tbuckley/cabot-search huggingface dataset:
Retrospective study of children with renal scarring associated with reflux and urinary infection
Authors: J M Smellie, A Poulton, N P Prescod
Journal: BMJ (1994)

<h3>Abstract</h3> <b>Objective</b>: To review the histories of children with bilateral renal scarring and severe vesicoureteric reflux to determine whether an improvement in early management might reduce the risk of scarring. <b>Design</b>: Retrospective study of medical records and discussion with parents. <b>Setting</b>: Outpatient departments of two teaching hospitals. <b>Patients</b>: 52 children aged 1-12 years participating in a randomised comparison of medical and surgical management. All had a history of symptomatic urinary tract infection. Two thirds presented with fever and two with hypertension or renal failure. In only one out of 32 children examined by antenatal ultrasonography was an abnormality suspected. Results - There was delay in diagnosis or appropriate imaging or effective treatment of urinary infection in 50 of the 52 children. In 41 there was delay in diagnosis; there was delay in treating a confirmed infection in 45; no antibacterial prophylaxis was prescribed before imaging in 28; and investigation of the urinary tract was delayed in 33. The severity of scarring was significantly related to delay in diagnosis (X<sup>2</sup> for trend 7.43, P=0.01).Four children of mothers known to have reflux nephropathy were not investigated until they developed urinary tract infection. <b>Conclusions</b>: Efforts to reduce the incidence and severity of renal scarring should be directed towards rapid diagnosis and effective early management of urinary tract infection in infancy and childhood. Stolings and offspring of known patients with severe reflux nephropathy should be investigated for reflux.
Quantitative and qualitative assessment of plasma von Willebrand factor in classic Kaposi's sarcoma
Authors: Emmilia Hodak, Akiva Trattner, Michael David, Nurit Kornbrot, Baruch Modan, Hedwig Lurie, Andrew Lawrie, Paul Harrison, Miriam Sandbank, Aida Inbal
Journal: Journal of the American Academy of Dermatology (1993)
Kentucky governor signs death warrant despite medical association guidance
Authors: Fred Charatan
Journal: BMJ (2004)

A newly elected state governor, a doctor, has been criticised by a group of medical students for signing a prisoner's death warrant, because guidelines from the American Medical Association say that doctors should not actively take part in executions or do anything that “would directly cause the death of the condemned.” The case is causing a furore, partly because the governor is a doctor and partly because the prisoner is thought to have an IQ of only 74.

Republican governor Ernest Fletcher last month signed the death warrant of convicted murderer Thomas Bowling, aged 51. The execution …
Magnesium Sulfate Reduces Myocardial Infarct Size When Administered Before but Not After Coronary Reperfusion in a Canine Model
Authors: Carl W. Christensen, Michelle A. Rieder, Eve L. Silverstein, Nelson E. Gencheff
Journal: Circulation (1995)

The role of magnesium in treating acute myocardial infarction (AMI) has been controversial. Several small clinical trials indicate that magnesium may have a role in treating AMI early, whereas the other results suggest that magnesium is of questionable benefit.We looked at the effect of magnesium on infarct size (IS) when given during a coronary occlusion and after reperfusion. Magnesium sulfate (6-mEq bolus plus 2 mEq/h for 5 hours) was given at 15 or 45 minutes of coronary occlusion or 15 minutes of reperfusion. The left anterior descending coronary artery was occluded for 90 minutes, followed by 300 minutes of reperfusion. IS to area at risk (IS/AR) was measured by planimetry after triphenyltetrazolium chloride staining. Collateral myocardial blood flow was measured with radioactive microspheres. The IS/AR ratio in the control group was 52.3 +/- 19.6% compared with 20.5 +/- 11.7% and 21.3 +/- 6.5% at 15 and 45 minutes of occlusion, respectively (P < .05). There were no significant differences in the reduction in IS at 15 and 45 minutes of occlusion. Although there was a reduction in the IS when magnesium was administered during reperfusion (38.2 +/- 13.4%), it was not statistically significant. There was no significant difference in the AR relative to the total left ventricular weight between the four groups.The data suggest that magnesium infusion during a coronary occlusion has a significant benefit in reducing the IS in this model. Magnesium may have a beneficial clinical role in AMI, especially if administered before reperfusion as a bolus followed by a constant infusion.
Bendectin--birth defects controversy
Authors: S. A. Newman
Journal: JAMA (1990)

