tbuckley/cabot-search huggingface dataset:
Review: Limited evidence suggests that clobetasol or mometasone is effective in genital lichen sclerosus
Authors: Daniel J. Hogan
Journal: Annals of Internal Medicine (2012)

ACP Journal Club15 May 2012Review: Limited evidence suggests that clobetasol or mometasone is effective in genital lichen sclerosusDaniel J. Hogan, MDDaniel J. Hogan, MDBay Pines VA Healthcare System and, NOVA Southeastern University College of Osteopathic Medicine, Bay Pines, Florida, USA (D.J.H.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-10-201205150-02010 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationChi CC, Kirtschig G, Baldo M, et al. Topical interventions for genital lichen sclerosus. Cochrane Database Syst Rev. 2011;(12):CD008240. https://pubmed.ncbi.nlm.nih.gov/22161424Clinical Impact RatingsGIM/FP/GP: Dermatology: References1 Choschzick M, Hantaredja W, Tennstedt P, et al. Role of TP53 mutations in vulvar carcinomas. Int J Gynecol Pathol. 2011;30:497-504. [PMID: 21804386]. Google Scholar2 Bunker CB. Comments on the British Association of Dermatologists guidelines for the management of lichen sclerosus. Br J Dermatol. 2011;164:894-5. [PMID: 21155756] Google Scholar3 Lewis FM, Shah M, Gawkrodger DJ. Contact sensitivity in pruritus vulvae: patch test results and clinical outcome. Am J Contact Dermat. 1997;8:137-40. [PMID: 9249280] Google Scholar4 Worldwide Lichen Sclerosus Support. www.lichensclerosus.org (accessed 5 Apr 2012). Google Scholar5 Schorge JO, Schaffer JI, Pietz J, et al. Benign disorders of the lower reproductive tract. In: Schorge JO, Schaffer JI, Pietz J, et al, eds. Williams Gynecology. New York: McGraw-Hill; 2008. www.accessmedicine.com/content.aspx?aID=3150841 (accessed 5 Apr 2012.) Google Scholar Author, Article, and Disclosure InformationAuthors: Daniel J. Hogan, MDAffiliations: Bay Pines VA Healthcare System and, NOVA Southeastern University College of Osteopathic Medicine, Bay Pines, Florida, USA (D.J.H.)This article was published at Annals.org on 1 May 2012. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 May 2012Volume 156, Issue 10Page: JC5-10KeywordsAdverse reactionsClinical trial reportingGenital anatomyProgesteroneRisk ratioSex hormonesSkin diseasesSystematic reviewsTestosterone ePublished: 15 May 2012 Issue Published: 15 May 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Biosurfactant-facilitated remediation of metal-contaminated soils.
Authors: R M Miller
Journal: Environmental Health Perspectives (1995)

Bioremediation of metal-contaminated wastestreams has been successfully demonstrated. Normally, whole cells or microbial exopolymers are used to concentrate and/or precipitate metals in the wastestream to aid in metal removal. Analogous remediation of metal-contaminated soils is more complex because microbial cells or large exopolymers do not move freely through the soil. The use of microbially produced surfactants (biosurfactants) is an alternative with potential for remediation of metal-contaminated soils. The distinct advantage of biosurfactants over whole cells or exopolymers is their small size, generally biosurfactant molecular weights are less than 1500. A second advantage is that biosurfactants have a wide variety of chemical structures that may show different metal selectivities and thus, metal removal efficiencies. A review of the literature shows that complexation capacities of several bacterial exopolymers was similar to the complexation capacity of a rhamnolipid biosurfactant produced by Pseudomonas aeruginosa ATCC 9027.
Activation and Entrainment Mapping Defines the Tricuspid Annulus as the Anterior Barrier in Typical Atrial Flutter
Authors: Jonathan M. Kalman, Jeffrey E. Olgin, Leslie A. Saxon, Westby G. Fisher, Randall J. Lee, Michael D. Lesh
Journal: Circulation (1996)

