United States Navy Nurse Corps

The United States Navy Nurse Corps was officially established by Congress in 1908; however, unofficially, women had been working as nurses aboard Navy ships and in Navy hospitals for nearly 100 years. The Corps was all-female until 1965.
Pre-1908.
In 1811, William P.C. Barton became the first to officially recommend that female nurses be added to naval hospital staff. However, it wasn't until 19 June 1861 that a Navy Department circular order finally established the designation of "Nurse", to be filled by junior enlisted men. Fifteen years later, the duties were transferred to the designation Bayman (US Navy Regulations, 1876). Although enlisted personnel were referred to as nurses, their duties and responsibilities were more related to those of a hospital corpsman.
During the American Civil War, several African American women served as paid crew aboard the hospital ship "Red Rover" in the Mississippi River area in the position of nurse. The known names of four nurses are: Alice Kennedy, Sarah Kinno, Ellen Campbell and Betsy Young (Fowler). In addition volunteer nuns from the Catholic Sisters of the Holy Cross served aboard as nurses.
During the 1898 Spanish–American War, the Navy employed a modest number of female contract nurses in its hospitals ashore and sent trained male nurses to sea on the hospital ship "Solace".
1908–1917.
After the establishment of the Nurse Corps in 1908 by an Act of Congress, twenty women were selected as the first members and assigned to the Naval Medical School Hospital in Washington, D.C. Unfortunately, the navy did not provide room or board for them, and so the nurses—being a determined lot—rented their own house and provided their own meals.
In time, the nurses would come to be known as "The Sacred Twenty" because they were the first women to serve formally as members of the Navy. The "Sacred Twenty", as shown in the photo at the top of this page, were Mary H. Du Bose; Adah M. Pendleton; Elizabeth M. Hewitt; Della V. Knight; Josephine Beatrice Bowman, the third Superintendent of the Navy Nurse Corps, 1922–1935; Lenah H. Sutcliffe Higbee, the second Superintendent of the Navy Nurse Corps, 1911–1922; Esther Voorhees Hasson, the first Superintendent of the Navy Nurse Corps, 1908–1911; Martha E. Pringle; Elizabeth J. Wells; Clare L. De Ceu.; Elizabeth Leonhardt; Estelle Hine; Ethel R. Parsons; Florence T. Milburn; Boniface T. Small; Victoria White; Isabelle Rose Roy; Margaret D. Murray; Sara B. Myer; and Sara M. Cox. They would include three Nurse Corps Superintendents and twelve chief nurses.
The Nurse Corps gradually expanded to 160 on the eve of World War I. In addition to normal hospital and clinic duties, the nurses were active in training natives in U.S. overseas possessions as well as the Navy's male enlisted medical personnel. For a few months in 1913, Navy nurses saw their first shipboard service, aboard "Mayflower" and "Dolphin". The first permanent shipboard positions came in late 1920, when "Relief" went into commission with a medical staff that included Navy nurses.
World War I.
The entry of the United States into the First World War brought a great expansion of the Nurse Corps, both regular and reserve.
In 1917–18, the Navy deployed five base hospital units to operational areas in France, Scotland and Ireland, with the first in place by late 1917. Also serving overseas were Navy operating teams, including nurses, established for detached duty near the combat frontlines. Some of these teams were loaned to the United States Army during the intense ground offensives of 1918 and worked in difficult field conditions far removed from regular hospitals.
During the war, 19 Navy nurses died on active duty, over half of them from influenza. Three of the four Navy Crosses awarded to wartime Navy nurses were given posthumously to women who sacrificed their lives during the 1918 flu pandemic. Among those awarded the Navy Cross posthumously was Lillian Marie “Lillie” Murphy RN USNR (1887 -1918). Her citation reads, “For distinguished service and devotion to duty while serving at the Naval Base Hospital, Hampton Roads Virginia. During the epidemic of influenza, nurse Murphy worked day and night among the patients until stricken with the disease, as a result of which she lost her life. Nurse Murphy an immigrant from Toronto Canada, had moved to New York to study nursing at St. Mary Hospital, where she volunteered for the duty with the Naval Reserve. The surviving fourth nurse was Lenah H. Sutcliffe Higbee, the second superintendent of the corps, and the first living woman to receive the medal. In 1945, the USS "Higbee" became the first fighting ship to be named after a woman in the service.
By the time of the armistice on 11 November 1918, over 1550 nurses had served in Naval hospitals and other facilities at home and abroad. Shortly after the fighting's end, several Navy nurses were assigned to duty aboard transports bringing troops home from Europe. Some Navy nurses even ventured on ground patrols and aided Army soldiers during this time.
Interwar period.
With the close of World War I, many turned away from all things war-related and by 1935 the Nurse Corps' numbers had been reduced to 332. However, this reduction did not stop the corps from making advances; new courses of study in the areas of diet therapy, neuropsychiatry, physiotherapy, and anesthesia were introduced and it was these educational advances which were key to the steady rise in the corps' professional status within the service. Though generally treated as officers socially and professionally, and wearing uniform stripes similar to those for the officer ranks of Ensign through Lieutenant Commander, formal recognition as Commissioned officers did not come until World War II.
It was also during this interwar period that paid retirement for longevity and disability was authorized as well as the extension of regular service to include Navy hospital ships. In addition to caring for Naval personnel at home and abroad, the corps responded to a number of civil disasters and assisted in the evacuation of dependents from war-torn China in 1937.
World War II.
Preparation for the conflict again saw the Nurse Corps grow, with nearly eight hundred members serving on active duty by November 1941, plus over nine hundred inactive reserves. By war's end there would be 1,799 active component nurses and 9,222 reserves (with the overwhelming number of reserves on active duty) scattered across six continents.
Though black nurses applied, until 1945, African-American nurses were rejected by the Navy. Phyllis Mae Dailey became the first black nurse accepted in the Navy Nurse Corps on March 8, 1945. Edith DeVoe, the only black navy nurse to be transferred at the end of the war to the regular service, took her oath on April 18, 1945, and Eula L. Stimley entered service on May 8, 1945. Along with Helen Fredericka Turner, these four nurses were the first African-American women to serve in the Navy during World War II.
Navy nurses were on duty during the initial Japanese attack on Pearl Harbor, Kāneʻohe Bay, the Philippines, Guam, and aboard the "Solace"; they were vital in preventing further loss of life and limb. In fact, the nursing profession's vital role was quickly recognized and it became the only women's profession that was deemed so essential as to be placed under the War Manpower Commission. Despite shortages of qualified nurses during the war, the navy was able to hold to its standards and enroll nurses of outstanding qualifications and experience. These outstanding nurses received advanced training in surgery, orthopedics, anesthesia, contagion, dietetics, physiotherapy, and psychiatry, the latter helping men understand and manage Post Traumatic Stress Syndrome (then known as shell-shock) and battlefield fatigue. But the navy nurses' duties not only included the tending to the injured and sick but also to the equally serious task of training Hospital Corpsmen. Many of these young men had never seen the inside of a hospital unless they themselves had been admitted, and as such it was training from the ground up. Once trained, the men were sent to work aboard fighting ships and on invasion beaches, where nurses were not yet officially assigned. Additionally, nurses trained WAVES for the Hospital Corps.
In the Pacific, Navy Nurses were the first American women to be sent to the islands north of New Caledonia, and the first group to Efate, in the New Hebrides. At Efate they cared for the wounded from the long Guadalcanal Campaign, Army as well as Navy and Marine personnel. Others were stationed in New Caledonia, the Solomons, New Zealand, Australia, New Guinea, Coral Sea, Savo, Samoa, Tarawa, Attu, Adak, Dutch Harbor, Kwajalein, Guam, Saipan, Tinian, Leyte, Samar, Iwo Jima, and Okinawa. The purpose of these forward operating areas was stabilization. Only when patients were fully stabilized were they sent on to Pearl Harbor, and then eventually to the contiguous United States.
In Europe, navy nurses served in both England and Italy and in North and South America at Trinidad, Panama, Puerto Rico, Bermuda, Brazil, and Newfoundland. Navy nurses were even stationed in Africa.
In the contiguous United States, navy nurses were stationed at 263 locations, consisting of both large naval hospital complexes such as USN Hospital San Diego, California and Bethesda, Maryland as well as at a multitude of smaller naval convalescent hospitals and training station facilities. One of the more colorful convalescent hospitals was the USN Convalescent Hospital located at the Sun Valley Lodge in Idaho. After the lodge – built by the Union Pacific Railroad and its chairman W. Averell Harriman – opened in 1936, it quickly became a hotspot for the rich and famous. Notables included Ernest Hemingway who worked on For Whom the Bell Tolls in room No. 206, Clark Gable, Errol Flynn, Claudette Colbert, Bing Crosby and Gary Cooper. However, as supporting the war became a top priority and recreation secondary, the lodge was converted into a hospital, opening its doors in July 1943. In 1946 it reverted to its intended use. The story of the USN Convalescent Hospital is not unlike a host of other facilities which were converted, including the Averell Harriman estate in the Bear Mountains of the Catskills and the Ahwahnee Hotel at Yosemite National Park.
