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1.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 38(3): 309-314, 2024 Mar 15.
Artigo em Chinês | MEDLINE | ID: mdl-38500424

RESUMO

Objective: To compare the effectiveness of talonavicular-cuneiform joint fusion with iliac bone grafting and without bone grafting in the treatment of Müller-Weiss diseases (MWD). Methods: The clinical data of 44 patients (44 feet) with MWD who received talonavicular-cuneiform joint fusion between January 2017 and November 2022 and met the selection criteria was retrospectively analyzed. Among them, 25 patients were treated with structural iliac bone grafting (bone grafting group) and 19 patients without bone grafting (non-bone grafting group). There was no significant difference ( P>0.05) in age, gender composition, body mass index, disease duration, affected side, Maceira stage, and preoperative American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS) score, anteroposterior/lateral Meary angle, and Pitch angle between the two groups. Operation time, operation cost, and postoperative complications were recorded in the two groups. AOFAS and VAS scores were used to evaluate the function and pain degree of the affected foot. Meary angle and Pitch angle were measured on the X-ray film, and the joint fusion was observed after operation. The difference (change value) of the above indexes before and after operation was calculated for comparison between groups to evaluate the difference in effectiveness. Results: The operation was successfully completed in both groups, and the incisions in the two groups healed by first intention. The operation time and cost in the bone grafting group were significantly more than those in the non-bone grafting group ( P<0.05). All patients were followed up. The median follow-up time was 41.0 months (range, 16-77 months) in the non-bone grafting group and 40.0 months (range, 16-80 months) in the bone grafting group. There was skin numbness of the medial dorsalis of the foot in 1 case, internal fixation stimulation in 2 cases, and pain at the iliac bone harvesting area in 1 case of the bone grafting group. There was skin numbness of the medial dorsalis of the foot in 1 case and muscle atrophy of the lower limb in 1 case of the non-bone grafting group. There was no significant difference in the incidence of complications between the two groups ( P>0.05). At last follow-up, the AOFAS scores of the two groups significantly improved when compared with those before operation, while the VAS scores significantly decreased, the anteroposterior/lateral Meary angle and Pitch angle significantly improved, and the differences were significant ( P<0.05). There was no significant difference in the change values of outcome indicators between the two groups ( P>0.05). There was no delayed bone union or bone nonunion in both groups, and joint fusion was achieved at last follow-up. Conclusion: In the treatment of MWD, there is no significant difference in effectiveness and imaging improvement of talonavicular-cuneiform joint fusion combined with or without bone grafting. However, non-bone grafting can shorten the operation time, reduce the cost, and may avoid the complications of bone donor site.


Assuntos
Doenças Ósseas , Doenças do Pé , Humanos , Resultado do Tratamento , Transplante Ósseo , Estudos Retrospectivos , Hipestesia , Doenças do Pé/cirurgia , Dor
3.
BMC Health Serv Res ; 24(1): 324, 2024 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-38468255

RESUMO

BACKGROUND: Pacific Island Countries and Territories (PICTs) are known to have high prevalence of Diabetes Mellitus and high incidence of diabetes-related foot disease. Diabetes-related foot disease can lead to lower limb amputation and is associated with poor outcomes, with increased morbidity and mortality. The purpose of this study was to gain a better understanding of diabetes-related foot disease management in selected countries in PICTs and to identify potential barriers in management of diabetes-related foot disease management in the region. METHODS: A cross-sectional survey was sent to eleven hospitals across six selected PICTs. The survey instrument was designed to provide an overview of diabetes-related foot disease (number of admissions, and number of lower limb amputations over 12 months) and to identify clinical services available within each institution. Two open-ended questions (free text responses) were included in the instrument to explore initiatives that have helped to improve management and treatment of diabetes-related foot diseases, as well as obstacles that clinicians have encountered in management of diabetes-related foot disease. The survey was conducted over 6 weeks. RESULTS: Seven hospitals across four countries provided responses. Number of admissions and amputations related to diabetes-related foot disease were only reported as an estimate by clinicians. Diabetes-related foot disease was managed primarily by general medicine physician, general surgeon and/or orthopaedic surgeon in the hospitals surveyed, as there were no subspecialty services in the region. Only one hospital had access to outpatient podiatry. Common themes identified around barriers faced in management of diabetes-related foot disease by clinicians were broadly centred around resource availability, awareness and education, and professional development. CONCLUSION: Despite the high prevalence of diabetes-related foot disease within PICTs, there appears to be a lack of functional multi-disciplinary foot services (MDFs). To improve the outcomes for diabetes-related foot disease patients in the region, there is a need to establish functional MDFs and engage international stakeholders to provide ongoing supports in the form of education, mentoring, as well as physical resources.


