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Podiatry

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/7

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End date: 2019Has files: No

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    Effects of pH on the antibiotic resistance of bacteria recovered from diabetic foot ulcer fluid
    (American Podiatric Medical Association, 2018-01-01) McArdle, Carla; Lagan, Katie M.; McDowell, David A.
    Background: This study investigated the resistance of bacteria isolated from diabetic foot ulcers (DFUs) to antibiotics frequently used in the management of the diabetic foot infections, at a range of pH values (pH 6.5, 7.5, and 8.5) known to exist in DFU wound fluid. This study aimed to determine whether changes (or atypical stasis) in wound fluid pH modulate the antibiotic resistance of DFU isolates, with potential implications in relation to the suppression/eradication of bacterial infections in DFUs. Methods: Thirty bacterial isolates were recovered from DFU wound fluid, including Staphylococcus spp, Staphylococcus aureus, Escherichia coli, Streptococcus spp, Pseudomonas spp, and Pseudomonas aeruginosa. The resistances of these isolates to a panel of antibiotics currently used in the treatment of infected or potentially infected DFUs, ie, ciprofloxacin, amoxicillin-clavulanate, doxycycline, and piperacillin-tazobactam, at the previously mentioned pH values were determined by a modification of the Kirby-Bauer assay. Results: The resistance of DFU isolates to clinically relevant antibiotics was significantly affected by the pH levels in DFU wound fluid. Conclusions: These findings highlight the importance of a more comprehensive understanding of the conditions in DFUs to inform clinical decision making in the selection and application of antibiotics in treating these difficult-to-heal wounds. The scale of the differences in the efficacies of antibiotics at the different pH values examined is likely to be sufficient to suggest reconsideration of the antibiotics of choice in the treatment of DFU infection.
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    Prediction of stump healing in lower limb amputation: A narrative review
    (Mark Allen Group, 2019-12-11) Ashraff, Suhel; Siddiqui, Muhammad A.; Santos, Derek; Carline, Tom
    Both types of diabetes, as well as different forms of acquired diabetes, are associated with diabetic peripheral neuropathy. Diabetic foot ulcers (DFU) is the condition most commonly related to somatic peripheral neuropathy, often leading to gangrene and limb amputation. Independent from large-vessel disease, sensory loss may result in DFU development and even amputation. The crucial part of any lower limb amputation is the stump healing process, which represents the central goal of postoperative management. Despite the importance attributed to this process, a standard set of guidelines regarding efficient healing methods is yet to be formulated. Health professionals are faced with the challenge of assessing the different risk factors and deciding which has a greater influence on the stump healing rate. There is currently an insufficient number of studies regarding factors effecting lower limb amputation. The main purpose of this review is to discuss the markers that can be helpful in the prediction of stump healing in patients who have undergone lower limb amputation.
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    Alcohol injections for the treatment of intermetatarsal neuromas [Summary]
    (2019-08-15) Santos, Derek; Coda, Andrea
    Intermetatarsal neuromas, sometimes called Morton’s neuroma, cause nerve pain in the forefoot. It arises due to entrapment of the nerve(s) supplying the toes(s) due to compression of the forefoot. Although any foot can be affected it’s uncommon to affect both feet. Similarly, it’s unusual to find multiple neuromas affecting the same foot. The condition is 8-10 times more common in females than males with people aged 45-50 years more at risk. The part of the forefoot most commonly affected is the third inter-metatarsal space with the first and fourth space rarely affected.
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    Assessment of pain in an elderly population: Practical difficulties.
    (Mark Allen Publishing LTD, 1998) Weir, Evelyn C.; Burrow, J. G.; Bell, F.
    Few studies focus on pain assessment in an elderly population. This article considers the applicability of several methods of pain assessment for an elderly subject group. Methods are discussed in terms of practical usage, preference, failure rates and sample studies. Assessment techniques for pain assessment in the older adult with pain are discussed. Problems particular to an elderly population are outlined. Complexities of pain assessment in the older adult are detailed with recommendations.