To the Editor.—  The recent Medical News article by Skolnick 1 on issues concerning the morning sickness drug Bendectin, which has been claimed to cause limb reduction and other birth defects, states that nearly every study provided reassuring evidence that Bendectin was safe. Perhaps he was alluding to epidemiologic studies, which have proved inconclusive. He certainly could not have been referring to the published experimental literature on the direct effects of Bendectin and its antihistamine component doxylamine on isolated limbforming tissues. All of these studies, 2-4 which were performed in one avian and two mammalian species, confirm that Bendectin, at a concentration of approximately 10 mg/L, drastically curtails the formation of embryonic cartilage, the tissue that forms the primordia of the developing skeleton. 5 This is the same concentration range in which diphenylhydantoin, a known teratogen, impairs development of these cells. 2   One recent study 4 has shown that in
Triparental Families: A New Genetic-Epidemiological Design Applied to Drug Abuse, Alcohol Use Disorders, and Criminal Behavior in a Swedish National Sample
Authors: Kenneth S. Kendler, Henrik Ohlsson, Jan Sundquist, Kristina Sundquist
Journal: American Journal of Psychiatry (2015)

The authors sought to clarify the sources of parent-offspring resemblance for drug abuse, alcohol use disorders, and criminal behavior, using a novel genetic-epidemiological design.Using national registries, the authors identified rates of drug abuse, alcohol use disorders, and criminal behavior in 41,360 Swedish individuals born between 1960 and 1990 and raised in triparental families comprising a biological mother who reared them, a "not-lived-with" biological father, and a stepfather.When each syndrome was examined individually, hazard rates for drug abuse in offspring of parents with drug abuse were highest for mothers (2.80, 95% CI=2.23-3.38), intermediate for not-lived-with fathers (2.45, 95% CI=2.14-2.79), and lowest for stepfathers (1.99, 95% CI=1.55-2.56). The same pattern was seen for alcohol use disorders (2.23, 95% CI=1.93-2.58; 1.84, 95% CI=1.69-2.00; and 1.27, 95% CI=1.12-1.43) and criminal behavior (1.55, 95% CI=1.44-1.66; 1.46, 95% CI=1.40-1.52; and 1.30, 95% CI=1.23-1.37). When all three syndromes were examined together, specificity of cross-generational transmission was highest for mothers, intermediate for not-lived-with fathers, and lowest for stepfathers. Analyses of intact families and other not-lived-with parents and stepparents showed similar cross-generation transmission for these syndromes in mothers and fathers, supporting the representativeness of results from triparental families.A major strength of the triparental design is its inclusion, within a single family, of parents who provide, to a first approximation, their offspring with genes plus rearing, genes only, and rearing only. For drug abuse, alcohol use disorders, and criminal behavior, the results of this study suggest that parent-offspring transmission involves both genetic and environmental processes, with genetic factors being somewhat more important. These results should be interpreted in the context of the strengths and limitations of national registry data.
Unilateral Nevoid Telangiectasia
Authors: VICTOR J. SELMANOWITZ
Journal: Annals of Internal Medicine (1970)

Telangiectases in unilateral dermatomal distributions developed in a woman at the time of puberty and were present in a man from the time of birth. The woman also had erythema palmare. Systemic disease was not demonstrable in either patient, and the cutaneous condition is considered nevoid in these cases. The same pattern of unilateral dermatomal telangiectasia has been previously described associated with pregnancy, hepatic and pulmonic disease, and scleroderma. A visceral-cutaneous neural reflex mechanism, in addition to hormonal stimulation, explains the phenomenon of the distribution pattern.
Abstract 3941: HAF promotes the switch from HIF-1α to HIF-2α signaling during chronic hypoxia and promotes stem cell characteristics
Authors: Mei Yee Koh, Robert Lemos, Garth Powis
Journal: Cancer Research (2012)

