tbuckley/cabot-search huggingface dataset:
The Increase in the Cesarean Birth Rate
Authors: Sidney F. Bottoms, Mortimer G. Rosen, Robert J. Sokol
Journal: New England Journal of Medicine (1980)

THE threefold increase in the cesarean birth* rate that has occurred in the United States during the last 10 years has been a source of concern to both obstetricians and the general public.1 2 3 This article describes the factors underlying the change in reasons for operative delivery and several areas in which cesarean birth rates may be altered by changes in obstetrical practice.Until the 20th century, the prohibitively high rates of maternal mortality after cesarean birth limited its use as a surgical procedure. However, as technical advances in the procedure itself became available, along with techniques of antisepsis, maternal mortality . . .
Regional Perfusion in Melanoma of Limbs
Authors: Oscar Creech, Edward T. Krementz
Journal: JAMA (1964)

Review of six years' experience with regional perfusion in the treatment of melanoma of the limbs reveals a four-year cure rate of 44%. Six of 12 patients treated five years ago have no evidence of malignant disease. Nine of 20 patients with satellitosis or clinically positive inguinal nodes treated four years ago are apparently free of melanoma.
The Relative Cost-Effectiveness of Anticoagulants
Authors: Jerry Avorn
Journal: Circulation (2011)

T he search for a safer and more tolerable anticoagulant alternative to warfarin has been the holy grail of thromboembolic research for decades.With its capacity to reduce the risk of ischemic stroke by nearly two thirds in patients with atrial fibrillation, warfarin remains one of the most powerful preventive tools in all of medicine. 1But in the 57 years since the drug was introduced, generations of clinicians and patients have become all too familiar with the difficulty of establishing and maintaining an adequate level of the international normalized ratio (INR) in the face of intercurrent illnesses, the use of myriad interacting drugs, and dietary changes.Partly as a result, anticoagulation remains woefully underused in patients for whom it could do enormous good. 2 Sensitive to problems that result from commission more than from omission, physicians often overestimate the likelihood of hemorrhagic complications and underestimate the consequences of failing to prevent embolic events.
Has teledermatology in the U.K. finally failed?
Authors: J.S.C. English, D.J. Eedy
Journal: British Journal of Dermatology (2007)

Has teledermatology in the U.K. finally failed?Although two papers published in this issue provide us with additional information about the current state of teledermatology services, we probably remain some way off a final evaluation of the current role of this technology in the provision of dermatology services in the NHS.Over the past decade many clinicians in the U.K. have expressed concerns over the development of teledermatology and this was probably reflected by the fact that the Action on Dermatology in 2001 had only three pilot sites out of 15 devoted to looking at teledermatology as a way of improving access for patients to secondary care.One of these never started and the status of the other two is unknown.It was thought by the Department of Health and Government policy advisers that the use of digital photography and improvements in electronic communications such as storeand-forward technology would provide a potential panacea for specialties like dermatology in an effort to decrease outpatient waiting times.The reason for this seems simple: the images obtained from digital photography are of such high quality that why couldn't images of skin conditions be e-mailed to a dermatologist and save the patient a hospital visit?This would reduce costs and decrease waiting times, but clinical effectiveness and cost-effectiveness of such services remain largely untested.If only dermatology were that simple!In an article on palpation of the skin, Dr Cox recently summarized some of the reasons, obvious to dermatologists, why this approach is simplistic. 1 They include the fact that it is often necessary to palpate the skin in order to help make the diagnosis, one cannot judge the patient's concerns and anxieties just from a series of digital images, other areas of pathology are missed that are not photographed and often the images are of poor quality, thus making a diagnosis difficult.In a recent NHS R&D Technology Assessment, patients referred to a 2-week wait clinic were invited to have a series of digital photographs, with and without dermoscopy, immediately before their face-to-face consultation. 2An unexpectedly high proportion (33%) of referrals proved to have a malignancy or a severely dysplastic lesion, with almost 22% having a malignant melanoma or squamous cell carcinoma, possibly reflecting the rise in incidence of skin cancers reported elsewhere.If the highest level of clinician confidence had been applied, no cancers would have been missed, but only 20% of patients would have avoided an outpatient appointment.It was concluded that it is unlikely that this approach can dramatically reduce the need for conventional clinical consultations while still maintaining clinical safety. 2 The first paper in this issue is a literature review of teledermatology evaluation and research. 3The authors carried out a systematic review of the literature over the last 40 years and
Bronchial hyperresponsiveness, epithelial damage, and airway eosinophilia after single and repeated allergen exposure in a rat model of anhydride‐induced asthma
Authors: Z.‐H. Cui, M. Sjöstrand, T. Pullerits, P. Andius, B.‐E. Skoogh, J. Lötvall
Journal: Allergy (1997)

