tbuckley/cabot-search huggingface dataset:
Rodent Ulcers: An Analysis of 711 Lesions Treated by Radiotherapy
Authors: I. Churchill-Davidson, E. Johnson
Journal: BMJ (1954)

Many papers have been published on the subject of rodent ulcers and their treatment by radiotherapy; in all those we have examined there is almost complete agreement on the excellent results produced, from the point of view of both cure and cosmetic appearance, in early lesions not previously treated. Some papers give no cure rate at all; others mention it in what can only be described as an expression of opinion, since it is unsupported by figures and at first sight these  cure  may appear unduly optimistic to a non-radio therapeutic eye. Finzi (1933), for example, stated:  the early stages, the method of radium treatment advised will cure 99% of cases. Windeyer (1951) said:  The great majority of all rodent ulcers occurring on the skin of the face or neck are treated by radiotherapy, and if they are still free from involvement of underlying bone or cartilage they are curable . . . to the order of 95% by this means. That there is justification for these high percentages is seen by a study of other works, which give figures showing clearly how the cure rate is arrived at. In 1935 Magnusson gave 93.3% + 2 as his highest estimated three-year cure rate for superficial lesions, using mainly radium. In 1946 Mustakallio's net three-year cure rate for superficial lesions less than 1 cm.2 was 97.8%, using both x rays and radium. Stanford Cade's (1952) three year cure rate for a series of Stage I (involving skin and subcutaneous tissue only) rodent ulcers treated from 1925 to 1937 was 98%, using radium only. The highest disease-free rate for Stage I basal-cell carcinomata men tioned by the National Radium Commission (1937-8) is 99%. It must be emphasized, however, that these cure rates refer to early lesions only and to treatment mainly by radium. The use of different methods of expressing results is one of the factors that make precise comparison of the above percentages very difficult. How much more diffi cult, then, is it to compare results of whole series, each of which is made up of lesions at all stages of develop ment. Although no attempt at comparison is made here, the results of three centres are shown in Table I, and readers are referred to the original works for further information. In stating the excellence of the results of radiothera peutic treatment of basal-cell carcinomata most papers lay emphasis on the part played by radium. It was therefore felt that the time had come to demonstrate the results of x-ray therapy and to show that equally satisfactory results could be obtained with suitable x ray techniques, which on the whole are easier to apply than radium and subject the patients to less inconveni TABLE I.-Results of Three Centres in the Treatment of Rodent Ulcers by Radiotherapy
Strontium-85 Scanning of Suspected Bone Disease
Authors: V. Parsons, M. Williams, D. Hill, P. Frost, A. Lapham
Journal: BMJ (1969)

Strontium-85 scanning of suspected bone lesions in 81 patients has added to the criteria for the diagnosis of malignant and other lesions of bone. Of 46 patients with a previous history of malignant disease and skeletal symptoms negative radiological findings were recorded in 19, but nine of these had positive scans, eight of which when followed up over periods of up to four years proved to be metastatic. A similar prevalence of positive scans occurred in patients without a previous history of malignancy. Because of the anatomical localization of lesions made possible by this technique a tissue diagnosis was made in six patients, while fields of radiotherapy were altered in another seven. This technique can improve the management of patients with suspected bone disease.
Increased Levothyroxine Requirements in Pregnancy — Why, When, and How Much?
Authors: Anthony Toft
Journal: New England Journal of Medicine (2004)

Those with sufficiently long memories must be somewhat bemused by the successive controversies surrounding the treatment of primary hypothyroidism, a condition viewed by many as simple, satisfying to manage, and very much within the purview of the primary care physician, rather than the specialist. The development of sensitive assays for measuring thyrotropin has led to a reduction in levothyroxine doses; in most patients, a dose of only 100 to 125 μg daily restores serum thyrotropin levels to the reference range, thereby satisfying the 1990 recommendations of the American Thyroid Association,1 which have since been reinforced.2 There is no consensus, however, . . .
A second look at efficacy criteria for onychomycosis: clinical and mycological cure
Authors: M. Ghannoum, N. Isham, V. Catalano
Journal: British Journal of Dermatology (2013)

