Personalized Orthoses as a Good Treatment Option for Charcot Neuro-osteoarthropathy of the Foot

2014 ◽  
Vol 104 (4) ◽  
pp. 375-382 ◽  
Author(s):  
Maria Luz González Fernández ◽  
Rosario Morales Lozano ◽  
Carmen Martínez Rincón ◽  
David Martínez Hernández
Keyword(s):  
Biomechanical Testing ◽  
Therapeutic Footwear ◽  
Treatment Type ◽  
Before And After ◽  
First Ray ◽  
History Of ◽  
Ankle Mobility ◽  
Good Treatment Option ◽  
Charcot Feet ◽  
Orthotic Treatment

Background We sought to assess the biomechanical characteristics of the feet of patients with Charcot neuro-osteoarthropathy and to determine reulceration rates before and after personalized conservative orthotic treatment. Methods A longitudinal prospective study was performed in 35 patients with Charcot's foot. Although some patients had a history of ulcers, at the study outset no patient had ulcers. All of the patients underwent biomechanical testing and a radiographic study. A radiophotopodogram was prepared by superimposing an imprint of the sole on a plantar radiograph. Based on the results of these tests, an orthopedic insole was prepared and therapeutic footwear prescribed for each foot. The following variables were compared between the Charcot and unaffected feet: previous ulcers and ulcer sites, reulcerations produced after treatment, type of foot (neuropathic/neuroischemic), ankle mobility, first-ray mobility, and relaxed calcaneal stance position. Treatment efficacy was determined by comparing ulcers presenting in patients in the year leading up to the study period and the year in which treatment was received. Results In a 1-year period, 70 feet received orthotic treatment, of which 41 were Charcot's feet. Ulceration rates before the study were 73.2% in feet with Charcot's and 31.0% in those without. After 1 year of wearing the customized orthoses, rates fell significantly to 9.8% in the Charcot feet and 0% in the feet without this condition. Conclusions Conservative customized orthotic treatment was effective at preventing ulcers and the complications that often lead these patients to surgery.

Study of Diabetic Mellitus and Knowledge of Lotion Foot Care on the Community

2018 ◽  
Vol 9 (3) ◽  
Author(s):  
Hariyadi DM ◽  
Athiyah U ◽  
Hendradi E ◽  
Rosita N ◽  
Erawati T ◽  
...  
Keyword(s):  
Blood Glucose ◽  
T Test ◽  
Small Scale ◽  
Scale Production ◽  
Foot Care ◽  
Diabetic Mellitus ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Before And After ◽  
History Of

The prevention of Diabetic Mellitus (DM) and its complications is the main aim of this study, in addition to the training of lotion foot care application and the development of small scale industry. The research team delivered knowledge in the form of training on Diabetic Mellitus, healthy food, treatment and prevention of complications, and small-scale production of cosmetic products. The aim of this study was to determine the correlation between training on diabetic and lotion foot care application as preventive measures against diabetic complications on the patient's blood glucose levels in the community of residents in Banyuurip Jaya, Surabaya. It was expected from this training that the knowledge of the residents increases and people living with diabetic undergo lifestyle changes and therefore blood sugar levels can be controlled. The parameters measured in this research were blood glucose levels, the anti diabetic drug types consumed, and compliance on diabetics. This study used the data taken from 60 patients with DM over a period of one month. Questionnaires and log books was used to retrieve data and changes in blood glucose levels in diabetic patients. The results showed the demographic data of patients with type 2 diabetic of 85% female and 15% male, with the range of patients aged of 61-70 years of 46.67% and had history of diabetic (90%). The history of drugs consumed by respondents was anti diabetic drugs such as metformin (40%), glimepiride (33.37%) and insulin (6.67%). In addition, the increased knowledge of DM patients after being given the training compared to before training was shown in several questions in the questionnaire. A statistical analysis using t-test analyzed a correlation between training provided in order to enhance understanding of the patient, as well as correlation with blood glucose levels. A paired T-test showed that there was a relationship between the knowledge of trainees before and after training (p less than 0.05). An interesting result was that there was no relationship between blood glucose levels before and after training provided (p> 0.05).

