tbuckley/cabot-search huggingface dataset:
Physician Responsibility for Drug Prescription
Authors: Don Harper Mills
Journal: JAMA (1965)

The tranylcypromine (Parnate) sulfate incident of 1964 has helped to crystallize several divisions of responsibility for drug safety among manufacturers, the Food and Drug Administration, and practicing physicians. Whereas recent literature and news reports have been devoted primarily to duties of and relationships between drug firms and the government, the purpose of this communication is to identify some of the more significant impacts these duties and relationships will have on the medical profession. The FDA now possesses broad powers to decide new drug marketability by evaluating both safety and efficacy. New drug applications can be rejected not only in the absence of sufficient evidence to establish safety, but also if substantial evidence is lacking to support represented drug effects under conditions of use recommended in proposed labelings.<sup>1</sup>This permits the FDA to balance risks against benefits to determine whether or not a new drug will be made available for
Bronchography in the assessment of patients with lung collapse for endoscopic laser therapy.
Authors: S. K. Morcos, P. B. Anderson
Journal: Thorax (1991)

Bronchography in the assessment of patients with lung collapse for endo- scopic laser therapy We would like to make the following comments on the bronchographic technique described in the study by Dr PJM George and colleagues (July 1990;45:503-8).Firstly, the iodine content and the osmolarity of the contrast medium Omnipaque used in the study were not mentioned, nor was it clear
Letter: Exfoliative dermatitis during treatment with pheneturide.
Authors: J W Rassam, G Anderson
Journal: BMJ (1975)

2 19 F. 5 Genital herpes (persisting for H.S.V. isolated from genital lesions.Fourfold 16 days) C.F. antibody rise to H.S.V. 66 34 62 3 5 M. 20 Erythema multiforme Primary H.S.V. infection.Sibling with herpes labialis.72 38 100 4 68 F. N.K. Atypical purpuric varicelliform Carcinoma of cervix.Treated with rash cyclophosphamide 2 months previously; on steroids.>4-fold C.F. antibody
The Usefulness of Tc-99m Pertechnetate Imaging With Vitamin C Stimulation in Warthin's Tumor
Authors: KOSHI IKEDA, SANG KIL HA-KAWA, AKIHIKO NAKAMURA, TOSHIO YAMASHITA, YOSHIMASA TANAKA
Journal: Clinical Nuclear Medicine (1998)

A 67-year-old man was evaluated for swelling of the left parotid region. Diffuse accumulation of Tc-99m pertechnetate in the left parotid gland was seen on initial salivary gland imaging. However, focal high uptake was clearly delineated after 200 mg vitamin C (ascorbic acid) stimulation subsequent to the prestimulated image. This patient was pathologically confirmed to have Warthin's tumor (papillary cystadenoma lymphomatosum). It has been reported that elevated uptake of Tc-99m pertechnetate in the Warthin's tumor is seen because this tumor does not communicate with the ductal system. Therefore, Vitamin C stimulated imaging may provide a useful method for differentiating Warthin's tumor from other parotid tumors and parotitis.
Standard Risk Factors for Lung Cancer, Cardiac Infarct, Apoplexy, Diabetes mellitus and, Their Changes in Psychosocial Context
Authors: Ronald Grossarth-Maticek, Miroslav Jankovic, Hermann Vetter
Journal: Psychotherapy and Psychosomatics (1982)

In a prospective study, 1,353 persons were administered a psychosocial questionnaire. At the same time, smoking, weight, and blood pressure were measured. 3 years later these variables were measured again. Another 7 years later the whole group was checked for clinical diagnoses that had occurred in the meantime. The main results were: (1) the 3-year changes of the somatic risk factors were almost as good predictors as their values themselves; (2) psychosocial variables were considerably better predictors of the diseases, and they also predicted the changes of the somatic risk factors about as well as the diseases.
Incontinence management is inadequate, UK audit shows
Authors: Susan Mayor
Journal: BMJ (2005)

The first national audit of incontinence care for older people in the United Kingdom has found widespread failure to diagnose and manage continence problems in results reported this week.

