tbuckley/cabot-search huggingface dataset:
High‐dose therapy and autologous peripheral blood stem cells transplantation followed by a very low reduced intensity regimen with fludarabine + cyclophosphamide and allograft improve complete remission rate in de novo multiple myeloma patients
Authors: Massimo Martino, Giuseppe Console, Giuseppe Irrera, Giulia Praticò, Caterina Stelitano, Vincenzo Callea, Fortunato Morabito, Eugenia Quartarone, Caterina Musolino, Eugenio Piro, Maura Brugiatelli, Pasquale Iacopino
Journal: American Journal of Hematology (2006)

Abstract The recent development of reduced intensity conditioning and allotransplantation (RICT) has opened a new way to assure engraftment of donor cells while reducing early transplant‐related mortality. We evaluated the combination of high‐dose therapy and autologous peripheral blood stem cells transplantation (APBSCT) followed by RICT to extend the benefit of allografting procedures in de novo multiple myeloma (MM) patients. Fifteen subjects with stage III MM (median age 51 years, range 40–57) received high dose melphalan (200 mg/m 2 ) followed by APBSCT previously collected after cyclophosphamide (4 g/m 2 ) and granulocyte colony‐stimulating factor (G‐CSF). After 3–4 months from APBSCT, the patients underwent RICT, consisting of fludarabine 30 mg/m 2 + cyclophosphamide 300 mg/m 2 on days −4, −3, and −2. Acute graft‐versus‐host disease (GVHD) occurred in 2 patients; 6 patients developed chronic GVHD; 4 patients developed CMV antigenemia and were treated pre‐emptively with ganciclovir. No transplant related mortality was shown. Response was simultaneously measured by both electrophoresis (EP) and immunofixation (IF); when IF was negative, patients were classified in complete remission (CR) and when it remained positive, near CR (nCR). After a median follow up of 44 months post APBSCT, 100 and 43% of patients are still alive and progression‐free, respectively. Overall, the CR + nCR rate after dose‐reduced allograft was enhanced from 26.7 to 73.3%. A correlation not statistically significant between GVHD and remission was found. In conclusion, an up‐front tandem strategy with a very low reduced intensity‐conditioning regimen for allografting following autografting is feasible and induces high CR/nCR rate in MM. Am. J. Hematol., 2006. © 2006 Wiley‐Liss, Inc.
Characterization of carotenoid, vitamin A, and alpha-tocopheral levels in human lung tissue and pulmonary macrophages.
Authors: C A Redlich, J N Grauer, A M Van Bennekum, S L Clever, R B Ponn, W S Blaner
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

Increasing evidence suggests that beta-carotene, retinol (vitamin A), and alpha-tocopheral (vitamin E) may have important protective effects in the lung. However, surprisingly little is known about their storage and metabolism in human lung. Levels of beta-carotene, retinol, and alpha-tocopherol in human lung tissues and bronchoalveolar lavage (BAL) cells were determined with reverse-phase high-pressure liquid chromatography (HPLC). Fresh lung tissue, serum, and dietary questionnaires were obtained from 21 patients undergoing open lung surgery, and BAL cells from 12 of these patients. Dietary and serum levels of carotenoids, beta-carotene, retinol, and alpha-tocopherol were consistent with previously reported values. Lung tissue levels of total carotenoids, beta-carotene, retinol, and alpha-tocopherol were respectively 0.34 +/- 0.36 microg/g, 0.13 +/- 0.27 microg/g, 0.15 +/- 0.06 microg/g, and 9.60 +/- 4.86 microg/g tissue. Levels of these nutrients were also measured in BAL cells to establish potential markers for their lung tissue levels. Correlations between serum, BAL-cell, tissue, and dietary levels of the nutrients were determined. Lung tissue levels of total carotenoids, beta-carotene, and alpha-tocopherol, but not retinol, correlated well with their serum levels. Lung tissue levels of retinol and alpha-tocopherol correlated with their BAL-cell levels. These studies demonstrate quantifiable levels of retinol, alpha-tocopherol, and total carotenoids or beta-carotene in human lung tissue and BAL cells, and show that serum and/or BAL-cell levels of these nutrients can potentially be used to predict their lung tissue levels.
Audit: an annual assessment of the work and performance of a surgical firm in a regional teaching hospital.
Authors: M H Gough, M G Kettlewell, C G Marks, S J Holmes, J Holderness
Journal: BMJ (1980)