Assuntos
Diabetes Mellitus , Pé Diabético , Doenças do Pé , Humanos , Estudos Transversais , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapia , Pé Diabético/terapia , Pé Diabético/cirurgia , Gerenciamento Clínico , Extremidade Inferior , Ilhas do Pacífico/epidemiologia
4.
Vet Immunol Immunopathol ; 270: 110738, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38452577

RESUMO

Laminitis is a pathology of the equine digit ultimately leading to a failure of the dermo-epidermal interface. Neutrophil activation is recognized as a major factor in SIRS-associated laminitis and has recently been described in induced endocrinopathic laminitis evidenced by the presence of myeloperoxidase (MPO). Neutrophil extracellular traps (NET) are released with neutrophil activation. This study aimed to investigate the presence and activity of MPO and NET in the lamellar tissue of equids presented with naturally occurring laminitis. Samples of lamellar tissue of five horses and five donkeys presented with laminitis, as well as eight control horses without laminitis, were collected. Lamellar tissue extracts were submitted to ELISA and specific immuno-extraction followed by enzymatic detection (SIEFED) assays to confirm the presence and activity of both MPO and NET. Lamellar sections were also immunohistopathologically stained for MPO and NET. Analysis of lamellar tissue extracts revealed that laminitis cases had significantly higher levels of total MPO concentration, MPO activity, and NET-bound MPO activity in comparison to control horses. Moreover, a strong correlation was identified between the activity of NET-bound MPO and the total MPO activity, which suggests that MPO activity partly originates from NET-bound MPO. Immunohistochemical staining showed that MPO and NET labelling in laminitis cases was moderate to marked, primarily in the epidermis and in inflammatory infiltrates containing neutrophils, while labelling in control horses was minimal. This article constitutes the first indication of the presence and activity of NET-bound MPO in the lamellar tissue of horses and donkeys with naturally occurring laminitis. Targeting these substances may provide new treatment possibilities for this debilitating disease.


Assuntos
Dermatite , Armadilhas Extracelulares , Doenças do Pé , Doenças dos Cavalos , Cavalos , Animais , Doenças do Pé/veterinária , Dermatite/veterinária , Equidae , Peroxidase , Extratos de Tecidos , Doenças dos Cavalos/patologia , Inflamação/veterinária
5.
JAMA ; 331(12): 1064-1065, 2024 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-38530262
7.
Poult Sci ; 103(4): 103542, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38417331

RESUMO

The type of litter material has direct impacts on production, behavioral, and welfare parameters of broilers. The price of conventionally-used litter materials is increasing. Salvinia molesta is a fast-growing aquatic plant which has become an environmental issue in some areas. This study assessed the suitability of air-dried Salvinia plants (SAL) as an alternate litter material to paddy husk (PH). Resulting in a completely randomized experiment, a total of 240 broilers was raised in 12 floor-pens each provided with either PH or SAL as litter materials, from 11 to 36 d. Scan sampling technique was employed to record the birds' engagement in 15 predetermined behaviors. Foot pad dermatitis (FPD), hock burn damage (HBD) and plumage cleanliness (PC) were assessed using Welfare Quality Scoring System. Litter samples were analyzed for pH, dry matter%, water holding capacity, porosity, N%, tapped-density and ammonia emission rate. The litter material had no significant effect (P > 0.05) on mortality, growth performance parameters, dressing % and visceral organ weight. The scores for FPD and PC were unaffected by the litter materials. SAL litter reported significantly lower (P < 0.05) HBD scores. The percentages of birds engaged in eating and wing flapping behaviors were significantly lower on SAL. Litter type had no significant influence on the color, aroma, flavor, texture and overall acceptability of breast meat. Air-dried Salvinia plants reported acidic pH. SAL litter gave a significantly higher tapped-density. Ammonia emission rate of SAL litter was significantly lower than that of PH. However, the final litter N content was higher for PH (3.7%) than SAL (3.2%). The study proposes air-dried Salvinia plants as a litter material for broilers since it gives growth performance comparable to PH with reduced hock burn damage incidences. Effects of SAL on behavior and the fertilizer value of the spent litter are to be studied further.


