Search Results
Podiatric Medical Resources on the Internet
A Fifth Update
An updated selection of high-quality Internet resources of potential use to the podiatric medical practitioner, educator, resident, and student is presented. Internet search tools and general Internet reference sources are briefly covered, including methods of locating material residing on the “invisible” Web. General medical and podiatric medical resources are emphasized. These Web sites were judged on the basis of their potential to enhance the practice of podiatric medicine in addition to their contribution to education. Podiatric medical students, educators, residents, and practitioners who require a quick reference guide to the Internet may find this article useful. (J Am Podiatr Med Assoc 96(2): 162–166, 2006)
Background:
Scholarly activity among students, residents, and faculty provides the foundation for medical education. However, a decline in the number of physician-scientists has been acknowledged during the past few decades. As a result, institutions have attempted to increase research activity among students and residents through a variety of means. This study describes a replicative model for medical institutions to increase their research enterprises among medical students, residents, and faculty.
Methods:
Des Moines University College of Podiatric Medicine and Surgery (DMU-CPMS) developed a Strategic Research Plan (SRP) to increase scholarly activity in the college. The SRP outlined an innovative model to increase research activity, including creating a Director of Research position, modifying the existing curriculum toward an evidence-based focus, increasing extracurricular research opportunities, and fostering collaborative research efforts among students, residents, and faculty.
Results:
After SRP implementation, an increase in scholarly activity was observed. In the 6 years before implementing the SRP, DMU-CPMS published 11 manuscripts. In the 6 years after initiating the SRP, manuscript publications increased to 50. During this same period, podium presentations at scientific meetings increased from 6 to 40, and students listed as lead author increased from 0 to 16.
Conclusions:
The SRP provides a replicative model for medical institutions seeking to increase their research enterprises through collaboration among students, residents, and faculty. To our knowledge, this is the first study to demonstrate a research plan aimed at increasing scholarly activity among a comprehensive scope of individuals in medical education.
Background: The ideal suture technique and type in tendon repair remain unclear. This biomechanical study aimed to assess the biomechanical characteristics of three techniques—modified Kessler (mKE), modified Krackow (mKR), and modified tension Bunnell (mtBU)—in sheep Achilles tendon tear repair using three suture types—polypropylene, polyester, and ultra-high-molecular-weight polyethylene (UHMWPE)—which are also compared.
Methods: Sixty-three Achilles tendons harvested from sheep were transversely hacked as a replacement for rupture in a standardized measure and repaired using mKE, mKR, and mtBU techniques with No. 2 polypropylene, polyester, and UHMWPE sutures. Biomechanical parameters, such as Young’s modulus, ultimate strength, and strength to the 5-mm gap, were recorded for statistical analysis.
Results: The mtBU technique with UHMWPE use resulted in increased ultimate strength, strength to 5-mm gap, Young’s modulus, and quantity of specimens with low clinical failure modes compared with the other techniques with other suture materials. Furthermore, mtBU has the lowest thickness at the repair side of the tendons. This approach showed tendon failure during maximal traction testing, whereas the mKE and mKR techniques had polyethylene and polyester suture failures.
Conclusions: The UHMWPE suture was significantly superior to the other sutures in each technique in terms of strength and durability. The mtBU technique using UHMWPE suture showed better biomechanical results, implying that this repair might be more appropriate to obtain early mobilization after tendon ruptures.
Background:
This study sought to assess the prevalence of flat feet in primary school children and to find correlations among arch height, ankle dorsiflexion range of motion (ROM), and obesity level.
Methods:
The 400 children aged 10 to 12 years who took part in the study had their body height, weight, and fat percentage measured. Based on these measurements, body mass index was calculated and weight status was categorized for all of the participants. The height of the longitudinal arch of the foot was measured on a computerized podoscope and given in Clarke's angles. Dorsiflexion ROM was assessed with the child in the nonweightbearing sitting position with the knees 90° flexed. The arithmetic mean and standard deviation were implemented to analyze the data. Intergroup differences were assessed by Mann-Whitney U, Kruskal-Wallis, and post hoc Tukey tests. Significance was accepted at P = .05.
Results:
Flat feet were found in 36% of participants; limited ROM was found in both feet in 25% of participants and in one foot in 12%. No significant differences in dorsiflexion ROM in children with high-arched, normal, and flat feet were revealed. Excessive body weight was disclosed in 21% of participants. Overweight and obese children had significantly lower foot arches and notably smaller ankle dorsiflexion ROM than those with normal weight.
Conclusions:
Ankle dorsiflexion ROM is similar in children with high-arched, normal, and flat feet. However, limited dorsiflexion ROM is more often found in children with excessive weight.
