tbuckley/cabot-search huggingface dataset:
Shave biopsy without local anaesthetic to diagnose basal cell carcinoma and other skin tumours prior to definitive treatment: analysis of 109 lesions
Authors: L.C. Smith, N.H. Cox, G. Dawn
Journal: British Journal of Dermatology (2008)

Diagnostic biopsy of basal cell carcinoma and other skin tumours may be necessary prior to definitive treatment.To assess whether shave biopsy sampling of tumours without local anaesthetic can provide adequate tissue to make an accurate histological diagnosis, and to determine whether any discomfort is associated with the technique.One hundred and nine lesions from 99 patients were sampled by shave biopsy without local anaesthetic. Any discomfort associated with the procedure, and the adequacy of the histological specimen, were documented. The pathology diagnosis was also compared against the clinically suspected diagnosis.In 108 of the 109 lesions sampled, sufficient tissue was obtained to make an accurate histological diagnosis. In only six of the 109 procedures was any discomfort reported and in all cases this was rated as minor. A high correlation was found between histological diagnosis and initial clinical suspicion.Shave biopsy without local anaesthetic is a simple, relatively pain-free method of obtaining tissue samples for histological diagnosis in appropriate tumours.
More on the Doctor's Anguish
Authors: Thomas G. Hooyman
Journal: Annals of Internal Medicine (1993)

Letters1 August 1993More on the Doctor's AnguishJeffrey L. Sandler, MD and Charles McDonald, MDJeffrey L. Sandler, MDSearch for more papers by this author and Charles McDonald, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-3-199308010-00030 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We commend Drs. Edwards and Tolle [1] for their contribution to the subject of withdrawal of care. However, the role they chose to play in disconnecting the ventilator and the subsequent emotional reactions they suffered should not be considered as typical when appropriately withdrawing care.The emotional turbulence they described may be more directly related to the circumstances surrounding the death of the patient. It is significant that they carried out this final and most profound act of treatment for a patient who was not even under their direct care.The ethics consultants were thrust into withdrawing ...REFERENCE1. Edwards MJ, Tolle SW. Disconnecting a ventilator at the request of a patient who knows he will then die: the doctor's anguish. Ann Intern Med. 1992; 117:254-6. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 August 1993Volume 119, Issue 3Page: 252-253KeywordsAnxietyEmotionsHealth carePatientsVentilators Issue Published: 1 August 1993 CopyrightCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Comparison of crossbridge dynamics between intact and skinned myocardium from ferret right ventricles.
Authors: Y Saeki, M Kawai, Y Zhao
Journal: Circulation Research (1991)

This study compares the crossbridge kinetics of intact and skinned preparations from ferret cardiac muscles at 20 degrees C to determine whether skinning causes any alteration in the crossbridge response to an imposed length change. A papillary or trabecular muscle was isolated from the right ventricle, the muscle length adjusted to give the maximum twitch tension (Lmax), and the preparation was subjected to Ba2+ contracture. When steady tension developed, the length of the preparation was perturbed sinusoidally in 19 discrete frequencies, ranging from 0.13 to 135 Hz, and at a small peak-to-peak amplitude (0.25% Lmax). We identified three exponential processes in the sinusodial force-response to the imposed length oscillation, and these were labeled processes B, C, and D in order of increasing speed. A slow process, A, normally present in fast-twitch skeletal muscles, is very small or absent in cardiac muscles. Process B is an exponential delay, and the muscle produces oscillatory work on the forcing apparatus; processes C and D are exponential advances in which the muscle absorbs work. The preparation was chemically skinned and activated in the presence of (mM) CaEGTA 6 (pCa 4.55), MgATP 5, magnesium propionate 1, and phosphate 1, pH 7.0, with ionic strength adjusted to 200 mM with potassium propionate. We found that the crossbridge kinetics were not altered by the skinning procedure. The apparent rate constants extracted from the sinusoidal analysis were nearly identical in Ba2+ contracture (intact preparation) and in Ca2+ activation (skinned preparation), and the Nyquist plots were similar. Because the rate constants changed sensitively with the substrate (MgATP) concentrations, we concluded that the substrate is adequately supplied during Ba2+ contracture in the intact preparation. Our study demonstrates the compatibility of results obtained from an intact and from a skinned preparation.
Automated calculation of aortic regurgitant volume and regurgitant fractions by a newly developed digital Doppler color flow mapping method: An animal study
Authors: Takahiro Shiota, Michael Jones, Hiroyuki Tsujino, Izumi Yamada, Satoshi Aida, Alain Delabays, Natesa Pandian, David J. Sahn
Journal: Journal of the American College of Cardiology (1996)
Pediatric Allergic Disease: Focus on Clinical Diagnosis
Authors: Irwin J. Polk
Journal: JAMA (1982)

