bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Acquired Midtarsus Deformity Classification System—Interobserver Reliability and Intraobserver Reproducibility
Authors: Schon Lew C. , Easley Mark E. , Cohen Ilan , Lam Peter W.-C. , Badekas Athanasios , Anderson Claude D. 
Published: January 2017

A radiographic classification (Schon's) divides Charcot midtarsus deformities into four types identified by Roman numerals (I to IV), according to the anatomical location of the pathological process, 11 and an objective method of severity staging using radiographic criteria is introduced and tested. A beta stage is assigned if one of the following criteria is met: a dislocation is present; the lateral talar-first metatarsal angle is ≥ 30°; the lateral calcaneal-fifth metatarsal angle ≥ 0; or the AP talar-first metatarsal angle is > 35°. An alpha stage can be assigned when all four features are absent. Clinical features useful in assessing and managing these deformities have been associated with the various types and stages. To determine whether the classification system is valid, a study was performed. Two examination booklets and an instructional booklet designed to teach the method were distributed to 75 orthopaedic surgeons at the AOFAS summer meeting to test for intraobserver reproducibility and interobserver reliability. Information about the participants was recorded, and the tests were scored. The highest scores for correct responses were achieved by foot and ankle fellows, followed by orthopaedic residents. Attending orthopaedic surgeons achieved the lowest scores. The most common error was a type I deformity misidentified as a type II. The interobserver reliability for correctly classifying the deformities was 81%, and the intraobserver reproducibility was 97%. We concluded that this classification system, intended to clarify the patterns of acquired midfoot collapse, permits assignment of both anatomic type (I to IV) and degree of severity (alpha-beta) with high reliability and reproducibility. It can therefore be used as a tool for diagnosis, planning treatment, and assessing the prognosis.
Arch Height and Lower Limb Pain: An Adult Civilian Study
Authors: Hogan Molly T. , Staheli Lynn T. 
Published: January 2017

Flexible flatfeet in children are still treated with orthotics and operative procedures by some physicians who believe such treatment will prevent disability in adult life. Opponents of treatment cite military studies that show flexible flatfeet are not a source of disability in soldiers. Because no study of adult civilians relating arch configuration and pain have been reported, this study was undertaken. Ninety-nine adult male and female physically active grocery-store employees were studied. Half-weight-bearing footprints were made, and leg and foot pain questionnaires were scored for each subject. No relationship was found between arch configuration and pain scores. This study suggests that in the civilian population flexible flatfeet are not a source of disability. This study is consistent with previous studies and provides additional evidence against the practice of treating flexible flatfeet in children.
Imaging of Frostbite Injury by Technetium-99m-Sestamibi Scintigraphy: A Case Report
Authors: Aygit A. Cemal , Sankaya Ali 
Published: January 2017

The appearance of superficial tissue is often an unreliable indicator of deep-tissue viability in cases of frostbite. We present a 34-year-old black man who was brought to the emergency department at fourth post-injury day with frostbite injury involving both lower extremities after prolonged exposure to subzero temperatures. In our previous experimental study, 99mTc sestamibi scintigraphy has been employed for evaluating frostbite injuries in rabbit hindlegs. In the case presented, 99mTc sestamibi scintigraphy, as a new diagnostic tool, was performed for detection of skeletal muscle perfusion on the fourth post-injury day. The scintigraphic images show diffusely reduced uptake in soft tissues of both calves and feet. It was thought that this hypoperfusion was due to viable but ischemic tissue. Five days after medical therapy, 99mTc sestamibi scan showed prominently increased uptake in both calves and feet and skin necrosis was observed. Debridement of necrotic skin and subcutaneous tissue was performed, and split-thickness skin graft was applied for coverage of the skin defect. Healing was good 15 days after grafting. We think 99mTc sestamibi scan can be used for assessment of soft-tissue perfusion and evaluation of treatment in frostbite injury.
The Coexistence of Psoriasis and Vitiligo: A review
Authors: Sawchuk Michael , Spano Frank , Loo Wei Jing , Guenther Lyn 
Published: January 2017

