Podiatry Commons^™

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 …

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, …

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 …

The Dialysis Foot- The Impact Of Presenting Estimated Glomerular Filtration Rate On Clinical Outcomes In Patients Hospitalized With Diabetic Foot Infections, Arthur Tarricone, Tyler L Coye, Allen Gee, Bijan Najafi, Michael C Siah, Lawrence A Lavery

Center on Aging Staff Publications

To evaluate the association between presenting estimated glomerular filtration rate (eGFR) and clinical outcomes in patients hospitalized with diabetic foot infections. This retrospective cohort study included 344 patients with moderate to severe diabetic foot infections. Patients were categorized into three groups based on presenting estimated eGFR: eGFR ≥60 (eGFR >60 mL/min), eGFR 30-60 (eGFR 30-60 mL/min) and eGFR < 30 (eGFR < 30 mL/min). Outcomes assessed included wound healing, time to heal, re-infection, amputation, mortality and re-hospitalization for infection. Compared with patients with eGFR < 30, patients with eGFR ≥60 had significantly lower rates of retinopathy, peripheral arterial disease and use of beta blockers or calcium channel blockers. Glycated haemoglobin levels were inversely related to eGFR, decreasing as eGFR severity increased. Haemoglobin levels were significantly lower, and inflammatory markers (ESR and CRP) were significantly higher in patients with eGFR < 30. There were no significant differences among eGFR groups in rates of wound healing, time to heal, re-infection or amputation. However, mortality increased with decreasing eGFR (1.9% in eGFR ≥60 vs. 3.2% in eGFR 30-60 vs. 8.1% in eGFR < 30; p = 0.04). Similarly, re-hospitalization for infection at a different site also increased with decreasing eGFR (20.5% in eGFR ≥60 vs. 28.1% in eGFR 30-60 vs. 48.4% in eGFR < 30; p <  0.01). In diabetic foot infections, presenting eGFR severity did not affect rates of wound healing, time to heal, re-infection or amputation. However, decreasing eGFR was associated with increased mortality and re-hospitalization for infection at a different site. In this study, presenting eGFR was not a predictive value for wound healing or time until healing, however was associated with rehospitalization and overall mortality this diabetic foot population.

The Infected Diabetic Foot: Bacteraemia And Endocarditis Complicating Moderate And Severe Foot Infections, Mario C Reyes, Arthur N Tarricone, Mathew J Sideman, Michael C Siah, Bijan Najafi, Edgar J G Peters, Lawrence A Lavery

Center on Aging Staff Publications

To identify the incidence of blood stream infections (BSIs) and endocarditis in patients with diabetic foot infections (DFIs), risk factors and clinical outcomes. A post hoc analysis of 280 patients using pooled patient level data from three RTCs. Blood cultures were drawn at time of admission for DFI. Deep intraoperative cultures were obtained from infected foot wounds. Data from the 12-month follow-up were used to determine clinical outcomes. 77.1% (N = 216) had blood cultures of which 15.7% (n = 34) had BSI. One patient (3.3%) had endocarditis. Risk factors for BSI included Charcot Neuroarthropathy history (20.6% vs. 7.1%, p …

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 …

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 …

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, …

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. …

Complete Closure Of Chronic Ankle Ulcerations In The Presence Of Lymphadema With Use Of Adipose Stem Cell Injectable Allograft, A Case Report, Orlexia Thomas Dpm, Francois M. Lokenye Dpm, Jasmine Sheikh Bs, Lady Paula Dejesus Dpm, Facfas, Facpm, Dwsp

Posters

This case illustrates the promising role of adipose stem cell injectable allografts in the management of complex chronic wounds, particularly in patients presenting with lymphedema and fat pad atrophy.

