tbuckley/cabot-search huggingface dataset:
Should fertile people have access to in vitro fertilisation?
Authors: B Cantwell
Journal: BMJ (1990)

We think that their suggestion that general prac- titioners should treat empirically for Chlamvdia trachomatis infection is highly inflammatory.As they admit, this infection has an appreciable morbidity; the correct management of such sexually transmitted infections requires accurate diagnosis, effective treatment, adequate tests of cure, and, very importantly, examination and treatment if necessary of all sexual partners.Suboptimal management, as they suggest, has no doubt contributed to the rising incidence of C trachomatis infection over the past decade.We stand by our recommendations that screening for genital infections be performed in selected women who have had one smear showing in- flammatory changes and in women undergoing colposcopic examination because of repeated smears showing inflammatory changes.Such policies should encourage closer links between departments of genitourinary medicine and colposcopy clinics, which can only be of mutual benefit to patients and staff.
Dermoscopy of the nail bed and matrix to assess melanonychia striata
Authors: Sergio H. Hirata, Sergio Yamada, Fernando A. Almeida, Jane Tomomori-Yamashita, Mauro Y. Enokihara, Francisco M. Paschoal, Milvia M. Enokihara, Cinthia M. Outi, Nilceo S. Michalany
Journal: Journal of the American Academy of Dermatology (2005)
Mechanisms and Future Directions for Angiogenesis-Based Cancer Therapies
Authors: Frank A. Scappaticci
Journal: Journal of Clinical Oncology (2002)

Targeting angiogenesis represents a new strategy for the development of anticancer therapies. New targets derived from proliferating endothelial cells may be useful in developing anticancer drugs that prolong or stabilize the progression of tumors with minimal systemic toxicities. These drugs may also be used as novel imaging and radiommunotherapeutic agents in cancer therapy. In this review, the mechanisms and control of angiogenesis are discussed. Genetic and proteomic approaches to defining new potential targets on tumor vasculature are then summarized, followed by discussion of possible antiangiogenic treatments that may be derived from these targets and current clinical trials. Such strategies involve the use of endogenous antiangiogenic agents, chemotherapy, gene therapy, antiangiogenic radioligands, immunotherapy, and endothelial cell-based therapies. The potential biologic end points, toxicities, and resistance mechanisms to antiangiogenic agents must be considered as these therapies enter clinical trials.
Concerns, Challenges of Keeping Nation's Food Supply Safe in 21st Century Being Studied Now
Authors: Kathryn Simmons Raithel
Journal: JAMA (1988)

DESPITE SCIENTIFIC, educational, and—when possible—regulatory measures to preserve the safety of the food supply, the incidence of food-borne disease is on the rise in the United States, with most cases or outbreaks resulting from mishandling of food in the home or food-service institutions. That's according to food safety and public health experts speaking at a recent conference in Arlington, Va, cosponsored by the American Medical Association and the Institute of Food Technologists. The conference focused on concerns and challenges in connection with safety of the food supply in the century ahead. Food and Drug Administration (FDA) officials estimate, for example, that at least one of every ten Americans will suffer from some form of food-borne diarrhea this year (<i>Am Fam Physician</i>1987;35:353-354). And one indication of the increase is the recent report that, in 1981, there were 568 food-borne disease outbreaks reported to the Centers for Disease Control, Atlanta, compared
Maharishi Ayur-Veda
Authors: Michael A. Patmas
Journal: JAMA (1991)

To the Editor.  —I was astonished that the editors would choose to publish the article by Sharma et al1when many other quality works were probably rejected for reasons of limitation of space. The practice of Ayur-Veda is nothing more than palpable balderdash. Any thoughtful individual spending a few moments reading this article would come to a similar conclusion. Though freedom of the press and expression of differing viewpoints is guaranteed by the Constitution, the legitimization of quackery is unacceptable. This article attempts to do precisely that.  Perhaps my greatest fear is that the federal government will mistake this article for legitimate medicine and issue new ICD-9 and CPT codes forVata, Pitta, andKapha. Of even greater concern would be the inevitable inclusion of Ayur-Veda in the Medicare program. It would not be the first time that a system of health care based on a whimsical theory, unsupported
NEUROPSYCHIATRY IN A STAGING AREA
Authors: LOUIS S. LIPSCHUTZ
Journal: American Journal of Psychiatry (1943)

