tbuckley/cabot-search huggingface dataset:
Attitudes to chemotherapy: comparing views of patients with cancer with those of doctors, nurses, and general public.
Authors: M L Slevin, L Stubbs, H J Plant, P Wilson, W M Gregory, P J Armes, S M Downer
Journal: BMJ (1990)

OBJECTIVE--To compare responses of patients with cancer with those of a matched control group, cancer specialists, general practitioners, and cancer nurses in assessing personal cost-benefit of chemotherapy. DESIGN--Prospective study of consecutively recruited patients with cancer and other groups by questionnaire; half of the patients received the questionnaire again three months after starting treatment. SETTING--A medical oncology ward of a London teaching hospital. SUBJECTS--106 Patients with newly diagnosed solid tumours referred to the unit for consideration of treatment with cytotoxic chemotherapy, 100 of whom were able to complete the questionnaire. 100 Matched controls, 315 cancer doctors (238 radiotherapists and 77 medical oncologists), 1500 randomly chosen general practitioners, and 1000 randomly chosen cancer nurses. MAIN OUTCOME MEASURES--Percentage chance of cure, prolonging life, or palliation of symptoms required to make treatment worth while with two hypothetical chemotherapy treatments, with severe and mild side effects respectively. RESULTS--Respondents to the questionnaire comprised 100 patients, 100 controls, 60 (78%) medical oncologists, 88 (37%) radiotherapists, 790 (53%) general practitioners, and 303 (30%) cancer nurses. Most patients were willing to accept intensive chemotherapy for a very small chance of benefit. The median benefit required to make the hypothetical intensive treatments worth while for patients compared with controls were: for chance of a cure (range 1 to 100%) 1% v 50%, for prolonging life (range three months to five years) 12 months v 24-60 months, and for relief of symptoms (range 1 to 100%) 10% v 75% respectively. There were no significant differences in the responses of the 50 patients completing the questionnaire on a second occasion. Doctors and nurses were less likely to accept radical treatment for minimal benefit compared with the patients (median scores 10-50%, 12-24 months, and 50-75%, for chance of cure, prolonging life, and relief of symptoms respectively). Significantly more patients than controls accepted treatments giving the minimal benefit for each category (cure 53.1 v 19.0%, 67.0 v 35.0%; prolonging life 42.1 v 10.0%, 53.0 v 25.0%; relief of symptoms 42.6 v 10.0%, 58.7 v 19.0% for intensive and mild treatments respectively, p less than 0.001) as was the case for comparison of patients with other groups. CONCLUSION--Patients with cancer are much more likely to opt for radical treatment with minimal chance of benefit than people who do not have cancer, including medical and nursing professionals. This could be taken into account when discussing treatment options with patients and their relatives.
Variability in Response to Drugs
Authors: K. Heymann
Journal: BMJ (1974)

together with uterine contractions and signs of fetal irritability.Relief was achieved with a pethidine injection.The relationship of the heparin injection to the uterine contraction was noticed but we decided to continue the treatment.After the second dose of heparin six hours later the patient immediately had the same abdominal pain, which was again relieved by pethidine.At this point we became sure that the uterine contractions were due to the heparin injections.Heparin was stopped, no other anticoagulants were given, and the patient was treated conservatively.So far as we know no such reaction to heparin has been reported before.We thought of a small retroplacental haemorrhage due to heparin as a possible cause of pain, but the speed of the reaction and the relatively small dose of heparin and absence of complications afterwards made this un- likely.-Weare, etc.,
T lymphocytes involved in inhibition of granulopoiesis in two neutropenic patients are of the cytotoxic/suppressor (T3+T8+) subset.
Authors: G C Bagby
Journal: Journal of Clinical Investigation (1981)

