tbuckley/cabot-search huggingface dataset:
The Endoscopic Intratumor Administration of OK-432 in Gastric Cancer Unsuitable for Surgery
Authors: S. Nakazawa, J. Yoshino, Y. Kijima, N. Yasumasa, S. Ohhashi, K. Mizutani
Journal: Endoscopy (1989)

In eleven patients with gastric cancer who could not be operated on because of advanced age, refusal of surgery, or the presence of complications, the streptococcal preparation OK-432 was administered, both intradermally and by direct injection into the tumor under endoscopic guidance. Via gastric x-ray and endoscopic examinations, the tumor was observed to disappear in two cases-one advanced cancer and one early gastric cancer endoscopically. Particularly in the latter case repeated biopsies revealed no evidence of cancer cells. All patients developed fever after intratumor injection, but in no case was it necessary to discontinue administration, and no other serious side effects were noted. The endoscopic injection of OK-432 appears to be a safe and useful form of therapy for gastric cancer unsuitable for surgery.
Primary Care Behavioral Interventions to Prevent or Reduce Illicit Drug Use and Nonmedical Pharmaceutical Use in Children and Adolescents: A Systematic Evidence Review for the U.S. Preventive Services Task Force
Authors: Carrie D. Patnode, Elizabeth O’Connor, Maya Rowland, Brittany U. Burda, Leslie A. Perdue, Evelyn P. Whitlock
Journal: Annals of Internal Medicine (2014)

Drug use among youths is associated with negative health and social consequences. Even infrequent use increases the risk for serious adverse events by increasing risk-taking behaviors in intoxicated or impaired persons.To systematically review the benefits and harms of primary care-relevant interventions designed to prevent or reduce illicit drug use or the nonmedical use of prescription drugs among youths.PubMed, PsycINFO, and the Cochrane Central Register of Controlled Trials through 4 June 2013; MEDLINE through 31 August 2013; and manual searches of reference lists and gray literature.Two investigators independently reviewed 2253 abstracts and 144 full-text articles. English-language trials of primary care-relevant behavioral interventions that reported drug use, health outcomes, or harms were included.One investigator abstracted data from good- and fair-quality trials into prespecified evidence tables, and a second investigator checked these data.Six trials were included, 4 of which examined the effect of the intervention on a health or social outcome. One trial found no effect of the intervention on marijuana-related consequences or driving under the influence of marijuana; 3 trials generally found no reduction in depressed mood at 12 or 24 months. Four of the 5 trials assessing self-reported marijuana use found statistically significant differences favoring the intervention group participants (such as a between-group difference of 0.10 to 0.17 use occasions in the past month). Three trials also reported positive outcomes in nonmedical prescription drug use occasions.The body of evidence was small, and there were heterogeneous measures of outcomes of limited clinical applicability. Trials primarily included adolescents with little or no substance use.Evidence is inadequate on the benefits of primary care-relevant behavioral interventions in reducing self-reported illicit and pharmaceutical drug use among adolescents.Agency for Healthcare Research and Quality.
Atorvastatin Inhibits Hypercholesterolemia-Induced Cellular Proliferation and Bone Matrix Production in the Rabbit Aortic Valve
Authors: Nalini M. Rajamannan, Malayannan Subramaniam, Margaret Springett, Thomas C. Sebo, Marek Niekrasz, Joseph P. McConnell, Ravinder J. Singh, Neil J. Stone, Robert O. Bonow, Thomas C. Spelsberg
Journal: Circulation (2002)

