RESUMO
BACKGROUND: Metastatic cancer may involve the central and peripheral nervous system, usually in the late stages of disease. At this point, most patients have been diagnosed and treated for widespread systemic disease. Rarely is the involvement of the peripheral nervous system the presenting manifestation of malignancy. One reason for this is a proposed "blood-nerve barrier" that renders the nerve sheath a relatively privileged site for metastases. OBSERVATIONS: The authors presented a novel case of metastatic melanoma presenting as intractable leg pain and numbness. Further workup revealed concurrent disease in the brain and breast, prompting urgent treatment with radiation and targeted immunotherapy. LESSONS: This case highlights the rare presentation of metastatic melanoma as a mononeuropathy. Although neurological complications of metastases tend to occur in later stages of disease after initial diagnosis and treatment, one must remember to consider malignancy in the initial differential diagnosis of mononeuropathy.
RESUMO
Incontinence pads are available in the USA without a prescription and are commonly the first treatment option a patient with incontinence uses. The goal of this study was to examine the difference in the performance and cost of commercially available incontinence pads with the intention of providing recommendations to women. Ten different urinary incontinence products were selected. A modified wetback test was used to test product performance. For the small volume leaks, the Walgreen's Extra pad generally performed worse on the wetback test than the three other pads tested (p = 0.001-0.012), but four tests were not statistically significant. At larger leak volumes, the Walgreen's underwear generally performed worse than other products (p < or = 0.001-0.046), with some exceptions. Brand name products generally performed better than generic products, but cost more. Undergarments and underwear do the worst job of keeping moisture inside the pad.
