tbuckley/cabot-search huggingface dataset:
Hope and Prognostic Disclosure
Authors: Jennifer W. Mack, Joanne Wolfe, E. Francis Cook, Holcombe E. Grier, Paul D. Cleary, Jane C. Weeks
Journal: Journal of Clinical Oncology (2007)

Physicians sometimes selectively convey prognostic information to support patients' hopes. However, the relationship between prognostic disclosure and hope is not known.We surveyed 194 parents of children with cancer (overall response rate, 70%) in their first year of treatment at the Dana-Farber Cancer Institute and Children's Hospital (Boston, MA), and we surveyed the children's physicians. We evaluated relationships between parental recall of prognostic disclosure by the physician and possible outcomes, including hope, trust, and emotional distress. Our main outcome was assessed by asking parents how often the way the child's oncologist communicated with them about the children's cancers made them feel hopeful.Nearly half of parents reported that physician communication always made them feel hopeful. Parents who reported receiving a greater number of elements of prognostic disclosure were more likely to report communication-related hope (odds ratio [OR], 1.77 per element of disclosure; P = .001), even when the likelihood of a cure was low (OR, 5.98 per element of disclosure with likelihood of a cure < 25%; P = .03). In a multivariable model, parents were more likely to report that physician communication always made them feel hopeful when they also reported receipt of more elements of prognostic disclosure (OR, 1.60; P = .03) and high-quality communication (OR, 6.58; P < .0001). Communication-related hope was inversely associated with the child's likelihood of cure (OR, 0.65; P = .005).Although physicians sometimes limit prognostic information to preserve hope, we found no evidence that prognostic disclosure makes parents less hopeful. Instead, disclosure of prognosis by the physician can support hope, even when the prognosis is poor.
913. Histone Deacetylase Inhibitors Improve Gene Transfer To Mature Skeletal Muscle
Authors: Nancy Larochelle, Jatinderpal R. Deol, Paul Holland, George Karpati, Josephine Nalbantoglu
Journal: Molecular Therapy (2006)

AdV-mediated gene transfer occurs inefficiently in adult skeletal muscle due to downregulation of the primary adenovirus receptor CAR during muscle maturation. We have shown previously that AdV-mediated gene transfer is enhanced in CAR transgenics, indicating that prior modulation of CAR expression results in very efficient AdV transducibility of mature skeletal muscle. We hypothesized that transient CAR expression could be achieved through activation of the transcription of the endogenous CAR gene using histone deacetylase (HDAC) inhibitors. HDACs are known to regulate gene expression via the modulation of chromatin structure by histone acetylation and deacetylation.
Comparison of Visidex and Chemstrip bG with Beckman Glucose Analyzer Determination of Blood Glucose
Authors: J Paul Frindik, Deborah A Kassner, Donna A Pirkle, Stephen F Kemp, Charles Hoff
Journal: Diabetes Care (1983)

Chemical test strips for estimating blood glucose have been shown to be reliable, rapid, and convenient when properly used. This study compares a new product, the Ames Visidex (Miles Laboratories, Elkhart, Indiana), and an established product, the Bio-Dynamics Chemstrip bG (Boehringer-Mannheim, Indianapolis, Indiana) with plasma glucose as measured by standard laboratory methods. Determination of blood glucose by visual inspection of both chemical strips gave an estimation of true plasma glucose in the hypoglycemic and euglycemic ranges. Both strips were reliable in predicting those values that were hyperglycemic (&amp;gt;180 mg/dl).
Website of the week: Genetics in Medicine: Real Promises, Unreal Expectations. One scientist's advice to policymakers in the United Kingdom and the United States
Authors: S. W G Derbyshire
Journal: BMJ (2001)

Steve Jones Milbank Memorial Fund Available at www.milbank.org/000712genetics.html Rating: ![Graphic][1]</img>![Graphic][2]</img>![Graphic][3]</img> You cannot accuse Professor Jones of having his head in the clouds. The past 20 years have brought forth a clatter of excessive claims for genetics, first in society and more recently in medicine. Jones' voice has been a welcome antidote, and his web-delivered report Genetics in Medicine: Real Promises, Unreal Expectations is a worthy addition to his realistic and balanced outlook. Jones is right to emphasise that the current clinical applications of genetic knowledge are minimal and are likely to remain limited for the next decade. While understanding genetic susceptibility for diabetes, for example, might eventually yield improved treatment for certain subpopulations, a change in … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif
Mutations in factor H reduce binding affinity to C3b and heparin and surface attachment to endothelial cells in hemolytic uremic syndrome
Authors: Tamara Manuelian, Jens Hellwage, Seppo Meri, Jessica Caprioli, Marina Noris, Stefan Heinen, Mihaly Jozsi, Hartmut P.H. Neumann, Giuseppe Remuzzi, Peter F. Zipfel
Journal: Journal of Clinical Investigation (2003)

