Analysis of Disease in the Rheumatoid Foot - Essay Example

Student’s Name Your Instructor’s name The Course Date Reflective Essays 1. Investigation of rheumatoid arthritis patients’ experiences of therapeutic footwear I found the investigation done by Anita Williams and friends, at United Kingdom’s University of Salford (Centre for Rehabilitation and Human Performance Research), quite influential. By using 10 female patients of rheumatic arthritis (RA), the research team effectively conducted a research on the women’s experience on wearing therapeutic footwear. Besides, I noted that the study resulted in various questions on freewill, gender, body image and gender roles. Most important, the study indicates that many patients do not comply with the therapeutic measures, hence impeding the desired results. This is because patients find the footwear very uncomfortable. The study’s aim is imperative in examining factors that hinder the patients’ use of therapeutic footwear, and their opinions or feelings about the therapy. The study is also important in that it helps patients express their experiences on the prescribed shoes in terms of the positive and negative effects. The idea of the therapeutic footwear is significant in enhancing the patients’ mobility, and reducing foot pain, nevertheless, it is a pity that most of them complain about the number of restrictions imposed by the prescription. According to the study, some of the participants complained that the shoes affect their choice of clothing since majority has to wear trousers. As a result, their gender perceptions are greatly affected. I find this inappropriate since most of these patients are compelled to use the shoes for lack of other alternatives. Although this service is satisfactory, patients complain about the medical practitioners’ consultation approach. Therefore, it is vital that the physicians work on ways of improving their services and patients’ feelings on the therapy. 2. Diagnostic ultrasound imaging reveals relevant subclinical disease in the rheumatoid foot Catherine Bowden and colleagues from the university of Southampton University examine the application of the ultrasound in the detection of the of swollen plantar footwear bursae among individuals with and without RA. The study is highly crucial in that it reveals that musculoskeletal ultrasound among the RA patients is four times stronger than clinical assessment done by a competent podiatrist. Through the study, I noted that RA patients experience pain in their feet, which is caused by the synovitis in their small joints that include metatarso-phalengeal (MTP) joints. Moreover, it indicates that there is little clarity on the soft tissue inflammation’s role in the process. In addition, there is inadequate research on the relationship between the anatomical site particular areas and foot disease burden. The study’s objective of investigating the use of the musculoskeletal ultrasound (MSUS) in the examination of the forefoot plantar bursae, and testing of the hypothesis that the availability of the MSUS notable swollen bursae is a clinically important factor in the RA’s burden, is quite significant. Additionally, the cross-sectional study method used by the research team is effective in the attainment of the appropriate results. Other methods used included linear regression and logistic, transverse and standard longitudinal methods and the Leeds Foot Impact Scale (LFIS).The study was also effective in that the laboratory and clinical data was studies for RA study participants. In conclusion, the research effectively indicated that there is an under-investigation of the swollen plantar bursae in the foot and that it significantly contributes to the RA disease burden. Therefore, in my opinion, there is a need for the examination, imaging and suitable training the method. It is imperative that the significance for the patients is determined by the detection of the swollen plantar bursae with MSUS, particularly, early disease and enhancing suitable treatment decisions of the painful situation. 3. The impact of inter-professional education on allied health students’ clinical learning The study conducted by Caroline Robinson, outlines a qualitative study project that examines the effect of the link between physiotherapy learners’ clinical and inter-professional podiatry education. In my opinion, the study is beneficial in that it indicates that common learning that exists between health professional groups enhances respect for, and a deeper comprehension of, the function of each healthcare expert in the multidisciplinary team. It is worth noting that common instruction in a classroom does not essentially promote learning and more intense learning is possible to happen whenever there is a shared goal, mutual benefit, mutual respect, and a balance of authority between the various groups involved. The study’s main objective was effective in that it examined the influence of the inter-professional learning on related health students’ medical learning. Additionally, the methodology employed is appropriate in the achievement of the