tbuckley/cabot-search huggingface dataset:
Critically Appraising Prenatal Genetic Diagnosis to Prevent Disorders of Sexual Development: An Opportunity Missed
Authors: Laurence B. McCullough
Journal: The American Journal of Bioethics (2013)

Click to increase image sizeClick to decrease image size Notes 1. In his justification of his reversion to a nomenclature—“intersex conditions”—that has been abandoned in clinical practice in favor of “disorders of sexual development” (DSD), Sparrow claims that the former “allows more conceptual space for understanding these anatomic variations as points on a wider spectrum of sexual diversity than as—by definition—disorders of ‘normal’ anatomical development” (29). This betrays a lack of understanding of a clinical discourse that is used precisely to identify and responsibly manage the full anatomic and physiologic range of the biological variation of genomic, hormonal, brain, internal reproductive-organ, and genital sex and its resulting wide biopsychosocial variation in gender (Douglas et al. 2010; 2012; McCullough 2002). Sparrow's use of “intersex conditions” retains the dimorphic, biomedical, and therefore reductionist conception of sex in our species that the replacement nomenclature of “disorders of sexual development” has successfully left behind. As an unwelcome result, the conceptual space that he wants to preserve becomes restricted to the biomedical. The use of “intersex conditions” also results in Sparrow making the mistake of thinking that clinicians can assign gender to a pediatric patient with a DSD. Clinicians can assign sex (with varying levels of reliability—see Douglas et al. 2010; 2012; McCullough 2002) but they cannot assign gender, because the latter is a complex social construction of sex in both gender identity and sexual orientation. I therefore do not follow Sparrow in his use of “intersex conditions,” which should be discarded.
The Submucosal Cushion Does Not Improve the Histologic Evaluation of Adenomatous Colon Polyps Resected by Snare Polypectomy
Authors: Ivan Jovanovic, Carlos Caro, Helmut Neumann, Anke Lux, Doerthe Kuester, Lucia C. Fry, Peter Malfertheiner, Klaus Mönkemüller
Journal: Clinical Gastroenterology and Hepatology (2011)
A REVIEW OF SEX CHARACTERS
Authors: L. R. Broster
Journal: BMJ (1931)

Science, so far, has been unable to explain what determines sex in animals.Among mammals, with rare exceptions, the sex once acquired is definite and unchangeable, but this stability of the sexes steadily declines as we descend the evolutionary scale.In man we have come to regard the differentiation of the sexes so much an accepted and universal feature of nature that any devia- tion from this rule at once excites our curiosity.There
Heterosexual Transmission of HIV-Reply
Authors: Nancy S. Padian
Journal: JAMA (1992)

In Reply.  —We did not attempt to examine gender-specific transmission rates by anal intercourse because we did not believe it to be a risk factor for female-to-male transmission. Anal intercourse among the uninfected male partners of infected women seems analogous to insertive anal intercourse between uninfected male partners of infected men, which poses far less risk than receptive anal intercourse.1There is no evidence that anal intercourse is prevalent in pattern II countries where bidirectional heterosexual transmission is common (areas of central, eastern, and southern Africa and in some Caribbean countries). Nevertheless, Dr Godfrey poses an interesting hypothesis: male-to-female transmission in our study could largely be attributed to anal intercourse, and once this practice is controlled for, rates of female-to-male transmission might approximate rates of male-to-female transmission.  Overall, we observed that 20% of 307 female partners of infected males were infected. One hundred ninety-three (37%) of these couples practiced
The Oslerian Tradition
Authors: Arthur J. Siegel
Journal: JAMA (1978)

<h3>To the Editor.—</h3> This letter is to express gratitude to Dr Regelson for his concern over a putative deterioration in the practice and teaching of clinical medicine at the Harvard hospitals. If accurate, his characterization of the "Harvard model" as a grant-grubbing machine subserviant to funding priorities with insensitivity to training and practice deserves prompt redress. My observations as a clinical full-time physician and faculty member at the Peter Bent Brigham Hospital indicate, however, that his description is incorrect. Innovations at this hospital over the last several years include the following: (1) creation of a primary care center within the teaching hospital (1973), (2) formation of a primary care tract within the internal medicine residency program (1973 to 1974), which will soon include ten to 12 trainees (one quarter of the medical house staff), (3) formation of a Division of General Medicine (1975), including eight full-time staff physicians, whose principal
Imatinib Mesylate for Cerebral Langerhans'-Cell Histiocytosis
Authors: Liliana Montella, Luigi Insabato, Giovannella Palmieri
Journal: New England Journal of Medicine (2004)

