Multiple eruptive dermatofibromas and immunosuppression: report of two cases and review of the literature.

Dermatofibromas are common benign fibrohistiocytic tumors that are most often solitary. The occurrence of multiple eruptive dermatofibromas (MEDF), on the contrary, is a rare event. MEDF have been reported in the setting of autoimmune diseases, treated with immunosuppressive drugs, in the course of HIV infection and in neoplastic diseases. An association with immunosuppression has led to the speculation that they are the result of an abortive immunoreactive process. Here, we describe a patient with Sézary syndrome and a patient with multiple IgA myeloma who developed MEDF. These associations have not been reported previously.

[Evaluation of the psychological well-being and coping strategies in a population of ex asbestos exposed on its work place]. / Valutazione del benessere psicologico e delle tecniche di coping in una popolazione di ex esposti all'amianto in ambiente lavorativo.

The aim of the current study was mainly to asses the coping strategies used by a sample of subjects (n = 100) and its psychological well-being. The INAIL had recognized these subjects in the past time had been massively exposed to asbestos in their work place. An anonymous self-report questionnaire, made up of (a) an explorative section, (b) the Carver's COPE, (c) the Carol Ryff's Psychological Wellbeing Scales (PWBS), has been used. Both tests parametric (Chi Square and t Student analysis) and not parametric (Mann-Whitney Test) were carried out in order to assure strength results. The survey data indicated that there were an acknowledge about the asbestos-related diseases' action and a general use of "avoidance" coping strategies. Contrary to expectation concerning the PWBS, there was a statistically significant higher score in the "exposed group" than the "control group" (n = 50) as regards the "Positive Relations with Others" and the "Personal Growth" scales. Different variables may concur to explain the results of this study.

Systemic candidiasis in extremely low birth weight infants receiving topical petrolatum ointment for skin care: a case-control study.

BACKGROUND AND OBJECTIVE: An increase in the incidence of systemic candidiasis (SC) followed a change in skin care for extremely low birth weight (ELBW) infants in our neonatal intensive care unit (NICU). We sought to determine whether the use of topical petrolatum ointment (TPO) for skin care of ELBW infants was associated with risk for SC. STUDY DESIGN: Case-control study. SETTING: A 48-bed NICU in a private hospital in Houston, Texas. PATIENTS: Ten ELBW infants with and 30 without SC admitted to the NICU from December 1, 1997 through July 31, 1998. METHODS: ELBW infants with SC were identified using hospital microbiology and infectious disease consultation databases. A case was defined as an infant weighing

Epidemiological analysis defining concurrent outbreaks of Serratia marcescens and methicillin-resistant Staphylococcus aureus in a neonatal intensive-care unit.

OBJECTIVE: To describe the epidemiology, interventions, and molecular typing methods used during the investigation and control of concurrent outbreaks of Serratia marcescens and methicillin-resistant Staphylococcus aureus (MRSA) infections in a neonatal intensive-care unit (NICU). SETTING: A 206-bed women's and infants' hospital with a 48-bed NICU. DESIGN: A 22-week, prospective, descriptive study of all NICU infants with S marcescens or MRSA infection or colonization. Repetitive polymerase chain reaction (rep PCR) and pulsed-field gel electrophoresis (PFGE), respectively, were applied to the typing of S marcescens and MRSA isolates. INTERVENTIONS: Infants with S marcescens or MRSA infection or colonization were placed in isolation; all other infants were cohorted. A multidisciplinary task force implemented education for all hospital and medical staff regarding policies essential for outbreak control. Changes in physical setting and patient contact procedure were required to promote adherence to existing policies. RESULTS: Two premature infants had S marcescens infection, and five were colonized; rep PCR verified that both invasive and three of five colonizing isolates were related genotypically. Five bacteremic and 10 MRSA-colonized infants were identified; PFGE confirmed that 12 of the isolates had similar electrophoretic patterns. S marcescens infection was eliminated from the NICU 3 weeks after interventions were initiated. MRSA infections also were eliminated, and MRSA colonization fell to below pre-outbreak rates within 8 weeks. Despite a 100% increase in NICU patient days per month during the subsequent 2 years, no further clusters of S marcescens or MRSA infection have occurred. CONCLUSIONS: Concurrent outbreaks of S marcescens and MRSA in an NICU were confirmed by genotyping of strains. Control was achieved by isolation and cohorting of patients and strict adherence to NICU policies and procedures.

Home mechanical ventilation in kyphoscoliosis.

The aim of the study was to determine whether intermittent positive pressure ventilation (IPPV), delivered either by nasal mask or by tracheostomy, is able to improve alveolar gas exchange in kyphoscoliotic patients with respiratory failure. We evaluated 17 patients, 10 females and 7 males, aged 52 +/- 12 (mean +/- SD) yrs. Eight had severe respiratory failure (arterial oxygen tension (PaO2) 53.2 +/- 9.3 mmHg (7.1 +/- 1.2 kPa); arterial carbon dioxide tension (PaCO2) 73.3 +/- 12.5 mmHg (9.7 +/- 1.6 kPa), breathing supplemental oxygen), and were put on IPPV via tracheostomy (TIPPV). The others (PaO2 54.5 +/- 5.5 mmHg (7.3 +/- 0.7 kPa); PaCO2 57.9 +/- 7 mmHg (7.7 +/- 0.9 kPa), breathing air), were put on IPPV via nasal mask (NIPPV). Home mechanical ventilation (HMV) was performed at night (7 +/- 1 h) by means of a volume-cycled pressure respirator in control mode. The frequency was adapted to the patient's spontaneous respiratory rate, and then eventually modified according to blood gases. A silicone mask was moulded onto the patient's nose. Supplemental oxygen (to maintain arterial oxygen saturation (SaO2) > 90%) was used only for tracheostomized patients, whereas NIPPV was performed with fractional inspiratory oxygen (FIO2) 21%. Arterial blood samples were obtained for all patients in steady-state condition, 8 +/- 1 h from the withdrawal, breathing air, after 1 and 6 months of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)