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1.
Pesqui. vet. bras ; 39(12): 970-977, Dec. 2019. tab, graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1056923

RESUMO

This study aimed to identify gross and microscopic changes, caused by high-energy diets, in the rumen environment and hoof of confined beef cattle. The study sample comprised 40 confined heifers (Bos taurus) with no disease history divided into four experimental groups using different diets: Group 1 (D1, control), 48:52 forage:concentrate ratio; Group 2 (D2), 30:70 forage:concentrate ratio; Group 3 (D3), 30:70 forage:concentrate ratio + sucrose; Group 4 (D4), 100% concentrate. All animals underwent clinical examination, assessment of ruminal fluid pH and lameness, and sample collection after slaughter for histopathology of the hoof laminae and digital cushion and ruminal tissue. All dependent variables of the study were compared using the SPSS 20.0 statistical software. The variables that did not show normality (HR, RM, ST, and CRT) were compared with application of the Kruskal-Wallis test followed by the Dunnet's multiple comparison test. All other variables were submitted to analysis of variance (ANOVA) followed by Tukey's test. The different diets had an impact on the rumen environment (p<0.05) of the heifers assessed, with momentary general depression in the first 12 h after sucrose induction (D3), as well as mild clinical signs in D4. The animals in D3 and D4 presented lower motility (p<0.05) and ruminal pH (p<0.01) than those in D1. Of the 40 heifers, 27.5% (n=11) showed gross lesions in the epithelium of ruminal pillars, whereas 22.5% (n=9) of those in D3 and D4 presented these lesions. Sole corium thickness varied between heifers in D3 compared with those in D1 and D2 (p<0.05). Therefore, high-energy diets, as used in this study, alter some clinical parameters and the rumen environment, causing lesions in the rumen mucosa, and of lesser intensity, in the hoof corium and laminae, suggestive of laminitis.(AU)


O objetivo deste trabalho foi identificar alterações macroscópicas e microscópicas provocadas por dietas de alto valor energético no ambiente ruminal e casco de bovinos de corte (Bos taurus) em confinamento. Foram utilizadas 40 novilhas mantidas em confinamento, sendo divididas em 4 grupos experimentais: Grupo D1(controle) - 48% de volumoso e 52% de concentrado; Grupo D2 - 30% de volumoso e 70% de concentrado; Grupo D3 - 30% de volumoso e 70% de concentrado + sacarose; Grupo D4 - 100% de concentrado. Foi realizado exame clínico dos animais, avaliação do pH ruminal, da claudicação, além de coletas de amostras post-mortem para análises histopatológicas da região laminar do casco, coxim digital e do rúmen. Todas as variáveis dependentes do estudo foram comparadas por meio do software estatístico SPSS 20.0. As variáveis sem normalidade (FC, MR, Tc e TPC) foram comparadas pelo teste de Kruskal Wallis, seguido pelo teste de comparação múltipla de Dunnet. Todas demais foram submetidas a análise de variância (ANOVA), seguida pelo teste de Tukey. Foi observado impacto das distintas dietas ao ambiente ruminal (p<0,05). Os grupos D3 e D4 exibiram menor motilidade (p<0,05) e pH ruminal (p<0,01). 27,5% (n=11) dos animais tiveram registros macroscópicos de lesões no epitélio dos pilares ruminais enquanto que os submetidos às dietas 3 e 4 foi observada ocorrência de 22,5% (n=9) de lesões macroscópicas no rúmen. As espessuras do córium solear variaram entre os grupos que receberam a indução de sacarose em relação ao grupo controle e novilhas alimentadas com a dieta 2 (p<0,05). Sendo assim dietas com elevada densidade energética, na condição em que foi empregada, alteraram alguns parâmetros clínicos e o ambiente ruminal, provocando lesões na mucosa do rúmen e de pouca intensidade no córium e tecido laminar, sugestiva de laminite.(AU)


Assuntos
Animais , Bovinos , Acidose/veterinária , Carboidratos da Dieta/efeitos adversos , Sacarose na Dieta , Dieta/veterinária , Doenças do Pé/etiologia , Doenças do Pé/veterinária , Ração Animal/efeitos adversos
2.
Fisioter. Pesqui. (Online) ; 26(3): 247-257, jul.-set. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1039888

RESUMO

ABSTRACT The purpose of this study is to analyze the effects of using customized insoles and leg and foot exercises on the feet of patients with neuropathy caused by leprosy. Thirty volunteers diagnosed with leprosy were assigned to one of three groups: (1) Exercise group (n=10): performed exercises for the intrinsic muscles of the foot; (2) Insole group (n=10): used insoles to correct foot positioning; (3) Insole and Exercise group (n=10): used insoles and performed an exercise routine. The results of the treatments were analyzed with photogrammetry using the Alcimagem® and AutoCAD® programs. Left hindfoot posture changed after treatment in the Exercise and Insole groups (hindfoot, pre versus post <0.001). We also found that combining exercise and insoles did not alter the alignment of the feet during the study's evaluation period (customized insoles and exercises, pre versus post <0.05), which suggests that follow-up for more than four months may be needed. The left hindfoot's alignment can be changed with supervised exercises and the use of insoles.