1. The functions of a `staging area' have been described. 2. The importance of adequate neuropsychiatric facilities including an out-patient clinic was emphasized. 3. Of these, the psychiatric out-patient clinic was considered most important. 4. Mandatory psychiatric study of the military prisoner was suggested. The large number of psychopathic personalities in this group was noted. 5. The opportunity for psychiatric education of the medical officer in the military hospital was mentioned. The importance of doing so in order to correct emotional attitudes interfering with proper disposition was stressed. 6. The need of developing a more efficient method of discharging men with inaptitude or undesirable habits or traits of character in a `staging area' was stressed. The possibility of handling such cases by medical disposition was mentioned. 7. A rapid method of recording clinical data with minimal clerical facilities was outlined. It is suggested that such a file may help to derive valuable conclusions in the future. 8. The importance of morale as a factor in minimizing the incidence of psychiatric disorders in the armed forces was mentioned. The need for a systematic program of indoctrination, particularly of service troops, was emphasized. 9. The necessity for maintaining adequate and appropriate occupational and recreational activities and facilities in the `staging area' was stressed.
Treatment of Primary and Secondary Syphilis: Defining Failure at Three- and Six-Month Follow-up
Authors: Mary E. Guinan
Journal: JAMA (1987)

In 1985, approximately 28 000 cases of primary and secondary syphilis were reported in the United States (Centers for Disease Control, unpublished data). A large proportion of these patients were treated with the recommended therapy, 2.4 million units of penicillin G benzathine given intramuscularly in one dose.<sup>1</sup>The proportion of patients who were cured with this regimen, however, is not known. No simple test is available that determines cure of syphilis within days (or even weeks) of treatment. To assess treatment, the patient is asked to return for a repeated serological test and clinical evaluation at varying intervals after treatment, usually 3-, 6-, and 12-month visits or until the patient is seronegative. When the serological test results revert to negative, the patient is considered cured. However, when they remain positive, a clinical dilemma arises. Criteria for determining treatment failures (or possible failures) during follow-up visits include the following: (1)
Why do doctors use treatments that do not work?
Authors: Jenny Doust, Chris Del Mar
Journal: BMJ (2004)

For many reasons—including their inability to stand idle and do nothing 

One of the surprising things about James Lind's celebrated trial of citrus fruit for scurvy was not just that he ignored the evidence from his own trial but that in clinical practice he continued to advocate treatments that he himself had found ineffective, including those containing sulphuric acid.w1 The history of medicine is replete with examples of treatments once common practice but now known not to work—or worse, cause harm. Only because the French surgeon Pare ran out of boiling oil did he discover that not cauterising gun shot wounds with it created much less pain and suffering.w2 Leeches and blood letting were used for thousands of years for almost everything. Attempts to show that they were ineffective were resisted with great passion by the medical profession.w3 More recently, we have had treatment with insulin for schizophrenia and vitamin K for myocardial infarction.1 2 In case we are all feeling too smug …
Human monoclonal macroglobulins with specificity for Klebsiella K polysaccharides that contain 3,4-pyruvylated-D-galactose and 4,6-pyruvylated-D-galactose.
Authors: E A Kabat, J Liao, H Bretting, E C Franklin, D Geltner, B Frangione, M E Koshland, J Shyong, E F Osserman
Journal: The Journal of Experimental Medicine (1980)

Two human IgM myeloma proteins, IgMWEA and IgMMAY, were found to react with agar and Klebsiella polysaccharides that contain pyruvylated D-galactose (DGal). Quantitative precipitin data and precipitin inhibition studies with methyl alpha- and beta-glycosides of 4,6-pyruvylated-D-galactose showed their combining sites to be different, although each was directed against the pyruvylated-D-Gal, one reacting most specifically with Klebsiella polysaccharides with terminal nonreducing beta-linked 2,4 pyruvylated-D-Gal, whereas the other reacted equally well with Klebsiella polysaccharides that contain 3,4 beta-linked and 4,6 alpha-linked terminal nonreducing pyruvylated-DGal. Inhibition studies showed that both sites are directed toward one of the two space isomers of 3,4- or 4,6-pyruvylated DGal, the form in which the methyl group of the pyruvate is equatorial, or endo, and its carboxyl group axial, or exo, to the plane of the acetal ring. Coprecipitation studies showed the combining site of IgMWEA to be located on an (Fab')2 fragment and not on the (Fc)5mu fragment. The monoclonal peak in the serum of IgMMAY was specifically precipitated by Klebsiella polysaccharide. Myeloma proteins with specificities of this type may occur with reasonable frequency in humans and may be a consequence of clonal expansion from inapparent infection, carrier states, or disease produced by various Klebsiella organisms.
Platelet-derived interleukin 1 induces human endothelial adhesion molecule expression and cytokine production.
Authors: C M Hawrylowicz, G L Howells, M Feldmann
Journal: The Journal of Experimental Medicine (1991)

