Reconstruction of plantar surgical defects with synthetic dermal matrix and split-thickness skin grafts: A case series and functional podiatry outcomes.

Reconstruction of surgical defects after wide local excision of acral melanoma on the sole should allow patients to walk and bear weight. Moreover, certain options such as local transposition flaps can compromise follow-up. We present a case series of surgical defects on weight-bearing areas of the sole reconstructed using a synthetic dermal matrix and a split-thickness skin graft. This approach prevents surrounding tissue displacement and results in good functional outcomes assessed by baropodometry and computer-based podoscopy.

Wellbeing and Complementary Therapies in Breast Cancer Peripheral Neuropathy Care: A Scoping Review Focused on Foot Health.

BACKGROUND: Chemotherapy-induced peripheral neuropathy is a multidimensional health problem. Up to now, little evidence has been found concerning its impact on quality of life and foot health. Evaluation tools and prevention and treatment strategies must be reported. This study aimed to map the literature on the impact of this side effect on the wellbeing and foot health of people with breast cancer and to describe their main assessment strategies and complementary therapies. METHODS: A scoping review was carried out while following the PRISMA-ScR and Arksey and O'Malley guidelines. Different databases (Cochrane Plus, Scopus, Web of Science, and Pubmed) were used. A total of 221 results were identified. Sixteen articles were included. RESULTS: The thematic analysis obtained the following categories: the impact of peripheral neuropathy on quality of life and foot health, complementary therapies as a path for new strategies, and the need for clinicians and researchers to get involved in researching this side effect. CONCLUSIONS: Peripheral neuropathy has a negative impact on people's quality of life. Implications for foot health and maintaining an active and healthy lifestyle have not been previously reported. Complementary therapies are recommended by scientific evidence, highlighting exercise. However, there is a need to develop more research that will help to incorporate them into evidence-based practice.

Concordance between Pressure Platform and Pedigraph.

OBJECTIVES: Determine the concordance between two methods of obtaining the plantar footprint (pedigraph and pressure platform). METHODS: A descriptive, cross-sectional, observational study of prevalence was carried out in the social center of Cariño (Coruña), Spain (n = 65 participants). Older people without amputations or the presence of dysmetria were included. The variables studied were: sociodemographic (age, sex), anthropometric (body mass index) and footprint measurement variables. These measurements were made by obtaining the plantar footprint using two methods: pedigraph and pressure platform. RESULTS: The mean age of the sample was 37.42 ± 15.05 years, with a predominance of the female gender (61.54%). Positive linear correlation between pedigraph and platform was observed in both feet in the Chippaux and Staheli indices (correlation coefficient > 0.3, p < 0.001 in each comparison). The reliability was good or moderate in relation with the Chippaux and Staheli index. Slightly lower coefficients were observed in the dimensions of the foot. CONCLUSIONS: A positive linear correlation between pedigraph and platform was observed in both feet in the Chippaux and Staheli indices. Significant differences were observed between pedigraph and platform in relation to the width and length of the foot. It is probably due to the fact that the pressure platform provides more exhaustive, detailed and accurate information of the foot.

Dermoscopic Features of a Digital Myxoid Cyst.

