Efficacy of Surgical Techniques in Hallux Abductus Valgus by Application of Scale American Orthopedic Foot and Ankle Society: literature review

[Resumen] Objetivos: Identificar las técnicas quirúrgicas más realizadas en el Hallux Abductus Valgus, identificar las principales ventajas e inconvenientes comparando la cirugía de mínima incisión y la tradicional mediante comparación funcional para determinar su eficacia. Metodología: Se llevó a cabo una revisión bibliográfica retrospectiva y analítica con las técnicas quirúrgicas más habituales en la cirugía del Hallux Abductus Valgus, observando su eficacia funcional. Mediante aplicación de escala de la American Orthopedic Foot and Ankle Society para evaluar los resultados funcionales, los valores más altos corresponden a las técnicas de mayor eficacia funcional. Resultados: El valor máximo en la escala AOFAS se sitúa en 96 al final del seguimiento mediante la técnica percutánea sin osteotomía, el valor más bajo obtenido en el estudio es de 79 en la osteotomía de Akin y la técnica de cirugía tradicional mediante abordaje abierto es la técnica que más ha escalado con un total de 65,2. Conclusiones: Artroplastias no son valorables por la falta de estudios, las artrodesis ofrecen óptimos resultados, pero no valorables, las osteotomías proponen técnicas muy variables y las Osteodesis brindan sobresalientes resultados.[Abstract] Objectives: To identify the most performed surgical techniques in Hallux Abductus Valgus, to identify the main advantages and disadvantages comparing the surgery of minimum incision and the traditional one by means of functional comparison to determine its effectiveness. Methodology: A retrospective and analytical literature review was carried out with the most common surgical techniques in Hallux Abductus Valgus surgery, observing its functional efficacy. By means of AOFAS scale application (American Orthopedic Foot and Ankle Society) to evaluate the functional results, the highest values correspond to the techniques of greater functional competence Results: The maximum value in the AOFAS scale is 96 at the end of the follow-up using the percutaneous technique without osteotomy, the lowest value in the study of 79 in Akin osteotomy with open approach and the traditional technique using open approach is the technique that has climbed the most with a total of 65.2. Conclusions: Arthroplasties are not valuable due to lack of studies, arthrodeses offer excellent but not valuable results, osteotomies propose very variable techniques and Osteodesis offer outstanding result

Influencia de los hábitos de salud general y podológica en el desarrollo de complicaciones en el pie diabético

En la actualidad las herramientas validadas para el estudio del nivel de autocuidados en el paciente con diabetes mellitus y como la influencia del mismo se relaciona con las complicaciones de pie diabético presentan un elevado déficit metodológico. El objetivo principal de nuestro trabajo ha sido primero evaluar la calidad metodológica de los estudios publicados al respecto, donde se observó que existe déficit metodológico con respecto a la misma; motivo por el cual en segundo lugar se propuso validar una herramienta válida y fiable con el fin de que sea aplicable en al ámbito clínico para aquellos profesionales que trabajan con pacientes diabéticos con el fin de cuantificar el estado de hábitos saludables. Para lo cual primero se procedió a la realización de un estudio piloto con 30 pacientes en el que se elaboró la redacción de una versión inicial del cuestionario de salud apd uma por medio de la técnica delphi de panel de expertos. Para después realizar mediante la clinimetría de la herramienta un estudio descriptivo, observacional en el que la muestra se compuso de 108 mujeres y 101 hombres con edades comprendidas entre los 18 y los 94 años mayoritariamente, con estudios primarios, jubilados. Se ha utilizado un cuestionario adaptado con semejanzas de ítems a los de calidad de vida y aquellos específicos para medir parámetros relacionados con alteraciones en el pie como pueden ver los validados sf 36 o el cuestionario manchester o fshq. que han sido validados y fiables para medir el estado de salud de los pacientes con problemas en los pies. En el análisis factorial se detectan factores compuestos por ítems que responden a la intencionalidad de la investigación. el coeficiente alfa de cronbach es elevado (0,875). Las correlaciones inter-elementos obtuvieron un valor medio de 0,34 (rango: 0,06 a 0,74). la solución rotada mostró una estructura de 3 factores para el cuestionario que representó conjuntamente por 60,88% de la varianza observada. Consideramos que profundizar en esta línea de investigación puede aportar avances en el campo de la diabetología dado que podrían relacionarse el nivel los autocuidados con la reducción del número de casos de pacientes ulcerados

