tbuckley/cabot-search huggingface dataset:
The “Difficult” Patient Reconceived: An Expanded Moral Mandate for Clinical Ethics
Authors: Autumn Fiester
Journal: The American Journal of Bioethics (2012)

Between 15 and 60% of patients are considered “difficult” by their treating physicians. Patient psychiatric pathology is the conventional explanation for why patients are deemed “difficult.” But the prevalence of the problem suggests the possibility of a less pathological cause. I argue that the phenomenon can be better explained as a response to problematic interactions related to health care delivery. If there are grounds to reconceive the “difficult” patient as reacting to the perception of ill treatment, then there is an ethical obligation to address this perception of harm. Resolution of such conflicts currently lies with the provider and patient. But the ethical stakes place these conflicts into the province of the ethics consult service. As the resource for addressing ethical dilemmas, there is a moral mandate to offer assistance in the resolution of these ethically charged conflicts that is no less pressing than the more familiar terrain of clinical ethics consultation.
Drug Therapy and Cancer Diagnosis
Authors: R. Walford
Journal: BMJ (1964)

Assuming we do not start from trap (3), the figures in the third column of the Table in the Minister's letter to Dr. Cameron (Supple- ment, 22 August, p. 121) do not matter.But, for my curiosity, how does 7s.9d. in the £1 on £200 become £30 ?Even at the lowest rate it is £40.
Assessment of portal hypertension by transient elastography in patients with compensated cirrhosis and potentially resectable liver tumors
Authors: Elba Llop, Annalisa Berzigotti, Maria Reig, Eva Erice, Enric Reverter, Susana Seijo, Juan G. Abraldes, Jordi Bruix, Jaime Bosch, Juan Carlos García-Pagan
Journal: Journal of Hepatology (2011)
Regular review: Managing testicular cancer
Authors: D. Dearnaley
Journal: BMJ (2001)

Germ cell tumours of the testis are the commonest malignancy in men aged 20–40 years. Considerable therapeutic improvements in management—based on the cancer's responsiveness to chemotherapy that contains platinum — mean that over 95% of these patients can now expect to be cured.

#### Summary points

Testicular cancer is the most common cancer in younger men

The incidence has been increasing by 15-20% in successive five year periods

Clinical trials organised by the UK's Medical Research Council and other international groups have defined modern clinical practice

Cure rates of >95% can be achieved

Advanced and recurrent cancers should be treated by multidisciplinary teams in specialist centres

Much of the clinical management discussed in this review is based on the guidelines of the UK's Clinical Oncology Information Network, which were developed with the Scottish Intercollegiate Guidelines Network.1 These were based on a systematic review of clinical data including prospective phase III randomised trials performed internationally. The sections that discuss causes, follow up, and future developments reflect our research interests and personal experience.

### Testicular germ cell tumours

Testicular germ cell tumours are uncommon cancers; they account for around 1% of all cancers in males. About 1400 new cases are diagnosed in the United Kingdom each year. Germ cell tumours have a unique epidemiological profile for a solid tumour. Their peak incidence occurs among men aged 25–35 years, and there is a distinctive geographical and racial variation. The highest incidence is among white men in northern Europe.

These factors suggest that both genetic and environmental factors are important in the development of testicular germ cell tumours. The age distribution at onset suggests that an initiating event occurs prenatally and that the tumour develops from adolescence. The overall incidence of testicular germ cell tumours has been steadily rising throughout the 20th century, with an increase of 15-20% being seen in …
BASSINI'S OPERATION FOR RADICAL CURE OF HERNIA; SEVEN SUCCESSFUL CASES.
Authors: G. M. WOODS
Journal: JAMA (1900)