Assuntos
Doenças do Pé , Doenças das Aves Domésticas , Animais , Doenças do Pé/veterinária , Amônia/química , Galinhas , Abrigo para Animais , Doenças das Aves Domésticas/epidemiologia , Esterco , Pisos e Cobertura de Pisos
8.
Foot Ankle Int ; 45(3): 225-235, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38385244

RESUMO

BACKGROUND: Midfoot arthrodesis is regarded as the main surgical approach for treating Müller-Weiss disease (MWD). This study aimed to investigate the incidence of postoperative pain during MWD treatment through midfoot reduction or malreduction during arthrodesis and to explore the factors influencing postoperative pain in patients with MWD. METHODS: A total of 67 patients with MWD were recruited and divided into two groups according to whether midfoot alignment was reduced: reduction group (n = 38) and malreduction group (n = 29). Demographic characteristics before the operation and at the last follow-up, as well as clinical and radiographic parameters, were compared between the two groups. Clinical parameters included the American Orthopaedic Foot & Ankle Society score and visual analog scale score, whereas radiographic parameters included the calcaneal pitch angle, lateral Meary's angle, talometatarsal-1 angle dorsoplantar (TMT1dp), talocalcaneal angle dorsoplantar (Kite angle), talonavicular coverage angle, and medial navicular pole extrusion. Postoperative complications and incidence of midfoot pain were evaluated at the last follow-up visit. RESULTS: The reduction group exhibited better clinical and radiological parameters, including the TMT1dp and medial navicular pole extrusion, than the malreduction group at the last follow-up (all P < .05). However, the calcaneal pitch angle, lateral Meary's angle, Kite angle, and talonavicular coverage angle did not significantly differ between the two groups (all P > .05). The overall incidence of midfoot pain was 26.4%. The reduction group showed a lower incidence of medial pain than the malreduction group (15.7% vs. 40.0%, P < .05). Regression analysis revealed that midfoot abduction, represented by the TMT1dp, was a critical factor for midfoot arthrodesis failure and that medial navicular pole extrusion was not correlated with postoperative midfoot pain. CONCLUSION: Midfoot reduction arthrodesis yields better clinical outcomes than malreduction arthrodesis. The TMT1dp, representing midfoot abduction, is a key factor for midfoot arthrodesis failure. The extruded medial navicular bone may not affect postoperative medial midfoot pain. LEVEL OF EVIDENCE: Level III, retrospective comparative study.


Assuntos
Doenças Ósseas , Doenças do Pé , Ossos do Tarso , Humanos , Estudos Retrospectivos , Ossos do Tarso/cirurgia , Doenças do Pé/cirurgia , Artrodese , Dor Pós-Operatória , Resultado do Tratamento
9.
Res Vet Sci ; 170: 105180, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38359647

RESUMO

Our objective was to assess potassium monopersulfate as a disinfectant used in footbath to control digital dermatitis (DD) in dairy cows. We hypothesized that a potassium monopersulfate solution would control DD. A 180-day randomized negative controlled trial was conducted in a 265-Holstein free-stall facility. Throughout the trial, foot bathing was performed bi-weekly using a split (left vs. right feet) footbath: one tub filled with 1% potassium monopersulfate (treatment), the other with tap water (control). Digital dermatitis lesions were scored during trimming chute examinations of the unwashed hind heels every 90 days using the modified M-scoring system. Digital dermatitis lesions were re-categorized into four variables: 1) inactive; 2) active; 3) any; 4) inactive or absence of DD lesions. Three longitudinal outcomes were characterized: risks of 1) developing a DD lesion; 2) reactivating an inactive DD lesion; 3) development of an inactive or the absence of the DD lesion. A generalized linear model was used to compare the variables and longitudinal outcomes between treated and control groups. Prevalence of active DD lesions increased from 12.5% to 39.9% between days 0 and 90. This significant increase in prevalence justified the discontinuation of the study on day 90 for ethical reasons. There was no statistical difference between treated and control groups for the first outcome (RR: 1.0; 95% CI: 0.62, 1.7), the second outcome (RR: 1.0; 95% CI: 0.62,-1.7); or the third outcome (RR: 0.88; 95% CI: 0.37, 2.1). A 1% potassium monopersulfate footbath solution appears ineffective to control DD in this study.


