Volume 16 - Issue 7 - July 2003
Diabetes Watch »
Diabetic peripheral neuropathy is very common sequelae of diabetes mellitus. Patients often complain of burning, tingling, numbness and even sharp stabbing pain. These symptoms can cause sleep disturbances as well as problems with daily activities. Many primary care physicians and podiatrists overlook these symptoms which, in most cases, have been going on for years.
Diagnostic Dilemmas »
A patient comes into the office with an aching sensation in the posterior aspect of the right leg. He notes the pain has been increasing in the past two to three months and has gotten worse since he began to exercise. Specifically, in the past three weeks, the patient says he has had tightness in the Achilles tendon region.
During that specific time period, the patient notes that he began a walking program on a slight hill by his house. He notes the hill provides a slight exertion that has been excellent for his stamina. The patient says he has only had the pain after a long climb and when h
Surgical Pearls »
Minimizing postoperative discomfort for patients is a common goal of all surgeons. Techniques for achieving this goal seem to vary significantly among surgical specialties. Unfortunately, patients often have preconceived expectations that they will experience considerable discomfort after foot surgery. This is usually based on their experience with other surgical procedures or from discussions with other people in their community who have expressed their “experience” with foot surgery.
This fear of significant postoperative discomfort occasionally will preclude some patients from undergo
Wound Care Q&A »
While there is not an overwhelming amount of literature on hyperbaric oxygen therapy (HBO), the recent decision by the Centers for Medicare and Medicaid Services (CMS) to cover the use of HBO in treating diabetic foot wounds has fueled new discussions on the potential efficacy of the modality. With this in mind, our panelists discuss their experiences in using HBO, the current literature on the subject and reimbursement issues.
Q: What has been your experience in using hyperbaric oxygen therapy (HBO) to treat lower extremity wounds?
A: Leon Brill, DPM, says he has had a “very posi
Treating chronic lower extremity ulcerations successfully depends on how well one understands the complex and dynamic interaction of multiple factors that contribute to the slow or non-healing nature of these ulcerations. Wound bed preparation, which is essential to managing difficult ulcerations, involves exudate reduction, appropriate debridement and the reduction of the wound’s bioburden. Indeed, removing the local barriers to healing will prepare the wound bed to support the activities necessary for wound healing.
The process of wound bed preparation begins with the initial evaluatio
Editor's Perspective »
The avalanche of bad news is unrelenting. The medical malpractice crisis seems to be getting worse. In addition to the 18 states already declared as “crisis” states by the American Medical Association, physicians in another 26 states are facing escalating insurance premiums as well, according to a recent article in The New England Journal Of Medicine. Combine that with dwindling reimbursement for services and even the most dedicated physician would be hard-pressed for an optimistic view.
However, in the midst of all this depressing news, there is a very intriguing study that reaf