No abstract available.
Cellulitis* ; Klebsiella pneumoniae* ; Klebsiella* ; Leg*

Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used in various clinical situations, with excellent analgesic, anti-pyretic and anti-inflammatory effects. In addition to gastrointestinal bleeding, which was the first adverse effect to be reported, myriad adverse effects from the digestive system, cardiovascular system, renal system and hematology have been also reported. In early 2000s, a few new cyclooxygenase (COX)-2 selective inhibitors were developed with the expectation of better gastrointestinal safety profile, most of them were withdrawn from the market due to various adverse effects, and interest in safety of NSAIDs has been increased again. Over the past two decades, research on the safety and adverse effects of NSAIDs has accumulated. In brief, celecoxib is associated with fewer gastrointestinal adverse events compared to non-selective NSAIDs. In patients receiving aspirin, the use of non-selective NSAIDs should be avoided, and if an anti-inflammatory drug is required, a COX-2 selective inhibitor should be considered. Celecoxib has been shown to have similar or better safety profile than other non-selective COX inhibitors. Additionally, the new COX-2 selective inhibitors of etorixocib and polmacoxib have been approved. Many factors should be considered when prescribing NSAIDs, as the safety profile of indivisual NSAIDs vary, and NSAIDs have a high risk of duplicate prescription because of the variety of indications and over-the-counter products. Physicians should comprehend the updated guidelines and the results of new clinical studies, and the risk factors for each individual patient should also be reviewed. Physicians should therefore contemplate new prescription strategies.

Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used in various clinical situations, with excellent analgesic, anti-pyretic and anti-inflammatory effects. In addition to gastrointestinal bleeding, which was the first adverse effect to be reported, myriad adverse effects from the digestive system, cardiovascular system, renal system and hematology have been also reported. In early 2000s, a few new cyclooxygenase (COX)-2 selective inhibitors were developed with the expectation of better gastrointestinal safety profile, most of them were withdrawn from the market due to various adverse effects, and interest in safety of NSAIDs has been increased again. Over the past two decades, research on the safety and adverse effects of NSAIDs has accumulated. In brief, celecoxib is associated with fewer gastrointestinal adverse events compared to non-selective NSAIDs. In patients receiving aspirin, the use of non-selective NSAIDs should be avoided, and if an anti-inflammatory drug is required, a COX-2 selective inhibitor should be considered. Celecoxib has been shown to have similar or better safety profile than other non-selective COX inhibitors. Additionally, the new COX-2 selective inhibitors of etorixocib and polmacoxib have been approved. Many factors should be considered when prescribing NSAIDs, as the safety profile of indivisual NSAIDs vary, and NSAIDs have a high risk of duplicate prescription because of the variety of indications and over-the-counter products. Physicians should comprehend the updated guidelines and the results of new clinical studies, and the risk factors for each individual patient should also be reviewed. Physicians should therefore contemplate new prescription strategies.
Anti-Inflammatory Agents, Non-Steroidal ; Aspirin ; Cardiovascular System ; Celecoxib ; Digestive System ; Drug-Related Side Effects and Adverse Reactions ; Hematology ; Hemorrhage ; Humans ; Medication Therapy Management ; Prescriptions ; Prostaglandin-Endoperoxide Synthases ; Risk Factors

An association between drug treatment for viral infections and severe cutaneous adverse reactions has been noted. We investigated six patients diagnosed with Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) after being prescribed acetaminophen for suspected viral illnesses. Multiplex analysis was performed to measure cytokine levels in sera before and after treatment. IL-2Rα levels significantly decreased during the convalescence phase. Although acetaminophen is relatively safe, the drug can trigger SJS/TEN in patients with suspected viral infections. T-cells and monocytes may be key components of the link between viral infection and acetaminophen-induced SJS/TEN.
Acetaminophen* ; Convalescence ; Humans ; Monocytes ; Stevens-Johnson Syndrome* ; T-Lymphocytes

INTRODUCTIONThis study was conducted to provide an overview of the community-based hypertension and diabetes control programme of 19 cities in Korea and to evaluate its effectiveness in controlling hypertension at the community level.

MATERIALS AND METHODSIn this longitudinal observational study, we analysed the data of 117,264 hypertensive patients aged ≥65 years old from the time of their first enrolment in July 2012 to October 2013 (up to their 2-year follow-up).

RESULTSThe hypertension control rate of 72.5% at the time of enrolment increased to 81.3% and 82.4% at 1 and 2 years after enrolment. Treatment continuity, completion of hypertension self-management education, and longer enrolment duration in the programme contributed to improvements in hypertension control rate.

CONCLUSIONThis programme was characterised by a public health-clinical partnership at the community level. Despite its simplicity, the programme was evaluated as a successful attempt to control hypertension among patients aged >65 years at the community level.

