Sample records for chronic plantar heel

  1. Diagnostic imaging for chronic plantar heel pain: a systematic review and meta-analysis

    Microsoft Academic Search

    Andrew M McMillan; Karl B Landorf; Joanna T Barrett; Hylton B Menz; Adam R Bird

    2009-01-01

    BACKGROUND: Chronic plantar heel pain (CPHP) is a generalised term used to describe a range of undifferentiated conditions affecting the plantar heel. Plantar fasciitis is reported as the most common cause and the terms are frequently used interchangeably in the literature. Diagnostic imaging has been used by many researchers and practitioners to investigate the involvement of specific anatomical structures in

  2. Chronic heel pain due to the entrapment of the first branch of the lateral plantar nerve: analysis of surgical treatment

    Microsoft Academic Search

    Mohammad Mesmar; Zouhair Amarin; Nawaf Shatnawi; Khaldoon Bashaireh

    2010-01-01

    This is a case series study that was conducted to report the outcome of surgical release of the first branch of the lateral\\u000a plantar nerve in patients with chronic heel pain. Thirty-one patients with chronic heel pain underwent release of the first\\u000a branch of the lateral plantar nerve. The setting was a public university hospital and a public university-affiliated hospital

  3. Plantar and medial heel pain: diagnosis and management.

    PubMed

    Lareau, Craig R; Sawyer, Gregory A; Wang, Joanne H; DiGiovanni, Christopher W

    2014-06-01

    Heel pain is commonly encountered in orthopaedic practice. Establishing an accurate diagnosis is critical, but it can be challenging due to the complex regional anatomy. Subacute and chronic plantar and medial heel pain are most frequently the result of repetitive microtrauma or compression of neurologic structures, such as plantar fasciitis, heel pad atrophy, Baxter nerve entrapment, calcaneal stress fracture, and tarsal tunnel syndrome. Most causes of inferior heel pain can be successfully managed nonsurgically. Surgical intervention is reserved for patients who do not respond to nonsurgical measures. Although corticosteroid injections have a role in the management of select diagnoses, they should be used with caution. PMID:24860133

  4. Heel lipoma mimicking plantar fasciitis in a ballroom dancer.

    PubMed

    Taweel, Nicholas R; Raikin, Steven M

    2015-01-01

    The present case illustrates a lipoma as an unusual cause of heel pain. A 64-year-old female ballroom dancer presented with 8 months of pain that was unresponsive to previous treatment of plantar fasciitis. Magnetic resonance imaging revealed a heel lipoma. Her pain was fully resolved after surgical excision. Soft tissue tumors should be included in the differential diagnosis of heel pain, especially when symptoms and treatment response do not follow the typical course of plantar fasciitis. PMID:25624040

  5. Heel pain-plantar fasciitis: revision 2014.

    PubMed

    Martin, Robroy L; Davenport, Todd E; Reischl, Stephen F; McPoil, Thomas G; Matheson, James W; Wukich, Dane K; McDonough, Christine M

    2014-11-01

    The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The purpose of these revised clinical practice guidelines is to review recent peer-reviewed literature and make recommendations related to nonarthritic heel pain. PMID:25361863

  6. Regional plantar foot pressure distributions on high-heeled shoes-shank curve effects

    NASA Astrophysics Data System (ADS)

    Cong, Yan; Lee, Winson; Zhang, Ming

    2011-12-01

    Forefoot pain is common in high-heeled shoe wearers due to the high pressure caused by the center of body mass moving forward and the increased arch height with heel elevation. Sufficient arch support could reduce the high pressure over forefoot. However, too much arch support could lead to abnormal foot alignment and pain over midfoot. Little information is reported on the relationship among plantar arch height, shank curve design and plantar pressure. This study aimed at quantifying the plantar arch height changes at different heel heights and investigating the effect of shank curve on plantar pressure distribution. The plantar arch height increased to (7.6±1.3)mm at heel height of 75 mm. The Chinese standard suggests the depth of last should be 8.5mm for heel height of 75 mm. When a shank curve with higher depth of last (11 mm) was used, the peak pressure over forefoot further decreased in midstance phase, which might ease the forefoot problems, while the peak pressure over midfoot increased but not exceeded the discomfort pressure thresholds. To achieve a more ideal pressure distribution in high-heeled shoes, a higher than expected depth of last would be suggested that would not cause discomfort over midfoot.

  7. Clinical Presentation and Self-Reported Patterns of Pain and Function in Patients with Plantar Heel Pain

    PubMed Central

    Klein, Sandra E.; Dale, Ann Marie; Hayes, Marcie Harris; Johnson, Jeffrey E.; McCormick, Jeremy J.; Racette, Brad A.

    2014-01-01

    Background Plantar heel pain is a common disorder of the foot for which patients seek medical treatment. The purpose of this study is to explore the relationship between duration of symptoms in plantar fasciitis patients and demographic factors, the intensity and location of pain, extent of previous treatment and self reported pain and function. Methods The charts of patients presenting with plantar heel pain between June 2008 and October 2010 were reviewed retrospectively and 182 patients with a primary diagnosis of plantar fasciitis were identified. Patients with symptoms less than 6 months were identified as acute and patients with symptoms greater than or equal to six months were defined as having chronic symptoms. Comparisons based on duration of symptoms were performed for age, gender, BMI, comorbidities, pain location and intensity, and a functional score measured by the Foot and Ankle Ability Measure (FAAM). Results The two groups were similar in age, BMI, gender, and comorbidities. Pain severity, as measured by a VAS, was not statistically significant between the two groups (6.6 and 6.2). The acute and chronic groups of patients reported similar levels of function on both the activity of daily living (62 and 65) and sports (47 and 45) subscales of the FAAM. Patients in the chronic group were more likely to have seen more providers and tried more treatment options for this condition. Conclusion As plantar fasciitis symptoms extend beyond 6 months, patients do not experience increasing pain intensity or functional limitation. No specific risk factors have been identified to indicate a risk of developing chronic symptoms. PMID:22995253

  8. The effectiveness of manual stretching in the treatment of plantar heel pain: a systematic review

    PubMed Central

    2011-01-01

    Background Plantar heel pain is a commonly occurring foot complaint. Stretching is frequently utilised as a treatment, yet a systematic review focusing only on its effectiveness has not been published. This review aimed to assess the effectiveness of stretching on pain and function in people with plantar heel pain. Methods Medline, EMBASE, CINAHL, AMED, and The Cochrane Library were searched from inception to July 2010. Studies fulfilling the inclusion criteria were independently assessed, and their quality evaluated using the modified PEDro scale. Results Six studies including 365 symptomatic participants were included. Two compared stretching with a control, one study compared stretching to an alternative intervention, one study compared stretching to both alternative and control interventions, and two compared different stretching techniques and durations. Quality rating on the modified Pedro scale varied from two to eight out of a maximum of ten points. The methodologies and interventions varied significantly between studies, making meta-analysis inappropriate. Most participants improved over the course of the studies, but when stretching was compared to alternative or control interventions, the changes only reached statistical significance in one study that used a combination of calf muscle stretches and plantar fascia stretches in their stretching programme. Another study comparing different stretching techniques, showed a statistically significant reduction in some aspects of pain in favour of plantar fascia stretching over calf stretches in the short term. Conclusions There were too few studies to assess whether stretching is effective compared to control or other interventions, for either pain or function. However, there is some evidence that plantar fascia stretching may be more effective than Achilles tendon stretching alone in the short-term. Appropriately powered randomised controlled trials, utilizing validated outcome measures, blinded assessors and long-term follow up are needed to assess the efficacy of stretching. PMID:21703003

  9. Psychological variables associated with foot function and foot pain in patients with plantar heel pain.

    PubMed

    Cotchett, Matthew P; Whittaker, Glen; Erbas, Bircan

    2015-05-01

    It is widely accepted that psychological variables are associated with self-reported pain and self-reported physical function in patients with musculoskeletal pain. However, the relationship between psychological variables and foot pain and foot function has not been evaluated in people with plantar heel pain. Eighty-four participants with plantar heel pain completed the Depression, Anxiety and Stress Scale short version (DASS-21) and Foot Health Status Questionnaire. Using a hierarchical regression analysis, a baseline model with age, sex and BMI explained 10 % of the variability in foot function. The addition of depression and stress in separate models explained an additional 7.3 % and 8.1 % of foot function scores, respectively. In the respective models, depression was a significant predictor (??=?-0.28; p?=?0.009) as was stress (??=?-0.29; p?=?0.006). Females drove the effect between stress and foot function (??=?-0.50; p?=?0.001) and depression and foot function (??=?-0.53; p?plantar heel pain, stress and depression scores were significantly associated with foot function but not foot pain. When the data was stratified by sex, stress and depression were significant predictors of foot pain and function in females. PMID:24647980

  10. Comparison of ankle plantar flexor activity between double-leg heel raise and walking

    PubMed Central

    Fujisawa, Hiroyuki; Suzuki, Hiroto; Nishiyama, Toru; Suzuki, Makoto

    2015-01-01

    [Purpose] We aimed to evaluate the difference in the muscle activity between the double-leg heel raise (DHR) and treadmill walking. [Subjects] Thirty healthy males aged 21.5 ± 1.6?years (body mass 63.6 ± 9.3?kg, height 171.0 ± 4.5?cm) participated in the study. [Methods] Electromyograms were simultaneously recorded from both heads of the gastrocnemius and the soleus of the right side during the DHR and treadmill walking. The DHR conditions were maximum plantar flexion (MPF), 3/4 MPF, 2/4 MPF, and 1/4 MPF, and the walking speeds were 20, 40, 60, 80, and 100 m/min. [Results] The muscle activity during the DHR and walking significantly increased with increments in the height of the heel raise and walking speed, respectively. Comparison of the muscle activity at MPF with that at each walking speed revealed that the muscle activity in the soleus and gastrocnemius medial head during walking exceeded that during the DHR in less than 3.3% of cases. [Conclusion] The DHR test is useful for evaluating the ankle plantar flexor activity necessary for walking.

  11. Comparison of ankle plantar flexor activity between double-leg heel raise and walking.

    PubMed

    Fujisawa, Hiroyuki; Suzuki, Hiroto; Nishiyama, Toru; Suzuki, Makoto

    2015-05-01

    [Purpose] We aimed to evaluate the difference in the muscle activity between the double-leg heel raise (DHR) and treadmill walking. [Subjects] Thirty healthy males aged 21.5 ± 1.6?years (body mass 63.6 ± 9.3?kg, height 171.0 ± 4.5?cm) participated in the study. [Methods] Electromyograms were simultaneously recorded from both heads of the gastrocnemius and the soleus of the right side during the DHR and treadmill walking. The DHR conditions were maximum plantar flexion (MPF), 3/4 MPF, 2/4 MPF, and 1/4 MPF, and the walking speeds were 20, 40, 60, 80, and 100 m/min. [Results] The muscle activity during the DHR and walking significantly increased with increments in the height of the heel raise and walking speed, respectively. Comparison of the muscle activity at MPF with that at each walking speed revealed that the muscle activity in the soleus and gastrocnemius medial head during walking exceeded that during the DHR in less than 3.3% of cases. [Conclusion] The DHR test is useful for evaluating the ankle plantar flexor activity necessary for walking. PMID:26157255

  12. Refinements of medial plantar flap used for covering nonweightbearing ankle and posterior heel defects requiring thin flaps.

    PubMed

    Ulkür, Ersin; Açikel, Cengiz; Karagöz, Hüseyin; Celiköz, Bahattin

    2005-10-01

    We present our clinical experiences with the refinements that we applied to avoid circular flap contraction and achieve thin flap coverage in the reconstruction of posterior heel and tendocalcaneal skin defects with medial plantar flap. Eight male patients, aged 18 to 35 (mean 24 years), with nonweightbearing skin defects, were treated with refined medial plantar flaps. All flaps survived and no circulation problem was encountered. The flaps adapted well to the recipient area, and thin and well-contoured skin coverage was achieved by postoperative month 6. As a conclusion, it is possible to reconstruct the nonweightbearing defects needing thin flap by medial plantar flap with adding refinements: (1) adding triangles around the flap, (2) harvesting a thin flap by excluding the thick plantar fascia, (3) harvesting a further thin flap by defatting of the flap, (4) application of pressure to the flap. PMID:16186701

  13. Plantar fasciitis

    PubMed Central

    Tahririan, Mohammad Ali; Motififard, Mehdi; Tahmasebi, Mohammad Naghi; Siavashi, Babak

    2012-01-01

    Heel pain, mostly caused by plantar fasciitis (PF), is a common complaint of many patients who requiring professional orthopedic care and are mostly suffering from chronic pain beneath their heels. The present article reviews studies done by preeminent practitioners related to the anatomy of plantar fasciitis and their histo-pathological features, factors associated with PF, clinical features, imaging studies, differential diagnoses, and diverse treatment modalities for treatment of PF, with special emphasis on non-surgical treatment. Anti-inflammatory agents, plantar stretching, and orthosis proved to have highest priority; corticosteroid injection, night splints and extracorporeal shock wave therapy were of next priority, in patients with PF. In patients resistant to the mentioned treatments surgical intervention should be considered. PMID:23798950

  14. Effects of heel base size, walking speed, and slope angle on center of pressure trajectory and plantar pressure when wearing high-heeled shoes.

    PubMed

    Luximon, Yan; Cong, Yan; Luximon, Ameersing; Zhang, Ming

    2015-06-01

    High-heeled shoes are associated with instability and a high risk of fall, fracture, and ankle sprain. This study investigated the effects of heel base size (HBS) on walking stability under different walking speeds and slope angles. The trajectory of the center of pressure (COP), maximal peak pressure, pressure time integral, contact area, and perceived stability were analyzed. The results revealed that a small HBS increased the COP deviations, shifting the COP more medially at the beginning of the gait cycle. The slope angle mainly affected the COP in the anteroposterior direction. An increased slope angle shifted the COP posterior and caused greater pressure and a larger contact area in the midfoot and rearfoot regions, which can provide more support. Subjective measures on perceived stability were consistent with objective measures. The results suggested that high-heeled shoes with a small HBS did not provide stable plantar support, particularly on a small slope angle. The changes in the COP and pressure pattern caused by a small HBS might increase joint torque and muscle activity and induce lower limb problems. PMID:25910862

  15. The effectiveness of extra corporeal shock wave therapy for plantar heel pain: a systematic review and meta-analysis

    PubMed Central

    Thomson, Colin E; Crawford, Fay; Murray, Gordon D

    2005-01-01

    Background There is considerable controversy regarding the effectiveness of extracorporeal shock wave therapy in the management of plantar heel pain. Our aim was to conduct a systematic review of randomised controlled trials to investigate the effectiveness of extracorporeal shock wave therapy and to produce a precise estimate of the likely benefits of this therapy. Methods We conducted a systematic review of all randomised controlled trials (RCTs) identified from the Cochrane Controlled trials register, MEDLINE, EMBASE and CINAHL from 1966 until September 2004. We included randomised trials which evaluated extracorporeal shock wave therapy used to treat plantar heel pain. Trials comparing extra corporeal shock wave therapy with placebo or different doses of extra corporeal shock wave therapy were considered for inclusion in the review. We independently applied the inclusion and exclusion criteria to each identified randomised controlled trial, extracted data and assessed the methodological quality of each trial. Results Six RCTs (n = 897) permitted a pooled estimate of effectiveness based on pain scores collected using 10 cm visual analogue scales for morning pain. The estimated weighted mean difference was 0.42 (95% confidence interval 0.02 to 0.83) representing less than 0.5 cm on a visual analogue scale. There was no evidence of heterogeneity and a fixed effects model was used. Conclusion A meta-analysis of data from six randomised-controlled trials that included a total of 897 patients was statistically significant in favour of extracorporeal shock wave therapy for the treatment of plantar heel pain but the effect size was very small. A sensitivity analysis including only high quality trials did not detect a statistically significant effect. PMID:15847689

  16. Diagnosis and management of plantar fasciitis.

    PubMed

    Thompson, John V; Saini, Sundeep S; Reb, Christopher W; Daniel, Joseph N

    2014-12-01

    Plantar fasciitis, a chronic degenerative process that causes medial plantar heel pain, is responsible for approximately 1 million physician visits each year. Individuals with plantar fasciitis experience pain that is most intense during their first few steps of the day or after prolonged standing. The authors provide an overview of the diagnosis and management of a common problem encountered in the primary care setting. Routine imaging is not initially recommended for the evaluation of plantar fasciitis but may be required to rule out other pathologic conditions. Overall, plantar fasciitis carries a good prognosis when patients use a combination of several conservative treatment modalities. Occasionally, referral to a specialist may be necessary. PMID:25429080

  17. Stress analysis of the standing foot following surgical plantar fascia release

    Microsoft Academic Search

    Amit Gefen

    2002-01-01

    Plantar fascia release is a surgical alternative for patients who suffer chronic heel pain due to plantar fasciitis and are unaffected by conservative treatment. A computational (finite element) model for analysis of the structural behavior of the human foot during standing was utilized to investigate the biomechanical effects of releasing the plantar fascia. The model integrates a system of five

  18. Degenerative lesions of the plantar fascia : surgical treatment by fasciectomy and excision of the heel spur. A report on 38 cases

    Microsoft Academic Search

    Olivier JARDE; Patrice DIEBOLD; Eric HAVET; Gilles BOULU; Joël VERNOIS

    2003-01-01

    The authors studied 38 cases of degenerative lesions of the plantar fascia which were treated surgically between 1989 and 1999. MRI showed chronic fascii- tis in eight cases and an old rupture of the plantar fascia in 30 cases. Surgical treatment, which was per- formed in all cases after failure of conservative treat- ment of several months duration, combined excision

  19. Treatment of chronic plantar fasciopathy with extracorporeal shock waves (review)

    PubMed Central

    2013-01-01

    There is an increasing interest by doctors and patients in extracorporeal shock wave therapy (ESWT) for chronic plantar fasciopathy (PF), particularly in second generation radial extracorporeal shock wave therapy (RSWT). The present review aims at serving this interest by providing a comprehensive overview on physical and medical definitions of shock waves and a detailed assessment of the quality and significance of the randomized clinical trials published on ESWT and RSWT as it is used to treat chronic PF. Both ESWT and RSWT are safe, effective, and technically easy treatments for chronic PF. The main advantages of RSWT over ESWT are the lack of need for any anesthesia during the treatment and the demonstrated long-term treatment success (demonstrated at both 6 and 12 months after the first treatment using RSWT, compared to follow-up intervals of no more than 12 weeks after the first treatment using ESWT). In recent years, a greater understanding of the clinical outcomes in ESWT and RSWT for chronic PF has arisen in relationship not only in the design of studies, but also in procedure, energy level, and shock wave propagation. Either procedure should be considered for patients 18 years of age or older with chronic PF prior to surgical intervention. PMID:24004715

  20. Plantar fasciitis

    PubMed Central

    Cutts, S; Obi, N; Pasapula, C; Chan, W

    2012-01-01

    INTRODUCTION In this article we look at the aetiology of plantar fasciitis, the other common differentials for heel pain and the evidence available to support each of the major management options. We also review the literature and discuss the condition. METHODS A literature search was performed using PubMed and MEDLINE®. The following keywords were used, singly or in combination: ‘plantar fasciitis’, ‘plantar heel pain’, ‘heel spur’. To maximise the search, backward chaining of reference lists from retrieved papers was also undertaken. FINDINGS Plantar fasciitis is a common and often disabling condition. Because the natural history of plantar fasciitis is not understood, it is difficult to distinguish between those patients who recover spontaneously and those who respond to formal treatment. Surgical release of the plantar fascia is effective in the small proportion of patients who do not respond to conservative measures. New techniques such as endoscopic plantar release and extracorporeal shockwave therapy may have a role but the limited availability of equipment and skills means that most patients will continue to be treated by more traditional techniques. PMID:23131221

  1. Randomized multicenter trial on the effect of radiotherapy for plantar Fasciitis (painful heel spur) using very low doses – a study protocol

    PubMed Central

    Niewald, Marcus; Seegenschmiedt, M Heinrich; Micke, Oliver; Gräber, Stefan

    2008-01-01

    Background A lot of retrospective data concerning the effect of radiotherapy on the painful heel spur (plantar fasciitis) is available in the literature. Nevertheless, a randomized proof of this effect is still missing. Thus, the GCGBD (German cooperative group on radiotherapy for benign diseases) of the DEGRO (German Society for Radiation Oncology) decided to start a randomized multicenter trial in order to find out if the effect of a conventional total dose is superior compared to that of a very low dose. Methods/Design In a prospective, controlled and randomized phase III trial two radiotherapy schedules are to be compared: standard arm: total dose 6.0 Gy in single fractions of 1.0 Gy applied twice a week experimental arm: total dose 0.6 Gy in single fractions of 0.1 Gy applied twice a week (acting as a placebo) Patients aged over 40 years who have been diagnosed clinically and radiologically to be suffering from a painful heel spur for at least six months can be included. Former trauma, surgery or radiotherapy to the heel are not allowed nor are patients with a severe psychiatric disease or women during pregnancy and breastfeeding. According to the statistical power calculation 100 patients have to be enrolled into each arm. After having obtaining a written informed consent a patient is randomized by the statistician to one of the arms mentioned above. After radiotherapy, the patients are seen first every six weeks, then regularly up to 48 months after therapy, they additionally receive a questionnaire every six weeks after the follow-up examinations. The effect is measured using several target variables (scores): Calcaneodynia-score according to Rowe et al., SF-12 score, and visual analogue scale of pain. The most important endpoint is the pain relief three months after therapy. Patients with an inadequate result are offered a second radiotherapy series applying the standard dose (equally in both arms). This trial protocol has been approved by the expert panel of the DEGRO as well as by the Ethics committee of the Saarland Physicians' Chamber. The trial is supported by a HOMFOR grant (Saarland University Research Grant). Trial registration Current controlled trials ISRCTN94220918 PMID:18801159

  2. Chronic Achilles TendinopathyA Prospective Randomized Study Comparing the Therapeutic Effect of Eccentric Training, the AirHeel Brace, and a Combination of Both

    Microsoft Academic Search

    Wolf Petersen; Robert Welp; Dieter Rosenbaum

    2007-01-01

    Background: Previous studies have shown that eccentric training has a positive effect on chronic Achilles tendinopathy. A new strategy for the treatment of chronic Achilles tendinopathy is the AirHeel brace.Hypothesis: AirHeel brace treatment improves the clinical outcome of patients with chronic Achilles tendinopathy. The combination of the AirHeel brace and an eccentric training program has a synergistic effect.Study Design: Randomized

  3. Diagnosis and treatment of jogger's heel.

    PubMed

    Horobin, Laura

    2015-02-01

    Plantar fasciitis, the most common cause of heel pain, is a self-limiting condition exacerbated by weight bearing after episodes at rest that usually resolves within 12 months after conservative treatment. This article outlines the aetiology of plantar fasciitis and refers to a case study in discussing diagnosis, examination and management. PMID:25659794

  4. Effect of heel height on in-shoe localized triaxial stresses

    Microsoft Academic Search

    Yan Cong; Jason Tak-Man Cheung; Aaron KL Leung; Ming Zhang

    2011-01-01

    Abnormal and excessive plantar pressure and shear are potential risk factors for high-heeled related foot problems, such as forefoot pain, hallux valgus deformity and calluses. Plantar shear stresses could be of particular importance with an inclined supporting surface of high-heeled shoe. This study aimed to investigate the contact pressures and shear stresses simultaneously between plantar foot and high-heeled shoe over

  5. Targeting the Plantar Fascia for Corticosteroid Injection.

    PubMed

    Salvi, Andrea Emilio

    2014-11-26

    Plantar fasciitis is often a difficult condition to treat. It is related to repetitive strain of the fascia at its attachment to the heel bone. This condition quite often appears with the concomitant presence of a plantar calcaneal heel spur. Corticosteroid injection is a popular treatment choice for plantar fasciitis, and accurate localization of the injected medication is essential for successful resolution of symptoms after the injection. In the present brief technical communication, a method for targeting the attachment of the plantar fascia to the medial tubercle of the tuberosity of the calcaneus is described. The targeting method uses the lateral radiograph of the foot to aid in localization of the proximal attachment of the plantar fascia to the calcaneus. PMID:25432461

  6. Lung cancer presenting as heel pain: A case report

    PubMed Central

    DAI, HAO; QIANG, MINFEI; CHEN, YANXI; ZHAI, WEITAO; ZHANG, KUN

    2014-01-01

    Bone metastasis as the first symptom of lung cancer is common, particularly in the axial skeleton. The calcaneus is an unusual site of metastatic involvement. Chronic plantar heel pain (CPHP) is one of the most common complaints of the foot requiring medical treatment. The most typical symptom of CPHP is pain under the medial heel during weight-bearing, and this symptom is therefore generally initially diagnosed as CPHP by clinicians. The current case study reports a female patient never-smoker with non-small cell lung cancer accompanied by calcaneal metastasis presenting as heel pain. The patient was initially diagnosed with CPHP without any imaging examinations. As there was no relief from the heel pain six months later, a foot X-ray was performed, which revealed a lesion of the calcaneus. The analysis of a biopsy obtained from the lesion resulted in a diagnosis of adenocarcinoma. The present case indicates that patients suspected to have CPHP should be conventionally examined with radiography of the foot during the initial diagnosis. Similarly, if a patient with lung cancer has symptoms such as CPHP, distant metastasis should be accounted for; despite their rarity, clinicians should maintain a high level of suspicion, since accurate diagnosis and timely treatment is important in management and outcome. PMID:25009652

  7. The integration of acetic acid iontophoresis, orthotic therapy and physical rehabilitation for chronic plantar fasciitis: a case study

    PubMed Central

    Costa, Ivano A; Dyson, Anita

    2007-01-01

    A 15-year-old female soccer player presented with chronic plantar fasciitis. She was treated with acetic acid iontophoresis and a combination of rehabilitation protocols, ultrasound, athletic taping, custom orthotics and soft tissue therapies with symptom resolution and return to full activities within a period of 6 weeks. She reported no significant return of symptoms post follow-up at 2 months. Acetic acid iontophoresis has shown promising results and further studies should be considered to determine clinical effectiveness. The combination of acetic acid iontophoresis with conservative treatments may promote recovery within a shorter duration compared to the use of one-method treatment approaches. PMID:17885679

  8. Plantar fasciitis: what is the diagnosis and treatment?

    PubMed

    Johnson, Rachel E; Haas, Kim; Lindow, Kyle; Shields, Robert

    2014-01-01

    Foot pain, specifically plantar heel pain, is a common complaint among patients in a podiatric or orthopaedic office setting but may be seen in primary care offices, urgent care centers, or emergency departments as well. There are numerous causes for heel pain, but plantar fasciitis is the most frequent cause. The diagnosis of plantar fasciitis is generally made clinically, but there are many diagnostic modalities that may be used to confirm the diagnosis. Treatment of plantar fasciitis ranges from conservative measures to surgical interventions, but most cases of plantar fasciitis can be managed conservatively. There is no definitive treatment proven to be the best option for plantar fasciitis. Treatment is patient dependent and commonly requires a combination of different modalities to successfully alleviate the symptoms. In this article, plantar fasciitis from defining the disorder, diagnosis, and treatment are discussed. PMID:25058723

  9. The Efficacy of Physical Therapy in the Treatment of Chronic Plantar Fasciitis

    Microsoft Academic Search

    Adrienne S. Hays; Gwen M. H. Kurilik

    2007-01-01

    Clinical Bottom Line: Research shows that plantar fasciitis is a syndrome resulting from a multitude of factors that cannot be addressed by any single treatment currently available. Rather, each contributing factor should be independently identified and addressed as part of a comprehensive treatment regimen that is individualized to each patient’s clinical presentation. That being said, the majority of our patients

  10. Cracked Heels

    MedlinePLUS

    ... Size Print Bookmark Cracked Heels There are many potential causes of " cracked heels ." Dry skin (xerosis) is common and can get worse with wearing open-back shoes, increased weight, or increased friction from the back of shoes. Dry cracking skin can also be a subtle sign of ...

  11. Reliability and Validity of the Standing Heel-Rise Test

    ERIC Educational Resources Information Center

    Yocum, Allison; McCoy, Sarah Westcott; Bjornson, Kristie F.; Mullens, Pamela; Burton, Gay Naganuma

    2010-01-01

    A standardized protocol for a pediatric heel-rise test was developed and reliability and validity are reported. Fifty-seven children developing typically (CDT) and 34 children with plantar flexion weakness performed three tests: unilateral heel rise, vertical jump, and force measurement using handheld dynamometry. Intraclass correlation…

  12. Treatment of proximal plantar fasciitis with ultrasound-guided steroid injection

    Microsoft Academic Search

    Wen-Chung Tsai; Chung-Li Wang; Fuk-Tan Tang; Tsz-Ching Hsu; Kuang-Hung Hsu; May-Kuen Wong

    2000-01-01

    Tsai W-C, Wang C-L, Tang F-T, Hsu T-C, Hsu K-H, Wong M-K. Treatment of proximal plantar fasciitis with ultrasound-guided steroid injection. Arch Phys Med Rehabil 2000;81:1416-21. Objective: To investigate the efficacy of ultrasound-guided steroid injection for the treatment of proximal plantar fasciitis and to evaluate mechanical properties of the heel pad after steroid injection. Design: Proximal plantar fascia and heel

  13. Mechanical Information of Plantar Fascia during Normal Gait

    NASA Astrophysics Data System (ADS)

    Gu, Yaodong; Li, Zhiyong

    The plantar fascia is an important foot tissue in stabilizing the longitudinal arch of human foot. Direct measurement to monitor the mechanical situation of plantar fascia at human locomotion is difficult. The purpose of this study was to construct a three-dimensional finite element model of the foot to calculate the internal stress/strain value of plantar fascia during different stage of gait. The simulated stress distribution of plantar fascia was the lowest at heel-strike, which concentrated on the medial side of calcaneal tubercle. The peak stress of plantar fascia was appeared at push-off, and the value is more than 5 times of the heel-strike position. Current FE model was able to explore the plantar fascia tension trend at the main sub-phases of foot. More detailed fascia model and intrinsic muscle forces could be developed in the further study.

  14. Chronic Plantar Fasciitis is Mediated by Local Hemodynamics: Implications for Emerging Therapies.

    PubMed

    Miller, Larry E; Latt, Daniel L

    2015-01-01

    Plantar fasciitis (PF) is a common, disabling condition affecting millions of patients each year. With early diagnosis and timely application of traditional nonsurgical treatments, symptoms generally resolve over time. However, despite adequate treatment, 20% of patients will experience persistent symptoms. In these patients, minimally invasive therapies that augment local hemodynamics to initiate a regenerative tissue-healing cascade have the greatest potential to resolve long-standing symptoms. We performed a narrative review based on a best evidence evaluation of manuscripts published in Medline-indexed journals to determine the mechanisms involved in soft tissue injury and healing. This evaluation also highlights emerging minimally invasive therapies that exploit these mechanisms in recalcitrant PF. PMID:25709971

  15. Magnetic resonance imaging in the evaluation of heel pain.

    PubMed

    Hall, R L; Erickson, S J; Shereff, M J; Johnson, J E; Kneeland, J B

    1996-03-01

    This study demonstrates magnetic resonance findings in 16 patients (25 heels) with heel pain. Sixteen of 25 (64%) studies demonstrated abnormalities which could be related to the etiology of their heel pain. Eleven of 16 abnormal scans demonstrated thickening of the plantar aponeurosis with associated fibrosis (7 of 11), and a tear of the flexor digitorum brevis (1 of 11). One study demonstrated changes in the heel pad consistent with fluid. The other four abnormal studies demonstrated changes thought to be consistent with bilateral fibrous calcaneonavicular coalitions, subtalar arthrosis and tenosynovitis of the posterior tibial, flexor digitorum longus, and flexor hallucis longus tendons. PMID:8867550

  16. Heel Pain

    MedlinePLUS

    ... pain is generally the result of faulty biomechanics (walking gait abnormalities) that place too much stress on the heel bone and the soft tissues that attach to it. The stress may also result from injury, or a bruise incurred while walking, running, or jumping on hard surfaces; wearing poorly ...

  17. How effective is therapeutic ultrasound in the treatment of heel pain?

    Microsoft Academic Search

    F Crawford; M Snaith

    1996-01-01

    OBJECTIVES: To evaluate the therapeutic effect from ultrasound in the treatment of plantar heel pain by physiotherapists and podiatrists, and to quantify the placebo effect of this electrophysical agent. METHODS: Patients experiencing episodes of plantar heel pain were allocated randomly, at each episode, to receive either true ultrasound (machine calibrated to deliver a dose of ultrasound at 0.5 w\\/cm2, 3

  18. Our experiences with the surgical treatment of plantar fasciitis

    Microsoft Academic Search

    Zoltán Jónás; Laszlo Kiss; János Szabó; István Soltész; Levente Gáspár; Zoltán Csernátony

    2010-01-01

    The authors present the results of surgical treatment of plantar fasciitis done at the University of Debrecen, Department\\u000a of Orthopaedics, between 1996 and 2004 on 52 feet of 42 patients. The surgical indication was heel pain unresponsive to at\\u000a least 6 months of conservative treatment with the exclusion of all differential diagnosis. During surgery, the partial detachment\\u000a of the plantar aponeurosis

  19. Heel reconstruction with free instep flap: a case report

    PubMed Central

    2014-01-01

    Introduction Reconstruction of weight-bearing heel defects remains a challenge because of the unique characteristics of the plantar skin. Though numerous surgical reconstructive options have been reported, the instep flap represents an ideal option and seems to be more acceptable to patients than others. However, when the heel defect expands to the instep area, the ipsilateral instep is not available for flap elevation. A free instep flap harvested from the contralateral foot can be a good solution, but this method has been scarcely reported. Case presentation A 41-year-old Asian man presented to our institution with a soft-tissue lesion in the weight-bearing heel and instep area. His heel was reconstructed with a free instep flap from the other foot, end-to-side anastomosis of its medial plantar artery to the recipient posterior tibial artery and end-to-side coaptation of the cutaneous sensory fascicles of the flap to the medial plantar nerve. Conclusion The flap survived successfully, and no ulceration occurred in the flap. At the last follow-up appointment at 30 months post-surgery, a very good functional and aesthetic outcome was verified, indicating that the suggested approach may prove to be the treatment of choice in selected cases of weight-bearing heel reconstruction. PMID:25260532

  20. Heel Injuries and Disorders

    MedlinePLUS

    Heel problems are common and can be painful. Often, they result from too much stress on your heel bone and the tissues that surround it. That ... of inflammation of the tissues that surround your heel. Over time the stress can cause bone spurs ...

  1. Biomechanical evaluation of heel elevation on load transfer — experimental measurement and finite element analysis

    NASA Astrophysics Data System (ADS)

    Luximon, Yan; Luximon, Ameersing; Yu, Jia; Zhang, Ming

    2012-02-01

    In spite of ill-effects of high heel shoes, they are widely used for women. Hence, it is essential to understand the load transfer biomechanics in order to design better fit and comfortable shoes. In this study, both experimental measurement and finite element analysis were used to evaluate the biomechanical effects of heel height on foot load transfer. A controlled experiment was conducted using custom-designed platforms. Under different weight-bearing conditions, peak plantar pressure, contact area and center of pressure were analyzed. A three-dimensional finite element foot model was used to simulate the high-heel support and to predict the internal stress distributions and deformations for different heel heights. Results from both experiment and model indicated that heel elevations had significant effects on all variables. When heel elevation increased, the center of pressure shifted from the midfoot region to the forefoot region, the contact area was reduced by 26% from 0 to 10.2 cm heel and the internal stress of foot bones increased. Prediction results also showed that the strain and total tension force of plantar fascia was minimum at 5.1 cm heel condition. This study helps to better understand the biomechanical behavior of foot, and to provide better suggestions for design parameters of high heeled shoes.

  2. Explicit finite element modelling of heel pad mechanics in running: inclusion of body dynamics and application of physiological impact loads.

    PubMed

    Chen, Wen-Ming; Lee, Peter Vee-Sin

    2015-01-01

    Many heel pathologies including plantar heel pain may result from micro tears/trauma in the subcutaneous tissues, in which internal tissue deformation/stresses within the heel pad play an important role. Previously, many finite element models have been proposed to evaluate stresses inside the heel pad, but the majority of these models only focus on static loading boundary conditions. This study explored a dynamics modelling approach to the heel pad subjected to realistic impact loads during running. In this model, the inertial property and action of the body are described by a lumped parameter model, while the heel/shoe interactions are modelled using a viscoelastic heel pad model with contact properties. The impact force pattern, dynamic heel pad deformation and stress states predicted by the model were compared with published experimental data. Further parametrical studies revealed the model responses, in terms of internal stresses in the skin and fatty tissue, change nonlinearly when body dynamics changes. A reduction in foot's touchdown velocity resulted in a less severe impact landing and stress relief inside the heel pad, for example peak von-Mises stress in fatty tissue, was reduced by 11.3%. Applications of the model may be extendable to perform iterative analyses to further understand the complex relationships between body dynamics and stress distributions in the soft tissue of heel pad during running. This may open new opportunities to study the mechanical aetiology of plantar heel pain in runners. PMID:24980181

  3. Plantar fasciitis. Etiology, treatment, surgical results, and review of the literature.

    PubMed

    Schepsis, A A; Leach, R E; Gorzyca, J

    1991-05-01

    Plantar fasciitis is a common orthopedic syndrome among athletes and nonathletes. The etiology of the pain is multifactorial but usually involves inflammation and degeneration of the plantar fascia origin. The majority of patients will respond to conservative measures. Surgical treatment is reserved for those patients who do not respond. A complete plantar fascia release is performed through a medial longitudinal incision. Prominent heel spurs and degenerated areas in the plantar fascia are resected. Of 27 surgically treated cases followed from one to three years, satisfactory results were obtained in 24 cases. Histologically, localized fibrosis or granulomatous changes or both were noted in several cases. PMID:2019049

  4. Operative treatment of plantar fasciitis.

    PubMed

    Kulthanan, T

    1992-06-01

    Ten patients undergoing 12 fasciotomy by stripping the plantar fascia and superficial plantar muscles from the calcaneus have been reviewed for an average of 24.9 months after the operation. All patients failed to respond to conservative treatment by anti-inflammatory medication, heel pads and local steroid injections for a duration of 6 months to 3 years (average 15 months). There were 7 females and 3 males. Their work was of a light nature and none of them were professional athletes. The results indicated 91.6 per cent excellent, 8.4 per cent good and no failure. Complete pain relief at rest and walking was obtained in 11 of 12 for an average of 11.75 months (from 8 months to 18 months) after surgery. There was only 1 of 12 who had mild pain at walking that did not impair activity. All patients could return to their jobs about 4-6 weeks after surgery. Bloodless operation (under tourniquet control) was performed under general anaesthesia. PMID:1487681

  5. Examining the degree of pain reduction using a multielement exercise model with a conventional training shoe versus an ultraflexible training shoe for treating plantar fasciitis.

    PubMed

    Ryan, Michael; Fraser, Scott; McDonald, Kymberly; Taunton, Jack

    2009-12-01

    Plantar fasciitis is a common injury to the plantar aponeurosis, manifesting as pain surrounding its proximal insertion at the medial calcaneal tubercle. Pain is typically worse in the morning when getting out of bed, and may subside after the tissue is sufficiently warmed up. For running-based athletes and individuals who spend prolonged periods of time on their feet at work, plantar fasciitis may become recalcitrant to conservative treatments such as ice, rest, and anti-inflammatory medication. Exercise-based therapies have received only limited attention in the literature for this common problem, yet they are becoming increasingly validated for pain relief and positive tissue remodeling at other sites of similar soft-tissue overuse injury. This study reports on pain outcomes in individuals experiencing chronic plantar fasciitis while wearing a shoe with an ultraflexible midsole (Nike Free 5.0) (FREE) versus a conventional training (CON) shoe in a 12-week multielement exercise regimen, and after a 6-month follow-up. Adults with >or= 6-month history of painful heel pain were recruited and randomly assigned to wear 1 of the 2 shoes. All subjects completed the same exercise protocol. A visual analogue scale item tracked peak pain in the preceding 24 hours taken at baseline, 6- and 12-week points, and at the 6-month follow-up. Twenty-one subjects completed the program (9 FREE; 12 CON). Both groups reported significant improvements in pain by the 6-month follow-up, and the FREE group reported an overall reduced level of pain throughout the study as a result of lower mean pain scores at the midpoint and post-test compared with the CON group. The exercise regimen employed in this study appears to reduce pain associated with chronic plantar fasciitis, and in doing so, the Nike 5.0 shoe may result in reductions in pain earlier than conventional running shoes. PMID:20048543

  6. Classification of Calcaneal Spurs and Their Relationship With Plantar Fasciitis.

    PubMed

    Zhou, Binghua; Zhou, You; Tao, Xu; Yuan, Chengsong; Tang, Kanglai

    2015-01-01

    Calcaneal spurs, as a cause of plantar fasciitis, are currently debatable. A prospective study was performed to classify calcaneal spurs according to the findings from an investigation of the relationship between calcaneal spurs and plantar fasciitis. Thirty patients with calcaneal spurs and plantar heel pain underwent calcaneal spur removal and endoscopic plantar fasciotomy. The relationship between the classification of calcaneal spurs and plantar fasciitis was evaluated by endoscopic findings, clinical symptoms, radiographic images, and biopsy findings. The visual analog scale for pain and the American Orthopedic Foot and Ankle Society ankle-hindfoot scores for functional evaluation were used preoperatively and postoperatively, respectively. The mean follow-up period was 24 months. Two separate types of calcaneal spurs were recognized. Type A calcaneal spurs were located superior to the plantar fascia insertion, and type B calcaneal spurs were located within the plantar fascia. Magnetic resonance imaging results showed a more severe plantar fasciitis grade in type B calcaneal spurs preoperatively. Histologic examination showed that the numbers of granulocytes per image in type B spurs were significantly increased compared with those in type A spurs. Statistically significant improvements were found in the mean visual analog scale and American Orthopedic Foot and Ankle Society scores and magnetic resonance imaging results in both groups. The amount of change in the visual analog scale score and American Orthopedic Foot and Ankle Society score, the number of granulocytes per image, and calcaneal spur length showed a high association with the classification of the calcaneal spurs. Calcaneal spurs were completely removed and did not recur in any of the patients on radiographic assessment during the follow-up period. Calcaneal spurs can be classified into 2 distinct types that are indicative of the severity of plantar fasciitis. PMID:25771476

  7. Recurrent plantar keloid.

    PubMed

    Sandler, B

    1999-06-01

    Keloids of the plantar foot present a unique challenge to the surgical dermatologist. Many of the established regimens often fall short of their desired goals. Some of the obstacles to overcome include the repetitive nature of ambulation, the inability to primarily close the plantar foot, and the exquisite tendency for even fine suturing of skin grafts to form keloids. The use of excision, postoperative electron beam therapy, and secondary intention healing provides a useful approach in the management of plantar keloids. PMID:10388951

  8. Effect of Field Size and Length of Plantar Spur on Treatment Outcome in Radiation Therapy of Plantar Fasciitis: The Bigger the Better?

    SciTech Connect

    Hermann, Robert Michael, E-mail: hermann@strahlentherapie-westerstede.com [Zentrum für Strahlentherapie und Radioonkologie, Bremen/Westerstede (Germany); Abteilung Strahlentherapie und Spezielle Onkologie, Medizinische Hochschule Hannover (Germany); Meyer, Andreas [Abteilung Strahlentherapie und Spezielle Onkologie, Medizinische Hochschule Hannover (Germany); Gemeinschaftspraxis für Strahlentherapie Hildesheim/Goslar (Germany); Becker, Alexandra [Zentrum für Strahlentherapie und Radioonkologie, Bremen/Westerstede (Germany); Schneider, Michael [Orthopaedic Centre for Musculoskeletal Research, University of Würzburg (Germany); Reible, Michael; Carl, Ulrich Martin [Zentrum für Strahlentherapie und Radioonkologie, Bremen/Westerstede (Germany); Christiansen, Hans [Abteilung Strahlentherapie und Spezielle Onkologie, Medizinische Hochschule Hannover (Germany); Nitsche, Mirko [Zentrum für Strahlentherapie und Radioonkologie, Bremen/Westerstede (Germany); Klinik für Strahlentherapie, Karl-Lennert-Krebscentrum, Universität Kiel (Germany)

    2013-12-01

    Purpose: Radiation therapy is well established in the treatment of painful plantar fasciitis or heel spur. A retrospective analysis was conducted to investigate the effect of field definition on treatment outcome and to determine the impact of factors potentially involved. Methods and Materials: A review of treatment data of 250 patients (285 heels) with a mean follow-up time of 11 months showed that complete symptom remission occurred in 38%, partial remission in 32%, and no change in 19% (11% were lost to follow-up). Variables such as radiologic evidence of plantar spurs, their length, radiation dose, field size, age, sex, and onset of pain before administration of radiation therapy were investigated in univariate and multivariate regression analyses. Results: Treatment response depended upon age >53 years, length of heel spur ?6.5 mm (or no radiologic evidence of a heel spur), and onset of pain <12 months before radiation therapy. Patients with these clinical prerequisites stood a 93% chance of clinical response. Without these prerequisites, only 49% showed any impact. No influence of field size on treatment outcome became evident. Conclusion: Patients with short plantar heel spurs benefit from radiation therapy equally well as patients without any radiologic evidence. Moreover, smaller field sizes have the same positive effect as commonly used large field definitions covering the entire calcaneal bone. This leads to a recommendation of a considerable reduction of field size in future clinical practice.

  9. Fluoroscopy-assisted plantar fasciotomy and calcaneal exostectomy: a retrospective study and comparison of surgical techniques.

    PubMed

    Graves, R H; Levin, D R; Giacopelli, J; White, P R; Russell, R D

    1994-01-01

    A retrospective analysis of fluoroscopy-assisted plantar fasciotomy/calcaneal exostectomy is presented. The study included 34 patients whose symptoms were all improved to some degree by the procedure. On a five-point scale, the average improvement of preoperative symptoms was 3.2. There were a total of eight complications. The time it took to return to normal activities and until the pain became less than preoperatively was found to be decreased when compared with traditional methods. This technique, using a single, plantar medial, small incision should be considered as an option in the treatment of recalcitrant plantar fasciitis/heel spur syndrome. PMID:7849673

  10. Reconstruction of lateral forefoot using reversed medial plantar flap with free anterolateral thigh flap.

    PubMed

    Fujioka, Masaki; Hayashida, Kenji; Senju, Chikako

    2014-01-01

    Skin defects of the heel have frequently been reconstructed using the medial plantar flap; however, forefoot coverage has remained a challenge, because the alternatives for flap coverage have been very limited. We describe a case of malignant melanoma on the lateral forefoot that was radically removed and reconstructed successfully with a distally based medial plantar flap, together with a free anterolateral thigh flap. The advantages of this flap include that it does not reduce the vascular supply to the foot owing to reconstruction of the medial plantar vascular systems, reduces the risk of flap congestion, minimizes donor site morbidity, and enables the transport of structurally similar tissues to the plantar forefoot. We believe this technique is a reasonable reconstructive option for large lateral plantar forefoot defects. PMID:24534560

  11. Plantar fasciitis: diagnosis and therapeutic considerations.

    PubMed

    Roxas, Mario

    2005-06-01

    Plantar fasciitis is the most common cause of inferior heel pain. The pain and discomfort associated with this condition can have a dramatic impact on physical mobility. The etiology of this condition is not clearly understood and is probably multi-factorial in nature. Weight gain, occupation-related activity, anatomical variations, poor biomechanics, overexertion, and inadequate footwear are contributing factors. Although plantar fasciitis is generally regarded as a self-limited condition, it can take months to years to resolve, presenting a challenge for clinicians. Many treatment options are available that demonstrate variable levels of efficacy. Conservative therapies include rest and avoidance of potentially aggravating activities, stretching and strengthening exercises, orthotics, arch supports, and night splinting. Other considerations include use of anti-inflammatory agents, ultrasonic shockwave therapy, and, in the most extreme cases, surgery. This article reviews plantar fasciitis, presents the most effective treatment options currently available, and proposes nutritional considerations that may be beneficial in the management of this condition. PMID:15989378

  12. A novel treatment for refractory plantar fasciitis.

    PubMed

    Patel, Mihir M

    2015-03-01

    Chronic plantar fasciitis is a major health care problem worldwide and affects nearly 10% of the US population. Although most cases resolve with conservative care, the numerous treatments for refractory plantar fasciitis attest to the lack of consensus regarding these cases. The emerging goals for this condition are a minimally invasive percutaneous intervention that is safe, effective, and well-tolerated and has minimal morbidity and a low complication rate. We conducted a prospective study in which patients were allowed either to continue with noninvasive treatment or to undergo focal aspiration and partial fasciotomy with an ultrasonic probe. This is the first report of a plantar fascia partial release guided by ultrasonic energy delivered by a percutaneously inserted probe under local anesthesia. The procedure appears to be a safe, effective, well-tolerated treatment for a condition that is refractory to other options. PMID:25750942

  13. Retrospective analysis of minimal-incision, endoscopic, and open procedures for heel spur syndrome.

    PubMed

    Brekke, M K; Green, D R

    1998-02-01

    Forty-four patients with recalcitrant heel spur syndrome who underwent surgical correction (54 procedures) were studied retrospectively. The results of minimal-incision, endoscopic, and open plantar fasciotomy procedures were compared. This study focuses on patient satisfaction, pain reduction, convalescence, and postoperative problems. Although all procedure groups reported high degrees of patient satisfaction and reduction of pain, some notable differences among the three groups were observed. PMID:9503769

  14. Application of ultrasound in the assessment of plantar fascia in patients with plantar fasciitis: a systematic review.

    PubMed

    Mohseni-Bandpei, Mohammad Ali; Nakhaee, Masoomeh; Mousavi, Mohammad Ebrahim; Shakourirad, Ali; Safari, Mohammad Reza; Vahab Kashani, Reza

    2014-08-01

    Plantar fasciitis (PFS) is one of the most common causes of heel pain, estimated to affect 10% of the general population during their lifetime. Ultrasound (US) imaging technique is increasingly being used to assess plantar fascia (PF) thickness, monitor the effect of different interventions and guide therapeutic interventions in patients with PFS. The purpose of the present study was to systematically review previously published studies concerning the application of US in the assessment of PF in patients with PFS. A literature search was performed for the period 2000-2012 using the Science Direct, Scopus, PubMed, CINAHL, Medline, Embase and Springer databases. The key words used were: ultrasound, sonography, imaging techniques, ultrasonography, interventional ultrasonography, plantar fascia and plantar fasciitis. The literature search yielded 34 relevant studies. Sixteen studies evaluated the effect of different interventions on PF thickness in patients with PFS using US; 12 studies compared PF thickness between patients with and without PFS using US; 6 studies investigated the application of US as a guide for therapeutic intervention in patients with PFS. There were variations among studies in terms of methodology used. The results indicated that US can be considered a reliable imaging technique for assessing PF thickness, monitoring the effect of different interventions and guiding therapeutic interventions in patients with PFS. PMID:24798393

  15. Heel Pain in the Athlete

    PubMed Central

    Hunt, Kenneth John; Anderson, Robert B.

    2009-01-01

    Context: Heel pain, a relatively common problem in the athlete, can present a diagnostic and therapeutic dilemma. The purpose of this article is to review treatment techniques for common causes of heel pain in the athlete. Evidence Acquisition: Articles in the English literature through August 2008 were selected and reviewed in the context of the management of heel pain in the athlete. Clinical and surgical photographs are presented as an illustration of preferred techniques and pertinent pathologic findings. Results: Although nonoperative treatment remains the mainstay for most painful heel pathologies, a number of surgical interventions have shown encouraging results in carefully selected patients. Conclusions: The management of heel pain in the athlete requires diagnostic skill, appropriate imaging evaluation, and a careful, initially conservative approach to treatment. Surgical treatment can be successful in carefully selected patients. PMID:23015903

  16. Rearward movement of the heel at heel strike.

    PubMed

    McGorry, Raymond W; Chang, Chien-Chi; DiDomenico, Angela

    2008-11-01

    This paper describes the observation of rearward movement (RM) of the heel following heel strike occurring during normal gait. Thirty-one participants recruited as part of a larger study on slip kinematics walked the length of an 8-m runway at a speed of 1.5 m/s. Several floor surfaces, presented dry and with contaminant, were used for the purpose of eliciting a wide range of small slip distances. The normal force applied to a forceplate mounted in the runway was used to identify heel strike, as well as to calculate the utilized coefficient of friction during early stance phase. A motion analysis system tracked the displacement of two heel-mounted markers, and the data were used to derive kinematic variables related to the heel strike event. Results showed that RMs occurred in 18.1% of 494 trials, with a mean rearward displacement of 5.02 (+/-3.68) mm. When present, RMs occurred in close temporal proximity to heel strike, typically completing RM within 40 ms of the heel strike event. When divided into groups by age, older participants (>40 years) were more than twice as likely to have RMs as younger participants. When grouped by height or weight, differences in the proportion of trials with RMs were small. In trials where RMs were observed, forward slip distances were significantly less than for trials with no RMs, 2.17 (+/-3.87) mm vs. 12.58 (+/-10.71) mm, respectively. The time until the heel stopped moving during the post-heel strike period was not significantly different between RM and non-RM trials. Further investigation of this gait feature may improve understanding of normal gait patterns and may have implications for future slipmeter development. PMID:18280459

  17. A three-dimensional inverse finite element analysis of the heel pad.

    PubMed

    Chokhandre, Snehal; Halloran, Jason P; van den Bogert, Antonie J; Erdemir, Ahmet

    2012-03-01

    Quantification of plantar tissue behavior of the heel pad is essential in developing computational models for predictive analysis of preventive treatment options such as footwear for patients with diabetes. Simulation based studies in the past have generally adopted heel pad properties from the literature, in return using heel-specific geometry with material properties of a different heel. In exceptional cases, patient-specific material characterization was performed with simplified two-dimensional models, without further evaluation of a heel-specific response under different loading conditions. The aim of this study was to conduct an inverse finite element analysis of the heel in order to calculate heel-specific material properties in situ. Multidimensional experimental data available from a previous cadaver study by Erdemir et al. ("An Elaborate Data Set Characterizing the Mechanical Response of the Foot," ASME J. Biomech. Eng., 131(9), pp. 094502) was used for model development, optimization, and evaluation of material properties. A specimen-specific three-dimensional finite element representation was developed. Heel pad material properties were determined using inverse finite element analysis by fitting the model behavior to the experimental data. Compression dominant loading, applied using a spherical indenter, was used for optimization of the material properties. The optimized material properties were evaluated through simulations representative of a combined loading scenario (compression and anterior-posterior shear) with a spherical indenter and also of a compression dominant loading applied using an elevated platform. Optimized heel pad material coefficients were 0.001084 MPa (?), 9.780 (?) (with an effective Poisson's ratio (?) of 0.475), for a first-order nearly incompressible Ogden material model. The model predicted structural response of the heel pad was in good agreement for both the optimization (<1.05% maximum tool force, 0.9% maximum tool displacement) and validation cases (6.5% maximum tool force, 15% maximum tool displacement). The inverse analysis successfully predicted the material properties for the given specimen-specific heel pad using the experimental data for the specimen. The modeling framework and results can be used for accurate predictions of the three-dimensional interaction of the heel pad with its surroundings. PMID:22482682

  18. Injuries from High Heels on The Rise

    MedlinePLUS

    ... medlineplus/news/fullstory_152937.html Injuries From High Heels on the Rise Most of those seeking ER ... finds. U.S. emergency rooms treated 123,355 high-heel-related injuries between 2002 and 2012, say researchers ...

  19. Ultrasonographic findings of Achilles tendon and plantar fascia in patients with calcium pyrophosphate deposition disease.

    PubMed

    Ellabban, Abdou S; Kamel, Shereen R; Abo Omar, Hanaa A S; El-Sherif, Ashraf M H; Abdel-Magied, Rasha A

    2012-04-01

    The aims of the study were to detect the frequency of involvement of the Achilles tendon and plantar fascia in patients with calcium pyrophosphate deposition disease (CPPD) by high-frequency gray-scale ultrasonography (US) and power Doppler sonography (PDS) and to correlate these findings with demographic and clinical data. Two groups of patients were enrolled: group I (38 patients with CPPD) and group II (22 patients with knee OA). US/PDS examination of the heels was performed to both groups. In the CPPD group, US/PDS examination of the Achilles tendon revealed: calcification in 57.9%, enthesophytosis in 57.9%, enthesopathy in 23.7%, vascular sign in 21%, bursitis in 13.2%, and cortical bone irregularity in 10.5%. US/PDS examination of plantar fascia in the CPPD group revealed: calcification in 15.8%, cortical bone irregularity in 78.9%, enthesophytosis in 60.5%, and planter fasciitis in 42.1%. In patients with CPPD, age was significantly correlated with enthesophytosis and deep retrocalcaneal bursitis (p = 0.01 and p = 0.04, respectively). Heel tenderness and posterior talalgia were significantly correlated with Achilles tendon enthesopathy, vascular sign, and deep retrocalcaneal bursitis (p = 0.0001 for each). Inferior talalgia was significantly correlated with plantar fasciitis (p = 0.0001). The sensitivity of ultrasonography for detection of calcifications in Achilles tendon and plantar fascia was 57.9% and 15.8%, respectively, and the specificity was 100% for both. To conclude, ultrasonographic Achilles tendon and plantar fascia calcifications are frequent findings in patients with CPPD. These calcifications have a high specificity and can be used as a useful indirect sign of CPPD. PMID:22203095

  20. Runners of All Types Prone to Injuries

    MedlinePLUS

    ... The Achilles tendon is the connection between the heel and the muscles of the lower leg. Several ... Achilles tendinitis can develop into a chronic problem. Heel Pain (Heel Spurs and Plantar Fasciitis) – The most ...

  1. Greater toe grip and gentler heel strike are the strategies to adapt to slippery surface.

    PubMed

    Fong, Daniel Tik-Pui; Mao, De-Wei; Li, Jing-Xian; Hong, Youlian

    2008-01-01

    This study investigated the plantar pressure distribution during gait on wooden surface with different slipperiness in the presence of contaminants. Fifteen Chinese males performed 10 walking trials on a 5-m wooden walkway wearing cloth shoe in four contaminated conditions (dry, sand, water, oil). A pressure insole system was employed to record the plantar pressure data at 50Hz. Peak pressure and time-normalized pressure-time integral were evaluated in nine regions. In comparing walking on slippery to non-slippery surfaces, results showed a 30% increase of peak pressure beneath the hallux (from 195.6 to 254.1kPa), with a dramatic 79% increase in the pressure time integral beneath the hallux (from 63.8 to 114.3kPa) and a 34% increase beneath the lateral toes (from 35.1 to 47.2kPa). In addition, the peak pressure beneath the medial and lateral heel showed significant 20-24% reductions, respectively (from 233.6-253.5 to 204.0-219.0kPa). These findings suggested that greater toe grip and gentler heel strike are the strategies to adapt to slippery surface. Such strategies plantarflexed the ankle and the metatarsals to achieve a flat foot contact with the ground, especially at heel strike, in order to shift the ground reaction force to a more vertical direction. As the vertical ground reaction force component increased, the available ground friction increased and the floor became less slippery. Therefore, human could walk without slip on slippery surfaces with greater toe grip and gentler heel strike as adaptation strategies. PMID:18068710

  2. Plantar soft tissue thickness during ground contact in walking

    NASA Technical Reports Server (NTRS)

    Cavanagh, P. R.

    1999-01-01

    A technique is introduced for the measurement of plantar soft tissue thickness during barefoot walking. Subjects stepped into an adjustable Plexiglas frame which ensured that the required bony landmarks were appropriately positioned relative to a linear ultrasound probe connected to a conventional 7.5 MHz ultrasound scanner. Clear images of the metatarsal condyles or other foot bones were obtained throughout ground contact. Subsequent analysis of the video taped images using a motion analysis system allowed the tissue displacement to be calculated as a function of time. The tissue underneath the second metatarsal head was shown to undergo an average maximum compression of 45.7% during the late stages of ground contact during first step gait in a group of five normal subjects with a mean unloaded tissue thickness of 15.2 mm. The technique has a number of applications, including use in the validation of deformation predicted by finite element models of the soft tissue of the foot, and the study of alterations in the cushioning properties of the heel by devices which constrain the displacement of the heel pad.

  3. MRI of the plantar structures of the foot after falanga torture

    Microsoft Academic Search

    A. Savnik; K. Amris; H. Rřgind; K. Prip; B. Danneskiold-Samsře; F. Bojsen-Mřller; E. M. Bartels; H. Bliddal; J. Boesen; N. Egund

    2000-01-01

    .   Falanga is an ancient form of punishment or torture but is still commonly reported by our refugees. The late result of caning\\u000a the heel and ball of the foot is a chronic painful condition with few clinical signs. The aim of the present study was to\\u000a assess, by MRI, possible morphologic characteristics of the heel and ball of the

  4. Minimum indentation depth for characterization of 2nd sub-metatarsal head and heel pad tissue properties.

    PubMed

    Chin Teoh, Jee; Bena Lim, Ying; Lee, Taeyong

    2015-07-16

    Most in-vivo indentation techniques are limited by the lack of adequate indentation into the plantar soft tissue. The purpose of this study is therefore to assess the effect of deformation depth on plantar soft tissue behavior and to establish a guideline for the minimum indentation depth that is sufficient to quantify critical plantar soft tissue behavior. Twenty young subjects (20-25 years) participated in this study. The test was conducted with equal weight borne on each of the participants? feet to mimic the static stance of the gait cycle. During the experiment, the indenter probed the 2nd sub-metatarsal head (MTH) and heel pad tissue at a constant rate of 12.3mm/s. The maximum tissue deformation induced was varied from 1.2mm to 6.0mm, in steps of 1.2mm. The tissue stiffness obtained from the tissue response curves was compared and fitted to the proposed viscoelastic model. As the probe tip indents deeper into the plantar soft tissue beyond a threshold depth, Xs, the force gradient increases notably. The absolute value of Xs was approximately 2.23mm and 2.14mm at the heel and 2nd sub-MTH respectively. Indentation depths which were less than this threshold depth might not be representative of the nature of plantar soft tissue nor reflect the critical deformation it experiences during physical activities that expose the tissue to risk of ulceration. Our study indicated the necessity to induce a minimum tissue indentation depth in order to describe its actual characteristics. By doing so, additional useful parameters can be obtained to identify potentially abnormal soft tissue. PMID:25890816

  5. On high heels and short muscles: a multiscale model for sarcomere loss in the gastrocnemius muscle.

    PubMed

    Zöllner, Alexander M; Pok, Jacquelynn M; McWalter, Emily J; Gold, Garry E; Kuhl, Ellen

    2015-01-21

    High heels are a major source of chronic lower limb pain. Yet, more than one third of all women compromise health for looks and wear high heels on a daily basis. Changing from flat footwear to high heels induces chronic muscle shortening associated with discomfort, fatigue, reduced shock absorption, and increased injury risk. However, the long-term effects of high-heeled footwear on the musculoskeletal kinematics of the lower extremities remain poorly understood. Here we create a multiscale computational model for chronic muscle adaptation to characterize the acute and chronic effects of global muscle shortening on local sarcomere lengths. We perform a case study of a healthy female subject and show that raising the heel by 13cm shortens the gastrocnemius muscle by 5% while the Achilles tendon remains virtually unaffected. Our computational simulation indicates that muscle shortening displays significant regional variations with extreme values of 22% in the central gastrocnemius. Our model suggests that the muscle gradually adjusts to its new functional length by a chronic loss of sarcomeres in series. Sarcomere loss varies significantly across the muscle with an average loss of 9%, virtually no loss at the proximal and distal ends, and a maximum loss of 39% in the central region. These changes reposition the remaining sarcomeres back into their optimal operating regime. Computational modeling of chronic muscle shortening provides a valuable tool to shape our understanding of the underlying mechanisms of muscle adaptation. Our study could open new avenues in orthopedic surgery and enhance treatment for patients with muscle contracture caused by other conditions than high heel wear such as paralysis, muscular atrophy, and muscular dystrophy. PMID:25451524

  6. Proximally pedicled medial plantar flap based on superficial venous system alone for venous drainage.

    PubMed

    Wright, Thomas C; Mossaad, Bassem M; Chummun, Shaheel; Khan, Umraz; Chapman, Thomas W L

    2013-07-01

    The proximally pedicled medial plantar flap is well described for coverage of wounds around the ankle and heel. This flap is usually based on the deep venae comitantes for venous drainage, with the superficial veins divided during dissection. Usually any disruption of the deep venous system of the flap would result in abandoning this choice of flap. Venous congestion is a recognised complication of medial plantar flaps. The patient described in this case report had a medial ankle defect with exposed bone, for which a proximally pedicled medial plantar flap was used. As we raised the flap, both venae comitantes of the medial planter artery were found to be disrupted. The flap was raised based on the superficial veins draining into the great saphenous, as the only system for venous drainage, with no evidence of venous congestion. The flap was successfully transposed into the defect and healed with no complications. The proximally pedicled medial plantar flap can safely rely on the superficial venous system alone for drainage. In addition, preserving the superficial veins minimise the risk of venous congestion in this flap. We recommend preservation of superficial venous system when possible. PMID:23587679

  7. Body load in heel-strike running: The effect of a firm heel counter

    Microsoft Academic Search

    Uffe Jřrgensen

    1990-01-01

    The effect of a firm heel counter in the shoe was studied in 11 athletes during submaximal heel-strike running on a treadmill under standardized conditions. The runners were tested in identical shoes with and without the distal 2 cm of the firm heel counter. Body load was expressed by absolute and relative VO2, surface EMG on the right leg, and

  8. Complete remission of plantar fasciitis with a gluten-free diet: relationship or just coincidence?

    PubMed

    Paoloni, Marco; Tavernese, Emanuela; Ioppolo, Francesco; Fini, Massimo; Santilli, Valter

    2014-09-01

    We report the case of a 46-year-old woman with no known history for gluten sensitivity who presented severe heel pain, and was successfully managed with a gluten-free diet. Previously she had been unsuccessfully treated with several conservative remedies. The presence of musculoskeletal problems in patients with gluten sensitivity is not rare. To the best of our knowledge, however, this is the first case report mentioning the successful management of plantar fasciitis with a gluten-free diet. The case report highlights the importance of considering gluten sensitivity among other possible differential diagnosis for musculoskeletal pain insensitive to traditional therapies. PMID:25063015

  9. Significance of heel pad confinement for the shock absorption at heel strike.

    PubMed

    Jřrgensen, U; Ekstrand, J

    1988-12-01

    Shock absorption (SA) is a simple way to reduce the body load and can be used in the prevention and treatment of injuries. The heel pad is the most important shock absorber in the shoe heel complex. The purpose of this study was to investigate whether the SA at heel strike can be increased by heel support in people and shoes with high or low SA. The impact forces at heel strike were measured on an AMTI (R) force platform. Fourteen legs were tested in seven persons (nine with normal and five with low heel pad SA) in gait analysis and in human drop tests. The tests were performed barefooted, and in a soccer and a running shoe (selected by shoe drop test), with and without the distal 2 cm of the heel counter. The heel pad confinement produced by the heel counter (the heel counter effect) increased the SA in both shoe types significantly in both impact situations. The mean increase in SA was 8.8% (range 5.8%-15.5%). The heel counter effect was in all situations significantly higher in persons with low heel pad shock absorbency (LHPSA) than in those with normal heel pads. The barefoot impact peak force per kg body weight was significantly higher (6% mean) on the side with LHPSA. The running shoe provided the significantly greatest SA compared with the soccer shoe. It is concluded that the shock absorbency at heel strike can be increased significantly by heel support, with highest effect in persons with LHPSA, both in shoes with high and low SA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3253241

  10. Plantar Fasciitis: Prescribing Effective Treatments.

    ERIC Educational Resources Information Center

    Shea, Michael; Fields, Karl B.

