Podiatry Commons^™

New Year's Resolution, Graham A. Hamilton

School of Podiatric Medicine Publications

No abstract provided.

Digital Biomarkers Of Gait And Balance In Diabetic Foot, Measurable By Wearable Inertial Measurement Units: A Mini Review, Gu E. Kang, Angeloh Stout, Ke’Vaughn Waldon, Amanda L. Killeen, Peter A. Crisologo, Michael C. Siah, Daniel C. Jupiter, Bijan Najafi, Ashkan Vaziri, Lawrence A. Lavery

School of Podiatric Medicine Publications

People with diabetic foot frequently exhibit gait and balance dysfunction. Recent advances in wearable inertial measurement units (IMUs) enable to assess some of the gait and balance dysfunction associated with diabetic foot (i.e., digital biomarkers of gait and balance). However, there is no review to inform digital biomarkers of gait and balance dysfunction related to diabetic foot, measurable by wearable IMUs (e.g., what gait and balance parameters can wearable IMUs collect? Are the measurements repeatable?). Accordingly, we conducted a web-based, mini review using PubMed. Our search was limited to human subjects and English-written papers published in peer-reviewed journals. We identified …

Middle Cuneiform Stress Fracture In A Postal Worker: A Case Report, Stephanie N. Campbell, Jacob M. Jones, Raul Aviles, Loren K. Spencer, John J. Anderson

School of Podiatric Medicine Publications

This report is to supplement the limited nature of isolated cuneiform fractures. Cuneiform fractures are identified as “low risk stress fracture” but with delayed diagnosis may cause prolonged treatment due to continued foot pain. Delayed diagnosis may be due to low sensitivity on radiographic exam and/or low suspicion clinically due to the rare involvement of isolated cuneiform fractures.

Joint Angle Variability Is Altered In Patients With Peripheral Artery Disease After Six Months Of Exercise Intervention, Farahnaz Fallahtafti, Zahra Salamifar, Mahdi Hassan, Hafizur Rahman, Iraklis Pipinos, Sara A. Myers

School of Podiatric Medicine Publications

Supervised exercise therapy (SET) is a conservative non-operative treatment strategy for improving walking performance in patients with peripheral artery disease (PAD). Gait variability is altered in patients with PAD, but the effect of SET on gait variability is unknown. Forty-three claudicating patients with PAD underwent gait analysis before and immediately after a 6-month SET program. Nonlinear gait variability was assessed using sample entropy, and the largest Lyapunov exponent of the ankle, knee, and hip joint angle time series. Linear mean and variability of the range of motion time series for these three joint angles were also calculated. Two-factor repeated measure …

Meta-Analysis: Outcomes Of Surgical And Medical Management Of Diabetic Foot Osteomyelitis, David H. Truong, Roger Bedimo, Matthew Malone, Dane K. Wukich, Orhan Oz, Amanda L. Killeen, Lawrence A. Lavery

School of Podiatric Medicine Publications

Background

The aim of this study was to evaluate clinical outcomes in the published literature on medical and surgical management of diabetic foot osteomyelitis (DFO).

Methods

A PubMed and Google Scholar search of articles relating to DFO was performed over the dates of January 1931 to January 2020. Articles that involved Charcot arthropathy, case reports, small case series, review articles, commentaries, nonhuman studies, and non-English articles were excluded. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to rate the bias of each study. A meta-analysis was performed using random-effects and inverse variance methods. The search yielded 1192 …

Effect Of Sensory Neuropathy On The Predictive Value Of Inflammatory Biomarkers For Osteomyelitis In Diabetic And Nondiabetic Patients With Foot Infections, Easton Ryan, Junho Ahn, Dane K. Wukich, Javier La Fontaine, Andrew Crisologo, Matthew Malone, Orhan Oz, Lawrence A. Lavery

School of Podiatric Medicine Publications

Objective: To investigate the predictive value of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in persons with and without diabetes with osteomyelitis (OM).

