Biomedical subjects
Publications and source records attributed to J Sloan.
Crohn's disease of the vulva is a rare disease, only eight cases having been described in the literature (Parks, Morson & Pegum, 1965; Mountain, 1970; Ansell & Hogbin, 1973; Devroede et al., 1975; Kao, Paulson & Askin, 1975; Levine, Barton & Grier, 1982). Two additional cases are presented, one of whom is the sixth reported with metastatic Crohn's disease of the vulva.
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The general public and the medical community often perceive dying patients' quality of life (QOL) as rapidly deteriorating before death. However, with appropriate palliative services, this effect may be positively modified. Objective data are lacking on the true experience of dying from the point of view of the patient that this pilot study begins to address. Patients caregivers, and staff in our hospice program completed questionnaires evaluating the patient's QOL every 2 weeks until the patient's death. This pilot study found that patients QOL was relatively high and stable over time. Primary caregivers rated the patient's QOL lower than patient self-ratings, whereas the hospice staff evaluated the patient's QOL similarly to the patient. Many dying patients suffer and are perceived as having no QOL in the final days by their caregivers. This perception may be modified to maintain one's QOL with the help of palliative medical services, thereby relieving the suffering of those who are actively facing death.
Although changes in the health care arena have made inroads in physicians' autonomy and reimbursement, new opportunities have also emerged. We describe basic principles that can help develop freestanding, independent, physician-owned imaging centers offering cost-competitive, high-quality services. To succeed, physicians must invest in their companies, think strategically, pursue clear objectives, examine data and be willing to assume a certain amount of risk. Marketing their services is critically important and requires careful attention to patients and referring physicians. We have found that, while these challenges are large, the rewards are substantial.
Proboscis lateralis is a rare craniofacial malformation. We present a case in a 1-week-old male infant, describe the clinical and imaging findings, and discuss the pertinent embryology. MR and CT proved to be complementary: CT provided anatomic detail in bone, defined the nasal cavity, and aided in determining the relationship of the proboscis and orbit; MR clarified the relationship of the proboscis to the orbit and skull base, and the relationships of normal brain to the dysplastic ethmoid centers.
The discovery of H. pylori is the most important development in gastroduodenal disease this century. It has completely changed our understanding of conditions that occur in the upper gastrointestinal tract. Eradication of the bacterium will cure peptic ulcer disease, decrease the symptoms of non-ulcer dyspepsia and may prevent gastric cancer. There has been an exponential increase in the amount of research in this area in recent years and, consequently, there is considerable confusion as to how H. pylori-related conditions should be managed. It is hoped that these guidelines will clarify some of these issues.