Synchronous reconstruction of both the upper and lower eyelids with a temporoparietal fascial flap

No abstract available.

A Rare Case of Posterior Horseshoe Abscess Extending to Anterolateral Extraperitoneal Compartment: Anatomical and Technical Considerations

Perianal abscess and fistula are 2 distinct entities that share a common pathology. A horseshoe fistulous abscess, a complex type of these conditions, occurs when the suppurative inflammation spreads through the deep anal space to the bilateral ischiorectal fossae. Following the intersphincteric plane, this infection may extend to the pararectal space, forming a supralevator abscess. We present a very rare case involving a 52-year-old male patient who was admitted to our surgical department with an extraperitoneal purulent inflammation as a complication following multiple drainage procedures for a posterior horseshoe abscess. Emphasis is given to the anatomical and technical considerations of eradication of anorectal sepsis and the management of complex fistula-in-ano along with a concise review of the literature.

Feasibility study of dose-dense biweekly administered pemetrexed in patients with non-small cell lung cancer

Pemetrexed is a multitargeted folate pathway inhibitor with documented activity in non-small cell lung cancer [NSCLC]. The presumed maximum tolerated dose is 500 mg/m[2] every 3 weeks, but pemetrexed-related toxicity is ameliorated when folate and B12 supplementation is provided and therefore a higher dose intensity may be tolerated. The current exploratory study assessed the feasibility of administration of pemetrexed at a fixed dose of 1000 mg every 2 weeks in patients with relapsed or refractory NSCLC. The first cohort of 12 patients received pemetrexed monotherapy. No doselimiting grade 4 toxicity was noted after 4 cycles, so the subsequent cohort of 14 patients received additional anticancer agents [bevacizumab, erlotinib, carboplatin, docetaxel, vinorelbine] given along with dose-dense pemetrexed. Toxicity overall was reversible and manageable. Among 19 patients who received pemetrexed either alone or with non-myelosuppressive targeted agents, there were only 2 instances of grade 4 neutropenia after prolonged treatment. Grade 3-4 hematologic toxicity was eventually noted in 11 of the 26 patients [42%; 95% confidence interval, 23% to 61%] after a median of 4 cycles [range, 2-14 cycles]. There was no significant additional toxicity nor any treatment-related deaths. Our preliminary observations indicate that dosedense pemetrexed every 2 weeks is feasible and this regimen can be used as monotherapy. These data may serve as a scaffold for combination studies