Involvement of foot in patients with spondyloarthritis: Prevalence and clinical features

Background

The purpose of this study was to evaluate the foot involvement in a group of patients with spondyloarthritis in regard to symptoms, type and frequency of deformities, location and radiological changes.

温室作业对蔬菜种植人员职业性肌肉骨骼疾患的影响

目的 探讨温室作业对蔬菜种植人员职业性肌肉骨骼疾患（WMSDs）的影响。方法 采用流行病学横断面调查方法，选取西北某地区602人作为研究对象，其中温室作业人员（温室组）307人、非温室作业人员（非温室组）295人。通过问卷调查和体格检查，收集研究对象个人基本信息和各部位WMSDs检出信息。采用卡方检验进行组间WMSDs检出率的比较、Logistic回归模型进行多因素分析。结果 温室组WMSDs检出率为84.04%，高于非温室组（60.68%）（χ2=41.265，P＜0.001）。温室组颈部、肩部、下背部、手部和腿部5个部位WMSDs检出率分别为36.2%、29.0%、62.2%、20.2%和51.1%，均显著高于非温室组（24.7%、18.6%、41.4%、12.2%和26.4%）（P＜0.05）。温室组2个部位、3个部位和≥4个部位WMSDs检出率分别为25.1%、16.9%和19.2%，亦显著高于非温室组（18.3%、9.2%和10.2%），但两组间单一部位WMSDs检出率差异无统计学意义。校正性别、年龄等因素后，从事温室作业能增加作业人员WMSDs的风险（OR=3.558，95%CI 2.338～5.414），女性患病风险（OR=4.682，95%CI 2.600～8.433）高于男性（OR=2.667，95%CI 1.421～5.007）。结论 温室作业可增加蔬菜种植人员WMSDs的患病风险，多部位WMSDs尤其值得关注。     

A rare case of invasive melanoma likely arising from passenger melanocytes of a basal cell carcinoma

Neoplasms consisting of different cell lineages within a single skin specimen are rare, yet well documented in the literature. However, to date, there appears to be no report of invasive melanoma arising directly from the passenger melanocytes of a basal cell carcinoma (BCC). We present a case of a 91-year-old male with a suspicious lesion on the ear. Histopathology and immunohistochemical staining revealed BCC closely intertwined with invasive melanoma that exhibited foci of chondroid differentiation. The melanoma appeared to arise from the benign-appearing passenger melanocytes of the BCC and lacked connection to the overlying epidermis or an in situ component. Multiple dermatopathologists reviewed the case and agreed that the most likely explanation for the histopathologic findings was that the invasive melanoma arose from the passenger melanocytes within the BCC.     

Fatal neonatal nephrocutaneous syndrome in 18 Roma children with EGFR deficiency

Epidermal growth factor receptor (EGFR) is a transmembrane glycoprotein with tyrosine-kinase signaling activity, involved in many cellular functions including cell growth and differentiation. Germ line loss-of-function mutations in EGFR lead to a severe neonatal skin disorder (Online Mendelian Inheritance in Man #131550). We report 18 premature Roma children from 16 families with birthweights ranging 440–1470 g and multisystem diseases due to the homozygous mutation c.1283G˃A (p.Gly428Asp) in EGFR. They presented with thin, translucent, fragile skin (14/15), skin desquamation (10/17), ichthyosis (9/17), recurrent skin infections and sepsis (9/12), nephromegaly (10/16) and congenital heart defects (7/17). Their prognosis was poor, and all died before the age of 6 months except one 13-year-old boy with a severe skin disorder, dentinogenesis imperfecta, Fanconi-like syndrome and secondary hyperaldosteronism. Management of ion and water imbalances and extremely demanding skin care may improve the unfavorable outcome of such patients.     

The impact of public performance reporting on health plan selection and switching: A systematic review and meta-analysis

The dissemination of public performance reporting (PPR) cards aims to increase utilisation of information on quality of care by consumers when making health plan choices. However, evaluations of PPR cards show that they have little impact on consumer choices. The aim of this study is to undertake a systematic review and meta-analysis of the impact of PPR cards in promoting health plan selection and switching between health plans by consumers. We searched five online databases and eight previous reviews for studies reporting findings on PPR and health plans. We extracted data and conducted quality assessment, systematic critical synthesis and meta-analyses on the included studies. We identified eight relevant health plan articles related to selection (n?=?2), switching (n?=?4), selection/switching (n?=?2). Meta-analyses showed that PPR was associated with an improvement in health plan selection and a very small deterioration in switching health plans though these changes were not statistically significant. Differences were observed between employer-sponsored health insurance and Medicare/Medicaid insurance. Given the small number of studies included in the review, further research examining the impact of PPR on health plan selection and switching in a range of insurance markets is required.     

Circumstances of provoked recurrent venous thromboembolism: the Austrian study on recurrent venous thromboembolism

Journal of Thrombosis and Thrombolysis - Patients with unprovoked deep-vein thrombosis (DVT) of the leg or pulmonary embolism (PE) have a high recurrence risk. How often these recurrences are...