Madura's foot in native of the Philippines immigrant in northern Italy

Clinical case about a man, emigrated from Philippines. The patient presented a single cutaneous lesion on a foot that was thick, swollen and blackish. There were no fistulas. He remenbers a traumatic implantation of wood splinters on the sole foot 10 years ago. Radiography, Magnetic Resonance, tomographic investigation were performed. The exceptional occurrence of the mycetoma in our countries and absence of clear infectious picture were the reason for an initial clinical misinterpretation as a benign neoplasm of soft tissues.We performed surgical removal of neoplasm, with histological examination.Histopathologic exam revealed an unexpected mass of fungal hyphae; diagnosis of Madura’s foot was confirmed. We started pharmacological therapy with “itracozanole”.Our case offers opportunity to stress need for clinical suspicion of fungal infection, considering increase of immigration by the countries with endemic mycetoma, and we must prepare to observe and treat many pathologies now unknown in our practice

IGV short scale to assess implicit value of visualizations through explicit interaction

This paper reports the assessment of the infographics-value (IGV) short scale, designed to measure the value in the use of infographics. The scale was made to assess the implicit quality dimensions of infographics. These dimensions were experienced during the execution of tasks in a contextualized scenario. Users were asked to retrieve a piece of information by explicitly interacting with the infographics. After usage, they were asked to rate quality dimensions of infographics, namely, usefulness, intuitiveness, clarity, informativity, and beauty; the overall value perceived from interacting with infographics was also included in the survey. Each quality dimension was coded as a six-point rating scale item, with overall value included. The proposed IGV short scale model was validated with 650 people. Our analysis confirmed that all considered dimensions in our scale were independently significant and contributed to assessing the implicit value of infographics. The IGV short scale is a lightweight but exhaustive tool to rapidly assess the implicit value of an explicit interaction with infographics in daily tasks, where value in use is crucial to measuring the situated effectiveness of visual tools

Sonography in the diagnosis of tear of the knee menisci

Goal of the study. The purpose of this study is to compare the accuracy of sonographic to radiographic measurements of subacromial space, and verify its variations in relation to acromial morphology, age, sex and rotator cuff pathologies. Materials and methods. As a result, we have compared a radiographic examination to sonographic examination, each measuring the subacromial space in 200 random shoulders, with a personal method. The sonographic examination was performed by using a HDI 5000 ultrasound scanner Sono-CT with 7.5 MHz linear array transducer. No stand-off pad was utilized. Results. The statistical analysis of the data derived from the two measurements was not sufficient to conclude that the two techniques are different (p>0.8). They also correspond with the radiographic morphology of the acromion. The size of subacromial space was related to the acromial morphology, female gender, and rotator cuff pathology, however, it was not related to age. Discussion and conclusions. Our results clearly show that sonographic measurements are very close to those obtained by X-ray (p>0.8). The Bland\u2013Altman analysis showed that for all groups, the were small enough to give us confidence that the sonographic technique may be used in place of the radiographic one for clinical purposes. One-way ANOVA showed that sonographic measurements were statistically different among the four groups (p<0.05). The sonography demonstrated precision, accuracy and carefulness in the measurement of the subacromial space

Sonographic evaluation of subacromial space

Goal of the study. The purpose of this study is to compare the accuracy of sonographic to radiographic measurements of subacromial space, and verify its variations in relation to acromial morphology, age, sex and rotator cuff pathologies. Materials and methods. As a result, we have compared a radiographic examination to sonographic examination, each measuring the subacromial space in 200 random shoulders, with a personal method. The sonographic examination was performed by using a HDI 5000 ultrasound scanner Sono-CT with 7.5 MHz linear array transducer. No stand-off pad was utilized. Results. The statistical analysis of the data derived from the two measurements was not sufficient to conclude that the two techniques are different (p>0.8). They also correspond with the radiographic morphology of the acromion. The size of subacromial space was related to the acromial morphology, female gender, and rotator cuff pathology, however, it was not related to age. Discussion and conclusions. Our results clearly show that sonographic measurements are very close to those obtained by X-ray (p>0.8). The Bland\u2013Altman analysis showed that for all groups, the were small enough to give us confidence that the sonographic technique may be used in place of the radiographic one for clinical purposes. One-way ANOVA showed that sonographic measurements were statistically different among the four groups (p<0.05). The sonography demonstrated precision, accuracy and carefulness in the measurement of the subacromial space

