Podiatry Commons^™

Aged And Induced-Premature Ovarian Failure Mouse Models Affect Diestrus Profile And Ovarian Features, Ana Carolina Zucon Bacelar, Nataira Regina Momesso, Felipe Haddad Martim Pederro, Alaíde Gonçalves, Edilson Ervolino, Antonio Hernandes Chaves-Neto, Cláudia Cristina Biguetti, Mariza Akemi Matsumoto

School of Podiatric Medicine Publications

Sex hormones exert a wide influence on several systems of the human body, especially in women, who undergo intense changes in the trans and postmenopausal periods. Different experimental models are used to mimic these conditions; however, the impact on hormonal profile may be different. This study aimed to analyze and compare vaginal cytology of different post-estropausal mice models, along with their microscopical ovarian features. Forty-six C57BL/6J female mice with the ages of 4, 6 and 18 months at the beginning of the experiment, weighing about 25–28 grams, constituted five groups: NC–(negative control) animals with no treatment, OVX-SHAM—sham ovariectomized, OVX–ovariectomized, VCD–medicated …

Using Plastinated Cadaveric Models For Anatomical Study Of Dorsalis Pedis Artery And Its Variation, Steven Bolton, Ifunanya Monube, Hooman Tabatabai-Mir

School of Podiatric Medicine - Student Research

The dorsalis pedis artery is a main artery of the dorsum of the foot. It directly arises from the anterior tibial artery and travels distally to the base of the 1st metatarsal. Its main function includes supplying oxygenated blood to the dorsal surface of the foot. A weak dorsalis pedis pulse is an indication of underlying circulation issue, such as peripheral vascular disease. Anatomical variations of the artery are not uncommon, including the total absence of the artery. Branching variations occur in approximately 10% of the population. Knowledge of these variations is critical for surgeons to prevent surgical complications

A Model Of Immediate Implant Placement To Evaluate Early Osseointegration In 129/Sv Diabetic Mice, Cláudia Cristina Biguetti, Alexandra Arteaga, Bhuvana Lakkasetter Chandrashekar, Evelin Rios, Ryan Margolis, Danieli C. Rodrigues

School of Podiatric Medicine Publications

Purpose: To analyze the process of early oral osseointegration of titanium (Ti) implants in diabetic 129/Sv mice through microCT and histologic and immunohistochemical analysis.

Materials and methods: A group of 30 male 129/Sv mice was equally subdivided into two groups: (1) nondiabetic (ND), in which mice did not undergo systemic alterations and received a standard diet, and (2) diabetic (D), in which mice were provided a high-fat diet from the age of 6 weeks until the conclusion of the study and received two intraperitoneal (IP) injections of streptozotocin (STZ) at a concentration of 100 mg/Kg each. Each mouse underwent extraction …

Revolutionizing Fracture Fixation In Diabetic And Non-Diabetic Rats: High Mobility Group Box 1-Based Coating For Enhanced Osseointegration, Alexandra Arteaga, Cláudia Cristina Biguetti, Bhuvana Lakkasetter Chandrashekar, Javier La Fontaine, Danieli C. Rodrigues

School of Podiatric Medicine Publications

Chronic inflammation and hyperglycemia in diabetic patients increase the risk of implant failure and impaired fracture healing. We previously developed and characterized a titanium (Ti) coating strategy using an imidazolium-based ionic liquid (IonL) with a fully reduced, non-oxidizable High Mobility Group Box 1 (HMGB1) isoform (Ti-IonL-HMGB1) to immunomodulate tissue healing. In this study, we used an open reduction fracture fixation (ORIF) model in non-diabetic (ND) and diabetic (D) rats to further investigate the effectiveness of this Ti-IonL-HMGB1 coating on orthopedic applications. Ninety male Lewis rats (12–15 weeks) were divided into D (n = 45) and ND (n = …

Preoperative Serum Albumin And Other Risk Factors Related To 30-Day Postoperative Complications In Total Ankle Arthroplasty, Jeffrey T. Bowcutt, Naohiro Shibuya, Daniel C. Jupiter