Bronchial hyperresponsiveness (BHR) and damage of the epithelium, as well as eosinophilia in the airway wall, induced by trimellitic anhydride (TMA) in sensitized brown Norway rats were studied. Rats were challenged once or seven times with aerosol of TMA conjugated to rat serum albumin (TMA‐RSA) 3 weeks after intradermal TMA sensitization. Airway responsiveness (‐log PC 300 of acetylcholine i.v.) was measured 24 h after allergen challenge. Epithelial lesion and eosinophil infiltration in the airway walls were quantified under light microscopy, and TMA‐specific IgE and IgG in serum were evaluated with ELISA. High levels of TMA‐specific IgE and IgG were found in all rats in the sensitized groups compared to nonsensitized groups ( P &lt; 0.001). Repeated allergen challenges of 0.03% TMA‐RSA for 7 consecutive days enhanced the level of TMA‐specific IgG, compared to single challenge ( P &lt; 0.05). Single allergen challenge of 0.3% TMA‐RSA had a nonsignificant tendency to produce BHR in sensitized rats compared to nonsensitized rats ( P =0.06). However, repeated allergen challenges (0.003% and 0.03% TMA‐RSA for 7 consecutive days) produced significant BHR in sensitized rats ( P &lt; 0.05). Furthermore, repeated low‐dose (0.003%) TMA‐RSA challenge produced more BHR than a 10 times higher single dose (0.03%) ( P &lt; 0.05). Slight damage of the airway epithelium was seen in sensitized and repeat‐challenged groups. However, bronchial eosinophilia was found in the sensitized and single‐challenged groups, but not in nonsensitized nonchallenged, and sensitized repeat‐challenged groups ( P &lt; 0.005). We conclude that the brown Norway rat can be sensitized with TMA, and that repeated low‐dose allergen challenges produce slight epithelial damage and BHR which is independent of ongoing eosinophilia in the airway wall.
Theatre: Mr Placebo
Authors: I. McClure
Journal: BMJ (2003)

Traverse Theatre, Edinburgh, until 1 March www.theatreroyal.com/ Rating: ![Graphic][1]</img>![Graphic][2]</img> www.traverse.co.uk/ Drum Theatre, Plymouth, 6 to 22 March The Traverse Theatre has brought us some of the United Kingdom's best new plays and this latest offering, written by Isabel Wright, promised much. It kicks off with the brilliant scenario that the mini society created by a drug trial, with its privations and restrictions, serves as a microcosm in which to explore concepts such as chance and fate, personal responsibility, and the morality of modern science. The action centres around four men in their early 20s who enrol for a clinical … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif
Signal Conflicts in the Phylogeny of the Primary Photosynthetic Eukaryotes
Authors: P. Deschamps, D. Moreira
Journal: Molecular Biology and Evolution (2009)

