tbuckley/cabot-search huggingface dataset:
Can primary prevention or selective screening for melanoma be more precisely targeted through general practice? A prospective study to validate a self administered risk score
Authors: A. Jackson, C. Wilkinson, M. Ranger, R. Pill, P. August
Journal: BMJ (1998)

<h3>Abstract</h3> <b>Objectives</b>: To establish whether a questionnaire incorporating MacKie9s risk factor flow chart can identify patients at high risk for melanoma so that they can be targeted for primary and secondary prevention. To validate the risk score derived from the questionnaire and test the feasibility of self completion by comparing patients9 self reported skin characteristics with a skin examination performed by an experienced general practitioner. <b>Design</b>: Prospective questionnaire survey followed by a comparative study. <b>Setting</b>: 16 randomly selected group practices in a health district in Cheshire, United Kingdom. <b>Subjects</b>: Questionnaire survey—3105 consecutive patients aged 16 years and over attending for a primary care consultation; comparative study—a self selected subsample of 388 of the 3105 patients. <b>Main outcome measures</b>: MacKie risk group for melanoma. Comparison of high risk skin characteristics reported by patients and those noted during a skin examination by a doctor (κ statistic). <b>Results</b>: 4.3% of patients (87% women) were in the highest risk group and 4.4% (79% men) were in the second highest risk group, as defined by the MacKie score. Agreement between patients9 self appraisal of skin characteristics and clinical skin examinations was reflected in κ values of 0.67 for freckles, 0.60 for moles, and 0.43 for atypical naevi. <b>Conclusion</b>: This questionnaire helped to identify a group at high risk for melanoma. Furthermore, good agreement was found when the patient9s risk scores were compared with results of the clinical skin examination. This risk score is potentially useful in targeting primary and secondary prevention of melanoma through general practice. <h3>Key messages</h3> Successful treatment of melanoma depends on its early diagnosis and excision The MacKie risk factors score flow chart was used to identify a group of patients at high risk of melanoma from a sample of general practice patients who had completed a questionnaire A good measure of agreement was achieved when self appraisal of high risk skin characteristics by patients was compared with a clinical skin examination A self report risk score is a feasible means of identifying high risk patients and targeting prevention of melanoma
<i>BCCIP</i> Suppresses Tumor Initiation but Is Required for Tumor Progression
Authors: Yi-Yuan Huang, Li Dai, Dakim Gaines, Roberto Droz-Rosario, Huimei Lu, Jingmei Liu, Zhiyuan Shen
Journal: Cancer Research (2013)

Dysfunctions of genome caretaker genes contribute to genomic instability and tumor initiation. Because many of the caretaker genes are also essential for cell viability, permanent loss of function of these genes would prohibit further tumor progression. How essential caretaker genes contribute to tumorigenesis is not fully understood. Here, we report a "hit-and-run" mode of action for an essential caretaker gene in tumorigenesis. Using a BRCA2-interacting protein BCCIP as the platform, we found that a conditional BCCIP knockdown and concomitant p53 deletion caused rapid development of medulloblastomas, which bear a wide spectrum of alterations involving the Sonic Hedgehog (Shh) pathway, consistent with a caretaker responsibility of BCCIP on genomic integrity. Surprisingly, the progressed tumors have spontaneously lost the transgenic BCCIP knockdown cassette and restored BCCIP expression. Thus, a transient downregulation of BCCIP, but not necessarily a permanent mutation, is sufficient to initiate tumorigenesis. After the malignant transformation has been accomplished and autonomous cancer growth has been established, BCCIP reverses its role from a tumor-initiation suppressor to become a requisite for progression. This exemplifies a new type of tumor suppressor, which is distinct from the classical tumor suppressors that are often permanently abrogated during tumorigenesis. It has major implications on how a nonmutagenic or transient regulation of essential caretaker gene contributes to tumorigenesis. We further suggest that BCCIP represents a paradoxical class of modulators for tumorigenesis as a suppressor for initiation but a requisite for progression (SIRP).
REST TREATMENT FOR HYSTERICAL DISEASE.
Authors: JOHN K. MITCHELL
Journal: JAMA (1901)

