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1.
J Surg Oncol ; 123(1): 110-116, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33125739

RESUMO

BACKGROUND AND OBJECTIVES: Describe patient-reported functional outcomes for hand and foot sarcoma survivors treated with limb-sparing surgery and radiation therapy (LSS + RT). METHODS: Fifty-four patients with hand/wrist and foot/ankle sarcomas treated with LSS + RT from 1991 to 2015 were identified. Survivors ≥18 years old without subsequent amputation completed self-assessed functional surveys: Toronto upper extremity salvage score (TESS-UE) and Michigan hand outcomes (MHQ) surveys for hand; TESS lower extremity (TESS-LE) and Foot and Ankle Outcomes (FAOS) surveys for foot. Scoring scales: 0-100, MHQ and TESS; -26 to 56 and 25-59, FAOS core and shoe comfort, respectively. Higher scores denote superior function. RESULTS: Five-year local tumor control was 88%. Fourteen of 24 hand (58%) and 14/18 foot (78%) survivors completed surveys. Mean TESS-UE and MHQ scores were 89.4 and 72.8, respectively. Mean TESS-LE, core FAOS, and shoe comfort scores were 92.4, 46.19, and 53.1, respectively. No factors correlated with outcomes. TESS-UE and MHQ scores strongly correlated (r = .87). TESS-LE and FAOS scores were associated with a poor correlation (r = .02 and r = .69). CONCLUSIONS: The largest patient-reported functional outcomes analysis for hand and foot sarcoma survivors treated with LSS + RT demonstrates excellent local tumor control and acceptable functional outcomes. Further exploration of optimal functional assessment tools is needed given the potential scope differences.


Assuntos
Sobreviventes de Câncer/estatística & dados numéricos , Doenças do Pé/terapia , Mãos/efeitos da radiação , Mãos/cirurgia , Salvamento de Membro/métodos , Medidas de Resultados Relatados pelo Paciente , Sarcoma/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Terapia Combinada , Feminino , Seguimentos , Doenças do Pé/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Radioterapia , Estudos Retrospectivos , Sarcoma/patologia , Adulto Jovem
2.
Med Clin North Am ; 105(1): 187-197, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33246518

RESUMO

Primary care providers frequently care for complaints of the hands and feet. Here, the author describes the typical presentations of hand osteoarthritis, carpal tunnel syndrome, ganglion cysts, plantar fasciitis, onychomycosis, and Morton neuroma. Useful physical examination techniques are described. The history and physical examination are usually sufficient to diagnose these conditions without the need for more advanced testing. All of these conditions have evidence-based therapy that can be initiated by the primary care provider. These treatments as well as reasons to refer to a specialist are reviewed.


Assuntos
Doenças do Pé/diagnóstico , Doenças do Pé/terapia , Mãos , Síndrome do Túnel Carpal/diagnóstico , Síndrome do Túnel Carpal/terapia , Fasciíte Plantar/diagnóstico , Fasciíte Plantar/terapia , Cistos Glanglionares/diagnóstico , Cistos Glanglionares/terapia , Articulação da Mão , Humanos , Anamnese , Neuroma Intermetatársico/diagnóstico , Neuroma Intermetatársico/terapia , Onicomicose/diagnóstico , Onicomicose/terapia , Osteoartrite/diagnóstico , Osteoartrite/terapia , Educação de Pacientes como Assunto , Exame Físico , Autogestão
4.
Clin Sports Med ; 39(4): 859-876, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32892972

RESUMO

Painful accessory navicular and spring ligament injuries in athletes are different entities from more common posterior tibialis tendon problems seen in older individuals. These injuries typically affect running and jumping athletes, causing medial arch pain and in severe cases a pes planus deformity. Diagnosis requires a detailed physical examination, standing radiographs, and MRI. Initial treatment focuses on rest, immobilization, and restriction from sports. Orthotic insoles may alleviate minor pain, but many patients need surgery to expedite recovery and return to sports. The authors review their approach to these injuries and provide surgical tips along with expected rehabilitation to provide optimal outcomes.


