North American Journal of Medicine and Science
Not a member yet
440 research outputs found
Sort by
Is There a Doctor on Board?
Get PDFWe were somewhere in the middle of Atlantic Ocean when the captain of the airplane announced: “Is there a doctor on the plane?” I thought to myself: “I don’t like flying, forget doing anything else, there must be at least one more doctor on this plane; I am not the only one … At least, I need a colleague…” I counted to three, got up and went to the stewardess: “I’m a doctor”
CD5-positive, Small B-Cell Lymphoproliferative Disorders: Aberrant Findings of CLL/SLL and MCL
Get PDFMost common CD5-positive, small B cell lymphoproliferative disorders include chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) and mantle cell lymphoma (MCL). Among these cases, atypical morphology, immunophenotype, and/or cytogenetic abnormalities are not uncommon. As an aberrant marker, CD5 expression is not limited to the cells of CLL/SLL or MCL and has been found in other B cell lymphomas ( both low grade and more aggressive types). CD5-negative CLL/SLL and MCL also are well documented, as are reports of other aberrant immunophenotypes of CLL/SLL and MCL. In addition, monoclonal B-cell lymphocytosis (MBL) of unknown significance has recently been reported in otherwise healthy individuals. We review here the findings that do not fulfill the current definitions of CLL/SLL or MCL. It is imperative that a pathologist should be familiar with these aberrant findings when considering CLL/SLL or MCL as a possible diagnosis. Furthermore, these aberrant findings may be clues to further understanding these entities
Water-Clear Cell Adenoma of Parathyroid Gland: A Case Report and Literature Review
Get PDFParathyroid adenoma of water-clear cell type is an extremely rare neoplasm, and only very few cases have been reported to date. Here we report a case of water-clear cell adenoma of the parathyroid in a 59-year old female patient who presented with hypercalcemia and high parathyroid hormone (PTH) level. Sestamibi scan showed a possible parathyroid adenoma involving the right superior parathyroid gland. The surgically excised specimen weighed 13.3 grams and contained a cystic hemorrhagic mass measuring 1 x 1 x 0.8 cm. Histologically, the tumor mass was surrounded by a thin fibrous capsule with a compressed thin rim of normal parathyroid tissue. High power examination revealed the tumor to be composed of cells with vacuolated cytoplasm, and with minimal nuclear pleomorphism. Immunohistochemical analysis demonstrated positive staining for PTH and chromogranin. Histological examination of the right inferior parathyroid gland showed unremarkable parathyroid tissue. Post-operatively, the patient’s serum calcium level returned to normal. These findings support the diagnosis of water-clear cell adenoma of the parathyroid gland. In this report, we also reviewed related literature and compared our case with similar cases reported before.
Human Papillomavirus Vaccine – Where are We Now?
Get PDFThis paper attempts to review the currently available relevant information about the two widely distributed human papillomavirus (HPV) vaccines in use today and place it in an easily understandable and readable format for busy clinicians to access. The article briefly reviews the background of the HPV virus and cervical cancer. It details to the vaccines currently licensed for use in the United States, Gardasil and Cervarix, going over the mechanisms of action for both, as well as administration routes. Efficacy of the vaccines was discussed in terms of the available phase II and phase III trial data available to date. Vaccination in males, cost-effectiveness and social acceptance were also reviewed. A brief discussion about the future development of second generation HPV vaccines was included. Although the data collected to date are promising, there is still much to learn about exactly what the future impact of the HPV vaccine will be in the United States and globally. Further research and analysis are necessary to determine the long term medical, social, and economic impact of the HPV vaccine
WRN Protein and Werner Syndrome
Get PDFWerner syndrome is an autosomal recessive disorder associated with premature aging and cancer predisposition. Cells from Werner syndrome patients show increased genomic instability and are hypersensitive to DNA damage agents. Werner syndrome is caused by mutations of the WRN gene. WRN protein is a member of RecQ DNA helicase family. It not only contains a conserved 3’-5’ helicase domain as other members of the RecQ family but also contains a unique 3’-5’ exonuclease domain. WRN recognizes specific DNA structures as substrates which are intermediates of DNA metabolism. WRN interacts with many other proteins, which function in telomere maintenance, DNA replication, and DNA repair through different pathways
Rationale for the Use of Natural Anti-Inflammatory Agents in Cancer Chemotherapy
Get PDFChemotherapeutic drugs have been conventionally used for the cancer treatments, but the efficacy of the therapy remains problematic. It has been strongly suggested that the anti-inflammatory drugs, such as COX-2 inhibitors, may enhance the anti-cancer efficacy of chemotherapeutic drugs and reduce the chemo-resistance. Herein, the rational of the use of anti-inflammatory agents in the cancer treatment is summarized. One of the most important inflammatory processes occurs during metabolism of the eicosanoids, which involved arachidonic acid (AA), cyclooxygenase 2 (COX-2), prostaglandins (PGs) and leukotriens (LTs). As the results of excessive up-regulation of COX-2 and production of PGE2, for example, the harmful inflammation may promote the cancer development. The inflammation also involve in the drug resistance of the chemotherapy. In fact, many in vitro and in vivo studies have showed the positive potentials using COX-2 inhibitors in the