This is an incredibly cool animation of the central dogma of molecular biology. It was made by an very talented BAFTA- and Emmy-award winning medical illustrator named Drew Berry at the Walter and Eliza Hall Institute of Medical Research in Melbourne.
Clinical Presentation
A 33 year-old woman with cystic fibrosis who underwent bilateral orthotopic lung transplantation twelve weeks ago presented to the emergency department complaining of increasingly severe right upper quadrant pain of one week’s duration. Physical examination was remarkable for moderate jaundice and marked right upper quadrant tenderness to palpation. Liver function testing revealed markedly elevated AST and ALT, moderate indirect and direct hyperbilirubinemia, and a moderately elevated alkaline phosphatase. Serological testing for common viral hepatitides were negative, serum PCR for cytomegalovirus DNA was negative. Hepatobiliary imaging was normal. A percutaneous liver biopsy was performed.
Pathological Findings
Microscopic examination of the liver biopsy revealed approximately five small fragments of liver tissue. There was a mild portal infiltrate of mixed inflammatory cells without evidence of limiting plate inflammation. Within the lobules, there were scattered, randomly distributed foci of hepatocyte necrosis with mixed inflammation. In a few foci, collections of epithelioid cells suggestive of poorly-formed granulomas were seen. Only rare eosinophils were present. There was one large area of inflammation and fibrosis with central necrosis.
Welcome to this weeks edition of Grand Rounds, the week’s best from the medical blogosphere.
And if you haven’t been to our new site before, welcome to PathTalk, a community blog for all things pathology. We’ve only been around for a few months, and have taken a short hiatus recently, but hope to ring in the new year with more content from a specialty that is relevant to all of our medical colleagues out there. Please take a look at Gretchen’s series on lab testing, my musings on medical topics “off the stage“, and Kenneth’s great slide case studies.
So without further ado, let’s take a look around and see what medical bloggers are thinking about this week…
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Late addition secondary to my own oversight: Pearls and Dreams on eating disorders.
Dr. Toni Brayer at Everything Health wonders whether sexual misconduct complaints against doctors are being properly investigated.
Tony Chen at Hospital Impact links to an article that claims the US has too many doctors. The article’s author is Shannon Brownlee, who wrote Overtreated.
Emily at crzegrl.net relays an interesting and touching narrative from a recent adventure as a flight nurse.
The Physician Executive examines immigration laws, and to what extent health care costs play into the debate.
“The Fine Art Doctor” at In My Humble Opinion has some good rules to keep your patients out of the hospital.
Roy at Shrink Rap counts down his top 25 posts of 2007.
Bongi at Other Things Amanzi relates a story about crime, police, and the hospital in South Africa.
Kim at Emergiblog remind doctors that nurses are beholden to their own code of ethics, not the doctors they support. ERNursery chimes in.
A 23-year-old medical student at Vitum Medicinus reflects on age discrimination and maturity.
For you patients out there with back pain, Dean Moyer has some guidelines about which caregivers to see.
Allergy notes wonders whether Platelet Activating Factor will be for anaphylaxis what BNP has become for heart failure.
Clinical Cases and Images opines on the NEJM Image Challenge and the “wisdom of crowds.”
The internet is the ideal place to talk about those issues that doctors and patients may not feel the most comfortable about. Searah Deysach at ChronicBabe discusses lubricants.
For the sake of our patients, doctors must look at alternative health seriously and critically. Val Jones at Revolution Health takes a look at the plausibility of homeopathy and does not like what she sees.
Interested Participant passes along accusations that some British NHS hospitals are lying on death certificates to cover up death from hosptial-acquired infections.
In the wake of the San Francisco Zoo tragedy, Dr. Paul Auerbach of Healthline details the prevelance and health issues of large cat attacks.
Also from Healthline, JC Jones reminds that the third world struggles with diseases the developed world has conquered.
Tara Gidus explains why men, compared to women, can lose more weight faster.
Nancy Brown speaks to anyone who may be experiencing post-holiday blues.
Jolie Bookspan has some tips for improving fitness.
A volunteer ER chaplain who blogs at Rickety Contrivances of Doing Good looks at the human side of organ donation.
Ian at ImpactEDNurse.com examines the origins of the word “hysterical”. The posts title: Escaped Uterus Sparks Mass Hysteria in Emergency Department! - I think that is all I need to say.
Kolahun studies malnutrition in Darfur.
“Mother Jones” at Nurse Ratched’s Place claims that Orville Redenbacher should stick to the popcorn, and Johnson&Johnson should stick to making drugs.
Gerry at Disease Proof has everything you ever wanted to know about organic bananas.
David Williams at Health Business Blog sees that a minority of pharmaceutical samples find their way to poor patients and asks, “So what?”
The Colorado Health Insurance Insider examines the high price of becoming a doctor.
HealthBlawgs David Harlow discusses Federal ERISA laws.
Lindsay at Living With Fibromyalgia struggles with the politics of paying for drugs at Britains NHS.
A Filipino physician at Prudence MD takes a look at that country’s effort to require nutritional information on restaurant menus.
Alvaro at Sharp Brains has a roundup on brain fitness and cognitive health.
Christian at Med Journal Watch claims that for coping with stress and trauma, religion can be a double-edged sword.
Mike Feehan at InsureBlog highlights a scandal in Japan that has left 10,000 patients with Hepatitis C from fibrinogen tranfusion.
Jeffrey MD looks at the decline in physician salaries.
How To Cope With Pain has a roundup of the December Pain Blog Carnival.
Terry at Counting Sheep says that insurance companies are not covering anesthesia adequately.
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Thank you for stopping by this week for Grand Rounds, and thank you to all those who contributed. Next weeks edition will be at Sharp Brains.
We’ve taken a little time off here at PathTalk, but hope to resume in a big way with the next edition of Grand Rounds - the best of the medical blogosphere.
If you have a submission, send to trentmcbride -at- gmail -dot- com; please have submissions by 5 PM on Monday the 7th. There is no theme, so send whatever you’d like.
And, please, everyone stop by next Tuesday to see the best from the medical blogosphere!
This is a superficial post on point-of-care (POC) testing touching on general background info. This topic and especially “Lab On A Chip (LOC)” has been addressed several times by Dr. Friedman in LabSoftNews (see links tab to the right).
Over a dinner of delicious home-cooked food, my mother, in a perpetual exercise to understand the scope of exactly what it is a pathologist does, asked me on my last visit home about laboratory testing. She wondered how her cousin, who is a high school graduate, could be involved with medical laboratory testing–including DNA test handling–without additional training. As I am not a laboratory manager and still consider myself a somewhat green resident (Will this feeling ever go away?), my first response was “?”.
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