Beyond handover: supporting awareness for continuous coverage

Abstract Hospitals are required to operate as a continuous system because patient care cannot be temporarily suspended and handover is seen as a key method for enabling this. This paper reports a study of handover in a medical admissions unit. We draw on the notion of awareness as conceptualised within the Computer Supported Cooperative Work literature to explore the role played by a variety of cognitive artifacts in supporting continuous coverage. While such awareness is typically characterised as being ‘effortless’, our study reveals that maintaining awareness in a context such as the medical admissions unit is effortful due to invisible work. We suggest that the notion of awareness is beneficial for exploring the practices of continuous coverage because it moves attention away from the moment of handover, instead encouraging consideration of the variety of practices through which clinicians display their work to, and monitor the work of, colleagues on different shifts. We argue that efforts to support continuous coverage should focus on improving awareness by increasing the visibility of information

La protesi di spalla negli esiti traumatici

Le fratture di omero prossimale esitano frequentemente in sequele che richiedono, nei casi gravi, un intervento di protesizzazione dell\u2019articolazione gleno-omerale. Lo scopo del nostro studio \ue8 analizzare i risultati clinici e funzionali dell\u2019utilizzo della protesi di spalla negli esiti traumatici. Abbiamo eseguito una revisione della letteratura dal 2005 al 2015 e abbiamo identificato 20 lavori che dimostrano come le protesi di spalla siano in grado di migliorare il dolore e la mobilit\ue0 nei pazienti con esiti di fratture dell\u2019omero prossimale ma con risultati inferiori rispetto a quelli ottenuti nel trattamento delle fratture in acuto o nell\u2019artrosi primaria. Nelle sequele di frattura infatti, l\u2019impianto di una protesi \ue8 spesso una procedura complessa con tassi di complicanze elevati. Se in passato erano tradizionalmente utilizzate le emiartroprotesi, recentemente le protesi totali anatomiche e inverse hanno mostrato risultati migliori anche nelle casiste con follow-up a medio-lungo termine.The treatment of fracture sequelae of proximal humerus is still a challenge. Shoulder arthroplasty improves pain and Range Of Motion (ROM) but the results are inferior to the outcomes currently obtained in primary osteoarthritis or acute trauma. Anatomical and reverse total shoulder prosthesis are becoming increasingly popular because of better results than hemiarthroplasty

Data Work in a Knowledge-Broker Organization: How Cross-Organizational Data Maintenance shapes Human Data Interactions.

The term Human-Data Interaction (HDI) conceptualizes the growing importance of understanding how people need and desire to use and interact with data. Previous HDI cases have mainly focused on the interface between personal health data and the healthcare sector. This paper argues that it is relevant to consider HDI at an organisational level and examines how HDI can look in such a context, where data and data maintenance are core assets and activities. We report on initial findings of a study of a knowledge-broker organisation, where we follow how data are produced, shared, and maintained in a cross-organisational context. We discuss similarities and differences of HDI aroundpersonal health data and cross-organisational data maintenance. We propose to extend the notion of HDI to include the complexity of cross-organisational data work

Il controllo del sanguinamento nella protesi totale di ginocchio

Total knee arthroplasty is associated with high blood loss and high incidence of blood transfusion. In order to reduce the bleeding after total knee replacement, several strategies have been used simultaneously, including surgical and medical techniques, technological devices and drugs. The synergistic use of the available methods may be a good solution for reducing blood loss and requests for autologous blood transfusion

Revision reverse shoulder arthroplasty in failed shoulder arthroplasties for rotator cuff deficiency

PURPOSE: the aim of this systematic literature review is to report clinical outcomes of reverse shoulder arthroplasty (RSA) used as a revision surgery following failure of the primary implant due to rotator cuff insufficiency. METHODS: a systematic review was performed using the following key words: revision, shoulder, rotator cuff deficiency, outcome assessment, treatment outcome, complications. Studies eligible for inclusion in the review were clinical trials investigating patients in whom a primary shoulder arthroplasty implant with an incompetent rotator cuff was replaced with a reverse shoulder prosthesis. RESULTS: nine articles were identified and further reviewed. The results refer to a total of 226 shoulders that were treated with RSA as revision surgery. The patients in the studies had a mean age ranging from 64 to 72 years and the longest follow-up was 3.8 years. Improvements in function and reduction of pain were shown by many studies, but the mean Constant score ranged from 44.2 to 56. High complication rates (of up to 62%) were recorded, and a mean reoperation rate of 27.5%. CONCLUSIONS: RSA as revision surgery for patients with rotator cuff deficiency is a valid option, and often the only solution available, but it should be limited to elderly patients with poor function and severe pain. LEVEL OF EVIDENCE: level IV, systematic review of level I-IV studies