Aboard hospital ships, navy nurses followed the fleet in their assaults, and were eventually permitted to go to the beaches with the fighting men to pick up the wounded. Early in the war only the USS "Solace" and USS "Relief" brought comfort to the wounded fighting men via all-navy medical personnel. Later the "Bountiful", "Samaritan", "Refuge", "Haven", "Benevolence", "Tranquility", "Consolation", "Repose", "Sanctuary", and "Rescue" were added.
Prisoners of War.
Two groups of Navy nurses were held prisoner by the Japanese in World War II. Chief Nurse Marion Olds and nurses Leona Jackson, Lorraine Christiansen, Virginia Fogerty and Doris Yetter were taken prisoner on Guam shortly after Pearl Harbor and transported to Japan. They were repatriated in August 1942, although the newspaper did not identify them as Navy nurses.
Chief Nurse Laura Cobb and her nurses, Mary Chapman, Bertha Evans, Helen Gorzelanski, Mary Harrington, Margaret Nash, Goldia O'Haver, Eldene Paige, Susie Pitcher, Dorothy Still and C. Edwina Todd (some of the "Angels of Bataan") were captured in 1942 and imprisoned in the Los Baños internment camp, where they continued to function as a nursing unit, until they were rescued by American forces in 1945. Other Los Baños prisoners later said: "We are absolutely certain that had it not been for these nurses many of us who are alive and well would have died." The nurses were awarded the Bronze Star Medal by the Army, a second award by the Navy and the Army's Distinguished Unit Badge.
Ann Agnes Bernatitus, one of the Angels of Bataan, nearly became a POW; she was one of the last to escape Corregidor Island, via the USS "Spearfish". Upon her return to the United States she became the first American to receive the Legion of Merit.
Flight nurses.
The first group of 24 Naval Flight Nurses graduated from the Navy Flight Nurse School at the Naval Air Station Alameda, California on 22 January 1945. In addition to flight nurse procedures, they were trained to swim one mile, tow or push a victim for 220 yards, and swim 440 yards in 10 minutes. The newly minted flight nurses soon began active flying service on 24 flying teams, consisting of a nurse and a pharmacist's mate. Each 12-plane squadron operated with the following medical personnel: 24 flight nurses, 24 pharmacists' mates, one flight surgeon, and one Hospital Corps officer. After a certain number of transcontinental trips with wounded servicemen, the teams were sent to the Pacific to serve in the Naval Air Evacuation Service, the first arriving in Guam in early February 1945. There were three main flights of air evacuation planes to which flight nurses were assigned. First, from target areas to forward hospitals, such as Guam: second, from those forward hospitals to Pearl Harbor; and third, from Pearl Harbor to the contiguous United States. Nurses were rotated so that flight hours did not exceed 100 per month and they were also rotated between combat and noncombat flights.
An efficient procedure for aerial evacuation from target areas was quickly developed. The squadron flight surgeon and several pharmacists' mates were on the first hospital plane to land on the captured airfield. The surgeon established an evacuation clearing station adjacent to the airstrip, where with the help of his corpsmen, he collected patients from the first-aid and holding stations and screened them for air transport, giving necessary treatment prior to flight. As soon as the second hospital plane landed, the flight nurse aboard received her orders. The plane was loaded and usually departed in approximately 45 minutes, the flight nurse being responsible for all patients aboard. With the corpsman's aid, she dressed wounds, administered whole blood or plasma, gave medications, and fed the patients. Using this procedure, within 30 days, approximately 4,500 injured men were flown out of Okinawa alone.
Flight nurse Jane "Candy" Kendeigh was among the first flight nurses to fly to and from an active battlefield in the Pacific when, on 3 March 1945, she flew round-trip from Guam to Iwo Jima to aid in the evacuation of wounded U.S. Marines. As luck would have it, Ensign Kendeigh was also aboard the Navy's first medical evacuation flight bound for Okinawa, making her the first Navy flight nurse on both Iwo Jima and Okinawa. After her heroic work in Iwo Jima, she was sent back to the U.S. to participate in a War Bond drive. Soon after she started that assignment, she requested to be sent back into the Pacific combat zone. She flew her missions with Agana, Guam based Air Evacuation Transport Squadron One (VRE-1), which was an elite unit of the Naval Air Transport Service (NATS).
Korea.
 The need for naval medical facilities in Asia grew when the Korean War began. A small naval dispensary at Yokosuka, staffed by only six nurses, evolved into a full-fledged hospital staffed by 200 nurses. The Navy Nurse Corps expanded its ranks by recalling Reserve nurses with World War II experience. It temporarily reduced staffs at continental hospitals to staff the forward area. The Navy also commissioned civilian nurses. These nurses served in hospitals as well as aboard the USS "Haven" and two other Haven-class ships, where almost 35 percent of battle casualties were admitted through September 1952. These hospital ships were a new type of mobile hospital, moving from place to place, sometimes supporting the Inchon invasion or aiding the Hungnam evacuation, or simply shifting about the Korean coast as needed. Two senior Navy nurses, Commander Estelle Kalnoske Lange and Lieutenant Ruth Cohen, received the Bronze Star for their work on the Navy hospital ships.
Lt. Sarah Griffin Chapman, who had lost her lower left leg in an accident and retired prior to Korea, fought to be recalled to active duty so that she could teach other young amputees how to walk again.
Though outside the Korean theater, one aviation accident claimed the lives of 11 Navy nurses. The mishap occurred on the South Pacific island of Kwajalein on 19 September 1950. These women were en route to hospitals in Japan to care for war casualties when their plane crashed into the Pacific shortly after take off.
Vietnam.
In 1963, LT Bobbi Hovis volunteered to go to Vietnam, where she and four other nurses were tasked with converting a run-down Saigon apartment into the first US Navy Station Hospital—in four days.
In 1965 George M. Silver became the first man to be commissioned in the Navy Nurse Corps.
The first four Navy Nurse Corps officers to be injured in combat support were injured in Vietnam [Saigon] when LT Ruth Mason, LT Frances Crumpton, LT Barbara Wooster and LTJG Ann Darby Reynolds were wounded and later received the Purple Heart. Navy nurses went on to serve: in the Provincial Health Assistance Program at Rach Gia from 1965 to 1968; on the USS "Repose" from January 1966 to May 1970 (reaching a full complement of 29 nurses by March 1966 and serving as many as 200 helicopter admissions during a 24-hour period of intense fighting); on the USS "Sanctuary" from April 1967 to summer 1971 (also with a complement of 29 nurses); and at the station hospital at DaNang from August 1967 to May 1970 (which became the largest combat casualty treatment facility in the world, with 600 beds and admissions of 63,000 patients)., In and Out of Harm's Way, by CAPT Doris Sterner, USN p. 358.
Currently.
Operation Iraqi Freedom (OIF) 2006 in Al-Taqaddum Air Base (also known as Tammuz Airbase), Iraq, Active Duty Commander Lenora C. Langlais was the first African American female and first African American Nurse in the history of the U.S.Navy to received the Purple Heart after being injured by a mortar bomb while serving as the Fleet Marine Force (FMF) Senior Combat Nurse with the 1st Marine Logistic Group (1st MLG) Surgical Shock Trauma Platoon (SSTP) combat hospital from Camp Pendleton United States Marine Corps. Navy Nurses (2900) are deployed all over the world; participating in humanitarian and combat support missions with Expeditionary Resuscitative Surgical Service (ERSS) teams aboard amphibious assault and amphibious warfare ships; Fleet Surgical Teams aboard amphibious assault and amphibious warfare ships in addition to boots on ground; as flight nurses; as organic crew aboard hospital ships and aircraft carriers; boots on ground with the Marine Corps; individually augmented with the Army; and select sub-specialties in support of special operations including (but not limited to) Surgical Response Teams (SRTs).
Modern Nurse Corps.
The Nurse Corps continues as a prominent part of the Navy Medicine establishment. It consists of officers of the rank of Ensign and to Rear Admiral (upper half). Navy Nurse Corps officers are commissioned through ROTC, STA-21, Medical Enlisted Commissioning Program (MECP), Nurse Candidate Program, and by direct commission.
Insignia, badges and aiguillettes.
The Nurse Corps has a distinctive insignia of a single Oak Leaf, on one collar point, or in place of a line officer's star on shoulder boards.
Navy Nurse Corps officers (2900s) are eligible to earn and wear the Fleet Marine Force, Surface, Basic Parachutist Badge, Navy and Marine Corps Parachutist insignia, Air Crew and Flight Nurse warfare badges. Select Navy Nurse Corps officers are eligible to wear special-warfare insignia. Officers selected to formally serve as executive assistants to flag officers or congressional leaders may be eligible to wear an aiguillette and/or unique insignia. Navy Nurse Corps officers can also earn the Army Combat Badge but are not currently authorized to wear it. Executive-grade Navy Nurse Corps officers who have, or had, command of an installation or commissioned unit ashore are eligible to wear the Navy Command Ashore insignia. Navy Nurse Corps officers who have had command of a hospital ship are authorized to wear the Navy Command at Sea insignia.
Superintendents and directors.
From its founding in 1908 until after World War II in 1947, the Navy Nurse Corps was led by a superintendent. Its nurses had no permanent commissioned rank during that time. The Army-Navy Nurses Act took effect on 16 April 1947, establishing the Navy Nurse Corps as a staff corps, with officers holding permanent commissioned rank from Ensign to Commander. The corps was to be led by a director holding the rank of Captain while in that position. This position later evolved into a flag-rank appointment and there can be up to four Navy Nurse Corps flag-rank officers serving concurrently, .
Ships named after Navy Nurse Corps officers.
The Navy has so far named two warships in honor of Navy Nurse Corps officers, both for Supt. Lenah Higbee;


