scholarly journals Factores asociados a la ocurrencia de úlceras en miembros inferiores en pacientes diabéticos, en una población que asiste a dos instituciones de salud de la ciudad de cali

2017 ◽  
Vol 3 (1) ◽  
pp. 18-24
Author(s):  
Diego Fernando Moreno Sánchez ◽  
Olga Lucía Gómez
Keyword(s):  
Social Context ◽  
Health Beliefs ◽  
Lower Limb ◽  
Lower Limbs ◽  
Diabetic Patients ◽  
Behavioral Factors ◽  
Context Factors ◽  
Level 3 ◽  
Para Determinar ◽  
The City

Introducción: Las úlceras del pie son frecuentes en las personas con diabetes. Conocer los factores del comportamiento, y su relación con los factores biológicos y del ambiente puede favorecer el entendimiento de esta patología y sentar las bases para su intervención.Métodos: Se realizó un estudio de casos y controles para determinar los factores asociados a la ocurrencia de úlceras en pacientes diabéticos. Los participantes fueron personas que asisten a una institución hospitalaria de nivel II y a una institución de nivel III de la ciudad de Cali. Los casos fueron pacientes diabéticos hospitalizados con diagnóstico de úlcera de miembros inferiores con o sin sobreinfección, y los controles pacientes hospitalizados con diagnóstico de diabetes pero sin úlceras.Resultados: Se encontró en el análisis por regresión logística múltiple que hubo factores biológicos asociados a úlcera de miembros inferiores como la neuropatía periférica (OR: 3,95; IC: 2,01 – 7,71) y la presencia de dolor o calambres en las piernas (OR: 2,31; IC: 1,05 – 5,09), factores del comportamiento como no revisar nunca o revisar los pies una vez al mes (OR 2,78; IC: 1,16 -6,64) y factores del contexto social que fueron protectores como ir al parque a caminar o hacer ejercicio (OR 0,76; IC: 0,56- 1,04) y participar con frecuencia como voluntario en organizaciones locales como juntas de acción comunal, juntas de acción local (OR 0,68; IC: 0,44 – 1,07).Discusión: El desarrollo de úlceras en los miembros inferiores tiene una base clínica ampliamente conocida, pero además se asocia a factores del comportamiento y del contexto social que implican autocuidado, adherencia, y dentro del modelo de creencias en salud claves para la acción y beneficios percibidos indirectos que deben evaluarse integralmente para impactar en la prevalencia y las complicaciones de esta patología.Summary Introduction: Foot ulcers are common in people with diabetes. Knowing behavioral factors and their relationship with biological and environmental factors can foster understanding of this disease, and set the stage for its intervention. Methods: A study of cases and controls was conducted in order to determine the factors associated with the occurrence of ulcers in diabetic patients. Participants were people attending a Level 2 hospital and a Level 3 institution in the city of Cali. The cases were hospitalized diabetic patients diagnosed with lower limb ulcer with or without superinfection, and controls of hospitalized patients diagnosed with diabetes but without ulcers. Results: In the analysis, it was found that biological factors were associated with lower limb ulcers and peripheral neuropathy by multiple logistic regression (OR: 3.95; IC: 2.01 – 7.71) and the presence of pain or cramps in the legs (OR: 2.31; IC: 1.05 –5.09), behavioral factors such as never checking or checking the feet once a month (OR 2.78; IC: 1.16 -6.64) and social context factors which were protective such as going to the park to walk or exercise (OR 0.76; IC: 0.56- 1.04) and frequently participate as a volunteer in local organizations such as communal action boards, local action boards (OR 0.68; IC: 0.44 – 1.07). Discussion: The development of ulcer in the lower limbs has a well-known clinical basis, but also, it is associated with behavioral and social context factors which involve self-care, adherence, and within the model of key health beliefs for action and indirect benefits received that must be fully evaluated to decrease the prevalence and complications of this disease.

