Papillary transitional cell bladder carcinoma and systematized epidermal nevus syndrome.

Epidermal nevus syndrome (ENS), also known as Solomon syndrome, is a rare neurocutaneous disorder defined by mosaicism. Epidermal nevus syndrome may be associated with a variety of systemic findings, several of which have been described in the literature, including but not limited to central nervous system abnormalities and internal malignancies. There is a paucity of reports of patients with both epidermal nevi and papillary transitional cell bladder carcinoma in the literature. We present a rare case of systematized epidermal nevi associated with development of papillary transitional cell bladder carcinoma in a young woman. Patients diagnosed with generalized epidermal nevi should have workup for possible associated central nervous system, musculoskeletal, genitourinary abnormalities, and internal malignancies. The association of epidermal nevi and transitional cell bladder carcinoma may be linked to a mutation in the fibroblast growth factor receptor 3 gene, FGFR3, but a clear link has yet to be substantiated and additional molecular studies are needed.

Real-Time Monitoring of Post-Surgical and Post-Traumatic Eye Injuries Using Multilayered Electrical Biosensor Chip.

Lack of current techniques for the early monitoring of bleb leaks and other post-traumatic or post-surgical ocular injury has posed an unmet clinical need for the development of new techniques. Present evaluation techniques use either subjective or nonquantitative approaches. At present, there are no FDA approved ocular devices that can directly measure ascorbic acid (AA) concentration levels for both tear film (TF) and aqueous humor (AH) at point-of-care (POC) level. Toward this aim, we present a novel POC quantitative assay, called the ocular biosensor device, which can be used to evaluate the integrity of the anterior surface of the eye by measuring the concentration of AA in TF and AH. Herein, we utilize a novel scientific engineering approach for the development of a disposable paper based POC ocular biosensor strip. A grafted poly(styrene)-block-poly(acrylic acid) (PS-b-PAA) and graphene platelet composite with contour based µ-electrodes design (CBµE) exhibit a highly sensitive platform to perform electrochemical immunosensing technique to study clinical samples that have small volumes like tear fluid. Samples used in this study were collected clinically from subjects undergoing therapeutic anterior chamber paracentesis. The proposed biosensor reports the level of AA concentration on an electronic screen, making the results easy to read, efficient, and reliable.

Generalized eruptive syringomas.

Eruptive syringoma is a rare variant of syringoma, benign neoplasms of the eccrine sweat ducts that appear on the face, neck, chest, and axillae of predominately Asian and African American women before or during puberty [1, 2]. Lesions appear as small skin-colored or slightly pigmented, flat-topped papules [2]. The condition can be cosmetically disfiguring and difficult to treat, especially in dark-skinned patients. The investigators report a 52-year old Guyanese woman who presented with widespread, chronic, non-pruritic and nontender, skin-colored papules that arose approximately 20 years earlier. A punch biopsy of affected skin was obtained and the histological diagnosis was eruptive syringoma. The patient pursued no further treatment, after discussion of costs and risks.

Unilateral indurated plaque in the axilla: a case of metastatic breast carcinoma.

Breast cancer is the most commonly diagnosed cancer among American women and is also the most common internal malignancy to metastasize to the skin. Rarely, cutaneous metastases represent the first indication of breast carcinoma, putting dermatologists in an instrumental position to make the diagnosis of breast carcinoma. We report the case of a 71-year-old woman with a 10-year history of a slowly-enlarging, indurated plaque in the right axilla. Review of symptoms was significant only for occasional numbness and tingling that extended from the right axilla to the right hand. Biopsy revealed cells infiltrating in a single-file between the collagen bundles in the dermis and subcutis and immunohistochemical staining consistent with a diagnosis of invasive lobular carcinoma. Subsequent work up revealed a primary breast lesion and extensive bony metastases.

Silicone Granulomas, a Growing Problem?

The formation of granulomas is known to be a possible adverse effect of liquid silicone administration, used for soft tissue augmentation. Its plumping effects provide enhancement of certain body parts, such as the lips, hips, and buttocks. The desire for enhancement, perhaps influenced by popular culture and an unrealistic standard of beauty, leads individuals to seek silicone injections. There is a growing population of women and men receiving injections by unlicensed, unskilled "practitioners" not related to the healthcare profession. Complications under such circumstances are not uncommon, particularly the emergence of silicone granulomas, and the authors' medical center has seen an increase in such cases. In this case report, the authors illustrate a young patient with significant complications from her silicone injections, review current therapies for silicone granulomas, and discuss this growing medical problem.

Benzoyl peroxide-based combination therapies for acne vulgaris: a comparative review.

Benzoyl peroxide, with its broad-spectrum antimicrobial activity, is among the most widely used topical agents in the treatment of inflammatory acne vulgaris. Benzoyl peroxide is marketed either alone or in combination with other topical antibiotics; namely, erythromycin and clindamycin. The combination products confer specific advantages over benzoyl peroxide alone, particularly in decreasing the in vivo follicular counts of Propionibacterium acnes, the anaerobic bacterium implicated in the pathogenesis of acne. In addition, the topical treatment of inflammatory acne has been complicated by the development of P acnes resistance to topical erythromycin and clindamycin. Combination products containing benzoyl peroxide and the topical antibiotics have been shown to both: (i) prevent the development of antibiotic resistance in acne patients; and (ii) confer significant clinical improvement to patients who have already developed antibiotic resistance.

Mergers and the new workplace: the effects of a merger of two emergency departments on nursing staff.

Even small mergers have big consequences. This case study demonstrates the complex nature of organizational change found even in small organizational subunits and provides important insight for managers and leaders who have completed or are considering such mergers. The study examined the amalgamation of two emergency departments. Quantitative and qualitative techniques were used to analyze the planning, implementation, and outcomes of this amalgamation on the nursing staff. This case study draws upon the literature pertaining to change survivor's syndrome, prescribed approaches to change, and the difficulties in changing cultures and making complex decisions. Change in hospitals has been shown to have negative consequences for nurses. The goal of this study was to examine in greater detail what aspects of change are associated with these effects. The findings suggest that the planning of the amalgamation was consistent with rational decision-making. The goals of changing to a single emergency unit and cost savings were achieved. However, the nurses experienced stress due to the pace of work and the physical layout of the newly renovated department. The findings also suggest that personal-level problems that the nurses experienced were consistent with the consequences of survivor's syndrome, the psychological contract, and communication issues. It was recommended that the organization undertake initiative to alleviate these stresses.