Approval of topical onychomycosis drugs by regulatory agencies may be negatively impacted by an overly stringent definition of complete cure, which includes nail clearing plus mycological cure.In this position paper, we discuss interpretation of mycological outcome and clinical trial length.We reviewed data from seven international onychomycosis trials that enrolled subjects with positive KOH and dermatophyte-positive culture at screening followed by 48 weeks of treatment. Further, we examined 94 KOH-positive/culture-negative week 52 follow-up samples for morphological hyphal damage.From 3054 samples collected at week 52 follow-up visits, 2360 were culture-negative. However, a significant percentage (78.7%) of these subungual samples (n = 1857) remained KOH-positive. From the subset of follow-up samples examined for morphological changes, we identified hyphal breakage or distortion in 56 direct smears (60%), which may indicate nonviability.Reassessment of the definition of onychomycosis cure is critical. For clinical trials of topical agents, length of treatment should be re-examined. Further, in our experience, a high rate of subungual debris samples remained direct smear-positive while converting to negative culture. Evidence of morphological hyphal damage suggests that late-visit microscopic results may be false-positives. Therefore, the absence of clinical signs following an adequate washout period, coupled with a negative culture, with or without negative microscopy, should be considered the definition of onychomycosis cure.
Where shall John go? West Germany.
Authors: M Ball
Journal: BMJ (1977)

I myself came over for one or two years in 1971, partly out of interest, partly out of fairness to my German wife, and partly to enable our children to feel at home in both our cul tures. I certainly underestimated the difficulties and over estimated my own resilience and command of the German language. The first step-finding a job-was surprisingly, and perhaps deceptively, easy. An introduction to an anglophile German psychiatrist, kindly provided by Dr Winstanley of the Anglo-German Medical Society, led to my visiting several psychiatric hospitals and very soon being offered a junior post (that of Wissenschaftlicher Angestellter) in the Universitats Nervenklinik at Tubingen. At first this was on a temporary basis, the plan being that I should apply as soon as possible for a research grant-but, when my application failed, I was offered a long-term contract. This was a stroke of good fortune as the waiting list for junior training posts was, as is usual in university hospitals, a long one. A sense of moral obligation on the part of the professor was no doubt partly responsible, but I believe the high standing of British psychiatry and the friendly feelings of German doctors towards the British also played a part. I should, however, pass on a warning which several anglophile colleagues have given me: this friendliness may well go sour if the market is flooded with British graduates whose main reason for coming here is for material gain. There was a great deal of paperwork to be tackled before taking up work but, as that procedure is now out of date, with relief I can leave the details of this first encounter with German bureaucracy in my subconscious. The first few months were very hard. The German language, which in the mouths of my German colleagues sounded bewilderingly scientific and gave an impression of colossal diligence, was when I spoke it a sort of grotesque baby language. And the hierarchy, paternalistic though it was, increased my sense of inadequacy. Transfer after six months to a newly opened day clinic some way from the main hospital provided welcome relief and the chance of seeing how relaxed and pragmatic (how almost English ?) the younger generation of Germans can be. Speaking German had by then become relatively easy; writing it, on the other hand, was, for much longer, a fairly agonising experience.
Bottle or Breast Feeding of Infants
Authors: Thomas C. Washburn
Journal: JAMA (1974)

To the Editor.—  Breast feeding in human beings has been the subject of much controversy in the 20th century. Our rapid technological advances have enabled men and women to adapt their bodies and psyches to unusual, if not unnatural, situations. Only too often, we have lost connection with our usual and natural body/mind instincts and traits. We have seen this happen in the changeover from breast (natural) feeding to bottle (artificial) feeding. We have helped ourselves along this path of self-abnegation and self-destruction by heeding the high-powered advertising of commercial industries in many areas of our lives (eg, infant formulas, baby foods, dairy products, breads, cigarettes).  The time has almost elapsed for humanity to look hard at its self-destructive and wasteful habits and practices and policies. In the area of feeding human infants, we must change back to emphasis on breast feeding. I feel that the most important reason is
Insulin Action in AgRP-Expressing Neurons Is Required for Suppression of Hepatic Glucose Production
Authors: A. Christine Könner, Ruth Janoschek, Leona Plum, Sabine D. Jordan, Eva Rother, Xiaosong Ma, Chun Xu, Pablo Enriori, Brigitte Hampel, Gregory S. Barsh, C. Ronald Kahn, Michael A. Cowley, Frances M. Ashcroft, Jens C. Brüning
Journal: Cell Metabolism (2007)
Injections and physiotherapy for the painful stiff shoulder
Authors: B A Latham
Journal: Annals of the Rheumatic Diseases (1989)

