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Aim and Objective: The present study was undertaken for assessing the prevalence of recurrent aphthous stomatitis (RAS) in the North Indian population. Materials and Methods: Assessment of a total of 4255 patients was done over a period of 2 years, who came for a routine dental checkup. Recording of the complete demographic and clinical details of all the patients was done. The prevalence of RAS was assessed. Profile of patients with RAS was assessed separately. A pro forma was made and the type of treatment protocol followed by patients with RAS was also recorded. All the results were recorded in a Microsoft Excel sheet and were analyzed using SPSS software. Results: Analysis of a total of 4255 patients was done. RAS was found to be present in 800 patients. The overall prevalence of RAS was found to be 18.93%. Significant results were obtained when analyzing age, gender, and occupation as risk factors for RAS. Labial/buccal mucosa involvement occurred in 51.875% of the cases. In 44% of the cases, the size of the RAS was between 1 cm and 3 cm. Home remedy was followed in 17.875% of the cases. Conclusion: A significant proportion of patients in the North Indian population is affected by RAS. In comparison to males, females are more commonly affected. [ABSTRACT FROM AUTHOR]

Abstract We present an unusual case of a persistent solitary left palatoglossal ulcer with no history of trauma or associated risk factors. A TUGSE lesion, which mimics that of malignancy, must always be noted as a differential even in risk factor absence.

Leprosy, a chronic granulomatous disease, has been known since ages but even today continues to baffle the clinicians with a wide spectrum of clinical, histopathological, and immunological characteristics. Leprosy reactions are mainly of two types, namely, Type 1 and Type 2. In Type 1 leprosy reaction, the preexisting lesions become erythematous, edematous, and rarely ulcerate. Ulcerating Type 1 reaction is called lazarine leprosy. Ulcerations may occur in borderline tuberculoid (BT) pole or borderline lepromatous pole but more common in BT pole. In this postelimination era of leprosy, we report an interesting case report of BT Hansen's disease with Type 1 lepra reaction with ulceration, namely, lazarine leprosy.

Salvage surgery is an acceptable option for palliative treatment of thyroid bed recurrence in metastatic papillary thyroid carcinoma when other non‐invasive options fail to control local skin complications. [ABSTRACT FROM AUTHOR]

Abstract Background Diabetic foot ulceration (DFUs) is increasingly prevalent in Singapore. Appropriate management is important since DFU brings with it an associated risk for lower limb amputations, high morbidity rates and costs. Footwear prescription has been a part of clinical guidelines to manage DFUs. However, adherence to prescription footwear is typically poor amongst patients. Reasons for this have been explored in Northern American and Western European studies, but not in Singapore’s context. As cultural and climate differences limit transferability of findings from existing studies to individuals in Singapore, this study aims to explore the lived experiences of participants with diabetes using prescription footwear in Singapore. Methods This was a qualitative study using interpretative phenomenological analysis (IPA) to understand some people’s personal experience of using off the shelf prescription footwear. A total of 8 people with diabetes who received prescription footwear as part of their diabetic foot management were recruited. All participants provided written consent and took part in a semi-structured interview lasting up to an hour. Interviews were digitally recorded, transcribed and analysed using an IPA approach. Findings and discussion The analysis identified the super-ordinate themes of 1) security and 2) acceptance with sub-themes of 1.1) risk and 1.2) protection and 2.1) personal and social acceptance and 2.2) social and cultural acceptance respectively that inter-related to influence how participants’ made footwear decisions. This process of evaluation was portrayed to be a fluctuant one, making it difficult to predict yet necessary to understand. A modified seesaw model of adherence is suggested to explain this decision-making process. Conclusions The complex manner by which participants grappled with security and acceptance is often overlooked when footwear is prescribed, highlighting a need for a more collaborative clinician-patient partnership for these issues to surface in clinical practice. Furthermore, prescription footwear should be seen more holistically. Empowering patients with choice to select from a range of therapeutic yet normalised footwear could increase the level of security and acceptance they experience with its use.

