RESUMO
BACKGROUND AND OBJECTIVES: Extracorporeal membrane oxygenation (ECMO) support is increasingly used in primary percutaneous coronary intervention (PCI) during cardiopulmonary resuscitation (CPR) to treat acute myocardial infarction (AMI) patients who experienced cardiogenic shock. However, to date, there have been no studies on the relationship between clinical outcomes and CPR time in such patients with AMI treated by ECMO-assisted primary PCI. METHODS: From July 2008 to March 2016, we analyzed data from 42 AMI with cardiogenic shock patients who underwent CPR and were treated by ECMO-assisted primary PCI. The primary outcome was 30-day in-hospital mortality after primary PCI. The predictors of mortality were determined using a Cox proportional hazards model. RESULTS: Thirty-day in-hospital mortality was observed for 33 patients (78.6%). The mean CPR time was 37.0±37.3 minutes. The best cut-off CPR time value associated with clinical outcome was calculated to be 12.5 minutes using receiver operating characteristic curve analysis. Multivariate analysis revealed that CPR time of > 12.5 minutes was an independent predictor of 30-day mortality (adjusted hazard ratio, 4.71; 95% confidence interval, 1.30–17.406; p=0.018). CONCLUSIONS: Despite ECMO support, the clinical outcomes of AMI patients with a complication of cardiogenic shock remain poor. Prolonged CPR time is associated with a poor prognosis in patients with AMI treated by ECMO-assisted primary PCI.
Assuntos
Humanos , Reanimação Cardiopulmonar , Oxigenação por Membrana Extracorpórea , Mortalidade Hospitalar , Membranas , Mortalidade , Análise Multivariada , Infarto do Miocárdio , Intervenção Coronária Percutânea , Prognóstico , Modelos de Riscos Proporcionais , Curva ROC , Choque CardiogênicoRESUMO
BACKGROUND AND OBJECTIVES@#Extracorporeal membrane oxygenation (ECMO) support is increasingly used in primary percutaneous coronary intervention (PCI) during cardiopulmonary resuscitation (CPR) to treat acute myocardial infarction (AMI) patients who experienced cardiogenic shock. However, to date, there have been no studies on the relationship between clinical outcomes and CPR time in such patients with AMI treated by ECMO-assisted primary PCI.@*METHODS@#From July 2008 to March 2016, we analyzed data from 42 AMI with cardiogenic shock patients who underwent CPR and were treated by ECMO-assisted primary PCI. The primary outcome was 30-day in-hospital mortality after primary PCI. The predictors of mortality were determined using a Cox proportional hazards model.@*RESULTS@#Thirty-day in-hospital mortality was observed for 33 patients (78.6%). The mean CPR time was 37.0±37.3 minutes. The best cut-off CPR time value associated with clinical outcome was calculated to be 12.5 minutes using receiver operating characteristic curve analysis. Multivariate analysis revealed that CPR time of > 12.5 minutes was an independent predictor of 30-day mortality (adjusted hazard ratio, 4.71; 95% confidence interval, 1.30–17.406; p=0.018).@*CONCLUSIONS@#Despite ECMO support, the clinical outcomes of AMI patients with a complication of cardiogenic shock remain poor. Prolonged CPR time is associated with a poor prognosis in patients with AMI treated by ECMO-assisted primary PCI.
RESUMO
BACKGROUND: The efficacy and safety of daily maintenance treatment with an adapalene-benzoyl peroxide (adapalene-BPO) fixed-dose combination gel is established in acne vulgaris in adults. OBJECTIVE: This study evaluated the efficacy and tolerability of twice-per-week maintenance therapy with an adapalene-BPO combination gel for acne vulgaris in adults. METHODS: All patients applied the adapalene-BPO combination gel once daily during the initial 8 weeks. Subsequently, the patients were randomized into two groups. The maintenance group applied the ointment twice-per-week for 12 weeks of maintenance treatment, while the control group discontinued treatment after the initial 8 weeks active treatment. The changes in the mean numbers of total, inflammatory, and non-inflammatory lesions were assessed. RESULTS: During maintenance treatment, the changes in the average numbers of total and inflammatory lesions in the maintenance group differed significantly from the control group. CONCLUSION: Twice-per-week application of an adapalene-BPO combination gel after active treatment appears to be a good option for the maintenance therapy of acne vulgaris in adults.
Assuntos
Adulto , Humanos , Acne Vulgar , Peróxido de Benzoíla , AdapalenoRESUMO
A 29-year-old Korean man presented with erythematous nodules on his right arm and left leg. He had been diagnosed with mycosis fungoides 10 years prior and was treated with phototherapy continuously. A diagnostic skin biopsy was performed, and the histopathologic findings of the specimen revealed dense infiltration of atypical large lymphoid cells through the entire dermis. These cells showed positive CD3 and CD30 staining. Despite the atypical finding that T cells represented less than 75% of the infiltrated cells, primary cutaneous CD30 positive anaplastic large cell lymphoma was ultimately diagnosed based on the overall consideration of the clinical features and favorable prognosis. Because primary cutaneous CD30 positive anaplastic large cell lymphoma has a favorable prognosis, it should be differentiated from large cell transformation of mycosis fungoides, which has a poor prognosis and requires aggressive treatment. However, this differential diagnosis is challenging. Herein, we report a rare case of primary cutaneous CD30 positive anaplastic large cell lymphoma with mycosis fungoides differentially diagnosed from large cell transformation.
