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[PMID]: 29524857
[Au] Autor:Hazir B; Haberal HB; Akinci D; Akdogan B
[Ad] Address:Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey. Electronic address: berkhazir@hacettepe.edu.tr.
[Ti] Title:An unusual localization of seven months delayed pelvic lymphocele following radical retropubic prostatectomy: Case report and literature review.
[So] Source:Int J Surg Case Rep;44:181-184, 2018 Mar 06.
[Is] ISSN:2210-2612
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:INTRODUCTION: A pelvic lymphocele is a collection of lymphatic fluid that develops after extensive lymphadenectomies in surgeries such as urological malignancies or renal transplantation. Pelvic lymphoceles may cause complications such as fever, abdominal pain, leg swelling, genital swelling and flank pain. This report summarizes the management of a pelvic lymphocele after open radical retropubic prostatectomy with bilateral lymphadenectomy. PRESENTATION OF CASE: Herein, we present a case in which a pelvic lymphocele developed seven months post-radical open retropubic prostatectomy and through this patient we discussed the lymphocele following radical prostatectomy. The pelvic lymphocele occurred along the sciatic nerve from the sciatica foramen to the intergluteal muscles. The patient was treated with three drainage catheters. This localization is an atypical and unusual for lymphocele after radical retropubic prostatectomy. DISCUSSION: Lymphocele formation that leads to major complications after radical prostatectomy is rare. Lymphocele formation is most commonly seen in the early postoperative period, but it should be considered in patients with fever, abdominal pain or leg swelling during the late postoperative period. Lymphocele formation was the most common cause of hospital readmission after radical prostatectomy. CONCLUSION: Lymphocele formation can be seen in atypical regions and can lead to unexpected complications after radical prostatectomy. Therefore, it should be brought to mind when complaints such as fever and lower extremity swelling occurred in patients underwent extensive lymph node dissection. Surgical treatment options are available, but percutaneous interventions can also be used.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  2 / 54412 MEDLINE  
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[PMID]: 29520184
[Au] Autor:Masuda T; Nakaura T; Funama Y; Sato T; Higaki T; Kiguchi M; Yamashita Y; Imada N; Awai K
[Ad] Address:Department of Radiological Technology, Tsuchiya General Hospital, Hiroshima 730-8655, Japan.
[Ti] Title:Effect of Patient Characteristics on Vessel Enhancement at Lower Extremity CT Angiography.
[So] Source:Korean J Radiol;19(2):265-271, 2018 Mar-Apr.
[Is] ISSN:2005-8330
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:Objective: To evaluate the effect of patient characteristics on popliteal aortic contrast enhancement at lower extremity CT angiography (LE-CTA) scanning. Materials and Methods: Prior informed consent to participate was obtained from all 158 patients. All were examined using a routine protocol; the scanning parameters were tube voltage 100 kVp, tube current 100 mA to 770 mA (noise index 12), 0.5-second rotation, 1.25-mm detector row width, 0.516 beam pitch, and 41.2-mm table movement, and the contrast material was 85.0 mL. Cardiac output (CO) was measured with a portable electrical velocimeter within 5 minutes of starting the CT scan. To evaluate the effects of age, sex, body size, CO, and scan delay on the CT number of popliteal artery, the researchers used multivariate regression analysis. Results: A significant positive correlation was seen between the CT number of the popliteal artery and the patient age ( = 0.39, < 0.01). A significant inverse correlation was observed between the CT number of the popliteal artery and the height ( = -0.48), total body weight ( = -0.52), body mass index ( = -0.33), body surface area (BSA) ( = -0.56), lean body weight ( = -0.56), and CO ( = -0.35) ( < 0.001 for all). There was no significant correlation between the enhancement and the scan delay ( = 0.06, = 0.47). The BSA, CO, and age had significant effects on the CT number (standardized regression: BSA -0.42, CO -0.22, age 0.15; < 0.05, respectively). Conclusion: The BSA, CO, and age are significantly correlated with the CT number of the popliteal artery on LE-CTA.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Data-Review
[do] DOI:10.3348/kjr.2018.19.2.265

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[PMID]: 29491344
[Au] Autor:Pfirman KS; Haile R
[Ad] Address:Department of Medical Education, Camden Clark Medical Center, Parkersburg, WV, USA.