Dear Editor, We report a case of a patient admitted to our Department presenting a typical digital myxoid cyst. A 54-year-old man was referred by his general practitioner to the Department of Dermatology at our hospital due to the presence of an asymptomatic lesion on the third right toe. Physical examination revealed a rounded, red-bluish lesion in the eponychium less than 0.5 cm in diameter with a cystic appearance that secondarily caused a longitudinal depression in the nail plate (Figure 1). Dermoscopy showed arboriform telangiectasias over white, bluish, and reddish-orange diffuse areas (Figure 2, a). Direct needle puncture with a 25-gauge needle and drainage was performed showing a clear gelatinous material (Figure 2, b), confirming the diagnosis of digital myxoid cyst. No recurrence was seen during the 9-month follow-up period. A digital myxoid (or mucous) cyst is a benign recurrent cystic lesion of less than 1 cm in diameter and rounded or oval morphology typically located at the distal interphalangeal joint (DIJ) or eponychium in the digits. Digital myxoid cysts have a higher incidence in adult women and are more likely to be found on the fingers than on the toes, especially on the index finger of the dominant hand. Typically, digital myxoid cysts are recognized as unique asymptomatic lesions and do not require treatment, although there can be multiple lesions in case of osteoarthritis (1,2). Its etiology and pathogenesis remains unclear, although some theories indicate that myxoid cysts could appear as a result of a mucoid degeneration of the connective tissue, the exit of synovial fluid from the DIJ capsule, repetitive trauma, the herniation of tendon sheaths or synovial linings associated with degenerative joint diseases and osteophytes in the elderly, or due to an overproduction of mucin by fibroblasts (1,3,4). Furthermore, there is no treatment consensus nor a treatment algorithm for its management, although surgical excision has shown high cure rates. Dermoscopy is a non-invasive imaging technique that allows accurate diagnosis of the digital myxoid cyst. As reported in this case, dermoscopy examination facilitates identification of telangiectasias following different vascular patterns (arboriform, polymorphic, punctate, or linear vessels), reddish-violet lagoons, ulceration, and a bright-whitish reticulum that could be related to an increase in collagen (5,6). Differential diagnosis mainly includes ganglion, Heberden's nodes associated with osteoarthritis, glomus tumors, and dermatofibromas (5). Treatment options range from observation (when there is no symptomatology), puncture and drainage of the cyst and corticosteroid injections to surgical intervention with reported healing rates of 95%. Sclerotherapy, cryotherapy, CO2 laser vaporization, infrared coagulation, caustic elimination, and manual compression of the cyst can also be used. Within non-surgical measures sclerotherapy has reported a 77% healing rate, followed by cryotherapy (72%), corticosteroid injections (61%), and manual compression (39%) (1,7). In summary, we reported a case of a digital myxoid cyst in an adult patient presenting with its main characteristics and typical location. This cystic lesion must be considered in the differential diagnosis with other benign tumors. Dermatoscopy should be an essential diagnostic tool and must be taken into account in cases of doubtful diagnosis. Its value in the evaluation of tumor processes is already well-known but it cannot be ignored when assessing other skin lesions or cutaneous infections.

Alopecia friccional de piernas / Frictional leg alopecia

No disponible

Clasificaciones de lesiones en pie diabético II. El problema permanece / Diabetic foot Classifications II. The problem remains

Introducción: Se han publicado diversos sistemas de clasificación para las lesiones de pie diabético, si bien ninguno de los propuestos ha sido asumido por la comunidad científica como el sistema a utilizar por todos, y esto es debido a múltiples razones. Objetivos: Dar visibilidad a los nuevos sistemas de clasificación de pie diabético surgidos en los últimos años, además de poder contrastarlos con los sistemas ya conocidos anteriormente. Material y método: Búsqueda bibliográfica en las bases de datos SCOPUS, PubMed/Medline, WOS, CINHAL, Cochrane y CUIDEN. La ecuación de búsqueda utilizada fue la combinación booleana de los términos MeSH "diabetic foot AND classification". La búsqueda se realizó entre el 1 febrero de 2018 y el 30 marzo de 2018. Resultados: Existen 25 sistemas de clasificación de úlceras de pie diabético, que se pueden dividir en sistemas de clasificación-severidad de la lesión o sistemas de predicción de curación-amputación. Muy pocos sistemas han sido validados adecuadamente. Conclusiones: La elección del sistema de pie diabético a utilizar va a estar condicionada por aspectos como el ámbito asistencial, los recursos disponibles o los objetivos que se persiguen. En los últimos años se prefiere el uso de sistemas con enfoque predictivo frente a los sistemas con enfoque descriptivo

