Answer to Case 285
Answer: leishmaniasis, presenting as atypical perianal and rectal wart-like lesions (see below for patient follow up)As Anon and Florida Fan mention, the differential of small intracellular objects in the 2-5 micron range includes leishmania amastigotes, small yeasts (primarily Histoplasma capsulatum), microsporidia spores, and Toxoplasma gondii tachyzoites. We can exclude Histoplasma capsulatum, other yeasts, and microsporidia based on the negative GMS stain, thereby leaving Toxoplasma and Leishmania in our differential. These two organisms are differentiated by morphologic features: Toxoplasma...
Source: Creepy Dreadful Wonderful Parasites - December 8, 2013 Category: Pathologists Source Type: blogs
Why Do Alzheimer's and Dementia Drugs Fail in Clinical Trials ?
Why do certain Alzheimer medications work in animal models but not in clinical trials in humans?+Alzheimer's Reading Room Alzheimer's disease is the most common cause of dementia among older people, yet there currently are no effective drugs to stop, slow or prevent disease progression.Subscribe to the Alzheimer's Reading RoomEmail: New study explains why promising dementia drugs failed in clinical trialsIn the brains of Alzheimer patients, deposits form that consist essentially of beta-amyloid and are harmful to nerve cells. Scientists are therefore searching for pharmaceutical compounds that prevent the formation of thes...
Source: Alzheimer's Reading Room, The - December 8, 2013 Category: Dementia Authors: Bob DeMarco Source Type: blogs
Joslin Diabetes Center Seeks Study Volunteers
By Web Team
Would you like to contribute to cutting-edge diabetes research? If you are between the ages of 18 and 70, with or without diabetes, you may be eligible to participate in a new study being conducted at Joslin Diabetes Center.
Joslin researchers are investigating Induced Pluripotent cells (iPS), a type of cell that can be grown forever in a laboratory and become another type of cell, in diabetes. According to Joslin, "these cells may someday help us to predict who is at risk of developing diabetes, which may lead to a better understanding of the disease process or possible new therapies."
Study participants ...
Source: Diabetes Self-Management - November 28, 2013 Category: Diabetes Authors: Web Team Source Type: blogs
Critical Care Compendium update
LITFL’s Critical Care Compendium is a comprehensive collection of pages concisely covering the core topics and controversies of critical care.
Currently there are almost 1,500 entries with more in the works… Some pages are more developed than others, and all the pages are being constantly revised and improved. Links to new references and online resources are added daily, with an emphasis on those that are free and open access (FOAM!).
These pages originated from the FCICM exam study notes created by Dr Jeremy Fernando in 2011, and have been updated, modified and added to since. As such will be particularly us...
Source: Life in the Fast Lane - November 17, 2013 Category: Emergency Medicine Doctors Authors: Chris Nickson Tags: Critical Care Compendium Education eLearning Emergency Medicine Featured CCC LITFL collection Source Type: blogs
Gluten Sensitivity: Real or Hype?
By Amy Campbell
What's your take on gluten? Have you cut it out of your diet? Do you scour the grocery store for gluten-free foods? If so, you're not alone. According to a survey done earlier this year by the NPD Group (a market research company), almost 30% of Americans are trying to "cut down or be free of gluten." Another survey, conducted by Packaged Facts (also a market research company) in 2012, found that 18% of Americans buy or eat gluten-free foods. The market for gluten-free foods was $4.2 billion in 2012 and is expected to increase to $6.6 billion by 2017. The question is, why?
What is gluten?
Gluten is a protei...
Source: Diabetes Self-Management - November 11, 2013 Category: Diabetes Authors: Amy Campbell Source Type: blogs
3 products that your dermatologist won’t like
As a light skinned, be-freckled woman with a history of pre-melanoma, I have been sternly instructed to keep my dermatologist on speed dial. Every six months I dutifully return to his office for inspection — nervously eyeing the biopsy tray as I sweat through my paper gown, legs dangling from a vinyl exam table.
