bluuebunny/crossref_metadata_2025_split huggingface dataset:
Essential Features of a Handheld Infrared Thermometer Used to Guide the Treatment of Neuropathic Feet
Authors: Foto James G. , Brasseaux Denise , Birke James A. 
Published: April 2014

Background: A study was conducted to compare the accuracy, reliability, and essential features of nine commercially available handheld infrared thermometers used to manage the neuropathic foot.
Methods: The thermometers were compared using two temperature-control sources simulating physiologic conditions found in a foot-care clinic. With each control source independently set, temperature difference ranges of 0°, 2°, 4°, and 6° C were randomly sampled and analyzed for each thermometer by two testers. The order of testing was randomly assigned for testers and instruments.
Results: There were differences in mean temperature change among thermometers (P &lt; .001) and between testers (P = .0247). Differences in mean temperature change among instruments (&lt;0.5°C), although small, could affect interpretation of skin temperature if temperature comparisons are made using two different instruments. The difference in temperature change between testers (0.06°C) was not large enough to affect decisions in clinical practice. Instrument response time, distance-to-spot ratio, sensor diameter, display resolution, emissivity, and cost were compared.
Conclusions: The low-cost, general-use infrared thermometers used in this study showed good accuracy, reliability, and performance and are appropriate for use in a foot-care clinic. (J Am Podiatr Med Assoc 97(5): 360–365, 2007)
Podiatric Involvement in Multidisciplinary Falls-Prevention Clinics in Australia
Authors: Menz Hylton B. , Hill Keith D. 
Published: April 2014

Background: Falls in older people are a major public health problem, and there is increasing evidence that foot problems and inappropriate footwear increase the risk of falls. Several multidisciplinary prevention clinics have been established to address the problem of falls; however, the role of podiatry in these clinics has not been clearly defined. The aims of this study were to determine the level of podiatric involvement in multidisciplinary falls clinics in Australia and to describe the assessments undertaken and interventions provided by podiatrists in these settings.Methods: A database of falls clinics was developed through consultation with departments of health in each state and territory. Clinic managers were contacted and surveyed as to whether the clinic incorporated podiatry services. If so, the podiatrists were contacted and asked to complete a brief questionnaire regarding their level of involvement and the assessment procedures and interventions offered.Results: Of the 36 clinics contacted, 25 completed the survey. Only four of these clinics reported direct podiatric involvement. Despite the limited involvement of podiatry in these clinics, all of the clinic managers stated that they considered podiatry to have an important role to play in falls prevention. Podiatry service provision in falls clinics varied considerably in relation to eligibility criteria, assessments undertaken, and interventions provided.Conclusions: Despite the recognition that foot problems and inappropriate footwear are risk factors for falls, podiatry currently has a relatively minor and poorly defined role in multidisciplinary falls-prevention clinics in Australia. (J Am Podiatr Med Assoc 97(5): 377–384, 2007)
Second-Toe Length and Forefoot Disorders in Ballet and Folk Dancers
Authors: Oztekin Haluk H. , Boya Hakan , Nalcakan Mesut , Ozcan Ozal 
Published: April 2014

Background: Although there is no ideal foot type for classical dancers, second-toe length seems to be a factor in the etiology of foot disorders in ballet dancers.
Methods: We investigated the relationship between second-toe length and foot disorders in 30 ballet dance students and 25 folk dance students. Second-toe length in relation to the hallux (longer or equal/shorter), hallux deformities, first metatarsophalangeal joint inflammation, number of callosities, and daily pain scores were recorded in both groups and compared.
Results: There was no statistically significant difference in toe length between the two groups (P &gt; .05). Ballet dancers with equal-length or shorter second toes had lower pain scores, less first metatarsophalangeal joint inflammation, and fewer callosities in their feet compared with dancers with longer second toes.
Conclusions: Second-toe length seems to be a factor in the development of forefoot disorders in classical ballet dancers but not folk dancers. Dancers who have equal-length or shorter second toes in relation to the hallux may have fewer forefoot disorders as dance professionals. (J Am Podiatr Med Assoc 97(5): 385–388, 2007)
Low Bone Mass and Fractures on Foot Radiographs: Missed Opportunities to Evaluate for Osteoporosis
Authors: Newton Marisha T. , Archer Juanita A. , Scruggs Michangelo , Geter Kirk , Al-Dabagh Hiba , Lloyd Errol , Nwokike Maria 
Published: April 2014

