tbuckley/cabot-search huggingface dataset:
Inflammation and functional outcome in diisocyanate‐induced asthma after cessation of exposure
Authors: P. L. Piirilä, A. Meuronen, M.‐L. Majuri, R. Luukkonen, T. Mäntylä, H. J. Wolff, H. Nordman, H. Alenius, A. Laitinen
Journal: Allergy (2008)

Background: The clinical outcome of diisocyanate‐induced asthma has been found to be poor despite cessation of exposure. Our aim was to study the outcome of diisocyanate‐induced asthma after initiation of inhaled steroid treatment at a mean period of 7 months (range 2–60 months) after cessation of exposure by following up lung function and bronchial inflammation. Methods: Bronchoscopy was performed on 17 patients 2 days after a positive inhalation challenge test, after which budesonide 1600 μg a day was started. Bronchoscopy, spirometry, and histamine challenge tests were repeated at 6 months and on average 3 years. The results were also compared with those obtained from 15 healthy control subjects. Results: Nonspecific bronchial hyperreactivity diminished significantly ( P = 0.006); however, forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) values decreased, with a median yearly reduction of FEV1 of 79 ml. The count of mast cells in bronchial mucosa decreased ( P = 0.012) and that of macrophages increased ( P = 0.001). Interleukin‐4 level in mucosa was during the first year significantly higher than in controls but its level decreased in the follow‐up. Interleukin‐6, interleukin‐15, and tumour necrosis factor alpha messenger‐RNA levels were significantly higher in hyperreactive patients than in nonhyperreactive patients at the end of the follow‐up. Conclusion: Our results indicate that inflammation may persist in diisocyanate‐induced asthma despite inhaled steroid medication. However, TH2‐type inflammation diminished. Persistent nonspecific bronchial hyperreactivity was associated with proinflammatory acting cytokines produced mainly by macrophages. Considering the poor prognosis of the disease the findings could be utilized to develop the follow‐up and treatment of diisocyanate‐induced asthma.
Off at the Races — A Graphic Patient History
Authors: Stephen Goldfinger
Journal: New England Journal of Medicine (1998)

Sildenafil in the Treatment of Erectile DysfunctionTo the Editor: In their study of sildenafil in men with erectile dysfunction, Goldstein et al. (May 14 issue) 1 found that the drug had few major side effects.I would like to bring to your attention two cases of ventricular tachycardia that occurred within one hour after ingestion of sildenafil.Patient 1 was a 52-year-old man who had a large myocardial infarction of the anterior wall 20 years ago, which resulted in an enlarged left ventricle and a severely depressed ejection fraction, but he had never had ventricular tachycardia.One hour after taking sildenafil, during sexual activity with his girlfriend, he felt short of breath and lightheaded.He waited an hour and then drove himself to the emergency department where he was noted to have rapid sustained monomorphic ventricular tachycardia.He promptly underwent cardioversion to sinus rhythm with direct-current countershock.Patient 2 was a 71-year-old man who had an extensive myocardial infarction of the anterior wall 25 years ago, which also resulted in an enlarged left ventricle and a severely depressed ejection fraction.He had a cardioverterdefibrillator implanted four years ago because of infrequent symptomatic episodes of ventricular tachycardia.He had not received any shocks in the preceding six months.One hour after taking sildenafil, while engaging in sexual activity, he received three shocks, each a few minutes apart, after which he immediately stopped the activity.Data recovered from the implantable cardioverter-defibrillator revealed appropriate discharge of the device for a rapid, regular tachycardia consistent with the patient's known ventricular tachycardia.Neither of the men had ever had similar episodes during sexual activity in the past, and neither was taking any nitrate-containing drugs.These cases suggest the possibility that in men at risk for serious ventricular arrhythmias, the risk may increase during sexual activity after administration of sildenafil.Caution should be exercised in prescribing sildenafil to men with a history of ventricular arrhythmias, especially if they are not already protected by an implantable cardioverter-defibrillator.
TREATMENT OF DISCOID AND SUBACUTE LUPUS ERYTHEMATOSUS WITH CYCLOPHOSPHAMIDE
Authors: E. J. SCHULZ, M. A. MENTER
Journal: British Journal of Dermatology (1971)

