tbuckley/cabot-search huggingface dataset:
Pregnancy and Crohn's Disease
Authors: J. F. Fielding, W. T. Cooke
Journal: BMJ (1970)

Of 77 married women with Crohn's disease, 25 were sterile. In the remaining 52 (98 pregnancies) the risks of prematurity, stillbirth, abortion, or congenital abnormality were not increased. There was no evidence that pregnancy exerted adverse effects on the course of the disease or increased the mortality rate. Sterility was the main problem encountered.
Gloomy prognoses: Represent honesty, not fear of litigation
Authors: John M Reynard
Journal: BMJ (2006)

Editor—Discussing the worst case scenario is not about avoiding litigation, but rather it is about effective communication—the imparting of information.1 This cannot be achieved without honesty, unpleasant though this may be.

In the context of bladder cancer doctors often use the euphemisms warts, mushrooms, polyps, or trouble in the bladder when referring to the cystoscopic appearance of the tumour. Such “kindness” is misguided and can ultimately destroy trust between patient and doctor when the truth finally comes out—“If he couldn't tell me I had cancer, what else is he hiding?” Bladder “cancer” is potentially lethal, “warts” are not. Unless armed with this upsetting fact, patients cannot make the choices that are appropriate for them.

Being honest and compassionate are not mutually exclusive. There are ways of saying cancer or risk of death in a compassionate way, but at the end of the day we must be honest with ourselves and our patients. Give me an honest doctor any day rather than a kind one who dodges difficult issues.
Abstract 3621: Polymorphisms in genes related to DNA repair and to apoptosis: Link with the outcome after radiochemotherapy in head and neck cancer patients
Authors: Delphine Borchiellini, Marie-Christine Etienne-Grimaldi, Juliette Thariat, Yann Chateau, Jean-Louis Formento, Patricia Formento, Laurence Llorca, Gerard Milano
Journal: Cancer Research (2012)

Abstract Background For patients with locally-advanced head and neck cancer (LAHNC), treatment with irradiation (RT), associated or not with chemotherapy (CT), remains a valuable alternative to surgery and is currently being actively investigated. Identification of individual factors able to discriminate good candidates for radiochemotherapy (RCT) would allow optimal handling of RCT (doses, associated drugs). We examined whether functional single nucleotide polymorphisms (SNPs) in genes related to DNA repair and to apoptosis could be related to the outcome of patients with LAHNC treated with RCT. Methods A homogeneous group of 90 patients with LAHNC were treated by either RT (29%) or cisplatin-based RCT (71%). For all study patients, we used DNA extracted from tumor samples stored in liquid nitrogen from 1992 to 2006. The following SNPs (rs) were analysed by PCR-RFLP: ERCC2 (XPD) 751Lys≫Gln (rs13181), XRCC1 399Arg≫Gln (rs25487), TP53 72Arg≫Pro (rs1042522) and MDM2 309T&amp;gt;G (rs2279744). The SNPs ERCC1 259Lys≫Thr (rs735482) and ERCC5 46His C&amp;gt;T (rs1047768) were investigated by Single Base Extension. Results Univariate analyses showed no link between the studied SNPs and overall response rate evaluated at 3 months or 6 months from the end of the treatment. In contrast, there was a significant association between the polymorphism MDM2 309T&amp;gt;G and the occurrence of cutaneous toxicity, since G/G subjects had a higher risk of severe radiation dermatitis (p=0.047). Similarly, the Gln allele of ERCC2 751Lys≫Gln was specifically related to a risk of acute radiation dermatitis following exclusive RT (p=0.009). Also, homozygous patients for XRCC1 399Arg≫Gln (Arg/Arg or Gln/Gln) had an increased risk of developing early osteoradionecrosis, particularly for patients receiving RCT (p=0.032). The occurrence of late toxicities (cervical fibrosis, p=0.011 or xerostomia, p=0.043) was associated with the genotype T/T of ERCC5 46His C&amp;gt;T. Conclusion Individually-based decision criteria are eagerly needed in the context of concurrent chemoradiation in LAHNC, especially with the introduction of anti-EGFR targeted therapies, which increase both anti-tumor efficacy and side-effects (radiation dermatitis). We believe that analyses of gene polymorphisms such as MDM2 and ERCC2 could be of clinical value in establishing the necessary guidelines. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3621. doi:1538-7445.AM2012-3621
The influence of surgeon and pathologist in obtaining high median lymph node yields after colorectal resection for adenocarcinoma
Authors: M. Rahman, C. J. Walter, A. Webster, N. Borley, J. M. Wheeler
Journal: Gut (2011)

