tbuckley/cabot-search huggingface dataset:
Changes in Career Decisions of Internal Medicine Residents during Training
Authors: Colin P. West, Carol Popkave, Henry J. Schultz, Steven E. Weinberger, Joseph C. Kolars
Journal: Annals of Internal Medicine (2006)

Little is known about the timing and stability of internal medicine resident career decisions during the course of residency training.To assess changes in reported career plans among internal medicine trainees during their training.Observational cohort using data collected as part of the annual Internal Medicine In-Training Examination (IM-ITE) survey.411 internal medicine residency programs in North America participating in the annual IM-ITE.2638 internal medicine residents who took the IM-ITE and responded to career plan questions on the test survey in all 3 years of training (2002-2004).Self-reported career plans for individual residents during their postgraduate year 1 (PGY-1), postgraduate year 2 (PGY-2), and postgraduate year 3 (PGY-3) of training.2281 of 2638 residents (86.5%) identified a specific career plan in internal medicine during PGY-3. Of these 2281 residents, 1417 (62.1%) changed career plans at least once during the study period. Career plans reported by PGY-1 and PGY-2 residents matched subsequent PGY-3 plans for 55.1% and 68.4%, respectively. Six hundred eighty-six (26.0%) PGY-1, 278 (10.5%) PGY-2, and 205 (7.8%) PGY-3 residents remained undecided about their career plans at the time of the IM-ITE. Only 25.0% of graduating residents reported plans for a general internal medicine career.The study cohort represents a convenience sample and is restricted to the subset of residents sitting for the IM-ITE and responding to career plan questions in all 3 years of postgraduate training. Career plans were assessed by self-report, and it is possible that residents who responded in all years of training differed from those who did not.In a subset of internal medicine residents in the class of 2004, career decisions changed late into residency training and enthusiasm for careers in general internal medicine remained low.
Mimetic Aspects of Ascites
Authors: Samuel Hyman, Fernando Villa, Frederick Steigmann
Journal: JAMA (1963)

This paper is a report of 100 patients with ascites undiagnosed by the usual diagnostic procedures but definitively diagnosed by peritoneoscopy. The causes of ascites in these patients were, in order of frequency, cirrhosis (34), metastatic malignancy (24), tuberculous peritonitis (23), hepatoma (13), pancreatitis (4), myxedema (1), and constrictive pericarditis (1). Helpful clinical hints are provided for the differential diagnosis of these conditions. The best laboratory test in the diagnosis of ascites is the study of the ascitic fluid. Cirrhosis and constrictive pericarditis had fluids containing less than 3.0 gm of protein per 100 ml, indicating a transudate. Carcinomatosis, hepatoma, tuberculous peritonitis, and pancreatitis had fluids containing more than 3.0 gm of protein per 100 ml, indicating an exudate. A scheme is presented which should help in the differential diagnosis of most cases of ascites.
The beginning of the end of the internal market
Authors: J. Warden
Journal: BMJ (1997)

How the NHS will be reshaped under a Labour government began to emerge this week, with official guidance diluting the internal market created by the last Conservative government. Although the system of purchasers and providers remains, new priorities for next year's commissioning round for England place the emphasis on cooperation and transparency rather than competition.

Specific plans to replace the internal market await a forthcoming white paper, but 1998-9 is to be a transitional year in which the planning and delivery of health services reflect the emerging new …
CORONARY MICROVASCULAR FUNCTION IS IMPAIRED IN HIGH-RISK PATIENTS WITH CHRONIC RENAL DYSFUNCTION AND NORMAL EPICARDIAL CORONARY ARTERIES: A TRANSTHORACIC ECHOCARDIOGRAPHIC DOPPLER STUDY
Authors: Francesco Lo Iudice, Maurizio Galderisi, Stefania Paolillo, Carmen D'Amore, Antonio Parente, Gianluigi Savarese, Caterina Marciano, Irma Fabiani, Angela M. Pellegrino, Laura Casaretti, Pasquale Perrone-Filardi
Journal: Journal of the American College of Cardiology (2013)
Bisphosphonates as adjuvant treatment for breast cancer
Authors: J. R Gralow
Journal: BMJ (2002)

Bisphosphonates are potent inhibitors of the osteoclastic bone resorption that is associated with skeletal metastases, with proved efficacy in reducing skeletal complications in metastatic cancer. Randomised clinical trials investigating the adjuvant use of bisphosphonates to prevent bone metastases in patients with breast cancer have yielded intriguing yet conflicting results. Defining the potential role of these agents in the treatment of breast cancer is of great clinical relevance.

