tbuckley/cabot-search huggingface dataset:
Effects of Outcome on Physicians' Judgment of Appropriateness of Care
Authors: David D. Woods
Journal: JAMA (1991)

To the Editor.  —Caplan et al1showed an outcome bias in physician evaluations of patient care. In research on error, it is critical to distinguish outcome failures from deficiencies or defects in the decision-making or problem-solving process.  Not all defects in decision processes are associated with bad outcomes; other factors may be necessary for the defect to propagate along a chain of negative consequences.2Conversely, bad outcomes can occur despite good decisions, ie, despite complete and thorough consideration of all of the available information, goals, and contributing factors.3Appreciating this fundamental aspect of human decision behavior is critical for  Guidelines for Letters  Letters will be published at the discretion of the editor as space permits and subject to editing and abridgment. They should be typewritten double-spaced and submitted in duplicate. They should not exceed 500 words of text. References, if any, should be held to a minimum,
Hyposensitization in asthmatics with mPEG‐modified and unmodified house dust mite extract
Authors: H. Mosbech, R. Djurup, S. Dreborg, L. Kærgaard Poulsen, P. Stahl Skov, I. Steringer
Journal: Allergy (1990)

Forty‐six adult asthmatics allergic to D. pteronyssinus (Dp) participated in a 2‐year study. Thirty‐one underwent hyposensitization (HS‐group). Fifteen were treated with Dp‐extract (Dp‐group), and 16 with a similar extract modified by monomethoxypolyethylene glycol with reduced allergenicity (mPEG‐Dp‐group). Fifteen patients served as controls. Dp‐specific antibodies and histamine release from blood basophils were determined and compared with Dp‐sensitivity in lungs and skin. In addition, IgG and IgE against the major allergen Der p I were followed in a subgroup. Dp‐specific IgG, IgG., and IgG 4 increased significantly in both HS‐treated groups after 1 and 2 years (median; 2.5‐ to 11.6‐fold). IgG 4 was not induced if maintenance dose during the first year was less than 20,000 BU. Median skin sensitivity decreased 4.4‐ to 8.2‐fold after 1 year and 7.4‐ to 21.4‐fold after 2 years. Der p I specific IgG response was unrelated to the occurrence or change in IgE with the same specificity. The mPEG‐Dp‐extract tended to have less effect on skin sensitivity and immunological parameters, differences reaching statistical significance for skin sensitivity only. In the HS‐group, the decrease in bronchial sensitivity was significantly correlated to a decrease in IgE (r = 0.36), IgG 1 /IgG 4 (r = 0.49), Dp‐specific histamine release (r = 0.58), and to an increase in Dp‐specific IgG, (r =−0.36) and IgG 4 /IgE (r =−0.48). In patients improving clinically. Dp‐specific IgG 4 /IgE increased, and median Dp‐specific IgE was reduced to 80 % compared with an increase to 150–160% seen in the unchanged or deteriorated group ( P &lt; 0.05). Findings indicate an improvement of effect, if the allergen dose is sufficient to reduce specific IgE and/or induce an IgG and especially IgG 4 response.
Thrombin generation in human coronary arteries after percutaneous transluminal balloon angioplasty
Authors: Jonathan D. Marmur, Samin K. Sharma, Neda Khaghan, Sabino R. Torre, Douglas H. Israel, Piera A. Merlini, Diego Ardissino, John A. Ambrose
Journal: Journal of the American College of Cardiology (1994)
Risk of Persistent Growth Impairment after Alternate-Day Prednisone Treatment in Children with Cystic Fibrosis
Authors: Hui-Chuan Lai, Stacey C. FitzSimmons, David B. Allen, Michael R. Kosorok, Beryl J. Rosenstein, Preston W. Campbell, Philip M. Farrell
Journal: New England Journal of Medicine (2000)

It is uncertain whether the growth impairment that occurs in children during long-term treatment with glucocorticoids persists after the medication is discontinued and ultimately affects adult height.
Molecular characterization of Hb S(C) β‐thalassemia in American blacks
Authors: J. M. Gonzalez‐Redondo, A. Kutlar, F. Kutlar, V. C. McKie, K. M. McKie, E. Baysal, T. H. J. Huisman
Journal: American Journal of Hematology (1991)

