tbuckley/cabot-search huggingface dataset:
UK audit shows need for greater caution with chemotherapy in very sick patients
Authors: S. Mayor
Journal: BMJ (2008)

Chemotherapy probably caused or hastened death in just over a quarter of patients with cancer who died within 30 days of receiving the treatment, a study by the UK National Confidential Enquiry into Patient Outcome and Death (NCEPOD) published this week has shown. The study calls for greater caution in prescribing chemotherapy for very sick patients.

The study reviewed the quality of care provided to more than 600 patients who received systemic anticancer treatment at NHS and independent hospitals throughout the United Kingdom, apart from Scotland. It included all patients aged 16 and over who were treated with chemotherapy between 1 June and 31 July 2006 and who subsequently died between 1 June and 31 August that year.

The inquiry’s coordinators collected information for patients who had died from consultants who managed their treatment and from consultants who cared for them at the time of death. As well as questionnaires the coordinators also requested copies of the patient’s case notes. All data were anonymised …
Helicobacter pylori infection does not reduce the viscosity of human gastric mucus gel.
Authors: D C Markesich, B S Anand, G M Lew, D Y Graham
Journal: Gut (1995)

The mechanism by which Helicobacter pylori undermines host defence mechanisms is unclear. Several in vitro studies using soluble mucins have suggested that H pylori may compromise mucus function. Gastric mucus gel was obtained from 13 H pylori infected patients; six untreated subjects and seven after eradication of the infection. Gastric mucus is a non-Newtonian substance in that its viscosity changes with changing rates of shear, requiring mucus viscosity to be measured in a rotational cone-plate microviscometer. Viscosity was measured at shear rates varying from 1.15 s-1 to 46 s-1. The gastric mucus viscosity was significantly higher in patients infected with H pylori compared with mucus gel obtained after eradication of the infection. The results of our study suggest that the previous studies using in vitro methods involving soluble mucins or its components may have lead to erroneous conclusions about the in vivo interactions of H pylori and gastric mucus gel. The present findings argue against the hypothesis that degradation of gastric mucus by H pylori is important in the pathogenesis of peptic ulcer.
Improved risk-benefit ratio for topical triamcinolone acetonide in TransfersomeR in comparison with equipotent cream and ointment: a randomized controlled trial
Authors: H. Fesq, J. Lehmann, A. Kontny, I. Erdmann, K. Theiling, M. Rother, J. Ring, G. Cevc, D. Abeck
Journal: British Journal of Dermatology (2003)

Background Transfersome® is a drug delivery technology based on highly deformable, ultraflexible lipid vesicles which penetrate the skin when applied non-occlusively. Objectives To assess the advantages of this carrier-based formulation in humans, the efficacy and the atrophogenic potential of triamcinolone acetonide (TAC) in Transfersome® was compared with commercially available TAC-containing cream and ointment. Methods Healthy volunteers were enrolled in double-blind, placebo-controlled clinical trials with random study medication assignment to the test areas. Results A 10-fold lower dose of TAC in Transfersome® (2·5 µg cm−2) was bioequivalent to 25 µg cm−2 TAC in conventional formulations as measured by erythema suppression (cream: P = 0·01, ointment: P < 0·001). A skin blanching assay revealed different kinetics of the formulations, with a delayed onset of action of the Transfersome® and ointment preparations. Ultrasonic measurements revealed a significantly reduced atrophogenic potential. There was a 12·1% reduction in skin thickness given by TAC in Transfersome® compared with a 21·1% reduction given by a bioequivalent dose in TAC cream after a 6-week treatment period (P = 0·007). Conclusions Transfersome® may significantly improve the risk–benefit ratio of topically applied glucocorticosteroids.
Determination of Medical Disability
Authors: KUSUM KUMAR
Journal: Annals of Internal Medicine (1986)

