Journal of Foot and Ankle Research最新文献

{"title":"Consensus-based statements for assessing clinical competency in podiatry-related work integrated learning.","authors":"Ryan S Causby, Sindhrani Dars, Malia Ho, Steven Walmsley, Shannon Munteanu, Helen A Banwell","doi":"10.1186/s13047-023-00639-7","DOIUrl":"10.1186/s13047-023-00639-7","url":null,"abstract":"<p><strong>Background: </strong>The training of undergraduate and graduate-entry podiatry students in Australia and New Zealand includes practical sessions in a simulated and real-life clinical setting and Work Integrated Learning (WIL) comprising professional clinical placements. Student performance during WIL is evaluated by their Clinical Educators using clinical competency tools. Having a standardised and validated clinical assessment tool for WIL in podiatry would facilitate consistency in assessment, promote standardisation between programs, and ensure that all podiatry students are assessed against a set of criteria over the course of their clinical programs to the point of threshold clinical competency. Therefore, the aim of this study was to develop a series of consensus-based statements via Delphi technique as the first step towards developing guidelines to direct the assessment of podiatry students during WIL.</p><p><strong>Methods: </strong>This study used a three-round modified Delphi consensus method. A panel of 25 stakeholders was sought. Specifically, representation from each of the universities in Australia and New Zealand who provide entry level programs, Clinical Educators, podiatry student representatives, new podiatry graduates and consumers (podiatrists hiring new graduates). The survey for Round 1 aimed for consensus and consisted of five open-ended questions. Questions one to three asked respondents to nominate what they considered were the important elements that needed to be assessed for podiatry students undertaking WIL for: Clinical performance/skills, Communication and Professional behaviour, Question 4 asked respondents to identify further/other elements of importance, whilst Question 5 asked a) how these elements should be evaluated and b) how should overall competency and ability to progress within the program be determined. Round 2 and 3 aimed to gather agreement and the questions were based on the responses from previous rounds.</p><p><strong>Results: </strong>Twenty-five participants agreed to participate, 17 females (68%) and eight males (32%). The panel consisted of 10 podiatry educators (40%), nine Clinical Educators (36%), two student representatives (8%), two new podiatry graduates (8%) and two consumers (8%). From the 25 recruited participants, 21 responded to Round one, 18 to Round two and 17 in Round three. At the conclusion of the Delphi survey, 55 statements had reached consensus or agreement.</p><p><strong>Conclusions: </strong>This Delphi study is the first of its kind for the podiatry profession to develop consensus-based statements regarding the assessment of WIL. Fifty-five statements pertinent to the assessment of WIL were identified. This is an important first step toward the development of a consistent WIL assessment tool which may be applied across entry-level podiatry programs across Australia and New Zealand.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"16 1","pages":"43"},"PeriodicalIF":2.5,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10354956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10220904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variability of toe pressures during haemodialysis: comparison of people with and without diabetes; a pilot study.","authors":"Rachel Carle,&nbsp;Peta Tehan,&nbsp;Sarah Stewart,&nbsp;David Semple,&nbsp;Andrew Pilmore,&nbsp;Matthew R Carroll","doi":"10.1186/s13047-023-00642-y","DOIUrl":"https://doi.org/10.1186/s13047-023-00642-y","url":null,"abstract":"<p><strong>Background: </strong>Diabetes, end stage renal disease (ESRD), and peripheral arterial disease (PAD) are associated with a higher risk of diabetes-related lower limb amputation. Timely identification of PAD with toe systolic blood pressure (TSBP) and toe-brachial pressure index (TBPI) is critical in order to implement foot protection strategies to prevent foot complications in people with ESRD. There is limited evidence describing the effect of haemodialysis on TSBP and TBPI. This study aimed to determine the variability of TSBP and TBPI during haemodialysis in people with ESRD, and to determine whether any observed variability differed between people with and without diabetes.