One case report and literature review of arrhythmia caused by pituitrin

Arrhythmias are perceived as a complication of pituitrin. However, injecting a standard dose of pituitrin via vein causes different arrhythmias. In our case, a 35-year-old female patient was admitted to the hospital due to a productive cough with sputum for 5 days and two occasions of massive hemoptysis. After 1 day of treatment using 500 ml normal saline with 10u pituitrin, the sputum was filled with small amounts of kermesinus bloodstains. When pituitrin was stopped without any other treatment, all presenting symptoms gradually subsided after half an hour, and the ECG returned to normal. Therefore, when treating massive hemoptysis by administering pituitrin intravenously, it is necessary to exercise great precaution and therapeutic measures.     

Diversity of atrioventricular conduction in a female teenager

A 13-year-old girl was admitted to the Cardiology Clinic of West China Hospital with complains of recurrent palpitations for 1 year, dizziness, and chest tightness. Her ECG intercepted at different time periods in the Holter exhibited complex electrophysiological phenomena, such as sinus arrhythmia, dominant PJB, interpolated PJB, concealed PJB, isolated forward block, insularly retrograde block, reciprocal beat, junctional escape beat, interference atrioventricular dissociation, pseudo-I°AVB, and pseudo-II°AVB, which occurred simultaneously. This condition is extremely rare in clinical practice. The patient was prescribed an antiarrhythmic drug (propafenone 50 mg tid). After treatment, the PJB gradually decreased, and the pseudo-AVB disappeared. Pseudo AVB is generally a benign phenomenon and proper recognition may avoid erroneously permanent pacemaker implantation.     

Association of adiposity indices with prehypertension among Chinese adults: A cross-sectional study

The association of adiposity indices with prehypertension remains unclear in the Chinese non-hypertensive population. This study aimed to compare the association of adiposity indices, including waist circumference (WC), waist-to-height ratio, body roundness index (BRI), a body shape index (ABSI), and conicity index (CI), and prehypertension in the Chinese population. We recruited 61 475 participants from a population-based screening project in Guangdong province, China. Multiple logistic regression analyses were performed to detect the association between the six adiposity indices and prehypertension. Receiver operator characteristic curve (ROC) analysis was used to evaluate the predictive values of adiposity indices to prehypertension. The individuals were divided into two categories by blood pressure (BP) levels: normotension (<120/80 mmHg) and prehypertension (120–139/80–89 mmHg). A total of 33 233 people had prehypertension, with a prevalence of 54.04% and 42% males. Both logistics regression models presented a positive association between each adiposity index and prehypertension (p < .05), except for ABSI. The body mass index (BMI) was slightly more correlated with prehypertension than any other index. The standardized ORs for the six indices were 1.392, 1.361, 1.406, 1.039, 1.372, and 1.151, respectively. Compared to other adiposity indices, the WC had a significantly higher area under the curve (AUC) for predicting prehypertension (AUC: .619, sensitivity: 57%, specificity: 60.6%). In conclusion, WC and BMI might be the best indicators for prehypertension. Increasing evidence supports avoiding obesity as a preferred primary prevention strategy for prehypertension while controlling other major hypertension risk factors.     

Association between lean body mass and hypertension: A cross-sectional study of 50 159 NHANES participants

Increasing attention has been paid to the association between lean body mass (LBM) and hypertension in recent years, but the previous findings have often been contradictory. Therefore, the authors investigated the association between LBM and hypertension through a cross-sectional study in the United States. To investigate the relationship between LBM and hypertension, the authors conducted weighted multivariable logistic regression models. The authors used the restricted cubic spline regression model to determine if there was a nonlinear correlation. In order to locate the inflection point, the authors built a two-part linear regression model using a recursive method. In the full adjustment model, LBM was positively associated with hypertension, with ORs (95% CI) of 1.19 (1.02, 1.38). In the further linear trend test, the ORs (95% CI) for Q2, Q3, and Q4 were 0.76 (0.60, 0.95), 0.62 (0.47, 0.80), and 0.66 (0.48, 0.91), respectively, compared to Q1, which suggested that the association between LBM and hypertension might be non-linear. The authors performed the restricted cubic spline curve to confirm this non-linear relationship and found the inflection point of 43.21 kg with an opposite relationship in which LBM and hypertension exhibited a negative correction of 0.66 (0.50, 0.86) before the inflection point and a positive correlation of 1.20 (1.03, 1.39) after the inflection point. Our study highlighted a non-linear association between LBM and hypertension in the general US population.     

Reflectance confocal microscopy-assisted diagnosis of lichen planus pigmentosus distributed along multiple unilateral Blaschko's lines in a child: A case report

A boy with a 2-year history of asymptomatic, linear pigmented macules involving the right side of the trunk and right upper limb. RCM revealed the dermal papillary rings were destroyed, and numerous irregular particulate structures with high refractive values were distributed in the superficial dermis. The RCM features implied the possibility of interface dermatitis. RCM was a complementary diagnostic tool for linear pigmented macules.     

Analysis of pathogen distribution and antimicrobial resistance at infected sites in plastic surgery

Objective

By analyzing the distribution and drug resistance of common pathogen in different sites in plastic surgery to provide reference for clinicians to choose the best antibacterial treatment plan.

