Dermatofibrosarcoma Protuberans Arising From a Chronic Wound in the Left Shoulder: A Case Report

Dermatofibrosarcoma protuberans (DFSP) is a rare, slow-growing soft tissue sarcoma, typically presenting as a cutaneous lesion. However, its occurrence in chronic wounds is infrequently documented, posing diagnostic and therapeutic challenges. This report details the case of a 59-year-old female with no significant medical history, presenting with a chronic, non-healing wound on the left shoulder, persisting for three years. Initially a small nodule, it progressed into an ulcerating lesion. Physical examination revealed a contracted scar with restricted shoulder mobility. After obtaining informed consent, a surgical excision of the lesion was performed by an electrocautery. Histopathology confirmed DFSP, characterized by spindle fibrous cells, with skin ulceration and deep dermal infiltration. A split-thickness skin graft achieved successful closure. This case underscores the importance of considering DFSP in chronic, non-healing wounds. Timely intervention and appropriate surgical management are crucial for favorable outcomes.

Intraocular lens power calculation after excimer laser corneal refractive surgery: A retrospective study to compare the predictability and the efficacy of commonly used and modified formulas

PURPOSE

Our article aims to assess the accuracy of modified and commonly used formulas of intraocular lens (IOL) power calculation after excimer laser corneal refractive surgery.

METHODS

This is a retrospective study, with data retrieved for 50 eyes of 32 patients who underwent uncomplicated cataract surgery after excimer laser corneal refractive surgery. The expected spherical equivalent was calculated using the American Society of Cataract and Refractive Surgeons (ASCRS) IOL power calculator for Shammas and Barrett True-K, using three-fourth generation formulas (Haigis-L, Barrett True-K no history, and Holladay 2), and using three-third generation formulas (SRKT, Holladay 1, and Hoffer Q) with single k, as a reference, and adjusting these formulas by calculating the keratometry readings by two methods (Jarade's index and formula). The mean refractive error and mean absolute refractive error (MARE) were calculated at the 1 postoperative month.

RESULTS

When all data was available (eight eyes), 13 formulas were compared. Holladay 1 as modified by Jarade's index and formula, and Hoffer Q as modified by Jarade's formula resulted in MARE <0.75D (P < 0.05). In the group of 25 eyes with only ablation available, the formulas with MARE <0.75D were Haigis L, Barrett TK (from ASCRS), Hoffer Q, and the three conventional formulas in Jarade's index (P < 0.001). In the group of 17 eyes with no available prerefractive data, only Haigis-L and Barret TK (no history) had a MARE <0.75 D.

CONCLUSION

The use of Hoffer Q or Holladay 1, when prerefractive data are available, gives reliable results with Jarade's index.

Phosphaturic Mesenchymal Tumor

Phosphaturic mesenchymal tumors (PMTs) are neoplasms associated with tumor-induced osteomalacia. Patients typically present with pathologic fractures in the setting of chronic hypophosphatemic hyperphosphaturic osteomalacia, as well as gradual muscle weakness, bone pain, and difficulty walking. Because of their rarity and nonspecific symptomatology, phosphaturic mesenchymal tumors often go undiagnosed for years. Even when discovered on imaging, the tumors can be diagnostically challenging for radiologists. Phosphaturic mesenchymal tumors often tend to be small and can be located nearly anywhere in the body, and, therefore, can mimic many other tumors. This case highlights the imaging and pathologic markers of a phosphaturic mesenchymal tumor, often found in a patient with tumor-induced osteomalacia.

Oxidative stress and prostatic diseases

Prostatic diseases are a common health problem among males in Western countries, and include chronic prostatic diseases, which have an unclear pathogenesis and few treatment options. In vitro and in vivo studies describe oxidative stress as a major pathway involved in the occurrence of benign prostatic hyperplasia, prostatic cancer and chronic prostatitis. Thus, the oxidative stress cascade is a potential target for the treatment of prostatic diseases. This paper presents a systematic review of the available data concerning the association between oxidative stress and the most common chronic prostatic diseases, and describes the available treatment options that act upon this pathway.

Platelet-activating factor acetylhydrolase in term and preterm human milk: a preliminary report

Human milk may protect against necrotizing enterocolitis (NEC). Since platelet-activating factor (PAF) may participate in the pathophysiology of NEC, we measured PAF acetylhydrolase (PAF-AH), which metabolizes PAF, in term and preterm human milk. The activity of PAF-AH in term milk collected 2-4 days after delivery (n = 17) was 2.7 +/- 1.2 nmol x min-1 x ml-1. A higher activity was found in milk collected at similar times from mothers who delivered between 33 and 36 weeks of gestation (n = 6, 5.6 +/- 2.1 nmol x min-1 x ml-1, p < 0.01). However, milk from mothers who delivered between 26 and 32 weeks of gestation had a PAF-AH activity similar to that of term milk (n = 6, 3.0 +/- 0.7 nmol x min-1 x ml-1). With advancing lactational age, PAF-AH activity in term milk decreased, whereas the activity of this enzyme in preterm milk remained unchanged. In milk samples collected beyond 14 days after delivery from women who gave birth between 33 and 36 weeks or 26 and 32 weeks of gestation, PAF-AH activity was fivefold higher than that found in milk for women delivering at term (3.7 +/- 1.3 and 3.6 +/- 3.6 nmol x min-1 x ml-1 serum 0.7 +/- 0.4 nmol x min-1 x ml-1, respectively, p < 0.05). We speculate that the presence of PAF-AH in human milk may protect against NEC in preterm newborns.

[Early onset neonatal septicemia caused by Listeria monocytogenes]

Listeria monocytogenes can cause sepsis and meningitis during the neonatal period. Six cases of early onset neonatal sepsis caused by Listeria monocytogenes are reported here. These cases were diagnosed in a private hospital at Santiago, Chile from December 1984 throughout November 1986. The incidence rate was 1.4 x 1,000 liveborns. Clinical findings included prematurity (6), meconium stained amniotic fluid (6), hepatomegaly (6), splenomegaly (6), maculopapular exanthem (4), anal prolapse (3) and meningitis (1). Additionally 5 patients developed respiratory distress and 4 required ventilatory support. Overall mortality was 50% (3/6). All deaths were related to respiratory failure and occurred during the first week of disease. All patients received ampicillin and amikacin early in the course of their infection. Listeriosis of the newborn infant might be preventable by prompt recognition and treatment of maternal infections. Since Listeria infection in pregnancy is usually mild and symptoms and signs are nonspecific, prevention may be difficult. Pregnant women with fever of no clear origin or with an influenza like syndrome should be screened for listeriosis with cultures from blood, vagina and cervix samples.

[Home oxygen therapy in children with bronchopulmonary dysplasia]

Eight babies with severe bronchopulmonary dysplasia (BPD) were discharged from a private hospital at Santiago, Chile, on a program that provided oxygen therapy at home. Mean gestational age was 27 +/- 2 weeks and mean birth weight was 1,181 +/- 353 g. Discharge was decided after stabilization of arterial PO2 or O2 Sat, PCO2 less than 50 mmHg and adequate weight gain. Prior to discharge parents were trained in O2 administration and cardiopulmonary resuscitation. Oxygen was given at home for a mean of 71 days (range 7 to 339). There were no complications secondary to oxygen therapy. At follow up in only two cases additional hospitalizations were needed, in both instances because of intercurrent respiratory infections. Weight gain between 3d and 50th percentile were seen in all cases. Oxygen therapy at home appears to be a good alternative in the treatment of infants with BPD, and it reduces significantly hospital stay and costs. Both optimal family conditions and adequate support at home are needed.