The Foot Blog News-October 2007
Amputation in Military Trauma Surgery
A recent report in The Journal of Trauma reviews the published historic and modern battle casualty information undertaken in the collections of the medical library of the National Naval Medical Center and the National Library of Medicine, both in Bethesda, Maryland, and the University of Maryland Health Sciences Center in Baltimore, Maryland. It reports the potential utility of major limb amputation as a life-saving surgical intervention for compound fractures and other devastating limb injuries has been recognized through much of written human history. However, the advent of gunpowder onto the battlefields of Europe in the 14th century forced surgeons to solve the problems of, first, hemorrhage and then, as casualties survived the initial surgery, sepsis for amputation to actually improve outcomes. In the latter half of the 20th century, rapid evacuation from the battlefield and successful neurovascular repair has reduced the need for major limb amputations essentially for those required by insurmountable tissue loss. The article concludes that major limb amputation remains a fearsome outcome of limb injury. However, during the last 500 years, military trauma surgeons have solved the problems of bleeding, infection, and neurovascular repair after major limb injury such that amputation rates even during times of active military conflict are at historic lows.
Simple Foot Stomping, In-line Dancing and Squats may help reduce Osteoporosis in Post-Menopausal Women
The journal Osteoporosis International reports that a simple, appealing, physical activity program can be prescribed to reduce the risk of falls in sedentary, postmenopausal, independent-living, Caucasian women. Foot stamping, progressively loaded squats, and in-line dancing positively influence proximal femoral bone mineral density, lower extremity strength, and static and dynamic balance.
You Can’t Judge a Running Shoe by Its Price Tag
Medpage Today-DUNDEE, Scotland, Oct. 10 — Lower-cost running shoes provide as good or better protection for the foot as high-priced shoes, according to investigators here.Plantar pressure measured using a specially designed insole was not significantly different when wearing shoes that cost less than $100 than it was with shoes that cost more than $150, said Rami J. Abboud, M.D., of the Institute of Motion Analysis and Research at Ninewells Hospital and Medical School here, and colleagues. The results, based on a study of 52 healthy male volunteers who tested low-, medium-, and high-cost running shoes, were published online today by the British Journal of Sports Medicine..
A Potential Leg Up For Diabetes Patients
MNT-Disease of and injury to the feet and lower legs is a lifelong concern for diabetes patients. They are twice as likely to suffer from these conditions as non-diabetic patients. These problems also affect 30 percent of patients dealing with diabetes who are over the age of 40.However, new research offers more hope for effective treatment of lower extremity disease, as well as prevention of the condition. “What’s New in Orthopaedic Rehabilitation,” a paper published in the October, 2007 issue of The Journal of Bone and Joint Surgery , reviews some of these discoveries, as well as other innovations on the horizon in the field of orthopaedic surgery.
Grow new arteries to banish leg pains
Daily Mail-An injection that stimulates the body to grow new blood vessels could be a new treatment for peripheral artery disease (PAD).The condition, caused by a build-up of fat in the arteries, prevents oxygenated blood reaching the kidneys, stomach, arms, legs and feet.It is estimated that, in the UK, 2.7 million people aged over 55 have some degree of PAD. In about half, there are no obvious symptoms and the first indication of arterial disease may be a heart attack or stroke – others suffer from chronic, severe cramping and fatigue in the leg.Current treatments include painkillers, drugs such as aspirin and clopidogrel to help prevent blood clots, and calcium channel blockers which help to dilate the arteries.Non-drug treatments range from exercise to angioplasty – where a balloon is inflated to widen the blood vessels — and bypass surgery.In the new treatment, doctors strip out a short section of vein from the patient’s arm under local anaesthetic. Then they remove cells from the vein tissue and mix these cells with genes that help trigger growth of new blood vessels.
Finally, the solution is injected into the patient’s legs in the area immediately around the blocked arteries. Researchers say that over the following four weeks, the cells expand to form new arteries which grow around the blockage and improve blood flow.
The technique is based on a natural process known as arteriogenesis or collateral artery growth, in which the body can grow new arteries to bypass a blockage. The aim of the new symptoms and the first indication treatment, which is being given to the first PAD patients in a clinical trial, is both to trigger and speed up that process.
Animal studies have already shown the therapy to be highly effective.
In the trial at Michigan and Pennsylvania universities, the first patients to have the new treatment have had symptoms of PAD for at least two months. The patients have one injection and the effect is expected to be apparent within four weeks.
