Abandoned on Bataan: One Man's Story of Survival 

October, 2002

by Oliver Craig Allen  (Author), Mildred Faye Allen (Author)

"Back in the Philippines, there was no hero worship."

Battle of the Coral Sea and Corregidor: When America’s worst defeat gave way to victory

"As the Japanese tightened their grip on Bataan, President Franklin Roosevelt ordered MacArthur to leave Corregidor and proceed to Australia, ostensibly to take command of a relief expedition. His return to the Philippines would take years, but MacArthur’s dramatic escape by PT-boat propelled him into legend as the hero the American public desperately needed during the uncertain early months of the war.

Back in the Philippines, there was no hero worship. Faced with starvation, forces on Bataan surrendered early in April. Corregidor hung on until May 6. Where did this disastrous defeat leave America and its allies? As MacArthur hunkered down in Australia and mourned the fall of Corregidor, two aircraft carriers of the US Navy sailed into the Coral Sea to counter an invasion aimed at Port Moresby on New Guinea that threatened Australia itself."

Surviving veteran of Bataan Death March recalls horror 75 years later

Andrew J. Evans, Mohamed E. Salama, Walter H. Henricks, and Liron Pantanowitz (2017) Implementation of Whole Slide Imaging for Clinical Purposes: Issues to Consider From the Perspective of Early Adopters. Archives of Pathology & Laboratory Medicine In-Press.

Early Online Release

Implementation of Whole Slide Imaging for Clinical Purposes: Issues to Consider From the Perspective of Early Adopters

Andrew J. Evans, MD, PhD; Mohamed E. Salama, MD; Walter H. Henricks, MD; Liron Pantanowitz, MD

From the Department of Pathology, University Health Network, Toronto, Ontario, Canada (Dr Evans); the Department of Pathology, University of Utah and ARUP Laboratories, Reference Laboratory, Salt Lake City (Dr Salama); the Department of Pathology, Cleveland Clinic Foundation, Cleveland, Ohio (Dr Henricks); and the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Pantanowitz).

Reprints: Andrew J. Evans, MD, PhD, Department of Pathology, University Health Network, Toronto General Hospital, 11-Eaton-223, 200 Elizabeth St, Toronto, ON M5G 2C4, Canada (email: andrew.evans@uhn.ca).

Context.— There is growing interest in the use of digital pathology, especially whole slide imaging, for diagnostic purposes. Many issues need to be considered when incorporating this technology into a clinical laboratory. The College of American Pathologists established a Digital Pathology Committee to support the development of College programs related to digital pathology. One of its many initiatives was a panel discussion entitled “Implementing Whole-Slide Imaging for Clinical Use: What to Do and What to Avoid,” given for 3 years at the College's annual meetings starting in 2014.

Objectives.— To review major issues to consider when implementing whole slide imaging for clinical purposes as covered during the panel discussion.

Design.— The views expressed and recommendations given are based primarily on the personal experience of the authors as early adopters of this technology. It is not intended to be an exhaustive review of digital pathology.

Results.— Implementation is best approached in phases. Early efforts are directed toward identifying initial clinical applications and assembling an implementation team. Scanner selection should be based on intended use and budget. Recognizing pathologist concerns over the use of digital pathology for diagnostic purposes, ensuring adequate training, and performing appropriate validation studies will enhance adoption. Once implemented, the transition period from glass slide to image-based diagnostics will be associated with challenges, especially those related to a hybrid glass slide–digital slide workflow.

Conclusions.— With appropriate preparation, planning, and stepwise implementation, whole slide imaging can be used safely and reliably for frozen sections, consultation, quality assurance, and primary diagnosis.

30% of Americans have fatty liver disease

30% of Americans Have This Obesity-Related Disease

There are no drugs approved to treat fatty liver disease, although losing weight through diet and exercise can help reduce fat in the liver and related inflammation. Doctors can also help patients identify other obstacles to weight loss, like sleep problems or certain medications.

“For the majority of patients, lifestyle modification is way more effective than any drug,” says Behari. “All of these chronic disorders—fatty liver, diabetes, heart disease—share an underlying metabolic component, and the same common-sense healthy living principles apply for all of them.”

Transplant Proc. 2017 May;49(4):707-710. doi: 10.1016/j.transproceed.2017.02.013.

