tbuckley/cabot-search huggingface dataset:
Talking Medicine: America's Doctors Tell Their Stories
Authors: Harriet S. Meyer
Journal: JAMA (1981)

Twenty-two physicians and four medical students speak freely about their involvement in medicine in the pages of<i>Talking Medicine</i>, a collection of interviews by a third-year medical student. One virtue of the book is a laying-out of the transition through medical school and training to full-fledged practitioner, though the transition remains enigmatic. Another virtue is the balance of subjects, whose interviews are grouped according to "Education," "Training," "Practicing," "Researchers," "Personal Lives," and "The Big Picture." Interviewees include William Foege, Benjamin Spock, and Robert Hunter, and, under pseudonyms, a women's health physician, a surgeon (who discusses finances), a general practitioner, and a physician who has chosen to leave the country. The author's preface, conclusion, and introductions to each interview, and his balance in reporting his own observations and letting his subjects speak for themselves, make this an integrated work. He suggests that it will interest the person contemplating
A Controlled Study of Recombinant Human Granulocyte Colony-Stimulating Factor in Elderly Patients after Treatment for Acute Myelogenous Leukemia
Authors: Hervé Dombret, Claude Chastang, Pierre Fenaux, Josy Reiffers, Dominique Bordessoule, Réda Bouabdallah, Franco Mandelli, Augustin Ferrant, Gilles Auzanneau, Hervé Tilly, Antoine Yver, Laurent Degos
Journal: New England Journal of Medicine (1995)

Intensive chemotherapy for acute myelogenous leukemia (AML) continues to yield low rates of complete remission and survival among patients over the age of 65 years. Infection-related mortality is particularly high among these patients during the period of neutropenia that follows chemotherapy. We determined the effect of lenograstim (glycosylated recombinant human granulocyte colony-stimulating factor) on mortality at eight weeks (the main end point) and the rate of complete remission among patients with AML who were 65 years old or older.
NHS has no way of knowing if it is on track to meet financial targets, expert says
Authors: N. Hawkes
Journal: BMJ (2011)

The NHS faces a hard road to meet its financial targets, with no clear signposts to guide it or milestones by which to measure its progress, a breakfast meeting at the health policy think tank the King’s Fund in London was told on 18 October.

Although the NHS is spared the deep cuts faced by other government departments, zero growth in cash terms translates into budget reductions in real terms, meaning that the same job will need to be done on £20bn (€23bn; $32bn) less over four years. But a lack of accessible measures makes it impossible to say whether this process is on track, said the King’s Fund’s chief economist, John Appleby.

“The Department of Health’s public relations for the productivity drive has been …
A Randomised Controlled Trial to Evaluate the Effects of Flumazenil after Midazolam Premedication in Outpatients Undergoing Colonoscopy
Authors: M. Saletin, H. Malchow, H. Mühlhofer, M. Fischer, J. Pilot, H. Rohde
Journal: Endoscopy (1991)

The degree of sedation and amnesia, subjective assessment of awakening and side effects after intravenous injection of 3-4 mg midazolam and 1 mg flumazenil or placebo were studied directly after colonoscopy, and on the first and the eight day. A total of 91 patients were studied; 45 patients were given flumazenil and 46 patients a placebo. Five minutes after injection of the test drugs all 45 patients given flumazenil but only 38 patients given the placebo were alert (p = 0.006). All three response criteria (for sedation, amnesia and subjective assessment of awakening) were fulfilled by 84.4 % of the patients given flumazenil and 45.7 % of the patients given the placebo (p = 0.0002). Thirty minutes after injection of the test drugs dizziness, nausea, and fatigue were found in 3 patients given flumazenil and in 10 patients given placebo. One day after colonoscopy 9 of 45 patients (20 %) given midazolam and flumazenil complained of fatigue and 9 of 46 patients (19.5 %) given midazolam and placebo. Eight days (± 1 day) later two patients in each group complained of headache, nausea and fatigue. No patient developed phlebitis at the injection site. Flumazenil seems to be a safe and efficient drug for reversing the sedative effect of midazolam, premedication after colonoscopy. However, resedation due to the effects of midazolam may occur. Flumazenil thus permits administration of a higher dose of midazolam without prolongation of the surveillance time. Improved exploitation of time, space and nursing resources is thus possible without jeopardizing patient safety, although caution is necessary since patients may not be fit to resume all normal activities.
Kussmaul's Sign
Authors: André M Mansoor, Sudhakar P Karlapudi
Journal: New England Journal of Medicine (2015)

