tbuckley/cabot-search huggingface dataset:
Improvement of malignant/benign ratio in excised melanocytic lesions in the 'dermoscopy era': a retrospective study 1997-2001
Authors: P. Carli, V. De Giorgi, E. Crocetti, F. Mannone, D. Massi, A. Chiarugi, B. Giannotti
Journal: British Journal of Dermatology (2004)

Background Because of the many limitations of studies based on the diagnostic setting of excised lesions, the impact of dermoscopy (epiluminescence microscopy, dermatoscopy) in melanoma screening during practice remains to be established. Objectives We assumed that effects of the use of dermoscopy on some indicators of diagnostic performance in melanoma screening should be traceable retrospectively; therefore, we analysed the impact of routine dermoscopy use on the malignant/benign ratio in excised melanocytic lesions. Methods Preoperative and histological diagnosis of 3053 melanocytic lesions [319 melanomas (10·4%)] consecutively diagnosed and excised at the Department of Dermatology, University of Florence in the period 1997–2001 inclusive were retrieved. Six dermatologists who selected the lesions to excise and who performed preoperative diagnosis were divided into two groups according to their use of dermoscopy in routine activity (n = 2 dermoscopy users and n = 4 nonusers). The study period was divided into a predermoscopy period (1997), a shift phase (1998) and a dermoscopy period (1999–2001). Results During the study period, the malignant/benign ratio improved in dermoscopy users only (from 1 : 18 to 1 : 4·3, P = 0·037). No significant difference was found for nonusers (from 1 : 11·8 to 1 : 14·4). Dermoscopy users were more likely to have a melanoma diagnosed within a series of excised lesions than nonusers, even taking into account potential confounders such as sex, age and study period by means of multivariate analysis (odds ratio 1·55, 95% confidence interval 1·17–2·01). The percentage of 'problem' naevi (naevi with architectural disorder with or without cytological atypia and Spitz or Reed naevi) over the total number of excised lesions was higher in dermoscopy users than in nonusers (year 2001, 51·6% vs. 40·9%, P = 0·014). Similar findings were obtained after exclusion from the data set of lesions excised for cosmetic reasons. Conclusions The adoption of dermoscopy in routine melanoma screening is followed by an improvement of the malignant/benign ratio in excised lesions, suggesting a more appropriate selection of pigmented lesions referred to surgery. Because of the possible limitations of a retrospective study design, future confirmation of this finding by means of a prospective, randomized study is advisable. The introduction of dermoscopy in routine practice may have major implications in large‐scale melanoma screening with cost savings and a reduction of the dermosurgery workload.
Affected sib-pair and mutation analyses of the high affinity IgE receptor beta chain locus in Italian families with atopic asthmatic children.
Authors: L C Martinati, E Trabetti, A Casartelli, A L Boner, P F Pignatti
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

Previous studies reported linkage between maternally inherited atopy and the beta subunit of the high affinity IgE receptor (Fc epsilon RI-beta) located on chromosome 11q13. We have investigated 45 Italian families with atopic asthmatic children, for a total of 213 subjects, including 148 patients. Genotyping was carried out with two microsatellite DNA markers: one (Fc epsilon RI-beta CA) located inside the gene, and one (CI11-319 CA) closely linked to it. Affected sib-pair analysis in families with several affected children indicated 128 pairs in which either both markers were informative. An excess of maternal allele sharing was observed, although not significant. The allele-specific DNA amplification test for the FcRI-beta Ile181Leu mutation, described previously in 17% of atopic English families by Shirakawa and coworkers, was negative in all our families, as well as in 42 Italian children with atopic asthma and without family histories of the disease.
A NEW OPERATION FOR SLIPPING PATELLA
Authors: Robert Soutter
Journal: JAMA (1924)

An extreme case of slipping patella was observed in the Children's Hospital, in a girl aged about 9 years, with a double congenital dislocation of the patella gradually increasing in laxity. The ordinary methods of treatment did not seem appropriate or adequate. The left patella constantly and without warning would dislocate over the external condyle, causing the child to fall without warning. The action of the quadriceps was uncertain, and walking was not sure. The child was healthy and normal. Examination of the legs showed good muscle tone and normal range of motion of the hips, knees and feet. Everything was normal except for the knees. One was impressed with four things: (1) the looseness of the patellar ligament and all the tissues to the inner side of the patella; (2)the ease with which the patella could be placed over to the outer side, so far over that the internal
Primary intestinal autoimmune disease as a cause of chronic intestinal pseudo-obstruction
Authors: S Ghirardo
Journal: Gut (2005)