Hemolytic uremic syndrome (HUS) is a disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. Recent studies have identified a factor H–associated form of HUS, caused by gene mutations that cluster in the C-terminal region of the complement regulator factor H. Here we report how three mutations (E1172Stop, R1210C, and R1215G; each of the latter two identified in three independent cases from different, unrelated families) affect protein function. All three mutations cause reduced binding to the central complement component C3b/C3d to heparin, as well as to endothelial cells. These defective features of the mutant factor H proteins explain progression of endothelial cell and microvascular damage in factor H–associated genetic HUS and indicate a protective role of factor H for tissue integrity during thrombus formation.
The rususcitation game
Authors: L Doyal
Journal: BMJ (1994)

Few doctors now openly reject the right of patients to consent to invasive treatment on the basis of accurate information about prognosis, side effects, and alternative therapies. If competent patients refuse lifesaving treatments which are deemed to be in their best medical interest then so be it. Any attempt to force treatment on patients is an unwarranted moral and legal intrusion on their autonomy.

Yet in one area of clinical care, a pervading silence surrounds the issue of informed consent - cardiopulmonary resuscitation. Confusion can exist between clinicians, nurses, patients, and families about resuscitation status. Equally, the decision not to resuscitate competent patients - a DNR order - is sometimes made without their consent. This is partly due to lack of clinical experience in how to communicate …
TRAUMATIC RUPTURE OF THE LUNGS WITHOUT SIGNS OF TRAUMA IN THE CHEST WALL
Authors: W. E. Cooke
Journal: BMJ (1934)

TRAUMTI RUPTURE-OF-LUNGS .-r 4E-AJNAL 62, because the dilatation of the pulmonary capillaries in- creases the cross-sectional area of the vessels through which the linear velocity of flow is measured.The linear velocity of blood flow can therefore be taken as an index of the work done by the heart onily if it can be shown that the cross-sectional area of the vessels remains un- altered.In the cases under consideration there is no absolute proof of this, though there is indirect evidence pointing in this direction.The vital capacity of the lungs gives an indication of the cross-sectional area of the pulmonary vessels, since if these are dilated the vital capacity is diminished as the air space is encroached upon.In Blumgart's cases, as in our own, the vital capacity was unaltered or slightly increased, showing that the pul- monary vessels were, if anything, less dilated than before.The velocity of circulation through the lungs after the operation is either unaltered or slowed (see table ).These two facts together-namely, a lessened linear velocity through narrowed vessels s-how that the volume of blood flowing through the lungs per minute is diminished.Since the output of the left ventricle must equal that of the right, this indicates that the heart as a whole is doing less work.Summary and Conclusions The whole thyroid gland has been removed in six patients without hyperthyroidism, showing incapacitating congestive heart failure, angina pectoris, or both, in whom all previous treatment had been ineffectual.There were no operative deaths, though one patient with a very high blood pressure died of cerebral haemorrhage six weeks after the operation.All six patients showed slight to fairly marked improvement in their circulatory symptoms after the operation, and were capable of more exertion.One of them, who had done no housework for over six months, is now doing all her housework except the heavy washing.The cases are all too recent for the permanent bffects to be judged, but it is hoped to report on their condition again in about twelve months' time.Slight signs of hypothyroidism appeared in two cases only.The rationale of this method of treatment is discussed.
Preemployment Drug Screening and Employment Outcome
Authors: David C. Parish
Journal: JAMA (1991)

