Ingrown Toenail Management

2021 ◽  
pp. 31-34
Author(s):  
Asma Ghafoor ◽  
Hamza Paracha ◽  
Zoie Goldstein
Keyword(s):  
Risk Factors ◽  
Recurrence Rate ◽  
Clinical Manifestations ◽  
General Medicine ◽  
Common Condition ◽  
Young Adolescents ◽  
Topical Antibiotics ◽  
Concise Review ◽  
Ingrown Toenail ◽  
Ingrown Toenails

Ingrown toenails are a common condition in general medicine and dermatology, and they occur when the nail curves inward and pierces the nail fold. Symptoms include pain in the affected toe, erythema and edema. The diagnosis is made clinically and, if left untreated, ingrown toenails can lead to infections and even cellulitis and osteomyelitis. Conservative treatments involve clipping on the spicule and topical antibiotics. However, the mainstay of treatment is matricectomy to reduce the recurrence rate. The risk of ingrown toenail development can be reduced by wearing proper footwear, keeping toenails cut straight and overall foot hygiene. Ingrown toenails can affect various patient populations but are more prevalent in males, young adolescents and pregnant patients. Risk factors include obesity, diabetes, improper toenail clipping and improper footwear. This review explores the clinical manifestations of ingrown toenails, along with their diagnosis and treatment, providing a concise review for physicians to accurately identify and effectively treat patients with ingrown toenails or their resultant complications.

Diagnostic scales for suicide risk assessment

2020 ◽  
pp. 67-79
Author(s):  
L. Gelda ◽  
L. Nesterovich
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Medical Research ◽  
Suicide Risk ◽  
General Medicine ◽  
Diagnostic Tools ◽  
Suicide Risk Assessment ◽  
Research And Practice ◽  
Psychometric Instruments ◽  
High Incidence

The problem of adequate diagnostic tools use for suicide risk assessment т medical research and practice is of extreme importance because of the high incidence of suicide in the population of psychotic patients and the high vulnerability of the latter to the known risk factors. The article provides ап overview of the existing psychometric instruments (scales) used to assess the risk of suicide in psychiatry as well as in general medicine.

Colon cancer: risk factors and screening

2020 ◽  
pp. 13-22
Author(s):  
Mark Natanson
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Cancer Risk ◽  
Clinical Manifestations ◽  
Dysplastic Lesion ◽  
Test Analysis ◽  
Cancer Risk Factors ◽  
Colon Cancer Risk ◽  
Neoplastic Process ◽  
Rectal Cancers

Colon and rectal cancers are usually combined under the same term "colorectal cancer". It should be noted that the lesion of the colon is much more common. Colorectal cancer ranks fourth in the overall structure of oncological pathology in terms of prevalence, and in some countries even comes third after lung and stomach cancer. Risk factors that contribute to the development of colorectal cancer include bowel polyps, ulcerative colitis and Crohn's disease, and a genetic predisposition. Most often, neoplastic transformation occurs at the site of an adenoma or dysplastic lesion of the intestinal mucosa. Due to the high risk of neoplastic process in a sufficiently large number of elderly people, it is recommended that every person over the age of 50 should undergo compulsory screening to detect latent cancer. The simplest, but at the same time insufficiently informative method is a blood culture test - analysis for the presence of blood in the feces. Method of total colonoscopy and double-contrast radiography is distinguished by a higher information content, but at the same time a higher cost. It is recommended to have these examinations every three to five years after the age of 50 years without clinical manifestations, and after the age of 40 for those at risk for colorectal cancer.

scholarly journals Ultrasound-Guided Popliteal Nerve Block with Short-Acting Lidocaine in the Surgical Treatment of Ingrown Toenails

2021 ◽  
Vol 18 (10) ◽  
pp. 5059
Author(s):  
Beom Suk Kim ◽  
Kyungho Kim ◽  
Jonathan Day ◽  
Jesse Seilern Und Seilern Und Aspang ◽  
Jaeyoung Kim
Keyword(s):  
Surgical Treatment ◽  
Adverse Events ◽  
Nerve Block ◽  
Skin Penetration ◽  
Sensory Block ◽  
Foot And Ankle ◽  
Ingrown Toenail ◽  
Ankle Surgery ◽  
Ingrown Toenails ◽  
Digital Nerve Block