<h3>Introduction</h3> The number of lymph nodes evaluated in resected colorectal adenocarcinoma specimens is associated with patient survival and therefore used as a marker of quality in colon cancer care.1 The aim of this study was to assess whether individual surgeons and pathologists retrieving and analysing colorectal resection specimens at our centre differed in their lymph node yields (LNY). <h3>Methods</h3> Casenotes for all elective Right Hemicolectomies (RHC) and Anterior Resections (AR) performed at our centre for adenocarcinoma between 2008–2009 were identified using hospital coding and histology reports were assessed for LNYs. Total and positive LNYs were compared between surgeons and pathologists using GnuPSPP statistical software. <h3>Results</h3> Two dedicated colorectal surgeons and 5 pathologists produced 77 RHC and 125 AR (of which 62 were Total Mesorectal Excisions (TME)) specimens. Median total LNYs for each of our surgeons were: 22(16.5–28.6) and 23(17–31) p = 0.95 for RHC; 21(12–28) and 16(12.5–27) p = 0.37 for all ARs; and 19(9.5–25) and 15(12–24) p = 0.13 for TMEs. Positive LNYs from RHC (p = 0.5), AR (p = 0.80) and TME (p = 0.23) were also similar between the surgeons. Of the 5 pathologists the highest and lowest median total LNYs for RHC, AR and TME specimens were: 28(21–32) to 16.5(14.5–18.5); 28(21–35) to 14.5(10–19.72); and 25(16.5–34) to 9(8.5–16.5), respectively. Oneway ANOVA testing of the 5 pathologists total LNYs for RHC, AR and TME gave p values of 0.02, 0.00 and 0.01, respectively. The pathologist with the lowest LNY after TME had significantly more specimens (57%) treated with neoadjuvant radiotherapy than the other pathologists. Comparison of positive LNYs between pathologists showed no differences in yields with p = 0.05 for RHC, p = 0.80 for AR and p = 0.23 for TME. <h3>Conclusion</h3> Lymph node yields following colorectal resection at our centre are far higher than published yields from other centres.2 No difference was seen in the LNYs delivered by the 2 surgeons studied; however, there was a significant difference in total LNYs between our 5 pathologists; with some pathologists consistently producing huge yields. This did not, however, translate to a difference in positive LNYs produced by our pathologists although our study is underpowered to demonstrate equivalence.
Once-daily versus Twice-daily Levobunolol (0.5%) Therapy
Authors: Robert J. Derick, Alan L. Robin, James Tielsch, Jeffrey L. Wexler, Elaine P. Kelley, Jack F. Stoecker, Gary D. Novack, Anne L. Coleman
Journal: Ophthalmology (1992)

The authors executed a two-period, randomized, double-masked, crossover study comparing once-daily to twice-daily levobunolol hydrochloride (0.5%) in 20 patients with elevated intraocular pressure (10P). Modified diurnal curves were performed at four times for each study arm: baseline, day 1, day 14, and day 28. The mean diurnal corrected decrease in 10P from baseline ranged from 16% ± 11 % to 22% ± 9% when the subjects were treated twice daily, and from 14% ± 10% to 18% ± 8% when the same subjects were treated once daily. At day 1, patients had a significantly greater 101? lowering after twice-daily therapy than after once-daily therapy (P < 0.05). At 14 and 28 days, there was no clinically significant difference between the two treatment regimens. The results of our crossover study suggest that once-daily treatment with levobunolol (0.5%) is as effective as twice-daily treatment. The authors executed a two-period, randomized, double-masked, crossover study comparing once-daily to twice-daily levobunolol hydrochloride (0.5%) in 20 patients with elevated intraocular pressure (10P). Modified diurnal curves were performed at four times for each study arm: baseline, day 1, day 14, and day 28. The mean diurnal corrected decrease in 10P from baseline ranged from 16% ± 11 % to 22% ± 9% when the subjects were treated twice daily, and from 14% ± 10% to 18% ± 8% when the same subjects were treated once daily. At day 1, patients had a significantly greater 101? lowering after twice-daily therapy than after once-daily therapy (P < 0.05). At 14 and 28 days, there was no clinically significant difference between the two treatment regimens. The results of our crossover study suggest that once-daily treatment with levobunolol (0.5%) is as effective as twice-daily treatment.
Mechanisms of regulation of CXCR4/SDF-1 (CXCL12)–dependent migration and homing in multiple myeloma
Authors: Yazan Alsayed, Hai Ngo, Judith Runnels, Xavier Leleu, Ujjal K. Singha, Costas M. Pitsillides, Joel A. Spencer, Teresa Kimlinger, Joanna M. Ghobrial, Xiaoying Jia, Ganwei Lu, Michael Timm, Ashok Kumar, Daniel Côté, Israel Veilleux, Karen E. Hedin, G. David Roodman, Thomas E. Witzig, Andrew L. Kung, Teru Hideshima, Kenneth C. Anderson, Charles P. Lin, Irene M. Ghobrial
Journal: Blood (2006)
Critical Reevaluation of Endothelial Progenitor Cell Phenotypes for Therapeutic and Diagnostic Use
Authors: Gian Paolo Fadini, Douglas Losordo, Stefanie Dimmeler
Journal: Circulation Research (2012)