Background: Psoriasis and vitiligo are both autoimmune diseases with an increased incidence noted in genetic relatives. They share similar trigger factors and have been observed to coexist in individuals. Objective: The purpose was to review the literature on the coexistence of psoriasis and vitiligo and to determine if there is a higher than expected prevalence of psoriasis in patients with vitiligo and vice versa. Methods: A literature review was conducted using Medline, EMBASE, and the Cochrane Library from 1968 to 2010. All articles that included reports of individuals with both psoriasis and vitiligo in the English language were documented. Results: We identified 338 articles, among which 35 case reports and 7 case series were mentioned. For each case series, the prevalence of psoriasis in patients with vitiligo, or vice versa, falls within the prevalence range of the background population on which the study was based. Conclusion: An increase in the expected prevalence of psoriasis in individuals with vitiligo, or vice versa, was not found in our study, suggesting that the coexistence of the two diseases appears to be due to chance alone. Large epidemiologic studies are required to address with certainty whether psoriasis is more common in individuals with vitiligo and vice versa. Renseignements de base: Le psoriasis et le vitiligo sont deux affections auto-immunes qui ont une incidence accrue observée chez les membres de la famille apparentée. Ils partagent des facteurs déclencheurs similaires, et des études ont démontré leur coexistence chez les personnes. Objectif: Le but était de faire une analyse documentaire sur la coexistence du psoriasis et du vitiligo et de déterminer s'il y a une prévalence plus élevée que prévu du psoriasis chez les patients atteints de vitiligo et vice versa. Méthodes: Une analyse documentaire a été effectuée en utilisant Medline, EMBASE, et la Cochrane Library de 1968 à 2010. Tous les articles comportant des rapports sur des personnes souffrant à la fois de psoriasis et de vitiligo rédigés en anglais ont été documentés. Résultats: Nous avons trouvé 338 articles, parmi lesquels 35 exposés de cas et 7 séries de cas ont été mentionnés. Pour chaque série de cas, la prévalence du psoriasis chez les patients atteints de vitiligo, ou vice versa, s'inscrit dans la fourchette de prévalence de la population de base qui a fait l'objet de l'étude. Conclusion: Notre étude n'a pas démontré une augmentation de la prévalence de psoriasis attendue chez les personnes atteintes de vitiligo, ou vice versa, ce qui suggère que la coexistence des deux affections semble être due au seul hasard. D'importantes études épidémiologiques sont nécessaires pour démontrer avec certitude que le psoriasis est plus fréquent chez les personnes atteintes de vitiligo et vice versa.
Agreement between Dermatologists and Primary Care Practitioners in the Diagnosis of Malignant Melanoma: Review of the Literature
Authors: Corbo Michael D. , Wismer Judy 
Published: January 2017

Background: The incidence of melanoma continues to rise in the developed world. It is therefore essential for primary care practitioners (PCPs) to be able to discriminate between malignant and benign cutaneous findings, as most patients present to PCPs first for examination of suspicious lesions. Objective: To compare dermatologists and PCPs in the diagnosis of malignant melanoma. Methods: Prospective studies published from January 1950 to August 2010 in MEDLINE, EMBASE, CINAHL, and CancerLit databases were examined. Relevant medical search terms, discussed amongst the authors, were entered into the databases. Only articles comparing dermatologists and PCPs in the diagnosis of malignant melanoma were selected. Results: Dermatologists were reported as having sensitivities, specificities, and diagnostic accuracies ranging from 0.74 to 1.00, 0.56 to 0.95, and 0.85 to 0.89, respectively. PCPs had sensitivities, specificities, and diagnostic accuracies ranging from 0.25 to 0.88, 0.26 to 0.71, and 0.49 to 0.80, respectively. Conclusions: PCPs should receive more training to improve their ability in the diagnosis of malignant melanoma. Contexte: La fréquence du mélanome est en hausse continue dans les pays développés. Dans ce contexte, il est essentiel que les médecins de premier recours (MPR) puissent distinguer les lésions cutanées malignes des lésions cutanées bénignes, étant donné que la plupart des patients consultent d'abord un MPR pour l'examen des lésions douteuses. Objectif: L'étude visait à comparer les dermatologues et les MPR dans le diagnostic du mélanome malin. Méthode: Nous avons procédé à un examen d'études prospectives, publiées de janvier 1950 à août 2010, dans les bases de données MEDLINE, EMBASE, CINAHL, et CancerLit. Les termes d'interrogation médicaux pertinents, ayant fait l'objet de discussion parmi les auteurs, ont été inscrits dans les bases de données. Seuls les articles dans lesquels il y avait une comparaison entre dermatologues et MPR dans le diagnostic du mélanome malin ont été sélectionnés. Résultats: La sensibilité, la spécificité, et la précision du diagnostic parmi les dermatologues variaient de 0.74 à 1.00, de 0.56 à 0.95, et de 0.85 à 0.89, respectivement, tandis que la sensibilité, la spécificité, et la précision du diagnostic parmi les MPR variaient 0.25 à 0.88, de 0.26 à 0.71, et de 0.49 à 0.80, respectivement. Conclusion: Les MPR devraient recevoir plus de formation afin d'améliorer leur capacité de diagnostic du mélanome malin.
Occurrence of Squamous Cell Carcinoma in an Area of Lichen Simplex Chronicus: Case Report and Pathogenetic Hypothesis
Authors: Tiengo Cesare , Deluca Jenny , Belloni-Fortina Anna , Salmaso Roberto , Galifi Flavia , Alaibac Mauro 
Published: January 2017

