Diaphyseal nutrient foramina in the first metatarsals in normal and hallux valgus feet: location and surgical implications.

We examined 47 first metatarsals from amputated lower limbs to determine the situation of the main diaphyseal nutrient foramina (NFs) in normal and hallux valgus feet. All the NFs, excepting one, were in a plantar-fibular location. The NF situation was analyzed by means of the foraminal index and three minimum distances: from NF to proximal extremity, from NF to the shaft dorsal face (NFDS) and from NF to the border of the cartilaginous coating of the metatarsal head. We found a constant location of the NF in the middle of the total metatarsal length and sexual dimorphism in NFDS (lower in females); there were no differences by side, neither by digital or metatarsal types, nor between normal and hallux valgus types. Vascular complications in some osteotomies are discussed. In the surgical design, the NF situation can be estimated from either the total or physiological metatarsal length by means of the corresponding equations as reported here.

[Prevalence of alcoholism in the population attending a urban health center]. / Prevalencia de alcoholismo entre la población que acude a un centro de salud urbano.

OBJECTIVE: To find out the prevalence of alcoholism among those attending an urban Health Centre. To establish the level of concordance between the CAGE and MALT-O tests in the detection of alcoholism and to assess the effectiveness of the joint use of the above tests. DESIGN: Observational, crossover study. SITE. San Ignacio de Loyola Health Centre (Cuenca). PARTICIPANTS: A sample of 499 people of both sexes and over 18 years old was chosen from among the people attending the Centre. Systematic sampling from a random starting-point was used. MAIN MEASUREMENTS AND RESULTS: Each person was interviewed with a questionnaire containing the CAGE and MALT-O items and sociodemographic data. The person who gave at least two positive answers in both tests was considered an alcoholic. A total of 402 filled-in questionnaires were returned. 27 people were found to have two or more positive items, which mean a 6.7% prevalence of alcoholism (CI 95% = 4.2-9.1). This broke down into a prevalence of 1.33% among women and 13.63% among men (p < 0.0001). The concordance level, determined by the Kappa coefficient, between the two tests was 0.29 (CI 95% = 0.11-0.47). CONCLUSIONS: The prevalence of alcoholism found is greater than in other national studies on the out-patient population, although it continues to be low in comparison with several foreign surveys. On the other hand, we seem to gain nothing in the detection of alcoholism by adding the MALT-O to the CAGE test, even when the concordance level between the two tests has come out low.