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Biomedical subjects

S Bruce

Publications and source records attributed to S Bruce.

At least 37 records · Page 2Linked to original sources
PubMed1995

Basal cell carcinoma on the scalp of an Indian patient.

BACKGROUND: Basal cell carcinoma (BCC) is the most common malignancy in whites, but it rarely occurs in dark persons. OBJECTIVE: To report a BCC on the hairy scalp of an Asian Indian female with no obvious risk factors except previous scalp trauma. METHODS: We review the English literature concerning BCC in Indians, and compare this with data for North American blacks and whites; and reports of BCC arising in areas of prior trauma. RESULTS/CONCLUSION: Skin cancer accounts for 1-2% of malignancies in blacks and Indians, compared with one-third of neoplasms in whites. BCC comprises 75% of skin cancers in whites, but squamous cell carcinoma represents 60-65% of skin cancers in blacks and Indians. Although most BCCs occur in sun-exposed areas in whites, blacks, and Indians, a significant percentage also develop in photoprotected areas. Trauma may be a significant risk factor for BCC, either with actinic damage or alone, as in our case.

Black People↗
PubMed1995

Noninvasive investigation of infantile hepatic hemangioma: a case study.

A preterm infant presented with high-output cardiac failure. Color Doppler imaging of the liver revealed a large hepatic hemangioma. Pulsed-wave Doppler of the proximal aorta was used to monitor noninvasively the reduction in flow through the arteriovenous malformation in response to steroid therapy. The hemangioma resolved completely by 7 weeks of age.

Aorta↗
PubMed1994

Color Doppler imaging of the uteroplacental circulation in the middle trimester: observations on the development of a low-resistance circulation.

We aimed to study the changes in the flow dynamics of the uteroplacental and umbilical circulations in the middle trimester of normal pregnancy, and establish normal ranges for indices of the Doppler flow velocity waveforms (FVWs) from both circulations at 14, 18 and 24 weeks. A longitudinal study was conducted with the use of color Doppler imaging to localize both uterine arteries and umbilical arteries and obtain FVWs from 106 healthy nulliparous women with a singleton pregnancy. Of these, 70 did not have a complicated pregnancy outcome, defined as hypertension, growth retardation, preterm delivery or perinatal death. We measured the resistance index (RI), pulsatility index (PI), systolic/diastolic (S/D) ratio and presence of early diastolic notching in both uterine arteries, and RI, PI and S/D in one umbilical artery. The results showed a fall in all measured indices of blood flow impedance in the uteroplacental and umbilical circulations and a marked reduction in the incidence of the early diastolic notch in the uterine artery FVWs during the mid-trimester. Our conclusion was that color Doppler imaging allows for the accurate localization of both uterine and umbilical arteries. Doppler FVWs then obtained confirm the development of the low-resistance uteroplacental and umbilical circulations in the mid-trimester. Diastolic notching is common at 14 weeks in normal pregnancy but uncommon at 24 weeks.

Journal Article↗
PubMed1994

Effect of a low-fat diet on the incidence of actinic keratosis.

BACKGROUND: Actinic keratoses are premalignant lesions and are a sensitive and important manifestation of sun-induced skin damage. Studies in animals have shown that dietary fat influences the incidence of sun-induced skin cancer, but the effect of diet on the incidence of actinic keratosis in humans is not known. METHODS: We randomly assigned 76 patients with nonmelanoma skin cancer either to continue their usual diet (control group) or to eat a diet with 20 percent of total caloric intake as fat (dietary-intervention group). For 24 months, the patients were examined for the presence of new actinic keratoses by physicians unaware of their assigned diets. RESULTS: At base line, the mean (+/- SD) percentage of caloric intake as fat was 40 +/- 4 percent in the control group and 39 +/- 3 percent in the dietary-intervention group. After 4 months of dietary therapy the percentage of calories as fat had decreased to 21 percent in the dietary-intervention group, and it remained below this level throughout the 24-month study period. The percentage of calories as fat in the control group did not fall below 36 percent at any time. The cumulative number of new actinic keratoses per patient from months 4 through 24 was 10 +/- 13 in the control group and 3 +/- 7 in the dietary-intervention group (P = 0.001). CONCLUSIONS: In patients with a history of nonmelanoma skin cancer, a low-fat diet reduces the incidence of actinic keratosis.

Basal Cell Carcinoma↗
PubMed1994

Comparative study of calcipotriene (MC 903) ointment and fluocinonide ointment in the treatment of psoriasis.

