tbuckley/cabot-search huggingface dataset:
Phosphorus Poisoning-Reply
Authors: Frank A. Simon
Journal: JAMA (1976)

Jackson's letter discusses several divergent opinions in relation to our original article. There is a marked disagreement between EPA labeling regulations, National Pest Control Association good conduct practice statement, and the instructions printed on the label of a readily available paste. The instructions state: apply rat paste on bread, cheese, or other food they (rodents) will eat. Cautions are recommended on the label but are not always followed by the public.  A survey of multiple supermarkets, which are members of various local and national chains in the Houston area, showed that rat paste containing yellow phosphorus was available for purchase by the general public in all the stores that were contacted. This current public availability of toxic rat paste is supported by the occurrence of our reported cases during the spring of 1975.  We appreciate Dr Jackson's differentiation of zinc phosphide from yellow phosphorus; however, both compounds manifest
Treatment of Mental Illness at Home by Small Doses of Insulin
Authors: Newman Cohen
Journal: New England Journal of Medicine (1949)

THE belief that treatment of mental illness requires a hospital setting is no longer uniformly accepted. The extramural approach has been strengthened substantially by an increasing number of favorable reports.Electroshock therapy, formerly used only in hospitalized patients, has been used successfully in ambulatory patients.1 2 3 4 5 6 Today it is possible, in many cases, to administer this type of treatment outside the hospital, thus obviating loss of time and any stigma connected with hospitalization in a mental institution. However, such a procedure is recommended only in carefully selected cases and with adequate safeguards.Insulin-coma therapy as a potent therapeutic agent in schizophrenia . . .
Cholesterol lowering margarine is effective
Authors: G. R Thompson
Journal: BMJ (1999)

<h3>Objective.</h3> Patient assessments of disease activity (PtGA) and general health (GH) measured by visual analog scale (VAS) are widely used in rheumatoid arthritis (RA) clinical practice and research. These require comprehension of the question's wording and translation of disease activity onto a written VAS, which is problematic for patients with limited health literacy (HL) or difficulty completing forms. This study's objective was to validate verbally administered versions of patient assessments and identify factors that might explain discrepancies between verbal and written measures. <h3>Methods.</h3> We enrolled patients with RA at the Denver Health rheumatology clinic (n = 300). Subjects were randomized to complete the traditional written PtGA and GH and one of the verbal assessments. Subjects provided a verbal numeric response after reading the question, having the question read to them in person, or hearing the question over the phone. Spearman and Lin correlations comparing written and verbal assessments were determined. Multivariate logistic regression was performed to explain any discrepancies. <h3>Results.</h3> The instruments administered verbally in-person showed good, but not excellent, correlation with traditional written VAS forms (Spearman coefficients 0.59 to 0.70; p &lt; 0.001 for all correlations). Twenty-three percent of subjects were unable to complete 1 of the written VAS assessments without assistance. HL predicted missing written data and discrepancies between verbal and written assessments (p &lt; 0.05 for all correlations). <h3>Conclusion.</h3> Providers should use verbal versions of PtGA and GH with caution while caring for patients unable to complete traditional written version. Limited HL is widely prevalent and a barrier to obtaining patient-oriented data.
Provision of services for cleft lip and palate in England and Wales
Authors: A. Williams, W. C Shaw, H B. Devlin
Journal: BMJ (1994)

one of the three senior house officers, 10 of the 13 registrars, one of the two senior registrars, and one of the five consultants were incorrect), cardiothoracic surgeons (three of the four registrars and all three consultants were wrong), and physicians (15 of the 23 senior house officers (65%), 10 of the 13 registrars (77%), seven of the 10 senior registrars (700/%), and 10 of the 12 consultants (83%) were wrong.Overall, if defining the PR and QT intervals and the duration of one small square on the electrocardiogram were together needed to pass an examination 90% (142/158) of those questioned would have failed.
Teleological behaviorism and altruism
Authors: Hugh Lacey
Journal: Behavioral and Brain Sciences (2002)

Rachlin shows that experiments about social cooperation may fruitfully be grouped with experiments on self-control, and that this suggests interesting possibilities for practical behavioral controls. The concepts of selfishness and altruism, however, that inform his theorizing about these experiments, do not serve to provide understanding of the behavior that commonly is referred to, derogatorily, as selfish.
Systemic delivery of TLR9-activating/STAT3-blocking oligonucleotides induces leukemia regression
Authors: Qifang Zhang, Dewan Md Sakib Hossain, Sergey Nechaev, Ralf Buettner, Piotr Swiderski, Agnieszka Jozwiak, Stephen J Forman, Ravi Bhatia, Ya-Huei Kuo, Marcin Kortylewski
Journal: Journal for ImmunoTherapy of Cancer (2014)