Background The importance of anatomic barriers in the atrial flutter reentry circuit has been well demonstrated in canine models. It has been shown previously that the crista terminalis and its continuation as the eustachian ridge form a posterior barrier. In this study we tested the hypothesis that the tricuspid annulus forms the continuous anterior barrier to the flutter circuit. Methods and Results Thirteen patients with typical atrial flutter were studied. A 20-pole halo catheter was situated around the tricuspid annulus. A mapping catheter was used for activation and entrainment mapping from seven sequential sites around the tricuspid annulus and from three additional sites including the tip of the right atrial appendage, at the fossa ovalis, and in the distal coronary sinus. Sites were considered to be within the circuit when the postpacing interval minus the flutter cycle length and the stimulus time minus the activation time were ≤10 ms; sites were considered to be outside the circuit when these intervals were &gt;10 ms. All seven annular sites were within the circuit; activation occurred sequentially around the annulus and accounted for 100% of the flutter cycle length. The fossa ovalis, the distal coronary sinus, and the right atrial appendage were outside the circuit. Conclusions Closely spaced sites around the tricuspid annulus are activated sequentially, and are all within the flutter circuit according to entrainment criteria. This demonstrates that the tricuspid annulus constitutes a continuous anterior barrier constraining the reentrant wave front of human counterclockwise atrial flutter.
Diffuse Muscle Uptake of Technetium-99M MDP in a Patient with Lung Cancer
Authors: ARTHUR Z. KRASNOW, B DAVID COLLIER, ALI T. ISITMAN, RICHARD M. HANSEN, FARROKH DEHDASHTI, ROBERT S. HELLMAN
Journal: Clinical Nuclear Medicine (1988)

An unusual case is presented in which there is diffuse muscle uptake of a bone seeking agent in the neck and proximal upper extremities. The patient had squamous cell carcinoma of the lung with profound muscle weakness and was believed to have a paraneoplastic syndrome manifest as inflammation of the muscles and nerves.
Composite Metastatic Carcinoma in Lymph Nodes of Patients with Concurrent Medullary and Papillary Thyroid Carcinoma: A Report of Two Cases
Authors: Tomohisa Seki, Kaori Kameyama, Hiroshi Hayashi, Mitsuji Nagahama, Katsuhiko Masudo, Nobuhiro Fukunari, Kumi Tanaka, Kiminori Sugino, Koichi Ito, Hiroshi Takami
Journal: Endocrine Pathology (2004)
Effects of F-180, a new selective vasoconstrictor peptide, compared with terlipressin and vasopressin on systemic and splanchnic hemodynamics in a rat model of portal hypertension
Authors: Cristina Bernadich, Juan-Carlos Bandi, Per Melin, Jaime Bosch
Journal: Hepatology (1998)

The present study is aimed at characterizing the portal, splanchnic, and systemic circulatory effects of F-180, a new long-acting analog of vasopressin (VP) with selective effect on the vascular (V1) receptor, both in normal rats and in portal-hypertensive animals. In preliminary vasopressor tests, F-180 was 18 times more potent than terlipressin (TP) (164 +/- 10 IU x mmol(-1) vs. 9.2 +/- 1.2 IU x mmol(-1)) and four times less potent than arginine VP (614 +/- 25 IU x mmol(-1)). F-180 had negligible antidiuretic potency, resulting in vascular selectivity (V1/V2) of 858 compared with 1.0 for VP and 2.2 for TP. In portal-hypertensive rats with partial portal vein ligation (PPVL), the vasopressor effect of F-180 was 19 times that of TP on a molar basis (ED50 F-180: 0.54 vs. TP: 10.02 nmol x kg(-1)). At low doses (0.405 nmol x kg(-1)), F-180 significantly reduced portal pressure (PP) (-13.8% +/- 6.7%) and superior mesenteric artery blood flow (SMABF) (-25.6% +/- 4.5%), whereas TP at 8.10 nmol x kg(-1) was required to achieve comparable splanchnic effects; however, this dose caused a significantly greater increase in mean arterial pressure (MAP) than F-180 at 0.405 nmol x kg(-1) (28.2% +/- 2.7% vs. 8.9% +/- 2.7% at 20 minutes; P < .05). F-180 at 0.405 nmol x kg(-1) had effects on PP and SMABF similar to a 30-minute intravenous infusion of VP at 10 mU x kg(-1) in PPVL rats, but VP caused a significantly greater elevation in systemic vascular resistance (SVR) and MAP, and more pronounced reduction in cardiac index (P < .05).
Primary Care and Health
Authors: Barbara Starfield
Journal: JAMA (1991)

