Did the Clinical Spectrum of Thromboangiitis Obliterans Change in the Past 40 Years?

Angiology ◽  
2020 ◽  
Vol 71 (7) ◽  
pp. 621-625
Author(s):  
Simon Soudet ◽  
Alexandre Le Joncour ◽  
Thomas Quemeneur ◽  
Helene Maillard ◽  
Fabien Koskas ◽  
...  
Keyword(s):  
Upper Limb ◽  
Lower Limb ◽  
Lower Limbs ◽  
Clinical Spectrum ◽  
Thromboangiitis Obliterans ◽  
Female Ratio ◽  
The Past ◽  
Before And After ◽  
Young Smokers ◽  
Male To Female

Thromboangiitis obliterans (TAO) is an inflammatory disease that usually affects small and medium-sized arteries in the upper and lower limbs of young smokers. Previous studies showed that the spectrum TAO has changed in the 80s: the male-to-female ratio decreased, older patients were diagnosed, and upper limb involvement was more common. The aim of our study was to assess the changing clinical spectrum of TAO in France during the past 40 years. All consecutive patients fulfilling TAO’s criteria between January 1967 and January 2016 were retrospectively included in 3 departments of internal medicine. We compared TAO features in patients diagnosed before and after 2002; 141 (77.5%) men and 41 (22.5%) women were included. Patients diagnosed after 2002 were older (37 [31-39] vs 34 [29-35] years P = .03), had a more frequent isolated upper limb involvement (34.3% vs 7.8% P = .001), and less frequent isolated lower limb involvement (55.7% vs 74.5%, P < .001). The clinical spectrum of TAO has changed in France since the beginning of the 21st century.

Computed tomography angiography and microsurgical flaps for traumatic wounds: What is the added value?

2021 ◽  
pp. 1-9
Author(s):  
Lucas Sousa Macedo ◽  
Renato Polese Rusig ◽  
Gustavo Bersani Silva ◽  
Alvaro Baik Cho ◽  
Teng Hsiang Wei ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Upper Limb ◽  
Computed Tomography Angiography ◽  
Lower Limb ◽  
High Energy ◽  
Lower Limbs ◽  
Added Value ◽  
Vascular Lesions ◽  
Limb Injuries ◽  
Significant Difference

BACKGROUND: Microsurgical flaps are widely used to treat complex traumatic wounds of upper and lower limbs. Few studies have evaluated whether the vascular changes in preoperative computed tomography angiography (CTA) influence the selection of recipient vessel and type of anastomosis and the microsurgical flaps outcomes including complications. OBJECTIVE: The aim of this study was to evaluate if preoperative CTA reduces the occurrence of major complications (revision of the anastomosis, partial or total flap failure, and amputation) of the flaps in upper and lower limb trauma, and to describe and analyze the vascular lesions of the group with CTA and its relationship with complications. METHODS: A retrospective cohort study was undertaken with all 121 consecutive patients submitted to microsurgical flaps for traumatic lower and upper limb, from 2014 to 2020. Patients were divided into two groups: patients with preoperative CTA (CTA+) and patients not submitted to CTA (CTA–). The presence of postoperative complications was assessed and, within CTA+, we also analyzed the number of patent arteries on CTA and described the arterial lesions. RESULTS: Of the 121 flaps evaluated (84 in the lower limb and 37 in the upper limb), 64 patients underwent preoperative CTA. In the CTA+ group, 56% of patients with free flaps for lower limb had complete occlusion of one artery. CTA+ patients had a higher rate of complications (p = 0.031), which may represent a selection bias as the most complex limb injuries and may have CTA indicated more frequently. The highest rate of complications was observed in chronic cases (p = 0.034). There was no statistically significant difference in complications in patients with preoperative vascular injury or the number of patent arteries. CONCLUSIONS: CTA should not be performed routinely, however, CTA may help in surgical planning, especially in complex cases of high-energy and chronic cases, since it provides information on the best recipient artery and the adequate level to perform the microanastomosis, outside the lesion area.

scholarly journals Audio-visual stimulation in conjunction with functional electrical stimulation to address upper limb and lower limb movement disorder

2016 ◽  
Vol 26 (2) ◽  
Author(s):  
Deepesh Kumar ◽  
Sunny Verma ◽  
Sutapa Bhattacharya ◽  
Uttama Lahiri
Keyword(s):  
Electrical Stimulation ◽  
Movement Disorder ◽  
Upper Limb ◽  
Functional Electrical Stimulation ◽  
Lower Limb ◽  
Neurological Disorders ◽  
Visual Stimulation ◽  
Lower Limbs ◽  
Lower Limb Movement ◽  
Rehabilitation Exercises

