Citation: Foot & Ankle International. 2014 Nov;35(11):1103-7
Author: Shivarathre DG, Howard N, Krishna S, Cowan C, Platt SR
Abstract: BACKGROUND: The impact of psychosocial factors and personality traits in chronic
pain is well established. However, there has been limited literature analyzing
the influence of psychological issues in chronic foot and ankle pain. The aim of
our study was to identify the association of certain psychosocial factors and
personality traits in individuals with chronic painful foot and ankle
disorders.
METHODS: Patients with chronic foot and ankle pain were recruited
from the specialist foot and ankle clinic. The Eysenck Personality
Questionnaire-Revised (EPQ-R), Dysfunctional Attitude Scale (DAS), and Hospital
Anxiety Depression (HAD) scale were administered in the form of questionnaires.
An age- and sex-matched cohort of healthy volunteers served as the control
group. Sample size was determined after power calculation, and a total of 90
participants were recruited with informed consent with 45 participants in each
arm. Results were analyzed and statistical analyses were performed using
SPSS.
RESULTS: Patients with chronic foot and ankle pain had significantly
higher neuroticism scores than the control group (P < .05). The study also
revealed greater prevalence of anxiety and depression in patients with chronic
pain (P < .05).
CONCLUSION: The study showed a significant association of
anxiety, depression, and neuroticism in patients presenting with chronic foot
and ankle pain. Clinicians should recognize the influence of these specific
psychological issues to provide a more holistic approach to the clinical
problem.
LEVEL OF EVIDENCE: Level III, case control study.
Link to PubMed record
Friday 28 November 2014
WUTH publication: MRI use with artificial erection in cases of painful erections
Citation: Can Urol Assoc J. 2014 Nov;8(11-12):394.
Author: Lucky, Marc A, McGuinness, Luke A, Floyd, Michael S, Parr, Nigel J
Link to PubMed record.
Author: Lucky, Marc A, McGuinness, Luke A, Floyd, Michael S, Parr, Nigel J
Link to PubMed record.
Friday 14 November 2014
WUTH publication: Lower limb amputation in England: prevalence, regional variation and relationship with revascularisation, deprivation and risk factors. A retrospective review of hospital data
Citation: Journal of the Royal Society of Medicine. 2014 Nov 11. pii: 0141076814557301. [Epub ahead of print]
Author: Ahmad N, Thomas GN, Gill P, Chan C, Torella F
Abstract: OBJECTIVE: We describe the prevalence of major lower limb amputation across England and its relationship with revascularisation, patient demography and disease risk factors.
DESIGN: Retrospective cohort study.
SETTING: England 1 April 2003 to 31 March 2009.
PARTICIPANTS: Patients aged 50-84 years.
MAIN OUTCOME MEASURES: Age standardised prevalence rates were calculated using Hospital Episode Statistics as the numerator with census data as the denominator. The outcome measure 'amputation with revascularisation' was created if an amputation could be linked with a revascularisation. Logistic regression determined the odds of having an amputation with a revascularisation across England. Regression was performed unadjusted and repeated after controlling for demographic (age, sex, social deprivation) and disease risk factors (diabetes, hypertension, coronary heart disease, cerebrovascular disease, smoking).
RESULTS: There were 25,312 amputations and 136,215 revascularisations, and 7543 cases were linked. The prevalence rate per 100,000 (95% confidence intervals) for amputation was 26.3 (26.0-26.6) with rates significantly higher in Northern England (North: 31.7; 31.0-32.3, Midlands: 26.0; 25.3-26.7, South: 23.1; 22.6-23.5). The revascularisation rate was 141.6 (140.8-142.3) with significantly higher rates again in Northern England (North: 182.1; 180.5-183.7, Midlands: 121.3; 119.8-122.9, South 124.9; 123.9-125.8). The odds of having an amputation with a revascularisation remained significantly higher in the North (OR 1.22; 1.13-1.33) even after controlling demographic and disease risk factors.
CONCLUSIONS: There is a North-South divide in England for both major lower limb amputation and revascularisation. The higher odds of having an amputation with a revascularisation in the North were not fully explained by greater levels of deprivation or disease risk factors.
Link to PubMed record.