Letters and Corrections1 August 1986Determination of Medical DisabilityKUSUM KUMAR, M.D., DAVID A. NARDONE, M.D., RICHARD DILBECKKUSUM KUMAR, M.D.Search for more papers by this author, DAVID A. NARDONE, M.D.Search for more papers by this author, RICHARD DILBECKSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-105-2-292_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The article by Carey and Hadler (1) on medical disability determination was very informative. However, we would like to add that the federal government, under auspices of the Veterans Administration, also provides to eligible claimants disability benefits that are similar to those of the Social Security Administration.During fiscal year 1984, the Department of Veterans Benefits awarded $13.9 billion to 2.9 million veterans with service-connected (compensation) and non-service-connected disabilities (pension). Many of these patients have similar problems regarding social, economic, and psychological issues of illness. The Veterans Administration system has uniform comprehensive guidelines for physicians (2); however,...References1. CAREYHADLER TN. The role of the primary physician in disability determination for the Social Security insurance and for worker's compensation. Ann Intern Med. 1986;104:706-10. LinkGoogle Scholar2. SELFON P ed. Physician's Guide for Disability Evaluation Examinations. Washington, D.C.: Veterans Administration; March 1985. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Veterans Administration Medical Center Portland, OR 97207 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 August 1986Volume 105, Issue 2Page: 292-293KeywordsDisabilities Issue Published: 1 August 1986 PDF DownloadLoading ...
HOW DO REST AND COLLAPSE TREATMENT CURE PULMONARY TUBERCULOSIS?
Authors: POL N. CORYLLOS
Journal: JAMA (1933)

The basic principle in the treatment of tuberculosis in all its forms is rest. In tuberculosis of the lungs or of the joints the physician endeavors to obtain as complete a rest as possible of the diseased organs. More especially in pulmonary tuberculosis, complete and prolonged bed rest is advised in order to "immobilize the lungs" and "favor healing by fibrosis." During the past years, a number of surgical procedures have been adopted for reinforcing rest by mechanical splinting of the diseased lung, as pneumothorax, phrenic exeresis or thoracoplastic collapse. It is peculiar, however, that very little investigation has been done so far on the physiologic action of this mode of treatment. It is thought that by rest fibrous tissue develops both in the joints and in the lungs and that the lesions are encapsulated in a fibrous shell, bringing its development to a standstill; or that "nature" is helped
THE PHYSIOLOGY OF THE SYMPATHETIC IN RELATION TO THE EYE.
Authors: G. E. DE SCHWEINITZ
Journal: JAMA (1904)

[Dr. de Schweinitz reviewed the entire literature pertaining to the subject, and from this review and the various opinions of the authors quoted thought the following conclusions might be drawn:] 1. Although lachrymal secretion may be caused by excitation of the sympathetic, and increased lachrymation by section of the cervical sympathetic or removal of the superior cervical ganglion, the sympathetic itself should not be considered the nerve of secretion for the lachrymal gland. 2. Dilatation of the pupil is probably caused by contraction of a set of radially arranged muscular or contractile fibers, the so-called dilatator pupillæ, which is supplied by the sympathetic, and by inhibition of the sphincter of the iris. The dilating impulse transmitted to the iris passes through the cervical sympathetic and in general terms along the mydriatic tract of the pupil, which proceeds from a center in the medulla as far as the second dorsal
Poster 1, Haemorrhagic bullae in a child with Henoch–Schönlein purpura
Authors: S. Abdul-Ghaffar, S.K. Chan, N.P. Burrows
Journal: British Journal of Dermatology (2007)

Henoch–Schönlein purpura (HSP) is one of the most common types of vasculitis in children. It usually presents with purpura, abdominal pain, arthralgia/arthritis and nephritis. The purpura seen in HSP is typically petechial or target-like and is the presenting sign in 50% of patients. Haemorrhagic bullae are rarely reported in children. We describe a 10-year-old boy who presented with a 1-week history of a petechial rash on his legs and buttocks, associated with abdominal pain and tender, swollen ankles and knees in May 2006. He had a history of a preceding upper respiratory tract infection. A clinical diagnosis of HSP was made at this stage. However, the rash became more extensive, involving his arms, shoulders and ears. Within 2 weeks, large tense haemorrhagic bullae developed on the lower legs, feet and hands. Urinalysis was positive for blood and protein but his blood pressure and renal function were normal. The rest of his investigations, including a full vasculitis screen, were normal. Because of the atypical bullae, a skin biopsy was performed. This showed leucocytoclastic vasculitis with IgA deposition consistent with HSP. The lesions improved with prednisolone, starting at 2 mg kg–1 daily, gradually reducing the dose over 3 months. Bullous HSP has been seen in up to 60% of adult patients but only in 2% of children. There have been only 11 reported cases of bullous HSP to date and the commonest sites were feet, ankles, legs and buttocks, suggesting that pressure is the most likely factor in its pathogenesis. This is an important observation as the presence of these atypical bullous lesions may pose a diagnostic challenge.
INTEGRATION OF A DAY-CARE PROGRAM INTO A GENERAL PSYCHIATRIC HOSPITAL
Authors: JACK A. MORGENSTERN, J. THOMAS UNGERLEIDER
Journal: American Journal of Psychiatry (1966)