Ethical Issues in Uterine Transplantation: Psychological Implications and Informed Consent.

Petrini C1, Gainotti S2, Morresi A3, Nanni Costa A4.

Author information

1

Bioethics Unit, Istituto Superiore di Sanità (Italian National Institute of Health), Rome, Italy. Electronic address: carlo.petrini@iss.it.

2

Bioethics Unit, Istituto Superiore di Sanità (Italian National Institute of Health), Rome, Italy.

3

Dipartimento di Chimica, Biologia e Biotecnologie, Università degli Studi di Perugia, Perugia, Italy.

4

Centro Nazionale Trapianti (National Transplant Centre), Istituto Superiore di Sanità (Italian National Institute of Health), Rome, Italy.

Abstract

Since 2000, 13 uterine transplantations (UTxs) have been performed in women with absolute uterine infertility factor (AUIF), from both living and deceased donors, in different transplantation centers worldwide. At present the birth of 4 children following UTx is documented by the literature, and a woman was having a second pregnancy in October 2015. Following these successes it is likely that the procedure will become part of normal healthcare practice, even though at the moment it is still experimental and, as such, requires careful attention. Because the emotional aspects that are tied to UTx may foster the "therapeutic misconception" of participants, which consists in an overestimation of the benefits and an underestimation of the risks, careful attention should be paid also to informed consent (IC), which must include the following: describing techniques, pointing out risks and possibility of failure, and informing about the treatments required after the intervention. Because the final aim of UTx is the birth of a healthy child, the IC document must include details not only of the transplantation itself, but also of the very particular pregnancy deriving from it, and the need to remove the uterus following delivery(ies) to avoid these risks. Here we suggest that the IC process includes counselling techniques, possibly involving the psychologist that is part of the transplantation team, to target the information and decision-making process to the specific situation of each couple.

Med Decis Making. 2017 Apr 1:272989X17696999. doi: 10.1177/0272989X17696999. [Epub ahead of print]

An Approach to Reconciling Competing Ethical Principles in Aggregating Heterogeneous Health Preferences.

Dewitt B1,2,3, Davis A1,2,3, Fischhoff B1,2,3, Hanmer J1,2,3.

Author information

1

Department of Engineering and Public Policy, Carnegie Mellon University, Pittsburgh, PA, USA (BD, AD).

2

Department of Engineering and Public Policy and the Institute for Politics and Strategy, Carnegie Mellon University, Pittsburgh, PA, USA (BF).

3

Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA (JH).

Abstract

BACKGROUND:

Health-related quality of life (HRQL) scores are used extensively to quantify the effectiveness of medical interventions. Societal preference-based HRQL scores aim to produce societal valuations of health by aggregating valuations from individuals in the general population, where each aggregation procedure embodies different ethical principles, as explained in social choice theory.

METHODS:

Using the Health Utilities Index as an exemplar, we evaluate societal preference-based HRQL measures in the social choice theory framework.

RESULTS:

We find that current preference aggregation procedures are typically justified in terms of social choice theory. However, by convention, they use only one of many possible aggregation procedures (the mean). Central to the choice of aggregation procedure is how to treat preference heterogeneity, which can affect analyses that rely on HRQL scores, such as cost-effectiveness analyses. We propose an analytical-deliberative framework for choosing one (or a set of) aggregation procedure(s) in a socially credible way, which we believe to be analytically sound and empirically tractable, but leave open the institutional mechanism needed to implement it.

CONCLUSIONS:

Socially acceptable decisions about aggregating heterogeneous preferences require eliciting stakeholders' preferences among the set of analytically sound procedures, representing different ethical principles. We describe a framework for eliciting such preferences for the creation of HRQL scores, informed by social choice theory and behavioral decision research.

Alternate-day fasting not shown to increase weight loss: Study

"The researchers found at the end of the year that there was not a significant difference between the group that practiced alternate fasting and the group that cut calories."

Marijuana "...properly being considered a 'gateway drug'."

CNS Neurol Disord Drug Targets. 2017 Apr 13. doi: 10.2174/1871527316666170413113246. [Epub ahead of print]

Cannabis; epidemiological, neurobiological and psychopathological issues: an update.

De Luca MA1, Di Chiara G1, Cadoni C2, Lecca D1, Orsolini L3, Papanti D3, Corkery J3, Schifano F3.