Background: Lichen simplex chronicus is a common skin disorder characterized by circumscribed, lichenified, pruritic plaque secondary to local repetitive trauma, notably rubbing and scratching. Objective: We describe a case of a squamous cell carcinoma arising in a patient with a long-lasting history of lichen simplex chronicus and discuss the potential role of the microenvironment in predisposing the malignant transformation. Conclusion: Here we propose a hypothesis in which rubbing and scratching contribute to an excess of inflammatory mediators, which in turn may lead to alterations in the processes of keratinocyte proliferation and differentiation. Renseignements de base: Le lichen simplex chronique est une affection cutanée courante caractérisée par une plaque pruritique lichénifiée circonscrite consécutive à des traumatismes locaux répétés, notamment le frottement et le grattage. Objectif: Nous décrivons un cas de carcinome squameux chez un patient présentant depuis longtemps des antécédents de lichen simplex chronique, et nous discutons du rôle potentiel du micro-environnement dans la prédisposition de la transformation maligne. Conclusion: Nous proposons ici une hypothèse selon laquelle le frottement et le grattage contribuent à un excès de médiateurs inflammatoires, lesquels peuvent à leur tour venir modifier les processus de prolifération et de différenciation des kératinocytes.
Endogenous Ochronosis with a Fatal Outcome
Authors: Zaraa Inès , Labbène Imen , Trojjet Sondes , Mrabet Dalila , Meddeb Nihel , Chelly Ines , Haouet Slim , Mokni Mourad , Sellami Slaheddine , Osman Amel Ben 
Published: January 2017

