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At least 1,243 records · Page 69Linked to original sources
PubMed2003

Accuracy of home blood glucose monitors using forearm blood samples: FreeStyle versus One Touch Ultra.

The accuracy of two home blood glucose monitors using forearm blood samples was studied. Blood samples were obtained from adults by venipuncture and analyzed for glucose concentration. Within five minutes after venipuncture, peripheral blood glucose measurements were taken in duplicate with the FreeStyle and One Touch Ultra monitors by using the same forearm as used for venipuncture. Accuracy was assessed by comparing the results for each first peripheral stick obtained by each monitor with the laboratory reference value. Monitor precision was evaluated by evaluating the mean difference in glucose values between the first and second peripheral sticks. Blood samples were obtained from 250 subjects, 170 (68%) of whom had diabetes mellitus. A total of 98.8% and 98.4% of the blood glucose readings obtained with FreeStyle and One Touch Ultra, respectively, were clinically acceptable, and 65.2% and 59.2% of the measurements, respectively, were within 10% of the laboratory reference values. The average difference between the first and second glucose measurements was 9.7 mg/dL for FreeStyle and 5.2 mg/dL for One Touch Ultra. One peripheral stick was needed to obtain an adequate blood sample in 95.6% of subjects using FreeStyle, compared with 83.2% of subjects using One Touch Ultra. Forearm blood glucose measurements obtained with the FreeStyle and One Touch Ultra devices were similar to laboratory reference values obtained by venipuncture.

Adult↗
PubMed2006

The Narcotrend 'depth of anaesthesia' monitor cannot reliably detect consciousness during general anaesthesia: an investigation using the isolated forearm technique.

BACKGROUND: During general anaesthesia in the presence of neuromuscular blocking drugs clinical criteria cannot detect the presence of consciousness. Various 'depth of anaesthesia' monitors are available which claim to prevent consciousness and/or reduce anaesthetic drug use. This study uses the Narcotrend anaesthesia brain monitor to guide anaesthetic administration but at the same time checks for the presence of intra-operative consciousness by using the 'isolated forearm' technique throughout the whole surgical/anaesthetic procedure. METHODS: Twelve women presenting for major gynaecological surgery under general anaesthesia, which included the use of neuromuscular blocking drugs, had a target controlled infusion of propofol adjusted according to the anaesthetic 'stage' indicated by a Narcotrend 'Depth of Anaesthesia Monitor'. Throughout surgery the isolated forearm technique was used to detect for the presence of consciousness at 1 min intervals. RESULTS: Isolated forearm responses to commands occurred in all 12 patients at some time during surgery, frequently in the absence of any significant changes in the usually monitored clinical variables. Overall, the 12 patients responded a total of 92 times during surgery. Only 41 (45%) responses were associated with an increase in the Narcotrend stage to a level suggesting consciousness (above stage C(0)). For the remaining responses, either there was no significant increase in the Narcotrend stage (above C(0)) or there was no change at all in the Narcotrend stage before, during, or after the patient responded to the taped command. CONCLUSIONS: The Narcotrend was unable to differentiate reliably between conscious and unconscious patients during general anaesthesia when neuromuscular blocking agents were used.

Acoustic Stimulation↗
PubMed1988

Forearm haemodynamics and blood pressure variability in hypertensive patients.

Ambulatory blood pressure variability and forearm haemodynamics were measured in 23 untreated hypertensive patients with a mean casual blood pressure of 162/102(11/9) mmHg (without target organ damage). There was a good inverse correlation between blood pressure variability and the ability of the forearm resistance vessels to dilate after a period of venous occlusion. Previous work has shown that this vasodilatory component of the response to forearm venous occlusion is significantly reduced in hypertensive patients compared with normotensive controls and is probably an indicator of the compliance properties of these vessels. The present results suggest that blood pressure variability is greater when resistance vessels are stiffer and emphasise the need to account for this vascular factor in studies of blood pressure behaviour.