Author information

1

Department of Biomedical Sciences, Neuropsychopharmacology Unit, University of Cagliari, Italy Cagliari. Italy.

2

Centre of Excellence "Neurobiology of Dependence", University of Cagliari-Cagliari, Italy Cagliari. Italy.

3

Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, College Lane Campus, University of Hertfordshire, Hatfield, Herts, AL10 9AB, UK herts. United Kingdom.

Abstract

Cannabis is the illicit drug with both the largest current levels of consumption and the highest lifetime prevalence in the world. Across different countries, the prevalence of cannabis use varies according to the individual income, with the highest use reported in North America, Australia and Europe. Despite its 'soft drug' reputation, cannabis misuse may be associated with several acute and chronic adverse effects. The present article aims at reviewing several papers on epidemiological, neurobiological and psychopathological aspects of the use of cannabis. To this end, the PubMed database was examined in order to collect and discuss several papers. Cannabis intake usually starts during late adolescence/early adulthood (15-24 years) and drastically decreases in adulthood with the acquisition of working/familiar and social responsibilities. Clinical evidence supports the current socio-epidemiological alarm concerning the increased consumption among youngsters and the risks related to the onset of psychotic disorders. The mechanism of action of cannabis presents some analogies with other abused drugs, e.g. opiates. Furthermore, it has been well demonstrated that intake in adolescence may facilitate the transition to the use and/or abuse of other psychotropic drugs, hence properly being considered a 'gateway drug'. Some considerations on synthetic cannabimimetics are provided here as well. In conclusion, the highest prevalence of cannabis use and the social perception of a relatively low associated risk are in contrast with current knowledge based on biological and clinical evidence. Indeed, there are concerns relating to cannabis intake association with detrimental effects on both cognitive impairment and mental health.

Med J Aust. 2017 May 1;206(8):363-368.

Neurobionics and the brain-computer interface: current applications and future horizons.

Rosenfeld JV1, Wong YT2.

Author information

1

Monash Institute of Medical Engineering, Monash University, Melbourne, VIC j.rosenfeld@alfred.org.au.

2

Electrical and Computer Systems Engineering, University of Melbourne, Melbourne, VIC.

Abstract

The brain-computer interface (BCI) is an exciting advance in neuroscience and engineering. In a motor BCI, electrical recordings from the motor cortex of paralysed humans are decoded by a computer and used to drive robotic arms or to restore movement in a paralysed hand by stimulating the muscles in the forearm. Simultaneously integrating a BCI with the sensory cortex will further enhance dexterity and fine control. BCIs are also being developed to: provide ambulation for paraplegic patients through controlling robotic exoskeletons; restore vision in people with acquired blindness; detect and control epileptic seizures; and improve control of movement disorders and memory enhancement. High-fidelity connectivity with small groups of neurons requires microelectrode placement in the cerebral cortex. Electrodes placed on the cortical surface are less invasive but produce inferior fidelity. Scalp surface recording using electroencephalography is much less precise. BCI technology is still in an early phase of development and awaits further technical improvements and larger multicentre clinical trials before wider clinical application and impact on the care of people with disabilities. There are also many ethical challenges to explore as this technology evolves.

"The onus lies on medical schools and healthcare bodies endorsing international electives to ensure that individuals are appropriately prepared..."

Int J Surg. 2017 Apr 19. pii: S1743-9191(17)30331-X. doi: 10.1016/j.ijsu.2017.04.020. [Epub ahead of print]

Surgical volunteerism or voluntourism - Are we doing more harm than good?

Ahmed F1, Grade M2, Malm C3, Michelen S4, Ahmed N5.

Author information

1

NHS England, UK; London School of Hygiene and Tropical Medicine, UK. Electronic address: faheem.ahmed@doctors.org.uk.

2

Stanford Medical School, USA. Electronic address: madelinegrade@gmail.com.

3

Harvard Medical School, USA. Electronic address: carl_malm@hms.harvard.edu.

4

Harvard Medical School, USA; London School of Hygiene and Tropical Medicine, UK. Electronic address: sophia_michelen@hms.harvard.edu.

5

St George's Hospital, UK. Electronic address: naeem.ahmed@nhs.net.