<h3>Indications and Technique.</h3> —Hysteria is a term which I once regarded as a vague excuse for a diagnosis, but for the last six or seven years it has been, I think, somewhat displaced from this proud position of general scapegoat by the word neurasthenia. What are the symptoms which indicate that a hysterical case is one for the rest-treatment? When we find a case in which there is great nervous instability combined with physical weakness, and usually with absence of distinct organic disease, especially if there are present some or all of the moral defects which so commonly accompany pronounced hysterical disease, then we have a symptomcomplex calling for treatment by rest and isolation. I need not dwell on the other hysterical stigmata; the list is a long and varying one, although the more essential points are well known and fairly common: backache, headache, insomnia, constant fatigue, are signs not
Walter B. Cannon: The Life and Times of a Young Scientist.
Authors: Jo Ann Carrigan, Saul Benison, A. Clifford Barger, Elin L. Wolfe
Journal: Annals of Internal Medicine (1987)

Reviewsrepertoire of the hospital's surgical staff, beginning with Salmon as "pile doctor" and extending into the era of an increasingly elaborate and invasive surgery.This is, in short, an extremely well-balanced and generously detailed study that constitutes a significant contribution to social and institutional history as well as to the history of medicine construed more narrowly.Her concluding chapter is titled 'A Study in Specialism', but this careful and unpretentious book is more than that.It would be unfortunate if a seemingly technical and circumscribed subject matter should obscure its more general relevance.
P-selectin mediates reperfusion injury through neutrophil and platelet sequestration in the warm ischemic mouse liver
Authors: Surinder S. Yadav, David N. Howell, Douglas A. Steeber, Robert C. Harland, Thomas F. Tedder, Pierre-Alain Clavien
Journal: Hepatology (1999)

Hepatic damage following ischemia-reperfusion injury involves polymorphonuclear leukocytes (PMN) and platelet sequestration, however the mechanisms of adhesion remain elusive. In this study, using gene-targeted deficient mice, we evaluated P-selectin and its contribution to PMN and platelet adhesion in hepatic damage. In an in vivo warm ischemia model, hepatic injury was assessed by serum transaminase levels, survival, PMN adhesion by histological analysis, and platelet sequestration by immunostaining. Serum transaminase levels were strikingly reduced (by up to threefold) in the P-selectin deficient mice, particularly at 90 minutes of ischemia, when compared with wild-type controls. PMN adhesion and platelet sequestration was also significantly decreased in P-selectin deficient mice following 90 minutes of partial ischemia. Animal survival was significantly improved after 75 minutes of total hepatic ischemia in P-selectin deficient mice when compared with wild-type mice. Survival was also achieved after 90 minutes of ischemia in the mutant mice whereas none of the wild-type animals survived. These data show that P-selectin plays a critical role in PMN and platelet adhesion following ischemia-reperfusion injury to the liver.
Difference of high-sensitive C-reactive protein levels in patients treated with statins, aspirin, and angiotensin II modulators
Authors: Toshihiro Takeda, Shiro Hoshida, Shinichiro Suna, Masayuki Taniike, Yasuyuki Egami, Ryu Shutta, Masayoshi Kawabata, Masami Nishino, Hideo Tanahashi, Jun Tanouchi, Yoshio Yamada
Journal: Journal of the American College of Cardiology (2002)
How to investigate and analyse clinical incidents: Clinical Risk Unit and Association of Litigation and Risk Management protocol
Authors: C. Vincent
Journal: BMJ (2000)

Why do things go wrong? Human error is routinely blamed for disasters in the air, on the railways, in complex surgery, and in health care generally. However, quick judgments and routine assignment of blame obscure a more complex truth. The identification of an obvious departure from good practice is usually only the first step of an investigation. Although a particular action or omission may be the immediate cause of an incident, closer analysis usually reveals a series of events and departures from safe practice, each influenced by the working environment and the wider organisational context. This more complex picture is gaining acceptance in health care, 1 2 but it is seldom put into practice in the investigation of actual incidents.

