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261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Onychocryptosis (onyx: nail and kriptos: hidden) is the main reason for consultation due to nail pain. It is secondary to the penetration of the lateral border of the nail plate into the lateral nail fold causing pain and inflammation in the surrounding tissue. Symptoms range from erythema, edema, and pain when pressure is applied on the nail fold, up to secondary infection and functional impotence. It is a mechanical onicopathy, almost exclusively of the first toe, which recognizes multiple causes. We present the therapeutic management in children by conservative measures and the spiculectomy.
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PMID:[Onichocryptosis in pediatrics: conservative treatment and spiculectomy]. 2054 40

Interdigital intertrigo and onychomycosis has the potential cause of severe bacterial infectious complications with pain, mobility problems, abscess, erysipelas, cellulitis, fasciitis and osteomyelitis. In another hand, diabetic neuropathy, which affects 60-70% of those with diabetes mellitus, is one of the most troubling complications for persons with diabetes. These people are high suspecting to be infected by dermatophytic infections in interdigital spaces or onychomycosis witch are frequently induce damage to the stratum corneum, leading to bacterial proliferation and secondary infection. A patient presented with an asymptomatic warm, painless, erythematous swelling of the second left toe, which had been present for a few weeks. Clinically, the lesion was categorized as erysipelas upon an insidious abscess formation. Further investigation was undertaken to confirm the presence of diabetes. Leg erysipelas is a common affection which, according to various studies, has both local concomitants (interdigital intertrigo, lymphoedema, surgical antecedents) and/or general causes (immune suppression, diabetes, alcoholism, etc). Interdigital intertrigo, tinea pedis, and onychomycosis present as public health problems that could trigger serious deterioration in patient quality of life, due to complications induced by secondary bacterial infections.
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PMID:Chronic interdigital dermatophytic infection: a common lesion associated with potentially severe consequences. 2103 87

Cystic echinococcosis (CE) (hydatidosis, hydatid disease) is a zoonosis caused by the larval stage of Echinococcus granulosus, typically affecting the liver. Hepatic cystic echinococcosis (HCE) is often asymptomatic, and symptoms occur largely when complications develop. Up to one-third of HCE can be shown their complications such as rupture of the cyst, secondary infection, and anaphylactic reaction. Clinically, patients present with pain, obstructive jaundice, cholangitis, anaphylactic reaction, and shock. Early diagnosis and treatment of complications of CE must be very important, since mortality is high when obstruction of the biliary ducts occurs, leading to ascending cholangitis and septicemia, anaphylactic shock, or even life-threatening conditions.
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PMID:Diagnosis and management against the complications of human cystic echinococcosis. 2112 46

CASE DESCRIPTION-A 2-year-old female green iguana was examined for anorexia and swelling and pain on palpation in the cranial cervical area. CLINICAL FINDINGS-Marked soft tissue swelling in the cranial cervical area with corresponding cystic swellings in the pharynx were noted. The iguana was considered to be 50% under the expected body weight, given diet and husbandry conditions. The WBC count was markedly elevated, characterized by heterophilia and lymphocytosis. Surgical exploration of the cranial cervical area and histologic and microbial testing identified lymphoma with secondary infection as the cause of the swelling. TREATMENT AND OUTCOME-The tumor was initially treated with a single 10-Gy fraction of radiation directed at the masses in the neck. A vascular access port was placed in the ventral abdominal vein, and a canine chemotherapy protocol was modified for use in the iguana. During the course of treatment, the protocol was modified twice. At 1,008 days from the initiation of treatment, the iguana appeared to be in remission. CLINICAL RELEVANCE-To our knowledge, this is the first reported use of radiation with doxorubicin, vincristine, cyclophosphamide, and prednisone to successfully manage lymphoma in a reptile. A vascular access port was used effectively for drug administration for an extended period. The doxorubicin, vincristine, cyclophosphamide, and prednisone protocol appeared to be safe and effective in this iguana for the management of lymphoma.
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PMID:Diagnosis and management of lymphoma in a green iguana (Iguana iguana). 2196 40