Management of acute pancreatitisNo account of the complications of acute pancreatitis (Gut 2005;54:426-36) would be complete without mention of diabetic ketoacidosis as an association, which is either fortuitous or one which exists as a complication in its own right.Recognition of this association has been inhibited by the complicated relationship between diabetic ketoacidosis, acute abdominal pain, and hyperamylassaemia, notwithstanding the
Public health benefits of strategies to reduce greenhouse-gas emissions: overview and implications for policy makers
Authors: Andy Haines, Anthony J McMichael, Kirk R Smith, Ian Roberts, James Woodcock, Anil Markandya, Ben G Armstrong, Diarmid Campbell-Lendrum, Alan D Dangour, Michael Davies, Nigel Bruce, Cathryn Tonne, Mark Barrett, Paul Wilkinson
Journal: The Lancet (2009)
TCT-33 Large Versus Standard Thromboaspiration Device Comparison in Patients Undergoing Primary Percutaneous Coronary Intervention
Authors: Fernando Rivero-Crespo, Jorge-Andrés Restrepo, Javier Cuesta, Teresa Bastante-Valiente, Amparo Benedicto, Guillermo Diego-Nieto, Fernando Alfonso
Journal: Journal of the American College of Cardiology (2014)
Relief of pain by infusion of morphine after operation
Authors: H J McQuay, R A Moore
Journal: BMJ (1985)

increased incidence of nausea and vomiting was during the first or second 24 hour period.In either casc higher peak blood morphine concentrations would have been experienced by the infusion group, so this finding is not unexpected.We feel that this study has given a false impression of the technique of continuous opiate analgesia.
Requirement of Board Certification
Authors: Fred Lathrop
Journal: JAMA (1978)

To the Editor.—  The article by Levit and Holden of the National Board of Medical Examiners (239:407, 1978) emphasizes how more and more physicians are becoming board-certified without any legal or legislative requirements.  The board of governors of Muhlenberg Hospital in Plainfield, NJ, have specified that board certification is a requirement to be on the medical staff of Muhlenberg. If this is a nationwide tendency, then there is indeed a legislative (or is the word governatorial) requirement and inducement for practicing physicians to obtain board certification.
Website of the week: Infant sleep
Authors: A. Ellis
Journal: BMJ (2002)

My mother has told me once or twice that I was a “difficult baby.” As Hiscock and Wake say in this week's BMJ (p 1062), babies who don't sleep through the night can leave their mothers with postnatal depression.

When it comes to pregnancy and parenting, magazines, television programmes, and well meaning friends and family automatically feel it their duty to tell you that you are doing it all wrong. Add the internet to all this and you have information overload. And there is a lot of rubbish out there.

The latest big issue in the baby world is “co-sleeping”—babies sleeping with their parents in the same bed. Natural Parenting UK (www.natural-parenting.com) is very emotive, heading its co-sleeping page: “We are the only mammals that push our babies out of the ‘nest’ at birth.” I laughed out loud at www.littlekoala.com/familybed.html as the “local expert” carefully weighs up most of the pros and a few of the cons of co-sleeping, concluding that it is safe but not before putting a whopping disclaimer that he accepts no responsibility and advising that you seek medical advice.

But what if you are the medical advice? Easy enough for those who have children, but not for those who don't. Concise, gentle advice can be found at www.health.state.ok.us/program/mchecd/infsleep.html and equally rational but more comprehensive is www.ivillage.co.uk/pregnancyandbaby/baby/sleepbaby/articles/0,9547,27_167511,00.html

www.isisweb.org/icis2000program/web_pages/group330.html presents the evidence. The site is wordy and wouldn't be the most parent friendly site in the world, but it is good for facts.

There are sensible, downloadable parent guides at the Australian based Child and Youth Health (www.cyh.com/cyh/parentopics/usr_index0.stm?topic_id=269). These are free and cover a broad range of information. Sleepnet.com is a good general sleeping site (although I did its sleep questionnaire and it told me I had sleep apnoea). And Babyworld (www.babyworld.co.uk) has some balanced advice—if you can fight your way through the advertising.

