The Experts below are selected from a list of 690 Experts worldwide ranked by ideXlab platform
Richard L. Jacobs - One of the best experts on this subject based on the ideXlab platform.
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Healing of foot ulcers in immunosuppressed renal transplant patients : The diabetic foot
Clinical Orthopaedics and Related Research, 1993Co-Authors: F. Fletcher, Michael C. Ain, Richard L. JacobsAbstract:Sixteen renal transplant patients were retrospectively studied to determine the time foot ulcerations healed. All patients were taking imuran and medrol. More recently, patients were also on cyclosporine. All were insulin-dependent diabetics. A control group was established from a pool of randomly selected, age-matched, insulin-dependent diabetics who were also observed for foot ulcerations. All treatment was given by one physician. Pulse Volume Recordings were obtained in all but eight patients, who were clinically believed to have normal vascular supply to the affected extremity. No statistically significant difference was found between these groups in this regard. Cultures were obtained in all patients when indicated; appropriate antibiotics were started
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Healing of foot ulcers in immunosuppressed renal transplant patients
Clinical orthopaedics and related research, 1993Co-Authors: F. Fletcher, Michael C. Ain, Richard L. JacobsAbstract:Sixteen renal transplant patients were retrospectively studied to determine the time foot ulcerations healed. All patients were taking imuran and medrol. More recently, patients were also on cyclosporine. All were insulin-dependent diabetics. A control group was established from a pool of randomly selected, age-matched, insulin-dependent diabetics who were also observed for foot ulcerations. All treatment was given by one physician. Pulse Volume Recordings were obtained in all but eight patients, who were clinically believed to have normal vascular supply to the affected extremity. No statistically significant difference was found between these groups in this regard. Cultures were obtained in all patients when indicated; appropriate antibiotics were started. No major differences were noted with respect to infecting organism. The immunosuppressed group had no excellent results, and three good, 14 fair, and 23 poor results. The control group had ten excellent, 14 good, 11 fair, and 17 poor results. A higher failure rate may occur with limb-salvage surgery in the immunosuppressed patient. This observation confirms a long-held clinical suspicion.
F. Fletcher - One of the best experts on this subject based on the ideXlab platform.
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Healing of foot ulcers in immunosuppressed renal transplant patients : The diabetic foot
Clinical Orthopaedics and Related Research, 1993Co-Authors: F. Fletcher, Michael C. Ain, Richard L. JacobsAbstract:Sixteen renal transplant patients were retrospectively studied to determine the time foot ulcerations healed. All patients were taking imuran and medrol. More recently, patients were also on cyclosporine. All were insulin-dependent diabetics. A control group was established from a pool of randomly selected, age-matched, insulin-dependent diabetics who were also observed for foot ulcerations. All treatment was given by one physician. Pulse Volume Recordings were obtained in all but eight patients, who were clinically believed to have normal vascular supply to the affected extremity. No statistically significant difference was found between these groups in this regard. Cultures were obtained in all patients when indicated; appropriate antibiotics were started
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Healing of foot ulcers in immunosuppressed renal transplant patients
Clinical orthopaedics and related research, 1993Co-Authors: F. Fletcher, Michael C. Ain, Richard L. JacobsAbstract:Sixteen renal transplant patients were retrospectively studied to determine the time foot ulcerations healed. All patients were taking imuran and medrol. More recently, patients were also on cyclosporine. All were insulin-dependent diabetics. A control group was established from a pool of randomly selected, age-matched, insulin-dependent diabetics who were also observed for foot ulcerations. All treatment was given by one physician. Pulse Volume Recordings were obtained in all but eight patients, who were clinically believed to have normal vascular supply to the affected extremity. No statistically significant difference was found between these groups in this regard. Cultures were obtained in all patients when indicated; appropriate antibiotics were started. No major differences were noted with respect to infecting organism. The immunosuppressed group had no excellent results, and three good, 14 fair, and 23 poor results. The control group had ten excellent, 14 good, 11 fair, and 17 poor results. A higher failure rate may occur with limb-salvage surgery in the immunosuppressed patient. This observation confirms a long-held clinical suspicion.
Frank J. Veith - One of the best experts on this subject based on the ideXlab platform.
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Correction of steal syndrome secondary to hemodialysis access fistulas: a simplified quantitative technique.
