The cost-effectiveness of fine-needle aspiration cytology and 14-gauge core needle biopsy compared with open surgical biopsy in the diagnosis of breast carcinoma.

Background: Judicious utilization of fine-needle aspiration cytology (FNAC) and 14-gauge core needle biopsy (CB) theoretically should result in greater accuracy in breast carcinoma diagnosis and fewer unnecessary open surgical biopsies (OSBs), thus lowering health care costs.

Methods: In 1995 in Rochester, New York, the ratio of open surgical breast biopsies per each verified breast carcinoma (OSB/Ca) in a freestanding breast clinic (EWBC) was compared with the OSB/Ca ratio of all physicians in the remainder of the city. The EWBC differs from all other diagnostic facilities in Rochester in that it routinely performs FNAC and CB.

Hepatic cysticercosis. Report of an unusual case.

We report a case of hepatic cysticercosis in a 62-year-old man who had been diagnosed with a colonic adenocarcinoma 9 years previously. Additional clinical studies failed to show disease in the soft tissues, brain, orbit and heart. The patient was successfully treated with a course of praziquantel and prednisone and is alive and well 28 months after diagnosis.

A critical survey of fresh-frozen plasma use.

The use of 534 units of fresh-frozen plasma (FFP) during 160 transfusion episodes in 135 consecutive patients was reviewed. Only 27 percent of transfusions were indicated by a need for replacement of labile coagulation factors. Other uses included volume repletion (31%), intraoperative bleeding or massive transfusion without coagulopathy (19%), and miscellaneous indications unrelated to labile coagulation factors (23%).

Self-poisoning with enteric-coated aspirin.

A case of self-poisoning by enteric-coated aspirin tablets is described. Absorption of salicylate was delayed, resulting in serum kinetics different from that obtained with regular aspirin. When the ingested aspirin is enteric coated, the use of Done's nomogram may be inappropriate.