Introduction: Various classification systems have been published for diabetic foot ulcers, although none of the proposed systems has been accepted by the scientific community as the system to be used by all, and this is due to multiple reasons. Objectives: To give visibility to the new systems of diabetic foot classification that have emerged in recent years, as well as to compare them with the systems already known previously. Methods: Bibliographic search in the SCOPUS, Pubmed/Medline, WOS, CINHAL, Cochrane and CUIDEN databases. The search equation used was the boolean combination of the MeSH terms "diabetic foot AND classification". The search was conducted between 1 February 2018 and 30 March 2018. Results: There are 25 classification systems for diabetic foot ulcers, which can be divided into classification-severity systems or healing-amputation prediction systems. Very few systems have been properly validated. Conclusions: The choice of the diabetic foot system to be used will be conditioned by aspects such as the assistencial scene, the available resources or the objectives pursued. In recent years, the use of systems with a predictive approach has been preferred over systems with a descriptive approach

Hábitos podológicos en personas con alteraciones ungueales.

OBJECTIVE: To determine the prevalence of onychocryptosis and onychomycosis confirmed by culture in subjects attending a Podiatric University Hospital and to describe their podiatric habits. METHOD: Cross-sectional study of prevalence. The study was carried out at the Clinic University of Podology of A Coruna University (Ferrol, Spain). Review of 1082 clinical histories, of which 170 were selected, persons who had onychocryptosis diagnosed clinically. The presence of onychomycosis confirmed by cultivation, presence of onychocryptosis through clinical diagnosis and a questionnaire was handed out of podologic habits. RESULTS: Mean age of the total sample (n = 1082) was 47.9 ± 22.1 years. Prevalence of onychocryptosis was 15.7% (n = 170) with a mean age of 54.1 ± 20.1 years and with a significantly higher affectation in women and people under 65. Prevalence of onychomycosis was 17.6% (n = 30), mean age 59.5 ± 20.5 years with greater involvement in women and people over 65 years. With regard to the questionnaire of habits, the footwear more employee was the closed, cordoned off and heel flat. The majority of the subject came to a podiatrist for the first time; walked approximately 1 hour and their daily activity made of foot with short displacements. CONCLUSIONS: A high prevalence of onychocryptosis and onychomycosis in people attending Podiatric services has been found. For its part using a type of flat or low heel and who does the care of toenails are shown as predictive variables of onychomycosis.

Estucoqueratosis. A propósito de un caso / Stucco keratosis. A case report

La estucoqueratosis es una patología dérmica que cursa con tumoraciones queratósicas asintomáticas, benignas, blanco-grisáceas y de pequeño tamaño. Éstas suelen localizarse en las extremidades (especialmente en las inferiores) en torno al tobillo. Su etiología es desconocida y su diagnóstico se realiza mediante una correcta anamnesis y exploración física ya que la morfología, localización y edad de presentación son claves para poder establecer un diagnóstico diferencial con otras afecciones aunque en caso necesario también se puede recurrir a la biopsia. Constituye una entidad clínica con especial interés podológico dada su frecuente aparición en las extremidades inferiores, de ahí la necesidad de conocerla y de saber realizar un correcto diagnóstico diferencial. Presentamos el caso de un varón de 45 años sin antecedentes dermatológicos que presenta estucoqueratosis en la extremidad inferior y que acude al Servicio de Dermatología del Hospital Naval de Ferrol (AU)

Stucco keratosis is a dermal pathology that causes small, white-greyish, asymptomatic benign keratotic tumors. These are usually located in the extremities (especially in the lower) around the ankle. Its etiology is unknown and diagnosis is made through a proper clinical history and physical examination as morphology, location and age of presentation are key to establishing a diferential diagnosis with other conditions although if necessary biopsy is also avalaible. Stucco keratosis is a clinical entity with special podiatric interest given its frequent appearance in the lower extremities, hence the need to know and be able to perform a correct differential diagnosis. We report the case of a 45 year old man with no previous dermatological history presenting stucco keratosis in the lower extremity admitted to the outpatient clinic in the Dermatology Department of the Naval Hospital of Ferrol (AU)