Adult↗
PubMed1988

Vascular changes in forearm and calf during sleep in man.

Cardiovascular variables were monitored in 15 healthy young subjects during night sleep and in waking state during the day. Forearm and calf blood flow, blood pressure, and interbeat interval were measured at regular intervals with simultaneous monitoring of electroencephalogram, EOG, and chin, calf, and forearm EMG during sleep. In eight subjects the same variables were monitored during the day in recumbent positions. Large variations in all recorded cardiovascular variables were observed during sleep. Calf and forearm blood flow and conductance varied independently and reached increases of up to 700% of the resting value. Variations during the day were less frequent and smaller; heart rate also showed large variations. None of the changes showed any association with the sleep stages. The origin of the variations is uncertain; during sleep the neuronal networks integrating and patterning cardiovascular response may not be exerting their control. As a result the cardiovascular variables behave in an independent fashion. A parallel is drawn with dreams, which consist of disjointed and distorted information encoded during waking hours.

Adult↗
PubMed2004

Nutrition influences skeletal development from childhood to adulthood: a study of hip, spine, and forearm in adolescent females.

This study evaluated the long-term efficacy of supplemental calcium and dairy products on bone mineral areal density of the hip and spine and on the bone geometry and volumetric bone mineral density of the forearm in young females during late adolescence. The study was conducted among participants of a randomized double-blinded, placebo-controlled clinical trial with calcium supplements and among participants of an observational study with higher consumption of dairy products. Hip and spine measurements by dual-energy X-ray absorptiometry were done every 6 mo (dairy group every 12 mo) during last 3 y of the follow-up while peripheral quantitative computerized tomography of the forearm was done at the last visit. The results of the study show a positive influence of calcium supplementation and dairy products on bone mineral density of the hip and the forearm. Dairy products were also associated with a higher bone mineral density of the spine while calcium supplementation did not have an effect. Calcium exerts its action on bone accretion during growth primarily by influencing volumetric bone mineral density while milk may have an additional impact on bone growth and periosteal bone expansion.

Adolescent↗
PubMed1998

Bone mineral density at distal forearm can identify patients with osteoporosis at spine or femoral neck.

Forearm bone mineral density (BMD) was investigated in women to identify osteoporosis at the spine or femoral neck (or both) defined by WHO criteria (T score -2.5) without requirement for fracture. BMD was measured by single-energy X-ray absorptiometry (DTX100) and by dual-energy X-ray absorptiometry (DXA) in the lumbar spine and femoral neck in 422 subjects aged 22-90 yr. A total of 62% of subjects with osteoporosis (at the spine, femoral neck, or both sites) were detected with 89% specificity [receiver operating characteristics (ROC) analysis] and included all subjects below forearm BMD 0.34 g/cm2. Conversely, above 0.419 g/cm2, only 10% of patients had osteoporosis. A total of 71.8% of women could be assigned either to those who warranted therapy (<0.34 g/cm2) or to those who did not (>0.419 g/cm2) with 90% certainty. Subjects with forearm BMD between 0.34 and 0.419 g/cm2, who constituted 28.2% of the total group and included 31% of subjects with osteoporosis, had a 40% chance of having osteoporosis. This leads to a high identification rate on subsequent DXA scanning, which is thus used efficiently.

Absorptiometry, Photon↗
PubMed2006

Rapid recurrence of hyperparathyroidism from both nodularly hyperplastic autograft at forearm and residual tissues at neck after parathyroidectomy in a hemodialysis patient with calciphylaxis.