<h3>To the Editor.—</h3> The statistical analysis used by Zwerling et al<sup>1</sup>is flawed. The major defect is that "the six covariates and four drug categories were included<i>simultaneously</i>in the [Cox proportional hazards] models" (p 2642, emphasis added). The purpose of introducing covariates is, of course, to remove their influence<i>prior</i>to testing the influence of the independent variable (in this case, drug category). However, removing the influence of covariates requires that they be entered into the model in hierarchical, not simultaneous, fashion.<sup>2-4</sup>Thus, the risk estimates for drug categories reported in Table 4 are not adjusted fully for the covariates. The authors use a classification of jobs in their statistical model that renders their analysis meaningless. Six job classes are collapsed into two or three categories for each end point; the job classifications used in each analysis are almost certainly different. The authors describe the study conducted
655 GENOMIC VARIATIONS OF THE PRE-S/S REGION OF HBV WITH GENOTYPE C BY SPONTANEOUS ACUTE EXACERBATION IN HBEAG-POSITIVE CHRONIC HBV INFECTION
Authors: M.K. Jang, S.E. Kim, H.S. Kim, J.S. Jang, T.H. Hahn, S.H. Park, C.K. Park, M.S. Lee, J.B. Kim, D.J. Kim
Journal: Journal of Hepatology (2008)
Feigned or Hysterical Disease of Skin
Authors: T. Flower
Journal: BMJ (1870)

rest.It is difficult to reconcile such a supposition with the circumstantial description of the occurrence given in the letter.It seems more probable that the woman was acting under an irrational impulse to deceive; and the hypochondriacal vein running through her letter, and especially her laborious anxiety to describe her very trivial symptoms to her physician, indicate exactly the nalade-inmaginiaire type of mind in which such an impulse might be expected to arise.CASE IV.-A Boy Vomitintg large n?zmbers of Mfenmbrantous Tibes, lzoiclz turned ouit to be pieces ofArteries.-The subject of this singular case was a well-grown healthy boy of fourteen.He was sent to me by his medical attendant from Oldham, with a request that I would take him into the Infirmary, and have him watched.The boy was accom- panied by his mother, who produced a piece of glistening membranous tube, three inches long and as thick as the thumb, which had been vomited by the boy, as she alleged, as they were coming in the train.* Cf.Liebermeister's account of the outbreak at Basel, in the Dewtscke Kbinik for I866, Nos. 6, 7, 9, io.
MAGNETIC FOREIGN BODIES IN THE EYE.
Authors: E. VILLIERS APPLEBY
Journal: JAMA (1901)

The class of patients with whom we have to deal in our subject may be said to belong for the most part to laborers or mechanics, whose daily occupation requires that they strike steel upon steel or steel upon iron as the case may be. We may speak of steel or iron interchangeably. Either causes deflection of the magnetic needle; each can be located by means of the Röntgen rays; both are attracted by the magnet, and the one is as destructive as the other. Small particles of iron or steel are occasionally found loose in the conjunctival sac. When seen there they have usually first struck and probably loosely imbedded themselves in the cornea or bulbar conjunctiva and afterward become dislodged. They are then principally found just under and a little above the margin of the upper lid and are naturally easily removed. Small chips of iron or steel
Allogeneic blood and bone-marrow stem-cell transplantation in haematological malignant diseases: a randomised trial
Authors: Ray Powles, Jayesh Mehta, Samar Kulkarni, Jennifer Treleaven, Barbara Millar, Jill Marsden, Val Shepherd, April Rowland, Bhawna Sirohi, Diana Tait, Clive Horton, Simon Long, Seema Singhal
Journal: The Lancet (2000)
Anti‐platelet and Anti‐DNA IgM in waldenström macroglobulinemia and ITP
Authors: L. Vartlcovski, A. I. Pick, A. Schattner, Y. Shoenfeld
Journal: American Journal of Hematology (1987)

Abstract We describe a monoclonal IgM that was purified from the serum of a patient with Waldenstrom macroglobulinemia and thrombocytopenia. The binding and idiotypic characteristics of the patient's macroglobulin were similar to those of a human monoclonal IgM secreted by a hybridoma established from peripheal blood lymphocytes of a patient with systemic lupus erythematosus and immune thrombocytepenia. In the absence of other causes for thrombocytopenia in this patient, our results suggest an autoimmune mechanism for destruction of platelets by the monoclonal IgM. This is the first report of a Waldenstrom macroglobulinemia with anti‐platelet activity of monoclonal IgM. Although the study involves a single patient, the results suggest that there may be a common origin for autoantibodies in autoimmune diseases and monoclonal immunoglobulins having autoantibody activity in monoclonal gammopathies.
Serial MRI to determine the effect of dexamethasone on the cerebral pathology of tuberculous meningitis: an observational study
Authors: Guy E Thwaites, Jeremy Macmullen-Price, Tran Thi Hong Chau, Pham Phuong Mai, Nguyen Thi Dung, Cameron P Simmons, Nicholas J White, Tran Tinh Hien, David Summers, Jeremy J Farrar
Journal: The Lancet Neurology (2007)