Abstract

The significant rise in the number of international health electives undertaken by medical students and doctors in the US, Canada and UK reflects acknowledgement of the inter-connected nature of these challenges to health systems and the drive to help solve them. However, the next generation of international volunteers often operate under a conflicting duality: whilst many of their role models have devoted their lives to global health following a similar volunteering experience, there are pervasive ethical problems associated with short-term global health work that must be identified and addressed to ensure positive outcomes for all parties involved. The general shortage of healthcare staff in resource-poor countries has significantly contributed to the disparities between need and provision.1 The majority of populations served by shortterm surgical volunteer trips are vulnerable communities; this raises ethical questions such as the lack of informed consent, use of unauthorised photos for marketing, and practicing new procedural techniques. 2 Whilst there exist various models that can be used to facilitate effective international health electives, there is a lack of stringent monitoring and enforcement both on the part of healthcare institutions deploying volunteers as well as recipient bodies in LMICS. Well-organised programmes prevent cases of 'poor care given to poor people' as medical students and doctors are expected to act in their patients' best interests as they would do in their home country. As clinician interest in global health projects continue to rise, too-common trainee naivety - while rooted in goodwill - must be supplanted by adequate training, ethical coherence, and cultural fluency. The onus lies on medical schools and healthcare bodies endorsing international electives to ensure that individuals are appropriately prepared and only travel through programmes that are able to demonstrate that they meet the necessary requirements and follow guidelines to avoid doing more harm than good.

Obesity - the new smoking

Obesity Tops List of Causes for Lost Years of Life, Beating Tobacco

Mary Caffey

"Obesity causes Americans to lose more years of life than any other cause, including smoking cigarettes, according to a new study from researchers at the Cleveland Clinic and the New York University School of Medicine.

The team found that obesity resulted in as much as 47% more lost life years than tobacco, while high blood pressure and tobacco took a similar number of years off the life span."




 - See more at: http://www.ajmc.com/newsroom/obesity-tops-list-of-causes-for-lost-years-of-life-beating-tobacco#sthash.ahYwwtHi.dpuf

Kids With Bedtimes, Mealtimes Less Likely To Be Obese, Study Finds

"The study tracked 11,000 kids for more than a decade to pull the data from. They found that when the kids were three years old, just under half had a bedtime. Close to half had scheduled mealtimes and a fifth of them had TV and videos restricted to less than an hour a day. Of those kids, just 6% were obese by 11 years old."

Chip Roy: ObamaCare repeal: GOP leaders are missing their chance

ObamaCare repeal: GOP leaders are missing their chance

By Chip Roy

 Published April 24, 2017

"First, Congress is turning away from the free market.  Republicans talk a big game about believing in free enterprise and capitalism. But the grassroots out in real America see their actions as more cronyism than principle. Whether it’s subsidizing big corporations through the Export-Import Bank or the more recent $100 billion insurer slush fund included in the American Health Care Act, the grassroots understandably consider Congress’ actions to be political pay-offs and more of Washington picking winners and losers rather than the free market at work."

Arch Pathol Lab Med. 2017 Apr 18. doi: 10.5858/arpa.2017-0105-SA. [Epub ahead of print]

Twenty-First Century Pathologists' Advocacy.

Allen TC.

Abstract

Pathologists' advocacy plays a central role in the establishment of continuously improving patient care quality and patient safety, and in the maintenance and progress of pathology as a profession. Pathology advocacy's primary goal is the betterment of patient safety and quality medical care; however, payment is a necessary and appropriate component to both, and has a central role in advocacy. Now is the time to become involved in pathology advocacy; the Medicare Access and Children's Health Insurance Program (CHIP) Reauthorization Act of 2015 (MACRA) and the Protecting Access to Medicare Act of 2014 (PAMA) are two of the most consequential pieces of legislation impacting the pathology and laboratory industry in the last 20 years. Another current issue of far-reaching impact for pathologists is balance billing, and yet many pathologists have little or no understanding of balance billing. Pathologists at all stages of their careers, and in every professional setting, need to participate. Academic pathologists have a special obligation to, if not become directly involved in advocacy, at least have a broad and current understanding of those issues, as well as the need and responsibility of pathologists to actively engage in advocacy efforts to address them, in order to teach residents the place of advocacy, and its value, as an inseparable and indispensable component of their professional responsibilities.