</p><p><strong>Methods: </strong>TSBP and TBPI were taken before dialysis (T1), one hour into dialysis (T2) and in the last 15 min of dialysis (T3) during a single dialysis session. Linear mixed effects models were undertaken to determine the variability in TSBP and TBPI across the three time points and to determine whether this variability differed between people with and without diabetes.</p><p><strong>Results: </strong>Thirty participants were recruited, including 17 (57%) with diabetes and 13 (43%) with no diabetes. A significant overall reduction in TSBP was observed across all participants (P < 0.001). There was a significant reduction in TSBP between T1 and T2 (P < 0.001) and between T1 and T3 (P < 0.001). There was no significant overall change in TBPI over time (P = 0.62). There was no significant overall difference in TSBP between people with diabetes and people with no diabetes (mean difference [95% CI]: -9.28 [-40.20, 21.64], P = 0.54). There was no significant overall difference in TBPI between people with diabetes and people with no diabetes (mean difference [95% CI]: -0.01 [-0.17, 03.16], P = 0.91).</p><p><strong>Conclusion: </strong>TSBP and TBPI are an essential part of vascular assessment of the lower limb. TBPI remained stable and TSBP significantly reduced during dialysis. Given the frequency and duration of dialysis, clinicians taking toe pressures to screen for PAD should be aware of this reduction and consider how this may have an impact on wound healing capacity and the development of foot related complications.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"16 1","pages":"42"},"PeriodicalIF":2.9,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10332079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9802876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Independent prescribing in the UK: insights from the Department of Health Allied Health Professions Medicines Project team.","authors":"Ivan Bristow,&nbsp;Catherine Bowen,&nbsp;Nicky Wilson,&nbsp;Alan Borthwick","doi":"10.1186/s13047-023-00641-z","DOIUrl":"https://doi.org/10.1186/s13047-023-00641-z","url":null,"abstract":"<p><strong>Background: </strong>The UK medicines legislation was amended ten years ago (2013) to allow podiatrists and physiotherapists independent prescribing rights, the first of the allied health professions to do so. Non-medical prescribing formed one part of a broader policy agenda promoting role flexibility in response to the challenge of an ageing population and the need to maintain effective health provision in the face of a contracting workforce.</p><p><strong>Aim: </strong>The aim of this study was to outline the experiences of the Department of Health AHP medicines project board team in working towards independent prescribing for podiatry and physiotherapy, with a particular focus on the challenges encountered.</p><p><strong>Methods: </strong>In depth, open-ended interviews were conducted with eight of the core members of the project team, drawn from those individuals who served throughout the duration of the project (2010-2013). Included were the former Department of Health Chief and Deputy Chief Allied Health Professions Officers; the Department of Health Engagement and Communications Officer; representatives of the Health and Care Professions Council; the Medicines and Healthcare products Regulatory Agency; the Council of Deans of Health; the Royal College of Podiatry and the Chartered Society of Physiotherapy (The team also included the representative of the Allied Health Professions Federation. However, as that representative is also a researcher in this study, he has recused himself from any role as a participant.). Data were transcribed and subject to a thematic analysis.</p><p><strong>Results: </strong>A complex picture of the project emerged revealing a range of obstacles and challenges, including inter-professional role boundary tensions and negative prior assumptions about the two professions. Success hinged upon the adoption of a dual strategy involving submission of a robust case of need focused on patient benefit coupled with the careful management of professional expectations. Underpinning theory from the sociology of the professions offers a supportive explanatory framework for understanding the relationships between the various stakeholders involved.</p><p><strong>Conclusions: </strong>Ultimately, success depended upon aligning the project aims with healthcare policy through a clear focus on patient benefit. Balancing competing professional and policy demands through a continual emphasis on improved patient care laid the foundations for future projects by other allied health professions.