tbuckley/cabot-search huggingface dataset:
Variability In Little People
Authors: Lytt I. Gardner
Journal: JAMA (1969)

<h3>To the Editor:—</h3> Your editorial, "Big Variability in 'Little' People" (<b>209</b>: 411, 1969), raises some interesting points concerning the nosology of disease. As your discussion implies, increasing scientific information concerning dwarfism, chromosomal aberrations, and inborn errors of metabolism has resulted in what appears to be greater heterogeneity in the classification of the disease mechanisms in these patients. Our perception of disease is improved by new data derived from technological advances, and thus the state in question seems to exhibit greater "variability." This "variability" is a prelude to more precise (but more complex) classification. For some years in teaching I have used the condition of cretinism to exemplify this nosologic phenomenon. As the Figure shows, there has been a progressive heterogeneity in the classification of cretinism since the 18th century. With increasing scientific knowledge, the concept of cretinism has developed from the rather primitive notion of 1800 that the patients were
953-34 Pulmonary Vascular Endothelium is Capable of Producing Nitric Oxide After Cardiopulmonary Bypass and Circulatory Arrest
Authors: Paul M. Kirshbom, Steven S.L. Tsui, Louis R. DiBernardo, Jon N. Meliones, Debra A. Schwinn, Ross M. Ungerleider, J. William Gaynor
Journal: Journal of the American College of Cardiology (1995)
The use of a spectrophotometric intracutaneous analysis device in the real-time diagnosis of melanoma in the setting of a melanoma screening clinic
Authors: M.A. Haniffa, J.J. Lloyd, C.M. Lawrence
Journal: British Journal of Dermatology (2007)

Skin imaging devices to aid melanoma diagnosis have been developed in recent years but few have been assessed clinically.To investigate if a spectrophotometric skin imaging device, the SIAscope, could increase a dermatologist's ability to distinguish melanoma from nonmelanoma in a melanoma screening clinic.Eight hundred and eighty-one pigmented lesions from 860 patients were prospectively assessed clinically and with the aid of the spectrophotometric device by a dermatologist. Assessment before and after spectrophotometric imaging was made and compared with histology, where available, or with the clinical diagnosis of a dermatologist with 20 years of experience.One hundred and seventy-nine biopsies were performed, with 31 melanomas diagnosed. Sensitivity and specificity for melanoma diagnosis before and after spectrophotometry were 94% and 91% vs. 87% and 91%, respectively, with no significant difference in the area under the receiver operating characteristic curves (0.932 and 0.929).Our study provides no evidence for the use of SIAscope by dermatologists to help distinguish melanoma from benign lesions.
Gallium-67 Uptake in Cutaneous Lepromatous Lesions
Authors: MARIE PRIMEAU, LUCIE CARRIER, RAYMONDE CHATRAND, DANIEL PICARD, JEAN-MARC VERRAULT
Journal: Clinical Nuclear Medicine (1988)

Log in or Register Subscribe to journalSubscribe Get new issue alertsGet alerts Enter your Email address: Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. Subscribe to eTOC Secondary Logo Journal Logo All Articles Images Videos Podcasts Blogs Advanced Search Toggle navigation Subscribe Register Login Articles & Issues Current IssuePrevious IssuesPublished Online First Collections ACNM MeetingsCMECommunication in OrganizationCOVID-19Feedback and RewardsFrom the American College of Nuclear MedicineHighly Cited and Frequently Read ArticlesPlanning and Conducting Meetings EffectivelyQuality and Safety in Health CareRecruitment of New PhysiciansTips for Giving a Memorable PresentationTips for LeadersTips for Physicians in Getting the Right Job ACNM ArticlesACNM Website For Authors Submit a ManuscriptInformation for AuthorsLanguage Editing ServicesAuthor PermissionsLippincott&#174; Preprints Journal Info About the JournalEditorial BoardAdvertisingOpen AccessSubscription ServicesReprintsRights and Permissions All Articles Images Videos Podcasts Blogs Advanced Search
Using National Board of Medical Examiners Scores in Selection of Residents
Authors: Robert L. Volle
Journal: JAMA (1988)

