A case of porphyria cutanea tarda in the setting of hepatitis C infection and tobacco usage

Porphyria cutanea tarda (PCT) is the most common type of porphyria, presenting in middle-aged patients with a photodistributed vesiculobullous eruption, milia, and scars. Porphyria cutanea tarda occurs in relation to inhibition of uroporphyrinogen decarboxylase, a key enzyme in the heme biosynthesis pathway. A number of genetic and acquired factors increase susceptibility to PCT by reducing uroporphyrinogen decarboxylase activity. A handful of other vesiculobullous conditions may mimic PCT both clinically and histologically; therefore, both skin biopsy and laboratory evaluation are helpful in confirming the diagnosis. We report a case of PCT in the setting of cigarette usage and untreated hepatitis C infection

Escherichia coli-infected cephalohematoma in an infant

We report a case of Escherichia coli infection of a cephalohematoma in an infant delivered by vacuum extraction. After excluding potential complications, the patient was treated with intravenous ceftriaxone while hospitalized followed by oral cephalexin after discharge. Infection is a rare but serious complication of cephalohematomas in the newborn period. Escherichia coli is the most common pathogen responsible for infected cephalohematomas. Clinicians should be aware that infected cephalohematomas may be complicated by sepsis, meningitis, or osteomyelitis

Ownership mix of addiction treatment centres in the USA

The dominant presence of private Addiction Treatment Centres (ATCs) raises questions about how changes in ownership mix affect access to and quality of care. This paper examines the relationship between an ATC's ownership choice and the ownership mix in its market. Organisational and market characteristics are considered by using data from the National Survey of Substance Abuse Treatment Services, North American Industry Classification System, Internal Revenue Service's Business Master File, US Census Bureau Population Estimate Survey, Uniform Crime Reporting Program Data and Local Area Unemployment Statistics. We use linear probability models to link the facility's choice of ownership with the ownership status of its competitors. The results indicate that the value of being non-profit is higher in markets where many ATCs are non-profit and lower in markets where many are for-profit. The likelihood of a non-profit status appears to be more influenced by the presence of incumbent non-profits, rather than by high earnings or longevity.non-profit status; ownership mix; addiction treatment centres; USA; United States; access to care; quality of care; ownership choice; substance abuse treatment; linear probability modelling; for-profit status.