tbuckley/cabot-search huggingface dataset:
A bipolar story
Authors: Raquel Duarte
Journal: BMJ (2006)

Being a medical student has its ups and downs. As I sat in the busy psychiatric outpatient clinic, I was having a particularly “up” day, giggling while the senior house officer vainly tried to hang up the telephone. On the other end was a bipolar patient, currently manic. “Yes, I understand, but I really have to go… Yes, goodbye… No, I am in a clinic….”

“Pressure of speech,” I ruminated, proud at how good my psychiatric terminology was coming along on only the second day of my attachment. When my colleague finally managed to disentangle himself from the conversation, he looked at me with a strangely vindictive grin and told me that the patient was being admitted and that she would be a “wonderful candidate” for a detailed …
Torture in Israel
Authors: D. Summerfield
Journal: BMJ (1995)

EDITOR,—Jon Immanuel may not have intended to be an apologist for torture in Israel, but his review does insufficient justice to the stark material gathered by Human Rights Watch and other bodies.1 Over 100000 Palestinians have been arrested since 1987, thousands of whomentered the closed world of Israeli interrogation centres. Amnesty International concurs with Human Rights Watch that torture is institutionalised during interrogation and 90% of convictions in military courts are based on a “confession” alone. The International Committee of the Red Cross, the only …
THE GYNECOLOGICAL AND OBSTETRICAL SIGNIFICANCE OF GIRLHOOD.
Authors: HENRY P. NEWMAN
Journal: JAMA (1901)

I have recently received a letter from Dr. George Engelmann, of Boston, announcing his intention of reading a paper before the Gynecological and Obstetrical Section at the June meeting of the Americal Medical Association, on "The Causes of the Increasing Sterility of American Women," and stating his conviction that the subject is of vital importance and needs investigating. The same authority, as President of the American Gynecological Society, made an elaborate address last year upon a very nearly related topic: "The American Girl of To-day," and aroused much interest in his carefully prepared and somewhat startling statistics. It would appear from his researches, and in these he was assisted by prominent educators, teachers in young women's colleges and normal schools and by the heads of mercantile houses where women are employed, that the absolutely normal, healthy girl is exceedingly rare. It is evident that for her own sake as a
Doctors and the Law: Defendants and Expert Witnesses
Authors: Cyril H. Wecht
Journal: JAMA (1994)

Doctors and the Law: Medical Jurisprudence in Nineteenth-Century America, by James C. Mohr, 319 pp, $30, ISBN 0-19-505384-2, New York, NY, Oxford University Press, 1993.  The physician who is a defendant in a medical malpractice action is in an obviously involuntary position, while the doctor who agrees to serve as a consultant and potential expert witness for an attorney does so on a purely voluntary basis. Nevertheless, there are numerous similarities between the two visa-vis lawyers, courts, and the legal process, and both roles are fraught with much danger if the physician is unprepared, legally inexperienced, and naive.  What should a physician do when confronted with the possibility of being sued for alleged professional negligence? How do you react then and later, if the threat of a lawsuit becomes a painful reality?  If your patient sues a third party for personal injuries (eg, automobile accident, product liability, job-related injury), what are your rights and responsibilities as a
Role of Compensatory Enlargement and Shrinkage in Transplant Coronary Artery Disease
Authors: Tai Tian Lim, David H. Liang, Javier Botas, John S. Schroeder, Stephen N. Oesterle, Alan C. Yeung
Journal: Circulation (1997)

