tbuckley/cabot-search huggingface dataset:
Drug Use in Outpatient Treatment
Authors: KARL RICKELS
Journal: American Journal of Psychiatry (1968)

Drugs may be a useful adjunct to psychotherapy in the treatment of the neuroses, affording the patient a measure of symptom relief so that he can cope with his problems more efficiently. The author stresses, however, that appropriate drug treatment prescribed for appropriate, realistic reasons is of the greatest importance for the achievement of good therapeutic results. The anti-anxiety drugs, or minor tranquilizers, are discussed in terms of their specific efficacy in the alleviation of symptomatology and their possible side effects. The effects of social class, education, and other nondrug variables upon clinical outcome are also examined.
Peace Corps Doctor
Authors: Hugh Clark
Journal: JAMA (1964)

<h3>To the Editor:—</h3> In truth, my mind constantly questions: Why did I ever leave the secure ivied walls of a university hospital to come to Dire Dawa, where a positive diagnosis can be confirmed only one twentieth of the time in the lab, where one's confreres speak a different tongue, where the x-ray technician cannot tell an anteroposterior chest from a right anterior oblique abdomen, where superstition dictates one third of the treatments,.... Except that I also wonder why I did not come two years earlier. I ask why all clinical training in medical school does not include a trip to a place where the pathology resembles the classical description, where infectious disease of every sort presents daily, where you must know your pharmacology because half the medicines you want as first choice do not exist, where your x-ray consultant is yourself, where a gram stain is your only bacteriological
Liver iron is a surrogate marker of severe fibrosis in chronic hepatitis C
Authors: Dominique Guyader, Anne-Sophie Thirouard, Lars Erdtmann, Nafissa Rakba, Sylvie Jacquelinet, Hélène Danielou, Michèle Perrin, Anne-Marie Jouanolle, Pierre Brissot, Yves Deugnier
Journal: Journal of Hepatology (2006)
A Gradient of Silent Substitution Rate in the Human Pseudoautosomal Region
Authors: D. A. Filatov
Journal: Molecular Biology and Evolution (2003)

It has been demonstrated that recombination in the human p-arm pseudoautosomal region (p-PAR) is at least twenty times more frequent than the genomic average of ∼1 cM/Mb, which may affect substitution patterns and rates in this region. Here I report the analysis of substitution patterns and rates in 10 human, chimpanzee, gorilla, and orangutan genes across the p-PAR. Between species silent divergence in the p-PAR forms a gradient, increasing toward the telomere. The correlation of silent divergence with distance from the p-PAR boundary is highly significant (ρ = 0.911, P < 0.001). After exclusion of the CpG dinucleotides this correlation is still significant (ρ = 0.89, P < 0.01), thus the substitution rate gradient cannot be explained solely by the differences in the extent of methylation across the p-PAR. Frequent recombination in the PAR may result in a relatively strong effect of biased gene conversion (BGC), which, because of the increased probability of fixation of the G or C nucleotides at (A or T)/(G or C) segregating sites, may affect substitution rates. BGC, however, does not seem to be the factor creating the substitution rate gradient in the p-PAR, because the only gradient is still detactable if only A↔T and G↔C substitutions are taken into account (ρ = 0.82, P < 0.01). I hypothesize that the substitution rate gradient in the p-PAR is due to the mutagenic effect of recombination, which is very frequent in the distal human p-PAR and might be lower near the p-PAR boundary.
1056. Suppression and Enhancement of Gene Repair by the Modulation of ATM Function in Mammalian Cells
Authors: Julia Engstrom, Luciana Ferrara, Hetal Parekh-Olmedo, Eric B. Kmiec
Journal: Molecular Therapy (2005)

