Σάββατο 17 Μαρτίου 2018
Ion homeostasis and ion channels in NLRP3 inflammasome activation and regulation
Iva Hafner-Bratkovic | Pablo Pelegrín
http://ift.tt/2pkkJSE
Immune-based identification of cancer patients at high risk of progression
Yann-Alexandre Vano | Florent Petitprez | Nicolas A Giraldo | Wolf H Fridman | Catherine Sautès-Fridman
http://ift.tt/2HHr1Ct
Driving CARs on the uneven road of antigen heterogeneity in solid tumors
Nan Chen | Xiaoyu Li | Navin K Chintala | Zachary E Tano | Prasad S Adusumilli
http://ift.tt/2pndAko
Cancer vaccines: translation from mice to human clinical trials
Hoyoung Maeng | Masaki Terabe | Jay A Berzofsky
http://ift.tt/2HHr3u5
Oncolytic viruses and immunity
Shyambabu Chaurasiya | Nanhai G Chen | Yuman Fong
http://ift.tt/2FLQ9f2
Recurrent Pneumonia due to Fibrosing Mediastinitis in a Teenage Girl: A Case Report with Long-Term Follow-Up
A teenage girl was evaluated for recurrent right pneumonia. The evaluation revealed a calcified mediastinal mass that compressed the right intermediate and middle lobar bronchi, as well as the right pulmonary artery and veins. The clinical picture together with imaging studies and borderline positive serology testing suggested a diagnosis of fibrosing mediastinitis associated with histoplasmosis. This rare condition is characterized by the local proliferation of invasive fibrous tissue within the mediastinum due to a hyperimmune reaction to Histoplasma capsulatum. Antifungal and anti-inflammatory therapies are usually ineffective, and surgical intervention contains a high morbidity risk. Palliative surgery and stenting of the compressed airway have been suggested. In the past, the prognosis was thought to be poor, but recent studies demonstrate a more positive outcome. Our patient had been radiologically and functionally stable under follow-up for over thirteen years and has married and delivered two healthy children, both following an uneventful pregnancy.
http://ift.tt/2DAxWv5
Skull Base Osteomyelitis from Otitis Media Presenting as the Collet-Sicard Syndrome
Skull base osteomyelitis can involve the jugular foramen and its associated cranial nerves resulting in specific clinical syndromes. The Collet-Sicard syndrome describes the clinical manifestations of palsies involving cranial nerves IX, X, XI, and XII. We present a rare atypical case of skull base osteomyelitis originating from infection of the middle ear and causing the Collet-Sicard syndrome. Caused by Pseudomonas aeruginosa and Klebsiella pneumoniae, this occurred in an elderly diabetic man subsequent to retention of a cotton swab in an ear with chronic suppurative otitis media. This case report illustrates the possibility of retained cotton swabs contributing to the development of otitis media, skull base osteomyelitis, and ultimately the Collet-Sicard syndrome in the ears of immune-compromised patients with chronically perforated eardrums.
http://ift.tt/2pnNGw7
Multivariate analysis of preoperative and postoperative neutrophil-to-lymphocyte ratio as an indicator of head and neck squamous cell carcinoma outcome
Recent publications have highlighted a greater utility of routine blood tests in patients with various cancers than previously assumed. It appears that the neutrophil-to-lymphocyte ratio (NLR) may be a good predictive biomarker for overall survival (OS) and disease-free survival (DFS). Preoperative and postoperative NLR data for patients with head and neck cancers have yet to be established. The aim of this study was to evaluate the preoperative and postoperative NLR in 182 patients with head and neck squamous cell carcinoma and to determine the association of NLR with OS and DFS.
http://ift.tt/2pniVbB
Ustekinumab treatment is associated with decreased systemic and vascular inflammation in patients with moderate to severe psoriasis: Feasibility study using 18F-fluorodeoxyglucose positron emission tomography-computed tomography
Psoriasis may be associated with metabolic syndrome and an increased risk of cardiovascular disease.; Patients with psoriasis had increased hepatic, splenic, and arterial inflammation, which decreased with ustekinumab therapy.; Ustekinumab treatment was significantly associated with decreased systemic and vascular inflammation related to metabolic syndrome and cardiovascular disease among patients with psoriasis.
