This chapter utilises data gleaned from botanical treatises, missionary accounts and official correspondence to approach diagnostic categories in early modern medicine in Angola. It also discusses early modern constructions of mental pathology. West-Central African history is exceptional in providing ample primary sources for discussing health and disease in Africa prior to the nineteenth century. The documentation abounds with contemporary social diagnoses of diseases in West-Central Africa occasionally written by physicians or surgeons, but almost as often uttered by colonial administrators, priests, naturalists and common people. Yet, they are often of little use in determining the modern biological diagnoses. Essentially, they point out that humoural theory was rarely a reference point when making social diagnoses. Instead, laypeople and doctors usually referred to very general symptoms and conditions. The Portuguese understanding of epidemic diseases remained extremely limited throughout the era of the slave trade.

The bone marrow (BM) is a frequent site of haematogenous spread for all types of cancer. Metastatic spread of disseminated tumour cells (DTCs) to the BM is detected in 0.2 to 12% of patients with solid tumours [1]. The variability in incidence is related to the incidence of the primary tumour and its homing behaviour [2]. Common primary tumours affecting the BM are listed below (Table 17.1).

Immunophenotyping is an important part of the integrated haematopathologic diagnostics of bone marrow (BM) samples. Integrated diagnosis should include clinical information, peripheral blood (PB) and BM smear cytology, flow cytometry (FCM) of BM aspirate, BM trephine biopsy (BMB) morphology, BMB immunohistochemistry (IHC) and cytogenetic/molecular genetic data if appropriate. Flow cytometry and IHC provide complementary information [1]. Immunophenotyping by FCM has the advantage of measuring high numbers of cells and the possibility to evaluate co-expression of several markers in various cell populations in a multicolour setting. Immunohistochemistry provides a possibility of in situ interpretation of morphology and immunophenotype simultaneously. Double IHC stains are possible but not widely used as of yet.

The Innovation Pyramid, like any tool, comes down to how well we learn to use it to improve our collective judgement. Reviewing innovation projects allows us to better understand the linkages between the specific-level decisions and the overall project outcome. This deeper discernment requires a critical analysis of the entire innovation system – every decision taken between the initial situation and overall desired outcome must be reviewed. Fortunately, the structure of The Innovation Pyramid is equally useful in guiding the identification of the well-rationalized choice made during the design and execution of the innovation that inadvertently caused us to veer away from our overall, macro-level, desired impact of the original situation. This chapter lays out a structure to systematically review the project elements that could be associated with the variance between the actual and forecasted impact of the innovation. The guidance that The Pyramid provides for a project's post-execution review must often be augmented with additional research. Firms should consider this additional research an investment in their emerging core competency of serial innovation.

Acute myeloid leukaemia (AML) is a highly complex and heterogeneous disease. Proper classification according to the 2016 World Health Organization (WHO) classification requires a systematic approach and integration of key clinical, laboratory, pathologic and genetic information [1, 2]. Great advances in our understanding of the pathogenesis and molecular underpinnings of AML have been realized since the original AML classification using the French–American–British (FAB) system (1976). This genetic revolution not only contributes to enhanced disease diagnosis and prognostication but also to ongoing improvements in therapeutic strategies.

The Innovation Pyramid is an inverted triangular pyramid. The methodology for creating impactful solutions to real problems separates the innovation's design from its execution. It further bifurcates design into identifying the real problem before crafting a solution to it. Execution is similarly bifurcated into execution planning and implementation. The four stacked levels of The Innovation Pyramid, from top to bottom, represent Problem Identification, Solution Formulation, Planning and Implementation; two design stages followed by two execution stages. The Pyramid has three faces. These three pyramid sections address three different aspects of designing and executing impactful solutions:

What: What is the desired outcome at that level?

How: How will this be accomplished or enabled?

Who: Who will lead the activities and/or is impacted by the outcome of this level?

This structure streamlines innovation creation as well as providing a structural means for diagnosing the cause of the variance between the actual and forecasted impact of the innovation. This diagnostic aspect is especially important when we may be traversing The Innovation Pyramid structure multiple times, once for say, prototype development, and a second time for the final product launch.

With the exception of near-occlusion, CEA is of overall benefit for selected patients with recent symptomatic carotid stenosis =50% (NASCET method), provided surgical stroke/death risk is low. The benefit is greater with greater stenosis, men, the elderly (aged =75y), most recent ischaemic event within 2w, irregular plaque surface, and impaired cerebral perfusion reserve. Patients with recent symptomatic carotid territory ischaemic events should be screened by Doppler ultrasonography, MRA, or CTA, confirming substantial stenosis with a second non-invasive investigation. Catheter angiography may be required to confirm uncertain results. The surgical peri-operative stroke and death rate (7% in RCTs) is higher in women, hypertension, peripheral arterial disease, and occlusion of the contralateral ICA or ipsilateral ECA. The experience of the surgeon and hospital are crucial, and audited peri-operative complication rates should be publically available. Carotid stenting is less invasive than CEA and causes fewer local complications (cranial neuropathy and neck haematoma), but carries a higher procedural risk of stroke. Stenting should be considered in younger patients, or those at increased risk from CEA. While stenting is of high risk for intracranial vertebral artery stenosis, risk is low for extracranial stenosis and should be considered for recurrent symptoms despite optimal medical therapy.

Aneurysmal SAH is a severe disease, and the post-haemorrhage period fraught with potential complications that must be recognized and treated early for favourable outcome. While diagnosis of SAH is often straightforward from clinical history and initial CT, some patients will require cerebrospinal fluid evaluation. The aneurysm must be secured urgently to reduce rerupture and clinical worsening. Endovascular coiling is preferable when feasible, but surgical clipping is sometimes needed based on patient or aneurysmal characteristics, or presence of intraparenchymal haemorrhage requiring evacuation. Treatment of symptomatic hydrocephalus with CSF diversion is also crucial. Patients with aneurysmal SAH should be managed by a team of nurses and physicians with neurocritical care, neuroendovascular, and neurosurgical expertise, preferably in a dedicated neurosciences intensive care unit. Early complications include aneurysmal rebleeding, hydrocephalus, and neurogenic cardiopulmonary injury. In the subacute phase, delayed cerebral ischaemia and hyponatremia are more commonly seen. With optimal multidisciplinary management, many patients can return to their previous level of function only weeks after the aneurysm rupture. Still, most treatments in SAH are based on insufficient evidence, and more collaborative research from the bench to the bedside is necessary to continue improving patient outcomes.

Chapter 8: This chapter analyzes the legacy and influence of the diagnostic gaze in contemporary British theatre, examining how theatre can offer a site to negotiate the complex dynamic between psychiatric institutions and the experiences of patients. Contemporary psychiatry has overseen a vast expansion in the categorization of mental illness. Mental disorders can be identified and ascribed to individual patients in an act of diagnosis that signals mental illness as a ‘performative malady’. Alongside reflecting shifts in the etiology of mental disorder (increasingly focused upon a biomedical model), the speech-act of diagnosis has implications for the legal status and care of the patient. Analyzing works such as Joe Penhall’s Some Voices and Lucy Prebble’s The Effect, this chapter suggests how theatre can offer a reimagination of diagnosis by situating and troubling the role of the psychiatric user.