    2002-01-01

    Plantar fasciitis is an extremely common, painful injury seen among people in running and jumping sports. While prognosis for recovery with conservative care is excellent, prolonged duration of symptoms affects sports participation. Studies on treatment options show mixed results, so finding effective treatments can be challenging. A logical…

  11. Pseudoaneurysm of the lateral plantar artery after foot laceration

    Microsoft Academic Search

    Brian P. Thornton; David J. Minion; Rhonda Quick; Henry C. Vasconez; Eric D. Endean

    2003-01-01

    Two children with lateral plantar artery pseudoaneurysms are presented. Both cases were associated with a plantar laceration and were successfully treated with ligation. Only one other report of a lateral plantar artery pseudoaneurysm was found in the literature; no reports involving the medial plantar artery have been reported. A cadaver dissection supports the hypothesis that the lateral plantar artery is

  12. The Three Dimensional Conformal Radiotherapy for Hyperkeratotic Plantar Mycosis Fungoides

    PubMed Central

    Lee, Sun Young; Kwon, Hyoung Cheol; Cho, Yong-Sun; Nam, Kyung-Hwa; Ihm, Chull-Wan

    2011-01-01

    The localized early-stage of Mycosis fungoides (MF) (stage IA-IIA) is usually treated with topical agents, such as nitrogen mustard, steroids, and phototherapy (UVB/PUVA) as first line therapy; response to these initial treatments is usually good. However, hyperkeratotic plantar lesions are clinically rare and have decreased responsiveness to topical agents. For such cases, physicians may consider local radiotherapy. Here, a case of an 18-year-old Korean woman who was treated with three-dimensional conformal radiotherapy (3D-CRT) for hyperkeratotic plantar lesions that were refractory to UVA-1, methotrexate, and topical steroids is reported. Complete remission was attained after radiotherapy. During the one-year follow-up period, there has been no evidence of disease recurrence and no chronic complications have been observed. PMID:22028574

  13. Homeopathic treatment of plantar warts.

    PubMed Central

    Labrecque, M; Audet, D; Latulippe, L G; Drouin, J

    1992-01-01

    OBJECTIVE: To evaluate the efficacy of a homeopathic treatment of plantar warts. DESIGN: Randomized double-blind placebo-controlled trial. SETTING: Hospital-based family medicine unit. PATIENTS: Patients were recruited from the unit, through advertisements in the local media and through personal contacts with colleagues. Of the 853 people screened between December 1987 and January 1989, 174 met the eligibility criteria (age 6 to 59 years and presence of one or more plantar warts untreated during the previous 3 months) and agreed to participate; 162 (93%) completed the 18-week follow-up. INTERVENTIONS: The 6-week homeopathic treatment consisted of thuya 30 "centésimal hahnemannien" (CH) (one tube containing 200 pellets weekly), antimonium crudum 7 CH (5 pellets daily) and nitricum acidum 7 CH (one tube containing 200 pellets daily). The placebo pellets were identical to the treatment pellets in appearance and taste. MAIN OUTCOME MEASURE: The proportion of healed patients; a patient was considered healed if all of the warts had disappeared. MAIN RESULTS: The rates of healing at 6, 12 and 18 weeks were 4.8%, 13.4% and 20.0% respectively in the homeopathic treatment group and 4.6%, 13.1% and 24.4% in the placebo treatment group. CONCLUSION: The homeopathic treatment was no more effective than the placebo treatment of plantar warts. PMID:1596811

  14. Infant heel nodules. Calcification of epidermal cysts.

    PubMed

    Lemont, Harvey; Brady, Jane

    2002-02-01

    Calcified nodules of the heel have been reported in high-risk neonates following multiple needle sticks to draw blood. Previous reports suggest that the needle stick trauma causes dystrophic calcification. A case of multiple discrete firm heel lesions, which began shortly after birth in an immature-birth weight neonate who had sustained multiple needle sticks of the heel, is presented. Histologically, these lesions demonstrated foci of calcification and fragments of keratin surrounded by an epithelial lining, suggesting that calcified nodules may also arise from epidermal implantation cysts that secondarily calcify. PMID:11847264

  15. The effect of customised and sham foot orthoses on plantar pressures

    PubMed Central

    2013-01-01

    Background The effectiveness of foot orthoses has been evaluated in many clinical trials with sham foot orthoses used as the control intervention in at least 10 clinical trials. However, the mechanical effects and credibility of sham orthoses has been rarely quantified. This study aimed to: (i) compare the effects on plantar pressures of three sham foot orthoses to a customised foot orthosis, and (ii) establish the perceived credibility and the expected benefit of each orthotic condition. Methods Thirty adults aged between 18 and 51 participated in this study. At 0 and 4 weeks, plantar pressure data were collected for the heel, midfoot and forefoot using the pedar®-X in-shoe system for the following five randomly assigned conditions: (i) shoe alone, (ii) customised foot orthosis, (iii) contoured polyethylene sham foot orthosis, (iv) contoured EVA sham foot orthosis, and (v) flat EVA sham foot orthosis. At the initial data collection session, each participant completed a Credibility/Expectancy Questionnaire (CEQ) to determine the credibility and expected benefit of each orthotic condition. Results Compared to the shoe alone at week 0, the contoured polyethylene sham orthosis was the only condition to not significantly effect peak pressure at any region of the foot. In contrast, the contoured EVA sham orthosis, the flat EVA sham orthosis and the customised orthosis significantly reduced peak pressure at the heel. At the medial midfoot, all sham orthoses provided the same effect as the shoe alone, which corresponded to effects that were significantly different to the customised orthosis. There were no differences in peak pressure between conditions at the other mask regions, the lateral midfoot and forefoot. When the conditions were compared at week 4, the differences between the conditions were generally similar to the findings observed at week 0. With respect to credibility and expected benefit, all orthotic conditions were considered the same with the exception of the contoured polyethylene sham orthosis, which was perceived as being less credible and less likely to provide benefits. Conclusion The findings of this study indicate that all of the sham orthoses tested provided the same effect on plantar pressures at the midfoot and forefoot as a shoe alone. However, the contoured EVA sham orthosis and the flat EVA sham orthosis significantly reduced peak pressure under the heel, which was similar to the customised orthosis. In contrast, the contoured polyethylene sham orthosis had no significant effect on plantar pressure and was comparable to the shoe alone at all regions of the foot. Hence, lower plantar pressures were found under the heel with some sham orthoses, but not with others. Importantly, participants perceived the polyethylene sham orthosis – the sham that had no effect on plantar pressure – to be the least credible orthosis and the least likely to provide benefits. This may be critical for the design of future clinical trials as it may introduce confounding effects that produce inaccurate results. These findings provide some evidence for the mechanical effects, treatment credibility and expected benefit of sham foot orthoses, which should be considered when they are used as a control intervention in a clinical trial. PMID:23680496

  16. Classification of plantar pressure and heel acceleration patterns using neural networks

    Microsoft Academic Search

    E. S. Sazonov; T. Bumpus; S. Zeigler; S. Marocco

    2005-01-01

    Postural control in humans relies on information from receptors in the proprioceptive, visual, and vestibular systems of the body. As part of human aging, declines in all three postural control systems occur. Age-related changes impact multiple gait parameters, such as decreased range of motion in plantarflexion, increased hip flexion, and reduced stride length and gait velocity. In addition, excessive weight

  17. Histomorphological Evaluation of Diabetic and Non-Diabetic Plantar Soft Tissue

    PubMed Central

    Wang, Yak-Nam; Lee, Kara; Ledoux, William R.

    2014-01-01

    Background Diabetic foot ulceration has a complex and multi-factorial etiology and can involve changes in the pathophysiology of the plantar soft tissue. In the current study, histomorphological analyses of diabetic and non-diabetic plantar tissue were performed. It was hypothesized that the diabetic tissue would have thicker skin (epidermis and dermis), less interdigitation between the dermis and epidermis, thicker elastic septa and decreased adipose cell size. Materials and Methods Two locations of the foot (the heel and the first metatarsal) were examined, both of which have been reported to be locations with a high incidence of ulceration. Stereological methods and quantitative morphological techniques were used to evaluate the skin thickness, interdigitation index, elastic septae thickness and adipocyte cell size. Results The diabetic donors had a greater body mass index (BMI) than the non-diabetic donors. The diabetic tissue had significantly thicker elastic septae and dermis. However, no significant difference was observed in the interdigitation index or adipocyte size. Conclusion These findings demonstrate that morphological changes can be evaluated histologically to give a better understanding of the pathological changes in the plantar soft tissue with diabetes. These evaluations can then be associated with biomechanical changes that occur in diabetes to provide new insight into how microstructural changes can alter macroscopic properties. Clinical Relevance An understanding of the histomorphological changes in the soft tissue in relationship to the location on the foot could help to explain the biomechanical changes that occur in diabetes and the subsequent increase in susceptibility to breakdown. PMID:22049867

  18. Effect of custom-made and prefabricated insoles on plantar loading parameters during running with and without fatigue.

    PubMed

    Lucas-Cuevas, Angel Gabriel; Pérez-Soriano, Pedro; Llana-Belloch, Salvador; Macián-Romero, Cecili; Sánchez-Zuriaga, Daniel

    2014-01-01

    Controversy exists whether custom-made insoles are more effective in reducing plantar loading compared to prefabricated insoles. Forty recreational athletes ran using custom-made, prefabricated, and the original insoles of their running shoes, at rest and after a fatigue run. Contact time, stride rate, and plantar loading parameters were measured. Neither the insole conditions nor the fatigue state modified contact time and stride rate. Addressing prevention of running injuries, post-fatigue loading values are of great interest. Custom-made insoles reduced the post-fatigue loading under the hallux (92 vs. 130 kPa, P < 0.05), medial midfoot (70 vs. 105 kPa, P < 0.01), and lateral midfoot (62 vs 96 kPa, P < 0.01). Prefabricated insoles provoked reductions in post-fatigue loading under the toes (120 vs. 175 kPa, P < 0.05), medial midfoot (71 vs. 105 kPa, P < 0.01), and lateral midfoot (68 vs. 96 kPa, P < 0.01). Regarding both study insoles, custom-made insoles reduced by 31% and 54% plantar loading under the medial and lateral heel compared to the prefabricated insoles. Finally, fatigue state did not influence plantar loading regardless the insole condition. In long-distance races, even a slight reduction in plantar loading at each foot strike may suppose a significant decrease in the overall stress experienced by the foot, and therefore the use of insoles may be an important protective mechanism for plantar overloading. PMID:24823258

  19. Body load in heel-strike running: the effect of a firm heel counter.

    PubMed

    Jřrgensen, U

    1990-01-01

    The effect of a firm heel counter in the shoe was studied in 11 athletes during submaximal heel-strike running on a treadmill under standardized conditions. The runners were tested in identical shoes with and without the distal 2 cm of the firm heel counter. Body load was expressed by absolute and relative VO2, surface EMG on the right leg, and g-force registration from an accelerometer below the right tibial tuberosity. The heel counter caused a 2.4% significant decrease in VO2, a reduction in musculoskeletal transients, and a decrease in the activity of the triceps surae and quadriceps muscles at heel strike. The changes found are expressions of kinematic adaptations in the body to increased or decreased load and provide functional evidence for the loading factor in the pathophysiology of overuse injuries. PMID:2343986

  20. Effect of heel pressure pad attached to ankle-foot orthosis on the energy conversion efficiency in post-stroke hemiplegic gait

    PubMed Central

    Kon, Keisuke; Hayakawa, Yasuyuki; Shimizu, Shingo; Tsuruga, Takeshi; Murahara, Shin; Haruna, Hirokazu; Ino, Takumi; Inagaki, Jun; Yamamoto, Sumiko

    2015-01-01

    [Purpose] This study aimed to analyze the effect of heel pads in ankle-foot orthoses on dynamic motion aspects of gait in stroke patients from the viewpoint of energy conversion efficiency. [Subjects] Fourteen chronic stroke patients who were ambulatory and had lower extremity motor function categorized as Brunnstrom stage IV participated in the study. [Methods] A three-dimensional motion analysis system was used to assess the effect of heel pad intervention on dynamic motion gait parameters using a single-system A-B-A design. [Results] The results showed that a heel pad attached to the ankle-foot orthosis caused significant retention of the center-of-pressure at the heel during the heel rocker function and significant increase in the dorsiflexion moment and the height of the center of gravity. [Conclusion] The present study showed that a heel pad attached to the calcaneal region of an ankle-foot orthosis caused slight retention of the center-of-pressure at the heel during the heel rocker function along with center of gravity elevation in the stance phase and improved the energy conversion efficiency, especially on the non-paretic side. PMID:26157215

  1. Effect of heel pressure pad attached to ankle-foot orthosis on the energy conversion efficiency in post-stroke hemiplegic gait.

    PubMed

    Kon, Keisuke; Hayakawa, Yasuyuki; Shimizu, Shingo; Tsuruga, Takeshi; Murahara, Shin; Haruna, Hirokazu; Ino, Takumi; Inagaki, Jun; Yamamoto, Sumiko

    2015-05-01

    [Purpose] This study aimed to analyze the effect of heel pads in ankle-foot orthoses on dynamic motion aspects of gait in stroke patients from the viewpoint of energy conversion efficiency. [Subjects] Fourteen chronic stroke patients who were ambulatory and had lower extremity motor function categorized as Brunnstrom stage IV participated in the study. [Methods] A three-dimensional motion analysis system was used to assess the effect of heel pad intervention on dynamic motion gait parameters using a single-system A-B-A design. [Results] The results showed that a heel pad attached to the ankle-foot orthosis caused significant retention of the center-of-pressure at the heel during the heel rocker function and significant increase in the dorsiflexion moment and the height of the center of gravity. [Conclusion] The present study showed that a heel pad attached to the calcaneal region of an ankle-foot orthosis caused slight retention of the center-of-pressure at the heel during the heel rocker function along with center of gravity elevation in the stance phase and improved the energy conversion efficiency, especially on the non-paretic side. PMID:26157215

  2. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up.

    PubMed

    Rathleff, M S; Mřlgaard, C M; Fredberg, U; Kaalund, S; Andersen, K B; Jensen, T T; Aaskov, S; Olesen, J L

    2015-06-01

    The aim of this study was to investigate the effectiveness of shoe inserts and plantar fascia-specific stretching vs shoe inserts and high-load strength training in patients with plantar fasciitis. Forty-eight patients with ultrasonography-verified plantar fasciitis were randomized to shoe inserts and daily plantar-specific stretching (the stretch group) or shoe inserts and high-load progressive strength training (the strength group) performed every second day. High-load strength training consisted of unilateral heel raises with a towel inserted under the toes. Primary outcome was the foot function index (FFI) at 3 months. Additional follow-ups were performed at 1, 6, and 12 months. At the primary endpoint, at 3 months, the strength group had a FFI that was 29 points lower [95% confidence interval (CI): 6-52, P?=?0.016] compared with the stretch group. At 1, 6, and 12 months, there were no differences between groups (P?>?0.34). At 12 months, the FFI was 22 points (95% CI: 9-36) in the strength group and 16 points (95% CI: 0-32) in the stretch group. There were no differences in any of the secondary outcomes. A simple progressive exercise protocol, performed every second day, resulted in superior self-reported outcome after 3 months compared with plantar-specific stretching. High-load strength training may aid in a quicker reduction in pain and improvements in function. PMID:25145882

  3. Foot Plantar Pressure Measurement System: A Review

    PubMed Central

    Razak, Abdul Hadi Abdul; Zayegh, Aladin; Begg, Rezaul K.; Wahab, Yufridin

    2012-01-01

    Foot plantar pressure is the pressure field that acts between the foot and the support surface during everyday locomotor activities. Information derived from such pressure measures is important in gait and posture research for diagnosing lower limb problems, footwear design, sport biomechanics, injury prevention and other applications. This paper reviews foot plantar sensors characteristics as reported in the literature in addition to foot plantar pressure measurement systems applied to a variety of research problems. Strengths and limitations of current systems are discussed and a wireless foot plantar pressure system is proposed suitable for measuring high pressure distributions under the foot with high accuracy and reliability. The novel system is based on highly linear pressure sensors with no hysteresis. PMID:23012576

  4. Improved method for determining tank heel volumes

    Microsoft Academic Search

    S. H. Holt; R. R. Livingston; S. E. Nave

    1994-01-01

    As part of the tank calibration process, the instrument heel is that part of the tank that cannot be measured by the liquid level instrumentation. if the tank being calibrated is not a bottom drain tank, some volume of fluid will be present in the bottom of the tank after draining as much as possible. The amount of fluid remaining

  5. Effect of overground vs treadmill running on plantar pressure: influence of fatigue.

    PubMed

    García-Pérez, José A; Pérez-Soriano, Pedro; Llana, Salvador; Martínez-Nova, Alfonso; Sánchez-Zuriaga, Daniel

    2013-09-01

    The differences produced when running on a treadmill vs overground may call into question the use and validity of the treadmill as a piece of equipment commonly used in research, training, and rehabilitation. The aim of the present study was to analyze under pre/post fatigue conditions the effect of treadmill vs overground on plantar pressures. Twenty-seven recreational runners (17 men and 10 women) ran on a treadmill and overground at two speeds: S1=3.33 m/s and S2=4.00 m/s, before and after a fatigue protocol consisting of a 30-min run at 85% of their individual maximal aerobic speed (MAS). Contact time (CT in seconds), peak pressure (PP in kPa), and relative load (RL in %) were analyzed under nine foot zones of the left foot using an in-shoe plantar pressure device. A two-way repeated measures ANOVA showed that running on a treadmill increases CT (7.70% S1 and 9.91% S2), modifies the pressure distribution and reduces PP (25.98% S1 and 31.76% S2), especially under the heel, medial metatarsals, and hallux, compared to running overground. Moreover, on both surfaces, fatigue (S2) led to a reduced stride frequency (2.78%) and reduced PP on the lateral heel and hallux (15.96% and 16.35%, respectively), and (S1) increased relative load on the medial arch (9.53%). There was no significant interaction between the two factors analyzed (surface and fatigue). Therefore, the aforementioned surface effect, which occurs independently of the fatigue state, should be taken into account when interpreting the results of studies that use the treadmill in their experimental protocols, and when prescribing physical exercise on a treadmill. PMID:23746487

  6. In the clinic. Plantar fasciitis.

    PubMed

    Young, Craig

    2012-01-01

    This issue provides a clinical overview of plantar fasciitis focusing on prevention, diagnosis, treatment, practice improvement, and patient information. Readers can complete the accompanying CME quiz for 1.5 credits. Only ACP members and individual subscribers can access the electronic features of In the Clinic. Non-subscribers who wish to access this issue of In the Clinic can elect "Pay for View." Subscribers can receive 1.5 category 1 CME credits by completing the CME quiz that accompanies this issue of In the Clinic. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including PIER (Physicians' Information and Education Resource) and MKSAP (Medical Knowledge and Self Assessment Program). Annals of Internal Medicine editors develop In the Clinic from these primary sources in collaboration with the ACP's Medical Education and Publishing division and with assistance of science writers and physician writers. Editorial consultants from PIER and MKSAP provide expert review of the content. Readers who are interested in these primary resources for more detail can consult www.acponline.org, http://pier.acponline.org, and other resources referenced within each issue of In the Clinic. PMID:22213510

  7. Different surgical treatment of post-burn trophic ulcers of the plantar surface in foot burns.

    PubMed

    Shakirov, Babur M

    2011-12-01

    Burns of the plantar surface of the foot with the subsequent formation of scar is often complicated by unhealing trophic ulcers. Trophic ulcers increase due to constant local irritation, reaching various depth and area, penetrating to the bone and the tendons and covering the area of several centimetres in diameter up to the whole heel area. A total of 21 patients (12 men and nine women) have been under our observation at Samarkand Inter-Regional Burn Center, Uzbekistan, for prolonged trophic ulcers of soft tissues of the plantar surface of the foot. Ulcers sizes were from 1.0-2.5 to 3-5 cm in diameter. All patients had undergone earlier unsuccessful operation (3-5 times). The method of closure should be chosen according to both severity and localisation of the injury, using local uninjured tissues and soft scars to make bilobed skin-flap plasty, one-lobed skin-flat flap, tube graft and other shaped flaps and free grafts placed on the area of the excised scars. In 18 observations, a good result was achieved and no complications were noted. The grafts were viable, sensibility was preserved and no marginal necrosis was noticed. Patients can take up their work by 1.5-2.0 months after surgery. PMID:21924835

  8. Effect of rocker shoes on plantar pressure pattern in healthy female runners.

    PubMed

    Sobhani, Sobhan; van den Heuvel, Edwin; Bredeweg, Steef; Kluitenberg, Bas; Postema, Klaas; Hijmans, Juha M; Dekker, Rienk

    2014-03-01

    Rocker profile shoes (rocker shoes) are one of the treatment options of metatarsalgia and forefoot stress fractures. The efficacy of rocker shoes in unloading the forefoot pressure has been shown in walking. In running, however, the effect of rocker shoes on forefoot pressure is unknown. Eighteen healthy female runners participated in this study. In-shoe plantar pressures were recorded during running with the standard running shoes and rocker shoes. Shoe comfort was assessed after each shoe measurement. Peak pressure (PP), maximum mean pressure (MMP) and force-time integral (FTI) were determined for seven foot areas. The effects of shoes on the different outcome variables were statistically analyzed using a linear mixed model. Running with the rocker shoes caused a significant reduction (p<0.001) in all pressure parameters in the central and lateral forefoot. FTI and MMP were also reduced by 11% and 12% in the medial forefoot while running with rocker shoes. Running with rocker shoes resulted in a significant increase in all pressure parameters at the heel region (p<0.001). Running with rocker shoes received a significant (p<0.01) lower comfort rate than running with standard running shoes. Rocker shoes might be beneficial for runners who are recovering from metatarsalgia or stress fractures of the forefoot region, as it reduces plantar pressure in the forefoot region. PMID:24370440

  9. The effect of backpack load on muscle activities of the trunk and lower extremities and plantar foot pressure in flatfoot.

    PubMed

    Son, Hohee

    2013-11-01

    [Purpose] The purpose of this study was to investigate the changes in muscle activation of the trunk and lower extremities and plantar foot pressure due to backpack loads of 0, 10, 15, and 20% of body weight during level walking in individuals with flatfoot. [Methods] Fourteen young flatfoot subjects and 12 normal foot subjects participated in this study. In each session, the subjects were assigned to carry a backpack load, and there were four level walking modes: (1) unloaded walking (0%), (2) 10% body weight (BW) load, (3) 15% BW load, and (4) 20% BW load. Trunk and lower extremity muscle activities were recorded by surface EMG, and contact area and plantar foot pressure were determined using a RS scan system. [Results] The erector spinae, vastus medialis, tibialis anterior and gastrocnemius muscle activities, but not the rectus femoris and rectus abdominis muscle activities of flatfoot subjects significantly and progressively increased as load increased in flatfoot subjects. Contact area and pressure of the lateral and medial heel zones were significantly increased too. [Conclusion] Based on this data, the weight of a backpack could influence muscle activation and plantar foot pressure in flatfoot. PMID:24396193

  10. The Effect of Backpack Load on Muscle Activities of the Trunk and Lower Extremities and Plantar Foot Pressure in Flatfoot

    PubMed Central

    Son, Hohee

    2013-01-01

    [Purpose] The purpose of this study was to investigate the changes in muscle activation of the trunk and lower extremities and plantar foot pressure due to backpack loads of 0, 10, 15, and 20% of body weight during level walking in individuals with flatfoot. [Methods] Fourteen young flatfoot subjects and 12 normal foot subjects participated in this study. In each session, the subjects were assigned to carry a backpack load, and there were four level walking modes: (1) unloaded walking (0%), (2) 10% body weight (BW) load, (3) 15% BW load, and (4) 20% BW load. Trunk and lower extremity muscle activities were recorded by surface EMG, and contact area and plantar foot pressure were determined using a RS scan system. [Results] The erector spinae, vastus medialis, tibialis anterior and gastrocnemius muscle activities, but not the rectus femoris and rectus abdominis muscle activities of flatfoot subjects significantly and progressively increased as load increased in flatfoot subjects. Contact area and pressure of the lateral and medial heel zones were significantly increased too. [Conclusion] Based on this data, the weight of a backpack could influence muscle activation and plantar foot pressure in flatfoot. PMID:24396193

  11. A functional foot type classification with cluster analysis based on plantar pressure distribution during jogging.

    PubMed

    De Cock, A; Willems, T; Witvrouw, E; Vanrenterghem, J; De Clercq, D

    2006-04-01

    The purpose of this study was to establish a reference dataset for peak pressures and pressure-time integrals during jogging, to compare this reference dataset with existing walking data and to develop a foot type classification, all based on plantar pressure data obtained from 215 healthy young adults. The subjects ran at 3.3 m s(-1) over a 16.5 m long running track, with a built-in pressure platform mounted on top of a force platform. Peak pressures, regional impulses and relative regional impulses were measured. These variables were found to be reliable (all intra class correlation coefficients above 0.75) and, except for the heel areas, gender and asymmetry effects could be neglected. Highest peak pressures were found under the heel due to large impact forces during initial contact phase (ICP). In the forefoot, the highest peak pressure was found under the second metatarsal (64.2 +/- 21.1 N cm(-2)). Compared to walking data, overall higher peak pressures and impulses and difference in hallux loading were found during barefoot jogging. Four pressure loading patterns were identified using a K-means cluster analysis, based on the relative regional impulses underneath the forefoot: medial M1 pattern, medial M2 pattern, central pattern and central-lateral pattern. These four pressure loading patterns could help in the functional interpretation of the foot behaviour during the stance phase in slow running. PMID:15990311

  12. Plantar Stresses on the Neuropathic Foot During Barefoot Walking

    Microsoft Academic Search

    Michael J Mueller; Dequan Zou; Kathryn L Bohnert; Lori J Tuttle; David R Sinacore

    2008-01-01

    Background and Purpose. Patients with diabetes mellitus and peripheral neuropathy are at high risk for plantar skin breakdown due to unnoticed plantar stresses during walking. The purpose of this study was to determine differences in stress variables (peak plantar pressure, peak pressure gradient, peak maximal sub- surface shear stress, and depth of peak maximal subsurface shear stress) between the forefoot

  13. Plantar vibration improves leg fluid flow in perimenopausal women

    Microsoft Academic Search

    Julian M. Stewart; Carol Karman; Leslie D. Montgomery

    2004-01-01

    Abstract Recent studies have indicated that plantar based vibration may be an effective approach for the prevention and treatment of osteoporosis. We addressed the hypothesis of whether the plantar vibration operated by way of the skeletal muscle pump, resulting in enhanced blood and fluid flow to the lower body. We combined,plantar stimulation with upright tilt table testing in 18 women

  14. Using horizontal heel displacement to identify heel strike instants in normal gait.

    PubMed

    Banks, Jacob J; Chang, Wen-Ruey; Xu, Xu; Chang, Chien-Chi

    2015-06-01

    Heel strike instants are an important component of gait analyses, yet accurate detection can be difficult without a force plate. This paper presents two novel techniques for kinematic heel strike instant (kHSI) detection which examined maximal resultant horizontal heel displacement (HHD). Each of these HHD techniques calculates HHD from a selected reference location of either the stance ankle or stance heel to the swing heel. The proposed techniques, along with other previously established techniques, were validated against a 10N force plate threshold. Fifty-four healthy adults walked overground at both normal and fast speeds while wearing athletic shoes. The reported true and absolute errors were as low as 3.2 (4.4) and 5.7 (3.4)ms, respectively, across 8678kHSI when using the stance ankle as a reference, which significantly outperformed (p<0.0001) the established techniques. Gait speed was shown to have a significant effect (p<0.0001) on HHD-determined kHSI, as well as the three other techniques evaluated, highlighting the need for condition-specific identification of kHSI. PMID:25907129

  15. Neuromuscular performance of paretic versus non-paretic plantar flexors after stroke

    Microsoft Academic Search

    Marius Steiro Fimland; Per Marius R. Moen; Tessa Hill; Tor Ivar Gjellesvik; Tom Třrhaug; Jan Helgerud; Jan Hoff

    The objective of this study was to compare the neuromuscular function of the paretic and non-paretic plantar flexors (i.e.\\u000a soleus, gastrocnemius medialis, lateralis) in chronic stroke patients. It was hypothesized that the contractile rate of force\\u000a development (RFD) and neural activation, assessed by electromyogram (EMG) and V-waves normalized to the M-wave, and voluntary\\u000a activation (twitch interpolation) would be reduced during

  16. Contribution of plantar pressure to the prevention and quantification of the muscle-skeletal injury risk in hiking trails--a pilot study.

    PubMed

    Gabriel, Ronaldo; Monteiro, Marco; Moreira, Helena; Maia, Miguel

    2008-01-01

    Hiking trails have been growing in popularity in the health and well-being promotion. Consequently, the foot became an object of study in order to understand the discomfort and pain in the lower limb. The aims of the work were: 1) to detect tendencies for behaviour of maximum values of plantar pressure (MaxP) during the walk on different slopes, 2) to contribute to the methodology of the difficulty level of hiking trails. Equations show strong tendencies (R2 > 0.8) of behaviour of MaxP in the lateral zones of the heel, 4th and 5th metatarsus as well as in the plantar zone of the hallux. The analysis of the difficulty level of the hiking trails branches deserves a separate presentation, including the technical difficulty analysis (with a compulsory emphasis on the biomechanics) and information on the caloric consumption and on the slopes of each branch. PMID:19152473

  17. The effects of orthotic intervention on multisegment foot kinematics and plantar fascia strain in recreational runners.

    PubMed

    Sinclair, Jonathan; Isherwood, Josh; Taylor, Paul J

    2015-02-01

    Chronic injuries are a common complaint in recreational runners. Foot orthoses have been shown to be effective for the treatment of running injuries but their mechanical effects are still not well understood. This study aims to examine the influence of orthotic intervention on multisegment foot kinematics and plantar fascia strain during running. Fifteen male participants ran at 4.0 m · s(-1) with and without orthotics. Multisegment foot kinematics and plantar fascia strain were obtained during the stance phase and contrasted using paired t tests. Relative coronal plane range of motion of the midfoot relative to the rearfoot was significantly reduced with orthotics (1.0°) compared to without (2.2°). Similarly, relative transverse plane range of motion was significantly lower with orthotics (1.1°) compared to without (1.8°). Plantar fascia strain did not differ significantly between orthotic (7.1) and nonorthotic (7.1) conditions. This study shows that although orthotics did not serve to reduce plantar fascia strain, they are able to mediate reductions in coronal and transverse plane rotations of the midfoot. PMID:25268399

  18. Plantar decubitus ulcers in rats and rabbits.

    PubMed

    Honma, M; Kast, A

    1989-07-01

    A high incidence of plantar decubitus ulcers, 35% in males and 22 or 45% in females, respectively, occurred in rats of two carcinogenicity studies independent of the bedding used, hard or soft wood chips. Among rabbits kept in chrome-plated wire cages, about 2-year-old female breeders suffered from the plantar ulcers, but not their male partners of the same age group. The causes of the foot disease appear to be manifold, however, in our cases the lesions could be prevented in both species by housing on a cage floor made from flattened stainless wire. PMID:2792208

  19. Detection Human Motion with Heel Strikes for Surveillance Analysis

    Microsoft Academic Search

    Sung-Uk Jung; Mark S. Nixon

    \\u000a Heel strike detection is an important cue for human gait recognition and detection in visual surveillance since the heel strike\\u000a position can be used to derive the gait periodicity, stride and step length. We propose a novel method for heel strike detection\\u000a using a gait trajectory model, which is robust to occlusion, camera view and to low resolution which can

  20. Effects of Combined Foot/Ankle Electromyostimulation and Resistance Training on the In-Shoe Plantar Pressure Patterns during Sprint in Young Athletes

    PubMed Central

    Fourchet, François; Kuitunen, Sami; Girard, Olivier; Beard, Adam J.; Millet, Grégoire P.

    2011-01-01

    Several studies have already reported that specific foot/ankle muscle reinforcement strategies induced strength and joint position sense performance enhancement. Nevertheless the effects of such protocols on sprint performance and plantar loading distribution have not been addressed yet. The objective of the study is to investigate the influence of a 5-wk foot/ankle strength training program on plantar loading characteristics during sprinting in adolescent males. Sixteen adolescent male athletes of a national training academy were randomly assigned to either a combined foot/ankle electromyostimulation and resistance training (FAST) or a control (C) group. FAST consisted of foot medial arch and extrinsic ankle muscles reinforcement exercises, whereas C maintained their usual training routine. Before and after training, in-shoe loading patterns were measured during 30-m running sprints using pressure sensitive insoles (right foot) and divided into nine regions for analysis. Although sprint times remained unchanged in both groups from pre- to post- training (3.90 ± 0.32 vs. 3.98 ± 0.46 s in FAST and 3.83 ± 0.42 vs. 3.81 ± 0.44 s in C), changes in force and pressure appeared from heel to forefoot between FAST and C. In FAST, mean pressure and force increased in the lateral heel area from pre- to post- training (67.1 ± 44.1 vs. 82.9 ± 28.6 kPa [p = 0.06]; 25.5 ± 17.8 vs. 34.1 ± 14.3 N [p = 0.05]) and did not change in the medial forefoot (151.0 ± 23.2 vs. 146.1 ± 30.0 kPa; 142.1 ± 29.4 vs. 136.0 ± 33.8; NS). Mean area increased in FAST under the lateral heel from pre- to post- (4.5 ± 1.3 vs. 5.7 ± 1.6 cm2 [p < 0.05]) and remained unchanged in C (5.5 ± 2.8 vs. 5.0 ± 3.0 cm2). FAST program induced significant promising lateral and unwanted posterior transfer of the plantar loads without affecting significantly sprinting performance. Key points We have evaluated the effects of a foot/ankle strength training program on sprint performance and on related plantar loading characteristics in teenage athletes, and this have not been examined previously. Our results showed no significant pre- to post- changes in sprint performance. This study revealed initially a lateral transfer and secondly a posterior transfer of the plantar loads after the foot/ankle strength training program. PMID:24149874

  1. Glabrous skin grafts for plantar defects.

    PubMed

    Banis, J C

    2001-12-01

    The principle of reconstructing like to like has been a long-standing and useful concept for plastic surgeons. One arena in which this concept has not been put to its full use is that of reconstructing soft tissue deficits of the sole of the foot. Most commonly, plantar defects that are to be skin grafted are reconstructed with split- or full-thickness, nonglabrous skin grafts. Nonglabrous skin grafts have significant disadvantages when used for reconstruction of plantar defects. These include painful hyperkeratotic build up at the periphery of the skin grafts, craters, contractures, and tight subgraft fibrosis. Glabrous skin grafting has been applied widely for coverage of smaller defects in the hand and has yielded superior results with improved function and sensation, more normalcy of appearance, and increase durability. The concept of reconstructing plantar defects by this method has probably been impeded by the vague and erroneous, but broadly held, belief that donor-site healing in the foot would be problematic, that is, significant potential for excessive scarring, pain, and functional deficit. The long-standing use of glabrous skin grafts for plantar defects in this unit, however, confirms the desirability, functional advantage, and minimal morbidity of this technique. PMID:12134583

  2. Chemical lumbar sympathectomy in plantar hyperhidrosis

    Microsoft Academic Search

    Winston Bonetti Yoshida; Daniele Cristina Cataneo; Guilherme André Zottele Bomfim; Érica Hasimoto; Antonio José Maria Cataneo

    2010-01-01

    Plantar hyperhidrosis can cause great changes to an individual’s quality of life. We described a case successfully treated\\u000a by the minimally invasive method of percutaneous injection of 7.0% phenolic solution into the lumbar sympathetic chains.

  3. The reliability of isokinetic testing of the ankle joint and a heel-raise test for endurance.

    PubMed

    Möller, Michael; Lind, Karin; Styf, Jorma; Karlsson, Jon

    2005-01-01

    The aim of the present study was to investigate the reliability of different methods used for isokinetic testing of calf muscle strength and endurance. The detailed evaluation of test-retest reliability serves the purpose of establishing reliable research tools when evaluating patients who have sustained an Achilles tendon rupture. The test-retest reliability of isokinetic measurements at the ankle for eccentric and concentric muscle action was calculated in ten healthy male volunteers using intra-class correlation (ICC) and coefficient of variation (CV). Three different positions were compared at the angular velocities of 30 degrees /s and 180 degrees /s for right and left ankles. The ICC for plantar flexion was 0.37-0.95, whilst it was 0.00-0.96 for dorsiflexion. The corresponding CVs were 4.0-19.9 and 2.4-19.8 respectively. The test-retest reliability of standardised heel-raises, Achilles tendon width, calf circumference and ankle range of motion revealed ICC values of 0.71-0.98 and CVs of 0.67-19.1. The test-retest interval was 5 to 7 days. We conclude that all three positions studied for the isokinetic evaluation of calf muscle function are equally reliable concerning plantar flexion at the ankle joint. The same level of reliability was also found in the evaluation of the standing heel-raise test and the isokinetic dorsiflexion test, except for dorsiflexion in the supine position. The reliability of the investigated methods was only fair despite the use of a detailed and standardised test protocol. PMID:14634720

  4. Screening Method Based on Walking Plantar Impulse for Detecting Musculoskeletal Senescence and Injury

    PubMed Central

    Fan, Yifang; Fan, Yubo; Li, Zhiyu; Newman, Tony; Lv, Changsheng; Zhou, Yi

    2013-01-01

    No consensus has been reached on how musculoskeletal system injuries or aging can be explained by a walking plantar impulse. We standardize the plantar impulse by defining a principal axis of plantar impulse. Based upon this standardized plantar impulse, two indexes are presented: plantar pressure record time series and plantar-impulse distribution along the principal axis of plantar impulse. These indexes are applied to analyze the plantar impulse collected by plantar pressure plates from three sources: Achilles tendon ruptures; elderly people (ages 62–71); and young people (ages 19–23). Our findings reveal that plantar impulse distribution curves for Achilles tendon ruptures change irregularly with subjects’ walking speed changes. When comparing distribution curves of the young, we see a significant difference in the elderly subjects’ phalanges plantar pressure record time series. This verifies our hypothesis that a plantar impulse can function as a means to assess and evaluate musculoskeletal system injuries and aging. PMID:24386288

  5. The effect of the gastrocnemius on the plantar fascia.

    PubMed

    Pascual Huerta, Javier

    2014-12-01

    Although anatomic and functional relationship has been established between the gastrocnemius muscle, via the Achilles tendon, and the plantar fascia, the exact role of gastrocnemius tightness in foot and plantar fascia problems is not completely understood. This article summarizes past and current literature linking these 2 structures and gives a mechanical explanation based on functional models of the relationship between gastrocnemius tightness and plantar fascia. The effect of gastrocnemius tightness on the sagittal behavior of the foot is also discussed. PMID:25456717

  6. Plantar melanoma: a case-control study in Paraguay

    Microsoft Academic Search

    P. A. Rolón; E. Kramárová; H. I. Rolón; M. Khlat; D. M. Parkin

    1997-01-01

    In Paraguay, the plantar surface of the foot is the most common site for malignant melanoma, as it is in several other populations\\u000a worldwide, most notably in those of African descent. Here, we report the results of the first case-control study of plantar\\u000a melanoma, carried out in Paraguay. Sixty incident, histologically confirmed cases of plantar melanoma and 256 hospital controls

  7. Blunt dissection for the treatment of plantar verrucae.

    PubMed

    Baruch, K

    1990-08-01

    The treatment of plantar verrucae has always been a challenging and perplexing problem to physicians. Due to the inherent nature of verrucae, response to various forms of treatment has been extremely unpredictable. It is believed that hyperhidrosis and abnormal pressure to the plantar aspects of the feet are contributing factors predisposing one to developing verrucae. This article describes a painless and effective approach to the treatment of plantar verruca through the use of blunt dissection. Following anesthesia obtained with a posterior tibial nerve block, the plantar verruca can be successfully dissected with an 80 percent cure rate. PMID:2209078

  8. Foot Skin Ischemic Necrosis following Heel Prick in a Newborn

    PubMed Central

    Ariguloglu, Erdal Avni; Koklu, Selmin

    2013-01-01

    There are only a few reports on side effects after heel prick in neonates although heel prick has been performed all over the world for many years. The medicine staff had obtained only a drop of blood by pricking the baby's heel using a lancet without compressing the heel or foot to measure his blood glucose level 3 hours after birth. However he developed a severe and hemorrhagic skin reaction on his entire left foot, beginning 30 minutes after obtaining the drop of blood by pricking the baby's heel using a lancet. The lesion, which was treated with topical mupirocin and povidone-iodine solution daily, slowly decreased in size and had almost fully resolved within 3 weeks. He was healthy and 9 months old at the time of writing this paper. We herein report a case of foot skin ischemic necrosis following heel prick in a newborn. To our knowledge this patient is the first case of foot skin ischemic necrosis due to heel prick in newborns. PMID:24288643

  9. In-shoe plantar tri-axial stress profiles during maximum-effort cutting maneuvers.

    PubMed

    Cong, Yan; Lam, Wing Kai; Cheung, Jason Tak-Man; Zhang, Ming

    2014-12-18

    Soft tissue injuries, such as anterior cruciate ligament rupture, ankle sprain and foot skin problems, frequently occur during cutting maneuvers. These injuries are often regarded as associated with abnormal joint torque and interfacial friction caused by excessive external and in-shoe shear forces. This study simultaneously investigated the dynamic in-shoe localized plantar pressure and shear stress during lateral shuffling and 45° sidestep cutting maneuvers. Tri-axial force transducers were affixed at the first and second metatarsal heads, lateral forefoot, and heel regions in the midsole of a basketball shoe. Seventeen basketball players executed both cutting maneuvers with maximum efforts. Lateral shuffling cutting had a larger mediolateral braking force than 45° sidestep cutting. This large braking force was concentrated at the first metatarsal head, as indicated by its maximum medial shear stress (312.2 ± 157.0 kPa). During propulsion phase, peak shear stress occurred at the second metatarsal head (271.3 ± 124.3 kPa). Compared with lateral shuffling cutting, 45° sidestep cutting produced larger peak propulsion shear stress (463.0 ± 272.6 kPa) but smaller peak braking shear stress (184.8 ± 181.7 kPa), of which both were found at the first metatarsal head. During both cutting maneuvers, maximum medial and posterior shear stress occurred at the first metatarsal head, whereas maximum pressure occurred at the second metatarsal head. The first and second metatarsal heads sustained relatively high pressure and shear stress and were expected to be susceptible to plantar tissue discomfort or injury. Due to different stress distribution, distinct pressure and shear cushioning mechanisms in basketball footwear might be considered over different foot regions. PMID:25468303

  10. An evaluation of a silicone adhesive shaped heel dressing.

    PubMed

    Hampton, Sylvie

    Tissue breakdown is complex and involves many factors. Pressure ulcer development in the heels is subject to extrinsic factors such as pressure, shear, friction and moisture. The heels are the most common sites for friction and shear damage, which can lead to blistering, skin erosion and tissue breakdown (Grey et al, 2006). To address the issues of wounds that are painful on dressing removal and friable skin, Smith & Nephew has introduced a soft silicone adhesive dressing to its Allevyn dressing range. Silicone does not adhere to wounded areas and can be removed gently without trauma to the periwound area. This paper discusses the findings of a 20-patient multi-site evaluation examining the performance and acceptability of Allevyn Gentle Border Heel dressing in the management of heel wounds. PMID:20335927

  11. MR elastographic methods for the evaluation of plantar fat pads: preliminary comparison of the shear modulus for shearing deformation and compressive deformation in normal subjects

    NASA Astrophysics Data System (ADS)

    Weaver, John B.; Miller, Timothy B.; Perrinez, Philip R.; Doyley, Marvin M.; Wang, Huifang; Cheung, Yvonne Y.; Wrobel, James S.; Comi, Richard J.; Kennedy, Francis E.; Paulsen, Keith D.

    2006-03-01

    MR elastography (MRE) images the intrinsic mechanical properties of soft tissues; e.g., the shear modulus, ?. The ? of the plantar soft tissues is important in understanding the mechanisms whereby the forces induced during normal motion produce ulcers that lead to amputation in diabetic feet. We compared the compliance of the heel fat pad to compressive forces and to shearing forces. The design of prosthetics to protect the foot depends on the proper understanding of the mechanisms inducing damage. In the heel fat pads of six normal subjects, between 25 and 65 years of age, the ? for deformation perpendicular to the direction of weight bearing is similar but not identical to that determined for deformation along the weight bearing axis. The average difference between ? along the weight bearing axis and ? perpendicular to the weight bearing axis, is well correlated with age (Correlation Coefficient = 0.789). The p-value for the data being random was 0.0347 indicating that the observed difference is not likely to be random. The p-value for control points is 0.8989, indicating a random process. The results are suggestive that the high compressive forces imposed during walking damage the heel fat pads over time resulting in softening to compression preferentially over shearing. It is important to validate the observed effect with larger numbers of subjects, and better controls including measures of activity, and to understand if diseases like diabetes increase the observed damage.

  12. Ultrasound-Assisted Endoscopic Partial Plantar Fascia Release

    PubMed Central

    Ohuchi, Hiroshi; Ichikawa, Ken; Shinga, Kotaro; Hattori, Soichi; Yamada, Shin; Takahashi, Kazuhisa

    2013-01-01

    Various surgical treatment procedures for plantar fasciitis, such as open surgery, percutaneous release, and endoscopic surgery, exist. Skin trouble, nerve disturbance, infection, and persistent pain associated with prolonged recovery time are complications of open surgery. Endoscopic partial plantar fascia release offers the surgeon clear visualization of the anatomy at the surgical site. However, the primary medial portal and portal tract used for this technique have been shown to be in close proximity to the posterior tibial nerves and their branches, and there is always the risk of nerve damage by introducing the endoscope deep to the plantar fascia. By performing endoscopic partial plantar fascia release under ultrasound assistance, we could dynamically visualize the direction of the endoscope and instrument introduction, thus preventing nerve damage from inadvertent insertion deep to the fascia. Full-thickness release of the plantar fascia at the ideal position could also be confirmed under ultrasound imaging. We discuss the technique for this new procedure. PMID:24265989

  13. Variation in the location of the shoe sole flexion point influences plantar loading patterns during gait

    PubMed Central

    2014-01-01

    Background Several footwear design characteristics are known to have detrimental effects on the foot. However, one characteristic that has received relatively little attention is the point where the sole flexes in the sagittal plane. Several footwear assessment forms assume that this should ideally be located directly under the metarsophalangeal joints (MTPJs), but this has not been directly evaluated. The aim of this study was therefore to assess the influence on plantar loading of different locations of the shoe sole flexion point. Method Twenty-one asymptomatic females with normal foot posture participated. Standardised shoes were incised directly underneath the metatarsophalangeal joints, proximal to the MTPJs or underneath the midfoot. The participants walked in a randomised sequence of the three shoes whilst plantar loading patterns were obtained using the Pedar® in-shoe pressure measurement system. The foot was divided into nine anatomically important masks, and peak pressure (PP), contact time (CT) and pressure time integral (PTI) were determined. A ratio of PP and PTI between MTPJ2-3/MTPJ1 was also calculated. Results Wearing the shoe with the sole flexion point located proximal to the MTPJs resulted in increased PP under MTPJ 4–5 (6.2%) and decreased PP under the medial midfoot compared to the sub-MTPJ flexion point (?8.4%). Wearing the shoe with the sole flexion point located under the midfoot resulted in decreased PP, CT and PTI in the medial and lateral hindfoot (PP: ?4.2% and ?5.1%, CT: ?3.4% and ?6.6%, PTI: ?6.9% and ?5.7%) and medial midfoot (PP: ?5.9% CT: ?2.9% PTI: ?12.2%) compared to the other two shoes. Conclusion The findings of this study indicate that the location of the sole flexion point of the shoe influences plantar loading patterns during gait. Specifically, shoes with a sole flexion point located under the midfoot significantly decrease the magnitude and duration of loading under the midfoot and hindfoot, which may be indicative of an earlier heel lift. PMID:24642291

  14. Iontophoresis for palmar and plantar hyperhidrosis.

    PubMed

    Pariser, David M; Ballard, Angela

    2014-10-01

    Iontophoresis is a safe, efficacious, and cost-effective primary treatment of palmar and plantar hyperhidrosis. Decades of clinical experience and research show significant reduction in palmoplantar excessive sweating with minimal side effects. To get the best results from iontophoresis, health care professionals need to provide education on the mechanism of action and benefits, evidence of its use, and creation of a future patient-specific plan of care for continued treatments at home or in the physician's office. Iontophoresis may be combined with other hyperhidrosis treatments, such as topical antiperspirants and botulinum toxin injections. PMID:25152342

  15. Does Plasmodium falciparum have an Achilles' heel?

    E-print Network

    Liao Y Chen

    2013-05-21

    Plasmodium falciparum is the parasite that causes the most severe form of malaria. Currently, science has been established about its cellular structures, its metabolic processes, and even the molecular structures of its intrinsic membrane proteins responsible for transporting water, nutrient, and waste molecules across the parasite plasma membrane (PPM). I hypothesize that Plasmodium falciparum has an Achilles' heel that can be attacked with erythritol, the well-known sweetener that is classified as generally safe. Most organisms have in their cell membrane two types of water-channel proteins: aquaporins to maintain hydro-homeostasis across the membrane and aquaglyceroporins to uptake glycerols etc. In contrast, P. falciparum has only one type of such proteins---the multi-functional aquaglyceroporin (PfAQP) expressed in the PPM---to do both jobs. Moreover, the parasite also uses PfAQP to excrete its metabolic wastes (ammonia included) produced at a very high rate in the blood stage. This extremely high efficiency of the bug using one protein for multiple essential tasks makes the parasite fatally vulnerable. Erythritol in the blood stream can kill the parasite by clogging up its PfAQP channel that needs to be open for maintaining hydro-homeostasis and for excreting toxic wastes across the bug's PPM. In vitro tests are to measure the growth/death rate of P. falciparum in blood with various erythritol concentrations. In vivo experiments are to administer groups of infected mice with various doses of erythritol and monitor the parasite growth levels from blood samples drawn from each group. Clinic trials can be performed to observe the added effects of administering to patients erythritol along with the known drugs because erythritol was classified as a safe food ingredient.

  16. Surgery of Morton's neuroma: dorsal or plantar approach?

    PubMed

    Nashi, M; Venkatachalam, A K; Muddu, B N

    1997-02-01

    In this prospective study, 52 patients with 55 neuromas were studied in two groups. 26 patients underwent excision of the neuroma through a plantar approach and 26 through a dorsal approach. Average follow-up was 3.1 years after excision. Histology confirmed a neuroma in 51 cases. Results show that in the dorsal group weight-bearing and return to work was faster, and the duration of hospital stay was shorter, than in the plantar group. There were five painful scars in the plantar group and two in the dorsal group. PMID:9046143

  17. Capillary blood sampling: should the heel be warmed?

    PubMed Central

    Barker, D. P.; Willetts, B.; Cappendijk, V. C.; Rutter, N.

    1996-01-01

    The hypothesis that capillary blood sampling is made easier by warming the heel was examined in a randomised, controlled trial of healthy newborn infants. Sampling was performed using an automated lancet with or without prior warming. The time taken to collect a standard volume of blood, the number of repeat procedures needed, and the infants' behavioural responses were measured. Eighty one procedures were studied in 57 infants. Warming produced a median rise in heel skin temperature of 4.7 degrees C. However, there were no significant differences between the warmed and unwarmed groups in any of the outcome measures. Heel skin temperature is not an important factor in capillary blood sampling. Attention should be directed towards improving sampling devices and technique. PMID:8777665

  18. Reduced plantar sensation causes a cautious walking pattern

    Microsoft Academic Search

    Eric Eils; Susann Behrens; Oliver Mers; Lothar Thorwesten; Klaus Völker; Dieter Rosenbaum

    2004-01-01

    The aim of this study was to investigate the influence of reduced plantar sensation on gait patterns during walking in 20 healthy subjects (25.9±1.2 years, 61.6±11.5kg, 178±9.5cm) with no history of sensory disorders. Force plate measurements, electromyography (EMG) measurements and a three-dimensional movement analysis were performed simultaneously during barefoot walking before and after reduction of plantar sensation using an ice

  19. Torque, work and EMG development in a heel-rise test

    Microsoft Academic Search

    U. Österberg; U. Svantesson; H. Takahashi; G. Grimby

    1998-01-01

    Objective. To study the fatigue process in the calf muscle during a standing heel-rise test.Design. Heel-rises were performed on a force plate measuring development of torque in the ankle joint.Background. The heel-rise test is a commonly employed clinical test to evaluate the function of the calf muscle by counting the number of heel-rises before exhaustion. Development of fatigue during other

  20. [Squamous cell carcinoma in neuropathic plantar ulcers in leprosy: another example of Marjolin's ulcer].

    PubMed

    Schoeman, B J

    1996-08-01

    Seven cases of squamous cell carcinoma (SCC) arising in chronic neuropathic plantar ulcers of leprosy are described. These patients (average age 59 years) presented over a 5-year period. The mean duration of neuropathic ulceration until diagnosis of SCC was 24.5 years. Six patients required limb amputations and 3 underwent lymphadenectomy for involved nodes. One patient died of disseminated disease. The history of the eponym "Marjolin's ulcer' is traced and a case put forward for recognition of malignant change in neuropathic ulcers as yet another example of Marjolin's ulcer. A plea is made for an increased awareness of the possibility of malignant transformation in chronic neuropathic ulcers in order to effect an early diagnosis of a potentially aggressive cancer. This is the first report of its kind in South Africa. Similar cases, however, have been reported from other parts of the world where leprosy is endemic. PMID:8966648

  1. High heels and polished floors: The ultimate challenge in research on slip-resistance

    Microsoft Academic Search

    D. P. Manning; C. Jones

    1995-01-01

    The walking traction test was put to the ultimate test by measuring the coefficient of friction (cof) of six pairs of women's shoes including one with a flat profiled rubber sole and no separate heel and five with a range of raised heels (high heels), on a variety of dry and wet floors. The effect of applying three types of

  2. Biomechanical simulation of high-heeled shoe donning and walking.

    PubMed

    Yu, Jia; Cheung, Jason Tak-Man; Wong, Duo Wai-Chi; Cong, Yan; Zhang, Ming

    2013-08-01

    Footwear serves to protect the foot in various activities, to enhance athletic performance in sports and in many cases to fulfill aesthetic and cultural needs of urban society. Most women like wearing high-heeled shoes (HHS) for the benefit of sensuous attractiveness, while foot problems are often associated. Computational modeling based on finite element (FE) analysis is a useful tool for deep understanding of foot and footwear biomechanics and incorporating footwear with foot in the model is the prerequisite. In this study, a three-dimensional FE model of coupled foot-ankle-shoe complex and preceding gait simulation were established. Interfacial contact simulation was employed to complete the donning process of foot and shoe upper contact. Three major stance phases namely heel strike, midstance and push off were simulated to investigate the biomechanical response of high-heeled shod walking. It was found that the contact pressure at all metatarsophalangeal (MTP) joints intensified and reached their maximum at push off phase during locomotion, meanwhile the first MTP had the largest magnitude. The first and fifth MTP joints had larger movements in transverse plane among all MTP joints, indicating that these two joints bended more significantly by toe box restraint during locomotion. The dorsal contact pressure at the first toe increased by four times from heel strike to push off. The established HHS donning and walking simulation in this study proved the versatility and promising potential of computational approach for realistic biomechanical evaluation and optimization of footwear design in a virtual environment. PMID:23855974

  3. Mechanical power of ankle plantar flexion and subjective pain by monophasic electrical stimulation

    Microsoft Academic Search

    Tatsuto Suzuki; Takashi Watanabe; Ryuichi Saura; Hironobu Uchiyama

    2011-01-01

    The aim of this study was to investigate the mechanical power of the ankle plantar flexion. The investigated power of the ankle plantar flexion would help to improve effectively the FES walking system using the ankle plantar flexion for patients and aged people in slow walking. The subjective pain by electrical stimulation sometimes becomes the burden to use the FES

  4. A Case of Recalcitrant Plantar Warts Associated with Statin Use

    PubMed Central

    Wernham, Aaron G.; Velangi, Shireen S.

    2015-01-01

    Background. Plantar warts are a common presenting skin complaint caused by the human papillomavirus. 1st line therapies include cryotherapy and topical salicylic acid. Where there is resistance to these treatments, consideration is made for 2nd line therapies, including intralesional bleomycin, imiquimod, 5-fluorouracil, and photodynamic therapy. We present a case of bilateral persistent plantar warts, resistant to treatment with repeated cryotherapy and topical salicylic acid over a 6-year period. Following a patient initiated decision to discontinue their statin medication, we observed rapid clearance of plantar warts without change to standard therapy or their environment. This case correlates with emerging literature demonstrating a link between statin medication and proliferation of HPV through increased levels of FOXP3+ regulatory T cells. PMID:25789179

  5. Heel and toe driving on fuel cell vehicle

    DOEpatents

    Choi, Tayoung; Chen, Dongmei

    2012-12-11

    A system and method for providing nearly instantaneous power in a fuel cell vehicle. The method includes monitoring the brake pedal angle and the accelerator pedal angle of the vehicle, and if the vehicle driver is pressing both the brake pedal and the accelerator pedal at the same time and the vehicle is in a drive gear, activating a heel and toe mode. When the heel and toe mode is activated, the speed of a cathode compressor is increased to a predetermined speed set-point, which is higher than the normal compressor speed for the pedal position. Thus, when the vehicle brake is removed, the compressor speed is high enough to provide enough air to the cathode, so that the stack can generate nearly immediate power.

  6. Quantitative scintigraphy in diagnosis and management of plantar fasciitis (Calcaneal periostitis): concise communication

    SciTech Connect

    Sewell, J.R.; Black, C.M.; Chapman, A.H.; Statham, J.; Hughes, G.R.V.; Lavender, J.P.

    1980-07-01

    We have found that Tc-99m methylene diphosphonate imaging of the heel is of diagnostic value in the painful heel syndrome, permitting positive identification of the site of inflammation in cases where radiography is unhelpful. With this technique, tracer uptake in the heel is susceptible to quantification, allowing a serial and objective assessment of response to therapy.

  7. Plantar reconstruction using the medial sural artery perforator free flap.

    PubMed

    Kim, Eui Sik; Hwang, Jae Ha; Kim, Kwang Seog; Lee, Sam Yong

    2009-06-01

    Free flaps are usually required rather than local flaps for large plantar defects, due to a lack of locally available tissue. The medial sural artery perforator free flap, recently introduced clinically by several authors, is a noticeable option for soft tissue coverage, but it has still not been widely used for the reconstruction of various large plantar defects. Between 2005 and 2007, medial sural artery perforator free flaps were used to reconstruct soft tissue defects in plantar areas in 11 patients at our institute. Patient ages ranged from 10 to 68 years (mean, 43 years), and follow-up periods ranged from 7 to 22 months (mean, 13 months). Flap sizes ranged from 10 to 14 cm in length and from 5 to 7 cm in width. Flaps survived in all patients. Marginal loss over the distal flap region was noted in 1 patient, and this was treated successfully with a subsequent split-thickness skin graft. In another one case, venous insufficiency developed, but salvage was successful with leech application. Long-term follow-up showed good flap durability with a protective sensation. The medial sural artery perforator flap provides sufficient durability for weight-bearing areas, even though it is a thin cutaneous flap. The authors recommend that this flap be considered as a reliable alternative for the reconstruction of large plantar defects. PMID:19461285

  8. Reconstruction of traumatic plantar foot defects in diabetic patients.

    PubMed

    Vaienti, Luca; Palitta, Giovanni; Ravasio, Giovanni; Randelli, Pietro; Arrigoni, Paolo

    2010-05-01

    Plantar reconstruction is often challenging for plastic surgeons because of the peculiar anatomical features of this region. A large variety of reconstructive techniques for the plantar aspect of the foot have been described previously, including skin grafts, local flaps, fasciocutaneous flaps, perforator flaps, cross-limb flaps, and free flaps. This article presents a case of a 64-year-old patient with insulin-dependent diabetes who was involved in a traffic accident that resulted in a large plantar tissue defect (9x4 cm) extending to the base of the toes. After debridement of the wound, a subcutaneous flap was raised from the medial aspect of the lower leg in a sovrafascial plane. The flap was based on a double vascularization given by the great saphenous vein and by the perforator vessels from the posterior tibial artery, located anteriorly and inferiorly to the medial malleolus. The flap showed excellent vitality and long-term result with reduced donor site morbidity. We believe this flap represents a reliable surgical option in superficial plantar defects due to easy harvesting, short operative time, and minimal donor site morbidity. The subcutaneous flap of the distal medial fourth of the leg is a safe technique because of the vascular components of the pedicle. It provides durable coverage, mechanical resistance to pressure and shear stresses and, in selected cases (superficial defects, thin patients), is an interesting option to avoid major free flap procedures. PMID:20506944

  9. Plantar melanoma: a case-control study in Paraguay.

    PubMed

    Rolón, P A; Kramárová, E; Rolón, H I; Khlat, M; Parkin, D M

    1997-11-01

    In Paraguay, the plantar surface of the foot is the most common site for malignant melanoma, as it is in several other populations worldwide, most notably in those of African descent. Here, we report the results of the first case-control study of plantar melanoma, carried out in Paraguay. Sixty incident, histologically confirmed cases of plantar melanoma and 256 hospital controls were recruited in 11 hospitals throughout the country during 1988-93. Information was collected on general demographic, social, and lifestyle variables, on external exposures of feet (shoewear, work activities, injuries), and on some constitutional factors (skin, eye and hair color, and pigmented lesions of the feet). Few of the factors examined appeared to be associated with the risk of plantar melanoma. Adjusted for possible confounders, the strongest association was found for reported injuries (odds ratio [OR] = 40.9, 95 percent confidence interval [CI] = 14.8-112.7) and for occurrence of naevi on the soles (OR = 5.9, CI = 2.5-14.3). Walking barefoot did not seem to contribute to the risk although an outdoor workplace was associated with an increased melanoma occurrence (OR = 2.3, CI = 1.1-4.8). Future studies should be aware of problems of recall bias with respect to previous injuries, and ensure that evaluation of pigmentation of the sole is carried out blind to case/control status. PMID:9427427

  10. Bone Scintigraphy Predicts Outcome of Steroid Injection for Plantar Fasciitis

    Microsoft Academic Search

    Clayton Frater; D zung Vu; Hans Van der Wall; Chandima Perera; Paul Halasz; Louise Emmett; Ignac Fogelman

    2006-01-01

    Plantar fasciitis is a common cause of foot pain and may be dis- abling. Although localized injection is painful, anesthetics or cor- ticosteroids can relieve symptoms well. Bone scintigraphy can confirm the diagnosis. We hypothesized that blood-pool abnor- malities could provide prognostic information on the response to such injections. Methods: We devised scintigraphic criteria that graded the blood-pool abnormalities as

  11. Comparison of the mechanical properties of the heel pad between young and elderly adults

    Microsoft Academic Search

    Tsz-Ching Hsu; Chung-Li Wang; Wen-Chung Tsai; Jung-Kun Kuo; Fuk-Tan Tang

    1998-01-01

    Objective: To compare the mechanical properties of the human heel pad between young and aged adults.Design: A 7.5-MHz linear-array ultrasound transducer was incorporated into a specially designed device to measure the thickness of the heel pad under different loads. The heel pad was compressed with serial increments of 0.5kg to a maximum of 3kg and then relaxed sequentially. Then the

  12. Deformation characteristics of the heel region of the shod foot during a simulated heel strike: the effect of varying midsole hardness.

