Background: The goal of the US Department of Veterans Affairs (VA) Amputation System of Care (ASoC) is to enhance the quality and consistency of amputation rehabilitation care for veterans with limb loss.
Objective: The ASoC provides specialized expertise in amputation rehabilitation incorporating the latest practices in medical management, rehabilitation, and artificial limbs in order to minimize disability and to enable the highest level of social, vocational, and recreational success for veterans with amputation.
Discussion: The ASoC serves veterans with limb amputation from any etiology. Between 2009 and 2019, the VA experienced a 34% increase in the number of veterans with amputation who received care. During the same 10-year period, the percentage of veterans with major limb amputation seen in an outpatient amputation specialty clinic each year increased from 4.8 to 26%. This article highlights how the mission of the ASoC has been accomplished over the past decade through prioritization and implementation of key strategic initiatives in learning organization creation, trust in VA care, modernization, and development of a high-performance network with enhanced access and customer service.
Conclusions: This synopsis of the VA amputation care program serves as a model of amputation care that can be utilized outside the federal sector and has the potential to serve as a systems-based example for providing longitudinal care to other populations within the VA.
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http://dx.doi.org/10.12788/fp.0024 | DOI Listing |
Background: Although revascularization is first-line therapy for chronic limb-threatening ischemia (CLTI), there are no established treatments for patients in whom revascularization is not (or is a poor) option, including CLTI that has responded poorly to revascularization. This study verified the efficacy of the Rheocarna, a novel apheresis device, for no-option CLTI or poor-response CLTI after revascularization.
Methods And Results: This multicenter retrospective observational study analyzed 221 patients (221 limbs) with no- or poor-option CLTI (mean [±SD] age 71±10 years; males, 70.
IDCases
January 2025
University of Kansas Medical Center, Department of Internal Medicine, Division of Infectious Diseases, 3901 Rainbow Blvd., Mailstop 1028, Kansas City, KS 66160, USA.
() was first isolated from the larval stage of the fly vector It is a gram-negative, non-motile, strictly aerobic rod that thrives in temperatures between 28º C and 37º C. Its strong chitinase activity aids in metamorphosis, which suggests a symbiotic relationship with the fly. Although rare, has been implicated in human infections, like bacteremia and osteomyelitis, typically transmitted through fly larvae in skin wounds.
View Article and Find Full Text PDFDiabetol Int
January 2025
Department of Plastic and Reconstructive Surgery and Maxillofacial Surgery, Kurume University School of Medicine, Kurume, Japan.
Aim: Patients with diabetes are frequently complicated with diabetic foot ulcers (DFUs) which are vulnerable to recurrence after healing. We retrospectively surveyed the recurrence of foot ulcer and related factors in Japanese patients with DFUs.
Subjects And Methods: Forty-two feet of 39 patients were initially recruited in this study.
Ann Vasc Dis
January 2025
Department of Vascular Surgery, Aichi Medical University, Nagakute, Aichi, Japan.
Chronic limb-threatening ischemia (CLTI) occurs in the advanced stage of peripheral artery disease and is associated with high risks of mortality and amputation. Universal management strategies are not always applicable, owing to population diversity, and the Western trials may not be applicable to Japanese patients, owing to differences in demographics and clinical profiles. This paper examines the outcomes of revascularization in Japanese CLTI patients and emphasizes the benefits of tailored management.
View Article and Find Full Text PDFCNS Drugs
January 2025
Faculty of Environmental and Life Sciences, Centre for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, UK.
Background: Raynaud syndrome (RS) is a peripheral vasculopathy characterised be impaired acral perfusion typically manifesting as skin discolouration with pallor, cyanosis and/or erythema, and increased sensitivity to cold. RS may be primary or secondary to systemic disease, lifestyle and environmental factors or medication. RS has been reported with medication to treat ADHD, but we found no recent comprehensive overview of the literature.
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