ABSTRACT
Traumatic leg amputation, but not arm amputation, in World War II combat veterans has been associated with subsequent increased ischemic heart disease mortality. In a pilot project we examined a group of 19 high-risk Vietnam War veterans with bilateral above-knee amputations in comparison with a control group with unilateral below-elbow amputations. Nine of the 19 above-knee amputees were hypertensive (p = 0.05) and obese by hydrostatic weighing (p less than 0.001). Obesity was strongly associated with hypertension, decreased glucose tolerance, and marked hyperinsulinemia. Cigarette smoking, blood lipid abnormalities, and decreased cardiovascular fitness were not implicated as significant risk factors. Long-term risks of amputation may be related to metabolic and hemodynamic sequelae of excessive maturity-onset weight gain in young men immobilized by loss of lower limbs.
Subject(s)
Amputation, Traumatic/complications , Cardiovascular Diseases/etiology , Leg Injuries/complications , Veterans , Adult , Follow-Up Studies , Humans , Male , Obesity/complications , Risk , Smoking , United States , WarfareSubject(s)
Angioplasty, Balloon , Hemodynamics , Aged , Arterial Occlusive Diseases/therapy , Arteriosclerosis/therapy , Humans , Male , Middle AgedSubject(s)
Blood Vessel Prosthesis/adverse effects , Polyethylene Terephthalates/adverse effects , Postoperative Complications/etiology , Thromboembolism/etiology , Animals , Aorta, Abdominal/pathology , Aorta, Abdominal/surgery , Bioprosthesis , Constriction, Pathologic , Dogs , Endothelium/pathology , Female , Infarction/etiology , Kidney/blood supply , MaleABSTRACT
Preoperative preparation of rats with lactulose, 2.5 ml/kg of a 52.5% w/w solution, for two days resulted in increased bursting pressure and bursting wall tension of low colonic anastomoses three days postoperatively when compared with unprepared controls (85.8, viz, 36.1 mm Hg and 0.55, viz, 0.19 dynes/cm X 10(-5). After seven days, there was no appreciable difference in the rats with colonic acidification and in the controls.