A systematic review of the claw toe deformity: What is known and what is needed apart from surgical procedures.

The claw toe deformity is a painful condition that mainly affects the adult population. Although there are many different treatments to solve the deformity, there is no optimal procedure to restore the normal foot mechanics. The objective of this review was to identify the technical features of the kinematic evaluation methods used in patients with claw toes. Furthermore, the aim of this review was to clarify what is known and what is needed apart from the surgical procedures to correct the claw toe deformity, with the purpose of reducing risk factors of falling in elderly people. A search in electronic databases, such as Scopus (n = 78), Google Scholar (n = 705) and ScienceDirect (n = 290) was conducted. There were seven articles (43.75%) related to the fixation (arthrodesis) of proximal and distal interphalangeal joints, one article (6.25%) describes the correction of the claw toe through plantar plate tenodesis and release of collateral ligaments, four articles (25%) describe the procedure of tendon transfer, one article (6.25%) describes flexor digitorum brevis tenotomy and a proximal interphalangeal joint arthrolysis, and another article (6.25%) presented the impact of partial phalanx osteotomy to treat the claw toe deformity. In conclusion, the review indicates that there are several studies related to the treatment or correction of claw toe deformity. However, there is a lack of knowledge of the postsurgical effects of treating claw toe condition, especially in the structural mechanics (plantar pressure distribution, stability, gait, foot mechanics and so on) of the foot after the correction of the claw toe deformity. The analysis of the foot mechanics after the correction of the claw toes has to be paramount to determine the benefits of the correction.

Novel technique of pupillary dilation during retinal detachment surgery in an eye with iris claw lens.

Iris fixated intraocular lens (IOLs) have been used for Aphakia and capsular bag instability. The IOLs cause a postoperative non dilating pupil in most cases. We encountered such a case which presented with rhegmatogenous retinal detachment. We describe a novel technique of operating for retinal reattachment in such a case using iris hooks passing in the potential plane between the IOL optic and the iris. The technique had advantages of obviating the need for IOL explantation, associated large corneal entry wound, allowing silicone oil tamponade by retaining an IOL-iris diaphragm, early visual rehabilitation, reduced surgical time, and avoiding multiple surgeries.

Benchmarking claw health across three dairy cow breeds in 508 dairy farms using numerical claw health indicators.

Currently, prevalence and incidence of claw lesions are used as parameters for benchmarking claw health. The aims of this study were to create a benchmarking system for claw health utilizing the claw health indicators Farm-Claw-Score (FCS) for the herd and Cow-Claw-Score (CCS) for the individual animal, and to benchmark claw health of the three predominant dairy cattle breeds in Austria. Claw health data from 17,642 cows from 508 Austrian dairy farms were analyzed. The CCS and FCS were calculated based on recorded claw lesions and their three severity levels using geometrically weighted scoring. The FCS of each of the dairy farms was classified into five percentile thresholds (P10, P25, P50, P75, P90), with the FCS calculated using the median value of CCS in each herd. Furthermore, claw health was benchmarked for three breeds (Fleckvieh, Holstein, Brown Swiss cows), using claw lesion prevalences and CCS values. When the median FCS was calculated, dairy farms in P50 and below had an FCS of 20.0, indicating very good claw health. However, P90 farms showed an FCS-MEDIAN of 67.5. Evaluation of the prevalences of the 14 claw lesions considered and the CCS values revealed that Fleckvieh cows (CCS-MEDIAN: 24.0), followed closely by Holstein cows (CCS-MEDIAN: 22.7) had significantly poorer claw health (P < 0.0001) compared to Brown Swiss cows (CCS-MEDIAN: 12.0). The use of CCS and FCS as primary claw health indicators allowed for a quick assessment of the current state of an individual cow and a dairy herd in a benchmarking system. Detailed information on the claw health of each animal and the dairy herd can be easily reviewed by examining diagnosis lists that display prevalences, particularly those related to lameness, in the respective electronic documentation systems.

Exploring anisotropic mechanical properties of lobster claw exoskeleton through fractal models.

