Surgical and postsurgical wound care in hidradenitis suppurativa

Hidradenitis suppurativa (HS) is a chronic inflammatory disorder. Several medical treatments, with varying degree of efficacy, have been developed. However, in most cases of advanced (HS), the definitive treatment option is often represented by surgical excisions. Surgical techniques, reconstructive approach, and local wound care should be accurately designed in order to obtain the best result. In this letter, we analyzed the possible surgical treatments and local wound care. A literature review was performed on the various surgical treatments, reconstructive techniques, and local wound care. Surgical treatment is a common therapeutic modality for HS. Different surgical reconstructive techniques and postsurgical wound care approaches are described for the management of HS patients. There were few high-quality evidence-based studies evaluating the surgical management of HS. Many disparate HS severity scores were used in these studies making comparison between them difficult. Nonetheless, research into different surgical approaches and wound care management has increased substantially in the past decade and has given patients more surgical therapeutic strategies. The description of the best combinations and timing of surgery, wound care and medical therapies, will be a matter of future research for the definition of the optimal management of HS patient

Hidradenitis suppurativa: Surgical and postsurgical management

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disorder. Several medical treatments, with varying degrees of efficacy, have been developed. However, in most cases of advanced HS, the definitive treatment option is often represented by surgical excisions. Objective: Surgical techniques, reconstructive approach, and local wound care should be accurately designed in order to obtain the best result. In this review we analyze the possible surgical treatments and local wound care. Methods: A MEDLINE search was performed on the various surgical treatments, reconstructive techniques, and local wound care. Results: Surgical treatment is a common therapeutic modality for HS. Different surgical reconstructive techniques and post-surgical wound care approaches are described for the management of HS patients. Conclusions: There were few high-quality evidence-based studies evaluating the surgical management of HS. Many disparate HS severity scores were used in these studies, making comparisons between them difficult. Nonetheless, research on different surgical approaches and wound care management has increased substantially in the past decade and it has given patients more surgical therapeutic strategies. The description of the best combinations and timing of surgery, wound care, and medical therapies will be a matter of future research for the definition of the optimal management of the HS patient

Structural control on the directional amplification of seismic noise (Campo Imperatore, central Italy)

Abstract Seismic signals propagating across a fault may yield information on the internal structure of the fault zone. Here we have assessed the amplification of seismic noise (i.e., ambient vibrations generated by natural or anthropogenic disturbances) across the Vado di Corno Fault (Campo Imperatore, central Italy). The fault zone is considered as an exhumed analogue of the normal faults activated during the L'Aquila 2009 earthquake sequence. Detailed structural geological survey of the footwall block revealed that the fault zone is highly anisotropic and is affected by a complex network of faults and fractures with dominant WNW–ESE strike. We measured seismic noise with portable seismometers along a ∼500 m long transect perpendicular to the average fault strike. Seismic signals were processed calculating the horizontal-to-vertical spectral ratios and performing wavefield polarization analyses. We found a predominant NE–SW to NNE–SSW (i.e., ca. perpendicular to the average strike of the fault-fracture network) amplification of the horizontal component of the seismic waves. Numerical simulations of earthquake-induced ground motions ruled out the role of topography in controlling the polarization and the amplitude of the waves. Therefore, the higher seismic noise amplitude observed in the fault-perpendicular direction was related to the measured fracture network and the resulting stiffness anisotropy of the rock mass. These observations open new perspectives in using measures of ambient seismic noise, which are fast and inexpensive, to estimate the dominant orientation of fracture networks within fault zones

A modular multipurpose, parameter centered electronic health record architecture

Health Information Technology is playing a key role in healthcare. Specifically, the use of electronic health records has been found to bring about most significant improvements in healthcare quality, mainly as relates to patient management, healthcare delivery and research support. Health record systems adoption has been promoted in many countries to support efficient, high quality integrated healthcare. The objective of this work is the implementation of an Electronic Health Record system based on a relational database. The system architecture is modular and based on the concentration of specific pathology related parameters in one module, therefore the system can be easily applied to different pathologies. Several examples of its application are described. It is intended to extend the system integrating genomic data

Biomimetic Electrospun Self-Assembling Peptide Scaffolds for Neural Stem Cell Transplantation in Neural Tissue Engineering