Assuntos
Traumatismos em Atletas/terapia , Traumatismos do Pé/terapia , Ligamentos Articulares/lesões , Dor Musculoesquelética/etiologia , Procedimentos Ortopédicos/métodos , Ossos do Tarso/anormalidades , Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/fisiopatologia , Pé Chato/etiologia , Pé Chato/terapia , Doenças do Pé/diagnóstico , Doenças do Pé/fisiopatologia , Doenças do Pé/terapia , Traumatismos do Pé/diagnóstico , Traumatismos do Pé/etiologia , Traumatismos do Pé/fisiopatologia , Humanos , Ligamentos Articulares/cirurgia , Dor Musculoesquelética/terapia , Ossos do Tarso/lesões , Ossos do Tarso/fisiopatologia , Resultado do Tratamento
5.
J Foot Ankle Res ; 13(1): 38, 2020 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-32576291

RESUMO

The recent and rapid emergence of COVID-19 infection has led to a flood of publications describing all aspects of the disease and its presentation. The appearance of chilblain-like lesions, in children and young adults has particularly caught the attention of healthcare professionals with an interest in the foot. With such a novel infection, demand for information is high at a time when evidence is scarce. Consequently, there has been a renaissance in the publication of case studies. This type of research, previously relegated from many mainstream journals, as a low level source of evidence, has permitted the rapid reporting, publication and dissemination of much needed clinical data which can be used as a foundation to inform further research and investigations about a new global infection.


Assuntos
Infecções por Coronavirus , Medicina Baseada em Evidências , Pandemias , Pneumonia Viral , Publicações/tendências , Projetos de Pesquisa/tendências , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Gerenciamento Clínico , Medicina Baseada em Evidências/métodos , Medicina Baseada em Evidências/tendências , Doenças do Pé/epidemiologia , Doenças do Pé/terapia , Humanos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia
6.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 34(4): 518-523, 2020 Apr 15.
Artigo em Chinês | MEDLINE | ID: mdl-32291992

RESUMO

Objective: To review the current research on the diagnosis and treatment of Haglund syndrome. Methods: The domestic and foreign literature about Haglund syndrome in recent years was extensively reviewed to summarize and analyze the etiology, anatomy, clinical manifestations, diagnosis, and treatment of Haglund syndrome. Results: The etiology of Haglund syndrome is not very clear, and it may be related to local friction and high gastrocnemius muscle tension, and there may be a certain genetic tendency. The local anatomy is more complex and there are many adjacent tissue structures. Haglund malformation may cause the impingement of the posterior heel bursa and Achilles tendon insertion, lead to wear of the posterior heel bursa and the Achilles tendon insertion, and finally result in pain. The FPA (Fowler-Philipp angle), CPA (calcaneal pith angle), PPL (parallel pitch lines), CLA (Chauveaux-Liet angle), and X/Y ratios (ratio of total calcaneal length to calcaneal tuberosity length) measured on X-ray film can be used for the diagnostic measurement of Haglund malformation. Treatment includes conservative and surgical treatment (open Haglund ostectomy, dorsal closed wedge osteotomy of the calcaneus, and arthroscopic Haglund osteotomy). Conclusion: Both open and arthroscopic Haglund ostectomy and dorsal closed wedge osteotomy of the calcaneus can achieve satisfactory results, but minimally invasive treatment is the current development trend. Surgeons should pay attention to the management of the calcification of Achilles tendon insertion and reconstruction of Achilles tendon insertion.


Assuntos
Doenças do Pé/diagnóstico , Doenças do Pé/terapia , Tendão do Calcâneo/patologia , Calcâneo/patologia , Calcanhar/patologia , Humanos , Osteotomia , Síndrome
7.
Clin Podiatr Med Surg ; 37(2): 317-325, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32146987

RESUMO

A higher incidence of plantar verrucae, commonly known as plantar warts, has been shown in patients infected with the human immunodeficiency virus. Several strains of human papillomavirus are associated with clinical manifestations of plantar verrucae. In this literature review, we examine the incidence and clinical manifestations of plantar verrucae in dual coinfection with human immunodeficiency virus and human papillomavirus. We discuss changes in the clinical scenario brought about by the introduction of human immunodeficiency virus antiretroviral therapy. As a clinical condition with notable presence in podiatric medicine, we also confer these findings to increase clinical awareness with treatment modalities.


