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Other Complications of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
All patients with diabetes must receive a complete foot examination annually. This must include assessments of foot structure, biomechanics, protective sensation, skin integrity, and vascular status. A somatosensory test, using the Semmes-Weinstein monofilament should be performed. This inexpensive device tests loss of protective sensation as the monofilament is held either with the hand or attached to a handle. When the other end of the monofilament presses against the skin, buckling or bending slightly, 10 g of pressure are delivered where it makes contact. The patient should report when he or she feels the monofilament, usually in four different sites on the foot. Just one incorrect response may indicate loss of protective sensation and higher risk of ulcers. Diabetics must wear correctly fitted shoes and inspect their feet every day for open sores, blisters, and fungal infections between the toes. Another person should assist if the patient’s eyesight is poor.
How to prevent and treat chemotherapy-induced nail abnormalities
Published in Robert Baran, Dimitris Rigopoulos, Chander Grover, Eckart Haneke, Nail Therapies, 2021
Furthermore, the patients can be advised about preventative measures to limit nail toxicities (nail plate changes, onycholysis and periungual lesions) (Robert et al. 2015; Lacouture 2015):Keep fingernails as dry as possible.Always use a double pair of gloves (first in cotton and second in vinyl, nitrile, or latex).Avoid repeated trauma or friction from manicuring and restrict frequent use of nail polish and nail polish removers.Use wide and comfortable shoes.Apply topical emollients to cuticles and periungual tissues frequently.Some nail lacquers such as hydroxypropyl chitosan or polyurethane 16% seem to be useful to reduce water evaporation from the nail plate and have a barrier effectCollaboration with a podiatrist can be useful.
The cavovarus foot
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
Footwear modification in the form of wide toe box shoes to accommodate the lesser toe deformities. Adding a slight heel raise to the rearfoot can help increase the available ankle joint dorsiflexion by plantarflexing the talus.
Footwear characteristics and foot problems in community dwelling people with stroke: a cross-sectional observational study
Published in Disability and Rehabilitation, 2023
Dorit Kunkel, Louis Mamode, Malcolm Burnett, Ruth Pickering, Dan Bader, Margaret Donovan-Hall, Mark Cole, Ann Ashburn, Catherine Bowen
Findings from the fall-events recall aid showed that over half of the participants reported falls (n = 16, 53%) and nine (30%) had fallen repeatedly. Participants who reported falls experienced a greater levels of stroke related disability (p = 0.006) as they achieved lower scores on the SIS (55.1 (SD 22.8); 95% CI 42.9–67.2) than non-fallers (75.1 (SD 8.6); 95% CI 70.1–80.1). A significantly greater proportion of fallers (13/16) reported foot problems (p = 0.029) in comparison to non-fallers (4/14). Of those who experienced falls, nine wore adequate indoor shoes and seven inadequate indoor shoes; however, nine of the non-fallers also wore inadequate indoor shoes. Fourteen fallers and 10 non fallers wore adequate outdoor shoes. Among nine fallers and six non-fallers indoor shoes did not fit well and among seven fallers and seven non-fallers outdoor shoes fitted poorly. Eleven fallers and six non-fallers wore indoor shoes that they had worn for longer than 12 months and nine non-fallers and 11 fallers had been wearing their outdoor shoes for longer than 12 months.
Experimental and numerical diagnosis of fatigue foot using convolutional neural network
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
Abbas Sharifi, Mohsen Ahmadi, Mohammad Amin Mehni, Saeid Jafarzadeh Ghoushchi, Yaghoub Pourasad
Wang et al. (2016) studied the ulcers of foots using color segmentation. They analyzed diabetic feet and healing scores based on real-time mean-shift-based methods. Moreover, Sudha et al. (2017) applied a thermal segmentation method for foot image assessment. They used the acquisition protocol to reach the goal. Li et al. (2017) suggested an appropriate approach for evaluating plantar pressure pictures to obtain the main areas of foot plantar pressure characteristics. The CNN-based K-mean clustering and ISOMAP were also implemented to accomplish segments of the imaging dataset. The suggested solution identified possible applications for shoe-last diabetic foot customization. In another study, Wang et al. (2018) extracted features of foot images, including Hue-Saturation-Value (HSV) color, gray difference-based characteristics (mean, entropy, and auto-correlation function), gray-level co-occurrence matrix-based characteristics (energy and correlation), and HOG. Finally, in various classifiers, including SVM, LSVM, and FSVM, typical characteristics and HOG were contrasted. The suggested methods showed the diabetic foot plantar central region. In the case of various layer numbers of wavelet decomposition, Cao et al. (2020) calculated evaluation criteria to assess the best degree of decomposition and test the fused image consistency using different wavelet functions.
Ultrathin free flaps for foot reconstruction: impact on ambulation, functional recovery, and patient satisfaction
Published in Journal of Plastic Surgery and Hand Surgery, 2021
Beatriz Hatsue Kushida-Contreras, Miguel Angel Gaxiola-García
We registered objective assessments during scheduled follow-up visits on an outpatient basis. No patient presented plantar ulceration during the physical exam. The plantar arch was preserved in all but two patients; in these cases, some bulkiness was noted in the flap but with no indication for further thinning, both patients were using regular shoes. Eleven out of twelve patients reported deep sensation after monofilament testing; protective sensation was present in 9 of 12 patients (75%). Ten patients were using normal footwear regularly (usually sneakers), one patient was using slippers and another patient was using insoles by choice, i.e. not prescribed by a podiatrist. The whole group of patients was satisfied with the procedure. Two of the patients presented with melanoma-associated vitiligo, now recognized to associate with favorable outcomes [30], see Table 2.