The Challenges in Dealing with Organized Crime and its Consequences in Modern Societies in Albania, Kosovo and Macedonia – the Balkan Peninsula

2015 ◽  
Vol 5 (1) ◽  
pp. 161
Author(s):  
Bashkim Selmani ◽  
Bekim Maksuti
Keyword(s):  
Organized Crime ◽  
Balkan Peninsula ◽  
Human Mind ◽  
Negative Consequences ◽  
The Public ◽  
Before And After ◽  
History Of ◽  
European Standards ◽  
Organized Crime Groups ◽  
Further Development

The profound changes within the Albanian society, including Albania, Kosovo and Macedonia, before and after they proclaimed independence (in exception of Albania), with the establishment of the parliamentary system resulted in mass spread social negative consequences such as crime, drugs, prostitution, child beggars on the street etc. As a result of these occurred circumstances emerged a substantial need for changes within the legal system in order to meet and achieve the European standards or behaviors and the need for adoption of many laws imported from abroad, but without actually reading the factual situation of the psycho-economic position of the citizens and the consequences of the peoples’ occupations without proper compensation, as a remedy for the victims of war or peace in these countries. The sad truth is that the perpetrators not only weren’t sanctioned, but these regions remained an untouched haven for further development of criminal activities, be it from the public state officials through property privatization or in the private field. The organized crime groups, almost in all cases, are perceived by the human mind as “Mafia” and it is a fact that this cannot be denied easily. The widely spread term “Mafia” is mostly known around the world to define criminal organizations.The Balkan Peninsula is highly involved in these illegal groups of organized crime whose practice of criminal activities is largely extended through the Balkan countries such as Kosovo, Albania, Macedonia, Serbia, Bosnia, Croatia, Montenegro, etc. Many factors contributed to these strategic countries to be part of these types of activities. In general, some of the countries have been affected more specifically, but in all of the abovementioned countries organized crime has affected all areas of life, leaving a black mark in the history of these states.

scholarly journals Rupture Risk of Intracranial Aneurysm and Prediction of Hemorrhagic Stroke after Liver Transplant

2021 ◽  
Vol 11 (4) ◽  
pp. 445
Author(s):  
Hye-Mee Kwon ◽  
In-Gu Jun ◽  
Kyoung-Sun Kim ◽  
Young-Jin Moon ◽  
In Young Huh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intracranial Aneurysm ◽  
Hemorrhagic Stroke ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Hazard Analysis ◽  
Related Data ◽  
Incidence And Mortality ◽  
Before And After ◽  
History Of ◽  
Cirrhotic Patients

Postoperative hemorrhagic stroke (HS) is a rare yet devastating complication after liver transplantation (LT). Unruptured intracranial aneurysm (UIA) may contribute to HS; however, related data are limited. We investigated UIA prevalence and aneurysmal subarachnoid hemorrhage (SAH) and HS incidence post-LT. We identified risk factors for 1-year HS and constructed a prediction model. This study included 3544 patients who underwent LT from January 2008 to February 2019. Primary outcomes were incidence of SAH, HS, and mortality within 1-year post-LT. Propensity score matching (PSM) analysis and Cox proportional hazard analysis were performed. The prevalence of UIAs was 4.63% (n = 164; 95% confidence interval (CI), 3.95–5.39%). The 1-year SAH incidence was 0.68% (95% CI, 0.02–3.79%) in patients with UIA. SAH and HS incidence and mortality were not different between those with and without UIA before and after PSM. Cirrhosis severity, thrombocytopenia, inflammation, and history of SAH were identified as risk factors for 1-year HS. UIA presence was not a risk factor for SAH, HS, or mortality in cirrhotic patients post-LT. Given the fatal impact of HS, a simple scoring system was constructed to predict 1-year HS risk. These results enable clinical risk stratification of LT recipients with UIA and help assess perioperative HS risk before LT.

