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1.  Cyclic neutropenia and pyomyositis: a rare cause of overwhelming sepsis. 
Primary pyomyositis is a pyogenic infection of skeletal muscle with abscess formation, which traditionally lacks an identifiable cause. We present a case of pyomyositis for which a cause was established. This was largely due to the fact that the patient was young and fit, enabling him to survive such overwhelming sepsis long enough for cycling of his neutrophil count to become apparent. Having had multiple abscesses drained, he was successfully treated with granulocyte colony stimulating factor and has remained well since.
PMCID: PMC2503747  PMID: 11890621
2.  'Tactile sensation': a new clinical sign during fine needle aspiration of breast lumps. 
The tactile sensation (TS) felt during fine needle aspiration (FNA) of symptomatic breast abnormalities was recorded prospectively in 169 patients. TS was classified as malignant (if 'gritty'), or benign (if 'rubbery', 'soft' or 'fibrous'). This assessment was compared with fine needle aspiration cytology (FNAC) and the final diagnosis, to evaluate the clinical utility of TS. A 'gritty' TS was recorded in 55/59 cancers and 22/110 benign lesions (sensitivity 93.2%, specificity 80%). Comparison of TS and FNAC in 69 patients with definitive histopathology revealed complementary results (TS, sensitivity 88.9%, specificity 48.5%; FNAC, sensitivity 55.6%, specificity 100%). Combining the sensitivity of TS with that of FNAC increased the overall sensitivity to 97.2%. Recording TS during FNA of symptomatic breast lumps enhances diagnosis, and alerts the clinician to the possibility of an underlying carcinoma when FNAC fails to confirm malignancy.
PMCID: PMC2502213  PMID: 8154809
4.  Local audit in vascular surgery. 
A 2-year audit of the Southampton Vascular Unit showed marked discrepancies in workload from nationally accepted figures. All forms of reconstructive surgery except emergency aortic aneurysm grafting were performed more frequently than expected. The vascular population is elderly and at high risk from major surgery. Mortality was appreciable in all major vascular procedures and usually cardiac or renal related. The elderly population and resulting workload is likely to increase in the near future. The role of local audit in vascular surgery is emphasised.
PMCID: PMC2499189  PMID: 2221761

Results 1-5 (5)