The clinical manifestations of hyperostosis frontalis interna: A qualitative systematic review of cases.

Hyperostosis frontalis interna (HFI) is a condition defined as abnormal bone growth on the posterior aspect of the frontal bone. Despite uncertainties regarding its etiology and prognosis, clinicians typically consider HFI a benign pathology. There are no studies organizing all the possible manifestations of the disease. The present study aims to organize all the clinical manifestations of HFI within the current case report/series literature. A blinded PRISMA-guided search of HFI case reports and case series yielded 43 relevant articles and provided 110 patients for analysis. The symptoms presenting alongside HFI were extracted and tabulated. We found high-frequency clinical manifestations of HFI (>20% of patients) to include headaches, obesity, vertigo/dizziness symptoms, cognitive decline, and depression. An additional 15 symptoms were tabulated at frequencies found to be less than 20%. Based on our analysis, we suggest the constellation of high-frequency symptoms can offer a more comprehensive clinical picture of symptomatic HFI which may be valuable to consider for clinicians and future researchers in the field of HFI.

Live kidney donations and the ethic of care.

In this paper, we seek to re-conceptualize the ethical framework through which ethicists and medical professionals view the practice of live kidney donations. The ethics of organ donation has been understood primarily within the framework of individual rights and impartiality, but we show that the ethic of care captures the moral situation of live kidney donations in a more coherent and comprehensive way, and offers guidance for practitioners that is more attentive to the actual moral transactions among donors and recipients. A final section offers guidelines for the practice of live kidney transplants that emerge from an ethic of care.

Kinetic analysis of planned gait termination in healthy subjects and patients with balance disorders.

We examined the stability and strategies used by balance impaired (vestibular hypofunction, VH: n=25; cerebellar damage, CB: n=20) patients and healthy (HE: n=52) controls during planned gait termination. Upper body strategies (during final stride and final step) were investigated using peak positive kinetic power (KP((+)): kinetic energy increasing), and peak negative kinetic power (KP((-)): kinetic energy decreasing) of the head-arms-trunk segment. Compared to HE controls (P<0.05): CB patients' medio-lateral KP((+)) and KP((-)) and were 53 and 71% higher during final stride, respectively; VH patients medio-lateral KP((+)) and KP((-)) was 78 and 57% higher during final step, respectively, and; during the final, standing stage VH patients were 32% less stable (from phase plane analysis) in the frontal plane. The excessive energy transfers in final stride for CB patients was likely due to poor eccentric muscle control when preparing for the stop. VH patients had difficulty controlling lateral stability during final step and once they had stopped walking, probably due to the lack of vestibular feedback regarding forward velocity changes. A better understanding of these abnormal movement patterns or compensatory strategies may assist in rehabilitation of patients with balance dysfunction.