tbuckley/cabot-search huggingface dataset:
Football yes, surgery no
Authors: C. Wigfield
Journal: BMJ (2002)

The main purpose of the football premiership is to provide entertainment. Competition is a source of excitement in sport, and league tables are essential tools to measure success. The prime target of cardiothoracic surgery is to restore health, often in life threatening circumstances. The process requires the application of highly technical and skilled surgery, anaesthesia, and intensive care by numerous professionals, to achieve a favourable outcome for the patient.

> League tables will inevitably result in additional premature deaths 

At first sight it may appear useful to introduce an element of competition as an incentive to improve performance. However, publishing league tables that claim to provide evidence of standards in health care can deceive the public, make patients anxious, and be scornful and demotivating for healthcare professionals.

Inferior premier league football clubs get relegated and replaced by new contenders every season. Sampling errors are virtually impossible …
Multiple Extremity Amputations in Hypotensive Patients Treated With Dopamine
Authors: Frank L. Golbranson
Journal: JAMA (1980)

Dopamine hydrochloride has been established as effective in the treatment of hypotension and shock in patients with adequate blood volume. The physiological response is dose related. Administration of more than 10 μg/kg/min results in α-receptor stimulation and vasoconstriction, and peripheral extremity ischemia has been reported. Four patients treated with dopamine subsequently had the development of peripheral ischemia and gangrene, resulting in the need for multiple extremity amputations. These reactions represent a major complication of treatment. (<i>JAMA</i>243:1145-1146, 1980)
EVALUATION OF CAUSES OF FALSE POSITIVE Tc-99m-IDA SCINTIGRAPHY IN BILIARY ATRESIA
Authors: Dennis Kumura, John Miller, Larry Eisenberg, Bennett S. Greenspan
Journal: Clinical Nuclear Medicine (1984)

Fourty-three patients were evaluated by Tc-99m-IDA scintigraphy for possible biliary atresia. Thirty-four earlier scans were done with Tc-99m-PIPIDA and nine scans were done with Tc-99m-DISIDA. There were sixteen true positives, defined as no gastrointestinal activity by twenty-four hours after pre-treatment with phenobarbital 5 mg/kg/day for three days. There were seventeen true negatives, ten false positives and no false negatives. Causes for false positives included two studies done without phenobarbital, five neonatal hepatitis and three cases of cholestasis associated with septo-optic dysplasia. If the two cases done without phenobarbital are excluded, sensitivity is 100% and specificity is 68%. Recognizing septo-optic dysplasia and cholestasis clinically further increases specificity to 77%. In the remaining false positives with neonatal hepatitis, four of five had poor hepatic uptake however two of sixteen biliary atresia cases also had poor hepatic uptake. If reduced hepatic activity is used as a criterion against biliary atresia, specificity increases to 94% but sensitivitiy decreases to 88%. Septo-optic dysplasia is an unusual syndrome characterized by absent septum pellucidum, hypoplasia of one or both optic nerves, and hypothalamic pituitary dysfunction. False positive biliary atresia interpretation can be reduced by careful physical examination and recognition of this entity. Poor hepatic uptake in cases with no twenty-four hour gastrointestinal activity can be helpful in ruling against biliary atresia.
The sodium, potassium, and water contents of red blood cells of healthy human adults.
Authors: L J Beilin, G J Knight, A D Munro-Faure, J Anderson
Journal: Journal of Clinical Investigation (1966)

Intracellular sodium and potassium concentra- tions in man can only be measured with ease and accuracy in red blood cells (RBC).Although there are many published reports of RBC sodium and potassium concentrations, the number of healthy subjects studied has been small, indirect methods of measurement have often been used, and biological sources of variation have not been defined.This paper describes the results of a study of 142 healthy adults and delineates some of the factors influencing RBC sodium and potassium concentrations. MethodsBlood was drawn with minimal venous compression into plastic syringes containing ammonium heparin' in isotonic glucose (0.005 ml of solution containing 0.25 mg heparin per ml of whole blood).Five-g samples of blood were immediately centrifuged in cellulose nitrate tubes (i.d.11 mm) 2 for 1 hour in a governed hematocrit cen- trifuge.3The relative centrifugal force (RCF) at the base of the tubes was 1,460 g; mean RCF applied to the cells thus depended on hematocrit and varied from approximately 1,330 to 1,370 g.Two or three tubes were used for estimation of plasma and RBC sodium and potassium concentrations and one or two tubes for water and hemoglobin content.After spinning, a weighed plasma sample was removed and the centrifuge tubes containing a layer of plasma and the packed cell column were frozen in an ethanol-CO2 mixture and sectioned 0.5 to 1.0 mm below the buffy
Trisomy-18 Syndrome in a Patient With Normal Karyotype
Authors: Ernest B. Hook
Journal: JAMA (1965)

