tbuckley/cabot-search huggingface dataset:
Impact of Older Age on Presentation and Management of Breast Cancer in the Multi-Ethnic Population of Singapore.
Authors: H. Verkooijen, H. Verkooijen, N. Saxena, Z. Hussain, S. Lim, M. Hartman, K. Chia, S. Lee
Journal: Cancer Research (2009)

Abstract Background: Studies in Caucasian populations have shown that older breast cancer patients are less likely to be treated according to standard guidelines and that this under-treatment is strongly associated with impaired survival. In Asia, where population sizes and life expectancy rates are rising, the number of older women developing breast cancer is growing rapidly. This study aims to evaluate characteristics and treatment patterns of older breast cancer patients in the multi-ethnic population of Singapore, where breast cancer rates have tripled over the past three decades.Methods: This study includes all 2547 women, diagnosed with breast cancer between 1995 and 2006 at the National University Hospital in Singapore. Patients were classified into younger (&amp;lt; 65 years, n=2220) and older (&amp;gt;= 65 years, n=327). Differences in patient and tumor characteristics and treatment between older and younger age groups were explored using multivariate logistic regression models.Results: Even though older Singapore breast cancer patients had more favorable tumor characteristics than younger ones (better tumor differentiation, more often expressing estrogen and progesterone receptors), they presented significantly more often with stage III (adjusted Odds Ratio [ORadj] 1.57, 95%CI 1.0-2.4) and metastatic disease (ORadj 4.3, 95%CI 2.9-6.5). Elderly women were at increased risk not to receive breast surgery (ORadj 1.61, 95%CI 1.0-2.6) and axillary clearance (ORadj 1.74, 95%CI 1.2-2.6). In case of stage I disease, older women were significantly less likely than younger women to be treated with breast conserving surgery (ORadj 0.31, 95%CI 0.2-0.5).Conclusion: Similar to their Caucasian counterparts, older Asian breast cancer patients in Singapore are diagnosed at a later stage and receive less often standard treatment than younger women. Further studies are being undertaken to estimate the impact of these discrepancies on outcome. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3078.
Points: High doses of aspirin
Authors: A Zinovieff
Journal: BMJ (1981)

question about the distinction between a Down's syndrome baby aged 1 week and a fetus of 20 weeks' gestation (28 November, p 1464) has, I think, an answer in a recent article by the legal correspondent of the Lancet.'Killing a baby of 1 week is illegal because in English law it is held to be a "living being" in a way that a fetus of 20 weeks is not (despite the fact that a fetus, or zygote, is even more distinctly alive than most living human tissue and has unique potential).The baby is capable of an independent existence, and so, of course, potentially is a fetus of 28 weeks or more (or perhaps 24 weeks, as discussed recently).Its independence exists even though (as Diana Brahams points out') it may be attached to its mother by the umbilical cord, and obviously is almost totally dependant on it for food....
Learning To Heal: The Development of American Medical Education
Authors: Alberto Galofré
Journal: JAMA (1986)

George Miller, the eminent medical educator, once said, only half seriously, that not even knowledge of history would help medical educators avoid repeating errors of the past. Ludmerer, a physician and historian, believes that medical educators will be better prepared by learning from the past and presents the message that each generation has alternatives from which to choose. <i>Learning to Heal</i>examines events from the 19th century to the present: the creation of the modern American medical school by an amalgamation of elements from European influences with homegrown adaptations; the preand post-Flexner eras, including the crucial role of philanthropy, which gave impetus to some of the more prestigious current schools; and, finally, the corporate model or modern medical education system. In conducting the research for this book, Ludmerer visited more than 30 cities and obtained documents from most medical schools active at the time of the famed Flexner report. Events
Reminding patients by text message: Why do texts need sponsorship?
Authors: R. J Tomlinson
Journal: BMJ (2003)

Editor—Dyer reports that patients will be reminded of appointments by text message and raises the issue of sponsorship.1 Sponsorship is not sought for clinic appointment letters and other hospital correspondence, so why a 5p text?

