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2.
Nature ; 579(7797): 31-32, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32123361
3.
Acta Chir Orthop Traumatol Cech ; 87(1): 58-61, 2020.
Artigo em Tcheco | MEDLINE | ID: mdl-32131973

RESUMO

Congenital cleft foot is a deformity characterised by genetic heterogeneity and a high degree of phenotypic variability. This together with its very low incidence is the reason for rather controversial opinions on the treatment. The authors present a case study of a boy with unilateral cleft foot classified as type III by Blauth-Borisch and type II by Abraham et al., who underwent a surgery at the age of 12 months. The defect was closed by rectangular soft tissue flaps, the intermetatarsal ligament connecting the first metatarsal head and the third metatarsal head was reconstructed with local fibrous tissue flap. The present hypermobility with extension position of the first ray were stabilised by the Kirschner wire inserted along the axis of the first ray from the dorsum of the talus through the middle of its head to the medial chondrogenic tarsal bones and further through the first metatarsal bone and the corrected metatarsophalangeal joint of the hallux. At the age of 6 years and 7 months, due to dynamic abductovalgus foot deformity, lengthening calcaneal osteotomy was also performed. Favourable clinical and radiographic outcomes of the used surgical technique were observed by the authors. The cleft foot as such shall be treated after a thorough evaluation of the patient and his/her necessary monitoring during the childhood. Key words: ectrodactyly, cleft foot, split hand/foot malformation.


Assuntos
Hallux Valgus , Deformidades Congênitas dos Membros , Ossos do Metatarso , Articulação Metatarsofalângica , Criança , Feminino , , Hallux Valgus/cirurgia , Humanos , Deformidades Congênitas dos Membros/cirurgia , Masculino , Ossos do Metatarso/cirurgia , Articulação Metatarsofalângica/cirurgia
4.
Zhonghua Shao Shang Za Zhi ; 36(2): 131-132, 2020 Feb 20.
Artigo em Chinês | MEDLINE | ID: mdl-32114731

RESUMO

Suspension bed are often used to treat and nurse the wounds of burn patients in clinic. Because of the suspension force, the patients' activities are limited, and they stay in bed for a long time, which is very easy to cause foot drop, affecting the recovery of the patients. Aiming at this problem, we designed and made a foot drop prevention baffle made of stainless steel, which could withstand the buoyancy of the suspension bed, adjust the feet forwardly and backwardly, to the left and right according to the height of the patients and the distance of the feet to be separated, and keep the foot in a positive and external rotation position according to the comfort of the patients, which achieved good results in clinical application.


Assuntos
Neuropatias Fibulares , Queimaduras , , Humanos
5.
West Afr J Med ; 37(2): 189-196, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32150639

RESUMO

Extremity gangrene is a fairly common pathology, which complicates systemic vascular and endocrine diseases. Most often, it is encountered in diseases like uncontrolled Diabetes Mellitus, presenting as diabetic foot gangrene, severe peripheral arteriosclerosis with gangrene of the extremity complicating severe uncontrolled systemic hypertension and meningococcal septicaemia with peripheral gangrene. It also occurs in some cases of snake bite as well as frost bite (in regions with extreme cold weather conditions). Some of them present as monolateral extremity gangrene. However, others present as bilateral symmetrical peripheral gangrene (SPG) characterized by bilateral extremity ischaemia resulting in gangrene in which there is no major vascular occlusive disease. There is disseminated intravascular coagulation with the gangrene being considered as a cutaneous marker and some of the patients that survive ultimately require amputation of the affected limb(s) in the severe cases. The mild cases end up losing some of the digits or just exfoliation of the dead cutaneous layer. The effects are generally more severe in the lower limbs than in upper limbs. Notable among these are some of those complicating meningococcal sepsis resulting from peripheral intravascular coagulation. We present here, five patients who presented with varying degrees of peripheral gangrene during an epidemic of meningitis and the treatments that were carried out depending on the severity of their cases.