Meeting abstracts Inhibition of transcription factors (TF) that drive tumor progression and immune evasion, such as STAT3, remains a challenge for pharmacological drugs. Blocking STAT3 binding to DNA using specific decoy oligodeoxynucleotides (dODN) provides an alternative targeted inhibitory
Preferential Inhibition of Tumors by Drugs Depressing DNA Polymerases
Authors: Frances E. Knock
Journal: JAMA (1971)

<h3>To the Editor.—</h3> In chemical sensitivity tests on hundreds of human cancers and in radioactive tracer studies on more than 80 human cancers, one or more sulfhydryl (SH) inhibitors have shown greater activity against tumors than against normal tissues.<sup>1,2</sup>The clinically useful SH inhibitors have now been found to depress DNA polymerases in vitro, with greater effect against RNA-dependent DNA-polymerase activity than against DNA-dependent DNA-polymerase activity. Clinically, SH inhibitors, selected according to individual patient sensitivity tests, have led to regression of a wide range of human tumors, without apparent interference with wound healing or injury to hematologic status. In two series totaling over 120 patients, the majority of patients whose cancers could be tested obtained objective regression from the SH inhibitors alone, or combined with other selected drugs. Randomized experiments in Japan with the Kondo sensitivity test<sup>3</sup>similarly have shown promising clinical results for patients receiving antitumor agents
Long-term clinical course and symptomatic status of patients after operation for hypertrophic subaortic stenosis.
Authors: B J Maron, W H Merrill, P A Freier, K M Kent, S E Epstein, A G Morrow
Journal: Circulation (1978)

Long-term results of operation for IHSS were reviewed in 124 patients operated upon between 1960 and 1975. Most patients improved symptomatically and manifested marked reduction in LV outflow gradient at rest postoperatively. However, ten (8%) patients died of causes related to operation, 14 (12%) had persistent or recurrent severe functional limitation, and 11 (9%) died up to 13 years postoperatively due to hypertrophic cardiomyopathy. Overall annual mortality rate was 3.5% and was 1.8% for late deaths alone. Of 11 late postoperative deaths, six were sudden and five were due to chronic heart failure. Atrial fibrillation was significantly more common in patients who died late postoperatively than in survivors. Nine of the 11 late deaths had associated medical problems that may have contributed to their outcome. In conclusion, long-lasting clinical improvement occurred in most patients who survived operation for IHSS. However, 12% of patients deteriorated clinically over the 5.2 year average follow-up, and there is continued, small annual mortality.
Folic Acid-Preventable Spina Bifida and Anencephaly
Authors: Godfrey P. Oakley
Journal: JAMA (1993)

One of the most exciting medical findings of the last part of the 20th century is that folic acid, a simple, widely available, water-soluble vitamin, can prevent spina bifida and anencephaly (SBA). Not since the rubella vaccine became available 30 years ago have we had a comparable opportunity for primary prevention of such common and serious birth defects. The many epidemiologic studies that resulted in the identification of the preventive effect of folic acid is a model for the kind of research that needs to be done to identify the causes of and primary prevention strategies for other birth defects, the leading cause of infant mortality in the United States. An overview of this research will let readers appreciate the contribution of the article by Werler et al,<sup>1</sup>which is published in this issue of<i>JAMA</i>. See also pp 1233 and 1257. Spina bifida and anencephaly are common, serious
Tracheo-esophageal Fistula Due to Wegener's Granulomatosis
Authors: John C. Kulis, Noel D. Nequin
Journal: JAMA (1965)

