tbuckley/cabot-search huggingface dataset:
In vivo mutations in human blood cells: biomarkers for molecular epidemiology.
Authors: R J Albertini, J A Nicklas, J C Fuscoe, T R Skopek, R F Branda, J P O'Neill
Journal: Environmental Health Perspectives (1993)

Mutations arising in vivo in recorder genes of human blood cells provide biomarkers for molecular epidemiology by serving as surrogates for cancer-causing genetic changes. Current markers include mutations of the glycophorin-A (GPA) or hemoglobin (Hb) genes, measured in red blood cells, or mutations of the hypoxanthine-guanine phosphoribosyltransferase (hprt) or HLA genes, measured in T-lymphocytes. Mean mutant frequencies (variant frequencies) for normal young adults are approximately: Hb (4 x 10(-8)) < hprt (5 x 10(-6)) = GPA (10 x 10(-6)) < HLA (30 x 10(-6)). Mutagen-exposed individuals show decided elevations. Molecular mutational spectra are also being defined. For the hprt marker system, about 15% of background mutations are gross structural alterations of the hprt gene (e.g., deletions); the remainder are point mutations (e.g., base substitutions or frameshifts). Ionizing radiations result in dose-related increases in total gene deletions. Large deletions may encompass several megabases as shown by co-deletions of linked markers. Possible hprt spectra for defining radiation and chemical exposures are being sought. In addition to their responsiveness to environmental mutagens/carcinogens, three additional findings suggest that the in vivo recorder mutations are relevant in vivo surrogates for cancer mutations. First, a large fraction of GPA and HLA mutations show exchanges due to homologous recombination, an important mutational event in cancer. Second, hprt mutations arise preferentially in dividing T-cells, which can accumulate additional mutations in the same clone, reminiscent of the multiple hits required in the evolution of malignancy.(ABSTRACT TRUNCATED AT 250 WORDS)
Safety strategy needed in NHS to stop injuries to staff
Authors: Z. Kmietowicz
Journal: BMJ (2003)

Better and more well coordinated safety strategies are needed in the NHS to prevent accidents among staff that currently cost the health service more than £170m ($282m; €242m) a year, says the public spending watchdog, the Public Accounts Committee.

In 20012 more than 135 000 accidents were reported among NHS staff; this figure was described by the chairman of the committee as a “substantial increase” on previous years.

Accidents to NHS staff lead to staff shortages and increased workloads, both …
Integrin-dependent homotypic adhesion of neutrophils. Arachidonic acid activates Raf-1/Mek/Erk via a 5-lipoxygenase- dependent pathway.
Authors: C Capodici, M H Pillinger, G Han, M R Philips, G Weissmann
Journal: Journal of Clinical Investigation (1998)

AA stimulates integrin-dependent neutrophil adhesion, a critical early step in acute inflammation. However, neither the signaling pathway(s) of AA-stimulated adhesion, nor whether AA acts directly or through the generation of active metabolites, has been elucidated. Previously, we have observed a tight association between neutrophil Erk activation and homotypic adhesion in response to chemoattractants acting through G protein-linked receptors. We now report a similar association between homotypic adhesion and Erk activation in response to AA. Erk activation was cyclooxygenase independent and required AA metabolism to 5(S)- hydroperoxyeicosatetraenoic acid (5-HpETE) via 5-lipoxygenase, but not the further lipoxygenase-dependent metabolism of 5-HpETE to leukotrienes. AA stimulation of Erk was accompanied by Raf-1 activation and was sensitive to inhibitors of Raf-1 and Mek. Whereas activation of Erk by AA was pertussis toxin sensitive, [3H]-AA binding to neutrophils was not saturable, suggesting that an AA metabolite activates a G protein. Consistent with this hypothesis, Erk activation by 5(S)-hydroxyeicosatetraenoic acid (5-HETE; lipoxygenase-independent metabolite of 5-HpETE) was also pertussis toxin sensitive. These data suggest that a 5-lipoxygenase metabolite of AA, e.g., 5-HETE, is released from AA-treated cells to engage a plasma membrane-associated, pertussis toxin-sensitive, G protein-linked receptor, leading to activation of Erk and adhesion via the Raf-1/Mek signal transduction pathway.
The boredom of everyday life
Authors: T. Dalrymple
Journal: BMJ (2011)

Is it possible for a writer to describe, as from the inside, an experience that he has never himself had? Can he, for example, describe what it is like to be delirious without ever having been delirious (and remembering it)? And if he does describe it, is his description worth anything; does it convey any real knowledge or insight to the reader?