.
Rotigotine Transdermal System Shows Significant Symptom Reduction And Tolerability In Patients With Restless Legs Syndrome
MNT-UCB, Inc. presented results from two Phase III pivotal trials and one open-label extension trial of rotigotine transdermal system for the treatment of moderate-to-severe restless legs syndrome (RLS). These rotigotine data showed significant drops in RLS symptoms, including changes of up to 8 points over placebo using the International Restless Legs Syndrome Study Group Rating Scale (IRLS) and a reduction in disease severity over a two-year period.”Given the strong efficacy and tolerability seen to date, rotigotine, if approved, would provide a new and valuable alternative for many patients negatively impacted by the symptoms of moderate-to-severe RLS,” said Wayne Hening, M.D., a lead study investigator and Assistant Clinical Professor of Neurology at the Robert Wood Johnson Medical School.
More than a pain in the foot?
Fox News-Foot pain can mean a lot more than the usual aches from a long walk or standing on the feet all day.Some foot pains, particularly those that persist for more than a couple of days, even weeks, can be early signs of vascular disease, diabetes, even cancer, according to podiatrists, and should not be overlooked. Dr. Jennifer Fung-Schwartz, podiatrist at the Cabrini Medical Center in New York and spokeswoman for the American Podiatric Medical Association (APMA), said that retailers or other people who may spend all day on their feet at work will usually have foot pain because the muscles may be worn or they may not be getting the right support in their footwear. But the pain should not be taken for granted and checked by a doctor, especially if pains persist, because it could be something serious, she said.
Tips to Avoid Foot Pain From High Heels
WebMD-Do the most important men in your life — and the shoe boxes in your closet — bear the names Manolo, Jimmy C, Enzo, and Stevie M? If so, then there’s a good chance high heels are a part of your life. But unlike Carrie Bradshaw in TV’s Sex and the City — who chased men, taxis, and sometimes a dog in the park while teetering on 4-inch stilettos — high-heeled life in the real world can be a killer.”Women do love their high heels, but if you wear them all the time, significant foot pain and other problems can ensue, either as a direct result of the heels or exacerbated by them,” says Morris Morin, DPM, director of podiatric medicine at the Hackensack University Medical Center.
New Data Show Ceftobiprole as Effective as Combination Therapy in Treating Patients with Diabetic Foot Infections
HSMN- RARITAN, N.J., Oct. 8 (HSMN NewsFeed) — Johnson & Johnson Pharmaceutical Research & Development, L.L.C. today announced results from a Phase III trial that showed that investigational antibiotic ceftobiprole was found to clinically cure 86% of patients with diabetic foot infections — including some infections that were caused by methicillin-resistant Staphylococcus aureus (MRSA). These data were presented at the 45th annual meeting of the Infectious Disease Society of America (IDSA) in San Diego, California. Ceftobiprole is licensed from, and is being co-developed with, Basilea Pharmaceutica Ltd.
Health Tip: Even babies can have foot problems
Healthday News- New parents are understandably concerned about the health of their baby. But while worrying about hearing, eyesight and other things, they might forget the feet.The American Podiatric Medical Association warns that foot problems that flare up in adults often start in infancy. The association says parents should report anything suspicious to the family doctor. To maintain healthy feet, parents should make sure blankets are loose and allow the baby to kick. Also, be sure to change the baby’s position often because lying too long in one position can strain the legs and feet.
MacroChem Corp. has purchased the license to a treatment for diabetic foot infection
MHT- MacroChem executives report the company has exercised an option to acquire exclusive worldwide license rights for pexiganan, a novel, small peptide anti-infective, from New York City-based Genaera Corp.The terms of the license agreement call for MacroChem to pay Genaera an upfront fee of $1 million through Feb. 1, 2008. The terms also include payments of $7 million to Genaera based on the achievement of certain clinical, regulatory and other milestones of up to $35 million, as well as 10 percent royalty payments on net sales. In addition, MacroChem is expected to assume all clinical development, manufacturing and regulatory activities for pexiganan.
