A Lisfranc (midfoot) injury is a significant injury that often has a prolonged recovery time. Fracture of the midfoot bones and/or disruption of the midfoot ligaments (Figure 1) leads to pain, swelling, and often an inability to weight-bear. During normal standing and walking the ligaments of the midfoot are subject to forces that are 2-3 times body weight.
What is lisfranc injury
The Lisfranc fracture is a fracture of the foot in which one or all of the metatarsals are displaced from the tarsus. It is named after 18th- and 19th-century surgeon and gynecologist Jacques Lisfranc de St. Martin. This type of injury classically occurred when a horseman fell while riding, having trapped his foot in the stirrup or fallen into a drain. At present, such an injury happens typically in activities such as windsurfing (where participants' feet are in foot straps that pass over the metatarsals), or when one steps into a hole and the foot twists heavily. Falling from a height of two or three stories can also cause this fracture. American football players occasionally get this injury, often when they have their foot pointing down and someone lands on their heel.
A Lisfranc injury is initially diagnosed based on the history and description of the athlete’s acute injury. Often an athletic trainer at the practice or competition may see the injury occur in real time and have an immediate suspicion for the injury. The athlete will describe the immediate onset of pain in the midfoot region. There may be difficulty or even an inability to put weight on the injured foot. Over the course of the ensuing day, swelling and bruising often occurs that when serious may even become evident on the bottom of the foot. On a physical exam, the injured athlete will be tender over Lisfranc’s joint and any others involved in the injury. In the most severe of injuries, those that involve a large direct crushing force to the foot, the swelling may be so severe that an emergent evaluation in an emergency room is necessary and possibly even immediate surgery. This is however extremely rare in the setting of athletic injuries.
Lisfranc injury recovery time
Most often the treatment of a Lisfranc injury is surgical, although some minor injuries can be treated conservatively. If there is minimal displacement of the bones, a stiff walking cast applied for approximately eight weeks is an appropriate alternative. However, the more common treatment is to secure the fractured and dislocated bones with either internal (screws) or external (pins) fixation.
Stable Lisfranc injuries that do not require surgery may cause an athlete to miss 2 months or more of their season. However, most athletes are able to successfully return at some point. Those injuries that are unstable, and require surgical repair, are serious injuries that almost always cause the injured athlete to miss the remainder of their season. It is also not uncommon for a high level athlete to not be able to return to the same level of athletic performance even in following seasons. Two well-known examples are Eric Rhett and Duce Staley both of whom had surgery for a serious Lisfranc injury and never successfully returned to their pre-injury form.
Women and Cardiovascular Disease Heart disease is the number one killer of both men and women. In the United States, heart attacks kill about 240,000 women a year; stroke takes another 88,000 women’s lives. That compares with about 43,000 women who die annually from breast cancer. In fact, nearly twice as many women die of CVD (Cardiovascular Disease) than all cancers combined.
While men do have more heart attacks and have them earlier in life, women have a much lower chance of surviving a heart attack. We understand the mechanism that cause CVD in men from years of male-oriented research. But only within the last decade have we moved toward a better understanding of how CVD manifests itself in women.
Evaluation of the Child with Frequent Infections Immunodeficiencies can be divided into primary and secondary immune deficiencies. There are about 70 primary immunodeficiencies and they are mostly antibody defects. Overall incidence is about 1 in 10,000. They are really pretty uncommon, primary immunodeficiencies do not happen all that often. This next slide shows you the distribution. Pure antibody deficiencies are present in about 50%. You’ll see antibody deficiency and combined cellular deficiencies here in this green, and 20% cellular deficiencies are present in about 10%. Phagocytic disorders, 18% and complement is the rarest of all, which is 2%. Go back for a moment again - secondary immunodeficiencies are much more common than the primary immunodeficiencies and there are many, many causes of secondary immunodeficiency. But we are going to focus mostly on the primary immunodeficiencies. Most, in contrast to the primary immunodeficiencies where the primary immunodeficiencies or antibody deficiencies, most of these are T-cell defects. And as many as 50% of hospitalized patients may be immunocompromised to some degree. Some of the things like uremic patients, just poor nutrition, things like that can lead to immunodeficiency in those hospitalized patients.
Cyclosporin As we move on, drugs like CellCept and Prograf are replacing cyclosporin, but cyclosporin can take a normal person and give him tophaceous gout in about 24 months. Because it is a causer of renal insufficiency it also inhibits the secretion of uric acid by the kidney and resorption from uric acids, so it is a three-fold toxin in terms of developing gout in patients. It can develop raging tophaceous gout, and one of the problems was is that most patients with renal and heart transplant were on drugs such as Imuran and Cyclosporin, and Allopurinol interact with one another. You have a real difficult time of using Allopurinol on a patient and Azathioprine because of drug interactions and toxicities. These individuals are difficult to treat. Rapid in onset and have severe tophaceous gout.
Myelodysplastic Syndrome Treatment Guidelines What is Myelodysplastic syndromes? Myelodysplastic syndromes (MDS) is a term for a group of disorders that cause the bone marrow to produce an inadequate number of healthy blood cells — red blood cells, white blood cells and platelets. In MDS, cells in the bone marrow responsible for making blood cells (stem cells) don't mature, don't make enough blood cells or make defective cells.
Myelodysplastic Syndrome Treatment
The prognosis depends on the following:
Whether the myelodysplastic syndrome occurred after chemotherapy or radiation therapy for another disease.
The number of blast cells in the bone marrow.
Whether one or more types of blood cells are affected.
Certain changes in the chromosomes.
Treatment options depend on the following:
Whether the myelodysplastic syndrome occurred after chemotherapy or radiation therapy for another disease.