DRIVERS NEEDED

How Ambulance Drivers Hemingway and Dos Passos Rerouted the Course of American Literature

The ambulance corps was one of the few ways Americans could get into WWI until the US finally entered the fray in 1917. The experience was crucial for two great authors.

JAMES MCGRATH MORRIS

04.06.17 3:31 PM ET

"If the record of war in the 20^th century is an indicator, Hemingway’s view prevailed while Dos Passos’s impassioned warning against war sadly fell on deaf ears."

"...since 2005 more than one in 10 children in Scotland had started primary school overweight or obese."

Obesity campaigners call for more salads and fewer puddings in school

"A study last year found that since 2005 more than one in 10 children in Scotland had started primary school overweight or obese.

The figures showed almost 83,000 four to five-year-olds entered P1 carrying excess weight between 2005-2006 and 2014-2015."

"Because of the complexity of cancer immunity, we still do not have a reliable biomarker to predict the response of PD-1/PD-L1–targeted therapy."

Jian Guan,Khin Sandar Lim,Tarek Mekhail,Chung-Che Chang, (2017) Programmed Death Ligand-1 (PD-L1) Expression in the Programmed Death Receptor-1 (PD-1)/PD-L1 Blockade: A Key Player Against Various Cancers. Archives of Pathology & Laboratory Medicine In-Press.

Early Online Release

Programmed Death Ligand-1 (PD-L1) Expression in the Programmed Death Receptor-1 (PD-1)/PD-L1 Blockade: A Key Player Against Various Cancers

Jian Guan, MD, PhD; Khin Sandar Lim, MD; Tarek Mekhail, MD; Chung-Che Chang, MD, PhD

From the Departments of Internal Medicine (Drs Guan, Lim, and Mekhail) and Pathology and Laboratory Medicine (Dr Chang), Florida Hospital, Orlando; and the Department of Pathology, University of Central Florida College of Medicine, Orlando (Dr Chang).

Reprints: Chung-Che Chang, MD, PhD, Department of Pathology and Laboratory Medicine, Florida Hospital, 601 Rollins St, Orlando, FL 32803 (email: c.jeff.chang.md@flhosp.org).

Context.— Immune checkpoint pathways, including programmed death receptor-1/programmed death ligand-1 (PD-1/PD-L1) signaling pathway, which are important in mediating self-tolerance and controlling self-damage, can sometimes be manipulated by cancer cells to evade immune surveillance. Recent clinical trials further demonstrate the efficacy of PD-1/PD-L1–targeted therapy in various cancers and reveal a new era of cancer immunotherapy.

Objective.— To review the mechanism of the PD-1/PD-L1 signaling pathway, the regulation of this pathway, PD-1/PD-L1 as a predictive and/or prognostic marker in various cancers, and strategies of measuring PD-L1 expression.

Data Sources.— Representative medical literature regarding PD-L1 expression in various cancers, including the preliminary results of the Blue Proposal, which compares different immunohistochemical stains for PD-L1 reported in the recent American Association of Cancer Research (AACR) Annual Meeting (April 16–20, 2016).

Conclusion.— Either PD-1/PD-L1–targeted therapy alone or in combination with other treatment modalities provides benefit for patients with advanced cancers. Because of the complexity of cancer immunity, we still do not have a reliable biomarker to predict the response of PD-1/PD-L1–targeted therapy. Future studies, including methods beyond immunohistochemical stains, are needed to develop reliable biomarker/biomarkers for pathology laboratories to aid in selecting patients who will benefit most from PD-1/PD-L1–targeted therapy.

J Nurse Pract. 2016 Jul-Aug;12(7):425-432. doi: 10.1016/j.nurpra.2016.05.013.

Obesity Stigma and Bias.

Fruh SM1, Nadglowski J2, Hall HR3, Davis SL4, Crook ED5, Zlomke K6.

Author information

1

Professor at the University of South Alabama in Mobile.

2

President/CEO of Obesity Action Coalition in Tampa, FL.

3

Professor and Associate Dean for Academic Affairs at the University of South Alabama.

4

Instructor at the Division of Nursing at Springhill College in Mobile, AL.

5

Abraham A. Mitchell Professor and Chair at the Department of Internal Medicine at the University of South Alabama.

6

Assistant Professor at the Department of Psychology at the University of South Alabama.