http://ift.tt/2DBc2Yq
Mycoplasma pneumoniae-related erythema multiforme: clinical and histological features. A single center series of 33 cases compared to 100 cases induced by other causes
Clinical aspects of Mycoplasma pneumoniae-related erythema multiforme (MP-EM) have been poorly described, MP-EM has a distinctive presentation compared with non-MP EM with diffuse atypical targets, and severe and extensive mucositis. Histology is similar to toxic epidermal necrolysis. Mucosal involvement management is essential in MP-EM to prevent possible sequelae.
http://ift.tt/2G033p0
Fate of mandibular canals displaced by enlarged cystic lesions: does the inferior alveolar neurovascular bundle relocate to its original position?
Our aim was to identify the positional changes of the inferior alveolar neurovascular bundle and evaluate the relocation of the displaced mandibular canal after enucleation of a cyst. Seventy patients (72 sites) who had had cysts enucleated were divided into three groups based on the degree of encroachment of the cystic lesion into the mandibular canal and whether a bone graft had been inserted after the cyst had been enucleated. The mean (range) of patients' ages was 45 (18–75) years, and there were 29 male and 41 female patients.
http://ift.tt/2GAe661
List of Reviewers
Publication date: June 2018
Source:Auris Nasus Larynx, Volume 45, Issue 3
http://ift.tt/2G3dNmE
Announcement SPIO Award 2017
Source:Auris Nasus Larynx, Volume 45, Issue 3
http://ift.tt/2DB1dFM
Editorial Board
Source:Auris Nasus Larynx, Volume 45, Issue 3
http://ift.tt/2G2xGde
Comparison between clinical and audiological results of tympanoplasty with double layer graft (modified sandwich fascia) technique and single layer graft (underlay fascia and underlay cartilage) technique
Source:Auris Nasus Larynx, Volume 45, Issue 3
Author(s): Sanjana Vijay Nemade, Kiran Jaywant Shinde, Pratibha Bharat Sampate
IntroductionSurgical repair of the tympanic membrane, termed a type one tympanoplasty is a tried and tested treatment modality. Overlay or underlay technique of tympanoplasty is common. Sandwich Tympanoplasty is the combined overlay and underlay grafting of tympanic membrane.ObjectiveTo describe and evaluate the modified sandwich graft (mediolateral double layer graft) tympanoplasty using temporalis fascia and areolar fascia. To compare the clinical and audiological outcome of modified sandwich tympanoplasty with underlay tympanoplasty.MethodsA total of 88 patients of chronic otitis media were studied. 48 patients (Group A) underwent type one tympanoplasty with modified sandwich graft. Temporalis fascia was underlaid and the areolar fascia was overlaid. 48 patients (Group B) underwent type one tympanoplasty with underlay fascia technique. 48 patients (Group C) underwent type one tympanoplasty with underlay cartilage technique. We assessed the healing and hearing results.ResultsSuccessful graft take up was accomplished in 47 patients (97.9%) in Group A, in 40 patients (83.3%) Group B, and in 46 (95.8%) patients in Group C. The average Air-Bone gap closure achieved in Group A was 24.4±1.7dB, in Group B, it was 22.5±3.5dB and in group C, it was 19.8±2.6dB. Statistically significant difference was found in graft healing rate. Difference in hearing improvement was not statistically significant.ConclusionDouble layered graft with drum-malleus as a 'meat' of sandwich maintains a perfect balance between sufficient stability and adequate acoustic sensitivity.
