The American journal of the medical sciences
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William Osler, the founding Chair of Medicine at the Johns Hopkins College of Medicine, left for Oxford in 1905. He delivered a valedictory lecture February 1905 at Johns Hopkins in which he referred to a novel by Anthony Trollope called The Fixed Period. Osler stated that almost all important work was done prior to the age of 40 and the retirement age should be 60, at least for professors. ⋯ Osler's reaction to the controversy has not been commonly documented. We examined an unpublished manuscript by Osler's student Francis Packard that contributes to the knowledge of Osler's feeling about The Fixed Period address and the reaction to it. In addition, for the first time we examine the extent and geography of newspaper articles about Olser's Fixed Period address.
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Esophageal squamous cell carcinoma (SCC) is a highly lethal malignancy with a low survival rate, often presenting at an advanced stage. Cutaneous metastasis from esophageal SCC is exceedingly rare, affecting less than 1% of cases, and is associated with a poor prognosis. This review particularly focuses on facial metastasis and discusses the clinical presentation, diagnostic challenges, and management of cutaneous metastases. ⋯ Histopathological examination and immunohistochemical staining are crucial for accurate diagnosis. Management involves a combination of local and systemic therapies, tailored to the patient's overall health and disease extent. This topic emphasizes the need for vigilance and thorough diagnostic workups in patients with unusual skin lesions and highlights the importance of multidisciplinary care in optimizing treatment outcomes for patients with advanced esophageal cancer.
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Empagliflozin was associated with a slower progression of kidney disease. We aimed to investigate the effect of empagliflozin on alleviating complement over-activation in DKD. ⋯ Empagliflozin may have a beneficial effect on mitigating complement over-activation in DKD. Further research is needed to confirm our findings.
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Noninvasive positive pressure ventilation (NIV) is a positive pressure ventilation method employed across various disease processes, utilizing noninvasive interfaces such as helmets and facemasks rather than invasive methods such as endotracheal intubation. The benefits of NIV are significant in both the acute care setting, such as improving work of breathing and avoiding the need for endotracheal intubation, as well as in the chronic care setting, improving quality of life and mortality. ⋯ The review also summarizes the current guidelines on the use of NIV in the acute care setting. Although primarily targeted towards the acute indications of NIV, we believe this review will aid in better understanding and managing noninvasive ventilation for clinicians across both the inpatient and outpatient settings.