AIDS education for the podiatric physician. Evaluating program impact.

An important component in the development of any educational program is the evaluation of its effectiveness. The program described in this article was designed in such a way that its impact on practitioners' knowledge, attitudes, and clinical practices regarding human immunodeficiency virus (HIV) could be evaluated. One hundred ten participants were asked to complete pre-conference and post-conference tests in order to measure improvement that resulted from program attendance.

Epidemiology and pathogenesis of HIV infection. Approaching the second decade.

Human immunodeficiency virus (HIV) is a retrovirus that can be transmitted through sexual activity, blood products, and perinatal exposure. The virus is composed of core, transmembrane, and envelope proteins. Cells of the immune system are the primary target of HIV, and destruction of the immune response is characteristic of end-stage disease.

Podiatric manifestations of AIDS.

Dermatologic, vascular, neurologic, and musculoskeletal complications are common among persons with acquired immunodeficiency syndrome (AIDS). These manifestations frequently involve the lower extremities and may be the initial presenting symptoms of human immunodeficiency virus (HIV) infection. It is important that practitioners of podiatric medicine be aware of these syndromes to facilitate early diagnosis of AIDS and to provide the best possible care for immunodeficient patients.

Educating podiatric medical assistants about AIDS and HIV infection.

In order to assess the need for acquired immunodeficiency syndrome education among podiatric assistants, comprehensive questionnaires on human immunodeficiency virus infection were distributed in February and March 1989. The findings presented here are based upon questionnaires completed and returned by 300 assistants. The purpose of the needs assessment was three-fold: to find out how much the surveyed assistants know about AIDS and HIV infection, how they feel about working with HIV-infected patients, and to what extent they understand and follow recommended infection control practices.

Concurrent calcaneonavicular and talocalcaneal coalitions.

Dual calcaneonavicular and talocalcaneal coalitions are probably not rare. Given the possibility for failed calcaneonavicular bar resection if a concurrent talocalcaneal bar goes undetected, careful preoperative evaluation is suggested. A case presentation has been made to illustrate the clinical significance of this problem.

An unusual complication of the Keller bunionectomy: spontaneous stress fractures of all lesser metatarsals.

The authors describe the etiology and pathomechanics of the more commonly encountered complications of the Keller bunionectomy with an unusual case report wherein a patient sustained spontaneous fractures of all lesser metatarsals after the Keller procedure.

Antibiotic-impregnated bone cement: an in vitro comparative analysis.

This manuscript examines the in vitro antibacterial activity of eight different antibiotics when mixed with polymethyl methacrylate. Two different parameters are presented as being important considerations in the choice of antibiotic. One parameter is the bacterial inhibition created by the direct contact of the antibiotic-impregnated bone cement.

A study of the use of a double tourniquet technique to obtain hemostasis in combination with local standby sedation during podiatric surgery.

Most surgeons believe that incorporation of a pneumatic thigh tourniquet requires concomitant use of general anesthesia to prevent the patient from experiencing intolerable discomfort. These authors explored use of pneumatic thigh tourniquets in combination with local standby sedation by conducting a two-part study. A group of nonsedated student volunteers was first studied, after applying pneumatic thigh tourniquets.

Computed tomographic scanning of the foot and ankle.

Computed tomography (CT) has become the gold standard for cross-sectional imaging in the foot and ankle. The literature is full of studies and case reports where CT has definately elucidated osseous and soft-tissue pathology.

Radiographic evaluation of inflammatory arthritis of the foot.

This article provides a brief overview of the radiographic appearance of the more commonly encountered arthridities in the foot. Also reviewed is a stepwise approach to interpreting radiographs in a patient suspected of having a synovial-based disease.

Radiation safety and protection.

Often overlooked are the consequences of low-level radiation. This article increases awareness of the short- and long-term effects of x-rays on the podiatrist, his staff and patients. Protection can be achieved for all concerned by using the radiographic techniques, low-cost ways for dosage reduction, and monitoring devices discussed.

Interevaluator variability in the measurement of proximal articular set angle.

The proximal articular set angle (PASA) is used in the evaluation of hallux abducto valgus, as well as a criterial parameter for the selection or rejection of various hallux abducto valgus corrective procedures. The authors casually observed variability in the measurement of PASA in clinical situations, stimulating the development of the presented study to determine if, in fact, the measurement of PASA varies excessively from one physician to another. The results clearly indicate that the interevaluator measurement of PASA is excessive (p less than 0.

Immunohistochemical renin study of DES-induced renal tumor in the Syrian hamster.

Diethylstilbestrol (DES) treatment of a male Syrian hamster resulted in the development of a renal tumor and its widely scattered serosal metastases. Cells in both the primary tumor and metastatic nodules contained secretory granules. The tumors were transplanted serially into DES-supported and non-DES-supported host hamsters until DES-independent tumors developed.

Orientation of the first metatarsal base wedge osteotomy: perpendicular to the metatarsal versus weight-bearing surface.

Changes have been proposed in the orientation of the first metatarsal base closing abductory wedge osteotomy based on sound theoretical reasoning. The newer proposed method, utilizing an orientation of the osteotomy perpendicular to the weight-bearing surface, produces only pure transverse plane motion and no loss of ground contact by hinge axis mechanisms. In contrast, the traditional orientation of the osteotomy, perpendicular to the long axis of the metatarsal, produces extraneous frontal plane motion that results in loss of ground contact as the osteotomy site is closed.

Pedal manifestations of systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is an autoimmune disease with numerous pedal manifestations. Since pedal manifestations are often its first presentation, it is important that the podiatrist knows how to recognize the disease. This article discusses the manifestations, diagnosis, and treatment of SLE as they relate to podiatry.

Special radiographic techniques in the evaluation of arthritic disease.

The radiographic modalities discussed in this article are useful adjunctive techniques in the evaluation of arthritic disease. None of these modalities should be considered for baseline study. Rather, they should be considered following plain film examination when further information is required.

Implant arthroplasty in the rheumatoid arthritic patient.

Implant arthroplasty was introduced with the intention that it would relieve pain, provide stability, provide motion, and allow the part to be mobilized. It is a relatively recent phenomenon and long-term results remain difficult to predict.

Perioperative considerations in the arthritic patient.

It should become clear that the surgeon's responsibility to the patient does not end with knowledge of the surgical procedure. The arthritis patient poses a vexing problem in a variety of ways. The surgeon not only has to understand the particulars of surgery, but also should have a working knowledge of the disease process so that the chance for complications is lessened.

Adhesive capsulitis of the ankle.

Adhesive capsulitis is a rheumatologic complication that may be encountered in the ankle joint in posttraumatic situations. The condition presents with chronic ankle pain, stiffness, and swelling. The diagnosis can be confirmed arthrographically.