tbuckley/cabot-search huggingface dataset:
Book Review of Doctors, Patients, and Placebos
Authors: WILLIAM BACHRACH
Journal: Annals of Internal Medicine (1987)

Letters and Corrections1 July 1987Book Review of Doctors, Patients, and PlacebosWILLIAM BACHRACH, M.D.WILLIAM BACHRACH, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-107-1-124_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Having read (and reviewed for another journal) Howard Spiro's Doctors, Patients, and Placebos, I find several aspects of Dr. Sidney Shindell's review of the same book (1) open to question.Dr. Shindell: "The author discusses what he considers the three elements that interact when placebos are used."The book (p. 10): "There are four parts to the placebo transaction."Dr. Shindell: "The major deficiency in the book, however, is the literature the author does not deal with in his discussion. The field of medical sociology seems to have escaped his attention, despite major contributions people from his...References1. SHINDELL S. Doctors, Patients, and Placebos [Book review]. Ann Intern Med. 1987;106:144. MedlineGoogle Scholar2. VISELTEAR A. A brief chapter in the history of social medicine. Yale J Biol Med. 1984;57:869-89. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: George Washington University Medical Center Washington DC PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCorrection: Quotation in Letter on Doctors, Patients, and Placebos 1 July 1987Volume 107, Issue 1Page: 124-124KeywordsMedical sociology ePublished: 1 December 2008 Issue Published: 1 July 1987 PDF downloadLoading ...
Fifty Hours for the Poor-Reply
Authors: Laurence Bodine
Journal: JAMA (1990)

<h3>In Reply. —</h3> Dr Evans will be interested to know that 100 000 lawyers participate each year in some 500 organized pro bono programs for the poor in this country. This does not include private, nonreported pro bono work for the local church, art center, or service club. Since August 1988 — 7 months after the editorial was first published in the<i>ABA Journal and JAMA</i>— it has been the official policy of the American Bar Association that lawyers should devote at least 50 hours of their time to the poor each year. Dr Haynes misses the point. I believe that the moral price for holding a license to practice a profession of specialized knowledge is devotion of some of one's skills at no charge to the needy. The country cannot afford otherwise. Dr Tauber is wrong. The duty to devote time to the poor arises not from the
Effects of Different Ventilator Settings on Sleep and Inspiratory Effort in Patients with Neuromuscular Disease
Authors: Francesco Fanfulla, Monica Delmastro, Angela Berardinelli, Nadia D'Artavilla Lupo, Stefano Nava
Journal: American Journal of Respiratory and Critical Care Medicine (2005)

Patients with neuromuscular disease (NMD) who require long-term ventilation normally have the ventilation set using empirical daytime parameters. We evaluated arterial blood gases (ABG), breathing pattern, respiratory muscle function, and sleep architecture during ventilation with two noninvasive Pressure Support Ventilation (nPSV) settings in nine patients with NMD. The two settings were randomly applied: the usual (US), with the nPSV setting titrated on simple clinical parameters, and the physiological (PHYS), tailored to the patient's respiratory effort. During wakefulness, nPSV significantly improved ABG and minute ventilation and reduced the diaphragmatic pressure-time product (PTPdi/breath), independently of the type of setting (PTPdi/breath spontaneous breathing 5.7 +/- 2.4, US 3.2 +/- 2, PHYS 3.6 +/- 1.6 cm H2O . seconds(-1), p < 0.001). However, during sleep, PHY nPSV resulted in a significant improvement of gas exchange, sleep efficiency (71.7% +/- 14 US vs. 80.6% +/- 8.3 PHYS, p < 0.01) and % of REM sleep (9.1% +/- 7 US vs. 17.3% +/- 5.4 PHYS, p < 0.01). This improvement was significantly correlated with the reduction in ineffective efforts. In NMD, nPSV is effective in improving daytime ABG and in unloading inspiratory muscles independently of whether it is set on the basis of the patient's comfort or the patient's respiratory mechanics. However, PHYS was associated with better sleep architecture and nighttime gas exchange.
Role of Hepatic Cytochrome P450s in the Pharmacokinetics and Toxicity of Cyclophosphamide: Studies with the Hepatic Cytochrome P450 Reductase Null Mouse
Authors: Georgia J. Pass, Dianne Carrie, Michael Boylan, Sally Lorimore, Eric Wright, Brian Houston, Colin J. Henderson, C. Roland Wolf
Journal: Cancer Research (2005)

