scholarly journals High lower limb amputations in gangren. Russsian Consensus

2021 ◽  
Vol 7 (4) ◽  
pp. 6-55
Author(s):  
Article Editorial
Keyword(s):  
General Practitioners ◽  
Lower Limb ◽  
Lower Extremities ◽  
Treatment Methods ◽  
Federal Level ◽  
X Ray ◽  
Practical Conference

The presented recommendations were developed by federal level experts, approved at the International Scientific and Practical Conference "High amputations of the lower extremities in children and adults" (Moscow, 2019) and published on the website www.woundsurgery.ru for use in work by general, purulent, cardiovascular surgeons, specialists in X-ray endovascular diagnostic and treatment methods, endocrinologists, combustiologists and general practitioners.

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).

Limitations of body mass index for counseling individuals with unilateral lower extremity amputation

2016 ◽  
Vol 41 (2) ◽  
pp. 186-193 ◽  
Author(s):  
Alexandra P Frost ◽  
Tracy Norman Giest ◽  
Allison A Ruta ◽  
Teresa K Snow ◽  
Mindy Millard-Stafford
Keyword(s):  
Body Mass Index ◽  
Lower Extremity ◽  
Health Risk ◽  
Body Mass ◽  
Body Fat ◽  
Lower Limb ◽  
Dual Energy ◽  
Limb Loss ◽  
Percent Body Fat ◽  
X Ray

Background: Body composition is important for health screening, but appropriate methods for unilateral lower extremity amputees have not been validated. Objectives: To compare body mass index adjusted using Amputee Coalition equations (body mass index–Amputee Coalition) to dual-energy X-ray absorptiometry in unilateral lower limb amputees. Study design: Cross-sectional, experimental. Methods: Thirty-eight men and women with lower limb amputations (transfemoral, transtibial, hip disarticulation, Symes) participated. Body mass index (mass/height2) was compared to body mass index corrected for limb loss (body mass index–Amputee Coalition). Accuracy of classification and extrapolation of percent body fat with body mass index was compared to dual-energy X-ray absorptiometry. Results: Body mass index–Amputee Coalition increased body mass index (by ~ 1.1 kg/m2) but underestimated and mis-classified 60% of obese and overestimated 100% of lean individuals according to dual-energy X-ray absorptiometry. Estimated mean percent body fat (95% confidence interval) from body mass index–Amputee Coalition (28.3% (24.9%, 31.7%)) was similar to dual-energy X-ray absorptiometry percent body fat (29.5% (25.2%, 33.7%)) but both were significantly higher ( p < 0.05) than percent body fat estimated from uncorrected body mass index (23.6% (20.4%, 26.8%)). However, total errors for body mass index and body mass index–Amputee Coalition converted to percent body fat were unacceptably large (standard error of the estimate = 6.8%, 6.2% body fat) and the discrepancy between both methods and dual-energy X-ray absorptiometry was inversely related ( r = −0.59 and r = −0.66, p < 0.05) to the individual’s level of body fatness. Conclusions: Body mass index (despite correction) underestimates health risk for obese patients and overestimates lean, muscular individuals with lower limb amputation. Clinical relevance Clinical recommendations for an ideal body mass based on body mass index–Amputee Coalition should not be relied upon in lower extremity amputees. This is of particular concern for obese lower extremity amputees whose health risk might be significantly underestimated based on body mass index despite a “correction” formula for limb loss.

Place of angiography, oscillography and rheography in the examination of patients with obliterating diseases of the arteries of the lower extremities

1982 ◽  
Vol 63 (3) ◽  
pp. 17-19
Author(s):  
M. N. Malinovsky ◽  
A. A. Zamaletdinov ◽  
V. E. Mamaev
Keyword(s):  
Research Methods ◽  
Lower Limb ◽  
Lower Extremities ◽  
Functional Changes ◽  
Initial Stage ◽  
Pharmacological Test ◽  
Literary Process

The data of angiographic, oscillographic and rheographic research methods were compared in 63 patients with obliterating diseases of the lower limb arteries. It has been established that arterial oscillography and rheovasography objectively reflect and document the changes occurring in the arterial bed of patients with obliterating endarteritis and atherosclerosis, only when they are used together. The pharmacological test with nitroglycerin makes it possible to differentiate organic and functional changes in the arterial bed only in the initial stage of the disease, in later periods it only helps in predicting the course of the disease. Angiographic methods of examination clarify the diagnosis, localization and length of the literary process.

scholarly journals Sonography and multislice contrast tomography in the diagnosis of chronic venous insufficiency complicated by trophic ulcers

2021 ◽  
Vol 11 (7) ◽  
pp. 316-323
Author(s):  
O. Kolomiets
Keyword(s):  
Computed Tomography ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Multislice Computed Tomography ◽  
Venous Blood ◽  
Lower Extremities ◽  
Venous System ◽  
Venous Blood Flow ◽  
Planning Stage ◽  
X Ray