    PubMed

    Aerts, P; De Clercq, D

    1993-10-01

    Impact tests using a pendulum were performed on the shod heel region of nine subjects. Both soft- and hard-soled shoes were used. The deformations involved were calculated from the registered decelerations during impact. Thus, load-deformation cycles were recorded for various impact velocities. In contrast to in vivo force-platform recordings, peak loadings for the soft- and hard-soled conditions differed significantly (614 +/- 29 N vs 864 +/- 49 N, respectively), thus challenging the evidence for compensation at the level of the heel pad. Moreover, computation of the compression of the heel pad in the shoe showed an unexpected inverse relationship between shoe midsole hardness and degree of heel pad compression: the harder the midsole, the smaller the compression (soft shoe 7.6 +/- 0.9 mm; hard shoe 6.7 +/- 0.9 mm). This can be explained by assuming a loading rate dependent stiffness of the heel pad in the shod condition (stiffness in N.m-1 = 51.25x (loading rate in N.s-1)0.76; R2 = 0.90), determined by the visco-elastic nature of the heel pad and the spatial confinement of the heel counter of the shoe. PMID:8301705

  13. Greater toe grip and gentler heel strike are the strategies to adapt to slippery surface

    Microsoft Academic Search

    Daniel Tik-Pui Fong; De-Wei Mao; Jing-Xian Li; Youlian Hong

    2008-01-01

    This study investigated the plantar pressure distribution during gait on wooden surface with different slipperiness in the presence of contaminants. Fifteen Chinese males performed 10 walking trials on a 5-m wooden walkway wearing cloth shoe in four contaminated conditions (dry, sand, water, oil). A pressure insole system was employed to record the plantar pressure data at 50Hz. Peak pressure and

  14. The plantar marginal septum cutaneous island flap: a new flap in forefoot reconstruction.

    PubMed

    Bertelli, J A; Duarte, H E

    1997-04-01

    Soft-tissue reconstruction of the foot very often requires flap coverage to preserve exposed structures such as bone, joint, tendons, and weight-bearing areas. However, forefoot coverage remains a challenge, since the alternatives for flap coverage are very limited. The vascularization of the medial side of the foot was studied in 25 injected limbs. Based on this anatomic knowledge, the plantar marginal septum cutaneous island flap is described. The plantar marginal septum cutaneous island flap is a reversed-flow flap based on the superficial branch of the medial division of the medial plantar artery and its distal anastomosis with the lateral plantar artery, first dorsal metatarsal artery, and lateral branch of the medial plantar artery. The venous drainage is ensured by the accompanying veins. The flap arc of rotation includes the forefoot plantar and dorsal region and the first and second toes. Eight cases have been operated on and are reported. PMID:9105367

  15. Finite element analysis of heel pad with insoles.

    PubMed

    Luo, Gangming; Houston, Vern L; Garbarini, Mary Anne; Beattie, Aaron C; Thongpop, Chaiya

    2011-05-17

    To design optimal insoles for reduction of pedal tissue trauma, experimental measurements and computational analyses were performed. To characterize the mechanical properties of the tissues, indentation tests were performed. Pedal tissue geometry and morphology were obtained from magnetic resonance scan of the subject's foot. Axisymmetrical finite element models of the heel of the foot were created with 1/4 of body weight load applied. The stress, strain and strain energy density (SED) fields produced in the pedal tissues were computed. The effects of various insole designs and materials on the resulting stress, strain, and SED in the soft pedal tissues were analyzed. The results showed: (a) Flat insoles made of soft material provide some reductions in the maximum stress, strain and SED produced in the pedal tissues. These maximum values were computed near the calcaneus. (b) Flat insoles, with conical/cylindrical reliefs, provided more reductions in these maximum values than without reliefs. (c) Custom insoles, contoured to match the pedal geometry provide most reductions in the maximum stress, strain and SED. Also note, the maximum stress, strain and SED computed near the calcaneus were found to be about 10 times the corresponding peak values computed on the skin surface. Based on the FEA analysis, it can be concluded that changing insole design and using different material can significantly redistribute the stress/strain inside the heel pad as well as on the skin surface. PMID:21420682

  16. Two emerging technologies for Achilles tendinopathy and plantar fasciopathy.

    PubMed

    Langer, Paul R

    2015-04-01

    Some common overuse injuries, such as Achilles tendinopathy and plantar fasciitis (or fasciopathy), can be refractory to treatment. When standard treatment options fail, operative intervention often becomes the treatment of last resort. Recently, newer technologies have been developed and refined, and can provide potential benefits for these conditions using noninvasive and minimally invasive approaches. Two technologies, extracorporeal shock wave therapy and ultrasound-guided percutaneous tenotomy/fasciotomy are discussed. PMID:25804709

  17. A knowledge-based modeling for plantar pressure image reconstruction.

    PubMed

    Ostadabbas, Sarah; Nourani, Mehrdad; Saeed, Adnan; Yousefi, Rasoul; Pompeo, Matthew

    2014-10-01

    It is known that prolonged pressure on the plantar area is one of the main factors in developing foot ulcers. With current technology, electronic pressure monitoring systems can be placed as an insole into regular shoes to continuously monitor the plantar area and provide evidence on ulcer formation process as well as insight for proper orthotic footwear design. The reliability of these systems heavily depends on the spatial resolution of their sensor platforms. However, due to the cost and energy constraints, practical wireless in-shoe pressure monitoring systems have a limited number of sensors, i.e., typically K < 10. In this paper, we present a knowledge-based regression model (SCPM) to reconstruct a spatially continuous plantar pressure image from a small number of pressure sensors. This model makes use of high-resolution pressure data collected clinically to train a per-subject regression function. SCPM is shown to outperform all other tested interpolation methods for K < 60 sensors, with less than one-third of the error for K = 10 sensors. SCPM bridges the gap between the technological capability and medical need and can play an important role in the adoption of sensing insole for a wide range of medical applications. PMID:24833414

  18. Toe and plantar dermatoglyphics in adult American Caucasians.

    PubMed

    Fox, K M; Plato, C C

    1987-09-01

    The scarcity of information on control data of toe and plantar dermatoglyphics led us to undertake this study of adult American Caucasians. Toe and sole prints of 168 male and 83 female participants of the Baltimore Longitudinal Study of Aging were analyzed. Toe pattern frequencies demonstrate that fibular loops are the most prevalent pattern on the toes in both males and females. Pattern distribution by digit shows that arches are most often located on the fifth toe while whorls are found with greatest frequency on the third toe. Plantar pattern frequencies indicate that the most common pattern found in the hallucal area is the distal loop. Open fields are frequently found in the II and IV interdigital areas while distal loops are prevalent in the III area. These results are compared to the finger and palmar patterns of the same individuals. The distribution of patterns on the toes and fingers of the same individuals appear to be quite different. Population comparisons did not demonstrate a clear racial difference in the toe pattern frequencies or in the plantar areas. PMID:3688210

  19. Epidemiology of High-Heel Shoe Injuries in U.S. Women: 2002 to 2012.

    PubMed

    Moore, Justin Xavier; Lambert, Brice; Jenkins, Gabrielle P; McGwin, Gerald

    2015-01-01

    The purpose of the present study was to investigate the epidemiology of high-heel-related injuries among a nationally representative population of women in the United States and to analyze the demographic differences within this group. The data used in the present study were collected from the Consumer Product Safety Commission's National Electronic Injury Surveillance System. A total of 3294 injuries, representing an estimated 123,355 high-heel-related injuries, were treated in emergency departments within the United States from 2002 to 2012. The overall rate of high-heel-related injuries for the study was 7.32 per 100,000 females (95% confidence interval 7.08 to 7.56). The injury rate was greatest for young adult females, with the greatest rates observed for those aged 20 to 29 years (18.38 per 100,000 females) and those aged 30 to 39 years (11.07 per 100,000 females). The results from the present study suggest that high-heel-related injuries have nearly doubled during the 11-year period from 2002 to 2012. Injuries from high heels are differential by body region, with most injuries occurring as sprains and strains to the foot and ankle. Although high heels might be stylish, from a health standpoint, it could be worthwhile for females and those interested in wearing high heels to understand the risks of wearing high-heeled shoes and the potential harm that precarious activities in high-heeled shoes can cause. The results of the present study can be used in the development of a prospective cohort study to investigate the risk of injury from high-heeled shoes, accounting for the exposure time and studying differences in demographics (e.g., age and race). PMID:25977152

  20. A Biomechanical Evaluation of Standing in High-Heeled Shoes Paula D. Henderson, McNair Scholar, Penn State

    E-print Network

    Omiecinski, Curtis

    ", projected women to outnumber men by 10 million by the year 2005. (Spraggins, 2005) A 1986 Gallup25 25 A Biomechanical Evaluation of Standing in High- Heeled Shoes Paula D. Henderson, Mc the action of the ground reaction force upon the heels of women standing in high-heeled shoes. The study

  1. Targeting late SV40 factor: is the achilles heel of hepatocarcinogenesis revealed?

    PubMed

    Shlomai, Amir

    2012-12-14

    Hepatocellular carcinoma (HCC) is a dreadful cancer and a major cause of death among patients with chronic liver disease and cirrhosis. The apparent alterations in a diversity of intracellular pathways found in HCC has set the rational for developing molecular-directed drugs that simultaneously inhibit multiple pathways, such as the multi-kinase inhibitor Sorafenib. However, recently this concept has been challenged by showing that HCC is heavily dependent on a single oncogene designated late SV-40 factor (LSF), a transcription factor that is over-expressed in liver cancer cells and that its expression is strongly correlated with tumor grade and aggressiveness. Furthermore, using an intensive screening for drugs that inhibit LSF activity, Grant et al have found a molecule designated factor quinolinone inhibitor 1 that can specifically block the ability of LSF to bind its target promoters, resulting in a massive death of HCC cells both in vitro and in vivo. The innovative findings of HCC representing "oncogene addiction" to LSF and the ability of a single molecule to block the activity of this oncogene resulting in tumor abolishment are encouraging and provide us with the hope that the "Achilles heel" of HCC has been found. PMID:23239907

  2. Long-Term Outcome of Low-Energy Extracorporeal Shock Wave Therapy for Plantar Fasciitis: Comparative Analysis According to Ultrasonographic Findings

    PubMed Central

    Park, Jong-Wan; Yoon, Kyungjae; Chun, Kwang-Soo; Lee, Joon-Youn; Park, Hee-Jin; Lee, So-Yeon

    2014-01-01

    Objective To investigate the long-term effect of low-energy extracorporeal shock wave therapy (ESWT) for plantar fasciitis (PF) according to ultrasonography (US) findings. Methods Thirty feet of 25 patients with clinical diagnosis of PF were enrolled and divided into two groups (Apparent-US and Uncertain-US) according to US findings, such as plantar fascia thickening or hypoechogenicity. Inclusion criteria were symptom duration >6 months and a fair or poor grade in Roles-Maudsley score (RMS). ESWT (0.10 mJ/mm2, 600 shocks) was given once a week for 6 weeks. Numeric rating scale (NRS) and RMS were evaluated prior to each ESWT session, at short-term follow-up (one week after all ESWT sessions) and long-term follow-up telephone interview (mean 24 months after ESWT). Good and excellent grade in RMS were considered as treatment success. Results Repeated measure ANOVA demonstrated that NRS significantly decreased with time after ESWT up to the long-term follow-up (time effect, p<0.001) without group-time interaction (p=0.641), indicating that ESWT equally decreased pain in both groups. Overall success rate was 63.3% (short-term follow-up) and 80.0% (long-term follow-up). In comparative analysis between groups, success rate of Apparent-US and Uncertain-US at short-term follow-up was 61.9% and 66.7%, respectively, and 85.7% and 66.7%, respectively, at long-term follow-up. Conclusion If other causes of heel pain are ruled out through meticulous physical examination and ultrasonography, low-energy ESWT in PF seems to be beneficial regardless of US findings. In terms of success rate, however, long-term outcome of Apparent-US appears to be superior to Uncertain-US. PMID:25229032

  3. Radiation levels on empty cylinders containing heel material

    SciTech Connect

    Shockley, C.W. [Martin Marietta Energy Systems, Inc., Paducah, KY (United States)

    1991-12-31

    Empty UF{sub 6} cylinders containing heel material were found to emit radiation levels in excess of 200 mr/hr, the maximum amount stated in ORO-651. The radiation levels were as high as 335 mr/hr for thick wall (48X and 48Y) cylinders and 1050 mr/hr for thin wall (48G and 48H) cylinders. The high readings were found only on the bottom of the cylinders. These radiation levels exceeded the maximum levels established in DOT 49 CFR, Part 173.441 for shipment of cylinders. Holding periods of four weeks for thick-wall cylinders and ten weeks for thin-wall cylinders were established to allow the radiation levels to decay prior to shipment.

  4. Internal strain estimation for quantification of human heel pad elastic modulus: A phantom study.

    PubMed

    Holst, Karen; Liebgott, Hervé; Wilhjelm, Jens E; Nikolov, Svetoslav; Torp-Pedersen, Sřren T; Delachartre, Philippe; Jensen, Jřrgen A

    2013-02-01

    Shock absorption is the most important function of the human heel pad. However, changes in heel pad elasticity, as seen in e.g. long-distance runners, diabetes patients, and victims of Falanga torture are affecting this function, often in a painful manner. Assessment of heel pad elasticity is usually based on one or a few strain measurements obtained by an external load-deformation system. The aim of this study was to develop a technique for quantitative measurements of heel pad elastic modulus based on several internal strain measures from within the heel pad by use of ultrasound images. Nine heel phantoms were manufactured featuring a combination of three heel pad stiffnesses and three heel pad thicknesses to model the normal human variation. Each phantom was tested in an indentation system comprising a 7MHz linear array ultrasound transducer, working as the indentor, and a connected load cell. Load-compression data and ultrasound B-mode images were simultaneously acquired in 19 compression steps of 0.1mm each. The internal tissue displacement was for each step calculated by a phase-based cross-correlation technique and internal strain maps were derived from these displacement maps. Elastic moduli were found from the resulting stress-strain curves. The elastic moduli made it possible to distinguish eight of nine phantoms from each other according to the manufactured stiffness and showed very little dependence of the thickness. Mean elastic moduli for the three soft, the three medium, and the three hard phantoms were 89kPa, 153kPa, and 168kPa, respectively. The combination of ultrasound images and force measurements provided an effective way of assessing the elastic properties of the heel pad due to the internal strain estimation. PMID:23079052

  5. Vitamin E-induced chronic inflammation in rats

    Microsoft Academic Search

    Joseph W. Berkenkopf; Barry N. Lutsky

    1979-01-01

    Sub-plantar injection of vitamin E (VE) oil produces a highly localized, chronic inflammation which is sustained for at least 8 weeks. As a result of studies using mediator inhibitors and depletors, it appears that histamine, serotonin, kinins, and prostaglandins may be involved in at least the early response to VE. This early phase is dominated by a massive influx of

  6. The Changes of COP and Foot Pressure after One Hour's Walking Wearing High-heeled and Flat Shoes

    PubMed Central

    Ko, Dong Yeol; Lee, Han Suk

    2013-01-01

    [Purpose] This study aimed to determine the most appropriate height for shoe heels by measuring the displacement of the COP (center of pressure) and changes in the distribution of foot pressure after walking in flat (0.5 cm), middle-heeled (4 cm), and high-heeled (9 cm) shoes for 1 hour. [Methods] A single-subject design was used, with 15 healthy women wearing shoes with heels of each height in a random order. The foot pressure and displacement of COP before and after walking in an ordinary environment for 1 hour were measured using an FDM-S (zebris Medical GmbH, Germany). [Results] The distribution of foot pressure did not change significantly after walking in middle-heeled (4 cm) shoes but did change significantly after walking in either flat (0.5 cm) or high-heeled (9 cm) shoes. Similarly, the COP was not significantly displaced after walking in middle-heeled (4 cm) shoes but was significantly displaced after walking in either flat (0.5 cm) or high-heeled (9 cm) shoes. [Conclusion] Both flat and high-heeled shoes had adverse effects on the body. Middle-heeled (4 cm) shoes are preferable to both flat (0.5 cm) and high-heeled (9 cm) shoes for the health and comfort of the feet. PMID:24259782

  7. Relationships between segmental foot mobility and plantar loading in individuals with and without diabetes and neuropathy

    Microsoft Academic Search

    Smita Rao; Charles L. Saltzman; H. John Yack

    2010-01-01

    The purpose of our study was to examine dynamic foot function during gait as it relates to plantar loading in individuals with DM (diabetes mellitus and neuropathy) compared to matched control subjects. Foot mobility during gait was examined using a multi-segment kinematic model, and plantar loading was measured using a pedobarograph in subjects with DM (N=15), control subjects (N=15). Pearson

  8. Flat Feet and a Diagnosis of Plantar Fasciitis in a Marine Corps Recruit.

    PubMed

    Lurati, Ann R

    2015-04-01

    A 22-year-old man sought care at an orthopedic clinic for acute plantar fasciitis. He reported that he had begun an intensive exercise program to prepare himself for Marine Corps Officer Candidate School. Pes Planus, or flat feet, was noted on physical examination. This article reviews the diagnoses of pes planus and plantar fasciitis as well as current intervention strategies. PMID:26081472

  9. Contributions of the individual ankle plantar flexors to support, forward progression and swing initiation during walking

    Microsoft Academic Search

    R. R. Neptune; S. A. Kautz; F. E. Zajac

    2001-01-01

    Walking is a motor task requiring coordination of many muscles. Previous biomechanical studies, based primarily on analyses of the net ankle moment during stance, have concluded different functional roles for the plantar flexors. We hypothesize that some of the disparities in interpretation arise because of the effects of the uniarticular and biarticular muscles that comprise the plantar flexor group have

  10. Giant right plantar keloid treated with excision and tissue-engineered allograft.

    PubMed

    Osswald, Sandra S; Elston, Dirk M; Vogel, Paula S

    2003-01-01

    Plantar keloids are a management problem as a result of the pain and mechanic restriction with ambulation. We present the treatment of a patient with a particularly large plantar keloid that was refractory to multiple excisions, adjunctive intralesional steroids, and radiation therapy, who was successfully treated with excision, intralesional steroids, and tissue-engineered allograft placement. PMID:12522384

  11. Influencia del vendaje neuromuscular sobre la presión plantar durante la marcha

    Microsoft Academic Search

    P. Pérez Soriano; J. Gascó López de Lacalle; M. A. Merino Josa; A. Sandá Meijide; R. Moll Puigcerver; V. Castillo Antúnez

    2010-01-01

    Application of the neuromuscular bandage has frequently been used in sports and rehabilitation. There are several benefits associated with this bandage, although its influence and effects on the plantar pressure pattern have not been analyzed. In this sense, our study has analyzed plantar pressure in 5 foot zones with the pedobarographic system Biofoot IBV® 6.0 as well as cadence and

  12. Expanded butterfly plots: A new method to analyze simultaneous pressure and shear on the plantar skin surface during gait.

    PubMed

    Berki, Visar; Boswell, Melissa A; Ciltea, Daniela; Guseila, Loredana M; Goss, Larry; Barnes, Scott; Berme, Necip; McMillan, Grant R; Davis, Brian L

    2015-07-16

    The current method of visualizing pressure and shear data under a subject's foot during gait is the Pedotti, or "butterfly" diagram. This method of force platform data visualization was introduced in the 1970s to display the projection of the ground reaction force vector in the sagittal plane. The purpose of the current study was to examine individual sub-components of the vectors displayed in Pedotti diagrams, in order to better understand the relationship between one foot region and another. For this, new instrumentation was used that allows multiple Pedotti diagrams to be constructed at any instant during the gait cycle. The custom built shear-and-pressure-evaluating camera system (SPECS) allows for simultaneous recordings of pressure and both components of the horizontal force vector (medio-lateral and antero-posterior) at distinctive regions under one's foot during gait. Data analysis of such recordings affirms three conclusions: (i) pressure and shear values on individual sites on the plantar surface of the foot are not associated in a linear manner, (ii) force vectors in the heel and forefoot regions exhibit horizontal force components that oppose one another, and similarly, (iii) force vectors in the frontal plane transecting the forefoot region also exhibit medial-lateral shear components that counteract one another. This approach sheds light on individual vectors that collectively sum to each vector displayed in a Pedotti diagram. The results indicate that shearing between the foot and the ground is not simply a passive event. The structures of the arches and/or muscular activities are major contributors to the observed interfacial stresses. PMID:25895644

  13. ESTUDO RETROSPECTIVO DO TRATAMENTO CIRÚRGICO DO NEUROMA DE MORTON POR VIA PLANTAR RETROSPECTIVE STUDY OF SURGERY TREATMENT IN MORTONS NEUROMA BY PLANTAR APPROACH

    Microsoft Academic Search

    GUSTAVO GENNARI BARBOSA; GUSTAVO MALUF TIRADENTES; HELENCAR IGNÁCIO; GUARACY CARVALHO FILHO; ALCEU GOMES CHUEIRE

    SUMMARY With an eye to evaluate the surgical technic efficiency - neurectomy by plantar approach -, 19 patients with Mortons neuroma were submitted to this treatment. Therefore, were 19 neuroma patients including 84,3% female, 15,7% male; 31,5% in second intermeta- tarsal space, 68,5% in third; 47,3% on right side and 52,7% on left side. The surgery was made by plantar

  14. Botulinum neurotoxin treatment of palmar and plantar hyperhidrosis.

    PubMed

    Weinberg, Tessa; Solish, Nowell; Murray, Christian

    2014-10-01

    Palmar and plantar hyperhidrosis is relatively common and can have severe psychological and medical consequences for those afflicted. A multitude of treatments exist but are often inadequate especially for those with significant disease. In these cases botulinum neurotoxin provides a reliable method for reducing the symptoms and improving quality of life. Although actual administration is relatively straightforward, pain management is a crucial component that requires a mastery of several techniques. Patients have a high degree of satisfaction with botulinum neurotoxin treatment and are motivated to come back for repeat treatments, usually every 6 months. PMID:25152344

  15. [The treatment of heel pressure ulcer with V.A.C. therapy using the new V.A.C. GranuFoam "Heel-Dressing"].

    PubMed

    Mauckner, P

    2004-05-01

    The treatment of heel pressure ulcer represents one od the difficulties in treatment of pressure ulcer, because of its pressure load conditional on the calcaneus, the missing of muscle buffer and the huge number of tender insertions. With the V.A.C.-Therapy based upon interdisciplinary pretreatment (debridement, control of infection, circulation and metabolism and pressure relief) the growth of granulation tissure succeeds in a very fast time. The new V.A.C.-GranuFoam Heel Dressing contains the possibility to apply the V.A.C.-Therapy safe and very quick, in spite of the difficult ulcer location at the heel. Moreover it includes the necessary transfer of the T.R.A.C-Pad on the top of the foot to prevent new increase of pressure. PMID:15168303

  16. Analysis of Factors Affecting Stress Solution at Concrete Gravity Dam Heel

    NASA Astrophysics Data System (ADS)

    Hung, Vu Hoang; Quoc Cong, Trinh; Tongchun, Li

    2010-05-01

    Along with Vietnam's development, various hydraulic constructions including concrete gravity dams have been being built. In some of these dams, the fractures occurred at the heel of the dams are even in small and media dams. There are various reasons cause the factures at dam heel but the main reason is the stress states at dam heel are not determined correctly while designing dam. In this paper, several factors affecting stress solution at concrete gravity dam heel such as element mesh size, crack joints of upstream foundation, execution process are investigated by using finite element model of Banve concrete gravity dam. This work is very significant when the more high concrete gravity dams will be constructed in Vietnam year after year.

  17. Bilateral Heel Numbness due to External Compression during Obstetric Epidural Analgesia

    PubMed Central

    Kamphuis, Vivian P.; Zegers, Marie P.A.; Koppen, Hille

    2015-01-01

    We describe the case of a 32-year-old woman who developed bilateral heel numbness after obstetric epidural analgesia. We diagnosed her with bilateral neuropathy of the medial calcaneal nerve, most likely due to longstanding pressure on both heels. Risk factors for the development of this neuropathy were prolonged labour with spinal analgesia and a continuation of analgesia during episiotomy. Padded footrests decrease pressure and can possibly prevent this neuropathy. PMID:25802500

  18. Knee Stretch Walking Method for Biped Robot: Using Toe and Heel Joints to Increase Walking Strides

    NASA Astrophysics Data System (ADS)

    Sato, Takahiko; Shimmyo, Shuhei; Nakazato, Miki; Mikami, Kei; Sato, Tomoya; Sakaino, Sho; Ohnishi, Kouhei

    This paper proposes a knee stretch walking method for biped robots; the method involves the use of the toes and heel joints to increase walking strides. A knee can be stretched by switching control variables. By a knee stretch walking with heel contacts to the ground and toe takeoffs from the ground, biped robots can increase their walking stride and speed. The validity of the proposed method is confirmed by simulation and experimental results.

  19. Muscle activity reduces soft-tissue resonance at heel-strike during walking

    Microsoft Academic Search

    James M. Wakeling; Anna-maria Liphardt; Benno M. Nigg

    Abstract Muscle activity has previously been suggested,to minimize,soft-tissue resonance,which,occurs at heel-strike during walking,and running. If this concept were true then the greatest vibration damping,would,occur when,the input force was closest to the resonant frequency of the soft-tissues at heel-strike. However, this idea has not been tested. The purpose of this study was to test whether muscle,activity in the lower extremity is

  20. Thinking While Walking: Experienced High-Heel Walkers Flexibly Adjust Their Gait

    PubMed Central

    Schaefer, Sabine; Lindenberger, Ulman

    2013-01-01

    Theories of motor-skill acquisition postulate that attentional demands of motor execution decrease with practice. Hence, motor experts should experience less attentional resource conflict when performing a motor task in their domain of expertise concurrently with a demanding cognitive task. We assessed cognitive and motor performance in high-heel experts and novices who were performing a working memory task while walking in gym shoes or high heels on a treadmill. Surprisingly, neither group showed lower working memory performance when walking than when sitting, irrespective of shoe type. However, high-heel experts adapted walking regularity more flexibly to shoe type and cognitive load than novices, by reducing the variability of time spent in the single-support phase of the gait cycle in high heels when cognitively challenged. We conclude that high-heel expertise is associated with more flexible adjustments of movement patterns. Future research should investigate whether a more demanding walking task (e.g., wearing high heels on uneven surfaces and during gait perturbations) results in expertise-related differences in the simultaneous execution of a cognitive task. PMID:23760158

  1. Determinants of premature infant pain responses to heel sticks.

    PubMed

    Badr, Lina Kurdahi; Abdallah, Bahia; Hawari, Mirvat; Sidani, Saadieh; Kassar, May; Nakad, Pascale; Breidi, Julianna

    2010-01-01

    The exposure of premature infants to stressors, such as pain intended to ensure their survival, may instead alter their brain development and contribute to several learning and behavioral difficulties observed in later childhood. The objective of this descriptive, cross-sectional study was to compare the pain responses of 72 preterm infants to a heel stick procedure taking into consideration a variety of factors, including the use of opioids and sedatives. The pain scores assessed on the Preterm Infant Pain Profile (PIPP) scale were highest for the lowest gestational age (GA) group. Multiple linear regression analysis with the four predictor variables noted to be correlated with the PIPP scores (GA, type of needle, severity of illness, and behavioral state) indicated a significant overall relationship (F [5/66] = 5.62, p < 0.01) and accounted for 44% of the variance. All but severity of illness did not add significantly to the variance. Gender, postnatal age, amount, opioids, and sedatives used were not correlated to the PIPP scores. It was concluded that sick premature infants and those who have been exposed to a variety of painful procedures may not manifest behavioral or physiological signs of pain, but may be the most to benefit from precise pain assessment and prudent management. PMID:20687304

  2. Benefits of conservative "wait and see" approach for recurrent plantar keloid.

    PubMed

    Gideroglu, Kaan; Misirlioglu, Aykut; Toksoy, Serdar; Yildirim, Serkan; Akoz, Tayfun

    2013-12-01

    Keloid formation of the plantar region is rare and a unique challenge to surgeons. We used a conservative "wait and see" approach for recurrent keloid in the plantar region in two patients and recommended that the patients used custom-made shoes. Both patients were pleased with the result. The keloids regressed and flattened. During our minimum of five years follow-up the patients had no pain, tenderness, paraesthesiae, or problems with walking. We found no complications. Keloids should not be treated aggressively, and in plantar keloids the conservative "wait and see" approach may provide successful results without any complication. PMID:23802183

  3. [Palmar and plantar keloid in a black African male].

    PubMed

    Kossoko, H; Allah, K C; Assi Djč Bi Djč, V; Yéo, S; Koffi, K E; Richard Kadio, M

    2012-09-01

    The keloid scar is a fibrous skin tumor, intradermal, and exuberant. It is commonly found on the glabrous skin. The keloid of the palms and soles are rare. Small series are reported in English literature. The authors report a case of large keloids located on both palms and soles, within a context of keloid disease, in a man of 37 years. On the left hand, the keloid scar caused a partial syndactyly IV-V. Large keloid tumors occupied the inner edge and, weight-bearing areas of both feet. These tumors rendered wearing of shoes impossible and interfered with walking. The treatment consisted of total excision of palmar and plantar keloid tumors. The residual defects were covered by a total skin graft taken from the suprapubic region. The results were satisfactory aesthetically, functionally and psychosocially. PMID:22980992

  4. Anode heel affect in thoracic radiology: a visual grading analysis

    NASA Astrophysics Data System (ADS)

    Mearon, T.; Brennan, P. C.

    2006-03-01

    For decades, the antero-posterior (AP) projection of the thoracic spine has represented a substantial challenge. Patient thickness varies substantially along the cranio-caudal axis resulting in images that are too dark for the upper vertebrae and too light, or with excessive quantum mottle, towards the 9th to 12th thoracic vertebra. The anode heel affect is a well known phenomenon, however there is a paucity of reports demonstrating its exploitation in clinical departments for optimising images. The current work, using an adult, tissue-equivalent anthropomorphic phantom, explores if appropriate positioning ofthe anode can improve image quality for thoracic spine radiology. At each of 5 kVps (70, 81, 90, 102, 109) thirty AP thoracic spine images were produced, 15 with the anode end of the tube towards the cranial part of the phantom and 15 with the anode end of the tube facing caudally. Visual grading analysis of the resultant images demonstrated significant improvements in overall image quality and visualisation of specific anatomical features for the cranially facing anode compared with the alternative position, which were most pronounced for the 1st to 4th and 9th to 12th vertebrae. These improvements were evident at 70, 81 and 90 kVp, but not for the higher beam energies. The results demonstrate that correct positioning of the X-ray tube can improve image quality for thoracic radiology at specific tube potentials. Further work is ongoing to investigate whether this easy to implement and cost-free technique can be employed for other examinations.

  5. Benign dermoscopic parallel ridge pattern in plantar hyperpigmentation due to capecitabine.

    PubMed

    Tognetti, Linda; Fimiani, Michele; Rubegni, Pietro

    2015-04-01

    We report the case of a 37-year-old woman (phototype II) who presented at our outpatient clinic with a two-month history of hyperpigmented plantar macules. Medical history revealed that the patient had taken capecitabine in the past three months as adjuvant chemotherapy for recurrent breast cancer. Dermoscopic examination of the plantar macules showed parallel ridge pattern with pigmentation in the furrows without obliteration of eccrine gland apertures. Besides in acral melanoma, parallel ridge pattern can also be observed in benign plantar lesions, such as congenital or acquired acral nevi, subcorneal hemorrhage, dye-related pigmentation and drug-induced hyperpigmentation, especially in patients with phototypes III-VI. The few reported cases of capecitabine-induced hyperpigmentation have been associated with hand and foot syndrome in patients with phototypes IV-V and palmar as well as plantar involvement. PMID:26114058

  6. Benign dermoscopic parallel ridge pattern in plantar hyperpigmentation due to capecitabine

    PubMed Central

    Tognetti, Linda; Fimiani, Michele; Rubegni, Pietro

    2015-01-01

    We report the case of a 37-year-old woman (phototype II) who presented at our outpatient clinic with a two-month history of hyperpigmented plantar macules. Medical history revealed that the patient had taken capecitabine in the past three months as adjuvant chemotherapy for recurrent breast cancer. Dermoscopic examination of the plantar macules showed parallel ridge pattern with pigmentation in the furrows without obliteration of eccrine gland apertures. Besides in acral melanoma, parallel ridge pattern can also be observed in benign plantar lesions, such as congenital or acquired acral nevi, subcorneal hemorrhage, dye-related pigmentation and drug-induced hyperpigmentation, especially in patients with phototypes III–VI. The few reported cases of capecitabine-induced hyperpigmentation have been associated with hand and foot syndrome in patients with phototypes IV–V and palmar as well as plantar involvement. PMID:26114058

  7. Change of weight-bearing pattern before and after plantar reconstruction with free anterolateral thigh flap.

    PubMed

    Sekido, Mitsuru; Yamamoto, Yuhei; Furukawa, Hiroshi; Sugihara, Tsuneki

    2004-01-01

    We reconstructed a large-sized defect at the weight-bearing plantar region by a free anterolateral thigh flap successfully. This is the first case report of using the anterolateral thigh flap for reconstruction of the plantar foot. Based on the preoperative and postoperative pedogram examinations, the pressure distribution on the weight-bearing area reconstructed by the transferred flap was obviously improved and demonstrated a nearly normal pattern. No previous report has compared the weight-bearing pattern before and after large plantar reconstruction with a free flap. The anterolateral thigh free flap, which provides adequate bulk and contour of the foot, and which withstands weight pressure and shearing force and has the ability to provide recovery of sensation, is considered a good alternative in covering a large weight-bearing plantar defect. PMID:15274185

  8. Ground reaction forces and plantar pressure distribution during occasional loaded gait.

    PubMed

    Castro, Marcelo; Abreu, Sofia; Sousa, Helena; Machado, Leandro; Santos, Rubim; Vilas-Boas, Joăo Paulo

    2013-05-01

    This study compared the ground reaction forces (GRF) and plantar pressures between unloaded and occasional loaded gait. The GRF and plantar pressures of 60 participants were recorded during unloaded gait and occasional loaded gait (wearing a backpack that raised their body mass index to 30); this load criterion was adopted because is considered potentially harmful in permanent loaded gait (obese people). The results indicate an overall increase (absolute values) of GRF and plantar pressures during occasional loaded gait (p < 0.05); also, higher normalized (by total weight) values in the medial midfoot and toes, and lower values in the lateral rearfoot region were observed. During loaded gait the magnitude of the vertical GRF (impact and thrust maximum) decreased and the shear forces increased more than did the proportion of the load (normalized values). These data suggest a different pattern of GRF and plantar pressure distribution during occasional loaded compared to unloaded gait. PMID:23157973

  9. The use of a heel-mounted accelerometer as an adjunct measure of slip distance.

    PubMed

    McGorry, Raymond W; DiDomenico, Angela; Chang, Chien-Chi

    2007-05-01

    A human-centered measure of floor slipperiness could be useful as an adjunct to conventional tribologic measures. This paper reports on the development and evaluation of a measure of slip distance based on variables derived from the signal of a heel-mounted accelerometer. Twenty-one participants walked on a laboratory runway under several surface slipperiness conditions at three walking speeds during a protocol designed to produce a wide range of slip distances at heel strike. Analysis of variance showed significant effects of slip distance (no-slip, micro-slip and slide), walking speed (1.52, 1.78 and 2.13 m/s) and their interactions on peak forward acceleration, peak vertical acceleration and deceleration time of the heel following heel strike in 704 trials. Regression analysis of slip distance and deceleration time showed the strongest relationship with R2=0.511. Large individual variation in the strength of this relationship was observed. The heel-mounted accelerometer may have utility as an adjunct measure in the evaluation of floor slipperiness, particularly for field applications where direct measurement may not be feasible. PMID:16806040

  10. Plantar pressure distribution in normal, hallux valgus and hallux limitus feet

    Microsoft Academic Search

    A. Bryant; P. Tinley; K. Singer

    1999-01-01

    Selected dynamic plantar pressure measurements of 30 control, 30 hallux valgus and 30 hallux limitus subjects, using an EMED-SF system and a two-step method of data collection, were analysed for significant differences, with a one-way analysis of variance being performed with P<0.05. In comparison to normal control subjects, those with hallux valgus feet demonstrated significant medial plantar peak and mean

  11. The effects of extracorporeal shock wave therapy on stroke patients with plantar fasciitis.

    PubMed

    Kim, Tae Gon; Bae, Sea Hyun; Kim, Gye Yeop; Kim, Kyung Yoon

    2015-02-01

    [Purpose] The purpose of this research was to analyze the efficacy of extracorporeal shock wave therapy for the treatment of stroke patients with plantar fasciitis. [Subjects and Methods] This study included 10 stroke patients diagnosed with plantar fasciitis who were administered 3 sessions of extracorporeal shock wave therapy per week. After the last session, they performed stretching exercises for their Achilles tendon and plantar fascia for 30?min/day, 5 times a week for 6 months. The following parameters were measured and compared prior to therapy, 6 weeks after therapy, and 6 months after therapy: thickness of the plantar fascia, using an ultrasonic imaging system; degree of spasticity, using a muscle tension measuring instrument; degree of pain, using the visual analogue scale; and gait ability, using the Functional Gait Assessment. [Results] Decreased plantar fascia thickness, spasticity, and pain and increased gait ability were noted after therapy. These changes were significantly greater at 6 months after therapy than at 6 weeks after therapy. [Conclusion] These results indicated that extracorporeal shock wave therapy reduced tension in the plantar fascia, relieving pain and improving gait ability in stroke patients. PMID:25729207

  12. The effects of extracorporeal shock wave therapy on stroke patients with plantar fasciitis

    PubMed Central

    Kim, Tae Gon; Bae, Sea Hyun; Kim, Gye Yeop; Kim, Kyung Yoon

    2015-01-01

    [Purpose] The purpose of this research was to analyze the efficacy of extracorporeal shock wave therapy for the treatment of stroke patients with plantar fasciitis. [Subjects and Methods] This study included 10 stroke patients diagnosed with plantar fasciitis who were administered 3 sessions of extracorporeal shock wave therapy per week. After the last session, they performed stretching exercises for their Achilles tendon and plantar fascia for 30?min/day, 5 times a week for 6 months. The following parameters were measured and compared prior to therapy, 6 weeks after therapy, and 6 months after therapy: thickness of the plantar fascia, using an ultrasonic imaging system; degree of spasticity, using a muscle tension measuring instrument; degree of pain, using the visual analogue scale; and gait ability, using the Functional Gait Assessment. [Results] Decreased plantar fascia thickness, spasticity, and pain and increased gait ability were noted after therapy. These changes were significantly greater at 6 months after therapy than at 6 weeks after therapy. [Conclusion] These results indicated that extracorporeal shock wave therapy reduced tension in the plantar fascia, relieving pain and improving gait ability in stroke patients. PMID:25729207

  13. Deformation characteristics of the heel region of the shod foot during a simulated heel strike: The effect of varying midsole hardness

    Microsoft Academic Search

    P. Aerts; D. De Clercq

    1993-01-01

    Impact tests using a pendulum were performed on the shod heel region of nine subjects. Both soft? and hard?soled shoes were used. The deformations involved were calculated from the registered decelerations during impact. Thus, load?deformation cycles were recorded for various impact velocities. In contrast to in vivo force?platform recordings, peak loadings for the soft? and hard?soled conditions differed significantly (614

  14. An investigation into plantar pressure measurement protocols for footwear research.

    PubMed

    Melvin, J M A; Preece, S; Nester, C J; Howard, D

    2014-09-01

    Many researchers investigate how footwear design affects plantar pressure (PP) and ask participants to walk in unfamiliar footwear as part of their studies. However, there are no clear guidelines for the required period of time or number of steps a healthy participant requires to acclimatise to unfamiliar footwear. Nor are there clear guidelines for how many steps should be collected to produce data that is representative of gait in each particular shoe being tested. There were therefore two aims to this study: (1) to investigate the number of steps required to produce an average step that is representative of normal gait; (2) to investigate the number of steps required for a participant to acclimatise to a range of footwear types. PP data were collected in 20 healthy participants whilst they walked for 400 m in a range of footwear. The results showed that the number of steps required for both acclimatisation and to ensure data quality are dependent on shoe type and the foot region being investigated. It is recommended that 30 steps from one foot are collected during data collection and an acclimatisation period of at least 166 steps is given for each shoe condition. The former recommendation is not met by most studies in the literature. PMID:25161007

  15. Platelet-rich plasma: a ‘feeling' and ‘hope' ailing athletes

    Microsoft Academic Search

    Vijay D Shetty

    2010-01-01

    IntroductionA number of orthopaedic and sports conditions remain a major therapeutic challenge to orthopaedic surgeons even in this day and age of technological advance. Some of these difficult conditions include plantar fasciitis (chronic pain in the sole of the foot), tennis elbow (chronic pain in the elbow), ligament and muscle injuries (around the knee and other joints) and tendo-achelles (heel)

  16. Heel and toe clearance estimation for gait analysis using wireless inertial sensors.

    PubMed

    Mariani, Benoit; Rochat, Stephane; Büla, Christophe J; Aminian, Kamiar

    2012-11-01

    Tripping is considered a major cause of fall in older people. Therefore, foot clearance (i.e., height of the foot above ground during swing phase) could be a key factor to better understand the complex relationship between gait and falls. This paper presents a new method to estimate clearance using a foot-worn and wireless inertial sensor system. The method relies on the computation of foot orientation and trajectory from sensors signal data fusion, combined with the temporal detection of toe-off and heel-strike events. Based on a kinematic model that automatically estimates sensor position relative to the foot, heel and toe trajectories are estimated. 2-D and 3-D models are presented with different solving approaches, and validated against an optical motion capture system on 12 healthy adults performing short walking trials at self-selected, slow, and fast speed. Parameters corresponding to local minimum and maximum of heel and toe clearance were extracted and showed accuracy ± precision of 4.1 ± 2.3 cm for maximal heel clearance and 1.3 ± 0.9 cm for minimal toe clearance compared to the reference. The system is lightweight, wireless, easy to wear and to use, and provide a new and useful tool for routine clinical assessment of gait outside a dedicated laboratory. PMID:22955865

  17. Reliability model for Al wire bonds subjected to heel crack failures

    Microsoft Academic Search

    S. Ramminger; N. Seliger; G. Wachutka

    2000-01-01

    In power electronic packages wire bonding is used for the electrical contact of the chips and for interconnections on the module substrate. Limiting factors for the reliability are solder fatigue and wire bond failures. In this work we investigate the material fatigue of aluminum bonding wires stressed by cyclic lateral bonding area displacement. Bond wire heel crack failures observed by

  18. Bilateral heel pain in a patient with Diamond-Blackfan anaemia.

    PubMed

    Charles, Loren T R; Mehdi, Adil M S; Baker, Dennis; Edwards, Max R

    2015-06-01

    A rare case of bilateral calcaneal stress fractures in a patient with Diamond-Blackfan anaemia is described. This has not been previously reported in the literature. A calcaneal stress fracture is an important differential diagnosis in a patient presenting with heel pain. Bilaterality of symptoms should not exclude this diagnosis and clinicians should be especially vigilant with predisposed patients. PMID:26004126

  19. Randomised controlled trial of paracetamol for heel prick pain in neonates

    PubMed Central

    Shah, V.; Taddio, A.; Ohlsson, A.

    1998-01-01

    AIM—To evaluate the effectiveness of paracetamol in decreasing the pain from heel prick.?METHODS—A prospective randomised double blind placebo controlled trial was conducted of 75 term neonates undergoing heel prick. Sixty to 90 minutes before the procedure neonates received paracetamol orally in a dose of 20 mg/kg (group 1) or an equal volume of placebo (group 2). Heel prick was performed in a standardised manner. Pain assessments were made using per cent facial action (brow bulge, eye squeeze, and nasolabial fold (range 0-300%) and per cent of time spent crying (range 0-100%).?RESULTS—Thirty eight neonates were enrolled in group 1 and 37 neonates in group 2. There were no significant differences in the demographic characteristics between groups. Mean gestational age was 39 (SD 1.4) vs 39.4 (SD 1.2) weeks, p=0.86, mean birthweight 3.45 (SD 0.45) vs 3.44 (SD 0.42) kg; p=0.31 for groups 1 and 2, respectively. Facial action pain scores did not differ between groups (143.5(SD 54.2)% vs 131.1 (SD 59.6)%; p=0.38). Cry scores also did not differ (29.4 (SD 19.9)% vs 26.8 (SD 20.2)%; p=0.60). No adverse effects were observed.?CONCLUSION—Paracetamol is ineffective for decreasing the pain from heel prick in term neonates.?? PMID:10194994

  20. Arthroscopic approach and intra-articular anatomy of the plantar pouch of the equine tarsocrural joint.

    PubMed

    Zamos, D T; Honnas, C M; Hoffman, A G

    1994-01-01

    Arthroscopic examination of structures within the plantar pouch of the tarsocrural joint was accomplished via portals in both the plantaromedial and plantarolateral aspects of the joint. Flexion and extension of the tarsus while examining the joint through either portal allowed observation of the proximal and plantar aspects of the lateral and medial trochlear ridges, the trochlear groove, the caudal aspect of the distal tibia, and the deep digital flexor tendon (DDFT) in its sheath. From a plantarolateral portal, the plantar talocalcaneal ligament and the plantar aspect of the lateral malleolus could be observed. The caudal aspect of the medial malleolus could not be observed with flexion or extension of the joint from a plantaromedial portal, but in some horses, the caudal aspect of the lateral malleolus could be observed. The dorsolateral and dorsomedial aspects of the plantar pouch were best examined from a portal on the ipsilateral side of the joint. An instrument portal opposite either arthroscope portal allowed access to most regions of the joint except the abaxial surface of the trochlear ridge opposite the instrument. PMID:8066979

  1. The Relationship of Body Weight and Clinical Foot and Ankle Measurements to the Heel Forces of Forward and Backward Walking

    PubMed Central

    Albensi, Raymond J.; Nyland, John; Caborn, David N.M.

    1999-01-01

    Objective: To compare and contrast the relationships of selected static clinical measurements with the heel forces of forward and backward walking among healthy high school athletes. Design and Setting: Single-group, cross-order-controlled, repeated-measures design. All data were collected in a high school athletic training room. Subjects: Seventeen healthy high school student-athlete volunteers. Measurements: We performed static clinical measurements of the foot, ankle, and knee using handheld goniometers. We used a metric ruler to assess navicular drop and a beam balance platform scale to measure body weight. Mean peak heel forces were measured using F-scan insole force sensors. Data were sampled for 3 5-second trials (50-Hz sampling rate). Mean peak heel forces were determined from 3 to 5 consecutive right foot contacts during forward and backward walking at approximately 4.02 to 4.83 km/h (2.5 to 3.0 mph). Subjects wore their own athletic shoes and alternated their initial walking direction. Results: Forward stepwise multiple regression analyses revealed that body weight, navicular drop, and standing foot angle predicted mean peak heel forces during forward and backward walking. Conclusions: Heel forces during forward and backward walking increase as body weight and navicular drop magnitude increase, and they decrease as standing foot angle increases. Subtle differences in foot, ankle, and knee joint postures and kinematics can affect heel forces even among normal subjects. Injury and protective bracing or taping may further affect these heel forces. PMID:16558581

  2. Effects of plantar cutaneo-muscular and tendon vibration on posture and balance during quiet and perturbed stance

    Microsoft Academic Search

    Cynthia Thompson; Marc Bélanger; Joyce Fung

    2011-01-01

    Modulation of lower limb somatosensory information by tendon or plantar vibration produces directionally specific, vibration-induced falling reactions that depend on the tendon or the region of the sole that is vibrated. This study characterized the effects of different patterns of plantar cutaneo-muscular vibration and bilateral Achilles tendon vibration (ATV) on the postural strategies observed during quiet and perturbed stance. Twelve

  3. Chronic spinal infusion of loperamide alleviates postsurgical pain in rats.

    PubMed

    Kumar, Rakesh; Reeta, K H; Ray, Subrata Basu

    2014-04-01

    Plantar incision in rat generates spontaneous pain behaviour. The opioid drug, morphine used to treat postsurgical pain produces tolerance after long-term administration. Loperamide, a potent mu-opioid agonist, has documented analgesic action in various pain conditions. However, loperamide analgesia and associated tolerance following continuous spinal administration in postsurgical pain has not been reported. Chronic spinal infusion of drugs was achieved using intrathecal catheters connected to osmotic minipump. Coinciding with the onset of spinal infusion of loperamide or morphine, rats were subjected to plantar incision. Pain-related behaviour was assessed by Hargreaves apparatus (thermal hyperalgesia) and von Frey filaments (mechanical allodynia). Morphine and loperamide (0.5, 1 and 2 microL/h) induced analgesia was observed until 7th day post-plantar incision in Sprague-Dawley rats. Morphine and loperamide produced dose-dependent analgesia. Loperamide, in the highest dose, produced analgesia till 7th day. However, the highest dose of morphine produced inhibition of thermal hyperalgesia till 5th day and mechanical allodynia only till 3rd day post-plantar incision. Morphine and loperamide produced analgesia in postsurgical pain, which may be mediated through different mechanisms. Longer duration of analgesia with loperamide could probably be due sustained blockade of calcium channels. PMID:24772934

  4. Constitutive Modeling of Time-Dependent Response of Human Plantar Aponeurosis

    PubMed Central

    Pavan, P. G.; Pachera, P.; Stecco, C.; Natali, A. N.

    2014-01-01

    The attention is focused on the viscoelastic behavior of human plantar aponeurosis tissue. At this purpose, stress relaxation tests were developed on samples taken from the plantar aponeurosis of frozen adult donors with age ranging from 67 to 78 years, imposing three levels of strain in the physiological range (4%, 6%, and 8%) and observing stress decay for 240?s. A viscohyperelastic fiber-reinforced constitutive model with transverse isotropy was assumed to describe the time-dependent behavior of the aponeurotic tissue. This model is consistent with the structural conformation of the tissue where collagen fibers are mainly aligned with the proximal-distal direction. Constitutive model fitting to experimental data was made by implementing a stochastic-deterministic procedure. The stress relaxation was found close to 40%, independently of the level of strain applied. The agreement between experimental data and numerical results confirms the suitability of the constitutive model to describe the viscoelastic behaviour of the plantar aponeurosis. PMID:24701249

  5. A new method of excision of painful plantar forefoot lesions using a rotation advancement flap.

    PubMed

    Satterfield, V K; Jolly, G P

    1994-01-01

    A new method of excision of painful plantar lesions in the forefoot was studied in 13 feet (12 patients). Etiology of the lesions was variable, including traumatic and iatrogenic scars. Localized transfer of partially undermined tissue is used to fill a triangular defect created by excising the lesions. The flap is advanced/rotated into place, without gapping or tension. Full sensation is maintained and because of the significant vascular contribution by the proximal plantar subcutaneous plexus, there is little chance of vascular compromise. Problematic scars occurred in only three feet (two patients). Complications included inclusion cysts in two cases, one parakeratotic nodule and an incidental occurrence of verruca in one case. Follow-up average was 25 months. This procedure provides an alternative method for resolving patients' painful plantar lesions. PMID:8019532

  6. Hallux valgus and plantar pressure loading: the Framingham foot study

    PubMed Central

    2013-01-01

    Background Hallux valgus (HV), a common structural foot deformity, can cause foot pain and lead to limited mobility. The purpose of this study was to evaluate differences in plantar pressure and force during gait by HV status in a large population-based cohort of men and women. Methods A trained examiner performed a validated physical examination on participants’ feet and recorded the presence of hallux valgus and other specific foot disorders. Each foot was classified into one of four mutually exclusive groups based on the foot examination. Foot groups were: (i) HV only, (ii) HV and at least one additional foot disorder (FD), (iii) no HV but at least one other FD, and (iv) neither HV nor FD (referent). Biomechanical data for both feet were collected using Tekscan Matscan. Foot posture during quiet standing, using modified arch index (MAI), and foot function during gait, using center of pressure excursion index (CPEI), were calculated per foot. Further, walking scans were masked into eight sub-regions using Novel Automask, and peak pressure and maximum force exerted in each region were calculated. Results There were 3205 participants, contributing 6393 feet with complete foot exam data and valid biomechanical measurements. Participants with HV had lower hallucal loading and higher forces at lesser toes as well as higher MAI and lower CPEI values compared to the referent. Participants with HV and other FDs were also noted to have aberrant rearfoot forces and pressures. Conclusions These results suggest that HV alters foot loading patterns and pressure profiles. Future work should investigate how these changes affect the risk of other foot and lower extremity ailments. PMID:24138804

  7. Plantar shear stress distributions in diabetic patients with and without neuropathy

    PubMed Central

    Yavuz, Metin

    2014-01-01

    Background The exact pathology of diabetic foot ulcers remains to be resolved. Evidence suggests that plantar shear forces play a major role in diabetic ulceration. Unfortunately, only a few manuscripts exist on the clinical implications of plantar shear. The purpose of this study was to compare global and regional peak plantar stress values in three groups; diabetic patients with neuropathy, diabetic patients without neuropathy and healthy control subjects. Methods Fourteen diabetic neuropathic patients, 14 non-neuropathic diabetic control and 11 non-diabetic control subjects were recruited. Subjects walked on a custom-built stress plate that quantified plantar pressures and shear. Four stress variables were analyzed; peak pressure, peak shear, peak pressure-time and shear-time integral. Findings Global peak values of peak shear (p=0.039), shear-time integral (p=0.002) and pressure-time integral (p=0.003) were significantly higher in the diabetic neuropathic group. Local peak shear stress and shear-time integral were also significantly higher in diabetic neuropathic patients compared to both control groups, in particular, at the hallux and central forefoot. Local peak pressure and pressure-time integral were significantly different between the three groups at the medial and lateral forefoot. Interpretation Plantar shear and shear-time integral magnitudes were elevated in diabetic patients with peripheral neuropathy, which indicates the potential clinical significance of these factors in ulceration. It is thought that further investigation of plantar shear would lead to a better understanding of ulceration pathomechanics, which in turn will assist researchers in developing more effective preventive devices and strategies. PMID:24332719

  8. Misdiagnosis of plexiform neurofibroma of the medial plantar nerve: case report.

    PubMed

    D'Orazi, Valerio; Venditto, Teresa; Panunzi, Andrea; Anichini, Silvia; Manzini, Gabriele; Tallarico, Arturo; Bernetti, Andrea; Paoloni, Marco

    2014-09-01

    Plexiform neurofibromas are benign tumors of the peripheral nerve. Diagnosis may be challenging, if they present mimicking other peripheral nerve pathologies. We report the case of a patient who had severe foot pain, which progressively hampered her walking ability, erroneously attributed to recurrent Morton's neuroma. Diagnosis of plexiform neurofibroma of her right medial plantar nerve was made 15 years after the appearance of symptoms. Pain and function recovered after radical neurotomy of the medial plantar nerve. A correct diagnosis is an essential starting point in the treatment of neurofibromas and a misdiagnosis may lead to an inappropriate treatment. PMID:25024003

  9. Does obesity influence foot structure and plantar pressure patterns in prepubescent children?

    Microsoft Academic Search

    AM Dowling; JR Steele; LA Baur

    2001-01-01

    OBJECTIVE: This study examined the effects of obesity on plantar pressure distributions in prepubescent children.DESIGN: Field-based, experimental data on BMI (body mass index), foot structure and plantar pressures were collected for 13 consenting obese children and 13 non-obese controls.SUBJECTS: Thirteen obese (age 8.1±1.2 y; BMI 25.5±2.9 kg\\/m2) and 13 non-obese (age 8.4±0.9 y; BMI 16.9±1.2 kg\\/m2) prepubescent children, matched to

  10. EM-31 RETRIEVAL KNOWLEDGE CENTER MEETING REPORT: MOBILIZE AND DISLODGE TANK WASTE HEELS

    SciTech Connect

    Fellinger, A.

    2010-02-16

    The Retrieval Knowledge Center sponsored a meeting in June 2009 to review challenges and gaps to retrieval of tank waste heels. The facilitated meeting was held at the Savannah River Research Campus with personnel broadly representing tank waste retrieval knowledge at Hanford, Savannah River, Idaho, and Oak Ridge. This document captures the results of this meeting. In summary, it was agreed that the challenges to retrieval of tank waste heels fell into two broad categories: (1) mechanical heel waste retrieval methodologies and equipment and (2) understanding and manipulating the heel waste (physical, radiological, and chemical characteristics) to support retrieval options and subsequent processing. Recent successes and lessons from deployments of the Sand and Salt Mantis vehicles as well as retrieval of C-Area tanks at Hanford were reviewed. Suggestions to address existing retrieval approaches that utilize a limited set of tools and techniques are included in this report. The meeting found that there had been very little effort to improve or integrate the multiple proven or new techniques and tools available into a menu of available methods for rapid insertion into baselines. It is recommended that focused developmental efforts continue in the two areas underway (low-level mixing evaluation and pumping slurries with large solid materials) and that projects to demonstrate new/improved tools be launched to outfit tank farm operators with the needed tools to complete tank heel retrievals effectively and efficiently. This document describes the results of a meeting held on June 3, 2009 at the Savannah River Site in South Carolina to identify technology gaps and potential technology solutions to retrieving high-level waste (HLW) heels from waste tanks within the complex of sites run by the U. S. Department of Energy (DOE). The meeting brought together personnel with extensive tank waste retrieval knowledge from DOE's four major waste sites - Hanford, Savannah River, Idaho, and Oak Ridge. The meeting was arranged by the Retrieval Knowledge Center (RKC), which is a technology development project sponsored by the Office of Technology Innovation & Development - formerly the Office of Engineering and Technology - within the DOE Office of Environmental Management (EM).

  11. An exploration of emergency department presentations related to high heel footwear in Victoria, Australia, 2006–2010

    PubMed Central

    2014-01-01

    Background Many women are warned against the dangers of wearing high heel footwear however there is limited empirical evidence demonstrating an association between wearing high heel with injury. Gait laboratory testing has found a higher heel height placed the foot in a position that increases the risk of ankle sprain. Women have also been surveyed about wearing high heels and approximately half of those reported inconvenience and pain after wearing a high heel shoe. This study aims to explore emergency department presentations of injuries and the estimated costs that have been directly attributed to wearing high heeled footwear within Victoria, Australia during 2006–2010. Methods The Victorian Emergency Minimum Dataset (VEMD) was searched for all injuries attributed to wearing high heel footwear presenting to emergency departments in Victoria Australia, between the years of 2006–2010. The VEMD produced a report detailing sex, age at presentation, month of presentation, time of day of presentation, day of presentation, location that injury occurred and type of injury for presentation. Monash Health in Victoria Australia, provided emergency department estimates for injury types to calculate an estimated cost of an acute injury related to wearing high heel footwear. Results There were 240 injuries presenting to Victorian emergency departments directly attributed to wearing high heeled footwear. The majority of people injured were women (n?=?236) and all were less than 55 years of age. More injuries presented on a Sunday (n?=?83) and more in the 8 am-12 pm time bracket (n?=?64). There were also more injuries presenting in the months of November, December and January (n?=?80). The most commonly injured body part was the ankle (n?=?123). The emergency department estimate of the cost of these injuries over this time-frame was almost $72,000 (mean of $316.72 per presentation). Conclusions People who wear high heel footwear on weekends appear to be at higher risk for injury that leads to emergency department presentation. However, there was not a large cost associated with emergency department presentations attributable to wearing high heel footwear over a 5 year period. PMID:24456691

  12. Relationship between navicular drop and measuring position of maximal plantar flexion torque of the first and second-fifth metatarsophalangeal joints

    PubMed Central

    Saeki, Junya; Tojima, Michio; Torii, Suguru

    2015-01-01

    [Purpose] The purpose of this study was to determine the relationship between navicular drop and plantar flexion torque of the first and second-fifth metatarsophalangeal joints. [Subjects] Ten healthy young men participated in this study. [Methods] The Pearson product-moment correlation coefficient was calculated to determine the relationship between navicular drop and plantar flexion torque of the first and second-fifth metatarsophalangeal joints. [Results] Significant negative correlations were observed between navicular drop and plantar flexion torques in the lengthened position of the intrinsic toe plantar flexion muscles, but no correlations were found between navicular drop and plantar flexion torques in the neutral position of the ankle and metatarsophalangeal joints. Moreover, the intrinsic toe plantar flexion muscles were found to contribute to the formation of the medial longitudinal arch. [Conclusion] Navicular drop correlates with metatarsophalangeal joint muscle strength in plantar flexion where the intrinsic toe muscles are capable of exerting force. PMID:26180323

  13. Project W-320 Heel Jet Secondary Catch Mechanism lateral load test

    SciTech Connect

    Bellomy, J.R.

    1994-09-01

    This test procedure establishes the requirements for performing a lateral load test of the Heel Jet Secondary Catch Mechanism (SCM). Successful performance of this test will demonstrate that the SCM is capable of performing as designed when subjected to a force applied normal to the longitudinal axis of the mechanism. This test procedure is prepared following the recommended format and content guidelines for test procedures as prescribed in WHC-IP-1026, Engineering Practice Guidelines, Appendix K, Test Plans, Specifications, Procedures and Reports.

