Red Breast Syndrome and Acellular Dermal Matrix

Increasingly popular for use in breast reconstruction, acellular dermal matrix (ADM) can provide support and protection to implants. However, use of ADM may be associated with infection and complications, including red breast syndrome (RBS). RBS is an inflammatory event that typically presents with cutaneous erythema over the domain where the ADM is surgically implanted. As ADM use increases, presumably, more cases of RBS will occur. Thus, techniques and tools to mitigate or manage RBS are needed to improve patient outcomes. Here, we describe a case where RBS was diagnosed and interestingly resolved after exchange for a different brand of dermal matrix. This surgical resolution maintained excellent reconstructive results with no recurrent erythema over a follow-up period of 7 months. Although we cannot rule out RBS due to other variables, RBS due to patient hypersensitivity to certain ADMs has been documented in the literature. In this instance, our results suggest that revision with an alternate ADM brand may serve as a potential solution

Efecto antifúngico de una solución doble antibiótica modificada con fluconazol sobre Candida albicans in vitro

Introducción: Dentro de la infección endodóntica primaria se pueden encontrar, además de múltiples especies de bacterias, la presencia de Candida albicans y el uso de antibióticos no es suficiente para su erradicación. Objetivo: Evaluar el efecto antifúngico de una solución doble antibiótica modificada con fluconazol sobre Cándida albicans in vitro. Métodos: Se realizó la preparación de la solución doble antibiótica modificada con Fluconazol en tres concentraciones diferentes (.4 mg/ml, .2 mg/ml y .1 mg/ml). Como grupo control se preparó DAP (ciprofloxacino y metronidazol 1:1) mezclada con propilenglicol. Las soluciones fueron embebidas en esponjas de colágeno y colocadas en pozos de Agar con Candida albicans previamente sembrado, y se evaluó su crecimiento a las 24 y 48 horas. Resultados: Se observó que la solución doble antibiótica con Fluconazol, tiene efecto antifúngico a bajas concentraciones y que la DAP no es eficaz para la erradicación de C. albicans. Conclusión: Por lo tanto, la esponja de colágeno cargada con la solución doble antibiótica modificada con fluconazol podría ser una alternativa efectiva para erradicar C. albicans durante procedimientos regenerativos en endodoncia. ABSTRACT Introduction: Within the primary endodontic infection can be found, in addition to multiple species of bacteria, the presence of Candida albicans and the use of antibiotics is not enough for eradication. Objective: To evaluate the antifungal effect of a double antibiotic solution modified with fluconazole on Candida albicans in vitro. Methods: The preparation of the double antibiotic solution modified with Fluconazole was carried out in three different concentrations (.4 mg / ml, .2 mg / ml and .1 mg / ml). As a control group, DAP (ciprofloxacin and metronidazole 1: 1) prepared with propylene glycol. The solutions were embedded in collagen sponges and placed in agar with previously seeded Candida albicans, and their growth was evaluated at 24 and 48 hours. Results: It was observed that the double antibiotic solution with Fluconazole has an antifungal effect at low concentrations and that DAP is not effective for the eradication of C. albicans. Conclusion: Therefore, the collagen sponge loaded with the double antibiotic solution modified with fluconazole could be an effective alternative to eradicate C. albicans during regenerative procedures in endodontics

Comportamiento sísmico de marcos a momento de acero considerando la influencia de sus conexiones

Dentro de este trabajo de investigación se estudia el efecto que tienen diferentes conexiones viga-columna y columna-placa base en el comportamiento sísmico de una estructura de acero. Para lograr este objetivo la primera parte del trabajo se centra en la calibración y análisis de diferentes conexiones viga-columna y conexiones columna-placa base, así como en la calibración y análisis de la zona del panel. En una segunda parte se realiza la calibración de un modelo no lineal de un marco (que incluye el modelado de las conexiones) para que reproduzca la respuesta de un edificio a escala real ensayado experimentalmente en mesa vibradora. La calibración global de este edificio permite verificar que todos los componentes calibrados individualmente tengan una correcta interacción entre ellos. En la parte final se realizan múltiples análisis y comparativas que buscan evaluar la influencia de las conexiones viga-columna y columna-placa base en la respuesta sísmica no lineal de marcos de acero. El resultado de los diversos análisis no-lineales muestra que diferentes tipos de conexiones, tanto viga-columna como columna-placa base, generan diferentes mecanismos de disipación de energía en una estructura de acero. El estudio se centra en marcos momento resistentes de acero formados por vigas laminadas I (IR o W) que se conectan a columnas de sección hueca (OR o HSS)