Background: Digital nerve block (DB) is a commonly utilized anesthetic procedure in ingrown toenail surgery. However, severe procedure-related pain has been reported. Although the popliteal sciatic nerve block (PB) is widely accepted in foot and ankle surgery, its use in ingrown toenail surgery has not been reported. Therefore, this study aimed to investigate the safety and effectiveness of PB in the surgical treatment of ingrown toenails. Methods: One-hundred-ten patients surgically treated for an ingrown toenail were enrolled. Sixty-six patients underwent DB, and 44 underwent PB. PB was performed under ultrasound-guidance via a 22-gauge needle with 15 mL of 1% lidocaine in the popliteal region. The visual analogue scale was used to assess pain at two-time points: pain with skin penetration and pain with the solution injection. Time to sensory block, duration of sensory block, need for additional injections, and adverse events were recorded. Results: PB group demonstrated significantly lower procedure-related pain than the DB group. Time to sensory block was significantly longer in the PB group (20.8 ± 4.6 versus 6.5 ± 1.6 minutes). The sensory block duration was significantly longer in the PB group (187.9 ± 22.0 versus 106.5 ± 19.1 minutes). Additional injections were required in 16 (24.2%) DB cases, while no additional injections were required in PB cases. Four adverse events occurred in the DB group and two in the PB group. Conclusion: PB was a less painful anesthetic procedure associated with a longer sensory block duration and fewer repeat injections compared with DB. The result of this study implicates that PB can be an alternative anesthetic option in the surgical treatment of ingrown toenails.

The physiopathology of spontaneous hemorrhagic stroke: a systematic review

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Alcivan Batista de Morais Filho ◽  
Thiago Luis de Holanda Rego ◽  
Letícia de Lima Mendonça ◽  
Sulyanne Saraiva de Almeida ◽  
Mariana Lima da Nóbrega ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Ischemic Stroke ◽  
Subarachnoid Hemorrhage ◽  
Natural History ◽  
Hemorrhagic Stroke ◽  
Recent Literature ◽  
Clinical Manifestations ◽  
The Road ◽  
History Of

Abstract Hemorrhagic stroke (HS) is a major cause of death and disability worldwide, despite being less common, it presents more aggressively and leads to more severe sequelae than ischemic stroke. There are two types of HS: Intracerebral Hemorrhage (ICH) and Subarachnoid Hemorrhage (SAH), differing not only in the site of bleeding, but also in the mechanisms responsible for acute and subacute symptoms. This is a systematic review of databases in search of works of the last five years relating to the comprehension of both kinds of HS. Sixty two articles composed the direct findings of the recent literature and were further characterized to construct the pathophysiology in the order of events. The road to the understanding of the spontaneous HS pathophysiology is far from complete. Our findings show specific and individual results relating to the natural history of the disease of ICH and SAH, presenting common and different risk factors, distinct and similar clinical manifestations at onset or later days to weeks, and possible complications for both.

scholarly journals Adenovirus viremia may predict adenovirus pneumonia severity in immunocompetent children

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruimu Zhang ◽  
Hongmei Wang ◽  
Shufeng Tian ◽  
Jikui Deng
Keyword(s):  
Risk Factors ◽  
Viral Load ◽  
Disease Severity ◽  
Mycoplasma Pneumoniae ◽  
Quantitative Polymerase Chain Reaction ◽  
Univariate Analysis ◽  
Clinical Manifestations ◽  
Pneumonia Severity ◽  
Adenovirus Pneumonia ◽  
Blood Viral Load

Abstract Background Previous studies have demonstrated an association between adenovirus viremia and disease severity in immunocompromised children. However, few studies have focused on this association in immunocompetent children. This study explored the association between adenovirus viremia and adenovirus pneumonia severity in immunocompetent children. Methods We performed a retrospective, observational study of immunocompetent children with adenovirus pneumonia admitted to Shenzhen Children’s Hospital in Shenzhen, China. Pneumonia was classified as severe or mild based on the Chinese guideline for the classification of pneumonia severity. Serum samples from all the children included in the study were tested for adenovirus DNA with a quantitative polymerase chain reaction. Clinical manifestations, laboratory examinations, and disease severity were compared between children with severe and mild pneumonia. Results A total of 111 immunocompetent children with adenovirus pneumonia (60 severe, 51 mild) were included. The median age was 40 months, and 64 patients were male. Five patients were admitted to the intensive care unit, and two underwent endotracheal intubation. All patients were discharged after recovery or improvement. Univariate analysis and binary logistic regression analysis showed that leukocytosis (OR = 1.1; 95% CI: 1.0 to 1.2; P = 0.033), co-infection with Mycoplasma pneumoniae (OR = 5.0; 95% CI: 2.1 to 12.3; P <  0.001), and high blood viral load (OR = 1.5; 95% CI: 1.2 to 2.0; P = 0.001) may be risk factors for severe adenovirus pneumonia. Conclusions Leukocytosis, co-infection with Mycoplasma pneumoniae, and high blood viral load may be risk factors for severe adenovirus pneumonia in immunocompetent children. Blood viral load may predict pneumonia severity.