Despite the common occurrence of aortic stenosis, the cellular causes of the disorder are unknown, in part because of the absence of experimental models. We hypothesized that atherosclerosis and early bone matrix expression in the aortic valve occurs secondary to experimental hypercholesterolemia and that treatment with atorvastatin modifies this transformation.To test this hypothesis, we developed an experimental hypercholesterolemic rabbit model. New Zealand White rabbits (n=48) were studied: group 1 (n=16), normal diet; group 2 (n=16), 1% (wt/wt) cholesterol diet; and group 3 (n=16), 1% (wt/wt) cholesterol diet plus atorvastatin (3 mg/kg per day). The aortic valves were examined with hematoxylin and eosin stain, Masson trichrome, macrophage (RAM 11), proliferation cell nuclear antigen (PCNA), and osteopontin immunostains. Cholesterol and highly sensitive C-reactive protein (hsCRP) serum levels were obtained by standard assays. Computerized morphometry and digital image analysis were performed for quantifying PCNA (% area). Electron microscopy and immunogold labeling were performed for osteopontin. Semiquantitative RT-PCR was performed for the osteoblast bone markers [alkaline phosphatase, osteopontin, and osteoblast lineage-specific transcription factor (Cbfa-1)]. There was an increase in cholesterol, hsCRP, PCNA, RAM 11, and osteopontin and osteoblast gene markers (alkaline phosphatase, osteopontin, and Cbfa-1) in the cholesterol-fed rabbits compared with control rabbits. All markers except hsCRP were reduced by atorvastatin.These findings of increased macrophages, PCNA levels, and bone matrix proteins in the aortic valve during experimental hypercholesterolemia provide evidence of a proliferative atherosclerosis-like process in the aortic valve associated with the transformation to an osteoblast-like phenotype that is inhibited by atorvastatin.
Progressive Disseminated Histoplasmosis: Favorable Response to Ketoconazole
Authors: STEPHEN S. HAWKINS
Journal: Annals of Internal Medicine (1981)

Four patients with disseminated histoplasmosis, two of whom had late relapses after previous therapy with amphotericin B, were treated with ketoconazole, 200 to 400 mg daily for 1 year. All patients improved markedly during therapy, with resolution of symptoms, decreasing liver and spleen size, and weight gain; resolution of oral ulcers occurred in the two patients in whom they were present. Decrease in serum alkaline phosphatase levels correlated well with clinical improvement. One patient who was much improved while receiving ketoconazole continued to harbor Histoplasma capsulatum in an abdominal aortic aneurysm, which became symptomatic 4 months after cessation of the drug. He underwent aneurysmectomy, and H. capsulatum isolated from the resected aneurysm was susceptible in vitro to ketoconazole. No significant adverse reactions to the drug were noted despite prolonged therapy. Our results indicate that ketoconazole may have a role in the therapy of disseminated histoplasmosis in adults.
The Physician as a Double Agent
Authors: John F. Burnum
Journal: New England Journal of Medicine (1977)

Ideal medical care depends to an important degree on the physician's being an advocate of the patient.1,2 In fact, however, we physicians have long been double agents, serving other interests as well; and now, as medical-care rationing begins, we face the unpleasant prospect of representing the conflicting interests of the patient and society. How should we respond?In conventional practice, to cite a few examples, the physician may be forced to wear two hats and be thrown into mild ethical conflict when requested by an insurance company to judge the ability of one of his elderly patients to drive an . . .
A Study of 65 Cases of Compound Presentation
Authors: D. P. C. Chan
Journal: BMJ (1961)

and anal mucosae.She was edentulous at the first visit, and we were unable to find out if she had any dental abnormality, such as has been described by various authors (Gerth and Flegel, 1956).The salivary-gland enlargement, which has previously been described, was unlikely to be mumps, even though she had been a contact, as the clinical course was dissimilar.Since 1943 endocranial calcification has been noted in some of these patients, and fits, thought to be associated with it, occurred in two cases.
The Report of the Council on Medical Education.
Authors: John M. Dodson
Journal: JAMA (1906)

<h3>To the Editor:</h3> —The recent report of the Council on Medical Education inThe JournalA. M. A., June 16, 1906, page 1853, invites comment and suggestion. I am prompted to indulge in such comment because it seems to me that in this present time, full of great possibilities for advancement in medical education and practice, nothing will promote sure and rapid progress, and the avoidance of missteps, more certainly than a full and free discussion by all who are in any way related to, or interested in, the subject. The decision of the Council to make its chief function that of co-ordinating the various forces at work among them, the medical schools and their associations, the literary colleges and medical examining boards, can not be too highly commended. It would have been a great mistake at this time to have attempted to force any arbitrary standards by drastic measures,
Use of Animals in Medical Education-Reply
Authors: Jerod M. Loeb
Journal: JAMA (1991)

