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https://www.readbyqxmd.com/read/29772673/reducing-amputations-in-people-with-diabetes-rapid-evaluation-of-a-new-care-pathway
#1
Sandra MacRury, Kate Stephen, Fiona Main, Jane Gorman, Sandra Jones, David Macfarlane
People with diabetes are at increased risk of foot ulcers, which, if left untreated, can lead to infection, gangrene, and subsequent amputation. Management by a multidisciplinary diabetes foot team has been shown to reduce amputation rates; however, accessing specialist treatment is made particularly difficult when living in remote and rural locations, such as many individuals cared for within NHS Highland. The RAPID project was made up of two phases: firstly, to evaluate the technical feasibility of a new integrated care pathway using innovative technology, and secondly, to establish process enhancement of the pathway to justify a larger-scale study...
May 16, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29738299/perception-of-diabetic-foot-ulcers-among-general-practitioners-in-four-european-countries-knowledge-skills-and-urgency
#2
José Luis Garcia-Klepzig, Juan Pedro Sánchez-Ríos, Chris Manu, Raju Ahluwalia, Claas Lüdemann, Marco Meloni, Elisabetta Lacopi, Víctor Rodriguez-Saenz De Buruaga, Benjamin Bouillet, Julien Vouillarmet, Jose Luis Lazaro Martinez, Kristien Van Acker
OBJECTIVE: Diabetic foot ulcers (DFU) have the potential to deteriorate rapidly, in the absence of prompt assessment and treatment. The aim of this study was to analyse the awareness and perception of DFU among general practitioners (GPs) from four European countries, and to find possible differences between these countries in terms of management. METHOD: A two-part, quantitative, online questionnaire was distributed to GPs across four countries in Europe-the UK, France, Germany and Spain...
May 2, 2018: Journal of Wound Care
https://www.readbyqxmd.com/read/29682429/when-why-and-how-foot-orthoses-fos-should-be-prescribed-for-children-with-flexible-pes-planus-a-delphi-survey-of-podiatrists
#3
Sindhrani Dars, Hayley Uden, Saravana Kumar, Helen A Banwell
Background: Flexible pes planus (flat feet) in children is a common reason parents and caregivers seek health professionals consult and a frequent reason podiatrists prescribe foot orthoses. Yet no universal agreement exists on the diagnosis of this condition, or when and how foot orthoses should be prescribed. The aim of this study was to garner consensus and agreement among podiatrists on the use of FOs for paediatric flexible pes planus. Methods: A three round Delphi consensus survey was undertaken with 15 podiatry experts from Australia, New Zealand and the United Kingdom...
2018: PeerJ
https://www.readbyqxmd.com/read/29656142/management-of-foot-ankle-osteoarthritis-by-australian-general-practitioners-an-analysis-of-national-patient-encounter-records
#4
Kade L Paterson, Christopher Harrison, Helena Britt, Rana S Hinman, Kim L Bennell
OBJECTIVE: To document the management of foot/ankle osteoarthritis/arthritis (OA) by general practitioners (GP) in Australia. DESIGN: We analysed data from the Bettering the Evaluation and Care of Health Program April 2010-March 2016 inclusive. Patient and GP encounter characteristics were extracted. Data were classified by the International Classification of Primary Care, Version 2, and summarised using descriptive statistics and 95% confidence intervals (95% CIs) around point estimates...
April 12, 2018: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/29608799/one-stop-microvascular-screening-service-an-effective-model-for-the-early-detection-of-diabetic-peripheral-neuropathy-and-the-high-risk-foot
#5
O Binns-Hall, D Selvarajah, D Sanger, J Walker, A Scott, S Tesfaye
AIMS: To evaluate the feasibility of a one-stop microvascular screening service for the early diagnosis of diabetic distal symmetrical polyneuropathy, painful distal symmetrical polyneuropathy and the at-risk diabetic foot. METHODS: People with diabetes attending retinal screening in hospital and community settings had their feet examined by a podiatrist. Assessment included: Toronto Clinical Neuropathy Score evaluation; a 10-g monofilament test; and two validated, objective and quick measures of neuropathy obtained using the point-of-care devices 'DPN-Check', a hand-held device that measures sural nerve conduction velocity and amplitude, and 'Sudoscan', a device that measures sudomotor function...