#### Summary points

Analyses of clinical incidents should focus less on individuals and more on organisational factors

Use of a formal protocol ensures a systematic, comprehensive, and efficient investigation

The protocol reduces the chance of simplistic explanations and routine assignment of blame

Experience with the protocol suggests that training is needed for it to be used effectively

Analysis of incidents is a powerful method of learning about healthcare organisations

Organisational analyses lead directly to strategies for enhancing patient safety

The Clinical Risk Unit has developed a process of investigation and analysis of adverse events for use by researchers.3–7 Two years ago a collaborative research group was formed between the unit and members of the Association of Litigation and Risk Management (ALARM). This group has adapted the research methods to produce a protocol for the investigation and analysis of serious incidents for use by risk managers and others trained in incident analysis. The protocol gives a detailed account of the theoretical background and process of investigation and analysis together with case examples.8 In this article we introduce the main ideas …
Direct evidence for a causative role of FGF23 in the abnormal renal phosphate handling and vitamin D metabolism in rats with early-stage chronic kidney disease
Authors: Hisashi Hasegawa, Nobuo Nagano, Itaru Urakawa, Yuji Yamazaki, Kousuke Iijima, Toshiro Fujita, Takeyoshi Yamashita, Seiji Fukumoto, Takashi Shimada
Journal: Kidney International (2010)
Determinants of Response to the DNA Topoisomerase II Inhibitors Doxorubicin and Etoposide in Human Lung Cancer Cell Lines
Authors: K. Kasahara, Y. Fujiwara, Y. Sugimoto, K. Nishio, T. Tamura, T. Matsuda, N. Saijo
Journal: JNCI Journal of the National Cancer Institute (1992)

Background : Small-cell lung cancer (SCLC) is more sensitive to anticancer agents than non-small-cell lung cancer (NSCLC), but few studies have analyzed the mechanisms of natural drugresistance responsible for this difference. Purpose : To elucidate these mechanisms, we determined drug sensitivity and evaluated the biochemical parameters affecting response to the DNA topoisomerase II inhibitors doxorubicin and etoposide in both types of cancer cell lines, in particular the activity and content of DNA topoisomerase II, as well as etoposide uptake and cell doubling time. Methods : Drug sensitivity and cellular uptake of etoposide were determined by clonogenic assay and accumulation of radiolabeled drug, respectively. The topoisomerase II activity was assayed by decatenation of kinetoplast DNA to minicircle DNA using nuclear protein, and the content was determined by immunoblot analysis of nuclear extracts. We also compared the topoisomerase II content in parent cell lines with that in lines with cisplatin resistance acquired in vitro. Results : Sensitivities to doxorubicin and etoposide were higher in SCLC cell lines than in NSCLC lines, and the difference was statistically significant. Etoposide uptake in SCLC cells was higher than in NSCLC cells; the difference was statistically significant, but this difference may not be sufficient to account for the variation in sensitivities of the cell lines. Topoisomerase II activities of nuclear protein from SCLC cell lines were reproducibly twofold higher than those for NSCLC cell lines. The topoisomerase II content in nuclear protein appeared to be higher in SCLC cell lines than in NSCLC cell lines and corresponded to the sensitivities to doxorubicin and etoposide. In the cisplatin-resistant NSCLC cell lines PC-7/CDDP and PC-14/CDDP, the topoisomerase II content was increased compared with that in the parent lines, but the topoisomerase II content in other cisplatin-sensitive parent lines was similar to that in resistant sublines. Conclusions : These findings suggest that the topoisomerase II activity and content may be major factors in determining sensitivity to topoisomerase II inhibitors. [J Natl Cancer Inst 84:113–118, 1992]
Suitable for Framing
Authors: Antolin C Trinidad
Journal: JAMA (2010)

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The morning lecture
Authors: F. I Jackson
Journal: Journal of the Royal Society of Medicine (2002)

Ovoid semipellucid discerned discs are there, like frosted scales on a fish, with its skin stretched out enormously.

These, in the morning faces of alarmclock awakened students, their faces semisurrounding me, quasi-expectantly as if my words may stem some unconscious apparition of their past, resolve the memory of a dream or awaken some inkling of the future.