  14. Heel contact dynamics during slip events on level and inclined surfaces

    Microsoft Academic Search

    Rakié Cham; Mark S Redfern

    2002-01-01

    This study describes heel contact dynamics during slip events, information that must be known to develop biomechanically relevant shoe-floor coefficient of friction measurement systems. Sixteen subjects walked on a level, 5 and 10° ramp with two possible contaminants (dry, oil). Foot motion was recorded at 350 Hz and compared among no-slip, slip-recovery and slip-fall events. For all trials, the foot

  15. Muscle activity reduces soft-tissue resonance at heel-strike during walking.

    PubMed

    Wakeling, James M; Liphardt, Anna-Maria; Nigg, Benno M

    2003-12-01

    Muscle activity has previously been suggested to minimize soft-tissue resonance which occurs at heel-strike during walking and running. If this concept were true then the greatest vibration damping would occur when the input force was closest to the resonant frequency of the soft-tissues at heel-strike. However, this idea has not been tested. The purpose of this study was to test whether muscle activity in the lower extremity is used to damp soft-tissue resonance which occurs at heel-strike during walking. Hard and soft shoe conditions were tested in a randomized block design. Ground reaction forces, soft-tissue accelerations and myoelectric activity were measured during walking for 40 subjects. Soft-tissue mass was estimated from anthropologic measurements, allowing inertial forces in the soft-tissues to be calculated. The force transfer from the ground to the tissues was compared with changes in the muscle activity. The soft condition resulted in relative frequencies (input/tissue) to be closer to resonance for the main soft-tissue groups. However, no increase in force transmission was observed. Therefore, the vibration damping in the tissues must have increased. This increase concurred with increases in the muscle activity for the biceps femoris and lateral gastrocnemius. The evidence supports the proposal that muscle activity damps soft-tissue resonance at heel-strike. Muscles generate forces which act across the joints and, therefore, shoe design may be used to modify muscle activity and thus joint loading during walking and running. PMID:14614930

  16. Biochemical response to chronic shortening in unloaded soleus muscles

    NASA Technical Reports Server (NTRS)

    Jaspers, S. R.; Fagan, J. M.; Tischler, M. E.

    1985-01-01

    One leg of tail-casted suspended rats was immobilized in a plantar-flexed position to test whether chronic shortening of posterior leg muscles affected the metabolic response to unloading. The immobilized plantaris and gastrocnemius muscles of these animals showed approximately 20 percent loss of muscle mass in contrast to simply a slower growth rate with unloading. Loss of mass of the soleus muscle during suspension was not accentuated by chronic shortening. Although protein degradation in the isolated soleus muscle of the plantar-flexed limb was slightly faster than in the contralateral free limb, this difference was offset by faster synthesis of the myofibrillar protein fraction of the chronically shortened muscle. Total adenine nucleotides were 17 percent lower (P less than 0.005) in the chronically shortened soleus muscle following incubation. Glutamate, glutamine, and alanine metabolism showed little response to chronic shortening. These results suggest that, in the soleus muscle, chronic shortening did not alter significantly the metabolic responses to unloading and reduced activity.

  17. Localized Palmar-Plantar Epidermal Hyperplasia: A Previously Undefined Dermatologic Toxicity to Sorafenib

    Microsoft Academic Search

    MATTHEW BELDNER; MICHAEL JACOBSON; GENE E. BURGES; DEBORAH DEWAAY; JOHN C. MAIZE; UZAIR B. CHAUDHARYa

    The development of multitargeted tyrosine kinase in- hibitors has provided significant advances in the treat- ment of renal cell carcinoma. This case describes initial therapy for managing renal cell cancer with the admin- istration of sorafenib, a multitargeted tyrosine kinase inhibitor. We report the development of localized pal- mar-plantar epidermal hyperplasia, a rare but signifi- cant cutaneous adverse event from

  18. [Therapeutic solutions in post-excision defects for plantar verrucous carcinoma].

    PubMed

    Apostolescu, Ioana; Matusz, P; Florescu, I P; Giuglea, Carmen; Marinescu, S

    2005-01-01

    Carcinoma verrucous--anatomoclinical entity histological high rate of differentiation of the spinocellular epithelioma, clinically associated with 3 types of lesion. We present the therapeutical solution of a plantar carcinoma verrucous case, a large post-excisional defect-free flap transfer of latissimus dorsi muscle using microsurgical techniques. PMID:16607749

  19. Specific whole-body shifts induced by frequency-modulated vibrations of human plantar soles

    Microsoft Academic Search

    Anne Kavounoudias; Régine Roll; Jean-Pierre Roll

    1999-01-01

    This study sought to analyze the postural responses induced by separately or simultaneously vibrating with different frequencies the forefoot and rear foot zones of both soles in standing subjects. Stimulating each zone separately resulted in spatially oriented body tilts; their amplitude and velocity varied linearly according to the frequency, and their direction was always opposite to the plantar site vibrated.

  20. Risk of plantar ulceration in diabetic patients with single-leg amputation

    Microsoft Academic Search

    R. V. Kanade; R. W. M. van Deursen; Patricia Price; Keith Harding

    2006-01-01

    BackgroundThere is a disconcerting rate of bilateral limb loss in patients with diabetes. Therefore, this study aimed to explore plantar loading of the surviving foot following unilateral trans-tibial amputation within a wider context of daily walking activity to investigate the precise risk to the surviving limb.

  1. In-Shoe Plantar Pressures and Ground Reaction Forces during Overweight Adults' Overground Walking

    ERIC Educational Resources Information Center

    de Castro, Marcelo P.; Abreu, Sofia C.; Sousa, Helena; Machado, Leandro; Santos, Rubim; Vilas-Boas, Joăo Paulo

    2014-01-01

    Purpose: Because walking is highly recommended for prevention and treatment of obesity and some of its biomechanical aspects are not clearly understood for overweight people, we compared the absolute and normalized ground reaction forces (GRF), plantar pressures, and temporal parameters of normal-weight and overweight participants during…

  2. Medium thickness plantar skin graft for the management of digital and palmar flexion contractures

    Microsoft Academic Search

    A. R Bunyan; Bhagwat S Mathur

    2000-01-01

    The fundamental principle of reconstruction is to replace the lost tissue with similar tissue. Because of the unique similarities in characteristics, plantar skin is an excellent donor area for skin grafting for the palmar aspect of the digits and hand. It provides an ideal color and texture match and long durability with an inconspicuous donor site. However, the use of

  3. Hypertrophic scar formation following carbon dioxide laser ablation of plantar warts in cyclosporin-treated patients.

    PubMed

    Ozluer, S M; Chuen, B Y; Barlow, R J; Markey, A C

    2001-12-01

    We present four renal transplant patients who developed hypertrophic scars following carbon dioxide laser ablation of recalcitrant plantar warts. All of the patients were on long-term treatment with cyclosporin, which we believe to be responsible. We discuss several possible mechanisms by which cyclosporin may influence wound healing and scarring. PMID:11899123

  4. Assessment of Effective Ankle Joint Positioning in Strength Training for Intrinsic Foot Flexor Muscles: A Comparison of Intrinsic Foot Flexor Muscle Activity in a Position Intermediate to Plantar and Dorsiflexion with that in Maximum Plantar Flexion Using Needle Electromyography

    PubMed Central

    Hashimoto, Takayuki; Sakuraba, Keishoku

    2014-01-01

    [Purpose] The effectiveness of intrinsic foot flexor strength training performed in the plantar flexion position was examined using needle electromyography. [Subjects] The subjects of this study were 18 healthy men. [Methods] We used needle electromyography to measure the muscle activities of the flexor hallucis brevis (FHB), and the flexor digitorum brevis (FDB) in maximum plantar and an intermediate position. [Results] Significant increases in muscle activities were observed for both FHB and FDB, and the rates of increase from the intermediate position to the plantar flexion position were 43% for FHB and 46% for FDB. [Conclusion] This study demonstrated that it is possible to evaluate intrinsic foot flexors, in addition to the numerous reports on treatment methods focusing on extrinsic foot flexors. Furthermore, the results suggest that toe flexion exercises performed during plantar flexion of the ankle joint are an effective method for intrinsic foot flexor strength training. PMID:24707106

  5. Methods for Heel Retrieval for Tanks C-101, C-102, and C-111 at the Hanford Site - 13064

    SciTech Connect

    Sams, T.L.; Kirch, N.W.; Reynolds, J.H. [Washington River protection Solutions, Richland, WA 99352 (United States)] [Washington River protection Solutions, Richland, WA 99352 (United States)

    2013-07-01

    The purpose of this paper is to evaluate the prospects of using bulk waste characteristics to determine the most appropriate heel retrieval technology. If the properties of hard to remove heels can be determined before bulk retrieval, then a heel retrieval technology can be selected before bulk retrieval is complete. This would save substantially on sampling costs and would allow the deployment of the heel retrieval technology immediately after bulk retrieval. The latter would also accelerate the heel removal schedule. A number of C-farm retrievals have been fully or partially completed at the time of this writing. Thus, there is already substantial information on the success of different technologies and the composition of the heels. There is also substantial information on the waste types in each tank based on historical records. Therefore, this study will correlate the performance of technologies used so far and compare them to the known waste types in the tanks. This will be used to estimate the performance of future C Farm heel retrievals. An initial decision tree is developed and employed on tanks C-101, C-102, and C 111. An assumption of this study is that no additional characterization information would be available, before or after retrieval. Note that collecting additional information would substantially increase the probability of success. Deploying some in-situ testing technologies, such as a water lance or an in-situ Raman probe, might substantially increase the probability of successfully selecting the process conditions without having to take samples from the tanks for laboratory analysis. (authors)

  6. A prospective 2-year follow-up study of plantar incisions in the treatment of primary intermetatarsal neuromas (Morton's neuroma)

    Microsoft Academic Search

    Christian Ĺkermark; Tönu Saartok; Zbigniew Zuber

    2008-01-01

    BackgroundThe aim of this prospective study, with a mean 29 (minimum 24) months follow-up was to evaluate the outcome of surgical treatment with a longitudinal, plantar incision of primary Morton's neuromas.

  7. The effect of melody on the physiological responses of heel sticks pain in neonates

    PubMed Central

    Marofi, Maryam; Nikobakht, Farzaneh; Badiee, Zohreh; Golchin, Mehri

    2015-01-01

    Background: During health care in the neonatal intensive care unit (NICU), infants undergo extremely painful procedures, which may cause problems, if not controlled, such as changes in the pattern of respiratory rate, heart rate, and blood oxygen saturation. The present study aimed to find the effect of melody on the physiological responses of neonates’ heel stick pain. Materials and Methods: This quasi-experimental study was conducted in Alzahra Hospital (Isfahan, Iran) for 5 months. Fifty infants were selected through convenient sampling method and were randomly assigned in equal numbers to two groups (n = 25). In the melody group (intervention), a selected melody was played for the infants at a distance of 1 m from them, with a sound intensity of 65 dB, from 3 minutes before, during, and after the heel stick procedure, respectively, and their physiological responses were observed with a monitoring system and recorded at the afore-mentioned time periods. Physiological responses were also recorded in the control group (no intervention) 3 min before, during, and after the heel stick procedure, respectively. Results: Means of respiratory and pulse rates in the melody and control groups showed a significant difference at different time points. But the mean blood oxygen saturation in the melody group showed no significant difference at different time points, although the difference was significant in the control group. Conclusions: The results showed that melody could maintain more balance in some physiological responses of infants, such as the respiratory rate and pulse rate during the Guthrie test. Therefore, melody is recommended to be used to prevent the destructive effects of pain in infants during painful procedures. PMID:26120343

  8. Results of Characterization and Retrieval Testing on Tank 241-C-110 Heel Solids

    SciTech Connect

    Callaway, William S.

    2013-09-30

    Nine samples of heel solids from tank 241-C-110 were delivered to the 222-S Laboratory for characterization and dissolution testing. After being drained thoroughly, the sample solids were primarily white to light-brown with minor dark-colored inclusions. The maximum dimension of the majority of the solids was <2 mm; however, numerous pieces of aggregate, microcrystalline, and crystalline solids with maximum dimensions ranging from 5-70 mm were observed. In general, the larger pieces of aggregate solids were strongly cemented. Natrophosphate [Na{sub 7}F(PO{sub 4}){sub 2}?19H{sub 2}O] was the dominant solid phase identified in the heel solids. Results of chemical analyses suggested that 85-87 wt% of the heel solids were the fluoridephosphate double salt. The average bulk density measured for the heel solids was 1.689 g/mL; the reference density of natrophosphate is 1.71 g/mL. Dissolution tests on composite samples indicate that 94 to 97 wt% of the tank 241-C-110 heel solids can be retrieved by dissolution in water. Dissolution and recovery of the soluble components in 1 kg (0.59 L) of the heel solids required the addition of ≈9.5 kg (9.5 L) of water at 15 ?C and ≈4.4 kg (4.45 L) of water at 45 ?C. Calculations performed using the Environmental Simulation Program indicate that dissolution of the ≈0.86 kg of natrophosphate in each kilogram of the tank 241-C-110 heel solids would require ≈9.45 kg of water at 15 ?C and ≈4.25 kg of water at 45 ?C. The slightly larger quantities of water determined to be required to retrieve the soluble components in 1 kg of the heel solids are consistent with that required for the dissolution of solids composed mainly of natrophosphate with a major portion of the balance consisting of highly soluble sodium salts. At least 98% of the structural water, soluble phosphate, sodium, fluoride, nitrate, carbonate, nitrite, sulfate, oxalate, and chloride in the test composites was dissolved and recovered in the dissolution tests. Most of the {sup 99}Tc and {sup 137}Cs present in the initial heel solids composites was removed in the water dissolution tests. The estimated activities/weights of {sup 129}I, {sup 234}U, {sup 235}U, {sup 236}U, and {sup 238}U in the dry residual solids were <25% of the weights/activities in the initial composite solids. Gibbsite and nordstrandite [both Al(OH){sub 3}] were the major solid phases identified in the solids remaining after completion of the dissolution tests. Chemical analysis indicated that the residual solids may have contained up to 62 wt% Al(OH){sub 3}. Significant quantities of unidentified phosphate-, iron-, bismuth-, silicon-, and strontium- bearing species were also present in the residual solids. The reference density of gibbsite (and nordstrandite) is 2.42 g/mL. The measured density of the residual solids, 2.65 g/mL, would be a reasonable value for solids containing gibbsite as the major component with minor quantities of other, higher density solids. Sieve analysis indicated that 22.2 wt% of the residual solids were discrete particles >710 μm in size, and 77.8 wt% were particulates <710 μm in size. Light-scattering measurements suggested that nearly all of the <710-μm particulates with diameters >12 μm were weakly bound aggregates of particles with diameters <2 μm. The <710-μm residual solids settled very slowly when dispersed in reagent water. The physical appearance of a suspension containing ≈0.4 vol% of the solids in pure water changed very little over a period of 46.5 hours. It should be noted that the distribution of particle sizes in the residual solids and the observed settling behavior were both strongly influenced by the procedures followed in the dissolution tests.

  9. The reliability of medial and lateral plantar nerve recordings in healthy elderly individuals.

    PubMed

    Keskin, Gokce; Kahraman Koytak, Pinar; Bastan, Birgul; Tanridag, Tulin; Us, Onder; Uluc, Kayihan

    2015-06-01

    The aim of this study was to investigate the reliability of medial plantar (MP) and lateral plantar (LP) nerve conduction studies (NCS) in healthy individuals aged >65 years, and to obtain reference values for this age group. The study included 81 healthy subjects. MP response was absent in only 2 subjects, but LP response could not be obtained bilaterally in 43 of the 81 subjects. Regression analysis showed that MP NCS could be reliably performed in those aged ?72 years and normal values for MP nerve in individuals aged 66-72 years would be strongly against a large-fiber neuropathy. However, LP response was absent in 53.1 % of the healthy elderly subjects; therefore, we think it is unreliable to study the LP nerve in this age group. PMID:25557236

  10. Randomized trial - oxybutynin for treatment of persistent plantar hyperhidrosis in women after sympathectomy

    PubMed Central

    da Silva Costa, Altair; Leăo, Luiz Eduardo Villaça; Succi, José Ernesto; Perfeito, Joao Aléssio Juliano; Filho, Adauto Castelo; Rymkiewicz, Erika; Filho, Marco Aurelio Marchetti

    2014-01-01

    OBJECTIVE: Hyperhidrosis is a common disease, and thoracoscopic sympathectomy improves its symptoms in up to 95% of cases. Unfortunately, after surgery, plantar hyperhidrosis may remain in 50% of patients, and compensatory sweating may be observed in 70%. This clinical scenario remains a challenge. Our objective was to evaluate the effectiveness of oxybutynin in the treatment of persistent plantar hyperhidrosis and compensatory sweating and its effects on quality of life in women after thoracoscopic sympathectomy. METHOD: We conducted a prospective, randomized study to compare the effects of oxybutynin at 10 mg daily and placebo in women with persistent plantar hyperhidrosis. The assessment was performed using a quality-of-life questionnaire for hyperhidrosis and sweating measurement with a device for quantifying transepidermal water loss. Clinicaltrials.gov: NCT01328015. RESULTS: Sixteen patients were included in each group (placebo and oxybutynin). There were no significant differences between the groups prior to treatment. After oxybutynin treatment, there was a decrease in symptoms and clinical improvement based on the quality-of-life questionnaire (before treatment, 40.4 vs. after treatment, 17.5; p?=?0.001). The placebo group showed modest improvement (p?=?0.09). The outcomes of the transepidermal water loss measurements in the placebo group showed no differences (p?=?0.95), whereas the oxybutynin group revealed a significant decrease (p?=?0.001). The most common side effect was dry mouth (100% in the oxybutynin group vs. 43.8% in the placebo group; p?=?0.001). CONCLUSION: Oxybutynin was effective in the treatment of persistent plantar hyperhidrosis, resulting in a better quality of life in women who had undergone thoracoscopic sympathectomy. PMID:24519200

  11. Extracorporeal shock wave therapy for plantar fasciitis. A double blind randomised controlled trial

    Microsoft Academic Search

    C. A. Speed; D. Nichols; J. Wies; H. Humphreys; C. Richards; S. Burnet; B. L. Hazleman

    2003-01-01

    Background: Extracorporeal shock wave therapy (ESWT) is an increasingly popular therapeutic approach in the management of a number of tendinopathies. Benefit has been shown in calcific tendinitis of the rotator cuff, but evidence for its use in non-calcific disorders is limited.Aims: To perform a double blind randomised controlled trial of moderate dose shock wave therapy in plantar fasciitis.Methods: Adults with

  12. TRATAMENTO DO NEUROMA DE MORTON VIA PLANTAR: AVALIAÇAO RETROSPECTIVA DOS RESULTADOS CIRÚRGICOS

    Microsoft Academic Search

    CAIO AUGUSTO DE; SOUZA NERY; RUI DOS; SANTOS BARROCO; CLEBER FURLAN; CARLOS HENRIQUE TARDINI; FABIO SERRA CEMIN; RENAN GALAS MOMBACH

    SUMMARY With the objective of assessing the effectiveness of the surgical technique involving neurectomy through plantar, cross-sectional port out of the load zone in individuals with Morton's neuroma, 217 patients were submitted to this treatment. A total of 264 feet were observed, being 32.2% right feet, 46.1% left feet, and 21.7% bilaterally. Regarding gender, 86.6% of the occurrences were seen

  13. [Realization of a compact mobile phone based wireless plantar pressure monitoring system and application].

    PubMed

    Liu, Lin; Liu, Jing

    2012-05-01

    An improved compact mobile phone based wireless plantar pressure monitoring system and software are proposed based on former progress, which can collect pressure data by sensors and circuit board, transmit data through Bluetooth wirelessly, and display and calculate the data on the mobile terminal. Conceptual experiments carried out demonstrate the feasibility and accuracy of the new system The system is expected to be widely used in the future owing to its portability, ease of use, and cost-effectiveness PMID:22916468

  14. Medial plantar nerve conduction velocities among patients with vibration syndrome due to chain-saw work

    Microsoft Academic Search

    M. Hirata; H. Sakakibara; S. Yamada; T. Hashiguchi; N. Toibana; H. Koshiyama; H. Hirano

    1999-01-01

    Objective: The present study examined the effect of the vibration syndrome (VS) on the peripheral nervous system in the lower extremities.\\u000a Methods: Thirty-eight patients with VS due to previous exposure to vibration from chain-saw work and 55 age-matched controls were\\u000a examined for sensory nerve conduction velocities in the medial plantar nerve (SCV-P). The patient group was divided into two\\u000a subgroups,

  15. Multi-plug insole design to reduce peak plantar pressure on the diabetic foot during walking

    Microsoft Academic Search

    Ricardo L. Actis; Liliana B. Ventura; Donovan J. Lott; Kirk E. Smith; Paul K. Commean; Mary K. Hastings; Michael J. Mueller

    2008-01-01

    There is evidence that appropriate footwear is an important factor in the prevention of foot pain in otherwise healthy people\\u000a or foot ulcers in people with diabetes and peripheral neuropathy. A standard care for reducing forefoot plantar pressure is\\u000a the utilization of orthotic devices such as total contact inserts (TCI) with therapeutic footwear. Most neuropathic ulcers\\u000a occur under the metatarsal

  16. Fatigue during repeated eccentric-concentric and pure concentric muscle actions of the plantar flexors

    Microsoft Academic Search

    U. Svantesson; U. Österberg; R. Thomeé; M. Peeters; G. Grimby

    1998-01-01

    Objective. To compare the fatigue development during pure concentric actions with eccentric-concentric actions in standardized isokinetic, open-chain conditions.Design. The study was performed with measurement of muscular strength and EMG of the plantar flexors on an isokinetic dynamometer.Background. Fatigue development on a dynamometer has mostly been studied with repeated pure concentric actions. Eccentric-concentric actions are, however, often used in normal activities.

  17. Removable Fiberglass De-loading Cast for the Management of Neuropathic Plantar Ulceration of the Foot

    Microsoft Academic Search

    Eran Tamir; Mike Heim MB; Itzhac Siev-Ner

    2005-01-01

    Background: Neuropathic plantar ulceration of the foot is treated by de-loading the ulcer. The total contact cast is considered to be the gold standard, but it is a labor-intensive procedure and frequent cast changes are needed. Objectives: To describe an alternative de-loading method using a fiberglass removable walking cast. Methods: This prospective uncontrolled study comprised 24 diabetic and non-diabetic patients

  18. Plantar soft tissue loading under the medial metatarsals in the standing diabetic foot

    Microsoft Academic Search

    Amit Gefen

    2003-01-01

    Diabetes mellitus (type 2) is the most frequent cause of non-traumatic lower-limb amputations. The major cause of impairment to the feet of diabetics is persistent hyperglycemia, potentially leading to peripheral neuropathy as well as to pathological changes in plantar soft tissue, which stiffen its structure and diminish its ability to effectively distribute foot-ground contact loads. In this study, a computational

  19. Carbon dioxide laser and Apligraf for a painful plantar hypertrophic scar.

    PubMed

    Lee, Daniel K; Serkin, Arnold L

    2004-01-01

    We report on a patient with a large, painful hypertrophic scar on the plantar aspect of the left foot who was treated with carbon dioxide laser and a skin substitute (Apligraf) and followed up for longer than 1 year. To our knowledge, no other case reports have been published on the use of a skin substitute to gain coverage and resolution after excision of a hypertrophic scar by carbon dioxide laser. PMID:14729994

  20. Dilated cardiomyopathy and sudden death in a teenager with palmar-plantar keratosis (occult Carvajal syndrome)

    Microsoft Academic Search

    A. J. O. Kolar; C. M. Milroy; P. F. Day; S. K. Suvarna

    2008-01-01

    A 16-year-old female who was diagnosed with palmar-plantar keratosis and Papillon-Lefevre syndrome in life died following a period of stress\\/affray. Autopsy examination revealed evidence of minor trauma and a grossly abnormal heart. The heart was sent fresh and intact to a cardiac pathologist for examination. This revealed a dilated cardiomyopathy with left ventricular fibrosis, without fatty infiltration of the right

  1. Do spike insoles enhance postural stability and plantar-surface cutaneous sensitivity in the elderly?

    PubMed Central

    Nougier, Vincent; Olivier, Isabelle

    2008-01-01

    Balance problems are often related to a loss of plantar-sensitivity in elderly people. The purpose of this study was to explore the contribution of plantar cutaneous inputs induced by a spike support surface to the control of stance. Nineteen elderly (mean age 69.0 years, range 62–80) and 19 young adults (mean age 25.9 years, range 21–32) were instructed to stand (standing session) or to walk (walking session) for 5 min with sandals equipped with spike insoles (spike condition). Both sessions also involved a no spike condition in which participants stood or walked for 5 min without these insoles (no spike condition). In all conditions, postural responses were assessed during unperturbed stance and were performed (1) immediately after putting the spike or the no spike insoles, and (2) 5 min after standing or walking with them. Sway parameters, such as centre of foot pressure mean location, surface area, mean speed, root mean square and median frequency on the antero-posterior and medio-lateral axes, were calculated. As postural performances are often related to plantar-surface sensitivity, cutaneous sensitivity threshold was also evaluated with Semmes–Weinstein monofilaments. Although no immediate effect of the spike insoles was found, results indicated that standing or walking for 5 min with sandals equipped with spike insoles led to a significant improvement of quiet standing in the elderly. Balance improvement was also observed in young adults. The results provided evidence that wearing sandals with spike insoles can contribute, at least temporarily, to the improvement of unperturbed stance in elderly people with relatively intact plantar cutaneous sensation. Further research is needed to assess the effects of longer and discontinuous stimulations with spike insoles on postural control. PMID:19424873

  2. Recalibration of somesthetic plantar information in the control of undisturbed upright stance maintenance.

    PubMed

    Bernard-Demanze, L; Burdet, C; Berger, L; Rougier, P

    2004-12-01

    To assess the effects of changes in somesthetic plantar information on upright quiet stance, a rotary plantar massage was applied under the feet of healthy subjects for ten minutes. The controlling variable, the centre of pressure (CP) displacements, were recorded, before and after massage, through a force platform and decomposed into two elementary motions: the vertical projection of the centre of gravity (CG(v)) and the difference between the latter and the CP (CP-CG(v)) along medio-lateral ML and antero-posterior AP directions. These motions were processed through frequency analysis and modelled as fractional Brownian motion. For CP-CG(v) motions, the frequency analysis shows that massage under the plantar soles induces a decrease of the amplitudes along the ML direction suggesting reduced overall muscular activity (abductor-adductor muscles of the hip according to Winter et al.). A general trend is that the CG(v) amplitudes are also diminished after massage especially in the ML direction, indicating a better distribution of the body weight on the two supports. On the other hand, the effects tend to vanish after about 8 minutes. Conversely, when the massage was given under the toes, no particular effect on any elementary motion was observed, suggesting that the plantar mechanoreceptors under the toes necessitate stronger stimulation to respond significantly and/or that the greater sensitivity obtained was not used by the CNS. Overall, this data emphasises the fact that a recalibration of somesthetic cues may occur when enhanced afferent information is fed to the postural system. PMID:15657978

  3. Energy metabolism in human calf muscle performing isometric plantar flexion superimposed by 20Hz vibration

    Microsoft Academic Search

    Jochen Zange; Timo Haller; Klaus Müller; Anna-Maria Liphardt; Joachim Mester

    2009-01-01

    Vibration training is commonly expected to induce an active muscle contraction via a complex reflex mechanism. In calf muscles\\u000a of 20 untrained subjects, the additional energy consumption in response to vibration superimposed on an isometric contraction\\u000a was examined by 31P magnetic resonance spectroscopy and by near infrared spectroscopy. Subjects performed 3 min of isometric plantar flexion\\u000a exercise at 40% MVC under

  4. Double cancer of plantar malignant melanoma and vulvar extramammary Paget's disease.

    PubMed

    Tsuji, Masataka; Nakai, Noriaki; Ueda, Eiichiro; Takenaka, Hideya; Katoh, Norito; Kishimoto, Saburo

    2010-05-01

    A 75-year-old woman presented with a 2-year history of a pigmented nodular lesion on her left sole and a 9-year history of a red infiltrative plaque on the vulva. The plantar lesion was a 15-mm ulcerated nodule located at the center of a 25-mm atypical pigmentation region; the nodule was clinically suspected to be a malignant melanoma. Histopathological analysis of the vulvar lesion biopsy sample indicated extramammary Paget's disease (EMPD). There was no evidence of metastasis in the computed tomography (CT) and (18)F-fluorodeoxyglucose positron emission tomography scans. We simultaneously performed a wide excision of both lesions and a left inguinal sentinel lymph node biopsy. Melanoma cells were identified in the sentinel lymph nodes, and left radical lymph node dissection was performed after a course of neoadjuvant chemotherapy. All the lymph nodes that were resected during the second operation tested negative for melanomas, and the plantar lesion was diagnosed as a stage IIIB malignant melanoma (pT4b, Na2, M0). Thereafter, we administrated four courses of chemotherapy, and 8 months after the operation, there was no evidence of recurrence or metastatic lesions. We present a case report of double cancer: a plantar malignant melanoma and vulvar EMPD, and also discuss the possible genetic mutations responsible for these two tumors. PMID:20536656

  5. Inter-joint sharing of total support moments in the lower extremities during gait in narrow-heeled shoes of different heights.

    PubMed

    Chien, Hui-Lien; Liu, Ming-Wei; Lu, Tung-Wu; Kuo, Chien-Chung; Chung, Pei-Chen

    2014-01-01

    The study aimed to investigate the influence of the base and height of shoe heels on the total support moment (Ms) and individual joint contributions during gait. Fifteen healthy females walked barefoot and with narrow-heeled shoes (heel heights: 3.9, 6.3 and 7.3 cm) while kinematic and kinetic data were measured. Compared with the barefoot condition, the subjects maintained unaltered Ms in the sagittal plane in shod conditions. This was achieved by increasing the knee extensor moment to compensate for the diminished ankle plantarflexor moments in medium and high heel conditions. In the frontal plane, subjects in shod conditions had to sustain an increased Ms for balance control during late single-leg stance with increased knee abductor and ankle pronator moments as a result of the reduced base of the heels. The results will be helpful for future shoe designs to reduce fall risks and prevent relevant musculoskeletal problems. PMID:24294947

  6. Chronic Bronchitis

    MedlinePLUS

    ... chronic. Chronic bronchitis is one type of COPD (chronic obstructive pulmonary disease). The inflamed bronchi produce a lot of mucus. This leads to cough and difficulty getting air in and out of the ... cause chronic bronchitis. Treatment will help your symptoms, but chronic ...

  7. Musculoskeletal modelling deconstructs the paradoxical effects of elastic ankle exoskeletons on plantar-flexor mechanics and energetics during hopping.

    PubMed

    Farris, Dominic James; Hicks, Jennifer L; Delp, Scott L; Sawicki, Gregory S

    2014-11-15

    Experiments have shown that elastic ankle exoskeletons can be used to reduce ankle joint and plantar-flexor muscle loading when hopping in place and, in turn, reduce metabolic energy consumption. However, recent experimental work has shown that such exoskeletons cause less favourable soleus (SO) muscle-tendon mechanics than is observed during normal hopping, which might limit the capacity of the exoskeleton to reduce energy consumption. To directly link plantar-flexor mechanics and energy consumption when hopping in exoskeletons, we used a musculoskeletal model of the human leg and a model of muscle energetics in simulations of muscle-tendon dynamics during hopping with and without elastic ankle exoskeletons. Simulations were driven by experimental electromyograms, joint kinematics and exoskeleton torque taken from previously published data. The data were from seven males who hopped at 2.5 Hz with and without elastic ankle exoskeletons. The energetics model showed that the total rate of metabolic energy consumption by ankle muscles was not significantly reduced by an ankle exoskeleton. This was despite large reductions in plantar-flexor force production (40-50%). The lack of larger metabolic reductions with exoskeletons was attributed to increases in plantar-flexor muscle fibre velocities and a shift to less favourable muscle fibre lengths during active force production. This limited the capacity for plantar-flexors to reduce activation and energy consumption when hopping with exoskeleton assistance. PMID:25278469

  8. Topical Adapalene in the Treatment of Plantar Warts; Randomized Comparative Open Trial in Comparison with Cryo-Therapy

    PubMed Central

    Gupta, Ramji; Gupta, Sarthak

    2015-01-01

    Background: Various therapeutic modalities, which are available for treating plantar wart, have not been successful every time. Aims: To evaluate topical adapalene under occlusion in the treatment of plantar warts and compare it with cryo-therapy. Materials and Methods: 50 patients with 424 plantar warts were included in this single center, two arm, prospective, randomized, control, open study. Patients were allocated randomly into two groups consisting of 25 patients each. Group A patients having 299 plantar warts were treated using adapalene gel 0.1% under occlusion while Group B patients having 125 warts were treated using cryo-therapy. All the patients were evaluated weekly till the clearance of all the warts and the results compared. Result: All the warts of 25 patients of Group A that were treated using adapalene gel 0.1% cleared in 36.71 ± 19.24 (55.95-17.47) days except those in one patient. In Group B, warts in all except one treated by cryo-therapy cleared in 52.17 ± 30.06 (82.23-22.11) days. There were no side effects like scar formation, irritation, erythema, or infections with adapalene group while in the cryo group scar was seen in 2 patients, pain in 24, erythema in 10, and infection in 3 patients. Conclusion: Adapalene gel 0.1% under occlusion is an effective, safe and easy to use treatment for plantar warts and may help clear lesions faster than cryo-therapy. PMID:25657417

  9. VLAAMS LOKET VOOR KARAKTERISERING VAN COATINGS In Vlaanderen is heel wat expertise en technologie aanwezig voor functionele karakterisering en structuuranalyse

    E-print Network

    karakteriseringstechnieken voor coatings! Dus wacht niet langer en neem een kijkje op www.coatingloket.be Info : ir. Els VanVLAAMS LOKET VOOR KARAKTERISERING VAN COATINGS In Vlaanderen is heel wat expertise en technologie aanwezig voor functionele karakterisering en structuuranalyse van coatings. Toch kan de zoektocht om een

  10. Ultrasound measurements in the calcaneus: Precision and its relation with bone mineral density of the heel, hip, and lumbar spine

    Microsoft Academic Search

    W. C. Graafmans; A. v. Lingen; M. E. Ooms; P. D. Bezemer; P. Lips

    1996-01-01

    Broadband ultrasound attenuation (BUA) and speed of sound (SOS) in the heel are suggested to measure bone density and structure and to predict fracture risk. Short-term precision (five consecutive measurements in 1 h) and longterm precision (six within 3 months) of ultrasound parameters were studied in 20 healthy subjects. The coefficient of variation (CV) did not change over a 3-month

  11. Functional total and subtotal heel reconstruction with free composite osteofasciocutaneous groin flaps of the deep circumflex iliac vessels.

    PubMed

    Peek, Alberto; Giessler, Goetz A

    2006-06-01

    Functional and esthetic reconstruction of the bony and tendinous structures with a stable, sensate soft tissue integument after complex posttraumatic defects of the heel is demanding. Cases are rare in the literature and hardly comparable due to their heterogeneity. The reconstructive approach has to consider both patient profile and the reconstructive tree, with free microvascular flaps playing a primary role. The goals are the reconstruction of both osteotendinous structures and slender soft tissue lining for proper shoe fitting for ambulation and mechanical and thermal protection. The flap should be sensate in weightbearing areas to optimize gait and to prevent long-term complications by ulcers. The osteofasciocutaneous deep inferior circumflex artery (DCIA) flap is especially suitable for complex heel defects with subtotal or total loss of the calcaneal bone as all components (iliac bone, groin skin, and fascia lata) can have a wide range of size and shape. We operated on 2 cases with this variable composite flap. One patient had a complete heel defect by war shrapnel. The complete calcaneus, soft heel, and Achilles tendon were reconstructed. The second patient had an empty os calcis after a comminuted fracture and a lateral crush-induced soft tissue defect. In both patients, a stable wound closure, osseous integration, and weightbearing ambulation could be achieved. PMID:16721075

  12. The effects of fatigue of the plantar flexors on peak torque and voluntary activation in untrained and resistance-trained men.

    PubMed

    Hartman, Michael J; Ryan, Eric D; Cramer, Joel T; Bemben, Michael G

    2011-02-01

    The purpose of this study was to compare the effects of fatigue of the plantar flexors on peak torque and voluntary activation in untrained (UT) and resistance-trained (RT) men. Six men with no previous resistance training experience and 8 men with similar histories of chronic resistance training (9.8 ± 5.9 years, 3.8 ± 0.7 days/week) volunteered for this study. Subjects performed isometric maximal voluntary contractions (MVCs) before and immediately after unilateral dynamic isotonic contractions performed at 40% of MVC until volitional exhaustion. Voluntary activation of the plantar flexors was assessed using the interpolated twitch method (ITT) and central activation ratio (CAR). Surface electromyographic (EMG) amplitude of the soleus and medial gastrocnemius (MG) was measured during the MVC. There were significant reductions in MVC torque in both UT and RT groups after the fatiguing exercise (-10.7 ± 6.8%, p < 0.02; -9.1 ± 8.7%, p < 0.02, respectively), with no difference in the number of repetitions performed between groups. The UT and RT men experienced a significant decrease in ITT after the fatiguing exercise bout (-14.2 ± 11.8%, p = 0.03; -7.8 ± 9.3%, p = 0.045, respectively). The UT group experienced a significant decrease in CAR (99.5 ± 0.8% to 91.4 ± 6.4%, p = 0.025) with no change (p > 0.05) in the RT group. There was also a fatigue-induced decrease in normalized EMG amplitude for the soleus and MG muscles in both groups (p < 0.05). However, no differences were determined between groups for ITT, CAR, or EMG. Despite similar reductions in MVC torque postexercise, the UT men had a significant decrease in CAR and experienced nearly twice the decline in ITT than the RT men. These results indicate that the neural adaptations associated with chronic resistance training may lead to less susceptibility to central fatigue as measured by ITT and CAR. PMID:20512071

  13. How Could We Explain the Changes of the Plantar Muscle Tone in the Patients with Type I Diabetes Mellitus and Interpret These Findings

    Microsoft Academic Search

    R. Kerpe; A. Krisciunas

    PURPOSE: The investigators determined that thickening of the plantar fascia in diabetics concurs to develop a rigid foot, which poorly absorbs shock during loading. They concluded that the diabetic foot often undergoes abnormal plantar pressures, changing walking strategy and ulcerative processes (1; 2). In our study, we investigated the muscle tone in patients with type I diabetes mellitus (DM). We

  14. Corticosteroid versus placebo injection for plantar fasciitis: A meta-analysis of randomized controlled trials

    PubMed Central

    LI, ZONGHUAN; YU, AIXI; QI, BAIWEN; ZHAO, YONG; WANG, WEIYANG; LI, PING; DING, JUNHUI

    2015-01-01

    The aim of this meta-analysis was to determine the efficacy of corticosteroid versus placebo injection for the treatment of plantar fasciitis. Databases (Medline, Embase, the Cochrane Library and Google Scholar) and study references were searched for randomized controlled trials comparing corticosteroid with placebo injection for plantar fasciitis. Studies that met the inclusion criteria were selected for the analysis. The risk of bias tool was used for the methodological assessment. Outcomes including visual analogue score (VAS) and plantar fascia thickness (PFT) were extracted and pooled. Egger's test was used to detect publication bias. The evidence quality was assessed by the Grading of Recommendations Assessment, Development and Evaluation system. Statistical analysis was performed using RevMan 5.2. A total of four studies with 289 patients were included in the analysis. Compared with the placebo, corticosteroid injection provided better pain relief after one month [standardized mean difference (SMD), ?0.32; 95% confidence interval (CI), ?0.59--0.06); P=0.02). No difference was detected with respect to the VAS after two months (SMD, ?0.04; 95% CI, ?0.35–0.27; P=0.79) or three months (SMD, ?0.42; 95% CI, ?1.00–0.16; P=0.15) or to the PFT (MD, 0.70; 95% CI, ?1.77–0.38; P=0.20), although a tendency of favoring corticosteroid injection was observed. No obvious publication bias was detected. In conclusion, corticosteroid injection may provide pain relief for a short period of time, but the efficacy may disappear with the progression of time.

  15. Ultrasound-Guided Percutaneous Radiofrequency Lesioning When Treating Recalcitrant Plantar Fasciitis: Clinical Results.

    PubMed

    Wu, P T; Lee, J S; Wu, K C; Wu, T T; Shao, C J; Liang, F W; Chern, T C; Su, F C; Jou, I M

    2014-11-12

    Purpose: We evaluated the effects of ultrasound (US)-guided percutaneous radiofrequency thermal lesioning (RTL) and the impact of obesity when treating patients with recalcitrant plantar fasciitis. Materials and Methods: 30 consecutive patients were enrolled. The visual analog scale (VAS), American Orthopedic Foot-Ankle Society (AOFAS) Ankle-Hindfoot Score, and plantar fascia thickness measured using US were recorded at baseline and at follow-up 1, 3, 6, and 12 months after surgery under local anesthesia. Results: 12 patients in the obese (BMI ??30?kg/m(2)) group and 18 patients in the non-obese group.?There were significant postoperative decreases in VAS scores and in fascial thickness, and an increase in the AOFAS scores (all p?Plantar fascial thickness was correlated with VAS and AOFAS scores. PMID:25389914

  16. Intermediate-term results of partial plantar fascia release with microtenotomy using bipolar radiofrequency microtenotomy.

    PubMed

    Lucas, Douglas E; Ekroth, Scott R; Hyer, Christopher F

    2015-01-01

    Plantar fasciitis is a common condition, with most patients treated successfully with nonoperative management. Recalcitrant disease has been managed with surgical procedures that vary in design and associated morbidity. The present study sought to determine the intermediate-term results of percutaneous bipolar radiofrequency microtenotomy in recalcitrant plantar fasciitis. The patient medical records were reviewed, and data were gathered for all the patients who met the inclusion criteria. The foot function index and visual analog scale (VAS) pain scale questionnaires were mailed to the 111 patients. Of the 111 patients, 61 (55.0%) returned their questionnaires and were ultimately included in the present analysis. Of the 61 patients, 44 (72.1%) were female and 17 were (27.9%) male, with an average reported follow-up of 33.3 ± 8.6 (range 16.1 to 46.6) months. The median postoperative VAS score was 0.0 (range 0.0 to 10.0), and the median foot function index score was 3.1 (range 0.0 to 97.1). The patients were subdivided into success and failure groups according to their satisfaction. Of the 61 patients, 51 (83.6%) were satisfied and would recommend the procedure to a friend. The median VAS score in the success group was 0.0 (range 0.0 to 5.0), and the median VAS score in the failure group was 6.0 (range 0.0 to 10.0), a significant difference (p < .001). A significant difference was also seen in the foot function index score between the success (median 2.4, range 0.0 to 25.7) and failure (median 37.4, range 0.0 to 97.1) groups (p < .001). Bipolar radiofrequency microtenotomy appears to be a safe procedure that can provide outcomes equivalent to those with open surgery, with less morbidity, for recalcitrant plantar fasciitis. PMID:25617155

  17. Neuromuscular function and fatigue resistance of the plantar flexors following short-term cycling endurance training.

    PubMed

    Behrens, Martin; Weippert, Matthias; Wassermann, Franziska; Bader, Rainer; Bruhn, Sven; Mau-Moeller, Anett

    2015-01-01

    Previously published studies on the effect of short-term endurance training on neuromuscular function of the plantar flexors have shown that the H-reflex elicited at rest and during weak voluntary contractions was increased following the training regime. However, these studies did not test H-reflex modulation during isometric maximum voluntary contraction (iMVC) and did not incorporate a control group in their study design to compare the results of the endurance training group to individuals without the endurance training stimulus. Therefore, this randomized controlled study was directed to investigate the neuromuscular function of the plantar flexors at rest and during iMVC before and after 8 weeks of cycling endurance training. Twenty-two young adults were randomly assigned to an intervention group and a control group. During neuromuscular testing, rate of torque development, isometric maximum voluntary torque and muscle activation were measured. Triceps surae muscle activation and tibialis anterior muscle co-activation were assessed by normalized root mean square of the EMG signal during the initial phase of contraction (0-100, 100-200 ms) and iMVC of the plantar flexors. Furthermore, evoked spinal reflex responses of the soleus muscle (H-reflex evoked at rest and during iMVC, V-wave), peak twitch torques induced by electrical stimulation of the posterior tibial nerve at rest and fatigue resistance were evaluated. The results indicate that cycling endurance training did not lead to a significant change in any variable of interest. Data of the present study conflict with the outcome of previously published studies that have found an increase in H-reflex excitability after endurance training. However, these studies had not included a control group in their study design as was the case here. It is concluded that short-term cycling endurance training does not necessarily enhance H-reflex responses and fatigue resistance. PMID:26029114

  18. Plantar loading during jumping while wearing a rigid carbon graphite footplate.

    PubMed

    Queen, Robin M; Verma, Ravi; Abbey, Alicia N; Nunley, James A; Butler, Robert J

    2014-02-01

    Fifth metatarsal stress fractures are common in sports and often result in delayed and non-union. The purpose of this study was to examine the effect of a rigid carbon graphite footplate (CGF) on plantar loading during take-off and landing from a jump. Nineteen recreational male athletes with no history of lower extremity injury in the past 6 months and no foot or ankle surgery in the past 3 years participated in this study. Subjects completed 7 jumping tasks while wearing a standard running shoe and then the shoe plus the CGF while plantar loading data was recorded. A series of paired t-tests were used to examine differences between the two footwear conditions independently for both takeoff and landing (a = 0.05). The contact area in the medial midfoot (p < .001) and forefoot (p = .010) statistically decreased when wearing the CGFP. The force–time integral was significantly greater when wearing the CGFP in the middle (p < .001) and lateral forefoot (p = .019). Maximum force was significantly greater beneath the middle (p < .001) and lateral forefoot (p < .001) when wearing the CGFP, while it was decreased beneath the medial midfoot (p < .001). During landing, the contact area beneath the medial (p = .017) and lateral midfoot (p = .004) were significantly decreased when wearing the CGFP. The force– time integral was significantly decrease beneath the medial midfoot (p < .001) when wearing the CGFP. The maximum force was significantly greater beneath the medial (p = .047) and middle forefoot (p = .001) when the subject was wearing the CGFP. The maximum force beneath the medial midfoot (p < .001) was significantly reduced when wearing the carbon graphite footplate. The results of the study indicate that the CGF is ineffective at reducing plantar loading during jumping and landing. PMID:24611163

  19. Effect of Orthotics on Postural Sway After Fatigue of the Plantar Flexors and Dorsiflexors

    PubMed Central

    Ochsendorf, David T.; Mattacola, Carl G.; Arnold, Brent L.

    2000-01-01

    Objective: To examine the effects of orthotic intervention on unilateral postural sway after fatigue of the plantar flexor and dorsiflexor muscle groups. Design and Setting: Subjects were assigned to both orthotic and nonorthotic testing conditions in a counterbalanced order, then assessed for postural sway before and after isokinetic fatiguing contractions of the plantar flexors and dorsiflexors. Postural stability was measured on the motor-dominant extremity. (Motor dominance was assessed as the foot the subject used to kick a ball.) Subjects: Eleven active, healthy male subjects (mean age = 24 ± 2.0 years, wt = 74.5 ± 8.8 kg, ht = 180.3 ± 8.4 cm) volunteered to participate in the study. Measurements: Center-of-pressure postural sway was assessed via the force platforms of a Chattecx Dynamic Balance System and transformed via 4 transducers as values indicative of sway in the anterior-posterior and medial-lateral directions. The dependent measure was postural sway in centimeters. Fatigue was induced by consecutive concentric plantar flexiondorsiflexion contractions on a Kin-Com II isokinetic dynamometer. Results: A repeated-measures analysis of variance revealed a significant orthotic-by-test interaction. Post hoc analysis with the Tukey honestly significant difference method revealed that postural sway values of the postfatigue nonorthotic condition were significantly greater when compared with the prefatigue orthotic, prefatigue nonorthotic, and postfatigue orthotic conditions. Conclusions: Our results suggest that molded orthotics may be an effective means of decreasing postural sway after an isokinetic fatigue protocol. Further research is needed to determine the exact mechanism of this improvement and whether orthotics are an effective means of preventing ankle injury. PMID:16558604

  20. Anatomy and Biomechanical Properties of the Plantar Aponeurosis: A Cadaveric Study

    PubMed Central

    Chen, Da-wei; Li, Bing; Aubeeluck, Ashwin; Yang, Yun-feng; Huang, Yi-gang; Zhou, Jia-qian; Yu, Guang-rong

    2014-01-01

    Objectives To explore the anatomy of the plantar aponeurosis (PA) and its biomechanical effects on the first metatarsophalangeal (MTP) joint and foot arch. Methods Anatomic parameters (length, width and thickness of each central PA bundle and the main body of the central part) were measured in 8 cadaveric specimens. The ratios of the length and width of each bundle to the length and width of the central part were used to describe these bundles. Six cadaveric specimens were used to measure the range of motion of the first MTP joint before and after releasing the first bundle of the PA. Another 6 specimens were used to evaluate simulated static weight-bearing. Changes in foot arch height and plantar pressure were measured before and after dividing the first bundle. Results The average width and thickness of the origin of the central part at the calcaneal tubercle were 15.45 mm and 2.79 mm respectively. The ratio of the length of each bundle to the length of the central part was (from medial to lateral) 0.29, 0.30, 0.28, 0.25, and 0.27, respectively. Similarly, the ratio of the widths was 0.26, 0.25, 0.23, 0.19 and 0.17. The thickness of each bundle at the bifurcation of the PA into bundles was (from medial to lateral) 1.26 mm, 1.04 mm, 0.91 mm, 0.84 mm and 0.72 mm. The average dorsiflexion of the first MTP joint increased 10.16° after the first bundle was divided. Marked acute changes in the foot arch height and the plantar pressure were not observed after division. Conclusions The first PA bundle was not the longest, widest, or the thickest bundle. Releasing the first bundle increased the range of motion of the first MTP joint, but did not acutely change foot arch height or plantar pressure during static load testing. PMID:24392127

  1. Influence of backpack load and gait speed on plantar forces during walking.

    PubMed

    Watanabe, Kazuhiko; Wang, Yun

    2013-01-01

    The purpose of this study is to examine the differences in plantar force associated with changes in backpack load and gait speed during walking. The F-scan tethered system was used to collect plantar pressure data. Subjects were asked to walk on a treadmill with varied levels of backpack load (0%, 10%, 20%, and 30% of body mass) and gait speed (4, 5, and 6 km/h). We found that an increase in gait speed and backpack load lead to increase in the magnitude of the first vertical ground reaction force (vGRF) peak. Greater magnitudes of the second vGRF peak were only associated with an increase when gait speeds were 4 km/h and 5 km/h. There was no speed-related change in the magnitudes of the second vGRF peak at the speed of 6 km/h. The results of this study may be important for the purpose of constituting a load-bearing walking program for protecting against osteoporosis. PMID:24067124

  2. Ankle Plantar-Flexion Contracture Complication After Aesthetic Calf Volume Reduction Procedure.

    PubMed

    Han, Seung Hwan; Chung, Nam Su; Park, Do Young

    2015-07-01

    Minimally invasive, aesthetic calf volume reduction procedures are considered to be relatively safe. Published complications are mostly transient, with minimal functional loss. We hereby report debilitating ankle plantar-flexion contracture after aesthetic calf volume reduction procedure by selective neurectomy, with magnetic resonance imaging analysis and surgical treatment outcomes of this complication. From 2009 to 2010, 11 patients (17 lower legs) were surgically treated for this complication. The average preoperative ankle contracture angle of all involved lower legs was -22 degrees (range, -5 to -30 degrees). Magnetic resonance imaging performed in 14 lower legs showed lesions indicative of denervation atrophy, with fibrotic lesions causing longitudinal shortening of the gastrocnemius muscle. Of the 17 ankle contractures, 15 Silfverskiöld test-positive cases received miniopen gastrocnemius release, whereas 2 Silfverskiöld test-negative cases received Achilles tendon lengthening by percutaneous triple hemiresection. At last follow-up, the dorsiflexion angle of all ankles improved to an average of 25 degrees (range, 20-30 degrees) with full plantar flexion in all patients, whereas the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale scores improved from an average of 59.2 to 94.2. Surgeons and patients alike should be aware of debilitating ankle planter flexion contractures after aesthetic calf volume reduction procedures. Using minimally invasive gastrocnemius and Achilles tendon release, we were able to provide symptomatic and functional relief from this complication with minimal cosmetic sacrifice. PMID:24727446

  3. Palmar and plantar pads and flexion creases of the rat (Rattus norvegicus).

    PubMed

    Kimura, S; Schaumann, B A; Plato, C C

    1994-06-01

    The recent detection of dermal ridge configurations on the volar pads of the rat (Rattus norvegicus) has created opportunities for experimental studies of dermatoglyphics. In the present work, the palmar and plantar surfaces of the rat were studied to establish the feasibility of comparative rat and human dermatoglyphic investigations. The studied features included the volar pads and flexion creases. The number and location of the palmar and plantar pads in the rat were found to be similar to those of humans. The exception was a previously unrecognized small pad on the palms and soles of the rat, located on the radial and tibial side, respectively, of the proximal component of the first interdigital pad. This pad has no parallel in human embryos. Rats were found to have flexion creases in the non-pad areas between the neighboring pads, similar in location and appearance to those of humans. Unlike humans, however, rats also have boundary creases, separating the pad and non-pad areas. The marked similarities in the morphology of the volar areas between rats and humans make the rat ideally suitable for experimental studies of dermatoglyphics and flexion creases. Results of such studies should be applicable to human developmental dermatoglyphics, including those pertaining to medical disorders. PMID:8035464

  4. Acute effects of two massage techniques on ankle joint flexibility and power of the plantar flexors.

    PubMed

    McKechnie, Grant J B; Young, Warren B; Behm, David G

    2007-01-01

    The purpose of this study was to determine if three minutes of petrissage and tapotement forms of massage would influence plantar flexors' flexibility, and muscle power. Nineteen participants were randomly subjected to three conditions (control and two massages) before performing two power tests. Prior to the intervention, subjects completed ankle joint flexibility assessments. The conditions were; (1) control, where subjects lay prone and had a therapist's hands resting, (2) vigorous petrissage, and (3) tapotement applied at a rate of 4Hz; all on the triceps surae. Following completion of the intervention, subjects immediately completed a post- ankle joint flexibility test, followed by a drop-jump and concentric calf raise. The power measures were; concentric peak force, rate of force development, and drop-jump height / contact time. The data showed a significant increase (p < 0.05) in ankle joint angle on the right leg and a corresponding tendency on the left. No significant change was seen with the power measures. Results suggest that massage can increase plantar flexors' flexibility without a change in power and thus may be an alternative to static stretching during an athletic warm-up. Key pointsThree minutes of petrissage and tapotement forms of massage increased ankle flexibility.Massage did not adversely affect jump power measures.Massage may be an effective alternative to static stretching as a component of a pre-event warm-up. PMID:24149484

  5. Osteochondral fragmentation of the plantar/palmar proximal aspect of the proximal phalanx in racing horses.

    PubMed

    Whitton, R C; Kannegieter, N J

    1994-10-01

    The clinical presentation and outcome of treatment is presented for 26 cases of osteochondral fragmentation of the plantar/palmar proximal aspect of the proximal phalanx. Twenty-three were racing Standardbreds and three were racing Thoroughbreds. The most common reason for presentation was an inability to run straight at high speed. Only eight horses presented for lameness, although on examination 19 were lame. A positive flexion test was recorded in 90% of affected fetlock joints and effusion in 48%. Arthroscopic fragment removal was performed on 23 occasions in 21 horses and arthrotomy in one horse. Of the 16 horses that had returned to racing, 12 had improved their performance, while three showed no improvement, and one was retired for other reasons. In three horses refragmentation occurred after surgery, two of which had improved after initial arthroscopic removal. Degenerative changes within the fetlock joint were detected at surgery in eight horses. Of the four horses treated conservatively, one returned to its previous level of performance temporarily after intra-articular medication, one showed no improvement and two were still resting. Plantar/palmar osteochondral fragmentation of the proximal aspect of the first phalanx is a common cause of low-grade lameness in racing horses, and arthroscopic removal results in improvement in race performance in a high percentage of cases. PMID:7848178

  6. EMG activities and plantar pressures during ski jumping take-off on three different sized hills.

    PubMed

    Virmavirta, M; Perttunen, J; Komi, P V

    2001-04-01

    Different profiles of ski jumping hills have been assumed to make the initiation of take-off difficult especially when moving from one hill to another. Neuromuscular adaptation of ski jumpers to the different jumping hills was examined by measuring muscle activation and plantar pressure of the primary take-off muscles on three different sized hills. Two young ski jumpers volunteered as subjects and they performed several trials from each hill (K-35 m, K-65 m and K-90 m) with the same electromyographic (EMG) electrode and insole pressure transducer set-up. The results showed that the differences in plantar pressure and EMGs between the jumping hills were smaller than expected for both jumpers. The small changes in EMG amplitudes between the hills support the assumption that the take-off was performed with the same intensity on different jumping hills and the timing of the gluteus EMG demonstrates well the similarity of the muscle activation on different hills. On the basis of the results obtained it seems that ski jumping training on small hills does not disturb the movement patterns for bigger hills and can also be helpful for special take-off training with low speed. PMID:11228427

  7. Plantar pressure patterns in women affected by Ehlers-Danlos syndrome while standing and walking.

    PubMed

    Pau, Massimiliano; Galli, Manuela; Celletti, Claudia; Morico, Gianfranco; Leban, Bruno; Albertini, Giorgio; Camerota, Filippo

    2013-11-01

    This study aims to quantitatively characterize plantar pressure distribution in women affected by Ehlers-Danlos syndrome of the hypermobile type (EDS-HT) to verify the existence of peculiar patterns possibly related to postural anomalies or physical and functional lower limb impairments typical of this disease. A sample of 26 women affected by EDS-HT (mean age 36.8, SD 12.0) was tested using a pressure platform in two conditions, namely static standing and walking. Raw data were processed to assess contact area and mean and peak pressure distribution in rearfoot, midfoot and forefoot. Collected data were then compared with those obtained from an equally numbered control group of unaffected women matched for age and anthropometric features. The results show that, in both tested conditions, women with EDS-HT exhibited significantly smaller forefoot contact areas and higher peak and mean pressure than the control group. No differences in the analyzed parameters were found between right and left limb. The findings of the present study suggest that individuals with EDS-HT are characterized by specific plantar pressure patterns that are likely to be caused by the morphologic and functional foot modification associated with the syndrome. The use of electronic pedobarography may provide physicians and rehabilitation therapists with information useful in monitoring the disease's progression and the effectiveness of orthotic treatments. PMID:24021390

  8. Alteration in neuromuscular function of the plantar flexors following caffeine ingestion.

    PubMed

    Behrens, Martin; Mau-Moeller, Anett; Heise, Sandra; Skripitz, Ralf; Bader, Rainer; Bruhn, Sven

    2015-02-01

    The aim of this study was to compare the neuromuscular function of the plantar flexors following caffeine or placebo administration. Thirteen subjects (25 ± 3 years) ingested caffeine or placebo in a randomized, controlled, counterbalanced, double-blind crossover design. Neuromuscular tests were performed before and 1 h after caffeine or placebo intake. During neuromuscular testing, rate of torque development, isometric maximum voluntary torque, and neural drive to the muscles were measured. Triceps surae muscle activation was assessed by normalized root mean square of the EMG signal during the initial phase of contraction (0-100 ms, 100-200 ms) and maximal voluntary contraction (MVC). Furthermore, evoked spinal reflex responses of the soleus muscle (H-reflex evoked at rest and during MVC, V-wave) and peak twitch torques were evaluated. The isometric maximum voluntary torque and evoked potentials were not different. However, we found a significant difference between groups for rate of torque development in the time intervals 0-100 ms [41.1 N · m/s (95% CI: 8.3-73.9 N · m/s, P = 0.016)] and 100-200 ms [32.8 N · m/s (95% CI: 2.8-62.8 N · m/s, P = 0.034)]. These changes were accompanied by enhanced neural drive to the plantar flexors. Data suggest that caffeine solely increased explosive voluntary strength of the triceps surae because of enhanced neural activation at the onset of contraction whereas MVC strength was not affected. PMID:24798789

  9. REMOVING SLUDGE HEELS FROM SAVANNAH RIVER SITE WASTE TANKS BY OXALIC ACID DISSOLUTION

    SciTech Connect

    Poirier, M; David Herman, D; Fernando Fondeur, F; John Pareizs, J; Michael Hay, M; Bruce Wiersma, B; Kim Crapse, K; Thomas Peters, T; Samuel Fink, S; Donald Thaxton, D

    2009-03-01

    The Savannah River Site (SRS) will remove sludge as part of waste tank closure operations. Typically the bulk sludge is removed by mixing it with supernate to produce a slurry, and transporting the slurry to a downstream tank for processing. Experience shows that a residual heel may remain in the tank that cannot be removed by this conventional technique. In the past, SRS used oxalic acid solutions to disperse or dissolve the sludge heel to complete the waste removal. To better understand the actual conditions of oxalic acid cleaning of waste from carbon steel tanks, the authors developed and conducted an experimental program to determine its effectiveness in dissolving sludge, the hydrogen generation rate, the generation rate of other gases, the carbon steel corrosion rate, the impact of mixing on chemical cleaning, the impact of temperature, and the types of precipitates formed during the neutralization process. The test samples included actual SRS sludge and simulated SRS sludge. The authors performed the simulated waste tests at 25, 50, and 75 C by adding 8 wt % oxalic acid to the sludge over seven days. They conducted the actual waste tests at 50 and 75 C by adding 8 wt % oxalic acid to the sludge as a single batch. Following the testing, SRS conducted chemical cleaning with oxalic acid in two waste tanks. In Tank 5F, the oxalic acid (8 wt %) addition occurred over seven days, followed by inhibited water to ensure the tank contained enough liquid to operate the mixer pumps. The tank temperature during oxalic acid addition and dissolution was approximately 45 C. The authors analyzed samples from the chemical cleaning process and compared it with test data. The conclusions from the work are: (1) Oxalic acid addition proved effective in dissolving sludge heels in the simulant demonstration, the actual waste demonstration, and in SRS Tank 5F. (2) The oxalic acid dissolved {approx} 100% of the uranium, {approx} 100% of the iron, and {approx} 40% of the manganese during a single contact in the simulant demonstration. (The iron dissolution may be high due to corrosion of carbon steel coupons.) (3) The oxalic acid dissolved {approx} 80% of the uranium, {approx} 70% of the iron, {approx} 50% of the manganese, and {approx} 90% of the aluminum in the actual waste demonstration for a single contact. (4) The oxalic acid dissolved {approx} 100% of the uranium, {approx} 15% of the iron, {approx} 40% of the manganese, and {approx} 80% of the aluminum in Tank 5F during the first contact cycle. Except for the iron, these results agree well with the demonstrations. The data suggest that a much larger fraction of the iron in the sludge dissolved, but it re-precipitated with the oxalate added to Tank 5F. (5) The demonstrations produced large volumes (i.e., 2-14 gallons of gas/gallon of oxalic acid) of gas (primarily carbon dioxide) by the reaction of oxalic acid with sludge and carbon steel. (6) The reaction of oxalic acid with carbon steel produced hydrogen in the simulant and actual waste demonstrations. The volume produced varied from 0.00002-0.00100 ft{sup 3} hydrogen/ft{sup 2} carbon steel. The hydrogen production proved higher in unmixed tanks than in mixed tanks.

