tbuckley/cabot-search huggingface dataset:
The use of targeted and non-targeted advertising to enrich skin cancer screening samples
Authors: P. KATRIS, R. J. DONOVAN, B. N. GRAY
Journal: British Journal of Dermatology (1996)

The purpose of this study was to determine whether the risk factor profile of persons attending skin cancer screening clinics could be enriched by appropriate advertising prior to the screening events. Eleven screening clinics were held in eight rural and three suburban communities. Matched communities were randomly assigned to either a target or non-target condition. Targeted communities received an advertisement designed to attract high-risk individuals. The advertisement listed a number of risk factors and encouraged readers with one or more of the listed risk factors to attend the screening. Non-targeted communities received a general advertisement requesting individuals who felt they were at risk of skin cancer to attend the clinic. Risk factor profiles of all participants were measured on the factors listed in the targeted advertisement. The risk factor profiles of screenees and the referral rates for skin lesions requiring attention were significantly higher in the targeted communities than in the non-targeted communities. Lesions suspicious of malignant melanoma or Hutchinson's melanotic freckle also were higher, but not statistically significant, in the targeted communities. Population samples attending community-based skin cancer screening clinics can be enriched by appropriate targeted advertising prior to the screening events. This has important implications for determining the potential cost-effectiveness of population screening programmes.
Hyaluronic acid content of deep and subcutaneous bursae of man.
Authors: J J Canoso, M T Stack, K D Brandt
Journal: Annals of the Rheumatic Diseases (1983)

To provide a comparison of the contents of subcutaneous and deep bursae we dissected these structures from unfixed cadavers without apparent joint disease. No free fluid was found within any olecranon or prepatellar bursae (examples of subcutaneous bursae), while viscous fluid was invariably present in the (deep) retrocalcaneal bursae. The hyaluronic acid content of the washings of 5 rectrocalcaneal bursae ranged from 142 to 591 nmol hexosamine (mean = 281 nmol hexosamine). In contrast, the hyaluronic acid content of 4 olecranon bursae was much lower (range 35-72 nmol, mean 53 nmol hexosamine), and hyaluronate was not detected in washings from either of 2 prepatellar bursae. The greater hyaluronate content of the retrocalcaneal bursae did not appear to be due to a greater surface area, since on the basis of calculations made from plaster casts the surface areas of the olecranon and prepatellar bursae were approximately 3 times and 2 times, respectively, greater than that of the retrocalcaneal bursae. The data suggest that, although hyaluronic acid may lubricate deep bursae, other factors may be more important in reducing friction within superficial bursae.
What should we do about climate change?
Authors: Robin Stott, Fiona Godlee
Journal: BMJ (2006)

Action on climate change has been likened to teenage sex. Everyone claims to be in on the action, but only a few are, and those not very effectively. Given the scientific consensus that global warming—the underlying cause of climate change—is mainly caused by human beings1 2 and its effects are likely to be seriously damaging to global health,3 4 citizens and governments must take much more effective action. This sense of urgency has been confirmed by the Stern report, commissioned by the UK chancellor, Gordon Brown, and published last week.5 It concludes that the cost of doing something to combat climate change is likely to be 1% of global gross domestic product, but the cost of doing nothing will be up to 20% of global gross domestic product. It also concludes that the cost to the environment of each ton of carbon dioxide emitted is £50 (€75; $95), a figure that gives us a financial yardstick of the damage we are doing by our continued reliance on fossil fuels. 

Health professionals have a track record of identifying and helping resolve serious public …
Evaluation of angioplasty modalities for recanalization of peripheral vascular disease: Angioscopic and angio-graphic observations of laser photoablation combined with balloon dilation or atherectomy
Authors: Garrett Lee, C.Allen Wall, Robert Murray, William Shea, Eugene Groeger, James Feeney, Anthony Lopez, Thomas Cunningham, Dean T. Mason
Journal: Journal of the American College of Cardiology (1990)
From Delirium Cordis to Atrial Fibrillation: Historical Development of a Disease Concept
Authors: Kenneth M. Flegel
Journal: Annals of Internal Medicine (1995)

