Efficacy of 25% dextrose versus breast milk on pain and duration of cry during heel prick in neonates: A systematic review and meta-analysis

Neonates,especially admitted to neonatal intensive care unit,frequently need various medical interventions in their early days.A common procedure is the heel prick for blood sampling.Although necessary for diagnosis,this procedure can be stressful for neonates,causing pain,extended crying,and discomfort.Reducing distress in neonates during such procedures is important for the well‐being of neonates and the satisfaction of caregivers and healthcare providers.Therefore,this review aims to identify and compare the efficacy of 25%dextrose and breast milk on pain and duration of cry among neonates during heel-lance.As part of its review process,the article examined widely used databases,including PubMed,EMBASE,Cochrane,Academia,and Google Scholar.For the meta-analysis,the authors utilized RevMan 5.4.All eligible trials were analyzed using the Cochrane Risk of Bias Tool to assess the quality of the included studies and evaluate the risk of bias.Out of 131 studies reviewed,seven studies were included in meta-analysis of pain,and four studies were included in duration of cry.The results show that 25%dextrose is more effective to reduce pain among neonates during minor invasive procedure like heel prick(P<0.00001),whereas both interventions are effective in the reduction of crying duration.This review highlights that dextrose is more effective in reducing pain in comparison to breast milk.However,additional well-designed studies with larger sample sizes and extended follow-up periods are needed to validate and build upon the current findings.Hence,this review underscores the importance of utilizing effective pain management strategies,such as 25%dextrose,to enhance neonatal care and improve the overall well-being of newborns during invasive procedures.

Topical 15% Zinc Sulfate Solution Is an Effective Therapy for Feet Odor

Background: Feet odor is a common sociomedical problem that affects the feet of human beings of different etiological factors. Multiple modalities of therapy have been used in the treatment of feet odor. Objective: To evaluate the efficacy and safety of topical 15% zinc sulfate solution in the treatment of feet odor. Patients and Methods: This single blind, placebo, controlled therapeutic study was conducted at the Department of Dermatology-Baghdad Teaching Hospital, from March 2010 to July 2011. A total of 108 (88 males and 20 females) patients with feet odor were enrolled and were divided into 2 groups: Group A: treated with 15% zinc sulfate solution. Group B: treated with distilled water as placebo control group. Full history and examination were carried out including all relevant points. Four scoring had been used to assess the severity of odor in patients with bared feet Score 0: no odor, Score 1: mild odor, Score 2: moderate odor and Score 3: severe odor. Zinc sulfate solution 15% was applied to sole and toe webs once daily for two weeks, three times per week for next two weeks and followed by single application weekly as maintenance after clearance of odor for two months. Patients were seen every two weeks to be examined and to score the odor again and to record side effects. Results: Group A: Fifty patients completed the study, their ages ranged from 8 - 68 (33 + 14.5) years, while the duration of the disease ranged from 1 - 180 (7.22 + 38.24) months. The complete clearance of feet odor after two weeks of therapy was 35 (70%) patients which was similar to two months maintenance therapy 35 (70%) and was highly statistically significant (p value = 0.0000001). Group B: Fifty patients received the placebo solution, their ages ranged from 16 - 75 (32.6 + 13.4) years, while the duration of the disease ranged from 1 - 180 (43.7 + 47.65) months. The complete clearance of feet odor was in 1 (2%) patient after two weeks therapy and after two months maintenance therapy. No side effects were recorded. Conclusions: Topical 15% zinc sulfate solution had an effective therapeutic and prophylactic action against feet odor.

Calcified plaque: the Achilles' Heel of present computed tomography coronary angiography for the elderly?