  10. DXA of the Hip and Heel Ultrasound but not Densitometry of the Fingers Can Discriminate Female Hip Fracture Patients from Controls: A Comparison Between Four Different Methods

    Microsoft Academic Search

    A. Ekman; K. Michaëlsson; M. Petrén-Mallmin; S. Ljunghall; H. Mallmin

    2001-01-01

    :   Dual-energy X-ray absorptiometry (DXA) of the proximal femur and in more recent years quantitative ultrasound (QUS) of the\\u000a heel are the most established methods for assessing hip fracture risk. Measurement of the fingers offers a new approach. We\\u000a performed DXA of the proximal femur, QUS of the heel and fingers, and radiographic absorptiometry (RA) of the fingers in 87

  11. Ankle dorsi- and plantar-flexion torques measured by dynamometry in healthy subjects from 5 to 80?years

    PubMed Central

    2013-01-01

    Background Ankle strength is often impaired in some of the most common neuromuscular disorders. Consequently, strength generated around this joint is important to assess, because it has a great impact on balance and gait. The objectives of this study were to establish normative data and predictive equations for both ankle dorsi- and plantar-flexion strength from a population of healthy subjects (children and adults), to assess the reliability of the measurements and to study the feasibility of using a novel dynamometer on a group of patients with a neuromuscular disorder. Methods Measurements of maximal isometric torque for dorsi- and plantar-flexion were performed on 345 healthy subjects from 5 to 80?years of age. The feasibility of the method was tested on nine patients diagnosed with type 2A limb girdle muscular dystrophy. Results The results documented normal strength values depending on gender and age on ankle dorsi- and plantar-flexion. The reliability of the technique was good with no evaluator effect and a small learning effect. The dynamometer was found suitable in the group of patients, even very weak. Conclusions The device developed was both reliable and accurate in assessing both ankle dorsi-flexion and plantar-flexion torque measurements from weak patients and children to strong healthy adults. Norms and predictive equations are provided for these two muscle functions. PMID:23522186

  12. Ultrasonographic diagnosis of porcupine quill foreign bodies in the plantar flexor tendon sheath region in a heifer

    PubMed Central

    Mulon, Pierre-Yves; Achard, Damien; Babkine, Marie

    2010-01-01

    A 17-month-old Holstein heifer was presented for persistent enlargement above the right hind fetlock of 1-month’s duration. Diffuse plantar soft tissue swelling was present on the radiographs and ultrasonography revealed the presence of multiple porcupine quill extremities embedded in the subcutaneous tissue within the flexor tendon sheath wall. Surgical removal was performed. PMID:21037892

  13. Ultrasonographic diagnosis of porcupine quill foreign bodies in the plantar flexor tendon sheath region in a heifer.

    PubMed

    Mulon, Pierre-Yves; Achard, Damien; Babkine, Marie

    2010-08-01

    A 17-month-old Holstein heifer was presented for persistent enlargement above the right hind fetlock of 1-month's duration. Diffuse plantar soft tissue swelling was present on the radiographs and ultrasonography revealed the presence of multiple porcupine quill extremities embedded in the subcutaneous tissue within the flexor tendon sheath wall. Surgical removal was performed. PMID:21037892

  14. Effects of Immobilization on Plantar-Flexion Torque, Fatigue Resistance, and Functional Ability Following an Ankle Fracture

    Microsoft Academic Search

    Michael A Shaffer; Enyi Okereke; John L Esterhai Jr; Mark A Elliott; Glenn A Walter; Steven H Yim; Krista Vandenborne

    Background and Purpose. The goal of this investigation was to study the recovery of ankle plantar-flexor peak torque, fatigue resistance, and functional ability (stair climbing, walking) following cast immobilization in patients with ankle fractures. Subjects. The participants were 10 patients who underwent open reduction-internal fixation and 8 weeks of cast immobilization following a fracture of the ankle mortise and 10

  15. The influence of gait cadence on the ground reaction forces and plantar pressures during load carriage of young adults.

    PubMed

    Castro, Marcelo P; Figueiredo, Maria Cristina; Abreu, Sofia; Sousa, Helena; Machado, Leandro; Santos, Rubim; Vilas-Boas, Joăo Paulo

    2015-07-01

    Biomechanical gait parameters--ground reaction forces (GRFs) and plantar pressures--during load carriage of young adults were compared at a low gait cadence and a high gait cadence. Differences between load carriage and normal walking during both gait cadences were also assessed. A force plate and an in-shoe plantar pressure system were used to assess 60 adults while they were walking either normally (unloaded condition) or wearing a backpack (loaded condition) at low (70 steps per minute) and high gait cadences (120 steps per minute). GRF and plantar pressure peaks were scaled to body weight (or body weight plus backpack weight). With medium to high effect sizes we found greater anterior-posterior and vertical GRFs and greater plantar pressure peaks in the rearfoot, forefoot and hallux when the participants walked carrying a backpack at high gait cadences compared to walking at low gait cadences. Differences between loaded and unloaded conditions in both gait cadences were also observed. PMID:25766421

  16. Association of Posterior Tibial Tendon Injury with Spring Ligament Injury, Sinus Tarsi Abnormality, and Plantar Fasciitis on MR Imaging

    Microsoft Academic Search

    Paul F. Balen; Clyde A. Helms

    OBJECTIVE . The purpose of this study was to investigate the frequency of abnormalities of the spring ligament, sinus tarsi, and plantar fascia revealed on MR imaging in a group of patients with advanced injury of the posterior tibial tendon. MATERIALS AND METHODS . MR images from 25 patients with advanced posterior tibial tendon injury were retrospectively examined for spring

  17. Mixing of process heels, process solutions, and recycle streams: Results of the small-scale radioactive tests

    SciTech Connect

    GJ Lumetta; JP Bramson; OT Farmer III; LR Greenwood; FV Hoopes; MA Mann; MJ Steele; RT Steele; RG Swoboda; MW Urie

    2000-05-17

    Various recycle streams will be combined with the low-activity waste (LAW) or the high-level waste (HLW) feed solutions during the processing of the Hanford tank wastes by BNFL, Inc. In addition, the LAW and HLW feed solutions will also be mixed with heels present in the processing equipment. This report describes the results of a test conducted by Battelle to assess the effects of mixing specific process streams. Observations were made regarding adverse reactions (mainly precipitation) and effects on the Tc oxidation state (as indicated by K{sub d} measurements with SuperLig{reg_sign} 639). The work was conducted according to test plan BNFL-TP-29953-023, Rev. 0, Small Scale Mixing of Process Heels, Solutions, and Recycle Streams. The test went according to plan, with only minor deviations from the test plan. The deviations from the test plan are discussed in the experimental section.

  18. Correlations between subjective treatment responses and plantar pressure parameters of metatarsal pad treatment in metatarsalgia patients: a prospective study

    PubMed Central

    Kang, Jiunn-Horng; Chen, Min-Der; Chen, Shih-Ching; Hsi, Wei-Li

    2006-01-01

    Background Metatarsalgia is related to repetitive high-pressure loading under the metatarsal head (MH) that causes pain. The high pressure under the MH can be reduced by adequately applying metatarsal pads (MPs). Plantar pressure measurements may provide a method to objectively evaluate pressure loading under the MH. However, it is still unclear if the decrease in plantar pressure under the MH after MP treatment is associated with subjective improvement. This study aims to explore the correlations between subjective pain improvement and outcome rating, and the plantar pressure parameters in metatarsalgia patients treated using MPs. Methods Thirteen patients (a total of 18 feet) with secondary metatarsalgia were included in this study. Teardrop-shaped MPs made of polyurethane foam were applied just proximal to the second MH by an experienced physiatrist. Insole plantar pressure was measured under the second MH before and after MP application. Visual analog scale (VAS) scores of pain were obtained from all subjects before and after 2 weeks of MP treatment. The subjects rated using four-point subjective outcome scales. The Wilcoxon signed-rank test was used to analyze the difference between the plantar pressure parameters and VAS scores before and after treatment. The Kruskal-Wallis test was applied to compare the plantar pressure parameters in each outcome group. Pearson's correlation was applied to analyze the correlation between the changes in plantar pressure parameters and VAS scores. Statistical significance was set as p < 0.05. Results MP application decreased the maximal peak pressure (MPP) and pressure-time integral (PTI) under the second MH and also statistically improved subjective pain scores. However, neither the pre-treatment values of the MPP and PTI shift in the position of the MPP after treatment, nor the age, gender and body mass index (BMI) of the subjects were statistically correlated with subjective improvement. Declines in the PTI and MPP values after MP application were statistically correlated with the improvement in VAS scores (r = 0.77, R2 = 0.59, p < 0.001; r = 0.60, R2 = 0.36, p = 0.009). Conclusion We found that the successful decline in the PTI and MPP under the second MH after MP application was correlated to subjective pain improvement. This study provides a strategy for the further design and application of MPs for metatarsalgia treatment. PMID:17147793

  19. Management of heel ulcers in insensate foot by using free prefabricated radial fascial flap — a new flap

    Microsoft Academic Search

    Vishwa Prakash

    2010-01-01

    Heel ulcers are common in insensate foot. The management of such ulcers require tissue not only to resurface the skin defect,\\u000a which is small in most of the cases; but also well vascularised tissue to fill the cavity which results after excision of\\u000a the ulcer. We have described a new flap prefabricated radial fascial flap, by which both aims are

  20. A comparison of the effectiveness of extracorporeal shock wave and ultrasound therapy in the management of heel pain

    NASA Astrophysics Data System (ADS)

    Cheing, G. L. Y.; Chang, H.; Lo, S. K.

    2007-11-01

    The aim of this study was to compare the effectiveness of extracorporeal shock wave therapy (ESWT) and ultrasound therapy (US) for managing heel pain. Thirty-seven subjects received either: ESWT (once a week), US (three times a week), or CONTROL (no treatment) for 3 consecutive weeks and were followed-up for 3 more weeks. A visual analogue scale (VAS), the maximum tolerable duration for prolonged walking or standing, and the Mayo clinical scoring system (MCSS) were evaluated. Mixed models treating baseline measures as covariates were adopted for statistical analysis. By week 3, intensity of heel pain on palpation was reduced by 37% (VAS score from 7.5 to 4.6) in the ESWT group, 24% (from 5.3 to 4.2) in the US group, and increased by 3% (5.6-5.7) in the control group; this difference was significant after adjusting for baseline VAS scores ( p = 0.022). The improvements in the maximum tolerable duration of prolonged walking or standing was only significant in the ESWT group (157% increase, p = 0.043) but not the other two groups. Both active treatment groups maintained the treatment effect at the three-week follow-up. We conclude that ESWT is potentially more effective in reducing heel pain than ultrasound therapy but additional evidence is needed due to the various limitations of the study.

  1. Knee extensor and plantar flexor muscle size and function following 90 days of bed rest with or without resistance exercise.

    PubMed

    Alkner, Björn A; Tesch, Per A

    2004-12-01

    Skeletal muscle atrophy and strength loss induced by short-term simulated spaceflight are offset or attenuated by resistance exercise (RE). This study compared the effects of plantar flexor and knee extensor RE on muscle size and function in 17 healthy men (aged 26-41years) subjected to 90 days 6 degrees head-down-tilt bed rest with (BRE; n = 8) or without (BR; n = 9) RE. The RE program consisted of coupled maximal concentric and eccentric actions in the supine squat (4 sets of 7 repetitions) and calf press (4 x 14) every third day employing a gravity-independent flywheel ergometer (FW). Prior to, and following bed rest, muscle volume was assessed using magnetic resonance imaging. Similarly, muscle strength and power and surface electromyographic (EMG) activity were determined during maximal actions using FW or isokinetic dynamometry. In BR, knee extensor and plantar flexor muscle volume decreased (P < 0.05) 18% and 29%, respectively. Torque or force and power decreased (P < 0.05) 31 60% (knee extension) and 37-56% (plantar flexion) while knee extensor and plantar flexor EMG activity decreased 31-38% and 28-35%, respectively following BR. Muscle atrophy in BRE was prevented (P > 0.05; knee extensors) or attenuated (-15%; plantar flexors). BRE maintained task-specific force, power and EMG activity. The decrease in non-task-specific torque was less (P < 0.05) than in BR. The present data imply that the triceps surae and quadriceps muscles show different responsiveness to long-term bed rest with or without resistance exercise. The results also suggest that designing in-flight resistance exercise protocols for space travellers is complex and must extend beyond preserving muscle only. PMID:15338217

  2. Chronic pancreatitis

    MedlinePLUS

    Chronic pancreatitis is inflammation of the pancreas that does not heal or improve, gets worse over time, and leads ... abuse over many years. Repeated episodes of acute pancreatitis can lead to chronic pancreatitis. Genetics may be ...

  3. Palmar and plantar pads and flexion creases of genetic polydactyly mice (Pdn).

    PubMed

    Kimura, S; Naruse, I; Schaumann, B A; Plato, C C; Shimada, M; Shiota, K

    1999-01-01

    Attempts to gain a better understanding of the relationship between the epidermal ridge patterns (dermatoglyphics) and flexion creases on the volar aspects of human hands and feet and specific medical disorders led to a search for a suitable animal model, allowing studies of the fetal development of the pertinent structures. A common experimental animal, the rat (Rattus norvegicus), was found to be an excellent candidate, owing to the strong resemblance of the volar pads and flexion creases on its palmar and plantar surfaces to those of human subjects. A hereditary preaxial polydactyly mouse (Pdn) provides an opportunity to study the effects of this malformation on the surrounding morphological structures and, specifically, on the volar pads, i.e., the sites over which the dermatoglyphic patterns develop. The hands and feet of the wild-type (+/+) mice show no anomalies, and their major pad and flexion crease configurations correspond to those of normal rats. The heterozygous (Pdn/+) mice, in spite of having a thumb/big toe with a duplicated distal phalanx on their hands/feet, did not display any alterations in palmar/plantar pads. The homozygous (Pdn/Pdn) mice have a protrusion in the thenar area and one to three supernumerary digits on the preaxial portion of both the hands and feet. The effect of these anomalies was found to be limited to the pad and flexion crease configurations in the preaxial areas; the postaxial sites were not affected. The original number of pads on the thenar/first interdigital areas of Pdn/Pdn mice was apparently identical to that of the +/+ and Pdn/+mice. The preaxial protrusion, however, affected the number, size, and location of the pads observed in the newborn mice, resulting in varying pad configurations, such as fused and scattered pads or a pad cluster formed by gathering the neighboring pads. These pad modifications were induced by the preaxial plantar/palmar protrusion only and were not affected by the presence of supernumerary preaxial digits. In view of the similarities in the morphology and fetal development of human and mouse distal limbs, the present study is relevant to human subjects, particularly to the understanding of the significance of dermatoglyphic variations in individuals with specific medical disorders. Future studies of naturally occurring or experimentally induced limb malformations in mice or rats should provide valuable insights into the development of human hands and feet and into factors contributing to their congenital anomalies. PMID:9918099

  4. Dendritic cells as Achilles’ heel and Trojan horse during varicella zoster virus infection

    PubMed Central

    Schönrich, Günther; Raftery, Martin J.

    2015-01-01

    Varicella zoster virus (VZV), a human alphaherpesvirus, causes varicella and subsequently establishes latency within sensory nerve ganglia. Later in life VZV can reactivate to cause herpes zoster. A reduced frequency of VZV-specific T cells is strongly associated with herpes zoster illustrating that these immune cells are central to control latency. Dendritic cells (DCs) are required for the generation of VZV-specific T cells. However, DCs can also be infected in vitro and in vivo allowing VZV to evade the antiviral immune response. Thus, DCs represent the immune systems’ Achilles heel. Uniquely among the human herpesviruses, VZV infects both DCs and T cells, and exploits both as Trojan horses. During primary infection VZV-infected DCs traffic to the draining lymph nodes and tonsils, where the virus is transferred to T cells. VZV-infected T cells subsequently spread infection throughout the body to give the typical varicella skin rash. The delicate interplay between VZV and DCs and its consequences for viral immune evasion and viral dissemination will be discussed in this article. PMID:26005438

  5. Dendritic cells as Achilles' heel and Trojan horse during varicella zoster virus infection.

    PubMed

    Schönrich, Günther; Raftery, Martin J

    2015-01-01

    Varicella zoster virus (VZV), a human alphaherpesvirus, causes varicella and subsequently establishes latency within sensory nerve ganglia. Later in life VZV can reactivate to cause herpes zoster. A reduced frequency of VZV-specific T cells is strongly associated with herpes zoster illustrating that these immune cells are central to control latency. Dendritic cells (DCs) are required for the generation of VZV-specific T cells. However, DCs can also be infected in vitro and in vivo allowing VZV to evade the antiviral immune response. Thus, DCs represent the immune systems' Achilles heel. Uniquely among the human herpesviruses, VZV infects both DCs and T cells, and exploits both as Trojan horses. During primary infection VZV-infected DCs traffic to the draining lymph nodes and tonsils, where the virus is transferred to T cells. VZV-infected T cells subsequently spread infection throughout the body to give the typical varicella skin rash. The delicate interplay between VZV and DCs and its consequences for viral immune evasion and viral dissemination will be discussed in this article. PMID:26005438

  6. EM-31 ALTERNATIVE AND ENHANCED CHEMICAL CLEANING PROGRAM FOR SLUDGE HEEL REMOVAL - 11220

    SciTech Connect

    King, W.; Hay, M.; Wiersma, B.; Pennebaker, F.

    2010-12-10

    Mixtures of oxalic acid with nitric acid have been shown to be superior to oxalic acid alone for the dissolution of iron-rich High Level Waste sludge heels. Optimized conditions resulting in minimal oxalate usage and stoichiometric iron dissolution (based on added oxalate ion) have been determined for hematite (a primary sludge iron phase) in oxalic/nitric acid mixtures. The acid mixtures performed better than expected based on the solubility of hematite in the individual acids through a synergistic effect in which the preferred 1:1 Fe:oxalate complex is formed. This allows for the minimization of oxalate additions to the waste stream. Carbon steel corrosion rates were measured in oxalic/nitric acid mixtures to evaluate the impacts of chemical cleaning with these solutions on waste tank integrity. Manageable corrosion rates were observed in the concentration ranges of interest for an acid contact timescale of 1 month. Kinetics tests involving hematite and gibbsite (a primary sludge aluminum phase) have confirmed that {ge}90% solids dissolution occurs within 3 weeks. Based on these results, the chemical cleaning conditions recommended to promote minimal oxalate usage and manageable corrosion include: 0.5 wt. % oxalic acid/0.175 M nitric acid mixture, 50 C, 2-3 week contact time with agitation.

  7. Plantar Wart

    MedlinePLUS

    ... Terms of Use | Contact Us © 2006-2013 Logical Images, Inc. All rights reserved. Advertising Notice This Site and third parties who place ... practices and to make choices about online behavioral advertising, please click here . ... here . © Logical Images, Inc. All rights reserved. Use of this site ...

  8. Comparative investigations of human and rat dermatoglyphics: palmar, plantar and digital pads and flexion creases.

    PubMed

    Kimura, Sumiko; Schaumann, Blanka A; Shiota, Kohei

    2002-03-01

    The morphological features of the palmar, plantar and digital areas of the rat were studied and compared to the corresponding human traits. The location and the timing of appearance of the volar pads and flexion creases of human and rat fetuses were investigated to determine the feasibility of using rats as an experimental model for studying the factors influencing early development of the dermatoglyphics in humans. Comparisons between analogous developmental stages of human and rat fetuses demonstrate striking similarities in overall fetal development. However, marked differences between human and rat fetuses were found in the timing of developmental milestones and in some morphological features. Provided that these differences are taken into consideration, rats can serve as a useful experimental model in studies of the utility of the epidermal ridge configurations and flexion creases in medical disorders. PMID:12418082

  9. Forefoot plantar multilobular noninfiltrating angiolipoma: a case report and review of the literature

    PubMed Central

    Grivas, Theodoros B; Savvidou, Olga D; Psarakis, Spyridon A; Liapi, Georgia; Triantafyllopoulos, George; Kovanis, Ioannis; Alexandropoulos, Panagiotis; Katsiva, Vasiliki

    2008-01-01

    Background Soft tissue tumors of the feet are uncommon and there have been very few reports of large series in the literature. These tumors continue to present the clinician with one of the most difficult problems in medicine. Case presentation We present a case of a large multilobular noninfiltrating angiolipoma at the plantar surface of the forefoot. Only three cases occurring at the foot have been previously described. We report this new case due to unusual location of the tumor, the long duration (25 years) of its existence and the unique surgical approach for the tumor excision. Conclusion Surgical excision is the treatment of choice and adjuvant radiotherapy is indicated in select cases. PMID:18234106

  10. Dilated cardiomyopathy and sudden death in a teenager with palmar-plantar keratosis (occult Carvajal syndrome).

    PubMed

    Kolar, A J O; Milroy, C M; Day, P F; Suvarna, S K

    2008-04-01

    A 16-year-old female who was diagnosed with palmar-plantar keratosis and Papillon-Lefevre syndrome in life died following a period of stress/affray. Autopsy examination revealed evidence of minor trauma and a grossly abnormal heart. The heart was sent fresh and intact to a cardiac pathologist for examination. This revealed a dilated cardiomyopathy with left ventricular fibrosis, without fatty infiltration of the right ventricle. The features were in keeping with Carvajal syndrome, a variant of Naxos disease. This rare cardiac pathology and the interaction between stress (physiological, psychological and traumatic) and natural disease are discussed. The role of prompt referral for cardiac pathology assessment and association with the genodermatoses is also considered. PMID:18313016

  11. Plantar Pressure as a Risk Assessment Tool for Diabetic Foot Ulceration in Egyptian Patients with Diabetes

    PubMed Central

    Fawzy, Olfat A; Arafa, Asmaa I; El Wakeel, Mervat A; Abdul Kareem, Shaimaa H

    2014-01-01

    BACKGROUND Diabetic foot ulceration is a preventable long-term complication of diabetes. In the present study, peak plantar pressures (PPP) and other characteristics were assessed in a group of 100 Egyptian patients with diabetes with or without neuropathy and foot ulcers. The aim was to study the relationship between plantar pressure (PP) and neuropathy with or without ulceration and trying to clarify the utility of pedobarography as an ulceration risk assessment tool in patients with diabetes. SUBJECTS AND METHODS A total of 100 patients having diabetes were selected. All patients had a comprehensive foot evaluation, including assessment for neuropathy using modified neuropathy disability score (MNDS), for peripheral vascular disease using ankle brachial index, and for dynamic foot pressures using the MAT system (Tekscan). The studied patients were grouped into: (1) diabetic control group (DC), which included 37 patients who had diabetes without neuropathy or ulceration and MNDS ?2; (2) diabetic neuropathy group (DN), which included 33 patients who had diabetes with neuropathy and MNDS >2, without current or a history of ulceration; and (3) diabetic ulcer group (DU), which included 30 patients who had diabetes and current ulceration, seven of those patients also gave a history of ulceration. RESULTS PP parameters were significantly different between the studied groups, namely, forefoot peak plantar pressure (FFPPP), rearfoot peak plantar pressure (RFPPP), forefoot/rearfoot ratio (F/R), forefoot peak pressure gradient (FFPPG) rearfoot peak pressure gradient (RFPPG), and forefoot peak pressure gradient/rearfoot peak pressure gradient (FFPPG/RFPPG) (P < 0.05). FFPPP and F/R were significantly higher in the DU group compared to the DN and DC groups (P < 0.05), with no significant difference between DN and DC. FFPPG was significantly higher in the DU and DN groups compared to the DC group (P < 0.05). RFPPP and FFPPG/RFPPG were significantly higher in the DU and DN groups compared to the DC group (P < 0.05) with no significant difference between the DN and DU groups (P > 0.05). FFPPP, F/R ratio, FFPPG, and FFPPG/RFPPG correlated significantly with the severity of neuropathy according to MNDS (P < 0.05). These same variables as well as MNDS were also significantly higher in patients with foot deformity compared to those without deformity (P < 0.05). Using the receiver operating characteristic analysis, the optimal cut-point of PPP for ulceration risk, as determined by a balance of sensitivity, specificity, and accuracy was 335 kPa and was found at the forefoot. Multivariate logistical regression analysis for ulceration risk was statistically significant for duration of diabetes (odds ratio [OR] = 0.8), smoking (OR = 9.7), foot deformity (OR = 8.7), MNDS (OR = 1.5), 2-h postprandial plasma glucose (2 h-PPG) (OR = 0.9), glycated hemoglobin (HbA1c) (OR = 2.1), FFPPP (OR = 1.0), and FFPPG (OR = 1.0). CONCLUSION In conclusion, persons with diabetes having neuropathy and/or ulcers have elevated PPP. Risk of ulceration was highly associated with duration of diabetes, smoking, severity of neuropathy, glycemic control, and high PP variables especially the FFPPP, F/R, and FFPPG. We suggest a cut-point of 355 kPa for FFPPP to denote high risk for ulceration that would be more valid when used in conjunction with other contributory risk factors, namely, duration of diabetes, smoking, glycemic load, foot deformity, and severity of neuropathy. PMID:25520564

  12. Use of locally made off-loading techniques for diabetic plantar foot ulcer in Karachi, Pakistan.

    PubMed

    Miyan, Zahid; Ahmed, Jameel; Zaidi, Syed I; Ahmedani, Muhammad Y; Fawwad, Asher; Basit, Abdul

    2014-12-01

    The aim of this study was to evaluate the effectiveness of applying locally made pressure off-loading techniques on plantar foot ulcer in individuals with diabetes. This prospective study of 70 diabetic patients was conducted at the foot clinic of Baqai Institute of Diabetology & Endocrinology. Plantar foot ulcer, stages 1A and 2A according to the University of Texas classification, was treated by using three off-loading techniques: modified foot wear (sandal), modified plaster of Paris cast with plywood platform and Scotchcast boot. The outcome was assessed at either complete wound healing (defined as complete epithelialisation) or at 12 weeks, whichever came first. Of the 70 patients, 24 were in modified foot wear group, 23 in modified plaster of Paris cast and 23 in Scotchcast boot group. There was almost equal proportion of patients healed within 12 weeks period treated with these three off-loading techniques, i.e. 22 (95·7%) for modified foot wear group, 19 (95%) for modified plaster cast and 18 (94·7%) for Scotchcast boot group. No significant difference was observed in median healing time and cumulative wound survival at 12 weeks in the three off-loading techniques. Modified foot wear group was the most cost effective ($7) amongst the three off-loading techniques. It is concluded that in this cohort, no significant difference in healing time was observed in the three off-loading techniques, although modified foot wear (sandal) was found to be a more cost-effective treatment modality. PMID:23369009

  13. The effect of three different toe props on plantar pressure and patient comfort

    PubMed Central

    2012-01-01

    Background Arthritic toe pathologies frequently lead to the development of painful apical pressure skin lesions that can compromise gait and affect quality of life. Historically conservative treatments involve the use of a toe prop with the intended aim of reducing plantar pressure from the apex of the digit. However, the effect of toe prop treatment on plantar digital pressure has not been investigated. Method Twenty two subjects were recruited with lesser digital deformities and associated apical skin lesions. Individual pressure sensors were placed on the apices of the lesser toes and pressure was recorded under three toe prop conditions (leather, gel and silicone mould). A modified comfort index was utilised to assess the comfort of each condition. Results Significant difference (p?

  14. Utilization of the foot load monitor for evaluating deep plantar tissue stresses in patients with diabetes: Proof-of-concept studies

    Microsoft Academic Search

    Eran Atlas; Ziva Yizhar; Sam Khamis; Noa Slomka; Shlomo Hayek; Amit Gefen

    2009-01-01

    The purposes of the present study were to (1) determine the internal plantar mechanical stresses in diabetic and healthy subjects during everyday activities, and (2) identify stress parameters potentially capable of distinguishing between diabetic and healthy subjects. A self-designed, portable, real-time and subject-specific foot load monitor which employs the Hertz contact theory was utilized to determine the internal dynamic plantar

  15. Physiological response of the heel tissue on pressure relief between three alternating pressure air mattresses.

    PubMed

    Goossens, Richard H M; Rithalia, Shyam V S

    2008-02-01

    Heels have substantially higher tissue interface pressures and are prone to ulceration compared to other bony prominences. Although many different types of alternating pressure air mattresses (APAMs) are used for the prevention and treatment of pressure ulcers, a few high-quality randomised controlled trials (RCTs) are available on which to base purchasing decisions. Faced with this situation, physiological measurements are increasingly being used as a surrogate. A time-based technique, which calculates pressure relief index (PRI), has been previously reported for analysing the ability of such systems. This technique has demonstrated that different designs produce variable results in this regard. The aim of the present study is to investigate the performance of three APAMs using PRI and blood perfusion measurements. Eleven able-bodied adult volunteers (6 males and 5 females) participated in the study. Their age, weight, height and body mass index (BMI) were (mean +/- s.d.) 23.9 +/- 2.1 years, 65.6 +/- 12.4 kg, 1.76 +/- 0.84 m and 21.0 +/- 2.4 kg/m2, respectively. There was no statistically significant difference in maximum interface pressure for the three mattresses. However, the AUTOlogic produced a statistically significant lower minimum interface pressure (Duo Care Plus, p < 0.0001 and higher pressure relief index below 30 mmHg than either the Duo Care Plus, p = 0.002 or Proficare, p < 0.0001. The AUTOlogic also gave a statistically significant enhanced perfusion per cycle when compared to other two mattresses (Duo Care Plus, p = 0.03 or Proficare, p = 0.01). PMID:18293766

  16. Behavioral and Electrophysiological Evidence for the Differential Functions of TRPV1 at Early and Late Stages of Chronic Inflammatory Nociception in Rats

    Microsoft Academic Search

    Hao Luo; Isabella Shi Xu; Yi Chen; Fei Yang; Lu Yu; Guang-Xin Li; Feng-Yu Liu; Guo-Gang Xing; Yu-Shun Shi; Tan Li; Ji-Sheng Han; You Wan

    2008-01-01

    We previously reported that vanilloid receptor type 1 (VR1, or TRPV1) was up-regulated in dorsal root ganglion (DRG) and the\\u000a spinal dorsal horn after chronic inflammatory pain produced by complete Freund’s adjuvant (CFA) injection into the plantar\\u000a of rat hind paw. In the present study, we found that subcutaneous or intrathecal application of capsazepine (CPZ), a TRPV1\\u000a competitive antagonist, could

  17. The human foot and heel-sole-toe walking strategy: a mechanism enabling an inverted pendular gait with low isometric muscle force?

    PubMed

    Usherwood, J R; Channon, A J; Myatt, J P; Rankin, J W; Hubel, T Y

    2012-10-01

    Mechanically, the most economical gait for slow bipedal locomotion requires walking as an 'inverted pendulum', with: I, an impulsive, energy-dissipating leg compression at the beginning of stance; II, a stiff-limbed vault; and III, an impulsive, powering push-off at the end of stance. The characteristic 'M'-shaped vertical ground reaction forces of walking in humans reflect this impulse-vault-impulse strategy. Humans achieve this gait by dissipating energy during the heel-to-sole transition in early stance, approximately stiff-limbed, flat-footed vaulting over midstance and ankle plantarflexion (powering the toes down) in late stance. Here, we show that the 'M'-shaped walking ground reaction force profile does not require the plantigrade human foot or heel-sole-toe stance; it is maintained in tip-toe and high-heel walking as well as in ostriches. However, the unusual, stiff, human foot structure--with ground-contacting heel behind ankle and toes in front--enables both mechanically economical inverted pendular walking and physiologically economical muscle loading, by producing extreme changes in mechanical advantage between muscles and ground reaction forces. With a human foot, and heel-sole-toe strategy during stance, the shin muscles that dissipate energy, or calf muscles that power the push-off, need not be loaded at all--largely avoiding the 'cost of muscle force'--during the passive vaulting phase. PMID:22572024

  18. Kinaesthetic ipsilateral and crossed extensor plantar response: A new way to elicit upgoing toe sign (Babinski response)?

    PubMed Central

    Kuruvilla, Abraham; Wattamwar, Pandurang R.

    2011-01-01

    We describe a phenomenon of “kinaesthetic extensor plantar response” in advanced pyramidal dysfunction, an interesting observation noted in a patient with dorsal myelopathy. A 44-year-old woman presented with one-year history of gradually progressive weakness and stiffness of both lower limbs along with urge incontinence of urine. Examination showed spontaneous elicitation of extensor plantar response while assessing the tone by rolling method as well as on noxious stimulation of the thigh. Magnetic resonance imaging (MRI) of the dorsal spine and digital subtraction angiography showed the presence of spinal dural arteriovenous fistula causing myelopathy. This case exemplifies the fact that in advanced pyramidal dysfunction, not only the receptive field of Babinski reflex may extend to the leg or thigh, but may also integrate with other modalities of stimulation, such as the rolling movement. The possible underlying pathophysiology of such a phenomenon is discussed. PMID:22028534

  19. Chronic inflammatory polyneuropathy

    MedlinePLUS

    Polyneuropathy - chronic inflammatory; CIDP; Chronic inflammatory demyelinating polyneuropathy ... usually affects both sides of the body equally. Chronic inflammatory demyelinating polyneuropathy (CIDP) is the most common chronic neuropathy caused ...

  20. The relationship between ankle plantar flexor muscle moments and knee compressive forces in subjects with and without pain

    Microsoft Academic Search

    Matthew J Robon; Karen L Perell; Meika Fang; Emmanuel Guererro

    2000-01-01

    Objective. The purpose of this study was to compare the compressive knee joint reaction force and ankle plantar flexor muscle moment during the terminal stance phase in symptomatic osteoarthritic and non-symptomatic subjects.Design. The study design was a comparative investigation of walking patterns.Background. Patients with knee osteoarthritic symptoms may employ altered gait patterns to reduce the loading of painful joints. Speculation

  1. Development of fatigue during repeated eccentric-concentric muscle contractions of plantar flexors in patients with stroke

    Microsoft Academic Search

    Ulla M. Svantesson; Katharina Stibrant Sunnerhagen; Ulrika S. Carlsson; Gunnar Grimby

    1999-01-01

    Objective: To better understand the mechanisms behind fatigue in muscles affected by a neuromuscular disease.Design: Patients recruited by convenience compared to age-matched healthy subjects from a population study.Setting: University hospital laboratory.Methods: Repetitive eccentric-concentric plantar flexions at 60°\\/sec were performed on a dynamometer until exhaustion. The mean power frequency and root mean square of the electromyogram were recorded, and work was

  2. Why person affected by leprosy did not look after their plantar ulcer? Experience from Pakokku zone, Myanmar.

    PubMed

    Win, Le Le; Shwe, San; Maw, Win; Ishida, Yutaka; Myint, Kyaw; Mar, Kyi Kyi; Min, Thandar; Oo, Phyo Min; Khine, Aye Win

    2010-09-01

    A cross-sectional study was carried out to identify methods of caring plantar ulcers in leprosy patients and the underlying causes of poor plantar ulcer care during January and February 2008. This was conducted in Pakokku zone as it was one of the "9 selected townships of the Disabilities survey, i.e., Basic Health Staff project 2003/4", which was funded by Japan International Cooperation Agency. After getting consent, all available leprosy cases, i.e., 101 cases with foot disability grade 2 were interviewed with the pre-tested questionnaire. Among 101 cases, 13 cases who took care of their ulcer poorly and 20 who did none of the recommended measures were recruited for in-depth interview (IDI). The subjects were largely old people, males and people with no marriage partner. The majority had earned money by doing sedentary job. Prolongation of ulcers was observed in 78 cases. Most had been suffering from ulcers for years. When asking face-to-face interview, all the recommended care measures were not reported. Among these recommended measures, a large number of respondents reported about soaking measure. However, these reported measures were contradicted to the preventive methods which they disclosed in IDI. Plantar ulcer care seemed to be an individualised practice. The individual ways of performing were related to their view of ulcer, the environment, and occupation, and custom, communication with family and health staff. The findings identified the actual practice of plantar ulcer care in study areas. It is suggested that the current performance of planar ulcer care is inadequate and more attention should be given to achieve the target set by the programme as a recommendation. PMID:20857653

  3. Effect of plantar subcutaneous administration of bergamot essential oil and linalool on formalin-induced nociceptive behavior in mice.

    PubMed

    Katsuyama, Soh; Otowa, Akira; Kamio, Satomi; Sato, Kazuma; Yagi, Tomomi; Kishikawa, Yukinaga; Komatsu, Takaaki; Bagetta, Giacinto; Sakurada, Tsukasa; Nakamura, Hitoshi

    2015-01-01

    This study investigated the effect of bergamot essential oil (BEO) or linalool, a major volatile component of BEO, on the nociceptive response to formalin. Plantar subcutaneous injection of BEO or linalool into the ipsilateral hindpaw reduced both the first and late phases of the formalin-induced licking and biting responses in mice. Plantar subcutaneous injection of BEO or linalool into the contralateral hindpaw did not yield an antinociceptive effect, suggesting that the antinociceptive effect of BEO or linalool in the formalin test occurred peripherally. Intraperitoneal and plantar subcutaneous injection pretreatment with naloxone hydrochloride, an opioid receptor antagonist, significantly attenuated both BEO- and linalool-induced antinociception. Pretreatment with naloxone methiodide, a peripherally acting opioid receptor antagonists, also significantly antagonized the antinociceptive effects of BEO and linalool. Our results provide evidence for the involvement of peripheral opioids in antinociception induced by BEO and linalool. These results suggest that activation of peripheral opioid receptors may play an important role in reducing formalin-induced nociception. PMID:25749150

  4. Chronic Depression

    Microsoft Academic Search

    Lawrence P. Riso; Michael E. Thase

    While once of limited interest to the field, chronic depression is now recognized as a major public health problem (Howland, 1993). Not only is chronic depression common, representing 19% of all depressed patients (Keller & Hanks, 1995) and 6% in the community (Kessler et al., 1994), but it is also associated with considerable psychosocial impairment (Howland, 1993), and is extremely

  5. [Chronic leukemia].

    PubMed

    Shibata, A; Narita, M

    1989-05-01

    As compared with advances in the treatment of acute leukemia, we have made little progress in chronic leukemia. Recently we have attempted some new treatments for chronic phase of CML, and confirmed those effectiveness. But for blastic crisis, we still grope in the dark. In this paper, we review the chemotherapy of CML and CLL including new treatments except bone marrow transplantation. PMID:2658837

  6. Citral: a monoterpene with prophylactic and therapeutic anti-nociceptive effects in experimental models of acute and chronic pain.

    PubMed

    Nishijima, Catarine M; Ganev, Ellen G; Mazzardo-Martins, Leidiane; Martins, Daniel F; Rocha, Lúcia R M; Santos, Adair R S; Hiruma-Lima, Clelia A

    2014-08-01

    Citral (3,7-dimethyl-2,6-octadienal) is an open-chain monoterpenoid present in the essential oils of several medicinal plants. The aim of this work was to evaluate the effects of orally administered citral in experimental models of acute and chronic nociception, inflammation, and gastric ulcers caused by non-steroidal anti-inflammatory drugs (NSAIDs). Oral treatment with citral significantly inhibited the neurogenic and inflammatory pain responses induced by intra-plantar injection of formalin. Citral also had prophylactic and therapeutic anti-nociceptive effects against mechanical hyperalgesia in plantar incision surgery, chronic regional pain syndrome, and partial ligation of sciatic nerve models, without producing any significant motor dysfunction. In addition, citral markedly attenuated the pain response induced by intra-plantar injection of glutamate and phorbol 12-myristate 13-acetate (PMA, a protein kinase C activator), as well as by intrathecal (i.t.) injection of ionotropic and metabotropic glutamate receptor agonists (N-methyl-D-aspartic acid [NMDA] and 1-amino-1,3-dicarboxycyclopentane [trans-ACPD], respectively), substance P, and cytokine tumour necrosis factor-?. However, citral potentiated behaviours indicative of pain caused by i.t., but not intra-plantar, injection of a transient receptor potential vanilloid receptor type 1 (TRPV1) agonist. Finally, the anti-nociceptive action of citral was found to involve significant activation of the 5-HT2A serotonin receptor. The effect of citral was accompanied by a gastro-protective effect against NSAID-induced ulcers. Together, these results show the potential of citral as a new drug for the treatment of pain. PMID:24792822

  7. Changes in Plantar Loading Based on Shoe Type and Sex During a Jump-Landing Task

    PubMed Central

    DeBiasio, Justin C.; Russell, Mary E.; Butler, Robert J.; Nunley, James A.; Queen, Robin M.

    2013-01-01

    Context: Metatarsal stress fractures are common in cleated-sport athletes. Previous authors have shown that plantar loading varies with footwear, sex, and the athletic task. Objective: To examine the effects of shoe type and sex on plantar loading in the medial midfoot (MMF), lateral midfoot (LMF), medial forefoot (MFF), middle forefoot (MidFF), and lateral forefoot (LFF) during a jump-landing task. Design: Crossover study. Setting: Laboratory. Patients or Other Participants: Twenty-seven recreational athletes (14 men, 13 women) with no history of lower extremity injury in the last 6 months and no history of foot or ankle surgery. Main Outcome Measure(s): The athletes completed 7 jumping trials while wearing bladed-cleat, turf-cleat, and running shoes. Maximum force, contact area, contact time, and the force-time integral were analyzed in each foot region. We calculated 2 × 3 analyses of variance (? = .05) to identify shoe-condition and sex differences. Results: We found no shoe × sex interactions, but the MMF, LMF, MFF, and LFF force-time integrals were greater in men (P < .03). The MMF maximum force was less with the bladed-cleat shoes (P = .02). Total foot and MidFF maximum force was less with the running shoes (P < .01). The MFF and LFF maximum forces were different among all shoe conditions (P < .01). Total foot contact area was less in the bladed-cleat shoes (P = .01). The MMF contact area was greatest in the running shoes (P < .01). The LFF contact area was less in the running shoes (P = .03). The MFF and LFF force-time integrals were greater with the bladed-cleat shoes (P < .01). The MidFF force-time integral was less in the running shoes (P < .01). Conclusions: Independent of shoe, men and women loaded the foot differently during a jump landing. The bladed cleat increased forefoot loading, which may increase the risk for forefoot injury. The type of shoe should be considered when choosing footwear for athletes returning to activity after metatarsal stress fractures. PMID:24067149

  8. Unilateral plantar flexors static-stretching effects on ipsilateral and contralateral jump measures.

    PubMed

    da Silva, Josinaldo Jarbas; Behm, David George; Gomes, Willy Andrade; Silva, Fernando Henrique Domingues de Oliveira; Soares, Enrico Gori; Serpa, Érica Paes; Vilela Junior, Guanis de Barros; Lopes, Charles Ricardo; Marchetti, Paulo Henrique

    2015-06-01

    The aim of this study was to evaluate the acute effects of unilateral ankle plantar flexors static-stretching (SS) on the passive range of movement (ROM) of the stretched limb, surface electromyography (sEMG) and single-leg bounce drop jump (SBDJ) performance measures of the ipsilateral stretched and contralateral non-stretched lower limbs. Seventeen young men (24 ± 5 years) performed SBDJ before and after (stretched limb: immediately post-stretch, 10 and 20 minutes and non-stretched limb: immediately post-stretch) unilateral ankle plantar flexor SS (6 sets of 45s/15s, 70-90% point of discomfort). SBDJ performance measures included jump height, impulse, time to reach peak force, contact time as well as the sEMG integral (IEMG) and pre-activation (IEMGpre-activation) of the gastrocnemius lateralis. Ankle dorsiflexion passive ROM increased in the stretched limb after the SS (pre-test: 21 ± 4° and post-test: 26.5 ± 5°, p < 0.001). Post-stretching decreases were observed with peak force (p = 0.029), IEMG (P<0.001), and IEMGpre-activation (p = 0.015) in the stretched limb; as well as impulse (p = 0.03), and jump height (p = 0.032) in the non-stretched limb. In conclusion, SS effectively increased passive ankle ROM of the stretched limb, and transiently (less than 10 minutes) decreased muscle peak force and pre-activation. The decrease of jump height and impulse for the non-stretched limb suggests a SS-induced central nervous system inhibitory effect. Key pointsWhen considering whether or not to SS prior to athletic activities, one must consider the potential positive effects of increased ankle dorsiflexion motion with the potential deleterious effects of power and muscle activity during a simple jumping task or as part of the rehabilitation process.Since decreased jump performance measures can persist for 10 minutes in the stretched leg, the timing of SS prior to performance must be taken into consideration.Athletes, fitness enthusiasts and therapists should also keep in mind that SS one limb has generalized effects upon contralateral limbs as well. PMID:25983580

  9. Evaluation of potential variables contributing to the development and duration of plantar lesions in a population of aquarium-maintained African penguins (Spheniscus demersus).

    PubMed

    Erlacher-Reid, Claire; Dunn, J Lawrence; Camp, Tracy; Macha, Laurie; Mazzaro, Lisa; Tuttle, Allison D

    2012-01-01

    Bumblefoot (pododermatitis), often described as the most significant environmental disease of captive penguins, is commonly due to excessive pressure or trauma on the plantar surface of the avian foot, resulting in inflammation or necrosis and causing severe swelling, abrasions, or cracks in the skin. Although not formally evaluated in penguins, contributing factors for bumblefoot are thought to be similar to those initiating the condition in raptors and poultry. These factors include substrate, body weight, and lack of exercise. The primary purpose of this retrospective study was to evaluate variables potentially contributing to the development and duration of plantar lesions in aquarium-maintained African penguins (Spheniscus demersus), including sex, weight, age, season, exhibit activity, and territory substrate. Results indicate that males develop significantly more plantar lesions than females. Penguins weighing between 3.51 and 4.0 kg develop plantar lesions significantly more often than penguins weighing between 2.5 and 3.5 kg, and because male African penguins ordinarily weigh significantly more than females, weight is likely a contributing factor in the development of lesions in males compared with females. Significantly more plantar lesions were observed in penguins standing for greater than 50% of their time on exhibit than swimming. Penguins occupying smooth concrete territories developed more plantar lesions compared with penguins occupying grate territories. Recommendations for minimizing bumblefoot in African penguins include training penguins for monthly foot examinations for early detection of plantar lesions predisposing for the disease, encouraging swimming activity, and replacing smooth surfaces on exhibit with surfaces providing variable degrees of pressure and texture on the feet. PMID:21557300

  10. REPERCUSSŐES BIOMECÂNICAS DO USO DE SALTO ALTO NA CINEMÁTICA DA MARCHA: UM ESTUDO RETROSPECTIVO DE 1990 A 2007 Biomechanical repercussions of the use of high heels in the kinematics of the march: a retrospective study from 1990 to 2007

    Microsoft Academic Search

    Cleber Luz Santos; Diana Oliveira Noronha; Cleber Araújo Gomes; Paula Roquetti Fernandes; José Fernandes Filho

    The purpose of this study was to investigate the biomechanical repercussions of the use of high heels in march kinematics, considering diverse heights and shoe models. A revision of literature was realized with articles published between January, 1990 and December, 2007 using the databases BIREME, MEDLINE, LlLACS. Heels superior to 3 centimeters generate repercussions in the locomotive device, mainly in

  11. [IMMUNOLOGICAL REACTIVITY AND CORRECTION OF IMMUNOLOGICAL DISORDERS BY BIOLOGICAL MEDICINES IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE EXACERBATIONS].

    PubMed

    2014-01-01

    The results of systemic immunological reactivity research were presented in 97 patients with chronic obstructive pulmonary disease (COPD) exacerbations. The patients were randomized on two groups. 67 patients, which additionally to standard anti-inflammatory therapy were prescribed different combinations of homotoxicological medicines, entered in a clinical group. The homotoxicological medicines such as Lymphomyosot, Galium-Heel®, Traumeel S, Echinacea compositum S, Bronchalis-Heel®, Mucosa compositum were prescribed according to the value of immune-regulatory index and type of T-cells immune disorders. 30 patients, which got standard anti-inflammatory therapy, entered in the group. of comparison. For the patients of clinical group immunological values were improved after the conducted treatment, unlike the patients of group of comparison in which an immunodeficiency was deepened. PMID:26118077

  12. The epidemiology and clinical manifestations of hamstring muscle and plantar foot flexor shortening.

    PubMed

    Jo?wiak, M; Pietrzak, S; Tobjasz, F

    1997-07-01

    A population of 920 healthy children was studied with the aim of assessing the incidence of hamstring muscle and plantar foot flexor tightness, and to correlate such symptoms with gait, posture, and low back discomfort or pain. Special attention was paid to the popliteal angle and dorsal foot flexion. The borderline values for the popliteal angle in the following age groups were, boys: 3 to 5 years, 40 degrees; 6 to 15 years, 50 degrees; and 16 to 19 years, 40 degrees; girls: 3 to 5 years, 30 degrees; 6 to 14 years, 45 degrees; 15 to 19 years, 30 degrees. The borderline values for dorsal foot flexion in the following age groups were 3 to 4 years, 7 degrees; 5 to 13 years, 10 degrees; and 14 to 19 years, 5 degrees. The results obtained indicate a natural increase in hamstring tightness, particularly shortly before the pubertal growth spurt. This seems to be linked with the natural evolution of lumbar lordosis and pelvic tilt. When hamstring tightness surpassed borderline values, dorsiflexion and lumbar lordosis decreased leading to postural deformities, bending-forward deficit, discomfort when sitting, and a shambling gait. PMID:9285439

  13. The operational characteristics of ultrasonography for the diagnosis of plantar intermetatarsal neuroma.

    PubMed

    Kankanala, Gowtham; Jain, Amar Singh

    2007-01-01

    A retrospective study was carried out on 48 patients to correlate preoperative ultrasound findings with postoperative histopathology findings and to assess the sensitivity, specificity, positive predictive values, and negative predictive values of ultrasound in the diagnosis of Morton's interdigital neuroma. All case sheets of 48 patients operated on between 1997 and 2005 were reviewed in the medical record section of Ninewells Hospital, Dundee, Scotland, so that preoperative ultrasound reports were compared with the postoperative histopathological reports. A statistical analysis of the results was performed. Ultrasonography showed 43 true-positive cases, 1 true-negative case, and 4 false-negative cases out of 48 cases. Histopathology showed 47 true-positive cases and 1 true-negative case; statistical analysis performed on the results showed a sensitivity of 91.48%, a specificity of 100%, and 100% positive and 20% negative predictive values, respectively. In our analysis, the probability that ultrasound will confirm the presence of plantar intermetatarsal neuroma is 91.67%. PMID:17586431

  14. Enhanced physiological tremor deteriorates plantar flexor torque steadiness after bed rest.

    PubMed

    Mulder, Edwin R; Horstman, Astrid M; Gerrits, Karin; Massa, Mark; Kleine, Bert U; de Haan, Arnold; Belavý, Daniel L; Felsenberg, Dieter; Zwarts, Machiel; Stegeman, Dick F

    2011-04-01

    This study evaluated the effectiveness of resistance training to preserve submaximal plantar flexor (PF) torque steadiness following 60 days of bed rest (BR). Twenty-two healthy male subjects underwent either BR only (CTR, n=8), or BR plus resistance training (RT, n=14). The magnitude of torque fluctuations during steady submaximal isometric PF contractions (20%, 40%, 60% and 80% of maximum) were assessed before and after BR. Across contraction intensities, torque fluctuations (coefficient of variation, CV) increased more (P<0.05) after BR for CTR (from 0.31±0.10 to 0.92±0.63; P<0.001), than for RT (from 0.30±0.09 to 0.54±0.27; P<0.01). A shift in the spectral content of torque fluctuations towards increased rhythmic activity between 6.5 and 20Hz was observed in CTR only (P<0.05). H-reflex amplitude (H(max)/M(max) ratio) declined across groups from 0.57±0.18 before BR to 0.44±0.14 following BR (P<0.01) without correlation to CV. The present study showed that increased torque fluctuation after BR resulted from enhanced physiological tremor. Resistance training prevented the spectral shift in isometric PF torque fluctuation and offset ?50% of the decline in performance associated with long-term BR. PMID:21131213

  15. Influence of pressure-relief insoles developed for loaded gait (backpackers and obese people) on plantar pressure distribution and ground reaction forces.

    PubMed

    Peduzzi de Castro, Marcelo; Abreu, Sofia; Pinto, Viviana; Santos, Rubim; Machado, Leandro; Vaz, Mario; Vilas-Boas, Joăo Paulo

    2014-07-01

    The aims of this study were to test the effects of two pressure relief insoles developed for backpackers and obese people on the ground reaction forces (GRF) and plantar pressure peaks during gait; and to compare the GRF and plantar pressures among normal-weight, backpackers, and obese participants. Based on GRF, plantar pressures, and finite element analysis two insoles were manufactured: flat cork-based insole with (i) corkgel in the rearfoot and forefoot (SLS1) and with (ii) poron foam in the great toe and lateral forefoot (SLS2). Gait data were recorded from 21 normal-weight/backpackers and 10 obese participants. The SLS1 did not influence the GRF, but it relieved the pressure peaks for both backpackers and obese participants. In SLS2 the load acceptance GRF peak was lower; however, it did not reduce the plantar pressure peaks. The GRF and plantar pressure gait pattern were different among the normal-weight, backpackers and obese participants. PMID:24468683

  16. Chronic Bronchitis

    MedlinePLUS

    ... More About Us Newsroom Departments & Divisions Locations & Directions Who We Are Connect With Us Contact Us More Chronic Bronchitis ... Information Pediatric Conditions Healthy Lifestyle More About Us Who We Are Newsroom Network of Locations More eNewsletters and More © ...

  17. Chronic Meningitis

    MedlinePLUS

    ... not infections can cause chronic meningitis. They include sarcoidosis and certain disorders that cause inflammation, such as ... For disorders that are not infections, such as sarcoidosis and Behçet syndrome: Corticosteroids or other drugs that ...

  18. Large heel soft tissue defects managed successfully with reverse medial crural fasciocutaneous flap: a 7-year single-center experience with 21 consecutive cases.

    PubMed

    Jing-Chun, Zhao; Kai, Shi; Jia-Ao, Yu; Chun-Jing, Xian; Lai-Jin, Lu; Chun-Hui, Xie

    2015-01-01

    The medial crural fasciocutaneous flap is a reliable cutaneous flap that can be used for soft tissue reconstruction in the extremities. The purpose of this article is to evaluate the application and clinical significance of this surgical technique in the reconstruction of heel soft tissue defects. Twenty-one cases of heel soft tissue defect between March 2005 and March 2012 were included in this study. Wound sizes varied from 5.0 × 5.5 to 7.5 × 10.0 cm. All cases were managed with a reverse medial crural fasciocutaneous flap. Patient demographics and case information were analyzed and are reported. The sizes of the reverse medial crural fasciocutaneous flap varied from 6.5 × 10.0 to 9.0 × 15.0 cm; the average size was 7.7 × 13.8 cm. Out of the 21 consecutive cases, 20 flaps survived intact and one flap underwent partial necrosis. Follow-up observations were conducted for 6-36 months. The cosmetic results were satisfactory, without apparent bulkiness; the weight-bearing outcomes were satisfactory. The donor site can be closed primarily or by skin graft. Reverse medial crural fasciocutaneous flap transfer is appropriate for the reconstruction of heel soft tissue defects. The method is safe and can cover large heel defects. PMID:25448373

  19. The Daily Tar Heel URL: http://www.dailytarheel.com/index.php/article/2010/09/grant_money_to_help_scholars

    E-print Network

    Sekelsky, Jeff

    The Daily Tar Heel URL: http://www.dailytarheel.com/index.php/article/2010/09/grant_money_to_help_scholars Current Date: Sun, 26 Sep 2010 13:05:26 -0400 Grant money to help scholars To benefit biomedical students in biology, physics and chemistry, as well as high-level math and applied sciences courses. The grant money

  20. Tibialis Anterior Tendon Lengthening: Adjunctive Treatment of Plantar Lateral Column Diabetic Foot Ulcers.

    PubMed

    Kim, Paul J; Steinberg, John S; Kikuchi, Mamoru; Attinger, Christopher E

    2015-01-01

    Tendon lengthening and rebalancing are adjunctive procedures for the treatment of chronic ulcerations in the diabetic foot. For example, the equinus deformity has been implicated as a major deforming force and is surgically treated by lengthening the Achilles tendon. A contracted tibialis anterior tendon can also play a role by potentiating a varus rotational force, increasing the pressures along the lateral column of the forefoot, and resulting in the development or chronicity of an ulceration. We present a novel application of tibialis anterior tendon lengthening for the adjunctive treatment of chronic ulcerations in the diabetic foot. PMID:25977151

  1. Endoscopic Transthoracic Limited Sympathotomy for Palmar-Plantar Hyperhidrosis: Outcomes and Complications During a 10-Year Period

    PubMed Central

    Atkinson, John L. D.; Fode-Thomas, Nicolee C.; Fealey, Robert D.; Eisenach, John H.; Goerss, Stephan J.

    2011-01-01

    OBJECTIVE: To review surgical results of endoscopic transthoracic limited sympathotomy for palmar-plantar hyperhidrosis during the past decade. PATIENTS AND METHODS: We retrospectively reviewed 155 consecutive patients who underwent surgery from June 30, 2000, through December 31, 2009, for medically refractory palmar-plantar hyperhidrosis using a technique of T1-T2 sympathotomy disconnection, designed for successful palmar response and minimization of complications. RESULTS: Of the 155 patients, 44 (28.4%) were male, and 111 (71.6%) were female; operative times averaged 38 minutes. No patient experienced Horner syndrome, intercostal neuralgia, or pneumothorax. The only surgical complication was hemothorax in 2 patients (1.3%); in 1 patient, it occurred immediately postoperatively and in the other patient, 10 days postoperatively; treatment in both patients was successful. All 155 patients had successful (warm and dry) palmar responses at discharge. Long-term follow-up (>3 months; mean, 40.2 months) was obtained for 148 patients (95.5%) with the following responses to surgery: 96.6% of patients experienced successful control of palmar sweating; 69.2% of patients experienced decreased axillary sweating; and 39.8% of patients experienced decreased plantar sweating. At follow-up, 5 patients had palmar sweating (3 patients, <3 months; 1 patient, 10-12 months; 1 patient, 16-18 months). Compensatory hyperhidrosis did not occur in 47 patients (31.7%); it was mild in 92 patients (62.2%), moderate in 7 patients (4.7%), and severe in 2 patients (1.3%). CONCLUSION: In this series, a small-diameter uniportal approach has eliminated intercostal neuralgia. Selecting a T1-T2 sympathotomy yields an excellent palmar response, with a very low severe compensatory hyperhidrosis complication rate. The low failure rate was noted during 18 months of follow-up and suggests that longer follow-up is necessary in these patients. PMID:21803954

  2. Extracorporeal shock wave therapy in patients with plantar fasciitis. A randomized, placebo-controlled trial with ultrasonographic and subjective outcome assessments

    PubMed Central

    Vahdatpour, Babak; Sajadieh, Sepideh; Bateni, Vahid; Karami, Mehdi; Sajjadieh, Hamidreza

    2012-01-01

    Background and Aim: Results of previous studies have been conflicting on the efficacy of extracorporeal shock wave therapy (ESWT) in the treatment of plantar fasciitis. We evaluated the effects of ESWT on plantar fasciitis in terms of ultrasonographic and subjective evaluations. Materials and Methods: In this randomized placebo-controlled trial, patients with plantar fasciitis were assigned to receive ESWT (4000 shock waves/session of 0.2 mJ/mm2) in 3 sessions at weekly intervals) or sham therapy (n = 20 in each group). Outcomes were documented by the ultrasonographic appearance of the aponeurosis and by patients’ pain scores, performed at baseline and 12 weeks after completion of the therapy. Results: The two groups were similar in baseline characteristics. Over the study period, plantar fascia thickness significantly reduced in the ESWT group (4.1 ± 1.3 to 3.6 ± 1.2 mm, P < 0.001), but slightly increased in the sham group (4.1 ± 0.8 to 4.5 ± 0.9 mm, P = 0.03). Both groups showed significant pain improvement over the course of the study (P < 0.001), though pain scores were significantly more reduced in the ESWT than the sham group (-4.2 ± 2.9 vs. -2.7 ± 1.8, P = 0.049). Conclusions: Extracorporeal shock wave therapy contributes to healing and pain reduction in plantar fasciitis and ultrasound imaging is able to depict the morphologic changes related to plantar fasciitis as a result of this therapy. PMID:23826009

  3. Chronic pancreatitis.

    PubMed

    Nair, Rajasree J; Lawler, Lanika; Miller, Mark R

    2007-12-01

    Chronic pancreatitis is the progressive and permanent destruction of the pancreas resulting in exocrine and endocrine insufficiency and, often, chronic disabling pain. The etiology is multifactorial. Alcoholism plays a significant role in adults, whereas genetic and structural defects predominate in children. The average age at diagnosis is 35 to 55 years. Morbidity and mortality are secondary to chronic pain and complications (e.g., diabetes, pancreatic cancer). Contrast-enhanced computed tomography is the radiographic test of choice for diagnosis, with ductal calcifications being pathognomonic. Newer modalities, such as endoscopic ultrasonography and magnetic resonance cholangiopancreatography, provide diagnostic results similar to those of endoscopic retrograde cholangiopancreatography. Management begins with lifestyle modifications (e.g., cessation of alcohol and tobacco use) and dietary changes followed by analgesics and pancreatic enzyme supplementation. Before proceeding with endoscopic or surgical interventions, physicians and patients should weigh the risks and benefits of each procedure. Therapeutic endoscopy is indicated for symptomatic or complicated pseudocyst, biliary obstruction, and decompression of pancreatic duct. Surgical procedures include decompression for large duct disease (pancreatic duct dilatation of 7 mm or more) and resection for small duct disease. Lateral pancreaticojejunostomy is the most commonly performed surgery in patients with large duct disease. Pancreatoduodenectomy is indicated for the treatment of chronic pancreatitis with pancreatic head enlargement. Patients with chronic pancreatitis are at increased risk of pancreatic neoplasm; regular surveillance is sometimes advocated, but formal guidelines and evidence of clinical benefit are lacking. PMID:18092710

  4. [Chronic hepatitis].

    PubMed

    Figueroa Barrios, R

    1995-01-01

    Medical literature about chronic hepatitis is reviewed. This unresolving disease caused by viruses, drugs or unknown factors may progress to in cirrhosis and hepatocarcinoma. A classification based on liver biopsy histology into chronic persistent and chronic active types has been largely abandoned and emphasis is placed on recognizing the etiology of the various types. One is associated with continuing hepatitis B virus infection; another is related to chronic hepatitis C virus infection and the third is termed autoinmune, because of the association with positive serum autoantibodies. A fourth type with similar clinical functional and morphologic features is found with some drug reactions. Long term corticoesteroid therapy is usually successful in autoinmune type. Associations between antibodies to liver-kidney microsomes and the hepatitis C virus can cause diagnostic difficulties. Antiviral treatment of chronic hepatitis B and C with interpheron alfa is employed, controlling symptoms and abnormal biochemistry and the progression to cirrhosis and liver cancer in 30 to 40% patients. Alternative therapies or combinations with interpheron are being evaluated waiting for final results. PMID:8520023

  5. Chronic urticaria.

    PubMed Central

    Leznoff, A.

    1998-01-01

    OBJECTIVE: To review the pathophysiology of chronic urticaria in light of recent evidence for it being an autoimmune disease, and to recommend appropriate management. QUALITY OF EVIDENCE: An extensive literature review was supplemented with a MEDLINE search. Articles from easily available journals were preferred. These consisted of the most recent basic articles on autoimmunity in relation to chronic urticaria and a selection of previous articles on pathophysiology, which illustrate consistencies with recent evidence. The investigation and management protocol is supported by original and relevant literature. MAIN FINDINGS: The histopathology and immunohistology of chronic urticaria and certain clinical studies were a prelude to definitive evidence that most instances of chronic urticaria are autoimmune. Although allergic and other causes are uncommon, these must be sought because identification can lead to cure or specific treatment. Management of the much more common autoimmune urticaria is based on principles derived from the demonstrated pathogenesis and on results of published clinical trials. CONCLUSIONS: In most instances, chronic urticaria is an autoimmune disease, but uncommon allergic or other causes must be considered. PMID:9805172

  6. The influence of the heel effect in cone-beam computed tomography: artifacts in standard and novel geometries and their correction

    NASA Astrophysics Data System (ADS)

    Braun, H.; Kyriakou, Y.; Kachelrieß, M.; Kalender, W. A.

    2010-10-01

    For decades, the heel effect has been known to cause an angular dependence of the emitted spectrum of an x-ray tube. In radiography, artifacts were observed and attributed to the heel effect. However, no problems due to the heel effect were discerned in multi-slice computed tomography (MSCT) so far. With flat-detector CT (FDCT), involving larger cone angles and different system geometries, the heel effect might cause new artifacts. These artifacts were analyzed in this paper for system geometries different from the ones widely used nowadays. Simulations and measurements were performed. Simulations included symmetric as well as asymmetric detector layouts and different x-ray tube orientations with respect to the detector plane. The measurements were performed on a micro-CT system in an asymmetric detector layout. Furthermore, an analytical correction scheme is proposed to overcome heel effect artifacts. It was shown that the type of artifact greatly depends on the orientation of the x-ray tube and also on the type of detector alignment (i.e. symmetric or different types of asymmetric alignment). Certain combinations exhibited almost no significant artifact while others greatly influenced the quality of the reconstructed images. The proposed correction scheme showed good results that were further improved when also applying a scatter correction. When designing CT systems, care should be taken when placing the tube and the detector. Orientation of the x-ray tube like in most MSCT systems seems advisable in asymmetric detector layouts. However, a different type of tube orientation can be overcome with suitable correction schemes.

  7. Equine developmental orthopaedic diseases--a genome-wide association study of first phalanx plantar osteochondral fragments in Standardbred trotters.

