bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of statisticians in intervention trials
Authors: Simon Richard
Published: January 2017

The planning, conduct, analysis and reporting of randomized trials to reliably evaluate an intervention create a complex intellectual and logistical endeavour. Success generally requires active collaboration of a well-trained, experienced and committed statistician. A good intervention trial asks an important question, gets a reliable answer and is honestly reported. Many trials fail on one of these components and some of these failures could have been avoided with better statistical involvement. Many subject matter investigators do not understand how to effectively collaborate with statisticians. The objective here is to outline some of the important responsibilities of the statistician in intervention trials.
Individually randomized intervention trials for disease prevention and control
Authors: Anderson Garnet L , Prentice Ross L
Published: January 2017

It is argued that randomized, controlled trials should fulfil a critical role in the identification of practical approaches to the prevention and control of chronic diseases. Because of the great public health potential of chemopreventive and behavioural approaches to chronic disease prevention there is need for a major interdisciplinary scientific effort aimed at intervention development. Because of the cost and duration of controlled trials to evaluate specific interventions there is a need for well-conducted feasibility, pilot and intermediate outcome trials, to inform and to justify corresponding full-scale trials having clinical disease outcomes. Compared to therapeutic trials, prevention trials need to have a greater emphasis on overall benefit versus risk assessment. Such trials need to be large enough, and of sufficient duration, to yield powerful tests of key hypotheses, and informative benefit versus risk summary statements. These requirements have a range of implications for intervention trial design, conduct, monitoring and reporting, which are reviewed and discussed. The clinical trial component of the ongoing Women's Health Initiative provides illustration throughout this discussion.
Estimating the population impact of an intervention: a decision-analytic approach
Authors: Hersh Adam L , Black William C , Tosteson Anna NA
Published: January 2017

The aim of this paper is to highlight the role for decision analysis in assessing outcomes of medical interventions at a population level. The basic steps of decision analysis are introduced and an illustrative hypothetical preventive intervention is examined. Specific modelling challenges that arise when estimating the population impact of an intervention are described and each is accompanied by an example. Decision analysis can provide useful information for health policy decision makers by identifying the intervention(s) with the largest beneficial impact on health over a wide range of assumptions. In addition, by focusing attention on the parameters with the greatest influence on projected outcomes, decision analysis can aid in identifying critical areas for future research.
Professor Bernardo Alberto Houssay, MD (1887–1971): Argentine Physiologist and Nobel Laureate
Authors: Hawgood Barbara J
Published: January 2017

Professor Bernardo A Houssay, Director of the Institute of Physiology at the University of Buenos Aires, was an outstanding physiologist who created the first school of medical research in Argentina and brought it to world attention. His research covered a wide range of physiological fields, but particularly concerned the hormonal control of metabolism and arterial hypertension. Houssay was dismissed from the university during the Perón era but was able to found and direct the Institute of Biology and Experimental Medicine in Buenos Aires. He was joint winner of the Nobel Prize for Physiology or Medicine in 1947 for his discovery of the role of the anterior pituitary in carbohydrate metabolism.
James Alison Glover (1874–1963), OBE (1919) CBE (1941) MD (1905) DPH (1905) FRCP (1933)
Authors: Storey Geoffrey O
Published: January 2017

James Allison Glover served in the Boer War and World War I. In 1917 he was appointed to the Cerebro-spinal Laboratory in London. There, his work on cerebrospinal fever resulted in the “spacing out” of beds in huts and earned him the name of “good friend of the private soldier”. In 1919 he proceeded OBE for his work during the war. In 1920 he was appointed medical officer to the new Ministry of Health. He made significant contributions to rheumatology and the understanding and treatment of tonsillitis, and to public health more widely.
Wilhelm Conrad Röntgen (1845–1923) and the 1914 Affair
Authors: Isherwood Ian
Published: January 2017

In August 1914 the university library of Leuven (Louvain) was destroyed by the German occupying forces. In October 1914 an Appeal was addressed to “The World of Culture” by 93 German academics and artists in which they disclaimed any German responsibility — “It is not true that our troops have brutally destroyed Louvain”. The Appeal had a profound, although mainly negative, effect, especially in the United States, where it almost certainly influenced that country's decision to enter the conflict. Signatories to the Appeal included Wilhelm Conrad Röntgen, the discoverer of X-rays. Why did Röntgen sign such an extraordinary and untrue statement? He claimed that he had not read it, but both the personal and political backgrounds to his action were complex and are worthy of further scrutiny. This paper explores the issue and the reception of the notorious Appeal by the British radiology community.
Britain's First Medical Marriage: Frances Morgan (1843–1927), George Hoggan (1837–1891) and the Mysterious “Elsie”
Authors: McIntyre Neil
Published: January 2017

Britain's first medical marriage was between George Hoggan and Frances Morgan, in 1874. George was a naval engineer before he studied medicine; he showed great promise in research before his death, aged 54, after a long illness. Frances was arguably the most gifted of the early medical women. She was the first British woman to obtain an MD in Europe and the first to do high-quality medical research. Her clinical practice was curtailed by George's illness and death but she continued to campaign on social issues — including women's education, health education and civil rights. Her life was all the more remarkable because new evidence suggests that, at the age of 17, before she started her medical studies, she gave birth to an illegitimate child. Had this been known it would, in Victorian times, have dashed her hopes of a career in medicine.
Did Michelangelo (1475–1564) have High-Functioning Autism?
Authors: Arshad Muhammad , Fitzgerald Michael
Published: January 2017