Bisphosphonates are used worldwide as a successful treatment for people with osteoporosis, which is the major underlying cause of fractures in postmenopausal women and older adults. These agents are successful at increasing bone mass and bone trabecular thickness, decreasing the risk of fracture, and decreasing bone pain, enabling individuals to have better quality of life. Bisphosphonates are also used to treat multiple myeloma, bone metastasis, and Paget's disease; however, bisphosphonate treatment may result in negative side effects, including osteonecrosis of the jaw (ONJ). ONJ involves necrotic, exposed bone in the jaw, pain, possible secondary infection, swelling, painful lesions, and various dysesthesias, although less-severe cases may be asymptomatic. First-generation bisphosphonates, which do not contain nitrogen, are metabolized into a nonfunctional, cytotoxic analogue of adenosine triphosphate and cause osteoclast death by starvation. Second-generation bisphosphonates are nitrogen-containing agents; these inhibit osteoclast vesicular trafficking, membrane ruffling, morphology, and cytoskeletal arrangement by inhibiting farnesyl diphosphate synthase in the mevalonate pathway. Physicians treating older adults with osteoporosis and cancer should work together with dental practitioners, pharmacists, and other clinicians to inform individuals receiving bisphosphonates of their possible side effects and to suggest precautionary steps that may minimize the risk of osteonecrosis, particularly of the jaw. These include practicing good oral hygiene; scheduling regular dental examinations and cleanings; and cautioning people who are scheduling treatment for periodontal disease, oral and maxillofacial therapy, endodontics, implant placement, restorative dentistry, and prosthodontics. Recommendations for management of people with ONJ include an oral rinse, such as chlorhexidine, and antibiotics.
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PMID:Bisphosphonates and osteonecrosis of the jaw. 2209 98

A 56-year-old white man presented with a lesion on the right shoulder. The lesion developed during a short period and recently became irritated with occasional bleeding and mild pruritus. The patient denied pain. Medical history included melanoma, nonmelanoma skin cancer, diabetes mellitus type II, hyperlipidemia, multinodular thyroid goiter, and obesity. Medications and family and social history were noncontributory. Review of systems was negative. Examination revealed a slightly raised, friable yellow-pink waxy plaque located on the right shoulder (Figure 1). There was no evidence of excoriation, secondary infection, drainage, scale, crust, atrophy, lichenification, or telangiectasia. The patient had no mucosal or nail changes and the remainder of his skin examination was normal. A shave biopsy on the right shoulder revealed a nodular deposit of homogenous eosinophilic material associated with extravasated erythrocytes within the dermis. An infiltrate of lymphocytes and plasma cells was associated with the deposits. Immunohistochemical stains revealed positive plasma cells with kappa light chain and negative with lambda light chain. Congo red stain was positive and supported the diagnosis. The findings were consistent with nodular cutaneous amyloidosis (NCA) of the amyloid light-type. Initial work-up included referrals to hematology/oncology and to general surgery. The patient had a complete blood cell count (CBC), complete metabolic profile (CMP), serum protein electrophoresis (S-PEP), urine protein electrophoresis (U-PEP), 24-hour urine creatinine clearance, and protein, serum immunoglobulins and 132 microglobulin. These were all within normal limits. Abdominal/pelvic computed tomography and positron emission tomography scan also were within normal limits. Bone marrow biopsy showed no abnormalities. The patient underwent both an abdominal fat pad biopsy as well as a colonoscopy with rectal biopsy. Both were negative for amyloidosis. Initially, the patient's cutaneous amyloidosis remained localized and mild pruritus was controlled with low potency topical steroids. The patient was closely monitored by hematology/oncology and general surgery on a biannual basis to assess the possibility of progression to systemic amyloidosis. Over the course of the subsequent two years, the patient developed multiple similar lesions across the back, shoulders, and chest, which were biopsied and found to be consistent with NCA. Progression of the cutaneous nodules led to disfiguring, painful, and friable pink to yellow waxy papules coalescing into plaques with obvious hemorrhage diffusely over the trunk (Figure 2). In lieu of the painful and disfiguring progression of disease, the patient desired a more aggressive treatment plan. At present, the treatment option recommended to the patient is carbon dioxide laser ablation. Hematology/oncology recommendation consists of a general systemic amyloid reevaluation annually, including CBC, CMP, S-PEP, U-PEP, 24-hour urine collection with creatinine clearance, and history and physical examination.
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PMID:Nodular cutaneous amyloidosis. 2216 48