T lymphocyte-mediated bone marrow failure is a recently recognized clinical disorder, but the T lymphocyte subsets responsible for mediating the inhibitory effect have not been identified. We obtained T lymphocytes from the bone marrow of two patients with T lymphocyte-mediated granulopoietic failure, exposed them to monoclonal antibodies (OKT3, OKT4, and OKT8) in cytotoxicity assays, then recombined the treated T cells with autologous T-depleted marrow cells in clonal assays for granulocyte/macrophage progenitors (CFU-GM). Treatment of T cells with OKT3 and OKT8 abrogated their granulopoietic inhibitory effect but treatment with OKT4 did not. Therefore, in these two patients, the lymphocytes that played a role in the inhibition of granulopoiesis were of the cytotoxic/suppressor subset.
Up-regulation of c-FLIPS+R upon CD40 stimulation is associated with inhibition of CD95-induced apoptosis in primary precursor B-ALL
Authors: Anja Troeger, Ingo Schmitz, Meinolf Siepermann, Ludmila Glouchkova, Ulrike Gerdemann, Gritta E. Janka-Schaub, Klaus Schulze-Osthoff, Dagmar Dilloo
Journal: Blood (2007)
The relationship between physicians' malpractice claims history and later claims
Authors: E. Frank
Journal: JAMA (1995)

To the Editor.  —Messrs Bovbjerg and Petronis 1 present a cogent actuarial analysis of the relationship between physicians'  claims history and subsequent claims. However, the most telling comment on the  fiasco is their assertion that malpractice claims remain relatively rare, a contention supported by the fact that during almost 9 years in continuous practice, 41% of the 8247 Florida physicians observed were targets of litigation. By whose standard is this rare?  This pronouncement on the rarity of  highlights the insensitivity of those outside the medical profession to the seriousness of lawsuits—the psychological toll they take on physicians, the erosion in a physician-patient relationship that they engender, and the tremendous costs in defensive medicine that they beget. Though lawsuits are not the focus of their article, the authors appear to trivialize them, especially those concluded without payment or with minimal outlay. This trivialization reflects either a callous indifference
Darwin's triumph: Explaining the uniqueness of the human mind without a<i>deus ex machina</i>
Authors: Derek C. Penn, Keith J. Holyoak, Daniel J. Povinelli
Journal: Behavioral and Brain Sciences (2008)

Abstract In our target article, we argued that there is a profound functional discontinuity between the cognitive abilities of modern humans and those of all other extant species. Unsurprisingly, our hypothesis elicited a wide range of responses from commentators. After responding to the commentaries, we conclude that our hypothesis lies closer to Darwin's views on the matter than to those of many of our contemporaries.
CONCORDANCE BETWEEN SPECKLE TRACKING ECHOCARDIOGRAPHY AND PHASE ANALYSIS OF MYOCARDIAL SPECT FOR LV SEGMENT OF LATEST MECHANICAL ACTIVATION
Authors: Hussein Abu Daya, Samir Saba, Serge Van Kriekinge, Didier Chalhoub, Guido Germano, Daniel Berman, John Gorcsan, Prem Soman
Journal: Journal of the American College of Cardiology (2015)
No need to stay in hospital after antibiotic switch in pneumonia
Authors: M Pagaria
Journal: Thorax (2006)

▴ Nathan RV, Rhew DC, Murray C, et al. In-hospital observation after antibiotic switch in pneumonia: a national evaluation. Am J Med2006;119:512–8[OpenUrl][1][CrossRef][2][PubMed][3] This was a multicentre retrospective analysis during one of two 6 month periods in 1998–9 which assessed the benefit of in-hospital observation after the switch from intravenous to oral antibiotics in patients … [1]: {openurl}?query=rft.jtitle%253DThe%2BAmerican%2Bjournal%2Bof%2Bmedicine%26rft.stitle%253DAm%2BJ%2BMed%26rft.aulast%253DNathan%26rft.auinit1%253DR.%2BV.%26rft.volume%253D119%26rft.issue%253D6%26rft.spage%253D512.e1%26rft.epage%253D512.e7%26rft.atitle%253DIn-hospital%2Bobservation%2Bafter%2Bantibiotic%2Bswitch%2Bin%2Bpneumonia%253A%2Ba%2Bnational%2Bevaluation.%26rft_id%253Dinfo%253Adoi%252F10.1016%252Fj.amjmed.2005.09.012%26rft_id%253Dinfo%253Apmid%252F16750965%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1016/j.amjmed.2005.09.012&link_type=DOI [3]: /lookup/external-ref?access_num=16750965&link_type=MED&atom=%2Fthoraxjnl%2F61%2F10%2F908.2.atom
The sesquiterpene lactone parthenolide inhibits LPS- but not TNF-α-induced maturation of human monocyte-derived dendritic cells by inhibition of the p38 mitogen-activated protein kinase pathway
Authors: Hiroshi Uchi, Jean-François Arrighi, Jean-Pierre Aubry, Masutaka Furue, Conrad Hauser
Journal: Journal of Allergy and Clinical Immunology (2002)
Cost-effectiveness of Zidovudine to Prevent Mother-to-Child Transmission of HIV in Sub-Saharan Africa
Authors: G. Mansergh
Journal: JAMA (1998)