School of Podiatric Medicine Publications

This study investigates effects of preoperative albumin on 30-day TAA outcomes. Additionally, other preoperative risk factors are addressed, including American Anesthesia Society (ASA) class, functional status, chronic obstructive pulmonary disease (COPD), diabetes, smoking status, time of operation, and age. Outcomes assessed were readmission, return to operating room, surgical site infection, wound dehiscence, and total length of stay (TLOS). Data was extracted from the National Surgical Quality Improvement Program database. Bivariate comparisons were analyzed using correlation coefficients, t tests, or chi-squared tests; multivariate comparisons used linear or logistic regression. Our data showed no significant correlation between serum albumin and patients with …

Limited Clinical Utility Of Routine Mycobacterial Cultures For The Management Of Diabetic Foot Infections, Laila M. Castellino, Clare Mccormick-Baw, Tyler Coye, Peter A. Crisologo, John J. Hanna, Francesca Lee, Andrew Clark, Michael Fanning, Amanda L. Killeen

School of Podiatric Medicine Publications

Mycobacterial infections of the foot and ankle are uncommon. In a cohort of 2340 patients with diabetic foot infection (DFI) in a region with increased prevalence of mycobacterial disease, we identified no clinically significant positive cultures over a 3-year period. Routine mycobacterial culture of DFIs is of limited clinical utility.

Empowering Foot Health: Harnessing The Adaptive Weighted Sub-Gradient Convolutional Neural Network For Diabetic Foot Ulcer Classification, Abdullah Alqahtani, Shtwai Alsubai, Mohamudha Parveen Rahamathulla, Abdu Gumaei, Mohemmed Sha, Yu-Dong Zhang, Muhammad Attique Khan

School of Podiatric Medicine Publications

In recent times, DFU (diabetic foot ulcer) has become a universal health problem that affects many diabetes patients severely. DFU requires immediate proper treatment to avert amputation. Clinical examination of DFU is a tedious process and complex in nature. Concurrently, DL (deep learning) methodologies can show prominent outcomes in the classification of DFU because of their efficient learning capacity. Though traditional systems have tried using DL-based models to procure better performance, there is room for enhancement in accuracy. Therefore, the present study uses the AWSg-CNN (Adaptive Weighted Sub-gradient Convolutional Neural Network) method to classify DFU. A DFUC dataset is considered, …

Glycemic Markers And Insulin-Related Parameters In The Progression Of Diabetes And Lower Extremities Complications: A Pilot Study In Mexican Americans From Starr County, Peter Elvin, Garrett Edwards, Walid Fakhouri, Craig Hanis, Cláudia Cristina Biguetti

School of Podiatric Medicine Publications

No abstract provided.

Therapeutic Effects Of Fully Reduced Hmgb1 On Fibroblasts And Pre-Osteoblasts Cultured Under Diabetic Conditions, Alfonso Reyes, Bhuvana Lakkasetter Chandrashekar, Peter Elvin, Danieli Rodrigues, Javier La Fontaine, Claudia Biguetti

School of Podiatric Medicine - Student Research

Background: Recent studies have shown that fully reduced High Mobility Group Box-1 (FR-HMGB1) can improve wound healing under normoglycemic conditions, but it has not been tested for diabetic conditions. This study aimed to assess the regenerative potential of FR-HMGB1 under high glucose levels in vitro.

Methods: Migration of human fibroblasts (HF) was tested using a scratch assay in control conditions, and in the presence of FR-HMGB1 (1.0 µg/mL and 10 µg/mL), both in non-diabetic (ND) and diabetic (D) conditions (60mM of glucose added to the culture media). HF cells were tested after 18 hours of scratching and stained with …

Mönckeberg's Medial Calcific Sclerosis In Diabetic And Non-Diabetic Foot Infections, Mehmet A. Suludere, Amanda L. Killeen, Peter A. Crisologo, Gu E. Kang, Matthew Malone, Michael C. Siah, Lawrence A. Lavery