http://ift.tt/2DB11Gy
High-dose corticosteroids improve the prognosis of Bell’s palsy compared with low-dose corticosteroids: A propensity score analysis
Source:Auris Nasus Larynx, Volume 45, Issue 3
Author(s): Takashi Fujiwara, Yasuharu Haku, Takuya Miyazaki, Atsuhiro Yoshida, Shin-ich Sato, Hisanobu Tamaki
ObjectiveThe aim of this study was to evaluate the effectiveness of high-dose corticosteroid (120mg prednisolone equivalent daily) in Bell's palsy compared with low-dose corticosteroid (60mg PSL equivalent).MethodsA single-center retrospective observational study was performed. We included adult Bell's palsy patients who were treated within 7days after disease onset. We compared high- and low-dose corticosteroid for the non-recovery rate at 6 months after disease onset using inverse probability-weighted propensity score analysis (IPW-PS).ResultsA total of 368 Bell's palsy patients (281 in the high-dose and 87 in the low-dose group) were included. The non-recovery rate without IPW-PS was 13.8% in the low-dose and 8.2% in the high-dose group. After IPW-PS adjustment, the non-recovery rate was 13.1% in the low-dose and 7.8% in the high-dose group (difference=−5.28%, 95% confidence interval [CI] −12.7% to −2.1%, p=0.040). High-dose corticosteroid decreased the non-recovery rate in severe Bell's palsy patients with a Yanagihara score of 0–10 (difference=−16.1%, 95% CI −38.5% to −6.2%, p=0.012), but did not decrease in moderate Bell's palsy patients with a Yanagihara score of 12–18 (difference=−2.0%, 95% CI −11.0% to 7.0%, p=0.591). Subgroup analysis revealed that the efficacy of high-dose corticosteroids was higher when patients were treated within 3days after disease onset, but not when patients were treated at 4days or later after disease onset.ConclusionsPhysicians would be better to treat severe Bell's palsy patients with high-dose corticosteroids when the patients are treated within 3days after disease onset.
http://ift.tt/2G3YQRd
Gender difference and laterality of sleep position
Publication date: June 2018
Source:Auris Nasus Larynx, Volume 45, Issue 3
Author(s): Hiroaki Ichijo, Miwaoki Akita
ObjectiveA higher incidence in women (approximately 7:3) and a predominant involvement of the right ear (approximately 7:5) are interesting features of BPPV (benign paroxysmal positional vertigo). It is speculated that these features are related to sleep position. The first aim of this study was to compare the frequency of position shifts during sleep between men and women. The second aim was to elucidate any differences in sleep position between men and women. The third aim was to clarify the laterality of sleep position.MethodsWe retrospectively selected the data of 30 males (mean, 53.1 years) and 22 females (mean, 50.6 years) diagnosed as mild or moderate obstructive sleep apnea. A position sensor was attached to the patient's anterior chest. Supine position was defined as less than 45° tilt, and lateral position was defined as more than 45° tilt. A single overnight laboratory polysomnography provided the number of position shifts, total sleep time, sleep time spent in the supine position (S), sleep time spent in the right-side-down lateral position (R), and sleep time spent in the left-side-down lateral position (L).ResultsThe mean value and standard deviation of the number of position shifts per hour was 2.4±1.3 in males, and 2.3±1.1 in females. There was no significant difference between males and females. Twelve cases (40%) were lateral type (S<R+L), and 18 (60%) were supine type (S>R+L) in males. Ten cases (45%) were lateral type, and 12 (55%) were supine type in females. There was no significant difference between males and females. Seventeen cases (56.6%) were right-dominant type (R−L>0), and 13 (43.3%) were left-dominant type (R−L<0) in males. Thirteen cases (59%) were right-dominant type, and 9 (41%) were left-dominant type in females.ConclusionBody position and the number of position shifts during sleep differ substantially between individuals. There is no gender difference in the frequency of position shifts. Although the supine type is more common than the lateral type, there is no gender difference in sleep position. Therefore, the reason of higher incidence in women is not related to sleep. The right-dominant type occurs more than the left-dominant type in both genders. It is possible that this behavior is the reason for the predominant involvement of the right ear in BPPV.