This volume might be suitably subtitled Everything You Ever Wanted to Know About the Diagnosis of Allergic Disease but Were Too Busy to Ask. It is a remarkable compilation of diagnostic information about a carefully circumscribed field, pediatric allergic diseases. Perhaps because so limited an area was selected, the information presented is remarkably complete.  The opening chapter deals with differential diagnosis of the most common pediatric allergy syndromes, including tables of differential diagnosis, which are listings grouped by etiology, and explanatory text, which is concise but complete. The chapter on history provides sample forms and a brief text describing nuances in history taking that may aid in the differential diagnosis. Other sections discuss things to look for on a physical examination and in routine laboratory studies that might point to the diagnosis of allergy. There are 45 x-ray films, mostly of chest conditions that enter into the differential diagnosis of
Longitudinal Study of Lesions of the Posterior Segment in Onchocerciasis
Authors: Richard D. Semba, Robert P. Murphy, Henry S. Newland, Kwablah Awadzi, Bruce M. Greene, Hugh R. Taylor
Journal: Ophthalmology (1990)

Onchocerciasis is a major cause of blindness, and much of the blindness due to onchocerciasis is caused by chorioretinitis. Little is known about the progression of lesions in the posterior segment in either untreated or treated disease. The authors studied the progression of onchocercal chorioretinitis in 57 patients from 1 to 3 years. Changes were documented from detailed ocular examinations, fundus photographs, and fluorescein angiograms, and included live intraretinal microfilariae, intraretinal hemorrhages, cotton-wool opacities, intraretinal pigment, white and shiny intraretinal deposits, retinal pigment epithelial window defects, and atrophy. Depigmentation at the edge of chorioretinal scarring progressed at a rate of up to 200 microns per year. Ivermectin or mebendazole treatment did not appear to alter the progress of depigmentation at the edge of chorioretinal scars. These observations suggest that onchocercal chorioretinitis is associated with early changes in the retina and retinal pigment epithelium, and that disease in the posterior segment may progress rapidly.
Human Subcutaneous Dirofilariasis in Illinois
Authors: Lawrence J. Blecka
Journal: JAMA (1978)

<i>DIROFILARIA</i>are roundworms that parasitize mammals such as dogs, raccoons, rabbits, bears, and, at times, man. They are transmitted by insect vectors such as mosquitoes, flies, fleas, and ticks. Zoonotic<i>Dirofilaria</i>infections acquired in the southern and northeastern United States and Canada have been reported with increasing frequency.<sup>1-3</sup>Subcutaneous zoonotic infections may be caused by several species including<i>D tenuis, D ursi</i>, and<i>D repens</i>. Physicians should be alerted to the possibility that zoonotic roundworms may be the cause of subcutaneous lumps that appear anywhere on the body and may mimic neoplasms. <h3>Report of a Case</h3> A 44-year-old man noted a painless lump on the left testicle that had increased in size during the previous three to four weeks. The nodule was 1×1 cm, firm, nontender, easily movable, and was located in subcutaneous connective tissue just proximal to the left testis. A diagnosis of left hydrocele was made, and
TCT-495 Novel Use of Micro-Infusion Catheter for Site-Specific Delivery of Local Anesthetic Agent for Pain Control in Renal Sympathetic Denervation - First-in-Man Experience
Authors: Simon C.C. Lam, Stefan C. Bertog, Sameer Gafoor, Jennifer Franke, Laura Vaskelyte, Ilona Hofmann, Horst Sievert
Journal: Journal of the American College of Cardiology (2013)
Insufficiency Fractures of the Pelvis
Authors: A GAUCHER, P PERE, B BANNWARTH
Journal: Clinical Nuclear Medicine (1986)

There are two kinds of stress fracture. One is fatigue fracture of a healthy bone during unusual mechanical overloading. This kind is seen particularly in young persons, such as soldiers and athletes, and most often affects the metatarsals, calcaneum, tibia, and fibula. The second kind is insufficiency fracture, in which the bone has become fragile because of age, metabolic disorder, static disorder of a leg, or prior orthopedic surgery, and cannot withstand even moderate stress. This type of fracture particularly affects the elderly, and is by far most frequent in the pelvis. Bone imaging is very helpful in early diagnosis of stress fractures, because as soon as there are clinical signs it reveals some degree of very localized uptake.
99mTc-MDP- and 18F-FDG-Avid Metastatic Liver Lesion
Authors: Mustafa Aras, Fuat Dede, Tunc Ones, Faysal Dane, Sabahat Inanir, Tanju Yusuf Erdil, Halil Turgut Turoglu
Journal: Clinical Nuclear Medicine (2012)

