Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “AMPUTATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 649 records · Page 36Linked to original sources
PubMed1996

[Amputation of the lower extremities for non-traumatic causes in Slovakia in 1995].

The authors submit a questionnaire-based epidemiological study from 61 surgical departments in Slovakia, focused on the problem of amputation of the lower extremities. The objective of the study was to evaluate indirectly the standard of care of diabetic feet in Slovakia. In the study 61 surgical departments participated with a catchment area comprising 4,814,000 insured persons, i.e. 85% of the Slovak population. In these patients a total of 2116 amputations on account of non-traumatic causes were performed (44/100000 population). This number included 1578 diabetic patients (74.6%). Minor amputations were performed 1044 times, incl. 92.2% in diabetic subjects. Major amputations were made 1072 times, incl. 57.3% in diabetics. The prevalence of major amputations in 1995 was 21.8/100000 population. The authors recorded a 2.65 fold increase of the total number of amputations since 1985. They recorded dissatisfaction with the small number of revascularization operations-total 294 (13.9%) which is only one quarter of the desirable number. The authors submit their study as the basis for a systemic solution of care of the diabetic foot in Slovakia and as a challenge for its improvement.

Amputation, Surgical↗
PubMed1998

Failure of reducing lower extremity amputations in diabetic patients: results of two subsequent population based surveys 1990 and 1995 in Germany.

BACKGROUND: A 50% reduction of lower extremity amputations during the subsequent 5 year period has been targeted by the St. Vincent-Declaration issued in 1989/90 for a better care of diabetic patients across Europe. PATIENTS AND METHODS: In two adjacent counties far off major city areas 10 hospitals without specialised diabetes centers in the area provide care to about 300,000 inhabitants. Based on the official operation books and verified by the individual patient file all patients amputated in the 10 hospitals during the years 1990 and 1995 were evaluated retrospectively. RESULTS: A total of 119 patients (66 males, 53 females, age median 72 years) were amputated in the 10 hospitals 1990, and 162 (89 males, 73 females, age median 74 years) in 1995. The proportion of diabetic amputees amounted to 70.6 and 62.3%, respectively. A trend towards more toe amputations in diabetic versus nondiabetic patients was seen in both surveys which reached significance in 1995 (59 vs. 41%; p < 0.05). Based on the total population and the estimated number of diabetic patients (5% of the population) 1.4 and 2/10,000 nondiabetics were amputated in 1990 and 1995, respectively, in contrast to 61 and 66/10,000 diabetic individuals, indicating a 44 fold and 33 fold excess risk of diabetic patients. CONCLUSION: It is concluded that these 2 surveys 5 years apart reveal a failure of reducing lower extremity amputations in people with diabetes--despite the objectives of the St. Vincent-Declaration.

Adolescent↗
PubMed1986

Induction of a specific (LM) protein in the submandibular gland of the rat by repeated amputation of the lower incisor teeth.

Chronic administration of the beta-adrenergic agonist isoproterenol (IPR) leads to marked hyperplastic/hypertrophic enlargements of the parotid and submandibular glands in rats and mice with concomitant changes in the composition of both the glands and the saliva. Conspicuous among the alterations of the submandibular saliva is the appearance of a 13,000 Mr protein, termed LM (large mobile) protein. Repeated amputation of the lower incisor teeth also causes enlargements of the major salivary glands in rats. In this study, we have compared the enlargements of submandibular glands of rats produced by IPR administration or teeth amputation with respect to the relative levels of the LM protein in gland extracts and saliva. Administration of IPR-HCl (40 mg/kg) twice daily for 5 days or amputation of the lower incisor teeth 3 times a week for 3 weeks resulted in a 2.2-fold increase in the weight of the submandibular gland. Amputation for one week led to a 1.4-fold increase in gland weight. Double immunodiffusion in agar antibodies against the purified LM protein gave a single precipitin line with gland extracts and saliva of IPR-treated and teeth-amputated rats, indicating immunological identity of the reacting antigens. No precipitin lines were seen with gland extracts or saliva of untreated rats. Immunoblots of pooled saliva obtained from IPR-treated or teeth-amputated rats revealed a single protein band of the same electrophoretic mobility in SDS-polyacrylamide gels when stained using anti-LM antibodies. The relative concentrations of LM protein in gland extracts and saliva were measured by a solid-phase enzyme-linked immunoabsorption assay using antibodies against the purified LM protein.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

Adenine nucleotide changes in submandibular salivary glands of rats following isoproterenol or incisor tooth amputation.