In general, alternative means of communication are an excellent idea, which we are exploring in Bath.
MEDICAL ASPECTS OF THE UNEMPLOYABLE CLIENT FOR RELIEF
Authors: CHARLES V. CRASTER
Journal: JAMA (1941)

Relief authorities have often been accused of hardness of heart when it has come to granting relief to those applicants who have claimed some physical disability as the basis for inability to carry on ordinary employment. Human nature is prone to exaggerate physical aches and pains, so that relief authorities have sometimes been compelled to disregard even the family physician's certificate of disability in the face of a history of malingering and deceit on the part of the applicant. Whether or not an applicant for relief is truly disabled could of course be determined only by an examination carefully and scientifically carried out by a disinterested physician or group of physicians. The whole matter of the proper disposition of persons claiming disability has been an administrative headache. The reason for this has been that relief officials have lacked any tribunal of a medical type before which clients of this kind
Soft Tissue Rheumatic Pain: Recognition, Management, Prevention
Authors: George E. Ehrlich
Journal: JAMA (1982)

This timely book discusses a number of rheumatic afflictions that are responsible for much of the disability that puts rheumatic diseases in first place among potential causes. Not all the disorders are caused by soft-tissue lesions; some derive from joint and bone disease, but their major manifestations are in the soft tissues, and they figure among the important differential diagnoses. Even the introduction alone could teach worthwhile lessons in clinical diagnosis and therapy. However, the first 11 chapters address themselves to various regions, beginning with the head and neck and including the thoracic outlet, shoulder girdle, elbow, wrist, hand, thoracic cage, dorsal spine, lower back, pelvis, thigh, knee, foreleg, and, finally, the ankle and foot. Peritendinitis, bursitis, ganglia, tendinitis, and psychologically induced syndromes are discussed in detail. Vascular and joint dysfunctions also come under scrutiny, and the medical approach to rotator cuff disorders is carefully detailed. Appropriate illustrations make difficult
SURGERY FOR CANCER OF THE PROSTATE
Authors: George Gilbert Smith
Journal: JAMA (1942)

<h3>To the Editor:—</h3> InThe Journal, March 7, page 855, there is a statement with regard to cancer of the prostate. In the first paragraph of the reply to the question it is stated that: It is the opinion among urologists that once the diagnosis of carcinoma of the prostate has been made it is technically impossible to do any sort of surgical procedure that would effect a cure. Once the diagnosis of carcinoma of the prostate has been definitely made, the condition is no longer surgical. Undoubtedly the opinion that is expressed is held by a large proportion of urologists, chiefly those who have never done a perineal prostatectomy. A small but steadily increasing number have become convinced of the soundness of Hugh Young's teachings concerning the value of total perineal prostatectomy for selected cases of early prostatic cancer. Frank Hinman, Alexander Randall and Roy Henline are among the
The Effect of Oral Iodide on Serum Butanol-Insoluble Protein-Bound Iodine in Various Species
Authors: HELEN B. BROWN, IRVINE H. PAGE
Journal: Circulation (1954)

It is possible that there is an association between the butanol-insoluble protein-bound iodine developed in plasma when potassium iodide is fed and the reduction of serum and hepatic cholesterol. This fraction constitutes most of the protein-bound iodine increase observed in iodide-fed rabbits, dogs, rats and hypertensive human beings. It appears a few days after iodide feeding is begun and disappears four to eight weeks after discontinuing iodide. The dose required to produce minimum and maximum concentrations has been determined in all of these animals and in men. Further, it was found that hypothyroidism reduced the iodide requirement to one-tenth that necessary to produce comparable amounts of butanol-insoluble protein-bound iodine in normal animals.
Finding New Treatments for Diabetes — How Many, How Fast . . . How Good?
Authors: David M. Nathan
Journal: New England Journal of Medicine (2007)

Two modern-day epidemics, HIV–AIDS and type 2 diabetes mellitus, have inspired impassioned calls for more effective interventions. In the 1980s, the rapid spread of HIV, with its associated severe, acute illness and high mortality, prompted activist groups and others to call for the accelerated approval of medications that showed promise of efficacy. There was no treatment available, and people were dying quickly. More recently, pressure to develop new drugs for type 2 diabetes has been stimulated by the remarkable worldwide increase in the incidence of this disease (54% in the past 7 years in the United States1) and the . . .
Effectiveness of right heart catheterization: time for a randomized trial
Authors: J. W. Hoyt
Journal: JAMA (1997)