Assuntos
Doenças dos Bovinos , Dermatite Digital , Doenças do Pé , Casco e Garras , Compostos de Potássio , Sulfatos , Feminino , Bovinos , Animais , Lactação , Dermatite Digital/tratamento farmacológico , Dermatite Digital/prevenção & controle , Dermatite Digital/epidemiologia , Doenças dos Bovinos/tratamento farmacológico , Doenças dos Bovinos/prevenção & controle , Doenças dos Bovinos/epidemiologia , Casco e Garras/patologia , Indústria de Laticínios , Doenças do Pé/prevenção & controle , Doenças do Pé/veterinária
10.
BMJ Open ; 14(1): e074155, 2024 01 18.
Artigo em Inglês | MEDLINE | ID: mdl-38238174

RESUMO

OBJECTIVES: Logan local government area (LGA) in Queensland has the highest diabetes prevalence (6.5%) within Metro South Health (MSH). The study aimed to determine the burden of, and equity of access to secondary healthcare, for diabetic foot disease (DFD) for Logan residents to better inform healthcare services planning. DESIGN: A retrospective analysis of hospital admissions data between January 2018 and December 2021. SETTING, PARTICIPANTS: All episodes of care for DFD provided by MSH hospitals to patients with a residential address in the three LGAs serving the region were included. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome was number of episodes of care for DFD by LGA of residence and hospital of presentation. Secondary outcomes were DFD-related hospital occupied bed days and number of lower extremity amputations. RESULTS: Among residents in the MSH region, almost half of all episodes of care (47%) and bed days (48%) for DFD were for patients residing in Logan LGA. 40% of episodes of care, 57% of bed days and 73% of lower extremity amputations for DFD for these patients occurred outside of Logan LGA. These findings led to the planning of an integrated model of care for DFD at Logan hospital to improve and make care available locally. CONCLUSIONS: Our study suggests that Logan residents with DFD had poor access to care despite the highest burden. Analysing epidemiology of care for DFD with an equity lens and highlighting gaps in service delivery is paramount to addressing the inequity paradigm.


Assuntos
Diabetes Mellitus , Pé Diabético , Doenças do Pé , Humanos , Pé Diabético/epidemiologia , Pé Diabético/cirurgia , Queensland/epidemiologia , Estudos Retrospectivos , Pacientes , Acesso aos Serviços de Saúde , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapia
11.
BMC Musculoskelet Disord ; 25(1): 52, 2024 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-38216960

RESUMO

BACKGROUND: Foot pain has been associated to factors like: fat, body mass index, age increased, female gender and the presence of pathologies. Although evidence is limited. The purpose is to determine the predictive factors for foot pain in the adult population. METHODS: From January to December 2021, 457 patients were > 18 years, gave signed informed consent to take part to this cross sectional study. All completed demographic data and various questionnaires related to pain: Foot Function Index, EuroQoL-5D and Visual Analogue Scale (foot pain). Anthropometric measurements were obtained using McPoil platform and foot posture was assessed by the Foot Posture Index (FPI). To determine whether a volume change is a predictive factor for foot pain, a parameter was established: the volumetric index for footwear (VIF). Factors linked to the presence of pain, including the considered VIF variables, were analyzed through multivariable logistic regression. RESULTS: Among the study population, 40.7% were male and 59.3% female. The mean age of 39.06 years and a body mass index of 25.58 Kg/cm2. The logistic regression model had a classification capability of 72.4%, a sensitivity of 72.3% and a specificity of 73%, in which, the predictors considered were the variables found to have a significant association with FFI-pain > 45 points,, showed that younger women, with a higher BMI, higher values of right FPI (pronation), poorer overall perceived health and with problems in walking were more likely to experience foot pain. CONCLUSION: Predictive factors for foot pain in the adult population include gender, age, Body Mass Index, FPI on the right foot, perceived health and mobility. Clinical implication, the presented measure aids physicians in assessing their patients´ foot pain likelihood.