A 42-year-old woman underwent hemodialysis secondary to diabetic nephropathy. Total parathyroidectomy with forearm autograft was performed due to secondary hyperparathyroidism (HPT) complicated with calciphylaxis. Rapidly progressive enlargement of autograft with unusual "gourd-shape" developed, and then it was removed. Pathologic examination of the autograft disclosed multinodular hyperplasia. Residual parathyroid gland in the retrothyroid region was found later. Rapidly recurrent HPT originating from both the residual parathyroid tissues and the enlarged autograft within such short time after parathyroidectomy is rare in the literature. The multinodular hyperplasia pattern of the parathyroid gland may be a major factor for such rapid recurrence. In addition to good control of calcium and phosphate, regular follow-up of parathyroid hormone level and imaging studies of not only autografted gland at the forearm but also possibly residual parathyroid tissues at the neck are important for monitoring recurrence in maintenance hemodialysis patients after parathyroidectomy with forearm autograft, especially in those with pathologic type of nodular hyperplasia and calciphylaxis.

Adult↗
PubMed1983

Forearm replantation--long-term functional results.

The replantation of amputated extremities is justified only by the ultimate good function and appearance of the replanted part. This paper is a critical review of our clinical experience with forearm replantation and revascularization in 6 patients over the past ten years. All replanted parts survived. The long-term functional results of the forearm replants are analyzed. Return of function depends on nerve regeneration. The functional outcome in the first patient was unsatisfactory due to poor motor and sensory return. Specific attention directed to careful primary neurorrhaphy in subsequent cases yielded favorable results. We believe that two factors in particular are central in achieving good functional results in forearm replantation--careful repair of the severed major peripheral nerves, and postoperative hand rehabilitation programs.

Adult↗
PubMed1990

Full-thickness cheek and lip reconstruction with the radial forearm free flap.

The radial forearm free flap has proven versatility in head and neck reconstruction. It is superior to regional alternatives such as the pectoralis flap because it is thin, pliable, and predominantly hairless. A more recent application is the use of the folded forearm flap to replace both the skin and inner lining, simultaneously, in full-thickness cheek and lip defects. Nine such cases are presented in this report. Each patient had a recurrent lesion that had been reconstructed previously with local flaps, and all but one were treated with postoperative radiation therapy. The average size of the external defects after resection was 27 cm2, and of the intraoral defects, 18 cm2. All free flaps survived completely. The folded forearm flap solved the reconstructive problem for each patient in a single-stage procedure, providing good contour and a reasonable color match. The flap is easy to raise, has a long pedicle with large-diameter vessels, and has an acceptable donor site defect not associated with long-term morbidity.

Adult↗
PubMed1992

The superficial ulnar artery "trap" and the free forearm flap.

A superficial ulnar artery identified during the elevation of a free forearm flap is reported. This is the second case appearing in the English literature. The free forearm flap is increasingly popular among plastic surgeons, and it is therefore imperative that this anomaly be well recognized because inadvertent injury of this anomalous artery may devascularize the hand. In cadaver dissections, the incidence of this anomaly has been reported to be 3.1%. This variation is probably encountered in clinical practice more commonly, but it is not recognized. Identification of this anomalous artery is facilitated by elevating but not exsanguinating the forearm prior to harvesting the flap.

Arteries↗
PubMed1994

The radial forearm flap as a pedicled flap for resurfacing a scarred nose.

The radial forearm flap, applied as a free flap, has been shown to be very versatile, if covering a defect with a thin, flexible flap is of predominant importance. The advantage of this technique compensates for any disadvantages in the donor area. Under certain circumstances it is a better solution to design the radial forearm flap as a distant, vascular pedicled flap than to perform it as a free flap with microvascular anastomoses. In treatment of this patient we used a distally pedicled radial forearm flap to resurface a burned nose and to reconstruct the tip of the nose. In this case a scarred forehead prevented us from using an expanded forehead flap. The increased morbidity of a distant, pedicled flap was well accepted as the price for preventing additional scarring in the face, as would have occurred in the case of a free flap, through the exposure of vessels for the vascular anastomoses.

Adolescent↗
PubMed1994

Forearm compartment syndrome following brachial arterial puncture in uremia.

