Effect of raloxifene on the vaginal epithelium of postmenopausal women

OBJECTIVE: The objective was to analyze the effect of raloxifene on the vaginal epithelium of postmenopausal women. STUDY DESIGN: In this non-randomized clinical trial, 80 women (mean age = 60.6 years) were prospectively studied. Forty patients received 60 mg/day of raloxifene (RG), and 40 women constituted a non-treated control group (CG), paired by age and time since menopause. The treated group consisted of patients with osteoporosis of the lumbar spine. Those with a diagnosis of infection in the lower genital tract and using hormone therapy (HT) up to 6 months prior to the study were excluded. Vaginal smears were collected at baseline and after 6 months of intervention. The vaginal maturation value (VMV) was determined, and counts of superficial, intermediate and parabasal cells were performed. Smears were analyzed by only one cytopathologist who was blinded to patient data. The t-test, Wilcoxon test, and Chi-Squared test were used in the statistical analysis. RESULTS: The study groups were homogeneous regarding age, time since menopause, parity, HT use, smoking, and body mass index. No statistically significant differences were observed in VMV median values (RG, 39.7 and 35.7; CG, 50.0 and 50.0, respectively) or in the percentage of superficial, intermediate and parabasal cells between the groups at baseline and after 6 months (p>0.05). There was no significant correlation between VMV and age, time since menopause, previous HT use, or body mass index, in either of the groups. CONCLUSION: Treatment with raloxifene for 6 months has no effect on the maturation of the vaginal epithelium in postmenopausal women with osteoporosis.     

Congenital Degos Disease: Case Report and Dermoscopic Findings

Pediatric Degos disease is rare, with only 36 cases reported in the medical literature. Classically the diagnosis has been established according to pathognomonic histopathologic findings, but when these features are not present, there may be a delay in diagnosis. We report the second congenital case of Degos disease, highlighting the clinical and dermoscopic findings.     

Early failure of a unicompartmental knee arthroplasty design with an all-polyethylene tibial component

Refined prosthetic designs and surgical techniques for unicompartmental knee arthroplasty have recently been associated with improved outcomes. The purpose of the present study was to evaluate the clinical and radiographic outcomes of the EIUS unicompartmental design, which has an all-polyethylene tibial component, and to compare these outcomes with published reports of other unicompartmental prostheses. Between February 2002 and March 2005, 113 patients (144 knees) underwent a medial unicompartmental knee arthroplasty, all performed by a single surgeon who used the EIUS prosthesis. At a mean follow-up of 36 months (range, 24–54 months), the mean Knee Society objective and functional scores improved from 55 points (range, 31–77 points) and 49 points (range, 35–60 points) to 92 points (range, 45–100 points) and 89 points (range, 10–100 points), respectively. The implant survival rate was 89%, with 16 knees either revised or scheduled for revision. The reasons for revision included aseptic loosening of the tibial component (eight knees), progressive symptomatic patellofemoral disease (four knees), and tibial component subsidence (four knees). Multiple regression analysis revealed that age, gender, and body mass index were not significantly correlated with success or failure of this design, although nine of the 16 patients who required revision were obese. This prosthesis was associated with higher revision rates than components which utilize metal-backed implants. Further modifications in the design, indications, or technique may be necessary to improve outcomes of this unicompartmental knee arthroplasty system.     

Efficacy of Chloroquine for the Treatment of Uncomplicated Plasmodium falciparum Malaria in Honduras

Chloroquine (CQ) is officially used for the primary treatment of Plasmodium falciparum malaria in Honduras. In this study, the therapeutic efficacy of CQ for the treatment of uncomplicated P. falciparum malaria in the municipality of Puerto Lempira, Gracias a Dios, Honduras was evaluated using the Pan American Health Organization—World Health Organization protocol with a follow-up of 28 days. Sixty-eight patients from 6 months to 60 years of age microscopically diagnosed with uncomplicated P. falciparum malaria were included in the final analysis. All patients who were treated with CQ (25 mg/kg over 3 days) cleared parasitemia by day 3 and acquired no new P. falciparum infection within 28 days of follow-up. All the parasite samples sequenced for CQ resistance mutations (pfcrt) showed only the CQ-sensitive genotype (CVMNK). This finding shows that CQ remains highly efficacious for the treatment of uncomplicated P. falciparum malaria in Gracias a Dios, Honduras.