Footprint Curvature in Spanish Women: Implications for Footwear Fit

The incorrect adjustment of footwear produces alterations in the foot that affect quality of life. The usual measurements for shoe design are lengths, widths and girths, but these measures are insufficient. The foot presents an angle between the forefoot and the rearfoot in the transverse plane, which is associated with foot pronation, hallux valgus and metatarsus adductus. Here, we aimed at identifying the groups formed by the angulations between the forefoot and rearfoot using a sample of footprints from 102 Spanish women. The angle between the forefoot and rearfoot was measured according to the method described by Bunch. A cluster analysis was performed using the K-means algorithm. Footprints were grouped into three types: curved, semi-curved and straight, according to the degrees of angulation between the forefoot and rearfoot. There is great variability in the morphology of the foot. Based on our findings, to achieve a better footwear fit, we propose the manufacture of three types of lasts with different curvatures

The Association between Cognitive Impairment and Diabetic Foot Care : Role of Neuropathy and Glycated Hemoglobin

Diabetes mellitus is associated with impairment in cognitive functions which can complicate adherence to self-care behaviors. We evaluated the incidence of cognitive impairment in patients with diabetes mellitus to determine the strength of the association between diabetic foot (a complication that occurs in about 10% of diabetic patients), adherence to the clinician's recommendations, glycemic control, and cognitive function. A prospective study was carried out in a probabilistic sample of older patients with diabetic foot living in three nursing homes. Cognitive functions were evaluated by the MMSE (Mini-Mental State Examination), the Trail Making test (TMT), and the Michigan neuropathy screening instrument (MNSI). There were no significant associations between cognitive function and neuropathy or foot alterations, although glycated hemoglobin (HB1Ac > 7%) significantly (p 7%) and a neuropathy score of 5.5 in the MNSI are the best-cut off points to discriminate poor adherence to the clinician's recommendations for self-care behaviors in people with diabetic foot complication. In this study, we observed that foot disorders were associated with impaired global cognitive function in elderly patients (aged ≥ 65). Podiatrists and physicians should consider cognitive dysfunction as an important chronic complication in the management of diabetic foot

Efectividad del láser en el tratamiento de úlceras neuropáticas plantares en pie diabetico. Revisión bibliográfica

The diabetic foot is an alteration induced by maintained hyperglycemia independently of the coexistence of ischemia, and previous traumatic trigger, which can produce ulceration of the foot, which supposes a high economic cost. This is the reason why it is essential to accelerate the process of tissue repair, with laser therapy being a very efficient therapeutic resource. The main objective of this work is to assess the effectiveness of the laser in the treatment of diabetic foot neuropathic ulcers. By bibliographic search in PubMed / Medline, Dialnet, Science Direct and Theseus databases, by keywords; diabetic foot, diabetic neuropathy, neuropathic ulcer, treatment and Laser. After conducting the search, 236 articles were found, of which 35 were included in the review. The work done has determined the effectiveness of this therapy. As a result of the limitations, it has not been possible to establish a uniform treatment protocol due to the lack of studies with a larger sample. Therefore, laser therapy can be used as adjuvant treatment neuropathic ulcers in diabetic patients, Keywords: Diabetic foot; Diabetic Neuropathies; Ulcers neuropatic; Treatment; Laser therap

Ultrasound imaging evaluation of textural features in athletes with soleus pathology : a novel case-control study

Background: the aim of this study was to compare the echotexture of patients with soleus muscle injury and age matched controls. Methods: a sample of 62 athletes was recruited at the private clinic and was divided in two group: a healthy group (n = 31) and a soleus pathology group whose athletes had soleus muscle injury, located in the central tendon (n = 31). The muscle thickness (MTh), echointensity (EI) and echovariation (EV) were analyzed. An intra-rater reliability test (Intraclass Correlation Coefficient-ICC) was performed in order to analyze the reliability of the values of the measurements. Results: Sociodemographic variables did not show statistically significant differences (p > 0.05). Ultrasound imaging measurements who reported statistically significant differences were EI (p = 0.001) and standard deviation (SD) (p = 0.001). MTh and EV variables did not show statistically significant differences (p = 0.381 and p = 0.364, respectively). Moreover, reliability values for the MTh (ICC = 0.911), EI (ICC = 0.982), SD (ICC = 0.955) and EV (ICC = 0.963). Based on these results the intra-rater reliability was considered excellent. Conclusion: Athletes with a central tendon injury of soleus muscle showed a lower EI when they were compared to healthy athletes. The echogenicity showed by the quantitative ultrasound imaging measurement may be a more objective parameter for the diagnosis and follow-up the soleus muscle injurie