desired results. The study has used a mixed-techniques explanatory chronological design that allows the assessment of the participants’ reactions through a survey instrument and focus groups. In its initial, the study significantly employs quantitative methods in order to collect data, while in the second stage; it applies qualitative techniques through use of samples in order to obtain more detailed and richer information. In conclusion, it is true that inter-professional learning in a medical context improves professional education and development. Additionally, collaborative working with various connected medical practitioners enables learners to attain new thinking ways. Moreover, I find the article significant in addressing the issue at hand. 4. Root biomechanics versus biomechanics research data-time for change in podiatry biomechanics education This article is vital in the examination of the Professor Chris Nester’s presentation of a provocative address on the changing landscape of podiatric biomechanics. Additionally, the speaker foresees an unstoppable death of Root Biomechanics, and describes seven major matters in the Root Model. These include the emphasis rear foot and stationary assessment, normal foot, reward patterns for structural disorders, and foot mobility during the cycle. Moreover, I find it appropriate for the speaker to challenge the profession’s moving away from pseudoscience to the study-driven biomechanics in the medal practice and undergraduate education system. Moreover, his question on the need to up-skill in the employment of the actual employment of the biomechanics standards and to adopt changing examination with the patients-centered biomechanical models is significant. Moreover, the article addresses the issue of biomechanics’ future in medical practice. In addition, it imperatively handles the ways in which the students’ perspective on healthcare is changed by the understanding and the use of the podiatric biomechanics. Nevertheless, the article is inadequate in that it has not provided any of background information of the issue at hand, the research objectives, methodology, results and the discussion of the findings. As a result, it is hard to draw conclusions on the issue without any investigations done. 5. Healing the pigeon racer: closing the gap between hospital and ambulatory care This is an article by Danielle Veldhoen and friends from the Diabetes Center High-Risk Foot Clinic. This is article seeks to address the risks involved in the unseen foot ulceration. Through the case history, the article brings out the common issues of diabetic vasculopathy and neuropathy, with the history of amputation ad ulceration. It also significantly notes that the patients’ non-compliance with routine inspection and their inability to detect and know the symptoms delays medical treatment of a new case by a month. In addition, it explores ways in which patients’ compliance with the routine foot inspections and their ability to see and know the infection symptoms can be improved. Moreover, the article addresses other surgical alternatives for revascularization of the lower limbs. I find the article quite beneficial in that it demonstrates how people often misinterpret the infection symptoms for influenza. The fact that the article employs an illustration of local pigeon-racing fan and the 53-year old Sydney woman with prior foot ulceration medical history makes it very effective. Here, it is critical to learn ways in which the infection can be managed, that is instant treatment with intravenous drugs, debridement and revascularization succeeded by vacuum-assisted closure (VAC). Moreover, the article indicates that the care management that includes inpatient care, community nursing and multidisciplinary foot clinic management is influential in the preservation of the foot. This is also vital in that it emphasizes on the need to get medical attention and expert treatment in order to provide proper management of the ulceration. In addition, the article explicitly explains the importance of the collaboration between the outpatient and inpatient services in ensuring continuity of medical care, and the benefits of VAC in the treatment of complex and large foot wounds. Therefore, the article is suitable in that it illustrates better treatment and management of foot ulceration among patients. 