Abstract Cyclophosphamide (CPA) is an anticancer prodrug that is dependent on cytochrome P450 (CYP) metabolism for its therapeutic effectiveness. In spite of the use of CPA in the clinic for over 50 years, little is known about the relationship between its toxicokinetics and therapeutic response. We have employed a powerful new model, the Hepatic Cytochrome P450 Reductase Null (HRN) mouse, which has almost no hepatic cytochrome P450 activity, to study the toxicokinetics of CPA and to establish in vivo the role of hepatic P450 metabolism in its pharmacokinetics. In HRN mice the in vitro metabolism and intrinsic clearance of CPA was over 6-fold lower than in wild-type animals. This change in CPA metabolism was also reflected in vivo, with a profound difference in the pharmacokinetics of both CPA and its metabolites. At a CPA dose of 100 mg/kg, the Cmax, plasma area under the curve (AUC) and half-life were increased by 2.6-, 6.2-, and 3.2-fold, respectively, in the HRN mice. Similar changes were also observed at a dose of 300 mg/kg. These data confirm that hepatic metabolism is the major route of CPA elimination and disposition. The primary metabolites of CPA, 4-hydroxycyclophosphamide (4-OH-CPA) and 3-dechloroethylcyclophosphamide, were still formed, but at altered rates in the HRN mice. At 100 mg/kg the t1/2 for 4-OH-CPA was increased 1.8-fold, the Cmax reduced 1.7-fold, and the AUC remained unchanged. This latter finding shows that P450-mediated oxidative metabolism is essential for the clearance of this compound. Toxicokinetic analysis of CPA-induced myelosuppression and granulocytopenia showed that at high doses (≥100 mg/kg) there was no difference in myelotoxicity between the wild-type and HRN mice. However, at lower doses (≤70 mg/kg) a significant difference was observed, with little toxicity seen in HRN mice but at least a 45% reduction in the bone marrow granulocyte population in wild-type mice. Meta-analysis of the toxicity experiments showed the myelotoxicity of CPA was found to be closely correlated with the Cmax of 4-OH-CPA (r2 = 0.80, P = 0.002). As the therapeutic effectiveness of CPA has been linked to the AUC for 4-OH-CPA, the finding that 4-OH-CPA Cmax may determine its level of myelotoxicity indicates that the therapeutic index could be altered by changing the method of CPA administration. Furthermore, monitoring 4-OH-CPA Cmax may identify individuals at most risk of CPA side effects.
Oximetry in Congenital Heart Disease with Special Reference to the Effects of Voluntary Hyperventilation
Authors: B. VAN LINGEN, JOANNA WHIDBORNE
Journal: Circulation (1952)

An oximeter has been used to measure the arterial oxygen saturation of patients with a variety of congenital heart anomalies. The effects of exercise and oxygen administration have been of value in ascertaining the presence of a venous-arterial shunt. The rise in arterial oxygen saturation during a vigorously performed voluntary hyperventilation appears to offer a means of gaging the extent to which the pulmonary circulation may be increased; a less than normal increase has only been found in the presence of pulmonic stenosis or in some instances of pulmonary hypertension and a relatively fixed pulmonary resistance. The results of hyperventilation are sufficiently distinctive to be of diagnostic value in cases of Fallot's tetralogy, Eisenmenger's complex, isolated pulmonic stenosis, pulmonic stenosis with intact ventricular septum and patent foramen ovale, and Ebstein's anomaly of the tricuspid valve with patent foramen ovale.
Pain and Nociception: Mechanisms of Cancer-Induced Bone Pain
Authors: Sarah Falk, Anthony H. Dickenson
Journal: Journal of Clinical Oncology (2014)

Cancer pain, especially pain caused by metastasis to bone, is a severe type of pain, and unless the cause and consequences can be resolved, the pain will become chronic. As detection and survival among patients with cancer have improved, pain has become an increasing challenge, because traditional therapies are often only partially effective. Until recently, knowledge of cancer pain mechanisms was poor compared with understanding of neuropathic and inflammatory pain states. We now view cancer-induced bone pain as a complex pain state involving components of both inflammatory and neuropathic pain but also exhibiting elements that seem unique to cancer pain. In addition, the pain state is often unpredictable, and the intensity of the pain is highly variable, making it difficult to manage. The establishment of translational animal models has started to reveal some of the molecular components involved in cancer pain. We present the essential pharmacologic and neurobiologic mechanisms involved in the generation and continuance of cancer-induced bone pain and discuss these in the context of understanding and treating patients. We discuss changes in peripheral signaling in the area of tumor growth, examine spinal cord mechanisms of sensitization, and finally address central processing. Our aim is to provide a mechanistic background for the sensory characteristics of cancer-induced bone pain as a basis for better understanding and treating this condition.
The forgotten war in the hidden valley.
Authors: H D Powell
Journal: BMJ (1987)