Nine patients with discoid and subacute lupus erythematosus were treated with oral cyclophosphamide for periods varying from 3–38 months. Previous treatment with anti‐malarials, systemic and topical corticosteroids had given unsatisfactory results and caused untoward side effects. Clinical improvement was excellent in 5 patients, moderate in 3 and negligible in 1. In 2 patients in whom cyclophosphamide has heen stopped there has been no recurrence after 6 and 23 months respectively. Cyclophosphamide appears to be a useful addition to the treatment of widespread cutaneous lupus erythematosus.
Western Bioethics on the Navajo Reservation
Authors: Joseph A. Carrese, Lorna A. Rhodes
Journal: JAMA (1995)

<h3>Objective.</h3> —To understand the Navajo perspective regarding the discussion of negative information and to consider the limitations of dominant Western bioethical perspectives. <h3>Design.</h3> —Focused ethnography. <h3>Setting.</h3> —Navajo Indian reservation in northeast Arizona. <h3>Participants.</h3> —Thirty-four Navajo informants, including patients, biomedical health care providers, and traditional healers. <h3>Results.</h3> —Informants explained that patients and providers should think and speak in a positive way and avoid thinking or speaking in a negative way; 86% of those questioned considered advance care planning a dangerous violation of traditional Navajo values. These findings are consistent with<i>hózhó</i>, the most important concept in traditional Navajo culture, which combines the concepts of beauty, goodness, order, harmony, and everything that is positive or ideal. <h3>Conclusions.</h3> —Discussing negative information conflicts with the Navajo concept<i>hózhó</i>and was viewed as potentially harmful by these Navajo informants. Policies complying with the Patient Self-determination Act, which are intended to expose all hospitalized Navajo patients to advance care planning, are ethically troublesome and warrant reevaluation. (<i>JAMA</i>. 1995;274:826-829)
Developing countries cannot afford high fees for speakers
Authors: T. Jargensettasin, G. Edwards
Journal: BMJ (1999)

EDITOR—Doctors visit Thailand to give lectures at the invitation of Thai universities or royal colleges or are invited by drug firms. Some pay all of their own expenses, or only claim minimal expenses, and give generously of their time. These doctors contribute much to the educational programme in Thailand and to good international relations. However, for the reasons illustrated by the following examples, our Thai colleagues have expressed concern about some of those lecturers who are invited by Thai divisions of international drug firms.

After …
Long-term outcome and prospective validation of NIH response criteria in 39 patients receiving imatinib for steroid-refractory chronic GVHD
Authors: Attilio Olivieri, Michele Cimminiello, Paolo Corradini, Nicola Mordini, Roberta Fedele, Carmine Selleri, Francesco Onida, Francesca Patriarca, Enzo Pavone, Silvia Svegliati, Armando Gabrielli, Paola Bresciani, Roberta Nuccorini, Sara Pascale, Sabrina Coluzzi, Fabrizio Pane, Antonella Poloni, Jacopo Olivieri, Pietro Leoni, Andrea Bacigalupo
Journal: Blood (2013)
"The Sanctity of Life": An Analysis of a Concept
Authors: K. DANNER CLOUSER
Journal: Annals of Internal Medicine (1973)

The concept of the sanctity of life has been frequently appealed to but seldom examined. In much of biomedical ethics it is treated as a basic principle. This article is an attempt to discover what this pivotal concept means and to see if it can do the conceptual job in biomedical ethics it purports to do. The concept is found to be impossibly vague and misleading. It can be replaced to advantage by other well-established concepts.
Vovulus of the small bowel in a diabetic patient.
Authors: G A Fitzgerald, B Colgan, M I Drury, F X O'Connell
Journal: BMJ (1976)

prescribed, as "we are already too far down that path to turn back."In "an issue in which there is more emotion than reason" we would make a plea for continued evaluation of therapy.If acceptable studies do not provide evidence of the superiority of oestrogens over placebo then we should stop prescribing them.
Physiatry and Care of Patients With Neurofibromatosis-Reply
Authors: David H. Gutmann
Journal: JAMA (1997)