Two Cases of Autoimmune Syndrome Induced by Adjuvants (ASIA): A Multifaceted Condition Calling for a Multidisciplinary Approach

Silicone implants have been used for cosmetic enhancement and reconstructive purposes for over 60 years. Despite assiduous efforts to ensure safety, there is continuous evidence that they are not as biologically inert as previously postulated. We present two cases of autoimmune syndrome induced by adjuvants (ASIA) in Hispanic women. The first patient developed biopsy-proven immune-mediated necrotizing myopathy that was successfully treated with the combination of silicone explantation along with immunosuppressive therapy. Findings after implant removal demonstrated rupture and leakage of silicone from gluteal implants. The second patient developed autoimmune hemolytic anemia in the setting of a ruptured silicone breast implant. Similarly, the patient was treated with corticosteroids followed by breast implant removal with complete resolution of symptoms. The successful treatment of these patients was achieved by collaboration between rheumatology and plastic surgery, which emphasizes the need for a multidisciplinary approach in the diagnosis and management of patients with ASIA

Two Cases of Autoimmune Syndrome Induced by Adjuvants (ASIA): A Multifaceted Condition Calling for a Multidisciplinary Approach

Silicone implants have been used for cosmetic enhancement and reconstructive purposes for over 60 years. Despite assiduous efforts to ensure safety, there is continuous evidence that they are not as biologically inert as previously postulated. We present two cases of autoimmune syndrome induced by adjuvants (ASIA) in Hispanic women. The first patient developed biopsy-proven immune-mediated necrotizing myopathy that was successfully treated with the combination of silicone explantation along with immunosuppressive therapy. Findings after implant removal demonstrated rupture and leakage of silicone from gluteal implants. The second patient developed autoimmune hemolytic anemia in the setting of a ruptured silicone breast implant. Similarly, the patient was treated with corticosteroids followed by breast implant removal with complete resolution of symptoms. The successful treatment of these patients was achieved by collaboration between rheumatology and plastic surgery, which emphasizes the need for a multidisciplinary approach in the diagnosis and management of patients with ASIA

Deeper Seated Than Skin Deep: Report of a Rare Case of Follicular Occlusion Tetrad and a Literature Review

Follicular occlusion tetrad (FOT) is a clinical syndrome consisting of hidradenitis suppurativa (HS), acne conglobata (AC), dissecting cellulitis of the scalp (DCS), and pilonidal cyst (PC). These entities typically occur independently, but occasionally present simultaneously comprising FOT. The four components share similar pathophysiology affecting the apocrine glands, follicular hyperkeratinization being the hallmark of each entity.Understanding shared similarities of each disease is paramount for the treatment approach as the relapsing and chronic nature of this syndrome can be burdening to patients. We present the case of a 22- year-old obese Hispanic man with a history of tobacco use who presented with worsening skin lesions. The patient developed extensive facial cystic acne 5 years before presentation, followed by left axillary hidradenitis suppurativa lesions two years before the presentation and right axillary involvement one year after. Skin manifestations then expanded to include the lower back, gluteal and perineal areas. The patient was diagnosed with FOT and despite conservative medical management, his lesions failed to improve. He ultimately underwent multiple staged excisional debridement surgeries and skin grafts. Our case underlines the presence of a syndromic association of cutaneous lesions that share a common pathogenesis and emphasizes that this entity requires a multidisciplinary approach. New biologic therapies continue to emerge and may potentially prevent the need for surgical intervention and the burden associated with it