Abstract An extension of previous reports describing the molecular defects and hematological abnormalities in black patients with Hb S(C) β‐thalassemia living in the Southeastern United States is presented. As many as 58 patients with Hb S‐β + ‐thalassemia, 16 with Hb C‐β + ‐thalassemia and 12 with Hb S‐β°‐thalassemia have been studied. Patients with Hb S(C) β + ‐thalassemia type 2 (high Hb A values) were most common; the thalassemia was due to mutations in the promoter of the β‐globin gene [−88 (C → T) and −29 (A → G)] or at the polyadenylation signal (T → C). Two patients with lower Hb A values (type 1) carried a mutation in the first intron of the β‐globin gene (IVS‐1‐5: G → T). The simultaneous presence of an α‐thalassemia −2( − αl ) resulted in some modifications of the hematological parameters, but had a minimal effect on the clinical condition. Patients with Hb S‐β°‐thalassemia had lower hemoglobin values, lower number of red blood cells, and lower MCHC values and suffered more frequently from complications than the patients with Hb S‐β + ‐thalassemia. A total of 17 different β‐thalassemia mutations were observed in 128 chromosomes; two mild β + ‐thalassemia mutations [−88(C → T) and −29(A → G)] account for more than 80% of the thalassemic chromosomes.
The Examination of One Hundred Cases of Typhoid Fever by Widal's Serum Test
Authors: J. Colville, W. D. Donnan
Journal: BMJ (1897)

With a little education of the eye, any stone-oxalate, turate, or phosphate-can be detected in the kidney or its pelvis, if sufficient strength of x ray is employed and the screen is held near the organ.Figs. 4 and 5 represent the visual appearances of these 'Fig.5.-Radiograph of phosphatic and uratic stone in pelvis of kidney.three classes of calculus.The screen, which can be much improved, is of a kidney shape, so as to be easily adaptable to the edge of the loin.It was3 made for me by Mr. Montague, of New Bond Street, who has kindly helped me throughout the work.The disadvantages of the method are as follows:i.The kidney must be brought on to the loin, and it is not every kidney that can be dislocated.In some the vessels are too short, in others the kidney is fixed high up under the ribs, and the operator may at once feel that free separation ought not to be risked.Women, of course, are easy subjects for renal dislocation-in fact, renal surgery in women bears no comparison, as regards difficulty, with that of men.2. The operating room must be absolutely dark, and the initial steps of exposing the organ of course need a fair light.3. The rays ought to be from a io-inch coil, and concen- trated upon the kidney, the tube being placed near the -organ.4. The screen used must be a good one, for there are many sereens on the market which do not deserve the name of a fluoroscope.It should be made so that it can be rendered a-septic, and must be brought near the kidney.In Fig. 5, whiceh is introduced to emphasise the fact that the kidney is exposed, the fluoroscope is, for the sake of clear- ness, placed too far off the kidney.
Cryohypophysectomy for Diabetic Retinopathy
Authors: Dorothy T. Krieger, David K. Sirota, Theodore Lieberman
Journal: Annals of Internal Medicine (1970)

Transphenoidal cryohypophysectomy was performed on 20 diabetic subjects with retinopathy. Preoperative fundoscopic findings were hemorrhagic activity and neovascularization with proliferation. Completeness of hypophysectomy was evaluated by tests involving determination of growth-hormone responsiveness to infusion of 2-deoxy-D-glucose and thyroid, adrenal and gonadotrophic function. All tests were performed pre- and postoperatively. Sixteen patients were followed for an average of 38.4 months. Improved vision was noted in 19%, stabilization in 25%, and progression in 56%. This percentage is concordant with that noted in studies of the natural history of diabetic retinopathy. There was no correlation between the degree of improvement in the retinopathy and the presence or absence of complete hypophysectomy.
Intrinsic Diseases of Bones
Authors: Edward B. Singleton
Journal: JAMA (1973)

The previous three editions concerned themselves with the respiratory, gastrointestinal, and genitourinary tracts. The current edition on intrinsic diseases of bones includes 500 pages on a variety of conditions, all of which are beautifully illustrated. The foreword may, at first glance, dismay the reader because of its completeness and the inclusion of many unfamiliar terms and syndromes. However, once this obstacle is overcome, the subject matter is presented in a progressive and interesting manner, beginning with a comprehensive but simple description of the genetic basis of intrinsic diseases of bones, followed by an equally understandable description of the biologic basis of bone dysplasia and a discussion of bone growth. Histologic illustrations, including electron microscopy, enhance the value of the latter subject material. Consequently, the pathologist as well as radiologist and clinician should find their own special interest in this volume. Specific topics, including descriptions of achondroplasia and differential considerations of
Guiding the Hand That Feeds
Authors: Bernard Lo, Laurie Dornbrand
Journal: New England Journal of Medicine (1984)