To the Editor: Langerhans'-cell histiocytosis (LCH) is a rare disorder characterized by tissue infiltrates of CD1a+ Langerhans' cells, eosinophils, neutrophils, macrophages, and lymphocytes. System...
Lower-Extremity Amputations in NIDDM: 12-Yr Follow-Up Study in Pima Indians
Authors: Robert G Nelson, Dorothy M Gohdes, James E Everhart, Judith A Hartner, Frank L Zwemer, David J Pettitt, William C Knowler
Journal: Diabetes Care (1988)

The incidence of lower-extremity amputations was estimated in the Pima Indians of the Gila River Indian Community in Arizona, a population with a high prevalence of non-insulin-dependent diabetes mellitus (NIDDM). Between 1972 and 1984, from a study population of 4399 subjects, lower-extremity amputations were performed on 84 patients, 80 (95%) of whom had NIDDM. Among diabetic subjects, the incidence rate of first lower-extremity amputations was higher in men than in women. Rates increased significantly with increasing duration of diabetes. Presence of medial arterial calcification, retinopathy, or nephropathy; absence of patellar tendon reflexes; impaired great toe vibration-perception threshold; and degree of fasting and 2-h postload hyperglycemia were significant risk factors for amputations. Serum cholesterol concentration, blood pressure, age, and absence of Achilles tendon reflexes were not predictive of amputations. The death rate was greater in diabetic amputees than in diabetic nonamputees of similar age, sex, and duration of diabetes, and a significant increase in cardiovascular deaths was observed in diabetic subjects with amputations. The incidence rate of lowerextremity amputations in diabetic Pima Indians is higher than that reported in other diabetic populations. This may reflect differences in risk or a more complete case ascertainment than was possible in previous studies. If the latter is true, the rate of amputations in diabetic individuals may be higher than has been previously appreciated.
Technical Aspects of Performing Lymphoscintigraphy
Authors: BORYS R. KRYNYCKYI, MICHELE MINER, JENNIFER M. RAGONESE, MICHAEL FIRESTONE, CHUN K. KIM, JOSEF MACHAC
Journal: Clinical Nuclear Medicine (2000)

Sentinel node detection is an important part of the clinical management of newly diagnosed melanoma. Now there is a similar or even greater enthusiasm for sentinel node evaluation in patients with breast carcinoma. However, controversies exist regarding the dose, volume, and route of administration. Even the role of lymphoscintigraphy itself, in contrast to using only a hand-held gamma probe during surgery for sentinel node detection, is being debated. Nevertheless, many centers and surgeons find that lymphoscintigraphy images are valuable in the treatment of patients and they use lymphoscintigraphy as a guide during surgery and to confirm the results obtained with the hand-held probe. Centers just beginning to use lymphoscintigraphy may find the images especially useful. Given this fact, the authors wanted to define the practical and technical aspects of performing lymphoscintigraphy in patients with breast cancer and examined various methods for the optimization of the technique of image acquisition. The suggested technique is generally free of the controversies noted above and applies to most patients. It includes various maneuvers that aim to improve the rate of sentinel node visualization using the gamma camera and the accuracy of node detection. The recommendations presented here should prove useful for both those experienced and for those centers just beginning to use the technique of lymphoscintigraphy.
HEMORRHAGE FROM THE NON-PREGNANT UTERUS
Authors: JOHN B. DEAVER
Journal: JAMA (1913)

Even a casual glance over recent literature indicates that the subject of uterine hemorrhage is so complex as to make practically impossible a comprehensive classification of causes. At the same time, the subject is simple enough to be readily understood. Such confusion indicates ignorance of the underlying principles of menstruation—its anomalies and abnormalities. Without accurate knowledge of the regular menstrual function, attempts to treat departures from the normal must depend almost entirely on empiric rules, the result of experience in practice. Such clinical experience, in the treatment of the various forms of uterine hemorrhage, I may claim without unduly violating the canons of modesty. It is on the result of this experience that I wish to speak. In practice one meets hemorrhage from the non-pregnant uterus during the three important epochs of a woman's life—puberty, the child-bearing period and the menopause. Whatever the time of life at which such bleeding
Swapping Health Care Systems
Authors: Colin I. Johnston
Journal: JAMA (1996)

