tbuckley/cabot-search huggingface dataset:
Ethics of Commercial Screening Tests
Authors: David L. Keller
Journal: Annals of Internal Medicine (2013)

Letters19 March 2013Ethics of Commercial Screening TestsDavid L. Keller, MDDavid L. Keller, MDFrom Providence Medical Group, Torrance, California.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-6-201303190-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I disagree with the recent commentary by Wallace and colleagues (1) condemning the ethics of commercial screening tests that are marketed directly to the public, without requiring individuals to first spend the time and money to have a physician order the tests. In my opinion, there should be no restrictions placed on access by consumers to screening tests, such as ultrasound examinations and genetic testing, which do not cause direct physical harm. In distinction, tests that expose patients to harms, such as ionizing radiation or intravenous contrast, should only be performed after a thorough evaluation by a ...References1. Wallace EA, Schumann JH, Weinberger SE. Ethics of commercial screening tests. Ann Intern Med. 2012;157:747-8. [PMID: 22928174] LinkGoogle Scholar2. Life Line Screening of America. Accessed at https://secure.lifelinescreening.com/ecom/package.aspx on 1 December 2012. Google Scholar3. U.S. Preventive Services Task Force. Screening for carotid artery stenosis: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2007;147:854-9. [PMID: 18087056] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Providence Medical Group, Torrance, California.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEthics of Commercial Screening Tests Erik A. Wallace , John H. Schumann , and Steven E. Weinberger Ethics of Commercial Screening Tests Erik A. Wallace , John H. Schumann , and Steven E. Weinberger Metrics 19 March 2013Volume 158, Issue 6Page: 499-500KeywordsAngiographyIonizing radiationMedical risk factorsPatientsStatinsStenosisUltrasound imagingVascular diseases ePublished: 19 March 2013 Issue Published: 19 March 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Can Complexed Prostate Specific Antigen Enhance Prostate Cancer Detection in Japanese Men?
Authors: Koji Okihara, Osamu Ukimura, Terukazu Nakamura, Yoichi Mizutani, Akihiro Kawauchi, Yoshio Naya, Mutsumi Uchida, Takahiro Ogiwara, Tsuneharu Miki
Journal: European Urology (2003)
Proportion of Physicians to Population.
Authors: George H. Rohe
Journal: JAMA (1898)

Sykesville, Md., Jan. 24, 1898. <h3>To the Editor:</h3> —The statistics quoted in theJournalof January 22 (p. 231) from "Hirschwald's Medical Directory" furnish a good refutation of the reckless statements so often made by careless writers in American medical journals concerning the great disproportion in the number of physicians to population in this and other countries. I have thought it might be of interest to give a comparative statement of the number of physicians to the population in a few of the large cities in the United States and in the German Empire. The figures for the former are taken from "Flint's Medical and Surgical Directory" for 1897 and the "New York World Almanac" for 1897 and 1898, and those for Germany from the work mentioned above. The statistics are as follows: United States: New York, 1 physician to 650 of population; Philadelphia, 1 physician to 661 of population;
Oncogenic and Wild-type Ras Play Divergent Roles in the Regulation of Mitogen-Activated Protein Kinase Signaling
Authors: Amy Young, David Lou, Frank McCormick
Journal: Cancer Discovery (2012)

H-Ras, K-Ras, and N-Ras regulate cellular growth and survival and are often activated by somatic mutation in human tumors. Although oncogenic lesions occur in a single Ras isoform within individual tumors, it is unclear whether the remaining wild-type isoforms play supporting roles in tumor growth. Here, we show that oncogenic and wild-type Ras isoforms play independent and nonredundant roles within the cell. Oncogenic Ras regulates basal effector pathway signaling, whereas wild-type Ras mediates signaling downstream of activated receptor tyrosine kinases (RTK). We show that both are necessary for exponential growth of Ras-mutant cell lines. Furthermore, we show that oncogenic Ras desensitizes signaling from EGF receptor (EGFR). Depletion of oncogenic Ras with siRNA oligonucleotides relieves this negative feedback, leading to the hyperactivation of EGFR and wild-type Ras signaling. Consistent with this model, combining oncogenic Ras depletion with EGFR inhibition potently increases cell death.The results of this study highlight a novel role for wild-type Ras signaling in cancer cells harboring oncogenic RAS mutations. Furthermore, these findings reveal that therapeutically targeting oncogenic Ras signaling alone may be ineffective owing to feedback activation of RTKs, and suggest that blocking upstream RTKs in combination with downstream effector pathways may be beneficial in the treatment of Ras-mutant tumors.
INFECTION OF ACCESSORY SINUSES AND UPPER RESPIRATORY TRACT IN VITAMIN A DEFICIENCY
Authors: BURT R. SHURLY
Journal: JAMA (1930)

