tbuckley/cabot-search huggingface dataset:
Proposal to allow drug companies to give information to public sparks outcry
Authors: R. Watson
Journal: BMJ (2008)

Consumers’ groups and medical organisations have reacted angrily to moves by the European Commission to allow drug companies to provide information on prescription only drugs to the public.

The proposal to relax the existing restrictions is in a package of measures designed to make the drug industry more competitive, encourage research, clamp down on counterfeit products, and guarantee patients across Europe the same degree of information on drugs.

Presenting the measures, Gunter Verheugen, the industry commissioner, said, “European citizens should benefit from safe, innovative, and accessible medicines. They should be best informed about available medicines and treatments, since their …
Treatment of atopic eczema with evening primrose oil
Authors: M. W. Greaves, Margaret F. Corbett
Journal: British Journal of Dermatology (1988)

Journal Article Treatment of atopic eczema with evening primrose oil Get access M. W. Greaves, M. W. Greaves St Johns Hospital for Diseases of the Skin, Lisle Street, Leicester Square, London WC2H 7BJ, U.K. Search for other works by this author on: Oxford Academic Google Scholar Margaret F. Corbett Margaret F. Corbett St Johns Hospital for Diseases of the Skin, Lisle Street, Leicester Square, London WC2H 7BJ, U.K. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 118, Issue 3, 1 March 1988, Pages 449–450, https://doi.org/10.1111/j.1365-2133.1988.tb02445.x Published: 01 March 1988
Geriatric Care Management for Low-Income Seniors
Authors: Steven R. Counsell, Christopher M. Callahan, Daniel O. Clark, Wanzhu Tu, Amna B. Buttar, Timothy E. Stump, Gretchen D. Ricketts
Journal: JAMA (2007)

Low-income seniors frequently have multiple chronic medical conditions for which they often fail to receive the recommended standard of care.To test the effectiveness of a geriatric care management model on improving the quality of care for low-income seniors in primary care.Controlled clinical trial of 951 adults 65 years or older with an annual income less than 200% of the federal poverty level, whose primary care physicians were randomized from January 2002 through August 2004 to participate in the intervention (474 patients) or usual care (477 patients) in community-based health centers.Patients received 2 years of home-based care management by a nurse practitioner and social worker who collaborated with the primary care physician and a geriatrics interdisciplinary team and were guided by 12 care protocols for common geriatric conditions.The Medical Outcomes 36-Item Short-Form (SF-36) scales and summary measures; instrumental and basic activities of daily living (ADLs); and emergency department (ED) visits not resulting in hospitalization and hospitalizations.Intention-to-treat analysis revealed significant improvements for intervention patients compared with usual care at 24 months in 4 of 8 SF-36 scales: general health (0.2 vs -2.3, P = .045), vitality (2.6 vs -2.6, P < .001), social functioning (3.0 vs -2.3, P = .008), and mental health (3.6 vs -0.3, P = .001); and in the Mental Component Summary (2.1 vs -0.3, P < .001). No group differences were found for ADLs or death. The cumulative 2-year ED visit rate per 1000 was lower in the intervention group (1445 [n = 474] vs 1748 [n = 477], P = .03) but hospital admission rates per 1000 were not significantly different between groups (700 [n = 474] vs 740 [n = 477], P = .66). In a predefined group at high risk of hospitalization (comprising 112 intervention and 114 usual-care patients), ED visit and hospital admission rates were lower for intervention patients in the second year (848 [n = 106] vs 1314 [n = 105]; P = .03 and 396 [n = 106] vs 705 [n = 105]; P = .03, respectively).Integrated and home-based geriatric care management resulted in improved quality of care and reduced acute care utilization among a high-risk group. Improvements in health-related quality of life were mixed and physical function outcomes did not differ between groups. Future studies are needed to determine whether more specific targeting will improve the program's effectiveness and whether reductions in acute care utilization will offset program costs.clinicaltrials.gov Identifier: NCT00182962.
Serving up food safety: who wants a piece of the pie?
Authors: C W Schmidt
Journal: Environmental Health Perspectives (2001)

A total of 12 federal agencies, plus their state counterparts, contribute to the regulatory snarl that governs the safety of the American food supply. With so much federal oversight, one might expect U.S. foods to be virtually risk-free. But this is hardly the case; contaminated food is responsible for 75 million illnesses, 325,000 hospitalizations, and 5,000 deaths in the United States each year. Recent reports from the General Accounting Office and the National Research Council claim that creation of a single agency with centralized authority is the best solution to U.S. food safety problems. Some experts agree that regulatory gaps in food safety highlight the need for centralized leadership, and that more money is necessary to fund the number of inspectors needed to adequately inspect the food supply before it reaches consumers. The single-agency concept has garnered congressional, industry, and scientific support, but the idea isn't without its skeptics, who believe that consolidating food safety under a single agency eliminates checks and balances offered by the current system and, more importantly, runs the risk of politicizing the agency.
Violent Cardiology: Rhythm Reversion by Patient Inversion
Authors: Lawrence A. Gould
Journal: JAMA (1989)

