tbuckley/cabot-search huggingface dataset:
Medical Malpractice: A Preventive Approach
Authors: Miles J. Gullickson
Journal: JAMA (1985)

This excellent analysis of the potentialities of preventive measures applied to medical malpractice is written by a physician singularly well qualified to address the problem. His comprehensive personal experience, so evident in the book, is unintentionally further emphasized by the brief list of less than a score of references to sources other than the Washington State Medical Society programs, in which he has played so important a role. Prospective readers of this book might well begin by perusing the last paragraph, wherein Robertson explains that his goal is, as ours can be, to "eliminate the causes of malpractice [by] adapting the medical model of disease elimination to the malpractice scene." In pursuing a solution to the problem by such a method, the author devotes his entire text to the advocacy of procedures by which the medical profession can conscientiously and effectively reduce the frequency of actual malpractice to an irreducible
Angiotropic lymphoma: proliferation of B cells in the capillaries of cutaneous angiomas
Authors: T. Kobayashi, S. Munakata, H. Sugiura, M. Koizumi, M. Sumida, K. Murata, H. Shinkai
Journal: British Journal of Dermatology (2000)

We report a 52-year-old patient with cutaneous angiomas on the trunk in association with angiotropic lymphoma involving the nervous system. The lesional skin showed proliferation of atypical B cells in the capillaries. The diagnosis of angiotropic lymphoma with neurological deficits is often difficult before death. Thus, skin biopsy in this case proved to be diagnostic of the central nervous system disease without the risk of brain biopsy. The diagnosis of angiotropic lymphoma in the future may be achievable by biopsy of coincidental angiomas.
Management of anorexia nervosa revisited
Authors: Janice Russell
Journal: BMJ (2004)

effective treatment, are exciting.However, before aspirin resistance can be accepted as a valid clinical entity worthy of screening and treatment, the other criteria mentioned above must be met.The first step is to develop a standardised definition and test of aspirin resistance.An appropriate definition of aspirin resistance may be: the lack of anticipated response to a therapeutic dose of aspirin (75-150 mg per day for at least five days in a compliant patient) that can be demonstrated by a specific, valid, and reliable laboratory measure of the antiplatelet effects of aspirin and which correlates significantly, independently, and consistently with an increased incidence of atherothrombotic vascular events.The definition may be refined in the future to include proven genetic determinants (for example, platelet polymorphisms), which mediate aspirin resistance and risk of ischaemic events.Further studies are required to externally validate the promise of urinary 11-dehydrothromboxane B2 and optical platelet aggregometry as laboratory measures of "clinical" aspirin resistance.While awaiting the development of a reliable test and effective treatment for aspirin resistance, the most efficient strategy for clinicians to prevent aspirin failure is to make sure that the index event was atherothrombotic in origin, use an appropriate dose of aspirin (75-150 mg daily), maintain a high level of compliance, and avoid combining aspirin with drugs such as ibuprofen that may reduce its effectiveness for the prevention of atherothrombotic vascular events. 10 11
Extracorporeal high-intensity focused ultrasound for VX2 liver tumors in the rabbit
Authors: Frédéric Prat, Maria Centarti, Alain Sibille, Fatima Abou El Fadil, Luc Henry, Jean-Yves Chapelon, Dominique Cathignol
Journal: Hepatology (1995)