The phone message from the patient's daughter is ominous. "Mrs. F. has eaten nothing all weekend. What should we do?" A 70-year-old woman with severe dementia, Mrs. F. rarely speaks, is confined to a wheelchair, and requires diapers because of incontinence. She has been kept out of a nursing home by the efforts of a devoted family and daily attendance at a geriatric day-care center. During the past year, her social interactions have decreased, and her food intake has become increasingly erratic. First, she stopped feeding herself; now, even though she is fed by hand, her intake continues to decline. . . .
Weight Loss and the Belt
Authors: ROBERT A. WINFIELD
Journal: Annals of Internal Medicine (1973)

Comments and Corrections1 December 1973Weight Loss and the BeltROBERT A. WINFIELD, M.D.ROBERT A. WINFIELD, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-79-6-910_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: I have found examination of the belt, in male patients complaining of weight loss, to be useful. Not infrequently, the patient is unable to give a clear history or he may be suspected of malingering. A history of progressive weight loss will often get a malingerer a hospital bed for the duration of an investigation for neoplasm. On several occasions I have correctly suspected malingering because the patient's belt is worn at only one site, without evidence of drawing in on the belt as is seen in true weight loss. On the other hand, I was recently... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ROBERT A. WINFIELD, M.D.Affiliations: Department of Internal Medicine University of Michigan Medical Center Ann Arbor, Michigan PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe diagnostic spectrum of unintentional weight lossCancer SurveysPatients who lose weight.Involuntary Weight Loss: Diagnostic and Prognostic SignificanceKEITH I. MARTON, M.D., HAROLD C. SOX Jr., M.D., JAN R. KRUPP, M.D. 1 December 1973Volume 79, Issue 6Page: 910-910KeywordsWeight loss ePublished: 1 December 2008 Issue Published: 1 December 1973 PDF downloadLoading ...
Enhanced Efficacy of Tumor Cell Vaccines Transfected with Secretable hsp70
Authors: Chiara Massa, Cristiana Guiducci, Ivano Arioli, Mariella Parenza, Mario P. Colombo, Cecilia Melani
Journal: Cancer Research (2004)

Abstract Tumor immunotherapy has exploited the ability of heat shock proteins to chaperone precursors of antigenic peptides to antigen-presenting cells and to activate efficiently an immune response against tumor-associated antigens. The most common strategy is based on the purification of heat shock protein-peptide complexes from tumor cell lines or from tumor surgical samples for in vivo administration. In this article, we have modified the murine-inducible hsp70 into a secreted protein and engineered tumor cells to secrete constitutively their antigenic repertoire associated with the hsp70 protein. In vitro studies showed that the relocalization of hsp70 from the cytoplasm to the secretory pathway did not modify the ability of hsp70 to interact with peptides derived either from natural tumor-associated antigens or model antigens, and that antigen-presenting cells specifically took up the secreted hsp70 and presented the chaperoned epitopes to T cells. In vivo studies showed that tumors secreting hsp70 displayed increased immunogenicity, with induction of a strong and specific CTL response. Mice injected with hsp70-secreting tumors showed increased survival and impaired tumor take compared with mice bearing parental tumors. More than 70% of mice rejected tumor cells secreting hsp70 through mechanisms that involve T lymphocytes and natural killer cells, with the induction of a memory response in the case of T lymphocytes. Moreover, hsp70 secretion increased the immunogenic potential of tumor cell vaccines.
The Attending Physician as Teacher
Authors: William D. Mattern, Donn Weinholtz, Charles P. Friedman
Journal: New England Journal of Medicine (1983)

THE task faced by the clinical teacher "is unique in the entire realm of teaching. In no other field does the nature of the material demand of the teacher this degree of preparedness without preparation. We suggest that the problem of learning how to teach as a clinician deserves much thoughtful study...."1 Despite the obvious value of this suggestion by Reichsman et al., relatively few pertinent studies have been conducted.2 3 4 5 6 7 8 Although these studies have been useful in identifying several general problems in clinical teaching, we have yet to develop and validate specific recommendations that will help attending physicians improve instruction . . .
Experiences of arthroplasty of the rheumatoid knee using Macintosh prostheses.
Authors: A Kates, A Kay, J Wojtulewski, T Riley, E N Coomes
Journal: Annals of the Rheumatic Diseases (1969)

