Abstract Purpose of Review The human epidermal growth factor receptor 2 (HER2) is an important prognostic and predictive biomarker in the breast cancer. The American Society of Clinical Oncology/College of American Pathology (ASCO/CAP) has published HER2 testing guidelines in breast cancer. We herein reviewed the HER2 testing guidelines in breast cancer with a focus on the application of the current guidelines. ...
2h
This is a case of a young healthy woman who presented with left groin pain. On work-up, she was found to have a large, well-defined mass in the ischiorectal fossa with a percutaneous biopsy of only a benign mesenchymal mass. A multidisciplinary team of surgeons (ie, colorectal, orthopaedic, vascular and urological surgery) collaborated in planning and performing the extirpation of the tumour. Final histopathology identified the tumour to be an aggressive angiomyxoma, a benign tumour with a high predilection...
2h
We report an 86-year-old woman who was diagnosed with multiple myeloma (MM) and was receiving chemotherapy since the age of 82. A high echoic mass attached to the mitral valve was observed on transthoracic echocardiography 4 years after the treatment. The possibility of malignancy could not be ruled out, and hence, the mass was excised surgically. Pathologically, most of the mass consisted of calcified lesion without tumour tissue, and these findings were not inconsistent with calcified amorphous...
2h
A 40-year-old man, with a history of metastatic parathyroid carcinoma, status post primary tumour resection and lung metastasectomy, was hospitalised for persistent severe hypercalcaemia and elevated parathyroid hormone levels despite conventional management and escalating doses of cinacalcet. A single dose (120 mg) of denosumab was given and his calcium level plummeted from 14.8 mg/dL to 5.5 mg/dL. After second lung metastasectomy, he developed prolonged hypocalcaemia that required calcium and vitamin...
2h
A 51-year-old woman had been diagnosed and treated for schizophrenia for 10 years. Two weeks prior to admission, she developed headache and diplopia. Then, she was found unconscious and was sent to the hospital. A tumour in the left frontal lobe of the brain, causing brain herniation, was diagnosed and surgical excision of tumour was performed immediately. The psychotic symptoms of the patient were completely resolved after surgery. The histological diagnosis was meningioma. This case demonstrates...
2h
A 30-year-old male American football player presented to the acute medical unit with left-hand and hemifacial spasms. History and examination revealed hemifacial spasms in keeping with seizure-like activity possibly due to symptomatic hypocalcaemia. Subsequent investigations revealed an adjusted calcium of 1.87 mmol/L and, hence, he was managed with intravenous calcium replacement. He presented two further times in a 1-month period, with subjective limb weakness, despite normal adjusted calcium....
2h
Transient global amnesia (TGA) is characterised by the sudden onset of isolated anterograde amnesia, which resolves within 24 hours. Here, we discuss the case of a 63-year-old woman who underwent a transoesophageal echocardiogram (TOE) as part of her workup for pulmonary hypertension. She was well on the morning of the procedure, and following consent, underwent transoesophageal echocardiography without sedation. The procedure was uncomplicated with normal observations throughout, confirming a suspected...
2h
A 77-year-old woman presented with a rare surgical phenomenon known as De Garengeot hernia. This unique presentation occurs due to the presence of a vermiform appendix in a femoral hernia sac. The patient presented with right-sided groin pain and a partially reducible hernia; she was otherwise haemodynamically stable and denied fevers, nausea and vomiting. The diagnosis was confirmed with CT which demonstrated a right-sided femoral hernia containing a perforated tip of the appendix. The patient urgently...
1d
Endotipsitis is a vegetative endovascular infection of a transjugular intrahepatic portosystemic shunt (TIPS). There is currently no uniformly accepted diagnostic criterion, and most cases are diagnosed by clinical diagnosis of recurrent bacteraemia in patients with TIPS and no identifiable source after appropriate investigation. We present a case of 62-year-old man in whom endotipsitis was suspected clinically after emergent TIPS placement complicated by TIPS thrombosis, need for TIPS revision and...
1d
A 77-year-old woman presented with right flank pain radiating to the ipsilateral groin and associated nausea, consistent with renal colic. In the emergency department, a non-contrast CT scan revealed severe right-sided hydronephrosis but failed to demonstrate a calculus or ureteropelvic obstruction. The patient improved with fluids and followed up with a community urologist. Initial work-up with cystoscopy and ureteroscopy, voiding cystourethrogram and diuretic renography failed to deduce a diagnosis....
1d
Major abdominal arteriovenous fistula (AVF) is a rare clinical condition defined as an abnormal communication between the aorta or iliac arteries and the inferior vena cava or the iliac or renal veins. Penetrating trauma, including iatrogenic injuries, accounts for less than 20% of these AVFs. Endovascular techniques were useful in the management of vascular lesions. The authors report the case of a patient with high-output heart failure and high-flow AVF between the left external iliac artery and...
1d
Mixed adenocarcinoma with neuroendocrine tumour of pancreas has been reported infrequently and consists of both epithelial and neuroendocrine component. We encountered an 81-year-old male patient who presented with clinical features of painful progressive jaundice for 1 month. Contrast-enhanced CT abdomen reported a mass in the pancreatic head with dilated common bile duct and pancreatic duct. He underwent pancreatoduodenectomy and histopathological examination revealed two different tumours: ductal...
1d
The prehospital treatment team (PHTT) involves a small team working under the clinical supervision of a clinical lead. The clinical lead can be a general duties medical officer (Post Foundation Years Doctor), military nurse practitioner or more senior clinician. The team is mounted in vehicles appropriate to the environment they expect to operate in. A PHTT is closely located to the front line reducing transportation timelines from the point of wounding to more definitive care. The PHTT can provide...
