Podiatry Commons^™

Slimmer’S Paralysis In The Era Of Glp-1 Therapy: A Review Of Recent Cases, Nidhin John, Amayrani Sanchez, Naomie Jean

School of Podiatric Medicine - Student Research

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) such as semaglutide and tirzepatide have transformed obesity management by producing substantial and sustained weight loss. However, rapid weight reduction has been increasingly associated with peroneal neuropathy, or “slimmer’s paralysis.” This review summarizes the pathophysiology, recent case reports, and clinical implications of this emerging complication. Slimmer’s paralysis arises indirectly through loss of protective adipose tissue around the fibular head and nutritional deficiencies, rather than direct neurotoxic effects of GLP-1 agents. Recognition is critical, as timely intervention with conservative or surgical management can restore function. Clinicians should maintain vigilance in patients undergoing rapid pharmacologic weight …

Single Local Injection Of 3s-Hmgb1 Enhances Early Bone Healing And Titanium Implant Osseointegration In Type 2 Diabetic Mice, Bhuvana L. Chandrashekar, Alexandra Arteaga, Evelin Rios, Jimena Mora, Gustavo P. Garlet, Danieli Rodrigues, Cláudia Cristina Biguetti

School of Podiatric Medicine Publications

Diabetes significantly impairs bone healing via several mechanisms, including sustained inflammation, oxidative stress, and poor osteogenic responses. Fully reduced isoform of High Mobility Group Box 1 with three serine substitutions (3S-HMGB1) has shown regenerative properties while being resistant to oxidative degradation.

Objective: This study evaluated the therapeutic potential of a single local injection of 3S-HMGB1 in early osseointegration under diabetic conditions in mice.

Methodology: A total of 48 male 129/Sv mice (24 non-diabetic [ND], 24 diabetic [D]) received titanium implants following maxillary first molar extraction. ND and D mice (n:12) were injected with either saline (control) or 3S-HMGB1 (0.75 mg/kg) …

Diabetes-Related Foot Complications And Socioeconomic Influences Among Hispanic Males In South Texas: A Scoping Review, Mariana J. Rodriguez, Demian Rodriguez, Amanda Killeen

School of Podiatric Medicine Publications

Introduction: Diabetes mellitus is the 7th leading cause of death in the U.S. and 6th in Texas. South Texas counties have higher diabetes rates than state and national averages. This complex, progressive disease affects multiple body systems and can lead to serious complications, especially in the lower extremities. Uncontrolled diabetes is often associated with diabetic foot ulcers (DFU), foot infections, and lower extremity amputations (LEA). South Texas, predominantly Hispanic American, is disproportionately affected. This demographic faces clinical barriers due to a lack of cultural understanding, highlighting the need for culturally sensitive healthcare workers such as promotoras. This study aimed to …

Soft Tissue Envelope Compromise Following Low-Side Motorcycle Accident: A Case Study And Literature Review, Steven A. Bolton, Ali Ahmad, Jonathan Rodriguez, Hooman Mir

School of Podiatric Medicine - Student Research

Purpose: This case report details a staged approach in managing a patient who presented to the ER with a displaced proximal second phalanx fracture, extensive soft tissue damage, and diffuse fracture blistering following a motorcycle crash. This case highlights that soft tissue damage may not always correlate with severe osseous injury.

Methodology: This case is a concurrent chart review of a 40-year-old who sustained a low side motorcycle injury resulting in a minimally displaced avulsion fracture of the medial 2nd toe proximal phalanx base with extensive soft tissue damage, fracture blisters, and lower extremity edema.

