Sprint Start Kinetics of Amputee and Non-Amputee Sprinters.

The purpose of this study was to explore the relationship between the forces applied to the starting blocks and the start performances (SPs) of amputee sprinters (ASs) and non-amputee sprinters (NASs). SPs of 154 male and female NASs (100-m personal records [PRs], 9.58-14.00 s) and 7 male ASs (3 unilateral above knee, 3 unilateral below knee, 1 bilateral below knee; 100 m PRs, 11.70-12.70 s) with running specific prostheses (RSPs) were analysed during full-effort sprint starts using instrumented starting blocks that measured the applied forces in 3D. Using the NAS dataset and a combination of factor analysis and multiple regression techniques, we explored the relationship between force characteristics and SP (quantified by normalized average horizontal block power). Start kinetics were subsequently compared between ASs and NASs who were matched based on their absolute 100 m PR and their 100 m PR relative to the world record in their starting class. In NASs, 86% of the variance in SP was shared with five latent factors on which measured parameters related to force application to the rear and front blocks and the respective push-off directions in the sagittal plane of motion were loaded. Mediolateral force application had little influence on SP. The SP of ASs was significantly reduced compared to that of NASs matched on the basis of relative 100-m PR (-33.8%; d = 2.11, p < 0.001), while a non-significant performance reduction was observed when absolute 100-m PRs were used (-17.7%; d = 0.79, p = 0.09). These results are at least partially explained by the fact that force application to the rear block was clearly impaired in the affected legs of ASs.

Nail and skin disorders of the foot.

Disorders of the dermis and the nails on the feet are common. Despite the simplicity of the skin and nail disorders of the foot, they can be debilitating and impact the patient's ability to ambulate and perform activities of daily living. Diagnosis in most cases is confirmed on physical examination alone. Diligent care of skin and nail disorders can prevent further pathology involving the deeper structures of the foot and allow the patient to fully participate in their usual activities.

Usefulness and pharmacokinetic study of oral terbinafine for hyperkeratotic type tinea pedis.

To study and establish an optimal administration method of oral antifungal, terbinafine (TBF), for hyperkeratotic type tinea pedis, from the pharmacokinetic point of view, 20 patients with hyperkeratotic type tinea pedis were given TBF 125 mg once daily for 4 weeks and observed over time for improvement in dermatological symptoms and mycological efficacy. Targeting five of the patients, TBF concentration in the stratum corneum was measured using the liquid chromatography/tandem mass spectrometry (LC-MS/MS) method. TBF was detected in the stratum corneum of the sole 1 week after beginning the treatment in some cases and reached its peak 1 week after the completion of the treatment with a concentration of 247.8 ng g(-1), which was approximately more than 50 times higher than its minimal inhibitory concentration against dermatophytes. TBF was not detected at 8 weeks post-treatment, although its concentration was 50.73 ng g(-1) at 6 weeks post-treatment. Its effectiveness rate (effective + markedly effective) was 95% (19/20) with no adverse reactions, including abnormal changes in the laboratory test values, in any patient. These results suggest that TBF is a useful drug to treat hyperkeratotic tinea pedis from the pharmacokinetic point of view.

Novel, single-dose, topical treatment of tinea pedis using terbinafine: results of a dose-finding clinical trial.

Tinea pedis is the most common dermatophytosis requiring topical antifungals for at least 1-4 weeks. To determine the effectiveness of a novel topical single dose formulation of terbinafine (film forming solution-FFS) in the treatment of tinea pedis, 344 outpatients from 43 dermatological centres in France and Bulgaria suffering from tinea pedis with possible extension to soles confirmed by mycological examination (direct and culture) were evaluated for efficacy of terbinafine 1%, 5%, 10% FFS in a randomised double blind vehicle controlled parallel group dose finding study. Evaluations were carried out at baseline, 1 and 6 weeks after a single application of FFS. Effective treatment rate based on negative mycology (direct and culture) and minimal signs and symptoms (two or less with only mild recorded) was measured at week 6. Effective treatment rates at week 6 with terbinafine 1%, 5% and 10% FFS were 66%, 70%, 61% compared with 18% with placebo. All three active preparations were shown to be significantly superior to placebo (P < 0.001). Terbinafine 1% and 5% FFS were shown to be non-inferior to terbinafine 10% FFS. Terbinafine 1% FFS is an effective, safe dose for the treatment of tinea pedis. This novel product represents a significant advance with the enhanced compliance and convenience that it offers.