To the Editor.  —The article by Dr Connors and colleagues1on RHC raised significant concerns about this diagnostic procedure for the members of the Society of Critical Care Medicine (SCCM). The balloon-tipped, flow-directed PA catheter has been an essential part of the cardiac diagnostic armamentarium since the inception of the SCCM 25 years ago. An important part of fellowship training in critical care is learning how to interpret information from RHC and how to develop the expertise to make therapeutic judgments based on that information.  Thus, both the SCCM Council and I reacted strongly to the article and accompanying Editorial by Drs Bone and Dalen.2We were concerned that the influence of the article and the Editorial might cause physicians to change practice before the findings of this article and others critical of RHC are scientifically clear. Future projects must sort out the risk of the procedure itself vs the risk
Loss-of-function variations within the filaggrin gene predispose for atopic dermatitis with allergic sensitizations
Authors: Stephan Weidinger, Thomas Illig, Hansjörg Baurecht, Alan D. Irvine, Elke Rodriguez, Amalia Diaz-Lacava, Norman Klopp, Stefan Wagenpfeil, Yiwei Zhao, Haihui Liao, Simon P. Lee, Colin N.A. Palmer, Claudia Jenneck, Laura Maintz, Tobias Hagemann, Heidrun Behrendt, Johannes Ring, Markus M. Nothen, W. H. Irwin McLean, Natalija Novak
Journal: Journal of Allergy and Clinical Immunology (2006)
Magnetic Resonance Imaging Overestimates Ferumoxide-Labeled Stem Cell Survival After Transplantation in the Heart
Authors: John Terrovitis, Matthias Stuber, Amr Youssef, Steve Preece, Michelle Leppo, Eddy Kizana, Michael Schär, Gary Gerstenblith, Robert G. Weiss, Eduardo Marbán, M. Roselle Abraham
Journal: Circulation (2008)

Background— Stem cell labeling with iron oxide (ferumoxide) particles allows labeled cells to be detected by magnetic resonance imaging (MRI) and is commonly used to track stem cell engraftment. However, the validity of MRI for distinguishing surviving ferumoxide-labeled cells from other sources of MRI signal, for example, macrophages containing ferumoxides released from nonsurviving cells, has not been thoroughly investigated. We sought to determine the relationship between the persistence of iron-dependent MRI signals and cell survival 3 weeks after injection of syngeneic or xenogeneic ferumoxides-labeled stem cells (cardiac-derived stem cells) in rats. Methods and Results— We studied nonimmunoprivileged human and rat cardiac-derived stem cells and human mesenchymal stem cells doubly labeled with ferumoxides and β-galactosidase and injected intramyocardially into immunocompetent Wistar-Kyoto rats. Animals were imaged at 2 days and 3 weeks after stem cell injection in a clinical 3-T MRI scanner. At 2 days, injection sites of xenogeneic and syngeneic cells (cardiac-derived stem cells and mesenchymal stem cells) were identified by MRI as large intramyocardial signal voids that persisted at 3 weeks (50% to 90% of initial signal). Histology (at 3 weeks) revealed the presence of iron-containing macrophages at the injection site, identified by CD68 staining, but very few or no β-galactosidase–positive stem cells in the animals transplanted with syngeneic or xenogeneic cells, respectively. Conclusions— The persistence of significant iron-dependent MRI signal derived from ferumoxide-containing macrophages despite few or no viable stem cells 3 weeks after transplantation indicates that MRI of ferumoxide-labeled cells does not reliably report long-term stem cell engraftment in the heart.
Low-dose rituximab in adult patients with idiopathic autoimmune hemolytic anemia: clinical efficacy and biologic studies
Authors: Wilma Barcellini, Francesco Zaja, Anna Zaninoni, Francesca Guia Imperiali, Marta Lisa Battista, Eros Di Bona, Bruno Fattizzo, Dario Consonni, Agostino Cortelezzi, Renato Fanin, Alberto Zanella
Journal: Blood (2012)
Holding Fast That Which Is Good (St. Paul).
Authors: Thomas M. Durant
Journal: Annals of Internal Medicine (1972)