Abstract Most solid tumors and their metastases experience periods of hypoxia, which promotes tumor progression and resistance to therapy. Hypoxia is also an important micro-environmental factor supporting the maintenance of pluripotent cancer stem/progenitor cells (CSCs) within the stem cell niche. The clinical relevance of CSCs is underscored by their resistance to cytotoxic therapies, invasive potential and role in tumor recurrence. Critical mediators of the hypoxia response are the hypoxia-inducible factors HIF-1α and HIF-2α. Although they have some overlapping functions, the HIFs are generally non-redundant whereby HIF-1α regulates the acute metabolic changes required for hypoxic survival, whereas HIF-2α promotes the adaptation to chronic hypoxia, including the maintenance of CSCs. However, the mechanism determining selectivity for HIF-1α versus HIF-2α activation is unclear. Here we describe a new mechanism for the switch between HIF-1α and HIF-2α dependent transcription during chronic hypoxia by the hypoxia associated factor (HAF). HAF is overexpressed in a number of tumor types and is an E3 ubiquitin ligase that ubiquitinates HIF-1α independently of oxygen and pVHL, thus targeting HIF-1α for proteasomal degradation. HAF also binds to HIF-2α but at a different site than it binds to HIF-1α, increasing HIF-2α transactivation without causing its degradation. Hence HAF switches cellular dependence from HIF-1α towards HIF-2α, resulting in the activation of HIF-2α specific target genes (MMP9, OCT3/4)and the simultaneous inhibition of HIF-1α specific target genes (CA-IX, DDIT4). HAF itself is hypoxia regulated - decreasing during acute hypoxia, but increasing with hypoxic duration. Hence HAF is a key determinant of HIF-2 versus HIF-1 activation in response to hypoxia. Using cell-free recombinant proteins and in vitro binding assays, we show that HAF binding to HIF-2α requires a novel eukaryotic post-translational modification of HIF-2α within a unique region of HIF-2 that is absent from HIF-1. HAF binding to HIF-2α is increased in cells exposed to prolonged hypoxia and promotes the transcription of HIF-2α target genes important in CSC maintenance such as OCT3/4 and SOX2. HAF levels are elevated in CD133+ U87 glioblastoma stem/progenitor cells and HAF knockdown decreases neurosphere formation suggesting a key role for HAF in the maintenance of the stem cell phenotype. The HAF-induced switch to HIF-2α dependent transcription promotes invasion and enriches the proportion of stem/progenitor CD133+ U87 cells. This increases the rate of tumor take and increases tumor morbidity in vivo. Funded by NIH CA095060, CA17094, CA098920 Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3941. doi:1538-7445.AM2012-3941
Analysis of Serial Ovarian Volume Measurements and Incidence of Ovarian Cancer: Implications for Pathogenesis
Authors: Clara Bodelon, Ruth M. Pfeiffer, Saundra S. Buys, Amanda Black, Mark E. Sherman
Journal: JNCI Journal of the National Cancer Institute (2014)

Accumulating evidence suggests that many ovarian cancers represent metastases from occult fallopian tube carcinomas or tumors arising within ovarian endometriosis. We hypothesized that small ovarian volumes, as reflected in nonvisualization by transvaginal ultrasound (TVU), would be a marker of lower ovarian cancer risk, whereas enlargement on serial examinations would indicate higher risk.To address these hypotheses, we analyzed serial ovarian volume measurements determined by TVU for 29321 women (102787 scans) performed in the ovarian cancer screening arm of the Prostate, Lung, Colorectal, and Ovarian (PLCO) trial. Cox models were used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) as measures of association between TVU results and ovarian cancer. We assessed whether increasing ovarian volume preceded diagnosis of ovarian cancer in a nested case-control analysis comparing case patients and control patients matched on age, center, and screening year (1:4 ratio). All statistical tests were two-sided.Visualization of normal-appearing ovaries at the last TVU scan was associated with marginally higher ovarian cancer risk compared with nonvisualization of the ovaries (HR = 1.42, 95% CI = 1.00 to 2.01). Ovarian volume increased statistically significantly in ovarian cancer case patients one to two years before diagnosis (P < .001), but not in matched control patients.Our analysis of TVU data suggests that increasing ovarian volume is associated with greater ovarian cancer risk, but it is only detectable one to two years before diagnosis.
Aberrant DNA hypermethylation signature in acute myeloid leukemia directed by EVI1
Authors: Sanne Lugthart, Maria E. Figueroa, Eric Bindels, Lucy Skrabanek, Peter J. M. Valk, Yushan Li, Stefan Meyer, Claudia Erpelinck-Verschueren, John Greally, Bob Löwenberg, Ari Melnick, Ruud Delwel
Journal: Blood (2010)
The isochromosome i(7)(q10) carrying c.258+2t&gt;c mutation of the SBDS gene does not promote development of myeloid malignancies in patients with Shwachman syndrome
Authors: A Minelli, E Maserati, E Nicolis, M Zecca, L Sainati, D Longoni, F Lo Curto, G Menna, F Poli, E De Paoli, M Cipolli, F Locatelli, F Pasquali, C Danesino
Journal: Leukemia (2009)
Physicians and Preventive Services
Authors: David L. Hahn
Journal: Annals of Internal Medicine (1992)