Background: Endogenous ochronosis (EO) is an autosomal recessive inherited disorder where there is incomplete oxidation of tyrosine and phenylalanine due to a lack of the enzyme homogentisic acid oxidase. Objective: We report a singular observation of EO with a fatal outcome. Case Report: We report the case of a 46-year-old man born to consanguineous parents with a medical history of recurrent renal colic and chronic nonspecific arthropathy. On clinical examination, slate blue pigmentation was seen on the cheeks, forehead, and nose, as well as blue-gray patches on all fingernails and bluish discoloration of the gums. Familial investigation revealed that his sister had similar pigmentation on the ears, hands, and fingernails. Histologic examination of a biopsy specimen from a pigmented lesion showed a dermal deposit of an acellular, eosinophilic material without cell reaction. Based on the clinical and histopathologic data, combined with the family medical history, our patient was considered to have EO with mucocutaneous, articular, and renal involvement. Unfortunately, the diagnosis was late because our patient died a few months later of terminal renal failure. Conclusion: Skin signs are the hallmarks of EO and must alert the clinician to look for involvement of vital organs. Renseignements de base: L'ochronose endogène (OE) est une affection héréditaire récessive autosomique où il se produit une oxydation incomplète de la tyrosine et de la phénylalanine en raison d'un manque d'oxydase de l'acide homogentisique. Objectif: Nous présentons une observation singulière d'OE dont l'issue a été fatale. Rapport de cas: Nous exposons le cas d'un homme de 46 ans né de parents consanguins ayant des antécédents médicaux de coliques néphrétiques récurrentes et une arthropathie chronique non spécifique. À l'examen clinique, nous avons observé une pigmentation bleu ardoise au niveau des joues, du front, et du nez, ainsi que des plaques bleu gris sur tous les ongles de doigts et une décoloration bleuâtre des gencives. Une étude des antécédents familiaux a révélé que sa sœur présentait une pigmentation semblable au niveau des oreilles, des mains, et des ongles de doigts. L'examen histologique de l'échantillon de la biopsie pratiquée sur une lésion pigmentée a montré un dépôt cutané de matériel éosinophile acellulaire sans réaction cellulaire. Selon les données cliniques et histopathologiques, combinées aux antécédents médicaux familiaux, notre patient présentait une OE avec une atteinte rénale, articulaire, et muco-cutanée. Malheureusement, le diagnostic a été tardif puisque notre patient est décédé quelques mois plus tard d'insuffisance rénale terminale. Conclusion: Les signes cutanés constituent les caractéristiques de l'OE et ceux-ci doivent alerter le clinicien de manière à ce qu'il cherche la contribution des organes vitaux.
Are Women More Ready to Consult than Men? Gender Differences in Family Practitioner Consultation for Common Chronic Conditions
Authors: Hunt Kate , Ford Graeme , Harkins Leigh , Wyke Sally 
Published: January 2017

Background: When consultations for all reasons are combined, women are seen to consult their general practitioners more than men through most of adult life. It is, therefore, often assumed that women are more likely to consult for every condition. Objectives: To examine whether women report being more likely to consult a general practitioner than men when taking account of the underlying condition and various aspects of the experience of the condition consulted for. Methods: Home-based nurse-interviews with 852 people in early middle age (39 years) and 858 in late middle age (58 years) sampled from the general population in the West of Scotland. Detailed information about current chronic conditions included general practitioner consultation and reported experience of pain frequency, pain severity, limitation to normal activities and restricted activity in the previous four weeks. Results: Women were no more likely than men to consult a general practitioner in the previous year when experiencing the five most common groups of conditions; in addition, women were no more likely than men to consult at a given level of severity for a given condition type, except in the case of one aspect of reported experience of mental health problems. Conclusions: The results argue against the most widely accepted explanation for gender differences in consulting, namely, that women are simply more likely to consult a general practitioner than men irrespective of underlying morbidity. Reasons for the higher rates of women consulting observed in general practice-based studies are discussed in relation to these data.
Social Conditions and Paediatric Day Case Tonsillectomy
Authors: Drake-Lee Adrian , Harris Stuart 
Published: January 2017

Objective: To develop a simple method for assessing the proportion of children referred to hospital for tonsillectomy in different areas likely to be suitable for day case treatment based on their medical and social characteristics. Methods: Four patient suitability criteria were selected based on previous experience of successful day case surgery and a literature review of the prevalence of contraindications and postoperative complications, as follows: medical contraindications (at least American Society of Anesthetists grade ASA2 to be eligible); home circumstances (no telephone, no car and single parent households were ineligible); distance from the hospital (more than 10 miles resulted in ineligibility); and likelihood of postoperative complications. Data relating to the social criteria were collected prospectively from 500 children under 12 years of age reviewed in the outpatient department and under the care of one of the authors. In addition, the electoral ward UPA8 (Jarman 8) deprivation score relevant to each child was recorded and the sample was divided into quintiles according to mean UPA8 scores. In each quintile, the percentage of children with the appropriate social criteria for day case tonsillectomy was calculated. The relationship between deprivation score and social criteria for day case tonsillectomy was determined using logistic regression. Results: The proportion of children deemed socially suitable for day surgery fell continuously from 95% in the least deprived quintile to 55% in the most deprived group (proportion passing the social criteria for suitability= − 1.5035+0.0298UPA8). Using these findings and those from the literature review on the nature and prevalence of contraindications and postoperative complications, a simple formula for realistic day case tonsillectomy targets was specified as A × B × C × D × 100%, where A is the proportion of children with no additional medical problems, B is the proportion passing the social suitability criteria, C is the proportion living within 10 miles and D is the proportion with no postoperative complications. Values for A and D would be derived from local audits. Conclusions: The formula can be used by purchasers and hospital managers to set differential day case targets for hospitals related to the characteristics of their patients referred for tonsillectomy. In principle, a similar approach could be applicable to other procedures and other age groups.
Prospective Evaluation of Symptom Responses to Successful Operation for Mild-Moderate Primary Hyperparathyroidism
Authors: Järhult J. 
Published: January 2017