ABSTRACT To the Editor.— A 43-year-old woman had a ventricular-inhibited permanent pacemaker implanted on February 10, 1988, for sick sinus syndrome. The pacemaker initially functioned properly. However, 6 weeks after the implantation, the pacemaker was not capturing the ventricle. A chest roentgenogram revealed that the lead had displaced to the level of the tricuspid valve. The patient was advised to enter the hospital for repositioning of the electrode.The patient was not anxious to have another operation. Further, the patient's husband felt that there must be an alternative solution. The following week, the husband stated that he had adjusted the pacemaker electrode and the unit was now functioning perfectly. An electrocardiogram revealed that there was consistent atrial pacing. A repeated chest roentgenogram showed the electrode in the coronary sinus.The patient's husband had placed the patient upside down so that her head was touching the floor. He then grasped her feet
Contraception in Copenhagen
Authors: J. O. Drife
Journal: BMJ (2013)

The first thing you notice in Copenhagen is that people are slim. Then you notice the bikes, parked in vast numbers both in the city and beside rural railway stations throughout Denmark. How delightful it must be to live in a flat country where cyclists have the right of way.

The Danish empire once stretched from Greenland to southern England. A thousand years later the Danes seem relaxed about having let it go, but I think it’s a shame that these amiable people lost the battle of Hastings. I blame their snobbish cousins …
Pyoderma gangrenosum treated with cyclosporin A
Authors: R.K. CURLEY, A.W. MACFARLANE, C.F.H. VICKERS
Journal: British Journal of Dermatology (1985)

A 49‐year‐old woman with a 14‐year history of pyoderma gangrenosum unresponsive to a variety of systemic and topical treatments was given oral cyclosporin A (CyA), a potent immunosuppressive agent widely used in organ transplantation for the prophylaxis of acute graft‐versus‐host disease. Improvement and subsequent healing of the lesions was evident within 3 weeks of starting treatment and has continued for the duration of treatment (12 months).
P737The pro-inflammatory environment of the atherosclerotic plaque influences the biology of vascular smooth muscle cells in by regulating calcium-calmodulin dependent Kinase II
Authors: A S Maione, M R Rusciano, D Sorriento, M Soprano, L Maresca, P Campiglia, P Formisano, V D'esposito, G Iaccarino, M Illario
Journal: Cardiovascular Research (2014)

Aims: Arteriosclerosis is a degenerative process of the arterial wall implicating activation of macrophages and proliferation of vascular smooth muscle cells. Calcium-Calmodulin dependent Kinase II (CaMKII) regulates vascular smooth muscle cells (VSMCs) proliferation, as well as macrophage activities, such as diapedesis, infiltration and release of extracellular matrix enzymes. We investigated the role of CaMKII in the setup of arteriosclerosis. Methods and results: Clinically defined stable and unstable plaques obtained from patients undergoing carotid endoarteriectomy were processed for evaluation of CaMKs protein expression, activity and localization. The levels of expression and activation of CaMKII were significantly higher, and localized mostly in macrophages. The larger content of CaMKII was found in macrophages that were more abundant in unstable rather than stable plaques. Stable and unstable plaques also differed for the CaMKs isoforms, with a dominance of CaMKIId in unstable plaques. To test the biological effect of activated macrophages, VSMCs were exposed to the medium conditioned (CM) by macrophages extracted from carotid plaques. CM induced attenuation of CaMKs expression and activity in VSMCs, leading to the reduction of VSMCs proliferation. A possible role of proinflammatory cytokines interleukin-6 (IL6) and interleukin-8 (IL8) in CaMKII modulation was demonstrated. In a related model, CaMKII inhibition in macrophages prevents the inhibition VSMCs proliferation. Conclusion: Our results indicate a pivotal role of CaMKs in arteriosclerosis by regulating macrophages on VSMCs activity. CaMKII could represent a possible target for therapeutic strategies based on macrophages specific inhibition for the stabilization of atherosclerotic lesions.
Dopaminergic Abnormalities in Select Thalamic Nuclei in Schizophrenia: Involvement of the Intracellular Signal Integrating Proteins Calcyon and Spinophilin
Authors: Sarah M. Clinton, Hisham M. Ibrahim, Kirk A. Frey, Kenneth L. Davis, Vahram Haroutunian, James H. Meador-Woodruff
Journal: American Journal of Psychiatry (2005)