Background Compensatory enlargement of the vessel wall has been described in the early stages of native atherosclerosis. Whether compensatory enlargement plays a role in transplant coronary artery disease is not known. The objective of this study was to determine, by use of serial intravascular ultrasound (IVUS), whether compensatory dilation occurs in transplant coronary artery disease over time. Methods and Results Seventy-five heart transplant recipients with 151 matched coronary segments were selected for the presence of intimal disease progression as detected by serial IVUS examinations 1 to 3 years apart. Intimal disease progression was defined as a &gt;10% increase in intimal area (IA). IVUS catheter location in follow-up studies was verified angiographically in relation to branch vessels. Luminal area (LA) and total vessel area (TA) were measured at each site. Intimal area (IA=TA−LA) was calculated. Changes in IA (ΔIA) and TA (ΔTA) between baseline and follow-up IVUS were compared: ΔIA, 2.9±0.2 mm 2 ; ΔTA, 2.7±0.4 mm 2 . A remodeling index (RI) was defined as RI=ΔTA/ΔIA. Three subgroups could be distinguished: overcompensation (RI &gt;1), partial compensation (RI 0 to 1), and no compensation or shrinkage (RI ≤0). Seventy-four segments (49%) showed overcompensation, 44 (29%) showed partial compensation, and 33 (22%) showed no compensation or shrinkage. Conclusions In this study, serial IVUS shows that early after cardiac transplantation, a large proportion of the coronary segments with progression of intimal thickening have compensatory dilation of the vessel wall. However, a substantial number of coronary segments (22%) show no compensatory dilation or shrinkage. The progressive luminal narrowing in transplant patients may be due in part to vessel shrinkage or the lack of compensatory dilation over time.
A Vascular Targeted Pan Phosphoinositide 3-Kinase Inhibitor Prodrug, SF1126, with Antitumor and Antiangiogenic Activity
Authors: Joseph R. Garlich, Pradip De, Nandini Dey, Jing Dong Su, Xiaodong Peng, Antoinette Miller, Ravoori Murali, Yiling Lu, Gordon B. Mills, Vikas Kundra, H-K. Shu, Qiong Peng, Donald L. Durden
Journal: Cancer Research (2008)

Abstract PTEN and the pan phosphoinositide 3-kinase (PI3K) inhibitor 2-(4-morpholinyl)-8-phenyl-4H-1benzopyran-4-one (LY294002) exert significant control over tumor-induced angiogenesis and tumor growth in vivo. The LY294002 compound is not a viable drug candidate due to poor pharmacologic variables of insolubility and short half-life. Herein, we describe the development and antitumor activity of a novel RGDS-conjugated LY294002 prodrug, termed SF1126, which is designed to exhibit increased solubility and bind to specific integrins within the tumor compartment, resulting in enhanced delivery of the active compound to the tumor vasculature and tumor. SF1126 is water soluble, has favorable pharmacokinetics, and is well tolerated in murine systems. The capacity of SF1126 to inhibit U87MG and PC3 tumor growth was enhanced by the RGDS integrin (αvβ3/α5β1) binding component, exhibiting increased activity compared with a false RADS-targeted prodrug, SF1326. Antitumor activity of SF1126 was associated with the pharmacokinetic accumulation of SF1126 in tumor tissue and the pharmacodynamic knockdown of phosphorylated AKT in vivo. Furthermore, SF1126 seems to exhibit both antitumor and antiangiogenic activity. The results support SF1126 as a viable pan PI3K inhibitor for phase I clinical trials in cancer and provide support for a new paradigm, the application of pan PI3K inhibitory prodrugs for the treatment of cancer. [Cancer Res 2008;68(1):206–15]
Dietary Intake of Fiber and Decreased Risk of Cancers of the Colon and Rectum: Evidence From the Combined Analysis of 13 Case-Control Studies
Authors: Geoffrey R. Howe, Enrique Benito, Roberto Castelleto, Jacqueline Cornée, Jacques Estève, Richard P. Gallagher, José M. Iscovich, Jiao Deng-ao, Rudolf Kaaks, Gabriel A. Kune, Susan Kune, Kristan A. L'Abbé, Hin P. Lee, Marion Lee, Anthony B. Miller, Ruth K. Peters, John D. Potter, Elio Riboli, Martha L. Slattery, Dimitrios Trichopoulos, Albert Tuyns, Anastasia Tzonou, Alice S. Whittemore, Anna H. Wu-Williams, Zheng Shu
Journal: JNCI Journal of the National Cancer Institute (1992)

