Francis Camps

Francis Edward Camps, FRCP, FRCPath (28 June 1905 – 8 July 1972) was a famous English pathologist notable for his work on the cases of serial killer John Christie and suspected serial killer John Bodkin Adams.
Early life and training.
Camps was born in Teddington, Middlesex, the son of Dr Percy William Leopold Camps (1878–1956), a general practitioner and surgeon. Camps was educated at Marlborough College, followed by a medical degree at Guy's Hospital. He went on to postgraduate studies at the Liverpool School of Tropical Medicine and the Neuchâtel University, Switzerland.
Career.
In 1935, Camps decided to specialise in pathology, and took up the post of pathologist at the Chelmsford and Essex Hospital. He was professor of Forensic Medicine at the London Hospital Medical College since 1963 (Reader 1954–63). President of the International Association of Forensic Scientists, 1963–66. Honorary Consultant to the Army in Forensic Medicine after 1964. He was a Past-President of the British Association and Secretary General, British Academy of Forensic Sciences. Professor Camps was the author of many papers on forensic medicine, and of "Practical Forensic Medicine".
Medico-legal work.
He worked on, amongst others, the Dr John Bodkin Adams case in 1956 where he identified 163 suspicious deaths and was an expert witness in the trial the following year. However, Adams was acquitted of murdering one of his patients, owing to lack of evidence of motive, among other uncertainties.
10 Rillington Place.
Camps gave evidence during the trial of John Christie in 1953, having produced a detailed and comprehensive report on the many bodies found at 10 Rillington Place. The bodies were well preserved and so much relevant information could be gleaned from their condition. His report showed a consistent pattern of attack by Christie, most of the intact victims having been sexually molested and strangled. Beryl and Geraldine Evans had alone been strangled, and their bodies were exhumed to be re-examined for Christie's trial.
The skeletal remains of Christie's older victims buried in the back garden at Rillington Place (a human thigh bone visibly propped up a small fence) provided less information, although it proved possible to identify the women involved. There could be little doubt that Christie had murdered them all, that Timothy Evans was innocent, and that he had been wrongly executed, although it took many years to establish the truth of the matter. The forensic and witness evidence pointed to a serious miscarriage of justice, although it was contested by a series of lawyers and politicians well after the events.
However, several authors, such as Ludovic Kennedy, pointed out the many contradictions and errors in the Crown's case, and the innocence of Evans is now widely accepted, both by public, experts and by the Crown itself. The case was the most prominent of a series of miscarriages which ultimately led to the abolition of capital punishment for murder in England, Wales and Scotland in 1965.
Other cases.
He reported on numerous deaths from carbon monoxide poisoning, accounting for nearly half of all suicides in Britain in the 1950s when coal gas was widely available in many homes until in the 1960s it was progressively replaced by the less toxic natural gas: the suicide rate in Britain fell by almost a third and has not risen since.
His analysis of the problem of identifying the gas in bodies after death was published posthumously in his autobiography, together with other of his cases such as the Rhyl mummy and the Colchester taxi cab murder. In the same book, he also examined the forensic evidence involving Jack the Ripper.
Tribute.
The famous crime fiction author Earl Stanley Gardner dedicated one of his novels, "The Case Of Duplicate Daughter", to his friend Dr Camps in appreciation of his professional acumen. A short dedication note by the author can be found at the beginning of the novel.


John Patrick Molloy

John Patrick Molloy (March 13, 1873 – March 16, 1948) was a Canadian veterinarian and politician.
Born in Arthur, Ontario of Irish Canadian parentage, Molloy was educated in the public and secondary schools of Ontario. He later attended the Ontario Veterinary College where he graduated in 1902. He spent the following year doing post graduate studies at the McKillip Veterinary College in Chicago where he received a M.D.V. degree. He returned to Canada settling in Morris, Manitoba where he established a practice.
He ran as a candidate for the Legislative Assembly of Manitoba in the 1907 election but was defeated. He was elected to the House of Commons of Canada for the electoral district of Provencher in the 1908 federal election. A Liberal, he was re-elected in 1911 and 1917. He was defeated in 1921 and was summoned to the Senate of Canada on the advice of William Lyon Mackenzie King in 1925 representing the senatorial division of Provencher, Manitoba. He served until his death in 1948.