Assuntos
Amputação , Coagulação Intravascular Disseminada/cirurgia , Gangrena/etiologia , Meningite Meningocócica/complicações , Infecções Meningocócicas/cirurgia , Sepse/microbiologia , Coagulação Intravascular Disseminada/complicações , Coagulação Intravascular Disseminada/diagnóstico , , Gangrena/cirurgia , Humanos , Perna (Membro) , Infecções Meningocócicas/complicações , Sepse/complicações
6.
Am J Phys Med Rehabil ; 99(4): 330-337, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32195716

RESUMO

OBJECTIVE: The aims of the study were to investigate the kinetic effects of sit-to-stand training in various foot positions on the coronal plane in patients with strokes and to suggest appropriate exercises. DESIGN: Thirty-six poststroke subjects participated in this study. The subjects performed three sit-to-stand trials in the following foot positions: (a) symmetric foot positioning (symmetric), (b) affected foot placed to the side (asymmetric 1), and (c) and less affected foot placed to the side (asymmetric 2). They were asked to perform sit-to-stand training at a spontaneous velocity and remain standing for 5 secs, whereas the vertical ground reaction force was measured using force platforms. The activation of lower limb muscles was evaluated using surface electromyography, and the peak and mean vertical ground reaction force and weight-bearing symmetry ratio were evaluated using force platforms. RESULTS: Our results showed significant increases in the muscle activation, peak and mean vertical ground reaction force, and weight-bearing symmetry ratio of the lower limbs using the asymmetric 2 strategy (P < 0.05). CONCLUSIONS: Our results suggest that sit-to-stand training with the less affected foot placed to the side by the width of the subject's foot may be the most beneficial in the rehabilitation of patients with hemiparetic stroke.


Assuntos
Hemiplegia/reabilitação , Posicionamento do Paciente/métodos , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/fisiopatologia , Eletromiografia , Feminino , Pé/fisiopatologia , Hemiplegia/etiologia , Hemiplegia/fisiopatologia , Humanos , Cinética , Extremidade Inferior/fisiopatologia , Masculino , Pessoa de Meia-Idade , Postura , Acidente Vascular Cerebral/complicações , Suporte de Carga
7.
Nature ; 579(7797): 97-100, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32103182

RESUMO

The stiff human foot enables an efficient push-off when walking or running, and was critical for the evolution of bipedalism1-6. The uniquely arched morphology of the human midfoot is thought to stiffen it5-9, whereas other primates have flat feet that bend severely in the midfoot7,10,11. However, the relationship between midfoot geometry and stiffness remains debated in foot biomechanics12,13, podiatry14,15 and palaeontology4-6. These debates centre on the medial longitudinal arch5,6 and have not considered whether stiffness is affected by the second, transverse tarsal arch of the human foot16. Here we show that the transverse tarsal arch, acting through the inter-metatarsal tissues, is responsible for more than 40% of the longitudinal stiffness of the foot. The underlying principle resembles a floppy currency note that stiffens considerably when it curls transversally. We derive a dimensionless curvature parameter that governs the stiffness contribution of the transverse tarsal arch, demonstrate its predictive power using mechanical models of the foot and find its skeletal correlate in hominin feet. In the foot, the material properties of the inter-metatarsal tissues and the mobility of the metatarsals may additionally influence the longitudinal stiffness of the foot and thus the curvature-stiffness relationship of the transverse tarsal arch. By analysing fossils, we track the evolution of the curvature parameter among extinct hominins and show that a human-like transverse arch was a key step in the evolution of human bipedalism that predates the genus Homo by at least 1.5 million years. This renewed understanding of the foot may improve the clinical treatment of flatfoot disorders, the design of robotic feet and the study of foot function in locomotion.


Assuntos
Evolução Biológica , Fenômenos Biomecânicos , Pé/anatomia & histologia , Pé/fisiologia , Testes de Dureza , Animais , Cadáver , Extinção Biológica , Feminino , Pé/fisiopatologia , Hominidae/anatomia & histologia , Hominidae/fisiologia , Humanos , Pessoa de Meia-Idade , Pan troglodytes/anatomia & histologia , Pan troglodytes/fisiologia , Maleabilidade , Pé Cavo/fisiopatologia
8.
Medicine (Baltimore) ; 99(8): e19110, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32080084