In this paper evidence is presented that Michelangelo met the criteria for Asperger's disorder, or high-functioning autism. The evidence relates to his single-minded work routine, unusual lifestyle, limited interests, poor social and communication skills, and issues of life control. Depression and various medical conditions, including gout, renal colic and renal stones, did not stop his obsessive working habits.
Caleb Hillier Parry (1755–1822): Clinician, Scientist, Friend of Edward Jenner (1749–1823)
Authors: Lamer Andrew J
Published: January 2017

This article summarizes briefly the life and work of Dr Caleb Hillier Parry (1755–1822), a friend of Dr Edward Jenner. He made original clinical observations, including the bradycardic effect of carotid artery compression, and the association of thyroid enlargement with cardiac disease. He also undertook experimental work and published extensively, including the first book devoted to angina.
The Influence of Sir Andrew Clark (1826–93) on William Osler (1849–1919)
Authors: Bryan Charles S
Published: January 2017

Three lines of evidence suggest that Sir Andrew Clark had a significant influence on William Osler's postgraduate training: (1) numerous references to Clark in Osler's textbook of medicine; (2) the similarity of Clark's and Osler's aphoristic messages for students; and (3) personal encounters, including Clark's reminiscence that he ‘had striven ten years for bread, ten years for bread and butter, and twenty years for cakes and ale’. Clark's meticulous approach to clinical problems, his work ethic and his enthusiasm for bedside teaching may have fostered or reinforced these same attributes in Osler. Osler honoured Clark's memory by helping Sir John MacAlister and others realize Clark's ambition to unite various London medical societies into a single organization, which, in 1907, became the Royal Society of Medicine.
George E Holtzapple (1862–1946) and Oxygen Therapy for Lobar Pneumonia: The First Reported Case (1887) and a Review of the Contemporary Literature to 1899
Authors: Shultz Suzanne M , Hartmann Peter M
Published: January 2017

A commemorative plaque in York Hospital in Pennsylvania, USA, records that George E Holtzapple MD is the physician ‘who discovered the use of oxygen for the treatment of pneumonia on March 6,1885’. This paper suggests that Dr Holtzapple was not the first to use oxygen for pneumonia patients but was the first to publish a case report with a reasoned physiological explanation of oxygen therapy. His publication was intended, in his own words, to benefit ‘average country practitioners' who had no other means of learning about this valuable therapy.
Edinburgh Medical Students Peculiarly Described as ‘Occasional Auditors’
Authors: Swan Harold T
Published: January 2017

The phrase ‘occasional auditor’ appears to have been coined by a Royal Commission of 1826–32 to describe students who attended classes but did not intend to graduate. ‘Occasional’ meant ‘infrequent’, ‘auditor’ meant ‘listener’, and the Commission paid scant attention to these students. At the Edinburgh Medical School, however, such non-graduating students significantly outnumbered the graduates, and this can be shown to have been the case from as early as 1726 and to have continued until 1858, particular attention being paid here to the last two decades (i.e. 1839–58). There is no existing Edinburgh University list of ‘occasional auditors’, but a methodology of cross-referencing is described which makes it possible to identify the ‘occasional auditors' by name. ‘Occasional auditors' in the Faculty of Medicine can now be redefined as serious students who had assembled their own course of study in order to further their personal careers, and it is possible to show that very many of these careers were in medicine, largely in the emerging field of general practice.
Genealogy of John and Charles Bell: Their Relationship with the Children of Charles Shaw of Ayr
Authors: Kaufman M H
Published: January 2017

The Reverend William Bell had six children who survived infancy. Two of his sons entered the legal profession and two other sons became distinguished anatomists and surgeons — John Bell, said for 20 years to have been the leading operating surgeon in Britain and throughout the world -and Sir Charles Bell, possibly the most distinguished anatomist and physiologist of his day. Information is not known about the fifth son or their sister. Charles Shaw, a lawyer of Ayr, had four sons and two daughters who survived infancy. Two of his sons, John and Alexander, became anatomists and later surgeons at the Middlesex Hospital, and both worked closely with Charles Bell at the Great Windmill Street School of Anatomy. His third son entered the law and his fourth son became a distinguished soldier. The two daughters of Charles Shaw married into the Bell family: Barbara married George Joseph Bell and Marion married Mr (later Sir) Charles Bell.
Maud Gönne MacBride (1866–1953): An Indomitable Consumptive
Authors: Breathnach Caoimhghín S
Published: January 2017

Maud Gonne MacBride was an English debutante who became an Irish rebel and muse to William Butler Yeats. Wealth did not protect her or her family from tuberculosis but, in spite of frequent relapses and three pregnancies, she invariably recovered to lead an active, fruitful life until her death in 1953 at the age of 86. She refused treatment with tuberculin and the induction of an artificial pneumothorax but went through a course of creosote inhalations. Her indomitable spirit helped her to outwit the ‘Captain of these Men of Death’ at a time when he fully deserved that title.
Monitoring Interval Cancers in Breast Screening Programmes: The East Anglian Experience
Authors: Day Nicholas , McCann Jenny , Camilleri-Ferrante Corinne , Britton Peter , Hurst Graham , Cush Sarah , Duffy Stephen
Published: January 2017