Ten Western industrialized nations were compared on the basis of three characteristics: the extent of their primary health service, their levels of 12 health indicators (eg, infant mortality, life expectancy, and age-adjusted death rates), and the satisfaction of their populations in relation to overall costs of the systems. Information was derived primarily from published sources. Indices were developed to characterize the extent of primary care in each country and the standing of each country relative to the others on the health indicators. There was general concordance for primary care, the health indicators, and the satisfaction-expense ratio in nine of the 10 countries. Ratings for the United States were low on all three measures. West Germany also had low ratings. In contrast, Canada, Sweden, and the Netherlands had generally high ratings for all three measures. The lack of concordance in the ratings in the United Kingdom may be a result of relatively low expenditures for other social services and public education in that country. The findings may add to the debate and deliberations concerning modifications in organization and financing of care that are currently being considered in the United States. (<i>JAMA</i>. 1991;266:2268-2271)
The Prevention of Adolescent Pregnancy
Authors: Elizabeth R. McAnarney
Journal: JAMA (1989)

THE PREVENTION of adolescent pregnancy and its consequences must be considered at several levels.<i>Primary prevention</i>focuses on preventing pregnancy by the development of responsible sexual behaviors by means such as influencing cultural attitudes and values, teaching about sexuality in the clinical environment, and discussing the subject in school.<i>Secondary prevention</i>considers the prevention of pregnancy by encouraging contraception for sexually active young people.<i>Tertiary prevention</i>addresses the prevention of morbidity in young mothers and their children through adequate prenatal care and follow-up. Although most professionals agree that abortion is not a desirable form of pregnancy prevention, it should be included in discussions of tertiary prevention. It is difficult to separate the different levels of prevention in an absolute sense. For example, the physician may provide primary and secondary prevention services in the office, and sex and family life education may cover all levels. The following principles underlie this report:
Testicular vein ligation and fertility in men with varicoceles.
Authors: D I Lewis-Jones, R V Lynch, A D Desmond, D G Machin
Journal: BMJ (1986)

Pregnancy rates in 651 subfertile couples in which the man had a varicocele were analysed by life table methods and were not found to be significantly different before and after testicular vein ligation performed in 283 patients. Estimated proportions of couples conceiving were roughly 30% by one year and 45% by two years in both groups. The operation was also not associated with improvement in results of semen analysis. These findings suggest that testicular vein ligation for varicoceles does not improve fertility.
Radical prostatectomy and watchful waiting for localized prostate cancer did not differ for quality of life
Authors: Allan V Prochazka, Tanner J Caverly
Journal: Annals of Internal Medicine (2012)

Source Citation Johansson E, Steineck G, Holmberg L, et al. Long-term quality-of-life outcomes after radical prostatectomy or watchful waiting: the Scandinavian Prostate Cancer Group-4 randomised trial. Lancet Oncol. 2011;12:891-9. 21821474
CHANGES IN THE SALIVARY SECRETION, AFFECTED BY SYSTEMIC DISEASE.
Authors: Heinrich Stern, William J Lederer
Journal: JAMA (1904)

Compared to other subjects of interest to the stomatologist, only a few papers of practical value have appeared on this subject as yet. Various experiments, and conclusions drawn therefrom, are scattered throughout medical literature, but these are of no great practical value, as the investigations were carried on at different times, under varying conditions and on different subjects. The task which the writers have undertaken is to study the saliva in a number of systemic diseases under as analogous conditions as possible, which is rendered more difficult by the fact that the literature existing on the subject is so little congruous and the results so far obtained are at a great variance. For example, if we study the investigations of the saliva in febrile conditions, what a chaos confronts us. If investigators do not agree on the modifications of the salivary secretion in so ordinary a condition as a
Three-Dimensional Reconstruction of the Biliary Tract from Two-Dimensional Biliary Images
Authors: X Z Lin, Y N Sun, J S Hu, C C Ko, C Y Chen, T H Wang
Journal: Endoscopy (1995)

To make conventinal two-dimensional cholangiography easier and more precise to read, we used techniques in computer vision to reconstruct the images in three dimensions. A 72-year-old man and a 70-year-old woman suffering from acute cholangitis were treated using endoscopic nasobiliary drainage. Their cholangiograms, from two orthogonal views, were used for three-dimensional reconstruction. We used video image grabber and film scanner methods to digitize the original conventional biliary radiographs, and applied two different image processing methods to show the biliary structure. Both methods of three-dimensional reconstruction of the biliary tract were highly useful in evaluating the biliary tracts in these two patients, especially when a semitranslucence overlapping display technique was applied in the second patient. With this technique, the biliary tree itself and the stones inside the common bile duct can be clearly delineated. The technique of three-dimensional reconstruction of biliary images can make the conventional cholangiographs more lifelike and has great potential in surgical simulation in the near future.
Brain Scans in Schilder's Disease
Authors: N. Paul Rosman
Journal: JAMA (1971)

