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The Permanente Press, in conjunction with The Permanente Journal presents this medical literary and arts e-journal, leaflet -- to open greater opportunity to share the creative visual and written works of physicians and nurses.

 

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On The Cover

China Dr Clarke1

 

Cathedral
photograph
By Brad Christian McDowell, MD

 

From the artist: “I look for variety in my photography and am always seeking something new to capture. My primary interests are local Colorado landscapes and travel photography. Many of my images seek to express the simple message of ‘Welcome to our world.’”

 

Dr McDowell is a Plastic Surgeon at the Denver Medical Office in CO. More of his photography can be viewed online at www.diversityofvision.com.

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thwackcomicbook

 

Thwack
By Barry Abrams, MD

 

This is the story of a physician with hypertrophic cardiomyopathy being managed by an implantable cardioverter-defibrillator. In the middle of a snowstorm, he receives his first of many staggering shocks from his runaway defibrillator. Learning to live in this new reality includes learning to live with the strong magnet that blocks the defibrillator signal, much to his own chagrin and the amusement of others. (The first Graphic Medicine book.) Available at: www.permanentepress.com.

 

 

Sphenoid Fungus

Deadly Sphenoid Fungus—Isolated Sphenoid Invasive Fungal Rhinosinusitis: A Case Report
Manvi R Nagam, MBBS; David R Vinson, MD; Joel T Levis, MD, PhD, FACEP, FAAEM

 

Acute invasive fungal rhinosinusitis (AIFRS) is a potentially fatal infection, usually affecting immunocompromised patients. Isolated sphenoid sinus involvement is rare and has been reported in only a few cases. The authors discuss the clinical characteristics, histopathologic features, and differential diagnosis of AIFRS of the sphenoid sinus, and the case of a 57-year-old man with a history of refractory non-Hodgkin lymphoma and neutropenia.

 

   

Knee Osteoarthritis

Knee Osteoarthritis: A Primer
Michelle J Lespasio, DNP, JD, ANP; Nicolas S Piuzzi, MD; M Elaine Husni, MD, MPH; George F Muschler, MD; AJ Guarino, PhD; Michael A Mont, MD

 

The purpose of this article is to provide a synopsis of the current medical understanding of knee osteoarthritis. We describe the prevalence, causes and associated risk factors, symptoms, diagnosis and classification, and treatment options. A quiz serves to assist readers in their understanding of the presented material.

 

 

Yellow Palms and Soles

Image Diagnosis: Yellow Palms and Soles
Puneet Chhabra, MBBS, MD, DM; Deepak K Bhasin, MD, DM, FASGE, AGAF, FAMS

 

Puneet Chhabra, MBBS, MD, DM; Deepak K Bhasin, MD, DM, FASGE, AGAF, FAMSOur patient’s yellow palms and soles were attributed to diabetes mellitus. Other causes of yellow palms and soles, like carotenemia caused by ingestion of nutritional supplements, hypothyroidism, and renal and hepatic failure, were ruled out. Yellow palms and soles in patients with diabetes are caused by impaired metabolism of carotene in the liver.

 

 

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