Livedo of the Forearm in the Aftermath of Forearm Erysipelas

Livedo is an ischemic dermopathy caused by vasculopathies or prothrombotic states, and characterized by the violaceous lace-like mottling of the skin. We report on a patient who developed livedo reticularis – livedo racemosa overlap syndrome as a late sequel of erysipelas, the livedo being restricted to the limb segment affected earlier by erysipelas and devoid of systemic vasculopathy. Though erysipelas and livedo are common disorders, we could not find in the literature reports of an occurrence like that observed in this patient. In this case a favorable prognosis of livedo could be predicted. In a different context, livedo may be the alarming signal of an undiagnosed systemic disease.

Experience in the use of tissue flossing for the prevention and treatment of muscle cramps

Introduction. Cramps are sudden, involuntary, painful tonic muscle spasms of individual muscles or muscle groups lasting from several seconds to several minutes. It occurs in patients of different age categories with a frequency of up to 37 %. Tissue flossing (flossing, voodoo flossing) is an effect on the musculature, tendons, fascia (myofascial structures) of the extremities with the help of a special elastic band circularly wound on the limb, and subsequent physical exercises in this condition in order to improve blood circulation in the limb segment, increase tissue mobility, elasticity and extensibility of muscle-fascial structures. Tissue flossing can help to increase the volume of movements in the joints, reduce pain and increase flexibility.The aim to study the effects of tissue flossing on the frequency and intensity of manifestations of cramps. Materials and methods. The publication was based on the materials obtained during the observation of 7 patients with cramps. The aggressive nature of the muscle spasms forced them to seek medical help. In order to assess the effect on the frequency and intensity of cramps, patients underwent circular winding of an elastic band on a limb segment (tissue flossing) in which cramps occurred, followed by physical exercises (mainly flexion and extension at a pace of one movement per second) without additional load (with their weight) for 1 minute. Then the elastic band was removed and the patient continued to perform the same movements also for a minute with a frequency of one movement per second. Patients performed exercises 1-2 times a day for 5-14 days.Results. In five out of seven patients, cramps did not resume after the first use of tissue flossing. In two of the seven patients, cramps stopped after 7 days of exercise use. At follow-up in one (out of seven) patients, cramps resumed 2 months after the use of tissue flossing, but with a lower intensity. In the other six (out of seven) patients in the subsequent follow-up period (from 14 days to 6 months), cramps did not resume.Conclusion. According to the preliminary results of observations, it can be assumed that the tissue flossing method is effective for preventing cramps of various genesis as an independent and additional method of treatment.

Characteristics of patients with systemic sclerosis suffering from a lower limb amputation: Results of a French collaborative study

Objective: Systemic sclerosis mainly affects the microvascular network. However, macrovascular manifestations have been reported. We aimed to investigate the characteristics of systemic sclerosis patients with an amputation of a lower limb segment. Methods: We designed a retrospective, case–control, multicentric study on systemic sclerosis patients with amputation of a lower limb segment secondary to critical ischemia via the French Research Group on Systemic Sclerosis. For each case, a control (systemic sclerosis patient without lower limb symptom) was matched with sex, age (±5 years), and cutaneous subset of systemic sclerosis. Results: In total, 26 systemic sclerosis patients (mean age of 67.2 ± 10.9 years, 20 females, 21 limited cutaneous forms) with a lower limb amputation and 26 matched controls (mean age of 67.3 ± 11.2 years, 20 females, 22 limited cutaneous forms) were included. At the time of amputation, the mean disease duration was 12.8 (±8.6) years. In comparison to controls, systemic sclerosis patients with amputation had more digital ulcers (p = 0.048), history of digital ulcers (p = 0.026), and a higher prevalence of pulmonary arterial hypertension (p = 0.024). Systemic sclerosis patients with amputation were more often smokers (p = 0.008) and under corticosteroids (p = 0.015). In the multivariate model, pulmonary arterial hypertension, smoking status, and corticosteroids were independent markers associated with lower limb amputation in systemic sclerosis. In the follow-up, 10 patients (38.5%) had recurrent ischemia requiring a new limb amputation, and five patients (19.2%) had an amputation of the contralateral limb. Conclusion: This study identifies some markers associated with lower limb amputation in systemic sclerosis such as digital ulcers and pulmonary arterial hypertension and points out the high risk associated with tobacco consumption and corticosteroid use.

Using Step Size and Lower Limb Segment Orientation from Multiple Low-Cost Wearable Inertial/Magnetic Sensors for Pedestrian Navigation

This paper demonstrates the use of multiple low-cost inertial/magnetic sensors as a pedestrian navigation system for indoor positioning. This research looks at the problem of pedestrian navigation in a practical manner by investigating dead-reckoning methods using low-cost sensors. This work uses the estimated sensor orientation angles to compute the step size from the kinematics of a skeletal model. The orientations of limbs are represented by the tilt angles estimated from the inertial measurements, especially the pitch angle. In addition, different step size estimation methods are compared. A sensor data logging system is developed in order to record all motion data from every limb segment using a single platform and similar types of sensors. A skeletal model of five segments is chosen to model the forward kinematics of the lower limbs. A treadmill walk experiment with an optical motion capture system is conducted for algorithm evaluation. The mean error of the estimated orientation angles of the limbs is less than 6 degrees. The results show that the step length mean error is 3.2 cm, the left stride length mean error is 12.5 cm, and the right stride length mean error is 9 cm. The expected positioning error is less than 5% of the total distance travelled.