INTRODUCTION: Plantar fasciitis (PF) is one of the most common running-related injuries. PURPOSE: The aim of this prospective study was to determine the incidence of PF and identify potential risk or protective factors for PF in runners and non-runners. METHODS: Data from 1206 participants from the 4HAIE cohort study (563 females/643 males; 715 runners/491 non-runners; 18-65 yr of age) were included in the analysis. We collected biomechanical data during overground running using a three-dimensional motion capture system at the baseline and running distance data via retrospective questionnaires and followed the participants for 12 months following the baseline data collection. Participants were asked weekly about any sports-related injury (including PF). A binary logistic regression was performed to reveal potential associations between running distance and biomechanical risk factors and PF while controlling for running distance, sex, and age. RESULTS: The total incidence of PF was 2.3% (28 PF from 1206 participants), 2.5% in runners and 2.0% in non-runners ( P = 0.248). Runners who ran more than 40 km·wk -1 had six times higher odds of suffering PF than individuals who ran 6-20 km·wk -1 ( P = 0.009). There was a significant association between maximal ankle adduction and PF; that is, runners with a lower abduction angle during the stance period had higher risk of PF ( P = 0.024). No other biomechanical variables indicated significant associations with PF. CONCLUSIONS: Regular running with a moderate weekly volume and more toeing out of the foot relative to the shank may reduce the risk against PF in runners, which may be useful for researchers, runners, coaches, and health professionals to minimize PF injury risk.
- MeSH
- Running * physiology injuries MeSH
- Biomechanical Phenomena MeSH
- Adult MeSH
- Fasciitis, Plantar * epidemiology physiopathology MeSH
- Incidence MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Prospective Studies MeSH
- Risk Factors MeSH
- Aged MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
AIMS: This retrospective non-randomised study aims to identify new and rare fusion partners with USP6 in the setting of nodular fasciitis. It has been proven, that nodular fasciitis can harbour different variants of USP6 fusions, which can be used in routine diagnostics and even determine the biological behaviour of the process. METHODS: A total of 19 cases of nodular fasciitis examined between 2011 and 2022 at Motol University Hospital in Prague were included into this study. Next to the histopathological evaluation, all cases were assessed using immunohistochemistry, RT-PCR and Anchored multiplex RNA methods. Patient's main demographic characteristics and corresponding clinical data were also analysed. RESULTS: This study presents one novel (KIF1A) and five rare examples (TMP4, SPARC, EIF5A, MIR22HG, COL1A2) of fusion partners with USP6 among 19 cases of nodular fasciitis. CONCLUSION: Identification of USP6 fusion partners in nodular fasciitis helps to understand the biology of such lesions. Moreover, it can be useful in routine histopathological practice of soft-tissues diagnostics, especially in preventing possible misdiagnosis of malignancy.
- MeSH
- Adult MeSH
- Fasciitis * genetics pathology MeSH
- Oncogene Proteins, Fusion genetics MeSH
- Gene Rearrangement * MeSH
- Immunohistochemistry MeSH
- Kinesins genetics MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Retrospective Studies MeSH
- Aged MeSH
- Ubiquitin Thiolesterase * genetics MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
Eozinofilní fasciitida (EF) je vzácné systémové autoimunitní onemocnění neznámé etiologie, které se projevuje postupným tuhnutím a fibrotizací kůže, nejčastěji na končetinách. Při pozdní diagnóze může dojít k tvorbě kontraktur, progredujícímu funkčnímu postižení a invaliditě pacienta. Ke zpoždění diagnózy často dochází kvůli záměně s významně častější systémovou sklerodermií. Lékem první volby jsou glukokortikoidy, které se případně doplňují methotrexátem. Při včasném zahájení léčby se významně zvyšuje šance na dobrou terapeutickou odpověď. V kazuistice předkládáme stručný přehled klinických projevů, diagnostiky a léčby EF a prezentujeme případ 62leté ženy, která byla hospitalizována na našem oddělení. Pacientka měla typické postižení končetin s otoky a fibrotizací kůže, ale onemocnění u ní postupovalo netypicky rychle a byl postižen i trup. Postižení trupu způsobovalo omezení dechových exkurzí, pocit svírání na hrudi a dušnost. Laboratorně byla prokázána eozinofilie a pozitivita antinukleárních protilátek. Diagnóza eozinofilní fasciitidy byla potvrzena biopsií. Díky včasné diagnóze a zahájení léčby došlo k rychlému zlepšení už během týdenní hospitalizace. Po 4 měsících léčby má pacientka už jen minimální nález na předloktích.
