scholarly journals THE PLACE OF VASCULAR SURGERY IN TREATMENT OF DIABETIC PATIENTS

2012 ◽  
Vol 67 (1) ◽  
pp. 27-30
Author(s):  
А. V. Pokrovskiy
Keyword(s):  
Surgical Intervention ◽  
Surgical Techniques ◽  
Vascular Complications ◽  
Lower Limbs ◽  
Diabetic Patients ◽  
Critical Ischemia ◽  
X Ray ◽  
Latent Stage ◽  
Main Tendency

This article is dedicated to diagnostics, prevention and surgical treatment of vascular complications of diabetes mellitus, particularly prevention of ischemic strokes and treatment of critical ischemia of lower limbs. The main tendency in treatment of brachiocephalic artery lesions nowadays is a surgical intervention in the latent stage of the disease. X-ray endovascular surgical techniques are being increasingly used to treat lesions of lower limbs arteries. Limb preservation is impossible without cooperation of many specialists. It’s essential to perform careful out-patient follow up of the patient after vascular reconstructive surgery.

Congenital Syphilis Simulating Bone Neoplasm in 2-Month Old Infant – Case Report

2017 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Case Report ◽  
Congenital Syphilis ◽  
Eosinophilic Granuloma ◽  
Osteolytic Lesion ◽  
Lower Limbs ◽  
Upper Body ◽  
Elective Cesarean Section ◽  
Distal Fibula ◽  
X Ray

Introduction: Congenital Syphilis (CS) occurs through the transplacental transmission of Treponema pallidum in inadequately treated or non-treated pregnant women, and is capable of severe consequences such as miscarriage, preterm birth, congenital disease and/or neonatal death. CS has been showing an increasing incidence worldwide, with an increase of 208% from 2009 to 2015 in Brazil. Case report: 2-month old infant receives care in emergency service due to edema of right lower limb with pain in mobilization. X-ray with osteolytic lesion in distal fibula. Infant was sent to the Pediatrics Oncology clinic. Perinatal data: 7 prenatal appointments, negative serology at 10 and 30 weeks of gestation. End of pregnancy tests were not examined and tests for mother’s hospital admission were not requested. Mother undergone elective cesarean section at 38 weeks without complications. During the pediatric oncologist appointment, patient showed erythematous-squamous lesions in neck and other scar-like lesions in upper body. A new X-ray of lower limbs showed lesions in right fibula with periosteal reaction associated with aggressive osteolytic lesion compromising distal diaphysis, with cortical bone rupture and signs of pathological fracture, suggestive of eosinophilic granuloma. She was hospitalized for a lesion biopsy. Laboratory tests: hematocrit: 23.1 / hemoglobin 7.7 / leukocytes 10,130 (without left deviation) / platelets 638,000 / Negative Cytomegalovirus IgG and IgM and Toxoplasmosis IgG and IgM / VDRL 1:128. Congenital syphilis diagnosis with skin lesions, bone alterations and anemia. Lumbar puncture: glucose 55 / total proteins 26 / VDRL non reagent / 13 leukocytes (8% neutrophils; 84% monomorphonuclear; 8% macrophages) and 160 erythrocytes / negative VDRL and culture. X-ray of other long bones, ophthalmological evaluation and abdominal ultrasound without alterations. Patient was hospitalized for 14 days for treatment with Ceftriaxone 100mg/kg/day, due to the lack of Crystalline Penicillin in the hospital. She is now under outpatient follow-up. Discussion: CS is responsible for high rates of morbidity and mortality. The ongoing increase of cases of this pathology reflects a severe health issue and indicates failures in policies for the prevention of sexually transmitted diseases, with inadequate follow-up of prenatal and maternity protocols.

Autologous Skin Fibroblast and Keratinocyte Grafts in the Treatment of Chronic Foot Ulcers in Aging Type 2 Diabetic Patients

2011 ◽  
Vol 101 (1) ◽  
pp. 55-58 ◽  
Author(s):  
Matteo Monami ◽  
Maria Vivarelli ◽  
Carla Maria Desideri ◽  
Giulio Ippolito ◽  
Niccolò Marchionni ◽  
...  
Keyword(s):  
Healing Time ◽  
Lower Limbs ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Consecutive Series ◽  
Type 2 Diabetic Patients ◽  
Skin Cell ◽  
Type 2 Diabetic