Artificial induction of immunity

Artificial induction of immunity makes people immune to specific diseases by means other than waiting for them to catch the disease. The purpose is to reduce the risk of death and suffering.
Immunity against infections that can cause serious illness is generally beneficial. Founded on a germ theory of infectious diseases, as demonstrated by Louis Pasteur's discoveries, modern medicine has provided means for inducing immunity against a widening range of diseases to prevent the associated risks from the wild infections. It is hoped that further understanding of the molecular basis of immunity will translate to improved clinical practice in the future.
Variolation and smallpox.
The earliest recorded artificial induction of immunity in humans was by variolation or inoculation, which is the controlled infection of a subject with a less lethal natural form of smallpox (known as Variola Minor) to make him or her immune to re-infection with the more lethal natural form, Variola Major. This was practiced in ancient times in China and India, and imported into Europe, via Turkey, around 1720 by Lady Montagu and perhaps others. From England, the technique spread rapidly to the Colonies, and was also spread by African slaves arriving into Boston.
Variolation had the disadvantage that the inoculating agent used was still an active form of smallpox and, although less potent, could still kill the inoculee or spread in its full form to others nearby. However, as the risk of death from inoculation with Variola Minor was just 1% to 2%, as compared to the 20% risk of death from the natural form of smallpox, the risks of inoculation were generally considered acceptable.
Vaccination.
In 1796, Edward Jenner FRS, a doctor and scientist who had practiced variolation, performed an experiment based on the folk-knowledge that infection with cowpox, a disease with minor symptoms which was never fatal, also conferred immunity to smallpox. The idea was not new; it had been demonstrated some years earlier by Benjamin Jesty, who had not publicized his discovery. In 1798, Jenner extended his observations by showing that cowpox could be passed from a lesion on one patient to others through four arm to arm transfers and that the last in the series was immune by exposing him to smallpox. Jenner described the procedure, distributed his vaccine freely, and provided information to help those hoping to establish their own vaccines. In 1798 he published his information in his famous "Inquiry into the Causes and Effects...of the Cow Pox". He is credited with being the first to start detailed investigations of the subject and of bringing it to the attention of the medical profession. Despite some opposition vaccination took over from variolation.
Jenner, like all members of the Royal Society in those days, was an empiricist. The theory to support further advances in vaccination came later.
Germ Theory.
Main articles: Pasteur Louis Pasteur; Germ Theory: Germ theory of disease
In the second half of the 1800s Louis Pasteur perfected experiments which disproved the then-popular theory of spontaneous generation and from which he derived the modern theory of (infectious) disease. Using experiments based on this theory, which posited that specific microorganisms cause specific diseases, Pasteur isolated the infectious agent from anthrax. He then derived a vaccine by altering the infectious agent so as to make it harmless and then introducing this inactivated form of the infectious agents into farm animals, which then proved to be immune to the disease.
Pasteur also isolated a crude preparation of the infectious agent for rabies. In a brave piece of rapid medicine development, he probably saved the life of a person who had been bitten by a clearly rabid dog by performing the same inactivating process upon his rabies preparation and then inoculating the patient with it. The patient, who was expected to die, lived, and thus was the first person successfully vaccinated against rabies. René Dubos, Louis Pasteur: Freelance Of Science, Little, Brown and Company, 1950.
Anthrax is now known to be caused by a bacterium, and rabies is known to be caused by a virus. The microscopes of the time could reasonably be expected to show bacteria, but imaging of viruses had to wait until the development of electron microscopes with their greater resolving power in the 20th century.
Toxoids.
Some diseases, such as tetanus, cause disease not by bacterial growth but by bacterial production of a toxin. Tetanus toxin is so lethal that humans cannot develop immunity to a natural infection, as the amount of toxin and time required to kill a person is much less than is required by the immune system to recognize the toxin and produce antibodies against it. However the tetanus toxin is easily denatured losing its ability to produce disease, but leaving it able to induce immunity to tetanus when injected into subjects. The denatured toxin is called a toxoid.
Adjuvants.
The use of simple molecules such as toxoids for immunization tends to produce a low response by the immune system, and thus poor immune memory. However, adding certain substances to the mixture, for example adsorbing tetanus toxoid onto alum, greatly enhances the immune response (see Roitt etc. below). These substances are known as adjuvants. Several different adjuvants have been used in vaccine preparation. Adjuvants are also used in other ways in researching the immune system.
A more contemporary approach for "boosting" the immune response to simpler immunogenic molecules (known as antigens) is to "conjugate" the antigens. Conjugation is the attachment to the antigen of another substance which also generates an immune response, thus amplifying the overall response and causing a more robust immune memory to the antigen. For example, a toxoid might be attached to a polysaccharide from the capsule of the bacteria responsible for most lobar pneumonia.
Temporarily induced immunity.
Temporary immunity to a specific infection can be induced in a subject by providing the subject with externally produced immune molecules, known as antibodies or immunoglobulins. This was first performed (and is still sometimes performed) by taking blood from a subject who is already immune, isolating the fraction of the blood which contains antibodies (known as the serum), and injecting this serum into the person for whom immunity is desired. This is known as passive immunity, and the serum that is isolated from one subject and injected into another is sometimes called antiserum. Antiserum from other mammals, notably horses, has been used in humans with generally good and often life-saving results, but there is some risk of anaphylactic shock and even death from this procedure because the human body sometimes recognizes antibodies from other animals as foreign proteins.
Passive immunity is temporary, because the antibodies which are transferred have a lifespan of only about 3–6 months. Every placental mammal (which includes humans) has experienced temporarily induced immunity by transfer of homologous antibodies from its mother across the placenta, giving it passive immunity to whatever its mother became immune to. This allows some protection for the young while its own immune system is developing.
Synthetic (recombinant or cell-clone) human immunoglobulins can now be made, and for several reasons (including the risk of prion contamination of biological materials) are likely to be used more and more often. However, they are expensive to produce and are not in large-scale production as of 2013. In the future it might be possible to artificially design antibodies to fit specific antigens, then produce them in large quantities to induce temporary immunity in people in advance of exposure to a specific pathogen, such as a bacterium, a virus, or a prion. At present, the science to understand this process is available but not the technology to perform it.


Hemangiomatosis

Hemangiomatosis may refer to:


Involucrum

An involucrum (plural involucra) is a layer of new bone growth outside existing bone.
There are two main contexts:


Michael Dixon (doctor)

Michael Dixon LVO, OBE, MA, FRCGP is an English general practitioner and healthcare leader. He served as chair of the NHS Alliance from 1998 to 2015 and is a past President of the NHS Clinical Commissioners. He also chairs the College of Medicine. He is a Visiting Professor at University College London and the University of Westminster and National Clinical Champion for Social Prescribing (NHS England).
Career.
Dixon studied psychology and philosophy at University of Oxford before studying medicine at Guy’s Hospital. He is Senior Partner at College Surgery in Cullompton, Devon, where he has practiced as a GP since 1984. In 2007 he and his GP partners in Cullompton, Devon created the “Culm Valley Integrated Centre for Health”, which has been seen as a model for the future of general practice and was rated outstanding by the Care Quality Commission in 2015.
His national appointments have included membership of the National Leadership Network for Health and Social Care, the National Stakeholder Forum and National Steering Group for GP Commissioning. He is an Honorary Senior Fellow in Public Policy at HSMC University of Birmingham, Honorary Senior /Lecturer in Integrated Health at the Peninsula Medical School.
He has been active in the commissioning movement since the early 1990s, when he co-founded the Mid Devon Family Doctors Commissioning Group. Since then he has campaigned for the right of GPs and practices to have a role in improving local health and services and been a prime mover in developing GP commissioning models that will allow them to do so. He sat on the National Executive of the National Association of Commissioning GPs (NACGP) - founded in 1993, and was a co-writer of its document “Restoring the Vision” (1997), which was commissioned by the then Minister of Health, Alan Milburn. When NACGP became NHS Alliance in 1998, he was elected Chairman and has continued in this role by annual election until he announced his retirement in 2015. He is a frequent speaker and national advisor on GP commissioning and co-author of a number of books and chapters in this area (e.g. The Locality Commissioning Handbook (1998, Radcliffe Press) and A Practical Guide to Primary Care Groups and Trusts (2001) Radcliffe Press).
Past ministerial appointments include Chair of the NHS LifeCheck Board and Practice Based Commissioning Advisor to Lord Darzi. He is a past President of the Health Writers Guild and was previously Senior Advisor of the King’s Fund and Steering Group member of the King’s Fund Enquiry on General Practice
Since 2010, he has been Chair of the College of Medicine, which emphasises the importance of non-biomedical interventions in health and care, which include social prescription, lifestyle interventions and complementary and traditional approaches.
He was listed in the top ten most influential clinical leaders in the Health Service Journal 2013. He has been listed among the Pulse (magazine) most influential GPs for several years.
Social prescribing.
He has pioneered social prescribing in his Devon GP practice for several years, arguing it is an answer to over medicalisation and soaring health costs. Social prescription facilitates patients with a range of social, psychological and physical problems to access a wide range of local interventions and services provided by the voluntary and volunteer sectors and others. In 2015 he co-founded the National Social Prescribing Steering Group, which he co-chairs. This leads a network created in 2016, which has over 500 members active in social prescription with eight Clinical Commissioning Groups now offering universal provision. In June 2016 he was appointed National Clinical Champion for Social Prescription (NHS England) and his ambition is that social prescription should be available to every patient and GP.
Complementary medicine.
His other main field of interest is complementary medicine. Co-author of "The Human Effect" (Radcliffe Press 2000), he believes in “patient centred medicine” and the role of the patient in self healing. Reviewing the book, David Short, Emeritus Professor of Clinical Medicine at the University of Aberdeen writes "the authors urge doctors to move beyond the idea of the body as a machine. If doctors do indeed regard their patients in this way, then this book is timely. One cannot help feeling that what is advocated is really a return to best practice of family doctors of an earlier generation. Perhaps the authors recognise this in saying 'what is called for is less of a revolution and more of a revival'"
Dixon describes his approach to medicine in the BBC Radio 4 programme Healthy Visions which especially focuses on prevention and looking at the whole lives of patients. He argues that it is beneficial to 'break down the boundaries' between orthodox and complementary medicine, and that an increasing number of GPs are doing so.
In a paper for the British Journal of General Practice The physician healer: ancient magic or modern science? he writes "it seems that the physician healer is now poised to rise again like a phoenix, not on a wave of nostalgia, but because modern science demands it. Placebo research and psychoneuroimmunology are beginning to clarify a role in which caring is no longer an act of compassion or indulgence but has everything to do with curing or in the preferred modern term 'effectiveness'.
He was the medical director of The Prince's Foundation for Integrated Health, which closed in 2010 after its finance director was arrested for stealing £253,000 from the organisation. Dixon is a director of the College of Medicine which opened in 2010 with former Chair of the General Medical Council Sir Graeme Catto as its President. He has been criticised by professor of complementary medicine and alternative medicine campaigner Edzard Ernst for advocating the use of complementary medicine. Ernst said that the stance of the NHS Alliance on complementary medicine was "misleading to the degree of being irresponsible." Ernst had previously been sympathetic to building a bridge between complementary and mainstream medicine, co-writing an article with Michael Dixon in 1997 on the benefits of such an approach. Ernst and Dixon write "missed diagnoses by complementary therapists giving patients long term treatments are often cited but in the experience of one of the authors (MD) are extremely rare. It can also cut both ways. A patient was recently referred back to her general practitioner by an osteopath, who was questioning, as it turned out quite correctly, whether her pain was caused by metastates. Good communication between general practitioner and complementary therapist can reduce conflicts and contradictions, which otherwise have the potential to put orthodox medicine and complementary therapy in an either/or situation."
Personal life.
In his free time, he gardens and fishes whenever possible. His wife, Joanna, is a professional artist and they have three children, two of whom are GPs and the other working in health and science policy.