Background: Osteoporosis is often unrecognized, even in the presence of radiologic evidence of vertebral or nonvertebral fragility fractures.
Methods: Ninety patients aged 50 years and older with radiographs of the foot taken at Howard University Hospital between 2003 and 2005 were randomly selected. In phase 1, standard radiograph reports were reviewed for evidence of osteopenia, fractures, or both. In phase 2, risk factors for osteoporosis and dual energy x-ray absorptiometry scans were obtained.
Results: In phase 1, radiologists reported all of the fractures for all 90 participants; however, osteopenia was reported in only 54.7% of these. In phase 2, for 50% of the participants with radiographic evidence of osteopenia, fractures, or both, there was no evidence that the clinicians evaluated risk factors for low bone mass or requested a dual energy x-ray absorptiometry scan. Of participants who had radiographic evidence of osteopenia, osteoporosis, or both, 83.3% met the criteria for dual energy x-ray absorptiometry scans.
Conclusions: Osteopenia or fracture observed on radiographs of the foot are predictive of low bone mass but are often not evaluated. (J Am Podiatr Med Assoc 99(1): 1–7, 2009)
Effectiveness and Safety of Using Podikon Digital Silicone Padding in the Primary Prevention of Neuropathic Lesions in the Forefoot of Diabetic Patients
Authors: Scirè Vincenzo , Leporati Elisa , Teobaldi Ilaria , Nobili Laura Ambrosini , Rizzo Loredana , Piaggesi Alberto 
Published: April 2014

Background: In diabetic patients with complications from peripheral neuropathy, the hyperpressure areas can rapidly lead to ulcerative lesions in the absence of protective sensation. Partial digital silicone orthoses could provide an innovative and functional therapeutic solution in the management of preulcerative areas of the forefoot in neuropathic diabetic patients. We clinically tested this hypothesis.
Methods: Digital off-loading silicone padding was prepared for 89 neuropathic patients with deformities and localized hyperkeratosis in the forefoot. After 3 months and in basal conditions, the number of areas of hyperkeratosis was evaluated together with the hardness of the skin, the number of active lesions, and any adverse events associated with use of the orthosis. The patients were compared to a control group of 78 randomized patients undergoing standard therapy. In a subgroup of 10 patients, a static and dynamic biomechanical evaluation was also conducted with a computerized podobarometric platform.
Results: Both the number of lesions and the prevalence of hyperkeratosis and skin hardness were significantly lower (P &lt; .01) in the group treated with the silicone orthoses than in the control group. No adverse events were reported during the 3 months of observation. The podobarometric analysis highlighted a significant (P &lt; .001) reduction of peak pressure in the areas undergoing orthotic correction.
Conclusions: Silicone padding is effective and safe in the prevention of lesions in neuropathic patients at high risk of ulceration and significantly reduces the incidence of new lesions in the 3-month follow-up period compared to standard treatment. (J Am Podiatr Med Assoc 99(1): 28–34, 2009)
Flexor Tendon Sheath as a Source of Pain in Lesser Metatarsal Overload
Authors: Perez Hugo R. , Roberts Joshua 
Published: April 2014

Background: Lesser metatarsal overload may lead to pathologic conditions ranging from plantar metatarsophalangeal joint pain to dislocation. The flexor tendon sheath lies directly plantar to the joint. The increased pressure associated with lesser metatarsal overload may lead to synovitis and pain of the flexor tendon sheath.
Methods: Fifteen consecutive patients with lesser metatarsal overload had visual analog scale scores determined at three metatarsophalangeal joint areas to determine the source of pain. The patients underwent seven maneuvers to determine the pain scale score: single-leg heel raise and palpation of the second and third metatarsophalangeal joints on the plantar proximal, plantar distal, and dorsal aspects. The patients were then injected with 0.5 mL of lidocaine, 2%, into the second and third flexor tendon sheaths, and the maneuvers were repeated.
Results: Before the injection, the second metatarsophalangeal joint had a significantly greater visual analog scale score plantar than dorsal (6.9 and 2.6, P ≤ .01). The flexor tendon sheath injection significantly improved all seven pain scale scores.
Conclusions: Patients with lesser metatarsal overload experienced significantly greater visual analog scale pain scores on the plantar than the dorsal aspect of the second metatarsophalangeal joint. The scores significantly improved after diagnostic injection in the flexor tendon sheaths. The flexor tendon sheaths are probably involved in patients with primarily plantar pain. (J Am Podiatr Med Assoc 99(2): 129–134, 2009)
Bilateral Measurement of Resting Calcaneal Stance Position and Tibial Varum Using Digital Photography and Standardized Positioning Protocols
Authors: Mahar Shannon M. , Livingston Lori A. 
Published: April 2014