Targeted gene repair utilizes oligonucleotides to direct single base alterations in the genomes of mammalian cells. These vectors are designed to hybridize to the site of interest and to create a single mismatch with the mutant base. Although the mechanism of the nucleotide exchange phase of the reaction remains to be fully elucidated, evidence suggests that the induction of homologous recombination (HR) in response to DNA damage elevates DNA pairing activity and results in increased levels of gene repair. The HR pathway is controlled by the activation of the cell cycle checkpoint regulator, Ataxia-Telangiectasia mutated (ATM), which is induced by either DNA damage or by the presence of single stranded DNA. The radio-sensitizer, caffeine, has previously been shown to inhibit ATM kinase activity, by interfering with the phosphorylation of downstream substrates. When caffeine was added to a gene repair reaction prior to the introduction of the oligonucleotide, the frequency of correction was reduced, reinforcing the importance of HR in gene repair. If, however, caffeine was added after the oligonucleotide, the correction frequency was enhanced suggesting a dual functionality for caffeine in the gene repair reaction. Thus, we utilize caffeine as a reagent and a tool to understand the regulation of this reaction in greater detail. ATM activation in cells exposed to 4mM caffeine was examined following oligonucleotide delivery. At 18 and 24 hours, the level of ATM activation was increased significantly and even at 48 hours post-delivery, when ATM activation form the introduction of the ssDNA vector disappears, activated ATM was still quite discernable in caffeine treated cells. This sustained ATM activation could be explained by a concurrent effect of caffeine on the gene repair reaction; the oligonucleotide is retained by the cell for a longer period than in untreated cells. At 16 hours post electroporation, both cell populations exhibited about a 70% uptake of the oligonucleotide (as measured by the fluorescence of a FAM conjugated oligonucleotide). However, between 16 and 48 hours, the non-treated cells exhibit a steep drop in oligonucleotide levels, as compared to the caffeine treated cells. This suggests that the oligonucleotide activates ATM in all cells but in cells treated with caffeine, it reactivates ATM through an extended cellular half-life. The use of caffeine as a tool for studying the regulatory pathways of gene repair lead us to conclude that the activation of ATM is a critical step in promoting successful gene correction. On one hand ATM is required to induce HR which catalyses the first phase of gene repair (DNA pairing), but on the other hand, activated ATM can block the replication of corrected cells affecting the overall frequency of the reaction. We are now modulating the levels of ATM so that the balance can be tipped in favor of more robust levels of gene repair.
Antimalarials in Treatment of Sjogren's Syndrome
Authors: J. M. Heaton
Journal: BMJ (1959)

DYSPAREUNIABRrTSH often numerous small implants, so-called, scattered about the peritoneal surface of the adjacent bladder, rectum, or sigmoid.In the vast majority of cases following such resection there is sufficient interruption of the pituitary-ovarian hormonal axis to allow for regression and atrophy of these small areas of tissue. Chronic Infection
A135: Final Year Undergraduate Medical Student Use and Acceptability of an e-Learning Module in Pediatric Rheumatology
Authors: Taunton R. Southwood, Peter Rainger, Dabir Hussain, John Couperthwaite, Giles Perryer
Journal: Arthritis & Rheumatology (2014)

Background/Purpose:

Traditional medical student learning and teaching methods, such as lectures and bedside teaching, maybe inadequate for providing core knowledge and clinical skills in paediatrics, with reduction in undergraduate time allocated to paediatrics and increasing medical student numbers. To supplement paediatric knowledge and improve access to essential clinical skills, we developed an e-;learning module, “paediatric rheumatolog-e”, within a Canvas(c) learning management system. The design promoted revision of basic sciences (e.g. musculoskeletal anatomy, inflammation and immunological processes), in the context of clinical sciences (e.g. pharmacology, rheumatology and child development). Learning content comprised videos of patient and family narratives, clinical skills and layered information on 4 key learning outcomes: joint swelling, limb pain, back pain and the limping child. Optional information on juvenile idiopathic arthritis was provided. Core knowledge was consolidated using interaction, reflection and formatively assessed case-based quizzes.



Purpose: The aim of this study was to assess final year medical student use and acceptabilty of an e-learning module in paediatric rheumatology.



Methods:

341 final year medical students were notified of the e-learning module by email at the beginning of the academic year, and again 3 months later. Students beginning their paediatric rotation were reminded in the introductory lecture and written course materials. Use of the module was assessed 4 months into the academic year, after 3 blocks of medical students (193 students, 53% of the year) had undertaken a paediatric rotation. Canvas(c) embedded in-course analytics were used and acceptability was ascertained through online feedback and an email questionnaire.



Results:

187 students (55%) accessed the e-learning module (a mean of 14.8 pages per student, range 1–270, 28% >3); of these 20 (11%) answered at least one clinical quiz. Higher median quiz scores were found in the joint swelling quiz and back pain quiz. There was a preference for accessing the module during a paediatric rotation (74/193 students to date, 62%). Time for completion of the module was 1–1.5 hours. Student acceptability was high, with comments such as “thorough” and “engaging”, and requests for more e-learning modules.



