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20

Novel drugs and drug combinations for treating tuberculosis

A 56 year old man presented with pain and numbness in his lower legs. He had been treated for pulmonary tuberculosis for the previous six weeks. He thought that his symptoms had started a fortnight previously, after the tuberculosis clinic changed his treatment from a fixed dose combination preparation to multiple, separate drugs. He thought that the new tablets may be causing his symptoms. His partner was also being treated for tuberculosis but with even fewer tablets taken once weekly, and he wondered whether he could take the same treatment as she had. He had a history of excess alcohol intake and admitted to binge drinking at the weekends.  
feeds.bmj.com
over 6 years ago
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22

Chronic and slowly progressive weakness of the legs and hands

A 59 year old man was referred for a definitive diagnosis of chronic and progressive bilateral weakness of his feet and legs, which began aged 11 years. This was associated with gradual clawing of his feet, bilateral hand weakness, bilateral mild numbness of his hands and feet, and foot pain. No bladder or bowel disturbance was reported.  
feeds.bmj.com
over 6 years ago
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8

Focal neurological deficits after trauma

A 38 year old woman developed headache (without neck pain) and weakness of her left upper and lower limbs after a concussive head trauma with scalp lacerations in a motor vehicle crash. On examination (more than 4.5 hours after the trauma), she was conscious, alert, and in cardiac sinus rhythm. There was no carotid bruit. She scored 7 points on the National Institute of Health stroke scale (maximum possible score 42). Positive neurological findings included mild blunting of the left nasolabial fold; left hemiparesis, with extensor muscles being weaker (3/5) than flexors in the left upper limb (4+/5), flexors being weaker (4 to 4+/5) than extensors in the left lower limb (4+ to 5/5), and distal more than proximal weakness in the left arm and leg. She also had brisk deep tendon reflexes in the limbs on the left side; a left extensor plantar response; left hemianopia; and left hemisensory (including the face) hypoaesthesia for pain, cold, and touch. Eyelid ptosis or paresis of extraocular movements were not present, and pupillary size and light reaction were normal.  
feeds.bmj.com
over 6 years ago
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9

Negative pressure wound therapy for treating leg ulcers | Cochrane

Leg ulcers are wounds that occur between the ankle and the knee as a result of poor blood flow in the legs. These wounds are relatively common often affecting older people. There are several different treatments for these ulcers and the underlying problems that cause them. Negative pressure wound therapy (NPWT) is a treatment currently beng used for wounds including leg ulcers. NPWT involves the application to the wound of a dressing to which a machine is attached. The machine then applies a carefully controlled negative pressure (or vacuum), and sucks any wound and tissue fluid away from the treated area into a canister.  
cochrane.org
over 6 years ago
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7

Electromagnetic therapy (EMT) for treating venous leg ulcers | Cochrane

Venous leg ulcers (which appear as open sores) can be caused by a blockage or breakdown in the veins of the legs. Compression of the leg, using bandages or hosiery (stockings), can help heal most of these ulcers. Electromagnetic therapy is also sometimes offered. Electromagnetic therapy is not a form of radiation or heat, but uses an electromagnetic field to try to promote healing. This review of clinical trials concluded that there is no high quality evidence about whether electromagnetic therapy speeds the healing of venous leg ulcers and its effect is unclear.  
cochrane.org
over 6 years ago
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13

Novel oral anticoagulants for the treatment of deep vein thrombosis | Cochrane

Deep vein thrombosis (DVT) is a condition in which a blood clot forms in the deep vein of the leg or pelvis. It affects approximately 1 in 1000 people. If it is not treated, the clot can travel in the blood and block the arteries in the lungs. This life-threatening condition is called a pulmonary embolism (PE) and occurs in approximately 3 to 4 per 10,000 people. The chances of getting a DVT can be increased if people have certain risk factors. These include previous clots, prolonged periods of immobility (such as travelling on aeroplanes or bed rest), cancer, exposure to oestrogens (pregnancy, oral contraceptives or hormone replacement therapy), trauma and blood disorders such as thrombophilia (abnormal blood clotting). A DVT is diagnosed through determining the risk factors and performing an ultrasound of the leg veins. If a DVT is confirmed, people are treated with an anticoagulant. This medicine prevents further clots from forming. Until recently, the drugs of choice were heparin, fondaparinux and vitamin K antagonists. However, these drugs can cause side effects and have limitations. Two further classes of novel oral anticoagulants have been developed: these are called direct thrombin inhibitors (DTI) and factor Xa inhibitors. There are particular reasons why oral DTIs and factor Xa inhibitors might now be better medicines to use. They can be given orally, they have a predictable effect, they do not require frequent monitoring or re-dosing and they have few known drug interactions. This review measures the effectiveness and safety of these new drugs with conventional treatment.  
cochrane.org
over 6 years ago
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34

CHIVA method for the treatment of varicose veins | Cochrane

Chronic venous insufficiency (CVI) is a disorder in which veins fail to pump blood back to the heart adequately. It can cause varicose veins, skin ulcers, and superficial or deep vein thrombosis in the legs. The ambulatory conservative hemodynamic correction of venous insufficiency (CHIVA) method is a minimally invasive surgical technique to treat varicose veins. The aim of the CHIVA treatment is to eliminate the venous-venous shunts by disconnecting the escape points, preserving the saphenous vein and normal venous drainage of the superficial tissues of the limb.  
cochrane.org
over 6 years ago
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26

