Descending necrotizing mediastinitis: Systematic review on its treatment in the last 6 years, 75 years after its description.

Background: Descending necrotizing mediastinitis is a serious infection involving the neck and the chest, in which an odontogenic, pharyngeal, or cervical infection spreads rapidly to the thoracic cavity, with a high death rate by sepsis and organic failure if not treated quickly and properly.

Methods: A systematic search in the electronic database PubMed was conducted using the keywords "mediastinitis" and "descending necrotizing mediastinitis" resulting in 2560 items, filters were activated (systematic review, meta-analysis, and clinical trial) resulting in 60 articles, from which we selected relevant articles on the topic.

Results: The best available evidence we could obtain was from 26 case series with evidence level III.

Myocutaneous sternocleidomastoid flap for reconstruction after the resection of a parapharyngeal heterotopic glioma in a child with cleft palate, and systematic review of parapharyngeal glial heterotopia.

We describe the surgery and reconstruction employed with a sternocleidomastoid myocutaneous flap for the treatment of a heterotopic glioma in a 2-year-old boy with incomplete palatal fissure who presented with dysphagia and snoring, in whom a lateral pharyngeal wall mass obstructing 60% of the airway was noted. Heterotopic gliomas are uncommonly reported in the parapharyngeal space and should be included in the differential diagnosis at this location in children. Parapharyngeal tumors present difficult diagnostic and management challenges; head and neck surgeons must be prepared not only for the resection but also for the reconstruction of these rare lesions.

The amniotic band syndrome in the rat is associated with the activation of transforming growth factor-β.

Amniocentesis in rats is associated with different malformations, such as cleft palate and limb deformation, resembling the human congenital amniotic band syndrome (ABS). Despite many human cases reported in the literature, little is known about the mechanisms involved in ABS. This study addressed if the activation of the transforming growth factor-β1 (TGF-β1) pathway is, in part, associated with amniotic band formation and growth restriction induced in rats by amniocentesis, as by a previously published model.

Modified PAS stain: A new diagnostic method for onychomycosis.

Background: Onychomycosis is the most common nail disease and represents around 50% of nail disorders. Accurate diagnosis with adequate evidence is ideal before starting any treatment. Current diagnostic methods offer low specificity and sensitivity.

Aesthetic and functional outcomes of the innervated and thinned anterolateral thigh flap in reconstruction of upper limb defects.

Background. The anterolateral thigh (ALT) flap has been widely described in reconstruction of the upper extremity. However, some details require refinement to improve both functional and aesthetic results.

Another Perspective on Fasciculations: When is it not Caused by the Classic form of Amyotrophic Lateral Sclerosis or Progressive Spinal Atrophy?

Fasciculations are visible, fine and fast, sometimes vermicular contractions of fine muscle fibers that occur spontaneously and intermittently. The aim of this article is to discuss the main causes for fasciculations and their pathophysiology in different sites of the central/peripheral injury and in particular to disprove that the presence of this finding in the neurological examination is indicative of amyotrophic lateral sclerosis. Undoubtedly, most fasciculations have a distal origin in the motor nerve both in normal subjects and in patients with motor neuron disease.

The invA gene of Brucella melitensis is involved in intracellular invasion and is required to establish infection in a mouse model.

Some of the mechanisms underlying the invasion and intracellular survival of B. melitensis are still unknown, including the role of a subfamily of NUDIX enzymes, which have been described in other bacterial species as invasins and are present in Brucella spp. We have generated a mutation in the coding gene of one of these proteins, the invA gene (BMEI0215) of B.

Association of genetic polymorphism of HLA-DRB1 antigens with the susceptibility to lepromatous leprosy.

Despite the introduction of multidrug therapy and the overall reduction of leprosy prevalence in Mexico, the disease remains endemic in certain regions of the country. A genetic basis for the immune susceptibility to has already been established in different populations worldwide. In this study, we investigated the possible association of the HLA-DRB1 alleles with leprosy in a Mexican Mestizo population.

Proliferating trichilemmal cyst: the value of ki67 immunostaining.

Background: A proliferating trichilemmal cyst (PTC) is an uncommon, rapidly-reproducing cutaneous epithelial cyst, differentiating from the isthmic portion of the outer hair root sheath. It is usually described as a benign tumor, but malignant transformation has been reported and is then denominated as a malignant proliferating trichilemmal tumor. Ki67 immunostaining has been used as a methodology for the evaluation of tumor grade in other tumors, due to its distinctive reaction patterns which exclusively involve proliferating cells.

Lack of IgG antibody seropositivity to Borrelia burgdorferi in patients with Parry-Romberg syndrome and linear morphea en coup de sabre in Mexico.

Background: Progressive hemifacial atrophy or Parry-Romberg Syndrome (PRS) is a rare, acquired, progressive dysplasia of subcutaneous tissue and bone characterized by unilateral facial involvement. Its etiology is unknown, but theories about its pathogenesis include infectious, degenerative, autoimmune, and traumatic causes among others. The causal relationship of PRS and linear morphea en coup de sabre (LMCS) with Borrelia burgdorferi infection remains controversial.

Alterations in the Synthesis of IL-1β, TNF-α, IL-6, and Their Downstream Targets RANKL and OPG by Mouse Calvarial Osteoblasts In vitro: Inhibition of Bone Resorption by Cyclic Mechanical Strain.