Standardized tests were introduced to provide individuals with an opportunity to demonstrate some facets of academic achievement or clinical competence in a way that is fair to all. The broad use of examinations attests to their acceptance within our culture. Nevertheless, critics express valid concerns about examination bias (intended or not), the relationship between examination content and purpose, accessibility to or eligibility for the examination, and the inappropriate use of examination results. McCollister1writes about a perceived inappropriate use of National Board of Medical Examiners (NBME) examinations in the selection of residents, an issue of moment to the NBME.  See also p 240.  Certification by the NBME requires successful completion of a three-part examination, graduation from a school of medicine approved by the Liaison Committee on Medical Education (LCME), and satisfactory completion of one full year in an accredited graduate medical education program. Approximately 80% of the graduates of
Tyrphostin AG 556 improves survival and reduces multiorgan failure in canine Escherichia coli peritonitis.
Authors: J E Sevransky, G Shaked, A Novogrodsky, A Levitzki, A Gazit, A Hoffman, R J Elin, Z M Quezado, B D Freeman, P Q Eichacker, R L Danner, S M Banks, J Bacher, M L Thomas, C Natanson
Journal: Journal of Clinical Investigation (1997)

Tyrosine kinase-dependent cell signaling is postulated to be a pivotal control point in inflammatory responses initiated by bacterial products and TNF. Using a canine model of gram-negative septic shock, we investigated the effect of tyrosine kinase inhibitors (tyrphostins) on survival. Animals were infected intraperitoneally with Escherichia coli 0111: B4, and then, in a randomized, blinded fashion, were treated immediately with one of two tyrphostins, AG 556 (n = 40) or AG 126 (n = 10), or with control (n = 50), and followed for 28 d or until death. All animals received supplemental oxygen, fluids, and antibiotics. Tyrphostin AG 556 improved survival times when compared to controls (P = 0.05). During the first 48 h after infection, AG 556 also improved mean arterial pressure, left ventricular ejection fraction, cardiac output, oxygen delivery, and alveolar-arterial oxygen gradient compared to controls (all P < or = 0.05). These improvements in organ injury were significantly predictive of survival. Treatment with AG 556 had no effect on clearance of endotoxin or bacteria from the blood (both P = NS); however, AG 556 did significantly lower serum TNF levels (P = 0.03). These data are consistent with the conclusion that AG 556 prevented cytokine-induced multiorgan failure and death during septic shock by inhibiting cell-signaling pathways without impairing host defenses as determined by clearance of bacteria and endotoxin.
Peak inspiratory flow through Turbuhaler in acute asthma
Authors: PH Brown, AC Ning, AP Greening, A McLean, GK Crompton
Journal: European Respiratory Journal (1995)

Efficient use of dry powder inhalers, such as Turbuhaler, is dependent on the generation of adequate inspiratory flow. It is not clear whether patients with acute asthma are able to generate adequate flow. Peak inspiratory flow (PIF) was measured through an empty Turbuhaler, and without this device, in 99 adults presenting to hospital with acute exacerbations of asthma. Where possible, patients were studied prior to nebulized bronchodilator therapy. Mean (SD) forced expiratory volume in one second (FEV1) was 1.2 (0.7) L, forced vital capacity (FVC) 2.1(1.0) L and peak expiratory flow (PEF) 199 (92) L.min-1. PIF without Turbuhaler was 152 (77) L.min-1 and correlated with PEF (r = 0.69). PIF through Turbuhaler was 60 (20) L.min-1 and weakly correlated with PEF (r = 0.35), and with PIF without Turbuhaler (r = 0.43). Two patients failed to generate the minimum inspiratory flow (30 L.min) required for efficient use of Turbuhaler; both recorded 26 L.min-1. Acute asthma is associated with considerable inspiratory, as well as expiratory airflow limitation. The relationship between inspiratory and expiratory airflow is not strong enough to predict whether patients with severe acute asthma will have difficulty using dry powder inhalers efficiently. Despite this, 98% of patients in this study generated inspiratory flow through Turbuhaler which would allow a therapeutically active amount of bronchodilator drug to be delivered to the airways.
Role of MRI in diagnosing multiple sclerosis: Magnetic resonance imaging is valuable
Authors: David H Miller
Journal: BMJ (2006)

New UK policy on overseas doctorsWhat future for international medical graduates in the NHS?Editor-Of 449 applications for six posts on our basic surgical training scheme which started in August 2005, 78% graduated from non-European Union (EU) countries, 61% coming from India.In all, 276 doctors from India applied for a place on a scheme in a district hospital.Anecdotal evidence suggests that only a small proportion of them gained positions on official training programmes (one to our rotation).Many of the rest will have "settled" for trust grade or staff grade posts, while many others will have been trapped in financially unrewarding clinical assistantships.Those in trust grade posts make a significant contribution to the overall medical staffing in the NHS.It remains unclear how this gap will be filled.There will not be sufficient numbers of UK graduates willing and able to fill such service posts.In our study only 6% of applicants came from non-UK EU countries.At this time of crisis 1 the General Medical Council continues to hold Professional and Linguistic Assessments Board (PLAB) examinations in India, Africa, and other countries.This practice constitutes an indirect invitation by the GMC to come to work in the UK.Instead, these young doctors should be fully appraised of the new regulations and discouraged from coming, except in extraordinary circumstances of specific manpower shortages.
The Argon Laser for Cutaneous Lesions
Authors: David B. Apfelberg
Journal: JAMA (1981)