OBJECTIVE: While both thalamic abnormalities and dopaminergic dysregulation have been separately implicated in the pathophysiology of schizophrenia, little is known about the possible dysfunction of molecules associated with dopaminergic neurotransmission in the thalamus in this illness. In this study, the authors studied this question by measuring in postmortem brain the expression of molecules associated with dopaminergic neurotransmission. METHOD: Using in situ hybridization and receptor autoradiography, the authors determined in schizophrenia and comparison subjects 1) thalamic expression of the transcripts encoding the five dopamine receptors; 2) binding to the dopamine D1, D2, and D3 receptors; 3) monoaminergic innervation as assessed by binding to the vesicular monoamine transporter; and 4) transcripts encoding three dopamine receptor-associated intracellular proteins (calcyon, spinophilin, and DARPP-32) that mediate integration of dopaminergic signaling with other neurotransmitter systems. RESULTS: Both calcyon and spinophilin transcripts were significantly elevated in schizophrenia subjects. Monoaminergic innervation, as well as dopamine receptor transcripts and binding sites, were unaffected in this illness. CONCLUSIONS: These data indicate that there are dopaminergic abnormalities in the thalamus in schizophrenia but that they are at the level of intracellular integration of dopamine signaling with other neurotransmitter systems, likely including glutamate, in thalamic neurons.
Typical and Atypical Bronchopulmonary Carcinoid Tumors on FDG PET/CT Imaging
Authors: Myriam Wartski, Jean-Louis Alberini, François Leroy-Ladurie, Vincent De Montpreville, Charles Nguyen, Carine Corone, Philippe Dartevelle, Alain Paul Pecking
Journal: Clinical Nuclear Medicine (2004)

The authors report 2 cases of bronchial carcinoid tumor (BCT). One had a typical and the other had an atypical histologic pattern. BCTs represent 1 to 2% of all lung cancers and are usually located in the hilar or perihilar areas. They can be associated with infectious processes. Typical carcinoids are considered as having low-grade malignancy although atypical carcinoids are of intermediate grade. The authors showed that even a typical carcinoid can show intense F-18 FDG uptake. The number of reports of BCT in PET imaging using FDG in BCT is very limited, but several cases of FDG-negative BCT have been described.
A 69-year-old smoker with mediastinal and hilar lymphadenopathy
Authors: Y. H. Khor, D. P. Steinfort, M. R. Buchanan, D. Gunawardana, P. Antippa, L. B. Irving
Journal: Thorax (2010)

A 69-year-old male heavy smoker was referred to our service with 6 months minimal productive cough and 2 weeks pleuritic central chest pain, with no weight loss or constitutional symptoms. There was no relevant previous medical history. Clinical examination demonstrated no abnormalities. CT …
<i>Clostridium difficile</i>— Beyond Antibiotics
Authors: Lorraine Kyne
Journal: New England Journal of Medicine (2010)

In this decade, the prevention and control of Clostridium difficile infection in health care settings has become a global public health challenge. Infection rates have increased dramatically, and several large outbreaks associated with toxinotype III BI/NAP1/027 strains have been described.1 One of the major incongruities in the management of C. difficile infection is that antibiotics are the mainstay of treatment for this antibiotic-associated condition. Standard therapy with oral metronidazole or vancomycin has not changed since the 1970s. Although antibiotics are effective at inhibiting C. difficile and treating symptoms, the use of such drugs does not allow for the reestablishment of . . .
Prostaglandin Synthesis Inhibitors in Prophylaxis of Coffee Intolerance
Authors: Julian Lieb
Journal: JAMA (1980)

<h3>To the Editor.—</h3> Prostaglandin synthesis inhibitors such as ibuprofen, aspirin, and indomethacin can be effective in the prophylaxis of acute gastrointestinal symptoms following the ingestion of certain foods, ie, pork chops, mussels, sweet corn, eggs, bananas, shellfish, wine, beer, citrus fruit,<sup>1</sup>and dairy products.<sup>1,2</sup> <h3>Report of a Case.—</h3> A 32-year-old woman had a ten-year history of intolerance to coffee. Even small quantities of black coffee were capable of inducing abdominal cramps and diarrhea. She readily agreed to a coffee challenge following aspirin prophylaxis. On three successive mornings, she took 975 mg of aspirin followed, one half hour later, by two large mugs of sugarless, black coffee and was not troubled by her customary gastrointestinal symptoms. <h3>Comment.—</h3> This finding suggests that coffee may cause an excessive release of prostaglandins, possibly by stimulating prostaglandin synthetase. The physiological effects of coffee, including insomnia, might therefore be mediated through an excessive release
Surgery for the Aged
Authors: Reuben Tizes
Journal: JAMA (1973)