    PubMed

    Lykkjen, S; Dolvik, N I; McCue, M E; Rendahl, A K; Mickelson, J R; Rřed, K H

    2013-12-01

    Palmar/plantar osteochondral fragments (POF) in fetlock joints commonly affect and influence the athletic performance of horses. In this study, we used the Equine SNP50 BeadChip® to perform a genome-wide association study of metatarsophalangeal POF in 176 Norwegian Standardbred trotter yearlings. Putative quantitative trait loci (QTL) for medial and/or lateral POF, and medial POF only were identified on ECA1, 2, 7, 9 and 31, whereas for lateral POF, only on ECA7, 11, 27 and X. The moderate number of QTL evidences a complex inheritance and suggests various genes controlling POF development in medial and lateral locations. PMID:23742657

  8. The effect of shoe toe box shape and volume on forefoot interdigital and plantar pressures in healthy females

    PubMed Central

    2013-01-01

    Background Ill-fitting footwear can be detrimental to foot health with the forefoot being an area for most discomfort. Studies on footwear have primarily examined sports or orthopaedic prescription shoes and little is known about the effects that everyday flat shoes have on the forefoot. The aim of this study was to investigate the effect of toe box shape in a popular slip-on pump on dorsal and plantar pressures with particular interest around the forefoot in a healthy female population. Method A convenience sample of 27 female participants with no known foot pathologies was recruited. After assessment of foot size, plantar foot pressure and interdigital pressures were recorded for each of the 3 different toe box styles; round, square and pointed. Participants walked at a self-selected speed over a 10 m walkway whilst wearing each of the 3 styles of shoe and also whilst barefoot. Processed and analysed data extracted included peak pressure, time to peak pressure, contact time and pressure time integral. ANOVA and Freidman analysis was used to test for statistical significance. Results Shoes with a round toe showed least pressure around the medial aspect of the toes whilst the pointed shoe had least pressure on the lateral toes. Contact times for the plantar regions were not altered in any shoe condition yet contact around the medial aspect of the toes was highest in the pointed shoe. Conclusion This study highlights that the shape of the toe box in footwear can significantly influence the amount of pressure applied to the forefoot. Furthermore, the contours of the shoe also have an impact on the contact time and pressure time integral around the forefoot and also the peak plantar pressure in the toe region. The changes observed could be significant in the development of pathology in certain footwear toe box shapes. Consideration should be given to footwear design around the toe box to improve fit and reduce pressure. Further work is required to investigate the effect of toe box shape and volume on a pathological population with pressure related lesions. PMID:23886242

  9. Joplin's neuroma or compression neuropathy of the plantar proper digital nerve to the hallux: clinicopathologic study of three cases.

    PubMed

    Still, G P; Fowler, M B

    1998-01-01

    Both nonsurgical and surgical treatment of compressive and/or entrapment neuropathy of the plantar proper digital nerve to the hallux, also known as Joplin's neuroma, are very uncommon in the literature. The condition of perineural fibrosis of this nerve was first described in 1971 by Joplin. Diagnosis of this nerve in a localized pathologic process based on physical exam and surgical pathology and noniatrogenic etiology are discussed. Three case studies of Joplin's neuroma are followed through the treatment course from initial presentation to postoperative follow-up. PMID:9879048

  10. Low-pressure, single-point grout injection for tank heel sludge mixing and in-situ immobilization

    SciTech Connect

    Whyatt, G.A.; Hymas, C.R.

    1998-09-01

    This report describes tests conducted in an approximately 9-ft diameter test tank situated outside the 336 building in Hanford`s 300 area. The tests were performed to measure the ability of jets of grout slurry to mobilize and mix simulated tank sludge. The technique is intended for in situ immobilization of tank waste heels. The current approach uses a single, rotated, larger-diameter nozzle driven at lower pressure. Due to the larger diameter, the potential for plugging is reduced and the effective radius around an injection point over which the jet is effective in mobilizing sludge from the tank bottom can be made larger. A total of three grout injection tests were conducted in a 9-ft diameter tank. In each case, a 2-in. layer of kaolin clay paste was placed on a dry tank floor to simulate a sludge heel. The clay was covered with 4 inches of water. The grout slurry, consisting of Portland cement, class F fly ash, and eater, was prepared and delivered by an offsite vendor. In the third test, the sludge in half of the tank was replaced by a layer of 20x50 mesh zeolite, and bentonite clay was added to the grout formulation. After injection, the grout was allowed to set and then the entire grout monolith was manually broken up and excavated using a jack hammer. Intact pieces of clay were visually apparent due to a sharp color contrast between the grout and clay. Remaining clay deposits were collected and weighed and suspended clay pieces within the monolith were photographed. The mobilization performance of the grout jets exceeded expectations.

  11. Chronic myelogenous leukemia (CML)

    MedlinePLUS

    CML; Chronic myeloid leukemia; Chronic granulocytic leukemia; Leukemia - chronic granulocytic ... nuclear disaster. It takes many years to develop leukemia from radiation exposure. Most people treated for cancer ...

  12. Chronic obstructive pulmonary disease

    MedlinePLUS

    ... airways disease; Chronic obstructive lung disease; Chronic bronchitis; Emphysema; Bronchitis - chronic ... a protein called alpha-1 antitrypsin can develop emphysema. Other risk factors for COPD are: Exposure to ...

  13. B cell receptor signaling in chronic lymphocytic leukemia

    PubMed Central

    Burger, Jan A.; Chiorazzi, Nicholas

    2013-01-01

    BCR signaling plays an important pathogenic role in chronic lymphocytic leukemia (CLL) and B cell lymphomas, based on structural restrictions of the BCR, and BCR-dependent survival and growth of the malignant B cells. In CLL and lymphoma subtypes, ligand-independent (“tonic”) and ligand-dependent BCR signaling have been characterized, which can involve mutations of BCR pathway components or be triggered by (auto-) antigens present in the tissue microenvironment. In CLL, based on high response rates and durable remissions in early-stage clinical trials, there is rapid clinical development of inhibitors targeting BCR-associated kinases (BTK, PI3K?), which will change treatment paradigms in CLL and other B cell malignancies. Here, we discuss the evolution of this field, from BCR-related prognostic markers, to mechanisms of BCR activation, and targeting of BCR-associated kinases, the emerging Achilles’ heel in CLL pathogenesis. PMID:23928062

  14. Test-retest reliability of dynamic plantar loading and foot geometry measures in diabetics with peripheral neuropathy.

    PubMed

    Gurney, J K; Marshall, P W M; Rosenbaum, D; Kersting, U G

    2013-01-01

    Pedobarography is commonly employed in patients with diabetic peripheral neuropathy (DPN). However there is no evidence regarding test-retest reliability of this technique in this population, and therefore it was the purpose of the current study to address this clear gap. Dynamic plantar loading and foot geometry data were collected during barefoot gait with the EMED platform (Novel GmbH, Germany) from 10 patients with DPN over two sessions, separated by 28 days. Intra-class Correlation Coefficients (ICCs) and Coefficients of Variation (CoVs) were calculated to determine test-retest reliability. For dynamic plantar loading, reliability differed by outcome measure and foot region, with ICCs of >0.8 and CoVs of <15% observed in most cases. For dynamic foot geometry, ICCs of >0.88 and CoVs of <3% were observed for hallux angle, arch index and coefficient of spreading, while sub-arch angle was less reliable (ICC 0.76, CoV 23%). Overall, the current study observed high levels of test-retest reliability which were generally commensurate with that previously reported in healthy populations. PMID:22819069

  15. Classification of Forefoot Plantar Pressure Distribution in Persons with Diabetes: A Novel Perspective for the Mechanical Management of Diabetic Foot?

    PubMed Central

    Deschamps, Kevin; Matricali, Giovanni Arnoldo; Roosen, Philip; Desloovere, Kaat; Bruyninckx, Herman; Spaepen, Pieter; Nobels, Frank; Tits, Jos; Flour, Mieke; Staes, Filip

    2013-01-01

    Background The aim of this study was to identify groups of subjects with similar patterns of forefoot loading and verify if specific groups of patients with diabetes could be isolated from non-diabetics. Methodology/Principal Findings Ninety-seven patients with diabetes and 33 control participants between 45 and 70 years were prospectively recruited in two Belgian Diabetic Foot Clinics. Barefoot plantar pressure measurements were recorded and subsequently analysed using a semi-automatic total mapping technique. Kmeans cluster analysis was applied on relative regional impulses of six forefoot segments in order to pursue a classification for the control group separately, the diabetic group separately and both groups together. Cluster analysis led to identification of three distinct groups when considering only the control group. For the diabetic group, and the computation considering both groups together, four distinct groups were isolated. Compared to the cluster analysis of the control group an additional forefoot loading pattern was identified. This group comprised diabetic feet only. The relevance of the reported clusters was supported by ANOVA statistics indicating significant differences between different regions of interest and different clusters. Conclusion/s Significance There seems to emerge a new era in diabetic foot medicine which embraces the classification of diabetic patients according to their biomechanical profile. Classification of the plantar pressure distribution has the potential to provide a means to determine mechanical interventions for the prevention and/or treatment of the diabetic foot. PMID:24278219

  16. Ear infection - chronic

    MedlinePLUS

    Middle ear infection - chronic; Otitis media - chronic; Chronic otitis media; Chronic ear infection ... Kerschner JE. Otitis media. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Saunders ...

  17. Chronic Pancreatitis in Children

    MedlinePLUS

    Chronic Pancreatitis in Children What symptoms would my child have? Frequent or chronic abdominal pain is the most common ... will develop diabetes in adolescence. Who gets chronic pancreatitis? Those at risk for chronic pancreatitis are children ...

  18. Chronic pain - resources

    MedlinePLUS

    Pain - resources; Resources - chronic pain ... The following organizations are good resources for information on chronic pain: American Chronic Pain Association - www.theacpa.org National Fibromyalgia and Chronic Pain Association - www.fmcpaware.org ...

  19. Chronic motor tic disorder

    MedlinePLUS

    Chronic vocal tic disorder; Tic - chronic motor tic disorder ... Chronic motor tic disorder is more common than Tourette syndrome . Chronic tics may be forms of Tourette syndrome. Tics usually start ...

  20. Chronic Kidney Disease (CKD)

    MedlinePLUS

    ... www.kidneyfund.org > Kidney Disease > Chronic Kidney Disease Chronic Kidney Disease (CKD) An estimated 31 million people in the United ... living with chronic kidney disease (CKD). What is CKD? The term “chronic kidney disease” (CKD) means lasting ...

  1. Genetic determinants of heel bone properties: genome-wide association meta-analysis and replication in the GEFOS/GENOMOS consortium

    PubMed Central

    Moayyeri, Alireza; Hsu, Yi-Hsiang; Karasik, David; Estrada, Karol; Xiao, Su-Mei; Nielson, Carrie; Srikanth, Priya; Giroux, Sylvie; Wilson, Scott G.; Zheng, Hou-Feng; Smith, Albert V.; Pye, Stephen R.; Leo, Paul J.; Teumer, Alexander; Hwang, Joo-Yeon; Ohlsson, Claes; McGuigan, Fiona; Minster, Ryan L.; Hayward, Caroline; Olmos, José M.; Lyytikäinen, Leo-Pekka; Lewis, Joshua R.; Swart, Karin M.A.; Masi, Laura; Oldmeadow, Chris; Holliday, Elizabeth G.; Cheng, Sulin; van Schoor, Natasja M.; Harvey, Nicholas C.; Kruk, Marcin; del Greco M, Fabiola; Igl, Wilmar; Trummer, Olivia; Grigoriou, Efi; Luben, Robert; Liu, Ching-Ti; Zhou, Yanhua; Oei, Ling; Medina-Gomez, Carolina; Zmuda, Joseph; Tranah, Greg; Brown, Suzanne J.; Williams, Frances M.; Soranzo, Nicole; Jakobsdottir, Johanna; Siggeirsdottir, Kristin; Holliday, Kate L.; Hannemann, Anke; Go, Min Jin; Garcia, Melissa; Polasek, Ozren; Laaksonen, Marika; Zhu, Kun; Enneman, Anke W.; McEvoy, Mark; Peel, Roseanne; Sham, Pak Chung; Jaworski, Maciej; Johansson, Ĺsa; Hicks, Andrew A.; Pludowski, Pawel; Scott, Rodney; Dhonukshe-Rutten, Rosalie A.M.; van der Velde, Nathalie; Kähönen, Mika; Viikari, Jorma S.; Sievänen, Harri; Raitakari, Olli T.; González-Macías, Jesús; Hernández, Jose L.; Mellström, Dan; Ljunggren, Östen; Cho, Yoon Shin; Völker, Uwe; Nauck, Matthias; Homuth, Georg; Völzke, Henry; Haring, Robin; Brown, Matthew A.; McCloskey, Eugene; Nicholson, Geoffrey C.; Eastell, Richard; Eisman, John A.; Jones, Graeme; Reid, Ian R.; Dennison, Elaine M.; Wark, John; Boonen, Steven; Vanderschueren, Dirk; Wu, Frederick C.W.; Aspelund, Thor; Richards, J. Brent; Bauer, Doug; Hofman, Albert; Khaw, Kay-Tee; Dedoussis, George; Obermayer-Pietsch, Barbara; Gyllensten, Ulf; Pramstaller, Peter P.; Lorenc, Roman S.; Cooper, Cyrus; Kung, Annie Wai Chee; Lips, Paul; Alen, Markku; Attia, John; Brandi, Maria Luisa; de Groot, Lisette C.P.G.M.; Lehtimäki, Terho; Riancho, José A.; Campbell, Harry; Liu, Yongmei; Harris, Tamara B.; Akesson, Kristina; Karlsson, Magnus; Lee, Jong-Young; Wallaschofski, Henri; Duncan, Emma L.; O'Neill, Terence W.; Gudnason, Vilmundur; Spector, Timothy D.; Rousseau, François; Orwoll, Eric; Cummings, Steven R.; Wareham, Nick J.; Rivadeneira, Fernando; Uitterlinden, Andre G.; Prince, Richard L.; Kiel, Douglas P.; Reeve, Jonathan; Kaptoge, Stephen K.

    2014-01-01

    Quantitative ultrasound of the heel captures heel bone properties that independently predict fracture risk and, with bone mineral density (BMD) assessed by X-ray (DXA), may be convenient alternatives for evaluating osteoporosis and fracture risk. We performed a meta-analysis of genome-wide association (GWA) studies to assess the genetic determinants of heel broadband ultrasound attenuation (BUA; n = 14 260), velocity of sound (VOS; n = 15 514) and BMD (n = 4566) in 13 discovery cohorts. Independent replication involved seven cohorts with GWA data (in silico n = 11 452) and new genotyping in 15 cohorts (de novo n = 24 902). In combined random effects, meta-analysis of the discovery and replication cohorts, nine single nucleotide polymorphisms (SNPs) had genome-wide significant (P < 5 × 10?8) associations with heel bone properties. Alongside SNPs within or near previously identified osteoporosis susceptibility genes including ESR1 (6q25.1: rs4869739, rs3020331, rs2982552), SPTBN1 (2p16.2: rs11898505), RSPO3 (6q22.33: rs7741021), WNT16 (7q31.31: rs2908007), DKK1 (10q21.1: rs7902708) and GPATCH1 (19q13.11: rs10416265), we identified a new locus on chromosome 11q14.2 (rs597319 close to TMEM135, a gene recently linked to osteoblastogenesis and longevity) significantly associated with both BUA and VOS (P < 8.23 × 10?14). In meta-analyses involving 25 cohorts with up to 14 985 fracture cases, six of 10 SNPs associated with heel bone properties at P < 5 × 10?6 also had the expected direction of association with any fracture (P < 0.05), including three SNPs with P < 0.005: 6q22.33 (rs7741021), 7q31.31 (rs2908007) and 10q21.1 (rs7902708). In conclusion, this GWA study reveals the effect of several genes common to central DXA-derived BMD and heel ultrasound/DXA measures and points to a new genetic locus with potential implications for better understanding of osteoporosis pathophysiology. PMID:24430505

  2. Chronic urticaria.

    PubMed Central

    Burrall, B. A.; Halpern, G. M.; Huntley, A. C.

    1990-01-01

    Urticaria affects 15% to 20% of the population once or more during a lifetime. Chronic urticaria is a frequent recurrent eruption over a period greater than 6 weeks; the cause remains a mystery in more than 75% of cases. Urticaria and angioedema may be produced by immunologic or nonimmunologic means. Urticarial vasculitis, contact urticaria, mastocytosis, physical urticarias, dermatographism, cholinergic urticaria, localized heat urticaria, cold urticaria, aquagenic urticaria, and vibratory angioedema all require specific evaluation and treatment. Chronic idiopathic urticaria is usually controlled by antihistamines; depending on the circadian rhythm of the eruption, sedative or nonsedative antihistamines are prescribed. Some patients will require a combination of H1 and H2 antagonists, or even parenteral corticosteroids. PMID:1970697

  3. Chronic Diseases

    Microsoft Academic Search

    Sharon R. Schatz

    Although diabetes mellitus, cardiovascular disease, and human immunodeficiency virus infection are three separate entities,\\u000a each has causal and non-causal risk factors that are common in the stage 5 chronic kidney disease population. The medical\\u000a nutrition therapies are similar, which emphasize adequate protein and energy intakes, fluid control, and possibly carbohydrate\\u000a and fat modifications. Each patient requires an individualized evaluation, taking

  4. Chronic cough.

    PubMed

    Rai, S P

    2013-05-01

    Chronic cough is often viewed as a difficult clinical problem. It can be physically and psychologically debilitating, occasionally leading to serious complications. Although there are many etiologies, an organized approach including focused history and physical examination, directed testing in select cases, and treatment trials lead to accurate, safe, and cost-effective diagnoses in most patients. Additional symptomatic treatment is frequently beneficial. Occasionally, diagnostic dilemmas, treatment failures, or more serious causative disorders necessitate referral for further testing and management. PMID:24490448

  5. Do Markers of Bone Resorption Add to Bone Mineral Density and Ultrasonographic Heel Measurement for the Prediction of Hip Fracture in Elderly Women? The EPIDOS Prospective Study

    Microsoft Academic Search

    P. Garnero; P. Dargent-Molina; D. Hans; A. M. Schott; G. Bréart; P. J. Meunier; P. D. Delmas

    1998-01-01

    :   We have previously shown that hip bone mineral density (BMD), heel broadband ultrasound attenuation (BUA) and bone resorption\\u000a markers are independent predictors of hip fracture in elderly women. We investigated whether a combination of these three\\u000a parameters could improve the predictive value of a single test in a nested case–control analysis (75 hip fractures and 228\\u000a age-matched controls) of

  6. Papillon-Lefevre syndrome-like presentation in chronic arsenicosis: A rare mimicry

    PubMed Central

    Das, Somak K.; Nath, Tanusree; Ghosal, Anirban; Jana, Chanchal K.

    2012-01-01

    Chronic arsenicosis is a major health and occupational problem in rural parts of West Bengal such as in parts of the Gangetic plain of India. Chronic arsenicosis occurs due to accidental ingestion of repeated amounts of small doses by those working with metal or by taking food or drink in which there are traces of arsenic. Chronic exposure may result accumulation in the hair, nail, and skin. Arsenic can also cross the placenta. Papillon-Lefčvre syndrome is a rare disease characterized by skin lesions caused by palmar-plantar hyperkeratosis and severe periodontal destruction involving both the primary and permanent dentitions. Until date, more than 200 cases have been reported worldwide. Palmoplantar hyperkeratosis is a major manifestation in both chronic arsenicosis and Papillon-Lefčvre syndrome. We report herein a rare case of chronic arsenicosis in a patient from rural Bengal, whose all features mimic Papillon-Lefčvre syndrome. It is probably the first case of Papillon-Lefevre syndrome-like presentation in chronic arsenicosis from India. PMID:23776326

  7. The Achilles' heel of senescent cells: from transcriptome to senolytic drugs.

    PubMed

    Zhu, Yi; Tchkonia, Tamara; Pirtskhalava, Tamar; Gower, Adam C; Ding, Husheng; Giorgadze, Nino; Palmer, Allyson K; Ikeno, Yuji; Hubbard, Gene B; Lenburg, Marc; O'Hara, Steven P; LaRusso, Nicholas F; Miller, Jordan D; Roos, Carolyn M; Verzosa, Grace C; LeBrasseur, Nathan K; Wren, Jonathan D; Farr, Joshua N; Khosla, Sundeep; Stout, Michael B; McGowan, Sara J; Fuhrmann-Stroissnigg, Heike; Gurkar, Aditi U; Zhao, Jing; Colangelo, Debora; Dorronsoro, Akaitz; Ling, Yuan Yuan; Barghouthy, Amira S; Navarro, Diana C; Sano, Tokio; Robbins, Paul D; Niedernhofer, Laura J; Kirkland, James L

    2015-08-01

    The healthspan of mice is enhanced by killing senescent cells using a transgenic suicide gene. Achieving the same using small molecules would have a tremendous impact on quality of life and the burden of age-related chronic diseases. Here, we describe the rationale for identification and validation of a new class of drugs termed senolytics, which selectively kill senescent cells. By transcript analysis, we discovered increased expression of pro-survival networks in senescent cells, consistent with their established resistance to apoptosis. Using siRNA to silence expression of key nodes of this network, including ephrins (EFNB1 or 3), PI3K?, p21, BCL-xL, or plasminogen-activated inhibitor-2, killed senescent cells, but not proliferating or quiescent, differentiated cells. Drugs targeting these same factors selectively killed senescent cells. Dasatinib eliminated senescent human fat cell progenitors, while quercetin was more effective against senescent human endothelial cells and mouse BM-MSCs. The combination of dasatinib and quercetin was effective in eliminating senescent MEFs. In vivo, this combination reduced senescent cell burden in chronologically aged, radiation-exposed, and progeroid Ercc1(-/?) mice. In old mice, cardiac function and carotid vascular reactivity were improved 5 days after a single dose. Following irradiation of one limb in mice, a single dose led to improved exercise capacity for at least 7 months following drug treatment. Periodic drug administration extended healthspan in Ercc1(-/?) mice, delaying age-related symptoms and pathology, osteoporosis, and loss of intervertebral disk proteoglycans. These results demonstrate the feasibility of selectively ablating senescent cells and the efficacy of senolytics for alleviating symptoms of frailty and extending healthspan. PMID:25754370

  8. Quantitative ultrasound measurements at the heel: improvement of short- and mid-term speed of sound precision.

    PubMed

    Daugschies, Melanie; Brixen, Kim; Hermann, Pernille; Rohde, Kerstin; Glüer, Claus-Christian; Barkmann, Reinhard

    2015-03-01

    Calcaneal quantitative ultrasound can be used to predict osteoporotic fracture risk, but its ability to monitor therapy is unclear possibly because of its limited precision. We developed a quantitative ultrasound device (foot ultrasound scanner) that measures the speed of sound at the heel with the aim of minimizing common error sources like the position and penetration angle of the ultrasound beam, as well as the soft tissue temperature. To achieve these objectives, we used a receiver array, mechanics to adjust the beam direction and a foot temperature sensor. In a group of 60 volunteers, short-term precision was evaluated for the foot ultrasound scanner and a commercial device (Achilles Insight, GE Medical, Fairfield, CT, USA?). In a subgroup of 20 subjects, mid-term precision (1-mo follow-up) was obtained. Compared with measurement of the speed of sound with the Achilles Insight, measurement with the foot ultrasound scanner reduced precision errors by half (p < 0.05). The study indicates that improvement of the precision of calcaneal quantitative ultrasound measurements is feasible. PMID:25619776

  9. [Chronic rhinosinusitis].

    PubMed

    Cuevas, M; Zahnert, T

    2015-06-01

    Chronic Rhinosinusitis (CRS) is a common disease with a major impact on quality of life. Its etiology is multifactorial and the causal pathology is an inflammation and not an infection. The affected region is the nasal mucosa as well as the mucosa of the sinuses. The symptoms are nasal obstruction, nasal discharge (anterior/post nasal drip), facial pain or pressure and/or olfactory disorder for more than 12 weeks. Beside association to hereditary or systemic diseases, CRS can be divided in chronic local findings (e.?g. dental origin, muco- or pyocele, local mycosis, choanal polyp) and general CRS. The latter appears as CRS with nasal polyps or without nasal polyps. According to this, nasal endoscopy combined with investigation for the above mentioned symptoms is essential to diagnose CRS. In order to indicate and plan surgical treatment, CT-scans are necessary. Furthermore, diagnostic tools such as allergy tests, olfactory assessment, laboratory and microbiologic examination, biopsies and tests for aspirin hypersensitivity complete the diagnostic pathway of CRS. The therapeutic approach is local and if necessary oral application of steroids, nasal saline douche and oral long term antibiotics. If this conservative therapy leads to no effect, surgical treatment in terms of functional endoscopic sinus surgery (FESS) has to be considered. PMID:26039039

  10. Chronic pancreatitis.

    PubMed

    Braganza, Joan M; Lee, Stephen H; McCloy, Rory F; McMahon, Michael J

    2011-04-01

    Chronic pancreatitis is a progressive fibroinflammatory disease that exists in large-duct (often with intraductal calculi) or small-duct form. In many patients this disease results from a complex mix of environmental (eg, alcohol, cigarettes, and occupational chemicals) and genetic factors (eg, mutation in a trypsin-controlling gene or the cystic fibrosis transmembrane conductance regulator); a few patients have hereditary or autoimmune disease. Pain in the form of recurrent attacks of pancreatitis (representing paralysis of apical exocytosis in acinar cells) or constant and disabling pain is usually the main symptom. Management of the pain is mainly empirical, involving potent analgesics, duct drainage by endoscopic or surgical means, and partial or total pancreatectomy. However, steroids rapidly reduce symptoms in patients with autoimmune pancreatitis, and micronutrient therapy to correct electrophilic stress is emerging as a promising treatment in the other patients. Steatorrhoea, diabetes, local complications, and psychosocial issues associated with the disease are additional therapeutic challenges. PMID:21397320

  11. Chronic Sinusitis

    PubMed Central

    Steinberg, Johannes; Modi, Pradip

    1990-01-01

    Paranasal sinuses, which communicate with the nasal passages through the sinus ostia, are essentially sterile structures, sterility being maintained by a healthy epithelium with normal actively beating cilia. Irritants, including viruses and bacteria, are trapped in mucus and cilia to allow the clearance of sinuses through the natural ostia into the nasal cavity. Interference with this normal physiological function results in inflammation and infection within the sinus cavities. All of the sinuses are subjected to the same environmental as well as physiological stimuli; thus it is uncommon for a single sinus to be infected and for the others to remain entirely normal. Allergic and non-allergic vasomotor rhinitis should be differentiated from chronic bacterial rhinosinusitis. The understanding of these diseases cannot be separated from the physiological function of the sinus mucosa. PMID:21234027

  12. Utilization of the MPI Process for in-tank solidification of heel material in large-diameter cylindrical tanks

    SciTech Connect

    Kauschinger, J.L.; Lewis, B.E.

    2000-01-01

    A major problem faced by the US Department of Energy is remediation of sludge and supernatant waste in underground storage tanks. Exhumation of the waste is currently the preferred remediation method. However, exhumation cannot completely remove all of the contaminated materials from the tanks. For large-diameter tanks, amounts of highly contaminated ``heel'' material approaching 20,000 gal can remain. Often sludge containing zeolite particles leaves ``sand bars'' of locally contaminated material across the floor of the tank. The best management practices for in-tank treatment (stabilization and immobilization) of wastes require an integrated approach to develop appropriate treatment agents that can be safely delivered and mixed uniformly with sludge. Ground Environmental Services has developed and demonstrated a remotely controlled, high-velocity jet delivery system termed, Multi-Point-Injection (MPI). This robust jet delivery system has been field-deployed to create homogeneous monoliths containing shallow buried miscellaneous waste in trenches [fiscal year (FY) 1995] and surrogate sludge in cylindrical (FY 1998) and long, horizontal tanks (FY 1999). During the FY 1998 demonstration, the MPI process successfully formed a 32-ton uniform monolith of grout and waste surrogates in about 8 min. Analytical data indicated that 10 tons of zeolite-type physical surrogate were uniformly mixed within a 40-in.-thick monolith without lifting the MPI jetting tools off the tank floor. Over 1,000 lb of cohesive surrogates, with consistencies similar to Gunite and Associated Tank (GAAT) TH-4 and Hanford tank sludges, were easily intermixed into the monolith without exceeding a core temperature of 100 F during curing.

  13. Native American lithic procurement along the international border in the boot heel region of southwestern New Mexico

    NASA Astrophysics Data System (ADS)

    Zeigler, K. E.; Hughes, C.; Kurota, A.; Hogan, P.

    2010-12-01

    Multidisciplinary field projects can be very useful to a more fundamental understanding of the world around us, though these projects are not as common as they should be. In particular, the combination of archeology and geology combines our understanding of human behavior and human use of the landscape with an intimate knowledge of geologic processes and the materials available for human use in order to gain a broader understanding of human-Earth interaction. Here we present data from a cross-disciplinary project that uses a common dataset, archeological artifacts, to explore the anthropological and geologic implications of useage patterns. Archeological excavations and surveys conducted by the Office of Contract Archeology in 2007 along the route of the proposed international border fence reveal patterns of use of geologic materials by Archaic, Formative and Protohistoric Native Americans in the Boot Heel of southwestern New Mexico. Thousands of artifacts were recorded in multiple sites from Guadalupe Pass in the southern Peloncillo Mountains to the Carrizalillo Hills west of Columbus. We identified the lithologies of artifacts, ranging from projectile points to groundstones, and then constructed material movement maps based on either known procurement sites ("quarries") or outcrops identified as the closest source to a given site for each lithology. Not unexpectedly, the majority of the rock types utilized by native peoples are local siliceous volcanic materials. However, several artifacts constructed from obsidian were transported into the region from northern Mexico and eastern Arizona, indicating long-distance travel and/or trade routes. We also examine useage pattern difference between Archaic, Formative and Protohistoric sites. Additionally, a dramatic change in distribution of sources for geologic materials occurs between one pre-Spanish site and one post-Spanish site that are adjacent to one another.

  14. Native American lithic procurement along the international border in the boot heel region of southwestern New Mexico

    NASA Astrophysics Data System (ADS)

    Zeigler, K. E.; Hogan, P.; Hughes, C.; Kurota, A.

    2011-06-01

    Multidisciplinary field projects can be very useful to a more fundamental understanding of the world around us, though these projects are not as common as they should be. In particular, the combination of archeology and geology combines our understanding of human behavior and human use of the landscape with an intimate knowledge of geologic processes and the materials available for human use in order to gain a broader understanding of human-Earth interaction. Here we present data from a cross-disciplinary project that uses a common dataset, archeological artifacts, to explore the anthropological and geologic implications of useage patterns. Archeological excavations and surveys conducted by the Office of Contract Archeology in 2007 along the route of the proposed international border fence reveal patterns of use of geologic materials by Archaic, Formative and Protohistoric Native Americans in the Boot Heel of southwestern New Mexico. Thousands of artifacts were recorded in multiple sites from Guadalupe Pass in the southern Peloncillo Mountains to the Carrizalillo Hills west of Columbus. We identified the lithologies of artifacts, ranging from projectile points to groundstones, and then constructed material movement maps based on either known procurement sites ("quarries") or outcrops identified as the closest source to a given site for each lithology. Not unexpectedly, the majority of the rock types utilized by native peoples are local siliceous volcanic materials. However, several artifacts constructed from obsidian were transported into the region from northern Mexico and eastern Arizona, indicating long-distance travel and/or trade routes. We also examine useage pattern difference between Archaic, Formative and Protohistoric sites. Additionally, a dramatic change in distribution of sources for geologic materials occurs between one pre-Spanish site and one post-Spanish site that are adjacent to one another.

  15. Cost-effectiveness of cryotherapy versus salicylic acid for the treatment of plantar warts: economic evaluation alongside a randomised controlled trial (EVerT trial)

    PubMed Central

    2012-01-01

    Abstract Background Plantar warts (verrucae) are extremely common. Although many will spontaneously disappear without treatment, treatment may be sought for a variety of reasons such as discomfort. There are a number of different treatments for cutaneous warts, with salicylic acid and cryotherapy using liquid nitrogen being two of the most common forms of treatment. To date, no full economic evaluation of either salicylic acid or cryotherapy has been conducted based on the use of primary data in a pragmatic setting. This paper describes the cost-effectiveness analysis which was conducted alongside a pragmatic multicentre, randomised trial evaluating the clinical effectiveness of cryotherapy versus 50% salicylic acid of the treatment of plantar warts. Methods A cost-effectiveness analysis was undertaken alongside a pragmatic multicentre, randomised controlled trial assessing the clinical effectiveness of 50% salicylic acid and cryotherapy using liquid nitrogen at 12 weeks after randomisation of patients. Cost-effectiveness outcomes were expressed as the additional cost required to completely cure the plantar warts of one additional patient. A NHS perspective was taken for the analysis. Results Cryotherapy costs on average Ł101.17 (bias corrected and accelerated (BCA) 95% CI: 85.09-117.26) more per participant over the 12 week time-frame, while there is no additional benefit, in terms of proportion of patients healed compared with salicylic acid. Conclusions Cryotherapy is more costly and no more effective than salicylic acid. Trial registration Current Controlled Trials ISRCTN18994246 [controlled-trials.com] and National Research Register N0484189151. PMID:22369511

  16. Use of split thickness plantar skin grafts in the treatment of hyperpigmented skin-grafted fingers and palms in previously burned patients.

    PubMed

    Moon, Suk-Ho; Lee, So-Young; Jung, Sung-No; Kim, Sang-Wha; Seo, Bommie F; Kwon, Ho; Sohn, Won-Il

    2011-06-01

    Palmar and finger burns are often seen in children, and are usually as a result of contact burns. Some patients with deep hand burns are treated with full-thickness or split-thickness skin grafts. Skin graft is commonly used for hand reconstruction. However, the grafted skin would be more pigmented than the adjacent skin and different from skin texture. 19 patients who showed hyperpigmentation after skin graft of finger and palm were treated. They all were injured by hand burns. We performed mechanical dermabrasion of the hyperpigmentation scar and application of a split thickness skin harvested from medial aspect of plantar of foot. Patients were asked about their level of satisfaction with the procedure and scar appearance was assessed using a five-point Likert scale. Also scar appearances were assessed using a Vancouver Scar Scale (VSS). The grafts were completely taken in all 19 patients. The color of the graft became similar to adjacent tissue. 15 patients were very satisfied, and four patients were relatively satisfied. The average score of the patients postoperative appearance improvement was 4.5 (improved to significantly improved postoperative appearance). Average VSS score was improved from 9.53 to 2.53. There was no hypertrophic scar on plantar donor site. The technique of the split-thickness plantar skin graft after mechanical dermabrasion is simple and provided good results in both color and texture for the patients who showed hyperpigmentation after grafting. PMID:21316154

  17. Hereditary chronic pancreatitis

    Microsoft Academic Search

    Jonas Rosendahl; Hans Bödeker; Joachim Mössner; Niels Teich

    2007-01-01

    Hereditary chronic pancreatitis (HCP) is a very rare form of early onset chronic pancreatitis. With the exception of the young age at diagnosis and a slower progression, the clinical course, morphological features and laboratory findings of HCP do not differ from those of patients with alcoholic chronic pancreatitis. As well, diagnostic criteria and treatment of HCP resemble that of chronic

  18. Patterns of physical activity and ultrasound attenuation by heel bone among Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk): population based study

    PubMed Central

    Jakes, Rupert W; Khaw, Kay-Tee; Day, Nicholas E; Bingham, Sheila; Welch, Ailsa; Oakes, Suzy; Luben, Robert; Dalzell, Nicola; Reeve, Jonathan; Wareham, Nicholas J

    2001-01-01

    Objectives To study associations between patterns of physical activity and ultrasound attenuation by the heel bone in men and women. Design Cross sectional, population based study. Setting Norfolk. Participants 2296 men and 2914 women aged 45-74 registered with general practices participating in European Prospective Investigation into Cancer (EPIC Norfolk). Results Self reported time spent in high impact physical activity was strongly and positively associated with ultrasound attenuation by the heel bone, independently of age, weight, and other confounding factors. Men who reported participating in ?2 hours/week of high impact activity had 8.44 dB/MHz (95% confidence interval 4.49 to 12.40) or 9.5%, higher ultrasound attenuation than men who reported no activity of this type. In women, the difference in ultrasound attenuation between those reporting any high impact activity and those reporting none was 2.41 dB/MHz (0.45 to 4.37) or 3.4% higher. In women this effect was similar in size to that of an age difference of four years. Moderate impact activity had no effect. However, climbing stairs was strongly independently associated with ultrasound attenuation in women (0.64 dB/MHz (0.19 to 1.09) for each additional five flights of stairs). There was a significant negative association in women between time spent watching television or video and heel bone ultrasound attenuation, which decreased by 0.08 dB/MHz (0.02 to 0.14) for each additional hour of viewing a week. Conclusions High impact physical activity is independently associated with ultrasound attenuation by the heel bone in men and women. As low ultrasound attenuation has been shown to predict increased risk of hip fracture, interventions to promote participation in high impact activities may help preserve bone density and reduce the risk of fracture. However, in older people such interventions may be inappropriate as they could increase the likelihood of falls. PMID:11159572

  19. The validity and reliability of a portable slip meter for determining floor slipperiness during simulated heel strike.

    PubMed

    Grönqvist, Raoul; Hirvonen, Mikko; Rajamäki, Erkki; Matz, Simon

    2003-03-01

    A previously developed test rig was used as starting point for designing a portable slip meter with two new features. First, an inflatable pneumatic test wheel, consisting of six slider units, was introduced as the impacting contact element relative to floor surface. Second, an inductive trigger was built into the system to facilitate a precise timing of the slider-floor contact during the test. This new test rig was designed to measure transitional friction properties of contaminated floor surfaces during simulated heel strike, which is considered the most critical phase of gait from the slip and fall point of view. Another objective was to quantify the validity and reliability of this test method in the laboratory, but not yet in the field. The measurement process was evaluated on eight wet and oily floor surfaces (vinyl and ceramic tile floorings) using two slider materials (plain, profiled), two normal loads (100, 200 N), and two sliding velocities (0.15, 0.30 m/s) as independent variables. The outputs of the portable slip meter, in terms of transitional friction coefficients, were compared to force platform-based friction values and to slip resistance values obtained with a slip simulator apparatus for laboratory testing of shoes and floor surfaces. The outputs were also evaluated against slipperiness ratings made by three male subjects in paired comparison trials, in which the subjects walked over eight wet floor surfaces wearing shoes with the plain soling material. The results showed that test option 200 N and 0.15m/s led to optimum validity despite its tendency to promote frictional vibrations (stick-slip) in the contact surface. Compared to the lower sliding speed, the higher speed reduced both stick-slip and measurement bias. Test option 200 N and 0.30 m/s was the most reliable one in this experiment. It yielded lower friction coefficients than any other test option and reduced the likelihood of underestimating slip and fall hazards. The results implied that the minimum friction coefficient was 0.25 for preventing a fall on wet floor surfaces, whereas the limit for preventing a slip was in the range 0.30-0.35. Transitional friction measurement was found to be a valid and reliable indicator for slip resistance. A more accurate control of the normal force during testing is needed for actual field use of the test method. PMID:12504142

  20. Pathogenesis of canine interdigital palmar and plantar comedones and follicular cysts, and their response to laser surgery.

    PubMed

    Duclos, David D; Hargis, Ann M; Hanley, Patrick W

    2008-06-01

    This study documents the presence of comedones and follicular cysts of palmar and plantar interdigital skin as an underlying cause of recurrent dermatitis, and describes the use of a carbon dioxide laser to surgically remove lesions. The 28 dogs included in the study had: (i) recurrent lameness, pain, and nodules, or draining sinuses in the dorsal interdigital skin, (ii) failed to respond to antibiotic therapy, and (iii) were negative for Demodex mites and dermatophytes. All 28 had laser surgery; nine dogs had two surgical procedures and two dogs had three surgical procedures for lesion recurrence. Fifteen dogs had skin samples collected for histopathology. Clinical features in ventral interdigital skin included alopecia, callus-like thickening, and comedones. Histological features included hyperkeratosis, acanthosis, comedones and follicular cysts, furunculosis, draining sinuses, and scarring. Surface trauma to the ventral interdigital skin appeared to contribute to lesion development. Laser surgery allowed removal of multiple layers of cysts and adjacent hair follicles and the tracking and removal of sinuses. One dog was euthanized for orthopaedic lameness 1 month after laser surgery, but post-surgical follow-up (1.0-8.0 years - mean 3 years) from the remaining 27 dogs revealed that laser therapy of affected skin and adjacent hair follicles resulted in resolution of interdigital lesions in 25. Two dogs continued to develop interdigital cysts. PMID:18477329

  1. Acute effects of 5 min of plantar flexor static stretching on balance and gait in the elderly.

    PubMed

    Han, Min-Jung; Yuk, Goon-Chang; Gak, Hwangbo; Suh, Soon-Rim; Kim, Seong-Gil

    2014-01-01

    [Purpose] The purpose of this study was to examine the acute effects of five minutes of plantar flexor static stretching (PSS) on the balance and gait of the elderly. [Subjects and Methods] Twenty-five subjects aged 65?years and above performed 5?min of PSS in the form of wedge board standing. The sway length of each subject's center of mass was measured to examine the subject's static balance. It was measured by one minute of quiet standing with the eyes closed. Functional reach tests (FRTs), timed up and go tests (TUGs), and 10-meter walk tests (10MWTs) were performed to examine dynamic balance and gait before and after PSS. [Results] The outcome showed significant increases in sway distances (6.55 ± 5.03?cm) after stretching. However, in the FRTs, TUGs, and 10MWTs, the reach distance and time did not show any significant changes. [Conclusion] These results suggest that the elderly subjects temporarily experienced difficulties in maintaining balance immediately after the PSS but that their dynamic balance and gait were not adversely affected after a short period of time. Therefore, to prevent falls and perform exercises in a safe way, it is recommended to allow patients to rest after performing PSS. PMID:24567692

  2. Fetal and postnatal development of palmar, plantar, and digital pads, and flexion creases of the rat (Rattus norvegicus).

    PubMed

    Kimura, S; Schaumann, B A; Shiota, K

    1996-05-01

    Fetal development of the hands and feet of rats was investigated to determine the feasibility of using rats as an experimental model for studying the factors influencing early development of the hands and feet, and especially the dermatoglyphics in humans. Eighty rats fetuses of 14-21 days gestational age and 80 newborn rats of 0-7 days of age were used to study the morphological features of the palmar, plantar, and digital areas and to determine the timing of appearance and the location of the volar pads and flexion creases. Comparisons between analoguous developmental stages of rat and human fetuses demonstrate striking similarities in overall fetal development. Marked differences, however, were found between rat and human fetuses in the timing of developmental milestones and in some morphological features. The results indicate that rats can serve as a useful experimental model in studies of the utility of the epidermal ridge configurations and flexion creases in medical disorders, provided that the differences in the timing of development are taken into consideration. PMID:8935911

  3. Long-Term Efficacy of Oxybutynin for Palmar and Plantar Hyperhidrosis in Children Younger than 14 Years.

    PubMed

    Wolosker, Nelson; Teivelis, Marcelo P; Krutman, Mariana; de Paula, Rafael P; Schvartsman, Claudio; Kauffman, Paulo; de Campos, José R M; Puech-Leăo, Pedro

    2014-12-10

    Oxybutynin for treating hyperhidrosis in children has been evaluated only in short-term studies. We aimed to investigate the long-term effects of oxybutynin in treating children with palmar and plantar hyperhidrosis who had not undergone surgery and who were monitored for at least 6 months (median 19.6 mos). A cohort of 97 patients was evaluated retrospectively, with particular attention to 59 children (ages 4-14 yrs) who were treated for longer than 6 months. Their quality of life (QOL) was evaluated using a validated clinical questionnaire before and after 6 weeks of pharmacologic therapy. A self-assessment of hyperhidrosis was performed after 6 weeks and after the last consultation. By their final office visit, more than 91% of the children with hyperhidrosis treated with oxybutynin experienced moderate or great improvement in their level of sweating and 94.9% experienced improvement in QOL. More than 90% of children reported improvement of hyperhidrosis at other sites. Dry mouth was the most common side effect. Oxybutynin appears to be an effective treatment option for children with hyperhidrosis, and positive results are maintained over the long term (median 19.6 mos). PMID:25490865

  4. Leg soft tissue position and velocity data from skin markers can be obtained with good to acceptable reliability following heel impacts.

    PubMed

    Brydges, Evan A; Burkhart, Timothy A; Altenhof, William J; Andrews, David M

    2015-08-01

    Quantifying soft tissue motion following impact is important in human motion analysis as soft tissues attenuate potentially injurious forces resulting from activities such as running and jumping. This study determined the reliability of leg soft tissue position and velocity following heel impacts. A grid of black dots was applied to the skin of the right leg and foot (n = 20). Dots were automatically detected (ProAnalyst(®)) from high-speed records of pendulum and drop impacts. Three trained measurers selected columns of dots on each participant for analysis; one measurer 6 months later. Between- and within-measurer differences in kinematic variables were all relatively small (<0.8 cm for position; <3.7 cm/s for velocity) between-measurers and (<0.5 cm for position; <2.6 cm/s for velocity) within-measurer. Good (coefficients of variation (CV) ? 10%) to acceptable (CV > 10% and ?20%) reliability was shown for 95% of the position measures, with mean CVs of 10% and 11% within-measurers and between-measures, respectively. Velocity measures were less reliable; 40% of the measures showed good to marginal (CV > 20% and ?30%) reliability. This study established that leg soft tissue position data from skin markers could be obtained with good to acceptable reliability following heel impacts. Velocity data were less reliable but still acceptable in many cases. PMID:25626597

  5. Stages of Chronic Lymphocytic Leukemia

    MedlinePLUS

    ... ALL Treatment Childhood AML Treatment Research Chronic Lymphocytic Leukemia Treatment (PDQ®) General Information About Chronic Lymphocytic Leukemia Key Points Chronic lymphocytic leukemia is a type ...

  6. High Heel Dangers

    MedlinePLUS Videos and Cool Tools

    ... reading – health news for healthier living. Related MedlinePlus Health Topics Foot Injuries and Disorders About MedlinePlus Site ... Rockville Pike, Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page ...

  7. 5-HT2 and 5-HT7 receptor agonists facilitate plantar stepping in chronic spinal rats through actions on different populations of spinal neurons

    PubMed Central

    S?awi?ska, Urszula; Miazga, Krzysztof; Jordan, Larry M.

    2014-01-01

    There is considerable evidence from research in neonatal and adult rat and mouse preparations to warrant the conclusion that activation of 5-HT2 and 5-HT1A/7 receptors leads to activation of the spinal cord circuitry for locomotion. These receptors are involved in control of locomotor movements, but it is not clear how they are implicated in the responses to 5-HT agonists observed after spinal cord injury. Here we used agonists that are efficient in promoting locomotor recovery in paraplegic rats, 8-hydroxy-2-(di-n-propylamino)-tetralin (8-OHDPAT) (acting on 5-HT1A/7 receptors) and quipazine (acting on 5-HT2 receptors), to examine this issue. Analysis of intra- and interlimb coordination confirmed that the locomotor performance was significantly improved by either drug, but the data revealed marked differences in their mode of action. Interlimb coordination was significantly better after 8-OHDPAT application, and the activity of the extensor soleus muscle was significantly longer during the stance phase of locomotor movements enhanced by quipazine. Our results show that activation of both receptors facilitates locomotion, but their effects are likely exerted on different populations of spinal neurons. Activation of 5-HT2 receptors facilitates the output stage of the locomotor system, in part by directly activating motoneurons, and also through activation of interneurons of the locomotor central pattern generator (CPG). Activation of 5-HT7/1A receptors facilitates the activity of the locomotor CPG, without direct actions on the output components of the locomotor system, including motoneurons. Although our findings show that the combined use of these two drugs results in production of well-coordinated weight supported locomotion with a reduced need for exteroceptive stimulation, they also indicate that there might be some limitations to the utility of combined treatment. Sensory feedback and some intraspinal circuitry recruited by the drugs can conflict with the locomotor activation. PMID:25191231

  8. Depression and Chronic Illness

    MedlinePLUS

    ... related to increased symptoms of depression. Examples of chronic illness include: • heart disease • Parkinson’s disease • multiple sclerosis • stroke • ... not be dismissed as a “normal” reaction to chronic illness, but it is common. Depression is a problem ...

  9. Understanding Chronic Bronchitis

    MedlinePLUS

    ... that 9.9 million Americans reported a physician diagnosis of chronic bronchitis. A person with chronic bronchitis also may develop emphysema. These two conditions together are commonly referred to ...

  10. Chronic thyroiditis (Hashimoto disease)

    MedlinePLUS

    Hashimoto thyroiditis; Chronic lymphocytic thyroiditis; Autoimmune thyroiditis ... Chronic thyroiditis or Hashimoto disease is a common thyroid gland disorder. It can occur at any age, but is most often seen in ...

  11. What Is Chronic Myeloid Leukemia?

    MedlinePLUS

    ... about chronic myeloid leukemia? What is chronic myeloid leukemia? Chronic myeloid leukemia (CML), also known as chronic ... is the same as for adults. What is leukemia? Leukemia is a cancer that starts in the ...

  12. Sleep and chronic pain

    Microsoft Academic Search

    Jeanetta C Rains; Donald B Penzien

    2003-01-01

    Objective: The ?-EEG sleep anomaly has been associated with chronic benign pain syndromes. Although controversial, the anomaly is believed by some to be an important biologic correlate of certain otherwise poorly explained painful conditions (e.g., fibromyalgia and chronic fatigue syndrome). To shed further light on this phenomenon, this study compared the sleep and psychological characteristics of chronic pain patients who

  13. Chronic pain in adults.

    PubMed

    Ostler, Anneli

    2015-06-10

    Reading the CPD article helped improve my understanding of the importance of identifying chronic pain. Chronic pain may occur on its own or as a feature of other chronic conditions, and it may be nociceptive or neuropathic, or a combination of the two. PMID:26058654

  14. Treatment of plantar fasciitis by LowDye taping and iontophoresis: short term results of a double blinded, randomised, placebo controlled clinical trial of dexamethasone and acetic acid

    PubMed Central

    Osborne, H R; Allison, G T

    2006-01-01

    Objectives To determine if, in the short term, acetic acid and dexamethasone iontophoresis combined with LowDye (low?Dye) taping are effective in treating the symptoms of plantar fasciitis. Methods A double blinded, randomised, placebo controlled trial of 31 patients with medial calcaneal origin plantar fasciitis recruited from three sports medicine clinics. All subjects received six treatments of iontophoresis to the site of maximum tenderness on the plantar aspect of the foot over a period of two weeks, continuous LowDye taping during this time, and instructions on stretching exercises for the gastrocnemius/soleus. They received 0.4% dexamethasone, placebo (0.9% NaCl), or 5% acetic acid. Stiffness and pain were recorded at the initial session, the end of six treatments, and the follow up at four weeks. Results Data for 42 feet from 31 subjects were used in the study. After the treatment phase, all groups showed significant improvements in morning pain, average pain, and morning stiffness. However for morning pain, the acetic acid/taping group showed a significantly greater improvement than the dexamethasone/taping intervention. At the follow up, the treatment effect of acetic acid/taping and dexamethasone/taping remained significant for symptoms of pain. In contrast, only acetic acid maintained treatment effect for stiffness symptoms compared with placebo (p ?=? 0.031) and dexamethasone. Conclusions Six treatments of acetic acid iontophoresis combined with taping gave greater relief from stiffness symptoms than, and equivalent relief from pain symptoms to, treatment with dexamethasone/taping. For the best clinical results at four weeks, taping combined with acetic acid is the preferred treatment option compared with taping combined with dexamethasone or saline iontophoresis. PMID:16488901

  15. Changes in length of the plantar aponeurosis during the stance phase of gait--an in vivo dynamic fluoroscopic study.

    PubMed

    Fessel, G; Jacob, H A C; Wyss, Ch; Mittlmeier, Th; Müller-Gerbl, M; Büttner, A

    2014-12-01

    In locomotion, ligaments and muscles have been recognized to support the arch of the foot. However, it remains unclear to what extent the passive and active structures of the lower extremity support the longitudinal arch of the foot during walking. In this study, the mechanical function of the plantar aponeurosis (PA) is investigated by elongation measurements in vivo during the stance phase of gait, in combination with measurements of the mechanical properties of the PA in vitro. Fluoroscopy was used to measure the dynamic changes in PA length and the angular motion of the metatarsophalangeal joint of the first ray, measured during the stance phase (StPh) in 11 feet. Simultaneously, ground forces were measured. Additionally, four cadaver feet delivered topographic information relating to the PA, and three autopsy specimens of PA served to determine the in vitro mechanical properties of PA. The present study revealed a non-significant peak average PA shortening of 0.48% at about 32.5% StPh, followed by a significant average peak elongation of 3.6% at 77.5% StPh. This average peak elongation of 3.6% corresponds to a force of 292N, as estimated by mechanical testing of the autopsy PA specimens. Considering the maximum peak elongation measured in one volunteer of 4.8% at 76% StPh, a peak PA load of 488N might be expected. Hence, with an average body weight of 751N, as allocated to the 11 investigated feet, this maximum peak force would correspond to about 0.65×body weight. As far as we are aware, this is the first report on a dynamic fluoroscopic study of the PA in gait with an appreciable number of feet (11 feet). In conclusion, muscles contribute to support of the longitudinal arch of the foot and can possibly relax the PA during gait. The 'windlass effect' for support of the arch in this context is therefore questionable. PMID:25113063

  16. Predicting Complete Ground Reaction Forces and Moments During Gait With Insole Plantar Pressure Information Using a Wavelet Neural Network.

    PubMed

    Sim, Taeyong; Kwon, Hyunbin; Oh, Seung Eel; Joo, Su-Bin; Choi, Ahnryul; Heo, Hyun Mu; Kim, Kisun; Mun, Joung Hwan

    2015-09-01

    In general, three-dimensional ground reaction forces (GRFs) and ground reaction moments (GRMs) that occur during human gait are measured using a force plate, which are expensive and have spatial limitations. Therefore, we proposed a prediction model for GRFs and GRMs, which only uses plantar pressure information measured from insole pressure sensors with a wavelet neural network (WNN) and principal component analysis-mutual information (PCA-MI). For this, the prediction model estimated GRFs and GRMs with three different gait speeds (slow, normal, and fast groups) and healthy/pathological gait patterns (healthy and adolescent idiopathic scoliosis (AIS) groups). Model performance was validated using correlation coefficients (r) and the normalized root mean square error (NRMSE%) and was compared to the prediction accuracy of the previous methods using the same dataset. As a result, the performance of the GRF and GRM prediction model proposed in this study (slow group: r?=?0.840-0.989 and NRMSE%?=?10.693-15.894%; normal group: r?=?0.847-0.988 and NRMSE% =?10.920-19.216%; fast group: r?=?0.823-0.953 and NRMSE%?=?12.009-20.182%; healthy group: r?=?0.836-0.976 and NRMSE%?=?12.920-18.088%; and AIS group: r?=?0.917-0.993 and NRMSE%?=?7.914-15.671%) was better than that of the prediction models suggested in previous studies for every group and component (p?

  17. Influence of musculo-tendinous stiffness of the plantar ankle flexor muscles upon maximal power output on a cycle ergometre.

    PubMed

    Driss, Tarak; Lambertz, Daniel; Rouis, Majdi; Vandewalle, Henry

    2012-11-01

    The importance of maximal voluntary torque (T (MVC)), maximal rate of torque development (MRTD) and musculo-tendinous stiffness of the triceps surae for maximal power output on a cycle ergometre (Pmax) was studied in 21 healthy subjects by studying the relationships between maximal cycling power related to body mass (Pmax BM(-1)) with T (MVC), MRTD and different indices of musculo-tendinous stiffness of the ankle flexor. Pmax BM(-1) was calculated from the data of an all-out force-velocity test on a Monark cycle ergometre. T (MVC) and MRTD were measured on a specific ankle ergometre. Musculo-tendinous stiffness was estimated by means of quick releases at 20, 40, 60 and 80% T (MVC) on the same ankle ergometre. Pmax BM(-1) was significantly and positively correlated with MRTD related to body mass but the positive correlation between Pmax BM(-1) and T (MVC) did not reach the significance level (0.05). Pmax BM(-1) was significantly and positively correlated with the estimation of stiffness at 40% T (MVC) (S(0.4)), but not with stiffness at 20, 60 and 80% T (MVC). The results of the present study suggest that maximal power output during cycling is significantly correlated with the level of musculo-tendinous stiffness which corresponds to torque range around peak torque at optimal pedal rate. However, the low coefficient of determination (r2 = 0.203) between Pmax BM(-1) and S (0.4) BM(-1) suggested that Pmax BM(-1) largely depended on other factors than the musculo-tendinous stiffness of the only plantar flexors. PMID:22354446

  18. Adherence to Wearing Prescription Custom-Made Footwear in Patients With Diabetes at High Risk for Plantar Foot Ulceration

    PubMed Central

    Waaijman, Roelof; Keukenkamp, Renske; de Haart, Mirjam; Polomski, Wojtek P.; Nollet, Frans; Bus, Sicco A.

    2013-01-01

    OBJECTIVE Prescription custom-made footwear can only be effective in preventing diabetic foot ulcers if worn by the patient. Particularly, the high prevalence of recurrent foot ulcers focuses the attention on adherence, for which objective data are nonexisting. We objectively assessed adherence in patients with high risk of ulcer recurrence and evaluated what determines adherence. RESEARCH DESIGN AND METHODS In 107 patients with diabetes, neuropathy, a recently healed plantar foot ulcer, and custom-made footwear, footwear use was measured during 7 consecutive days using a shoe-worn, temperature-based monitor. Daily step count was measured simultaneously using an ankle-worn activity monitor. Patients logged time away from home. Adherence was calculated as the percentage of steps that prescription footwear was worn. Determinants of adherence were evaluated in multivariate linear regression analysis. RESULTS Mean ± SD adherence was 71 ± 25%. Adherence at home was 61 ± 32%, over 3,959 ± 2,594 steps, and away from home 87 ± 26%, over 2,604 ± 2,507 steps. In 35 patients with low adherence (<60%), adherence at home was 28 ± 24%. Lower BMI, more severe foot deformity, and more appealing footwear were significantly associated with higher adherence. CONCLUSIONS The results show that adherence to wearing custom-made footwear is insufficient, particularly at home where patients exhibit their largest walking activity. This low adherence is a major threat for reulceration. These objective findings provide directions for improvement in adherence, which could include prescribing specific off-loading footwear for indoors, and they set a reference for future comparative research on footwear adherence in diabetes. PMID:23321218

  19. Age-related greater Achilles tendon compliance is not associated with larger plantar flexor muscle fascicle strains in senior women

    PubMed Central

    Csapo, R.; Malis, V.; Hodgson, J.

    2014-01-01

    The aim of the present study was to test the hypothesis that the age-associated decrease of tendon stiffness would necessitate greater muscle fascicle strains to produce similar levels of force during isometric contraction. Greater fascicle strains could force sarcomeres to operate in less advantageous regions of their force-length and force-velocity relationships, thus impairing the capacity to generate strong and explosive contractions. To test this hypothesis, sagittal-plane dynamic velocity-encoded phase-contrast magnetic resonance images of the gastrocnemius medialis (GM) muscle and Achilles tendon (AT) were acquired in six young (YW; 26.1 ± 2.3 yr) and six senior (SW; 76.7 ± 8.3 yr) women during submaximal isometric contraction (35% maximum voluntary isometric contraction) of the plantar flexor muscles. Multiple GM fascicle lengths were continuously determined by automatically tracking regions of interest coinciding with the end points of muscle fascicles evenly distributed along the muscle's proximo-distal length. AT stiffness and Young's modulus were measured as the slopes of the tendon's force-elongation and stress-strain curves, respectively. Despite significantly lower AT stiffness at older age (YW: 120.2 ± 52.3 N/mm vs. SW: 53.9 ± 44.4 N/mm, P = 0.040), contraction-induced changes in GM fascicle lengths were similar in both age groups at equal levels of absolute muscular force (4–5% fascicle shortening in both groups), and even significantly larger in YW (YW: 11–12% vs. SW: 6–8% fascicle shortening) at equal percentage of maximum voluntary contraction. These results suggest that factors other than AT stiffness, such as age-associated changes in muscle composition or fascicle slack, might serve as compensatory adaptations, limiting the degree of fascicle strains upon contraction. PMID:24505104

  20. [Quantification of gait using insole type foot pressure monitor : clinical application for chronic hemiplegia].

    PubMed

    Naito, Yutaro; Kimura, Yoshiko; Hashimoto, Takashi; Mori, Masao; Takemoto, Yoshimi

    2014-03-01

    Home-based stroke hemiplegia patients tend to fall easily. Poor toe clearance is reported to be one of the causes of falling, although there are many other related factors. We developed a low-priced insole type portable foot pressure measurement device, and measured the foot pressure distribution and the foot pressure-time curve of 20 chronic hemiplegia patients and compared them with 36 healthy controls. We also analyzed the outdoor gait of a chronic hemiplegia patient on flat ground, on rough terrain, walking up stairs and on a downward slope. The result was that the load rate of the unaffected heel was significantly increased in hemiplegic gait, and there was a significant negative correlation between the affected side stance phase rate and gait time for 10 m distance (r = -0.73, P < 0.01). The primary role of the unaffected side and the poor toe clearance on the affected side were assured in the uneven ground gait, and it was suggested that chronic hemiplegia patients tend to be highly dependent on their unaffected side during indoor and outdoor gait. PMID:24633184

  1. Chronic Idiopathic Diarrhea

    Microsoft Academic Search

    Lawrence R. Schiller

    \\u000a Chronic diarrhea is defined as passage of loose stools for more than 4 weeks. In most instances the cause of chronic diarrhea\\u000a can be discovered and treated effectively. A few less common causes also play a role: laxative abuse, small bowel bacterial\\u000a overgrowth, and even bile acid malabsorption. Rarer syndromes account for a much smaller percentage of chronic diarrheas but

  2. Nonoperative, dynamic treatment of acute achilles tendon rupture: influence of early weightbearing on biomechanical properties of the plantar flexor muscle-tendon complex-a blinded, randomized, controlled trial.

    PubMed

    Barfod, Kristoffer Weisskirchner; Bencke, Jesper; Lauridsen, Hanne Bloch; Dippmann, Christian; Ebskov, Lars; Troelsen, Anders

    2015-01-01

    Acute Achilles tendon rupture alters the biomechanical properties of the plantar flexor muscle-tendon complex that can affect functional performance and the risk of repeat injury. The purpose of the present study was to compare the biomechanical properties of the plantar flexor muscle-tendon complex in patients randomized to early weightbearing or non-weightbearing in the nonoperative treatment of Achilles tendon rupture. A total of 60 patients were randomized to full weightbearing from day 1 of treatment or non-weightbearing for 6 weeks. After 6 and 12 months, the peak passive torque at 20° dorsiflexion, the stiffness during slow stretching, and the maximal strength were measured in both limbs. The stiffness of the plantar flexor muscle-tendon complex in the terminal part of dorsiflexion was significantly increased (p = .024) in the non-weightbearing group at 12 months. The peak passive torque was significantly lower for the affected limb at 6 months (91%; p = .01), and the stiffness was significantly lower for the affected limb during the early part of dorsiflexion at 6 (67%; p < .001) and 12 (77%; p < .001) months. In conclusion, an increased stiffness of the plantar flexor muscle-tendon complex in the terminal part of dorsiflexion was found in the non-weightbearing group. The altered stiffness and strength in the affected limb could affect the coordination of gait and running. PMID:25618802

  3. Targeting the Achilles heel of the hepatitis B virus: a review of current treatments against covalently closed circular DNA.

    PubMed

    Ahmed, Marawan; Wang, Feng; Levin, Aviad; Le, Connie; Eltayebi, Yomna; Houghton, Michael; Tyrrell, Lorne; Barakat, Khaled

    2015-05-01

    Chronic infection with hepatitis B virus (HBV) often leads to the development of liver cancer and cirrhosis, creating immense sociological, clinical and economic burdens worldwide. Although current anti-HBV medications manage to control the disease progression and help restore normal liver functions, they often fail to eliminate the virus completely. A major reason for this failure is the presence of a stable viral genome in the hepatocyte nucleus: the covalently closed circular DNA (cccDNA). Targeting HBV cccDNA is a promising approach that could lead to a complete cure. Here, we review various research approaches that are directed toward eliminating HBV cccDNA. This is a brief, yet comprehensive, summary of current state-of-the-art developments in this emerging area of interest. PMID:25622780

  4. INFLUĘNCIA GENÉTICA NA DEGENERAÇĂO DO DISCO INTERVERTEBRAL RETROSPECTIVE STUDY OF SURGERY TREATMENT IN MORTONS NEUROMA BY PLANTAR APPROACH

    Microsoft Academic Search

    Rua Cristóvăo Colombo

    SUMMARY Disorders affecting musculoskeletal system affect hundreds of millions individuals worldwide and are one of the most common causes of disability and chronic suffering. The degenerative vertebral disease is an exacerbation of the aging process, and genetic and environmental factors, as well as traumatic injuries, deformities and pre-existent diseases may be involved. Much has been discussed about the many factors

  5. Chronic Disease Indicators

    NSDL National Science Digital Library

    Center for Disease Control

    The Chronic Disease Indicators (CDI) is a cross-cutting set of 97 indicators that were developed by consensus and that allows states and territories and large metropolitan areas to uniformly define, collect, and report chronic disease data that are important to public health practice and available for states, territories and large metropolitan areas. 