It is widely accepted that the first photosynthetic eukaryotes arose from a single primary endosymbiosis of a cyanobacterium in a phagotrophic eukaryotic host, which led to the emergence of three major lineages: Chloroplastida (green algae and land plants), Rhodophyta, and Glaucophyta. For a long time, Glaucophyta have been thought to represent the earliest branch among them. However, recent massive phylogenomic analyses of nuclear genes have challenged this view, because most of them suggested a basal position of Rhodophyta, though with moderate statistical support. We have addressed this question by phylogenomic analysis of a large data set of 124 proteins transferred from the chloroplast to the nuclear genome of the three Archaeplastida lineages. In contrast to previous analyses, we found strong support for the basal emergence of the Chloroplastida and the sister-group relationship of Glaucophyta and Rhodophyta. Moreover, the reanalysis of chloroplast gene sequences using methods more robust against compositional and evolutionary rate biases sustained the same result. Finally, we observed that the basal position of Rhodophyta found in the phylogenies based on nuclear genes depended on the sampling of sequences used as outgroup. When eukaryotes supposed to have never had plastids (animals and fungi) were used, the analysis strongly supported the early emergence of Glaucophyta instead of Rhodophyta. Therefore, there is a conflicting signal between genes of different evolutionary origins supporting either the basal branching of Glaucophyta or of Chloroplastida within the Archaeplastida. This second possibility would agree with the existence of the subkingdom Biliphyta, joining Glaucophyta and Rhodophyta.
Survival benefit associated with liver transplantation (LT) in patients transplanted for hepatocellular carcinoma (HCC)
Authors: C. Duvoux, F. Roudot-Thoraval, L. Traissac, C. Vanlemmens, F. Conti, G. Pageaux, B. Malassagne, P. Sockeel, D. Cherqui, D. Dhumeaux
Journal: Journal of Hepatology (2001)
Prevalence of child sexual abuse among adolescents in Geneva: results of a cross sectional survey
Authors: D. S Halperin, P. Bouvier, P. D Jaffe, R.-L. Mounoud, C. H Pawlak, J. Laederach, H. R. Wicky, F. Astie
Journal: BMJ (1996)

<h3>Abstract</h3> <b>Objective</b>: To measure the cumulative prevalence of child sexual abuse in a representative sample of the adolescent population of Geneva. <b>Design</b>: Cross sectional survey with an anonymous self administered questionnaire centred on a factual description of sexual activities. <b>Setting</b>: 68 classes (17 schools) randomly selected from the 201 ninth grade classes of the public school system in Geneva. <b>Subjects</b>: 1193 adolescents aged 13-17 years, of whom 1116 (93.5%; 568 girls, 548 boys) consented to the study and returned completed questionnaires. <b>Results</b>: 192 (33.8%) girls and 60 (10.9%) boys reported having experienced at least one sexually abusive event. The prevalence of abuse involving physical contact was 20.4% (116 cases) among girls and 3.3% (18) among boys. The prevalence of abuse involving some form of penetration was 5.6% (32 cases) among girls and 1.1% (six) among boys. One third of the abused adolescents had experienced more than one abusive event and 46.5% (92/198) had experienced the first event before age 12. Abuse by a family member was reported by 20.5% (36/176) of abused girls and 6.3% (3/48) of abused boys. Abusers were known to victims in two thirds of cases. Ninety per cent of abusers were male and 35.3% (71/201) came from the victims9 peer group. Over 80% of participants found the questionnaire interesting, clearly formulated, and useful. <b>Conclusions</b>: Child sexual abuse is a universal social phenomenon. Adolescents themselves can contribute to research and so help in the search for more efficient prevention and intervention strategies. <h3>Key messages</h3> The prevalence of sexual abuse involving physical contact was 20.4% among girls and 3.3% among boys; the prevalence of abuse involving some form of penetration was 5.6% among girls and 1.1% among boys Half of the children reporting sexual abuse expe- rienced the first event before the age of 12; in one third of cases the abuser was an adolescent Lengthy preparation resulting in ethical approval, firm political and administrative backing, and a complex operational partnership with schools were prerequisites for a study that confronted adolescents with a sensitive topic The responsible participation of the adolescents indicated that they could provide useful collabora- tion in epidemiological research in a topic of con- cern to them
Deaths from Occlusive Arterial Disease in Renal Allograft Recipients
Authors: L. S. Ibels, J. H. Stewart, J. F. Mahony, A. G. R. Sheil
Journal: BMJ (1974)

In a series of 325 recipients of cadaveric renal transplants sudden occlusive arterial disease was found to be responsible for 12% of deaths. Acute myocardial infarction (9%) occurred 25 times more than expected in the normal population and cerebral thrombosis (3%) 300 times more. The greatest loss was in the initial three-month period after transplantation. Patients with renal failure due to essential hypertension were especially at risk, accounting for six of the 12 deaths.
Erythema Chronicum Migrans and Lyme Arthritis
Authors: Steere Ac, Malawista Se, Hardin Ja, Ruddy S, Askenase W, Andiman Wa
Journal: Annals of Internal Medicine (1977)