I have for hours been searching for the phrases, the way in which to convey to them how and why things should be distilled from the horrors of what I have seen what done, what not done, the tears, the memories of mistakes, and the rare triumphs for which God has acted and I have taken credit, and I know I cannot reach them, for it is certain that they must agonize alone along the way, as I have done, and reach the solutions by themselves.

And some of my listeners are sensing this, covering themselves with a veneer of concern, and others feel this as an unanticipated perception, and some few show incuriosity, and pathy— from adolescence and last night's partying or so I trust—

And I hope that, sometime before the inevitable blight of a catastrophe, someone else has forewarned them.
Immunity to Old and New Strains of Influenza A Virus
Authors: P. N. Edmunds
Journal: BMJ (1951)

MEDICAL JOURNL is therefore suggested that the medical examination and short-term observation of poliomyelitis contacts might pro- vide a more realistic picture of familial and contact incidence and give* further information on the transmission channels which result in clinical poliomyelitis in a pro- portion of those infected with the virus.It was noticed that in' some of the contacts, whether family or otherwise, there was an apparent similarity of the type of infection or the location of paralysis.The numbers dealt with here are too small to justify deductions, but it is suggested that this is an aspect for further inquiry in future investigations of family and contact cases.I acknowledge with thanks the co-operation of Dr.
Marine ω-3 Polyunsaturated Fatty Acids and Risk for Colorectal Cancer According to Microsatellite Instability
Authors: Mingyang Song, Reiko Nishihara, Kana Wu, Zhi Rong Qian, Sun A. Kim, Yasutaka Sukawa, Kosuke Mima, Kentaro Inamura, Atsuhiro Masuda, Juhong Yang, Charles S. Fuchs, Edward L. Giovannucci, Shuji Ogino, Andrew T. Chan
Journal: JNCI Journal of the National Cancer Institute (2015)

Background: Chronic inflammation is involved in the development of colorectal cancer (CRC) and microsatellite instability (MSI), a distinct phenotype of CRC.Experimental evidence indicates an anti-inflammatory and antineoplastic effect of marine ω-3 polyunsaturated fatty acids (PUFAs).However, epidemiologic data remain inconclusive. Methods:We investigated whether the association between marine ω-3 PUFAs and CRC varies by MSI-defined subtypes of tumors in the Nurses' Health Study and Health Professionals Follow-up Study.We documented and classified 1125 CRC cases into either MSI-high tumors, in which 30% or more of the 10 microsatellite markers demonstrated instability, or microsatellite-stable (MSS) tumors.Cox proportional hazards model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of MSS tumors and MSI-high tumors in relation to marine ω-3 PUFA intake.All statistical tests were two-sided.Results: Marine ω-3 PUFA intake was not associated with overall incidence of CRC.However, a statistically significant difference was detected by MSI status (P heterogeneity = .02):High marine ω-3 PUFA intake was associated with a lower risk for MSI-high tumors (comparing ≥0.30g/d with <0.10g/d: multivariable HR = 0.54, 95% CI = 0.35 to 0.83, P linearity = .03)but not MSS tumors (HR = 0.97, 95% CI = 0.78 to 1.20, P linearity = .28).This differential association appeared to be independent of CpG island methylator phenotype and BRAF mutation status.Conclusions: High marine ω-3 PUFA intake is associated with lower risk for MSI-high CRC but not MSS tumors, suggesting a potential role of ω-3 PUFAs in protection against CRC through DNA mismatch repair.Further research is needed to confirm our findings and elucidate potential underlying mechanisms.Chronic inflammation plays an important role in the development of colorectal cancer (CRC), a leading cause of cancer-related death worldwide (1,2).Accumulating evidence from animal and in vitro studies indicates that long-chain
Unusual Manifestations of Hemorrhage During Technetium-99m Red Cell Blood Pool Imaging
Authors: ALBERT J. MORENO, TERRY A. REEVES, VINCNET D. PEARSON, ANA A. RODRIGUEZ, GOTTLIEB L. TURNBULL
Journal: Clinical Nuclear Medicine (1989)