Nine percent to 27% of cardiac catheterizations today showed either angiographic normal coronary arteries or minimal atherosclerosis. 1,2 Given the expense of cardiac catheterization and the desire to use this valuable resource for therapeutic rather than diagnostic purpose, there is a strong impetus to develop non-invasive means of accurately detecting significant coronary artery stenosis.……

The Effect of Taping on Foot Structure, Functional Foot Stability and Running Gait Patterns of the Foot

Running related foot injuries are associated with excessive foot movements due to malaligned foot structure and poor functional foot stability. Clinicians tape the foot to alleviate pain and prevent further injuries, whilst allowing the athlete to continue training. However, the effect of taping is not conclusive. The purpose of this study is to investigate if taping effectively improves foot structure, functional foot stability and reduces excessive foot movements during running. Twenty-two subjects had their foot structure identified as： fiat foot stable, fiat foot unstable and normal arched unstable according to the FPI （foot posture index） and the Modified Romberg＇s Test with the BESS （balance error scoring system） criteria. The subjects ran on an instrumented treadmill barefooted with their feet taped and untaped. Running kinetic and kinematic data were collected and analysed using a paired t-test and 3x2 ANOVA. Taping improved foot structure but not functional foot stability. During running, taping significantly reduced rearfoot eversion. Taping increased the loading rate in the fiat foot and normal arched unstable groups but reduced the loading rate for the flat foot stable group. Implication on the appropriate use of foot taping was discussed.

A Prospective Single-Arm Investigation Assessing Performance of a Multifunctional Foot Cream in Subjects with Tinea Pedis Interdigitalis and Heel Cracks, Calluses and/or Dry Feet

This prospective, open-label, single-arm investigation evaluated the performance of a multifunctional foot cream used twice daily for 8 weeks in the combined treatment of mild/moderate tinea pedis interdigitalis (TPI) and heel cracks, calluses and/or dry feet in 46 adult subjects. All subjects showed reductions in the severity of symptoms of both TPI (53.7% reduction) and heel cracks, calluses and/or dry feet (51.6% reduction), beginning already after 2 weeks of treatment, with reduction continuation and improvement after 4 and 8 weeks of treatment. Negative mycological cultures were obtained post-treatment in 85.7% of subjects, while 35.7% of subjects also obtained mycological cure (negative mycological culture + negative KOH test). Post-treatment questionnaires showed improved quality of life, good treatment tolerability, easy use, and that 69% of subjects would recommend the product. The results reveal that the foot cream is safe and effective in the combined treatment of TPI and heel cracks, calluses and/or dry feet.

Study on the Effect of the Intervention on Traditional Chinese Medicine Negative Heel Shoes in Geriatric Orthopedics Patients

In the clinical practice of orthopedics,geriatric patients are prone to form and exhibit complex and diverse clinical complications during long-term bedridden treatment.This can result in poor survival rate and adverse final clinical outcomes.Hence,it is essential to select appropriate methods for nursing intervention and health-care support for long-term bedridden geriatric orthopedic patients.It is of great significance to support and guarantee patients to obtain the best clinical results.This article focuses on the topic of interventional health effects of traditional Chinese medicine negative-heeled shoes in orthopedic bedridden patients,and two specific aspects were selected for a brief explanation.

“the Heel of Achilles”中的heel是脚后跟吗?

英语中的“heel”,就是汉语里的“脚后跟”,无可争议。但成语“the heel of Achilles”(或“Achilles’s heel”),在《新英汉词典》里的释义是“唯一致命的弱点”,一般也可译成“致命弱点'、“要害”、“可乘之隙”,都与“脚后跟”不相干。有例句为证:

Biomechanical evaluation of heel elevation on load transfer——experimental measurement and finite element analysis

In spite of ill-effects of high heel shoes, they are widely used for women. Hence, it is essential to understand the load transfer biomechanics in order to design better fit and comfortable shoes. In this study, both experimental measurement and finite element analysis were used to evaluate the biomechanical effects of heel height on foot load transfer. A controlled experiment was conducted using custom-designed platforms. Under different weight-bearing conditions, peak plantar pressure, contact area and center of pressure were analyzed. A three-dimensional finite element foot model was used to simulate the high-heel support and to predict the internal stress distributions and deformations for different heel heights. Results from both experiment and model indicated that heel elevations had significant effects on all variables. When heel elevation increased, the center of pressure shifted from the midfoot region to the forefoot region, the contact area was reduced by 26% from 0 to 10.2 cm heel and the internal stress of foot bones increased. Prediction results also showed that the strain and total tension force of plantar fascia was minimum at 5.1 cm heel condition. This study helps to better understand the biomechanical behavior of foot, and to provide better suggestions for design parameters of high heeled shoes.

