tbuckley/cabot-search huggingface dataset:
Development of squamous cell carcinoma after photodynamic therapy with methyl aminoleuvulinate
Authors: D. Calista
Journal: British Journal of Dermatology (2014)

Funding sources: none. Conflicts of interest: none declared. Dear Editor, Topical photodynamic therapy (PDT) consists of the local administration of a photosensitizer, which is accumulated and retained in cancerous cells, but not in normal cells, and activated by exposure to specific wavelengths of light. Sensitizing drugs, usually precursors of haematoporphyrin, absorb photons of light and transfer their energy to the surrounding oxygen molecules. The subsequent formation of cytotoxic oxygen species, singlet oxygen and free radicals results in selective cellular damage and cell death through apoptosis, autophagy or necrosis.1 2 Besides this, PDT has a direct effect on the vasculature of the tumour, depriving it of oxygen and nutrients, eventually affecting the immune system, which can be either stimulated or suppressed.2 PDT has proved effective in the management of actinic keratoses (AKs), superficial basal cell carcinomas and Bowen disease. Over the last 10 years, its use as an off‐label treatment has extended to a number of cutaneous diseases.2
Accuracy of Rapid Influenza Diagnostic Tests
Authors: Caroline Chartrand, Mariska M.G. Leeflang, Jessica Minion, Timothy Brewer, Madhukar Pai
Journal: Annals of Internal Medicine (2012)

Background: Timely diagnosis of influenza can help clinical management. Purpose: To examine the accuracy of rapid influenza diagnostic tests (RIDTs) in adults and children with influenza-like illness and evaluate factors associated with higher accuracy. Data Sources: PubMed and EMBASE through December 2011; BIOSIS and Web of Science through March 2010; and citations of articles, guidelines, reviews, and manufacturers. Study Selection: Studies that compared RIDTs with a reference standard of either reverse transcriptase polymerase chain reaction (first choice) or viral culture. Data Extraction: Reviewers abstracted study data by using a standardized form and assessed quality by using Quality Assessment of Diagnostic Accuracy Studies criteria. Data Synthesis: 159 studies evaluated 26 RIDTs, and 35% were conducted during the H1N1 pandemic. Failure to report whether results were assessed in a blinded manner and the basis for patient recruitment were important quality concerns. The pooled sensitivity and specificity were 62.3% (95% CI, 57.9% to 66.6%) and 98.2% (CI, 97.5% to 98.7%), respectively. The positive and negative likelihood ratios were 34.5 (CI, 23.8 to 45.2) and 0.38 (CI, 0.34 to 0.43), respectively. Sensitivity estimates were highly heterogeneous, which was partially explained by lower sensitivity in adults (53.9% [CI, 47.9% to 59.8%]) than in children (66.6% [CI, 61.6% to 71.7%]) and a higher sensitivity for influenza A (64.6% [CI, 59.0% to 70.1%) than for influenza B (52.2% [CI, 45.0% to 59.3%). Limitation: Incomplete reporting limited the ability to assess the effect of important factors, such as specimen type and duration of influenza symptoms, on diagnostic accuracy. Conclusion: Influenza can be ruled in but not ruled out through the use of RIDTs. Sensitivity varies across populations, but it is higher in children than in adults and for influenza A than for influenza B. Primary Funding Source: Canadian Institutes of Health Research.
What Treatments are “Satisfactory?” Divining Regulatory Intent and an Ethical Basis for Exception to Informed Consent for Emergency Research
Authors: Robert Silbergleit, Drew Watters, Michael R. Sayre
Journal: The American Journal of Bioethics (2006)