Meeting Abstracts1 May 1972Holding Fast That Which Is Good (St. Paul).Thomas M. Durant, M.D., M.A.C.P.Thomas M. Durant, M.D., M.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-76-5-853_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptModern medical education is in an era of experimentation. Many of the new developments will stand the test of time, but one of the paradoxes of today is the neglect of the old that is good while searching for the new that will endure. A thoughtful analysis of the possible pros and cons of both the new and the old is perhaps not amiss at this stage of trial and error in which there is an attempt to produce the best possible physician of the future.The Old-Neglected Good Features:[1] Underemphasis on the humanities; [2] inadequate use of teachers... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Philadelphia, Pa. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1972Volume 76, Issue 5Page: 853-853KeywordsForecastingMedical education ePublished: 1 December 2008 Issue Published: 1 May 1972 PDF downloadLoading ...
The Second Impact in Catastrophic Contact-Sports Head Trauma
Authors: Richard L. Saunders, Robert E. Harbaugh
Journal: JAMA (1984)

CATASTROPHIC brain injury following minor impact has been known to occur in contact sports, particularly football.<sup>1</sup>This peculiar susceptibility remains unexplained. However, the common resumption of contact play soon after concussion suggests that sequential minor impacts may occasionally lead to major cerebral pathological conditions. If these injuries have a compounding effect rather than representing isolated events, then additional impact to an already compliance-compromised brain might precipitate a catastrophic increase in intracranial pressure, perhaps through loss of vasomotor tone. We report a case documenting a preexisting cerebral contusion and the lethal effect of a second minor impact. This case suggests that clinical examination alone may sometimes be inadequate in evaluating persisting symptoms after minor head injury. In the athlete who has had a cerebral concussion, computed tomographic (CT) scanning may be required before medical clearance to resume play is justified. <h3>Report of a Case</h3> A 19-year-old, right-handed, college football player
Convictions and Predictions on the Role of Internists in Medical Education
Authors: Lawrence E. Young
Journal: JAMA (1971)

The 1970s already are recognized as a decade of crises in health care. Because of their numbers and their relatively central position in health care, internists have heavy responsibilities for dealing with these crises. I shall express my views on only one of these responsibilities, that of education in the health professions. My philosophy of education of physicians, both predoctoral and postdoctoral, is very simply stated. We learn chiefly from the study of patients as we are privileged to care for them, one by one, from the earliest clerkships of medical school to the last days of our professional careers. We read in textbooks, monographs and journals to seek answers to questions raised as we study and care for individual patients. The increasing flood of literature pouring into the library and across our desks does not overwhelm us if we learn how to use it with speed and diligence appropriate
Detection of Occult Tumor Cells in Lymph Nodes from Bladder Cancer Patients by MUC7 Nested RT-PCR
Authors: Margitta Retz, Jan Lehmann, Celine Szysnik, Stephanie Zwank, Thorsten Venzke, Christian Röder, Holger Kalthoff, Carol Basbaum, Michael Stöckle
Journal: European Urology (2003)
Blocking Oncogenic Ras Signaling for Cancer Therapy
Authors: A. A. Adjei
Journal: JNCI Journal of the National Cancer Institute (2001)

