tbuckley/cabot-search huggingface dataset:
Responsibilities of Primary Physicians in Organ Donation
Authors: Susan W. Tolle, William M. Bennett, David H. Hickam, John A. Benson
Journal: Annals of Internal Medicine (1987)

As transplantation success rates have improved, the demand for donor organs has steadily increased. A shortage of donor organs has led to legislation requiring hospital personnel to provide families routinely with the opportunity to authorize organ donation. Primary physicians have an important role in identifying potential donors while continuing to assure that the survivors' needs are met. The major implications of organ donation for the primary physician are reviewed. Patients who die will more frequently be eligible as corneal, skin, or bone donors, but the criteria for both tissue and internal organ donation are reviewed. Ethical issues unique to organ donation and responses of survivors to donation requests are described. If appropriately offered, the opportunity to authorize an anatomic gift can be a source of comfort to survivors while the donation provides the benefits of transplantation to persons on organ waiting lists.
Concurrent Vismodegib and Radiotherapy for Recurrent, Advanced Basal Cell Carcinoma
Authors: Erqi L. Pollom, Timothy T. Bui, Anne Lynn S. Chang, A. Dimitrios Colevas, Wendy Y. Hara
Journal: JAMA Dermatology (2015)

<h3>Importance</h3> Vismodegib is a targeted agent recently approved for treating patients who develop recurrent or locally advanced basal cell carcinoma (BCC), and will inevitably be integrated into existing therapy for advanced BCC as it becomes increasingly used. Improved understanding of how vismodegib interacts with other treatment modalities, including radiotherapy, would help optimize multidisciplinary therapy and clinical outcomes. <h3>Observations</h3> We report 2 cases of recurrent, advanced BCC treated from April 1, 2012, through October 31, 2014, with concurrent radiotherapy and vismodegib. Concurrent treatment appeared to be well tolerated and efficacious, with both patients having no evidence of progressive disease at last follow-up. <h3>Conclusions and Relevance</h3> We found that the combination of vismodegib and radiotherapy is feasible for patients with recurrent or locally advanced BCC and that combined use of currently available therapies for advanced BCC warrants further prospective study.
The citizen's charter and the NHS.
Authors: D Plamping, T Delamothe
Journal: BMJ (1991)

neck muscles as deliberate muscular relaxation relieves it.Masters and Johnson observed that "the muscles of the neck contract involuntarily in a spastic pattern" during inter- course.5The second component, which may follow the first or arise without warning, occurs abruptly at the time of orgasm as a severe occipital or generalised ache, described as explosive or excruciating.The mechanism of this, one of several "thunderclap"
NUP98/NSD1 characterizes a novel poor prognostic group in acute myeloid leukemia with a distinct HOX gene expression pattern
Authors: Iris H. I. M. Hollink, Marry M. van den Heuvel-Eibrink, Susan T. C. J. M. Arentsen-Peters, Marta Pratcorona, Saman Abbas, Jenny E. Kuipers, Janneke F. van Galen, H. Berna Beverloo, Edwin Sonneveld, Gert-Jan J. L. Kaspers, Jan Trka, Andre Baruchel, Martin Zimmermann, Ursula Creutzig, Dirk Reinhardt, Rob Pieters, Peter J. M. Valk, C. Michel Zwaan
Journal: Blood (2011)
The homozygous FcγRIIIa-158V genotype is a risk factor for heparin-induced thrombocytopenia in patients with antibodies to heparin-platelet factor 4 complexes
Authors: Yves Gruel, Claire Pouplard, Dominique Lasne, Charlotte Magdelaine-Beuzelin, Chloé Charroing, Hervé Watier
Journal: Blood (2004)
NIH Called to Task: Women Needed in Clinical Trials
Authors: D. A. Tisevich
Journal: JNCI Journal of the National Cancer Institute (1990)