Interpretation of the Federal regulations governing exception to informed consent (21 CFR 50.24) is difficult, in part, because relatively little guidance has been given to institutional review boards (IRBs) in defining the regulation’s terms. Exception to consent is only permitted, for example, when the available treatments for the lifethreatening condition being investigated “are unproven or unsatisfactory,” but how does one define unsatisfactory in this context? Kipnis et al. argue that the in-hospital phase of the PolyHeme ©R Hemorrhagic Shock trial (of PolyHeme ©R , Northfield Laboratories, Inc., Evanston, IL) does not meet the regulatory requirements for research performed using exception to informed consent for emergency research because they believe that the control therapy in that phase, blood transfusion, is “proven and satisfactory” (Kipnis, King and Nelson 2006). We are concerned that this definition of “unsatisfactory” is too narrow and cannot be justified. We present an alternative definition, developed and put forward by a recent consensus conference on resuscitation research and exception to consent (Watters 2005), that has a more satisfactory ethical basis and that we think is more consistent with the regulatory intent. We are concerned about the effect of the narrow definition on all emergency research and on the patients affected by emergency conditions. We critique this definition of “satisfactory” and then explain the reasoning and definition developed by the consensus conference.
Slippery platform: The role of automatic and intentional processes in testing the effect of notation
Authors: Daniel Algom
Journal: Behavioral and Brain Sciences (2009)

Abstract The type of processing of numerical dimensions varies greatly and is governed by context. Considering this flexibility in tandem with a fuzzy demarcation line between automatic and intentional processes, it is suggested that testing the effect of notation should not be confined to automatic processing, in particular to passive viewing. Recent behavioral data satisfying the authors' stipulations reveal a considerable, though perhaps not exclusive, core of common abstract processing.
A Collaborative Epidemiological Investigation into the Criminal Fake Artesunate Trade in South East Asia
Authors: Paul N Newton, Facundo M Fernández, Aline Plançon, Dallas C Mildenhall, Michael D Green, Li Ziyong, Eva Maria Christophel, Souly Phanouvong, Stephen Howells, Eric McIntosh, Paul Laurin, Nancy Blum, Christina Y Hampton, Kevin Faure, Leonard Nyadong, C. W. Ray Soong, Budiono Santoso, Wang Zhiguang, John Newton, Kevin Palmer
Journal: PLoS Medicine (2008)

Background Since 1998 the serious public health problem in South East Asia of counterfeit artesunate, containing no or subtherapeutic amounts of the active antimalarial ingredient, has led to deaths from untreated malaria, reduced confidence in this vital drug, large economic losses for the legitimate manufacturers, and concerns that artemisinin resistance might be engendered. Methods and Findings With evidence of a deteriorating situation, a group of police, criminal analysts, chemists, palynologists, and health workers collaborated to determine the source of these counterfeits under the auspices of the International Criminal Police Organization (INTERPOL) and the Western Pacific World Health Organization Regional Office. A total of 391 samples of genuine and counterfeit artesunate collected in Vietnam (75), Cambodia (48), Lao PDR (115), Myanmar (Burma) (137) and the Thai/Myanmar border (16), were available for analysis. Sixteen different fake hologram types were identified. High-performance liquid chromatography and/or mass spectrometry confirmed that all specimens thought to be counterfeit (195/391, 49.9%) on the basis of packaging contained no or small quantities of artesunate (up to 12 mg per tablet as opposed to ∼ 50 mg per genuine tablet). Chemical analysis demonstrated a wide diversity of wrong active ingredients, including banned pharmaceuticals, such as metamizole, and safrole, a carcinogen, and raw material for manufacture of methylenedioxymethamphetamine ('ecstasy'). Evidence from chemical, mineralogical, biological, and packaging analysis suggested that at least some of the counterfeits were manufactured in southeast People's Republic of China. This evidence prompted the Chinese Government to act quickly against the criminal traders with arrests and seizures. Conclusions An international multi-disciplinary group obtained evidence that some of the counterfeit artesunate was manufactured in China, and this prompted a criminal investigation. International cross-disciplinary collaborations may be appropriate in the investigation of other serious counterfeit medicine public health problems elsewhere, but strengthening of international collaborations and forensic and drug regulatory authority capacity will be required.
Noninvasive identification of initial site of abnormal ventricular activation by least-square phase analysis of radionuclide cineangiograms.
Authors: D A Turner, P L Von Behren, N T Ruggie, R G Hauser, P Denes, A Ali, J V Messer, E W Fordham, M W Groch
Journal: Circulation (1982)