Methods: We evaluated 455 patients in a retrospective cohort study of patients admitted to the hospital with diabetic foot OM (n = 177), diabetic foot soft-tissue infections (STIs) (n = 176), nondiabetic OM (n = 51), and nondiabetic STIs (n = 51). Infection diagnosis was determined through bone culture, histopathologic examination for OM, and/or imaging (magnetic resonance imaging/single-photon emission computed tomography) for STI. The optimal cutoff values of ESR and CRP in predicting OM were determined …

Streptococcus Pneumoniae, S. Mitis, And S. Oralis Produce A Phosphatidylglycerol-Dependent, Ltas-Independent Glycerophosphate-Linked Glycolipid, Yahan Wei, Luke R. Joyce, Ashley M. Wall, Ziqiang Guan, Kelli L. Palmer

School of Podiatric Medicine Publications

Lipoteichoic acid (LTA) is a Gram-positive bacterial cell surface polymer that participates in host-microbe interactions. It was previously reported that the major human pathogen Streptococcus pneumoniae and the closely related oral commensals S. mitis and S. oralis produce type IV LTAs. Herein, using liquid chromatography/mass spectrometry-based lipidomic analysis, we found that in addition to type IV LTA biosynthetic precursors, S. mitis, S. oralis, and S. pneumoniae also produce glycerophosphate (Gro-P)-linked dihexosyl (DH)-diacylglycerol (DAG), which is a biosynthetic precursor of type I LTA. cdsA and pgsA mutants produce DHDAG but lack (Gro-P)-DHDAG, indicating that the Gro-P moiety is derived from phosphatidylglycerol …

The Effect Of Continuous Diffusion Of Oxygen Treatment On Cytokines, Perfusion, Bacterial Load, And Healing In Patients With Diabetic Foot Ulcers, Lawrence A. Lavery, Amanda L. Killeen, David Farrar, Yucel Akgul, Peter A. Crisologo, Matthew Malone, Kathryn E. Davis

School of Podiatric Medicine Publications

To evaluate continuous diffusion of oxygen therapy (CDO) on cytokines, perfusion, and bacterial load in diabetic foot ulcers we evaluated 23 patients for 3 weeks. Tissues biopsies were obtained at each visit to evaluate cytokines and quantitative bacterial cultures. Perfusion was measured with hyperspectral imaging and transcutaneous oxygen. We used paired T tests to compare continuous variables and independent T tests to compare healers and nonhealers. There was an increase from baseline to week 1 in TGF-β (P = .008), TNF-α (P = .014), VEGF (P = .008), PDGF (P = .087), and IGF-1 (P …

Lyopreserved Amniotic Membrane Is Cellularly And Clinically Similar To Cryopreserved Construct For Treating Foot Ulcers, Kathryn E. Davis, Amanda L. Killeen, David Farrar, Katherine M. Raspovic, Zachary D. Berriman-Rozen, Matthew Malone, Lawrence A. Lavery

School of Podiatric Medicine Publications

We compared cellular viability between cryopreserved and lyopreserved amniotic membranes and clinical outcomes of the lyopreserved construct in a prospective cohort study of 40 patients with neuropathic foot ulcers. Patients received weekly application of lyopreserved membrane for 12 weeks with standard weekly debridement and offloading. We evaluated the proportion of foot ulcers that closed, time to closure, closure trajectories, and infection during therapy. We used chi-square tests for dichotomous variables and independent t-tests for continuous variables with an alpha of α = .10. Cellular viability was equivalent between cryo- and lyopreserved amniotic tissues. Clinically, 48% of subjects' wounds closed in …

Length Of Stay And Hospital Cost Comparison In Hind Foot And Ankle Surgery On Patients With Anxiety And Depression Versus Those Without Psychopathology Diagnoses., Christopher J. Betrus, Sham J. Persaud, Stephanie N. Campbell, Alan R. Catanzariti

School of Podiatric Medicine Publications

To evaluate if patients with depression and/or anxiety have more post-operative pain, necessitating more pain medication and requiring longer hospital stays, corresponding to increased costs following elective hind foot and/or ankle surgery.

Through comparing the LOS between our study group and our control group, a diagnosis of depression and/or anxiety did not seem to extend the length of time admitted to the hospital. We found, as expected, the average VAS pain score was increased in the study group, which has been previously seen in the available literature.

Does The Start Of Dialysis Initiate A Period Of Increased Risk Of Ulceration Or Amputation?, Lawrence A. Lavery, David C. Lavery, Nathan A. Hunt, Javier La Fontaine, Ryan D. Lavery

School of Podiatric Medicine Publications

Background: Dialysis therapy is associated with an increased incidence of lower-extremity wounds and amputations. We compared the incidence of foot ulcers and amputations before and after the start of dialysis.