scholarly journals Coronary risk of patients with valvular heart disease: prospective validation of CT-Valve Score

Open Heart ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e001380
Author(s):  
Rasmus Bo Hasselbalch ◽  
Mia Marie Pries-Heje ◽  
Sarah Louise Kjølhede Holle ◽  
Thomas Engstrøm ◽  
Merete Heitmann ◽  
...  
Keyword(s):  
Heart Disease ◽  
Valvular Heart Disease ◽  
Primary Outcome ◽  
Multislice Ct ◽  
Cost Effective ◽  
University Hospital ◽  
Before And After ◽  
History Of ◽  
Artery Disease

ObjectiveTo prospectively validate the CT-Valve score, a new risk score designed to identify patients with valvular heart disease at a low risk of coronary artery disease (CAD) who could benefit from multislice CT (MSCT) first instead of coronary angiography (CAG).MethodsThis was a prospective cohort study of patients referred for valve surgery in the Capital Region of Denmark and Odense University Hospital from the 1 February 2015 to the 1 February 2017. MSCT was implemented for patients with a CT-Valve score ≤7 at the referring physician’s discretion. Patients with a history of CAD or chronic kidney disease were excluded. The primary outcome was the proportion of patients needing reevaluation with CAG after MSCT and risk of CAD among the patients determined to be low to intermediate risk.ResultsIn total, 1149 patients were included. The median score was 9 (IQR 3) and 339 (30%) had a score ≤7. MSCT was used for 117 patients. Of these 29 (25%) were reevaluated and 9 (7.7%) had CAD. Of the 222 patients with a score ≤7 that did not receive an MSCT, 14 (6%) had significant CAD. The estimated total cost of evaluation among patients with a score ≤7 before implementation was €132 093 compared with €79 073 after, a 40% reduction. Similarly, estimated total radiation before and after was 608 mSv and 362 mSv, a 41% reduction. Follow-up at a median of 32 months (18–48) showed no ischaemic events for patients receiving only MSCT.ConclusionThe CT-Valve score is a valid method for determining risk of CAD among patients with valvular heart disease. Using a score ≤7 as a cut-off for the use of MSCT is safe and cost-effective.

Dynamic history of low-grade gliomas before and after temozolomide treatment

2007 ◽  
Vol 61 (5) ◽  
pp. 484-490 ◽  
Author(s):  
Damien Ricard ◽  
Gentian Kaloshi ◽  
Alexandra Amiel-Benouaich ◽  
Julie Lejeune ◽  
Yannick Marie ◽  
...  
Keyword(s):  
Low Grade ◽  
Low Grade Gliomas ◽  
Before And After ◽  
History Of

Postactivation Potentiation of Force Is Independent of H-Reflex Excitability

2008 ◽  
Vol 3 (2) ◽  
pp. 219-231 ◽  
Author(s):  
Matthew J. Hodgson ◽  
David Docherty ◽  
E. Paul Zehr
Keyword(s):  
Isometric Force ◽  
Plantar Flexion ◽  
Force Production ◽  
H Reflex ◽  
Postactivation Potentiation ◽  
Neural Excitability ◽  
Reflex Excitability ◽  
Before And After ◽  
History Of ◽  
A Minor