TRACHEO-ESOPHAGEAL FISTULAE are either congenital or acquired. The acquired variety may be due to malignant or nonmalignant causes, the latter being due to infection, chemicals, trauma, and esophageal diverticula.<sup>1</sup>This case report presents the first known case of tracheo-esophageal fistula due to necrotizing vasculitis. <h3>Report of a Case</h3> A 47-year-old white woman entered the Swedish Covenant Hospital on April 6, 1963, because of fever, productive cough, and facial eruption of two months' duration. She had developed a pruritic, papular, erythematous rash on her face, followed two weeks later by a sore throat and cough productive of profuse, whitish-mucoid sputum, without associated chest pain or respiratory difficulty. One week prior to admission the patient developed chills with constant fever. Personal history revealed that the patient was a dressmaker who did not indulge in alcoholic beverages or tobacco. She gave no history of injuries or surgical operations. For one year prior
Computer Physician Order Entry: Benefits, Costs, and Issues
Authors: Gilad J. Kuperman, Richard F. Gibson
Journal: Annals of Internal Medicine (2003)

Several analyses have detected substantial quality problems throughout the health care system. Information technology has consistently been identified as an important component of any approach for improvement. Computerized physician order entry (CPOE) is a promising technology that allows physicians to enter orders into a computer instead of handwriting them. Because CPOE fundamentally changes the ordering process, it can substantially decrease the overuse, underuse, and misuse of health care services. Studies have documented that CPOE can decrease costs, shorten length of stay, decrease medical errors, and improve compliance with several types of guidelines. The costs of CPOE are substantial both in terms of technology and organizational process analysis and redesign, system implementation, and user training and support. Computerized physician order entry is a relatively new technology, and there is no consensus on the best approaches to many of the challenges it presents. This technology can yield many significant benefits and is an important platform for future changes to the health care system. Organizational leaders must advocate for CPOE as a critical tool in improving health care quality.
Dupilumab improves the molecular signature in skin of patients with moderate-to-severe atopic dermatitis
Authors: Jennifer D. Hamilton, Mayte Suárez-Fariñas, Nikhil Dhingra, Irma Cardinale, Xuan Li, Ana Kostic, Jeffrey E. Ming, Allen R. Radin, James G. Krueger, Neil Graham, George D. Yancopoulos, Gianluca Pirozzi, Emma Guttman-Yassky
Journal: Journal of Allergy and Clinical Immunology (2014)

BackgroundSevere atopic dermatitis (AD) has a high unmet need for effective and safe therapeutics. In early-phase trials, dupilumab, a fully human mAb targeting IL-4 receptor α, markedly improved disease activity, but the effect of IL-4/IL-13 blockade on AD at the molecular level has not been characterized.ObjectivesWe sought to evaluate dupilumab modulation of the AD molecular signature.MethodsWe performed transcriptomic analyses of pretreatment and posttreatment skin biopsy specimens from patients with moderate-to-severe AD treated weekly with 150 or 300 mg of dupilumab or placebo.ResultsExacerbation of the AD transcriptome was observed in placebo-treated patients. Dupilumab improved the AD signature in a dose-dependent manner. Expression of genes upregulated in AD lesions decreased in patients treated with dupilumab by 26% (95% CI, 21% to 32%) and 65% (95% CI, 60% to 71%) for treatment with 150 and 300 mg, respectively. Genes downregulated in AD lesions increased by 21% (95% CI, 16% to 27%) and 32% (95% CI, 26% to 37%) with dupilumab (150 and 300 mg, respectively). The molecular changes paralleled improvements in clinical scores. A dupilumab treatment signature of 821 probes (>2-fold change, P < .05) significantly modulated in the 300-mg dupilumab group at week 4 compared with baseline was identified in this sample set. Significant (P < .05) decreases in mRNA expression of genes related to hyperplasia (K16 and MKI67), T cells, and dendritic cells (CD1b and CD1c) and potent inhibition of TH2-associated chemokines (CCL17, CCL18, CCL22, and CCL26) were noted without significant modulation of TH1-associated genes (IFNG).ConclusionsThis is the first report showing rapid improvement of the AD molecular signature with targeted anti–IL-4 receptor α therapy. These data suggest that IL-4 and IL-13 drive a complex, TH2-centered inflammatory axis in patients with AD.
Intravenous thrombolysis for stroke
Authors: L. Derex
Journal: BMJ (2010)

Elderly patients should not be excluded solely on the basis of age

Intravenous thrombolytic treatment for acute ischaemic stroke is controversial in patients over 80 years, mainly because they have been excluded from or under-represented in the large scale randomised controlled trials of such treatment.1 2 3 In the linked study (doi:10.1136/bmj.c6046), Mishra and colleagues assess the influence of age on the response to thrombolysis (alteplase) in people with acute ischaemic stroke⇓.4 



