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The Permanente Journal advances knowledge in scientific research, clinical medicine, and innovative health care delivery.

On the Cover

The Permanente Journal

Rocky Perspective
by David L Shenson, MD

This photograph was taken at Ruby Beach, on the Olympic Peninsula in Washington. The contrast in depth of field creates an interesting perspective of these stones ground smooth by the elements and the passage of time. Dr Shenson is an Internist at the Mt Scott Medical Office in Clackamas, OR. More of his photography may be viewed at: www.davidshenson.com.

 

Soul of the Healer

The Permanente Journal

Pinnacle
photograph
Brad Christian McDowell, MD

The Permanente Journal

Seville
photograph
Samuel H Glassner, MD

The Permanente Journal

Dorothy’s View
photograph
Bridget Bourgon, PA-C

The Permanente Journal

So Much Sky
Colored pencils on paper
3” x 6”
Sharon Lee Hostler, MD

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Case Report

The Permanente Journal

Pneumomediastinum Diagnosed on Ultrasound in the Emergency Department: A Case Report

A previously healthy patient was seen in the Emergency Department for evaluation of a one-month history of cough and one-day history of hemoptysis. This case report, from a pulmonologist’s perspective, includes a comprehensive review of the patient’s clinical presentation and outcome, as well as a discussion of recurrent respiratory papillomatosis.

The Permanente Journal

Case Report: Pulmonary Papillomatosis in a Patient Presenting with Cough and Hemoptysis

An emergency ultrasound performed at bedside helped to confirm and to expedite the diagnosis of esophageal perforation in a 23-year-old man. To our knowledge, this is the first published report of using ultrasound as an aid in the diagnosis of Boerhaave syndrome by diagnosing pneumomediastinum in an adult male.

Clinical Medicine

The Permanente Journal Image Diagnosis: Inferior Mesenteric Vein Thrombosis

A 59-year-old man presented to the gastroenterology clinic with 2 weeks of worsening lower back pain. There was associated poor appetite, fatigue, night sweats, and chills. The patient’s medical history was significant for well-controlled hypertension and sigmoid diverticulosis. The thrombosis probably resulted from inflammation in the adjacent diverticulum.

Book Review

The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma

This book explores the ways that patients and healers can develop the skills to appropriately evaluate historic traumatic events and how to successfully begin treating them. From the scientifically oriented physician, the biochemical, physiologic, and anatomic effects of trauma on the body are well explored in this detailed exposé. What is more important though is the invisible mark that is embedded permanently on the mind and body by past traumatic events

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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. Health care professionals and employees are encouraged to submit original poetry, prose, and artwork for future issues.

 

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Letters

Articles, editorials, letters to the editor, and other material represent the opinion of the authors. Send your comments to permanente.journal@kp.org.


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