Male rats (180-220 g) were injected daily with isoproterenol (2 mg/kg of body weight) for up to 6 days, or their incisor teeth were amputated on every other day for up to six amputations. The animals were subdivided into groups killed 12 or 24 h after the first or last intervention. In the development of sialadenosis caused by isoproterenol, the levels of ATP were greater (13-30%), while those of AMP were lower (13-19%) in the experimental groups. No variation was noted in ADP content. In tooth-amputated animals, only the five and six amputation subgroups showed higher values for ATP (approx. 17%), and ADP (12 and 15%, respectively). The inorganic phosphate level was lower in both experimental groups (between 11-28% for isoproterenol and 13-22% for amputation). Thus isoproterenol caused different metabolic responses in submandibular salivary glands from those induced by incisor amputation.

Adenine Nucleotides↗
PubMed1981

Supra-vaginal uterine amputation vs. abdominal hysterectomy: the effects on urinary symptoms with special reference to pollakisuria, nocturia and dysuria.

Post-operative symptoms of hysterectomy have received relatively little attention in the literature. In the present study the first author has personally interviewed and examined 105 abdominal hysterectomy patients and 107 patients with supravaginal uterine amputation pre-operatively and thrice post-operatively. At one year the follow-up percentage was 99.5 (211/212). In the statistical analysis McNemar's test of symmetry and Fisher's exact test were used. Loglinear models were developed where applicable. A number of patients had urinary symptoms pre-operatively: 27.6% of the abdominal hysterectomy and 48.6% of the supra-vaginal amputation patients suffered from pollakisuria; preoperative nocturia and dysuria were present in about 10% of patients in each group. These urinary symptoms disappeared more frequently in patients who underwent supra-vaginal amputation; with regard to pollakisuria the difference is statistically significant. Twelve months post-operatively pollakisuria was present in 10.3% of supra-vaginal amputation and 13.5% of hysterectomy patients. The advantage of supra-vaginal amputation over abdominal hysterectomy with regard to these symptoms may result from the considerably less extensive manipulation of the bladder during supra-vaginal amputation. Possibly the support provided by the remaining stump and the round ligaments fixed to it also help to reduce urinary symptoms in these patients. However, further urodynamic studies are needed.

Adult↗
PubMed2000

Effects of tail amputation and treatment with an albendazole controlled-release capsule on the health and productivity of prime lambs.

OBJECTIVE: To assess the effects of tail amputation and treatment with albendazole controlled-release capsule (CRC) on the health and productivity of prime lambs. DESIGN: Field trials on three farms. ANIMALS: About 551 Coopworth-Poll Dorset cross, 588 Border Leicester-Merino-Poll Dorset cross and 575 Corriedale-Poll Dorset cross lambs. PROCEDURE: On three farms, lambs with amputated tails were compared with an equal number of lambs with tails left entire. In both of these groups half the lambs were treated with an albendazole CRC 13 weeks after the start of lambing. Faecal soiling of the breech and flystrike of the breech were recorded. Lambs were weighed and body condition scored at each visit and carcase weights and fat score of each lamb at slaughter. Procedures on the slaughter chain were monitored to determine whether the retention of the tail caused any problems. RESULTS: There were no observed benefits of treatment with an albendazole CRC on the farms in the study. There was no strong evidence that tail amputation had any long-term effect on the growth rate of lambs or carcase traits. No detrimental effects were observed during processing of lambs with long tails in the abattoir. Lambs with entire tails had significantly greater mean dag scores than lambs with amputated tails. On one farm lambs with entire tails were at about twice the risk of requiring crutching and on another farm were at three times the risk of breech strike compared with lambs with amputated tails. CONCLUSION: This study provides evidence that amputating the tail is not an absolute requirement to maintain the health and welfare of prime lambs, but leaving the tail of prime lambs entire is likely to increase chemical usage to control flystrike, and to increase the frequency of crutching.

Albendazole↗
PubMed2005

Prolonged membrane potential depolarization in cingulate pyramidal cells after digit amputation in adult rats.

The anterior cingulate cortex (ACC) plays an important role in higher brain functions including learning, memory, and persistent pain. Long-term potentiation of excitatory synaptic transmission has been observed in the ACC after digit amputation, which might contribute to plastic changes associated with the phantom pain. Here we report a long-lasting membrane potential depolarization in ACC neurons of adult rats after digit amputation in vivo. Shortly after digit amputation of the hind paw, the membrane potential of intracellularly recorded ACC neurons quickly depolarized from approximately -70 mV to approximately -15 mV and then slowly repolarized. The duration of this amputation-induced depolarization was about 40 min. Intracellular staining revealed that these neurons were pyramidal neurons in the ACC. The depolarization is activity-dependent, since peripheral application of lidocaine significantly reduced it. Furthermore, the depolarization was significantly reduced by a NMDA receptor antagonist MK-801. Our results provide direct in vivo electrophysiological evidence that ACC pyramidal cells undergo rapid and prolonged depolarization after digit amputation, and the amputation-induced depolarization in ACC neurons might be associated with the synaptic mechanisms for phantom pain.