BACKGROUND: The topical vitamin D analogue calcipotriene has been reported to be an effective treatment for patients with psoriasis. Comparative studies with topical steroids are informative in judging this new therapy. OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of calcipotriene ointment 0.005% versus fluocinonide ointment 0.05% in the treatment of plaque psoriasis. METHODS: This study was a randomized, double-blind, parallel-group, active-controlled trial in adults who had at least mild overall disease severity and plaque elevation of at least moderate severity. Treatments were applied twice daily for 6 weeks, and subjects were evaluated at weeks 0, 2, 4, and 6. Subjects were graded on a 9-point scale (0 to 8) for scaling, erythema, plaque elevation, and for overall disease severity. A physician's global assessment of improvement/worsening was performed at every visit. RESULTS: A total of 114 subjects were enrolled at six study sites. Ninety-nine subjects completed the trial. Mean scores for signs of scaling and plaque elevation in calcipotriene-treated subjects were significantly lower by week 2 than in the fluocinonide-treated subjects. These scores continued to be significantly lower than fluocinonide through week 6 (p < 0.05). Mean scores for erythema in calcipotriene-treated subjects were significantly lower than those in fluocinonide-treated subjects at weeks 4 and 6 (p < 0.05). Both the physician's global assessment and overall disease severity showed statistically significant treatment differences in favor of calcipotriene at week 4 (p < 0.05). This superior efficacy continued through week 6. Treatment-related adverse events were observed in 12 calcipotriene-treated subjects and 5 fluocinonide-treated subjects; all were considered minor. CONCLUSION: Calcipotriene was superior to fluocinonide in the treatment of plaque psoriasis.

Adult↗
PubMed1994

Early detection of skin cancer: racial/ethnic differences in behaviors and attitudes.

Data from 384 individuals participating in a worksite skin cancer screening program were used to assess racial/ethnic differences in attitudes toward and practice of prevention and early detection of skin cancer. Caucasians and Hispanics were more likely than African Americans to report having used a sunscreen during the past year. Caucasians performed skin self-examination more frequently than Hispanics, but African Americans did not differ in their frequency of skin self-examination from the other two groups. African Americans and Hispanics reported that they would be less likely than Caucasians to seek immediate follow-up care for suspicious skin lesions. Both similarities and differences were found in a variety of health belief variables across the three groups. These findings suggest a need for intensified efforts at primary and secondary prevention of skin cancer among African Americans.

Adult↗
PubMed1994

Beau's lines and pyogenic granulomas following hand trauma.

We report two cases of trauma-induced Beau's lines accompanied by pyogenic granulomas of the proximal nail folds of the affected fingers. The preceding trauma was not directly to the nail matrix but was more proximal, on the palm in one case and the arm in the other. The simultaneous occurrence of Beau's lines and pyogenic granulomas following trauma has not been reported previously in the literature.

Adolescent↗
PubMed1993

Intralesional interferon-alpha and zidovudine in epidemic Kaposi's sarcoma.

BACKGROUND: Kaposi's sarcoma (KS) is the most common neoplasm in patients with acquired immunodeficiency syndrome (AIDS). To date, no therapy has proved to be consistently effective. OBJECTIVE: The purpose of this study was to evaluate the efficacy of intralesional interferon-alpha in patients with epidemic KS who were taking zidovudine. METHODS: Up to five lesions in each of 14 patients entered into the study were injected with 1 million U of interferon-alpha three times weekly for 6 weeks. Sterile water was used as a placebo control. The median zidovudine dose was 500 mg/day. The median CD4 count was 23/microliters. RESULTS: Of 14 patients evaluated, 13 of 14 (93%) showed a clinical complete response (CR) or partial response (PR) to therapy. Of 54 lesions injected, 41 (76%) showed a CR and 5 (9%) showed a PR, which resulted in an overall response rate of 85%. CONCLUSION: Intralesional interferon-alpha produced a high response rate in injected lesions of KS, but it failed to demonstrate superior efficacy over the placebo.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Pyoderma gangrenosum treated with hyperbaric oxygen therapy.

The management of pyoderma gangrenosum often requires systemic drug therapy, such as corticosteroids, sulfones, or immunosuppressants, either alone or in combination. Inconsistent response to therapy is a source of frustration to both patient and physician. Several reports in the literature document the successful treatment of pyoderma gangrenosum with hyperbaric oxygen therapy. In our patient, a woman with severe rheumatoid arthritis and diabetes mellitus, hyperbaric oxygen therapy not only promoted healing of pyoderma gangrenosum but permitted reduction of systemic corticosteroids.

Arthritis, Rheumatoid↗
PubMed1991

Suppressed natural killer cell activity in patients with chronic autoimmune thrombocytopenic purpura.

