Esporotricosis linfangítica bilateral y simultánea

BackgroundSporotrichosis is the most frequent subcutaneous mycoses in Jalisco, Mexico. The forms of transmission described in the literature are from bites of different animals and injuries due to utensils.AimsWe present an unusual case with bilateral and lymphangitic cutaneous lesions in the upper limbs caused by a pocket gopher bite (Geomys bursarius).MethodsMycology studies were performed on the arm lesions, including Gram and Ziehl Neelsen stains, direct exam, Sabouraud and mycobiotic cultures at temperatures of 25–28 °C.ResultsGram and Ziehl Neelsen stains were negative. Sporothrix schenckii grew in the culture plates. Treatment with saturated potassium iodide solution was prescribed and four months later complete remissions of the lesions were achieved, and the control cultures were negative.ConclusionsThe most common clinical presentations of sporotrichosis are the fixed and lymphangitic forms. Bilateral lymphangitic sporotrichosis is rare.     

Does tumescent infiltration have a deleterious effect on undermined skin flaps?

In summary, we think that the intradermal injection of the tumescent solution with epinephrine, which produced a peau d'orange appearance of the overlying skin, resulted in superficial flap loss secondary to the vasoconstrictive property of epinephrine combined with the hydrostatic pressure of the injection in this patient within a superficial plane and flap elevation. This delayed the clearance of epinephrine from the flaps. In this case, removal of the sutures did not result in any improvement in the flap, and this maneuver was performed too late. If a peau d'orange appearance is observed after injection, we recommend waiting until the fluid has time to recirculate (15 to 30 minutes, at a minimum) and avoid immediate incising or undermining of the flap.     

Are scared prey as good as dead?

Predators affect prey and their resources by changing the density and traits (e.g. morphology and behavior) of those prey. Ecological studies and models of community dynamics, however, typically only incorporate how changes in prey densities, rather than their traits, affect community dynamics. In a recent meta-analysis, Preisser et al. show that trait effects are as large, if not larger than density effects. This strongly suggests that trait effects should be integrated into empirical and theoretical studies.     

Are culture-bound syndromes as real as universally-occurring disorders?

This paper asks what it means to say that a disorder is a "real" disorder and then considers whether culture-bound syndromes are real disorders. Following J.L. Austin I note that when we ask whether some supposed culture-bound syndrome is a real disorder we should start by specifying what possible alternatives we have in mind. We might be asking whether the reported behaviours genuinely occur, that is, whether the culture-bound syndrome is a genuine phenomenon as opposed to a myth. We might be wondering whether the condition should rightly be considered a disorder, as opposed to some sort of non-disorder condition (for example, a non-disorder form of deviance, or a potentially valuable condition). We might want to know whether the culture-bound syndrome is really a distinct disorder, in the sense that scientific classification systems should include it as a separate category, or whether it is just a variant of a universally occurring disorder. I argue that some specific difficulties can arise with determining whether a culture-bound syndrome is a real disorder in each of these three senses. However, the frequent assumption that real disorders will necessarily occur universally, and that those that occur only in certain environments are suspicious is not generally justified.