tbuckley/cabot-search huggingface dataset:
A piece of my mind. Stein-Bockenheim
Authors: G. D. Curfman
Journal: JAMA (1990)

During my childhood I was only dimly aware of my family's German heritage. I was born in the United States less than two years after the end of Hitler's war, and my grandfather once mentioned that we were of German descent. My American-born father, a US Navy officer during the Second World War, never brought up the subject. At that time, an ancestral link to Germany was not considered altogether respectable. Although my family's religious affiliation was Protestant, I attended grade school with a preponderance of Jewish children from a neighboring community. With my unmistakably Teutonic surname and shock of blond hair, I stood out from my darker-haired classmates, but nevertheless I had many friends and was enriched by their traditions, religion, and culture. Little by little, my closest friends virtually adopted me into their families. At that young age, we had only the faintest perception that not long before,
Tranquility Remembered in Emotion
Authors: Oscar W. Haffke
Journal: JAMA (1961)

To the Editor:—  In regard to the article inThe Journal, Nov. 5, 1960, p. 1242, and to many articles on the use of tranquilizers: One is apt to become more than a little frustrated. There appears to be a psychological mania for reporting the use of tranquilizers in a semihysterical (conscious or unconcious) manner. In fact, one has the definite impression that many physicians are afflicted with a neurotic compulsion for writing and prescribing tranquilizing drugs. In other words, too many physicians are on a tranquilizer dispensing and writing jag which must be motivated by some insecure feelings about their attempt to help people with emotional problems and their desire to report something.  Now I would like to pose a few questions.   What does psychoneurotic schizophrenic reaction mean?  Why give occasional sedation and psychotherapy at intervals if the tranquilizers were being so helpful?  The majority of
Right-Sided Spleen with Partial Situs Inversus of the Abdominal Viscera: Visualization of the Spleen by Dynamic and Static 99mTc-Sulfur Colloid Imaging and 51Cr-Labeled Red Blood Cell Sequestration Imaging
Authors: KOKILA VYAS, JAMES E. HAINES, CURTIS HOLZGANG
Journal: Clinical Nuclear Medicine (1979)

In a patient with right-sided stomach and malrotation of the small bowel and cecum visualized by gastrointestinal x-ray studies using barium, a right-sided spleen was demonstrated by 99mTc-sulfur colloid and 51Cr-labeled red blood cell imaging. The sulfur colloid study also demonstrated that the liver was in its usual right upper quadrant location.
Teaching students in general practice can affect patients' blood pressure
Authors: Jan H Matthys
Journal: BMJ (2005)

Timing of tracheostomy in adult patients Potential ramifications are alarmingEditor-In their systematic review and meta-analysis Griffiths et al conclude that tracheostomies should be performed earlier in critically ill patients. 1As ear, nose, and throat surgeons we find the potential ramifications quite alarming, primarily as undertaking this major operation is not without potential morbidity in patients who are already systemically unwell. 2 3 These patients are often anaemic and have coagulopathies and sepsis among other comorbidities-points that we thought the authors had not discussed, and factors that have implications for the surgical procedure.In our experience, many patients listed for tracheostomy from intensive care units are extubated or sometimes die while waiting for their procedure; if tracheostomy were performed immediately these patients would be subjected to unnecessary procedures.The postoperative sequelae of tracheostomy are a slow weaning process before patients can be decannulated, followed by potential tracheal stenosis. 4hese patients may be able to leave intensive care earlier, but Griffiths et al do not say how long they then remain inpatients before discharge because of problems with rehabilitation with a tracheostomy tube in situ.Interestingly, although duration of ventilation and stay in the intensive care unit were shortened by an earlier tracheostomy, mortality was not altered and inpatient stay was likely to have been lengthened. 5he authors divided timing of tracheostomy into two groups, demarcated by seven days after intubation, making an artificial separation that seems invalid.It would have been more interesting to see whether increasing number of days have a proportional relation to the duration of ventilation and stay in intensive care on a linear scale.We advise great caution in interpreting the findings of Griffiths et al and about its impact on the delivery of the tracheostomy service in hospitals.
Bovine Creutzfeldt-Jakob disease?
Authors: S. M Gore
Journal: BMJ (1996)