Ever since my association with the United States Navy, and especially my connection with its hospital practice, I have been impressed with the necessity of an operation which should be a radical cure for hernia, it being the opprobrium of both the army and navy medical service that so many enlisted men of both are discharged with this disability without any attempt at cure, due to the fact that the men decline operation —which they are permitted to do—because their attending surgeon could not promise them a cure, himself firmly believing that no operation could be performed which would ensure perfect ability to do duty. This has been the history of most cases in my operative experience of an earlier date, in which the operations of Wood and Wiitzer were the rule, which I early instituted in hospitals under my charge. But with the introduction of the operation of Bassini,
Tsc2-Rheb signaling regulates EphA-mediated axon guidance
Authors: Duyu Nie, Alessia Di Nardo, Juliette M Han, Hasani Baharanyi, Ioannis Kramvis, ThanhThao Huynh, Sandra Dabora, Simone Codeluppi, Pier Paolo Pandolfi, Elena B Pasquale, Mustafa Sahin
Journal: Nature Neuroscience (2010)
1113-157 Real-time three-dimensional echocardiography for assessment of left ventricular function in children: A validation study compared with magnetic resonance imaging
Authors: Stephanie Munns, Liping Bu, Honghai Zhang, Michelle Disterhoft, Michael Dixon, Alan Stolpen, Milan Sonka, Larry Mahoney, Shuping Ge
Journal: Journal of the American College of Cardiology (2004)
Reviews and Notes: Spare Parts: Organ Replacement in American Society
Authors: George J. Annas
Journal: Annals of Internal Medicine (1994)

Literature of Medicine1 February 1994Reviews and Notes: Spare Parts: Organ Replacement in American SocietyGeorge J. AnnasGeorge J. AnnasBoston University Schools of Medicine and Public Health, Boston, MA 02118Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-3-199402010-00027 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Spare Parts: Organ Replacement in American SocietyRenee C. Fox and Judith P. Swazey. 254 pages. New York: Oxford University Press; 1992. $29.95.The history of organ transplantation is, to a large extent, a history of technical success and ethical failure. Transplantation of solid organs has impelled the development of new immunosuppressive drugs and methods and impressive organ procurement mechanisms. We have also developed new laws: the Uniform Definition of Death Act, the Uniform Anatomical Gift Act, and the End Stage Renal Disease Act. Yet, ethics and law have always been peripheral to organ transplantation, and experimentation in this area ... Author, Article, and Disclosure InformationAffiliations: Boston University Schools of Medicine and Public Health, Boston, MA 02118 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byClass and Ethnicity in the Global Market for Organs: The Case of Korean Cinema 1 February 1994Volume 120, Issue 3Page: 252KeywordsHeartImmunosuppressivesInstitutional review boardsLongitudinal studiesLungsMedical servicesOrgan transplantationPublic policyRenal failureTransplantation ePublished: 15 August 2000 Issue Published: 1 February 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Synchronized repolarization after defibrillation shocks. A possible component of the defibrillation process demonstrated by optical recordings in rabbit heart.
Authors: S M Dillon
Journal: Circulation (1992)

BACKGROUND It is currently believed that defibrillation shocks act primarily by stimulating excitable myocardium to abolish wave fronts. Recent studies have shown that shocks applied during pacing not only stimulate excitable myocardium but also prolong the depolarization and refractoriness of myocardium already in a depolarized state. This study investigates the effects of shocks on fibrillation action potentials. METHODS AND RESULTS Recordings of membrane action potentials free of shock artifact were obtained using the voltage-sensitive dye WW781 during defibrillation of isolated rabbit hearts. These records showed that the shocks caused an additional phase of depolarization beginning with an initial rapid depolarization of the optical signal followed by a slow phase of repolarization. This occurred throughout all phases of the fibrillation action potential from just after completion of the upstroke to a time of near maximal repolarization. Defibrillation shocks, however, had the additional effect of causing the myocardium to repolarize at a constant time after the shock regardless of its prior electrical activity--the constant repolarization time response. This effect was not dependent on the presence of D600 (methoxyverapamil) or continuous coronary perfusion. It was accompanied by a similar constancy in the return of myocardial excitability. Recordings taken from multiple adjacent recording sites also showed a constant repolarization time among them. CONCLUSIONS A simple model of reentry is used to illustrate how the constant repolarization response, in addition to wave front termination and refractoriness extension, could play a role in the successful termination of fibrillation by electrical shock.
Thymidine Kinase Suicide Gene-mediated Ganciclovir Ablation of Autologous Gene-modified Rhesus Hematopoiesis
Authors: Cecilia N Barese, Allen E Krouse, Mark E Metzger, Connor A King, Catia Traversari, Frank C Marini, Robert E Donahue, Cynthia E Dunbar
Journal: Molecular Therapy (2012)