Actinic keratosis

Actinic keratosis (AK), sometimes called solar keratosis or senile keratosis, is a pre-cancerous area of thick, scaly, or crusty skin. Actinic keratosis is a disorder ("-osis") of epidermal keratinocytes that is induced by ultraviolet (UV) light exposure ("actin-"). These growths are more common in fair-skinned people and those who are frequently in the sun. They are believed to form when skin gets damaged by UV radiation from the sun or indoor tanning beds, usually over the course of decades. Given their pre-cancerous nature, if left untreated, they may turn into a type of skin cancer called squamous cell carcinoma. Untreated lesions have up to a 20% risk of progression to squamous cell carcinoma, so treatment by a dermatologist is recommended.
Actinic keratoses characteristically appear as thick, scaly, or crusty areas that often feel dry or rough. Size commonly ranges between 2 and 6 millimeters, but they can grow to be several centimeters in diameter. Notably, AKs are often felt before they are seen, and the texture is sometimes compared to sandpaper. They may be dark, light, tan, pink, red, a combination of all these, or have the same color as the surrounding skin.
Given the causal relationship between sun exposure and AK growth, they often appear on a background of sun-damaged skin and in areas that are commonly sun-exposed, such as the face, ears, neck, scalp, chest, backs of hands, forearms, or lips. Because sun exposure is rarely limited to a small area, most people who have an AK have more than one.
If clinical examination findings are not typical of AK and the possibility of in situ or invasive squamous cell carcinoma (SCC) cannot be excluded based on clinical examination alone, a biopsy or excision can be considered for definitive diagnosis by histologic examination of the lesional tissue. Multiple treatment options for AK are available. Photodynamic therapy (PDT) is one option the treatment of numerous AK lesions in a region of the skin, termed field cancerization. It involves the application of a photosensitizer to the skin followed by illumination with a strong light source. Topical creams, such as 5-fluorouracil or imiquimod, may require daily application to affected skin areas over a typical time course of weeks.
Cryotherapy is frequently used for few and well-defined lesions, but undesired skin lightening, or hypopigmentation, may occur at the treatment site. By following up with a dermatologist, AKs can be treated before they progress to skin cancer. If cancer does develop from an AK lesion, it can be caught early with close monitoring, at a time when treatment is likely to have a high cure rate.
Signs and symptoms.
Actinic keratoses (AKs) most commonly present as a white, scaly plaque of variable thickness with surrounding redness; they are most notable for having a sandpaper-like texture when felt with a gloved hand. Skin nearby the lesion often shows evidence of solar damage characterized by notable pigmentary alterations, being yellow or pale in color with areas of hyperpigmentation; deep wrinkles, coarse texture, purpura and ecchymoses, dry skin, and scattered telangiectasias are also characteristic.
Photoaging leads to an accumulation of oncogenic changes, resulting in a proliferation of mutated keratinocytes that can manifest as AKs or other neoplastic growths. With years of sun damage, it is possible to develop multiple AKs in a single area on the skin. This condition is termed field cancerization.
The lesions are usually asymptomatic, but can be tender, itch, bleed, or produce a stinging or burning sensation. AKs are typically graded in accordance with their clinical presentation: Grade I (easily visible, slightly palpable), Grade II (easily visible, palpable), and Grade III (frankly visible and hyperkeratotic).
Variants.
Actinic keratoses can have various clinical presentations, often characterized as follows:
The presence of ulceration, nodularity, or bleeding should raise concern for malignancy. Specifically, clinical findings suggesting an increased risk of progression to squamous cell carcinoma can be recognized as "IDRBEU": I (induration/inflammation), D (diameter > 1 cm), R (rapid enlargement), B (bleeding), E (erythema), and U (ulceration). AKs are usually diagnosed clinically, but because they are difficult to clinically differentiate from squamous cell carcinoma, any concerning features warrant biopsy for diagnostic confirmation.
Causes.
The most important cause of AK formation is solar radiation, through a variety of mechanisms. Mutation of the p53 tumor suppressor gene, induced by UV radiation, has been identified as a crucial step in AK formation. This tumor suppressor gene, located on chromosome 17p132, allows for cell cycle arrest when DNA or RNA is damaged. Dysregulation of the p53 pathway can thus result in unchecked replication of dysplastic keratinocytes, thereby serving as a source of neoplastic growth and the development of AK, as well as possible progression from AK to skin cancer. Other molecular markers that have been associated with the development of AK include the expression of p16ink4, p14, the CD95 ligand, TNF-related apoptosis-inducing ligand (TRAIL) and TRAIL receptors, and loss of heterozygosity.
Evidence also suggests that the human papillomavirus (HPV) plays a role in the development of AKs. The HPV virus has been detected in AKs, with measurable HPV viral loads (one HPV-DNA copy per less than 50 cells) measured in 40% of AKs. Similar to UV radiation, higher levels of HPV found in AKs reflect enhanced viral DNA replication. This is suspected to be related to the abnormal keratinocyte proliferation and differentiation in AKs, which facilitate an environment for HPV replication. This in turn may further stimulate the abnormal proliferation that contributes to the development of AKs and carcinogenesis.
Ultraviolet radiation.
It is thought that ultraviolet (UV) radiation induces mutations in the keratinocytes of the epidermis, promoting the survival and proliferation of these atypical cells. Both UV-A and UV-B radiation have been implicated as causes of AKs. UV-A radiation (wavelength 320–400 nm) reaches more deeply into the skin and can lead to the generation of reactive oxygen species, which in turn can damage cell membranes, signaling proteins, and nucleic acids. UV-B radiation (wavelength 290–320 nm) causes thymidine dimer formation in DNA and RNA, leading to significant cellular mutations. In particular, mutations in the p53 tumor suppressor gene have been found in 30–50% of AK lesion skin samples.
UV radiation has also been shown to cause elevated inflammatory markers such as arachidonic acid, as well as other molecules associated with inflammation. Eventually, over time these changes lead to the formation of AKs. Several predictors for increased AK risk from UV radiation have been identified:
Skin pigmentation.
Melanin is a pigment in the epidermis that functions to protect keratinocytes from the damage caused by UV radiation; it is found in higher concentration in the epidermis of darker-skinned individuals, affording them protection against the development of AKs.
Fair-skinned individuals have a significantly increased risk of developing AKs when compared to olive-skinned individuals (odds ratios of 14.1 and 6.5, respectively), and AKs are uncommon in dark-skinned people of African descent. Other phenotypic features seen in fair-skinned individuals that are associated with an increased propensity to develop AKs include:
Diagnosis.
Physicians usually diagnose actinic keratosis by doing a thorough physical examination, through a combination of visual observation and touch. However a biopsy may be necessary when the keratosis is large in diameter, thick, or bleeding, in order to make sure that the lesion is not a skin cancer. Actinic keratosis may progress to invasive squamous cell carcinoma (SCC) but both diseases can present similarly upon physical exam and can be difficult to distinguish clinically. Histological examination of the lesion from a biopsy or excision may be necessary to definitively distinguish AK from in situ or invasive SCC. In addition to SCCs, AKs can be mistaken for other cutaneous lesions including seborrheic keratoses, basal cell carcinoma, lichenoid keratosis, porokeratosis, viral warts, erosive pustular dermatosis of the scalp, pemphigus foliaceus, inflammatory dermatoses like psoriasis, or melanoma.
Biopsy.
A lesion biopsy is performed if the diagnosis remains uncertain after a clinical physical exam, or if there is suspicion that the AK might have progressed to squamous cell carcinoma. The most common tissue sampling techniques include shave or punch biopsy. When only a portion of the lesion can be removed due to its size or location, the biopsy should sample tissue from the thickest area of the lesion, as SCCs are most likely to be detected in that area.
If a shave biopsy is performed, it should extend through to the level of the dermis in order to provide sufficient tissue for diagnosis; ideally, it would extend to the mid-reticular dermis. Punch biopsy usually extends to the subcutaneous fat when the entire length of the punch blade is utilized.
Histopathology.
On histologic examination, actinic keratoses usually show a collection of atypical keratinocytes with hyperpigmented or pleomorphic nuclei, extending to the basal layer of the epidermis. A "flag sign" is often described, referring to alternating areas of orthokeratosis and parakeratosis. Epidermal thickening and surrounding areas of sun-damaged skin are often seen. The normal ordered maturation of the keratinocytes is disordered to varying degrees: there may be widening of the intracellular spaces, cytologic atypia such as abnormally large nuclei, and a mild chronic inflammatory infiltrate.
Specific findings depend on the clinical variant and particular lesion characteristics. The seven major histopathologic variants are all characterized by atypical keratinocytic proliferation beginning in the basal layer and confined to the epidermis; they include:
Dermoscopy.
Dermoscopy is a noninvasive technique utilizing a handheld magnifying device coupled with a transilluminating lift. It is often used in the evaluation of cutaneous lesions, but lacks the definitive diagnostic ability of biopsy-based tissue diagnosis. Histopathologic exam remains the gold standard.
Polarized contact dermoscopy of AKs occasionally reveals a "rosette sign," described as four white points arranged in a clover pattern, often localized to within a follicular opening. It is hypothesized that the "rosette sign" corresponds histologically to the changes of orthokeratosis and parakeratosis known as the "flag sign."
Prevention.
Ultraviolet radiation is believed to contribute to the development of actinic keratoses by inducing mutations in epidermal keratinocytes, leading to proliferation of atypical cells. Therefore, preventive measures for AKs are targeted at limiting exposure to solar radiation, including:
Recent research implicating human papillomavirus (HPV) in the development of AKs suggests that HPV prevention might in turn help prevent development of AKs, as UV-induced mutations and oncogenic transformation are likely facilitated in cases of active HPV infection. A key component of HPV prevention includes vaccination, and the CDC currently recommends routine vaccination in all children at age 11 or 12.
There is some data that in individuals with a history of non-melanoma skin cancer, a low-fat diet can serve as a preventative measure against future actinic keratoses.
Management.
There are a variety of treatment options for AK depending on the patient and the clinical characteristics of the lesion. AKs show a wide range of features, which guide decision-making in choosing treatment. As there are multiple effective treatments, patient preference and lifestyle are also factors that physicians consider when determining the management plan for actinic keratosis. Although overall cure rates are high, experts agree that the best treatment for AK is prevention. Regular follow-up is advisable after any treatment to make sure no new lesions have developed and that old ones are not progressing. Adding topical treatment after a procedure may improve outcomes.
Medication.
Topical medications are often recommended for areas where multiple or ill-defined AKs are present, as the medication can easily be used to treat a relatively large area.
Fluorouracil cream.
Topical fluorouracil (5-FU) destroys AKs by blocking methylation of thymidylate synthetase, thereby interrupting DNA and RNA synthesis. This in turn prevents the proliferation of dysplastic cells in AK. Topical 5-FU is the most utilized treatment for AK, and often results in effective removal of the lesion. Overall, there is a 50% efficacy rate resulting in 100% clearance of AKs treated with topical 5-FU. 5-FU may be up to 90% effective in treating non-hyperkeratotic lesions. While topical 5-FU is a widely used and cost-effective treatment for AKs and is generally well tolerated, its potential side-effects can include: pain, crusting, redness, and local swelling. These adverse effects can be mitigated or minimized by reducing the frequency of application or taking breaks between uses. The most commonly used application regimen consists of applying a layer of topical cream to the lesion twice a day after washing; duration of treatment is typically 2–4 weeks to thinner skin like the cheeks and up to 8 weeks for the arms; treatment of up to 8 weeks has demonstrated a higher cure rate.
Imiquimod cream.
Imiquimod is a topical immune-enhancing agent licensed for the treatment of genital warts. Imiquimod stimulates the immune system through the release and up-regulation of cytokines. Treatment with Imiquimod cream applied 2–3 times per week for 12 to 16 weeks was found to result in complete resolution of AKs in 50% of people, compared to 5% of controls. The Imiquimod 3.75% cream has been validated in a treatment regimen consisting of daily application to entire face and scalp for two 2-week treatment cycles, with a complete clearance rate of 36%.
While the clearance rate observed with the Imiquimod 3.75% cream was lower than that observed with the 5% cream (36 and 50 percent, respectively), there are lower reported rates of adverse reactions with the 3.75% cream: 19% of individuals using Imiquimod 3.75% cream reported adverse reactions including local erythema, scabbing, and flaking at the application site, while nearly a third of individuals using the 5% cream reported the same types of reactions with Imiquimod treatment. However, it is ultimately difficult to compare the efficacy of the different strength creams directly, as current study data varies in methodology (e.g. duration and frequency of treatment, and amount of skin surface area covered).
Ingenol mebutate gel.
Ingenol mebutate is a newer treatment for AK used in Europe and the United States. It works in two ways, first by disrupting cell membranes and mitochondria resulting cell death, and then by inducing antibody-dependent cellular cytotoxicity to eliminate remaining tumor cells. A 3-day treatment course with the 0.015% gel is recommended for the scalp and face, while a 2-day treatment course with the 0.05% gel is recommended for the trunk and extremities. Treatment with the 0.015% gel was found to completely clear 57% of AK, while the 0.05% gel had a 34% clearance rate. Advantages of ingenol mebutate treatment include the short duration of therapy and a low recurrence rate. Local skin reactions including pain, itching and redness can be expected during treatment with ingenol mebutate. This treatment was derived from the petty spurge, "Euphorbia peplus" which has been used as a traditional remedy for keratosis.
Diclofenac sodium gel.
Topical diclofenac sodium gel is a nonsteroidal anti-inflammatory drug that is thought to work in the treatment of AK through its inhibition of the arachidonic acid pathway, thereby limiting the production of prostaglandins which are thought to be involved in the development of UVB-induced skin cancers. Recommended duration of therapy is 60 to 90 days with twice daily application. Treatment of facial AK with diclofenac gel led to complete lesion resolution in 40% of cases. Common side effects include dryness, itching, redness, and rash at the site of application.
Retinoids.
Topical retinoids have been studied in the treatment of AK with modest results, and the American Academy of Dermatology does not currently recommend this as a first-line therapy. Treatment with adapalene gel daily for 4 weeks, and then twice daily thereafter for a total of nine months led to a significant but modest reduction in the number AKs compared to placebo; it demonstrated the additional advantage of improving the appearance of photodamaged skin.
Topical tretinoin is ineffective as treatment for reducing the number of AKs. For secondary prevention of AK, systemic, low-dose acitretin was found to be safe, well tolerated and moderately effective in chemoprophylaxis for skin cancers in kidney transplant patients. Acitretin is a viable treatment option for organ transplant patients according to expert opinion.
Tirbanibulin.
Tirbanibulin (Klisyri) was approved for medical use in the United States in December 2020, for the treatment of actinic keratosis on the face or scalp.
Procedures.
Cryotherapy.
Liquid nitrogen (−195.8 °C) is the most commonly used destructive therapy for the treatment of AK in the United States. It is a well-tolerated office procedure that does not require anesthesia.
Cryotherapy is particularly indicated for cases where there are fewer than 15 thin, well-demarcated lesions. Caution is encouraged for thicker, more hyperkeratotic lesions, as dysplastic cells may evade treatment. Treatment with both cryotherapy and field treatment can be considered for these more advanced lesions. Cryotherapy is generally performed using an open-spray technique, wherein the AK is sprayed for several seconds.
The process can be repeated multiple times in one office visit, as tolerated. Cure rates from 67 to 99 percent have been reported, depending on freeze time and lesion characteristics. Disadvantages include discomfort during and after the procedure; blistering, scarring and redness; hypo- or hyperpigmentation; and destruction of healthy tissue.
Photodynamic therapy.
AKs are one of the most common dermatologic lesions for which photodynamic therapy, including topical methyl aminolevulinate (MAL) or 5-aminolevulinic acid (5-ALA), is indicated.
Treatment begins with preparation of the lesion, which includes scraping away scales and crusts using a dermal curette. A thick layer of topical MAL or 5-ALA cream is applied to the lesion and a small area surrounding the lesion, which is then covered with an occlusive dressing and left for a period of time. During this time the photosensitizer accumulates in the target cells within the AK lesion. The dressings are then removed and the lesion is treated with light at a specified wavelength.
Multiple treatment regimens using different photosensitizers, incubation times, light sources, and pretreatment regimens have been studied and suggest that longer incubation times lead to higher rates of lesion clearance. Photodynamic therapy is gaining in popularity. It has been found to have a 14% higher likelihood of achieving complete lesion clearance at 3 months compared to cryotherapy, and seems to result in superior cosmetic outcomes when compared to cryotherapy or 5-FU treatment. Photodynamic therapy can be particularly effective in treating areas with multiple AK lesions.
Laser therapy.
Laser therapy using carbon dioxide () or erbium:yttrium aluminum garnet () lasers is a treatment approach being utilized with increased frequency, and sometimes in conjunction with computer scanning technology. Laser therapy has not been extensively studied, but current evidence suggests it may be effective in cases involving multiple AKs refractive to medical therapy, or AKs located in cosmetically sensitive locations such as the face. The laser has been recommended for extensive actinic cheilitis that has not responded to 5-FU.
Chemical peels.
A chemical peel is a topically applied agent that wounds the outermost layer of the skin, promoting organized repair, exfoliation, and eventually the development of smooth and rejuvenated skin. Multiple therapies have been studied. A medium-depth peel may effectively treat multiple non-hyperkeratotic AKs. It can be achieved with 35% to 50% trichloroacetic acid (TCA) alone or at 35% in combination with Jessner's solution in a once-daily application for a minimum of 3 weeks; 70% glycolic acid (α-hydroxy acid); or solid . When compared to treatment with 5-FU, chemical peels have demonstrated similar efficacy and increased ease of use with similar morbidity. Chemical peels must be performed in a controlled clinic environment and are recommended only for individuals who are able to comply with follow-up precautions, including avoidance of sun exposure. Furthermore, they should be avoided in individuals with a history of HSV infection or keloids, and in those who are immunosuppressed or who are taking photosensitizing medications.
Prognosis.
Untreated AKs follow one of three paths: they can either persist as AKs, regress, or progress to invasive skin cancer, as AK lesions are considered to be on the same continuum with squamous cell carcinoma (SCC). AK lesions that regress also have the potential to recur.
Clinical course.
Given the aforementioned differering clinical outcomes, it is difficult to predict the clinical course of any given actinic keratosis. AK lesions may also come and go—in a cycle of appearing on the skin, remaining for months, and then disappearing. Often they will reappear in a few weeks or months, particularly after unprotected sun exposure. Left untreated, there is a chance that the lesion will advance to become invasive. Although it is difficult to predict whether an AK will advance to become squamous cell carcinoma, it has been noted that squamous cell carcinomas originate in lesions formerly diagnosed as AKs with frequencies reported between 65 and 97%.
Epidemiology.
Actinic keratosis is very common, with an estimated 14% of dermatology visits related to AKs. It is seen more often in fair-skinned individuals, and rates vary with geographical location and age. Other factors such as exposure to ultraviolet (UV) radiation, certain phenotypic features, and immunosuppression can also contribute to the development of AKs.
Men are more likely to develop AK than women, and the risk of developing AK lesions increases with age. These findings have been observed in multiple studies, with numbers from one study suggesting that approximately 5% of women ages 20–29 develop AK compared to 68% of women ages 60–69, and 10% of men ages 20–29 develop AK compared to 79% of men ages 60–69.
Geography seems to play a role in the sense that individuals living in locations where they are exposed to more UV radiation throughout their lifetime have a significantly higher risk of developing AK. Much of the literature on AK comes from Australia, where prevalence of AK is estimated at 40–50% in adults over 40, as compared to the United States and Europe, where prevalence is estimated at under 11–38% in adults. One study found that those who immigrated to Australia after age 20 had fewer AKs than native Australians in all age groups.
Research.
Diagnostically, researchers are investigating the role of novel biomarkers to assist in determining which AKs are more likely to develop into cutaneous or metastatic SCC. Upregulation of matrix metalloproteinases (MMP) is seen in many different types of cancers, and the expression and production of MMP-7 in particular has been found to be elevated in SCC specifically. The role of serin peptidase inhibitors (Serpins) is also being investigated. SerpinA1 was found to be elevated in the keratinocytes of SCC cell lines, and SerpinA1 upregulation was correlated with SCC tumor progression "in vivo". Further investigation into specific biomarkers could help providers better assess prognosis and determine best treatment approaches for particular lesions.
In terms of treatment, a number of medications are being studied. Resiquimod is a TLR 7/8 agonist that works similarly to imiquimod, but is 10 to 100 times more potent; when used to treat AK lesions, complete response rates have range from 40 to 74%. Afamelanotide is a drug that induces the production of melanin by melanocytes to act as a protective factor against UVB radiation. It is being studied to determine its efficacy in preventing AKs in organ transplant patients who are on immunosuppressive therapy. Epidermal growth factor receptor (EGFR) inhibitors such as gefitinib, and anti-EGFR antibodies such as cetuximab are used in the treatment of various types of cancers, and are currently being investigated for potential use in the treatment and prevention of AKs.