Charcot Foot
Journal of the American Podiatric Medical Association, May 1989
Subtalar Arthroereisis for Pediatric Flexible Pes Planovalgus
Fifteen Years Experience with the Cone-shaped Implant
Flexible pes planovalgus is a common condition with flattening of the medial longitudinal arch accompanied by hindfoot valgus. Severe cases of pes planovalgus may need surgery, and a technique that has gained popularity over the past decades is subtalar arthroereisis. An endoorthotic implant of various shapes is inserted in the sinus tarsus, which limits the excessive eversion of the subtalar joint present in flexible pes planovalgus. None of these implants, however, allow for easy control of the extent of talocalcaneal and talonavicular correction. The primary aim of this study was to describe our technique with the custom-built cone-shaped implant. Our secondary aim was to evaluate patient satisfaction, clinical and radiologic results, and complications with a minimal follow-up of 5 years. Between January 1992 and June 2002, 40 patients (80 feet) underwent subtalar arthroereisis for flexible pes planovalgus. After temporary sinus tarsi tenderness (12 feet), implant dislocation (two feet) was the most common complication. Questionnaires from 27 patients (54 feet) were analyzed and 44 feet were also clinically and radiographically evaluated. Thirteen patients were lost to follow-up. Mean (± SD) follow-up was 12.6 years (range, 5.9–16.1). Eighty-one percent of the patients were satisfied with the result. Clinically, normal alignment was present in 14 feet, and mild deformities remained in 26 feet. Radiographically, the average foot angle measurements were normal. We conclude that subtalar arthroereisis is a simple, minimally invasive operative option with satisfactory subjective and clinical results after mid- to long-term follow-up. (J Am Podiatr Med Assoc 99(5): 447–453, 2009)
Background
We sought to evaluate the influence of obesity level on the medial longitudinal arch (MLA) of the foot in 7- to 12-year-old children.
Methods
The study group consisted of 925 children (450 girls and 475 boys). All of the children were subjected to podoscopic foot examination and measurement of weight, height, three skinfolds, fat weight, and fat-free body weight.
Results
The most common type of MLA was high-arched foot, which was observed in the left foot of 523 children (56.5%) and in the right foot in 592 children (64%). In almost all of the age groups, high-arched foot was the most common disorder. High-arched foot was more common in girls than in boys, and boys displayed a higher percentage of flatfoot. Also, sex-related differences were more prominent in urban children. There was a strongly positive correlation between obesity level and MLA in the examined group.
Conclusions
These results suggest that the type of foot arch is influenced by parameters such as age, sex, and obesity level. High-arched foot seemed to be the most frequent pathologic abnormality in the examined group, and flatfoot, which was predominant in boys and obese children, diminished with age. High-arched foot was a more common MLA type than flatfoot regardless of obesity level assessed on the basis of body mass index and sum of three skinfolds.
This article presents a selection of Internet resources covering most of the subject areas found in standard medical education curricula. Basic-sciences sites are emphasized, but clinical resources are also included. Sites were evaluated on the basis of their potential to enhance the learning process, provide practice questions or study guides for examinations, or aid in the preparation of papers. Podiatric medical students, residents, and practitioners who require a quick reference guide to sources covering the basic-science foundations of podiatric medicine or the clinical side of general medicine may find this article useful. (J Am Podiatr Med Assoc 95(2): 211–215, 2005)
Background
Medical students (MSs) in allopathic and osteopathic medical programs may not be adequately exposed to the role of podiatric physicians and surgeons in health care. We explored perceptions of the specialty field of podiatric medicine from the perspective of MSs in the Philadelphia, Pennsylvania, area.
Methods
In this cross-sectional survey study, responses regarding podiatric education and scope of practice were collected via a 16-question, self-reported, anonymous online survey distributed to MSs at one osteopathic and three allopathic medical schools in the Philadelphia area. Inferences and conclusions were drawn from the percentages of respondents. Statistical analyses for school of attendance, year of study, and physician relative subgroups were performed.
Results
The 129 survey responses obtained revealed misunderstandings regarding podiatric education and training. Only 45.7% correctly answered that podiatric medical students do not take the United States Medical Licensing Examination. The results also showed the perception of podiatry in a positive light, with approximately 80% of respondents agreeing that the term doctor is applicable when referring to a podiatrist. Respondents with a physician relative were more likely to rate podiatry's role in health care higher on a scale from 0 (inessential) to 5 (equivalent to MDs/DOs) than those without a physician relative.
Conclusions
The results of this preliminary survey were generally positive and optimistic while also identifying some misconceptions regarding MS perceptions of podiatric medical training and scope of practice. Further studies are needed to evaluate perceptions of podiatry from the perspective of other members of the health-care team to improve interprofessional relations and understanding.
Transformative Learning
Empathy and Multicultural Awareness in Podiatric Medical Education
Background:
Short-term medical missions are common in medical educational settings and could possibly affect student learning. Little research has been conducted about the potential of these missions on students’ transformative learning, in particular as it relates to empathy and multicultural awareness.
Methods:
Eight podiatric medical students who participated in short-term medical missions in 2008 and 2009 completed an electronic survey to investigate the effect of their experience as it relates to their learning. The empathy and multicultural awareness impact of the mission experience was emphasized. Qualitative questions in the survey were coded, themed, and triangulated with the quantitative responses.
Results:
Six students (75%) “strongly agreed” that participating in the medical mission was a significant positive experience in their podiatric medical training. Six students felt that their experiences in serving these communities increased their personal awareness of multicultural/diversity needs in general. All of the students agreed that they will become better podiatric physicians because of their experiences in the medical missions. The qualitative data also indicate that the experience had an effect on the students’ views of health care and increased empathy toward their patients.
Conclusions:
Short-term medical missions could play a significant role in the transformative learning experience in podiatric medical education. This could affect the empathy and multicultural awareness of podiatric medical students. Further and more extensive evaluations of the potential impact of short-term medical missions in podiatric medical education should be explored because it could influence curriculum and global health in the field of podiatric medicine. (J Am Podiatr Med Assoc 102(1): 39–46, 2012)