http://ift.tt/2u1pYvq
Schwannoma of external auditory canal
Publication date: June 2018
Source:Auris Nasus Larynx, Volume 45, Issue 3
Author(s): Dong Hoon Lee, Kyung Hwa Lee, Tae Mi Yoon, Joon Kyoo Lee, Sang Chul Lim
Schwannomas of the external auditory canal are extremely rare and only a few cases have been reported in the literature. Herein, we report a case of schwannoma of the external ear canal in a 41-year male. Clinicians should consider the possibility that the schwannoma may originate in the external auditory canal mimicking other more frequently observed lesions.
http://ift.tt/2pjI46P
Infrahyoid involvement may be a high-risk factor in the management of non-odontogenic deep neck infection: Retrospective study
Publication date: Available online 16 March 2018
Source:American Journal of Otolaryngology
Author(s): Hui Yuan, Rong Gao
ObjectivesThis study sought to investigate the impact of involvement of the infrahyoid neck space on the management of non-odontogenic DNI.MethodEighty-one patients treated for non-odontogenic DNI over 5 years were retrospectively recruited into this study. Demographics, etiology, radiology results, treatments, duration/cost of hospital stay, and complications were recorded. Differences between DNIs with and without infrahyoid involvement, as defined based on an anatomical chart, were analyzed.ResultsSixty-two male and 19 female patients with a median age of 46.22 years were included. Fifteen patients had cellulitis, and 66 patients had abscesses. Streptococcus was the most commonly observed bacterium. Compared with DNIs only in suprahyoid spaces (n = 60, 74.07%), DNIs with infrahyoid space involvement (n = 21, 25.93%) were associated with higher incidences of the involvement of ≥3 spaces (85.71%, P = 0.000), mediastinitis (38.10%, P = 0.000), tracheostomy (28.57%, P = 0.008), surgery using a transcervical approach (66.67%, P = 0.000), and intensive care unit therapy (19.05%, P = 0.004), as well as longer hospital stays (16 days, P = 0.000) and higher costs ($2872, P = 0.000).ConclusionInfrahyoid involvement should be regarded as a high-risk factor in the management of deep neck infection (DNI). A relatively aggressive plan that includes transcervical surgery and tracheostomy should be considered at earlier stages for DNI with infrahyoid involvement.
http://ift.tt/2GAXmvv
Idiopathic condylar resorption
Publication date: Available online 16 March 2018
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): K. Mitsimponas, S. Mehmet, R. Kennedy, K. Shakib
Idiopathic condylar resorption is a well-documented but poorly-understood pathological entity that predominantly affects young women, particularly during the pubertal growth spurt. Several theories have been proposed to explain its aetiopathogenesis, the most favoured of which are the hormonally mediated theory, the theory of avascular necrosis, and the dysfunctional remodelling theory. The condition is diagnosed by a combination of clinical and radiological data as well as elements from the patient's history. Treatments such as orthognathic surgery, repositioning and stabilisation of the disc, condylectomy and condylar repair with a costochondral graft, or total prosthetic joint reconstruction, have been suggested, but so far, no method has proved superior. Further research is required to better understand the pathophysiology of the condition and identify the optimal treatment.
http://ift.tt/2plE84T
Early experience of a nurse-led clinic in a tertiary centre
Publication date: Available online 16 March 2018
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): J. Spellman, A. Kanatas, T.K. Ong
A busy head and neck or oral and maxillofacial (OMFS) National Health Service (NHS) clinic treats patients with many different conditions. A large proportion will have cancer of the head and neck, and they will be at different stages of their treatment. Their clinical needs may be different from a larger group of patients who have been referred through the "two-week wait" referral pathway, and who are present in the same clinic for their biopsy results. We present our early experience of "fast-track" referrals and their potential effect on the overall volume of work. They are only a small number of the patients who are typically seen in a nurse-led clinic.