The outstanding mechanical properties of lobster claw exoskeletons are intricately tied to their internal microstructure. Investigating this relationship can offer vital insights for designing high-performance additive manufacturing structures. Fractal theory, with its fractional dimensional perspective, suits the complexity of real-world phenomena. Our study examines fully hydrated lobster claw exoskeletons using a multifaceted approach: four-point bending tests, scanning electron microscopy observations, and fractal models. Test results reveal superior mechanical properties in longitudinal specimens. Scanning electron microscopy shows non-uniform fiber helical structures and porous elements in the exoskeleton. Fracture mechanisms involve both breaking fiber fragments perpendicular to the cross-section and tearing between these fragments. The observed crack propagation paths exhibit statistical self-similarity. Consequently, we develop fractal models for the crack propagation paths in longitudinal and transverse specimens, calculating crack extension forces. Using the box-counting method and its improved variant, we determine the fractal dimensions of specimen sections. The fractal dimension of longitudinal models exceeds that of transverse models, and calculated crack extension forces are higher in longitudinal models. These findings align well with experimental data, demonstrating fractal theory's efficacy in analyzing the lobster claw exoskeleton's anisotropic mechanical properties.

Claw lesion status in Brazilian commercial sow herds from 2013 to 2023.

Introduction: Claw lesions significantly contribute to lameness, greatly affecting sow welfare. This study investigated different factors that would impact the severity of claw lesions in the sows of Brazilian commercial herds. Methods: A total of 129 herds (n = 12,364 sows) were included in the study. Herds were in the Midwest, Southeast, or South regions of Brazil. Inventory sizes were stratified into 250-810 sows, 811-1,300 sows, 1,301-3,000 sows, and 3,001-10,000 sows. Herds belonged to Cooperative (Coop), Integrator, or Independent structures. The herd management was conducted either maintaining breeds from stock on-site (internal), or through purchase of commercially available genetics (external). Herds adopted either individual crates or group housing during gestation. Within each farm, one randomly selected group of sows was scored by the same evaluator (two independent experts evaluated a total of 129 herds) from 0 (none) to 3 (severe) for heel overgrowth and erosion (HOE), heel-sole crack (HSC), separation along the white line (WL), horizontal (CHW) and vertical (CVW) wall cracks, and overgrown toes (T), or dewclaws (DC) in the hind legs after parturition. The study assessed differences and similarities between herds using Principal Component Analysis (PCA) and Hierarchical Agglomerative Clustering (HAC) analysis. The effects of factors (i.e., production structure, management, housing during gestation, and region) were assessed using the partial least squares method (PLS). Results and discussion: Heel overgrowth and erosion had the highest prevalence, followed by WL and CHW, while the lowest scores were observed for T, DC, and CVW. Herds were grouped in three clusters (i.e., C1, C2, and C3). Heel overgrowth and erosion, HSC, WL, CHW, CVW, and T were decreased by 17, 25, 11, 25, 21, and 17%, respectively, in C3 compared to C1 and 2 combined. Independent structure increased the L-Index in all three clusters. Furthermore, individual housing increased the L-Index regardless of the cluster. The results suggest that shifting toward larger, more technologically advanced herds could potentially benefit claw health. Additionally, adopting group gestation housing appears to mitigate the adverse effects on claw health, although further validation is necessary, as Brazil has only recently transitioned from individual housing practices.

Validation of the hind feet position score and its association with heel height difference in dairy cows.

Hind feet position scoring (HFPS) categorizes the outward rotation of the hind feet from the line parallel to the midline of the body in standing dairy cows. It has previously been used as an indication of both differences in heel height between the lateral and medial hind claw (to determine the need of hoof trimming) and the presence of claw lesions in sound cattle. In this observational study, the agreement of HFPS with other types of hoof angle measurements, as well as its association with the heel height difference (HHD) between the claws were investigated.A total of 51 dairy cows were assessed independently by three observers in two measuring rounds on two different measuring days each. On each occasion, they scored the HFPS, and measured the angle of outward rotation of both hind feet using a digital protractor (DIG) and a compass app (COMP). Heel height difference was measured only during the second occasion. Intra- and interobserver agreement were calculated using weighted kappa statistics (HFPS) and intraclass correlation (DIG, COMP and HHD). Associations between HFPS and DIG, COMP and HHD were analyzed using linear mixed models.Intra- and interobserver reliability were poor to good for HFPS, DIG, COMP and HHD. HFPS was significantly associated with DIG and COMP but not with HHD. Using the median value of repeated HFPS scores could increase the robustness of the HFPS assessment, as our data indicate that the cows frequently shift the position of their hind claws. Overall, there was a poor correlation between HHD and HFPS, so HFPS may not be determined by HHD alone; future research should consider other reasons for outward rotation of the hind feet.

