Efficacy of Intraoperative Cell Salvage on Perioperative Blood Transfusion in Pelvic and Acetabular Surgery: A Matched Cohort Analysis.

Background: Pelvic fractures often result in traumatic and intraoperative blood loss. Cell salvage (CS) is a tool where autologous blood lost during surgery is collected and recycled with anticoagulation, centrifugation to separate red blood cells, and washing to be reinfused back to the patient. The purpose of this study was to investigate our experience with CS in pelvic and acetabular surgery and its relationship to perioperative transfusion requirements.

Medialized Trochanteric Starting Point and Focused Lateral Endosteal Beak Reaming to Optimize Success of Intramedullary Nailing in Atypical Femur Fractures: A Technical Trick and Case Series.

Optimal intramedullary treatment of atypical femur fractures associated with bisphosphonate use requires avoidance of postoperative malreduction, particularly varus. This can be difficult to achieve, given the fracture location, errors with nail entry point, endosteal beaking, and underlying patient osteology, all of which can contribute to postoperative varus and predispose the patient to treatment failure. We present a surgical technique and clinical series of 10 patients emphasizing a medialized trochanteric nail entry point and preferential lateral endosteal reaming to secure a biologically and biomechanically favorable reduction and fixation.

Intra-operative multi-dimensional fluoroscopy of guidepin placement prior to iliosacral screw fixation for posterior pelvic ring injuries and sacroiliac dislocation: an early case series.

Purpose: Traditional fluoroscopic techniques during percutaneous fixation of the posterior pelvic ring at times cannot adequately visualize errant or malpositioned iliosacral screws. Intra-operative fluoroscopic techniques have been advanced using multi-dimensional fluoroscopy to generate computed tomography-like images. This provides the surgeon not only the ability to assess iliosacral screw placement, but also the opportunity to assess reduction.

Hyperglycemia following intralesional corticosteroid injection in a patient with type I diabetes mellitus.

Case Report: A 36-year-old woman with well-controlled type 1 diabetes mellitus reported hyperglycemia (plasma glucose peaked at 21.3 mmol/L) after her first injection with intralesional triamcinolone acetonide for alopecia areata.

Conclusion: Intralesional corticosteroids are used to maximize local effect while presumably minimizing systemic complications.

Socioeconomic status influences care of patients with acne in Ontario, Canada.

Background: Canada's universal health care system is designed to ensure equitable access to medical care based on need rather than socioeconomic status, although a number of studies indicate a preferential access and greater use of specialist services for those patients in higher socioeconomic groups.

Objectives: The primary objective of this study was to determine whether socioeconomic status influences access to specialist care by a dermatologist for the management of acne in Ontario, Canada. A secondary objective was to determine whether the urban-rural dwelling status of patients affects access to specialty care.

Segmental neurofibromatosis follows blaschko's lines or dermatomes depending on the cell line affected: case report and literature review.

Background: Segmental neurofibromatosis type 1 (NF-1) has the characteristic features of generalized NF-1 but is isolated to a particular segment of the body. Segmental NF-1 results from a postzygotic mutation during embryogenesis in the NF-1 gene on chromosome 17. The embryologic timing of the mutation and cell types affected predict the clinical phenotype.

Evaluation of sun-protective practices of organ transplant recipients.

The incidence, morbidity and mortality of skin cancer are markedly increased in organ transplant recipients. Efforts aimed at reducing sun exposure through sun avoidance, sunscreens and sun-protective clothing are the most effective means to reduce the risk of skin cancer. We evaluated the sun-protective behaviors of 205 transplant recipients.

Treatment of acne vulgaris.

Context: Management of acne vulgaris by nondermatologists is increasing. Current understanding of the different presentations of acne allows for individualized treatments and improved outcomes.

Objective: To review the best evidence available for individualized treatment of acne.

Specialty clinics for the dermatologic care of solid-organ transplant recipients.

Background: Solid-organ transplant recipients constitute a complex patient population that experiences numerous and aggressive skin cancers. Proactive, comprehensive, ongoing, and effective dermatologic care of these patients is a necessity.

Objective: The objective of this study was to emphasize the need for organized dermatologic care for transplant recipients and to collect and present various proactive paradigms established in and designed for different practice settings to manage organ transplant recipients at high risk for skin cancer.

A systemic type I 5 alpha-reductase inhibitor is ineffective in the treatment of acne vulgaris.

Excessive sebum production is a central aspect of the pathophysiology of acne vulgaris. Sebaceous gland function is under androgen control and it is hypothesized that dihydrotestosterone is formed by the action of 5 alpha-reductase. Type I is the controlling isoenzyme.

Unilateral Darier's disease with unilateral guttate leukoderma.

We report a case of diffuse unilateral Darier's disease that is associated with unilateral macular hypopigmentation. The histologic evidence of the hypopigmented macules revealed features of Darier's disease.

Recurrent adenoid cystic carcinoma of the scalp treated with mohs micrographic surgery.

Primary cutaneous adenoid cystic carcinoma is a rare skin neoplasm with a high potential for recurrence after local excision. We present a case of a 45-year-old white female with recurrent primary cutaneous adenoid cystic carcinoma of the scalp. The tumor was resected with Mohs surgery in two stages and defect repaired with split-thickness skin graft.

Anterolateral leg alopecia revisited.

Alopecia of the leg-an extremely common yet ill-defined condition-is described in few contemporary dermatology textbooks. In this article, we describe 3 patients with anterolateral alopecia of the legs and further characterize this condition through a review of the literature.

Acne: effect of hormones on pathogenesis and management.

In the pathogenesis of acne, androgen hormones play a crucial role. In the treatment of acne, hormonal therapies provide valuable alternatives to standard modalities in selected women. Although numerous factors contribute to the development of acne, the requirement for androgens is absolute and is one that allows for effective treatments in women through inhibition of androgen expression.

Long-term safety of spironolactone in acne: results of an 8-year followup study.

Background: Spironolactone has been used for over 20 years as an antiandrogen in the treatment of acne and hirsutism. No long-term studies of the safety of spironolactone used in this manner have been published. We present a study of the long-term safety and tolerance of spironolactone in 91 women with acne who were followed for up to 8 years.