Journal Article NIH Called to Task: Women Needed in Clinical Trials Get access Dorothy A. Tisevich Dorothy A. Tisevich Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 82, Issue 14, 18 July 1990, Pages 1181–1183, https://doi.org/10.1093/jnci/82.14.1181 Published: 18 July 1990
Day case surgery has benefited patients with cataract in North Gwent
Authors: E. Evans
Journal: BMJ (1998)

The human gut microbiome is a complex ecosystem, densely colonised by thousands of microbial species. It varies among individuals and depends on host genotype and environmental factors, such as diet and antibiotics. In this review, we focus on stability and resilience as essential ecological characteristics of the gut microbiome and its relevance for human health. Microbial diversity, metabolic flexibility, functional redundancy, microbe–microbe and host–microbe interactions seem to be critical for maintaining resilience. The equilibrium of the gut ecosystem can be disrupted by perturbations, such as antibiotic therapy, causing significant decreases in functional richness and microbial diversity as well as impacting metabolic health. As a consequence, unbalanced states or even unhealthy stable states can develop, potentially leading to or supporting diseases. Accordingly, strategies have been developed to manipulate the gut microbiome in order to prevent or revert unhealthy states caused by perturbations, including faecal microbiota transplantation, supplementation with probiotics or non-digestible carbohydrates, and more extensive dietary modifications. Nevertheless, an increasing number of studies has evidenced interindividual variability in extent and direction of response to diet and perturbations, which has been attributed to the unique characteristics of each individual’s microbiome. From a clinical, translational perspective, the ability to improve resilience of the gut microbial ecosystem prior to perturbations, or to restore its equilibrium afterwards, would offer significant benefits. To be effective, this therapeutic approach will likely need a personalised or subgroup-based understanding of individual genetics, diet, gut microbiome and other environmental factors that might be involved.
Oocytes for Research: Reevaluating Risks and Compensation
Authors: Robin N. Fiore, Kathryn M. Hinsch
Journal: The American Journal of Bioethics (2011)

In “Risk of Ovarian Hyperstimulation Syndrome in Egg Donation,” Ellison and Meliker (2011) argue that the risk of ovarian hyperstimulation syndrome (OHSS)—a sometimes lethal reaction to ovulation-i...
Hematopoietic Stem Cell Transplantation for MS
Authors: Stephen L. Hauser
Journal: JAMA (2015)

Multiple sclerosis (MS) is a central nervous system disorder characterized by inflammation, loss of the insulating tissue (myelin) surrounding and protecting nerve axons, and multifocal scarring.1 Multiple sclerosis is a prototypic autoimmune disease likely mediated by pathogenic T and B lymphocytes. There has been substantial progress in the management of MS during the past decade, with 10 variably effective therapies now available and approved by the US Food and Drug Administration (FDA). These therapies suppress the early relapsing-remitting form of MS; however, the late neurodegenerative phase of the disease, progressive MS, remains largely untreatable.
Researchers Address Childhood Obesity Through Community-Based Programs
Authors: M. J. Friedrich
Journal: JAMA (2007)