Colorectal cancer is a major public health problem in both North America and western Europe, and incidence and mortality rates are rapidly increasing in many previously low-risk countries. It has been hypothesized that increased intakes of fiber, vitamin C, and beta carotene could decrease the risk of colorectal cancer.The objective of this study was to examine the effects of fiber, vitamin C, and beta-carotene intakes on colorectal cancer risk in a combined analysis of data from 13 case-control studies previously conducted in populations with differing colorectal cancer rates and dietary practices. The study was designed to estimate risks in the pooled data, to test the consistency of the associations across the studies, and to examine interactions of the effects of the nutrients with cancer site, sex, and age.Original data records for 5287 case subjects with colorectal cancer and 10,470 control subjects without disease were combined. Logistic regression analysis was used to estimate relative risks and confidence intervals for intakes of fiber, vitamin C, and beta carotene, with the effects of study, sex, and age group being adjusted by stratification.Risk decreased as fiber intake increased; relative risks were 0.79, 0.69, 0.63, and 0.53 for the four highest quintiles of intake compared with the lowest quintile (trend, P < .0001). The inverse association with fiber is seen in 12 of the 13 studies and is similar in magnitude for left- and right-sided colon and rectal cancers, for men and for women, and for different age groups. In contrast, after adjustment for fiber intake, only weak inverse associations are seen for the intakes of vitamin C and beta carotene.This analysis provides substantive evidence that intake of fiber-rich foods is inversely related to risk of cancers of both the colon and rectum.If causality is assumed, we estimate that risk of colorectal cancer in the U.S. population could be reduced about 31% (50,000 cases annually) by an average increase in fiber intake from food sources of about 13 g/d, corresponding to an average increase of about 70%.
Abstract P3-07-11: Nipple aspiration fluid yielders and non-yielders: Genetic characteristics
Authors: A Shidfar, J Wang, S Allu, D Scholtens, R Chatterton, S Khan
Journal: Cancer Research (2013)

Abstract Background: Nipple aspiration fluid (NAF) is a noninvasively acquired biosample that can provide a window of observation into the breast environment, but NAF yield is variable across studies, and is related to a variety of demographic and reproductive factors. We have recently observed a positive correlation between serum prolactin level and NAF yield status. The genetic traits determining NAF yield are unknown, but data from the 1970s linked wet type ear wax to NAF yield, and recent studies point to single nucleotide polymorphisms (SNPs) in the ABCC11 gene as a determinant of earwax type. Further, prolactin and prolactin receptor SNPs are related to serum prolactin level. We have investigated associations between NAF yield and SNPs in prolactin, prolactin receptor and ABCC11 genes in a recently completed case-control study. Method: NAF and/or blood were collected from 916 women. Subjects were defined as yielder if NAF volume was equal or more than 2μL and non-yielder if it was less than 2μL. According to this definition, our subjects categorized as 557 yielders and 359 non-yielders. DNA was extracted from blood using Qiagen kit and 20 ng of DNA was used to amplify and genotype for ABCC11 (rs17822931), PRLR (rs37364), PRL (rs2244502), PRL (rs849872) SNPs using Taqman genotyping assay on an Applied Biosystems 7900HT machine. Results: The median age of Yielders and Non-yielders was 51 and 54, respectively, with the same range of 31-70 for both groups (P&amp;lt;0.0001). There were 209(38%) premenopausal, 257(46%) postmenopausal and 81(15%) perimenopausal of yielders vs. 99(28%) premenopausal, 229(64%) postmenopausal and 26(7%) perimenopausal of non-yielders (P&amp;lt;0.0001). ABCC11 genotype distribution was significantly different between yielders and non-yielders (P = 0.00163). However, genotype distribution was not significantly different for PRLR (rs37364), PRL (rs2244502) and PRL (rs849872). YNYTotalP (N vs. NY)ABCC11 (rs17822931)5413578980.00163CC437 (81%)269 (75%)706 TT5 (1%)16 (4%)21 CT99 (18%)72 (20%)171 PRLR (rs37364)5483599070.176GG89 (16%)43 (12%)132 TT272 (50%)181 (50%)453 GT187 (34%)135 (38%)322 PRL (rs2244502)5393588970.087AA73 (14%)32 (9%)105 TT233 (43%)155 (43%)388 AT233 (43%)171 (48%)404 PRL (rs849872)5433599020.102CC17 (3%)11 (3%)28 TT332 (61%)244 (68%)576 CT194 (36%)104 (29%)298 Conclusion: Our analysis demonstrates a correlation between ABCC11 (rs17822931) SNP and NAF yield status, with the major homozygous CC allele associated with NAF yielder and minor homozygous TT allele associated with non-yielder status. If NAF-based risk biomarkers are to be developed, a better understanding of the genetics of NAF yield is required. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-07-11.
LONG-TERM OUTCOME OF CENTRALLY LOCATED LOW-GRADE GLIOMA IN CHILDREN
Authors: K. Terashima, K. Chow, J. Jones, C. Ahern, E. Jo, B. Ellezam, A. C. Paulino, M. F. Okcu, J. Su, A. Adesina, A. Mahajan, R. Dauser, W. Whitehead, C. Lau, M. Chintagumpala
Journal: Neuro-Oncology (2014)

