Vasc Med 2017 Jun 1:1358863X17714884. Epub 2017 Jun 1.

Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (Lymphoedèmes Primaires), Hôpital Cognacq-Jay, Paris, France.

Lymphedema, a chronic debilitating disease, is not always easily diagnosed. A total of 254 new patients ((217 women, 37 men), median (Q1-Q3) age 61 (46-72) years) were referred for suspected limb lymphedema to an exclusively lymphedema-dedicated department for a first consultation (January - March 2015) were included; among 118 with upper limb involvement, 100 (84.7%) were diagnosed with post-breast cancer therapy and four with primary lymphedemas; among 136 with lower limb involvement, 31 (22. Read More

Cochrane Database Syst Rev 2017 Jun 20;6:CD009758. Epub 2017 Jun 20.

Department of Dermatology, Beilinson Hospital, Rabin Medical Center, 39 Jabotinski Street, Petah Tikva, Israel, 49100.

Background: Erysipelas and cellulitis (hereafter referred to as 'cellulitis') are common bacterial skin infections usually affecting the lower extremities. Despite their burden of morbidity, the evidence for different prevention strategies is unclear.

Objectives: To assess the beneficial and adverse effects of antibiotic prophylaxis or other prophylactic interventions for the prevention of recurrent episodes of cellulitis in adults aged over 16. Read More

BMJ Case Rep 2017 Jun 18;2017. Epub 2017 Jun 18.

Department of Urology, Austin Hospital, Heidelberg, Victoria, Australia.

An 81-year-old man from rural Australia presented with right pretibial cellulitis 7 days after minor trauma against furniture. He failed to improve despite antibiotics and surgical debridement. Subsequent cultures grew the rare fungus Saksenaea vasiformis, which was treated with further surgical debridement, amphotericin B and posaconazole. Read More

BMC Vet Res 2017 Jun 19;13(1):183. Epub 2017 Jun 19.

Department of Clinical Sciences, ENVT, University of Toulouse, 31076, Toulouse, France.

Background: Among coagulation disorders, primary fibrinogen deficiency is very rare in dogs. It is divided into hypofibrinogenemia, afibrinogenemia and dysfibrinogenemia. Afibrinogenemia has been described in three dogs. Read More

J Med Case Rep 2017 Jun 20;11(1):164. Epub 2017 Jun 20.

Eye Clinic, Melegnano Hospital, Vizzolo Predabissi, Milan, Italy.

Background: This case illustrates the importance of prompt assessment and treatment of orbital cellulitis. In fact the ocular signs and symptoms may be associated with systemic complications which should be investigated and identified as soon as possible to avoid a poor prognosis.

Case Presentation: A 46-year-old white woman presented to our emergency room with proptosis, ophthalmoplegia, and conjunctival chemosis of her left eye. Read More

Emerg Infect Dis 2017 Jul;23(7):1118-1123

Little is known about concurrent infection with hepatitis C virus (HCV) and Streptococcus pneumoniae, which causes invasive pneumococcal disease (IPD). We hypothesized that co-infection with HCV and S. pneumoniae would increase risk for death and complications. Read More

J Oral Maxillofac Surg 2017 May 24. Epub 2017 May 24.

Associate Professor, Department of Orthodontics, University of Florida College of Dentistry, Gainesville, FL. Electronic address:

Purpose: The purpose of this study was to evaluate the early postoperative complications related to tracheotomy performed by surgeons and residents in the Department of Oral and Maxillofacial Surgery (OMS) at the University of Florida College of Dentistry (UFCD; Gainesville, FL). The authors hypothesized that complications with this surgical technique would be substantially different among the different medical diagnoses of these patients and the number of complications would positively correlate with the American Society of Anesthesiologists (ASA) physical status classification.

Patients And Methods: The authors implemented a retrospective study of all patients who underwent a tracheotomy procedure by the UFCD OMS department from July 2011 through March 2015. Read More

Am J Obstet Gynecol 2017 Jun 12. Epub 2017 Jun 12.

