tbuckley/cabot-search huggingface dataset:
The role of dermoscopy in the diagnosis of cicatricial marginal alopecia
Authors: A. Tosti, F. Torres, C. Misciali, C. Vincenzi, B. Duque-Estrada
Journal: British Journal of Dermatology (2009)

Conflicts of interest: none declared. Sir, A distinctive pattern of alopecia has been recently described by Goldberg1 as a new entity: cicatricial marginal alopecia (CMA). Although her patients presented clinical features suggestive of traction alopecia the author questioned this diagnosis as the hair loss was severe, most patients were not African‐American and 40% of them had no history of traction or hair styling. The occipital area, which is usually not affected in traction alopecia, was commonly involved, making alopecia areata an important differential diagnosis. We report five white women with identical clinical and pathological features and no history of hair styling or other causes of traction. Patients were seen at the University of Bologna from 2005 to 2008. Dermoscopic images were obtained with a computerized polarized‐light videomicroscope (FotoFinder dermoscope®; Teachscreen Software, Bad Birnbach, Germany) with lenses with × 20 to × 70 magnification, at × 10 increments. Epiluminescent mode was used. Biopsies were performed with two 4‐mm punches for horizontal and vertical sections.
Keratinocyte growth factor and androgen blockade work in concert to protect against conditioning regimen-induced thymic epithelial damage and enhance T-cell reconstitution after murine bone marrow transplantation
Authors: Ryan M. Kelly, Steven L. Highfill, Angela Panoskaltsis-Mortari, Patricia A. Taylor, Richard L. Boyd, Georg A. Holländer, Bruce R. Blazar
Journal: Blood (2008)
And When Did You Last See Your Father?
Authors: T. Rader
Journal: BMJ (2003)

Blake Morrison Granta, £7.99, pp 224 ISBN 1 86207 093 8 Rating: ![Graphic][1]</img>![Graphic][2]</img>![Graphic][3]</img>![Graphic][4]</img> Sooner or later we all die. And so do our parents. Blake Morrison has generously offered his insight into the experience of losing his father. This book met with critical acclaim on its publication almost 10 years ago and has inspired similar confessional memoirs. It is a testament to the quality of Morrison's writing that details of everyday family … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif [4]: /embed/inline-graphic-4.gif
Should the Electrocardiogram Be Used to Guide Therapy for Patients With Left Bundle-Branch Block and Suspected Myocardial Infarction?
Authors: Michael G. Shlipak
Journal: JAMA (1999)

Recently, an algorithm based on the electrocardiogram (ECG) was reported to predict myocardial infarction (MI) in patients with left bundle-branch block (LBBB), but the clinical impact of this testing strategy is unknown.To determine the diagnostic test characteristics and clinical utility of this ECG algorithm for patients with suspected MI.Retrospective cohort study to which an algorithm was applied, followed by decision analysis regarding thrombolysis made with or without the algorithm.University emergency department, 1994 through 1997.Eighty-three patients with LBBB who presented 103 times with symptoms suggestive of MI.Myocardial infarction determined by serial cardiac enzyme analyses and stroke-free survival.Of 9 ECG findings assessed, none effectively distinguished the 30% of patients with MI from those with other diagnoses. The ECG algorithm indicated positive findings in only 3% of presentations and had a sensitivity of 10% (95% confidence interval, 2%-26%). The decision analysis showed that among 1000 patients with LBBB and chest pain, 929 would survive without major stroke if all received thrombolysis compared with 918 if the ECG algorithm was used as a screening test.The ECG is a poor predictor of MI in a community-based cohort of patients with LBBB and acute cardiopulmonary symptoms. Acute thrombolytic therapy should be considered for all patients with LBBB who have symptoms consistent with MI.
Association Between Sauna Bathing and Fatal Cardiovascular and All-Cause Mortality Events
Authors: Tanjaniina Laukkanen, Hassan Khan, Francesco Zaccardi, Jari A. Laukkanen
Journal: JAMA Internal Medicine (2015)