In 1874, the electrical stimulation of animal hearts made known the existence of atrial fibrillation, but atrial fibrillation was not associated with its clinical counterpart, arrhythmia perpetua, until 1909, by which time simultaneous recordings of the human heartbeat, the venous and arterial pulses, and electrocardiographic activity had revealed the common origin of these events.After the electrical basis of atrial fibrillation was found and after atrial fibrillation was clearly distinguished from ventricular fibrillation, investigation into its mechanism ensued. Two contrasting theories, that of circus movement and that of tachysystole from a single focus, led to 30 years of research and debate. Pivotal to the argument was the notion of blocked conduction. Although the theory of circus movement prevailed for a long time, it appeared to be demolished by electrophysiologic experiments done between 1948 and 1950. The realization that blocked conduction could later reenter led to more recent research in animals and humans that revived the notion of circular conduction, although in a much more sophisticated form.
Hepatitis C Virus Genotype Analysis in Patients with Type II Mixed Cryoglobulinemia
Authors: Anna Linda Zignego
Journal: Annals of Internal Medicine (1996)

Objective: To investigate the possible role of HCV variants in the pathogenesis of mixed cryoglobulinemia. Setting: Medical service (rheumatology and hepatology units) of urban, university-affiliated teaching hospitals. Design: Analysis of viral genotypes in a cohort of patients with hepatitis C virus (HCV) infection and mixed cryoglobulinemia. Patients: 90 unselected HCV-positive (anti-HCV antibody-positive and HCV RNA-positive) patients consecutively recruited at routine ambulatory visits: 29 with and 61 without (control group) mixed cryoglobulinemia. Measurements: Clinical and histologic data; HCV RNA detection in serum and peripheral blood mononuclear cells by polymerase chain reaction (PCR); HCV genotype determination by two methods based on genotype-specific primer PCR and genotype-specific probe hybridization, respectively. Results: Persistent aminotransferase increases were found in 55% of patients with mixed cryoglobulinemia. Peripheral blood mononuclear cells were infected in 80% of cases. In serum samples, HCV genotype 2a/III was detected with a higher prevalence in patients with mixed cryoglobulinemia than in controls (41% compared with 15%). The overall prevalence of genotype 2a/III in mixed cryoglobulinemia increased to 52% when findings in peripheral blood mononuclear cells were also considered. Among patients with mixed cryoglobulinemia, this genotype was more frequent in those without clinical and biochemical signs of liver disease (85%) or with serum autoantibodies (75%). Conclusions: Mixed cryoglobulinemia may be related, at least in part, to the HCV genotype infecting the host.
Endothelin A Receptor Antagonism in Experimental Congestive Heart Failure Results in Augmentation of the Renin-Angiotensin System and Sustained Sodium Retention
Authors: John A. Schirger, Horng H. Chen, Michihisa Jougasaki, Ondrej Lisy, Guido Boerrigter, Alessandro Cataliotti, John C. Burnett
Journal: Circulation (2003)

Background— While both the endothelin-1 (ET-1) and renin-angiotensin systems (RAS) are activated in congestive heart failure (CHF), the temporal sequence of this activation remains unclear. Understanding this pattern of neurohumoral activation may aid in understanding the significance of ET-1 in CHF and provide strategies for ET-1 antagonism. Although acute endothelin (ET) receptor antagonism improves systemic hemodynamics in CHF, clinical trials with chronic ET receptor antagonism report worsening CHF symptoms. Methods and Results— In a canine model of progressive left ventricular dysfunction, we demonstrated activation of myocardial and plasma ET-1 without activation of the RAS during transition to overt CHF, suggesting that ET-1 contributes to this transition. We next evaluated the effects of chronic oral ET-A receptor antagonism on neurohumoral function, renal hemodynamics, and sodium excretion in pacing-induced CHF. After 7 days of treatment (n=7) with ET-A receptor antagonism (with LU135252), sodium excretion did not improve in treated versus untreated CHF (n=6). Furthermore, both plasma renin activity and plasma ET-1 increased with ET-A receptor blockade. Conclusions— Activation of the myocardial and plasma ET-1 systems precedes activation of the myocardial and plasma RAS in CHF. ET-A receptor antagonism in experimental CHF further activates the RAS without improving sodium excretion. These findings suggest an important role for ET-1 in the progression of CHF and a potential mechanism for the exacerbation of CHF symptoms observed in clinical trials with chronic ET receptor antagonism. Further studies with combined modulation of the ET and other neurohumoral systems in CHF are required.
Targeted expression of IL-11 in the murine airway causes lymphocytic inflammation, bronchial remodeling, and airways obstruction.
Authors: W Tang, G P Geba, T Zheng, P Ray, R J Homer, C Kuhn, R A Flavell, J A Elias
Journal: Journal of Clinical Investigation (1996)

