Podiatry Today Current Issue

Examining The Evidence For Preventing Diabetic Foot Ulcers

admin — Wed, 03 Sep 2008 17:01:39 -0400

When it comes to patients with diabetes and lower extremity ulcers and complications, what does the evidence-based medicine say about high-risk patients and proactive prevention? These panelists examine risk factors for ulcerations, appropriate screening and offer their thoughts on what works and what does not work in terms of prevention.

Q: What does evidence-based medicine show in regard to who is at risk for limb loss and foot ulcerations?
A: Thomas Zgonis, DPM, says approximately 15 percent of patients with diabetes will experience a

How To Recognize And Treat Community-Acquired MRSA

admin — Wed, 03 Sep 2008 17:01:39 -0400

In the past few months, we have heard numerous reports in the news about a “new super bug” that is resistant to conventional antibiotics and is sweeping through high school sports locker rooms and classrooms. The alleged new super bug is methicillin resistant Staphylococcus aureus (MRSA) and, more specifically, community-acquired MRSA (CA-MRSA).
However, MRSA is not a new type of bacteria that has suddenly appeared in the community. The organism has actually been around for quite a few decades.
In 1941, all S. aureus isolates were suscept

Pertinent Pearls On Grading Diabetic Foot Ulcers

admin — Wed, 03 Sep 2008 17:01:39 -0400

Please click here for the full Continuing Medical Education article:

http://www.naccme.com/program/n-234/

Given that ulcers are a common complication for patients with diabetes, it is important to understand the various ulcer grading systems and how they can aid in treatment. This author reviews common classification systems and how to apply them in a clinical setting.

Preventing Amputation In Patients With Diabetes

admin — Wed, 03 Sep 2008 17:01:39 -0400

The World Health Organization and the International Diabetes Federation have stated that up to 85 percent of diabetic lower extremity amputations are preventable. There are approximately 82,000 diabetes-related lower extremity amputations (LEA) annually at an estimated cost of over $11 billion.^1,2 Eighty-five percent of amputations are preceded by a foot ulcer.³ Diabetic foot ulcers are caused by neuropathy, deformity and repetitive microtrauma.⁴The treatment of diabetic foot ulcers may cost the United States healthcare system as much as $19 billion

Can Diabetic Nerve Decompression Have An Impact?

admin — Wed, 03 Sep 2008 17:01:39 -0400

The treatment of patients with diabetes and associated complications has been extensively studied. Over the past several decades, the treatment of foot and ankle ailments in patients with diabetes has dramatically shifted from conservative measures of “do not perform surgery” to the present day thinking that has taught us that diabetic feet are not very different from normal feet.
The most common misconception with diabetic foot ailments has been that the loss of limbs is due to severe vascular problems. However, with time, we have found that vascular issues in the

Understanding The Connection Between Diabetes And Depression

admin — Wed, 03 Sep 2008 17:01:39 -0400

When it comes to patients with diabetes, the important roles of depression and distress have received more attention in the literature within the past year.^1-6 While these topics are typically off our radar screens, having a stronger understanding of these connections can enable podiatric physicians to make meaningful differences in our patients’ lives. We care for patients in transitional health states across the continuum of care when these problems are more likely to surface. We also have more frequent contacts that can make us more sensitive and responsive to subt

Nutritional Compounds: Can They Have An Impact With Diabetic Neuropathy?

admin — Wed, 03 Sep 2008 17:01:39 -0400

Diabetic neuropathies are a consequence of long-term hyperglycemia and occur in patients with type 2 diabetes, usually those who are 40 years of age or older. Diabetic neuropathy may occur regardless of whether a patient has insulin-dependent or non-insulin dependent diabetes.
Bear in mind that diabetic neuropathy may have a variety of clinical characteristics. Patients may have a symmetric or asymmetric presentation. They may have sensory or autonomic neuropathy.

Recalling Previous Battles Over Hospital Privileges

admin — Wed, 03 Sep 2008 17:01:39 -0400

A fellow podiatrist recently called and wanted my advice on what to do after retirement. In the course of our conversation, we talked about our journey during the first years of practice. He commented that he had struggles with discrimination by hospitals. He assumed that I had these problems based on my previous “Forum” columns.
I assured him that I did have challenges but never considered them interesting enough to write about.
However, the call did spark my curiosity so I dug out an old file titled “Hospital Privileges Fiasco.” It contained letters that I wrote and

How To Influence The Overwhelmed Patient With Diabetic Neuropathy

admin — Wed, 03 Sep 2008 17:01:39 -0400

The patient with diabetic neuropathy is truly overwhelmed.
He or she has gone through the discovery of the disease and perhaps a subsequent refusal to believe it. The patient may not have been following the diet or medication regimen, and now he or she is facing neuropathy and other complications. These patients are now facing decisions about shoes, medications and perhaps even surgical decisions. There may have been career changes, difficulty paying bills and even shifting relationships.

A Unique Dressing

admin — Wed, 03 Sep 2008 17:01:39 -0400

A Unique Dressing

A new dressing attacks wounds from more than one angle.
Biostep^™ Ag Collagen Matrix Dressings use a unique dual-action approach to target and deactivate excess matrix metalloproteinases (MMPs), according to the manufacturer Smith and Nephew Wound Management.
The company says the dressings also use the antimicrobial effects of silver to minimize the chance of infection.
Smith and Nephew says Biostep has a six-day wear time and is more absorbent than other dressings.