<h3>Background</h3> In this study, we sought to evaluate the efficacy of inpatient interventions on hospitalization-related complications in patients with Parkinson disease (PD). Hospitalized patients with PD have an increased risk of complications. Although several interventions have been suggested in the literature, data-driven recommendations are limited. <h3>Methods</h3> This study was designed as a prospective cohort study. A hospital-wide alert system was incorporated into the electronic medical record (EMR) system. The alert was triggered when a patient with PD or on dopaminergic therapy was admitted prompting the inpatient pharmacy to confirm medication details. A warning was also triggered if antidopaminergic medications were ordered. In-services were performed for nursing staff and physicians regarding these measures. Charts of patients with PD admitted 6 months before and after the intervention were reviewed to serve as the 2 comparison groups. <h3>Results</h3> There were 73 patients (mean 73.2 years) preintervention group and 103 patients (mean 72.3 years) postintervention group. There were no significant differences in reasons for admission, admission to neurologic vs non-neurologic floor, or admitting service between the groups. The percentage of patients for whom contraindicated medications were ordered decreased from 42.5% to 17.5% (<i>p</i> &lt; 0.001). Medication administration with doses given over 30 minutes late decreased from 46% to 39% (<i>p</i> = 0.068). Medications ordered correctly were 42.9% vs 54.7% (<i>p</i> = 0.131) before and after the intervention. Length of stay was 5.3 vs 5.2 days (<i>p</i> = 0.896), and mean complications were 0.38 vs 0.37 (<i>p</i> = 0.864). <h3>Conclusion</h3> An intervention involving EMR alerts and in-service didactics for nurses and physicians decreased the frequency of contraindicated medications ordered in hospitalized patients with PD, but it did not change other hospital outcomes or complications.
PATHOPHYSIOLOGY OF ACUTE CORONARY SYNDROME IN HIV POSITIVE PATIENTS: INSIGHT FROM VIRTUAL HISTOLOGY ANALYSIS
Authors: Paolo Severino, Simone Calcagno, Gennaro Sardella, Gabriella d’Ettorre, Vincenzo Vullo, Alessandra Cinque, Nicolo’ Salvi, Pasqualina Bruno, Massimo Mancone, Francesco Fedele
Journal: Journal of the American College of Cardiology (2015)
Prescriber Education on Opioids
Authors: William C. Becker, David A. Fiellin
Journal: Annals of Internal Medicine (2012)

Letters18 December 2012Prescriber Education on OpioidsWilliam C. Becker, MD and David A. Fiellin, MDWilliam C. Becker, MDFrom Yale University School of Medicine, New Haven, CT 06520-8056.Search for more papers by this author and David A. Fiellin, MDFrom Yale University School of Medicine, New Haven, CT 06520-8056.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-12-201212180-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate Dr. Webster's points and agree that curbing abuse of, addiction to, and overdose deaths from prescription opioids and other controlled substances will require more than provider education. Regarding “pill mills”—a major focus of the Drug Enforcement Administration's efforts—anonymous tip lines have been established in counties with unusually high levels of opioid prescribing. The expansion of such programs should be considered (1). We have a professional and, in some states, a legally mandated duty to report unethical or frankly criminal activity (2).We agree that a national prescription monitoring program makes sense; overcoming logistical barriers to linking ...References1. Palm Beach County Substance Awareness Coalition. New Hotline to Report Pill Mills. 2011. Accessed at www.pbcsac.org/new-hotline-report-pill-mills on 7 September 2012. Google Scholar2. American Medical Association. American Medical Association Code of Ethics: Opinion 9.031-Reporting Impaired, Incompetent, or Unethical Colleagues. 1992. Accessed at www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion9031.page on 7 September 2012. Google Scholar3. Paulozzi LJ, Kilbourne EM, Desai HA. Prescription drug monitoring programs and death rates from drug overdose. Pain Med. 2011;12:747-54. [PMID: 21332934] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: William C. Becker, MD; David A. Fiellin, MDAffiliations: From Yale University School of Medicine, New Haven, CT 06520-8056.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-0251. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoFederal Plan for Prescriber Education on Opioids Misses Opportunities William C. Becker and David A. Fiellin Prescriber Education on Opioids James Webster Metrics 18 December 2012Volume 157, Issue 12Page: 917KeywordsConflicts of interestDisclosureDrug administrationDrug policyDrug regulationDrugsOpioid addictionOpioids ePublished: 18 December 2012 Issue Published: 18 December 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
«Feinhörigkeit»: anthropologische Überlegungen zu einem tiefenpsychologischen Postulat
Authors: P. Seidmann
Journal: Psychotherapy and Psychosomatics (1973)