Sovereign, ISM/Science Photo Library

Contrary to the recommendations and conditions for use in North America, the European Medicines Agency (EMEA) does not approve intravenous thrombolysis with recombinant tissue plasminogen activator in patients over 80 years with acute ischaemic stroke. This has important consequences: as the proportion of elderly people is rising in developed countries, 20-30% of patients with acute ischaemic stroke may be excluded from receiving the only curative emergency treatment available.5 6 7 In practice, the exclusion of patients on the grounds of age alone, along with poor public awareness of the stroke …
Leptin-dependent serotonin control of appetite: temporal specificity, transcriptional regulation, and therapeutic implications
Authors: Vijay K. Yadav, Franck Oury, Kenji F. Tanaka, Tiffany Thomas, Ying Wang, Serge Cremers, Rene Hen, Andree Krust, Pierre Chambon, Gerard Karsenty
Journal: The Journal of Experimental Medicine (2010)

Recent evidence indicates that leptin regulates appetite and energy expenditure, at least in part by inhibiting serotonin synthesis and release from brainstem neurons. To demonstrate that this pathway works postnatally, we used a conditional, brainstem-specific mouse CreERT2 driver to show that leptin signals in brainstem neurons after birth to decrease appetite by inhibiting serotonin synthesis. Cell-specific gene deletion experiments and intracerebroventricular leptin infusions reveal that serotonin signals in arcuate nuclei of the hypothalamus through the Htr1a receptor to favor food intake and that this serotonin function requires the expression of Creb, which regulates the expression of several genes affecting appetite. Accordingly, a specific antagonist of the Htr1a receptor decreases food intake in leptin-deficient but not in Htr1a−/− mice. Collectively, these results establish that leptin inhibition of serotonin is necessary to inhibit appetite postnatally and provide a proof of principle that selective inhibition of this pathway may be a viable option to treat appetite disorders.
The Nursing Bottle Caries Syndrome
Authors: Thomas E. Cone
Journal: JAMA (1981)

Most of us, as we read our contemporary medical journals, tend to accept the findings said to be characteristic of the so-called new syndromes as being just that. We tuck these reports away in our heads, rarely suspecting that someone in past centuries may have already beaten us to it. A case in point is the nursing bottle caries syndrome associated with prolonged bottle feeding of sweetened milk, usually offered as a pacifier, to infants beyond 1 year of age. This results in a devastating condition that may render young children dental cripples.<sup>1</sup>Pediatricians were first made aware of this syndrome in the mid-1960s.<sup>2</sup>However, Daniel Clarke (1622-1710), writing to Governor John Winthrop, Jr (1606-1676), on Feb 11, 1652, described the rampant dental disease in his 4-year-old son. Clarke was seeking help from Governor Winthrop in understanding his son's condition. In so doing he wrote, in my opinion,
Adenosine triphosphate depletion induces a rise in cytosolic free calcium in canine renal epithelial cells.
Authors: C E McCoy, A M Selvaggio, E A Alexander, J H Schwartz
Journal: Journal of Clinical Investigation (1988)

An elevation in cytosolic free calcium (Cai) produced by cellular ATP depletion may contribute to the initiation of cytotoxic events in renal ischemia. To evaluate whether ATP depletion results in a rise in Cai we examined the effect of cyanide and 2-deoxy-D-glucose on the Cai of Madin-Darby canine kidney cells. Exposure to the metabolic inhibitors resulted in a rise in Cai from 112 +/- 11 to 649 +/- 99 nM in 15 min. This combination of metabolic inhibitors also resulted in a decrement of cell ATP to 11 +/- 2% of control by 15 min. Experiments that were performed with other metabolic inhibitors confirm that the increment in Cai is due to inhibition of ATP synthesis. With the removal of cyanide and 2-deoxy-D-glucose, Cai recovered to 101 +/- 16 nM. In the absence of extracellular calcium activity (Ca0), Cai declined from 127 +/- 7 to 38 +/- 6 nM, whereas with cyanide plus 2-deoxy-D-glucose in the absence of Ca0 the Cai rose from 108 +/- 21 to 151 +/- 28 nM. Because the rise in Cai produced by ATP depletion in the absence of Ca0 is significantly less than that which occurs in the presence of Ca0, influx of Ca0 is necessary for the maximal rise of Cai. The rise in Cai that occurred in the absence of Ca0 suggests that the release of calcium from intracellular stores contributes to the increment in Cai seen with ATP depletion. TMB-8, an inhibitor of calcium release from intracellular stores, blunted the rise in Cai by nearly 50%. Neither verapamil nor nifedipine inhibited the rise in Cai. This study demonstrates that ATP depletion induced by the metabolic inhibitors cyanide and 2-deoxy-D-glucose is associated with a rapid and reversible increase in Cai. Both Ca0 influx and Cai redistribution contribute to this rise.
Total Parenteral Nutrition in Obstetrics
Authors: David B. Seifer, Howard Silberman, Valerian A. Catanzarite, Chris N. Conteas, Robert Wood, Kent Ueland
Journal: JAMA (1985)