RESUMO O objetivo deste estudo é analisar a influência do uso de palmilhas personalizadas e exercícios para perna e pés nos ângulos do antepé, retropé e arco plantar de pacientes com neuropatia causada por hanseníase. Trinta voluntários diagnosticados com hanseníase foram designados para um dos três grupos: (1) grupo exercício (n=10): realização de exercícios para pernas e pés; (2) grupo palmilha (n=10): utilização de palmilhas para corrigir o posicionamento do pé; (3) grupo palmilha e exercícios (n=10): uso de palmilhas associado a uma rotina de exercícios. O resultado dos tratamentos foi analisado por meio de fotogrametria, com os softwares Alcimagem e AutoCAD. A postura do retropé esquerdo foi modificada após o tratamento no "grupo exercício" e "grupo palmilha" (retropé, pré versus pós<0,001). Também foi observado que a combinação entre exercícios e palmilhas não alterou o alinhamento dos pés durante o período de avaliação do estudo (palmilha e exercícios, pré versus pós>0,05), o que sugere que o acompanhamento por mais de quatro meses pode ser necessário. Assim, o uso isolado de exercícios supervisionados ou de palmilhas altera o alinhamento do retropé, como aferido por fotogrametria.


RESUMEN El presente estudio tiene como objetivo analizar la influencia del uso de plantillas personalizadas y la práctica ejercicios de piernas y pies en los ángulos del antepié, del retropié y del arco plantar de pacientes con neuropatía debido a lepra. Treinta voluntarios diagnosticados con lepra fueron asignados a uno de estos tres grupos: (1) grupo de ejercicios (n=10): hacer ejercicios de piernas y pies; (2) grupo de plantillas (n=10): utilizar plantillas para corregir la posición del pie; (3) grupo de plantillas y ejercicios (n=10): utilizar plantillas asociadas con una rutina de ejercicios. Los resultados de los tratamientos se analizaron mediante fotogrametría, con los softwares Alcimagem y AutoCAD. La postura del retropié izquierdo se modificó tras el tratamiento en el "grupo de ejercicios" y en el "grupo de plantillas" (retropié, pre versus pos <0,001). También se observó que la combinación de ejercicios y plantillas no alteró la alineación del pie durante el período de evaluación del estudio (plantilla y ejercicios, pre versus pos >0,05), lo que sugiere que puede requerirse seguimiento durante más de cuatro meses. Por lo tanto, la práctica aislada de ejercicios supervisados o el uso de plantillas altera la alineación del retropié, medido por fotogrametría.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Aparelhos Ortopédicos , Doenças do Sistema Nervoso Periférico/reabilitação , Terapia por Exercício , Fotogrametria , Doenças do Sistema Nervoso Periférico/etiologia , Doenças do Pé/etiologia , Doenças do Pé/reabilitação , Hanseníase/complicações
3.
Vet J ; 250: 28-35, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31383417

RESUMO

Granulomas and shelly hoof (SH), are lesions of sheep feet. Our objective was to use data from four questionnaires on lameness sent to English sheep farmers in 2004, 2013, 2014 and 2015 to further understanding of the risks and aetiologies of both lesions. Granulomas were more likely in flocks where routine foot trimming (odds ratio [OR]=3.17; 95% confidence intervals [CI] 1.11-11.47) and routine footbathing (OR=2.38; 95% CI 1.19-4.83) were practised than where these management protocols were not. SH was more likely in flocks that were footbathed in formalin compared with not footbathing (OR=1.65; 95% CI 1.19-2.30), and was less common in flocks that stocked ewes at more than eight vs. four per acre (OR=0.34; 95% CI 0.17-0.68). There were weak associations between SH and foot trimming. In 2004 only, SH was more likely in flocks where therapeutic foot trimming was practised than not practised (OR=2.24; 95% CI 1.12-4.68). In 2014 only, SH was marginally less likely in flocks where no feet bled during trimming, compared with flocks not routinely trimmed (OR=0.55; CI 0.30-1.00); SH was not related to foot trimming once severe footrot was included. We propose that flocks with granulomas and SH would decrease if farmers stopped footbathing in general, in particular with formalin, and avoided foot trimming whether as a therapeutic or routine practice. Further work is needed to understand the role of stocking density.


