Comparative analysis of moral distress and values of the work organization between American and Spanish podiatric physicians.

Background: Moral distress is a stress symptom arising from situations that involve ethical dimensions where the health-care provider believes that he or she is unable to preserve all interests and values at stake. The aims of this study were to evaluate the impact of, and identify possible differences in, moral distress in podiatric physicians in the United States and Spain and to determine the ethical principles most closely related to moral distress.

Methods: A 2008 e-mail survey of 93 US podiatric physicians and 93 Spanish podiatric physicians (N = 186) presented statements about different ethical dilemmas, values, and goals in the workplace.

Knowledge and positions on bioethical dilemmas in a sample of Spanish nursing students: a questionnaire study.

This study, performed in Madrid, Spain, evaluates nursing students' understanding and attitudes about bioethical dilemmas that they will likely confront as health care providers. We asked 86 juniors in the King Juan Carlos University Nursing baccalaureate program about their knowledge of and personal attitudes on five biomedical advances: eugenics, experimentation with unimplanted embryos, human cloning, abortion, and euthanasia. Students reported being most knowledgeable about abortion and euthanasia and least familiar with eugenics.

Dorsal approach to transfer of the flexor digitorum brevis tendon.

Background: Transposition of the flexor digitorum longus tendon has been widely reported for the correction of flexible claw and hammer toe deformities. Only transposition of the flexor digitorum brevis tendon has been reported in the literature in a cadaveric study that used the dorsal and plantar approach. A search of the literature revealed no reports of transposition of the flexor digitorum brevis tendon for treatment of these conditions through a unique dorsal cutaneous incision.

Plantar pressures in children with and without sever's disease.

Background: a case-control study was conducted to compare static plantar pressures and distribution of body weight across the two lower limbs, as well as the prevalence of gastrocnemius soleus equinus, in children with and without calcaneal apophysitis (Sever's disease).

Methods: the participants were 54 boys enrolled in a soccer academy, of which eight were lost to follow-up. Twenty-two boys with unilateral Sever's disease comprised the Sever's disease group and 24 healthy boys constituted a control group.

Efficacy of intraoperative surgical irrigation with polihexanide and nitrofurazone in reducing bacterial load after nail removal surgery.

Background: A common challenge of nail avulsion surgery is the associated bacterial contamination and infection that can manifest. The toe has a difficult anatomy to antiseptically prepare and properly maintain throughout the surgical procedure, lending to this widespread problem.

Objective: We conducted a controlled, prospective randomized study to examine the antiseptic efficacy of 3 intraoperative irrigation methods during nail avulsion surgery.

Efficacy of preoperative and intraoperative skin and nail surgical preparation of the foot in reducing bacterial load.

Background: A common problem associated with toenail removal surgery is the accompanying bacterial infection that often ensues. The foot has a particularly difficult anatomy to prepare antiseptically for surgery, which contributes to this wide-spread problem.

Objective: To compare the antiseptic efficacy of two skin pretreatment methods before toenail avulsion surgery.

Advantages and drawbacks of proximal interphalangeal joint fusion versus flexor tendon transfer in the correction of hammer and claw toe deformity. A finite-element study.

Correction of claw or hammer toe deformity can be achieved using various techniques, including proximal interphalangeal joint arthrodesis (PIPJA), flexor digitorum longus tendon transfer (FDLT), and flexor digitorum brevis transfer. PIPJA is the oldest technique, but is associated with significant complications (infection, fracture, delayed union, and nonunion). FDLT eliminates the deformity, but leads to loss of stability during gait.

Moral distress related to ethical dilemmas among Spanish podiatrists.

Objectives: To describe the distress experienced by Spanish podiatrists related to ethical dilemmas, organisational matters, and lack of resources.

Design: A 2008 email survey of a representative sample of 485 Spanish podiatrists presenting statements about different ethical dilemmas, values and goals at the workplace.

Results: The response rate was 44.

Preoperative skin and nail preparation of the foot: comparison of the efficacy of 4 different methods in reducing bacterial load.