Sauna bathing is a health habit associated with better hemodynamic function; however, the association of sauna bathing with cardiovascular and all-cause mortality is not known.To investigate the association of frequency and duration of sauna bathing with the risk of sudden cardiac death (SCD), fatal coronary heart disease (CHD), fatal cardiovascular disease (CVD), and all-cause mortality.We performed a prospective cohort study (Finnish Kuopio Ischemic Heart Disease Risk Factor Study) of a population-based sample of 2315 middle-aged (age range, 42-60 years) men from Eastern Finland. Baseline examinations were conducted from March 1, 1984, through December 31, 1989.Frequency and duration of sauna bathing assessed at baseline.During a median follow-up of 20.7 years (interquartile range, 18.1-22.6 years), 190 SCDs, 281 fatal CHDs, 407 fatal CVDs, and 929 all-cause mortality events occurred. A total of 601, 1513, and 201 participants reported having a sauna bathing session 1 time per week, 2 to 3 times per week, and 4 to 7 times per week, respectively. The numbers (percentages) of SCDs were 61 (10.1%), 119 (7.8%), and 10 (5.0%) in the 3 groups of the frequency of sauna bathing. The respective numbers were 89 (14.9%), 175 (11.5%), and 17 (8.5%) for fatal CHDs; 134 (22.3%), 249 (16.4%), and 24 (12.0%) for fatal CVDs; and 295 (49.1%), 572 (37.8%), and 62 (30.8%) for all-cause mortality events. After adjustment for CVD risk factors, compared with men with 1 sauna bathing session per week, the hazard ratio of SCD was 0.78 (95% CI, 0.57-1.07) for 2 to 3 sauna bathing sessions per week and 0.37 (95% CI, 0.18-0.75) for 4 to 7 sauna bathing sessions per week (P for trend = .005). Similar associations were found with CHD, CVD, and all-cause mortality (P for trend ≤.005). Compared with men having a sauna bathing session of less than 11 minutes, the adjusted hazard ratio for SCD was 0.93 (95% CI, 0.67-1.28) for sauna bathing sessions of 11 to 19 minutes and 0.48 (95% CI, 0.31-0.75) for sessions lasting more than 19 minutes (P for trend = .002); significant inverse associations were also observed for fatal CHDs and fatal CVDs (P for trend ≤.03) but not for all-cause mortality events.Increased frequency of sauna bathing is associated with a reduced risk of SCD, CHD, CVD, and all-cause mortality. Further studies are warranted to establish the potential mechanism that links sauna bathing and cardiovascular health.
Diagnostic Accuracy of Point-of-Care Tests for Detecting Albuminuria
Authors: Malcolm P. McTaggart, Ronald G. Newall, Jennifer A. Hirst, Clare R. Bankhead, Edmund J. Lamb, Nia W. Roberts, Christopher P. Price
Journal: Annals of Internal Medicine (2014)

Experts recommend screening for albuminuria in patients at risk for kidney disease.To systematically review evidence about the diagnostic accuracy of point-of-care (POC) tests for detecting albuminuria in individuals for whom guidelines recommend such detection.Cochrane Library, EMBASE, Medion database, MEDLINE, and Science Citation Index from 1963 through 5 December 2013; hand searches of other relevant journals; and reference lists.Cross-sectional studies, published in any language, that compared the accuracy of machine-read POC tests of urinary albumin-creatinine ratio with that of laboratory measurement.Two independent reviewers extracted study data and assessed study quality using the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies 2) tool.Sixteen studies (n = 3356 patients) that evaluated semiquantitative or quantitative POC tests and used random urine samples collected in primary or secondary ambulatory care settings met inclusion criteria. Pooling results from a bivariate random-effects model gave sensitivity and specificity estimates of 76% (95% CI, 63% to 86%) and 93% (CI, 84% to 97%), respectively, for the semiquantitative test. Sensitivity and specificity estimates for the quantitative test were 96% (CI, 78% to 99%) and 98% (CI, 93% to 99%), respectively. The negative likelihood ratios for the semiquantitative and quantitative tests were 0.26 (CI, 0.16 to 0.40) and 0.04 (CI, 0.01 to 0.25), respectively.Accuracy estimates were based on data from single-sample urine measurement, but guidelines require that diagnosis of albuminuria be based on at least 2 of 3 samples collected in a 6-month period.A negative semiquantitative POC test result does not rule out albuminuria, whereas quantitative POC testing meets required performance standards and can be used to rule out albuminuria.None.
Sticks and stones?
Authors: D. Spence
Journal: BMJ (2011)