Background: We assessed the tolerability and efficacy of autologous skin cell grafts in older type 2 diabetic patients with chronic foot ulcers. Methods: Treatment with Hyalograft 3D and Laserskin Autograft was proposed to a consecutive series of type 2 diabetic patients older than 65 years affected by long-standing (>6 months) foot ulcers with an area greater than 15 cm2. Ulcer healing rates and measurements of ulcer area were determined monthly for 12 months. Results: Seven patients with 12 ulcers, nine of which received the described treatment, were enrolled. During 12-month follow-up, all of the ulcers healed except one. In the remaining eight ulcers, the median healing time was 21 weeks (interquartile range, 4–29 weeks). Conclusions: Autologous skin cell grafts are feasible, well tolerated, and apparently effective in the treatment of diabetic ulcers of the lower limbs in advanced age. Age did not seem to moderate healing times. (J Am Podiatr Med Assoc 101(1): 55–58, 2011)

scholarly journals NEXT AND LONG-TERM RESULTS OF X-RAY ENDOVASCULAR INTERVENTIONS IN TREATMENT OF CHRONIC CRITICAL ATHERODIABETIC ISCHEMIA OF LOWER EXTREMITIES

2020 ◽  
Vol 18 (6) ◽  
pp. 710-715
Author(s):  
N. N. Ioskevich ◽  
◽  
L. F. Vasilchuk ◽  
P. E. Vankovich ◽  
S. P. Antonenko ◽  
...  
Keyword(s):  
Lower Limb ◽  
Type I Diabetes ◽  
Lower Extremities ◽  
Limb Ischemia ◽  
Type I ◽  
Critical Ischemia ◽  
Lower Limb Ischemia ◽  
X Ray ◽  
Endovascular Interventions

Background. The treatment of chronic critical ischemia of the lower extremities with their combined atherodiabetic lesion is one of the far from the resolved problems of modern surgery. Aim of the study. Analysis of the results of X-ray endovascular interventions in patients with critical lower limb ischemia due to atherodiabetic lesions of the femoral-popliteal-tibial segment. Material and methods. We analyzed the results of REVS in 60 patients with diabetes mellitus with critical ischemia of the lower extremities due to infra-anginal atherosclerotic occlusions with a follow-up period of up to 5 years from the moment of the manipulation. Results. The total shelf life of the lower limb after REVV was 492.4 ± 10.1 days. Out of 26 amputations performed, balloon angioplasty was performed in 18 cases and stenting in 8 cases. In individuals with type I diabetes, the duration of painless period was 415.4 ± 5.1 days, and the total shelf life of the leg was 465.4 ± 4.3 days. In type II diabetes, these indicators were, respectively, 181.4 ± 4.4 days and 317.8 ± 6.7 days. In the group of patients with type I diabetes, the lower limb was saved in 55.6% of cases (in 20 out of 36 patients), and in type II diabetes - in 58.3% (in 14 out of 24 people). Conclusions. The presence of simultaneously obliterating atherosclerosis and diabetes mellitus in patients leads to a combined atherodiabetic lesion of the arterial bed, including infra-anginal arteries. X-ray endovascular interventions (balloon angioplasty and stenting) on the arterial femoral-popliteal-tibial segment are a rather effective method of eliminating chronic critical lower limb ischemia, which allows preserving the lower limb in 56.7% patients with a follow-up period of up to 5 years from the date of surgery. Improving the results of X-ray endovascular interventions in case of chronic critical atherodiabetic lower limb ischemia requires a comprehensive study of the possible causes of occlusions of reconstructed arterial segments (blood coagulation potential, non-optimal processes in the intervention zone).

VENOGRAPHY (VG) OF THE LOWER LIMBS IN THE MANAGEMENT OF PATIENTS WITH SUSPECTED PULMONARY EMBOLISM (PE)

1987 ◽  
Author(s):  
W H J Kruit ◽  
A K Sing ◽  
G J H den Ottolander ◽  
A C de Beor ◽  
J J C Jonker
Keyword(s):  
Pulmonary Embolism ◽  
Impedance Plethysmography ◽  
Lower Limbs ◽  
Surgical Patients ◽  
Additional Patient ◽  
Suspected Pulmonary Embolism ◽  
X Ray ◽  
Group A ◽  
Group B

