tbuckley/cabot-search huggingface dataset:
Reflections on death in childhood.
Authors: F Dominica
Journal: BMJ (1987)

During the past four years I have been involved in varying degrees in the death of about 70 people, most of them children and teenagers. Almost anything worth while that I have learnt about death, I have learnt from those young people and from those closest to them. Perhaps the most important thing has been the gradual recognition that however ill at ease and maladroit Western society is in the face of death, given permission and a loving, affirming environment, the individual will meet death with what I can describe only as a severe beauty. Death is familiar to us in war, in holocaust, and in massive famine disasters, but we know it as remote control statistics. Death is no longer the familiar part of the domestic neighbourhood scene that it was 100 or even 50 years ago. Improved living conditions, health care, and highly developed skills in medicine and surgery, the breakdown of the extended family and the close knit local community, the tendency for the fatally ill, even the elderly, to be taken away to hospital or institution, all contribute to an unfamiliarity with death. Many people will reach middle age without ever having been in the presence of death and possibly without having attended a funeral. The more sophisticated our society becomes and the more it pays homage to intellect and powers of reasoning the more ill at ease it is with death and that which lies beyond. Religion, belief in that which cannot be proved, and the readiness to allow ourselves to be led beyond our ken into the realms of mystery are things less and less to be trusted. Sometimes those who wield the greatest power and possess the greatest wealth are those who fare worst for here, finally, is something which neither money nor position can win back?life itself.
FRACTURE OF THE MONTH
Authors: Edwin F. Cave
Journal: JAMA (1960)

INCE prehistoric times the teaching of medicine has been by precept and example. Before the establishment of formal medical schools, apprenticeship to a senior physician was the only means by which a young man could get a medical education. This came through practical experience. Case presentations became a part of medical teaching in medieval times, when Taddeo Alderotti (1223-1303) at Bologna introduced a new form of medical literature called "consilia." These were discussions of clinical cases, giving a description of symptoms and full details of treatment. The case method of teaching has stood the test of time for centuries; it has been used in the law as well as in medicine. Fractures lend themselves well to this type of instruction, and amazingly accurate presentations of certain fractures were given by Percivall Pott (1713-1788 and Abraham Colles (1773-1843) even before Roentgen's discovery of the x-ray in 1896. Since the turn of
The Smokeless Pipe
Authors: Joseph H. Davis
Journal: JAMA (1970)

<h3>To the Editor:—</h3> The device renews, at the adult level, the controversy over the relative merits and harm from the use of the pacifier vs the thumb as a source of oral gratification. Ours is not particularly a pacifier-oriented culture, as is the case in many European countries. Here we seem to accept the normal mechanism of thumb sucking for oral gratification in infancy. If this is to be carried over into "manhood," why not keep the same image; Dr. Friederici's device reminded us of a similar device made by the late Dr. Richard Cutter (Figure) extolling the thumb as the ultimate sucking device. This was made up in response to a comment in an article on psychodynamics in dentistry: I am often intrigued watching how pipe-smokers use the stem of their pipes; or more particularly, the choice of the shape of the pipe stem for one that resembles a
Pre‐discharge B‐type natriuretic peptide predicts early recurrence of decompensated heart failure in patients admitted to a general medical unit
Authors: Valerio Verdiani, Carlo Nozzoli, Francesca Bacci, Adriana Cecchin, Maria Serena Rutili, Sergio Paladini, Iacopo Olivotto
Journal: European Journal of Heart Failure (2005)
NK314 potentiates antitumor activity with adult T-cell leukemia-lymphoma cells by inhibition of dual targets on topoisomerase IIα and DNA-dependent protein kinase
Authors: Takashi Hisatomi, Naoko Sueoka-Aragane, Akemi Sato, Rika Tomimasu, Masaru Ide, Akihiro Kurimasa, Kazuya Okamoto, Shinya Kimura, Eisaburo Sueoka
Journal: Blood (2011)
HLA phenotypes and gene polymorphisms in juvenile liver disease associated with α1-antitrypsin deficiency
Authors: Derek G. Doherty, Peter T. Donaldson, David B. Whitehouse, Giorgina Mieli-Vergani, Ann Duthie, David A. Hopkinson, Alex P. Mowat
Journal: Hepatology (1990)