An attempt to integrate day-care patients on the general psychiatric wards of our hospital has been unsatisfactory, as evidenced by the fact that of the first 40 patients admitted, 21 were unable to continue on day-care status to discharge. Reasons for this difficulty have been explored and suggestions for improvement are discussed. Further evaluation is being undertaken to see if changes such as those mentioned will help in the assimilation of the day-care patient.
Medicine, Radiation, and Probability of Causation-Reply
Authors: William R. Hendee
Journal: JAMA (1987)

<h3>In Reply.—</h3> Drs Rail and Yalow state correctly that Public Law 97-414 requires the development of the Radioepidemiological Tables without identification of how the tables should be used in lawsuits. That observation is exactly the concern addressed in the recommendations of the Council on Scientific Affairs. These recommendations do not propose revisions in the existing law. Instead, they counsel against possible misapplications of the tables. This counsel does not imply that groups to be exempted from application of the tables may be guilty of practices leading to a high probability of causation. Instead, it suggests that diagnostic and therapeutic applications of radiation, and the small exposures that accompany these applications, constitute conditions different from those providing most of the data for construction of the Radioepidemiological Tables. In medical procedures using radiation, the exposure usually is confined to a specific anatomic region and delivered under carefully controlled conditions. Furthermore, radiation is
Mutation of the signal peptide-encoding region of the preproparathyroid hormone gene in familial isolated hypoparathyroidism.
Authors: A Arnold, S A Horst, T J Gardella, H Baba, M A Levine, H M Kronenberg
Journal: Journal of Clinical Investigation (1990)

Preproparathyroid hormone (preproPTH) gene mutation has been proposed as a cause of familial isolated hypoparathyroidism (FIH). We cloned the preproPTH alleles of a patient with autosomal dominant FIH and sequenced the coding regions, 5' flanking regions, and splice junctions. The putatively abnormal (based on previous linkage studies) allele differed from the other allele's normal sequence at only one nucleotide. This T to C point mutation changes the codon for position 18 of the 31 amino acid prepro sequence from cysteine to arginine, disrupting the hydrophobic core of the signal sequence. Because the hydrophobic core is required by secreted proteins for efficient translocation across the endoplasmic reticulum, the mutant protein is likely to be inefficiently processed. Indeed, in vitro studies demonstrated dramatically impaired processing of the mutant preproPTH to proPTH. In summary, we observed a point mutation in the signal peptide-encoding region of a preproPTH gene in one FIH kindred and demonstrated a functional defect caused by the mutation. Mutation of the signal sequence constitutes a novel pathophysiologic mechanism in man, and further study may yield important insights both into this form of hormone deficiency and into the role of signal sequences in human physiology.
Acquired immunodeficiency syndrome, hepatitis, and haemophilia.
Authors: P Jones
Journal: BMJ (1983)

Acquired immunodeficiency syndrome, hepatitis, and haemophiliaPeople with haemophilia, their families, and their doctors feel threatened by the deluge of speculation about the possible side effects of treatment with blood products.Two topics hold their attention: the risk of contracting the acquired immunodeficiency syndrome (AIDS) and the risk of develop- ing hepatitis and subsequent chronic liver disease.Centers for Disease Control in Atlanta define a case of AIDS as "a reliably diagnosed disease that is at least moder- ately indicative of an underlying cellular immunodeficiency in a person who has had no known underlying cause of cellular immunodeficiency and no other cause of reduced resistance reported to be associated with that disease."'For epidemio- logical purposes this definition is wide; it does not suggest a single aetiological agent, merely a similar response, or lack of it, to injury.It is important to recognise this in view of the difficulty in classifying the different disorders concerned and the current reaction of the media to announcements of "new" cases.Until diagnostic markers for the disorder are found terms like "confirmed AIDS" are unhelpful in defining what may well be a multifactorial disorder.To date, patients fulfilling the Centers for Disease Control definition have included male homosexuals (71 %) intravenous drug abusers of both sexes (17%O) and people from Haiti
EFFECTS OF SLEEP APNEA ON CARDIAC SYMPATHETIC ACTIVITY IN PATIENTS WITH SEVERE SYSTOLIC HEART FAILURE: A 123 MIBG SCINTIGRAPHIC STUDY
Authors: Oriana Scala, Stefania Paolillo, Giuseppe Rengo, Gennaro Pagano, Roberto Formisano, Teresa Pellegrino, Fausto De Michele, Antonio Starace, Annapaola Cirillo, Alice Vitagliano, Tiziana Formisano, Dario Leosco, Alberto Cuocolo, Pasquale Perrone-Filardi
Journal: Journal of the American College of Cardiology (2013)
Endoscopic Papillary Balloon Dilation in Cirrhotic Patients: Removal of Common Bile Duct Stones without Sphincterotomy
Authors: T. Kawabe, Y. Komatsu, M. Tada, N. Toda, M. Ohashi, Y. Shiratori, M. Omata
Journal: Endoscopy (1996)