Cell differentiation in the embryonic periderm and in scaffolding epithelia of skin appendages.

Terminal differentiation of epithelial cells is critical for the barrier function of the skin, the growth of skin appendages, such as hair and nails, and the development of the skin of amniotes. Here, we present the hypothesis that the differentiation of cells in the embryonic periderm shares characteristic features with the differentiation of epithelial cells that support the morphogenesis of cornified skin appendages during postnatal life. The periderm prevents aberrant fusion of adjacent epithelial sites during early skin development. It is shed off when keratinocytes of the epidermis form the cornified layer, the stratum corneum. A similar role is played by epithelia that ensheath cornifying skin appendages until they disintegrate to allow the separation of the mature part of the skin appendage from the adjacent tissue. These epithelia, exemplified by the inner root sheath of hair follicles and the epithelia close to the free edge of nails or claws, are referred to as scaffolding epithelia. The periderm and scaffolding epithelia are similar with regard to their transient functions in separating tissues and the conserved expression of trichohyalin and trichohyalin-like genes in mammals and birds. Thus, we propose that parts of the peridermal differentiation program were coopted to a new postnatal function during the evolution of cornified skin appendages in amniotes.

Effect of pretreatment with Devil's Claw on locomotor activity, infarct volume, and neuronal density in focal cerebral ischemia in rats.

Objective: Stroke is a highly prevalent and devastating condition affecting millions worldwide. The Devil's Claw (DCW) plant is a native African plant whose anti-inflammatory, antioxidant, and neuroprotective properties have been investigated. We postulated that DCW could protect the brain injury caused by cerebral ischemia. Materials and Methods: The rats were randomly divided into four groups. The sham and control (Ctrl) groups received pretreatment with a distilled water vehicle. Doses of 200 and 400 mg/kg were selected for pretreatment with DCW. The filament or intravascular occlusion method was used for middle cerebral artery occlusion (MCAO). The Triphenyl tetrazolium chloride (TTC) staining method was used to investigate the infarct zone and penumbra volume. The neuroprotective effect of DCW was measured by hematoxylin staining. Movement performance was evaluated from neurological deficit score, rotarod performance, and open field tests. Results: TTC staining showed that the DCW/400 group could maintain the penumbra's structure and reduce the infarct volume compared to the Ctrl group (p<0.001). Histological studies confirmed the neuroprotective properties of DCW at doses of 200 and 400 mg/kg compared to the Ctrl group (p<0.01 and p<0.0001, respectively). The results of behavioral tests showed an improvement in behavioral performance in pretreatment 400 mg/kg doses compare to Ctrl group (p<0.0001). Conclusion: The study showed that pretreatment with DCW with its neuron protection potential reduces the infarct area and restores motor function after MCAO.

Visual Outcomes and Complications of Intraocular Lens Placement in the Absence of Capsular Support in a Philippine Tertiary Hospital.

Background: Surgical correction of aphakia without capsular support continues to be a challenge. Improvements in the technology of cataract surgery have provided advancements in techniques in surgical management of aphakia. Locally, we have limited data on the outcomes of the different intraocular lenses used in aphakia. Objective: This study aimed to determine visual outcomes and complications associated with different techniques of intraocular lens implantation in the absence of capsular support. Methods: We reviewed the medical charts of 207 patients who underwent intraocular lens implantation without capsular support. Excluded were patients with incomplete follow up, pediatric patients, and lost records. Best corrected visual acuity at day 1, 1st month, 3rd month and 6th month postoperatively, and the complications were noted. Results: Mean age was 60 and 51% (n=105) were females. The mean follow-up time was 9.33 ± 0.71 months. Loss of capsular support was most frequently caused by intraoperative complication (n=146, 70%) and trauma. Retropupillary fixation iris claw intraocular lens was frequently used (n=93, 44.9%). Across all patients, visual acuities showed excellent outcomes with 20/50 or better. Across IOL types, the most frequent postoperative complication was increase in IOP. Statistically significant results were set at P <0.05. Conclusion: There is a notable preference towards iris claw retropupillary lenses through time. Iris claw lenses showed the shortest operative time. All intraocular lenses used in aphakia showed comparably good postoperative visual acuities, except for the superior visual acuity trend seen among retropupillary iris claw and anterior chamber IOL groups. Complications included elevated intraocular pressures, corneal edema, and pigment dispersion.