First initial and soundex of surname European Union regulations on live exports, not to mention * Gender reductions in compensation to farmers for slaughtered * Date ofbirth animals.This compensation was reduced in April 1994 from * Postcode ofresidence the average market price of a young bovine to the value of Riskfactors older bovines,"2 which may ironically have jeopardised * Any occupational CJD risk (1981 or later)?the selectivity and speed of the very case reporting on * Any occupational CJD risk (1980 or before)?which we rely for projections.* Anly familial CJD risk?* Any iatrogenic CJDrisk?Although it is too early to make confident projections about * Any growth hormone deficiency CJD risk?the new Creutzfeldt-Jakob disease variant, it is not too early to * Valine homozygote?identify our data requirements.These include an estimate of * Other genetic risk factors? the disease's incubation period and plausible scenarios for the Risk precautionary information infection curve in humans from 1981.Such scenarios should * Ever blood, tissue, or breast milk donor?take account of British consumption of bovine tissue at three * Iffemale, pregnant now or in past x years?potential levels of infectivity, the highest being the specified * Voluntary notification of current and past sexual partner(s)?bovine offals banned in 1989; the next being those additionally Crucial dates proscribed in Britain or (which are not the same) elsewhere in * Date ofreferral to medical practitioner the European Union since then.* Date of referral to neurologist Wisely, even before the recent moves to ban British beef, * Date of referral to CJD Surveillance Unit (may be post mortem)the European Union was not content to rely on standard * Date of death (or, if not dead, date last known to be alive) t 3 * Date of CJD confirmatory diagnosis: postmortem or antemortem qualitative assays of infectivity'3 for reassurance on the safety biopsy of beef.It restricted exports to bovines born after the ban and Mode ofclassification from farms that had not had a recent case of bovine * Postmortem neuropathology?spongiform encephalopathy.312No such restrictions limited * Confirmed CJD case?British consumption.Practically, we do not have rapid in * "Bovine CJD" case? vitro or in vivo tests for infected cattle and so have continued to play Russian roulette with no information on the odds.Age spongiform encephalopathy .Occupational precautions to safeguard abattoir workers against exposure to infected Key actions either to safeguard the public health or tissues have not been persuasively advocated and, if press and properly to acquire data to quantify risks television pictures are typical, have been lax.If careless of * Quarterly publication of surveillance data for patients referred to themselves, such workers will have been hapless guardians of the CJD Surveillance Unit: patients under 40 at referral (whenever
Different Proliferative Properties of Smooth Muscle Cells of Human Arterial and Venous Bypass Vessels
Authors: Zhihong Yang, Barry S. Oemar, Thiery Carrel, Beat Kipfer, Friedgard Julmy, Thomas F. Lüscher
Journal: Circulation (1998)

Background —Internal mammary artery (IMA) bypass grafts have a higher patency than saphenous vein (SV) grafts. Intimal hyperplasia of SV grafts is due to smooth muscle cell (SMC) proliferation and migration. We hypothesized that different SMC growth activity exists in IMA and SV, which may explain the different patencies of arterial and venous grafts. Methods and Results —SMCs were isolated from IMA and SV by explant culture and stimulated with serum or platelet-derived growth factor-BB (PDGF-BB). Cell growth was analyzed by explant outgrowth rate, 3 H-thymidine incorporation, or cell counting. PDGF receptor expression and autophosphorylation, regulation of mitogen-activated protein kinases (MAPKs), and cyclin-dependent kinase inhibitors (p27 Kip1 and p21 Cip1 ) were analyzed by molecular techniques. SMC outgrowth from explants by serum (20%) over a 20-day period was more pronounced in SV (37±5%) than in IMA (4±3%; P &lt;.001) of the same patients. Serum (10%) increased cell number more rapidly in SV (2×10 4 /well to 18±4×10 4 /well; P &lt;.05) than in IMA (2×10 4 /well to 9±4×10 4 /well; P &lt;.05) over an 8-day period. PDGF-BB (0.01 to 10 ng/mL) stimulated 3 H-thymidine incorporation (1347±470% above control levels) and increased cell number in SV (2×10 4 /well to 5±1×10 4 /well; P &lt;.05) but not in IMA. PDGF α- and β-receptors were similarly expressed and were activated in both SV and IMA. PDGF-BB induced a similar MAPK activation (kinetics and maximal activity) in both SV and IMA cells but increased MAPK protein level only in SV. Furthermore, PDGF-BB markedly downregulated the cell cycle inhibitor p27 Kip1 in SV, but this was much less pronounced in IMA. Conclusions —SMCs from SVs exhibit enhanced proliferation compared with IMA in spite of functional growth factor receptor expression and MAPK activation. However, PDGF increased MAPK protein level only in SV and downregulated cell cycle inhibitor (p27 Kip1 ) more potently in SV than in IMA. This may explain the resistance to growth stimuli of IMA SMCs and may contribute to the longer patency of arterial versus venous grafts.
P5-14-26: Results from a Prospective Clinical Study on the Impact of Oncotype DX on Adjuvant Treatment Decision Making in a Cohort of 142 UK Patients.
Authors: S Holt, G Bertelli, E Brinkworth, S Durrani, S Jones, S Khawaja, U Laggner, M Moe, D Pudney, S Pitcher, M Rolles, Y Sharaiha, S Whelan
Journal: Cancer Research (2011)