In a prospective cohort study, we evaluated X-ray VG in the management of non-surgical patients with clinically suspected PE. Thusfar follow up is available on 131 consecutive patients with suspected PE. In all patients a perfusion lungscan (PS) was carried out within 24 hours. In case of a normal PS (group A, n=32), no anticoagulant (AC) therapy was given. In case of an abnormal PS, AC therapy was started (heparin) and a bilateral ascending VG was carried out within 72 hours. In 46 patients (group C) venous thrombosis (DVT) was demonstrated by VG, and these patients were treated with AC for 6 months. In 53 patients with suspected PE and an abnormal lungscan, bilateral VG did not show DVT (group B). AC therapy was discontinued in these patients These patients were then screened for 14 days with fibrinogen legscanning and impedance plethysmography (IPG), followed by IPG alone every 2 months for at least 1 year. In group B, 6 patients died in the follow up period. None of the patients had signs of PE at autopsy. One additional patient in group B developed DVT documented by repeat VG, 6 months after entry into the trial. According to these preliminary data, it seems safe to base the decision whether or not to treat a patient with suspected PE with AC, on the presence or absence of DVT in the lower limbs as demonstrated by VG

scholarly journals Extra-thoracal migration of the Nuss Bar in corrective surgery for pectus excavatum: a very rare late complication

2020 ◽  
Vol 2020 (10) ◽  
Author(s):  
Natalie Simon ◽  
Shyam Kolvekar ◽  
Amir Khosravi
Keyword(s):  
Pectus Excavatum ◽  
Surgical Intervention ◽  
Rare Complication ◽  
Late Complication ◽  
Nuss Procedure ◽  
Corrective Surgery ◽  
Chest Wall Deformity ◽  
X Ray ◽  
First Case

Abstract Pectus excavatum is a chest wall deformity with an incidence of around 1 in 400 live births. The Nuss procedure is a surgical intervention that aims to restore functional integrity in these patients. We report the first case of bar migration into the stomach necessitating further surgical intervention for removal. Our case presents a rare complication of pectus excavatum repair and highlights the importance of vigilant follow-up in these patients. If bar migration does occur, imaging in the form of X-ray and CT scans may be of use in early detection in order to expedite management.

OPYT PRIMENENIYa KOMPOZITsIONNYKh BIOSOVMESTIMYKh IMPLANTATOV V KLINIKE DETSKOY I PODROSTKOVOY ORTOPEDII

2003 ◽  
Vol 10 (1) ◽  
pp. 78-83
Author(s):  
O A Malakhov ◽  
G A Krasnoyarov ◽  
S I Belykh ◽  
O V Kozhevnikov ◽  
A V Ivanov ◽  
...  
Keyword(s):  
Experimental Study ◽  
Medical Technology ◽  
Surgical Intervention ◽  
Hip Dislocation ◽  
Varus Deformity ◽  
Functional Results ◽  
Lower Limbs ◽  
Femur Head ◽  
Congenital Hip Dislocation

Specialists from Children Orthopedic Clinic (CITO) and Institute of Medical Technology elaborated therapeutically active implants on the base of N-vinilpirrolidone and methylmethacrylate with different additives. Those implants were successfully applied in clinical practice. Experimental study on rabbits showed the possibility of implants to stimulate osteogenesis. Various types and shapes of implants were elaborated using different combinations of additives. Minimum invasive surgical intervention and indications to implants' application were worked out. From 1987 to 2001 one hundred thirteen patients with various pathology (obstetrical paresis, clubfoot, juvenile femur head ephiphysiolysis, congenital hip dislocation, funnel-shaped deformity of thorax, dystrophic varus deformity of femur head, osteochondropathy of lower limbs) were treated surgically using new implants. At 3-5 years follow up good and excellent anatomic and functional results were noted in 89% of cases.

Study on spontaneous cerebrospinal fluid rhinorrhoea: its aetiology and management

2005 ◽  
Vol 119 (1) ◽  
pp. 12-15 ◽  
Author(s):  
C J Dunn ◽  
A Alaani ◽  
A P Johnson
Keyword(s):  
Cerebrospinal Fluid ◽  
Surgical Intervention ◽  
Surgical Techniques ◽  
Queen Elizabeth Hospital ◽  
Study Group ◽  
Common Features ◽  
Csf Rhinorrhoea ◽  
The Common ◽  
Csf Leaks

