tbuckley/cabot-search huggingface dataset:
Graduate Medical Education Confronted
Authors: William A. Hensel
Journal: JAMA (1988)

<h3>To the Editor.</h3> —Dr Perkoff argues convincingly that society should support medical education via taxation and that this support will not happen unless educators meet society's needs by supplying more generalists. Despite the evident social need, Dr Perkoff states that there is no general agreement that graduate medical education should change. To many educators, traditional specialty training is seen as highly effective, while education in the ambulatory setting is viewed as "uninteresting and ineffective." These attitudes are pedantic and destructive to the improvement of medical education. We continue to suffer from the problem that Peabody<sup>2</sup>recognized 60 years ago: we are training physicians who "are too 'scientific' and do not know how to take care of patients." Giving students the opportunity to care for ambulatory patients allows them to learn valuable lessons absent from the inpatient experience. A few of these lessons follow: Students need to learn that most
Drug Purpura Due to Surreptitious Quinidine Intake
Authors: DIANE M. REID
Journal: Annals of Internal Medicine (1988)

Three patients had recurrent episodes of thrombocytopenia that resembled drug purpura, but the drug history in each case did not support the diagnosis. Although the patients specifically denied taking quinidine, serologic testing with this drug was done because the patients had access to it, and it is the commonest cause of drug purpura. Highly specific quinidine-dependent antiplatelet antibodies were found in the sera of all three patients. After being informed of the laboratory findings, the patients have had no recurrences of purpura. Serologic tests for quinidine- or quinine-dependent antibodies can help elucidate some obscure cases of purpura that may be self-induced.
Restless legs syndrome and leg cramps in fibromyalgia syndrome: a controlled study
Authors: M. B Yunus, J. C Aldag
Journal: BMJ (1996)

Restless legs syndrome is characterised by an unpleasant, difficult-to-describe sensation in the legs that produces an invariable urge to move them frequently.1 2 3 This symptom typically occurs at rest or before sleep and is alleviated by activity.1 2 3 Restless legs syndrome may occur without or with an associated condition, such as rheumatoid arthritis.1 3 We investigated the prevalence of restless legs syndrome and of leg cramps in patients with fibromyalgia syndrome, a common condition with widespread musculoskeletal aching and tender points,2 4 and in controls.

One hundred and thirty five consecutive new female patients referred with primary fibromyalgia, 54 women with rheumatoid arthritis without concomitant fibromyalgia, and 87 healthy, pain free women acting as controls were studied at our outpatient rheumatology clinic. All patients with fibromyalgia …
Lead Poisoning From Cocktail Glasses
Authors: Josef Eisinger
Journal: JAMA (1977)

<h3>To the Editor.—</h3> The article by Natelson and Fred (236:2527, 1976) reporting a nowadays unusual but still fascinating source of undue lead exposure should remind us not to disregard origins of diseases that have fallen into oblivion. Since the cocktail glasses implicated in this case were probably marketed by the thousands and most of them are likely to have been put to use similar to that reported, one wonders how many cases of lead poisoning they might have caused and what fraction of these were diagnosed as such. Lead poisoning from ingestion of acidic beverages (ie, fruit juices, cider, wine, and rum) contained in leadglazed earthenware or contaminated with lead during manufacture was an important (unrecognized) cause of serious and fatal lead poisoning for hundreds of years. During the Middle Ages, the practice of vintners of adding lead-containing mixtures to poor vintages caused widespread epidemics of colic, with symptoms that
Decline in Hospital Utilization and Cost Inflation Under Managed Care in California
Authors: James C. Robinson
Journal: JAMA (1996)

