tbuckley/cabot-search huggingface dataset:
Association of Marketing Interactions With Medical Trainees’ Knowledge About Evidence-Based Prescribing
Authors: Kirsten E. Austad, Jerry Avorn, Jessica M. Franklin, Eric G. Campbell, Aaron S. Kesselheim
Journal: JAMA Internal Medicine (2014)

In recent years, numerous US medical schools and academic medical centers have enacted policies preventing pharmaceutical sales representatives from interacting directly with students. Little is known about how pharmaceutical sales representatives affect trainees' knowledge about pharmaceutical prescribing.To determine whether there is an association between medical trainees' interactions with pharmaceutical promotion and their preferences in medication use.We surveyed a nationally representative sample of first- and fourth-year medical students and third-year residents by randomly selecting at least 14 trainees at each level per school.All trainees were asked how often they used different educational resources to learn about prescription drugs. Among fourth-year students and residents, we posed a series of multiple choice knowledge questions asking about the appropriate initial therapy for clinical scenarios involving patients with diabetes, hyperlipidemia, hypertension, and difficulty sleeping.Evidence-based answers followed widely used clinical guidelines, while marketed-drug answers favored brand-name drugs over generic alternatives. We used survey answers to build an industry relations index assessing each trainee's level of acceptance of pharmaceutical promotion; we used proportional odds logistic regression models to estimate the association between the index and responses to the knowledge questions.The 1601 student (49.0% response rate) and 735 resident (42.9% response rate) respondents reported common use of unfiltered sources of drug information such as Google (74.2%-88.9%) and Wikipedia (45.2%-84.5%). We found that 48% to 90% of fourth-year students and residents accurately identified evidence-based prescribing choices. A 10-point higher industry relations index was associated with 15% lower odds of selecting an evidence-based prescribing choice (odds ratio [OR], 0.85; 95% CI, 0.79-0.92) (P < .001). There was also a significant association between the industry relations index and greater odds of choosing to prescribe brand-name drugs (OR, 1.08; 95% CI, 1.00-1.16) (P = .04).Among physician trainees, our survey showed an association between positive attitudes toward industry-physician interactions and less knowledge about evidence-based prescribing and greater inclination to recommend brand-name drugs. Policies intended to insulate trainees from pharmaceutical marketing may promote better educational outcomes.
Experts call for a global fund for family planning
Authors: R. Coombes
Journal: BMJ (2009)

The world’s health leaders have neglected the issue of family planning, and funds have been raided to support diseases with a higher profile, such as AIDS and malaria, a UK expert has said.

Judith Stephenson, who holds the Margaret Pyke chair of sexual and reproductive health at University College London, was speaking at the annual conference of the Optimum Population Trust. The trust argues that reducing population is a key factor in controlling climate change.

Professor Stephenson said that governments were too much under the “long shadows” cast by bad examples of coercive family planning programmes in the 1970s and 1980s and had neglected the importance of family planning. 

“Family planning has been a huge success,” she said. “The …
It ain't what you do (it's the way that you do it)
Authors: Kenneth John Aitken
Journal: Behavioral and Brain Sciences (2013)

Abstract Knowledge of the complexity of human communication comes from three main sources – (i) studies of the linguistics and neuropsychology of dysfunction after brain injury; (ii) studies of the development of social communication in infancy, and its dysfunction in developmental psychopathologies; and (iii) the evolutionary history of human communicative interaction. Together, these suggest the need for a broad, integrated theory of communication of which language forms a small but critical component.
Myiasis Due to <i>Dermatobia hominis</i> (Human Botfly)
Authors: Francisco M. Marty, Kristen R. Whiteside
Journal: New England Journal of Medicine (2005)