Eosinophilic fasciitis (EF) is a rare systemic autoimmune disease of unknown etiology, which manifests with progressive stiffening and fibrosis of the skin, most commonly on the extremities. Late diagnosis can lead to contracture formation, progressive functional impairment, and disability. Delay in diagnosis is often due to confusion with the significantly more common systemic sclerosis. Glucocorticoids are the first-line treatment of choice, supplemented with methotrexate where appropriate. Early initiation of treatment significantly increases the chance of a good therapeutic response. In this case report, we present a brief overview of the clinical manifestations, diagnosis, and treatment of EF and present the case of a 62-year-old woman who was admitted to our department. The patient had typical limb involvement with swelling and fibrosis of the skin, but her disease progressed uncharacteristically rapidly and the trunk was also affected. The trunk involvement caused limitation of breathing excursions, chest tightness, and shortness of breath. Laboratory evidence showed eosinophilia and antinuclear antibody positivity. The diagnosis of eosinophilic fasciitis was confirmed by biopsy. Due to early diagnosis and initiation of treatment, rapid improvement occurred within a week of hospitalization. After 4 months of treatment, the patient has only minimal skin involvement on her forearms.
- MeSH
- Autoimmune Diseases diagnosis drug therapy classification MeSH
- Cellulite diagnosis etiology MeSH
- Diagnosis, Differential MeSH
- Eosinophilia * diagnosis etiology drug therapy immunology classification MeSH
- Fasciitis * diagnosis etiology drug therapy immunology classification MeSH
- Glucocorticoids administration & dosage pharmacology classification therapeutic use MeSH
- Middle Aged MeSH
- Humans MeSH
- Muscles pathology MeSH
- Scleroderma, Systemic diagnosis classification MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Necrotizing fasciitis is a life-threatening skin and soft tissue infection associated with high morbidity and mortality in adult patients. This infection can present as either type 1 infection caused by a mixed microflora (Streptococci, Enterobacteriacae, Bacteroides sp., and Peptostreptococcus sp.), most commonly developing in patients after surgery or in diabetic patients, or as type 2. The latter type is monomicrobial and, usually, caused by group A Streptococci. Rarely, this type can be also caused by other pathogens, such as Vibrio vulnificus. V vulnificus is a small mobile Gram-negative rod capable of causing 3 types of infections in humans-gastroenteritis, primary infection of the vascular bed, and wound infections. If infecting a wound, V vulnificus can cause a life-threatening condition-necrotizing fasciitis. We present a rare case of necrotizing fasciitis developing after an insect bite followed by exposure to the seawater. Rapid propagation of the infectious complication in the region of the right lower limb led to a serious consideration of the necessity of amputation. Due to the clearly demarcated necroses and secondary skin and soft tissue infection caused by a multiresistant strain of Acinetobacter baumannii, we, however, resorted to the use of selective chemical necrectomy using 40% benzoic acid-a unique application in this kind of condition. The chemical necrectomy was successful, relatively gentle and thanks to its selectivity, vital parts of the limb remained preserved and could have been subsequently salvaged at minimum blood loss. Moreover, the antimicrobial effect of benzoic acid led to rapid decolonization of the necrosis and wound bed preparation, which allowed us to perform defect closure using split-thickness skin grafts. The patient subsequently healed without further complications and returned to normal life.
- MeSH
- Acinetobacter baumannii * MeSH
- Adult MeSH
- Fasciitis, Necrotizing * diagnosis MeSH
- Vibrio Infections * complications MeSH
- Soft Tissue Infections * diagnosis complications MeSH
- Humans MeSH
- Vibrio vulnificus * MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
Necrotising fasciitis (NF) is a rapidly spreading bacterial infection of the fascial planes and can be fatal if is not treated urgently. Here, we present the case of a 65-year-old female, with oral squamous cell carcinoma, treated surgically with curative intent. On the second post-operative day from a mandibulectomy, selective neck dissection and reconstruction with a fibula free flap, she developed rapidly progressing NF, at the surgical site.
- MeSH
- Fasciitis, Necrotizing * etiology surgery MeSH
- Humans MeSH
- Mouth Neoplasms * surgery MeSH
- Aged MeSH
- Carcinoma, Squamous Cell * surgery MeSH
- Free Tissue Flaps * MeSH
- Plastic Surgery Procedures * MeSH
- Check Tag
- Humans MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
- MeSH
- Blood Chemical Analysis MeSH
- Escherichia coli pathogenicity MeSH
- Fasciitis, Necrotizing * surgery diagnosis blood microbiology pathology therapy MeSH
- Middle Aged MeSH
- Humans MeSH
- Obesity, Morbid complications MeSH
- Vulvar Diseases classification MeSH
- Proteus mirabilis pathogenicity MeSH
- Vulva surgery pathology MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Diferenciálně diagnostické stavy systémové sklerodermie (SSc) spojuje určitý stupeň fibrózy kůže. Tato onemocnění jsou někdy označována jako pseudosklerodermie. Jedná se o onemocnění rozmanité a naprosto odlišné etiologie a často i nejasné patogeneze. Odlišné a poměrně různorodé klinické charakteristiky těchto jednotlivých onemocnění mohou pomoci odlišit tyto stavy od systémové sklerodermie. Histopatologické vyšetření s klinicko-patologickou korelací je v některých případech nezbytné ke stanovení definitivní diagnózy a následného zvolení adekvátního terapeutického přístupu. V tomto článku je podán stručný přehled onemocnění, která pro své kožní postižení, jsou nejčastější součástí diferenciální diagnózy SSc. Zahrnují generalizovanou morfeu (lokalizovanou sklerodermii), eozinofilní fascitidu, nefrogenní systémovou fibrózu, syndrom ztuhlé kůže (stiff skin syndrome), skleromyxedém, scleredema adultorum, diabetickou cheiroartropatii a systémovou amyloidózu. Mezioborový přístup a zejména spolupráce revmatologie a dermatologie je nenahraditelným diferenciálně diagnostickým postupem jak tato onemocnění správně diagnostikovat.
