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Systemic Diseases and the Skin
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Jana Kazandjieva, Razvigor Darlenski, Nikolai Tsankov
Management: Early detection and treatment of the esophageal malignancy is necessary. Application of emollients, particularly ones with urea, are helpful. Podiatric care and specialized shoes are often required. More specific treatment for the thick skin is available in the form of oral retinoids such as etretinate and acitretin. These treatments can be effective in causing the thick skin to regress but unfortunately side effects are common.
Falls
Published in Henry J. Woodford, Essential Geriatrics, 2022
Foot-related problems are associated with an increased risk of falling. These include foot pain, reduced ankle joint range of motion, hallux valgus deformity and foot drop. Footwear-related risk factors include increased heel height and reduced sole surface area. Possible podiatry interventions include callous debridement, insole or orthosis provision, footwear advice and foot/ankle exercises. A systematic review found that both multi-faceted podiatry interventions (RR 0.77; 95% CI 0.61–0.99) and multi-factorial interventions including podiatry components (RR 0.73; 95% CI 0.54–0.98) reduced falls.45
Leg, foot and nail disease in the elderly
Published in Robert A. Norman, Geriatric Dermatology, 2020
M. Alam, R. K. Scher, P. I. Schneiderman
Responsible care of the foot in the elderly is based on early and careful attention to problems. If hyperkeratotic lesions become erosive, debridement coupled with padding and polo rings may be appropriate60,61. Nurse-educators and physical therapists should be consulted early in the course of foot treatment to help the patient understand self-administered techniques that may enhance symptom reduction. Shoe selection is particularly important yet often overlooked4,54. Shoes should have firm soles, soft uppers, good shock absorption properties and proper fit. Sneakers or running sboes are normally sufficient, provided they are replaced often, and custom shoes may be needed only in exceptional circumstances. Absorbent socks protect the foot from shoes and reduce maceration. Acrylic socks may be superior to cotton socks in mitigating blister formation. Closed-cell neoprene insoles are available over-the-counter and may be useful for augmenting the plantar fat pads. As previously noted, dermatologic problems of the foot may be associated with deeper pathology that is best managed by early referral to podiatry or orthopedic surgery. In elderly patients with multiple medical problems, prescription of non-steroidal anti-inflammatory drugs and other medications for pain relief should be discussed with the patient’s internist.
Experiences of foot health in patients with rheumatoid arthritis: a qualitative study
Published in Disability and Rehabilitation, 2022
Anne-Marie Laitinen, Carina Boström, Sasu Hyytiä, Minna Stolt
It is important to consider patients’ perspectives on foot health in order to understand their experiences of living with foot problems. The global focus in foot health is strongly oriented towards diabetic foot care. Due to severe diabetic-related foot problems, such as diabetic foot ulcers, the majority of patients with diabetes need podiatric services [5]. Patients with diabetic foot ulcers have reported significant consequences for their physical, social and psychological well-being [6]. Among patients with RA in particular, foot problems are often a major concern; however, they are often ignored by health-care professionals [7] and patients’ foot-health needs go unmet [8]. Therefore patients with RA often need to seek themselves for professional care and purchase services from private podiatry clinics [9,10].
Counting the cost of preventable diabetes-related lower limb amputations at a single district hospital in KwaZulu-Natal: what does this mean, what can be done?
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2020
AT Thompson, JL Bruce, VY Kong, DL Clarke, C Aldous
Several research outcomes have led to the International Diabetes Federation's statement that all people with diabetes should have a foot assessment that places them in the appropriate risk stratification to indicate the clinical pathway for foot disease prevention and treatment. A multidisciplinary team approach, with the inclusion of podiatry in treating the diabetic foot, is central for good outcomes, to protect the diabetic foot from breakdown, preventing foot ulceration and lower limb amputations. Podiatry takes preventive measures early in the disease process such that treating the foot in the early risk categories prevents patients from becoming high risk.2 Although the value of podiatry and the approach of a multidisciplinary team in diabetes care has been widely acknowledged,3–20 very few such teams that include podiatry are in place in state health. Healthcare policy decisions are driven by many factors, including cost, hence the need to begin the process of calculating the costs of diabetes-related lower limb amputations. Since lower limb amputations in diabetes are largely preventable, they are a measure of inadequate care on the part of any healthcare service.
Affective temperaments and stimulant medications misuse for neuroenhancement in graduate students
Published in Journal of Substance Use, 2018
Ludovico Mineo, Yasmin Sarraf, Cody Ingram, Scott Hanauer, Carmenrita Infortuna, Eileen Chusid, Diego Coira, Eugenio Aguglia, Fortunato Battaglia
This cross-sectional study was performed at the New York College of Podiatry Medicine (February 2016–July 2016). A total of 350 graduate medical students in the program (Year 1, Year 2, Year 3, Year 4) were asked to participate in the survey through a general invitation (emails and other written communications). The survey was completed by participants in hardcopy after a lecture. All students were given an explanation regarding the purpose and content of the survey; their participation was voluntary and the responses were anonymous. The survey had a statement of consent. All data were de-identified and student respondents were invited to seal the questionnaire in an envelope and drop it in an empty paper box to ensure confidentiality. The response was 86.5% (303 out of 350, the total student population in the program). The study was approved by the local Institutional Review Board (NY College of Podiatric Medicine).