Medicine
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Henoch-Schönlein purpura (HSP) is a small-vessel vasculitis that has been extensively studied in children, but little is known about its natural history in adults. There is no consensus regarding the treatment of glucocorticosteroids use for HSP. The efficacy of glucocorticoid for preventing from severe complications or relapse is also controversial in HSP. ⋯ Our patient has a good response to glucocorticoid. Glucocorticosteroids may be effective for the treatment of HSP.
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The challenges with reconstruction of penile defects are plenty. In addition, no single and universally accepted reconstructive method exists for penile defect repair. Herein, we present the application of a circumferential penile shaft defect reconstruction using pull-up double-opposing keystone-designed perforator island flaps (KDPIFs) in one patient. This is the first case report of a circumferential penile shaft defect reconstruction using KDPIFs. ⋯ We successfully reconstructed a circumferential penile defect with pull-up double-opposing KDPIFs both esthetically and functionally. Our technique can be a good alternative modality for extensive penile defect reconstruction.
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Knee osteoarthritis (KOA) is a common disease. It has long been believed that the main causes of KOA are knee degenerative diseases, trauma, overwork, and labor habits. However, long-term deformity leads to uneven stress on the surface of the knee joint, and the cause of lower limb force line damage has not been taken seriously. Comprehensive application of high tibial osteotomy (HTO), chronic distraction tissue regeneration, and computer-assisted external fixation for the treatment of severe KOA has many advantages over total knee arthroplasty, such as lasting and thorough orthopedic effects, a lower cost, and a faster recovery. ⋯ For the treatment of KOA patients with genu varus, the combination of HTO, chronic distraction tissue regeneration, and computer-assisted adjustment of external fixation technology have a good effect on the correction of genu varus deformity and the recovery of the lower limb force line. This treatment method is also conducive to preventing postoperative infection and avoiding secondary trauma caused by the removal of internal fixation plates.
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Case Reports
Effectiveness of Tocilizumab in juvenile patients with refractory Takayasu arteritis: Two case reports.
Takayasu arteritis (TA) is a systemic large-vessel vasculitis which can be accompanied by the symptoms associated with vascular stenosis. ⋯ Juvenile patients with TA presenting with advanced stenosis of the femoral arteries are not rare. The clinical courses of our patients suggested the beneficial effects of TCZ against the progressive vascular stenosis observed in refractory TA.
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Observational Study
Towards ending the human immunodeficiency virus epidemic in the US: State of human immunodeficiency virus screening during physician and emergency department visits, 2009 to 2014.
Human immunodeficiency virus (HIV) testing is important for prevention and treatment. Ending the HIV epidemic is unattainable if significant proportions of people living with HIV remain undiagnosed, making HIV testing critical for prevention and treatment. The Centers for Disease Control and Prevention (CDC) recommends routine HIV testing for persons aged 13 to 64 years in all health care settings. ⋯ While progress has been made in screening, HIV testing rates remains sub-optimal for ED visits. Populations visiting the ED for routine care may suffer missed opportunities for HIV testing, which delays their entry into HIV medical care. To end the epidemic, new approaches for increasing targeted routine HIV testing for populations attending health care settings is recommended.