New OSHA standards managers must know.

For home care agencies, compliance encompasses far more than HCFA and the Joint Commission specifics. Other organizations also provide strict guidelines regarding daily operations and activities. This article describes the proposed OSHA ergonomics regulations and provides suggestions for managers on how to prepare for the changes.

Occult breast carcinoma in patients undergoing reduction mammaplasty.

Seven patients who had breast reduction surgery and whose preoperative physical examinations were unremarkable were found to have breast carcinoma. In the five in whom mastectomy was performed, most closures were difficult, and in one patient bilateral mastectomy was complicated by wound dehiscence. In only one of these seven was it possible to obtain information regarding the hormonal binding status of the tumor cells. These and other sequelae would not have occurred had the tumors been diagnosed before operation. Because physical examination alone is not sufficiently sensitive for the diagnosis of breast cancer, we suggest that mammography be included in the evaluation of patients consulting surgeons for breast reduction.

Hemangiopericytoma of the maxilla.

Hemangiopericytoma is a vascular tumor that typically occurs in the soft tissues of the extremities and trunk, and only rarely occurs in the paranasal sinuses and nasal cavity. We report a case of hemangiopericytoma of the maxilla and review the pertinent literature. Based on a propensity for local recurrence and occasional metastasis, a radical excision was performed.