Objective. Adults with foot symptoms (i.e., pain, aching, or stiffness) may be at increased risk of reduced time to all‐cause mortality. The purpose of this study was to evaluate whether foot symptoms are independently associated with all‐cause mortality in older adults.Methods. We analyzed longitudinal data from 2613 participants from the Johnston County Osteoarthritis Project (JoCoOA), a longitudinal population‐based cohort of adults 45 years of age and older. Participants completed questionnaires at baseline to determine presence of foot symptoms and covariable status. Baseline walking speed was measured via an 8‐foot walk test. To examine the association of foot symptoms with time to mortality, hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox regression models, adjusted for potential confounders. Results. We observed 813 deaths over 4 to 14.5 years of follow‐up. At baseline, 37% of participants had foot symptoms, mean age was 63 years, mean BMI was approximately 31 kg/m2, 65% were women, and 33% were Black. Moderate to severe foot symptoms were associated with reduced time to mortality after adjustment for demographics, comorbidities, physical activity, and knee and hip symptoms (HR=1.30, 95%CI=1.09‐1.54). Importantly, this association was not modified by walking speed or diabetes. Conclusion. Individuals with foot symptoms had an increased hazard of all‐cause mortality compared to those with no foot symptoms. These effects were independent of key confounders and were not moderated by walking speed. Effective interventions to identify and manage at least moderate foot symptoms may reduce the risk of decreased time to mortality.This article is protected by copyright. All rights reserved.
A 32-year-old man presents to the clinic with multiple subcutaneous masses. Further history and a review of the literature are discussed. This is a case study of a patient with familial multiple lipomatosis and our management. Liposuction was performed after informed consent was obtained to manage familial multiple lipomatosis in an aesthetically pleasing manner without recurrence. Liposuction is an excellent technique for an aesthetically pleasing outcome to manage familial multiple lipomatosis. Additional therapy modalities including laser, chemicals, high-pressure tumescent injection, and Vibration Amplification of Sound Energy at Resonance (VASER) are reviewed. To avoid multiple incisions and scars, liposuction for familial multiple lipomatosis is an aesthetically pleasing, definitive treatment modality with no recurrence of lipomas.
Objective: To determine if patients with a prior history of axillary lymph node dissection (ALND) secondary to breast cancer surgery and other procedures are at an increased risk of postoperative complications including lymphedema and infection following elective upper extremity surgery. Furthermore, the study aimed to evaluate the extent of patient education regarding lymphedema as a possible complication of upper extremity surgery.Methods: A review of 312 patients presenting to the clinic with upper extremity pathologies was performed of which 15 patients had a history of surgeries secondary to breast cancer and 297 had no prior history of breast cancer. Nine out of 15 patients with prior breast procedures and 66 out of 297 patients with no such history underwent elective hand surgeries, with 22 out of the 75 patients having a history of ALND. Incidences of postoperative complications including lymphedema and infection were recorded. Afterward, a survey inquiring about patient education was conducted to assess whether the patients were educated regarding lymphedema and if so, when and from whom they received the counseling.Results: No patients with a prior history of ALND secondary to breast cancer or other surgeries developed a postoperative infection or onset of lymphedema, and no patients with preoperative lymphedema had any worsening of lymphedema or infection postoperatively. The survey conducted afterward revealed that 61% of the patients with a prior history of breast cancer-related procedures including lymph node dissection were never counseled regarding lymphedema as a possible complication of hand surgery. Furthermore, 75% of the survey participants wished they were given more information about possible causes and complications of, and ways to prevent or minimize the possibility of lymphedema developing postoperatively.Conclusion: Prior history of ALND did not make patients more susceptible to postoperative complications, thus a history of isolated ALND or breast cancer surgery including ALND should not preclude elective hand surgical procedures from being performed ipsilaterally. Additionally, improvements in the degree of patient counseling regarding postoperative complications following hand surgery are needed as increased patient education is shown to be associated with a lower rate of complications and faster recovery times.
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