tbuckley/cabot-search huggingface dataset:
Metastasis to the Liver from a Colonic Polyp
Authors: Leon H. Manheimer
Journal: New England Journal of Medicine (1965)

THE central issue of a major controversy involving pathologists and roentgenologists, as well as clinicians, for a number of years has been the question whether adenomatous polyps of the colon become malignant.1 The malignant potential of villous adenomas is generally accepted, even though surgeons occasionally disagree on the extent of the resection indicated. Before the excellent studies of Spratt, Ackerman and Moyer2 and Castleman and Krickstein1 many clinicians considered all polypoid lesions of the colon potentially or actually malignant. The aforementioned reviews cast considerable doubt on such a premise. Spratt et al.2 said, "To date we have not seen or . . .
Captopril-Augmented Renal Scan
Authors: A Goto, N Kawauchi
Journal: New England Journal of Medicine (2001)

Figure 1. A 22-year-old woman had had hypertension for one year. Her only symptom was an occasional headache. Examination revealed a blood pressure of 148/110 mm Hg, a vascular bruit on the left-hand side of the upper abdomen, and no cardiomegaly. The electrocardiogram was normal. Renal scanning with [99mTc]pentetic acid (DTPA) showed less uptake of the tracer in the left kidney than in the right, with a similar time to peak uptake (Panel A). The patient was then given 25 mg of captopril orally, and renal scanning was repeated one hour later. The curve for the left kidney was . . .
The Nile blue test in the detection of steatorrhoea
Authors: J. Polyzos, T. D. Kellock
Journal: Gut (1961)

The Nile blue test for the detection of steatorrhoea has been compared with the estimation of 24-hour faecal excretion by the method of Weijers and Van der Kamer modified by Anderson, Frazer, French, Gerrard, Simmons, and Smellie (1952). The Nile blue test is easily and quickly carried out. A positive result was only found in cases showing a considerable degree of steatorrhoea but it was often negative when the excretion of fat was abnormally high. This test appears to be of considerable use as a rapid, semiquantitative screening test in the investigation of possible cases of steatorrhoea.
More than 1500 patients recalled after team finds serious shortcomings in surgeon's work
Authors: C. Dyer
Journal: BMJ (2012)

More than 1500 patients of a recently retired consultant obstetrician and gynaecologist are to have their cases reviewed after an investigation by a team of experts found serious shortcomings in his work.

Rob Jones was a consultant with the Royal Cornwall Hospitals NHS Trust for 20 years, but a team from the Royal College of Obstetricians and Gynaecologists found “major concerns about his colposcopy practice for some years.”

The team, which reported last April, said it was “disappointed” with the way the trust had managed the situation, missing a “clear opportunity” in 2007 …
Serum levels of the nm23-H1 protein and their clinical implication in extranodal NK/T-cell lymphoma
Authors: N Niitsu, M Okamoto, Y Honma, H Nakamine, J-I Tamaru, S Nakamura, T Yoshino, M Higashihara, M Hirano, J Okabe-Kado
Journal: Leukemia (2003)
PWE-087 A Critical Review of Grounded Theory use in Inflammatory Bowel Disease Studies
Authors: K C Fragkos, A Forbes
Journal: Gut (2013)