My favourite site was Family and Children's Services, another Australian site. Its advice on infant sleeping (www.fcs.wa.gov.au/_content/parenting_information/lws/baby-19.html) seemed sensible and non-inflammatory, and the site had a strangely calming layout, with a picture of a baby yawning.
Phosphodiesterase inhibitors for the treatment of pulmonary hypertension
Authors: M. R. Wilkins, J. Wharton, F. Grimminger, H. A. Ghofrani
Journal: European Respiratory Journal (2008)

The pulmonary vascular bed is both a source of and target for a number of vasoactive factors. Among the most important for pulmonary vascular homeostasis are factors that utilise cyclic guanosine monophosphate (cGMP) as an intracellular second messenger. These include nitric oxide and the natriuretic peptide family (atrial, brain and C-type natriuretic peptides). In the search for therapeutic strategies that engage the cGMP signalling pathway for the treatment of pulmonary arterial hypertension (PAH), inhibition of cGMP metabolism by phosphodiesterase type 5 (PDE5)-targeted compounds has proven most successful to date. One PDE5 inhibitor, sildenafil, has been shown to improve pulmonary haemodynamics and exercise capacity in patients with PAH and is now an approved treatment. Others are under investigation. An interesting, although still tentative, observation is the potential of sildenafil to reduce pulmonary vascular resistance without adversely affecting ventilation–perfusion matching. Another is the expression of phosphodiesterase type 5 in the hypertrophied right ventricle. These data suggest that phosphodiesterase type 5 inhibitors may have effects that distinguish them from other treatments for pulmonary hypertension and merit further study.
Abstract 4805: Carcinogenesis by stem cell misplacement–a novel cancer theory and its implications
Authors: Rui-An Wang
Journal: Cancer Research (2014)

Abstract For rather a long period of time, it has been widely accepted that cancer was caused by gene mutations which is termed somatic mutation theory (SMT). But now the SMT theory has met with increasing doubts, disbelieves, and been facing challenges from other alternative theories. I here from a pathological perspective, and with the evidences from molecular pathology, hisopathology, and epidemiology, show that the 80 year old paradigm of carcinogenesis process from atypia to in situ carcinoma to invasive cancer is wrong. Since 90% of the human cancers are epithelially derived “carcinomas”, the turnover of this paradigm naturally negates the SMT theory for SMT sits on this model. The invasive cancer grows out in the stroma de novo from misplaced stem cells rather than deriving from the transformed in situ carcinoma cells. Also, I will show evidences that cancer cells are not so-believed “apoptosis-resistant”, but rather “short-lived sick cells”. In fact, it is the increased cell death which makes the cancer cells proliferate ceaselessly to compensate for the cell loss, and move to new locations for better chance of survival. I design this novel cancer theory as SCMT, stem cell misplacement theory. This theory is backed by huge amount of solid evidences and will bring revolutionary conceptual changes to our understanding and treatment of cancer, e.g., in situ carcinomas are not genuine cancer biologically, thus should not be treated the same as cancer. Citation Format: Rui-An Wang. Carcinogenesis by stem cell misplacement–a novel cancer theory and its implications. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4805. doi:10.1158/1538-7445.AM2014-4805
Primary-Care Education in Multiple Specialties
Authors: Jack M. Colwill
Journal: New England Journal of Medicine (1978)

Views of primary-care education are somewhat analogous to the old fable about three blind men and an elephant. Each blind man, when asked, gave a very different description of the elephant — an accurate description reflecting his area of contact. In this analogy, the blind men can be construed to be family medicine, general internal medicine and general pediatrics. The elephant, an animal of potentially enormous proportions, is primary-care education. There also is a fourth blind man — a man of lesser stature — who is too far removed to touch the animal directly. That man is the medical student . . .
The Use of Blood in Massachusetts Hospitals
Authors: Mark Falcon Lesses, Huston J. Banton
Journal: New England Journal of Medicine (1955)

