tbuckley/cabot-search huggingface dataset:
Survival is better after lumpectomy than mastectomy in early breast cancer, US study shows
Authors: S. Mayor
Journal: BMJ (2013)

Women with early stage breast cancer who are treated with lumpectomy and radiotherapy have significantly better survival than women who have a mastectomy, a retrospective study of US data has found.1

Researchers analyzed data in the California cancer registry from all 112 154 women in the state who had been given a diagnosis of early stage, invasive breast cancer between 1990 and 2004 and who were treated with either lumpectomy and radiotherapy or mastectomy and were followed to December 2009. Just over half (55%) had breast conserving therapy, and the remainder had mastectomy without radiation.

“Despite randomized trials suggesting that breast conserving …
Iraqi doctors overseas are asked to go back home and help
Authors: I. Vlad
Journal: BMJ (2003)

Dr Khudair Abbas, Iraq's interim minister of health, has asked Iraqi doctors currently working overseas to go back to Iraq, even for short periods, to advise and train local doctors.

Speaking at a seminar at the London School of Hygiene and Tropical Medicine, Dr Abbas said that among the problems of postwar Iraq were the lack of doctors and the inadequate training of the existing ones.

During the three wars that Iraq has gone through since the Iran-Iraq conflict in 1980 no …
Seasonal Changes in Body Composition and Blood HbA1c Levels Without Weight Change in Male Patients With Type 2 Diabetes Treated With Insulin
Authors: Motoi Sohmiya, Ippei Kanazawa, Yuzuru Kato
Journal: Diabetes Care (2004)

We have often observed increases in plasma glucose and HbA1c levels in patients with type 2 diabetes during the winter in Japan. This phenomenon has been explained in part by weight gain due to increases in food intake and decreases in exercise during the winter. However, HbA1c levels are also increased during the winter season in most patients with type 2 diabetes without weight gain. In this study, we examined the relationship between seasonal changes in body composition and blood HbA1c levels in patients with type 2 diabetes treated with insulin over a 2-year period.

Eleven male patients with type 2 diabetes treated with insulin were investigated. …
Testing Treatments: Better Research for Better Healthcare
Authors: Ike Iheanacho
Journal: BMJ (2006)

W hat characterises a great doctor? A list of required qualities might well include a wealth of clinical experience, brilliant diagnostic and other technical skills, and a wonderful bedside manner. Most people would hope for, or even expect, such features in anybody labelled as an exemplary clinician. But how many would suggest another, much less glamorous but essential marker—knowledgeable ignorance?

This oxymoronic term refers to an acute awareness of and readiness to admit personal and profession-wide uncertainties about key healthcare questions and dilemmas. It encapsulates an attitude seen in all the best doctors. These are the people who do not pretend to know all the answers. When out of their depth, they happily seek advice or assistance from colleagues. They look up drug doses rather than half remembering them. And, crucially, they are able to declare their ignorance to patients in ways that inspire respect rather than undermine trust and confidence.

One thing that typifies such professionals is their …
Impact of ruxolitinib on the natural history of primary myelofibrosis: a comparison of the DIPSS and the COMFORT-2 cohorts
Authors: Francesco Passamonti, Margherita Maffioli, Francisco Cervantes, Alessandro Maria Vannucchi, Enrica Morra, Tiziano Barbui, Domenica Caramazza, Lisa Pieri, Elisa Rumi, Heinz Gisslinger, Laurent Knoops, Jean Jaques Kiladjian, Barbara Mora, Norbert Hollaender, Cristiana Pascutto, Claire Harrison, Mario Cazzola
Journal: Blood (2014)
Warfarin
Authors: Jeffrey S. Flier, Lisa H. Underhill, Stanford Wessler, Sanford N. Gitel
Journal: New England Journal of Medicine (1984)