BACKGROUND: Optimal management of children with centrally located low-grade glioma (LGG) is unclear. A better understanding of the inherent risk factors along with the effects of interventions on long-term outcome can lead to reassessment of the current approaches to minimize long-term morbidity. Our goal was to reassess the current treatment strategies to gain a better understanding of the benefits and risks of different treatment approaches. A secondary goal was to determine whether BRAF-KIAA1549 (B-K) fusion is associated with a better PFS. METHODS: To reassess the current treatment strategies of centrally located LGG, we compared the long-term survival and morbidity of different treatment regimens. Medical records of patients primarily treated at Texas Children's Cancer and Hematology Center, Baylor College of Medicine between 1987 and 2008 were reviewed. Fluorescent in situ hybridization (FISH) for B-Kfusion/duplication was performed. RESULTS: Forty-seven patients with a median follow-up of 79 months were included in the analysis. The 5-year overall survival (OS) and progression-free survival (PFS) for all patients were 96% and 53%, respectively. The 5 year PFS for those treated initially with RT (12 patients, median age 11 years, range 3-15) and with chemotherapy (28 patients, median age 2 years, range 0-8) were 76% and 37%, respectively (log-rank test p = 0.02). Among children who progressed after chemotherapy, the 5-year PFS after salvage RT was 55%. Patients diagnosed at a younger age (<5yrs) were more likely to experience endocrine abnormalities (Fisher's Exact test, p < 0.00001). In 27 patients with qualified tissue sample, risk of progression is nearly 3 times higher with presence of B-K fusion/duplication compared to the absence of B-K fusion/duplication (HR 2.95, 95% CI: 0.83-10.51). CONCLUSIONS: Effective and durable tumor control was obtained with RT as initial treatment. In younger patients, chemotherapy can delay the use of RT; however, frequent progression and long-term morbidity are common. More effective and less toxic therapies are required in these patients, the majority of whom are long-term survivors. Our cohort confirmed the previous report of frequent B-K fusion in pilocytic astrocytoma, but did not find any significant association between this fusion and clinical outcomes. Molecular-targeting therapeutics for B-K fusion specifically or MAPK pathway are promising future treatment with potentially less toxic effect. SECONDARY CATEGORY: Clinical Neuro-Oncology.
Unsuspected Metastatic Male Breast Nodule From Synovial Sarcoma Detected by FDG PET
Authors: Narendra Nair, Sandip Basu
Journal: Clinical Nuclear Medicine (2005)

The literature of serendipitous findings on whole-body FDG PET continues to grow. Whole-body FDG PET imaging of a 24-year-old man with treated synovial sarcoma of the right upper extremity showed an abnormal focus of activity over the right chest in addition to abnormal uptake in the lungs. On reexamination, he was found to have a hitherto unknown 2.5-cm mobile nodule in the right breast. Histopathology confirmed it to be metastasis from the synovial sarcoma. Extramammary malignancies metastasizing to the breast constitute approximately 2% of all breast tumors.
Studies on the metabolism of vinyl chloride.
Authors: H Antweiler
Journal: Environmental Health Perspectives (1976)

Vinyl chloride (VCM) is not carcinogenic by itself, it is bioactivated to the highly reactive alkylating oxirane chloroethylene oxide. Further metabolism, apparently, leads via an interaction of the primary alkylating metabolites with glutathion to S-(2-carboxy-methyl)-cysteine and thiodiacetic acid which are eliminated with the urine. Up to now, it has not been ascertained whether the oxirane alone is the essential carcinogenic factor or whether other metabolites are also involved in carcinogenicity. Likewise, it is still unknown whether the metabolites excreted in the urine might be used as biological criteria for exposure to VCM, because these metabolites probably can originate from a series of substances other than VCM. This problem could stimulate investigations on the possible carcinogenic activity of these substances.
Is omniscience enough?
Authors: Colin Douglas
Journal: BMJ (2006)

In the real world, some of us know a little about a lot, quite a few know a lot about a little, and there is a troubling minority that knows practically everything about hardly anything. That's in the real world. But when it comes to examining in the Practical Assessment of Clinical Examination Skills for the Membership of the Royal College of Physicians, we are all omniscient.