'Sentient listening' for the unconscious repressed is, or ought to be, for every practical depth-psychologist, one of the essential working-instruments, independent of every school of thought. In 1926, Sigmund Freud was the first to recognize the necessity for 'sentient listening' as an analytic, hermeneutic skill. We are concerned here with the place of 'sentient listening' in the tension-field of depth-psychological practice and anthropological reflection. Proceeding from gnoseological considerations, the anthropological meaning of 'sentient listening' is developed.
Early control of severe unstable angina by high-dose intravenous isosorbide dinitrate boluses compared to sublingual sprays
Authors: Gad Cotter, Hedy Faibel, Paul Barash, Eyal Shemesh, Yaron Moshkovitz, Ahuva Golik, Zwi Schlezinger
Journal: Journal of the American College of Cardiology (1996)
Eating more fibre increases survival after myocardial infarction
Authors: Z. Kmietowicz
Journal: BMJ (2014)

People who have had a myocardial infarction (MI) live longer if they increase their intake of dietary fibre, a new study has found.

The researchers, based in Boston, Massachusetts, said that lifestyle advice for survivors of myocardial infarction tended to be overlooked but that this segment of the population was growing, was at higher risk of death than the general population, and was motivated to change its behaviour. 

One trial, the Diet and Reinfarction Trial (DART), has looked at fibre in MI survivors. It failed to show an effect and …
Wider use of colonoscopy could improve outcomes in bowel cancer
Authors: Zosia Kmietowicz
Journal: BMJ (2007)

Increasing the use of colonoscopy to investigate potential cases of bowel cancer could help to improve outcomes in people with the disease while also reducing costs, suggest the results of an economic modelling study.

The study, commissioned by the Department of Health, looked at the costs of different aspects of managing bowel cancer in England and also at how developing bowel cancer services in different ways could affect costs and benefits for patients. The findings will feed into a review of cancer services by the department. 

Bowel cancer is the third most common cancer in England; 27 800 new cases were diagnosed in …
Development, standardization, and evaluation of NOTES cholecystectomy using a transsigmoid approach in the porcine model: an acute feasibility study
Authors: A. Meining, D. Wilhelm, M. Burian, M. Dundoulakis, A. Schneider, S. von Delius, H. Feussner
Journal: Endoscopy (2007)

Transluminal cholecystectomy is feasible. However, the procedure is time consuming, difficult, and poorly standardized so far. In the present study we therefore aimed to further evaluate and optimize a transsigmoid approach for cholecystectomy with minimal transabdominal assistance in the porcine model.After a pilot series of 6 pigs, NOTES (natural-orifice transluminal endoscopic surgery) cholecystectomy was performed in a standardized manner in another 12 pigs. A transsigmoid approach was applied via a specially designed trocar (ISSA) with a double-channel gastroscope advanced into the peritoneal cavity. After identification of the infundibulum, the cystic duct and artery were closed by application of hemostasis clips. After dissection of these structures, the gallbladder was separated from the liver by electrocautery following injection of isotonic saline solution. A grasper introduced through a modified Veress needle (initially used for establishing the hydroperitoneum) and an additional transcutaneous stay suture were used to ease preparation of the gallbladder.Transluminal cholecystectomy was successfully performed in all animals. No serious acute complications occurred; minor bleeding in 4 out of 12 cases (1 cystic artery and 3 liver parenchyma) was successfully handled by electrocautery. Clip application to close the cystic duct and artery resulted in complete sealing. Standardization of the procedure was associated with a significant decrease in total operating time (113.3 +/- 31.8 minutes for the first 6 pigs and 73.6 +/- 17.2 minutes for the last 6 pigs).In pigs with a healthy gallbladder, our standardized technique of transsigmoid cholecystectomy could be performed relatively fast with acceptable complication rates at this level of evolution, as shown in these acute experiments.
Community Physician of the Future
Authors: A. B. Semple
Journal: BMJ (1970)

