maintaining excellent fit, to maximise function and comfort. Prosthetic sockets are designed by capturing the residual limb’s shape and applying a series of geometrical modifications, called rectifications. Expert knowledge is required to achieve a comfortable fit in this iterative process. A variety of rectifications can be made, grouped into established strategies [e.g. in transtibial sockets: patellar tendon bearing (PTB) and total surface bearing (TSB)], creating a complex design space. To date, adoption of advanced engineering solutions to support fitting has been limited. One method is numerical optimisation, which allows the designer a number of likely candidate solutions to start the design process. Numerical optimisation is commonly used in many industries but not prevalent in the design of prosthetic sockets. This paper therefore presents candidate shape optimisation methods which might benefit the prosthetist and the limb user, by blending the state of the art from prosthetic mechanical design, surrogate modelling and evolutionary computation. The result of the analysis is a series of prosthetic socket designs that preferentially load and unload the pressure tolerant and intolerant regions of the residual limb. This spectrum is bounded by the general forms of the PTB and TSB designs, with a series of variations in between that represent a compromise between these accepted approaches. This results in a difference in pressure of up to 31 kPa over the fibula head and 14 kPa over the residuum tip. The presented methods would allow a trained prosthetist to rapidly assess these likely candidates and then to make final detailed modifications and fine-tuning. Importantly, insights gained about the design should be seen as a compliment, not a replacement, for the prosthetist’s skill and experience. We propose instead that this method might reduce the time spent on the early stages of socket design and allow prosthetists to focus on the most skilled and creative tasks of fine-tuning the design, in face-to-face consultation with their client.
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- 2019
29. Different types of bullae of limbs with necrotizing fasciitis predict different outcome: a prospective study
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Yen-Yao Li, Yao-Hung Tsai, Hui-Ju Chuang, Liang-Tseng Kuo, Han-Ru Wu, Cheng-Ting Hsiao, Tsung-Yu Huang, Kuo-Ti Peng, Chien-Hui Hung, Wan-Yu Huang, and Wei-Hsiu Hsu
- Subjects
Male ,0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Necrotizing fasciitis ,medicine.medical_treatment ,030106 microbiology ,Taiwan ,Bacteremia ,Skin necrosis ,medicine.disease_cause ,Amputation, Surgical ,law.invention ,03 medical and health sciences ,Blister ,0302 clinical medicine ,law ,Internal medicine ,medicine ,Humans ,Fasciitis, Necrotizing ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,Fasciitis ,Vibrio infection ,Aged ,Aged, 80 and over ,Original Paper ,Streptococcus ,Septic shock ,business.industry ,Soft Tissue Infections ,General Medicine ,Emergency department ,Middle Aged ,medicine.disease ,Shock, Septic ,Intensive care unit ,Infectious Diseases ,Amputation ,Female ,Hemorrhagic bullae ,business - Abstract
Study objective Necrotizing fasciitis (NF) is an uncommon life-threatening necrotizing skin and soft tissue infection. Bullae are special skin manifestations of NF. This study was conducted to analyze the differences between different types of bullae of limbs with NF for providing the information to emergency treatment. Methods From April 2015 to August 2018, patients were initially enrolled based on surgical confirmation of limbs with NF. According to the presence of different bullae types, patients were divided into no bullae group (Group N), serous-filled bullae group (Group S), and hemorrhagic bullae group (Group H). Data such as demographics, clinical outcomes, microbiological results, presenting symptoms/signs, and laboratory findings were compared among these groups. Results In total, 187 patients were collected, with 111 (59.4%) patients in Group N, 35 (18.7%) in Group S, and 41 (21.9%) in Group H. Group H had the highest incidence of amputation, required intensive care unit care, and most patients infected with Vibrio species. In Group N, more patients were infected with Staphylococcus spp. than Group H. In Group S, more patients were infected with β-hemolytic Streptococcus than Group H. Patients with bacteremia, shock, skin necrosis, anemia, and longer prothrombin time constituted higher proportions in Group H and S than in Group N. Conclusions In southern Taiwan, patients with NF accompanied by hemorrhagic bullae appear to have more bacteremia, Vibrio infection, septic shock, and risk for amputation. If the physicians at the emergency department can detect for the early signs of NF as soon as possible, and more patient’s life and limbs may be saved.