Thirty-two patients with the onset of erythema chronicum migrans, Lyme arthritis, or both in mid-1976 were studied prospectively. The skin lesion (24 patients) typically lasted about 3 weeks, beginning as a red macule or papule that expanded to form a large ring with central clearing. Associated symptoms ranged from none to malaise, fatigue, chills and fever, headache, stiff neck, backache, myalgias, nausea, vomiting, and sore throat. Three patients had been bitten by ticks at the site of the initial lesion 4 to 20 days before its onset. Nineteen patients suddenly developed a monoarticular or oligoarticular arthritis 4 days to 22 weeks (median, 4 weeks) after onset of the skin lesion; eight developed arthritis without a preceding skin lesion. Seven of these 27 experienced migratory joint pains. Arthritis attacks, most commonly in the knee, were typically short (median, 8 days) but sometimes persisted for months. Other manifestations included neurologic abnormalties, myocardial conduction abnormalities, serum cryoprecipitates, elevated serum IgM levels, and elevated erythrocyte sedimentation rates. The diagnostic marker is the skin lesion; without it, geographic clustering is the most important clue.
Abnormal Bone and Gallium Scans in a Case of Multifocal Systemic Sporotrichosis
Authors: AHMED ANEES, AMJAD ALI, ERNEST W. FORDHAM
Journal: Clinical Nuclear Medicine (1986)

Sporotrichosis is a chronic infection of world wide distribution. It is caused by the diamorphic fungus Sporotrichum schenkii. The multifocal form of sporotrichosis usually involves skin, joints, long bones, lungs, and lymph nodes. Involvement of central nervous system although described is extremely rare. Bone and gallium imaging findings in a case of multifocal systemic sporotrichosis which nicely demonstrated the extensive spread of the disease are presented.
ARTERY CLAMP AS A BETTER ANTRUM PUNCH
Authors: Louis M. Pearlman
Journal: JAMA (1927)

The many varieties of antrum punches on the market are a result of their frequent inadequacy. The curved tonsil artery clamp is to be found in the instrument cabinet of every otolaryngologist, and this makes a surprisingly good antrum punch. The use of the curved tip tonsil artery clamp has proved by experience to be a great improvement in the puncturing of the antrum. 1 West Eighty-Sixth Street.
Ventilation/Perfusion Scanning for Acute Pulmonary Embolism
Authors: Lauren K. Toney, David H. Lewis, Michael L. Richardson
Journal: Clinical Nuclear Medicine (2013)

Although the synthesis of ventilation-perfusion (V/Q) scan result and clinical pretest probability is vital to the diagnostic accuracy of V/Q scanning, there is no updated pretest/posttest tabular decision tool since that presented in the Prospective Investigation of Pulmonary Embolism Diagnosis I data. Because this verbal communication between the nuclear medicine physician and referring clinician is indispensable in this process, we sought to study the relationship between documentation of such communication (DCOMM) of the result of a V/Q scan and patient treatment outcome in patients with suspected acute pulmonary embolus (PE).Electronic medical records were searched for patients who underwent V/Q scan for the workup of acute pulmonary embolism from 2000 through 2009 at Harborview Medical Center in Seattle, Washington.Sin hundred eighty-two patients were included in the analysis. Ventilation-perfusion scan outcomes are reported categorically as normal (N), very low (V), low (L), intermediate (I), or high (H) probability. The distribution of V/Q results was 58 (N), 58 (V), 454 (L), 83 (I), and 29 (H). The treatment rates by group were 1.7% (N), 1.7% (V), 1.1% (L), 25.3% (I), and 96.6% (H). The rates of electronic documentation of communication between the nuclear medicine physician and referring physician were 16% (N), 22% (V), 19% (L), 30% (I), and 69% (H). In a logistic regression analysis, odds ratios for treatment relative to the N group were 1596 (P < 0.001) (H), 19 (P < 0.01) (I), and 0.63 (not statistically significant) (L). DCOMM predicted a higher rate of treatment, independent of the outcome of the V/Q scan. In a multivariate logistic regression, the odds ratio for treatment after DCOMM is 2.7 (P < 0.05) and increases to 4.8 (P < 0.01) when on-call studies are excluded.Review of 682 patients who underwent V/Q scan for suspected PE during 2000-2009 at a single institution demonstrates that DCOMM is a strong predictor of subsequent treatment for PE, across all probability outcomes. The results of this study demonstrate the potential effect of verbal communication from nuclear medicine physicians in this decision process, and a suggested precedent for critical results is presented.
The D.O.'s: Osteopathic Medicine in America
Authors: Martin Kaufman
Journal: JAMA (1983)

