Cutaneous hydrophilic polymer emboli following endovascular repair of an abdominal aortic aneurysm: a case and review of literature

Hydrophilic polymer embolism (HPE) is a rare iatrogenic complication of the use of polymer-coated intravascular devices, which may affect several organ systems including the skin. Herein, we present a patient who developed a cutaneous eruption with associated neurologic manifestations secondary to localized HPE. This is a potentially underdiagnosed, life-threatening complication and physicians should consider HPE when evaluating skin eruptions in patients who have undergone endovascular procedures

Melanoma: Does It Present Differently in Darker Skin Tones?

Introduction There are vast differences in clinical presentations of melanoma across skin tones. Individuals with darker skin tones tend to have a higher prevalence of advanced-stage melanoma, which correlates with increased mortality. We designed this interactive workshop to increase nursing and medical trainees’ awareness of the epidemiology, prevention, and treatment of melanoma in individuals of darker skin tones. Methods The Kern model was used in the design, implementation, and evaluation of the workshop. The 75-minute workshop consisted of a PowerPoint presentation, video-based reflection activities, and case studies. Evaluation consisted of pre- and postworkshop questionnaires. The workshop was implemented two times among 63 nursing students, 11 medical students/residents, and six medical faculty. Results Seventy-one participants completed the pre- and postworkshop evaluations. A comparison of pre- and postworkshop responses utilizing the Wilcoxon matched-pair signed rank test showed a statistically significant increase in learners’ confidence to address each learning objective. Discussion Through this interactive educational presentation, medical and nursing trainees can gain heightened awareness of melanoma across various skin tones, especially unique presentations in darker skin tones

Evaluación de la procalcitonina sérica en recién nacidos a término con sospecha de infección/sepsis

Tipo de estudio: cohorte prospectivo. Antecedentes: la infección/sepsis bacteriana es una causa importante de morbi-mortalidad en unidades de cuidados intensivos neonatales; siendo la causante de 1.6 millones de muertes a nivel mundial en este grupo etario. Debido a su sintomatología inespecífica y baja sensibilidad de exámenes diagnósticos, los neonatólogos se han visto en la necesidad de usar métodos rápidos, tales como la procalcitonina, para el diagnóstico de infección/sepsis bacteriana al momento de su sospecha. Objetivo: comparar los valores de la procalcitonina con los resultados obtenidos del hemocultivo y los valores de glóbulos blancos en neonatos con diagnóstico de infección/sepsis tardía. Metodología: se realizó un estudio cohorte/prospectivo en la Unidad de Cuidados Intensivos Neonatal (UCIN) del hospital "Dr. Francisco de Ycaza Bustamante", durante el período de tres meses, donde se incluyeron 15 neonatos a término de 2 a 28 días de vida con criterios de sepsis, a quienes se les realizó biometría hemática completa, procalcitonina sérica y hemocultivo; se realizó el seguimiento del grupo de estudio hasta el alta médica o fallecimiento. Resultados: la procalcitonina sérica se efectuó en un total de 15 pacientes, teniendo como punto de corte ≥0.5ng/ml, donde se observó un resultado positivo en 7 pacientes (6.6% ≥0.5ng/ml; 33.3% ≥2ng/ml y 6.6%≥10ng/ml), obteniéndose una sensibilidad del 75% (IC 95%= 19.41%-99.37%) y especificidad del 63.6% (IC 95%= 30.79%- 89.07%) [p= 0.179]. Conclusiones: se demostró que la elevación de la PCT en pacientes con antecedentes prenatales y cuadro clínico sugestivo de infección/sepsis se correlacionó con el hallazgo de hemocultivo positivo; sin embargo sería deseable a futuro ampliar el universo de pacientes y controlar la PCT sérica cuantitativamente en 48-72 horas de iniciado el tratamiento

Cardiac Manifestations of Systemic Lupus Erythematous: An Overview of the Incidence, Risk Factors, Diagnostic Criteria, Pathophysiology and Treatment Options

Systemic lupus erythematosus (SLE) is a complex connective tissue disease that can potentially affect every organ of the human body. In some cases, SLE may present with diverse cardiac manifestations including pericarditis, myocarditis, valvular disease, atherosclerosis, thrombosis, and arrhythmias. Heart disease in SLE is associated with increased morbidity and mortality. It is unclear whether traditional treatments for coronary artery disease significantly impact mortality in this population. Current therapeutic agents for SLE include glucocorticoids, hydroxychloroquine, mycophenolate mofetil, azathioprine, methotrexate, cyclophosphamide, and B cell-directed therapies. This article will provide a comprehensive review and update on this important disease state