Incidence of Venous Thromboembolism in Patients Receiving Anticoagulation for Foot and Ankle Surgery.

Venous thromboembolism (VTE) is a serious medical condition that can be an unfortunate complication arising from foot and ankle surgery. Many factors may predispose a patient to a VTE event including prolonged postoperative immobilization, comorbidities, extended length of tourniquet time, and higher risk surgeries. Unfortunately, there is no clinical consensus for guidelines on VTE prophylaxis following foot and ankle surgery. In this retrospective cohort study, we present our patient population who were prophylactically anticoagulated following foot and ankle surgery along with their incidence of deep vein thrombosis and pulmonary embolism (PE). Included in the study were patients who had undergone elective and traumatic foot and ankle surgery from June 2017 to December 2018. Using retrospective data obtained we compared patient demographics, surgery type, length of tourniquet time, postoperative immobilization, type of VTE prophylaxis, and comorbidities including history of smoking, peripheral vascular disease, bleeding disorders, and patients undergoing dialysis. Five of 425 (1.2%) patients were diagnosed with a deep vein thrombosis and 1 of 425 (0.2%) patients was diagnosed with a pulmonary embolism. Risks factors statistically significant for developing a VTE in our patient population included extended periods of immobilization and an increasing patient age. We were able to conclude that routine prophylaxis for elective and traumatic foot and ankle surgery is both effective and safe for especially in older patients requiring extended immobilization. It's also important to take into consideration comorbidities, smoking history, tourniquet time, and the type of surgery that is being performed.

A retrospective comparison of percutaneous plantar fasciotomy and open plantar fasciotomy with heel spur resection.

Minimally invasive surgery for the treatment of recalcitrant heel pain is a relatively new approach. To compare the 2 approaches, a retrospective chart review was conducted of 53 patients (55 feet) who had undergone surgical treatment of plantar fasciitis by either open fasciotomy with heel spur resection or percutaneous medial fascial release. The outcomes measures included perioperative pain and the interval to return to full activity. Pain was measured on a subjective 10-point visual analog scale. Of the 55 fasciotomies performed, 23 were percutaneous and 32 were open, with adjunctive heel spur resection. The percutaneous group experienced a mean pain reduction of 5.69 points at the first postoperative visit, whereas open fasciotomy group experienced a mean pain reduction of 3.53 points. At 12 months postoperatively, no statistically significant difference was found in the pain levels between the 2 groups. The results also showed that the percutaneous group returned to normal activity an average of 2.82 weeks (p < .001) faster than the open group. In the patient cohorts studied, percutaneous medial fascial release was as effective at resolving recalcitrant plantar fasciitis pain as the open procedure and involved less postoperative pain and a faster return to full activity.

Do angry women choose alcohol?

Women's alcohol treatment usually includes anger management, predicated on the hypothesis that anger increases their drinking. Studies show strong association between anger and drinking but to date there is no laboratory support for this hypothesis. We examined effects of a "female-specific" anger provocation on young adult women's drinking behavior by randomly assigning 30 women (age 21-30) to one of two conditions: Provocation (n=15) or Non-Provocation (n=15). In the Provocation condition, a female confederate was both annoying and condescending to the participant for 8min. A manipulation check showed heightened anger and hostility (but not anxiety or depression) in the Provocation participants. In a subsequent taste-task, all participants could drink placebo "beer" and ginger ale. When the data analysis controlled for participants' baseline negative emotions, Provocation participants consumed more "beer" (M=172.33ml, SD=78.90) than did Non-Provocation participants (M=118.60ml, SD=75.74) (p<.04), with no differences in ginger ale consumption. Results support a causal relationship between young women's anger and their specific choice to drink alcohol.

Acceptability of heat treating breast milk to prevent mother-to-child transmission of human immunodeficiency virus in Zimbabwe: a qualitative study.

Although heat treatment of human milk is an official infant-feeding recommendation for human immunodeficiency virus (HIV)-positive mothers in Zimbabwe, its implementation has not been adequately addressed, because knowledge about the safety of this method is rudimentary and its acceptability is poorly understood. To address this knowledge gap, the authors conducted focus group discussions among mothers, grandmothers, midwives, and husbands in various regions of Zimbabwe. Although the practice of heat treating expressed human milk was initially met with skepticism because of potential obstacles, including time constraints and social and cultural stigma, a pattern of opinion reversal emerged in all groups. By the end of each discussion, participants believed that, given its affordability and its potential to protect infants from HIV infection, heat-treated human milk may be a feasible infant-feeding option for HIV-positive mothers in Zimbabwe. These findings merit further investigation so that appropriate behavioral strategies can be designed.