Medical education in the United States

Medical education in the United States includes educational activities involved in the education and training of physicians in the United States, from entry-level training through to continuing education of qualified specialists.
A typical outline of the medical education pathway is presented below; however, medicine is a diverse profession with many options available. For example, some physicians work in pharmaceutical research, occupational medicine (within a company), public health medicine (working for the general health of a population in an area), or join the armed forces.
Medical school.
In the United States a medical school is an institution with the purpose of educating medical students in the field of medicine. Admission into medical school may not technically require completion of a previous degree; however, applicants are usually required to complete at least 3 years of "pre-med" courses at the university level because in the US medical degrees are classified as Second entry degrees. Once enrolled in a medical school the four years progressive study is divided into two roughly equal components: pre-clinical (consisting of didactic courses in the basic sciences) and clinical (clerkships consisting of rotations through different wards of a teaching hospital). The degree granted at the conclusion of these four years of study is Doctor of Medicine (M.D.) or, less commonly, Doctor of Osteopathic Medicine (D.O.) depending on the medical school; both degrees allow the holder to practice medicine after completing an accredited residency program.
Internship.
During the last year of graduate medical education, students apply for postgraduate "residencies" in their chosen field of specialization. These vary in competitiveness depending upon the desirability of the specialty, prestige of the program, and the number of applicants relative to the number of available positions. All but a few positions are granted via a national computer match which pairs an applicant's preference with the programs' preference for applicants.
Historically, post-graduate medical education began with a free-standing, one-year internship. Completion of this year continues to be the minimum training requirement for obtaining a general license to practice medicine in most states. However, because of the gradual lengthening of post-graduate medical education, and the decline of its use as the terminal stage in training, most new physicians complete the internship requirement as their first year of residency.
Notwithstanding the trend toward internships integrated into categorical residencies, the one-year "traditional rotating internship" (sometimes called a "transitional year") continues to exist. Some residency training programs, such as in neurology and ophthalmology, do not include an internship year and begin after completion of an internship or transitional year. Some use it to re-apply to programs into which they were not accepted, while others use it as a year to decide upon a specialty. In addition, osteopathic physicians "are required to have completed an American Osteopathic Association (AOA)-approved first year of training in order to be licensed in Florida, Michigan, Oklahoma and Pennsylvania."
Residency.
Each of the specialties in medicine has established its own curriculum, which defines the length and content of residency training necessary to practice in that specialty. Programs range from 3 years after medical school for internal medicine and pediatrics, to 5 years for general surgery, to 7 years for neurosurgery. Each specialty training program either incorporates an internship year to satisfy the requirements of state licensure, or stipulates that an internship year be completed "before" starting the program at the second post-graduate year (PGY-2).
Fellowship.
A fellowship is a formal, full-time training program that focuses on a particular area within the specialty, with requirements beyond the related residency. Many highly specialized fields require formal training beyond residency. Examples of these include cardiology, endocrinology, oncology after internal medicine; cardiothoracic anesthesiology after anesthesiology; cardiothoracic surgery, pediatric surgery, surgical oncology after general surgery; reproductive endocrinology/infertility, maternal-fetal medicine, gynecologic oncology after obstetrics/gynecology. There are many others for each field of study. In some specialties such as pathology and radiology, a majority of graduating residents go on to further their training. The training programs for these fields are known as "fellowships" and their participants are "fellows", to denote that they already have completed a residency and are board eligible or board certified in their basic specialty. Fellowships range in length from one to three years and are granted by application to the individual program or sub-specialty organizing board. Fellowships often contain a research component.
Board certification.
The physician or surgeon who has completed his or her residency and possibly fellowship training and is in the practice of his or her specialty is known as an attending physician. Physicians then must pass written and oral exams in their specialty in order to become board certified. Each of the 26 medical specialties has different requirements for practitioners to undertake continuing medical education activities.
Continuing Medical Education.
Continuing medical education (CME) refers to educational activities designed for practicing physicians. Many states require physicians to earn a certain amount of CME credit in order to maintain their licenses.  Physicians can receive CME credit from a variety of activities, including attending live events, publishing peer-reviewed articles, and completing online courses. The Accreditation Council for Continuing Medical Education (ACCME) determines what activities are eligible for CME.


Mary V. Seeman

Mary V. Seeman, FRCPC, is a Canadian psychiatrist who is Professor Emerita in the Department of Psychiatry at the University of Toronto. She served as the Tapscott Chair in Schizophrenia from 1997 to 2000.
Seeman is a psychiatrist who has written on gender influences on outcome in schizophrenia, women in schizophrenia, and the impact of parenting with a mental illness.
Personal life.
She is married to scientist Philip Seeman. Mother to Marc, Bob, and Neil Seeman, and grandmother to Ahron, Geoff, Ciara, David, Ronan, and Dori.


William Henry Sutherland

Dr. William Henry Sutherland (November 19, 1876 – September 3, 1945) was a physician and political figure in British Columbia. He was mayor of Revelstoke from 1912 to 1916. He represented Revelstoke from 1916 to 1933 and Columbia-Revelstoke from 1933 to 1937 in the Legislative Assembly of British Columbia as a Liberal.
He was born in Sea View, Prince Edward Island, the son of Robert Sutherland, and received his early education at Prince of Wales College and his medical degree at McGill University. He served as house surgeon for the Royal Victoria Hospital in Montreal from 1899 to 1901. He then became divisional surgeon for the C.P.R. and moved to Kamloops. In 1902, Sutherland set up practice in Revelstoke. He married Lillian O'Donahoe in 1907. Sutherland became president of the British Columbia Medical Council in 1909. Sutherland served in the provincial cabinet as Minister of Public Works from 1922 to 1928 and was regarded as a leading figure in the Liberal party. When the Liberal government was defeated in 1928, he became house surgeon for the Hotel Vancouver. Sutherland married Ruth Catherine McKinnon after the death of his first wife. He died, while retired, in Vancouver at the age of 68.