Interleukin-11 is a pleotropic cytokine produced by lung stromal cells in response to respiratory viruses, cytokines, and histamine. To further define its potential effector functions, the Clara cell 10-kD protein promoter was used to express IL-11 and the airways of the resulting transgene mice were characterized. In contrast to transgene (-) littermates, the airways of IL-11 transgene (+) animals manifest nodular peribronchiolar mononuclear cell infiltrates and impressive airways remodeling with subepithelial fibrosis. The inflammatory foci contained large numbers of B220(+) and MHC Class II(+) cells and lesser numbers of CD3(+), CD4(+), and CD8(+) cells. The fibrotic response contained increased amounts of types III and I collagen, increased numbers of alpha smooth muscle actin and desmin-containing cells and a spectrum of stromal elements including fibroblasts, myofibroblasts, and smooth muscle cells. Physiologic evaluation also demonstrated that 2-mo-old transgene (+) mice had increased airways resistance and non-specific airways hyperresponsiveness to methacholine when compared with their transgene (-) littermates. These studies demonstrate that the targeted expression of IL-11 in the mouse airway causes a B and T cell-predominant inflammatory response, airway remodeling with increased types III and I collagen, the local accumulation of fibroblasts, myofibroblasts, and myocytes, and obstructive physiologic dysregulation. IL-11 may play an important role in the inflammatory and fibrotic responses in viral and/or nonviral human airway disorders.
Caring for a woman with intellectual disabilities who refuses clinical diagnostic investigations
Authors: P. Heslop, A. Marriott, M. Hoghton, M. Jepson, A. Noble
Journal: BMJ (2014)

A 56 year old woman with moderate intellectual disabilities who lived in a residential care home presented to her general practitioner with iron deficiency anaemia, weight loss, and dyspepsia. She had severe osteoarthritis of one hip as a consequence of untreated Perthes’ disease, which necessitated her using a wheelchair. Her vision was severely impaired and her speech was unclear. She was able to make day to day decisions about her choice of food and clothing but required a full assessment of her capacity to make more complex decisions. Her behaviour was described as “difficult” at times, and she had severe anxiety about medical consultations and interventions.

A “fast track” referral was made for an endoscopy, but she refused to attend. Two months later her haemoglobin had dropped to 68 g/L and faecal occult blood testing at that time was positive. She was referred for an ultrasound scan of her abdomen but again refused to attend.



### 1 The Mental Capacity Act states a presumption of capacity unless proved otherwise. When people refuse examination or clinical diagnostic investigations, how should a doctor question the assumption of capacity?

#### Short answer

The Mental Capacity Act 2005 requires the doctor to conduct a two stage functional assessment of capacity regarding consent to the examination …
Collagenous colitis: a case series with confocal laser microscopy and histology correlation
Authors: A. Zambelli, V. Villanacci, E. Buscarini, G. Bassotti, L. Albarello
Journal: Endoscopy (2008)

Confocal laser endomicroscopy (CLE) was carried out in seven patients with chronic watery diarrhea (three men; age range 68 - 84 years) to find the correspondence between CLE and histological findings in collagenous colitis. On the basis of the CLE images, two to five biopsies were performed in various segments of the colon. The endoscopic and histological diagnoses of collagenous colitis were made blindly. The quality of the CLE images was quantified from 0 (the endoscopist could not visualize the corresponding histologic equivalent) to 3 (the endoscopist could identify >or= 80 % of the corresponding histologic equivalent). Four out of seven patients had histological findings of collagenous colitis. Correspondence between histology and CLE images yielded the following scores: 3 for epithelial architecture, 3 for goblet cells, 3 for vessels, and 2 for inflammatory infiltrate. In collagenous colitis patients, CLE identified a well-defined "shell" around the crypts, corresponding to the increase in the thickness of the subepithelial collagenous plate evidenced by histology. CLE appears to be a promising means of identifying typical collagenous colitis features.
Left ventricular thrombus in anterior acute myocardial infarction after thrombolysis. A GISSI-2 connected study.
Authors: C Vecchio, F Chiarella, G Lupi, P Bellotti, S Domenicucci
Journal: Circulation (1991)

