Explore the vast range of titles available.

A growing number of studies report dermal malignancies mimicking diabetic foot ulcers (DFUs). We reviewed clinical cases reporting malignant tumours misdiagnosed to be DFU aiming to identify factors contributing to misdiagnosis. We systematically searched in PubMed for clinical cases reporting on misdiagnosis of DFU in patients with cancer. A chi‐square analysis was conducted to show the link between the incidence of initial DFU misdiagnosis and patient age, gender and wound duration. Lesions misdiagnosed to be DFU were subsequently diagnosed as melanoma (68% of the cases), Kaposi's sarcoma (14%), squamous cell carcinoma (11%), mantle cell lymphoma, and diffuse B‐cell lymphoma (both by 4%). Older age (≥65 years) was associated with a significantly increased risk of malignancy masked as DFU (OR: 2.452; 95% CI: 1.132 to 5.312; P value = .019). The risk of such suspicion in older patients (age ≥ 65 years) was 145% higher than in younger patients (age < 65 years). Clinicians should maintain a high level of awareness towards potentially malignant foot lesions in elderly patients with diabetes (age ≥ 65).

It is very difficult to identify the genetic variation of haemophilia A. We examined a case report from a sizable, uncommon haemophilia family, analysing the application of DHPLC in the diagnosis of haemophilia A. The comprehensive clinical data and laboratory assessments of the proband within the family were meticulously compiled. Subsequent to this, tests were conducted to evaluate the activated partial prothrombin time (APTT) and the clotting activity of coagulation factor VIII (F VIII: C). Polymerase chain reaction (PCR) techniques were employed to identify any inversions within the F8 gene's introns 22 and 1. Thereafter, direct sequencing methodology was utilised to sequence all exons of the F8 gene. To analyse the copy number variations across all exons of the F8 gene, a multiple PCR combined with denaturing high‐performance liquid chromatography (DHPLC) approach was adopted. In addition, specific pathogenic mutations predisposing to progenitor cell disorders were screened in family members. The APTT of the proband was 60 s. F VIII: C is < 1%. It was found that the progenitor F8 gene exon 14 had a 226 bp insertion sequence, which was of unknown origin and was a pathogenic mutation. The analysis combined with this family situation is consistent with the expectation. The mutation was used as the detection target to complete the prenatal diagnosis. The pathogenic mutation found in this family is a rare large fragment insertion mutation. It is necessary to combine multiple experimental methods to improve the success rate of genetic diagnosis of haemophilia A.

Background Thread lifting is a minimally invasive technique for addressing facial aging and skin laxity. Despite its popularity, it carries risks of complications ranging from minor bruising to severe structural injuries. Comprehensive understanding of these complications is vital for optimizing outcomes. Aims To analyze the complications associated with facial thread lifting, provide insights into their underlying mechanisms, and propose effective management strategies to minimize risks. Patients/Methods A comprehensive review of complications from thread lifting was conducted, focusing on patient outcomes and procedural challenges. Data from clinical studies, case reports, and expert recommendations were analyzed to identify common and severe complications. Advanced techniques, such as ultrasound‐guided procedures, were evaluated for their efficacy in preventing complications. Results Common complications included bruising, pain, swelling, bleeding, and dimpling, often arising from improper technique or anatomical factors. Severe issues such as infection, granuloma, thread migration, nerve damage, and parotid gland injuries were less frequent but posed significant challenges. Management strategies included massage, saline or filler injections, botulinum toxin, and surgical interventions for persistent or severe cases. Ultrasound‐guided techniques demonstrated efficacy in reducing risks, particularly for glandular and vascular injuries. Conclusions While thread lifting offers a promising alternative to surgical facelifts, its success depends on precise technique, anatomical knowledge, and effective complication management. Preventive measures, including preoperative planning, proper thread placement, and patient‐specific customization, are crucial. Future advancements in imaging technologies and thread materials will likely enhance safety and efficacy, ensuring better patient satisfaction and outcomes.