April 2, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29581729/national-profile-of-foot-orthotic-provision-in-the-united-kingdom-part-2-podiatrist-orthotist-and-physiotherapy-practices
#6
C J Nester, A Graham, A Martinez-Santos, A E Williams, J McAdam, V Newton, D Sweeney, D Walker
Background: A national survey recently provided the first description of foot orthotic provision in the United Kingdom. This article aims to profile and compare the foot orthoses practice of podiatrists, orthotists and physiotherapists within the current provision. Method: Quantitative data were collected from podiatrists, orthotists and physiotherapists via an online questionnaire. The topics, questions and answers were developed through a series of pilot phases...
2018: Journal of Foot and Ankle Research
https://www.readbyqxmd.com/read/29580717/national-trends-in-the-utilization-of-skeletal-radiography-from-2003-to-2015
#7
Daniel J Mizrahi, Laurence Parker, Adam M Zoga, David C Levin
PURPOSE: Examine recent trends in the use of skeletal radiography and assess the roles of various nonradiologic specialties in the interpretations. METHODS: Medicare Part B fee-for-service claims data files from 2003 to 2015 were analyzed for all Current Procedural Terminology, version 4 (CPT-4) procedure codes related to skeletal radiography. The files provide examination volume, and we calculated utilization rates per 1,000 Medicare beneficiaries. Medicare's physician specialty codes were used to determine the specialties of the providers...
March 23, 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29561340/validation-of-the-healthy-foot-screen-a-novel-assessment-tool-for-common-clinical-abnormalities
#8
Reneeka Persaud, Patricia M Coutts, Alisa Brandon, Luvneet Verma, James A Elliott, R Gary Sibbald
GENERAL PURPOSE: The purpose of this learning activity is to provide information about the Healthy Foot Screen, a new tool for assessment of common foot abnormalities. 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 completing this continuing education activity, you should be able to:1...
April 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29560031/-a-good-fit-bringing-the-sociology-of-footwear-to-the-clinical-encounter-in-podiatry-services-a-narrative-review
#9
REVIEW
Emily Nicholls, Victoria Robinson, Lisa Farndon, Wesley Vernon
Background: This narrative review explores the ways in which drawing on theories and methods used in sociological work on footwear and identity can contribute to healthcare research with podiatrists and their patients, highlighting recent research in this field, implications for practice and potential areas for future development.Traditionally, research within Podiatry Services has tended to adopt a quantitative, positivist focus, developing separately from a growing body of sociological work exploring the importance of shoes in constructing identity and self-image...
2018: Journal of Foot and Ankle Research
https://www.readbyqxmd.com/read/29509111/using-a-modified-delphi-methodology-to-gain-consensus-on-the-use-of-dressings-in-chronic-wounds-management
#10
David Russell, Leanne Atkin, April Betts, Caroline Dowsett, Francis Fatoye, Sarah Gardner, Julie Green, Chris Manu, Tracey McKenzie, Helena Meally, Louise Mitchell, Julie Mullings, Isaac Odeyemi, Andrew Sharpe, Gillian Yeowell, Nancy Devlin
OBJECTIVE: Managing chronic wounds is associated with a burden to patients, caregivers, health services and society and there is a lack of clarity regarding the role of dressings in improving outcomes. This study aimed to provide understanding on a range of topics, including: the definition of chronicity in wounds, the burden of illness, clinical outcomes of reducing healing time and the impact of early interventions on clinical and economic outcomes and the role of matrix metalloproteinases (MMPs) in wound healing...