We report two unrelated infants who presented with orolabial ulcerations as a presenting manifestation of neonatal lupus erythematosus (NLE). Subsequent positive anti‐SSA/SSB titers confirmed the diagnosis. In both infants, the ulcerations were painless and spontaneously resolved. NLE should be included in the differential diagnosis of orolabial ulcerations in the newborn, especially since mothers of affected infants may be asymptomatic. [ABSTRACT FROM AUTHOR]

Our study group was comprised of 67 patients with melanoma, admitted and operated in our clinic between 2010-2018. Only the patients with melanoma localized on the head, torso and upper limb were selected for our study. We attempted to establish a link between the clinical appearance, presence or absence of ulceration, presence or absence of regional lymphadenopathy or distant metastases, surgical technique, histopathological type, Clark level and Breslow depth, disease stage (TNM), adjuvant therapies and survival rates at 1, 3, 5 and 10 years. [ABSTRACT FROM AUTHOR]

Charcot neuropathic arthropathy is frequently associated with a prolonged healing time and risk of ulceration, infection and amputation. Originally described by Jean-Martin Charcot as characteristic changes of the foot in tertiary syphilis in 1883, the 'Charcot foot' was described as a complication of diabetes in 1936. Diagnosis of Charcot is based on a clinical history and both clinical and radiological findings, and the demonstration of fractures or dislocations in one or more bones of the foot. The multidisciplinary team (MDT) approach to ulcer and amputation prevention has been well-documented, aiming to improve quality of life in addition to reducing amputations rates. Professionals within the MDT include: podiatrist, diabetes physician, orthotist, diabetes nurse specialist, vascular surgeon, orthopaedic surgeon and radiographer. [ABSTRACT FROM AUTHOR]

Diabetic foot disease is the leading cause of lower-extremity amputation globally and imposes a significant burden for healthcare services and patients alike. The main pathology is ulceration, due to neuropathy or peripheral arterial disease. The most frequent sign is ulceration on the foot. Ulceration needs to be referred to the multidisciplinary diabetic foot team promptly for a comprehensive management plan to be developed. Delay in referral is associated with poor outcomes. Management of diabetic foot ulceration is multifaceted, including offloading, revascularisation, infection control, debridement, glycaemic control and wound care. Management plans need to be patient focused and developed collaboratively across primary and secondary care settings. [ABSTRACT FROM AUTHOR]

Introduction: Post-thrombotic syndrome (PTS) is a common lifelong condition affecting up to 50% of those suffering from deep vein thrombosis (DVT). PTS compromises function and quality of life with subsequent venous ulceration in up to 29% of those affected.Areas covered: A literature review of surgical and non-surgical approaches in the prevention and treatment of PTS was undertaken. Notable areas include the use of percutaneous endovenous interventions and the use of graduated compression stockings (GCS) after acute proximal DVT.Expert opinion: In patients with acute iliofemoral DVT, we think it is important to have a frank conversation with the patient about catheter-directed thrombolysis, aiming to reduce the severity of PTS experienced. We advocate ultrasound-accelerated thrombolysis with adjunctive procedures, such as deep venous stenting for proximal iliofemoral DVT. For patients with isolated femoral DVT, we believe that anticoagulation and GCS should be recommended. In patients with established PTS, we recommend GCS for symptomatic relief. We recommend that patients engage in regular exercise where possible with the prospect of gaining symptomatic relief. For those with severe PTS that has a significant effect on quality of life, we discuss the patient's case at a multi-disciplinary team meeting to plan for endovenous intervention. [ABSTRACT FROM AUTHOR]