BACKGROUND Streptokinase reduces the incidence of left ventricular thrombosis after acute myocardial infarction. However, it is unknown whether a similar effect can be obtained with different thrombolytic agents and whether subcutaneous calcium heparin can have an additional efficacy. METHODS AND RESULTS To compare the effects of two different thrombolytic agents combined or not with heparin on the incidence and features of left ventricular thrombi and their related embolic events, we performed a GISSI-2 ancillary echocardiographic study (the first echocardiogram obtained within 48 hours of symptoms onset and the second before hospital discharge) that enrolled 180 consecutive patients (mean age, 63 +/- 11 years, 142 men) with a first anterior acute myocardial infarction. Patients were randomized into four groups of treatment: recombinant tissue-type plasminogen activator (rt-PA) (n = 47), rt-PA plus heparin (n = 45), streptokinase (n = 39), and streptokinase plus heparin (n = 49). Left ventricular thrombosis was observed in 51 of 180 patients (28%). No significant differences were found concerning the incidence of thrombi in the four treatment groups. Mural shape of left ventricular thrombi was found more frequently than the protruding shape (71% versus 29% at the first examination, 64% versus 36% at the second), particularly in heparin-treated patients (93% versus 7% at first examination, 70% versus 30% at the second). Only one embolic event (0.5%) occurred during the hospitalization. CONCLUSIONS We conclude that 1) the rate of left ventricular thrombi does not differ in patients with acute myocardial infarction treated either with streptokinase or rt-PA, 2) subcutaneous heparin, when begun 12 hours after intravenous thrombolysis, does not appear to further reduce the occurrence of thrombi but seems to influence the shape of left ventricular thrombi, and 3) during the predischarge period, embolic events are rare in patients treated by thrombolysis.
Respiratory diseases and allergies in two polluted areas in East Germany.
Authors: J Heinrich, B Hoelscher, M Wjst, B Ritz, J Cyrys, H Wichmann
Journal: Environmental Health Perspectives (1999)

This cross-sectional epidemiological study collected health data for 2,470 school children between 5 and 14 years of age (89% of eligible children) who had lived most of their lives in either one of two counties strongly impacted by industrial pollution (Bitterfeld and Hettstedt) or in a neighboring county without any sources of industrial pollution (Zerbst). The objective of the study was to examine whether regional differences--with respect to the occurrence of childhood respiratory diseases and symptoms or allergies--exist and, if such differences are found, whether they persist when we adjust for the effects of known risk factors such as medical and sociodemographic factors or factors related to the indoor environment. Controlling for medical, sociodemographic, and indoor factors, according to parental reports, children residing in Hettstedt have about a 50% increased lifetime prevalence for physician-diagnosed allergies, eczema, and bronchitis compared to children from Zerbst and about twice the number of respiratory symptoms such as wheeze, shortness of breath, and cough without cold. Sensitization to common aeroallergens according to skin prick tests [odds ratio (OR) = 1.38; 95% confidence interval (CI), 1.02-1.86] and specific IgE levels (OR = 1.75; CI, 1.31-2.33) was more common for children from Hettstedt than children from the nonpolluted county. Bitterfeld children, on the other hand, more often received a diagnosis of asthma and eczema than children residing in Zerbst and also showed slightly increased sensitization rates. In conclusion, industrial pollution related to mining and smelting operations in the county of Hettstedt were associated with a higher lifetime prevalence of respiratory disorders and an increased rate of allergic sensitization in children between the ages of 5 and 14 years. Further studies are needed to determine what role the high dust content of heavy metals plays in Hettstedt.
Anesthesia During Sleep.
Authors: P. G. Paugh
Journal: JAMA (1901)