High-Intensity Focused Ultrasound (HIFU) can produce radical tissue necrosis. We wanted to assess tumor destruction, proliferation, and tumorigenesis after HIFU, in an animal model of hepatic tumor. New Zealand rabbits bearing VX-2 solitary liver tumors were treated with extracorporeal HIFU under ultrasound (US) guidance and standardized conditions. Groups differed only for the administration of either one or two consecutive HIFU procedures. Tissue destruction was assessed by stereomicroscopy and planimetry, cell proliferation was estimated by in vivo intra-arterial injection of 1200 muCi [3H]thymidine, and tumorigenesis was tested by reimplantation of treated or untreated pieces of liver tumors into the thighs of nontumor-bearing animals. Mortality was 0. Tumor destruction rates were 76.3% +/- 16% after one procedure and 94.2% +/- 7.3% after two procedures. Nuclear staining was heavy in control tumors and was absent in treated tumors. Untreated hepatic tumors induced measurable tumors at 3 weeks in thighs of all recipients, 7.8 +/- 2.4 cm3 in volume. Hepatic tumors treated with one HIFU procedure induced tumors in the thigh of recipients in 31.3% of cases (0.47 +/- 0.06 cm3), and those treated with two HIFU procedures induced tumors in 0% even after 8 weeks of follow-up. In conclusion, HIFU allows a noninvasive approach to the destruction of liver tumors in this model, with little toxicity but significant effects on proliferation and tumorigenesis. The repetition of HIFU procedures may improve results.
Corticosteroid treatment of prolidase deficiency skin lesions by inhibiting iminodipeptide-primed neutrophil superoxide generation
Authors: K. Yasuda, K. Ogata, K. Kariya, Hajime Kodama, J. Zhang, K. Sugahara, Y. Sagara, Hiroyuki Kodama
Journal: British Journal of Dermatology (1999)

We studied the pathogenetic role of iminodipeptides, and the effects of corticosteroids on the skin lesions of two adult female siblings with prolidase deficiency. The elder sister had had severe skin ulcers and mental retardation since childhood, while the younger sister had shown milder clinical manifestations since late adolescence. The ulcers showed vascular wall thickening and neutrophil infiltration. Oral prednisolone at moderate doses was not effective, but corticosteroid pulse therapy followed by a moderate dose of prednisolone improved the preulcerative indurated lesions and ulcers. A 2‐year follow‐up of the younger patient indicated that N‐formyl methionyl leucyl phenylalanine‐induced neutrophil superoxide generation was elevated, in parallel with an increase in the serum iminodipeptide level, when the skin ulcers and preulcerative indurated lesions were most active. Corticosteroid pulse therapy downregulated the superoxide generation by neutrophils. The serum iminodipeptide level, however, did not decrease during 25 days after pulse therapy. These findings suggest that iminodipeptides may play an important part in aggravating the skin lesions by priming neutrophil superoxide generation, and that high‐dose corticosteroids improve the skin lesions, probably by inhibiting the infiltration, and superoxide generation by, neutrophils. Neutrophil superoxide generation was more prominent in the elder sister, suggesting that clinical severity may depend on the response of neutrophils to the iminodipeptides. Chronic stimulation by superoxide may cause thickening of cerebral blood vessels and eventual mental retardation.
The bitter taste of infection
Authors: Alice Prince
Journal: Journal of Clinical Investigation (2012)

The human innate immune response to pathogens is complex, and it has been difficult to establish the contribution of epithelial signaling in the prevention of upper respiratory tract infection. The prevalence of chronic sinusitis in the absence of systemic immune defects indicates that there may be local defects in innate immunity associated with such mucosal infections. In this issue of the JCI, Cohen and colleagues investigate the role of the bitter taste receptors in airway epithelial cells, and find that these are critical to sensing the presence of invading pathogens.
Magnitude of the fetal hemoglobin response to acute hemolytic anemia in baboons is controlled by genetic factors.
Authors: J DeSimone, P Heller, J Amsel, M Usman
Journal: Journal of Clinical Investigation (1980)

When hemolytic anemia was induced in 26 baboons (Papio cynocephalus), aged 7-22 mo, they increased their production of fetal hemoglobin (HbF). Although the resulting reduction in hematocrits and increases of reticulocyte counts were similar in all stressed animals there was marked variability in the maximal rates of HbF synthesis. The maximal levels of HbF attained appeared to fall into three separate groups: low, intermediate, and high. These differences were not related to sex or several measures of erythrocyte metabolism. Animals exposed to repeated episodes of erythropoietic stress after full hematologic recovery demonstrated some variability in their maximal HbF levels attained from one episode to another, but these variations never extended to adjacent classes. The described biochemical and mating data suggest that the magnitude of the HbF response to hemolytic anemia is controlled by genetic factors.
The Qualitative I-131 Hippuran Renogram
Authors: ANDREW TAYLOR, MICHAEL S. KIPPER
Journal: Clinical Nuclear Medicine (1983)