the vast Indian plain, which stretched for hundreds of miles in front.Here our expedition was to end and we were saddened that our existing trip was, drawing to a close.We travelled back to Kathmandu by road and joined Dave Young, now out of hospital and recovering well-from his injuries. Cameraman as well as doctorThe tri'p was a memnorable adventure for me.I had been fairly busy with the 12 team members and up to 130 porters.As well as ilUnesses there were many minor injuries, including bad bruises in a porter who had encountered an irritable yak on the trail.Local people also presented with more chronic problems, leg ulcers, eye infections, boils, and productive coughs.Apart from my role as a doctor I was also assistant to the cameraman.I learnt techniques ofsoundrecordinganddocumentary film making, which was interesting and enjoyable, and the film we made, Thin Air White Water, was screened on Channel 4. My third major role was as stills photographer.The professional photographer we had planned to take had withdrawn at short notice, so official photography was designated to three of us with the most photo- graphic experience.We have used the results for slide talks and to illustrate magazine articles about the-expedition.
Chromatin Remodeling Underlies the Senescence-Associated Secretory Phenotype of Tumor Stromal Fibroblasts That Supports Cancer Progression
Authors: Ermira Pazolli, Elise Alspach, Agnieszka Milczarek, Julie Prior, David Piwnica-Worms, Sheila A. Stewart
Journal: Cancer Research (2012)

Abstract Age is a major risk factor for the development of cancer. Senescent fibroblasts, which accumulate with age, secrete protumorigenic factors collectively referred to as the senescence-associated secretory phenotype (SASP). Here, we examined the molecular mechanisms that control SASP activation, focusing on the known SASP factor osteopontin (OPN). We found that expression of the canonical SASP members interleukin (IL)-6 and IL-8, but not OPN, were dependent upon a persistent DNA damage response (DDR) as evidenced by ATM and NF-κB activation. Treatment with several histone deacetylase (HDAC) inhibitors robustly activated SASP in the absence of DNA breaks, suggesting that DDR-dependent SASP activation occurs in response to chromatin remodeling rather than physical breaks in DNA. In the setting of HDAC inhibition, IL-6 and IL-8 expression remained dependent upon ATM and NF-κB, while OPN expression remained independent of these factors. Further analysis revealed that HDAC1 inhibition was sufficient to induce OPN expression, which is interesting given that loss of HDAC1 expression correlates with increased OPN expression within the stromal compartment of invasive breast cancers. Importantly, fibroblasts treated with HDAC inhibitors promoted tumor growth in vivo. Our findings therefore indicate that HDAC modulation plays an important role in stromal cell activation, with important implications for the use of HDAC inhibitors in the treatment of cancer. Cancer Res; 72(9); 2251–61. ©2012 AACR.
Crutch Is Sled and Nothing's Twisted in The Cider Mill
Authors: Jonathan D. Adams
Journal: JAMA (1991)

<h3>To the Editor. —</h3> I am an utter philistine in the field of art criticism, so it is with great hesitancy that I offer some alternative views on the painting<i>The Cider Mill</i>by John George Brown on the cover of the August 22/29 issue of<i>JAMA</i>.<sup>1</sup>All five of the girls are sitting on what appears to be a sled. The sled is stored off the ground on planks to reduce rusting of the metal runners. I do not think that there is a crutch in the painting as Dr Southgate indicates, but rather the drawbar for the sled. The end of the drawbar is not visible, but I would surmise that it has a T-handle to be pulled by an adult. One does not see in the painting a double drawbar to which a horse would be attached. The sled is, of course, a means of transportation
False-positive Studies in Early 67Ga-Citrate Scintigraphy
Authors: GLENDA D. DONOGHUE, JEHUDA J. STEINBACH, JAI Y. LEE
Journal: Clinical Nuclear Medicine (1979)

Two cases of false-positive early 67Ga-citrate scintigraphs are presented. In both cases, the initial accumulation of the radiotracer in the region of the right iliac fossa could not be substantiated on the delayed study. It is suggested that the results of an early gallium scan be interpretated cautiously, especially when any apparent abnormality is within the region of the normal co- Ionic anatomy. A delayed study should be performed whenever possible.
National Policy on AIDS
Authors: Robert W. Wood
Journal: JAMA (1988)

