Ingrowing toenails are common, cause serious disability, and affect mainly young men. Most patients with ingrowing toenails are usually male, between the ages of 15 and 40 years.
There is a spectrum to the clinical presentation with pain progressing to infection, hypergranulation, and finally chronic infection.
Ingrowing toenails can occur in normal or abnormally shaped nails.
Cases in abnormally shaped nails are more difficult to manage conservatively and usually require surgery
Historically, a recurrence rate of 13-50% has been reported after surgical treatment, although more recent papers have reported recurrence rates of less than 5%.
Symptoms are less likely to recur after partial nail avulsion and segmental phenol ablation than after simple nail avulsion or wedge excisions alone.
Podiatrist Dr. Matthew Neuhaus explains what an ingrown toenail is (video):
Ingrown toenail surgery by Dr. Leo Krawetz (video). Warning: graphic content, do not try this at home:
References:
The management of ingrowing toenails. BMJ, 2012;344:e2089.
Nail Abnormalities: Clues to Systemic Disease - a good review from American Family Physician http://buff.ly/1irL0kQ
The life of a science article: From submission to citation, see a manuscript pass through Nature's editorial process (video)
Source: Nature YouTube channel
Comments from Twitter:
Dean Giustini @giustini: Good one~
Link via the medical blog ScienceRoll.
Best of Medical Blogs - weekly review and blog carnival
The “Best of Medical Blogs - weekly review and blog carnival” is a weekly summary of the best posts from medical blogs. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best of Medical Blogs (BMB) is published every Tuesday, just like the old Grand Rounds.Choosing Wisely - Good Medical Practice or Prelude to Rationing?
From the White Coat blog: “If we want to decrease the amount of “unnecessary” testing, we need to address all of the reasons that such testing is performed. Why doesn’t Choosing Wisely change the preamble of its campaign to include: “The following tests are medically unnecessary and no type of professional or legal liability should ever be imposed upon physicians for failing to order or perform them …”? http://goo.gl/gG0Qp
The Food Challenge Challenge
Remember: No one "fails" a food challenge. The test is either positive or negative. http://buff.ly/Ql0fCh
Urologist performed his own vasectomy
From A Cartoon Guide to Becoming a Doctor: "When I was a med student on my surgery rotation, there was one urologist in our department who had actually performed his own vasectomy. He apparently used local anesthesia and did the procedure with a colleague present in the room "just in case." There were no complications. I dare you to find a female ob/gyn who tied her own tubes." http://buff.ly/PZOm4v
Science-Based Medicine » Andrew Weil’s Seasonal Supplements http://bit.ly/O38fZc
Dr. Wes @doctorwes: In Defense of the American Cowboy http://goo.gl/L7fKZ
What is a Direct Care practice? http://goo.gl/wJpn8 and http://goo.gl/nVZK8
Ask Skeptical Scalpel: A college student has second thoughts about medical school http://goo.gl/yRUsx
Dr. Wes: Out-of-the-Box Thinking on Avoiding Hospital Readmissions. When intent of the measure is to cut payments http://buff.ly/PZQidh
Wisdom vs. knowledge http://buff.ly/PQtief
New Obstructive Sleep Apnea Guidelines: What Do They Mean For Your Child? | Craig Canapari, MD http://bit.ly/SMiaP4
"Allergy Action Plan: Bring The Paperwork To Life" (video) http://buff.ly/QN8tTW
Healthcare social media #HCSM - top articles
Here are my suggestions for some of the top articles related to healthcare social media (#HCSM) in the past 2 weeks:EM and critical care physicians adopt social media at rapid pace - growth in 18 months: 77% Twitter, 42% Facebook http://goo.gl/MySga
All Students Need Blogs - Share what you have learned http://goo.gl/w9Utd
Are Twitter friends real friends? A rheumatologists' tweetup proves they're real, and yes, they're friends http://goo.gl/6oE93
4 ways for practices to benefit from a social media presence: Offer information beyond the appointment, Raise physician profiles, Influence online search, Marketing toolkit http://goo.gl/5mAz4
How Sanofi Is Writing The Social Media Rules For Big Pharma Without Running Afoul Of The FDA http://goo.gl/TNF4l
Dell CEO's security shut down his daughter’s Twitter account, revealed too many specifics about family’s whereabouts http://goo.gl/BrgwK
“Most essential app for Physician Residents is not medical and is free - Evernote” http://goo.gl/U8AfC
How to Automatically Archive Your Life with IFTTT and Evernote http://goo.gl/ocAOM
What is #FOAM? Free Open Access Meducation http://goo.gl/ILrMh
How physician practices can stir up Pinterest - amednews http://goo.gl/4BFgU
Social media and health care: opportunities and obstacles (interactive graph) http://pwc.to/OaRWHX
10 Social Media Tips for Physicians http://bit.ly/OaS5Lz
Facebook’s Gen Y Nightmare http://buff.ly/PqgMli
A Tweet Meme Farewell - they were the first to create the retweet button http://bit.ly/UvKAht
How Twitter connects Mayo Clinic and patients - Lee Aase's presentation http://goo.gl/7LNde
The articles were selected from my Twitter and Google Reader streams. Please feel free to send suggestions for articles to clinicalcases@gmail.com and you will receive an acknowledgement in the next edition of this publication.
Mayo Clinic uses smartphone images to evaluate stroke patients in remote locations through telemedicine
A new Mayo Clinic study confirms the use of smartphones medical images to evaluate stroke patients in remote locations through telemedicine. The study, the first to test the effectiveness of smartphone teleradiology applications in a real-world telestroke network, was recently published in Stroke, a journal of the American Heart Association.
Bart Demaerschalk, M.D., neurologist and medical director of Mayo Clinic Telestroke, shows us how the smartphone technology works:
Bart Demaerschalk, M.D., neurologist and medical director of Mayo Clinic Telestroke, shows us how the smartphone technology works:
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