A 9-year-old girl presented 3 weeks after an elbow injury that had initially been treated conservatively. Clinical evaluation revealed tenderness over the lateral aspect of the elbow and motion limitation. Imaging studies showed a radial neck fracture that was classified as Judet type IVb. Management comprised open surgery, fracture reduction, and transcapitellar K‑wire fixation. The immediate follow-up period was uneventful. At the final follow-up after 6 months, the fracture showed complete healing, and the elbow function was almost comparable to the other side. Neglected radial neck fractures are rare; attempts should be made to preserve the normal anatomy by open surgical reduction and fixation before deciding on salvage procedures.

Background: Protracted withdrawal syndrome (PWS) after stopping antidepressants (frequently also referred to as post-acute withdrawal syndrome or PAWS) has been described in a few case reports. However, a detailed quantitative analysis of specific symptom manifestations in antidepressant PWS is still lacking. Methods: We extracted patient narratives from a large English-language internet forum SurvivingAntidepressants.org, a peer support site concerned about withdrawal from antidepressants. PWS was ascertained based on diagnostic criteria proposed by Chouinard and Chouinard, specifically ⩾6 months of continuous antidepressant use, with emergence of new and/or more intense symptoms after discontinuation that last beyond the initial 6 weeks of acute withdrawal. We assessed medication history, outcome of PWS, and the prevalence of specific symptoms. Results: In total, n = 69 individual reports of protracted withdrawal were selected for analysis. At time of the subjects’ most recent reports, duration of PWS ranged from 5 to 166 months, mean = 37 months, median = 26 months. Length of time on the antidepressant causing protracted withdrawal ranged from 6 to 278 months, mean = 96 months, and median = 79 months. Throughout the withdrawal experience, affective symptoms, mostly anxiety, depression, emerging suicidality and agitation, were reported by 81%. Somatic symptoms, mostly headache, fatigue, dizziness, brain zaps, visual changes, muscle aches, tremor, diarrhea, and nausea were reported by 75%. Sleep problems (44%) and cognitive impairments (32%) were mentioned less frequently. These broad symptom domains were largely uncorrelated. Conclusion: PWS or PAWS from antidepressants can be severe and long-lasting, and its manifestations clinically heterogeneous. Long-term antidepressant exposure may cause multiple body system impairments. Although both somatic and affective symptoms are frequent, they are mostly unrelated in terms of occurrence. Proper recognition and detection of PWS thus requires a comprehensive assessment of medication history, duration of the withdrawal syndrome, and its various somatic, affective, sleep, and cognitive symptoms.

Background Case-Based Learning (CBL) has seen widespread implementation in undergraduate education since the early 1920s. Ample data has shown CBL to be an enjoyable and motivational didactic tool, and effective in assisting the expansion of declarative and procedural knowledge in academia. Although a plethora of studies apply multiple choice questions (MCQs) in their investigation, few studies measure CBL or case-based blended learning (CBBL)-mediated changes in students’ procedural knowledge in practice or employ comparison or control groups in isolating causal relationships. Methods Utilizing the flexibilities of an e-learning platform, a CBBL framework consisting of a) anonymized patient cases, b) case-related textbook material and online e-CBL modules, and c) simulated patient (SP) contact seminars, was developed and implemented in multiple medical fields for undergraduate medical education. Additionally, other fields saw a solo implementation of e-CBL in the same format. E- cases were constructed according to the criteria of Bloom’s taxonomy. In this study, Objective Structured Clinical Examination (OSCE) results from 1886 medical students were analyzed in total, stratified into the following groups: medical students in 2013 ( n  = 619) before CBBL implementation, and after CBBL implementation in 2015 ( n  = 624) and 2016 ( n  = 643). Results A significant improvement (adjusted p  = .002) of the mean OSCE score by 1.02 points was seen between 2013 and 2015 (min = 0, max = 25). Conclusion E-Case-Based Learning is an effective tool in improving performance outcomes and may provide a sustainable learning platform for many fields of medicine in future.