The audit, funded by the Healthcare Commission and undertaken by the Royal College of Physician's Clinical Effectiveness and Evaluation Unit, examined the quality of care for 9197 older people (65 years and above) with urinary and faecal incontinence in primary and secondary care and 749 residents in care homes in England, Wales, and Northern Ireland. It compared their continence care to standards set in the National Service Framework for Older People and the Department of Health guidance Good Practice …
Human Immunodeficiency Virus-Associated Skin Lesions
Authors: Emily F. Omura
Journal: JAMA (1989)

To the Editor.—  We write concerning the report by Knobler et al1of four patients with unique vascular skin lesions associated with human immunodeficiency virus antibodies or acquired immunodeficiency syndrome (AIDS). In 1968 we saw a 61-year-old white man in New York who had received chemotherapy for several months for a malignant lymphoma. Shortly before his death, he developed numerous bright red tumors over the skin of all body areas. These began as small lesions resembling cherry angiomas, but rapidly enlarged to centimeter-size, sharply demarcated, easily eroded tumors (Figure); new ones appeared daily. Biopsies of several lesions were done and all appeared to be typical of pyogenic granulomas, with an epidermal collarette and thin-walled vessels in an edematous stroma, as in Figs 2 and 3 of the recentJAMAreport. Our patient died without any spontaneous resolution of the lesions.  At that time, which was before the first description
Interdisciplinary team approach to general practice in Canada
Authors: Lee Mantini
Journal: BMJ (2008)

It is not easy to change from working autonomously to working as an interdisciplinary team. GPs’ way of practising now requires new ways of thinking, communicating, and responding to patients’ needs. Howie et al are concerned about loss of tradition and a “new culture” of care.1 They fear that practice change could be harmful and want …
Coping With Juvenile Diabetes
Authors: Stephen LaFranchi
Journal: JAMA (1985)

Resentment, shame, guilt, helplessness, excessive dependency, perfectionism, rebellion—these are reactions commonly experienced by juvenile diabetics and their parents. While the last decade has seen dramatic advances in unraveling the etiology of type I or insulin-dependent diabetes mellitus as well as newer tools for monitoring and treating it, the authors point out that understanding and managing the psychosocial complications of juvenile diabetes have lagged behind these technical advances. This book, focusing on the psychosocial aspects of coping with juvenile diabetes, is aimed at all health care providers, including physicians, nurses, dieticians, psychologists, and social workers. The authors also emphasize that, while professional care givers are important, families provide 99% of care, and so the book is also written for older patients, parents, teachers, and camp and youth leaders. A portion of the book, primarily a section on the "Epidemiology of Juvenile Diabetes," summarizes recent medical advances, including information on the incidence
ATORVASTATIN BUT NOT PITAVASTATIN SIGNIFICANTLY INCREASES FASTING PLASMA GLUCOSE IN PATIENTS WITH TYPE 2 DIABETES AND COMBINED DYSLIPIDEMIA
Authors: Vladimir Kryzhanovski, Janusz Gumprecht, Baojin Zhu, Christine Y. Yu, Neil Hounslow, Craig A. Sponseller
Journal: Journal of the American College of Cardiology (2011)
Cancer prevention and control in Eastern Mediterranean region
Authors: Salman Rawaf, Elizabeth Dubois, Oussama M N Khatib, Sherif Omar
Journal: BMJ (2006)

EDITOR—In the Eastern Mediterranean region (population 492 million) cancer is the fourth most common killer with about half a million new cases a year.1 2 Lung, liver, and bladder cancer are commonest among men and breast cancer among women, the highest rates among Jewish women.3

World Health Organization modelling shows that over the next 15 years the increase in cancer incidence in the region will outstrip that in any other region (figure).4



Predicted increase in …
Access to heart surgery for smokers. Higher complication rate not confined to smokers.
Authors: S Bhattacharya
Journal: BMJ (1993)

determine the level of services rather than to ration special services to particular patients, and it would be up to the government to decide the level of services offered to people.Smokers might argue that the revenue generated by their smoking sustains more than just the NHS budget.Secondly, failure rates derived by statistics do not apply to individual people.It is unethical to deny a patient the benefit of any treatment simply to reduce failure rates.Even the authors admit that the success rate of the operation is not spectacular.Probably there is a stronger case to look at the operation itself than at the imperfect people who have it.The third argument is that the damage caused by smoking is self inflicted.If we extend that argu- ment we might be tempted to deny services to people who do not adhere to a "healthy" lifestyle or strict medical advice; we would end up with an NHS treating only saints.
Refractory neuroendocrine tumor—response to liposomal doxorubicin and capecitabine
Authors: Gianluca Masi, Lorenzo Fornaro, Samanta Cupini, Fotios Loupakis, Enrico Vasile, Giacomo G. Baldi, Irene Stasi, Lisa Salvatore, Alfredo Falcone
Journal: Nature Reviews Clinical Oncology (2009)
Intra-articular corticosteroid injections in osteoarthritis: do they work and if so, how?
Authors: P CREAMER
Journal: Annals of the Rheumatic Diseases (1997)

Intra-articular (IA) corticosteroids are recommended in several guidelines for the treatment of patients with knee osteoarthritis (OA).1 2 They are also widely used: a recent survey of rheumatologists in the United States suggesting that over 95% use them at least ‘sometimes’ and 53% ‘frequently’.3 Before considering mechanisms of action of IA corticsteroids we should first consider the evidence that they are effective in OA.