The polymicrobial nature of the oral cavity and claws of cats diagnosed by mass spectrometry and next-generation sequencing.

Close contact between cats and humans increases the risk of transmission of zoonotic pathogens, through bites and scratches due to the complexity of microorganisms in the oral and nail microbiotas of felines. This study investigated the presence of bacteria and fungi in the oral cavity and claws of 100 apparently healthy cats using conventional and selective microbiological culture media, and next-generation sequencing (NGS) and mass spectrometry (MALDI-TOF MS). Furthermore, antimicrobial susceptibility testing of bacteria isolates was performed by disc diffusion method. In total, 671 bacteria and 33 yeasts were identified by MALDI-TOF MS. Neisseria animaloris (10.8 %), Staphylococcus felis (8.5 %), and Pasteurella multocida (7 %) were the most prevalent bacteria in oral cavity samples (n = 343), while the most common yeast (n = 19) was Candida albicans (68.4 %). Staphylococcus pettenkoferi (13.4 %), Staphylococcus felis (6.4 %), and Staphylococcus simulans (5.8 %) were the prevalent bacteria identified in the claw samples (n = 328), while Rhodotorula mucilaginosa (57.2 %) was the most common yeast (n = 14). NGS predominantly identified the genera Moraxella, Neisseria, Pasteurella, and Fusobacterium in oral cavity samples, whereas enterobacteria and staphylococci were prevalent in nail bed samples. In addition, the genera Capnocytophaga and Bartonella were identified, which have been described in serious human infections secondary to feline aggressions. Levofloxacin, marbofloxacin, and amoxicillin/clavulanic acid were the most effective drugs against the main groups of bacteria identified. Multidrug resistance was observed in 17 % of the bacterial isolates. Furthermore, three staphylococci harboring the methicillin resistance gene mecA were identified. We highlight the complexity of microorganisms inhabiting the oral/claw microbiotas of cats, the high resistance rate of the isolates to conventional antimicrobial agents, and the zoonotic risk of aggressions caused by bites and scratches from domestic cats.

Measuring hoof horn haemorrhage in heifers: A history.

Understanding the aetiology and pathogenesis of claw-horn disease (CHD) is essential for developing prevention/treatment programmes. Haemorrhages in the hoof horn (i.e. white line/sole haemorrhages) are an important part of the pathogenesis of CHD, being precursors to and predictors of lesions such as white-line disease and sole ulcer. Understanding haemorrhage development can provide useful information about the aetiology and pathogenesis of CHD. The development of hoof horn haemorrhages is best studied in cattle without previous claw-horn damage, as previous history of damage can markedly alter the hoof's response to stressors. Since the early 1990s, many prospective studies of the risk factors associated with CHD have been undertaken in late pregnant and early lactation heifers, which have a low risk of having had CHD but which are exposed to the same risk factors as lactating cows. Those studies have used a range of methods to assess hoof horn haemorrhages, with the principal focus, particularly initially (but also more recently), being on measuring lesion severity. However, as the science developed it became clear that measuring lesion extent was also important and that combining severity and extent in a single measure was the best approach to assess hoof horn haemorrhages. Studies of hoof horn haemorrhage in heifers have significantly increased our understanding of CHD, demonstrating the importance of housing and the relative lack of importance of post-calving nutrition. Most importantly, they have shown the importance of parturition as a risk factor for CHD, and how parturition interacts with other risk factors to accentuate their effect. The use of such studies has decreased in recent years, despite recent research showing that we still have much to learn from prospective studies of hoof horn haemorrhages in heifers.

Aphakia treatment with sutureless scleral fixation or retropupillary iris-claw intraocular lens implantation: visual acuity, anterior segment and keratometry outcomes.