<h3>In Reply.</h3> —While testimony against the use of animals in medical education contained in these letters may lead readers to believe that such attitudes are commonplace, the facts speak otherwise. First, the president of the Physicians Committee for Responsible Medicine has orchestrated a letter-writing campaign to<i>JAMA</i>designed to promote the idea that physicians believe "the use of animals in medical education is unnecessary." On the contrary, in a recent national survey of over 1500 physicians on attitudes toward the use of animals in medical research and education, more than 91% maintained that the use of animals was important for their own training, and more than 93% advocated the continued use of animals for medical education.<sup>1</sup> It is correct that about 25% of medical schools no longer use animal laboratories as part of the basic science curriculum; however, many of these schools report that the basis for this decision
Mechanisms of Aβ induced synaptic toxicity
Authors: Edward H Koo
Journal: Molecular Neurodegeneration (2013)

Increasing evidence favors the synapse as one of the initial sites of neuronal damage by amyloid β-protein (Aβ) and such synaptic damage is thought to underlie the cognitive deficits seen in Alzheimer's disease.A decade ago, Roberto Malinow and colleagues published a seminal paper proposing that neuronal activity augments processing of the amyloid precursor protein (APP) by βand γ-secretases to enhance Aβ production and release.In turn, Aβ then depresses synaptic activity.Thus, an interesting positive feed forward and negative feedback loop is created during periods of neuronal activation.Since publication of this report, a number of elements within this intriguing pathway have been confirmed by other laboratories in both the in vitro and in vivo settings.Specifically, there is compelling evidence that neuronal activity is associated with enhanced Aβ generation and subsequent amyloid deposition.Similarly, Aβ has been shown by multiple investigators to depress synaptic activity and synaptic plasticity.In this presentation, I will summarize some recent work examining the mechanisms that underlie both pathways.In particular, among the many proposed pathways of Aβ toxicity, I will discuss the potential involvement of APP in Aβ-initiated synaptic damage.
Practical Cardiac Hemodynamics
Authors: Richard Gorlin
Journal: New England Journal of Medicine (1977)

Until recently, the need to understand the details of cardiac hemodynamics was confined to the small group of cardiologists who performed, or were required to interpret the results of, cardiac catheterization. This situation has all changed, however, because of the clear-cut demonstration that hemodynamic measurements have become essential in the standard management of certain cardiac conditions, particularly if blood volume, pressure or flow is to be manipulated. This development has come about through the simplification of the procedure of catheterization of the right side of the heart (flotation catheter)1 and the ability to measure cardiac output readily.Although intrinsic cardiac . . .
The Berlin Wall
Authors: Howard Trachtman
Journal: The American Journal of Bioethics (2003)

A disclaimer at the outset: according to current NIHguidelines, I am classi” ed as a white, non-Hispanic male.Presumably my speech, clothing, attire, and lifestyle couldbe categorized accordingly. What about my bioethics? Ac-cording to Catherine Myser (2003), the answer is an em-phatic “ Yes.” If she is right and this is a problem thatneeds to be redressed, will decreasing the “ whiteness ofbioethics in the United States” improve how bioethics ispracticed in this country? Will this enhance the clinicaloutcome when bioethics is applied to actual scenarios thatoccur in hospitals and doctors’ of” ces?To live the good and moral life has always beendif” cult and fraught with con‘ ict. The purpose of ethics isto help people recognize the moral dimension of problemsthat arise in their life, to delineate the individual compo-nents and competing interests in these complex situations,to de” ne priorities, and to provide guidance on how to actin these circumstances. Underlying the whole concept ofethical conduct is the idea that people are autonomous in-dividuals who have free choice and, thus, are responsiblefor the consequences of their actions. There can be no eth-ics when people are ignorant of the facts, constrained intheir options, and not held accountable for what they de-cide to do. By most accounts, these features describe a freeperson; by implication, without freedom there is no ethics.This formulation is no less true for bioethics.There has been much discussion in the past two mil-lennia about freedom and what political and social condi-tions are needed to foster its development and survival.According to Berlin (1969), the most durable form of free-dom is not active liberty; that is, the right to do whateveran individual wishes. Instead, the form of freedom that hasproven the most resilient in modern open societies like theUnited States is negative liberty. This concept signi” es theassurance that each person is entitled to the opportunity tomake major life decisions such as where to live, what towear, how to earn a livelihood, and what to think or be-lieve without interference from outside forces. Under thesecircumstances we consider to be genuine the choices that aperson makes, and we feel entitled to hold him or her re-sponsible for the consequences of these life selections.In
1172 PREVALENCE OF HCV INFECTION, LIVER DYSFUNCTION AND OUTCOME AT 2 YEARS IN A COHORT OF NON-HODGKIN'S LYMPHOMA (NHL) PATIENTS TREATED WITH CHEMOTHERAPY
Authors: L. Nosotti, A. Morrone, M. D'Andrea, M.L. Dessanti, F. Pisani, M.C. Petti
Journal: Journal of Hepatology (2011)
Comparison of Three Regimens for Treatment of Mild to Moderate Pneumocystis carinii Pneumonia in Patients with AIDS: A Double-Blind, Randomized Trial of Oral Trimethoprim-Sulfamethoxazole, Dapsone-Trimethoprim, and Clindamycin-Primaquine
Authors: Sharon Safrin
Journal: Annals of Internal Medicine (1996)