Objective: Acral melanoma is an uncommon subtype of melanoma that occurs on palmoplantar surfaces and the nail unit. The prognosis is usually poorer as compared to other subtypes of melanoma due to the delayed diagnosis. Breslow thickness, age at diagnosis, ulceration, and the sentinel lymph node status are the main prognostic factors. In this retrospective study, we aimed to analyze the clinicopathological features of 43 acral melanoma patients and to determine the predictors of sentinel lymph node positivity. Material and Methods: A total of 43 patients who were diagnosed with acral melanoma at our department or consulted to our department from January 2010 to January 2020 were enrolled in this study. Demographic features and histopathological data were collected from medical records. The statistical analysis was performed with the SPSS 21. Results: The mean age of the patients was 62.7±13 (28-82). Breslow thickness was 5.80±6.15 mm (0-29). Sentinel lymph node involvement was negative in 27 (62.7%) patients. Ulceration was detected in 30 (69.7%) patients. A statistically significant relation was detected between sentinel lymph node positivity and Breslow thickness and number of mitosis (p<0.001). There was a statistically significant relation between the ulceration and mitosis (p=0.033). Also, the relation between the ulceration and Breslow thickness was statistically significant (p=0.011). A significant difference was established between the patients with lymphovascular invasion and a moderate negative correlation was detected between tumor-infiltrating lymphocytes in terms of the sentinel lymph node positivity. Conclusion: In cases with acral melanoma alongside Breslow thickness, ulceration, mitosis rate, and lymphovascular invasion are major predictors of sentinel lymph node positivity. As taking into consideration of the delayed prognosis of acral melanoma, in every patient presence and intensity of these parameters should be carefully evaluated during patient follow-up. [ABSTRACT FROM AUTHOR]

This study compared the outcome of an innovative in-shoe pressure and temperature measuring device as an adjunct to standard clinical care for diabetic foot versus standard clinical care alone. It included 88 participants with Type 2 diabetes mellitus with a history of one or more plantar foot ulceration who were already using prescription orthoses. These were randomly divided into the control group ( n  = 44, standard care only) and the experimental group ( n  = 44, standard care plus the innovative device). Both groups were monitored for re-ulceration for one year. Overall, the control group exhibited a higher number of re-ulcerations ( n  = 14) with 2 amputations in comparison with the experimental group (only 2 ulcerations and no amputations) at the end of the study. In conclusion, this innovative in-shoe pressure and temperature measuring device appears to reduce re-ulcerations by offering objective data for clinical decision making in the management of the diabetic high-risk foot., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background/aim: Non-steroidal anti-inflammatory drugs (NSAIDs), the most widely used pharmaceuticals, induce various adverse effects, including gastrointestinal injuries, such as ulcers and bleeding. Animal models of NSAID-induced small intestinal injury (NSI) have been extensively employed for the development of preventive and therapeutic agents. However, some experimental variations related to feeding times have been observed following NSI induction. This study aimed to investigate the impact of feeding time on an NSI mouse model., Materials and Methods: The mice were divided into eight groups: normal, sham, and model groups (with feeding times of 2 h, 6 h, 10 h, 14 h, 18 h, and 22 h; n=10 in each group). The mice were fasted for 18 h before the injection of indomethacin (15 mg/kg, subcutaneously), except for the normal group. Food supply was halted at specific time points (2 h, 6 h, 10 h, 14 h, 18 h, and 22 h); however, the normal and sham groups were continuously fed throughout the experiment. The length of the small intestine was measured, and histological analysis was performed 24 h after induction., Results: Up to 14 h after induction, NSI, indicated by small intestine shortening, remained consistent, with a reduction in length of approximately 10-20%. However, feeding for more than 14 h significantly exacerbated NSI, both anatomically and histologically., Conclusion: The ulcerative changes observed in the small intestine 14 h after indomethacin injection may be closely associated with the influence of food on NSI., (Copyright © 2024, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