Flutter valve

A flutter valve (also known as the Heimlich valve after its inventor, Henry Heimlich) is a one-way valve used in respiratory medicine to prevent air from travelling back along a chest tube. One can also use a chest drainage management system, which typically enables vacuum to be applied along with quantifying the effluent. However, it is much larger with more tubing, which may encumber the patient.
It is most commonly used to help remove air from a pneumothorax. The valve is usually designed as a rubber sleeve within a plastic case where the rubber sleeve is arranged so that when air passes through the valve one way the sleeve opens and lets the air through. However, when air is sucked back the other way, the sleeve closes off and no air is allowed backwards. This construction enables it to act as a one-way valve allowing air (or fluid) to flow only one way along the drainage tube. The end of the drainage tube is placed inside the patient's chest cavity, within the air or fluid to be drained. The flutter valve is placed in the appropriate orientation (most packages are designed so the valve can only be connected in the appropriate orientation) and the pneumothorax is thus evacuated from the patient's chest.
There are several potential problems with these valves. One is that the chest tube can clog. When chest tube clogging occurs, the pneumothorax or subcutaneous emphysema can recur. This can also lead to empyema. The other is that these tend to leak fluid. To address this, some have turned to small chest drainage alternatives, such as the Atrium Express Mini 500 or the Teleflex Mini Sahara. An alternative solution is to attach a sputum trap to the valve, thus providing a reservoir to capture the draining fluid. The Atrium Pneumostat chest drain valve combines a one way valve and a 30cc collection chamber to address this issue.
The flutter valves or Pneumostat valves allow patients to ambulate more easily and patients may be able leave the hospital in certain instances. The traditional chest tube collection box often would require longer hospital stay.


Sailakshmi Balijepally

Sailakshmi Balijepally or Sai Balijepally (born ) is an Indian paediatrician and charity founder. She was awarded the Nari Shakti Award in 2015 by the President of India.
Life.
Balijepally was brought up in Secunderabad where she attended Keyes High School for Girls for 12 years. Her parents were both doctors and it was expected that she would do to. Her elder sister was her role model and she was en route to being a cardiologist. She went on to St Francis College for Women for two years before gaining entry to the Gandhi Medical College. She was there for five years and she left qualified as both a physician and as a surgeon.
On 20 January 2001 an earthquake hit Gujurat killing 20,000, injuring many more and making 400,000 homeless. She stepped forward to volunteer then despite it clashing with her exams. Seven years later she volunteered again when the Bihar flood made millions homeless when a river changed course and flooded many inhabited areas.
She had been working as a junior consultant when she had tried to work out how to support 60 orphanages and she had teamed each one up with a colleague paediatrician. Her colleagues were keen to help but in time the system was not really working. The establishment of the EKAM foundation in 2009 was her attempt to refocus on the problem of supplying care.
Balijepally was awarded one of the first eight Nari Shakti Awards for her leadership and achievement in 2015. The award was made on International Women's Day from the then Indian President Pranab Mukherjee.
In 2018 her EKAM foundation went into a partnership with Royal Enfield with the aim of improving the health and well-being of mothers and children in Kancheepuram. They were working with Chengalpattu Medical College.


Nicolas-Jean-Baptiste-Gaston Guibourt

Nicolas-Jean-Baptiste-Gaston Guibourt was a French pharmacist. He was born in Paris on July 2, 1790, and died on August 22, 1867 in the same city.
Nicolas Guibourt received his diploma of Pharmacy in 1816 from the École Spéciale de Pharmacie, with a thesis on the oxides and sulfides of mercury.
He became member of the Académie de Médécine in 1824, and professor of the École de Pharmacie in 1832.


Jacob H. Friedman

Jacob H. Friedman (born 1905 in New York, New York - died January 28, 1973 in Bronx, New York) was an American psychiatrist, one of the pioneers of geriatric psychiatry and an authority on marriage phobia. He was a professor of psychiatry at Albert Einstein College of Medicine and published over one hundred peer-reviewed papers in his field.
Friedman established a geriatric psychiatry program at Lebanon Hospital in 1961 and later served as chairman of the neuropsychiatry department at Fordham Hospital. He also headed the geriatric psychiatry program at the Bronx State Psychiatric Hospital.
Friedman's expert testimony at the civil trial of cartoonist Frank Moser, accused of running down the son of Lindbergh baby kidnapper Richard Bruno Hauptmann, proved decisive in securing a verdict for Hauptmann's widow.
Friedman graduated from City College and Tulane Medical School (1929). He did additional training at the New York Psychoanalytic Institute.


Arthur Gamgee

Prof Arthur Gamgee FRS FRSE (11 October 1841 – 29 May 1909) was a British biochemist.
Life.
Arthur Gamgee was the youngest of eight children of Joseph Gamgee, an Edinburgh-born veterinarian and pathologist and his wife Mary Ann West. He was born in Florence, Italy, where his father had a practice nearby in Leghorn. His family moved back to England when he was fourteen years old. He was educated at University College School in London and at the University of Edinburgh, graduating with an MD in 1862. For his thesis, "Contributions to the Chemistry and Physiology of Foetal Nutrition", he was awarded a gold medal. He did postgraduate studies in both Heidelberg and Leipzig in Germany.
In 1867 he was elected a Fellow of the Royal Society of Edinburgh his proposer being Sir Andrew Douglas Maclagan.
He taught in the Edinburgh Extramural School of Medicine, giving lectures on physiology and histology at Surgeon's Hall. Between 1863-1869 he was Physician to the Royal Hospital for Sick Children. In 1873 he was appointed Professor of Physiology at the Royal Manchester School of Medicine. He was also Physician to the Manchester Hospital for Consumption. In 1872 he was elected a Fellow of the Royal Society and delivered its Croonian Lecture in 1902. Manuscript notes of Gamgee's physiology lectures from both Edinburgh and Manchester survive as part of the Manchester Medical Manuscripts Collection held by special collections at the University of Manchester with the reference MMM/19/1.
From 1884 to 1886 he was Fullerian Professor of Physiology and Comparative Anatomy at the Royal Institution of Great Britain; he did not serve the full three years of the Fullerian appointment because he resigned his chair in 1886 to take up private practice. He was also the author of "A Text-book of the Physiological Chemistry of the Animal Body: including an account of the chemical changes occurring in disease", published in 1880.
Arthur Gamgee was fluent in French, German, and Italian.
On 29 March 1909, he died of pneumonia during a visit to Paris. He was buried in the family vault in Arnos Vale Cemetery, Bristol.
Family.
He married Mary Louisa Clark in 1875.
He was the brother of John Gamgee and Joseph Sampson Gamgee and uncle of D'Arcy Thompson.


Graham MacGregor Bull

Sir Graham MacGregor Bull (30 January 1918 – 14 November 1987) was a South African-British physician, nephrologist, medical administrator, and director of medical research.
Biography.
Graham Bull grew up in South Africa. After education at Cape Town's Diocesan College, he attended the University of Cape Town, where he graduated MB ChB in 1939. After briefly engaging in general practice, he was appointed tutor and medical assistant at the Groote Schuur Hospital. In 1947 the South African Council for Scientific and Industrial Research awarded him a travelling fellowship, enabling him to study in London at the Hammersmith Hospital's Royal Postgraduate Medical School, where he graduated MD in 1947 with thesis "Postural Proteinuria". The cardiologist John McMichael appointed him to a lectureship at the school of medicine in Hammersmith. Shortly after the end of WWII, Willem Johan Kolff, the famous pioneer of hemodialysis, donated artificial kidney machines to institutions in Poland, as well as Amsterdam and London. Kolff briefly worked at Hammersmith to set up an artificial kidney machine with the rheumatologist Eric Bywaters and the nephrologist A. Mark 'Jo' Joekes. Bull joined the team of Bywaters and Joekes working on renal therapies. When Bywaters left in 1947 to become a medical director in Buckinghamshire, Bull became the leader of the renal unit at Hammersmith.
Bull was appointed in 1952 to a professorial chair of medicine at Queen's University, Belfast (that institution's first such professorship). He directed the establishment of record linking systems among hospitals and general practitioners and also supported Belfast's flying ambulance service for heart attack victims. He helped to establish a department of medical statistics and served as chair of the Northern Ireland Hospital Authority's committees for medical education and research. In 1955 he delivered the Goulstonian Lectures on "The Uræmias".
Bull was appointed in 1966 director of the Medical Research Council’s new clinical research centre at Northwick Park in northwest London. He served on several committees for medical advice and investigation. In 1970 he became a member of the executive council of the Ciba Foundation and was a trustee from 1979 until his death.
Bull was elected FRCP in 1954 and was knighted in 1976. He retired in 1978. In 1988 the Sir Graham Bull Memorial Prize was founded at the Royal College of Physicians.
Graham and Megan Bull had four children: a daughter who became a consulting paediatric cardiologist, and three sons who became, respectively, an accountant, a zoologist and a musician.
Bull regime.
J. G. G. Borst in Amsterdam and Bull and his colleagues in London based their dietary therapy on 3 principles: (1) restrict the patient's intake of fluid to precisely balance the patient's output of fluid; (2) eliminate the patient's dietary protein and provide adequate calories to reduce the patient's endogenous breakdown of proteins; (3) give the patient no electrolytes except to replace known losses. Bull achieved these 3 objectives by feeding the patient a carefully measured, synthetic 'diet' consisting of glucose, peanut oil, and water.


Marilynn Brewer

Marilynn B. Brewer (Ph.D., Northwestern University, 1968) is a prominent American social psychologist. She is now professor emeritus of psychology at Ohio State University and currently resides at the University of New South Wales. She was formerly Professor of Psychology and Director of the Institute for Social Science Research at UCLA.
Biography.
In 1942, Brewer was born in Chicago, Illinois as Marilynn Bolt. In 1966, she married Robert Brewer. Her parents both did not attend college but encouraged her to pursue her education. Brewer received her Bachelors of Arts in Social Sciences in 1963 from North Park college with honors. She was greatly influenced and encouraged by her mentor, Jean Driscoll. Brewer received the National Institute of Mental Health Fellowship to fund her graduate education at Northwestern University.
Brewer served as President of the American Psychological Society from 1993-1995, Midwestern Psychological Association in 2004, Society for the Psychological Study of Social Issues in 1984-1985, and the Society for Personality and Social Psychology from 1990-1991. She has also served as Editor of Personality and Social Psychological Review and Associate Editor of the Psychological Review.
Research.
Brewer is well known for her contributions to the field of social identity and has also conducted research in the areas of social cognition and intergroup relations. While she is particularly recognized for her theory of optimal distinctiveness, she has been honored by a variety of organizations for wide-ranging and diverse contributions to the field of social psychology.


Michael H. Birnbaum

Michael H. Birnbaum is a professor of Psychology and Director of the Decision Research Center at California State University, Fullerton. He has researched widely in psychology but his major focus has been on individual and social judgment and decision making, and the modelling of behavior. Birnbaum has been president of the Society for Mathematical Psychology, the Society for Judgment and Decision Making, and the Society for Computers in Psychology.


