Funtabulously Frivolous Friday Five 282

Camptodactyly – fixed flexion of the PIPJ, always affects the 5th digit.

The term was coined by the french Neurologist Dr Louis Théophile Joseph Landouzy in 1906.

There are 3 main classifications:

• Type I (most common form): An isolated anomaly of the little finger, presents in infancy (sporadic or genetic) and treatment involves stretching and splinting.
• Type II: Similar to type I but presents in adolescence and is usually due to an abnormal lumbrical insertion, abnormal FDS origin or insertion. Requires a surgical repair.
• Type III: Severe contractors involving multiple digits and is present at birth. There is usually an associated congenital syndrome. Can either be treated non-operatively or some may require osteotomy and fusions.

References

• Louis Théophile Joseph Landouzy (1845 – 1917)
• Landouzy L. Camptodactylie: stigmate organique precoce du neuro-arthritisme. La Presse Médicale. 1906; 14: 251.
• Gordon H, Davies D, Berman M. Camptodactyly, cleft palate, and club foot. A syndrome showing the autosomal-dominant pattern of inheritance. J Med Genet. 1969 Sep;6(3):266-74.
• Orthobullets – Camptodactyly.

Ganser syndrome.

Ganser syndrome (1898) is a rare and controversial condition, whose main and most striking feature is the production of approximate answers (or near misses) to very simple questions.

Dr Sigbert Josef Maria Ganser (1853 – 1931) was a German psychiatrist first described this syndrome in three prisoners while working at a prison in Halle (1898)

Ganser syndrome is described as a dissociative disorder not otherwise specified in the DSM-IV but is not listed in DSM-V. In most cases, it is preceded by extreme stress and followed by amnesia for the period of psychosis. In addition to approximate answers, other symptoms include a clouding of consciousness, somatic conversion disorder symptoms, confusion, stress, loss of personal identity, echolalia, and echopraxia.

The syndrome has also been called:

• Nonsense syndrome
• Balderdash syndrome
• Syndrome of approximate answers
• Prison psychosis

References

• Ganser S. Über einen eigenartigen hysterischen Dämmerzustand. Archiv für Psychiatrie und Nervenkrankheiten. 1898; 30(2): 633-640. English translation Schorer CE. ‘The Ganser syndrome: A peculiar hysterical state‘. British Journal of Criminology, 1965;5(2): 120-131
• Sigbert Josef Maria Ganser (1853 – 1931)

Passengers that were seated either side of the affected individual.

This assumes that no household contacts of the affected individual were also on the plane, and that the stricken person didn’t join the ‘mile high’ club with anyone en route to Sydney.

This advice applies to flights of 8 or more hours duration. Passengers sitting in the row ahead or behind, or more than one seat away to the side, do not need chemoprophylaxis.

Summary of who needs prophylaxis:

• Household contacts of a case
• Persons who share sleeping arrangements with the case
• Persons who have direct contamination of their nose or mouth with the oral/nasal secretions of a case (e.g. kissing on the mouth, shared cigarettes, shared drinking bottles)
• Health care workers (HCWs) who have had intensive unprotected contact (without wearing a mask) with infected patients (e.g. intubating, resuscitating or closely examining the oropharynx)
• Children and staff in child care and nursery school facilities
• Airline passengers sitting immediately on either side of the case (but not across the aisle) when the total time spent aboard the aircraft was at least 8 hours 

References

• CDC – Exposure to Patients with meningococcal disease on aircrafts.
• BCCDC – Meningococcal disease
• CCDR – Guidelines for the Prevention and Control of Meningococcal Disease

Longer than 3 hours…

Apparently there is an urban myth in Denmark that you can get drunk by submerging your feet in alcohol. Hansen CS and colleagues tested this by putting their feet in vodka for 3 hours. No ethanol was detectable in their blood and no one got drunk.

Reference:

• Hansen CS, Faerch LH and Kristensen PL. Testing the validity of the Danish urban myth that alcohol can be absorbed through feet: open labelled self experimental study. BMJ. 2010 PMID: 21156749

Lipoma – diagnosed after surgical excision.

Lipoma is one of the most common benign neoplasms; the buccal mucosa and tongue are the most frequent sites in the mouth. For more fun image challenges check out the NEJM – image challenge.