Author: Ahmad N, Thomas GN, Gill P, Chan C, Torella F
Abstract: OBJECTIVE: We describe the prevalence of major lower limb amputation across England and its relationship with revascularisation, patient demography and disease risk factors.
DESIGN: Retrospective cohort study.
SETTING: England 1 April 2003 to 31 March 2009.
PARTICIPANTS: Patients aged 50-84 years.
MAIN OUTCOME MEASURES: Age standardised prevalence rates were calculated using Hospital Episode Statistics as the numerator with census data as the denominator. The outcome measure 'amputation with revascularisation' was created if an amputation could be linked with a revascularisation. Logistic regression determined the odds of having an amputation with a revascularisation across England. Regression was performed unadjusted and repeated after controlling for demographic (age, sex, social deprivation) and disease risk factors (diabetes, hypertension, coronary heart disease, cerebrovascular disease, smoking).
RESULTS: There were 25,312 amputations and 136,215 revascularisations, and 7543 cases were linked. The prevalence rate per 100,000 (95% confidence intervals) for amputation was 26.3 (26.0-26.6) with rates significantly higher in Northern England (North: 31.7; 31.0-32.3, Midlands: 26.0; 25.3-26.7, South: 23.1; 22.6-23.5). The revascularisation rate was 141.6 (140.8-142.3) with significantly higher rates again in Northern England (North: 182.1; 180.5-183.7, Midlands: 121.3; 119.8-122.9, South 124.9; 123.9-125.8). The odds of having an amputation with a revascularisation remained significantly higher in the North (OR 1.22; 1.13-1.33) even after controlling demographic and disease risk factors.
CONCLUSIONS: There is a North-South divide in England for both major lower limb amputation and revascularisation. The higher odds of having an amputation with a revascularisation in the North were not fully explained by greater levels of deprivation or disease risk factors.
Link to PubMed record.
Monday 10 November 2014
WUTH publication: Radiological Prevalence of Degenerative Arthritis of the First Metatarsophalangeal Joint
Citation: Foot & Ankle International. 2014 Nov 6 [epub ahead of print]
Author: Howard N, Cowen C, Caplan M, Platt S
Abstract: BACKGROUND: The prevalence of osteoarthritis of the first metatarsophalangeal joint (MTPJ) has not been completely determined in a population-based study. The aim of the study was to determine the age- and gender-related prevalence of radiological first MTPJ arthritis.
METHODS: We analyzed 517 consecutive radiographs of adult patients who presented with acute foot injuries to the accident and emergency department over a 6-month period. Radiographs were assessed independently by 2 authors using the Hattrup and Johnson grading system for osteoarthritic changes in the first MTPJ.
RESULTS: The radiographic prevalence of MTPJ arthritis in our population was 25% (127/517). Overall incidence was higher in females, with 32% (85/269) of females affected in comparison to 18% (44/248) of males. Variance between the sexes was insignificant until the age of 60, at which point the prevalence rose to 66% (53/80) in females compared with 47% (18/38) in males of the same age.
CONCLUSIONS: The development of first MTPJ arthritis follows a typical pattern of degenerative arthritis, as shown in other joints, with increasing age being an important factor. The results of this study suggest that first MTPJ arthritis begins to appear in most cases in middle age and is significantly more apparent in females.
LEVEL OF EVIDENCE: Level III, comparative case series.
Link to PubMed record
Author: Howard N, Cowen C, Caplan M, Platt S
Abstract: BACKGROUND: The prevalence of osteoarthritis of the first metatarsophalangeal joint (MTPJ) has not been completely determined in a population-based study. The aim of the study was to determine the age- and gender-related prevalence of radiological first MTPJ arthritis.
METHODS: We analyzed 517 consecutive radiographs of adult patients who presented with acute foot injuries to the accident and emergency department over a 6-month period. Radiographs were assessed independently by 2 authors using the Hattrup and Johnson grading system for osteoarthritic changes in the first MTPJ.
RESULTS: The radiographic prevalence of MTPJ arthritis in our population was 25% (127/517). Overall incidence was higher in females, with 32% (85/269) of females affected in comparison to 18% (44/248) of males. Variance between the sexes was insignificant until the age of 60, at which point the prevalence rose to 66% (53/80) in females compared with 47% (18/38) in males of the same age.