Charles A. Dinarello

Charles A. Dinarello (born April 22, 1943) is a professor of medicine at the University of Colorado at Denver. He is an expert on inflammatory cytokines, specifically Interleukin 1.
Education and career.
Dinarello received his Doctor of Medicine in 1969 at Yale University and since 1996, he is Professor of Medicine at University of Colorado School of Medicine. He is also Professor of Experimental Medicine at the Radboud University Medical Center in Nijmegen, The Netherlands. Dinarello is considered one of the founding fathers of cytokines having purified and cloned interleukin-1. This important step established the validation of cytokines as mediators of disease, particularly of inflammation. Current studies blocking IL-1 in humans supports Dinarello's and his co-workers pivotal contributions to cytokine biology and the pathogenesis of inflammatory diseases.
He is fluent in English, Italian and German.


Bone marrow-derived macrophage

Bone-marrow-derived macrophage (BMDM) refers to macrophage cells that are generated in a research laboratory from mammalian bone marrow cells. BMDMs can differentiate into mature macrophages in the presence of growth factors and other signaling molecules. Undifferentiated bone marrow cells are cultured in the presence of macrophage colony-stimulating factor (M-CSF; CSF-1). M-CSF is a cytokine and growth factor that is responsible for the proliferation and commitment of myeloid progenitors into monocytes (which then mature into macrophages). Macrophages have a wide variety of functions in the body including phagocytosis of foreign invaders and other cellular debris, releasing cytokines to trigger immune responses, and antigen presentation. BMDMs provide a large homogenous population of macrophages that play an increasingly important role in making macrophage-related research possible and financially feasible.
Production.
In order to produce BMDMs, mesenchymal stem cells are removed from the tibia or femur of mice. Since BMDMs are derived from bone marrow, withdrawn cells are healthy and naïve (or unactivated), regardless of the condition of donor mice. After removal, stem-cells are incubated with CSF-1. Without CSF-1, the cells enter an inactive state but can reinitiate growth and differentiation if stimulated later. Mature macrophages and fibroblasts, which may carry unwanted growth factors, are removed. Next, IL-3 and IL-1, two growth factors, are often added to increase yield and promote rapid terminal differentiation. Exogenous media containing growth factors and other serums must also be added to make the cells continually viable. Full growth and differentiation take approximately 5–8 days.
Millions of BMDMs can be derived from one mouse and frozen for years. After being thawed BMDMs can respond to a variety of stimuli such as LPS, IFN-γ, PAMPs, NF-κB, and IRF3. These signals induce translation of genes that produce cytokines and determine if macrophages are M1 (pro-inflammatory) or M2 (anti-inflammatory). If BMDMs are not frozen, they age and become less viable as CSF-1 and growth factors in their media decreases.
Proliferation of BMDMs can also be inhibited by a number of reagents. For example, growth and differentiation is dependent on CSF-1 and a functional CSF-1 receptor, a member of the tyrosine kinase family. Without a functional CSF-1 receptors, stem cells cannot respond to CSF-1 stimuli and therefore cannot differentiate; interferons can cause a down regulation of the CSF-1 receptor. Additionally, without stimuli like LPS to induce macrophage maturation to M1 or M2, mice accumulate a large pool of monocytes, the precursor cells to macrophages, which are less helpful for macrophage-specific research


Henry M. Jackson Foundation for the Advancement of Military Medicine

The Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF) was created by Congress in 1983 to accelerate progress in military medicine. HJF is a global nonprofit organization providing investigators and clinicians scientific, administrative and program management services. HJF serves as a trusted and responsive link between the military medical community, federal and private partners, and the millions of American service families, veterans and civilians who benefit from the on the medical research advances and that result from this work.
HJF was created to support Uniformed Services University of the Health Sciences (USU)[1] and throughout the military medical community. HJF was named in honor of Washington State Senator Henry "Scoop" Jackson, who sponsored the original legislation. Senator Jackson had a long-standing commitment to military medicine and health.
HJF provides scientific and management services, from infrastructure development, financial administration, clinical trials management to staffing and event planning. HJF works with a variety of programs, from large multi-site clinical trials to small, bench top projects, both nationally and abroad.
Long-time chief executive officer and president John W. Lowe retired after 25 years of serving HJF in May 2017. Retired Army Major General (Dr.) Joseph Caravalho, Jr. was named HJF CEO and president on September 1, 2017.
In 2000, HJF established the John W. Lowe Joint Office of Technology Transfer (JOTT) in partnership with USU. This department helps scientists expedite their novel inventions, devices and technologies to possible patenting and commercialization. The office's achievements vividly illustrate a tremendous untold story about military medicine: its commitment to sharing advances with service members and civilians alike. The JOTT has won 6 Federal Laboratory Consortium awards (2012, 2013, 2014, 2016, 2017, 2018).
HJF supports hundreds of additional research projects at USU and throughout military medicine, including the Center for Prostate Disease Research,[4] the Center for the Study of Traumatic Stress,[6] and the Center for Disaster and Humanitarian Assistance Medicine.[7] HJF's largest program is the U.S. Military HIV Research Program (MHRP),[3]whose mission is to protect U.S. military personnel and aid the international fight against HIV. Established in 1988, the program focuses on HIV vaccine development, prevention, disease surveillance, care and treatment for HIV.
HJF employs more than 2,600 scientific, medical, management and administrative personnel around the world. HJF also manages endowments for USU and promotes government-civilian partnerships[8] through its Public-Private Partnerships division, part of HJF's Strategic Initiatives [9].
Major events.
1983 – Congress passes legislation form the Foundation for the Advancement of Military Medicine and authorizes the Foundation to support medical research and education at USU and throughout the military medical community.
1983 – Renamed to The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. to honor the Senator that sponsored the legislation.
1990 – John W. Lowe becomes executive director of HJF. HJF manages over 80 education events for the three armed services as well as the Department of Veterans Affairs.
1992 – John W. Lowe becomes CEO and president. HJF sees continued expansion in support of more than 150 research programs.
1998 – HJF celebrates 15 years of service.
1998 – HJF Fellowship program is initiated, with awards presented annually to an outstanding graduate student at USU.
2000 – HJF employs nearly 1,200 scientific, medical, management and administrative personnel and ranks in the top 7 percent of all NIH-funded organizations.
2000 – In partnership with USU, HJF establishes the Joint Office of Technology Transfer to help scientists expedite their novel inventions, devices and technologies.
2001 – HJF establishes HJF Medical Research International, a subsidiary that registers its first branch office in Kampala, Uganda, to support employees and projects in foreign jurisdictions, including Egypt, Ghana, Thailand and Uganda. The subsidiary supports MHRP.
2003 – HJF begins support of Project Phidisa, an HIV clinical research program in South Africa.
2004 – HJF ranks as top 5 percent of institutions receiving funds from NIH.
2006 – HJFMRI Ltd./Gte., an independent Nigerian company, was created to fulfill specific research program needs in Nigeria.
2007 – HJF hires 250 employees in Kenya.
2008 – HJF celebrates its 25-year anniversary.
2009 – HJF surpasses the 2,000-employee mark for the first time in its history.
2009 – The Center for Public-Private Partnerships is created.
2011 – HJF moves its headquarters from Rockville to Bethesda to be closer to USU and other major clients.
2012 – HJF marks the 100-year anniversary of its namesake's birth with nearly 2,400 employees in 106 locations.
2015 – HJF receives the Military Officers Association of America's Distinguished Service Award for outstanding support to the military and veteran community.
2016 – A regional office opens in Nairobi, Kenya, to improve customer service to sub-Saharan clients.
2017 – Dr. Joseph Caravalho is named as president and CEO to replace John W. Lowe.
2018 – HJF celebrates its 35th anniversary with its Annual Report: We Are HJF.


Lieber Institute for Brain Development

The Lieber Institute for Brain Development (LIBD) is a nonprofit research center located in Baltimore, Maryland, that studies brain development issues such as schizophrenia and autism. The cause of most neuropsychiatric disorders remains unknown and current therapies such as antipsychotics and antidepressants treat symptoms rather than the underlying illness. Lieber is working to unravel the biological basis of these brain disorders and is developing therapies to treat or prevent their development.
History and Description.
The Lieber Institute was started in 2010 by Steve and Connie Lieber along with Milton and Tamar Maltz—both families have children with schizophrenia. Psychiatrist Daniel R. Weinberger is the CEO. Having gathered over 3,000 brains for research purposes, the institute has the largest collection of post-mortem brains diagnosed with post-traumatic stress disorder. These brains are used to study the biological basis for mental illnesses. In one study of post-mortem brains, LIBD researchers found that patients with schizophrenia had high levels of DNA methylation in brain regions associated with risk for schizophrenia. They are also developing a drug to prevent post-traumatic stress disorder.
Research and Partnerships.
In 2011, researchers who later joined the Lieber Institute published a review of brain banks for studying diseases such as schizophrenia, alzheimer’s diseases, bipolar disorder, and other psychiatric illnesses. Postmortem human brain tissue is critical for advancing neurobiological studies of psychiatric illness.
In a December 2015 paper in Neuron, the Lieber Institute announced the formation of a new consortium called BrainSeq, along with seven pharmaceutical partners. The consortium’s goal is to analyze post mortem brain samples for DNA, RNA and DNA-methylation differences establish a public database.
A paper by Lieber scientists found that altering brain proteins caused the cells of autistic brains to behave normally. The specific type of autism is called Pitt–Hopkins syndrome and researchers are looking into possible treatments that could be used for the condition and for other types of autism.
Researchers with Lieber published a paper in "Nature Medicine" that examined the placenta and found that genes and pregnancy problems combine to increase the likelihood of developing schizophrenia. This study adds to growing evidence that the placenta is critical to understanding the health and course of pregnancy.
African Ancestry Neuroscience Research Initiative.
In 2019, the Lieber Institute announced a new initiative to study brain diseases in African Americans. The venture is a partnership with the African-American Clergy Medical Research Initiative, a group of clergy leaders in Baltimore. Research suggests that neuropsychiatric diagnoses are 20% more frequent in African-American communities than in communities of European ancestry. In studies of brain disorders, individuals of African descent make up, on average, less than 5% of research cohorts. Lieber Institute Director Daniel R. Weinberger wrote that individuals of African ancestry must be included in research for brain illnesses.
The African Ancestry Neuroscience Research Initiative will generate brain gene and protein expression profiles for people of African ancestry, a group that is greatly underrepresented in research examining the genetic causes of diseases. Lack of research involving African Americans is problematic because African Americans are 20% more likely to experience serious mental health problems than the general population and are about twice as likely to develop Alzheimer’s disease. Suicide rates for African American children aged 5–11 are twice as high as comparable individuals of European ancestry even after controlling for socioeconomic factors. In the summer of 2020, Governor Larry Hogan of Maryland budgeted $1.25 million to the effort, with another $1 million coming from Brown Capital, one of the oldest African-American founded asset management firms in the country.
LIBD Champions Council.
LIBD established a champions council of celebrities to mobilize awareness of the need for brain research . Members include actor John Turturro; country singer Naomi Judd; philanthropist Cynthia Germanotta; and composer Carman Moore.