Chronic liver disease affects up to 20% of children with α–antitrypsin deficiency owing to the PiZZ genotype. Previous observations of a familial occurrence and abnormal immune responses to liver antigens in these patients suggests that immunoregulatory genes may be involved in the pathogenesis of liver damage. We have identified HLA phenotypes and class II (HLA–DR) gene polymorphisms in 140 white PiZZ subjects, of whom 92 (83 index patients) had liver disease, and 206 first–degree relatives. DR3* was present in 35 of 75 (46.7%) unrelated patients with liver disease compared with 5 of 28 (17.8%) patients without (p &lt; 0.01) and 23 of 100 controls (p &lt; 0.001). DR4 was increased in patients without liver disease; it was present in 17 of 28 (60.7%) compared with 29 of 75 (38.7%) patients with liver disease (p &lt; 0.05) and 36 of 100 controls (p &lt; 0.025). Using Southern blot analysis with HLA–DRB and DQB DNA probes, we identified two polymorphisms of DR3, only one (Dw25) of which is raised in PiZZ individuals with liver disease (9 of 55: 16.4%) compared with 1 of 23 (4.4%) without and 2 of 52 (3.9%) controls (p &lt; 0.05). Analysis of the segregation of HLA haplotypes in 77 families revealed no concordance for liver disease with HLA in those with affected sibships, indicating that, although DR3–Dw25 is associated with liver disease in α 1 –antitrypsin deficiency, other factors must play a pathogenic role. (Hepatology 1990;12:218-223).
Selective Modulation of Inducible Nitric Oxide Synthase Isozyme in Myocardial Infarction
Authors: Stephen M. Wildhirt, Hiroshi Suzuki, Damian Horstman, Susanne Weismüller, Ryszard R. Dudek, Kazuhide Akiyama, Bruno Reichart
Journal: Circulation (1997)

Inducible nitric oxide synthase (iNOS) is activated in cardiac disorders. We investigated the contribution of increased iNOS activity to the development of left ventricular dysfunction after myocardial infarction by selective inhibition of the isozyme.Male New Zealand rabbits were subjected to myocardial infarction. Animals were treated with either saline, S-methylisothiourea sulfate (SMT) (a selective iNOS inhibitor), or N(omega)-nitro-L-arginine (L-NNA) (a nonselective NOS inhibitor). Inducible and constitutive NOS (cNOS) activity, plasma NO(x), cGMP, hemodynamics, and myocardial blood flow were measured before and 5, 24, and 72 hours after coronary occlusion. Infarction 72 hours after occlusion resulted in increased myocardial iNOS activity, increased cardiac NO(x) production, and elevated cGMP levels. cNOS remained unchanged. Infarction increased left ventricular end-diastolic pressure (LVEDP) and decreased maximum +dP/dt and -dP/dt. L-NNA inhibited iNOS and cNOS activities and plasma NO(x) levels. L-NNA further increased LVEDP and reduced myocardial blood flow. Administration of SMT 72 hours after infarction significantly inhibited iNOS and cardiac NO(x) production but had no effects on cNOS. SMT improved left ventricular maximum +dP/dt and -dP/dt and decreased LVEDP. Myocardial blood flow in the remote myocardium increased.These findings suggest that induction of iNOS activity 72 hours after infarction exerts negative inotropic effects and contributes to the development of myocardial dysfunction; selective modulation of increased iNOS activity by SMT improves cardiac performance, enhances myocardial blood flow, and may be beneficial in the treatment of acute myocardial infarction.
Where next for the research assessment exercise?
Authors: Fiona Godlee
Journal: BMJ (2006)

The rules for deciding who gets public money for research in the United Kingdom are set to change. The world's largest research assessment exercise (RAE)—which has dominated the lives of UK academics for the past 20 years—is to be ditched after the next round in 2008, and consultation begins next month to find an alternative. This week's BMJ carries the first of a series of contributions debating the future of research assessment in the UK and around the world.

Many will welcome an end to the tyranny of the RAE. It has clearly succeeded …
Immunopharmacologic response of patients with B-lineage acute lymphoblastic leukemia to continuous infusion of T cell–engaging CD19/CD3-bispecific BiTE antibody blinatumomab
Authors: Matthias Klinger, Christian Brandl, Gerhard Zugmaier, Youssef Hijazi, Ralf C. Bargou, Max S. Topp, Nicola Gökbuget, Svenja Neumann, Mariele Goebeler, Andreas Viardot, Matthias Stelljes, Monika Brüggemann, Dieter Hoelzer, Evelyn Degenhard, Dirk Nagorsen, Patrick A. Baeuerle, Andreas Wolf, Peter Kufer
Journal: Blood (2012)
TCT-229 First generation versus new generation drug-eluting stents for the treatment of ostial/midshaft lesions in unprotected left main coronary artery: The Milan and New-Tokyo (MITO) registry
Authors: Toru Naganuma, Alaide Chieffo, Kensuke Takagi, Vasileios F. Panoulas, Satoru Mitomo, Charis Costopoulos, Yusuke Fujino, Alessandro Sticchi, Azeem Latib, Tadashi Miyazaki, Katsumasa Sato, Matteo Montorfano, Mauro Carlino, Sunao Nakamura, Antonio Colombo
Journal: Journal of the American College of Cardiology (2014)
Food in Diabetes. A Reply to Dr. Cutter.
Authors: Edward L. Munson
Journal: JAMA (1897)

