Pyoderma Gangrenosum after Breast Mammoplasty Surgery: A Case Report.

Pyoderma gangrenosum (PG) is a rare inflammatory neutrophilic dermatosis, characterized by painful ulcerative, bullous, or pustular skin conditions. Pathergy is usually used to describe PG which refers to initiation or exacerbation of the disease after accidental or iatrogenic skin trauma. Diagnosis of postoperative PG is challenging not only due to its presentation mimics infectious wounds, but also because there are no standard laboratory parameters for diagnosis. Herein, we present a case of a 46-year-old female patient who had recurrent bilateral breast wound erythema, swelling, pain and necrosis after breast reduction mammoplasty at Centro Hospitalar Conde São Januário Macau SAR in 2018. We diagnosed her postoperative PG and successfully treated her with oral prednisolone with significant therapy response.

The aging burden of hospitalization for heart failure in Chinese populations: evidence from the Macao Heart Failure Study.

OBJECTIVE: To assess the aging burden of hospitalization for heart failure in Chinese populations in Macao. METHODS: The Macao Heart Failure Study consists of patients hospitalized with a diagnosis of acute heart failure (AHF) at Centro Hospitalar Conde de São Januário (the only public hospital that provides medical care for the approximately 600, 000 residents of Macao) from January 2014 to December 2016. First, we investigated the relationship between socioeconomic development and epidemiological characteristics of HF in Macao. Then we assessed the patientso clinical features and outcomes according to the age groups. RESULTS: A total of 967 patients were included in the final analysis. The median age at admission was 82 years old. The advanced age at the admission of HF in Macao was significantly associated with a high-income level and the aging population structure. Marked heterogeneity existed in the epidemiological characteristics, clinical features, utilization of evidence-based therapies, short- and long-term outcomes, and prognostic utility of clinical variables among the different age groups. CONCLUSION: Rapid economic development and significantly aging populations have produced a profound impact on the epidemiological characteristics of HF in Chinese populations. Acute decompensated heart failure (ADHF) is predominantly a disease of the elderly in Macao, and a significant heterogeneity exists in the clinical features, managements, and outcomes among different age groups. Age-based risk stratification models and multidisciplinary HF teams are urgently needed to improve the management and outcomes of hospitalized heart failure (HHF) patients.

IgG4-Related Aortitis.

Immunoglobulin G4-related disease (IgG4-RD) is a systemic immune-mediated fibroinflammatory condition characterized by tumefactive lesions that can affect multiple organs. Serum IgG4 levels may be elevated. Early recognition is sometimes difficult but is important to avoid irreversible organ damage. We describe the case of a 28-year-old male patient who presented with a 2-year history of recurrent low-grade fever, night sweats and non-specific manifestations. We eventually diagnosed IgG4-related aortitis by PET-CT scan. The patient was successfully treated with prednisolone and mycophenolate mofetil with complete clinical and radiological resolution. LEARNING POINTS: IgG4-related disease is a systemic immune-mediated disease that can affect many organs and systems.Aortitis can be one of the differential diagnoses in patients with fever of unknown origin, back pain and other unspecific symptoms.Delayed diagnosis and treatment may cause major complications or irreversible damage, so timely diagnosis and appropriate treatment is very important.