ON the basis of two facts — that bishydroxycoumarin produced a bleeding disease in cattle and that it retarded blood clotting — coumarin compounds were hailed in 1941 as likely antithrombotic agents, a rather debatable prediction on the basis of the facts then available.With the development of the prothrombin-time assay to monitor the drug-induced defect in plasma,1 the stage was set, after a few studies in animals, for the first clinical trials. These studies were reported in 1941, one fifth of a century after "sweet clover disease" was first recognized by Schofield.2 Since World War II, information has accumulated . . .
DIAGNOSTIC ACCURACY OF SYMPTOMS IN DETERMINING THE PRESENCE OF VALVULAR HEART DISEASE IN PATIENTS EXPOSED TO PERGOLIDE MESYLATE
Authors: Ashok Krishnaswami, Kathleen B. Albers, Sarah Berkheimer, Robin D. Fross, Valeri C. Kwai Ben, James J. Jang, Stephen Van Den Eeeden
Journal: Journal of the American College of Cardiology (2011)
Dacarbazine Treatment before Peptide Vaccination Enlarges T-Cell Repertoire Diversity of Melan-A–Specific, Tumor-Reactive CTL in Melanoma Patients
Authors: Belinda Palermo, Duilia Del Bello, Alessandra Sottini, Federico Serana, Claudia Ghidini, Novella Gualtieri, Virginia Ferraresi, Caterina Catricalà, Filippo Belardelli, Enrico Proietti, Pier Giorgio Natali, Luisa Imberti, Paola Nisticò
Journal: Cancer Research (2010)

Combination of chemotherapy and immunotherapy to increase the effectiveness of an antitumor immune response is currently regarded as an attractive antitumor strategy. In a pilot clinical trial, we have recently documented an increase of melanoma antigen A (Melan-A)-specific, tumor-reactive, long-lasting effector-memory CD8(+) T cells after the administration of dacarbazine (DTIC) 1 day before peptide vaccination in melanoma patients. Global transcriptional analysis revealed a DTIC-induced activation of genes involved in the immune response and leukocyte activation. To identify the possible mechanisms underlying this improved immune response, we have compared the endogenous and the treatment-induced anti-Melan-A response at the clonal level in patients treated with the vaccine alone or with DTIC plus vaccine. We report a progressive widening of T-cell receptor (TCR) repertoire diversity, accompanied by high avidity and tumor reactivity, only in Melan-A-specific T-cell clones of patients treated with chemoimmunotherapy, with a trend toward longer survival. Differently, patients treated with vaccine alone showed a tendency to narrowing the TCR repertoire diversity, accompanied by a decrease of tumor lytic activity in one patient. Collectively, our findings indicate that DTIC plus vaccination shapes the TCR repertoire in terms of diversity and antitumor response, suggesting that this combined therapy could be effective in preventing melanoma relapse.
Geographical analysis of cardiovasscular mortality: a cautionary note.
Authors: S Openshaw, M Charlton
Journal: BMJ (1980)

described but mistaken fears about quality of care and patient satisfaction that prevents team care progressing.Let there be no mistake, I believe in the National Health Service, I love working in it, I am happy to have entered medicine in the year that it was born.I have proclaimed, I think convincingly, its virtues in several parts of the world.Nevertheless we must be ever watchful that it does not become wasteful.
Prazosin Treatment of Ergotamine-Induced Peripheral Ischemia
Authors: Donn S. Cobaugh
Journal: JAMA (1980)

SEVERAL recent reports in the literature have recommended intravenous or intra-arterial sodium nitroprusside administration for the treatment of severe ergotamine-induced peripheral ischemia.<sup>1-4</sup>Most treatments, prior to sodium nitroprusside, have been unsuccessful. Because of the similarities of action of prazosin and sodium nitroprusside,<sup>5,6</sup>a trial of prazosin hydrochloride in the treatment of ergotism seemed reasonable. Peripheral ischemia of all four extremities and claudication of the right arm and leg were successfully treated with prazosin given orally. <h3>Report of a Case</h3> A 42-year-old woman was referred because of absent pulses and unobtainable blood pressure. She had a seven-year history of migraine headaches for which she had been taking suppositories containing 2 mg of ergotamine tartrate and 100 mg of caffeine (Cafergot) once weekly. During the 12 months before admission, the patient had used two suppositories daily (total dose of ergotamine, 28 mg weekly). In 1976 the patient had been examined
Renin–angiotensin system blockade in heart failure patients on long‐term haemodialysis in Taiwan
Authors: Chao‐Hsiun Tang, Tso‐Hsiao Chen, Chia‐Chen Wang, Chuang‐Ye Hong, Kuan‐Chih Huang, Yuh‐Mou Sue
Journal: European Journal of Heart Failure (2013)
The Disclosure Dilemma — Large-Scale Adverse Events
Authors: John A. Fromson, Linda K. Kenney
Journal: New England Journal of Medicine (2010)