Assuntos
Coinfecção/epidemiologia , Doenças do Pé/epidemiologia , Infecções por HIV/complicações , Verrugas/epidemiologia , Doenças do Pé/complicações , Doenças do Pé/terapia , Humanos , Incidência , Papillomaviridae , Verrugas/complicações , Verrugas/terapia
8.
BMC Dermatol ; 20(1): 1, 2020 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-31918687

RESUMO

BACKGROUND: Mycetoma is an uncommon chronic granulomatous infection of cutaneous and subcutaneous tissues that can be caused by filamentous bacteria (actinomycetoma) or fungi (eumycetoma). It is the prerogative of young men between the third and fourth decade and is transmitted through any trauma causing an inoculating point. The classic clinical triad associates a painless hard and swelling subcutaneous mass, multiple fistulas, and the pathognomonic discharge of grains. Although endemic in many tropical and subtropical countries, mycetoma can also be found in non-endemic areas as in Morocco, and causes then diagnosis problems leading to long lasting complications. Therefore, we should raise awareness of this neglected disease for an earlier management. Under medical treatment however, mycetoma has a slow healing and surgery is often needed, and relapses are possible. CASE PRESENTATION: Herein we report a case of a 64 years old patient, with a history of eumycetoma occurring ten years ago treated with oral terbinafine coupled with surgery. A complete remission was seen after 2 years. He presented a relapse on the previous scar 6 months ago. There wasn't any bone involvement in the magnetic resonance imaging (MRI). The patient was put under oral terbinafine with a slow but positive outcome. CONCLUSION: Through this case report, we perform a literature review and highlight the importance of increase awareness of mycetoma in clinical practice especially in non-endemic regions.


Assuntos
Doenças do Pé/diagnóstico , Madurella/isolamento & purificação , Micetoma/diagnóstico , Antifúngicos/uso terapêutico , Diagnóstico Diferencial , Pé/diagnóstico por imagem , Pé/microbiologia , Pé/patologia , Doenças do Pé/microbiologia , Doenças do Pé/patologia , Doenças do Pé/terapia , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Marrocos , Micetoma/microbiologia , Micetoma/patologia , Micetoma/terapia , Doenças Negligenciadas , Medicina Tropical
9.
J Dermatolog Treat ; 31(3): 235-240, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31096794

RESUMO

Background: The aim of this study was to assess the efficacy of combination between microneedling with dermapen and topical bleomycin in the treatment of plantar warts in comparison with intralesional bleomycin and intralesional saline (placebo).Methods: Fifty-four patients were assigned into three groups, each containing 18 patients. The first group treated by micro-needling phenotype with topical bleomycin at 2 weeks interval, the second group received intralesional bleomycin at 3 weeks interval and the control group was intralesional saline for a maximum of four weeks.Results: Complete clearance of warts in 16 patients in the micro-needling group (88.9%) versus 15 patients (83.3%) in the intralesional bleomycin group versus one patient (5.6%) in the control group .Conclusions: Microneedling assisted topical bleomycin spraying seems to be a promising effective and noninvasive therapeutic modality for recalcitrant plantar warts that facilitates delivery and absorption of bleomycin into the lesion .


Assuntos
Antibióticos Antineoplásicos/uso terapêutico , Bleomicina/uso terapêutico , Doenças do Pé/terapia , Verrugas/terapia , Adolescente , Adulto , Crioterapia , Feminino , Doenças do Pé/tratamento farmacológico , Doenças do Pé/patologia , Humanos , Injeções Intralesionais , Masculino , Pessoa de Meia-Idade , Agulhas , Verrugas/tratamento farmacológico , Verrugas/patologia , Adulto Jovem
10.
Pediatr Clin North Am ; 67(1): 169-183, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31779831

RESUMO

Foot and ankle pathology is common in the pediatric population. Common issues may be traumatic in nature, congenital, or age dependent. This article reviews common problems and pathology found in the pediatric foot and ankle.