RESUMO

BACKGROUND: Cold hypersensitivity in the hands and feet (CHHF) is a common complaint in Asian female population especially in Korea. Due to the symptoms of CHHF the quality of individual's daily life can be degraded. Ucha-Shinki-Hwan (UCHA) is widely used in the treatment of various diseases including CHHF by harmonizing Yin and Yang, and improving the vitality of whole body. However, the efficacy of UCHA as a treatment option of CHHF has not been assessed in trials. Thus, we aimed to investigate the efficacy and safety of UCHA in Korean women with CHHF through this trial. METHODS: This study will be an exploratory, randomized, double-blind, placebo-controlled, parallel-group, multicenter trial. Korean women aged 19 to 59 years who complaint with CHHF will be enrolled from 5 university affiliated Korean medicine hospitals. A total of 164 subjects will be randomly assigned to a treatment group (UCHA) or a placebo group at a 1:1 ratio. The subjects will receive 2.5 g of either UCHA or placebo three times a day for 8 weeks. The primary outcome will be evaluated with the visual analog scale score of CHHF. The secondary outcome measures will be changes in skin temperature in extremities as measured by using a thermometer and the Korean version of the World Health Organization Quality of Life Scale Abbreviated Version. DISCUSSION: This study will be the first trial to explore the efficacy and safety of UCHA for CHHF patient. This will provide meaningful clinical information on herbal medicine treatment of CHHF and a clinical evidence for planning a full randomized clinical trial. DISCLOSURES AND ACKNOWLEDGMENTS: The authors report no competing interests. TRIAL REGISTRATION: This study is registered at ClinicalTrials.gov, ID: NCT03790033. Registered on (31 December 2018) PROTOCOL VERSION:: The final approved version of the trial protocol is V1.3. (25 January 2019).


Assuntos
Síndromes Periódicas Associadas à Criopirina/tratamento farmacológico , Síndromes Periódicas Associadas à Criopirina/epidemiologia , Medicina Herbária/métodos , Temperatura Cutânea/efeitos dos fármacos , Adulto , Síndromes Periódicas Associadas à Criopirina/psicologia , Método Duplo-Cego , Feminino , Pé/fisiopatologia , Mãos/fisiopatologia , Humanos , Medicina Tradicional Coreana/métodos , Pessoa de Meia-Idade , Fitoterapia/métodos , Placebos/administração & dosagem , Qualidade de Vida , República da Coreia/epidemiologia , Temperatura Cutânea/fisiologia , Escala Visual Analógica
9.
J Physiol Anthropol ; 39(1): 3, 2020 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-32059744

RESUMO

BACKGROUND: Car accidents due to unexpected forward or backward runaway by older drivers are a serious social problem. Although the cause of these accidents is often attributed to stepping on the accelerator instead of the brake, it is difficult to induce such pedal application errors systematically with usual drive simulators. We developed a simple personal computer system that induces the pedal errors, and investigate the effects of age on the error behaviors. METHODS: The system consisted of a laptop computer and a three-pedal foot mouse. It measured response time, accuracy, and flexibility of pedal operation to visual stimuli. The system displayed two open circles on the computer display, lighting one of the circles in a random order and interval. Subjects were instructed to press the foot pedal with their right foot as quickly as possible when the circle was lit; the ipsilateral pedal to the lit circle in a parallel mode and the contralateral pedal in a cross mode. When the correct pedal was pressed, the light went off immediately, but when the wrong pedal was pressed, the buzzer sounded and the light remained on until the correct pedal was pressed. During a 6-min trial, the mode was switched between parallel and cross every 2 min. During the cross mode, a cross mark appears on the display. The pedal responses were evaluated in 52 subjects divided into young (20-29 years), middle-aged (30-64 years), and older (65-84 years) groups. Additionally, the repeatability of the pedal response characteristic indicators was examined in 14 subjects who performed this test twice. RESULTS: The mean response time was 95 ms (17%) longer in the older group than in the young group. More characteristically, however, the older group showed 2.1 times more frequent pedal errors, fell into long hesitations (response freezing > 3 s) 16 times more often, and took 1.8 times longer period to correct the wrong pedal than the young groups. The indicators of pedal response characteristics showed within-individual repeatability to the extent that can identify the age-dependent changes. CONCLUSIONS: Hesitations and extended error correction time can be associated with increased crash risk due to unexpected runaway by older drivers. The system we have developed may help to uncover and evaluate physiological characteristics related to crash risk in the elderly population.