Although 99mTc-MDP uptake in the extraskeletal tissues was presented before in the literature, FDG PET/CT and conventional bone scan findings have not been discussed together yet. Herein, we presented 99mTc-MDP- and 18F-FDG-avid metastatic liver lesion in a breast cancer patient and compared 2 modalities in terms of tracer uptake.
National Study of Internal Medicine Manpower: XI. Internal Medicine Residency and Fellowship Training in the 1980s
Authors: MICHAEL W. COX
Journal: Annals of Internal Medicine (1987)

The number of residents beginning training in internal medicine continued to increase slightly in 1985-86. However, the total number of residents in internal residency training decreased slightly from the previous year due to a decrease in the number of second- and third-year residents. The proportion of first-year residents who were foreign-trained physicians decreased from 21% to 20%, and the proportion of residents who finished training and went on to subspecialty training in 1985 decreased substantially to 56%. The number of physicians entering residency and fellowship training in internal medicine considerably exceeds the number projected by the Graduate Medical Education National Advisory Committee. In this article, we discuss implications of these trends for medical education and practice.
Canada's first mental health strategy calls for major improvements to services
Authors: B. Kermode-Scott
Journal: BMJ (2012)

Too many Canadians with mental illness receive inadequate or no treatment, and too many end up homeless or incarcerated, says the Mental Health Commission of Canada. On 8 May the commission, which is funded by the federal health department, Health Canada, released its first national mental health blueprint for action.1

In any given year a fifth of people in Canada experience a mental health problem or illness, with a cost to the economy of more than $C50bn (£30bn; €38bn; $50bn), says the commission.

However, only a third of Canadians who experience a mental health problem or illness, and as few as one in four children or young people, report that they have sought and received services and treatment. Of the 4000 Canadians who die every year as a result of suicide, most had a …
Weak healthcare systems and lack of money hamper efforts to reduce mortality worldwide
Authors: Caroline White
Journal: BMJ (2007)

Plenty of cheap, simple ways exist to tackle global poverty, but the world lacks the commitment to implement them, health experts and economists said at an international conference in London last week.

Convened to celebrate the centenary of the Royal Society of Tropical Medicine, the conference aimed to assess progress, at the halfway point, towards meeting the eight millennium development goals set by the United Nations for 2015.

One goal is to cut by two thirds the 10 million deaths each year of children aged under 5 years old, but only seven of the 60 countries with the highest child mortalities are on …
Immunofluorescent localization of type IV collagen and laminin in human skin and its application in junctional zone pathology
Authors: LUTZ WEBER, THOMAS KRIEG, PETER K.MULLER, EMILIE KIRSCH, RUPERT TIMPL
Journal: British Journal of Dermatology (1982)

Purified antibodies against type IV collagen and laminin were used to localize basement membranes by indirect immunofluorescence in various anatomical regions of normal and diseased human skin. The two proteins showed extensive codistribution. A continuous linear staining was found along the epidermal-dermal junction and around hair follicles, sebaceous gland acini and small capillaries. The same proteins also surrounded individual cells such as those found in vessels, hair erector muscles and subcutaneous tissue. Blister formation in bullous pemphigoid left type IV collagen and laminin on the floor of the blister, while the bullous pemphigoid antigen as detected by human autoantibodies was found on both sides of the blister. In solid basal cell carcinoma a strong staining was found around all tumour islands as well as focally within the cell clusters. This suggests that the tumour cells produce these basement membrane proteins but have lost, at least in part, control of polar deposition.
THE EFFECT OF ENZYME DETERGENTS ON TRANSEPIDERMAL WATER LOSS FROM NORMAL SKIN
Authors: ROWAN ADAMS, C. L. HALES, E.J. RAFFLE
Journal: British Journal of Dermatology (1972)

