The Yale journal of biology and medicine
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Although not common, acute leg ischemia is an important element in the clinical presentation of a patient with aortic dissection. This report describes a case of aortic dissection in which the main feature at presentation was acute right leg ischemia. The angiography showed right common iliac artery and external iliac artery occlusion. ⋯ Fortunately, the patient had good recovery. Aortic dissection is potentially lethal if misdiagnosed or if recognition is delayed. As such, aortic dissection should be considered in the differential diagnosis.
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This is a brief overview of the development of cancer therapy with a focus on systemic therapy. The modern era of chemotherapy developed at Yale University Medical School during World War II, a fact that has been generally unrecognized until recently. The observations preceding and involved in the discovery of effective drugs for cancer seem particularly pertinent for this anniversary year.
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Hemostasis after traumatic liver injury can be extremely difficult to obtain, particularly in coagulopathic patients who have suffered extensive liver damage. We determined the ability of a fibrin glue preparation (FG) to terminate ongoing bleeding using a new, clinically relevant porcine model of complex hepatic injury. Anesthetized swine (n = 6, 18 to 19 kg) received an external blast to the right upper abdomen and were immediately anticoagulated with intravenous heparin (200 u/kg). ⋯ Re-bleeding was noted in only one animal (portal vein injury). FG can control severe hepatic hemorrhage when surgical techniques fail. Further work in the clinical arena is warranted to determine the potential benefits of FG in arresting hemorrhage in hemodynamically unstable coagulopathic patients with complex hepatic injuries.
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The physical examination has a historically prominent role in medical practice, being an important tool in diagnosis and in developing rapport with patients. Yet, physicians have lost bedside skills in recent years, with increasing use of technology at the expense of time spent with the patient. ⋯ Approaches to improve bedside diagnosis skills include increased emphasis on instruction in physical examination during medical school and postgraduate training, and careful scrutiny of physical examination techniques, with formal evaluation of their accuracy and reproducibility. Only through education and research will the physical examination recover its central role in the clinical encounter.
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Biography Historical Article Classical Article
Peculiar elongated and sickle-shaped red blood corpuscles in a case of severe anemia. 1910.