Division of Gynecologic Oncology, Obstetrics, Gynecology and Women's Health Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, USA, 44195.

Background: Single port laparoscopy has gained popularity within minimally invasive gynecologic surgery for its feasibility, cosmetic outcomes and safety. However, within gynecologic oncology, there is limited data regarding short-term adverse outcomes and long term hernia risk in patients undergoing single port laparoscopic surgery.

Objective: To describe short-term outcomes and hernia rates in patients after single port laparoscopy in a gynecologic oncology practice. Read More

Biomedicine (Taipei) 2017 Jun 14;7(2):14. Epub 2017 Jun 14.

Department of Family Medicine, China Medical University Hospital, Taichung 404, Taiwan - Department of Family Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan.

In the hospice ward where patients are in the terminal stages of cancer, it is common practice to give them a subcutaneous injection of pain relievers to reduce their pain and make them more comfortable. Most of these patients are elderly and have low blood pressure or poor veins, which often makes it difficult to inject them because of the calcification at previous injection sites. Thus, subcutaneous injections are a convenient way to maintain analgesia and patient comfort. Read More

West J Emerg Med 2017 Jun 15;18(4):761-769. Epub 2017 May 15.

University of California, San Diego, Department of Emergency Medicine, San Diego, California.

Introduction: The study objective was to explore emergency physicians' (EP) awareness, willingness, and prior experience regarding transitioning patients to home-based healthcare following emergency department (ED) evaluation and treatment; and to explore patient selection criteria, processes, and services that would facilitate use of home-based healthcare as an alternative to hospitalization.

Methods: We provided a five-question survey to 52 EPs, gauging previous experience referring patients to home-based healthcare, patient selection, and motivators and challenges when considering home-based options as an alternative to admission. In addition, we conducted three focus groups and four interviews. Read More

West J Emerg Med 2017 Jun 12;18(4):684-689. Epub 2017 May 12.

Arrowhead Regional Medical Center, Department of Emergency Medicine, Colton, California.

Introduction: Necrotizing fasciitis (NF) is an uncommon but rapidly progressive infection that results in gross morbidity and mortality if not treated in its early stages. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score is used to distinguish NF from other soft tissue infections such as cellulitis or abscess. This study analyzed the ability of the LRINEC score to accurately rule out NF in patients who were confirmed to have cellulitis, as well as the capability to differentiate cellulitis from NF. Read More

BMC Infect Dis 2017 Jun 13;17(1):424. Epub 2017 Jun 13.

Center of Excellence for Chang Gung Research Datalink, Chang Gung Memorial Hospital, Chiayi, Taiwan.

Background: Uremia is likely a risk factor for deep neck infection (DNI). However, only a few relevant cases have been reported, and evidence sufficient to support this hypothesis is lacking. The aim of the study is to investigate the effects of end-stage renal disease (ESRD) on DNI. Read More

Eur Arch Otorhinolaryngol 2017 Jun 12. Epub 2017 Jun 12.

Department of Otorhinolaryngology-Head and Neck Surgery, Bakırköy Dr.Sadi Konuk Training and Research Hospital, Zuhuratbaba Mah. Tevfik Sağlam Cad. No: 11, Bakırköy, Istanbul, Turkey.

Vitamin D deficiency is effective in the development of acute rhinosinusitis and prolongation of inflammation by increasing inflammation in the sinonasal epithelium. Vitamin D deficiency is important in the development of bone barriers that prevent the complication of acute rhinosinusitis. Although Vitamin D levels may be a variable risk factor for various respiratory tract disorders, there are limited data on the role in sinonasal infections. Read More

BMC Infect Dis 2017 Jun 12;17(1):418. Epub 2017 Jun 12.

Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Old Road Campus, University of Oxford, Oxford, OX3 7BN, UK.

