Google Trends proves to be a novel tool to ascertain the level of public interest in pathology and treatments. From anticipating nascent epidemics with data-driven prevention campaigns to identifying interest in cosmetic or bariatric surgery, Google Trends provides physicians real-time insight into the latest consumer trends.
We used Google Trends to identify temporal trends and variation in the search volume index of four groups of keywords that assessed practitioner-nomenclature inquiries, in addition to podiatric-specific searches for pain, traumatic injury, and common podiatric pathology over a 10-year period. The Mann-Kendall trend test was used to determine a trend in the series, and the Wilcoxon signed-rank test was used to determine whether there was a significant difference between summer and winter season inquiries. Significance was set at P ≤ .05.
The terms “podiatrist” and “foot doctor” experienced increasing Search Volume Index (SVI) and seasonal variation, whereas the terms “foot surgeon” and “podiatric surgeon” experienced no such increase. “Foot pain,” “heel pain,” “toe pain,” and “ankle pain” experienced a significant increase in SVI, with “foot pain” maintaining the highest SVI at all times. Similar results were seen with the terms “foot fractures,” “bunion,” “ingrown toenail,” and “heel spur.” These terms all experienced statistically significant increasing trends; moreover, the SVI was significantly higher in the summer than in the winter for each of these terms.
The results of this study show the utility in illustrating seasonal variation in Internet interest of pathologies today's podiatrist commonly encounters. By identifying the popularity and seasonal variation of practitioner- and pathology-specific search inquiries, resources can be allocated to effectively address current public inquiries. With this knowledge, providers can learn what podiatric-specific interests are trending in their local communities and market their practice accordingly throughout the year.
Professional dancers have a 90% risk of injury during their career. The lower extremity is involved in approximately 75% of the injuries sustained by dancers. Proper biomechanical evaluation, risk assessment, and prevention-oriented treatment are necessary to minimize future problems and promote a full and lasting recovery when an injury is sustained. This article outlines the in-office evaluation process and discusses backstage care. (J Am Podiatr Med Assoc 97(1): 75–80, 2007)
The development of pin tract reactions and their sequelae is based on a complex series of events. Analysis of pin tract infections directly related to static external wire fixation at Kern Hospital for Special Surgery from 1981 through 1988 showed an incidence of 0.46%; however, the overall incidence is probably higher. A discussion of the pathogenesis and guidelines for prevention, diagnosis, and treatment are presented. The authors suggest that pin tract infections occur because of postoperative skin contamination, rather than intraoperative implantation.
Changes in the health-care system will continue to modify the delivery of podiatric medical care and podiatric medical education. Podiatric medicine and its educational programs will need to focus on the management of care, special populations, and disease prevention. Future providers will need to participate as team members and respond to new patterns of care, including the special needs of the older population. This article explores methodologies for professional activities, administration, incentives for change, academic issues, innovation, implementation, outcome measures, and health policy development. Podiatric medicine must be prepared to establish standards, protocols, and guidelines to serve as the benchmark for foot health.
This study is an attempt to assess the role of dietary supplementation in the treatment and prevention of diabetic peripheral neuropathy. The authors developed an animal model system to study this problem. Animals given streptozotocin to induce a type I diabetic state showed elevated glucose levels and decreased body weight. Analysis of the sciatic nerve revealed a decrease in nerve conduction velocity and Na(+)-K(+)-ATPase activity. The activity of protein kinase C, another component of the nerve transmission process, was also affected by the diabetic state. The dietary intervention of polyunsaturated fatty acids seemed to revert some of these changes toward normal.
Tillaux fracture is known to occur in adolescents once it happens during the transition period when the medial and central physis has finished closure, but the lateral physis is still opened. The trauma mechanism is typically external rotation ankle injury resulting in an avulsion fracture of the anterolateral tibial plafond. This fracture has rarely been reported in adults, especially associated with other injuries. We report a case of Tillaux fracture in an adult, associated with a Volkmann fracture and a Maisonneuve fracture, that were surgically treated with open reduction and internal fixation and had an excellent outcome. Recognizing and appropriately treating these injuries is key in the prevention of further degenerative arthritis and instability.
A longitudinal single-blind study was conducted to test the friction blister prevention properties of synthetic acrylic socks in a generic construction. This study serves as a comparison with the authors' previous work comparing acrylic and cotton socks in a patented padded construction. Twenty-seven long-distance runners provided data regarding dampness, temperature, friction blister incidence, severity, and size. Two different socks were tested; each was identical in every aspect of construction except the fiber content. One test sock was composed of 100% synthetic acrylic fibers, and the other was composed of 100% natural cotton fibers. These results were unsuccessful at demonstrating any superiority of cotton or acrylic fibers when knitting produced a generic "cushion sole" sock. The superiority of acrylic fibers has thus far been demonstrated only when sock knitting provides adequate anatomical padding [corrected].
Spinal anesthetic is a common form of surgical anesthetic used in foot and ankle surgery. Spinal morphine anesthetic is less common, but has the advantage of providing postoperative analgesia for 12 to 24 hr. A number of complications can occur with spinal anesthesia, including urinary retention that may be a source of severe and often prolonged discomfort and pain for the patient. Management of this problem may require repeated bladder catheterization, which may lead to urinary tract infections or impairment of urethrovesicular function. This study reviews the incidence of urinary retention in 80 patients (40 after general anesthesia and 40 after spinal anesthesia) who underwent foot and ankle surgery at Saint Joseph's Hospital, Philadelphia, PA. Twenty-five percent of the patients who had spinal anesthesia experienced urinary retention, while only 7 1/2% of the group who had general anesthesia had this complication. Predisposing factors, treatment regimen, and recommendations for the prevention and management of urinary retention are presented.
Despite advanced medical technology, deep venous thrombosis continues to be a seriously underdiagnosed common postsurgical complication of the patient, particularly of lower extremity procedures, often requiring postoperative bed rest as in any routine podiatric surgery. Deep venous thrombosis and its complication, pulmonary embolism, are elusive clinical conditions since patients often tend to exhibit neither specific nor reliable signs or symptoms. However, the suspicion of the surgeon, generally based on subtle clinical manifestations, is the most important step in the diagnosis. Diagnosis will never be made unless he or she entertains the possibility. Since prevention of the potentially fatal outcome of pulmonary emboli secondary to deep venous thrombosis and possibly the serious morbidity caused by long-term sequelae in the lower extremity is now possible, the importance of an early, adequate diagnosis is indisputable. Diagnosis on clinical grounds alone is notoriously unreliable and objective tests are necessary to avoid overtreatment or undertreatment.
A prospective study examining the epidemiology of blisters and, in particular, the association of blisters with subsequent injuries was conducted involving 2,130 male US Marine Corps recruits participating in initial physical training at the Marine Corps Recruit Depot in San Diego, California. From January 1993 through September 1994, recruits experienced an incidence of 2.05 blisters per 100 recruit-months. Recruits with blisters were 50% more likely to experience an additional training-related injury. Blisters, in combination with other related injuries, resulted in 159 clinic visits, 103 days of assigned light duty, and 177 lost days of training. This loss of time cost a minimum of $29,529. Extrapolating to the annual population of recruits, this represents an approximate annual expense of $690,000. Aggressive blister prevention and management in this setting has the potential to greatly reduce morbidity and fiscal costs.