To measure the impact of health maintenance organizations (HMOs) on hospital capacity, utilization, and expenditures between 1983 and 1993.Multivariate regression analysis.Private nonprofit and for-profit hospitals in California with 25 or more beds.Patient discharge abstract data were used to measure growth of HMO penetration of local hospital markets.None.Hospital closures, changes in bed capacity, changes in acute care admissions and length of stay, psychiatric inpatient days, subacute inpatient days, inpatient and outpatient surgical procedures, ambulatory patient visits, and hospital expenditures.Between 1983 and 1993 hospital expenditures grew 44% less rapidly in markets with high HMO penetration than in markets with low HMO penetration. Of this, 28% was due to reductions in the volume and mix of services, 6% was due to reductions in bed capacity, and 10% was due to changes in the intensity of services provided. Health maintenance organizations accelerated the substitution of outpatient for inpatient surgery, the shift from acute to subacute inpatient days, and the reduction of psychiatric hospitalization.Managed care is shifting the acute hospital from the center toward the periphery of the health care system.
Guideline is misleading
Authors: C. Egeler
Journal: BMJ (2009)

<h3>Background</h3> The proinflammatory cytokines interleukin 1β (IL-1β) and IL-18 are central players in the pathogenesis of inflammatory bowel disease (IBD). In response to a variety of microbial components and crystalline substances, both cytokines are processed via the caspase-1-activating multiprotein complex, the NLRP3 inflammasome. Here, the role of the NLRP3 inflammasome in experimental colitis induced by dextran sodium sulfate (DSS) was examined. <h3>Methods</h3> IL-1β production in response to DSS was studied in macrophages of wild-type, caspase-1<sup>−/−</sup>, NLRP3<sup>−/−</sup>, ASC<sup>−/−</sup>, cathepsin B<sup>−/−</sup> or cathepsin L<sup>−/−</sup> mice. Colitis was induced in C57BL/6 and NLRP3<sup>−/−</sup> mice by oral DSS administration. A clinical disease activity score was evaluated daily. Histological colitis severity and expression of cytokines were determined in colonic tissue. <h3>Results</h3> Macrophages incubated with DSS in vitro secreted high levels of IL-1β in a caspase-1-dependent manner. IL-1β secretion was abrogated in macrophages lacking NLRP3, ASC or caspase-1, indicating that DSS activates caspase-1 via the NLRP3 inflammasome. Moreover, IL-1β secretion was dependent on phagocytosis, lysosomal maturation, cathepsin B and L, and reactive oxygen species (ROS). After oral administration of DSS, NLRP3<sup>−/−</sup> mice developed a less severe colitis than wild-type mice and produced lower levels of proinflammatory cytokines in colonic tissue. Pharmacological inhibition of caspase-1 with pralnacasan achieved a level of mucosal protection comparable with NLRP3 deficiency. <h3>Conclusions</h3> The NLRP3 inflammasome was identified as a critical mechanism of intestinal inflammation in the DSS colitis model. The NLRP3 inflammasome may serve as a potential target for the development of novel therapeutics for patients with IBD.
Animal Testing of Endoscopic Hemostasis with Lasers and other Devices
Authors: D.C. Auth
Journal: Endoscopy (1986)

A variety of animal models for testing endoscopic control of gastrointestinal hemorrhage are reviewed. Advantages and disadvantages of each are discussed. New types of mechanical devices for controllable injury are presented, and the efficacy of laser photocoagulators and other recently developed electronic devices on these new lesions is compared.
Standardisation of tests for antinuclear antibody.
Authors: G D Johnson, E J Holborow
Journal: Annals of the Rheumatic Diseases (1980)