A 55-year-old woman with a remote history of Hodgkin's lymphoma was admitted with subacute, progressive dyspnea on exertion. Distention of the jugular veins and elevation of jugular venous pressure during inspiration were observed and are shown in a video.
Abstract LB-216: Integrated analysis of differential pathway resiliency in response to MAPK inhibition in BRAF-mutant cancer
Authors: Martin L. Sos, Rebecca Levin, John Gordan, Juan Oses-Prieto, James Webber, Megan Salt, Byron Hann, Alma Burlingame, Frank Mccormick, Sourav Bandyopadhyay, Kevan Shokat
Journal: Cancer Research (2014)

Abstract Despite the development of potent RAF-MAPK pathway inhibitors, only a fraction of BRAF-mutant patients responds to the treatment with these drugs. Here, we applied a combined chemo-genomics and chemo-proteomics approach to gain insights into the dynamics of primary resistance signaling and to define novel cancer vulnerabilities in these tumors. These analyses uncovered differential pathway resiliency in response to MAPK inhibition in BRAF-mutant cancer cells. Using forward- and reverse-genetics we identify the assembly of RAS/RAF/MEK complexes as a critical force to override RAF-MAPK pathway inhibitor efficacy. Mapping of global phosphorylation dynamics using orthogonal mass-spectrometry based methods revealed multi-layered MAPK pathway feedback-loop release that feeds into MAPK-pathway hyperactivation. The phosphoprotein nuclear interacting partner of ALK (NIPA) identified in the phosphoproteome screen is critical for maintenance of the primary resistance phenotype. Overall, our data provide a kinome- and phosphoproteome-wide view of the adaptive process of primary resistance to MAPK inhibitors in BRAF-mutant tumors and reveals translatable strategies toward improvement of the efficacy of individualized therapies in these patients. Citation Format: Martin L. Sos, Rebecca Levin, John Gordan, Juan Oses-Prieto, James Webber, Megan Salt, Byron Hann, Alma Burlingame, Frank Mccormick, Sourav Bandyopadhyay, Kevan Shokat. Integrated analysis of differential pathway resiliency in response to MAPK inhibition in BRAF-mutant cancer. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr LB-216. doi:10.1158/1538-7445.AM2014-LB-216
Single F-18 Fluorodeoxyglucose Positron Emission Tomography Hypermetabolic Focus Containing Metastatic Papillary Thyroid Cancer Within a Primary Scarring Adenocarcinoma Lung Cancer
Authors: Kevin J. Roscoe, Shankar Raja, Bruce Tronic, Yamin Dou
Journal: Clinical Nuclear Medicine (2006)

A 64-year-old woman presented with hoarseness, and her workup revealed an RUL mass. FDG PET revealed a corresponding single hypermetabolic focus in the RUL with additional thyroid-hypermetabolic focus. The RUL mass resection revealed a primary lung, moderately differentiated scarring adenocarcinoma. Contained within the RUL mass were multiple foci of metastatic papillary thyroid carcinoma. Subsequent thyroid resection revealed papillary thyroid carcinoma of identical histology. This is a rare report of a single positive FDG PET focus containing metastatic papillary thyroid within a primary lung cancer. This case highlights the necessity of histologic confirmation of FDG PET-positive lesions in subsequent patient management.
Treatment of Peripheral Arterial Disease — Extending “Intervention” to “Therapeutic Choice”
Authors: Alan T. Hirsch
Journal: New England Journal of Medicine (2006)

Lower-extremity peripheral arterial disease is an important manifestation of systemic atherosclerosis that is associated with markedly increased rates of cardiovascular ischemic events and death.1 Although most patients with peripheral arterial disease are asymptomatic, many have claudication, chronic critical limb ischemia, or acute limb ischemia. As a result, peripheral arterial disease considerably impairs functional status and the quality of life, and it is the most important cause of limb amputation. These effects are magnified by the high prevalence of peripheral arterial disease and the lack of provision of timely care.2 The recognition that standards of care for patients with peripheral arterial . . .
Bayesian transcriptome assembly
Authors: Lasse Maretty, Jonas Andreas Sibbesen, Anders Krogh
Journal: Genome biology (2014)