The contractile history of muscle can potentiate electrically evoked force production. A link to voluntary force production, related in part to an increase in reflex excitability, has been suggested.Purpose:Our purpose was to quantify the effect of postactivation potentiation on voluntary force production and spinal H-reflex excitability during explosive plantar fexion actions.Methods:Plantar flexor twitch torque, soleus H-reflex amplitudes, and the rate of force development of explosive plantar fexion were measured before and after 4 separate conditioning trials (3 × 5 s maximal contractions).Results:Twitch torque and rate of force production during voluntary explosive plantar flexion were significantly increased (P < .05) while H-reflex amplitudes remained unchanged. Although twitch torque was significantly higher after conditioning, leading to a small increase in the rate of voluntary force production, this was unrelated to changes in reflex excitability.Conclusion:We conclude that postactivation potentiation may result in a minor increase in the rate of voluntary isometric force production that is unrelated to neural excitability.

scholarly journals Salivary Pro-Inflammatory Markers and Smoking Status Influences the Treatment Effectiveness of Periodontal Disease Patients with Hypertension

2021 ◽  
Vol 18 (14) ◽  
pp. 7364
Author(s):  
Kun-Tsung Lee ◽  
Zhu-Ling Guo ◽  
Nai-Chia Teng ◽  
Kuei-Ling Christine Hsu ◽  
I-Hui Chen ◽  
...  
Keyword(s):  
Periodontal Disease ◽  
Recovery Rate ◽  
Inflammatory Markers ◽  
Treatment Effectiveness ◽  
Smoking Status ◽  
Periodontal Diseases ◽  
Probing Depth ◽  
Before And After ◽  
Therapeutic Procedures ◽  
History Of

Background: Hypertension and periodontal diseases share several risk factors. Inflammation biomarkers in saliva are related to hypertension and periodontal disease. The aim of this study was to explore the role of the salivary inflammatory biomarkers in the treatment effectiveness of patients with hypertension and periodontal disease. Methods: This observational study enrolled 160 subjects diagnosed with periodontitis, 40 of which had a history of hypertension. All subjects had completed scaling and root planning therapeutic procedures within four weeks. The clinical periodontal parameters (i.e., bleeding on probing, plaque control record (PCR), and probing depth (PD)) were evaluated before and after the treatment. Pro-inflammatory markers were determined using a commercial kit. Results: The recovery rate (PD 4–9 mm) in non-hypertensive subjects was significantly higher than in hypertensive subjects (60.47% vs. 52.60%, respectively; p = 0.04). All clinical parameters, excluding PCR, positively correlated with salivary IL-1β at baseline and after completing treatment. Our results showed that increased salivary IL-1β levels were positively associated with decreased PCR (β = −27.65 and p = 0.05) and PD recovery rate (β = −17.05 and p = 0.02) in hypertensive subjects. Conclusions: The present study sheds important light on the clinical use of salivary pro-inflammatory cytokines as valuable biomarkers for predicting the treatment effectiveness of patients suffering from hypertension and periodontitis.

Tracheobronchial Foreign Bodies: The Impact of a Postgraduate Educational Program on Diagnosis, Morbidity, and Treatment

PEDIATRICS ◽  
1982 ◽  
Vol 70 (1) ◽  
pp. 96-98
Author(s):  
Marc Puterman ◽  
Rafael Gorodischer ◽  
Alberto Leiberman
Keyword(s):  
Educational Program ◽  
Foreign Bodies ◽  
Final Diagnosis ◽  
Physician Performance ◽  
Postgraduate Educational ◽  
Before And After ◽  
History Of ◽  
The Mean ◽  
Hospital Days ◽  
The Impact

Aspirated foreign bodies (FBs) may remain undetected and cause serious complications. As part of a postgraduate educational program, results of a local survey were presented to the local medical staff in order to increase its awareness of this diagnostic possibility. The present study was carried out in order to evaluate the management of children with tracheobronchial FBs during two 2-year periods, before and after teaching sessions held in December 1976. In comparison with the previous two years during the 1977-1978 period, the percentage of cases in which a positive history of aspiration was obtained increased from 47.6% to 84.0%; the mean number of hospitalizations due to tracheobronchial FBs decreased from 1.9 to 1.04 per infant, and the mean number of hospital days required for final diagnosis decreased from 17.6 to 5.3. The postgraduate educational program had a positive effect on physician performance and patient care.