Chandipura vesiculovirus

Chandipura vesiculovirus (CHPV) is a member of the "Rhabdoviridae" family that is associated with an encephalitic illness in humans. It was first identified in 1965 after isolation from the blood of two patients from Chandipura village in Maharashtra state, India and has been associated with a number of otherwise unexplained outbreaks of encephalitic illness in central India. The most recent occurred in Andhra Pradesh and Maharashtra in June–August 2003 with 329 children affected and 183 deaths.
Further sporadic cases and deaths in children were observed in Gujarat state in 2004.
"Chandipura vesiculovirus" has been isolated from sandflies in India and West Africa and is probably spread through its bite. The presence of the virus in Africa indicates a wide distribution although no human cases have been observed outside India.
The significance of "Chandipura vesiculovirus" as a human pathogen is unresolved due to doubts over its role in the 2003 and 2004 outbreaks.
Virology.
"Chandipura vesiculovirus" is an enveloped RNA virus with an approximate genome length of ~11 kb. Viral genome codes for five polypeptides, namely, Nucleocapsid protein N, Phosphoprotein P, Matrix protein M, Glycoprotein G and Large protein L in five monocistronic mRNAs. N protein encapsidates genome RNA into a nuclease-resistant form to protect in from cellular RNAse function. L and P protein together forms viral RNA dependent RNA polymerase; where catalytic functions for RNA polymerization, Capping and Poly-A polymerase resides within the L protein and P acts as a transcriptional activator. Matrix protein glues the encapsidated genome RNA, also known as nucleocapsid, with the outer membrane envelope. G protein spikes out of the membrane and acts as a major antigenic determinant.
Viral life cycle is cytosolic. During transcription, viral polymerase synthesizes five discrete mRNAs and obeys to stop signals that are present at the gene boundaries. Accumulation of adequate amounts of viral proteins within infected cells through viral transcription and subsequent translation potentiate the onset of viral replicative cycle. In this phase, same L protein acts as a replicase and ignore the gene junctions to generate a polycistronic anti-genomic analogue that acts as a template for further rounds of replication to generate many more copies of the genome RNA. This progeny genome RNA upon packaging by viral proteins bud out as mature virus particles. The precise mechanism underlying the switch in polymerase function during viral replication remains unknown.
Recent outbreaks.
In 2003, 329 people died in outbreak in Andhra Pradesh and Maharashtra. In 2009, the virus infected 52 people and claimed 15 lives. In 2010, a total of 50 people contracted the virus and 16 died. A majority of the infected patients were below 14 years of age. Between 2009 and 2011, 110 tested positive, and 11 died in 2011.
An outbreak in Gujarat in Kheda District, Vadodara District, and Panchmahal District had killed 17 people in 2010.
Sandfly bites are blamed as they inhabit cracks in walls or parts of homes made of sand or mud. The sporadic cases appeared in Gujarat in 2014 and 2016. One girl died in Ahmedabad in 2016. In 2019 one girl died in Bhayli village of Vadodara.


Robert G. Ritter

Robert G. Ritter is an American dentist and a co-founder of "Ritter & Ramsey General and Cosmetic Dentistry" based in Jupiter, Florida.
Career.
Ritter is a graduate of Medical University of South Carolina College of Dental Medicine. He
is known for his contributions in esthetic dentistry. He has written and published several articles on adhesive and cosmetic dentistry. He speaks and lectures on cosmetic dentistry, implant dentistry, and other aspects of general dentistry across the US.
Ritter is an Adjunct Assistant Clinical Professor, Prosthodontics and Operative Dentistry, Dental Research Administration at Tufts University School of Dental Medicine. He is a former President of the "Florida Academy of Cosmetic Dentistry" and a member of the "Seaside Study Club".
Ritter is a board member of "Inside Dentistry" and "The Journal of The Academy of Cosmetic Dentistry". He is also an Editorial Board member of "REALITY", a publication for dentists.
Professional memberships.
Ritter is a member of the following professional associations:
Personal life.
Ritter is married to his wife Isabelle and they have a daughter, Olivia. He resides with his family in Palm Beach Gardens, Florida.


Ravi Kannan R

Ravi Kannan R is an Indian Surgical oncologist based in Assam, India. He is the Director of Cachar Cancer Hospital and Research Centre (CCHRC), a nonprofit hospital that treats cancer patients, and the former Head of Department of surgical oncology at Adyar Cancer Institute in Chennai. He is the recipient of Padma Shri, India's fourth highest civilian honour.
Education.
Kannan graduated with a MBBS degree from the Kilpauk Medical College in Chennai and holds a master of science degree in surgical oncology from Maulana Azad Medical College, New Delhi.
Career.
Kannan was heading the surgical oncology department of Adyar Cancer Institute. In 2006, he visited the Cachar Cancer Hospital and Research Centre for the first time for a consultation on the request of a colleague and that's when he met the then director of CCHRC who offered him to head the centre. Kannan left his practice in Chennai and moved to Assam with his family in 2007 to provide basic healthcare facilities to the people of Barak Valley through Cachar Cancer Hospital and Research Centre in Silchar.


Elizabeth Glaser Pediatric AIDS Foundation

The Elizabeth Glaser Pediatric AIDS Foundation ("EGPAF") is a nonprofit organization dedicated to preventing pediatric HIV infection and eliminating pediatric AIDS through research, advocacy, and prevention and treatment programs. Founded in 1988, the organization works in 12 countries around the world.
History.
Background.
Elizabeth Glaser (née Elizabeth Meyer) (November 11, 1947 – December 3, 1994) was an American AIDS activist and child advocate. She was married to actor and director Paul Michael Glaser. Glaser contracted HIV in 1981 during the early stages of the AIDS epidemic after receiving a transfusion of contaminated blood while giving birth to her daughter Ariel. Glaser unknowingly passed the virus to Ariel and to her son Jake, who was born three years later.
The virus went undetected in all three family members until they underwent HIV testing in 1985, at which time Ariel began suffering from a series of unexplained illnesses. Ariel had developed advanced AIDS at a time when the medical community knew very little about the disease, and there were no available treatment options particularly for children. The U.S. Food and Drug Administration approved AZT in 1987 as a drug that could extend the lives of AIDS patients, but this approval only extended to adults. Although the Glasers fought to have their daughter treated with AZT intravenously, Ariel died from complications of AIDS in 1988.
In the aftermath of Ariel's death, and determined to save her son Jake, as well as to give hope to other HIV-positive children, Glaser co-founded the Pediatric AIDS Foundation in 1988 with friends Susan DeLaurentis and Susie Zeegen. Their work raised public awareness about HIV infection in children, and spurred funding for the development of pediatric AIDS drugs as well as research into mother-to-child transmission of HIV. In 1991, Glaser published an autobiography about her family's ordeal. The book was entitled "In the Absence of Angels", and it was co-written with author Laura Palmer.
An advocate for the elimination of pediatric AIDS, Glaser became known to audiences nationwide when she was a featured speaker at the 1992 Democratic National Convention. During her speech, she criticized the federal government's underfunding of AIDS research and its lack of initiative in addressing the AIDS crisis. Elizabeth and her family also were profiled in a 1991 edition of "People".
Glaser died in 1994, and the Pediatric AIDS Foundation was renamed the Elizabeth Glaser Pediatric AIDS Foundation in her honor shortly thereafter.
1994 - present.
As of December 31, 2009, the Foundation reached the following milestones in its prevention, care, and treatment initiatives:
Activities.
EGPAF works to eliminate pediatric AIDS in three ways:
Grants and awards.
The Elizabeth Glaser Pediatric AIDS Foundation provides several grants and awards to scientists performing research aimed towards the study and eradication of pediatric AIDS. The Elizabeth Glaser Scientist Award is one of the many awards that the foundation offers through a competitive award application process.
Goals.
The Foundation’s overarching goals include:


Ambulatory phlebectomy

Ambulatory phlebectomy is a minisurgical treatment for superficial varicose veins and so-called side branches.
History.
This technique has been attributed to Dr Robert Muller a Swiss dermatologist who started experimenting with this technique in the mid-fifties of the last century because he was unsatisfied with the results of sclerotherapy. Moreover, he wanted an alternative for the large eyecatching scars patients were left with after classical varicose vein surgery. After ten years of experience he demonstrated this technique during the annual meeting of the French Phlebology Society.
Indications.
General accepted indications for this technique are side branch varicose veins (semicirculatory varicose veins), varicose veins of the foot, around the ankle and the knee pit. It has been successfully used in arm varicosities and peri-ocular veins (around the eyes).
Technique.
The procedure involves the removal of the varicose veins through multiple small 2–3 mm incisions in the skin overlying the varicose veins. First the veins are marked with the patient in standing position. Then the patient is positioned on the operating table and local anesthesia is applied. Incisions are made using a surgical blade. The most important instrument for this technique is the vein retractor or phlebectomy hook. There are two ways by which the veins can be grasped. Into the vein itself with a sharp instrument or around the vein with a blunt instrument. The phlebectomy hook is inserted through an incision and the varicose veins is hooked, extracted, and subsequently fixed with a clamp (e.g. Mosquito clamp). Next the vein is pulled out by turning or “wenching” the exteriorized part of the vein and moving the clamps as the vein is pulled out further. Dependent on the amount of varicose vein that has been removed the next incision is made 5 to 10 cm. along the pre-operative markings.
Results.
The procedure may be performed with tumescent or local anesthesia, such as with lidocaine. It is called ambulatory phlebectomy because patients usually return to normal daily activity immediately after the procedure which therefore may be performed in hospital or outpatient settings. Ambulatory phlebectomy is considered to be more effective than sclerotherapy.
Post-operative care.
Graded compression stockings are usually worn for 1–2 weeks after the procedure but compression bandages may also be used.
This procedure is often used as an adjunct to endovenous laser treatment or other endovenous ablations of the greater saphenous vein.
Complications.
Complications are uncommon, but include paresthesia, bruising, hemorrhage and hematoma.


Primary interventricular foramen

In human embryology, the primary interventricular foramen is a temporary opening between the developing ventricles of the heart. The ventricles arise as a single cavity that is divided by the developing interventricular septum. Before the septum closes completely, the remaining opening between the two ventricles is termed the interventricular foramen.
In some individuals, the foramen fails to close, leading to an interventricular septal defect known as a patent interventricular foramen.


