Amputation

In certain diseases, such as osteomalacia, syphilis, and osteomyeHtis, bones break spontaneously and without a trauma. The severity of the fracture usually depends on the force that caused the fracture. If a bone s breaking point was exceeded only slightly, then the bone may crack rather than break all the way through. If the force is extreme, such as in an automobile collision or a gunshot, the bone may shatter. An open or compound fracture is particularly serious because infection is possible in both the wound and the bone. A serious bone infection can result in amputation. 

TNF was originally identified because of its cytotoxic activity against some tumor cell lines and its ability to induce hemorrhagic necrosis of solid tumors in various animal models. However, the clinical use of TNF as an anticancer drug has been so far limited by its severe cardiovascular side effects. Therefore, TNF treatment is limited to regional and local administration of high doses of TNF, often in combination with chemotherapy, as accomplished in isolated limb and isolated hepatic perfusion (ILP and IHP, respectively) [5]. In the case of ILP, typically metastases are treated, patients benefit from this procedure by salvage of limbs from a loss by amputation. 

Diabetes mellitus is a complicated, chronic disorder characterized by either insufficient insulin production by the beta cells of die pancreas or by cellular resistance to insulin. Insulin insufficiency results in elevated blood glucose levels, or hyperglycemia As a result of the disease, individuals with diabetes are at greater risk for a number of disorders, including myocardial infarction, cerebrovascular accident (stroke), blindness, kidney disease, and lower limb amputations. 

Association of Pain, neuropathic pain is defined as pain initiated or caused by a primary lesion, dysfunction in the nervous system". Neuropathy can be divided broadly into peripheral and central neuropathic pain, depending on whether the primary lesion or dysfunction is situated in the peripheral or central nervous system. In the periphery, neuropathic pain can result from disease or inflammatory states that affect peripheral nerves (e.g. diabetes mellitus, herpes zoster, HIV) or alternatively due to neuroma formation (amputation, nerve transection), nerve compression (e.g. tumours, entrapment) or other injuries (e.g. nerve crush, trauma). Central pain syndromes, on the other hand, result from alterations in different regions of the brain or the spinal cord. Examples include tumour or trauma affecting particular CNS structures (e.g. brainstem and thalamus) or spinal cord injury. Both the symptoms and origins of neuropathic pain are extremely diverse. Due to this variability, neuropathic pain syndromes are often difficult to treat. Some of the clinical symptoms associated with this condition include spontaneous pain, tactile allodynia (touch-evoked pain), hyperalgesia (enhanced responses to a painful stimulus) and sensory deficits. 

Foot ulcers and related infections are among the most common, severe, and costly complications of diabetes mellitus (DM). Fifteen percent of all patients with DM develop at least one foot ulcer, resulting in direct health care expenditures of approximately 9 billion annually in the United States.26,27 Diabetic foot ulcers and wounds are highly susceptible to infection. Related skin, soft tissue, and bone infections account for 25% of all diabetes-related hospitalizations.28 More than half of all nontraumatic lower extremity amputations (LEAs) performed each year in Western nations are linked to diabetic foot infection 80,000 LEAs are performed annually in the United States alone.29,30... 

The most feared complication of infected diabetic foot ulcers is LEA. Diabetic patients are approximately 40 times more likely to require an amputation than nondiabetics.34 Morbidity and mortality rates are high following amputation. Mortality ranges from 40% to 80% after 5 years, generally secondary to comorbid conditions, including heart and renal disease.28,30... 

The goals of therapy for diabetic foot infection are eradication of the infection and avoidance of soft tissue loss and amputation. 

I Human bites are third most common and the most serious.44 Before the availability of antibiotics, up to 20% resulted in amputation. Currently, human bite-associated amputation rates remain at 5%, secondary to vascular compromise and infectious complications.43... 

Therefore, in chronic osteomyelitis, a common treatment goal for many patients is to prevent complications such as amputation. 

AKA Above-knee amputation alcoholic ketoacidosis all BCPP Board Certified Psychiatric Pharmacist... 

Heparin-induced thrombocytopenia A clinical syndrome of IgG antibody production against the heparin-platelet factor 4 complex occurring in approximately 1% to 5% of patients exposed to either heparin or low-molecular-weight heparin. Heparin-induced thrombocytopenia results in excess production of thrombin, platelet aggregation, and thrombocytopenia (due to platelet clumping), often leading to venous and arterial thrombosis, amputation of extremities, and death. 

Synovium Real-time PCR ELISA Elevated levels compared with tissue obtained from amputation for diabetes or other etiologies. ... 

Phantom pain is pain that appears to arise from an amputated limb or body part as many as 70% of amputees experience phantom pain. This pain may begin with sensations of tingling, heat and cold, or heaviness, followed by burning, cramping, or shooting pain. Phantom pain may disappear spontaneously or persist for many years. 

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