PURPOSE: Evaluation of anterior segment parameters using the Scheimpflug corneal topography 1 year after surgery in patients who underwent sutureless scleral fixation intraocular lens (SFIOL) implantation using the modified Yamane technique and retropupillary iris-claw intraocular lens (RPIOL) implantation. METHODS: A total of 60 eyes from 57 patients who underwent sutureless SFIOL implantation and 57 eyes from 52 patients who underwent RPIOL implantation were included. Anterior chamber depth (ACD), anterior chamber angle (ACA), anterior chamber volume (ACV), anterior-posterior corneal astigmatism, and keratometric values were assessed using the Scheimpflug corneal topography (Pentacam HR, Germany). RESULTS: There was no statistically significant difference in postoperative UCVA and BCVA between the sutureless SFIOL and the RPIOL group (p = 0.236, p = 0.293, respectively). While there was no statistically significant difference in postoperative IOP between the two groups (p = 0.223), a statistically significant decrease in IOP was observed in both groups (p < 0.001). While there was no statistical difference between the sutureless SFIOL group and the RPIOL group in terms of spherical value (p = 0.441) and spherical equivalence (p = 0.237), there was a statistically significant difference in cylindrical value (p < 0.001). While there was a statistical difference in anterior astigmatism (p < 0.001), there was no statistical difference in posterior astigmatism (p = 0.405). There was no statistical difference in terms of ACV, ACD, and ACA between the sutureless SFIOL and the RPIOL group (p = 0.812, p = 0.770, p = 0.401, respectively). CONCLUSION: In this study, although there was a statistical difference in cylindrical value and anterior corneal astigmatism between the sutureless SFIOL and RPIOL groups, vision was not affected. According to this study, sutureless SFIOL and RPIOL are two successful methods in terms of visual acuity, anterior segment, and keratometry outcomes in aphakic patients after phacoemulsification.

A Modification to the Brand Transfer for Claw Hand: The Four-Tailed Extensor Carpi Radialis Brevis to Lateral Band Transfer.

BACKGROUND: Claw deformity is a devastating consequence of low ulnar nerve palsy, resulting in loss of finger function. Traditionally, the Brand transfer is a favored intervention but requires lengthy grafts and bulky tenorrhaphies, risking adhesions in the lumbrical canal. We present a modified Brand tendon transfer, which extends the extensor carpi radialis brevis (ECRB) into 4 tails for individual grafting into the lateral band, decreasing adhesion risk and graft length need. METHODS: Nine consecutive patients with claw hand were examined in detail to confirm the diagnosis and appropriateness for claw-correction surgery by the senior author. All patients underwent our modified Brand transfer. Follow-up for a minimum of 6 months was pursued for each patient, with range of motion, grip strength, and pinch strength recorded at that time. RESULTS: Treated patients demonstrate maintained grip and pinch strength, coordinated grasp, and improvement in metacarpophalangeal posture. One patient required reoperation for extensive scarring and underwent tenolysis of the tendon grafts and revision grafting for the small finger. CONCLUSION: We concluded that our modified weave of a 4-tailed tendon graft through the ECRB is a synergistic transfer that maintains acceptable hand strength in the setting of a chronic low ulnar nerve palsy with a lower risk of tendon adhesion and length of grafting, offering an additional tool in the armamentarium of the hand surgeon approaching the ulnar nerve-injured hand.

Bovine Digital Dermatitis: Treponema spp. on trimming equipment and chutes - effect of washing and disinfection.

BACKGROUND: Digital dermatitis (DD) is a contagious bovine foot disease causing reduced animal welfare and negative economic consequences for the farmer. Treponema spp. are the most important causative agents. Studies indicate that trimming equipment can transfer DD-associated treponemes between cows. The aim of this observational study in 22 DD-positive Norwegian dairy herds was to investigate the risk of transferring Treponema spp. with trimming equipment and chutes after claw trimming, and after washing and disinfection. Swabs from the trimming equipment and chutes were collected from nine different locations, at five different time points. Bacterial DNA was extracted from 647 swabs and analysed by qPCR for Treponema spp. In addition, 172 swabs taken immediately after trimming, were analysed by a multiplex qPCR targeting T. phagedenis, T. pedis and T. medium/vincentii. Biopsy sampling from DD lesions was performed on cows in the same herds during trimming. Altogether 109 biopsies were analysed by FISH for confirmation of the DD diagnosis and identification of Treponema phylotypes (PTs). RESULTS: High numbers of Treponema spp. were detected from all nine locations on the trimming equipment and chutes immediately after trimming, and T. phagedenis was detected on two or more locations in all but two herds, 1 and 19. There was a decline in the amount of Treponema spp. after washing and disinfection. The belly belt, the cuff, and the footrest on the chute had the highest proportion of positive samples after disinfection. The belly belt had the highest copy numbers of all nine locations (median = 7.9, max = 545.1). No Treponema spp. was detected on the hoof knives after disinfection. Treponema phagedenis, T. pedis, and Treponema phylotype 3 (T. refringens) were detected by FISH analysis of the biopsies. Treponema phagedenis was detected in biopsies from all herds except 1 and 19. CONCLUSION: This study shows that DD-associated Treponema spp. were present on the trimming equipment and chutes after trimming cows in DD-positive herds. Washing and disinfection reduced the load of Treponema spp. However, large differences in Treponema spp. between different locations were documented. High copy numbers on the grinder and the chute after disinfection, indicates that sufficient cleaning and disinfection of these locations is difficult, and that passive transfer of DD-associated treponemes (viable or not) is possible.

