Assessing the Vulnerability of Military Installations in the Coterminous United States to Potential Biome Shifts Resulting from Rapid Climate Change.

Climate-change impacts to Department of Defense (DoD) installations will challenge military mission and natural resource stewardship efforts by increasing vulnerability to flooding, drought, altered fire regimes, and invasive species. We developed biome classifications based on current climate for the coterminous United States using the Holdridge Life Zone system to assess potential change on DoD lands. We validated classifications using comparisons to existing ecoregional classifications, the distribution of major forest types, and tree species in eastern North America.

Standard management options for rosacea, part 2: options according to subtype.

The standard management options were developed by a consensus committee and review panel of 26 experts to assist in providing optimal patient care based on the standard classification and grading systems for rosacea that were developed to perform research; analyze results and compare data from different sources; and provide a common terminology and reference for the diagnosis, treatment, and assessment of results in clinical practice. We discuss the standard management options for rosacea in 2 parts: (1) overview and broad spectrum of care, and (2) management options according to subtype. The menu of options is considered provisional and may be expanded and updated as appropriate.

Standard management options for rosacea, part 1: overview and broad spectrum of care.

The standard management options were developed by a consensus committee and review panel of 26 experts to assist in providing optimal patient care based on the standard classification and grading systems for rosacea that were developed to perform research; analyze results and compare data from different sources; and provide a common terminology and reference for the diagnosis, treatment, and assessment of results in clinical practice. We discuss standard management options for rosacea in 2 parts: (1) overview and broad spectrum of care, and (2) options according to subtype. The options are considered provisional and may be expanded and updated as appropriate.

Lesser-metatarsal medial displacement osteotomy for the treatment of digital transverse plane deformities.

We sought to evaluate the clinical and radiographic outcomes in patients treated with a medial displacement transverse osteotomy of the second metatarsal to correct transverse hammer toe deformities. Eighteen patients underwent 20 procedures in 3 years. Each patient had a transverse plane deformity of the second metatarsophalangeal joint.

The nosology of rosacea.

The National Rosacea Society (NRS) convened a committee of dermatology thought leaders to develop a standard classification system for rosacea. Based on the primary and secondary characteristics of this disorder, the NRS Expert Committee identified 4 types of rosacea: erythematotelangiectatic, papulopustular, phymatous, and ocular; one variant, granulomatous, also was recognized. The NRS Expert Committee also developed a grading system for rosacea signs and symptoms that will complement this classification system.

Skin and soft tissue infections in special populations.

Skin infections often develop in children, immunosuppressed patients, and patients with chronic conditions such as diabetes. Commonly encountered cutaneous infections are described herein, and treatments are briefly discussed. Photographs of infections provide assistance with differential diagnosis.

The treatment of rosacea.

The roundtable discussion encompassed many topics-from seminal research by Ronald Marks to the latest National Rosacea Society-funded studies on the pathophysiology of rosacea. All participants commented on the value of the new National Rosacea Society classification system for subtypes of rosacea, designed to direct future research and help physicians better diagnose and manage these subtypes. A lively discussion centered on treatment options for the various subtypes of rosacea ensued.

The subtypes of rosacea: implications for treatment.

Lack of standardized rosacea nosology was the rationale for the National Rosacea Society to convene a committee of dermatology thought leaders to develop a standard classification system. Standardization of rosacea classification should be followed by standardization of treatment. Many pharmacologic and nonpharmacologic interventions for rosacea are being used based on clinical observation alone.