By international comparisons, Australians enjoy good health and have health services with access and equity at reasonable cost.<sup>1</sup>During the past 2 decades, longevity has increased significantly, deaths from cardiovascular disease have declined, and the human immunodeficiency virus (HIV) epidemic has been relatively contained in this country. Some proponents believe the Australian health system combines the best features of the systems in the United States and the United Kingdom. Critics harp that it has the worst of both systems. Unfortunately, health has become a political issue, not just an issue of well-being, and as a result there are constant changes and attempts by all levels of government to limit costs. See also p 1944. Australia's health care system is pluralistic, involving both the commonwealth (federal) and state governments, private and public medicine and hospitals, and medical insurance companies. The basic underlying principle is universal health coverage for the entire
The Protective Effect of Moderate Alcohol Consumption on Ischemic Stroke
Authors: Sacco Rl, Elkind M, Boden-Albala B, Lin If, Kargman De, Hauser Wa, Shea S, Paik Mc
Journal: JAMA (1999)

Moderate alcohol consumption has been shown to be protective for coronary heart disease, but the relationship between moderate alcohol consumption and ischemic stroke is more controversial.To determine the association between alcohol consumption and risk of ischemic stroke.Population-based case-control study conducted between July 1993 and June 1997.Multiethnic population in northern Manhattan, New York, NY, aged 40 years or older.Cases (n = 677) had first ischemic stroke and were matched to community controls (n = 1139) derived through random digit dialing by age, sex, and race/ethnicity. Mean +/- SD age of cases was 70.0+/-12.7 years; 55.8% were women; 19.5% were white, 28.4% black, and 50.7% Hispanic.First ischemic stroke (fatal or nonfatal).Moderate alcohol consumption, up to 2 drinks per day, was significantly protective for ischemic stroke after adjustment for cardiac disease, hypertension, diabetes, current smoking, body mass index, and education (odds ratio [OR], 0.51; 95% confidence interval [CI], 0.39-0.67). This protective effect of alcohol consumption was detected in both younger and older groups, in men and women, and in whites, blacks, and Hispanics. In a quadratic model of stroke risk, increased risk of ischemic stroke was statistically significant among those consuming 7 or more drinks per day (OR, 2.96; 95% CI, 1.05-8.29).Moderate alcohol consumption was independently associated with a decreased risk of ischemic stroke in our elderly, multiethnic, urban subjects, while heavy alcohol consumption had deleterious effects. Our data support the National Stroke Association Stroke Prevention Guidelines regarding the beneficial effects of moderate alcohol consumption.
HDAC Inhibitors Target HDAC5, Upregulate MicroRNA-125a-5p, and Induce Apoptosis in Breast Cancer Cells
Authors: Tsung-Hua Hsieh, Chia-Yi Hsu, Cheng-Fang Tsai, Cheng-Yu Long, Chin-Hu Wu, Deng-Chyang Wu, Jau-Nan Lee, Wei-Chun Chang, Eing-Mei Tsai
Journal: Molecular Therapy (2014)