Acute gout during hypouricaemic therapy: prophylaxis with colchicine Sir, The efficacy of the uricosuric diuretic agent tienilic acid in the treatment of both gout and hypertension is confirmed in 2 papers.1 2 During our inpatient study 3 of the 4 patients suffered attacks of gout, as is often the case when starting other kinds of hypouricaemic therapy.It is commonly held that the concomitant use of col- chicine prevents such attacks, and accordingly we looked into this in a long-term outpatient study.Twenty patients were given tienilic acid alone and 10 patients were given tienilic acid together with colchicine 1 mg b.d. on a non- selective basis.The patients were followed for between 2 and 12 months, with encouraging results in lowering both the blood pressure and serum uric acid, but owing to reports from elsewhere of hepatotoxicity the study had to be abandoned.Of the patients who received tienilic acid alone 15 suffered 27 attacks of gout within 2 months of starting therapy, whereas none of the 10 patients who received colchicine in addition suffered an attack of gout over the same period.This gives support to the unsubstantiated belief that colchicine prevents the attacks of gout which are seen after starting hypouricaemic therapy.
Large-Scale Screening and Molecular Characterization of EML4-ALK Fusion Variants in Archival Non–Small-Cell Lung Cancer Tumor Specimens Using Quantitative Reverse Transcription Polymerase Chain Reaction Assays
Authors: Tianhong Li, Martin K.H. Maus, Sonal J. Desai, Laurel A. Beckett, Craig Stephens, Eric Huang, Jack Hsiang, Gary Zeger, Kathleen D. Danenberg, Stephanie H. Astrow, David R. Gandara
Journal: Journal of Thoracic Oncology (2013)
Medical advances mask epidemic of violence by cutting murder rate
Authors: R. Dobson
Journal: BMJ (2002)

Murder rates would be up to five times higher than they are but for medical developments over the past 40 years.

According to new research, doctors are saving the lives of thousands of victims of attack who four decades ago would have died and become murder statistics.

Although the study is based on US data, the researchers say the principle applies to other countries too: “There is reason to expect a similar trend overall in Britain,” said Dr Anthony Harris, the lead author of the study.

In the research he and …
The Medical-Care Problem in the United States
Authors: Louis H. Bauer
Journal: New England Journal of Medicine (1946)

I SUPPOSE that there is no problem quite so controversial in the United States as that of medical care. We hear a great deal of propaganda — in its modern connotation, not its original one. It is not information; it is information on one side, an attempt to sway people into changing their opinions, regardless of facts. The medical profession and the whole subject of medical care have been the object of considerable vicious propaganda of that order for the last several years.It is quite true that medical care in many areas of the United States is not what . . .
Internal Medicine: Stop Reporting Problems and Start Solving Them
Authors: Jerome S. Reich
Journal: Annals of Internal Medicine (1993)

Letters15 February 1993Internal Medicine: Stop Reporting Problems and Start Solving ThemJerome S. Reich, MDJerome S. Reich, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-4-199302150-00031 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Regarding the National Study of Internal Medicine Manpower in Residency Training [1] and the editorial on activism and academic internal medicine [2], my response is to quote Bart Simpson: “Blah, blah, blah”.If we want more residents to select internal medicine and more primary community internists, which this country desperately needs, then let's see real change. Let's deal with the real problems and not have meetings and write reports and accomplish nothing.References1. Andersen RM, Lyttle CS, Kohrman CH, Levey GS, Clements MM. National Study of Internal Medicine Manpower: XIX. Trends in internal medicine residency training programs. Ann Intern Med. 1992; 117:243-50. Google Scholar2. Glickman R, Bennett JC, Nolan J, Stobo J, Rubenstein A, Terwilliger J. Activism in academic internal medicine. Ann Intern Med. 1992; 117:259-60. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 February 1993Volume 118, Issue 4Page: 319-320KeywordsAcademic medicineResidency Issue Published: 15 February 1993 CopyrightCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Unusual Radioiodine Uptake Caused by Metallic Sutures in the Skull in a Patient with Thyroid Cancer
Authors: SERGIO MODONI, GAETANO MARTINO, MICHELE GUERRA, VINCENZO FRUSCIANTE
Journal: Clinical Nuclear Medicine (2000)

After surgery for a papillary carcinoma of the thyroid, a 22-year-old man received I-131 therapy for thyroid ablation. A meningioma had been removed when the patient was 4 years old and metallic sutures were used then in the skull. I-131 uptake was apparent in the skull at the sites of the sutures, which could have been confused with metastases.
PRIMARY EPITHELIOMA OF THE URETER
Authors: EDWARD N. COOK
Journal: JAMA (1941)