http://ift.tt/2IyTBqY
Influence of venous stasis on survival of epigastric flaps in rats
Publication date: Available online 17 March 2018
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): T. Mücke, L.H. Schmidt, A.M. Fichter, K.-D. Wolff, L.M. Ritschl
Venous congestion results in tissue damage and remains the most common reason for failure of transfer of microvascular free flaps if it is not recognised early. The purpose of this study was to measure the critical duration of venous congestion and the resultant survival of flaps according to the duration of venous stasis. A standard epigastric flap was raised and repositioned in 35 rats, seven of which acted as controls. The superficial inferior epigastric vein was fully occluded for four, five, six, or seven hours in the rest (n=7 each group). Subsequently, the rats were monitored for one week, and the resultant necrotic areas were photographed. After five, six, and seven hours of venous stasis, the incidence and area of necrosis were significantly increased (p=0.04 in each) above that of the control. The degree of necrosis after seven hours of venous stasis was significantly greater than that after four or five hours (p=0.01 and 0.02, respectively). The duration of venous congestion is therefore a potential risk for the survival of free flaps, as it results in operative complications and may jeopardise the whole procedure. After a critical period of venous stasis we reach a point of no return, and any attempt to salvage the compromised flap will be in vain. Based on these results, we think that monitoring by an experienced surgeon at intervals of no longer than three hours is essential for the successful salvage of venous congestion in microvascular free flaps.
http://ift.tt/2pnfocn
Erratum: Behandlung im Voraus planen – Bedeutung für die Intensiv- und Notfallmedizin
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: e1-e1
DOI: 10.1055/a-0591-7094
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
http://ift.tt/2HI4A09
Survival of dental implants placed in HIV-positive patients: a systematic review
Publication date: Available online 16 March 2018
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): C.A.A. Lemos, F.R. Verri, R.S. Cruz, J.F. Santiago Júnior, L.P. Faverani, E.P. Pellizzer
No consensus has been reached on the use of dental implants in human immunodeficiency virus (HIV)-positive patients. This systematic review evaluated dental implants in HIV-positive patients in terms of implant survival and success rates, marginal bone loss, and complications. The review was conducted according to the PRISMA checklist. Two independent reviewers performed a comprehensive search of the PubMed/MEDLINE, Scopus, and Cochrane Library databases for studies published until October 2017. Six studies were selected for review. In total, 821 implants were placed: 493 in 169 HIV-positive patients, and 328 in 135 HIV-negative patients. The mean duration of follow-up was 47.9 months. Weighted mean survival rate, success rate, and marginal bone loss values were calculated for the HIV-positive patients. Mean survival and success rates at the patient level (according to the number of patients) were 94.76% and 93.81%, respectively; when calculated at the implant level (according to the number of implants), these rates were 94.53% and 90.37%, respectively. Mean marginal bone loss was 0.83mm at the patient level and 0.99mm at the implant level. Thus, dental implants are suitable for the rehabilitation of HIV-positive patients with controlled risk factors and normal CD4+ cell counts.
http://ift.tt/2FR5ZRA
The multidimensional burden of atopic dermatitis: an update
Source:Annals of Allergy, Asthma & Immunology
Author(s): Alanna C. Bridgman, Julie K. Block, Aaron M. Drucker
http://ift.tt/2tV5CDZ
Mycoplasma pneumoniae induces allergy by producing p1-specific IgE
Publication date: Available online 16 March 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Qing Ye, Jian-hua Mao, Qiang Shu, Shi-qiang Shang
BackgroundOur previous study found that most of MPP patients had elevated serum total IgE levels.ObjectiveThe purpose of this paper is to determine components of mycoplasma pneumoniae that can cause IgE increase in children, and to clarify its specific mechanism.MethodsThe components of MP cells were isolated by serum IgE from patients with MP pneumonia (MPP). These components obtained through the prokaryotic expression were used as allergens to detect the proportion of allergen-specific IgE produced in MPP patients, and the clinical characteristics and related immune parameters of these patients who produced this allergen-specific IgE were also analyzed. In addition, cell experiment was used to verify the biological effect of these components in vitro.ResultsP1-specific IgE was detected in serum of MPP children. An about 24-kDa polypeptide of P1 protein was obtained through prokaryotic expression purified by nickel agarose affinity chromatography. Approximately 9.2% of MPP patients produced IgE against this polypeptide of P1 protein, which was more likely to be produced in MPP patients with no history of allergies or family history of allergy-related diseases. P1-specific IgE-positive MPP patients had more severe clinical symptoms, with excessive secretion of IL-4 and IL-5 and over-differentiation of Th0 cells into Th2 cells. Tests also demonstrated that the P1 protein stimulated excessive secretion of IL-4 and IL-5 in PBMCs from the peripheral blood of healthy donors.ConclusionMP is not only an infectious agent but also an allergen for certain individuals. The P1 protein of MP can induce the production of P1-specific IgE.