Northern Hemisphere Glaciation, African Climate and Evolution

2021 ◽  
Author(s):  
Martin H. Trauth ◽  
Asfawossen Asrat ◽  
Nadine Berner ◽  
Faysal Bibi ◽  
Verena Foerster ◽  
...  
Keyword(s):  
Northern Hemisphere ◽  
Species Turnover ◽  
Abrupt Onset ◽  
Data Sets ◽  
Scientific Idea ◽  
Gradual Process ◽  
Before And After ◽  
History Of ◽  
Change Point Models ◽  
Original Interpretation

&lt;p&gt;The hypothesis of a connection between the onset (or intensification) of Northern Hemisphere Glaciation (NHG), the stepwise increase in African aridity (and climate variability) and an important mammalian (including hominin) species turnover is a textbook example of the initiation of a scientific idea and its propagation in science. It is, however, also an example of the persistent popularity of a hypothesis despite mounting evidence against it. The first part of our work analyzes of the history of the scientific idea by seeking its roots, including coincidental meetings and exchanges between of scientists, at project meetings, conferences and workshops. The consequences of this idea are examined and its influence on subsequent scientific investigations both before and after it has been falsified. In the second part of our investigation, we examine why the idea that the high latitudes have a major control on the climate of the low latitudes and thus early human evolution persists. For this purpose, an attempt is made to understand the original interpretation of the data, with special consideration of the composition of the scientific team and their scientific backgrounds and persuasions. Some of the key records in support of the hypothesis of a step-wise transition will be statistically re-analyzed by fitting change-point models to the time series to determine the midpoint and duration of the transition &amp;#8211; in case such a transition is found in the data. A critical review of key publications in support of such a connection and a statistical re-analysis of key data sets leads to three conclusions: (1) Northern Hemisphere Glaciation is a gradual process between ~3.5&amp;#8211;2.5 Ma, not an abrupt onset, either at ~2.5 Ma, nor at ~2.8 Ma, or any other time in the Late Cenozoic Era, (2) the trend towards greater aridity in Africa during this period was also gradual, not stepwise in the sense of a consistent transition of a duration of &amp;#8804;0.2 Ma, and (3) accordingly, a step-wise change in environmental conditions cannot be used to explain an important mammalian (including hominin) species turnover.&lt;/p&gt;

FRI0488 CLINICAL AND LABORATORY FEATURES OF PATIENTS WITH REMITTING SERONEGATIVE SYMMETRICAL SYNOVITIS WITH PITTING EDEMA COMPARED TO PATIENTS WITH SERONEGATIVE RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 842-843
Author(s):  
M. Higashida-Konishi ◽  
K. Izumi ◽  
S. Hama ◽  
Y. Hayashi ◽  
Y. Okano ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Secondary Analysis ◽  
Sudden Onset ◽  
Finger Joints ◽  
Before And After ◽  
History Of ◽  
Rs3pe Syndrome ◽  
The Mean ◽  
Old Females ◽  
Pitting Edema