Assuntos
Doenças do Pé , Adulto , Humanos , Masculino , Feminino , Estudos Transversais , Doenças do Pé/diagnóstico , Doenças do Pé/epidemiologia , Índice de Massa Corporal , Dor , Postura
12.
Medicine (Baltimore) ; 103(3): e36912, 2024 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-38241574

RESUMO

Hallux valgus (HV) is often accompanied by metatarsalgia. This study compared the radiological and clinical outcomes of new triplanar chevron osteotomy (TCO) and chevron osteotomy (CO) in the treatment of HV, especially for patients with plantar callosities and metatarsalgia. In this retrospective analysis, 90 patients (45 patients per group) with mild to moderate HV and plantar callosities were treated with TCO and CO from July 2020 to January 2022. In both procedures, the apex was located in the center of the head of the first metatarsal bone, and the CO was oriented towards the fourth MTPJ at a 60° angle. Plantar-oblique chevron osteotomy was defined as chevron osteotomy and a 20° plantar tilt; TCO was defined as plantar-oblique chevron osteotomy-based metatarsal osteotomy with a 10° tilt towards the metatarsal head. Primary outcome measures included preoperative and postoperative hallux valgus angle, 1 to 2 intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), first metatarsal length (FML), and second metatarsal head height X-ray images; clinical measurements, including visual analogue scale and American Orthopaedic Foot & Ankle Society (AOFAS) scores; changes in callosity grade and area; and changes in the number of people with metatarsalgia. Secondary outcomes included complications, recurrence rates, and cosmetic appearance. The hallux valgus angle, IMA, and DMAA were significantly lower after surgery (P  < .001) in all patients. In the TCO group, the mean FML and second metatarsal head height increased significantly postoperatively (P < .001). The AOFAS and visual analogue scale scores improved postoperatively in both groups (P < .001). All patients experienced satisfactory pain relief and acceptable cosmesis. The plantar callosity areas were smaller postoperatively in both the TCO and CO groups, but the change in the area (Δarea) in the TCO group significantly differed from that in the CO group (P < .001). The number of postoperative patients with metatarsalgia and the plantar callosity grade were both significantly lower in the TCO group than in the CO group after osteotomy (P < .05). TCO prevents dorsal shift of the metatarsal head and preserves and even increases FML, thereby preventing future metatarsalgia in patients. Therefore, compared with CO, TCO has better orthopedic outcomes and is an effective method for treating mild to moderate HV and preventing transfer metatarsalgia.


Assuntos
Calosidades , Doenças do Pé , Hallux Valgus , Ossos do Metatarso , Metatarsalgia , Articulação Metatarsofalângica , Humanos , Hallux Valgus/diagnóstico por imagem , Hallux Valgus/cirurgia , Resultado do Tratamento , Estudos Retrospectivos , Fluormetolona , Metatarsalgia/cirurgia , Osteotomia/métodos , Ossos do Metatarso/cirurgia
13.
BMC Vet Res ; 20(1): 29, 2024 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-38245728

RESUMO

BACKGROUND: Lameness has been associated with compromised animal welfare and reduced productivity in dairy cattle herds worldwide. However, little is known about the prevalence of claw lesions in the dairy buffalo population in Egypt. Furthermore, the optimum measurements for claw trimming in buffalo are unknown. A cross-sectional cadaver study was conducted where 135 pair buffalo hind feet were collected from 4 slaughterhouses and examined for the presence of claw lesions. The proportion and associated 95% confidence interval (CI) of each type of lesion were calculated. A separate set of healthy claws (n = 26) underwent ultrasonography (US) and computed tomography (CT). The agreement between US and CT measurements was assessed using Passing-Bablok regression and intraclass correlation coefficient. The CT measurements were used to calculate trimming recommendations. RESULTS: At least one lesion was identified in 242 claws (89.6%, 95% CI = 85.4-93.0). In healthy claws, poor to moderate agreement was identified between US and CT measurements which could be due a sample size of the study. The average ± standard deviation (SD) minimum recommended external wall length of the lateral and medial claws in heifers was 7.1 ± 0.36 cm and 7.5 ± 0.35 cm, respectively. The average ± SD minimum recommended external wall length in buffaloes over five years of age was 8.2 ± 0.27 cm and 8.4 ± 0.39 cm for the lateral and medial claws, respectively. CONCLUSIONS: The study found a high prevalence of claw lesions in buffalo in Egypt, the clinical significance of which requires further elucidation. Recommended measurements will help guide claw trimming in buffalo to minimise lesions.


