First Necrotizing Fasciitis Caused by Serotype a.

Necrotizing fasciitis (NF) is an infrequently encountered skin infection that has high morbidity and mortality, even with prompt medical and surgical intervention. We describe the case of a 67-year-old male presenting with significant NF in his left lower extremity, despite aggressive surgical intervention, and included multiple surgical debridements, ACell Matrix, split-thickness, and negative wound VAC therapy. Ultimately, this patient required a below the knee amputation.

Double Cystic Duct in a Septated Gallbladder.

Double cystic duct in a single gallbladder is one of the least common variances encountered in the biliary system. This article presents a 54-year-old man who had a septated gallbladder with 2 separate cystic ducts. With intraoperative cholangiogram, he had successful laparoscopic cholecystectomy without any ductal injuries or complications.

Effect of Sleeve Gastrectomy Plus Side-to-Side Jejunoileal Anastomosis for Type 2 Diabetes Control in an Obese Rat Model.

Background: Sleeve gastrectomy plus side-to-side jejunoileal anastomosis (JI-SG), a relatively new approach to bariatric surgeries, has shown promising results for treating obesity and metabolic comorbidities. This study investigated the feasibility and safety of JI-SG in weight loss and diabetes remission compared with sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB).

Methods: Forty 10-week-old male Zucker diabetic fatty rats were randomly assigned to four groups: control, SG, JI-SG, and RYGB.

Intermittent left bundle branch block: an overlooked cause of electrocardiographic changes that mimic high-grade stenosis of the left anterior descending coronary artery.

Context: The electrocardiographic (ECG) pattern of high-grade stenosis of the left anterior descending coronary artery (LAD) is important clinically because of the high risk of myocardial infarction and cardiac death if the pattern is not recognized. Although the recognition of this pattern is currently widespread, false-positive ECG changes that mimic this pattern are infrequently reported.

Objective: To demonstrate that ECG changes from intermittent left bundle branch block (LBBB) and cardiac memory can mimic anterior ischemia.

Is there a true concern regarding the use of hair dye and malignancy development?: a review of the epidemiological evidence relating personal hair dye use to the risk of malignancy.

Many advances in the cosmetic industry have increased our ability to enhance youth and beauty. Hair-coloring products are one such innovation. Over the past several decades, a significant amount of work has been dedicated to understanding the possible long-term side effects associated with hair-dye use, specifically looking at cancer risk.

An update on the presence of psychiatric comorbidities in acne patients, part 1: overview of prevalence.

Acne vulgaris (AV) is a chronic inflammatory skin disease that affects millions of people. Psychologic disorders such as depression, anxiety, and body dysmorphic disorder (BDD) are common in patients with AV This article in a 2-part series provides a review of the rates of general psychologic comorbidity, depression, anxiety, and BDD.

Muir-torre syndrome: a case report.

Muir-Torre syndrome is an autosomal dominant genodermatosis associated with sebaceous neoplasms and visceral malignancies. Characteristic sebaceous neoplasms include sebaceous adenoma, sebaceous carcinoma, sebaceoma, and keratoacanthoma with sebaceous differentiation. The most common visceral malignancies are colorectal and genitourinary tumors.

Late-onset focal dermal elastosis: a case report and review of the literature.

Late-onset focal dermal elastosis is a condition characterized by a localized increase in healthy-appearing elastic tissue in the mid and deep reticular dermis. The condition may clinically mimic pseudoxanthoma elasticum (PXE) and linear focal elastosis. We report a case of an 87-year-old woman who presented with a markedly thickened, yellow, pruritic plaque on the posterior neck and discuss the clinical and histopathologic distinctions between late-onset focal dermal elastosis, PXE, and linear focal elastosis.

Peripartum heart failure caused by left ventricular diastolic dysfunction.

Peripartum cardiomyopathy (PPCM) is a rare but serious cause of heart failure occurring in the last month of pregnancy or the first 5 months postpartum. The current definition of PPCM only includes patients with left ventricular systolic dysfunction. The authors present a case of peripartum heart failure with normal ejection fraction and raise the possibility that the definition of PPCM be expanded to include left ventricular diastolic dysfunction.

Brooke-Spiegler syndrome with associated pegged teeth.

The occurrence of cylindromas, trichoepitheliomas, and spiradenomas completes the triad for Brooke-Spiegler syndrome (BSS). This combination represents a rare genetic syndrome with tumors expressing adnexal differentiation. Malignant transformation is rare but reported, and surgical excision is warranted to prevent turban tumor formation of the scalp.

Acquired periungual fibrokeratoma: a case report.

Acquired periungual fibrokeratoma (APF) is an uncommon lesion located around the nail and related to acquired digital fibrokeratoma. Histologic features of APF include a core of thick collagen bundles oriented along the longitudinal axis of the tumor and a very characteristic pseudo-nail plate formation. Different terms have been used to describe these lesions, and there has been no consensus on the terminology for some years.

Resident attitudes regarding the impact of the 80-duty-hours work standards.

The authors report on results from a survey assessing the attitudes of medical residents toward the American Osteopathic Association and the Accreditation Council for Graduate Medical Education duty-hour standards that became effective for all accredited residency programs on July 1, 2003. Data were gathered from 128 residents in four medical specialties: family medicine, general surgery, internal medicine, and obstetrics and gynecology. Participating residents worked at four teaching hospitals with allopathic, osteopathic, or dual-accredited programs.

Reasons for student debt during medical education: a Michigan study.

The authors address the need for a better understanding of the reasons for greater indebtedness among today's osteopathic medical students. In May 2000, a survey was mailed to all 219 osteopathic interns at participating institutions in Michigan. The self-administered survey contained 19 questions designed to gather basic financial information, demographic characteristics, and subjective perceptions of student debt loads from participating interns.