Journal Article↗
PubMed2000

Proboscis amputation facilitates the study of mosquito (Diptera: Culicidae) attractants, repellents, and host preference.

Proboscis amputation has facilitated the study of mosquito behavior. Using humans as a host is very important in the study of mosquito attractants, repellents, and host preference. However, mosquito bites cause potential medical problems because of hypersensitivity and perhaps secondary bacterial infection, even using laboratory mosquitoes. Moreover, once a normal female mosquito bites and feeds on human blood, it cannot be used in subsequent probing tests. These problems were resolved by proboscis amputation. Variation of attraction among humans was examined effectively without bites using proboscis-amputated Aedes albopictus Skuse. Proboscis-amputated and normal mosquitoes also showed equal repellency against 1% L-lactic acid. Although the mosquitoes lacked the tip of the labium and some sensilla, they alighted on human forearms in the same way as normal mosquitoes. Because proboscis-amputated mosquitoes continued to probe avidly, they could be used repeatedly, thereby reducing the number of mosquitoes required for experimentation. The use of proboscis-amputated mosquitoes would promote various studies of mosquito attraction or repellency with no risk of hypersensitivity and secondary bacterial infection by mosquito bites.

Aedes↗
PubMed1983

Supravaginal uterine amputation vs. hysterectomy. Effects on libido and orgasm.

Postoperative symptoms of hysterectomy have received relatively little attention. In the present study, the first author has personally interviewed and examined 105 abdominal hysterectomy patients and 107 patients with supravaginal uterine amputation preoperatively and 6 weeks, 6 months and 12 months postoperatively. Participation in the follow-up study was 99.5% (211/212) at one year. This paper deals with the effects of the two operations on libido and the frequency of orgasms. In the statistical analysis, McNemar's test of symmetry and the Fisher exact test were used. Weak or absent libido was reported preoperatively by 28.0% of hysterectomy patients and by 26.4% of amputation patients. One year postoperatively the corresponding figures were 35.4% and 31.4%. No statistical changes were observed between the two groups or within either group. In the frequency of orgasms a highly significant (p less than 0.001) reduction from the situation before operation to one year postoperatively was detected after hysterectomy. In the supravaginal amputation group no statistically significant decrease was detected. Preoperatively the two groups were alike; one year postoperatively the difference was almost significant (p less than 0.05). The reductions in orgasms after hysterectomy as compared with supravaginal amputation appears to result from the greater radicality of the former; at hysterectomy, the autonomous innervation of the proximal vagina and cervix is damaged more than in supravaginal amputation, the anatomy of the vagina is altered and scar tissue forms in the vagina. It is probable that these changes and subconscious psychological reactions due to total removal of the uterus explain why supravaginal uterine amputation gives better results than hysterectomy.

Adult↗
PubMed1985

Supravaginal uterine amputation versus hysterectomy with reference to subjective bladder symptoms and incontinence.

Studies on postoperative symptoms of hysterectomy have devoted scarcely any attention to malfunctioning micturition and pressure sensation in the bladder region. Postoperative occurrence of incontinence is mentioned in some studies. Preoperatively, 33.3% of abdominal hysterectomy patients and 38.3% of patients with supravaginal uterine amputation complained of pressure sensation in the bladder region; one year after operation the corresponding percentages were 9.6 and 10.3. Prior to the operation, a sensation of residual urine after micturition occurred in 28.6% of hysterectomy patients and 35.5% of supravaginal amputation patients; at 1 year postoperatively these figures were 22.1 and 10.3% respectively. The decrease in the supravaginal amputation group is statistically highly significant. Preoperative incontinence occurred in 36.2% of hysterectomy and 47.7% of supravaginal amputation patients. Twelve months postoperatively the values were 28.8 and 22.6% respectively, the decrease in the supravaginal amputation group being again statistically highly significant. Development of log-linear models for both groups gave interactions "earlier urinary tract infections/sensation of residual urine" and "earlier urinary tract infections/incontinence". Thus the greater reduction in the symptoms in the supravaginal amputation group appears to result rather from the type of operation than from the differences in the two patient groups.