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"16 1","pages":"41"},"PeriodicalIF":2.9,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10318698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10113896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a clinical tool to semi-automatic measure three-dimensional TAR alignment on two-dimensional radiographs.","authors":"Sanne W G van Hoogstraten,&nbsp;Joris Hermus,&nbsp;Vera Verbiest,&nbsp;Bert van Rietbergen,&nbsp;Jacobus J C Arts","doi":"10.1186/s13047-023-00640-0","DOIUrl":"https://doi.org/10.1186/s13047-023-00640-0","url":null,"abstract":"<p><strong>Background: </strong>Malalignment is often postulated as an important reason for the high failure rate of total ankle replacements (TARs). The correlation between TAR malalignment and clinical outcome, however, is not fully understood. Improving and expanding radiographic TAR alignment measurements in the clinic might lead to a better insight into the correlation between malalignment and the clinical outcome. This study aims to develop and validate a tool to semi-automatic measure TAR alignment, and to improve alignment measurements on radiographs in the clinic.</p><p><strong>Methods: </strong>A tool to semi-automatically measure TAR alignment on anteroposterior and lateral radiographs was developed in MATLAB. Using the principle of edge contouring and the perpendicular relationship between the anteroposterior and lateral radiographs, the exact configuration of the TAR components can be found. Two observers validated the tool by measuring TAR alignment of ten patients using the tool. The Intraclass Coefficient (ICC) was calculated to assess the reliability of the developed method. The results obtained by the tool were compared to clinical results during radiographic follow-up in the past, and the accuracy of both methods was calculated using three-dimensional CT data.</p><p><strong>Results: </strong>The tool showed an accuracy of 76% compared to 71% for the method used during follow-up. ICC values were 0.94 (p < 0.01) and higher for both inter-and intra-observer reliability.</p><p><strong>Conclusions: </strong>The tool presents a reproducible method to measure TAR alignment parameters. Three-dimensional alignment parameters are obtained from two-dimensional radiographs, and as the tool can be applied to most TAR designs, it offers a valuable addition in the clinic and for research purposes.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"16 1","pages":"40"},"PeriodicalIF":2.9,"publicationDate":"2023-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10290371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10072044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International differences and inaccuracies in the public advertising about calcaneal apophysitis: an audit of websites originating in Australia, UK and USA.","authors":"Sue Liu,&nbsp;Cylie M Williams,&nbsp;James J Welch","doi":"10.1186/s13047-023-00637-9","DOIUrl":"https://doi.org/10.1186/s13047-023-00637-9","url":null,"abstract":"<p><strong>Background: </strong>Calcaneal apophysitis is a common condition in childhood. Parents often seek online information for children's' health care concerns prior to seeking care. Therefore, we aimed to evaluate the credibility, readability, and accuracy of calcaneal apophysitis advertising on popular websites in three countries.</p><p><strong>Methods: </strong>We used content analysis of publicly accessible data. This involved identifying the top 50 websites in each country from their hit rates. We used elements of validated tools to audit and determine frequencies relevant to credibility (e.g. publisher), readability (e.g. literacy score) and accuracy (e.g. alignment with evidence). Data were analysed quantitatively and reported against each element.</p><p><strong>Results: </strong>Websites were predominantly hosted by private health services (n = 118, 79%). The mean (SD) SMOG (readability) score was 9.3 (4.5). The majority of websites (n = 140, 93%) provided at least one treatment recommendation, and less than 10% (n = 11) of websites advertised treatments fully aligned with evidence. Use of treatment modalities without evidence and with high risk to children were also found including surgery, extracorporeal shock wave therapy and laser.</p><p><strong>Conclusions: </strong>Calcaneal apophysitis online advertising is mostly curated by clinicians. Clinicians should consider revising online advertising to increase understandability and accuracy to reduce health care wastage, risk, and low value care.