BackgroundAdjunctive dexamethasone increases survival from tuberculous meningitis, but the underlying mechanism is unclear. We aimed to determine the effect of dexamethasone on cerebral MRI changes and their association with intracerebral inflammatory responses and clinical outcome in adults treated for tuberculous meningitis.MethodsCerebral MRI was undertaken, when possible, at diagnosis and after 60 days and 270 days of treatment in adults with tuberculous meningitis admitted to two hospitals in Vietnam. Patients were randomly assigned either dexamethasone (n=24) or placebo (n=19) and received 9 months of treatment with standard first-line antituberculosis drugs. We assessed associations between MRI findings, treatment allocation, and resolution of fever, coma, cerebrospinal fluid inflammation, and neurological outcome.Findings83 scans were done for 43 patients: 19 given placebo, 24 given dexamethasone. Basal meningeal enhancement (82%) and hydrocephalus (77%) were the most common presenting findings. Fewer patients had hydrocephalus after 60 days of treatment with dexamethasone than after placebo treatment (p=0·217). Tuberculomas developed in 74% of patients during treatment and in equal proportions in the treatment groups; they were associated with long-term fever, but not relapse or poor clinical outcome. The basal ganglia were the most common site of infarction; the proportion with infarction after 60 days was halved in the dexamethasone group (27% vs 58%, p=0·130).InterpretationDexamethasone may affect outcome from tuberculous meningitis by reducing hydrocephalus and preventing infarction. The effect may have been under-estimated because the most severe patients could not be scanned.
Animal Rights and Human Morality
Authors: Michael T. McGuire
Journal: JAMA (1982)

Bernard Rollin is an academic philosopher, and he approaches his subject as good philosophers do—identifying critical questions, explicating their meanings, and pondering their implications. <i>Animal Rights and Human Morality</i>is about whether animals have moral and legal rights, particularly in the area of medical research. This is not an easy issue to tackle, nor one devoid of confusion. The author makes an interesting and erudite case for such rights and the need to recognize them, drawing on a wide variety of sources, including Kant, theories of animal awareness, moral theory, and law. His arguments are followed by a section on supposed abuses of animals used for research purposes. At issue are the practical demands of medical research set against animals' rights. A book as broad ranging as this one cannot hope to achieve all its objectives in 182 pages. But some things are clear. The author considerably broadens our awareness
Abstract 1414: The role of RUNX3 and RUNX3-related chemokines in lung cancer-induced bone resorption.
Authors: Hyun-Jeong Kim, Won-Yoon Chung, Kwang-Kyun Park
Journal: Cancer Research (2013)

Abstract Lung cancer frequently metastasizes to bone, which is associated with significant morbidity and a dismal prognosis. Runt-related transcription factor 3 (RUNX3) functions as a tumor suppressor in many cancers, and may be also important in the development of lung cancer. In this study, we found that RUNX3 knockdown increased the proliferation, migration and invasion of human lung cancer A549 cells. Interestingly, the receptor activator of nuclear factor-kappaB ligand (RANKL)/osteoprotegerin (OPG) ratio, an index of osteoclastogenic stimulation, was significantly increased in human osteoblastic hFOB1.19 cells treated with RUNX3 knockdown A549 cell-derived conditioned medium (CM) as compared to CM of RUNX3-expressing A549 cells. In the chemokine and receptor PCR array to identify RUNX3-regulated factors that mediate bone invasion of lung cancer cells, RUNX3 knockdown led to upregulation of CCL5 and downregulation of CCL19 and CXCL11 in A549 cells. CCL5 increased the proliferation, migration and invasion of A549 cells but CCL19 and CXCL11 had not a remarkable effect. CCL5 increased RANKL/OPG ratio in hFOB1.19 cells but CCL19 and CXCL11 decreased. CCL5 promoted RANKL-induced osteoclast differentiation in BMMs, while CCL19 and CXCL11 reduced. In the mouse model that RUNX3-expressing or RUNX3 knockdown A549 cells were injected subcutaneously over the calvaria, RUNX3 knockdown resulted in the increased tumor size and severe bone destruction. Additionally, in the osteolytic bone invasion model that the cells were inoculated into bone marrow of mouse tibia, bone lesions appeared more seriously in mice injected with RUNX3 knockdown A549 cells. The serum level of CCL5 was increased, while those of CCL19 and CXCL11 were decreased, in RUNX3 knockdown A549 cell-inoculated mice as compared with RUNX3-expressing A549 cell-inoculated mice. Taken together, bone invasion of lung cancer cells may be closely related with RUNX3 and RUNX3-regulated chemokines. Citation Format: Hyun-Jeong Kim, Won-Yoon Chung, Kwang-Kyun Park. The role of RUNX3 and RUNX3-related chemokines in lung cancer-induced bone resorption. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1414. doi:10.1158/1538-7445.AM2013-1414
Recurrence of Cardiovascular Events in Patients With Type 2 Diabetes
Authors: Carlo B. Giorda, Angelo Avogaro, Marina Maggini, Flavia Lombardo, Edoardo Mannucci, Salvatore Turco, Stefania Spila Alegiani, Roberto Raschetti, Mario Velussi, Ele Ferrannini
Journal: Diabetes Care (2008)