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Background: Recent data have shown an inverse association between serum 25-hydroxyvitamin D concentration and incidence of several cancers, including cutaneous malignant melanoma (CMM). In addition, lower serum 25-hydroxyvitamin D levels have been associated with thicker or higher stage melanomas and worse survival in observational studies. Materials and Methods: Ninety-nine patients diagnosed with primary CMM and 97 matched healthy controls entered the study. Demographic characteristics, risk factors for CMM, and clinical and histological characteristics were recorded for patients with primary CMM. Total serum 25-hydroxyvitamin D levels of melanoma patients measured by fully automated chemiluminescent vitamin D total immunoassay (Elecsys vitamin D total, Roche) at the time of diagnosis were compared with those of healthy controls. In addition, we tested the association of serum total 25-hydroxyvitamin D levels at melanoma diagnosis with known risk and prognostic factors for CMM. Results: Of the melanoma patients, 49 (49.49%) had deficient serum total 25-hydroxyvitamin D levels (30 ng/mL). The median serum total 25-hydroxyvitamin D levels were significantly lower in melanoma patients (20.62 ng/mL) compared with healthy controls (24.71 ng/mL), but statistical significance was not reached (chi-square test, P = 0.051) No statistically significant association was found between serum total 25-hydroxyvitamin D levels and demographic characteristics; risk factors for CMM; prognostic factors, such as Breslow thickness and ulceration; as well as clinical characteristics, such as melanoma stage, clinical type, and location. Conclusions: Lower serum 25-hydroxyvitamin D levels were found in our Greek cohort of melanoma patients compared with healthy controls, without reaching, however, statistical significance; these levels were not statistically associated with established risk and prognostic factors for CMM.

A 39-year-old woman with ulcerative colitis in clinical remission under salicylate treatment, hospitalized for rectal bleeding and fever. On clinical examination, the patient was tachycardic with a fever of 39 and abdominal tenderness. The biological assessment showed anaemia with thrombocytosis and elevation of C-reactive protein with hypoalbuminemia. A careful colonoscopy was performed showing fragile erythematous mucosa with spontaneous bleeding and pseudopolypoid mucosal lesions (A) and endoscopic signs of severity consisting of deep ulcerations and of mucosal detachment (B). Pathological examination showed severe inflammation with deep ulcerations and cryptic abscess suggestive of severe acute ulcerohemorrhagic colitis, stool examination was negative for pathogens and clostridium difficile toxin, serology and cytomegalovirus PCR (polymerase chain reaction) were negative. The diagnosis of severe acute colitis complicating the ulcerohemorrhagic colitis disease was retained, the patient was put on injectable corticosteroids, the evolution was favourable after 5 days with normalization of the C-reactive protein level and disappearance of the rectorrhages thus a relay by oral corticosteroids associated with azathioprine was indicated. After 2 years of follow-up, the patient remained asymptomatic with salicylate and azathioprine.

Abstract A porcine model of second intention wound healing was established and gross and histological changes needed for accurate assessing the age of wounds were determined. Twenty-five pigs were anesthetized before incision of four wounds on each. The wounds were left to heal from 1 h to 35 days when the pigs were euthanized. In 14 pigs, biopsies were sampled from two wounds between days 2 and 18. By histological evaluation the following characteristics were found useful for determining the age of wounds: neutrophil:macrophage ratio, angiogenesis, hyperplasia of fibroblasts, presence of hemosiderophages and granulation tissue. The latter was present from day 4 (n = 8 wounds, 100%), but by gross evaluation it was not recognized until day 5 (n = 4 wounds, 100%). From day 4 to 10, the thickness of granulation tissue increased by 1.2 ± 2.4 mm/day. The thickness of collagen fibers within granulation tissue increased throughout the study period, and complete epithelization was reached from day 18.

