Complications After Mohs Micrographic Surgery in Patients Aged 85 and Older.

Background: As the US population ages, safe surgical procedures are necessary for treatment of cutaneous neoplasms in very elderly patients.

Objective: To determine the incidence of complications associated with Mohs micrographic surgery (MMS) in patients aged 85 and older, and the risk factors that predispose to complications.

Methods: A 9-year retrospective chart review of patients aged 85 and older who underwent MMS at our institution between 07/2007 and 11/2016 was performed.

Positive Bacterial Culture Results at a Dermatologic Surgery Center: A Single-Site Retrospective Review.

Background: Typical prophylactic coverage of suspected cutaneous surgical-site infections (SSIs) predominantly covers gram-positive bacteria. Data regarding the frequency of infection with unusual bacteria, not covered by prophylaxis, are not available.

Objective: A retrospective 10-year review of culture-positive infections at a single academic site was performed.

The persistent and broadly modulating effect of inhibitory rTMS in nonfluent aphasic patients: a sham-controlled, double-blind study.

Background: While prior preliminary studies have broadened our understanding of how repetitive transcranial magnetic stimulation (rTMS) improves language outcomes in stroke patients with nonfluent aphasia, the evidence base of the effectiveness of this method remains inadequate.

Objective: In this study, we aimed to strengthen the evidence that this approach improves language performance and to identify characteristics of patients predisposed to benefit most from this treatment.

Methods: Fifty-six stroke patients with nonfluent aphasia were randomly allocated to a real or a sham stimulation group: Group A (n = 33), who underwent 10 sessions of 1-Hz rTMS over the contralesional pars triangularis (PTr), and Group B (n = 23), who received sham 1-Hz stimulation.

Topographic scale-range synergy at the functional bone/implant interface.

We sought to explore the biological mechanisms by which endosseous implant surface topography contributes to bone anchorage. To address this experimentally, we implanted five groups of custom-made commercially pure titanium implants of varying surface topographical complexity in rat femora for 9 days; subjected them to mechanical testing; and then examined the interfacial bone matrix by electron microscopy. The five implant surfaces were prepared by combinations of dual acid etching and grit blasting the titanium substrates and, in some cases, modifying the created surfaces with the deposition of nanocrystals of calcium phosphate, which resulted in 10 samples per group.

Breast cancers detected by breast MRI screening and ultrasound in asymptomatic Asian women: 8 years of experience in Taiwan.

Background: This study investigated one-stop breast screening combining magnetic resonance imaging (MRI) and ultrasound (US) in asymptomatic Asian women.

Methods: 3,586 asymptomatic women (mean age, 45.3 years) were retrospectively analyzed by breast MRI followed by US.

Magnetic resonance imaging for lung cancer detection: experience in a population of more than 10,000 healthy individuals.

Background: Recent refinements of lung MRI techniques have reduced the examination time and improved diagnostic sensitivity and specificity. We conducted a study to assess the feasibility of MRI for the detection of primary lung cancer in asymptomatic individuals.

Methods: A retrospective chart review was performed on images of lung parenchyma, which were extracted from whole-body MRI examinations between October 2000 and December 2007.

Comorbid intracranial vertebral artery asymmetry as a risk factor for severe vestibular neuronitis.

Background: Our previous study had demonstrated that verterbral artery hypoplasia (VAH) contribute to ipsilateral vestibular dysfunction. The aim of this study was to test if VAH contributes to prognosis of vestibular neuronitis (VN) through presumed regional malperfusion.

Methods: We performed a prospective magnetic resonance angiographic registry in patients with acute vestibular neuritis in which were then assigned to VAH (n=29) and control group (n=40).

Clinical implications of neuraxial anesthesia in the parturient with scoliosis.

Scoliosis can pose challenges to the initiation and function of neuraxial anesthetics. We reviewed the available literature exploring neuraxial techniques in parturients with uncorrected or corrected (i.e.

Excipient choices for special populations.