RNA sequencing allows for simultaneous transcript discovery and quantification, but reconstructing complete transcripts from such data remains difficult. Here, we introduce Bayesembler, a novel probabilistic method for transcriptome assembly built on a Bayesian model of the RNA sequencing process. Under this model, samples from the posterior distribution over transcripts and their abundance values are obtained using Gibbs sampling. By using the frequency at which transcripts are observed during sampling to select the final assembly, we demonstrate marked improvements in sensitivity and precision over state-of-the-art assemblers on both simulated and real data. Bayesembler is available at https://github.com/bioinformatics-centre/bayesembler .
The Engle verdicts and tobacco litigation
Authors: R. A Daynard
Journal: BMJ (2000)

Education and debate p 366 

It may be portentous that the $145bn in punitive damage verdicts against the American cigarette manufacturers were handed down by the jury in the Engle class action on 14 July. 1 2 The industry's lawyers alternatively characterised the verdicts as a mortal threat to the industry or as a legal chimera, certain to evaporate when tested on appeal. We will not know whether these verdicts were the tobacco industry's death knell until the Florida Supreme Court rules, perhaps two years from now.

The punitive awards for damages were actually the third round of verdicts that the Engle jury lobbed at the tobacco industry. A year earlier the jury found that cigarette smoking caused 20 diseases, and that the five cigarette manufacturer defendants, individually and in conspiracy with each other and two trade groups they had created, committed a variety of torts including fraud and fraudulent concealment. Then, in April 2000 the …
Cancer mortality in England and Wales varies with country of birth
Authors: Roger Dobson
Journal: BMJ (2006)

Death rates from cancer vary widely in England and Wales according to people's country of birth, a new study shows. It shows that people who were born in Ireland and Scotland have a higher mortality from cancer than the population as a whole, people born in West Africa and the West Indies have a lower mortality from lung cancer, and West African men have a higher mortality from prostate cancer. …
Assessing Clinical Instability at Discharge The Clinician's Responsibility
Authors: Robert H. Brook
Journal: JAMA (1992)

A great deal of attention has been given to what should be hospital policies when a patient is admitted to the hospital. Who should see the patient? At what time after admission? What should constitute an admission history and physical? Very little attention, however, has been paid to determining when it is safe to send a patient home from the hospital. In addition, precious few randomized trials have been performed that use clinical criteria to compare outcomes following discharge for those people who had the customary length of stay vs a medically correct length of stay. 1,2   A little over a year ago, we wrote a series of articles 3-10 about the impact of diagnosis related group (DRG)—based prospective payment on quality of care for Medicare patients hospitalized with one of five conditions: congestive heart failure, acute myocardial infarction, pneumonia, cerebrovascular accident, and hip fracture. Our data source was a
Enhanced Paracrine FGF10 Expression Promotes Formation of Multifocal Prostate Adenocarcinoma and an Increase in Epithelial Androgen Receptor
Authors: Sanaz Memarzadeh, Li Xin, David J. Mulholland, Alka Mansukhani, Hong Wu, Michael A. Teitell, Owen N. Witte
Journal: Cancer Cell (2007)
Cizolirtine Citrate, an Effective Treatment for Symptomatic Patients with Urinary Incontinence Secondary to Overactive Bladder: A Pilot Dose-Finding Study
Authors: Roberto Martínez-García, Montserrat Abadías, Pere Arañó, Lorenzo Perales, José Luis Ruíz, Mariano Sust, Juan Conejero
Journal: European Urology (2008)
A1.33 Predicting the evolution of inflammatory arthritis in ACPA-positive individuals: can T-cell subsets help?:
Authors: EMA Hensor, L Hunt, R Parmar, A Burska, P Emery, F Ponchel
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background and Objectives</h3> ACPA+ individuals with non-specific musculoskeletal symptoms are at high risk of developing rheumatoid arthritis (RA). We previously demonstrated dys-regulation of T-cell subsets with loss of naïve and regulatory T-cells (Treg) in early disease. The aim of the current study is to demonstrate the predictive value of T-cell subset analysis for progression towards symptom onset in ACPA+ individuals. <h3>Materials and Methods</h3> 84 ACPA+ individuals without clinical synovitis at recruitment were followed. 95 healthy controls (HC) provided a reference group. At baseline T-cell subset analyses were performed using 6-colour flowcytometry for naïve T-cells (CD4+ CD45RB + CD45RA+ CD62L+), Treg (CD4+ CD25<sup>high</sup>Foxp3 + CD127<sup>low</sup>) and inflammation related cells (IRC: CD4+ CD45RB + CD45RA+ CD62L-). The relationship between naïve cell frequency and age was established in HC and used to age-correct values in ACPA+ . ROC curve analysis was used to identify 2 T-cell cut-offs predicting progression to IA at any time; one which maximised the Youden index (sensitivity + specificity-1), and one which prioritised specificity over sensitivity. <h3>Results</h3> 42/84 (50%) of patients developed clinical synovitis within a median follow-up of 6.0 months (range 1 week-46 months). For age-corrected naïve T-cells area under the ROC curve (AUC) was 0.67 (95% CI 0.55, 0.79; n = 84, p = 0.007), for IRC 0.70 (0.59, 0.81; n = 81, p = 0.002) and for Treg 0.67 (0.53, 0.80; n = 65, p = 0.021). For each of the three subsets, the Youden index cut-off correctly classified &gt;65% of patients (Table 1). Cut-offs prioritising specificity were identified which did not greatly reduce overall classification success. The confidence intervals for these estimates remain wide and our sample size may still be limited for running such analysis. <h3>Abstract A1.33 Table 1 Sensitivity and specificity of T-cell subset frequencies for progression to IA, using two different cut-off values for each subset; one where the Youden index was maximised and another that prioritised specificity over sensitivity.</h3> <h3>Conclusions</h3> T-cell dys-regulation in ACPA+ individuals with non-specific musculoskeletal pain may be useful in predicting progression to inflammatory arthritis. Multivariable modelling in larger cohorts is needed to quantify the utility of T-cell subsets in predicting progression to IA.
The Psychoanalytic Study of Society
Authors: Emmett Wilson
Journal: JAMA (1972)