Anton Chekhov (1860-1904), who was a doctor when delirium must have been much more common than it is today, describes both its exterior and interior, objectively and subjectively. In the story “The Teacher of Literature,” for example, Ippolit Ippolititch, a teacher of history and geography at a local school, dies of erysipelas of the face after a period of …
The Office Practice of Internists
Authors: Hilda H. Kroeger
Journal: JAMA (1965)

A review of the literature over the past few decades reveals an increasing interest in the evaluation of the quality of care rendered by physicians. The majority of studies<sup>1-5</sup>of the quality of medical care in the United States have been in organized settings, such as hospitals or group practice. The initial work in hospitals was stimulated by the American College of Surgeons. This was followed by the accreditation program of the Joint Commission on Accreditation of Hospitals. A decade ago the American College of Physicians<sup>6-8</sup>undertook the task of attempting to evaluate the work done in hospitals by internists. In their progress report<sup>7</sup>they stated "by systematic critical review of the records of patients hospitalized, competent clinicians could render reasonably satisfactory judgments." In England<sup>9,10</sup>especially, and also in Canada,<sup>11</sup>considerable work has been done in examining the practice of private physicians in their own
The Epstein-Barr Virus and Chronic Fatigue Syndrome
Authors: William J. Hermann
Journal: JAMA (1989)

<h3>To the Editor.—</h3> Based on eight years of clinical experience and having performed many thousands of Epstein-Barr virus (EBV) serological assays with emphasis on IgG anti-early antigen I cannot agree with the conclusion of Hellinger et al<sup>1</sup>that the antibody to EBV early antigen is not helpful in the clinical evaluation of patients with chronic fatigue syndrome. The initial suspicion of a direct etiologic link between EBV and chronic fatigue syndrome has yielded to the probability that EBV reactivation is a secondary phenomenon related to a primary, transient immune dysfunction, the cause of which is currently unknown. In contrast to all other EBV serological markers, which reflect only previous infection, anti-early antigen does rise and fall with clinical activity of the signs and symptoms used to define the chronic fatigue syndrome.<sup>2</sup>Although not diagnostic, it is a useful therapeutic marker when initially found in significant elevation (ie, ≥1:80).
The Mentally Disabled and the Law
Authors: Louis L. Lunsky
Journal: JAMA (1987)

This is the third edition of a very comprehensive book, the size of a telephone directory, dealing with the mentally disabled. The term itself is defined in a general and generic way. It subsumes such areas as mental illness, retardation, and alcoholism and other drug addiction. According to the authors, there were few legal practitioners in this area at first, but today, a substantial legal industry has evolved around it. Newspaper advertisements and television commercials are proof of the enormous expansion. The American Bar Association has a long history of concern about laws relating to the mentally disabled. In 1954, the American Bar Association referred a proposed study to the American Bar Foundation, which led to the publication of the initial and subsequent editions of this volume. This volume deals with all facets of the law. Civil commitment, right to treatment, deinstitutionalization, community treatment, right to refuse treatment, competency, rights
Psychotherapeutic Effects by Audiovisual Heteroconfrontation in a Case of Anorexia nervosa
Authors: H.O. Badura, E.M. Steinmeyer
Journal: Psychotherapy and Psychosomatics (1984)

After a short overview about the use of audiovisual methods in psychiatry and psychotherapy we present a single case study of a young woman suffering from anorexia nervosa. In a typical way the patient could not accept the idea that she had an emotional disorder and did not accept being admitted to hospital or to come as an outpatient to psycho-therapeutic treatment. We used the method of audiovisual heteroconfrontation, i.e., she was confronted with the videotape of another patient suffering from the same disorder. After four sessions of confrontation she was extremely occupied with herself, she suffered more from her condition and was motivated to undergo psychotherapy. Finally, the process of heteroconfrontation is discussed.
Racial Differences in Cardiac Procedure Use-Reply
Authors: George E. Thibault
Journal: JAMA (1994)

<h3>In Reply.</h3> —Dr Zucker raises the concern that our findings of racial variation in cardiac procedure use in the Veterans Health Administration (VHA) may be explained by unmeasured differences in severity of illness or comorbidity. In the "Comment" section of our article and in subsequent interviews, we acknowledged this limitation of administrative data and, therefore, did not conclude that our findings proved VHA care was "racially biased."<sup>1,2</sup>Instead, we suggested that using detailed clinical databases for further investigating the remaining cause for these variations in care and outcome was indicated. As an example, a subsequent preliminary report suggests that black veterans with angiographically defined coronary disease remained significantly less likely than whites to receive revascularization procedures after adjusting for history, cardiac risk factors (including smoking), and lesion severity.<sup>3</sup> We would also agree with Zucker that SES is an important determinant of health outcomes. Although we were not able
Use and Abuse of Intravenous Solutions
Authors: Donald G. Vidt
Journal: JAMA (1975)