Data Presented Confirms The Efficacy And Value Of Rapid MRSA Detection Test, UK
MNT- The recently launched culture based rapid MRSA test demonstrates continued efficiency and reliability in the fight against Methicillin-resistant Staphyloccocus aureus (commonly referred to as MRSA), according to a UK study presented at the Infectious Diseases Society of America 45th annual meeting1. The study confirms that the 3M BacLite rapid MRSA test provides consistent, fast and accurate results as the first rapid culture test that can effectively and reliably detect the absence of MRSA in just five hours.The multi-centre study based on results from three hospitals in the United Kingdom processed 458 nasal and groin MRSA screening swabs using the 3M BacLite rapid MRSA test, a five-hour culture-based test that detects the potentially deadly bacteria direct from clinical specimens. Of the 248 nasal screening swabs analysed, results demonstrated a diagnostic sensitivity of 94.6% and a diagnostic specificity of 96.9%.
Study: diabetic neuropathy costs billions per year in lost work time
Eurekalert- DANVILLE, PA. – Workers who have diabetes with neuropathic symptoms such as numbness or tingling in feet or hands lose the equivalent of 1.4 hours a week or $3.65 billion per year in health-related lost productive time, a recent study finds.The 1.4 hours lost was more than twice the amount of lost time of diabetic workers without neuropathic symptoms. For this reason, individuals with diabetes are much more likely to be unemployed.Geisinger Center for Health Research investigators looked at 19,075 working adults, including 1,003 who were diagnosed with diabetes. Of these workers, 38% reported diabetes-related numbness or tingling in their feet or hands. When the investigators compared health-related lost productive time, it was 18% higher in diabetics with symptoms and 5% higher in diabetics without symptoms. Those with diabetes were about twice more likely than those without diabetes to be unemployed.
Varicose Veins Treated Quickly And Effectively With Next-generation Ablation Catheter
MNT- An estimated 25 million Americans-mostly women-suffer from varicose veins, and 30-something Deborah Heine was one of them. As soon as the Santa Monica mother of three would wake up each morning, she’d complain, “My feet are killing me!”After her baby was born last year, she’d tried running to get back into shape but had to stop because her feet-which ached constantly-hurt even more when she exercised.
Wright Medical Group, Inc. Announces Exclusive Agreement to Distribute the Foot and Ankle Product Line of A.M. Surgical, Inc.
THSM Network- ARLINGTON, Tenn.–(HSMN NewsFeed)–Wright Medical Group, Inc. (NASDAQ: WMGI ), a global orthopaedic medical device company, announced today that it has entered into an exclusive worldwide license and distribution agreement with A.M. Surgical, Inc., a Smithtown, New York-based company focused on providing endoscopic soft tissue release products for orthopaedic and foot and ankle surgeons.The ten-year agreement includes all of A.M. Surgical’s current and future products for the foot and ankle market. Products currently available include the A.M. Surgical foot and ankle endoscopic tissue release product line which consists of the A.M. EPF (plantar fascia release), A.M. UDIN (interdigital nerve decompression) and A.M. EGR (gastrocnemius release). These three systems address the decompression and soft tissue release procedures most commonly performed by foot and ankle surgeons. Wright will begin offering the A.M. foot and ankle tissue release systems through its U.S. sales force immediately, with expansion into the Company’s international markets occurring in 2008.
Hot Chili Peppers May Relieve Pain: Animal Study Shows Pain Relief Benefits From Anesthetic Using Chili Pepper Ingredient
WebMD- A new hot-chili-pepper-based anesthetic may offer better pain relief during childbirth, surgery, or other painful situations than conventional anesthetics.Preliminary tests of the anesthetic in rats show it effectively blocked pain without causing complete loss of movement in the targeted areas.Researchers say the experimental anesthetic works by selectively blocking pain-sensing nerve cells without disrupting other nerve cells that control movement or nonpainful sensations. If the results are confirmed in humans, the method could be used in procedures ranging from knee surgery to tooth extractions.”Eventually this method could completely transform surgical and post-surgical analgesia, allowing patients to remain fully alert without experiencing pain or paralysis,” says researcher Clifford Woolf of Massachusetts General Hospital in a news release. “In fact, the possibilities seem endless. I could even imagine using this method to treat itch, as itch-sensitive neurons fall into the same group as pain-sensing ones.”
Postoperative Pain Is An Under Appreciated, Under Treated Problem In The United States
MNT- At a time when both inadequate and overly aggressive pain management after surgery are commonplace in the United States, the American Society of PeriAnesthesia Nurses (ASPAN) has issued a 10-step action plan to address the factors that may lead to inappropriate medication use and potential adverse events for patients. ASPAN is the professional organization representing more than 55,000 nurses practicing in all phases of preanesthesia and postanesthesia.The report — The State of Postoperative Pain Management: A Need For Improvement — states that only by elevating postoperative pain management as a priority concern among health care institutions, providers and policymakers, will the significant costs of inadequate care be reduced in the United States. According to studies cited in the report, up to 75 percent of patients experience pain after surgery. However, many receive inadequate treatment, which can result in extended hospitalization, delayed healing and mobility, higher morbidity and mortality, and the development of a chronic pain state.