[Ti] Title:Intracardiac Abscess and Pacemaker Lead Infection Secondary to Hematogenous Dissemination of Methicillin-Sensitive Staphylococcus Aureus from a Prior Diabetic Foot Ulcer and Osteomyelitis.
[So] Source:Am J Case Rep;19:224-228, 2018 Mar 01.
[Is] ISSN:1941-5923
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND Intracardiac abscesses are an unusual occurrence in developed countries. With the increase in use of implantable cardiac devices, the increase use of and advancements in antibiotics, and the longevity of patients with cardiac devices, one may expect an increase in such infections; however, case reports are rare. We are presenting a case in which hematogenous dissemination of methicillin-sensitive Staphylococcus aureus (MSSA) infection from a lower extremity diabetic ulcer propagated into an infected pacemaker lead and ultimately an intracardiac abscess of the right atrium. CASE REPORT A 77-year-old male with a history of MSSA diabetic foot infection complicated by osteomyelitis presented with fever, syncope, and wide complex tachycardia, and he was found to have an intracardiac abscess and fibrinous lead vegetations. The patient was deemed too ill for invasive surgical intervention given his comorbidities, pacemaker generator replacement requirement, and intermittent ventricular tachycardia. The patient was subsequently sent home with oral antibiotics and home hospice per patient and family wishes. CONCLUSIONS This case demonstrated how hematogenous dissemination of MSSA infections from a diabetic foot ulcer and osteomyelitis can seed pacemaker hardware resulting in an intracardiac abscess. Unfortunately, our patient was too ill to undergo all procedures required to eradicate the abscess and infected pacemaker hardware. The standard of care would be complete hardware removal. Conservative management would include indefinite or prolonged antibiotic therapy, with the notion that intracardiac abscesses cannot be cured with antibiotics alone. This conservative management approach would be deemed necessary in a select population that cannot undergo surgical intervention.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Process

  4 / 54412 MEDLINE  
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[PMID]: 29488166
[Au] Autor:Nagai T; Schilaty ND; Strauss JD; Crowley EM; Hewett TE
[Ad] Address:Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
[Ti] Title:Analysis of Lower Extremity Proprioception for Anterior Cruciate Ligament Injury Prevention: Current Opinion.
[So] Source:Sports Med;, 2018 Feb 27.
[Is] ISSN:1179-2035
[Cp] Country of publication:New Zealand
[La] Language:eng
[Ab] Abstract:Lower extremity musculoskeletal injuries-such as ACL injury-are common, and the majority of those injuries occur without external player contact. In order to prevent non-contact musculoskeletal injuries, athletes must rely on accurate sensory information (such as visual, vestibular, and somatosensory) and stabilize joints during athletic tasks. Previously, proprioception tests (the senses of joint position, movement, tension or force) have been examined using static tests. Due to the role of proprioception in achievement of joint stability, it is essential to explore the development of dynamic proprioception tests. In this current opinion, the basic background on proprioception is covered, and the research gaps and future directions are discussed.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:Publisher
[do] DOI:10.1007/s40279-018-0889-1

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[PMID]: 29288908
[Au] Autor:Simpson JD; DeBusk H; Hill C; Knight A; Chander H
[Ad] Address:Neuromechanics Laboratory, Department of Kinesiology, Mississippi State University, P.O. Box 6186, Mississippi State, MS 39762, United States. Electronic address: jds1313@msstate.edu.
[Ti] Title:The role of military footwear and workload on ground reaction forces during a simulated lateral ankle sprain mechanism.
[So] Source:Foot (Edinb);34:53-57, 2017 Nov 22.