Endoscopic papillary balloon dilation (EPBD) is a less invasive alternative to endoscopic sphincterotomy (EST). This study reviews a series of cirrhotic patients with bile duct stones who were treated with EPBD.EPBD was used to remove common bile duct stones in nine cirrhotic patients (one in Child-Pugh grade A, four in grade B, and four in grade C). After the papilla was dilated with balloon-tipped catheter, the stones were removed with a retrieval basket catheter or a retrieval balloon, or both. Mechanical lithotripsy was required in two patients with stones of more than 1 cm in diameter.Clearance of the common bile duct was achieved in all patients without any serious complications such as hemorrhage or perforation.These results suggest that EPBD is a safe and effective technique for the treatment of common bile duct stones in patients with liver cirrhosis.
Alopecia neoplastica in a patient with gastric carcinoma
Authors: H.J. Kim, H.G. Min, E.S. Lee
Journal: British Journal of Dermatology (1999)

A well‐recognized but rare presentation of scalp metastasis is alopecia neoplastica, which occurs as a single or multiple areas of cicatricial alopecia. Alopecia neoplastica is usually a presentation of metastasis from breast cancer, and other primary sites are extremely rare. We report a 36‐year‐old woman with alopecia neoplastica due to metastasis from gastric carcinoma. She also had pelvic metastases. An asymptomatic erythematous alopecic plaque had developed 10 months before presentation and biopsy was consistent with scalp metastasis. Total abdominal hysterectomy and salphingo‐oophorectomy was performed and chemotherapy was proposed.
Zimbabwe says the proportion of HIV positive adults has fallen from a third to a fifth
Authors: Pat Sidley
Journal: BMJ (2005)

Zimbabwe's health minister tells Pat Sidley that drugs should be excluded from the international sanctions affecting his country

Zimbabwe has a similar sized epidemic to that of its neighbour Botswana but is facing the additional problem of sanctions. Its deputy minister of health and child welfare, Edwin Muguti, claims that despite being “squeezed” by the international community the country has an antiretroviral programme up and running.

The HIV and AIDS statistics are dogged by under-reporting in many African countries, Dr Muguti says, and in addition most countries have poor laboratory facilities, a low awareness of the epidemic, and inadequate access to health facilities.

To monitor its epidemic Zimbabwe uses antenatal clinics, producing a …
Pemphigus autoantibodies generated through somatic mutations target the desmoglein-3 cis-interface
Authors: Giovanni Di Zenzo, Giulia Di Lullo, Davide Corti, Valentina Calabresi, Anna Sinistro, Fabrizia Vanzetta, Biagio Didona, Giuseppe Cianchini, Michael Hertl, Rudiger Eming, Masayuki Amagai, Bungo Ohyama, Takashi Hashimoto, Jerry Sloostra, Federica Sallusto, Giovanna Zambruno, Antonio Lanzavecchia
Journal: Journal of Clinical Investigation (2012)