Experimental and clinical evidence has clearly established that deficiency of vitamin A produces a pathologic entity classified as xerophthalmia. The lowered resistance to infection and the development of lesions in the lacrimal apparatus, corneal ulceration and of infection of the nasal passages, accessory sinuses, middle ear, tongue, and upper respiratory tract are of particular interest to this section. The virulence of the micro-organism and the resistance of the cell to toxemia are underlying principles that determine the degree of pathogenesis. We look to biochemistry to explain many of the mysteries that surround us in the various epidemics of influenza, tonsillitis, mastoiditis or diphtheria. Why does acute sinusitis, tonsillitis, acute laryngitis or mastoiditis prevail in epidemic form and change in type overnight to a greater or less degree of virulence and become engrafted on a new area of mucous membrane or lymphoid tissue? If the influence is climatic or microbic, the
Hair Theory Pelted
Authors: Harold M. Childress
Journal: JAMA (1964)

<h3>To the Editor:—</h3> The recent theories and conclusions of Dr. Montagu were extremely interesting, but he must be challenged on one statement. His assertion that man's comfort zone for external temperature is between 65 and 95 F is not acceptable. Swimming frequently with water temperatures down to 50 F, I am more than casually interested in the body's reaction to its environment. Best and Taylor believe that the comfort zone for a resting naked male body is 78 to 95 F, in which range neither sweating nor shivering occurs. They further point out that at 68.5 F gooseflesh and shivering usually develop. Clinical proof that the body is losing heat when external environment is at 65 F is easily obtained. Remaining inactive and in bare skin with air temperature at 65 F soon becomes uncomfortable and is followed by contractions of the smooth muscles of the skin. The water test
Severe Extrapyramidal Motor Activity Induced by Prochlorperazine
Authors: William H. Waugh, James C. Metts
Journal: New England Journal of Medicine (1960)

PHENOTHIAZINE derivatives are currently widely used as potent tranquilizing and antiemetic agents. Unfortunately, the more potent therapeutically these drugs are, the more frequent are their toxic or untoward side effects.1 Extrapyramidal motor reactions are very common side effects. Although these drug-induced dystonias or syndromes similar to Parkinson's disease may be dramatic and frightening, it has generally been held that even the severe reactions need not cause undue alarm, for they can be effectively controlled by sedation or by the administration of such drugs as trihexyphenidyl, benztropine, procyclidine and cycrimine.2 However, these currently used drugs, as well as others such as . . .
Radiotherapy With Rituximab Is Better than Radiotherapy alone In First Line Treatment Of Localized Follicular Lymphoma. Time To Change a Standard Strategy?
Authors: Andrea Janikova, Katerina Benesova, Zbynek Bortlicek, Vit Campr, Natasa Kopalova, David Belada, Vit Prochazka, Robert Pytlik, Samuel Vokurka, Jan Pirnos, Milan Matuska, Heidi Mocikova, Jiri Mayer, Marek Trneny
Journal: Blood (2013)
Findings of Intramediastinal Gossypiboma With F-18 FDG PET in a Melanoma Patient
Authors: Jian Q. Yu, Barton N. Milestone, Rosaleen B. Parsons, Mohan Doss, Naomi Haas
Journal: Clinical Nuclear Medicine (2008)

FDG PET/CT scan was performed to evaluate recurrence in an asymptomatic 64-year-old man with a history of melanoma in the left posterior ear. PET/CT images showed an intense ring-shaped area of FDG activity in the posterior mediastinum in a large posterior mediastinal mass. However, further evaluation indicated that this activity was caused by an intramediastinal gossypiboma after coronary artery bypass graft surgery 4 years before the PET/CT scan.
Quality and Quantity: The Quest for Biological Regeneration in Twentieth-Century France
Authors: George Weisz
Journal: JAMA (1991)

