Journal of the American Podiatric Medical Association

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Open AccessEditorial

e-Advocacy: Your Immediate Link to Members of Congress

by Robert D. “Doug” Sowell

J. Am. Podiatr. Med. Assoc. 2001, 91(9), 499; https://doi.org/10.7547/87507315-91-9-499 - 1 Oct 2001

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The legislative agenda of the American Podiatric Medical Association was the topic of a previous “President’s Message” from me [...] Full article

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Open AccessCommunication

A Conceptual Model for Public Health Education in Podiatric Medicine

by Arthur E. Helfand and Alice J. Hausman

J. Am. Podiatr. Med. Assoc. 2001, 91(9), 488-495; https://doi.org/10.7547/87507315-91-9-488 - 1 Oct 2001

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Abstract

This article discusses the need for and the advantages of a dual degree program between podiatric medicine and public health. The authors expand on the existing program for public health education at the first professional degree level to include a conceptual model for a dual degree program developed at Temple University’s Department of Health Studies, through the Graduate School and the School of Podiatric Medicine. The model combines didactic and clinical education at the graduate level to ensure that clinicians involved in determining health policy are prepared to represent the profession in the restructuring of the health-care system. (J Am Podiatr Med Assoc 91(9): 488-495, 2001) Full article

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Open AccessArticle

Subtalar Joint Axis Location and Rotational Equilibrium Theory of Foot Function

by Kevin A. Kirby

J. Am. Podiatr. Med. Assoc. 2001, 91(9), 465-487; https://doi.org/10.7547/87507315-91-9-465 - 1 Oct 2001

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Abstract

A new theory of foot function based on the spatial location of the subtalar joint axis in relation to the weightbearing structures of the plantar foot is proposed. The theory relies on the concept of subtalar joint rotational equilibrium to explain how externally generated forces, such as ground reaction force, and internally generated forces, such as ligamentous and tendon tensile forces and joint compression forces, affect the mechanical behavior of the foot and lower extremity. The biomechanical effect of variations among individuals in the spatial location of the subtalar joint axis are explored, along with their clinical consequences, to offer an additional theory of foot function, which may improve on existing podiatric biomechanics theory. (J Am Podiatr Med Assoc 91(9): 465-487, 2001) Full article

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Open AccessArticle

The Diagnosis of Onychomycosis in a Geriatric Population. A Study of 450 Cases in South Florida

by William P. Scherer, Jon P. McCreary and Walter W. Hayes

J. Am. Podiatr. Med. Assoc. 2001, 91(9), 456-464; https://doi.org/10.7547/87507315-91-9-456 - 1 Oct 2001

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Abstract

An investigative study was performed to determine the diagnosis of onychomycosis in a South Florida geriatric population. In this study, 450 cases of suspected onychomycosis involving men and women 65 years of age and older from a private practice office and two nursing home settings were used. Samples were taken from the hallux toenail and sent to a mycology laboratory for fluorescent potassium hydroxide (KOH) preparation and microscopic examination of a fungal culture. Of the 450 cases studied, 46.4% of the patients had a single fungal organism cultured, 30.4% had a mixed fungal infection cultured, and 23.1% had no fungal growth. Saprophytes were found in 59.9% of the 526 total fungal organisms cultured while dermatophytes were found in only 23.8%. The results of this investigation demonstrate that there may be a shift from isolated dermatophyte infection to mixed saprophyte infections in a geriatric population with onychomycosis. (J Am Podiatr Med Assoc 91(9): 456-464, 2001) Full article

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Open AccessArticle

Continuous Activity Monitoring in Persons at High Risk for Diabetes-Related Lower-Extremity Amputation

by David G. Armstrong, Patricia L. Abu-Rumman, Brent P. Nixon and Andrew J.M. Boulton

J. Am. Podiatr. Med. Assoc. 2001, 91(9), 451-455; https://doi.org/10.7547/87507315-91-9-451 - 1 Oct 2001

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Abstract

This study evaluated the magnitude and location of activity of diabetic patients at high risk for foot amputation. Twenty subjects aged 64.6 ± 1.8 years with diabetes, neuropathy, deformity, or a history of lower-extremity ulceration or partial foot amputation were dispensed a continuous activity monitor and a log book to record time periods spent in and out of their homes for 1 week. The results indicate that patients took more steps per hour outside their home, but took more steps per day inside their homes. Although 85% of the patients wore their physician-approved shoes most or all of the time while they were outside their homes, only 15% continued to wear them at home. Focusing on protection of the foot during in-home ambulation may be an important factor on which to focus future multidisciplinary efforts to reduce the incidence of ulceration and amputation. The ability to continuously monitor the magnitude, duration, and time of activity ultimately may assist clinicians in dosing activity just as they dose drugs. (J Am Podiatr Med Assoc 91(9): 451-455, 2001) Full article

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Open AccessArticle

The Diagnosis of Osteomyelitis in Diabetes Using Erythrocyte Sedimentation Rate. A Pilot Study

by Jennifer L. Kaleta, Jeffrey W. Fleischli and Charles H. Reilly

J. Am. Podiatr. Med. Assoc. 2001, 91(9), 445-450; https://doi.org/10.7547/87507315-91-9-445 - 1 Oct 2001

Cited by 89 | Viewed by 61

Abstract

Osteomyelitis secondary to diabetic foot infections can lead to proximal amputation if not diagnosed in a timely and accurate manner. The authors have found no studies to date that correlate a specific erythrocyte sedimentation rate with osteomyelitis. A retrospective chart review of 29 diabetic patients admitted to the hospital with diagnoses of osteomyelitis or cellulitis of the foot during a 1-year period was performed. Of the various lab values and demographic factors compared, erythrocyte sedimentation rate was the only measure that differed significantly between the two groups. A receiver operating characteristic curve was used to obtain the optimal cutoff value of 70 mm/h, a level above which osteomyelitis was present with the highest sensitivity (89.5%) and highest specificity (100%), along with a positive predictive value of 100% and a negative predictive value of 83%. This study shows that in combination with clinical suspicion in diabetic foot infections, the erythrocyte sedimentation rate is highly predictive of osteomyelitis, and that the value of 70 mm/h is the optimal cutoff to predict accurately the presence or absence of bone infection. (J Am Podiatr Med Assoc 91(9): 445-450, 2001) Full article

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J. Am. Podiatr. Med. Assoc., Volume 91, Issue 9 (10 2001) – 6 articles , Pages 445-499

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