Interleukin 1 (IL-1) plays a central role in the regulation of the body's response to infectious and inflammatory stimuli. Recent evidence has shown that human platelets express a cell associated form of this proinflammatory cytokine very rapidly following activation. Since one of the earliest events in inflammation is frequently the rapid adhesion of platelets to injured endothelium, it was of interest to determine whether platelets express IL-1 in a functionally relevant form that can alter the phenotype of human endothelial cells in vitro. Thrombin activated platelets induced significant expression of the adhesion molecule intercellular adhesion molecule 1, as well as secretion of the IL-1 inducible cytokines IL-6 and granulocyte macrophage colony stimulating factor by cultured human umbilical cord and saphenous vein endothelial cells. This was inhibited by prior treatment of the platelets with antibody specific for IL-1. These results suggest that platelet delivered IL-1 might initiate and regulate some of the earliest phases of the inflammatory response. An additional observation of interest was differential induction of endothelial leucocyte adhesion molecule 1 by activated platelets on saphenous vein but not umbilical vein but not umbilical vein endothelial cells, which suggests functional heterogeneity of the endothelial cells.
Sixteen–Kinase Gene Expression Identifies Luminal Breast Cancers with Poor Prognosis
Authors: Pascal Finetti, Nathalie Cervera, Emmanuelle Charafe-Jauffret, Christian Chabannon, Colette Charpin, Max Chaffanet, Jocelyne Jacquemier, Patrice Viens, Daniel Birnbaum, François Bertucci
Journal: Cancer Research (2008)

Breast cancer is a heterogeneous disease made of various molecular subtypes with different prognosis. However, evolution remains difficult to predict within some subtypes, such as luminal A, and treatment is not as adapted as it should be. Refinement of prognostic classification and identification of new therapeutic targets are needed. Using oligonucleotide microarrays, we profiled 227 breast cancers. We focused our analysis on two major breast cancer subtypes with opposite prognosis, luminal A (n = 80) and basal (n = 58), and on genes encoding protein kinases. Whole-kinome expression separated luminal A and basal tumors. The expression (measured by a kinase score) of 16 genes encoding serine/threonine kinases involved in mitosis distinguished two subgroups of luminal A tumors: Aa, of good prognosis and Ab, of poor prognosis. This classification and its prognostic effect were validated in 276 luminal A cases from three independent series profiled across different microarray platforms. The classification outperformed the current prognostic factors in univariate and multivariate analyses in both training and validation sets. The luminal Ab subgroup, characterized by high mitotic activity compared with luminal Aa tumors, displayed clinical characteristics and a kinase score intermediate between the luminal Aa subgroup and the luminal B subtype, suggesting a continuum in luminal tumors. Some of the mitotic kinases of the signature represent therapeutic targets under investigation. The identification of luminal A cases of poor prognosis should help select appropriate treatment, whereas the identification of a relevant kinase set provides potential targets.
Deficiency of thiosulphate sulphurtransferase (rhodanese) in Leber's hereditary optic neuropathy.
Authors: C J Poole, P R Kind
Journal: BMJ (1986)

Leber9s hereditary optic neuropathy is a rare cause of progressive visual failure. Its cause is unknown, but one hypothesis is that patients have a defect in the detoxication of cyanide. One of the enzymes used in this detoxication is thiosulphate sulphurtransferase (rhodanese). The activity of this enzyme was measured in the rectal mucosa of a group of subjects with Leber9s hereditary optic neuropathy, and it was found to be considerably reduced compared with that in a group of controls (p less than 0.001). This finding supports the hypothesis of an inborn error of cyanide detoxication in this condition.
Doctors in occupational medicine
Authors: F H Tyrer
Journal: BMJ (1983)