Fort Assinniboine, Mont., June 10, 1897. <h3>To the Editor:</h3> —The communication of Dr. J. A. Cutter, published in the issue of theJournalfor May 29, should not pass without a reply. In this letter he states "my plan of treatment has been to stop the fermentation of any kind of food in the alimentary tract because such fermentation produces carbonic acid and other paralyzing gases<i>and these gases act directly on the liver and help to increase the production of sugar</i>." (The italics are mine.) This is certainly important if true and, being unable to find any reference to this point in the various works on physiology accessible, I would beg Dr. Cutter to name his authorities for such a surprising statement. "Again," he says, "American morphologists have shown for over thirty years that starches and sugars promote alcoholic and acetic acid fermentation in the stomach and bowel." Unfortunately
Primary Amebic Encephalitis, Probably from Acanthamoeba
Authors: VICTOR B. ROBERT
Journal: Annals of Internal Medicine (1973)

A 58-year-old man had primary amebic encephalitis, probably caused by Acanthamoeba. Unlike cases of amebic meningoencephalitis due to Naegleria, the evolution was subacute, and cerebrospinal fluid lymphocytosis was an important feature. The patient had contact with contaminated water 2 weeks before the onset of symptoms. Although the precise portal of entry is unknown, evidence suggests a hematogenous spread in spite of the lack of a primary focus. The pathological process was characterized by a necrotizing, granulomatous encephalitis with predilection for the temporal lobes, deep gray masses, and brain stem. The information on this infection has been reviewed, and the clinical and pathological differences between infection caused by Naegleria and that produced by Acanthamoeba are discussed.
FDG PET/CT Findings of Common Bile Duct Tuberculosis
Authors: Aisheng Dong, Yang Wang, Jing Gong, Changjing Zuo
Journal: Clinical Nuclear Medicine (2013)

Common bile duct (CBD) tuberculosis is rare. A 39-year-old woman was referred because of a 5-month history of abdominal pain. Abdominal enhanced MRI and CT showed dilatation of the distal CBD with irregularly thickened wall. Enhanced CT revealed enlarged retroperitoneal lymph nodes. FDG PET/CT showed increased FDG uptake of the CBD lesion and several retroperitoneal lymph nodes with slight FDG uptake. CBD cholangiocarcinoma with retroperitoneal lymph node metastasis was suspected. CBD tuberculosis was confirmed by endoluminal biopsy. Tuberculosis should be considered in the differential diagnosis of abnormal biliary FDG accumulation, particularly in tuberculosis endemic areas.
Modes of memory.
Authors: R D Hinshelwood
Journal: BMJ (1970)

endocrine hypothesis.For example, there must be in the population many men who have regularly donated blood every six months for many years.Obviously this is not equivalent to a monthly menstrual bleed.Nevertheless it would be interesting to see whether these men are in any way protected against coronary thrombosis as compared with a group of non-donors.(2) If true the concept would mean that protection against coronary thrombosis could be provided at very low cost.There would be no need for life-long drug taking or dietary changes.
Shared Care in Gastroenterology
Authors: P HUNGIN
Journal: Gut (1998)

Shared Care in Gastroenterology. Travis S, Stevens R, Dalton H. (Pp 226; illustrated; £22.50.) Oxford: Isis Medical Media, 1997. ISBN 1-899066-40-6.

