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At least 163 records · Page 9Linked to original sources
PubMed1990

The cold face test (diving reflex) in clinical autonomic assessment: methodological considerations and repeatability of responses.

1. Cold stimulus applied to the face causes bradycardia and peripheral vasoconstriction (i.e. the diving reflex), and has been suggested as a test of the autonomic pathways involved. The purpose of this study was to define standard procedures for conducting the test and analysing the responses to the cold face test, to evaluate variability in responses between subjects and within subjects when the same test is repeated, and to examine its usefulness in clinical autonomic assessment. 2. Sixteen (nine female, seven male) healthy adult (21-35 years old) subjects were used. Cold stimulus was applied with gel-filled compresses. Forehead temperature under the compress as an indication of stimulus magnitude, heart rate, blood flow in the finger, toe and calf by venous occlusion plethysmography, and systolic and diastolic blood pressure were monitored. Three protocols were carried out in which the temperature (0, 5, 10, 15 degrees C), placement (whole face, unilateral, forehead) and duration (20, 40, 60, 120 s) of the cold compress application were varied. 3. The data indicate that 0 degrees C compresses applied bilaterally for 40 s produced the maximum bradycardia and peripheral vasoconstriction. No subject found this test to be obnoxious, but a 120 s application was objectionable to some subjects. This cold face test resulted in 22%, 72%, 59% and 44% reductions in heart rate and blood flow to the finger, toe and calf, respectively. There was significant between-subject variability, but good consistency in responses to tests repeated in the same subject on different days, at different times of day and in different seasons.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1998

Calciphylaxis: a syndrome of skin necrosis and acral gangrene in chronic renal failure.

BACKGROUND: Calciphylaxis is a rare condition of rapidly extending ischemic skin necrosis or acral gangrene of fingers, toes or penis in patients with chronic renal failure. It may be accompanied by extensive metastatic calcification of soft tissues. Histology of infarcted tissues shows prominent medial calcification and intimal hyperplasia of subcutaneous arteries and/or digital arteries, respectively. The pathogenesis of calciphylaxis is only poorly understood. Most patients have hyperparathyroidism and an elevated calcium-phosphate-product, which is thought to be a major pathogenetic factor of calciphylaxis. PATIENTS AND METHODS: All published cases of calciphylaxis including nine of own (155 patients in total) from 1936 through 1996 were reviewed and subjected to statistical meta-analysis (Fisher's exact test). RESULTS: Proximal locations of necrosis (thighs, buttocks, trunk) carried an unfavourable prognosis (63% mortality) compared to distal locations (calves, forearms, fingers, toes, penis) with 23% mortality (p < 0.0001). Parathyroidectomy was associated with a favourable outcome (p < 0.004). Diabetics with chronic renal failure had acral gangrene in 61% compared to 34% of the non-diabetic calciphylaxis-patients (p < 0.007). CONCLUSIONS: The present analysis of all published cases of calciphylaxis is limited by patient selection and publication bias. The unfavourable prognosis of patients with proximal necrosis is impressive and might justify an early and aggressive treatment in such cases. However, the general benefit of parathyroidectomy remains debatable. Hyperparathyroidism should be managed primarily by conservative means. Parathyroidectomy should be reserved for patients with very high parathyroid hormone level and calcium-phosphate-product or with a rapidly progressive disease.

Calciphylaxis↗
PubMed2001

Raynaud's phenomenon.

Many persons are affected by the phenomenon known as Raynaud's. Raynaud's is classified in 2 ways-as Raynaud's disease or Raynaud's syndrome. Classification is based on the presence of associated conditions. Raynaud's is characterized by vasospasm-induced color changes of the fingers, toes, and ears. The fingers are most commonly affected. Studies involving cause, diagnosis, and treatment have been instituted with varied results. Diagnosis is primarily based on clinical symptoms involving digital color changes. Treatment is aimed at prevention of attacks and includes medication, stress reduction, and avoidance of vasoconstricting agents. Whether the phenomenon will develop into a more serious condition with which Raynaud's is associated is important. This article describes the etiology, pathophysiology, diagnosis, treatment, and nursing implications with regard to Raynaud's.