cancer treatment. However, the regular anti-inflammatory agents, mainly COX-2 inhibitors, may induce serious damages to stomach, kidney and heart, which have restricted the clinical uses of these drugs. For the reason, growing numbers of studied have targeted on the natural anti-inflammatory substances and expected to find the effective adjuvant to the chemotherapeutic drugs without the safety concern. On the other hand, the counteraction between the chemotherapy and natural substances has been concerned clinically. Therefore, the natural substances, which were studied for their anti-inflammation effects, are listed. The potential enhancing effects of some of the national anti-inflammatory agents on chemotherapeutic agents are reviewed. A guideline for clinical use of these natural agents with chemotherapy is suggested although limited clinical trial data available. In conclusion, the existing evidences suggest that some natural anti-inflammatory substances have potential to be used as adjuvant agents to enhance the efficacy and reduce the resistance of the chemotherapy. But more research and clinical trials are needed to support the suggestions
Early Detection and Prevention of Breast Cancer - A reflection of the USPSTF 2009 recommendation
Get PDFAs a practitioner focusing on women's health, I have seen many changes in the way that breast cancer detection has been addressed. One of the most notable events at the turn of the century was the new breast cancer screening recommendation. In 2009, after much analysis, the U.S. Preventive Services Task Force (USPSTF) changed its 2002 guideline.1 Response from the public, other medical organizations and legislators was swift and at times, became harsh. This review outlines the rationale of the new recommendation, states the opposite opinions and describes possible ways to prevent breast cancer
Physician Frustrations and the ‘Economics’ of Growth Hormone Therapy Prior-Authorization Requests and Their Denial by Insurance Payers
Get PDFGrowth hormone has been approved by the Food and Drug Administration (FDA) for treating short children with growth failure due to a variety of causes, including growth hormone deficiency (GHD), Turner Syndrome, Prader-Willi Syndrome, idiopathic short stature (ISS), chronic renal insufficiency and children born small for gestational age (SGA) with inadequate growth by their second birthday. Children with GHD tend to be the largest proportion of short children with growth failure. Growth hormone has a very short half-life in serum with a pulsatile pattern of release, like most pituitary hormones. A random blood draw for growth hormone is thus impractical as a means of diagnosing GHD. The diagnosis of GHD must be established usually by performing a growth hormone stimulation test. This is done by ‘provocation’ with pharmacological agents that cause the anterior pituitary to release stored growth hormone. The conventional cut off for diagnosing GHD under testing conditions is currently 5 micrograms/dL for adults and 10 micrograms/dL for children. Generally, growing children secrete higher levels of growth hormone than do adults, and thus would have higher serum levels under physiological conditions. Endocrinologists utilize various agents for the provocative tests; these include arginine, levodopa, clonidine, glucagon and insulin. Insulin is considered the ‘gold standard’ for growth hormone provocation tests though it is the least utilized, because of the associated danger of hypoglycemia and the need for the presence of qualified staff throughout the testing procedure to monitor and prevent such a complication
Liver Cancer Free Campaign: Mobilizing Public Support for Congressional Funding for Viral Hepatitis Research and Prevention Programs
Get PDFFew in the general public know that Hepatitis B virus (HBV) is a leading cause of cancer in humans, most notably liver cancer, the fifth leading type of cancer in the world. As many as 2 million Americans and 500 million people worldwide have viral hepatitis B, which accounts for 80% of all liver cancers worldwide. Most notably, Asian Americans have higher prevalence of viral hepatitis B than other racial and ethnic groups. Of the estimated 2 million chronic hepatitis B patient in the US, over half are Asian Americans. Among API men living in California, liver cancer ranks as a leading cause of cancer death: #1 for Laotian Americans, #2 for Vietnamese and Cambodian Americans, #4 for Chinese and Korean Americans and #5 for Filipino Americans
Environmental Epidemiology of Sporadic Parkinson’s Disease
Get PDFParkinson’s disease (PD) is the second most prevalent neurodegenerative disease of the elderly. The causes of PD are largely unknown, but probably involve both genetic and environmental factors. Breakthroughs have been made in the past decade to identify genes that are responsible for early-onset familial PD, yet the role of genes in sporadic PD needs to be defined. Twin studies suggest that environmental factors may be crucial in determining the risk of late-onset sporadic PD. To date, strong epidemiological evidence links environmental factors like cigarette smoking and coffee drinking to a lower PD risk, and to a lesser extent, pesticide exposures to a higher PD risk. Several novel findings have emerged from recent prospective studies on PD, such as a positive association with consumption of dairy products, and an inverse relationship with plasma urate concentration. Although gene-environment interactions are thought to be important in PD etiology, they rarely have been investigated. In the search of environmental PD risk factors, future multidisciplinary research is needed that includes input from both genetics and experimental biology. Interaction analysis requires information on both environmental and genetic factors from a large population, and such future studies will benefit from collaborative pooled analysis