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A case is described in which a deep palmo-planar wart (myrmecia) caused erosion of the underlying phalanx.

The use of preoperative intraincisional (POII) single dose antibiotic prophylaxis has the advantage of providing extremely high concentrations of antibiotic along all layers of the wound, whilst achieving adequate systemic concentrations throughout the operation. In a single blind controlled trial, 250 patients undergoing upper abdominal surgery were randomised to receive POII cefamandole (2g) or to act as control. There was one wound infection in the POII group compared with 18 in the control group (P less than 0.001). Hospital stay was reduced by an average of one day (P less than 0.02) in the antibiotic treated group.

From a consecutive series of 2,221 cholecystectomies, 177 patients underwent combined supraduodenal and transduodenal exploration of the common bile duct and 390 were treated by supraduodenal exploration alone. The mortality rate after both exploration procedures was the same (2.8 per cent). However, two patients died of septic complications associated with duodenal fistulas in the combined exploration group. Five patients had retained stones in the common bile duct which subsequently flushed out with a saline solution irrigation administered through the T tube in three patients and the stone passed spontaneously in one patient. Clinically significant and biochemically documented acute pancreatitis occurred in five patients, one of whom died. Four patients had postoperative cholangitis develop which responded to antibiotic therapy. We are not aware of any patient who had common bile duct stones, chronic pancreatitis or ampullary stenosis after the combined procedure at follow-up study of between six months and 13 years.

Psychiatrists, psychologists, and social workers were compared on their assessments of pathology, treatment techniques, and theoretical orientation for a typical hospitalized psychiatric patient. The purpose was to determine the relationship between treatment-team members' professional discipline and their clinical approach to a patient. Clinical discipline was significantly related to assessment, treatment, and theory. Psychiatrists favored medication, hospitalization, support, and brief, infrequent structured treatment focused on the present and external factors with an aim of social adaptation. Social workers were similar, but added types of treatment and longer, more frequent treatment. Psychologists were unique with an emphasis on psychoanalytically oriented psychotherapy aimed at personality change.