Procedures: Radiographic evaluation demonstrated no …

Diabetes-Related Foot Complications And Socioeconomic Influences Among Hispanic Males In South Texas: A Scoping Review, Mariana J. Rodriguez, Demian Rodriguez, Amanda L. Killeen

School of Podiatric Medicine - Student Research

Introduction: Diabetes mellitus is the 7^th leading cause of death in the United States and is 6^th in the state of Texas. Counties from South Texas are primarily affected with higher rates of diabetes than both the state and national average. Diabetes mellitus is a complex and progressive disease which can affect multiple systems of the body, leading to serious complications if untreated, especially in the lower extremities. Uncontrolled diabetes is often associated with diabetic foot ulcers (DFU), foot infections, and lower extremity amputations (LEA). South Texas is a region predominantly populated by Hispanic Americans who are disproportionally …

The Association Between Glp-1 Receptor Agonist Use And Gastroparesis In Patients With Type 2 Diabetes Mellitus: A Scoping Review, Daniela Lizbeth Avilez, Amanda Killeen

School of Podiatric Medicine - Student Research

Poster Category:  Non-sponsored

Level of Evidence:  Level V

Introduction:  GLP-1 receptor agonists (GLP-1 RAs), widely used for glycemic control and weight management in Type 2 Diabetes Mellitus (T2DM), slow gastric motility.

Reports of “gastroparesis” in GLP-1 RA users raise the question whether this reflects reversible pharmacologic effects or true diabetic autonomic neuropathy. This distinction matters for podiatric physicians, as gastroparesis indicates systemic autonomic dysfunction that parallels peripheral neuropathy, impaired wound healing, and heightened foot ulcer risk. Most prior studies rely on symptoms rather than validated gastric emptying (GE) measures.

Aim:  To evaluate the association between GLP-1 RA use and gastroparesis …

Screw Diameter And Healing Outcomes In Jones Fractures: A Scoping Review, Merlin Sajeev, Jessica Sima, Srilalitha Lanka, Amanda Killeen

School of Podiatric Medicine - Student Research

Introduction: Jones fractures occur at the metaphyseal–diaphyseal junction of the fifth metatarsal and are prone to delayed or nonunion due to limited perfusion and high mechanical stress. Intramedullary (IM) screw fixation is the standard operative treatment, yielding higher union rates than conservative management. There is no clear consensus on the influence of screw size on healing outcomes.

Aim: To examine the impact of IM screw diameter on union rates in Jones fracture fixation.

Methods: A literature search was conducted using Google Scholar and PubMed with the search term: “"Screw" AND "Diameter" AND "Union" AND "Jones Fractures"”. Articles published between 2015 …

Evaluating Trending Topics Published In The Journal Of Foot And Ankle Surgery, Sarah Weisbrodt, Asad Mustafa, Demian Rodriguez, Naohiro Shibuya

School of Podiatric Medicine - Student Research

Introduction: As the field of podiatry advances, it is valuable to identify the areas of research that receive the greatest focus. Evaluating popular topics published in podiatric medicine and surgery peer-reviewed journals helps us consider current trends in procedures, surgeon preferences, and current interest in our profession.

Aim: To evaluate current trends in podiatric medicine and surgery through compiling topics published in the Journal of Foot and Ankle Surgery (JFAS) and their frequency.

Methods: JFAS was selected for our analysis as it has the highest impact factor out of the indexed journals in our profession. We used Scopus to identify …

Tissue-Like Fracture Toughness And Stress–Relaxation Ability In Pva-Agar-Based Hydrogels For Biomedical Applications, Ismael Lamas Jr., Bhuvana L. Chandrashekar, Cláudia C. Biguetti, Mohammad R. Islam

Mechanical Engineering Faculty Publications

Soft tissues exhibit remarkable stretchability, fracture toughness, and stress–relaxation ability. They possess a large water content to support cellular processes. Mimicking such a combination of mechanical and physical properties in hydrogels is important for tissue engineering applications but remains challenging. This work aims to develop a hydrogel that can combine excellent mechanical properties with cellular viability. The research focused on polyvinyl alcohol (PVA)/agar double-network (DN) hydrogels, fabricated by thermal gelation and freeze–thawing methods. Their mechanical properties were characterized through tension, compression, fracture, and stress–relaxation tests, and their cellular viability was measured through cytotoxicity tests. The results show that the PVA/agar …

Actin Up And Factor’D In: ​ A Pediatric Spindle Cell Lesion Case Presentation, Michael Higham, Stephanie Campbell, Naomie Jean, Amanda Killeen

School of Podiatric Medicine Publications

Introduction: Solitary spindle cell nodules on the foot in pediatric patients are rare and diagnostically challenging. Dermatofibroma (benign fibrous histiocytoma), a common adult dermal lesion, is infrequently observed in children under 18.