Objective: To compare the tolerability and efficacy of three oral regimens for the treatment of patients with the acquired immunodeficiency syndrome (AIDS) and Pneumocystis carinii pneumonia. Design: A randomized, double-blind study. Setting: 24 U.S. academic medical centers. Patients: 181 patients with morphologically confirmed P. carinii pneumonia and alveolar-arterial oxygen differences (PAO2-PaO2) of 45 mm Hg or less. Intervention: Patients were randomly assigned to receive trimethoprim-sulfamethoxazole, dapsone-trimethoprim, or clindamycin-primaquine for 21 days. Patients with a PAO (2-PaO)2 of 35 to 45 mm Hg at study entry also received prednisone. Measurements: Serial clinical and laboratory evaluations for therapeutic response and toxicity. Therapeutic failure at day 21 was defined by any of the following: increase in PAO2-PaO2 of greater than 20 mm Hg; no remission of baseline signs and symptoms; and change in antipneumocystis therapy for reasons other than toxicity, intubation, or death. Dose-limiting toxicity was defined as discontinuation of therapy by the primary physician because of one or more adverse reactions. Results: No statistically significant differences were seen among treatment groups in the proportions of patients who had dose-limiting toxicity (P = 0.2), therapeutic failure (P > 0.2), or a complete course of therapy (P > 0.2). Survival during therapy or for 2 months thereafter did not differ among the three groups (P > 0.2). However, elevation of serum aminotransferase levels to more than five times the baseline levels was more frequent in the trimethoprim-sulfamethoxazole group (P = 0.003), and one or more serious hematologic toxicities (neutropenia, anemia, thrombocytopenia, or methemoglobinemia) occurred more frequently in the clindamycin-primaquine group (P = 0.01). Conclusions: The rates of dose-limiting toxicity, therapeutic failure, and survival did not differ among patients with AIDS who were receiving oral trimethoprim-sulfamethoxazole, dapsone-trimethoprim, or clindamycin-primaquine for mild to moderate P. carinii pneumonia. However, the limited sample size prevents the unequivocal demonstration of the equality of these three regimens. Differences in expected categories of toxicities associated with each regimen should guide the clinician in choosing first-line therapy, particularly for patients with baseline hepatic insufficiency or myelosuppression.
Characterization of pDJA1, a cardiac-specific chaperone found by genomic profiling of the post-ischemic swine heart
Authors: C DEPRE, L WANG, J TOMLINSON, V GAUSSIN, M ABDELLATIF, J TOPPER, S VATNER
Journal: Cardiovascular Research (2003)