Background: Excessive calcaneal eversion and tibial varum are thought to predispose individuals to overuse injuries such as patellofemoral pain, yet investigations of this relationship have yielded equivocal results. Differences in the methods used, including stance position, may contribute to the observed differences.
Methods: Forty-six young adults (29 asymptomatic control patients and 17 patients with patellofemoral pain syndrome) participated. Resting calcaneal stance position and tibial varum were measured using a digital photographic-goniometric method while participants adopted three upright, weightbearing stance positions (self-selected, Romberg, and single-limb right or left). Data were collapsed and analyzed by group (asymptomatic, symptomatic) or limb status (uninjured, injured), stance, and limb (right, left).
Results: Mean resting calcaneal stance position and tibial varum values differed significantly among the three stance conditions, whereas differences between groups, limb status, and limb were not observed. Pearson product moment correlations revealed no relationship between measures derived under the differing stance conditions (r = −0.08 to −0.37, P &gt; .05) and only weak to moderate relationships in resting calcaneal stance position and tibial varum measures between the right and left limbs (r = 0.37 to 0.71, P &lt; .01).
Conclusions: If differences in reported values for resting calcaneal stance position and tibial varum in an individual, between groups, or from study to study are to be interpreted as true differences or as products of the measurement method used, a standardized measurement method must be established and methods must be accurately reported. (J Am Podiatr Med Assoc 99(3): 198–205, 2009)
Scientific Assessment of Over-the-Counter Foot Orthoses to Determine Their Effects on Pain, Balance, and Foot Deformities
Authors: Landsman Adam , DeFronzo Donna , Anderson Julie , Roukis Thomas 
Published: April 2014

Background: A scientific study was conducted to evaluate the effects of non–custom-molded (over-the-counter) foot orthoses.
Methods: Several parameters were examined, including foot, knee, hip, and back pain; balance; and reduction in flexible deformities, such as hammer toes and hallux valgus. Wherever possible, objective measurements were used, including measurements of shifts in center of pressure to assess balance and changes in bone position examined on radiographs. Forty-one individuals were analyzed using one of two types of prefabricated, noncustom insoles. Insoles were fit by an assistant trained to follow the fitting recommendations of the manufacturer under the direct supervision of a podiatric physician.
Results: Use of these arch supports resulted in a significant reduction in some types of foot pain associated with hallux valgus (P = .04) and pain in the arch area (P = .004), knee (P = .002), and back (P = .007) by week 4. We also measured changes in foot position documented by radiography, although some changes may be attributed to parallax associated with measurement techniques. Improvement in balance was not observed to be significant when the orthoses were worn.
Conclusions: Using both subjective and objective measures, we found that these over-the-counter foot orthoses were effective in bringing about changes in foot shape and concomitant relief of certain specific painful conditions. This study indicates that there is a scientific basis for attempting to relieve pain with orthoses. (J Am Podiatr Med Assoc 99(3): 206–215, 2009)
Late Rearfoot Eversion and Lower-limb Internal Rotation Caused by Changes in the Interaction between Forefoot and Support Surface
Authors: Souza Thales R. , Pinto Rafael Z. , Trede Renato G. , Kirkwood Renata N. , Pertence Antônio E. , Fonseca Sérgio T. 
Published: April 2014