The Ras gene product is a monomeric membrane-localized G protein of 21 kd that functions as a molecular switch linking receptor and nonreceptor tyrosine kinase activation to downstream cytoplasmic or nuclear events. Each mammalian cell contains at least three distinct ras proto-oncogenes encoding closely related, but distinct proteins. Activating mutations in these Ras proteins result in constitutive signaling, thereby stimulating cell proliferation and inhibiting apoptosis. Oncogenic mutations in the ras gene are present in approximately 30% of all human cancers. K-ras mutations occur frequently in non-small-cell lung, colorectal, and pancreatic carcinomas; H-ras mutations are common in bladder, kidney, and thyroid carcinomas; N-ras mutations are found in melanoma, hepatocellular carcinoma, and hematologic malignancies. The ras-signaling pathway has attracted considerable attention as a target for anticancer therapy because of its important role in carcinogenesis. In this review, the physiologic and biochemical properties of the Ras proteins, their mechanism of cell signaling, and their relation to human cancer will be discussed. Novel cancer therapeutic approaches based on the inhibition of Ras-mediated signaling, including inhibition of Ras processing, inhibition of Ras protein synthesis, and blockage of downstream Ras effectors, will be discussed.
Osgood-Schlatter's disease in the ninth century.
Authors: C. Wells
Journal: BMJ (1968)

In view of the increasing popularity of this technique since the introduction of Marcaine (marketed in 10-ml.ampoules containing bupivacaine 0.5 % + adrenaline 1: 200,000) we feel that these effects should be more widely known and that the use of the undiluted solu- tion should be actively avoided.-Weare, etc.,
Review: SSRIs are associated with increased risk for attempted or completed suicide in adolescents but not in adults or the elderly
Authors: Amy Cheung
Journal: Annals of Internal Medicine (2009)

ACP Journal Club16 June 2009Review: SSRIs are associated with increased risk for attempted or completed suicide in adolescents but not in adults or the elderlyAmy Cheung, MD, MScAmy Cheung, MD, MScUniversity of Toronto, Toronto, Ontario, Canada (A.C.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-12-200906160-02013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationBarbui C, Esposito E, Cipriani A. Selective serotonin reuptake inhibitors and risk of suicide: a systematic review of observational studies. CMAJ. 2009;180:291-7. https://pubmed.ncbi.nlm.nih.gov/19188627Clinical Impact RatingsGIM/FP/GP: Mental Health: References1 Bridge JA, Birmaher B, Iyengar S, Barbe RP, Brent DA. Placebo response in randomized controlled trials of antidepressants for pediatric major depressive disorder. Am J Psychiatry. 2009;166:42-9. [PMID: 19047322] Google Scholar2 Cheung AH, Emslie GJ, Mayes TL. Review of the efficacy and safety of antidepressants in youth depression. J Child Psychol Psychiatry. 2005;46:735-54. [PMID: 15972068] Google Scholar3 Gibbons RD, Brown CH, Hur K, et al. Early evidence on the effects of regulators’ suicidality warnings on SSRI prescriptions and suicide in children and adolescents. Am J Psychiatry. 2007;164:1356-63. [PMID: 17728420] Google Scholar Author, Article, and Disclosure InformationAuthors: Amy Cheung, MD, MScAffiliations: University of Toronto, Toronto, Ontario, Canada (A.C.)This article was published at Annals.org on 2 June 2009. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 16 June 2009Volume 150, Issue 12Page: JC6-13KeywordsAdolescentsAntidepressantsClinical trialsCohort studiesElderlyFood and Drug AdministrationSelective serotonin reuptake inhibitorsSelf harmSuicideSystematic reviews ePublished: 16 June 2009 Issue Published: 16 June 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Use of minocycline in rheumatoid arthritis: a district general hospital experience
Authors: E Suresh, I M Morris, P C Mattingly
Journal: Annals of the Rheumatic Diseases (2004)

Double blind, randomised controlled trials have shown that minocycline is an effective disease modifying antirheumatic drug (DMARD) in rheumatoid arthritis (RA), compared with placebo1–4 or hydroxychloroquine.5 Minocycline was first used on the premise that RA may be caused by an infection but, subsequently, it was also shown to possess other properties such as matrix metalloproteinase inhibition and immunomodulation. Despite reported proof of its efficacy, most rheumatologists do not favour the use of minocycline in RA, possibly owing to availability of other “standard” DMARDs.

We performed a retrospective review of the case notes of 28 patients with RA who were prescribed minocycline. Treatment with minocycline in these patients began before the widespread availability of biological agents. Our aim was to assess the efficacy and safety of this drug in our hands compared with published trials. Our patients included 24 women …