Sonography has become the gold standard in the diagnosis of pathological changes in venous insufficiency, however, studies by other scientists indicate the need for a comprehensive study using phlebographic methods. The aim of the work was to compare the results of sonography and multislice tomography in the diagnosis of chronic venous insufficiency complicated by trophic ulcers. Materials and methods. The results of treatment of 97 patients with chronic venous insufficiency in stage C6 and C6r were evaluated. Ultrasound angioscanning of the venous system of the lower extremities at the planning stage of surgical treatment and in the postoperative period (early and after a year of observation) was performed on a digital device of expert class for cardiovascular studies (Toshiba Aplio 500) with 5-10 MHz sensor and appropriate standard software package examination of the venous system of the lower extremities. Multislice computed tomography was performed using X-ray computed tomography (Philips Brilliance 64). The study was performed using X-ray contrast iodine-containing medium (Omnipack-350) at the rate of 1 ml of the drug per kilogram of patient weight. Research results and their discussion. the sonographic study found that the causes of trophic ulcers were impaired venous blood flow in the veins of the lower extremities due to severe varicose transformation and decompensated reflux, and changes in the deep venous system due to thrombosis of the deep veins. Greater sensitivity and specificity of multislice computed tomography in the diagnosis of postthrombotic stenoses and obliterations were found compared with sonographic examination. This method is valuable in the study of the anatomy of the venous system, but does not allow to assess the parameters of hemodynamics (duration and degree of reflux, but only its presence).

scholarly journals Anatomical axis validation of lower extremity for different deformities: A radiological study

2020 ◽  
Vol 8 ◽  
pp. 205031212092382
Author(s):  
Meric Unal ◽  
Sabriye Ercan ◽  
Aydin Budeyri ◽  
Uğur Toprak ◽  
Abdülkerim Şalkaci
Keyword(s):  
Lower Limb ◽  
Mechanical Axis ◽  
Correlation Coefficients ◽  
Strong Positive Correlation ◽  
Knee Alignment ◽  
Intra Class Correlation ◽  
X Ray ◽  
The Past ◽  
Radiology Assistant ◽  
Anatomical Axis

Aim: The aim of this study was to derive a pure, unbiased, reliable and accurate objective relationship between the local knee axis measurements through a short knee anteroposterior roentgenogram and the lower limb axis measurement through an orthoroentgenogram. Patients and Methods: Radiographs of 114 patients (114 knees) were evaluated by two independent raters for measurement of lower limb axis on an orthoroentgenogram and the local knee axis on short knee anteroposterior X-ray, which was derived by cropping the orthoroentgenogram by a blinded radiology assistant. The raters measured at two different time-points separated by an interval of 30-day period. Intra-rater and inter-rater reliabilities were calculated by intra-class correlation coefficients and three models were built to establish the relationships of X-ray anatomical axis with orthoroentgenogram anatomical axis, orthoroentgenogram anatomical axis with orthoroentgenogram mechanical axis and X-ray anatomical axis with orthoroentgenogram mechanical axis. Results: For three different measurements, intra-class correlation coefficients of Rater 2 were higher than 0.90 which shows perfect reliability, while that for Rater 1 was low. Furthermore, first measurements were more consistent than the second measurement. There was a strong positive correlation in all the three models except for varus cases in the last. Conclusion: The standardized correlation derived between the two different techniques for measuring knee alignment is fairly comparable with the studies in the past and would serve as a reliable template for future studies concerning relationships between the two, in addition to helping knee surgeons make more reliable and accurate interpretations through local knee axis measurements.

scholarly journals Knowledge, Attitude, and Practice (KAP) of Radiographic Protection by Dental Undergraduate and Endodontic Postgraduate Students, General Practitioners, and Endodontists

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Amal A. Almohaimede ◽  
Mohammad W. Bendahmash ◽  
Feras M. Dhafr ◽  
Abdullah F. Awwad ◽  
Ebtissam M. Al-Madi
Keyword(s):  
Saudi Arabia ◽  
Radiation Protection ◽  
General Practitioners ◽  
Undergraduate Students ◽  
Preventive Measures ◽  
Dental Students ◽  
National Council ◽  
Academic Field ◽  
Postgraduate Students ◽  
X Ray

The aim of this study is to evaluate the knowledge, attitude, and perception of radiation hazard and preventive measures among dental undergraduate students, general practitioners, endodontic postgraduate students, and endodontists in Saudi Arabia. Multiple choice questions questionnaires were distributed among undergraduate and endodontic postgraduate dental students, general practitioners, and endodontists in the colleges of dentistry in Saudi Arabia, government hospitals, and private clinics. The questionnaire included sociodemographic data, assessment of the knowledge of radiation physics and biology, assessment of the practice of dental radiography, and assessment of knowledge of radiation protection. Chi-square test was used for individual and multiresponse analysis. Level of statistical significance was set at P≤0.05. Three hundred and twenty-nine responded to the questionnaire. More than half of the respondents agreed that dental X-ray is hazardous to health (60.79%), and 68.1% were familiar with ALARA (as low as reasonably achievable) principle. However, only 34% are familiar with the recommendations of the National Council on Radiation Protection (NCRP) and International Commission on Radiological Protection (ICRP). The use of lead apron and thyroid collar for patients’ protection from X-ray radiation was practiced among endodontic postgraduate students more frequently as well as those who are proactive in the academic field. Undergraduate students, endodontic postgraduate students, and endodontists in the academic field were the most aware towards radiation reduction measures. The use of the preventive measures needs to be emphasized more among general practitioners, endodontic postgraduate students, and endodontists especially in governmental hospitals and private sectors.