Conclusion:

An e-learning module in a paediatric speciality was widely used and found to be acceptable by final year medical students.
RISK FACTORS FOR SEROCONVERSION TO HUMAN IMMUNODEFICIENCY VIRUS AMONG MALE HOMOSEXUALS
Authors: LawrenceA. Kingsley, Richard Kaslow, CharlesR. Rinaldo, Katherine Detre, Nancy Odaka, Mark Vanraden, Roger Detels, B.Frank Polk, Joan Chmiel, SherylF. Kelsey, David Ostrow, Barbara Visscher
Journal: The Lancet (1987)
Case 13-1982
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, Betty U. McNeely, E. Chester Ridgway, Austin L. Vickery
Journal: New England Journal of Medicine (1982)

Presentation of CaseA 54-year-old man was admitted to the hospital because of a goiter.He was well until five months earlier, when he experienced fever, cough, and a sore throat that persisted for five or six weeks. After the illness resolved he noticed bilateral hearing loss accompanied by a pressure sensation in the ears and by nasal discharge. Three and a half months before admission a physician found that the thyroid gland was three to four times the normal size and hard. The white-cell count was 13,300. The cholesterol, protein, albumin, globulin, and calcium were normal. The thyroxine was . . .
THE TREATMENT OF GASTRIC HEMORRHAGE
Authors: ALBERT F. R. ANDRESEN
Journal: JAMA (1927)

By gastric hemorrhage is meant a hemorrhage from the stomach or duodenum, manifesting itself as hematemesis or melena or both, and accompanied by the usual general symptoms of internal hemorrhage; namely, shock, thirst, restlessness and pallor, the severity of these symptoms depending, of course, on the extent of the hemorrhage. The bleeding may be due to a number of different factors, gastric or duodenal ulcer being most commonly thought of in the presence of a hemorrhage, but the rupture of esophageal or gastric varices secondary to portal stasis and gastric neoplasm are equally important and frequent causes. Vomiting of swallowed blood from pulmonary hemorrhage may be difficult to differentiate from true gastric hemorrhage, and occasionally immediate and careful nose and throat examination will show that the blood came from an ulcer or a varicosity in these locations. The mucosal hemorrhages of hemophilia, leukemia, splenic anemia, pernicious anemia, vicarious menstruation and
Hospitals are failing patients at end of life
Authors: I. Torjesen
Journal: BMJ (2012)

Patients who die in hospital are treated with less dignity and respect than those who die in hospices, especially the older people, according to the first official government survey to probe the quality of care people receive at the end of life.

The survey, which was commissioned by the Department of Health and will be repeated annually, found that wide discrepancies exist in the quality of care provided to people in the last three months of their life depending on their age, cause of death and place of death.

For the National Bereavement Survey 2011 the Office of National Statistics surveyed more than 48 000 bereaved people between …
Recurrent inactivation of STAG2 in bladder cancer is not associated with aneuploidy
Authors: Cristina Balbás-Martínez, Ana Sagrera, Enrique Carrillo-de-Santa-Pau, Julie Earl, Mirari Márquez, Miguel Vazquez, Eleonora Lapi, Francesc Castro-Giner, Sergi Beltran, Mònica Bayés, Alfredo Carrato, Juan C Cigudosa, Orlando Domínguez, Marta Gut, Jesús Herranz, Núria Juanpere, Manolis Kogevinas, Xavier Langa, Elena López-Knowles, José A Lorente, Josep Lloreta, David G Pisano, Laia Richart, Daniel Rico, Rocío N Salgado, Adonina Tardón, Stephen Chanock, Simon Heath, Alfonso Valencia, Ana Losada, Ivo Gut, Núria Malats, Francisco X Real
Journal: Nature Genetics (2013)
Protein ingestion increases muscle protein synthesis after, but not during, endurance exercise
Authors: C Hulston, E Wolsk, T Grøndahl, C Yfanti, G van Hall
Journal: British Journal of Sports Medicine (2010)