Diverse subsets of endothelial progenitor cells (EPCs) are used for the treatment of ischemic diseases in clinical trials, and circulating EPCs levels are considered as biomarkers for coronary and peripheral artery disease. However, despite significant steps forward in defining their potential for both therapeutic and diagnostic purposes, further progress has been mired by unresolved questions around the definition and the mechanism of action of EPCs. Diverse culturing methods and detection of various combinations of different surface antigens were used to enrich and identify EPCs. These attempts were particularly challenged by the close relationship and overlapping markers of the endothelial and hematopoietic lineages. This article will critically review the most commonly used protocols to define EPCs by culture assays or by fluorescence-activated cell sorter in the context of their therapeutic or diagnostic use. We also delineate new research avenues to move forward our knowledge on EPC biology.
Ornament and Symbolism in Early Medical Books
Authors: Fisher H. Nesmith
Journal: JAMA (1970)

A century before the discovery of printing with movable type the illuminated manuscripts of Europe reached a peak of beauty. To some critics, the rich coloring, and design and craftsmanship throughout, have not been exceeded since. It was logical that the printers of 1450 would turn to these hand-written and hand-decorated books for their models, and attempt to reproduce their main features by new mechanical means. The first interchangeable letters were accordingly cut and cast in metal to resemble script. In general, the printed text began with a title high on the second leaf, each chapter began at the top of a new page, and the whole ended with a colophon or short paragraph which included the date and the printer's name. The spaces which remained at chapter ends were left empty. In manuscripts, the illuminator added a picture and ornament to a scribe's first page which were far more
Tumour necrosis factor alpha and the cardiovascular system: its role in cardiac allograft rejection and heart disease
Authors: M Azzawi
Journal: Cardiovascular Research (1999)

Time for primary review 32 days. 

Tumour necrosis factor alpha (TNFα) is a pleiotropic cytokine that has many proinflammatory actions with negative inotropic effects. It has been implicated in the pathogenesis of many non-infectious disorders, from rheumatoid disease [1], to multiple sclerosis [2]. This cytokine also affects the heart [3] where it is produced by immune cells and the myocardium in some diseases. Raised serum TNFα is seen in patients with cardiomyopathy, myocardial infarction, and chronic heart failure [4], thus implicating TNFα in disease pathogenesis. Raised serum levels of this cytokine have also been identified in transplant patients following episodes of acute cellular rejection. There is a correlation between TNFα expression and rejection grade [5] suggesting that the cytokine is a candidate marker of rejection.

In this review, we consider the basic biology of TNFα in relation to certain cardiac diseases. There are interrelationships between some of the conditions described, but these have been arbitrarily divided into three main groups: allograft rejection, coronary artery disease, and heart failure.

Tumor necrosis factor alpha, cachectin (TNFα), was originally identified for its potent toxicity against tumour cells, hence its name [6]. Today, TNFα is recognised as a pleiotropic cytokine functioning within a complex and tightly regulated cytokine network. It activates multiple transduction pathways, inducing or suppressing a wide variety of genes, including those encoding the production of cytokines, adhesion molecules, and inducible nitric oxide synthase (iNOS). TNFα has many proinflammatory actions: orchestrating the inflammatory response through activation of proinflammatory cytokine genes, such as IL-1 and IL-6, as well as its own production [7]. This section will summarise our current understanding of the biology and function of TNFα with particular emphasis on the heart, and review recent work on the regulation of its production.