Least-square phase analysis (LSPA) of radionuclide cineangiograms demonstrates the sequence of onset of inward ventricular movement noninvasively. To validate the method and explore its ability to identify abnormal initial sites of ventricular activation, LSPA was applied to 14 patients with pacemakers (one with electrodes in two locations) (group 1) and three patients with recurrent ventricular tachycardia (VT) (group 2) who had undergone electrophysiologic endocardial mapping. The segment in which the site of initial ventricular activation was located was correctly identified in 13 of 15 paced studies and in two of three group 2 patients during VT. Pacing increased the duration of spread of onset of inward ventricular movement, and the duration of spread of onset correlated well with the duration of the QRS (r = 0.80). The sequence of onset of inward ventricular movement during VT was similar to the sequence of depolarization in all three group 2 patients. These preliminary results suggest that the sequence of onset of ventricular contraction as depicted by LSPA is a valid representation of the actual contraction sequence and that LSPA or radionuclide cineangiography correctly identifies abnormal sites of initial ventricular activation.
Are We Building Too Many Medical Schools?
Authors: Kenneth B. Castelton
Journal: JAMA (1971)

The health care delivery system is in trouble. An alleged shortage of physicians is only one facet of the problem and may not even be the most important. We don't know exactly how many doctors we need. First we must solve some of the other facets of the problem. We must make the system more efficient and make health care more readily available to all citizens at a reasonable cost. We must make better use of the physicians' time by better utilization of "middle medical personnel" and automation. We must provide and place greater emphasis on health services and not just medical care, and we must do something to improve distribution of available physicians. Establishment of new medical schools is probably the most expensive and surely the slowest approach to solving the problem. We will never solve our problem merely by increasing the number of doctors.
Familial Aggregation of Calcific Aortic Valve Stenosis in the Western Part of France
Authors: Vincent Probst, Solena Le Scouarnec, Antoine Legendre, Valérie Jousseaume, Philippe Jaafar, Jean-Michel Nguyen, André Chaventré, Hervé Le Marec, Jean-Jacques Schott
Journal: Circulation (2006)

Background— Calcific aortic valve stenosis (CAVS) is the most common valvular defect in developed countries. Unlike mitral valve prolapse, there is no demonstration that a familial factor could play a role in the occurrence of this disease. The aim of this study was to demonstrate a familial aggregation for CAVS. Methods and Results— We used the files of 2527 consecutive patients operated on for CAVS in our institution between 1992 and 2002 to map the distribution of operated CAVS in the western part of France. In a second step, we investigated clinically and genealogically the clusters with the highest rates of operated CAVS to detect familial forms of the disease. The geographic distribution of CAVS is highly heterogeneous, with an average frequency of operated CAVS of 1.13 per 1000 inhabitants but up to 9.38 per 1000 in specific parishes. A screening of the population from the parishes with the highest rate of operated CAVS allowed us to identify 5 families with ≥3 sibs affected by CAVS. A large genealogical analysis performed in one of these families allowed us to link 48 patients who derived from 34 nuclear families. Genealogical information could be traced to a common ancestor within 13 generations. Conclusions— Identification of clusters and large families affected by a classic form of CAVS demonstrates a familial aggregation for this disease.
Quinine's Predecessor: Francesco Torti and the Early History of Cinchona
Authors: James P. Morgan
Journal: JAMA (1994)

According to the author, "the purpose of this book is to relate, in ample detail, the early history of the Peruvian bark, also known as Jesuits' bark and later formally baptized cinchona." In this task, Jarcho, a retired internist who received special training in pathology, tropical medicine, public health, and ancient and modern languages, succeeds magnificently. The 354 pages of text, illustrations, and references that follow detail the discovery of cinchona by Europeans and its introduction into Western medical practice. The contributions of the Modenese physician Francesco Torti are particularly emphasized. Torti was one of the first European physicians to successfully use cinchona bark in the treatment of malarial infections. Succinct biographical sketches of other practitioners during the 17th and 18th centuries who were instrumental in promoting the use of this drug among the European medical community are also presented. It was especially interesting to read of the problems these
SOME OBSERVATIONS UPON THE MECHANICAL TREATMENT OF POTT'S DISEASE.
Authors: A. E. HOADLEY
Journal: JAMA (1892)