scholarly journals AB0533 ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODY (ANCA) IN GENERAL POPULATION WITHOUT ANCA ASSOCIATED VASCULITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1563.3-1563
Author(s):  
H. Tamaki ◽  
S. Fukui ◽  
T. Nakai ◽  
G. Kidoguchi ◽  
S. Kawaai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Autoimmune Disease ◽  
General Population ◽  
Granulomatosis With Polyangiitis ◽  
Dietary Habits ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Anca Associated Vasculitis ◽  
The Mean

Background:Currently it is hypothesized that many systemic autoimmune diseases occur due to environmental risk factors in addition to genetic risk factors. Anti-Neutrophil Cytoplasmic Antibody (ANCA) is mainly associated with three systemic autoimmune disease including granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), eosinophilic granulomatosis with polyangiitis (EGPA). It is known that ANCA can be positive before clinical symptoms in patients with known diagnosis of GPA and ANCA titers rise before clinical manifestations appear. However, prevalence of ANCA among general population is not well known. It has not been described as well how many of people with positive ANCA eventually develop clinical manifestations of ANCA associated Vasculitis.Objectives:This study aims to estimate prevalence of ANCA in general population without ANCA associated Vasculitis. It also describes natural disease course of people with positive ANCA without ANCA associated Vasculitis. Risk factors for positive ANCA are also analyzed.Methods:This is a single center retrospective study at Center for Preventive Medicine of St. Luke’s International Hospital in Tokyo. ANCA was checked among the patients who wished to between 2018 and 2019. St. Luke’s Health Check-up Database (SLHCD) was utilized to collect the data. The patients whose serum was measured for ANCA were identified. The data for basic demographics, social habits, dietary habits and laboratory data were extracted. The charts of the patients with positive ANCA were reviewed.Results:Sera of total 1204 people were checked for ANCA. Of these 1204 people, 587 (48.8%) are male and the mean age was 55.8 years (32.6 to 79). There were total 11 patients with positive ANCA. Myeloperoxidase ANCA (MPO-ANCA) was positive for 3 patients and proteinase 3 ANCA (PR3-ANCA) was positive for 8 patients. Of these 11 patients, 5 were male (45.5%) and the mean age was 54.6 years. Two patients had history of autoimmune disease (primary biliary cirrhosis and ulcerative colitis). Five patients were evaluated by rheumatologists with the median follow-up period of 274 days. None of them developed clinical signs and symptoms of ANCA associated Vasculitis. Four out of five patients had ANCA checked later, two of which turned negative. The prevalence of ANCA in this cohort was 0.9% (95% confidence interval [95% CI]: 0.5% to 1.6%). Univariate analysis was performed to identify risk factors of positive ANCA. The variables analyzed include age, gender, body mass index (BMI), smoking habits, alcohol intake, dietary habits (fruits, fish, red meat), hypertension, dyslipidemia, and laboratory data. None of these variables demonstrated statistically significant differences except for positive rheumatoid factor (ANCA positive group: 33 % vs ANCA negative group: 9.1%, p value = 0.044).Conclusion:The prevalence of ANCA in this cohort was 0.9% (95% CI: 0.5% to 1.6%). None of them who had a follow-up developed ANCA associated Vasculitis during the follow-up period. Longer follow-up and more patients are necessary to determine natural course of people with positive ANCA.Disclosure of Interests:None declared

scholarly journals Current diagnostic tools and management modalities of Nocardia keratitis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Mohammad Soleimani ◽  
Ahmad Masoumi ◽  
Sadegh Khodavaisy ◽  
Mostafa Heidari ◽  
Ali A. Haydar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Trauma Surgery ◽  
Clinical Manifestations ◽  
Topical Steroid ◽  
Nocardia Asteroides ◽  
Diagnostic Tools ◽  
Contact Lens Wear ◽  
Drug Of Choice ◽  
Good Visual Acuity ◽  
Lens Wear

AbstractNocardia species are an uncommon but important cause of keratitis. The purpose of this review is to discus previous published papers relation to the epidemiology, etiology, diagnosis and management of Nocardia keratitis. Nocardia asteroides is the most frequently reported from Nocardia keratitis. Pain, photophobia, blepharospasm and lid swelling are mainly clinical manifestations. Usual risk factors for Nocardia keratitis are trauma, surgery, corticosteroids, and contact lens wear. Several antibiotics were used for treatment of Nocardia infection but according to studies, topical amikacin is the drug of choice for Nocardia keratitis. Topical steroid should not prescribe in these patients. In conclusion, although Nocardia keratitis is rare, early diagnosis and treatment are essential to prevent any scar formation and preserve a good visual acuity.

scholarly journals Beta-Lactams Toxicity in the Intensive Care Unit: An Underestimated Collateral Damage?