The skeleton is the first site of recurrence in 25-40% of patients with metastatic breast cancer. The development of bone metastases entails complex interactions between cancer cells and the microenvironment of bones. In the early establishment of metastases, bone is destroyed by the osteoclast, which is activated by a variety of cytokines produced directly or indirectly by the tumour cell. As bone matrix is broken down, a rich supply of mitogenic factors is released, which in turn can lead to increased proliferation of cancer cells.

Bisphosphonates are effective in treating conditions in which excessive bone resorption and osteoclast activity prevail, including osteoporosis and Paget's disease of bone. Several randomised clinical trials in patients with breast cancer with bone metastases have shown the ability of bisphosphonates to reduce skeletal related events and symptoms, including pathological fractures, surgery, radiation, compression of the spinal cord, hypercalcaemia, and pain, although they …
Natural progression of a nonpolypoid colon cancer: endoscopic morphological changes over 3 years
Authors: Y. Oono, K. Fu, M. Ohura, H. Nakamura, Y. Iriguchi, A. Yamamura, J. Oda, D. Kishi, H. Ikematsu, M. Mizutani
Journal: Endoscopy (2010)

A 63-year-old woman underwent surveillance colonoscopy, which revealed a flat elevated polyp (IIa), about 5 mm in diameter, in the cecum ([Fig. 1]). A second colonoscopy (2 years later) showed a flat elevated polyp with a mild depression, about 5 mm in diameter (IIa + IIc) ([Fig. 2]). A third colonoscopy (3 years later) revealed a faintly reddish depressed lesion (IIc), about 9 mm in diameter ([Fig. 3 a, b]). Magnifying chromoendoscopy showed a type VI pit pattern (Kudo classification) in the depression ([Fig. 3 c]). Endoscopic resection was carried out for histological evaluation. Histologically, the resected specimen was composed of well to moderately differentiated adenocarcinoma without any adenomatous components, which had infiltrated superficially into the submucosal layer along with lymphatic invasion ([Fig. 4]). Laparoscopy-assisted colectomy was thereafter carried out with curative intent. Histologically, no locally residual tumor or lymph node metastasis was detected.
MxA overexpression reveals a common genetic link in four Fanconi anemia complementation groups.
Authors: Y Li, H Youssoufian
Journal: Journal of Clinical Investigation (1997)

Fanconi anemia (FA) consists of a group of at least five autosomal recessive disorders that share both clinical (e.g., birth defects and hematopoietic failure) and cellular (e.g., sensitivity to cross-linking agents and predisposition to apoptosis) features with each other. However, a common pathogenetic link among these groups has not been established. To identify genetic pathways that are altered in FA and characterize shared molecular defects, we used mRNA differential display to isolate genes that have altered expression patterns in FA cells. Here, we report that the expression of an interferon-inducible gene, MxA, is highly upregulated in cells of FA complementation groups A, B, C, and D, but it is suppressed in FA group C cells complemented with wild-type FAC cDNA as well as in non-FA cells. A posttranscriptional mechanism rather than transcriptional induction appears to account for MxA overexpression. Forced expression of MxA in Hep3B cells enhances their sensitivity to mitomycin C and induces apoptosis, similar to the FA phenotype. Thus, MxA is a downstream target of FAC and is the first genetic marker to be identified among multiple FA complementation groups. These data suggest that FA subtypes converge onto a final common pathway, which is intimately related to the interferon signaling mechanism. Constitutive activity of this pathway may explain a number of the phenotypic features of FA, particularly the pathogenesis of bone marrow failure.
Optimizing P2Y12 Receptor Inhibition in Patients With Acute Coronary Syndrome on the Basis of Platelet Function Testing
Authors: Dániel Aradi, Adrienn Tornyos, Tünde Pintér, András Vorobcsuk, Attila Kónyi, József Faluközy, Gábor Veress, Balázs Magyari, Iván G Horváth, András Komócsi
Journal: Journal of the American College of Cardiology (2014)
Radionuclide Shuntogram Demonstrating Migration of Distal Ventriculoperitoneal Shunt Tubing out of the Peritoneal Cavity
Authors: Daniel Sigg, Ronald Rich, Sean Ashby, Bradley Jabour, Edwin Glass
Journal: Clinical Nuclear Medicine (2005)

