Squamous intra-epithelial neoplasia presenting as a urethral caruncle.
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Biomedical subjects
Publications and source records attributed to D Neilson.
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We report a case of squamous cell carcinoma of the skin of the right ring finger which was treated by excision and split skin grafting. Three months later the patient presented with a further lesion at the margin of the skin graft donor site on the right thigh. Excision biopsy of this second lesion revealed a squamous cell carcinoma of a similar pathological appearance to the original lesion. We have been unable to trace any previous similar reports. A possible pathological basis for the sequence of events is discussed.
Carcinoma (epithelioma) cuniculatum is an uncommon variety of squamous cell carcinoma formerly considered to be limited to the foot. It has recently been reported in other parts of the body. We report a case in the hand and describe its management.
In this open-label, randomized drug study, we compared two cephalosporin prophylactic regimens, one using cefazolin and one using cefuroxime, in 100 patients having coronary bypass surgery. Additional epidemiological data were collected to identify the patient at higher risk for acquiring an infection. Patients were categorized into four groups: (1) no infection; (2) clinically determined infection without a culture or prescription of additional antibiotics; (3) clinical infection with no or negative wound culture and prescription of additional antibiotics; and (4) clinical infection with positive culture and need for additional antibiotics. Seven cefuroxime patients (13.5%) and 9 cefazolin patients (18.8%; p = 0.471) had a wound that became clinically infected (Groups 2-4). In a univariate analysis, 11 variables were statistically associated with the development of a wound infection. A logistic regression model defined 3 variables at an alpha level of 0.05 and 3 at an alpha level of 0.10 that predicted a wound infection. Patients were identified at high risk of wound infection if they had postoperative weight gain, long operative hospitalization, prolonged use of a Foley catheter, postoperative use of blood products, and operation performed by two specific surgeons. Our results indicated that closer observation of the high-risk patients and a definition of the mechanism of the infections are needed.
Several previous studies have reported increased rates of schizophrenia among Afro-Caribbean immigrants, although doubt has been cast upon the value of case-note diagnoses and retrospective case-finding. A prospective study was therefore undertaken, including all patients of Afro-Caribbean ethnic origin with a first onset psychosis presenting to the psychiatric services from a defined catchment area. Utilizing several diagnostic classifications, rates for schizophrenia were found to be substantially increased in the Afro-Caribbean community, and especially in the 'second generation' British born. Mode of onset and symptom profiles of psychoses suggest that atypical syndromes, and by implication 'misdiagnoses', do not account for reported higher rates of schizophrenic illness in these patients.
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