THIS REVIEW of the uses and dangers of intravenous fluid therapy is part of the Drug Spotlight Program of the American Society for Clinical Pharmacology and Therapeutics. It is hoped that it will stimulate hospital pharmacy and therapeutics committees to review critically the use of intravenous fluids in their institutions. <h3>Purposes of Fluid Therapy</h3> Establishing and maintaining adequate composition of fluids and electrolytes in patients who suffer from a variety of diseases has become one of the most important functions of modern hospitals. Therapy of disturbed metabolism of fluids and electrolytes is also one of the most frequently misunderstood and most difficult problems for clinicians who are not accustomed to thinking in quantitative terms and who may focus on only one aspect of a complex situation. Intravenous fluids are used (1) to maintain normal body composition when normal food or fluid intake is impossible and (2) to correct acute or
Obstructive Sleep Apnea
Authors: Abu S. M. Shamsuzzaman, Bernard J. Gersh, Virend K. Somers
Journal: JAMA (2003)

Obstructive sleep apnea (OSA) has been increasingly implicated in the initiation and progression of cardiovascular diseases.To systematically review the interactions of OSA with cardiovascular pathophysiology and diseases.The MEDLINE database from January 1966 to March 2003 was searched using the Medical Subject Headings sleep, sleep apnea, obesity, hypertension, heart failure, cardiac arrhythmia, coronary artery disease, stroke, sympathetic activity, endothelium, inflammation, and continuous positive airway pressure (CPAP) to identify peer-reviewed studies of OSA. Priority was given to large prospective cohort studies and to randomized controlled trials.We identified 154 original investigations and reviews of sleep-related breathing disorders. Data from these studies were examined for relevance and extracted by one of the authors.Approximately 1 in 5 adults has at least mild OSA (apnea-hypopnea index [ie, the number of apneic and hypopneic events per hour], 5-15), and 1 in 15 adults has at least moderate OSA (apnea-hypopnea index, 15-30). Repetitive apneic events disrupt the normal physiologic interactions between sleep and the cardiovascular system. Such sleep fragmentation, as well as abnormalities evident in patients with OSA (eg, increased sympathetic activation, vascular endothelial dysfunction, increased oxidative stress, inflammation, increased platelet aggregability, metabolic dysregulation), may be implicated in the initiation and progression of cardiac and vascular disease. Persuasive data implicate OSA in the development of hypertension, and OSA also may contribute to cardiac ischemia, congestive heart failure, cardiac arrhythmias, and perhaps also to cerebrovascular disease and stroke.Obstructive sleep apnea is common, readily diagnosed, and usually treatable. It frequently coexists undiagnosed in patients with cardiovascular disease, activates disease mechanisms known to elicit cardiac and vascular damage, and may be implicated in progression of cardiovascular disease and resistance to conventional therapeutic strategies. In the absence of definitive evidence from large-scale trials and a better understanding of potential cost-effectiveness, the likely benefits of diagnosis and treatment of OSA are presently best appraised on an individualized patient basis.
Case of Large Hydatid Tumour of the Omentum Treated Successfully by a Free Incision, with Antiseptic Precautions
Authors: T. Annandale
Journal: BMJ (1877)

THE BRITISH MEDICAL OVRNAL. 99 the other tube give way ?When we came to examine it, a little pinhole was found at the bottom of the chamber, and through that pinhole the germs got in.Here is a melon infusion; and, in order to show you
Enzyme activities and morphological appearance in functioning and excluded segments of the small intestine after shunt operation for obesity.
Authors: N G Asp, E Gudmand-Hoyer, B Andersen, N O Berg
Journal: Gut (1979)