Many historians have, during the past several decades, been fascinated by that body of ideas called "eugenics." Small wonder. Eugenics made a not insignificant contribution to the conditions that made the Holocaust possible. While Nazi medical atrocities, for instance, can be passed over as the work of a handful of evil, mad, or corrupt men, eugenics, by virtue of its widespread popularity in elite scientific circles of Western democracies, raises fundamental questions about the nature of medical science and its impact on modern societies. Most histories of eugenics concentrate on its development in Germany, where it became something of an official ideology, and in the United States, which until the 1930s provided the major models of eugenic legislation. William Schneider has written an important study of eugenics in France, designed in part to demonstrate that the quest for "biological regeneration" was not limited to German- and English-speaking nations in the
THROMBOSIS OF THE INFERIOR VENA CAVA FOLLOWING PHYSICAL EXERTION
Authors: Ruth C. Foster
Journal: JAMA (1941)

During the past year we have had the opportunity to observe a case of obstruction of the inferior vena cava from shortly after the onset of the condition to the establishment of an apparently adequate collateral circulation. Because of the rarity of the condition and the unusual etiology, the case seems worth reporting.  REPORT OF CASE  A white girl aged 20, a physical education student, consulted the University of Wisconsin Health Service on Nov. 6, 1940 because of edema of the legs and enlarging abdominal veins. She had been well until July 29, 1940, when while tumbling she did a back flip. At this time she felt something pull in the lower part of the back. There was little discomfort, however, until two days later, at which time there was aching in the small of the back, particularly when she was in the recumbent position, which was somewhat relieved by
Abstract 1277: The association between seasonality, vitamin D and calcium intake and mammographic density in Norwegian postmenopausal women
Authors: Merete Ellingjord-Dale, Isabel dos Santos Silva, Tom Grotmol, Amrit Kaur Sakhi, Samera Qureshi, Solveig Hofvind, Marianne Skov Markussen, Elisabeth Couto, Lene Frost Andersen, Giske Ursin, Giske Ursin
Journal: Cancer Research (2014)

Abstract Background: Mammographic density (MD) is one of the strongest known breast cancer risk factors. The role of vitamin D in breast cancer etiology is unclear. The evidence of an association between Vitamin D and MD is limited and inconsistent, as is the seasonal variation of MD. We evaluated the association between MD and season/month the mammogram was obtained, as well as vitamin D intake, energy and calcium intake in a population of women from Norway, a country with limited sunlight exposure for a large part of the year. Methods: We studied 2662 postmenopausal women aged 50-69 who participated in the Norwegian Breast Cancer Screening Program (NBCSP) in 2004 or 2006/07. Women completed risk factor and food frequency questionnaires (FFQ). Vitamin D and calcium intake was assessed with and without taking supplements into consideration. Month of mammogram was recorded from the mammogram. MD was assessed using a computer assisted method (Madena, University of Southern California). We used linear regression to determine the association between month of mammogram and MD, as well as vitamin D and calcium intake (assessed from the FFQ) and MD, adjusting for age, education, body mass index (BMI), parity and postmenopausal estrogen and progestin therapy. We also examined the association between vitamin D, calcium and MD by season (month) the mammogram was obtained. Results: Age, BMI and parity were inversely associated with MD, while education and postmenopausal estrogen and progestin therapy were positively associated\ with MD. There was no association between quartiles of vitamin D or calcium intake and MD, regardless of whether the nutrients were estimated with our without supplements. We found no association between season (month) and MD. There was no evidence for an inverse association between vitamin D intake and MD when women were stratified by the month the mammogram was obtained. Conclusion: Our results provide no support for a protective effect of dietary vitamin D intake against increased MD. We found no evidence that season or month the mammogram was obtained, was associated with MD. Citation Format: Merete Ellingjord-Dale, Isabel dos Santos Silva, Tom Grotmol, Amrit Kaur Sakhi, Samera Qureshi, Solveig Hofvind, Marianne Skov Markussen, Elisabeth Couto, Lene Frost Andersen, Giske Ursin, Giske Ursin. The association between seasonality, vitamin D and calcium intake and mammographic density in Norwegian postmenopausal women. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1277. doi:10.1158/1538-7445.AM2014-1277
Y Chromosome Evidence for Anglo-Saxon Mass Migration
Authors: Michael E. Weale, Deborah A. Weiss, Rolf F. Jager, Neil Bradman, Mark G. Thomas
Journal: Molecular Biology and Evolution (2002)

