Objectives: Inflammation is a component in the pathogenesis of critical limb ischemia. We aimed to assess how inflammation affects response to treatment in patients treated for critical limb ischemia using neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocytes ratios (PLR) as markers of inflammation.
Methods: Patients in a single tertiary cardiovascular center with critical limb ischemia unsuitable for surgical or interventional revascularization were retrospectively identified. Data were collected on medical history for risk factors, previous surgical or endovascular revascularization, and outcome. A standard regimen of low molecular weight heparin, aspirin, statins, iloprost infusions, and a standard pain medication protocol were applied to each patient per hospital protocol. Patients with improvement in ischemic pain and healed ulcers made up the responders group and cases with no worsening pain or ulcer size or progression to minor or major amputations made up the non-responders group. Responders and Non-responders were compared for risk factors including pretreatment NLR and PLR.
Results: 268 included patients who were not candidates for surgical or endovascular revascularization were identified. Responders had significantly lower pretreatment NLR (4.48 vs 8.47, p < 0.001) and PLR (162.19 vs 225.43, p = 0.001) values. After controlling for associated risk factors NLR ≥ 4.63 (p < 0.001) and PLR ≥ 151.24 (p = 0.016) were independently associated with no response to treatment.
Conclusions: Neutrophil-to-lymphocyte ratio and platelet-to-lymphocytes ratio are markers of inflammation that are reduced in patients improving with medical treatment suggesting a decreased state of inflammation before treatment in responding patients.
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http://dx.doi.org/10.1177/1708538120986294 | DOI Listing |
Korean J Neurotrauma
December 2024
Department of Neurosurgery, College of Medicine, Korea University Guro Hospital, Seoul, Korea.
Tuberculous (TB) spondylitis, also known as Pott's disease, was first described by Percivall Pott in 1779. The diagnosis of TB spondylitis is often delayed because of the non-specific nature of the infection, which can lead to severe consequences. Differential diagnosis is especially critical in cancer patients undergoing chemotherapy who present with lymph node or bone metastasis.
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December 2024
Anesthesiology and Critical Care, Uttar Pradesh University of Medical Sciences, Etawah, IND.
Background: In epidural anaesthesia, the addition of an adjuvant to local anaesthetics enhances the efficacy, thereby providing increased duration and intensity of blockade in lower limb surgeries. The aim was to compare the efficacy, onset, and duration of sensory and motor blockade; haemodynamic changes; and sedative and analgesic effects of nalbuphine, clonidine, and dexmedetomidine as an adjuvant to ropivacaine in epidural anaesthesia.
Methodology: A prospective, randomised, double-blind study among 90 patients after taking consent was divided into three groups (30 patients each; Group D received 15 ml of 0.
J Vasc Surg Cases Innov Tech
February 2025
Department of Surgery, George Washington University Hospital, Washington, DC.
Acute limb ischemia is a critical vascular emergency often resulting from embolic sources, requiring prompt intervention to prevent significant morbidity and mortality. This paper presents a case of a 74-year-old female with acute limb ischemia due to a thromboembolus in the distal brachial artery and a nonocclusive mobile thrombus in the innominate artery. The patient underwent urgent brachial artery thromboembolectomy and subsequent retrograde innominate artery stenting via right open transcarotid approach.
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January 2025
Department of Intensive Care, Medical Center Leeuwarden, Leeuwarden, Netherlands.
Introduction: Early mobilization reduces long-term muscle weakness after intensive care unit (ICU) admission, but barriers (e.g., anxiety, lack of motivation) may complicate patients' adherence to exercise.
View Article and Find Full Text PDFHeliyon
January 2025
Faculty of Sport Science, Ningbo University, Ningbo, 315211, China.
The long jump is an athletic event that demands speed, power, force application, and balance, with each phase being critical to overall performance. However, previous research has neglected the limiting effect of the wedge pedals on ankle dorsiflexion range of motion. This cross-sectional study investigated biomechanical changes in the lower extremities during long jumps under varying degrees of ankle dorsiflexion.
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