The relationship between general practitioners and gastroenterologists has, generally, been a better one than with most other specialists. In the UK, this has in part been due to long fostered relationships between the British Society of Gastroenterology and the Primary Care Society for Gastroenterology. Also, there is a closely shared and common clinical agenda between general practitioners and gastroenterologists. Some aspects of gastroenterology, particularly dyspepsia, are managed essentially in primary …
Developmentally timed expression of an embryonic growth phenotype in vascular smooth muscle cells.
Authors: C L Cook, M C Weiser, P E Schwartz, C L Jones, R A Majack
Journal: Circulation Research (1994)

Little is known about the phenotypic changes that occur in vascular smooth muscle cells (SMCs) as the developing aorta undergoes the transition from a loosely organized, highly replicative tissue to a morphologically mature, quiescent tissue. In the present study, we have characterized the in vivo pattern of SMC replication during intrauterine and neonatal aortic development in the rat and have cultured and assessed the in vitro growth properties of embryonic, fetal, and neonatal vascular SMCs. Embryonic SMCs, which exhibited a very high in vivo replication rate (75% to 80% per day), demonstrated a significant potential for self-driven replication, as assessed by the ability to proliferate under serum-deprived conditions. Several lines of evidence suggest that the autonomous growth of SMCs in the "embryonic growth phenotype" may be driven by a unique mechanism independent of known adult SMC mitogens: embryonic SMC replication was not associated with the detectable secretion of mitogenic activity capable of stimulating adult SMCs, and embryonic SMCs were mitogenically unresponsive to a variety of known adult SMC growth factors. The capacity for self-driven growth was lost by embryonic day 20, suggesting that important changes in gene expression and phenotype occur in developing SMCs between embryonic days 18 and 20. Taken together, the data describe a unique embryonic growth phenotype of vascular SMCs and suggest that the replication of aortic SMCs during intrauterine development is self driven, self regulated, and controlled by a developmental timing mechanism. The conversion of SMCs from the embryonic to the late fetal/adult growth phenotype will likely be found to be an important component of a developmental system controlling vascular morphogenesis.
Soc Trang: A Vietnamese Odyssey
Authors: Gentry W. Yeatman
Journal: JAMA (1984)

This is an exciting story about an army physician's effort to win the other war in Vietnam. Stationed at a helicopter base in the Mekong Delta in the late 1960s, the author's activities went far beyond the assigned duty of caring for wounded troops. Venturing into hostile territory to visit an orphanage, he was appalled to find malnourished, diseased children two or three to a crib. The orphanage had been operated for 35 years by a French nun who struggled to care for dying infants without adequate food, medications, or even soap.  Rising to the task, Dr Bartecchi and his staff revolutionized the orphanage. After news of their effort reached stateside newspapers, they were deluged with literally tons of equipment and supplies. Soon the number of orphans began to rise the day before each weekly visit by the medical team. These babies were also treated, and the town of Soc
A PLASMIN-SPLIT FRAGMENT OF C'3 AS A NEW CHEMOTACTIC FACTOR
Authors: Peter A. Ward
Journal: The Journal of Experimental Medicine (1967)

When streptokinase and highly purified human plasminogen are added to human serum or to partly purified or highly purified preparations containing the third component of complement (C'3), either rabbit or human, a chemotactic factor is generated. This chemotactic factor is a split product of C'3 and is dialyzable, fast moving electrophoretically, slowly sedimenting in sucrose density gradient ultracentrifugation, and has an approximate molecular weight of 6000. It is calculated that this fragment accounts for approximately 4% of the intact molecule. The C'3 fragment has the following biologic properties: It is chemotactic for rabbit PMN's in vitro, it causes accumulation of PMN's in vivo, and it increases vascular permeability in rat skin. In addition to generating a chemotactic factor, plasmin destroys the complement-associated chemotactic factor that is a trimolecular complex consisting of the fifth (C'5), sixth (C'6), and seventh (C'7) components of complement. This has been shown by a loss of chemotactic activity, as well as a dissociation of the C'5, C'6, C'7 complex and a destruction of C'6 hemolytic activity. The biologic significance of the plasmin-generated chemotactic factor is discussed in relation to other recently discovered biologically active fragments of C'3.
Gastric endoscopic submucosal dissection using novel 2.6-mm articulating devices: an ex vivo comparative and in vivo feasibility study
Authors: Ryu Nakadate, Shotaro Nakamura, Tomohiko Moriyama, Hajime Kenmotsu, Susumu Oguri, Jumpei Arata, Munenori Uemura, Kenoki Ohuchida, Tomohiko Akahoshi, Tetsuo Ikeda, Makoto Hashizume
Journal: Endoscopy (2015)