Assuntos
Criação de Animais Domésticos/métodos , Banhos/estatística & dados numéricos , Doenças do Pé/veterinária , Formaldeído/uso terapêutico , Granuloma/veterinária , Coxeadura Animal/epidemiologia , Doenças dos Ovinos/epidemiologia , Animais , Inglaterra/epidemiologia , Feminino , Doenças do Pé/epidemiologia , Doenças do Pé/etiologia , Granuloma/epidemiologia , Granuloma/etiologia , Casco e Garras/patologia , Coxeadura Animal/etiologia , Prevalência , Risco , Ovinos , Doenças dos Ovinos/etiologia
4.
Appl Ergon ; 80: 130-135, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31280796

RESUMO

BACKGROUND: The prolonged standing position is an important factor in the onset of foot musculoskeletal disorders among workers. Safety shoes, designed to protect against the physical constraints of the work environment, do not address this issue to date. OBJECTIVES: The goal of this study is to assess the possible benefits of custom-made foot orthoses among prolonged standing workers. STUDY DESIGN: repeated measures without control group. METHODS: Thirty-four standing workers who suffer from foot pain volunteered for the study. Custom-made foot orthoses, designed by a podiatrist, were 3D-printed and distributed to each volunteer. Static balance as well as static and dynamic plantar pressure measurements were carried out with sensors inserted in the safety shoes, before and after three weeks of wearing foot orthoses daily. A questionnaire on pain and comfort was also distributed before and after treatment. RESULTS: Feelings of pain, discomfort and heavy legs were found to be significantly reduced after wearing 3D-printed orthoses (p<0.05). Additionally, in static and dynamic conditions, a significant decrease in mean peak pressure in the rearfoot area was observed along with a significant increase in mean peak pressure in the midfoot area (p<0.05). There was also a significant improvement of balance in the medial-lateral direction. CONCLUSION: Custom-made orthoses significantly increase the well-being of standing workers in our experimental testing conditions. The custom-made shape allows for a better balanced distribution of foot peak pressure thanks to its support and stimulation of the foot arches particularly through a shift of pressure from the heel to the midfoot.


Assuntos
Doenças do Pé/reabilitação , Órtoses do Pé , Doenças Profissionais/reabilitação , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Posição Ortostática , Adulto , Desenho de Equipamento , Feminino , Pé/fisiopatologia , Doenças do Pé/etiologia , Doenças do Pé/psicologia , Humanos , Masculino , Doenças Profissionais/etiologia , Doenças Profissionais/psicologia , Trabalho/fisiologia
5.
BMJ Case Rep ; 12(7)2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31302625

RESUMO

Toe necrosis has many aetiologies. The most common one is ischaemia. In fact, both direct and indirect toe necrosis, as well as related lower limb gangrene, could be secondary to mechanical trauma, infections, pharmacological sensitivity, cancer, blue toe syndrome and other granulomatous diseases. We report a case of toes necrosis caused by an uncommon aetiology.


Assuntos
Angiopatias Diabéticas/complicações , Doenças do Pé/etiologia , Gangrena/etiologia , Fumar Maconha/efeitos adversos , Amputação , Humanos , Masculino , Dedos do Pé/cirurgia , Adulto Jovem
6.
J Foot Ankle Res ; 12: 26, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31164925

RESUMO

Objective: The aim of this study was to investigate whether foot and lower limb related symptoms were associated with work participation and poor mobility in people with Systemic Lupus Erythematosus (SLE). Method: A quantitative, cross-sectional, self-reported survey design was utilised. People with SLE from six United Kingdom (UK) treatment centres and a national register were invited to complete a survey about lower limb and foot health, work participation and mobility. Data collected included work status and the prevalence of foot symptoms. The focus of the analyses was to explore potential associations between poor foot health work non-participation. Results: In total, 182 useable surveys were returned. Seventy-nine respondents reported themselves as employed and 32 reported work non-participation. The remaining were retired due to age or reported work non-participation for other reasons. Work non-participation due to foot symptoms was significantly associated with difficulty walking (p = 0.024), past episodes of foot swelling (p = 0.041), and past episodes of foot ulceration (p = 0.018). There was a significant increase in foot disability scores amongst those not working (mean 18.13, 95% CI: 14.85-21.41) compared to those employed (mean 10.16, 95% CI: 8.11-12.21). Conclusions: Twenty-nine% of people with SLE reported work non-participation because of lower limb or foot problems. Our results suggest that foot health and mobility may be important contributors to a persons' ability to remain in work and should be considered as part of a clinical assessment.