Assuntos
Envelhecimento/fisiologia , Condução de Veículo , Pé/fisiologia , Tempo de Reação/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Simulação por Computador , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
10.
Bone Joint J ; 102-B(2): 205-211, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32009424

RESUMO

AIMS: To evaluate the donor site morbidity and tendon morphology after harvesting whole length, full-thickness peroneus longus tendon (PLT) proximal to the lateral malleolus for ligament reconstructions or tendon transfer. METHODS: A total of 21 eligible patients (mean age 34.0 years (standard deviation (SD) 11.2); mean follow-up period 31.8 months (SD 7.7), and 12 healthy controls (mean age, 26.8 years (SD 5.9) were included. For patients, clinical evaluation of the donor ankle was performed preoperatively and postoperatively. Square hop test, ankle strength assessment, and MRI of distal calf were assessed bilaterally in the final follow-up. The morphological symmetry of peroneal tendons bilaterally was evaluated by MRI in healthy controls. RESULTS: Among the patients, the mean pre- and postoperative American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score and Karlsson-Peterson score were 98.7 (SD 2.5; p = 0.480) and 98.5 (SD 2.4; p = 0.480), and 98.3 (SD 2.4; p = 0.162) and 97.9 (SD 2.5; p = 0.162), respectively. There was no significant difference between square hop test bilaterally (p = 0.109) and plantar flexion peak force bilaterally (p = 0.371). The harvested limb had significantly less eversion peak force compared to the contralateral limb (p < 0.001). Evidence of probable tendon regeneration was observed in all the patients by MRI and the total bilateral peroneal tendon index (mean ratio of harvested side cross-sectional area of peroneal tendon compared with the contralateral side) was 82.9% (SD 17.4). In 12 healthy controls, peroneal tendons (mean 99.4% (SD 4.3) were found to be morphologically symmetrical between the two sides. CONCLUSION: The current study showed satisfactory clinical foot and ankle outcomes after full-thickness PLT harvesting and indicated the regenerative potential of PLT after its removal. Level of Evidence: Level IV, therapeutic retrospective case series. Cite this article: Bone Joint J 2020;102-B(2):205-211.


Assuntos
Articulação do Tornozelo/fisiopatologia , Tornozelo/fisiopatologia , Pé/fisiopatologia , Ligamentos Articulares/fisiopatologia , Tendões/transplante , Sítio Doador de Transplante/fisiopatologia , Adulto , Tornozelo/diagnóstico por imagem , Articulação do Tornozelo/diagnóstico por imagem , Feminino , Pé/diagnóstico por imagem , Humanos , Ligamentos Articulares/cirurgia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Reconstrutivos , Recuperação de Função Fisiológica , Regeneração , Estudos Retrospectivos , Transferência Tendinosa , Tendões/diagnóstico por imagem , Tendões/fisiologia , Coleta de Tecidos e Órgãos/métodos , Coleta de Tecidos e Órgãos/reabilitação , Sítio Doador de Transplante/diagnóstico por imagem , Transplante Autólogo , Resultado do Tratamento , Adulto Jovem
11.
Instr Course Lect ; 69: 509-522, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32017749

RESUMO

Numerous nerve disorders affect the foot and ankle, and specificity is essential for diagnosis. We review a systematic process to conduct a history and physical examination for nerve disorders and how to categorize these pathologies. Several common nerve-related pathologies of the foot and ankle are then described. Finally, we discuss systemic neurologic conditions which can cause symptoms in the foot and ankle. A vast array of treatment options exist for painful nerve lesions of the foot: both nonsurgical and surgical. Treatment options depend on the affected nerve's function and location within the foot. Essential nerves will be managed much differently than nonessential nerves. Also important to consider is whether this is the initial treatment, treatment following one recurrence, or treatment following multiple recurrences. After the proper diagnosis is made, consideration of these principles should allow for early and effective interventions to be made. Recalcitrant nerve conditions of the foot and ankle can represent a management challenge. As with primary nerve disorders, surgical management is warranted in cases where conservative management fails. Furthermore, patients may continue to experience neurologic complications or recurrence of symptoms even after surgical intervention, at which point further surgical procedures may be undertaken. Neurolysis, transection with or without containment, barrier procedures, and peripheral nerve stimulation are viable potential surgical options for patients with chronic or recurrent nerve pain, depending upon patient-specific underlying pathology.