A recent systematic review 4 summarised evidence from five controlled studies of IA corticosteroid in patients with OA knee. Using a quality rating system (originally designed to assess methodology and reporting of NSAID studies), critical analysis showed that none of the studies achieved a score of more than 3 out of a possible 8 for design. It would not be unreasonable, therefore, to conclude that our knowledge of the efficacy of corticosteroid in OA is based on inadequate data. Table 1 summarises the five studies, and two more recent studies. Generally, they show a positive effect but one that is short lived and confounded by a powerful response to placebo (in all cases an equal volume of saline). In one study,5 for example, both placebo and corticosteroid groups showed significant decreases in pain at one week, lasting for the duration of the study (eight weeks). A more recent double blind, placebo controlled, crossover study 6found a significantly greater decrease in pain with corticosteroid than placebo at three weeks. The inability to detect an effect of corticosteroids beyond three weeks may reflect insensitivity of pain as an outcome measure, rather than a lack of corticosteroid effect.

View this table:

Table 1 
Controlled trials of intra-articular corticosteroids in OA (modified with permission from ref 4). All drugs given by intra-articular injection unless otherwise stated



There is, therefore, some discordance between the modest and short lived benefit over placebo seen …
Disparities in the treatment of acute myocardial infarction: Underutilization of evidence-based therapies for patients with non-ST-segment myocardial infarction
Authors: Matthew T. Roe, Lori Parsons, Charles Pollack, John G. Canto, Hal V. Barron, Nathan Every, William Rogers, Eric D. Peterson
Journal: Journal of the American College of Cardiology (2003)
Nadolol can prevent the first gastrointestinal bleeding in cirrhotics: A prospective, randomized study†
Authors: Gaetanô Idéo, Giorgio Bellati, Edoardo Fesce, Daniela Grimoldi
Journal: Hepatology (1988)

Propranolol has been reported to prevent the risk of hemorrhage in patients who survived episodes of variceal rupture. Since the first bleeding episode can be lethal, we did a prospective, randomized trial to see whether β-blockers could also prevent the first hemorrhage. Seventy-nine consecutive cirrhotics with large esophageal varices by endoscopy and who had never bled were randomly allocated to one of the following treatments: placebo; ranitidine (300 mg per day), or nadolol (40 to 120 mg per day)—which is not cardioselective, reduces portal hypertension and does not interfere with renal flow. Since no significant differences between ranitidine and placebo treatment were observed, the two groups were combined as the control group and compared with the nadolol group. After a mean follow-up of 24 months, only 1 of the 30 patients in the nadolol group had bled, while 11 of the 49 patients in the control group had bled. The percentages of patients who had not bled 1 and 2 years after the inclusion-were 100 and 94.4% for the nadolol group and 81.2 and 70.2% for the control group (p &lt; 0.02), respectively. There were no differences in the mortality rate. In conclusion, nadolol significantly protects against the first gastrointestinal bleeding episode in cirrhotics.
POST-MORTEM FINDINGS IN A CASE OF RENAL DWARFISM
Authors: H. A. Cookson
Journal: BMJ (1928)

BtaL DWAI-W R or conditions giving rise -to it, oxygen must be given early, before the pjatient becomes obviously very ill.A girt in my ward for some weeks had small boils in various parts of her body, then she developed acute periostitis of the right radius-all due to a staphylocoecie infection.When admitted her -rine sws very acid and contained sugar-it reduced Fehling's solution with the gieatest ease S.'se was giveln 200 C.Cm. of Oxygen, and ill twenty-four .loursher urinoe contaiued only a tiace of sugar.She had another 00.e.m. of oxygen,.and next day he- urine was free fjromn suimaer.uninjg'thatm no incisions had been made in her.atm-.
Repeal law that puts “FDA on the payroll of the industry,” says former <i>NEJM</i> editor
Authors: Zosia Kmietowicz
Journal: BMJ (2007)