It was a different time. The clinical director twisted his wedding ring nervously, shut the door, and inhaled. “I’ll get to the point: the cleaners tell me that a man has been sleeping in your room at the residency.” “That’s my brother.” His relief was palpable. I said, “I will sort it out,” and I shook his hand. As ever my younger sibling’s “crash for a couple of nights” had turned into a few weeks. How we deal with junior doctors is important. Recently the case of Gillian Needham and “Scot Junior” has been raised …
“High Probability” Perfusion Lung Scans in Pulmonary Venoocclusive Disease
Authors: COLLEEN L. BAILEY, RICHARD N. CHANNICK, WILLIAM R. AUGER, PETER F. FEDULLO, KIM M. KERR, GORDON L. YUNG, LEWIS J. RUBIN
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

"High-probability" ventilation/perfusion (V˙/Q˙) lung scans generally indicate proximal pulmonary arterial occlusion by thromboemboli or, rarely, other processes such as tumors, fibrosing mediastinitis, or vasculitis. In this report we describe three patients with high probability V˙/Q˙ scans in whom pulmonary angiography failed to demonstrate arterial occlusion. All three patients were determined to have pulmonary venoocclusive disease (PVOD). In two patients, a tissue diagnosis of PVOD was made, in one case with explanted tissue taken after a successful heart–lung transplant and in the other case with tissue taken at autopsy. PVOD in the third patient was diagnosed with pulmonary venography. A potential explanation for the discrepancy between perfusion lung scan and pulmonary angiographic findings in PVOD is discussed.
Sarcoidosis is a frequent benign cause of lymphadenopathy in neoplastic patients
Authors: Claudia Ravaglia, Carlo Gurioli, GianLuca Casoni, Micaela Romagnoli, Sara Tomassetti, Christian Gurioli, Poletti Venerino
Journal: European Respiratory Journal (2012)

BACKGROUND : clinical and radiographic aspects of sarcoidosis and malignancy might mimic one another, making the distinction between the two difficult in some cases. Cancer and sarcoidosis have been associated in some case series from the literature but this association remains controversial. Objectives: a descriptive retrospective study to evaluate the incidence of sarcoidosis in patients followed-up for previous cancer and referred for hilar/mediastinal lymphadenopathies, with no pulmonary lesions.

METHODS : we conducted a retrospective chart review of all patients who were referred to our pulmonology department in the period between January 2007 and Dicember 2011 with a new onset hilar/mediastinal lymphadenopathies during follow-up for previous neoplasms.

RESULTS : forty-eight patients (31 males, 17 females) of mean age 63 years (range 20-81) underwent EBUS/EUS trans-bronchial needle aspiration (TBNA). Patients had been followed-up for lung cancer (10 cases), lymphoma (9 cases), breast cancer (7 cases), urologic cancer (6 cases), gastro-intestinal tumors (6 cases), larynx/pharynx tumors (4 cases), gynecologic tumors (3 cases), other cancer (8 cases). Six patients had a history of two tumors or more in the past. Procedure was diagnostic in 45 patients (94%) and diagnosis was sarcoidosis in 12 patients (26,7%), metastasis from previous cancer in 13 patients (28,9%) and normal lymph node in 20 patients (44,4%).

CONCLUSIONS : our study suggests that sarcoidosis should be considered in the differential diagnosis of patients with a history of malignancy who develop hilar/mediastinal lymphadenopathies; a tissue diagnosis should be obtained before instituting therapy for presumed cancer recurrence.
Long-term risk of recurrent peptic ulcer bleeding in patients with liver cirrhosis: A 10-year nationwide cohort study
Authors: Yao-Chun Hsu, Jaw-Town Lin, Tzu-Ting Chen, Ming-Shiang Wu, Chun-Ying Wu
Journal: Hepatology (2012)