• This is one the first published cases of gestational gigantomastia in Saudi Arabia. • Gestational gigantomastia is a very rare disease (1 in 100 000 pregnancies). • This case of gestational gigantomastia is complicated by ulceration and discharge. • The treatment options are skin-sparing mastectomy and breast reconstruction. • Immediate reconstruction by pre-pectoral implant and ADM is an option. Gestational gigantomastia (GG) is a rare condition manifesting as a fast and excessive growth of the breasts in pregnant women. Its etiology is still unclear, with theories ranging from hormonal imbalances, unregulated immune response, to hypersensitivity. Medical interventions are mainly surgical in nature, though some pharmacological medications are of debatable efficacy. A 33-year old Saudi gravida 3 para 2 presents continuous breast enlargement since the start of her pregnancy. She complains of skin ulcerations and discharge which was initially treated conservatively with topical antibiotics. Days after she came back with worsening GG symptoms, and was admitted for bilateral skin sparing mastectomy and reconstruction, and successfully recovered. The patient came back with problems concerning the surgical implant and wound infection. Emergency operation was performed for implant removal and wound treatment. Labor induction was performed by the OB-GYN on her 39 week. The patient opted for autogenous reconstruction by bilateral latissimus dorsi flap months after delivery. After treatment of minor surgical complications, the patient successfully recovered. Surgery is one of the most effective interventions for GG. Total mastectomy is preferred due to lesser risk of recurrence in subsequent pregnancies. Reduction mammoplasty offers the breastfeeding option if conducted before the delivery, but poses higher risk of recurrence in future pregnancies. The patient's gestational gigantomastia condition was complicated by several ulcerations and infections. Surgery was conducted alongside antibiotic treatment. This report also highlights the importance of follow ups in managing complications. [ABSTRACT FROM AUTHOR]

Diabetes-Related Foot Ulcers (DRFUs) are a common and devastating consequence of Diabetes Mellitus and are associated with high morbidity, mortality, social and economic costs. Whilst peak plantar pressures during gait are implicated cited as a major contributory factor, DRFU occurrence has also been associated with increased periods of sedentary behaviour. The present study was designed aimed to assess the effects of sitting postures on plantar tissue health. After a period of acclimatisation, transcutaneous oxygen tensions (T C PO 2) and inflammatory cytokines (IL-1α and IL-1RA) were measured at the dorsal and plantar aspects of the forefoot before, during and after a 20-min period of seated-weight-bearing in participants with diabetes (n = 11) and no diabetes (n = 10). Corresponding interface pressures at the plantar site were also measured. During weight-bearing, participants with diabetes showed increases in tissue ischaemia which were linearly correlated proportional to plantar pressures (Pearson's r = 0.81; p < 0.05). Within the healthy group, no such correlation was evident (p > 0.05). There were also significant increases in post seated weight-bearing values for ratio for IL-1α and IL-1RA, normalised to total protein, post seated weight-bearing in participants with diabetes compared to healthy controls. This study shows that prolonged sitting may be detrimental to plantar skin health. It highlights the need to further examine the effects of prolonged sitting in individuals, who may have a reduced tolerance to loading in the plantar skin and soft tissues. • Peak plantar pressures during gait contribute to diabetes related foot ulcers. Sedentary behaviour is also associated with ulceration. • Significant increases in ratio for IL-1α and IL-1RA were observed post seated weight-bearing in participants with diabetes compared to controls. • Prolonged sitting may cause local plantar tissue ischemia in individuals with diabetes but not in healthy control participants. • A high degree of variability in each of the output parameters was reported in both cohorts. This could be attributed to comorbidities or medication. • Further studies are warranted to examine the effects of prolonged sitting in individuals with diabetes who may have a reduced tolerance to loading. [ABSTRACT FROM AUTHOR]

Copyright of Polish Nursing / Pielegniarstwo Polskie is the property of Poznan University of Medical Sciences Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Late growth of infantile hemangiomas is an uncommon complication. We report three patients with segmental facial hemangiomas who experienced late growth and recurrent ulceration predominantly of the lower lip. These patients shared common clinical features including involvement of the S3 facial segment, oral and airway hemangiomas, and vascular anomalies associated with PHACE syndrome. This report highlights a clinical presentation at‐risk for late growth and recurrent ulceration. [ABSTRACT FROM AUTHOR]