Interval cancer rates are a major determinant of the success of a screening programme. In the Swedish two county study, on which the United Kingdom programme is based, a 39% reduction in mortality was observed in screened women aged 50–64. Using data from the Swedish study, the relationship between interval cancer incidence and the likely future effect on breast cancer mortality was quantified. In East Anglia, as elsewhere in the United Kingdom, interval cancers rates are nearly double those obtained in Sweden: interval cancer rates in the first, second, and third years respectively, after a negative screen were 24%, 59%, and 79% of the expected underlying incidence in the absence of screening. The corresponding figures from the two county study were 17%, 30%, and 56%. From these it was estimated that the mortality reduction in East Anglia will be 21%, which is lower than the 35% observed in invited women in this age group in the Swedish two county study and the 25% specified in the Health of the Nation target. In a rereading exercise, using screening mammograms from women who were screen normal, who had screen detected cancers, or who subsequently developed interval cancers, four out of five radiologists recommended recall for around 70% of the original mammograms (classed as screen normal at time of screening) from 33 interval cancers. This suggests that sensitivity is a contributory factor to the higher interval cancer rates in East Anglia.
Measurement of the Costs in Two Mammographic Screening Programmes in the Province of Florence, Italy
Authors: Zappa Marco , Spagnolo Gianfranco , Ciatto Stefano , Giorgi Daniela , Paci Eugenio , Del Turco Marco Rosselli
Published: January 2017

Objectives

– To estimate and to compare the cost per woman examined and per breast cancer detected in two mammographic screening programmes in the province of Florence.

Setting

–Two ongoing, population based, mammographic screening programmes in the province of Florence. The first (district project) was started in the seventies in a rural area, whereas the second (city project) was started in the city at the end of 1990.

Methods

–All relevant resources consumed by the programmes (costs) were listed and measured. The costs are related to 1993. The unit cost for each phase (recruitment, screening, assessment) of the screening process was estimated by dividing the total cost of the phase by the number of women examined. The cost per cancer detected was obtained by dividing the total cost of the programme by the number of cancers detected at screening.

Results

–The costs per woman examined were $38.1 and $41.1 in the district and city programmes respectively. The cost per breast cancer detected was $7424 in the district programme and $5180 in the city programme. Staff acccounted for more than 50% of the total cost. The unit cost in the screening phase was higher in the district programme, whereas it was lower in the assessment phase.

Conclusions

–Our results are consistent with, although slightly lower than, published estimates of the cost per woman screened. Important parameters for determining the efficiency of a mammographic screening programme are the compliance rate and the recall rate.
Compliance after 17 Years of Breast Cancer Screening
Authors: Scaf-Klomp W , van Sonderen F L P , Stewart R , van Dijck J A A M , van den Heuvel W J A
Published: January 2017

Objective

–To investigate changes in attendance over the course of a population based breast screening programme.

Design

– Longitudinal; analysis of registered data over nine screening rounds.

Setting

–Subjects belong to the screening population of the Nijmegen experimental breast screening programme (1975–1990).

Subjects

–A cohort of 6898 women who were enrolled in 1975 at the age of 50–69 years and who were invited to nine subsequent screening rounds, irrespective of their attendance at previous rounds.

Results

–Attendance of women aged 50–53 years at entry was high at the initial screening (88%), decreased in the course of the programme, but remained well over 60% until round 8; 39% completed nine rounds and 24% completed seven to eight rounds. Attendance of women who were older at entry was somewhat lower at the initial screening (87%–82%) and declined more strongly. Regular compliance was also lower. Specific compliance patterns are found that can be relevant for further research.

Conclusions

–A substantial proportion of eligible women can be committed to mammography every two years, possibly even after reaching the age of 70, if the age at entry is around 50 and the screening programme is well established in the community. Starting a screening programme in older women seems ineffective.
Evaluating the National Screening Programme for Congenital Dislocation of the Hip
Authors: Dezateux Carol , Godward Sara
Published: January 2017

In 1969 universal clinical screening for neonatal hip instability was formally adopted in the United Kingdom with the aim of detecting and treating children considered to be at high risk of congenital dislocation of the hip (CDH). However, clinical screening is associated with both false positive and false negative diagnoses and has never been evaluated in a randomised trial. The emergence of hip ultrasound provides renewed impetus to reconsider and formally evaluate screening for CDH. Ultrasound imaging of the newborn hip may be used as a screening test and to assess and manage infants with clinically detected hip instability. Universal primary ultrasound screening has been adopted in some European countries, but enthusiasm for this new technology has been tempered by the subsequent large' increases in treatment and follow up. This paper reviews the existing evidence to support the different approaches to screening and describes the research agenda of the MRC working party on congenital dislocation of the hip. A randomised trial of screening is required to evaluate the policy options before ultrasound screening becomes widely adopted within the United Kingdom. The feasibility and acceptability of a trial need to be explored and key issues relating to trial design addressed.
Screening for Down's Syndrome: The First Two Years Experience in Bristol
Authors: Goldie D J , Astley J P , Beaman J M , Bickley D A , Gunneberg A , Jones S R
Published: January 2017

Objectives

– To evaluate the effectiveness of a programme for antenatal screening for Down's syndrome using a fetoprotein and total human chorionic gonadotrophin as maternal serum markers.