<h3>Introduction</h3> Grounded Theory (GT) is a research methodology predominantly used with qualitative data. The purpose of the present study is to critically evaluate the use of GT in inflammatory bowel disease (IBD) studies and to examine the clinical implications this entails. <h3>Methods</h3> A systematic literature review was performed using keywords <i>Grounded Theory</i> and <i>IBD</i> in Pubmed, EMBASE and Scopus with no time limits. Assessment of GT was performed using standard criteria suggested by Glaser (1998). The application of the following basic principles was examined: simultaneous data collection and analysis; construction of analytic codes and categories from data, not from preconceived logically deduced hypotheses; use of constant comparative method; advancement of theory development during each step of data collection and analysis; memo-writing; sampling aimed toward theory construction (theoretical); Literature review after the core category emergence. <h3>Results</h3> Fifteen studies have used GT investigating patient education, quality of life, experiences with therapeutic strategies or coping mechanisms in IBD, providing theories based on emerging categories. About half of all studies have applied the basic principles of GT, with the remaining studies being unclear or having not applied them. The most reported priniciple was Glaserian selective coding and least reported were memoing, theoretical sampling and the achievement of theoretical completeness, while the identification of the core category was unclear in many instances (Figure 1). These weaknesses are attributed predominantly to methodological, verification and reporting bias. These biases affect the applicability of these results in clinical practise. Hence, results concerning quality of life or experiences of IBD patients should be treated with caution, as they could represent authors’ predisposition from the their experience (empirical or from literature reviews). <h3>Conclusion</h3> The main advantage of GT studies remains the generation of theory that can be applied in practise, reinforced by the presentation of conceptual prospects for testing new variables in quantitative studies. Overall, the contribution of Grounded Theory studies to IBD should be based on more rigorous methodology and aim to challenge rather than confirm existing conceptions with the purpose of advancing knowledge in the field. <h3>Disclosure of Interest</h3> None Declared. <h3>References</h3> Glaser BG, (1998), Doing Grounded Theory: Issues and Discussions, Sociology Press, Mill Valley, CA.
Improving drug accumulation and photothermal efficacy in tumor depending on size of ICG loaded lipid-polymer nanoparticles
Authors: Pengfei Zhao, Mingbin Zheng, Caixia Yue, Zhenyu Luo, Ping Gong, Guanhui Gao, Zonghai Sheng, Cuifang Zheng, Lintao Cai
Journal: Biomaterials (2014)
Sequential bilateral femoral fractures
Authors: S. A. Moeinoddini, R. J. Parikh, S. R. Moore, D. J. Moore
Journal: BMJ (2012)

A 78 year old woman presented to the emergency department with an off-ended, shortened, anteriorly deviated, long oblique fracture of the right femoral diaphysis. She had been experiencing thigh pain for several weeks before this acute presentation and analgesia had been prescribed.

She described feeling the bone “crack” as she turned around. There was no history of trauma. The fracture was surgically treated with an intramedullary nail.

Six months earlier she had sustained a similar fracture of the midshaft of her left femur. Again, there was no trauma and she described feeling the bone “crack” as she twisted slightly to go through her front door. She was unable to reach a telephone to call for help and spent some time on the ground before a passer by called an ambulance. After initial treatment with a Thomas splint, she was treated surgically with an intramedullary nail. After two weeks of rehabilitation she returned home to live independently and was able to go out with one stick to do her shopping.

Her medical history included osteoporosis and hypovitaminosis D. The diagnosis of osteoporosis was made after she sustained a vertebral crush fracture. She had been receiving bisphosphonates to prevent further fractures for nearly five years.



### 1 Why are such fractures described as “atypical”?

#### Short answer

Atypical fractures involve little or no trauma.1

#### Long answer

“Typical” subtrochanteric or femoral shaft (ST/FS) fractures are comminuted (sometimes obliquely, rarely transversely) and result from trauma. In atypical fractures, structural failure occurs in the absence of trauma.1 Thus, they are by definition pathological. The differential diagnoses of atypical fractures include well described causes such as a bony metastasis from a …
People with HIV in China are routinely denied medical treatment
Authors: J. Parry
Journal: BMJ (2011)

People in China infected with HIV face severe discrimination in the healthcare system, including denial of treatment for conditions not related to HIV, finds research conducted by the International Labour Organization’s Office for China and Mongolia. It also says that healthcare workers face stigma and inadequate protection when treating patients with the infection.

At the same time a non-governmental organisation, the China Alliance of People Living with HIV/AIDS (CAP+), has released a report recommending changes to tackle poor access to healthcare that people with HIV in China face.

The International Labour Organization’s study, done in collaboration with …
Special support is offered to dementia sufferers in Scotland
Authors: B. Christie
Journal: BMJ (2012)

Everyone newly diagnosed with dementia in Scotland is to be guaranteed at least a year’s support in what is said to be one of the first commitments of its kind in the world.

It is part of a wider programme of improvements to dementia care which has seen 100 dementia champions trained to work in Scottish hospitals and the appointment of specialist dementia nurses across the country.