Neurological disorders often manifest themselves in the form of movement deficit on the part of the patient. Conventional rehabilitation often used to address these deficits, though powerful are often monotonous in nature. Adequate audio-visual stimulation can prove to be motivational. In the research presented here we indicate the applicability of audio-visual stimulation to rehabilitation exercises to address at least some of the movement deficits for upper and lower limbs. Added to the audio-visual stimulation, we also use Functional Electrical Stimulation (FES). In our presented research we also show the applicability of FES in conjunction with audio-visual stimulation delivered through VR-based platform for grasping skills of patients with movement disorder.

scholarly journals A study of clinical spectrum of opportunistic infections in HIV infected children and its correlation with CD4 count and anti-retroviral therapy

2017 ◽  
Vol 4 (4) ◽  
pp. 1485
Author(s):  
Vishal Manohar Jadhav ◽  
Yashwant Raghu Gabhale ◽  
Mamatha Murad Lala ◽  
Nikita Dilip Shah ◽  
Mamta Vijay Manglani
Keyword(s):  
Opportunistic Infections ◽  
Molluscum Contagiosum ◽  
Cd4 Count ◽  
Clinical Spectrum ◽  
Pneumocystis Jiroveci ◽  
Female Ratio ◽  
Cd4 Counts ◽  
Pneumocystis Jiroveci Pneumonia ◽  
High Index Of Suspicion ◽  
Male To Female

Background: To determine the clinical spectrum and prevalence of opportunistic infections (OIs) in HIV infected children and correlate the occurrence of opportunistic infections with their CD4 count and Anti-retroviral treatment (ART).Methods: A total of 100 HIV infected children diagnosed with opportunistic infections were included in the study. Demographic details, clinical examination and relevant investigations were done for all the children. Clinical spectrum of OIs and HIV staging was recorded. CD4 counts were done at baseline and were repeated at 6 monthly intervals.Results: Mean age of the patients was 7.08±3.48 years (ranging from 6 months to 15 years) at enrollment with male to female ratio of 1.2:1. Fever (91%) was a common presenting symptom followed by weight loss (74%), cough (37%), abdominal pain (29%) and breathlessness (16%). CD4 count was significantly associated with presence of opportunistic infection in the study group. Tuberculosis - pulmonary (32%) and extra-pulmonary (29%) was the most common oppurtunistic infections, followed by oral thrush (13%), Herpes zoster (10%), Molluscum Contagiosum (9%), Pneumocystis jiroveci pneumonia (3%), Parvovirus infection (3%) and Pruritic Papular Eruptions (2%). 70% children were on ART as per clinical and immunological staging of HIV.Conclusions: Low CD4 count is significantly associated with severe opportunistic infections, therefore drop in CD4 count should serve as an alarming signal for the treating physician. High index of suspicion is required to detect opportunistic infections and therefore CD4 counts should be done more frequently to predict occurrence of OIs. 

scholarly journals Cross-Sectional Survey of Musculoskeletal Disorders in Workers Practicing Traditional Methods of Underground Coal Mining

2020 ◽  
Vol 17 (7) ◽  
pp. 2566
Author(s):  
Madiha Ijaz ◽  
Sajid Rashid Ahmad ◽  
Muhammad M. Akram ◽  
Steven M. Thygerson ◽  
Falaq Ali Nadeem ◽  
...  
Keyword(s):  
Coal Mining ◽  
Upper Limb ◽  
Lower Limb ◽  
Lower Limbs ◽  
Underground Mines ◽  
Upper Limbs ◽  
Underground Coal Mining ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
R Programming

Background: In subcontinental underground mines, coal mining is carried out manually and requires many laborers to practice traditional means of coal excavation. Each task of this occupation disturbs workers’ musculoskeletal order. In order to propose and practice possible ergonomic interventions, it is necessary to know what tasks (drilling and blasting, coal cutting, dumping, transporting, timbering and supporting, loading and unloading) cause disorder in either upper limbs, lower limbs, or both. Methods: To this end, R-programming, version R 3.1.2 and SPSS, software 20, were used to calculate data obtained by studying 260 workers (working at different tasks of coal mining) from 20 mines of four districts of Punjab, Pakistan. In addition, a Standard Nordic Musculoskeletal Questionnaire (SNMQ) and Rapid Upper Limb Assessment (RULA) sheet were used to collect data and to analyze postures respectively. Results: In multi regression models, significance of the five tasks for upper and lower limb disorder is 0.00, which means that task based prevalence of upper and lower limb disorders are common in underground coal mines. The results of the multiple bar chart showed that 96 coal cutters got upper limb disorders and 82 got lower limb disorders. The task of timbering and supporting was shown to be dangerous for the lower limbs and relatively less dangerous for the upper limbs, with 25 workers reporting pain in their lower limbs, and 19 workers reporting pain in their upper limbs. Documented on the RULA sheet, all tasks got the maximum possible score (7), meaning that each of these tasks pose a threat to the posture of 100% of workers. The majority of participants (182) fell in the age group of 26 to 35 years. Of those workers, 131 reported pain in the lower limbs and slight discomfort (128) in the upper limbs. The significance value of age was 0.00 for upper limb disorder and was 0.012 for lower limb disorder. Frequency graphs show age in direct proportion to severity of pain while in inverse proportion with number of repetitions performed per min. Conclusions: All findings infer that each task of underground coal mining inflicts different levels of disorder in a workers’ musculoskeletal structure of the upper and lower limbs. It highlighted the need for urgent intervention in postural aspects of each task.