The purpose of this study was to determine muscle protein turnover and fractional synthetic rates during endurance exercise and recovery with carbohydrate (CHO) or CHO plus protein (CHO+P) ingestion. On two occasions, eight healthy males were studied at rest and during 3 h cycling and 3 h recovery. Leg muscle protein turnover was determined from stable isotope infusion (L-[ring-13C6]phenylalanine), arterial femoral-venous blood sampling and plasma flow measurements. Fractional synthetic rates (FSR) of the vastus lateralis were determined from the incorporation of L-[ring-13C6]phenylalanine into bound protein. Leg phenylalanine release, which is indicative of muscle protein breakdown, was ∼twofold higher during exercise than at rest (p&lt;0.05), and was not different between CHO and CHO+P (p&gt;0.05). CHO+P ingestion increased leg phenylalanine uptake during exercise (p&lt;0.05) and increased muscle intracellular phenylalanine concentration (p&lt;0.05). However, FSR were not different between CHO and CHO+P (0.029±0.004 and 0.030±0.003%/h respectively, p=0.88). During the recovery period, FSR were 0.070±0.003 and 0.105±0.013%/h for CHO and CHO+P, respectively (p&lt;0.01). Furthermore, ingesting CHO+P during recovery resulted in a net phenylalanine uptake, compared with a net phenylalanine release in the CHO trial. The authors conclude: (1) that endurance exercise increases muscle protein breakdown, (2) protein ingestion does not reduce muscle protein breakdown or increase muscle protein synthesis during exercise, (3) protein ingestion augments post-exercise muscle protein synthesis and (4) protein ingestion is essential to achieve positive muscle protein balance during recovery from endurance exercise.
Comparison of rates of adverse events in adolescent and adult women undergoing medical abortion: population register based study
Authors: M. Niinimaki, S. Suhonen, M. Mentula, E. Hemminki, O. Heikinheimo, M. Gissler
Journal: BMJ (2011)

<b>Objective</b> To determine the risks of short term adverse events in adolescent and older women undergoing medical abortion. <b>Design</b> Population based retrospective cohort study. <b>Setting</b> Finnish abortion register 2000-6. <b>Participants</b> All women (n=27 030) undergoing medical abortion during 2000-6, with only the first induced abortion analysed for each woman. <b>Main outcome measures</b> Incidence of adverse events (haemorrhage, infection, incomplete abortion, surgical evacuation, psychiatric morbidity, injury, thromboembolic disease, and death) among adolescent (&lt;18 years) and older (≥18 years) women through record linkage of Finnish registries and genital <i>Chlamydia trachomatis</i> infections detected concomitantly with abortion and linked with data from the abortion register for 2004-6. <b>Results</b> During 2000-6, 3024 adolescents and 24 006 adults underwent at least one medical abortion. The rate of chlamydia infections was higher in the adolescent cohort (5.7% <i>v</i> 3.7%, P&lt;0.001). The incidence of adverse events among adolescents was similar or lower than that among the adults. The risks of haemorrhage (adjusted odds ratio 0.87, 95% confidence interval 0.77 to 0.99), incomplete abortion (0.69, 0.59 to 0.82), and surgical evacuation (0.78, 0.67 to 0.90) were lower in the adolescent cohort. In subgroup analysis of primigravid women, the risks of incomplete abortion (0.68, 0.56 to 0.81) and surgical evacuation (0.75, 0.64 to 0.88) were lower in the adolescent cohort. In logistic regression, duration of gestation was the most important risk factor for infection, incomplete abortion, and surgical evacuation. <b>Conclusions</b> The incidence of adverse events after medical abortion was similar or lower among adolescents than among older women. Thus, medical abortion seems to be at least as safe in adolescents as it is in adults.
Double blind clinical and laboratory study of hypoglycaemia with human and porcine insulin in diabetic patients reporting hypoglycaemia unawareness after transferring to human insulin.
Authors: A Maran, J Lomas, H Archibald, I A Macdonald, E A Gale, S A Amiel
Journal: BMJ (1993)

OBJECTIVES--To compare awareness of hypoglycaemia and physiological responses to hypoglycaemia with human and porcine insulin in diabetic patients who reported loss of hypoglycaemia awareness after transferring to human insulin. DESIGN--Double blind randomised crossover study of clinical experience and physiological responses during slow fall hypoglycaemic clamping with porcine and human insulin. SETTING--Clinical investigation unit of teaching hospital recruiting from diabetes clinics of five teaching hospitals and one district general hospital. SUBJECTS--17 patients with insulin dependent diabetes mellitus of more than five years9 duration who had reported altered hypoglycaemia awareness within three months of transferring to human insulin. MAIN OUTCOME MEASURES--Glycaemic control and frequency of hypoglycaemic episodes during two months9 treatment with each insulin. Glucose thresholds for physiological and symptomatic responses during clamping. RESULTS--Glycaemic control did not change with either insulin. 136 hypoglycaemic episodes (eight severe) were reported with human insulin and 149 (nine severe) with porcine insulin (95% confidence interval -4 to 2.5, p = 0.63). 20 episodes of biochemical hypoglycaemia occurred with human insulin versus 18 with porcine insulin (-0.8 to 1, p = 0.78). During controlled hypoglycaemia the mean adrenaline response was 138 nmol/l/240 min for both insulins; neurohormonal responses were triggered at 3.0 (SE 0.2) versus 3.1 (0.2) mmol/l of glucose for adrenaline and 2.5 (0.1) versus 2.5 (0.1) mmol/l for subjective awareness. CONCLUSIONS--These data suggest that human insulin per se does not affect the presentation of hypoglycaemia or the neurohumoral, symptomatic, and cognitive function responses to hypoglycaemia in insulin dependent diabetic patients with a history of hypoglycaemia unawareness.
Induction of Abortion by Prostaglandins E1 and E2
Authors: M. P. Embrey
Journal: BMJ (1970)