Cyclo-oxygenase-2 (COX 2) inhibitors should be used only as the last choice after other types of non-steroidal anti-inflammatory drugs (NSAIDs) to relieve chronic pain in people with heart disease or at high risk of it, the American Heart Association has recommended.Its statement, published online in Circulation on 26 February (http://circ.ahajournals.orgdoi:10.1161/circulationaha.106.181424), was designed to end any remaining confusion about the cardiovascular risk of these agents.The association has recommended a stepped approach to treatment.The first step should be non-pharmacological approaches, such as physical therapy and weight loss, for patients with known cardiovascular disease or with risk factors for ischaemic heart disease.Drug treatment should start with agents with the lowest reported risk of cardiovascular events, before other agents are prescribed, and at each step account should be taken of the risk-benefit balance.First line drug choices include paracetamol (acetaminophen), aspirin, tramadol, and short term use of other narcotic analgesics.If these fail to achieve adequate pain control, the next option is non-acetylated salicylates, such as naproxen.The association recommended NSAIDs that aren't COX 2 inhibitors if pain is still inadequately controlled, then NSAIDs with some COX 2 activity as the next step, and lastly COX 2 selective NSAIDs.The committee considered the risk of all three of these classes to be sufficiently high to require that patients taking them should be monitored regularly for sustained hypertension (or worsening of prior blood pressure control), oedema, worsening renal function, or gastrointestinal bleeding.See pp 436, 450. Save COX 2 inhibitors till last for cardiac patientsUK NEWS HFEA allows women to donate eggs for research, p445 World NEWS repeal law that puts "FdA on the payroll of the industry", p447 bmj.comUK government defeated on community treatment forms
804-4 A Randomized, Double-blind Trial of Streptokinase Versus Placebo for the Management of Unstable Angina and Non-Q-wave Myocardial Infarction in Patients with Previous Coronary Artery Bypass Surgery
Authors: Faryala Shabani, Pierre Théroux, Pierre de Guise, Bernard Thibault
Journal: Journal of the American College of Cardiology (1995)
ACC Features Clinical Trial Presentations
Authors: Donald F. Phillips
Journal: JAMA (1996)

A HIGHLIGHT of this year's American College of Cardiology meeting, held in Orlando, Fla, was the great number of presentations devoted to the results of more than 20 major clinical trials that are ongoing or recently completed. Most of these studies are referred to by their acronyms—a virtual alphabet soup of clinical discourse. The following are capsule summaries of some of these studies. <h3>New Treatments for Heart Disease</h3> • CHAOS (Cambridge Heart Anti-Oxidant Study) found that a daily regimen of vitamin E (400 to 800 U/d) for two years reduces the risk of myocardial infarction (MI) in patients with angiographically confirmed coronary heart disease (CHD). Of the 2002 participants in the trial, all of whom had CHD, 1035 received vitamin E, and 967 placebo. In the vitamin E group, there were 14 nonfatal MIs, compared to 41 in the placebo group. Of the 36 deaths that occurred in the vitamin
1128. Ad-sig-TAA/ecdCD40L Vector Prime, TAA/CD40L Protein Boost Vaccine Breaks Tolerance for Tumor Assoicated Antigens (TAA) and Suppresses Growth and Metastasis of Epithelial Neoplastic Cells
Authors: Yucheng Tang, Jonathan Maynard, Xiang Ming Fang, Wei Wei Zhang, Albert Deisseroth
Journal: Molecular Therapy (2005)

In order to develop a method to overcome the immune tolerance of cancer, we have designed an adenoviral vector, designated Ad-sig-TAA/ecdCD40L, which carries a transcription unit encoding the extracellular domain (ecd) of the CD40 ligand (CD40L) linked to TAA. The TAA are in turn linked to a secretory signal peptide (sig). This work was based on earlier DNA vaccines reported by Ralph Reisfeld. The binding of the CD40L to the CD40 receptor on DCs activates them. The binding of the TAA/CD40L chimeric protein leads to the internalization of the TAA and its ultimate presentation of Class I MHC on the DCs. In vivo and in vitro analysis showed that the subcutaneous injection of the Ad-sig-TAA/ecdCD40L adenoviral vector led to the development of a CD8+ T cell lymphocyte systemic immune response against TAA for up to a year. One of the TAA tested is MUC-1, which is overexpressed in epithelial cancer cells. We have shown that the Ad-sig-ecdhMUC-1/ecdCD40L vector makes the hMUC-1.Tg mice (which otherwise are killed by the growth of hMUC-1 positive cancer cell lines) resistant to the engraftment and growth of a hMUC-1 positive cancer cell line. In contrast, the cancer cell line which lacks the hMUC-1 antigen engrafts and grows well in these transgenic mice. We have also shown that subcutaneous injections of the hMUC-1/ecdCD40L protein following the vector injection increase the level of the hMUC-1 specific T cells, and generates high levels of serum antibodies against the hMUC-1 antigen. Importantly, these antibodies bind to breast and prostate cancer cancer cells in biopsy specimens from human subjects. The target of these antibodies is a 20 amino acid repeat in the MUC-1 extracellular domain which can completely block the binding of the antibodies to the human breast cancer epithelial cells in biopsy specimens. The schedule of one subcutaneous (sc) injection of the Ad-sig-MUC-1/ecdCD40L vector followed in 7 and 14 days by a sc injection of the MUC-1/ecdCD40L protein is the best schedule among many other combinations and schedules tested. In addition to the MUC-1 self antigen, we have tested the Ad-sig-rH2N/ecdCD40L vector which contains the rat her-2-neu (rH2N) antigen. We tested this vaccine in rH2N.Tg mice which are anergic to the rH2Nantigen. We found that one sc injection of the Ad-sig-rH2N/ecdCD40L vector followed by 2 sc injections of the rH2N/ecdCD40L protein breaks tolerance which exists in the rH2N.Tg mice which are otherwise tolerant of the rH2N TAA. This Ad-sig-TAA/ecdCD40L vector strategy outperforms both corresponding DNA vaccines as well as cellular based cytokine modified tumor cell vaccines. We plan to complete the preclinical testing necessary to bring this new strategy into phase I toxicity testing in the near future.
N-Butyl-2-Cyanoacrylate (Histoacryl) Plus Sclerotherapy Versus Sclerotherapy Alone in the Treatment of Bleeding Esophageal Varices: a Randomized Prospective Study
Authors: C. Feretis, C. Dimopoulos, P. Benakis, B. Kalliakmanis, N. Apostolidis
Journal: Endoscopy (1995)

