Abdominal ultrasound in amazonian manatee (Trichechus inunguis) (Natterer, 1883)

Morphophysiological species researches are fundamental, and diagnostic imaging is an excellent technique, already used in wild animals, with great application, not invasive and provide real-time information of each body. Amazonian manatees are on the list of endangered animals classified in the vulnerable category and knowledge of the normal pattern of ultrasound anatomy of organs and tissues is important for the maintenance and well-being of captive specimens contributing to reintroduction actions. The objective of the study was to standardize the examination technique and describe the ultrasound findings of the liver, gallbladder, stomach, urinary bladder and the subcutaneous tissue of the abdominal region in Trichechus inunguis, in order to contribute with the anatomical and sonographic knowledge and assist in the diagnosis and prognosis diseases. The study used 18 animals to describe the normal sonographic anatomy in the abdominal cavity of the Amazonian manatee. During abdominal scan, it was possible to visualize the features of the liver, gallbladder, stomach, urinary bladder obtained satisfactory results in this study. Therefore, other structures were not primarily identified by the reduced time, lots of fat and gases in intestines of animals.

WSES/GAIS/WSIS/SIS-E/AAST global clinical pathways for patients with skin and soft tissue infections

Skin and soft-tissue infections (SSTIs) encompass a variety of pathological conditions that involve the skin and underlying subcutaneous tissue, fascia, or muscle, ranging from simple superficial infections to severe necrotizing infections.Together, the World Society of Emergency Surgery, the Global Alliance for Infections in Surgery, the Surgical Infection Society-Europe, The World Surgical Infection Society, and the American Association for the Surgery of Trauma have jointly completed an international multi-society document to promote global standards of care in SSTIs guiding clinicians by describing reasonable approaches to the management of SSTIs.An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting evidence was shared by an international task force with different clinical backgrounds.

Cervical Necrotizing Fasciitis: An Uncommon Fulminant Disease Entity

Cervical necrotizing fasciitis is an uncommon fulminant disease of single or polymicrobial infectious origin characterized by rapid necrosis of the subcutaneous tissue and fasciae. The disease has high mortality rate. Early identification, timely surgical debridement, broad spectrum antibiotic therapy, aggressive wound care and intensive medical care of the patient are of paramount importance for better prognosis. We present a case report and review of literature of cervical necrotizing fasciitis with a thorough insight into its epidemiology, etiology, pathogenesis, diagnosis and management.

Idiopathic calcinosis cutis of the right iliac region: Common lesion at uncommon

Calcinosis cutis is an uncommon soft tissue lesion characterized by the deposition of calcium salts in the skin or subcutaneous tissue attributed to a wide variety of causes. We present a case of idiopathic calcinosis cutis in an adult male, who presented with a swelling in the right iliac region. Chalky white aspirate and amorphous basophilic granular material on microscopy suggestive of calcium deposits were noted. Histopathological examination of the excised mass coupled with appropriate clinical background led to the final diagnosis of idiopathic calcinosis cutis. We present this case with a complete diagnostic workup to undermine the importance of considering this lesion in the differential diagnoses of a subcutaneous hard lump in an otherwise healthy patient.

Concomitant spinal dural arteriovenous fistula and nodular fasciitis in an adolescent: case report

Background Spinal dural arteriovenous fistula (SDAVF) usually occurs during the 4th to 6th decades of life, and adolescent SDAVF is rarely reported. SDAVF arising around a tumor is also rare, and reported tumors are mostly schwannoma and lipoma. Case presentation We reported a 16-year-old male presented with progressive weakness and numbness of lower limbs for 3 months. A SDAVF was found, which was fed by right radicular arteries from segmental artery at L2 level and drained retrogradely into perimedullary veins. A concomitant spinal extradural nodular fasciitis at right L1/L2 intervertebral foramen was also noted. The SDAVF was completely obliterated by endovascular treatment and the tumor was debulked. The patient recovered well after the procedures. Conclusions Our case report suggests SDAVF can occur in adolescent. The concomitant presence with a nodular fasciitis indicates that although it usually arises in subcutaneous tissue but can rarely form on the dura of spine.

Microdosing as a Potential Tool to Enhance Clinical Development of Novel Antibiotics: A Tissue and Plasma PK Feasibility Study with Ciprofloxacin

Background and Objective In microdose studies, drug pharmacokinetics is measured in humans after administration of subtherapeutic doses. While previous microdose studies focused primarily on plasma pharmacokinetics, we set out to evaluate the feasibility of microdosing for a pharmacokinetic assessment in subcutaneous tissue and epithelial lining fluid. Methods Healthy subjects received a single intravenous bolus injection of a microdose of [14C]ciprofloxacin (1.1 µg, 7 kBq) with (cohort A, n = 9) or without (cohort B, n = 9) a prior intravenous infusion of a therapeutic dose of unlabeled ciprofloxacin (400 mg). Microdialysis and bronchoalveolar lavage were applied for determination of subcutaneous and intrapulmonary drug concentrations. Microdose [14C]ciprofloxacin was quantified by accelerator mass spectrometry and therapeutic-dose ciprofloxacin by liquid chromatography–tandem mass spectrometry. Results The pharmacokinetics of therapeutic-dose ciprofloxacin (cohort A) in plasma, subcutaneous tissue, and epithelial lining fluid was in accordance with previous data. In plasma and subcutaneous tissue, the dose-adjusted area under the concentration–time curve of microdose ciprofloxacin was similar in cohorts A and B and within an 0.8-fold to 1.1-fold range of the area under the concentration–time curve of therapeutic-dose ciprofloxacin. Penetration of microdose ciprofloxacin into subcutaneous tissue was similar in cohorts A and B and comparable to that of therapeutic-dose ciprofloxacin with subcutaneous tissue-to-plasma area under the concentration–time curve ratios of 0.44, 0.44, and 0.38, respectively. Penetration of microdose ciprofloxacin into epithelial lining fluid was highly variable and failed to predict the epithelial lining fluid penetration of therapeutic-dose ciprofloxacin. Conclusions Our study confirms the feasibility of microdosing for pharmacokinetic measurements in plasma and subcutaneous tissue. Microdosing combined with microdialysis is a potentially useful tool in clinical antimicrobial drug development, but its applicability for the assessment of pulmonary pharmacokinetics with bronchoalveolar lavage requires further studies. Clinical Trial Registration ClinicalTrials.gov NCT03177720 (registered 6 June, 2017).