The assessment of the results of treatment has for long been one of the responsibilities of the medical profession. Prospective and retrospective surveys have formed the basis of original and review articles in the medical press, and of lectures and seminars. Postgraduate education has been well served by these traditional methods, which have often led the individual doctor to change and so improve his or her techniques in diagnosis and treatment. The scene, however, is changing. The cost of medical treat ment required to provide a comprehensive health service has, for various reasons, outstripped the resources available from the State. As a consequence the allocation and reallocation of finances and personnel have become matters of great importance to administrators, doctors, and politicians. A second change has been in the attitude of the patient, who has become more knowledgeable about health, and if, sometimes, higher expecta tions of hospital or medical care are unrealised may more often turn to some form of official complaint, or even litigation. Thirdly, the profession itself is changing. The number of graduates is increasing, and their attitude is naturally influenced by the changes in the medical curriculum over the past 20 years: overall there has been a reduction in the emphasis on acute hospital medical and surgical care, which has often been a dominant factor in health care planning in the past. It would be surprising if demands for the more accurate assessment of clinical performance, related especially to cost, had not been heard. It would be equally surprising if the pro fession had not responded. Demands there are?for example,
A Case of Acute Phthisis from Direct Contagion in a Dog
Authors: D. H. Cullimore
Journal: BMJ (1880)

years.The surgeon who brought the lady to nie had a very good case of instruments, and as he undertook, with I)r.Grabham, the charge of the patient after operation, I was able (although I had not extracted a cataract for about twenty years) to remove both lenses, and thus save this old lady the voyage to Lisbon; and I have lately heard from Dr.
Dynamic contrast enhanced computed tomography: a precise technique for identifying and localising pancreatic necrosis.
Authors: M Larvin, A G Chalmers, M J McMahon
Journal: BMJ (1990)

OBJECTIVE--To evaluate dynamic contrast enhanced computed tomography for detecting and localising pancreatic necrosis in acute pancreatitis. DESIGN--Prospective evaluation with blind reporting of scans. SETTING--Single teaching hospital. PATIENTS--60 Consecutive patients with acute pancreatitis suspected to have pancreatic necrosis because of major organ system failure (13); slow recovery five to seven days after admission with raised scores on the acute physiological and chronic health evaluation (APACHE-II) system (27); or findings on previous ultrasonography or computed tomography (20). MAIN OUTCOME MEASURE--Pancreatic necrosis proved histologically--that is, greater than 30 g necrotic tissue debrided at laparotomy (for life threatening sepsis or peritonitis) or necropsy. RESULTS--Dynamic computed tomography correctly localised pancreatic necrosis in 11 patients (confirmed at laparotomy in nine and at necropsy in two). Of nine patients with low enhancement of peripancreatic tissues alone, eight recovered after conservative management; necropsy confirmed viable pancreas and necrosis of peripancreatic fat in one patient. Of 40 patients with normal contrast enhancement, none required laparotomy to debride pancreatic necrosis. CONCLUSION--Dynamic contrast enhanced computed tomography seems to be a safe and accurate method of identifying and localising pancreatic and peripancreatic necrosis, which cannot be predicted accurately by conventional imaging techniques.
The Last Watcher
Authors: Brian Christman
Journal: Annals of Internal Medicine (2014)

Ad Libitum15 April 2014The Last WatcherBrian Christman, MDBrian Christman, MDFrom Nashville, TennesseeSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M13-2300 Audio Reading - “The Last Watcher” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "The Last Watcher," by B. Christman. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail I hope the birds never forgetWhat their renaissance meant to the old womanNestled on the sloping porchBeneath a beige afghanAfter the stroke.Brian Christman, MDNashville, Tennessee Author, Article, and Disclosure InformationAffiliations: From Nashville, TennesseeCurrent Author Address: Brian Christman, MD; e-mail, [email protected]net. PreviousarticleNextarticle Advertisement Audio Reading - “The Last Watcher” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "The Last Watcher," by B. Christman. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 15 April 2014Volume 160, Issue 8Page: 557KeywordsStroke ePublished: 15 April 2014 Issue Published: 15 April 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Case of Masculinovoblastoma
Authors: W. H. H. Merivale, L. Forman
Journal: BMJ (1951)