A summary of the pathophysiology and clinical use of the argon laser in the treatment of cutaneous lesions is presented. The nonionizing blue-green argon laser light is absorbed by pigment, is converted to heat, and selectively destroys specific cutaneous lesions with sparing of adjacent dermal appendages and healing of the laser wound with minimal scarring. Vascular lesions (port wine hemangioma, capillary-cavernous hemangioma, telangiectasia), inflammatory lesions (pyogenic granuloma), nevoid lesions, tattoo lesions, and a variety of miscellaneous lesions have been successfully treated.
Spectrum of Adrenal Dysfunction in Patients with Acquired Immunodeficiency Syndrome
Authors: Pamela U Freda, Anastasios D Papadopoulos, Sharon L Wardlaw, Robin S Goland
Journal: Trends in Endocrinology and Metabolism (1997)

<h2>Abstract</h2> <i>Patients with acquired immunodeficiency syndrome (AIDS) have been reported to develop abnormalities of the endocrine system and in particular of the hypothalamic-pituitary-adrenal (HPA) axis. To define the abnormalities of HPA function in AIDS patients better, we performed ACTH and ovine corticotropin-releasing hormone (oCRH) testing in a group of AIDS patients and oCRH testing in a group of healthy subjects. Our study found that in AIDS patients with normal ACTH testing, oCRH testing revealed a variety of subclinical abnormalities of ACTH and cortisol responses. Although we did not find frank adrenal insufficiency in any of these AIDS patients, it remains to be determined if any of the subclinical abnormalities we identified are predictive of clinically significant adrenal insufficiency; it may be that as AIDS patients live longer, the subclinical abnormalities will progress to adrenal insufficiency</i>. (Trends Endocrinol Metab 1997;8:173–180). © <i>1997, Elsevier Science Inc.</i>
Who Should Do Gastrointestinal Endoscopy?-Reply
Authors: Melvin Schapiro
Journal: JAMA (1981)

In Reply.—  The COMMENTARY Who Should Be Doing Gastrointestinal Endoscopy? was intended to address the problem of untrained persons attempting fiberoptic endoscopy on patients when expertise is available. The value of flexible sigmoidoscopy as a screening tool for colon cancer is not disputed. However, this half-a-loaf procedure (flexible fiberoptic sigmoidoscopy) 1,2 may lead to inadequate examinations when the need for total colonoscopy exists.  Drs Felmar and Rodney agree that teaching the procedure is appropriate. The basic question concerns who should do flexible sigmoidoscopy. It should not be assumed that proficiency at rigid sigmoidoscopy implies competency to perform flexible sigmoidoscopy. It is not appropriate, therefore, to attempt flexible sigmoidoscopy without first obtaining training and demonstrating competency in the performance of the procedure. The training required to perform short colonoscopy with the 60-cm instrument may be less than that required for total colonoscopy, though the negotiation of the sigmoid-descending colon junction is
Hypolipidemic Drugs in Coronary Artery Disease
Authors: George B. Bittar
Journal: Annals of Internal Medicine (1997)

Letters1 June 1997Hypolipidemic Drugs in Coronary Artery DiseaseGeorge B. Bittar, MDGeorge B. Bittar, MDNasser Smith Pinkerton Cardiology, Inc., Terre Haute, IN 47802Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-11-199706010-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I read with interest the article by Pasternak and colleagues on behalf of the Harvard Atherosclerosis Reversibility Project (HARP) Study Group [1]. I was disappointed in the authors' discussion of the article by Stein and colleagues [2], which compared simvastatin with cholestyramine. Pasternak and coworkers stated that combination therapy with simvastatin and cholestyramine decreased total and LDL cholesterol levels by only 15% and 21%, respectively. In fact, these numbers were related to the reduction induced only by the cholestyramine resin; simvastatin alone in dosages of 20 mg/d and 40 mg/d reduced the total cholesterol level by 26% ...References1. Pasternak CR, Brown LE, Stone PH, Silverman DI, Gibson MC, Sacks FM. Effects of combination therapy with lipid-reducing drugs in patients with coronary heart disease and “normal” cholesterol levels. A randomized, placebo-controlled trial. The Harvard Atherosclerosis Reversibility Project (HARP) Study Group. Ann Intern Med. 1996; 125:529-40. Google Scholar2. Stein E, Kreisberg R, Miller V, Mantell G, Washington L, Shapiro DR. Effects of simvastatin and cholestyramine in familial and nonfamilial hypercholesterolemia. Multicenter Group I. Arch Intern Med. 1990; 150:341-5. Google Scholar Author, Article, and Disclosure InformationAffiliations: Nasser Smith Pinkerton Cardiology, Inc., Terre Haute, IN 47802 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1997Volume 126, Issue 11Page: 916-917KeywordsAtherosclerosisCholesterolDrugsLow density lipoproteinStable coronary artery disease Issue Published: 1 June 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Disseminated Tuberculosis of Bone: Report of Two Cases
Authors: Y. K. Seedat, S. M. Wolpert
Journal: BMJ (1965)