Preliminary research results from Thailand indicate zidovudine (ZDV) administered from 36 weeks of pregnancy through labor produces a 51% reduction in vertical transmission of HIV infection.  The authors of this letter used this efficacy estimate adjusted for a breast-feeding population updated information on a range of counseling and testing costs prenatal maternal test rates and recent reductions in ZDVs cost to recalculate the cost-effectiveness of short-course ZDV in sub-Saharan Africa.  The revised model estimates that a national short-course ZDV program in a setting with 12.5% HIV seroprevalence in childbearing women would reduce perinatal HIV incidence from 42.5 to 35.8 infections per 1000 births at a cost of US$850000 per 1000 births.  The cost to the health care system per case of infant HIV prevented would be $1269.  If productivity losses due to HIV infection are factored in the societal cost saving would be $1582 per infant HIV infection prevented or $1.06 million per 100000 births.  The per capita program cost would be $0.36 in the Ivory Coast and $0.38 in Uganda--countries with especially high burdens of maternal and infant HIV infection.  The $8.50 cost per birth in sub-Saharan Africa incurred by a short-course ZDV program compares favorably with the cost of other child survival programs in the region.
Abstract 842: Messenger RNA Processing Body Participates In Cardiac Protection Induced By Heat Shock Preconditioning In Mouse Hearts
Authors: Chang Yin, Rakesh C Kukreja
Journal: Circulation (2007)

mRNA Processing Body (P-Body) is a specialized cytoplasmic structure that functions as a major site for post-transcriptional and trnanslational repression. Target mRNA is guided into P-Body through base-pairing with its micro-RNA (miRNA), where they further bind to P-Body components such as GW182 and AGO2; thus get retained away from translation machinery or degraded. Our previous study detected an increase of a key component of P-Body, miRNA, in heat-shock (HS) protected hearts. To gain further insights into the protective mechanism, we hypothesized that the miRNA-associated protection is mediated through P-Body formation. This hypothesis was tested by measuring three key components of P-Body, i.e., miRNA (target seeker), GW182 (marker of P-Body, also called GW-Body) and AGO2 (mRNA catalytic enzyme). METHODS : ICR mice were either HS-preconditioned (15 min, 42°C, anal temperature) or kept at room temperature (controls). miRNA and proteins were extracted 2 hour after HS. miRNA induction was verified by RT-PCR. P-Body formation was evaluated by measuring the binding of GW182 and AGO2, using a combination of immunopricipitation and Western blotting techniques. To study the role of miRNA in P-Body formation, identical experiments were also repeated in mice treated with miRNA-1 inhibitor (antisense miRNA-1 with 2′-O-methyl base at every nucleotide). RESULTS : Compared to the control, HS-preconditioning significantly induced miRNA-1 (150 ± 11%, mean ± SEM), miRNA-21 (71 ± 10%) and miRNA-24 (68 ± 14%). GW182 (109 ± 16%) and AGO2 (50 ± 16%) were also increased in the HS-group. More importantly, there was an increase (39 ± 11%) in co-immunopricipitation between GW182 and AGO2 in the HS-group than in the control, indicating more binding of the two key P-Body components. However, this co-immunoprecipitation was significantly reduced (−68 ± 8%) in the mice treated with the miRNA-1 inhibitor after HS. CONCLUSION : The formation of P-Body following HS-preconditioning represents a novel protective pathway against ischemic injury. The pharmaceutical potential of P-Body formation may offer a new strategy in cardiac preconditioning.
Intermittent coronary sinus occlusion after coronary arterial ligation results in venous retroperfusion.
Authors: R Beyar, A D Guerci, H R Halperin, J E Tsitlik, M L Weisfeldt
Journal: Circulation Research (1989)