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"16 1","pages":"39"},"PeriodicalIF":2.9,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10280899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10066961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of supportive and minimalist footwear on standing balance and walking stability in older women.","authors":"Ameer Nor Azhar,&nbsp;Shannon E Munteanu,&nbsp;Hylton B Menz","doi":"10.1186/s13047-023-00634-y","DOIUrl":"https://doi.org/10.1186/s13047-023-00634-y","url":null,"abstract":"<p><strong>Background: </strong>Footwear has been shown to influence balance and is an important consideration in relation to the prevention of falls. However, it remains unclear as to what type of footwear is most beneficial for balance in older people: sturdy, supportive footwear, or minimalist footwear to maximise plantar sensory input. The objectives of this study were therefore to compare standing balance and walking stability in older women wearing these two footwear styles, and to investigate participants' perceptions in relation to comfort, ease of use and fit.</p><p><strong>Methods: </strong>Older women (n = 20) aged 66 to 82 years (mean 73.4, SD 3.9) performed a series of laboratory tests of standing balance (eyes open and closed on floor and foam rubber mat, near tandem standing) and walking stability (treadmill, level and irregular surface) using a wearable sensor motion analysis system. Participants were tested wearing supportive footwear (incorporating design features to improve balance) and minimalist footwear. Perceptions of the footwear were documented using structured questionnaires.</p><p><strong>Results: </strong>There were no statistically significant differences in balance performance between the supportive and minimalist footwear. Participants perceived the supportive footwear to be significantly more attractive to self and others, easier to put on and off but heavier compared to the minimalist footwear. Overall comfort was similar between the footwear conditions, although the supportive footwear was reported to be significantly more comfortable in the heel, arch height, heel cup, heel width and forefoot width regions. Eighteen participants (90%) reported that they felt more stable in the supportive footwear and 17 (85%) reported that they would consider wearing them to reduce their risk of falling.</p><p><strong>Conclusion: </strong>Balance performance and walking stability were similar in supportive footwear designed to reduce the risk of falling and minimalist footwear, although participants preferred the supportive footwear in relation to aesthetics, ease of use, comfort and perceived stability. Prospective studies are now required to ascertain the longer-term advantages and disadvantages of these footwear styles on comfort and stability in older people.</p><p><strong>Trial registration: </strong>Australian New Zealand Clinical Trials Registry. ACTRN12622001257752p, 20/9/2022 (prospectively registered).</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"16 1","pages":"38"},"PeriodicalIF":2.9,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10278322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9671955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microwave therapy for the treatment of plantar warts.","authors":"Wendy Hagon,&nbsp;Jonathan Hagon,&nbsp;Greer Noble,&nbsp;Angela Brenton-Rule,&nbsp;Sarah Stewart,&nbsp;Ivan Bristow","doi":"10.1186/s13047-023-00638-8","DOIUrl":"https://doi.org/10.1186/s13047-023-00638-8","url":null,"abstract":"<p><strong>Background: </strong>Plantar warts, or verrucae plantaris, are common lesions causing considerable pain during weightbearing activity. Although current treatment modalities have low success rates, microwave therapy has been introduced as a promising intervention. This study aimed to determine the effectiveness of microwave therapy for the treatment of plantar warts and to determine the clinical factors associated with plantar wart resolution.</p><p><strong>Methods: </strong>A retrospective analysis of 150 plantar warts from 45 patients treated with microwave therapy was undertaken. Binomial regression was conducted to explore clinical characteristics (age, gender, immunosuppression, impaired healing, multiple vs single wart, location of lesion, lesion diameter) associated with lesion resolution.</p><p><strong>Results: </strong>Of the total 150 plantar warts treated with microwave therapy, 125 (83.3%) warts resolved and 25 (17%) warts did not resolve. The mean (SD) total treatment sessions for resolved lesions was 2.8 (1.0). Decreasing age (P = 0.046) was the only clinical characteristic associated with resolution.</p><p><strong>Conclusions: </strong>This retrospective study has shown that plantar warts may be resolved with two to three sessions of microwave therapy, which may be more successful in younger populations.