Although compartment syndromes of the forearm are infrequently encountered, they are well described in the literature. Forearm compartment syndrome uncommonly occurs after percutaneous arterial blood sampling and is usually associated with anticoagulant therapy. Our review of the English literature revealed no other cases of forearm compartment syndrome after arterial blood sampling in patients with bleeding diathesis due to chronic renal failure. This article discusses a 30-year-old woman with Good-pasture's syndrome who developed a compartment syndrome after a brachial artery blood gas. The cause, diagnosis, and treatment of compartment syndrome and uremic bleeding, as well as a review of the literature, are discussed.

Adult↗
PubMed1999

Permanent nerve injury in the forearm following radial artery harvest: a report of two cases.

Radial artery grafts for coronary artery bypass surgery have recently gained renewed clinical interest. The procedure has been reported to be successful, with a low incidence of morbidity. Although permanent injury to the sensory nerves of the forearm has not been reported, transient or temporary dysesthesia has been known to occur. Recently, 2 patients were referred for long-standing debilitating dysesthesia in their forearms following radial artery harvesting. Electrical studies documented radial sensory nerve injury in both patients, one of whom underwent surgical treatment. Because radial artery grafting for coronary artery bypass surgery may be increasing in popularity, disability from sensory nerve injury may become more frequent. Because of the susceptibility to injury of the sensory nerves in the forearm, and because of the anatomic variations in this region, surgical personnel performing radial artery harvesting should be familiar with the pertinent anatomy so that this complication can be avoided.

Female↗
PubMed2001

Coverage of a thumb wound and correction of a first web space contracture using a longitudinally split reverse radial forearm flap.

The authors describe a new design for a reverse-flow radial forearm flap. A total thumb amputation by severe avulsion was salvaged by microsurgical replantation and a reverse-flow radial forearm flap with a modified design to allow repair of two separate hand defects concomitantly. This newly described flap design for the reverse radial forearm flap offers a refined technique for simultaneous reconstruction of multiple defects in the hand.

Adolescent↗
PubMed2003

Use of radial forearm free flap with palmaris longus tendon in reconstruction of total maxillectomy with sparing of orbital contents.

Nasal paragangliomas are extremely rare. The most adequate treatment is total excision. After surgical excision requiring total maxillectomy, there has been no ideal technique for reconstruction. A 47-year-old man was admitted to our clinic because of recurrent epistaxis, which lasted for 2 months. He was also suffering from nasal airway obstruction. The physical examination revealed a mass originating from the medial aspect of the middle turbinate of the right nasal cavity. It invaded the anterior maxillary wall and hard and soft palate. Endoscopic examination showed that the mass pushed the nasal septum to the left side and protruded into the nasopharynx. The mass was fleshy and had a rich capillary network. Conventional paranasal sinus radiographs were normal. Computerized tomography of the skull showed the mass protruding into the nasopharynx. A total maxillectomy was performed. Histopathological evaluation showed neoplastic tissue consisting of round, oval, or slightly elongated cells, altogether of a rather monomorphous appearance, tending to arrange themselves in clusters adjacent to or around capillary blood vessels. The blood vessels were numerous and branched. Reticulum staining showed a typical Zellballen arrangement of the neoplastic cells to provide a firmer basis for the diagnosis of paraganglioma. To reconstruct the total maxillectomy defect, a radial forearm free flap with the palmaris longus tendon was elevated to inlay the nasal cavity and the oral cavity and to suspend the ocular globe. The flap was placed into the defect, and the palmaris longus tendon was medially and laterally anchored to the periosteum of the frontal bone to suspend the ocular globe in the orbital cavity. One part of the skin island was used to close the defect of the nasal mucosal cavity, and the other part was used to repair the oral mucosal defect of the palate. Consequently, speech was considered near normal; the patient was able to eat an unrestricted diet and to retain both solid and liquid food inside the oral cavity without drooling, and there was no diplopia or enophthalmos. Six months later, porous polyethylene was inserted and fixed to the zygomatic bone with a miniplate and miniscrews to restore malar contour. No further procedure was believed to be necessary later on. Two years later, a satisfactory and functional esthetic result was obtained, providing an acceptable suspension of the ocular globe and filling of the total maxillectomy defect. We believe that a total maxillectomy is indicated if it is needed in nasal paragangliomas and that microsurgical repair with the composite radial forearm-palmaris longus free flap has several advantages: 1) it can offer en bloc reconstruction of the entire defect after a total maxillectomy in terms of good function and cosmesis; 2) it can repair mucosal defects; and 3) it can anchor and suspend the ocular globe in its original anatomical location, protecting against gravity through the sling effect of the palmaris longus tendon. The composite radial forearm-palmaris longus free flap has not been described previously for suspension of the ocular globe.