Assuntos
Bison , Doenças dos Bovinos , Doenças do Pé , Casco e Garras , Animais , Feminino , Bovinos , Doenças do Pé/diagnóstico por imagem , Doenças do Pé/epidemiologia , Doenças do Pé/veterinária , Búfalos , Matadouros , Prevalência , Estudos Transversais , Egito/epidemiologia , Casco e Garras/diagnóstico por imagem , Casco e Garras/patologia , Criação de Animais Domésticos/métodos , Doenças dos Bovinos/diagnóstico por imagem , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/patologia , Coxeadura Animal/epidemiologia
14.
Am J Vet Res ; 85(1)2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-37903449

RESUMO

OBJECTIVE: To identify and measure radiolucencies at the solear margin of the distal phalanx in radiographs of healthy and laminitic hooves. SAMPLE: Clinical records and dorsoproximal-palmarodistal radiographs of equine forelimbs with radiological diagnoses of either laminitis (n = 40, L) or navicular syndrome (n = 40, NS). METHODS: Outlines of the radiolucent structures at the solar margin were drawn in ImageJ, and a customized novel plugin "Arteries Analyzer/ImageJ" was used for measurements. The diverging radiolucencies outside the terminal arc of the distal phalanx were differentiated as arterial channels (open at the solear margin) and ellipses (closed at the solear margin). Comparisons between L and NS, between distal phalanges with and without ellipses, and of arterial channels and ellipses in areas were compared using Wilcoxon and the Mann-Whitney U tests, respectively. The reliability and repeatability of the method were tested using Friedman's test. RESULTS: Fewer arterial channels but more ellipses were identified in L than in NS. In phalanges with ellipses (n = 47), the number of ellipses and the number of arterial channels were negatively correlated (PCC -0.181, P = .224). The number of ellipses correlated positively with the severity of laminitis (PCC 0.495, P < .001; n = 80) and with the degree of rotation of the distal phalanx (PCC 0.392, P < .001; n = 80). CLINICAL RELEVANCE: The software tool successfully measured arterial channels and ellipses outlined by the evaluators. Results indicate that healthy arteries develop into pathological ellipses in laminitic feet. This may be used to complement the interpretation of radiographs and support clinical decision-making.


Assuntos
Doenças do Pé , Doenças dos Cavalos , Cavalos , Animais , Reprodutibilidade dos Testes , Radiografia , Membro Anterior/diagnóstico por imagem , Membro Anterior/patologia , Osso e Ossos/patologia , Artérias , Doenças dos Cavalos/diagnóstico por imagem , Doenças dos Cavalos/patologia , Doenças do Pé/diagnóstico por imagem , Doenças do Pé/veterinária , Doenças do Pé/patologia
15.
Am J Vet Res ; 85(1)2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-37903451

RESUMO

OBJECTIVE: To evaluate the radiographic thickness of the dorsal hoof wall in normal draft horse feet. ANIMALS: 33 adult draft horses with no history of laminitis, no clinically obvious lameness, and visibly unremarkable front feet were included. METHODS: This was a prospective, descriptive study of clinically normal draft horses' front feet. Lateromedial radiographs were acquired of the front feet. A ratio of the dorsal hoof wall thickness to the length of the distal phalanx (DHWP3 ratio) was calculated. RESULTS: The dorsal hoof wall thickness to length of the distal phalanx was calculated as 0.33 ± 0.03 (range of 0.28 to 0.39) in this population of draft horses. CLINICAL RELEVANCE: With very few exceptions, the heterogeneous population of draft horses evaluated in this study had a DHWP3 ratio greater than previously published values in lighter breeds (< 0.30).