Since the introduction of the plaster jacket for the treatment of Pott's disease, it has been positively demonstrated that mechanical fixation inducing physiological rest, is competent and sufficient means in the majority of cases; and the jacket alone will fully meet these indications when judiciously applied, provided the disease exists below the middle of the upper half of the dorsal region. It is the mechanical treatment of this particular class of uncomplicated cases of which I wish to speak. I do not include those severe and rapidly developing cases that demand extension together with other means of fixation. The amount of deformity which occurs, where there has been destruction of the vertebral bodies, depends upon the number of bodies involved and the extent of destruction of each, and also upon the treatment which has been employed to restrain deformity. Upon the first condition depends all the deformity that must of
INOPERABLE SARCOMATA TREATED WITH RADIUM
Authors: R. Ward
Journal: BMJ (1928)

Primiary or " Residual " C'ystitis.By this is meant an inflammation of the uriniarv tract entir ely confined to the bladder; either it is a primary Cystitis, or it is seconidary to pyelitis, pyeloleplhriti"s, etc., which lhas been cured.Cystoscopy shows the cystitis, while the uirine obtained from each kidney (by means of a ureteral catheter) is free from pus.If tlle bladder is constantly reinfected by septic urine, tlheni the source of the sepsis in the kidney must be attacked before local treatment to the bladder is of any use.Primary or residual cystitis, withl or witlhout ulceratioil, can be cured, or at any rate the distressing symptoms caii be abated, by treatment with antisepitic ernulsions.Thie details of the treatment are as follows.Twice weekly a catheter is passed and the bladder dis- tended ulider the usual strict aseptic precautions witl either solution 1 or solution 2. The iodoformiii emulsion (No. 2) is too irritating to use too ofteni.Solutioni 1 is utsed three times to one of solution-2--that is, solutioln 1 is used oni the 3rd, 6th, 10th, 17th, 20tl, anid 24tl davs of a monitlh, -while solution 2 is used on the 13tlh and 27tlh (h/VS of a month.The solutioni is allowed to remaill in tle bladder for thirty minutes, when it is mictur-ated.I carrv out the treatmenit for eight weeks, or longer if a cure has not theni been obtainied.The composition of the soluttiolls is as follows.Silrcr-Iodidc Emulsion, o-.Solititloa L. Potassium iodide 21.66 grams in 150 c.crn.water.Silver nitrate ... ... 21.66 grams i;o 150 c.cnm.water.These solutions are mixed with 150 c.cm. of mucilage of Iliish nm oss.
Functional Evaluation of Prolactin Secretion: a Guide to Therapy
Authors: H. Friesen, H. Guyda, P. Hwang, J. E. Tyson, A. Barbeau
Journal: Journal of Clinical Investigation (1972)

Stimulation and inhibition tests are proposed for evaluating prolactin secretion. Thyrotropin-releasing hormone (TRH) stimulates the release of prolactin from the pituitary. Chlorpromazine acts presumably at the hypothalamic level to increase prolactin secretion. L-Dopa (D,L-alpha-hydrazino-alpha-methyl-beta-[3,4-di-hydroxyphenyl]) has the opposite effect; it inhibits prolactin secretion and may be effective in suppressing galactorrhea.
Second NHS hospital in financial difficulty is put out to tender
Authors: G. Iacobucci
Journal: BMJ (2013)

A second NHS hospital trust in England could be franchised out to a private company after the government approved plans for an open market tender to source a partner for the George Eliot Hospital in Warwickshire.

Following the analysis of a business case, the NHS Trust Development Authority concluded that an open procurement process should commence, which will lead to the trust being merged or acquired by another NHS trust, or “a franchise that may be a non-NHS organisation.”

If the bid …
Effect of environment on blood pressure: home versus hospital.
Authors: M A Young, D B Rowlands, T J Stallard, R D Watson, W A Littler
Journal: BMJ (1983)

The effect of environment on blood pressure was studied by recording intra-arterial pressure continuously in nine patients with essential hypertension during controlled periods of activity and rest at home and in hospital. Mean systolic pressure was higher at home (152 +/- 16 mm Hg) than in hospital (138 +/- 11 mm Hg, p less than 0.01), the difference being greatest during the period of activity (165 +/- 21 v 142 +/- 13 mm Hg, p less than 0.001); heart rates and diastolic pressures did not differ significantly at these times. Systolic pressure recorded by conventional sphygmomanometry was also higher at home (173 +/- 23 v 159 +/- 23 mm Hg, p less than 0.01), as was diastolic pressure (98 +/- 10 v 89 +/- 11 mm Hg, p less than 0.02). Systolic pressure was consistently higher at home, and this effect was independent of the pressure of an observer. This must be taken into consideration when assessing blood pressure and efficacy of treatment in hospital.
Gastric ulcer and regurgitation gastritis.
Authors: J P Delaney, J W Cheng, B A Butler, W P Ritchie
Journal: Gut (1970)