Use of traditional and alternative healers by psychiatric patients: A descriptive study in urban South Africa

2018 ◽  
Vol 56 (1) ◽  
pp. 146-166 ◽  
Author(s):  
Zukiswa Zingela ◽  
Stephan van Wyk ◽  
Jacques Pietersen
Keyword(s):  
Psychiatric Patients ◽  
Mixed Race ◽  
Psychiatric Medication ◽  
Female Ratio ◽  
The Past ◽  
Nelson Mandela ◽  
Urban South ◽  
Lower Education ◽  
Male To Female ◽  
Ethnic Distribution

This study investigates the pattern of use of traditional and alternative healers among psychiatric patients in Nelson Mandela Metropole. An interview schedule was applied to 254 subjects at six sites, enquiring about consultations with traditional and alternative healers in the past year. Multivariate analysis was performed to determine predictors of consultation. Overall, 78 (31%) of respondents had consulted a healer in the past year. The ethnic distribution was: 156 (61%) Black, 53 (21%) Coloured (Mixed Race), 42 (17%) White and three (1%) Indian. The male to female ratio was 119 (46.85%):135 (53.14%). The healers gave no advice about psychiatric medication to 48 (61.5%) of consulters, 23 (29.5%) were told to continue their medication, four (5.1%) told to stop, and one (1.3%) told to stop and restart later. In multivariate models, predictors of consultation were being Black and of lower education. Although 45 (58%) of the consulters indicated that medical treatment was more helpful than the healer’s, 45 (58%) intended to consult again. Overall, 22% of consulters reported abuse by the healer.

The Effects of Uni- and Bilateral Fatigue on Postural and Power Tasks

2013 ◽  
Vol 29 (1) ◽  
pp. 44-48 ◽  
Author(s):  
Paulo H. Marchetti ◽  
Maria I.V. Orselli ◽  
Marcos Duarte
Keyword(s):  
Lower Limb ◽  
Healthy Subjects ◽  
Postural Sway ◽  
Center Of Pressure ◽  
Lower Limbs ◽  
Quiet Standing ◽  
Ground Reaction Forces ◽  
Before And After ◽  
Reaction Forces ◽  
The Mean

The aim of this study was to investigate the effects of unilateral and bilateral fatigue on both postural and power bipedal tasks. Ten healthy subjects performed two tasks: bipedal quiet standing and a maximal bipedal counter-movement jumping before and after unilateral (with either the dominant or nondominant lower limb) and bilateral (with both lower limbs) fatigue. We employed two force plates (one under each lower limb) to measure the ground reaction forces and center of pressure produced by subjects during the tasks. To quantify the postural sway during quiet standing, we calculated the resultant center of pressure (COP) speed and COP area of sway, as well as the mean weight distribution between lower limbs. To quantify the performance during the countermovement jumping, we calculated the jump height and the peak force of each lower limb. We observed that both unilateral and bilateral fatigue affected the performance of maximal voluntary jumping and standing tasks and that the effects of unilateral and bilateral fatigue were stronger in the dominant limb than in the nondominant limb during bipedal tasks. We conclude that unilateral neuromuscular fatigue affects both postural and power tasks negatively.

scholarly journals Asymmetry and changes in the neuromuscular profile of short-track athletes as a result of strength training

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261265
Author(s):  
Paweł Pakosz ◽  
Anna Lukanova-Jakubowska ◽  
Edyta Łuszczki ◽  
Mariusz Gnoiński ◽  
Oscar García-García
Keyword(s):  
Strength Training ◽  
Lower Limb ◽  
Female Athletes ◽  
Lower Limbs ◽  
Lower Limb Muscles ◽  
Limb Muscles ◽  
Before And After ◽  
Monthly Period ◽  
Track Athletes ◽  
The Right