Dressings and topical agents for arterial leg ulcers | Cochrane

People with blood circulation problems in their legs can develop leg ulcers. The majority of ulcers result from poor blood flow in the veins and are treated by compression. Arterial leg ulcers occur because of poor blood supply to the legs when there is a block in a leg artery or narrowing of the arteries (atherosclerosis). Without treatment of the underlying poor arterial blood supply, ulcers take a long time to heal or may never heal. These ulcers are treated by covering them with dressings, or using creams or ointments (topical agents), or both to promote healing and protect the ulcers from infection. A variety of types of dressings can be used depending on the overall aim of the treatment. The intention is to select dressings to reduce ulcer pain, manage exudate if present (the fluid that can leak from these ulcers) and promote healing.  
cochrane.org
over 6 years ago
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12

Paralysed man walks with robotic legs - BBC News

Simon Kindleysides, who lost the use of his legs in 2013, says it is an "incredible feeling" to walk with robotic legs.  
bbc.co.uk
over 6 years ago
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13

Prevention of blood clots in patients undergoing cardiac or thoracic surgery | Cochrane

Patients undergoing surgery have an increased probability of developing blood clots in their veins (venous thromboembolism). These clots may be in the deep veins (deep vein thrombosis) or travel to the lungs (pulmonary embolism). As in other types of surgery, effective prevention of blood clots (thromboprophylaxis) after cardiac or thoracic surgery may reduce the risk of postoperative vein clots. These potential benefits, however, have to be balanced against the associated risks of bleeding. This systematic review looked at the effectiveness and safety of anticoagulants (medicines that reduce the ability of the blood to clot), mechanical interventions (such as pneumatic pumps on the legs to promote blood flow), and caval filters (a type of vascular filter, implanted into the main abdominal vein to prevent movement of clots from the legs to the lungs) in patients undergoing cardiac or thoracic surgery.  
cochrane.org
over 6 years ago
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8

A really bad leg swelling | EMBlog Mayo Clinic

Author: Sara Aberle, M.D. https://youtu.be/Jea_um6Syv8  
emblog.mayo.edu
over 6 years ago
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3

World's First Prosthetic Leg With Real Sense of Feeling |

Researchers at the University of Applied Sciences Upper Austria are reporting the installation of the first prosthetic leg with the ability of letting the  
medgadget.com
over 6 years ago
Www.bmj
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8

Treatment of pyoderma gangrenosum

Pyoderma gangrenosum is a rare, severe skin disease in which progressive ulceration develops spontaneously or after skin trauma. Unrecognised pyoderma gangrenosum may result in the destruction of an entire leg or arm or large parts of the trunk, and the condition is potentially lethal. Patients with severe disease are usually treated with immunosuppressants such as prednisolone. Because of the rarity of the disease, clinical trials are scarce.  
feeds.bmj.com
over 6 years ago
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8

Treatment of pyoderma gangrenosum

Pyoderma gangrenosum is a rare, severe skin disease in which progressive ulceration develops spontaneously or after skin trauma. Unrecognised pyoderma gangrenosum may result in the destruction of an entire leg or arm or large parts of the trunk, and the condition is potentially lethal. Patients with severe disease are usually treated with immunosuppressants such as prednisolone. Because of the rarity of the disease, clinical trials are scarce.  
feeds.bmj.com
over 6 years ago
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2

Treatment of pyoderma gangrenosum

Pyoderma gangrenosum is a rare, severe skin disease in which progressive ulceration develops spontaneously or after skin trauma. Unrecognised pyoderma gangrenosum may result in the destruction of an entire leg or arm or large parts of the trunk, and the condition is potentially lethal. Patients with severe disease are usually treated with immunosuppressants such as prednisolone. Because of the rarity of the disease, clinical trials are scarce.  
feeds.bmj.com
over 6 years ago
Www.bmj
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7

Treatment of pyoderma gangrenosum

Pyoderma gangrenosum is a rare, severe skin disease in which progressive ulceration develops spontaneously or after skin trauma. Unrecognised pyoderma gangrenosum may result in the destruction of an entire leg or arm or large parts of the trunk, and the condition is potentially lethal. Patients with severe disease are usually treated with immunosuppressants such as prednisolone. Because of the rarity of the disease, clinical trials are scarce.  
feeds.bmj.com
over 6 years ago
Www.bmj
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7

Treatment of pyoderma gangrenosum

Pyoderma gangrenosum is a rare, severe skin disease in which progressive ulceration develops spontaneously or after skin trauma. Unrecognised pyoderma gangrenosum may result in the destruction of an entire leg or arm or large parts of the trunk, and the condition is potentially lethal. Patients with severe disease are usually treated with immunosuppressants such as prednisolone. Because of the rarity of the disease, clinical trials are scarce.  
feeds.bmj.com
over 6 years ago
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10

Critical Care

In a recent editorial in Critical Care, Monnet and Teboul emphasize the value of passive leg raising (PLR) as a reliable bedside indicator of fluid responsiveness in critically ill patients [1]. This is because PLR induces changes in venous return, regardless of the mode of ventilation or the underlying cardiac arrhythmias. In their eloquently written editorial, they provide five practical rules for performing a PLR maneuver.  
ccforum.com
over 6 years ago