Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 18 de 18
Filter
1.
Clin Exp Dermatol ; 42(2): 189-191, 2017 Mar.
Article in English | MEDLINE | ID: mdl-28052370

ABSTRACT

We report the case of a 24-year-old woman with an 8-month history of deep pelvic pain and postcoital bleeding. Examination revealed desquamation of the vaginal epithelium with tender fissured plaques in the vagina, initially thought to be vaginal intraepithelial neoplasia. Histology showed squamous mucosa with suprabasal acantholysis and hyperkeratosis, and no evidence of viral infection, dysplasia or malignancy. These findings were consistent with acantholytic dermatosis (AD), a rare lesion that resembles Hailey-Hailey and Darier disease histopathologically, but can be distinguished on a clinical basis. Vulval cases of AD are well recognized, but to our knowledge, this is the first reported case involving the vaginal epithelium alone.


Subject(s)
Acantholysis/diagnosis , Vaginal Diseases/diagnosis , Acantholysis/pathology , Biopsy , Colposcopy , Diagnosis, Differential , Epithelium/pathology , Female , Humans , Vagina/pathology , Vaginal Diseases/pathology , Young Adult
2.
J Bodyw Mov Ther ; 17(4): 462-8, 2013 Oct.
Article in English | MEDLINE | ID: mdl-24139004

ABSTRACT

The aim of this study was to determine the kinematic differences between movements on a new exercise device (EX) that promotes a stable trunk over a moving, unstable base of support, and overground walking (OW). Sixteen male participants performed EX and OW trials while their movements were tracked using a 3D motion capture system. Trunk and pelvis range of motion (ROM) were similar between EX and OW in the sagittal and frontal planes, and reduced for EX in the transverse plane. The pelvis was tilted anteriorly, on average, by about 16° in EX compared to OW. Hip and knee ROM were reduced in EX compared to OW. The exercise device appears to promote similar or reduced lumbopelvic motion, compared to walking, which could contribute to more tonic activity of the local lumbopelvic musculature.


Subject(s)
Lumbosacral Region/physiology , Pelvis/physiology , Posture , Resistance Training/methods , Walking/physiology , Adult , Biomechanical Phenomena , Female , Gait , Humans , Male , Range of Motion, Articular
4.
Br J Cancer ; 102(6): 1044-51, 2010 Mar 16.
Article in English | MEDLINE | ID: mdl-20234371

ABSTRACT

BACKGROUND: The incidence of human papillomavirus-associated vulval neoplasia is increasing worldwide; yet the associated genetic changes remain poorly understood. METHODS: We have used single-nucleotide polymorphism microarray analysis to perform the first high-resolution investigation of genome-wide allelic imbalance in vulval neoplasia. Our sample series comprised 21 high-grade vulval intraepithelial neoplasia and 6 vulval squamous cell carcinomas, with paired non-lesional samples used to adjust for normal copy number variation. RESULTS: Overall the most common recurrent aberrations were gains at 1p and 20, with the most frequent deletions observed at 2q, 3p and 10. Copy-neutral loss of heterozygosity at 6p was a recurrent event in vulval intraepithelial neoplasia. The pattern of genetic alterations differed from the characteristic changes we previously identified in cutaneous squamous cell carcinomas. Vulval neoplasia samples did not exhibit gain at 5p, a frequent recurrent aberration in a series of cervical tumours analysed elsewhere using an identical protocol. CONCLUSION: This series of 27 vulval samples comprises the largest systematic genome-wide analysis of vulval neoplasia performed to date. Despite shared papillomavirus status and regional proximity, our data suggest that the frequency of certain genetic alterations may differ in vulval and cervical tumours.


Subject(s)
Alphapapillomavirus/physiology , Carcinoma in Situ/genetics , Carcinoma, Squamous Cell/genetics , Gene Expression Profiling/methods , Vulvar Neoplasms/genetics , Carcinoma in Situ/etiology , Carcinoma in Situ/virology , Carcinoma, Squamous Cell/etiology , Carcinoma, Squamous Cell/virology , Chromosome Aberrations , DNA, Viral/analysis , Female , Gene Expression Regulation, Neoplastic , Genomics/methods , Human papillomavirus 16/physiology , Humans , Loss of Heterozygosity , Oligonucleotide Array Sequence Analysis , Polymorphism, Single Nucleotide , Uterine Cervical Neoplasms/genetics , Vulvar Neoplasms/etiology , Vulvar Neoplasms/virology , Uterine Cervical Dysplasia/genetics
5.
Clin Exp Dermatol ; 32(3): 304-7, 2007 May.
Article in English | MEDLINE | ID: mdl-17362236

ABSTRACT

Human papillomavirus (HPV) infection is associated with genital malignancy and specific cutaneous malignancies. We report a case of an HPV-associated concurrent vulval intraepithelial neoplasia and periungual Bowen's disease in a young immunocompetent Afro-Caribbean woman with no known risk factors for either disease. HPV genotyping studies detected multiple alpha and beta papillomaviruses with concordance for HPV-34 [a high-risk (HR) mucosal type], and HPV-21 [an epidermodyslasia verruciformis (EV) type] in both vulval and finger tissue. Although the HR-mucosal viruses detected are likely to have a pathogenic role in vulval intraepithelial neoplasia, this is the first report of concordance for EV HPV types in both genital and nongenital skin premalignancies. This case, in the context of accumulating epidemiological and experimental data in cutaneous SCC, raises the question of whether EV HPV may contribute to vulval malignancy, and further study is merited.