Calcaneal osteochondroma masquerading as plantar fasciitis: An approach to plantar heel pain-A case report and literature review

BACKGROUND Heel pain is a common orthopaedic complaint,and if left untreated can be a source of chronic morbidity.Accurate diagnosis can be challenging,owing to the complex anatomy and multiple pain generators present in the foot.We aim to share our clinical experience managing an unusual case of chronic heel pain secondary to osteochondroma.CASE SUMMARY A 41-year-old obese male who works as a porter presented with a long-standing history of left plantar heel pain.He was assessed to have point tenderness over the plantar insertion of the calcaneus as well as a positive Silfverski?ld test.He was treated for plantar fasciitis and tight gastrocnemius but failed conservative therapies as well as surgical intervention.Magnetic resonance imaging revealed the presence of a pedunculated bony protrusion over the plantar aspect of the calcaneus.The decision was made for excision of the osteochondroma,and the patient has been pain-free since.CONCLUSION Osteochondromas are rarely symptomatic in skeletally mature patients.While most are benign with a very low risk of malignant transformation,surgical excision can yield excellent results and significant pain relief in symptomatic patients.

Footwear modification following hallux valgus surgery: The all-or-none phenomenon

AIM:To define footwear outcomes following hallux valgus surgery,focusing on patient return to comfortable and heeled footwear and patterns of post-operative footwear selection.METHODS:Surgical intervention is indicated for symptomatic cases of hallux valgus unresponsive to conservative methods,with favourable reported outcomes.The return to various types of footwear postoperatively is reflective of the degree of correction achieved,and corresponds to patient satisfaction.Patients are expected to return to comfortable footwear post-operatively without significant residual symptoms.Many female patients will additionally attempt to return to high-heeled,narrow toe box shoes.However,minimal evidence exists to guide their expectations.Sixtyfive female hallux valgus patients that had undergone primary surgery bet ween 2011 and 2013 were retrospectively identified using our hospital surgical database.Patients were reviewed using a footwearspecific outcome questionnaire at a mean 18.5 mo follow-up.RESULTS:Eighty-six percent of patients were able to return to comfortable footwear post-operatively with minimal discomfort.Of those intending to resume wearing heeled footwear,62%were able to do so,with 77%of these patients wearing these as or more frequently than pre-operatively.No significant difference was observed between pre-and post-operative heel size.Mean time to return to heeled footwear was 21.4wk post-operation.Cosmetic outcomes were very high and did not adversely impact footwear selection.CONCLUSION:We report high rates of return to both comfortable and heeled shoes in female patients following primary hallux valgus surgery.We observed an"all-ornone phenomenon"where patients rejected a return to heeled footwear unless able to tolerate them at the same frequency and heel size as pre-operatively.A minority of patients were unable to return to comfortable footwear post-operatively,which had adverse ramifications on their quality-of-life.We recommend that the importance of managing patient expectations through appropriate pre-operative counselling be emphasized in forefoot surgery.

Modeling and analysis of passive dynamic bipedal walking with segmented feet and compliant joints

Passive dynamic walking has been developed as a possible explanation for the efficiency of the human gait. This paper presents a passive dynamic walking model with segmented feet, which makes the bipedal walking gait more close to natural human-like gait. The proposed model extends the simplest walking model with the addition of fiat feet and torsional spring based compliance on ankle joints and toe joints, to achieve stable walking on a slope driven by gravity. The push-off phase includes foot rotations around the toe joint and around the toe tip, which shows a great resemblance to human normal walking. This paper investigates the effects of the segmented foot structure on bipedal walking in simulations. The model achieves satisfactory walking results on even or uneven slopes.

Where Do We Stand on High Heels in 2018? An Audit

We present an audit of public awareness, freedom of choice and health behavior change relating to high heel wear subsequent to a major public awareness campaign in the summer of 2017. Substantial reductions in workplace high heel wear were found, whereby increasingly those who wear high heels regularly at work have freely chosen to do so, although certain issues of social expectations remain in certain sectors. Largely, freedom of choice has greatly increased in workplaces in line with increased public and employer awareness.? However, high heel wear has not substantially reduced in social settings, and progress has not been made with social expectation and explicit requirement to wear high heels at social events.