scholarly journals Lower limb cellulitis in non-diabetic patients: a prospective study

2018 ◽  
Vol 5 (6) ◽  
pp. 2336
Author(s):  
Eakanathan Adimoolam ◽  
Rajapandi Pitchai
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Lower Limb ◽  
Skin Grafting ◽  
Lower Limbs ◽  
Diabetic Patients ◽  
Minor Trauma ◽  
Medical College ◽  
Bite Wounds ◽  
A Prospective Study

Background: Lower limbs are commonly involved in cellulitis as they are more susceptible to injuries. This study analyzes the various causes and risk factors for cellulitis in the non-diabetics.Methods: This prospective study was conducted at the Department of General Surgery, Government Thanjavur Medical College and included 100 non-diabetic patients with lower limb cellulitis. The severity of cellulitis was graded as per the CREST guidelines. Demographics, risk factors, grades, management and treatment outcomes were recorded and analyzed.Results: Cellulitis was more common in females (58%) and old age group (37%). It was more unilateral (86%) and resulted more from post bite wounds (21%). 76% had culture-positive wound infections. Severe grades of cellulitis needed surgical intervention and many patients needed skin grafting.Conclusions: Nondiabetic patients with lower limb cellulitis can also result in severe morbid consequences but in the absence of co-morbid illness, they usually recover with minimal residual disabilities. Nondiabetic elderly patients have to be motivated to take care of their feet as the diabetic patients, as neglect of minor trauma or bites can lead to morbid illness necessitating major treatment like skin grafting.

627-P: Efficacy and Safety of Allogeneic Platelet Rich Plasma in Treatment of Diabetic Patients with Lower Limb Ulcers: A Pilot Study

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 627-P
Author(s):  
WUQUAN DENG ◽  
MIN HE ◽  
BING CHEN ◽  
YU MA ◽  
DAVID ARMSTRONG ◽  
...  
Keyword(s):  
Pilot Study ◽  
Lower Limb ◽  
Platelet Rich Plasma ◽  
Diabetic Patients ◽  
Efficacy And Safety

Design of a Human Knee Reeducation Mechanism

2019 ◽  
Vol 11 (1) ◽  
pp. 42-53
Author(s):  
Allaoua Brahmia ◽  
Ridha Kelaiaia
Keyword(s):  
Lower Limb ◽  
Mechanical Design ◽  
Kinematic Chain ◽  
Lower Limbs ◽  
Kinematic Structure ◽  
Robotic Device ◽  
Human Knee ◽  
Kinematic Study ◽  
Rehabilitation Exercise ◽  
New Machine

Abstract To establish an exercise in open muscular chain rehabilitation (OMC), it is necessary to choose the type of kinematic chain of the mechanical / biomechanical system that constitutes the lower limbs in interaction with the robotic device. Indeed, it’s accepted in biomechanics that a rehabilitation exercise in OMC of the lower limb is performed with a fixed hip and a free foot. Based on these findings, a kinematic structure of a new machine, named Reeduc-Knee, is proposed, and a mechanical design is carried out. The contribution of this work is not limited to the mechanical design of the Reeduc-Knee system. Indeed, to define the minimum parameterizing defining the configuration of the device relative to an absolute reference, a geometric and kinematic study is presented.

Effect of spinal anaesthesia on perioperative hyperglycemia in diabetic patients undergoing lower limb orthopaedic surgeries

2018 ◽  
Vol 6 (1) ◽  
pp. 01-05
Author(s):  
Shaily Gokhru ◽  
◽  
Shalini Jain ◽  
Keyword(s):  
Spinal Anaesthesia ◽  
Lower Limb ◽  
Diabetic Patients

scholarly journals Effects of Dominant and Nondominant Limb Immobilization on Muscle Activation and Physical Demand during Ambulation with Axillary Crutches