Background: Cellulitis is a common infection of the skin and subcutaneous tissues. It is associated with significant morbidity from necrosectomies and amputations especially in sub-Saharan Africa. We aimed at identifying the risk factors and burden of lower limb cellulitis to inform preventive strategies in Cameroon. Read More

Aust N Z J Psychiatry 2017 Jun 1:4867417710732. Epub 2017 Jun 1.

1 School of Psychiatry, UNSW Sydney, Sydney, NSW, Australia.

Am J Obstet Gynecol 2017 Jun 7. Epub 2017 Jun 7.

Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, MO.

Background: A number of evidence-based interventions have been proposed to reduce post cesarean wound complications. Examples of such interventions include appropriate timing of preoperative antibiotics, appropriate choice of skin antisepsis, closure of the subcutaneous layer if subcutaneous depth is ≥ 2 cm, and subcuticular skin closure with suture rather than staples. However, the collective impact of these measures is unclear. Read More

Acta Biochim Pol 2017 9;64(2):207-213. Epub 2017 Jun 9.

Department of Biotechnology, P D Patel Institute of Applied Sciences, Charotar University of Science and Technology (CHARUSAT), Changa-388421, India.

Clostridium perfringens (MTCC 1349) is a Gram-positive, anaerobic, endospore forming, and rod-shaped bacterium. This bacterium produces a variety of toxins under strict anaerobic environment. C. Read More

Orthopedics 2017 Jun 9:1-4. Epub 2017 Jun 9.

Wound closure in primary knee arthroplasty is important both for surgical success, by minimizing the risk of wound complications and infection, and for patient satisfaction with wound care and cosmesis. This article reports the use of a topical self-adhering, pressure-sensitive polyester mesh combined with 2-octyl cyanoacrylate adhesive for final skin closure of primary knee arthroplasty without external staples or sutures. During a 2. Read More

PLoS One 2017 8;12(6):e0178941. Epub 2017 Jun 8.

Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.

More than 90% of head and neck infections are caused by pathological changes originating in the teeth. When odontogenic infections are not properly treated, infections may spread to distant spaces and cause more serious infections in fascial spaces, ultimately leading to deep neck infections. Clinical experience has indicated that patients with diabetes mellitus (DM) may be more susceptible to facial cellulitis and deep neck infections caused by odontogenic infections. Read More

Ann Surg 2017 Jun 7. Epub 2017 Jun 7.

*Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University of Heidelberg, BG Trauma Center Ludwigshafen, Heidelberg, Germany †Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Linkou, Tauyuan, Taiwan ‡Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, Tauyuan, Taiwan.

Objective: This study investigated the outcome of lymphedema microsurgery with or without microsurgical breast reconstruction for breast cancer-related lymphedema (BCRL).

Background: Complete decongestive therapy, lymphovenous anastomosis, and vascularized lymph node flap transfer are the 3 major treatment modalities for BCRL. Releasing axillary contracture and transferring a free flap may potentially improve the BCRL. Read More

Orbit 2017 Jun 3;36(3):135-136. Epub 2017 Mar 3.

a Ophthalmology Department , Mater Misericordiae University Hospital , Dublin , Ireland.

Orbital cellulitis is a serious sight threatening and potentially life threatening condition which can be complicated by orbital abscess formation. Posterior subtenon (PST) injection of corticosteroid is commonly used in the treatment of posterior segment inflammation including post-operative macular oedema. We report a case of orbital abscess formation as a late complication of PST triamcinolone acetonide and discuss the presentation, diagnosis and management. Read More

Intern Emerg Med 2017 Jun 7. Epub 2017 Jun 7.

Infectious Diseases Unit, Hillel Yaffe Medical Center, Hashalom St., 36100, Hadera, Israel.

The objective of this study is to report the clinical course and risk factors of trunk cellulitis, to identify diagnostic and therapeutic approaches, and compare them to patients with lower limb cellulitis. Medical records of adult patients with trunk cellulitis were reviewed and compared to an equal number of randomly selected patients with lower limb cellulitis. Demographic, clinical, and laboratory data were collected and analyzed using binary univariate and multivariate logistic regression analyses. Read More

J Surg Oncol 2017 Jun 7. Epub 2017 Jun 7.

Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, Boston, Massachusetts.

Background And Objectives: Two staged tissue expander-implant with acellular dermal matrix (TE/I + ADM) and deep inferior epigastric perforator (DIEP) flap are the most common implant and autologous methods of reconstruction in the U.S. Implant-based techniques are disproportionally more popular, partially due to its presumed cost effectiveness. Read More

Eur J Clin Microbiol Infect Dis 2017 Jun 7. Epub 2017 Jun 7.

Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Centre, University of Amsterdam, Room F4-132, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.

The utility of performing blood cultures in patients with a suspected skin infection is debated. We investigated the association between blood culture positivity rates and patients' clinical condition, including acute disease severity and comorbidity. We performed a retrospective study, including patients with cellulitis and wound infection who had been enrolled in three Dutch multicenter studies between 2011 and 2015. Read More

Mol Clin Oncol 2017 Jun 8;6(6):963-967. Epub 2017 May 8.

Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036-8562, Japan.

The aim of the present study was to investigate the early treatment outcomes of combined gemcitabine and nab-paclitaxel treatment for locally advanced unresectable pancreatic cancer (LURPC). The subjects comprised 7 patients with LURPC receiving the abovementioned combination therapy at the Hirosaki University Hospital (Hirosaki, Japan) between January and September, 2015. The clinicopathological factors, adverse events and response to treatment were investigated. Read More

Surg Neurol Int 2017 10;8:78. Epub 2017 May 10.

Department of Neurosurgery, Riverside University Health System - Medical Center, Cactus Avenue, Moreno Valley, CA, USA.

Background: Ventriculoperitoneal (VP) shunt placement is one of the most commonly performed procedures in neurosurgery. One rare complication is the formation of an abdominal pseudocyst, which can cause shunt malfunction.

Case Descriptions: We present four unique cases of abdominal pseudocyst formation. Read More

Int J Pediatr Otorhinolaryngol 2017 Apr 13;95:101-103. Epub 2017 Feb 13.

Department of Otorhinolaryngology - Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA.

Cavernous sinus thrombosis is a rare but well-documented complication of sinus disease, propagated by intracranial spread of infection via valveless veins of the midface, with facial cellulitis as an uncommon source of infection. We present a case of significant intracranial thromboses secondary to nasal dorsal abscess after trauma that was successfully treated with bedside drainage of the abscess in addition to broad-spectrum antibiotics, anticoagulation, and steroids, and remains asymptomatic with seven months follow-up. Read More

J Pediatric Infect Dis Soc 2017 Jun 1. Epub 2017 Jun 1.

Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston; and.

Background.: Periorbital and orbital cellulitis cause significant pediatric morbidity. Here, we define the clinical features of and characterize isolates from children with periorbital or orbital cellulitis caused by Staphylococcus aureus at Texas Children's Hospital in Houston. Read More

Br J Dermatol 2017 Jun 2. Epub 2017 Jun 2.

Vanderbilt University School of Nursing, Nashville, Tennessee (Ridner); Vanderbilt Ingram Cancer Center, Nashville, Tennessee.

Background: Patients with lymphedema suffer lifelong swelling and recurrent cellulitis despite use of complete decongestive therapy. Pneumatic compression devices (PCDs), including non-programmable and programmable devices that meet individual patient needs, support long term self-care in the home. Yet, to date, no direct comparison of their relative benefits has been available. Read More

Br J Community Nurs 2017 Jun;22(6):272-275

Dermatology Staff Nurse, Norfolk and Norwich University Hospital.

Saudi J Ophthalmol 2017 Apr-Jun;31(2):109-111. Epub 2017 Feb 21.

Department of Ocular Pathology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.

