Beyond fibrocystic disease: the evolving concept of pre-malignant breast cancer

There is a broad spectrum of benign and pre-malignant breast disease that may be diagnosed on biopsy. Some of these conditions place affected women at significantly increased risk for breast cancer, particularly the atypical hyperplasias. All health care workers should be aware of recent developments in this important aspect of breast disease. The classification, criteria for diagnosis, associated risks for cancer development and various controversies related to these benign and borderline breast diseases are discussed.(AU)

Evaluation of thyroid nodules by fine needle aspiration cytology: a prospective study

A prospective study of 200 fine aspiration cytology specimens from 194 patients with thyroid nodules at the University Hospital of the West Indies in Jamaica showed a 95 percent accuracy when the results were compared with histopathology reports of the subsequent thyroidectomy surgical specimens in 86 patients. The false negative rate was 3 percent (for neoplasia), and there was a false positive rate of 10.5 percent. Fine needle aspiration cytology thus proves to be an accurate, specific and sensitive method of assessment of thyroid nodules which ultimately reduces unnecessary surgical intervention (AU)

Open prostatectomy: a study on 132 cases done at two hospitals in Port of Spain

Clinical data on 132 patients who received open prostatectomy during a 9-year period at two institutions in Port-of-Spain, Trinidad, are presented. There were 104 patients from the Port-of-Spain General Hospital and 28 from a private institution. The overall mortality was 38 percent, wound infection contributing to death in most of these cases. The majority of complications which followed prostatectomy performed under the conditions which exist in these two institutions were infective in origin. These can be prevented by performing early prostatectomies when the need for catheterization arises. It is concluded from the results of this study that, despite the conditions which exist at the Port-of-Spain General Hospital, open prostatectomy in old men is a safe procedure. (AU)

Primary hyperparathyroidism at the U.H.W.I

Twenty-two cases of primary hyperparathyroidism were seen at the University Hospital of the West Indies during the twelve year period, January, 1966, to December 1977. Three groups of patients were identified depending on the main symptom complex at presentation: (1) renal calculi (2) bone pain and (3) symptoms of hypercalcaemia. All cases had elevated serum calcium levels. Twenty-one patients were found to have a single parathyroid adenoma at surgery and there was one case of hypersia. No cases with the multiple endocrine adenoma syndrome were identified. The pathology of the disease is described, aspects of diagnosis are outlined and methods of tumour localization are discussed (AU)

The bone changes in sickle cell anaemia and its genetic variants

The bone changes are described in fifty-one cases of sickle cell anaemia, nineteen cases of sickle cell haemoglobin C disease and two cases of sickle cell thalassaemia. Avascular necrosis of the head of the femur has been found in all three types of sickle cell disease. These responded to treatment. The changes found in six cases of Perthes' disease in the negro compared with the changes in avascular necrosis of the head of the femur in sickle cell disease. Hyperplastic bone changes are seen only in true sickle cell anaemia and not in the variants. Secondary osteomyelitis appears to be fairly common in sickle cell anaemia. Organisms of the salmonella group have often been found in these cases (Summary)