Abstract:
:Over the last 30 years, the impurities in the vancomycin product have been reduced, perhaps resulting in a lower rate of adverse reactions. Vancomycin is bactericidal against most susceptible organisms, but is bacteriostatic against the enterococcus. Vancomycin is the drug of choice for methicillin-resistant Staphylococcus aureus. Vancomycin attains good tissue and bone penetration and must be administered intravenously for systemic infections. It is eliminated renally with a half-life of about 6 hours; this half-life is prolonged with advanced age and reduced renal function. Significant adverse reactions can be minimized with careful attention to administration technique. Metronidazole has excellent tissue penetration; its antibacterial site of action is within anaerobic bacterial cells. Metronidazole is cleared by hepatic metabolism with a half-life of about 7 to 8 hours. The half-life is unchanged with renal dysfunction but is prolonged in patients with hepatic function impairment. Although adverse effects are relatively minor, there is an important interaction with warfarin. For podiatric infections, metronidazole can be used in skin- and soft-tissue infections; anaerobes in bone and joint infections are rare. Topical metronidazole has been used successfully in the treatment of decubitus ulcers, and this needs further evaluation. The most commonly used tetracyclines are tetracycline, doxycycline, and minocycline. The tetracyclines are broad spectrum antimicrobial agents, but their usefulness is limited by resistant strains. Tetracycline's absorption is significantly impaired by food, and it is cleared renally and fecally. Doxycycline has the highest protein binding and the longest half-life; it is cleared both renally and fecally without hepatic metabolism. Minocycline has the best absorption and tissue penetration; the unchanged drug is cleared renally and fecally, and it also undergoes hepatic metabolism. All tetracyclines have important adverse reactions with respect to teeth and bones, and they are contraindicated during pregnancy and for children under age eight.
journal_name
Clin Podiatr Med Surgjournal_title
Clinics in podiatric medicine and surgeryauthors
Ellison MJsubject
Has Abstractpub_date
1992-04-01 00:00:00pages
425-42issue
2eissn
0891-8422issn
1558-2302journal_volume
9pub_type
杂志文章,评审abstract::Total ankle replacement (TAR) has evolved over the past decade as a treatment for end-stage ankle arthritis with improved survivorship. Despite the improving outcomes, ankle deformity represents a challenge to the foot and ankle surgeon with increased risk of implant failure. The use of preoperative computer-assisted ...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:10.1016/j.cpm.2017.08.004
更新日期:2018-01-01 00:00:00
abstract::Amputation may be the most appropriate therapy for an ischemic or infected limb, but the level at which to amputate is often difficult to determine. Selecting the appropriate level is crucial when performing an amputation. The goals of surgery are to maintain maximal limb length and ensure successful healing. When mor...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:10.1016/j.cpm.2005.03.002
更新日期:2005-07-01 00:00:00
abstract::The Agility total ankle replacement system was the most commonly performed implant in the United States for more than 20 years and has undergone four generations and seven phases of improvement. Much attention has been placed on intraoperative complications, such as malleolar fracture; nerve or tendon injury; and inci...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 历史文章,杂志文章,评审
doi:10.1016/j.cpm.2012.10.001
更新日期:2013-04-01 00:00:00
abstract::The clinical case presented in this article demonstrates the necessity of prompt treatment of suspicious mass lesions and highlights the importance of always sending tissue specimens for proper evaluation. In this case, the prognosis was directly related to extent of the disease. Delaying treatment or improper treatme...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:
更新日期:1993-10-01 00:00:00
abstract::Pediatric and adolescent patients facing analgesia, anesthesia, and surgical procedures require different considerations than adults do. The preoperative, intraoperative, and postoperative time periods are discussed. Analgesia considerations outside the operating room are covered. The practicing podiatric physician wi...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:
更新日期:1997-01-01 00:00:00
abstract::Intra-articular fractures of the calcaneus should be treated like any other fractures of major weight-bearing joints. Technology has advanced significantly in the evaluation of such complex pathology. Surgical instrumentation is now available to address any fracture classification. In the past, this had been a problem...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:
更新日期:1995-10-01 00:00:00
