Volume 15 - Issue 3 - March 2002
News and Trends »
The American Diabetes Association (ADA) recently released its revisions of the 2002 Clinical Practice Recommendations. Will these revisions lead to improved clarity, better outcomes and a heightened awareness of diagnostic indicators among all health care professionals? Those in the know seem to have a favorable impression.
“Two of the association’s most critical position statements have been completely revised and several others have been updated, using the ADA’s system for grading scientific evidence to support clinical practice recommendations,” says Lee Sanders, DPM, the Former P
Surgical Pearls »
Distal posterior heel pain is a deformity we see quite often. It masquerades as chronic Achilles tendinitis, when in fact a calcaneal step (aka retrocalcaneal exostoses) is present at the Achilles insertion. You must also clinically differentiate it from adjacent problems, such as Haglund’s deformity, retrocalcaneal bursitis and intra-Achilles tendon tear. Often, these problems may be concurrent, however, you must treat the calcaneal exostoses for complete cessation of pain. Keep in mind that retrocalcaneal exostoses are most symptomatic in active individuals over 30.
On inspection, you w
Type 2 diabetes is one of the fastest growing diseases in the United States, with 15.7 million Americans afflicted with the disease, according to the American Diabetes Association. Diabetes is one of the leading causes of death in the United States, and the primary cause of blindness in people (due to diabetic retinopathy) between the ages of 20 and 70.1
Diabetes is considered one of the most psychologically and behaviorally demanding of the chronic medical illnesses. Patients with diabetes are particularly vulnerable to depression. Indeed, up to one in every three diabetics has depression at a level that impairs functioning and quality of life, and lowers adherence to glucose monitoring, exercise, diet, medication regimes and glycemic control. As a result, depression increases the risk of long-term diabetic complications.
When you use self-reporting surveys as a gauge, you’ll find an even broader spectrum of depressive illness in diabetic
The prevalence of diabetic ulceration is alarmingly high and increasing. Currently, it is between 4 and 10 percent, depending on a host of factors including ethnicity, geographic region and duration of disease. Wounds are clearly associated with infection and a high risk of future amputation. The economic implications are overwhelming to the health care system. As clinicians, we must be able to rapidly identify, access and manipulate the factors necessary for wound healing.
Indeed, it is vital to approach the wound healing process as a whole body process when you’re treating a patient who
Is it an infection or an inflammation? That’s just one of the questions about the paronychia that came up during a roundtable discussion among DPMs. They also addressed the debate over doing a P&A for a paronychia, whether soaking is the ideal treatment and what you should do differently when treating a diabetic who has a paronychia. Here are their comments.
Warren Joseph, DPM: Any of us who have had a paronychia know they hurt. These patients will come into your office and they are in pain. They’ve all been to their family doctor, their primary doctor if they’re HMO patients a
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