OBJECTIVE—The purpose of this study was to assess incidence of and risk factors for recurrent cardiovascular disease (CVD) in type 2 diabetes. RESEARCH DESIGN AND METHODS—We estimated the incidence of recurrent cardiovascular events in type 2 diabetic patients, aged 40–97 years, followed by a network of diabetes clinics. The analysis was conducted separately for 2,788 patients with CVD at enrollment (cohort A) and for 844 patients developing the first episode during the observation period (cohort B). RESULTS—During 4 years of follow-up, in cohort A the age-adjusted incidence of a recurrent event (per 1,000 person-years) was 72.7 (95% CI 58.3–87.1) in men and 32.5 (21.2–43.7) in women, whereas in cohort B it was 40.1 (17.4–62.9) in men and 22.4 (12.9–32.0) in women. After controls were included for potential predictors (familial CVD, obesity, smoking, diabetes duration, glycemic control, microvascular complications, geographic area, and antihypertensive and lipid-lowering treatment), male sex, older age, and insulin use were significant independent risk predictors (cohort A) and serum triglyceride levels ≥1.69 mmol/l emerged as the only metabolic (negative) prognostic factor (cohort B). In both cohorts, a prior CVD episode, especially myocardial infarction, was by far the strongest predictor of recurrent CVD. CONCLUSIONS—Approximately 6% of unselected diabetic patients in secondary prevention develop recurrent major CVD every year. Those with long-standing previous CVD show a higher incidence of recurrence. Male sex, age, high triglyceride levels, and insulin use are additional predictors of recurrence.
Two Cases of Diffuse Osteoblastic Metastases From Early Type Gastric Cancer
Authors: Masamichi Koyama, Mitsuru Koizumi
Journal: Clinical Nuclear Medicine (2007)

We report 2 cases of diffuse osteoblastic metastasis from early type gastric cancer. A 41-year-old woman complained of lumbago. She presented poorly differentiated adenocarcinoma on gastroscopic examination. The other case was a 64-year-old man who had a history of surgical removal of chondrosarcoma of the left rib. He presented signet-ring cell carcinoma on gastroscopic examination. Osseous metastasis was confirmed by biopsy in both patients. In patients with diffuse osteoblastic metastasis, bone scintigraphy shows remarkably increased accumulation or ‘super scan’, which shows usually more clear finding than positron emission tomography with F-18 fluorodeoxyglucose.
Case 27-1970
Authors: Richard C. Cabot, Benjamin Castleman, Betty U. McNeely, J. Warren Harthorne, Robert E. Scully
Journal: New England Journal of Medicine (1970)

Presentation of CaseA 62-year-old man was admitted to the hospital because of bradycardia.On the morning of admission, while eating breakfast, he had the onset of a mild ache in the neck, profuse sweating and weakness. A physician found bradycardia and sent him to the hospital via ambulance. As the patient arrived in the Emergency Ward cardiac arrest developed. With external cardiac massage and electric countershock cardiac activity was restored. A few minutes later effective cardiac action again ceased, and a cardiac monitor disclosed ventricular fibrillation. External countershock was again applied successfully, although the blood pressure remained low. Isoproterenol . . .