Background: Previously, we showed by subtractive hybridization in a swine model of ischemia/reperfusion that an upregulation of genes participating in mechanisms of cell survival is a potential genomic mechanism to tilt the balance from necrosis to functional reversibility. Methods and results: We present here the full-length sequencing and characterization of a novel gene that was found in this subtraction, encoding a cardiac-specific DnaJ-like co-chaperone that we call Pig DnaJ-like protein A1 (pDJA1). The expression of pDJA1 was found to be restricted to the heart, as opposed to skeletal muscle, liver, lung, kidney, aorta, stomach and spleen. Expression of pDJA1 is restricted to cardiac myocytes, as determined by in situ hybridization. The transcript is expressed more in the left ventricle than in the other cardiac chambers. Remarkably, expression of pDJA1 follows a transmural gradient in the left ventricle, with the highest level of expression in the subendocardium. Expression of pDJA1 slightly increased during an episode of ischemia, but increased by 4-fold during the following period of reperfusion. Adenovirus-mediated transduction of pDJA1 in isolated rat neonatal cardiac myocytes decreased by 65% the rate of apoptosis induced by staurosporine. Conclusion: Therefore, pDJA1 is a novel heart-specific, ventricle-enriched cardioprotective co-chaperone, which participates in the program of cell survival that limits irreversible damage in post-ischemic myocardium.
Medical Mystery: Constipation — The Answer
Authors: Ioannis Karakis
Journal: New England Journal of Medicine (2009)

Schillaci et al. suggest that hypotension-related adverse events and renal complications resulting from the use of multiple renin-angiotensin system inhibitors may have counterbalanced the beneficial effects of the study drug in the I-PRESERVE trial.Our data do not support this hypothesis.There were no significant differences between the treatment groups in any major trial outcome according to the presence or absence of a history of hypertension, baseline blood pressures above or below the median (137 mm Hg systolic and 79 mg Hg diastolic), or baseline blood pressure with values grouped in thirds.Nor were there any significant differences between the treatment groups in the number of serious adverse events related to hypotension, renal dysfunction, or hyperkalemia.
Steroid-induced atrophy in an animal and human model
Authors: JOHN D. KIRBY, D.D. MUNRO
Journal: British Journal of Dermatology (1976)

A ratchet-controlled micrometer screw gauge has been used to measure the changes in skin thickness produced by topical corticosteroids. Measurable thinning of the mouse ear followed repeated daily application of corticosteroids. This response in the animal was used to assess the atrophic potential in a variety of standard formulations. The same compounds were applied to human skin and the changes in thickness measured. Patterns of response and the rank order of thinning obtained from the animal model were found to parallel closely the human results.
AN ACCOUNT, WITH COMMENTARY, OF A CASE OF SPLENECTOMY: IN ADDENBROOKE'S HOSPITAL, CAMBRIDGE
Authors: C. Allbutt, L. Humphry, F. Deighton, D. C. Hare
Journal: BMJ (1916)

SPLENIC ANAEMIA, thlat is, a progressive "secondary" anaemia witlh enlargemient of the spleen, is probably more common tlhan was supposed before tlle comparatively recent investigations of Sir W. Osler and othlers drew the attention of the clinician more definitely to its characters.During the autumn of 1915 three cases of this malady camie under tlle care of one of us (C.A.) in tlhe.Addenbrooke's Hospital (Malaria has been unknown in Cambridgeshire for more than forty years.).One of these cases was seen once or twice only and lost sight of; the second was in a little boy (aged 6 or 7) who presented all the now well-known features of the disease.After long considera- tion it was decided to remove the spleen, an operation to which the mother gave her consent; unilckily however tlle boy got to hear of our intention and lhowled until the motlher's resolution, not unnaturally, gave way, and he was removed.The case was a severe one; haemorrhages, intestinal and otlher, were frequent, and probably the boy is no longer living.In this case Dr. Dorotlhy Hare and Dr. Humphry took mutch pains to perfect the method of testing for corpuscular fragility, and Dr. Hare, oni repeated examinations, found the fragility normal.There was no other point in it of sufficient importance to detain us.The tlhird case was as follows:Mrs. K., aged 45, was admitted under the care of Pro- fessor Allbutt on October 25thl, 1915.She was extremely prostrate, blanched, and short of breatlh.The colour of the face-save some venous injection on the malar bones-and of the wMhole body was that of an old tallow candle.No discol6ration could be found on tlle skin; indeed the axillary and other folds of the body were, like the skin elsewlhere, unusually pallid.No notable emacia- tion.The mucous membranes were almost as pale as the