podiatry neurology

PURPOSE: Diabetes education for those patients at risk of diabetes complications remains a mainstay of diabetes treatment. This study aimed primarily to determine the retention of foot health information 6 months post delivery of education. The secondary aim was to determine the type and delivery method of diabetes-specific foot health information during a podiatry consultation. METHODS: This study was a prospective cohort study with two groups: patients with diabetes and their treating podiatrist...

Diabetic foot problems are responsible for nearly 50% of all diabetes-related hospital bed days. Approximately 10-15% of diabetic patients developed foot ulcers at some state in their life and 15% of all load in amputations are performed in patients with diabetes. There is a need to provide extensive education to both primary care physicians and the patients regarding the relationship between glucose control and complications encountered in the foot and ankle. The management of diabetic foot disease is focussed primarily on avoiding amputation of lower extremities and should be carried out through three main strategies; identification of the "at risk" foot, treatment of acutely diseased foot, and prevention of further problems...

Surgical power tools (SPTs) are frequently used in many surgical specialties such as dentistry, orthopaedics, ophthalmology, neurology, and podiatry. They have complex designs that may restrict access to cleaning and sterilization agents and frequently become contaminated with microbial and tissue residues following use. Due to these challenges, surgical power tools can be considered the weak link in the decontamination cycle and present a potential for iatrogenic transmission of infection. We aimed to review the existing literature on the decontamination of surgical power tools and associated iatrogenic transmission of infection...

BACKGROUND: It is unclear if podiatric foot care for people with rheumatoid arthritis (RA) in New South Wales (NSW) meets current clinical recommendations. The objective of this study was to survey podiatrists' perceptions of the nature of podiatric foot care provision for people who have RA in NSW. METHODS: An anonymous, cross-sectional survey with a web-based questionnaire was conducted. The survey questionnaire was developed according to clinical experience and current foot care recommendations...

INTRODUCTION: Although highly prevalent and painful, night-time calf muscle cramping is poorly understood, and no treatment has shown consistent efficacy or safety. METHODS: One hundred sixty adults were recruited from New South Wales, Australia, including 80 who had night-time calf cramping at least once per week and 80 age- and gender-matched adults who did not. Participants were assessed using reliable tests of lower limb strength, flexibility, morphometrics, circulation, and sensation, and were questioned about health and lifestyle factors, diet, medications, exercise, symptomatology, sleeping habits, and footwear...

AIM: The prevalence of diabetes and its associated manifestations is higher in New Zealand Maori than New Zealand Europeans. There is no current evidence regarding podiatric clinical characteristics of Maori with diabetes. The aim of this study was to determine the clinical and foot characteristics of Maori with diabetes using a podiatry-specific assessment tool. METHOD: This study used a cross-sectional design. Participants with diabetes were recruited from two Maori Primary Health Organisations...

Neuropathies are amongst the most common of the long-term complications of diabetes, affecting up to 50% of patients. Their clinical features vary immensely and patients may present with a wide spectrum of specialties, from neurology to urology, for example, or from cardiology to podiatry. Neuropathies are typically characterized by a progressive loss of nerve fibres which may affect both of the principal divisions of the peripheral nervous system. The epidemiology and natural history of the diabetic neuropathies remain poorly defined...

BACKGROUND: Diabetic foot care has yet to be enhanced in a universal health-care system in which specialized podiatric medical services are unavailable. This baseline assessment surveyed diabetic patients attending group education to improve current foot-care practices. METHODS: Of 302 diabetic patients receiving usual outpatient care, 155 received group patient education on general diabetes-related information, which included foot care and an annual checkup by a diabetes association during the previous 2 years, and 147 did not...

Peripheral nerve disorders are difficult to manage. In the surgical treatment of patients with peripheral nerve pathology, there are a multitude of factors that may alter the outcome of the patient's recovery and lead to incomplete recovery or possibly worsening of symptoms. The anatomy and function of the peripheral nerve is unique and the evaluation and management of these disorders must be approached in a manner different from musculoskeletal disorders. Many anatomic areas can tolerate scar tissue and adhesions, but in peripheral nerves, loss of the gliding functional and adherence to surrounding soft tissue structures is a common complication from over-zealous dissection and repeat peripheral nerve surgery without modification of technique...

