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PubMed2001

[Clinical picture and differential diagnosis of foot and mouth disease in cattle].

Foot-and-mouth disease (FMD) in cattle is characterized by the formation of vesicles and erosions in the mouth, teats and feet. Despite extremely high morbidity, mortality in adults is usually very low, however up to 50% of calves dies due to cardiac involvement or secondary infections. This paper describes the signs of FMD in cattle as well as those of other diseases which causes similar lesions in this species.

Age Factors↗
PubMed2000

The role of management segregations in controlling intra-herd foot-and-mouth disease.

Transmission of foot-and-mouth disease virus (FMDV) by aerosol spread can occur over considerable distances. However, this is less effective in hot, dry environmental conditions, and a detailed study of an outbreak within a large dairy herd in Saudi Arabia has shown that contact spread is the main mode of transmission within a herd: both physical and spatial barriers curtailed the course of disease across the farm. Hence, the speed and path of an outbreak can be altered by changing the positioning of spatial or physical barriers. Extending the distances between pens, increasing the number of farm pens, decreasing the number of animals within the pens, and placing pens of well-protected stock between those of susceptible stock, can all contribute to the control of FMD involving contact and short-distance aerosol spread. Such management techniques offer a cost-effective supplement to control by vaccination.

Animal Husbandry↗
PubMedDate not supplied

[Effective operations of the foot. Report of experiences after 25 years of administration of the orthopedic department].

Report on proven methods of operation for the typical foot diseases. Particular emphasis is put on the possibilities for correction of many deformities of the foot through Chopart-arthrodesis by corresponding wedge-removal from the root of the foot, as underlined by Imhäuser. The Chopart-arthrodesis is especially suitable for treating weight-bearing complaints of mal-healed fractures of the calcaneum, because this procedure stabilizes the hindfoot and sets the mid- and forefoot plantarly. For post-operative recurrences of toe deformities, syndactily-operations are recommended.

Ankle Injuries↗
PubMedDate not supplied

Iloprost infusion in diabetic patients with peripheral arterial occlusive disease and foot ulcers.

The aim of the study was to evaluate iloprost infusion as an alternative to open surgical revascularisation in diabetic patients with foot ulcers, also as a support measure in conjunction with endovascular procedures. We studied 244 patients with critical ischaemia of the lower limbs, 146 of whom (59.8%) affected by diabetes. A femoro-distal bypass was performed in 175 patients. In the 69 nonsurgical diabetic patients (47.3% of the diabetics) an iloprost infusion was started. These diabetics presented foot ulcers, a palpable or slightly hypo-sphygmic popliteal pulse and high distal arterial flow at the ankle. In 55 of these patients (79.7% of those not operated on and 37.6% of the diabetics) who were non-responders to medical therapy, an endovascular procedure was also performed. The results of the iloprost infusion (69 pts.) were evaluated after one week. In 14 responders treated only with iloprost infusion, complete healing of the lesions occurred during the 3 weeks following the end of the 4-week course of therapy. No severe ischaemia recurrences were reported in the follow-up of these 69 patients. In the 47.3% of subjects with diabetic arteriopathy presenting foot ulcers and high distal flow, it proved possible to avoid an open surgical revascularisation procedure and to resort to medical therapy with iloprost, completed in 79.7% of cases with endovascular procedures. Iloprost infusion improves limb perfusion and, in selected cases may be an important therapeutic tool for the care of ulcerative lesions of the diabetic foot, also as a support measure in conjunction with endovascular procedures.

Angioplasty, Balloon↗
PubMed2002

Further studies to quantify the dose of natural aerosols of foot-and-mouth disease virus for pigs.

Foot-and-mouth disease virus (FMDV) can be spread by a variety of mechanisms, including wind. Simulation models, developed to predict the risk of airborne spread, have played an important part in decision making in some outbreaks. The amount of airborne virus excreted as well as the minimal infectious dose (MID) of FMDV for different species are important determinants of airborne spread. The objective of this study was to obtain data for the O1 Lausanne, O SKR 2000 and O UKG 2001 strains of FMDV to enhance the capability of such models. Pigs were exposed to naturally generated aerosols of the three strains using an experimental design which delivered high doses of the two strains O1 Lausanne and O SKR 2000 over a short period, or of the O UKG 2001 strain over an extended period. The average excretion of the O1 Lausanne strain was 10(6.4) TCID50 per pig per hour. The excretion of the O SKR 2000 strain averaged 10(5.8) and the O UKG 2001 strain 10(6.1) TCID per pig per 24 h. The results show that the previous estimate of 'above' 800 TCID50 as the MID50 for the O1 Lausanne strain is a considerable under-estimate and that the real dose may be as high as 6000 TCID50. A dose of around 650 TCID50 of the O SKR 2000 strain failed to infect any pigs. Thus, the aerosol MID50 for pigs for this isolate is at least 1000 TCID50 and likely to be as high or higher than the O1 Lausanne strain. The exposure of pairs of recipient pigs kept physically separated from donor pigs in a series of rooms to aerosol exposure doses of the O UKG 2001 strain of around 50 TCID50 per min for 24-48 h failed to infect any of eight pigs. Thus, the present experiment confirms our previous findings that pigs, compared to cattle and sheep, are relatively resistant to infection with airborne FMDV.