Congenital erythropoietic porphyria (CEP or Gunther disease) is a very rare subtype of porphyria with a prevalence of <0.9 per 1 000 000. A 13-year-old female patient came to our hospital complaining of a severe cutaneous ulceration and scarring. The symptoms began in her first year of life as urine discoloration and skin blistering in sun-exposed areas. The family had been trapped in a high-risk conflict zone in Syria for many years, which precipitated the aggravation of symptoms. Based on clinical examination and laboratory tests, we diagnosed the patient with CEP and treated her with vitamin D supplementation alongside chronic blood transfusions, strict photoprotection and psychotherapy. After 7 months, there were no longer active ulcers or novel complications. Psychotherapy and patient education were important for her psychological development at this age. This treatment limited the deterioration of the symptoms and made the patient more committed to the periodic examinations. [ABSTRACT FROM AUTHOR]

Copyright of Acta Veterinaria Brasilica is the property of Acta Veterinaria Brasilica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The purpose of this study is to report the outcome of the conversion of a first metatarsophalangeal (MTP) joint arthrodesis to an interpositional arthroplasty with an acellular dermal matrix for a chronic nonhealing first ray wound. To our knowledge, this is the first case report converting a first ray arthrodesis to an interpositional arthroplasty to heal a chronic ulceration. A 78-year-old female developed a chronic neuropathic ulceration under the first metatarsal head and hallux after a first MTP joint arthrodesis. The patient failed local wound care and underwent gastrocnemius recession, hallux interphalangeal joint fusion, and an interpositional arthroplasty with the use of an acellular dermal matrix. Bone tunnels were placed proximal to the metatarsal neck, where absorbable sutures affixed to the dermal matrix were passed from plantar to dorsal, and the graft was secured to the reamed metatarsal head and associated capsule. Postoperative radiographs revealed improved alignment of the first MTP joint. Complete reepithelialization of the plantar ulceration occurred within 2 weeks postoperatively. At the 16-month follow-up, the patient was ambulating without restriction and continued to be free of first ray ulceration and infection. This case study details the use of an acellular dermal matrix in an interpositional arthroplasty to offload a chronic nonhealing ulceration secondary to elevated first ray pressure associated with first MTP joint arthrodesis. The goal of this treatment is to reduce pain, heal the ulceration, and prevent its recurrence. [ABSTRACT FROM AUTHOR]

Ulcerations under the medial column in patients with acquired neuropathic pes planus may be intractable to conservative techniques such as regular debridement, offloading, bracing, and accommodative shoes. When surgery becomes necessary for these patients, the foot and ankle surgeon has the option of exostectomy, medial column beaming, medial column fusion, and external fixation, among others. In the case of a flexible midfoot collapse, the option of arthroereisis for indirect medial column support may be warranted. In this preliminary report, the authors detail a technique of Achilles tendon lengthening, arthroereisis implantation, and advanced cellular tissue product application in an attempt at wound coverage and prevention of recurrence. Three patients presenting with intractable medial column ulcerations of ∼1 year's duration underwent this procedure, and within 7 weeks (range 5 to 7), all medial column ulcerations healed. These patients remained healed at last follow-up (average 29 months; range 8 to 44). This preliminary report provides evidence for a minimally invasive procedure aimed at offloading, healing, and preventing recurrence of medial column ulcerations in patients with flexible neuropathic pes planus. [ABSTRACT FROM AUTHOR]

Introduction: Behcet's disease is a multisystemic inflammatory condition, with unknown etiology. Most common clinical manifestations include painful oral mucosa ulcerations, painful genital mucosa ulcerations, cutaneous lesions and ocular lesions. Positive HLA-B51 antigen is a well-known risk factor. The etiopathogenesis of the disease includes bacterial, viral and environmental factors. Case report: Wie report the case of a 24-year-old female patient, from urban area, who presented to our clinic for painful polymorphic cutaneo-mucosal lesions. Skin assessment revealed multiple painful oral and genital mucosa ulcerations, as well as upper chest pustules and pretybial bilateral subcutaneous nodules. Ophtalmological examination identified conjunctival hyperemia, right palpebral edema and photophobia. Laboratory findings revealed leukocytosis with neutrophilia, elevated erythrocite sedimentation rate (ESR) and positive rheumatoid factor (PR). Bacteriological and micological tests performed from the lesions were negative. Serological tests were performed and IgM anti herpes simplex virus type 1 (Ig M anti HSV-1) and IgM anti herpes simplex virus type 2 (IgM anti HSV-2) were identified. The patient followed systemic treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) and local treatment with a combination of steroidal and antibiotic cream. Clinical evolution was favorable, with complete resolution of lesions in approximatively 1 week. Conclusions: The possible viral etiology of Behcet's disease is a long investigated topic. Complete evaluation and multidisciplinary follow-up of these patients is vital in the approach of these cases. [ABSTRACT FROM AUTHOR]