This contrasted significantly (P< 0-01) with a mean rise in the placebo group of 2,000 cells/c.mm.(S.D.+2,100).There was no important overall difference in the haemoglobin, the platelets, the E.S.R., the titre ofthe latex tests, the strength of grip, or the blood pressures between the two groups.* Pronestyl.
CLINICAL ASPECT OF LEPROSY
Authors: EDUARD BOECKMANN
Journal: JAMA (1913)

Our medical text-books tell us that we have many lepers in this state and that they are immigrants from the Scandinavian countries, particularly from Norway. Our lepers are gradually dying out and there are not enough left for clinical demonstration even if all were at hand at this meeting. A few cases will give us only a faint idea of the clinical aspect of this exceedingly varying disease with its different forms, many stages, all possible degrees, irregularities, asymmetry, complications and great variability in the final mutilations. One case is not like another and a complete clinical demonstration would mean hundreds—and we have not got them. As everyone knows, leprosy appears in two clinically different and, when developed, sharply defined forms. In both forms, a macular cutaneous eruption is the first symptom—the initial lesion, which probably exists, having never been discovered—and in this stage it might be questionable which special form of leprosy will develop. This
PREVENTING LEAKAGE AFTER GASTROSTOMY
Authors: Charles Everett Haines
Journal: JAMA (1925)

In none of the common methods of gastrostomy is there adequate provision against leakage around the gastrostomy tube and into the peritoneal cavity. I therefore suggest an expedient to which I have resorted for preventing this leakage. The gastric wall is sutured around the tube. Then, before the stomach is anchored to the anterior abdominal wall, a piece of the omentum is drawn up and sutured to the stomach wall around the tube. The omentum used in this way is more than a reinforcement. Its value lies rather in its inherent properties, for it heals more quickly than other body tissues; then, too, it has a tendency to insinuate itself into tiny nooks and crannies, thus sealing them up in a most satisfactory and efficacious manner. <h3>Ulcer and Cancer.</h3> —Many cases of cancer of the stomach could be prevented by earlier and better treatment of chronic gastric
Mental health of refugee children: comparative study
Authors: M. Fazel
Journal: BMJ (2003)

In 2002, over 110 000 people entered Britain to seek asylum-a 250% increase in five years. 1 Children, who comprise at least a quarter of asylum seekers, are exposed to numerous risk factors for psychological disturbance, including exposure to violence, forced displacement, and multiple losses. 2 The rates of mental health problems in refugee children are uncertain, but the few studies that have been done suggest that refugee children incur significant morbidity. 2 We examined the rates of psychological disturbance in a sample of UK children who were refugees and compared them with a group of children who were from an ethnic minority but were not refugees and a group of indigenous white children.
The link between allergic rhinitis and allergic asthma: A prospective population‐based study. The Copenhagen Allergy Study
Authors: A. Linneberg, N. Henrik Nielsen, L. Frølund, F. Madsen, A. Dirksen, T. Jørgensen
Journal: Allergy (2002)

Background: It has been hypothesized that allergic rhinitis and allergic asthma are manifestations of the same disease entity. We aimed to investigate the relationship between allergic rhinitis and allergic asthma. Methods: Participants in a population‐based study of 15–69‐year‐olds in 1990 were invited to a follow‐up in 1998. A total of 734 subjects were examined on two occasions eight years apart. Allergic rhinitis to pollen was defined as a history of nasal symptoms on exposure to pollens and IgE specific to pollen. Allergic asthma to pollen was defined as a history of lower airway symptoms on exposure to pollens and IgE specific to pollen. Similarly, diagnoses of allergic rhinitis and allergic asthma to animals or mite were defined. Results: At follow‐up, all subjects with allergic asthma to pollen ( n = 52) had in addition allergic rhinitis to pollen. In the longitudinal analysis, there were a total of 28 new (incident) cases of allergic asthma to pollen. They all had allergic rhinitis to pollen at baseline, or had developed allergic rhinitis to pollen at follow‐up. Accordingly, allergic rhinitis to animals and mite were ubiquitous in subjects with allergic asthma to animals and mite, respectively. Conclusions: The results support the hypothesis that allergic rhinitis and allergic asthma are manifestations of the same disease entity.
Prevention of systemic lupus erythematosus in autoimmune BXSB mice by a transgene encoding I-E alpha chain.
Authors: R Merino, M Iwamoto, L Fossati, P Muniesa, K Araki, S Takahashi, J Huarte, K Yamamura, J D Vassalli, S Izui
Journal: The Journal of Experimental Medicine (1993)