It has been reported previously that the tetrahydropyranyl naphthtalenic lignan lactone L-702,539 is a potent nonredox, 5-lipoxygenase inhibitor that has the advantage that it can be dosed either as the lactone or as the corresponding nonactive hydroxy acid L-702,618 (opened lactone). Studies with hepatic microsomes from the rat, rhesus monkey, and human were undertaken in a phosphate buffer and suggested that the closure of the hydroxy acid L-702,618 to the lactone L-702,539 was an enzymatic process. The incubation of L-702,539 under oxidative conditions with these specific hepatic microsomes resulted in the formation of three significant metabolites (&gt; 0.4 nmol/mg protein/hr) as determined by HPLC with UV detection. These metabolites were isolated from large microsomal incubations and were characterized by MS and NMR spectroscopy. Data showed that the lactone and tetrahydropyran portions of the molecule were both susceptible to hydroxylation, and the hydroxylated tetrahydropyran was further oxidized to the hydroxy acid. Analysis of plasma samples obtained from rat and rhesus monkeys following L-702,618 administration indicated that the in vivo metabolic pathway was similar to the one observed in vitro using hepatic microsomes. Studies conducted with microsomes from genetically engineered human cell lines expressing individual cytochrome P450s indicated that the isozyme responsible for the metabolism at the tetrahydropyran ring, was P4503A4. These findings were supported by studies conducted in human microsomes using an inhibitory P4503A4 antibody and troleandomycin, which is a potent P4503A inhibitor.
Abscess of the Brain in a Patient with Ventricular Septal Defect
Authors: Sidney Goldfischer
Journal: JAMA (1963)

CALCIFICATION of the pulmonary artery of a patient suffering from enlargement of the right ventricle and main pulmonary arteries has been considered indicative of the presence of a patent ductus arteriosus with right-to-left shunt.<sup>1</sup>In the case reported here, calcification of the pulmonary artery with reversal of blood flow was found to be associated with a defect of the membranous portion of the interventricular septum and closed ductus in a patient with an abscess of the brain. <h3>Report of a Case</h3> A 49-yr-old female was admitted to the Bronx Municipal Hospital Center on July 5, 1961, because of vomiting, headache, and unresponsive and bizarre behavior of 1 day's duration. Two weeks prior to this admission she had been admitted because of the sudden onset of confusion, aphasia, and a generalized seizure with postictal, right-sided hemiparesis. Laboratory data revealed a hematocrit reading of 60%; white blood cell count, 6,300; and
A genome-wide association study identifies genetic variants in the CDKN2BAS locus associated with endometriosis in Japanese
Authors: Satoko Uno, Hitoshi Zembutsu, Akira Hirasawa, Atsushi Takahashi, Michiaki Kubo, Tomoko Akahane, Daisuke Aoki, Naoyuki Kamatani, Koichi Hirata, Yusuke Nakamura
Journal: Nature Genetics (2010)
Stray dogs are a growing threat to public health
Authors: S. Kumar
Journal: BMJ (2002)

Almost all cases of rabies in India are due to stray dogs, which act as a reservoir for the disease, according to the National Institute of Communicable Diseases, based in Delhi. The number of bites remain high, yet legal pressure from animal rights groups is thwarting attempts to tackle the problem.

Delhi alone is believed to have some 250 000 stray dogs, which are multiplying, intimidating, creating a nuisance, and biting people—infecting some with rabies. The number nationwide is estimated at around 25-8 million, according to the institute, although there has not been a count. Almost all the dogs are unvaccinated against rabies.

When a night guard was bitten by a suspected rabid dog …
Intravascular ultrasound molecular imaging of ICAM-1, VCAM-1, fibrinogen, and fibrin in a Yucatan miniswine model of antherosclerosis
Authors: Andrew J. Hamilton, Shao-Ling Huang, Mark Rabbat, Drew Warnick, Ashwin Nagaraj, Bonnie J. Kane, Melvin Klegerman, Robert C. MacDonald, David D. McPherson
Journal: Journal of the American College of Cardiology (2003)
THE CAUSES AND TREATMENT OF SEVERE PRURITUS ANI
Authors: P. Lockhart-Mummery
Journal: BMJ (1915)

