Eccrine syringofibroadenoma treated with a dual pulse width flashlamp pumped pulsed dye laser.

BACKGROUND: Eccrine syringofibroadenoma is a rare benign eccrine ductal proliferation with a predilection for the extremities, most often found in middle-aged and elderly patients. Reported treatments have included excision and conventional destructive modalities; however, recurrences may be common. OBJECTIVE: We describe a patient with a chronic ulcerated verrucoid eccrine syringofibroadenoma that persisted despite cryotherapy or curettage and electrodessication. RESULTS: Treatment with a dual pulse width flashlamp pumped pulsed dye laser (FPDL) produced an excellent clinical response. CONCLUSION: Treatment of eccrine syringofibroadenoma with a FPDL may provide both a vascular specific injury, analogous to the treatment of verruca vulgaris, and nonspecific thermal destruction at high fluences.

Isotretinoin induced rhabdomyolysis? A case report.

Isotretinoin, an effective therapy for nodulocystic acne and dissecting cellulitis of the scalp, has many known side effects. However, its association with elevated creatine kinase levels and its potential to cause rhabdomyolysis is not well established. We describe a patient with a significant elevation in creatine kinase after beginning therapy with isotretinoin for dissecting cellulitis of the scalp. The implications of isotretinoin causing rhabdomyolysis are discussed.

Association of physical fitness and transient myocardial ischemia in patients with coronary artery disease.

PURPOSE: To examine the relationship between physical fitness and transient myocardial ischemia (TMI) in the laboratory and during daily life, in a sample of coronary patients with a recent positive exercise test. METHODS: 47 patients with coronary disease (CAD) participated in laboratory mental and exercise stress testing and 48-hour outpatient Holter monitoring after being withdrawn from ant-ischemic medications. During laboratory testing, left ventricular performance was assessed by radionuclide ventriculography. Physical fitness was assessed by measurement of oxygen consumption during symptom-limited exercise treadmill testing. RESULTS: Higher physical fitness subjects were less likely to exhibit wall-motion abnormalities in response to mental stress (P < .05), and to exercise stress (P < .05) testing. They also had smaller decreases in left ventricular ejection fraction (LVEF) in response to mental stress than less fit subjects (P .056), and exhibited a mean increase in LVEF during exercise, compared to the less fit subjects who exhibited a decrease in LVEF (P < .02). Moreover, higher fit subjects exhibited fewer episodes of TMI (P < .04), for a shorter duration (P < .04), and less total ischemic burden (P < .04) during Holter monitoring. CONCLUSION: These findings suggest that within a population of CAD patients, higher levels of physical fitness are associated with less TMI assessed in the laboratory and during routine activities of daily living.

Modeling signal features of escape response: effects of cessation conditioning in "learned helplessness" paradigm.

Six experiments examined the effects of signaling the termination of inescapable shock (cessation conditioning) or shock-free periods (backward conditioning) on later escape deficits in the learned helplessness paradigm, using rats (Sprague-Dawley and Bantin-Kingman). A cessation signal prevented later performance deficits when highly variable inescapable shock durations were used during pretreatment. The inclusion of short minimum intertrial intervals during pretreatment did not alter the benefits of cessation conditioning but eliminated the protection afforded by a safety signal. The beneficial effects of both cessation and backward signals were eliminated when a single stimulus signaled shock termination and a shock-free period. Finally, a combination of cessation and backward signals was found to be most effective in immunizing against the effects of subsequent unsignaled, inescapable shock on later escape performance. These data suggest that cessation conditioning may be crucial to the prophylactic action of an escape response.