2021 ◽  
Vol 6 (1) ◽  
pp. 16
Author(s):  
Kara B. Bellenfant ◽  
Gracie L. Robbins ◽  
Rebecca R. Rogers ◽  
Thomas J. Kopec ◽  
Christopher G. Ballmann
Keyword(s):  
Lower Limb ◽  
Muscle Activation ◽  
Weight Bearing ◽  
Lower Limbs ◽  
Medial Gastrocnemius ◽  
Bipedal Walking ◽  
Lower Limb Muscle ◽  
Limb Muscle ◽  
Physical Demand ◽  
Limb Dominance

The purpose of this study was to investigate the effects of how limb dominance and joint immobilization alter markers of physical demand and muscle activation during ambulation with axillary crutches. In a crossover, counterbalanced study design, physically active females completed ambulation trials with three conditions: (1) bipedal walking (BW), (2) axillary crutch ambulation with their dominant limb (DOM), and (3) axillary crutch ambulation with their nondominant limb (NDOM). During the axillary crutch ambulation conditions, the non-weight-bearing knee joint was immobilized at a 30-degree flexion angle with a postoperative knee stabilizer. For each trial/condition, participants ambulated at 0.6, 0.8, and 1.0 mph for five minutes at each speed. Heart rate (HR) and rate of perceived exertion (RPE) were monitored throughout. Surface electromyography (sEMG) was used to record muscle activation of the medial gastrocnemius (MG), soleus (SOL), and tibialis anterior (TA) unilaterally on the weight-bearing limb. Biceps brachii (BB) and triceps brachii (TB) sEMG were measured bilaterally. sEMG signals for each immobilization condition were normalized to corresponding values for BW.HR (p < 0.001) and RPE (p < 0.001) were significantly higher for both the DOM and NDOM conditions compared to BW but no differences existed between the DOM and NDOM conditions (p > 0.05). No differences in lower limb muscle activation were noted for any muscles between the DOM and NDOM conditions (p > 0.05). Regardless of condition, BB activation ipsilateral to the ambulating limb was significantly lower during 0.6 mph (p = 0.005) and 0.8 mph (p = 0.016) compared to the same speeds for BB on the contralateral side. Contralateral TB activation was significantly higher during 0.6 mph compared to 0.8 mph (p = 0.009) and 1.0 mph (p = 0.029) irrespective of condition. In conclusion, limb dominance appears to not alter lower limb muscle activation and walking intensity while using axillary crutches. However, upper limb muscle activation was asymmetrical during axillary crutch use and largely dependent on speed. These results suggest that functional asymmetry may exist in upper limbs but not lower limbs during assistive device supported ambulation.

scholarly journals COVID-19 era in long-term cardiac rehabilitation programs: how was muscle strenght and lean mass affected in cardiovascular patients?

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Borges ◽  
M Lemos Pires ◽  
R Pinto ◽  
G De Sa ◽  
I Ricardo ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Cardiac Rehabilitation ◽  
Lean Mass ◽  
Lower Limb ◽  
Lower Limbs ◽  
Phase Iii ◽  
Face To Face ◽  
Home Based ◽  
Lower Limb Strength