Scotland already outperforms other parts of the UK in diagnosing dementia. A report earlier this year …
The "Mystery" Illness
Authors: J. SCHOUTEN
Journal: JAMA (1974)

<h3>To the Editor.—</h3> With reference to the article " 'Medical Sleuth' Tries to Identify Mystery Illness in School Children" (226:11, 1973), I should like to make the following remark. Herman Boerhaave (1668-1738) was consulted about an identical epidemic in an orphanage at the Dutch town Haarlem. His biographer, Prof G. A. Lindeboom, wrote: The consultation that Boerhaave once gave in an orphanage at Haarlem, where the doctors were not able to suppress an outbreak of hysterical fits, is well known. The condition was intolerable: once one child had developed fits, others—boys and girls—also showed them. Then Boerhaave took drastic measures and made his full authority felt. He had fires lit all over the house, with branding irons hanging next to each. Then he gathered the orphans together, and in a serious mood he threatened that the first who developed a fit would be branded to the bone. This threat ended the
Thymic hypoplasia, auto-immune haemolytic anaemia and juvenile pemphigoid in an infant
Authors: SUSAN BLOOMFIELD, G. STOCKDILL, R.StC. BARNETSON
Journal: British Journal of Dermatology (1982)

Journal Article Thymic hypoplasia, auto‐immune haemolytic anaemia and juvenile pemphigoid in an infant Get access SUSAN BLOOMFIELD, SUSAN BLOOMFIELD Departments of Paediatrics and Haematology, Western General Hospital, and Department of Dermatology, Royal Infirmary, Edinburgh Search for other works by this author on: Oxford Academic Google Scholar G. STOCKDILL, G. STOCKDILL Departments of Paediatrics and Haematology, Western General Hospital, and Department of Dermatology, Royal Infirmary, Edinburgh Search for other works by this author on: Oxford Academic Google Scholar R.StC. BARNETSON R.StC. BARNETSON Departments of Paediatrics and Haematology, Western General Hospital, and Department of Dermatology, Royal Infirmary, Edinburgh R.St C.Barnetson, Department of Dermatology, Royal Infirmary, Edinburgh. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 106, Issue 3, 1 March 1982, Pages 353–355, https://doi.org/10.1111/j.1365-2133.1982.tb01735.x Published: 01 March 1982 Article history Accepted: 04 June 1981 Published: 01 March 1982
PATTERNS OF LEFT VENTRICULAR REMODELING IN PATIENTS WITH SEVERE AORTIC STENOSIS IN THE PARTNER TRIAL
Authors: Sammy Elmariah, Ignacio Inglessis, Joshua Baker, William Stewart, Brian Lindman, Ke Xu, Maria Alu, Gus Vlahakes, Susheel Kodali, Jacob Dal-Bianco, Serguei Melnitchouk, Martin Leon, Lars Svensson, Philippe Pibarot, Pamela Douglas, Neil Weissman, Rebecca Hahn, Igor Palacios, Jonathan Passeri
Journal: Journal of the American College of Cardiology (2014)
The Medical Commercial
Authors: Samuel Bigg
Journal: JAMA (1966)

<h3>To the Editor:—</h3> Much has been said about medical writing in recent years. Most of the comment is not flattering. "Have you ever picked up a journal," asks Glickman,<sup>1</sup>"opened it, read halfway through the first page, then, losing patience, riffed through the summaries of everything else in the book?" The answer, of course, is "Yes!" Medical writing is much too<i>dull</i>(acronym for drab, uninteresting, long, lifeless) to hold the reader's attention. Many remedies have been suggested. Authors and editors are urged to pay more attention to literary style, to reinstate humor, wit, and satire, to reinsert poetry and emotion, even to restore the exclamation mark! All these cures belong in the realm of wishful thinking. How, indeed, can a gaussian curve be made humorous or a statistical tabulation poetic? Why not follow the lead of radio and television? These communication media solved the problem of program tedium
High Variation Between Hospitals in Vena Cava Filter Use for Venous Thromboembolism
Authors: Richard H. White, Estella Marie Geraghty, Ann Brunson, Susan Murin, Ted Wun, Fred Spencer, Patrick S. Romano
Journal: JAMA Internal Medicine (2013)

