ABSTRACT
Chronic decubitus ulceration of the heels is a common condition encountered by podiatric physicians, especially in diabetic patients. Very often these ulcerations can progress to osteomyelitis of the calcaneus. Many times, this in turn leads to a below-the-knee amputation. A partial calcanectomy is a viable alternative to below-the-knee amputation. A more functional limb both mechanically and cosmetically is achieved, and the morbidity and mortality associated with the calcanectomy is less than with a below-the-knee amputation. A brief overview of the history and outcomes associated with this procedure is outlined and a case utilizing a partial calcanectomy is presented.
Subject(s)
Calcaneus/surgery , Diabetic Foot/surgery , Chronic Disease , Heel , Humans , Male , Middle Aged , Orthopedic Procedures/methodsABSTRACT
The anatomy, mechanism, and two treatment approaches of an avulsion fracture at the plantar lateral base of the first metatarsal without any joint dislocation were discussed. The authors presented an injury that has not been reported in the literature but has only been seen as a part of Lisfranc's fracture dislocation types B and C.
Subject(s)
Fractures, Closed/etiology , Metatarsal Bones/injuries , Adult , Female , Fractures, Closed/diagnostic imaging , Fractures, Closed/surgery , Humans , Male , Metatarsal Bones/diagnostic imaging , Metatarsal Bones/surgery , RadiographyABSTRACT
Infectious endocarditis is occasionally a complication of Staphylococcus aureus sepsis in previously well individuals with no heart disease or history of intravenous drug use. We report a case of a 16 year old who developed Staphylococcal sepsis and endocarditis probably as the result of neglected paronychia of her toes. Despite adequate antibiotic therapy, the infectious process destroyed her aortic valve, thereby producing aortic regurgitation complicated by cerebral embolism. Aortic valve replacement surgery was required. Endocarditis should always be sought with S. aureus bacteremia. Intravenous high-dose antibiotic therapy for at least 4 weeks is the recommended therapy.
Subject(s)
Endocarditis, Bacterial/etiology , Staphylococcal Infections , Adolescent , Echocardiography , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/therapy , Female , Humans , Nafcillin/therapeutic use , Staphylococcal Infections/diagnosis , Staphylococcal Infections/therapy , Vancomycin/therapeutic useABSTRACT
Male Sprague-Dawley rats were assigned to three groups designated as diabetic, diabetic-plus-insulin, and control and tested for maximum oxygen consumption (VO2max) and maximum heart rate on three different occasions during the 6- to 8-wk experimental period. Compared with the prediabetic values and the means of the other two groups, diabetic animals had significantly higher submaximum and lower maximum VO2 values. These relationships prevailed when the groups were evaluated in terms of ml.kg-1.min-1 or ml.(kg0.79-1).min-1. In addition, the diabetic animals had significantly lower submaximum and maximum heart rates and shorter run times. Daily injections of insulin (2 U.day-1.rat-1) restored VO2max to within the limits of the control animals but did not normalize heart rates or run-time values. The linear relationship between heart rates and VO2 was repeatedly demonstrated with normal animals. However, this relationship progressively declined with the time course of diabetes. These results indicate that, in untreated diabetes, functional capacity is markedly reduced with the progression of the disease and suggest that alterations in the autonomic nervous system, tissue metabolic capacity, and decreases in lean body mass are responsible for the changes noted.
Subject(s)
Diabetes Mellitus, Experimental/physiopathology , Heart Rate/drug effects , Insulin/pharmacology , Oxygen Consumption/drug effects , Physical Exertion , Animals , Blood Glucose/metabolism , Diabetes Mellitus, Experimental/metabolism , Male , Rats , StreptozocinSubject(s)
Lung/metabolism , Prostaglandins E/metabolism , Adrenalectomy , Animals , Cycloheximide/pharmacology , Female , Hydrocortisone/pharmacology , In Vitro Techniques , Lung/drug effects , Perfusion , Pregnancy , Probenecid/pharmacology , Pulmonary Circulation , Rats , Sex Factors , Species SpecificityABSTRACT
1. The effect of thromboxane B2 (TxB2) on inactivation of prostaglandin E2 (PGE2) by the rat isolated perfused lung has been studied. 2. TxB2 when infused in low concentrations (100 ng/ml) into the pulmonary artery reduced PGE2 inactivation approximately two-fold. 3. The rat isolated fundus strip was contracted by higher concentrations of TxB2 (1.0 microgram/ml) in the presence of hyoscine, mepyramine, methysergide, phenoxybenzamine and propranolol. The size of contraction was reduced by indomethacin in concentrations known to inhibit prostaglandin synthetase. 4. Thus, in circumstances in which TxB2 and PGE2 are released concomitantly by the lung, low concentrations of TxB2 may augment PGE2 release by reducing its inactivation.