AROUND THE GLOBE, CHILDHOOD obesity rates have soared in the last 30 years, creating a public health crisis. Overweight children are likely to have serious medical problems in adulthood—a grim prognosis. But reversing the trend of weight gain is not as simple as trading potato chips for carrots or shutting off the television and heading outdoors. Individual behavioral change is only one piece of the puzzle, said Christina Economos, PhD, assistant professor of nutrition science and policy at Tufts University’s Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy in Boston. “If you don’t have the healthy options and the policies being implemented around you, it’s hard to execute a healthy behavior,” she said. This can be particularly challenging in low-income neighborhoods, where healthy food choices are scarce and playing outside may not be safe. “Most of the prevention studies in the literature that focus on children target the school environment—an obvious place,” said Economos, speaking in October at a symposium organized by Tufts. However, she noted that data from recent observational studies involving cohorts of young children indicate “we need to go beyond schools.” One such study comparing children’s gains in body mass index (BMI) when school is in session (during the kindergarten and firstgrade school years) and during summer vacation found that summer gain rates exceeded gain rates during the school year (von Hippel PT et al. Am J Public Health. 2007;97[4]:696-702). To really change lifestyles, said Economos, you have to change the environment. With this in mind, many public health experts worldwide have been pursuing a community-based approach to obesity prevention that enlists not only schools, but also businesses, families, restaurants, grocery and convenience stores, and local government. This multilevel approach lets the stakeholders in a community devise a plan that provides opportunities for children to eat right and exercise and is tailored to their particular needs.
ECHOCARDIOGRAPHIC FINDINGS IN TAKOTSUBO CARDIOMYOPATHY: BEYOND APICAL BALLOONING
Authors: Nobuyuki Kagiyama, Hiroyuki Okura, Tomoko Tamada, Teruyoshi Kume, Akihiro Hayashida, Yoji Neishi, Takahiro Kawamoto, Kiyoshi Yoshida
Journal: Journal of the American College of Cardiology (2014)
SANITARY FEATURES OF SMALLPOX.
Authors: LOUIS LEROY
Journal: JAMA (1901)

Smallpox is a disease which possibly above all others should be dealt with by health authorities. The question as to whether it is best handled by local or state boards of health will depend, of course, largely upon the organization and efficiency of the former. In well-organized communities, such as is usually found in the larger cities, it is wisest to deal with the cases at the place of development rather than to attempt any transportation. In some of the more scattered cases, which will come under the jurisdiction of the county boards of health, oftentimes the intervention and usually more rigid management of the state authorities is unquestionably required. This occasionally will meet with some local opposition by individuals who may regard it as an act usurping the local rights, but experience had shown that a great many personal interests are constantly at stake and these often tend greatly
CEA, CA 15-3 and CYFRA 21-1 in serum and pleural fluid of patients with pleural effusions
Authors: S Romero, C Fernandez, JM Arriero, A Espasa, A Candela, C Martin, J Sanchez-Paya
Journal: European Respiratory Journal (1996)

The role of tumour marker assays in differentiating malignant from benign pleural effusions is not yet clear. This study was designed to prospectively assess the individual and combined diagnostic utility of three tumour markers in patients with pleural effusion. Pleural and serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 15-3 (CA 15-3) and cytokeratin 19 fragment (CYFRA 21-1) were determined in 115 patients with pleural effusions (42 malignant and 73 benign). The diagnostic utility of each tumour marker was assessed using accuracy to determine the optimal cut-off point, whilst a logistic regression model was used to obtain the optimal combined test. In serum, every marker showed an individual high specificity (over 97%) for malignancy. The sensitivity of CEA, CA 15-3 and CYFRA 21-1 was 36, 48 and 31%, respectively. In patients without renal failure, the sensitivity of CYFRA 21-1 rose to 53%, while those of CEA and CA 15-3 remained almost unchanged. In pleural fluid, CYFRA 21-1 showed low sensitivity (32%) and specificity (82%), while CEA showed the highest sensitivity (57%). Excluding patients with renal failure, the combined determination in serum of CEA, CA 15-3 and CYFRA 21-1 has a high accuracy (88%), similar to that for CEA plus CA 15-3 in pleural fluid (87%). We conclude that CYFRA 21-1 is useless in pleural fluid and should not be used in serum for patients with renal failure. The combined determination of CEA, CA 15-3 and CYFRA 21-1 in serum may obviate its determination in pleural fluid.
Effects of the very late adhesion molecule 4 antagonist WAY103 on human peripheral blood eosinophil vascular cell adhesion molecule 1–dependent functions
Authors: Julie B. Sedgwick, Kristyn J. Jansen, Jeffrey D. Kennedy, Hirohito Kita, William W. Busse
Journal: Journal of Allergy and Clinical Immunology (2005)

