Correction of Postaxial Metatarsal Polydactyly of the Foot by Percutaneous Ray Amputation and Osteotomy

Polydactyly of the foot is a congenital anomaly characterized by the appearance of all or part of 1 or more additional rays. The patient with this condition might complain of an abnormal cosmetic appearance or difficulty with footwear. A minimally invasive technique for correction of postaxial metatarsal polydactyly of the foot is presented in this techniques report.     

Abnormal vitamin D metabolism in patients with cirrhosis

To assess the role of hepatic function and alcohol on vitamin D metabolism, serum 25-hydroxyvitamin D (25-OHD) levels were measured in 20 healthy nonalcoholic control subjects, 31 inactive cirrhotics whose alcoholism was in remission, 8 alcoholic cirrhotics, and 15 alcoholics with normal liver function. Cirrhosis, but not alcoholism, was associated with low serum 25-OHD levels. The aminopyrine breath test (ABT) was performed because aminopyrine, like vitamin D₃, is metabolized by hepatic microsomes; the ABT correlated highly (r-0.74,P<0.01) with serum 25-OHD in the inactive cirrhotics. After an intravenous injection of 120 g vitamin D₃, serum 25-OHD rose significantly within 24 hr in 6 healthy controls and 2 patients with celiac disease but not in 6 inactive cirrhotics. The data suggest impaired 25-hydroxylation of vitamin-D impaired in patients with cirrhosis, related predominantly to the degree of hepatic dysfunction.This work was supported in part by Grant AM 17303 from the National Institutes of Health.     

Implications of increased weight and waist circumference on vascular risk in an older Chinese population: the Guangzhou Biobank Cohort Study

BackgroundThe relationships between weight and waist on vascular risk are well described, but the long-term impact of these parameters is less clearly defined, particularly in Chinese populations.MethodsTen thousand four hundred and ten older subjects (50–85 years) were recruited and blood pressure, anthropometric, and fasting vascular risk factors measured. Socioeconomic and demographic data, including self-reported weight and waist gain since 18 years. The association of weight and waist gain with these vascular risk factors was analysed.ResultsWeight, and particularly waist gain were associated with a more adverse vascular risk factor profile, with the most adverse profile associated with gains in both weight and waist. Anthropometric gains were associated with increased risk even in non-obese subjects (p < 0.05). Even after adjustment for a range of demographic and socioeconomic factors, waist gain was associated with additional risk of having the metabolic syndrome and its components and self-reported vascular disease in those centrally obese subjects (p < 0.05 for all).ConclusionIncreased weight and waist increased the level of vascular risk factors and self-reported disease in both non-obese and obese subjects. The high prevalence of vascular risk factors in this population forewarns of a major developing health burden in the rapidly modernising 1.2 billion Chinese population.     

POLLAR: Impact of air POLLution on Asthma and Rhinitis; a European Institute of Innovation and Technology Health (EIT Health) project

Allergic rhinitis (AR) is impacted by allergens and air pollution but interactions between air pollution, sleep and allergic diseases are insufficiently understood. POLLAR (Impact of air POLLution on sleep, Asthma and Rhinitis) is a project of the European Institute of Innovation and Technology (EIT Health). It will use a freely-existing application for AR monitoring that has been tested in 23 countries (the Allergy Diary, iOS and Android, 17,000 users, TLR8). The Allergy Diary will be combined with a new tool allowing queries on allergen, pollen (TLR2), sleep quality and disorders (TRL2) as well as existing longitudinal and geolocalized pollution data. Machine learning will be used to assess the relationship between air pollution, sleep and AR comparing polluted and non-polluted areas in 6 EU countries. Data generated in 2018 will be confirmed in 2019 and extended by the individual prospective assessment of pollution (portable sensor, TLR7) in AR. Sleep apnea patients will be used as a demonstrator of sleep disorder that can be modulated in terms of symptoms and severity by air pollution and AR. The geographic information system GIS will map the results. Consequences on quality of life (EQ-5D), asthma, school, work and sleep will be monitored and disseminated towards the population. The impacts of POLLAR will be (1) to propose novel care pathways integrating pollution, sleep and patients’ literacy, (2) to study sleep consequences of pollution and its impact on frequent chronic diseases, (3) to improve work productivity, (4) to propose the basis for a sentinel network at the EU level for pollution and allergy, (5) to assess the societal implications of the interaction. MASK paper N°32.     

Voluntary HIV antibody testing amongst youth in Hong Kong

We performed a study to estimate the prevalence of and factors associated with human immunodeficiency virus (HIV) antibody-testing behaviour among youth in Hong Kong. It was a population-based cross-sectional study. Questions on HIV testing were asked as part of a youth sexuality study conducted in July to December 1996 among young adults in Hong Kong. A total of 517 (53.6%) males and 447 (46.4%) females aged 17 to 28 years completed an anonymous structured self-administered questionnaire. Respondents had good knowledge about correct modes of HIV transmission and prevention. 9.4% (95% confidence interval [CI]: 7.0, 12.3) of males and 6.4% (95% CI: 4.3, 9.1) of females had been tested for HIV through blood donation. Excluding blood donation, 3.7% (95% CI: 2.2, 5.7) of males and 3.6% (95% CI: 2.1, 5.9) of females had been tested (voluntary testing). 47.5% (95% CI: 44.4, 50.7) of subjects reported at least one major risk factor for HIV infection. In multivariate analyses, factors independently associated with both voluntary HIV testing and HIV testing by blood donation were age and having had sex with multiple partners. A higher educational level was a predictor of HIV testing by blood donation. Self-assessment of having sufficient sex education was also significantly associated with voluntary HIV testing. HIV testing is not widespread in Hong Kong and those at risk are more likely to have been tested. It is of concern, however, that many of those reporting risk factors have not been tested.