OBJECTIVE: Healthcare providers commonly refer patients to physiatrists and neurologists for electrodiagnostic testing when they have symptoms suggestive of a peripheral nerve disorder. Published practice guidelines specify that electrodiagnostic medicine consultants should possess special neurologic and procedural training in this area. We recently found that despite these practice guidelines, physical therapists, chiropractors, and podiatrists perform 17% of electrodiagnostic studies in the United States...

AIM: The aim was to evaluate variation among clinicians in the outcome of assessments of foot health status and risk status in patients with diabetes. METHODS: Seventeen clinicians assessed three patients with diabetes using a standardized assessment form and risk classification system. RESULTS: There was variation among clinicians in all aspects of the assessment; recording basic demographic information; taking a medical history; vascular and neurological assessments...

Podiatric physicians care for a wide spectrum of patients with neurologic illness. Often, patients with neurologic disease present to their podiatric physician with unrelated complaints that can be easily separated from their underlying neurologic condition. However, some neurologic conditions predictably lead to podiatric disease and, as such, are best treated in the context of the broader disease process. Neuropathies, spastic disorders, and cerebral palsy are examples of common neurologic disorders that can be associated with substantial podiatric manifestations; therefore, it is important for podiatric physicians to be familiar with these conditions...

No abstract text is available yet for this article.

The phrase "lower extremity neurological evaluation" is a misnomer. The evaluation focuses on deficits that manifest in the lower extremity, but the expert knowledge of the competent examiner may indicate that the cause is remote from the lower limbs. Moreover, the skilled examiner must evaluate the patient in toto to determine the etiology of any abnormalities manifesting in the lower extremities. For these reasons and others, the neurological evaluation of the older patient is of particular importance and should be performed routinely...

This 6-month prospective study investigated the outcomes of foot surgery performed by Fellows of the Australian College of Podiatric Surgeons. The study recruited 140 patients who were treated for orthopedic, neurological, or integumentary diseases of the foot. The majority of subjects who underwent podiatric surgery experienced significant postoperative improvements in a range of health-related quality-of-life dimensions as measured by the disease-specific Foot Health Status Questionnaire (FHSQ) and the generic Short Form 36 (SF-36) questionnaire...

This article is an overview of a variety of neurologic disorders that a podiatrist may encounter. Obviously, the topic is broad. A method of forming a differential diagnosis is attempted, rather than generating a list of disorders. To make a diagnosis, neurologists identify the affected area of the nervous system, then generate a differential diagnosis of the disorders that cause disease in that location. The reader is referred to general neurology textbooks for further details. A brief review of the anatomy of the nervous system clarifies the origin of neurologic symptoms...

Quantitative sensory testing techniques have been developed to yield more consistent and objective measures of sensory deficits than can be obtained through the traditional clinical evaluation of the patient. At the same time, these measures are less invasive and uncomfortable than typical electrophysiologic studies. This article provides an overview of the principles of quantitative sensory testing, and discusses currently available instruments.

Podiatrists often refer patients to electromyographers to determine the cause of pain, tingling, numbness, and other paresthesias of unknown cause. Hence, some knowledge of the study and an understanding that it is an extension of the patient's history and physical examination is imperative. To enhance the podiatrist's understanding of electromyography, a review of basic neurophysiology, the neurologic examination, and electromyography/nerve conduction velocities (EMG/NCV) are discussed. Definitions are provided for the terms introduced in the article...

This article discusses the techniques and logic of the lower extremity evaluation of patients with possible neuromuscular disorders. Its emphasis is on the efficient development of a clinical database from which to draw inferences to probable pathologic diagnoses. As such, this article provides review material for the articles elsewhere in this issue regarding specialized examination techniques, differential diagnosis, and specific pathologies.

BACKGROUND: This study describes a system for prospectively reviewing non-urgent consultation or referral requests in a family practice residency program. METHODS: A committee composed of four rotating family physicians met weekly during a 22-month period to review all non-urgent proposed consultations. The committee either approved consultations or made other recommendations to the primary care physician for clinical management. Data were prospectively recorded to determine what types of referrals were most commonly made and approved, and if the number of consultations changed after the system was instituted...