Drs Levy and Krietemeyer make an important point that rehabilitation is an essential component of the care of individuals affected with NF1 and that such issues, often overlooked in the midst of complicated medical problems, deserve more attention. Neurofibromas are benign growths that can result in significant morbidity depending on the extent and location of the nerves associated with them. One of the more morbid anatomical sites for neurofibroma involvement is the vertebral column. Neurofibromas associated with the spinal column have been reported in as few as 2% of individuals with NF1.<sup>1</sup>In other series,<sup>2</sup>as many as 14% to 19% of individuals with NF1 had spinal neurofibromas. Spinal root neurofibromas can compress the spinal cord or the spinal root on which they are growing and lead to neurological abnormalities. This may result in progressive paraparesis, severe radicular pain, sensory loss, gait disturbances, and bowel and bladder dysfunction.
Fundamental Purposes of Formal Education Beyond Medical School
Authors: John Z. Bowers
Journal: JAMA (1962)

THE MOUNTING CRITICISM of internship and residency programs suggests that a discussion of purposes and practices in this area is timely. Happily, the Council on Medical Education and Hospitals has determined to undertake an objective analysis of this phase of medical education, with the possibility that some significant improvements may be recommended. My comments will emphasize the divergence in career interests among interns and residents and the need for maximum flexibility in establishing standards for their programs. It is clear that education must always be our first objective in this phase of medical education. The internship has been constricted or has deteriorated to such a degree that there is serious question as to its future essentiality. If we are to achieve flexibility in our residency programs, a review of the standards set by the specialty boards is indicated. <h3>History</h3> In 1940, the Commission on Graduate Education, Dr. Willard Rappleye, Chairman
Northumbria women's police doctor scheme
Authors: R. A A R Lawrence
Journal: BMJ (1989)

group of fit 29 year old men.The slight reductions in protein synthesis in the patients with myalgic encephalomyelitis might well be explained by the differences in age, sex, and body build between the control and study groups.In addition, since there was no evidence of muscle wasting in the patients it follows that protein degradation was reduced to the same degree as protein synthesis.We have studied patients with muscle pain and weakness, many of whom dated the onset of their
Prediction of drug–ABC-transporter interaction — Recent advances and future challenges
Authors: Floriane Montanari, Gerhard F. Ecker
Journal: Advanced Drug Delivery Reviews (2015)

With the discovery of P-glycoprotein (P-gp), it became evident that ABC-transporters play a vital role in bioavailability and toxicity of drugs. They prevent intracellular accumulation of toxic compounds, which renders them a major defense mechanism against xenotoxic compounds. Their expression in cells of all major barriers (intestine, blood-brain barrier, blood-placenta barrier) as well as in metabolic organs (liver, kidney) also explains their influence on the ADMET properties of drugs and drug candidates. Thus, in silico models for the prediction of the probability of a compound to interact with P-gp or analogous transporters are of high value in the early phase of the drug discovery process. Within this review, we highlight recent developments in the area, with a special focus on the molecular basis of drug-transporter interaction. In addition, with the recent availability of X-ray structures of several ABC-transporters, also structure-based design methods have been applied and will be addressed.
CARE OF THE PATIENT IN THE MEDICAL SCHOOL SETTING
Authors: Edmund D. Pellegrino
Journal: JAMA (1960)

Patient care and clinical teaching bear an integral and reciprocal relationship. Each must be conducted at a level of excellence if the medical school and the teaching hospital are to fulfill their missions. Yet, within this axiomatic statement, there lies a difficult and unresolved practical problem. How can the goals and purposes of patient care and clinical teaching be made compatible and reenforcing, and how can each derive maximum advantage from the presence of the other? The contribution of the medical school setting to the solution of this problem lies in the following three unique responsibilities: (1) to provide that quality of patient care which can be a model to the student and a standard of reference for the community; (2) to refurbish this care continuously and keep it responsive to the needs of society; and (3) to keep abreast of useful knowledge in the natural and social sciences. It
The Relationship Between GLUT-1 and Vascular Endothelial Growth Factor Expression and 18F-FDG Uptake in Esophageal Squamous Cell Cancer Patients
Authors: Maiko Kobayashi, Hayato Kaida, Akihiko Kawahara, Satoshi Hattori, Seiji Kurata, Masanobu Hayakawa, Yasumitsu Hirose, Masafumi Uchida, Masayoshi Kage, Hiromasa Fujita, Naofumi Hayabuchi, Masatoshi Ishibashi
Journal: Clinical Nuclear Medicine (2012)

