tbuckley/cabot-search huggingface dataset:
"Primary Care" and Graduate Medical Education
Authors: Leonard D. Fenninger
Journal: JAMA (1976)

The term "primary care" has come into wide usage. It is an abbreviation and symbol of complex attitudes on the part of physicians, patients, the public, and politicians, of a multitude of functions in the medical care of individuals and families, and of a variety of settings in which medical care is given. Current popularity and interest in the concept of "primary care" on the part of medical students, the medical profession, legislators, and other members of the public is a reflection of a highly specialized and mobile society whose members increasingly feel the need for more permanent relationships, greater continuity in their lives, and the desire to have their medical needs met primarily by physicians who will give them continuing care, if they seek it, and will assume responsibility for their medical requirements beyond those that the individual and family can sustain without professional help. The responses of practitioners,
Liver transplantation and alcoholics: is the glass half full or half empty?
Authors: M R LUCEY, R M WEINRIEB
Journal: Gut (1999)

See article on page 421 

Over the past 15 years, opinion regarding the suitability of alcoholic patients for liver transplantation has fluctuated from overt disapproval to optimism that liver transplantation might have a beneficial effect on alcoholic behaviour. The former view was evaluated by an opinion survey among the general population, general practitioners and hospital specialists in Great Britain, in which the vignette of an alcoholic in need of liver transplant was consistently rated as justifying a low priority.1 The origin of optimism about the salutary effects of transplantation on alcoholic relapse came from Thomas Starzl, who coined the aphorism that, “liver transplantation was the ultimate sobering experience”.2The current status of liver transplantation for alcoholic liver disease rests somewhere between these two extremes.

Alcoholic liver disease is a common diagnosis among patients selected for liver transplantation in North America and Europe. It often occurs in conjunction with chronic hepatitis C infection. All transplant programmes try to identify patients who will remain abstinent, although how best to achieve this end is less certain. The study by Pageaux et al , in this issue (see page 421), is unusual in not including psychiatry as part of the pretransplant assessment.4 The requirement for a fixed period of abstinence, the so called six …
663 Does celts reached rome on the east side of appennini mountains? An open population screening study for hfe gene major mutations in Central Italy
Authors: E. Rosa Rizzotto, A. Floreani, D. Basso, E. Navaglia, M. Zaninotto, J. Petridis, O. D'Andrea, R. Testa, M. Marra, M. Chiaramonte
Journal: Journal of Hepatology (2006)
Echocardiographic abnormalities in Brazilian sickle cell patients
Authors: Perla Vicari, Rita de Cassia Rosario Cavalheiro, Aparecida de Gouveia, Orlando Campos Filho, Maria Stella Figueiredo
Journal: American Journal of Hematology (2005)

of thalassemics due to the development of better chelating drugs will surely make HCC a major problem for thalassemics in future.Nowadays the outcome of HCC can be improved by various treatments, and when HCC develops in absence of cirrhosis, liver surgery can be curative [1,2].However, early detection of HCC is mandatory.Our experience suggests that US screening should be performed strictly in thalassemia syndromes, particularly when there is either HCV or HBV infection or sustained iron overload.
Lymphoma Chemovirotherapy: CD20-Targeted and Convertase-Armed Measles Virus Can Synergize with Fludarabine
Authors: Guy Ungerechts, Christoph Springfeld, Marie E. Frenzke, Johanna Lampe, Patrick B. Johnston, William B. Parker, Eric J. Sorscher, Roberto Cattaneo
Journal: Cancer Research (2007)