Grado de evidencia en la utilización del índice tobillo-brazo para el diagnóstico de la Arteriopatía Periférica en diabéticos tipo 2 / Grade of evidence on the use of the ankle brachial index to diagnose Peripheral Arterial Disease in type 2 diabetics

La aterosclerosis es un proceso inflamatorio crónico y progresivo que actúa como principal factor etiológico de la Arteriopatía Periférica. En la población general española la prevalencia de Arteriopatía Periférica se sitúa entre el 4% y el 9% y en los próximos años se espera que vaya en aumento. Se ha demostrado que las personas diabéticas presentan una elevada morbimortalidad cardiovascular y que el índice tobillo brazo ayuda a mejorar la estratificación del riesgo cardiovascular. En este artículo se realiza una revisión bibliográfica mediante metodología GRADE (Graduación de la valoración, desarrollo y evaluación de las recomendaciones) en las bases de datos Pubmed, Scopus, IBECS y Biblioteca Cochrane Plus con el objetivo de conocer la prevalencia de Arteriopatía Periférica diagnosticada mediante la determinación del índice tobillo brazo, conocer la existencia de evidencias que avalen la utilidad del índice tobillo brazo para el diagnóstico arteriopático y conocer cuáles son los factores de riesgo que influyen en la determinación de un índice tobillo brazo bajo (< 0,90) (AU)

Atherosclerosis is a chronic and progressive inflammatory disorder that appears as the main etiological factor of Peripheral Arterial Disease. The prevalence of Peripheral Arterial Disease in the Spanish general population is between 4% and 9% and is expected to be increasing in the coming years. It has been shown that diabetics have high cardiovascular morbidity and mortality and that the ankle brachial index helps to improve cardiovascular risk stratification. In this paper a review is performed using GRADE methodology (Grading of Recommendations, Assessment, Development and Evaluations) in PubMed, Scopus, IBECS and Cochrane Library Plus databases in order to determine the prevalence of Peripheral Arterial Disease diagnosed by the ankle brachial index, to know the existence of evidence supporting the utility of the ankle brachial index for its diagnose and to know which are the risk factors influencing a low ankle brachial index determination (< 0.90) (AU)

Líquen plano hipertrófico. A propósito de un caso / Hypertrophic lichen planus. A case report

El liquen plano es una dermatosis inflamatoria crónica relativamente frecuente en adultos de edad media y que normalmente afecta a la piel, membranas mucosas, pelo y uñas bajo diferentes patrones morfológicos motivo por el que su diagnóstico puede presentar cierta dificultad. Para un diagnóstico correcto es imprescindible el examen físico y complementario. La etiología del liquen plano es desconocida aunque se han postulado diferentes mecanismos etiopatogénicos de los que el inmune es el más prevalente. El liquen plano hipertrófico constituye una de sus variedades morfológicas que se caracteriza por localizarse a nivel de las extremidades y por ser muy pruriginoso. En aquellos pacientes con una presentación clínica atípica es además necesario realizar un seguimiento por la posibilidad de malignización que se ha descrito en la literatura científica. Describimos el caso clínico de una mujer de 70 años con liquen plano hipertrófico a nivel de la extremidad inferior que acude al Servicio de Dermatología del Hospital Naval de Ferrol (AU)

Lichen planus is a chronic and relatively common inflammatory dermatosis in middle aged adults that usually affects the skin, mucous membranes, hair and nails under different morphological patterns reason for why its diagnosis can present some difficulty. To perform an accurate diagnosis a physical and complementary exam is essential. The etiology of lichen planus is unknown although different etiologic mechanisms have been postulated of which the immune is the most prevalent. Hypertrophic lichen planus constitutes one of its morphological varieties characterized by a very itchy rash and by being localized at limbs level. In patients with an atypical clinical presentation a follow up is also necessary to monitor the possibility of malignant transformation that has been described in the scientific literature. We report the case of a 70 year old woman with hypertrophic lichen planus affecting the lower extremities admitted to the outpatient clinic in the Dermatology Department of the Naval Hospital of Ferrol (AU)