Setting

–A district general hospital providing a screening service to a local purchasing authority and (under contract) to another purchasing authority in the same region.

Methods

– Patients were counselled and screened between 15 and 20 weeks gestation and Down's risk estimates calculated using the maternal serum marker results as modifiers of the age related risk. Outcome was determined in collaboration with the Regional Cytogenetics Unit.

Outcome Measures

– Detection rate for Down's syndrome, false positive rate, uptake of screening, and uptake of amniocentesis.

Results–

In two years 22 816 women were screened (approximately 84% of population); 32 Down's pregnancies were identified, 19 (59.4%) had a reported risk of ≥1:250 and 20 (62.5%) a reported risk of ≥1:300. Of those screened before 17 weeks, 16/20 (80%) had a reported risk of ≥1: 300 compared with 4/12 (33%) of those screened later (P = 0.008); 4.64% of patients screened had reported risks ≥1: 250 and 5.87% reported risks of ≥ 1:300. Amniocentesis uptake was 70% in patients with reported risks of ≥ 1:300.

Conclusions

–Overall the screening programme was effective but screening before 17 weeks was very much more effective than screening later.
Feed-Forwardness of Spinal Networks in Posture and Locomotion
Authors: Gerasimenko Yury , Sayenko Dimitry , Gad Parag , Liu Chao-Tuan , Tillakaratne Niranjala J. K. , Roy Roland R. , Kozlovskaya Inessa , Edgerton V. Reggie
Published: January 2017

We present a new perspective on the concept of feed-forward compared to feedback mechanisms for motor control. We propose that conceptually all sensory information in real time provided to the brain and spinal cord can be viewed as a feed-forward phenomenon. We also propose that the spinal cord continually adapts to a broad array of ongoing sensory information that is used to adjust the probability of making timely and predictable decisions of selected networks that will execute a given response. One interpretation of the term feedback historically entails responses with short delays. We propose that feed-forward mechanisms, however, range in timeframes of milliseconds to an evolutionary perspective, that is, “evolutionary learning.” Continuously adapting events enable a high level of automaticity within the sensorimotor networks that mediate “planned” motor tasks. We emphasize that either a very small or a very large proportion of motor responses can be under some level of conscious vs automatic control. Furthermore, we make a case that a major component of automaticity of the neural control of movement in vertebrates is located within spinal cord networks. Even without brain input, the spinal cord routinely uses feed-forward processing of sensory information, particularly proprioceptive and cutaneous, to continuously make fundamental decisions that define motor responses. In effect, these spinal networks may be largely responsible for executing coordinated sensorimotor tasks, even those under normal “conscious” control.
On Not Being Able to Sleep: After the U.S. 2016 Presidential Election
Authors: Pelias Ronald J.
Published: January 2017

Following the 2016 U.S. presidential election, I find myself struggling, wanting to find a narrative that will let me sleep, but I am unable to find any comfort in the current political landscape. I call upon a fragmentary structure in this autoethnographic essay to display the troubling thoughts and incidents that have assailed me since the election, to point toward a frightening right wing agenda, and to demonstrate why I cannot sleep. Each numbered section offers evidence that the moral core of the United States has been deeply damaged by the election of Donald Trump.
Developing Effective Helping Relationships in Health Education Practice
Authors: Ryn Michelle van
Published: January 2017

Health educators who interact directly with the people they serve must be able to establish effective relationships. Helping relationships are effective if they facilitate clients' progress toward health-promoting goals. Health educators are usually well versed in learning activities and spend a significant proportion of their time interacting with clients. However, many health educators have never received explicit training in how to establish effective formal helping relationships. Research on social influence processes has provided a set of empirical findings that suggest interpersonal behaviors that are likely to maximize the effectiveness of formal helping relationships. This literature indicates that formal helping relationships characterized by interpersonal behaviors that enhance client self-esteem and feelings of control are most effective in helping clients achieve specific goals. Interestingly, enhancement of self-esteem and feelings of control are consistent with many definitions of personal empowerment. Since the social influence and empowerment literatures come from very different intellectual roots and have different approaches to power and influence, their convergence is especially notable. These literatures combine to establish the bases for proposing two essential components of effective helping relationships: (1) providing unconditional acceptance and positive regard for clients, and (2) sharing power and control through participatory processes.
A Simple Reinforcement Strategy for Increasing Attendance at a Fitness Facility
Authors: Courneya Kerry S. , Estabrooks Paul A. , Nigg Claudio R.
Published: January 2017

The purpose of the present study was to examine the effect of a previously untested reinforcement strategy (i.e., 1 month's free membership) on attendance at a fitness facility. Participants were paying members of a fitness facility randomly assigned to control ( n = 100), placebo ( n = 100), and reinforcement ( n = 100) conditions. The control condition received no intervention; the placebo condition received a letter by mail; and the reinforcement condition received the same letter by mail, except that it included an additional paragraph instructing them that they could earn 1 month's free membership if they attended the fitness facility at least 12 times in the next month. Attendance was monitored for I month baseline and postintervention by using the facility's computer system. Analysis of variance, t tests, and chi-square analysis all revealed that the reinforcement condition had the best attendance record during the intervention period. These preliminary results shed some light on increasing attendance at a fitness facility. Discussion highlighted the practical implications of the findings and offered directions for future research.
HIV Testing Among Haitian Women: Lessons in the Recognition of Risk
Authors: Wingerd Judith L. , Page J. Bryan
Published: January 2017