6. An improbable patient; the risk/benefit ratio Reche Stevenson and Caroline Robinson of Charles Sturt University wrote the article with aim of exploring the medical decision-making process of examining highly vulnerable patients for nail surgery. The article is very useful in the establishment of the benefit or risk ratio and the comparative against absolute contraindications risks. To effectively address this issue, the authors have used an example of a 98-year old woman whose life involved lymphoedema, diabetes, hemiparesis, cardiac and immunicomprise disease. This also shows medical pathway that facilitated effective incomplete nail avulsions in domestic anesthesia through the application of electrosurgical matrixectomy. Explicitly, the article in explaining that surgical decisions require the consideration of the risk: benefit ratio. Moreover, it clearly notes that the effective surgical processes are those whose benefits outweigh the risks involved. Through an illustration of a patient that had multiple co-morbidities that underwent fruitful nail surgery for serious hallux nails involution. Additionally, the article’s significance is seen in the way it brings out the issue of Onychocryptosis as a substantial cause of pain, and the ability to result in morbidity, especially with the vulnerable patients. Consequently, the recommendation that such patients’ management should firstly be traditional with surgery kept for inflexible cases. In relation to this, I noticed that the risks of delayed would healing and post-operative infection associated with nail surgery can become a great threat to the limb itself. Therefore, the article is quite indispensable in facilitating successful nail surgery that is based on careful decisions, which entail minimal risks against numerous post-operative results even for the complex patients. 7. Charcot Arthropathy – the rocky road to healing: a case study This is a report submitted by David Wong and his friends at High-Risk Foot Clinic of Royal Prince Alfred Hospital (RPA). According to their report, the delayed medical attention, misdiagnosis, and unsuitable treatment negatively influence patients’ outcomes. Among the significant objectives of the report include the establishment of the clinical symptoms and signs of Charcot Arthropathy, and the patients who are at high risk. The article explains the meaning of Charcot Arthropathy as a late complication of diabetes, which typically happens among patients with a long time of stern peripheral neuropathy and diabetes. it s through the article that I learned that poor management and misdiagnosis issues are routine matters that are caused by the uncoordinated multidisciplinary and low prevalence foot healthcare, which failure to manage may lead to amputation. Understanding of the articles issues is made easier through outlining of major issues that include: risks involved in iatrogenic ulceration that follows total contact casting (TCC); orthopedic surgery’s role for elimination of skeletal prominence; necessity for multidisciplinary management; bivalving total contact casts and wound care; and alternative prevention with clinical grade footwear and foot orthoses. These issues are studied by use of an example of a 52-year old female patient that has type-2 diabetes, who is a social worker. Furthermore, the paper evidently indicates that an instant elimination of a severe Charcot foot is crucial, but because of misdiagnoses, this effect is rarely is attained. Moreover, application of TCC by inexperienced technician can have detrimental in the patients. Therefore, through the article, I learnt that successful elimination of the Charcot Arthropathy is achieved by orthopedic surgery, hospitalization for intravenous medicine, absolute casting and HRFC wound care. Further, it is note-worthy that patients should adhere to the pressure elimination in the achievement of the positive results. 8. Evaluating Abductor Hallucis Muscle Using Ultrasound: Reliability Study Professor Keith Rome and friends of Auckland University of Technology wrote an article that is influential in testing the reliability of ultrasound examination of the abductor hallucis muscle. Interestingly, this turns out to be the initial research on the application of the ultrasound in measuring abductor hallucis in asymptomatic individuals. It is notable that medio-lateral width, dorso-planter thickness, and cross-sectional area showed great reliability both in each session and in a seven-day interval sessions. The study is important because it addresses issues that include the attachment sites of the abductor hallucis, and the clinical implications of a test that has great intra-rater reliability, but with reduced inter-rater reliability. The research’s objective is vital in that it seeks to assess between and within session intra-tester reliability by use of ultrasound of medio-lateral width, dorso-planter and cross-sectional area among adults. The use of the Philips HD11 Real-time Ultrasound machine in measuring 30 asymptomatic adults is appropriate in the attainment of the desired outcomes. The repetition of the study on both feet is instrumental in the provision of appropriate and reliable results in the study. Therefore, the most important matters addressed in the research include the ability to use ultrasound in the evaluation of the AbdH muscle; the fact that future study can consider three-dimensional measurements in collaboration with the advanced technology; and that future studies done with the present protocol can provide an explicit understanding of the function of the AbdH muscle in pathological situation, which may influence ankle and foot. 9. Clinical relevance of standardized paediatric assessments for the profession This is a highly-indispensable article in the exploration of benefits of standardization of paediatric evaluation. The according