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ACFAOM
If you have been following recent articles in Podiatry Today and PM News about the different approaches to prescribing custom foot orthoses, you may be confused and troubled. Was what you learned in your training still the best approach, or are there new theories that you are not completely familiar with? And how can you tell whether you can improve your success rate by changing approaches? ACFAOM 2016 will include a 3-hour interactive debate with nationally-known proponents of the Root, Tissue Stress, and MASS approaches. Each presenter will have time to make his case, and then panel and audience members will be able to challenge each presenter with actual cases. So if you are scratching your head about Root vs Tissue Stress vs MASS approaches you will leave this debate with a clear understanding of each and be able to compare them and apply what you have learned in practice immediately.
The 2016 Annual Meeting will take place at the Westin Savannah Harbor Golf Resort and Spa in historic Savannah, GA, June 24-26, 2016. Thinking about bringing your family? Golfing? Shopping? Take a look at the Top 50 things you must do in Savannah! Also visit the hotel site here, so you can imagine yourself enjoying a few days in luxury. More information about ACFAOM 2016 will be distributed as it becomes available over the next few weeks. For now, save these dates! More details will be posted at ACFAOM.org in the coming weeks.
| CURRENT RESEARCH ARTICLE OF INTEREST |
Journal of the American Podiatric Medical Association
We analyzed 1,655 patients, aged 18 to 70 years, randomized to receive efinaconazole topical solution, 10 percent, or vehicle from two identical multicenter, double-blind, vehicle-controlled 48-week studies evaluating safety and efficacy. The primary end point was complete cure rate (0 percent clinical involvement of the target toenail and negative potassium hydroxide examination and fungal culture findings) at week 52. Three groups were compared: patients with onychomycosis and coexisting interdigital tinea pedis on-study (treated or left untreated) and those with no coexisting tinea pedis.
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Podiatry Managment
Partial lower limb amputation is a common outcome in the high risk patient with lower extremity chronic ulcerations, ischemia, and infection. The significant decline in the quality of life and economic burden caused by lower extremity infections leading to amputations in the high risk population warrants further study in order to better understand the elements that improve limb viability and the causal factors related to major limb loss (below or above the knee).
The unfortunate pathway to amputation in the high risk patient with a lower limb ulceration or infection
can be caused by major and minor etiologies, mainly diabetes and peripheral arterial disease. The
literature recognizes that approximately 80-85 percent of non-traumatic amputations are preceded by lower extremity ulcers.
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The Philadelphia Inquirer
When wearing a stiff orthopedic boot to recover from a foot or ankle injury, patients are commonly told to put less weight on the limb in question.
Sounds simple enough, but modern medicine has two blind spots when this advice is put into practice:
Are patients good at following the directions? And are the directions even meaningful?
Now comes the SmartBoot, a device that University of Delaware researchers have customized so it measures forces on the patient's foot.
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Podiatry Today
The challenges associated with recovery from plantar plate injury include understanding the biomechanics, histologic and gross anatomy, the properties of the tissue and the appreciation of extrinsic factors. Not unlike fibrocartilage found elsewhere including the meniscus of the knee, spring ligament and intervertebral bodies, pathology to the plantar plate is often challenging to address. Not only is there a need for the management of extrinsic factors but the intrinsic nature of the tissue can lead to difficulty in restoring its function. Having a better appreciation of these factors will help the practitioner in instituting appropriate treatment alternatives, particularly within a timeline of care.
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Journal of Foot and Ankle Research
Forefoot offloading shoes are special orthopedic footwear designed to protect and unload the injured part of the foot after surgery and for conservative treatments.
The offloading action is often achieved by transferring plantar load to the rearfoot via rocker shoes with reduced contact area between shoe and ground. While these shoes are intended to be worn only for short periods, a compromise must be found between functionality and the risk of alterations in gait patterns at the lower limb joints. In this study, the pedobarographic, kinematic and kinetic effects of a traditional half-shoe and a double-rocker full-outsole shoe were compared to those of a comfortable shoe (control).
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TIME
Nearly 30 million Americans, or 9 percent of the population, have diabetes. The vast majority of these cases involve Type 2, which develops when the body can no longer handle excess sugar in the diet.
Being overweight or obese is an important trigger for Type 2 diabetes, and researchers at the American Heart Association meeting in Orlando report that one way to combat obesity and diabetes is to cook more meals at home.
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O&P News
The early symptoms might seem harmless enough.
One foot feels a little warmer than the other. But redness, swelling and pain follow. Bones weaken and fracture. The ankle joint dislocates and collapses. The shape of the arch sags from convex to concave. Walking becomes extremely painful and difficult, if not impossible.
The debilitating condition is called Charcot arthropathy, or Charcot foot. A crippling deformity linked to diabetes, especially in morbidly obese patients, Charcot foot is on the increase nationwide.
Like diabetes itself, severe cases of Charcot foot can lead to amputation.
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FiercePracticeManagement
When a physician chooses to order more imaging exams or labs, he or she may be practicing defensive medicine — or maybe not. The potentially unnecessary tests and procedures increase the cost of care, but they can also reduce the chance that the physician will get hit with a malpractice suit.
A study published in The BMJ reveals that physicians with the highest hospital charges also had fewer malpractice claims. The study includes data from 2000 to 2009 on malpractice claims filed in Florida, in addition to hospital discharges and physicians' specialties in that state.
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| PRACTICE MANAGEMENT PEARLS FROM AAPPM |
Physician's Practice
How can you tell a prospect is someone you should absolutely hire? What about when someone should be fired? Here are five tips to help.
Your new billing clerk looked great on paper. She had all the right credentials, interviewed well and appeared eager to hit the ground running. Three weeks after you brought her aboard, however, it was painfully clear she was in over her head.
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