Necrotizing fasciitis secondary to bevacizumab treatment for metastatic rectal adenocarcinoma

Bevacizumab is a recombinant humanized monoclonal antibody that selectively blocks the activity of vascular endothelial growth factor (VEGF) receptor and it is used in metastatic colorectal patients. We present here a case of fatal necrotizing fasciitis in a patient during bevacizumab treatment for colorectal cancer. In our review of the literature, necrotizing fasciitis was not reported before or during bevacizumab treatment.KEY WORDS: Adverse drug reactions, bevacizumab, colorectal cancer, necrotizing fasciitis     

Association of choroidal thickness with eye growth: a cross-sectional study of individuals between 4 and 23 years

Background and aims

We aimed to evaluate the association of subfoveal choroidal thickness (SFCT) with age and to determine its relationship with axial length (AL) and ocular biometric parameters, in children and young adults during growth period.

Methods

One hundred and sixty patients (80 male, 80 female) aged between 4 and 23 years were included. Patients were classified into five groups according to their ages as group 1 (4–7 years of age), group 2 (8–11 years), group 3 (12–15 years), group 4 (16–19 years), and group 5 (20–23 years). SFCT was assessed using spectral-domain optical coherence tomography (3D OCT-2000). The measurements were taken at the same daytime (1000–1200 hours) to avoid diurnal fluctuation. Ocular AL and anterior segment parameters were measured using optical biometry (Lenstar LS900)).

Results

The average SFCT was 308.1±47.6 μm, ranging from 206 to 410 μm. The mean SFCT values in group 1 to 5 were measured as 306.8±42.0, 297.8±48.1, 283.2±38.9, 326.9±57.4, and 325.8±35.9 μm, respectively. The mean CT of group 3 was significantly thinner than group 4 and 5 (P<0.05 for two groups), however, there was no statistical significance compared with group 1 (P=0.227) and group 2 (P=0.693). On stepwise regression analysis, age exhibited a positive association with SFCT (B=2.8, P<0.001) and AL exhibited a negative association with choroidal thickness (B=−16.7, P<0.001).

Conclusions

We found that SFCT shows no age-related difference until age of 15, whereas 16–23-year old participants had thicker SFCT compared with the younger ones. In that aspect, a thicker choroid associated with age in certain age groups suggests an age period of SFCT increase to a plateau in young adulthood. Larger studies are warranted to elucidate the age-related changes in SFCT in childhood, as improved evaluation of normal choroidal thicknesses during eye growth should assist in the diagnosis of choroidal abnormalities associated with eye disease.     

Microvascular damage evaluation based on nailfold videocapillarosopy in sarcoidosis

Clinical Rheumatology - Microvascular damage is thought to play a role in the pathogenesis of sarcoidosis. We aimed to evaluate the nailfold capillaroscopy (NVC) pattern to detect microvascular...     

Long-term results of permanent urethral stent Memotherm implantation in the management of recurrent bulbar urethral stenosis

Study Type – Therapy (case series) Level of Evidence 4 What’s known on the subject? and What does the study add? Milroy reported 84% success at a mean of 4.5 years follow‐up by usage of a permanently implantable “urolume” spent in 1993. Memotherm was developed later, especially for urologic use. Our study is one of the largest in this urea, with a high number of patients and a long follow‐up period.

OBJECTIVE

? To evaluate the effectiveness and long‐term results of permanent urethral stent (Memotherm) implantation in the treatment of recurrent bulbar urethral stricture.

PATIENTS AND METHODS

? In all, 47 patients with a history of previous unsuccessful treatment for bulbar urethral stricture were treated using Memotherm bulbar urethral stents between 1998 and 2002. ? Long‐term follow‐up data was analysed and discussed.

RESULTS

? At the end of the 7‐year period 37 of 47 patients (78.7%) had been treated successfully. ? Post‐micturition dribbling incontinence lasting up to 3 months after stent placement occurred in 32 (68.1%) patients, but this was reduced to only seven patients (14.9%) by the 7‐year follow‐up. ? There was stress incontinence of various severities in nine (19.2%) patients at the 1‐year follow‐up. These patients were those who had stenosed urethral segments adjacent to the external sphincter. At the long‐term follow‐up <10% of the patients had stress incontinence complaints.

CONCLUSION

? Memotherm is a good treatment option in patients with recurrent bulbar urethral stricture of any cause.     

Evaluation of DNA extraction kits for molecular diagnosis of human <Emphasis Type="Italic">Blastocystis</Emphasis> subtypes from fecal samples

Blastocystis sp. is now recognized as one of the most common intestinal parasite in human fecal examinations. Recently, PCR-based diagnostic methods of Blastocystis infection using direct DNA extraction from fresh fecal samples with commercially available kits are reported. Several kits have been developed, but little has been done in comparing the detective sensitivity between PCR methods using the commercial kits. In this study, we compared the detective sensitivity among five commercially available kits (MagNA Pure LC DNA Isolation Kit I, Roche; QuickGene SP Kit DNA, FujiFilm; NucleoSpin Plant II, Macherey-Nagel; QIAamp DNA Stool Mini Kit, Qiagen; ZR Fecal DNA Kit, Zymo Research) and fecal culture method. In a preliminary test, the DNA isolated with two kits (FujiFilm and Macherey-Nagel) showed negative PCR, while the other three kits showed positive PCR. Then, DNA from 50 clinical samples that was Blastocystis-positive in the examination of fecal culture method were isolated with the three kits and 1.1 kbp SSU rRNA gene was detected with PCR. The positive rates of the three kits (Roche, Qiagen, and Zymo Research) were 10, 48 and 94%, respectively. The present study indicated that there is different detective sensitivity among the commercial kits, and fecal culture method is superior in detection rate and cost performance than DNA-elution kits for diagnosis of Blastocystis sp. subtypes.     

Assessing undergraduate nursing and midwifery students' compliance with hand hygiene by self-report

The aim of the study was to assess undergraduate nursing and midwifery students' hand hygiene (HH) compliance. The questionnaire included questions about HH behaviours and compliance during patient care, and Fulkerson scale was used to relate HH to cleanliness of various activities. 57.4% of them reported that they used liquid soap for HH. 18.6% of them did not dry their hands after washing. 65.9% of them said that they performed HH when passing from one patient to another. HH rates were 80.7% after removing gloves. The first six activities on the Fulkerson scale were described as 'clean'; most of the students assessed the third, fourth, fifth and sixth activities as 'dirty'. Compliance with HH was high for all dirty and clean activities. Self-report method indicates compliance with HH which was an easy and inexpensive way to provide the information on HH.