The spectrum of pediatric spindle cell tumors includes reactive entities like nodular fasciitis and dermatomyofibroma, benign neoplasms such as myofibroma, and malignant tumors including spindle cell rhabdomyosarcoma, fibrosarcoma, and dermatofibrosarcoma protuberans (DFSP). Accurate differential diagnosis is essential, as DFSP requires wide excision or Mohs surgery to reduce recurrence risk.

Methods (Case Presentation): An 11-year-old boy presented with a one-year history of a non-healing lesion on the heel, initially …

Chronic Lower Extremity Anomalies: Impact Of Diabetic Induced Foot Amputations On Human Locomotion, Anthony Arnoldo Melgar

Theses and Dissertations

This research aims to understand the physiological changes that the human body undergoes post partial foot amputation (PFA). A total of three studies were conducted to fully comprehend biomechanical changes and adjustments that occur during locomotion for affected individuals. The first study of this thesis focuses on obtaining kinematic data for both the ankle joint angle and ankle joint torque for the healthy population, as well as for the affected PFA population. Results were compared, and notable differences were present between the two. The second study of this thesis dealt with individual muscle forces. To obtain the muscle force data, …

Il-17a Immune Signature Across Stratified Stages Of Type 2 Diabetes​, Brittney C. White, Antonio Hernandes Chaves-Neto, Peter Elvin, Javier La Fontaine, Eric L. Brown, Walid Fakhouri, Craig Hanis, Claudia Biguetti

School of Podiatric Medicine - Student Research

Purpose: This study investigated whether IL-17A, a pro-inflammatory cytokine associated with Th17 cell activity, reflects distinct stages of type 2 diabetes progression.

Methods: Forty-two obese individuals (average age: 60.4 ± 10.3 years; 55% male; BMI: 31.3 ± 4.9) from Starr County, Texas, were matched for gender and BMI and stratified into five metabolic groups based on fasting blood glucose, 2-hour oral glucose tolerance test, and HbA1c levels. Groups included diabetes-free, isolated impaired glucose tolerance, combined glucose impairment, diabetes without complications, and diabetes with lower extremity complications. IL-17A protein levels were quantified from buffy coat samples using ELISA. After excluding …

Comparison Of Recurrence Rates In Chemical Matricectomy With Phenol And Nail Bracing: A Scoping Review, Jessica Sima, Amanda Killeen

School of Podiatric Medicine - Student Research

Introduction: Ingrown toenails are one of the most common nail conditions and are usually treated with chemical matricectomy using phenol (CMP). However, this procedure is often contraindicated in patients with diabetes mellitus or peripheral vascular disease. Orthonyxia, or nail braces application, is a non-invasive alternative treatment for ingrown toenails. The nail braces are spring wires with one side shaped into a hook that is placed under one side of the nail, and the other side attached to a plastic pad that is glued to the nail plate. The braces retain the normal shape of the nails without removing them, allowing …

Beyond The Bone: A Misdiagnosis Of Paget’S Disease Reveals Polyostotic Mazabraud Syndrome, Michael Higham, Stephanie Campbell, Amanda Killeen

School of Podiatric Medicine Publications

Introduction: Mazabraud Syndrome is a rare benign condition characterized by polyostotic fibrous dysplasia and intramuscular myxomas. Due to its overlapping radiographic features, it is frequently misdiagnosed. We present a case where Mazabraud Syndrome was misdiagnosed as Paget’s disease for nearly 6 decades.

Case Presentation: A 59-year-old woman presented to the podiatry clinic with complaints of numbness and sharp pain of the left foot while in stance. Her surgical history is positive for numerous lower extremity myxomas excised over her lifetime, beginning in adolescence, and now with non-mobile soft tissue mass at the porta pedis of the left foot for 1 …

Diabetic Foot Ulcer Healing Time With Silver Alginate Dressing: A Scoping Review, Srilalitha Lanka, Merlin Sajeev, Jessica Sima, Amanda Killeen

School of Podiatric Medicine - Student Research

Introduction: Diabetic foot ulcers (DFUs) are slow-healing wounds that can lead to serious complications. Choosing the right dressing is important for improving healing. Silver alginate dressings are commonly used because they help fight infection and may promote faster recovery. This scoping review examines existing research on the effect of silver alginate dressings on DFU healing time.