Ramaswami Venkataswami

Professor Ramaswami Venkataswami is a plastic surgeon, founder of the Institute for the Research and Rehabilitation of Hand and the Department of Plastic Surgery (IRRH and DPS) of Stanley Medical College and Hospitals (SMC), Chennai, India. He founded the department in 1971 and headed it until 1991 when he retired from Government service. His major accomplishments include the creation of a dedicated hand injury service with staff, beds and operating theatre dedicated to the service. The service provided 24/7 management of acute hand injuries and housed all specialities related to the long-term management of such injuries - including physiotherapy, occupational health, and workplace rehabilitation. He also initiated the use of microsurgical methods in the repair and reconstruction at Stanley in 1978-79 (the first microsurgical procedure in the department was carried out in 1980). He is an alumnus of SMC and an elected fellow of the National Academy of Medical Sciences.
Prof. Venkataswami joined SMC in 1951 for his MBBS and followed it with a postgraduation in general surgery. After this, he went to Nagpur Medical College to specialise in plastic surgery. He later founded the Department of Plastic Surgery at SMC.
Prof. R. Venkataswamy is awarded Padma Shri, the fourth highest civilian award in the Republic of India, for his outstanding contribution in the year 2019.
As of July 2012, Prof. Venkataswami practices at Apollo First Med Hospital in Chennai.


Monica Fletcher

Monica Fletcher OBE (née Smith) is a British nurse.
Monica Fletcher has been Chief Executive of Education for Health, an international medical education charity based in Warwick which focuses on improving the quality of life of people living with long term conditions through the provision of high quality health professional education, since 2001.
Fletcher graduated from the Health Services Management Centre at Birmingham University with an MSc degree in Healthcare Policy and Management in 1997.
Monica Fletcher was Co-director of Primary Care for the NHS Executive London, Director of Primary Care in the Tower Hamlets Healthcare Trust, and Nurse Advisor in Birmingham. She is past Chair of the European Lung Foundation.
Fletcher was appointed an Officer of the Order of the British Empire (OBE) in the 2013 Birthday Honours for services to nursing and nursing education. She was named as a Fellow of The Queen's Nursing Institute in 2014. Fletcher is an Associate of the Center for Managing Chronic Disease at the University of Michigan. Fletcher took up the role of Knowledge Exchange Lead for the Asthma UK Centre for Applied Research (AUKCAR) in 2015.


Shahnaz Ali

Shahnaz Ali OBE is a British woman best known for her leadership role in equality, inclusion and human rights in the National Health Service and local government in England. She is also known for her activism, as a young woman, in the anti-racist struggles in Bradford in the 1980s. She was appointed an OBE in the Queen's New Year's Honours list, December 2012 in recognition of her contributions to Equality and Diversity.
Family and educational background.
Shahnaz Ali was born in Pakistan and came to England with her family, at the age of 3, in summer of 1965. She grew up in Bradford and attended Leeds Metropolitan University, earning an MA in Policy Studies in 1996.
Political activism.
As a teenager growing up in Bradford, Shahnaz Ali was part of a South Asian community that was increasingly subject to hostility and racist attacks from part of the white, indigenous population. She became involved in the United Black Youth League of Bradford and took an active part in its struggles for justice and the right to live without victimisation. See also 1981 England riots. This included resisting the regular bouts of 'Paki-bashing' undertaken in the city by racists, because the police did little to protect the communities under attack. In July 1981, 12 young men from the League were arrested and charged with making explosive substances and a conspiracy to make explosive substances. If found guilty, they would have faced life imprisonment. Shahnaz Ali was detained and interviewed along with the 12 young Asian men, but never charged. The 12 were found not guilty by a verdict of 11–1 in 1982 after a trial lasting 31 days.
Ali was interviewed by the BBC for a documentary it made to mark the 30th anniversary of the Bradford 12 event. She also describes her own involvement in these events in a Podcast interview with Christine Burns.
Work history.
From December 2007, Ali was Director of Equality, Inclusion and Human Rights at NHS North West, the strategic health authority for the region. During that time, she has gained national recognition for her strategic leadership on equalities work.
Her work has included publishing a five-year strategy, Narrowing the Gaps, for transformative change of equality outcomes at regional level.
The strategy was in turn based on original in-depth research and analysis, published in October 2008 as "A Landscape of the Region"
Based on that research her programme also involved:
Ali and her team developed a philosophy for transformation over the period 2008–12 which they published in a recent peer reviewed journal paper. The paper was followed by the publication of a textbook, 'Making Equality Work' co-authored with Christine Burns and Loren Grant, in September 2013.


Sidney Coupland

Sidney Coupland (3 December 1849 – 29 April 1930 in Boars Hill near Oxford) was an English physician, specializing in pathological anatomy.
Life.
He was the son of William Newton Coupland, a merchant of Streatham. After education at Hove House School, Brighton, Sidney Coupland became a medical student at University College, London, where he qualified M.R.C.S. in 1871 and then held residency posts. At Middlesex Hospital, he became in 1873 pathologist, in 1875 assistant physician, in 1879 full physician, and in 1891 dean of the medical school. After serving as a full physician from 1879 to 1898 at Middlesex Hospital, he resigned to become one of the eleven Commissioners in Lunacy and served in that capacity from 1898 to 1914, and then from 1914 to 1921 as a member of the Board of Control for Lunacy and Mental Deficiency. He retired in 1921.
Coupland received his higher medical doctorate M.D.Lond. in 1874 and was elected F.R.C.P. in 1880. Perhaps his most important publications were the 6 reports, published from 1889 to 1896, on smallpox outbreaks; the reports were prepared for the 1889 Royal Commission on Vaccination.
Coupland delivered the Goulstonian Lectures ("Anaemia") in 1881 and the Harveian Oration ("Observations on the Statistics in Regard to Mental Disorders and their Occurrence") in 1915.
In 1880 in Bath, Somerset, he married Bessie Potter. Their only surviving son was Reginald Coupland, who became a professor of history at the University of Oxford.


Gina M. Biegel

Gina M. Biegel is an American Author and Psychotherapist.
Biography.
Gina M. Biegel is a graduate of Santa Clara University. She is the author of "The Stress Reduction Workbook for Teens". Biegel is a Licensed Marriage and Family Therapist (LMFT) specializing in mindfulness-based stress reduction. She is also the director of research for Mindful Schools.


Jean-Pierre Garen

Jean-Pierre Garen (10 November 1932 – 4 March 2004) was a French physician and author of soft science fiction novels about Mark Stone, agent of the Surveillance Service Of Primitive Planets.


National Committee for Quality Assurance

The National Committee for Quality Assurance (NCQA) is an independent 501(c)(3) nonprofit organization in the United States that works to improve health care quality through the administration of evidence-based standards, measures, programs, and accreditation. The National Committee for Quality Assurance operates on a formula of measure, analyze, and improve and it aims to build consensus across the industry by working with policymakers, employers, doctors, and patients, as well as health plans.
History.
The National Committee for Quality Assurance was established in 1990 with support from the Robert Wood Johnson Foundation.
Programs.
The National Committee for Quality Assurance manages voluntary accreditation programs for individual physicians, health plans, and medical groups. It offers dedicated programs targeting vendor certification, software certification, and compliance auditing.
Health plans seek accreditation and measure performance through the administration and submission of the Healthcare Effectiveness Data and Information Set (HEDIS) and Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. The National Committee for Quality Assurance provides an evidence-based program for case-management accreditation available for uses in payer, provider, and community-based organizations.


Association of Cancer Physicians

The Association of Cancer Physicians (ACP) is a specialty association in the United Kingdom for medical oncologists. The ACP is recognised by the Royal College of Physicians and the Department of Health, and provides training and regular meetings for members.
Membership of the ACP gives medical oncologists an independent voice in the affairs of the Royal College of Physicians, the Joint Collegiate Council for Oncology (JCCO) and the Specialty Advisory Committee (SAC), who supervise training and accreditation.
Through this, we:
Meetings and workshops.
Calendar of Events
2017
2016
2015


Pierre-Constant Budin

Pierre-Constant Budin (; 9 November 1846 – 22 January 1907) was a French obstetrician who was a native of Enencourt-le-Sec, a village in northern France.
In 1876 he earned his medical degree in Paris, and in 1882 became chief obstetrician at the Hôpital de la Charité. In 1895 he succeeded Étienne Stéphane Tarnier (1828-1897) as chair of obstetrics at the Hôpital Maternité. Budin was a member of the Académie de Médecine, and an officer of the Légion d'honneur.
Pierre Budin was a founder of modern perinatal medicine, and made many contributions in efforts to reduce infant mortality. He stressed the importance of proper nutrition and prevention of infectious disease in newborns, as well as education of new mothers on these subjects. Due to the problem of gastroenteritis in infants caused by contaminated cow's milk, Budin was a major proponent of breastfeeding, and believed in a substitution of sterilized milk if natural nutrition failed. He also popularized a technique known as gavage for feeding premature infants who were too weak to receive nourishment by conventional methods.
He was the author of "Le nourrisson: alimentation et hygiène - enfants débiles, enfants nés à terme" (1900), a book that was later translated into English as "The Nursling. The feeding and hygiene of premature and full-term infants" (1907).