THE demand for human blood for therapeutic purposes in Massachusetts has nearly trebled during the past seven years, as indicated by the data reported below.In 1947 Moore, Edsall and Getting1 described the use of blood before the inception of the present cooperative effort by the hospitals and the American Red Cross to supply blood needs within the Commonwealth. To a survey questionnaire 94 Massachusetts hospitals replied in 1944, and 78 in 1947. This survey showed the 1947 use of blood to be 3.4 pints per hospital bed per year (an estimated total of 40,000 pints). Through the combined efforts . . .
Pancreatic Cancer: An Epidemiologic Approach and Model
Authors: Nathaniel I. Berlin
Journal: JAMA (1981)

ABSTRACT In recent years there has been a rapid increase in pancreatic cancer. One method of searching for clues to the causes of cancer is the case-controlled epidemiologic survey. Investigators ask patients with a particular disease questions about their family and personal history, education, occupation, and medical history and ask the same questions of persons without the disease. Computers are programmed to store the data, search for differences in the patient and control group, and calculate the probability that the observed differences are due to chance. Such studies are successful only if the control group is chosen properly and the questions asked include some that ultimately prove relevant to the causes of the disease.By such a method, Lin and Kessler (p 147) have identified several factors that may cause pancreatic cancer, and some of these seem to be different in men than in women. They created a model for estimating
Pseudolipoma of the breast: a mask for cancer.
Authors: H. S. Shucksmith, J. A. Dossett
Journal: BMJ (1965)

Dunlop, G. R., and Santos, R. (1957). New Engl. J. Med., 256, 577. Haimovici, H., Shapiro, J. H., and Jacobson, H. G. (1960). Amer. J. Roentgenol., 83, 1042. Leriche, R., and Bertrand, I. (1946). Thromboses art?rielles. Masson, Paris. Lindbom, A. (1950). Acta radial. (Stockh.), suppl. No. 80. Martin, P. (1958). Angiology, 9, 349. Mavor, G. E. (1958). J. roy. Coll. Surg. Edlnb., 3, 264. Palma, E. C. (1959). Angiology, 10, 134. Robertson, J. H. (1960). J. clin. Path., 13, 199. Singer, A. (1963). Arch. Surg., 87, 384. Texon, M., Imparato, A. M., and Lord, J. W. (1960). Ibid., 80, 47. Winternitz, M. C, Thomas, R. M., and LeCompte, P. M. (1938). The Biology of Arteriosclerosis. Thomas, Springfield.
A Multicenter Risk Index for Atrial Fibrillation After Cardiac Surgery
Authors: Joseph P. Mathew
Journal: JAMA (2004)

Atrial fibrillation is a common, but potentially preventable, complication following coronary artery bypass graft (CABG) surgery.To assess the nature and consequences of atrial fibrillation after CABG surgery and to develop a comprehensive risk index that can better identify patients at risk for atrial fibrillation.Prospective observational study of 4657 patients undergoing CABG surgery between November 1996 and June 2000 at 70 centers located within 17 countries, selected using a systematic sampling technique. From a derivation cohort of 3093 patients, associations between predictor variables and postoperative atrial fibrillation were identified to develop a risk model, which was assessed in a validation cohort of 1564 patients.New-onset atrial fibrillation after CABG surgery.A total of 1503 patients (32.3%) developed atrial fibrillation after CABG surgery. Postoperative atrial fibrillation was associated with subsequent greater resource use as well as with cognitive changes, renal dysfunction, and infection. Among patients in the derivation cohort, risk factors associated with atrial fibrillation were advanced age (odds ratio [OR] for 10-year increase, 1.75; 95% confidence interval [CI], 1.59-1.93); history of atrial fibrillation (OR, 2.11; 95% CI, 1.57-2.85) or chronic obstructive pulmonary disease (OR, 1.43; 95% CI, 1.09-1.87); valve surgery (OR, 1.74; 95% CI, 1.31-2.32); and postoperative withdrawal of a beta-blocker (OR, 1.91; 95% CI, 1.52-2.40) or an angiotensin-converting enzyme (ACE) inhibitor (OR 1.69; 95% CI, 1.38-2.08). Conversely, reduced risk was associated with postoperative administration of beta-blockers (OR, 0.32; 95% CI, 0.22-0.46), ACE inhibitors (OR, 0.62; 95% CI, 0.48-0.79), potassium supplementation (OR, 0.53; 95% CI, 0.42-0.68), and nonsteroidal anti-inflammatory drugs (OR, 0.49; 95% CI, 0.40-0.60). The resulting multivariable risk index had adequate discriminative power with an area under the receiver operating characteristic (ROC) curve of 0.77 in the validation sample. Forty-three percent (640/1503) of patients who had atrial fibrillation after CABG surgery experienced more than 1 episode of atrial fibrillation. Predictors of recurrent atrial fibrillation included older age, history of congestive heart failure, left ventricular hypertrophy, aortic atherosclerosis, bicaval venous cannulation, withdrawal of ACE inhibitor or beta-blocker therapy, and use of amiodarone or digoxin (area under the ROC curve of 0.66). Patients with recurrent atrial fibrillation had longer hospital stays and experienced greater infectious, renal, and neurological complications than those with a single episode.We have developed and validated models predicting the occurrence of atrial fibrillation after CABG surgery based on an analysis of a large multicenter international cohort. Our findings suggest that treatment with beta-blockers, ACE inhibitors, and/or nonsteroidal anti-inflammatory drugs may offer protection. Atrial fibrillation after CABG surgery is associated with important complications.
Cannabis in Costa Rica: A Study of Chronic Marijuana Use
Authors: Donald W. Goodwin
Journal: JAMA (1981)

