Rivaroxaban-Associated Bullous Pemphigoid in a Patient With Atrial Fibrillation.

Rivaroxaban is commonly used for prevention of thromboembolic diseases in patients with atrial fibrillation. We report a case of an 86-year-old man with hypertension, chronic kidney disease, type 2 diabetes mellitus, dyslipidemia, and atrial fibrillation who developed bullous eruptions 1 week after a rivaroxaban dose increase. He was subsequently hospitalized, and direct immunofluorescence confirmed bullous pemphigoid (BP).

A Review of 101 Consecutive Subcutaneous Mastectomies and Male Chest Contouring Using the Concentric Circular and Free Nipple Graft Techniques in Female-to-Male Transgender Patients.

Background: Many techniques exist for subcutaneous mastectomy in female-to-male transgender patients. The authors review outcomes for two techniques and present an algorithm to aid surgeons in technique selection.

Methods: One hundred one consecutive female-to-male transgender patients undergoing subcutaneous mastectomy using the concentric circular or free nipple graft technique were retrospectively reviewed.

Diagnosis, Prevention, and Management of Statin Adverse Effects and Intolerance: Canadian Consensus Working Group Update (2016).

The Canadian Consensus Working Group has updated its evaluation of the literature pertaining to statin intolerance and adverse effects. This overview introduces a pragmatic definition of statin intolerance (goal-inhibiting statin intolerance) that emphasizes the effects of symptoms on achieving nationally vetted goals in patients fulfilling indications for lipid-lowering therapy and cardiovascular risk reduction. The Canadian Consensus Working Group provides a structured framework for avoiding, evaluating and managing goal-inhibiting statin intolerance.

The relationship between visual word and face processing lateralization in the fusiform gyri: A cross-sectional study.

Visual words and faces activate similar networks but with complementary hemispheric asymmetries, faces being lateralized to the right and words to the left. A recent theory proposes that this reflects developmental competition between visual word and face processing. We investigated whether this results in an inverse correlation between the degree of lateralization of visual word and face activation in the fusiform gyri.

Is it Time to Update How Suspected Angina Is Evaluated prior to the Use of Specialized Tests Implications Based on a Systematic Review.

Objectives: Appropriate use of specialized tests to assess chest pain is based classically on minimal information such as age, gender and the patient's description of pain. This approach has not been reevaluated in decades. We examined the relationship between history, examination and routine laboratory tests to identify factors warranting prospective validation as predictors of underlying coronary artery disease (CAD).

Comparison of Outcomes following Autologous Breast Reconstruction Using the DIEP and Pedicled TRAM Flaps: A 12-Year Clinical Retrospective Study and Literature Review.

Background: There are few studies that compare the deep inferior epigastric artery perforator (DIEP) flap to the pedicled transverse rectus abdominis myocutaneous (pTRAM) flap for use in reconstructive breast surgery. The authors examined four factors that aid in decision-making: donor-site morbidity, need for surgery related to abdominal morbidity, operative time, and complications.

Methods: This is a retrospective review of patients undergoing breast reconstruction using the DIEP or pTRAM flap at the University of British Columbia between 2002 and 2013.

Predictors of Mastectomy Flap Necrosis in Patients Undergoing Immediate Breast Reconstruction: A Review of 718 Patients.

Background: Mastectomy flap necrosis (MFN) after mastectomy and immediate breast reconstruction can compromise postsurgical recovery, lead to additional surgeries, and compromise aesthetic outcome. The objective of this study was to determine if there is a difference in the rate of MFN in patients undergoing immediate alloplastic versus immediate autologous breast reconstruction. The secondary objective was to identify additional patient and surgical factors that may influence the rate of MFN.

Diagnosis, prevention, and management of statin adverse effects and intolerance: Canadian Working Group Consensus update.

The Proceedings of a Canadian Working Group Consensus Conference, first published in 2011, provided a summary of statin-associated adverse effects and intolerance and management suggestions. In this update, new clinical studies identified since then that provide further insight into effects on muscle, cognition, cataracts, diabetes, kidney disease, and cancer are discussed. Of these, the arenas of greatest controversy pertain to purported effects on cognition and the emergence of diabetes during long-term therapy.

The relationship between skin cholesterol testing and parameters of cardiovascular risk: a systematic review.

Background: A potential correlation between skin cholesterol levels obtained via skin biopsy and evidence of underlying atherosclerosis has been reported. With the availability of a noninvasive method of skin cholesterol measurement, multiple studies investigated the association of skin cholesterol and traditional cardiovascular risk factors. We provide a systematic review of clinical data to assist physicians counselling patients that have undergone skin cholesterol testing and to provide a framework for future research.

Lower extremity anterior compartment syndrome complicating bilateral mastectomy and immediate breast reconstruction: A case report and literature review.

'Well leg compartment syndrome' refers to compartment syndrome occurring in a nontraumatic setting. This occurs most commonly in the lower limb during surgery performed with the patient in an anatomically vulnerable position. While this complication is well documented in the setting of orthopedic, urological and gynecological surgeries, it is an exceptionally rare complication in plastic surgery; only seven cases have been published on compartment syndrome complicating an operation performed on a supine patient.

The emerging role of cardiac computed tomography for the assessment of coronary perfusion: a systematic review and meta-analysis.

Background: Computed tomography perfusion (CTP) is an emerging method which, coupled with the anatomical detail afforded by cardiac computed tomographic angiography (CCTA), may allow for determination of both structural and physiologic significance of coronary stenoses with a single imaging modality. This study was designed to execute a systematic review/meta-analysis to determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CTP as compared with reference standards for detection of significant coronary artery stenoses and impaired perfusion.

Methods: A systematic review identified 13 out of 4368 studies allowing a calculation of sensitivity, specificity, PPV, and NPV on a per patient or per vessel or per segment basis using radionuclide myocardial perfusion imaging (MPI), conventional coronary angiography (CCA), magnetic resonance perfusion imaging (MRPI), or fractional flow reserve (FFR) as the reference standard.