BackgroundEosinophil infiltration to the lung in allergic inflammation can be initiated by the tethering of circulating cells through very late adhesion molecule 4 (VLA-4; α4β1, CD49d/CD29) to vascular cell adhesion molecule 1 (VCAM-1) expressed on pulmonary vascular endothelium. Small-molecule VLA-4 antagonists have been proposed as a therapeutic mechanism to prevent eosinophil infiltration in asthma; however, they might affect other eosinophil functions.ObjectiveThe small-molecule VLA-4 antagonist (2S)-3-(4-Dimethylcarbamoyloxyphenyl)-2-{[(4R)-5,5-dimethyl-3-(1-methyl-1H-pyrazole-4 sulfonyl)thiazolidine-4-carbonyl]amino}propionic acid (WAY103) was assessed for its effects on eosinophil VLA-4–dependent functions, including adhesion, migration, respiratory burst, and degranulation.MethodsHuman peripheral blood eosinophils were preincubated with WAY103, anti-α4, and/or anti-β2 integrin mAbs and then assessed for adhesion to recombinant VCAM-1, intercellular adhesion molecule 1, and endothelial cell monolayers. Transmigration was measured by using human pulmonary microvascular endothelial cell monolayers and Transwell filters. Superoxide anion generation was determined by means of cytochrome C reduction and degranulation by means of eosinophil-derived neurotoxin release.ResultsWAY103 inhibition of eosinophil adhesion to recombinant VCAM-1 was dose dependent (63% inhibition with 100 nM WAY103, P < .04) and comparable with inhibition caused by anti-α4 mAb (60.1% inhibition). Although pretreatment with WAY103 also decreased eosinophil adhesion to TNF-α plus IL-4–activated human pulmonary microvascular endothelial cell monolayers, it did not prevent eosinophil transendothelial migration in response to RANTES. Finally, WAY103 inhibited VCAM-1–stimulated superoxide generation but enhanced cytokine-activated eosinophil-derived neurotoxin degranulation.ConclusionAlthough small-molecule VLA-4 antagonists, such as WAY103, might reduce eosinophil adhesion, this approach might not be sufficient to eliminate this cell from in vivo allergic airway inflammatory participation and could even promote specific cell activation.
Lettsomian Lectures on the Objects and Limits of Operations for Cancer: Delivered before the Medical Society of London, February 17th, 1896
Authors: W. W. Cheyne
Journal: BMJ (1896)

HERE, as in tlhe case of tile breast, there is no real alternative operative procedure to that of removal with the view of cure.C.sopliagotomy, gastrostomy, or tracheotomy, although tlley miiay prolong the patient's life for a very slhort time, do not add materially to his comfort, and can in no way be looked on as alternatives to a radical operation, and in those cases, therefore, as in the breast, I do not thlink that we can do very mucil in the waly of selection of cases for operation.As compared with canieer of the breast, the disease in the
ABCC2, ABCC3, and ABCB1, but not CYP3A, Protect against Trabectedin-Mediated Hepatotoxicity
Authors: Robert A.B. van Waterschoot, Rhandy M. Eman, Els Wagenaar, Cornelia M.M. van der Kruijssen, Hilde Rosing, Jos H. Beijnen, Alfred H. Schinkel
Journal: Clinical Cancer Research (2009)

