tbuckley/cabot-search huggingface dataset:
Integrating Palliative Care for Liver Transplant Candidates
Authors: Anne M. Larson, J. Randall Curtis
Journal: JAMA (2006)

Chronic liver disease results in more than 1 million physician visits and more than 300,000 hospitalizations per year in the United States. More than 27,000 patients annually progress to end-stage liver disease (ESLD), liver failure, or death. Patients with ESLD experience such complications as encephalopathy, malnutrition, muscle wasting, ascites, esophagogastric variceal hemorrhage, spontaneous bacterial peritonitis, fatigue, and depression. Despite significant improvements in palliation, patients' quality of life diminishes and their disease will often inexorably progress. Liver transplantation, a valid treatment option, increases life and reduces many symptoms. With the current shortage of organs, up to 10% to 15% of these patients die without receiving an organ. Many patients also are not candidates for transplantation due to comorbid illness. In addition, some patients receive a transplant but succumb to complications of the transplant itself. Such patients and families face the conundrum of a potentially treatable yet often fatal illness. Through the case of a 55-year-old woman with a life-long history of hepatitis B virus infection who is awaiting transplant, we discuss the transplant eligibility process and the struggle with maintaining hope for a cure in the face a life-threatening illness. In all of these circumstances, the health care team must combine elements of palliative care with life-sustaining therapy to maximize the patient's quality and quantity of life.
Profile of the GMC. Discipline II: The preliminary screener--a powerful gatekeeper.
Authors: R. Smith
Journal: BMJ (1989)

The preliminary screener of the General Medical Council is a powerful person.He (and it was always a he until February of this year) must decide which disciplinary cases will proceed and which will not.The screener will discuss some cases with other members of the council, and a report on his activities is submitted to the preliminary proceedings committee.Critics of the GMC worry that so much power is concentrated in one man and that his accountability is limited.'The preliminary screener has not been required to discuss cases with the lay members of the council, although he may have done sometimes.A working party that reported at the end of last month has, however, suggested that lay members should participate more in this preliminary screening.Some regard this as an important advance, but others see it as a sop to public
PrimerSeq: Design and Visualization of RT-PCR Primers for Alternative Splicing Using RNA-Seq Data
Authors: Collin Tokheim, Juw Won Park, Yi Xing
Journal: Genomics Proteomics & Bioinformatics (2014)

Abstract The vast majority of multi-exon genes in higher eukaryotes are alternatively spliced and changes in alternative splicing (AS) can impact gene function or cause disease. High-throughput RNA sequencing (RNA-seq) has become a powerful technology for transcriptome-wide analysis of AS, but RT-PCR still remains the gold-standard approach for quantifying and validating exon splicing levels. We have developed PrimerSeq, a user-friendly software for systematic design and visualization of RT-PCR primers using RNA-seq data. PrimerSeq incorporates user-provided transcriptome profiles (i.e., RNA-seq data) in the design process, and is particularly useful for large-scale quantitative analysis of AS events discovered from RNA-seq experiments. PrimerSeq features a graphical user interface (GUI) that displays the RNA-seq data juxtaposed with the expected RT-PCR results. To enable primer design and visualization on user-provided RNA-seq data and transcript annotations, we have developed PrimerSeq as a stand-alone software that runs on local computers. PrimerSeq is freely available for Windows and Mac OS X along with source code at http://primerseq.sourceforge.net/. With the growing popularity of RNA-seq for transcriptome studies, we expect PrimerSeq to help bridge the gap between high-throughput RNA-seq discovery of AS events and molecular analysis of candidate events by RT-PCR.
"Night-blindness" -- A Psycho-physiological Study -- I
Authors: E. Wittkower, T. F. Rodger, G. I. Scott, B. Semeonoff
Journal: BMJ (1941)

The pressure and constitution of the C.S.F. have been studied in relation to the clinical condition in 85 cases of recent closed head injury.The C.S.F.pressure bears little relation to the state of consciousness, but in conscious patients a raised pressure is usually accompanied by headache.The C.S.F.pressure may fall steadily even when a space-occupying lesion is present.The degree ot consciousness is not related directly to the amount of blood present in the C.S.F.; it depends rather on the site of origin of the blood.The importance of a differential white cell count and a culture on a blood-stained C.S.F. is emphasized.If these are not done the presence of subarachnoid bleeding may mask an infective meningitis.A lymphocytosis in the C.S.F. may be present for three to four weeks after a severe head injury.I wish to thank Mr.
Combination OX40 agonism/CTLA-4 blockade with vaccination reverses anergy and primes tumor-specific CD8 T cells in mice with spontaneous prostate cancer
Authors: Stefanie N Linch, Melissa J Kasiewicz, William L Redmond
Journal: Journal for ImmunoTherapy of Cancer (2013)