Progress reportGastric ulcer and regurgitation gastritis Experimental and clinical data have incriminated excess gastric acid secretion as an important factor in the development of duodenal ulcer.On the other hand, gastric ulcer is characteristically associated with normal to low levels of acid secretion, and mucosal resistance factors have been invoked to explain the pathogenesis.The purpose of this report is to summarize the evidence favouring the hypothesis that regurgitation of duodenal contents into the stomach causes gastritis and an attendant decrease in mucosal resistance to ulceration.Recent experimental results from our laboratory support this propo-sition1' 2 , 4 The concept of regurgitation gastritis is not original with us but has received inadequate attention.Four lines of evidence favour the proposed hypothesis.(1) Gastric ulcer is invariably accompanied by gastritis.(2) Individuals with gastric ulcer have greater than normal regurgitation of duodenal contents into the stomach.(3) Exposure of normal gastric mucosa to intestinal contents leads to gastritis.(4) Gastritis increases the susceptibility of the mucosa to ulcer formation. Gastric Ulcer and GastritisCruveilhier,5 in 1862, pointed out the association of gastric ulcer and atrophic gastritis.Konjetzny6 observed that gastric ulcer is invariably surrounded by inflammatory changes, and noted further that the mucosa in an ulcer- bearing stomach is diffusely abnormal.He proposed the dictum that gastric ulcer never develops in normal mucosa.Magnus7 correlated gastroscopic and histological appearances of stomachs removed for treatment of peptic ulceration.Thirty per cent of the specimens excised for gastric ulcer had diffuse gastritic changes in the body mucosa.None of the stomachs resected for duodenal ulcer demonstrated such an abnormality.Hebbel8 made a thorough study of the relationship of chronic gastritis to gastric ulcer.Of 15 resected stomachs, 12 demonstrated moderate to severe gastritis involving the entire antrum in addition to the immediate region of the ulcer.The diffuse distribution of histological changes suggested to him that gastritis was a primary process rather than the result of the ulcer.Stomachs seen at necropsy from subjects with no known gastric or duodenal disease showed gastritic changes in only 18% of specimens.Guiss and on July 11, 2023 by guest.
Smartphone applications for melanoma detection by community, patient and generalist clinician users: a review
Authors: A.P. Kassianos, J.D. Emery, P. Murchie, F.M. Walter
Journal: British Journal of Dermatology (2015)

Smartphone health applications (‘apps’) are widely available but experts remain cautious about their utility and safety. We reviewed currently available apps for the detection of melanoma (July 2014), aimed at general community, patient and generalist clinician users. A proforma was used to extract and assess each app that met the inclusion criteria, and we undertook content analysis to evaluate their content and the evidence applied in their development. Thirty‐nine apps were identified with the majority available only for Apple users. Over half (n =22) provided information or education about melanoma, ultraviolet radiation exposure prevention advice, and skin self‐examination strategies, mainly using the ABCDE (A, Asymmetry; B, Border; C, Colour; D, Diameter; E, Evolving) method. Half (n =19) helped users take and store images of their skin lesions either for review by a dermatologist or for self‐monitoring to identify change, an important predictor of melanoma; a similar number (n =18) used reminders to help users monitor their skin lesions. A few (n =9) offered expert review of images. Four apps provided a risk assessment to patients about the probability that a lesion was malignant or benign, and one app calculated users’ future risk of melanoma. None of the apps appeared to have been validated for diagnostic accuracy or utility using established research methods. Smartphone apps for detecting melanoma by nonspecialist users have a range of functions including information, education, classification, risk assessment and monitoring change. Despite their potential usefulness, and while clinicians may choose to use apps that provide information to educate their patients, apps for melanoma detection require further validation of their utility and safety.