The aim of this study was to identify the common features in a study group of patients with spontaneous cerebrospinal fluid (CSF) rhinorrhoea, to develop a hypothesis to explain the cause of this condition and to investigate the outcome of surgical techniques adopted to repair the leak. In this retrospective study the authors have reviewed all the cases of spontaneous CSF leaks attending and receiving treatment from the otolaryngology department of Queen Elizabeth Hospital, Birmingham, from 1992 to 2002.Of 34 patients with CSF leaks, 15 were spontaneous in nature and formed the study group. Of these 15 patients, 14 were female; with ages ranging from 37 to 70 years and a median age of 50 years. All the female patients were overweight with a body mass index (BMI) >24.9 and, of these, nine were considered obese with a BMI >30. It was attempted to identify common factors in the study group and it was evident that female sex, obesity and age played a key role in this condition.The follow-up period ranged from two to 98 months. Thirteen patients were asymptomatic but two patients remained symptomatic, one of these despite repeated surgical intervention.

scholarly journals Surgical Treatment of Juvenile Femoral Head Epiphysiolysis in Children

2016 ◽  
Vol 23 (1) ◽  
pp. 40-47
Author(s):  
D. B Barsukov ◽  
A. I Krasnov ◽  
M. M Kamosko ◽  
V. E Baskov ◽  
I. Yu Pozdnikin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Magnetic Resonance ◽  
Femoral Head ◽  
Femoral Neck ◽  
Surgical Intervention ◽  
Treatment Results ◽  
Surgical Interventions ◽  
X Ray ◽  
Endochondral Growth

To optimize the anatomical and functional surgical treatment results in patients with early (I-II) stages of juvenile femoral head epiphysiolysis both pre- and postoperative data of clinical, x-ray and magnetic-resonance examinations were analyzed for 120 patients aged 11 - 15 years. Maximum follow up period after surgical interventions, i.e. femoral head epiphysiodesis (n=60) and femoral head epiphysis fixation (n=60) made up 23 and 3 years, respectively. It was shown that surgical intervention for the fixation of femoral head epiphysis ensured reliable stability of the epiphysis preventing the latter from displacement development and progression, and did not exert significant influence upon either femoral neck and head endochondral growth or the length of the upper extremity.

scholarly journals Sortilin levels correlate with major cardiovascular events of diabetic patients with peripheral artery disease following revascularization: a prospective study

2020 ◽  
Author(s):  
Federico Biscetti ◽  
Elisabetta Nardella ◽  
Maria Margherita Rando ◽  
Andrea Leonardo Cecchini ◽  
Nicola Bonadia ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Cardiovascular Events ◽  
Vascular Complications ◽  
Diabetic Patients ◽  
Operating Characteristics ◽  
Peripheral Artery ◽  
Baseline Serum ◽  
Increased Risk ◽  
Artery Disease

Abstract Background: Peripheral artery disease (PAD) represents one of the most relevant vascular complications of type 2 diabetes mellitus (T2DM). Moreover, T2DM patients suffering from PAD have an increased risk of major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Sortilin, a protein involved in apolipoproteins trafficking, is associated with lower limb PAD in T2DM patients.Objective: To evaluate the relationship between baseline serum levels of sortilin, MACE and MALE occurrence after revascularization of T2DM patients with PAD and chronic limb-threatening ischemia (CLTI).Research Design and Methods: We performed a prospective non-randomized study including 230 statin-free T2DM patients with PAD and CLTI. Sortilin levels were measured before the endovascular intervention and incident outcomes were assessed during a 12-month follow-up.Results: Sortilin levels were significantly increased in individuals with more aggressive PAD (2.25 ± 0.51 ng/mL vs 1.44 ± 0.47 ng/mL, p < 0.001). During follow-up, 83 MACE and 116 MALE occurred. In patients, who then developed MACE and MALE, sortilin was higher. In particular, 2.46 ± 0.53 ng/mL vs 1.55 ± 0.42 ng/mL, p < 0.001 for MACE and 2.10 ± 0.54 ng/mL vs 1.65 ± 0.65 ng/mL, p < 0.001 for MALE. After adjusting for traditional atherosclerosis risk factors, the association between sortilin and vascular outcomes remained significant in a multivariate analysis. In our receiver operating characteristics (ROC) curve analysis using sortilin levels the prediction of MACE incidence improved (area under the curve [AUC] = 0.94) and MALE (AUC = 0.72).Conclusions: This study demonstrates that sortilin correlates with incidence of MACE and MALE after endovascular revascularization in a diabetic population with PAD and CLTI.

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