Bronchogenic cysts are congenital. They are typically discovered in infancy or early childhood. Secondary infection of the cyst is uncommon. We present the case of a 17-year-old female who presented to the emergency department with intermediate onset of upper abdominal, and retrosternal chest pain and fever. Subsequent X-ray and computerised tomography scan showed a bronchogenic cyst. The patient underwent subacute thoracotomy where a bronchogenic cyst filled with pus was located and excised. Bronchogenic cysts can be a rare cause of retrosternal pain.
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PMID:Infected bronchogenic cyst causing dysphagia and retrosternal pain. 2258 76

This study evaluated the performance of an upgrading of the micro-marsupialisation technique for the management of mucus extravasation or retention phenomena. This study presents a prospective case series of management of ranulas and mucoceles, with a follow-up ranging from 6 to 18 months. Data included the age and gender of patients, as well as the type, size, and site of lesions, and number of punctures. The treatment performance was evaluated according to: postoperative pain, oedema, secondary infection, clinical healing, retreatment, and recurrence of the lesions. All patients showed clinical healing of the lesions within 30 days after the micro-marsupialisation technique. None of patients presented a recurrence or required retreatment, there was no oedema or infection. No pain, or mild pain was reported by the majority of patients (58.81%). Micro-marsupialisation proved to be a simple, low cost, relatively non-invasive, painless, effective, and low recurrence technique to treat mucus extravasation or retention phenomena. Micro-marsupialisation can be recommended primarily to treat oral ranulas and selected mucoceles.
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PMID:Upgrading of the micro-marsupialisation technique for the management of mucus extravasation or retention phenomena. 2261 11

Cryosurgery is a method of achieving lesion destruction by rapid freezing in situ. Application of cryosurgery in medicine widespread and its use within dentistry is also well documented, using both open and closed liquid nitrogen and carbon dioxide. The major advantages of oral cryosurgery include bloodless treatment, very low incidence of secondary infection, and a relative lack of scarring and pain. This review outlines knowledge on the mechanisms, tissue response, and current practices of cryosurgery in the oral and peri-oral region. More experimental studies are needed to better understand this important modality at cellular and molecular levels. Inconsistency in the current protocols used for the treatment of the oral lesions is evident. Additional studies are needed to define the treatment protocols for different types of oral lesions. Information on the cryogen type and dose and the delivery technique required would help to produce reproducible outcomes for the treatment of targeted lesions.
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PMID:Cryosurgery of the oral and peri-oral region: a literature review of the mechanism, tissue response, and clinical applications. 2300 38

Chronic and acute infected wounds can pose a major clinical problem because of associated complications and slow healing. In addition to classic preparations for wound treatment, an array of modern dressings for chronic wound care are currently available on the market. These dressings are intended for the wounds due to intralesional physiological, pathophysiological and pathological causes and which failed to heal as expected upon the use of standard procedures. Classic materials such as gauze and bandage are now considered obsolete and of just historical relevance because modern materials employed in wound treatment, such as moisture, warmth and appropriate pH are known to ensure optimal conditions for wound healing. Modern wound dressings absorb wound discharge, reduce bacterial contamination, while protecting wound surrounding from secondary infection and preventing transfer of infection from the surrounding area onto the wound surface. The use of modern wound dressings is only justified when the cause of wound development has been established or chronic wound due to the underlying disease has been diagnosed. Wound dressing is chosen according to wound characteristics and by experience. We believe that the main advantages of modern wound dressings versus classic materials include more efficient wound cleaning, simpler placement of the dressing, reduced pain to touch, decreased sticking to the wound surface, and increased capacity of absorbing wound exudate. Modern wound dressings accelerate the formation of granulation tissue, reduce the length of possible hospital stay and facilitate personnel work. Thus, the overall cost of treatment is reduced, although the price of modern wound dressings is higher than that of classic materials. All types of modern wound dressings, their characteristics and indications for use are described.
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PMID:[Application of modern wound dressings in the treatment of chronic wounds]. 2319 24


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