Method: A literature search was conducted using Google Scholar and PubMed with the search terms: ““Diabetic foot ulcer” AND "wound healing" AND “silver Dressing” AND "alginate"” and “Diabetic foot ulcer AND wound healing AND silver Dressing AND alginate”, respectively. Articles published between 2005 and …

From Likes To Insights: Perceptions Of Peripheral Nerve Surgery On Tiktok, Madeleine G. Mehaffey, Nicholas Obias, James Hughes, John Gouin

School of Podiatric Medicine - Student Research

Introduction: Peripheral nerve surgery is a therapeutic modality for many diagnoses, such as nerve compression syndromes, peripheral neuropathy, and neuroma. In response to the increasing number of people seeking health information on social media, this study explores public perceptions of peripheral nerve surgery on the social media platform TikTok (1). Conclusions from this study may provide insight to medical personnel looking to use social media to improve patient education.

Methods: A new TikTok account was used to search “Peripheral Nerve Surgery.” The top 25 posts, including sponsored advertisements, were analyzed based on number of likes and comments, relevance, type, authorship, …

Evaluation Of Wound Dehiscence Rate Between Total Ankle Replacement (Tar) And Ankle Arthrodesis (Aa): A Systematic Review And Meta-Analysis, Asad Mustafa, Sarah Weisbrodt, Naohiro Shibuya

School of Podiatric Medicine - Student Research

Introduction

Total ankle replacement (TAR) and ankle arthrodesis (AA) are surgical interventions used for patients with degenerative ankle arthritis. Historically, AA has been the standard treatment for ankle arthritis; however, in recent years, TAR has become just as popular, if not more so. The TARVA study, a randomized controlled trial examining the outcomes of each procedure for a population with end-stage osteoarthritis, reports similar results between the two procedures, except that TAR may have a higher incidence of wound dehiscence. TAR typically requires a larger incision than AA, which may influence patient selection for the procedure. However, data from the …

Diabetic Foot Ulcer Recurrence In Hispanic Americans: A Growing Concern, Daniela Lizbeth Avilez, Amanda Killeen

School of Podiatric Medicine - Student Research

Background: Diabetic foot ulcers (DFUs) represent a critical public health concern among Hispanic populations, contributing significantly to healthcare disparities and an elevated risk of amputations. Although Hispanic Americans account for 11.7% of the U.S. population with diabetes, they experience disproportionately higher rates of DFUs and amputations compared to non-Hispanic White individuals. Additionally, Hispanic adults exhibit lower rates of attempted revascularization, which exacerbates their susceptibility to severe complications. As the Hispanic population continues to grow, particularly in Texas, addressing DFU recurrence is crucial for improving clinical outcomes and reducing health inequities. This review evaluates evidence on DFU recurrence within Hispanic populations. …

The Multiple Roles Of 5-Lo In Tissue Regeneration – Insights From Translational Animal Models Utilizing Pharmacological And Genetic Approaches, Roel Navarro, Nidhin John, Claudia Biguetti

School of Podiatric Medicine - Student Research

Inflammation following tissue injury is a natural physiological response, where its course, duration, and intensity help determine whether it promotes beneficial or detrimental outcomes in tissue healing. Arachidonic acid (AA) serves as a substrate for5-lipoxygenase (5-LO) pathway, which synthesizes metabolites such as leukotrienes that influence both acute and chronic inflammatory response.  AA and its product's inhibitors are currently used to treat hypersensitivity reactions. However, literature suggests potential therapeutic efficacy in tissue healing.

