Education Level Among Patients with Major Limb Amputation.

Introduction Despite all the advances in medicine and attempts to delay and prevent amputations, the number of amputations remains high. The state of South Carolina has one of the highest rates of major limb amputation in the country, with Florence and neighboring counties particularly affected. Education level has been associated with an increased number of amputations and worse outcomes post-amputation. The aim of this study was to investigate the education level among patients with major upper and lower limb amputation within the Florence and neighboring counties, which is a part of the Pee Dee region of the state of South Carolina. Materials and methods This is a retrospective chart review study conducted at the outpatient hospital-based Physical Medicine and Rehabilitation clinic. All consecutive amputee patients visiting our outpatient amputee clinic from January 2018 to January 2019 and who met the study inclusion criteria were included in the study. The main outcome measure was the education level. Results Of the sample, 26% had below high school education, 33.8% had high school education, 14.2% had some college education, 19.7% had a college education, and 6.3% had an advanced college degree. Conclusions Patients with major limb amputation have a lower education level compared to the general population. Lower education level as a part of the broader and more complex socioeconomic status may be a possible barrier in the process of post-amputation rehabilitation and long-term care of patients with major limb amputation.

Shewanella putrefaciens infective endocarditis

Shewanella putrefaciens rarely causes infection in humans. In the last few decades a growing number of cases have been described. The following report outlines the case of a 40-year- old immunocompetent white man with S. putrefaciens infective endocarditis. This is the first known case of infective endocarditis due to an apparently monomicrobial S. putrefaciens infection, and the second known case of S. putrefaciens-related infective endocarditis worldwide.

Disseminated cutaneous herpes zoster in an immunocompetent elderly patient.

Herpes zoster is a clinical syndrome which usually presents with a localized, vesicular rash in a dermatomal distribution. Cutaneous dissemination rarely occurs in immunocompetent patients, therefore little is known about the baseline demographic, clinical characteristics, management and outcome of these patients. Herein, we report a case of disseminated cutaneous herpes zoster in an immunocompetent patient along with a review and analysis of 28 cases previously reported in the literature.

Shewanella putrefaciens infective endocarditis.

Shewanella putrefaciens rarely causes infection in humans. In the last few decades a growing number of cases have been described. The following report outlines the case of a 40-year-old immunocompetent white man with S. putrefaciens infective endocarditis. This is the first known case of infective endocarditis due to an apparently monomicrobial S. putrefaciens infection, and the second known case of S. putrefaciens-related infective endocarditis worldwide.

Herpes zoster duplex bilateralis.

Disseminated herpes zoster has been defined by some authors as a generalized eruption of more than 20 lesions beyond the primary or adjacent dermatomes, usually within a week of clinical manifestation of the primary lesion. In the case described by Takaoka et al. the two lesions presented simultaneously with no evidence of widespread eruption. Perhaps the term, disseminated should not have been employed in this situation.

Intramuscular lipoma: a review of the literature.

Lipomas are the most common type of soft tissue mesenchymal tumors. They are typically located subcutaneously and consist of mature fatty tissue. When they occur under the enclosing fascia, they are called deep-seated lipomas. Infrequently, lipomas can arise inside the muscle and are called intramuscular lipomas. Intramuscular lipomas have been commonly investigated and categorized in the same group as other deep-seated and superficial lipomatous lesions. Their clinical, histological and imaging characteristics may resemble well-differentiated liposarcomas, further adding to the difficulties in the differential diagnosis. This article summarizes the available literature and describes the typical epidemiological, pathological and clinical features of intramuscular lipomas, as well as delineating their treatment and prognosis.

Segmental zoster abdominal paresis (zoster pseudohernia): a review of the literature.

Herpes zoster is a distinct clinical syndrome that may present with a segmental zoster paresis. Although thoracic dermatomes are the most commonly affected, paresis of the abdominal muscles has been less frequently reported. To review the existing published evidence regarding this unusual clinical entity, a literature search of PubMed and Google was performed. In total, 35 articles that described 36 individual cases were identified. The information from all the cases was tabulated for the analysis. The mean age was 67.5 years. The ratio of men to women was approximately 4:1. The left and right side were approximately equally affected. The most affected associated dermatome was T11. In 88.9% of the patients, the typical herpetic rash preceded the abdominal weakness. The mean latent period from rash to onset of abdominal muscle weakness was 3.5 weeks. Electrodiagnostic studies confirmed the diagnosis in 95% of the tested patients. Complete recovery with conservative measures occurred in 79.3% of the patients who were followed-up for recovery, with a mean time for recovery of 4.9 months. Visceral neuropathy co-occurred in 19.4% of the patients. Because of its self-limited nature and good prognosis, recognition of this complication is important to prevent unnecessary diagnostic studies and procedures. Electrodiagnostic studies can be effectively used to confirm the diagnosis. Because visceral neuropathy commonly co-occurs with segmental zoster abdominal paresis, it should be actively investigated and treated.

Combined mirror visual and auditory feedback therapy for upper limb phantom pain: a case report.

INTRODUCTION: Phantom limb sensation and phantom limb pain is a very common issue after amputations. In recent years there has been accumulating data implicating 'mirror visual feedback' or 'mirror therapy' as helpful in the treatment of phantom limb sensation and phantom limb pain. CASE PRESENTATION: We present the case of a 24-year-old Caucasian man, a left upper limb amputee, treated with mirror visual feedback combined with auditory feedback with improved pain relief. CONCLUSION: This case may suggest that auditory feedback might enhance the effectiveness of mirror visual feedback and serve as a valuable addition to the complex multi-sensory processing of body perception in patients who are amputees.