<b>Background and study aims: </b>The conventional procedure of endoscopic submucosal dissection (ESD) is technically demanding. This study investigated the efficiency of novel articulating devices (maximum diameter 2.6 mm), which can be used with commercially available, standard endoscopes. <b>Patients and methods: </b>In an ex vivo comparative study, eight endoscopists were divided into novices and experienced operators, and performed ESD using new devices and the conventional setup. An in vivo animal experiment was performed by two experts. Procedure times for incision and dissection were recorded, and unit times for circumferential length and area of specimens were calculated. <b>Results:</b> All procedures were successfully completed with en bloc resection. In the ex vivo study, the unit procedure times for incision and dissection by novices were significantly shorter using the new system (<i>P</i> < 0.01 and <i>P</i> < 0.05), whereas there was no significant difference for experienced endoscopists. Perforation occurred during one procedure in which the new system was used. The in vivo experiments were successfully completed without adverse events. <b>Conclusions: </b>ESD using novel articulating devices was feasible. These devices were able to reduce the procedure time for novices.
Delay of Surgery for Melanoma Among Medicare Beneficiaries
Authors: Jason P. Lott, Deepak Narayan, Pamela R. Soulos, Jenerius Aminawung, Cary P. Gross
Journal: JAMA Dermatology (2015)

Timely delivery of surgery for cancer affects health care quality and outcomes. However, population-based studies characterizing the delay of surgery for melanoma in the United States have not been performed.To assess the delay of surgery for melanoma by tumor-, patient-, and physician-level characteristics.We performed a retrospective cohort study of Medicare beneficiaries diagnosed as having melanoma from January 1, 2000, through December 31, 2009, using the Surveillance, Epidemiology, and End Results-Medicare database. We included all patients undergoing surgical excision of melanoma diagnosed by means of results of skin biopsy.Anatomic location and stage of the tumor, patient sociodemographic characteristics, prior melanoma, Elixhauser comorbidities, and the specialties of the physicians who performed the biopsy and surgery.Surgical delay, measured as the time from the biopsy to surgical excision. We estimated risk-adjusted odds ratios (ORs) and marginal probabilities of delay with 95% CIs for each covariate using mixed-effects logistic regression.Our cohort consisted of 32 501 cases of melanoma. Most of the patients were white (95.4%), male (63.1%), married (47.9%), and 75 years or older (60.8%) and did not have a prior melanoma (93.7%). Melanomas were most frequently located on the head and neck (40.5%) and staged as in situ disease (48.2%). More than three-quarters of cases (25 269 [77.7%]) underwent excision within 1.5 months of biopsy. Among those treated after 1.5 months (7232 [22.3%]), 2620 (8.1% of all cases) experienced a delay of longer than 3 months. The incidence of a risk-adjusted surgical delay longer than 1.5 months was significantly increased among patients 85 years or older compared with those younger than 65 years (odds ratio [OR], 1.28 [95% CI, 1.05-1.55]; P = .02), those with a prior melanoma (OR, 1.20 [95% CI, 1.08-1.34]; P = .001), and those with an increased comorbidity burden (OR, 1.18 [95% CI, 1.09-1.27]; P < .001). Melanomas that underwent biopsy and excision by dermatologists had the lowest likelihood of delay (probability, 16% [95% CI, 14%-18%]). The highest likelihood of delay (probability, 31% [95% CI, 24%-37%]) occurred when the biopsy was performed by a nondermatologist and excised by a primary care physician. Similar findings were observed for a delay longer than 3 months.Approximately 1 in 5 Medicare beneficiaries experience a delay of surgery for melanoma that is longer than 1.5 months. Those patients undergoing biopsy and surgery by dermatologists have the lowest risk for delay, highlighting potential opportunities for improved access to and coordination of dermatologic care.
Correlation of plasma propranolol concentration with therapeutic response in patients with angina pectoris.
Authors: M Pine, L Favrot, S Smith, K McDonald, C A Chidsey
Journal: Circulation (1975)

The therapeutic response to propranolol was evaluated in patients with documented coronary artery disease at doses varying from 40 to 320 mg/day. Therapeutic response was quantified by evaluating exercise performance on a treadmill and then related to plasma propranolol concentration. Plasma propranolol was defined in terms of beta-adrenergic blockade by comparison with dose (concentration) response curves in normal subjects. Individual therapeutic benefit occurred at doses which averaged 144 +/- 21 mg/day and at concentrations which averaged 30 +/- 7 ng/ml. There was a wide variation between both dose and concentration among the patients at maximum therapeutic response, but when the plasma propranolol was related to pharmacologic activity, the maximum therapeutic response was observed between 64 to 98% of total blockade. Despite the increased exercise performance in these patients, the double product of heart rate and systolic blood pressure was always less, suggesting either an alteration of the relation between myocardial oxygen consumption and the double product during propranolol or a reduction on oxygen delivery to the myocardium as the result of beta-adrenergic blockade of the coronary vasculature.