Dermatofibroma: a curious tumor.

A tumor, such as a dermatofibroma, causes consternation among many patients, but it rarely creates problems on its own. Also called a histiocytoma, it remains one of the most common mesenchymal growths. Its etiology is unknown with the previous theory that it is a dermal response to injury, such as an insect bite, being challenged. As much as patients like to blame spiders or other arthropods for traumatizing an arm or leg, no definitive explanation is available for its etiology

COVID-19, Serendipity, and Strange Interlude: Gloria in Absurdicum with an Apology to Ovid

The absurd edicts initially issued by several governors, including those of Michigan and New York, prohibiting physicians from ordering hydroxychloroquine for patients suspected of or diagnosed with COV-19 are reprehensible. Their reasoning is beyond the pale. Hydroxychloroquine was first approved by the FDA in 1955 and has a remarkable safety record in its use as a preventative for malaria and in the treatment of several immunologic and/or light induced diseases. Its use came about serendipitously, and its mechanism of action is unclear, but the fact remains that it seems to work

Why Medical (and Dermatologic) Practice Has Become So Convoluted: The Complexity/Convolutional/Obfuscatory Kleptocracies.

Consider dermatology (or medical) practice from the aspect of those who manage, and seek to glean a profit from, medical management corporations, including but not limited to third party payers. Although much of the complexity burden thrust upon doctors’ offices is borne by the offices and doctors, there is also much that is borne by the companies, and the entire process appears to make no sense whatsoever. How can the business professionals who run these outfits make such blunders? Let us approach this question by examining another industry: fast food franchising

Disestablishmentarianism: Or Why Political Correctness Is Racist, Anti-Gay, Anti-Transgender, Misogynist, Anti-Science, and Anti-You.

Disestablishmentarianism is known to most of us as one of the longest words in the English language (before some over-eager college students, even a few doctors, invented some mostly quite silly longer ones). A few may also know it as a rather dull, perhaps equally silly facet of British history. This is a shame, because this rather bizarre movement that began in eighteenth century England, has much to teach us about modern times

Dermatology Journals and the Impact Factor

The noted informatics authority, Eugene Garfield (1925-2017), while working at the Johns Hopkins Medical Library, decided to assist medical librarians in selecting the publications to which they should subscribe. Not only at issue was the expense of subscribing and binding the periodicals, but there was also the physical space for shelving them. This was the birth of the Science Citation Index (SCI), the Impact Factor (IF), and the Institute for Scientific Information (ISI)in Philidelphia. The role of the SCI has expanded over the years. Libraries may still continue to select journals on the basis of their IF, with many institutions subscribing to their periodicals digitally or by group selection from the publishers’ packages. What was never anticipated, however, is the importance given to the IF, not only by libraries, but also by readers and even academia. Unfortunately, this has produced some untoward and even bizarre results

Mixing of Supersonic Streams

The Strutjet approach to Rocket Based Combined Cycle (RBCC) propulsion depends upon fuel-rich flows from the rocket nozzles and turbine exhaust products mixing with the ingested air for successful operation in the ramjet and scramjet modes. A model of the Strutjet device has been built and is undergoing test to investigate the mixing of the streams as a function of distance from the Strutjet exit plane. Initial cold flow testing of the model is underway to determine both, the behavior of the ingested air in the duct and to validate the mixing diagnostics. During the tests, each of the two rocket nozzles ejected up to two pounds mass per second into the 13.6 square inch duct. The tests showed that the mass flow of the rockets was great enough to cause the entrained air to go sonic at the strut, which is the location of the rocket nozzles. More tests are necessary to determine whether the entrained air chokes due to the reduction in the area of the duct at the strut (a physical choke), or because of the addition of mass inside the duct at the nozzle exit (a Fabri choke). The initial tests of the mixing diagnostics are showing promise

Changing times in England: the influence on geography teachers’ professional practice

School geography in England has been characterised as a pendulum swinging between policies that emphasise curriculum and pedagogy alternately. In this paper, I illustrate the influence of these shifts on geography teacher's professional practice, by drawing on three “moments” from my experience as a student, teacher and teacher educator. Barnett's description of teacher professionalism as a continuous project of “being” illuminates how geography teachers can adapt to competing influences. It reflects teacher professionalism as an unfinished project, which is responsive, but not beholden, to shifting trends, and is informed by how teachers frame and enact policies. I argue that recognising these contextual factors is key to supporting geography teachers in “being” geography education professionals. As education becomes increasingly competitive on a global scale, individual governments are looking internationally for “solutions” to improve educational rankings. In this climate, the future of geography education will rest on how teachers react locally to international trends. Geography teacher educators can support this process by continuing to inform the field through meaningful geography education research, in particular in making the contextual factors of their research explicit. This can be supported through continued successful international collaboration in geography education research

Perils of Diagnosis and Detection of Subungual Squamous Cell Carcinoma

Subungual squamous cell carcinoma often presents with atypical clinical manifestations, which can lead to delays in diagnosis. The presence of a tumor can be masked by the presence of infections or other misleading pathological conditions. The authors report on techniques for adequate biopsy and excision of such tumors. A case of subungual squamous cell carcinoma with invasion into the underlying bone is presented. Clinical histopathological evidence is reviewed along with human papillomavirus typing. Accurate diagnosis requires a high index of suspicion and appropriate tissue sampling