Changes in Salivary amylase and glucose in diabetes : a scoping review

Background and Objective: Diabetes mellitus (DM) is a common long-term disease which can be related with salivary amylase levels. DM has recently been associated with salivary amylase diagnostics that could further impair diagnoses in the diabetic population, as well as being an interesting alternative to traditional methods of determine glucose levels. The main advantage of this method is related to the fact that it is a fast diagnostic method. The DM population experiences changes to their metabolism which affects their salivary parameters, making this an alternative procedure for diagnosis and follow-up of the illness due to the non-invasive nature of salivary analyzes. The objective of this review is to summarize the evidence regarding the changes in salivary amylase and glucose levels, and their relationship with blood markers of glycemic control used in clinical settings such as blood glucose and glycated hemoglobin. The differences in salivary amylase levels depending on the method of saliva collection under fasting or non-fasting conditions. The changes in salivary amylase depends on the type of diabetes, the type of insulin treatment or the quality of glycemic control. Conclusions: Salivary amylase concentration is increased in diabetic patients in most of the studies and salivary glucose concentration in all studies in both fasting and non-fasting (post-prandial) conditions. Salivary amylase and glucose concentration represent potential non-invasive biomarkers to evaluate glycemic control and clinical management of diabetic patients, although it is necessary to evaluate the influence of potential modulating factors such as age, duration diseases, sex and the effects of pharmacological treatments in these outcomes which remained to be elucidated

Psychometric evaluation of the Persian version of the diabetic foot self-care questionnaire in Iranian patients with diabetes

Background: Diabetic foot self-care refers to a group of self-management behaviors that can reduce the incidence of foot ulcers and amputations. It is necessary to have a valid and reliable standard tool to measure foot self-care in diabetic patients. This study aimed to evaluate the psychometric properties of the Persian version of the Diabetic Foot Self-Care Questionnaire of the University of Malaga, Spain (DFSQ-UMA) in Iran. Methods: This cross-sectional study was conducted with 407 diabetic patients who were selected using a convenient sampling method. Construct validity was assessed by exploratory (with 207 patients) and confirmatory (with 200 patients) factor analyses. Internal consistency was calculated using Cronbach's alpha and McDonald's omega coefficients. Results: In the exploratory factor analysis, three factors with eigenvalues of 3.84, 2.41, and 2.26 were extracted that together explained 56.74% of the total variance of diabetic foot self-care. A Cronbach's alpha of 0.865 was found for the total instrument. Conclusions: The Persian version of the DFSQ-UMA has good validity and reliability, and given its good psychometric properties, it can be used in future studies

El índice de postura del pie en escolares de 8 a 13 años

Se exponen los resultados de un programa de nutrición infantil en relación a la obesidad y como ésta puede provocar alteraciones biomecánicas en el pie, en relación a las alteraciones provocadas en la biomecánica del pie y como las tecnologías pueden servir, así como la colaboración multidisciplinar

Ultrasound-Guided Percutaneous Neuromodulation in Patients with Chronic Lateral Epicondylalgia : A Pilot Randomized Clinical Trial

Objective: The aim was to analyze effects of a percutaneous neuromodulation (PNM) treatment on the radial nerve, regarding pain, functionality, electrophysiologic excitability, and morphology, in patients with chronic lateral epicondylalgia (LE). Methods: Twenty-four patients with chronic unilateral elbow pain were recruited for this preliminary study and were divided into two groups: control (n = 12) and PNM group (n = 12). The subjects in the PNM group received percutaneous peripheral neurostimulation with an acupuncture needle that was located next to the nerve with ultrasound guidance. Pain using a numerical rating scale (NRS), functional ability using patient-rated tennis elbow evaluation (PRTEE), radial nerve cross-sectional area measured by ultrasound, and chronaxie and accommodation index (AI) measured by the strength-duration curve were evaluated. Results: Both groups showed no differences in the baseline measurements (all p = 0.001). However, at the end of the treatment, there were significant differences between groups since only the PNM group significantly improved their values compared to their baseline values: level of pain and cross-sectional area (CSA) values showed a significant decrease while the PRTEE scores showed a significant improvement. Then, regarding AI, the PNM group showed significant improvement for the electrophysiologic nerve excitability pattern, reporting normal function in all radial nerves after treatment (p = 0.001). However, chronaxie values always reported similar values with no differences between groups (p >0.05); Conclusion: Ultrasound-PNM technique may be an interesting therapeutic tool for the treatment of chronic LE due to the improvement in the level of pain, functionality, nerve morphology, and excitability in this population