A previously diagnosed child of persistent hyperplastic primary vitreous (PHPV) with painless blind eye remained clinically silent for about 3 years follow-up. The child suddenly presented as a case of orbital cellulitis and panopthalmitis with meningitis. No definite mass lesion was detected on ultrasonography, magnetic resonance imaging (MRI) and positron emission tomography (PET) scan. Read More

J Glaucoma 2017 May 26. Epub 2017 May 26.

Sunderland Eye Infirmary, Sunderland, UK.

J Glaucoma 2017 May 26. Epub 2017 May 26.

Shri Ganesh Vinayak Eye Hospital, Raipur, India.

Br J Dermatol 2017 May 27. Epub 2017 May 27.

Dermatology Clinic, University of Catania, Italy.

dissecting cellulitis of the scalp (DCS) is a chronic inflammatory condition characterized by recurrent nodules, abscesses and sinus tract formation.(1-3) It usually starts as a simple folliculitis with occlusion of follicular openings mainly on the scalp vertex or nape, generally followed by perifollicular pustules and painful firm or fluctuant nodules releasing a purulent discharge, either spontaneously or after a gentle pressure. This article is protected by copyright. Read More

J Minim Invasive Gynecol 2017 May 25. Epub 2017 May 25.

Department of Obstetrics and Gynecology Kaiser Permanente San Leandro.

Study Objective: After the FDA statement warning against electronic morcellation devices, gynecologic surgeons are performing laparoscopic and robotic myomectomies with minilaparotomy incisions for tissue morcellation and removal. No data exists focusing on the superficial wound complications as a result of these larger incisions. The objective of this study is to compare the rate of wound complications for myomectomy via minilaparotomy vs laparoscopic or robotic myomectomy. Read More

J Infect Chemother 2017 May 25. Epub 2017 May 25.

Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo 192-0392, Japan. Electronic address:

The prevalence of Panton-Valentine leukocidin gene (pvl)-positive community-acquired methicillin-resistant Staphylococcus aureus USA300 clone, which is designated as the ST8-staphylococcal cassette chromosome (SCC) mec type IV (ST8-IV) lineage, is a major public health concern worldwide. Thus, to elucidate the prevalence and characteristics of pvl-positive community-onset MRSA in Japan, we conducted a molecular epidemiological analysis for 854 S. aureus isolates obtained from outpatients with skin infections during 2013 and 2014. Read More

BMJ Case Rep 2017 May 27;2017. Epub 2017 May 27.

We present a case of Vibrio vulnificus septic shock and cellulitis in a patient with chronic liver disease that occurred after obtaining a leg tattoo with subsequent seawater exposure in the Gulf of Mexico. Initial suspicion for V. vulnificus was high and he was started on empiric doxycycline and ceftriaxone at admission. Read More

Plast Reconstr Surg 2017 Jun;139(6):1300-1310

New York, N.Y. From the Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center.

Background: Nipple-sparing mastectomy permits complete preservation of the nipple-areola complex with excellent aesthetic results and with oncologic safety similar to that associated with traditional mastectomy techniques. However, outcomes have not been directly compared for tissue expander-, immediate implant-, and autologous tissue-based breast reconstruction after nipple-sparing mastectomy.

Methods: All patients undergoing nipple-sparing mastectomy from 2006 to June of 2016 were identified at a single institution. Read More

Ocul Immunol Inflamm 2017 May 24:1-3. Epub 2017 May 24.

a Department of Ophthalmology , University Hospital Centre Zagreb , Zagreb , Croatia.

Purpose: To present our experience in the management of superior ophthalmic vein thrombosis (SOVT), which is a rare, but extremely serious condition if not recognized and managed promptly and appropriately.

Methods: Two patients with septic and aseptic SOVT are presented. Clinical characteristics, radiographic features, management techniques, and outcomes are described. Read More

JAMA 2017 05;317(20):2142

JAMA 2017 May;317(20):2088-2096

Department of Emergency Medicine, Olive View-UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California2Division of Infectious Diseases, Department of Medicine, Olive View-UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California.

