Granulocytic sarcoma: An atypical presentation in the oral cavity

Acute myelogenous leukemia (AMU is a hematologic disorder that is characterized by an abnormal proliferation of immature myeloid cells. Granulocytic sarcomas are clusters of leukemic myeloid cells that may develop as a result of AML. Oral manifestations of AML are common and often involve enlargements of the gingiva and/or mucosal tissue from direct leukemia cell infiltration. We describe the case history of a 50-year-old man who had an ulcera-tive lesion of the oral mucosa that was determined to be a granulocytic sarcoma of AML-M0 subtype. The combination of both the subtype and clinical presentation of the leukemia makes this presentation unusual, and to the best of our knowledge, of a type that has not been previously reported in the literature.     

A skin abscess model for teaching incision and drainage procedures

Background  

Skin and soft tissue infections are increasingly prevalent clinical problems, and it is important for health care practitioners to be well trained in how to treat skin abscesses. A realistic model of abscess incision and drainage will allow trainees to learn and practice this basic physician procedure.     

Extended spectrum beta lactamase-producing Klebsiella pneumoniae infections: a review of the literature.

Infections caused by extended-spectrum beta-lactamase (ESBL)-producing pathogens, particularly Klebsiella pneumoniae, are increasing. The epidemiology of ESBL-producing K. pneumoniae, the mechanisms of resistance, and treatment strategies for infections caused by these organisms are reviewed.     

Diagnosis goes digital.

Accurate images of the craniofacial region are critical for the development of an orthodontic diagnosis and treatment plan. The NewTom QR 9000 Volume Scanner (QR s.r.l., Verona, Italy) represents a significant advance in imaging capabilities for dentistry and orthodontics. This new-generation scanner uses computed tomography technology to provide a complete 3D view of the maxilla and mandible with relatively high resolution and low radiation exposure to patients. This article discusses some technical aspects of this new scanner and its possible orthodontic uses.     

Monotherapy with enoxaparin for the prevention of recurrent venous thromboembolism.

This study aimed to determine whether a weight-adjusted dose of subcutaneous enoxaparin is as effective and safe as oral acenocoumarol for the secondary prophylaxis of pulmonary embolism. Three hundred and eighty consecutive noncancer outpatients hospitalized with an episode of symptomatic pulmonary embolism selected treatment with acenocoumarol or enoxaparin at a dose of 1 mg/kg once daily after being informed of the type of administration and expected frequency of laboratory monitoring for both medicinal products. Endpoints were symptomatic recurrent thromboembolic events evaluated by standard objective testing, and a composite endpoint of recurrent venous thromboembolism, major bleeding, and death from any cause. One hundred and ninety-nine patients (52%) chose acenocoumarol therapy and 181 chose enoxaparin monotherapy. Four patients in the enoxaparin group (2.2%) and six patients in the acenocoumarol group (3%) had an objective thromboembolic recurrence (hazard ratio, 1.35; 95% confidence interval, 0.38-4.79; P = 0.64). Nine patients in the enoxaparin group (5.0%) had a hemorrhagic complication compared with 11 in the acenocoumarol group (5.5%) (P = 0.81). The hospital length of stay was shorter with enoxaparin compared with acenocoumarol (11 versus 16 days, P = 0.0001). Enoxaparin is as effective and safe as acenocoumarol in the secondary prevention of recurrent thromboembolic disease and is associated with shorter hospitalization.     

World Trade Center Cough Syndrome and Its Treatment

To date, the main respiratory health consequence from the collapse of the World Trade Center (WTC) on September 11, 2001 has been the “WTC Cough Syndrome” (chronic rhinosinusitis, asthma, and/or bronchitis, often complicated by gastroesophageal reflux dysfunction). Syndrome incidence and severity have been linked to WTC dust exposure intensity. While it is too early to ascertain long-term effects of WTC dust exposure, effective treatment guidelines have been designed through a collaborative effort by the three established centers of excellence for WTC medical monitoring and treatment and the WTC Registry. These treatment recommendations are described here.

     

Editorial comment

Building small things for small patients is tough, and sometimesexpensive, but it really needs to be done. I was pleased tosee the paper by Thierry Scohy et al., the Rotterdam PediatricCardiology, Anesthesiology and Surgery group, in a paper publishedin this issue of the European Journal of Echocardiography, asuitable venue for this report, since so much of the developmentof this device has been European. In this paper, the group reportstheir experience using a micromultiplane transesophageal probe