Natural killer (NK) cell activity was studied in 17 patients with primary chronic idiopathic autoimmune thrombocytopenic purpura (ATP). Fifteen of 17 patients had a significantly reduced NK cytotoxicity against 51chromium labeled K562 target cells (mean LU20% = 18 +/- 20 in patients versus 65 +/- 25 in controls, P less than 0.001). NK activity was also significantly reduced in all of six patients with secondary ATP as compared with normal controls (LU20% 28 +/- 15, respectively, P less than 0.005). The NK activity in both patient groups correlated with the duration of therapy being received (r = 0.60, P less than 0.001). Immunophenotypic analysis of peripheral blood mononuclear cells from patients with ATP revealed that CD8- cells bearing CD57 (HNK-1, Leu 7) and CD3- cells bearing CD56 (Leu 19) were quantitatively within the normal range. These findings indicate that patients with ATP have a functional defect in NK cytolytic activity.

Adolescent↗
PubMed1991

Evidence for percutaneous inoculation as the mode of transmission for chromoblastomycosis.

The exact pathogenesis of chromoblastomycosis is unknown. Direct percutaneous inoculation, inhalation, and hematogenous dissemination have been implicated. We report a case of chromoblastomycosis that followed a well-defined episode of penetrating trauma. The causative organism, Fonsecaea pedrosi, was cultured from the patient's lesion and from the tree branch responsible for the trauma. This "natural" experiment supports the contention that one cause of chromoblastomycosis is traumatic cutaneous implantation of the fungus.

Chromoblastomycosis↗
PubMed1991

Estimating left ventricular ejection fraction from two-dimensional echocardiograms: visual and computer-processed interpretations.

Digital echocardiography makes computer-processed estimates of ejection fraction feasible for clinical use but increases physician reading time. The practicabilities were examined by three novice fellows and four experienced attendings. Ejection fraction was visually estimated from playback of videotape or cine-loop displays. Ejection fraction was also estimated from single tracings of endocardium, digitized and applied to biplane Simpson's rule, and expressed in whole units. Differences between fellows' and attendings' visual estimates were close to 0 +/- 6.4 median standard deviation. The 95% confidence intervals for reproducing visual and computer-processed ejection fractions ranged from 15% to 46% of mean ejection fraction; for comparing the two methods, from 7% to 36%. Intraobserver reading errors varied widely and with one observer, systematically, and were independent of experience, but dependent on the quality of signals. Computer-processed readings of ejection fraction should be reserved for images of reasonable quality and for confirming visually estimated ejection fractions between the lower limits of normal (45%-50%) to moderately severely depressed (25%-30%), when accuracy is clinically relevant or when a serial change is at the confidence limits of the reader and needs verification.

Aged↗
PubMed1991

Ichthyosiform sarcoidosis: report of a case.

Sarcoidosis is a systemic granulomatous disease of undetermined cause, with cutaneous manifestations occurring in up to 35 percent of patients. We report a case of the rare form of ichthyosiform sarcoidosis occurring in a young black woman.

Adult↗
PubMed1990

Urticaria: clinical efficacy of cetirizine in comparison with hydroxyzine and placebo.

Chronic urticaria is a problem for both physician and patient. In an effort to avoid the risks associated with corticosteroid treatment, many first-generation H1-receptor antagonists have been tried and found to induce undesirable levels of sedation when given in amounts sufficient to control urticaria. Cetirizine, a pharmacologically active oxidized metabolite of hydroxyzine, was developed to provide selective H1-receptor inhibition without depression of the central nervous system. In a 4-week, multicenter, double-blind, placebo-controlled safety and efficacy study, cetirizine, in a once-a-day dose (5 to 20 mg), was equivalent in efficacy to hydroxyzine in divided doses (25 to 75 mg/day). The incidence of somnolence in the cetirizine group was not significantly different from that of the placebo group. However, in the hydroxyzine group, the incidence of somnolence was significantly higher than that in the placebo group (p = 0.001). The results of this study demonstrate that cetirizine has a greater safety margin over the older parent drug hydroxyzine.

Adolescent↗
PubMed1989

Acute acral pustulosis.

We report a patient with a pustular eruption in an acral distribution that developed abruptly 4 days after a streptococcal pharyngitis. The histology showed an intraepidermal vesicle filled with neutrophils with an underlying lymphocytic vasculitis. Direct immunofluorescence demonstrated heavy deposition of C3 within the vessel walls. In addition, circulating immune complexes were found.

Acute Disease↗
PubMed1989

Psychological components and the role of adjunct interventions in chronic idiopathic urticaria.

A psychological assessment (Symptom Checklist-90) was performed on 19 patients with chronic idiopathic urticaria. Compared to the control group, the urticaria patients had significantly higher scores on the scales of somatization, obsessive-compulsive, interpersonal sensitivity, depression, and anxiety. In general, the urticaria patients were quite anxious and experienced significant discomfort in interpersonal relationships. Based on the results of this study and other similar reports in the literature, it is suggested that adjunctive treatment of urticaria patients should focus primarily on stress management training aimed at relieving anxiety and group therapy which focuses on an exploration of interpersonal issues.

Adult↗