ANALYSIS OF SKIN DISEASE INFECTION AFTER THE PALU EARTHQUAKE USING BINARY LOGISTIC REGRESSION

The incidence of skin disease in Indonesia is still relatively high and is a significant problem. This is evidenced by the 2010 Indonesian Health Profile data which shows that skin and subcutaneous tissue diseases are the third rank of the 10 most common diseases among outpatients in hospitals throughout Indonesia. Skin disease is growing, as evidenced by data from the Indonesian Ministry of Health, the prevalence of skin disease throughout Indonesia in 2012 was 8.46%, then increased in 2013 by 9 %. Palu City is an area that has a high skin disease problem. According to the 2016 BPS of Palu City, skin diseases are among the top 10 diseases in Palu City with a total of 11,363 sufferers. The method used in this research is binary logistic regression. Based on the analysis that has been done, it can be concluded that the best model is formed as follows:. Based on the best model, it is found that the factors that influence the transmission of skin diseases after the Palu earthquake are genetic factors.

Clinical Presentation and Outcomes of Surgery for Upper Extremity Lipomas

Background. Lipomas are benign neoplasms arising from fat tissue, with an incidence in the upper extremity of 1%-3,8%. There is scarce literature on the outcomes of the treatment of lipomas in this region. The objective of this study was to assess clinical manifestations and outcomes of surgery for upper extremity lipomas. Material and methods. The sample comprised 40 patients, including 26 women (65%) and 14 men (35%), at a mean age of 37 years, with lipomas located in the upper limbs. Treatment outcomes were assessed at a mean of 4.2 years after surgery in 27 patients from this group. Results. Most of the tumours (29 cases, 73%) were located in the forearm and arm, with 11 patients (27%) presenting with lipomas of the metacarpus and wrist. In 35 patients (87%), lesions were located superficially, within subcutaneous tissue, whereas in 5 (13%) they were located more deeply, in the metacarpus and in the forearm muscles. The follow-up assessment was conducted as telephone interviews in 27 patients. No recurrence was noted. Seven patients (26%) complained of mild tenderness of the postoperative scar. Conclusions. 1. Lipomas are moderately frequent benign lesions occurring in the upper limb. 2. Surgical treat­ment is effective and the recurrence rate is very low.

Contextualizing adverse event following immunization data of coronavirus disease 2019 (COVID-19) vaccines in VigiAccess: An approach for reducing COVID-19 vaccine hesitancy

IntroductionVaccination features high among the public health interventions that have contributed significantly to global health. Following the March 2020 declaration by the World Health Organization that coronavirus 2019 (COVID-19) is a global pandemic, several vaccines have been developed and administered to curb the spread of COVID-19. One of the threats to attaining adequate vaccination uptake for these relatively new vaccines are concerns people have about the adverse event following immunization (AEFI) information. This study sought to assess AEFIs reported on COVID-19 vaccines approved for use so far in VigiAccess and to make a case for why AEFIs data in the database must be interpreted with caution.MethodsThe study followed a cross-sectional quantitative study design. VigiAccess was searched on November 10, 2021 for AEFIs reported so far for all the 12 approved COVID-19 vaccines. Data were captured among age groups, sex and continents of the world. Descriptive data were summarized using tables. Frequencies and percentages were used to categorize descriptive variables. No ethical approval was obtained before the commencement of the study as this was essentially a secondary data analysis of AEFI reports which cannot be linked to any individual. Consequently, there was no need for the informed consent process.ResultsOverall, 2,457,386 AEFIs had been reported in VigiAccess. AEFIs were found to be highest among the 18-44 age group (39.7%) and lowest in vaccine recipients below 12 years (0.1%). AEFIs were more common in females than male vaccine recipients with over two-thirds of the vaccine recipients being females. Among the continents of the world, AEFI reports were highest for Europe (50%) and lowest for Africa (3%). The top 10 commonly reported AEFI types were as follows: general disorders and vaccine administrative site conditions (1,481,549, 60.1%), nervous system disorders (1,046,928, 42.6%), musculoskeletal and connective tissue disorders (704,657, 28.6%), gastrointestinal disorders (495,997, 20.2%), investigations with undesirable outcomes (341,677, 13.9%), skin and subcutaneous tissue disorders (335,932, 13.6%), respiratory, thoracic and mediastinal disorders (262,158, 10.6%), infections and infestations (180,873, 7.3%), vascular disorders (132,533, 5.3%) and injury, poisoning and procedural complications (122,519, 5%).ConclusionThe study showed that over 2 million COVID-19 AEFIs were spontaneously reported in VigiAccess, however, no causal relationships could be established between the vaccines and the AEFIs. The public accessing VigiAccess data should be made aware of this lack of association so that they may make well informed health decisions.