Background: Hidradenitis suppurativa (HS) is a persistent, recurring skin inflammatory condition linked to various comorbidities. Management involves antibiotics, hormone therapy, immune-modulating drugs, surgery, and treatment of comorbidities. The objectives of the study were to assess the comorbidities, clinical presentation subtypes, and applied treatment of patients with HS. Methods: Patients with HS who visited the Centre of Dermatovenereology at Vilnius University Hospital Santaros Klinikos in Lithuania underwent evaluation based on the guidelines of the European Hidradenitis Suppurativa Foundation Registry questionnaire. Results: The study included 49 patients, and 61.22% (n = 30) had comorbidities. A strong positive correlation was found between a family history of inflammatory diseases (69.38% (n = 34)) and the severity of HS according to Hurley stage (r = 0.71 p < 0.05). A statistically significant correlation (r = 0.944, p = 0.02) was found between metabolic comorbidities and Hurley stage. Patients on biologic treatment had a mean IHS4 of 7.38 at the beginning of treatment and 3.22 at follow-up (p < 0.05). For patients not on biologics, the initial IHS4 score was 6.21 and 5.42 at follow-up (p > 0.05). Conclusions: A family history of inflammatory diseases and metabolic comorbidities showed a strong correlation with HS severity. Treatment with biologics showed significant improvement in HS scores compared to systemic antibiotics.
With the increase of high energy injuries, acetabular and pelvic ring fractures tend to be a more common part of polytrauma patients. Despite growing incidence, management of these injuries remains one of the most difficult challenges in orthopedic surgery. As these patients are usually multiply injured, it is not only life-threatening trauma in acute settings but also crippling in long time. We present a case of a 40-year-old male who suffered from a dreadful traffic accident following the fractures of pelvic ring and both acetabulum, open fracture of tibia, urinary bladder rupture, and crush syndrome. We discuss the factors which dictated the timing of definitive management of pelvic and associated injuries and compare it with this study. Furthermore, we present patients' final outcomes and management of long-term complications.
Background: Hidradenitis suppurativa (HS) diagnosis often faces a global delay of 7.2 years due to factors like lack of recognition, stigma, and socioeconomic barriers. Limited effective therapies and frequent exacerbations impact patients’ quality of life, posing a significant burden on healthcare systems. Methods: HS patients were assessed according to European Hidradenitis Suppurativa Foundation (EHSF) Registry questionnaire guidelines at various stages of the disease and treatment. Results: The study included 49 patients; 57.14% (n = 28) of them were male. The average age of the subjects was 39.91 ± 13.665 years; the average BMI was 27.84 ± 7.362. A total of 59.18% (n = 29) were active or previous smokers. There were statistically more male smokers than female (p < 0.01). Average disease onset was 25.71 ± 13.743 years; the mean time to diagnosis was 5.2 ± 7.607 years. A total of 70.2% (n = 33) were previously misdiagnosed. Subjects had 6.17 ± 6.98 painful days over the preceding 4 weeks. The average intensity of pain according to the visual analogue scale (VAS) was 5.60 ± 3.36 points. The mean dermatology life quality index (DLQI) at baseline was 8.9 ± 7.436. Conclusions: The research revealed delayed diagnoses, especially for females. Smoking was linked to higher Hurley stages, with a prevalence among male smokers, and HS had a substantial impact on patients’ quality of life.
Introduction: Despite relatively low incidence, dislocation remains one of the main reasons for total hip arthroplasty (THA) revision. It is a devastating complication for a patient and a surgeon, and has high burden on the healthcare system. The aim of the present study was to assess and compare the risk factors for revision after early and delayed THA dislocations. Methods: Some 3403 THA through posterior approach for primary osteoarthritis were retrospectively studied in the Lithuanian Arthroplasty Register from 2011 to 2018. Three months after THA was the splitting time between the first event of early and delayed dislocations. Revision was set as outcome measure. Gender, affected side, number of dislocations, femoral head and neck size, and prosthesis fixation type were tested as risk factors for revision after early and delayed THA dislocations. Results: Dislocation occurred in 108 patients (3.2%), and 26 cases (0.8%) required revision. Men had statistically significant higher risk for revision due to early dislocation [hazard ratio (HR) 4.7; 1.3-17.7 confidence interval (CI)] and considerably lower risk for revision due to delayed dislocation (HR 0.5; 0.1-1.7 CI). The left side THA had twice the risk as compared to the right in the early settings (HR 2.1; 0.6-6.9 CI) which equalized after three months (HR 1.1; 0.4-3.1 CI). Some 32 mm femoral head had significantly lower risk in the early group as compared to 28 mm head (HR 0.3; 0.1-0.5 CI). Short head was associated with increased risk for revision after early dislocation, although, not statistically significant. Prosthesis fixation type was not a risk factor for revision surgery neither after early nor after delayed dislocation. Conclusion: The unique finding of gender separation was found -- men tend for revision after early dislocation and women after delayed dislocation. In early stage, additional precautions should be considered when 28 mm short metal heads are used.