Estudio observacional y descriptivo de prevalencia de onicomicosis en una población que acude a una consulta de dermatología del Área Sanitaria de Ferrol / Observational and descriptive study of prevalence of onychomycosis in a population attending a dermatology office in the Health Area of Ferrol

Objetivos: Determinar la prevalencia de onicomicosis en una muestra de personas que acuden a una consulta de dermatología y estudiar cómo influyen diversos factores personales en la frecuencia de aparición de esta enfermedad. Metodología: Se seleccionó una muestra de 100 sujetos (42 hombres y 58 mujeres) atendidos de forma consecutiva durante el periodo de estudio. Se realizó un diagnóstico clínico de la patología basado en los signos clínicos observados durante la exploración de las extremidades inferiores. Resultados: El 18% de los participantes presentó onicomicosis, de los cuales el 61,1% fueron mujeres y el 38,9% hombres. Las enfermedades asociadas más prevalentes que presentaban las personas con onicomicosis fueron por este orden las de tipo dermatológico (16,7%) y las de tipo cardiovascular y endocrino (ambas con un 11,1%). La tinea pedis estuvo presente en el 33,3% de aquellos que presentaban onicomicosis no existiendo diferencias en los porcentajes entre tinea pedis plantar e interdigital. El tipo de onicomicosis más frecuente fue la subungueal distal (en el 100% de los casos) y el primer dedo del pie resultó ser el más afectado. Conclusiones: Se ha obtenido una presvalencia de onicomicosis consistente con lo publicado en la literatura actual. Nuestros resultados confirman la relación entre las enfermedades concomitantes encontradas y la presencia de tinea pedis con la presencia de la onicomicosis (AU)

Objectives: To determine the prevalence of onychomycosis in a sample of subjects attending a dermatology office and to study how different personal factors influence the frequency of occurrence of this disease. Methods: This study comprised a sample of 100 subjects (42 men and 58 women) attended consecutively during the course of the study. A clinical diagnosis of the disease was performed based on clinical signs observed during physical examination of the lower extremities. Results: 18% of the participants had onychomycosis, of whom 61.1% were women and 38.9% were men. The most prevalent associated diseases in subjects with onychomycosis were in this order dermatological type diseases (16.7%) and cardiovascular and endocrine type diseases (both with 11.1%). Tinea pedis was present in 33.3% of those with onychomycosis with no difference in percentage between plantar and interdigital tinea pedis. The most common type of onychomycosis was the distal subungueal type (in 100% of the cases) and the great toe was the most affected one. Conclusions: A prevalence of onychomycosis consistent with the published current literature has been obtained. Our results confirm the relationship between comorbidities found and the presence of tinea pedis with the presence of onychomycosis (AU)

Cribado nutricional en pacientes inmovilizados del Servicio de Atención Domiciliaria de una zona básica de salud del área de Salud de Gran Canaria / Nutritional screening of immobilized Home Care Service patients in a district Health Centre corresponding to the Health Area of Gran Canary

La desnutrición es un problema grave y conlleva importantes consecuencias sociosanitarias y económicas. En pacientes inmovilizados, las úlceras por presión son una de las complicaciones más frecuentes, constituyendo una epidemia silente evitable en el mayor número de casos, donde la valoración o cribado nutricional juega un papel primordial en su prevención. La prevalencia de desnutrición cercana al 50%, observada en una muestra de 62 pacientes de un centro de salud, subrayan la necesidad de su diagnóstico precoz para poner en marcha medidas preventivas y terapéuticas que mejoren la calidad de vida de los pacientes, disminuyendo la aparición de patologías asociadas y la institucionalización/hospitalización (AU)

Undernourishment is a serious problem with important social, sanitary and economical consequences. Concerning immobilised patients, ulcers caused by pressure are the most frequent and they represent a silent epidemic which in most cases is not necessarily unavoidable because a correct nutrition screening plays a decisive role in preventing it. The alarming lack of nutrition, 50%, in a survey of 62 patients who were observed in out-patient clinics (Centros de Salud) underline the necessity of an early diagnosis so as to activate prevention and therapeutical measures to improve the patients' well-being, thereby reducing possible associated pathologies and subsequential hospitalization (AU)