Background:In the case of seronegative arthritis, it was difficult to make a differential diagnosis between remitting seronegative symmetrical synovitis with pitting edema syndrome (RS3PE) and seronegative rheumatoid arthritis (seronegative RA) because the distribution of affected joints was similar and the patients with RS3PE or seronegative RA may have edema.Objectives:To compare the clinical characteristics of RS3PE and seronegative RAMethods:We retrospectively examine consecutive patients diagnosed with RS3PE or seronegative RA in our hospital from 2007 to 2019. Patients in whom both ACPA and RF were negative were included. The patients with RS3PE met the criteria of McCarty et al.: (1) pitting edema of the dorsum of both hands and both feet, (2) sudden onset of polyarthritis, (3) seronegative for ACPA and RF. (4)no radiologically evident erosions developed. The patients with seronegative RA met the EULAR/ACR 2010 criteria. The patients who were diagnosed with RS3PE at first and then diagnosed with seronegative RA afterward were included in seronegative RA group. The first analysis was performed on the affected joints, CRP, ESR, Hb, LDH, edema, the history of malignancy 2 years before and after the diagnosis, treatment, and the history of infection requiring hospitalization after the start of treatment. The affected joints were shoulders, elbows, wrists, finger joints (the MCP, and PIP joints), hips, knees, ankles, and toe joints (the MTP and PIP joints). The secondary analysis was performed on the above evaluations with a propensity score (PS) matching for age.Results:In the first analysis, 20 patients with RS3PE and 122 patients with seronegative RA were enrolled. The mean ages (RS3PE, seronegative RA) were 81.1, 67.4 years old. Females were 60.0%, 63.1%. The mean observation period was 25.4, 63.6 months. The proportion of affected joints were shoulders (25.0%, 42.6%), elbows (10.0%, 29.5%: p=0.06), wrists (85.0%, 73.8%), finger joints (80.0%, 95.1%: p=0.01), hips (0%, 9.8%), knees (40.0%, 37.7%), ankles (65.0%, 39.3%: p=0.03) and toe joints (40.0%, 32.8%). Edema at diganosis was observed in 100%, 17.21% (p <0.0001). The mean levels of the following blood tests at diagnosis were noted: CRP, 9.0 and 4.8 mg/dL (p=0.02); ESR, 87.6 and 60.7 mm/1h (p=0.003); Hb, 10.4 and 11.8 mg/dl (p=0.001); LDH, 198.3 and 177.9 U/L (p = 0.12); MMP-3, 742.5 and 633.8 ng/mL (p = 0.14). The proportion of patients with high LDH levels (>222 U/L) was 13.6% and 9.0% (p=0.0269). The proportion of patients having the history of malignancy was 20.0%, 8.2% (p=0.10). The patient treated with prednisolone as the initial treatment was 100% and 41.0%; the mean dose was 14.3 and 9.9 mg/d. After the start of treatment, the proportion of infection requiring hospitalization was 20.0 and 3.28% (p=0.002).In the secondary analysis with PS, 17 patients with RS3PE and 17 patients with seronegative RA were enrolled. The mean ages were 80.4, 78.9 years old. Females were 52.9, 76.4%. The affected joints with difference were elbows (11.8, 35.3%: p=0.10), wrists (82.4, 100%: p=0.06), and finger joints (82.4, 100%: p=0.06). The mean levels of Hb at diagnosis was 10.4, 11.4 mg/dL (p=0.01). The proportion of patients having the history of malignancy was 23.5% and 0% (p=0.03). After the start of treatment, the proportion of infection requiring hospitalization was 23.5% and 0% (p=0.03).Conclusion:When the ankles are affected and edema is observed, RS3PE is more likely than seronegative RA. RS3PE had higher levels of CRP, ESR, and LDH. The proportion of anemia was higher in RS3PE. The proportions of infection requiring hospitalization and the history of malignancy were higher in RS3PE.References:[1]McCarty DJ, O’Duffy JD et al. Remitting Seronegative Symmetrical Synovitis with Pitting Edema (RS3PE Syndrome). JAMA 1985; 254: 2763–2767. DOI:10.1001/jama.1985.03360190069027Disclosure of Interests:Misako Higashida-Konishi: None declared, Keisuke Izumi Grant/research support from: Asahi Kasei Pharma, Takeda Pharmaceutical Co., Ltd., Speakers bureau: Asahi Kasei Pharma Corp, Astellas Pharma Inc., Bristol Myers Squibb, Chugai Pharmaceutical Co., Ltd., Eli Lilly Japan K.K., Mitsubishi Tanabe Pharma Co., Satoshi Hama: None declared, Yutaro Hayashi: None declared, Yutaka Okano: None declared, Hisaji Oshima: None declared

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