An 81-year-old man with a history of ventriculoperitoneal (V-P) shunt placement for symptomatic normal pressure hydrocephalus presented with recurrence of confusion and gait disturbance. Radionuclide cisternography demonstrated loculation of In-111 DTPA in the abdominal wall. A soft tissue mass palpated at the location of tracer accumulation was confirmed to be extraperitoneal pooling of fluid at the site of coiling of the distal shunt tip. After surgical revision, with repositioning of the distal tube in the peritoneal cavity, the patient's symptoms promptly improved. When symptoms of hydrocephalus recur after successful V-P shunt placement, shunt malfunction should be suspected and evaluation for mechanical failure pursued. Catheter migration should be recognized as a correctable cause of shunt malfunction.
Acneform Eruptions Induced by Drugs and Chemicals
Authors: Joseph M. Hitch
Journal: JAMA (1967)

The often repeated assertion that any drug can produce a skin eruption of any gross morphology is probably true. However, acneform lesions are a relatively infrequent manifestation of druginduced eruptions, and the number of drugs that characteristically produce this type of lesion is rather small. An appreciation of the relationship therefore is important in prompt and accurate diagnosis. <h3>Hormones.—</h3> Since hormonal drugs are basically physiologic, one would expect that acneform eruptions produced by them would closely resemble naturally occuring acne vulgaris. Although this is indeed the case, there are some significant differences: (1) eruptions associated with the use of hormones are not necessarily limited to the sebaceous areas; (2) there is no age of predilection; (3) there is apt to be less pustulation and essentially no cyst formation; (4) the onset is likely to be abrupt; (5) when the eruption is caused by the administration of corticotropin (ACTH) or corticosteroids,
Results of Surgical and Nonsurgical Treatment for Small–Sized Hepatocellular Carcinomas: A Retrospective and Nationwide Survey in Japan
Authors: Shigeki Arii, Yoshio Yamaoka, Syunji Futagawa, Kyoichi Inoue, Kenichi Kobayashi, Masamichi Kojiro, Masatoshi Makuuchi, Yasuni Nakamura, Kiwamu Okita, Ryusaku Yamada
Journal: Hepatology (2000)

Hepatic resection (HX), percutaneous ethanol injection (PEI), and transcatheter arterial embolization (TCAE) have all been used in the treatment of patients with small-sized hepatocellular carcinomas (HCCs). However, the indications for these therapeutic modalities remain unclear. Therefore, the first step to minimize the debate on these indications is to review the standard results from each treatment based on an extensive survey. The participants in this study were patients with HCCs less than 5 cm in diameter who were enrolled in The Liver Cancer Study Group of Japan. The survival rates in the HX (n = 8,010), PEI (n = 4,037), and TCAE (n = 841) groups were calculated in relation to the number of tumors and the clinical stage. In the clinical stage I cases with a solitary tumor less than 2 cm in diameter and in all clinical stages with a solitary tumor greater than 2 cm and in the clinical stage II cases with 2 tumors greater than 2 cm, the HX group showed higher survival rates than the nonsurgical groups. The HX group had a higher male/female ratio and a younger mean age than the PEI or TCAE group. The ratio of HBs antigen-positive cases/hepatitis C virus antibody-positive cases in the PEI group was lower than that in the corresponding HX group. In contrast, the PIVKA-II values in the HX group tended to be higher than in the PEI group. In conclusion, these findings will provide useful information for selection of a therapeutic modality for small-sized HCCs.
Addiction, procrastination, and failure points in decision-making systems
Authors: Chrisoula Andreou
Journal: Behavioral and Brain Sciences (2008)

Abstract Redish et al. suggest that their failures-in-decision-making framework for understanding addiction can also contribute to improving our understanding of a variety of psychiatric disorders. In the spirit of reflecting on the significance and scope of their research, I briefly develop the idea that their framework can also contribute to improving our understanding of the pervasive problem of procrastination.
Principles and Management of Human Reproduction
Authors: George D. Wilbanks
Journal: JAMA (1972)

