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Biomedical subjects

Michael Nash

Publications and source records attributed to Michael Nash.

12 recordsLinked to original sources
PubMed2006

Metastatic tumors to the jaws: a report of eight new cases.

PURPOSE: The purpose of the article is to present 8 new cases of metastatic tumors occurring in the jawbones, their clinical features , diagnostic workup and management. PATIENTS AND METHODS: The records of 8 patients with metastatic jaw lesions were reviewed. Demographic data, presenting symptoms, primary tumor site, radiographic findings, bone scintigraphy , histopathology and clinical management were analyzed. RESULTS: The patients , ranged in age from 44 to 80 years, with a mean of 64.5 years. The primary malignant sites were: the lung , the breast , the rectum, the thyroid, the uterus and the parotid gland . The mandible was the site of oral involvement in seven cases and the maxilla in one. There was no gender difference with respect to the oral site affected. The clinical jaw presentations were: exophytic soft tissue mass, paresthesia of the lower lip and a periapical lesion The provided treatment protocols were: chemotherapy , radiotherapy and chemotherapy, surgery and chemotherapy and supportive care only. In one case the jaw lesion was the first indication of an unknown malignancy at a distant primary site. CONCLUSIONS: Metastatic jaw lesions are uncommon. Paresthesia of the lower lip and the chin is a sinister sign for patients with a metastatic jaw lesion. In view of these cases it can be said that meticulous work-up of of jaw lesions suspected of being metastatic, may be life saving or extend the patient s survival period.

Adult↗
PubMed2006

Candida parotitis with abscess formation.

This report describes the case of an elderly, diabetic man who developed acute suppurative parotitis with abscess formation. The causative agent of parotid abscess was Candida albicans, which is an unusual cause of salivary gland pathology. The parotid gland is the salivary gland most commonly affected by inflammation. Acute parotitis occurs most often in elderly patients who are debilitated by systemic disease or are in a state of dehydration following major surgical procedures. Despite the high prevalence of oral candida carriage, there have been few previous reports of candida sialoadenitis in the literature. This is due to the toxicity of saliva to fungi under normal conditions. The diagnosis of candidiasis in our patient was made by culturing the purulent discharge from Stensen's duct and by culture of the pus obtained at surgical drainage of the abscess. After incision and drainage, the patient was treated with intravenous and then oral fluconazole for a total of 4 weeks with complete resolution of his condition. This case is interesting in light of recent and ongoing investigations of salivary proteins as potential new antifungal agents.

Abscess↗
PubMed2005

Peripheral osteoma of the maxillofacial region. Diagnosis and management: a study of 14 cases.

PURPOSE: The purpose of the article was to present 14 new cases of peripheral osteoma and to evaluate the diagnosis and management of peripheral osteoma of the maxillofacial region with an analysis of the literature. PATIENTS AND METHODS: The records of 14 consecutive patients (6 males and 8 females) referred for the management of peripheral osteoma the maxillofacial region were reviewed. Demographic data, location, presenting symptoms, radiographic findings, bone scan, colonoscopy results and surgical management were analyzed. The criteria used to diagnose peripheral osteoma included radiographic and histologic features. RESULTS: The 14 patients, ranged in age from 13 to 79 years with a mean age of 40.5 years. The lesions were located in the mandible (64%), maxilla (7%), temporal bone (22%) and maxillary sinus (7%). Colonoscopy results performed in 10 subjects were negative. Surgical excision was the treatment of choice with good results. There were no complications or recurrences. CONCLUSIONS: Peripheral osteoma of the jaw bones is uncommon. The post surgical follow-up should include periodic clinical and radiographic studies. Patients with osteoma associated with impacted or supernumerary teeth, should be evaluated for the possible Gardner's syndrome.

Adolescent↗
PubMed2004

Control of massive bleeding from facial gunshot wound with a compact elastic adhesive compression dressing.

The issue of immediate control of acute external traumatic hemorrhage is poorly dealt with in the medical literature. A compact unit incorporating the desired components capable of applying significant compression over diverse body areas has been suggested in the past but not formally demonstrated effective in practice. In this report we describe the treatment of a young man presenting with a very large, complex, profusely bleeding facial gunshot wound. The calvarium remained intact. The upper airway was diverted and secured by performing a cricothyroidotomy. A transparent elastic adhesive dressing was then applied by covering the anterior aspect of the face by a contact pad followed by sequential wrapping of the roll covering all structures between the forehead and the neck. This procedure successfully controlled the hemorrhage and maintained the victim's condition hemodynamically stable until definitive surgical intervention at the level 1 medical center. We attribute the survival of this victim to the innovative dressing technique and excellent cooperation between the trauma team and hospital staff. This case demonstrates the contribution of elastic adhesive compression dressing towards saving the lives of those inflicted by severely challenging bleeding wounds. We suggest this technique be considered by Emergency personnel working in the prehospital arena in selected cases.

Adhesiveness↗
PubMed2004

Intrasinus wood foreign body causing orbital cellulitis in congenital insensitivity to pain with anhidrosis syndrome.