Assuntos
Emprego/estatística & dados numéricos , Doenças do Pé/epidemiologia , Lúpus Eritematoso Sistêmico/complicações , Limitação da Mobilidade , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Doenças do Pé/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Autorrelato , Reino Unido/epidemiologia , Adulto Jovem
7.
Ergonomics ; 62(9): 1202-1213, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31177967

RESUMO

Vibration-white foot as an occupational disease has underscored the need to better understand the vibration response of the foot. While vibration transmissibility data exist for a natural standing position, it is anticipated that weight distribution will affect the response. The purpose of this study was to determine the effects of changes in centre of pressure (COP) on the foot's biomechanical response. Twenty-one participants were exposed to vertical vibration of 30 mm/s, with a sine sweep from 10-200 Hz. Z-axis (vertical) vibration was measured at 24 locations on the right foot, with the COP shifted forward or toward the heel. A mixed model analysis at each location revealed significant differences (p < .001) in the transmissibility response when the COP was altered to the forefoot and rearfoot. In general, the peak frequency of the average vibration response increased for a region of the foot when the COP was shifted toward that region. Practitioner Summary: Altering the centre of pressure location resulted in changes in the transmission of vibration through the foot. The forward lean position was associated with the greatest amplitude of vibration transmissibility at the toes. This information is relevant for clinicians studying vibration-induced white-foot and engineers designing protective equipment.


Assuntos
Pé/fisiologia , Pressão , Posição Ortostática , Vibração/efeitos adversos , Suporte de Carga/fisiologia , Adulto , Fenômenos Biomecânicos , Feminino , Doenças do Pé/etiologia , Humanos , Masculino , Doenças Profissionais/etiologia , Equilíbrio Postural/fisiologia , Adulto Jovem
8.
J Foot Ankle Res ; 12: 32, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31210785

RESUMO

Background: Foot orthoses (FOs) are prescribed as an important conservative treatment option in patients with foot problems related to rheumatoid arthritis. However, a broad variation in FOs is used, both in clinical practice and in research. To date, there is no overview on the outcomes of the treatment with different kinds of FOs in patients with rheumatoid arthritis and a specific foot problem. The objectives of the present study were to summarize the comparative effectiveness of FOs in the treatment of various foot problems in patients with rheumatoid arthritis, on the primary outcomes foot function and foot pain, and the secondary outcomes physical functioning, health related quality of life, compliance, adverse events, the costs of FOs and patient satisfaction. Methods: Studies comparing different kinds of FOs, with a presumed therapeutic effect, in the treatment of foot problems related to rheumatoid arthritis were included. A literature search was conducted in The Cochrane Central Registry for Controlled Trials (CENTRAL), PubMed, EMBASE and PEDro up to May 18th, 2018. Data was meta-analyzed, when this was not possible qualitative data analysis was performed. Results: Ten studies were identified, with a total number of 235 patients. These studies made a comparison between different materials used (soft versus semi-rigid), types of FOs (custom-made versus ready-made; total-contact versus non-total contact), or modifications applied (metatarsal bars versus domes). Also, different techniques to construct custom-made FOs were compared (standard custom-molding techniques versus more sophisticated techniques). A medium effect for (immediate) reduction of forefoot plantar pressure was found in favor of treatment with soft FOs compared to semi-rigid FOs (SMD 0.60, 95% CI 0.07-1.14; P = 0.03; 28 participants). Other comparisons between FOs resulted in non-significant effects or inconclusive evidence for one kind of FOs over the other. Conclusions: Foot orthoses made of soft materials may lead to more (immediate) forefoot plantar pressure reduction compared to foot orthoses constructed of semi-rigid materials. Definitive high quality RCTs, with adequate sample sizes and long-term follow-up, are needed to investigate the comparative (cost-) effectiveness of different kinds of foot orthoses for the treatment of foot problems related to rheumatoid arthritis.


Assuntos
Artrite Reumatoide/fisiopatologia , Doenças do Pé/terapia , Órtoses do Pé , Adulto , Artrite Reumatoide/complicações , Artrite Reumatoide/economia , Pesquisa Comparativa da Efetividade , Análise Custo-Benefício , Desenho de Equipamento , Feminino , Pé/fisiopatologia , Doenças do Pé/economia , Doenças do Pé/etiologia , Órtoses do Pé/economia , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
9.
J Foot Ankle Res ; 12: 33, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31210786

RESUMO

Background: Charcot foot arthropathy is a potentially limb-threatening condition that leads to progressive destruction of the bones and joints in the neuropathic foot. One of its main causes is diabetes mellitus whose prevalence is steadily increasing. The acute phase is often misdiagnosed thus leading to foot deformity, ulceration and increased risk of amputation. There is a paucity of literature on this condition from sub-Saharan Africa. This study aimed at determining the extent of Charcot foot arthropathy, the radiological patterns of Charcot foot arthropathy and patient's factors associated with Charcot foot arthropathy among adult patients with longstanding diabetes in an African setting. Methods: This was a cross-sectional study that was carried at a national referral and university teaching hospital in Kampala, Uganda. One hundred patients with longstanding diabetes mellitus were consecutively recruited. Patients with a history of having diabetes mellitus for at least seven years since diagnosis were considered to have a longstanding disease. Clinical assessment of both feet was done. Weight-bearing radiographs of the selected foot were taken and evaluated using the Sanders and Frykberg and modified Eichenholtz classifications. A blood sample was taken for glycosylated haemoglobin (HbA1c). Data were summarized using descriptive statistics and student t-test. Results: The proportion of Charcot foot arthropathy among patients with longstanding diabetes was 12% of which one-third (4 out of 12) were acute cases. Fifty percent of the lesions were in the forefoot and 50% in the midfoot. Seventeen percent of lesions were at the inflammatory stage of the modified Eichenholtz classification, 50% at the developmental stage, 25% at the healing stage, and 8% at the remodelling stage. An abnormal foot radiograph was significantly associated with Charcot foot arthropathy among patients with longstanding diabetes. Conclusion: Charcot foot arthropathy is fairly common in patients with longstanding diabetes mellitus in these settings with one third of patients presenting in the early acute phase. An abnormal weight-bearing radiograph was an associated factor of Charcot foot arthropathy among this specific group of patients. To reduce on the morbidity and limb threatening sequelae of this condition, clinicians are therefore advised to routinely examine the feet of patients with diabetes and send those with suspicious signs and symptoms for radiographic assessment.