Peptic ulcer bleeding leads to substantial morbidity and mortality in patients with liver cirrhosis, but their long-term risk of recurrent bleeding remains elusive. This nationwide cohort study aimed to elucidate the association between cirrhosis and recurrent peptic ulcer bleeding by analyzing the Taiwan National Health Insurance Research Database. We enrolled a total of 9,711 patients who had cirrhosis with clinical complications of portal hypertension from all patients (n = 271,030) hospitalized for peptic ulcer bleeding between January 1997 and December 2006, along with 38,844 controls who were matched at a 1:4 proportion for age, sex, and antisecretory agents. We accounted for death as the competing cause of risk when calculating the cumulative incidences and hazard ratios of recurrent bleeding during the 10-year study period. Overall, patients with cirrhosis had a significantly higher death-adjusted rebleeding rate compared with controls (1 year, 14.4% versus 11.3%; 5 years, 26.1% versus 22.5%; 10 years, 28.4% versus 27.1%; P &lt; 0.001). The modified Cox proportional hazard model verified that cirrhosis was significantly associated with peptic ulcer rebleeding (adjusted hazard ratio, 3.19; 95% confidence interval, 2.62-3.88), but also uncovered a seemingly paradoxical interaction between cirrhosis and age. Multivariate stratified analysis further revealed that the rebleeding risk after adjustment for death diminished with age in patients with cirrhosis, whose risk of death far exceeded that of rebleeding when they grew old. Conclusion : Liver cirrhosis is associated with long-term risk of recurrent peptic ulcer bleeding, although the risk declines with age because of death being the competing cause. Effective therapy should be sought to reduce this excessive risk in these critically ill patients, particularly for those at younger age with longer life expectancy. (HEPATOLOGY 2012)
19 The grape-derived polyphenol resveratrol inhibits growth factor signaling in human liver myofibroblasts. Specific inhibition of the activity of the phospho-inositide-dependent kinase-1 in cells treated with epidermal growth factor and resveratrol
Authors: K. Si-Tayeb, S. Godichaud, N. Augé, A. Desmoulière, B. Payrastre, A. Nègre-Salvayre, J. Rosenbaum
Journal: Journal of Hepatology (2004)
Government proposes food safety adviser
Authors: J. Warden
Journal: BMJ (1997)

Alternative systems for controlling food hygiene have been proposed for Britain, depending on who wins the coming general election. The Conservative and Labour parties have different methods for restoring public confidence in meat and other foods in the aftermath of the recent food scares concerning bovine spongiform encephalopathy and Escherichia coli .



The government hopes to restore public confidence in meat

ROGER PERRY/IMPACT



The Conservative government announced last week that if re-elected it will appoint an independent food safety adviser, with …
Use of 'Single Donor' Factor VIII From Plasma Exchange Donation
Authors: Bruce C. McLeod
Journal: JAMA (1984)

We investigated the advantages of using "single donor" factor VIII derived from a new cyclic apheresis donation (plasma exchange donation) to treat hemophiliac children. By selecting donors with high factor VIII levels and using thaw-siphon isolation of cryoprecipitate, we achieved a mean yield of 1,360 units of factor VIII per weekly donation. The half-life, posttransfusion increments, and clinical efficacy of factor VIII in this material are comparable with those of factor VIII from other sources. A single donor has provided total support for seven months for one patient with severe hemophilia, and another for 24 months for a patient with mild hemophilia. Other patients have been supported through major surgery or CNS hemorrhage by a single donor. This approach to factor VIII replacement is hemostatically effective and can substantially decrease donor exposure for both major and minor bleeding episodes. The reduction in donor exposure should result in a reduced risk of acquiring hepatitis and perhaps the acquired immune deficiency syndrome in patients with hemophilia A.
Association of use of a log book and experience as a preregistration house officer: interview survey
Authors: E. Paice, F. Moss, G. West, J. Grant
Journal: BMJ (1997)

To determine whether use of a log book improved the experiences of preregistration house officers.Confidential questionnaire and interview survey of preregistration house officers carried out as part of University of London inspection process.Preregistration house officers were asked to rate educational and pastoral elements of their posts and about the use made of previously distributed log books.Preregistration house officers in North Thames.The incumbents of 535 of 560 (95%) preregistration house officer posts in the region were surveyed between June 1994 and July 1995, 490 by questionnaire and interview, 45 by questionnaire alone. House officers who had discussed the log book with their consultant expressed more satisfaction with their induction, consultant supervision and feedback, and formal and informal education and were more likely to recommend their job to a friend.Preregistration house officers who had discussed the log book with their consultant expressed more satisfaction with the educational elements of their jobs. The structured discussion with their consultant about the job and their performance seemed to make the difference.
Biologic Response Modifiers in Primary Immunodeficiency Disorders
Authors: Avi Hassner, Daniel C. Adelman
Journal: Annals of Internal Medicine (1991)