Importance: Emergency department visits for skin infections in the United States have increased with the emergence of methicillin-resistant Staphylococcus aureus (MRSA). For cellulitis without purulent drainage, β-hemolytic streptococci are presumed to be the predominant pathogens. It is unknown if antimicrobial regimens possessing in vitro MRSA activity provide improved outcomes compared with treatments lacking MRSA activity. Read More

JAMA 2017 05;317(20):2070-2071

Division of Infectious Diseases, Department of Internal Medicine, University of Michigan Health System, Ann Arbor2Associate Editor, JAMA.

Vestn Oftalmol 2017 ;133(2):86-91

Research Institute of Eye Diseases, 11 A,B Rossolimo St., Moscow, Russian Federation, 119021; I.M. Sechenov First Moscow State Medical University, 2, str. 4 Bol'shaya Pirogovskaya St., Moscow, Russian Federation, 119991.

Granulomatous orbital cellulitis is one of the most common ocular manifestations of granulomatosis with polyangiitis (Wegener's). The process is often refractory to conventional immunosuppressive therapy and requires a more radical treatment approach. However, surgical experience with this type of patients is limited. Read More

J Am Acad Dermatol 2017 Jun;76(6):e215-e216

Dermatology Service, Trichology Unit, Ramon y Cajal Hospital, Madrid, Spain; Trichology Unit, Grupo Pedro Jaén, Madrid, Spain.

J Am Acad Dermatol 2017 Jun;76(6):e213

Dermatology Clinic, University of Catania, Italy. Electronic address:

J Matern Fetal Neonatal Med 2017 Jun 8:1-8. Epub 2017 Jun 8.

a Obstetrics, Gynecology and Women's Health Institute , Cleveland Clinic , Cleveland , OH , USA.

Purpose: To identify the rate of surgical site infection (SSI) after Cesarean delivery (CD) and determine risk factors predictive for infection at a large academic institution.

Methods: This was a retrospective cohort study in women undergoing CD during 2013. SSIs were defined by Centers for Disease Control (CDC) criteria. Read More

Dermatology 2017 May 13. Epub 2017 May 13.

Department of Dermatology, Hofstra Northwell School of Medicine, Hempstead, NY, USA.

Background: There is substantial allocation of resources directed towards evaluation and management of lower limb cellulitis (LLC) in the acute care setting. Readmission for LLC is poorly understood, and there is little evidence with which to identify patients at risk for readmission.

Objective: To describe demographics, comorbidities, admission vital signs, and laboratory markers of infection among patients with LLC who are readmitted, and to investigate which among these factors is associated with readmission. Read More

J Allergy Clin Immunol Pract 2017 May 9. Epub 2017 May 9.

Department of Dermatology, Venereology, and Allergy, University Hospital Würzburg, Würzburg, Germany.

Background: Immediate discontinuation or replacement of suspected drugs is considered standard medical care in acute exanthematous skin reactions. In the treatment of bacterial infections, structurally different alternative antibiotics, however, are commonly second choice options due to a suboptimal antimicrobial activity or an unfavorable side effect profile. Nonetheless, "treating through," the continuation of antibiotic treatment despite an objective exanthema, is practiced only rarely. Read More

Int J Gynaecol Obstet 2017 May 11. Epub 2017 May 11.

Department of Obstetrics and Gynecology, Aultman Health Foundation, Northeast Ohio Medical University, Canton, OH, USA.

Objective: To report postoperative outcomes among patients undergoing indicated non-cosmetic panniculectomy at the time of gynecologic surgery.

Methods: Medical charts were retrospectively reviewed for patients who underwent panniculectomy coupled with gynecologic surgery at a university-affiliated hospital in the USA in 1990-2014. The data reviewed included age, body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters), surgical procedure, estimated blood loss, pathology, wound complication, diabetes, hypertension, smoking, and readmission rate. Read More