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"16 1","pages":"37"},"PeriodicalIF":2.9,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10268531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9652382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of below-knee and above-knee amputations with demographic, comorbidity, and haematological parameters in patients who died.","authors":"Cafer Özgür Hançerli,&nbsp;Necati Doğan","doi":"10.1186/s13047-023-00635-x","DOIUrl":"https://doi.org/10.1186/s13047-023-00635-x","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to establish mortality predictive parameters with a higher contribution to mortality by comparing the demographic data, comorbid factors, and haematological values of patients who underwent below-knee and above-knee amputation and had died during the follow-up period.</p><p><strong>Materials and methods: </strong>Between March 2014 and January 2022, 122 patients in a single centre who developed foot gangrene due to chronic diabetes and underwent below-knee or above-knee amputation were evaluated retrospectively. Patients who died of natural causes during the post-operative period were included in the study. Those who were amputated below the knee were assigned to Group 1, and those who were amputated above the knee were assigned to Group 2. The patients' age, gender, side of amputation, comorbid diseases, American Society of Anaesthesiologists (ASA) score, Charlson comorbidity index (CCI), death time, and haematological values at the time of first admission were compared between the two groups and statistical analyses were performed.</p><p><strong>Results: </strong>Group 1 (n = 50) and Group 2 (n = 37) had similar distributions in terms of age, gender, side of operation, number of comorbidities, and CCI (p > 0.05). Group 2's mean ASA score and c-reactive protein (CRP) levels were statistically higher than those of Group 1 (p < 0.05). Death time, albumin value, and HbA1c levels were statistically lower in Group 2 than in Group 1 (p < 0.05). There were no significant differences between the groups in haemogram, white blood cells (WBC), lymphocytes, neutrophils, creatinine, and Na values at the time of first admission (p > 0.05).</p><p><strong>Conclusion: </strong>A high ASA score, low albumin value, and high CRP value were significant predictors of high mortality. Creatinine levels and HbA1c values were quite ineffective in predicting mortality.</p><p><strong>Level of evidence: </strong>Level 3, retrospective comparative study.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"16 1","pages":"36"},"PeriodicalIF":2.9,"publicationDate":"2023-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10260379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9629709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis of randomised controlled trials on surgical treatments for ingrown toenails part I: recurrence and relief of symptoms.","authors":"Victoria Exley,&nbsp;Katherine Jones,&nbsp;Grace O'Carroll,&nbsp;Judith Watson,&nbsp;Michael Backhouse","doi":"10.1186/s13047-023-00631-1","DOIUrl":"https://doi.org/10.1186/s13047-023-00631-1","url":null,"abstract":"<p><strong>Background: </strong>Ingrown toenails are a common nail pathology. When conservative treatments are ineffective, a surgical approach is often utilised. Despite recent narrative reviews, there is a need for an up-to-date and rigorous systematic review of surgical methods for treating ingrown toenails.</p><p><strong>Methods: </strong>Five databases (MEDLINE, Embase, CINAHL, Web of Science and CENTRAL) and two registers (Clinicaltrials.gov and ISRCTN) were searched to January 2022 for randomised trials evaluating the effects of a surgical intervention(s) for ingrown toenails with a follow-up of at least 1 month. Two independent reviewers screened records, extracted data, assessed risk of bias and certainty of evidence.</p><p><strong>Results: </strong>Of 3,928 records identified, 36 (3,756 participants; 62.7% males) surgical interventions were included in the systematic review and 31 studies in the meta-analysis. There was very low quality evidence that using phenol with nail avulsion vs nail avulsion without phenol reduces the risk of recurrence (risk ratio [RR] 0.13 [95% CI 0.06 to 0.27], p < 0.001). No favourable effect was observed between chemical or surgical vs conservative management (0.55 [0.19 to 1.61], p = 0.280; 0.72 [0.33 to 1.56], p = 0.410), chemical or surgical vs other (e.g., CO₂ laser, electrocautery) (1.61 [0.88 to 2.95], p = 0.120; 0.58 [0.25 to 1.37], p = 0.220), chemical vs surgical (0.75 [0.46 to 1.21], p = 0.230), surgical vs surgical (0.42 [0.21 to 0.85]), chemical vs chemical (0.19 [0.01 to 3.80], p = 0.280), surgical vs surgical + chemical (3.68 [0.20 to 67.35], p = 0.380), chemical vs surgical + chemical (1.92 [0.06 to 62.30], p = 0.710), local anaesthetic vs local anaesthetic + adrenaline (1.03 [0.22 to 4.86], p = 0.970), chemical timings 30 s vs 60 s (2.00 [0.19 to 21.41]) or antibiotics vs no antibiotics (0.54 [0.12 to 2.52], p = 0.430). Central toenail resection was the only procedure to significantly relieve symptoms (p = 0.001) but data were only available up to 8 weeks post-surgery.