A 65-year-old man presented with skin lesions on his chest and left arm and shoulder six weeks after returning from a vacation in Belize at the beach and in the rain forest. The lesions occasionally stung, drained a dark exudate, and enlarged despite two weeks of treatment with cephalexin. The patient had no constitutional symptoms. Physical examination revealed five nodules of varying sizes with surrounding erythema and a central pore through which a single, moving larva was observed (Panel A). The pores were occluded with petrolatum for two hours. After lidocaine was injected around the nodules, five Dermatobia hominis larvae . . .
Endothelial cell damage and angiotensin-converting enzyme insertion/deletion genotype in elderly hypertensive patients
Authors: Kazuomi Kario, Takefumi Matsuo, Hiroko Kobayashi, Nobuyuki Kanai, Satoshi Hoshide, Takeshi Mitsuhashi, Uichi Ikeda, Shinichi Nishiuma, Masafumi Matsuo, Kazuyuki Shimada
Journal: Journal of the American College of Cardiology (1998)
A framework for tobacco control: lessons learnt from Veterans Health Administration
Authors: Scott E Sherman
Journal: BMJ (2008)

In this article, I describe how the Veterans Health Administration (VHA; one of the largest managed care organisations in the United States) has carried out a large scale quality improvement and system change in tobacco control.This created a framework for how organisations approach tobacco control, moving through four increasingly complex stages (table 1).By anticipating these stages and approaching the challenges of each in sequence, systems may be able to set goals for quality improvement appropriate to their levels of readiness.A four stage framework for tobacco control Stage 1-No system for tobacco control The chief feature of the first stage (in the VHA, before 1996) is the lack of a system.Providers act independently and care is haphazard, with major variations between sites and between providers.Before the 1990s, smoking cessation was not a high priority for the VHA.Though many medical centres had smoking cessation programmes, few offered drugs for cessation.All facilities were required to have a smoking cessation coordinator, but this role was not clearly or consistently defined.Nor was there a system for collecting data on clinical performance.The only data available were from researchers.Within the VHA, it was difficult to determine the answers to basic questions, such as the percentage of patients who use tobacco, how many were screened or advised to quit, and whether smokers were offered counselling or treatment.What led to the transition to the next stage was the mandated use of evidence based guidelines and measurement of the level of adherence.Stage 2-Systematic screening Stage 2 (in the VHA, 1996-2002) is characterised by an organised approach to asking about smoking and advising smokers to quit.Practice guidelines advocate systematically asking about smoking at every visit, and
Trinucleotide repeat length instability and age of onset in Huntington's disease
Authors: M. Duyao, C. Ambrose, R. Myers, A. Novelletto, F. Persichetti, M. Frontali, S. Folstein, C. Ross, M. Franz, M. Abbott, J. Gray, P. Conneally, A. Young, J. Penney, Z. Hollingsworth, I. Shoulson, A. Lazzarini, A. Falek, W. Koroshetz, D. Sax, E. Bird, J. Vonsattel, E. Bonilla, J. Alvir, J. Bickham Conde, J.-H. Cha, L. Dure, F. Gomez, M. Ramos, J. Sanchez-Ramos, S. Snodgrass, M. de Young, N. Wexler, C. Moscowitz, G. Penchaszadeh, H. MacFarlane, M. Anderson, B. Jenkins, J. Srinidhi, G. Barnes, J. Gusella, M. MacDonald
Journal: Nature Genetics (1993)
Acute renal failure after infusion of gelatin: Authors' reply
Authors: P J T Drew, S F Hussain
Journal: BMJ (1989)

Although there are published references on the effects of Gelofusine on renal function, not one was cited.Had the authors so chosen they could have discussed the evidence that operations on the aorta are associated with the development of acute renal failure'; that the fall in urine output was noted before the Gelofusine was infused (and therefore a cause preceding Gelofusine administration re- quired exclusion); and the longstanding belief that, rather than being nephrotoxic,4 the gelatins
Potassium Iodide Sensitivity in Four Patients with Hypocomplementemic Vasculitis
Authors: JOHN G. CURD
Journal: Annals of Internal Medicine (1979)

