Concurrent toxoplasmosis and feline infectious peritonitis in a cat.

A 13-year-old, 4-kg, neutered male Maine coon presented with ascites. Toxoplasma gondii tachyzoites were seen within neutrophils and macrophages, and free within the abdominal fluid. At necropsy, many abdominal organs were positive for feline infectious peritonitis (FIP) antigens using immunohistochemical staining. This apparently is the first report of concurrent toxoplasmosis and FIP in a domestic cat.

Justification and implementation of a cancer center pharmacy satellite.

The justification, establishment, and evaluation of a full-service cancer center pharmacy satellite for a university hospital are described. Providing efficient and effective pharmaceutical services was difficult because (1) the cancer center is housed in a freestanding building adjacent to the hospital and (2) there are special considerations inherent in the ordering and preparation of antineoplastic medications. Data collected and presented by the pharmacy, along with letters of support from nursing and medical staff, provided justification of the need to establish an oncology satellite pharmacy. The satellite, open 8.0 hours per day Monday through Friday, is primarily responsible for preparing antineoplastic agents and dispensing first doses of other intravenous and oral medications for the cancer center. Satellite staffing consists of 1.2 full-time-equivalent (FTE) pharmacists and 2.0 FTE technicians. A technician works in the satellite the same number of hours as the pharmacist but is also available to prepare antineoplastic drugs in the central pharmacy on weekends. Pharmacist activities also include providing drug and dosing information to the medical and nursing staff, as well as handling investigational drugs. The satellite pharmacy has decreased medication turnaround time by one-half and has improved pharmaceutical services to the nursing staff.

Pancreatic injuries. Effectiveness of debridement and drainage for nontransecting injuries.

Injuries to the pancreas are encountered infrequently and are associated with significant morbidity and mortality. Controversy regarding the management of these injuries exists between the advocates of resection and the advocates of simple debridement and drainage. A retrospective review of 42 patients suffering injuries to the pancreas between 1969 and 1982 at the authors' institution was undertaken. Operative pancreatography was not performed, and all injuries were managed by debridement and drainage unless complete transection of the pancreas was present. The results support the use of debridement and drainage of nontransecting pancreatic injuries.

Blood transfusion and disease-free survival in carcinoma of the breast.

A retrospective study was undertaken to determine the effect of perioperative blood transfusion on disease-free survival rates in patients with carcinoma of the breast. The charts of 81 patients participating in a NSABP breast cancer protocol at The Mt. Sinai Medical Center, Cleveland, Ohio, were reviewed. There was no statistically significant difference in disease-free survival between those patients receiving blood transfusions and those that did not when considering the entire group of patients or subgroups based upon age, nodal status, estrogen receptor status, or progesterone receptor status. However, the subgroup of patients receiving tamoxifen chemotherapy, especially those with positive estrogen receptors, had significantly reduced disease-free survival (P less than .05) when given blood transfusions. These results suggest an adverse effect of blood transfusion on disease-free survival in breast cancer patients treated with tamoxifen chemotherapy.

Hepatocellular carcinoma metastatic to rib: an approach to an unusual chest wall tumor.

Thoracic cage tumors are infrequently encountered and may present a dilemma in diagnosis and treatment. A case of hepatocellular carcinoma metastatic to rib, an unusual chest wall tumor, is presented here, and an orderly and effective approach to chest wall lesions is described. Computerized tomography and biopsy are the most efficacious diagnostic modalities.