Percutaneous distal bicortical proximal phalanx osteotomy for second toe deformities - A two-year prospective cohort study.

PURPOSE: The main purpose of our study was to evaluate satisfaction, recurrence, bone union and other complications after a minimum of two years follow-up in patients who had percutaneous claw and hammer (CHT) second toe correction utilizing a novel distal and bicortical proximal phalanx osteotomy (DBPPO). METHODS: A minimum two-year follow-up prospective cohort study was conducted on consecutive patients with symptomatic CHT deformities of the second toe corrected with percutaneous surgery. Primary outcomes included satisfaction, recurrence, bony union, and other complication rates specific to the second toe deformity correction. Secondary outcomes included Metatarsophalangeal-Interphalangeal AOFAS scale and Visual Analogue Scale (VAS). RESULTS: Between January and October 2020, 34 patients (43 feet) were clinically and radiologically evaluated pre and postoperatively at a mean of 26.6 months. Thirty-eight feet (88.4 %) were satisfied or very satisfied with their second toe deformity correction and 41 feet (95.3 %) would undergo surgery on this toe again. No deformity recurrence requiring revision was found. There were two complications (4.7 %): one toe (2.3 %) with persistent numbness and one (2.3 %) had a simple infection that resolved with oral antibiotics. All 43 s toe osteotomies demonstrated bony consolidation. Stiffness was reported in nine second toes (20.9 %), seven of them (77.8 %) having a rigid pre-operative deformity. Secondary outcomes demonstrated significant improvement in the mean ( ± standard deviation) AOFAS score which increased from 47.5 ± 17.9 preoperatively to 95.7 ± 7.7 postoperatively (p < .001). Mean VAS significantly improved from 4.9 ± 2.5 preoperatively to 0.3 ± 1.3 postoperatively (p < .001). CONCLUSION: Percutaneous treatment of claw and hammer second toe deformities utilizing a DBPPO resulted in high levels of satisfaction with bony consolidation, no recurrence and low complication rates at two years follow-up. LEVEL OF EVIDENCE: Level II - Prospective cohort study.

The Outcome of Artisan Intraocular Lens Implantation in Children: A Narrative Review.

Aphakia is a condition in which the eye's crystalline lens is not in its proper position because of a perforating injury, surgical removal, dislocation of the lens, or congenital anomaly. The management of aphakia can be either conservative or surgical. Various surgical techniques could be used, including retro pupillary-fixated iris-claw intraocular lenses (IOLs) and anterior-fixated iris-claw IOLs. One of the challenges faced by ophthalmologists is the optical rehabilitation of pediatric aphakic patients because a child's eye is still growing, resulting in fundamental variations in their refractive elements, and the immature visual system faces the risks of amblyopia development in the case of defocus or inequality of visual input between both eyes. There is also the risk of the incidence of side effects that can be accepted in adults but not in children. Finally, accurate postoperative supervision and optical rehabilitation in pediatrics will be more complex than that in adults. This review showed that it is possible to place, replace, and exchange the Artisan IOL with minor surgical trauma. Hence, this procedure can be an acceptable therapeutic method for correcting the developmental refractive changes of the growing aphakic eye. However, some worries are still caused by probable long-term side effects, including endothelial cell loss. Finally, a significant attempt at visual rehabilitation is to treat pediatric aphakia with Artisan IOL.

Posttraumatic Compressive Neuropathy of the Deep Motor Branch of the Ulnar Nerve Caused by Heterotopic Ossification.