Whether the myelodysplastic syndrome has progressed after being treated.
The age and general health of the patient.
Tamiflu Side Effects Children Tamiflu side effects in children
New research claims that “more than half of children taking Tamiflu to combat swine flu suffer side effects such as nausea, insomnia and nightmares,” said The Daily Telegraph. It also said the study suggests that one in five children who took part reported having a neuropsychiatric side effect, such as poor concentration, inability to think clearly, problems sleeping, and feeling dazed or confused.
Foods to help anemia treatment Abnormally low numbers of red blood cells and reduction in the amount of hemoglobin in those cells results in anemia. Because red blood cells are needed as carriers of oxygen to the tissues, oxygen supply to the body is subsequently interrupted. The exact cause of anemia must be diagnosed by physician before any treatment can begin.
Anemia can be caused bay an iron deficiency due to blood loss from excessive menstrual flow, gastrointestinal bleeding and ulcers, during pregnancy, breast-feeding, from frequent blood donations, colon cancer, or lack of iron in the diet. It can result from autoimmunity, a condition in which the immune system mistakenly attacks itself, in this case the red blood cells; or from a malfunction of the bone marrow system when it is adversely affected by infection, cancer or toxic chemical exposure or radiation. Anemia can also occur because of a deficiency of vitamin B6, B12, folic acid, or copper; and from certain anti-inflammatory drugs or antibiotics or an excessive consumption of alcohol. Genetics may also be a factor.
Tips for Getting Pregnant You have been married for years? but have not had children. Maybe it helps you practice the following tips for couples to get pregnant.
Carpal tunnel syndrome symptoms and treatment Carpal tunnel syndrome is characterized by weakness, pain, tingling, numbness, or burning in the palm, the thumb, the index finger, the middle finger, and the ring finger, caused by entrapment of the median nerve in the wrist. (This condition, like any syndrome, is not a disease in itself but rather a collection of symptoms.) The condition most often affects women in their 30s, 40s, and 50s. it may develop or become worse because of work that requires repeated grasping, twisting, or turning of the hand and wrist, especially against resistance or while using vibrating tools.
The carpal tunnel is formed by the bones of the wrist (carpal means wrist) and the tough band of connective tissue known as the transverse carpal ligament. Among the structures inside the tunnel are the median nerve and the tendons that flex the fingers and thumb. Any swelling or thickening of tissue within the tunnel can cause the median nerve to be compressed between the transverse carpal ligament and the tendons and other contents of the tunnel. The squeezed nerve, which controls the thumb, index finger, and third finger, cannot work as it should, and the symptoms of carpal tunnel syndrome result.
Furosemide Side Effects and Dosage Furosemide is a loop diuretic (water pill) that prevents your body from absorbing too much salt, allowing the salt to instead be passed in your urine. Furosemide treats fluid retention in people with congestive heart failure, liver disease, or a kidney disorder such as nephrotic syndrome. This medication is also used to treat high blood pressure. Here is some stuff about Furosemide Side Effects and Dosage.
Osteoporosis Treatment Guidelines 2011 UK Osteoporosis Treatment
The goal of treatment of osteoporosis is the prevention of bone fractures by reducing bone loss or, preferably, by increasing bone density and strength.
Tips for Cancer Prevention What to do
Eat more broccoli, cauliflower, and brussels sprouts. Eat more cabbage-type vegetables. All cabbages and kale are examples. These vegetables protect against cancers of the colon, rectum, stomach, and lung.
Add more high-fiber foods to your diet. Eat more peaches, strawberries, potatoes, spinach, tomatoes, wheat and bran cereals, rice, popcorn, and wholewheat bread. Fiber protects against cancer of the colon.
Choose foods containing vitamin A. Eat more carrots, peaches, apricots, squash, and broccoli. Fresh foods are the best source and are far better than vitamin pills. Vitamin A protects against cancers of the esophagus, larynx, and lung.
Choose foods containing vitamin C. Eat more grapefruit, cantaloupe, oranges, strawberries, red peppers, green peppers, broccoli, and tomatoes. These help fight cancers of the esophagus and stomach.
Practice weight control. Exercise and eat foods low in calories. A good exercise for most people is walking. Obese people have a high chance of getting cancers of the uterus, gallbladder, breast, and colon. Check with your doctor before you start an exercise program or a special diet.
Physical Allergy Some persons, when exposed to changes in temperature such as cold or heat or when exposed to sudden effort or sunlight, may develop manifestation, such as asthma, hay fever, or hives. In these instances the cold or heat acts as an antigen, much the same as milk or pollen may produce allergy. The demonstration of the presence of such sensitivity requires special tests. In the case of a patient sensitive to cold one tests the patient by attaching a small tube containing ice water to the skin of the arm. The tube is held in place with adhesive. Sensitivity to cold is determined by the appearance of large welt or hive at the point of contact. A similar of allergy are also included those patients who when exposed to a draft or a cod breeze develop nasal symptoms followed by severe so-called sinus headaches.
Dysthymic Disorder Symptoms and Treatments Depressed mood is present for most of the day, for more days than it is not present, and depression has been present for at least two years.
Presence of at least two of the following:
Poor appetite or overeating.
Insomnia or hypersomnia.
Low energy or fatigue.
Poor concentration or difficulty making decisions.
Over the two year period, the patient has never been without symptoms for more than two months consecutively.
No major depressive episode has occurred during the first two years of the disturbance.
No manic, hypomanic or mixed episode, or evidence of cyclothymia is present.
Symptoms do not occur with a chronic psychotic disorder.
Symptoms are not due to substance use or a general medical condition.
Symptoms cause significant social or occupational dysfunction or marked subjective distress.