Subject(s)
Bowen's Disease/virology , Fingers/virology , Papillomaviridae/isolation & purification , Papillomavirus Infections/virology , Skin Neoplasms/virology , Vulvar Neoplasms/virology , Adult , Female , Humans
6.
Nurse Educ Today ; 27(8): 915-22, 2007 Nov.
Article in English | MEDLINE | ID: mdl-17376563

ABSTRACT

OBJECTIVE: To determine the most effective method of delivering training to staff on the management of an obstetric emergency. SUBJECTS: The research was conducted in a District General Hospital in the UK, delivering approximately 3500 women per year. Thirty-six staff, comprising of junior and senior medical and midwifery staff were included as research subjects. Each of the staff members were put into one of six multi-professional teams. Effectively, this gave six teams, each comprising of six members. METHOD: Three teaching methods were employed. Lecture based teaching (LBT), simulation based teaching (SBT) or a combination of these two (LAS). Each team of staff were randomly allocated to undertake a full day of training in the management of Post Partum Haemorrhage utilising one of these three teaching methods. Team knowledge and performance were assessed pre-training, post training and at three months later. In addition to this assessment of knowledge and performance, qualitative semi-structured interviews were carried out with 50% of the original cohort one year after the training, to explore anxiety, confidence, communication, knowledge retention, enjoyment and transferable skills. RESULTS: All teams improved in their performance and knowledge. The teams taught using simulation only (SBT) were the only group to demonstrate sustained improvement in clinical management of the case, confidence, communication skills and knowledge. However, the study did not have enough power to reach statistical significance. The SBT group reported transferable skills and less anxiety in subsequent emergencies. SBT and LAS reported improved multidisciplinary communication. Although tiring, the SBT was enjoyed the most. CONCLUSION: Obstetrics is a high risk speciality, in which emergencies are to some extent, inevitable. Training staff to manage these emergencies is a fundamental principal of risk management. Traditional risk management strategies based on incident reporting and event analysis are reactive and not always effective. Simulation based training is an appropriate proactive approach to reducing errors and risk in obstetrics, improving teamwork and communication, whilst giving the student a multiplicity of transferable skills to improve their performance.


Subject(s)
Education, Nursing, Continuing/methods , Nursing Staff, Hospital , Obstetric Nursing/education , Postpartum Hemorrhage/nursing , Problem-Based Learning/methods , Teaching/methods , Attitude of Health Personnel , Clinical Competence , Communication , Education, Nursing, Continuing/standards , Emergencies/nursing , Hospitals, District , Hospitals, General , Humans , Interprofessional Relations , Nursing Education Research , Nursing Methodology Research , Nursing Staff, Hospital/education , Nursing Staff, Hospital/psychology , Patient Care Team , Problem-Based Learning/standards , Program Evaluation , Qualitative Research , Risk Management , Self Efficacy , Surveys and Questionnaires , Teaching/standards , United Kingdom
9.
J Am Acad Dermatol ; 45(6 Suppl): S220-1, 2001 Dec.
Article in English | MEDLINE | ID: mdl-11712065

ABSTRACT

We describe a patient with acute generalized eosinophilic pustuloderma induced by mesalazine therapy. The patient responded to cessation of mesalazine and treatment with systemic corticosteroids. This type of unusual pustuloderma to mesalazine has not to our knowledge been described before.


Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Colitis, Ulcerative/drug therapy , Drug Eruptions/diagnosis , Mesalamine/adverse effects , Adult , Diagnosis, Differential , Drug Eruptions/etiology , Drug Eruptions/pathology , Face , Female , Forearm , Humans
10.
Br J Dermatol ; 144(2): 347-50, 2001 Feb.
Article in English | MEDLINE | ID: mdl-11251570

ABSTRACT

BACKGROUND: Healthcare workers (clinical, allied/paramedical professions and ancillary workers) may have prolonged contact with natural rubber latex devices, particularly in the form of natural rubber latex gloves. OBJECTIVES: To examine the changing frequency of type IV thiuram allergy in healthcare workers with hand dermatitis over a 16-year period. METHODS: During the study period, 450 healthcare workers (352 women and 98 men) with hand dermatitis were investigated, and their patch test results were analysed retrospectively. RESULTS: On average, a thiuram-positive patch test was noted in 12% of individuals, with a peak incidence of 27% of the patients patch tested in 1994. Comparison of results between 1983--88 and 1989--93 showed a statistically significant increase in the incidence of thiuram-positive patch tests (odds ratio 2.55, 95% confidence interval 1.25--5.20, P = 0.01). CONCLUSIONS: We have documented a changing frequency of thiuram-positive patch tests in healthcare workers with hand dermatitis since 1983. This may reflect changes in degree of exposure to thiurams in medical gloves during this period.