Adult↗
PubMed1987

[Multiple simultaneous hematomas of the finger and toe nails with subsequent onychomadesis in pemphigus vulgaris].

Multiple simultaneous subungual and intraungual haemorrhages were seen in eight fingernails and several toenails of a patient suffering from pemphigus vulgaris. As other causes of nail haematomas, such as traumas, were absent, this symptom was referred to the underlying disease. Nail and nailbed involvement in pemphigus vulgaris is extremely rare, and onychomadesis is the form that has been reported more frequently than any others.

Hematoma↗
PubMed1971

Fingers to toes.

Explore the source record for details and available documents.

Exercise Therapy↗
PubMed1997

Possible interaction between vibration thresholds by sex and motor dominance in the index finger and big toe.

Two studies suggest a possible interaction among sex, motor dominance, and vibrotactile threshold for the great toe and index finger. In study 1 a forced-choice procedure with the Vibratron II (Physitemp Instruments, Inc.) was used; a significant interaction between sex and foot dominance for vibratory threshold was noted with no main effects for the great toe. The greatest difference between men and women was on the nondominant side on the foot. Study 2 replicated Study 1 using the index finger as well as the great toe and used the Semmes. Weinstein monofilament test for a cross-modal comparison. A method of limits procedure was used to increase the generalizability of the data. A similar interaction was found between sex and motor dominance for the index finger but not the great toe. This was attributed to skewing of data for the toe. No effects were found for the Semmes-Weinstein test. Possible usefulness in detecting neuropathies is considered. Larger normative studies including variables such as age, height, and weight are required for generalizable conclusions.

Adolescent↗
PubMed2004

The indications for toe transfer after "minor" finger injuries.

Toe-to-hand transfer is widely considered to be unjustified for "minor" finger injuries. In this invited personal view article the indications for toe-to-hand transfer for finger amputation and neurocutaneous and major pulp defects are discussed, and a classification of multidigital injury that has both prognostic and decision-making value is presented. In the author's opinion a toe transfer should always be considered as an option when reconstructing "minor" finger injuries, as it can reproduce significant long-term benefit to the hand and the patient's sense of well being. The procedure should be carried out in the acute period, not only because it is technically easier and better for hand function, but above all because the surgeon can save structures that will be lost if the transfer is delayed.

Amputation, Traumatic↗
PubMed2005

Ungual basal cell carcinoma on the fifth toe mimicking chronic dermatitis: case study.

BACKGROUND: The finger, toe, and nail unit are rare sites of basal cell carcinoma (BCC). Only a few patients with BCC of the foot have been described in the world literature, and ungual BCC is even less frequent. OBJECTIVE: To discuss through a case report the clinical features and diagnosis of BCC of the foot. METHODS: We report an unusual case of BCC of the nail unit of the fifth toe of an elderly woman that mimicked chronic dermatitis. CONCLUSION: Our case clearly highlights the need for biopsy and histopathologic examination whenever we see inflammatory lesions with a loss of substance that are refractory to systemic or topical treatments.

Aged↗
PubMed1990

Neuropathy, myopathy and destructive arthropathy in primary hypothyroidism.

A 75-year-old woman with untreated primary hypothyroidism was found with peripheral neuropathy (including carpal tunnel syndrome), severe myopathy (high levels of creatine phosphokinase) and destructive arthropathy, affecting fingers, toes and the left knee. Radiographs of her knee showed destructive lesions of the tibial plateau similar to a pathologic compression fracture, while the joints of the fingers and toes showed all signs of severe erosive osteoarthritis (OA), radiographically documented over a period of 7 years. It is suggested that hypothyroidism is causally related to the development of erosive OA.

Aged↗