Abstract Combination chemotherapy regimen incorporating CD20 antibodies are commonly used in the treatment of CD20-positive non–Hodgkin's lymphoma (NHL). Fludarabine phosphate (F-araAMP), cyclophosphamide, and CD20 antibodies (Rituximab) constitute the FCR regimen for treating selected NHL, including aggressive mantle cell lymphoma (MCL). As an alternative to the CD20 antibody, we generated a CD20-targeted measles virus (MV)–based vector. This vector was also armed with the prodrug convertase purine nucleoside phosphorylase (PNP) that locally converts the active metabolite of F-araAMP to a highly diffusible substance capable of efficiently killing bystander cells. We showed in infected cells that early prodrug administration controls vector spread, whereas late administration enhances cell killing. Control of spread by early prodrug administration was also shown in an animal model: F-araAMP protected genetically modified mice susceptible to MV infection from a potentially lethal intracerebral challenge. Enhanced oncolytic potency after extensive infection was shown in a Burkitt's lymphoma xenograft model (Raji cells): After systemic vector inoculation, prodrug administration enhanced the therapeutic effect synergistically. In a MCL xenograft model (Granta 519 cells), intratumoral (i.t.) vector administration alone had high oncolytic efficacy: All mice experienced complete but temporary tumor regression, and survival was two to four times longer than that of untreated mice. Cells from MCL patients were shown to be sensitive to infection. Thus, synergy of F-araAMP with a PNP-armed and CD20-targeted MV was shown in one lymphoma therapy model after systemic vector inoculation. [Cancer Res 2007;67(22):10939–47]
Chronic urticaria and coagulation: pathophysiological and clinical aspects
Authors: A. Tedeschi, P. Kolkhir, R. Asero, D. Pogorelov, O. Olisova, N. Kochergin, M. Cugno
Journal: Allergy (2014)

Chronic urticaria (CU) is a widespread skin disease, characterized by the recurrence of transient wheals and itch for more than 6 weeks. Besides autoimmune mechanisms, coagulation factors, in particular tissue factor and thrombin, might also participate in the disease pathophysiology. Tissue factor expressed by eosinophils can induce activation of blood coagulation generating thrombin which in turn can increase vascular permeability both directly, acting on endothelial cells, and indirectly, inducing degranulation of mast cells with release of histamine, as demonstrated in experimental models. D-dimer, a fibrin degradation product, generated following activation of the coagulation cascade and fibrinolysis, has been found to be increased during urticaria exacerbations; moreover, it has been proposed as a biomarker of severity and resistance to H1-antihistamines in CU patients. The possible role of coagulation in CU is also supported by case reports, case series and a small controlled study showing the efficacy of anticoagulant therapy in this disease. The purpose of this review was to summarize the available data on the possible contribution of coagulation to the pathophysiology of CU focusing on clinical aspects and possible future therapeutic developments.
USE OF ERGOT TO CONTRACT CAPILLARIES IN PURPURA
Authors: Jack C. Norris
Journal: JAMA (1933)

To the Editor:  —Recently we have had a patient at Grady Hospital suffering from thrombocytopenic purpura haemorrhagica, probably resulting from intravenous arsenic. He was bleeding continuously from the mucous membranes. There were many large purpuric spots over the body surfaces. The blood examination revealed 2,000,000 red blood cells, 5,000 white blood cells, 65,000 platelets, and clot retraction sixty minutes plus.  Repeated transfusions gave temporary support, yet it seemed that he would bleed to death in spite of all medication.  Finally we administered to him ergot in 1 drachm doses every four hours, and solution of pituitary, 0.5 cc., hypodermically. Following the first two doses of ergot and one hypodermic of pituitary the bleeding diminished. After twenty-four hours slight bleeding again occurred. The medication was repeated, another transfusion was given, and after this his recovery was rapid and progressive. He is now well.  The ergot and solution of pituitary were suggested
The Role of Myocardial Viability Assessed by Perfusion/F-18 FDG Imaging in Children With Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery
Authors: Min-Fu Yang, Bo-Qia Xie, Xiao-Dong Lv, Zhong-Dong Hua, Fu-Jian Duan, Chao-Wu Yan, Guang Xu, Li-Ping Song, Yue-Qin Tian, Shou-Jun Li
Journal: Clinical Nuclear Medicine (2011)