Histone deacetylase inhibitors (HDACi) are novel clinical anticancer drugs that inhibit HDAC gene expression and induce cell apoptosis in human cancers. Nevertheless, the detailed mechanism or the downstream HDAC targets by which HDACi mediates apoptosis in human breast cancer cells remains unclear. Here, we show that HDACi reduce tumorigenesis and induce intrinsic apoptosis of human breast cancer cells through the microRNA miR-125a-5p in vivo and in vitro. Intrinsic apoptosis was activated by the caspase 9/3 signaling pathway. In addition, HDACi mediated the expression of miR-125a-5p by activating RUNX3/p300/HDAC5 complex. Subsequently, miR-125a-5p silenced HDAC5 post-transcriptionally in the cells treated with HDACi. Thus, a regulatory loop may exist in human breast cancer cells involving miR-125a-5p and HDAC5 that is controlled by RUNX3 signaling. Silencing of miR-125a-5p and RUNX3 inhibited cancer progression and activated apoptosis, but silencing of HDAC5 had a converse effect. In conclusion, we demonstrate a possible new mechanism by which HDACi influence tumorigenesis and apoptosis via downregulation of miR-125a-5p expression. This study provides clinical implications in cancer chemotherapy using HDACi. Histone deacetylase inhibitors (HDACi) are novel clinical anticancer drugs that inhibit HDAC gene expression and induce cell apoptosis in human cancers. Nevertheless, the detailed mechanism or the downstream HDAC targets by which HDACi mediates apoptosis in human breast cancer cells remains unclear. Here, we show that HDACi reduce tumorigenesis and induce intrinsic apoptosis of human breast cancer cells through the microRNA miR-125a-5p in vivo and in vitro. Intrinsic apoptosis was activated by the caspase 9/3 signaling pathway. In addition, HDACi mediated the expression of miR-125a-5p by activating RUNX3/p300/HDAC5 complex. Subsequently, miR-125a-5p silenced HDAC5 post-transcriptionally in the cells treated with HDACi. Thus, a regulatory loop may exist in human breast cancer cells involving miR-125a-5p and HDAC5 that is controlled by RUNX3 signaling. Silencing of miR-125a-5p and RUNX3 inhibited cancer progression and activated apoptosis, but silencing of HDAC5 had a converse effect. In conclusion, we demonstrate a possible new mechanism by which HDACi influence tumorigenesis and apoptosis via downregulation of miR-125a-5p expression. This study provides clinical implications in cancer chemotherapy using HDACi.
Hypotensive Agents in Renal Biopsy
Authors: Alvin E. Parrish, Norman C. Kramer, William K. Bowman, Marshall S. Miller, Mary F. Watt
Journal: JAMA (1964)

ALTHOUGH COMPLICATIONS of kidney biopsy are rare,<sup>1</sup>hemorrhage following needle biopsy of the kidney may occur.<sup>2-5</sup>In our experience, this has been more common in hypertensive patients. A reduction in blood pressure prior to biopsy might be expected to reduce the incidence of complications with the procedure and to permit needle biopsy in those patients in whom it might otherwise be contraindicated because of hypertension. <h3>Methods</h3> Patients with blood pressures higher than 140/90 mm Hg at the time of renal biopsy were given either hexamethonium chloride or diazoxide immediately prior to biopsy and their blood pressure reduced to below 140/90 mm Hg. The complications in this group were then compared with a group of similar patients whose blood pressure remained above 140/90 mm Hg during renal needle biopsy. Hexamethonium chloride was used initially until the drug was no longer available. It was given slowly intravenously as a solution
Iron-Deficiency Pruritus
Authors: Heikki Takkunen
Journal: JAMA (1978)

<h3>To the Editor.—</h3> I read the article by Lewiecki and Rahman (236:2319, 1976) and the letter by Vickers (238:129, 1977) about iron deficiency and pruritus, and I would like to present some epidemiological findings that have relevance to this matter. During the years 1967 to 1972, the mobile clinic of the Social Insurance Institution in Finland carried out multiphasic screening examinations in various parts of the country. In all, 23,189 men and 19,902 women aged 15 years or older were examined.<sup>1</sup> In men, 0.7% of those screened had a hemoglobin level under 13 g/dl and serum transferrin saturation under 15%. According to a questionnaire, 13.6% of these men with iron deficiency anemia had frequent itching. The respective figure of the other men was 5.3%. The difference was highly significant (<i>P</i>&lt;.001, even when adjusted for age). In women, 3.7% of those screened had a hemoglobin level under 12 g/dl and
Abstract 1105: MicroRNAs and their targets genes promote cisplatin resistance in epithelial ovarian cancer cells
Authors: Ileabett M. Echevarria Vargas, Fatma Valiyeva, Pablo Vivas-Mejía
Journal: Cancer Research (2012)