Total parenteral nutrition was provided to ten patients during pregnancy. No obstetrical or fetal complications attributable to the nutrition therapy occurred. All infants were at or above the tenth percentile in weight for gestational age. Total parenteral nutrition appears to be safe for the mother and fetus when given after the first trimester; the safety of total parenteral nutrition in the first trimester requires further study.
Racial Differences in the Use of Invasive Cardiovascular Procedures: Review of the Literature and Prescription for Future Research
Authors: Nancy R. Kressin, Laura A. Petersen
Journal: Annals of Internal Medicine (2001)

Purpose: The cause of racial disparities in the use of invasive cardiac procedures remains unclear. To summarize, evaluate, and clarify gaps in the literature, studies examining racial differences in cardiac catheterization, percutaneous transluminal coronary angioplasty (PTCA), and coronary artery bypass grafting (CABG) were reviewed. Data Sources: MEDLINE search for English-language articles published from 1966 to May 2000. Study Selection: Empirical studies of adults. Data Extraction: The odds ratios for procedure use by race were examined for each study; cohorts and covariates were also documented. Data Synthesis: Literature was classified as one of three groups on the basis of study design. For the first group, which used administrative data, odds ratios (ORs) for African-American patients compared with white patients ranged from 0.41 to 0.94 for cardiac catheterization, from 0.32 to 0.80 for PTCA, and from 0.23 to 0.68 for CABG. Procedure rates were also lower for Hispanic and Asian patients. In the second group, which used detailed clinical data, African-American patients remained disproportionately less likely to receive cardiac catheterization (OR, 0.03 to 0.85), PTCA (OR, 0.20 to 0.87), and CABG (OR, 0.22 to 0.68). A few studies noted that Hispanic and Asian patients were also disproportionately less likely to receive such procedures. The third group used survey methods but found conflicting results regarding patient refusals as a source of racial variation. Less-educated patients and patients who were not as experienced with the procedure were more likely to decline PTCA. Physician bias was also associated with racial variation in recommendations for treatment. Conclusions: Racial differences in invasive cardiac procedure use were found even after adjustment for disease severity. Future studies should comprehensively and simultaneously examine the full range of patient, physician, and health care system variables related to racial differences in the provision of invasive cardiac procedures.
Kinematic models cannot provide insight into motor control
Authors: Arnold B. Mitnitski
Journal: Behavioral and Brain Sciences (1997)

In Plamondon &amp; Alimi's target article, a bell-shaped velocity profile typically observed in fast movements is used as a basis for the “kinematic theory” of motor control. In our opinion, kinematics is a necessary but insufficient ground for a theory of motor control. Relationships between different kinematic characteristics are an emergent property of the system dynamics controlled by the brain in a specific way. In particular, bell-shaped velocity profiles with or without additional waves are a trivial consequence of shifts in the equilibrium state of the system as suggested, for example, in the λ-model of motor control.
Severe Hemoptysis During Pregnancy Treated by Mitral Commissurotomy
Authors: WILLIAM F. M. FULTON, GEORGE SMITH
Journal: Circulation (1958)

Pulmonary bleeding in mitral stenosis is not commonly regarded as an indication for operation. A case is reported in which mitral commissurotomy was performed during pregnancy primarily because of recurrent profuse hemoptysis. Some relevant points are briefly discussed.
GOSPEL: A Neuroprotective Protein that Binds to GAPDH upon S-Nitrosylation
Authors: Nilkantha Sen, Makoto R. Hara, Abdullah Shafique Ahmad, Matthew B. Cascio, Atsushi Kamiya, Jeffrey T. Ehmsen, Nishant Aggrawal, Lynda Hester, Sylvain Doré, Solomon H. Snyder, Akira Sawa
Journal: Neuron (2009)