Podiatry Institute

Klinefelter syndrome (KS), the most common male aneuploidy (47,XXY), is linked to hypogonadism, gynecomastia, and infertility, with an established but underrecognized association with venous thromboembolism and limited data on mechanisms in patients without additional thrombophilic conditions. We report the case of a 33-year-old South Asian male with subacute-to-chronic deep vein thrombosis (DVT) of the right leg and absent traditional thrombosis risk factors. Clinical evaluation, hormonal assays, and karyotyping confirmed KS. Extensive investigations ruled out congenital and acquired thrombophilias. The patient responded well to anticoagulation therapy, achieving symptom resolution. This case highlights the need for awareness of thrombotic risks in KS and underscores the importance of further research into the underlying mechanisms of this association.

Chronic wounds such as diabetic foot ulcers (DFUs) affect almost 20 million people worldwide often resulting in limb amputation rates of around 20% and 5-year mortality rates of 50-70%. Depending on the pathophysiology of the ulcer, DFUs can take beyond 3 months to heal. A steady supply of oxygen to the tissues surrounding the wound is crucial for wound healing. However, in DFUs, the supply of oxygen is compromised in 50-70% of the patients due to diabetes-related complications such as peripheral vascular disease. Therefore, to effectively track DFU healing, it is critical to have a rapid, point-of-care method to spatially image the tissue oxygen saturation (StO₂). Here, we present Illuminate-OxyView, an AIpowered rapid, point-of-care handheld imager that houses NIR-reflectance-based StO₂ imaging to assess DFUs in low resource settings. Oxygenated and deoxygenated hemoglobin (HbO₂ and Hb) exhibit significant differences in their near infrared (NIR) absorption spectra at certain wavelength bands. This results in a difference in NIR reflectance which is used to infer the spatial distribution of StO₂ in and around the wound. However, reflectance based StO₂ inference is often confounded by melanin concentration in the outermost layer of the skin which varies across different population groups. Owing to this, it is crucial to have a skin-tone specific imaging technique. Therefore, we capture multispectral reflectance at wavelengths 𝜆 = 660 nm, 740 nm, and 850 nm and, in addition, a white light reflectance for the prediction model to infer the skin tone. We conducted a clinical study spanning 300 patients where white light images were used to first detect the Fitz-Patrick score of the skin-tone and, subsequently, NIR reflectance characteristics were processed by a Random- Forest regressor to determine the StO₂ at each point. We demonstrate a >90% correlation of the predicted StO₂ with gold standard FDA-approved StO₂ imager with a root mean squared error (RMSE) of less than 10% StO₂. In summary, we demonstrate an accurate Fitz-Patrick score-specific handheld point-of-care Machine learning (ML)-based StO₂ imager for DFU management in low resource settings.

burim i informacioneve edukative për nxënësit ? Pjesëmarrësit e përfshirë në hulumtim janë nxënësit e klasave të teta, mosha e të cilëve është 13-15 vjeç. Hulumtimi është realizuar në periudhën mars-qershor. Mostra e studimit është 260 nxënës të 12 shkollave, të komunave të ndryshme të Kosovës: Prishtina, Mitrovica, Ferizaj, Hani i Elezit, Podujeva. Tetë shkolla janë përfaqësuar nga 25 nxënës, ndërsa katër shkolla nga 15 nxënës. Të dhënat janë mbledhur përmes teknikës së anketimit, ndërsa instrument i hulumtimit ishte pyetësori për nxënës. Televizioni zë vend shumë të rëndësishëm në jetën e nxënësve. Televizioni më shumë se çdo mjet tjetër e përgatit nxënësit si të sillen në shoqëri. Qëllimi i hulumtimit është analiza e perceptimeve të nxënësve për rolin edukativ të përmbajtjeve programore të televizioneve: RTK, KTV, RTV21 dhe Klan Kosova. Studimi është kuantitativ, të cilit i paraprijnë dy pyetje kërkimore: Çfarë roli luan televizioni në edukimin e nxënësve? A janë programet televizive: RTK, KTV, RTV21, Klan Kosova burim i informacioneve edukative për fëmijët? Rezultatet tregojnë se roli i këtyre programeve televizive, sipas perceptimit të nxënësve, është për të informuar opinionin, sidomos të rriturit, për ngjarjet nga politika, për të transmetuar serie zbavitëse (humoristike) dhe shumë pak për të ndihmuar nxënësit në aspektin edukativo-arsimor. Nxënësit nuk janë të kënaqur me këto programe, pasi, sipas tyre, nuk janë të kohës, janë të mërzitshme dhe duhet të ndryshojnë. Po ashtu, rezultatet tregojnë se përmbajtjet programore janë të varfra, nuk janë interesante dhe shumë pak janë burim i informacioneve edukative. Televizioni publik, RTK, për dallim nga televizionet tjera (KTV, Klan Kosova RTV21), e ka për obligim ligjor që të ofrojë përmbajtje edukativo- arsimore të cilësisë së lartë (Ligji për RTK, neni 7, paragrafi 1.3), mirëpo, sipas perceptimit të nxënësve, rëndësia dhe cilësia e programeve edukativo- arsimore renditet në pozitën e katërt, gjë që, sipas këtij rezultati, televizioni në jetën e nxënësve është mjet që shërben për zbavitje dhe rrallë mjet edukativ. Televizionet, në të ardhmen, në paketën e tyre programore të kenë më shumë emisione edukativo-arsimore, të cilat do të ndihmonin nxënësit në përvetësimin e Kurrikulës së shkollës, të transmetojnë sa më shumë shembuj pozitivë për këtë grup-moshë, si dhe t’u krijohet mundësia e hartimit të emisioneve /artikujve bazuar në opinionet e tyre, me qëllim të përfaqësimit (portretizimit) sa më të shpeshtë të tyre në medie.

