[A man with a red umbilicus].

A 76-year-old man was sent to the dermatology department because of a red, sore belly button since 3 weeks. Based on histology, a CT-scan and increased Cancer Antigen 19-9 levels, this was interpreted as a pancreas carcinoma metastasis. This type of metastasis is also called a 'Sister Mary Joseph's nodule'.

Does acromioplasty result in favorable clinical and radiologic outcomes in the management of chronic subacromial pain syndrome? A double-blinded randomized clinical trial with 9 to 14 years' follow-up.

Background: The treatment effect of acromioplasty for chronic subacromial pain syndrome (SAPS) on long-term shoulder function and rotator cuff deterioration has still to be determined. This study aimed to determine the long-term clinical and radiologic treatment effect of arthroscopic acromioplasty in patients with chronic SAPS.

Methods: In this double-blind, randomized clinical trial, 56 patients with chronic SAPS (median age, 47 years; age range, 31-60 years) were randomly allocated to arthroscopic bursectomy alone or to bursectomy combined with acromioplasty and were followed up for a median of 12 years.

Providing services globally: the experience of an internet pharmacy.

Globalization of hospital-based medical services represents another step in the globalization of healthcare. The rise of transnational pharmaceutical firms represents an early example of the globalization of healthcare, which on the whole has provided many benefits. Medical discoveries made in one country are rapidly and seamlessly made available to patients in other parts of the world.