CAPN3, DCT, MLANA and TYRP1 are overexpressed in skin of vitiligo vulgaris Mexican patients

Abstract. Vitiligo is a disorder causing skin depigmentation, in which several factors have been proposed for its pathogenesis: Environmental, genetic and biological aspects of melanocytes, even those of the surrounding keratinocytes. However, the lack of understanding of the mechanisms has complicated the task of predicting the development and progression. The present study used microarray analysis to characterize the transcriptional profile of skin from Vitiligo Vulgaris (VV) patients and the identified transcripts were validated using targeted high-throughput RNA sequencing in a broader set of patients. For microarrays, mRNA was taken from 20 skin biopsies of 10 patients with VV (pigmented and depigmented skin biopsy of each), and 5 biopsies of healthy subjects matched for age and sex were used as a control. A signature was identified that contains the expression pattern of 722 genes between depigmented vitiligo skin vs. healthy control, 1,108 between the pigmented skin of vitiligo vs. healthy controls and 1,927 between pigmented skin, depigmented vitiligo and healthy controls (P<0.05; false discovery rate, <0.1). When comparing the pigmented and depigmented skin of patients with vitiligo, which reflects the real difference between both skin types, 5 differentially expressed genes were identified and further validated in 45 additional VV patients by RNA sequencing. This analysis showed significantly higher RNA levels of calpain-3, dopachrome tautomerase, melan-A and tyrosinase-related protein-1 genes. The data revealed that the pigmented skin of vitiligo is already affected at the level of gene expression and that the main differences between pigmented and non-pigmented skin are explained by the expression of genes associated with pigment metabolism

Evaluation of the Expression of Genes Associated with Inflammation and Apoptosis in Androgenetic Alopecia by Targeted RNA-Seq

Abstract Androgenetic alopecia (AGA) or male pattern baldness is the most common form of hair loss in humans. Despite being a very frequent dermatological entity, molecular pathophysiology remains unclear. Several authors relate the presentation of AGA with a premature apoptotic process during the anagen phase and with an inflammatory microenvironment in the hair follicle. We evaluated a panel of 30 genes associated with inflammation and apoptosis in 5 AGA patients by targeted RNA-Seq. WNT7A gene was highly expressed in patients in stages 3V to 5 on the Hamilton-Norwood scale compared to patients with 5A stage. CASP7 and TNF genes were overexpressed in stages 3V and 4 compared to stages 5 and 5A. Overexpression of these genes detected only at early stages of AGA proves the role of WNT pathway, apoptosis, and inflammation in the development of this disorder

Population-based analysis of POT1 variants in a cutaneous melanoma case–control cohort

Article describes how pathogenic germline variants in the protection of telomeres 1 gene (POT1) have been associated with predisposition to a range of tumor types, including melanoma, glioma, leukemia and cardiac angiosarcoma. The authors sequenced all coding exons of the POT1 gene in 2928 European-descent melanoma cases and 3298 controls, identifying 43 protein-changing genetic variants

Improved functionalization of oleic acid-coated iron oxide nanoparticles for biomedical applications

Superparamagnetic iron oxide nanoparticles can providemultiple benefits for biomedical applications in aqueous environments such asmagnetic separation or magnetic resonance imaging. To increase the colloidal stability and allow subsequent reactions, the introduction of hydrophilic functional groups onto the particles’ surface is essential. During this process, the original coating is exchanged by preferably covalently bonded ligands such as trialkoxysilanes. The duration of the silane exchange reaction, which commonly takes more than 24 h, is an important drawback for this approach. In this paper, we present a novel method, which introduces ultrasonication as an energy source to dramatically accelerate this process, resulting in high-quality waterdispersible nanoparticles around 10 nmin size. To prove the generic character, different functional groups were introduced on the surface including polyethylene glycol chains, carboxylic acid, amine, and thiol groups. Their colloidal stability in various aqueous buffer solutions as well as human plasma and serum was investigated to allow implementation in biomedical and sensing applications.status: publishe