tbuckley/cabot-search huggingface dataset:
Dermoscopic patterns of melanoma metastases: interobserver consistency and accuracy for metastasis recognition
Authors: J. Costa, K. Ortiz-Ibañez, G. Salerni, V. Borges, C. Carrera, S. Puig, J. Malvehy
Journal: British Journal of Dermatology (2013)

Cutaneous metastases of malignant melanoma (CMMM) can be confused with other skin lesions. Dermoscopy could be helpful in the differential diagnosis. To describe distinctive dermoscopic patterns that are reproducible and accurate in the identification of CMMM. A retrospective study of 146 dermoscopic images of CMMM from 42 patients attending a melanoma unit between 2002 and 2009 was performed. Firstly, two investigators established six dermoscopic patterns for CMMM. The correlation of 73 dermoscopic images with their distinctive patterns was assessed by four independent dermatologists to evaluate the reproducibility in the identification of the patterns. Finally, 163 dermoscopic images, including CMMM and nonmetastatic lesions, were evaluated by the same four dermatologists to calculate the accuracy of the patterns in the recognition of CMMM. Five CMMM dermoscopic patterns had a good interobserver agreement (blue naevus‐like, naevus‐like, angioma‐like, vascular and unspecific). When CMMM were classified according to these patterns, correlation between the investigators and the four dermatologists ranged from κ = 0·56 to κ = 0·7. In total, 71 CMMM, 16 angiomas, 22 blue naevi, 15 malignant melanomas, 11 seborrhoeic keratoses, 15 melanocytic naevi with a globular pattern and 13 pink lesions with a vascular pattern were evaluated according to the previously described CMMM dermoscopy patterns, showing an overall sensitivity of 67·9% (range 54·9–76%) and a specificity of 79·9% (range 68·5–93·5%) for the diagnosis of CMMM. Five dermoscopic patterns of CMMM with good interobserver agreement obtained a high sensitivity and specificity in the diagnosis of metastasis, with the accuracy varying according to the experience of the observer.
Plasma exchange in severe rhesus disease.
Authors: R J Ancill
Journal: BMJ (1977)

<h3>Objective</h3> Investigations into surgical expertise have almost exclusively focused on overt behavioral characteristics with little consideration of the underlying neural processes. Recent advances in neuroimaging technologies, for example, wireless, wearable scalp-recorded electroencephalography (EEG), allow an insight into the neural processes governing performance. We used scalp-recorded EEG to examine whether surgical expertise and task performance could be differentiated according to an oscillatory brain activity signal known as frontal theta—a putative biomarker for cognitive control processes. <h3>Design, setting, and participants</h3> Behavioral and EEG data were acquired from dental surgery trainees with 1 year (n=25) and 4 years of experience (n=20) while they performed low and high difficulty drilling tasks on a virtual reality surgical simulator. EEG power in the 4–7 Hz range in frontal electrodes (indexing frontal theta) was examined as a function of experience, task difficulty and error rate. <h3>Results</h3> Frontal theta power was greater for novices relative to experts (p=0.001), but did not vary according to task difficulty (p=0.15) and there was no Experience × Difficulty interaction (p=0.87). Brain–behavior correlations revealed a significant negative relationship between frontal theta and error in the experienced group for the difficult task (r=−0.594, p=0.0058), but no such relationship emerged for novices. <h3>Conclusion</h3> We find frontal theta power differentiates between surgical experiences but correlates only with error rates for experienced surgeons while performing difficult tasks. These results provide a novel perspective on the relationship between expertise and surgical performance.
Pemphigus associated with nail dystrophy
Authors: D. BERKER, K. DALZIEL, R.P.R. DAWBER, F. WOJNAROWSKA
Journal: British Journal of Dermatology (1993)

Two patients suffering from pemphigus vulgaris were found to have nail dystrophies which antedated the onset of mucocutaneous lesions by many years. The nail changes improved substantially on treatment of the bullous disease. One patient had nail matrix histology consistent with pemphigus, and both had positive direct immunofluorescence with intercellular IgG in the matrix epithelium, as well as at other body sites. We propose that dystrophic nails, as a non-specific indicator of autoimmune disease, are a genuine and relevant finding in pemphigus.
Capillary blood flow in the canine colon and other organs at normal and raised portal pressure.
Authors: A S Grandison, J Yates, R Shields
Journal: Gut (1981)