Intravenous infusions of prostaglandin E (E(1) or E(2)) were used for termination of pregnancy in 11 patients. Induction of abortion was successful in nine instances and in eight the abortion was complete. No undesirable side-effects were recorded.
Biofeedback and Behavioral Approaches in Japan
Authors: Hitoshi Ishikawa, Allen Robinson
Journal: Psychotherapy and Psychosomatics (1981)

A number of studies and case histories involving the use of biofeedback and behavioral approaches throughout Japan have been selected from Japanese journals and summarized. Areas of biofeedback research covered are experimental, clinical and psychological/educational. The behavioral approaches mentioned have been limited to those currently being used in Japan in conjunction with various biofeedback modalities. A brief explanation of a new biofeedback-monitored multi-modal psychosomatic therapy approach developed in Japan, termed cybernation therapy, is also presented along with current Japanese thought on the use of biofeedback in psychotherapy.
New authority to monitor xenotransplantation experiments
Authors: J. Wise
Journal: BMJ (1997)

The British government is to set up a regulatory authority to monitor all research into xeno-transplantation– the transplantation of animal tissue into humans. Human trials will not be allowed to go ahead until there has been more research into aspects of physiology, immunology, and the risk of infection.



Pigs would be ethically acceptable as a source material.

IMUTRAN



Health secretary Stephen Dorrell accepted the main recommendations of the advisory group on the ethics of xeno-transplantation headed by Ian Kennedy, professor of medical law and ethics at King's College, London. He announced the establishment of the Xenotransplantation Interim Regulatory Authority, which will be chaired by Lord Habgood of Calverton. The authority will regulate developments until there is a suitable opportunity for primary legislation.

The advisory committee's report Animal Tissue into Humans concluded that xenotransplantation could be ethically acceptable if certain conditions were met. It states that it would not be ethically acceptable to use primates as a source of materials for xenotransplantation, mainly because they would …
REPORT OF COMMITTEE ON EXAMINATION AND CARE OF EYES DURING SCHOOL LIFE—INSTRUCTION OF TEACHERS AND SCHOOL AUTHORITIES AND LEGAL PROVISIONS.
Authors: B. ALEX. RANDALL
Journal: JAMA (1895)

<h3>Mr. Chairman and Gentlemen:</h3> —Your Committee in approaching the subject assigned to them, find themselves of one mind in advocating advance in this important field of preventive medicine; but can less easily concur upon the exact lines within which they deem it practicable to advise action at the present time. Located in cities of various sizes and widely separated portions of the country, the environment of each member must react distinctly upon his view of what it is judicious to attempt, for it is practically self-evident that the popular mind is but little prepared for any active steps in the matter, and that it will be very unwise to take a position too advanced to secure the indorsement of reasonable men, medical and lay. Public opinion alone can carry this project through; and even in the profession—nay, even among our ophthalmic colleagues—this opinion has still largely to be shaped.
Postpartum Hemolytic Uremic Syndrome
Authors: Allen R. Nissenson
Journal: JAMA (1979)

POSTPARTUM hemolytic uremic syndrome (HUS) is a condition of obscure origin with grave prognostic implications. Of the 40 cases described to date, 80% of the patients have died, and 15% have required maintenance dialysis or renal transplantation. Only 5% have recovered, and all of these showed improvement within one month.<sup>1</sup> We describe a patient with postpartum HUS and renal failure who recovered much later than previously reported, after more than a year of receiving maintenance dialysis. <h3>Report of a Case</h3> A 28-year-old woman (gravida 2, para 0) was admitted to the Prentice Women's Hospital at the 28th week of pregnancy because of mild hypertension and protein-uria. Her first pregnancy five years earlier was interrupted by a spontaneous abortion at 15 weeks. During the current pregnancy, she gained 11.4 kg during a seven-month period, and her blood pressure (BP) had increased from 110/60 to 150/70 mm Hg. Results of urinalysis