We report a case of posttraumatic compressive neuropathy of the deep motor branch of the ulnar nerve occurring in the setting of heterotopic ossification following a direct blow to the hypothenar eminence. Over several weeks, the patient developed ring and little finger claw deformities and atrophy of his first dorsal interosseous and adductor pollicis muscles with sparing of sensation. Electromyography and nerve conduction study localized the area of injury, and computed tomography confirmed the presence of heterotopic bone near the deep motor branch of the ulnar nerve. Intraoperatively, the deep motor branch of the ulnar nerve was under tension as it traversed volarly over the hook of hamate and heterotopic bone. Decompression of the deep motor branch of the ulnar nerve with resection of heterotopic bone and the hook of hamate was performed. Six months postoperatively, the patient demonstrated resolution of clawing and improving strength of his ulnar nerve innervated intrinsic muscles.

Osteoarthritis: Insights into Diagnosis, Pathophysiology, Therapeutic Avenues, and the Potential of Natural Extracts.

Osteoarthritis (OA) stands as a prevalent and progressively debilitating clinical condition globally, impacting joint structures and leading to their gradual deterioration through inflammatory mechanisms. While both non-modifiable and modifiable factors contribute to its onset, numerous aspects of OA pathophysiology remain elusive despite considerable research strides. Presently, diagnosis heavily relies on clinician expertise and meticulous differential diagnosis to exclude other joint-affecting conditions. Therapeutic approaches for OA predominantly focus on patient education for self-management alongside tailored exercise regimens, often complemented by various pharmacological interventions primarily targeting pain alleviation. However, pharmacological treatments typically exhibit short-term efficacy and local and/or systemic side effects, with prosthetic surgery being the ultimate resolution in severe cases. Thus, exploring the potential integration or substitution of conventional drug therapies with natural compounds and extracts emerges as a promising frontier in enhancing OA management. These alternatives offer improved safety profiles and possess the potential to target specific dysregulated pathways implicated in OA pathogenesis, thereby presenting a holistic approach to address the condition's complexities.

Uncommon dermatologic manifestation (paronychia) in a cat with diabetes mellitus.

A 3.5-year-old male intact domestic short hair cat presented for a chronic wound and crusts over the claw and claw folds over several months. The cat was diagnosed with diabetes mellitus based on the presence of persistent hyperglycemia, glucosuria, and compatible clinical signs which consist of polyuria, polydipsia, polyphagia, and weight loss. Glipizide (Glucotrol XL, Pfizer, Indonesia) 2.5 mg orally twice daily was prescribed. By the seventeenth day, the patient's claws and skin around the paw had normalized and the abnormal claw sloughed off, revealing a normal claw underneath. Blood glucose, urinalysis and serum fructosamine were also normalized by the thirtieth day. The patient underwent diabetic remission, and the skin and claw lesions have remained in remission and not recurred since the treatment of the diabetes mellitus. This is the first report of a diabetic cat with dermatologic changes to the skin and claw regions. As the diabetes mellitus went into clinical remission, so too did the dermatologic manifestations, even without any specific dermatologic treatment.

Ontogeny of the autopodial skeleton of the gecko Tarentola (Squamata: Phyllodactylidae).

Squamates exhibit evident diversity in their limb morphology. Gekkotans are a particularly diverse group in this respect. The appearance of toepads in gekkotans usually cooccurs with the reduction or loss of claws. The gecko Tarentola (Phyllodactylidae) shows a unique combination of features among geckos, with toepads, hyperphalangy, and dimorphism of claw expression (claws are retained on digits III and IV, but lost (manus) or strongly reduced (pes) on the remaining digits). Despite being a candidate model for studying embryonic skeletal development of the autopodium, no studies have investigated the autopodial development of the gecko Tarentola in detail. Here, we aim to follow up the development of the autopodial skeleton in T. annularis and T. mauritanica using acid-free double staining. The results indicate that the terminal phalanges of claw-bearing digits III and IV ossify earlier than in the remaining digits. This confirms the differential ossification as a result of claw regression in Tarentola. The strongly reduced second phalanges of digits IV in both the fore- and hindlimbs are the last ossifying phalanges. Such late ossification may precede the evolutionary loss of this phalanx. If this is correct, the autopodia of Tarentola would be an interesting example of both the hyperphalangy in digit I and the process of phalanx loss in digit IV. Delay in ossification of the miniaturised phalanx probably represents an example of paedomorphosis.