http://ift.tt/2piDy8Q
Environmental exposure to peanut and the risk of an allergic reaction
Publication date: Available online 16 March 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Matthew Greenhawt
The purpose of this review is to detail the medical evidence surrounding such potential risk of reaction to peanut in public venues, focusing on educational settings and commercial aircraft, and to review the medical evidence and best-practices regarding potential risk mitigating strategies.
http://ift.tt/2DA3hOx
Aeromonas caviae mimicking Vibrio cholerae infectious enteropathy in a cholera-endemic region with possible public health consequences: two case reports
Aeromonas species have been documented to yield false positive results in microbiological tests for Vibrio cholerae. They share many biochemical properties with Vibrio species, with which they were jointly classi...
http://ift.tt/2pjAfOP
Definitive chemoradiation for locally-advanced oral cavity cancer: A 20-year experience
Source:Oral Oncology, Volume 80
Author(s): Corey C. Foster, James M. Melotek, Ryan J. Brisson, Tanguy Y. Seiwert, Ezra E.W. Cohen, Kerstin M. Stenson, Elizabeth A. Blair, Louis Portugal, Zhen Gooi, Nishant Agrawal, Everett E. Vokes, Daniel J. Haraf
ObjectivesDefinitive chemoradiation (CRT) for oral cavity squamous cell carcinoma (OC-SCC) is often criticized for poor efficacy or toxicity. We describe a favorable 20-year experience of primary CRT for locally-advanced OC-SCC.Materials and MethodsPatients with locally-advanced, stage III/IV OC-SCC receiving primary concomitant CRT on protocols from 1994 to 2014 were analyzed. Chemotherapy included fluorouracil and hydroxyurea with other third agents. Radiotherapy (RT) was delivered once or twice daily to a maximum dose of 70–75 Gy. Intensity-modulated RT (IMRT) was exclusively used after 2004. Progression-free survival (PFS), overall survival (OS), locoregional control (LRC), and distant control (DC) were calculated by the Kaplan-Meier method and compared across treatment decades using the log-rank test. Rates of osteoradionecrosis (ORN) requiring surgery were compared across treatment decades using the Chi-square test.Results140 patients with locally-advanced OC-SCC were treated with definitive CRT. Of these, 75.7% had T3/T4 disease, 68.6% had ≥N2 nodal disease, and 91.4% had stage IV disease. Most common primary sites were oral tongue (47.9%) and floor of mouth (24.3%). Median follow-up was 5.7 years. Five-year OS, PFS, LRC, and DC were 63.2%, 58.7%, 78.6%, and 87.2%, respectively. Rates of ORN and long-term feeding tube dependence were 20.7% and 10.0%, respectively. Differences in LRC (P = 0.90), DC (P = 0.24), PFS (P = 0.38), OS (P = 0.10), or ORN (P = 0.38) were not significant across treatment decades.ConclusionDefinitive CRT is a viable and feasible strategy for organ preservation for patients with locally-advanced OC-SCC.