Males from the BXSB murine strain (H-2b) spontaneously develop an autoimmune syndrome with features of systemic lupus erythematosus (SLE), which results in part from the action of a mutant gene (Yaa) located on the Y chromosome. Like other H-2b mice, the BXSB strain does not express the class II major histocompatibility complex antigen, I-E. Here we report that the expression of I-E (E alpha dE beta b) in BXSB males bearing an E alpha d transgene prevents hypergammaglobulinemia, autoantibody production, and subsequent autoimmune glomerulonephritis. These transgenic mice bear on the majority of their B cells not only I-E molecules, but also an I-E alpha chain-derived peptide presented by a higher number of I-Ab molecules, as recognized by the Y-Ae monoclonal antibody. The I-E+ B cells appear less activated in vivo than the I-E- B cells, a minor population. This limited activation of the I-E+ B cells does not reflect a functional deficiency of this cell population, since it can be stimulated to IgM production in vitro by lipopolysaccharides at an even higher level than the I-E- B cell population. The development of the autoimmune syndrome in the transgenic and nontransgenic bone marrow chimeric mice argues against the possibility that the induction of regulatory T cells or clonal deletion of potential autoreactive T cells as a result of I-E expression is a mechanism of the protection conferred by the E alpha d transgene. We propose a novel mechanism by which the E alpha d transgene protects BXSB mice against SLE: overexpression of I-E alpha chains results in the generation of excessive amounts of a peptide displaying a high affinity to the I-Ab molecule, thereby competing with pathogenic autoantigen-derived peptides for presentation by B lymphocytes and preventing their excessive stimulation.
Abstract 5376: Immunosuppressive T regs and MDSCs in human melanoma
Authors: Kimberly R. Jordan, Martin D. McCarter
Journal: Cancer Research (2012)

Abstract Despite the ability to elicit active immune responses, most immunotherapies fail to eliminate tumors in human cancer patients. One reason immunotherapy has not met expectations may be due to immunosuppression in the local environment of the tumor. We have previously reported that untreated advanced-stage melanoma patients have increased numbers of peripheral T regs. In addition, exposure to melanoma cells in vitro expands T regs from normal human peripheral blood mononuclear cells (PBMCs). We have shown that melanoma-conditioned media have increased levels of TGF-beta, which may be responsible for the expansion of these suppressive cells in culture. Here we show that the number of peripheral T regs directly correlates with the amount of TGF-beta in the plasma of late-stage melanoma patients. We also show that melanoma patients have increased numbers of other suppressive cells, known as myeloid-derived suppressor cells (MDSCs). These MDSCs may further contribute to immunosuppression in advanced-stage melanoma patients. Finally, we show that the tumor-induced T regs and the T regs and MDSCs from the peripheral blood of melanoma patients suppress T cell responses in vitro, including proliferation, cytokine production, and cytotoxic activity. We are currently investigating whether MDSCs from melanoma patients contribute to the accumulation of T regs and whether immunotherapies used in the treatment of advanced-stage melanoma patients, particularly IL-2 and ipilimumab, affect their frequency or function. An understanding of the potential interaction between melanoma, MDSCs, and regulatory T cells will further our goal in identifying ways of blocking the function of these suppressive cells in melanoma patients to improve the effectiveness of future therapies. 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 5376. doi:1538-7445.AM2012-5376
Pancreatic Cancer in Patients With Pancreatic Cystic Lesions: A Prospective Study in 197 Patients
Authors: Minoru Tada, Takao Kawabe, Masatoshi Arizumi, Osamu Togawa, Saburo Matsubara, Natsuyo Yamamoto, Yosuke Nakai, Naoki Sasahira, Kenji Hirano, Takeshi Tsujino, Keisuke Tateishi, Hiroyuki Isayama, Nobuo Toda, Haruhiko Yoshida, Masao Omata
Journal: Clinical Gastroenterology and Hepatology (2006)
Association of a decrease in antithrombin III activity with a perinatal elevation in aspartate aminotransferase in women with twin pregnancies: relevance to the HELLP syndrome
Authors: Hisanori Minakami, Takashi Watanabe, Akio Izumi, Shigeki Matsubara, Toshimitsu Koike, Masaaki Sayama, Ikuko Moriyama, Ikuo Sato
Journal: Journal of Hepatology (1999)