THE CLINICAL spectrum of trisomy-18 syndrome has now been sufficiently characterized1so that this condition may be suspected before chromosome analysis is carried out.  The dermatoglyphic pattern is also highly characteristic. In all but one case in which the fingerprints were reported, an increased number of arches were noted.2  We report here the case of an infant with both clinical and dermatoglyphic stigmata of trisomy18syndrome who was found to have a normal karyotype.  Report of a Case  The patient was a white female infant born after a 37-week pregnancy to a 23-year-old mother and 36-year-old father. The mother was overweight at the beginning of her pregnancy and was placed on a diet at the onset. She gained only 3 lb (1.3 kg) in contrast to the 30-lb (13.6 kg) weight gain she had with her first pregnancy. From the second month of pregnancy, she took 7 1/2
Cigarette smoking and p53 mutations in lung cancer and bladder cancer.
Authors: K Husgafvel-Pursiainen, A Kannio
Journal: Environmental Health Perspectives (1996)

We report here a compilation of p53 mutation results from two smoking-related cancers, lung cancer and bladder cancer. The overall mutation frequencies reported for these two types of cancer were relatively similar--50% in lung cancer and 40% in bladder cancer. The compiled data from lung cancer and bladder cancer suggest an increasing proportion of patients with p53 mutations in nonsmokers, former smokers, and current smokers, in that order, in both cancer groups. Taken together, more than half (55% and 56% for lung cancer and bladder cancer, respectively) of the patients who continued smoking (CS), less than 40% (38% and 38%) of those who had stopped smoking before > or = 1 or > or = 5 years) clinical diagnosis (ES), and less than 30% (25% and 29%) of those who were nonsmokers (NS) had a p53 mutation. The differences seen in the mutation frequencies between the three smoking groups did not, however, reach statistical significance (lung cancer--CS vs ES: odds ratio [OR] = 2.0, 95% CI 0.7-5.4; CS vs NS: OR = 3.7, 95% CI 0.4-37; bladder cancer--CS vs ES: OR = 2.1, 95% CI 0.6-7.9; CS vs NS: OR = 3.1, 95% CI 0.7-13). Guanine to thymine transversions were the most common type in lung cancer followed by guanine to adenine transitions. In bladder cancer, on the contrary, G:C to A:T transitions at cytosine-guanine dinucleotide sites were the most frequently detected base substitutions. Analysis of the compiled p53 mutation data suggest that, in addition to lifetime cumulative exposure to cigarette smoke, also stopping smoking for years prior to clinical manifestation of the disease may affect the incidence of p53 mutations. The differences in the mutation profiles appear to support the view that the main genotoxic agents from cigarette smoke exposure may be different in bladder cancer as compared to lung cancer, as suggested previously by DNA adduct studies.
Distinct Loci Influence Radiation-Induced Alveolitis from Fibrosing Alveolitis in the Mouse
Authors: Christina K. Haston, Michelle Begin, Genevieve Dorion, Sean M. Cory
Journal: Cancer Research (2007)

Abstract Thoracic radiotherapy may produce the morbidity-associated lung responses of alveolitis or fibrosing alveolitis in treated cancer patients. The genetic factors that influence a patient's likelihood of developing alveolitis and the relationship of this inflammatory response to the development of fibrosis are largely unknown. Herein we use genetic mapping to identify radiation-induced lung response susceptibility loci in reciprocal backcross mice bred from C3H/HeJ (alveolitis response) and C57BL/6J (fibrosing alveolitis/fibrosis response) strains. Mice were treated with 18-Gy whole thorax irradiation and their survival, lung histopathology, and bronchoalveolar lavage cell types were recorded. A genome-wide scan was completed using 139 markers. The C3H/HeJ alveolitis response included mast cell infiltration and increased neutrophil numbers in the lavage compared with the level in the C57BL/6J strain, which developed fibrosis. In backcross mice, posttreatment survival was dictated by the development of an alveolitis response with increased mast cell, bronchoalveolar lavage total cell, and neutrophil numbers. Fibrosis was measured only in a subset of mice developing alveolitis and, in these mice, was associated with neutrophil count. Genotyping revealed coinheritance of C3H alleles (chromosomes 2, 4, 19, and X) and C57BL/6J alleles (chromosomes 1, 7, 9, and 17) to result in higher fibrosis scores in backcross mice. Mice that inherited C57BL/6J alleles at the putative alveolitis susceptibility loci were spared this response and lived to the end of the experiment. In this animal model, independent loci control the development of alveolitis from fibrosis, whereas fibrosing alveolitis occurs with the coinheritance of these factors. [Cancer Res 2007;67(22):10796–803]
Abstract IA37: Clinical genomics
Authors: Katherine A. Janeway
Journal: Cancer Research (2014)