A case of bullous tinea pedis with dermatophytid reaction caused by Trichophyton violaceum.

Summary The authors report a case of bullous tinea pedis caused by Trichophyton violaceum with dermatophytid reaction in a 26-year-old woman who had been in Africa. Diagnosis was based on mycological examination (direct microscope observation and culture). Recovery was achieved after systemic antimycotic therapy with itraconazole and topical imidazole for a month.

Common fungal infections of the feet in patients with diabetes mellitus.

Superficial fungal infections of the foot (tinea pedis and onychomycosis) are common among elderly patients. Although most authorities believe that patients with diabetes mellitus have an increased predisposition to dermatophytic infections, some controversies still remain. Because these infections disrupt the skin integrity and provide an avenue for bacterial superinfection, elderly diabetic patients with dermatophytic infection should be promptly treated with an antifungal agent. For most dermatophytic infections of the foot, topical agents are usually effective and less expensive than oral agents. Laboratory diagnosis of fungal infection prior to institution of therapy is recommended. Proper technique for obtaining the specimen is important to ensure a higher chance of isolating the infecting fungus. Commonly used anti-dermatophytic agents that are also active against the yeasts include the imidazoles, the allylamines-benzylamines and the hydroxypyridones, which are also effective against most of the moulds. Oral therapy for tinea pedis, although not well studied, should be limited to patients with more extensive infections, such as vesicobullous and moccasin type, resistant infections or chronic infections. In addition, oral agents should also be considered in diabetic and immunosuppressed patients. On the other hand, treatment of onychomycosis of the foot usually requires systemic therapy. Griseofulvin is the least effective agent when compared with the newer agents. Terbinafine, itraconazole and fluconazole have been shown to have acceptable cure rates. More recently, topical treatment of the nail with 8% ciclopirox nail lacquer, bifonazole with urea and amorolfine have been reported to be successful. Over the past decade, fungal foot infections of the skin and nail are more effectively treated with the introduction of numerous topical and oral agents.

Clinical and mycological study of occult tinea pedis and tinea unguium in dermatological patients from Tokyo.

An epidemiological investigation was conducted to determine the prevalence and circumstances of untreated, unsuspected tinea pedis and tinea unguium, morbid conditions that could be termed occult athlete's foot, in patients visiting a dermatology clinic in Tokyo, Japan, for the first time, for other complaints. All subjects completed a questionnaire covering comprehensive anamnestic details, and were examined for disposition of toes, presence of signs suggestive of tinea pedis, other diseases of the foot, score of clinical signs and symptoms, potassium hydroxide (KOH) test, severity score, and mycological culture. The results showed that the prevalence of occult athlete's foot was 25%, and that 59% of those cases were complicated by tinea unguium. The characteristics of patients with occult athlete's foot included a higher proportion of men and a tendency toward a low clinical score together with a high severity score. In the patient background, a strong correlation was observed between a positive KOH test result and characteristics such as age, disposition of toes, and predisposing disease.

[Epidemiology, physiopathology and treatment of a frequent ailment: tinea pedis]. / Epidémiologie, physiopathologie et traitement d'une affection fréquente: tinea pedis.

