Complex surgical and medical therapy was used for 386 patients with lower limb variceal disease 2nd and 3rd form (segmental and disseminated varices with reflux through the superficial and perforant veins) and chronic venous insufficiency stage I (according to the Russian classification). Five main types of surgical interventions were fulfilled: combined phlebectomy, trunk scleroobliteration, short stripping with insufficient perforants ligation, short stripping with excision or damage of variceal influx, and short stripping with trunk scleroobliteration. Besides, vast majority of patients received venotonic drug Phlebodia 600 pre and postoperatively. Miniinvasive and atraumatic interventions were characterized by the decrease of postoperative subcutaneous hematomas, no incidence of n. saphenus damage and lymphorrhea, good cosmetic outcomes due to the absence of additional incisions. The duration of postoperative recovery correlated with intraoperative trauma and Phlebodia 600 administration. In conclusion, combination of complex surgical procedures and venotonic drugs can be widely used for the management of lower limb variceal disease, especially for its uncomplicated forms. While preserving the radicality, these interventions yield favorite esthetical results, reduce the time of postoperative recovery and disability, thus, appear to be cost effective.
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JAMA Surg
January 2025
Department of Surgery, State University of New York, Downstate Health Sciences University, Brooklyn.
Importance: Chronic limb-threatening ischemia (CLTI) is a major public health issue that requires considerable human and physical resources to provide optimal patient care. It is essential to characterize the disease severity and resource needs of patients with CLTI presenting to facilities of varying resource capacities.
Objective: To investigate the association between facility-level Medicaid payer proportions and the incidence of nonelective admissions among patients admitted for CLTI.
JAMA Surg
January 2025
Vanderbilt University Medical Center, Nashville, Tennessee.
Importance: Fracture-related infection (FRI) is a serious complication following fracture fixation surgery. Current treatment of FRIs entails debridement and 6 weeks of intravenous (IV) antibiotics. Lab data and retrospective clinical studies support use of oral antibiotics, which are less expensive and may have fewer complications than IV antibiotics.
View Article and Find Full Text PDFJAMA Dermatol
January 2025
Division of Dermatology, Departments of Medicine and Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri.
Importance: Cutaneous pyogenic granulomas (PGs) are commonly encountered, benign, vascular tumors, in which epidemiologic factors have been variably reported, in part, due to sample size limitations and a focus on either adult or pediatric patients.
Objective: To assemble a large dataset of pathologically diagnosed PGs across the continuum of age and investigate patterns of PGs by demographic factors, including age, sex, and anatomical location.
Design, Setting, And Participants: This retrospective case series included case reports of patients with pathologically confirmed PGs of cutaneous origin reported between April 1, 2010, to March 31, 2020.
Adv Wound Care (New Rochelle)
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Rubrum Advising, Fort Washington, Pennsylvania, USA.
Lower-extremity diabetic ulcers (LEDUs) affect more than 500,000 U.S. Medicare beneficiaries each year.
View Article and Find Full Text PDFRev Sci Instrum
January 2025
Shenyang Bluewisdom Technology Co., Ltd., Shenyang, Liaoning Province 110623, China.
Existing lower limb exoskeletons (LLEs) have demonstrated a lack of sufficient patient involvement during rehabilitation training. To address this issue and better incorporate the patient's motion intentions, this paper proposes an online brain-computer interface (BCI) system for LLE based motor imagery and stacked ensemble. The establishment of this online BCI system enables a comprehensive closed-loop control process, which includes the collection and decoding of brain signals, robotic control, and real-time feedback mechanisms.
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