</p><p><strong>Conclusion: </strong>Despite the high number of publications, the quality of research was poor and the conclusions that can be inferred from existing trials is limited. Phenolisation of the nail matrix appears to reduce the risk of recurrence following nail ablation, and with less certainty 1 min appears to be the optimum time for application. Despite this being a widely performed procedure there remains a lack of good quality evidence to guide practice.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"16 1","pages":"35"},"PeriodicalIF":2.9,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10257290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10663635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of the consensus-based recommendations for Podiatry care of Neuropathy In Cancer Survivors (PodNICS): a Delphi consensus study of Australian podiatrists.","authors":"Sindhrani Dars, Elizabeth Buckley, Kerri Beckmann, David Roder, Helen Banwell","doi":"10.1186/s13047-023-00632-0","DOIUrl":"10.1186/s13047-023-00632-0","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy Induced Peripheral Neuropathy (CIPN) is the most common presenting side effect of chemotherapy. As a sensory based neuropathy, this condition can persist for a long time after cessation of chemotherapy and impact the quality of life of cancer survivors. Podiatrists in Australia have been managing people with CIPN related lower limb complications, however guidelines on management of CIPN do not exist. The aim of this study was to achieve consensus and agreement of Australian podiatrists on strategies to best manage people presenting with symptoms of CIPN.</p><p><strong>Methods: </strong>An online three-round modified Delphi survey of Australian podiatrists with expertise in CIPN was conducted in line with recommendations for conducting and reporting of Delphi studies (CREDES). Panellists responded to open-ended questions in Round 1, whereupon their responses were themed into statements and analysed for existing consensus. Statements not reaching consensus were returned during Round 2 to seek agreement from responders using a five-point Likert scale and to allow responders to make further comments. For a statement to reach consensus or agreement, 70% or more of panellists needed to make the same comment or agree or strongly agree with the same themed statement. Statements reaching 50 to 69% consensus or agreement were returned to panellists in Round 3 for them to consider their responses in the light of group outcomes.</p><p><strong>Results: </strong>Round one resulted in 229 comments from 21 of 26 podiatrists who agreed to participate. These comments were themed into 53 statements with 11 consensus statements accepted. Round 2 resulted in 22 statements reaching agreement, and 15 new statements being generated from 18 comments made by 17 respondents. Round 3 resulted in 11 statements reaching agreement. Outcomes were developed into a set of clinical recommendations for diagnosis and management of people presenting with CIPN. These recommendations provide guidance on 1) identifying common signs and symptoms of CIPN including sensory, motor and autonomic symptoms; 2) diagnosis and assessment of CIPN including neurological, motor and dermatological assessment modalities; and 3) best clinical practice and management strategies for CIPN identified by podiatrists including both podiatry and non-podiatry specific care.</p><p><strong>Conclusions: </strong>This is the first study in podiatry literature to develop expert-informed consensus-based recommendations for clinical presentation, diagnosis and assessment and management of people with CIPN. These recommendations aim to help guide podiatrists in the consistent care of people with CIPN.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"16 1","pages":"33"},"PeriodicalIF":2.5,"publicationDate":"2023-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10251566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9612470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}