Three experts in human reproduction have revised Reid's<i>Textbook of Obstetrics</i>in keeping with current changes in obstetrical knowledge and practice. Recently, classic concepts in human reproduction have broadened to include reproductive endocrinology, perinatal medicine, and total reproductive health care. This book assembles basic material and clinical obstetrics in an orderly fashion. Despite the authors' intentions, it goes beyond basic core teaching material and functions more successfully as a review book. Because it was designed as a text, it falls short of being a definitive reference work. Part one is a scholarly yet readable review, by Dr. Ryan, of the endocrine and neuroendocrine control of reproduction. He balances the basic research with a clinical perspective at a level which is understandable to the beginner but detailed enough for those with added experience. The chapters on the various reproductive hormones, the endocrine organs, and their interrelationship are by themselves worth the
Detection of basal cell carcinomas in Mohs excisions with fluorescence confocal mosaicing microscopy
Authors: J.K. Karen, D.S. Gareau, S.W. Dusza, M. Tudisco, M. Rajadhyaksha, K.S. Nehal
Journal: British Journal of Dermatology (2009)

High-resolution real-time imaging of human skin is possible with a confocal microscope either in vivo or in freshly excised tissue ex vivo. Nuclear and cellular morphology is observed in thin optical sections, similar to that in conventional histology. Contrast agents such as acridine orange in fluorescence and acetic acid in reflectance have been used in ex vivo imaging to enhance nuclear contrast.To evaluate the sensitivity and specificity of ex vivo real-time imaging with fluorescence confocal mosaicing microscopy, using acridine orange, for the detection of residual basal cell carcinoma (BCC) in Mohs fresh tissue excisions.Forty-eight discarded skin excisions were collected following completion of Mohs surgery, consisting of excisions with and without residual BCC of all major subtypes. The tissue was stained with acridine orange and imaged with a fluorescent confocal mosaicing microscope. Confocal mosaics were matched to the corresponding haematoxylin and eosin-stained Mohs frozen sections. Each mosaic was divided into subsections, resulting in 149 submosaics for study. Two Mohs surgeons, who were blinded to the cases, independently assessed confocal submosaics and recorded the presence or absence of BCC, location, and histological subtype(s). Assessment of confocal mosaics was by comparison with corresponding Mohs surgery maps.The overall sensitivity and specificity of detecting residual BCC was 96.6% and 89.2%, respectively. The positive predictive value was 92.3% and the negative predictive value 94.7%. Very good correlation was observed between confocal mosaics and matched Mohs frozen sections for benign and malignant skin structures, overall tumour burden and location, and identification of all major histological subtypes of BCC.Fluorescent confocal mosaicing microscopy using acridine orange enables detection of residual BCC of all subtypes in Mohs fresh tissue excisions with high accuracy. This observation is an important step towards the long-term clinical goal of using a noninvasive imaging modality for potential real-time surgical pathology-at-the-bedside for skin and other tissues.
IVIG pluripotency and the concept of Fc-sialylation: challenges to the scientist
Authors: Stephan von Gunten, Yehuda Shoenfeld, Miri Blank, Donald R. Branch, Tchavdar Vassilev, Fabian Käsermann, Jagadeesh Bayry, Srini Kaveri, Hans-Uwe Simon
Journal: Nature reviews. Immunology (2014)
Opportunities in British Medicine
Authors: D. C. Prior
Journal: BMJ (1967)

Sugar Consumption and Acne SIR,-I was interested in the study by Dr. D. G. G. Bett and others (15 July, p. 153) in which they found raised sugar consumption in patients with seborrhoeic dermatitis but not in those with acne.In a study of 2,720 soldiers it was estab- lished that there is no correlation between the incidence or severity of acne and dandruff.'There was also no correlation between acne and obesity in men under 20 years old--the age group studied by Bett et al.However, in older men (age 20-40) there was a signifi- cant correlation between acne and obesity.It appears, therefore, that perhaps Bett et al. should extend their study to see if there is raised sugar intake in this older group before it can be settled that sugar intake in acne is not raised.-Iam, etc.,
Comparison of atopic cough with cough variant asthma: is atopic cough a precursor of asthma?
Authors: M Fujimura
Journal: Thorax (2003)