To the Editor.  —I commend the recent article entitled Prevention and Control of the Acquired Immunodeficiency Syndrome [AIDS]: An Interim Report1 from the American Medical Association's Board of Trustees, but, as medical director of the AIDS Control Program in Seattle, I would like to make several comments.  The need for a national policy on AIDS, while critical, will apparently not be a product of the work of the Presidential Commission on AIDS. This was not one of the President's charges to the Commission, and the development of such a policy was not listed in their December interim report as a priority for the remainder of the Commission's work, to be completed in mid-1988. While I agree that such a policy must represent a coordinated effort between all levels of government and private concerns, some entity must lead the way in suggesting the framework for such a policy or it will
Adrenaline and nocturnal asthma.
Authors: J F Morrison, C Teale, S B Pearson, P Marshall, N M Dwyer, S Jones, H G Dean
Journal: BMJ (1990)

OBJECTIVE--To determine whether the nocturnal fall in plasma adrenaline is a cause of nocturnal asthma. DESIGN--Double blind placebo controlled cross-over study. In the first experiment the nocturnal fall in plasma adrenaline at 4 am was corrected in 10 asthmatic subjects with an infusion of adrenaline after parasympathetic blockade with 30 micrograms/kg intravenous atropine. In the second experiment 11 asthmatic subjects showing similar variations in peak expiratory flow rate had the nocturnal fall in plasma adrenaline corrected by infusion before atropine was given. PATIENTS--Asthmatic subjects with a diurnal variation in home peak expiratory flow rate of greater than 20% for at least 75% of the time in the two weeks before the study. MAIN OUTCOME MEASURES--Peak expiratory flow rate and plasma adrenaline. RESULTS--Correction of the nocturnal fall in plasma adrenaline at 4 am to resting 4 pm levels did not alter peak expiratory flow rate either before or after parasympathetic blockade with atropine. CONCLUSION--A nighttime fall in plasma adrenaline is not a cause of nocturnal asthma.
Left ventricular ultrastructural lesions are independent predictors for 10-year mortality after aortic valve replacement in chronic aortic regurgitation: a study with percutaneous endomyocardial left ventricular biopsy
Authors: Katy Didier, François Schiele, Bernardette Kantelip, Yvette Bernard, Jean-Pierre L. Bassand
Journal: Journal of the American College of Cardiology (2002)
EFFECT ON INTRA-OCULAR PRESSURE OF INTRAVENOUS INJECTIONS OF HYPERTONIC SALT SOLUTION
Authors: ROBERT K. LAMBERT
Journal: JAMA (1928)

Attention has recently<sup>1</sup>been called to the similarity between the cerebrospinal fluid and the aqueous humor. The dialysate nature of the cerebrospinal fluid has long been recognized,<sup>2</sup>and the fact that in animals the production, composition and response of the aqueous humor to changes in the blood are the same, indicating a like nature, has now been conclusively shown.<sup>1</sup> The main factors controlling the secretion-absorption equilibrium of these fluids are the hydrostatic pressure of the blood (capillary blood pressure), the osmotic pressure of the blood, and the capillary permeability. The influence of external pressure, brought to bear on these fluids by the walls of the closed chambers into which they are secreted, results in the intracranial and intra-ocular pressures. It has been shown experimentally in animals<sup>3</sup>that there is a simultaneous response of both the intracranial and the intra-ocular pressures to general changes in the hydrostatic
Effect of Socioeconomic Status on Hyperglycemia and Retinopathy Levels in Mexican Americans With NIDDM
Authors: Steven M Haffner, Helen P Hazuda, Michael P Stern, Judith K Patterson, W A J Van Heuven, Donald Fong
Journal: Diabetes Care (1989)