Wound Dehiscence Rate Between Chevron Osteotomy Procedure Vs. Lapidus For Correction Of Hallux Valgus Deformity, Isabella V. Strash, Abelardo Osuna, Madelaine Adkins

School of Podiatric Medicine - Student Research

Format: Scientific

Length of follow-up: n/a

Level of Evidence: Cross-Sectional Study (Level III)

Classification: Surgery

Purpose: Distal metatarsal osteotomies, like the chevron procedure, were once preferred for their stability and faster recovery in hallux valgus correction. However, recent advancements have increased the use of proximal procedures, such as the lapidus. This study aims to compare complications between distal and proximal hallux valgus surgeries.

Methodology & Procedure: Data was downloaded from the TriNetX Research Network on February 2, 2023 using CPT codes 28296 (chevron) and 28297 (lapidus). Inclusion criteria consisted of patients between 18 and 60 years of age and required …

Successful Limb Salvage In A Severe Diabetic Foot Infection: A Case Study Of Aggressive Surgical Intervention And Grafting Technique, Stephanie N. Campbell, Amanda Killeen, Michael Sobolevsky

Research Symposium

Background: Severe necrotizing diabetic foot infections are known to have high morbidity, high amputation risk, and high complication rates. Efforts at preserving the limb require significant surgical efforts and lengthy wound care. This process is more complicated in patients with significant housing instability.

Case Presentation: A 53-year-old male with uncontrolled diabetes (A1c 7.9%), housing insecurity, food insecurity presented with severe necrotizing diabetic foot infection with ascending cellulitis, infectious hemorrhagic bullae, multi-compartment abscesses of the foot and anterior leg. It is known that patients with diabetes are at increased risk of both amputation and surgical interventions than patients without diabetes. This …

Investing In Limb Preservation: A Case Report In Avoiding Bilateral Amputation In A Vasculopathy Patient, Stephanie N. Campbell, Craig J. Verdin, Heather V. Tran, Nikita Gambhir

Research Symposium

Background: Limb salvage and prosthetics play vital roles in restoring function and mobility for patients with severe injuries or metabolic conditions. Limb salvage involves surgical techniques aimed at preserving a limb rather than resorting to amputation, while prosthetics provide artificial devices to replace lost limbs. Key considerations for limb salvage include restoring a functional foot, maintaining patient independence, minimizing hospitalizations, and avoiding bilateral lower limb amputations.

Case Presentation: The patient, already at single-limb status, presented with a necrotic heel ulcer, exposed calcaneus, and necrotic Achilles tendon. After vascular optimization, the risks and benefits of final aggressive measures were discussed, leading …

Train Foot: History Of The Migrant Worker, Stephanie N. Campbell, Heather V. Tran, Nikita V. Gambhir, Luis Caporusso

School of Podiatric Medicine Publications

Immigrant labor has a long history in the United States, comprised of millions of workers from various ethnic and cultural backgrounds supporting multiple industries from farm work to steel. As of 2019, 25.6% of total migrant workers employed in the Americas [1,2]. Crush injuries or “pinch points” are events when a body part is entangled within machinery or under or between an object [3]. After a series of crush related injuries of young (20s), male Latino patients across Texas to a level 1 trauma center, case review was performed for 2 patients for which follow up could be evaluated. The …

Under Pressure: A Rare Presentation Of Crude Oil Injection Injury To The Foot Secondary To Pressure Washer Injury, Stephanie N. Campbell, Heather V. Tran, Nikita V. Gambhir, Connor Krolikowski

School of Podiatric Medicine Publications

No abstract provided.

Investing In Limb Preservation: A Case Report In Avoiding Bilateral Amputation In A Vasculopathy Patient, Stephanie N. Campbell, Craig J. Verdin, Heather V. Tran, Nikita Gambhir

School of Podiatric Medicine Publications

Limb salvage and prosthetics play vital roles in restoring function and mobility for patients with severe injuries or metabolic conditions. Limb salvage involves surgical techniques aimed at preserving a limb rather than resorting to amputation, while prosthetics provide artificial devices to replace lost limbs. Key considerations for limb salvage include restoring a functional foot, maintaining patient independence, minimizing hospitalizations, and avoiding bilateral lower limb amputations.

