Two Suturing Techniques for the Prevention and Treatment of Nasal Valve Collapse After Mohs Micrographic Surgery.

Background: Tumor extirpation of nonmelanoma skin cancer (NMSC) adjacent to the alar groove, using Mohs micrographic surgery (MMS), may risk causing internal nasal valve (INV) collapse, resulting in reduced airflow during inspiration. There are many surgical options described in the literature to repair INV collapse as a postoperative corrective procedure, but few exist as an intra-operative preventative procedure.

Objective: The authors present 2 distinct methods to prevent and treat INV collapse during the repair of a perialar surgical defect caused by MMS.

Primary lung abscess caused by multidrug-nonsusceptible Streptococcus pneumoniae in a child.

We report a 21-month-old boy with primary lung abscess caused by multidrug-nonsusceptible Streptococcus pneumoniae. A computed tomography-guided aspirate obtained on admission grew penicillin-, ceftriaxone-, erythromycin- and clindamycin-nonsusceptible S. pneumoniae.

Classification of acute coronary syndromes using the 12-lead electrocardiogram as a guide.

The management of patients with acute coronary syndromes (ACS) is becoming more complicated. With the advent of new therapies and surgical techniques, the likelihood that patients will make a full recovery improves. Cardiovascular disease remains the leading cause of death for adults in the United States, and with continually increasing trends such as obesity and diabetes, will likely remain so in the future.

Laparoscopic versus open appendectomy: what is the real difference? Results of a prospective randomized double-blinded trial.

Background: The comparison of laparoscopic to open appendectomy has been reviewed in many retrospective and prospective studies. Some report shorter hospital stays, less postoperative pain, and earlier return to work while others fail to demonstrate such differences. We performed a prospective, randomized double-blinded trial to evaluate this ongoing debate.

A novel use of U-500 insulin for continuous subcutaneous insulin infusion in patients with insulin resistance: a case series.

Objective: To report our experience with use of U-500 regular insulin (U-500) for continuous subcutaneous insulin infusion (CSII) in four patients with type 2 diabetes requiring high-dose insulin.

Methods: We performed a retrospective review of medical records of four patients with type 2 diabetes and insulin resistance who were using U-500 in a CSII regimen for at least 6 months. Before treatment conversion, two patients were receiving CSII with use of insulin lispro, and two were receiving multiple daily insulin injections.

Acetabular stress fractures in military endurance athletes and recruits: incidence and MRI and scintigraphic findings.

Objective: To evaluate the incidence and the MRI and scintigraphic appearance of acetabular stress (fatigue) fractures in military endurance athletes and recruits.

Design And Patients: One hundred and seventy-eight active duty military endurance trainees with a history of activity-related hip pain were evaluated by both MRI and bone scan over a 2-year period. Patients in the study ranged in age from 17 to 45 years.

EUS and fine-needle aspiration in the evaluation of mediastinal masses superior to the aortic arch.

Background: Mediastinal lesions require a tissue diagnosis. This cannot be obtained with CT-guided biopsy or bronchoscopy in many patients. Co-morbid diseases increase the risk of mediastinoscopy in some of these patients.