Spinal cord regeneration using stem cell transplantation is a promising strategy for regenerative therapy. Stem cells transplanted onto scaffolds that can mimic natural extracellular matrix (ECM) have the potential to significantly improve outcomes. In this study, we strived to develop a cell carrier by culturing neural stem cells (NSCs) onto electrospun 2D and 3D constructs made up of specific crosslinked functionalized self-assembling peptides (SAPs) featuring enhanced biomimetic and biomechanical properties. Morphology, architecture, and secondary structures of electrospun scaffolds in the solid-state and electrospinning solution were studied step by step. Morphological studies showed the benefit of mixed peptides and surfactants as additives to form thinner, uniform, and defect-free fibers. It has been observed that β-sheet conformation as evidence of self-assembling has been predominant throughout the process except for the electrospinning solution. In vitro NSCs seeded on electrospun SAP scaffolds in 2D and 3D conditions displayed desirable proliferation, viability, and differentiation in comparison to the gold standard. In vivo biocompatibility assay confirmed the permissibility of implanted fibrous channels by foreign body reaction. The results of this study demonstrated that fibrous 2D/3D electrospun SAP scaffolds, when shaped as micro-channels, can be suitable to support NSC transplantation for regeneration following spinal cord injury

Acute maculopapular eruption in Covid-19 patient: A case report

We report the case of a positive COVID-19 patient who presented to our hospital for a maculopapular skin rash which appeared 7 days after the onset of COVID-19 symptoms. He was 34 years old and nothing relevant was recorded at his previous anamnesis. The patient was hospitalized for 3 days and received systemic therapy with steroid, antihistamines, tocilizumab, and hydroxicloroquine. On the third day of the hospitalization the cutaneous rash had almost completely disappeared

The COVID-19 outbreak in dermatologic surgery: resetting clinical priorities

Emilia-Romagna was one of the Italian regions mostly affected by the COVID-19 pandemic and lockdown measures were taken to slow the COVID-19 outbreak. All routine activities in Modena hospitals were suspended; however, urgent procedures were still to be performed. Setting the priority of procedures in oncological dermatology in the COVID-19 era is challenging

Which are the main fluorophores in skin and oral mucosa? A review with emphasis on clinical applications of tissue autofluorescence

Abstract OBJECTIVES: The present review provides information about which molecules appear to be the main fluorophores in skin and oral mucosa, together with their clinical applications. DESIGN: The MEDLINE database was searched, using "oral mucosa AND fluorophores", "skin AND fluorophores", "epidermal AND fluorophores", "dermal AND fluorophores" and "cutaneous AND fluorophores" as entry terms. We searched the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The level of evidence in the studies was assessed using the Classification of the Oxford Centre for Evidence-based Medicine (CEBM) Levels for Diagnosis. RESULTS: Five papers and 17 were primarily focused on description of fluorophores in oral mucosa and skin Evidence exists that fluorophores of oral mucosa and skin are mainly proteins such as collagen, elastin, keratin and tryptophan. Other possible fluorophores identified are: porphyrins, advanced glycation end products, flavins, lipopigment, nicotinamide adenine dinucleotide, flavin adenine dinucleotide, pheomelanin, eumelanin and components of lipofuscin. Clinical applications of oral mucosal autofluorescence (AF) are related to management of malignant and potentially malignant lesions. In the skin, AF has been used for acne assessment, diagnosis of sweat-gland pathologies, glycemic control and management of malignant lesions and as a marker for skin aging. CONCLUSION: Fluorophores stimulated through AF devices are implied in different physiologic and pathologic processes. AF seems to be useful for several clinical applications, especially in skin department. Because most of the studies show a low level of evidence, further studies are necessary in such a promising and fascinating field

Histopathological determinants of autofluorescence patterns in oral carcinoma

Biological tissues (including oral mucosa) can absorb and re-emit specific light wavelengths, detectable through spectrophotometric devices. Such a phenomenon is known as \u201cautofluorescence\u201d (AF). Several devices evaluating tissue AF have been developed and commercialized in the last two decades. Among these, the VELscope\uae system has been proposed as a visual diagnostic aid for potentially malignant disorders and malignant lesions of the oral mucosa. In the present pilot study, we investigated which are the main histopathological features possibly related to variations in AF patterns in a set of 20 oral squamous cell verrucous carcinoma. Among all the histological features investigated, only the mean width of keratin was significantly different between hypofluorescent and hyperfluorescent carcinomas. The results of the present study demonstrate that AF features of oral malignant lesions are significantly associated with the width of their keratin layer