Are Mild Wound And Diabetic Foot Infections Like Mild Cancers?

David G. Armstrong DPM MD PhD
4/18/12 | 3723 reads | 0 comments
I was listening to a superb talk recently by Otis Brawley, MD, for our TEDMED at University of Arizona simulcast. Dr. Brawley, the Chief Medical Officer for the American Cancer Society, was speaking about the dramatic overtreatment of prostate and some breast cancers when they were in their early stages. Late in the 18-minute talk, he recounted an anecdote that I had not heard. It had to do with Donald Gleason, MD, PhD, and a meeting he had more than 50 years ago. Dr. Gleason is best known for the eponymous "Gleason Score" for prostate cancer. Read More.

Highlights From The Recent DFCon Meeting

David G. Armstrong DPM MD PhD
4/6/12 | 3772 reads | 0 comments
Diabetes and diabetic foot experts from around the globe met March 15 to 17 at the tenth DFCon Global Diabetic Foot Conference in Los Angeles to share ideas on how to prevent lower limb amputations due to the complications of diabetes. Lee C. Rogers, DPM, and Joseph L. Mills, Sr., MD, were the course directors. More than 30 internationally known experts from 11 countries served on the DFCon faculty. The speakers offered a number of insights. Dr. Mills presented the details on WIFI, a proposed classification for diabetic foot ulcers: Read More.

Will U.S. Amputation Rates Continue To Fall In People With Diabetes?

David G. Armstrong DPM MD PhD
2/13/12 | 5080 reads | 0 comments
There may be some good news in regard to amputation rates in patients with diabetes in the United States. A recent study in Diabetes Care found that nontraumatic lower extremity amputation rates have decreased in patients with diabetes over age 40.1 Lin and colleagues found the amputation discharge rate per 1,000 people with diabetes was 3.9 in 2008 — down from 11.2 in 1996. Read More.

Breaking Out Of Our ‘Echo Chamber’ At Conferences

David G. Armstrong DPM MD PhD
1/16/12 | 2933 reads | 3 comments
As a new year begins, so does a new slate of podiatric scientific conferences. Podiatric physicians have no shortage of educational experiences from which to choose. Read More.

Where Is The Urgency For Treating Disastrous Non-Communicable Diseases (NCDs)?

David G. Armstrong DPM MD PhD
10/17/11 | 2903 reads | 0 comments
I was thinking recently about how we react to shared impending calamity (or challenge). The Allies worked together to battle a shared enemy in World War II. The Manhattan Project was an example of this (for better or worse). We worked together within the United States to reach the moon (as a challenge from Sputnik and our then adversaries in the U.S.S.R.). I am sure that if we faced a shared disaster such as a killer asteroid, we would all probably team up to nudge that rock into someone else's orbit. Read More.

Can 3D Templating And Simulation Enhance Surgical Planning?

David G. Armstrong DPM MD PhD
9/27/11 | 3687 reads | 0 comments
We at the Southern Arizona Limb Salvage Alliance (SALSA) have long embraced the benefits of interconnectivity and open source solutions. Surgical planning and collaboration are no exception. The concept of 3D surgical “printing” (templating and simulation) in lower extremity reconstruction is not entirely commonplace. This is likely for a number of reasons. With the continual maturation of free and open source software applications as well as the ever increasing capabilities of “RepRap” technology (see http://reprap.org/wiki/Main_Page ), we can overcome these limitations. Read More.

Taking Advantage Of ‘App’ Technology To Make Wound Care More Efficient

David G. Armstrong DPM MD PhD
8/2/11 | 2941 reads | 0 comments
For a number of years, we at the Southern Arizona Limb Salvage Alliance (SALSA) have been discussing the philosophical similarities between what we have called “wound chemotherapy” — or the instillation of therapeutics into a wound by way of a negative pressure wound therapy (NPWT) device — and the iPhone (or perhaps more apropos, the iPad). Imagine a day when you will be able to do the following. * Take a product like Vacuum Assisted Closure (VAC therapy, KCI), which might have instillation capabilities. Read More.

Rethinking Clinical Study Protocols To Include Patients With Neuroischemic Wounds

David G. Armstrong DPM MD PhD
7/5/11 | 4160 reads | 0 comments
We at the Southern Arizona Limb Salvage Alliance (SALSA) wanted to give a heads up to some of the work that has been occupying our time. We are now working on a piece on neuroischemic wounds with our friends Bill Marston, MD, from the University of North Carolina, and Kel Cohen, MD, an Emeritus Professor from Medical College of Virginia. We are all rather flummoxed that many clinical studies in which we participate — and from which our patients can benefit — systematically exclude patients for whom these treatments may provide the most benefit. Read More.

Are We Entering The Age Of Decay?

David G. Armstrong DPM MD PhD
6/10/11 | 3006 reads | 0 comments
I was listening to my favorite program the other night, BBC Radio 4's In Our Time. This program focused on “The Origins of Infectious Disease.” As usual, Melvyn Bragg puts forth a fascinating topic. One of the superb panelists, Steve Jones, BSc, PhD, a Professor of Genetics at University College London and a UK Stem Cell Foundation Trustee, pointed out that we could divide the roughly 200,000 years of Homo sapiens into the following three ages of death. The Age of Disaster: When we often met our demise as we were bitten, impaled or otherwise devoured. Read More.