March 2, 2018: Journal of Wound Care
https://www.readbyqxmd.com/read/29489411/who-refers-musculoskeletal-extremity-imaging-examinations-to-radiologists
#11
Paul Harkey, Richard Duszak, Soterios Gyftopoulos, Andrew B Rosenkrantz
OBJECTIVE: The purpose of this study is to identify the specialty characteristics of providers referring musculoskeletal (MSK) extremity imaging examinations to radiologists, so as to better understand the drivers of MSK imaging utilization and potentially improve the appropriateness of such imaging examinations. MATERIALS AND METHODS: Data on provider referral for MSK extremity imaging services were extracted from the 2014 Medicare Referring Provider Utilization for Procedures public use file, which aggregates data on diagnostic procedures according to referring provider identities and service codes...
April 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29468052/prevalence-of-staphylococcus-spp-nasal-colonization-among-doctors-of-podiatric-medicine-and-associated-risk-factors-in-spain
#12
Sheila de Benito, Luis Alou, Ricardo Becerro-de-Bengoa-Vallejo, Marta Elena Losa-Iglesias, María Luisa Gómez-Lus, Luis Collado, David Sevillano
Background: This study aimed to estimate the prevalence of methicillin-susceptible and -resistant Staphylococcus aureus (MSSA and MRSA) and methicillin-resistant Staphylococcus epidermidis (MRSE) nasopharyngeal carriage among Doctors of Podiatric Medicine (Podiatrists) and to determine the potential risk factors. Methods: A cross-sectional study was carried out in 2016-2017 among 239 podiatrists in Spain. The presence of MSSA, MRSA, and MRSE was determined by microbiological analysis of nasal exudate and antimicrobial susceptibility was determined...
2018: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29314628/perceptions-of-hyperbaric-oxygen-therapy-among-podiatrists-practicing-in-high-risk-foot-clinics
#13
Frances R Henshaw, Lauren Brennan, Freya MacMillan
Foot ulceration is a devastating and costly consequence of diabetes. Hyperbaric oxygen therapy is recognised as an adjunctive therapy to treat diabetes-related foot ulceration, yet uptake is low. Semi-structured interviews were conducted with 16 podiatrists who manage patients with foot ulcers related to diabetes to explore their perceptions of, and the barriers/facilitators to, referral for hyperbaric oxygen. Podiatrists cited logistical issues such as location of facilities as well as poor communication pathways, lack of delegation and lack of follow up when patients presented for hyperbaric treatment...
January 3, 2018: International Wound Journal
https://www.readbyqxmd.com/read/29243399/diabetic-foot-ulcer-management-in-clinical-practice-in-the-uk-costs-and-outcomes
#14
Julian F Guest, Graham W Fuller, Peter Vowden
The aim of this study was to estimate the patterns of care and annual levels of health care resource use attributable to managing diabetic foot ulcers (DFUs) in clinical practice by the UK's National Health Service (NHS), and the associated costs of patient management. This was a retrospective cohort analysis of the records of 130 patients with a newly diagnosed DFU in The Health Improvement Network (THIN) database. Patients' characteristics, wound-related health outcomes and health care resource use were quantified, and the total NHS cost of patient management was estimated at 2015-2016 prices...
February 2018: International Wound Journal
https://www.readbyqxmd.com/read/29240657/inequalities-in-health-services-usage-in-a-national-health-system-scheme-the-case-of-a-southern-social-european-region
#15
Maite Morteruel, Elena Rodriguez-Alvarez, Unai Martin, Amaia Bacigalupe
BACKGROUND: Health services can reduce inequalities caused by other determinants of health or increase them due to the effect of the inverse care law-the principle that the availability of good quality care tends to vary inversely with the need for it in the population served. OBJECTIVE: The purpose of the research was to describe inequalities in the use of nursing services, medical services in primary care, specialist care, and services not fully covered by the Basque public health system in Spain...