A 2-year-old boy with congenital insensitivity to pain with anhidrosis (CIPA) was referred with a 2-day history of left periorbital swelling and mucoid conjunctival discharge. Marked worsening was noted despite intramuscular ceftriaxone treatment for 3 days, with marked proptosis, conjunctival chemosis, and a frozen eye. Orbital cellulitis was suspected. Ceftriaxone was intravenously administered. Orbital computed tomography (CT) disclosed an inflammatory process in the medial aspect of the left orbit with ethmoiditis. Improvement was not noted after external ethmoidectomy and drainage of the intraconal abscess. Repeat CT showed a recurrent intraconal abscess. A revision external ethmoidectomy was performed, and a bent wooden match was removed from the posterior aspect of the ethmoidal sinus, after which significant clinical improvement was noted. In patients with CIPA, accidental or self-penetrated foreign bodies must be kept in mind when treating all types of wounds.

Cellulitis↗
PubMed2004

Ophthalmic manifestations in Langerhans cell histiocytosis.

Histiocytosis of childhood is characterized by localized or generalized proliferation of cells of the mononuclear phagocyte system and the dendritic cell system. In patients with Langerhans cell histiocytosis, the orbit is the most involved site encountered in ophthalmic practice, usually as a lytic lesion in the zygomaticofrontal suture. Patients usually present with acute or chronic periorbital swelling. Electron microscopic findings of Birbeck granules and positive staining for CD1 antigenic determinant confirm the diagnosis.

Eye Diseases↗
PubMed2003

Langerhans cell histiocytosis with periorbital cellulitis.

PURPOSE: To report a case of Langerhans cell histiocytosis presenting as periorbital cellulitis. DESIGN: Interventional case report. METHODS: A 3-year-old girl presented with periorbital swelling of the right upper lid laterally of two days' duration. A history of recent eye trauma was reported. RESULTS: Computed tomography showed a soft tissue mass that eroded the frontozygomatic suture. The lesion was debulked through a lateral orbitotomy. Electron microscopy disclosed Birbeck granules. Immunohistochemistry stained positively for CD68 and CD1a antigenic determinants. CONCLUSIONS: Although rare, Langerhans cell histiocytosis can cause acute periorbital cellulitis in children. Trauma can induce an inflammatory response, allowing for earlier diagnosis of the orbital lesion.

Antigens, CD↗
PubMed2003

Use of the CBDI to detect malingering when malingerers do their "homework".

Previous research has demonstrated the ability of the Cognitive Behavioral Driver's Inventory (CBDI) to detect neuropsychological malingering [Arch. Clin. Neuropsychol. 12 (5) (1997) 491.], however, the present study tests if the CBDI can discern malingerers when they are "coached" on how brain-damaged patients actually perform on neuropsychological tests. Ninety-eight college student participants were given financial incentive to fake brain damage on the CBDI. Fifty-three of these subjects were "coached" and 45 were not. The coached and uncoached subjects performed indistinguishably on the CBDI. Both types of malingerers were discernable from real brain-damaged patients (99.2% accuracy area under the sensitivity-specificity curve). Further, CBDI profiles of five actual plaintiffs judged to be malingering were compared to CBDI profiles of experimental subjects. In each case, the malingering plaintiff's CBDI profile was indistinguishable from that of malingering experimental subjects and was clearly discernable from that of actual brain-damaged patients.

Adult↗
PubMed2002

The Jackson Dental Study Group.

The Jackson (Mississippi) Dental Study Group has grown over twenty-seven years into one of the strongest such groups in the state. Over this period the group evolved through a rather formal structure with a strong emphasis on education to one including more social elements, and eventually into a balanced organization serving the professional needs of dentistry in the Jackson area. Throughout its history, the JDSG has maintained a healthy inclusive orientation.

Clinical Competence↗
PubMedDate not supplied

The training needs of primary care nurses in relation to mental health.

Nurses working in primary care are in the front line of providing mental health services. The National Service Framework for Mental Health sets out new standards in service provision, yet this key group of staff is, in many cases, not fully equipped with the necessary skills and knowledge to comply. Michael Nash has conducted a training needs analysis of primary care nurses in a London borough. The results highlight areas of concern and indicate a way forward to ensure appropriate mental health care training for these professionals.

Clinical Competence↗
PubMedDate not supplied

Eosinophilic angiocentric fibrosis of the sinonasal tract in a male patient with chronic bowel inflammation.

BACKGROUND: Eosinophilic angiocentric fibrosis (EAF) is an uncommon inflammatory fibrosing lesion involving the upper respiratory mucosa, occurring mainly in young to middle aged women (female/male ratio = 2:1). The etiology is unknown; however, severalfactors might play a role in the development of EAF. Among them are prior nasal trauma (in most of the reported cases nasal surgery had been performed afew years prior to diagnosis) and inflammatory or autoimmune etiology (suggested by the ratio and the fact that in many of the reported cases a history of nonspecific allergy was found). METHODS: We report the first case of EAF affecting a male patient who also suffered from chronic inflammatory bowel disease and rheumatic fever. RESULTS: The patient underwent a diagnostic biopsy of his nasal lesion via an open rhinoplasty approach, with the resulting diagnosis of EAF. Despite the fact that the literature does not show advantages to any specific therapy, the patient elected to remain under observation. During a two-year follow-up period, there is no evidence of progression of disease. CONCLUSION: The presence of concomitant rheumatoid arthritis and chronic inflammatory bowel disease in our patient, as well as the fact that nine previously reported cases of EAF had allergic/immune symptoms, raise the possibility that inflammatory or autoimmune factors may have a role in the development of this unusual pathological entity.

Adult↗