The aim of this study was to evaluate the efficacy of a 3D electrospun synthetic polymer matrix (3DESPM) on hard-to-heal wounds. This prospective case series took place at four sites. The primary endpoints were the percentage area reduction (PAR) in wound area at four and eight weeks. Secondary endpoints included time to heal (Kaplan-Meier analysis) and the proportion of healed wounds at 12 weeks. After applying 3DESPM, the physician applied sterile saline, as appropriate, to adhere the matrix to the wound bed and facilitate the polymer degradation process. A nonadherent dressing, a secondary dressing, and additional bandages (as needed) were then applied. The physician left the product on the wound until complete degradation was observed, as appropriate, and reapplied, as appropriate. Combination advanced therapies were applied, per physician discretion. Thirty-eight patients (mean age: 64.3 years [SD: 17.6]) with 50 wounds (35 chronic, 70%) participated. The mean number of comorbidities per patient was 4.4 (2.3). All wounds received 3DESPM; 12 wounds (24%) received combination therapies; and 38 wounds (76%) completed the study. The mean (SD) PAR at four and eight weeks was 67.6% (38%) and 80% (35%), respectively. Thirty-three wounds (66%) healed at 12 weeks. The Kaplan-Meier mean time to heal for all wounds was 49.0 days (95% confidence interval: 41.3-56.7). In a complex patient population with severe comorbidities and heterogeneous wounds, 3DESPM appeared to accelerate the stalled healing process to contribute to wound closure. Further investigation of 3DESPM on a larger patient population and in a controlled setting is pending.

Tibial sesamoidectomy is frequently the treatment of choice for different tibial sesamoid pathologies when non-surgical treatment fails. However, surgery is not without postoperative complications, such as hallux abducto valgus (HAV) deformity. Currently, there is a paucity of research regarding isolated tibial sesamoidectomy and its complications. The purpose of this paper is to present two cases of isolated tibial sesamoidectomy, a brief description of surgical technique, an anatomic and functional description of hallux sesamoids, and an updated literature review on isolated tibial sesamoidectomy.

Objective: To evaluate the clinical outcomes of lyopreserved placental membrane containing viable cells (vLPM) in the treatment of nonhealing wounds of various etiologies, and to compare them to those previously reported for cryopreserved placental membrane containing viable cells (vCPM).Approach: Patients with nonhealing wounds who qualified to receive advanced wound therapies were consecutively enrolled and treated weekly with vLPM plus standard of care (SOC) at five centers. Data were de-identified and retrospectively analyzed. Outcomes included closure, time to closure, number of vLPM applications, and adverse events (AEs).Results: Seventy-eight patients with 98 wounds (41 diabetic foot ulcers [DFUs], 19 venous leg ulcers [VLUs], 10 surgical, and 28 others) with an average size of 13.3 cm2 and 8.7 months duration were treated. Fifty-eight of the 98 wounds (59.2%) achieved complete closure with median time to closure of 63 days and 6 vLPM applications. The closure by wound etiology was 63% for DFUs, 47% for VLUs, 70% for surgical wounds, and 57% for other types of wounds. Similar closure rates have been previously demonstrated for vCPM. Wound duration was the main predictor of closure: 65.8% versus 30.0% (p = 0.004) closure was achieved for wounds of ≤12 and >12 months duration, respectively. There were no AEs related to vLPM application.Innovation: This is the first multicenter case series evaluating the clinical outcomes of vLPM in a real-world setting.Conclusion: These results support clinical equivalency between the two placental membrane formulations with the added convenience of room-temperature storage for vLPM, allowing it to be used in any wound-care setting.

Digital hammertoe and claw toe deformities of the forefoot remain a constant challenge to the foot and ankle surgeons daily. Patients often present with complaints of painful callosities on the dorsal or distal aspect of the affected digit with or without concomitant pain under the lesser metatarsophalangeal joints (MTPs). Digital contractures cause a retrograde pressure on the metatarsal heads leading to this “metatarsalgia” or plantar forefoot pain. The etiology is multifactorial and often treated nonoperatively with prefabricated or custom orthoses, padding, shoe gear modification, and taping. The lesser toe deformities can be associated with hallux abducto valgus deformities, pes plano valgus, neuromuscular disorders, and ankle equinus and can lead to pathologic plantar plate ruptures of the MTPs. When conservative management has failed, surgical intervention is necessary to provide adequate joint stability and pain reduction. The appropriate etiology and accurate diagnosis must be identified in order to provide the best treatment and surgical plan for each patient.