- Published
- 2021
30. 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
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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
31. Ambulatory continuous peripheral nerve blocks to treat postamputation phantom limb pain: a multicenter, randomized, quadruple-masked, placebo-controlled clinical trial
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Sarah J. Madison, Daniel I. Sessler, PAINfRE Investigators, Jennifer Padwal, Steven P. Cohen, Michael L. Kent, Wael Ali Sakr Esa, Steven R. Hanling, Kamal Maheshwari, Brian M. Ilfeld, James C. Eisenach, Chao Ma, Edward J. Mascha, Alparslan Turan, Edward R. Mariano, and Bahareh Khatibi
- Subjects
medicine.drug_class ,medicine.medical_treatment ,Continuous peripheral nerve blocks ,Chronic pain ,Perineural local anesthetic infusion ,Placebo ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,030202 anesthesiology ,Interquartile range ,law ,medicine ,Humans ,Ropivacaine ,Peripheral Nerves ,Anesthetics, Local ,Pain, Postoperative ,business.industry ,Local anesthetic ,Nerve Block ,medicine.disease ,body regions ,Anesthesiology and Pain Medicine ,Phantom Limb ,Neurology ,Amputation ,Anesthesia ,Nerve block ,Neurology (clinical) ,business ,Phantom pain ,Ambulatory analgesia ,030217 neurology & neurosurgery ,Research Paper ,medicine.drug - Abstract
Supplemental Digital Content is Available in the Text. A 6-day ambulatory continuous peripheral nerve block reduces phantom limb pain and pain-induced physical and emotional dysfunction for at least 4 weeks after treatment., Phantom limb pain is thought to be sustained by reentrant neural pathways, which provoke dysfunctional reorganization in the somatosensory cortex. We hypothesized that disrupting reentrant pathways with a 6-day-long continuous peripheral nerve block reduces phantom pain 4 weeks after treatment. We enrolled patients who had an upper- or lower-limb amputation and established phantom pain. Each was randomized to receive a 6-day perineural infusion of either ropivacaine or normal saline. The primary outcome was the average phantom pain severity as measured with a Numeric Rating Scale (0-10) at 4 weeks, after which an optional crossover treatment was offered within the following 0 to 12 weeks. Pretreatment pain scores were similar in both groups, with a median (interquartile range) of 5.0 (4.0, 7.0) for each. After 4 weeks, average phantom limb pain intensity was a mean (SD) of 3.0 (2.9) in patients given local anesthetic vs 4.5 (2.6) in those given placebo (difference [95% confidence interval] 1.3 [0.4, 2.2], P = 0.003). Patients given local anesthetic had improved global impression of change and less pain-induced physical and emotional dysfunction, but did not differ on depression scores. For subjects who received only the first infusion (no self-selected crossover), the median decrease in phantom limb pain at 6 months for treated subjects was 3.0 (0, 5.0) vs 1.5 (0, 5.0) for the placebo group; there seemed to be little residual benefit at 12 months. We conclude that a 6-day continuous peripheral nerve block reduces phantom limb pain as well as physical and emotional dysfunction for at least 1 month.
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- 2020
32. War surgery in Afghanistan: a model for mass causalities in terror attacks?
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F. Wichlas, G. Strada, Christian Deininger, and V Hofmann
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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.
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- 2020
33. Desirability of Difference: Georges Canguilhem and Body Integrity Identity Disorder.
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Gibson, Richard B
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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]
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- 2022
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34. Sexual functioning and self-esteem in women after mastectomy – a single-centre, non-randomised, cross-sectional study
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Agata Gastecka, Ewelina Monastyrska-Waszak, Aleksander Goch, Iwona Głowacka-Mrotek, Tomasz Nowikiewicz, Magdalena Tarkowska, and Wojciech Zegarski
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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.