Background The purpose of this study was to identify the biomedical signals of short-track athletes by evaluating the effects of monthly strength training on changes in their neuromuscular profile, strength, and power parameters of the lower limb muscles. Muscle asymmetry, which can cause a risk of injury, was also evaluated. Methods and results This study involved female athletes, age 18.8 ± 2.7 years, with a height of 162 ± 2.4 cm, and weight of 55.9 ± 3.9 kg. Before and after the monthly preparatory period prior to the season, strength measurements were assessed through the Swift SpeedMat platform, and reactivity of the lower limb muscles was assessed with tensiomyography (TMG). The athletes were also tested before and after the recovery training period. In the test after strength training, all average countermovement jump (CMJ) results improved. Flight time showed an increase with a moderate to large effect, using both legs (5.21%). Among the TMG parameters, time contraction (Tc) changed globally with a decrease (-5.20%). Changes in the results of the test after recovery training were most often not significant. Conclusion A monthly period of strength training changes the neuromuscular profile of short-track female athletes, with no significant differences between the right and left lower limbs.

scholarly journals Peripheral microcircuiation in patients over 60 years with atherosclerosis of lower limb arteries

2015 ◽  
Vol 17 (2) ◽  
pp. 22
Author(s):  
O. V. Kamenskaya ◽  
A. S. Klinkova ◽  
A. A. Karpenko ◽  
A. M. Karaskov ◽  
V. B. Starodubtsev ◽  
...  
Keyword(s):  
Lower Limb ◽  
High Volume ◽  
The Elderly ◽  
Early Postoperative Period ◽  
Lower Limbs ◽  
Orthostatic Test ◽  
Doppler Flowmetry ◽  
Functional Reserves ◽  
Before And After ◽  
Fontaine Classification

We investigated peripheral microcirculatory blood flow (MBF) by using laser Doppler flowmetry in 146 patients with IIB-IV stage chronic ischemia of lower limbs (CILL) according to the Pokrovsky-Fontaine classification. The objective was to study the state of peripheral MBF while carrying out functional tests in patients over 60 years with IIB-IV stage CILL before and after revascularization of lower limb arteries. When ageing, CILL patients demonstrate a decrease in the peripheral MBF baseline indicators and an increase in the quantity of defects of regulatory mechanisms and functional reserves of microcirculation, which manifest themselves as a severe paradoxical reaction of the microvasculature during an orthostatic test. In the early postoperative period the elderly patients tend to have reduced functional reserves and regulation mechanisms of MBF, with a high volume and degree of severity of MBF paradoxical reactions during an orthostatic test.

scholarly journals The Hierarchy of Oral Cancer in India

2012 ◽  
Vol 3 (3) ◽  
pp. 143-146 ◽  
Author(s):  
Naik Balachandra Ramachandra
Keyword(s):  
Oral Cancer ◽  
Medical Service ◽  
Oral Cavity Cancer ◽  
Small Towns ◽  
Female Ratio ◽  
The Past ◽  
Medical Facilities ◽  
Economically Deprived ◽  
Village People ◽  
Male To Female

ABSTRACT Background India constitutes more than 80% of population from the villages and are not only socially and economically deprived but also do not get medical facilities compared to small towns and cities. Newspaper says India is fastest developing country, but, in respect to medical service to her citizens at rural level, it is nil. Now, oral cavity cancer is 3rd commonest cancer, which is seen commonly in village people in both sexes. We reviewed the past studies on oral cancer and the same is compared with the present trend. Oral cancer biopsies secured 29.54% among all malignant biopsies. Male to female ratio is 1:1. Majority of patients (38.5%) got oral cancer in 4th decade, followed by 35.2% patients in 3rd decade. Buccal mucosa (57.5%) was the commonest site, followed by tongue (24.2%). Gutkha (the smokeless tobacco) is commonest cause for this cancer. Conclusion Apart from chewing habits, illiteracy, poverty, low caloric diet and nonavailability of free medical facility is the cause for rise in oral cancer incidences. How to cite this article Ramachandra NB. The Hierarchy of Oral Cancer in India. Int J Head and Neck Surg 2012;3(3):143-146.

scholarly journals Functional outcomes in a lower limb amputee population

1995 ◽  
Vol 19 (2) ◽  
pp. 92-96 ◽  
Author(s):  
L. Sapp ◽  
C. E. Little
Keyword(s):  
Nova Scotia ◽  
Lower Limb ◽  
Functional Outcomes ◽  
Return Rate ◽  
Rehabilitation Centre ◽  
Female Ratio ◽  
Training Time ◽  
Patient Profile ◽  
Lower Limb Amputee ◽  
Male To Female

This paper reports an evaluation of 132 patients seen at the Nova Scotia Rehabilitation Centre amputee programme during a 24-month period, carried out to evaluate the programme's effectiveness. In addition to a reveiw of charts, a questionnaire was used (85% return rate) to help determine functional outcomes. The patient profile revealed a 3.4:1 male-to-female ratio and an average age of 64.8 ± 13.0 years. The average overall training time was 44.0 ± 26.5 days. Of the respondents, 65.5% wore their prosthesis at least 9 hours/day, 11.5% wore it at least 4 hours/day, and only 16.1% were no longer using their prosthesis. The programme's effectiveness appears to compare well with that of others reported in the literature.

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