To the Editor: Dudzinski et al. (Sept. 2 issue)1 highlight the challenging dilemma that institutions face in disclosing adverse events to their patients and the public at large. Another important dimension of this issue is the effect of these events on patients, families, and caregivers. The uniqueness of medically induced trauma and the broad scope of its impact necessitate the need for supportive services for all persons who are affected by an unexpected medical outcome or error. Institutions should establish critical-incident stress management (CISM) for their staff members.2 CISM centers on helping individual staff members or groups deal with unusually . . .
The major histocompatibility complex class II-linked cim locus controls the kinetics of intracellular transport of a classical class I molecule.
Authors: S J Powis, J C Howard, G W Butcher
Journal: The Journal of Experimental Medicine (1991)

The dominant trans-acting major histocompatibility complex (MHC)-linked class I modifier (cim) locus, previously recognized through its ability to determine altered alloantigenicity of a rat class I molecule, RT1.A3, is shown here to influence class I intracellular transport. The MHC recombinant laboratory rat strains PVG.R1 and PVG.R8 display unusually long retention of RT1.Aa within the endoplasmic reticulum or cis-Golgi. In appropriate F1 hybrid cells heterozygous for RT1.Aa and another class I MHC allele, RT1.Ac, only the RT1.Aa protein is subject to slow transport. The cim gene product therefore shows class I allele specificity in its action, cim appears to be a polymorphic locus whose product is directly involved in the processes of class I MHC assembly and/or intracellular transport.
Reply to Berardino De Bari, Stefano Arcangeli, and Filippo Alongi's Letter to the Editor re: Nazareno Suardi, Andrea Gallina, Giuliana Lista, et al. Impact of Adjuvant Radiation Therapy on Urinary Continence Recovery After Radical Prostatectomy. Eur Urol 2014;65:546–51
Authors: Nazareno Suardi, Cesare Cozzarini, Francesco Montorsi, Alberto Briganti
Journal: European Urology (2014)
Henry Maurice (“Harry”) Rapport
Authors: Marjorie Davies, Née Rapport
Journal: BMJ (2006)

​FormerFormer general practitioner Cardiff (b 1912; q Welsh National School of Medicine 37; FRCGP, MBE), died from heart failure on 9 June 2006.



Figure 1



After completing two years in house jobs at Cardiff Royal Infirmary, Henry Rapport (“Harry”) volunteered for the Royal Army Medical Corps and served five years in the Middle East and Greece. On returning to Cardiff in 1945 he set up in general practice. On retirement he worked for 14 years at the Marie Curie Hospice in Penarth, for which services he was awarded the MBE. He also spent time in retirement to indulge his love of music. Predeceased by his wife, Gwen, in 2003, he leaves two daughters and three grandsons.
Serum screening for Down's syndrome. Widening the programme would be costly.
Authors: A Phillips
Journal: BMJ (1993)

distress.This test, with a positive predictive value of less than 3%,4 will generate many false positive results.Women who receive a positive result from a screening test are entitled to much greater support than they now receive.The costs of such a service would, however, outweigh the benefits of routine screening.Districts now considering the introduction of such a programme should bear in mind the maxim quoted by Marteau: "first do no harm.
Clinical Sense, Social Sense, Common Sense
Authors: Dwight L. Wilbur
Journal: JAMA (1969)

As I address this House of Delegates for the last time as President of the Association, let me express my great pride in the medical profession and the American Medical Association. I am grateful to hundreds of members of the Association and to its staff who during the past year have so ably and effectively pushed toward its goals and have helped me so much. I am indeed grateful. It is not my purpose to review the accomplishments and the disappointments since June 1968. Instead, I would like to discuss some thoughtful and practical considerations of the road ahead, particularly as medicine relates to society and to government. Medicine is really in its infancy! Medicine in human service has almost unlimited possibilities. As it becomes increasingly scientifically based—as it surely will in the years ahead—we and our successors will see fantastic developments, many of them unpredictable. One can predict that
A Pathogenic Retrovirus (HTLV-III) Linked to AIDS
Authors: Samuel Broder, Robert C. Gallo
Journal: New England Journal of Medicine (1984)