School of Podiatric Medicine Publications

The aim of this study was to evaluate the prevalence and extent of lower extremity Mönckeberg's Medial Calcific Sclerosis (MMCS) in patients with and without diabetes in patients admitted to the hospital for foot infections. This study retrospectively reviewed 446 patients admitted to the hospital with a moderate or severe foot infection. We defined diabetes based on ADA criteria and reviewed electronic medical records for demographics, medical history and physical examination data. Anterior–posterior and lateral foot radiographs were examined to identify the presence and extent of vascular calcification. We categorised MMCS based on anatomical location: ankle joint to the navicular-cuneiform …

Biological Effects Of New Titanium Surface Coatings Based On Ionic Liquids And Hmgb1: A Cellular And Molecular Characterization In Lewis Rats, Alexandra Arteaga, Cláudia Cristina Biguetti, Bhuvana Lakkasetter Chandrashekar, Jimena Mora, Adeena Qureshi, Danieli C. Rodrigues

School of Podiatric Medicine Publications

High Mobility Group Box 1 (HMGB1) is a redox-sensitive molecule that plays dual roles in tissue healing and inflammation. We previously demonstrated that HMGB1 is stable when anchored by a well-characterized imidazolium-based ionic liquid (IonL), which serves as a delivery vehicle for exogenous HMGB1 to the site of injury and prevents denaturation from surface adherence. However, HMGB1 exists in different isoforms [fully reduced HMGB1 (FR), a recombinant version of FR resistant to oxidation (3S), disulfide HMGB1 (DS), and inactive sulfonyl HMGB1(SO)] that have distinct biological functions in health and disease. Thus, the goal of this study was to evaluate the …

Mönckeberg's Medial Calcific Sclerosis Makes Traditional Arterial Doppler's Unreliable In High-Risk Patients With Diabetes, Mehmet A. Suludere, Sahab K. Danesh, Amanda L. Killeen, Peter A. Crisologo, Matthew Malone, Michael C. Siah, Lawrence A. Lavery

School of Podiatric Medicine Publications

Objective

To assess Mönckeberg's medial calcific sclerosis (MMCS) severity in patients with a diabetic foot infection.

Methods

This was an analysis of 2 randomized clinical trials in which we evaluated the treatment of 233 patients admitted to the hospital for moderate and severe foot infections. Arterial calcification was defined as visible radiopaque arteries on foot and ankle radiographs, recorded as the most distal visible artery involved (toes, metatarsals, and ankle/hindfoot).

Results

Most subjects (57.1%, n = 133) had MMCS, with extension to toes in 79 (59.4%), to metatarsals in 32 (24.1%), and to ankle/hindfoot in 22 patients (16.5%). In 7 …

Water-Tight Arthrotomy Joint Closure Of Modified Intervastus Approach In Total Knee Arthroplasty, Muthana M. Sartawi, James M. Kohlmann, Karam R. Abdelsamie, Hafizur Rahman

School of Podiatric Medicine Publications

Background: The joint closure technique used for total knee arthroplasty cases can have an impact on outcomes, especially when considering accelerated rehabilitation programs that follow surgery. In this study, we describe the details of the technical steps involved in performing the water-tight arthrotomy joint closure technique that we developed and use. Methods: A total of 536 patients (average age: 62 years, average body mass index: 34 kg/m2) with primary osteoarthritis of the knee underwent total knee arthroplasty using the modified intervastus approach between 2019 and 2021. We used the water-tight arthrotomy joint closure technique to close the knee arthrotomy incision. …

A Model Study To Evaluate Osseointegration And Fracture Healing Following Open Reduction And Internal Fixation (Orif) In Diabetic Lewis Rats, Alexandra Arteaga, Claudia Biguetti, Bhuvana Lakkasetter Chandrashekar, Jimena Mora, Adeena Qureshi, Evelin Rios, Javier La Fontaine, Danieli C. Rodrigues