Assuntos
Traumatismos do Tornozelo , Articulação do Tornozelo , Doenças do Pé , Traumatismos do Pé , Artropatias , Traumatismos do Tornozelo/diagnóstico , Traumatismos do Tornozelo/terapia , Criança , Doenças do Pé/diagnóstico , Doenças do Pé/terapia , Traumatismos do Pé/diagnóstico , Traumatismos do Pé/terapia , Humanos , Artropatias/diagnóstico , Artropatias/terapia
11.
J Dairy Sci ; 103(1): 898-901, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31704019

RESUMO

Hoof lesions in dairy cows are usually treated by trimming the hoof. However, trimming by itself can cause severe pain or exacerbate already existing pain. Hoof trimming is usually not carried out by trained veterinarians, and pain management is not provided. Pain control during trimming is not only an ethical obligation but also allows for better manipulation and more meticulous treatment. Tri-Solfen (Bayer Animal Health, Pymble, Australia) is a spray gel containing lidocaine, bupivacaine, and cetrimide that is easily applied topically and has demonstrated pain-mitigation effects during and after hoof trimming. In the European Union, these local anesthetics are not approved for use in food-producing animals because of a lack of residue data and concerns about genotoxic effects in cattle and humans. The aim of this study was to assess lidocaine, bupivacaine, and 2,6-xylidine residues in milk after Tri-Solfen application in dairy cows. Five dairy cattle in the dry-off period were enrolled in the study based on clinical evidence of lameness (score ≥3 on a 5-point scale). After cleaning and superficial trimming, we applied 3 to 14 mL of Tri-Solfen to the lesions before continuing treatment. Two milk samples were collected per animal in the following 4 milkings and analyzed in a reference laboratory. Residues of lidocaine above the limits of quantification (0.2 µg/L) were found in milk samples in the first milking 6 h after treatment in only 2 cows. This study shows that excretion of local anesthetics and their metabolites in milk after topical application of Tri-Solfen is negligible and even undetectable after the first milking 6 h post-treatment.


Assuntos
Anestésicos Locais/química , Doenças dos Bovinos/terapia , Resíduos de Drogas/química , Doenças do Pé/veterinária , Casco e Garras/patologia , Leite/química , Anestésicos Locais/farmacocinética , Animais , Bovinos , Doenças dos Bovinos/metabolismo , Resíduos de Drogas/farmacocinética , Feminino , Doenças do Pé/terapia , Casco e Garras/cirurgia , Leite/metabolismo , Dor/tratamento farmacológico , Dor/prevenção & controle , Dor/veterinária
12.
Vet Clin North Am Equine Pract ; 35(3): 643-658, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31587970

RESUMO

This article provides a review of hoof anatomy and care in donkeys and mules. Hoof disease is a major cause of poor welfare and mortality globally. Problems associated with hoof disease are discussed in the context of behavior, diet, treatment, and prevention. The most common conditions encountered are discussed, including laminitis, the overgrown unbalanced hoof, white line disease, flexural deformities, and other significant issues. Differences between donkey and horse hoof anatomy are described.


Assuntos
Criação de Animais Domésticos/métodos , Equidae , Doenças do Pé/veterinária , Casco e Garras , Doenças dos Cavalos/terapia , Animais , Doenças do Pé/prevenção & controle , Doenças do Pé/terapia , Doenças dos Cavalos/prevenção & controle , Cavalos
13.
Adv Skin Wound Care ; 32(11): 490-501, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31625965

RESUMO

GENERAL PURPOSE: To provide information on a 60-second General Foot Screen to assist in the prevention and/or identification and management of common foot problems. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to:1. Use the 60-second General Foot Screen to assist healthcare professionals in the recognition of common foot problems.2. Identify risk factors, causes, and treatment of selected foot problems. ABSTRACT: Foot health is important to overall patient health. Early diagnosis and treatment of diabetes, neuropathy, fungal foot infections, foot deformity, and vascular disease/lower leg edema can improve patient quality of life. One way to achieve this is effective screening. To this end, researchers piloted a validated 10-item screening tool to assess foot health on 120 patients; 74.17% had at least one positive abnormality, demonstrating the critical importance of these early findings. Only 25.83% of individuals had completely low-risk feet. This easy-to-use tool can assist healthcare professionals in the recognition and treatment of common foot problems. The article also outlines the early signs of disease by screening item and provides a guide to treatment to enable effective prevention and quality care.


