A 70-year-old female presented with recurring cervical lymphadenopathy over a 5-year period. Intermittently, symptoms of respiratory and GI tract disease occurred, raising the possibility of malignancy. Investigation of these systems and of the breasts were negative. A lymph node biopsy was eventually done and showed intrasinusoidal proliferations of CD30-positive malignant cells which were also characterized ultrastructurally. Therapy with CHOP has produced a good initial response. The value of electron microscopy in diagnostic pathology is illustrated.
By the mid-1960s, a steady drain of Caribbean doctors to Canada, the United States of America (USA) and the United Kingdom was subsidizing these already well-endowed health systems, and depriving the struggling Caribbean economies of millions of rare dollars annually. This uncompensated loss denied the region of half or more of the annual output of doctors from The University of the West Indies (UWI). This book deals with the challenges that poor nations face when they seek to develop educational programmes of high standard, free of external vested interests and control. It describes the actions taken at that crucial time in UWI history, soon after its independence from London University, when it was expanding, facing financial and social difficulties, with internal want and unrest, and external pressures threatening its integrity. This was a time of global conflict, the Cold War and student protests, spreading in and from the USA. Immersed in this problem from the mid-1960s and the need for other reforms, the author became the first full-time Dean of the Medical Faculty at Mona, Jamaica, in 1971, and worked with medical colleagues and a few from other faculties and with external agencies (whose names are given in the book) to combat the forces threatening UWI's existence as a regional body and threatening to destroy its potential to unite the 14 units of the Commonwealth Caribbean that funded it, and gave its scholars a place and a voice. Given the bare minimum in resources, he and others initiated a series of reforms and innovations in medical education, programmes and policies to produce a range of specialists, family doctors and other manpower, and start a novel division of Community Medicine tailored to Caribbean needs.
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