Purpose: Although surgical treatments evolved, the short-term postoperative mortality is still high in children with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), and long-term survivors may suffer from restrained functional recovery. Therefore, an optimal means in predicting postoperative reversal is demanded. In this study, we assess the utility of myocardial perfusion/F-18 fluorodeoxyglucose (FDG) imaging in the evaluation of myocardial viability and postsurgery functional recovery in children with ALCAPA. Materials and Methods: A retrospective study was performed in 7 children with diagnosed ALCAPA who underwent myocardial perfusion/F-18 FDG imaging preoperatively. Global viability index was used to evaluate myocardial viability and was compared with the preoperative deviations of left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) from age-matched healthy children and with the postoperative durations of intensive care. Results: Children with more viable myocardium had less severe clinical symptoms. The viability index was correlated well with the preoperative deviations of LVEF (r = −0.98, P = 0.001) and LVEDD (r = 0.87, P = 0.02) and postoperative durations of intensive care hospitalization (r = 0.77, P = 0.04) and mechanical ventilation (r = 0.83, P = 0.02). LVEF and LVEDD reached normal range within 5 months in viable children, whereas incomplete reversal was observed in partial- and nonviable children. Conclusions: In children with ALCAPA, myocardial viability evaluated by perfusion/F-18 FDG imaging is related to the preoperative clinical manifestations and cardiac function. Additionally, it may predict functional recovery after surgical repair.
Gramineae pollen as trigger factors of atopic eczema: evaluation of diagnostic measures using the atopy patch test
Authors: U. DARSOW, H. BEHRENDT, J. RING
Journal: British Journal of Dermatology (1997)

After contact with grass pollen, seasonal exacerbations of eczematous skin lesions have been described in a subgroup of patients with atopic eczema (AE). Epicutaneous patch testing with aeroallergens (atopy patch test, APT) has been used to investigate these patients. We performed comparative APT in 79 patients with AE and 20 control subjects (14 non-atopic volunteers and six patients with grass pollen allergic rhinoconjunctivitis). Subjects were tested with grass pollen allergen extract in petrolatum and with unprocessed native dry pollen of Dactylis glomerata. Results after 48 h were compared with the patient's history, corresponding skin prick test and specific IgE. Fifteen of the 79 AE patients showed clear-cut eczematous reactions to unprocessed D. glomerata pollen; 14 of these had an elevated serum IgE to D. glomerata and 13 had a positive skin prick test. Twenty patients had a positive APT reaction to grass pollen allergen extract, including 12 of the D. glomerata reactive subjects (P < 0.001). Positive patch test reactions to D. glomerata were seen in 66.7% of cases with and 10.5% of patients without a predictive history of exacerbations during the pollen season. For the standardized extract, these percentages were 75% vs. 16.4% (P < 0.001). No side-effects were observed. Control subjects showed no positive reactions. We conclude that grass pollen preparations may be used to investigate trigger factors for eczematous skin lesions in a subgroup of patients with AE.
Protective action of hepatocyte growth factor for acute liver injury caused by D-galactosamine in transgenic mice
Authors: J Okano, G Shiota, H Kawasaki
Journal: Hepatology (1997)

Hepatocyte growth factor (HGF) has been reported to be a potent mitogen for hepatocytes in vivo and in vitro . Recent reports have shown that HGF has cytoprotective actions in acute liver injury models, but its mechanisms remain to be resolved. In the present study, we investigated whether HGF could work as an anti-hepatitis agent for acute liver injury caused by D-galactosamine (D-GalN) using transgenic (TG) mice expressing HGF in hepatocytes, compared with wild-type (WT) mice of their siblings. After administration of 3 g/kg body weight of D-GalN, elevated serum transaminase levels and severe liver damage that were observed in WT mice were significantly improved in TG mice. In TG mice, the percentage of proliferating cell nuclear antigen (PCNA)-positive hepatocytes was high at 0 hours after D-GalN treatment, and increased at 24 hours. The percentage of PCNA-positive cells in WT mice was very low at 0 hours and 24 hours after treatment, but increased at 48 hours. To clarify the mechanisms via which HGF acts, we measured hepatic HGF and prostaglandin E 2 (PGE 2 ) contents after D-GalN administration by an enzyme immunoassay. Total hepatic HGF contents, which were composed of murine (endogeneous) and human (derived from transgene) HGF, in TG mice were higher than those in WT mice at 0, 12, and 24 hours after administration of 3 g/kg body weight of D-GalN. Hepatic PGE 2 contents in TG mice were also significantly higher than those in WT mice. Hepatic PGE 2 contents had a positive correlation with total HGF contents at both 12 hours and 24 hours after the treatment. Moreover, an administration of 0.5 μg of anti-HGF antibody into the portal vein suppressed hepatic PGE 2 contents of mice, compared with saline- injected mice in acute liver injury. Anti-PGE 2 antibody administration caused more severe liver damage than saline solution. A survival rate of TG mice that were given 6 g/kg body weight of D-GalN-a lethal dose of D-GalN-was improved compared with WT mice. These results provided direct evidences that HGF worked as an anti-hepatitis agent against acute liver injury caused by D-GalN, and that this action might be exerted through accelerated hepatic PGE 2 production.
Scottish model for surgical mortality used in Australasia
Authors: Robert James Aitken
Journal: BMJ (2005)

