ABSTRACT
An injury to a finger or toe can result in a collection of blood under the nail plate that if unrelieved can cause extreme discomfort due to pressure. In this case, a 47-year-old man developed a subungual hematoma of the right thumb due to a crush injury. Controlled nail trephination was performed using a uniquely designed drill that penetrated the nail plate without breaching the nail bed. The subungual hematoma was successfully drained, and there was a substantial relief in pain over the subsequent 8 hours. This technique appears to be a quick and convenient method of evacuating subungual hematomas with minimal discomfort and minimal risk.
Subject(s)
Drainage/instrumentation , Hematoma/surgery , Nail Diseases/surgery , Thumb/injuries , Hematoma/etiology , Humans , Male , Middle Aged , Nail Diseases/etiologyABSTRACT
Pelvic relaxation, a weakening of pelvic support structures, is an under-reported condition that affects a multitude of women. In the United States alone, more than 338,000 procedures for prolapse are performed annually. Decreased collagen content has been noted in the tissues of women affected by this condition. Interestingly, biopsy specimens of women with striae also show a diminution of collagen. Using self-reported anonymous data, we compared the prevalence of striae in women with and without pelvic relaxation to see if an association between these two disorders of connective tissue existed. More than half the women with prolapse (54.7%) (n = 41) reported striae, whereas only 25.0% of women in the non-prolapse group (n = 8) reported striae (P < 0.01). Multivariate logistic regression analysis confirmed striae as a significant risk factor for the development of clinical prolapse (odds ratio 3.12, P < 0.05). There appears to be a strong association between the presence of striae and the development of pelvic relaxation, which is unrelated to conventionally cited risk factors, such as age, weight, number of pregnancies, or postmenopausal status.
Subject(s)
Cicatrix/epidemiology , Cicatrix/pathology , Pelvic Floor/pathology , Pregnancy Complications/epidemiology , Pregnancy Complications/pathology , Adult , Aged , Aged, 80 and over , Data Collection , Female , Humans , Middle Aged , Predictive Value of Tests , Pregnancy , Prevalence , Risk Factors , Urinary Bladder Diseases/epidemiology , Urinary Bladder Diseases/pathology , Uterine Prolapse/epidemiology , Uterine Prolapse/pathologyABSTRACT
Striae are atrophic linear plaques, most often found on the breasts, abdomen, hips, and thighs. They develop in a variety of circumstances, some of which involve physical stretching of the skin, such as adolescent growth spurts, and during hormonal changes, such as Cushing's syndrome. It has been suggested that genetics may play a role in their development. Regardless of the etiology, all striae display the same histological changes in the dermis showing atrophy and loss of rete ridges. These findings are similar to those seen with scar formation. At present, no definitive treatments have been established.
Subject(s)
Cicatrix/physiopathology , Pregnancy Complications/physiopathology , Female , Humans , PregnancyABSTRACT
BACKGROUND: Educational debt levels are outpacing inflation. OBJECTIVE: To determine whether debt levels influence career choices of graduating dermatology residents. METHODS: Anonymous surveys of graduating dermatology residents. RESULTS: The presence of debt was associated negatively with pursuing fellowship training in 1999 and 2004 (P < .05) but did not affect choices about entering solo practice or job dissatisfaction levels. LIMITATIONS: This study relies on self-reported data, and some surveys were incomplete. CONCLUSION: Debt levels do not appear to significantly influence the career choices of dermatology residents.