Despite the genotoxic complications encountered in clinical gene therapy trials for primary immunodeficiency diseases targeting hematopoietic cells with integrating vectors; this strategy holds promise for the cure of several monogenic blood, metabolic and neurodegenerative diseases. In this study, we asked whether the inclusion of a suicide gene in a standard retrovirus vector would allow elimination of vector-containing stem and progenitor cells and their progeny in vivo following transplantation, using our rhesus macaque transplantation model. Following stable engraftment with autologous CD34(+) cells transduced with a retrovirus vector encoding a highly sensitive modified Herpes simplex virus thymidine kinase SR39, the administration of the antiviral prodrug ganciclovir (GCV) was effective in completely eliminating vector-containing cells in all hematopoietic lineages in vivo. The sustained absence of vector-containing cells over time, without additional GCV administration, suggests that the ablation of TkSR39 GCV-sensitive cells occurred in the most primitive hematopoietic long-term repopulating stem or progenitor cell compartment. These results are a proof-of-concept that the inclusion of a suicide gene in integrating vectors, in addition to a therapeutic gene, can provide a mechanism for later elimination of vector-containing cells, thereby increasing the safety of gene transfer.
An ethically defensible market in organs
Authors: J. Harris
Journal: BMJ (2002)

The American Medical Association has just voted to encourage studies that would determine whether financial incentives would increase the pool of donor organs from cadavers.1 The association is only eight years behind a proposal that we made, outlining probably the only circumstances in which a market in donor organs could be achieved ethically and in a way that minimised the dangers of such a scheme. This is how an ethical market in live organs would work.

To meet legitimate ethical and regulatory concerns any such scheme must have built into it safeguards against wrongful exploitation and show concern for vulnerable people, as well as taking into account considerations of justice and equity. If all this can be done then a market in human body products will be shown to be, at the very least, not prima facie unethical.2

One way of attending to this need for prudent regulation would be to establish a monopsony, a situation where only one buyer exists for the products of several sellers.3 The one legitimate purchaser in the marketplace would be required to take on responsibility for ensuring equitable distribution of all organs and tissues purchased. This would prevent the rich using their purchasing power to exploit …
Narrative Exposure Therapy versus Interpersonal Psychotherapy
Authors: Susanne Schaal, Thomas Elbert, Frank Neuner
Journal: Psychotherapy and Psychosomatics (2009)

&lt;i&gt;Background:&lt;/i&gt; The aim of the present study was to evaluate the efficacy of treatment modules for trauma spectrum disorders in a sample of Rwandan genocide orphans. &lt;i&gt;Methods:&lt;/i&gt; Twenty-six orphans (originally 27) who presented with posttraumatic stress disorder (PTSD) at first assessment continued to meet a PTSD DSM-IV diagnosis 6 months after their initial assessment. They were offered participation in a controlled treatment trial. A group adaptation of interpersonal psychotherapy (IPT, n = 14) was compared to individual narrative exposure therapy (NET, n = 12). The last NET session involved guided mourning. Each treatment program consisted of 4 weekly sessions. Main outcome measures were diagnostic status and symptoms of PTSD and depression assessed before treatment, at 3 months post-test and at 6 months follow-up using the Clinician-Administered PTSD Scale, Mini-International Neuropsychiatric Interview, and Hamilton Rating Scale. &lt;i&gt;Results:&lt;/i&gt; At post-test, there were no significant group differences between NET and IPT on any of the examined outcome measures. At 6-month follow-up, only 25% of NET, but 71% of IPT participants still fulfilled PTSD criteria. There was a significant time × treatment interaction in the severity of PTSD [Wilks’ Λ = 0.75, F(2,23) = 3.93; p &lt; 0.05] and depression symptoms [Wilks’ Λ = 0.23, F(2,23) = 3.40; p = 0.05]. At follow-up, NET participants were significantly more improved than IPT participants with respect to both the severity of symptoms of PTSD and depression. &lt;i&gt;Conclusions:&lt;/i&gt; Individual NET in combination with group-based mourning comprises an effective treatment for traumatized survivors who have to bear the loss of loved ones and have been suffering from symptoms of PTSD and depression.
OBSERVATIONS ON THE IRIS IN HEALTH AND DISEASE AS SEEN WITH THE SLIT LAMP
Authors: ARTHUR J. BEDELL
Journal: JAMA (1922)