January 2018: Nursing Research
https://www.readbyqxmd.com/read/29214861/podiatry-ankle-duplex-scan-readily-learned-and-accurate-in-diabetes
#16
Pasha Normahani, Katarzyna Powezka, Mohammed Aslam, Nigel J Standfield, Usman Jaffer
We aimed to train podiatrists to perform a focused duplex ultrasound scan (DUS) of the tibial vessels at the ankle in diabetic patients; podiatry ankle (PodAnk) duplex scan. Thirteen podiatrists underwent an intensive 3-hour long simulation training session. Participants were then assessed performing bilateral PodAnk duplex scans of 3 diabetic patients with peripheral arterial disease. Participants were assessed using the duplex ultrasound objective structured assessment of technical skills (DUOSATS) tool and an "Imaging Score"...
March 2018: Angiology
https://www.readbyqxmd.com/read/29212862/ataxia-with-oculomotor-apraxia-type-2-an-evolving-axonal-neuropathy
#17
Tahira N Choudry, David Hilton-Jones, Graham Lennox, Henry Houlden
A 23-year-old woman had presented initially to a podiatrist complaining of poorly fitting shoes during her adolescence. After extensive neurological review, she was diagnosed with ataxia with oculomotor apraxia type 2. This is a progressive autosomal recessive ataxia associated with cerebellar atrophy, peripheral neuropathy and an elevated serum α-fetoprotein. Within Europe, it is the most frequent autosomal recessive ataxia after Friedreich's ataxia and is due to mutations in the senataxin ( SETX ) gene. The age of onset is approximately 15 years...
February 2018: Practical Neurology
https://www.readbyqxmd.com/read/29206884/rapid-research-and-implementation-priority-setting-for-wound-care-uncertainties
#18
Trish A Gray, Jo C Dumville, Janice Christie, Nicky A Cullum
INTRODUCTION: People with complex wounds are more likely to be elderly, living with multimorbidity and wound related symptoms. A variety of products are available for managing complex wounds and a range of healthcare professionals are involved in wound care, yet there is a lack of good evidence to guide practice and services. These factors create uncertainty for those who deliver and those who manage wound care. Formal priority setting for research and implementation topics is needed to more accurately target the gaps in treatment and services...
2017: PloS One
https://www.readbyqxmd.com/read/29166260/the-development-and-content-validation-of-a-multidisciplinary-evidence-based-wound-infection-prevention-and-treatment-guideline
#19
Sammy A Zakhary, Chris Davey, Rebecca Bari, Jordan Bean, Tyler Reber, Kathy Gallagher, Kara Couch, Jennifer Hurlow, Karen Laforet, Corrine McIssac, Karen Napier, Diana Vilar-Compte, Emily Zakhary, Michel Hermans, Laura Bolton
Acute and chronic wound infections create clinical, economic, and patient-centered challenges best met by multidisciplinary wound care teams providing consistent, valid, clinically relevant, safe, evidence-based management across settings. To develop an evidence-based wound infection guideline, PubMed, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature databases were searched from inception through August 1, 2017 using the terms (or synonyms) wound infection and risk factor, significant, diagnosis, prevention, treatment, or surveillance...
November 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/29165397/low-computational-cost-footprint-deformities-diagnosis-sensor-through-angles-dimensions-analysis-and-image-processing-techniques
#20
J Rodolfo Maestre-Rendon, Tomas A Rivera-Roman, Juan M Sierra-Hernandez, Ivan Cruz-Aceves, Luis M Contreras-Medina, Carlos Duarte-Galvan, Arturo A Fernandez-Jaramillo
Manual measurements of foot anthropometry can lead to errors since this task involves the experience of the specialist who performs them, resulting in different subjective measures from the same footprint. Moreover, some of the diagnoses that are given to classify a footprint deformity are based on a qualitative interpretation by the physician; there is no quantitative interpretation of the footprint. The importance of providing a correct and accurate diagnosis lies in the need to ensure that an appropriate treatment is provided for the improvement of the patient without risking his or her health...
November 22, 2017: Sensors
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