Abstract

Overweight and obesity are escalating in epidemic proportions in the United States. Individuals with overweight and obesity are often reluctant to seek medical help, not only for weight reduction but also for any health issue because of perceived provider discrimination. Providers who are biased against individuals with obesity can hinder our nation's effort to effectively fight the obesity epidemic. By addressing weight bias in the provider setting, individuals affected by obesity may be more likely to engage in a meaningful and productive discussion of weight. Providers need to be the go-to source for obesity-focused information on new and emerging treatments.

Stroke rates are rising in young adults

"The results showed an increase in hospitalization rates in younger adults, ages 18-44, since 1995. Increases were seen most specifically in men 35 to 44 by 42% and women of the same age group by 30%.

Even though deaths due to strokes have significantly decreased over the last 50 years, strokes were the fifth leading cause of death among all adults in 2013, according to The Washington Post."

Sci Eng Ethics. 2017 Apr 11. doi: 10.1007/s11948-017-9905-3. [Epub ahead of print]

The Ethical and Academic Implications of the Jeffrey Beall (www.scholarlyoa.com) Blog Shutdown.

Teixeira da Silva JA1.

Author information

1

, Miki-cho Post Office, 3011-2, P.O. Box 7, Ikenobe, Kagawa-ken, 761-0799, Japan. jaimetex@yahoo.com.

Abstract

A very important event took place on January 15, 2017. On that day, the Jeffrey Beall blog ( www.scholarlyoa.com ) was silently, and suddenly, shut down by Beall himself. A profoundly divisive and controversial site, the Beall blog represented an existential threat to those journals and publishers that were listed there. On the other hand, the Beall blog was a ray of hope to critics of bad publishing practices that a culture of public shaming was perhaps the only way to rout out those journals-and their editors-and publishers who did not respect basic publishing ethical principles and intrinsic academic values. While members of the former group vilified Beall and his blog, members of the latter camp tried to elevate it to the level of policy. Split by extreme polar forces, for reasons still unknown to the public, Beall deliberately shut down his blog, causing some academic chaos among global scholars, including to the open access movement.

"We’re in a culture with very few real friends, and an enormous number of unctuous sales people who will adopt the language of friendship, care and help."

INTERVIEW WITH MARK GREIF

"I wonder, often, whether I’m crazy.  Because I wander around and I find menus addressing me, to tell me how much they care about my dining experience. And the paper sacks that my hamburger comes in, telling me how much the gigantic company cares about the cows they’ve slaughtered for my food. And I’m constantly being offered advice on how I should dress, eat, sleep, have sex. And yet I suspect that actually, all of these sources don’t care very much about how I do these things. That’s the kind of dishonesty that I imagine. We’re in a culture with very few real friends, and an enormous number of unctuous sales people who will adopt the language of friendship, care and help."

"About 17% of kids and teens in the U.S. are now considered obese, a figure that has more than tripled since the 1970s..."

With Rise in Childhood Obesity, Corresponding Increase in Type 2 Diabetes Seen in Young Americans

"For years, health experts have bemoaned the rise of childhood obesity in the United States. About 17% of kids and teens in the U.S. are now considered obese, a figure that has more than tripled since the 1970s, according to data from the Centers for Disease Control and Prevention.

A report in this week’s edition of the New England Journal of Medicine lays out one of the consequences of all this excess weight: a corresponding increase in childhood cases of type 2 diabetes."

From Emory U: New Developments in Breast Cancer and Their Impact on Daily Practice in Pathology

Xiaoxian Li, Gabriela M. Oprea-Ilies, and Uma Krishnamurti (2017) New Developments in Breast Cancer and Their Impact on Daily Practice in Pathology. Archives of Pathology & Laboratory Medicine: April 2017, Vol. 141, No. 4, pp. 490-498.

SPECIAL SECTION—CONTRIBUTIONS FROM EMORY UNIVERSITY SCHOOL OF MEDICINE, PART II

New Developments in Breast Cancer and Their Impact on Daily Practice in Pathology

Xiaoxian Li, MD, PhD; Gabriela M. Oprea-Ilies, MD; Uma Krishnamurti, MD, PhD

From the Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Gerogia.

Reprints: Xiaoxian Li, MD, PhD, Department of Pathology and Laboratory Medicine, Emory University, 1364 Clifton Rd NE, Atlanta, GA (email: xli40@emory.edu).