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Exercise prescription is one of the main components of phase III Cardiac Rehabilitation (CR) programs due to its documented prognostic benefits. It has been well established that, when added to aerobic training, resistance training (RT) leads to greater improvements in peripheral muscle strength and muscle mass in patients with cardiovascular disease (CVD). With COVID-19, most centre-based CR programs had to be suspended and CR patients had to readjust their RT program to a home-based model where weight training was more difficult to perform. How COVID-19 Era impacted lean mass and muscle strength in trained CVD patients who were attending long-term CR programs has yet to be discussed. Purpose To assess upper and lower limb muscle strength and lean mass in CVD patients who had their centre-based CR program suspended due to COVID-19 and compare it with previous assessments. Methods 87 CVD patients (mean age 62.9 ± 9.1, 82.8% male), before COVID-19, were attending a phase III centre-based CR program 3x/week and were evaluated annually. After 7 months of suspension, 57.5% (n = 50) patients returned to the face-to-face CR program. Despite all constraints caused by COVID-19, body composition and muscle strength of 35 participants (mean age 64.7 ± 7.9, 88.6% male) were assessed. We compared this assessment with previous years and established three assessment time points: M1) one year before COVID-19 (2018); M2) last assessment before COVID-19 (2019); M3) the assessment 7 months after CR program suspension (last trimester of 2020). Upper limbs strength was measured using a JAMAR dynamometer, 30 second chair stand test (number of repetitions – reps) was used to measure lower limbs strength and dual energy x-ray absorptiometry was used to measure upper and lower limbs lean mass. Repeated measures ANOVA were used. Results Intention to treat analysis showed that upper and lower limbs lean mass did not change from M1 to M2 but decreased significantly from M2 to M3 (arms lean mass in M2: 5.68 ± 1.00kg vs M3: 5.52 ± 1.06kg, p = 0.004; legs lean mass in M2: 17.40 ± 2.46kg vs M3: 16.77 ± 2.61kg, p = 0.040). Lower limb strength also decreased significantly from M2 to M3 (M2: 23.31 ± 5.76 reps vs M3: 21.11 ± 5.31 reps, p = 0.014) after remaining stable in the year prior to COVID-19. Upper limb strength improved significantly from M1 to M2 (M1: 39.00 ± 8.64kg vs M2: 40.53 ± 8.77kg, p = 0.034) but did not change significantly from M2 to M3 (M2 vs M3: 41.29 ± 9.13kg, p = 0.517). Conclusion After CR centre-based suspension due to COVID-19, we observed a decrease in upper and lower limbs lean mass and lower limb strength in previously trained CVD patients. These results should emphasize the need to promote all efforts to maintain physical activity and RT through alternative effective home-based CR programs when face-to-face models are not available or possible to be implemented.

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.

Objectivization of vacuum-compression therapy effects on micro- and macrovascular perfusion in type 2 diabetic patients

2020 ◽  
Vol 65 (4) ◽  
pp. 469-476
Author(s):  
Jaroslav Prucha ◽  
Vladimir Socha ◽  
Lenka Hanakova ◽  
Andrej Lalis ◽  
Karel Hana
Keyword(s):  
Lower Limb ◽  
Compression Therapy ◽  
Neurological Complications ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Therapeutic Procedures ◽  
History Of ◽  
Injury Recovery ◽  
Type 2 Diabetic

AbstractThe present study aimed to evaluate the characteristic influence of physical therapeutic procedures of vacuum-compression therapy (VCT) on microvascular perfusion (MiP) and macrovascular perfusion (MaP) of the lower limb in diabetic patients. A sample of nine patients with a medical history of type 2 diabetes was used for the purpose of this study. Most of the subjects’ medical conditions included venous and neurological complications of the lower limb, whereas the rest of the subjects entered the treatment due to injury recovery or their phlebological disease. The PeriFlux System 5000 (Perimed, Sweden) diagnostic device was used to measure MiP. The MaP was evaluated based on the perfusion index (PI) using the Extremiter monitoring device (Embitron, Czech Republic) designed to perform VCT procedures. The study found that MiP and MaP increase as an effect of VCT procedures and at the same time PI clearly reflects the effect of the applied vacuum and compression phases, verifying the method’s vital influence on peripheral perfusion disorders.

scholarly journals SGLT2 inhibitors and lower limb complications: an updated meta‐analysis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Chu Lin ◽  
Xingyun Zhu ◽  
Xiaoling Cai ◽  
Wenjia Yang ◽  
Fang Lv ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Lower Limb ◽  
Blood Pressure Reduction ◽  
Random Effect Model ◽  
Diabetic Patients ◽  
Controlled Trials ◽  
Pressure Reduction ◽  
Effect Model ◽  
Meta Regression

