Now You See It,Now You Don't – A Case of ‘Vanishing Bone’

Vanishing bones – no, not the movie fantasy of the ‘Invisible Man’ but a case of a rare disease that causes massive osteolysis or progressive bone dissolution. The idiopathic disease, which causes bone to be replaced by angiomatous tissue, has resulted in the disappearance of this patient's right clavicle and glenoid. Diagnostic evaluation can sometimes prove difficult but ironically in this age of higher technology, plain radiography has demonstrated to be more effective for a definitive diagnosis than nuclear medicine, MRI, CT, etc. The rate of progress of the disease is as unpredictable as the prognosis. While a variety of treatments have been tried, the results have been inconsistent and as yet there is still no consensus on successful patient treatment.     

Medicine, ethics and money

Since the end of the Middle Ages, physicians have been paid in different ways for the care they give. This payment must respect the ethical principles of equity, autonomy and benevolence-beneficence. Equity requires that everybody be treated according to his needs and not according to his means, the necessary means being offered by physicians or provided by society. Autonomy requires that the physician be independent so that no other consideration--including his own material interest--takes precedent over the patient's interests. Benevolence-beneficence places the emphasis on means, in accordance with evidence-based medicine, results being impossible to guarantee.     

Is What You See What You Get? Breast Specimen Handling Re-visited

Specimen radiography is already established as an essential adjunct to excisional biopsy of mammographically detected abnormalities. Two methods of specimen sectioning following the initial specimen radiograph are described. The techniques were devised to identify the lesion accurately in the specimen for subsequent pathological analysis. They have been tailored to suit the differing facilities at two Breast Screening Centres. The methods highlight the desirability of a cooperative multidisciplinary approach to the management of breast disease. They underline the importance of radiological localization of the lesion; not only for the surgeon, but also for the pathologist.     

循证医学与临床病案

临床医学正沿着循证医学的理念前进.临床医学的基石就是病历.病历是始于问病史,体格检查,加上常规检验和已普及的仪器检查.这些都是临床医学的原始资料,即证据.文章强调了提高病历质量的重要性,必需客观、真实、负责.     

Hidden in Plain Sight: Clinical Informaticians are the Oncology Subspecialists You Did Not Know You Needed

Clinical informatics is a young, diverse and rapidly growing field. We asked eight clinical informaticians from a variety of oncology specialties, training pathways and careers for personal narratives to illustrate the wide spectrum of clinical informatics careers. Primary clinical specialties included radiation oncology, medical/haematology oncology and palliative care. Training pathways included fellowship, non-fellowship formal training and informal training. Careers included clinical care, research, operations and industry. We summarised common themes and advice for trainees. We hope to raise awareness of clinical informatics among trainees and oncologists to reveal new career opportunities and to avoid inadvertently taking clinical informatics and informaticians for granted.