Summary.— Transepidermal water loss from normal forearm skin was measured in 15 normal subjects before and after a standardized “skin insult” produced by friction with a detergent alone or with the detergent plus proteolytic enzyme. No statistically significant difference was discernible between the results obtained with the two solutions.
Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor Treatment Response in Advanced Lung Adenocarcinomas with G719X/L861Q/S768I Mutations
Authors: Chao-Hua Chiu, Cheng-Ta Yang, Jin-Yuan Shih, Ming-Shyan Huang, Wu-Chou Su, Ruay-Sheng Lai, Chin-Chou Wang, Shih-Hsin Hsiao, Yu-Ching Lin, Ching-Liang Ho, Te-Chun Hsia, Ming-Fang Wu, Chun-Liang Lai, Kang-Yun Lee, Chih-Bin Lin, Diana Yu-Wung Yeh, Chi-Yuan Chuang, Fu-Kang Chang, Chun-Ming Tsai, Reury-Perng Perng, James Chih-Hsin Yang
Journal: Journal of Thoracic Oncology (2015)
Vascular Disease: Diagnostic and Therapeutic ApproachesJaffMichael R., DO andWhiteChristopher J., MD, eds. 582 pages. Minneapolis, MN, USA: Cardiotext, 2011. $169.00 ISBN: 978-1-935395-16-4
Authors: Manesh R. Patel, W. Schuyler Jones
Journal: Circulation (2012)
Malcolm Arthur Holmes Graham
Authors: D. Almond
Journal: BMJ (2002)

General practitioner Potters Bar 1958-95 (b Farnborough 1931; q St Bartholomew's Hospital, London, 1955; DObstRCOG), d 2 July 2002.

In his early years in practice, Malcolm attended some 50 home confinements a year. He always had a special interest in heart disease, and, unusually for those times, had his own electrocardiograph. He worked in the diabetes clinic at Barnet General Hospital and set up a diabetes clinic in the practice. Malcolm was a keen sportsman, and played rugby until he arrived in Potters Bar—rugby was considered too dangerous a game for a partner! He played tennis until 2000, despite a hip replacement. He wrote regularly for Hertfordshire Countryside magazine. Divorced from his first wife, Christine, with whom he had four children, he leaves his second wife, Brenda.
Ascending Aortic Replacement With Aortic Valve Reimplantation
Authors: W. Harringer, K. Pethig, C. Hagl, G. P. Meyer, A. Haverich
Journal: Circulation (1999)

Reimplantation of the native, structurally intact aortic valve within a Dacron tube graft in patients with aortic root aneurysms corrects annular ectasia and dilatation of the sinotubular junction. The durability of this valve repair with respect to the increased mechanical stress on valve cusps has been discussed, is quite controversial, and is yet unknown.From July 1993 to November 1998, a replacement of the ascending aorta with a repair of the aortic valve was performed in 75 patients (53 men and 22 women aged 50+/-19 years). Twenty-one patients (28%) had Marfan syndrome, and 11 patients (15%) had an aortic dissection, type Stanford A (6 acute, 5 chronic). In 17 patients (23%), concomitant replacement of the aortic arch was necessary. Clinical and echocardiographic follow-up was performed in 6- to 12-month intervals for a cumulative study period of 137 patient-years. No operative deaths occurred. Two patients (3%) died 5 and 20 months postoperatively. One additional patient experienced a transient ischemic attack within the first postoperative week. Three patients (4%) with progressive aortic insufficiency required aortic valve replacement after 9, 11, and 14 months. All other patients had no or mild aortic insufficiency. The repairs have now remained stable for </=65 months (mean, 22+/-20 months). Other valve-related complications did not occur.Our results demonstrate that this type of aortic valve repair achieves excellent results in selected patients. Perfect coaptation of valve cusps during the repair with no or only trace aortic insufficiency at initial echocardiography seems to be essential for durability.
Intracellular Protein Aggregation Is a Proximal Trigger of Cardiomyocyte Autophagy
Authors: Paul Tannous, Hongxin Zhu, Andriy Nemchenko, Jeff M. Berry, Janet L. Johnstone, John M. Shelton, Francis J. Miller, Beverly A. Rothermel, Joseph A. Hill
Journal: Circulation (2008)