Assuntos
Artropatia Neurogênica/epidemiologia , Pé Diabético/complicações , Doenças do Pé/epidemiologia , Adulto , Artropatia Neurogênica/etiologia , Estudos Transversais , Feminino , Doenças do Pé/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Centros de Atenção Terciária , Uganda/epidemiologia
10.
BMC Musculoskelet Disord ; 20(1): 208, 2019 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-31077163

RESUMO

BACKGROUND: Recent studies support the theory that ill-fitting shoes are an important source of pain and may lead to foot malformations in the medium term. Taking as reference the ideal allowance considered in the literature, the purpose of this study was to verify the outdoor footwear fit in a population of schoolchildren of southern Spain. METHODS: Five hundred and five children within the range of 3-12 years of age participated in this study. Using a measuring instrument designed and validated for this purpose, maximum foot length, width and height were obtained from the longest foot. These measurements were compared with the inner length, width and height of the footwear. An adequate toe allowance of 5-15 mm in length and 10 mm in width were estimated. RESULTS: Inner footwear length was shorter than foot length in 33.3% of the schoolchildren. Based on the allowance established, it was observed that the footwear of the schoolchildren was too short and too narrow in 72.5 and 66.7% of the cases, respectively. CONCLUSIONS: Only one third of the participants analysed had well-fitted footwear. The results show that it is necessary to raise awareness among parents and teachers about the importance of replacing, periodically, the footwear of children in primary education. Manufacturers should adapt the lasts considering the use of 90th percentiles instead of mean values obtained from the growth curves of schoolchildren's feet.


Assuntos
Doenças do Pé/epidemiologia , Pé/anatomia & histologia , Sapatos/efeitos adversos , Antropometria , Criança , Pré-Escolar , Feminino , Doenças do Pé/diagnóstico , Doenças do Pé/etiologia , Humanos , Masculino , Estudos Prospectivos , Reprodutibilidade dos Testes , Espanha/epidemiologia
11.
BMC Musculoskelet Disord ; 20(1): 191, 2019 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-31054575

RESUMO

BACKGROUND: Active foot disease persists in a high proportion of people with psoriatic arthritis despite the availability of pharmacological and non-pharmacological interventions to modify the course of the disease. Limited information exists on the provision of health care for foot disease in psoriatic arthritis. The objective of this study was to explore the views of health professionals on the assessment and management of people with psoriatic arthritis-related foot involvement. METHODS: Convenience sampling was used to recruit health professionals working in rheumatology outpatient clinics in Sydney, Australia and Auckland, New Zealand. Three focus groups were undertaken to explore the views and experiences of health professionals on the assessment and management of foot problems in people with psoriatic arthritis. All interviews were audio-recorded and transcribed verbatim. Qualitative data was analysed using a constant comparative analytic approach to identify themes. RESULTS: A total of seventeen health professionals participated including rheumatologists, podiatrists and a physiotherapist. Key themes derived from the focus groups suggest that health professionals perceived that people with psoriatic arthritis-related foot problems experience suboptimal management from symptom onset, to diagnosis and treatment. Frustration was expressed throughout discussions relating to lack of appropriate training and expertise required for the specialised management of foot problems typically encountered with psoriatic arthritis and poor access for patients to specialist podiatry services. CONCLUSIONS: This study provides new insight into the perspectives of health professionals on the management of foot problems related to psoriatic arthritis. Deficiencies in the diagnosis, assessment and treatment of foot problems were revealed. To meet the foot health needs of people with psoriatic arthritis, reducing diagnostic delay, improving knowledge and awareness about the disease among people with psoriatic arthritis and health professionals, and increasing specialist podiatry service provision may be required.