Genomic Health

Genomic Health was a company focusing on genetic research specifically in cancer detection, based out of Redwood City, California. The company was acquired by and merged with Exact Sciences Corporation in 2019.
History.
Genomic Health, Inc. was founded in 2000 by Randy Scott, who had previously founded and been CEO at Incyte. He formed the company after a close friend was diagnosed with cancer and had the idea for treatment based on the specific genome of their tumor.
By 2003 Genomic Health had developed Oncotype DX, a genomic assay that quantified the likelihood of breast cancer recurrence. This development took the company over three years and to complete and then had to convince skeptics at the time of the validity of genetic testing.
In July 2005 Genomic Health filed for an initial public offering to sell up to in common stock. Investors at the time already included Versant Ventures and Kleiner Perkins Caufield & Byers. On it was listed on the NASDAQ with the symbol GHDX with the initial share price of for 5016722 shares.
Genomic Health also started a subsidiary in 2010, Invitae, with the goal of aggregating multiple genetics tests. Invitae was spun off in 2012.
The company expanded with international headquarters in Geneva Switzerland and UK headquarters in London in 2011.
In July 2019, Exact Sciences announced that it was purchasing Genomic Health to increase the variety of medical tests they offer.


Podiatrist

A podiatrist (/poʊˈdaɪətrɪst/ poh-dye-eh-trist) or podiatric physician is a medical professional devoted to the treatment of disorders of the foot, ankle, and related structures of the leg. The term originated in North America but has now become the accepted term in the English-speaking world for all practitioners of podiatric medicine. The word chiropodist was previously used in the United States, but it is now regarded as antiquated.
In the United States, podiatrists are educated and licensed as Doctors of Podiatric Medicine (DPM). The preparatory education of most podiatric physicians
(similar to the paths of traditional MD, and Osteopathic Medicine (DO)) includes four years of undergraduate work, followed by four years in an accredited podiatric medical school, followed by a three- or four-year hospital-based surgical residency. Optional one- to two-year fellowship in foot & ankle reconstruction, surgical limb salvage, sports medicine, plastic surgery, pediatric foot & ankle surgery, and wound care is also available. Podiatrists are licensed in all fifty states, although each state has its own licensing requirements. The scope of practice may vary from state to state and residency training.
In many countries, the term "podiatrist "refers to allied health professionals who specialize in the treatment of the lower extremity, particularly the foot. Podiatrists in these countries are specialists in the diagnosis and nonsurgical treatment of foot pathology. In some circumstances, these practitioners will further specialise and, following further training, perform reconstructive foot and ankle surgery. In contrast, most American podiatrists complete residencies in surgical treatments of the foot and ankle.
The median annual podiatry salary in the USA was approximately $135,000 as of August 2018, with a wide range depending on years in practice. New podiatrists usually earn significantly less. First-year salaries ranging from $75,000 to $150,000 with performance and productivity incentives are common. Private practice revenues for solo podiatrists vary widely, with the majority of solo practices grossing between $200,000 and $600,000 before overhead.
Podiatric specialties.
Podiatrists treat a wide variety of foot and lower extremity conditions through nonsurgical and surgical approaches. The American Board of Podiatric Medicine (ABPM) offers a comprehensive board qualification and certification process in podiatric medicine and orthopedics. Subspecialties of podiatry include:
Podiatry assistant.
In Australia, podiatry assistant Certificate IV in Allied Health Assistance qualification. The podiatry assistant work as a part of a podiatric medical team in both clinical and nonclinical settings. Common professional accreditation pathways to becoming a podiatric assistant include:
Podiatric surgery.
Podiatric surgery is concerned with the diagnosis and treatment of disorders of the foot and ankle:
Responsibilities.
Podiatrists' roles include dealing with the conditions resulting from bone and joint disorders such as arthritis and soft-tissue and muscular pathologies as well as neurological and circulatory diseases. Podiatrists are also able to diagnose and treat any complications of the above which affect the lower limb, including skin and nail disorders, corns, calluses and ingrown toenails. Foot injuries and infections gained through sport or other activities are also diagnosed and treated by podiatrists.
Education and training.
Australia.
Australian podiatrists complete an undergraduate degree of Bachelor of Podiatry or Podiatric Medicine ranging from 3 to 4 years of education. The first 2 years of this program are generally focused on various biomedical science subjects including anatomy, medical chemistry, biochemistry, physiology, pathophysiology, sociology and patient psychology, similar to the medical curriculum. The following two years will then be spent focusing on podiatry specific areas such as podiatric biomechanics and human gait, podiatric orthopaedics or the non-surgical management of foot abnormalities, pharmacology & prescribing, general medicine, general pathology, local and general anaesthesia, and surgical procedural techniques such as partial and total nail avulsions, matricectomy, cryotherapy, wound debridement and care, enucleation, and other cutaneous and electro-surgical procedures such as electro-desiccation, fulagaration and electrosection. Postgraduate courses in podiatric therapeutics and prescribing are required for having endorsements in scheduled medicines. All podiatrists are required to register with AHPRA prior to be licensed to practice in Australia. Registration is required annually. There is a minimum of continuing professional development (CPD) hours a podiatrist must undertake to maintain said registration. Podiatric surgeons are specialist podiatrists who have completed extensive, post graduate medical and surgical training and perform reconstructive surgery of the foot and ankle. The qualifications of podiatric surgeons are recognised by Australian State and Federal Governments. It is an approved specialty by the Australian Health Practitioners Regulation Agency. Podiatric surgeons are included within both the Health Insurance Act and the National Health Act.
The Podiatry Board of Australia recognizes 3 pathways to attain specialist registration as a Podiatric Surgeon:
Podiatric surgical qualifications are a post-graduate speciality of the podiatric
profession. Before attaining a podiatric surgical fellowship qualification, a podiatrist
must complete an extensive training program, including:
1. Bachelor of Applied Science degree, majoring in Podiatry (4 years)
2. Minimum of 2 years post-graduate clinical practice
3. Master of Podiatry (2 years full-time university degree)
4. A 3-stage surgical fellowship training under supervision of the ACPS (4 to 6 years)
5. International residency training (usually in the UK and USA)
6. Demonstrated mastery of knowledge in foot and ankle surgery by passing oral and
written examinations administered by the ACPS
New Zealand.
Only one university, Auckland University of Technology (AUT), offers training to become a podiatrist. Podiatrists must have a Bachelor of Health Science majoring in podiatry from AUT, or an overseas qualification recognised by the Podiatrists Board of New Zealand, be registered with the Podiatrists Board of New Zealand and have a current Annual Practising Certificate.
Canada.
In Canada, the definition and scope of the practice of podiatry varies provincially. For instance, in some provinces like British Columbia and Alberta, the standards are the same as in the United States where the Doctor of Podiatric Medicine (DPM) is the accepted qualification.
Quebec, too, has recently changed to the DPM level of training, although other academic designations may also register. Also in Quebec, in 2004, Université du Québec à Trois-Rivières started the first program of Podiatric Medicine in Canada based on the American definition of podiatry. In the prairie and Atlantic provinces, the standard was originally based on the British model now called podiatry (chiropody). That model of podiatry is currently the accepted model for most of the world including the United Kingdom, Australia and South Africa.
The province of Ontario has been registering Chiropodists since July 1993 (when the Ontario Government imposed a cap on new podiatrists). If a registered podiatrist from outside of Ontario relocates to Ontario they are required to register with the province and practice as a chiropodist. Podiatrists who were practicing in Ontario previous to the imposed provincial cap were 'grandfathered' and allowed to keep the title of podiatrist as a subclass of chiropody. The scope of these 'grandfathered' (mostly American trained) podiatrists includes boney procedures of the forefoot and the ordering of x-rays in addition to the scope of the chiropodist.
In Ontario, podiatrists are required to have a "Doctor of Podiatric Medicine/DPM" degree (a post-baccalaureate, four-year degree), where the majority of chiropodists currently practicing hold a post-secondary diploma in chiropody, although many also have some university level schooling or a baccalaureate degree in the sciences or in another field. Podiatrists may bill OHIP for their services; chiropodists may not. Podiatrists may "communicate a diagnosis" to their patients (or to their patients' representatives) and perform surgical procedures on the bones of the forefoot; chiropodists may do neither.
Chiropodists and podiatrists are regulated by the College of Chiropodists of Ontario, which had 594 chiropodists and 65 podiatrists registered as of 29 July 2015.
The only English-speaking Chiropody program in Canada, in which also has a working Chiropody Clinic on campus for students to treat patients under the supervision of licensed Chiropodists is The Michener Institute. According to The Michener Institute website, Chiropody is a branch of medical science that involves the assessment and management of foot and lower limb disorders. This includes the management of a wide variety of disorders, injuries, foot deformities, infections and local manifestations of systemic conditions. A Chiropodist is a primary care professional practicing in podiatric medicine in Ontario that specializes in assessment, management and prevention of diseases and disorders of the foot. An essential member of the inter professional healthcare team, the Chiropodist is skilled in assessing the needs of their patients and of managing both chronic and acute conditions affecting foot and lower limb function. As a primary care provider capable of independent clinical practice, these skills are often practiced independent of medical referral and medical supervision.
United Kingdom.
In the UK, podiatrists usually undertake a 3-year undergraduate Bachelor of Science (Podiatry). Podiatric Surgeons have undertaken fellowships and postgraduate training. The scope of practice of a podiatrist falls into four key categories: General clinics, Biomechanics, High risk patient management and Surgery. There are two levels of surgical practice. As part of general podiatric care, podiatrists as HPC (Health Professions Council) registered practitioners are involved with nail and minor soft tissue surgical procedures and qualified to administer local anaesthetics. From 1 August 2012, the HPC is being rebranded to the HCPC (Health & Care Professions Council) as they are expanding their remit to include Social Workers. The old term of "State Registered" has been defunct for some time and is no longer used since the creation of the HPC. Some podiatrists go on to develop and train as podiatric surgeons, who surgically manage bone and joint disorders within the foot. It is to this latter group (Podiatric Surgeons) that the guidelines apply. Fellowship requires a minimum of six years postgraduate training. This includes a two or three year surgical residency with an approved centre. Podiatric surgeons acquire comprehensive knowledge of related subjects including pharmacology, regional anaesthetic techniques and radiographic interpretation, as well as in-depth knowledge of foot surgery. The surgical faculty of the College of Podiatrists has set the standards for fellowship.
In 2019 a 23% drop in podiatry students in the UK was reported. The Conference of Postgraduate Medical Deans called for full payment of their tuition fees and the introduction of a maintenance grant for healthcare students.
United States.
In the United States, medical and surgical care of the foot and ankle is mainly provided by two groups of professionals: podiatrists (Doctor of Podiatric Medicine or DPM) and orthopedists (MDs or DOs).
The first two years of podiatric medical school is similar to training that either Doctors of Medicine (M.D.) or Doctors of Osteopathic Medicine (D.O.) receive, but with an emphasized scope on foot, ankle, and lower extremity. To enter a college of podiatric medicine, the student must first complete at least three years or 90 semester hours of college credit at an accredited institution. Biology, Chemistry, Organic Chemistry, Physics (all science courses require a lab) and English are among the required classes. Over 95% of the students who enter a college of podiatric medicine have a bachelor's degree. Many have also completed some graduate study. Before entering a college of podiatric medicine, the student must take the MCAT (Medical College Admissions Test).
There are nine colleges of podiatric medicine in the United States. They all receive accreditation from the Council on Podiatric Medical Education, which is recognized by the U.S. Secretary of Education and the Council on Higher Education Accreditation. All of the colleges grant the degree of Doctor of Podiatric Medicine (DPM).
The four-year podiatric medical school is followed by a surgical based residency, which is hands-on post-doctoral training. Their residency model was standardized to 3-years of post-graduate training in 2011, and the residency is now known as the Podiatric Medicine and Surgery Residency (PMSR). Podiatric residents rotate through core areas of medicine and surgery. They work alongside their MD and DO counterparts in such rotations as emergency medicine, internal medicine, infectious disease, behavioral medicine, physical medicine & rehabilitation, vascular surgery, general surgery, orthopedic surgery, plastic surgery, dermatology and of course podiatric surgery and medicine. Fellowship training is available after residency in such fields such as foot & ankle traumatology or limb salvage.
Upon completion of their residency, podiatrists can decide to become board certified by a number of specialty boards including the American Board of Podiatric Medicine (ABPM) and/or the American Board of Foot and Ankle Surgery (ABFAS), which are both approved by the profession's credentialing arm, the CPME, and both have been certifying podiatrists since the 1970s. Though the ABPM and ABFAS are more common, other boards not recognized by CPME are challenging the "status quo" confer board qualified/certified status. The American Board of Podiatric Medical Specialties (ABPMS) is one additional option and has been certifying podiatrists since 1998.
The DPM superseded the historical DSC (Doctor of Surgical Chiropody) degree in the 1960s.


