tbuckley/cabot-search huggingface dataset:
Book Review Cancer of the Skin Edited by Darrell S. Rigel, Robert J. Friedman, Leonard M. Dzubow, Douglas S. Reintgen, Jean-Claude Bystryn, and Robin Marks. 711 pp., illustrated, with CD-ROM. Philadelphia, Saunders, 2005. $179. 0-7216-0544-3
Authors: Brent E. Pennington, David J. Leffell
Journal: New England Journal of Medicine (2005)
The need to consider the wider agenda in systematic reviews and meta-analyses: breadth, timing, and depth of the evidence
Authors: J. P. A. Ioannidis, F. B. Karassa
Journal: BMJ (2010)

As well as focusing on a precise question, systematic reviewers also need to consider the whole research programme for the interventions under study argue <b>John Ioannidis</b> and <b>Fotini Karassa</b>
PTU-114 Serological Autoantibodies in Health and Liver Disease in a Black African Population
Authors: J A Otegbayo, G O Arinola
Journal: Gut (2013)

<h3>Introduction</h3> Some pathologic autoantibodies are useful in the diagnosis of autoimmune liver diseases. There is dearth of literature on the prevalence and pattern of autoantibodies in black population of Africans with liver disease, and none from Nigeria. This study sought to determine the prevalence and pattern of autoantibodies among patients with liver diseases and apparently healthy individuals in Nigeria. <h3>Methods</h3> The seroprevalence of antinuclear antibodies (ANA), antimitochondrial antibodies (AMA), anti-liver kidney microsomal antibodies (Anti-LKM-1), anti-soluble liver antigen/liver pancreas (Anti-SLA-LP), perinuclear anti-neutrophil cytoplasmic antibodies (pANCA), were analysed in patients with liver diseases and apparently health controls, using ELISA method. Appropriate statistical methods were used for Odds ratio, Pearson Chi square and students’ t-test. Significant statistical difference was specified at p &lt; 0.05. <h3>Results</h3> One hundred and twenty six patients with liver diseases (91 (72.2%) males and 35 (27.8%) females) and 82 apparently normal control subjects (59 (72%) males and 23 (28%) females) were studied over a two year period. The patients consisted of HCC 77 (61.1%), liver cirrhosis 32 (25.4%), chronic hepatitis 10 (7.9%), acute viral hepatitis 4 (3.2%), alcoholic cirrhosis 1 (0.8%) and primary biliary cirrhosis 2 (1.6%). The control group consisted of Eighty two (82) apparently normal individuals consisting of were recruited over the study period to serve as controls. Of the 126 cases and 82 controls analysed for autoantibodies, except for ANA ( 107 cases and 67 controls) for autoantibodies only AMA was found to be significantly higher among cases compared with controls. Antimitochondrial antibodies were present in 76 (60.3%) of the cases compared with 36 (43.9%) controls (p &lt; 0.05), while ANA were present in 42 (39.3%) of cases compared with 27 (39.7%) controls (p = 0.68). Anti-soluble liver antigen (anti-SLA/LP) and pANCA were completely absent among cases and controls Table 2. Chronic hepatitis had the highest frequency of AMA, being positive in 9 (90%) of the 10 cases, this was followed by HCC, 48(62.3%) of the 77 cases tested were positive for AMA. <h3>Conclusion</h3> Serological autoantibodies were equally present in both liver diseases and in health, and would not be sufficient for the diagnosis of autoimmune liver disease in Africans. Therefore, other parameters have to be considered whenever there is a clinical suspicion of autoimmune liver disease among Nigerians. <h3>Disclosure of Interest</h3> None Declared
Abstract 730: Targeting colchicine binding site in tubulin for the treatment of advanced melanoma
Authors: Wei Li, Zhao Wang, Jianjun Chen, Yan Lu, Chien-Ming Li, James T. Dalton, Duane Miller
Journal: Cancer Research (2010)