Meeting abstracts Targeted immunotherapy, such as anti-CTLA-4 and anti-PD-1, has proven effective in treating cancer patients. However, despite these advances, cancer remains the second leading cause of death in the US. More effective strategies designed to maximize anti-tumor CD8 T cell responses
FREQUENCY OF INTESTINAL ACTIVITY i. ITS EFFECT ON SPECT Tc-99m SESTAMIBI (MIBI) INTERPRETATION
Authors: P. Rehm, S. Green, P. Atkins, E. Akin, L. Fox, D. J. Hixson, H. Zioasman
Journal: Clinical Nuclear Medicine (1994)

Rehm, P.; Green, S.; Atkins, P.; Akin, E.; Fox, L.; Hixson, D. J.; Zioasman, H. Author Information
Effects of Cannabis roots on the heart
Authors: M. Ham Ten
Journal: JAMA (1973)

To the Editor.—  Rodger (217:1705, 1971) mentioned a not widely known cardiac action of an extract of Cannabis roots in whiskey (about 45% alcohol). We report here our experiments on the supposed action of these roots in 50% alcohol, diluted to 18.4 mg/ml in 4% ethanol in water. This solution contained 18.4 mg dry substance/ml. This was injected in the perfusion fluid of an isolated guinea pig heart in vitro (Langendorff technique). Injection of 0.1 ml of the preparation was followed by bradycardia; the rate dropped from 240 beats/minute to 60 beats/minute. A quick recovery was seen when administration was stopped.  In our next experiment we studied the effect of root extract on the electrocardiogram of three guinea pigs under urethane anesthesia. The preparation was infused in the jugular vein at the rate of 0.2 ml/min. After some time bradycardia developed with prolongation of the PR interval and the QRS
Stent grafts were more effective than balloon angioplasty alone for revision of stenosis in failing dialysis-access grafts
Authors: Louise Moist
Journal: Annals of Internal Medicine (2010)

ACP Journal Club15 June 2010Stent grafts were more effective than balloon angioplasty alone for revision of stenosis in failing dialysis-access graftsLouise Moist, MD, MScLouise Moist, MD, MScUniversity of Western Ontario, London, Ontario, Canada (L.M.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-12-201006150-02008 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationHaskal ZJ, Trerotola S, Dolmatch B, et al. Stent graft versus balloon angioplasty for failing dialysis-access grafts. N Engl J Med. 2010;362:494-503. https://pubmed.ncbi.nlm.nih.gov/20147715Clinical Impact RatingsNephrology: References1 Tonelli M, James M, Wiebe N, Jindal K, Hemmelgarn B. Ultrasound monitoring to detect access stenosis in hemodialysis patients: a systematic review. Am J Kidney Dis. 2008;51:630-40. [PMID: 18371539] Google Scholar2 Vascular Access Work Group. Clinical practice guidelines for vascular access. Am J Kidney Dis. 2006;48:S248-73. [PMID: 16813991] Google Scholar3 Lumsden AB, MacDonald MJ, Kikeri D, et al. Prophylactic balloon angioplasty fails to prolong the patency of expanded polytetrafluoroethylene arteriovenous grafts: results of a prospective randomized study. J Vasc Surg. 1997;26:382-90. [PMID: 9308584] Google Scholar Author, Article, and Disclosure InformationAuthors: Louise Moist, MD, MScAffiliations: University of Western Ontario, London, Ontario, Canada (L.M.)This article was published at Annals.org on 1 June 2010. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 June 2010Volume 152, Issue 12Page: JC6-8KeywordsAngiographyAngioplastyHemodynamicsRenal diseasesRenal failureStenosisStent implantationThrombosisTreatment guidelinesVascular surgery ePublished: 15 June 2010 Issue Published: 15 June 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Differences that make a difference: Do locus equations result from physical principles characterizing all mammalian vocal tracts?
Authors: W. Tecumseh Fitch, Marc D. Hauser
Journal: Behavioral and Brain Sciences (1998)

