An advanced case of double primary malignancy involving the breasts and uterine cervix: satisfactory response to non-surgical management

Double primary cancers are fairly rare. We report here a case of metachronous lesions; advanced cancer of the breasts and squamous cell carcinoma of the cervix. What is peculiar in this case is the rather unusual positive response to conservative treatment. Despite widespread metastases even to the liver, the patient is well and active more than six years after breast cancer was first diagnosed. Treating such advanced cases may be rewarding at times.     

Preoperative methicillin‐resistant Staphylococcus aureus (MRSA) screening: An effective method to control MRSA infections on elective orthopaedics wards

Background: Methicillin‐resistant Staphylococcus aureus (MRSA) infections continue to increase in UK hospitals despite the introduction of various control measures. These infections have serious clinical and economic implications, particularly in relation to elective orthopaedic surgery. Methods: A prospective study was performed from August 2003 to July 2004 to assess the effect of preadmission screening and ‘ring fencing’ of beds on the incidence of infection in an elective orthopaedics unit. Results: The preoperative incidence of MRSA colonization was 2.25% and 53% of these patients had at least one risk factor. There were no postoperative MRSA infections in the ring‐fenced orthopaedic unit. Conclusions: Preoperative screening and ring fencing reduced the MRSA incidence to zero in the operated patients. Mechanisms need to be developed where screening and isolation of MRSA cases can be performed in most, if not all, hospital admissions.     

Deracemization of 1-phenylethanols in a one-pot process combining Mn-driven oxidation with enzymatic reduction utilizing a compartmentalization technique

Racemic 1-phenylethanols were converted into enantiopure (R)-1-phenylethanols via a chemoenzymatic process in which manganese oxide driven oxidation was coupled with enzymatic biotransformation by compartmentalization of the reactions, although the two reactions conducted under mixed conditions are not compatible due to enzyme deactivation by Mn ions. Achiral 1-phenylethanol is oxidized to produce acetophenone in the interior chamber of a polydimethylsiloxane thimble. The acetophenone passes through the membrane into the exterior chamber where enantioselective biotransformation takes place to produce (R)-1-phenylethanol with an enantioselectivity of >99% ee and with 96% yield. The developed sequential reaction could be applied to the deracemization of a wide range of methyl- and chloro-substituted 1-phenylethanols (up to 93%, >99% ee). In addition, this method was applied to the selective hydroxylation of ethylbenzene to afford chiral 1-phenylethanol.

PDMS thimble was the key to combining incompatible reactions to achieve deracemization of 1-phenylethanols in high yield with high optical yield.     

Problems with the approach to diagnosis and treatment of testicular cancer in a developing country: the case of an eight-year-old boy from Cameroon

Testicular cancer is believed to be rare among members of the black sub-Saharan population and has therefore been little studied in Africa. This may account for the problems encountered in the treatment of this condition, which are perfectly illustrated by this clinical case. We present here a brief report of the optimal diagnostic methods and therapeutic indications for this malignant disease.     

Therapeutic management of primary digestive lymphomas at Yaoundé: analysis of a series of 46 cases

The aim of this study was to identify the principal deficiencies and difficulties associated with the treatment of primary digestive lymphomas at Yaounde. We analyzed the medical records of 46 patients treated at Yaounde General Hospital over a period of 7 years (January 1989 to December 1996). The study population consisted of 24 men (52%) and 22 women (48%), giving a sex ratio of 1.08. The mean age of the patients was 49 years (range: 18 to 80 years). The treatment of these patients was not always optimal, due largely to socioeconomic and technical factors. We observed cases of very late diagnosis in which the histological data were imprecise or incomplete, in the absence of modern histological techniques. Assessment of the expansion of tumors was frequently inadequate, due to the absence of scanners or the inability to pay for their use. These problems, and the high cost of chemotherapy and radiotherapy, have severely limited the efficacy of treatment, resulting in poorer responses to treatment than reported elsewhere. In conclusion, national solidarity and cooperation at the regional and international levels seem to be necessary in these clinical conditions, to overcome these obstacles and to improve the quality of treatment for patients in general, and for those with primary digestive lymphomas in particular.     

Sister Mary Joseph’s nodule originating from carcinoma of uterine cervix: case report at Yaounde General Hospital, Cameroon

Skin metastasis from carcinoma of the uterine cervix is a rare event. The presence of an umbilical metastasis (Sister Mary Joseph’s nodule) usually indicates a poor prognosis, and is a sign of advanced neoplastic disease. The survival time is ranged from 2 to 11 months.We reported a case of Sister Mary Joseph’s nodule from a cervical carcinoma at the Yaounde General Hospital, Cameroon.     

Explanatory model of psychosis: impact on perception of self-stigma by patients in three sub-saharan African cities

Background

Most cultures in sub-Saharan Africa subscribe to the belief that the root cause of psychosis is supernatural. Individuals in the community who hold a religiomagical explanatory model of causation have been shown to exhibit more stigmatizing attitudes towards people with psychosis. Self-stigma among individuals with psychosis is less frequently studied.

Method

We used a mixed-method approach, consisting of key informant’s interviews to elicit information on explanatory models of causation of psychosis and questionnaire assessment of internalized stigma with an adapted version of the Scale for Internalized Stigma of Mental Illness. Twenty-four, 31, and 30 subjects with recent experience of utilizing the service of traditional or faith healers for severe mental disorders in Ibadan (Nigeria), Kumasi (Ghana), and Nairobi (Kenya), respectively, were interviewed.

Results

About 44 % (42.1 %) of the Nigerian respondents had a high (severe) level of self-stigma with the respective proportions among Ghanaian and Kenyan respondents being 20.7 and 37.5 %. Compared with 4 out of a total of 12 respondents (33.3 %) who reported low self-stigma reported supernatural attribution, 14 out of 20 respondents (70 %) with the highest level of self-stigma reported supernatural attribution across the three sites. When low scorers ascribed supernatural causation, it was often with a religious focus.

Conclusion

There is a greater tendency for persons with high levels of self-stigma than those with low levels to ascribe supernatural attribution to their experience of a severe mental health condition.