Assuntos
Doenças do Pé , Casco e Garras , Doenças dos Cavalos , Cavalos , Animais , Casco e Garras/diagnóstico por imagem , Estudos Prospectivos , Doenças dos Cavalos/diagnóstico por imagem , Radiografia , Osso e Ossos , Doenças do Pé/diagnóstico por imagem , Doenças do Pé/veterinária , Coxeadura Animal
16.
Vet J ; 303: 106053, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38043699

RESUMO

Hyperinsulinemia is the key feature of equine metabolic syndrome (EMS) which leads to debilitating sequelae. Hyperinsulinemia-associated laminitis (HAL) is one of the major sequelae of EMS, although the pathophysiological mechanisms are not well elucidated. Using an equine model, we hypothesized that expression of inflammatory markers would be increased in digital lamellae and striated muscle following prolonged hyperinsulinemia. Healthy Standardbred horses (5.4 ± 1.9 years) were alternately assigned to a prolonged euglycemic-hyperinsulinemic clamp (pEHC) or control group (n = 4 per group). Following a 48 h pEHC or a 48 h infusion of a balanced electrolyte solution (controls), biopsies were collected from digital lamellar tissue, skeletal muscle and cardiac muscle were obtained. All hyperinsulinemic horses developed laminitis regardless of previous health status at enrollment. Protein expression was quantified via Western blotting. A significant (P < 0.05) upregulation of the protein expression of heat shock protein 90 (HSP90), alpha 2 macroglobulin (A2M) and fibrinogen (α, ß isoforms), as well as inflammatory cytokines including interleukin-1ß were detected in digital lamellae following prolonged hyperinsulinemia. In contrast, protein expression of cytokines and acute phase proteins in heart and skeletal muscle was unchanged following hyperinsulinemia. Upregulation of inflammatory cytokines and acute phase proteins in digital lamellae during prolonged hyperinsulinemia may reveal potential biomarkers and novel therapeutic targets for equine endocrinopathic laminitis. Further, the lack of increase of inflammatory proteins and acute phase proteins in striated muscle following prolonged hyperinsulinemia may highlight potential anti-inflammatory and cardioprotective mechanisms in these insulin-sensitive tissues.


Assuntos
Doenças do Pé , Casco e Garras , Doenças dos Cavalos , Hiperinsulinismo , Síndrome Metabólica , Cavalos , Animais , Citocinas , Doenças do Pé/veterinária , Doenças dos Cavalos/patologia , Casco e Garras/patologia , Hiperinsulinismo/veterinária , Hiperinsulinismo/complicações , Músculo Esquelético , Síndrome Metabólica/veterinária , Proteínas de Fase Aguda , Inflamação/veterinária
17.
Cartilage ; 15(1): 65-71, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37850567

RESUMO

OBJECTIVE: Müller-Weiss disease (MWD) is a challenging condition involving the perinavicular region in the initial stages and subsequently the entire foot in the later stages. The goal of this article is to describe the pathomechanics, clinical evaluation, and nonoperative and operative treatment, including a treatment algorithm, based on current evidence and the combined authors' experience. DESIGN: We review the related articles and summarize the information about this condition. RESULTS: A number of related articles reveal that the treatments should focus on the management of degenerative regions and deformity correction to restore normal foot alignment and provide pain relief. CONCLUSION: This systematic review proposes a treatment algorithm that is comprehensive and practical to apply for the management of MWD.


Assuntos
Doenças Ósseas , Doenças do Pé , Ossos do Tarso , Humanos , Ossos do Tarso/cirurgia , Doenças do Pé/cirurgia , Manejo da Dor
18.
Explore (NY) ; 20(2): 261-263, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37673761

RESUMO

BACKGROUND: Warts result from an infection with the human papilloma virus (HPV). Plantar warts, also known as Verruca plantaris, can be notably painful for the patient and possess contagious qualities, thus necessitating assertive treatment. Despite several available approaches for addressing plantar warts, efficacy remains elusive. CASE PRESENTATION: One 22-year-old firefighter suffered from numerous plantar warts. After 26 days of traditional Chinese medicine soaking, the rashes completely disappeared. The treatment was without complications or discomfort, and a three-month follow-up showed no recurrence. CONCLUSION: Our case investigation highlighted the efficacy of herbal soaking as a safe, painless, and non-invasive therapeutic option, positioning it as a potential avenue for managing multiple plantar warts.