Abstract The genomic features of pediatric malignancies and pediatric-specific issues in clinical investigation pose pediatric-specific challenges with respect to translating genomic discoveries to the clinic. However, through large scale molecular profiling of pediatric tumors, continued coordinated efforts to evaluate novel therapies in the pediatric population, thoughtful phase II and III trial design and continued drug development, molecularly based targeted therapies will become more common in the pediatric oncology clinic in the future. Consequently, it is essential to rigorously evaluate the clinical utility of advanced molecular diagnostics in pediatric oncology and the efficacy of a precision medicine approach to therapy selection. We are conducting a multi-institution clinical tumor profiling study, the iCat1 study evaluating the feasibility of identifying actionable alterations and making individualized cancer therapy recommendations using currently available clinically applicable tumor profiling technologies. Citation Format: Katherine A. Janeway. Clinical genomics. [abstract]. In: Proceedings of the AACR Special Conference on Pediatric Cancer at the Crossroads: Translating Discovery into Improved Outcomes; Nov 3-6, 2013; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2013;74(20 Suppl):Abstract nr IA37.
Surgeon General Examines Options for Coping With Public Health Menace of Drunken Driving
Authors: Charles Marwick
Journal: JAMA (1988)

ANYTIME ALL 100 US senators can agree on something, it's news. The problem that's brought them to unanimous agreement: the public health menace of drunken driving. This week, Surgeon General C. Everett Koop, MD—who has been pondering the problem for some time—was expected to assign staff to develop a plan through which he and his successors can work with the states and other agencies to cope with the drunken driving menace. Koop has in hand a letter from senators, who call the situation a "national crisis." The one-page letter summarizes some statistics relating to alcohol-related road accidents: Two of five Americans will be involved in an alcohol-related accident at some point in their lives. Two million alcohol-related crashes occur in the United States each year at a cost of at least $10 billion to $15 billion annually. Alcohol is a factor in over half of fatal motor vehicle accidents. Every
Julius Wagner-Jauregg: pyrotherapy, simultanmethode, and ‘racial hygiene’
Authors: G Gartlehner, K Stepper
Journal: Journal of the Royal Society of Medicine (2012)

Julius Wagner-Jauregg, Nobel Laureate and one of the leading psychiatrists of his time, was born on 7 March 1857, in Wels, Austria. Colleagues described him as a brilliant but extremely difficult person – a man able to think ‘outside the box’ but who also claimed that ‘common principles’ did not apply to him – and who lived by the motto ‘a man with character needs no principles’.

Wagner-Jauregg's career path was steep and successful. After graduating with a medical degree from the University of Vienna in 1880, he worked at the Institute of Pathology and for four years as an assistant at the Vienna Psychiatric Clinic. During this time, he developed an interest in the therapeutic potential of fever in the treatment of psychotic patients.1
Abstract 1638: Imaging the interaction of αv integrin-GFP in osteosarcoma cells with RFP-expressing host stromal cells and tumor scaffold collagen in nude mice.
Authors: Yasunori Tome, Fuminori Uehara, Hiroki Maehara, Shinji Miwa, Hiroyuki Tsuchiya, Katsuro Tomita, Fuminori Kanaya, Michael Bouvet, Robert M. Hoffman
Journal: Cancer Research (2013)