Assuntos
Artrite Psoriásica/complicações , Doenças do Pé/diagnóstico , Necessidades e Demandas de Serviços de Saúde , Podiatria/organização & administração , Artrite Psoriásica/terapia , Austrália , Diagnóstico Tardio/prevenção & controle , Feminino , Grupos Focais , Doenças do Pé/etiologia , Doenças do Pé/terapia , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Humanos , Masculino , Nova Zelândia , Educação de Pacientes como Assunto , Pesquisa Qualitativa , Encaminhamento e Consulta
12.
J Vet Intern Med ; 33(3): 1473-1482, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30972832

RESUMO

BACKGROUND: Endocrinopathic laminitis is common in horses and ponies, but the recurrence rate of the disease is poorly defined. OBJECTIVES: To determine the incidence of, and risk factors for, the recurrence of endocrinopathic laminitis. ANIMALS: Privately owned horses and ponies with acute laminitis (n = 317, of which 276 cases with endocrinopathic laminitis were followed up to study completion). METHODS: This prospective cohort study collected data on veterinary-diagnosed cases of acute laminitis for 2 years. Each case was classified on acceptance to the study as endocrinopathic or non-endocrinopathic using data collected in a questionnaire completed by the animal's veterinarian. Follow-up data were collected at regular intervals to determine whether the laminitis recurred in the 2-year period after diagnosis. RESULTS: The recurrence rate for endocrinopathic laminitis was 34.1%. The risk of recurrence during the 2-year study period increased with basal, fasted serum insulin concentration (P ≤ .05), with the probability of recurrence increasing markedly as the insulin concentration increased beyond the normal range (0-20 µIU/mL) to over the threshold for normal (up to approximately 45 µIU/mL). Being previously diagnosed with laminitis (before the study; P = .05) was also a risk factor for recurrent laminitis. Cases with a higher Obel grade of laminitis were likely (P = .05) to recur sooner. CONCLUSIONS AND CLINICAL IMPORTANCE: Knowing that hyperinsulinemia and being previously diagnosed with laminitis are significant risk factors for recurrence will enable clinicians to proactively address these factors, thereby potentially reducing the risk of recurrence of laminitis.


Assuntos
Doenças do Sistema Endócrino/veterinária , Doenças do Pé/veterinária , Casco e Garras , Animais , Estudos de Coortes , Doenças do Sistema Endócrino/complicações , Feminino , Doenças do Pé/epidemiologia , Doenças do Pé/etiologia , Doenças dos Cavalos , Cavalos , Hiperinsulinismo/veterinária , Incidência , Masculino , Estudos Prospectivos , Recidiva , Fatores de Risco
13.
Poult Sci ; 98(10): 4868-4877, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-30995304

RESUMO

A study with 884 Ross 308 male broilers, housed in 68 floor pens (0.75 m2) from 0 to 35 days of age was conducted to evaluate the effects of low crude protein (CP) diets, with partial replacement of soybean meal by free amino acids (AA), on performance, slaughter yields, litter quality and footpad lesions. During the first 11 d, all broilers received the same control starter diet (216 g/kg CP, 11.5 g/kg apparent fecal digestible (AFD) lysine, and 2900 kcal/kg AMEn). Thereafter, four experimental feeding programs with different levels of dietary CP (control and control with 1% (CP-1%), 2% (CP-2%) and 3% (CP-3%) less CP units) were provided in both the grower and finisher phase. In the control grower and finisher diet, the CP content was 208 and 198 g/kg, respectively. All diets were formulated to meet or exceed the recommendations concerning AFD AA, and to be iso-caloric within each feeding phase. Feed and water were provided for ad libitum intake during the entire experimental period. None of the low CP feeding programs affected body weight gain, feed intake or mortality from 0 to 35 d. However, CP conversion was improved with the reduction of CP content of the diet. Broilers fed the CP-2% or CP-3% feeding program had an improved feed conversion ratio. Broilers fed the low CP protein feeding programs had a better litter quality and less footpad lesions, compared to broilers fed the control feeding program. Broilers fed the CP-3% feeding program had a lower breast meat yield than broilers fed the control feeding program. Slaughter yields of broilers fed CP-1% or CP-2% feeding program did not differ from the control feeding program. This study demonstrated that the CP content of grower and finisher diets can be reduced by 2.2-2.3% units without adverse effects on growth performance of broilers, while CP reduction seems promising to reduce nitrogen excretion from broiler houses, improve bird welfare, and reduces dependence on vegetable protein sources.