Clasificaciones de lesiones en pie diabético. Un problema no resuelto / Classifications of injuries on diabetic foot. A non-solved problem

La necesidad de unificar criterios empleando un mismo lenguaje que favorezca la comunicación y el intercambio de conocimientos unido al desconocimiento existente en cuanto a las distintas formas de clasificación de las heridas crónicas, ha motivado a los autores para llevar a cabo esta revisión bibliográfica en la que se analizan quince sistemas de clasificación de lesiones de pie diabético y se abordan entre otros, aspectos como la metodología, facilidad de utilización, grado de conocimiento, utilidad de la información aportada y limitaciones de cada uno de ellos. Con ello, los autores no pretenden sino facilitar que los profesionales implicados en el cuidado de las úlceras diabéticas conozcan las distintas formas de estadiaje existentes en el pie diabético y en general en las heridas crónicas (AU)

The need of unify criterions using a same idiom contributing communication and interchanging knowledge together with ignorance existing in relation to the different ways of classificating chronic wounds is the reason for the authors to carry out this review analyzing fifteen classification systems in diabetic foot wounds dealing with subjects such as methodology, simplicity of use, grade of knowledge, usefulness of the information provided and limitations of each one. And so the authors pretend helping that those professionals taking care of diabetic foot ulcers can get to know different ways of staging diabetic foot wounds and chronic wounds in general (AU)

Estratificación de riesgo en pie diabético / Risk stratification in diabetic foot

El pie diabético es una complicación crónica de la diabetes mellitus y constituye una problemática sanitaria al conllevar un enorme gasto económico a losservicios sanitarios y provocar a las personas que lo padecen y a su entorno familiar enormes repercusiones emocionales. La educación sanitaria en el cuidado de los pies de los diabéticos, así como la cuantificación del riesgo son aspectos que el enfermero debe incorporar en los planes de cuidados de los pacientes diabéticos. La detección de los posibles factores de riesgo es un paso previo imprescindible para estos cometidos. Este estudio tiene como finalidad analizar la presencia de determinados factores de riesgo en pie diabético en la población diabética del Centro de Salud de Triana, con el objetivo de poder realizar, así, una estratificación del riesgo. Para ello, se optó por la realización de un estudio observacional descriptivo. La muestra analizada estaba constituidapor 96 sujetos diabéticos pertenecientes a dicho centro de salud. Para la recogida de datos se utilizó un sistema de tres niveles consistente en entrevista,exploración física y consulta de registros disponibles (a través de las historias clínicas de los sujetos). Los datos se registraron en un formulario de recogida de datos para pie diabético. Se determinó la existencia de factores de riesgo, analizando las relaciones entre éstos y permitiendo la estratificación del riesgo en la población estudiada (AU)

The diabetic foot is a chronic complication of diabetes mellitus and constitutes asanitary problem which causes not only enormous expenses for the sanitary system but also provokes emotional repercussions for the person who suffers the illness and for the family. The sanitary education in taking care of the feet of diabetics and the identification of the health risk are both aspects that the nurse must include in the healthcare planning of diabetic patients. The detection of the possible risk factorsis an essential previous step in nursing. The purpose of this study is to detect the presence of certain risk factors in diabetic foot in the diabetic population of Triana Healthcare Centre to be able to carry out a stratification of the risk. For this research, there was chosen an observational, descriptive and transversal study.The analyzed sample was constituted by 96 diabetic subjects belonging to the Healthcare Centre. For the data collection, we use different systems such as interviews,physical exams and the available records (clinical history of the patients).The information has been recorded in a questionnaire of the diabetic foot. The existence of risk factors was determined by analyzing the relationship between them allowing the risk stratification of the studied sample (AU)

Patología de los pies y características sociodemográficas de la población usuaria de los centros Sociales de mayores de Galicia / No disponible