Coronary sinus occlusion retards necrosis of ischemic myocardium. To test the hypothesis that coronary sinus occlusion induces retrograde venoarterial flow, the coronary arteriovenous pressure gradient and the coronary arterial oxygen saturation were measured distal to a left anterior descending coronary artery ligature in dogs. In parallel, we constructed a mathematical model of known coronary physiology to characterize pressure and flow patterns during coronary sinus occlusion. In dogs, coronary sinus occlusion produced a systolic pressure gradient between the coronary artery and the coronary sinus of -20 +/- 9 mm Hg (higher venous pressure, p less than 0.0001) and a positive diastolic gradient of 3 +/- 5 mm Hg (lower venous pressure p less than 0.01). An average reduction in the oxygen saturation in the ligated coronary artery of 20 +/- 13% was also observed (p less than 0.005) consequent to admixture of venous (desaturated) blood. By graded inflation of the coronary sinus balloon, it was demonstrated that desaturation of arterial blood typically occurs above a coronary sinus systolic pressure of 40-50 mm Hg. The mathematical model indicates the possibility of venoarterial pressure gradients and reversal of flow at the microcirculatory level during coronary sinus occlusion. These studies provide evidence that retrograde flow into the ischemic zone occurs in association with intermittent coronary sinus occlusion. Thus, alternating flow over the ischemic territory may be the mechanism of myocardial salvage during intermittent coronary sinus occlusion.
The right bronchial artery: Anatomical considerations and surgical approach
Authors: H. Nathan, R. Orda, M. Barkay
Journal: Thorax (1970)

The precise course and relations of the right bronchial artery are presented with an emphasis on the characteristic parallelism between the arches of this artery and the azygos vein. The technique for an easy surgical approach to the bronchial artery is described. Various pathological conditions involving this artery are discussed in relation to possible surgical applications.
A no-win situation
Authors: Anne Foley
Journal: BMJ (2006)

Having recently started in a new hospital as a medical registrar, I was keen to make a good impression. My first on call fell right in the middle of the busy winter period. Patients were coming at us from all directions, and queues were building up. As a further incentive to stay on top of things, the registrar on night duty, my relieving angel, was a friend of mine. …
Renal Ischaemia Due to Thrombosis of Renal Artery Resulting from Metastases from Primary Carcinoma of Bronchus
Authors: R. C. Jennings, V. A. R. Shaikh, W. M. C. Allen
Journal: BMJ (1964)

NBRJSOUNAL 1053 returned to normal except for a small gangrenous patch which was buried by oversewing.The bowel was returned to the abdominal cavity without difficulty and the femoral sac excised.The femoral ring was so large that closure by insertion of two stitches between the medial end of the inguinal ligament and the pectineal fascia was necessary.The wound was then closed.The post-operative course was uneventful, and the child was discharged from hospital eight days later. COMMENTFemoral hernia in infancy and childhood is uncommon and has received only brief mention in British and American text- books of paediatric surgery.Mestel et al. (1959) reviewed the literature extensively and assessed the incidence of femoral to inguinal hernia at 4.5:1,000.Strangulation occurring as a complication is extremely rare.Gray and Skandalakis (1962) describe a strangulated femoral hernia containing small intestine in a 40-day-old girl and could find only eight other cases under the age of 10 recorded in the literature.Underhill (1954) also recorded a case of strangulated femoral hernia containing small intestine in a boy aged 5 weeks, and Temple (1952) reported another case, a boy of 31 years, in which the sac contained omentum.It is generally accepted that femoral hernia in adults is acquired and that no congenital sac is present (Lancet, 1962).McVay and Savage (1961) failed to find any evidence of a con- genital femoral hernial sac in a large series of necropsies in infants.However, it appears that very rarely a congenital sac may be present, as was almost certainly the case in Underhill's 5-week-old baby.Since femoral hernia is so rare in children there is a risk that if strangulation occurs the condition may be misdiagnosed and operation delayed.The most likely source of error is inguinal adenitis, which is common in children.Other conditions include strangulated inguinal hernia, acute hydrocele, and torsion of an ectopic testis or ovary.My thanks are due to Mr. W.
Lipidomic and metabolomic analyses reveal potential plasma biomarkers of early atheromatous plaque formation in hamsters
Authors: Mariona Jové, Victòria Ayala, Omar Ramírez-Núñez, José C. E. Serrano, Anna Cassanyé, Lluís Arola, Antoni Caimari, Josep M. del Bas, Anna Crescenti, Reinald Pamplona, Manuel Portero-Otín
Journal: Cardiovascular Research (2012)