Patients with allergies or intolerances and those requiring special diets are among the groups that require formulations with special excipients. When compounding preparations for this population, the suitability of dyes, flavorings, sweeteners, preservatives, gelatins, milk products, gluten, corn, soy, nuts, alcohol, chocolate, and other animal-derived ingredients must be considered. Unlike manufacturers of foods and nutritional supplements, pharmaceutical companies are not required to list certain ingredients of manufactured drugs, such as wheat.

Live/real time three-dimensional transthoracic echocardiographic assessment of left ventricular volumes, ejection fraction, and mass compared with magnetic resonance imaging.

Due to reliance upon geometric assumptions and foreshortening issues, the traditionally utilized transthoracic two-dimensional echocardiography (2DTTE) has shown limitations in assessing left ventricular (LV) volume, mass, and function. Cardiac magnetic resonance imaging (MRI) has shown potential in accurately defining these LV characteristics. Recently, the emergence of live/real time three-dimensional (3D) TTE has demonstrated incremental value over 2DTTE and comparable value with MRI in assessing LV parameters.

Seizures and brain tumors.

Seizures commonly occur in people with brain tumors. They may be the presenting symptom of a brain tumor, or develop some time after tumor diagnosis. The risk of seizures is greatest when the tumors have a central location, slow growth rate, and when multiple lesions are present.

Bipolar spectrum disorder: a pilot study.

Objective: To assess depressive features of a proposed definition of bipolar spectrum disorder (BSD).

Methods: Thirty-six patients with bipolar disorder type I or II were compared to 37 patients with unipolar major depressive disorder through patient interview and chart review.

Results: Univariate analysis suggests that 7 of 12 (recurrent major depressive episodes, brief major depressive episodes, atypical depressive symptoms, early age of onset, family history of bipolar disorder, antidepressant tolerance, and antidepressant-induced mania) features of major depressive episodes were more likely to occur in bipolar versus unipolar patients.

Pulmonary Langerhans cell granulomatosis with extrapulmonary involvement.

Pulmonary Langerhans cell granulomatosis is defined as an abnormal Langerhans cells infiltration in the lungs. Multifocal involvement is unusual, however. We report 3 cases of pulmonary Langerhans cell granulomatosis combined with either rib, thyroid or hypothalamus involvement.

Antidepressant treatment in bipolar versus unipolar depression.

Objective: Antidepressant responses were compared in DSM-IV bipolar and unipolar depression.

Method: The authors analyzed clinical records for outcomes of antidepressant trials for 41 patients with bipolar depression and 37 with unipolar depression, similar in age and sex distribution.

Results: Short-term nonresponse was more frequent in bipolar (51.

Oxcarbazepine treatment of refractory bipolar disorder: a retrospective chart review.

Objective: To determine if oxcarbazepine is effective as treatment for refractory bipolar illness in a naturalistic setting.

Methods: All charts of out-patients treated with oxcarbazepine (n=13) were reviewed and clinical response assessed retrospectively using the Clinical Global Impression of Improvement (CGI-I) rating scale. All patients had failed treatment with at least one previous mood stabilizer.

Valsalva-induced cluster: a new subtype of cluster headache.

We report the case of a man who suffered from Valsalva-induced cluster headaches. The headaches deviated from classic cluster in that they were solely induced by activity involving the Valsalva maneuver, such as coughing and sneezing, and never occurred spontaneously. The attacks were prevented by treatment with indomethacin.

"Cade's disease" and beyond: misdiagnosis, antidepressant use, and a proposed definition for bipolar spectrum disorder.

The diagnosis and treatment of bipolar disorder (BD) has been inconsistent and frequently misunderstood in recent years. To identify the causes of this problem and suggest possible solutions, we undertook a critical review of studies concerning the nosology of BD and the effects of antidepressant agents. Both the underdiagnosis of BD and its frequent misdiagnosis as unipolar major depressive disorder (MDD) appear to be problems in patients with BD.