Abstract Background To exam the associations between the use of sodium glucose co-transporter 2 inhibitor (SGLT2i) and the risk of lower limb complications, and to analyze the associated factors. Methods Pubmed, Medline, Embase, the Cochrane Center Register of Controlled Trials for Studies and Clinicaltrial.gov were searched from the inception to November 2020. Randomized controlled trials of SGLT2i conducted in population containing diabetic patients with reports of amputation, peripheral arterial disease (PAD) and diabetic foot (DF) events were included. Random-effect model, fixed-effect model and meta-regression analysis were accordingly used. Result The numbers of SGLT2i users versus non-SGLT2i users in the analyses of amputation, PAD and DF were 40,925/33,414, 36,446/28,685 and 31,907/25,570 respectively. Compared with non-SGLT2i users, the risks of amputation and PAD were slightly increased in patients with canagliflozin treatment (amputation: OR = 1.60, 95% CI 1.04 to 2.46; PAD: OR = 1.53, 95 % CI 1.14 to 2.05). Meta-regression analyses indicated that greater weight reduction in SGLT2i users was significantly associated with the increased risks of amputation (β = − 0.461, 95% CI − 0.726 to − 0.197), PAD (β = − 0.359, 95% CI − 0.545 to − 0.172) and DF (β = − 0.476, 95% CI − 0.836 to − 0.116). Lower baseline diastolic blood pressure (β = − 0.528, 95% CI − 0.852 to − 0.205), more systolic blood pressure reduction (β = − 0.207, 95% CI − 0.390 to − 0.023) and more diastolic blood pressure reduction (β = − 0.312, 95% CI − 0.610 to − 0.015) were significantly associated with the increased risks of amputation, PAD and DF respectively in patients with SGLT2i treatment. Conclusions The risks of amputation and PAD were slightly increased in patients with canagliflozin treatment. Reductions in body weight and blood pressure were associated with lower limb complications in patients with SGLT2i treatment.

scholarly journals Motor disability in patients with multiple sclerosis: transcranial magnetic stimulation study

2020 ◽  
Vol 56 (1) ◽  
Author(s):  
Anssam Bassem Mohy ◽  
Aqeel Kareem Hatem ◽  
Hussein Ghani Kadoori ◽  
Farqad Bader Hamdan
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Lower Limb ◽  
Magnetic Stimulation ◽  
Motor Evoked Potential ◽  
Invasive Procedure ◽  
Single Pulse ◽  
Lower Limbs ◽  
Control Group ◽  
Conduction Time ◽  
Motor Disability

Abstract Background Transcranial magnetic stimulation (TMS) is a non-invasive procedure used in a small targeted region of the brain via electromagnetic induction and used diagnostically to measure the connection between the central nervous system (CNS) and skeletal muscle to evaluate the damage that occurs in MS. Objectives The study aims to investigate whether single-pulse TMS measures differ between patients with MS and healthy controls and to consider if these measures are associated with clinical disability. Patients and methods Single-pulse TMS was performed in 26 patients with MS who hand an Expanded Disability Status Scale (EDSS) score between 0 and 9.5 and in 26 normal subjects. Different TMS parameters from upper and lower limbs were investigated. Results TMS disclosed no difference in all MEP parameters between the right and left side of the upper and lower limbs in patients with MS and controls. In all patients, TMS parameters were different from the control group. Upper limb central motor conduction time (CMCT) was prolonged in MS patients with pyramidal signs. Upper and lower limb CMCT and CMCT-f wave (CMCT-f) were prolonged in patients with ataxia. Moreover, CMCT and CMCT-f were prolonged in MS patients with EDSS of 5–9.5 as compared to those with a score of 0–4.5. EDSS correlated with upper and lower limb cortical latency (CL), CMCT, and CMCT-f whereas motor evoked potential (MEP) amplitude not. Conclusion TMS yields objective data to evaluate clinical disability and its parameters correlated well with EDSS.

Sign in / Sign up

Export Citation Format

Share Document