The authors have no relevant financial interest in the products or companies described in this article.

Advances in research have transformed our understanding of breast cancers and have altered the daily practice of pathology. Theranostic evaluations performed by pathologists are now critical in triaging the patients into appropriate treatment groups, as are new guidelines that were recently established for the evaluation of HER2/neu gene amplification. Emerging molecular classifications of breast cancers bring novel perspectives to the assessment of individual cases, and opportunities for better treatments. Molecular studies have particularly shed light on distinct biological subsets of triple-negative breast cancers, for which new targeted therapies are being developed. The prognostic and therapeutic utility of new histopathologic parameters, such as tumor-infiltrating lymphocytes, are also being elucidated, and new protocols have been devised for the pathologic evaluation of breast specimens that have undergone neoadjuvant treatment. Novel clinical practices, such as radioactive seed localization, also affect the way breast specimens are processed and evaluated. In this brief review, we highlight the developments that are most relevant to pathology and are changing or could potentially impact our daily practice.

CV risk parameters tied to TSH concentrations in overweight, obesity

“In euthyroid overweight and (morbidly) obese children serum TSH concentrations are positively associated with markers representing increased CVD risk, such as [total cholesterol], LDL-[cholesterol], [triacylglycerol] and [monocyte chemotactic protein-1] concentrations,” the researchers wrote. “The additional observation that changes in TSH are associated with changes in [total cholesterol], LDL-[cholesterol], and [triacylglycerol] concentrations in children with successful weight loss after 1 year participating in a lifestyle intervention strengthens the earlier assumptions that serum TSH is indeed an intermediary factor in modulating lipid and lipoprotein metabolism, although causality could not be demonstrated. It is worth exploring in more depth the potential association between TSH and whole body cholesterol metabolism, including endogenous cholesterol synthesis, intestinal cholesterol absorption, and receptor mediated cholesterol clearance.”

Game changer

Philips Awarded FDA Clearance for Digital Pathology Solution for Primary Diagnostic Use

Man Dragged Off Overbooked United Airlines Flight At O’Hare Airport

CHICAGO (CBS) — A man was dragged off a United Airlines flight from Chicago to Louisville on Sunday night, after the flight was overbooked, and the passenger refused to leave voluntarily.

"Globally, one in four adults are not active enough and more than 80% of the world’s adolescent population is insufficiently physically active."

Exercise is what the doctor ordered

"Globally, one in four adults are not active enough and more than 80% of the world’s adolescent population is insufficiently physically active."

"If we wish to accuse someone employing the word 'probable' or 'likely' of making a false probabilistic judgment, we need to be sure that they are employing the very same concept of probability that is the object of analysis in probability theory."

Invisible Manipulators of Your Mind

Tamsin Shaw 

APRIL 20, 2017 ISSUE

The Undoing Project: A Friendship That Changed Our Minds

by Michael Lewis

Norton, 362 pp., $28.95

"A further problem arises when we try to assign errors to a particular set of systematic biases, or attribute them to specific flawed heuristics. If we wish to accuse someone employing the word “probable” or “likely” of making a false probabilistic judgment, we need to be sure that they are employing the very same concept of probability that is the object of analysis in probability theory. If we wish to accuse someone of making false probabilistic judgments because they are employing a faulty heuristic, we need to be sure that the correct explanation isn’t that certain people have some complicating beliefs in the background, in luck or fate or God, for instance."

The diabetes drug that may be worth $10 bn

Ailing Novo seeks cure with diabetes drug targeting the fat

James Paton 

"The experimental treatment, called semaglutide, should go on sale next year as an injection for diabetes. But that’s only the first step of Novo’s development plan: Its scientists are working on a patient-friendly tablet version of the drug that could reach pharmacy shelves in 2020. They’re also testing the product for a form of liver disease, a market some analysts say may eventually yield $35 billion a year in sales, as well as obesity.

As a slimming medicine alone, its effect could get closer to the results delivered by bariatric surgery, Jorgensen said in an interview. The drug’s annual sales may climb to almost $10 billion over the next decade, even before taking into account its potential use as an obesity treatment, according to Nordea estimates, providing a much-needed boost for the Danish company. Only one drug in the entire pharmaceutical industry exceeded that last year."