Ouch! Young Soccer Players Sidelined By Painful Toes
MNT- This is a bad time of year to be a juvenile toenail. Suffolk, Va. foot and ankle surgeon Matthew Dairman, DPM, FACFAS, says he sees a lot of children with ingrown toenails during fall soccer season.”It seems like every child is enrolled in a league,” says Dairman, “The young kids wear hand-me-down cleats that don’t fit exactly right. The older kids like tighter cleats to get a better feel for the ball and the field.”Dairman says these tight shoes crowd the toes together. Combine that with repetitive kicking, and you’ve got a recipe for painful ingrown toenails. Dairman can relate to his young patients. He had an ingrown toenail himself.
LegDisorders.org – Offering Healthcare Providers The Latest Practical Information On The Broad Spectrum Of Leg Disorders
MNT- Professional Postgraduate Services® (PPS), renowned for its award-winning healthcare websites, recently launched LegDisorders.org , a one-stop educational resource for healthcare providers seeking information on a variety of leg disorders. The goal of the website is to enhance competency in the recognition and management of leg disorders via evolved understanding of disease differentiation and heightened awareness of prevalence and impact on patients and society.
Diabetic Limb Slavage: Special Teams Fight Diabetic Amputations
Nation/World- WASHINGTON (AP) — A stubbed toe can lead to having your foot amputated? It can if you’re a longtime diabetic. And it can happen fast
One recommendation: For hospitals to create diabetes limb-salvage teams. It sounds simple. But it involves pairing specialists who seldom work side-by-side – like podiatrists and vascular surgeons – to shave weeks off the time it can take to get proper care for a festering foot.
Amputation and diabetes: How to protect your feet
Mayo Clinic.com- Amputation is a frightening concept. And if you have diabetes, the risk of losing a toe or foot to amputation may be more real than you think. An estimated 5 percent of adults who have diabetes eventually require toe or foot amputation. Here’s what you need to know about the link between amputation and diabetes — and how to keep your feet healthy. Why does diabetes pose a risk of amputation? Amputation and diabetes might seem like an odd pair. After all, what does amputation have to do with diabetes? Plenty!.MRSA News: Strategies To Address Antimicrobial Resistance
MNT – With extensively drug-resistant tuberculosis, life-threatening drug-resistant respiratory and skin infections, and other “bad bugs” routinely making headlines, infectious diseases physicians are applauding Rep. Jim Matheson (D-UT) and Rep. Michael Ferguson (R-NJ) for introducing H.R. 3697, the Strategies To Address Antimicrobial Resistance (STAAR) Act.”The STAAR Act has the potential to save thousands of lives,” said Martin J. Blaser, MD, past president of the Infectious Diseases Society of America (IDSA). “IDSA strongly supports the STAAR Act and the comprehensive approach that Reps. Matheson and Ferguson are taking to tackle the problem of antimicrobial resistance. Infectious diseases physicians have watched in dismay for years as the antibacterials and other antimicrobials we rely upon to treat our patients have lost their power.”Burden of diabetes care rivals disease complications
Saving Limbs May Help Save Function & Dollars
AAOS Press Release- Patients with severe lower extremity trauma may undergo successful limb reconstruction. However, some of those injuries may eventually result in amputation. Orthopaedic surgeons, patients and family members usually weigh many factors when deciding on a treatment course. A recent study published in The Journal of Bone and Joint Surgery, reported the significant differences in long term health care costs related to these two outcomes. This study highlights the need for more research on improving the ability to successfully reconstruct severely traumatized limbs.FDA Approves Lamisil For Scalp Ringworm Treatment For Children
MNT- The Food and Drug Administration (USA) has approved Lamisil for the treatment of tinea capitis (scalp ringworm) for children aged 4 or more. The medication is presented in oral granules. Children are most susceptible to tinea capitis – an infected patient can experience severe itching, dandruff and bald patches. The fungal infection does not usually respond to topical treatment – it is persistent and contagious.
October 18, 2007 at 11:05 pm
This is great. You really did a good job thanks.