http://ift.tt/2pit4FG
Assessing the potential role of scaffold-mediated local chemotherapy in oral cancer
Source:Oral Oncology
Author(s): Archana A. Gupta, Nikhil Pande, Supriya Kheur, A. Thirumal Raj
http://ift.tt/2Iv8HxS
Thrombotic microangiopathy associated with Mycoplasma pneumoniae infection
Thrombotic microangiopathy (TMA) comprises a process of sequential endothelial damage, microvascular thrombosis, consumptive thrombocytopenia and microangiopathic haemolytic anaemia that can affect several organs, including the kidney. A 36-year-old woman was presented with a petechial rash 3 weeks after an upper respiratory tract infection. Laboratory results showed normocytic normochromic anaemia, thrombocytopenia and evidence of TMA with decreased haptoglobin, elevated serum lactate dehydrogenase and a peripheral blood smear with numerous schistocytes. Treatment included daily plasmapheresis and prednisolone, with favourable clinical evolution. Antibodies anti-ADAMTS13 were positive, establishing the diagnosis of acquired thrombotic thrombocytopenic purpura. There was also serological evidence of a recent infection by Mycoplasma pneumoniae, and therefore the preceding respiratory tract infection by this agent was the most likely trigger for the disease. Due to the high mortality rate and poor outcomes, the prompt diagnostic and treatment are crucial in this rare disease. The identification of triggers related to this pathology can allow new therapeutic targets or preventive strategies.
http://ift.tt/2pjAlWr
Fixed drug eruption associated with aspirin
Description
A previously healthy 27-year-old woman presented to the outpatient urgent care clinic complaining of dark spots that appeared suddenly on both her feet and face. She had been prescribed aspirin (650 mg orally every 6 hours as needed) the day prior to presentation as therapy for migraine-type headache. She also then recalled that these spots had appeared suddenly, in exactly the same areas approximately 1 year before the current episode, also associated with ingestion of an over-the-counter medication (Alka-Seltzer; aspirin/citric acid/sodium bicarbonate). Physical examination was unremarkable with the exception of dark, erythematous, slightly oedematous round plaques asymmetrically distributed over her feet (figure 1) and left eyelid (figure 2). A complete blood count was ordered (results within normal range), and the patient was advised to substitute aspirin with ibuprofen, which controlled her headache. The skin lesions subsided and disappeared without complications within 2 weeks. 1
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Acute scrotum in setting of acute pancreatitis
Acute scrotum is a urologic emergency with many aetiologies. Acute scrotum in setting of acute pancreatitis is a rare occurrence and results from an effusion of pancreatic juices into the inguinal canal along a retroperitoneal tract. Knowledge regarding the existence of this obscure condition is essential for its diagnosis. It is thus important for medical professionals, particularly internists, surgical trainees and emergency physicians, to be aware of the condition and the options for its management.
http://ift.tt/2pj6P3l
Case of hepatic flexure ectopic pregnancy medically managed with methotrexate
Abdominal pregnancies represent 1.4% of extrauterine pregnancies. A literature search of six cases involving bowel ectopic pregnancies provided anecdotal treatment options. This case involves a woman admitted at 6 weeks gestation with right iliac fossa and shoulder tip pain. An ultrasound scan revealed an empty uterus with free fluid in both adnexa and a 31x21 mm heterogenous mass adjacent to the right ovary. At laparoscopy, an ectopic pregnancy was identified at the hepatic flexure. The patient received two doses of methotrexate and monitored until the beta human chorionic gonadotropin reduced. The decision to manage with methotrexate was balanced against reported cases of bowel perforation and the possibility that a section of bowel may need removal if the pregnancy showed signs of invasion. Maternal mortality rate with abdominal pregnancy is 20% due to the risk of massive haemorrhage from placental separation or invasion of bowel vasculature. Medical treatment here was successful and avoided extensive surgery.
http://ift.tt/2DAgabg
Author Correction: Secukinumab Demonstrates Significantly Lower Immunogenicity Potential Compared to Ixekizumab
In the original publication, information regarding "ustekinumab" was incorrectly published under the Methods section. The correct information in the section "Antibodies and Control Protein" should be "(secukinumab, 150 mg/mL; ixekizumab, 90 mg/mL; adalimumab, 50 mg/mL; ustekinumab 90 mg/ml)". Infliximab, which is mentioned in that section, was not used in the study.
http://ift.tt/2Ix5w8S
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