This communication is based on the result of more than 250 examinations, including iridodialysis, iritis, uveitis, kerato-iritis, iridocyclitis, interstitial keratitis, glaucoma of all forms and cataract of many types. The usual routine has been followed with the slit lamp, using binocular 75 and ocular 33. Special studies have been made at greater magnification.  To present some new facts and emphasize the importance of this examination, it has seemed best to review part of our present knowledge regarding iris anatomy, and then to discuss embryologic remnants and pathologic changes.  An examination of the iris with oblique illumination will materially aid in understanding the usual contour and some of the common color arrangement. The microscopic section shows the zone about the pupil, which is usually a dense brown. There is a distinct bulge back of this margin which we call the spongy portion of the iris, and the most prominent part of
2,4-Dinitrophenol induced outward current
Authors: M. W Veldkamp, A. C G Van Ginneken
Journal: Cardiovascular Research (1992)

Journal Article 2,4-Dinitrophenol induced outward current Get access Marieke W Veldkamp, Marieke W Veldkamp Department of Physiology, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands Search for other works by this author on: Oxford Academic PubMed Google Scholar Antoni C G Van Ginneken Antoni C G Van Ginneken Department of Physiology, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 26, Issue 11, November 1992, Pages 1157–1158, https://doi.org/10.1093/cvr/26.11.1157 Published: 01 November 1992
Development of bronchial hyperreactivity following transient absence of salivary IgA.
Authors: M Gleeson, R L Clancy, M J Hensley, A W Cripps, R L Henry, J H Wlodarczyk, P G Gibson
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

In a birth cohort of 114 normal children, this study examined the hypothesis that a transient absence of salivary IgA in the first year of life was associated with an increased risk of developing atopy, asthma, or bronchial hyperreactivity (BHR) later in life. Episodes of transient absence of IgA in saliva, of less than 1 mo, occurred in 18% of the study population in the first year of life. The children were assessed at age 7.5 to 12 yr for the presence of atopy (skin prick test to inhaled allergens), asthma (wheeze in the previous 12 mo), and BHR (histamine provocation). The transient absence of salivary IgA in the first year of life was associated with an increased risk of BHR (adjusted odds ratio [Adj OR]: 11.6; 95% confidence interval [CI]: 2.2 to 60.9) and a trend toward a lowered risk of atopy to inhaled allergens (raw OR: 0.35; CI: 0.11 to 1.11). There was no relationship between the transient absence of salivary IgA and a clinical diagnosis of asthma (Adj OR: 0.9; CI: 0.2 to 3.6). The inconsistency in the relationships between the transient absence of salivary IgA and atopy, asthma, and BHR supports the concept that atopy, wheeze, and bronchial hyperreactivity are independent clinical outcomes. One possible explanation for the relationships observed in this study is that the transient absence of IgA in saliva in the first year of life identifies a cohort with mucosal hypoimmunity. These subjects are thus less likely to develop atopy and less able to effectively respond to a mucosal infection. Presentation of a mucosal antigen in these subjects may subsequently be associated with an inappropriate inflammatory response, which conditions bronchial hyperreactivity, and which is independent of atopy.
Cutaneous Manifestations of the Reticuloendothelial Granulomas
Authors: Adolph Rostenberg
Journal: JAMA (1961)

This book is one of a series edited by Dr. Bluefarb on the disorders of the lymphoreticular system. The present work consists of monographs on lipoidoses by Dr. Frederick Urbach, systemic reticuloendothelial granulomas by Dr. Bluefarb, sarcoidosis by Dr. Israel and co-workers, and mastocytosis by Drs. Segher and Even-Paz. Each monograph deals exhaustively with all aspects of the topic in question. In the monograph on lipoidoses there is a reasonable discussion of the chemistry of various lipids and the physiology of their metabolism, and in the discussion on mastocytosis there is much information about the physiology of the mast cell and the technics for staining it. The emphasis in each monograph is on the clinical manifestations and possible therapeutic approaches. Each of the sections concludes with a lengthy bibliography. A number of useful tables listing differential diagnostic points and other salient information about the conditions are included. There are also
Injuries From Fireworks-Reply
Authors: John M. Kobayashi
Journal: JAMA (1985)