The extent to which vena cava filter (VCF) use varies between hospitals in the management of acute venous thromboembolism (VTE) is not clear.We conducted a retrospective observational study that compared the frequency of VCF use among California hospitals from January 1, 2006, through December 31, 2010. Using administrative hospital discharge data, we followed explicit criteria to identify nontrauma patients with acute VTE, and determined the frequency of VCF placement in each of the hospitals that admitted more than 55 VTE patients. Multivariable hierarchical regression models to predict VCF use included important clinical and demographic variables as fixed effects and hospital as a random effect.Among the 263 hospitals included, 130 643 acute VTE hospitalizations occurred with the placement of 19 537 VCFs (14.95%). Variation in the percentage of acute VTE hospitalizations that included VCF placement was very high, from 0% to 38.96% (interquartile range, 6.23%-18.14%), with 18.49% of the observed variation due to differences among the hospitals that provided care. Significant clinical predictors of VCF use included acute bleeding at the time of admission (odds ratio, 3.4 [95% CI, 3.2-3.6]), a major operation after admission for VTE (3.4 [3.3-3.5]), presence of metastatic cancer (1.7 [1.6-1.8]), and extreme severity of illness (2.5 [2.3-2.7] vs mild). Insertion of VCFs occurred more frequently than expected in 109 hospitals and less frequently in 59. Hospital characteristics associated with VCF use included a small number of beds (odds ratio, 0.2 [95% CI, 0.2-0.4], <100 vs >400 beds), a rural location (0.4 [0.2-0.5]), and other private vs Kaiser hospitals (1.5 [1.1-2.0]). Use of VCFs varied widely even in geographically proximate areas.The frequency of VCF use in patients with acute VTE varied widely and depended on which hospital provided the care, even after adjusting for clinical and socioeconomic factors. Further research is needed to determine whether this variation is associated with local cultural differences between hospitals or with differences in the availability of interventional radiologists or specialists, or whether it reflects the absence of high-quality evidence that VCFs are effective.
PMO-191 Missed upper gastrointestinal cancer at endoscopy: can performance be improved by specialists?
Authors: A T Vesey, C D Auld, D McCole
Journal: Gut (2012)

<h3>Introduction</h3> Upper gastrointestinal (UGI) cancer continues to have a very poor prognosis; it tends to present late and at an advanced stage. The best hope for long term survival therefore remains early diagnosis with radical treatment. There has been increasing interest recently in measuring the accuracy of UGI endoscopy in diagnosing cancer. Depending on the population studied published missed rates vary between 3% and 20%. We hypothesised that concentrating the practice of UGI endoscopy into specialist hands would reduce the rate of missed diagnosis. <h3>Methods</h3> This is a historical cohort study. In 2001 our institution employed an UGI nurse endoscopist and concentrated the practise of UGI endoscopy into her hands and those of the only UGI surgeon in the hospital. Rates of missed cancer diagnosis were calculated for the 7 years up to and subsequent to 2001 by cross-referencing the regional electronic endoscopy reporting system and the regional UGI cancer registry. As in other similar studies, we defined a definitely missed cancer as one diagnosed within 1 year of previous endoscopy and a possibly missed cancer as one diagnosed between 1 and 3 years of previous endoscopy. Missed diagnoses were sub-classified as being due to endoscopist error, pathologist error or follow-up error. <h3>Results</h3> From 1994 to 2001 a total of 13 589 UGI endoscopies were performed—of a total of 305 UGI cancers diagnosed in this time 30 (10%) were missed (22 (7%) definitely missed and 8 (3%) possibly missed). From 2002 to 2009 a total of 16 503 UGI endoscopies were performed—of a total of 344 UGI cancers diagnosed in this time 20 (6%) were missed (11 (3.2%) definitely missed and 9 (2.6%) possibly missed). There was a statistically significant (p&lt;0.05) difference between definite miss rates but between total miss rates. The difference observed between groups was mostly explained by reductions in pathology errors and follow-up errors and not by improvements in endoscopist performance. <h3>Conclusion</h3> Missed diagnosis rates at our institution are within the ranges reported in other studies of Western populations. Performance was not significantly improved by concentrating the practice of UGI endoscopy into specialist hands. <h3>Competing interests</h3> None declared.
Cases and Notes from Hospital and Private Practice
Authors: C. M. Durrant
Journal: BMJ (1845)