Haitian women in Miami, Florida, responded to recruitment for testing of HIV antibody serostatus in ways that demonstrated the value of ethnographic methods for studying reactions to this kind of test, especially pre- and posttest counseling sessions. A total of 155 women between 14 and 61 years old, recruited in Miami in 1992 and 1993, participated. Response to testing identified three primary obstacles to the women's understanding of content presented in pre- and posttest counseling sessions: (1) their confusion about the meaning of positive versus negative, (2) the investigators' difficulty in communicating the concept of antibody, and (3) vagueness of the concept of window period between exposure and presentation of antibody. Retesting of a subset of Haitian participants helped to define sexual risk among these women in terms of having partners who had other partners and perception of supernatural risk.
Patterns of Onset and Cessation of Drug Use Over the Early Part of the Life Course
Authors: DeWit David J. , Offord David R. , Wong Maria
Published: January 2017

This study uses retrospective drug use histories to examine the timing of drug use behavior among young people participating in a large random probability survey of residents of the province of Ontario, Canada. Results reveal that the major risk period for initiation into alcohol, tobacco, and most illicit drugs begins around age 12 and is mostly over by age 22. For most drugs, peak periods of risk of initiation occur in the age range 15 to 19. For all categories of illicit drugs, results reveal high quit rates in the first few years of use followed by a sharp decline. Differences by gender reveal higher rates of onset for males for most drugs. Male drug users are significantly less likely than female users to quit using a drug. Results are discussed in terms of their implications for the development of primary prevention and early intervention programs for adolescents and young adults.
The Telephone as a Communication Medium for Health Education
Authors: Soet Johanna E. , Basch Charles E.
Published: January 2017

The telephone is being widely used by the private sector as a communication medium for understanding and influencing consumer behavior. Coinciding with the growth of telephone use in the private sector is the expansion of telephone use in health care to include complex health promotion and disease prevention interventions aimed at initiating and maintaining health-related behavioral changes. While several studies have evaluated the impact of telephone interventions on a wide range of health behaviors, no published reports synthesizing current knowledge about using the telephone as a communication medium for health education were identified. In this article, the authors therefore (1) examine recent applications of telephone use in health education by describing three example interventions, (2) outline key features and alternatives in conceptualizing and designing health education using the telephone, (3) review advantages and disadvantages of using the telephone for health education, and (4) discuss implications for health education practice and research.
Evaluating Community Coalitions for Prevention of Substance Abuse: The Case of Project Freedom
Authors: Fawcett Stephen B. , Lewis Rhonda K. , Paine-Andrews Adrienne , Francisco Vincent T. , Richter Kimber P. , Williams Ella L. , Copple Barbara
Published: January 2017

In the United States alone, there are more than 2,000 community coalitions to address local concerns about abuse of alcohol, tobacco, and other drugs. This article describes an evaluation system used to examine the process, outcome, and impact of coalitions for the prevention of substance abuse. The evaluation addresses five key questions: (a) Was the community mobilized to address substance abuse (Process)? (b) What changes in the community resulted from the coalition (Outcome)? (c) Is there a change in reported use of alcohol and other substances by youths (Outcome)? (d) Does the coalition have a community-level impact on substance abuse (Impact)? and (e) Is community-level impact related to changes facilitated by the coalition (Impact)? To address these and other questions, using eight core measurement instruments, the evaluation system collects 15 distinct measures. This evaluation system is illustrated with a multiyear study of Project Freedom, a substance abuse coalition in a large midwestem city.
Metachronous Occurrence of Colorectal Cancer in a Muir-Torre Syndrome Patient Presenting with Recurrent Sebaceous Adenoma of the Eyelid: Case Report and Updated Review of the Literature
Authors: Agiannidis Christos , Pana Zoe D. , Molyva Dimitra , Kalokasidis Konstantinos , Mixiou Maria
Published: January 2017

Background:

Muir-Torre syndrome (MTS) is a rare genodermatosis considered a subtype of hereditary nonpolyposis colorectal cancer and traditionally associated with mutations in the mismatch repair genes.

Objective:

We describe a 51-year-old male with primary manifestations of recurrent sebaceous adenoma of the upper eyelid, a positive cancer family history, and metachronous occurrence of colorectal cancer.

Method:

The diagnosis of MTS was established based on the clinical course, family history, and histopathologic findings, although further immunohistologic testing revealed the absence of MSH2 mutation. We additionally performed an updated summary of published MTS cases with sebaceous neoplasms originating from the eyelid and conjunctiva for the period 2005 to 2011.

Conclusion:

This patient, the second Greek case described in the international literature, is of interest mainly because of the metachronous occurrence of the visceral malignancy in combination with the absence of MSH2 mutation. The need for high clinical suspicion for MTS in cases with sebaceous lesions of the periocular region should therefore be reinforced regardless of the mutational screening test undertaken.

Contexte:

Le syndrome de Muir-Torre (SMT) est une génodermatose rare, considérée comme un sous-type du cancer colorectal héréditaire, non polyposique, et habituellement associée à des mutations des gènes de réparation des mésappariements.