Sussman and colleagues provide no evidence supporting their claim that the human vocal production system is specialized to produce locus equations with high correlations and linearity. We propose the alternative null hypothesis that these features result from physical and physiological factors common to all mammalian vocal tracts and we recommend caution in assuming that human speech production mechanisms are unique.
Glucagon regulates gluconeogenesis through KAT2B- and WDR5-mediated epigenetic effects
Authors: Kim Ravnskjaer, Meghan F. Hogan, Denise Lackey, Laszlo Tora, Sharon Y.R. Dent, Jerrold Olefsky, Marc Montminy
Journal: Journal of Clinical Investigation (2013)

Circulating pancreatic glucagon is increased during fasting and maintains glucose balance by stimulating hepatic gluconeogenesis. Glucagon triggering of the cAMP pathway upregulates the gluconeogenic program through the phosphorylation of cAMP response element-binding protein (CREB) and the dephosphorylation of the CREB coactivator CRTC2. Hormonal and nutrient signals are also thought to modulate gluconeogenic gene expression by promoting epigenetic changes that facilitate assembly of the transcriptional machinery. However, the nature of these modifications is unclear. Using mouse models and in vitro assays, we show that histone H3 acetylation at Lys 9 (H3K9Ac) was elevated over gluconeogenic genes and contributed to increased hepatic glucose production during fasting and in diabetes. Dephosphorylation of CRTC2 promoted increased H3K9Ac through recruitment of the lysine acetyltransferase 2B (KAT2B) and WD repeat-containing protein 5 (WDR5), a core subunit of histone methyltransferase (HMT) complexes. KAT2B and WDR5 stimulated the gluconeogenic program through a self-reinforcing cycle, whereby increases in H3K9Ac further potentiated CRTC2 occupancy at CREB binding sites. Depletion of KAT2B or WDR5 decreased gluconeogenic gene expression, consequently breaking the cycle. Administration of a small-molecule KAT2B antagonist lowered circulating blood glucose concentrations in insulin resistance, suggesting that this enzyme may be a useful target for diabetes treatment.
Immunoperoxidase in Fine-Needle Aspirate Specimens
Authors: David M. Reifler
Journal: JAMA (1985)

To the Editor.—  I read with interest the article by Tell and associates 1 regarding the clinical usefulness of the immunoperoxidase technique for prostate-specific antigen in the diagnosis of atypical metastasis from prostate cancer. This excellent article again brought to our attention the value of special histochemical techniques. I would only like to add that atypical metastasis from prostatic carcinoma may also be confirmed using immunoperoxidase techniques on cytological specimens obtained by fine-needle aspiration. Use of this technique was reported by Reifler and associates 2 in a case of orbital metastasis. Nadji 3 also demonstrated the possibilities of concurrent application of immunoperoxidase techniques with diagnostic cytology, including the establishment of a prostate carcinoma in a cervical lymph node. Certainly, fine-needle aspiration does not exclude the use of immunoperoxidase techniques and should be considered in selected cases, when an open biopsy would involve an extensive surgical procedure.
Modern Languages in the Service of Medicine
Authors: R. Whitehead
Journal: BMJ (1949)

At one time or another the problem of foreign languages pre- sents itself to a large proportion of the medical profession.French and German are among the essential tools of the teacher and research worker, and are of at least temporary concern7 to the candidate for a higher degree by thesis.Other modern foreign languages are not widely cultivated by British medical men, but those who can read them are valued as translators, reviewers, and abstracters.For these reasons it is of interest to determine how far various languages are used by medical writers and to discuss the problems that the diversity of languages creates for medical libraries, readers, and authors.
Effects of nitroglycerin on echocardiographic measurements of left ventricular wall thickness and regional myocardial performance during acute coronary ischemia.
Authors: R R Komer, A Edalji, W B Hood
Journal: Circulation (1979)