Assuntos
Tornozelo , , Neuralgia/terapia , Articulação do Tornozelo , Humanos , Exame Físico
12.
BMC Infect Dis ; 20(1): 23, 2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31914940

RESUMO

BACKGROUND: The prevalence of diabetes mellitus continues to inexorably rise in the United States and throughout the world. Lower limb amputations are a devastating comorbid complication of diabetes mellitus. Osteomyelitis increases the risk of amputation fourfold and commonly presages death. Antimicrobial therapy for diabetic foot osteomyelitis (DFO) varies greatly, indicating that high quality data are needed to inform clinical decision making. Several small trials have indicated that the addition of rifampin to backbone antimicrobial regimens for osteomyelitis outside the setting of the diabetic foot results in 28 to 42% higher cure rates. METHODS/DESIGN: This is a prospective, randomized, double-blind investigation of the addition of 6 weeks of rifampin, 600 mg daily, vs. matched placebo (riboflavin) to standard-of-care, backbone antimicrobial therapy for DFO. The study population are patients enrolled in Veteran Health Administration (VHA), ages ≥18 and ≤ 89 years with diabetes mellitus and definite or probable osteomyelitis of the foot for whom an extended course of oral or intravenous antibiotics is planned. The primary endpoint is amputation-free survival. The primary hypothesis is that using rifampin as adjunctive therapy will lower the hazard rate compared with the group that does not use rifampin as adjunctive therapy. The primary hypothesis will be tested by means of a two-sided log-rank test with a 5% significance level. The test has 90% power to detect a hazard ratio of 0.67 or lower with a total of 880 study participants followed on average for 1.8 years. DISCUSSION: VA INTREPID will test if a rifampin-adjunctive antibiotic regimen increases amputation-free survival in patients seeking care in the VHA with DFO. A positive finding and its adoption by clinicians would reduce lower extremity amputations and their associated physical and emotional impact and reduce mortality for Veterans and for the general population with diabetic foot osteomyelitis. Given that rifampin-adjunctive regimens are currently employed for therapy for the majority of DFO cases in Europe, and only in a small minority of cases in the United States, the trial results will impact therapeutic decisions, even if the null hypothesis is not rejected. TRIAL REGISTRATION: Registered January 6, 2017 at ClinicalTrials.gov, NCT03012529.


Assuntos
Amputação , Pé Diabético/tratamento farmacológico , Osteomielite/tratamento farmacológico , Rifampina/uso terapêutico , Veteranos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Amputação/estatística & dados numéricos , Antibacterianos/uso terapêutico , Antibioticoprofilaxia , Pé Diabético/complicações , Pé Diabético/epidemiologia , Pé Diabético/cirurgia , Método Duplo-Cego , Feminino , Pé/microbiologia , Pé/patologia , Pé/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Osteomielite/complicações , Osteomielite/epidemiologia , Osteomielite/cirurgia , Placebos , Estudos Prospectivos , Prevenção Secundária/métodos , Veteranos/estatística & dados numéricos , Adulto Jovem
13.
Oper Orthop Traumatol ; 32(1): 29-34, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-31940050

RESUMO

OBJECTIVE: The so-called ankle block represents a local anesthesia form which enables easy performance of all surgical procedures of the foot and ankle. INDICATIONS: Interventions distal to the medial and lateral malleoli. CONTRAINDICATIONS: Acute and chronic infections in the area of injection; allergy to the local anesthesia. SURGICAL TECHNIQUE: All five sensory foot nerves are blocked. The two deep lying nerves, the tibial nerve and the deep fibular nerve, can be directly anesthetized perineurally using anatomical landmarks. The other three nerves are subcutaneously infiltrated near their branches. RESULTS: The success rate ranges from 88 to 94%; smaller areas may also be further blocked intraoperatively. The ankle block is a cost-effective procedure which can also be performed without problems in multimorbid patients due to its minor side effects.


Assuntos
Tornozelo , Bloqueio Nervoso , Tornozelo/inervação , Tornozelo/cirurgia , , Humanos , Nervo Tibial , Resultado do Tratamento
14.
Adv Clin Exp Med ; 29(1): 157-163, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31990461

RESUMO

Palmoplantar pustulosis (PPP) is a chronic inflammatory disease, most often occurring in middle-aged women. In the course of the condition, painful skin lesions appear on the hands and feet, i.e., areas that are extremely important in everyday life. Therefore, the disease significantly reduces quality of life. The pathogenesis of this disease is poorly understood, although it is known that genetic, immunological and environmental factors play a role in its development. Clinical observations confirm the role of nicotine and contact allergens in the development of the lesions. The skin lesions can also occur as a side effect of certain medications. In some cases, PPP coexists with other diseases, i.e., seronegative arthropathies, as well as celiac and thyroid diseases. There is also a connection between the disease and infectious bacterial foci. Exacerbation of the skin lesions is triggered by stress. Therefore, patients require multidirectional tests, since finding the cause of the disease is essential to administering effective treatment.