### 2.1 TNFα molecule

The TNFα molecule (a 157 … 

* Corresponding author. Tel.: +44-161-282-1261; fax: +44-161-718-7167
Urethral Syndrome: A Study in Psychosomatic Urology
Authors: Franco Baldoni, Bruno Baldaro, Mauro Ercolani, Emilio Emili, Giancarlo Trombini
Journal: Psychotherapy and Psychosomatics (1989)

The authors studied a sampling of 50 female patients diagnosed with urethral syndrome (urinary symptoms and pain without infection or organic lesion) on purpose to explore some psychological aspects. The evaluation procedure began with a complete urodynamic examination followed by a clinical interview. After this all patients were given three questionnaires: Symptom Questionnaire, Illness Behaviour Questionnaire and a Biographic Questionnaire prepared specifically for this study. Statistical analysis of the data showed higher levels of hostility, irritability, anxiety, dysphoria and depression in the group of patients than in the control group. There was also a marked tendency to suffer from psychophysiological symptoms.
The Elderly Neighbor
Authors: Richard Cooper
Journal: JAMA (1984)

We bought a new house four years ago in an older Chicago neighborhood. After a couple of months, our children, all of whom are under 7 years, made the acquaintance of an elderly gentleman three doors down. At age 88, the fellow was very spry, and outgoing and friendly with the children. A widower for many years who had no close relatives, he cared for himself, drove a car, and managed his own financial affairs. Last year he had a bad fall in one of the early snows. As it turned out, this was secondary to diplopia accompanying the onset of myasthenia gravis. He experienced a difficult acute phase that required a long hospitalization, yet was subsequently stabilized on medication and he remained totally independent.  A few months later he fell in his basement. He got a bad cut on his head and hurt his hand as well, but was
Link-based learning theory creates more problems than it solves
Authors: Chris J. Mitchell, Jan De Houwer, Peter F. Lovibond
Journal: Behavioral and Brain Sciences (2009)

Abstract In this response, we provide further clarification of the propositional approach to human associative learning. We explain why the empirical evidence favors the propositional approach over a dual-system approach and how the propositional approach is compatible with evolution and neuroscience. Finally, we point out aspects of the propositional approach that need further development and challenge proponents of dual-system models to specify the systems more clearly so that these models can be tested.
Changes in mitochondrial adenine nucleotides and in permeability transition in two models of rat liver regeneration
Authors: Rolando Hernández-Muñoz, Lourdes Sánchez-Sevilla, Alejandro Martínez-Gómez, Myrna A.R. Dent
Journal: Hepatology (2003)

Although enhanced phosphorylative activity can be a requisite for later DNA synthesis during liver regeneration (LR), mitochondrial generation of reactive oxygen species could lead to altered mitochondrial membrane permeability during the prereplicative phase of LR. Therefore, the role of mitochondrial permeability transition (MPT) was evaluated during rat LR, induced by either partial hepatectomy (PH) or after CCl(4) administration. Parameters indicative of mitochondrial function and membrane potentials, those of oxidative stress, and in vivo changes of the intramitochondrial pool of adenine nucleotides were determined. Twelve hours after PH, mitochondrial oxidative and phosphorylative activities and adenosine diphosphate (ADP) content were increased, reaching a maximal peak at 24 hours after surgery (maximal DNA synthesis). Parameters suggestive of oxidant stress were enhanced, but mitochondrial volume and membrane electrical potential remained unaltered. Interestingly, moderate mitochondrial swelling and depolarization were found at later post-PH times (72 hours). In CCl(4)-treated animals, it was found that an active liver cell necrosis delayed mitotic activity and mitochondrial uncoupled respiration. Starting 12 hours after CCl(4) intoxication, a drastic increase of inorganic phosphate occurred within swollen and strongly depolarized mitochondria, suggesting changes in the MPT. Despite expression of messenger RNA (mRNA) for mitochondrial transcription, factor A showed a similar time course in both experimental models. The so-called augmenter liver regeneration was found significantly elevated only in PH rats. In conclusion, onset of MPT could be associated with cell necrosis and inflammation after CCl(4) treatment, whereas this mitochondrial event could constitute a putative effector mechanism, through which growth or inflammatory factors inhibiting cell proliferation could initiate LR termination.
Listen to children when deciding policy, says commissioner
Authors: Zosia Kmietowicz 
Journal: BMJ (2007)

A new five point plan has been launched by England's children's commissioner to improve the lives of the country's 11 million children and young people and to ensure that their views are heard in the development of policies and services that affect them.