Objective: To propose a new classification for the primary immunodeficiency disorders and to review potential therapeutic applications of biologic response modifiers in these disorders. Data Source: Relevant articles were identified through a search of MEDLINE using the following indexing terms: primary immunodeficiencies (and subclassifications), and human immunomodulators (and subclassifications). Study Selection: Articles were critically reviewed and included if relevant. Data Synthesis: The primary immunodeficiency disorders are classified according to functional abnormalities, specifically, abnormalities in early cellular maturation, differentiation, regulatory cell function, enzymatic function, and cytokine responses. Such a classification clarifies the potential role of biologic response modifiers in primary immunodeficiency disorders. Intravenous gammaglobulin and histamine-2 (H2)-receptor blockers modify regulatory cell function; retinoids modify abnormal cellular differentiation, gene transfer and enzyme replacement can be applied in disorders characterized by specific functional gene abnormalities; and interferons modify abnormal cytokine responses. Interleukin-2, thymic hormones, transfer factor, and levamisole appear to affect multiple functional defects. Conclusions: Biologic response modifiers are currently important ancillary tools in the treatment of immunodeficiency disorders, and their therapeutic role will become even more important in the future. Multicenter cooperative trials of new and existing agents are needed to fully define their roles and efficacy in the treatment of these disorders.
Hospital prices for outpatient services far exceed those of community providers, US study finds
Authors: M. McCarthy
Journal: BMJ (2014)

Prices charged by hospital outpatient departments for common imaging, colonoscopy, and laboratory services can be far higher than those charged by providers in the community, a new report has found.1

Researchers looked at private insurance claims of about 590 000 active and retired automobile workers and their dependants in 18 metropolitan areas. They found that hospital outpatient departments often charged at least twice what doctors and specialty clinics in the community charged for routine services.

For example, the researchers found that the average price charged by hospital outpatient …
Inhaled NO accelerates restoration of liver function in adults following orthotopic liver transplantation
Authors: John D. Lang, Xinjun Teng, Phillip Chumley, Jack H. Crawford, T. Scott Isbell, Balu K. Chacko, Yuliang Liu, Nirag Jhala, D. Ralph Crowe, Alvin B. Smith, Richard C. Cross, Luc Frenette, Eric E. Kelley, Diana W. Wilhite, Cheryl R. Hall, Grier P. Page, Michael B. Fallon, J. Steven Bynon, Devin E. Eckhoff, Rakesh P. Patel
Journal: Journal of Clinical Investigation (2007)

Ischemia/reperfusion (IR) injury in transplanted livers contributes to organ dysfunction and failure and is characterized in part by loss of NO bioavailability. Inhalation of NO is nontoxic and at high concentrations (80 ppm) inhibits IR injury in extrapulmonary tissues. In this prospective, blinded, placebo-controlled study, we evaluated the hypothesis that administration of inhaled NO (iNO; 80 ppm) to patients undergoing orthotopic liver transplantation inhibits hepatic IR injury, resulting in improved liver function. Patients were randomized to receive either placebo or iNO (n = 10 per group) during the operative period only. When results were adjusted for cold ischemia time and sex, iNO significantly decreased hospital length of stay, and evaluation of serum transaminases (alanine transaminase, aspartate aminotransferase) and coagulation times (prothrombin time, partial thromboplastin time) indicated that iNO improved the rate at which liver function was restored after transplantation. iNO did not significantly affect changes in inflammatory markers in liver tissue 1 hour after reperfusion but significantly lowered hepatocyte apoptosis. Evaluation of circulating NO metabolites indicated that the most likely candidate transducer of extrapulmonary effects of iNO was nitrite. In summary, this study supports the clinical use of iNO as an extrapulmonary therapeutic to improve organ function following transplantation.
Supraventricular Tachycardia: Mechanisms and Management
Authors: MARK E. JOSEPHSON
Journal: Annals of Internal Medicine (1977)

The phrase paroxysmal supraventricular tachycardia describes a group of arrhythmias with similar electrocardiographic features but different mechanisms that have been clarified in recent years with specialized intracardiac recording and pacing techniques. Reentry accounts for most cases and has been localized to the A-V node and less frequently to the sinus node, the atria themselves, and A-V nodal bypass tracts (Wolff-Parkinson-White syndrome). These forms of supraventricular tachycardia are initiated by premature beats that dissociate conduction between two pathways and permit the establishment of circulating electrical activity that spreads to atrial and ventricular myocardium. Paroxysms cease when the conducting properties of the reentrant circuits are disturbed by changes in autonomic tone or the application of certain drugs, pacing, or cardioversion. Supraventricular tachycardia may also result from abnormal automaticity in atrial tissues. Such automatic atrial tachycardias are often associated with A-V block ("paroxysmal atrial tachycardia with block") and may be due to digitalis intoxication. This arrhythmia is treated by withdrawal of digitalis or administration of antiarrhythmic drugs that decrease automaticity.