Mexican Americans have a threefold greater prevalence of non-insulin-dependent diabetes mellitus (NIDDM) than non-Hispanic Whites. Moreover, Mexican-American diabetic people have more severe hyperglycemia and diabetic retinopathy than non-Hispanic White diabetic people. Mexican Americans are predominantly of low socioeconomic status (SES), and low-SES Mexican Americans have a higher prevalence of NIDDM than higher-SES Mexican Americans. Therefore, we hypothesized that among diabetic people, low SES would be associated with more severe hyperglycemia and retinopathy. Three hundred forty-three Mexican Americans and 79 non-Hispanic Whites with NIDDM were identified from the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease. Hyperglycemia was assessed as the sum of the fasting, 1-h, and 2-h plasma glucose concentrations during a standard oral glucose tolerance test. Retinopathy was assessed by 7 standard stereoretinal photographs. SES was assessed with three indicators: Duncan's socioeconomic index, education, and income. Contrary to expectations, low SES was not associated with greater levels of hyperglycemia or grades of retinopathy.
The Development of a Novel Cancer Immunotherapeutic Platform Using Tumor-targeting Mesenchymal Stem Cells and a Protein Vaccine
Authors: Hon-Jian Wei, Alexander TH Wu, Chung-Huei Hsu, Yi-Ping Lin, Wen-Fang Cheng, Ching-Hua Su, Wen-Ta Chiu, Jacqueline Whang-Peng, Frank L Douglas, Win-Ping Deng
Journal: Molecular Therapy (2011)

An ideal anticancer strategy should target only the malignant cells but spare the normal ones. In this regard, we established a platform, consisting of an antigen-delivering vehicle and a protein vaccine, for developing an immunotherapeutic approach with the potential for eliminating various cancer types. Mesenchymal stem cells (MSCs) have been demonstrated capable of targeting tumors and integrating into the stroma. Moreover, we have developed a protein vaccine PE(ΔIII)-E7-KDEL3 which specifically recognized E7 antigen and elicited immunity against cervical cancer. Taking advantage of tumor-homing property of MSCs and PE(ΔIII)-E7-KDEL3, we used E6/E7-immortalized human MSCs (KP-hMSCs) as an E7 antigen-delivering vehicle to test if this protein vaccine could effectively eliminate non-E7-expressing tumor cells. Animals which received combined treatment of KP-hMSCs and PE(ΔIII)-E7-KDEL3 demonstrated a significant inhibition of tumor growth and lung-metastasis when compared to PE(ΔIII)-E7-KDEL3 only and KP-hMSCs only groups. The efficiency of tumor suppression correlated positively to the specific immune response induced by PE(ΔIII)-E7-KDEL3. In addition, this combined treatment inhibited tumor growth via inducing apoptosis. Our findings indicated that KP-hMSCs could be used as a tumor-targeting device and mediate antitumor effect of PE(ΔIII)-E7-KDEL3. We believe this strategy could serve as a platform for developing a universal vaccine for different cancer types.
Hmga2 is a direct target gene of RUNX1 and regulates expansion of myeloid progenitors in mice
Authors: Kentson Lam, Alexander Muselman, Randal Du, Yuka Harada, Amanda G. Scholl, Ming Yan, Shinobu Matsuura, Stephanie Weng, Hironori Harada, Dong-Er Zhang
Journal: Blood (2014)
Disclosure of diagnosis of acquired immune deficiency syndrome.
Authors: E C Bott
Journal: BMJ (1986)

At a time when ways of successfully sharing jobs-successful for the employer, the employees, and the patients-have been tried and tested and when society's attitudes towards sharing parental responsibility for child care are changing this document is, at best, anachronistic.We suggest that formal consideration of part time training should be an integral part of such planning docu- ments.
Resolution Due in Medical Software Regulation
Authors: Howard Wolinsky
Journal: Annals of Internal Medicine (1997)

Currents15 November 1997Resolution Due in Medical Software RegulationHoward WolinskyHoward WolinskySearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-10-199711150-00026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The U.S. Food and Drug Administration (FDA) has been trying for more than a decade to determine the best regulatory approach to the burgeoning “stand-alone” medical software industry. With the FDA's decision due soon, manufacturers of stand-alone software and members of the medical informatics community alike are optimistic that the agency will follow the path of least regulation.Since it began regulating medical devices under a 1976 statute, the FDA has required stringent review of software that is “embedded” inside such devices as pacemakers and ventilators. Likewise, it has regulated “accessory” software that can be run on general-purpose computers to ... Author, Article, and Disclosure InformationAuthors: Howard Wolinsky Previousarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAttitudes and beliefs of african americans toward participation in medical research 15 November 1997Volume 127, Issue 10Page: 953-954KeywordsComputer networksComputer softwareComputing systemsFood and Drug AdministrationHealth information technologyLibrariesPacemakersPrevention, policy, and public healthSoftware toolsVentilators ePublished: 15 August 2000 Issue Published: 15 November 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...