Sever’s Disease: An Underdiagnosed Foot Injury in the Pediatric Emergency Department

Sever’s disease—also known as calcaneal apophysitis—is a common cause of heel pain in pediatric patients typically aged 7 - 14 years old. Sever’s disease can be painful and limit a child’s function as well as participation in physical activity. Herein, we described a case of delayed presentation of chronic Sever’s disease in a child who had been experiencing heel pain for over one year which worsened substantially when the child began to participate in sports. This is important for the emergency medicine physician because Sever’s disease represents an underdiagnosed cause of foot and heel pain in the pediatric patient and may be often missed. We describe the diagnosis and treatment options of Sever’s disease as well as associated controversies, e.g., whether activity is indeed the cause of Sever’s disease and whether imaging is needed for a diagnosis.

街舞元素Happy feet基础动作理论及其文化价值

文章运用文献法、观摩法、视频分析法和实践法,首先从基本形态、节奏与呼吸、动作重难点这三个方面分析拆解街舞元素Happyfeet的基本动作理论,再根据经典作品案例分析该元素融入成人及少儿齐舞的方式特点,为该元素的运用提供理论依据。最后,从审美价值、健身价值、娱乐价值角度深度分析该元素存在的文化价值,进而探索该元素的运用规律。

Barefoot and High-Heeled Gait: Changes in Muscles Activation Patterns

Most women like wearing high-heeled shoes for the benefit of sensuous attractiveness and self-esteem while musculoskeletal problems and gait patterns changes are often associated. The present study aimed to identify changes during the gait stance and swing phases in some lower limb muscles. In addition, abdominal muscle was included due to its importance in dynamic trunk stability, and lack of studies on the subject. Here, we found that the use of high-heeled shoes elicited not only the increasing of the electrical activity from the muscles involved in the gait cycle, but also altered the temporal sequence of their recruitment. As practical applications, these changes may be strategies to maintain stability and minimize risks of falling, but they are often associated to diseases. Women that use high-heeled shoes for prolonged time must apply specific muscle exercises to minimize its long-term effects.

Effect of Flat Heel-Toe Difference of a Card on Yarn Unevenness and Usual Faults

Effect of flat heel-toe difference (HTD) of a card on some parameters of yarn quality was studied by testing the yarn which was produced under different HTDs, doffer speed, and cylinder speed with yarn evenness tester of PT7000. The effect of HTD on yarn parameters was analyzed by using SPSS. The results show that HTD has significant influence on parameters of thickness fault and nep. As a whole, the HTDs of 0.42 and 0.56 mm are beneficial to improving yarn quality in comparison with the other HTDs.

Clinical Assessment of a Mesotherapy Formulation for Skin Rejuvenation in Healthy Volunteers

Mesotherapy is a mildly invasive procedure involving several subcutaneous drug injections, which are performed simultaneously. The concept is to inject a very small amount of active compounds (hyaluronic acid, vitamins, antioxidants, enzymes, humectants, …) and the aim is to stimulate the biosynthetic capacity of fibroblasts, increase collagen and elastin production and to give active essential molecules for a fibroblasts environment. Numerous studies suggest that the mesotherapy procedure improves skin hydration and mechanical properties;however, some results have not been statistically significant. In this study, we investigated an antiaging treatment as a complementary approach to a non-surgical rejuvenating procedure after 5 sessions of mesotherapy. Our main objective was to assess the improvement of face, neck and neckline skin quality, after intradermal microinjections of NCTF 135HA&reg. This mixture, manufactured by FILORGA Laboratories, includes a non-cross-linked hyaluronic acid, vitamins, antioxidants, mineral salts and enzymes. A statistically significant decrease in the depth of crow’s-feet wrinkles (43.3%) and in pore size (58.5%) was observed. Also, dermatological scores showed a significant decrease, and data suggest that skin tone was improved with a brighter tone. The injected mixture could then have an action on the skin pigmentation process with a photoprotective effect. Evolution of Dermis density was also investigated and an increase of dermal density and thickness were highlighted, showing an improvement of skin firmness with significant increases of dermis thickness (20%) and dermis density (24%), indicating a neocollagen activity.