To examine the relationship between glucose transporter-1 (GLUT-1) and vascular endothelial growth factor (VEGF) expression and (18)F-FDG uptake in esophageal squamous cell cancer patients.Fifty-seven patients (52 male and 5 female) were included in this study. (18)F-FDG PET/CT was performed prior to the surgery. Immunohistochemistry was performed using postoperative histopathological specimens. The estimation of immunohistochemistry was conducted using scoring analysis. We investigated the correlations between maximum standardized uptake value (SUV(max)) and GLUT-1/VEGF expressions/pathologic tumor length (p-tumor length), and the relationships between pathologic T (p-T) stage and GLUT-1/VEGF expressions/SUV(max) and between lymph node metastasis (p-N) stage and GLUT-1/VEGF expressions/SUV(max).SUV(max) significantly correlated with GLUT-1 expressions and p-tumor length (GLUT-1: r = 0.475, P < 0.001; p-tumor length: r = 0.475, P < 0.001). SUV(max) of the primary tumor had a significant relationship with p-T stage, p-N stage, and VEGF expression (p-T stage: P < 0.001; p-N stage: P = 0.037; VEGF expression: P = 0.009). There was a statistically significant difference between GLUT-1 expression and p-T stage/VEGF expression, but not p-N stage (p-T stage: P = 0.012; VEGF expression: P = 0.01; p-N stage: P = 0.572). VEGF expression had a significant relationship with p-T stage, but not with p-N stage (p-T stage: P = 0.032; p-N stage: P = 0.763).(18)F-FDG uptake can be determined by GLUT-1 and VEGF. SUV(max) would have a connection with the tumor progression and lymph node metastasis.
"Munchausen Syndrome" Cases
Authors: FRANK SPARANDERO
Journal: Annals of Internal Medicine (1975)

Comments1 January 1975"Munchausen Syndrome" CasesFRANK SPARANDERO, M.D.FRANK SPARANDERO, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-82-1-123_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Fialk and Murray reported in the October 1974 issue (Ann Intern Med 81:562, 1974) a case of a 28-year-old man with a story of having had a floppy mitral valve; this case was thought to be a cardiac example of the Munchausen syndrome.On 3 August 1973 a 27-year-old man came to the emergency room of our hospital, and was subsequently hospitalized, with chest pain and a story similar to that mentioned in the letter by Fialk and Murray. We believe that both patients are the same man. Medical records were obtained from Deborah Hospital in Browns... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Department of Medicine The Staten Island HospitalStaten Island New York 10301 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMunchausen Cases with ConnectionsCHARLES R. RETHY, M.D. 1 January 1975Volume 82, Issue 1Page: 123-124KeywordsEmergency departmentIschemia Issue Published: 1 January 1975 PDF downloadLoading ...
Hepatitis A: A Potentially Serious Disease
Authors: Miguel J. Rodriguez
Journal: Annals of Internal Medicine (1998)

Letters15 September 1998Hepatitis A: A Potentially Serious DiseaseMiguel J. Rodriguez, MD, Eugene R. Schiff, MD, and Andreas G. Tzakis, MDMiguel J. Rodriguez, MDUniversity of Miami School of Medicine; Miami, FL 33136Search for more papers by this author, Eugene R. Schiff, MDUniversity of Miami School of Medicine; Miami, FL 33136Search for more papers by this author, and Andreas G. Tzakis, MDUniversity of Miami School of Medicine; Miami, FL 33136Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-6-199809150-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Willner and colleagues' brief communication [1] highlights the seriousness of the threat of hepatitis A to the United States, where the incidence of immunity is 38% [2]. We describe five patients with fulminant hepatic failure secondary to hepatitis A who were referred to the University of Miami Medical Center in the past 2 years, all of whom required liver transplantation.Four of the patients were previously healthy adults who lived in southern Florida (age range, 26 to 55 years) and denied high-risk behavior. The fifth patient was a 6-year-old boy referred from Puerto Rico. One of the ...References1. Willner IR, Uhl MD, Howard SC, Williams EQ, Riely CA, Waters B. Serious hepatitis A: an analysis of patients hospitalized during an urban epidemic in the United States. Ann Intern Med. 1998; 128:111-4. Google Scholar2. Alter MJ, Mast EE. The epidemiology of viral hepatitis in the United States. Gastroenterol Clin North Am. 1994; 23:437-55. Google Scholar Author, Article, and Disclosure InformationAuthors: Miguel J. Rodriguez, MD; Eugene R. Schiff, MD; Andreas G. Tzakis, MDAffiliations: University of Miami School of Medicine; Miami, FL 33136 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byHepatitis A. An uncommon associated pathologyCost-Utility Analysis of Hepatitis A Prevention Among Health-Care Workers in Israel 15 September 1998Volume 129, Issue 6Page: 506KeywordsAcute liver failureGenetic diseasesHepatitis AImmunityLiver transplantationNecrosisOrthotopic liver transplantationRetransplantationTransplantationVaccines ePublished: 15 August 2000 Issue Published: 15 September 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
THE CONTROL OF PROSTITUTION AND THE PREVENTION OF THE SPREAD OF VENEREAL DISEASES.
Authors: M. L. HEIDINGSFELD
Journal: JAMA (1904)