Carcinoma at any situation in the urinary tract is most serious, and the question of cure is controlled largely by the same factors which govern the cure of cancer in any other organ; namely, early diagnosis and radical treatment by surgery, radium and roentgen rays. Furthermore, the chance of cure is greater if the lesion originates in any portion of the urinary tract that can be completely removed surgically, together with all associated lymphatic vessels. Radical procedures instituted to eradicate any malignant process are always more favorable in the early small lesion of slow growth and are less favorable as the lesion extends and also if it is of greater activity. Our experience in eighteen positively proved cases of this disease has served to emphasize certain points in diagnosis and surgical management which we have noted are extremely essential if a higher percentage of cures are to be effected than
669 CHARACTERIZATION OF PROTEASE INHIBITOR RESISTANCE MUTATIONS IN UNTREATED PATIENTS INFECTED WITH GENOTYPE 1B HEPATITIS C VIRUS
Authors: H. Shindo, S. Maekawa, M. Miura, K. Komase, M. Kadokura, R. Sueki, F. Amemiya, T. Kitamura, T. Inoue, M. Sakamoto, S.-I. Okada, N. Enomoto
Journal: Journal of Hepatology (2010)
Circadian rhythm of serum erythropoietin in multiple myeloma
Authors: Paolo Pasqualetti, Antonio Collacciani, Raffaele Casale
Journal: American Journal of Hematology (1996)

The diurnal rhythm in the circulating serum levels of erythropoietin (EPO) were determined in a group of 20 adult clinically-healthy subjects, in a group of 10 patients with myeloma without renal impairment and 10 patients with myeloma and renal failure. Venous blood samples were drawn during the span of a whole day and every 4 hr, starting from midnight, for the measurement of serum EPO levels by radioimmunoassay (RIA). Statistical analysis was carried out by means of the “cosinor” method. Results show that the controls and the myeloma patients without renal insufficiency present significant (P < 0.05) circadian rhythms in serum EPO levels; no rhythm (P < 0.05) was detected in patients with myeloma and renal failure. Patients with myeloma and renal failure have significant (P < 0.05) lower mean daily levels and diurnal fluctuations of EPO than the other groups, whereas the patients with myeloma without renal involvement present higher (P < 0.05) mean daily levels and lower (P < 0.05) diurnal variations of EPO than controls; no differences (P > 0.05) exist between the groups regarding peaks of rhythms. These data confirm the existence of a physiological circadian rhythm in serum EPO concentrations, with maximum in the afternoon, and they suggest that renal failure is an important cause of anemia and loss of EPO circadian rhythm in patients with myeloma. © 1996 Wiley-Liss, Inc.
Malaria-Related Deaths among U.S. Travelers, 1963–2001
Authors: Robert D. Newman, Monica E. Parise, Ann M. Barber, Richard W. Steketee
Journal: Annals of Internal Medicine (2004)

Nearly 1500 malaria cases occur each year in the United States; approximately 60% are among U.S. travelers. Despite the availability of sophisticated medical care, malaria-related deaths continue to occur. The authors reviewed all 185 fatal cases between 1963 and 2001 that were reported to the National Malaria Surveillance System: 123 (66.5%) occurred among U.S. travelers, and of these, 114 (92.7%) were attributed to Plasmodium falciparum. Failure to take or adhere to recommended chemoprophylaxis, to promptly seek medical care for post-travel illness, and to promptly diagnose and treat suspected malaria all contributed to fatal outcomes. Health care providers need to take a travel history, obtain a blood film for suspected malaria, and use the 24-hour malaria management advice available through the Centers for Disease Control and Prevention (CDC) Malaria Hotline (770-488-7788) or the CDC Malaria Web site (www.cdc.gov/Malaria). Hospitals must maintain intravenous quinidine gluconate on formulary because it is the only drug available to treat severe malaria in the United States.
Abstract 1811: Antitumor activity of lapatinib in combination with the dual mTORC1/2 inhibitor INK-128 in breast tumors resistant to anti-HER2 therapy
Authors: Celina Garcia-Garcia, Yasir H. Ibrahim, Violeta Serra, Maria Teresa Calvo, Marta Guzman, Judit Grueso, Claudia Aura, Jose Perez, Katti Jesen, Yi Liu, Christian Rommel, Josep Tabernero, Jose Baselga, Maurizio Scaltriti
Journal: Cancer Research (2012)

