Preinjection aspiration for injectable fillers in aesthetic dermatology: Trust or bust?

In recent years, the utility of preinjection aspiration for injectable fillers as a safety checkpoint has been debated. It is a clinical technique that has become controversial in both the literature and at national aesthetic conferences. Many consensus papers and anecdotal reports have been divided on how helpful preinjection aspiration is in reducing adverse events and subsequently increasing patient safety. Here, we summarize the prominent studies in the literature and offer an evaluation and insights.

A Case Report of Tumor Necrosis Factor Alpha Inhibitors in an Active Duty Service Member with Dissecting Cellulitis of the Scalp Resistant to Treatment.

Dissecting cellulitis of the scalp represents a disease of follicular occlusion that may be worsened by tight-fitting clothing, such as the patrol cap or advanced combat helmet used by military service members. Treatment poses a challenge to the clinician, and the treatment of choice, oral retinoids, may not improve the condition sufficiently to maintain active duty status. Early treatment augmentation with tumor necrosis factor-alpha inhibitors may improve efficacy of oral retinoids and prevent medical separation of the active duty service member.

Case report: Hansen's disease in an active duty soldier presenting with type 1 reversal reaction.

Leprosy, or Hansen's disease (HD), is caused by the bacterium Mycobacterium leprae and is a significant cause of morbidity worldwide. Clinical manifestations range from isolated skin rash to severe peripheral neuropathy. Treatment involves a prolonged course of multiple antimicrobials. Although rare in the U.S., with only 168 new cases reported in 2016, HD remains a prevalent disease throughout the world, with 214,783 new cases worldwide that same year.1 It remains clinically relevant for service members born in and deployed to endemic regions. This report describes a case of HD diagnosed in an active duty soldier born and raised in Micronesia, a highly endemic region.

Combat dermatology: the role of the deployed army dermatologist.

Shortly after completing residency or fellowship, army dermatologists routinely deploy to combat zones as field surgeons. The US Army generally does not deploy dermatologists for their expertise in diagnosing and managing cutaneous diseases; rather, as field surgeons they provide routine, emergency, and trauma care for active-duty soldiers and coalition forces. In this article, we review the various functions of the deployed dermatologist and highlight the importance of maintaining basic emergency medical skills that could be generalized to the civilian population in case of local or national emergencies.

Three-dimensional reconstruction volume: a novel method for volume measurement in kidney cancer.

BACKGROUND AND PURPOSE: The role of volumetric estimation is becoming increasingly important in the staging, management, and prognostication of benign and cancerous conditions of the kidney. We evaluated the use of three-dimensional reconstruction volume (3DV) in determining renal parenchymal volumes (RPV) and renal tumor volumes (RTV). We compared 3DV with the currently available methods of volume assessment and determined its interuser reliability. PATIENTS AND METHODS: RPV and RTV were assessed in 28 patients who underwent robot-assisted laparoscopic partial nephrectomy for kidney cancer. Patients with a preoperative creatinine level of <1.2 mg/dL with available scans were selected. RPV and RTV were then assessed using 3DV, as well as cylindrical approximation for RPV and spherical approximation for RTV as described previously in the literature. Measures of the same quantity from each method were then compared. In addition, interuser reliability was determined for 3DV. RESULTS: Calculated volumes differed widely in comparison with 3DV. For example, cylindrical volumes for the contralateral kidney pre- and postsurgery overestimated 3D reconstruction volumes by 15% to 102% and 12% to 101%, respectively. In addition, volumes obtained from 3DV displayed high interuser reliability regardless of experience. CONCLUSIONS: 3DV provides a highly reliable way of assessing kidney volumes. Given that 3DV takes into account visible anatomy, the differences observed using previously published methods can be attributed to the failure of geometry to accurately approximate kidney or tumor shape. 3DV provides a more accurate, reproducible, and clinically useful tool for urologists looking to improve patient care using analysis related to volume.