School of Podiatric Medicine Publications

There is a higher risk of implant osseointegration failure after open reduction and internal fixation (ORIF) in patients with diabetes due to increased inflammatory conditions, associated metallic corrosion and infection. While it is possible to avoid elective osseous surgery in patients with diabetes, it may not be the case in nonelective cases, such as ORIF ankle fractures. A total of 30 male Lewis rats (12-15 weeks old) were distributed into diabetic (D) and nondiabetic (ND) groups. Fracture healing and osseointegration were evaluated at 2-, 10-, and 21-day time points. Microtomographic and histological analysis depicted distinct differences in fracture healing …

Failed Medial Column Fusion Due To Subtalar Joint Instability, Travis Rich, Randy Semma, Michele Bertelle-Semma

Posters

• CNA is a destructive complication affecting the bone and joint structure, most often in diabetics w/ longstanding peripheral neuropathy.
• High incidence of major amputation associated with Charcot foot

Utilization Of Negative Pressure Wound Therapy And Split Thickness Skin Grafts In The Context Of Complex Skin Closure Via Secondary Intention: A Protocol Approach, Jihan Toma, Eric Li, Randy Semma, Michele L. Bertelle-Semma, Asif Khan

Posters

Patients with complex, chronic foot wounds or ulcerations are at risk for major amputations. In this quality improvement (QI) initiative, we present an implemented protocol for patients with foot ulcerations and attempt to heal them using a combination of wound vac therapy and split thickness skin grafting. These patients have a history of either diabetes and/or neuropathy that makes wound healing more difficult than an otherwise healthy individua

Diabetic Limb Salvage: Chopart Amputation, Jesse Miller, Randy Semma

Posters

Diabetic limb salvage is the act of saving a limb, even with decreased function after infection.

It is the difficult choice of the surgeon/patient to decide to proceed with salvage versus amputation proximally.

Case Report Of Bullous Diabeticorum: A Self-Limiting Condition With Potentially Devastating Consequences, Taylor Allison, Randy Semma

Posters

Bullous diabeticorum (BD) is a skin manifestation of patients with diabetes mellitus with an incidence of about 0.16% per year (Larsen et al) although the condition is believed to be widely underdiagnosed. The blistering disease favors acral regions of the body including the feet. There are no accepted diagnostic tests, and histopathology results are often inconclusive which makes BD a clinical diagnosis of exclusion. It is often self-limiting and resolves in a few weeks without residual sequelae. However, it may present with a secondary bacterial infection which can put patients at risk for soft tissue infections and osteomyelitis requiring more …

Revisional Arthrodesis Of Tarsometatarsal (Lisfranc) Complex Injury Secondary To Non-Union, Lei Wilson, Randy Semma

Posters

The tarsometatarsal joint and its components provide structural support for the foot. Notably the Lisfranc ligament is a fundamental stabilizer for the midfoot. Injuries to this component are complex and can be debilitating. These injuries require surgical intervention when significant displacement resulting in instability is involved.

Following success of several previous repairs of Lisfranc fractures and dislocations, a treatment algorithm has been proposed. This case report demonstrates the success of the algorithm which has allowed the surgeon to perform reduction and repair in a reproducible, step-wise manner with minimal difficulty to ensure successional revisional arthrodesis of a nonunion

Cohort Study Using A Survey To Evaluate The Effects Of Sleep On Hba1c Levels And Foot Pathology In Patients Seen In The Podiatry Clinic, Carmen Johnson, Eric Li, Jihan Toma, Marshall G. Solomon

Posters

We investigate the impacts of sleep issues on patients in the podiatry clinic by comparing HbA1c, sleep, and foot pathology. Diabetic foot pathology of peripheral arterial disease, peripheral neuropathy, lower extremity ulcerations, and a history of lower extremity amputation all increase the patient's risk of future amputation. Once a patient has an amputation of the lower extremity the five-year mortality rates are 40-70%. So, limb salvage not only improves the quality of life, but also increases the life expectancy for patients. Through a survey and chart review, we are investigating possible impacts of sleep issues on diabetic patients seen in …