It takes a bit of getting used to. I have seen …
Lovastatin prevents the impairment of endothelium dependent relaxation and inhibits accumulation of cholesterol in the aorta in experimental atherosclerosis in rabbits
Authors: M. P J Senaratne, A. B R Thomson, C T. Kappagoda
Journal: Cardiovascular Research (1991)

The aim was to determine the effect of the HMG CoA reductase inhibitor, lovastatin, on the loss of endothelium dependent relaxation and the accumulation of cholesterol in the aorta produced by feeding a diet enriched with cholesterol.The study was conducted in two stages. In stage 1, New Zealand white rabbits were randomised into four groups. Group 1 (n = 15) was fed standard rabbit diet for 6 weeks. Groups 2 (n = 15), 3 (n = 12), and 4 (n = 12) were fed standard rabbit diet supplemented with 2% cholesterol for 2 weeks followed by standard rabbit diet only for the next 4 weeks. In addition, lovastatin (4 mg.kg-1.d-1) was given for the entire 6 weeks in group 3 and for the first 2 weeks only in group 4. In stage 2 a second group of animals was fed a diet supplemented with 0.5% cholesterol for 2 weeks in order to match the serum cholesterol levels in groups 3 and 4 of stage 1.Aortic tissue was removed for measurement of cholesterol content, endothelium dependent relaxation (to acetylcholine), contractile responses (to noradrenaline), relaxant responses (to sodium nitrite), and sudan staining. Serum was obtained for measurement of cholesterol and triglyceride concentrations.In stage 1, at the end of 2 weeks, the serum cholesterol was significantly lower in groups 3 and 4 than in group 2. At 6 weeks, endothelium dependent relaxation to acetylcholine (-6.0 log mol.litre-1) was impaired in group 2 compared to the other groups: group 1 78.5(SEM 5.0); group 2 43.5(7.8)%; group 3 79.4(4.6)%; group 4 84.7(3.4)%. The relaxant response to sodium nitrite was not impaired in group 2. Further, the aortic tissue cholesterol concentration in group 2 was significantly greater than that in group 1, at 355(65) v 105(10) nmol.mg-1 protein. In groups 3 and 4, the aortic cholesterol concentrations were significantly lower than those in group 2, at 74(4) and 94(17) nmol.mg-1 protein respectively. In stage 2, the serum cholesterol values were matched to those in groups 3 and 4 of stage 1. In these animals, after a further 4 weeks the aortic cholesterol was significantly greater than in group 3.Lovastatin attenuates the accumulation of cholesterol and preserves endothelium dependent relaxation in this model of experimental atherosclerosis. It is likely that the latter is a secondary phenomenon.
Drug company secretly briefed medical societies on HRT
Authors: R. Moynihan
Journal: BMJ (2003)

Pharmaceutical giant Wyeth has admitted that it secretly briefed a number of medical societies about the results of a study into hormone replacement therapy (HRT) and dementia before they were published this week.



On Wednesday JAMA published the study, funded by Wyeth, which shows that the company's combined oestrogen and progestogen pill doubled the risk of dementia among elderly women from about 1% to …
Recombinant Factor VIIa and Thromboembolic Events—Reply
Authors: Kathryn A. O’Connell, Robert P. Wise, Jay N. Lozier, M. Miles Braun
Journal: JAMA (2006)

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Povidone Iodine Skin Sensitivity Observed With Possibly Altered Immune Status
Authors: Robert W. Feldtman, Richard J. Andrassy, Carey P. Page
Journal: JAMA (1979)

<h3>To the Editor.—</h3> We have noted 11 patients who have had their surgical wounds covered with a dressing containing 10% povidone iodine (Betadine). The wounds showed cutaneous erythema, induration, and also papulation, which conformed to the configuration of the dressing. All 11 patients who demonstrated this also showed a similar reaction to a 2×2=cm cotton pledget saturated with 10% povidone iodine. Diagnosis in ten of the 11 patients was suspect for altered immune state. These observations prompted a prospective evaluation of povidone iodine skin sensitivity to confirm our incidental observations and to determine the incidence of skin sensitivity in the population of patients admitted to our surgical service. One hundred sixty-six consecutive patients admitted to the general surgical service were prospectively tested for skin sensitivity to povidone iodine. After we obtained informed consent, a 2×2=cm cotton povidone iodine swab was taped to the medial forearm with a piece of 2=in
Understanding addiction: Conventional rewards and lack of control
Authors: Clark McCauley
Journal: Behavioral and Brain Sciences (1996)

Abstract The conflict between drug and conventional rewards leads to a paradox: Sanctions against drug use decrease access to conventional rewards and push drug users toward drug abuse, whereas increased access to the rewards of family, friends, and work may help reduce drug abuse. Lack of control is not specific to drug addiction and is unlikely to yield to a shift in bookkeeping.