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- 2020
35. Long-term outcome upon treatment of calcified lesions of the lower limb using scoring angioplasty balloon (AngioSculpt™)
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Erwin Blessing, Oliver Müller, Carolin Werner, Matthias Dufner, Mariya Kronlage, Christian Erbel, Hugo A. Katus, and Britta Heilmeier
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Male ,Target lesion ,medicine.medical_specialty ,medicine.medical_treatment ,Percutaneous angioplasty ,030204 cardiovascular system & hematology ,Balloon ,AngioSculpt™® ,Severity of Illness Index ,Scoring balloon ,030218 nuclear medicine & medical imaging ,Lesion ,Peripheral Arterial Disease ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Angioplasty ,medicine ,Humans ,Drug-eluting balloon ,Prospective cohort study ,Vascular Patency ,Calcified lesions ,Aged ,Retrospective Studies ,Aged, 80 and over ,Original Paper ,business.industry ,Standard treatment ,Calcinosis ,Stent ,General Medicine ,Middle Aged ,Surgery ,Treatment Outcome ,Lower Extremity ,Amputation ,Cardiology ,Limb ischemia ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Angioplasty, Balloon ,Follow-Up Studies - Abstract
Aims In peripheral artery disease (PAD), endovascular treatment success of heavily calcified lesions is often compromised by a number of vascular complications, such as recoils, dissections and need for target vessel re-interventions. The increasing use of scoring balloon techniques has raised the hope for better periprocedural outcomes; however, the knowledge regarding the actual benefits of the scoring balloon technique in comparison to standard therapy is still limited. Thus, the aim of the current study was to determine the safety and effectiveness of scoring balloon angioplasty in a real-life patients’ collective with PAD. Methods and Results A total of 425 patients with moderate to severely calcified femoropopliteal lesions received interventional treatment between 2011 and 2018 at the single center; 230 received a treatment with a scoring balloon (AngioSculpt™), and 195 received a plain procedure without AngioSculpt™. Key questions of this analysis were: (1) whether AngioSculpt™ can be used as a safe and effective stand-alone treatment in heavily calcified lesions in a 24-month follow-up, as well as (2) whether target lesion preparation with scoring balloon bears additional benefits to standard treatment (PTA ± stent implantation). In terms of freedom from target lesion revascularization there were no significant differences between AngioSculpt™ and standard procedure (82.3% vs. 78.1%, P > 0.05). Vessel preparation with balloon angioplasty had no additional effects on survival and amputation rates in comparison to standard treatment without AngioSculpt™ (P > 0.05). The deployment of a scoring balloon did not reduce the subsequent need for additional stent implantations (32.6%, and 32.3%, P > 0.05). Conclusion Lesion preparation with AngioSculpt™ scoring balloon represents a safe and effective tool in the treatment of complex femoropopliteal lesions. In this retrospective analysis, AngioSculpt™ scoring balloon angioplasty did not significantly improve vessel patency- both when used as an adjunctive in preparation for stenting and as stand-alone treatment. A prospective study is needed to further investigate the scoring balloon treatment options. Graphic abstract
- Published
- 2020
36. Comparison of long-term outcomes after directional versus rotational atherectomy in peripheral artery disease
- Author
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Wojciech Trendel, Radosław S. Kiesz, Aleksandra Kolarczyk-Haczyk, Piotr P. Buszman, Krzysztof Milewski, Paweł Buszman, Maciej Pruski, Adam Janas, and Wojciech Wojakowski
- Subjects
critical limb ischemia ,medicine.medical_specialty ,medicine.medical_treatment ,atherectomy ,Revascularization ,law.invention ,Atherectomy ,Randomized controlled trial ,peripheral arterial disease ,law ,Internal medicine ,medicine ,Original Paper ,claudication ,business.industry ,Mortality rate ,Retrospective cohort study ,Critical limb ischemia ,Amputation ,Cardiology ,Medicine ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,Claudication ,business - Abstract
Introduction The rate of atherectomy utilization in peripheral artery diseases (PAD) is growing. The two atherectomy devices available on the market and used most frequently are the directional and rotational ones. Nonetheless, there is a lack of direct comparison between these two types of atherectomy in PAD. Aim To compare the long-term outcomes after PAD endovascular revascularization with two types of atherectomies: rotational (AR) (Phoenix Philips) and directional (AD) (SilverHawk Medtronic). Material and methods This was a single-center, retrospective study of obstructive and symptomatic PAD patients who underwent revascularization with atherectomy. The endpoints were considered as target lesion revascularization (TLR), death, amputations and bailout stenting (BS). Results The AR group consisted of 97 patients, while the AD group consisted of 85 individuals. There were no significant differences between the groups in terms of baseline characteristics except for an increased critical limb ischemia (CLI) prevalence in the AR group. The mean follow-up for AD and AR was 282.6 ±147.4 and 255.7 ±186.1 days, respectively (p = 0.44). There were no significant differences in the death rate (AD: 1 (1.7%) vs. AR: 5 (5.7%); p = 0.54), amputations (AD: 2 (2.3%) vs. AR: 5 (5.7%); p = 0.45) or bailout stenting (AD: 2 (2.3%) vs. AR: 3 (3.2%); p = 0.74), whereas TLR was more frequent in the AD group (AD: 25 (29%) vs. AR: 15 (15.9%; p = 0.03). The Kaplan-Meier analysis showed no significant differences between the groups in time to TLR, amputation or death. Conclusions In this hypothesis-generating study the AR had a lower rate of TLR when compared to the AD. Nevertheless, this should be confirmed in further controlled randomized trials.