Objectif:

Nous faisons état ici du cas d'un homme de 51 ans, présentant l'accumulation de faits suivants: manifestations primaires d'adénome sébacé récidivant de la paupière supérieure, antécédents familiaux de cancer, et apparition asynchrone d'un cancer colorectal.

Méthode:

Le diagnostic de SMT a été posé à partir de l'évolution clinique, des antécédents familiaux, et de l'examen histopathologique, bien que les analyses immunohistologiques ultérieures aient révélé l'absence de mutation du gène MSH2. Nous avons également procédé à la mise à jour d'un résumé de cas publiés de SMT, accompagné de néoplasmes sébacés prenant naissance dans la paupière et la conjonctive, qui se sont produits durant la période de 2005 à 2011.

Conclusion:

Ce qui fait surtout l'intérêt du présent cas, le deuxième cas grec décrit dans la documentation internationale, est l'apparition asynchrone d'un cancer des viscères malgré l'absence de mutation du gène MSH2. Ce cas vient donc renforcer la nécessité d'avoir constamment à l'esprit la possibilité de SMT dans les cas de lésions sébacées dans la région périoculaire, et ce, indépendamment du test de dépistage de mutations.
Epidemiology of Sebaceous Carcinoma in Alberta, Canada, from 1988 to 2007
Authors: Kuzel Paul , Metelitsa Andrei I. , Dover Douglas C. , Salopek Thomas G.
Published: January 2017

Background:

The epidemiology of sebaceous carcinoma (SC) has not previously been examined in a Canadian population.

Objective:

To determine the epidemiologic trends of SC in Alberta, Canada, from 1988 to 2007.

Methods:

This study was a population-based, retrospective, epidemiologic analysis of SC in Alberta over a 20-year span.

Results:

Over the study period, the age-standardized SC incidence increased from 0.22 per 100,000 to 0.65 per 100,000. Sebaceous carcinoma is a cancer that predominantly affects the elderly (over 85% of cases were in persons 60 years or older). Interestingly, the face (37.7% of cases), not the eyelids (26.2% of cases), was the most frequently affected site overall. Gender-specific trends reflected a slight male predominance (1.4:1) and significant differences in anatomic distribution between the sexes.

Conclusion:

For unexplained reasons, there has been a threefold increase in SC incidence in Alberta over the last two decades. In addition, there are significant gender-specific differences in the anatomic distribution of SC.

Contexte:

L'épidémiologie du carcinome sébacé (CS) n'a jamais fait l'objet d'étude au Canada.

Objectif:

L'étude visait à déterminer les tendances épidémiologiques du CS en Alberta, au Canada, de 1988 à 2007.

Méthodes:

Il s'agit d'une analyse épidémiologique, rétrospective, fondée sur la population, du CS, en Alberta, sur une période de 20 ans.

Résultats:

Au cours de la période à l'étude, l'incidence du CS normalisée selon l'âge est passée de 0.22 pour 100,000 à 0.65 pour 100,000. Le carcinome sébacé est un cancer qui touche surtout les personnes âgées (plus de 85% des cas se comptaient parmi les personnes de 60 ans et plus). Point intéressant, la région le plus souvent touchée, dans l'ensemble, était la face (37.7% des cas), et non les paupières (26.2% des cas). Les tendances propres à chaque sexe ont révélé une fréquence légèrement plus élevée chez les hommes que chez les femmes (1.4/1) et des différences importantes entre les sexes quant à la répartition anatomique du siège des lésions.

Conclusion:

Pour des raisons inconnues, l'incidence du CS a triplé en Alberta au cours des deux dernières décennies. De plus, il existe des différences importantes entre les sexes quant à la répartition anatomique du CS.
Nerve Involvement in Granuloma Annulare
Authors: Longmire Michelle , Dicaudo David J. , Dahl Mark V.
Published: January 2017

Background:

Nerve involvement developed in a patient with granuloma annulare, as evidenced by a perineural infiltrate of histiocytes in the dermis. The histopathologic pattern was suggestive of leprosy. No mycobacteria were observed, and neurologic testing was normal.

Objective:

To determine whether inflammation of the nerves or perineural tissue is common in granuloma annulare, we studied the cutaneous nerves in skin biopsy specimens from 14 patients with granuloma annulare.

Methods:

Sections were stained with hematoxylin-eosin to highlight inflammatory cells and with S-100 to identify cutaneous nerves.

Results:

No inflammation around nerves was found in 12 specimens, abutting granulomatous inflammation was found in 1 specimen, and enveloping granulomatous inflammation was found in 1 specimen. No nerves were infiltrated by inflammatory cells.

Conclusion:

Perineural granulomatous inflammation resembling the perineural infiltrate of leprosy appears to be an uncommon characteristic of granuloma annulare. Clinical correlation and acid-fast stains can assist in establishing the correct diagnosis.

Contexte:

Une atteinte nerveuse est apparue chez un patient atteint de granulome annulaire, comme en témoignait un infiltrat périneural d'histiocytes dans le derme. Les signes histopathologiques étaient évocateurs de la lèpre, mais aucune mycobactérie n'a été observée, et l'examen neurologique était normal.

Objectif:

L'étude visait à déterminer si l'inflammation des nerfs ou du tissu périneural est fréquente dans le granulome annulaire; pour ce faire, nous avons examiné les nerfs cutanés dans des prélèvements biopsiques de la peau, effectués sur 14 patients atteints de granulome annulaire.