Assuntos
Doenças do Pé , Verrugas , Humanos , Idoso de 80 Anos ou mais , Medicina Tradicional Chinesa , Verrugas/tratamento farmacológico , Doenças do Pé/terapia , Papillomaviridae , Resultado do Tratamento
19.
Int Orthop ; 48(2): 389-400, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37668730

RESUMO

PURPOSE: Foot tuberculosis is a rare form of osteoarticular tuberculosis, accounting for less than 1% of cases. It presents unique diagnostic challenges due to its nonspecific clinical features and overlapping symptoms with other conditions. This study aimed to investigate the clinical presentation, radiographic findings, and prognosis of foot tuberculosis, with the goal of improving early recognition and appropriate intervention. METHODS: A prospective study was conducted between November 2016 and July 2021, involving 39 patients diagnosed with foot tuberculosis. Clinical examinations, laboratory tests, X-rays, and MRI evaluations were performed to aid in the diagnosis. Biopsy was conducted on patients with radiological lesions. Patients were treated with an 18-month course of antitubercular therapy (ATT). Foot Function Index (FFI) scores were recorded before and after treatment. Statistical analysis was conducted to assess factors impacting prognosis. RESULTS: Unilateral foot involvement was observed in all patients, with a male predominance (61.5%) and a mean age of 31.3 years. The most common symptoms were pain and edema, with sinus tracts present in 17.9% of patients. Radiographic findings showed cystic and sclerotic lesions, with the "spina ventosa" appearance primarily affecting the metatarsal bones. MRI played a valuable role in early detection. Histopathological examination confirmed tuberculosis in all cases, and acid-fast bacilli were found in 23% of patients. Most patients (79.4%) responded well to ATT without requiring surgery. Factors such as high initial ESR, delayed ATT initiation, multiple lesions, and tarsal involvement were associated with unfavourable outcomes. CONCLUSION: Foot tuberculosis presents with nonspecific symptoms, leading to misdiagnosis and delays in appropriate treatment. Clinical examination, radiographic evaluation, and biopsy are essential for accurate diagnosis. Early initiation of ATT is crucial for favourable outcomes. Factors such as high initial ESR, delayed treatment initiation, multiple lesions, and tarsal involvement negatively impact prognosis. This study highlights the importance of recognizing foot tuberculosis and provides insights into its clinical presentation, radiographic features, and treatment outcomes, facilitating timely intervention and improved patient management.


Assuntos
Doenças do Pé , Tuberculose Osteoarticular , Humanos , Masculino , Adulto , Feminino , Estudos Prospectivos , , Tuberculose Osteoarticular/diagnóstico por imagem , Tuberculose Osteoarticular/tratamento farmacológico , Antituberculosos/uso terapêutico , Dor/tratamento farmacológico
20.
J Foot Ankle Surg ; 63(2): 199-206, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38061622

RESUMO

No consensus exists regarding operative treatment of Müller-Weiss disease (MWD). Its only classification is based solely on Méary's angle and serves neither as guide to management nor prognosis. We report on 33 feet that underwent surgery following failed conservative management. Treatment was directed towards joint(s) involved, as determined by clinical examination, plain radiography and SPECT-CT. Thus, surgery consisted of isolated talonavicular in 6 feet, triple in 8, subtalar and talonavicular in 7, talonaviculocuneiform in 4, talonaviculocuneiform with interpositional tricortical iliac crest graft in 6 and pantalar arthrodesis in 2. PROMIS scores for pain interference and depression decreased significantly (p < .001) with significant accompanying increase in physical function (p = .003). Union occurred in 31 of 33 feet (94%) with complete resolution of pain at an average follow-up of 84 months. Of the 2 nonunions, 1 had fracture through the lateral navicular, and the other marked sclerosis and avascularity of the lateral navicular. We describe our pathways for selecting arthrodesis based on the joints affected. Isolated talonavicular arthrodesis was performed in early stages of MWD, which begins at the talonavicular articulation. When disease extended to both sides of the navicular, we performed talonaviculocuneiform arthrodesis. When considering isolated talonavicular, double medial or triple arthrodesis, there should be adequate cancellous bone stock remaining in the lateral part of the navicular, as determined on medial oblique radiographs and CT scan. In case of inadequate bone stock or fracture through the lateral navicular, talonaviculocuneiform arthrodesis with interpositional iliac crest bone graft is recommended.


Assuntos
Doenças Ósseas , Doenças do Pé , Ossos do Tarso , Articulações Tarsianas , Humanos , Ossos do Tarso/diagnóstico por imagem , Ossos do Tarso/cirurgia , Doenças do Pé/cirurgia , Resultado do Tratamento , Articulações Tarsianas/diagnóstico por imagem , Articulações Tarsianas/cirurgia , Artrodese , Dor
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