<h3>To the Editor.—</h3> Daring surgical feats are performed daily. Unfortunately, some surgeons and physicians are concerned primarily with technical elements and do not give sufficient consideration to the human factors involved. Two index histories illustrate the point. <h3>Report of Cases.—Case 1.—</h3> An 87-year-old man with occasional minimal dysphagia, after two myocardial infarctions and suffering with pulmonary emphysema, was diagnosed as having carcinoma in the hiatus hernia of the stomach. A surgeon advised extensive curative surgery after a gastroenterologist gave medical clearance. The patient and his family had been told that the risk involved was probably no more than 10%. In order to obtain the patient's consent, the physicians painted a horrible pain-filled death as the alternative. The patient underwent a total gastrectomy through an abdominal-thoracic approach. Multiple complications included tracheoesophageal fistula, recurrent infections, and decubiti ulcers developed; he underwent many additional procedures, including tracheostomy and hyperalimentation. Most of
Isolated Central Nervous System Histoplasmosis Presenting With Ischemic Pontine Stroke and Meningitis in an Immune-Competent Patient
Authors: Frederic N. Nguyen, Jitesh K. Kar, Asma Zakaria, Mya C. Schiess
Journal: JAMA Neurology (2013)

Histoplasmosis, a systemic mycosis caused by the fungus Histoplasma capsulatum, primarily affects immune-suppressed patients and commonly involves the lung and rarely the central nervous system (CNS). Herein, we report a case of isolated CNS histoplasmosis presenting with pontine stroke and meningitis.A 35-year-old, white, immune-competent man was transferred from an outside facility with worsening dysarthria and confusion after having presented 4 weeks prior with dysarthria, gait ataxia, and bilateral upper extremity weakness. Brain magnetic resonance imaging revealed bilateral pontine strokes, and the working diagnosis was ischemic infarctions, presumed secondary to small vessel vasculitis. Cerebral spinal fluid (CSF) examination showed marked abnormalities including an elevated protein level (320 mg/dL), low glucose level (2 mg/dL), and high white blood cell count (330/mm(3); 28% lymphocytes, 56% neutrophils, and 16% monocytes) suggestive of a bacterial, fungal, or tuberculosis meningitis. Empirical antibiotics and a second trial of intravenous steroids were started before infectious etiologies of meningitis were ultimately ruled out. Repeated magnetic resonance imaging of the brain revealed no evidence of new ischemic lesions. On hospital day 11, results of his CSF Histoplasma antigen and urine antigen tests were positive. His CSF culture also was positive for H capsulatum. The patient was treated initially with liposomal amphotericin B, 430 mg daily, but changed to voriconazole, 300 mg twice daily, secondary to renal insufficiency and eventually continued treatment with itraconazole cyclodextrin, 100 mg twice daily. Computed tomographic imaging revealed obstructive hydrocephalus, and a ventriculoperitoneal shunt was placed that successfully decompressed the ventricles. At 1 year, the patient demonstrated good clinical improvement and results of follow-up CSF cultures were negative.While pulmonary involvement of histoplasmosis in immune-suppressed patients is common, systemic presentation of this fungal infection in immune-competent patients is rare and self-limiting. Isolated CNS histoplasmosis is exceedingly rare. Clinicians should consider CNS histoplasmosis in the differential diagnosis in atypical stroke cases, particularly those presenting with meningitis.
Decreased Tumor Surveillance after Adoptive T-Cell Therapy
Authors: Matthias Matter, Viktor Pavelic, Daniel D. Pinschewer, Sabine Mumprecht, Bruno Eschli, Tsanan Giroglou, Dorothee von Laer, Adrian F. Ochsenbein
Journal: Cancer Research (2007)