In preparation for my most recent trip, I decided to be “an empowered patient” and arrive with a list of general dermatology and skin care questions that could be answered during my skin check. Judging from the near-syncopal episodes that I induced in my dermatologist while describing some of my hygiene p...
Source: Kevin, M.D. - Medical Weblog - October 15, 2013 Category: Family Physicians Tags: Conditions Dermatology Source Type: blogs
Three Products That My Dermatologist Says Are “Of The Devil” – And Other Skin Tips
This actress keeps her dermatologist on speed dial too.
As a light skinned, be-freckled woman with a history of pre-melanoma, I have been sternly instructed to keep my dermatologist on speed dial. Every six months I dutifully return to his office for inspection – nervously eyeing the biopsy tray as I sweat through my paper gown, legs dangling from a vinyl exam table.
In preparation for my most recent trip, I decided to be “an empowered patient” and arrive with a list of general dermatology and skin care questions that could be answered during my skin check. Judging from the near-syncopal episodes that I i...
Source: Better Health - September 23, 2013 Category: Health Medicine and Bioethics Commentators Authors: Dr. Val Jones Tags: Health Tips Allergies Antibacterial Ointment Bounce Brush Clarisonic Contact Dermatitis Dermatologist Dermatology Dryer Sheets Exfoliator Hydroquinone melanoma Moisturizer Neosporin Physical Block Pores Skin Cancer Skin Source Type: blogs
Top stories in health and medicine, August 28, 2013
From MedPage Today:
ACOs Can Save Medicare $$$, Study Finds. An accountable care organization (ACO) established by a private insurer reduced costs of care for Medicare enrollees.
More Exercise, Metformin Alter Lipid Particles. Both metformin and changes in diet and exercise made significant changes to the size and types of lipid particles in patients with impaired glucose tolerance.
Ultrasound May Cut Thyroid Biopsy Rate. Certain characteristics of thyroid nodules identified on ultrasound can help predict the likelihood of cancer, and may also help determine if fine-needle aspiration biopsy can be deferred.
Under-the-Ski...
Source: Kevin, M.D. - Medical Weblog - August 28, 2013 Category: Family Physicians Tags: News Endocrinology Heart Medicare Medications Source Type: blogs
Scientists Turn Skin Cells Into Beating Heart Tissue
Mouse heart showing position of coronary arteries Credit: NIMR, MRC. Wellcome Images
People with advanced heart failure often live out the rest of their lives hoping that a donor heart might become available, and even if one does it’s often difficult for the recipient’s body to accept the new organ. Growing new hearts from stem cells may open the possibility of producing personalized organs that have an ideal size and shape, but more importantly that will not be rejected when transplanted.
Researchers at the University of Pittsburgh School of Medicine have taken a major step toward that goal by successfully po...
Source: Medgadget - August 13, 2013 Category: Technology Consultants Authors: Editors Tags: in the news... Source Type: blogs
Producing a Beating Mouse Heart Through Recellularization
Decellularization is the process of taking a complex organ or other tissue structure and stripping the cells from it, leaving behind the supporting extracellular matrix. The matrix can then be repopulated by new cells of the appropriate types in order to recreate a functional organ. This is in any case is the end goal of this ongoing line of research: decellularization has been used in recent years to produce tracheas and heart valves for transplantation, populating the tissue with the recipient's own cells so as to eliminate the possibility of rejection.
A trachea is a comparatively simple structure, however. Just as fo...
Source: Fight Aging! - August 13, 2013 Category: Health Medicine and Bioethics Commentators Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
Singer Steve Perry’s Melanoma: Before (?) and After Surgery
An inspiring performance by singer Steve Perry
Former Journey lead singer Steve Perry has been blessed with an amazing musical career, belting songs like the Glee-rific “Don’t Stop Believing” that celebrate optimism. Recently, via a fan site, Perry disclosed a health scare: A lesion on his right cheek was biopsied and found to be melanoma skin cancer.