In some US high schools, about a fourth of the seniors smoke marijuana every day. They could go to jail, but rarely do. Does daily use of marijuana carry other risks? Daily use by large groups is still fairly new in the United States. To study long-term effects, scientists have gone to other countries: Greece, Jamaica, Egypt. This book is about what they found or, more accurately, didn't find, in Costa Rica. The authors found 84 smokers: mostly youngish, lower-class men in San José, the capitol. They found nonsmoker control subjects of similar age and social status. The smokers and nonsmokers weren't much different. According to medical status, they weren't different at all. Both groups smoked nicotine and drank a lot. Both were fairly healthy. Adding ten or more marijuana cigarettes daily to the other "bad habits" apparently didn't make much difference. Even after ten or more years of smoking,
Taking Advance Directives Seriously: Prospective Autonomy and Decisions Near the End of Life
Authors: Mark D. Hannis
Journal: Annals of Internal Medicine (2005)

Medical Writings: Book Notes1 March 2005Taking Advance Directives Seriously: Prospective Autonomy and Decisions Near the End of LifeMark D. Hannis, MDMark D. Hannis, MDFrom Oakwood Healthcare, Dearborn, Michigan.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-5-200503010-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Taking Advance Directives Seriously: Prospective Autonomy and Decisions Near the End of Life Olick RS. 215 pages. Washington, DC: Georgetown Univ Pr; 2001. $26.95. ISBN 1589010299. Order at www.press.georgetown.edu.Field of medicine: Medical ethics and palliative care.Format: Softcover book.Audience: Clinicians in primary care, geriatrics, hematology and oncology, intensive care and hospitalist medicine, and nursing; teachers of medical ethics; students; residents; and members of hospital ethics committees.Purpose: “This book is about rethinking, enriching, and fortifying the case for patient and family control” in end-of life decisions. The book thoroughly analyzes important concepts underlying advance directives and end-of-life decisions.... Author, Article, and Disclosure InformationAffiliations: From Oakwood Healthcare, Dearborn, Michigan. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 March 2005Volume 142, Issue 5Page: 392KeywordsGeriatricsHealth careHematology and oncologyHospital medicineHospitalistsIntensive care unitsMedical ethicsPalliative careResidencySoftware tools ePublished: 1 March 2005 Issue Published: 1 March 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Researchers Struggle With Trials of Stem-Cell Transplants for Breast Cancer
Authors: Joan Stephenson
Journal: JAMA (1997)

A LEADING CANCER researcher tells a story that aptlyillustrates the conflicting feelings aroused by one of the most controversial issues in oncology: whether high-dose chemotherapy (HDC) followed by a bone marrow or peripheral blood stem-cell transplant offers breast cancer patients better survival odds than conventional treatment. "A biostatistician who was dead-set on the importance of randomized clinical trials to answer this question called me up when his sister got breast cancer to ask where she could get a transplant for sure," she said. "I have trouble with that kind of a double standard—if he's willing to put other patients on a randomized trial, then, by God, he shouldn't be finding his sister a sure transplant." The biostatistician's behavior reflects the uneasy position that the technique currently occupies in medicine—a potentially promising but costly treatment for which there is some indication of efficacy but no definitive proof. In addition to provoking