PURPOSE: Trabectedin (Yondelis, ET-743) is a novel anticancer drug with potent activity against various tumors. However, dose-limiting hepatotoxicity was observed during clinical trials. Because recent reports have suggested that cytochrome P450 3A (CYP3A), as well as the drug transporters ABCB1, ABCC2, and ABCC3 might protect against trabectedin-mediated hepatotoxicity, we investigated the individual and combined roles of these detoxifying systems. EXPERIMENTAL DESIGN: Madin-Darby canine kidney cells expressing ABCC2 and ABCC3 were used to study in vitro trabectedin transport. We investigated the hepatotoxicity of trabectedin, and the plasma and liver levels of this drug and its metabolites in mice deficient for CYP3A, Abcb1a/1b, Abcc2, and/or Abcc3 after i.v. trabectedin administration. RESULTS: Trabectedin was transported by ABCC2 but only modestly by ABCC3. Contrary to our expectation, absence of CYP3A resulted in only a marginal increase in hepatotoxicity. Some hepatotoxicity was observed in Abcc2(-/-) mice, but very little in Abcb1a/1b(-/-) and Abcc3(-/-) mice. Strikingly, severe hepatotoxicity was found in Abcb1a/1b/Abcc2(-/-) and Abcc2/Abcc3(-/-) mice. However, hepatotoxicity was drastically decreased in Cyp3a/Abcb1a/1b/Abcc2(-/-) compared with Abcb1a/1b/Abcc2(-/-) mice. This suggests that the formation of CYP3A-specific metabolites is an important prerequisite for trabectedin-mediated hepatotoxicity. Further studies revealed that there is increased accumulation of metabolites of trabectedin, but not of trabectedin itself, in the livers of mice that lack Abcc2 but are CYP3A proficient. CONCLUSIONS: Our data show that ABCB1, ABCC2, and ABCC3 have a profound and partially redundant function in protection from trabectedin-mediated hepatotoxicity, presumably by clearing the liver from hepatotoxic trabectedin metabolites that are primarily formed by CYP3A. (Clin Cancer Res 2009;15(24):7616-23).
A FATAL CASE OF ACUTE INFECTIOUS JAUNDICE (WEIL'S DISEASE).
Authors: ROBERT M. THORNBURGH
Journal: JAMA (1907)

A review of the literature reveals a very meager knowledge of this obscure disease, but few cases going to autopsy being reported (only ten reported cases could be found), and it is, therefore, deemed worth while to report this case: <h3>Patient.</h3> —R. S., white, aged 46, a civilian employé of the subsistence department of the U. S. Army, was admitted Feb. 20, 1906, to the medical side of the Division Hospital, U. S. Army, Manila, P. I. <h3>History.</h3> —Born in Maryland in 1860. Had resided in the Philippines for four years. Occupation, butcher in Depôt Commissary, U. S. Army, at Manila, P. I. Had the usual diseases of childhood. Was operated on for hernia six months previously. Family history negative. Shortly before admission he had noticed swelling of the feet and legs, and had suffered somewhat from anorexia. <h3>Condition on Admission.</h3> —Slight edema of feet and legs, and patient complained
Zinc Lowers High-Density Lipoprotein-Cholesterol Levels
Authors: Philip L. Hooper
Journal: JAMA (1980)

Zinc administration in rats is associated with a rise in serum cholesterol level. This study examined the effect of zinc administration on serum lipoprotein values in man. Twelve healthy adult men ingested 440 mg of zinc sulfate per day for five weeks. High-density lipoprotein-cholesterol concentration decreased 25% below baseline values (40.5 to 30.1 mg/dL). Total cholesterol, triglyceride, and low-density lipoprotein-cholesterol levels did not change throughout the study. The sharp fall of the "antiatherogenic" lipoprotein, high-density lipoprotein, associated with zinc administration supports the concept that zinc ingestion may be atherogenic in man.
The Tunnel Back: Synanon
Authors: Harris Isbell
Journal: JAMA (1965)

<i>The Tunnel Back</i>is a warm and moving account of the struggles of opiate addicts to treat each other for their addiction. In the Synanon Houses addicts live together, withdraw themselves from drugs, work, and give each other "therapy" in the form of "synanons," or seminars. In these sessions, the participants may assault each other vigorously but only verbally. The synanons are designed to debunk the false ideas the addict has had about his own behavior, the joys of using drugs, etc. The Synanon organization has already received wide publicity, both good and bad. Mr. Yablonsky's book is the best available description of the Synanon technique and will be read with interest by all persons interested in drug dependence and delinquent behavior. It will probably have even greater appeal to lay audiences. The author, a professional sociologist, lived in Synanon House at Santa Monica for a period of time and
The Relation of a Medical School to Its Surrounding Community
Authors: William H. Stewart
Journal: JAMA (1967)