Surgery, 1992Co-Authors: Steven P. Rivers, Larry A. Scher, Frank J. VeithAbstract:Abstract Correction of symptomatic vascular steal distal to an arteriovenous fistula requires either fistula ligation or banding. Ligation carries the obvious disadvantage of destruction of a functioning angioaccess, whereas banding procedures have been plagued by the complexity of many of the reported techniques and by the difficulty of balancing fistula flow with distal perfusion. In this study a simple plication technique is described that avoids the introduction of any additional foreign material and that quantifies distal perfusion by means of intraoperative Pulse Volume Recordings. Five patients have been treated by this method, two with autologous vein fistulas and three with bridge fistulas using polytetrafluorethylene. All five have had resolution of their ischemic symptoms with an increase in intraoperative Pulse Volume Recordings of 5 mm or more. Only three of the patients had restoration of the radial Pulse, which was not a specific end point of the banding procedure. Furthermore, all fistulas remained patent for at least 6 months and continued to provide adequate flows for hemodialysis. Banding/plication is clearly preferable to fistula closure for the management of steal syndrome. The method described herein is simple and hemodynamically identifies the minimal constriction that will resolve symptoms and preserve fistula flow.
Mauri Lepäntalo - One of the best experts on this subject based on the ideXlab platform.
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Transfer function index of Pulse Volume Recordings: A new method for vein graft surveillance
Journal of vascular surgery, 2001Co-Authors: Leo Ihlberg, Sorjo Mätzke, N.anders Albäck, Wolf-dieter Roth, Anssi Sovijärvi, Mauri LepäntaloAbstract:Abstract Objective: Color flow duplex scanning is currently the best method available for vein graft surveillance. However, it puts a considerable strain on the workload of a vascular unit and requires a highly trained operator. The aim of this study was to develop and validate a new, noninvasive tool for graft surveillance. The utility of transfer function index (TFI) of Pulse Volume Recordings is tested for this purpose. Methods: The design of the study was a blind comparative study that involved 70 testing procedures that were performed on 58 different infrainguinal vein bypass grafts. The TFI was measured with a portable vascular laboratory multi-cuff unit. Ankle/brachial indexes were obtained with the same device. Color flow duplex scanning was used as a diagnostic standard. A graft was defined as at risk, according to duplex scanning, if a local stenosis with a V2/V1 more than 2 was found or if peak systolic velocity remained less than 45 cm/s throughout the graft. The repeatability of the method was tested on 30 grafts. Results: A total of 63 tests were available for analysis. Seven tests were excluded. Four were excluded because they had unreliable TFI measurement due to cardiac arrhythmias, and in three tests, the whole graft could not be visualized in the duplex scan. Forty normal and 22 at-risk grafts were found. One graft was occluded. The TFI was significantly lower for at-risk grafts (0.89) versus normal grafts (1.09; P =.005). A TFI of 1.02 or less correctly detected 21 of 22 at-risk grafts. The sensitivity, specificity, and accuracy were 96%, 65%, and 76%, respectively. The ability of the ankle/brachial index to detect the at-risk grafts was clearly inferior to the TFI. The repeatability of the method at proximal thigh, distal thigh, and proximal calf was ± 0.21, ± 0.07, and ± 0.14, respectively. Conclusion: The TFI is a sensitive and reliable method to detect an at-risk graft. The examination is noninvasive, simple, quick to perform, and well tolerated by the patients. We suggest that the TFI could be the first-line screening method in vein graft surveillance. (J Vasc Surg 2001;33:546-53.)
D L Marinelli - One of the best experts on this subject based on the ideXlab platform.
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The value of duplex sonography after peripheral artery angioplasty in predicting subacute restenosis.
AJR. American journal of roentgenology, 1994Co-Authors: David Sacks, M L Robinson, T A Summers, D L MarinelliAbstract:The purpose of this study was to determine if abnormal findings on duplex sonographic examination after peripheral artery angioplasty correlate with the subsequent recurrence of a stenosis.We used duplex sonography to examine 35 stenoses in 23 patients within 48 hr after the patients had angioplasty to treat these stenoses. Patients were followed up for 3 years by using one or more of the following: assessment of signs and symptoms, monitoring of peripheral Pulses, Pulse Volume Recordings, and angiography. Life tables were constructed to compare long-term patency with the presence of abnormal findings seen on duplex sonograms. Abnormal findings at the dilated segment included a blood-flow velocity greater than 120 cm/sec or a residual elevated velocity ratio greater than 1.4 or 2.0 immediately after angioplasty.Twelve (34%) of 35 angioplasty sites showed recurrent stenosis before 36 months. Patency at 24 months was calculated for velocities less than 120 cm/sec vs velocities of 120 cm/sec or greater (41% ...