La Universidad de A Coruña a través de la Escuela Universitaria de Enfermería y Podología realizó para la Xunta de Galicia y el Ministerio de Trabajo y Asuntos Sociales, un proyecto de intervención podológica denominado “Programa de Podología Itinerante para la atención a las personas mayores con dependencias 2005”, cuyo objetivo principal era prestar atención podológica a las personas mayores de 65 años que acuden a los centros sociales gestionados por la Vicepresidencia de Igualdad y Bienestar de la Xunta de Galicia. En este programa se realiza un estudio sobre una muestra de 815 personas seleccionadas por la Vicepresidencia de Igualdad y Bienestar y los responsables de cada uno de los 16 centros, para identificar las prioridades de atención podológica en ancianos, estableciendo una correlación entre sus características socio-demográficas y la aparición de patologías quiropodológicas. La mayoría de la población de estudio eran mujeres (72,2%), con una media de edad de 74 años con un rango de edad de 40 a 98 años, con pensión contributiva (91,4%), que vivían acompañadas (79,3%), y con un nivel de estudios básico (74,5%). Las patologías podológicas más frecuentes han sido las queratopatías (73,6%) hiperqueratosis (53,4%) y helomas (52%). Onicopatías (49,8%), onicogrifosis (22%), onicomicosis (18%), onicocriptosis (15%), hematomas subungueales (3,7%) otro tipo de onicopatías (2,8%). Según los datos del estudio, el sexo femenino es más proclive a padecer queratopatías [OR 2,33; IC 95% (1,67-3,26)], hiperqueratosis [OR 1,96; IC 95% (1,43- 2,67)] y helomas (OR 2,44; IC 95% [1,776-3,352]) en particular. Que las personas mayores no vivan solas disminuye la probabilidad de padecer queratopatías [OR 0,50-0,77]), en concreto helomas [OR 0,68 IC 95% [0,48-0,966]. Los ancianos con mayor nivel de estudios tienen menor probabilidad de padecer onicopatías (p=0,032) (OR 0,50; IC 95% [(0,29-0,86]). Mientras que los pensionistas son más proclives a padecer hiperqueratosis (p=0,011) (OR de 1,10 IC 95% [1,01-1,04])(AU)

The University of A Coruña, through the Podiatry and Nursing University, carried out for the Xunta de Galicia and the Spanish Work Ministry and Social Services, a podiatry project named “Itinerant Podiatry Program to assist elderly people with dependency during the year 2005”. Its main goal was to give podiatry care to people older than 65 who usually went to social centers that were managed by the Vice-presidency of Equality and Social Welfare. The total sample comprised 815 participants, selected by the Vice-Presidency of Equality and Social Welfare and the responsible of each one of the 16 centers. The aim was to identify the priorities of podiatry care in elderly people, by establishing a relationship between the socio-demographic characteristics and the podiatry pathologies. The majority of the participants were women (72.2%), aged 40 to 98 years, with a mean age of 74, received a contributory pension (91.4%) living with someone (79.3%) and had an elementary level of studies (74.5%). The most common podiatry pathologies were keratopathy (73.6%) hyperkeratosis (53.4%), callus (52%). Onycopathy (49.8%), onychogryphosis (22%), onychomycosis (18%), onichocriptosis (15%), (3, 7%) or other nail diseases (2,8%). According to the study, women are more prone to suffer keratopathy [OR 2.33; IC 95% (1.67-3.26)], hyperkeratosis (OR 1.96; IC 95% [1.43-2.67]) and callus [OR 2.44; IC 95% (1.776-3.352)]. Living with someone, diminishes the probability of suffering keratopathy (OR 0.50 [0.322-0.777]), primarily callus (OR 0.68 IC 95% [0.488-0.966]). Elderly people with higher level of studies have smaller probability of suffering nail diseases (p=0.032) (OR 0.50; IC 95% [(0.29-0.86]). Meanwhile, pensioners are more likely to have hyperkeratosis (p=0.011) (OR of 1.10 IC 95% [1.01-1.04](AU)