Booker McDaniels

Booker Taliaferro McDaniels (September 13, 1913 – December 12, 1974) was an American baseball pitcher in the Negro leagues. He played from 1940 to 1946, and again in 1949 with the Kansas City Monarchs. He also played for the Los Angeles Angels of the Pacific Coast League in 1949 and 1950. McDaniels died of throat cancer.
External links.
 and Seamheads


Carl Haeberlin

Carl Haeberlin (15 December 1870 – 12 November 1954), sometimes also spelled Häberlin, was a German physician and natural historian. He was influential for the development of climatotherapy and thalassotherapy in Germany and founded the "Dr. Carl-Häberlin-Friesenmuseum" in Wyk auf Föhr. He is not to be confused with the German psychologist Carl Haeberlin (1878–1947).
Biography.
Haeberlin was born in Ranchi, India, as son of a Christian missionary. The family moved back to Germany in 1873 and settled in Swabia where Carl Haeberlin spent his youth.
He studied medicine, passed his exams in 1895 in Tübingen and received a doctorate. In 1902, he moved to Wyk auf Föhr on Föhr island in the North Sea where he began to practice. Apart from activities as a balneologist he also worked intensively on climatotherapy and thalassotherapy. His studies and reports formed the basis for the development of these disciplines in Germany. Together with Karl Gmelin he established a centre for bioclimatic research in Wyk auf Föhr which opened in 1926. Already in the early 1900s, Gmelin's and Haeberlin's activities attracted increasing numbers of tourists to the seaside spa of Wyk which had previously been less frequented.
In 1902 and 1919 he published two chronicles of the town of Wyk and Wyk as a seaside resort respectively. A museum of natural history and local history in Wyk that he had founded in 1908 was named "Dr. Carl-Haeberlin-Museum" in his honour in 1927. The museum displays artifacts from the Viking Age, the Age of Sail, and paintings with local motives.
Carl Haeberlin died in 1954 in Wyk auf Föhr. He was survived by his wife Leonore who died on 27 April 1994 aged 94.
Awards and honours.
Haeberlin was granted an honorary professorship in 1946. In 1954, he was awarded the Commander's Cross of Merit of the Federal Republic of Germany. The town of Wyk named a street in his honour.


Branching order of bacterial phyla (Cavalier-Smith, 2002)

There are several models of the Branching order of bacterial phyla, one of these was proposed in 2002 and 2004 by Thomas Cavalier-Smith. In this frame of work, the branching order of the major lineage of bacteria are determined based on some morphological characters, such as cell wall structure, and not based on the molecular evidence (molecular phylogeny).
Whereas modern molecular studies point towards the root of the tree of life being between a monophyletic Bacteria and Archaea+Eukarya (Neomura), in the Cavalier-Smith theory, the last common ancestor (cenansestor) was a Gram-negative diderm bacterium with peptidoglycan, while Archaea and Eukaryotes stem from Actinobacteria.


Orbit (journal)

Orbit, "the International Journal on Orbital Disorders, Oculoplastic and Lacrimal Surgery" is a bimonthly peer-reviewed medical journal covering orbital disorders including: ophthalmology, plastic surgery, dermatology, maxillofacial surgery, otolaryngology, endocrinology, radiology, oncology, neurology, neurosurgery, pathology, and immunology. The journal was established in 1980 when Gabe Bleeker, Chairman of the Board of the International Society for Orbital Disorders, came to an agreement with the Aeolus Press Publishing Company and became the first editor-in-chief. The journal is now published by Taylor & Francis and over the years is or has been the official journal of several organizations including the European Society of Ophthalmic Plastic and Reconstructive Surgery, the British Oculoplastic Surgery Society, and the Italian Society of Oculoplastic Surgery. Editors have included Leo Koornneef, Maarten Mourits, and Dion Paridaens. The current editor-in-chief is Suzanne K. Freitag (Harvard Medical School).


Michael Brown (physician)

Major General Michael Brown FRCPE FRCP (1931-1993) was a senior British physician, Director of Army Medicine and Physician to the Queen.
Biography.
Born in Ramsgate, Kent, on 17 January 1931, Michael Brown was educated at Bedford School and at University College London Medical School. He became a regular British Army officer in 1956 and was Consultant Physician at the Royal Army Medical College between 1966 and 1981. He was posted to military hospitals in Hong Kong, Nepal and Malaysia, where he co-authored a major paper on melioidosis. He was elected to the Fellowship of the Royal College of Physicians in 1976 and appointed as Professor of Military Medicine at the Royal College of Physicians and at the Royal Army Medical College between 1981 and 1985. He was Consultant Physician to the British Army of the Rhine between 1985 and 1988, Director of Army Medicine and Physician to the Queen between 1988 and 1990, and a Fellow of University College London between 1991 and 1993.
Major General Michael Brown died in Woolwich on 13 June 1993.


List of dermatologists

This is a list of dermatologists who have made notable contributions to the field of dermatology.


William Gates Building, Cambridge

The William Gates Building, or WGB, is a square building that houses the Computer Laboratory at the University of Cambridge, on the University's West Cambridge site in JJ Thomson Avenue south of the Madingley Road in Cambridge, England. Construction on the building began in 1999 and was completed in 2001 at a cost of £20 million. Opened by Maurice Wilkes, it was named after William H. Gates Sr., the father of Microsoft founder Bill Gates. The Bill & Melinda Gates Foundation provided 50% of the money for the building's construction.
Building features.
The building has the following features:
Energy efficiency.
The William Gates Building aims to be energy-efficient. Its energy-saving measures include:


Leopold Bellak

Leopold Bellak (1916–2000) was a psychologist, psychoanalyst, and psychiatrist who pioneered the Children's Apperception Test (CAT). He also collaborated on the Thematic Apperception Test (TAT), on clinical psychological assessments, and pioneered the understanding of ADHD (Attention Deficit Hyperactivity Disorder) as being a genetic disorder. Dr. Bellak created the 67-year-old publishing house, CPS Publishing LLC.
He was born in Vienna, Austria and as a refugee moved to the United States in 1939. In addition, he was the author of many books and manuscripts. His tests and books are used in universities, and by clinicians globally.
He received the APA Award for Distinguished Professional Contributions to Applied Research in 1979. He received the Bruno Klopfer Award in 1991. He was awarded these and many others for his many achievements.


Cryptic self epitopes

In immunology, cryptic self epitopes are a source of autoimmunity.
Self epitopes, which are found in high concentration on the surface of antigen-presenting cells (APC's) in association with its major histocompatibility complex (MHC) are known as dominant epitopes. These are stimulants of negative selection mechanisms to remove potentially self destructing autoreactive T cells. Their "self" antigens are displayed to a developing T-cell and signal those "self-reactive" T-cells to die via programmed cell death (apoptosis) and thereby deletion from the T cell repertoire, preventing autoimmunity.
However, self epitopes which appear in very low concentration on APC are termed cryptic in the sense that they do not delete autoreactive T-cells which will then join the peripheral adult T cell repertoire. This causes autoimmunity in the body.


Armand Nicholi

Armand M. Nicholi, M.D. Jr. (1928-2017) was a clinical professor of psychiatry at Harvard Medical School and the Massachusetts General Hospital. His clinical work and research focused on the impact of absent parents on the emotional development of children and young adults. He was the editor and coauthor of the classic "The Harvard Guide to Psychiatry" (3rd edition, 1999). He was also a founding board member of the Family Research Council.
Education.
He graduated from Cornell University and New York Medical College. He intended a career In neurosurgery so he began his internship at Cornell Surgical Division at Bellevue Hospital. After a year, he switched to psychiatry.
Personal life.
He taught a course on Sigmund Freud and C. S. Lewis at Harvard College and the Harvard Medical School for more than 35 years. For 15 years he served as the psychiatrist for the New England Patriots. He also had an active practice and served as a consultant to government groups, corporations, and professional athletes. He was married, with two children, and lived in Concord, Massachusetts until his death on June 22, 2017.


Henri Conneau

François-Alexandre-Henri Conneau (1803–1877) or Doctor Conneau ("Docteur"), was a loyal attendant of Napoleon III.