The problems of such pre-school children are being increasingly recognized, but there are still few well organized programmes of help.It says much for the perspicacity and drive of certain lay members of the Chelsea Group of Hospitals and of the South-west Metropolitan Regional Hospital Board that, despite formidable difficulties, a day as- sessment and treatment centre was established in Chelsea.The expanded centre has a flourishing existence and serves as a valuable model.It has not had the notice it deserves.Now at a time when the future of the
Dutch approve euthanasia for a patient with Alzheimer's disease
Authors: Tony Sheldon
Journal: BMJ (2005)

The Netherlands' first reported case of a doctor complying with a request for assisted suicide from a patient with Alzheimer's disease was lawful, a report has said.

The case was reported to the Netherlands' assessment committee system, which consists of five regional committees and checks whether doctors have followed the requirements of the law. If members of the relevant committee judge that the legal requirements have been met, they do not forward the case to the public prosecution service.

Committee …
The “Rationing” of Medical Care
Authors: Victor R. Fuchs
Journal: New England Journal of Medicine (1984)

“The United States will soon have to begin rationing medical care.” Although we hear this warning with increasing frequency,1 taken literally the statement is sheer nonsense. It is nonsense because the United States has always rationed medical care, just as every country always has and always will ration care. No nation is wealthy enough to supply all the care that is technically feasible and desirable; no nation can provide “presidential medicine” for all its citizens. Moreover, medical care is hardly unique in this respect. The United States “rations” automobiles, houses, restaurant meals — all the goods and services that make . . .
Carotid-Femoral Pulse Wave Velocity Is Associated With Cerebral White Matter Lesions in Type 2 Diabetes
Authors: Esben Laugesen, Pernille Høyem, Brian Stausbøl-Grøn, Anders Mikkelsen, Samuel Thrysøe, Mogens Erlandsen, Jens S. Christiansen, Søren T. Knudsen, Klavs W. Hansen, Won Y. Kim, Troels K. Hansen, Per L. Poulsen
Journal: Diabetes Care (2012)

Patients with type 2 diabetes have a high incidence of cardiovascular events including stroke. Increased arterial stiffness (AS) predicts cardiovascular events in the general population. Cerebral white matter lesions (WMLs) are associated with an increased risk of stroke. It is unknown whether AS in patients with type 2 diabetes is associated with WMLs.We examined 89 patients recently diagnosed with type 2 diabetes (<5 years) and 89 sex- and age-matched controls. AS was assessed with carotid-femoral pulse wave velocity (PWV). WMLs were identified using magnetic resonance imaging and graded qualitatively with the Breteler scale (no/slight changes = 0, moderate changes = 1, severe changes = 2) and semiquantitatively.The diabetic population had excellent glycemic control (HbA(1c), 6.5% [6.2-6.8]; median [interquartile range {IQR}]) and had, compared with the controls, lower office blood pressure (BP) (127 ± 12/79 ± 8 vs. 132 ± 14/84 ± 10 mmHg) and total cholesterol (4.3[3.9-4.7] vs. 5.6 [5.1-6.4]; mmol/L; median [IQR]), (P < 0.01 for all). Despite this, PWV was higher in the patients with diabetes compared with controls (9.3 ± 2.0 vs. 8.0 ± 1.6 m/s; P < 0.0001). PWV was associated with Breteler score (OR 1.36 [95% CI 1.17-1.58]; P < 0.001) and WML volume (OR 1.32 [95% CI 1.16-1.51]; P < 0.001) per 1 m/s increase in PWV. These associations remained significant when adjusted for age, sex, diabetes, 24-h mean arterial BP, BMI, heart rate, and use of antihypertensives and statins (Breteler score: OR 1.28 [95% CI 1.03-1.60]; P < 0.05 and WML volume: OR 1.30 [95% CI 1.06-1.58]; P < 0.05).PWV was higher among patients with well-controlled type 2 diabetes compared with controls and was independently associated with WMLs. PWV may represent a clinically relevant parameter in the evaluation of cerebrovascular disease risk in type 2 diabetes.