Five patients in whom small-intestinal bypass was performed for severe obesity had a second operation 11-19 months later because of insufficient weight loss. Mucosal enzyme activities and histological appearance were investigated in biopsies from different parts of the functioning and excluded small intestine. These were compared with biopsies form corresponding sites obtained at the first operation. In addition to a prominent increase in length, circumference, and mucosal thickness in the functioning shunt, the disaccharidases and two intracellular beta-galactosidases increased in specific activity,, especially in the distal ileal part of the shunt. In the excluded segment of the small intestine different enzymes showed a different response: trehalase increased and alkaline phosphate decreased significantly. Other enzymes that were measured showed a varied pattern. The results indicated that not only the luminal content but also other, presumably hormonal, factors regulated the enzyme activities, and that different regulating factors influenced the various enzymes differently. The marked adaptive increase in mucosal surface of the functioning shunt could be one factor in explaining the weight stabilisation and, in some cases, weight increase after the initial rapid weight loss after the operation for small-intestinal bypass. The increase in specific enzyme activities would further increase the digestive capacity of the shunt.
Targeting MICA with therapeutic antibodies for the treatment of cancer
Authors: Cécile Bonnafous, Valentine Peri, Sylvia Trichard, Ivan Perrot, Stéphanie Cornen, Ariane Thielens, Violette Breso, Yannis Morel, Benjamin Rossi, Carine Paturel, Laurent Gauthier, Mathieu Bléry
Journal: Journal for ImmunoTherapy of Cancer (2013)

Meeting abstracts MICA and MICB, along with ULPBs, are ligands for the activating receptor NKG2D expressed on NK cells and subsets of T cells in Human. NKG2D ligands are induced by cellular stress and pathogen infections. Their expression is tightly regulated by complex mechanisms both at the mRNA
Acidosis Stimulates Nitric Oxide Production and Lung Damage in Rats
Authors: ALESSIA PEDOTO, JENNIFER E. CARUSO, JYOTIRMOY NANDI, ALBERT OLER, STEPHEN P. HOFFMANN, APOSTOLOS K. TASSIOPOULOS, DANIEL J. McGRAW, ENRICO M. CAMPORESI, TAWFIC S. HAKIM
Journal: American Journal of Respiratory and Critical Care Medicine (1999)

Systemic hypotension during sepsis is thought to be due to nitric oxide (NO) overproduction, but it may also be due to acidosis. We evaluated in healthy rats the consequences of acid infusion on NO and blood pressure. Sprague-Dawley rats were anesthetized, and ventilated with room air. The animals were randomized into four groups. Group 1 (C, n = 10) received only normal saline at rates comparable to the other groups. Group 2 (A1, n = 10) received hydrochloric acid at 0.162 mmol in the first 15 to 30 min, followed by a continuous infusion of 0.058 mmol/h for 5 h. Group 3 (AG + A1, n = 6) was pretreated with aminoguanidine (AG, 50 mg/kg), and HCl was infused as above. Group 4 (A2, n = 7) received HCl at twice the rate used in A1. Nitric oxide concentration in the exhaled gas (ENO), blood gases, and mean arterial pressure were measured every 30 min. Acid infusion in A1 caused the pH to fall gradually from 7.43 ± 0.01 to 7.13 ± 0.05. This moderate decrease in pH was associated with a marked increase in ENO (1.6 ± 0.3 to 114.2 ± 22.3 ppb), an increase in plasma nitrite/nitrate (17.3 ± 3.7 to 35.2 ± 4.3 μ M), and a significant decrease in blood pressure (110.5 ± 6.3 to 63.3 ± 15.0 mm Hg). Furthermore, acidosis caused lung inflammation, as suggested by the increase in lung myeloperoxidase activity (282.2 ± 24.7 to 679.3 ± 57.3 U/min/g) and lung injury score (1.7 ± 0.2 to 3.5 ± 0.6). Acidosis after AG pretreatment was associated with a similar change in pH, but the increase in ENO, nitrite/nitrate, and systemic hypotension were prevented. Furthermore, lung injury was attenuated by AG, as suggested by a lower myeloperoxidase activity, though lung injury score was not altered. In this model, moderate acidosis causes increases in NO, hypotension, and lung inflammation. Lung inflammation and injury are due in part to acidosis and NO production. This is the first report to show a direct effect of chronic acidosis on NO production and lung injury. These results have profound implications on the role of acidosis on NO production and lung injury during sepsis.
Clinical effectiveness of oseltamivir for influenza A(H1N1) virus with H274Y neuraminidase mutation
Authors: Naoki Kawai, Hideyuki Ikematsu, Norio Iwaki, Kunio Kondou, Nobuo Hirotsu, Takashi Kawashima, Tetsunari Maeda, Osame Tanaka, Ken-ichi Doniwa, Seizaburo Kashiwagi
Journal: Journal of Infection (2009)
A PNEUMATIC HAMMER FOR BONE SURGERY
Authors: Horace C. Pitkin
Journal: JAMA (1927)