Abstract Human 143B osteosarcoma cells were stably transfected with an αv integrin-GFP vector. Confocal microscopy demonstrated that αv integrin immunofluorescence staining co-localized with αv integrin-GFP fluorescence. The αv integrin-GFP expressing tumors were established in transgenic nude mice ubiquitously expressing red fluorescent protein (RFP). The primary tumors acquired RFP-expressing stroma and were passaged orthotopically in the tibia in non-colored nude mice, which maintained the RFP stroma. The interaction of αv integrin-GFP expression in 143B cells with RFP-expressing host stromal cells was observed by confocal microscopy using the Olympus FV1000. Collagen fibers were imaged simultaneously in reflectance mode. The RFP-expressing stroma included cancer-associated fibroblasts (CAFs) and tumor-associated macrophages (TAMs) in the tumors which persisted even 3 weeks after passage. CAFs expressing RFP were aligned between collagen fibers and cancer cells expressing αv integrin-GFP. Six weeks after transplantation, pulmonary metastases expressing αv integrin-GFP could be identified. TAMs expressing RFP accompanied osteosarcoma cells expressing αv integrin-GFP in the lung. The present study demonstrates the importance of αv integrin interaction with stromal elements. Citation Format: Yasunori Tome, Fuminori Uehara, Hiroki Maehara, Shinji Miwa, Hiroyuki Tsuchiya, Katsuro Tomita, Fuminori Kanaya, Michael Bouvet, Robert M. Hoffman. Imaging the interaction of αv integrin-GFP in osteosarcoma cells with RFP-expressing host stromal cells and tumor scaffold collagen in nude mice. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1638. doi:10.1158/1538-7445.AM2013-1638
Familial ulcerative colitis
Authors: P. J. Morris
Journal: Gut (1965)

EDITORIAL SYNOPSiS A family in which eight members have or have had ulcerative colitis is presented and in them a genetic factor is considered to play a major part in the aetiology of the disease.The distribution of the disease in this family is consistent with an autosomal dominant pattern.Review of the literature suggests that a genetic influence is perhaps a more important factor in the aetiology of ulcerative colitis than previously supposed.It is not rare for ulcerative colitis to occur in families.Jackman and Bargen (1942) record an incidence of 1 8% of familial cases in a review of 900 cases from the Mayo Clinic, and Kirsner and Spencer (1963) an incidence of 6% in a study of 1,084 cases from the University of Chicago.However, it is rare for the disease to occur in more than two members of one family.The largest familial instances on record are a family described by Houghton and Naish (1958) with four members of the family affected, and another in the series of Kirsner and Spencer also with four members affected.The association of ulcerative colitis and regional enteritis in one family is also known.A most remarkable family is recorded by Sherlock, Bell, Steinberg, and Almy (1963) in which five members had regional enteritis and two members had ulcer- ative colitis.CASE HISTORIES in.6 B.R. is the propositus (Fig. 1).Her first attack of colitis was in 1950 at the age of 27, and continued with exacerbations and remissions until 1955.At that time, she became pregnant, and a moder- ately severe exacerbation occurred.Her pregnancy was carried on in hospital but she gave premature birth to a stillborn mongoloid infant.This precipated a most acute flare-up of her disease and she was desperately ill.An emergency ileostomy was performed, followed by a subtotal colectomy some weeks later.Eight months after this, the rectum was excised for continuing disease.Both specimens showed the changes of acute ulcerative colitis.Today she is well.ui.1 In A.B. the disease began at the age of 40 in 1955.On his first hospital admission during a subsequent
Pulmonary Function: Relation to Aging, Cigarette Habit, and Mortality
Authors: FRANTZ ASHLEY
Journal: Annals of Internal Medicine (1975)

The relation of pulmonary function to aging and cigarette habits has been examined cross sectionally and longitudinally in the Framingham cohort. On cross-sectional analysis, women were found to have lower forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) values than men even after adjusting for height. Their FEV1percent was, on the other hand, higher than those of men. As the population aged over 10 years, their FVC and FEV1declined 9% to 27% depending upon age and sex. The FEV1percent, however, showed a decline only in the older age groups. In a cross-sectional analysis, cigarette smoking showed an inverse association to FVC and FEV1percent. Longitudinally, cigarette smokers showed a more rapid decline in FVC in 10 years than nonsmokers. On giving up smoking their FVC became more like that of the nonsmokers. A striking relation of FVC to mortality was noted in both sexes, which is not accounted for by associated cigarette habits.
Identification and treatment of chronic hepatitis B in Chinese migrants: Results of a project offering on-site testing in Rotterdam, The Netherlands
Authors: Irene K. Veldhuijzen, Reinoud Wolter, Vincent Rijckborst, Marijke Mostert, Helene A. Voeten, Yiu Cheung, Charles A. Boucher, Jurriën G.P. Reijnders, Onno de Zwart, Harry L.A. Janssen
Journal: Journal of Hepatology (2012)
Of rabbit and humble pie
Authors: W. Moore
Journal: BMJ (2009)

In a world where health scares and medical uncertainty can so easily spiral into kneejerk reactions and blind panic, it is always useful to maintain a sense of reality. Or so Sir Richard Manningham, physician to George I, had to remind himself when faced with the unlikely tale of a woman who had given birth to 17 rabbits.