Méthodes:

Les coupes ont été colorées à l'hématoxyline-éosine pour mettre en évidence des cellules inflammatoires, ainsi qu'au S-100 pour repérer les nerfs cutanés.

Résultats:

Aucune inflammation autour des nerfs n'a été observée sur 12 prélèvements, mais il y avait présence d'inflammation granulomateuse contiguë sur un prélèvement et d'inflammation granulomateuse enveloppante, sur un autre prélèvement. Les nerfs n'ont pas été infiltrés par les cellules inflammatoires.

Conclusion:

L'inflammation granulomateuse périneurale qui ressemble à l'infiltration périneurale observée dans la lèpre semble un signe peu fréquent du granulome annulaire. L'établissement de corrélations cliniques et des colorations résistantes à l'acide peuvent faciliter la pose du bon diagnostic.
Strongyloidiasis Presenting as Larva Currens 38 Years after Presumed Exposure
Authors: Showier Adrienne , Boggild Andrea K.
Published: January 2017

Background:

We present a case of strongyloidiasis presenting as larva currens 38 years after potential exposure in a country with what is typically thought of as low epidemiologic risk.

Conclusion:

This case highlights several important features of strongyloidiasis, including its varied epidemiology, long incubation period, and cutaneous manifestations.

Contexte:

Nous exposons ici un cas de strongyloïdose, se manifestant sous forme de larva currens, 38 ans après une possible exposition dans un pays généralement considéré comme à faible risque épidémiologique.

Conclusion:

Le cas fait ressortir plusieurs particularités importantes de la strongyloïdose, dont sa distribution épidémiologique variée, sa longue période d'incubation et ses manifestations cutanées.
Linear Segmental Neurofibromatosis in an L5 Distribution
Authors: Umanoff Nicole , Viola Kate V. , Auerbach Jena , Cohen Steven R.
Published: January 2017

Background and Objective:

Neurofibromatosis (NF) is a neurocutaneous disorder with seven subtypes;segmental NF-1 is characterized by neurofibromas and or café-au-lait macules in one or more dermatomes, primarily the thorax and abdomen. We present the rare case of a 36-year-old African-American female with isolated, multiple soft nodules in a linear configuration on the plantar and dorsal surfaces of the left foot.

Conclusion:

This is the first report of isolated segmental NF-1 in a unique linear pattern confined to the L5 dermatome.

Contexte et objectif:

La neurofibromatose (NF) est un trouble neurocutané, qui se divise en sept sous-types; celle de type 1 (NF-1) segmentaire se caractérise par des neurofibromes ou des macules de couleur « café au lait » dans l'un ou plusieurs dermatomes, surtout sur le thorax et l'abdomen. Voici le rare cas d'une femme afro-américaine, de 36 ans, qui présente de nombreux nodules mous, isolés, suivant un trajet linéaire sur les faces plantaire et dorsale du pied gauche.

Conclusion:

Il s'agit du premier cas signalé de NF-1 segmentaire, isolée, suivant un trajet linéaire particulier, limité au dermatome L5.
Isotretinoin for the Treatment of Granulomatous Rosacea: Case Report and Review of the Literature
Authors: Rallis Efstathios , Korfitis Chrysovalantis
Published: January 2017

Background:

Granulomatous rosacea is considered a clinical variant of rosacea and is characterized by hard yellow, brown, red or flesh-colored cutaneous papules or nodules that may be severe and may lead to scarring. The lesions typically appear on the cheeks and periorificial lesions; they are monomorphic in each patient and sit on relatively normal-appearing skin. The diagnosis should be established by excluding other granulomatous disorders and rosacea-like eruptions such as sarcoidosis, tuberculosis, and lupus miliaris disseminatus faciei. The clinical course is chronic and unpredictable, and management can be very difficult.

Case Report:

We report the case of a 28-year-old female with granulomatous rosacea who responded successfully to oral isotretinoin. No recurrence was noticed 6 months after the completion of treatment.

Renseignements de base:

La rosacée granulomateuse est considérée comme une variante clinique de la rosacée et est caractérisée par la présence de papules cutanées jaunes, brunes, ou fleshed-colored rouges dures ou par de nodules qui peuvent être graves et qui peuvent causer des cicatrices. Les lésions sont généralement localisées aux joues et sur les lésions péri-orificielles; elles sont monomorphes chez chaque patient individuel et elles siègent sur une peau d'apparence relativement normale. Le diagnostic doit être établi en excluant les autres troubles granulomateux et les éruptions rosacéiformes comme la sarcoïdose, la tuberculose, et la tuberculide papulonodulaire. L'évolution clinique est chronique et imprévisible, et la gestion peut être très difficile.

Rapport de cas:

Nous rapportons le cas d'une femme âgée de 28 ans présentant une rosacée granulomateuse qui a été traité avec succès avec l'isotrétinoïne administrée par voie orale. Aucune récidive n'a été observée 6 mois après la fin du traitement.
Erythema Annulare Centrifugum in a Patient with Crohn Disease
Authors: Samycia Michael , Salopek Thomas G.
Published: January 2017

Background:

Erythema annulare centrifugum (EAC) represents a hypersensitivity reaction to a variety of conditions, many of which have been reported in the literature.