2h
BackgroundAccess to screening, brief intervention and referral to treatment programmes for alcohol use have been shown to be effective; however, little is known about access to these services among service members and veterans. We examined the association of service member or veteran rural-dwelling area and the following outcomes: recent general health check-up, alcohol screening and alcohol brief intervention.MethodsData on 5080 military service members and veterans were obtained from the 2017 Behavioural...
2h
Recent publications have highlighted the need to address inappropriate behaviours, including discrimination, bullying and sexual harassment, within the British Armed Forces; however, no UK work to date pays sufficient attention to sexual offences as defined by the Sexual Offences Act (2003). In trying to ascertain prevalence, nature and consequences of sexual offences in military and veteran populations, one is faced with majority United States (US) research with different definitions of offences,...
3h
IntroductionEx SAIF SAREEA 3 was a joint British-Omani military exercise involving approximately 5500 British personnel deployed to Oman over a 6-month period. Role 1 medical care was provided by medical treatment facilities (MTFs) deployed with medical equipment as per the UK 300 medical module.MethodRetrospective analysis was undertaken of prospectively collected equipment usage data from two Role 1 MTFs in Duqm (MTF 1) and Muaskar Al Murtafa (MTF 2) camps over a period of 6–8 weeks. Data were...
1d
IntroductionModule 501 provides core medications which are fundamental to the capability of a prehospital treatment team (PHTT). The quantities of each medication in the module inventory undergo regular review, but these do not correspond to a population at risk (PAR) figure or deployment length for which they intend to be used. This article proposes how the quantities of Module 501 drugs can be scaled for a given deployment, in this example using statistics taken from static PHTTs on Exercise Saif...
1d
Since the advent of women in ground close combat (WGCC) roles, the impact on women of the attendant risk of heat stress and heat illness has been considered. Much emphasis has been placed on sex differences in thermal physiology. This article considers the application of evidence of sex-associated thermoregulatory variation to the occupational and environmental setting of WGCC, and weighs the relative importance of physiological differences arising from biological sex, and behaviour associated with...
1d
1d
1d
IntroductionAeromedical Evacuation (AE) is a vital role of the Defence Medical Services (DMS). With a far-reaching defence global footprint, an AE capability is crucial to enable movement of patients in the fastest, safest and least stressful way that meets or exceeds the level of care an injured or ill person may expect to receive in the UK. Operation (Op) TRENTON is a UK military humanitarian operation in support of the United Nations (UN) Mission in South Sudan.MethodsA retrospective analysis...
1d
IntroductionEpidemiological data from military exercises are important to identify trends in medical presentations and treatment requirements to aid planning for future operations. UK Military exercises use the EpiNATO-2 surveillance system for this purpose, however it has some limitations in the spectrum of data it can collect. An enhanced reporting system titled EpiNATO-2 PLUS was developed and introduced in all LAND (Army) Role 1 Medical Treatment Facilities (MTFs) as part of Exercise Saif Sareea...
1d
Humans, chimpanzees, gorillas and bats have evolved to be good at metabolising alcohol, according to a study that suggests many mammals can get drunk
2h
The UK government has set a new target of recruiting an army of 18,000 coronavirus contact tracers by the middle of May, to be in place for the launch of the NHS contact tracing app
8h
The ongoing spread of bluetongue virus among European farm animals may have started when a cow was inseminated with infected bull semen stored from an earlier outbreak
8h
The latest coronavirus news updated every day including coronavirus cases, the latest news, features and interviews from New Scientist and essential information about the covid-19 pandemic
10h
Robots made of 3D-printed muscle and rat spines could help us understand conditions like motor neurone disease and the technique may eventually be used to build prosthetic devices
12h
Coffee has been linked to changes on our DNA that affect how active certain genes are. The finding may help explain some of coffee's touted health benefits
12h
The Pine Island glacier has three tipping points that could lead to the collapse of the entire West Antarctic ice sheet, potentially raising sea levels by 3 metres over centuries
17h
Lessons learned from natural disasters and the military can help guide our responses to help people's mental health during the covid-19 pandemic
19h
New images reveal threads of ultra-hot gas woven throughout the sun's corona, in the most detailed look at previously unseen parts of the atmosphere of our closest star
19h
In a small trial, implanting electrodes into the brain helped women with severe anorexia gain weight and feel less anxious and depressed
1d
The latest coronavirus news updated every day including coronavirus cases, the latest news, features and interviews from New Scientist and essential information about the covid-19 pandemic
1d
The membership of the UK's Scientific Advisory Group for Emergencies has so far been kept secret, but a list of names will soon be published, the UK's chief scientific adviser has said
1d
A 3D printed grate can be used to make a smart window that blocks heat from sunlight out in the summer while letting it through in the winter, conserving energy
1d
Half a million people taking part in the UK Biobank, which gathers genetic information for researchers to study, won't be told if they turn out to be genetically vulnerable to the coronavirus
1d
Acute pain is frequently encountered in the prehospital setting, and therefore, a fundamental aspect of quality emergency care. Research has shown a positive association between healthcare providers’ knowledge...
3h
Urinary catheterization is universally used during surgery, and the incidence of postoperative catheter-related bladder discomfort (CRBD) is very high during recovery. We conducted this study to identify the i...
3h
Abstract Pullulanase type I (PulA) is a debranching enzyme that specifically cleaves α-1,6-glycosidic linkages in pullulan. Pullulan has not only diverse applications in food industry but also has immune-stimulatory effects on B and T cells, and found to enhance the production of various anti-inflammatory cytokines in human. Moreover, pullulan has been suggested as a possible anti-cancer drug delivery agent without adjuvant due to its unique structure. The process of pullulan degradation...
3h
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου