Dermatosis perforante adquirida e Índice de Calidad de Vida en Dermatología en pacientes en hemodiálisis / Acquired perforating Dermatology Life Quality Index in dermatology in patients receiving hemodialysis

Introducción: La dermatosis perforante adquirida (DPA) es un trastorno frecuente en pacientes en hemodiálisis, y el efecto en la calidad de vida está poco descrito. Investigamos la prevalencia de DPA en pacientes en hemodiálisis, medimos y comparamos la calidad de vida asociada a DPA. Métodos: Desarrollamos un estudio prospectivo, observacional y descriptivo. Invitamos a pacientes mayores de 18 años en hemodiálisis. Se obtuvieron datos de su expediente electrónico, y se realizó exploración dermatológica. Se aplicó el Índice de Calidad de Vida en Dermatología (DLQI). Se hizo un análisis descriptivo de las variables demográficas, de las características clínicas y de los hallazgos de dermatoscopia, así como la comparación de los puntajes del DLQI. Resultados: La muestra fue de 46 pacientes, con una prevalencia de DPA del 11%. Los pacientes con DPA eran más delgados y jóvenes en comparación con los pacientes sin DPA. El tiempo en hemodiálisis fue mayor en los pacientes con DPA en comparación a los pacientes sin DPA, con una mediana de 90 versus 32 meses (p=0,015). La afección en calidad de vida fue mayor en los pacientes con DPA en comparación a los pacientes sin DPA, con un algún efecto en todos los pacientes con DPA y un 33% en los pacientes sin DPA (p=0,001). Los pacientes con DPA tuvieron con más frecuencia prurito en comparación con los pacientes sin DPA (p=0,007). Conclusiones: La edad, el tiempo en hemodiálisis y el índice de masa corporal se asocian con la presencia de DPA. Los pacientes con DPA tuvieron una prevalencia más alta de prurito y mayor afección en la calidad de vida en dermatología en comparación con los pacientes sin DPA. (AU)

Introduction: Acquired perforating dermatosis (APD) is a frequent disorder in hemodialysis patients and the effect on the quality of life is poorly described. We investigated the prevalence of APD in hemodialysis patients, measured and compared APD-associated quality of life. Methods: We developed a prospective, observational, and descriptive study. We invited patients over the age of 18 in hemodialysis. Data was obtained from their electronic file and a dermatological examination was performed. The Dermatology Life Quality Index (DLQI) was applied. Descriptive analysis of demographic variables, clinical features, and dermoscopy findings, as well as comparison of DLQI scores, was made. Results: The sample consisted of 46 patients, with a prevalence of APD of 11%. Patients with APD were leaner and younger compared to patients without APD. The time on hemodialysis was longer in patients with APD compared to those without APD, with a median of 90 versus 32 months (P=.015). The impact on quality of life was greater in patients with APD compared to those without APD, with some effect in all patients with APD and 33% in patients without APD (P=.001). Patients with APD had more frequent pruritus compared to those without APD (P=.007). Conclusions: Age, time on hemodialysis and BMI are associated with the presence of APD. Patients with APD had a higher prevalence of pruritus and a greater impact on quality of life in dermatology compared to patients without APD. (AU)

Acquired Perforating Dermatosis and Dermatology Life Quality Index in Patients Receiving hemodialysis.

INTRODUCTION: Acquired perforating dermatosis (APD) is a frequent disorder in hemodialysis patients and the effect on the quality of life is poorly described. We investigated the prevalence of APD in hemodialysis patients, measured and compared APD-associated quality of life. METHODS: We developed a prospective, observational, and descriptive study. We invited patients over the age of 18 in hemodialysis. Data was obtained from their electronic file and a dermatological examination was performed. The Dermatology Life Quality Index (DLQI) was applied. Descriptive analysis of demographic variables, clinical features, and dermoscopy findings, as well as comparison of DLQI scores, was made. RESULTS: The sample consisted of 46 patients, with a prevalence of APD of 11%. Patients with APD were leaner and younger compared to patients without APD. The time on hemodialysis was longer in patients with APD compared to those without APD, with a median of 90 versus 32 months (p = 0.015). The impact on quality of life was greater in patients with APD compared to those without APD, with some effect in all patients with APD and 33% in patients without APD (p = 0.001). Patients with APD had more frequent pruritus compared to those without APD (p = 0.007). CONCLUSIONS: Age, time on hemodialysis and BMI are associated with the presence of APD. Patients with APD had a higher prevalence of pruritus and a greater impact on quality of life in dermatology compared to patients without APD.

Jejunal perforation after abdominal liposuction, bilateral breast augmentation and facial fat grafting.

A 54-year-old woman presented to the emergency department 24 h after undergoing abdominal liposuction, bilateral breast augmentation and facial fat grafting at a private plastic surgery clinic. She presented with the classic evolution of a bowel perforation secondary to abdominal liposuction. A computed tomography (CT) scan found free air in her abdominal cavity. Based on the CT scan and the persistent pain experienced by the patient, an abdominal laparatomy was urgently performed. A jejunum perforation was found and was treated with a resection of the affected segment followed by intestinal anastomosis. The patient had a successful recovery and was discharged seven days later. The present article also reviews the classical presentation of a bowel perforation following abdominal liposuction.

Une femme de 54 ans a consulté à l'urgence 24 heures après avoir subi une liposuccion abdominale, une augmentation mammaire bilatérale et une greffe faciale d'adipocytes dans une clinique privée de chirurgie plastique. Elle présentait l'évolution classique d'une perforation intestinale secondaire à une liposuccion abdominale. La tomodensitométrie a indiqué la présence d'air libre dans la cavité abdominale. Compte tenu de la tomodensitométrie et de la douleur persistante que ressentait la patiente, celle-ci a subi une laparotomie abdominale d'urgence. Cette intervention a révélé une perforation jéjunale, traitée par résection du segment touché et suivie d'une anastomose intestinale. La patiente s'est rétablie et a obtenu son congé sept jours plus tard. Le présent article analyse également la présentation classique d'une perforation intestinale après une liposuccion abdominale.

Fat embolism syndrome secondary to injection of large amounts of soft tissue filler in the gluteal area.

There are no reports in the literature of an association between soft tissue filler (STF) injection and fat embolism syndrome (FES). The authors present the case of a 26-year-old woman who was injected in the gluteal area with approximately 200 cc of STF on each side for aesthetic purposes. After this procedure, she presented with the triad of hypoxemia, neurological impairment, and petechiae consistent with the diagnosis of FES. After advanced support measures, she recovered completely. This article reviews the presence of FES after a cosmetic procedure with STF.

[Progression toward type-2 diabetes mellitus among Mexican pre-diabetics. Assessment of a cohort]. / Progresión de prediabetes a diabetes mellitus tipo 2 en mexicanos. Evaluación en una cohorte.

BACKGROUND: Pre-diabetic Latino subjects have shown higher incidence of type 2 diabetes mellitus (DM2) compared with other populations. The incidence is unknown in the Mexican population. Our aim was to identify the annual incidence of DM2 among a Mexican pre-diabetic population. METHODS: An inception cohort of healthy Mexican patients was followed from 2001 to 2006. Those who fulfilled diagnosis of DM2 (ADA criteria) were registered at one and 2 years of follow-up among pre-diabetic and normoglucemic individuals. We compared relevant variables between both groups, those who developed diabetes and those who did not. RESULTS: 656 subjects were included; at one year, 14 patients were diagnosed with DM2, 11 among pre-diabetics, incidence of 4.5 %; 3 among normoglucemic subjects, incidence of 0.72 %. The relative risk for the development of DM2 in the pre-diabetic group was 7.7 (IC95 % 2.1-27.9), and among the normoglucemic group of 1.04 (IC95 % 1.02-1.08). At the 2nd year, DM2 incidence was 7.6 % in pre-diabetics, and 0.6 % in normoglucemics. Risk factors associated were higher fast glucose and greater BMI. CONCLUSIONS: We found a constant annual incidence of DM2 among prediabetics of 6 cases per 100 patient/year in follow-up. Higher fast glucose determinations and greater BMI are the main determinants for DM2 development.