Congenital Lipedematous Alopecia: Adding to the Differential Diagnosis of Congenital Alopecia

Lipedematous alopecia is a rare condition of unknown etiology characterized by a thick boggy scalp with varying degrees of hair loss. It is usually seen in adult African-American females, and a case in a 9-year-old was the youngest patient reported thus far. We report on the appearance of this condition in two children, a 6-year-old child and a 10-year-old child. Each presented with congenital patchy hair loss on the occipital area and the left temple. A boggy hairless scalp with soft swelling was detected in both patients. Histological examination showed increased thickness of the subcutaneous fat tissue with a decrease in hair follicles. These features were consistent with a diagnosis of lipedematous alopecia. We report two cases of congenital lipedematous alopecia, which has not been reported previously. Although congenital, these distinct clinical features should be kept in mind in the diagnosis of alopecic hair loss.     

Dactilitis producida por sarcoidosis subcutánea como presentación de sarcoidosis

Dactylitis, or sausage fingers or toes, refers to the swelling of 1 or more digits. Sarcoid dactylitis is an uncommon form that tends to be caused by granulomatous bone involvement in the underlying phalanges. Sarcoid dactylitis can, however, clinically resemble subcutaneous sarcoidosis with finger or toe involvement. We describe 5 patients with dactylitis due to subcutaneous sarcoidosis of the fingers. In all cases, the proximal phalanges were involved; sarcoid dactylitis, by contrast, tends to affect the medial and distal phalanges. Differential diagnosis is important, as dactylitis due to bone involvement tends to be much more persistent and is generally seen in chronic forms of sarcoidosis.     

负压抽吸联合搔刮术与腋皱襞小切口皮下修剪术治疗腋臭的效果

目的 探讨负压抽吸术联合搔刮术与腋皱襞小切口皮下修剪术对腋臭患者的临床治疗作用。 方法 选取我院2020年6月-2022年8月收治的100例腋臭患者为研究对象,采用随机数字表法将其分成观察组 和对照组,各50例。对照组采用腋皱襞小切口皮下修剪术对腋臭进行治疗,观察组在对照组基础上加用 负压抽吸术联合搔刮术,比较两组临床疗效、临床指标、疼痛情况和不良反应发生情况。结果 观察组 治疗总有效率为100.00%,高于对照组的80.00%（P＜0.05）;观察组住院时间和伤口拆线时间均短于对 照组（P＜0.05）;观察组手术后1、3、7 d VAS评分低于对照组（P＜0.05）;观察组不良反应发生率为 2.00%,低于对照组的16.00%（P＜0.05）。结论 负压抽吸联合搔刮术与腋皱襞小切口皮下修剪术联合使用 可以取得较为理想的治疗效果,可缩短住院时间、伤口拆线时间,改善患者的术后疼痛情况,减少并发症 的发生几率。     

PPDO可吸收线双平面皮下埋置在面部年轻化治疗中的应用效果

探究PPDO可吸收线双平面皮下埋置应用于面部年轻化治疗中的效果。方法 选取2022年1月-12月我院收治的60例面部皮肤松弛患者为研究对象,随机分为对照组和观察组,每组30例。对照组采用PPDO锯齿线单平面皮下埋置,观察组采用PPDO锯齿线与PPDO螺旋线相结合双平面皮下埋置,比较两组面部松弛改善效果及不良反应发生情况。结果 观察组面部松弛改善优良率为96.67%,高于对照组的80.00%（P ＜0.05）;观察组不良反应发生率为3.33%,低于对照组的6.67%,但差异无统计学意义（P ＞0.05）。结论 PPDO可吸收线双平面皮下埋置在面部年轻化治疗中的应用效果确切,可有效改善面部松弛情况,提升面部肌肤紧致度,进而有利于提高面部美观度,实现面部年轻化。     

Leuprolide Acetate for Puberty Suppression in Transgender and Gender Diverse Youth: A Comparison of Subcutaneous Eligard Versus Intramuscular Lupron

PurposeTo compare the efficacy of intramuscular Lupron and subcutaneous Eligard, two formulations of leuprolide, for puberty suppression in transgender and gender diverse (TGD) youth.MethodsA retrospective chart review of TGD youth receiving Lupron or Eligard 22.5 mg every 3 months was conducted to determine hormone levels obtained 1 hour after an injection (1hrPost) and patient-reported clinical puberty suppression.ResultsForty eight patients were analyzed: 33% assigned female at birth of which 25% were premenarchal, mean age at first injection 13.7 years, and 50% received concurrent gender affirming hormones. Of these, 13% received Lupron, 52% Eligard, and 35% initially received Lupron then transitioned to Eligard due to drug shortages. There were 55 incidents of 1hrPost levels, 42 after Eligard and 13 after Lupron. Clinical puberty suppression occurred in all patients; however, biochemical suppression occurred in 90% of Eligard and 69% of Lupron (p = .06).DiscussionEligard and Lupron were both effective in suppressing clinical puberty progression in our population of TGD youth, of which 50% were receiving concurrent gender affirming hormones.     

后腹腔镜手术CO2气腹致皮下气肿的护理

随着医学技术的日益进步,腹腔镜手术在泌尿外科得到了迅速发展,特别是在Gaur发明了后腹腔镜气囊扩张法后,后腹腔镜已被用于许多泌尿外科手术。与传统的开放手术相比,其具有创伤小、出血少、术后恢复时间短等优点。CO2气腹引起的皮下气肿为腹腔镜手术比较多见的并发症,由于后腹腔镜手术与普通腹腔镜手术相比,因其手术空间小,为了操作的需要,需要的气腹压力要大一些,     

Subcutaneous tunneling technique to improve outcomes for patients undergoing chemotherapy with peripherally inserted central catheters: a randomized controlled trial

ObjectiveTo compare the value of the subcutaneous tunneling technique versus the normal technique in improving the outcomes of patients undergoing chemotherapy with peripherally inserted central catheters (PICCs).MethodsOne hundred thirty patients were randomly divided into an experimental group (subcutaneous tunneling technique) and control group (normal technique) according to the PICC placement technique, and clinical data were compared between the groups.ResultsIn total, 129 PICCs were successfully inserted. Compared with the control group, the experimental group had a lower occurrence of complications after placement (especially catheter dislodgement: 3.1% vs. 15.4%, venous thrombosis: 3.1% vs. 15.4%, and wound oozing: 14.1% vs. 27.7%), lower occurrence of unscheduled PICC removal (3.1% vs. 13.8%), greater comfort during placement (14.16 ± 2.21 vs. 15.09 ± 2.49 on a scale ranging from 6 to 30 points, with higher scores indicating lower degrees of comfort), and lower costs of PICC maintenance (median (interquartile range) per-day maintenance cost: 13.90 (10.99–32.83) vs. 15.69 (10.51–57.46) Yuan). The occurrence of complications and amount of bleeding during placement were not significantly different between the two groups.ConclusionsThe subcutaneous tunneling technique can improve PICC placement by reducing complications and costs of maintenance with better patient comfort during placement.