ABSTRACT
Excessive axillary sweating is a frequent reason for seeking consultation in aesthetic medicine. Botulic toxin therapies have been used for years for this condition. A microwave-based treatment (MiraDry®) has been used in France since 2011. We present the case of a patient who developed complications following such a treatment for excessive axillary sweating, namely dermal detachment, subcutaneous collections, dermal thickening, retractile scars responsible for pain and limitation of axillary amplitudes. These complications mimic the natural evolution of deep axillary burns. In this paper, we propose a management method for patients with this type of complication.
ABSTRACT
INTRODUCTION: The surgical management of pressure ulcers in the paraplegic or quadriplegic population is marked by the high risk of recurrence in the long-term. In the current era of perforator flaps, newer reconstructive options are available for the management of pressure ulcers, decreasing the need to use the classically described muscular or musculocutaneous locoregional flaps. The coverage of ischial sores described in this article by a pedicled flap based on a deep femoral artery perforator, appears to be an effective first-line reconstructive option for the management of limited size pressure ulcers. PATIENTS AND METHOD: A number of fifteen paraplegic or quadriplegic patients having at least one ischial bed sore with underlying osteomyelitis were included in this series. The approximate location of the deep femoral artery perforator was initially identified using the "The Atlas of the perforator arteries of the skin, the trunk and limbs", which was confirmed, with the use of a Doppler device. A fasciocutaneous transposition flap was elevated, with the pivot point based on the cutaneous bridge centered on the perforator, and then transposed to cover the area of tissue loss. The donor site was closed primarily. RESULTS: A total of fifteen patients were operated from November 2015 to November 2016. The series comprised of 16 first presentations of a stage 4 pressure ulcers associated with underlying osteomyelitis that were subsequently reconstructed by the pedicled deep femoral artery perforator flap. The healing rate and functional results were both satisfactory. CONCLUSION: Fasciocutaneous flap reliable by deep femoral artery perforator appears to have a promising role in the treatment of ischial pressure sores. It is an attractive option to spare the use of musculocutaneous flaps in the area. Thus this flap could be used as a first-line option to cover ischial pressure ulcers of limited size.
Subject(s)
Femoral Artery , Perforator Flap/blood supply , Pressure Ulcer/surgery , Adult , Buttocks , Fascia/transplantation , Humans , Middle Aged , Skin Transplantation/methods , Young AdultABSTRACT
We synthesized a miR-122 antimiR library in which drug-like fragments were site-specifically introduced to short 2'-O-methyl-RNAs. At some sites selected fragments elevated cellular antimiR activity to that of an unmodified 23mer antimiR, whereas at others the same fragments abolished activity. The potency of the antimiRs correlated with uptake into miRISC.
Subject(s)
Gene Silencing , MicroRNAs/genetics , Neoplasms/genetics , Oligoribonucleotides, Antisense/genetics , RNA-Induced Silencing Complex/metabolism , Base Sequence , Drug Discovery , Humans , MicroRNAs/metabolism , Models, Molecular , Neoplasms/metabolism , Oligoribonucleotides, Antisense/chemistry , Oligoribonucleotides, Antisense/metabolismABSTRACT
While hemiendoprothesis has been established in the treatment of hip fractures of aged people because of less operative trauma, better effectiveness and satisfying functionality, surgical management of trochanteric fractures is still in discussion. In our study, we found no severe difference of living conditions or mortality after operating elderly patients with proximal femoral fractures comparing Hemiprotheses versus Endernails versus Dynamic Hip Screws.
Subject(s)
Hip Fractures/surgery , Hip Prosthesis , Postoperative Complications/mortality , Social Environment , Activities of Daily Living/classification , Aged , Bone Screws , Female , Fracture Fixation, Intramedullary/mortality , Geriatric Assessment , Hip Fractures/mortality , Humans , Male , Risk Factors , Social Support , Survival Analysis , Treatment OutcomeABSTRACT
We are reporting the case of a patient with a rare fracture of the corpus of the triquetrum after falling on the ulnar abducted and extended hand. The magnetic resonance imaging (MRI) of the wrist surprisingly showed an additional fracture of the hamate.
Subject(s)
Carpal Bones/injuries , Magnetic Resonance Imaging , Wrist Injuries/diagnosis , Carpal Bones/pathology , Casts, Surgical , Fracture Healing/physiology , Humans , Male , Middle Aged , Wrist Injuries/therapyABSTRACT
An isolated fracture of the proximal fibular shaft without associated tibial or ankle injury and without resulting from direct violence is extremely rare. This report presents a case of an unusual isolated proximal fibular fracture (stress-fracture) in a female tennis-player with Marfan-syndrome. The literature is reviewed and diagnosis, treatment and etiology are discussed.