Two unusual cases of hemorrhage in the pelvis as noted by technetium-99m red cell blood pool imaging are presented. The first case illustrates bleeding into the right rectus sheath with the development of a hematoma. The second case shows post-traumtic hemorrhage at the site of the sigmoid colon with resulting intraperitoneal and bowel accumulation of technetium-99m labeled red blood cells.
Abstract P5-12-03: Developing the ePromotora: Increasing Promotora's Access to Breast Cancer Electronic Resources
Authors: AM Lopez, J Ryan, A Valencia, Y El-Khayat, A Nunez
Journal: Cancer Research (2012)

Abstract Background: Disparities in breast cancer screening and survival have been attributed to multiple factors including limited access to breast health education. Innovative information technologies facilitate health education; however, access to information technology is not uniform. The resultant systematic gap in health knowledge has led to a new health disparity where higher socioeconomic individuals acquire health information electronically more easily than the disadvantaged. Promotoras or Community Health Workers (CHWs) facilitate access to culturally appropriate cancer health information, screening and care. Hypothesis: An electronic asynchronous breast cancer educational intervention developed by the Arizona Telemedicine Program and the Arizona Health Sciences Library will improve CHW computer literacy and will enhance health education communication. Specific Aims: to develop, implement and assess a 6-session e-promotora training curriculum with a focus on breast health. Methods: The first step in developing a training curriculum was a needs assessment and a computer literacy assessment. This assessment served as the foundation for the computer literacy curriculum which focused on breast health content. The educational intervention was delivered as a combination of on-line, webinar, and face-to-face seminars. To meet the needs of the participants all sessions were delivered bilingually, Spanish and English. Program evaluation included pre and post knowledge assessments, session assignments, program satisfaction and 6-month follow up focus groups or structured interviews to evaluate the utility, implementation and dissemination of knowledge gained. Results: 26 CHWs have completed the training. All participants identified as Latinas, average age – 51 years of age and educational attainment – 58% (15/26) reported high school or less. Pre and post assessment data reveal high program satisfaction scores, increased participant knowledge and confidence in knowledge, consistent and ongoing use of information learned and computer skills gained and effective dissemination of health information gained. Conclusions: The e-promotora training curriculum effectively improves CHW computer literacy, facilitates dissemination of electronic health information and helps address the disparities in electronic health information. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P5-12-03.
Ischemic preconditioning attenuates ischemia/reperfusion-induced activation of caspases and subsequent cleavage of poly(ADP-ribose) polymerase in rat hearts in vivo
Authors: Christophe A Piot, Jean-François Martini, Steve K Bui, Christopher L Wolfe
Journal: Cardiovascular Research (1999)

Recently, we have demonstrated that ischemic preconditioning (IP) both limits infarct size and decreases internucleosomal DNA fragmentation in rat hearts in vivo, and that there was a direct correlation between myocardial infarct size and DNA fragmentation even after IP. In this study, we examined the ability of IP to attenuate processing and activation of caspase-1 and caspase-3, and cleavage of poly(ADP-ribose) polymerase (PARP), after prolonged ischemia and reperfusion using the same in vivo animal model. Rats that underwent IP and controls (Ctrl) were subjected to 30 min of left coronary artery occlusion followed by 180 min of reperfusion. IP was accomplished by five 5-min cycles of ischemia, each followed by 5 min of reperfusion. The amount of soluble nucleosomes was measured by enzyme-linked immunosorbent assay. Cleavage of caspases-1 and -3, and of one of their substrates PARP, was analyzed by Western blotting. Nucleosomal DNA fragmentation was significantly reduced in ischemic left ventricular (LV) tissue obtained from IP compared with Ctrl animals. The proforms of caspases-1 and -3, and the active form of PARP were not cleaved in the nonischemic LV region of both IP and Ctrl hearts. In contrast, the proform of caspase-3 and the active form of PARP were cleaved in the ischemic LV region of Ctrl hearts, while processing of caspase-1 was increased. Cleavages of caspases-1 and -3, and inactivation of PARP were prevented by IP. The results of this study indicate that IP attenuates both internucleosomal DNA fragmentation and caspases processing, and suggest that the prevention of caspases activation by IP may be important steps in protecting the heart against ischemia/reperfusion injury in vivo.