Spectrum of infections and outcome among hospitalized South Africans with systemic lupus erythematosus

Clinical Rheumatology - Our aim was to determine reasons for admission, the prevalence and spectrum of infections, and the outcomes in a multiethnic cohort of hospitalized systemic lupus...     

Dermatofibrosarcoma protuberans: Rare cause of head and neck swelling

Dermatofibrosarcoma protuberance of head and neck is a rare neoplasm and accounts for less than one percent of Head and Neck Neoplasm. The objective of this report is to understand etiology, presentation, histopathologic identification and treatment option for this tumour. The goal of current report is to acquaint the clinician with presentation and treatment option for this disease.     

Clinical Experience with Light-Emitting Diode (LED) Photomodulation

Background. Light-emitting diode (LED) photomodulation is a novel nonthermal technology used to modulate cellular activity with light.
Objective:. We describe our experience over the last 2 years using 590 nm LED photomodulation within a dermatologic surgery environment.
Methods. Practical use of nonthermal light energy and emerging applications in 3,500 treatments delivered to 900 patients is detailed.
Results. LED photomodulation has been used alone for skin rejuvenation in over 300 patients but has been effective in augmentation of results in 600 patients receiving concomitant nonablative thermal and vascular treatments such as intense pulsed light, pulsed dye laser, KTP and infrared lasers, radiofrequency energy, and ablative lasers.
Conclusion:. LED photomodulation reverses signs of photoaging using a new nonthermal mechanism. The anti-inflammatory component of LED in combination with the cell regulatory component helps improve the outcome of other thermal-based rejuvenation treatments.     

Evaluation of peptone glucose fluconazole agar as a selective medium for rapid and enhanced isolation of Aspergillus fumigatus from the respiratory tract of bronchopulmonary aspergillosis patients colonized by Candida albicans.

We have reported earlier that Aspergillus fumigatus is inhibited in vitro by Candida albicans which also interferes in its isolation from sputum experimentally seeded with predetermined graded inocula of the two fungi. It was further shown that this interference was neutralized by employing peptone glucose agar with incorporation of fluconazole which is more inhibitory to C. albicans than to A. fumigatus. This communication embodies the results of evaluation of peptone glucose fluconazole agar (PGFA) as a selective culture medium for rapid and enhanced isolation of A. fumigatus from sputum of patients clinically suspected of aspergillosis with C. albicans colonization in the respiratory tract. Of the 23 sputum specimens and one broncho-alveolar lavage collected from 15 suspected aspergillosis patients, A. fumigatus was isolated from all (100%) on PGFA as against only 19 specimens (79%) that proved to be positive on the control PGA medium (P<0.05). The greater efficacy of PGFA than that of PGA was further evident from the 2-fold higher A. fumigatus mean colony count (8.2+/-1.87) on the former medium than on the latter (3.7+/-1.00), and this difference was found to be statistically significant (P<0.05). Besides, A. fumigatus colonies were macroscopically recognizable within 2-3 days on PGFA at 28 degrees C in strong contrast to 5-7 days required on PGA. Based upon these observations, PGFA is recommended for wider application as a selective medium for rapid and enhanced recovery of A. fumigatus from sputum of patients clinically suspected of aspergillosis with C. albicans colonization in their respiratory tract.     

Polydrug use (the use of drugs in combination): A brief review

This brief review provides an overview of this topic; it is not a critical review. Polydrug use is a poorly defined concept; it is taken here to mean the simultaneous use of more than one drug. Data on polydrug use is seldom systematically collected, and the use of alcohol and tobacco in combination with illegal drugs is frequently overlooked. If alcohol and tobacco are included, most users are polydrug users, since these drugs are used by most users of illegal drugs, and many people with alcohol problems also use illegal drugs. Polydrug use has increased; drug availability, cultural context and the 'normalization' of drug use are important factors. Gender and racial differences are observed in the prevalence of polydrug use. Implications for drug prevention include the importance of targeting multiple substance use rather than single substances. Aiming prevention campaigns at younger people and focusing on 'gateway' drugs might be more effective. But polydrug users are diverse, and a variety of strategies (aimed at different types of polydrug users) are necessary. Implications for treatment include the evidence of the greater difficulty that polydrug users have in quitting; they may therefore require additional help. A fuller, systematic, review is required; it is expected that this would recommend the commissioning of additional research on this poorly understood phenomenon.     

Oligoastrocytoma presenting with intractable epilepsy.

OBJECTIVE: Oligoastrocytomas (OA) are mixed gliomas with distinct oligodendroglial and astrocytic neoplastic components. Very little about OA has been reported in the intractable epilepsy population. METHODS: We undertook a retrospective review of 923 patients who underwent resective surgery for intractable epilepsy between 1996 and 2004. RESULTS: 6/923 (0.7%) patients were diagnosed with OA. Five patients were female, one was male. Median age at diagnosis was 25 years (range 19-44 years). Tumors arose from the left side in all patients and from the temporal lobe in five patients. Three patients had complex partial seizures. Median length of refractory epilepsy prior to surgery was 10.5 years (range 1-28 years), and the median number of antiepileptic drugs used was 2 (range 1-10). Preoperative WADA testing for language and memory localization was done for three patients; preoperative stereotactical localization was done for three patients. Surgical pathology revealed low-grade OA (WHO II) in five patients, and anaplastic OA in one. There were no surgical complications, clinical or radiographic tumor recurrence at a mean follow up period of 3.2 years (range 2-8). Excellent seizure freedom was achieved in 5/6 patients. CONCLUSION: As a result of our small sample size, general conclusions may be imprecise, but this review suggests that OA behave similar to other tumors related to intractable epilepsy: they usually have a preoperative seizure course of many years, an excellent rate of seizure-freedom following surgery, and are in general, low-grade tumors with an indolent course for which serial imaging is sufficient follow-up.