This volume continues the important series of studies on the nonclinical applications of psychoanalysis. The articles vary widely in quality and level of sophistication, and show a varying degree of understanding of the methodological issues involved in widening the scope of psychoanalysis. L. Bryce Boyer and Ruth Boyer have contributed an excellent study of aggression among the Apaches during the acculturation to contemporary society. There is a good study by Robert Levy on the personality factors integrated by the Tahitians into their moral system. Some of the authors, however, have difficulty in relating to their subjects. J. L. Titchener's "The Day of a Psychoanalyst at Woodstock" was a valuable chance for expert reportage; unfortunately the young seem more alien to him than aboriginal tribesmen, and his work is devoid of genuine understanding or empathy. The opposite extreme of overinvolvement is shown in Dale Meer's "Sexual Identity in the Ghetto." He
Pancreatitis—Intrapancreatic Proteolytic Trypsin Activity
Authors: Gordon McHardy, Claude C. Craighead, Louis Balart, Harold Cradic, Clinton LaGrange
Journal: JAMA (1963)

THE PATHOGENESIS of pancreatitis is not clearly defined. Intrapancreatic conversion of trypsinogen to trypsin is the most important, if not the sole, cause of this catastrophic illness.<sup>1-3</sup>Therapeutic limitation and a high case fatality rate warrant our revaluation of experimentally induced pancreatitis, as modified by a trypsin inhibitor, in an effort to establish its possible specificity in the management of pancreatitis in humans. The first objective was the confirmatory reproduction of acute pancreatitis through three successive events, creating intrapancreatic proteolytic trypsin activity<sup>1,2</sup>: (1) Entry of pancreatic secretion into the biliary tree by mixture of 1.35 gm of ox blood extract (Bilein) with 160,000 units of trypsin crystallized (Tryptar) (saline added); (2) Simulation of stasis in biliary system by incubation of mixture at 37 C (98.6 F) for 24 hr; and (3) Infusion of obstructed pancreatic duct with incubated material (20 cc) at low pressure (40 cm). The
Islet-Cell-Surface Antibodies in Juvenile Diabetes Mellitus
Authors: Åke Lernmark, Zachary R. Freedman, Cecilia Hofmann, Arthur H. Rubenstein, Donald F. Steiner, Robert L. Jackson, Robert J. Winter, Howard S. Traisman
Journal: New England Journal of Medicine (1978)