Widely disseminated tuberculosis of bone is a rare condition which may easily be mistaken for other conditions.Golding (1939), in a review of bone tuberculosis in Britain, did not describe any such cases, and only two references (Alexander and Mansuy, 1950 ; Jacobs, 1964) have been discovered in the English literature during the past 20 years.This paper describes two further cases seen within nine months at this hospital. CASE 1An African woman aged 30 was admitted to hospital with a history of pain in the left side of the chest and swellings in the left pectoral region and left upper arm for one month, together with severe pain in the back on sitting up.She was weak, febrile, and toxic.A fluctuant swelling 2 in.(5 cm.) in diameter was present over the sixth rib in the left mid-clavicular line and another swelling about 3 by 2 in.(7.5 by 5 cm.) in the left triceps area ; sternal tenderness was present.
Acinar-to-ductal metaplasia in pancreatic cancer development
Authors: Roland M. Schmid
Journal: Journal of Clinical Investigation (2002)

Ductal adenocarcinoma is by far the most frequent tumor of the pancreas.Although pancreatic cancer cells share substantial characteristics with pancreatic duct cells, the origin of these cancer cells is still a matter of debate.Progressive changes in the ductal epithelium range from non-papillary to papillary hyperplasia, with little or no development of atypical or dysplastic epithelial lesions.These ductal changes have been classified as "pancreatic intraepithelial neoplasia" (PanIN) (1).Studies examining the loss of heterozygosity at loci associated with pancreatic cancer have demonstrated the clonal evolution of the regions of PanINs (2).Some have proposed that pancreatic cancer develops from acinar cells, and indeed, acinar cell hyperplasia has been described in the human pancreas (3).Moreover, in TGF-α transgenic mice, an animal model for pancreatic cancer, acinar cells are the primary sites of pancreatic neoplasms (4).In this model, acinar cells lose their characteristic zymogen granules and become transitional cells, which subsequently acquire the features of duct cells.In animals older than one year, tumors develop from acinar-to-ductal metaplasia.In this issue of the JCI, Crawford et al. present data linking the development of acinar-to-ductal metaplasia to expression of the matrix metalloproteinase MMP-7 and the Fas ligand FasL (5).They found MMP-7 to be upregulated in human pancreatic cancer and PanINs, in metaplastic ducts of TGFα transgenic mice, and in metaplastic changes following pancreatic ductal ligation.Following up on this observation, Crawford and colleagues ligated the ducts of control and MMP-7 -/- mice.Remarkably, they observed acinar cell loss, caspase-3 activation, and subsequent metaplastic conversion in wild-type mice, but almost no such responses in the mutants.
Ability of Rabeprazole to Prevent Gastric Mucosal Damage From Clopidogrel and Low Doses of Aspirin Depends on CYP2C19 Genotype
Authors: Takahiro Uotani, Mitsushige Sugimoto, Masafumi Nishino, Chise Kodaira, Mihoko Yamade, Shu Sahara, Takanori Yamada, Satoshi Osawa, Ken Sugimoto, Tatsuo Tanaka, Kazuo Umemura, Hiroshi Watanabe, Hiroaki Miyajima, Takahisa Furuta
Journal: Clinical Gastroenterology and Hepatology (2012)
Response-guided peg-interferon plus ribavirin treatment duration in chronic hepatitis C: Meta-analyses of randomized, controlled trials and implications for the future
Authors: Vincent Di Martino, Carine Richou, Jean-Paul Cervoni, Jose M. Sanchez-Tapias, Donald M. Jensen, Alessandra Mangia, Maria Buti, Frances Sheppard, Peter Ferenci, Thierry Thévenot
Journal: Hepatology (2011)