Pemphigus vulgaris (PV) is an autoimmune blistering disease of skin and mucous membranes caused by autoantibodies to the desmoglein (DSG) family proteins DSG3 and DSG1, leading to loss of keratinocyte cell adhesion. To learn more about pathogenic PV autoantibodies, we isolated 15 IgG antibodies specific for DSG3 from 2 PV patients. Three antibodies disrupted keratinocyte monolayers in vitro, and 2 were pathogenic in a passive transfer model in neonatal mice. The epitopes recognized by the pathogenic antibodies were mapped to the DSG3 extracellular 1 (EC1) and EC2 subdomains, regions involved in cis-adhesive interactions. Using a site-specific serological assay, we found that the cis-adhesive interface on EC1 recognized by the pathogenic antibody PVA224 is the primary target of the autoantibodies present in the serum of PV patients. The autoantibodies isolated used different heavy- and light-chain variable region genes and carried high levels of somatic mutations in complementary-determining regions, consistent with antigenic selection. Remarkably, binding to DSG3 was lost when somatic mutations were reverted to the germline sequence. These findings identify the cis-adhesive interface of DSG3 as the immunodominant region targeted by pathogenic antibodies in PV and indicate that autoreactivity relies on somatic mutations generated in the response to an antigen unrelated to DSG3.
Better leukemia-free and overall survival in AML in first remission following cyclophosphamide in combination with busulfan compared with TBI
Authors: Edward A. Copelan, Betty K. Hamilton, Belinda Avalos, Kwang Woo Ahn, Brian J. Bolwell, Xiaochun Zhu, Mahmoud Aljurf, Koen van Besien, Christopher Bredeson, Jean-Yves Cahn, Luciano J. Costa, Marcos de Lima, Robert Peter Gale, Gregory A. Hale, Joerg Halter, Mehdi Hamadani, Yoshihiro Inamoto, Rammurti T. Kamble, Mark R. Litzow, Alison W. Loren, David I. Marks, Eduardo Olavarria, Vivek Roy, Mitchell Sabloff, Bipin N. Savani, Matthew Seftel, Harry C. Schouten, Celalettin Ustun, Edmund K. Waller, Daniel J. Weisdorf, Baldeep Wirk, Mary M. Horowitz, Mukta Arora, Jeff Szer, Jorge Cortes, Matt E. Kalaycio, Richard T. Maziarz, Wael Saber
Journal: Blood (2013)
Hospitals must be more open about safety, says chief medical officer
Authors: Andrew Cole
Journal: BMJ (2005)

The safety of patients is a lower priority for most hospitals than balancing the books and hitting performance targets, England's chief medical officer, Liam Donaldson, told a European Union summit on patient safety this week.

This was despite the fact that adverse events occurred in one in 10 hospitalisations and that people had a far higher risk of being killed by medical error than of dying in an air crash.

“When a chief executive puts their head on the pillow at night they will be worrying about two things: the financial position of the organisation and its performance targets,” Professor Donaldson told the conference, which was …
γm-Fluorescent Treponemal Antibody in the Diagnosis of Congenital Syphilis
Authors: C. A. Alford, S. S. Polt, G. E. Cassady, J. V. Straumfjord, J. S. Remington
Journal: New England Journal of Medicine (1969)

A comparative study of γM-fluorescent treponemal antibody (γM-FTA-ABS), routine FTA-ABS and γG-FTA-ABS, Venereal Disease Research Laboratory (VDRL) antibody levels, as well as total serum γM globulin amounts, in eight infants with different clinical forms of congenital syphilis indicated that a newly developed γM-FTA-ABS test is superior for early diagnosis of congenital syphilis whether specific antibody production is initiated in utero or postnatally. The usefulness of this test is emphasized by the fact that γM-FTA-ABS was detected in neonates and infants who were asymptomatic while other serologic tests gave inconclusive results. During the early phase of infection, as observed in late-onset disease, γM-FTA-ABS appeared and total serum γM globulin became elevated while VDRL antibody levels remained stable. Thereafter, all these measurements as well as routine FTA-ABS rose in parallel to reach high levels with the onset of symptoms and all likewise decreased after successful therapy.
CARDIOVASCULAR HEALTH: Traffic Trigger
Authors: Wendee Holtcamp
Journal: Environmental Health Perspectives (2011)

Study to examine health effects in Deepwater horizon oil Spill cleanup Workers Ant poison containing banned mirex was being sold online.Epifluorescence images of different portions of transgenic Arabidopsis roots shown before and after addition of the TNT ligand.Far right panels show DAPI nuclear staining.Arrowheads indicate nuclei.Scale bar = 25 µm.
Skull Traction for Cervical Spine Injury: Should It Be Abandoned?
Authors: Ralph B. Cloward
Journal: JAMA (1973)

<h3>To the Editor.—</h3> In the initial report of the National Spinal Cord Injury Registry, statistics related to the treatment instituted were revealed. Drucker and Perot<sup>1</sup>stated that "it may come as a surprise to many neurosurgeons and orthopedic surgeons to find that vertebral fusion is commonly carried out the day of the accident." There were 19 vertebral fusions, ten laminectomies, and 33 tong insertions performed on day 0. It is gratifying to see twice as many anterior operations as laminectomies. The large number treated by skull traction, however, is cause for concern. Treatment of fractures of the cervical spine by skull traction probably does more harm than good. Twenty-five years ago, it was sound surgical teaching and practice to place the part or organ of the body, damaged by injury or operation, at complete rest to obtain proper healing. Following major operations, patients were confined to bed for two