Results in 226 Cases(934 Cases) (50 Cases) (40 Cases) (97 Cases) (92 Cases) One or More Counts in a Differ-initial Count Under 60 mul.! Initial Count Over 60 mil.! All 3 Counts UnderAll Counts in ent Group from the Remainder, ml., any Subsequent Count ml., any Subsequent Count 60' mil./mi., the the Same Group the Initial Count Being:Over 60 miu/m., the Initial Below 60 mi/ml., the Lower
Effect of Clinical and Social Risk Factors on Hospital Profiling for Stroke Readmission
Authors: Salomeh Keyhani, Laura J. Myers, Eric Cheng, Paul Hebert, Linda S. Williams, Dawn M. Bravata
Journal: Annals of Internal Medicine (2014)

Background: The Centers for Medicare & Medicaid Services (CMS) and Veterans Health Administration (VA) will report 30-day stroke readmission rates as a measure of hospital quality. A national debate on whether social risk factors should be included in models developed for hospital profiling is ongoing. Objective: To compare a CMS-based model of 30-day readmission with a more comprehensive model that includes measures of social risk (such as homelessness) or clinical factors (such as stroke severity and functional status). Design: Data from a retrospective cohort study were used to develop a CMS-based 30-day readmission model that included age and comorbid conditions based on codes from the International Classification of Diseases, Ninth Revision, Clinical Modification (model 1). This model was then compared with one that included administrative social risk factors (model 2). Finally, the CMS model (model 1) was compared with a model that included social risk and clinical factors from chart review (model 3). These 3 models were used to rank hospitals by 30-day risk-standardized readmission rates and examine facility rankings among the models. Setting: Hospitals in the VA. Participants: Patients hospitalized with stroke in 2007. Measurements: 30-day readmission rates. Results: The 30-day readmission rate was 12.8%. The c-statistics for the 3 models were 0.636, 0.646, and 0.661, respectively. All hospitals were classified as performing “as expected” using all 3 models (that is, performance did not differ from the VA national average); therefore, the addition of detailed clinical information or social risk factors did not alter assessment of facility performance. Limitation: A predominantly male veteran cohort limits the generalizability of these findings. Conclusion: In the VA, more comprehensive models that included social risk and clinical factors did not affect hospital comparisons based on 30-day readmission rates. Primary Funding Source: U.S. Department of Veterans Affairs.
Children have feelings too
Authors: A. McFadyen
Journal: BMJ (1998)

As a child psychiatrist, one of my missions in life has been to teach medical students that children have feelings. A simple point, which as part of my job I have also had to remind paediatric colleagues about at times. Why then, was I so shocked by my own son's response to surgery?

Last year at the age of 7, my younger son had to have a circumcision. We had not taken the decision lightly, but he had had several local infections as a result of not being able to retract his foreskin. Fortunately, when we explained what was needed, he responded well. After some initial anxiety he took matters into his own hands, and came back from school one day with a list of those boys who had had the “special” operation. This seemed to reassure him enormously.

The staff at the local hospital were excellent. Apart from embarrassment at having to wear a backless theatre gown, the preoperative preparation went well. The hospital had a power cut just as we were going to theatre, but contingency plans were quickly put in place. Once there, the anaesthetist delivered an obviously well rehearsed line about …
EPIDEMIOLOGY OF LEAD POISONING
Authors: A. J. LANZA
Journal: JAMA (1935)

The use of lead is so widespread throughout all civilized countries that lead poisoning continues to be a matter of concern to the physician and the public health official. As new processes are evolved in industry and new materials devised for general consumption, so does lead poisoning continue to appear under new and sometimes strange circumstances. For centuries the origins of lead poisoning, its nature, its varied forms, the action of lead in the body, the treatment and the prevention of lead poisoning have all occupied the men of science and the men of industry and the last word has not yet been spoken. Lead poisoning may well be thought of as a counterpart of syphilis not only in the variety of its effects on the human system but in the manner in which it may be dormant and unsuspected in the tissues for years, apparently innocuous, until some alteration
Differences, Disparities, and Biases: Clarifying Racial Variations in Health Care Use
Authors: Saif S. Rathore, Harlan M. Krumholz
Journal: Annals of Internal Medicine (2004)