Are calves trainable?Low-intensity calf muscle training with or without bloodflow restriction:a randomized controlled trial

bjectives:Whether low-load resistance training(RT)without muscle failure,with or without bloodflow restriction(BFR),is suffcient to increase strength and muscle growth of calf musclesin trained individualsisstill unclear.This study aimed to compare the effects of low-intensity BFR RT vs.traditional low-intensity RT(noBFR)with moderate training volume on strength and circumference.Methods:We designed a parallel,randomized controlled trial including 36 RT-trained participants(BFR:7 females,32.9±8.8 years,11 males,28.4±3.6 years;noBFR;8 females,29.6±3.4 years;10 males,28.6±4.9 years)who underwent eight weeks of twice-weekly low-load RT with a total of 16 RT sets(30%of one-repetition maximum[1RM]).RT consisted of bilateral calf raises and seated unilateral calf raises,each conducted with 4 sets(30,15,15,15 repetitions not to failure)of either BFR or noBFR.Outcome measures included calf circumference(CC),leg stiffness(LS),and various strength tests(seated and standing calf raise 1RM,isokinetic strength of plantar-and dorsiflexion).Results:There were no significant interactions or group effects for most measures.Both groups showed significant improvementsin seated calf raise strength(p=0.046,η^(2)p=0.17).Pairwise comparisons indicated moderate to large effect sizes for strength improvements(standardized mean differences:0.35–1.11),but no changes in calf circumference were observed in either group.Conclusions:Low-load RT with and without BFR are useful to increase strength without necessarily affecting hypertrophy.Low-intensity BFR training did not confer additional benefits over traditional low-intensity RT for calf muscle strength or circumference,questioning its general advantage under such conditions.

活血跌打促愈方联合骨肽片对SandersⅡ、Ⅲ型跟骨骨折患者术后骨折愈合的影响

目的观察活血跌打促愈方联合骨肽片对SandersⅡ、Ⅲ型跟骨骨折患者术后骨折愈合的影响。方法选取2021年2月至2023年6月就诊于周口骨科医院的124例跟骨骨折(Sanders分型属于Ⅱ、Ⅲ型)患者,根据随机数字表法分为两组。两组均接受外侧入路手术治疗,术后均接受抗生素和甘露醇治疗,骨肽片组术后接受骨肽片治疗,联合组术后接受活血跌打促愈方联合骨肽片治疗。比较两组皮肤皱褶试验阳性时间、切口愈合时间、视觉模拟评分法(VAS)评分、肿胀消除率、术后足部功能优良率及不良反应率,检测两组疼痛介质、骨代谢水平。结果联合组皮肤皱褶试验阳性时间、切口愈合时间短于骨肽片组,术后1、5 d的VAS评分低于骨肽片组,术后1、5 d的肿胀消除率高于骨肽片组,差异有统计学意义(P<0.05)。两组术前疼痛介质、骨代谢比较,差异无统计学意义(P>0.05)。两组术后P物质(SP)、前列腺素E2(PGE2)均较术前降低,骨形成蛋白-2(BMP-2)、骨保护素(OPG)、Ⅰ型前胶原羧基端肽(PICP)、骨碱性磷酸酶(BALP)均较术前升高(P<0.05)。联合组术后SP、PGE2均低于骨肽片组,BMP-2、OPG、PICP、BALP均高于骨肽片组(P<0.05)。联合组术后足部功能优良率为91.94%,高于骨肽片组的79.03%,总不良反应率为6.45%,与骨肽片组的3.23%比较,差异无统计学意义(P>0.05)。结论活血跌打促愈方联合骨肽片可促进SandersⅡ、Ⅲ型跟骨骨折患者术后骨折愈合,减轻疼痛,促进骨代谢,提高术后足部功能。

左足颗粒细胞瘤一例

颗粒细胞瘤(granular cell tumor,GCT)是一种罕见软组织肿瘤,临床皮损不典型,好发于头颈部,发生于足部者少见。本患者左足跟角质性斑块20年,组织病理示:真皮内见大圆形细胞排列成巢状,细胞核小、居中,胞质内见嗜酸性颗粒。免疫组化:S-100(+)、SOX10(+)、NSE(+)、CD68(+)。诊断为颗粒细胞瘤,予以手术切除。