A Case of Diastematomyelia Presenting With Minimal Neurologic Deficits in a Middle-Aged Patient.

Diastematomyelia is a rare congenital deformity of the spine in which the spinal cord is split into two hemicords along the sagittal plane. This condition belongs to the group of spinal dysraphisms, is more common in females, and is usually diagnosed prenatally or during childhood; rarely is it diagnosed in adults. We report a male patient in his 50s in which diastematomyelia of the thoracic spine was incidentally encountered after receiving a CT scan of the chest for shortness of breath.

A Standardized Approach to Evaluating Lower Extremity Chronic Wounds Using a Checklist.

As the population ages and more people live with diabetes, obesity, and vascular disease, chronic wounds have become more prevalent. Increasingly, wound care falls into the hands of clinicians who may be new to the specialty. To facilitate a better understanding of wounds and to ensure all integral items for best outcomes are considered, an interprofessional panel of wound care experts developed a checklist to aid in lower extremity wound identification, assessment, evaluation, and potential complication recognition.

Clinical trial designs for topical antifungal treatments of onychomycosis and implications on clinical practice.

There currently are 3 topical agents approved by the US Food and Drug Administration (FDA) to treat onychomycosis: tavaborole, efinaconazole, and ciclopirox. The phase 3 clinical trial designs for these treatments and their notable differences make it difficult for clinicians to interpret the data into clinical practice. For example, the primary end point predominantly used to assess efficacy in all the trials is complete cure, defined as no involvement of the nail plus mycologic cure; also, a notable number of patients fail to achieve a complete cure despite clear improvement in the nail.

A Proposed New Classification of Skin and Soft Tissue Infections Modeled on the Subset of Diabetic Foot Infection.

Schemes for classifying skin and soft tissue infections (SSTIs) pose limitations for clinicians and regulatory agencies. Diabetic foot infections (DFIs) are a subset of SSTIs. We developed and are proposing a classification to harmonize current schemes for SSTIs and DFIs.

Measurements of CD34+/CD45-dim Stem Cells Predict Healing of Diabetic Neuropathic Wounds.

Management of neuropathic foot ulcers in patients with diabetes (DFUs) has changed little over the past decade, and there is currently no objective method to gauge probability of successful healing. We hypothesized that studies of stem/progenitor cells (SPCs) in the early weeks of standard wound management could predict who will heal within 16 weeks. Blood and debrided wound margins were collected for 8 weeks from 100 patients undergoing weekly evaluations and treatment.

Diagnosis and Management of Onychomycosis: Perspectives from a Joint Podiatry-Dermatology Roundtable.

Onychomycosis is a fungal infection, and, as such, one of the goals of treatment should be eradication of the infective agent. Despite this, in contrast to dermatologists, many podiatric physicians do not include antifungals in their onychomycosis treatment plans. Before initiating treatment, confirmation of mycologic status via laboratory testing (eg, microscopy with potassium hydroxide preparation, histopathology with periodic acid-Schiff staining, fungal culture, and polymerase chain reaction) is important; however, more podiatric physicians rely solely on clinical signs than do dermatologists.

Daptomycin for methicillin-resistant Staphylococcus aureus diabetic foot infections.

Background: Diabetic foot infection (DFI) is a serious, difficult-to-treat infection, especially when caused by methicillin-resistant Staphylococcus aureus (MRSA). Vancomycin has been the standard treatment for MRSA infection, but lower response rates in MRSA skin infections have been reported. This analysis assessed the outcome and safety of daptomycin therapy in patients with a DFI caused by MRSA.

Medical therapy of diabetic foot infections.

Diabetic foot infections are a common and often serious problem, accounting for a greater number of hospital bed days than any other complication of diabetes. Despite advances in both antibiotic therapy and surgical management, these infections continue to be a major risk factor for amputations of the lower extremity. Although a number of wound size and depth classification systems have been adapted for use in codifying diabetic foot ulcerations, none are specific for infection.

A prospective evaluation of a pressure ulcer prevention and management E-Learning Program for adults with spinal cord injury.

Pressure ulcers are a common complication of spinal cord injury (SCI). Pressure ulcer education programs for spinal cord injured individuals have been found to have a positive effect on care protocol adherence. A prospective study was conducted among hospitalized spinal cord-injured men and women to determine if viewing the Pressure Ulcer Prevention and Management Education for Adults with Spinal Cord Injury: E-Learning Program affects their knowledge scores.

Using metaphorical techniques in focus groups to uncover mothers' feelings about family meals.

Traditional nutrition education has not been shown to consistently produce behavior change. While it has been suggested that using emotion-based messages may be a better way to influence nutrition behavior change, this has not been well tested. Producing emotion-based messages is a multi-step process that begins with exploring subconscious barriers to behavior change rather than the more obvious and typically reported barriers.

Injection sclerotherapy.

Injection sclerotherapy is an important primary and adjunctive therapy in the spectrum of care for superficial venous insufficiency. This article briefly reviews the history of the procedure, agents used, technique, and outcomes. The place of injection sclerotherapy in the treatment of superficial venous disease is discussed.

Uterine artery embolization: state of the art.

Since the first report in 1995, there has been rapid expansion of uterine artery embolization as a therapy for symptomatic uterine fibroids. The published literature and clinical experience show that this procedure is safe and effective. This article discusses the history of the procedure, current issues in procedure technique, and the state of the literature regarding outcomes of embolization.

Breast cancer in older women: treatment, psychosocial effects, interventions, and outcomes.

It is estimated that 48% of women with breast cancer are age 65 and older; yet, scant research focuses on this cohort. Recent advances in breast cancer management have raised many questions regarding appropriate treatment of older patients with cancer. Despite recent emphasis on medical interventions for older women, there is little focus on the unique clinical presentation and psychological sequelae of breast cancer in this population.

Colon cancer. Prevention and detection strategies.

The majority of colon cancers are adenocarcinomas originating from colonic epithelial tissue. Most colon tumors originate in the left side of the colon. Right colon tumors grow into the bowel lumen.

Response of hand dermatitis to a new skin barrier-protectant cream.

Twenty-five patients with hand dermatitis participated in a pilot study utilizing a new skin barrier cream containing white petrolatum. Each patient received treatment with SBR-Lipocream, which was applied three to four times daily for a period ranging from one to four weeks. All patients completed pre- and postsurvey questionnaires and were evaluated by a staff physician prior to, and upon completion of, the study.

Giant cell tumor of tendon sheath.

The giant cell tumor of tendon sheath is a benign histiocytic proliferation of the articular and peritendinous synovial tissue that has only rarely been reported in the dermatologic literature. The lesion manifests as a firm 1 to 3 cm nodule most frequently occurring on the fingers, hands, and wrists, where it is attached to the tendon sheath. Its histopathologic appearance is characterized by the presence of multinucleate giant cells.

Basal cell carcinoma of the scrotum.

Basal cell carcinoma is the most common human neoplasm, with hundreds of thousands of new cases occurring on an annual basis. Involvement of the scrotum is quite rare, with fewer than twenty-five reported cases. We present a patient with a basal cell carcinoma of the scrotum and review the literature regarding this infrequently documented site.