  6. Chronic actinic dermatitis.

    PubMed

    Booth, Alexandria V; Mengden, Stephanie; Soter, Nicholas A; Cohen, David

    2008-01-01

    A 71-year-old man presented with a six-year history of a pruritic, erythematous, blistering eruption of the face, chest, and arms. Clinical findings, histopathologic features, and phototests were consistent with a diagnosis of chronic actinic dermatitis. The patient also had contact allergy and photocontact allergy to multiple allergens. A discussion of chronic actinic dermatitis is presented. PMID:18627761

  7. Chronic gastritis - an update.

    PubMed

    Varbanova, Mariya; Frauenschläger, Katrin; Malfertheiner, Peter

    2014-12-01

    Helicobacter pylori is the main aetiologic factor for chronic gastritis worldwide. The degree of inflammation and the evolution of this form of chronic gastritis can vary largely depending on bacterial virulence factors, host susceptibility factors and environmental conditions. Autoimmune gastritis is another cause of chronic inflammation in the stomach, which can occur in all age groups. This disease presents typically with vitamin B12 deficiency and pernicious anaemia. The presence of anti-parietal cell antibodies is highly specific for the diagnosis. The role of H. pylori as a trigger for autoimmune gastritis remains uncertain. Other rare conditions for chronic gastritis are chronic inflammatory conditions such as Crohn's disease or on the background of lymphocytic or collagenous gastroenteropathies. PMID:25439069

  8. Medial Plantar Nerve Entrapment

    MedlinePLUS

    ... Laminectomy (News) Cyberbullying Less Stressful Than In-Person Bullying, Study Claims (News) Summer Motorcycle Season Is Here, ... Day News Cyberbullying Less Stressful Than In-Person Bullying, Study Claims FRIDAY, June 5, 2015 (HealthDay News) -- ...

  9. Plantar Wart (Verruca Plantaris)

    MedlinePLUS

    ... in size and may eventually multiply, forming additional “satellite” warts. Mosaic warts are a cluster of several ... ankle surgeon may use topical or oral treatments, laser therapy, cryotherapy (freezing), acid treatments, or surgery to ...

  10. In Vitro Antifungal Activity of KP-103, a Novel Triazole Derivative, and Its Therapeutic Efficacy against Experimental Plantar Tinea Pedis and Cutaneous Candidiasis in Guinea Pigs

    PubMed Central

    Tatsumi, Yoshiyuki; Yokoo, Mamoru; Arika, Tadashi; Yamaguchi, Hideyo

    2001-01-01

    The in vitro activity of KP-103, a novel triazole derivative, against pathogenic fungi that cause dermatomycoses and its therapeutic efficacy against plantar tinea pedis and cutaneous candidiasis in guinea pigs were investigated. MICs were determined by a broth microdilution method with morpholinepropanesulfonic acid-buffered RPMI 1640 medium for Candida species and with Sabouraud dextrose broth for dermatophytes and by an agar dilution method with medium C for Malassezia furfur. KP-103 was the most active of all the drugs tested against Candida albicans (geometric mean [GM] MIC, 0.002 ?g/ml), other Candida species including Candida parapsilosis and Candida glabrata (GM MICs, 0.0039 to 0.0442 ?g/ml), and M. furfur (GM MIC, 0.025 ?g/ml). KP-103 (1% solution) was highly effective as a treatment for guinea pigs with cutaneous candidiasis and achieved mycological eradication in 8 of the 10 infected animals, whereas none of the imidazoles tested (1% solutions) was effective in even reducing the levels of the infecting fungi. KP-103 was as active as clotrimazole and neticonazole but was less active than lanoconazole and butenafine against Trichophyton rubrum (MIC at which 80% of isolates are inhibited [MIC80], 0.125 ?g/ml) and Trichophyton mentagrophytes (MIC80, 0.25 ?g/ml). However, KP-103 (1% solution) exerted therapeutic efficacy superior to that of neticonazole and comparable to those of lanoconazole and butenafine, yielding negative cultures for all samples from guinea pigs with plantar tinea pedis tested. This suggests that KP-103 has better pharmacokinetic properties in skin tissue than the reference drugs. Because the in vitro activity of KP-103, unlike those of the reference drugs, against T. mentagrophytes was not affected by hair as a keratinic substance, its excellent therapeutic efficacy seems to be attributable to good retention of its antifungal activity in skin tissue, in addition to its potency. PMID:11302816

  11. In vitro antifungal activity of KP-103, a novel triazole derivative, and its therapeutic efficacy against experimental plantar tinea pedis and cutaneous candidiasis in guinea pigs.

    PubMed

    Tatsumi, Y; Yokoo, M; Arika, T; Yamaguchi, H

    2001-05-01

    The in vitro activity of KP-103, a novel triazole derivative, against pathogenic fungi that cause dermatomycoses and its therapeutic efficacy against plantar tinea pedis and cutaneous candidiasis in guinea pigs were investigated. MICs were determined by a broth microdilution method with morpholinepropanesulfonic acid-buffered RPMI 1640 medium for Candida species and with Sabouraud dextrose broth for dermatophytes and by an agar dilution method with medium C for Malassezia furfur. KP-103 was the most active of all the drugs tested against Candida albicans (geometric mean [GM] MIC, 0.002 microg/ml), other Candida species including Candida parapsilosis and Candida glabrata (GM MICs, 0.0039 to 0.0442 microg/ml), and M. furfur (GM MIC, 0.025 microg/ml). KP-103 (1% solution) was highly effective as a treatment for guinea pigs with cutaneous candidiasis and achieved mycological eradication in 8 of the 10 infected animals, whereas none of the imidazoles tested (1% solutions) was effective in even reducing the levels of the infecting fungi. KP-103 was as active as clotrimazole and neticonazole but was less active than lanoconazole and butenafine against Trichophyton rubrum (MIC at which 80% of isolates are inhibited [MIC(80)], 0.125 microg/ml) and Trichophyton mentagrophytes (MIC(80), 0.25 microg/ml). However, KP-103 (1% solution) exerted therapeutic efficacy superior to that of neticonazole and comparable to those of lanoconazole and butenafine, yielding negative cultures for all samples from guinea pigs with plantar tinea pedis tested. This suggests that KP-103 has better pharmacokinetic properties in skin tissue than the reference drugs. Because the in vitro activity of KP-103, unlike those of the reference drugs, against T. mentagrophytes was not affected by hair as a keratinic substance, its excellent therapeutic efficacy seems to be attributable to good retention of its antifungal activity in skin tissue, in addition to its potency. PMID:11302816

  12. Improving the spectral resolution of a highly pixelated detector by applying a pixel-by-pixel energy calibration for investigating the spectral properties of the anode heel effect

    NASA Astrophysics Data System (ADS)

    Sievers, P.; Klammer, J.; Michel, T.; Hupe, O.; Anton, G.

    2012-07-01

    The energy deposition spectrum measured with highly pixelated photon-counting pixel detectors with a semiconductor sensor layer (e.g. silicon) differs significantly from the impinging X-ray spectrum. This is the main disadvantage compared to commonly known X-ray spectrometers, e.g. high purity Germanium (hpGe) detector. On the other hand, those hpGe-detectors have a lack of spatial resolution and can not be used for energy-resolved imaging. In case of measurements with highly pixelated detectors, a set of monoenergetic detector response functions is needed for the deconvolution of the measured distribution into the impinging spectrum. We have investigated the possibility of applying a pixel-by-pixel calibration on a highly pixelated detector for gaining a higher energy resolution and for lowering the minimal flux needed for the deconvolution. As a result it is now possible to utilize small ROIs of the pixel matrix for the deconvolution. With this analysis method the detector enables spectral X-ray imaging of high photon rates. This is in particular shown for the angular dependency of the anode heel effect on the emitted spectrum.

  13. American Chronic Pain Association

    MedlinePLUS

    ... to Chronic Pain Medications & Treatments The Art of Pain Management What We Have Learned Going to the ER Communication Tools Pain Management Programs Videos Resources Glossary FAQs Surveys September is ...

  14. [Chronic lichenoid keratosis].

    PubMed

    Kalamkarian, A A; Parastaeva, S A; Zabanova, E V

    1989-01-01

    This is the first case of chronic lichenoid keratosis described in this country. The clinical picture and histologic findings suggest that this dermatosis be regarded as an atypical variety of lichen ruber planus. PMID:2718621

  15. Chronic Kidney Disease

    MedlinePLUS

    ... well as they should. Normal, healthy kidneys remove waste from the blood. The waste then leaves your body in your urine. The ... have chronic kidney disease, your kidneys cannot remove waste from the blood as well as they should. ...

  16. Anemia of chronic disease

    MedlinePLUS

    Anemia of inflammation; AOCD; ACD ... Anemia is a lower-than-normal number of red blood cells in the blood. Some conditions can lead to anemia of chronic disease include: Autoimmune disorders , such as ...

  17. Chronic subdural hematoma

    MedlinePLUS

    ... the dura and surface of the brain (bridging veins) tear and leak blood. This is usually the result of a ... the brain. In a chronic subdural collection, blood leaks from the veins slowly over time, or a fast hemorrhage is ...

  18. Chronic hepatitis C

    Microsoft Academic Search

    Tram T. Tran; Paul Martin

    2001-01-01

    Opinion statement  Infection with hepatitis C virus (HCV) accounts for 40% of cases of chronic liver disease in the United States and is now\\u000a the most common indication for liver transplantation. Estimates suggest that 4 million people (1.8%) of the American population\\u000a are or have been infected with HCV. Currently, the treatment of choice for patients with chronic HCV infection is

  19. Chronic progressive external ophthalmoplegia

    Microsoft Academic Search

    Andrew G. Lee; Paul W. Brazis

    2002-01-01

    Chronic progressive external ophthalmoplegia (CPEO) is a descriptive term for a heterogenous group of disorders characterized\\u000a by chronic, progressive, bilateral, and usually symmetric ocular motility deficit and ptosis. Significant pain, proptosis,\\u000a or pupil involvement are not features of CPEO and should prompt evaluation for alternative etiologies. Mitochondrial DNA mutations\\u000a are increasingly being recognized as the etiology for CPEO syndromes. Clinicians

  20. Chronic Thromboembolic Pulmonary Hypertension

    Microsoft Academic Search

    Lara M. Wittine; William R. Auger

    2010-01-01

    Opinion statement  The pulmonary hypertension (PH) and right heart dysfunction that results from chronic thromboembolic involvement of the pulmonary\\u000a vascular bed is potentially curable with surgical endarterectomy. Over the past several decades, growing clinical experience\\u000a has brought about increased recognition of this treatable form of PH. Moreover, advances in cardiothoracic surgical techniques\\u000a have given an increasing number of patients with chronic

  1. Pathophysiology of Chronic Urticaria

    Microsoft Academic Search

    Malcolm W. Greaves

    2002-01-01

    Chronic urticaria includes several different subsets with distinct pathophysiologies, and with important implications for investigation and treatment. Chronic ‘idiopathic’ urticaria represents a special challenge, which, until recently, was not taken up by dermatological or immunological investigators. However, it has now emerged that at least 30% of patients possess histamine-releasing autoantibodies against FcεR1, or less commonly IgE itself. These autoantibodies are

  2. Chronic Pain Explained

    Microsoft Academic Search

    KENNETH J. SUFKA

    2000-01-01

    Pains that persist long after damaged tissue hasrecovered remain a perplexing phenomenon. Theseso-called chronic pains serve no useful function foran organism and, given its disabling effects, mighteven be considered maladaptive. However, a remarkablesimilarity exists between the neural bases thatunderlie the hallmark symptoms of chronic pain andthose that subserve learning and memory. Bothphenomena, wind-up in the pain literature andlong-term potentiation (LTP)

  3. Chronic dysimmune neuropathies: Beyond chronic demyelinating polyradiculoneuropathy

    PubMed Central

    Khadilkar, Satish V.; Deshmukh, Shrikant S.; Dhonde, Pramod D.

    2011-01-01

    The spectrum of chronic dysimmune neuropathies has widened well beyond chronic demyelinating polyradiculoneuropathy (CIDP). Pure motor (multifocal motor neuropathy), sensorimotor with asymmetrical involvement (multifocal acquired demylinating sensory and motor neuropathy), exclusively distal sensory (distal acquired demyelinating sensory neuropathy) and very proximal sensory (chronic immune sensory polyradiculopathy) constitute the variants of CIDP. Correct diagnosis of these entities is of importance in terms of initiation of appropriate therapy as well as prognostication of these patients. The rates of detection of immune-mediated neuropathies with monoclonal cell proliferation (monoclonal gammopathy of unknown significance, multiple myeloma, etc.) have been facilitated as better diagnostic tools such as serum immunofixation electrophoresis are being used more often. Immune neuropathies associated with malignancies and systemic vasculitic disorders are being defined further and treated early with better understanding of the disease processes. As this field of dysimmune neuropathies will evolve in the future, some of the curious aspects of the clinical presentations and response patterns to different immunosuppressants or immunomodulators will be further elucidated. This review also discusses representative case studies. PMID:21808468

  4. Nutrition and Chronic Wounds

    PubMed Central

    Molnar, Joseph Andrew; Underdown, Mary Jane; Clark, William Andrew

    2014-01-01

    Significance: Nutrition is one of the most basic of medical issues and is often ignored as a problem in the management of our chronic wound patients. Unfortunately, malnutrition is widespread in our geriatric patients even in nursing homes in developed countries. Attention to basic nutrition and providing appropriate supplements may assist in the healing of our chronic wounds. Recent Advances: Recent research has revealed the epidemiology of malnutrition in developed countries, the similarities to malnutrition in developing countries, and some of the physiologic and sociologic causes for this problem. More information is now available on the biochemical effects of nutrient deficiency and supplementation with macronutrients and micronutrients. In some cases, administration of isolated nutrients beyond recommended amounts for healthy individuals may have a pharmacologic effect to help wounds heal. Critical Issues: Much of the knowledge of the nutritional support of chronic wounds is based on information that has been obtained from trauma management. Due to the demographic differences of the patients and differences in the physiology of acute and chronic wounds, it is not logical to assume that all aspects of nutritional support are identical in these patient groups. Before providing specific nutritional supplements, appropriate assessments of patient general nutritional status and the reasons for malnutrition must be obtained or specific nutrient supplementation will not be utilized. Future Directions: Future research must concentrate on the biochemical and physiologic differences of the acute and chronic wounds and the interaction with specific supplements, such as antioxidants, vitamin A, and vitamin D. PMID:25371850

  5. Management of Chronic Paronychia

    PubMed Central

    Relhan, Vineet; Goel, Khushbu; Bansal, Shikha; Garg, Vijay Kumar

    2014-01-01

    Chronic paronychia is an inflammatory disorder of the nail folds of a toe or finger presenting as redness, tenderness, and swelling. It is recalcitrant dermatoses seen commonly in housewives and housemaids. It is a multifactorial inflammatory reaction of the proximal nail fold to irritants and allergens. Repeated bouts of inflammation lead to fibrosis of proximal nail fold with poor generation of cuticle, which in turn exposes the nail further to irritants and allergens. Thus, general preventive measures form cornerstone of the therapy. Though previously anti-fungals were the mainstay of therapy, topical steroid creams have been found to be more effective in the treatment of chronic paronychia. In recalcitrant cases, surgical treatment may be resorted to, which includes en bloc excision of the proximal nail fold or an eponychial marsupialization, with or without nail plate removal. Newer therapies and surgical modalities are being employed in the management of chronic paronychia. In this overview, we review recent epidemiological studies, present current thinking on the pathophysiology leading to chronic paronychia, discuss the challenges chronic paronychia presents, and recommend a commonsense approach to management. PMID:24470654

  6. Predictive control of ankle stiffness at heel contact is a key element of locomotor adaptation during split-belt treadmill walking in humans.

    PubMed

    Ogawa, Tetsuya; Kawashima, Noritaka; Ogata, Toru; Nakazawa, Kimitaka

    2014-02-01

    Split-belt treadmill walking has been extensively utilized as a useful model to reveal the adaptability of human bipedal locomotion. While previous studies have clearly identified different types of locomotor adaptation, such as reactive and predictive adjustments, details of how the gait pattern would be adjusted are not fully understood. To gain further knowledge of the strategies underlying split-belt treadmill adaptation, we examined the three-dimensional ground reaction forces (GRF) and lower limb muscle activities during and after split-belt treadmill walking in 22 healthy subjects. The results demonstrated that the anterior component of the GRF (braking force) showed a clear pattern of adaptation and subsequent aftereffects. The muscle activity in the tibialis anterior muscle during the early stance phase was associated with the change of braking force. In contrast, the posterior component of GRF (propulsive force) showed a consistent increase/decrease in the fast/slow leg during the adaptation period and was not followed by subsequent aftereffects. The muscle activity in the gastrocnemius muscle during the stance phase gradually decreased during the adaptation phase and then showed a compensatory reaction during the washout phase. The results indicate that predictive feedforward control is required to set the optimal ankle stiffness in preparation for the impact at the heel contact and passive feedback control is used for the production of reflexively induced propulsive force at the end of the stance phase during split-belt treadmill adaptation. The present study provides information about the detailed mechanisms underlying split-belt adaptation and should be useful for the construction of specific rehabilitation protocols. PMID:24225544

  7. Significance of including field non-uniformities such as the heel effect and beam scatter in the determination of the skin dose distribution during interventional fluoroscopic procedures

    NASA Astrophysics Data System (ADS)

    Rana, Vijay; Gill, Kamaljit; Rudin, Stephen; Bednarek, Daniel R.

    2012-03-01

    The current version of the real-time skin-dose-tracking system (DTS) we have developed assumes the exposure is contained within the collimated beam and is uniform except for inverse-square variation. This study investigates the significance of factors that contribute to beam non-uniformity such as the heel effect and backscatter from the patient to areas of the skin inside and outside the collimated beam. Dose-calibrated Gafchromic film (XR-RV3, ISP) was placed in the beam in the plane of the patient table at a position 15 cm tube-side of isocenter on a Toshiba Infinix C-Arm system. Separate exposures were made with the film in contact with a block of 20-cm solid water providing backscatter and with the film suspended in air without backscatter, both with and without the table in the beam. The film was scanned to obtain dose profiles and comparison of the profiles for the various conditions allowed a determination of field non-uniformity and backscatter contribution. With the solid-water phantom and with the collimator opened completely for the 20-cm mode, the dose profile decreased by about 40% on the anode side of the field. Backscatter falloff at the beam edge was about 10% from the center and extra-beam backscatter decreased slowly with distance from the field, being about 3% of the beam maximum at 6 cm from the edge. Determination of the magnitude of these factors will allow them to be included in the skin-dose-distribution calculation and should provide a more accurate determination of peak-skin dose for the DTS.

  8. Chronic thromboembolic pulmonary hypertension.

    PubMed

    Marshall, Peter S; Kerr, Kim M; Auger, William R

    2013-12-01

    Chronic thromboembolic pulmonary hypertension (CTEPH) is a disease with high mortality and few treatment options. This article reviews the epidemiology of CTEPH and identifies risk factors for its development. The pathobiology and the progression from thromboembolic events to chronically increased right-sided pressures are discussed. The diagnosis and assessment of CTEPH requires several modalities and the role of these is detailed. The pre-operative evaluation assesses peri-operative risk and determines the likelihood of benefit from PTE. Pulmonary thromboendarterectomy (PTE) remains the treatment of choice in appropriate patients. Nonsurgical therapies for CTEPH may provide benefit in patients who cannot be offered surgery. PMID:24267304

  9. Chronic inflammatory demyelinating polyneuropathy.

    PubMed

    Lewis, Richard A

    2007-02-01

    In 1975, clinical, electrodiagnostic, and pathologic features defined chronic inflammatory demyelinating polyneuropathy (CIDP). Subsequent reports have made it clear that demyelination is a cardinal feature of teh disorder. Over the past 30 years, variants have been described and associated systemic disorders identified. There continues to be discussion, however, as to how best to define CIDP and classify the disorders that are chronic, acquired, immune mediated, and demyelinating. Understanding the disorders allows clinicians to make appropriate treatment decisions. Some disorders originally considered as variants now are shown to have characteristic features that make them distinct from CIDP. It is imperative to recognize the differences between these disorders. PMID:17324721

  10. Chronic Inflammatory Demyelinating Polyradiculoneuropathy.

    PubMed

    Hughes, Richard

    2010-04-15

    BACKGROUND: Chronic inflammatory demyelinating polyradiculoneuropathy is a chronic progressive or relapsing and remitting disease with a prevalence of up to 8.9 per 100,000. METHODS: This review discusses possible mechanisms, none of which are proven, and describes the evidence for its treatment. RESULTS: Cochrane Reviews provide evidence that corticosteroids, intravenous immunoglobulin, and plasma exchange are effective short-term treatments. Attempts to confirm the efficacy of other immunosuppressant agents have not been successful, although they are often used in people whose disease is resistant to the first-line treatments. CONCLUSIONS: More and better trials are needed. PMID:20393791

  11. Chronic Inflammatory Demyelinating Polyradiculoneuropathy

    Microsoft Academic Search

    Richard Hughes

    2010-01-01

    Background  Chronic inflammatory demyelinating polyradiculoneuropathy is a chronic progressive or relapsing and remitting disease with\\u000a a prevalence of up to 8.9 per 100,000.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  This review discusses possible mechanisms, none of which are proven, and describes the evidence for its treatment.\\u000a \\u000a \\u000a \\u000a Results  Cochrane Reviews provide evidence that corticosteroids, intravenous immunoglobulin, and plasma exchange are effective short-term\\u000a treatments. Attempts to confirm the efficacy of

  12. Assessment of forearm and plantar foot load in the elderly using a four-wheeled walker with armrest and the effect of armrest height

    PubMed Central

    Ko, Chang-Yong; Kim, Sol-Bi; Choi, Hyuk-Jae; Chang, Yunhee; Kang, Sungjae; Heo, Yoon; Ryu, Jeicheong; Kim, Gyoosuk; Mun, Museong

    2014-01-01

    Background Patients with hand and/or wrist pathology are recommended to have a four-wheeled walker with an arm rest (FWW-AR) rather than a standard walker or a standard four-wheeled walker (FWW). However, only a few quantitative studies have been performed to compare upper and lower extremity weight bearing. The aim of this study was to evaluate forearm and foot weight bearing using a FWW-AR and the effect of the armrest height. Methods Eleven elderly women (mean age 80.1±5.3 years; mean height 148.5±4.0 cm; mean weight 51.2±9.0 kg) were enrolled. The subjects walked with an FWW-AR, with the elbow in either 90 degree (D90) or 130 degree (D130) flexion, for a distance of 10 m. Surface electromyographic signals were recorded for the upper, middle, and lower trapezius, anterior deltoid, and erector spinae muscles; walking velocity was measured with the subjects weight bearing on their feet and forearms while walking. Simultaneously, the maximum plantar and forearm loads during walking with an FWW-AR were measured. Results The normalized foot plantar loads were lower at D90 than at D130, while the normalized forearm load was higher at D90 than at D130 (all P<0.05; left foot, 7.9±0.1 N/kg versus 8.8±0.1 N/kg; right foot, 8.6±0.2 N/kg versus. 9.6±0.1 N/kg; left forearm, 1.8±0.5 N/kg versus 0.8±0.2 N/kg; and right forearm, 2.0±0.5 N/kg versus 1.0±0.2 N/kg, respectively). The surface electromyographic activity of the muscles involved in shoulder elevation and the walking velocity were both lower with the elbow at D90 than at D130 (all P<0.05; left upper trapezius, 98.7%±19.5% versus 132.6%±16.9%; right upper trapezius, 83.4%±10.6% versus 108.1%±10.5%; left anterior deltoid, 94.1%±12.8% versus 158.6%±40.4%; right anterior deltoid, 99.1%±15.0% versus 151.9%±19.4%; and velocity, 0.6±0.1 m/sec versus 0.7±0.1 m/sec, respectively). Conclusion Weight bearing on the lower extremities is significantly reduced when the upper extremities are supported during walking with an FWW-AR. Furthermore, the weight bearing profile is dependent on the armrest height. PMID:25342894

  13. The effect of patients’ preference on outcome in the EVerT cryotherapy versus salicylic acid for the treatment of plantar warts (verruca) trial

    PubMed Central

    2012-01-01

    Background Randomised controlled trials are widely accepted as the gold standard method to evaluate medical interventions, but they are still open to bias. One such bias is the effect of patient’s preference on outcome measures. The aims of this study were to examine whether patients’ treatment preference affected clearance of plantar warts and explore whether there were any associations between patients’ treatment preference and baseline variables in the EverT trial. Methods Two hundred and forty patients were recruited from University podiatry schools, NHS podiatry clinics and primary care. Patients were aged 12 years and over and had at least one plantar wart which was suitable for treatment with salicylic acid and cryotherapy. Patients were asked their treatment preference prior to randomisation. The Kruskal-Wallis test was performed to test the association between preference group and continuous baseline variables. The Fisher’s exact test was performed to test the association between preference group and categorical baseline variables. A logistic regression analysis was undertaken with verruca clearance (yes or no) as the dependent variable and treatment, age, type of verruca, previous treatment, treatment preference as independent variables. Two analyses were undertaken, one using the health professional reported outcome and one using the patient’s self reported outcomes. Data on whether the patient found it necessary to stop the treatment to which they had been allocated and whether they started another treatment were summarised by treatment group. Results Pre-randomisation preferences were: 10% for salicylic acid; 42% for cryotherapy and 48% no treatment preference. There was no evidence of an association between treatment preference group and either patient (p=0.95) or healthcare professional (p=0.46) reported verruca clearance rates. There was no evidence of an association between preference group and any of the baseline variables except gender, with more females expressing a preference for salicylic acid (p=0.004). There was no evidence that the number of times salicylic acid was applied was different between the preference groups at one week (p=0.89) or at three weeks (p=0.24). Similarly, for the number of clinic visits for cryotherapy (p=0.71) Conclusions This secondary analysis showed no evidence to suggest that patients’ baseline preferences affected verruca clearance rates or adherence with the treatment. Trial registration Current Controlled Trials ISRCTN18994246 and National Research Register N0484189151 PMID:23146114

  14. Hemodynamic responses during graded and constant-load plantar flexion exercise in middle-aged men and women with type 2 diabetes.

    PubMed

    Kiely, Catherine; O'Connor, Eamonn; O'Shea, Donal; Green, Simon; Egańa, Mikel

    2014-10-01

    We tested the hypotheses that type 2 diabetes (T2D) impairs the 1) leg hemodynamic responses to an incremental intermittent plantar-flexion exercise and 2) dynamic responses of leg vascular conductance (LVC) during low-intensity (30% maximal voluntary contraction, MVC) and high-intensity (70% MVC) constant-load plantar-flexion exercise in the supine posture. Forty-four middle-aged individuals with T2D (14 women), and 35 healthy nondiabetic (ND) individuals (18 women) were tested. Leg blood flow (LBF) was measured between each contraction using venous occlusion plethysmography. During the incremental test peak force (Fpeak) relative to MVC was significantly reduced (P < 0.05) in men and women with T2D compared with their respective nondiabetic counterparts. Peak LBF and the slope of LBF relative to percentage Fpeak were also reduced (P < 0.05) in women with T2D compared with healthy women (peak blood flow, 460.6 ± 126.8 vs. 628.3 ± 347.7 ml/min; slope, 3.78 ± 1.74 vs. 5.85 ± 3.14 ml·min(-1)·%Fpeak (-1)) and in men with T2D compared with nondiabetic men (peak blood flow, 621.7 ± 241.3 vs. 721.2 ± 359.7 ml/min; slope, 5.75 ± 2.66 vs. 6.33 ± 3.63 ml·min(-1)·%Fpeak (-1)). During constant-load contractions at 30% MVC T2D did not affect the dynamic responses of LVC (LBF/MAP). However, at 70% MVC [completed by a subgroup of participants (20 with T2D, 6 women; 13 ND, 6 women)] the time constant of the second growth phase of LVC was longer and the amplitude of the first growth phase was lower (P < 0.05 for both) in men and women with T2D. The results suggest that the T2D-induced impairments in performance of the leg muscles are related to reductions in blood flow in both men and women. PMID:25123197

  15. Influence of extero- and proprioceptive afferents of the plantar surface in determining subjective visual vertical in patients with unilateral vestibular dysfunction.

    PubMed

    Faralli, M; Longari, F; Ricci, G; Ibba, M C; Frenguelli, A

    2009-10-01

    Subjective visual vertical refers to an individual's ability to indicate what, in his or her opinion, is a perfectly vertical line in specific experimental conditions. Although the otolith organs play a key role in the perception of verticality, the contribution of other sensory systems, e.g. the visual and proprioceptive systems, cannot be overlooked. The aim of this study was to test the hypothesis that extero- and proprioceptive afferent signals, particularly from the plantar surface of the foot, can influence the temporal evolution of altered subjective visual vertical following unilateral acute vestibular dysfunction. Subjective visual vertical was studied in 40 consecutive patients: 19 females and 21 males (mean age 46.4 years). It was first measured at diagnosis (1-2 days after onset of symptoms). For this measurement, a baseline test was performed (patient standing in direct contact with the floor), followed by a provocation test with a soft support between the patient's feet and the floor. Based on a comparison between the baseline and provocation tests, the patients were divided into three groups: Group A--patients showing a significant increase (p < 0.05) in subjective visual vertical(0 )values in the provocation test compared to baseline values; Group B--patients showing a significant decrease (p < 0.05) in subjective visual vertical(0 )values in the provocation test compared to baseline values; Group C--patients showing no significant changes (p < 0.05) in subjective visual vertical(0 )values in the provocation test compared to baseline values. The baseline test was repeated at 30, 90 and 180 days. At the end of the follow-up, a persistent change in subjective visual vertical was noted in 87% of the patients from Group B, 31% of the patients from Group C but none of the patients from Group A, all of whom were able to correct the perception error during the second examination. The study demonstrates that normalisation of subjective visual vertical in subjects with unilateral vestibular lesions seems to be influenced by the possibility of exploiting extra-vestibular sensory information, particularly extero- and proprioceptive information from the plantar surface. PMID:20162024

  16. Powered ankle exoskeletons reveal the metabolic cost of plantar flexor mechanical work during walking with longer steps at constant step frequency.

    PubMed

    Sawicki, Gregory S; Ferris, Daniel P

    2009-01-01

    We examined the metabolic cost of plantar flexor muscle-tendon mechanical work during human walking. Nine healthy subjects walked at constant step frequency on a motorized treadmill at speeds corresponding to 80% (1.00 m s(-1)), 100% (1.25 m s(-1)), 120% (1.50 m s(-1)) and 140% (1.75 m s(-1)) of their preferred step length (L(*)) at 1.25 m s(-1). In each condition subjects donned robotic ankle exoskeletons on both legs. The exoskeletons were powered by artificial pneumatic muscles and controlled using soleus electromyography (i.e. proportional myoelectric control). We measured subjects' metabolic energy expenditure and exoskeleton mechanics during both unpowered and powered walking to test the hypothesis that ankle plantarflexion requires more net metabolic power (W kg(-1)) at longer step lengths for a constant step frequency (i.e. preferred at 1.25 m s(-1)). As step length increased from 0.8 L(*) to 1.4 L(*), exoskeletons delivered approximately 25% more average positive mechanical power (P=0.01; +0.20+/-0.02 W kg(-1) to +0.25+/-0.02 W kg(-1), respectively). The exoskeletons reduced net metabolic power by more at longer step lengths (P=0.002; -0.21+/-0.06 W kg(-1) at 0.8 L(*) and -0.70+/-0.12 W kg(-1) at 1.4 L(*)). For every 1 J of exoskeleton positive mechanical work subjects saved 0.72 J of metabolic energy ('apparent efficiency'=1.39) at 0.8 L(*) and 2.6 J of metabolic energy ('apparent efficiency'=0.38) at 1.4 L(*). Declining ankle muscle-tendon ;apparent efficiency' suggests an increase in ankle plantar flexor muscle work relative to Achilles' tendon elastic energy recoil during walking with longer steps. However, previously stored elastic energy in Achilles' tendon still probably contributes up to 34% of ankle muscle-tendon positive work even at the longest step lengths we tested. Across the range of step lengths we studied, the human ankle muscle-tendon system performed 34-40% of the total lower-limb positive mechanical work but accounted for only 7-26% of the net metabolic cost of walking. PMID:19088207

  17. Chronic Neuropathies – Chronic Inflammatory Demyelinating Neuropathy and Its Variants

    Microsoft Academic Search

    Sindhu Ramchandren; Richard A. Lewis

    2009-01-01

    Background: Chronic neuropathy is a highly prevalent condition, and an enormous burden to society, from a health, social and financial standpoint. Identifying new therapeutic strategies that have asignificant impact on the neuropathy patients’ quality of life has been difficult. Objective: This review presents a brief perspective on clinical evaluation of chronic neuropathies, with a focus on chronic inflammatory demyelinating neuropathy

  18. Chronic Obstructive Pulmonary Disease: A Chronic Systemic Inflammatory Disease

    Microsoft Academic Search

    Stephan F. van Eeden; Don D. Sin

    2008-01-01

    Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation in both the airways causing airway obstruction and the lung tissues causing emphysema. The disease is induced by inhalation of noxious gasses and particulate matter resulting in a chronic persistent inflammatory response in the lung, and the extent of the inflammatory reaction correlates with the severity of the disease. This

  19. [Imaging of chronic pelvis pain].

    PubMed

    Bazot, M; Thomassin-Naggara, I; Daraď, E; Marsault, C

    2008-01-01

    This is a review of different diseases implicated in chronic pelvic pain (endometriosis, adenomyosis, pelvic varices, and pelvic chronic inflammatory disease) assessed by different imaging modalities (US, CT, MRI). PMID:18288037

  20. Chronic manganese intoxication

    SciTech Connect

    Huang, C.C.; Chu, N.S.; Lu, C.S.; Wang, J.D.; Tsai, J.L.; Tzeng, J.L.; Wolters, E.C.; Calne, D.B. (Chang Gung Medical College Hospital, Taipei, Taiwan (China))

    1989-10-01

    We report six cases of chronic manganese intoxication in workers at a ferromanganese factory in Taiwan. Diagnosis was confirmed by assessing increased manganese concentrations in the blood, scalp, and pubic hair. In addition, increased manganese levels in the environmental air were established. The patients showed a bradykinetic-rigid syndrome indistinguishable from Parkinson's disease that responded to treatment with levodopa.

  1. Chronic Radiation Enteritis

    Microsoft Academic Search

    V. S. Theis; R. Sripadam; V. Ramani; S. Lal

    2010-01-01

    Chronic radiation enteritis is an increasing problem, as more patients receive radiotherapy as part of their cancer therapy and as the long-term survival of these patients improves. This review addresses the causes, investigation, treatment and prevention of this disease. A review of published studies was carried out using a variety of search terms, including radiation enteritis, investigation, treatment and prevention.

  2. Chronic thromboembolic pulmonary hypertension.

    PubMed

    Wittine, Lara M; Auger, William R

    2010-04-01

    The pulmonary hypertension (PH) and right heart dysfunction that results from chronic thromboembolic involvement of the pulmonary vascular bed is potentially curable with surgical endarterectomy. Over the past several decades, growing clinical experience has brought about increased recognition of this treatable form of PH. Moreover, advances in cardiothoracic surgical techniques have given an increasing number of patients with chronic thromboembolic PH (CTEPH) a surgical remedy with decreasing perioperative morbidity and mortality risks. The availability of pulmonary hypertensive-specific medical therapy for CTEPH patients with surgically inaccessible disease also has been a positive therapeutic advance over the past several years. However, despite this progress, chronic thromboembolic disease as a sequela of acute pulmonary emboli continues to be underappreciated. Furthermore, even if CTEPH has been appropriately diagnosed, misinterpretation of diagnostic information may lead to the inappropriate exclusion of patients from surgical consideration. This may result in the prescription of pulmonary hypertensive medical therapy in CTEPH patients with potentially surgically correctable disease. This difficulty arises from a lack of objective criteria as to what constitutes surgical chronic thromboembolic disease, which primarily is a result of the variability in surgical experience in specialty centers in the United States. Consequently, clinicians must be wary about using pulmonary hypertensive medications in CTEPH patients. Before prescription, it is important to exclude patients from surgical consideration by consulting a specialized center with expertise in this discipline. PMID:20376164

  3. Chronic fatigue syndrome

    Microsoft Academic Search

    Judith B Prins; Jos WM van der Meer; Gijs Bleijenberg

    2006-01-01

    During the past two decades, there has been heated debate about chronic fatigue syndrome (CFS) among researchers, practitioners, and patients. Few illnesses have been discussed so extensively. The existence of the disorder has been questioned, its underlying pathophysiology debated, and an effective treatment opposed; patients' organisations have participated in scientific discussions. In this review, we look back on several controversies

  4. Chronic wasting disease

    Microsoft Academic Search

    Christina J. Sigurdson; Adriano Aguzzi

    2007-01-01

    Until recently, chronic wasting disease of cervids, the only prion disease affecting wildlife, was believed to be geographically concentrated to Colorado and Wyoming within the United States. However, increased surveillance has unveiled several additional pockets of CWD-infected deer and elk in 12 additional states and 2 Canadian provinces. Deer and elk with CWD have extensive aggregates of PrPSc not only

  5. Chronic Wasting Disease

    Microsoft Academic Search

    E. S. Williams

    2005-01-01

    Chronic wasting disease (CWD) is a unique transmissible spongiform encephalopathy (TSE) of mule deer (Odocoileus hemionus), white-tailed deer (O. virginianus), and Rocky Mountain elk (Cervus elaphus nelsoni). The natural history of CWD is incompletely understood, but it differs from scrapie and bovine spon- giform encephalopathy (BSE) by virtue of its occurrence in nondomestic and free-ranging species. CWD has many features

  6. Opioids in chronic pain

    Microsoft Academic Search

    Ryszard Przew?ocki; Barbara Przew?ocka

    2001-01-01

    The advance in our understanding of the biogenesis of various endogenous opioid peptides, their anatomical distribution, and the characteristics of the multiple receptors with which they interact open a new avenue for understanding the role of opioid peptide systems in chronic pain. The main groups of opioid peptides: enkephalins, dynorphins and ?-endorphin derive from proenkephalin, prodynorphin and proopiomelanocortin, respectively. Recently,

  7. Chronic viral diseases.

    PubMed Central

    Berris, B

    1986-01-01

    Until 20 years ago the only chronic viral diseases known were those considered to be confined to the nervous system. As a result of recent advances in epidemiology, molecular biology and immunology, new viral diseases have been recognized and their clinical features and pathogenesis elucidated. Chronic disease may result from infection with the hepatitis B and D viruses and whatever agent or agents cause hepatitis non-A, non-B, the herpesviruses, Epstein-Barr virus, cytomegalovirus and human T-lymphotropic virus type III. These diseases have common features, including long-term or even lifetime asymptomatic carriage, viremia, with virus free in the plasma or attached to circulating mononuclear cells, presence of virus in body secretions, irreversible tissue injury in target organs and oncogenic potential. New information on these diseases is reviewed. Other chronic diseases for which the cause is currently unknown may eventually prove to be due to viral infection. In addition, vaccines may be developed for prophylaxis of some chronic viral diseases and associated malignant diseases. PMID:3022903

  8. Chronic granulomatous disease

    Microsoft Academic Search

    Paul G Heyworth; Andrew R Cross; John T Curnutte

    2003-01-01

    Chronic granulomatous disease (CGD) is a primary immunodeficiency that affects phagocytes of the innate immune system and is characterized by a greatly increased susceptibility to severe bacterial and fungal infections. CGD is caused by mutations in any one of four genes that encode the subunits of phagocyte NADPH oxidase, the enzyme that generates microbicidal (and pro-inflammatory) oxygen radicals. Of the

  9. Chronic obstructive pulmonary disease

    Microsoft Academic Search

    S Singh

    2003-01-01

    Chronic Obstructive Pulmonary disease (COPD), characterized by poorly reversible airflow limitation, and strongly associated with tobacco smoking, is estimated to cause >2.5 million deaths per year worldwide. Active smokers have more acute exacerbations, which correlate with long-term decline in lung function. The diagnosis, severity assessment and monitoring of COPD rely heavily but not exclusively on spirometry. Smoking cessation reduces exacerbation

  10. Acute and chronic stress

    Microsoft Academic Search

    Tini M Gruner

    2006-01-01

    Stress triggers fight\\/flight response with physiological changes including: – upregulation of heart rate, BP, breathing, glycogenolysis and gluconeogenesis, cytokine production, immune response, and water and sodium retention – downregulation of digestion, GnRH, GH, LH and TSH • Chronic stress (allostatic load) on the body leads to: – lack of hormonal inhibition through negative feedback – higher cortisol levels (with depletion

  11. Chronic recurrent multifocal osteomyelitis

    Microsoft Academic Search

    Dvora Cyrlak; M. J. Pais

    1986-01-01

    Chronic recurrent multifocal osteomyelitis was first described in 1972 and to date 33 cases have been reported, all but one from outside the United States. This unusual osteomyelitis is characteristically recurrent and multifocal with a predilection for the metaphyses. Cultures are persistently negative and antibiotics do not appear to affect the course of the disease, which may be as long

  12. Chronic Ankle Instability

    MedlinePLUS

    ... was not rehabilitated completely. When you sprain your ankle, the connective tissues (ligaments) are stretched or torn. The ability to balance ... Repeated ankle sprains often cause – and perpetuate – chronic ankle ... of the ligaments, resulting in greater instability and the likelihood of ...

  13. Chronic skin ulcers.

    PubMed

    Charles, Janice; Harrison, Christopher; Britt, Helena

    2014-09-01

    A rapid rise in the treatment of chronic wounds in the United States has been linked to an ageing population and an increasing incidence of diabetes and obesity. In Australia, we also have an ageing population, and increases in the prevalence of obesity and in the management rate of type 2 diabetes. PMID:25225640

  14. Chronic pain management: pharmacotherapy for chronic pain.

    PubMed

    Chang, Ku-Lang; Fillingim, Roger; Hurley, Robert W; Schmidt, Siegfried

    2015-05-01

    Clinicians should combine nonpharmacologic therapies and pharmacotherapy for management of chronic pain. Safety and effectiveness determine the choice of therapy. Typically, nonopioid analgesics are first-line treatment, including acetaminophen, nonsteroidal anti-inflammatory drugs, and topical drugs. A trial of an opioid, in combination with other modalities, should be considered if pain persists. Because of the potential for serious adverse effects, opioids should be prescribed only if the clinician is familiar with their use and associated risks. If pain is not controlled, consider pharmacogenetic effects or the addition of adjuvant therapy. In states with prescription drug monitoring programs, clinicians must access these programs regularly when prescribing a controlled substance. Consider performing pill counts and random urine drug screening for monitoring drug use. Adjuvant drugs to be considered include antidepressants, buspirone, anticonvulsants, muscle relaxants, onabotulinumtoxinA, clonidine, and corticosteroids, depending on type of pain and individual characteristics. PMID:25970870

  15. Chronic mucocutaneous candidosis: A review

    Microsoft Academic Search

    Iris K. Aronson; Keyoumars Soltani

    1976-01-01

    Clinical aspects Chronic mucocutaneous candidosis (CMCC) is an uncommon from of candidal infection. It usually starts in early life as a limited or widespread chronic infection and involves mucous membranes, skin and nails (37). The mucosal lesions of chronic mucocutaneous and acute candidosis are identical and consist of milk curd-like loosely adherent white patches on the oral and vaginal mucous

  16. Preliminary results of pinpoint plantar long-wavelength infrared light irradiation on blood glucose, insulin and stress hormones in patients with type 2 diabetes mellitus

    PubMed Central

    Ishimaru, Keisou; Kihara, Kazuhiko; Namiki, Yoshihisa; Hozumi, Nobumichi

    2013-01-01

    Background and aims: This study was aimed at the development of a novel noninvasive treatment system, “pinpoint plantar long-wavelength infrared light irradiation (PP-LILI)”, which may be able to relieve mental stress and normalize blood glucose level via the reduction of stress hormones in type 2 (non-insulin-dependent) diabetes mellitus (DM) patients. Materials (Subjects) and methods: Based on this hypothesis, the present study was undertaken to examine effects of PP-LILI on stress hormones (ACTH and cortisol), blood glucose, HbA1c, and insulin levels in 10 patients with type 2 DM. Each patient received PP-LILI of the foot for 15 minutes once weekly using a stress free apparatus (infrared wavelength, 9,000-12,000 nm/power 30 mW). Results: In response to this therapy, ACTH (P<0.01) and cortisol (P<0.05) levels decreased significantly. Fasting blood glucose (P<0.05) and insulin (P<0.05) levels also decreased significantly along with a tendency for HbA1c to decrease. Conclusions: The present data raise the possibility that PP-LILI can normalize blood glucose levels by reducing stress hormones such as cortisol, which aggravate DM, and by improving insulin sensitivity, thereby contributing to prevention and treatment of DM. PMID:24204095

  17. Arthroscopic removal of palmar/plantar osteochondral fragments (POF) in the metacarpo- and metatarso-phalangeal joints of standardbred trotters--outcome and possible genetic background to POF.

    PubMed

    Roneus, B; Arnason, T; Collinder, E; Rasmussen, M

    1998-01-01

    A clinical material of 133 Standardbred horses with palmar/plantar osteochondral fragments (POF) in the metacarpo- and metatarsophalangeal joints were studied. All horses had their fragments removed with arthroscopic surgery. 102 of the horses were 3 years old or younger when surgery was performed. Anatomical localisations of the fragments were in agreement with earlier reports. There was no statistical significant difference in month of birth in the POF--group compared to the total population. Eighty % of the horses that had raced before surgery came back to racing. The racing performance relative to their contemporaries remained the same after the POF operation. 65% of the horses that had not raced before surgery raced after the operation. The breeding index BLUP (Best Linear Unbiased Prediction) was used to evaluate if the POF-horses differed genetically in racing ability from the total population. The average BLUP value of the POF group was 103.4 (+/- 0.65), while the mean BLUP value of the total population was 98.9. This difference was highly significant and indicated that these POF horses belonged to a selected group. A homogeneity test of allele frequencies in blood type systems was performed to evaluate if any genetic difference was persistent between POF horses compared to the total population. The statistical analysis of gene frequencies for alleles in blood type systems indicated a genetic discrimination in blood type systems D and Tf. PMID:9592942

  18. Treatment Options for Chronic Myeloproliferative Neoplasms

    MedlinePLUS

    ... Myeloproliferative Neoplasms Treatment Myelodysplastic/ Myeloproliferative Neoplasms Treatment Chronic Myeloproliferative Neoplasms Treatment (PDQ®) General Information About Chronic Myeloproliferative Neoplasms ...

  19. CYBERWAR-2012/13: Siegel 2011 Predicted Cyberwar Via ACHILLES-HEEL DIGITS BEQS BEC ZERO-DIGIT BEC of/in ACHILLES-HEEL DIGITS Log-Law Algebraic-Inversion to ONLY BEQS BEC Digit-Physics U Barabasi Network/Graph-Physics BEQS BEC JAMMING Denial-of-Access(DOA) Attacks 2012-Instantiations

    NASA Astrophysics Data System (ADS)

    Huffmann, Master; Siegel, Edward Carl-Ludwig

    2013-03-01

    Newcomb-Benford(NeWBe)-Siegel log-law BEC Digit-Physics Network/Graph-Physics Barabasi et.al. evolving-``complex''-networks/graphs BEC JAMMING DOA attacks: Amazon(weekends: Microsoft I.E.-7/8(vs. Firefox): Memorial-day, Labor-day,...), MANY U.S.-Banks:WF,BoA,UB,UBS,...instantiations AGAIN militate for MANDATORY CONVERSION to PARALLEL ANALOG FAULT-TOLERANT but slow(er) SECURITY-ASSURANCE networks/graphs in parallel with faster ``sexy'' DIGITAL-Networks/graphs:``Cloud'', telecomm: n-G,..., because of common ACHILLES-HEEL VULNERABILITY: DIGITS!!! ``In fast-hare versus slow-tortoise race, Slow-But-Steady ALWAYS WINS!!!'' (Zeno). {Euler [#s(1732)] ?- ?()-Riemann[Monats. Akad. Berlin (1859)] ?- ?()- Kummer-Bernoulli (#s)}-Newcomb [Am.J.Math.4(1),39 (81) discovery of the QUANTUM!!!]-{Planck (01)]}-{Einstein (05)]-Poincar e [Calcul Probabilités,313(12)]-Weyl[Goett. Nach.(14); Math.Ann.77,313(16)]-(Bose (24)-Einstein(25)]-VS. -Fermi (27)-Dirac(27))-Menger [Dimensiontheorie(29)]-Benford [J.Am. Phil.Soc.78,115(38)]-Kac[Maths Stats.-Reason. (55)]- Raimi [Sci.Am.221,109(69)]-Jech-Hill [Proc.AMS,123,3,887(95)] log-function

  20. Reductions in heel bone quality across gestation are attenuated in pregnant adolescents with higher prepregnancy weight and greater increases in PTH across gestation.

    PubMed

    Whisner, Corrie M; Young, Bridget E; Witter, Frank R; Harris, Zena Leah; Queenan, Ruth A; Cooper, Elizabeth M; O'Brien, Kimberly O

    2014-09-01

    Few studies have examined the effect of maternal calcium intake and vitamin D status on bone health across gestation in pregnant adolescents. This study aimed to characterize maternal bone quality and determinants of bone-quality change across gestation in pregnant adolescents. Healthy pregnant adolescents (n?=?156; aged 13 to 18 years) with singleton pregnancies and at 12 to 30 weeks gestation at enrollment were recruited from two urban maternity clinics in Baltimore, MD, and Rochester, NY, for this prospective longitudinal study. Maternal serum was collected at midgestation and at delivery for assessment of bone biomarkers and calcitropic hormones. Maternal bone quality (assessed by heel ultrasound) and sonographic fetal biometry were measured up to three times across pregnancy. Racially diverse teens (64.7% African American, 35.3% white) were followed from 21.0 (interquartile range [IQR] 17.3, 27.0) weeks of gestation until delivery at 40.0 (IQR 39.0, 40.7) weeks. Significant decreases in calcaneal speed of sound (SOS), broadband ultrasound attenuation (BUA), and quantitative ultrasound index (QUI) (-9.2?±?16.1?m/s, -3.2 (-8.0, 2.1) dB/MHz and -5.3?±?8.8, respectively) were evident across pregnancy. Multivariate analysis controlling for baseline measures and measurement intervals was used to identify independent predictors of normalized (per week) calcaneal bone loss. Weekly decreases in bone quality were not significantly associated with maternal calcium intake or 25(OH)D concentration. Greater weekly reductions in calcaneal bone quality were evident in teens with lower prepregnancy weight (BUA, p?=?0.006 and QUI, p?=?0.012) and among those with lower weekly increase in PTH (SOS, p?=?0.046). Overall, significant decreases in calcaneal bone quality occurred across pregnancy in adolescents, but the magnitude of this loss was attenuated in those with greater prepregnancy weight and weekly increases in PTH. Further studies are needed to understand the role of elevated PTH and greater prepregnancy weight in preserving adolescent bone during pregnancy. PMID:24676885

  1. The consequences of chronic pain.

    PubMed

    Greenberg, Eric N

    2012-01-01

    Questions from patients about analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. The topic addressed in this issue is untreated/undertreated chronic pain and the physical, emotional, and social consequences that can profoundly affect a patient's quality of life. Chronic pain is no longer considered a symptom; it is a disease entity itself. Anxiety and depression often coexist with chronic pain. Chronic pain is the enemy of happiness. Further, chronic pain can activate the sympathetic nervous system, leading to the fight-or-flight response. PMID:22448948

  2. Management of Chronic Urticaria

    PubMed Central

    Grahame, Ann

    1987-01-01

    Effective treatment of chronic urticaria depends on identification of the etiologic factor, if possible, and its subsequent elimination, although symptoms may be suppressed by appropriate medication. The investigation of the patient who presents with chronic urticaria is discussed, with emphasis on the need for a detailed history, meticulous physical examination (including a search for occult infection) and full routine hematologic, biochemical and radiologic monitoring. The author discusses the use of intradermal skin tests, scratch tests for inhalants and the need for skin biopsy and gastro-intestinal tract screening. Dietary treatments reviewed include the elimination diet and the elemental diet, which is used in combination with gradual re-introduction of foods. Symptomatic treatments, including antihistamines, the newer H1-histamine receptor antagonists, used with tricyclic antidepressants and with combination therapy, and systemic corticosteroid therapy are also discussed. PMID:21263827

  3. [Pauciarticular juvenile chronic arthritis].

    PubMed

    Hertzberger-ten Cate, R; Fiselier, T

    1991-10-01

    On basis of clinical and immunogenetic factors most children with pauciarticular juvenile chronic arthritis can be included in one of the subtypes: type 1 and type 2 pauciarticular JCA. Type 1 occurs in young children, mainly girls, with involvement of knees, ankles or elbows. In the majority of children antinuclear antibodies can be detected. The presence of these autoantibodies is associated with chronic anterior uveitis. Type 2 or the juvenile spondylarthropathies include morbus Bechterew, the reactive arthritides and arthritis associated with psoriasis and inflammatory bowel diseases. Large joints of the lower extremities are involved, back pain is unusual at onset, but enthesitis is frequently present. There is a strong association with HLA-B27. Treatment of both subsets consists of non-steroidal anti-inflammatory drugs, application of intra-articular steroids, physio- and hydrotherapy and splinting. In children with a polyarticular course of type 1, or a prolonged course of type 2 disease modifying drugs are often needed. PMID:1957301

  4. Pentoxifylline reduces chronic post-ischemia pain by alleviating microvascular dysfunction

    PubMed Central

    Ragavendran, J. Vaigunda; Laferričre, André; Khorashadi, Mina; Coderre, Terence J.

    2015-01-01

    Background Microvascular dysfunction and ischemia in muscle play a role in the development of cutaneous tactile allodynia in chronic post-ischemia pain (CPIP). Hence, studies were designed to assess whether pentoxifylline (PTX), a vasodilator and hemorrheologic agent, relieves allodynia in CPIP rats by alleviating microvascular dysfunction. Methods Laser Doppler flowmetry of plantar blood flow was used to examine the effects of PTX on CPIP-induced alterations in post-occlusive reactive hyperemia (reflecting microvascular dysfunction), and von Frey testing was used to examine its effects on CPIP-induced allodynia. Time course effects of PTX on allodynia and microvascular dysfunction were assessed early (2–8 days) and late (18–25 days) post-ischemia/reperfusion (I/R) injury, and its effects on allodynia were also tested at 30 days post-I/R injury. Results PTX (25 mg/kg) produced significant anti-allodynic effects throughout the 21-day time course, but was not effective 30 days post-IR injury. In laser Doppler studies, the reduced reactive hyperemia in early CPIP rats was significantly improved by PTX (25 mg/kg). Conversely, treatment with PTX at the same dose did not affect reactive hyperemia in late CPIP rats, likely since reactive hyperemia was not significantly reduced pre-drug in these animals. Conclusion Since, poor tissue perfusion underlies early stages of CPIP pain, the ameliorative effect of PTX on microvascular dysfunction might account for its anti-allodynic effect in our experimental model of CRPS-I. PMID:23904273

  5. Effect of tape on dynamic postural stability in subjects with chronic ankle instability.

    PubMed

    De Ridder, R; Willems, T M; Vanrenterghem, J; Roosen, P

    2015-04-01

    The objective of our study was to evaluate the effect of taping on the dynamic postural stability during a jump landing protocol in subjects with chronic ankle instability (CAI). For this purpose, 28 subjects with CAI performed a sagittal and frontal plane landing task in a non-taped and taped condition. As main outcome measure, the dynamic postural stability index (DPSI) was calculated. In addition, subjective feelings of instability and perceived difficulty level were assessed. Furthermore, mechanical effectiveness of the tape on the ankle joint was determined by registering 3D kinematics. 3 subjects were excluded based on discomfort during the landing protocol. Study results indicated that the tape reduced plantar flexion and inversion at the ankle at touchdown and range of motion in the landing phase. There was, however, no effect on the DPSI or on its directional subcomponents. Subjective feelings of stability with tape improved significantly, whereas perceived difficulty did not change. In conclusion, our taping procedure did not improve postural control during a sagittal and frontal plane landing task in subjects with CAI. Perceived instability did improve and is considered an important treatment outcome, which suggests that taping could be considered as a treatment modality by clinicians. PMID:25665000

  6. Functionally Different Pads on the Same Foot Allow Control of Attachment: Stick Insects Have Load-Sensitive “Heel” Pads for Friction and Shear-Sensitive “Toe” Pads for Adhesion

    PubMed Central

    Labonte, David; Federle, Walter

    2013-01-01

    Stick insects (Carausius morosus) have two distinct types of attachment pad per leg, tarsal “heel” pads (euplantulae) and a pre-tarsal “toe” pad (arolium). Here we show that these two pad types are specialised for fundamentally different functions. When standing upright, stick insects rested on their proximal euplantulae, while arolia were the only pads in surface contact when hanging upside down. Single-pad force measurements showed that the adhesion of euplantulae was extremely small, but friction forces strongly increased with normal load and coefficients of friction were 1. The pre-tarsal arolium, in contrast, generated adhesion that strongly increased with pulling forces, allowing adhesion to be activated and deactivated by shear forces, which can be produced actively, or passively as a result of the insects' sprawled posture. The shear-sensitivity of the arolium was present even when corrected for contact area, and was independent of normal preloads covering nearly an order of magnitude. Attachment of both heel and toe pads is thus activated partly by the forces that arise passively in the situations in which they are used by the insects, ensuring safe attachment. Our results suggest that stick insect euplantulae are specialised “friction pads” that produce traction when pressed against the substrate, while arolia are “true” adhesive pads that stick to the substrate when activated by pulling forces. PMID:24349156

  7. Telenursing in Chronic Conditions

    Microsoft Academic Search

    Takayasu Kawaguchi; Masumi Azuma; Masae Satoh; Yoji Yoshioka

    \\u000a Advances in computer science and information technology (IT) are giving rise to the rapid development of health-care databases\\u000a and related information systems. The health-care environment is undergoing rapid changes as information systems develop. Disease\\u000a structure is also changing, from being dominated by acute and chronic infectious diseases to being dominated by lifestyle-related\\u000a diseases. As the size of the elderly population

  8. Chronic Thromboembolic Pulmonary Hypertension

    Microsoft Academic Search

    William R. Auger; Peter F. Fedullo

    Chronic thromboembolic pulmonary hypertension (CTEPH) is an important form of pulmonary hypertension to detect because prompt\\u000a treatment can lead to a surgical cure. The true incidence is unknown, but it is estimated to occur in 1% to 3% of patients\\u000a following acute thromboembolism. Detection may be difficult, because symptoms are nonspecific and other diagnoses are often\\u000a made before that of

  9. Chronic thromboembolic pulmonary hypertension

    Microsoft Academic Search

    P. Dartevelle; E. Fadel; S. Mussot; A. Chapelier; P. Herve; M. de Perrot; J. Cerrina; F. L. Ladurie; D. Lehouerou; M. Humbert; O. Sitbon; G. Simonneau

    2004-01-01

    ABSTRACT: Pulmonary arterial hypertension is a severe disease that has been ignored for a long time. However, over the past 20 yrs chest physicians, cardiologists and thoracic,surgeons,have,shown,increasing interest in this disease because,of the development of new therapies, that have improved both the outcome and quality of life of patients, including pulmonary transplantation and prostacyclin therapy. Chronic thromboembolic,pulmonary,arterial hypertension,(CTEPH) can be

  10. Chronic Thromboembolic Pulmonary Hypertension

    Microsoft Academic Search

    Irene M. Lang; Walter Klepetko

    Chronic thromboembolic pulmonary hypertension (CTEPH) is a poorly understood disorder. It is characterized by pulmonary hypertension\\u000a associated with an apparent failure to resolve extensive, typically major-vessel pulmonary thromboemboli. Although CTEPH is\\u000a believed to be a thromboembolic disease, the typical risk factors for venous thromboembolism are absent. According to the\\u000a 2003 Venice classification of pulmonary hypertension, CTEPH represents group IV of

  11. Technology for chronic pain.

    PubMed

    Zhang, Suyi; Seymour, Ben

    2014-09-22

    Technology developed for chronic pain management has been fast evolving and offers new stand-alone prospects for the diagnosis and treatment of pain, rather than simply addressing the limitations of pharmacology-based approaches. There are two central challenges to be tackled: developing objective measures that capture the subjectivity of pain experience, and providing technology-based interventions that offer new approaches for pain management. Here we highlight recent developments that hold promise in addressing both of these challenges. PMID:25247372

  12. Approach to chronic cough.

    PubMed

    Lahiri, Keya Rani; Landge, Amruta Avinash

    2014-10-01

    Chronic cough does affect quality of life in children. Most of the times it is treated with over-the-counter cough syrups and antibiotics. The etiology of chronic cough is so diverse, that treatment needs to be directed to the specific etiology, rather than treating symptomatically. Grossly, chronic cough is classified as specific and non-specific cough. Allergic conditions, followed by tuberculosis are more commonly encountered etiologies in India. Baseline investigations to be performed are chest radiograph and peak flow metry. If specific cause of cough is not obvious, then therapeutic trial with ?2 agonist, followed by peak flowmetry to evaluate reversibility of airway hypersensitivity, is useful to label the child asthmatic or non-asthmatic. Rampant uses of antibiotics need to be avoided for conditions like asthma. If tuberculosis is diagnosed or suspected, it is better to treat the child, rather than giving therapeutic trial. Over-the-counter cough syrups are as good as placebo, and should be avoided. Trial of anti asthma, anti allergic rhinitis and anti reflux therapies are avoided, unless the diagnosis is one of these conditions. If the child is distressed or the case seems to be complicated, it is best to refer the child to a tertiary care centre and keep a close follow up. PMID:24752628

  13. Nutrition in chronic pancreatitis

    PubMed Central

    Rasmussen, Henrik Hřjgaard; Irtun, Řivind; Olesen, Sřren Schou; Drewes, Asbjřrn Mohr; Holst, Mette

    2013-01-01

    The pancreas is a major player in nutrient digestion. In chronic pancreatitis both exocrine and endocrine insufficiency may develop leading to malnutrition over time. Maldigestion is often a late complication of chronic pancreatic and depends on the severity of the underlying disease. The severity of malnutrition is correlated with two major factors: (1) malabsorption and depletion of nutrients (e.g., alcoholism and pain) causes impaired nutritional status; and (2) increased metabolic activity due to the severity of the disease. Nutritional deficiencies negatively affect outcome if they are not treated. Nutritional assessment and the clinical severity of the disease are important for planning any nutritional intervention. Good nutritional practice includes screening to identify patients at risk, followed by a thoroughly nutritional assessment and nutrition plan for risk patients. Treatment should be multidisciplinary and the mainstay of treatment is abstinence from alcohol, pain treatment, dietary modifications and pancreatic enzyme supplementation. To achieve energy-end protein requirements, oral supplementation might be beneficial. Enteral nutrition may be used when patients do not have sufficient calorie intake as in pylero-duodenal-stenosis, inflammation or prior to surgery and can be necessary if weight loss continues. Parenteral nutrition is very seldom used in patients with chronic pancreatitis and should only be used in case of GI-tract obstruction or as a supplement to enteral nutrition. PMID:24259957

  14. Láser infrarrojo frente a acupuntura en el tratamiento del espolón calcáneo

    Microsoft Academic Search

    A. Orellana Molina; A. Hernández Díaz; P. J. Larrea Cox; S. Fernández Yanes; B. M. González Méndez

    2010-01-01

    IntroductionPhysical Medicine and Rehabilitation and Traditional and Natural Medicine are medical specialties that develop measures for the promotion of health, prevention, diagnosis and treatment, using physiotherapy and natural agents, along with acupuncture and therapeutic laser. The heel spur is an osteophyte that grows in the front part of the plantar tuberosity of the heel bone secondary to inflammatory processes of

  15. Palaeoclimate: East Antarctica's Achilles' heel

    NASA Astrophysics Data System (ADS)

    Hillenbrand, Claus-Dieter

    2013-09-01

    The East Antarctic ice sheet is believed to be Earth's most stable ice sheet. Changes in geochemical composition of offshore sediments suggest that its margin repeatedly retreated by at least 350-550 kilometres inland between 5.3 and 3.3 million years ago.