Abstract Inhibition of tubulin dynamics has been a fruitful drug target for cancer treatment. Out the three ligand binding sites in tubulin, drugs targeting taxane binding site (e.g. taxol and epithilones) and vinca alkaloids binding site (e.g. vinblastine) are clinically very successful drugs. However, no FDA-approved cancer drugs targeting the colchicine binding site in tubulin currently exist. In our ongoing efforts to search for effective drugs for the treatment of advanced melanoma that are highly resistant to all existing cancer treatment, we have discovered a new class of compounds that are not substrates of P-glycoprotein (Pgp) and are highly efficacious against human melanoma tumors in A375 xenograft models. At relatively low doses (5∼15 mg/kg), these compounds inhibit melanoma tumor growth more effectively than DTIC (the gold standard drug for advanced melanoma) at 60 mg/kg. Extensive biological and molecular modeling studies suggest that these compounds work by competitively binding to the colchicine site in tubulin. Further optimization of these compounds hold great promise in providing an effective agent for the treatment of advanced melanoma. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 730.
The Impact of Televised Movies about Suicide
Authors: Martin A. Tanner, Joseph A. Murray, David P. Phillips, Daniel J. Paight, Madelyn S. Gould, David Shaffer
Journal: New England Journal of Medicine (1988)

Abstract Gould and Shaffer studied suicides by teenagers in the New York City area before and after three fictional films about suicide were televised, and presented evidence suggesting that the films were followed by a significant increase in teenage suicides. Using their methods, we studied teenage suicides in California and Pennsylvania before and after the television broadcast of the same three films. In these states, there was no evidence of an increase in teenage suicides after the films were shown. This remained true when data for New York from the study of Gould and Shaffer were combined with our data from California and Pennsylvania. We conclude that it is premature to be concerned about possibly fatal effects of fictional televised films about suicide. (N Engl J Med 1987; 317:809–11.)
Apparent Left Ventricular Aneurysm Due to Unilateral Secretion of Tc-99m Pertechnetate in a Nursing Mother with Breast Cancer
Authors: DAVID B. CASSIDY, RICHARD A. GOLDSTEIN, DAVID B. WU, CARL M. SANDLER, ANNE MARIE MADDOX
Journal: Clinical Nuclear Medicine (1990)

This case presents a 28-year-old female patient with right breast cancer who had unilateral secretion of Tc-99m pertechnetate into her normal left breast milk during the course of a baseline stress-gated radionuclide ventriculogram. Initial evaluation of images suggested a possible left ventricular aneurysm and right ventricular enlargement. The left lateral image Showed that there Was an area of activity that was anterior to the heart. A bone scan performed a few days earlier With Tc-99m MDP Showed no breast activity. Radionuclide ventriculography eight months later showed normal cardiac structures and wall motion.
The Affliction of Internal Medicine
Authors: J. Claude Bennett
Journal: New England Journal of Medicine (1993)

To the Editor: Dr. Kassirer (March 4 issue)1 suggests that the need for primary care internists could be satisfied if the edentulous Federated Council for Internal Medicine (FCIM) would take a strong, enforceable stand. Historically, the FCIM was convened to discuss issues of mutual interest. Although its discussions have traditionally been candid and comprehensive, its record is more akin to whispering with one voice, because the issues have not always been clear and have not always had a direct, simultaneous effect on each of the organizations that make up the council. What seems to have changed dramatically in the past . . .
Apparent Posterior Misregistration of a Liver Lesion on PET/CT
Authors: Eugene Lin
Journal: Clinical Nuclear Medicine (2008)

A 63-year-old man with a history of colon cancer and partial hepatectomy for liver metastases underwent an F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) for restaging. This demonstrated misregistration of an inferior liver lesion into the lung. This was a potentially confusing interpretive situation as typically misregistration in the lungs occurs from superior liver lesions. This appearance was secondary to prior partial hepatectomy, which in combination with respiratory misregistration on PET/CT can create a pitfall for the interpreter.
Egyptian doctors held as prisoners of conscience
Authors: H. Phillipson
Journal: BMJ (1996)

