Therapy of livedo vasculitis with pentoxifylline.

Two patients with idiopathic livedo vasculitis responded favorably to therapy with pentoxifylline. One patient had responded to fibrinolytic therapy with phenformin and ethylestrenol before phenformin was taken off the market. Pentoxifylline (Trental) has multiple mechanisms of action, including stimulation of prostacyclin synthesis, decreased aggregation of platelets, increased deformability of red blood cells, increased mobility of neutrophils, and increased fibrinolysis. All of these factors may contribute to its successful use in the treatment of idiopathic livedo vasculitis.

Anesthetic implications of subacute left ventricular rupture following acute myocardial infarction: a case report.

Rupture of the free wall of the left ventricle, a relatively common complication of acute myocardial infarction, is associated with a high mortality rate. The clinical course can vary from catastrophic, that is death, to incomplete rupture with the formation of a pseudoaneurysm. Subacute rupture is a condition that demands expeditious diagnosis and surgical repair if the patient is to survive. Surgical repair can be difficult at best. This article reports a case of subacute rupture of the left ventricle that was successfully repaired using a novel surgical technique and discusses the anesthetic implications surrounding the case.

The BIS monitor: a review and technology assessment.

In the administration of anesthesia, clinicians have traditionally relied on a variety of autonomic signs to assess the pharmacologic effects of anesthetic agents on the central nervous system. As any experienced clinician knows, these signs can be misleading and lead to overdosing or underdosing of anesthetic drugs. The development of a monitor to measure the bispectral index (BIS) provides anesthetists with the first clinically tested and US Food and Drug Administration-approved monitor to assess the effects of anesthesia on the cerebral cortex. This article reviews the development of the BIS monitor, compares the BIS monitor with other commonly used clinical monitors, assesses the cost-benefit from the use of this monitor, and explores some of the possible uses for this monitor outside of the operating suite.

Chondrodermatitis nodularis chronica helicis.

23 clinically and pathologically typical lesions of chondrodermatitis nodularis chronica helicis occurring in 19 patients are reviewed. The lesions seem to fit well with the clinical and pathologic findings of diseases of transepidermal elimination. Clinically, one finds exceedingly chronic tender nodules of the ear with a central horny plug. Histologically, there is epidermal hyperplasia around an area in the upper dermis which displays fibrinoid material and/or necrobiotic collagen with the formation of a sinus tract through the epidermis. Although the derangement of the collagen in the upper dermis seems to be the inciting factor in producing transepidermal elimination, other factors such as anatomy, vascular deficiency and trauma are also important in pathogenesis.

Once-daily naftifine cream 1% in the treatment of tinea cruris and tinea corporis.

Seventy patients with tinea cruris or tinea corporis were treated with naftifine cream 1% or vehicle once daily for 4 weeks in this double-blind, randomized study. After two weeks, the patients using naftifine had a significantly higher mycologic cure rate than the vehicle-treated patients (79% vs. 31%, p less than 0.001), and they showed significantly better resolution of signs and symptoms. Statistically significantly differences favoring naftifine over its vehicle were found throughout the treatment period and 2 weeks posttreatment.