Letters15 January 1992Physicians and Preventive ServicesDavid L. Hahn, MDDavid L. Hahn, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-116-2-170_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors:In their recent article, Udvarhelyi and colleagues (1) compared the quality of ambulatory care (hypertension control and delivery of selected preventive procedures) by insurance status (fee-for-service compared with prepaid) for patients treated in the same medical offices by the same physicians. In their study setting, they found that the quality and quantity of ambulatory care for patients enrolled in a Health Maintenance Organization (HMO) was equal to or better than that for patients receiving care on a fee-for-service basis. In their Discussion the authors considered the hypothesis that "individual physicians were unable to differentiate their styles of...References1. UdvarhelyiJennisonPhillipsEpstein IKRA. Comparison of the quality of ambulatory care for fee-for-service and prepaid patients. Ann Intern Med. 1991;115:394-400. LinkGoogle Scholar2. Hahn D. Feasibility of sigmoidoscopic screening for bowel cancer in a primary care setting. J Am Board Fam Pract. 1989;2:25-9. MedlineGoogle Scholar3. HahnBerger DM. Implementation of a systematic health maintenance protocol in a private practice. J Fam Pract. 1990;31:492-504. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Arcand Park Clinic Madison, WI 53704 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 January 1992Volume 116, Issue 2Page: 170-171KeywordsHealth care qualityHealth maintenance organizationsHypertensionPatients Issue Published: 15 January 1992 PDF downloadLoading ...
Influence of intrinsic sympathomimetic activity on respiratory function.
Authors: R J Northcote
Journal: BMJ (1986)

Congress of the European Society of MagneticResonance in Medicine and Biology, Aberdeen 1986).In addition, the presence and extent of periventricular "lucency," representing a local increase in water content, is more clearly shown with magnetic resonance imaging.We think that cerebrospinal fluid volume measurements and ventricular:cortical sulcal ratios will provide a more rational basis for diagnosis and management.
Esophageal Leiomyoma: A Rare Cause of False-Positive FDG Scans
Authors: Gustavo S. P. Meirelles, Gregory Ravizzini, Henry W. D. Yeung, Timothy Akhurst
Journal: Clinical Nuclear Medicine (2006)

A 44-year-old nonsmoking man presented for evaluation of a positive PPD. Chest radiographs revealed a large mediastinal mass. Subsequent CT and MRI demonstrated a mediastinal mass extending from the region of the distal esophagus to the lesser curvature of the stomach. On the esophagogram, there was compression and displacement of the distal esophagus. PET/CT demonstrated increased FDG uptake suspicious for malignancy. EGD with endoscopic ultrasound and fine needle aspiration were performed and cytology was suspicious for spindle cell neoplasm. Pathologic evaluation of the surgical specimen was consistent with esophageal leiomyoma.
Hospice Use Among Medicare Managed Care and Fee-for-Service Patients Dying With Cancer
Authors: Ellen P. McCarthy
Journal: JAMA (2003)