Chlamydial infection is asymptomatic in England as well as Tanzania EDITOR,-H Grosskurth and colleagues con- clude that infection with Chlamydia trachomatis is commonly asymptomatic among rural Tanza- nian men.'In our experience, it is commonly asymptomatic among urban men in Lancashire, England.During April 1994 to April 1995, 84 male patients were seen in whom C trachomatis infection was diagnosed on culture.Of these, only 43 complained of urethral discharge or dysuria, or both.Forty one had no symptoms of urethritis.It is our policy to trace all sexual con- tacts of patients infected with C trachomatis.Eighteen of the 84 patients were contacts, but only one was symptomatic.The remaining 66, who were not known contacts, were diagnosed by routine screening.C trachomatis is a common cause of sexually transmfiitted diseases world wide and if not treated can lead to severe complications, especially in women.2Since 1988 it has been our policy to screen all men and women attending our department for C trachomatis infection.Some authors have argued against universal screening of men attending sexually transmitted diseases clinics,3 but, given our experience and that the true cost of any undiagnosed genital chlamydial infection to the community will be high, we will continue our current policy.We believe that the "syndromic approach" to the management of sexually transmitted diseases will not adequately address the impact of asymptomatic diseases and may lead to major gaps in programmes to control sexually transmitted diseases.
Serological Diagnosis of Idiopathic Pulmonary Alveolar Proteinosis
Authors: TAKAYUKI KITAMURA, KANJI UCHIDA, NAOHIKO TANAKA, TOMOKO TSUCHIYA, JUNICHI WATANABE, YOSHITSUGU YAMADA, KAZUO HANAOKA, JOHN F. SEYMOUR, OTTO D. SCHOCH, IAN DOYLE, YOSHIKAZU INOUE, MITSUNORI SAKATANI, SHOJI KUDOH, ARATA AZUMA, TOSHIHIRO NUKIWA, TOMOYUKI TOMITA, MAKOTO KATAGIRI, AKIRA FUJITA, ATSUYUKI KURASHIMA, SHIRO KANEGASAKI, KOH NAKATA
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Previously, we reported the specific occurrence of neutralizing autoantibodies against granulocyte–macrophage colony–stimulating factor (GM-CSF) in the bronchoalveolar lavage fluid from 11 Japanese patients with idiopathic pulmonary alveolar proteinosis (I-PAP). The autoantibody was also detected in sera from all 5 I-PAP patients examined. To determine that the existence of the autoantibody is not limited to the Japanese patients, we examined sera from 24 I-PAP patients in five countries and showed that the autoantibody was consistently and specifically present in such patients. Thus, detection of the autoantibody in sera can be used for diagnosis of I-PAP. To establish a simple and convenient method for diagnosis of I-PAP, we developed a novel latex agglutination test using latex beads coupled with recombinant human GM-CSF. GM-CSF binding proteins isolated from the sera using the latex beads were identified as the autoantibodies of IgG1 and IgG2. The titer of the autoantibody determined by this test correlated with that determined by ELISA. Agglutination was positive in 300-fold diluted sera from all 24 I-PAP patients, but negative in sera from four secondary PAP patients, two congenital PAP patients, 40 patients with other lung diseases, and 38 of 40 normal subjects. These results establish that the latex agglutination test is a reliable method for serological diagnosis of I-PAP with high sensitivity (100%) and specificity (98%).
Benzodiazepine Use and the Risk of Motor Vehicle Crash in the Elderly
Authors: Brenda Hemmelgarn
Journal: JAMA (1997)

Benzodiazepines, used by a sizable number of the elderly population, may affect the ability to drive and thus increase the risk of a motor vehicle crash. Epidemiologic studies of this question have produced inconsistent results that may be due to the different effects of long- and short-half-life benzodiazepines and variations in their duration of use.To determine whether the use of benzodiazepines of either long- or short-elimination half-life is associated with the risk of injurious motor vehicle crash in the elderly.Nested case-control design within a cohort of 224,734 drivers from the Canadian province of Quebec, aged 67 to 84 years, followed up from 1990 to 1993. Computerized data for the study were obtained from provincial driver's license files, police reports of injurious crashes, and health insurance records.We identified all 5579 drivers involved in an injurious crash (cases) and a random sample of 10 controls per case selected from a subcohort of 13,256 subjects.Involvement of a cohort member as a driver in a motor vehicle crash in which at least 1 person (not necessarily the driver) sustained bodily injury.The adjusted rate ratio of crash involvement within the first week of long-half-life benzodiazepine use was 1.45 (95% confidence interval [CI], 1.04-2.03). The rate ratio for continuous use of longer duration up to 1 year was slightly lower but remained significant (rate ratio, 1.26; 95% CI, 1.09-1.45). In contrast, there was no increased risk after the initiation of treatment with short-half-life benzodiazepines (rate ratio, 1.04; 95% CI, 0.81-1.34) or with their continued use (rate ratio, 0.91; 95% CI, 0.82-1.01).Brief or extended periods of exposure to long-half-life benzodiazepines are associated with an increased risk of motor vehicle crash involvement in the elderly population. There is no such elevated risk for short-half-life benzodiazepines.
SYPHILIS OF THE LARYNX.
Authors: CHARLES M. ROBERTSON
Journal: JAMA (1903)