To the Editor.—  We would like to add two additional comments to our paper  Disease: Positive Brain Scan ( 217 :1699, 1971) that we trust will be of interest to your readers.  The patient reported has since died and autopsy examination confirmed the diagnosis of Schilder's disease.  Since submission of our report, we have learned of a related case taken from the case records of the Massachusetts General Hospital ( New Eng J Med  266 :191,1962). The patient reported, a 17-year-old boy, developed a left homonymous hemianopsia and other signs of a right parietal abnormality. Radioactive arsenic scans demonstrated right parietal localization, and tumor or abscess were considered to be the leading diagnostic possibilities. At postmortem examination, the white matter of almost the entire cerebral hemisphere and to a lesser extent the left cerebral hemisphere was the site of an inflammatory destructive lesion that histopathologically proved to be Schilder's disease. It
Sequence of mitral valve motion and transmitral blood flow during manual cardiopulmonary resuscitation in dogs.
Authors: M P Feneley, G W Maier, J W Gaynor, S A Gall, J A Kisslo, J W Davis, J S Rankin
Journal: Circulation (1987)

According to the thoracic pump model of cardiopulmonary resuscitation (CPR), the heart serves as a passive conduit for blood flow from the pulmonary to the systemic vasculature, necessitating an open mitral valve and anterograde transmitral blood flow during chest compression. To assess the applicability of this model to manual CPR techniques, two-dimensional echocardiograms were recorded from the right chest wall and/or the esophagus in nine dogs (18 to 26 kg) during manual CPR. The aortic valve opened with chest compression and closed with release, while the pulmonary and tricuspid valve leaflets closed with compression and opened during release. The mitral valve remained open during ventilation alone and during abdominal compressions. With the onset of brief, high-velocity (high-impulse) chest compressions, the mitral valve closed rapidly and the left ventricle was deformed, whether compressions were applied to the sternum or the left mid-chest wall. The mitral valve reopened with release of each compression. Left atrial echocardiographic contrast injections confirmed the absence of anterograde transmitral blood flow during high-impulse compression and its presence during release. Failure of mitral leaflet approximation during chest compression was observed only when a very low-velocity, prolonged (low-impulse) compression technique was used, or when regions that did not directly overlie the heart were compressed. Consistent with these observations, simultaneous recordings of the left ventricular and left atrial pressures during high-impulse sternal compressions in five dogs (19 to 25 kg) demonstrated peak and mean left ventriculoatrial pressure gradients of 38.5 +/- 4.0 and 13.5 +/- 2.9 mm Hg, respectively, and these pressure gradients declined with less impulsive compressions. The observations made during all but low-impulse chest compressions are inconsistent with the thoracic pump model, and support direct cardiac compression as the primary mechanism of forward blood flow with more impulsive manual chest compression techniques.
Coronary blood flow in physically trained rats
Authors: K. L. SPEAR, J. E. KOERNER, R. L. TERJUNG
Journal: Cardiovascular Research (1978)

Coronary blood flow was measured using labelled microspheres (15 μm diameter) in sedentary and endurance trained rats during hypoxaemic conditions designed to develop coronary dilatation (Pa,o2 6.0 to 6.7 kPa [45 to 50 mmHg]). Rats that were trained for 12 to 18 weeks (26·8 m per minute, 15% gradient, 1 hour per day) had a significantly greater coronary blood flow conductance (15.3 ± 1.0 mm3·min−1 · kPa−1 aortic diastolic pressure, n = 20) than sedentary animals (10.8± 0.9, n = 19). Even though cardiac hypertrophy (17%) was found in the trained animals, this increase in perfused mass accounted for only one-third of the increase in total coronary blood flow. Thus, there was a greater coronary blood flow per unit mass of the myocardium in the trained rats.
Routine use of sedatives before surgery has little benefit, study shows
Authors: J. Wise
Journal: BMJ (2015)

Routinely giving a sedative before elective surgery under general anaesthetic does not improve the patient’s experience and is associated with a longer extubation time and a lower rate of early cognitive recovery, a randomised controlled trial has found.