Using an indirect immunofluorescence test on suspensions of viable, insulin-producing islet cells from rats, we found that 32 per cent (28/88) of insulin-treated patients with juvenile diabetes have islet-cell-surface antibodies in their circulation. These antibodies also occurred in four of nine children with glucose intolerance, in one of 24 healthy children and in nondiabetic children with thyroid disorders. In the diabetic children, the immunofluorescent reaction was inhibited by preadsorption of serum to islet cells but was little affected by preadsorption to rat hepatocytes or erythrocytes or to acetone powders of various rat tissues, including pancreas. These results show that organ-specific, nonspecies-specific antibodies reactive with the cell surface of the islet cells can be present in serum from diabetic children, and provide an approach to investigation of immunopathological aspects of diabetes mellitus.
Impact of microenvironment and stem-like plasticity in cholangiocarcinoma: Molecular networks and biological concepts
Authors: Chiara Raggi, Pietro Invernizzi, Jesper B. Andersen
Journal: Journal of Hepatology (2014)

Clinical complexity, anatomic diversity and molecular heterogeneity of cholangiocarcinoma (CCA) represent a major challenge in the assessment of effective targeted therapies. Molecular and cellular mechanisms underlying the diversity of CCA growth patterns remain a key issue of clinical concern. Crucial questions comprise the nature of the CCA-origin, the initial target for cellular transformation as well as the relationship with the cancer stem cells (CSC) concept. Additionally, since CCA often develops in the context of an inflammatory milieu (cirrhosis and cholangitis), the stromal compartment or tumour microenvironment (TME) likely promotes initiation and progression of this malignancy, contributing to its heterogeneity.This review will emphasize the dynamic interplay between stem-like intrinsic and TME-extrinsic pathways, which may represent novel options for multi-targeted therapies in CCA.
Physiologic Support of Heart Action
Authors: Harry S. Soroff, Fabio Giron, Ulises Ruiz, William C. Birtwell, Leroy J. Hirsch, Ralph A. Deterling
Journal: New England Journal of Medicine (1969)

DURING the past decade there has been increasing interest in methods of assisting the circulation of patients in circulatory failure. This review traces the development of synchronous types of circulatory assist and, in the last section, reports the progress to date in cardiac pacing by bigeminal electrical stimulation.Approaches to assisting the circulation fall into three major categories. In the first, the work of the heart is lessened by reduction of the amount of blood that the ventricle must eject (that is, the preload); this is referred to as shunt or flow assist because part of the circulation is diverted . . .
Role of intestinal epithelial cells in the host secretory response to infection by invasive bacteria. Bacterial entry induces epithelial prostaglandin h synthase-2 expression and prostaglandin E2 and F2alpha production.
Authors: L Eckmann, W F Stenson, T C Savidge, D C Lowe, K E Barrett, J Fierer, J R Smith, M F Kagnoff
Journal: Journal of Clinical Investigation (1997)

Increased intestinal fluid secretion is a protective host response after enteric infection with invasive bacteria that is initiated within hours after infection, and is mediated by prostaglandin H synthase (PGHS) products in animal models of infection. Intestinal epithelial cells are the first host cells to become infected with invasive bacteria, which enter and pass through these cells to initiate mucosal, and ultimately systemic, infection. The present studies characterized the role of intestinal epithelial cells in the host secretory response after infection with invasive bacteria. Infection of cultured human intestinal epithelial cell lines with invasive bacteria, but not noninvasive bacteria, is shown to induce the expression of one of the rate-limiting enzymes for prostaglandin formation, PGHS-2, and the production of PGE2 and PGF2alpha. Furthermore, increased PGHS-2 expression was observed in intestinal epithelial cells in vivo after infection with invasive bacteria, using a human intestinal xenograft model in SCID mice. In support of the physiologic importance of epithelial PGHS-2 expression, supernatants from bacteria-infected intestinal epithelial cells were shown to increase chloride secretion in an in vitro model using polarized epithelial cells, and this activity was accounted for by PGE2. These studies define a novel autocrine/paracrine function of mediators produced by intestinal epithelial cells in the rapid induction of increased fluid secretion in response to intestinal infection with invasive bacteria.