The I-131 Hippuran renogram time activity curve is usually generated by assigning computer assisted regions of interest over each kidney. Qualitative whole kidney renogram curves can be misleading when there is a nonobstructed but dilated collecting system or asymmetrical excretion of the tracer from the renal collecting system. This problem can be minimized by generating an additional renogram curve from a region of interest assigned over each renal cortex.
Omacetaxine: A Protein Translation Inhibitor for Treatment of Chronic Myelogenous Leukemia
Authors: Varsha Gandhi, William Plunkett, Jorge E. Cortes
Journal: Clinical Cancer Research (2014)

Chronic myelogenous leukemia (CML) is driven by the Bcr-Abl fusion protein, which is a result of a (9;22) chromosomal translocation. Imatinib, dasatinib, and nilotinib (tyrosine kinase inhibitors, TKI) have revolutionized how CML is treated. Although the majority of patients respond to these kinase inhibitors, a subset becomes resistant to these therapeutics. Synribo (omacetaxine mepesuccinate) was recently approved by the U.S. Food and Drug Administration for Philadelphia-positive CML either in the chronic or the accelerated phase whose disease failed two prior TKIs. With omacetaxine 1.25 mg/m(2) twice daily for 14 days during induction and for 7 days during maintenance, a major cytogenetic response occurred in 20% of patients in the chronic phase and major hematologic response in 27% of patients in the accelerated phase. Laboratory investigations unraveled the mechanism of action and effectiveness of this agent. Bcr-Abl protein is intrinsically programmed to turn over with a short half-life that makes it susceptible to protein translation inhibitors. Omacetaxine (homoharringtonine) inhibits total protein biosynthesis by binding to A-site cleft of ribosomes. As a corollary to this action, there is a diminution of short-lived proteins, such as Bcr-Abl, followed by cell death. Approval of this first-in-class protein translation inhibitor opens up new avenues for its use in other diseases as well as mechanism-based combinations.
Intrapsychic structural effects of psychiatric research
Authors: S G Siris, J P Docherty, T H McGlashan
Journal: American Journal of Psychiatry (1979)

The authors observed that many psychotic patients on a clinical/research ward incorporated various aspects of research organization into their own evolving intrapsychic structures. This process had either beneficial or deleterious clinical effects, depending on the attributes of the research and the specific mental functions to which these attributes became attached. The observations resulted in the development of a set of recommendations for maximizing the therapeutic usefulness of this phenomenon and minimizing its countertherapeutic drawbacks.
Effects of Tamoxifen on Bone Mineral Density in Postmenopausal Women with Breast Cancer
Authors: Richard R. Love, Richard B. Mazess, Howard S. Barden, Sol Epstein, Polly A. Newcomb, V. Craig Jordan, Paul P. Carbone, David L. DeMets
Journal: New England Journal of Medicine (1992)

Tamoxifen, a synthetic antiestrogen, increases disease-free and overall survival when used as adjuvant therapy for primary breast cancer. Because it is given for long periods, it is important to know whether tamoxifen affects the skeleton, particularly since it is used extensively in postmenopausal women who are at risk for osteoporosis. Using photon absorptiometry, we studied the effects of tamoxifen on the bone mineral density of the lumbar spine and radius and on biochemical measures of bone metabolism in 140 postmenopausal women with axillary-node—negative breast cancer, in a two-year randomized, double-blind, placebo-controlled trial.
Centenary of "Great Ormond Street"
Authors: T. T. Higgins
Journal: BMJ (1952)

In the England of a hundred years ago most children received but scanty consideration.Many of them died in infancy and so escaped much suffering.All too often those who survived were caught up in the industrial revo- lution.They toiled for long hours in coal-mine or factory, andlived in a deplorable environment of overcrowding and dirt.They were inadequately or wrongly fed.Even among the well-to-do there was little understanding of infant and cfiild nurture, either physical or psychological.The death rate among children was appalling, and no wonder.Of London's 50.000 annual deaths, 21,000 were those of children under the age of 10.Rickets became known as " the English disease."The grievously stunted, deformed, and battered bodies of many fellow citizens are still to some of us a vivid but grim memory of our youth, and our pathological museums display evidence of diseases of a type and degree now happily mainly a matter of historical interest.Awakening of the Social Conscience Yet, despite the general preoccupation of the public with industrial expansion and its indifference to the sufferings of children, the fire of reform was well alight among some social workers, ministers of religion, doctors, writers, and politicians, of whom Lord Ashley (later Lord Shaftesbury) especially championed the children's cause.In such a com- pany, Dr. Charles West must always stand pre-eminent for his service to children.After two years as a medical student at St. Bartholomew's, West completed his course at Bonn, Paris, and Berlin.becoming M.D.Berlin in 1837.Then, after studying midwifery in Dublin, he practised as a physician and accoucheur, lecturing on midwifery at the Middlesex Hospital.But soon his main interest became focused on the diseases of infancy and childhood, a sub-
SOME VITAL PHASES OF FRACTURES OF THE JAWS
Authors: CHALMERS J. LYONS
Journal: JAMA (1918)