Background: The influence of distal mechanical factors that change the interaction between the forefoot and the support surface on lower-limb kinematics is not well established. This study investigated the effects of the use of lateral wedges under the forefoot on the kinematics of the lower extremity during the stance phase of walking.
Methods: Sixteen healthy young adults participated in this repeated-measures study. They walked wearing flat sandals and laterally wedged sandals, which were medially inclined only in the forefoot. One wedged sandal had a forefoot lateral wedge of 5° and the other wedged sandal had a forefoot lateral wedge of 10°. Kinematic variables of the lower extremity, theoretically considered clinically relevant for injury development, were measured with a three-dimensional motion analysis system. The variables were evaluated for three subphases of stance: loading response, midstance, and late stance.
Results: The 5° laterally wedged sandal increased rearfoot eversion during midstance and the 10° laterally wedged sandal increased rearfoot eversion during mid- and late stances, in comparison to the use of flat sandals. The 10° laterally wedged sandal produced greater internal rotation of the shank relative to the pelvis and of the hip joint, during the midstance, also compared to the use of flat sandals.
Conclusions: Lateral wedges under the forefoot increase rearfoot eversion during mid-and late stances and may cause proximal kinematic changes throughout the lower-extremity kinetic chain. Distal mechanical factors should be clinically addressed when a patient presents late excessive rearfoot eversion during walking. (J Am Podiatr Med Assoc 99(6): 503–511, 2009)
Acute Phase Reactants Predict the Risk of Amputation in Diabetic Foot Infection
Authors: Akinci Baris , Yener Serkan , Yesil Sena , Yapar Nur , Kucukyavas Yasin , Bayraktar Firat 
Published: April 2014

Background: Prediction of amputation would aid clinicians in the management of diabetic foot infections. We aimed to assess the predictive value of baseline and post-treatment levels of acute phase reactants in the outcome of patients with diabetic foot infections.
Methods: We collected data prospectively during minimum follow-up of 6 months in patients with infected diabetic foot ulcers hospitalized in Dokuz Eylul University Hospital between January 1, 2003, and January 1, 2008. After excluding patients who did not attend the hospital for follow-up visits regularly (n = 36), we analyzed data from 165 foot ulcer episodes.
Results: Limb ischemia and osteomyelitis were much more frequent in patients who underwent amputation. Wagner grade, which assesses ulcer depth and the presence of osteomyelitis or gangrene, was higher in patients who needed amputation. Ulcer size was slightly larger in the amputation group. Baseline and post-treatment C-reactive protein levels, erythrocyte sedimentation rates, white blood cell counts, and platelet counts were significantly elevated in patients who underwent amputation. Albumin levels were significantly suppressed in the amputation group. Univariate analysis showed that a 1-SD increase in baseline and post-treatment C-reactive protein levels, erythrocyte sedimentation rates, and white blood cell counts and a 1-SD decrease in post-treatment albumin levels were significantly associated with increased risk of amputation. Post-treatment C-reactive protein level was strongly associated with amputation risk.
Conclusions: Circulating levels of acute phase reactants were associated with amputation risk in diabetic foot infections. (J Am Podiatr Med Assoc 101(1): 1–6, 2011)
Autologous Skin Fibroblast and Keratinocyte Grafts in the Treatment of Chronic Foot Ulcers in Aging Type 2 Diabetic Patients
Authors: Monami Matteo , Vivarelli Maria , Desideri Carla Maria , Ippolito Giulio , Marchionni Niccolò , Mannucci Edoardo 
Published: April 2014

Background: We assessed the tolerability and efficacy of autologous skin cell grafts in older type 2 diabetic patients with chronic foot ulcers.
Methods: Treatment with Hyalograft 3D and Laserskin Autograft was proposed to a consecutive series of type 2 diabetic patients older than 65 years affected by long-standing (&gt;6 months) foot ulcers with an area greater than 15 cm2. Ulcer healing rates and measurements of ulcer area were determined monthly for 12 months.
Results: Seven patients with 12 ulcers, nine of which received the described treatment, were enrolled. During 12-month follow-up, all of the ulcers healed except one. In the remaining eight ulcers, the median healing time was 21 weeks (interquartile range, 4–29 weeks).
Conclusions: Autologous skin cell grafts are feasible, well tolerated, and apparently effective in the treatment of diabetic ulcers of the lower limbs in advanced age. Age did not seem to moderate healing times. (J Am Podiatr Med Assoc 101(1): 55–58, 2011)
The Use of Superoxidized Aqueous Solution versus Saline as a Replacement Solution in the Versajet Lavage System in Chronic Diabetic Foot Ulcers
Authors: Bowling Frank L. , Crews Ryan T. , Salgami Eleanna , Armstrong David G. , Boulton Andrew J.M. 
Published: April 2014