Assuntos
Pé Diabético/diagnóstico , Pé Diabético/terapia , Programas de Rastreamento/normas , Cicatrização/fisiologia , Diagnóstico Precoce , Educação Médica Continuada , Feminino , Doenças do Pé/diagnóstico , Doenças do Pé/terapia , Humanos , Masculino , Projetos Piloto , Guias de Prática Clínica como Assunto , Reprodutibilidade dos Testes , Fatores de Tempo
15.
Prev Vet Med ; 171: 104767, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31518830

RESUMO

Foot lesions causing lameness in dairy cows have been demonstrated to adversely affect milk yield, reproductive performance and longevity, resulting in significant economic burden to individual dairy farmers and the dairy industry. Further, foot lesions compromise dairy cow welfare. Despite this knowledge, foot lesions remain a large problem in many dairy herds woldwide. Therefore, there is potential for dairy farmers to make changes to their current management practices of foot lesions. This study used the social-psychology framework, the Theory of Planned Behavior (TPB), to explore dairy farmers' intentions to make improvements to their current management practices of foot lesions in their dairy cows and to identify the underlying behavioral, normative and control beliefs facilitating and constraining this behavior. In accordance with the theoretical framework, Australian dairy farmers were invited to participate in an online questionnaire which included questions regarding intentions, attitudes, subjective norms and perceived behavioral control. Fifty-six dairy farmers completed the questionnaire. The overall intention of these dairy farmers to make improvements to their management practices of foot lesions in the next year was moderate. Dairy farmers believed improving their current management practices of foot lesions would improve animal welfare, increase milk production and was worth the cost involved (behavioral beliefs). They indicated that the opinions of consumers, staff, and animal welfare groups were important in their decision to make improvements (normative beliefs). Better equipment and facilities, improved knowledge and training, and a favorable cost-benefit ratio were perceived as factors that would enable dairy farmers to improve their management practices (control beliefs). While all of these beliefs may be considered as potential drivers to facilitate dairy farmers to change their management practices, the behavioral beliefs were identified as the priority beliefs that industry should target in the development of strategies to increase dairy farmer intentions to make improvements to their management practices of foot lesions.


Assuntos
Doenças dos Bovinos/psicologia , Fazendeiros/psicologia , Doenças do Pé/psicologia , Doenças do Pé/veterinária , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Idoso , Criação de Animais Domésticos/métodos , Animais , Austrália/epidemiologia , Bovinos , Doenças dos Bovinos/terapia , Indústria de Laticínios , Feminino , Doenças do Pé/complicações , Doenças do Pé/terapia , Humanos , Intenção , Coxeadura Animal/complicações , Coxeadura Animal/epidemiologia , Coxeadura Animal/psicologia , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
17.
Iowa Orthop J ; 39(1): 45-49, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31413673