Studies documenting racial differences in health care use are common in the medical literature. However, observational studies of racial differences in health care use lack a framework for interpreting reports of variations in health care use, leading to various terms, ranging from "variations" to "bias," that suggest different causes, consequences, and, ultimately, remedies for such variations in treatment. We propose criteria to assess racial differences in health care use by using a clinical equity (equal treatment based on equal clinical need) framework. This framework differentiates between initial reports of racial differences and subsequent classifications of their findings as racial disparities or racial bias in health care use. Racial variations in health care use may be considered disparities after demonstrating that racial differences are not attributable to treatment eligibility, clinical contraindications, patient preferences, or confounding by other clinical factors and are associated with adverse consequences. Racial bias with adverse consequences in health care may be inferred if a racial variation in treatment that has been characterized as a disparity persists after accounting for health care system factors (for example, type of hospital at which the patient was treated). We apply this framework to published reports of racial differences in treatment to determine which studies provide evidence of differences, disparities, and bias. We discuss the use of such a framework in directing policy interventions for alleviating inappropriate racial variations in health care use.
Protective effects of antiretrovirals are confirmed in community setting
Authors: Z. Kmietowicz
Journal: BMJ (2012)

People who live in areas where more than 30% of people infected with HIV are taking antiretrovirals have a significantly reduced risk of acquiring the virus than those who live in areas of low uptake (less than 10%), shows a study carried out in a rural area of South Africa.

It is the first time that the positive protective effect of antiretrovirals on the incidence of HIV has been shown in a community setting. The findings were presented at the 19th …
MOUNTAIN CLIMATES IN HEALTH AND DISEASE
Authors: B. Hudson
Journal: BMJ (1921)

fRITIS 7 in 1920.I saw the sister of this patient in a severe attack in March, 1920, and in February, 1921, slhe lhad a still more seriotus attack, in which some of the nodules became" vesicated and ulcerated.Thle mother of the two girls had erytlhema nodosum in 1886, and lher oldest daughter died in 1889 during «n attack of tonsillitis and erytlhema nodosum withi endocarditis and pericarditis.There was a strong rheumatic family history, anid several members of the family lhad suffered from multiple attacks of scarlet fever, measles, and diplhtheria, so their case might be used equally well as an argument for or against the theory of infection.Certainly second attacks are more common in tllis disease than in scarlet fever, but they are not of such frequent occurrence as to support tle view that the disease is a blood dyscrasia due to rheumatism, tuberculosis, or otlher clhronic constitutional weakness.I have not heard of a person suffering from more tllan two attacks.Conclusion.
Dengue Virus Infection Induces Expansion of a CD14+CD16+ Monocyte Population that Stimulates Plasmablast Differentiation
Authors: Marcin Kwissa, Helder I. Nakaya, Nattawat Onlamoon, Jens Wrammert, Francois Villinger, Guey Chuen Perng, Sutee Yoksan, Kovit Pattanapanyasat, Kulkanya Chokephaibulkit, Rafi Ahmed, Bali Pulendran
Journal: Cell Host & Microbe (2014)
I. Medical Care and Education in Hospitals Without Interns or Residents
Authors: Robert J. Glaser
Journal: JAMA (1961)

THE SUBJECT of this discussion, medical care and education in a hospital without interns and residents, is at once complex as well as important. At the outset, I must acknowledge that my entire hospital experience, as a medical student, during my internship and residency years, and continuing on to the present, has been gained in university teaching hospitals where there has, of course, been a full complement of house officers. Therefore, I have not had the opportunity to see at first hand the day-to-day problems of medical care and education in hospitals without house staffs. All of us in medical education, however, recognize the significance of this problem, and, therefore, I am glad to have an opportunity to be included as a participant in these deliberations. There are, at the present time, in the United States approximately 6,800 hospitals, and, of this total number, about 1,400 have internship or residency
Ribavirin ante portas: Uptake transporters into hepatocytes dissected
Authors: Bertram Bengsch, Robert Thimme
Journal: Journal of Hepatology (2010)