The strategy, which itself was developed in partnership with children and young people, identifies six areas where children's rights, health, and happiness can be improved. These are youth justice …
Thymectomy in Myasthenia Gravis
Authors: H. R. Viets
Journal: BMJ (1950)

The study rationale was to assess the performance of qualitative and semi-quantitative scoring methods for <sup>18</sup>F-fluorodeoxyglucose positron emission tomography (FDG-PET) assessment in large-vessel vasculitis (LVV). <b>Methods:</b> Patients with giant cell arteritis (GCA) or Takayasu’s arteritis (TAK) underwent clinical and imaging assessment, blinded to each other, within a prospective observational cohort. FDG-PET-CT scans were interpreted for active vasculitis by central reader assessment. Arterial FDG uptake was scored by qualitative visual assessment using the PET vascular activity score (PETVAS) and by semi-quantitative assessment using standardized uptake values (SUV) and target-to-background ratios (TBR) relative to liver/blood activity. Performance of each scoring method was assessed by intra-rater reliability using the intra-class coefficient (ICC) and area under receiver-operator characteristic curves (AUC), using physician assessment of clinical disease activity and reader interpretation of vascular PET activity as independent reference standards. Wilcoxon signed-rank test was used to analyze change in arterial FDG uptake over time. <b>Results:</b> Ninety-five patients (GCA=52; TAK=43) contributed 212 FDG-PET studies. The ICC for semi-quantitative evaluation [0.99 (range 0.98-1.00)] was greater than the ICC for qualitative evaluation [0.82 (range 0.56-0.93)]. PETVAS and TBR metrics were more strongly associated with reader interpretation of PET activity than SUV metrics. All assessment methods were significantly associated with physician assessment of clinical disease activity, but the semi-quantitative metric TBRLiver¬ achieved the highest AUC (0.66). Significant but weak correlations with C-reactive protein were observed for SUV metrics (r = 0.19, p&lt;0.01) and TBRLiver (r = 0.20, p&lt;0.01) but not for PETVAS. In response to increased treatment in 56 patients, arterial FDG uptake was significantly reduced when measured by semi-quantitative (TBRLiver 1.31 to 1.23, 6.1% ∆, p&lt;0.0001) or qualitative (PETVAS 22 to 18, p&lt;0.0001) methods. Semi-quantitative metrics provided complementary information to qualitative evaluation in cases of severe vascular inflammation. <b>Conclusion:</b> Both qualitative and semi-quantitative methods to measure arterial FDG uptake are useful to assess and monitor vascular inflammation in LVV. Compared to qualitative metrics, semi-quantitative methods have superior reliability and better discriminate treatment response in cases of severe inflammation.
Renal adaptation to potassium in the adrenalectomized rabbit. Role of distal tubular sodium-potassium adenosine triphosphatase.
Authors: L C Garg, N Narang
Journal: Journal of Clinical Investigation (1985)

Potassium secretion and sodium-potassium adenosine triphosphatase (Na-K-ATPase) activity in the distal nephron segments are known to be influenced by the dietary intake of K+. This has been attributed to a change in the plasma aldosterone level, which also influences K+ secretion and Na-K-ATPase activity in the distal nephron. To investigate whether or not dietary K+ can modulate Na-K-ATPase activity in the distal nephron independently of aldosterone, we determined Na-K-ATPase activity in four distinct nephron segments of adrenalectomized (adx) rabbits given four specific diets for 1 wk before experimentation. Na-K-ATPase activity was determined by a fluorometric microassay in which ATP hydrolysis is coupled to NADH oxidation. The nephron segments examined were the distal convoluted tubule (DCT), the connecting tubule (CNT), the cortical collecting duct (CCD), and the outer medullary collecting duct (MCD). All diets were similar in composition except for their K+ contents, which were 100, 300, 500, and 700 meq/kg in groups 1-4, respectively. In these adx animals, Na-K-ATPase activity increased greater than 200% in the CCD as the dietary intake of K+ increased. There was a linear relationship between K+ excretion and the enzyme activity in this segment. There was a 50% increase in Na-K-ATPase activity in the CNT as the dietary intake of K+ increased in adx animals. However, there were no significant differences in Na-K-ATPase activities in the DCT and MCD among the four treatment groups. It is concluded that dietary K+ intake can influence Na-K-ATPase activity in the CCD and CNT independently of plasma aldosterone levels.