This paper is presented under this double caption because venereal disease and prostitution are inseparable terms, and because the control of prostitution is engrossing the attention of most of the large and many of the smaller communities, solely for the avowed purpose of preventing the spread of venereal diseases. By far the more important of the two questions is that which refers to the prevention of the spread of venereal diseases; whatever preventative measures have thus far been instituted have been largely ineffective in character and have been directed against the chief source of infection, prostitution, with a view of either effecting its suppression or control. History is full of attempts of such manifold nature and character as to conclusively demonstrate that suppression is impossible and control impractical and at best of very doubtful value. I need only refer to a few well-known examples to convince the most skeptical that
Bone marrow morphology in myelodysplastic syndrome associated with isolated del(5q)
Authors: Kikkeri N. Naresh, Alistair Reid
Journal: American Journal of Hematology (2010)

A man in his 60s presented with persistent anemia and intermittently low white cell count. Platelet counts were normal. Bone marrow aspirate (upper panel) and bone marrow trephine biopsy (middle panel) showed a large number of megakaryocytes that were smaller in size and had characteristic unlobated or hypolobated nuclei. The megakaryocytes were highlighted by CD42b immunostain. CD34-positive cells amounted to 3–4% of the marrow cells and were seen occasionally in small clusters. Interphase FISH analysis using 5q31 (green) and 5q33 (red) specific probes showed loss of one hybridization signal from both probes, indicating a deletion of chromosome 5q, in 71 of 100 interphases examined. G-band karyotyping confirmed 5q deletion as a sole abnormality, revealing a karyotype of 46,XX,del(5)(q22q35). Myelodysplastic syndrome (MDS) with isolated del(5q) is associated with anemia with or without other cytopenias and/or thrombocytosis. The interstitial deletion of chromosome 5 occurring as a sole abnormality involves erythroid, myeloid, and megakaryocytic lineages. This is a form of low-risk MDS with transformation to acute myeloid leukemia reported in <10% patients [1]. Recent clinical results with lenalidomide, an oral immunomodulatory drug, have shown durable erythroid responses, including transfusion independence and complete cytogenetic remissions.
The clinical impact of sidebranch occlusion and sidebranch narrowing after elective coronary stent placement in STARS
Authors: A.S. Abizaid, J.J. Popma, A.J. Lansky, R. Mehran, J. Saucedo, K. Ho, R.E. Kuntz, M.B. Leon
Journal: Journal of the American College of Cardiology (1998)
Measles in New York City
Authors: Stephen Friedman
Journal: JAMA (1991)

<h3>To the Editor.</h3> —That measles is not a benign disease of childhood has been made painfully clear in the current outbreak in New York City. Among the more than 2000 reported measles cases in 1990 and the 3000 cases reported in the first 5 months of 1991, there have been 19 measles-associated deaths. The demographic characteristics of the deaths are different from the 1990 confirmed New York City cases. The New York City outbreak is concenated in preschool Latino (six deaths) and African-American (nine deaths) children; the remaining four deaths occurred in white children. Nearly one third of the cases that occurred in 1990 were in children under 1 year of age, and 70% of the cases overall occurred in children under 5 years of age (mean, 12.2 years [range, 6 months to 38 years]; median, 7 years). In comparison, only two (11%) of the deaths in 1991 were in