Kirk Wendelburg

An American veterinary surgeon, co-Inventor/developer of KYON Total Elbow Replacement and one of the first to implement Specialty Veterinary Hospitals in Southern California. He received his Doctorate of Veterinary Medicine from the University of Florida in 1982. Immediately upon receiving his doctorate, he continued onto a one-year internship and three-year residency at the Ohio State University. In 1989 he received board certification and is now recognized as a Diplomate of the American College of Veterinary Surgeons. He founded the Animal Specialty Group in 1990, and has proceeded to establish ASG as one of the leading veterinary specialty hospitals in the country.
Innovations.
Total Elbow Replacement.
 One of the most notable developments by Dr. Wendelburg in recent has been the invention of a prosthesis for canine total elbow replacement. This revolutionary prosthesis surgically treats elbow dysplasia in canines and was developed with the help of Kyon, a leading Swiss veterinary surgical product company . While many surgical procedures, including, but not limited to, arthroscopic techniques do not allow for a full recovery and may only lead to short-term results. Dr. Wendelburg's prosthesis is the "first and only to allow for a Biomechanically Anatomical, Nonconstrained, Compartmental (BANC) Elbow Arthroplasty" The prosthesis also allows the surgeon to make an intraoperative decision as to whether a partial or full replacement is necessary, which is due primarily to its modular design. It allows for a full recovery by allowing for normal movement by eliminating mechanical links that might cause unnecessary stress.
Along with the prosthesis, a repeatable and precise implantation method was created by Dr. Wendelburg. This procedure included the invention of different tools, including, but not limited to, a tool for identifying arc rotation within individual patients to allow for stress-free function of the joint.
Scientific Publications.
• Disease Mechanisms in Small Animals Surgery Second edition

• 42. Wendelburg K. et al.: Stress fractures of the acetabulum in 26 racing greyhounds Vet Surg 17:128, 1988

• Wendelburg K, (1993), Masticatory Muscle Myositis. In, Bojrab MJ,


Low-set ears

Low-set ears are a clinical feature in which the ears are positioned lower on the head than usual. They are present in many congenital conditions. Specifically, low-set ears are defined as outer ears positioned two or more standard deviations lower than the population average.
Low-set ears can be associated with conditions such as:
It is usually bilateral, but it can be unilateral in Goldenhar syndrome.


Vishnu Jejjala

Vishnumohan "Vishnu" Jejjala (born January 15, 1975) is an Indian-American physicist who specializes in string theory.
Jejjala was born in Coimbatore, India. His family moved to the United States in 1980. Jejjala earned Bachelor of Science degrees in physics, mathematics, and astronomy from University of Maryland at College Park in 1996. He earned a Master of Science and Ph.D. in physics in 2002 from University of Illinois at Urbana-Champaign. He did postdoctoral work at Virginia Tech from 2002 to 2004, Durham University from 2004 to 2007, and Institut des Hautes Études Scientifiques from 2007 to 2009. Since 2009, he has been at Queen Mary, University of London.


Maurice Favre

Maurice Favre (1876 – 1954) was a French dermatologist who gave his name to Durand-Nicolas-Favre disease, Gamna-Favre bodies and Favre–Racouchot syndrome.


John Primrose Douglas

Major-General John Primrose Douglas (22 February 1908 – 4 September 1975), was Honorary Surgeon to the Queen.
Commissioned a Lieutenant in the R.A.M.C. in April 1933, his first posting overseas was to Gibraltar, 1934–39, during the time of the Spanish Civil War. In May/June 1937 he assisted in treating two batches of naval casualties which were evacuated to the Military Hospital - one batch was from the German armoured ship Deutschland that had been attacked by Spanish Republican aircraft, and which had made for Gibraltar as the nearest specialist treatment centre. For his work with both casualty groups, Captain Douglas was awarded the M.B.E. (1938 Birthday Honours) and the German Red Cross Order.
His administrative work during World War 2 with the allies brought him a clutch of awards from the US, Czechoslovakia, Netherlands and Belgium, including Knight Commander of the Oranje Order Nassau with Swords (15 October 1945), and in addition he was awarded the O.B.E..
Promoted to Brigadier in May 1961, he was advanced to Major-General in August 1965. In 1965 he was appointed Honorary Surgeon to the Queen and in 1968 was awarded the C.B..


Resource-based relative value scale

Resource-based relative value scale (RBRVS) is a schema used to determine how much money medical providers should be paid. It is partially used by Medicare in the United States and by nearly all health maintenance organizations (HMOs).
RBRVS assigns procedures performed by a physician or other medical provider a "relative value" which is adjusted by geographic region (so a procedure performed in Manhattan is "worth" more than a procedure performed in Dallas). This value is then multiplied by a fixed "conversion factor," which changes annually, to determine the amount of payment.
RBRVS determines prices based on three separate factors: physician work (54%), practice expense (41%), and malpractice expense (5%).
The procedure codes and their associated RVUs are made publicly available by CMS as the Physician Fee Schedule.
Example.
For example, in 2005, a generic 99213 Current Procedural Terminology (CPT) code was worth 1.39 Relative Value Units, or RVUs. Adjusted for North Jersey, it was worth 1.57 RVUs. Using the 2005 Conversion Factor of $37.90, Medicare paid 1.57 * $37.90 for each 99213 performed, or $59.50. Most specialties charge 200–400% of Medicare rates for their procedures and collect between 50–80% of those charges, after contractual adjustments and write-offs.
Criticism.
The RBRVS system has been criticized on a number of grounds:
History.
RBRVS was created at Harvard University in their national RBRVS study from December 1985 and published in JAMA on September 29, 1988. William Hsiao was the principal investigator who organized a multi-disciplinary team of researchers, which included statisticians, physicians, economists and measurement specialists, to develop the RBRVS.
In 1988 the results were submitted to the Health Care Financing Administration (today CMS) to be used in the American Medicare system. In December of the following year, President George H. W. Bush signed into law the Omnibus Budget Reconciliation Act of 1989, switching Medicare to an RBRVS payment schedule. This took effect on January 1, 1992. Starting in 1991, the AMA has updated RBRVS continually. As of May 2003, over 3500 corrections have been submitted to CMS.
Procedure.
Committees.
Physicians bill their services using procedure codes developed by a seventeen-member committee known as the CPT Editorial Panel. The AMA nominates eleven of the members while the remaining seats are nominated by the Blue Cross and Blue Shield Association, the Health Insurance Association of America, CMS, and the American Hospital Association. The CPT Committee issues new codes twice each year.
A separate committee, the Specialty Society Relative Value Scale Update Committee (RUC), meets three times a year to set new values, determines the Relative Value Units (RVUs) for each new code, and revalues all existing codes at least once every five years. The RUC has 29 members, 23 of whom are appointed by major national medical societies. The six remaining seats are held by the Chair (an AMA appointee), an AMA representative, a representative from the CPT Editorial Panel, a representative from the American Osteopathic Association, a representative from the Health Care Professions Advisory Committee and a representative from the Practice Expense Review Committee. Anyone who attends its meetings must sign a confidentiality agreement.
Price setting.
The RBRVS for each CPT code is determined using three separate factors: physician work, practice expense, and malpractice expense.
The average relative weights of these are: physician work (52%), practice expense (44%), malpractice expense (4%).
A method to determine the physician work value was the primary contribution made by the Hsiao study. The RUC examines each new code to determine a relative value by comparing the physician work of the new code to the physician work involved in existing codes.
The practice expense, determined by the Practice Expense Review Committee, consists of the direct expenses related to supplies and non-physician labor used in providing the service, and the pro rata cost of the equipment used. In addition, there is an amount included for the indirect expenses.
In the development of the RBRVS, the physician work (including the physician's time, mental effort, technical skill, judgment, stress and an amortization of the physician's education), the practice expense and the malpractice expense are factored into the result. The calculation of the fee includes a geographic adjustment. The RBRVS does not include adjustments for outcomes, quality of service, severity, or demand.


Berenson-Eggers Type of Service

Berenson-Eggers Type of Service (BETOS) categories are used to analyze Medicare costs. All Health Care Financing Administration Common Procedure Coding System (HCPCS) procedure codes are assigned to a BETOS category. BETOS codes are clinical categories. There are seven high-level BETOS categories:
The Berenson-Eggers classification system was co-authored by Robert A. Berenson, MD, and colleague Dr. Egger.
The American College of Surgeons criticizes BETOS and suggests two improvements.
As of 01/27/2016, CMS stopped publishing the BETOS crosswalk file.


Shoumo Bhattacharya

Shoumo Bhattacharya is an Indian medical doctor and academic, and the British Heart Foundation (BHF) Professor of Cardiovascular Medicine at the BHF Centre of Research Excellence, University of Oxford.
Education and career.
Bhattacharya studied medicine at the All India Institute of Medical Sciences, Delhi, qualifying as MBBS 1983, and MD in 1985.
He trained in cardiology at Northwick Park and Hammersmith Hospitals in London, where he was also a Medical Research Council (MRC) Training Fellow. He then held BHF and National Institutes of Health (NIH) Fellowships at the Dana-Farber Cancer Institute. Bhattacharya was a Wellcome Trust Senior Fellow at Oxford from 1998 to 2008. He was awarded a BHF Professorship in 2009 and was elected to a statutory Professorship at the University of Oxford in 2010.
Bhattacharya is also a Governing Body Fellow of Green Templeton College and member of the College Council.
Research interests.
Bhattacharya's research focuses on genetic mechanisms in heart development and congenital heart disease, and developing novel therapeutics and targets. This includes research on how proteins in the saliva of ticks might be able to prevent myocarditis. His work has also investigated which genes are critical for the heart to develop normally and maitain healthy function in adulthood, using genetic techniques and state-of the art imaging technology to study how alterations in these genes affect the structure of the heart and lead to congential heart anomalies or heart failure. He has also been investigating how environmental factors act together with gene variations to influence the development of heart conditions, for example studying how a mother's diet may affect the chances of congenital heart disease in the baby, and how stress (such as high blood pressure) interacts with gene variations to cause heart failure.
Recognition.
Bhattacharya was elected a Fellow of the Royal College of Physicians in 2003 and was awarded the Graham Bull Prize from the Royal College of Physicians in 2005. He was elected a Fellow of the Academy of Medical Sciences in 2006.