Response-guided pegylated interferon (peg-IFN) plus ribavirin (P/R) therapy trials on genotype (G)1 and G2/G3 hepatitis C virus–infected patients provide contradictory results. We conducted meta-analyses of randomized, controlled trials to address (1) the benefit of a 72-week extended-duration therapy in G1-slow responders and (2) adequate shortened duration therapy in G1 and G2/G3-rapid responders. Seventeen trials were selected, including 624 G1 rapid responders, 570 G1 slow responders, and 2,062 G2/G3 rapid responders. Virologic outcomes and treatment discontinuation data were collected from published articles and by asking investigators. Pooled estimates of sustained virologic response (SVR), relapse, and dropouts were calculated using the random effects model, considering the variability of shortened duration, ribavirin dose, genotype, and baseline viral load. In G1 slow responders, a 72-week extended duration increased SVR (+10.7%; 95% CI [confidence interval]: +4.4% to + 17.1%), decreased relapse (−12.3%; 95% CI: −25.4% to 0%), and did not significantly increase drop-out rates (+4.5%; 95% CI: −0.6% to + 9.6%). The benefit of extended duration was lower when using a weight-based ribavirin regimen (+8.7%; 95% CI: +1.7% to + 15.8%). In G1 rapid responders, a 24-week shortened duration decreased SVR (−12.5%; 95% CI: −19.2% to −5.8%) and increased relapse rates (+8.8%; 95% CI: +2.9% to + 14.8%). Such differences were not significant in patients with baseline viral load <400,000 UL/mL (−4.4%; 95% CI: −9.8% to + 1%). In G2/G3 rapid responders, SVR was more common for standard 24-week duration than for shortened durations (+4.1%; 95% CI: +0.1% to + 8.5), but this benefit was not significant when ribavirin was weight-adjusted and the short duration was 16 weeks (−1.7%; 95% CI: −6.1% to + 2.7%) and for G2 patients (+1.6%; 95% CI: −0.2% to + 5.5%). Conclusion: Long durations of P/R therapy improve SVR, regardless of genotype. This effect is nonetheless negligible in rapid responders, with the most favorable conditions for SVR (G2, G1 with low viral load, and G3 with weight-adjusted ribavirin regimen). (HEPATOLOGY 2011;)
P103 SUCCESSFUL CRYOPRESERVATION OF HUMAN BILIARY TREE STEM/PROGENITOR CELLS (hbTSCS) ISOLATED FROM ADULT LIVER BASED ON GOOD MANUFACTURING PRACTICE
Authors: V. Cardinale, R. Gentile, L. Nevi, A. Fraveto, G. Carpino, A. Torrice, V. Pasqualino, F. Melandro, G. Mennini, F. Nudo, M. Rossi, P.B. Berloco, A. Cantafora, L. Reid, E. Gaudio, D. Alvaro
Journal: Journal of Hepatology (2014)
Case of Death by Lightning
Authors: A. V. Dill
Journal: BMJ (1942)

<h3>Background</h3> Obesity and gestational diabetes mellitus (GDM) increase the morbidity of the mother and newborn, which could increase further should they coexist. We aimed to determine the risk of adverse pregnancy and neonatal outcomes associated with excess weight (EW), and within this group identify potential differences between those with and without GDM. <h3>Methods</h3> We carried out a post-hoc analysis of the St. Carlos Gestational Study which included 3312 pregnant women, arranged in 3 groups: normal-weight women (NWw) (2398/72.4%), overweight women (OWw) (649/19.6%) and obese women (OBw) (265/8%). OWw and OBw were grouped as EW women (EWw). We analyzed variables related to adverse pregnancy and neonatal outcomes. <h3>Results</h3> The relative risk (95% CI) for GDM was 1.82 (1.47 to 2.25; p&lt;0.0001) for OWw, and 3.26 (2.45 to 4.35; p&lt;0.0001) in OBw. Univariate analysis showed associations of EW to higher rates of prematurity, birth weight &gt;90th centile, newborns admitted to neonatal intensive care unit (NICU), instrumental delivery and cesarean delivery (all p&lt;0.005). Multivariate analysis, adjusted for parity and ethnicity, showed that EW increased the risk of prematurity, admission to NICU, cesarean and instrumental delivery, especially in EWw without GDM. NWw with GDM had a significantly lower risk of admission to NICU and cesarean delivery, compared with NWw without GDM. <h3>Conclusions</h3> EW is detrimental for pregnancy and neonatal outcomes, and treatment of GDM contributes to lowering the risk in EWw and NWw. Applying the same lifestyle changes to all pregnant women, independent of their weight or GDM condition, could improve these outcomes.