RESUMO

Background: Initial management of symptomatic accessory navicular in pediatric patients is nonoperative. However, efficacy of nonoperative treatment has not been studied or established. If nonoperative treatment is frequently unsuccessful or does not give lasting pain relief, surgery could be offered as first line treatment. This study retrospectively reviewed outcomes of pediatric patients treated nonoperatively for symptomatic accessory naviculae in an effort to provide clinicians success rates for their discussion of treatment options with patients and their families. Methods: A retrospective analysis of pediatric patients diagnosed and treated nonoperatively for a symptomatic accessory navicular bone at Cincinnati Children's Hospital Medical Center between dates August 1st, 2006 and August 24th, 2016 was performed. Outcome measures consisted of complete pain relief, partial relief without operative intervention, or need for operative intervention. Radiographic imaging for each patient was also used to identify the type of accessory navicular and presence of concurrent pes planus. Results: A total of 169 patients were included, with 226 symptomatic accessory naviculae. Average age at diagnosis was 11.8 years, with majority females (78%). Type 2 accessory naviculae were most frequent (72.7%), with Type 1 and Type 3 in 9.7% and 17.4%, respectively. Average number of nonoperative trials was 2.1, with 28% experiencing complete pain relief, 30% requiring surgical intervention, and 41% that experienced partial pain relief and did not require surgical intervention, and were recommended as needed (PRN) follow-up based on clinical improvement. Of those that achieved complete pain relief, the average length of non-operative treatment was 8.0 months. Conclusions: The results of this study can be used by clinicians to frame discussions surrounding treatment options for symptomatic accessory navicular bones with both patients and their families.Level of Evidence: III.


Assuntos
Tratamento Conservador/métodos , Deformidades Congênitas do Pé/terapia , Doenças do Pé/diagnóstico por imagem , Doenças do Pé/terapia , Ossos do Tarso/anormalidades , Adolescente , Fatores Etários , Criança , Estudos de Coortes , Feminino , Seguimentos , Deformidades Congênitas do Pé/diagnóstico por imagem , Hospitais Pediátricos , Humanos , Masculino , Ohio , Medição da Dor , Radiografia/métodos , Estudos Retrospectivos , Medição de Risco , Fatores Sexuais , Ossos do Tarso/diagnóstico por imagem , Resultado do Tratamento
18.
Vet Dermatol ; 30(5): 371-e109, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31407840

RESUMO

BACKGROUND: Interdigital pyoderma is a common multifactorial, inflammatory disease of the canine interdigital skin. Lesions commonly become infected secondarily. In addition to management of the underlying cause, management of the chronic inflammatory changes in the interdigital skin created by secondary infection and by the release of keratin into deep tissues is required. Fluorescence biomodulation appears to modulate the inflammatory process in dermatological disorders and has shown promise in preliminary studies evaluating its use in superficial and deep pyoderma in dogs. HYPOTHESIS/OBJECTIVES: To evaluate the effect of a fluorescence biomodulation (FB) system used in conjunction with systemic antibiotic on clinical manifestations of canine interdigital pyoderma (CIP), compared to dogs treated with antibiotic alone. ANIMALS: Thirty-six dogs diagnosed with CIP. METHODS AND MATERIALS: Dogs were randomly allocated to treatment groups of either antibiotic alone (Group A) or antibiotic plus twice-weekly FB application (Group B). Dogs were scored over a 12 week period on the basis of two measured parameters: a global lesion score composed of four different lesions types and neutrophil engulfing bacterial scores. RESULTS: A statistically significant decrease was seen by Week 3 in both measured parameters for Group B compared to Group A. The mean time-to-resolution of lesions was 4.3 weeks in Group B and 10.4 weeks in Group A. CONCLUSION AND CLINICAL IMPORTANCE: The FB system shows promise as an adjunct therapy to systemic antibiotic use in the management of CIP.


Assuntos
Doenças do Cão/terapia , Doenças do Pé/veterinária , Terapia com Luz de Baixa Intensidade/veterinária , Pioderma/veterinária , Animais , Antibacterianos/uso terapêutico , Cefalexina/uso terapêutico , Cães , Doenças do Pé/terapia , Pioderma/terapia , Pele/patologia
19.
Trials ; 20(1): 480, 2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31391104