Recent reports demonstrate that multiple forms of cardiovascular stress, including pressure overload, chronic ischemia, and infarction-reperfusion injury, provoke an increase in autophagic activity in cardiomyocytes. However, nothing is known regarding molecular events that stimulate autophagic activity in stressed myocardium. Because autophagy is a highly conserved process through which damaged proteins and organelles can be degraded, we hypothesized that stress-induced protein aggregation is a proximal trigger of cardiomyocyte autophagy.Here, we report that pressure overload promotes accumulation of ubiquitinated protein aggregates in the left ventricle, development of aggresome-like structures, and a corresponding induction of autophagy. To test for causal links, we induced protein accumulation in cultured cardiomyocytes by inhibiting proteasome activity, finding that aggregation of polyubiquitinated proteins was sufficient to induce cardiomyocyte autophagy. Furthermore, attenuation of autophagic activity dramatically enhanced both aggresome size and abundance, consistent with a role for autophagic activity in protein aggregate clearance.We conclude that protein aggregation is a proximal trigger of cardiomyocyte autophagy and that autophagic activity functions to attenuate aggregate/aggresome formation in heart. Findings reported here are the first to demonstrate that protein aggregation occurs in response to hemodynamic stress, situating pressure-overload heart disease in the category of proteinopathies.
Mervyn W F Dunning
Authors: M. Dean
Journal: BMJ (2012)

Mervyn W F Dunning was educated at Hampton Grammar School. In 1937 he started his training in medicine and dental surgery. At the outbreak of war in 1939 he volunteered for service with the navy, but on the advice of the admiralty he qualified in dental surgery at the Royal Dental Hospital in London, obtaining his LDS (RCS Eng) in 1941, and then deferred his medical training. From 1941 to 1942 he was house surgeon and then senior house surgeon in jaw and maxillofacial surgery at the Royal Dental Hospital in London. At the conclusion of that appointment he was given a permanent commission …
THU0399 Systemic Amyloidosis as A Multi-Organ, Life-Threatening Disease: Predictive Baseline Factors Associated to Mortality in 570 Patients (Ramyd-Geas-Semi Registry)
Authors: P. Brito Zeron, L.E. Cajamarca, R. Perez-Alvarez, D. Real de Asua, S. Benito Conejero, F. Beamud, F. Martinez-Valle, X. Bosch, I. Villaverde, E. Fonseca, L. Acevedo, L. Gonzalez Vazquez, G. de la Red, C. Santiago, E. Gonzalez Vazquez, L. Inglada, A. Robles Marhuenda, A. Castro Salomo, R. Jordana, J. Fernandez Martin, M. Perez de Lis, S. Retamozo, H. Gheitasi, A. Lopez Soto, M. Ramos-Casals
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Objectives</h3> To analyze the main epidemiological, clinical and immunological characteristics and baseline predictors associated with survival in a large cohort of patients with systemic amyloidosis. <h3>Methods</h3> In May 2013, the Study Group on Autoimmune Diseases (GEAS) of the Spanish Society of Internal Medicine created the national registry of patients with amyloidosis (RAMYD). The classification of amyloidosis was based on the chemical characterization of the precursor protein. The 4 main types of systemic amyloidosis are AL, AA, ATTR, and Aβ2M type/others. Patients with localized deposition of amyloid were excluded. <h3>Results</h3> A total of 570 patients with amyloidosis were included, 311 men, 259 women (mean age at dx: 64 years, range 19-93). Associated diseases were: hematological diseases 19%, inflammatory rheumatic diseases 10%, systemic autoimmune diseases 8%, non-hematologic neoplasms 6% and chronic infections 6%. We were able to classify amyloidosis in 71% patients: 36% AA amyloidosis, 135% AL, 20% ATTR and 9% others. Vital status was obteined in 478 patients, of which 298 (62%) died. Patients who died had an older mean age at diagnosis (67.29 vs 57.58 years in survivals, p&lt;0.001). A higher mortality rate was observed in patients with associated hematological diseases (23% vs 16%, p=0.043), those with chronic infections (3% vs 8%, p=0.038), and in patients presenting with renal (38% vs 20%, p&lt;0.001), cardiac (29% vs 15%, p=0.002) and pulmonary (16% vs 10%, p=0.048) involvements, while those presenting with peripheral neuropathy (13% vs 29%, p&lt;0.001) and skin involvement (1% vs 7%, p=0.001) showed a low rate of mortality. Global mortality rate was 78% in AL amyloidosis, 66% in AA amyloidosis, 62% in patients who failed to amyloidosis classification, 47% in ATTR amyloidosis and 39% in patients with other types of amyloidosis. <h3>Conclusions</h3> The rate of mortality of patients diagnosed with systemic amyloidosis exceeds 60% of cases, with AL amyloidosis having the highest mortality rate. The main baseline prognostic factors associated with death were older age, hematological diseases, and involvement of kidneys, lungs, heart. Our results, which demonstrated a global mortality rate of two-thirds of cases, serve to emphasize that the optimal management for systemic amyloidosis remains to be defined. <h3>Disclosure of Interest</h3> : None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.5896