Capacidad pronóstica de los sistemas de clasificación de pie diabético para amputación de miembro inferior en América Latina y el Caribe: una revisión sistemática con metaanálisis DOI Creative Commons

Paola M. Tacca-Quinteros,

Lily Veronica Tantalean Gutierrez, Marlon Yovera-Aldana

и другие.

ACTA MEDICA PERUANA, Год журнала: 2024, Номер 41(3), С. 167 - 82

Опубликована: Дек. 30, 2024

Objetivo: estimar la exactitud pronóstica para amputación de miembro inferior las escalas pie diabético utilizadas en estudios realizados América Latina y el Caribe. Materiales métodos: se incluyó a longitudinales sin restricción idioma provenientes Scielo, Embase, PubMed, Web of Science (WOS) SCOPUS, hasta octubre 2024. Los registraron incidencia mayor o cualquier nivel según aplicación una escala al inicio atención médica. Mediante un metaanálisis estimó sensibilidad, especificidad, razón verosimilitud (LR, del inglés likelihood ratio) positiva (LR+) negativa (LR-), odds ratio diagnóstico área bajo curva ROC. El riesgo sesgo fue evaluado utilizando herramienta QUADAS-2 certeza evidencia analizó GRADE. Resultados: incluyeron 15 artículos identificaron cinco escalas: IDSA, San Elián, Wifi, Meggitt-Wagner (con umbrales 3 4) Universidad Texas, nueve países. Para nivel, clasificación que mostró sensibilidad ambos desenlaces umbral grado con valores 0,91. La Elián presentó especificidad valor 0,92. LR+ más significativo correspondió 4,1, mientras LR- impacto categoría 0,20. Las evaluaciones GRADE revelaron muy baja. Conclusión: Merritt-Wagner demostraron respectivamente. Sin embargo, nuestra investigación muestra importantes limitaciones, como déficits reporte seguimiento, elevada heterogeneidad número limitado estudios, lo explica baja evidencia. Se requiere realización rigor metodológico región.

Analysis of 19 439 lower limb amputations in children in Brazilian health system over 14 years DOI
Felipe Soares Oliveira Portela, Andressa Cristina Sposato Louzada, Marcelo Fiorelli Alexandrino da Silva

и другие.

Injury Prevention, Год журнала: 2025, Номер unknown, С. ip - 045472

Опубликована: Янв. 7, 2025

Background Amputations in children represent significant events. Few studies analyse amputations this specific population, and most of them are old, regionalised with small sample sizes. Besides, there no large low-income middle-income countries. This study aims to a (19 439 procedures performed the Brazilian public health system) aged 0–14 over 14 years. Methods Retrospective cross-sectional population-based analysis all lower limb system between 2008 2021 up 14. Using database, types were selected, defining number procedures, their main aetiologies, trends years, patient demographics regional distribution. Results 19 2021, mainly at toe level (85%). occurred predominantly males (64%) 0–4 (47%). The global trend is non-significant decrease total period (p=0.427), but we observe (p<0.001) older (aged 10–14). more concentrated populated regions, while highest mortality found least densely areas. Trauma aetiology associated (60%). Conclusion epidemiology Brazil differs from rest world. aetiology.

Язык: Английский

Процитировано

0

Neurophysiological Markers of Adaptation and Compensation Following Lower Limb Amputation: An Analysis of EEG Oscillations and Clinical Predictors from the DEFINE Cohort Study DOI Creative Commons

Guilherme J. M. Lacerda,

Valton Costa, Lucas Camargo

и другие.

Neurology International, Год журнала: 2025, Номер 17(2), С. 21 - 21

Опубликована: Янв. 28, 2025

Background: Neuroplasticity, involving cortical and subcortical reorganization, plays a critical role in the adaptation compensation process post-amputation. However, underlying neurophysiological changes remain unclear, particularly brain oscillations. Methods: This is cross-sectional analysis that includes baseline data from 48 individuals with lower limb amputation our DEFINE Cohort Study project. EEG were collected using 64-channel system during 5-min resting-state period. Preprocessed analyzed for delta alpha oscillations across frontal, central, parietal regions. Logistic regression models examined associations between clinical variables, including cognition (MoCA), functional independence (FIM), phantom sensations (PLS). Results: The multivariate logistic revealed distinct patterns of association variables. Delta inversely associated cognitive scores (OR: 0.69; p = 0.048), while higher power was related to absence PLS 58.55; < 0.01). Frontal positively linked function 1.55; 0.02) but negatively 0.75; 0.04). Conclusions: These findings suggest frequencies, such as oscillations, play potential compensatory rhythms. In contrast, may reflect more adapted pattern reorganization after amputation.

Язык: Английский

Процитировано

0

Fibula Graft under Compression for the Optimization of the Transtibial Amputation Stump DOI

E. Silva,

André Luís Lugnani de Andrade,

Felipe Lins Rossi

и другие.