RESUMO

BACKGROUND: Heel pain is a common foot disorder that causes pain and functional limitations. The prevalence of disabling foot pain will increase as the population ages. Previous studies have reported the positive therapeutic effects of electroacupuncture, warm needling, or the combination of both for heel pain but with limitations in the study methodologies. The current study is a rigorously designed randomized controlled trial that aims to evaluate the clinical efficacy and safety of electroacupuncture plus warm needling therapy in patients with heel pain. METHODS/DESIGN: The study protocol describes a prospective, open-label, parallel-group, randomized controlled trial to be conducted in Hong Kong. Eighty patients aged 50-80 years who have reported heel pain and first-step pain equal to or exceeding 50 mm on the 100-mm visual analog scale (VAS) will be recruited. They will be randomly assigned (1:1 ratio) to the electroacupuncture plus warm needling therapy (i.e., treatment) group or the waitlist (i.e., control) group. The treatment group will undergo six treatment sessions in 4 weeks. The control group will receive no treatment during the study period. The primary outcome measure is a mean change in the first-step pain VAS score from the baseline to week 4. Secondary outcome measures include a mean change in first-step pain VAS score from the baseline to week 2, a mean change in Foot Function Index (FFI) subscale scores and the total score from the baseline to week 2 and week 4, and patients' self-reported level of improvement at week 4. Additional week 8 follow-up assessments with first-step pain VAS and FFI measurements will be arranged for the treatment group. Any adverse events will be recorded throughout the study to evaluate safety. An intention-to-treat approach will be used to analyze the study results. DISCUSSION: This study will provide evidence on the efficacy and safety of electroacupuncture plus warm needling therapy as an alternative treatment method for heel pain. The findings will determine whether the treatment protocol is efficacious in relieving pain and improving foot function among older adults with heel pain. The study will also provide information for subsequent large-scale randomized controlled trials in the future. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR1800014906 . Registered on 12 February 2018.


Assuntos
Terapia por Acupuntura , Eletroacupuntura , Doenças do Pé/terapia , Manejo da Dor/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Terapia por Acupuntura/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Eletroacupuntura/efeitos adversos , Calcanhar , Humanos , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Estudos Prospectivos , Projetos de Pesquisa
20.
J Foot Ankle Res ; 12: 36, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31312257

RESUMO

Background: Multimorbidity is prevalent and adversely affects health outcomes. Foot pain is common and one of the primary reasons for utilisation of podiatry services. At present, little is known about the impact of multimorbidity on foot health and related outcomes following podiatric intervention. The aims of this study were to evaluate whether there is a difference in foot health outcomes following exposure to podiatric foot care for people with and without multimorbidity; and ii) to evaluate whether the presence or absence of multimorbidity affects patients' perceptions of change in foot pain. Methods: The PROMFoot study is a prospective cohort study of adults with a new episode of foot pain attending the podiatry service within the NHS Greater Glasgow and Clyde health board. Baseline medical comorbidity status (no condition, single condition, multiple conditions), longitudinal data on foot health measured using the Foot Health Status Questionnaire (FHSQ), and patient rating of change scores for foot pain were obtained from the PROMFoot study at baseline, and 3 and 6 months after podiatric intervention. Foot health scores (pain, function, footwear and general foot health) and perceptions of change for foot pain were compared between comorbidity groups. Results: A total of 115 participants (59% female) with a mean age of 55 years were included. Multimorbidity was common, affecting 61 participants (53%); while 28 (24.3%) and 26 (22.6%) reported single or no medical comorbidities respectively. Significantly worse foot health scores for all FHSQ domains were observed for the multimorbidity group at baseline, 3 and 6 months. Change scores for foot pain were similar between groups and demonstrate modest improvements, however multimorbidity group membership was strongly associated with a perceptions of change in foot pain. Multimorbidity was independently associated with poorer foot function outcomes at 3 months, and poorer foot pain and foot function outcomes at 6 months. Conclusions: Multimorbidity was associated with poor foot health outcomes and lower rates of self-perceived improvement in foot pain over 6 months following podiatric intervention in a sample of patients attending podiatric biomechanics clinics for a new episode of foot pain.


Assuntos
Doenças do Pé/epidemiologia , Doenças do Pé/terapia , Dor Musculoesquelética/epidemiologia , Dor Musculoesquelética/terapia , Podiatria/estatística & dados numéricos , Adulto , Feminino , Pé/patologia , Doenças do Pé/patologia , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Multimorbidade , Dor Musculoesquelética/patologia , Avaliação de Resultados em Cuidados de Saúde , Estudos Prospectivos
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