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Background: Impact of Merkel cell polyomavirus (MCPyV) associated Merkel cell carcinoma (MCC) has not been assessed in the Icelandic population, nor in a whole population elsewhere., Objectives: The primary objective was to assess trends in the incidence of MCC in Iceland and the association with MCPyV. Secondary objectives aimed to analyze MCC outcomes., Methods: In this retrospective cohort study, patients diagnosed with MCC between 1981 and 2021 were identified from the Icelandic Cancer Registry. Patients were separated into 2 groups based on MCPyV immunochemistry staining. Age-standardized incidence was calculated and Joinpoint analysis was used to assess incidence trends. A Cox proportional hazards model was used to assess survival differences between the 2 groups., Results: Overall incidence of MCC increased from 0.015 to 0.26 per 100,000 persons, though the incidence of MCPyV positive cases recently decreased while negative cases increased. MCPyV negative tumors were associated with sun exposure ( P  < .01), a history of keratinocyte carcinoma, smaller tumor size, and lower overall survival., Limitations: Even with population-level data, comprehensively investigating associations with MCC is difficult due to its rarity., Conclusion: MCPyV negative MCC tumors were associated with lower survival despite smaller tumor size. Thus, MCPyV status could be an important prognostic biomarker., Competing Interests: None disclosed., (© 2024 by the American Academy of Dermatology, Inc. Published by Elsevier Inc.)

Competing Interests: None disclosed.

Competing Interests: All authors declare that they have no commercial or other associations that might pose a conflict of interest.

Competing Interests: None disclosed.

Objective: Pacinian corpuscle hyperplasia typically presents as a tender nodule on the volar aspect of the palm or digit, often after trauma. Histologically, it presents as one to multiple normal-sized to enlarged Pacinian corpuscles in the deep dermis or subcutaneous adipose tissue. Given its rarity, its pathogenesis is debated and nomenclature is poorly defined. Herein, we present a case of Pacinian corpuscle hyperplasia and review the current literature., Methods: A literature review was conducted using PubMed with the following search terms: Pacinian corpuscle hyperplasia, Pacinian corpuscle neuroma, Pacinioma, Pacinian corpuscle hypertrophy, and heterotopic Pacinian corpuscles. All case reports and case series were reviewed for histopathologic evidence of true Pacinian corpuscle hyperplasia. Cadaveric studies, cases without true Pacinian corpuscles, and noncutaneous cases were excluded from our analysis., Results: Sixty patients with Pacinian corpuscle hyperplasia of the hands and feet (65 cases, some with >1 location) were reviewed. The mean age of presentation was 49.5 years, and women accounted for 60% of cases. Pain was the most commonly reported symptom (55 of 65 cases; 84.6%). Forty-five cases (69.2%) were localized to a digit, most commonly the second digit (17 of 65 cases; 26.2%), and 18 of 65 cases (27.6%) affected the palm, primarily the distal palm. Surgical excision was curative in 50 of 65 cases (76.9%)., Conclusion: Although relatively uncommon, Pacinian corpuscle hyperplasia should be considered in the differential diagnosis of a tender nodule on the digit or distal palm, particularly after trauma., (© 2020 Published by Elsevier Inc. on behalf of Women's Dermatologic Society.)

Objectives: Our aim was to investigate the outcome of patients with diabetes undergoing coronary artery bypass grafting (CABG) surgery in a whole population with main focus on long-term mortality and complications., Methods: This was a nationwide retrospective analysis of all patients who underwent isolated primary CABG in Iceland between 2001 and 2016. Overall survival together with the composite end point of major adverse cardiac and cerebrovascular events was compared between patients with diabetes and patients without diabetes during a median follow-up of 8.5 years. Multivariable regression analyses were used to evaluate the impact of diabetes on both short- and long-term outcomes., Results: Of a total of 2060 patients, 356 (17%) patients had diabetes. Patients with diabetes had a higher body mass index (29.9 vs 27.9 kg/m2) and more often had hypertension (83% vs 62%) and chronic kidney disease (estimated glomerular filtration rate ≤60 ml/min/1.73 m2, 21% vs 14%). Patients with diabetes had an increased risk of operative mortality [odds ratio 2.52, 95% confidence interval (CI) 1.27-4.80] when adjusted for confounders. 5-Year overall survival (85% vs 91%, P < 0.001) and 5-year freedom from major adverse cardiac and cerebrovascular events were also inferior for patients with diabetes (77% vs 82%, P < 0.001). Cox regression analysis adjusting for potential confounders showed that the diagnosis of diabetes significantly predicted all-cause mortality [hazard ratio (HR) 1.87, 95% CI 1.53-2.29] and increased risk of major adverse cardiac and cerebrovascular events (HR 1.47, 95% CI 1.23-1.75)., Conclusions: Patients with diabetes have significantly lower survival after CABG, both within 30 days and during long-term follow-up., (© The Author(s) 2020. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Foscarnet is an important antiviral medication used mainly in the treatment of complicated Herpes-simplex virus and cytomegalovirus (CMV) infections. Reported first in the 1990's, genital ulcers are a potential side effect in about 10% of cases. We report the case of a 29 year old man with acute myelogenous leukemia who was on ganciclovir for CMV prophylaxis. Three weeks after being switched to foscarnet because of neutropenia, he developed two, painful symmetric ulcers on the inferior aspect of glans penis. Viral and bacterial cultures were negative. Two weeks after stopping the infusion of foscarnet, the ulcers subsided without any additional treatment. It is important that physicians be aware of this potentially disfiguring side effect of foscarnet so that methods of prevention can be implemented early in the treatment of these patients., Competing Interests: Conflicts of interest: the authors declare no potential conflicts of interest.