Abstract MicroRNAs (miRNAs) are 21-25 nucleotides regulatory involved in silencing mRNAs in a sequence specific manner. Accumulated data has established the central role of various microRNAs in tumor initiation and progression. Furthermore, recent studies revealed that microRNAs participate in the resistance of cancer cells to different chemotherapeutic agents. In ovarian carcinoma, the fifth cause of cancer deaths in US, it has been shown that several miRNAs contribute to drug resistance. However, the role of these miRNAs in the cisplatin resistance of ovarian cancer cells is unclear. In a microarray study, we found that miR-21, miR27b and miR-622 were upregulated in the A2780CP20 cisplatin resistant ovarian cancer cells compared with the A2780PAR cells, which are sensitive to cisplatin treatment. Real-time PCR studies confirmed these findings. Opposite, the c-Jun transcription factor was upregulated in this microarray analysis. Then, we used TargetScan and miRBase tools to identify miR-21, miR-27b and miR-622- target genes. Interestingly, several of these miRNA-target genes were identified as downregulated in our microarray study. These results were corroborated by Western blot analysis. Moreover, cell survival experiments in the presence of a miR-21 mimic, made A2780PAR cells more resistant to cisplatin treatment. These results indicate that dysregulation of various miRNAs and their target genes contribute to the cisplatin resistance of ovarian cancer cells. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 1105. doi:1538-7445.AM2012-1105
FILARIASIS ON THE ISLAND OF GUAM
Authors: GEORGE B. CROW
Journal: JAMA (1910)

Two months ago I found filariae in a stained smear of sedimented blood which had been drawn from one of the arm veins of a native at 10 a. m. Investigation soon showed that the filariae were present in the skin capillaries only at night, except that occasionally one or two would be found in a specimen obtained as late as 8 a. m. and sometimes as early as 5 p. m. They were most numerous near midnight. In size, structure and movements they were likeFilaria nocturna. Their presence in the blood drawn at 10 a. m. can be accounted for by the fact that a comparatively large quantity of blood was drawn (10 c.c) and from a large vein.  A systematic examination of natives from various parts of the island was begun at once. Up to date 244 persons have been examined and filariae were found in the
Three Cases of Suppuration Due to Fusiformis Infection
Authors: W. M. R. Henderson
Journal: BMJ (1953)

A " new " Rh antibody, which we propose to call anti-f, has been found in the serum of a man, Mr. Cl., aged 30, who suffers from haemophilia.Since childhood Mr. Cl.has received about 35 trans- fusions of blood, the last of which, in December, 1951, was followed by a shaking chill.He was seen by us, for the first time, in March, 1952,* when three blood- group antibodies were found in his serum-anti-B, anti- K, and anti-S.In addition there was at least one other unidentified antibody.In the hope of clarifying the
Relative effects of inhaled corticosteroids on immunopathology and physiology in asthma: a controlled study.
Authors: C. M. Burke, S. Sreenan, S. Pathmakanthan, J. Patterson, B. Schmekel, L. W. Poulter
Journal: Thorax (1996)

BACKGROUND: Although corticosteroids are recognised as the most efficacious treatment for bronchial asthma, their mode of action remains unclear. A placebo controlled trial was undertaken of the effect of inhaled corticosteroids on physiological and immmunopathological parameters in asthmatic patients in whom the correlations between these indices were tested after treatment. METHODS: Sixteen patients (two women) with asthma entered a double blind, placebo controlled, parallel study during which they inhaled either budesonide 800 micrograms twice daily or matching placebo for six weeks. Spirometric parameters and bronchial reactivity to histamine and terbutaline were measured and endobronchial biopsy samples were taken before and after treatment. Patients recorded morning and evening flow rates during the treatment period. The biopsy samples were subjected to immunohistological analysis to determine the disposition of inflammatory cells within the bronchial wall. RESULTS: Treatment with budesonide resulted in a significant improvement in the 25-75% forced expiratory flow (FEF25-75) from a mean of 133 l/min before treatment to 169 l/min after treatment, and in the morning peak expiratory flow rate (PEFR) from a mean of 384 l/min before treatment to 415 l/min after treatment. No changes were seen in the placebo group. Comparison between the changes in the immunopathological indices after six weeks of treatment with placebo or budesonide showed a significant reduction in the numbers of mast cells (0.5/unit area to 0.2/ unit area), activated eosinophils, and the expression of HLA-DR antigens (relative density -1.9 before to 1.02 after treatment) on inflammatory cells in response to treatment with budesonide. Although reductions in the numbers of other inflammatory cells within the bronchial wall were recorded using immunohistological analysis, these changes were not statistically significant. Significant correlations were found between changing immunological indices and lung physiology. CONCLUSIONS: This controlled study shows that inhaled corticosteroids cause improvement in physiological and immunopathological parameters in patients with stable asthma that are not seen with placebo, and that cause and effect relationships may exist between these two measures of disease status.