No abstract

Nail changes occur more frequently than previous studies have shown. Furthermore, our study indicates that the nail changes are affecting a large proportion of the patients, both cosmetically and functionally, which may lead to a decrease in their quality of life. No significant association was found according to the possible relation between nail changes and fungal infection.

2 AbstractPurpose: The prognosis of ipsilateral supraclavicular lymph node recurrence after early breast cancer appears to be worse than for other loco-regional recurrences, but better than for distant metastases. The purpose of the present study was to investigate the relationship between different types of salvage treatment and primary patient characteristics, treatment response, and survival after supraclavicular recurrence (SR) in a large patient population. Results: The median follow-up time for progression after SR was 25 months.Complete remission was 76% among patients receiving excision surgery, 67% with combined loco-regional and systemic therapy, and 48% with systemic therapy alone. Median progression-free survival (PFS) and overall survival was 18 and 29 months, respectively. The 5-year PFS probability was 15%. In univariate analysis, combination salvage therapy, negative nodal status, and low malignancy grade were related to longer PFS. In multivariate analysis, salvage therapy and malignancy grade remained independent factors for survival. Conclusions:The prognosis of SR is generally poor. However, it appears to be a curable condition. An independent marker of improved outcome is local and systemic combination salvage treatment, which can be considered.3

Stomatococcus mucilaginosus was isolated from 8 patients suffering from lower respiratory tract infections over a 4-y period (1999-2003). The infections ranged from mild cases of pneumonia to a life-threatening case of recurrent lung abscesses in a neutropenic patient. The various strains were cultured from specimens obtained by bronchoscopy, blood, and sputum specimens. All strains were fully susceptible to rifampicin, vancomycin and gentamicin. They showed variable susceptibility to penicillin and ciprofloxacin. S. mucilaginosus is likely to be under-reported as a pathogen due to difficulties in obtaining samples for culture as well as misidentification due to its biochemical characteristics.

The influence of a prophylactic regimen consisting of ciprofloxacin 250 mg bid, was examined by surveillance cultures from nose, throat, axilla, gingiva, exit site of central venous catheters, blood, rectum and urine of 60 patients undergoing autologous bone marrow transplantation during a 6-year period. None of the 60 patients developed any infectious with Gram-negative rods belonging to the Enterobacteriaceae, or deep fungal infections, during hospitalization. All patients were neutropenic. Febrile episodes were seen in all patients but 3. From 13 patients, microorganisms in the blood, mostly nonhaemolytic streptococci (9/13), were cultured. Surveillance cultures did not predict later infections, but revealed the marked influence of the prophylactic antibiotics on the normal flora. Thus, mainly streptococci, coagulase-negative staphylococci and yeasts were cultured from the sites examined. It is concluded that the future objective of the microbiological surveillance should be restricted to monitoring the possible selection of drug-resistant microorganisms, and that routine cultures of blood and urine are unnecessary.