BACKGROUND Dermatofibrosarcoma protuberans(DFSP)is a rare,low-grade,locally aggressive cutaneous sarcoma.DFSP in the periocular region is exceedingly rare,leading to diagnostic and surgical challenges due to anatomica...BACKGROUND Dermatofibrosarcoma protuberans(DFSP)is a rare,low-grade,locally aggressive cutaneous sarcoma.DFSP in the periocular region is exceedingly rare,leading to diagnostic and surgical challenges due to anatomical constraints in the periocular region.Precise diagnosis is essential to guide appropriate surgical management and prevent recurrence.CASE SUMMARY A 32-year-old female presented with a recurrent tumor in the medial canthus,previously diagnosed as a solitary fibrous tumor in an outside institution.After complete radiological and systemic workup,she was scheduled for a wide local excision followed by reconstruction after getting tumor clear margins on frozen section.Histopathology confirmed DFSP,characterized by storiform spindle cell proliferation,diffuse cluster of differentiation 34 positivity,and signal transducer and activator of transcription 6 negativity.CONCLUSION This case highlights the challenges in the diagnostic and surgical management of DFSP in periocular tumors.Comprehensive surgical excision with appropriate reconstruction is critical for achieving oncological control while preserving aesthetics and function.展开更多
Obstructive sleep apnea(OSA)is a prevalent and underdiagnosed sleep disorder strongly associated with obesity.Traditional therapies such as continuous positive airway pressure are effective but often limited by poor a...Obstructive sleep apnea(OSA)is a prevalent and underdiagnosed sleep disorder strongly associated with obesity.Traditional therapies such as continuous positive airway pressure are effective but often limited by poor adherence.Recent evidence suggests that tirzepatide,a dual glucagon like receptor-1 and glucose dependent insulinotropic polypeptide receptor agonist,may offer a pharmacologic approach to OSA management through its weight-reducing and metabolic effects.This narrative review was conducted using a structured search of PubMed,Google Scholar,and Scopus databases for English-language articles published up to May 2024.Keywords included“tirzepatide”,“obstructive sleep apnea”,“OSA”,and“GLP-1 agonist”.Clinical trials,systematic reviews,and relevant observational studies focusing on tirzepatide’s role in OSA or obesity were included and thematically analyzed.Emerging evidence from the SURMOUNT-OSA and related trials indicates that tirzepatide leads to clinically significant reductions in body weight,apnea-hypopnea index,and systemic inflammation.The drug was found to be effective and also showed additional benefits in sleep quality and cardiovascular risk factors.Tirzepatide represents a promising pharmacologic advancement in the management of obesity-related OSA.By targeting both metabolic and structural contributors to OSA,it may serve as an adjunct or alternative to traditional therapies.Further research is warranted to evaluate long-term outcomes and to define its role in clinical practice guidelines.展开更多
文摘BACKGROUND Dermatofibrosarcoma protuberans(DFSP)is a rare,low-grade,locally aggressive cutaneous sarcoma.DFSP in the periocular region is exceedingly rare,leading to diagnostic and surgical challenges due to anatomical constraints in the periocular region.Precise diagnosis is essential to guide appropriate surgical management and prevent recurrence.CASE SUMMARY A 32-year-old female presented with a recurrent tumor in the medial canthus,previously diagnosed as a solitary fibrous tumor in an outside institution.After complete radiological and systemic workup,she was scheduled for a wide local excision followed by reconstruction after getting tumor clear margins on frozen section.Histopathology confirmed DFSP,characterized by storiform spindle cell proliferation,diffuse cluster of differentiation 34 positivity,and signal transducer and activator of transcription 6 negativity.CONCLUSION This case highlights the challenges in the diagnostic and surgical management of DFSP in periocular tumors.Comprehensive surgical excision with appropriate reconstruction is critical for achieving oncological control while preserving aesthetics and function.
文摘Obstructive sleep apnea(OSA)is a prevalent and underdiagnosed sleep disorder strongly associated with obesity.Traditional therapies such as continuous positive airway pressure are effective but often limited by poor adherence.Recent evidence suggests that tirzepatide,a dual glucagon like receptor-1 and glucose dependent insulinotropic polypeptide receptor agonist,may offer a pharmacologic approach to OSA management through its weight-reducing and metabolic effects.This narrative review was conducted using a structured search of PubMed,Google Scholar,and Scopus databases for English-language articles published up to May 2024.Keywords included“tirzepatide”,“obstructive sleep apnea”,“OSA”,and“GLP-1 agonist”.Clinical trials,systematic reviews,and relevant observational studies focusing on tirzepatide’s role in OSA or obesity were included and thematically analyzed.Emerging evidence from the SURMOUNT-OSA and related trials indicates that tirzepatide leads to clinically significant reductions in body weight,apnea-hypopnea index,and systemic inflammation.The drug was found to be effective and also showed additional benefits in sleep quality and cardiovascular risk factors.Tirzepatide represents a promising pharmacologic advancement in the management of obesity-related OSA.By targeting both metabolic and structural contributors to OSA,it may serve as an adjunct or alternative to traditional therapies.Further research is warranted to evaluate long-term outcomes and to define its role in clinical practice guidelines.