Syphilis of the larynx is the local manifestation in the larynx of constitutional lues. It is observed in all its different stages and may be either hereditary or acquired. It is classed as (<i>a</i>) the primary lesion, (<i>b</i>) the secondary, including the erythema, mucous patch and superficial ulcer, and (<i>c</i>) the tertiary, including the gumma, deep ulceration, perichondritis and stenosis. It is fortunately quite a rare manifestation in this disease, occurring in 2.9 per cent. of cases as observed by Lewin, 2.4 per cent. by Schrotter, 3.4 per cent. by McKenzie, 2.8 per cent. by Engelsted. These observations are not altogether unanimous, however, as some authors put the per cent. as high as 15. Its occurrence in the pharynx is given by these authors as 10 per cent., and in the nose as 2.8 per cent. The London Throat Hospital reports out of 10,000 cases of this disease, 308 affections
Single inhaler Therapy with budesonide/formoterol reduces the risk of severe exacerbations compared with budesonide plus terbutaline as needed in patients with asthma*1
Authors: R. Scicchitano, R. Aalbers, D. Ukena, A.I. Manjra, L. Fouquert, S. Centanni, L. Boulet
Journal: Journal of Allergy and Clinical Immunology (2004)
Continuity – our Achilles' heel
Authors: Mark Aitken
Journal: Journal of the Royal Society of Medicine (2010)

Your editorial, examining healthcare's Achilles' heels, failed to identify discontinuity of care.1 The article describes a ‘healthcare team’ but where are those teams that used to manage emergencies? Now it is easier to pass the patient than take the over-arching responsibility for those admitted when we are holding that emergency baton. Healthcare has become a relay race. The least expensive junior doctor emergency rotas usually have the participants out of sync with the senior members of the team to which they have nominally been seconded. Continuity of learning has been superseded by clockwatching.2

While a minority of emergency admissions require the expertise of a specific specialty, most patients have multiple co-morbidities and are best cared for throughout their hospital stay by the ‘generalist’ and his/her team who were holding the baton on the day of admission.

We might look to the universities and Royal Colleges to sort out this mess but that thread of continuity has been passed on to the GMC which has no track record in anything other than disciplinary matters. Alternatively, our politicians could intervene and legislate to put continuity of care at the heart of healthcare and then mould the infrastructure around it. But politicians and their parties are as ephemeral as the succession of management executives imposed upon us and whose only concern is the minimization of their loss-making emergency services.

The inherent risk in healthcare is so patently obvious but no-one appears to be able to see the wood for the trees. An onlooker might see us like a group enjoying a communal bath with the patients the bars of soap. Under the muddied water no one is quite sure who is holding what. When the bathwater has drained away we appear surprised that all the soap has gone down the plughole!
New powers for CHAI "threaten patient confidentiality"
Authors: C. Dyer
Journal: BMJ (2003)

New powers permitting the planned Commission for Health Care Audit and Inspection (CHAI) to look at individual patients' records if it deems access “necessary or expedient” provoked protests this week that the move threatened patient confidentiality and could undermine trust in doctors.

The General Medical Council, the regulatory body for UK doctors, and the Medical Defence Union, which provides legal and ethical advice for more than half of UK doctors, raised their concerns on the day that the House of Lords was due to give a second reading to the government's Health and Social …
The Specificity and Reliability of Roentgenographic Diagnosis
Authors: Merrill C. Sosman
Journal: New England Journal of Medicine (1950)

X-RAY films are not all black and white. Some parts may be black and others white, but there are many shades of gray in between. Similarly, the diagnoses from roentgenographic examinations are not all yes or no propositions. There are many shades of certainty in opinions and many degrees of reliability based on deductions. This essay is an attempt to estimate the accuracy and trustworthiness of diagnoses made primarily by the roentgenographic method. These estimates are based not only upon my own experience of thirty years with this method but also upon those of my colleagues both in roentgenology and . . .
Melioidosis Pneumonitis
Authors: Murray Spotnitz
Journal: JAMA (1967)