Abstract Objectives: International guidelines support the use of the Oncotype DX derived Recurrence Score (RS) to provide additional prognostic and predictive information in early breast cancer but experience in the UK is limited. In our prospective study we evaluate this test for the NHS and its impact on costs (subject of a separate abstract) and treatment recommendations by UK oncologists. Methods: 150 tests were made available to consecutive patients with ER+, pN0, pN1itc or pN1mic early breast cancer who had no contraindication to adjuvant chemotherapy (CT) and who would accept CT + hormone therapy (HT) if recommended. CT recommendations of oncologists based on Adjuvant! Online figures were recorded at an initial consultation. Eligible patients were consented to Oncotype DX testing and review arranged once the result was available. After a second consultation a final decision on adjuvant therapy was recorded. Results: Analysis is based on 142 patients. (150 tests performed, 3 failed to give a result, 3 repeated tests giving a result on the second block, one bilateral and one test stopped because the patient withdrew from the study). Initial treatment recommendations changed in 38 (26.8%) cases. Of the patients initially recommended CT + HT (total 57 patients), 26 (45.6%) patients were spared chemotherapy after review with the RS. Of the 85 patients initially recommended HT only 12 (14.1%) were changed to HT + CT. Further analysis shows that Grade, estrogen receptor status by immunohistochemistry (ER by IHC) and progesterone receptor by immunohistochemistry (PR by IHC) are correlated to RS but in our cohort age, size and node status were not. (Spearman rank correlation for grade is 0.05, 95%, Cl 0.36 to 0.61; for ER by IHC is −0.36, Cl −0.49 to −0.20; and for PR by IHC is −0.49, 95%, Cl −0.60 to −0.35). Apart from HER2 positive patients who are already recognized to return a high RS, further analysis of our series shows no clear combination of currently available prognostic factors that would predict RS and therefore reliably avoid testing of any subset of patients. Conclusion: The results of our study suggest that Oncotype DX is applicable and feasible to perform in UK patients with a reduction in the use of adjuvant chemotherapy consistent with findings of reported studies. RS added prognostic information beyond information provided by Adjuvant! Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-14-26.
A Modified Sclerosing Needle for the Sclerotherapy of Upper Gastrointestinal Bleeding
Authors: H.E. Reis, F.W. Korsten
Journal: Endoscopy (1985)

A modified instrument that permits simultaneous endoscopic irrigation and sclerotherapy of a bleeding site in the gastrointestinal tract under direct visualisation is presented. To date, the system has been used in 12 patients. Five cases of grade III esophageal varices have been treated and in three cases of acute bleeding, definitive arrest of the bleeding was achieved. In seven cases of acute upper gastrointestinal hemorrhage presenting with gastric ulcer (n = 2 Forrest-Ia and n = 2 Forrest-Ib) and duodenal ulcer (n = 3 Forrest-Ib) bleeding was successfully stopped. The system is easy to handle, reliable in clinical practice, can be employed anywhere and the instrument is inexpensive.
Risk of cancer and the oral contraceptive pill
Authors: Olav Meirik, Timothy M M Farley
Journal: BMJ (2007)