[Is] ISSN:1532-2963
[Cp] Country of publication:Scotland
[La] Language:eng
[Ab] Abstract:BACKGROUND: Ankle sprains are a common orthopedic injury in military populations, which may be attributed to occupational demands and footwear. Minimalist military boots have become popular, but their influence on ground reaction force (GRF) attenuation capabilities during an ankle inversion perturbation are unknown. Therefore, the purpose of this study was to examine potential differences in GRFs during an ankle inversion perturbation in a standard issue (STN) and minimalist military boot (MIN) before and after a simulated military workload. METHODS: Twenty-one healthy adult males completed an ankle inversion perturbation protocol in each footwear condition before and after an incremental treadmill exercise protocol to volitional exhaustion while wearing a 16kg rucksack. The ankle inversion perturbation protocol consisted of stepping down from a 27cm box onto a force platform with a fulcrum (FUL), which created 25° of inversion upon landing, or flat (FLT) outer sole attached to the plantar aspect of the participants' footwear in random order. Peak vertical, anterior/posterior, and medial/lateral components of the GRF during FUL and FLT conditions were assessed, normalized to multiples of body weight in each footwear. Dependent variables were then analyzed using separate 2 (footwear)×2 (time) repeated measures ANOVA (p<0.05). RESULTS: The MIN footwear demonstrated significantly greater vertical GRF and significantly less medial GRF during the FUL condition. CONCLUSIONS: These results indicate that various mechanical and design characteristics of military footwear may influence GRF attenuation capabilities and ankle joint loading when the foot/ankle complex is forced into inversion.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  6 / 54412 MEDLINE  
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[PMID]: 29278836
[Au] Autor:Chaney ME; Dao TV; Brechtel BS; Belovich SJ; Siesel KJ; Fredieu JR
[Ad] Address:Department of Anthropology & School of Biomedical Sciences, Kent State University, Kent, OH, United States. Electronic address: mchaney1@kent.edu.
[Ti] Title:The fibularis digiti quinti tendon: A cadaveric study with anthropological and clinical considerations.
[So] Source:Foot (Edinb);34:45-47, 2017 Dec 05.
[Is] ISSN:1532-2963
[Cp] Country of publication:Scotland
[La] Language:eng
[Ab] Abstract:In addition to the fibularis longus and brevis muscles, a number of anomalous muscles or tendons can arise from the lateral compartment of the leg. The authors describe a bilateral and robust fibularis digiti quinti (FDQ) tendon present in the foot of a 99-year-old female cadaver, present the incidence of this tendon in a cohort of 26 cadavers dissected by podiatric-medical students for a lower-extremity anatomy course, and discuss the anthropological and clinical significance of the findings. In these specimen, the FDQ tendon arose from the fibularis brevis tendon proximal to the lateral malleolus, but did not separate completely from the fibularis brevis tendon until passing through the inferior fibular retinaculum. On the lateral dorsum of the foot, the FDQ passed through a third fibular retinaculum formed by the fibularis tertius tendon, and inserted onto the extensor sling of the fifth digit. This case specimen is designated as an example of the fully present category. Of the 52 limbs dissected, 17 limbs (33%) showed a fully present FDQ, while 20 limbs (38%) exhibited an FDQ in a rudimentary form. Thus, 71% of the limbs showed some presence of the FDQ. Because human bipedality requires less dexterity than that of nonhuman primates in the routine use of their hindlimbs, the authors interpret the high variability of the FDQ, including its absence in many feet, as a relaxation of natural selection maintaining this trait since the divergence of humans from African apes.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  7 / 54412 MEDLINE  
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[PMID]: 29274894
[Au] Autor:Kumar AM; Lyden AK; Carlozzi NE; Sen A; Richardson CR; Jackson EA
[Ad] Address:Michigan State University, College of Human Medicine, 15 Michigan Street, Grand Rapids, MI 49503, USA.
[Ti] Title:The Physical Activity Daily (PAD) Trial: The rationale and design of a randomized controlled trial evaluating an internet walking program to improve maximal walking distance among patients with peripheral arterial disease.
[So] Source:Contemp Clin Trials;67:23-30, 2017 Dec 21.