Capillary blood flow in the canine colon and other organs has been assessed over a wide range of portal pressures using radio-labelled microspheres. The proximal colon received a greater proportionate flow than the distal region. At both normal and raised pressures, the mucosa received 90% of the total colonic capillary flow. A highly significant negative correlation (P less than 0.001) was found between colonic capillary blood flow and portal pressure. A highly significant positive correlation (P less than 0.001) was found between colonic capillary blood flow in the superior mesenteric artery.
Putrefactive Decomposition in the Intestinal Tract
Authors: Fredk. W. Burton
Journal: BMJ (1891)

THE Well-knOWn CSse in wirhiiclh excisioln of the spinal accessory nerve was first perfoiriied for spasmodic wrv-nieck by Mr.Campbell (le ilorgall was published in 1866.That case was an uniusual onie, because tlhe spasms existed in the sterno- mastoi land trapezius muscles on the riglht side, anid vet the head was drawN-ni into tle losition wlhiclh is usual in contrac- tioIn of the imtiscles oni tile left side: that is, the face was -turned towards tile riglht slhoulder.The spleinius and other -rotatory muscles oIn the same side were also affecte(, and this overcamle tile action of (he sterno-mastoidl ani( trapezius muscles, so tliat.as the report states, tuie posterior muscles
Gaining a Perspective on Childhood Seizures
Authors: Eileen P.G. Vining
Journal: New England Journal of Medicine (1998)

Three articles in this and the June 11 issue of the Journal give us an opportunity to reexamine issues that are critical to how we perceive and respond to seizures in children.13 Seizures are frightening; they are unpredictable and can result in injuries. But parents and many physicians are sometimes driven to try to prevent seizures because of unfounded fears. Seizures do not beget seizures, and in humans there is no solid evidence of “kindling,” which is seen in an experimental model of carefully delivered electrical stimulation that leads to spontaneous seizures in animals.4 Instead, it is likely that . . .
Results of the Treatment of Systemic Mycoses
Authors: John H. Seabury, Harry E. Dascomb
Journal: JAMA (1964)

In our experience, amphotericin B has been a satisfactory antibiotic for the treatment of 24 patients with histoplasmosis, 16 patients with cryptococcosis, 9 patients with candidemia, 15 patients with North American blastomycosis, and 5 patients with sporotrichosis. We have treated 20 patients with North American blastomycosis with either hydroxystilbamidine isethionate or stilbamidine isethionate with satisfactory results. Hydroxystilbamidine is less toxic than stilbamidine. Excellent results were achieved in the treatment of 20 patients with actinomycosis by means of penicillin or penicillin combined with sulfonamides. Our results in the treatment of eight patients with nocardiosis and six patients with coccidioidomycosis were unsatisfactory.
A Case of Medullary Thyroid Carcinoma with Adenomatous Nodule
Authors: HITOYA OHTA, KANJI KASAGI, KEIGO ENDO, JUNJI KONISHI, AKIRA MIYAUCHI, KANJI KUMA
Journal: Clinical Nuclear Medicine (1991)

The authors present a patient with two thyroid tumors. One was a medullary thyroid carcinoma and the other was an adenomatous nodule. Ultrasonography and scintigraphy were useful in suggesting the characteristic of the tumors.
Alpha, beta and gamma Human Papillomaviruses in the anal canal of HIV-infected and uninfected men who have sex with men
Authors: Maria Gabriella Donà, Tarik Gheit, Alessandra Latini, Maria Benevolo, Montserrat Torres, Vitaly Smelov, Sandrine McKay-Chopin, Amalia Giglio, Antonio Cristaudo, Mauro Zaccarelli, Massimo Tommasino, Massimo Giuliani
Journal: Journal of Infection (2015)
Abstract SY37-04: Bcl-2 family proteins as a paradigm for protein:protein interactions as chemotherapy targets
Authors: David W. Andrews
Journal: Cancer Research (2014)