Abstract The effect of cancer immunotherapy on the endogenous immune response against tumors is largely unknown. Therefore, we studied immune responses against murine tumors expressing the glycoprotein (GP) and/or nucleoprotein of lymphocytic choriomeningitis virus (LCMV) with or without adoptive T-cell therapy. In nontreated animals, CTLs specific for different epitopes as well as LCMV-GP–specific antibodies contributed to tumor surveillance. Adoptive immunotherapy with monoclonal CTLs specific for LCMV-gp33 impaired the endogenous tumor-specific antibody and CTL response by targeting antigen cross-presenting cells. As a consequence and in contrast to expectations, immunotherapy enhanced tumor growth. Thus, for certain immunogenic tumors, a reduction of tumor-specific B- and T-cell responses and enhanced tumor growth may be an unwanted consequence of adoptive immunotherapy. [Cancer Res 2007;67(15):7467–76]
A Rare Population of CD24+ITGB4+Notchhi Cells Drives Tumor Propagation in NSCLC and Requires Notch3 for Self-Renewal
Authors: Yanyan Zheng, Cecile C. de la Cruz, Leanne C. Sayles, Chris Alleyne-Chin, Dedeepya Vaka, Tim D. Knaak, Marty Bigos, Yue Xu, Chuong D. Hoang, Joseph B. Shrager, Hans Joerg Fehling, Dorothy French, William Forrest, Zhaoshi Jiang, Richard A.D. Carano, Kai H. Barck, Erica L. Jackson, E. Alejandro Sweet-Cordero
Journal: Cancer Cell (2013)
No closer to understanding racial bias, admits GMC
Authors: S. Hargreaves
Journal: BMJ (2003)

A debate at the General Medical Council last week into a report of racial bias in the council's treatment of complaints against doctors whoqualified outside the United Kingdom resulted in a unanimous agreement by the council to tackle the issues with utmost urgency.

“I am horrified that this investigation was first started in 1996,” said Mr Roland Doven, a council member. “And that the situation shown in this latest work indicates that the situation is getting worse.” He called for the reputation of the GMC to be defended.

The report, which based its conclusions on a statistical review ofcases over the past five years, was the third of its kind to be commissioned by the GMC from the Policy Studies Institute, London, since 1996 (22 February, p 411).

Again, the report …
Identification of FGFR4 as a Potential Therapeutic Target for Advanced-Stage, High-Grade Serous Ovarian Cancer
Authors: Tarrik M. Zaid, Tsz-Lun Yeung, Melissa S. Thompson, Cecilia S. Leung, Tom Harding, Ngai-Na Co, Rosie S. Schmandt, Suet-Ying Kwan, Cristian Rodriguez-Aguay, Gabriel Lopez-Berestein, Anil K. Sood, Kwong-Kwok Wong, Michael J. Birrer, Samuel C. Mok
Journal: Clinical Cancer Research (2013)

Abstract Purpose: To evaluate the prognostic value of fibroblast growth factor receptor 4 (FGFR4) protein expression in patients with advanced-stage, high-grade serous ovarian cancer, delineate the functional role of FGFR4 in ovarian cancer progression, and evaluate the feasibility of targeting FGFR4 in serous ovarian cancer treatment. Experimental Design: Immunolocalization of FGFR4 was conducted on 183 ovarian tumor samples. The collected FGFR4 expression data were correlated with overall survival using Kaplan–Meier and Cox regression analyses. The effects of FGFR4 silencing on ovarian cancer cell growth, survival, invasiveness, apoptosis, and FGF1-mediated signaling pathway activation were evaluated by transfecting cells with FGFR4-specific siRNAs. An orthotopic mouse model was used to evaluate the effect of injection of FGFR4-specific siRNAs and FGFR4 trap protein encapsulated in nanoliposomes on ovarian tumor growth in vivo. Results: Overexpression of FGFR4 protein was significantly associated with decreased overall survival durations. FGFR4 silencing significantly decreased the proliferation, survival, and invasiveness and increased apoptosis of ovarian cancer cells. Also, downregulation of FGFR4 significantly abrogated the mitogen-activated protein kinase (MAPK), nuclear factor-κB (NF-κB), and WNT signaling pathways, which are activated by FGF1. Targeting FGFR4 with the FGFR4-specific siRNAs and FGFR4 trap protein significantly decreased ovarian tumor growth in vivo. Conclusions: FGFR4 is a prognostic marker for advanced-stage, high-grade serous ovarian carcinoma. Silencing FGFR4 and inhibiting ligand-receptor binding significantly decrease ovarian tumor growth both in vitro and in vivo, suggesting that targeting ovarian cancer cells with high levels of FGFR4 protein expression is a new therapeutic modality for this disease and will improve survival of it. Clin Cancer Res; 19(4); 809–20. ©2012 AACR.
Predischarge myocardial contrast echocardiography predicts long-term clinical outcomes and left ventricular remodeling in patients with myocardial infarction
Authors: Yuya Nishida, Hiroshi Ito, Katsuomi Iwakura, Kouji Tanaka, Akio Yano, Noriyuki Hanibuchi, Atsunori Okamura, Shigeo Kawano, Kenshi Fujii
Journal: Journal of the American College of Cardiology (2003)