Conditions assessed in the differential diagnosis of systemic sclerosis or scleroderma (SSc) are associated with some degree of skin fibrosis. These diseases are sometimes referred to as scleroderma-like syndromes and they are diverse and completely different etiology and often unclear pathogenesis. The different and relatively various clinical characteristics of each of these diseases may help to differentiate these conditions from systemic sclerosis. Histopathological examination with clinical-pathological correlation is, in some cases, necessary to make a definitive diagnosis and to select an appropriate therapeutic approach. This summary provides a brief overview of diseases that, because of their skin involvement, are the most common parts of the differential diagnosis of SSc. The differential diagnosis includes generalized morphea (localized scleroderma), eosinophilic fasciitis, nephrogenic systemic fibrosis, stiff skin syndrome, scleromyxedema, scleredema adultorum, diabetic cheiroarthropathy and systemic amyloidosis. The interdisciplinary approach, and the cooperation of rheumatology and dermatology, is an irreplaceable differential diagnostic procedure for the correct diagnosis of these diseases.
- Keywords
- eozinofilní fasciitida,
- MeSH
- Diagnosis, Differential MeSH
- Eosinophilia diagnosis pathology therapy MeSH
- Fasciitis diagnosis pathology therapy MeSH
- Humans MeSH
- Scleroderma, Localized * diagnosis pathology therapy MeSH
- Nephrogenic Fibrosing Dermopathy diagnosis pathology therapy MeSH
- Scleredema Adultorum diagnosis pathology therapy MeSH
- Scleromyxedema diagnosis pathology therapy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
Background: Necrotizing fasciitis is a major health problem throughout the world. The purpose of this review is to assist providers with the care of these patients through a better understanding of the pathophysiology and management options. Methods: This is a collaborative review of the literature between members of the Surgical Infection Society of North America and World Society of Emergency Surgery. Results: Necrotizing fasciitis continues to be difficult to manage with the mainstay being early diagnosis and surgical intervention. Recognition of at-risk populations assists with the initiation of treatment, thereby impacting outcomes. Conclusions: Although there are some additional treatment strategies available, surgical debridement and antimicrobial therapy are central to the successful eradication of the disease process.
- MeSH
- Anti-Bacterial Agents therapeutic use MeSH
- Debridement methods MeSH
- Fasciitis, Necrotizing blood diagnosis physiopathology therapy MeSH
- Risk Assessment MeSH
- Soft Tissue Infections blood diagnosis physiopathology therapy MeSH
- Clostridium Infections physiopathology therapy MeSH
- Humans MeSH
- Risk Factors MeSH
- Staphylococcal Infections physiopathology therapy MeSH
- Staphylococcus aureus MeSH
- Streptococcus pyogenes MeSH
- Streptococcal Infections physiopathology therapy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Systematic Review MeSH
Nodular fasciitis (NF) is a benign self-limiting soft tissue lesion that has long been considered a reactive process. Recently, however, the USP6 gene rearrangement has been discovered, and the neoplastic nature of this tumor was suggested. Since then, many fusion partners of the USP6 gene have been reported, with the MYH9 gene as the most common. In this article, we describe a case of NF with a novel EIF5A-USP6 gene fusion associated with unusual pathological features. A 41-year-old healthy woman with a painful, rapidly growing subcutaneous mass on the left forearm with a size of 0.8 cm is presented. A soft tissue fragment measuring 1 cm was surgically excised. Owing to positive surgical margins, re-excision was performed, yielding another 2-cm fragment. The lesion was extensively histologically investigated. Immunohistochemical and molecular-genetic analysis, namely fluorescence in situ hybridization, next-generation sequencing, and reverse transcriptase-polymerase chain reaction, were also performed. Histology revealed a dermally located, mitotically active myofibroblastic proliferation with myxoid areas that ulcerated the overlying epidermis. One atypical mitotic figure was also found. The lesion showed positive immunohistochemical staining with smooth muscle actin, whereas S100 protein and CD34 stains were negative. Using fluorescence in situ hybridization, the USP6 gene rearrangement was detected and subsequent analysis using the Archer fusionPlex Sarcoma kit revealed a novel EIF5A-USP6 gene fusion. In the appropriate clinicopathological context, the detection of USP6 gene rearrangement is extremely useful when diagnosing NF, significantly reducing the risk of misdiagnosis and inappropriate overtreatment.
- MeSH
- Adult MeSH
- Fasciitis genetics pathology MeSH
- Peptide Initiation Factors genetics MeSH
- Humans MeSH
- Oncogene Fusion MeSH
- RNA-Binding Proteins genetics MeSH
- Ubiquitin Thiolesterase genetics MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
- Review MeSH
