BackgroundThe identification of central nervous system (CNS) involvement by malignancies, using cytological analysis of CSF, is crucial for the appropriate treatment of patients.1 The aim of this study was to identify CSF specimen characteristics that have the highest diagnostic yield.MethodsWe conducted a retrospective review of all CSF specimens submitted for cytological analysis at Cork University Hospital from January 2010 to December 2011.Results598 CSF samples were obtained from 390 people. The difference in volume between the diagnostic categories of equivocal (29%), inadequate (17%), positive (5%) and negative (48%) was found to be statistically significant, p-value <0.05 (kruskal-wallis test). Of the 66 (17%) requiring repeat CSF sampling 25% of initial samples were inadequate, falling to 10% on second sampling. The average volume of the initial samples was 2.72 ml, increasing to 3.93 ml on repeat sampling.DiscussionConventional cytology has shown high specificity but low sensitivity, being positive in 45% to 94% of initial specimens.1 Our study shows that factors increasing the likelihood of a definite result include a sample volume greater than 3 ml, and repeating sampling.
Trichorrhexis nodosa is a condition of hair fragility.
We present the case of a patient diagnosed with trichorrhexis nodosa improving with the novel treatment, low dose oral minoxidil (LDOM).
Concern has been raised that there is a potential for over treatment of NMSCs among older patients, given the relative low risk of the tumour to their health and the high burden of treatment. This article explores one patient’s perspective of the treatment of multiple NMSCs.
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