See Article, pages 486–492 Ribavirin is a key antiviral component in the treatment of hepatitis C virus (HCV) infection. Although it is only minimally effective as a monotherapeutic agent [2,7], in combination with Interferon it increases the sustained virological response rate (SVR) upon antiviral treatment compared to Interferon alone from 13% to 40% [11]. Thus, the combination therapy with Ribavirin and Interferon is currently recommended for the treatment of chronic HCV infection. Of note, high doses of Ribavirin and the presence of Ribavirin-associated side effects (e.g., anemia) are positive predictors of SVR, underlining the pivotal role of Ribavirin in the success of the combination therapy [10,12]. New antiviral therapies specifically targeted to HCV will further improve treatment success rates but a combination with Ribavirin will most likely continue to be required to reduce viral relapse and
Therapeutic Potential of RNA Interference
Authors: Mario Stevenson
Journal: New England Journal of Medicine (2004)

RNA interference (RNAi) involves the use of easily generated RNA fragments to down-regulate gene expression in a highly specific manner. Since its discovery, about seven years ago, the method has quickly evolved and is now a routine application in many molecular laboratories. Recent success in treating animal models of disease indicates that RNAi also has the potential to treat human disease.
Does Location of the Second Internal Thoracic Artery Graft Influence Outcome of Coronary Artery Bypass Grafting?
Authors: Joseph F. Sabik, Aleck Stockins, Edward R. Nowicki, Eugene H. Blackstone, Penny L. Houghtaling, Bruce W. Lytle, Floyd D. Loop
Journal: Circulation (2008)

We sought to determine whether location of the second internal thoracic artery (ITA) graft used for bilateral ITA grafting affects mortality and morbidity of patients with 3-system coronary artery disease and to identify factors associated with second ITA location.From January 1972 to June 2006, 3611 patients with 3-system coronary artery disease underwent bilateral ITA grafting with one graft anastomosed to the left anterior descending system and the second to either the circumflex (n=2926) or right coronary artery (n=685) system. Follow-up was 9.2+/-7.2 years. Propensity score methodology was used to obtain risk-adjusted outcome comparisons between patients with the second ITA to circumflex versus right coronary artery. Hospital mortality (0.34% versus 0.58%; P=0.4), stroke (0.96% versus 0.88%; P=0.8), myocardial infarction (1.3% versus 0.73%; P=0.2), renal failure (0.44% versus 0.29%; P=0.6), respiratory insufficiency (3.5% versus 3.8%; P=0.7), and reoperation for bleeding (3.4% versus 3.2%; P=0.8) were similar in patients who received the second ITA to circumflex or right coronary artery and remained similar after propensity score adjustment. Late survival (86% versus 87% at 10 years) was also similar. Despite this, there was a gradual decline in ITA to right coronary artery grafting.Contrary to prevailing wisdom that the second ITA graft should be anastomosed to the next most important left-sided coronary artery in 3-system coronary artery disease, it may be placed to either the circumflex or right coronary artery system with similar early and late outcomes.
Is drug regulation failing?
Authors: Kamran Abbasi
Journal: BMJ (2004)

Something is rotten at the heart of the FDA. The United States Food and Drug Administration, mired in controversy over the last 12 months, now faces an extraordinary charge of attempting to discredit a whistleblower. As this week's issue reveals, David Graham, the FDA's associate director of drug safety, was so bothered about the difficulties of presenting his data on rofecoxib (Vioxx) in the Lancet that he took his case to the Government Accountability Group, a public interest group that protects whistleblowers. What was extraordinary, reports Jeanne Lenzer on p 1255, was that an …
Abstract 1255: Autophagy is an Adaptive Response in Desmin-Related Cardiomyopathy
Authors: Paul Tannous, Hongxin Zhu, Janet L Johnstone, John M Shelton, Raj Soorappan, Ivor J Benjamin, Dennis K Burns, Beth Levine, Beverly A Rothermel, Joseph A Hill
Journal: Circulation (2007)

Background: A missense (R120G) mutation in the gene coding for αB-crystallin (CryAB) triggers a severe, familial form of desmin-related cardiomyopathy (DRCM) characterized by accumulation of aggreg...