Melioidosis has been known as a highly fatal bacterial infection of tropical areas. Epidemiological studies indicate that the disease is much more common than previously suspected because a high incidence of asymptomatic infections was found among natives of the endemic areas. In nine patients in whom the infection was confined to the lungs, the clinical manifestations closely mimicked pulmonary tuberculosis with upper-lobe infiltration and cavitation. The course was subacute, the patients had a productive cough, blood-tinged sputum, chest pain, fever, chills, weight loss, and anemia. This form of the disease showed an excellent response to appropriate antibiotic therapy. Isolated pulmonary melioidosis is a relatively benign disease and does not have the same prognosis as the septicemic form.
Road Crash Fatalities on US Income Tax Days
Authors: Donald A Redelmeier, Christopher J Yarnell
Journal: JAMA (2012)

study toward no observed effect.How many of the examined patient-years occurred prior to the MI definition change?Have the authors considered performing subgroup analyses of patient-years before and after this diagnostic change?Amphetamine and methylphenidate are sympathomimetics with mechanisms of action similar to cocaine (ie, inhibition of catecholamine reuptake).Although the risk of acute MI increases 24-fold in the first hour after exposure, the increased long-term risk of MI associated with cocaine use stems from accelerated atherosclerosis and other structural cardiac changes. 4 Recently, these changes have been demonstrated in asymptomatic cocaine users and are attributed to catecholamine excess. 5 In the current study, the interquartile range for follow-up was only 0.6 to 2.6 years per person and the median ADHD medication use was only 4 months per current user.Do the authors think their study design can address the longterm risk of cardiac disease in those who take ADHD medication long-term?Counseling patients on the long-term risks of ADHD medication use remains a challenge given the lack of randomized controlled trials with definitive results.Answers to these questions will assist in risk-benefit discussions.
Combined use of non-invasive techniques to predict pulmonary arterial pressure in chronic respiratory disease.
Authors: J M Bishop, M Csukas
Journal: Thorax (1989)

The value of non-invasive procedures for predicting pulmonary arterial pressure was investigated in 370 patients with chronic obstructive lung diseases and in 73 with fibrosing alveolitis in a combined study at nine centres in six European countries. Measurements included forced expiratory volume in one second, arterial blood gas tensions, standard electrocardiogram, radiographic dimensions of pulmonary artery, right ventricle dimensions by M mode echocardiography, and myocardial scintigraphy with thallium-201; and certain clinical signs were also used. No single variable was correlated closely enough to allow accurate prediction of pulmonary arterial pressure. Four methods were used to incorporate several variables into mathematical functions for predicting pulmonary arterial pressure. In patients with chronic obstructive lung disease multiple stepwise regression explained 49% of the variance in pulmonary arterial pressure but was not useful for prediction. Discriminant analysis allowed patients to be allocated to bands of pulmonary arterial pressure, as did two non-parametric procedures, in which decision trees were established using either the Kolmogoroff-Smirnoff statistic or Fisher9s exact test. Patients with a pulmonary arterial pressure of 30 mm Hg or more were identified with a sensitivity of 83% and a specificity of 91%. The non-parametric tests gave better results than discriminant function. A further 54 patients were studied to validate the functions. Of these, 90% with a pulmonary arterial pressure above 20 mm Hg were correctly identified, and 80% of those with a pulmonary arterial pressure above 29 mm Hg. Similar results were obtained in subjects with fibrosing alveolitis. These mathematical functions allow the use of combinations of non-invasive procedures to select from populations at risk of pulmonary hypertension those in whom direct measurement is required. The mathematical functions are capable of further development by incorporation of variables from newer non-invasive procedures.
The Canadian study of the sirolimus-eluting stent in the treatment of patients with long de novo lesions in small native coronary arteries (C-SIRIUS)
Authors: Erick Schampaert, Eric A. Cohen, Michael Schlüter, François Reeves, Mouhieddin Traboulsi, Lawrence M. Title, Richard E. Kuntz, Jeffrey J. Popma
Journal: Journal of the American College of Cardiology (2004)
An Afghan child with deep vein thrombosis
Authors: R Gupta, M Brueton, J Fell, H Lyall
Journal: Journal of the Royal Society of Medicine (2003)

A link between deep vein thrombosis (DVT) and pulmonary tuberculosis has been described,1,2 but not with gastrointestinal tuberculosis.​tuberculosis.



Figure 1

CT scan of pelvis showing thrombosis of iliac vein on right side