No word in the American vocabulary is more elastic than "community." We can stretch it to embrace the world, or tighten it to enclose a family or two. We use it literally to define a certain portion of geography, or figuratively to set apart a group of presumably kindred souls—the "scientific community," for example. Therefore when we talk about the relationship between medical school and community we have to watch our language. Which community are we talking about in connection with which medical school functions? Also, which community are we talking about in connection with which medical schools? For it seems likely that there should be some difference in community relationships between one of the five medical schools serving the super-community of New York, on the one hand, and a medical school serving a state like Vermont or Nevada on the other. Given this wide disparity of communities, is it
Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials
Authors: H A Bischoff-Ferrari, B Dawson-Hughes, H B Staehelin, J E Orav, A E Stuck, R Theiler, J B Wong, A Egli, D P Kiel, J Henschkowski
Journal: BMJ (2009)

<b>Objective</b> To test the efficacy of supplemental vitamin D and active forms of vitamin D with or without calcium in preventing falls among older individuals. <b>Data sources</b> We searched Medline, the Cochrane central register of controlled trials, BIOSIS, and Embase up to August 2008 for relevant articles. Further studies were identified by consulting clinical experts, bibliographies, and abstracts. We contacted authors for additional data when necessary. <b>Review methods</b> Only double blind randomised controlled trials of older individuals (mean age 65 years or older) receiving a defined oral dose of supplemental vitamin D (vitamin D<sub>3</sub> (cholecalciferol) or vitamin D<sub>2</sub> (ergocalciferol)) or an active form of vitamin D (1α-hydroxyvitamin D<sub>3</sub> (1α-hydroxycalciferol) or 1,25-dihydroxyvitamin D<sub>3</sub> (1,25-dihydroxycholecalciferol)) and with sufficiently specified fall assessment were considered for inclusion. <b>Results</b> Eight randomised controlled trials (n=2426) of supplemental vitamin D met our inclusion criteria. Heterogeneity among trials was observed for dose of vitamin D (700-1000 IU/day <i>v</i> 200-600 IU/day; P=0.02) and achieved 25-hydroxyvitamin D<sub>3</sub> concentration (25(OH)D concentration: &lt;60 nmol/l <i>v</i> ≥60 nmol/l; P=0.005). High dose supplemental vitamin D reduced fall risk by 19% (pooled relative risk (RR) 0.81, 95% CI 0.71 to 0.92; n=1921 from seven trials), whereas achieved serum 25(OH)D concentrations of 60 nmol/l or more resulted in a 23% fall reduction (pooled RR 0.77, 95% CI 0.65 to 0.90). Falls were not notably reduced by low dose supplemental vitamin D (pooled RR 1.10, 95% CI 0.89 to 1.35; n=505 from two trials) or by achieved serum 25-hydroxyvitamin D concentrations of less than 60 nmol/l (pooled RR 1.35, 95% CI 0.98 to 1.84). Two randomised controlled trials (n=624) of active forms of vitamin D met our inclusion criteria. Active forms of vitamin D reduced fall risk by 22% (pooled RR 0.78, 95% CI 0.64 to 0.94). <b>Conclusions</b> Supplemental vitamin D in a dose of 700-1000 IU a day reduced the risk of falling among older individuals by 19% and to a similar degree as active forms of vitamin D. Doses of supplemental vitamin D of less than 700 IU or serum 25-hydroxyvitamin D concentrations of less than 60 nmol/l may not reduce the risk of falling among older individuals.