abstract::This article examines fundamental laser physics and the manner in which the laser transfers energy to the surface of the body and how living cells react. Topics include the significance of absorption and scattering coefficients, assumptions for analysis of laser-beam interactions with living tissue, depth of vaporizat...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章
doi:
更新日期:1992-07-01 00:00:00
abstract::End-stage ankle arthritis is a debilitating condition that leads to pain and swelling in the ankle joint, with symptoms aggravated by standing and ambulation. Ankle arthritis commonly results from a history of trauma, or a series of recurrent injuries to the ankle. However, it may develop from other causes such as une...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章
doi:10.1016/j.cpm.2012.04.010
更新日期:2012-07-01 00:00:00
abstract::Total ankle arthroplasty has been in development for more than 40 years. Although early designs were experimental with high failure rates, current implants are significantly improved, showing promising functional results and clinical outcomes. Total ankle replacement designs are split into mobile-bearing and fixed-bea...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:10.1016/j.cpm.2019.06.005
更新日期:2019-10-01 00:00:00
abstract::The literature contains various nomenclature and classifications regarding the pigmented villonodular pathology that have proven to be quite confusing. This article clarifies this and emphasizes the fact that there is a spectrum of inflammatory pathologies that may affect synovial tissue. The primary focus of this art...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:10.1016/s0891-8422(02)00049-6
更新日期:2002-10-01 00:00:00
abstract::Interdigital corns or soft corns are the accumulation of spongy, hyperkeratotic, circumscribed tissue between opposing surfaces of adjacent digits of the foot. The authors discuss the incidence, causes, locations, and treatment of these interdigital corns. ...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:
更新日期:1996-04-01 00:00:00
abstract::The author presents an alternative approach to the pediatric flexible pes planovalgus patient. Hopefully, this algorithm can serve as a guide and not as a rule. It is meant to serve the foot and ankle surgeon as a means of eliminating the arbitrary assignment of a flatfoot to procedures. Instead, the algorithm assigns...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:10.1016/j.cpm.2005.10.001
更新日期:2006-01-01 00:00:00
abstract::Nerve conduction studies provide the most sensitive and accurate account of peripheral neuropathophysiology. Though nerve conduction studies should never be performed in lieu of a clinical examination, the electrodiagnostic evaluation provides an optimal adjuvant to the clinical examination. Indications for nerve cond...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:
更新日期:1990-01-01 00:00:00
abstract::Researchers often do not publish negative results; positive outcome reported bias remains rampant. This problem is pervasive throughout the medical continuum. Failure to release less than favorable results could be construed as ethically and morally inappropriate. Failure to make public less than favorable outcomes st...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:10.1016/j.cpm.2019.12.013
更新日期:2020-04-01 00:00:00
abstract::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. ...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:
更新日期:1988-10-01 00:00:00
abstract::Central metatarsal fractures are unique, secondary to biomechanical function, anatomy, and position within the foot. This article reviews the current and historical literature and the classic textbooks on fracture management to give a thorough understanding of the anatomy, biomechanics, incidence, mechanism of injury,...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:
更新日期:1995-10-01 00:00:00
abstract::Gaseous nitric oxide under increased atmospheric pressure (gNOp) has shown ability to kill multidrug-resistant bacteria in an in vitro model and in a live mammalian (porcine) model. Factors impacting the kill rate of the multidrug-resistant bacteria include atmospheric pressures, concentration of gaseous NO, flow rate...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:10.1016/j.cpm.2019.11.001
更新日期:2020-04-01 00:00:00
abstract::Charcot deformity is a challenge that foot and ankle surgeons struggle to manage successfully. Despite the advances in knowledge, technology, and treatment modalities, limb loss is still greater than 10%. This article discusses the efficacy of conservative measures and traditional surgical approaches. It proposes a mu...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:10.1016/j.cpm.2017.08.012
更新日期:2018-01-01 00:00:00
abstract::Achilles tendon pathologic conditions are implicated in contributing to the development of many diabetic foot complications including diabetic foot ulceration and Charcot neuroarthropathy. Surgical correction of the diabetic equinus deformity has been studied as an isolated or adjunctive treatment when dealing with di...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:10.1016/j.cpm.2016.10.013
