Reconstruction of Saddle Nose Deformity in Granulomatosis With Polyangiitis

This systematic review identifies which techniques were most successful in reconstructive rhinoplasty for patients with a saddle nose deformity secondary to granulomatosis with polyangiitis disease.

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Nasal Reconstruction in the Vasculopathic Patient

Saddle nose deformity ranks high among the burden of disease in patients diagnosed with systemic vascular disorders. Nearly one-quarter of patients diagnosed with granulomatosis with polyangiitis (GPA) develop this deformity. The process contributes to the overall cosmetic, mental, and functional toll taken on by a patient. It is only in the last several decades that literature has surfaced highlighting surgical interventions for vasculitis-induced saddle nose deformity.

http://ift.tt/2hBW9qM

Approach to hypersensitivity reactions from intravenous iron preparations

Abstract

Hypersensitivity reactions (HSRs) to intravenous iron preparations (IVIPs) are well known. With newer preparations, HSRs have become rarer; however, severe reactions may still occur. We retrospectively reviewed records of patients evaluated for HSRs to IVIPs, to determine the safety of controlled re-administration (CRA). Allergological workup included a detailed history, skin prick tests (SPTs) with IVIP, and basophil activation tests (BATs) in some patients. CRA with an IVIP was done if indicated. 31 patients with mild to severe reactions were evaluated. SPTs and BATs were negative in all patients tested. 18 CRAs in 15 patients were performed. 12 patients tolerated the procedure, including three with a previous grade IV HSR. Two developed urticaria, one developed urticaria and dyspnea. The pathophysiology of HSRs to IVIPs remains currently unclear. SPTs and BATs provided no additional information. However, in appropriate situations, CRA under surveillance can be safely performed in most patients.

This article is protected by copyright. All rights reserved.

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An Aggressive Mandibular Mass

A woman in her 70s presented with progressive supraclavicular, facial, and mandibular swelling of 3 months' duration; a fixed mass throughout the left preauricular space; and a right supraclavicular mass. What is your diagnosis?

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Vitamin D Receptor Genotype, Supplementation, and Colorectal Adenomas

This randomized clinical trial investigates whether common variants in vitamin D and calcium pathway genes modify the effects of vitamin D₃ or calcium supplementation on colorectal adenoma recurrence.

http://ift.tt/2hTddbe

Effect of Noncytotoxic Second-Line Regimen for Metastatic Pancreatic Cancer

This phase 2 randomized clinical trial compares selumetinib and MK-2206 vs modified FOLFOX chemotherapy in patients with metastatic pancreatic cancer for whom gemcitabine-based therapy had failed.

http://ift.tt/2gQ46u5

Approach to hypersensitivity reactions from intravenous iron preparations

Abstract

Hypersensitivity reactions (HSRs) to intravenous iron preparations (IVIPs) are well known. With newer preparations, HSRs have become rarer; however, severe reactions may still occur. We retrospectively reviewed records of patients evaluated for HSRs to IVIPs, to determine the safety of controlled re-administration (CRA). Allergological workup included a detailed history, skin prick tests (SPTs) with IVIP, and basophil activation tests (BATs) in some patients. CRA with an IVIP was done if indicated. 31 patients with mild to severe reactions were evaluated. SPTs and BATs were negative in all patients tested. 18 CRAs in 15 patients were performed. 12 patients tolerated the procedure, including three with a previous grade IV HSR. Two developed urticaria, one developed urticaria and dyspnea. The pathophysiology of HSRs to IVIPs remains currently unclear. SPTs and BATs provided no additional information. However, in appropriate situations, CRA under surveillance can be safely performed in most patients.

This article is protected by copyright. All rights reserved.

http://ift.tt/2hAEal9