The subject of fractures of the jaws is one that has attracted the attention of medicine since the days of Hippocrates. It also is a subject that was of considerable interest to dentistry long before it became a profession. Indeed, many of the principles laid down by Hippocrates can be used today with a moderate degree of success. It was Hippocrates who first originated interdental ligation. It was also Hippocrates who condemned the use of bandages alone as a procedure in the treatment of fractures of the jaws. In presenting the subject of fractures of the jaws at this time, we shall touch on only two or three vital phases of the subject. The first phase which we shall attempt to discuss will be the process of repair. We use the word "discuss" advisedly, because in our present state of knowledge of the subject, we can only discuss it. We
Inpatient Cognitive Behaviour Therapy for Anorexia Nervosa: A Randomized Controlled Trial
Authors: Riccardo Dalle Grave, Simona Calugi, Maddalena Conti, Helen Doll, Christopher G. Fairburn
Journal: Psychotherapy and Psychosomatics (2013)

&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; The aim of this study was to compare the immediate and longer-term effects of two cognitive behaviour therapy programmes for hospitalized patients with anorexia nervosa, one focused exclusively on the patients' eating disorder features and the other focused also on mood intolerance, clinical perfectionism, core low self-esteem or interpersonal difficulties. Both programmes were derived from enhanced cognitive behaviour therapy (CBT-E) for eating disorders. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; Eighty consecutive patients with severe anorexia nervosa were randomized to the two inpatient CBT-E programmes, both of which involved 20 weeks of treatment (13 weeks as an inpatient and 7 as a day patient). The patients were then followed up over 12 months. The assessments were made blind to treatment condition. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; Eighty-one percent of the eligible patients accepted inpatient CBT-E, of whom 90% completed the 20 weeks of treatment. The patients in both programmes showed significant improvements in weight, eating disorder and general psychopathology. Deterioration after discharge did occur but it was not marked and it was restricted to the first 6 months. There were no statistically significant differences between the effects of the two programmes. &lt;b&gt;&lt;i&gt;Conclusions:&lt;/i&gt;&lt;/b&gt; These findings suggest that both versions of inpatient CBT-E are well accepted by these severely ill patients and might be a viable and promising treatment for severe anorexia nervosa. There appears to be no benefit from using the more complex form of the treatment.
GP training will receive more funding
Authors: Kathryn Godfrey
Journal: BMJ (2004)

The minister of state for health in England, John Hutton, promised that training for future GPs will be properly resourced. He was speaking at a GP recruitment conference held last week by the British Medical Association.

Despite a loss of £50m ($90m; €74m) in the overall medical training budget, Mr Hutton said that he had no indication that the number of GP registrars could not be expanded as planned.

He said, “It is definitely not part of our agenda …
Support for varicose veins.
Authors: P H Fentem, M Goddard, B A Gooden
Journal: BMJ (1976)

A method has been devised to allow reliable comparison of different strengths and constructions of support hosiery. Five garments were evaluated for the compression they exerted on the leg and their ability to limit the distension of a model varicose vein. Stockings and tights which provide modest compression can achieve worthwhile control of vein distension.
Chromium Supplementation Does Not Improve Glucose Tolerance, Insulin Sensitivity, or Lipid Profile: A Randomized, Placebo-Controlled, Double-Blind Trial of Supplementation in Subjects With Impaired Glucose Tolerance
Authors: James Komorowski, Vijaya Juturu
Journal: Diabetes Care (2005)