Assuntos
Adulto , Humanos , Braço , Biópsia , Derme , Diagnóstico Diferencial , Perna (Membro) , Linfócitos , Linfoma Anaplásico de Células Grandes , Micose Fungoide , Fototerapia , Prognóstico , Pele , Linfócitos TRESUMO
Pemphigoid gestationis, also known as herpes gestationis, is a rare blistering disease associated with pregnancy, caused by autoantibody to the basement membrane component. It occurs in the second or third trimester of pregnancy or directly after delivery, as erythematous, urticarial papules, and plaques on the whole body, which aggravate to vesicles and bullae with severe pruritus. Histopathologically, subepidermal blisters and eosinophilic spongiosis are shown, and linear deposition of C3 in the dermoepidermal junction is seen on direct immunofluorescence assay. We present the case of 35-year-old woman who was diagnosed with pemphigoid gestationis, with the involvement of the uncommon site of the face.
Assuntos
Adulto , Feminino , Humanos , Gravidez , Membrana Basal , Vesícula , Eosinófilos , Técnica Direta de Fluorescência para Anticorpo , Penfigoide Gestacional , Penfigoide Bolhoso , Terceiro Trimestre da Gravidez , PruridoRESUMO
Microsporum(M.) gypseum, a geophilic dermatophyte, causes dermatophytosis that is characterized by rapid development and resolution. M. gypseum infection is rare due to its low infectivity, and there have been no previous case reports of infection with this dermatophyte after scratch injury by a dog. Here, we report a case of annular, scaly, erythematous plaques on the right ankle of a 5-year-old female patient after being scratched on the leg by a dog. Histopathological examination showed fungal hyphae on the stratum corneum. M. gypseum was identified by tissue culture and polymerase chain reaction. She was treated with sertaconazole cream. In this case, M. gypseum may have been transferred to the scratched area from contaminated soil or from the claws of the dog.
Assuntos
Animais , Pré-Escolar , Cães , Feminino , Humanos , Tornozelo , Arthrodermataceae , Casco e Garras , Hifas , Perna (Membro) , Microsporum , Reação em Cadeia da Polimerase , Solo , TinhaRESUMO
Here, we report a case of Cowden syndrome with an unusual clinical course of late-onset oral papillomatosis and a novel germline PTEN mutation. Cowden syndrome is the most common phosphatase and tensin homolog hamartomatous tumor syndrome. It is characterized by multiple hamartomas in the gastrointestinal tract and mucocutaneous lesions such as trichilemmomas, oral papillomatosis, facial papules, and acral keratoses. Patients with Cowden syndrome have a higher risk of malignancies, especially breast, colon, and thyroid cancers. A 53-year-old female presented with cobblestone-like papillomatous papules on the lower gums that developed 1 year earlier. She had no other mucocutaneous lesions besides oral papillomatosis. Gastrointestinal endoscopy and colonoscopy revealed multiple hamartomas in the stomach and colon. The patient had a history of breast cancer and multinodular goiter diagnosed 4 and 5 years ago, respectively. She was diagnosed with Cowden syndrome and a novel PTEN mutation was confirmed by direct sequencing.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Mama , Neoplasias da Mama , Colo , Colonoscopia , Endoscopia Gastrointestinal , Trato Gastrointestinal , Gengiva , Bócio , Hamartoma , Síndrome do Hamartoma Múltiplo , Ceratose , Papiloma , Estômago , Glândula TireoideRESUMO
Lichen planus is a chronic inflammatory disease that mainly involves the skin and oral mucosa. We report the case of a 57-year-old female who presented with a 6-week history of localized violaceous papules on her back and both extremities. Prior to presentation, she had received acupuncture on her back and both extremities, and 2 weeks later skin lesions occurred along the treated area. From the histopathologic findings of the lesion, the patient was diagnosed with lichen planus and treated with intralesional and topical corticosteroids. Dermatologic diseases such as atypical mycobacterial infection, foreign body granuloma and contact urticaria associated with traditional Korean medicine treatments have been reported. To the best of our knowledge, there has been only one report of eruptive lichen planus triggered by acupuncture in English literature to date. Herein, we report this rare and interesting case of lichen planus related to acupuncture.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Acupuntura , Corticosteroides , Extremidades , Granuloma de Corpo Estranho , Líquen Plano , Líquens , Mucosa Bucal , Pele , UrticáriaRESUMO
No abstract available.