Abstract Many aspects of cell signaling are regulated by protein:protein interactions including growth factor receptor signal transduction pathways, transcriptional regulatory complexes and programmed cell death. The Bcl-2 family proteins regulate programmed cell death via a series of protein:protein interactions that occur in the cytoplasm and in membranes. These interactions are regulated by the amount of the proteins, their locations and by post-translational modifications. The multi-domain pro-apoptotic Bcl-2 family members Bax and Bak directly regulate mitochondrial outer membrane permeabilization (MOMP), an event widely accepted as committing most cells to apoptosis. MOMP results from an ordered series of steps beginning with activation of one or more Bcl-2 homology 3 proteins (BH3-proteins). Once activated, BH3-proteins bind to mitochondria, directly recruit and activate Bax and the constitutively membrane bound Bak. In some cases ‘activation’ involves releasing a previously activated Bax or Bak from inhibition by an anti-apoptotic protein of the Bcl-2 family. Oligomerization of integral membrane Bax and/or Bak culminates in membrane permeabilization. The embedded together model describes these interactions as a series of dynamic equilibria that change when the proteins interact with membranes. Because of their role regulating apoptosis in cancer cells and in response to chemotherapy, Bcl-2 family proteins are attractive targets for the development of small molecule inhibitors. The rational development of small molecules requires understanding in detail the molecular interactions that regulate activity. However, studying protein:protein interactions for membrane bound proteins is fraught with difficulties. I will describe some of the challenges of studying this family of proteins and the successes and surprises that resulted from our analyzing and perturbing their interactions for a variety of Bcl-2 family proteins in live cells. I will highlight recent data that suggests new avenues to targeting Bcl-2 family protein:protein interactions therapeutically. Citation Format: David W. Andrews. Bcl-2 family proteins as a paradigm for protein:protein interactions as chemotherapy targets. [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 SY37-04. doi:10.1158/1538-7445.AM2014-SY37-04
Community-Acquired Pneumonia
Authors: Michael S. Niederman
Journal: Annals of Internal Medicine (2015)

This issue provides a clinical overview of community-acquired pneumonia, focusing on prevention, diagnosis, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.
Demarcation disputes in surgery.
Authors: M. G. Watson, G. E. Murty, A. R. Welch, D. Meikle
Journal: BMJ (1989)

the city practice.In the rural practice a nurse practitioner visited 23% for monitoring and surveillance of chronic diseases.All but one patient in each of these groups was also visited by a general practitioner.Although the contract requirements continue to change, the 1989 draft regulations recently laid before parliament by the Secretary of State for Health require general practitioners to offer to make a domiciliary visit annually to each patient over 75 for functional assessment.6If our figures are extrapolated to include all patients over 75 on the lists, visiting those who had not been visited would require an extra 256 home visits a year in the rural practice and 548 in the city practice.If 40 minutes (including travelling time) is allowed for each visit and assessment an additional 7 6 hours a week would be required in the city practice and 3 6 hours in the rural practice (assuming a 48 week working year).If all patients in this age group receive a home functional assessment, however, the time required will be 11 2 hours a week in the city practice and 6-2 in the rural practice.This takes no account of administrative time, follow up visits, or resources required to meet the needs discovered.We doubt that an annual home visit to every patient aged over 75 represents an effective use of health professionals' time.Selective visiting of patients not seen within a year may be useful, but for most patients over 75 who attend surgery opportunistic assessment there seems more appropriate.
Differences in the pathways for metabolism of benzene in rats and mice simulated by a physiological model.
Authors: M A Medinsky, P J Sabourin, R F Henderson, G Lucier, L S Birnbaum
Journal: Environmental Health Perspectives (1989)