During metabolism studies of radiolabeled proteins in 126 participants four patients were suspected of being sensitive to potassium iodide (KI) because they repeatedly developed urticaria and other symptoms after KI administration. Two of the four patients suspected of KI sensitivity and 10 control patients were orally challenged with KI to document and characterize KI sensitivity and to evaluate the possible association(s) of KI sensitivity with urticaria, hypocomplementemia, and vasculitis. The KI challenges in the two sensitive patients precipitated urticaria, angioedema, polymyalgias, conjunctivitis, and coryza. One of these two patients also developed a severe systemic illness characterized by fever, headache, peritonitis, episcleritis, and pneumonitis. The four sensitive patients were strikingly similar in that they exhibited hypocomplementemia and dermal vasculitis associated with chronic urticaria or systemic lupus erythematosus, suggesting that other patients with similar clinical features may be sensitive to KI and that KI may precipitate severe systemic illness in them.
Up-regulation of Flotillin-2 Is Associated with Melanoma Progression and Modulates Expression of the Thrombin Receptor Protease Activated Receptor 1
Authors: Parul Hazarika, Marya F. McCarty, Victor G. Prieto, Saira George, Daniel Babu, Dimpy Koul, Menashe Bar-Eli, Madeleine Duvic
Journal: Cancer Research (2004)

Abstract Flotillin 2 (flot-2) is a highly conserved protein isolated from caveolae/lipid raft domains that tether growth factor receptors linked to signal transduction pathways. Flot-2 protein and mRNA were increased in tumorigenic and metastatic melanoma cell lines in vitro, and the immunostaining intensity increased substantially across a tissue array of melanocytic lesions. Flot-2 transfection transformed SB2 melanoma cells from nontumorigenic, nonmetastatic to highly tumorigenic and metastatic in a nude mouse xenograft model. SB2 cells stably transfected with the flot-2 cDNA (SB2-flot)–2 cells proliferated faster in the absence of serum, and their migration through Matrigel was additionally enhanced by thrombin. When SB2-flot–2 cells were compared with SB2-vector–control cells on a cancer gene pathway array, SB2-flot–2 cells had increased expression of protease activated receptor 1 (PAR-1) mRNA, a transmembrane, G-protein–coupled receptor involved in melanoma progression. PAR-1 and flot-2 were coimmunoprecipitated from SB2-flot–2 cells. Up-regulation of PAR-1 was additionally confirmed in SB2-flot–2 cells and melanoma cell lines. SB2-flot–2 cells transfected with flot-2–specific small-interfering RNAs made substantially less flot-2 and PAR-1 mRNA. In conclusion, flot-2 overexpression is associated with melanoma progression, with increased PAR-1 expression, and with transformation of SB2 melanoma cells to a highly metastatic line. Flot-2 binds to PAR-1, a known upstream mediator of major signal transduction pathways implicated in cell growth and metastasis, and may thereby influence tumor progression.
A CASE OF ATTEMPTED SUICIDE WITH INSULIN
Authors: Joseph T. Beardwood
Journal: JAMA (1934)

The average diabetic patient is a well behaved member of society seldom given to acts of violence or attempts to inflict injury on himself or others. Indeed, aside from the tendency to deceive his physician in regard to his cooperation, he is apt to be an exemplary citizen. A careful search of the literature for the past ten years has revealed no case in which such a massive dose of insulin was taken and only one case<sup>1</sup>in which insulin was taken with suicidal intent; and in this case only 20 units was taken. This was but 12 units more than the patient had taken as a daily dose to control his diabetes. He promptly repented of his deed and took sugar within fifteen or twenty minutes and did not suffer any reaction. Hypoglycemia may produce death, and even mild degrees of depression of the level of the blood
PHILIP HENCH, 1896-1965
Authors: W. S. C. Copeman
Journal: Annals of the Rheumatic Diseases (1965)

In countries without a comprehensive national health service, many patients with rheumatic diseases cannot afford the cost of expensive x rays and diagnostic tests.Physicians practising rheumatology in these countries must accordingly sharpen up their clinical skills.The book by Rotes-Querol and his colleagues sets out in great detail (and with much emphasis on the underlying and surface anatomy) the methods of examination of the spine and joints and the detection of the clinical signs of the various rheumatic diseases.It opens with a detailed chapter on the physiology of pain and areas of pain referral.Then follows a chapter on the signs of articular inflammation, on deformity, on the noises arising in joints, and on limitation of movement and hypermobility.
Abstract 3306: Screening potential drug candidates for treatment of glioblastoma patients utilizing an in-vivo mouse/ rat model system
Authors: Jenna Passarini, John P. Cleary, Preetham Kumar, Trisha Newton, Michael Sharma, Cristian Sharma, Rubio R. Panunzalan, Parkash Gill, Sherven Sharma, Rakesh Srivastava, Sharmila Shankar, Jay P. Sharma
Journal: Cancer Research (2011)