A young lady, aged 19, of good constitution, was attacked in the spring of 1842 with cough, muco.purulent expectoration, and slight hmmopt sis.These symptoms continuing, she was placed unider my care in the summer of the same Tear.There was no ema.ciation; figure embonpoint; countenance sallow tongue slightly coated; appetite good ; bowels slug.gish; caramenia regular, butt attended with pain; pulse 80, of moderate strength; complained of erratic pains in the righit shoulder and upper part of the chest; cough short and hacking, and most troublesome in the morning; expectoration very inconsiderable, chiefly inspissated mucus; hbemoptysis to a slight extent had occurred on three separate occasions; no nocturnal perspiration.Physical Sigs.-Deficient expansion, and elevation of the ribs on the upper part of the right side.-Percussion: Stroke-sound under the right clavicle dull, and of a peculiarly well-marked wooden char.acter, with great resistance to the finger.-Auscultation:Itespiratory murmur very defective, and deeply seated in the right infira.claviculafregion; a faint muco- crepitation audible on deep inspiration; murmur of expiration unaffected.The remainder of the chest healthy.Treatment.-Emetics of ipecacuanha; the repeated application of two or three leeches under the right clavicle; counter-irritAtion; gently affecting the system with mercury; strict attention to the digestive organs;subsequently the sesquichloride of iron, with a nourishing but unstimulating diet, and horse exercise.Under these measures the patient apparently re- covered.The physical signs, however, with the exception of a somewhat improved condition of the respiratory muirmur, and the removal of the crepitation, remained unaltered.Three vears lhave n1ow elapsed, the patient reporting lherself well.She is still, how.ever, the Subject of an occasional short dry cough.CASE II.
Predominant IgG4 Disease and Concurrent Early-Stage Rectal Cancer
Authors: Yimin Liu, Libo Chen, Fang Li
Journal: Clinical Nuclear Medicine (2011)

A 66-year-old man underwent FDG PET/CT to assess a potential tumor of unknown origin. The images revealed multiple regions of increased metabolic activity in the body including supraclavicle, mediastinum, hilum, iliac lymph node, and rectum. Except for rectum where an early stage of rectal adenocarcinoma was found and surgically removed, the hypermetabolism of all other regions was caused by IgG4 disease. On follow-up, FDG PET/CT after therapy toward IgG4 disease was initiated, and abnormal FDG activity was no longer visualized.
Therapeutic Molecular Targetingof 15-Lipoxygenase-1 in Colon Cancer
Authors: Yuanqing Wu, Bingliang Fang, Xiulan Q Yang, Li Wang, Dongning Chen, Victor Krasnykh, Bing Z Carter, Jeffrey S Morris, Imad Shureiqi
Journal: Molecular Therapy (2008)

Molecular targeting for apoptosis induction is being developed for better treatment of cancer. Downregulation of 15-lipoxygenase-1 (15-LOX-1) is linked to colorectal tumorigenesis. Re-expression of 15-LOX-1 in cancer cells by pharmaceutical agents induces apoptosis. Antitumorigenic agents can also induce apoptosis via other molecular targets. Whether restoring 15-LOX-1 expression in cancer cells is therapeutically sufficient to inhibit colonic tumorigenesis remains unknown. We tested this question using an adenoviral delivery system to express 15-LOX-1 in in vitro and in vivo models of colon cancer. We found that (i) the adenoviral vector 5/3 fiber modification enhanced 15-LOX-1 gene transduction in various colorectal cancer cell lines, (ii) the adenoviral vector delivery restored 15-LOX-1 expression and enzymatic activity to therapeutic levels in colon cancer cell lines, and (iii) 15-LOX-1 expression downregulated the expression of the antiapoptotic proteins X-linked inhibitor of apoptosis protein (XIAP) and BcL-XL, activated caspase-3, triggered apoptosis, and inhibited cancer cell survival in vitro and the growth of colon cancer xenografts in vivo. Thus, selective molecular targeting of 15-LOX-1 expression is sufficient to re-establish apoptosis in colon cancer cells and inhibit tumorigenesis. These data provide the rationale for further development of therapeutic strategies to target 15-LOX-1 molecularly for treating colonic tumorigenesis.
Free Thyroxine Levels in Critically III Patients
Authors: Michael F. Slag
Journal: JAMA (1981)

Two indices of free thyroxine (T4) and four methods of free T4 measurement were compared in 85 patients with acute illness, hospitalized in intensive care units. All of the methods of free T4 measurement in critical illness were nonspecific, and two of the methods failed to suggest hypothyroidism in two patients with primary hypothyroidism and another associated critical illness. Since the ideal screening test should be both sensitive and specific, all tests for free T4 used in this study should be interpreted with caution in severely ill patients.