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Biomedical subjects

S R McBride

Publications and source records attributed to S R McBride.

8 recordsLinked to original sources
PubMed2005

Dementia associated with scleromyxoedema reversed by high-dose intravenous immunoglobulin.

Scleromyxoedema is a rare skin disease, characterized by deposition of acid mucopolysaccharides in the dermis. Although the disease primarily affects the skin, cardiovascular, renal and rheumatological manifestations have been described. In addition to these noncutaneous manifestations, about 15% of patients have central neurological symptoms such as psychosis, convulsions and encephalopathy. Successful therapy is difficult but high-dose intravenous immunoglobulin (IVIg) has been reported to be a successful treatment. We describe a patient with scleromyxoedema who presented with novel central nervous system manifestations of chronic cognitive impairment and dementia (Folstein Mini Mental State test score 8/30), which improved within a week after treatment with high-dose IVIg, with full restoration (Folstein Mini Mental State test score 27/30) at 2 months.

Aged↗
PubMed2003

Optimizing the frequency of outpatient short-contact dithranol treatment used in combination with broadband ultraviolet B for psoriasis: a randomized, within-patient controlled trial.

BACKGROUND: Recent concerns over the side-effects of psoralen plus ultraviolet (UV) A, immunosuppressive and cytotoxic treatments have led to increased interest in dithranol for treatment of psoriasis. Few studies have investigated how frequently dithranol should be applied. Dithranol-induced inflammation is maximal at 48-72 h, suggesting that daily application of dithranol may not be optimal. OBJECTIVES: To investigate the effectiveness of five times weekly application of short-contact dithranol (SCD) compared with three times weekly application in a dedicated hospital outpatient treatment unit. METHODS: A randomized, within-patient, controlled study was performed. Patients had SCD applied five times weekly to one half of the body, and three times weekly to the other side. Whole-body UVB irradiation was given 5 days a week. Patients were assessed weekly for 8 weeks. Principal outcome measures were percentage reduction in modified Psoriasis Area and Severity Index (mPASI) at the end of study and time to 50% improvement in mPASI score. RESULTS: Twenty-nine patients were recruited; four were excluded from analysis. Mean percentage reduction in mPASI score at the end of study for five times weekly application was 57.3% (95% confidence interval, CI 39.6-75.0%) and for three times weekly application was 55.4% (95% CI 37.8-73.1%; P = 0.34). Mean time to 50% improvement in mPASI for five times weekly treatment was 4.1 weeks and for three times weekly treatment was 4.0 weeks (P = 0.50). There was no difference in the frequency or severity of burning episodes for each side. CONCLUSIONS: This study suggests that three times weekly application of SCD may be as effective as five times weekly when used in conjunction with UVB administered five times weekly. Large studies of whole-body comparisons are warranted to assess further the optimal frequency of SCD and UVB therapy for psoriasis.

Administration, Topical↗
PubMed2002

Loss of p21(WAF1) compartmentalisation in sebaceous carcinoma compared with sebaceous hyperplasia and sebaceous adenoma.

AIMS: Regulation of cell cycle progression is a fundamental control process, linked to cellular differentiation and apoptosis in normal tissues. p21(WAF1) is a nuclear protein that regulates cell cycle progression. p21(WAF1) can be transcriptionally upregulated by p53, but may be activated independently of p53-for example, during terminal differentiation. Loss of topological control of p21(WAF1) expression is an early feature of malignancy in the colorectal system. Similar to the colonic mucosa, sebaceous glands contain cells that are constantly going through a process of cell division, differentiation, and cell death. This study investigated the expression of p53, p21(WAF1), and the proliferation marker Ki67 in normal sebaceous glands, sebaceous adenoma, sebaceoma, and sebaceous carcinoma. METHODS: Serial sections were stained with monoclonal antibodies to p21(WAF1), p53, and Ki67 (MIB1) using standard immunohistochemical techniques. RESULTS: In normal sebaceous glands, p21(WAF1) positive cells were only seen within the differentiating compartment, which was spatially distinct from the cycling peripheral Ki67 positive cells. In sebaceous adenoma and sebaceoma, topological control was maintained, with the distribution of markers being similar to that seen in normal sebaceous glands. Loss of topological control of markers of cellular control was seen in sebaceous carcinoma only. This contrasts with colonic tumours, in which loss of p21 compartmentalisation is seen in adenomas at an early stage of tumour progression. CONCLUSION: This work confirms the hypothesis that the dysregulation of cell cycle progression is an important process in the development of malignancy within sebaceous glands, although loss of topological control was seen only in sebaceous carcinoma.

Adenocarcinoma, Sebaceous↗
PubMed1998

Prevalence of skin disease in rural Tanzania and factors influencing the choice of health care, modern or traditional.

OBJECTIVES: To determine the prevalence of skin disease in a rural Tanzanian community and to investigate the health-seeking behavior of this community. DESIGN: The study was in 3 parts: (1) 120 heads of households were interviewed to determine the factors that influence the families' health-seeking behavior; (2) the 800 members of these families were examined for evidence of skin disease; and (3) a focus group discussion was held with influential members of the community to get a broader view of health-seeking behavior. SETTING: A rural village in the southwestern area of Tanzania: Individuals were interviewed and examined in their own homes. RESULTS: A total of 34.7% of 800 villagers had one or more skin diseases, the most common of which were tinea capitis, tinea corporis, scabies, acne, and eczema. Modern and traditional health facilities were equally used, but heads of the households older than 55 years who had never been to school and individuals who were not Christians favored traditional medicine. It was cheaper to go to a traditional healer, but modern medicine was thought to be more scientific. CONCLUSIONS: Skin disease was a problem in this village and was perceived to be a problem by both individuals and the community. There is a need to assess the clinical and diagnostic skills of both modern and traditional health practitioners and to instigate a preventive health education program to eradicate the common infections and infestations.

Adolescent↗
PubMed1998

Vesicular mycosis fungoides.

Blistering is not a feature normally associated with mycosis fungoides (MF). We present a case of MF in which histopathological vesicle formation was such a prominent feature that diagnosis was delayed. The patient's disease ran an aggressive course and death occurred within one year of presentation. Tumour involvement of the tongue with MF was an unusual late feature.

Blister↗