Right to die" Legal view of right to life and death could threaten philosophy of palliative careEditor-Grayling claims that the "right to life" means quite a rich life; withholding treatment with death as the result and giving treatment that causes death are indistinguishable; and death is the ultimate analgesic. 1 Grayling also implies that the double effect is widely abused.The EC Convention for the Protection of Human Rights and Fundamental Freedoms protects against intentional deprivation of life. 2 Quality of life is not mentioned, and terminating a life at a person's request is clearly not permitted."Right to life" is perhaps a "right not to be killed," in medicine, generally relating to survival and not assisted death.However, some interpret it as giving patients a right to cardiopulmonary resuscitation regardless of the clinical circumstances 3 ; extrapolation to all potential interventions at the life-death interface could have disastrous consequences for the medical profession.Patients obviously can wish for their life to be terminated without needing to explain why, and they arguably have a right to attempt suicide.However, a right to assisted dying equates to a right that somebody else will kill or help to kill them on request-very different from withholding treatment or the double effect.Withholding treatment relates to interventions unable to produce the desired benefit. 4 In palliative care withholding treatment does not directly cause death that arises from an irreversible and unsustainable pathological burden.And death without adequate analgesia is possibly the ultimate pain for everyone.Judicious use of analgesia is an essential part of good terminal care, and, in 15 years as a doctor, I have yet to see a death attributable to deliberate analgesic overdose by a doctor.Palliative care affirms life until the moment of death, regarding death from advanced incurable disease as a natural process. 5 It aims to relieve pain and other distressing symptoms, enhance remaining quality of life, and neither hasten nor postpone death.These human "death rights" should perhaps be protected by legislation.Ill-conceived legislative changes that take the right to life or the right to death beyond sensible limits or give certain doctors the right to kill on request could jeopardise palliative care.
Rites of Passage
Authors: Charles W. Jarvis
Journal: JAMA (1986)

The rituals of retirement had come to an end. The hospital tea had come first. It was much like all the many, many retirement teas I had attended over the decades. People from all walks of life and all areas of the hospital had stood in line to wish the honored-one well, to share a new joke, to ask about plans, and then had gathered in little talking knots about the long tea table. The table, as usual, was resplendent in white linen, the best tea service, tiny sandwiches, salted nuts, the regulation garlicflavored cheese ball, and, at each end, an attractively dressed pourer (tea or coffee?) from the department. The administrator had made a gracious speech to light and polite clapping from the assembled group. Yes, it had been a mirror image of a thousand other farewell teas, only this time I was at the wrong end of the
THE FAMILY ENVIRONMENT OF SCHIZOPHRENIC PATIENTS
Authors: RUTH WILMANNS LIDZ, THEODORE LIDZ
Journal: American Journal of Psychiatry (1949)