更新日期:2017-04-01 00:00:00
abstract::Many patients with foot and ankle deformities have concurrent deformities (osseous and soft tissue), with or without limb length discrepancies. Lower extremity deformities and limb length discrepancies typically result from trauma, congenital abnormality, avascular necrosis, previous surgery, nonunion, and malunion. L...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:10.1016/j.cpm.2004.04.004
更新日期:2004-07-01 00:00:00
abstract::The authors discuss a novel technique not previously published that incorporates a subtalar joint arthrodesis with an ankle joint arthrodiastasis as an alternative to a tibiotalocalcaneal arthrodesis. Young and active patients who experience refractory pain and stiffness to the rearfoot and ankle secondary to combined...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:10.1016/j.cpm.2008.05.012
更新日期:2008-10-01 00:00:00
abstract::The supination of the forefoot that develops with adult acquired flatfoot is defined as forefoot supinatus. This deformity is an acquired soft tissue adaptation in which the forefoot is inverted on the rearfoot. Forefoot supinatus is a reducible deformity. Forefoot supinatus can mimic, and often be mistaken for, a for...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:10.1016/j.cpm.2014.03.009
更新日期:2014-07-01 00:00:00
abstract::Wounds of the lower extremity involving the distal third of the leg remain a significant challenge due to anatomic location and often poor host physiology. Perforator-based propeller flaps may provide rapid coverage of these wounds with a relatively low rate of major complications and often readily managed minor compl...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:10.1016/j.cpm.2020.06.001
更新日期:2020-10-01 00:00:00
abstract::Revision hammertoe surgery can be extremely challenging for the foot and ankle surgeon given the scar tissue and available osseous and soft tissue. Although not a common procedure, lesser metatarsophalangeal joint arthrodesis is an option for the patient especially in lieu of an amputation. This article describes the ...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:10.1016/j.cpm.2020.03.006
更新日期:2020-07-01 00:00:00
abstract::The Evans calcaneal osteotomy is currently the premier procedure for lateral column lengthening of the flexible flatfoot deformity. It has withstood the test of time, proving itself an effective procedure for the correction of pediatric flexible flatfoot. Current understanding of the osteotomy has allowed the Evans ca...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:10.1016/j.cpm.2004.10.002
更新日期:2005-04-01 00:00:00
abstract::There has been extensive research and investigation into the subtalar joint (STJ), yet the biomechanics that relate to its anatomic function, especially instability after injury, are surrounded by controversy. With a mechanism of injury closely related to the classic inversion ankle sprain, chronic instability can res...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:10.1016/j.cpm.2004.03.003
更新日期:2004-07-01 00:00:00
abstract::Since wounds in patients with diabetes will heal slowly at best, and since they are so much more susceptible to infection and the infection will be more devastating, the old adage of "first do no harm" must be adhered to. Diabetics have poor circulation, poor resistance to infection, and poor local nutrition. Their wh...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章
doi:
更新日期:1987-04-01 00:00:00
abstract::Obtaining functional alignment of a total ankle replacement, including physiologic sagittal plane range of motion, is paramount for a successful outcome. This article reviews the literature on techniques available for correction of osseous and soft-tissue equinus at the time of index total ankle replacement. These tec...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:10.1016/j.cpm.2015.06.018
更新日期:2015-10-01 00:00:00
abstract::Total ankle arthroplasty (TAA) and ankle arthrodesis (AA) are complicated surgeries that carry a learning curve with them. Complications are an aspect of all surgeries that must be considered. Surgeons must be prepared to handle these complications. The most important things are early identification and treatment of t...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章,评审
doi:10.1016/j.cpm.2017.05.011
更新日期:2017-10-01 00:00:00
abstract::This article focuses on the application of the carbon dioxide (CO2) laser at various levels of power density to achieve a level of efficacy in tissue ablation for cutaneous and deep indolent ulcerations that afflict the lower extremities. This article also supports theories of the CO2 laser generating a sterile nonpat...
journal_title:Clinics in podiatric medicine and surgery
pub_type: 杂志文章
doi:
更新日期:1992-07-01 00:00:00