Abstract Cancer stem cells (CSCs) are thought to be critical for engraftment and long-term growth of many tumors, including glioblastoma multiforme (GBM). The cells are at least partially spared by traditional chemotherapies and radiation therapies, and finding new treatments that can target CSCs may be critical for improving patient survival. Human glioblastoma multiforme is a heterogenous tumor composed from tumor cells and small portion of cancer stem cells, which have a high tumorigenic potential and a low proliferation rate. Glioblastoma cancer stem cells are phenotypically similar to the normal stem cells, they express CD133 gene and other genes characteristic of neural stem cells and posses self-renewal potential. The CD133+ GBM CSCs have been isolated with Celprogen Media and ECM and characterized as chemo-/radio-resistant tumor-initiating cells which are responsible as one of the many factors involved in post-treatment recurrence. In order to explore the molecular properties of tumorigenic CD133+ GBM CSCs that resist treatment, we isolated CD133+ GBM CSCs from tumors that are recurrent and have previously received chemo-/radio-therapy. We found that the purified CD133+ GBM CSCs sorted from the CD133+ GBM CSC spheres express SOX2,CD44 and are capable of clonal self-renewal. We generated in-vivo model systems in mice and rats to screen potential drug agents for the treatment of GBM patients. We were capable of generating brain tumors in mice and rats within 20 days by subcutaneously injecting 1000 GBM CSCs at the hind limbs of the rodents. Within day 5 the GBM CSCs were already present in the brain's of the rodents. At days 10, 15 &amp; 20 the GBM CSCs labeled with GFP were located in the brain. We tested various compound candidates in this model system and we were able to show decrease in the migration of the GBM CSCs in the brain when we started the treatment at day 10 compared to non-treatment groups. We were able to demonstrate all the gene signatures associated with GBM CSCs in this model system. We do see a down regulation of certain cancer promotes genes in the treatment group when compared to non-treatment groups. The drug candidates were tested for TGFβ and STAT pathways. The chemotherapeutic agents tested were Among the 300 compounds tested Adria, Taxol, DTIC, Thalidomide, Paclitaxel, Abraxane, Ertibux and Velcade. We were able to show 4 compounds that were effective against GBM CSC targeting selected pathways. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3306. doi:10.1158/1538-7445.AM2011-3306
JC Polyomavirus Granule Cell Neuronopathy in a Patient Treated With Rituximab
Authors: Louis Dang, Xin Dang, Igor J. Koralnik, Peter K. Todd
Journal: JAMA Neurology (2014)

Progressive multifocal leukoencephalopathy results from lytic infection of the glia by the JC polyomavirus (JCV); JCV granule cell neuronopathy is caused by infection with a mutated form of JCV, leading to a shift in viral tropism from the glia to cerebellar granule cells. This shift results in a clinical syndrome dominated by progressive cerebellar dysfunction that might elude standard diagnostic workup strategies for ataxia.We present the case report of a patient receiving long-term rituximab therapy who developed progressive cerebellar ataxia and marked isolated cerebellar degeneration. This syndrome resulted from JCV granule cell neuronopathy associated with a novel JCV mutation.New onset or worsening of isolated cerebellar ataxia in patients being treated with rituximab or natalizumab warrants early assessment for JCV infection.
Thrombotic thrombocytopenic purpura associated with a prolactin‐producing pituitary adenoma
Authors: Kalman Kovacs, M. Bernadette Garvey
Journal: American Journal of Hematology (2003)