Assuntos
Aminoácidos/metabolismo , Galinhas/fisiologia , Dieta com Restrição de Proteínas/veterinária , Fezes/química , Doenças do Pé/veterinária , Carne/análise , Doenças das Aves Domésticas/patologia , Aminoácidos/administração & dosagem , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal/efeitos dos fármacos , Animais , Galinhas/crescimento & desenvolvimento , Suplementos Nutricionais/análise , Relação Dose-Resposta a Droga , Doenças do Pé/etiologia , Doenças do Pé/patologia , Doenças do Pé/terapia , Masculino , Doenças das Aves Domésticas/etiologia , Doenças das Aves Domésticas/terapia
14.
J Foot Ankle Surg ; 58(4): 771-774, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31027970

RESUMO

Heel pain is 1 of the most common presentations to the foot surgeon, and its causes are multifactorial. Baxter's neuropathy is caused by an impingement of the inferior calcaneal nerve and has been reported to be responsible for up to 20% of heel pain. The diagnostic imaging features are striking, with inflammation or atrophy of the abductor digiti minimi muscle. Multiple studies have found that the prevalence of this finding is much greater than initially thought. However, it is more unusual to find bilateral and symmetrical features. The possible causes of this condition lie along the course of the inferior calcaneal nerve. Management is focused on treating the underlying condition, with conservative therapy and steroid injection as the mainstay. Refractory cases may require surgical release. We present the case of a 56-year-old female presenting with bilateral foot pain. Imaging reveals symmetrical abductor digiti minimi atrophy associated with bilateral plantar fasciitis. These appearances are well demonstrated on both magnetic resonance imaging and ultrasound.


Assuntos
Fasciíte Plantar/complicações , Calcanhar/inervação , Síndromes de Compressão Nervosa/etiologia , Fasciíte Plantar/diagnóstico por imagem , Feminino , Pé/diagnóstico por imagem , Doenças do Pé/diagnóstico por imagem , Doenças do Pé/etiologia , Humanos , Pessoa de Meia-Idade , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/patologia , Síndromes de Compressão Nervosa/diagnóstico por imagem , Dor/etiologia , Ultrassonografia
16.
BMC Vet Res ; 15(1): 59, 2019 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-30755193

RESUMO

BACKGROUND: Equine laminitis is a complex disease that manifests as pain and lameness in the feet, often with debilitating consequences. There is a paucity of data that accounts for the multifactorial nature of laminitis and considers time-varying covariates that may be associated with disease development; particularly those that are modifiable and present potential interventions. A previous case-control study identified a number of novel, modifiable factors associated with laminitis which warranted further investigation and corroboration. The aim of this study was to identify factors associated with equine laminitis in horses/ponies in Great Britain (GB) using a prospective, web-based cohort study design, with particular interest in evaluating modifiable factors previously identified in the case-control study. RESULTS: Self-selected horse/pony owners in GB submitted initial baseline and follow-up health and management questionnaires for 1070 horses/ponies between August 2014 and December 2016. The enrolled horses/ponies contributed 1068 horse-years at risk with a median of 38 days between questionnaire submissions. Owners reported 123 owner-recognised and/or veterinary-diagnosed episodes of active laminitis using a previously-validated laminitis reporting form. Multivariable Cox regression modelling identified 16 risk/protective factors associated with laminitis development. In keeping with the previous case-control study, a prior history of laminitis (particularly non-veterinary-diagnosed episodes), soreness after shoeing/trimming and weight gain were associated with higher rates of laminitis. There is now strong evidence that these risk factors should be used to guide future recommendations in disease prevention. Factors with some prior evidence of association included breed, steroidal anti-inflammatory administration, transport and worming. The modifiable factors amongst these should be the focus of future laminitis studies. The remainder of the identified factors relating to health, turnout and grazing management and feeding are novel, and require further investigation to explore their relationship with laminitis and their applicability as potential interventions. CONCLUSIONS: This study has demonstrated a temporal relationship between a number of horse- and management-level factors and laminitis, identifying potential interventions and important risk groups for which these interventions would be of particular importance. These results serve as a sound evidence-base towards the development of strategic recommendations for the horse/pony-owning population to reduce the rate of laminitis in GB.


Assuntos
Doenças do Pé/veterinária , Casco e Garras , Doenças dos Cavalos/etiologia , Criação de Animais Domésticos , Animais , Feminino , Doenças do Pé/etiologia , Doenças do Pé/prevenção & controle , Doenças dos Cavalos/prevenção & controle , Cavalos , Coxeadura Animal/etiologia , Coxeadura Animal/prevenção & controle , Masculino , Estudos Prospectivos , Fatores de Risco , Inquéritos e Questionários , Reino Unido
18.
Clin Rheumatol ; 38(6): 1605-1613, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30617439

RESUMO

OBJECTIVE: The aim of the study was to explore how foot problems impact on the lives of people with psoriatic arthritis by interviewing patients and health professionals. METHOD: Participants were recruited from outpatient rheumatology clinics in Sydney, Australia, and in Auckland, New Zealand, using a convenience sampling strategy. People with psoriatic arthritis were asked questions in semi-structured interviews about their foot problems and the impact they have on daily living until qualitative data saturation. Focus groups were undertaken with health professionals to explore their understanding of the patient experience of psoriatic arthritis-related foot problems. All interviews were audio-recorded and transcribed verbatim. Constant comparative analysis was used to identify emerging themes from the data. RESULTS: Twenty-one people with psoriatic arthritis-related foot problems and 17 health professionals participated. Three overarching key themes were derived from patients and health professionals: (1) structural and functional foot manifestations, (2) impact on daily life leading to social withdrawal and reduced work productivity and (3) mediating factors influencing the severity of impact from foot problems on their lives such as social support, self-management strategies and experiences of health care. CONCLUSION: Foot problems caused functional disability and altered self-concept, which lead to a cascade of social, economic and psychological consequences. People with foot problems contend with profound disruption to their functioning and life roles. Whilst health professionals recognised the functional and visual impact that foot problems have on daily life, the emotional burden may be under-appreciated. Future work to determine the scale and types of foot problems in psoriatic arthritis is required.