<h3>In Reply.—</h3> We would like to address four points Mr Haarmann raised about our study of fireworks-related injuries. First, we did not conclude that "<i>all</i>fireworks are dangerous." In fact, we demonstrated that although 36% of injuries identified by active surveillance were caused by ground-display devices, the high proportion reflected device popularity, and not an increased risk of injury associated with use (odds ratio [OR], 0.9). However, firecrackers and aerial devices were associated with an elevated risk of injury above and beyond their popularity (OR, 3.3 and 2.9, respectively). Second, circumstances at the time of injury were not substantially different for devices that were legal or illegal under federal law. Of 66 injuries associated with legal devices, 62% were attributable to misuse, 17% to malfunction, and 21% to other circumstances. Of 22 injuries associated with illegal devices, 82% were attributable to misuse, 9% to malfunction, and 9% to other circumstances.
Pathophysiology and clinical significance of atherosclerotic plaque rupture
Authors: D Gutstein
Journal: Cardiovascular Research (1999)

Atherosclerotic plaque rupture and resulting intracoronary thrombosis are thought to account for most acute coronary syndromes. These syndromes include unstable angina, non-Q-wave myocardial infarction (MI) and Q-wave MI. In addition, many cases of sudden cardiac death may be attributable to atherosclerotic plaque disruption and its immediate complications. Our understanding of the atherosclerotic process and the pathophysiology of plaque disruption has advanced remarkably. Despite these advances, event rates after acute coronary syndromes remain unacceptably high. This review will focus on the pathophysiology underlying atherosclerotic plaque development, the sequellae of coronary plaque rupture, and current therapies designed to treat the acute coronary syndromes. It is hoped that as our understanding of the atherosclerotic plaque improves, treatment strategies for the acute coronary syndromes will advance.
Abstract 523: Detection of PIWI-piRNAS in the mitochondria of human normal and cancer cells
Authors: ChangHyuk Kwon, Hyosun Tak, Mina Rho, Hae Ryung Chang, Yon Hui Km, Kyung Tae Kim, Eun Kyung Lee, Curt Balch, Seungyoon Nam
Journal: Cancer Research (2014)

Abstract Piwi-interacting RNAs (piRNAs) are a class of small non-coding RNAs that regulate differentiation in primordial germ cells, found mainly in the nucleus and cytoplasm. However, despite the essentiality of mitochondria to intrinsic apoptosis and energy metabolism, the presence of piRNAs (and their associated Piwi proteins) in this organelle remains largely unknown. In this study, a public database comparison of mitochondrial RNA-seq data from human normal (HEK293) and cancer (HeLa and 143B) cells revealed the presence of 29 mature piRNA sequences, with 12 of those piRNA sequences perfectly matching 7 tRNAs (Phe, Val, Leu, His, Ser, Glu, and Thr), suggesting piRNAs and tRNAs derive from a common precursor mitochondrial polycistronic transcript. Consistent with their known interaction with piRNAs, further examination revealed the presence of PIWI proteins in mitochondria. Moreover, the majority of the 29 piRNA sequences overlapped multiple longer sequences (expressed sequence tags, ESTs) that uniquely mapped to the mitochondrial genome. To our knowledge, this is the first report of Piwi and piRNAs in the mitochondria of mammalian normal and cancer cells. Citation Format: ChangHyuk Kwon, Hyosun Tak, Mina Rho, Hae Ryung Chang, Yon Hui Km, Kyung Tae Kim, Eun Kyung Lee, Curt Balch, Seungyoon Nam. Detection of PIWI-piRNAS in the mitochondria of human normal and cancer cells. [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 523. doi:10.1158/1538-7445.AM2014-523
[474] FACTORS ASSOCIATED WITH SEROCLEARANCE OF HEPATITIS B e ANTIGEN: A LONG-TERM FOLLOW-UP STUDY
Authors: C.A. Chen, P.J. Chen, H.I. Yang, U.H. Iloeje, J. Su, C.L. Jen, S.H. Yeh, S.N. Lu, S.L. You, C.J. Chen
Journal: Journal of Hepatology (2007)