ContextFor most patients aged 65 years or older with cancer, hospice services are uniformly covered by Medicare. Hospice care is believed to improve care for patients at the end of life. However, few patients use hospice and others enroll too late to maximize the benefits of hospice services.ObjectivesBecause type of insurance may affect use, we examined whether patients with Medicare managed care insurance enrolled in hospice earlier and had longer hospice stays than patients with Medicare fee-for-service (FFS) insurance.Design and SettingRetrospective analysis of the last year of life using the Linked Medicare-Tumor Registry Database in 1 of 9 Surveillance, Epidemiology, and End Results program coverage areas.PatientsA total of 260 090 Medicare beneficiaries aged 66 years or older diagnosed with first primary lung (n = 62 117), colorectal (n = 57 260), prostate (n = 59 826), female breast (n = 37 609), bladder (n = 19 598), pancreatic (n = 11 378), gastric (n = 9599), or liver (n = 2703) cancer between January 1, 1973, and December 31, 1996, and who died between January 1, 1988, and December 31, 1998.Main Outcome MeasuresTime from diagnosis to hospice entry and hospice length of stay for patients enrolled in FFS vs managed care plans after adjusting for patient demographics, tumor registry, year of hospice entry, and type and cancer stage.ResultsOf the 260 090 patients, most were men (59%), white (85%), and enrolled in FFS (89.7%). Only 54 937 patients (21.1%) received hospice care before death. Hospice use varied by type of primary cancer ranging from 31.8% of patients with pancreatic cancer to 15.6% with bladder cancer. Managed care patients were more likely to use hospice than FFS patients (32.4% vs 19.8%, P<.001). Among hospice patients, median (interquartile range) length of stay was longer for managed care vs FFS patients (32 days [11-82] vs 25 days [9-66], P<.001). After adjustment, managed care patients had higher rates of hospice enrollment (adjusted hazard ratio [HR], 1.38; 95% CI, 1.35-1.42) and had a longer length of stay (adjusted HR, 0.91; 95% CI, 0.88-0.94) vs FFS patients. Managed care patients were less likely to enroll in hospice within 7 days of their death (18.6% vs 22.6%, P<.001) and somewhat more likely to enroll in hospice more than 180 days before death (7.8% vs 6.1%, P<.001); the results for each of the 8 cancer diagnoses were similar. Hospice enrollment and length of stay among managed care vs FFS patients differed significantly by region.ConclusionMedicare beneficiaries enrolled in managed care had consistently higher rates of hospice use and significantly longer hospice stays than those enrolled in FFS. Although these differences may reflect patient and family preferences, our findings raise the possibility that some managed care plans are more successful at facilitating or encouraging hospice use for patients dying with cancer.
NHS fails to charge local authorities for blocked hospital beds—but delayed discharge is mostly hospitals' fault
Authors: Roger Dobson
Journal: BMJ (2007)

Most hospitals in England do not charge local authorities for “bed blocking,” the term that describes extra stay in hospital because social services have failed to provide the care services that patients need after discharge, new research has found. However, it also found that the NHS, rather than local authorities, is responsible for two thirds of the number of bed days resulting from delayed discharge.

“There is no evidence to support government policy of charging social service departments for delay,” say the authors of the study, which provides data from across England on delays in discharge of patients from acute hospitals since the Community Care Act was introduced in 2003 ( Journal of Public Health doi: 10.1093/pubmed/fdm026). This act gave NHS hospitals the power to charge social …
Liver Disease Associated with Early Syphilis
Authors: Alfred L. Baker, Marshall M. Kaplan, Hubert J. Wolfe, John A. McGowan
Journal: New England Journal of Medicine (1971)

RECENT public-health surveys indicate a marked increase in the prevalence of needle-transferred hepatitis in young people.1 Similarly, an attitude of increasing sexual permissiveness has been accompanied by an increasing incidence of venereal disease.2 Although needle-transferred hepatitis is the most common cause of jaundice in this group, other rare but readily treatable causes of hepatitis must now be considered. The following case is an example of a patient with early syphilis who presented with jaundice.Case ReportA 36-year-old homosexual was admitted to the New England Medical Center Hospitals in August, 1969, with jaundice, dark urine and clay-colored stools of 2 . . .
Psychotherapy Training in an Isolated Setting
Authors: John Penman
Journal: Psychotherapy and Psychosomatics (1990)

This paper describes the setting up of a training programme in psychodynamic psychotherapy in Perth, 'the most isolated city in the world'. Previous attempts to do so have petered out after a short period of time. It had certainly never been possible to develop a training programme. Initially a study group of interested health professionals was formed in 1984 which met to study certain texts at fortnightly meetings and participated in workshops conducted by the supervisors who visited from Sydney, 3,400 km away. At the end of that year the study group was changed into the Association for Psychodynamic Psychotherapy of Western Australia. The foundation members were also the first training group. The training programme consisted of fortnightly meetings concerned with intragroup issues, administrative matters and with the didactic programme: this consisted of seminars being conducted as part of a training programme in Sydney which were recorded on videotape and flown to Perth. As the 3-year training progressed we also added additional topics of our own. On the alternative fortnight the members split into small groups for peer supervision of audiotape recordings of sessions with the patient being supervised. In addition there were supervision workshops conducted by the visiting supervisors from Sydney. The paper also discusses the logistical problems of conducting such a training as well as transference and countertransference issues that arose within the group of trainees as well as with the supervisors who were so far away.