Retrospective Analysis in Lower Limb Reconstruction: Propeller Perforator Flaps versus Free Flaps

2017 ◽  
Vol 33 (S 01) ◽  
pp. S34-S39 ◽  
Author(s):  
Marta Cajozzo ◽  
Alessandro Innocenti ◽  
Massimiliano Tripoli ◽  
Giovanni Zabbia ◽  
Salvatore D'Arpa ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Retrospective Analysis ◽  
Revision Surgery ◽  
Lower Limb ◽  
Lower Extremities ◽  
Free Flaps ◽  
Soft Tissue Defects ◽  
Perforator Flaps ◽  
Hospitalization Period ◽  
Tissue Defects

Background Technical advancements and increasing experience in the management of soft tissue defects in lower extremities have led to the evolution of decisional reconstructive algorithms. Both propeller perforator flaps (PPFs) and free flaps (FFs) proved to be useful methods of reconstruction for lower extremities defects, offering alternative reconstructive tools. We present a case series of PPFs and FFs for reconstruction of lower limbs defects, analyzing and comparing treatment and outcomes. Methods Through a retrospective analysis, we report our experience in performing PPFs or FFs for reconstruction of soft tissue defects of the lower extremities, in patients admitted between 2010 and 2015 at the Department of Plastic and Reconstructive Surgery, University of Palermo. In these patients, we evaluated location and causes of defects, types of flaps used, recipient vessels, complications, time to healing, and aesthetic outcome. Results A primary healing rate was obtained in 13 patients for PPF and 16 cases for FF. Revision surgery for partial skin necrosis was required in eight cases (PPF: four and FF: four). Recovery time and hospitalization period were eventually shorter in patients with FFs, due to lower rate of complications and revision surgery. Conclusion In the past years, our indications for reconstruction with PPFs in the lower limb have become more restricted, while we favor reconstruction with FFs. Recommendations are provided to orient surgical treatment in small, medium, and large lower limb defects.

scholarly journals X-ray unit for general practitioners.

BMJ ◽  
1968 ◽  
Vol 1 (5590) ◽  
pp. 502-504 ◽  
Author(s):  
R. H. Davis ◽  
J. E. Williams
Keyword(s):  
General Practitioners ◽  
X Ray

Agreement between anthropometric and dual-energy X-ray absorptiometry assessments of lower-limb volumes and composition estimates in youth-club rugby athletes

2012 ◽  
Vol 37 (3) ◽  
pp. 463-471 ◽  
Author(s):  
Humberto M. Carvalho ◽  
Manuel J. Coelho-e-Silva ◽  
Sérgio Franco ◽  
António J. Figueiredo ◽  
Óscar M. Tavares ◽  
...  
Keyword(s):  
Young Adult ◽  
Free Volume ◽  
Body Mass ◽  
Reference Values ◽  
Lower Limb ◽  
Dual Energy ◽  
Limb Volume ◽  
X Ray ◽  
Volume Estimates ◽  
Rugby Players

The purpose of this study was to assess the agreement of lower-limb volume estimates based on anthropometry and dual-energy X-ray absorptiometry (DXA) as a reference method in male rugby athletes. Predictive models using body mass and skinfolds were tested to improve the relative agreement between protocols (anthropometry, DXA). Rugby players (n = 41; 19.9 ± 2.2 years) volunteered for the study. Lower-limb total and fat-free volumes were estimated by anthropometry and also derived using DXA. Cross-validation between the anthropometry technique and DXA was then performed. Lower-limb volume estimates by anthropometry overestimated reference values and tended to be further from the reference values with the increase of scale. For the total sample, standard errors of measurement for volume estimates by anthropometry were 1.99 L and 1.34 L for total and fat-free volumes, respectively. Correlations with reference values were 0.81 for lower-limb volume and 0.90 for lower-limb fat-free volume. Correlations between estimated prediction equations and reference values showed higher correlations (r = 0.96 for lower-limb volume and r = 0.93 for lower-limb fat-free volume) compared with anthropometric estimates. Overall, the agreement of anthropometry method to quantify lower-limb volumes with DXA as a reference in young adult rugby players is acceptable and is a practical method when more expensive and complex techniques are not available. The consideration of body mass and lower-limb skinfolds increases the precision of lower-limb volume estimates using anthropometry in the young adult rugby players.

Sign in / Sign up

Export Citation Format

Share Document