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    A survey of babywalkers in GP's, health visitors and orthopaedic surgeons
    (The Society of Chiropodists and Podiatrists, 1999) Cashley, D.; Carline, Tom
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    Encouraging GPs to complete postal questionnaires-one big prize or many small prizes? A randomized controlled trial
    (2004-12) Thomson, Colin E.; Paterson-Brown, S.; Russell, D.; McCaldin, D.; Russell, I.
    Background. Low response rates to surveys are a problem in general practice. There is evidence that offering GPs incentives improves response rates to postal questionnaires. However, there is less evidence about the most effective form of incentive. Objective. Our trial aimed to maximize response to a postal questionnaire and to test the most effective form of incentive. Methods. The study involved a randomized controlled trial of a postal survey Results. The incentive of a lottery for six bottles of champagne generated a response rate of 79%. Furthermore, one chance of six bottles generated 9% more responses than six chances of one bottle. Conclusions. This study has established that, among incentives for postal questionnaires, one big prize improves the yield more than many small prizes despite the lower odds of winning. It has also confirmed that offering a modest incentive to GPs generates good response rates for postal questionnaires
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    Honey dressing versus paraffin tulle gras following toenail surgery
    (2006) McIntosh, C.; Thomson, Colin E.
    Objective: Anecdotal reports suggest that certain honey dressings have a positive effect on wound healing. However, there is limited empirical evidence supporting its use. This double-blind randomised controlled trial investigated the effect of a honey dressing on wound healing following toenail surgery with matrix phenolisation. Method: Participants (n=100) were randomly assigned to receive either an active manuka honey dressing (n=52) or paraffin-impregnated tulle gras (n=48). The primary outcome was time (days) taken for complete re-epithelialisation of the nail bed. Results: Mean healing times were 40.30 days (SD 18.21) for the honey group and 39.98 days (SD 25.42) for the paraffin tulle gras group. Partial avulsion wounds healed statistically significantly faster (p=0.01) with paraffin tulle gras (19.62 days, SD 9.31) than with the honey dressing (31.76 days, SD 18.8), but no significant difference (p=0.21) was found following total avulsion when comparing honey (45.28 days, SD 18.03.) with paraffin tulle gras dressings (52.03 days, SD 21.3). Conclusion: The results suggest that patients may benefit more from paraffin tulle gras dressings than honey dressings following partial toenail avulsion. No statistically significant difference was found for healing times after total toenail avulsion, although the marginal benefit of the honey dressing on these healing times warrants further investigation
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    Accidental intra-arterial injection -a cause of lower limb ischaemia in intravenous drug users
    (The Society of Chiropodists and Podiatrists, 1998) Weir, Evelyn C.; Carline, Tom
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    Violence in health care: the reality of occupational risk
    (Mark Allen Publishing LTD, 1999-02-01) Weir, Evelyn C.
    Violence in the workplace is an increasing occupational risk for health-care workers and can range from verbal abuse to serious physical assault. Health-care professionals are at risk from patients, patients' relatives and professional colleagues. This article provides an overview of the type and mode of violence evident in the health-care setting.
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    Clinical audit of a patient teaching programme in the care of wounds following toenail removal
    (Elsevier Science Ltd, 1998) Dunlop, G.
    A programme of patient teaching has been used in wound care after nail removal to reduce the number of healing weeks and to reduce the number of clinical visits for the patient. A stratified sample of podiatry patients who had undergone nail removal in a podiatry teaching centre was monitored regarding: the number of weeks attended; the interval of weeks between appointments; and the infection rate. The simplest and cheapest dressing was used to dress the wound between clinical visits. The mean number of healing weeks was 5.2 (standard deviation of 3.8) and the mean number of clinical visits was 3.2 (standard deviation of 1.5). As all the patients attending the unit were taught how to care for the wound between visits, the outcome would suggest that the care conducted by the patients themselves has been an influencing factor on the final result of the study.