Background Injectable Poly‐L‐lactic acid (PLLA) is effective in restoring mid‐face volume and is widely used treating the nasolabial fold (NLF). This study aimed to compare the safety and efficacy of a novel PDLLA based product (PDLLA + non‐cross‐linked HA; Poly‐D, L‐lactic acid + hyaluronic acid) with that of a commonly used PLLA for NLF correction. Methods In this multi‐center, randomized, split‐face, evaluator‐blinded study, 33 subjects received injections of the PDLLA based product on one NLF and PLLA injection on the other (three injections total, administered at 4‐week intervals). Wrinkle severity was assessed using standardized photographs taken at baseline (week 0); before the second and third injections (weeks 4 and 8); 4 weeks after the third injection (week 12); and 3 months after the final injection (week 24) using the Wrinkle Severity Rating Scale (WSRS). Safety data were collected through subject interviews and case report forms. Results Both the PDLLA based product and PLLA significantly improved NLF wrinkle severity at all time points compared to baseline (p < 0.001). The degree of improvement was comparable between the two products throughout the observation period. Conclusion The PDLLA based product demonstrated non‐inferiority to PLLA for NLF correction. Further studies are needed to assess long‐term safety.

Zusammenfassung Die IAM (Influenza-assoziierte Myositis) ist eine gutartige, im Anschluss an Infekten der oberen Atemwege auftretende Muskelentzündung bei Vorschul- und Schulkindern in einem Verhältnis Jungen zu Mädchen von 3:1. Sie ist meistens selbstlimitierend und heilt ohne Spätfolgen ab. Während der Grippezeit, aber auch zu Zeiten anderer saisonal auftretender Viruserkrankungen, die respiratorische Infekte verursachen können, sollte vermehrt die Aufmerksamkeit bei Gangstörungen oder Schmerzen der unteren Extremität auf die IAM (oder auch BACM) gelenkt werden. Wir empfehlen bei betroffenen Kindern eine Austestung auf Influenza oder RSV (Nasen‑/Rachenabstrich) sowie eine serumchemische Analyse der akuten Entzündungs- und CK-Werte. Damit kann die Diagnose IAM (oder BACM) relativ unkompliziert und sicher gestellt und Kindern die zumeist nicht erforderlichen, beschwerlichen Durchuntersuchungen anderer Muskelerkrankungen im Rahmen eines Spitalsaufenthaltes erspart werden. Da eine kausale medikamentöse Therapie zurzeit nicht möglich ist, sprechen die Autoren zur Vermeidung des spektakulären, schmerzhaften (gutartigen) Krankheitsbildes (Frankensteingang, Gehverlust) eine Empfehlung zur Influenza-A/B-Immunisierung im Kindesalter aus.

The transforming powder dressing (Altrazeal®, Uluru Inc, Addison, TX, USA) is simple to use, painless to apply and has a wear time of up to 30 days. This study aims to review the current literature to elucidate the impact of transforming powder dressing on healing, pain management and overall patient outcomes. We conducted a systematic review following Preferred Reporting Items of Systematic Reviews and Meta‐Analyses guidelines. Data including study characteristics, patient demographics and wound outcomes were extracted. Our systematic review included 26 articles (n = 175). Of these articles, 13 (50%) were case reports, 10 (38.5%) were case series, 2 (7.7%) were randomised controlled trials and 1 (3.8%) was a cohort study. Wound types included venous ulcer (23.9%), pressure sore (19.7%), burn (15.5%), skin graft (13.4%), diabetic foot ulcer (4.2%), Mohs defect (3.5%) and other (19.6%). Complete re‐epithelialization occurred in 90.1% of the wounds. A total of 19 studies (73%) discussed pain, each of which reported reduced pain with the use of transforming powder dressing. The evaluated studies collectively suggest that transforming powder dressing offers a promising re‐epithelialization rate and analgesic effect across various wound types.