Abstract We report here the case of a 44‐year‐old woman with thrombocytopenia, anemia, convulsions, hyperprolactinemia, and galactorrhea. The patient died of cardiac failure. Autopsy revealed PAS‐positive and von Willebrand factor‐positive microthrombi in the arterioles and capillaries of many organs, mainly in the heart and brain, confirming the clinical diagnosis of thrombotic thrombocytopenic purpura. In the pituitary, a prolactin‐producing adenoma was identified. To our knowledge, thrombotic thrombocytopenic purpura accompanied by a prolactin‐secreting pituitary adenoma has not yet been described. The question of whether the association between the vascular changes and the pituitary adenoma is incidental or causal cannot be answered. Further studies are required to determine whether prolactin released from the pituitary tumor in excess played a role in the formation of microthrombi causing multiple organ failure and the demise of the patient. Am. J. Hematol. 74:55–59, 2003. © 2003 Wiley‐Liss, Inc.
Neurohumoral effects of aliskiren in patients with symptomatic heart failure receiving a mineralocorticoid receptor antagonist: the Aliskiren Observation of Heart Failure Treatment study
Authors: Bertram Pitt, Roberto Latini, Aldo P. Maggioni, Scott D. Solomon, Beverly A. Smith, Melanie Wright, Margaret F. Prescott, John J.V. McMurray
Journal: European Journal of Heart Failure (2011)
Demonstration of bone marrow derived cells in synovial lining by means of giant intracellular granules as genetic markers.
Authors: J C Edwards, D A Willoughby
Journal: Annals of the Rheumatic Diseases (1982)

Beige mice carry a gene (bg) which codes for the presence of giant intracellular granules in a variety of cell types. Bone marrow from beige mice was transplanted into irradiated normal mice. Giant granules similar to those seen in beige mouse synovial cells were observed subsequently in the synovial lining cells of marrow recipients, indicating an influx of bone marrow derived cells into the synovial lining. Giant granule bearing cells also appeared in the subintima. On electron microscopy giant granules have been demonstrated only in macrophage-like or type A cells in marrow recipient synovia, despite the occurrence of giant granules in both type A and type B lining cells in donor material (beige). This tends to suggest that only the type A lining cells are derived from bone marrow, as might be expected from their similarity to mononuclear phagocytes elsewhere. However, the possibility remains that type B cells are also derived from bone marrow but have a slower rate of replacement.
The Compromised Host and Legionnaires' Disease
Authors: LOUIS D. SARAVOLATZ
Journal: Annals of Internal Medicine (1979)

Pneumonia caused by Legionnaires' disease bacterium was recognized in eight patients during a 7-month period. The patients were immunosuppressed by their underlying illness, corticosteroid therapy, and other exogenous immunosuppressive agents. Five of the patients had received immunosuppressive therapy for less than 16 days. Clinical presentation was similar to that of other bacterial pneumonias in compromised patients. Legionnaires' disease progressed to necrotizing pneumonia with abscess formation and respiratory failure in two patients. Diagnosis was made by [1] culture of lung tissue and bronchial washings; [2] direct fluorescent antibody staining of lung tissue, sputum, and bronchial washings; and [3] serologic evidence of infection. Therapy with oral erythromycin was ineffective. Intravenous erythromycin was given to six patients, with a good response. However, two patients showed further clinical improvement after rifampin was added. Because this illness may be more severe in compromised hosts, open lung biopsy and special microbiologic tests should be done when Legionnaires' disease is suspected.
Risk factors of failure and immediate complication of subclavian vein catheterization in critically ill patients
Authors: J.-Y. Lefrant, L. Muller, J.-E. De La Coussaye, M. Prudhomme, J. Ripart, C. Gouzes, P. Peray, G. Saissi, J.-J. Eledjam
Journal: Intensive Care Medicine (2002)
Intake and expenditure in obesity.
Authors: R. B. Bradfield, D. E. Curtis
Journal: BMJ (1968)

small proportion of potentially abnormal cases should be directed to the specialist units.Despite the good record of our unit it has recently been suggested that all patients booked there should be checked at a specialist unit during their pregnancy to ensure that our selection of cases was not faulty.Some statistical studies might well be made to ascertain how this type of proposal reduces recruitment to general practice.Capable doctors will be driven to practise in other countries where they can make use of their skills.-Iam, etc.,