The effects of nitroglycerin on regional left ventricular performance, assessed by echocardiographic techniques, were investigated in anesthetized, open-chest dogs during acute myocardial ischemia. During transient occlusion of the left anterior descending coronary artery, there was end-diastolic thinning and marked reduction in systolic thickening in the central ischemic zone. Similar changes of lesser degree were noted in the border zone. The normal zone was unaffected. Infusion of nitroglycerin during ischemia in dosages of 2.5--50 microgram/kg/min reduced left ventricular end-diastolic pressure without changing the abnormalities of systolic wall thickening. Effects of bolus injections of 20 and 50 microgram/kg of nitroglycerin were similar, although this also lowered aortic pressure. In a subgroup of animals in which nitroglycerin infusion was unaccompanied by tachycardia, there was also no evidence that ischemic dysfunction was altered. We conclude that nitroglycerin does not improve regional myocardial performance in acutely ischemic canine myocardium. The decrease in preload is probably entirely due to the peripheral effects of the agent.
Natural variability and the influence of concurrent control values on the detection and interpretation of low-dose or weak endocrine toxicities.
Authors: John Ashby, Helen Tinwell, Jenny Odum, Paul Lefevre
Journal: Environmental Health Perspectives (2004)

While defining the no effect level for the 5 alpha-reductase inhibitor finasteride in the Hershberger assay, we encountered an inverted-U low-dose trophic effect on the prostate gland of the rat. Two attempts to confirm this observation were unsuccessful, and we concluded that the positive effect initially observed was associated with normal biologic variability. During the same period we attempted, unsuccessfully, to repeat our own observation of weak uterotrophic activity in the rat for the sunscreen 3-(4-methylbenzylidene)camphor (4MBC). Further evaluation led us to conclude that 4MBC is uterotrophic only when the control uterine weights are at the low end of their normally encountered range. This led us to reevaluate our earlier mouse uterotrophic assay data for bisphenol A (BPA). Originally we had concluded that BPA gave irreproducible evidence of weak uterotrophic activity, but upon ordering the eight experiments we had conducted, according to decreasing control uterine weight, we confirmed reproducible weak uterotrophic activity for BPA when the control uteri were at the low end of their normal range. In this article, we describe these observations, together with a reanalysis of the data associated with several reported instances of weak or low-dose endocrine effects that have proven difficult to confirm in independent laboratories. These include the activity of BPA on the CF1 mouse prostate; the activities of BPA, octylphenol, and nonylphenol on the rat testis; and the effect of polycarbonate caging on control mouse uterine weight. In all of these cases, variability among controls provides a major obstacle to data interpretation and confirmation. Our recommendations on experimental design are also presented, with a view to ending the current impasse on the reality, or otherwise, of low-dose or weak endocrine toxicities.
Borderzone Contractile Dysfunction Is Transiently Attenuated and Left Ventricular Structural Remodeling Is Markedly Reduced Following Reperfused Myocardial Infarction in Inducible Nitric Oxide Synthase Knockout Mice
Authors: Wesley D. Gilson, Frederick H. Epstein, Zequan Yang, Yaqin Xu, Konkal-Matt R. Prasad, Marie-Claire Toufektsian, Victor E. Laubach, Brent A. French
Journal: Journal of the American College of Cardiology (2007)
The Prolonged Use of an Oral Mercurial Diuretic in Ambulatory Patients with Congestive Heart Failure
Authors: JOSEPH B. VANDER VEER, THOMAS W. CLARK, DAVID S. MARSHALL
Journal: Circulation (1950)

Tablets of an oral mercurial diuretic were utilized in the management of patients with severe congestive failure over a prolonged period of time. The need for parenteral mercurial diuretics was eliminated or greatly decreased by this therapy. The individual dosage was established by clinical trial. Minor toxic effects were encountered in several patients but in all instances it was possible to resume the therapy. Severe toxicity was not seen and there were no symptoms of salt depletion. Ease of administration, a more sustained diuresis, and good patient cooperation are advantages of this type of therapy.
Cholesterol embolization syndrome: cutaneous histopathological features and the variable onset of symptoms in patients with different risk factors
Authors: M. Pennington, J. Yeager, H. Skelton, K.J. Smith
Journal: British Journal of Dermatology (2002)