- Published
- 2020
37. 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
38. Long-term follow-up in adults with extremity osteosarcoma: comparison of different surgical procedures – single-center experience
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Marcin Zdzienicki, Piotr Rutkowski, Tomasz Goryń, Iwona Ługowska, Bartłomiej Szostakowski, and Andrzej Pieńkowski
- Subjects
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
39. 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
- Subjects
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]
- Published
- 2024
- Full Text
- View/download PDF
40. 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
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- *
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
- Full Text
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41. 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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42. 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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43. 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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44. 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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45. 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.
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- 2009
46. 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]
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- 2023
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47. Therapeutic Angiogenesis Using Bone Marrow-Derived Mononuclear Cell Implantation for Patients With Critical Limb-Threatening Ischemia Caused by Thromboangiitis Obliterans - Study Protocol for a Multicenter Prospective Interventional Trial
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Hirofumi Kawamata, Isao Yokota, Ayumu Fujioka, Satoshi Teramukai, Kenji Yanishi, Keisuke Shoji, Yusuke Hori, Satoaki Matoba, Arito Yukawa, and Ayumu Yamada
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Therapeutic angiogenesis ,Ischemia ,Bone marrow-derived mononuclear cells ,Protocol Paper ,General Medicine ,Revascularization ,medicine.disease ,Critical limb-threatening ischemia ,Surgery ,Amputation ,Bypass surgery ,Thromboangiitis obliterans ,medicine ,Clinical endpoint ,Stage (cooking) ,Adverse effect ,business - Abstract
Background: Patients with thromboangiitis obliterans (TAO) can develop critical limb-threatening ischemia (CLTI) and require limb amputation. Smoking cessation and exercise therapy are recommended as standard treatments, and revascularization by bypass surgery or endovascular therapy (EVT) is required for patients with CLTI. However, there are many cases in which revascularization is difficult because of vascular characteristics, and the patency rate after revascularization remains unsatisfactory. Therapeutic angiogenesis using bone marrow-derived mononuclear cell (BM-MNC) implantation is used clinically, with many trials demonstrating long-term efficacy and safety of the technique in patients with CLTI, especially that caused by TAO. To expand the use of BM-MNCs implantation in clinical practice, further evidence is required in patients with CLTI caused by TAO. Methods and Results: This trial is a multicenter, prospective, non-randomized interventional trial of an Advanced Medicine B treatment approach. We aim to enroll 25 patients aged 20-80 years with Fontaine classification Stage III or IV, who will undergo BM-MNC implantation. The primary endpoint is the improvement in skin perfusion pressure of the target limb 180 days after BM-MNC implantation, whereas secondary endpoints are improvements in rest pain or ulcer size. We will also investigate rates of major or minor amputation, survival, and adverse events during follow-up. Conclusions: BM-MNC implantation is expected to be an efficacious and feasible treatment for patients with CLTI caused by TAO.
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- 2021
48. 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
49. Predictive prosthetic socket design: part 1—population-based evaluation of transtibial prosthetic sockets by FEA-driven surrogate modelling
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Steer, J. W., Worsley, P. R., Browne, M., and Dickinson, A. S.