A pneumatic hammer was recently installed in the orthopedic operating room of the Massachusetts General Hospital, and met with such instant approval that a report of its salient features is here presented. Shorn of technical detail, the essential features of the apparatus are: 1. An adequate supply of compressed air, preferably generated outside and piped to some convenient point in the operating room. 2. A reducing valve capable of maintaining any desired working pressure in the line distal to itself, regardless of the rate of air flow, and providing for instant adjustment under the direct supervision of the operator. 3. A satisfactory air cleaner. This is essential because the waste air is necessarily exhausted in the sterile operating field. 4. A light, compact, pneumatic hammer whose speed is controlled by a throttle conveniently situated on the pistol-grip handle. The hammer has a top speed of
Diagnosis of Venous Thrombosis-Reply
Authors: Robert W. Barnes
Journal: JAMA (1976)

<h3>In Reply.—</h3> Dr Heckman is correct in his assertion that our study was not designed to assess the accuracy of the clinical diagnosis of venous thrombosis according to the degree of certainty of the clinical diagnosis made by the referring physician. This problem was well studied by Haeger,<sup>1</sup>who demonstrated that the clinical diagnosis of "suspected" and "classic" deep-vein thrombosis was correct in 34% and 55%, respectively, as confirmed by immediate contrast phlebography. The overall clinical accuracy in Haeger's study was 45%. The patients reported in our study had sufficient clinical signs of deepvein thrombosis to warrant anticoagulant therapy until the diagnosis was established by objective techniques. Indeed, prior to the establishment of our laboratory, these patients generally received a full course of anticoagulant therapy. It has been only since the availability of simple noninvasive diagnostic techniques, such as Doppler ultrasound, that we have come to appreciate the fallibility
Comparison of central nervous system malformations in spontaneous absortions in Northern Ireland and south-east England.
Authors: J C MacHenry, N C Nevin, J D Merrett
Journal: BMJ (1979)

A study of 1140 pregnancies ending in spontaneous abortion disclosed a central nervous system (CNS) malformation in 4.9% of all complete conceptuses. Life-table analysis suggested that the incidence of CNS malformations is 16/1000 at the beginning of the eighth week of gestation. It was also estimated that only one-fifth of these infants are born alive, 41% being aborted spontaneously and 38% stillborn. A hypothesis that differences in the incidence of CNS malformations result from area differences in the mortality rate of malformed embryos and fetuses was examined by comparing the findings in Northern Ireland, an area of high incidence, with those in south-east England, an area of low incidence. In Northern Ireland 4.6% of complete conceptuses had a CNS malformation compared with 3.0% in south-east England, but the difference was not statistically significant. There is no evidence that in Northern Ireland a lower mortality rate among malformed fetuses and embryos is responsible for the high incidence of malformation at birth. The geographical variation of CNS malformations in the United Kingdom still awaits explanation.
Time for Oncologists to Opt In for Routine Opt-Out HIV Testing?
Authors: Elizabeth Y. Chiao, Bruce J. Dezube, Susan E. Krown, William Wachsman, Malcolm V. Brock, Thomas P. Giordano, Ronald Mitsuyasu, Liron Pantanowitz
Journal: JAMA (2010)

Human immunodeficiency virus (HIV)–infected individuals are at high risk of malignancies. However, it is not currently the standard of care to routinely test cancer patients for HIV. In 2006, the Centers for Disease Control and Prevention recommended HIV testing in all health care settings, calling for standard nontargeted "opt-out" HIV screening. For a variety of reasons, routine opt-out HIV testing is still not widely used in the United States. Although many barriers to routine opt-out HIV testing have been addressed, such opt-out HIV testing continues to be conducted primarily in venues that target specific patient populations such as pregnant women. Although opt-out testing has been piloted in emergency departments, less emphasis has been placed on opt-out HIV testing in other clinical settings. In this article, the background, rationale, and evidence for supporting opt-out HIV testing as routine care for cancer patients are presented. In addition, evidence is discussed for the potential of opt-out HIV testing to improve clinical outcomes by facilitating appropriate HIV management during cancer treatment for individuals who are found to be HIV positive.
Accurate estimation of left ventricular mass in vivo by voxel-based three-dimensional echocardiography
Authors: Cleo Laskari, Alain Delabays, Jiefen Yao, Qi-Ling Cao, Giuseppina Magni, Stefano De Castro, Philippe Acar, Mani Vannan, Steven Schwartz, Natesa Pandian
Journal: Journal of the American College of Cardiology (1996)