Magnetic resonance imaging (MRI) is vital in the diagnosis of osteomyelitis (OM) in patients presenting with cellulitis. Typically, cellulitis is treated with oral antibiotics; however, patients with concomitant OM may require long-term intravenous antibiotics or surgical intervention. We reviewed lower extremity MRIs in patients presenting with cellulitis and clinical concern for OM. We found 488 patient examinations spanning 5 years (2011 to 2016); 47 patients were excluded (final N = 441). Each MRI was interpreted by a radiologist to determine the rate of OM, abscess, ulceration, and imaging diagnosis of cellulitis. Concurrent assessment of the electronic medical record was performed to review patient demographics, the presence of abscess and/or ulceration, and comorbidities such as diabetes, hyperlipidemia (HLD), atherosclerotic disease, and peripheral vascular disease. Of the 441 lower extremity MRIs included, 170 (39%) were diagnosed with OM, 236 (54%) had ulcers, and 66 (15%) had abscesses. Age, laterality, and reporting physician were not statistically significant independent variables in the rate of reported OM. Diabetes and HLD/atherosclerotic disease were both statistically significant variables with regard to OM rates. Clinical documentation and MRI diagnosis of ulceration were both statistically significant variables in the rate of OM. Regression analysis determined that body part, ulceration, HLD/atherosclerosis, and sex were independent predictors of OM. In our study, of the population of patients with a high clinical suspicion for OM, 39% had OM diagnosed on MRI. However, the incidence of OM in uncomplicated cellulitis was only 11.8% compared with 43.9% in complicated cellulitis. When considering the forefoot alone, patients with ulceration at MRI were 5.6 times more likely to have underlying OM than those without. [ABSTRACT FROM AUTHOR]

Background: Although carotid artery stenting achieves definite benefits, it carries a higher rate of embolization compared with carotid endarterectomy. The incidence of embolization may be related to plaque stability. Purpose: To assess for any relationship between plaque characteristics and cerebral emboli following carotid artery stenting. Material and Methods: Sixty-three patients with severe carotid stenosis underwent carotid artery stenting. They were divided into two groups according to whether new ischemic lesions were detected on diffusion-weighted imaging after carotid artery stenting. We evaluated the types and locations of calcification in plaques and extent of calcification. We then assessed for a correlation between each of these factors and occurrence of new lesions on diffusion-weighted imaging after carotid artery stenting. Results: The locations of calcification, percentage of plaque enhancement, and the number of plaques with irregular surface or ulceration were significantly different between the two groups. A peripheral position of calcification (close to the adventitia), enhancing plaques, and plaques with irregular surfaces or ulceration were statistically significant predictors of intracerebral embolization after carotid artery stenting. No significant differences in type of plaque or degree of calcification were found between two groups. Conclusion: Peripheral calcification, enhancing plaques, and plaques with irregular surfaces were risk factors for intracerebral embolization after carotid artery stenting. These plaque characteristics should be considered when choosing the optimal treatment for patients. [ABSTRACT FROM AUTHOR]