APPROXIMATELY three years ago an apparently new and unexplained disorder called the acquired immunodeficiency syndrome (AIDS) was recognized. Prompt worldwide recognition of this syndrome was brought about by a truly remarkable collaboration between practicing physicians in several parts of the United States and epidemiologists at the Centers for Disease Control. AIDS immediately became the subject of a number of reports, many of which have appeared in the Journal.1 2 3 4 5 6 7 8 9 The disorder is an epidemic immunosuppressive disease that predisposes to life-threatening infections with opportunistic organisms, Kaposi's sarcoma, and less commonly, other neoplasms such as non-Hodgkin's lymphomas. Characteristically, AIDS is associated with . . .
Effects of experimental rhinovirus 16 infection on airway hyperresponsiveness to bradykinin in asthmatic subjects in vivo.
Authors: K Grünberg, E A Kuijpers, E P de Klerk, H W de Gouw, A C Kroes, E C Dick, P J Sterk
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

Disturbance of the balance between excitatory and inhibitory activity of the airway sensory nerves has been implicated in asthma pathogenesis, particularly during exacerbations of the disease. The objective of this study was to examine the effect of experimental rhinovirus 16 (RV16) infection on airway responsiveness to bradykinin, a potent sensory nerve stimulus, in asthma. Thirteen atopic, mildly asthmatic subjects participated in a parallel, placebo-controlled study. A total dose of 2.6 to 5.6 x 10(4) TCID50 RV16 (n = 7) or its diluent (n = 6) was inoculated on 2 consecutive days (Days 0 and 1). Histamine and bradykinin challenges were performed before (Days-7 and-6) and after (Days 3 and 4) inoculation. The response was measured by FEV1 and partial flow-volume curves, and it was expressed as PC20FEV1 and PC40V40p, respectively (changes expressed in doubling dose: DD). Before inoculation, PC20FEV1 and PC40V40p to histamine were not significantly different between the groups (p > or = 0.22), whereas PC20FEV1 and PC40V40p to bradykinin tended to be higher in the RV16 group (p = 0.11 and p = 0.06, respectively). PC20FEV1 and PC40V40p to histamine decreased significantly in the RV16 group (mean change +/- SEM: -0.65 +/- 0.20 DD, p = 0.02 and -0.98 +/- 0.28 DD, p = 0.01, respectively), but not in the placebo group (p > or = 0.26). PC40V40p to bradykinin increased significantly in the placebo group (+2.46 +/- 0.92 DD, p = 0.04), with a similar trend for PC20FEV1 (+1.50 +/- 0.62 DD, p = 0.06), whereas there were no significant changes in the RV16 group (p > or = 0.77). These changes in PC40V40p to histamine and bradykinin were significantly different between the groups (p = 0.02). We conclude that repeated bradykinin challenge over a 10-d interval induces tachyphylaxis in asthmatic subjects in vivo and that experimental RV16 infection abolishes such tachyphylaxis to bradykinin while it enhances airway responsiveness to histamine. These results do not favor a predominant role of airway sensory nerves in rhinovirus-induced exacerbations of asthma.
Predictors of mortality in 1-antitrypsin deficiency
Authors: P A Dawkins
Journal: Thorax (2003)

Lung density measurements by computed tomography have previously been found to be a more sensitive indicator of disease progression in emphysema of alpha(1)-antitrypsin deficiency than lung function measurements. The aim of this study was to investigate the predictive potential of several parameters, including CT scanning, for mortality in patients with severe alpha(1)-antitrypsin deficiency.Over a 5 year period, 256 patients with alpha(1)-antitrypsin deficiency (PiZ phenotype) were assessed, of whom 254 underwent lung function testing and 197 had thoracic CT scans. Lung function, CT scans, health status (St George's Respiratory Questionnaire, SGRQ), and other clinical data of survivors and non-survivors were compared and these parameters were applied to survival analyses.There were 22 deaths in this patient cohort, 10 of which were classified as "respiratory" deaths. Baseline lung function parameters (forced expiratory volume in 1 second (FEV(1)), carbon monoxide transfer coefficient (KCO)), and CT scores were significantly lower in the non-survivors than in the survivors. 170 of the 256 patients had complete data for entry into multiple regression analyses (Cox proportional hazards model). In the univariate analysis, upper zone expiratory scan had the best association with all cause (p = 0.001) and respiratory mortality (p<0.001), whereas FEV(1) (p = 0.158 all cause, 0.015 respiratory) and KCO (p = 0.002 all cause, 0.012 respiratory) had poorer associations with mortality. Only age gave further independent predictive information regarding all cause or respiratory mortality when the CT scan was entered into the survival analyses.CT scanning predicts respiratory and all cause mortality in alpha(1)-antitrypsin deficiency and appears to be superior to lung function parameters, especially FEV(1).
Hyperbola-like discounting, impulsivity, and the analysis of will
Authors: Leonard Green, Joel Myerson
Journal: Behavioral and Brain Sciences (2005)

