Strengthening the relationship between intractable plantar keratosis and human papillomavirus.

The aim of the study was to determine the presence of human papillomavirus (HPV) in patients with intractable plantar keratosis (IPK) by comparing the histopathological findings of biopsies. A prospective, observational, and concordance study was carried out. Three different specimens were taken from each IPK. A first punch was sent for histopathological examination, and a second punch and a superficial skin scraping were both sent for HPV  polymerase chain reaction (PCR) and type determination. A total of 51 patients were included. From the histopathological examination, it was determined that 35 (68.6%) samples were diagnosed as warts and 16 (31.3%) as keratosis. However, the presence of HPV was confirmed by PCR in 49 (96.1%) and in 42 (82.4%) samples obtained by punch and superficial scraping, respectively. In the 49 PCR-positive samples, the most common HPV types were HPV1, HPV2, HPV27, HPV57, and HPV65, accounting for 81.6% of the samples. In conclusion, this study demonstrates that HPV infection and IPK lesions are very closely related. Although we cannot confirm that HPV is the cause of the development of IPK, the high prevalence of HPV observed in these lesions calls for a change to the procedures for managing IPK.

The Relationship Between Burnout and Health Professionals' Creativity, Method, and Organization.

BACKGROUND: This research focuses on problems relating to creativity and problem-solving capacity faced by a specific group of professionals, as they relate to worker burnout, which is prevalent in a large number of work environments. OBJECTIVES: Our hypothesis was that creative people who follow method and order are less likely to suffer from burnout. Our objective was to demonstrate that health professionals working in surgery who are creative, methodical, and orderly have lower levels of burnout compared to others. DESIGN: A correlational, analytical, and cross-sectional study with 70 health professionals working in surgery. METHODS: A random sample of health professionals who worked in surgery at the Hospital Universitario de La Princesa in Madrid, Spain from 2011 to 2014 were studied. The variables considered in the study were: gender, age, profession, creativity score, method and order score, and burnout score. Measurement tools were CREA: creative intelligence (Corbalán & Martinez, 2003), MO2: method and order (Seisdedos, 1994), and the Maslach Burnout Inventory (MBI), a test of emotional exhaustion, depersonalization, and personal accomplishment (Maslach, 1981), all of which were validated for the Spanish population. RESULTS: Our data indicate that a worker's age influences his/her capacity to work with method and order, and that workers with emotional exhaustion (a basic feature of burnout) have lower scores in method and order. Greater emotional exhaustion and greater depersonalization were related to lower personal accomplishment and greater burnout. CONCLUSION: people who work with method and order are less likely to suffer from burnout. We did not find a direct relationship between creativity and method and order or between creativity and burnout.

Mechanical Stress Redistribution in the First Metatarsal Bone After Autologous Bone Harvesting.

BACKGROUND: The first metatarsal bone is a viable source for autologous bone grafting in foot and ankle surgery and may serve as another convenient graft site to correct a flail toe deformity. We aimed to determine how progressive bone removal from the first metatarsal affects the mechanical redistribution of the foot and whether this bone removal increases the risk of fracture. METHODS: A three-dimensional finite element model developed from computed tomographic images obtained from a healthy man were used to evaluate traction stresses on the first metatarsal bone as a function of applied loads on the talus and Achilles tendon at two phases of the gait cycle (and according to the depth of bone removal). RESULTS: Simulations indicated that when maximum load was applied to the Achilles tendon, tensile stress increased from 2.049 MPa in the intact foot to 5.941 MPa in the area of maximum bone harvest during the stance phase. Furthermore, as the volume of bone extracted from the first metatarsal increased, there was a redistribution of stress that differed significantly from that of the intact foot. CONCLUSIONS: Although the maximum stress on the first metatarsal was not significantly affected by increasing the volume of bone harvested, the ankle should be splinted in plantarflexion during the postoperative period to eliminate the stance phase of gait and reduce the risk of metatarsal fracture.