Future of plastic surgery in the UK and role of overseas doctors.
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Biomedical subjects
Publications and source records attributed to M Javaid.
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Many advances in the management of melanoma have occurred in the last few years. These make this an exciting time for clinicians and allows them to offer glimmers of hope for patients with this disease. This article looks at the therapeutic aspects of the treatment of cutaneous melanoma.
Dog bites to the face can be life-threatening if major infection occurs, and traditional management consists of wound toilet and debridement, with repair only when the possibility of infection has been eliminated. Surgical opinion is now swinging towards earlier repair. We have analysed retrospectively the outcome of 40 cases that, irrespective of time delay between injury and presentation, underwent primary repair or reconstruction after wound toilet, debridement and administration of prophylactic antibiotics. The victims were 17 males and 23 females with ages ranging from 2 to 76 years (mean 25). Median delay between the injury and presentation in the emergency department was 60 minutes (range 7 minutes to 5 days). All patients received surgical treatment within 24 hours of admission, 18 being operated on within 6 hours. 31 had primary repairs and 9 patients had reconstructive procedures with local skin flaps or skin grafts. Primary healing was achieved in all but 2 patients, of whom one developed minor wound infection and one had necrosis of a composite graft. These results support the view that, for dog bites to the face, primary repair is the method of choice.
Malignant melanoma is a condition which kills many young people, yet early recognition can lead to cure. There are, however, new approaches to diagnosis and management of disease at high risk of recurrence, which raise glimmers of hope in this most capricious of conditions.
Fewer than 200 confirmed cases of babesiosis have been reported in the last decade. Most cases in the United States have occurred on Cape Cod, Nantucket Island, and Long Island. Babesia microti, a malaria-like protozoan that parasitizes erythrocytes, is responsible for this illness in the United States. Infection is often subclinical but may be fulminant, especially in infants, the elderly, and in asplenic patients. Symptoms are nonspecific, usually consisting of fever and myalgias. Common laboratory abnormalities include evidence of hemolysis and thrombocytopenia. We report a case of babesiosis in an elderly male manifested by high fevers, confusion, hemolytic anemia, and thrombocytopenia.
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