Persistent granulomatous inflammatory response induced by injectable poly-L-lactic acid for HIV lipoatrophy.
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Biomedical subjects
Derek H Jones
Publications and source records attributed to Derek H Jones.
Community-acquired methicillin-resistant Staphylococcus aureus skin infection: a retrospective analysis of clinical presentation and treatment of a local outbreak.
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA), a well-known nosocomial pathogen, is now emerging as a prominent cause of community acquired infections. We have noted an increase in number of cutaneous infections in Los Angeles over the past 2 years. The objective of the current study is to evaluate the clinical presentation and treatment of community acquired MRSA skin infections. METHODS: A retrospective chart review of 39 patients with 46 involved sites was performed. The sites of infection, morphology, antimicrobial susceptibility, and definitive treatment were evaluated. RESULTS: Cutaneous abscesses were the most common presentation of cutaneous MRSA infection. Definitive treatment consisted of incision and drainage in combination with antimicrobial therapy. The most effective antibiotics were vancomycin, trimethoprim/sulfamethoxazole in combination with rifampin, and linezolid. CONCLUSION: Community acquired MRSA infection appears to be a growing problem requiring prompt diagnosis and treatment. First line treatment is incision and drainage in combination with linezolid, vancomycin, or combination trimethoprim/sulfamethoxazole and rifampin.
Adult↗
Highly purified 1000-cSt silicone oil for treatment of human immunodeficiency virus-associated facial lipoatrophy: an open pilot trial.
BACKGROUND: Among human immunodeficiency virus-infected individuals, facial lipoatrophy has become epidemic. Those affected are stigmatized, leading to psychological distress, social and career impediments, and impaired compliance to human immunodeficiency virus medications. Temporary treatment options are limited by excessive cost, necessity of frequent treatments, and lack of a natural look or feel beneath the skin. Affected patients require more persistent, affordable, safe, and effective treatment options. OBJECTIVE: The objective was to evaluate the safety and efficacy of highly purified 1000-cSt silicone oil injected by microdroplet serial puncture technique for the treatment of human immunodeficiency virus-associated lipoatrophy. METHODS: Data on 77 patients with a complete correction were analyzed to determine the number of treatments, amount of silicone, and time required to reach complete correction, relative to initial severity. RESULTS: The volume of silicone, number of treatments, and time required to reach a complete correction were directly related to initial severity of lipoatrophy (p < 0.0001). Supple, even facial contours were routinely restored, with all patients tolerating treatments well. No adverse events were noted. CONCLUSION: In this pilot trial, we have demonstrated that highly purified 1000-cSt silicone oil is a safe and effective treatment option for human immunodeficiency virus facial lipoatrophy. Longer-term safety and efficacy in human immunodeficiency virus patients remain to be proven.
Adult↗
Liquid injectable silicone for soft tissue augmentation.
Liquid injectable silicone is a unique soft tissue augmenting agent that may be effectively utilized for the correction of specific cutaneous and subcutaneous atrophies. Although historical complications have occurred, resulting likely from the presence of adulterants and impurities, modern purified silicone products approved by the Food and Drug Administration for injection into the human body may be employed with minimal complications when strict protocol is followed. In this article the present authors review the history and controversy regarding silicone as well as describe the appropriate indications, patient selection, instrumentation, treatment protocol, and anticipated complications involved with the use of liquid injectable silicone for soft tissue augmentation. Although its use is controversial, the present authors maintain that liquid injectable silicone is an important and effective augmenting agent for the long-term correction of scars and facial contour defects such as HIV facial lipoatrophy. Furthermore, it is a treatment modality deserving of continued investigation.
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