Mechanical strain is an important determinant of bone mass and architecture, and the aim of this investigation was to further understand the role of the cell-cell signaling molecules, IL-1β, TNF-α, and IL-6 in the mechanobiology of bone. Mouse calvarial osteoblasts in monolayer culture were subjected to a cyclic out-of-plane deformation of 0.69% for 6 s, every 90 s for 2-48 h, and the levels of each cytokine plus their downstream targets RANKL and OPG measured in culture supernatants by ELISAs.

Intramuscular hemangiomas of the extremities: report of six cases.

Background: Hemangiomas are benign endothelial cell-derived tumors that are present in 1-2% of newborns. They are most frequent in females. Eighty per cent are located in the head and neck region.

Clinical, mycological and histological aspects of white onychomycosis.

Fungal leuconychia defines the clinical manifestations of white changes in onychomycosis. This uncommon clinical aspect is mostly seen, although not exclusively, in immunosuppressed patients. The principal isolated organism is Trichophyton spp.

Simultaneous erythema nodosum and erythema multiforme after local lidocaine injection.

Objective: To report a case of simultaneous erythema nodosum and erythema multiforme after local lidocaine injection.

Case Summary: A 33-year-old female experienced coexisting erythema nodosum and erythema multiforme after lidocaine spray was used for upper gastrointestinal endoscopy. The reaction was exacerbated after localized injection of 2% lidocaine for a skin biopsy.

Giant onychomatricoma: report of two cases with rare clinical presentation.

Background: Onychomatricoma was reported for the first time by Baran and Kint as a rare nail matrix tumor with specific clinical and histologic features, including a macroscopic appearance of filiform digitations originating from the nail matrix which are inserted in the nail plate.(1) The appearance of the lesion may resemble that of an "anemone." All previous reports have been mostly from Europe, with only one case from North America.

Treatment of nail bed defects with hard palate mucosal grafts.

Background: Nail bed defects produce a nail plate dystrophy that is permanent and presents important cosmetic problems. To correct the defect, we used a hard palate mucosal graft. This is a procedure with encouraging outcomes for nail bed scars.

Lichen planus in 24 children with review of the literature.

Lichen planus is a disease generally considered uncommon in children. Our objective was to obtain epidemiologic data retrospectively and determine the clinical characteristics of lichen planus in Mexican children seen in our dermatology department. We found 235 patients with the clinical and histologic diagnosis of lichen planus seen over a period of 22 years and 7 months.

Multimedia article: management of duodenal ulcer perforation with combined laparoscopic and endoscopic methods.

In the past, primary closes for perforated duodenal ulcer were not effective because of the high incidence of recurrence (42%), therefore most surgeons preferred definitive procedures to control acid production. Since the association of Helicobacter pylori with peptic ulcers and the effectiveness of the medication for acid control, definitive surgery is less frequently used. Today, primary closes of the perforation are the immediate alternative.

Congenital generalized terminal hypertrichosis with gingival hyperplasia.

Congenital generalized terminal hypertrichosis is a rare disease, especially when associated with gingival hyperplasia. Congenital hypertrichosis can be a clinical feature of several syndromes, so these patients must be studied by a multidisciplinary team that should include a dermatologist, geneticist, psychologist, odontologist, and an endocrinologist. We report a 7-year-old girl with congenital generalized hypertrichosis and gingival hyperplasia, and analyze the clinical approach, differential diagnosis, and treatment.

Frequency of toenail onychomycosis in patients with cutaneous manifestations of chronic venous insufficiency.

Background: Chronic venous insufficiency (CVI) can originate onychopathy per se. We have anecdotally observed nail changes in patients with CVI, but there are few studies which determine the frequency of both onychopathy and onychomycosis in these patients

Objective: The aim of the study was to determine the frequency of nail pathology and onychomycosis in patients with CVI PATIENTS AND METHODS: We included 36 adult patients, both men and women, aged from 18 to 59 years, with clinically documented venous leg ulcers. All patients were examined by a dermatologist and the venous leg ulcers were classified according to severity in three grades.

Free flaps for head and neck reconstruction in non-oncological patients: experience of 200 cases.

Two hundred free flaps for reconstructing the head and neck regions in 192 patients with non-oncological pathology were studied. Pathological entities included Romberg's disease, hemifacial microsomia, acquired facial palsy, trauma, and burn sequelae. Indications for selecting a specific free flap for reconstructing each case, details of anastomoses, reexploration, flap success, operative time, length of hospitalization, and complications were studied.

Restoration of facial contour in Romberg's disease and hemifacial microsomia: experience with 118 cases.

The experience with free flaps and conventional reconstructive procedures for 118 patients with Rombergapos;s disease and hemifacial microsomia over a 10-year period is presented. The groin free flap was used most frequently for patients with Rombergapos;s disease, whereas the scapular free flap was used for patients with hemifacial microsomia. The rectus abdominis or the latissimus dorsi free flap was chosen only when additional volume was required.

Combined maxillary and mandibular distraction osteogenesis.

Mandibular elongation by gradual distraction in patients with hemifacial microsomia is a simple and effective procedure to correct facial asymmetry. The changes in mandibular dimension result in changes in dental occlusion. These are minimal in children because of the rapid growth of the maxilla and can be corrected easily with minor orthodontic treatment.

Open randomized comparison of itraconazole versus terbinafine in onychomycosis.

Background: Onychomycoses are among the most frequent nail diseases. The principal agents are dermatophytes. Itraconazole and terbinafine are two effective and systemic antimycotics.