Young Mary Toft had become a “must see” on the Georgian tourist trail in her home town of Godalming, some 50 km south of London, in 1726. After watching two rabbits bounding in a field, the mother of three had given birth to an entire litter of bunnies—albeit in mangled parts—with the assistance of a local male midwife, John Howard. …
Combinative strategy using tamoxifen and other chemotherapeutic drugs for cholangiocarcinoma chemotherapy
Authors: Zhihua Liu, Yanlei Ma, Huanlong Qin
Journal: Hepatology (2010)

We read in HEPATOLOGY a very interesting and valuable article1 suggesting that the simultaneous targeting of epidermal growth factor receptor (ErbB1) and human epidermal growth factor receptor 2 (ErbB2) could potentially be a selective strategy for cholangiocarcinoma therapy. Reading this article and considering our own study on the treatment of cholangiocarcinoma with a combinative strategy involving tamoxifen and other chemotherapeutic drugs, we see indications that the use of tamoxifen for cholangiocarcinoma prevention and treatment will become more popular. Tamoxifen is a classic drug for estrogen receptor–positive primary breast cancer that is positive for ErbB1 and/or ErbB2,2 and the same mechanism could be indicated for the treatment of cholangiocarcinoma. We have also performed some experiments with this strategy (as mentioned later), and now we think that the expression levels of ErbB1, ErbB2, or both could be markers for the effects of tamoxifen. To find new ways of using chemotherapeutics for human cholangiocarcinoma, we have been paying attention to the growth-inhibition effects of tamoxifen in combination chemotherapeutics. Some of our pilot studies have shown that tamoxifen can lead to increased cell damage by competing with other chemotherapeutic molecules for binding sites on P-glycoprotein and by limiting the extracellular transport of drugs from the human cholangiocarcinoma cell line QBC939.3, 4 Because cholangiocarcinoma cells gradually develop resistance to conventional chemotherapeutic drugs, we have selected tamoxifen as a sensitizer that competes with chemotherapeutic drugs as the P-glycoprotein substrate for the P-glycoprotein binding site and enhances the drug concentration and effects of chemotherapy.3 To further our study, we have established a human, multidrug-resistant cholangiocarcinoma cell line (QBC939/ADM).4 We are now investigating the specific signal transduction pathway by which tamoxifen decreases P-glycoprotein expression levels, and we are determining whether other mechanisms are involved. Furthermore, tamoxifen has been used primarily to treat patients with nonbreast cancers, including hepatocellular, pancreatic, renal cell, ovarian, and melanoma carcinomas.3 Above all, we believe that although the use of tamoxifen for the prevention of breast cancer is exceptionally low, the use of tamoxifen for cancer prevention and treatment will become more popular and extensive with the decision-making process. Zhihua Liu Ph.D.*, Yanlei Ma Ph.D.*, Huanlong Qin M.D.*, * Department of Surgery, Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
Extramedullary Hematopoiesis and Myeloid Metaplasia of the Ovaries and Tubes in a Patient With Myelofibrosis: Case Report and Concise Review of the Reported Cases
Authors: Benoît Rabischong, Demetrio Larraín, Cécile Charpy, Pierre J. Déchelotte, Gérard Mage
Journal: Journal of Clinical Oncology (2010)
Pulmonary Artery Catheters
Authors: David H. Spodick
Journal: JAMA (1991)

To the Editor.—  The report of physicians' knowledge of the pulmonary artery catheter (PAC) by Iberti et al 1 and perceptive editorial by Bone 2 highlight an area of multiple concerns. Iberti et al have made some telling points that I would like to supplement.  The technical proficiency of those who use catheters and their ability both to get accurate results and to use them appropriately are crucial to any kind of test. The authors correctly note that our study 3 did not control for technical and intellectual proficiency. However, it was meant to provide a state-of-the-art basis for further investigation, in retrospective agreement with Bone's caveats about beginning with controlled investigations for anything we unleash on patients. The latter is identical in principle with the 1983 analysis, Randomize the First Patient, 4 a proposal to offer patients a 50-50 chance not to get a new treatment or diagnostic method,