Radiographic correlation of symptomatic and asymptomatic flexible flatfoot in young male adults

The purpose was to evaluate the value of radiology to distinguish between symptomatic and asymptomatic flexible flatfeet in young male adults. Among young male army recruits, 56 feet of 28 recruits were diagnosed as otherwise normal, flexible flatfoot with invisible longitudinal arch on stance and either symptomatic or asymptomatic unilaterally or bilaterally. The talus-first metatarsal and calcaneal pitch angles were measured on weight-bearing lateral radiographs, and the results were evaluated statistically. The talus-first metatarsal angle showed statistical significance in both non-parametric and logistic regression tests, but the calcaneal pitch angle showed statistical significance only in non-parametric test between symptomatic and asymptomatic flatfoot groups. Although the single gender and number of samples limit the applicability of our study, these results caused us to make an interpretation that increased talus-first metatarsal angle might be an important risk factor of being symptomatic in otherwise normal flexible flatfoot

Psoriasis and Vascular Disease—Risk Factors and Outcomes: A Systematic Review of the Literature

BACKGROUND: Psoriasis afflicts 2-3% of the world’s population. Affected patients commonly have risk factors for cardiovascular disease (CVD). In addition, psoriasis is independently associated with CVD and mortality. PURPOSE: To determine which CVD risk factors are associated with psoriasis independent of confounders, whether psoriasis is associated with CVD independent of CVD risk factors, and whether there is increased mortality among patients with psoriasis. DATA SOURCES: MEDLINE, Embase, and Cochrane Collaborations from inception through October 2009. We reviewed bibliographies of retrieved articles for additional references. STUDY SELECTION: Cross-sectional, cohort-based, case-control, and randomized controlled trials which involved patients with psoriasis. DATA EXTRACTION: Two investigators independently reviewed studies and resolved any discrepancies by consensus. DATA SYNTHESIS: Of the 2,303 articles identified by literature search, 90 studies met inclusion criteria for this review; 15 were cohort-based studies, 45 were case-control, and 30 were cross-sectional. LIMITATIONS: The quality of evidence was limited by study heterogeneity and lack of large scale prospective studies with long-term follow-up. CONCLUSIONS: Patients with psoriasis demonstrate a higher prevalence of cardiovascular risk factors and appear to be at increased risk for ischemic heart disease, cerebrovascular disease, and peripheral arterial disease. This increase in vascular disease may be independent of shared risk factors and may contribute to the increase in all-cause mortality. Future research should aim to more confidently distinguish between a true causal relationship or merely an association resulting from multiple shared risk factors. Physicians should screen for and aggressively treat modifiable risk factors for CVD in patients with psoriasis