Aged ; Community Networks ; Humans ; Hypertension ; drug therapy ; Longitudinal Studies ; Patient Education as Topic ; Program Evaluation ; Republic of Korea ; Self Care

Phacomatosis pigmentokeratotica (PPK) is a rare syndrome defined by the association of an organoid nevus occasionally with sebaceous differentiation, a speckled lentiginous nevus, and other extracutaneous anomalies. A preterm male infant of only 830 g at 27 week gestational age had an organoid nevus showing sebaceous differentiation. Also, he had multiple speckled-lentiginous nevus. Correlating the observed clinical presentation with the histopathological findings, the diagnosis of PPK was established. There have been less than 10 cases of PPK without extracutaneous manifestation. We present an uncommon case of a preterm patient with PPK who had no extracutaneous abnormalities.
Diagnosis, Differential ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Male ; Nevus, Pigmented/*diagnosis/pathology ; Skin Neoplasms/*diagnosis/pathology

The temporal lobe is essential in saving declarative memory and plays an important role along with the cerebral neocortex in creating and maintaining long-term memory. Damage to the temporal lobe is expected to result in cognitive impairment or dementia, which has characteristic symptoms such as cognitive and behavioral dysfunction and decreasing self-reliance in activities of daily living. We report on a patient, who suffered from dementia due to meningovascular syphilis affecting the medial temporal lobe, and on the outcome of cognitive rehabilitation.
Activities of Daily Living ; Dementia ; Humans ; Memory ; Memory, Long-Term ; Neocortex ; Syphilis ; Temporal Lobe

The temporal lobe is essential in saving declarative memory and plays an important role along with the cerebral neocortex in creating and maintaining long-term memory. Damage to the temporal lobe is expected to result in cognitive impairment or dementia, which has characteristic symptoms such as cognitive and behavioral dysfunction and decreasing self-reliance in activities of daily living. We report on a patient, who suffered from dementia due to meningovascular syphilis affecting the medial temporal lobe, and on the outcome of cognitive rehabilitation.
Activities of Daily Living ; Dementia ; Humans ; Memory ; Memory, Long-Term ; Neocortex ; Syphilis ; Temporal Lobe

Objective: We quantitatively measured the fat fraction (FF) in the vertebrae of patients with ankylosing spondylitis (AS) using magnetic resonance imaging (MRI) and investigated the role of FF as an indicator of both active inflammation and chronicity. Materials and Methods: A total of 52 patients with AS who underwent spinal MRI were retrospectively evaluated. The FF values of the anterosuperior and anteroinferior corners of the bone marrow in the L1–S1 spine were assessed using the modified Dixon technique. AS activity was measured using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), AS Disease Activity Score (ASDAS), and serum inflammatory marker levels. AS disease chronicity was assessed by AS disease duration and the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). Univariable and multivariable regression analyses were conducted to investigate the correlation between FF and other clinical characteristics. Results: The mean FF ± standard deviation of the total lumbar spine was 43.0% ± 11.3%. At univariable analysis, spinal FF showed significant negative correlation with BASDAI (β = -0.474, p = 0.002) and ASDAS with C-reactive protein (ASDAS-CRP; β = -0.478, p = 0.002) and a significant positive correlation with AS disease duration (β = 0.440, p = 0.001). After adjusting for patient age, sex, and total mSASSS score, spinal FF remained significantly negatively correlated with BASDAI (β = -0.543, p < 0.001), ASDAS-CRP (β = -0.568, p < 0.001), and ASDAS with erythrocyte sedimentation rate (β = -0.533, p = 0.001). Spinal FF was significantly lower in patients with very high disease activity (ASDAS-CRP > 3.5) than in those with only high disease activity (2.1 ≤ ASDAS-CRP ≤ 3.5) (p = 0.010). Conclusion Spinal FF may help assess both AS disease activity and chronicity.

Clear cell acanthoma (CCA) is an uncommon, benign epithelial tumor presenting as a well-defined, slow-growing solitary nodule. The diagnosis of CCA is usually based on clinical and histopathological evaluation of the tumor.However, when such type of benign tumor occurs on an exposed area, a biopsy is not always the best diagnostic option since it may leave scar. The recent advent of dermoscopy has offered an accurate and non-invasive method to diagnose CCA without resorting to skin biopsy. A 40-year-old male presented with a shiny, erythematous-to-brown, flattened nodule on the left cheek. Dermoscopic examination revealed a ‘string of pearls’ vascular pattern, a characteristic dermoscopic feature of CCA. Under the clinical and dermoscopic impression of CCA, a 595 nm pulsed dye laser (PDL) therapy targeting the vascular tissue in the superficial dermis of the lesion was chosen for a minimally invasive treatment.After repeated sessions of PDL, an optimal cosmetic outcome was achieved and no recurrence was recorded during the follow-up period. Herein, we report a case of presumed CCA which was successfully diagnosed and treated by utilizing non-invasive modalities.