Utilization of smartphone and tablet camera photographs to predict healing of diabetes-related foot ulcers.

The objective of this study was to build a machine learning model that can predict healing of diabetes-related foot ulcers, using both clinical attributes extracted from electronic health records (EHR) and image features extracted from photographs. The clinical information and photographs were collected at an academic podiatry wound clinic over a three-year period. Both hand-crafted color and texture features and deep learning-based features from the global average pooling layer of ResNet-50 were extracted from the wound photographs.

Dense pooling layers in fully convolutional network for skin lesion segmentation.

One of the essential tasks in medical image analysis is segmentation and accurate detection of borders. Lesion segmentation in skin images is an essential step in the computerized detection of skin cancer. However, many of the state-of-the-art segmentation methods have deficiencies in their border detection phase.

A case of mistaken identity: classic Kaposi sarcoma misdiagnosed as a diabetic foot ulcer in an atypical patient.

Background: The presentation of Kaposi sarcoma is divided into four known clinical subtypes. In this case report we describe classic Kaposi sarcoma in an African-American heterosexual, diabetic, seronegative human immunodeficiency virus male. Classic Kaposi sarcoma is rare in this patient demographic and can be easily misdiagnosed.

Describing Normative Foot Temperatures in Patients With Diabetes-Related Peripheral Neuropathy.

Background: Prior research shows increased foot temperatures are predictive of diabetes-related foot complications. Our aim was to describe normative skin foot temperatures for individuals with diabetic peripheral neuropathy to better inform new technologies. We also explored for potential risk factors which correlate with changes in foot temperatures.

Plantar fasciitis in patients with type 1 and type 2 diabetes: A contemporary cohort study.

Objective: Hyperglycemia leads to increase advanced glycation end products (AGEs) in patients with type 1 and type 2 diabetes. Subsequently, formation of AGEs can cause increased plantar fascial thickness (PFT), an imaging feature of plantar fasciitis (PF). This study evaluates the prevalence of PF in a contemporary cohort of type 1 diabetes and type 2 diabetes patients managed according to current standards, compared to patients without diabetes.

Prospective Analysis of Surgical Bone Margins After Partial Foot Amputation in Diabetic Patients Admitted With Moderate to Severe Foot Infections.

Background: Osteomyelitis is common in diabetic foot infections and medical management can lead to poor outcomes. Surgical management involves sending histopathologic and microbiologic specimens which guides future intervention. We examined the effect of obtainment of surgical margins in patients undergoing forefoot amputations to identify patient characteristics associated with outcomes.

Physician knowledge of a rare foot condition - influence of diabetic patient population on self-described knowledge and treatment.

Background: Charcot neuroarthopathy (CN), a rare foot and ankle condition usually complicating diabetes mellitus, leads to deformity, poor quality of life, and increased mortality and morbidity. The prevalence of this condition in the diabetic patient population is not currently known but has been reportedly misdiagnosed in up to 95% of cases.

Methods: We sought to evaluate general knowledge regarding CN in non-foot specialist clinical faculty at a large academic institution and to understand their practice habits.

Podiatry impact on high-low amputation ratio characteristics: A 16-year retrospective study.

Purpose: Complications from diabetes mellitus including major lower extremity amputation may have significant impact on a patient's mortality. This study determined what impact the addition of a limb salvage and diabetic foot program involving podiatry had at an academic institution over 16years by analyzing high-low amputation ratio data.

Methods: The high-low amputation ratio in the diabetic population who underwent non-traumatic amputation of the lower extremity was retrospectively evaluated at an academic institution via cohort discovery of the electronic medical record and analysis of billing over 16years.

Characteristics of High-Functioning Collaborations Between Primary Care and Podiatry in VHA Patient Aligned Care Teams.

The key to high-functioning PACT/Podiatry teams rests with the quality of the communication between providers.

Foot Complications and Mortality: Results from Translating Research Into Action for Diabetes (TRIAD).

Background: We sought to study the impact of foot complications on 10-year mortality independent of other demographic and biological risk factors in a racially and socioeconomically diverse managed-care population with access to high-quality medical care.

Methods: We studied 6,992 patients with diabetes in Translating Research Into Action for Diabetes (TRIAD), a prospective observational study of diabetes care in managed care. Foot complications were assessed using administrative claims data.

Charcot stage 0: A review and consideratons for making the correct diagnosis early.

Charcot neuropathic osteoarthropathy (CN) is a rare disease (NIDDK, NIH Summary Report Charcot Workshop, 2008) that causes significant morbidity and mortality for affected patients. The disease can result in severe deformities of the foot and ankle that contribute to the development of ulcerations and amputations. Medical advances have failed to find ways to stop the progression of the disease.

Physical Examination Variables Predict Response to Conservative Treatment of Nonchronic Plantar Fasciitis: Secondary Analysis of a Randomized, Placebo-Controlled Footwear Study.

Background: Plantar fasciitis is a common, disabling condition, and the prognosis of conservative treatment is difficult to predict.

Objective: To determine whether initial clinical findings could help predict patient response to conservative treatment that primarily consisted of supportive footwear and stretching.