Cholesterol embolization syndrome (CES) may not only be due to direct dislodgement of cholesterol crystals from atherosclerotic plaques on the walls of arteries by surgery, angiogram or trauma, but may occur after anticoagulant and thrombolytic therapy. The latter two therapies both weaken the fibrin clot that stabilizes the atheromas in place; however, these two therapies commonly have different onsets of CES after their institution. We present three patients with different risk factors for CES who all presented with the pathognomonic triad of leg and/or foot pain, livedo reticularis and good peripheral pulses. In all three patients cholesterol emboli were demonstrated in cutaneous biopsy sections. In two patients there was associated renal involvement, which was fatal in one case. These cases illustrate that cutaneous biopsy may be diagnostic in patients with livedo reticularis, which progresses to necrosis and gangrene. In addition, they illustrate the problems and contradictions involved in treating patients with CES.
Prison officers had no sign of Shipman's suicidal tendencies
Authors: Kaye McIntosh
Journal: BMJ (2005)

The death of the serial killer Harold Shipman in his cell “could not have been predicted or prevented,” an official investigation has found. But the ombudsman for prisons and probation, Stephen Shaw, said officers at Wakefield Prison “do not appear to have been alerted to the man's long term risk of suicide or what might finally trigger it.”

Mr Shaw examined how the former GP was able to hang himself in his cell in January 2004. Shipman was convicted of murdering 15 patients but is thought to have killed another 235.

Mr Shaw said the death raised “procedural issues relating …
Predicting the Outcome From Hypoxic-Ischemic Coma: Ethical Implications
Authors: Howard Brody
Journal: JAMA (1986)

<h3>To the Editor.—</h3> Dr Black's editorial<sup>1</sup>on predicting the outcome from hypoxic-ischemic coma correctly notes that predictors of bleak prognosis pose important ethical implications and that some of the key ethical assumptions may remain implicit and unexamined if one moves too quickly from prognostic judgments to public policy decisions. I question, however, his suggestion that a consequentialist analysis lies specifically at the root of any decision that one should withhold life-prolonging treatment from an irreversibly comatose patient. Consequentialist or utilitarian ethics are frequently contrasted to a deontological (rights- or duty-oriented) ethical approach. A fundamental deontological question therefore becomes what is required before one could be said to be the subject of rights and duties (since it is obvious that we should respect the rights of other normal human beings but that we should not worry about respecting the rights of trees and rocks). While opinions differ, one useful line of
RESPONSIBILITY OF THE PHYSICIAN IN VACCINATION.
Authors: JULIA W. CARPENTER
Journal: JAMA (1899)

That smallpox has ever been a fearful scourge in the world is known to but few outside of the medical profession, and the full extent of this scourge in the past, unless it has been portrayed in undying colors in the class-room, is not a vivid picture even now with the majority of physicians. So quickly does the world become accustomed to the absence of aonce dreaded disease that its reappearance is needed to force again a study of its history, its ravages, its cause, its prevention and obstacles to its prevention. Its history tells us that since the days of the immortal Jenner there has been a grand transformation scene on the face of the earth. This change has been almost incredible. Before the days of vaccination the ravages of smallpox were beyond belief. Two millions have sometimes died in one country in one year. Now the majority of
Treatment of Bed-wetting-Reply
Authors: Mark A. Stewart
Journal: JAMA (1975)

<h3>In Reply.—</h3> I believe that a number of urologists would agree with Dr Langlois, and I would gladly rebut his comments. The available data on urgency and frequency and the prevalence of meatal stenosis do not match Dr Langlois's impressions, but rather suggest that he sees a select population of enuretics. Hallgren,<sup>1</sup>in a study of several hundred enuretic children attending a clinic, found that 22% experienced frequent urination; 7%, urgent urination, and 14%, both. Only 2.5% of the enuretic children had malformed urinary tracts; 3% were found to have obstructive lesions by urethrocystogram; and less than 1% of intravenous pyelograms showed an anomaly. Very different figures have been reported from urologic clinics, for example, by Mahony.<sup>2</sup>The answer to these questions seems to depend on the pool of patients and on one's special interest, but Hallgren's data are probably closest to the experience of family practitioners and
Writing and speaking in medicine. How I referee.
Authors: D A Pyke
Journal: BMJ (1976)

There are many books and articles giving guidance to the writer and I have prepared a list of my favourites.In them you will find not only good advice but so many warnings of the pitfalls that all but the most daring will, I hope, be put off.Don't forget that much can be absorbed with pleasure from one's everyday reading.But in the final analysis nothing succeeds like repeatedly doing a job yourself and, to leave you with a few crumbs of comfort, I pass on the words of a respected