[Is] ISSN:1559-2030
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Despite established guidelines for regular walking as a first line therapy for adults with peripheral arterial disease (PAD), most patients do not walk routinely. This paper presents the design specifications for a randomized clinical trial to examine the effectiveness of an internet-based walking program compared to a telephone intervention, or the combination (internet-based with telephone counseling) for promotion of regular walking in patients with PAD. METHODS: Sedentary adults with documented lower extremity PAD are being recruited from the University of Michigan Health System and the surrounding area. Participants are randomized to one of four arms in a 2×2 factorial design: 1) telephone counseling to promote walking, 2) an internet-based walking program with tailored step-count goals, 3) the combination of telephone counseling with the internet-based walking program, or 4) waitlist control. Participants receive a 4-month intervention phase, after which all participants are followed for an additional 8months to assess long-term adherence to regular walking. Outcomes are assessed at baseline, 4 and 12months. The primary outcome is walking distance assessed through a standardized treadmill protocol. Additional outcomes include change in step-counts measured with a commercial activity tracker, pain-free walking distance, and changes in health-related quality of life from baseline to follow-up. CONCLUSION: Finding effective and feasible programs to promote walking among PAD patients is warranted. This study will add to current evidence regarding use of internet based programs with and without telephone counseling to promote regular walking in this population.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  8 / 54412 MEDLINE  
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[PMID]: 29523640
[Au] Autor:Moon SY; de Souto Barreto P; Rolland Y; Chupin M; Bouyahia A; Fillon L; Mangin JF; Andrieu S; Cesari M; Vellas B; MAPT/DSA Study Group
[Ad] Address:From Gerontopole of Toulouse (S.Y.M., P.d.S.B., Y.R., S.A., M.C., B.V.) and Department of Epidemiology and Public Health (S.A.), University Hospital of Toulouse (CHU-Toulouse); UMR INSERM 1027 (S.Y.M., P.d.S.B., Y.R., S.A., M.C., B.V.), University of Toulouse III, France; Department of Neurology (S.
[Ti] Title:Prospective associations between white matter hyperintensities and lower extremity function.
[So] Source:Neurology;, 2018 Mar 09.
[Is] ISSN:1526-632X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To evaluate the relationship of white matter hyperintensities (WMH) with decline in lower extremity function (LEF) over approximately 3 years in dementia-free older adults with memory complaints. METHODS: We obtained brain MRI data from 458 community-dwelling adults, aged 70 years or over, at baseline, and from 358 adults over an average follow-up of 963 days. We evaluated LEF using the Short Physical Performance Battery (SPPB). We related baseline WMH volumes and progression to SPPB scores over time, using mixed-effect linear regressions. For the secondary analyses, we categorized baseline WMH volume into quartiles, and dichotomized the WMH progression to compare fast and slow progression. RESULTS: Baseline WMH volume (ß = -0.017, 95% confidence interval [CI] -0.025 to -0.009), as well as WMH progression (ß = -0.002, 95% CI -0.003 to -0.001), significantly associated with a decline in SPPB performance in adjusted analyses. Compared with the lowest quartile of baseline WMH volume, the highest quartile associated with a decline in SPPB performance (ß = -0.301, 95% CI -0.558 to -0.044). Fast progression also associated with a decline in SPPB performance. We found clinically meaningful differences in the SPPB, with higher scores in participants with slow progression of WMH, at both 24 and 36 months. CONCLUSIONS: Baseline level and WMH progression associated with longitudinal decline in SPPB performance among older adults. We detected clinically meaningful differences in SPPB performance on comparing fast with slow progression of WMH, suggesting that speed of WMH progression is an important determinant of LEF during aging.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  9 / 54412 MEDLINE  
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[PMID]: 29523437
[Au] Autor:Jones DW; Goodney PP; Eldrup-Jorgensen J; Schermerhorn ML; Siracuse JJ; Kang J; Columbo JA; Suckow BD; Stone DH; Vascular Study Group of New England
[Ad] Address:Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Mass. Electronic address: douglas.jones@bmc.org.
[Ti] Title:Active smoking in claudicants undergoing lower extremity bypass predicts decreased graft patency and worse overall survival.
[So] Source:J Vasc Surg;, 2018 Mar 06.
