Cases reported "Foot Diseases"

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1/16. Common painful foot syndromes.

    The prevalence of foot problems in the general population is 10%, and in the elderly it ranges from 53% to 95%. Proximal plantar fasciitis is the most common cause of painful feet in clinical practice, and is twice as common among women as among men. metatarsalgia is probably the most common cause of foot pain among middle-aged women.
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keywords = elderly
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2/16. Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome: a review of the literature and a report of three cases.

    Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome is a disease that commonly produces symmetrical synovitis and swelling of both the upper and lower extremities. It generally involves the wrists, hands, feet, and ankles of the affected individual. This syndrome most often resembles that of polymyalgia rheumatica and rheumatoid arthritis and usually affects elderly Caucasian males. Serological testing is typically negative except for a mild to moderate elevation of the erythrocyte sedimentation rate. The HLA-B7 phenotype is present in approximately 50% of patients with this syndrome. Treatment of RS3PE syndrome is heralded by the predictable response to low-dose corticosteroid or hydroxychloroquine therapy. There has been no previous mention of this condition in the podiatric literature. Presented below is a review of this syndrome and three case studies.
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3/16. Elastofibroma of the foot: uncommon presentation: a case report and review of the literature.

    We report the clinical, microscopic and ultrastructural features of an elastofibroma arising in the foot. The lesion typically occurs in the elderly, and in 85% of cases arises from the connective tissue of the posterior chest wall. The histopathologic features of this lesion are distinctive, and are characterized by a haphazard array of eosinophilic collagen and elastic fibers, associated with fibroblasts and aggregates of mature fat cells. There are only two reported cases in the literature arising in the foot.
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keywords = elderly
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4/16. Hypernatremic dehydration complicated by peripheral gangrene in elderly--case reports.

    The authors describe the association of hypernatremic dehydration and peripheral gangrene in elderly patients. This association is known in infancy but hitherto has not been described in the elderly.
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keywords = elderly
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5/16. Classic Kaposi's sarcoma in the Inuit of northern quebec.

    BACKGROUND: Classic Kaposi's sarcoma (KS) is predominantly a disease of eastern Mediterranean and Ashkenazi Jewish elderly men. Nevertheless, the disease has been reported to occur in people from various other ethnic and regional backgrounds. OBJECTIVE: We report, for the first time, the occurrence of classic KS in five Inuit people living in northern quebec, canada. methods AND RESULTS: We describe the case of a 69-year-old Inuit man with classic KS, and report four other cases of KS in the Inuit population, identified by a review of our hospital's dermatopathology records. CONCLUSION: The discovery of classic KS in the Inuit population of northern quebec brings with it new questions as to the origins of the KS-associated herpes virus in this population. It is our belief that the answers to these questions are in the genotype of the virus that is present in this community.
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keywords = elderly
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6/16. Ungual basal cell carcinoma on the fifth toe mimicking chronic dermatitis: case study.

    BACKGROUND: The finger, toe, and nail unit are rare sites of basal cell carcinoma (BCC). Only a few patients with BCC of the foot have been described in the world literature, and ungual BCC is even less frequent. OBJECTIVE: To discuss through a case report the clinical features and diagnosis of BCC of the foot. methods: We report an unusual case of BCC of the nail unit of the fifth toe of an elderly woman that mimicked chronic dermatitis. CONCLUSION: Our case clearly highlights the need for biopsy and histopathologic examination whenever we see inflammatory lesions with a loss of substance that are refractory to systemic or topical treatments.
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keywords = elderly
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7/16. The use of adjuvant hyperbaric oxygen in treatment of the diabetic foot.

    Hypoxia in the relatively ischemic diabetic foot impairs leukocyte bacterial killing and fibroblast-collagen support for capillary angiogenesis. infection in even the relatively young, "warm-foot" diabetic with microangiopathy, neuropathy, and infection leads to hypoxia due to local high oxygen consumption. The 1100 to 1300 mm Hg arterial PO2 achievable with hyperbaric oxygen results in elevation of wound PO2. Periodic correction of wound hypoxia improves leukocyte bacterial killing and support for capillary angiogenesis. Hyperbaric oxygen is usually futile in the elderly diabetic with significant and generalized large-vessel occlusion.
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keywords = elderly
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8/16. Microvascular free tissue transfer after arterial revascularization in the elderly: an alternative to amputation.

    Extensive tissue loss associated with ischemia is a common problem in the elderly population with vascular insufficiency. This study involves 3 patients who underwent free tissue transfer following arterial revascularization for limb salvage. Latissimus dorsi, internal oblique muscles, and temporoparietal fascia free flaps were used. Two patients had the recipient vessel reconstituted by collaterals after complete atherosclerotic occlusion. There were no postoperative complications, and the reconstructive procedure never precipitated ischemia of the revascularized extremity. We conclude that free tissue transfers can be performed safely with good functional results in elderly patients. Such transfers should be considered an alternative to amputation and a rational step after arterial revascularization for limb salvage in patients with complex, nonhealing soft tissue defects.
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ranking = 6
keywords = elderly
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9/16. Multicentric giant lymph node hyperplasia, Kaposi's sarcoma, and lymphoma.

    We studied two cases of a recently recognized systemic lymphoproliferative disease with morphological features of Castleman's disease: multicentric giant lymph node hyperplasia. Both patients developed Kaposi's sarcoma and had laboratory evidence of immune abnormalities, including reversed T4 to T8 ratios. One patient's disease had a subacute course with fevers of unknown origin, mucocutaneous candidiasis, and progressive thrombocytopenia, while the other patient's disease had a fulminant course with anemia, thrombocytopenia, and splenic lymphoma. Both patients were elderly, and both died of complications of multicentric giant lymph node hyperplasia.
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keywords = elderly
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10/16. Remitting seronegative symmetrical synovitis with pitting edema. RS3PE syndrome.

    Eight elderly men and two elderly women presented with symmetrical polysynovitis of acute onset involving most of their appendicular joints and flexor digitorum tendons associated with pitting edema of the dorsum of both hands and both feet. Onset of seven of the ten cases could be pinpointed almost to the hour. Rheumatoid factors were absent from serum samples in all, and no radiologically evident erosions developed. Clinical and laboratory signs of inflammation and the edema disappeared gradually in each case. Treatment consisted of aspirin or other nonsteroidal anti-inflammatory drugs. hydroxychloroquine, 200 to 400 mg/day, was given in six and gold therapy in two cases. Painless limitation of motion of the wrists and/or fingers persisted in all, although the patients were both unaware of and unhampered by this abnormality. Six of eight cases where typing was possible were positive for HLA-B7, CW7, and DQW2 (relative risk for B7, 9.5). Three cases of this syndrome were found in a consecutive series of 52 men diagnosed as having definite "rheumatoid arthritis," and thus represent a distinctive condition with an excellent prognosis.
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keywords = elderly
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