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Statistical shape modelling ,Computer science ,Finite Element Analysis ,0206 medical engineering ,Artificial Limbs ,02 engineering and technology ,Population based ,Prosthesis Design ,Models, Biological ,Soft tissue compliance ,Pressure ,Humans ,Amputation ,Parametric statistics ,Original Paper ,Principal Component Analysis ,Tibia ,business.industry ,Mechanical Engineering ,Soft tissue ,Structural engineering ,Prosthetic socket ,Solver ,020601 biomedical engineering ,Finite element method ,Biomechanical Phenomena ,body regions ,Modeling and Simulation ,Regression Analysis ,business ,Reduction (mathematics) ,Biotechnology - Abstract
It has been proposed that finite element analysis can complement clinical decision making for the appropriate design and manufacture of prosthetic sockets for amputees. However, clinical translation has not been achieved, in part due to lengthy solver times and the complexity involved in model development. In this study, a parametric model was created, informed by variation in (i) population-driven residuum shape morphology, (ii) soft tissue compliance and (iii) prosthetic socket design. A Kriging surrogate model was fitted to the response of the analyses across the design space enabling prediction for new residual limb morphologies and socket designs. It was predicted that morphological variability and prosthetic socket design had a substantial effect on socket-limb interfacial pressure and shear conditions as well as sub-dermal soft tissue strains. These relationships were investigated with a higher resolution of anatomical, surgical and design variability than previously reported, with a reduction in computational expense of six orders of magnitude. This enabled real-time predictions (1.6 ms) with error vs the analytical solutions of
- Published
- 2019
50. Association between Peripheral Artery Disease and Major Adverse Cardiovascular Events in Patients with Acute Coronary Syndrome: Findings from the Gulf COAST Registry
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Abdulla Shehab, Mohammad Zubaid, Ekram Al Siyabi, Arif Al-Mulla, Abdullah Alnaeemi, Ibrahim Al-Zakwani, and Najib Alrawahi
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Male ,0301 basic medicine ,medicine.medical_specialty ,Acute coronary syndrome ,020205 medical informatics ,medicine.medical_treatment ,Comorbidity ,02 engineering and technology ,Middle East ,Peripheral Arterial Disease ,03 medical and health sciences ,Risk Factors ,Internal medicine ,0202 electrical engineering, electronic engineering, information engineering ,medicine ,Humans ,Longitudinal Studies ,Registries ,cardiovascular diseases ,Myocardial infarction ,Acute Coronary Syndrome ,Stroke ,Aged ,Aged, 80 and over ,Original Paper ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Amputation ,Bypass surgery ,Cardiovascular Diseases ,Cohort ,Cardiology ,Female ,030101 anatomy & morphology ,medicine.symptom ,business ,Claudication ,Mace - Abstract
Objective: To evaluate the association between peripheral artery disease (PAD) and major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS) in the Arabian Gulf. Methods: Data from 4,044 consecutive patients diagnosed with ACS admitted to 29 hospitals in four Arabian Gulf countries from January 2012 to January 2013 were analyzed. PAD was defined as any of the following: claudication, amputation for arterial vascular insufficiency, vascular reconstruction, bypass surgery, or percutaneous intervention in the extremities, documented aortic aneurysm or an ankle brachial index of Results: The overall mean age of the cohort was 60 ± 13 years and 66% (n = 2,686) were males. A total of 3.3% (n = 132) of the patients had PAD. Patients with PAD were more likely to be associated with smoking, prior MI, hypertension, diabetes mellitus, and stroke/TIA. At the 1-year follow-up, patients with PAD were significantly more likely to have MACE (adjusted OR [aOR], 2.07; 95% confidence interval [CI]: 1.41–3.06; p< 0.001). The higher rates of events were also observed across all MACE components; stroke/TIA (aOR, 3.22; 95% CI: 1.80–5.75; p< 0.001), MI (aOR, 2.15; 95% CI: 1.29–3.59; p =0.003), all-cause mortality (aOR, 2.21; 95% CI: 1.33–3.69; p =0.002), and readmissions for cardiac reasons (aOR, 1.83; 95% CI: 1.24–2.70; p =0.003). Conclusions: PAD was significantly associated with MACE in ACS patients in the Arabian Gulf.
- Published
- 2019
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