Methods

Pathogens of postoperative infection in plastic surgery from January 2011 to December 2021 were retrospectively analyzed to determine the species and quantity, and to access the trend of each pathogen's detection rate. The antibiotic sensitivity and distribution characteristics of common pathogens were studied in conjunction with the site of infection.

Results

A total of 1709 bacterial strains were detected, including 1244 gram-positive bacterial strains and 465 gram-negative bacterial strains. The main pathogen of perineum was Escherichia coli (E. coli) and Pseudomonas aeruginosa (P. aeruginosa), while Staphylococcus aureus (S. aureus) was the most common pathogen in the other infected sites. The detection rate of methicillin-resistant S. aureus (MRSA) and methicillin-resistant coagulase-negative staphylococcus (MRCNS) was on the rise from 2011 to 2021. No S. aureus and coagulase-negative staphylococcus (CoNS) strains were resistant to vancomycin. The sensitive rate of S. aureus from all parts and CoNS from all sites except lower limbs and mandible was higher than 80% to linezolid. The resistance rate of S. aureus and CoNS in all parts to penicillin, clindamycin, and erythromycin was high. The susceptibility rate of CoNS in lower mandible was high to gentamicin.

Conclusions

Staphylococcus aureus was the primary pathogen of gram-positive bacteria in all site of plastic surgery except perineum, followed by CoNS. The distribution and drug resistance of pathogen in different infection sites were different. We should formulate more accurate and reasonable antibacterial programs according to drug resistance results of various parts to reduce the emergence of resistant strains and effectively prevent and control infection.     

Acneiform eruption induced by molecularly targeted agents in antineoplastic therapy: A review

Background

Various biologic agents targeting specific molecules present new treatment options for various tumors. Acneiform eruption is a very common skin reaction to these agents. Although not life-threatening, acneiform eruption can affect patients' emotional and social lives. In very exceptional cases, it can lead to cancer therapy interruption.

Aims

The aim of this study was to review the incidence rate, clinical characteristics, pathogenesis, and current management of acneiform eruption induced by molecularly targeted agents.

Methods

This review was carried out through PubMed, Embase, and Cochrane searching terms ‘acneiform eruption’, ‘papulopustular eruption’ or ‘acne-like rash’ and ‘skin toxicity’, ‘cutaneous toxicity’, ‘skin reactions’, ‘dermatological toxicities’, ‘target therapy,’ or ‘drug therapy’.

Results

Of the 73 articles matched our search terms, 61 were original articles and 12 were case reports or case series. Acneiform eruption is most commonly observed in patients treated with epidermal growth factor receptor inhibitors and mitogen-activated protein kinase inhibitors. Typical lesions consist of erythematous papules and pustules without comedones, accompanying with burning, pruritus, or xerosis. The pathogenesis involves inflammation and abnormalities of the follicular epithelium, where a disorder in EGFR signaling plays a key role. The treatment of acneiform eruption depends on the severity of the rash.

Conclusions

Early recognition and effective management of this cutaneous adverse reaction can prevent unnecessary reduction and discontinuation of drug use and improve patient survival and quality of life. Close collaboration between oncologists and dermatologists is important to optimize therapy and improve patient survival.     

Efficacy and safety of oxymetazoline for the treatment of rosacea: A meta-analysis

Background

Since there is currently no conclusion on the efficacy and adverse effects of oxymetazoline, this meta-analysis attempts to explore its efficacy and adverse events, so as to provide guidance for clinical medication.

Methods

We searched PubMed, Embase, and Cochrane Library from the establishment of the database to May 2021. We included studies that patients were randomly assigned to receive oxymetazoline or vehicle, and we excluded duplicate publications, research without full text, incomplete information or inability to conduct data extraction, animal experiments, reviews, and systematic reviews. STATA 15.1 was used to analyze the data.

Results

The pooled results show that the 3 (RR = 1.76, 95% CI: 1.53–2.03), 6 (RR = 1.71, 95% CI: 1.47–2.00), 9 (RR = 1.63, 95% CI: 1.40–1.90), 12 (RR = 1.41, 95% CI: 1.18–1.67) -hours CEA success rate and the 3 (RR = 1.65, 95% CI: 1.34–2.03), 6 (RR = 1.75, 95% CI: 1.43–2.14), 9 (RR = 1.63, 95% CI: 1.33–2.00), 12 (RR = 1.78, 95% CI: 1.45–2.18) -hours SSA success rate after oxymetazoline treatment for rosacea is significantly higher than that of vehicle. Additionally, the pooled results show that the incidence of TEAEs after treatment with oxymetazoline is significantly higher than that of vehicle (RR = 1.34, 95% CI: 1.10–1.2). However, our analysis of specific adverse events found that the oxymetazoline group was only significantly higher than the vehicle group in the incidence of application-site dermatitis (RR = 8.91, 95% CI: 1.76–45.23), and there was no statistical significance in the difference in the incidence of other adverse events.

Conclusion

Oxymetazoline is effective and can be selected for the treatment of persistent facial erythema of rosacea. Additionally, application-site dermatitis was the most important one.