Tinea pedis is an infection of the stratum corneum caused by dermatophytes. Nowadays, fitness centers, saunas, subtropical swimming pools and sport-shoes are more and more fashionable and are certainly responsible for the increase of cases of tinea pedis as dermatophytes grow preferentially in warm and humid environments. The clinical aspect is affected by several factors such as the host reaction to the infection, the virulence of the infective strain, species, and some local and environmental factors. If a dermatophytosis is suspected, it is mandatory to validate the provisional diagnosis by demonstration of the fungus (by culture or/and microscopic examination) to avoid useless and expensive treatments. The new antifungal molecules are very effective, well tolerated and allow short course of therapy improving the compliance of the patient in clinical practice. Relapse of tinea pedis is very common but could be avoided by several simple preventive measures of hygiene.

Advances in the treatment of superficial fungal infections: focus on onychomycosis and dry tinea pedis.

Onychomycosis is one of the most stubborn superficial mycoses. With few exceptions, oral antifungal therapy is needed to achieve resolution. Before oral itraconazole, fluconazole, and terbinafine hydrochloride became available, physicians had to rely on prolonged therapy with griseofulvin or oral ketoconazole. Of the newer oral agents, itraconazole appears to have the broadest spectrum of action, with therapeutic activity against dermatophytes, yeasts, and some nondermatophyte molds. Tissue pharmacokinetics accounts for significantly greater efficacy and much shorter treatment courses for fungal infections of the skin and nails. In general, oral itraconazole, fluconazole, and terbinafine are very well tolerated. The newer oral agents offer improved efficacy over griseofulvin and ketoconazole for onychomycosis and dry tinea pedis.

Incidencia de pie cavo en atletas de alta competencia / Incidence of foot cavo in athlete of high competition

El pie normal en condiciones de relajación (fase de apoyo en el suelo) capta las informaciones del medio exterior, mientras que en condiciones de cavismo fucnional (fase de despegue del piso) efectúa respuestas motoras y determina el desplazamiento; estos dos aspectos que en el pie normal se realizan de manera funcional, coordinada y temporal, se encuentra en permanente condición de contracción o relajación en las dos clásicas deformidades del pie (pie plano o pie cavo); si bien esto es cierto en la población normal, con mayor razón esto puede recaer en atletas de muy alto nivel, donde se alcanza un gran desarrollo muscular en la zona del pie, pudiendo condicionarse con el entrenamiento constante y prolongado, la formación de un pie cavo secundario en dichos atletas; en este estudio intentamos demostrar lo antes expuesto

The descriptive epidemiology of tinea pedis in the community.

Tinea pedis is a common inflammatory skin condition due to infection by dermatophyte fungi. A number of epidemiological studies have been completed on the frequency of tinea pedis in the community, particularly sporting and occupational groups and schools. Most studies have focused on small, high-risk populations. These include occupational groups involving manual labour, sporting groups such as swimmers, and those working or living in confined conditions with shared washing facilities, which favour the opportunity for cross-infection. Most studies show that the frequency of tinea pedis is higher in males than females. Tinea pedis infections appear to be least common among children, but do occur, and are commonly misdiagnosed. The difference between clinical disease and confirmed diagnosis by culture is not always clear when statistics of disease frequency have been presented. Clear diagnosis criteria indicating the level of mycologically confirmed diagnosis should be reported in future studies that include statistics on disease frequency. Future epidemiological studies should also aim to be population-based in order to obtain a more complete picture of disease frequency.

Dermatophytosis of the feet.

Tinea pedis is the most common fungal infection worldwide. There are three well-accepted clinical presentations based on the offending organism. Predisposing factors include heat, humidity, and occlusion. Mild disease can evolve to "dermatophytosis complex" through bacterial superinfection. Potassium hydroxide preparation and culture are important diagnostic tests in each case.

Tinea pedis: diagnosis and treatment.

The authors review the common dermatophyte genera and the forms of tinea pedia they cause. They also provide a differential diagnosis, review diagnostic procedures, and outline the pathophysiology of this complex condition. A classification and treatment plan is provided, with an extensive review of recent clinical trials. The aim of the article is to expand practitioners' treatment options for individualizing treatment plans.