AimsAtherosclerosis is the main pathological process contributing to cardiovascular disease, with diet being the most important factor involved. Although the lipidome of atheromatous plaque has been studied previously, the use of comparative lipidomics and metabolomics in plasma in early atherogenesis could lead to the discovery of plasma biomarkers that allow not only disease prediction but also measurement of disease progression.
Use of low-dose insulin infusions in diabetics after myocardial infarction
Authors: D J Gwilt, M Nattrass, B L Pentecost
Journal: BMJ (1982)

Myocardial infarction in diabetics is often accompanied by poor diabetic control. An assessment of a low-dose insulin infusion regimen in 26 diabetic patients after myocardial infarction found this system to be simple, effective, and safe.
Incorporation of l-leucine-14C into immunoglobulins by jejunal biopsies of patients with celiac sprue and other gastrointestinal diseases
Authors: P. M. Loeb, W. Strober, Z. M. Falchuk, L. Laster
Journal: Journal of Clinical Investigation (1971)

Incorporation of L-leucine-(14)C into proteins and immunoglobulins in vitro was determined in jejunal biopsy specimens from normal volunteers, patients with celiac sprue before and after introduction of gluten into the diet, patients with Whipple's disease in remission, and patients with immune deficiency states. Values for incorporation of L-leucine-(14)C into total and soluble protein by biopsies from five celiac sprue patients on a gluten-free diet were within, or slightly above, the 95% confidence limits for control data. One patient with celiac sprue and with normal intestinal histology had a normal value for incorporation into IgA; the other four patients with flat mucosas had elevated values. In Whipple's disease in remission, values for incorporation into total protein and IgA were within the control limits, whereas incorporation into soluble protein was increased. Patients with hypogammaglobulinemia or IgA deficiency had normal or elevated values for incorporation into total and soluble proteins; in these cases, however, no incorporation into IgA was detected. Biopsies from the four celiac sprue patients studied revealed that with introduction of gluten into the diet (a) incorporation into total protein, soluble protein, or both, increased; (b) incorporation into IgA increased in all patients, and in two instances the increase was greater than the increase in incorporation into total protein; and (c) incorporation into IgM increased in all patients. The changes during gluten administration usually occurred before changes in gastrointestinal absorptive function or in concentration of IgA in serum could be detected. These results indicate that gluten challenge stimulates increased local intestinal synthesis of immunoglobulins in patients with celiac sprue. The reaction occurs within days and it is possible that it plays a primary role in the pathogenesis of the disease.
CERTAIN TRENDS IN UNDERGRADUATE MEDICAL EDUCATION
Authors: MAURICE C. PINCOFFS
Journal: Annals of Internal Medicine (1954)

Editorial1 December 1954CERTAIN TRENDS IN UNDERGRADUATE MEDICAL EDUCATIONMAURICE C. PINCOFFSMAURICE C. PINCOFFSSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-41-6-1250 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptFor twenty years at least the medical curriculum has been in a state of upheaval. Trends that first appeared at the beginning of the century are being opposed by contrary trends, and in some instances educational practices long since abandoned are being revived in new form. In addition to the changes in undergraduate medical education there has been a tremendous expansion in postgraduate and graduate education, but this is not our subject. The alterations in the undergraduate course are in part the outcome of attempts to include in the curriculum the many additions that have been made to specialized knowledge.... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 December 1954Volume 41, Issue 6Page: 1250-1254KeywordsGraduate medical educationMedical educationUndergraduates Issue Published: 1 December 1954 PDF downloadLoading ...
Effectiveness of ward based opportunistic immunisation policy.
Authors: S R Dobson, E Bixby, A Davies, R Booy, S Ledger, D Isaacs
Journal: BMJ (1991)

197980 81 82 83 84 85 86 87 88 89 90 YearImmutisation uptake rates (percentages), 1979-89 for children who reached their second birthdayThe reasons for the steady improvement in immunisation rates over recent years are probably complex but must encompass the substantial work of community child health doctors, general practi- tioners, health visitors, and consultants in public health medicine to achieve high rates of immunisation in their practices and populations.Some of the factors likely to be important are improvements in accessibility of services, increased parental knowledge through local and national educational initiatives, improved training and guidance for professionals, and coordination of services through relevant immunisation committees and nominated immunisation coordinators.Factors such as introduction of immunisation targets into the general practitioner contract and the new accelerated schedule may result in further improvements in immunisation rates but cannot have contributed greatly to our present levels of immunisation.