Assuntos
Artrite Psoriásica/complicações , Doenças do Pé/diagnóstico , Podiatria/organização & administração , Atividades Cotidianas , Adulto , Idoso , Artrite Psoriásica/terapia , Austrália , Diagnóstico Tardio/prevenção & controle , Feminino , Grupos Focais , Doenças do Pé/etiologia , Doenças do Pé/terapia , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Educação de Pacientes como Assunto , Pesquisa Qualitativa
19.
Foot (Edinb) ; 38: 50-53, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30639799

RESUMO

Bone Marrow Oedema Syndrome during childhood is a rare benign transient condition without clear pathophysiology. It usually resolves after conservative treatment, but resolution may exceed up to 8 months. A 12-year-old child with bone marrow oedema of the left foot which was diagnosed by magnetic resonance imaging (MRI) is reported. She presented with a six week subacute pain and mild swelling on the dorsal surface of the foot. Routine plain radiographs, blood tests, biochemical and serological tests were normal with the exception of serum Vitamin D levels that were reduced. The management of the child included partial weight-bearing, administration of anti-inflammatory drugs and supplementation of Vitamin D due to insufficient Vitamin D intake. After six months the child did not have any clinical symptoms and MRI showed complete resolution of the oedema. This is the first report of a juvenile bone marrow oedema correlated with hypovitaminosis D that was successfully treated with Vitamin D administration.


Assuntos
Doenças da Medula Óssea/etiologia , Edema/etiologia , Doenças do Pé/etiologia , Deficiência de Vitamina D/complicações , Vitamina D/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Biomarcadores/sangue , Doenças da Medula Óssea/diagnóstico por imagem , Doenças da Medula Óssea/tratamento farmacológico , Criança , Edema/diagnóstico por imagem , Edema/tratamento farmacológico , Feminino , Doenças do Pé/diagnóstico por imagem , Humanos , Deficiência de Vitamina D/tratamento farmacológico
20.
J Vet Intern Med ; 33(3): 1456-1463, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30697823

RESUMO

BACKGROUND: Equine endocrinopathic laminitis is common and can be associated with an underlying endocrinopathy, such as equine metabolic syndrome (EMS), pituitary pars intermedia dysfunction (PPID), pasture consumption, or any combination of these factors. OBJECTIVES: The aim of the study was to improve the risk assessment capabilities of clinicians, and to inform management strategies, for acute endocrinopathic laminitis by prospectively examining the phenotypic, hormonal, and clinical characteristics of the disease in a large cohort. ANIMALS: Privately owned horses and ponies (n = 301) of any age, sex, or breed diagnosed with laminitis by a veterinarian. A history of laminitis was acceptable. METHODS: This was a prospective cohort study. Veterinarians provided information on each case via an online questionnaire after informed consent from the animal's owner, and all data were de-identified before analysis. Serum insulin and plasma adrenocorticotrophic hormone concentrations were measured in each case. RESULTS: Most cases were recruited in spring (109/301; 36.2%). Concurrent EMS and PPID resulted in higher basal insulin concentrations (49 [21.5-141]; P < .02) than if an animal had a single underlying cause for their laminitis. The insulin concentration was negatively correlated (r2 = -0.38; P < .001) with the animal's height, being higher in ponies (33[10-14]; P < .001) than horses (9.5 [3-25.7]) and was positively correlated (r2 = 0.12; P = .05) with their grade (severity) of laminitis. CONCLUSIONS AND CLINICAL IMPORTANCE: Horses and ponies with concurrent endocrinopathies have more marked hyperinsulinemia. Higher basal insulin concentrations were associated with more severe lameness.


Assuntos
Doenças do Sistema Endócrino/veterinária , Doenças do Pé/veterinária , Casco e Garras , Doenças dos Cavalos/metabolismo , Hormônio Adrenocorticotrópico/sangue , Animais , Tamanho Corporal , Estudos de Coortes , Dieta/veterinária , Doenças do Sistema Endócrino/complicações , Feminino , Doenças do Pé/etiologia , Doenças dos Cavalos/patologia , Cavalos , Insulina/sangue , Masculino , Doenças Metabólicas/veterinária , Estudos Prospectivos
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