Successful Limb Salvage In A Severe Diabetic Foot Infection: A Case Study Of Aggressive Surgical Intervention And Grafting Technique, Stephanie N. Campbell, Amanda Killeen, Michael Sobolevsky

School of Podiatric Medicine Publications

A 53-year-old male with uncontrolled diabetes (A1c 7.9%), housing insecurity, food insecurity presented with severe necrotizing diabetic foot infection with ascending cellulitis, infectious hemorrhagic bullae, multi-compartment abscesses of the foot and anterior leg. It is known that patients with diabetes are at increased risk of both amputation and surgical interventions than patients without diabetes. This patient underwent aggressive surgical intervention to avoid primary below knee amputation.

The Effects Of Capsaicin On Vascularization In Patients With Diabetes Mellitus: A Literature Review, Karen Hernandez, Leslie Guerrero, Myra Mudassar, Amanda L. Killeen

School of Podiatric Medicine Publications

Diabetes Mellitus (DM) is a metabolic disorder affecting 11.6% of the United States population and 43.95% of the population in the Rio Grande Valley of Texas. A common complication of diabetes mellitus is neuropathy, a type of nerve damage that affects as many as half of the people with this condition. Vascular factors and metabolic interactions are major influencers of the pathogenesis of diabetic neuropathy. This literature review evaluates the therapeutic role of capsaicin, a known component of capsicum pepper, commonly used as a treatment for neuropathic pain. However, several studies show that in addition to pain management, capsaicin counters …

Early Tissue Changes Linked To Diabetes: Insights From A Preclinical Model, Bryan Liu, Ramiro Cisneros, Estephania Garcia, Jimena Mora, Sumedha Guha, Evelin Rios, Krishna Prajapati, Danieli Rodrigues, Bhuvana Lakkasetter Chandrashekar, Claudia Biguetti

School of Podiatric Medicine - Student Research

Introduction and Hypothesis: The aim of this study is to compare soft tissue morphology and fibrosis pathology of different organs between diabetic and non-diabetic rats. Type 2 diabetes causes soft tissue remodeling in organ systems including heart, kidney, spleen, and pancreas. Fibrotic remodeling is a common pathological mechanism seen in diabetes-related organ dysfunction. By understanding fibrotic pathology in rats, it serves as a foundation to develop lower limb models applicable to podiatry. These systemic changes caused by diabetes may also play a role in lower limb changes such as diabetic ulcers and delayed wound healing.

Methodology: Male Lewis rats (6 …

Demographic And Clinical Characteristics Of Patients With Charcot Neuro-Osteoarthropathy In People With Diabetes Mellitus In Six Countries: A Multicenter Observational Study From 1996 To 2022, E. B. Jude, C. Siafarikas, A. Rastogi, R. Bem, T. Tankova, M. -F. Kong, Javier La Fontaine, J. Pappachan, N. Tentolouris

School of Podiatric Medicine Publications

Aim: To describe the demographic and clinical characteristics of patients with Charcot neuro-osteoarthropathy (CNO) and to examine for differences between participants with Type 1 diabetes mellitus (DM) (T1DM) and Type 2 diabetes mellitus (T2DM).

Materials and Methods: Multicenter observational study in eight diabetic foot clinics in six countries between January 1, 1996, and December 31, 2022. Demographic, clinical, and laboratory parameters were obtained from the medical records. Analyses were performed using parametric or nonparametric statistical tests for variables with normally or nonnormally distributed values, respectively. Comparisons of the qualitative data were performed using the chi-square test.

Results: Seven hundred seventy-four …

Rare Case Of Osteomyelitis Caused By Achromobacter Xylosoxidans, Christopher P. Girgis, Tyler L. Coye, Elizabeth Ansert, Amanda L. Killeen, Peter A. Crisologo

School of Podiatric Medicine Publications

Achromobacter xylosoxidans is a rare opportunistic aerobe that has rarely been documented in the literature as a causative agent for osteomyelitis. It can present with antibiotic resistance, making treatment without operative management challenging. We present the case of a 51-year-old male with a past medical history of uncontrolled type 2 diabetes. The patient presented to a clinic with a grade 2 infection to the right fifth digit, as defined by the International Working Group on the Diabetic Foot, and was subsequently admitted for intravenous antibiotics and operative management. Magnetic resonance imaging revealed abnormal signal of the phalanges of the fifth …