Tropical medicine—Facing today's dilemmas

Dilemmas in drug development for tropical diseases. Experiences with praziquantel.

This article analyzes policies that affected the availability of praziquantel, the drug of choice for schistosomiasis. The study examines how interactions among four actors (pharmaceutical producers, international agencies, non-governmental agencies, and national governments) affected praziquantel availability in poor countries. It also examines trends in praziquantel prices over time in differ...

Training dilemmas and false dilemmas

Dioxin dilemmas.

Few chemicals have engendered as much public/political controversy as the dioxins, particularly 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). The scientific base for addressing this complex issue continues to feature differences of opinion among responsible scientists as to the quality and interpretation of data on dioxin epidemiology, animal bioassays, and mechanisms of carcinogenesis. Human stu...

Diagnostic Dilemmas

We report a case of metastatic malignant melanoma resembling a malignant peripheral sheath tumor, which posed a significant diagnostic challenge. The patient is a 76-year-old male, who presented in the emergency room with bilateral chest pain exacerbated by inspiration. The pain was present for 3 week and was not exacerbated by physical exercise. The diagnostic workup revealed bilateral parench...

Diagnostic Dilemmas

Peritoneal washing cytology is important in the staging, prognosis, and treatment schema for women diagnosed with gynecologic malignancies. Additionally, peritoneal washings are often performed before the specific diagnosis or even the distinction between benign or malignant lesion is known. Occasionally, the cytology and surgical pathology specimens, although obtained during the same procedure...