The study, reported in JAMA ,1 included 1062 adult patients who had various elective surgeries scheduled at five French teaching hospitals. They were randomly assigned to …
[186] BENEFIT OF PLASMAPHERESIS AND ANTICOAGULATION IN PATIENS TRANSPLANTED FOR END-STAGE LIVER DISEASE WITH HIGH RISK FOR ANTIPHOSPHOLIPID-ASSOCIATED VASCULAR EVENTS
Authors: A.G. Villamil, P. Casciato, F. Nunez, D. Alvarez, W. Scorso, M. Bujas, E. de Santibanes, A. Gadano
Journal: Journal of Hepatology (2007)
Clinical outcomes and inflammatory biomarkers in current smokers and exsmokers with severe asthma
Authors: Neil C. Thomson, Rekha Chaudhuri, Liam G. Heaney, Christine Bucknall, Robert M. Niven, Christopher E. Brightling, Andrew N. Menzies-Gow, Adel H. Mansur, Charles McSharry
Journal: Journal of Allergy and Clinical Immunology (2013)
Dermal Damage Promoted by Repeated Low-Level UV-A1 Exposure Despite Tanning Response in Human Skin
Authors: Frank Wang, Noah R. Smith, Bao Anh Patrick Tran, Sewon Kang, John J. Voorhees, Gary J. Fisher
Journal: JAMA Dermatology (2013)

IMPORTANCE Solar UV irradiation causes photoaging, characterized by fragmentation and reduced production of type I collagen fibrils that provide strength to skin.Exposure to UV-B irradiation (280-320 nm) causes these changes by inducing matrix metalloproteinase 1 and suppressing type I collagen synthesis.The role of UV-A irradiation (320-400 nm) in promoting similar molecular alterations is less clear yet important to consider because it is 10 to 100 times more abundant in natural sunlight than UV-B irradiation and penetrates deeper into the dermis than UV-B irradiation.Most (approximately 75%) of solar UV-A irradiation is composed of UV-A1 irradiation (340-400 nm), which is also the primary component of tanning beds.OBJECTIVE To evaluate the effects of low levels of UV-A1 irradiation, as might be encountered in daily life, on expression of matrix metalloproteinase 1 and type I procollagen (the precursor of type I collagen). DESIGN, SETTING, AND PARTICIPANTSIn vivo biochemical analyses were conducted after UV-A1 irradiation of normal human skin at an academic referral center.Participants included 22 healthy individuals without skin disease.MAIN OUTCOMES AND MEASURES Skin pigmentation was measured by a color meter (chromometer) under the L* variable (luminescence), which ranges from 0 (black) to 100 (white).Gene expression in skin samples was assessed by real-time polymerase chain reaction.RESULTS Lightly pigmented human skin (L* >65) was exposed up to 4 times (1 exposure/d) to UV-A1 irradiation at a low dose (20 J/cm 2 ), mimicking UV-A levels from strong sun exposure lasting approximately 2 hours.A single exposure to low-dose UV-A1 irradiation darkened skin slightly and did not alter matrix metalloproteinase 1 or type I procollagen gene expression.With repeated low-dose UV-A1 irradiation, skin darkened incrementally with each exposure.Despite this darkening, 2 or more exposures to low-dose UV-A1 irradiation significantly induced matrix metalloproteinase 1 gene expression, which increased progressively with successive exposures.Repeated UV-A1 exposures did not suppress type I procollagen expression. CONCLUSIONS AND RELEVANCEA limited number of low-dose UV-A1 exposures, as commonly experienced in daily life, potentially promotes photoaging by affecting breakdown, rather than synthesis, of collagen.Progressive skin darkening in response to repeated low-dose UV-A1 exposures in lightly pigmented individuals does not prevent UV-A1-induced collagenolytic changes.Therefore, for optimal protection against skin damage, sunscreen formulations should filter all UV wavelengths, including UV-A1 irradiation.
Administration of Fluorouracil-Reply
Authors: Henry M. Lemon
Journal: JAMA (1963)

Drs. Reitemeier and Moertel's "controlled" study did not include a true crossover comparison of the rapid vs slow methods of fluorouracil administration in each of their groups of patients, so that we do not know how many patients might have responded to slow infusion in glucose, after failure of remission with rapid therapy. Furthermore, the difference in tumor remission between their two treatment series occurred in only four of 45 patients, which is statistically insignificant (calculated from fourfold table using Yates' correction for small numbers, chi-square=0.07).<sup>1</sup>Their publication was included in our bibliography because it substantiated the major conclusions of our report, including reduction of toxicity of fluorouracil slowly infused in glucose (no "drug deaths" noted by them, in contrast to three "drug deaths" in a group of 45 patients receiving rapid infusion); the fact that "severe toxicity to 5FU did not correlate with