Ulceration of melanoma is associated with neutrophil infiltrates and lower survival rates opposite to non‐ulcerated melanoma. Neutrophils release neutrophil extracellular traps (NETs) that are chromatin structures loaded with antimicrobial proteins. Since NETs have been correlated with tumor progression, we investigated whether NETs appear in melanoma and affect melanoma cells. Indeed, human primary melanoma biopsies revealed neutrophils releasing NETs in all of 27 ulcerated melanomas, whereas NETs were absent in all of 7 non‐ulcerated melanomas. However, the quantity of intratumoral NETs did not correlate with tumor progression of melanoma. Interestingly, in vitro assays showed that melanoma cells attach to NETs via integrin‐mediated adhesion and that NETs inhibit tumor cell migration. Moreover, co‐culturing of NETs and melanoma cells had a cytotoxic effect on melanoma cells resulting in necrosis. Hence, we discovered in vitro an antineoplastic role of NETs in melanoma. [ABSTRACT FROM AUTHOR]

Methotrexate（MTX）is a structural analog of folate used as an antirheumatic drug and anticancer drug, and is classified as an antifolate. Recently, the occurrence of methotrexate-associated lymphoproliferative disorders（MTX-LPD）in the oral cavity have been reported. We describe a 62-year-old woman（Case 1）and a 76-year-old man（Case 2）. The diagnosis was MTX-LPD. The lesion disappeared after the withdrawal of MTX. We reviewed reports documenting 42 cases of oral MTX-LPD in Japan. The age of onset was 40-86 years old. There were 13 males and 29 females, with an average age of 69.1 years. [ABSTRACT FROM AUTHOR]

Diabetic foot ulcers can progress to the point where amputation is needed, and so these ulcers require active treatment. Skin grafts or flaps can be performed for coverage of this type of ulcer. Local flap surgery is relatively easy to perform and good results have been previously reported. We performed single-lobed rotation flap on 5 cases of forefoot ulcer around the site of weight bearing. The location of the foot ulcers was the medial part of the first metatarsophalangeal joint in all the patients. The mean size of the defect was 4.70 cm2. Managing of ulcers, controlling of diabetes and infection, and improving of peripheral blood flow were performed before surgery. In two cases, infection progressed to the articular cartilage and so metatarsophalangeal joint fusions were performed simultaneously. All the cases were completely transplanted. There was no recurrence of the ulcers, and all the patients were able to walk. [ABSTRACT FROM AUTHOR]

People with diabetes are more prone to vascular and neurological impairment, especially when glycaemic levels are uncontrolled. Diabetic foot problems are a common complication of type 2 diabetes mellitus, mainly caused by peripheral neuropathy, and could lead to ulceration and amputation. The frequency of foot examinations and the appropriate level of care are determined by the patient's risk profile. Regular diabetic foot assessment and good foot care practices are essential measures to prevent complications and to ensure optimal patient outcomes. [ABSTRACT FROM AUTHOR]

• Vascular injury is common pathology in β-thalassemic patients. • Metastasis associated lung adenocarcinoma transcript 1 (MALAT1) mRNA levels have been linked to vascular injury and wound healing. • MALAT1 mRNA quantification and attenuation may be novel therapeutic targets for β-thalassemia patients with vascular injury. Vascular injury is a common consequence in β-thalassemia patients with severe anemia. Vascular cell damage can result in cardiomyopathy, thrombosis, and persistent ulceration. Although it has been suggested that injury is caused by iron accumulation and oxidative stress, the exact molecular mechanism remains unknown. Here, we highlight the potential role of metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) in this pathophysiology. This hypothesis is based on the literature, which demonstrates that lncRNA expression of MALAT1-lncRNA is linked to vascular damage, wound healing capability, and cardiomyopathy. Furthermore, various technologies can be employed to manipulate the expression of MALAT1-lncRNA. In light of these studies, assessment of MALAT1 expression may enhance our understanding of the molecular pathophysiology of vascular damage in β-thalassemia. If confirmed, elevated MALAT1 expression could serve as a promising target for expediting the healing process in pathogenic tissues. Additionally, MALAT1 may serve as a surrogate biomarker for therapeutic management of patients with β-thalassemia who have vascular complications. [ABSTRACT FROM AUTHOR]