Background and Study Aims: N-2-cyanoacrylate (Histoacryl) and endoscopic sclerotherapy with polidocanol have both been reported to control variceal bleeding. The aim of the present study was to compare the effectiveness of the combination of Histoacryl and endoscopic sclerotherapy with polidocanol in the management of these patients regarding early rebleeding and hospital mortality rates.
HLA antigens Dw4 and Dw14 in rheumatoid arthritis.
Authors: M Hakala, J Ilonen, A Tiilikainen
Journal: Annals of the Rheumatic Diseases (1987)

renal failure or liver disease), as has been previously suggested; however, it can also be associated with an acute phase reaction, and this should be borne in mind when interpreting the significance of VWF measurements.
ULTRACENTRIFUGATION STUDIES ON THE ELEMENTARY BODIES OF VACCINE VIRUS
Authors: Joseph E. Smadel, Edward G. Pickels, Theodore Shedlovsky
Journal: The Journal of Experimental Medicine (1938)

ULTRACENTRIFUGAL STUDIES OF THE CL DERMAL STRAIN OF VACCINE VIRUS WARRANT THE FOLLOWING CONCLUSIONS: 1. When suspended in increasing concentrations of sucrose, glycerol, or urea solutions, elementary bodies of vaccinia show variations in sedimentation rate which indicate changes in the density or size of the particles. For a given change in the density of the medium these changes are smallest with sucrose and most marked with urea. The normal rate of sedimentation of Paschen bodies may be restored by resuspending them in dilute buffer solution. 2. The density of elementary bodies of vaccinia suspended in dilute buffer solutions is estimated to be 1.16 gm. per cc. Higher values for the density are found if the particles are suspended in solutions containing sucrose, glycerol, or urea. In 53 per cent sucrose, for example, the density is 1.25 gm. per cc. 3. Paschen bodies appear to be quite permeable to water and urea, less so to glycerol, and only slightly, if at all, to sucrose. 4. The increased density of the elementary bodies of vaccinia in sucrose solutions may be accounted for by an osmotic extraction of water from the particles. On this basis the water which can be thus extracted corresponds to at least a third of the original volume of the particles.
THE RECENTLY DESCRIBED PARASITE OF SYPHILIS
Authors: A K. Detwiler
Journal: JAMA (1913)

In a recent article E. H. Ross<sup>1</sup>describes his "jelly method" for the examination of blood, fluid expressed from the lymphnodes and the scrapings from sores or chancres in cases of suspected syphilis. I have repeated the technic and examined scrapings from chancres, the peripheral blood, and fluid squeezed from punctured lymph-nodes of syphilitic patients. I have found the parasites and followed most of the phases as described by him. "The jelly method" is so simple that I write this report with a view to its general adoption as a means of diagnosis of syphilis. The bodies found by this method are regarded as protozoa with definite staining reactions; they undergo visible changes and certain stages of development within the protoplasm of the cells of chancres, lymph-nodes and mononuclear leukocytes. When lymph or scrapings fom chancres cannot be obtained, an examination of the peripheral blood, prepared in the same