[Is] ISSN:1097-6809
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Performing lower extremity bypass (LEB) in actively smoking claudicants remains controversial. Whereas some surgeons advocate a strict nonoperative approach to active smokers, citing perceived inferior outcomes, others will proceed with surgical bypass if the patient is anatomically suited and medical management has failed. The purpose of this study was to determine the impact of active smoking on LEB outcomes among claudicants. METHODS: All patients undergoing infrainguinal LEB for claudication in the Vascular Study Group of New England from 2003 to 2016 were analyzed. Smoking was defined as active tobacco use within 1 month of surgery. End points included in-hospital outcomes; long-term primary, assisted primary, and secondary patency; and mortality. Univariate, Cox multivariable, and Kaplan-Meier methods were used to determine the impact of smoking. Propensity score matching was performed to control for intergroup differences. RESULTS: Of 1789 LEBs, 971 (54%) were performed in nonsmokers and 818 (46%) in smokers. The follow-up rate was 87% at a mean of 382 days (standard error, ±6.8 days). Smokers were younger (60 vs 68 years; P < .001) and were less likely to have multiple comorbidities, including hypertension, coronary artery disease, congestive heart failure, diabetes, and chronic renal insufficiency (P ≤ .05); they were more likely to have an above-knee popliteal bypass target (52% vs 43%; P = .001). Smokers also had lower rates of postoperative major cardiac events (2.4% vs 5.3%; P = .002) and perioperative blood transfusion (5.6% vs 11%; P < .001) compared with nonsmokers, but there was no difference in respiratory complications, wound complications, or mortality. At 2-year follow-up, smokers demonstrated inferior primary patency (48% vs 61%; P = .03) and assisted primary patency (59% vs 74%; P = .01), with comparable rates of secondary patency and overall mortality. Propensity matching yielded two similar groups (n = 450 for each). Propensity-matched smokers had significantly decreased 2-year primary patency (43% vs 58%; P = .02), assisted primary patency (54% vs 71%; P = .03), and 10-year survival (69% vs 76%; P < .01). Cox multivariable analysis confirmed that smoking was an independent predictor of diminished primary patency (hazard ratio [HR], 1.3; 95% confidence interval [CI], 1.0-1.6; P = .03), assisted primary patency (HR, 1.4; 95% CI, 1.1-1.8; P = .004), and overall survival (HR, 1.3; 95% CI, 1.1-1.5; P < .001). CONCLUSIONS: Despite the fact that smokers are younger and have fewer comorbidities than nonsmokers, active smoking at the time of LEB for claudication is associated with decreased long-term patency and decreased overall survival. Surgeons should consider smoking an important risk factor for worse LEB outcomes in smokers compared with nonsmokers.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  10 / 54412 MEDLINE  
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[PMID]: 29523435
[Au] Autor:Wilson DG; Harris SK; Barton C; Crawford JD; Azarbal AF; Jung E; Mitchell EL; Landry GJ; Moneta GL
[Ad] Address:Division of Vascular Surgery, Department of Surgery, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Ore.
[Ti] Title:Tibial artery duplex ultrasound-derived peak systolic velocities may be an objective performance measure after above-knee endovascular therapy for arterial stenosis.
[So] Source:J Vasc Surg;, 2018 Mar 06.
[Is] ISSN:1097-6809
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: The ankle-brachial index (ABI) is a well-established measure of distal perfusion in lower extremity ischemia; however, the ABI is of limited value in patients with noncompressible lower extremity arteries. We sought to demonstrate whether duplex ultrasound-determined tibial artery velocities can be used as an alternative to ABI as an objective performance measure after endovascular treatment of above-knee arterial stenosis. METHODS: Thirty-six patients undergoing above-knee endovascular intervention had preprocedure and postprocedure duplex ultrasound examination within 6 months of intervention. Preprocedure vs postprocedure changes in tibial artery mean peak systolic velocity (PSV; mean of proximal, mid, and distal velocities) were compared with changes in ABI and a reference (control) cohort of 68 patients without peripheral vascular disease. RESULTS: Thirty-six patients (41 limbs) had an above-knee endovascular intervention and had preprocedure and postprocedure duplex ultrasound examinations of the ipsilateral extremity including the tibial arteries. Before the procedure, mean tibial artery PSVs in the 36 patients undergoing intervention were outside (below) the 95% confidence intervals for the control patients. In comparing preprocedure and postprocedure PSVs, the mean anterior tibial (P < .01), mean peroneal (P < .01), and mean posterior tibial (P < .01) PSVs all increased and correlated with an increase in ABI (P < .01). After endovascular intervention, duplex ultrasound-derived mean PSVs fell within or near established reference ranges for patients without peripheral arterial disease. Mean tibial artery PSV increases were similar in patients with and without noncompressible vessels. CONCLUSIONS: Tibial artery PSVs increase, correlate with an increase in ABI, and fall within or near confidence intervals for normal controls after above-knee endovascular interventions. After endovascular intervention, tibial artery PSVs can supplement ABI as an objective performance measure in patients with and in particular without compressible tibial arteries.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher


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