CASE II.-Forty-six Seedlin2g Calcitli of the Prostate, Combined w'ith Urethro-Rectal anid other Fistuiae, azd Strictiures of thte Penile anid Butlbous Urethra.S. A., 35, Cingalese, cultivator, came into hospital on January 31st, 1914, complaining of great difficulty in micturition; he had also two urinary fistulae, one scrotal and one perineal, and a urethro-rectal fistula.There was frequency of micturition to the extent of about eight times during the day and five to six times at nlight.Whenever he urinated there was also an inclination to defaecate; he sometimes felt that urine dribbled through the anus.Micturition was most easily accomplished by resting on one or other buttock, especially the left, and coaxing the urine out by stroking the skin at the peno-scrotal junctioln.Even at the endof micturition he never felt that he had
Clinical Characteristics and In-Hospital Outcomes of Patients With Cardiogenic Shock Undergoing Coronary Artery Bypass Surgery
Authors: Rajendra H. Mehta, Joshua D. Grab, Sean M. O’Brien, Donald D. Glower, Constance K. Haan, James S. Gammie, Eric D. Peterson
Journal: Circulation (2008)

Background— There exist few studies that characterize contemporary clinical features and outcomes or risk factors for operative mortality in cardiogenic shock (CS) patients undergoing coronary artery bypass grafting (CABG). Methods and Results— We evaluated data of 708 593 patients with and without CS undergoing CABG enrolled in the Society of Thoracic Surgeons National Cardiac Database (2002–2005). Clinical, angiographic, and operative features and in-hospital outcomes were evaluated in patients with and without CS. Logistic regression was used to identify predictors of operative mortality and to estimate weights for an additive risk score. Patients with preoperative CS constituted 14 956 (2.1%) of patients undergoing CABG yet accounted for 14% of all CABG deaths. Operative mortality in CS patients was high and surgery specific, rising from 20% for isolated CABG to 33% for CABG plus valve surgery and 58% for CABG plus ventricular septal repair. Although mortality for CABG surgery overall declined significantly over time ( P for trend &lt;0.0001), mortality for CS patients undergoing CABG did not change significantly during the 4-year study period ( P =0.07). Factors associated with higher death risk for CS patients undergoing CABG were identified by multivariable analysis and summarized into a simple bedside risk score (c statistic=0.74) that accurately stratified those with low (&lt;10%) to very high (&gt;60%) mortality risk. Conclusions— Patients with CS represent a minority of those undergoing CABG yet have persistently high operative risks, accounting for 14% of deaths in CABG patients. Estimation of patient-specific risk of mortality is feasible with the simplified additive risk tool developed in our study with the use of routinely available preprocedural data.
Concurrent Chemoradiotherapy for Localized Nasal Natural Killer/T-Cell Lymphoma: An Updated Analysis of the Japan Clinical Oncology Group Study JCOG0211
Authors: Motoko Yamaguchi, Kensei Tobinai, Masahiko Oguchi, Naoki Ishizuka, Yukio Kobayashi, Yasushi Isobe, Kenichi Ishizawa, Nobuo Maseki, Kuniaki Itoh, Noriko Usui, Izumi Wasada, Tomohiro Kinoshita, Tomomitsu Hotta, Kunihiro Tsukasaki, Kazuo Oshimi
Journal: Journal of Clinical Oncology (2012)

We agree with Charalambous and Silbermann 1 that action needs to be taken to improve the skills of oncologists to manage chronic cancer pain.Their suggestion for clinical training programs at first seems logical; they cite findings that classroom training did not improve residents' knowledge, 2 a finding consistent with ours, that is, that continuing medical education in cancer pain management seemed to be ineffective. 3 They also cite a study showing that clinically based training in palliative care is effective. 4 In that study, however, there was only a 10% improvement, with statistically significant improvement in only six of 25 questions.In addition, the program was optional, which might suggest that those who took it were more motivated than most, making the generalizability of these findings questionable.Thus, although we agree that change is critically needed, the way to accomplish that change remains elusive.We continue to study this issue and hope that a more complete characterization of this problem will inform the development of more effective programs to support best practices in pain management and palliative care for the broad oncology community.
THE ALLEGED HETEROGENESIS IN ANKYLOSTOMA DUODENALE
Authors: R. T. Leiper
Journal: BMJ (1909)

URALa JmA ] ALLEGED HETEROGENESIS IN ANKYLOSTOMA DUODENALE.LNov. 6,I"og.bacillus of Morgan and the bacillus of Shiga, gave no agglu- tination reaction with a dilution of 1 in 20.But an extremely well-marked reaction was obtained with a dilution of 1 in 2, 1 in 50, and 1 in 100, and a slight reaction in a dilution of 1 in 1,000 with this bacillus and the bacillus of Flexner.The rabbit's serum was saturated with the bacillus of Flexner and the bacillus used for,the immunization of the rabbit, with the result that this bacillus was found to be specifically identical with the bacillus of Flexner."