Aerosols↗
PubMed1999

Preventing diabetic foot complications. Tight glucose control and patient education are the keys.

Foot disease is a common complication of diabetes that can have tragic consequences. Tight glucose control can reduce microvascular diabetic complications, including peripheral sensory neuropathy and thus development of foot ulcers. Patient education is essential for risk-factor reduction and early recognition of foot complications. Awareness and training of healthcare providers in diagnosing and treating diabetic foot disease are paramount and may begin with such simple measures as adding a wall poster or chart reminder to conduct foot examinations in all diabetic patients at every office visit.

Blood Glucose↗
PubMed2004

Cost-effectiveness of prevention and treatment of the diabetic foot: a Markov analysis.

OBJECTIVE: To estimate the lifetime health and economic effects of optimal prevention and treatment of the diabetic foot according to international standards and to determine the cost-effectiveness of these interventions in the Netherlands. RESEARCH DESIGN AND METHODS: A risk-based Markov model was developed to simulate the onset and progression of diabetic foot disease in patients with newly diagnosed type 2 diabetes managed with care according to guidelines for their lifetime. Mean survival time, quality of life, foot complications, and costs were the outcome measures assessed. Current care was the reference comparison. Data from Dutch studies on the epidemiology of diabetic foot disease, health care use, and costs, complemented with information from international studies, were used to feed the model. RESULTS: Compared with current care, guideline-based care resulted in improved life expectancy, gain of quality-adjusted life-years (QALYs), and reduced incidence of foot complications. The lifetime costs of management of the diabetic foot following guideline-based care resulted in a cost per QALY gained of < 25,000 US dollars, even for levels of preventive foot care as low as 10%. The cost-effectiveness varied sharply, depending on the level of foot ulcer reduction attained. CONCLUSIONS: Management of the diabetic foot according to guideline-based care improves survival, reduces diabetic foot complications, and is cost-effective and even cost saving compared with standard care.

Cohort Studies↗
PubMed1999

Achilles foot-screening project: background, objectives and design.

OBJECTIVE: A description of the background, objectives and design of the Achilles foot screening project. SUBJECT: Foot diseases, especially tinea pedis and onychomycosis. METHODS: Literature review and description of the Achilles set-up. RESULTS: The prevalence of tinea pedis and onychomycosis has sharply increased since 1950. Tinea pedis is one of the most common mycological diseases and onychomycosis is the most frequent nail disorder. They occur mainly in adults with an estimated overall prevalence of 10-20%, although epidemiological data are limited. The pan-European Achilles foot-screening project was undertaken to gather basic information on foot diseases, using a survey by questionnaire and a mycological assessment study. CONCLUSION: The prevalence of foot mycoses, particularly onychomycoses, is much higher than anticipated.

Adult↗
PubMed2005

Comparative studies of the capsid precursor polypeptide P1 and the capsid protein VP1 cDNA vectors for DNA vaccination against foot-and-mouth disease virus.

BACKGROUND: Foot-and-mouth disease virus (FMDV) causes a severe livestock disease, and the virus is an interesting target for virology and vaccine studies. MATERIALS AND METHODS: Here we evaluated comparatively three different viral antigen-encoding DNA sequences, delivered via two physical means (i.e., gene gun delivery into skin and electroporation delivery into muscle), for naked DNA-mediated vaccination in a mouse system. RESULTS: Both methods gave similar results, demonstrating commonality of the observed DNA vaccine effects. Immunization with a cDNA vector expressing the major viral antigen (VP1) alone routinely failed to induce the production of anti-VP1 or neutralizing antibodies in test mice. As a second approach, the plasmid L-VP1 that produces a transgenic membrane-anchored VP1 protein elicited a strong antibody response, but all test mice failed in the FMDV challenge experiment. In contrast, for mice immunized with the viral capsid precursor protein (P1) cDNA expression vector, both neutralizing antibodies and 80-100% protection in test mice were detected. CONCLUSIONS: This strategy of using the whole capsid precursor protein P1 cDNA for vaccination, intentionally without the use of virus-specific protease or other encoding genes for safety reasons, may thus be employed as a relevant experimental system for induction or upgrading of effective neutralizing antibody response, and as a convenient surrogate test system for DNA vaccination studies of FMDV and presumably other viral diseases.

Animals↗