Perry has long had a beauty mark-like mole.
Steve Perry is not our patient, but he has long had a small oval mole on his right cheek. Chr...
Source: Skinema, dermatology in the media blog - July 20, 2013 Category: Dermatologists Authors: vail reese Tags: Music Source Type: blogs
Prophylactic Mastectomy - is it right for you?
Having prophylactic mastectomy is a very personal choice. There is no "right answer", only what you consider is best for you.Women who are at high risk of developing breast cancer have the option of prophylactic (preventive) mastectomy as a way of decreasing their risk. Factors that increase a woman ’s chance of developing breast cancer include:a genetic predisposition to breast cancer e.g. BRCA+, Cowden's Syndrome, Li-Fraumeni Syndromea strong family history of breast cancera breast cancer diagnosis at a young ageabnormal breast cells on biopsy that increase the risk of breast cancer, e.g. LCISa history of previous ches...
Source: Breast Cancer Reconstruction Blog - July 11, 2013 Category: Cancer & Oncology Tags: BRCA breast reconstruction chemoprophylaxis cowden's syndrome li-fraumeni syndrome nipple-sparing mastectomy preventive mastectomy prophylactic mastectomy tamoxifen Source Type: blogs
Prophylactic Mastectomy - is it right for you?
Having prophylactic mastectomy is a very personal choice. There is no "right answer", only what you consider is best for you.
Women who are at high risk of developing breast cancer have the option of prophylactic (preventive) mastectomy as a way of decreasing their risk.
Factors that increase a woman’s chance of developing breast cancer include:
a genetic predisposition to breast cancer e.g. BRCA+, Cowden's Syndrome, Li-Fraumeni Syndrome
a strong family history of breast cancer
a breast cancer diagnosis at a young age
abnormal breast cells on biopsy that increase the risk of breast cancer, e.g. LCIS
a history of previo...
Source: Breast Cancer Reconstruction Blog - July 11, 2013 Category: Cancer Tags: chemoprophylaxis preventive mastectomy tamoxifen breast reconstruction cowden's syndrome li-fraumeni syndrome nipple-sparing mastectomy prophylactic mastectomy BRCA Source Type: blogs
Paget's disease if Nipple- Review
Clinical:
Approximately 1%–3% of women with adenocarcinoma of the
breast have Paget disease. Clinically-Paget disease has common dermatitis-like appearance,
as originally described in 1874, when Sir James Paget recorded that such
lesions may resemble “ordinary chronic eczema” or present as nipple erosion or
ulceration. Paget disease often has a deceptively banal clinical morphology but
should lead the list of differential diagnoses when evaluating unilateral
lesions of the nipple–areola complex in adults.
Paget disease presenting with nipple erosion.
Most women with the histopathologic finding o...
Source: Oncopathology - June 28, 2013 Category: Pathologists Tags: Breast Biopsy Procedure Breast Carcinoma vs. Pulmonary Adenocarcinoma a common misdiagnosis. Source Type: blogs
Paget's disease if Nipple- Review
Clinical:Approximately 1% –3% of women with adenocarcinoma of the breast have Paget disease. Clinically-Paget disease has common dermatitis-like appearance, as originally described in 1874, when Sir James Paget recorded that such lesions may resemble “ordinary chronic eczema” or present as nipple erosion or ulceration. Paget disease often has a deceptively banal clinical morphology but should lead the list of differential diagnoses when evaluating unilateral lesions of the nipple–areola complex in adults.Paget disease presenting with nipple erosion. Most women with the histopathologic finding of Paget disease ...
Source: Oncopathology - June 28, 2013 Category: Cancer & Oncology Tags: a common misdiagnosis. breast Breast Biopsy Procedure Breast Carcinoma vs. Pulmonary Adenocarcinoma Source Type: blogs