Back in 1971, the history of homeopathy, the largest unorthodox sect of the 19th century, was examined by this reviewer. Now, more than a decade later, osteopathy, homeopathy's 20th-century counterpart, has been studied by Norman Gevitz, a medical sociologist trained at the University of Chicago. Gevitz provides what may well be the definitive study of the early development of osteopathy, beginning with the ideas and actions of its founder, Andrew Taylor Still. The book has two distinct themes. First, it describes the transition in the philosophy and practice of osteopathy from a radical system to one similar to that of orthodox medicine. By the beginning of the 20th century, osteopathic leaders had accepted a multidimensional conception of disease, and osteopathic educational standards began to improve. Osteopaths sought to upgrade their colleges, intending to improve their graduates' chances of passing licensing examinations, and thereby raising the status of America's osteopaths. This
The LD50-Reply
Authors: Richmond C. Hubbard
Journal: JAMA (1985)

<h3>In Reply.—</h3> I appreciate the letters by Dr Friedman and Dr Llaurado and respect their points of view. The Medical Research Modernization Committee, of which I am a chairman, does not take an either/or position on animal research or the use of animals in medical school teaching. We desire, however, to see that animal research and experimentation is updated and supplanted where feasible by modern methods using, for example, cell cultures; tissue cultures; organ cultures; human volunteers; data banks; dummies; audiovisual aids; computer and mathematical models; microorganisms; clinical and epidemiologic studies; computed tomographic, positron emission tomographic, and nuclear magnetic resonance scans; and ultrasonography. Obviously, results obtained using animals are not directly applicable to humans. Modern advances make it possible to study human tissues, organs, and volunteers directly, and we favor this. Partly as a result of our efforts, the Environmental Protection Agency issued new guidelines (<i>New York Times</i>, Aug 30,
Measles in Patients Suspected of Having Rocky Mountain Spotted Fever
Authors: Phillip I. Nieburg
Journal: JAMA (1980)

Diagnostic titer rises of measles antibody were observed in six of 46 paired sera from persons originally suspected of having Rocky Mountain spotted fever and found to be serologically negative for this disease. Atypical or typical measles is now occurring relatively more frequently in adolescents and young adults and should be considered in the differential diagnosis for patients in these age groups who have undiagnosed febrile rash illnesses.
Low-Dose Adrenaline, Promethazine, and Hydrocortisone in the Prevention of Acute Adverse Reactions to Antivenom following Snakebite: A Randomised, Double-Blind, Placebo-Controlled Trial
Authors: H. Asita de Silva, Arunasalam Pathmeswaran, Channa D. Ranasinha, Shaluka Jayamanne, Senarath B. Samarakoon, Ariyasena Hittharage, Ranjith Kalupahana, G. Asoka Ratnatilaka, Wimalasiri Uluwatthage, Jeffrey K. Aronson, Jane M. Armitage, David G. Lalloo, H. Janaka de Silva
Journal: PLoS Medicine (2011)

In a factorial randomized trial conducted in Sri Lanka, de Silva and colleagues evaluate the safety and efficacy of pretreatments intended to reduce the risk of serious reactions to antivenom following snakebite.
Factors related to lymph node metastasis and the feasibility of endoscopic mucosal resection for treating poorly differentiated adenocarcinoma of the stomach
Authors: Y. Park, Y. Chung, H. Chung, W. Yu, H. Bae, S. Jeon, C. Cho, W. Tak, Y. Kweon
Journal: Endoscopy (2008)

See also: Commentaire de travail de D. Park et al., pp. 7Endoscopy 2008; 40(01): 88-89DOI: 10.1055/s-0032-1306799