Limb 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. 

A number of chronic conditions such as high blood pressure or diabetes bear certain similarities to snbstance use disorders. These illnesses prodnce a variety of physical symptoms that, if left untreated, can resnlt in significant medical complications and even death. Complications of uncontrolled diabetes inclnde blindness, kidney failure, neuropathies, and limb amputation. Similarly, inadeqnately controlled hypertension is a risk factor for stroke, heart attack, and other serions complications. Recognizing that these are diseases does not relieve the patient of responsibility indeed, the knowledge that one has snch an illness imposes significant responsibility. For example, knowing the likely ontcome of nncontrolled diabetes is hopefully an impetus for the diabetic to exercise, take medication, and... 

However, this setback did little to diminish his reputation as a physician. In 1527 he was called to Basel, a city some 70 miles away. The wealthy publisher and humanist Johan Froben was ill with an infected leg. The local doctors had recommended amputation, a very dangerous procedure. In those days, many people died after having a limb amputated. Paracelsus moved into Froben s house and was able to cure him without resorting to such drastic measures. At the time... 

Even in persons with welllong-term complications include stroke, heart attack, renal disease, blindness, and limb amputation. 

E. Therapeutic response Thrombin-dependent tests show dose dependency [aPTT rise proportionally to dose of Refludan]. The key criteria of efficacy in two pivotal clinical trials from a laboratory standpoint were platelet recovery and effective anticoagulation. Seven days after the start of treatment with Refludan in patients with HIT, the cumulative risk of death, limb amputation, or new thromboembolic complication was substantially lower than in a historical control group. 

Most first-aid measures are of little value and some are dangerous. The use of ice to prevent the spread of the venom has been linked to an increased frequency of limb amputations and should never be employed. Field procedures such as fang mark incisions may result in vein or artery damage and improperly placed tourniquets may impede blood flow. Electric shock directed at the site of envenomation has not been proven effective and is a dangerous procedure. 

Elevated serum copper levels were also found in dogs with radiation-induced and spontaneous osteosarcoma [353]. No clinical signs of metastasis were observed following tumour removal, by limb amputation, and there was a return to normal or near-normal serum copper levels. Dogs with nonmalig-nant nonosteosarcoma lesions were found to have normal serum copper levels. Detailed studies of altered copper metabolism in tumour-bearing mice and rats have also been recently reviewed [354]. 

An infected foot ulcer precedes approximately 60% of lower limb amputations in the diabetic population [13], thus the rapid and appropriate treatment of soft tissue infection is paramount. There is substantial evidence suggesting that people with diabetes are more susceptible to infection due to altered immune-response [14]. Polymorphonuclear neutrophil oxidative burst activity is thought to be reduced in addition to decreased bacterial killing... 

Pecoraro RE, Reiber GE, Bnrgess EM. Pathways to diabetic limb amputation. Basis for prevention. Diabetes Care 1990 3 513-521. 

CHppinger, F.W., A sensory feedback system for an upper-limb amputation prosthesis. Bull Prosthet. Res., 1974. BPR 10-22 247-258. 

The earliest limb amputations generally resulted in death due to blood loss or infection. The amputation was a guillotine operation such that all tissues were divided at the same level in one stroke of the blade. Bleeding vessels were immediately cauterized with heated irons or boiling oil. The first recorded successful amputation dates back to 484 B.C., when Hegesistratus reportedly... 

Dyer, D., Bouman, B., Davey, M., Ismond, P. K., An Intervention Program to Reduce Falls for Adult In-Patients Following Major Lower Limb Amputation, Healthcare Quarterly, Vol. 11,2008, pp. 117-120. 

April 15, 2013, Boston, Massachusetts. Two bombs planted by terrorists exploded among the crowd lining Boylston Street near the finish line of the Boston Marathon race. The bombs killed 3 people and injured 264. At least 14 people had limbs amputated because of the injuries from the shrapnel placed inside the home-made bombs. 

---