Studies conducted by the National Toxicology Program on the chronic toxicity of benzene indicated that B6C3F1 mice were more sensitive to the carcinogenic effects of benzene than were F344 rats. A physiological model was developed to describe the uptake and metabolism of benzene in rats and mice. Our objective was to determine if differences in toxic effects could be explained by differences in pathways for benzene metabolism or by differences in total uptake of benzene. Compartments incorporated into the model included liver, fat, a poorly perfused tissue group, a richly perfused tissue group, an alveolar or lung compartment and blood. Metabolism of benzene was assumed to take place only in the liver and to proceed by four major competing pathways. These included formation of hydroquinone conjugates (HQC), formation of phenyl conjugates (PHC), ring-breakage and formation of muconic acid (MUC), and conjugation with glutathione with subsequent mercapturic acid (PMA) formation. Values for parameters such as alveolar ventilation, cardiac output, organ volumes, blood flow, partition coefficients, and metabolic rate constants were taken from the literature. Model simulations confirmed that during and after 6-hr inhalation exposures mice metabolized more benzene on a mumole per kilogram body weight basis than did rats. After oral exposure, rats metabolized more benzene than mice at doses above 50 mg/kg because of the more rapid absorption and exhalation of benzene by mice. Model simulations for PHC and PMA, generally considered to be detoxification metabolites, were similar in shape and dose-response to those for total metabolism.(ABSTRACT TRUNCATED AT 250 WORDS)
Indications for Supervoltage Radiotherapy
Authors: Ferdinand A. Salzman, Magnus I. Smedal
Journal: New England Journal of Medicine (1967)

THE purpose of radiotherapy is to cure cancer or to palliate its accompanying physical disabilities and distresses. Achievement of these maximum and minimum goals implies the application of ionizing radiations in such a fashion as deliberately to destroy all or part of an abnormal population of cells while inflicting minimal damage to the normal surrounding tissues. A variety of types and sources of ionizing radiations is available for this purpose.Supervoltage radiotherapy implies the use of external beams of ionizing radiation produced with amounts above 1,000,000 volts (1 Mv). Some radiotherapists apply the term to the gamma rays from radioactive . . .
COMBINED SANITARY DISTRICTS
Authors: H. Jones
Journal: BMJ (1905)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following COMBINED SANITARY DISTRICTS Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Developmental changes in and contribute to age-related expression of dofetilide effects on repolarization and proarrhythmia
Authors: M OBREZTCHIKOVA, E SOSUNOV, A PLOTNIKOV, E ANYUKHOVSKY, R GAINULLIN, P DANILOJR, Z YEOM, R ROBINSON, M ROSEN
Journal: Cardiovascular Research (2003)

Objective: Clinical and experimental studies suggest that immature hearts are as or more sensitive than adult hearts to adverse effects of IKr blocking drugs. We hypothesized that age-dependent changes in IKr and IKs contribute to the different repolarization reserves and proarrhythmic effects of IKr blockers in the young and adult heart. Methods: Dogs aged 1–150 days and adults were used to study (1) proarrhythmic effects in situ of the IKr blocker dofetilide; (2) dofetilide effects on action potential duration (APD) recorded with microelectrodes from left ventricular (LV) slabs; (3) IKr and IKs in single LV myocytes using whole-cell voltage clamp. Results: In situ, dofetilide-induced proarrhythmia occurred in 40% of adults, 86% of young (20–150 day) dogs and 0% of neonatal (1–19 day) dogs (P<0.05). Isolated tissue experiments showed no transmural gradient for repolarization from neonate through 3 months of age, after which the gradient increased through adulthood. In the presence of dofetilide, the greatest APD prolongation occurred in neonates. Yet, transmural dispersion did not increase in neonates but significantly increased in young and adults. Dofetilide-induced early afterdepolarization (EAD) incidence was 23% in adults, 59% in young and 8% in neonates (P<0.05). IKr but not IKs was expressed at <30 days, whereas both currents were present in adult myocardium. Conclusions: Our data suggest that a lack of IKs results in a greater dependence on IKr for repolarization in neonates and is associated with exaggerated effects of IKr-blockade on APD. However, APD prolongation alone is insufficient for expression of proarrhythmia, which also requires transmural dispersion of repolarization and EADs. The extent to which APD prolongation, transmural dispersion and EADs are manifested at various ages in the absence and presence of IKr blocking drugs appears to be the ultimate determinant of proarrhythmia.
A randomised controlled trial comparing two schedules of antenatal visits: the antenatal care project
Authors: J. Sikorski, J. Wilson, S. Clement, S. Das, N. Smeeton
Journal: BMJ (1996)