Adult↗
PubMed1978

Sexual adjustment after lower extremity amputation.

Sexual adjustment following lower extremity amputation was evaluated by interviewing 60 adults with recent amputations, 39 men and 21 women, after they had become independent in ambulation with a prosthesis. Among the men, 77% reported a substantial decrease in the frequency of sexual intercourse following amputation, while only 38% of the women reported a decrease. The decreased frequency was greater for nonmarried men than for married men, greater for men with above-knee amputations than for men with below-knee amputations, and greater for male amputee patients in whom phantom phenomena persisted compared to those in whom phantom phenomena no longer existed. The decreased frequency of intercourse for male amputee patients was unrelated to the patient's age, education, and etiology of amputation. There was no significant change in other aspects of sexual activity, including oral-genital relations, masturbation, homosexuality, and extramarital relations.

Adolescent↗
PubMed2001

[Syme amputation in heel defects].

The main advantage of Syme's amputation is the end-bearing stump. A defective heel pad often leads to below-knee amputation. The question of interest is whether an atypical cutaneous flap also provides a covering for the stump adaptable to weight-bearing. Thirteen patients with heel pad ulcers or tumors who could not be attended to with a classic Syme's amputation were operated on in a modified fashion. Skin from the dorsum of the foot or a medial flap was used for covering the stump. Two patients underwent transtibial amputation. The remaining 11 patients received a covering for the end of the stump composed of tissue thick and bulky enough for weight-bearing in a prosthesis typical for a Syme stump. The results show that a transtibial amputation can be prevented by atypical soft-tissue coverage of a Syme stump with satisfactory results regarding function and cosmetics.

Amputation, Surgical↗
PubMed2026

Barefoot ambulation following partial foot amputation: A systematic review of biomechanical outcomes.

BACKGROUND: Partial foot amputation (PFA) is increasingly performed due to rising prevalence of diabetes and peripheral vascular disease. While PFA may preserve gait and reduce energy expenditure compared with transtibial amputation, biomechanical deficits are common. This review aimed to evaluate biomechanical outcomes during baref following PFA. METHODS: A systematic review was conducted. MEDLINE, Embase, CINAHL, SCOPUS and Web of Science databases were searched for studies reporting biomechanical outcomes in adults with PFA without prosthesis. Eligible outcomes included spatiotemporal metrics, joint kinematics and kinetics, plantar pressures, and ground reaction forces. FINDINGS: Twelve studies including a total of 101 participants met inclusion criteria. Across studies, PFA was associated with impaired barefoot gait. This included spatiotemporal changes, such as reduced walking speed and shorter step length, and kinetic changes, such as reduced ankle power. Elevated plantar pressures were commonly reported, particularly in the forefoot and midfoot, highlighting loading abnormalities in the residuum. Several studies also described proximal compensatory strategies at the knee and hip, suggesting that biomechanical consequences extend beyond the foot and ankle. However, the evidence base was limited by small sample sizes, inconsistent protocols, and substantial heterogeneity. INTERPRETATION: Barefoot walking is impaired after partial foot amputation and the degree of dysfunction may vary by amputation level. Abnormal loading and compensatory changes may extend beyond the foot and ankle to the knee and hip. Given the limited and methodologically heterogeneous evidence, larger prospective studies with standardised biomechanical outcomes are needed to clarify the effects of amputation level and aetiology. This standardisation is important to inform surgical planning, rehabilitation, and prosthetic device design.

Humans↗
PubMed1992

Lower-extremity amputation with immediate postoperative prosthetic placement.

To study the efficacy of an immediate postoperative prosthesis (IPOP) program, a retrospective review of 167 major lower-extremity amputations was performed. Patient enrollment in the IPOP program was based on the individual's potential for rehabilitation and participation in an aggressive postoperative physical therapy regimen, as determined by the surgeon, prosthetist, physical therapist, and social worker. Indications for amputation were intractable infection and/or severe unreconstructable arterial insufficiency. Sixty-five patients underwent 69 amputations with IPOP (59 below knee; 10 above knee). Successful program completion was defined as independent ambulation and occurred in 86% of those patients enrolled. The average interval from amputation to ambulation was 15.2 days for the below-knee amputees and 9.3 days for the above-knee amputees. Failure to complete the program occurred in 14% of patients and was due to noncompliance, stump infection, stump trauma, and death. The results of this review support the use of IPOP after major lower-extremity amputation.

Adult↗
PubMed2001

Muscle transposition and skin grafting for salvage of below-knee amputation level after bilateral lower extremity thermal injury.