2021 ◽  
Vol 9 (7) ◽  
pp. 1505
Author(s):  
Claire Roger ◽  
Benjamin Louart
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Manifestations ◽  
Acute Interstitial Nephritis ◽  
Convulsive Status Epilepticus ◽  
Beta Lactam ◽  
Beta Lactams ◽  
Drug Induced ◽  
Icu Patients

Beta-lactams are the most commonly prescribed antimicrobials in intensive care unit (ICU) settings and remain one of the safest antimicrobials prescribed. However, the misdiagnosis of beta-lactam-related adverse events may alter ICU patient management and impact clinical outcomes. To describe the clinical manifestations, risk factors and beta-lactam-induced neurological and renal adverse effects in the ICU setting, we performed a comprehensive literature review via an electronic search on PubMed up to April 2021 to provide updated clinical data. Beta-lactam neurotoxicity occurs in 10–15% of ICU patients and may be responsible for a large panel of clinical manifestations, ranging from confusion, encephalopathy and hallucinations to myoclonus, convulsions and non-convulsive status epilepticus. Renal impairment, underlying brain abnormalities and advanced age have been recognized as the main risk factors for neurotoxicity. In ICU patients, trough concentrations above 22 mg/L for cefepime, 64 mg/L for meropenem, 125 mg/L for flucloxacillin and 360 mg/L for piperacillin (used without tazobactam) are associated with neurotoxicity in 50% of patients. Even though renal complications (especially severe complications, such as acute interstitial nephritis, renal damage associated with drug induced hemolytic anemia and renal obstruction by crystallization) remain rare, there is compelling evidence of increased nephrotoxicity using well-known nephrotoxic drugs such as vancomycin combined with beta-lactams. Treatment mainly relies on the discontinuation of the offending drug but in the near future, antimicrobial optimal dosing regimens should be defined, not only based on pharmacokinetics/pharmacodynamic (PK/PD) targets associated with clinical and microbiological efficacy, but also on PK/toxicodynamic targets. The use of dosing software may help to achieve these goals.

scholarly journals Evaluation of Cases of Abdominal Wall Endometriosis at Universidade Estadual de Campinas in a period of 10 Years

2017 ◽  
Vol 39 (08) ◽  
pp. 403-407 ◽  
Author(s):  
Daniela Yela ◽  
Lucas Trigo ◽  
Cristina Benetti-Pinto
Keyword(s):  
Cesarean Section ◽  
Abdominal Wall ◽  
Recurrence Rate ◽  
Clinical Manifestations ◽  
Disease Recurrence ◽  
Surgical Margins ◽  
Abdominal Wall Endometriosis ◽  
Postoperative Control ◽  
Epidemiological Characteristics ◽  
Previous Cesarean

Purpose To determine the clinical and epidemiological characteristics of abdominal wall endometriosis (AWE), as well as the rate and recurrence factors for the disease. Methods A retrospective study of 52 women with AWE was performed at Universidade Estadual de Campinas from 2004 to 2014. Of the 231 surgeries performed for the diagnosis of endometriosis, 52 women were found to have abdominal wall endometriosis (AWE). The frequencies, means and standard deviations of the clinical characteristics of these women were calculated, as well as the recurrence rate of AWE. To determine the risk factors for disease recurrence, Fisher's exact test was used. Results The mean age of the patients was 30.71 ± 5.91 years. The main clinical manifestations were pain (98%) and sensation of a mass (36.5%). We observed that 94% of these women had undergone at least 1 cesarean section, and 73% had used medication for the postoperative control of endometriosis. The lesion was most commonly located in the cesarean section scar (65%). The recurrence rate of the disease was of 26.9%. All 14 women who had relapsed had surgical margins compromised in the previous surgery. There was no correlation between recurrent AWE and a previous cesarean section (p = 0.18), previous laparotomy (p = 0.11), previous laparoscopy (p = 0.12) and postoperative hormone therapy (p = 0.51). Conclusion Women with previous cesarean sections with local pain or lumps should be investigated for AWE. The recurrence of AWE is high, especially when the first surgery is not appropriate and leaves compromised surgical margins.

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