Journal of the American Podiatric Medical Association
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J Am Podiatr Med Assoc · May 2005
Case ReportsCutaneous larva migrans: case report with current recommendations for treatment.
Cutaneous larva migrans is a common skin pathology that occurs in people who have recently visited tropical or subtropical climates. Given the ubiquity of this condition, the podiatric physician may encounter cutaneous larva migrans during clinical practice and should be cognizant of the presenting signs and typical patient history given in these cases. We describe the case of a 62-year-old man who presented with a pruritic, erythematous, serpiginous lesion on the dorsum of his left foot after having vacationed in Florida for several weeks. The patient was treated successfully with oral thiabendazole, 500 mg after meals 4 times daily for 5 days.
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J Am Podiatr Med Assoc · Nov 2004
Effectiveness of different types of foot orthoses for the treatment of plantar fasciitis.
Clinicians often use foot orthoses to manage the symptoms of plantar fasciitis. Although there has been considerable research evaluating the effectiveness of orthoses for this condition, there is still a lack of scientific evidence that is of suitable quality to fully inform clinical practice. Randomized controlled trials are recognized as the "gold standard" when evaluating the effectiveness of treatments. ⋯ From the evidence to date, it seems that foot orthoses do have a role in the management of plantar fasciitis and that prefabricated orthoses are a worthwhile initial management strategy. At this time, however, it is not possible to recommend either prefabricated or customized orthoses as being better, and it cannot be inferred that customized orthoses are more effective over time and therefore have a cost advantage. Additional good-quality randomized controlled trials are needed to answer these questions.
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J Am Podiatr Med Assoc · Jul 2004
Combined popliteal and saphenous nerve blocks at the knee: an underused alternative to general or spinal anesthesia for foot and ankle surgery.
Peripheral nerve blocks at the ankle have long been used for foot surgery. However, when local foot and ankle blocks are inappropriate or contraindicated, general and spinal anesthesia are the common alternatives. ⋯ In addition, popliteal and saphenous nerve blocks provide anesthesia of the entire lower leg, thus permitting a greater variety of procedures to be performed. This article reviews the anatomical considerations, various block techniques, and surgical applications of this useful approach to lower-leg anesthesia.
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J Am Podiatr Med Assoc · May 2004
The need for randomized controlled trials in podiatric medical research.
The randomized controlled trial is the most robust method available to evaluate health-care treatments. If podiatric medical practice is to be based on rigorous evidence, then high-quality randomized controlled trials are needed to inform that practice. In this article, we examine the extent to which randomized controlled trials are used in recent podiatric medical research and appraise the quality of those that are available. ⋯ We also discuss the key features of a rigorous trial design. To date, the clinical practice of podiatric medicine is not adequately informed by the best available evidence. We call for more high-quality randomized controlled trials to be undertaken in podiatric medical research.
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J Am Podiatr Med Assoc · May 2004
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialAnalgesic efficacy of preoperative parecoxib sodium in an orthopedic pain model.
The efficacy and safety of preoperative intravenous administration of parecoxib sodium, a novel parenteral prodrug of a cyclooxygenase-2 selective inhibitor, in treating postoperative pain resulting from bunionectomy were evaluated in 50 patients who were part of a larger cohort of orthopedic and podiatric patients. Following bunionectomy, the median time to rescue medication (survival analysis) was 4 hours 18 min (95% confidence interval, 3 hours 4 min to 4 hours 37 min) in the placebo group, 7 hours 5 min (95% confidence interval, 3 hours 20 min to >24 hours) in the 20-mg parecoxib sodium group, and 10 hours 43 min (95% confidence interval, 4 hours 42 min to 14 hours 7 min) in the 40-mg parecoxib sodium group (significant for 40-mg parecoxib sodium versus placebo). Four or more hours after surgery, the mean pain-intensity (categorical) score was significantly lower in both parecoxib sodium groups than in the placebo group. Preoperative administration of parecoxib sodium was well tolerated and significantly reduced postoperative pain in patients who had undergone bunionectomy.