To compare the clinical and psychological effectiveness of the traditional British antenatal visit schedule (traditional care) with a reduced schedule of visits (new style care) for low risk women, together with maternal and professional satisfaction with care.Randomised controlled trial.Places in south east London providing antenatal care for women receiving shared care and planning to deliver in one of three hospitals or at home.2794 women at low risk fulfilling the trial's inclusion criteria between June 1993 and July 1994.Measures of fetal and maternal morbidity, health service use, psychosocial outcomes, and maternal and professional satisfaction.Pregnant women allocated to new style care had fewer day admissions (0.8 v 1.0; P=0.002) and ultrasound scans (1.6 v 1.7; P=0.003) and were less often suspected of carrying fetuses that were small for gestational age (odds ratio 0.73; 95% confidence interval 0.54 to 0.99). They also had some poorer psychosocial outcomes; for example, they were more worried about fetal wellbeing antenatally and coping with the baby postnatally, and they had more negative attitudes to their babies, both in pregnancy and postnatally. These women were also more dissatisfied with the number of visits they received (odds ratio 2.50; 2.00 to 3.11).Patterns of antenatal care involving fewer routine visits for women at low risk may lead to reduced psychosocial effectiveness and dissatisfaction with frequency of visits. The number of antenatal day admissions and ultrasound scans performed may also be reduced. For the variables reported, the visit schedules studied are similar in their clinical effectiveness. Uncertainty remains as to the clinical effectiveness of reduced visit schedules for rare pregnancy problems.
Case 33-1971
Authors: Richard C. Cabot, Benjamin Castleman, Betty U. McNeely, Raymond D. Adams, Edward P. Richardson, Gerald Nash
Journal: New England Journal of Medicine (1971)

Presentation of CaseA 58-year-old woman was admitted to the hospital because of persistent vomiting.Three months before admission she had the onset of progressive fatigue and headaches in the occiput and the left side of the neck. The headaches were dull and aching, lasting for an hour or two and occasionally all day. They stopped after two weeks but were followed by a tendency to veer to the right on walking, although she did not fall. Two weeks later nausea and retching developed, and she began to choke on swallowing food. Somnolence occurred, and she complained of paresthesia in . . .
Cancer Mortality in Workers Exposed to Organochlorine Compounds in thePulp and Paper Industry: An International Collaborative Study
Authors: David McLean, Neil Pearce, Hilde Langseth, Paavo Jäppinen, Irena Szadkowska-Stanczyk, Bodil Persson, Pascal Wild, Reiko Kishi, Elsebeth Lynge, Paul Henneberger, Maria Sala, Kay Teschke, Timo Kauppinen, Didier Colin, Manolis Kogevinas, Paolo Boffetta
Journal: Environmental Health Perspectives (2006)

The objective of this study was to evaluate cancer mortality in pulp and paper industry workers exposed to chlorinated organic compounds. We assembled a multinational cohort of workers employed between 1920 and 1996 in 11 countries. Exposure to both volatile and nonvolatile organochlorine compounds was estimated at the department level using an exposure matrix. We conducted a standardized mortality ratio (SMR) analysis based on age and calendar-period–specific national mortality rates and a Poisson regression analysis. The study population consisted of 60,468 workers. Workers exposed to volatile organochlorines experienced a deficit of all-cause [SMR = 0.91; 95% confidence interval (CI), 0.89–0.93] and all-cancer (SMR = 0.93; 95% CI, 0.89–0.97) mortality, with no evidence of increased risks for any cancer of a priori interest. There was a weak, but statistically significant, trend of increasing risk of all-cancer mortality with increasing weighted cumulative exposure. A similar deficit in all-cause (SMR = 0.94; 95% CI, 0.91–0.96) and all-cancer (SMR = 0.94; 95% CI, 0.89–1.00) mortality was observed in those exposed to non-volatile organochlorines. No excess risk was observed in cancers of a priori interest, although mortality from Hodgkin disease was elevated (SMR = 1.76; 95% CI, 1.02–2.82). In this study we found little evidence that exposure to organochlorines at the levels experienced in the pulp and paper industry is associated with an increased risk of cancer, apart from a weak but significant association between all-cancer mortality and weighted cumulative volatile organochlorine exposure.