Abstract Purpose: The PI3K/Akt/mTOR pathway is an attractive target in HER2 positive breast cancer refractory to anti-HER2 therapy. The hypothesis is that suppression of this pathway results in sensitization to anti-HER2 agents. However, this combinatorial strategy has not been comprehensively tested in models of trastuzumab and lapatinib resistance. Experimental Design: We analyzed in vitro cell viability and induction of apoptosis in five different cell lines resistant to trastuzumab and lapatinib. Inhibition of HER2/HER3 phosphorylation, PI3K/Akt/mTOR and ERK signaling pathways was evaluated by western blot. Tumor growth inhibition following treatment with lapatinib, INK-128 or the combination of both agents was evaluated in three different animal models: two cell-based xenograft models refractory to both trastuzumab and lapatinib and a xenograft derived from a patient who relapsed to trastuzumab-based therapy. Results: The addition of lapatinib to INK-128 prevented both HER2 and HER3 phosphorylation induced by INK-128, resulting in inhibition of both PI3K/Akt/mTOR and ERK pathways. This dual blockade synergistically enhanced cell death in five different HER2 positive cell lines resistant to trastuzumab and lapatinib. In vivo, both cell line-based and patient-derived xenografts showed exquisite sensitivity to the antitumor activity of the combination of lapatinib and INK-128, causing durable tumor shrinkage in the absence of any sign of toxicity. Conclusions: The simultaneous blockade of PI3K/Akt/mTOR and ERK pathways achieved by combining lapatinib with INK-128 acts synergistically in inducing cell death and tumor regression in breast cancer refractory to anti-HER2 therapy. 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 1811. doi:1538-7445.AM2012-1811
Where is the evidence that animal research benefits humans?
Authors: Pandora Pound, Shah Ebrahim, Peter Sandercock, Michael B Bracken, Ian Roberts
Journal: BMJ (2004)

Young people have the right to evidence based interventions.We know from the past that many well meaning attempts to do good resulted in harm, but we now have the means through systematic review, trials, sound evaluations, and good qualitative work, to do better.
Mechanical stimulation activates Gαq signaling pathways and 5-hydroxytryptamine release from human carcinoid BON cells
Authors: Minsoo Kim, Najma H. Javed, Jun-Ge Yu, Fievos Christofi, Helen J. Cooke
Journal: Journal of Clinical Investigation (2001)

5-Hydroxytryptamine (5-HT) released from enterochromaffin cells activates secretory and peristaltic reflexes necessary for lubrication and propulsion of intestinal luminal contents. The aim of this study was to identify mechanosensitive intracellular signaling pathways that regulate 5-HT release. Human carcinoid BON cells displayed 5-HT immunoreactivity associated with granules dispersed throughout the cells or at the borders. Mechanical stimulation by rotational shaking released 5-HT from BON cells or from guinea pig jejunum during neural blockade with tetrodotoxin. In streptolysin O–permeabilized cells, guanosine 5′-O- (2-thiodiphosphate) (GDP-β-S) and a synthetic peptide derived from the COOH terminus of Gαq abolished mechanically evoked 5-HT release, while the NH2-terminal peptide did not. An antisense phosphorothioated oligonucleotide targeted to a unique sequence of Gαq abolished mechanically evoked 5-HT release and reduced Gαq protein levels without affecting the expression of Gα11. Depletion and chelation of extracellular calcium did not alter mechanically evoked 5-HT release, whereas depletion of intracellular calcium stores by thapsigargin and chelation of intracellular calcium by 1,2-bis (o-Aminophenoxy) ethane-N,N,N′,N′-tetraacetic acid tetra (acetoxymethyl) ester (BAPTA-AM) reduced 5-HT release. Mechanically evoked 5-HT release was inhibited by somatostatin-14 in a concentration-dependent manner. The results suggest that mechanical stimulation of enterochromaffin-derived BON cells directly or indirectly stimulates a G protein–coupled receptor that activates Gαq, mobilizes intracellular calcium, and causes 5-HT release.