  16. Collapse of the keratin filament network through the expression of mutant keratin 6c observed in a case of focal plantar keratoderma.

    PubMed

    Kubo, Akiharu; Oura, Yuiko; Hirano, Takashige; Aoyama, Yumi; Sato, Showbu; Nakamura, Kaori; Takae, Yujiro; Amagai, Masayuki

    2013-07-01

    Focal palmoplantar keratoderma (PPK) with severe pain is a hallmark of pachyonychia congenita, a rare autosomal dominant disorder involving PPK and hypertrophic nail dystrophy. Some families present focal PPK with either minimal or no nail changes. Dominant-negative mutations in any of the four identified keratin genes, KRT6A, KRT6B, KRT16 or KRT17, lead to pachyonychia congenita. However, the majority of families with focal PPK showing minimal or no nail changes do not harbor mutations in these genes. Recently, mutations of KRT6C were identified in families with focal PPK alone. Here, we report a 26-year-old Japanese man with focal plantar hyperkeratosis that developed at approximately 10 years of age with no palmar involvement and no nail alterations. We identified a missense KRT6C mutation c.1414G>A resulting in an p.Glu472Lys substitution, as reported in other Japanese patients. When the mutant keratin 6c protein is exogenously expressed in human HaCaT cells, a collapse of the keratin filament network is observed in a dose-dependent manner, suggesting the mutation has a dominant-negative effect on keratin filament network formation. The mutated residue is located at the helix termination motif of keratin 6c. The peptide sequence around this residue is highly conserved among type II, III and IV intermediate filament proteins. Glu to Lys mutations of the equivalent residue have been reported in a variety of inherited diseases, including neurodegenerative diseases, corneal dystrophy and skin disorders, suggesting that this residue is vital to keratin function. PMID:23662636

  17. Tennis in hot and cool conditions decreases the rapid muscle torque production capacity of the knee extensors but not of the plantar flexors

    PubMed Central

    Girard, Olivier; Racinais, Sébastien; Périard, Julien D

    2014-01-01

    Objectives To assess the time course of changes in rapid muscle force/torque production capacity and neuromuscular activity of lower limb muscles in response to prolonged (?2?h) match-play tennis under heat stress. Methods The rates of torque development (RTD) and electromyographic activity (EMG; ie, root mean square) rise were recorded from 0 to 30, –50, –100 and –200?ms during brief (3–5?s) explosive maximal isometric voluntary contractions (MVC) of the knee extensors (KE) and plantar flexors (PF), along with the peak RTD within the entirety of the torque-time curve. These values were recorded in 12 male tennis players before (prematch) and after (postmatch, 24 and 48?h) match-play in HOT (?37°C) and COOL (?22°C) conditions. Results The postmatch core temperature was greater in the HOT (?39.4°C) vs COOL (?38.7°C) condition (p<0.05). Reductions in KE RTD occurred within the 0–200?ms epoch after contraction onset postmatch and at 24?h, compared with prematch, independent of environmental conditions (p<0.05). A similar reduction in the KE peak RTD was also observed postmatch relative to prematch (p<0.05). No differences in KE RTD values were observed after normalisation to MVC torque. Furthermore, the rate of KE EMG activity rise remained unchanged. Conversely, the PF contractile RTD and rate of EMG activity rise were unaffected by the exercise or environmental conditions. Conclusions In the KE, a reduction in maximal torque production capacity following prolonged match-play tennis appears to account for the decrease in the rate of torque development, independent of environmental conditions, while remaining unchanged in the PF. PMID:24668381

  18. Flavopiridol in Treating Patients With Chronic Lymphocytic Leukemia

    ClinicalTrials.gov

    2013-01-16

    B-cell Chronic Lymphocytic Leukemia; Refractory Chronic Lymphocytic Leukemia; Stage I Chronic Lymphocytic Leukemia; Stage II Chronic Lymphocytic Leukemia; Stage III Chronic Lymphocytic Leukemia; Stage IV Chronic Lymphocytic Leukemia

  19. Interventions for chronic blepharitis

    PubMed Central

    Lindsley, Kristina; Matsumura, Sueko; Hatef, Elham; Akpek, Esen K

    2012-01-01

    Background Blepharitis, an inflammatory condition associated with itchiness, redness, flaking, and crusting of the eyelids, is a common eye condition that affects both children and adults. It is common in all ethnic groups and across all ages. Although infrequent, blepharitis can lead to permanent alterations to the eyelid margin or vision loss from superficial keratopathy (abnormality of the cornea), corneal neovascularization, and ulceration. Most importantly, blepharitis frequently causes significant ocular symptoms such as burning sensation, irritation, tearing, and red eyes as well as visual problems such as photophobia and blurred vision. The exact etiopathogenesis is unknown, but suspected to be multifactorial, including chronic low-grade infections of the ocular surface with bacteria, infestations with certain parasites such as demodex, and inflammatory skin conditions such as atopy and seborrhea. Blepharitis can be categorized in several different ways. First, categorization is based on the length of disease process: acute or chronic blepharitis. Second, categorization is based on the anatomical location of disease: anterior, or front of the eye (e.g. staphylococcal and seborrheic blepharitis), and posterior, or back of the eye (e.g. meibomian gland dysfunction (MGD)). This review focuses on chronic blepharitis and stratifies anterior and posterior blepharitis. Objectives To examine the effectiveness of interventions in the treatment of chronic blepharitis. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 1), MEDLINE (January 1950 to February 2012), EMBASE (January 1980 to February 2012), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We searched the reference lists of included studies for any additional studies not identified by the electronic searches. There were no date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 9 February 2012. Selection criteria We included randomized controlled trials (RCTs) and quasi-randomized controlled trials (CCTs) in which participants were adults aged 16 years or older and clinically diagnosed with chronic blepharitis. We also included trials where participants with chronic blepharitis were a subset of the participants included in the study and data were reported separately for these participants. Interventions within the scope of this review included medical treatment and lid hygiene measures. Data collection and analysis Two authors independently assessed search results, reviewed full-text copies for eligibility, examined risk of bias, and extracted data. Data were meta-analyzed for studies comparing similar interventions and reporting comparable outcomes with the same timing. Otherwise, results for included studies were summarized in the text. Main results There were 34 studies (2169 participants with blepharitis) included in this review: 20 studies (14 RCTs and 6 CCTs) included 1661 participants with anterior or mixed blepharitis and 14 studies (12 RCTs and 2 CCTs) included 508 participants with posterior blepharitis (MGD). Due to the heterogeneity of study characteristics among the included studies, with respect to follow-up periods and types of interventions, comparisons, and condition of participants, our ability to perform meta-analyses was limited. Topical antibiotics were shown to provide some symptomatic relief and were effective in eradicating bacteria from the eyelid margin for anterior blepharitis. Lid hygiene may provide symptomatic relief for anterior and posterior blepharitis. The effectiveness of other treatments for blepharitis, such as topical steroids and oral antibiotics, were inconclusive. Authors’ conclusions Despite identifying 34 trials related to treatments for blepharitis, there is no strong evidence for any of the treatments in

  20. Psychiatric issues in chronic pain

    Microsoft Academic Search

    Michael R. Clark

    2009-01-01

    Chronic pain requires comprehensive care. While interdisciplinary approaches are recommended, the role of psychiatrists is\\u000a often misunderstood. Psychiatrists should be involved with the care of patients with chronic pain as early as possible to\\u000a maximize outcome. Psychiatrists offer an expertise that specifically addresses important deficiencies in the care of patients\\u000a with chronic pain: 1) the lack of a detailed formulation,

  1. Advanced Imaging of Chronic Pancreatitis

    Microsoft Academic Search

    Nabil Elia Choueiri; Numan Cem Balci; Samer Alkaade; Frank R. Burton

    2010-01-01

    Chronic pancreatitis is characterized by continuing inflammation, destruction, and irreversible morphological changes in the\\u000a pancreatic parenchyma and ductal anatomy. These changes lead to chronic pain and\\/or loss of function. Although these definitions\\u000a are simple, the clinical diagnosis of chronic pancreatitis remains difficult to make, especially for early disease. Routine\\u000a imaging modalities such as transabdominal ultrasound and standard CT scans are

  2. Chronic migraine in women.

    PubMed

    Cady, Roger K

    2014-02-01

    Chronic migraine is a frequent, severely disabling headache that often evolves from EM. Treatment should be individualized with consideration of the patient as a whole person rather than just the headaches. Many options have been used for acute and preventive pharmacologic management, although good scientific and clinical evidence is limited to a few options. Evidence supports the efficacy and tolerability of both topiramate and onabotulinumtoxinA for prevention of CM headaches. However, only onabotulinumtoxinA is approved by the FDA for preventive treatment of CM. PMID:24527485

  3. Brotizolam and chronic insomnia

    PubMed Central

    Fritz-Osner, A.; Arias-Ortiz, J. L.; Dorantes, J. F.; Rabago-Sánchez, J.; Rodríguez-Tenorio, A.; Sánchez-Martinez, J.

    1983-01-01

    1 A double-blind, crossover study was carried out on the acceptability of three doses of brotizolam (0.125, 0.25 and 0.5 mg) in chronic insomniacs aged between 21 and 75 years (33 men: 42 women). 2 Patients reported a shorter time to fall asleep and less nocturnal awakenings. Improvement in sleep was evident during the first week of the study when each patient received 0.25 mg. 3 There were no dose-related side-effects, and on withdrawal from the medication there was no evidence of disturbed sleep which would have suggested a rebound effect. PMID:6362700

  4. [Chronic thromboembolic pulmonary hypertension].

    PubMed

    Vavera, Zden?k

    2015-03-01

    In recent years, we have witnessed a growing interest in diseases of pulmonary circulation. It is due to the development of specific drug therapy for pulmonary hypertension (PH), improving the availability and performance of endarterectomy techniques of pulmonary artery. This technique has been established as method of choice for patients with chronic thromboembolic pulmonary hypertension (CTEPH). However, the crucial issue is early indication of treatment, right diagnosis and determination of exact type of pulmonary hypertension. Modern therapeutic approaches provide better prognosis, quality of life and even possibility to cure the patients, especially suffering from CTEPH. This article discusses the issue of CTEPH. PMID:25873119

  5. Chronic Wasting Disease

    USGS Publications Warehouse

    Richards, Bryan

    2007-01-01

    Chronic wasting disease (CWD) is an always-fatal, neurological illness occurring in North American cervids (members of the deer family), including white-tailed deer, mule deer, elk and moose. Since its discovery in 1967, CWD has spread geographically and increased in prevalence locally. CWD is contagious; it can be transmitted freely within and among free-ranging populations. It is likely that diseased animals can transmit CWD to healthy animals long before they become clinically ill. Managing CWD in free-ranging populations is extremely difficult, therefore preventative measures designed to reduce the chance for disease spread are critically important.

  6. Chronic inflammatory demyelinative polyneuropathy.

    PubMed

    Said, Gérard; Krarup, Christian

    2013-01-01

    Chronic inflammatory demyelinative polyneuropathy (CIDP) is an acquired polyneuropathy presumably of immunological origin. It is characterized by a progressive or a relapsing course with predominant motor deficit. The diagnosis rests on the association of non-length-dependent predominantly motor deficit following a progressive or a relapsing course associated with increased CSF protein content. The demonstration of asymmetrical demyelinating features on nerve conduction studies is needed for diagnosis. The outcome depends on the amplitude of axon loss associated with demyelination. CIDP must be differentiated from acquired demyelinative neuropathies associated with monoclonal gammopathies. CIDP responds well to treatment with corticosteroids, intravenous immunoglobulins, and plasma exchanges, at least initially. PMID:23931792

  7. FINAL REPORT FOR THE INITIAL SOLID PHASE CHARACTERIZATION OF THE 2011 GRAB SAMPLES AND COMPOSITE FOR THE C-109 HARD HEEL STUDY

    SciTech Connect

    PAGE JS; COOKE G; PESTOVICH JA

    2011-12-01

    On May 3, 2011, solid phase characterization subsamples were taken from six of the eight grab samples that had been collected from tank 241-C-109 in April, 2011 and delivered to the 222-S Laboratory. These subsamples were characterized in order to guide the creation of the composite for the C-109 hard heel study. Visual observation showed that there was a large variability in the physical characteristics of the eight individual grab samples. Several of the grab samples consisted of 'stone-like' cobbles (several > 25 mm in diameter) while the other grab samples were of a finer granular composition referred to as 'bulk material'. Half of the six subsamples taken for this initial SPC were of crushed cobbles and half were of the bulk material. Scanning electron microscopy was performed on all six subsamples, and X-ray diffraction was performed on all three of the 'bulk material' samples and one of the crushed cobble samples. The crushed cobbles were found to be composed primarily of gibbsite (Al[OHh]{sub 3}). Analysis by X-ray diffraction indicated gibbsite to be the only crystalline phase detected, and scanning electron microscopy showed the crushed cobbles to consist primarily of aggregates of euhedral to subhedral gibbsite crystals that were 20 to 100 {mu}m in size. The aggregates, having a moderate amount of pore space, were cemented primarily by recrystallized gibbsite making them resistant to crushing. The bulk material consisted of coarse to fine-grained pebble-sized (2 to 20 mm) particles. The X-ray diffraction analysis showed them to be a mixture of natrophosphate (Na{sub 7}[PO{sub 4}]{sub 2}F{center_dot}19[H{sub 2}O]) and gibbsite crystals in varying amounts in each of the three subsamples (i.e., some grab samples were primarily natrophosphate while others were mixed with gibbsite). The scanning electron microscopy analysis of the bulk material showed the crystals to be euhedral to anhedral (rounded) in shape. Trace phases, too minor to be detected by XRD, were observed in the SEM analysis of both the crushed cobble and bulk material. Some of the trace phases were identified as uranium-rich (sodium diuranate and/or clarkeite), sodium aluminum-rich (dawsonite and/or sodium aluminate), and a sludge-like phase with a variable chemistry rich in iron, nickel, and lead. A composite was created from the grab samples and a sample was taken from the composite, labeled S11T009482, for solid phase characterization. In general, the vast majority of the particles and aggregates analyzed in the composite were either gibbsite or natrophosphate. A very minor phase consisting of dispersed small particles was rich in uranium.

  8. Diagnostic dilemmas in chronic urticaria.

    PubMed

    Toubi, E; Grattan, C; Zuberbier, T

    2015-06-01

    The European Academy of Allergy and Clinical Immunology (EAACI)/Global Allergy and Asthma European Network (GA(2) LEN)/European Dermatology Forum (EDF)/World Allergy Organization (WAO) recently published updated recommendations for the classification, diagnosis and management of chronic urticaria (CU). This article discusses several cases of CU that provide examples of how the recommendations in the guidelines can be implemented in the diagnosis of chronic spontaneous urticaria (CSU) (also called chronic idiopathic urticaria [CIU]), chronic inducible urticaria (CINDU) or CU with comorbidities. PMID:26053291

  9. ACUTE TO CHRONIC ESTIMATION SOFTWARE FOR WINDOWS

    EPA Science Inventory

    Chronic No-Observed Effect Concentrations (NOEC) are commonly determined by either using acute-to-chronic ratios or by performing an ANOVA on chronic test data; both require lengthy and expensive chronic test results. Acute-to-Chronic Estimation (ACE) software was developed to p...

  10. Chronic cough due to occupational factors

    Microsoft Academic Search

    David A Groneberg; Dennis Nowak; Anke Wussow; Axel Fischer

    2006-01-01

    Within the large variety of subtypes of chronic cough, either defined by their clinical or pathogenetic causes, occupational chronic cough may be regarded as one of the most preventable forms of the disease. Next to obstructive airway diseases such as asthma or chronic obstructive pulmonary disease, which are sometimes concomitant with chronic cough, this chronic airway disease gains importance in

  11. Anti-inflammatory activity of four solvent fractions of ethanol extract of Mentha spicata L. investigated on acute and chronic inflammation induced rats.

    PubMed

    Arumugam, P; Priya, N Gayatri; Subathra, M; Ramesh, A

    2008-07-01

    Anti-inflammatory effects of four solvent fractions of ethanol extract of Mentha spicata were evaluated in acute and chronic inflammation induced in Wistar albino rats. Lipid peroxidation (LPO) and some antioxidants produced during chronic inflammation were quantitated. Hexane (320mg/kg of body weight in 25% DMSO), chloroform (320mg/kg body weight in 25% DMSO), ethyl acetate (160mg/kg body weight in 25% DMSO), aqueous (320mg/kg of body weight in ddH(2)O) fractions, two negative control groups (25% DMSO and ddH(2)O) and two anti-inflammatory drugs (Diclofenac: 25mg/kg of body weight; Indomethacin: 10mg/kg of body weight both in ddH(2)O) were administered by oral intubations to the eight groups of rats consisting six animals, each. In acute study, 1% carrageenan was injected subcutaneously in the sub-plantar region of the right hind paw after 1h of administration of test doses. The increased paw edema was measured at 0.5, 1, 2, 4, 8, 16 and 24h intervals. In the chronic study, the oral administration was carried out for seven consecutive days. On eighth day, four sterile cotton pellets (50mg each) were implanted subcutaneously in the dorsal region of the rats. On the sixteenth day, the rats were sacrificed and the cotton pellets with granulomatous tissue were dissected out and weighed (fresh and dry). Both in chronic and acute inflammation, ethyl acetate (EAF) and aqueous fraction (AF) were effective. EAF is comparable with the positive standards in chronic inflammation. The results indicate that EAF's anti-inflammatory activity is largely due to its ability to modulate in vivo antioxidants. PMID:21783894

  12. The Relationship Between Chronic and Non-Chronic Trends

    Microsoft Academic Search

    Kejian Niu; Liming Chen; Ying Liu; Herman Jenich

    2009-01-01

    Cost trend plays a crucial role in evaluating the outcome of disease management (DM) programs, which typ- ically attempt to manage members who have any of 5 major chronic conditions (the chronic population) through targeted intervention. A widely adopted methodology for evaluating DM outcomes is commonly referred to as the \\

  13. Chronic suppurative otitis media

    PubMed Central

    2012-01-01

    Introduction Chronic suppurative otitis media (CSOM) is a common cause of hearing impairment and disability. Occasionally it can lead to fatal intracranial infections and acute mastoiditis, especially in developing countries. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for chronic suppurative otitis media in adults and in children? What are the effects of treatments for cholesteatoma in adults and in children? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 51 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review, we present information relating to the effectiveness and safety of the following interventions: topical ear cleansing, surgery for cholesteatoma, systemic antibiotics, topical antibiotics, topical antibiotics plus topical corticosteroids, topical antiseptics, topical corticosteroids, tympanoplasty (with or without mastoidectomy). PMID:23870746

  14. Chronic suppurative otitis media

    PubMed Central

    2007-01-01

    Introduction Chronic suppurative otitis media (CSOM) is a common cause of hearing impairment, disability, and poor scholastic performance, and can occasionally lead to fatal intracranial infections and acute mastoiditis, especially in resource-poor countries. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for chronic suppurative otitis media in adults; and in children? We searched: Medline, Embase, The Cochrane Library and other important databases up to January 2007 (BMJ Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 48 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: ear cleansing, systemic antibiotics, topical antibiotics, topical antiseptics, topical corticosteroids, tympanoplasty (with or without mastoidectomy). PMID:19454051

  15. Chronic Daily Headache.

    PubMed

    Couch, James R.

    2003-11-01

    The therapy of chronic daily headache (CDH) is complex and involves a combination of drugs, supportive psychotherapy, nondrug therapy, "tender-loving care," and "tough love." CDH is a chronic problem with exacerbations and remissions. Patients with CDH often manifest mood disorders, and recognition and treatment of these problems is a key component of success. The use of preventative antimigraine therapy is a major component of treatment of this condition. Patients with exacerbations may need judicious short courses of medications that can produce medication-overuse headache. Patients may switch to another physician to get opiates or other pain relief medications. The patient may later realize this mistake and return to the physician. Use of patient "contracts," in which the patient agrees not to take more than a prescribed amount of restricted medication or seek it elsewhere, may be helpful. In this area, there is no standard patient or standard therapeutic regimen. The treatment plan must be individualized for each patient. Taking a little extra time to talk with patients and discuss medications, procedures, and goals and objectives may pay bigger dividends in the therapeutic relationship later in the course of treatment. PMID:14516524

  16. Chronic Wound Biofilm Model

    PubMed Central

    Ganesh, Kasturi; Sinha, Mithun; Mathew-Steiner, Shomita S.; Das, Amitava; Roy, Sashwati; Sen, Chandan K.

    2015-01-01

    Significance: Multispecies microbial biofilms may contribute to wound chronicity by derailing the inherent reparative process of the host tissue. In the biofilm form, bacteria are encased within an extracellular polymeric substance and become recalcitrant to antimicrobials and host defenses. For biofilms of relevance to human health, there are two primary contributing factors: the microbial species involved and host response which, in turn, shapes microbial processes over time. This progressive interaction between microbial species and the host is an iterative process that helps evolve an acute-phase infection to a pathogenic chronic biofilm. Thus, long-term wound infection studies are needed to understand the longitudinal cascade of events that culminate into a pathogenic wound biofilm. Recent Advances: Our laboratory has recently published the first long-term (2 month) study of polymicrobial wound biofilm infection in a translationally valuable porcine wound model. Critical Issues: It is widely recognized that the porcine system represents the most translationally valuable approach to experimentally model human skin wounds. A meaningful experimental biofilm model must be in vivo, include mixed species of clinically relevant microbes, and be studied longitudinally long term. Cross-validation of such experimental findings with findings from biofilm-infected patient wounds is critically important. Future Directions: Additional value may be added to the experimental system described above by studying pigs with underlying health complications (e.g., metabolic syndrome), as is typically seen in patient populations. PMID:26155380

  17. Chronic fatigue syndrome

    PubMed Central

    2011-01-01

    Introduction Chronic fatigue syndrome (CFS) affects between 0.006% and 3% of the population depending on the criteria of definition used, with women being at higher risk than men. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for chronic fatigue syndrome? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 46 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antidepressants, cognitive behavioural therapy (CBT), corticosteroids, dietary supplements, evening primrose oil, galantamine, graded exercise therapy, homeopathy, immunotherapy, intramuscular magnesium, oral nicotinamide adenine dinucleotide, and prolonged rest. PMID:21615974

  18. Chronic fatigue syndrome

    PubMed Central

    2008-01-01

    Introduction Chronic fatigue syndrome (CFS) affects between 0.006% and 3% of the population depending on the criteria of definition used, with women being at higher risk than men. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for chronic fatigue syndrome? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2007 (BMJ Clinical evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 45 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antidepressants, cognitive behavioural therapy (CBT), corticosteroids, dietary supplements, evening primrose oil, galantamine, graded exercise therapy, homeopathy, immunotherapy, intramuscular magnesium, oral nicotinamide adenine dinucleotide, and prolonged rest. PMID:19445810

  19. Chronic prostatitis: management strategies.

    PubMed

    Murphy, Adam B; Macejko, Amanda; Taylor, Aisha; Nadler, Robert B

    2009-01-01

    The National Institutes of Health (NIH) has redefined prostatitis into four distinct entities. Category I is acute bacterial prostatitis. It is an acute prostatic infection with a uropathogen, often with systemic symptoms of fever, chills and hypotension. The treatment hinges on antimicrobials and drainage of the bladder because the inflamed prostate may block urinary flow. Category II prostatitis is called chronic bacterial prostatitis. It is characterized by recurrent episodes of documented urinary tract infections with the same uropathogen and causes pelvic pain, urinary symptoms and ejaculatory pain. It is diagnosed by means of localization cultures that are 90% accurate in localizing the source of recurrent infections within the lower urinary tract. Asymptomatic inflammatory prostatitis comprises NIH category IV. This entity is, by definition, asymptomatic and is often diagnosed incidentally during the evaluation of infertility or prostate cancer. The clinical significance of category IV prostatitis is unknown and it is often left untreated. Category III prostatitis is called chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). It is characterized by pelvic pain for more than 3 of the previous 6 months, urinary symptoms and painful ejaculation, without documented urinary tract infections from uropathogens. The syndrome can be devastating, affecting 10-15% of the male population, and results in nearly 2 million outpatient visits each year. The aetiology of CP/CPPS is poorly understood, but may be the result of an infectious or inflammatory initiator that results in neurological injury and eventually results in pelvic floor dysfunction in the form of increased pelvic muscle tone. The diagnosis relies on separating this entity from chronic bacterial prostatitis. If there is no history of documented urinary tract infections with a urinary tract pathogen, then cultures should be taken when patients are symptomatic. Prostatic localization cultures, called the Meares-Stamey 4 glass test, would identify the prostate as the source for a urinary tract infection in chronic bacterial prostatitis. If there is no infection, then the patient is likely to have CP/CPPS. For healthcare providers, the focus of therapy is symptomatic relief. The first therapeutic measure is often a 4- to 6-week course of a fluoroquinolone, which provides relief in 50% of men and is more efficacious if prescribed soon after symptoms begin. Second-line pharmacotherapy involves anti-inflammatory agents for pain symptoms and alpha-adrenergic receptor antagonists (alpha-blockers) for urinary symptoms. Potentially more effective is pelvic floor training/biofeedback, but randomized controlled trials are needed to confirm this. Third-line agents include 5alpha-reductase inhibitors, glycosaminoglycans, quercetin, cernilton (CN-009) and saw palmetto. For treatment refractory patients, surgical interventions can be offered. Transurethral microwave therapy to ablate prostatic tissue has shown some promise. The treatment algorithm provided in this review involves a 4- to 6-week course of antibacterials, which may be repeated if the initial course provides relief. Pain and urinary symptoms can be ameliorated with anti-inflammatories and alpha-blockers. If the relief is not significant, then patients should be referred for biofeedback. Minimally invasive surgical options should be reserved for treatment-refractory patients. PMID:19192937

  20. Magnetic resonance imaging evaluation of calcaneal fat pads in patients with os calcis fractures.

    PubMed

    Levy, A S; Berkowitz, R; Franklin, P; Corbett, M; Whitelaw, G P

    1992-02-01

    Destruction of the calcaneal fat pad has been implicated as a source of chronic pain following fractures of the os calcis. Several investigators postulate that the initial trauma that produces a calcaneal fracture also results in destruction of the U-shaped fibrous septa that maintain the piston-like organization of the fat columns. Fibrosis and loss of the protective cushioning provided by the fat pad may eventually occur. The authors report on the largest series of magnetic resonance images of the calcaneal fat pad in the heels of patients with calcaneal fractures. A prospective consecutive study utilizing magnetic resonance imaging was performed on 22 heels with calcaneal fractures. Ten contralateral heels without calcaneal fracture and the heels of five normal subjects were scanned as controls. No signal changes suggestive of increased fat pad edema, fibrosis, or fatty release were detected. In addition, the vertical septa were well visualized and found to be intact in all cases. The height of the fat pad was measured, with no changes noted as compared with the contralateral heel. In those patients with acute fractures, signal changes suggestive of hematoma were well visualized in the soft tissue surrounding the calcaneus. In two of these cases, there was extension beneath the plantar fascia, but no penetration into the fat columns. Magnetic resonance imaging allows excellent detailed visualization of the calcaneal fat pad and surrounding structures. No evidence is found to support the hypothesis that marked damage to the gross structure of the fat pad occurs at the time of injury.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1572588

  1. Chronic dizziness: a practical approach

    Microsoft Academic Search

    A. M. Bronstein; T. Lempert; B. M. Seemungal

    2010-01-01

    Patients with chronic dizziness pose a particular challenge to the clinician, partly because their symptoms correlate poorly with standard vestibular tests; so a ‘test and think later’ approach is likely to lead to diagnostic confusion rather than clarity. Rather, a meticulous clinical assessment is required. Here our approach to the chronic dizzy patient is described with an emphasis on treating

  2. Children Coping with Chronic Illness.

    ERIC Educational Resources Information Center

    Perez, Lissette M.

    Children who live with chronic illness are confronted with challenges that frequently force them to cope in myriad ways. The ways in which children face chronic illness are summarized in this literature review. Also covered, are how the effects of family can influence coping strategies and how family members, especially parents, cope with their…

  3. Chronic Pain in College Students

    PubMed Central

    Thomas, Michael; Roy, Ranjan; Cook, Andrew; Marykuca, Steve

    1992-01-01

    A survey of university students confirms earlier studies that found chronic pain fairly common among young adults. Students with chronic pain were similar demographically and psychologically to students with pain of less than 3 months' duration, but were much more likely to use analgesics and alcohol and to report that pain interfered with school work. Treatment implications are discussed. PMID:21221345

  4. Chronic bronchitis in textile workers

    Microsoft Academic Search

    R. M. Niven; A. M. Fletcher; C. A. Pickering; D. Fishwick; C. J. Warburton; J. C. Simpson; H. Francis; L. A. Oldham

    1997-01-01

    BACKGROUND: Exposure to cotton is known to produce a specific occupational disease known as byssinosis. A large population of textile workers was investigated to determine whether such exposure was also associated with chronic bronchitis once other possible aetiological factors had been accounted for. METHODS: A total of 2991 workers were investigated for the presence of symptoms compatible with chronic bronchitis.

  5. Program for the Chronically Ill.

    ERIC Educational Resources Information Center

    Schoenherr, Arline; Schnarr, Barbara

    The program for chronically ill students in the Detroit public schools is described. Forms are presented listing needed information and implications for teachers of the following conditions: diabetes, sickle cell anemia, chronic renal failure, congenital heart disease, hemophilia, rheumatoid arthritis, asthma, leukemia, and cystic fibrosis. The…

  6. Chronic Pain and Neuropsychological Functioning

    Microsoft Academic Search

    Robert P. Hart; Michael F. Martelli; Nathan D. Zasler

    2000-01-01

    This review article examines the effect of chronic pain on neuropsychological functioning. Primary attention is given to studies that include patient groups without a history of traumatic brain injury (TBI) or neurologic disorders. Numerous studies were identified that demonstrate neuropsychological impairment in patients with chronic pain, particularly on measures assessing attentional capacity, processing speed, and psychomotor speed. Despite suggestive findings,

  7. A diagnosis challenge-L4 nerve root compression as the initial presentation of chronic inflammatory demyelinating polyneuropathy.

    PubMed

    Cojocaru, Inimioara Mihaela; Alexianu, Marilena; Bastian, Alexandra; Sapira, Violeta; Her?ea, Cristina; Cojocaru, M

    2012-01-01

    The authors present the case of a 65-year-old woman who was admitted for paraparesis and paresthesias in the inferior limbs. The neurological examination revealed the difficulty in extension of the right foot and of the right toe, accompanied by paresthesias located in the anterolateral area of the right leg, dorsum and plantar area of the foot, the reduction of the right knee jerk, and of the ankle tendon jerk both sides. The vertebro-spinal MRI showed lumbar canal stenosis with L4 intraforaminal compression on the right, and L2-L3 on the left. CSF examination revealed mild increase in protein concentration. The morphological picture of the sural nerve biopsy was compatible with a chronic inflammatory neuropathy and severe muscular lesions of neurogenic origin were observed on right gastrocnemius muscle biopsy. The diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP) was established. Solu-medrol (0.5 g/d)-5 days, then medrol (prednisolone) was done, followed by improving of the symptomatology. For the relapse of the disease intravenous immunoglobulins (IVIG)-0.4 g/kg/d-5 days was the elective treatment. Six months later she presented a new relapse. IVIG were administered with the remission of the sensitive symptoms. A chronic treatment with medrol was recommended. The diagnosis of L4 disc herniation was obvious in the studied case, but the electroneurographic examination brought extra data for the associated diagnosis of CIDP whose onset was asymmetrical and initially paucisymptomatic. Neither the electroneurographic examination nor the CSF examination were total relevant for CIDP, imposing the sural nerve biopsy. The diagnosis of CIDP involves a team-work composed of neurologist, electroneurophysiologist and neuropathologist. PMID:23610977

  8. Chronic Liver Disease and Hispanic Americans

    MedlinePLUS

    ... Population Profiles > Hispanic/Latino > Chronic Liver Disease Chronic Liver Disease and Hispanic Americans Among the Hispanic/Latino population, chronic liver disease is a leading cause of death. While the ...

  9. Chronic kidney disease.

    PubMed

    Drawz, Paul; Rahman, Mahboob

    2015-06-01

    This issue provides a clinical overview of chronic kidney disease, focusing on prevention, diagnosis, treatment, and patient information. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including ACP Smart Medicine and MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic from these primary sources in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of science writers and physician writers. Editorial consultants from ACP Smart Medicine and MKSAP provide expert review of the content. Readers who are interested in these primary resources for more detail can consult http://smartmedicine.acponline.org, http://mksap.acponline.org, and other resources referenced in each issue of In the Clinic. PMID:26030647

  10. Chronic thromboembolic pulmonary hypertension.

    PubMed

    Hoeper, Marius M; Madani, Michael M; Nakanishi, Norifumi; Meyer, Bernhard; Cebotari, Serghei; Rubin, Lewis J

    2014-07-01

    Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare but debilitating and life-threatening complication of acute pulmonary embolism. CTEPH results from persistent obstruction of pulmonary arteries and progressive vascular remodelling. Not all patients presenting with CTEPH have a history of clinically overt pulmonary embolism. The diagnostic work-up to detect or rule out CTEPH should include ventilation-perfusion scintigraphy, which has high sensitivity and a negative predictive value of nearly 100%. CT angiography usually reveals typical features of CTEPH, including mosaic perfusion, part or complete occlusion of pulmonary arteries, and intraluminal bands and webs. Patients with suspected CTEPH should be referred to a specialist centre for right-heart catheterisation and pulmonary angiography. Surgical pulmonary endarterectomy remains the treatment of choice for CTEPH and is associated with excellent long-term results and a high probability of cure. For patients with inoperable CTEPH, various medical and interventional therapies are being developed. PMID:24898750

  11. [Chronic inflammatory demyelinating polyneuropathy].

    PubMed

    Köller, H; Kieseier, B C; Jander, S; Hartung, H-P

    2003-04-01

    Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired immune-mediated disease of the peripheral nervous system with a prevalence of 1-2/100,000. Clinical and experimental findings suggest a role of immune pathomechanisms;however, the target antigens are still unknown. Beside classic CIDP with symmetrical proximal and distal paresis, subgroups of CIDP with pure motor or sensory deficits have been described. Diagnostic criteria include evidence of demyelination in electrophysiological examination and biopsy as well as elevated protein content in the CSF. Magnetic resonance imaging of plexuses and roots extends the diagnostic armamentarium and may be helpful in differential diagnosis. The utility of immunosuppressant/immunomodulatory therapies has been demonstrated in several studies. PMID:12707701

  12. Preventing Chronic Disease

    NSDL National Science Digital Library

    Persons with an interest in public health will want to make a beeline for this rather helpful and well-done journal offered by the Center for Disease Control (CDC). This online-only publication was started in January 2004, and contains a healthy mix of peer-reviewed articles, CDC announcements, and general interest pieces. The journal's interests are quite broad and include reproductive health, oral health, health risk behavior, and the value of policy and legislation in preventing chronic disease. Some of the recent articles in the journal have included pieces on childhood obesity prevention legislation, diabetes and tooth loss, and more specifically, "The Cradle to Prison Pipeline: An American Health Crisis". The site also contains an online archive and information for potential authors, peer reviewers, and information about email updates about new issues.

  13. Endotherapy in chronic pancreatitis.

    PubMed

    Tandan, Manu; Nageshwar Reddy, D

    2013-10-01

    Chronic pancreatitis (CP) is a progressive disease with irreversible changes in the pancreas. Patients commonly present with pain and with exocrine or endocrine insufficiency. All therapeutic efforts in CP are directed towards relief of pain as well as the management of associated complications. Endoscopic therapy offers many advantages in patients with CP who present with ductal calculi, strictures, ductal leaks, pseudocyst or associated biliary strictures. Endotherapy offers a high rate of success with low morbidity in properly selected patients. The procedure can be repeated and failed endotherapy is not a hindrance to subsequent surgery. Endoscopic pancreatic sphincterotomy is helpful in patients with CP with minimal ductal changes while minor papilla sphincterotomy provides relief in patients with pancreas divisum and chronic pancreatitis. Extracorporeal shock wave lithotripsy is the standard of care in patients with large pancreatic ductal calculi. Long term follow up has shown pain relief in over 60% of patients. A transpapillary stent placed across the disruption provides relief in over 90% of patients with ductal leaks. Pancreatic ductal strictures are managed by single large bore stents. Multiple stents are placed for refractory strictures. CP associated benign biliary strictures (BBS) are best treated with multiple plastic stents, as the response to a single plastic stent is poor. Covered self expanding metal stents are increasingly being used in the management of BBS though further long term studies are needed. Pseudocysts are best drained endoscopically with a success rate of 80%-95% at most centers. Endosonography (EUS) has added to the therapeutic armamentarium in the management of patients with CP. Drainage of pseudcysts, cannulation of inaccessible pancreatic ducts and celiac ganglion block in patients with intractable pain are all performed using EUS. Endotherapy should be offered as the first line of therapy in properly selected patients with CP who have failed to respond to medical therapy and require intervention. PMID:24115811

  14. Relationship of EMG/SMG features and muscle strength level: an exploratory study on tibialis anterior muscles during plantar-flexion among hemiplegia patients

    PubMed Central

    2014-01-01

    Background Improvement in muscle strength is an important aim for the rehabilitation of hemiplegia patients. Presently, the rehabilitation prescription depends on the evaluation results of muscle strength, which are routinely estimated by experienced physicians and therefore not finely quantitative. Widely-used quantification methods for disability, such as Barthel Index (BI) and motor component of Functional Independent Measure (M-FIM), yet have limitations in their application, since both of them differentiated disability better in lower than higher disability, and they are subjective and recorded in wide scales. In this paper, to explore finely quantitative measures for evaluation of muscle strength level (MSL), we start with the study on quantified electromyography (EMG) and sonomyography (SMG) features of tibialis anterior (TA) muscles among hemiplegia patients. Methods 12 hemiplegia subjects volunteered to perform several sets of plantar-flexion movements in the study, and their EMG signals and SMG signals were recorded on TA independently to avoid interference. EMG data were filtered and then the root-mean-square (RMS) was computed. SMG signals, specifically speaking, the muscle thickness of TA, were manually measured by two experienced operators using ultrasonography. Reproducibility of the SMG assessment on TA between operators was evaluated by non-parametric test (independent sample T test). Possible relationship between muscle thickness changes (TC) of TA and muscle strength level of hemiplegia patients was estimated. Results Mean of EMG RMS between subjects is found linearly correlated with MSL (R2?=?0.903). And mean of TA muscle TC amplitudes is also linearly correlated with MSL among dysfunctional legs (R2?=?0.949). Moreover, rectified TC amplitudes (dysfunctional leg/ healthy leg, DLHL) and rectified EMG signals (DLHL) are found in linear correlation with MSL, with R2?=?0.756 and R2?=?0.676 respectively. Meanwhile, the preliminary results demonstrate that patients’ peak values of TC are generally proportional to their personal EMG peak values in 12 dysfunctional legs and 12 healthy legs (R2?=?0.521). Conclusions It’s concluded that SMG could be a promising option to quantitatively estimate MSL for hemiplegia patients during rehabilitation besides EMG. However, after this exploratory study, they should be further investigated on a larger number of subjects. PMID:24461052

  15. [Neurosurgical treatment of chronic pain].

    PubMed

    Fontaine, Denys

    2013-06-01

    Neurosurgical treatment of pain is based on 3 concepts: 1) lesional techniques interrupt the transmission of nociceptive neural input by lesionning the nociceptive pathways (cordotomy, radicotomy...), they are indicated to treat morphine-resistant cancer pain; 2) neuromodulation techniques try to decrease pain by reinforcing inhibitory mechanisms, using chronic electrical stimulation of the nervous system (peripheral nerve stimulation, spinal cord stimulation, motor cortex stimulation...) to treat chronic neuropathic pain; 3) intrathecal infusion of analgesics (morphine, ziconotide), using implantable pumps, allows to increase their efficacy and to reduce their side effects. These techniques can improve, sometimes dramatically, patients with severe and chronic pain, refractory to all other treatments. PMID:23923757

  16. Chronic cancer: counseling the individual.

    PubMed

    Boerger-Knowles, Kimarie; Ridley, Tashi

    2014-01-01

    Advances in medicine significantly improved outcomes for many cancer patients, effectively moving it from an acute disease to a more chronic one. Living with a chronic cancer often prompts an existential search for meaning, as multiple losses impact the individual on a personal and familial level. At the same time, these patients must learn to adapt to the functional and relational changes necessitated by their disease. Two theoretical perspectives, meaning-making and family systems, are useful in understanding the experience of patients with chronic cancer and offering psychosocial interventions aimed at improving overall adjustment. PMID:24405236

  17. Chronic hypergastrinemia: causes and consequences.

    PubMed

    Orlando, Lori A; Lenard, Lane; Orlando, Roy C

    2007-10-01

    The hormone gastrin plays 2 important roles in gastrointestinal physiology--1 as a major factor in meal-stimulated gastric acid secretion and the other as a trophic hormone for epithelial and enterochromaffin cells. These roles are exaggerated to the point of pathology under conditions of chronic hypergastrinemia as exemplified by the Zollinger-Ellison syndrome and pernicious anemia. More recently, the concern about the potential risk of chronic hypergastrinemia has risen because of the widespread use of proton pump inhibitors for maintenance therapy in reflux esophagitis. For this reason, we present a concise overview of the origin, causes, and potential risks of chronic hypergastrinemia. PMID:17415644

  18. Chronic opioid pain management for chronic kidney disease.

    PubMed

    Nagar, Vittal R; Birthi, Pravardhan

    2015-03-01

    Questions from patients about pain conditions, pain treatment, and responses from authors are presented to help educate patients and make them effective self-advocates. The topics addressed in this issue are renal or kidney failure and chronic pain management with opioids, morphine, and oxycodone effect in the body over a period of time. This includes process of absorption, distribution, localization in tissues, biotransformation and excretion in chronic kidney disease, expected side effects and recommendations. PMID:25558925

  19. Low back pain (chronic)

    PubMed Central

    2008-01-01

    Introduction Over 70% of people in resource-rich countries develop low back pain (LBP) at some time. But recovery is not always favourable: 82% of non-recent-onset patients still experience pain one year later. Many chronic patients who were initially told that their natural history was good spend months or years seeking relief. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of oral drug treatments? What are the effects of injection therapy? What are the effects of non-drug treatments? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2007 (BMJ Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 74 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review, we present information relating to the effectiveness and safety of the following interventions: acupuncture, analgesics, antidepressants, back schools, behavioural therapy, electromyographic biofeedback, exercise, injections (epidural steroid injections, facet joint injections, local injections), intensive multidisciplinary treatment programmes, lumbar supports, massage, muscle relaxants, non-steroidal anti-inflammatory drugs (NSAIDs), spinal manipulative therapy, traction, and transcutaneous electrical nerve stimulation (TENS). PMID:19445791

  20. Chronic thromboembolic pulmonary hypertension.

    PubMed

    Kim, Nick H; Delcroix, Marion; Jenkins, David P; Channick, Richard; Dartevelle, Philippe; Jansa, Pavel; Lang, Irene; Madani, Michael M; Ogino, Hitoshi; Pengo, Vittorio; Mayer, Eckhard

    2013-12-24

    Since the last World Symposium on Pulmonary Hypertension in 2008, we have witnessed numerous and exciting developments in chronic thromboembolic pulmonary hypertension (CTEPH). Emerging clinical data and advances in technology have led to reinforcing and updated guidance on diagnostic approaches to pulmonary hypertension, guidelines that we hope will lead to better recognition and more timely diagnosis of CTEPH. We have new data on treatment practices across international boundaries as well as long-term outcomes for CTEPH patients treated with or without pulmonary endarterectomy. Furthermore, we have expanded data on alternative treatment options for select CTEPH patients, including data from multiple clinical trials of medical therapy, including 1 recent pivotal trial, and compelling case series of percutaneous pulmonary angioplasty. Lastly, we have garnered more experience, and on a larger international scale, with pulmonary endarterectomy, which is the treatment of choice for operable CTEPH. This report overviews and highlights these important interval developments as deliberated among our task force of CTEPH experts and presented at the 2013 World Symposium on Pulmonary Hypertension in Nice, France. PMID:24355646

  1. [Chronic thromboembolic pulmonary hypertension].

    PubMed

    Kim, Nick H; Delcroix, Marion; Jenkins, David P; Channick, Richard; Dartevelle, Philippe; Jansa, Pavel; Lang, Irene; Madani, Michael M; Ogino, Hitoshi; Pengo, Vittorio; Mayer, Eckhard

    2014-10-01

    Since the last World Symposium on Pulmonary Hypertension in 2008, we have witnessed numerous and exciting developments in chronic thromboembolic pulmonary hypertension (CTEPH). Emerging clinical data and advances in technology have led to reinforcing and updated guidance on diagnostic approaches to pulmonary hypertension, guidelines that we hope will lead to better recognition and more timely diagnosis of CTEPH. We have new data on treatment practices across international boundaries as well as long-term outcomes for CTEPH patients treated with or without pulmonary endarterectomy. Furthermore, we have expanded data on alternative treatment options for select CTEPH patients, including data from multiple clinical trials of medical therapy, including 1 recent pivotal trial, and compelling case series of percutaneous pulmonary angioplasty. Lastly, we have garnered more experience, and on a larger international scale, with pulmonary endarterectomy, which is the treatment of choice for operable CTEPH. This report overviews and highlights these important interval developments as deliberated among our task force of CTEPH experts and presented at the 2013 World Symposium on Pulmonary Hypertension in Nice, France. (J Am Coil Cardiol 2013;62:D92-9) ©2013 by the American College of Cardiology Foundation. PMID:25697039

  2. Chronic inflammatory demyelinating polyneuropathy.

    PubMed

    Vanasse, Michel; Rossignol, Elsa; Hadad, Elie

    2013-01-01

    Chronic inflammatory demyelinating polyneuropathy (CIDP) is characterized clinically by a progressive symmetrical weakness evolving over a period of at least 2 months. There is increased CSF protein and conduction block, reduced nerve conduction velocities, increased distal latencies, and/or absent F wave or prolonged F wave latency in two or more nerves. Incidence is lower in children (10 times less) than in adults, and the condition presents in an acute or subacute manner with frequent relapses. It is not associated with other systemic diseases such as neoplasia, diabetes mellitus, or monoclonal gammopathies. It appears to be immune-related as a variety of humoral and cellular autoimmune mechanisms have been implicated. Treatment is based on results obtained in randomized clinical trials (RCTs) conducted in adults as such studies are lacking in the pediatric population. The evolution of CIDP is more favorable in children than in adults, with 80-100% response rates to standard treatments (steroids, intravenous immunoglobulins, and/or plasmapheresis) and excellent outcome with complete functional recovery in most patients. Cases refractory to standard therapies do exist in children, for which azathioprine, methotrexate, and mycophenolate mofetil alone or more often in association with other treatments have been used. However, safety and efficacy data are still insufficient to give specific recommendations regarding the optimal choice. PMID:23622325

  3. Chronic Granulomatous Disease.

    PubMed

    Agarwal, Shreya

    2015-05-01

    Chronic Granulomatous Disease (CGD) is an inherited immunodeficiency disorder characterized by defective functioning of NADPH oxidase enzyme in the phagocytes. This leads to recurrent infections by catalase positive organisms and later, granuloma formation in multiple organs. This condition usually presents in the age group of 2-5 y and is uncommon in neonates. In this case report, we describe a rare case of CGD in a 40-day-old male child who initially presented with a history of erythematous pustular rash on left forearm and refusal to feeds. He remained unresponsive to regular antibiotics. CT chest and abdomen revealed multiple ill-defined lesions suggestive of granulomas or developing abscesses. Immunodeficiency workup showed negative Nitroblue Tetrazolium test and positive Dihydrorhodamine test (flow cytometry). A diagnosis of CGD was then made and treated accordingly. The aim of this report is to highlight the fact that although it is rare for CGD to present at such an early age, but in a neonate with multiple granulomas or abscesses, it should be considered as a differential and worked up accordingly. Early diagnosis and treatment can significantly improve the prognosis. PMID:26155526

  4. [Chronic myelogenous leukemia].

    PubMed

    Hochhaus, A; La Rosée, P; Eigendorff, E; Ernst, T

    2015-04-01

    The advent of tyrosine kinase inhibitors (TKI) has improved the prognosis and outcome of patients with chronic myelogenous leukemia (CML) considerably. Compared with imatinib, the first-line use of second-generation inhibitors nilotinib and dasatinib has led to faster and deeper molecular remissions accompanied by a differential adverse effect profile. An essential part of the management of CML patients is the guideline-based application of cytogenetics and standardized polymerase chain reaction techniques to regularly assess the remission status. Long-lasting treatment-free remission in a minority of patients led to hopes for the curability of CML in a significant minority of patients. The use of interferon alpha combined with or after TKI therapy is associated with the induction of an immune response toward the leukemic clone. This innovative treatment approach is currently under prospective investigation to improve long-term response. The coordinated cooperation of academic and regional hospitals, office-based hematologists, laboratories, and patient representatives allows for up-to-date patient care and the early use of new therapeutic options in patients at risk. PMID:25860113

  5. [Chronic total occlusions].

    PubMed

    Galassi, Alfredo R; Tomasello, Salvatore D; Costanzo, Luca; Tamburino, Corrado

    2008-10-01

    Many studies showed that successful recanalization of chronic total occlusion (CTO) provides an improvement of long-term outcome and left ventricular ejection fraction, electrical stability of the myocardium, increased tolerance to future coronary events, and last but not least an improvement in quality of life. Because of the perceived procedural complexity of percutaneous coronary interventions (PCI), patients with CTO are usually referred to coronary artery bypass surgery or medical therapy. Recent advances in PCI materials, devices, approaches, and techniques have allowed expert operators to tackle successfully with complex cases of CTO that many years ago would have sent patients to surgery. This has also been motivated by the long-term patency and freedom from restenosis obtained by drug-eluting stent implantation. Each strategy and device has advantages and disadvantages, even though percutaneous treatment of CTO needs a higher operator's skill with respect to other non-occlusive lesions as well as an appropriate training period. In order to avoid complications and to achieve CTO recanalization in more than 70% of cases, it is advisable to understand the principles of each strategy, to plan the proper strategy and choose the appropriate materials, to take time, to be zen and aware when to stop. PMID:18942554

  6. Chronic Pancreatitis (Beyond the Basics)

    MedlinePLUS

    ... occurs when the pancreas becomes damaged by long-standing inflammation. Inflammation changes the pancreas' ability to function ... most common symptom of chronic pancreatitis is long-standing pain in the middle of the abdomen. You ...

  7. Chronic Kidney Disease and Medicines

    MedlinePLUS

    ... Disease and Medicines (Brochure) Chronic Kidney Disease and Medicines (Brochure) What You Need to Know Because you ... pharmacist and provider need to know about your medicine and supplement use Your kidneys do not filter ...

  8. Physiology & Development of Chronic Fear

    E-print Network

    Dennis, Nancy

    Physiology & Development of Chronic Fear (Behavioral Neuroendocrinology Lab) Sonia Cavigelli (PI A Individual B interest fear physiology physiology Individual A Temperament, Physiology, and Health health health Overarching Question: How do individual difference in behavior and physiology influence health

  9. Role of Alcohol Metabolism in Chronic Pancreatitis

    Microsoft Academic Search

    Alain Vonlaufen; Jeremy S. Wilson; Romano C. Pirola; Minoti V. Apte

    2007-01-01

    Alcohol abuse is the major cause of chronic inflammation of the pancreas (i.e., chronic pancreatitis). Although it has long been thought that alcoholic pancreatitis is a chronic disease from the outset, evidence is accumulating to indicate that chronic damage in the pancreas may result from repeated attacks of acute tissue inflammation and death (i.e., necroinflammation). Initially, research into the pathogenesis

  10. Telenursing in Chronic Respiratory Diseases

    Microsoft Academic Search

    Carlos Zamarrón; Emilio Morete; Francisco Gonzalez

    \\u000a Patients with long-term conditions such as chronic pulmonary diseases represent a major health-care problem for the public\\u000a health-care systems. Among these conditions are the sleep apnea syndrome (SAS), neuromuscular diseases with respiratory involvement,\\u000a and chronic obstructive pulmonary disease (COPD). A recent study showed that over 27,000 people died from COPD in 2004 in\\u000a the UK, and that caring for these

  11. Pain Management in chronic pancreatitis

    Microsoft Academic Search

    Darwin L. Conwell; Gregory Zuccaro

    1999-01-01

    Opinion statement  Painful chronic pancreatitis is difficult to manage. We believe a multidisciplinary approach is the best means of evaluating\\u000a this complex syndrome. In our opinion, the initial evaluation should aim at firmly establishing the diagnosis of chronic pan-creatitis:\\u000a calcifications on imaging; duct morphologic changes on pancreatography; parenchymal changes on ultrasound; or evidence of\\u000a pancreatic dysfunction on secre-tin\\/ cholecystokinin stimulation tests.

  12. Surgical Treatment of Chronic Pancreatitis

    Microsoft Academic Search

    Matthew R. Porembka; William G. Hawkins; Steven M. Strasberg

    \\u000a Chronic pancreatitis is characterized by progressive parenchymal fibrosis resulting in loss of pancreatic exocrine and endocrine\\u000a function. The pathogenesis of chronic pancreatitis is unclear, but is thought to be secondary to repeated parenchymal injury.\\u000a Common etiologies include alcoholic pancreatitis, autoimmune pancreatitis, and pancreatic duct obstruction caused by pancreatic\\u000a divisum or stricture. The disease affects all elements of the gland; exocrine

  13. Chronic Copper Poisoning in Sheep. 

    E-print Network

    Boughton, I. B. (Ivan Bertrand); Hardy, W. T. (William Tyree)

    1934-01-01

    LIBRARY, - A & M COLLEGE, CAiQFUS. E-109-8M-L180 TEXAS AGRICULTURAL EXPERIMENT STATION A. B. CONNER, DIRECTOR COLLEGE STATION: BRAZOS COUNTY. TEXAS BULLETIN NO. 499 DECEMBER, 1934 DIVISION OF VETERINARY SCIENCE CHRONIC COPPER POISONING... of copper sulphate caused chronic copper poisoning among flocks of range sheep on several West Texas ranches during the past year. The salt licks were placed before the sheep as a means of preventing or controlling stomach worm infestation despite a...

  14. Footbed shapes for enhanced footwear comfort.

    PubMed

    Witana, Channa P; Goonetilleke, Ravindra S; Au, Emily Yim Lee; Xiong, Shuping; Lu, Xingfang

    2009-05-01

    A shoe wearer's comfort is related to the shape of the footbed of a shoe. Even though the footbed shape is important in footwear design, there exists no methodology to evaluate the existing guidelines used in last making. Thirty-two females participated in an experiment where heel seat length, heel seat inclination and heel height were investigated using the profile assessment device. The dependent variables were plantar pressure and perceived feeling of each participant. The results show that perceived feel is best for wedge angles of 4 degrees and 5 degrees at a heel height of 25 mm, 10 degrees and 11 degrees at a heel height of 50 mm and 16 degrees and 18 degrees at a heel height of 75 mm. A regression model was derived and this explained approximately 80% of the variation of perceived feeling with the contact area, peak plantar pressure and percentage of force acting on the forefoot region. Both heel wedge angle and heel seat length play an important role in the perceived feel of high-heeled shoes. This study, in relation to the load-bearing heel part of a shoe, highlights the importance of good footbed design. The findings can be used to design footwear with enhanced comfort. PMID:19424923

  15. Prognostic scale for chronic schizophrenia.

    PubMed

    Fenton, W S; McGlashan, T H

    1987-01-01

    Although prognostic scales are available for schizophrenia, these focus on acute or subacute populations where premorbid functioning and established chronicity are the best predictors of outcome. Their usefulness in chronic schizophrenia is limited. The authors describe a simple and reliable 5-item, 12-point prognostic scale for chronic schizophrenia independent of chronicity. It measures prognosis as the product of a dynamic interplay between the highest level of adaptive occupational and social functioning ever achieved by the individual and the "invasiveness" of the Axis I disorder as manifest by genetic loading (family history of schizophrenia), erosion of reality testing (psychotic assaultiveness), and preservation of affect in psychopathology (depressed mood). Among chronic schizophrenic patients in the Chestnut Lodge Followup Study (n = 163), the prognostic score (based on history and admission clinical picture) allowed strong probabilistic statements to be made about long-term outcome. Tables present the conditional probability or risk of specific outcomes in the domains of institutionalization, work functioning, social relations, and global outcome for patients at varying levels along the prognostic spectrum. Close examination of these predictor-outcome relationships suggests that prognosis in chronic schizophrenia may be thought of as the variability (as opposed to fixedness) remaining in the individual's future life course, and poor outcome can be predicted with greater sensitivity than good outcome. PMID:3616519

  16. Neurovascular Unit in Chronic Pain

    PubMed Central

    Radu, Beatrice Mihaela; Bramanti, Placido; Osculati, Francesco; Flonta, Maria-Luisa; Radu, Mihai; Bertini, Giuseppe; Fabene, Paolo Francesco

    2013-01-01

    Chronic pain is a debilitating condition with major socioeconomic impact, whose neurobiological basis is still not clear. An involvement of the neurovascular unit (NVU) has been recently proposed. In particular, the blood-brain barrier (BBB) and blood-spinal cord barrier (BSCB), two NVU key players, may be affected during the development of chronic pain; in particular, transient permeabilization of the barrier is suggested by several inflammatory- and nerve-injury-based pain models, and we argue that the clarification of molecular BBB/BSCB permeabilization events will shed new light in understanding chronic pain mechanisms. Possible biases in experiments supporting this theory and its translational potentials are discussed. Moving beyond an exclusive focus on the role of the endothelium, we propose that our understanding of the mechanisms subserving chronic pain will benefit from the extension of research efforts to the NVU as a whole. In this view, the available evidence on the interaction between analgesic drugs and the NVU is here reviewed. Chronic pain comorbidities, such as neuroinflammatory and neurodegenerative diseases, are also discussed in view of NVU changes, together with innovative pharmacological solutions targeting NVU components in chronic pain treatment. PMID:23840097

  17. Chronic exposure keratopathy complicating surgical correction of ptosis in patients with chronic progressive external ophthalmoplegia

    Microsoft Academic Search

    Peter M. Daut; Thomas L. Steinemann; Christopher T. Westfall

    2000-01-01

    PURPOSE: To report chronic exposure keratopathy related to surgical ptosis correction in patients with chronic, progressive, external ophthalmoplegia.METHODS: Case reports of three patients with chronic exposure keratopathy following blepharoptosis surgery.RESULTS: We report three patients with chronic progressive external ophthalmoplegia with chronic corneal complications after surgical ptosis repair. All three gave a history of blepharoptosis and extraocular muscle dysfunction. Each presented

  18. Deficits in foot skin sensation are related to alterations in balance control in chronic low back patients experiencing clinical signs of lumbar nerve root impingement.

    PubMed

    Frost, Lydia R; Bijman, Marc; Strzalkowski, Nicholas D J; Bent, Leah R; Brown, Stephen H M

    2015-05-01

    Chronic low back pain (LBP) patients with radiculopathy, or sciatica, experience pain, tingling or numbness radiating down their leg due to compression of the lumbar nerve root. The resulting reduction in somatosensory information from the foot sole may contribute to deficits in standing balance control. This work was designed to investigate the relationship between foot skin sensitivity and standing balance control in chronic LBP patients with associated radiculopathy. Patients (n=9) and matched healthy controls (n=9) were recruited to the study, and were tested for balance control in both quiet standing as well as during rapid arm raise perturbation trials on a force plate. Foot skin sensitivity was tested bilaterally for vibratory threshold (3, 40 and 250 Hz) and touch (monofilament) threshold. Results demonstrate that patients had reduced sensitivity to 250 Hz vibration in their affected compared to unaffected foot (at the great toe and heel), as well as compared to controls (at the great toe), but there were no differences with lower frequency vibratory testing or with monofilament testing. While there were no significant between-group differences in balance measures, moderate statistically significant correlations between 250 Hz sensitivity and quiet standing balance parameters were uncovered. Thus, patients demonstrate reduced high-frequency vibratory sensitivity at the foot sole, and correlations with quiet standing balance measures indicate a connection between these foot skin sensitivity deficits and alterations in balance control. Clinically, this identifies high frequency vibration testing as an important measure of skin sensitivity in patients with radiculopathy. PMID:25887249

  19. Short-term ankle motor performance with ankle robotics training in chronic hemiparetic stroke.

    PubMed

    Roy, Anindo; Forrester, Larry W; Macko, Richard F

    2011-01-01

    Cerebrovascular accident (stroke) often results in impaired motor control and persistent weakness that may lead to chronic disability, including deficits in gait and balance function. Finding ways to restore motor control may help reduce these deficits; however, little is known regarding the capacity or temporal profile of short-term motor adaptations and learning at the hemiparetic ankle. Our objective was to determine the short-term effects of a single session of impedance-controlled ankle robot ("anklebot") training on paretic ankle motor control in chronic stroke. This was a double-arm pilot study on a convenience sample of participants with chronic stroke (n = 7) who had residual hemiparetic deficits and an equal number of age- and sex-matched nondisabled control subjects. Training consisted of participants in each group playing a target-based video game with the anklebot for an hour, for a total of 560 movement repetitions in dorsiflexion/plantar flexion ranges followed by retest 48 hours later. Task difficulty was adjusted to ankle range of motion, with robotic assistance decreased incrementally across training. Assessments included robotic measures of ankle motor control on unassisted trials before and after training and at 48 hours after training. Following exposure to the task, subjects with stroke improved paretic ankle motor control across a single training session as indexed by increased targeting accuracy (21.6 +/- 8.0 to 31.4 +/- 4.8, p = 0.05), higher angular speeds (mean: 4.7 +/- 1.5 degrees/s to 6.5 +/- 2.6 degrees/s, p < 0.01, peak: 42.8 +/- 9.0 degrees/s to 45.6 +/- 9.4 degrees/s, p = 0.03), and smoother movements (normalized jerk: 654.1 +/- 103.3 s(-2) to 537.6 +/- 86.7 s(-2), p < 0.005, number of speed peaks: 27.1 +/- 5.8 to 23.7 +/- 4.1, p < 0.01). In contrast, nondisabled subjects did not make statistically significant gains in any metric after training except in the number of successful passages (32.3 +/- 7.5 to 36.5 +/- 6.4, p = 0.006). Gains in all five motor control metrics were retained (p > 0.05) at 48 hours in both groups. Robust maintenance of motor adaptation in the robot-trained paretic ankle over 48 hours may be indicative of short-term motor learning. Our initial results suggest that the anklebot may be a flexible motor learning platform with the potential to detect rapid changes in ankle motor performance poststroke. PMID:21674391

  20. Low back pain (chronic)

    PubMed Central

    2010-01-01

    Introduction Over 70% of people in developed countries develop low back pain (LBP) at some time. But recovery is not always favourable: 82% of non recent-onset patients still experience pain 1 year later. Many patients with chronic LBP who were initially told that their natural history was good spend months or years seeking relief. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of oral drug treatments? What are the effects of injection therapy? What are the effects of non-drug treatments? What are the effects of non-surgical and surgical treatments? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2009 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 64 systematic reviews or RCTs that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review, we present information relating to the effectiveness and safety of the following interventions: acupuncture, analgesics, antidepressants, back schools, behavioural therapy, electromyographic biofeedback, exercise, injections (epidural corticosteroid injections, facet joint injections, local injections), intensive multidisciplinary treatment programmes, lumbar supports, massage, muscle relaxants, non-steroidal anti-inflammatory drugs (NSAIDs), non-surgical interventional therapies (intradiscal electrothermal therapy, radiofrequency denervation), spinal manipulative therapy, surgery, traction, and transcutaneous electrical nerve stimulation (TENS). PMID:21418678