British history contains several periods of major cultural change. It remains controversial as to how much these periods coincided with substantial immigration from continental Europe, even for those that occurred most recently. In this study, we examine genetic data for evidence of male immigration at particular times into Central England and North Wales. To do this, we used 12 biallelic polymorphisms and six microsatellite markers to define high-resolution Y chromosome haplotypes in a sample of 313 males from seven towns located along an east-west transect from East Anglia to North Wales. The Central English towns were genetically very similar, whereas the two North Welsh towns differed significantly both from each other and from the Central English towns. When we compared our data with an additional 177 samples collected in Friesland and Norway, we found that the Central English and Frisian samples were statistically indistinguishable. Using novel population genetic models that incorporate both mass migration and continuous gene flow, we conclude that these striking patterns are best explained by a substantial migration of Anglo-Saxon Y chromosomes into Central England (contributing 50%–100% to the gene pool at that time) but not into North Wales.
Abstract P6-07-09: What should be done after PHARE and HERA? Using value of information analysis as a guide
Authors: HJ Conter
Journal: Cancer Research (2013)

Abstract Background: Adjuvant trastuzumab therapy totaling 12 months (AT-12) is the current standard of care in the treatment of early-stage, HER-2/neu amplified breast cancer. Two studies, PHARE and HERA, examined whether the duration of adjuvant trastuzumab should be decreased safely to 6 months (AT-6) or increased to 2 years (AT-24), respectively. Could the implementation of value of information (VOI) analysis inform future clinical trial priority setting in this sphere? Methods: A Markov health-state transition model was employed to compare 3 adjuvant therapy options: AT-12, AT-6, and AT-24. Patients transitioned through 3 health states, disease free, metastatic recurrence, and death, over 3-month time intervals. The simulation was run using a lifetime time horizon. Transition probabilities of the health states in the AT-12 cohort were estimated from the National Surgical Adjuvant Breast and Bowel Project B-31 and North Central Cancer Treatment Group N9831 trials. Based on the efficacy assumptions that provided the foundation for HERA, the AT-24 probabilities were imputed. AT-6 transition probabilities were assumed to equal AT-12 probabilities. Health outcomes were measured in quality adjusted life years (QALY) and costs in 2012 United States dollars. Health outcomes and costs were discounted to the present value by 5% annually, compounded quarterly. Result: In the reference case, AT-24 had an incremental cost-effectiveness ratio of $57,784/QALY. Probabilistic sensitivity analysis revealed that AT-24 was likely to be 0.3%, 11%, 58%, and 93% cost effective at a threshold willingness-to-pay (WTP) of $20,000, $40,000, $60,000, and $80,000/QALY, respectively. At a WTP threshold of 65,000, the expected VOI payoff from conducting the HERA trial was computed as $204,692 per patient treated per year. Conversely, AT-6 would be expected to cost $100,592 less than AT-12 over a patient's life, corresponding to an expected $249,564 per patient per year payoff for the PHARE trial. Since neither PHARE nor HERA were able to achieve their primary objectives, a new trial testing the duration of trastuzumab could be considered. Employing the same model, AT for 9 months would be expected to save $50,596 per patient compared to AT-12. The VOI of such a trial is estimated to be $224,504 per patient treated per year. Conclusion: Despite the results of PHARE and HERA, VOI analysis suggests that a non-inferiority trial examining 9 months of AT compared to AT-12 should be considered. The actual value of such a trial may be even greater if new HER-2 targeted therapies may be added to AT in the future. However, determining the total net benefit to society of performing such research requires information on its associated budgetary outlays. Cooperative groups should make the their individual trial expenses public to facilitate improved collective decision-making on future trials. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-07-09.
Abstract 5055: The role of estrogens and vascular endothelial growth factor (VEGF) in premenopausal breast cancer carginogenesis and disease progression
Authors: Francesco Recchia, Giampiero Candeloro, Giovambattista Desideri, Stefano Necozione, Silvio Rea
Journal: Cancer Research (2011)