St. Louis, Mo., May 4, 1901. <h3>To the Editor:</h3> —In view of the fact that I have not been able to find a recorded case of a sleeping individual being placed under the influence of an anesthetic without first awaking, and also from the medicolegal bearing which such a record would have—an expert medical witness in the recent trial in New York City in the Rice Will Case having stated that such a feat was impossible—I report three cases in which I succeeded in accomplishing such anesthesia: <h3>Case 1.</h3> —Dr. T. C. Witherspoon, professor of surgery in the Marion-Sims College of Medicine, St. Louis, requested me to give chloroform to a healthy boy of about 4½ years for a small operation. On arriving at the home we found the child asleep and I proceeded to administer the chloroform, and the child went under its influence easily; only once did he
Epstein-Barr virus LMP2A suppresses MHC class II expression by regulating the B-cell transcription factors E47 and PU.1
Authors: Jiun-Han Lin, Ju-Yin Lin, Ya-Ching Chou, Mei-Ru Chen, Te-Huei Yeh, Chung-Wu Lin, Sue-Jane Lin, Ching-Hwa Tsai
Journal: Blood (2015)
Hepatocyte growth factor-induced proliferation of hepatic stem-like cells depends on activation of NF-κB
Authors: Peng Yao, Yiqun Zhan, Wangxiang Xu, Changyan Li, Peibin Yue, Chengwang Xu, Darong Hu, Chengkui Qu, Xiaoming Yang
Journal: Journal of Hepatology (2003)
Hepatitis and blood donation.
Authors: R J Crawford, R Mitchell
Journal: BMJ (1980)

collection of information via poisons informa- tion inquiries and direct observation in a poisoning treatment centre.We feel obliged to remind two of our critics that they contribu- ted to a paper on paracetamol overdosage in which it was stated, "Within a few hours of ingestion of the drug most of the patients experienced anorexia, nausea, and vomiting, and this persisted in varying severity for the first and second days.3Oral therapy is unreliable and impracticable if vomiting occurs.
Immunochemical studies in four cases of alpha chain disease
Authors: Maxime Seligmann, Edith Mihaesco, Daniel Hurez, Constantin Mihaesco, Jean-Louis Preud'homme, Jean-Claude Rambaud
Journal: Journal of Clinical Investigation (1969)

Studies of a number of properties of the pathological gammaA-proteins in the first four cases of the recently recognized alpha-chain disease demonstrate that, as in gamma-heavy-chain disease, the abnormal protein is devoid of light chains and represents a portion of the alpha-heavy chain related to the Fc-fragment. In two patients, serum electrophoresis showed a broad abnormal band, whereas in the two others the pathological protein was not noticeable on the electrophoretic pattern. The diagnosis of alpha-chain disease can be established without purification of the protein by immuno-electrophoresis and gel diffusion experiments using selected antisera to gammaA and a reference alpha-chain disease protein. All four proteins belonged to the alpha1-subclass, displayed electrophoretic heterogeneity, and showed a strong tendency to polymerize. The polymers occurred in vivo and were held together both by disulfide bonds and by strong noncovalent forces. Two of the three purified proteins had a very high carbohydrate content. The abnormal protein was always found in concentrated urines in variable but generally low amounts. It was not detected in parotid saliva but was present in significant amounts in jejunal fluid of all four patients. The alpha-chain disease protein was shown to be associated with the secretory piece in external secretions of two patients. The clinicopathological features were strikingly similar in the four patients. All patients were affected with a neoplastic and mostly plasmacytic proliferation involving primarily the whole length of the small intestine and the mesenteric nodes and all exhibited a severe malabsorption syndrome. While Israeli authors have emphasized the frequency of this type of abdominal lymphoma in young Arabs and non-Ashkenazi Jews, two of our patients were Kabyles, one a Syrian Arab, and one an Eurasian. Cellular studies showed that the pathological protein was synthesized by the proliferating cells in the lymphoid tissue of the digestive tract and in the mesenteric nodes, and that there was no detectable light-chain synthesis at the intracellular level.
Evaluating the Competence of Health Professionals
Authors: Carlos J. M. Martini
Journal: JAMA (1988)

Since Sept 21, 1901,<i>JAMA</i>has published annually a special medical education issue that updates the most important events and information available on undergraduate, graduate, continuing, and allied health education. In 1988, a single theme that touches all these areas is emerging as the most controversial and important in the education of health professionals: evaluating competence. Related to this theme is the need to redefine what<i>professional competence</i>means and the need to look at existing mechanisms for evaluating competence. The emphasis on competence arises from a growing demand for public accountability in all health professions, from the continuous increase in the cost of medical care, from the tremendous explosion in technology and new knowledge, and particularly from a growing concern about the importance of ethical behavior of health professionals. Medicine has made spectacular contributions to our ability to survive and to our quality of life. Never before has medicine