Albert R. Behnke

Captain Albert Richard Behnke Jr. USN (ret.) (August 8, 1903 – January 16, 1992) was an American physician, who was principally responsible for developing the U.S. Naval Medical Research Institute. Behnke separated the symptoms of Arterial Gas Embolism (AGE) from those of decompression sickness and suggested the use of oxygen in recompression therapy.
Behnke is also known as the "modern-day father" of human body composition for his work in developing the hydrodensitometry method of measuring body density, his standard man and woman models as well as a somatogram based on anthropometric measurements.
Early life.
Behnke was born August 8, 1903, in Chicago, Illinois. He moved to New Mexico and settled in Whittier, California, by 1912. Behnke graduated from Whittier College in 1925 and moved to San Francisco to attend medical school at Stanford University. Stanford Medical School required a one-year internship prior to conferring a medical doctorate. Behnke joined the United States Navy and completed his internship at the Mare Island Naval Hospital in 1930. In 1932, the Navy sent Behnke to the Harvard School of Public Health.
Naval career.
Following medical school in 1930, Behnke found his lifelong interest in deep sea diving when he was assigned as an assistant medical officer to and Submarine Division Twenty in San Diego under the command of Chester W. Nimitz. In addition to his other duties, Behnke spent time covering medical watch on , a submarine rescue ship, where he performed his first hard hat dive.
In 1932 Behnke wrote a letter to the Surgeon General that was published in the "United States Naval Medical Bulletin" outlining the possible causes of arterial gas embolisms he was seeing related to submarine escape training. This separated the symptoms of arterial gas embolism (AGE) from those of decompression sickness. This letter caught the attention of the director of the submarine medicine in the Bureau of Medicine, Captain E.W. Brown. Brown sent Behnke to do postgraduate work at the Harvard School of Public Health and research on diving and submarine medicine with fellow student Charles W. Shilling. Philip Drinker asked Behnke to stay for two additional years and the Navy allowed it.
Lieutenant junior grade Behnke was then sent to Pearl Harbor in 1935 to the Submarine Escape Training Tower. Later that year, Behnke "et al." experimented with oxygen for recompression therapy. Evidence of the effectiveness of recompression therapy utilizing oxygen was later shown by Yarbrough and Behnke and has since become the standard of care for treatment of DCS.
Behnke also began to outline his idea for a medical laboratory in 1936. That outline would eventually become the Naval Medical Research Institute (NMRI) now located with the National Naval Medical Center. In 1937, Behnke introduced the “no-stop” decompression tables.
After being transferred to Washington, D.C., in 1938, Behnke was assigned to medical duty at the Experimental Diving Unit (NEDU).
The submarine USS "Squalus" sank in 1939 and Behnke responded with fellow NEDU personnel Commanders Charles Momsen and Allan McCann, Yarbrough and Wilmon, and master diver James McDonald with more divers. They met Shilling on site to begin work. Divers from the submarine rescue ship , under the direction of the salvage and rescue expert Momsen, employed the new Rescue Chamber he had invented years earlier but which the US Navy command had repeatedly blocked. They were able to rescue all 33 surviving crew members from the sunken submarine including future Rear Admiral Oliver F. Naquin. The salvage divers used recently developed heliox diving schedules and successfully avoided the cognitive impairment symptoms associated with such deep dives, thereby confirming Behnke's theory of nitrogen narcosis.
Later in 1939, Behnke and Yarborough demonstrated that gases other than nitrogen also could cause narcosis. From his results, he deduced that xenon gas could serve as an anesthetic, even under normobaric conditions but was too scarce to allow for confirmation. Although Lazharev, in Russia, apparently studied xenon anesthesia in 1941, the first published report confirming xenon anesthesia was in 1946 by J. H. Lawrence, who experimented on mice. Xenon was first used as a surgical anesthetic in 1951 by Stuart C. Cullen, who successfully operated on two patients.
Taking advantage of the positive public support for Navy diving following the "Squalus" rescue, Behnke contacted Franklin D. Roosevelt and with Presidential interest known, received approval for the construction of his research laboratory (NMRI).
On December 7, 1941, when the attack on Pearl Harbor began, Behnke was at sea on and immediately reassigned to medical posts around Hawaii.
Behnke returned to Washington and soon opened NMRI as the "research executive" in October 1942. Behnke focused his interest in how physical fitness and fat content effects inert gas elimination and started projects to evaluate this relationship. His research lead us to consider him the "modern-day father" of human body composition for "his pioneering studies of hydrostatic weighing in 1942, the development of a reference man and woman model, and somatogram based on anthropometric measurements underlie much current work in body composition assessment"
When the people of Occupied Germany were suffering from starvation, Behnke focused his attention to increasing their food ration.
Behnke remained at NMRI until 1950 when he was transferred to his final assignment at the Naval Radiological Defense Laboratory (NRDL) at the San Francisco Naval Shipyard. His work on physical fitness and body habitus continued in projects surrounding radiological shelters and decontamination.
In 1950, Behnke earned the Navy and Marine Corps Medal "for saving the life of a civilian skin diver who surfaced too quickly off Monterey. Behnke, then a Navy captain, spent two days in a decompression chamber with the man."
Upon retiring from the Navy in 1959, Behnke turned over command of the NRDL to Captain Harry S. Etter.
Civilian career.
Upon his retirement from the Navy in 1959, Behnke became a professor of preventive medicine at the University of California and Director of the Institute of Applied Biology, Presbyterian Medical Center, San Francisco, California.
Behnke served on the first Board of Advisors for the National Association of Underwater Instructors and taught medical aspects of diving at their first Instructor Candidate Course that started on August 26, 1960, in Houston, TX.
The bends prevention and safety program for crews working in underground caissons to build the Bay Area Rapid Transit system was designed by Behnke in 1964.
Behnke with several other researchers founded the Undersea Medical Society (now the Undersea and Hyperbaric Medical Society) in 1967.
The term "oxygen window" was first used by Behnke in 1967. Behnke refers to early work by Momsen on "partial pressure vacancy" (PPV) where he used partial pressures of O2 and He as high as 2-3 ATA to create a maximal PPV. Behnke then goes on to describe "isobaric inert gas transport" or "inherent unsaturation" as termed by LeMessurier and Hills, and separately by Hills, who made their independent observations at the same time. Van Liew "et al." also made a similar observation that they did not name at the time. The clinical significance of their work was later shown by Sass.
In 1975, Behnke was involved with experiments on cosmic particle radiation for the Apollo program.
Behnke award.
Starting in 1969, the Behnke award is given annually has been given each year by the Undersea and Hyperbaric Medical Society, Inc. to a scientist for outstanding scientific contributions to advances in undersea biomedical activity. The award carries an honorarium and a plaque. The first recipient was Behnke.
Awards and honors.
Established in 1916 and awarded by the Association of Military Surgeons of the United States, the Sir Henry S. Wellcome Medal and Prize is awarded annually for "the research work most valuable for the military service performed in any branch of medicine, surgery, or sanitation". Behnke was the 1941 recipient.
Behnke received the American College of Sports Medicine's Honor Award in 1976.
In 1977, Behnke was awarded an honorary Doctor of Science (Sc.D.) degree from Whittier College.
The Navy dedicated the NMRI Hyperbaric Research Facility on July 1, 1981, to Behnke.


Lab Lemco

'Lab Lemco' Powder is a refined meat extract that is very light in color and has been in production since 1865. This product is used in a wide range of bacteriological growth media. It has growth-promoting qualities for the culturing of cells in laboratories, and is much easier to handle than most other meat extracts.
Lemco refers to the original producer of the meat extract, the Liebig's Extract of Meat Company.


Keith Peters (physician)

Sir David Keith Peters (born 26 July 1938, in Baglan, Glamorgan) is a retired Welsh physician and academic. He was Regius Professor of Physic at the University of Cambridge from 1987 to 2005, where he was also head of the School of Clinical Medicine.
Education.
Educated at Glan Afan Grammar School Port Talbot, Peters graduated in Medicine from the Welsh National School of Medicine in 1961.
Career and research.
Peters' research interests focused on the role of the immune system in kidney and vascular diseases. His key achievements included increasing understanding of how a kidney disease called glomerulonephritis develops.
Between 1969 and 1975 Peters was successively Lecturer in Medicine, Lecturer in Medicine and Immunology, and Reader in Medicine, before being appointed Professor of Medicine and Director of the Department of Medicine at the Royal Postgraduate Medical School (RPMS) in 1977. Peters' research centred on the immunology of renal and vascular disease, and in particular on how delineation of immunological mechanisms could lead to new therapies for these disorders. In 1987 Peters moved to Cambridge where he was Head of the University's School of Medicine until 2005, and transformed its standing. Peters' major contributions to British medicine have been through the promotion of clinical research: at the RPMS he was responsible for sustaining the outstanding reputation of the Department of Medicine; and in Cambridge under his leadership the University's Clinical School became a major centre for medical research, complementing Cambridge's strengths in basic biomedical science. In 1990 he introduced the Cambridge MB-PhD programme which provides an integrated rsearch and clinical medicine training for gifted medical students, the first of its kind in the UK. He was a driving force for the partnership between the University, the Medical Research Council and Addenbrookes Hospital, for what has become the Cambridge Biomedical Campus. Many of the leading medical academics in the UK worked with Peters at Hammersmith and/or Cambridge.
From 2006-2008 Peters was Interim Director of the MRC National Institute of Medical Research and there conceived and initiated the development of what is now the Francis Crick Institute.
From 2012-2016 he served on the executive committee of the Francis Crick Institute in London.
Peters has also made national contributions to UK science through his memberships of the Prime Minister's Advisory Council of Science and Technology (ACOST) and its successor, the Council of Science and Technology (CST). He was Chair of Council of Cardiff University from 2004-2011.
From 2005-2016 he was a Senior Consultant in Research and Development for GlaxoSmithKline.
Awards and honours.
Peters was knighted in the 1993 New Year's Honours List, was elected a Fellow of the Royal Society (FRS) in 1995 and was the President of the Academy of Medical Sciences from 2002 to 2006 He was a Founding Fellow of the Learned Society of Wales.
Peters is an Honorary Fellow of Christ's College, Cambridge and Clare Hall, Cambridge, and has received Honorary Doctorates and Fellowships from the University of Wales College of Medicine and the following universities: Wales, Swansea, Aberdeen, Nottingham, Paris, Birmingham, Leicester, Glasgow, Edinburgh, St Andrews, Sussex, Bristol, Keele, Warwick, UCL, Kings College, Imperial College and Cardiff. At the Royal College of Physicians he delivered the Goulstonian Lecture in 1976, the Bradshaw Lecture in 1985, and the Harveian Oration in 2004. On 15 June 2016 he was awarded the degree of Doctor of Medical Science (honoris causa) by the University of Cambridge. He is a Foreign Member of the American Philosophical Society and a Foreign Member of the US National Academy of Medicine.In 2018 he was made an Honorary Freeman of the Worshipful Society of Apothecaries. In 2019 the research building housing the Cambridge Institute for Medical Research and the MRC Mitochondrial Biology Unit (the former MRC-Wellcome Trust Building) was renamed the Keith Peters Building.The Board Room at the Francis Crick Institute and a ward in the Renal Unit at Hammersmith Hospital are also named after him.
Peters was appointed Knight Grand Cross of the Order of the British Empire (GBE) in the 2018 New Year Honours for services to the advancement of medical science.