Circle Health


Soroti University School of Medicine and Health Sciences

Soroti University School of Medicine and Health Sciences (SUSMHS), is one of the three schools of Soroti University, one of Uganda's public universities. The school houses the university's medical school, the fifth public medical school in the country.
Location.
The school's campus is on the premises of Soroti Regional Referral Hospital, in the central business district of the city of Soroti in Soroti District, Eastern Region. This campus is approximately , by road, northeast of Kampala, Uganda's capital and largest city. The coordinates of the school are 1°42'57.0"N, 33°36'47.0"E (Latitude:1.715825; Longitude:33.613054).
Overview.
The school, whose official name is Soroti University School of Medicine and Health Sciences (SUSMHS), is organised in over 20 distinct departments, each led by a departmental head. The areas of study include human medicine, nursing, dentistry, biomedical science, pharmacy, and allied health professionals. The objectives of the school include the training of competent health professionals, who will provide the required health care and relieve the disease and morbidity burden in the region and the country.
Undergraduate courses.
The following undergraduate courses are offered:


UT Health San Antonio Cancer Center

UT Health San Antonio Cancer Center, founded in 1974, is an NCI-designated Cancer Center in San Antonio, Texas. It is a component of the University of Texas Health Science Center, San Antonio which is located adjacently.
The center serves more than 4.4 million people in the high-growth corridor of Central and South Texas including Austin, San Antonio, Laredo and the Rio Grande Valley, and handles more than 120,000 patient visits each year, and has a faculty staff of 140.


Joseph Dancis

Joseph Dancis (March 19, 1916 – March 30, 2010) was an American pediatrician at Bellevue Hospital in New York City known for his research contributions to neonatology and placentology. He received the John Howland Award in 1988.
Early life.
Dancis was born on March 19, 1916, in Brooklyn and was raised in the Bronx. He attended Columbia College from 1931 to 1934 and received an M.D. from Saint Louis University School of Medicine in 1938. After graduating, he returned to New York City to complete a rotating internship and a residency in pediatrics at Queens General Hospital. He served in the U.S. Army from 1941 to 1945 and was stationed in Hawaii. He achieved the rank of captain. He subsequently completed his training in pediatrics at Bellevue Hospital.
Career and research.
Dancis was appointed as an academic in the Bellevue Hospital pediatrics department led by L. Emmett Holt Jr. In the early 1950s, in order to advance his understanding of biochemistry, metabolism and radioisotopes, Dancis spent a year each at the New York University Department of Biochemistry and the Sloan Kettering Institute. He noticed that none of the staff members at Bellevue were particularly interested in neonatology, or study of the newborn, and so decided to "fill the vacuum" himself. He made significant contributions to the research of inborn errors of metabolism; this included identifying with colleagues the enzyme defect that causes maple syrup urine disease. He also published important research on familial dysautonomia, Lesch–Nyhan syndrome, and retinopathy of prematurity. He was particularly interested in the placenta, studying its role in synthesis as well as transport of substances from mother to fetus.
Dancis was appointed chairman of the pediatrics department at the New York University School of Medicine in 1974. He was elected president of the American Pediatric Society in 1983 and received the APS's most prestigious award, the John Howland Award, in 1988. During his career, he authored a total of 258 publications.
Death.
Dancis died in New York City on March 30, 2010. On the day that he died, he had attended the pediatrics grand rounds at NYU before collapsing while walking home to his apartment.


American Respiratory Care Foundation

The American Respiratory Care Foundation is a non-profit organization founded by the American Association for Respiratory Care formed to provide funding for research in the field of pulmonology and respiratory care. Formed in 1974 as the American Respiratory Therapy Foundation and then changed to the American Respiratory Care Foundation in 1986. The ARCF is a partner with the United States Environmental Protection Agency, who has awarded grants to the ARCF in order to help fund research directly related to asthma and asthma education.
International fellowship.
The International Fellowship Program was established in 1990 as a method of expanding respiratory care practices internationally by inviting physicians and nurses among other health professionals to shadow respiratory therapists to observe the practice and application in medicine.


Capsomere

The capsomere is a subunit of the capsid, an outer covering of protein that protects the genetic material of a virus. Capsomeres self-assemble to form the capsid.
Subunits called protomers aggregate to form capsomeres. Various arrangements of capsomeres are: 1) Icosahedral, 2) Helical, and 3) Complex.
1) Icosahedral- An icosahedron is a polyhedron with 12 vertices and 20 faces. Two types of capsomeres constitute the icosahedral capsid: pentagonal (pentons) at the vertices and hexagonal (hexons) at the faces. There are always twelve pentons, but the number of hexons varies among virus groups. In electron micrographs, capsomeres are recognized as regularly spaced rings with a central hole.
2) Helical- The protomers are not grouped in capsomeres, but are bound to each other so as to form a ribbon-like structure. This structure folds into a helix because the protomers are thicker at one end than at the other. The diameter of the helical capsid is determined by characteristics of its protomers, while its length is determined by the length of the nucleic acid it encloses.
3) Complex- e.g., that exhibited by poxvirus and rhabdovirus. This group comprises all those viruses which do not fit into either of the above two groups.
When the viral particle has entered a host cell, the host cellular enzymes digest the capsid and its constituent capsomeres, thereby exposing the naked genetic material (DNA/RNA) of the virus, which subsequently enters the replication cycle.
The capsomeres protect against physical, chemical, and enzymatic damage and are multiply redundant; having a few protein subunits that are repeated. This is because the viral genome is being as economic as possible by only needing a few protein codons to make a large structure. One of the major functions of a capsid is to introduce the enclosed viral genome into host cells by adsorbing readily to host cell surfaces.


Hypertelorism

Hypertelorism is an abnormally increased distance between two organs or bodily parts, usually referring to an increased distance between the orbits (eyes), or orbital hypertelorism. In this condition the distance between the inner eye corners as well as the distance between the pupils is greater than normal. Hypertelorism should not be confused with telecanthus, in which the distance between the inner eye corners is increased but the distances between the outer eye corners and the pupils remain unchanged.
Hypertelorism is a symptom in a variety of syndromes, including Edwards syndrome (trisomy 18), 1q21.1 duplication syndrome, basal cell nevus syndrome, DiGeorge syndrome and Loeys–Dietz syndrome.
Hypertelorism can also be seen in Apert syndrome, Autism spectrum disorder, craniofrontonasal dysplasia, Noonan syndrome, neurofibromatosis, LEOPARD syndrome, Crouzon syndrome, Wolf–Hirschhorn syndrome, Andersen–Tawil syndrome, Waardenburg syndrome and cri du chat syndrome, along with piebaldism, prominent inner third of the eyebrows, irises of different color, spondyloepiphyseal dysplasia, mucopolysaccharide metabolism disorders (Morquio syndrome and Hurler's syndrome), deafness and also in hypothyroidism. Some links have been found between hypertelorism and attention deficit/hyperactivity disorder.
Embryology.
Because hypertelorism is an anatomic condition associated with a heterogeneous group of congenital disorders, it is believed that the underlying mechanism of hypertelorism is also heterogeneous. Theories include too early ossification of the lower wings of the sphenoid, an increased space between the orbita, due to increasing width of the ethmoid sinuses, field defects during the development, a nasal capsule that fails to form, leading to a failure in normal medial orbital migration and also a disturbance in the formation of the cranial base, which can be seen in syndromes like Apert and Crouzon.
Treatment.
The craniofacial surgery to correct hypertelorism is usually done between five and eight years of age. This addresses the psychosocial aspects in the child's early school years. Another reason for correction age five or older is that the surgery should be delayed until the tooth buds have grown out low enough into the maxilla, thus preventing damage to them. Also, before age five the craniofacial bones are thin and fragile, which can make surgical correction difficult. In addition, it is possible that orbital surgery during infancy may inhibit midface growth.
For the treatment of hypertelorism there are two main operative options: The box osteotomy and the facial bipartition (also referred to as median fasciotomy).
Box osteotomy.
This treatment of orbital hypertelorism was first performed by Paul Tessier. The surgery starts off by various osteotomies that separate the entire bony part of the orbit from the skull and surrounding facial bones. One of the osteotomies consists of removing the bone between the orbits. The orbits are then mobilized and brought towards each other. Because this often creates excessive skin between the orbits a midline excision of skin is frequently necessary. This approximates the eyebrows and eye corners and provides a more pleasing look.
Facial bipartition.
The standard procedure (box osteotomy) was modified by Jacques van der Meulen and resulted in the development of the facial bipartition (or median faciotomy).
Facial bipartition first involves splitting the frontal bone from the supraorbital rim. Then the orbits and the midface are released from the skull-base using monoblock osteotomy. Then a triangular shaped piece of bone is removed from the midline of the midface. The base of this triangular segment lies above the orbita and the apex lies between the upper incisor teeth. After removing this segment it is possible to rotate the two halves of the midface towards each other, thus resulting in reduction of the distance between the orbits. It also results in leveling out the V-shaped maxilla and therefore widening of it.
Because hypertelorism is often associated with syndromes like Apert, hypertelorism is often seen in combination with midface dysplasia. If this is the case, facial bipartition can be combined with distraction osteogenesis. The aim of distraction osteogenesis of the midface is to normalize the relationship between orbital rim to eye and also normalize the position of zygomas, nose and maxilla in relation to the mandible.
Soft tissue reconstruction.
To create an acceptable aesthetic result in the correction of orbital hypertelorism, it is also important to take soft-tissue reconstruction in consideration. In this context, correction of the nasal deformities is one of the more difficult procedures. Bone and cartilage grafts may be necessary to create a nasal frame and local rotation with for example forehead flaps, or advancement flaps can be used to cover the nose.
Complications from surgery.
As with almost every kind of surgery, the main complications in both treatments of hypertelorism include excessive bleeding, risk of infection and CSF leaks and dural fistulas. Infections and leaks can be prevented by giving perioperative antibiotics and identifying and closing of any dural tears. The risk of significant bleeding can be prevented by meticulous technique and blood loss is compensated by transfusions. Blood loss can also be reduced by giving hypotensive anesthesia. Rarely major eye injuries, including blindness, are seen. Visual disturbances can occur due to the eye muscle imbalance after orbital mobilization. Ptosis and diplopia can also occur postoperatively, but this usually self-corrects. A quite difficult problem to correct postoperatively is canthal drift, which can be managed best by carefully preserving the canthal tendon attachments as much as possible. Despite the extensiveness in these procedures, mortality is rarely seen in operative correction of hypertelorism.