<b>Background:</b> We have described a group of patients who present with isolated chronic bronchodilator resistant non-productive cough with an atopic constitution, eosinophilic tracheobronchitis, and airway cough receptor hypersensitivity without bronchial hyperresponsiveness, which we have termed "atopic cough". Although cough variant asthma (in which the cough responds to bronchodilators) is recognised as a precursor of typical asthma, it is not known whether atopic cough is also a precursor of asthma. <b>Methods:</b> Eighty two patients with atopic cough were retrospectively examined for onset of typical asthma and compared with 55 patients with cough variant asthma (20 untreated patients and 35 treated with long term inhaled beclomethasone dipropionate (BDP), 218–467 μg/day). The median follow up period for patients with atopic cough and cough variant asthma was 4.8 (1–11.5) years and 3.7 (1–12.4) years, respectively. <b>Results:</b> Onset of typical asthma occurred in only one of the patients with atopic cough. In patients with cough variant asthma, typical asthma developed in two of 35 patients taking BDP and six of 20 untreated patients (difference 24.3%, 95% CI 2.8 to 45.8, p&lt;0.02). <b>Conclusions:</b> These findings suggest that cough variant asthma is a precursor of typical asthma but that atopic cough is not. Treatment with inhaled steroids may prevent the transformation of cough variant asthma into typical asthma.
NO ASSOCIATION OF PARAOXONASE-1 Q192R AND THROMBOTIC EVENTS DURING DUAL ANTI-PLATELET THERAPY IN PATIENTS AFTER ACUTE MYOCARDIAL INFARCTION
Authors: Jeffrey JW Verschuren, Hel&egrave;n Boden, Judith A. Wessels, B.L. van der Hoeven, Henk-Jan Guchelaar, Martin Schalij, Johan Jukema
Journal: Journal of the American College of Cardiology (2012)
Penicilloyl-Polylysine as an Intradermal Test of Penicillin Sensitivity
Authors: Bobby C. Brown, Eleanor V. Price, M. Brittain Moore
Journal: JAMA (1964)

Penicilloyl-polylysine was used in an intradermal skin test for the detection of penicillin hypersensitivity in 16,239 patients. In 1,003 patients with history of penicillin sensitivity, 396 had a positive skin test compared to a positive test in 775 of 12,559 patients with a negative history. Penicillin was administered to 13,530 patients with a negative skin test, of whom 63 had a reaction. Of 212 patients with a moderately positive and 206 with a strongly positive skin test who were given penicillin, 9 and 21 respectively experienced reactions. No anaphylaxis or life-threatening reactions occurred in patients with negative skin tests, although on the basis of previous experience this number of cases should have produced four reactions severe enough to require hospitalization.
Decreased tissue factor and tissue-plasminogen activator antigen in relapsed acute promyelocytic leukemia
Authors: Takahiro Nakasaki, Hideo Wada, Yoshitaka Mori, Yoshinaga Okugawa, Rika Watanabe, Masakatsu Nishikawa, Esteban C. Gabazza, Masahiro Masuya, Shinichi Kageyama, Kousuke Kumeda, Hisao Kato, Hiroshi Shiku
Journal: American Journal of Hematology (2000)

This study evaluated hemostatic data in 28 patients with newly diagnosed acute promyelocytic leukemia (APL) and 15 patients with relapsed APL. Activated partial thromboplastin time and prothrombin time were prolonged at initial onset of APL. Plasma level of fibrinogen was significantly decreased in patients with initial disease of APL, but it was not decreased significantly during the relapse of APL. Plasma fibrin and fibrinogen degradation products levels were significantly increased and platelet counts significantly decreased in both groups. Plasma levels of antiplasmin significantly decreased at initial onset but not during relapse. Plasma levels of antithrombin were within normal range in patients with initial disease but significantly decreased in those with relapse. Plasma levels of D-dimer, soluble fibrin monomer (sFM), plasmin–plasmin inhibitor complex (PPIC), and thrombin antithrombin complex (TAT) levels were significantly high in both groups. Plasma levels of PPIC, sFM, and D-dimer were significantly higher at initial onset of APL than during relapse. However, there was no significant difference in DIC score between patients with initial onset and those with relapse; plasma levels of tissue factor (TF) significantly increased in both groups, but they were significantly higher at initial onset of APL than during relapse. TF and tissue type plasminogen activator (t-PA) antigen levels in leukemic cell lysate were significantly increased in both groups, and they were significantly lower during relapse than at initial onset. Hemostatic abnormalities occurring in patients with relapsed APL might be the result of the decrease of TF and t-PA in leukemic cells. These findings suggest that DIC in APL patients with relapse might not be caused only by TF and t-PA and thus should be treated with different therapy from patients with initial onset of APL. Am. J. Hematol. 64:145–150, 2000. © 2000 Wiley-Liss, Inc.