Estudio de prevalencia de patologías podológicas y grado de dependencia en personas mayores de 65 años / No disponible

La prevalencia de patologías podológicas sufre un incremento desde los sesenta años de edad, de igual forma que el nivel de dependencia de las personas. En el presente estudio realizado sobre 748 pacientes mayores de 65 años de 16 municipios gallegos, valoramos la relación entre patologías podológicas y el grado de dependencia. No se observa relación directa de la mayoría de las patologías podológicas con el grado de dependencia, tan solo la onicocriptosis y otras patologías ungueales poco frecuentes muestran datos estadísticos significativos que establecen el grado de dependencia como factor predisponente(AU)

The prevalence of podiatric pathologies suffers an increase from sixty years of age, of equal form that the level of dependence of the persons. For the present study realized on 748 patients 65 and older taken in the region of Galicia we value the relation between podiatric pathologies and the degree of dependence. Is not observed direct relation of the majority of the podiatric pathologies by the degree of dependence, only the onichocryptosis and other nail pathologies slightly frequent show statistical significant information that establish the degree of dependence as predisposing factor(AU)

Aplicación del concepto “preparación del lecho de la herida” en el abordaje local de las lesiones crónicas / No disponible

A menudo es el podólogo quien debe enfrentarse a lesiones que se cronifican y que, en ocasiones, se asocian a afecciones de origen metabólico como la diabetes mellitus; desempeñando un importante papel para prevenir algunas de sus complicaciones. A pesar de ello, una vez que la lesión aparece, conseguir su cicatrización supone un reto complicado. El objetivo principal del presente artículo es aportar una perspectiva de abordaje local basado en la adecuada valoración y preparación de las características del lecho de la herida puesto que, independientemente del origen y etiología, su aspecto y características son de gran utilidad para la planificación de la estrategia terapéutica a seguir. A este respecto, el “concepto TIME” posibilita la correcta preparación del lecho de la herida mediante el empleo de productos de cura en ambiente húmedo que contribuyen a eliminar las barreras que dificultan el proceso natural de cicatrización(AU)

It is often the podiatrist the one who deals with chronic wounds as sometimes they appear associated to metabolic changes like diabetes mellitus. The podiatrist also plays an important role helping to prevent some of their common complications. Despite of that, once the wound shows up the process of healing is really a hard job. The main objective of the present article is to provide a current local strategy of treatment based on the characteristics of the wound bed because apart from wound’s origin and etiology its aspect and characteristics are useful to plan accurate treatment. According to it, the “TIME concept” allows accurate wound bed preparation by using moisture environment products that contribute to remove barriers interfering natural healing process(AU)

Evidencias científicas acerca de la educación del paciente diabético como prevención de úlceras en los pies / No disponible

En este artículo se realiza una búsqueda de la mejor evidencia disponible sobre la educación del paciente diabético para la prevención de úlceras en los pies. Siguiendo las diferentes fases de la podología basada en la evidencia se seleccionan tres estudios para ser evaluados críticamente. Aunque los resultados no han sido suficientemente significativos parece que la educación en los pacientes más graves y pacientes con neuropatía periférica podría resultar más efectiva. Por el contrario, otras medidas educacionales no obtuvieron diferencias concluyentes en comparación con la atención convencional. Ante la falta de evidencias debemos ser cautos en la aplicación de las medidas educacionales de forma generalizada, son necesarios más ensayos controlados aleatorios (ECAs), con una buena calidad metodológica, para esclarecer los resultados existentes(AU)

In this article we aim to achieve the best available evidence on the diabetic patient education as a prevention of feet ulcers. Three studies are selected to be evaluated through Podiatry Based on Evidence. Although the results have not been significant enough, it seems that educating patients with severe conditions and peripheric neuropathy could be more efficient. On the other hand, the other educational measures didn’t get convincing results as compared to those resulting from the conventional care. Due to the lack of evidence, we should be prudent when applying educational measures in a greater scope. In order to clarify the existing results, more randomised controlled trials with a good methodological quality are a must(AU)