Thermal injury to the lower extremity sometimes necessitates amputation around the knee joint. Knee function is so critical to prosthetic rehabilitation that every attempt should be made to salvage the knee joint. This report presents an unusual case of bilateral lower extremity flame burn requiring amputations. While the distal two-thirds of the legs and both feet were totally necrotic, the thermal damage was limited to skin and subcutaneous tissue sparing muscle and bone in the proximal one-third of the legs and posterior thighs. The below-knee amputation level was salvaged by muscle transposition over the anterior tibia and resurfacing of muscle cuffs with thick split-thickness skin grafts. The post-operative period was uneventful. Amputation stumps tolerated the below-knee prosthesis well and the patient attained independent functional prosthetic ambulation at the post-operative fourth month. It is known from the reconstruction of the plantar foot that skin-grafted muscle tissue tolerates weight bearing and shearing forces well. This principle can also be used for salvage aspects of the below-knee amputation level.

Adult↗
PubMed1991

The selection of amputation level: an approach using decision analysis.

The choice of level for a major amputation of the leg depends upon the careful balancing of the advantages of preserving the knee joint against the risks of failure to heal and subsequent revision of the amputation stump. A study has been carried out to measure the values that health care professionals put upon different levels of disability resulting from amputation. The results show that the reduction of quality of life is thought to be 5-10% and 10-20%, respectively, for ambulation upon a below-knee and above-knee prosthesis and about 50% for failure to mobilise on an artificial limb. These utilities have been incorporated into a decision analysis to determine the optimum strategy for evaluation of amputation level, with other probabilities obtained from published data. The results demonstrate the advantage of attempting to preserve the knee joint, even if the chance of primary healing is as low as 20%. Tests of likely healing are most useful if the sensitivity is high, with specificity being less important, and the advantages may be outweighed by the costs of false negatives if sensitivity is below 90%. Sensitivity analysis shows that these findings remain valid over a wide range of possible values. Further research is required to gain more accurate information on which to base decisions, but on current evidence a policy of below-knee amputation in all cases of clinical doubt may be preferable to the use of currently available tests.

Amputation, Surgical↗
PubMed1990

A multivariate analysis of determinants of wound healing in patients after amputation for peripheral vascular disease.

In a prospective study 53 patients undergoing amputations of the lower limb were evaluated for clinical criteria, laboratory results, pulse volume recordings, Doppler pressures, Photoplethysmographic Skin Perfusion Pressures (PPG/SPP) and angiography. The purpose of the study was to analyse which of these techniques predicts wound healing adequately after amputation. Forty-five patients eventually completed all tests. With the exception of PPG/SPP none of these tests were able to predict skin healing. The technique of PPG/SPP proved very reliable in helping to select the level of amputation, if measured anteriorly (P = 0.0001, r = 0.83). Angiographic scoring also correlated significantly (P = 0.0016) with a successful result. This study suggests that surgeons should not rely on their clinical acumen for the selection of the amputation level. In the absence of a reliable non-invasive test, angiography may well be useful but PPG/SPP will enable the surgeon to amputate on an optimal level and thus reduce complications and improve rehabilitation.

Aged↗
PubMed1998

A comparison of laser Doppler fluxmetry and transcutaneous oxygen pressure measurement in the dysvascular patient requiring amputation.

OBJECTIVE: To determine the predictive power of laser Doppler fluxmetry (LDF), both heated and unheated, as a preoperative investigation of wound healing potential in dysvascular patients requiring amputation, by comparison with transcutaneous oxygen pressure measurement (TcpO2) and the limb to chest TcpO2 index. METHODS: Thirty-five non-diabetic patients with peripheral vascular disease were investigated before amputation. Heated and unheated LDF and heated TcpO2 measurements were taken on the chest wall and at the routine above-knee, below-knee and mid-foot amputation levels. Wound healing potential was evaluated against a TcpO2 index value of 0.55 and on clinical outcome. RESULTS: A heated LDF value of 4.9 arbitrary units (au) was shown by receiver-operator characteristic curve to have the best predictive power, with an overall accuracy for preoperative prediction of wound healing of 91.4%, and a predictive value for wound failure of 89%. Based on the heated LDF of 4.9 au, review of 26 amputations performed shows the overall accuracy for preoperative prediction of wound healing of 92.3%, a predictive value for wound healing of 100%, and a predictive value for wound failure of 62.5%. CONCLUSION: A heated LDF value of 4.9 au appears to be a useful predictor of the potential of an amputation site to heal.

Amputation, Surgical↗