Subject(s)
Dermatitis, Allergic Contact/epidemiology , Dermatitis, Occupational/epidemiology , Hand Dermatoses/epidemiology , Health Personnel , Latex Hypersensitivity/epidemiology , Thiram/adverse effects , Adolescent , Adult , Aged , Dermatitis, Allergic Contact/etiology , Dermatitis, Occupational/etiology , Female , Gloves, Protective/adverse effects , Hand Dermatoses/chemically induced , Humans , Incidence , Latex Hypersensitivity/etiology , London/epidemiology , Male , Middle Aged , Patch Tests , Retrospective Studies
12.
Br J Dermatol ; 141(4): 717-9, 1999 Oct.
Article in English | MEDLINE | ID: mdl-10583124

ABSTRACT

Necrotizing fasciitis is an uncommon condition which may complicate any surgical procedure, including 'minor' dermatological procedures. However, it may arise de novo in the absence of any discernible trauma. We report a patient who acquired a fulminant form of this condition following excision of a malignant melanoma. The development of necrotizing fasciitis in association with melanoma has not previously been reported.


Subject(s)
Fasciitis, Necrotizing/microbiology , Melanoma/surgery , Postoperative Complications/microbiology , Skin Neoplasms/surgery , Streptococcal Infections/etiology , Adult , Ambulatory Surgical Procedures , Fatal Outcome , Humans , Male
14.
J Obstet Gynaecol ; 19(3): 273-5, 1999 May.
Article in English | MEDLINE | ID: mdl-15512294

ABSTRACT

This aim of this study was to undertake a retrospective analysis of the notes of all new patients who attended the joint vulval clinic between 1994 and 1997. One hundred and forty-five patients were seen, and data analysed for 133 (92%). The study identified the range of diagnoses seen; treatment modalities undertaken; and enabled comparisons to be made between our findings and those of other workers.

15.
Med Sci Law ; 38(3): 202-5, 1998 Jul.
Article in English | MEDLINE | ID: mdl-9717368

ABSTRACT

This report describes a female patient with Munchausen's syndrome who made a false allegation of rape, buggery and indecent assault to the Metropolitan Police. The indecent assault took the form of inserting numerous wax crayons into the vagina, necessitating her admission to hospital for their removal under a general anaesthetic. Whilst in hospital she developed a status epilepticus-like condition, requiring admission to the Intensive Therapy Unit. As a specific method of self-harm in Munchausen's syndrome, this case appears to be unique. It has not previously been reported in the literature.


Subject(s)
Child Abuse, Sexual/diagnosis , Forensic Psychiatry , Munchausen Syndrome/diagnosis , Adolescent , Diagnosis, Differential , England , Female , Humans , Munchausen Syndrome/psychology
17.
J Clin Forensic Med ; 5(4): 195-8, 1998 Dec.
Article in English | MEDLINE | ID: mdl-15335519

ABSTRACT

The term 'false allegation', when applied to rape and assault, is a difficult concept for forensic medical examiners and the police to comprehend. Reliable evidence about how prevalent these allegations are is hard to obtain. This paper is a transcript of the oral presentation given at the 6th Cross-Channel Conference in Clinical Forensic Medicine held in Southampton, May 14-16th, 1998.

18.
Scott Med J ; 36(3): 68-74, 1991 Jun.
Article in English | MEDLINE | ID: mdl-1925505

ABSTRACT

The histopathology and clinical presentation of 19 cases of primary gastrointestinal lymphoma is described. Our patients are similar to others in the Middle East but have a lower incidence of diarrhoea and malabsorption. All revealed a widespread chronic inflammatory background. Four patients with primary gastric lymphoma had endoscopic biopsies from the duodenum; these biopsies were completely free from tumour but showed a moderate to severe diffuse lymphoplasmacytic infiltrate. Electron microscopy shows that tumour cells penetrate basement membranes and invade the epithelium which becomes thin and attenuated. Substances which inhibit lymphocyte tropism might be useful in preventing intestinal ulceration. The MALT concept has been found useful in classification of the tumours. Two patients with unusual mesenteric node histology are described and it is thought that the appearances may indicate a substantial capacity for differentiation in the group of tumours.


Subject(s)
Gastrointestinal Neoplasms/pathology , Lymphoma, Non-Hodgkin/pathology , Adult , Aged , Duodenal Neoplasms/pathology , Duodenal Neoplasms/ultrastructure , Female , Gastrointestinal Neoplasms/ultrastructure , Humans , Lymph Nodes/pathology , Lymphoma, Non-Hodgkin/ultrastructure , Male , Mesentery , Microscopy, Electron , Microvilli/ultrastructure , Middle Aged , Neoplasm Invasiveness , Saudi Arabia , Stomach Neoplasms/pathology , Stomach Neoplasms/ultrastructure
SELECTION OF CITATIONS
SEARCH DETAIL
...