The case histories of a series of 50 patients who had become manifestly schizophrenic prior to the age of 21 were studied to evaluate the nature of their family environment. Twenty had lost a parent by death or separation prior to their 19th birthday; in 9 cases (possibly 10) this loss was due to the serious emotional illness of one parent. Twenty of the 33 for whom there were adequate data had parents who were clearly incompatible. Twenty-three had at least one parent who was grossly unstable. Eighteen patients had been raised in a manner which was clearly bizarre or deleterious according to conventional standards. Only 5 of the 50 patients could be considered to have been raised in homes that seemed reasonably favorable and which contained 2 stable and compatible parents until the patient was 18 years old. The large majority were impeded by multiple deleterious influences which were chronically present or frequently recurrent. The paternal influence, according to this gross evaluation, was harmful as frequently as the maternal. The implications for the further study of the etiology of schizophrenia are discussed.
Positive smear in pregnancy.
Authors: H. C. McLaren
Journal: BMJ (1969)

Of 8,500 consecutive cervical cytology tests in the antenatal period a positive or suspect result was found in about 1%. For the patients with a positive smear, examination under anaesthesia and small four-quadrant cervical biopsies are proposed as an alternative to antenatal conization, with its risk of subsequent haemorrhage or abortion.A waiting policy is safe and permits normal delivery in hospital. Clinical and cytological follow-up is a vital part of conization-excision therapy. For the suspect smear (dyskaryosis) follow-up tests may revert to normal, but others may become positive and demand biopsy.
The Meaning of Authorship
Authors: Ciaran S. Phibbs
Journal: JAMA (1996)

<h3>To the Editor.</h3> —While I agree in principle with the criteria set forth in the Editorial by Drs Lundberg and Glass,<sup>1</sup>I believe that there is an additional way to participate in research projects that can merit authorship. For projects that require large amounts of data management and computer programming, 1 or more of the programmers can meet authorship criteria. This does not apply to a programmer who just simply follows orders about what to do. I have participated in projects where the computer programmers were central to the research. These individuals participated in the regular research meetings and had a full understanding of the research. On a regular basis, comments and suggestions they made in response to programming requests would yield modifications to the analysis. In my experience, these individuals have been coauthors, and I fully believe that they should have been. I think that your criteria
Pressure-time product and work of breathing during biphasic continuous positive airway pressure and assisted spontaneous breathing.
Authors: E Calzia, K H Lindner, S Witt, U Schirmer, H Lange, R Stenz, M Georgieff
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

The pressure-time product (PTP) and work of breathing (W) were measured in 19 intubated patients during weaning from mechanical ventilation after aortocoronary bypass surgery. The patients were supported by two different ventilatory modes: biphasic continuous positive airway pressure (Biphasic CPAP; a ventilatory mode that permits spontaneous breathing at two different levels of airway pressure during inspiration and during expiration) and pressure-support ventilation (denominated as assisted spontaneous breathing, ASB). Our aim was to compare the energy cost of breathing imposed by both modes. The PTP was obtained by integrating the area enclosed by the esophageal and chest-wall static recoil pressure curves. The W performed by the patient (Wp) was calculated using Campbell's diagram method, based on the esophageal pressure curve and normalized per liter of ventilation. Two comparable support levels, corresponding to a high and a low degree of mechanical support, were studied for each ventilator mode. The levels of support were generally higher than that necessary to overcome inspiratory resistance. We found significantly higher PTP values during biphasic CPAP than during ASB (p < 0.01), whereas the Wp was the same with biphasic CPAP and ASB at both support levels. We conclude that because of the higher PTP values measured during biphasic CPAP, this mode of ventilation appears to have been more exhausting for our patients. The discrepancy between PTP and Wp is probably due to the different mechanisms of support given by the two ventilatory modes and the greater patient effort is related to those respiratory cycles that are not helped by the ventilator and which represent nearly half of the breaths during biphasic.
Prophylaxis in haemophilus meningitis
Authors: D. N K Symon, J. B Malcolm, G. Russell
Journal: BMJ (1984)

1091 patients, which are used for purposes of comparison, have been carried over from the data previously thrice published.1 3 No mention is made of this in this article.This illustrates a problem not raised in your leading article.Multiple reporting of this kind may mislead readers or reviewers into regarding repetitive publications as cumulative evidence.Two of the reports2 3 were quoted in one review as forming part of "formidable" scientific evidence in favour of a particular point.5Another reviewer6 cites two of the reports1 3 as though they were separate items of scientific evidence.