Limbgod(Pat. Pending): Wearable Garment For Amputation Prevention, Naomi Choi Dpm, Mba, Phuc An Dinh Bs, Ms, Eric Lee Bs, Francois M. Lokenye Dpm

Posters

Approximately 1.6 million people in the U.S. have lower limb amputations, which is expected to double by 2050 (Wong et al.). Socio-economic factors: income, education, rural residency & race, impact amputation risk (Okesina et al.), with Black Americans 70% are more likely to undergo major lower limb amputations than white Americans, even after adjusting for care access & comorbidities (Feinglass et al., Holman et al., Regenbogen et al.). Within 5 years, up to 50% of first-time amputees require another amputation (Dilingham et al., Glaser et al.) & those with comorbidities face a 77% five-year mortality rate (Fortington et al.).

Adipose Injectable Filler With Use Of Meshed Dermal Matrix And Porcine Urinary Bladder Matrix For The Management Of A Complex Achilles Wound, Francois M. Lokenye Dpm, Orlexia Thomas Dpm, Mariam Kamil Bs, Lady Paula Dejesus Dpm, Facfas, Facpm, Dwsp

Posters

Chronic Achilles wounds present a significant clinical challenge due to limited vascularity, high mechanical stress, and the complex anatomy of the posterior lower leg.

Regenerative medicine offers a promising alternative to traditional wound management through the use of advanced biologic materials.

This case highlights a novel approach utilizing a combination of adipose-derived injectable filler, acellular dermal matrix, and porcine urinary bladder matrix to enhance tissue regeneration, provide structural support, and promote wound healing.

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 …

Antibiotics Vs Surgical Resection In Foot And Ankle Osteomyelitis, Travis Rich, Marshall G. Solomon

Posters

Osteomyelitis, a serious bone infection, is particularly challenging in diabetic patients due to poor vascularization and impaired immune response.1 Timely and effective treatment is essential to prevent severe complications, including limb loss or even death.2 This study aims to evaluate the likelihood of surgical excision or amputation versus antibiotic treatment alone in diabetic patients with bone biopsyconfirmed acute osteomyelitis of the lower extremity.

Case Report Of Surgical Management For Charcot Foot Medial Column Beaming With Stj Arthrodesis, Prachi Patel, Randy Semma

Posters

Medial column beaming is a surgical procedure that involves inserting a metallic beam to the medial column of the foot to treat the Charcot deformity of the foot.

A surgeon will use a large diameter screw to insert a beam into medial column which includes the first metatarsal, medial cuneiform, navicular and talus (fig 3) The beam shares the load of weightbearing with the foot's ligaments and joints, reducing the abnormal loss of structural integrity that can occur in Charcot arthropathy of the foot.

Subtalar joint fusion is often performed concurrently with medial column beaming to enhance the overall stability …

Sole Searching: The Mystery Of A Left Foot Mood Swing Unraveled Patient, Kaitlin Sebranek

Posters

About 0.2% of patients in the Diabetic population have Charcot Neuroarthropathy.

When the gold standard of offloading in a total contact cast fails for CN patients, surgical treatment can be considered to achieve a stable, plantigrade, and functional foot.

Due to the complexity of the condition, potential complications such as hardware breakage, nonunion, and infection can result over time.

The Diagnosis Of Polyarteritis Nodosa In The Setting Of Lower Extremity Lesions: A Case Report, Eric Li, Jihan Toma

Posters

Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis affecting medium-sized arteries, involving multiple organs, with the most frequently affected tissues being skin and peripheral nerves (1). The distinct pearl neckless pattern led to the naming of this condition (2). Cutaneous polyarteritis nodosa (CPAN) is a variant of PAN confined to the skin, muscles and peripheral nerves in the absence of any systemic involvement (1). This rare form of systemic necrotizing vasculitis is limited to the medium-sized arteries of the skinand has a more favorable prognosis (1). PAN is also linked to Hepatitis B(2).The current diagnostic criteria for CPAN were proposed …

Stepping Into Relief: Conquering Rheumatoid Arthritic Foot Pain With Podiatric Management, Natalie Diaz, Marshall Solomon, Inocencio Cuesta

Posters

Rheumatoid arthritis (RA) is a chronic multifactorial autoimmune disease that causes progressive joint destruction along with causing cutaneous manifestations such as nodules. RA negatively impacts life by producing pain, impairing quality of life and biomechanical function of the lower extremities.