Injury, Год журнала: 2025, Номер unknown, С. 112264 - 112264

Опубликована: Март 1, 2025

Язык: Английский

Процитировано

0

Breaking Barriers—The Promise and Challenges of Limb Osseointegration Surgery DOI Creative Commons
Agnieszka Wnuk-Scardaccione, Jan Bilski

Medicina, Год журнала: 2025, Номер 61(3), С. 542 - 542

Опубликована: Март 20, 2025

Limb amputation remains a significant global health issue, affecting millions of individuals annually. A substantial proportion these patients struggle with the inadequate fit and discomfort conventional prosthetic sockets, leading to diminished quality life. Osseointegration surgery, promising alternative, offers direct skeletal attachment bone, implant, prosthetic, providing more stable functional interface. an emerging procedure, while exact figures are difficult pinpoint, estimates suggest that over 10,000 worldwide have received osseointegration implants since technique was first introduced. This perspective article analyzes recent advancements in field limb osseointegration, highlighting key achievements such as improved implant materials, surgical techniques, comprehensive integration strategies. Additionally, it explores future directions for development discusses latest research trends shaping evolution this field. Despite developments, widespread adoption faces barriers, including complications, limited access multidisciplinary care, economic constraints, need further long-term clinical evidence. In paper, we present extensive on current state discuss challenges impeding its broader implementation, offer recommendations address obstacles, goal enhancing patient outcomes facilitating into mainstream practice.

Язык: Английский

Процитировано

0

All the Limbs We Cannot See DOI

Moritz S. Bischoff,

Endre Kolossváry

European Journal of Vascular and Endovascular Surgery, Год журнала: 2024, Номер 68(1), С. 99 - 99

Опубликована: Фев. 17, 2024

Язык: Английский

Процитировано

0

Amputation Surgery: Not Very Trendy DOI
Brenig Llwyd Gwilym, David C. Bosanquet

European Journal of Vascular and Endovascular Surgery, Год журнала: 2024, Номер 68(5), С. 652 - 653

Опубликована: Авг. 3, 2024

Язык: Английский

Процитировано

0

Incidence and Risk Factors for Amputations in Persons with Diabetes Mellitus: A Retrospective Cohort Study DOI
Mariana Alves Bandeira, Rafaela Bicalho Viana Macedo, José Luís Lázaro‐Martínez

и другие.

The International Journal of Lower Extremity Wounds, Год журнала: 2024, Номер unknown

Опубликована: Ноя. 6, 2024

The aim of this study was to identify and analyze the incidence rate amputations their risk factors in people with Diabetes Mellitus (DM) two specialized outpatient clinics Brazil. This is an epidemiological, retrospective cohort using data collected from electronic health records 281 adult diabetic patient types 1 or 2; attended service between 2015 2020. Statistical analyses were performed 2 sample t-test Wilcoxon–Mann–Whitney test, for quantitative variables, Pearson's χ2 test Fisher's exact categorical variables. investigation amputation carried out through logistic regression. approved by ethical committee. mean age 65.6 years (SD 13.05), predominating male gender n = 211 (75%), type DM 223 (86.7%), cardiovascular disease 143 (63.2%), about 68.7% (n 156) peripheral arterial (PAD). Seventy-seven had lower limb (LLA), a 31.9% during five years. Logistic regression analysis showed following associations amputation: Diabetic neuropathy increased 3.6 times (OR 3.631, 95% CI 1.214-11.353; P .022), 10 10.631; 2.969-57.029; .001). LLA individuals services higher compared international literature; DPN PAD confirmed as amputation, according literature. finding suggests that population faces highlighting urgent need targeted interventions implementing robust preventive strategies transform current scenario mitigate these severe outcomes. A comprehensive approach essential proactively address underlying issues reduce prevalence impact

Язык: Английский

Процитировано

0

Capacidad pronóstica de los sistemas de clasificación de pie diabético para amputación de miembro inferior en América Latina y el Caribe: una revisión sistemática con metaanálisis DOI Creative Commons

Paola M. Tacca-Quinteros,

Lily Veronica Tantalean Gutierrez, Marlon Yovera-Aldana

и другие.

ACTA MEDICA PERUANA, Год журнала: 2024, Номер 41(3), С. 167 - 82

Опубликована: Дек. 30, 2024

Objetivo: estimar la exactitud pronóstica para amputación de miembro inferior las escalas pie diabético utilizadas en estudios realizados América Latina y el Caribe. Materiales métodos: se incluyó a longitudinales sin restricción idioma provenientes Scielo, Embase, PubMed, Web of Science (WOS) SCOPUS, hasta octubre 2024. Los registraron incidencia mayor o cualquier nivel según aplicación una escala al inicio atención médica. Mediante un metaanálisis estimó sensibilidad, especificidad, razón verosimilitud (LR, del inglés likelihood ratio) positiva (LR+) negativa (LR-), odds ratio diagnóstico área bajo curva ROC. El riesgo sesgo fue evaluado utilizando herramienta QUADAS-2 certeza evidencia analizó GRADE. Resultados: incluyeron 15 artículos identificaron cinco escalas: IDSA, San Elián, Wifi, Meggitt-Wagner (con umbrales 3 4) Universidad Texas, nueve países. Para nivel, clasificación que mostró sensibilidad ambos desenlaces umbral grado con valores 0,91. La Elián presentó especificidad valor 0,92. LR+ más significativo correspondió 4,1, mientras LR- impacto categoría 0,20. Las evaluaciones GRADE revelaron muy baja. Conclusión: Merritt-Wagner demostraron respectivamente. Sin embargo, nuestra investigación muestra importantes limitaciones, como déficits reporte seguimiento, elevada heterogeneidad número limitado estudios, lo explica baja evidencia. Se requiere realización rigor metodológico región.

Процитировано

0