Methods: We evaluated 150 consecutive diabetic patients receiving dialysis and compared the incidence of foot complications 30 months before and after initiation of hemodialysis. We used claims data for diabetes, ulceration, and dialysis and abstracted medical records to verify diagnoses and dates of ulcers and amputations. We compared initial and cumulative ulcer/amputation incidence to account for multiple events in the same person over time. We used the same formula to …

Characterization Of The Protective Role Of Regulatory T Cells In Experimental Periapical Lesions Development And Its Chemoattraction Manipulation As A Therapeutic Tool, Carolina Favaro Francisconi, Andreia Espindola Vieira, Cláudia Cristina Biguetti, Andrew J. Glowacki, Ana Paula Favaro Trombone, Ariadne Letra, Renato Menezes Silva, Charles S. Sfeir, Steven R. Little, Gustavo P. Garlet

School of Podiatric Medicine Publications

Introduction

The pathogenesis of periapical lesions is determined by the balance between host pro-inflammatory immune response and counteracting anti-inflammatory and reparative responses, which include regulatory T cells (Tregs) as potential immunoregulatory agents. In this study, we investigated (in a cause-and-effect manner) the involvement of CCL22-CCR4 axis in Tregs migration to the periapical area and the role of Tregs in the determination of outcomes in periapical lesions.

Methods

Periapical lesions were induced in C57Bl/6 (WT) and CCR4KO mice (pulp exposure and bacterial inoculation), and treated with anti-GITR to inhibit Tregs function or alternatively with CCL22-releasing, PLGA particles to induce site-specific migration …

Intramembranous Bone Healing Process Subsequent To Tooth Extraction In Mice: Micro-Computed Tomography, Histomorphometric And Molecular Characterization, Andreia Espindola Vieira, Carlos Eduardo Repeke, Samuel De Barros Ferreira Junior, Priscila Maria Colavite, Cláudia Cristina Biguetti, Rodrigo Cardoso Oliveira, Gerson Francisco Assis, Rumio Taga, Ana Paula Favaro Trombone, Gustavo P. Garlet

School of Podiatric Medicine Publications

Bone tissue has a significant potential for healing, which involves a significant the interplay between bone and immune cells. While fracture healing represents a useful model to investigate endochondral bone healing, intramembranous bone healing models are yet to be developed and characterized. In this study, a micro-computed tomography, histomorphometric and molecular (RealTimePCRarray) characterization of post tooth-extraction alveolar bone healing was performed on C57Bl/6 WT mice. After the initial clot dominance (0 h), the development of a provisional immature granulation tissue is evident (7 d), characterized by marked cell proliferation, angiogenesis and inflammatory cells infiltration; associated with peaks of growth factors …

Analysis Of Multiple Cytokine Polymorphisms In Individuals With Untreated Deep Carious Lesions Reveals Il1b (Rs1143643) As A Susceptibility Factor For Periapical Lesions Development, Alisa Dill, Ariadne Letra, Letıcia Chaves De Souza, Mamatha Yadlapati, Cláudia Cristina Biguetti, Gustavo P. Garlet, Alexandre R. Vieira, Renato Menezes Silva

School of Podiatric Medicine Publications

Introduction

It has been proposed that individual genetic predisposition may contribute to persistent apical periodontitis. Cytokines are associated with levels of inflammation and are involved in caries, pulpal, and periapical tissue destruction. We hypothesized that polymorphisms in cytokine genes may contribute to an individual’s increased susceptibility to apical tissue destruction in response to deep carious lesions.

Methods

Subjects with deep carious lesions, with or without periapical lesions (≥ 3 mm) were recruited at the University of Pittsburgh and the University of Texas at Houston. Genomic DNA samples of 316 patients were sorted into 2 groups: 136 cases with deep carious …

Simultaneous Analysis Of T Helper Subsets (Th1, Th2, Th9, Th17, Th22, Tfh, Tr1 And Tregs) Markers Expression In Periapical Lesions Reveals Multiple Cytokine Clusters Accountable For Lesions Activity And Inactivity Status, Ana Claudia Araujo-Pires, Carolina Favaro Francisconi, Cláudia Cristina Biguetti, Franco Cavalla, Andreza Maria Fabio Aranha, Ariadne Letra, Ana Paula Favaro Trombone, Marcelo Faveri, Renato Menezes Silva, Gustavo P. Garlet

School of Podiatric Medicine Publications

Previous studies demonstrate that the balance between pro- and anti-inflammatory mediators determines the stable or progressive nature of periapical granulomas by modulating the balance of the osteoclastogenic factor RANKL and its antagonist OPG. However, the cytokine networks operating in the development of periapical lesions are quite more complex than what the simple pro- versus anti-inflammatory mediators' paradigm suggests. Here we simultaneously investigated the patterns of Th1, Th2, Th9, Th17, Th22, Thf, Tr1 and Tregs cytokines/markers expression in human periapical granulomas.

Methods:

The expression of TNF-α, IFN-γ, IL-17A, IL23, IL21, IL-33, IL-10, IL-4, IL-9, IL-22, FOXp3 markers (via RealTimePCR array) was …