In the preface to the first comprehensive publication from the Royal College of General Practitioners oral contraception study Sir Richard Doll wrote Final judgement on the safety of the pill must still await the passage of time when observations can be made of women who have used the pill for 10 or 20  Thirty years later in this weeks BMJ Hannaford and colleagues report incidence rates of cancer in relation to use of the pill among women in the study cohort. Between 1968 and 1969 45 950 women in the United Kingdom were enrolled in the study and they were followed for a mean of 24 years. Full assessment of the risk of cancer needs a long follow-up as effects of the pill may persist many years after its use has been stopped. Incidence rates of cancer in women who ever used the pill were compared with rates in women who never used the pill. On balance no higher risk of cancer was found in pill users. Risks were significantly lower for cancer of the colon or rectum uterine body or ovaries; the main gynaecological cancers combined (uterine body ovaries cervix); and for any diagnosis of cancer. The incidence of breast cancer was similar in pill users and never users. (excerpt)
Abstract 2153: Metformin and aspirin synergistically inhibit mTOR and JAK/STAT3 signaling pathway and induce cell death in pancreatic cancer cells
Authors: Wen Yue, Yong Lin, Chunxia Chen, Darren R. Carpizo, Robert S. DiPaola, Xiang-Lin Tan
Journal: Cancer Research (2014)

Abstract Epidemiological studies have correlated a decreased risk of pancreatic cancer with patients who take either metformin or aspirin. In addition, animal studies have shown that either metformin or aspirin inhibits pancreatic tumor formation as well as the progression of pancreatic intraepithelial neoplasia (PanIN). Since the combination of metformin and aspirin and their potential synergistic effects on pancreatic cancer cells have not been investigated, we evaluated the effects of metformin and aspirin, alone or in combination, on cell viability, migration, and apoptosis in pancreatic cancer cell lines PANC-1 and BxPC3. Cell viability and migration were determined using the MTT assay, colony formation, and the wound-healing assay, and the molecular changes in the mTOR and JAK/STAT3 and apoptotic signaling pathways were evaluated. The synergistic effects of the combination of metformin with aspirin were assessed using a method based on isobologram analyses. We observed that the combination of metformin and aspirin at low concentrations showed significant synergistic effects on the inhibition of cell viability, migration and colony formation in both PANC-1 and BxPC-3 cells. We also found that the combination of metformin and aspirin significantly inhibited the phosphorylation of mTOR, S6K, JAK2 and STAT3. Furthermore, the combination of metformin and aspirin significantly inhibited the expression of Bcl-2 and Mcl-1, which are the downstream targets of STAT3, in both mRNA and protein levels. We also observed increased apoptosis as measured by caspase 3 and poly (ADP-ribose) polymerase (PARP) cleavage in PANC-1 cells treated with the combination of metformin and aspirin. These results suggest that metformin and aspirin synergistically induce cell death in pancreatic cancer cells associated with down-regulating Bcl-2 and Mcl-1 through the STAT3 pathway. Our results support the continued investigation of the combination of metformin and aspirin as chemopreventative or therapeutic agents in pancreatic cancer tumor models. Citation Format: Wen Yue, Yong Lin, Chunxia Chen, Darren R. Carpizo, Robert S. DiPaola, Xiang-Lin Tan. Metformin and aspirin synergistically inhibit mTOR and JAK/STAT3 signaling pathway and induce cell death in pancreatic 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 2153. doi:10.1158/1538-7445.AM2014-2153
Problems in extrapolating toxicity data for laboratory animals to man.
Authors: R L Dixon
Journal: Environmental Health Perspectives (1976)