Setting: Patients were recruited and seen at 2 outpatient podiatric clinics in the Chicago, Illinois, metropolitan area.

Prognostic Value of Diagnostic Sonography in Patients With Plantar Fasciitis.

Objectives: The primary objective of this study was to determine whether the sonographic appearance of the plantar fascia is predictive of the treatment (ie, pain) response in patients receiving supportive therapy for proximal plantar fasciitis. This study was a secondary analysis of data obtained from a randomized controlled trial of ambulatory adults, which examined the efficacy of 3 different foot supports for plantar fasciitis.

Methods: Participants underwent diagnostic sonographic examinations of their heel at baseline and again at 3 months by a single experienced foot and ankle surgeon.

Estimation of Center of Mass Trajectory using Wearable Sensors during Golf Swing.

This study suggests a wearable sensor technology to estimate center of mass (CoM) trajectory during a golf swing. Groups of 3, 4, and 18 participants were recruited, respectively, for the purpose of three validation studies. Study 1 examined the accuracy of the system to estimate a 3D body segment angle compared to a camera-based motion analyzer (Vicon®).

A randomized controlled trial of custom foot orthoses for the treatment of plantar heel pain.

Background: Up to 10% of people will experience heel pain. The purpose of this prospective, double-blind, randomized clinical trial was to compare custom foot orthoses (CFO), prefabricated foot orthoses (PFO), and sham insole treatment for plantar fasciitis.

Methods: Seventy-seven patients with plantar fasciitis for less than 1 year were included.

Bizarre parosteal osteochondromatous proliferation: a novel case report of recurrence in the toe.

Bizarre parosteal osteochondromatous proliferation (BPOP) is an uncommon reactive mesenchymal lesion mainly affecting the small bones of the hands and feet. They frequently occur in young adults. It is important to understand and differentiate BPOP from other lesions, especially because of its atypical microscopic features and tendency to recur.

A novel shear reduction insole effect on the thermal response to walking stress, balance, and gait.

Shear stresses have been implicated in the formation of diabetes-related foot ulcers. The aim of this study was to evaluate the effect of a novel shear-reducing insole on the thermal response to walking, balance, and gait. Twenty-seven diabetes peripheral neuropathy patients were enrolled and asked to take 200 steps in both intervention and standard insoles.

Data mining for identifying novel associations and temporal relationships with Charcot foot.

INTRODUCTION. Charcot foot is a rare and devastating complication of diabetes. While some risk factors are known, debate continues regarding etiology.

Association of footprint measurements with plantar kinetics: a linear regression model.

Background: The use of foot measurements to classify morphology and interpret foot function remains one of the focal concepts of lower-extremity biomechanics. However, only 27% to 55% of midfoot variance in foot pressures has been determined in the most comprehensive models. We investigated whether dynamic walking footprint measurements are associated with inter-individual foot loading variability.

Recognizing the prevalence of changing adult foot size: an opportunity to prevent diabetic foot ulcers?

Ill-fitting shoes may precipitate up to half of all diabetes-related amputations and are often cited as a leading cause of diabetic foot ulcers (DFU), with those patients being 5 to 10 times more likely to present wearing improperly fitting shoes. Among patients with prior DFU, those who self-select their shoe wear are at a three-fold risk for reulceration at 3 years versus those patients wearing prescribed shoes. Properly designed and fitted shoes should then address much of this problem, but evidence supporting the benefit of therapeutic shoe programs is inconclusive.

Mechanism of orthotic therapy for the painful cavus foot deformity.

Background: People who have extremely high arched feet or pes cavus often suffer from substantial foot pain. Custom-made foot orthoses (CFO) have been shown to be an effective treatment option, but their specificity is unclear. It is generally thought that one of the primary functions of CFO is redistributing abnormal plantar pressures.

The system of care for the diabetic foot: objectives, outcomes, and opportunities.

Most cases of lower extremity limb loss in the United States occur among people with diabetes who have a diabetic foot ulcer (DFU). These DFUs and the associated limb loss that may occur lead to excess healthcare costs and have a large negative impact on mobility, psychosocial well-being, and quality of life. The strategies for DFU prevention and management are evolving, but the implementation of these prevention and management strategies remains challenging.

Prevalence and risk factors for diabetes-related foot complications in Translating Research Into Action for Diabetes (TRIAD).

Aims: The objective was to describe the prevalence of diabetes-related foot complications in a managed care population and to identify the demographic and biological risk factors.

Methods: We assessed the period prevalence of foot complications on 6992 patients using ICD-9 diagnosis codes from health plan administrative data. Demographic and biological variables were ascertained from surveys and medical record reviews.

A novel plantar stimulation technology for improving protective sensation and postural control in patients with diabetic peripheral neuropathy: a double-blinded, randomized study.

Background: Many diabetes-related peripheral neuropathy (DPN) patients also experience postural instability.

Objective: This study examined the effect of electrical stimulation therapy on DPN patients' postural control as well as recovery of plantar sensation.

Methods: 54 patients with mild to moderate DPN were enrolled into this study evaluating treatment of DPN with electrical stimulation provided via aqueous solution.