Background: Parathyroidectomy is claimed to strongly improve the hypercalcemic symptoms in patients with primary hyperparathyroidism (HPT). The object of this study was to register the patients own experience of symptom changes in response to successful parathyroid surgery. Methods: Material one. 44 HPT patients filled in a questionnaire consisting of 8 visual analogue scales referring to “typical” hypercalcemic symptoms before as well as 2 and 12 months after neck surgery. Their results were compared with those obtained from an age — And sex-matched group of patients undergoing surgery for non-toxic thyroid disease. Material two. 25 elderly women with mild-moderate HPT were followed more closely up to 3 years after neck surgery with the same type of questionnaire. Results: HPT patients expressed significantly more of fatigue, muscular weakness, impaired memory, thirst and polyuria than patients with non-toxic thyroid disorders. These differences were eliminated 2 months after surgery. The pattern of response to parathyroidectomy was similar for most symptoms: an impressive improvement after 2 months and then a gradual return towards the preoperative value. However, the response was still significant for fatigue, weakness, thirst, polyuria and inactivity after 1 year. The effect of normalization of serum calcium on symptom scoring varied considerably between different individuals and also between different symptoms in the same individual. The elderly women responded in a similar biphasic way but their improvements were less pronounced. Conclusions: HPT patients experience significant improvements of most “hypercalcemic” symtoms after successful parathyroidectomy, but the effects are transient and vary considerably between different individuals.
Impact of Endovascular Treatment on Clinical Status and Health-Related Quality of Life
Authors: Virkkunen J. , Venermo M. , Saarinen J. , Keski-Nisula L. , Apuli P. , Kankainen A.-L. , Salenius J. 
Published: January 2017

Background and Aims: Investigating the impact of percutaneous transluminal angioplasty (PTA) on clinical status and health related quality of life in patients with claudication and critical limb ischaemia (CLI). Material and Methods: 61 patients and 64 limbs underwent a primary PTA (30 claudication and 34 CLI cases). Clinical status was graded according to Ahn and Rutherford and ankle/brachial index (ABI). Quality of life was assessed using the Nottingham Health Profile (NHP) preoperatively, one month and one year after the procedure. Triplex scan evaluation of the treated arterial segment was carried out postoperatively and one year after the procedure. Results: Claudication: 24/27 patients underwent one-year follow up, after which 20/24 had no claudication. In triplex evaluation 17 (63.0%) treated segments were open with 0–50% restenosis, 9 (33.3%) with 51–99% restenosis and one (3.7%) was occluded. CLI: 13/34 (38.2%) patients underwent one-year follow-up after which eight patients (61.5%) were asymptomatic and five (38.1%) had claudication. In triplex evaluation there was 0–50% restenosis in 6 (46.2%) segments treated with PTA and 51–99% restenosis in 7 (53.8%) segments. 21 (61.8%) patients did not conclude the one year follow up: 7 had died, 5 had undergone bypass surgery and 6 an amputation and 3 did not attend the follow-up up for unknown reasons. Quality of life: For CLI patients, improvement was observed in the domain of pain, which continued throughout the follow-up period. Among the claudicants, the domain of physical mobility was improved at one month's follow-up, but this effect disappeared during the following year and could not be seen at one the one- year follow-up. Conclusions: Technical success and one-year results in claudication are good, and the rate of complications is low. However, although PTA resulted in an immediate improvement in the quality of life, this effect was not seen in the long term. In critical limb ischemia there was a group of patients in whom PTA led to a significant benefit in terms of limb salvage and quality of life.