was written by Brett Waddell who is an occupational therapist and podiatrist. I agree with Brett’s argument that through standardization of pediatric evaluation, podiatrists can be well-equipped to interact and work in a multidisciplinary team. Through the standardization of the Peabody Developmental Motor Scales (PDMS-2) and Bruininks-Oseretsky Test of Motor Proficiency (Bot-2), the author effectively communicates his ideas. It is also through the article that I learnt that BOT-2 measures fine and gross motor skills among individuals aged between 4 and 21 years. On the other hand, PDMS-2 measures developmental landmarks from birth till the age of six years. Another significant thing about the article is that it addresses salient issues, such as, merits and demerits of employing standardized paediatric evaluation techniques as part of medical evaluation. Moreover, the article demonstrates that podiatrists usually work within various teams of other health specialists in assessment of children. Some of these teams include trans-disciplinary and multi-disciplinary teams that consist of speech pathologists, physiotherapists, psychologists, social workers and occupational therapists. Additionally, the article is useful in that it advises that strong communication and extensive examination across discipline is vial in devising reliable medical picture of children’s weaknesses and strengths. In addition, the exploration of the standardized evaluation can help the podiatrists working in team settings to enhance communication and exchange information with other medical professionals in the assessment of the children and development of the results that are founded on dependable evidence. 10. Management of diabetic foot infections This is an important article by Dr Robert Frykberg that handles the way in which management of diabetic infection of the foot can be effectively achieved by the medical practitioners. The author illuminates on the clinical types of the aforementioned infections, and the four available infection grades categorization that is developed by the International Consensus on the Diabetic Foot (ICDF). In addition, the authors’ description of the clinical evaluation and treatment of foot infections is extremely vital. I am also impressed by the presentation of results of the recent investigations on the risk factors for the development of the osteomyelitis. Additionally, I find the article quite advantageous in that it addresses the most salient issues that include the issues that constitute a grade three infection as per the ICDF’s infection classification. In addition, the article is important in that it discusses the microbial composition of most moderate to acute diabetic foot infections among individuals. Therefore, it is highly indispensable in that it enables the medical practitioners to effectively manage foot infections among diabetic patients. In turn, the medical officers will guide their patients on ways in which they can appropriately take care of their foot infections. Nevertheless, the author has failed to use illustrations in order to tackle his topic well. Illustrations would play a key role in enhancing the reader’s understanding and retention of the issue at hand. Moreover, evidence-based information is of utmost importance among clinicians since they can apply researched and proven knowledge and guidelines while carrying out their duties. Therefore, the author ought to add more examples in the article in order to help the physicians effectively manage foot infection among diabetic patients. 11. Prophylactic surgery in the diabetic foot This is an article prepared by Dr Robert Frykberg in form of a speech. This is his last performed in the 2009 conference where he sheds light on surgical alternatives of managing a diabetic foot. In his presentations, it is noteworthy that there are certain risks involved in common foot deformities, ulceration, and primary theories of diabetic foot wounds treatment. I also find his article very informative in that it has an introduction of Revised Classification of Diabetic Foot Surgery (RCDFS) and provision of indications and illustrations for each category. In order to effectively tackle aforementioned issues, the speaker discusses the available four categories of surgery as identified by the RCDFS. Nevertheless, the article has not provided adequate illustrations that could have been influential in the more understanding of the alternative of managing diabetic foot ulcers. Moreover, the use of studies could have been more advantageous in a more explicit illumination on the surgical alternatives of the foot infections. What is more, studies are beneficial in providing adequate reference guidance to the medical practitioners in the effective management and treatment of foot ulcers among diabetic patients. Therefore, the article is appropriate in examining surgical alternative ways of managing and treating foot ulcers in diabetic individuals. However, it is imperative that the author employs more examples, and refer to many early studies in order to bring out his subject clearly. Read More