Biocompatible Materials↗
PubMed2003

Total lower lip reconstruction using sensate composite radial forearm flap.

In modern plastic and reconstructive surgery, shape and function must be considered together. These are the most important goals of any operation. There are a lot of techniques that have been reported for total lower lip reconstruction. It is believed that the radial forearm flap is the most suitable technique for lower lip and chin reconstruction after tumor excision so as to achieve better shape and functional results. The sensate radial forearm-palmaris longus free flap was used for total lower lip reconstruction in 17 patients with lower lip carcinoma with a mean age of 51 years. Two of the patients were female, and 15 were male. All the patients had squamous cell carcinoma. The patients were followed up for 1 to 3 years. Complications of these operations were partial superficial flap loss in 1 patient, partial graft loss in the donor areas of two flaps, and infection in only 1 patient. Wound dehiscence, fistula formation, suture abscesses, or sialocele was not seen in any patient. In this study, the aim was to demonstrate that the sensate radial forearm flap could produce acceptable esthetic results, good sphincteric function, and sensation in the early period after surgery.

Adult↗
PubMed2006

Reconstruction of long cervical esophageal defects with the radial forearm flap.

The radial forearm flap has been used for reconstruction of the cervical esophagus most often as a patch or for circumferential repair of short defects (less than 5 cm). In the following three cases, the radial forearm flap was used to reconstruct circumferential cervical esophageal defects ranging from 5 to 12 mm in length. These procedures were successfully carried out in three patients in whom the intraoperative defect was unexpectedly large or the intra-abdominal viscera harvest would have been difficult. These patients had reliable esophageal function 8 to 24 months after surgery. We conclude that the radial forearm flap can be used for reconstruction of large circumferential defects of the cervical esophagus.

Adult↗
PubMed1993

Gender differences in pain and cardiovascular responses to forearm ischemia.

OBJECTIVE: To examine gender-related differences in pain and cardiovascular responses to forearm ischemia. DESIGN: Forearm ischemia was produced by the submaximal effort tourniquet procedure. Participants performed 2 min of dynamic hand exercise at 30% maximum grip strength. Forearm ischemia was maintained until the report of ischemic pain tolerance or until 20 min elapsed. Arterial blood pressure, heart rate, and verbal reports of ischemic pain were assessed at 2 min intervals. SUBJECTS: Thirty four male and 33 female participants of similar age. RESULTS: The times to ischemic pain onset and ischemic pain tolerance were similar for both male and female participants. However, during the ischemic period, females reported ischemic pain to be more intense and of greater unpleasantness than male participants. The relative changes in arterial blood pressure and heart rate during the exercise and occlusion period were equivalent for both male and female participants. In contrast, arterial blood pressure responses during the postexercise ischemic period were gender-dependent. Arm ischemia evoked pressor responses in male participants and either a decrease or no change in arterial pressure in female participants. Changes in arterial pressure during the postexercise ischemic period were significantly and positively correlated with verbal measures of ischemic pain for male subjects but not for female subjects. CONCLUSIONS: The data demonstrated that gender influences both the sensory and the cardiovascular responses to a tonic noxious stressor.

Adolescent↗