Background: Orthopedic surgical procedures involving the foot and ankle are associated with high rates of infection. The optimal method of preparing the skin and nails for foot and ankle surgery remains unknown.

Objective: This study was conducted to compare the efficacy of 4 different methods of skin and nail preparation of the foot using various antiseptic solutions.

The relationship between experiential avoidance and burnout syndrome in critical care nurses: a cross-sectional questionnaire survey.

Background: Critical care nurses often face complex stressful situations, and the phenomenon of burnout syndrome has been recognized as an important and increasing problem. Recent research suggests that another phenomenon, experiential avoidance, may be associated with burnout syndrome.

Objectives: To determine the relationship between burnout syndrome and experiential avoidance in Spanish critical care nurses and to evaluate the relationships between burnout, experiential avoidance, certain health habits, and sociodemographic and job-related factors.

In-toeing in children with type I osteogenesis imperfecta: an observational descriptive study.

Background: Osteogenesis imperfecta is an autosomal-dominant disorder of the connective tissue. Also known as brittle bone disease, it renders those affected susceptible to fractures after minimal trauma. Therefore, it is important to minimize the risk of falls and subsequent fractures in patients with this disease.

Finite-element simulation of flexor digitorum longus or flexor digitorum brevis tendon transfer for the treatment of claw toe deformity.

Claw toe deformity sometimes leads to dorsiflexion of the metatarsophalangeal joint (MPJ) and plantar flexion of the proximal (PIPJ) and distal interphalangeal (DIPJ) joints. Flexor digitorum longus tendon transfer (FDL) is currently the gold standard for the correction of this problem. Transfer of the flexor digitorum brevis (FDB) has been recently proposed as an alternative method to treat such deformity.

Application of cantharidin and podophyllotoxin for the treatment of plantar warts.

Background: A variety of treatment modalities have been described for cutaneous warts. We sought to determine the safety and efficacy of a topical formulation of cantharidin, podophyllotoxin, and salicylic acid in the treatment of plantar warts. This combination treatment is widely used in Europe and elsewhere but has not been described in the podiatric medical literature.

Gauze application of phenol for matrixectomy.

Phenol matrixectomy is commonly used to treat onychocryptosis. The podiatric medical community has been progressively improving the technique of phenol application to avoid cases of burns. We describe a modification that uses gauze to provide a safe way for the phenol to be applied and prevents skin lesions due to phenol burns.

Safety of phenol vapor inhalation during performance of chemical matrixectomy to treat ingrown toenails.

Background: Phenol is commonly used in chemical matrixectomies to treat ingrown toenails. Although many studies have documented the safety of phenol matrixectomy for the patient, few studies have investigated the procedure's safety for the physician and auxiliary health care personnel.

Objective: This study was undertaken to evaluate the safety of phenol vapor inhalation for health care personnel during performance of chemical matrixectomy.

Use of a Kirschner wire for distraction and capsular flaps in the Keller interpositional arthroplasty.

We describe a simplified capsular interpositional technique for the Keller bunionectomy that uses a Kirschner wire to interpose the capsule into the first metatarsophalangeal joint without requiring sutures. The capsule acts as a biologic spacer in the first metatarsophalangeal joint, allowing for fibrosis to fill the void created, with the Kirschner wire maintaining the distance between the metatarsal head and the stump of the proximal phalanx. This creation of a nonpainful pseudarthrosis prevents shortening of the hallux and retraction of the base of the proximal phalanx on the metatarsal head.

Transfer of the flexor digitorum brevis tendon.

Background: Transposition of the flexor digitorum longus tendon has been widely reported for the correction of flexible claw or hammer toe deformities. In contrast, a search of the literature revealed no previous reports of transposition of the flexor digitorum brevis tendon for treatment of these conditions. We performed a cadaver study to determine whether the flexor digitorum brevis tendon is long enough to be transferred to the dorsum of the proximal phalanx of the toe from its lateral or medial aspect.