Micromastia

Micromastia (also called hypomastia, breast aplasia, breast hypoplasia, or mammary hypoplasia) is a medical term describing the postpubertal underdevelopment of a woman's breast tissue. Just as it is impossible to define 'normal' breast size, there is no objective definition of micromastia. Breast development is commonly asymmetric and one or both breasts may be small. This condition may be a congenital defect associated with underlying abnormalities of the pectoral muscle (as in Poland's syndrome), related to trauma (typically surgery or radiotherapy) or it may be a more subjective aesthetic description.
Self perceived micromastia involves a discrepancy between a person's body image, and her internalized images of appropriate or desirable breast size and shape. Societal ideals over breast size vary over time, but there exist many conceived ideas involving breasts and sexual attractiveness and identity across different cultures.
Causes.
Micromastia can be congenital or acquired disorder and may be unilateral or bilateral. Congenital causes include ulnar–mammary syndrome (caused by mutations in the TBX3 gene), Poland syndrome, Turner syndrome, and congenital adrenal hyperplasia. There is also a case report of familial hypoplasia of the nipples and athelia associated with mammary hypoplasia that was described in a father and his daughters. Acquired causes of micromastia include irradiation in infancy and childhood and surgical removal of prepubertal breast bud.
Treatment.
The procedure to remedy micromastia is breast enlargement, most commonly augmentation mammoplasty using breast implants. Other techniques available involve using muscle flap-based reconstructive surgery techniques (latissimus dorsi and rectus abdominis muscles), microsurgical reconstruction, or fat grafting.
Another potential treatment is hormonal breast enhancement, such as with estrogens.


Victor Aronstein

Victor Aronstein (1 November 1896 – 13 January 1945) was a German-Jewish doctor whose practice in Alt-Hohenschönhausen, Berlin served as a meeting place for communists and social democrats during the rule of the Nazi Party. He was deported to the Łódź Ghetto in 1941 and was then moved to Auschwitz, where he was murdered in 1945.


Vajira Hospital

Vajira Hospital (, ) is one of the first hospitals in Thailand, founded by King Rama VI. It is a teaching university hospital of the Faculty of Medicine Vajira Hospital, Navamindradhiraj University. It is situated on Samsen Road, Dusit District, Bangkok, Thailand.
Background.
Vajira Hospital is funded and operated by the Bangkok Metropolitan Administration (BMA). Following the establishment of the Faculty of Medicine Vajira Hospital (then BMA Medical College) it has been a teaching hospital since. It now houses the campus of the Faculty of Medicine, and also the training center of the Kuakarun Faculty of Nursing which are faculties of Navamindradhiraj University. Vajira is known for its excellency in clinical services, medical education and urban medication programs.
The hospital serves a large numbers of patients, serving more than 700,000 out-patient visits and around 30,000 in-patient admitted annually, predominantly in general healthcare, it also has various specialized departments and excellency centers such as a Cardiovascular center, an Oncology center, Neurosurgery center, Kidney center, and a Trauma center, one of Bangkok's finest Emergency Medicine center, and many more, serving as a referral center for many other hospitals. It has an in-patient capacity of 900 beds, the largest operated by the BMA, and within some of the country's largest hospitals.
History.
Public healthcare facilities or modern hospitals only became available in Siam in the late 19th century. But the number and quality of facilities were still insufficient to meet the rising public demand. When H.M. the King Vajiravudh (Rama VI) ascended to the throne, he follow a royal tradition that Kings of Siam would build temples and monasteries in order to contribute to Buddhism. However at the time, there were already large numbers of religious sites in Bangkok, so H.M. the King Vajiravudh decides on building a hospital instead, as to improve the lives of citizens, providing efficient primary healthcare. He donated money from his own private funds for the establishment of the hospital. The hospital was built in an area once called “Himmapan Garden” located in the northern part of Bangkok, near the bank of Chao Phraya River.
The hospital was opened by King Vajiravudh on January 2, 1913 (B.E. 2455). The King named the hospital "Wachiraphayaban" (วชิรพยาบาล) translated "Vajira Healthcare" or simply "Vajira Hospital". The hospital was appointed to the Ministry of Metropolis (กระทรวงนครบาล) for administration, but currently operated by the Bangkok Metropolitan Administration. It was one of the earliest built modern hospitals in Bangkok, serving areas of northern Bangkok and northern part of Thonburi areas.
In 1923, Prince Mahidol, the father of Thai modern medicine, was appointed director of the hospital. Vajira hospital underwent immense changes and improvements. It expanded from its historic site next to Samsen road to the edges of the Chao Phraya River. In 1954 it became a teaching hospital for its nursing school, now Kuakarun college of nursing. In 1985 it became a Medical School known as the Faculty of Medicine Srinakharinwirot University. Srinakharinwirot medical student attend clinical years training at Vajira hospital. Later on in 1993 the BMA Medical College was established, which headquarters here in Vajira hospital. BMA medical students spends their pre-clinic years at Mahidol University and clinic years in Vajira hospital. At the time Vajira hospital handles over 600 medical students, in clinic years alone.
By 1998 Vajira Hospital and BMA Medical College were merged to form a unity in healthcare services and education, under the name "BMA Medical College & Vajira Hospital". In 2010 BMA Medical College & Vajira Hospital along with Kuakarun College of Nursing joined to form a new University named University of Bangkok Metropolis, with the medical school's name changed to "Faculty of Medicine Vajira Hospital, University of Bangkok Metropolis".


American Board of Pathology

The American Board of Pathology (ABPath) is one of 24 member boards of the American Board of Medical Specialties. This organization was assembled in May 1936, under the approval of the Advisory Board for Medical Specialties (ABMS) and the American Medical Association (AMA) Council on Medical Education and Hospitals. It is the duty of the ABPath to grant certification in Anatomic Pathology, Clinical Pathology and/or Anatomic/Neuropathology to qualified Doctors of Medicine (M.D.).
Subspecialty certificates.
The ABPath issues Subspecialty certificates in:
Board certification.
For physicians to receive ABPath certification, they must:
The American Board of Pathology administers two "primary examinations": one examination in anatomic pathology and one in clinical pathology, where candidates pursuing combined certification are required to take both. Both examinations are in multiple-choice format with one best answer for each question.
Continuing Certification.
A physician who is board certified is recognized as a diplomate; one who has medical specialty expertise. To maintain this precedence, the physician must participate in the ABPath's program for Continuing Certification (CC). This program has a four-part framework that emphasizes 1) Professionalism and Professional Standing, 2) Lifelong Learning and Self-Assessment, 3) Assessment of Knowledge, Judgment, and Skills, and 4) Improvement in Medical Practice. This framework is used to evaluate:
All member boards under the ABMS have this four-part framework and these six core competencies as bases for their MOC programs.


Ziad Nasreddine

Ziad Nasreddine is a Canadian neurologist notable for creating the Montreal Cognitive Assessment (MoCA).
Biography.
He is a Lebanese immigrate to Canada, graduated from the University of Sherbrooke, Québec, and then completed a fellowship in Cognitive Neurology/Neurobehavior at UCLA. In 1992, during his residency program, Dr Nasreddine perceived the need for a more comprehensive cognitive screening adapted for clinicians, and thus developed his first comprehensive cognitive screening test. In 1996, after his fellowship, he decided to adapt his comprehensive screen and create a much quicker comprehensive assessment that is adapted to first line specialty clinics with high volume of patients.


Laterodorsal thalamic vein

The paired (right and left) laterodorsal thalamic veins () originate each from the lateral dorsal part of the corresponding half of the thalamus. Benno Shlesinger in 1976 classified these veins as belonging to the lateral group of thalamic veins ("").


Alfred E. Mann Institute for Biomedical Engineering

Founded in 1998, Alfred E. Mann Institute for Biomedical Engineering at the University of Southern California (AMI-USC) is a 501c(3) non-profit organization dedicated to biomedical engineering technology development. The Institute is located on the University Park Campus of USC in Los Angeles, California and focuses on helping to bridge the gap between discovery research and product commercialization. As of 2017, the Institute financial endowment is $180 million, with over $150 million donated by medical device entrepreneur and philanthropist Alfred E. Mann.


Avsunviroidae

The Avsunviroidae are a family of viroids. There are four species in three genera ("Avsunviroid", "Elaviroid" and "Pelamoviroid"). They consist of RNA genomes between 246–375 nucleotides in length. They are single-stranded covalent circles and have intramolecular base pairing. All members lack a central conserved region.
Replication.
Replication occurs in the chloroplasts of plant cells. Key features of replication include no helper virus required and no proteins are encoded for. Unlike the other family of viroids, "Pospiviroidae", "Avsunviroidae" are thought to replicate via a symmetrical rolling mechanism. It is thought the positive RNA strand acts as a template to form negative strands with the help of an enzyme thought to be RNA polymerase plus 3 II. The negative RNA strands are then cleaved by ribozyme activity and circularises. A second rolling circle mechanism forms a positive strand which is also cleaved by ribozyme activity and then ligated to become circular.
The site of replication is unknown but it is thought to be in the chloroplast and in the presence of Mg2+ ions.
Structure.
Predictions of structure have suggested that they exist either as rod-shaped molecules with regions of base pairing causing formation of some hair pin loops or have branched configurations.
The family has four stretches of conserved nucleotides, , , , from 5' to 3', plus their Watson-Crick pairings on the other end of the loop. This is part of its hammerhead ribozyme. Otherwise there is little structural similarity in the family. They do not have the conserved CCH, TCR, or TCH motifs, which is one of the features defining their separation from the Pospiviroidae.
Classification.
The family has three genera, with a total of five species.
Detection.
The lack of a long, central conserved region makes Avsunviroidae harder to identify than Pospiviroidae. A method to detect them is to use their circularity: a computer can piece together many overlapping reads that appear to form repeats when placed linearly.