Tinea pedis in members of the Japanese Self-defence Forces: relationships of its prevalence and its severity with length of military service and width of interdigital spaces.

We examined the relationship between prevalence and severity of tinea pedis and the length of service and the width of the spaces between the toes in 74 members of the Japanese Self-Defence Forces (SDF) undergoing special training. The subjects were divided according to the width of these spaces into: group I, wide; group II, fairly wide; and group III, closed. The severity of tinea pedis was determined by its duration and the extent of the lesions in the 49 subjects who had tinea pedis. The combined prevalence of tinea pedis and tinea unguium was 66%. There was a tendency for the prevalence to be higher in subjects who had served for 10 years or more in the SDF than in those with fewer than 10 years of service. Classified by the disposition of their toes, 10 subjects fell into group I, 34 into group II, and 30 into group III. The prevalence of 90% (27/30) in group III was significantly higher than in the other groups. A significant positive correlation was seen between length of SDF service and severity. Subjects with both a long service record and closed interdigital spaces showed both a high prevalence and marked severity.

Tinea pedis pathophysiology and treatment.

Fungal infections of the foot can be divided into three major varieties, all of which have differing pathophysiologic aspects with therapeutic implications. Interdigital infections involve an ecological interplay between dermatophytes and bacteria. Simple scaling types of infection are caused by dermatophyte invasion of the stratum corneum, whereas macerated, erosive infections are caused by selection and overgrowth of bacteria, particularly Brevibacterium epidermidis, Micrococcus sedantarius, and various gram-negative species. Bacterial production of methanethiol and other sulfur compounds leads to inhibition of dermatophytes and accounts for the lower recovery of dermatophytes from the most severe cases. Plantar surface infections consist of widespread, moccasin-type infection caused by Trichophyton rubrum and localized scaling infections with episodes of intense inflammation caused by Trichophyton mentagrophytes. The former is particularly associated with an atopic background. Therapy is difficult because of poor immune responses and difficulty in delivering a sufficient quantity of drugs to the lower layers of a thick stratum corneum. Intense inflammation in T. mentagrophytes infections is the result of an immune, contact allergic response to fungal antigens.

Common sports injuries of the foot and ankle seen in children and adolescents.

Foot and ankle problems are common in child and adolescent athletes. These problems may include congenital variants and the osteochondroses, acute and chronic bone and soft-tissue injuries, and infections. In this article, the diagnosis and treatment of these foot and ankle conditions are discussed.

El porque de la tiña de los pies

Se realiza una encuesta clínico-epidemiológica a 100 personas, con el fin de evaluar elementos conocidos que influyen en muchos casos y en otros determinan condiciones favorables para adquirir y trasmitir la tiña de los pies, como son las medidas higiénico-epidemiológicas. Se tomaron en cuenta las variables de aseo personal, cuidado de los pies, medidas profilácticas, enfermedades asociadas y otras. Se encontró que la mayoría de los encuestados desconocen y no aplican las medidas de higiene y prevención de la afección. Se analizan los resultados que permitan establecer medidas de salud o tomar en cuenta, con el fin de disminuir la incindencia y la prevalencia, así como las complicaciones, elementos que como todos conocemos, influyen desfavorablemente en el hombre, la economía y la defensa(AU)

[The significance of occupational factors in the pathogenesis of foot mycoses in miners in deep coal mines]. / Znachenie professional'nykh faktorov v patogeneze mikozov stop u gornorabochikh glubokikh ugol'nykh shakht.

Skin and peripheral vessel functions, allergic status of the body, lysosomal enzymes activities, lipid peroxidation and antioxidant system status were examined in 280 coal miners suffering from mycoses of the soles, as were their working conditions, in order to clear out some aspects in the pathogenesis of this condition. The data evidence grave disorders of the function of the skin and peripheral vessels of the limbs, of the allergic status of the body, and of lipid peroxidation and antioxidant system, this pointing to a possible contribution of occupational factors to some aspects in the pathogenesis of mycoses of the soles.