We read the recent article by Gunton et al. (1) with great interest and feel that it warrants comment. In this study, the authors stated that they “found no beneficial effect of chromium supplementation in the treatment of people with IGT [impaired glucose tolerance].” The results are in conflict with other clinical studies that showed chromium picolinate can enhance or normalize impaired glucose metabolism, as described in a recent review (2). The lack of effect described by the authors may be …
Erythema migrans: a reassessment of diagnostic criteria for early cutaneous manifestations of borreliosis with particular emphasis on clonality investigations
Authors: A. Böer, M. Bresch, J. Dayrit, T.M. Falk
Journal: British Journal of Dermatology (2007)

Controversy exists about the relationship of borrelia infection with B-cell lymphomas because B-cell clonality has been identified in infiltrates that contained borrelia-specific DNA. Systematic clinicopathological, immunophenotypical and molecular pathological studies of early borreliosis are lacking.(i) To clarify whether clonal B-cell populations are present already in early borreliosis of the skin (erythema migrans); (ii) to re-evaluate clinicopathological, immunophenotypical and molecular pathological criteria for diagnosis of erythema migrans.Study of 34 patients with erythema migrans confirmed by polymerase chain reaction (PCR). Infiltrates were analysed by histopathological and immunohistochemical methods and multiplex PCR for clonal IgH rearrangements.Erythema migrans shows a broad spectrum of changes including sparse infiltrates of T lymphocytes, dense interstitial granulomatous infiltrates (CD68+), and pseudolymphomatous patterns with germinal centre formation. There were accompanying epidermal changes in 59% of patients, and plasma cells were an inconsistent finding. B cells were few when infiltrates were sparse, but increased disproportionately when infiltrates were dense. IgH rearrangement studies revealed one pseudo-oligoclonal, three pseudoclonal and three clonal infiltrates. Pseudoclonality was encountered when infiltrates contained only few B lymphocytes.Infiltrates in erythema migrans are dominated by T cells followed by CD68+ histiocytes and B lymphocytes. Plasma cells are an inconsistent finding. Pseudoclonality of IgH rearrangement is a result of infiltrates being sparse in B lymphocytes and represents a pitfall in molecular pathological diagnosis that can only be avoided by duplicate or triplicate tests. Incidental B-cell clonality may be encountered in patients with unequivocal erythema migrans and should not be interpreted as a malignant lymphomatous process induced by borrelia.
The effect of topical crude coal tar treatment on unstimulated hairless hamster skin
Authors: M.I. FOREMAN, W. PICTON, G.A. LUKOWIECKI, C. CLARK
Journal: British Journal of Dermatology (1979)

Topical treatment of hairless hamster skin with crude coal tar has been shown to induce epidermal thickening, an increased labelling index in the basal cell layer, an elevation in NADP-dependent glucose-6-phosphate dehydrogenase activity throughout the epidermis, an increased squame count, comedo formation, and atrophy of the sebaceous glands. Ultraviolet light fluorescence microscopy of sections of treated skin suggests that the hair follicle is an important route for skin penetration by coal tar.
Problems in Adapting a Glucose-Oxidase Electrochemical Sensor into an Implantable Glucose-Sensing Device
Authors: Daniel R Thévenot
Journal: Diabetes Care (1982)

Taking into account the analytic patterns of different types of glucose-oxidase electrochemical sensors, the specific problems which have to be solved for such a sensor to be implantable are outlined. Of particular interest is the lifetime of enzymatic membrane and the dependence of the sensor responses to oxygen concentration and hydrodynamics.
Researchers publish details of multiresistant HIV patient
Authors: Susan Mayor
Journal: BMJ (2005)

Researchers have published clinical and sequencing details of a unique variant of HIV in a patient who is resistant to several classes of antiretroviral drugs and who rapidly developed AIDS, after media reports of a possible new “super-strain” of the virus (Lancet 2005;365:1031-8).

The patient, a man in his 40s from New York, was given a diagnosis of HIV-1 infection in December 2004 after he had had fever, pharyngitis, weakness, and fatigue the previous month. Earlier he had tested negative for HIV-1 antibodies on several occasions between September 2000 and May 2003. His illness progressed to AIDS within 20 months—and perhaps as little as four months—of infection. The case was first publicised at a press conference in New York last month because of the possible public health …