Some of the problems in extrapolating laboratory animal toxicity data to man are considered. The quantitative predictiveness of preclinical studies of anticancer drugs using dogs and monkeys for man has also been examined. The relationship between the maximum tolerated dose (MTD) in the dog, monkey, and the more sensitive of the two species and clinical observations are discussed. The effectiveness of using doses expressed on the basis of body weight (mg/kg) and body surface area (mg/m2) are compared. A method is introduced to assess the "statistical risk" associated with the extrapolation of the initial clinical (phase I) dose from experimental animal data. The best clinical prediction is obtained when one uses the experimental MTD expressed in mg/kg for the more sensitive of the large animal species (dogs or monkeys). The clinical introduction of a new anticancer agent at a dose 1/10 the MTD in the more sensitive species carries a statistical risk of about 3%; that is, the initial doses of about 3 of every 100 new drugs introduced into the clinic will produce some toxic effects in man. These same data have been extended theoretically to the total population and toxic chemicals in general. Reliable extrapolation from laboratory test models to man requires a much more complete understanding of structure--activity relationships, pharmacokinetic factors, and mechanisms of toxicity.
Topical Remedies for Disorders of the Anus and Rectum, and Improved Instruments for their Application
Authors: J. W. Cousins
Journal: BMJ (1888)

Nov. 3,188& s concerned, and so far as variety of cases is concerned, it does not matter whether the hospital contains 100 or 800 beds.Each group of 50 is practically identical with the other.When anything unusual in interest occurs in one ward, means are taken to bring it before the students of other wards; but, as a rule, the occupants of each group of 50 beds, medical or su-rgical, are suf- fering from nearly allied diseases.
Methods used in economic evaluations of prenatal screening are disputed
Authors: D. J Torgerson, A. Spencer
Journal: BMJ (1996)

EDITOR,—Nicholas Wald and Hilary Watt's letter1 about our paper on marginal analysis2 contains some important misconceptions regarding economic evaluation of prenatal screening services.

Firstly, we agree with the authors that they did not properly evaluate the economic consequences of changing from screening based on maternal age to biochemical screening in their earlier work3: this is precisely the point that we were making in our paper. …
Clozapine -- Deciphering the Risks
Authors: Stanton L. Gerson
Journal: New England Journal of Medicine (1993)

Clozapine appears to induce two clinically distinct types of neutropenia; these are the basis for the study by Alvir et al., reported in this issue of the Journal1. One is a mild-to-moderate neutropenia (absolute neutrophil count, 500 to 1500 per cubic millimeter) that occurs in 1.5 to 2.0 percent of patients receiving clozapine. This form of neutropenia is probably due to premature destruction in blood or spleen, since abundant myeloid maturation is evident in the marrow. When clozapine is discontinued, recovery is rapid, within three to seven days, and patients remain asymptomatic.The second type of neutropenia is more . . .
A successful second unrelated BMT (UBMT) from a different unrelated donor to treat ALL that relapsed after the initial UBMT
Authors: Taeko Uehara, Chiaki Nakaseko, Akira Yokota, Yasushi Saito, Miki Nishimura
Journal: American Journal of Hematology (2002)

Abstract A 26‐year‐old male with acute lymphoblastic leukemia (ALL) in its second complete remission received an unrelated bone marrow transplantation (UBMT) following cyclophosphamide plus total body irradiation conditioning. The patient relapsed 7 months after the BMT. He received a second UBMT from a different donor 15 months after the initial UBMT. Conditioning for the second UBMT consisted of busulphan, melphalan, and anti‐thymocyte globulin. The regimen was well tolerated, and engraftment was achieved. Both acute and chronic graft‐versus‐host diseases occurred but were successfully controlled with immunosuppressive drugs. He is alive and disease‐free 29 months after the second UBMT. This is the first report of a successful second UBMT for ALL that had relapsed after the first UBMT and for which a different donor was used. Am. J. Hematol. 71:37–40, 2002. © 2002 Wiley‐Liss, Inc.
Management of Atrial Fibrillation — Radical Reform or Modest Modification?
Authors: Rodney H. Falk
Journal: New England Journal of Medicine (2002)

The concept that the restoration of sinus rhythm in patients with atrial fibrillation is always an important goal has been largely uncontested for many years. Now, in this issue of the Journal, two trials comparing heart-rate control with rhythm control have tested this assumption and have found it wanting. Both the Atrial Fibrillation Follow-up Investigation of Rhythm Management, a North American study,1 and the Rate Control versus Electrical Cardioversion for Persistent Atrial Fibrillation Study, conducted in Europe,2 tested the hypothesis that among patients with atrial fibrillation, attempted maintenance of sinus rhythm would be equivalent in outcome to control of the . . .