CONCLUSIONS: The development of first MTPJ arthritis follows a typical pattern of degenerative arthritis, as shown in other joints, with increasing age being an important factor. The results of this study suggest that first MTPJ arthritis begins to appear in most cases in middle age and is significantly more apparent in females.
LEVEL OF EVIDENCE: Level III, comparative case series.
Link to PubMed record
WUTH publication: Preoperative mapping of fistula-in-ano: a new three-dimensional MRI-based modelling technique
Citation: Colorectal Disease. 2013, 15(11), e699-701
Author: Day NJ, Earnshaw D, Salazar-Ferrer P, Walsh CJ
Abstract: AIM: We aimed to develop an intuitive, interactive, three-dimensional (3D) MRI modelling technique to produce a 3D image of fistula-in-ano.
METHOD: The 3D model was created from standard two-dimensional (2D) MRI sequences to produce an image that is anatomically correct. Individual muscle and soft-tissue layers were extracted from T1-weighted sequences and fistula pathology from short TI inversion recovery (STIR) sequences, to produce two separate volumes. These were then fused using postprocessing software (Vitrea Workstation version 6.3) to generate a 3D model.
RESULTS: The final 3D model was incorporated into a PDF file that has an integrated computer aided design (CAD) viewer, allowing the surgeon to rotate it in any direction during preoperative planning or whilst in theatre.
CONCLUSION: As an adjunct to 2D MRI images and the associated radiology report, this model communicates the fistula anatomy to the clinician more clearly and should be particularly useful in complex cases.
Link to PubMed record
Author: Day NJ, Earnshaw D, Salazar-Ferrer P, Walsh CJ
Abstract: AIM: We aimed to develop an intuitive, interactive, three-dimensional (3D) MRI modelling technique to produce a 3D image of fistula-in-ano.
METHOD: The 3D model was created from standard two-dimensional (2D) MRI sequences to produce an image that is anatomically correct. Individual muscle and soft-tissue layers were extracted from T1-weighted sequences and fistula pathology from short TI inversion recovery (STIR) sequences, to produce two separate volumes. These were then fused using postprocessing software (Vitrea Workstation version 6.3) to generate a 3D model.
RESULTS: The final 3D model was incorporated into a PDF file that has an integrated computer aided design (CAD) viewer, allowing the surgeon to rotate it in any direction during preoperative planning or whilst in theatre.
CONCLUSION: As an adjunct to 2D MRI images and the associated radiology report, this model communicates the fistula anatomy to the clinician more clearly and should be particularly useful in complex cases.
Link to PubMed record
Wednesday 5 November 2014
WUTH publication: An unusual presentation of a retroperitoneal cyst
Citation: BMJ Case Reports. 2014 Nov 3;2014
Author: Sarkar D, Gulur D, Patel S, Nambirajan T
Abstract: A 34-year-old woman presented to the surgical assessment unit with severe right loin to groin pain. An ultrasound scan of the abdomen revealed a complex cyst in the right iliac fossa and a subsequent CT scan revealed a 7.5 cm retroperitoneal cystic lesion below the lower pole of the right kidney. The patient also had MRI of the kidneys, which confirmed the finding. The image showed the cyst was not attached to the kidneys and was clearly separate. She underwent a laparoscopic excision of the cyst. Histopathology revealed a cyst lined by a single layer of mucinous epithelium of endocervical type with foci of calcification and hyalinisation on the wall. The cyst was thought to be a benign cyst of Mullerian origin.
Link to PubMed record.
Author: Sarkar D, Gulur D, Patel S, Nambirajan T
Abstract: A 34-year-old woman presented to the surgical assessment unit with severe right loin to groin pain. An ultrasound scan of the abdomen revealed a complex cyst in the right iliac fossa and a subsequent CT scan revealed a 7.5 cm retroperitoneal cystic lesion below the lower pole of the right kidney. The patient also had MRI of the kidneys, which confirmed the finding. The image showed the cyst was not attached to the kidneys and was clearly separate. She underwent a laparoscopic excision of the cyst. Histopathology revealed a cyst lined by a single layer of mucinous epithelium of endocervical type with foci of calcification and hyalinisation on the wall. The cyst was thought to be a benign cyst of Mullerian origin.
Link to PubMed record.
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