tissue necrosis or ulceration after each PDL treatment, and the rather prolonged time to lesion involution after therapy, suggest that mechanisms other than simple vascular occlusion are operative. References1 Wolf IH, Richtig E, Kopera D et al. Locoregional cutaneous metastases of malignant melanoma and their management. Dermatol Surg 2004; 30 (Suppl. 2):244-7. 2 Bong AB, Bonnekoh B, Franke I et al. Imiquimod, a topical immune response modifier, in the treatment of cutaneous metastases of malignant melanoma. Dermatology 2002; 205:135-8. 3 Steinmann A, Funk JO, Schuler G et al. Topical imiquimod treatment of a cutaneous melanoma metastasis. J Am Acad Dermatol 2000; 43:555-6. 4 Ugurel S, Wagner A, Pfohler C et al. Topical imiquimod eradicates skin metastases of malignant melanoma but fails to prevent rapid lymphogenous metastatic spread. Br J Dermatol 2002; 147:621-4. 5 Vereecken P, Mathieu A, Laporte M et al. Management of cutaneous locoregional recurrences of melanoma: a new therapeutic perspective with imiquimod. Dermatology 2003; 206:279-80. 6 Wolf IH, Smolle J, Binder B et al. Topical imiquimod in the treatment of metastatic melanoma to skin. Arch Dermatol 2003; 139:273-6. 7 Dummer R, Urosevic M, Kempf W et al. Imiquimod in basal cell carcinoma: how does it work? Br J Dermatol 2003; 149 (Suppl. 66):57-8. 8 Sullivan TP, Dearaujo T, Vincek V et al. Evaluation of superficial basal cell carcinomas after treatment with imiquimod 5% cream or vehicle for apoptosis and lymphocyte phenotyping.
Aortic pseudocoarctation is a rare congenital anomaly characterized by elongation and deformity of the aortic arch and is known to be associated with aneurysmal formation. Several studies unite to say it leads to a surgical sanction as soon as symptomatic or associated with aneurysms of the aortic arch. Our patient is a 12 years old boy, followed since birth for a little tight pseudocoarctation with a cervical aortic arch and transverse aortic arch hypoplasia. Close clinical and paraclinical monitoring including angioscans, showed the gradual enlargement of the superior mediastinum, in relation with the appearance of three aneurysms of the aortic arch. The intervention, performed by sternotomy, has consisted of the resection of the aneurysmal area and the interposition of a Dacron tube to repair the aortic arch and the reimplantation of the left subclavian artery into the left carotid artery. The postoperative course was uneventful. Management of pseudocoarctation associated with cervical aortic arch and aneurysms remains surgical. Close monitoring of patients with pseudocorctation, seems to be essential to avoid fatal complications such as aneurysmal rupture.
Background-It is known that obesity is associated with a chronic inflammatory state, but few studies have evaluated visceral fat (VF) content and its role in individuals with Crohn's disease (CD). Objetive-To compare the nutritional status, body composition and proportion of VF between CD individuals and healthy volunteers. Methods-Cross-sectional study that enrolled individuals with Crohn's disease and healthy controls. The stratification according to nutritional status was carried out by means of BMI. The percentage of body fat percentage (%BF) and VF were estimated by means of DEXA. VF proportion was evaluated by means of the VF/BMI and VF/%BF ratios. Results-A total of 78 individuals were included. The control group was comprised of 28 healthy subjects aged 35.39±10 years old (60.7% women); mean BMI=23.94±3.34 kg/m 2 ; mean VF=511.82±448.68 g; mean CRP=0.81±1.78 ng/mL. The CD group was comprised of 50 patients; 11 (22%) were underweight (BMI=18.20±1.97 kg/ m 2 ; %BF=24.46±10.01; VF=217.18±218.95 g; CRP=4.12±4.84 ng/mL); 18 (36%) presented normal weight (BMI=22.43±1.48 kg/m 2 ; %BF=30.92±6.63; VF=542.00±425.47 g and CRP=4.40±1.78 ng/mL); 21 (42%) were overweight or obese (BMI=29.48±3.78 kg/m 2 ; %BF=39.91±7.33; VF=1525.23±672.7 g and CRP=1.33±2.06 ng/mL). The VF/BMI ratio was higher in the CD group when compared to controls (32.41±24.63 vs 20.01±16.23 g per BMI point; P=0.02). Likewise, the VF/%BF was also higher in the CD group (35.21±23.33 vs 15.60±12.55 g per percentage point; P<0.001). Conclusion-Among individuals with Crohn's disease, BMI presents a direct correlation with visceral fat content. These results indicate the presence of an adiposopathy in Crohn's disease subjects, which is evidenced by a higher visceral fat. HEADINGS-Crohn's disease. Intra-abdominal fat. Body composition. Body mass index.
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