Assuntos
Psoríase , Doenças da Glândula Tireoide , Doença Crônica , Feminino , Pé/patologia , Mãos/patologia , Humanos , Pessoa de Meia-Idade , Psoríase/complicações , Psoríase/diagnóstico , Psoríase/terapia , Qualidade de Vida , Doenças da Glândula Tireoide/complicações , Doenças da Glândula Tireoide/diagnóstico , Doenças da Glândula Tireoide/terapia
16.
PLoS One ; 15(1): e0228016, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31999749

RESUMO

The taxonomy of foot shapes or other parts of the body is important, especially for design purposes. We propose a methodology based on archetypoid analysis (ADA) that overcomes the weaknesses of previous methodologies used to establish typologies. ADA is an objective, data-driven methodology that seeks extreme patterns, the archetypal profiles in the data. ADA also explains the data as percentages of the archetypal patterns, which makes this technique understandable and accessible even for non-experts. Clustering techniques are usually considered for establishing taxonomies, but we will show that finding the purest or most extreme patterns is more appropriate than using the central points returned by clustering techniques. We apply the methodology to an anthropometric database of 775 3D right foot scans representing the Spanish adult female and male population for footwear design. Each foot is described by a 5626 × 3 configuration matrix of landmarks. No multivariate features are used for establishing the taxonomy, but all the information gathered from the 3D scanning is employed. We use ADA for shapes described by landmarks. Women's and men's feet are analyzed separately. We have analyzed 3 archetypal feet for both men and women. These archetypal feet could not have been recovered using multivariate techniques.


Assuntos
Pontos de Referência Anatômicos , Análise de Dados , Pé/anatomia & histologia , Idoso , Feminino , Humanos , Masculino
17.
Medicine (Baltimore) ; 99(4): e18849, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31977883

RESUMO

BACKGROUND: Molecular targeted anticancer drugs such as multikinase inhibitors have shown obvious therapeutic advantages in a variety of tumors. The occurrence of hand-foot skin reaction (HFSR) is positively correlated with therapeutic effect, but it is also the most common cause of dose limiting toxicity for this treatment. This can lead to interruption or decrement of the treatment, a reduction in quality of life for patients, as well as potentially leading to secondary infections. As a result, the curative effect of targeted anticancer drugs will be negatively impacted. Currently, there is no certain and effective therapy. External use of Chinese herb medicine LC09 in the early treatment of HFSR has shown positive outcomes, but it is necessary to carry out further clinical research to confirm. OBJECTIVES: The purpose of this study was to investigate the efficacy and safety of topical soaks of Chinese herbal medicine LC09 for HFSR induced by molecular targeted anticancer drugs. METHODS: The trial is a prospective, randomized, controlled, double-blind, monocentric, and interventional study. A total of 66 patients with HFSR will be recruited and randomly assigned to receive either LC09 Granules or placebo. The primary outcomes are the assessment of HFSR grade and pain score. The secondary outcomes are the evaluation of the quality of life, incidence of targeted drug dosage reduction, and incidence of targeted drug withdrawal. DISCUSSION: This prospective, randomized clinical trial will provide valuable data regarding the efficacy and safety of topical soak treatments with LC09 granules for HFSR. Positive results would provide evidence-based complementary therapeutic approach future treatments of HFSR. TRIAL REGISTRATION: Chinese Clinical Trial Registry, http://www.chictr.org.cn, ChiCTR1900023679. Registered on 7 June 2019.


Assuntos
Antineoplásicos/efeitos adversos , Medicamentos de Ervas Chinesas/administração & dosagem , Dermatopatias/induzido quimicamente , Dermatopatias/tratamento farmacológico , Banhos , Método Duplo-Cego , , Mãos , Humanos , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
18.
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
20.
Unfallchirurg ; 123(Suppl 1): 20-24, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30993359

RESUMO

Young individuals with chronic exercise-induced lower leg pain (ELP) who have normal compartmental muscle pressures and normal imaging occasionally suffer from a nerve entrapment syndrome. These patients have consistently undergone a variety of diagnostic tests and often futile therapies prior to arriving at the correct diagnosis. Awareness among traumatologists regarding these nerve entities is low. A lower leg discomfort that is frequently present at night but worsens during exercise combined with altered foot skin sensations suggests an entrapment of the common peroneal or tibial nerve. If conservative therapies fail, neurolysis is advised.


Assuntos
Dor Crônica , Perna (Membro) , Síndromes de Compressão Nervosa , Nervo Fibular , Nervo Tibial , , Humanos
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