Background: The removal of necrotic tissue from chronic wounds is required for wound healing to occur. Hydrodebridement (jet lavage) and superoxidized aqueous solution have been independently used for debriding wounds. We sought to investigate the use of superoxidized aqueous solution with a jet lavage system.
Methods: Twenty patients with diabetic foot ulcers were randomly assigned in a 1:1 ratio to receive jet lavage debridement with either superoxidized aqueous solution or standard saline weekly.
Results: There was no significant difference between the two treatments in the reduction of bacterial load or wound size in 4 weeks. No adverse reactions were reported for either treatment.
Conclusions: The use of superoxidized aqueous solution for jet lavage debridement seemed to be as safe and effective as saline. Future investigations should concentrate on whether superoxidized aqueous solution may reduce the bacterial air contamination associated with hydrodebridement. (J Am Podiatr Med Assoc 101(2): 124–126, 2011)
In Vitro Antimicrobial Activity of Calcium Sulfate and Hydroxyapatite (Cerament Bone Void Filler) Discs Using Heat-Sensitive and Non–Heat-sensitive Antibiotics Against Methicillin-Resistant Staphylococcus aureus and Pseudomonas aeruginosa
Authors: Karr Jeffrey C. , Lauretta Joseph , Keriazes Georgia 
Published: April 2014

Background: Several absorbable and nonabsorbable antibiotic carrier systems are available in the adjunctive surgical management of osteomyelitis of the foot, ankle, and lower leg. These carrier systems have significant limitations regarding which antibiotics can be successfully incorporated into the carrier vehicle. The calcium sulfate and hydroxyapatite Cerament Bone Void Filler is a biocompatible, absorbable ceramic bone void filler that can successfully deliver multiple heat-stable and heat-unstable antibiotics that have not been generally used before with antibiotic beads in treating musculoskeletal infections.
Methods: Cerament Bone Void Filler discs with the antibiotics rifampin, vancomycin, tobramycin, cefazolin, cefepime hydrochloride, vancomycin-tobramycin, piperacillin-tazobactam, ceftazidime, and ticarcillin-clavulanate were tested in vitro against methicillin-resistant Staphylococcus aureus.
Results: The zones of inhibition for the Cerament Bone Void Filler antibiotic discs plated against Staphylococcus aureus obtained were 33% to 222% greater than the minimum zones of inhibition breakpoints for bacteria susceptibility as defined by the standard set by the Clinical and Laboratory Standards Institute. Cerament Bone Void Filler discs with the antibiotics plated against Pseudomonas aeruginosa produced zones of inhibition of 93% to 200% greater than the minimum zones of inhibition breakpoints for bacteria susceptibility as defined by the standard set by the Clinical and Laboratory Standards Institute.
Conclusions: The calcium sulfate and hydroxyapatite Cerament Bone Void Filler was an excellent carrier vehicle for multiple antibiotics creating in vitro significant zones of inhibition, thus demonstrating susceptibility against Staphylococcus aureus and Pseudomonas aeruginosa, which holds tremendous promise in treating osteomyeilits. (J Am Podiatr Med Assoc 101(2): 146–152, 2011)
Clinical Evaluation of 35% Urea in a Water-Lipid–Based Foam Containing Lactic Acid for Treatment of Mild-to-Moderate Xerosis of the Foot
Authors: Grossman Allan B. 
Published: April 2014

Background: We evaluated 35% urea in a water-lipid–based foam delivery system containing lactic acid in participants with mild-to-moderate xerosis of the foot.
Methods: This 4-week open-label study enrolled 12 participants with xerosis of the foot; six participants were diabetic and six were nondiabetic. Study medication was applied to the affected area twice daily. All adverse events were recorded. Disease severity was measured at baseline and at the end of treatment by Investigator’s Global Assessment, and investigator’s and participant’s signs and symptoms scores. At 4 weeks, compliance and participant satisfaction were determined from participant diaries and a 16-item survey instrument, respectively.
Results: Ten participants completed the study. No adverse reactions were noted with application of the foam. All of the participants who completed the study experienced an improvement in xerosis. The median Investigator’s Global Assessment score decreased significantly from baseline to the end of treatment (P = .005). The investigator and participants observed significant improvement (P &lt; .05) in redness, scaling, and cracking from baseline to the end of treatment. Compliance with the regimen was good, and participants expressed satisfaction with the product.
Conclusions: Thirty-five percent urea in a water-lipid–based foam delivery system containing lactic acid can be an appropriate treatment option for mild-to-moderate xerosis of the foot. (J Am Podiatr Med Assoc 101(2): 153–158, 2011)