Introduction The aim of this study was to evaluate the outcome of coronary artery bypass grafting (CABG) in women compared to men, with focus on short-term and long-term complications, 30 day mortality and survival. Materials and methods This was a retrospective study on all CABG patients operated in Iceland between 2001 and 2013. Clinical information was gathered from hospital charts and survival data was obtained from the National Statistics in Iceland. Overall survival was estimated with the Kaplan- Meier method. Logistic and Cox regression analysis were used to identify predictors of operative mortality and long-term survival. Mean follow-up was 6.8 years. Results Of 1755 patients 318 were women (18%). Women were on average four years older than men at the time of operation (69 vs. 65 yrs, p<0.001). Female patients had a higher incidence of hypertension (72 vs. 64%, p=0.009) and their EuroSCOREst was higher (6.1 vs. 4.3, p<0.001). The prevalence of diabetes, dyslipidemia and the extent of coronary artery disease was comparable between groups. The rate of short-term complications, both minor (53% vs. 48%, p=0.07) and major (27% vs. 32%, p=0.2), was similar and operative mortality for women was not statistically different from males (4% vs. 2%, p=0.08). Female gender was neither found to be a predictor of 30-day mortality (OR 0.99; 95%-CI: 0.98-1.01) nor survival (HR 1,08; 95%-ÖB: 0,82-1,42). Conclusions The number of women that undergo CABG is low and they are four years older than men when operated on. As is the case with men, outcome following CABG in Iceland is very good for women, their overall five-year survival being 87%.

Psoriasis vulgaris is a common, inflammatory skin disease affecting approximately 3% of the population in the United States. The etiology of psoriasis and its associated comorbidities are complex and the result of complicated interactions between the skin, immune system, disease-associated susceptibility loci, and multiple environmental triggers. The modeling of human disease in vivo through the use of murine models represents a powerful, indispensable tool for investigating the immune and genetic mechanisms contributing to a clinical disease phenotype. Nevertheless, modeling a complex, multigenic disease like psoriasis in mice has proven to be extremely challenging and is associated with significant limitations. Over the last four decades, more than 40 unique mouse models for psoriasis have been described. These models can be categorized into three major types: acute (inducible), genetically engineered (transgenic), and xenograft (humanized). The purpose of this Research Techniques Made Simple article is to provide an overview of the common types of psoriasis-like mouse models currently in use and their inherent advantages and limitations. We also highlight the need for improved psoriasis mouse model systems and several key factors to be considered as this field of laboratory science advances., (Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: Most patients that undergo coronary artery bypass grafting (CABG) are around 70 years of age when operated on. We investigated the outcome of CABG in patients 50 years and younger, focusing on early complications, operative mortality and long-term survival., Material and Method: A retrospective study on 1626 patients that underwent CABG in Iceland 2001-2012. One hundred patients aged 50 years or younger were compared to 1526 older patients., Results: The male:female ratio, risk factors and extension of coronary artery disease were comparable in both groups, as was the proportion of patients with left main disease. Left ventricular ejection fraction was significantly lower in the younger patients (52 vs. 55%, p=0.004) and more of them had a recent myocardial infarction (41 vs. 27%, p=0.003). Minor complications were less common in the younger group (30 vs. 50%, p<0.001), especially new onset atrial fibrillation (14 vs. 35%, p<0,001). Chest tube bleeding for the first 24 hours postoperatively was also less in the younger group (853 vs. 999 ml, p=0.015) and they received fewer units of packed red cells (1.3 vs. 2.8 units, p<0.001). However, the incidence of major complications was comparable (6 vs. 11%, p=0.13) and the same was true for 30 day mortality (1 vs. 3%, p=0.5). Mean hospital stay was 2 days shorter for younger patients (p<0.001). There was a non-significant trend for improved disease-specific survival for the younger patients, or 99% vs. 95% 5-year survival (p=0.07)., Conclusion: In younger patients undergoing CABG minor complications are less common than in older patients, their hospital stay is shorter and transfusions less common. There was also a trend for improved disease specific survival for the younger patients.

Introduction: Diabetes is one of the most important risk factors for coronary artery disease. Diabetics often have severe three vessel disease and coronary bypass surgery is in most cases the preferred treatment of choice in these patients. We investigated early surgical complications and outcomes in diabetic patients following isolated CABG in Iceland and compared them to those of non-diabetic patients., Materials and Methods: A retrospective study of 1626 consecutive CABG patients operated in Iceland 2001-2012. Diabetic patients were 261 (16%) and were compared to 1365 non-diabetics in terms of patient demographics, operative data, and postoperative outcomes. Logistic regression was used to identify risk factors for major complications and 30-day mortality., Results: The groups were similar in terms of age, gender and Euro-SCORE. Diabetic patients had a higher BMI (30 vs. 28 kg/m(2), p<0.001), were more likely to have hypertension (82% vs. 60%, p<0.01) and glomerular filtration rate <60 ml/min/1.73m(2) (22% vs. 15%, p=0.01). The rate of deep sternal wound infections, stroke and perioperative myo-cardial infarction was similar in both goups. Acute kidney injury, classified according to the RIFLE-criteria, was higher in diabetic patients, both in the RISK (14% vs. 9%, p=0.02) and FAILURE category (2% vs. 0.5%, p=0.01). Minor complications, (atrial fibrillation, pneumonia, urinary tract infections and superficial wound infections) were similar in both groups. 30-day mortality was 5.0% vs. 2% for diabetics and non-diabetics patients, respectively (p=0.01). Diabetes was not a significant risk factor for 30-day mortality when adjusted for other risk factors with logistic regression (OR=1.98, 95% CI 0.72-4.95)., Conclusions: Diabetic patients that underwent CABG more often suffered acute renal injury but diabetes was not an independent prognostic factor of operative mortality.