Abstract Background. Estrogen is important in breast cancer development and there is evidence in vitro, that it modulates VEGF expression in breast cancer cells through transcriptional activation. However few clinical studies have investigated the association between VEGF and estrogens in humans. Objective of this study was to evaluate weather estrogen suppression with an LH-RH analogue was able to downregulate VEGF expression, and thus decrease its plasma concentration, in premenopausal patients with high-risk early breast cancer. Patients and methods: From April 2003 to October 2008 we conducted this study on 100 premenopausal early breast cancer patients. At baseline, after surgery, before any type of therapy, plasma VEGF and sex hormones (estradiol, progesterone, FSH, LH) were evaluated. Evaluation was repeated each year. Patients received an LH-RH analogue for 5 years, a chemotherapy that was tailored to the biological characteristics of each patient, radiation therapy, and hormonal therapy in estrogen receptor positive (ER+) tumors. Primary end point was the evaluation of VEGF. Secondary end points were progression-free survival (PFS) and overall survival (OS). Results: Median age was 43 years (range 26-45); mean number of positive axillary nodes was 3.3. (Range 0-25). Fifty-three patients were ER+ and progesterone receptor positive (PGR+), 17 were ER negative (−) and PGR-, 30 were ER+ and PGR-, Median KI-67 was 33% (range 15%-100%). Twenty patients were Herb-2 positive by FISH. A statistically significant decrease of VEGF was observed after 1 year. At 5 years and during the study period, plasma VEGF continued to decrease (p&amp;lt;0.001) in 94% of patients that were disease-free, while in 6% of patients with disease relapse, VEGF increased with respect to baseline values. No unexpected toxicity of chemotherapy was observed, while hot flashes and G1 osteopenia occurred after LH-RH analogues administration. After a median follow-up of 50 months (range 24-90), 8-year disease free survival and overall survival rated were 94% and 100%, respectively. Conclusion: Estrogen deprivation with an LH-RH analogue is able to decrease plasma VEGF levels in premenopausal high risk breast cancer patients. These data show how estrogens, through VEGF modulation, may be responsible for the worst prognosis that is observed in premenopausal breast cancer patients. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 5055. doi:10.1158/1538-7445.AM2011-5055
Did Not Endorse Solidified Formaldehyd.
Authors: Henry Albert
Journal: JAMA (1907)

State University of Iowa, Iowa City, Jan. 18, 1907. <h3>To the Editor:</h3> —My attention has recently been called to a circular issued by the George Leininger Chemical Company, which now goes by the name of the International Chemical Company, in which I am quoted as recommending the George Leininger solidified formaldehyd for fumigation, and in which the State University of Iowa, the Iowa State Board of Health and I personally am mentioned as endorsing the products of this firm. It is true that I have examined the formadehyd mentioned and have found that when used in sufficient quantity (more than is recommended by the firm) and using it under certain conditions (such as a sufficient amount of moisture, a proper temperature, etc.), that it will disinfect. I have never, however, given it an unqualified recommendation and, so far as I know, it has never been endorsed by the Iowa State
Patient-Centered Pharmaceutical Design to Improve Acceptability of Medicines: Similarities and Differences in Paediatric and Geriatric Populations
Authors: Fang Liu, Sejal Ranmal, Hannah K. Batchelor, Mine Orlu-Gul, Terry B. Ernest, Iwan W. Thomas, Talia Flanagan, Catherine Tuleu
Journal: Drugs (2014)

Patient acceptability of a medicinal product is a key aspect in the development and prescribing of medicines. Children and older adults differ in many aspects from the other age subsets of population and require particular considerations in medication acceptability. This review highlights the similarities and differences in these two age groups in relation to factors affecting acceptability of medicines. New and conventional formulations of medicines are considered regarding their appropriateness for use in children and older people. Aspects of a formulation that impact acceptability in these patient groups are discussed, including, for example, taste/smell/viscosity of a liquid and size/shape of a tablet. A better understanding of the acceptability of existing formulations highlights opportunities for the development of new and more acceptable medicines and facilitates safe and effective prescribing for the young and older populations.