Methods and Results:

We report on a 38-year-old woman with a 5-year history of recurrent polycylic, arcuate, scaly, erythematous patches with central clearing on her thighs and trunk. Clinical examination and biopsy were both consistent with a diagnosis of EAC. Two years after the initial presentation, she was diagnosed with mild Crohn disease.

Conclusions:

The prolonged nature of EAC in our patient and our inability to identify known associations of malignancies, including medications, connective tissue disorders, systemic disorders, and infections, led us to postulate that her EAC was related to her Crohn disease. A thorough review of the literature failed to detect any previous reports linking Crohn disease and EAC.

Renseignements de base:

L'érythème centrifuge (EAC) représente une réaction d'hypersensibilité à une variété de conditions dont beaucoup ont été signalées dans la littérature.

Méthodes et résultats:

Nous présentons un rapport sur le cas d'une femme de 38 ans présentant 5 ans d'antécédents de taches érythémateuses squameuses, arquées, polycycliques récurrentes avec guérison centrale sur les cuisses et le tronc. L'examen clinique et la biopsie étaient tous les deux compatibles avec un diagnostic d'EAC. Deux ans après la présentation initiale, elle a été diagnostiquée avec une forme bénigne de la maladie de Crohn.

Conclusions:

La nature prolongée de l'EAC chez notre patiente, et notre incapacité à identifier les associations connues, y compris les médicaments, les maladies du tissu conjonctif, les troubles systémiques, et des infections, des tumeurs malignes, nous a conduit à postuler que son EAC était lié à sa maladie de Crohn. Un examen approfondi de la littérature ne nous a pas permis de trouver des rapports antérieurs qui établissent un lien entre la maladie de Crohn et l'EAC.
Verrucous Carcinoma due to Arsenic Ingestion in a Psoriasis Patient
Authors: Zhu Jian-Wei , Zheng Min
Published: January 2017

Background and Objective:

Verrucous carcinoma is a rare clinicopathologic entity caused by multifactorial influences. We report here a 64-year-old male patient presenting with a large exophytic mass in the right leg.

Results and Conclusion:

The patient had a 19-year duration of psoriasis and received various treatments. In his last year of life, he had been taking an illegally produced folk drug with the hope of controlling his psoriasis. However, 6 months after the drug ingestion, many papules appeared on his right leg, which eventually developed into a large tumor in the next few months. The patient died of acute pulmonary embolism only a week after hospitalization, when his tumor was pathologically confirmed as verrucous carcinoma. Later, the folk drug was analyzed and found to contain arsenic. The causative relevance of the tumor with his daily arsenic intake is discussed.

Contexte et objectif:

Le carcinome verruqueux est une entité clinicopathologique rare, causée par divers facteurs. Nous exposons ici le cas d'un homme de 64 ans, qui a consulté pour une grosse masse exophytique sur la jambe droite.

Résultats et conclusions:

Le patient souffrait de psoriasis depuis 19 ans et a été soumis à divers traitements. Au cours de sa dernière année de vie, il a pris un remède empirique traditionnel, illégal, dans l'espoir de soulager le psoriasis. Cependant, 6 mois après la consommation du remède, de nombreuses papules sont apparues sur la jambe droite, et ont fini par former une grosse tumeur au cours des mois suivants. Le patient est mort d'une embolie pulmonaire aiguë, une semaine seulement après son hospitalisation, lorsque l'examen histopathologique de la tumeur a révélé qu'il s'agissait d'un carcinome verruqueux. Le remède a été analysé plus tard, et il s'est avéré que celui-ci contenait de l'arsenic. Le lien de cause à effet entre la tumeur et la consommation quotidienne d'arsenic fera l'objet de discussion.
Pallor Sign: An Indicator of Hemangioma in Evolution
Authors: Chisti Muzamil , Banka Nusrat , Alfadley Abdullah
Published: January 2017

Background:

The typical presentation of infantile hemangioma is well known and is easily recognizable. However, it may have many atypical presentations, as reported in the literature. Most of the hemangiomas are not visible at birth and become apparent at about 3 to 4 weeks of age. There are very few case reports of hemangioma presenting as a pale patch in the dermatology literature, and none of them describe the etiopathogenesis of this presentation and its clinical implications.

Objective and Conclusion:

We report a case of an infantile hemangioma with a trichrome presentation: an erythematous oval patch with a dark red macule at the periphery enclosed by a hypopigmented halo. A brief description of the etiopathogenesis of the pallor sign is also given.

Renseignements de base:

La présentation typique d'un hémangiome infantile est bien connue et facilement reconnaissable. Toutefois, comme l'indique la documentation, il peut avoir de nombreuses présentations atypiques. La plupart des hémangiomes ne sont pas visibles à la naissance et deviennent apparents à environ 3 à 4 semaines. La documentation dermatologique ne compte que très peu d'observations d'hémangiome se présentant sous forme de plaque pâle, et aucune d'entre elles ne décrit l'étiopathogénie de cette présentation et ses conséquences cliniques.

Objectif et conclusion:

Nous signalons un cas d'hémangiome infantile avec présentation trichrome: plaque érythémateuse ovale avec une macule rouge foncée en périphérie, entourée d'un halo hypopigmenté. Une brève description de l'étiopathogénie de la pâleur est également donnée.