Ainslie's insightful treatment of dynamically inconsistent choice stands in contrast to traditional views in psychology, economics, and philosophy. We comment on the form of the discounting function and on new findings regarding choice between delayed rewards. Finally, we argue that the positive correlation between temporal and probability discounting is inconsistent with the view that impulsivity represents a unitary trait.
HELIOTHERAPY, WITH ESPECIAL REFERENCE TO SPINAL TUBERCULOSIS
Authors: CHARLES E. SEVIER
Journal: JAMA (1925)

The use of sunlight in the treatment of chronic diseases is as old as the study of medicine. The specific action of heliotherapy on deep seated tuberculous lesions was first emphasized by the Lyons school of surgeons in France. Their treatment consisted for the most part in exposure of the diseased area alone, although a few of the teachers recommended general, as well as local heliotherapy. In 1903, Rollier opened, in Leysin, Switzerland, the first clinic for the systematic application of the sun bath to the entire surface of the body, in the treatment of extrapulmonary tuberculosis. During the last fifteen years, heliotherapy has spread rapidly, and in our own country, a number of clinics are employing a more or less modified form of this treatment. The use of the sun bath as a therapeutic agent in the treatment of extrapulmonary tuberculosis is based on the recognition of the fact
Expression of TGF-β–induced matrix protein βig-h3 is up-regulated in the diabetic rat kidney and human proximal tubular epithelial cells treated with high glucose
Authors: Suk-Hee Lee, Jong-Sup Bae, Sun-Hee Park, Byung-Heon Lee, Rang-Woon Park, Je-Yong Choi, Jae Yong Park, Sung-Woo Ha, Yong-Lim Kim, Tae-Hwan Kwon, In-San Kim
Journal: Kidney International (2003)
Parental Atopy Is Not A Risk Factor For Ige-Mediated Cow's Milk Protein Allergy (Ige-CMA)
Authors: M. Goldberg, E. Eisenberg, N. Rajuan, M. Rachmiel, A. Cohen, A. Elizur, G. Zadik-Mnuchin, Y. Katz
Journal: Journal of Allergy and Clinical Immunology (2011)
Government proposes new dental fees system
Authors: C Court
Journal: BMJ (1994)

Patients could pay close to the full cost of advanced NHS dental treatment under proposals contained in a government green paper published last week. The paper, Improving NHS Dentistry, says that charges for routine examinations could then be reduced. Patients with no exemptions currently pay 80% of the cost of their dental care.

In a radical reappraisal of the existing system, the green paper also suggests that dentists' remuneration should be based on the time committed to treating NHS patients rather than the …
Epileptic seizures in a population of 6000. I: Demography, diagnosis and classification, and role of the hospital services.
Authors: D M Goodridge, S D Shorvon
Journal: BMJ (1983)

A total of 122 patients with a history of non-febrile epileptic seizures were identified in a survey of 6000 persons from a single general practice. The lifetime prevalence was 20.3/1000 including single seizures and 17.0/1000 excluding single seizures; 5.3/1000 had active epilepsy. Diagnosis and classification of seizures in such a survey were difficult. Most patients were seen by a hospital specialist at some point, but hospital follow up was sporadic. Overall patient assessment and monitoring was poor. There is a place for specialised epilepsy clinics that could be organised along the lines of the clinics for diabetes. These provide facilities for initial diagnosis and assessment, for planning long term management, for the selected follow up of difficult cases, and for referral for specific problems. Such a system would improve the long term care of patients with epilepsy.
Aurora kinase A is a target of Wnt/β-catenin involved in multiple myeloma disease progression
Authors: Jui Dutta-Simmons, Yunyu Zhang, Gullu Gorgun, Moshe Gatt, Mala Mani, Teru Hideshima, Kohichi Takada, Nicole E. Carlson, Daniel E. Carrasco, Yu-Tzu Tai, Noopur Raje, Anthony G. Letai, Kenneth C. Anderson, Daniel R. Carrasco
Journal: Blood (2009)