Biomedical subjects

K T Jules

Publications and source records attributed to K T Jules.

8 recordsLinked to original sources

PubMed1997

Buffered lidocaine decreases the pain of digital anesthesia in the foot.

The pain associated with injections for inducing digital anesthesia can be decreased by adding sodium bicarbonate to plain lidocaine. A randomized, double-blind study has demonstrated that 24 out of 30 participants indicated on a visual analogue scale that buffered lidocaine is less painful than plain lidocaine. The pain decreased by 50% or more for almost half of the participants. Practitioners can easily buffer lidocaine in the office by adding a small volume of sodium bicarbonate to plain lidocaine.

Adult↗

PubMed1996

Longitudinal epiphyseal bracket: associated foot deformities with implications for treatment.

The longitudinal epiphyseal bracket is a rare ossification defect of bones of the hands and feet and results in an abnormal epiphysis that is C-shaped, longitudinally oriented, and vertically extends into the diaphysis. The longitudinal epiphyseal bracket may exist as an isolated deformity, but is commonly associated with digital deformities such as polydactyly, duplicated digits, congenital hallux varus, and clinodactyly. Five case histories of children with the longitudinal epiphyseal bracket in different bones of the foot are described with three distinct clinical presentations. The development of the longitudinal epiphyseal bracket and implications for treatment are considered.

Adolescent↗

PubMed1996

Nailbed injuries with hallucal phalangeal fractures--evaluation and treatment.

Adequate assessment of crush injuries to the hallux is necessary before appropriate management can be initiated. When distal phalangeal fractures of the hallux are detected by routine radiography and subungual hematomas are present, open fractures of the hallux may be overlooked if the physician does not routinely avulse the nailplate. The authors review current modalities for the detection and evaluation of these injuries and present a protocol for treatment.

Anti-Bacterial Agents↗

PubMed1991

The clinical anatomy of tendons.

The main features of tendon anatomy are described. From the clinical viewpoint, the most significant are those relating to connective tissue layers surrounding tendons: the paratenon and the synovial (tendon) sheath, and the sources and sites of blood supply. These aspects of tendon anatomy are interactive in the healing process, which requires continuation of blood supply into the tendon while avoiding functionally inhibiting adhesions in the connective tissue. Surgical methods of tendon repair and techniques for achieving successful postoperative results are reviewed.

Humans↗

PubMed1989

Nail infections.

Nail infections are and will continue to be a diagnostic and therapeutic challenge to all foot physicians. Attention to basic concepts of accurate detailed history and physical examination will aid in the determination of the etiology of these infections. Following basic guidelines of incision and drainage, gram stain, soaks, and antibiotics will be the cornerstone of initial treatment of pyogenic infections. Upon resolution of the acute infection a permanent treatment plan can be constituted based on the etiology. Nail infections of mycotic nature require an understanding by both patient and doctor as to the difficulty and resistance to treatment of this problem. It is the authors' opinion that aggressive persistent treatment will provide the best long-term result when dealing with mycotic infections. This may require nail removal, local and systemic treatment as well as change in shoe environment. As we have seen and is stated throughout this text, the nail and its pathologic processes can be a mirror of systemic disease. Many times a dystrophic infected nail may be the initial clinical presentation of a much more involved disease process. It is the responsibility and duty of all foot physicians to have a total understanding of knowledge of normal and pathologic process that affect the nail plates, nail bed, and surrounding nail proper. I hope this article will stimulate the foot physician to approach the disease of the nail with a high index of suspicion and respect.

Bacterial Infections↗

PubMedDate not supplied

A double-blind study of the effect on hemostasis of nabumetone (Relafen) compared to placebo.

A double-blind, placebo-controlled clinical trial comparing the effect on hemostasis of nabumetone (Relafen) to placebo in patients who were about to undergo forefoot surgery was performed. Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) are reported to inhibit platelet cyclooxygenase activity, resulting in altered platelet function and thus potentially enhanced bleeding. Nabumetone has been reported to have no effect on platelet aggregation and bleeding time in normal volunteers and in patients who have undergone knee arthroscopy. After fulfilling the inclusion criteria and after a 1-week washout period (acetaminophen controlled), 15 patients were enrolled in the nabumetone group and 15 patients were randomized in the placebo group. Hemostatic parameters [prothrombin time (PT), partial thromboplastin time (PTT), and Ivy bleeding time (IBT)] were assessed at baseline, visit 2, visit 3, and final visit. No meaningful differences were observed between treatment groups in any of the measured hemostatic parameters. No significant adverse events were reported. There was no significant change from baseline for PT, PTT, and IBT in the nabumetone group (PT, p < .06; PTT, p < .64; IBT, p < .17) versus the placebo group (PT, p < .61; PTT, p < .63; IBT, p < .25). The lack of bleeding diathesis and significant prolongation of PT, PTT, or IBT in this study suggests that nabumetone in dosages up to 1000 mg/day can be administered safely in the immediate preoperative period to patients undergoing forefoot surgery.

Adult↗

PubMedDate not supplied

Dermatofibrosarcoma protuberans: 4 years after local trauma.

Dermatofibrosarcoma protuberans (DFSP) is a low grade, fibrohistiocytic malignant soft tissue tumor that arises infrequently in the foot and ankle region. It most frequently demonstrates a "storiform" histologic pattern, and if incompletely excised, may be recurrent, more anaplastic and metastatic. Soft tissue plain film radiography, as well as magnetic resonance imaging (MRI) help outline the tumor and involved tissues, which is beneficial in staging, determining surgical approach and evaluation of therapy. Definitive diagnosis is made by biopsy. A dermatofibrosarcoma protuberans is reported in the foot of a 14-year-old female patient, 4 years after trauma to the site.

Adolescent↗

PubMedDate not supplied

Fixation of the Austin osteotomy with bioresorbable pins.

Clinical trials were conducted at the Foot Clinics of New York, testing the use of the Johnson & Johnson Orthosorb absorbable pins as an integral absorbable form of fixation of the Austin osteotomy. Two Orthosorb pins were inserted across the osteotomy from dorsal to plantar. Patients were placed in a plaster splint and allowed to walk with weightbearing as tolerated within 2 weeks of the procedure. A protocol was designed to include a 6-month follow-up with regularly scheduled postoperative examinations. These examinations included a review of pain, walking ability, edema, and measurements of dorsiflexion and plantarflexion. No complications have occurred in this patient population. This study has shown that for a selected group of surgical candidates, Orthosorb bioresorbable pins are an effective form of fixation for the Austin osteotomy.

Absorption↗