On The Cover

 
Koi Pond at Ho’omaluhia
photograph
By Jae Lim, MD, PhD

This photograph was taken at Ho’omaluhia Botanical Garden in Kaneohe, Oahu, HI. The 400-acre park boasts hiking trails, freshwater lakes and streams, and a campground.

Dr Lim is an Otolaryngologist for the Hawaii Permanente Medical Group. He is passionate about exploring and photographing the natural beauty of Hawaii. More of his work can be seen at www.lim-photography.com.

Announcements

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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The Permanente Journal (ISSN 1552-5767) is a peer-reviewed journal of medical science, social science in medicine, and medical humanities published quarterly by The Permanente Press.

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Physicians may earn up to 1 AMA PRA Category 1 Credit per article for reading and analyzing the designated CME articles published in each edition of TPJ.


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