tbuckley/cabot-search huggingface dataset:
Sickle Cell Disease and the “Difficult Patient” Conundrum
Authors: Edward J. Bergman, Nicholas J. Diamond
Journal: The American Journal of Bioethics (2013)

The convergence of sickle cell disease's unique political, historical, cultural, medical, and psychological dimensions begets an especially distressing plight for sufferers of the disease. Too often, this convergence results in sickle cell patients being classified as "difficult." As Autumn Fiester recently argued, traditional understanding of the "difficult" patient warrants reevaluation. By acknowledging the nuanced dimensions of sickle cell disease, we identify barriers to care particular to the disease, which further substantiate the need to redefine orthodox notions of the "difficult" patient. We support development of mechanisms in both health care provider education and third-party consultation support by the Ethics Consultation Service, or by other appropriately designated specialists, to respect the manifold dimensions of sickle cell disease as a necessary step toward the enhancement of clinical care for sickle cell patients.
Cytokine response after severe respiratory syncytial virus bronchiolitis in early life
Authors: Mario Castro, Toni Schweiger, Huiquing Yin-DeClue, Thiruvamoor P. Ramkumar, Chandrika Christie, Jie Zheng, Rebecca Cohen, Kenneth B. Schechtman, Robert Strunk, Leonard B. Bacharier
Journal: Journal of Allergy and Clinical Immunology (2008)
Serial antipyrine clearance studies detect altered hepatic metabolic function during spontaneous and interferon-induced changes in chronic hepatitis B disease activity
Authors: Stephen J. Williams, Geoffrey C. Farrell
Journal: Hepatology (1989)

The present study was performed to establish whether sequential determinations of antipyrine clearance, using a simplified two-point test, are sensitive and specific indicators of changes in chronic hepatitis B disease activity. Sixteen patients were studied on four or more occasions during 18 to 30 months. Eleven patients were treated with recombinant human α-interferon (2.5, 5.0 or 10 × 10 6 per m 2 , intramuscularly, three times per week, for 24 weeks), and five patients were untreated controls. Among seven patients, (six interferon-treated and one control) who lost hepatitis B e antigen from serum, antipyrine clearance improved by 46% (range: 20 to 160%) from 0.37 ± 0.14 ml per kg per min (mean ± S.D.) to 0.54 ± 0.13 ml per kg per min, p &lt; 0.005. This change paralleled the loss of symptoms and reduction of serum ALT levels (from 206 ± 189 IU per liter (mean ± S.D.) to 38 ± 12 IU per liter, p &lt; 0.005). Conversely, antipyrine clearance declined to previous levels when reactivation of chronic hepatitis B with reappearance of HBeAg in serum occurred. Regardless of changes in hepatitis B serology, when serum ALT values fluctuated by more than 20% (presumed to reflect fluctuations in necroinflammatory activity of the liver disease), antipyrine clearance also changed whereas serum albumin and bilirubin concentrations and prothrombin time did not. It is concluded that antipyrine clearance is a more sensitive and specific parameter than conventional indices for assessing hepatic metabolic function during changes in chronic hepatitis B disease activity. Remission in disease with loss of HBeAg from serum is associated with improved hepatic metabolic function as determined by the antipyrine clearance test.
Identification of Intrathoracic Hemorrhage with Tc???99m Sulfur Colloid
Authors: F W SANCHEZ, J W REINIG, G T BAILEY, R P GOBIEN, I VUJIC
Journal: Clinical Nuclear Medicine (1984)

Tc-99m sulfur colloid has been shown to be accurate in the detection of intrapulmonary bleeding (1,2). The present example demonstrates the usefulness of Tc-99m sulfur colloid in identifying an unusual manifestation of intrathoracic hemorrhage.
Posttraumatic Stress Symptoms in Victims of Childhood Incest
Authors: Francine Albach, Walter Everaerd
Journal: Psychotherapy and Psychosomatics (1992)

The relationship between posttraumatic stress disorder (PTSD) and the experience of severe childhood incest was investigated in a comparison of 97 adult female victims of incest and 65 matched controls. It appeared that 62% of the incest victims and none of the controls met the DSM-III-R criteria for PTSD. The best predictor for the development of PTSD appeared to be the subjective reaction at the time of the event, consisting of anxiety, freezing and dissociation. The incest victims also displayed other psychiatric symptoms, such as self-mutilation and conversions. Although the relation incest-PTSD is quite obvious, the diagnosis may easily be missed because the symptoms may be masked by other psychiatric phenomena.
The Presence of Alzheimer's Disease in a Community Population
Authors: Lissy F. Jarvik
Journal: JAMA (1990)

To the Editor.—  The intriguing results reported from the study in East Boston by Evans et al 1 raise a number of concerns regarding their public health implications. 2 Some data already in the literature support the high prevalence rates, eg, in the first US prospective study of the development of dementia in community residents, 3-5 the prevalence of dementia (all degrees, from mild to severe) was 48% (N = 52) for those aged 80 years and older. 3 This result, obtained in New York State from a small group of surviving twins, who had been followed up for 25 years or more, is remarkably similar to that from the East Boston study, 1 as well as those of the much older Scandinavian epidemiologic studies, 6,7 in which dementia was reported for 47% (N = 55) and 48% (N = 175) of those aged 80 years or older.  Dementia due to vascular conditions
Case 12-1975
Authors: Denise J. Strieder, Gerald Nash
Journal: New England Journal of Medicine (1975)

Presentation of CaseA 17-month-old boy was admitted to the hospital because of respiratory difficulty.He had experienced four attacks of otitis media, two episodes of bronchitis and one of croup. During the two months before admission he lost 0.5 kg in weight. He was otherwise well until two weeks before entry, when a cough and wheezing developed. Epinephrine was ineffective, and he was admitted to another hospital, where he was given erythromycin. A tuberculin Tine test was negative. Ten days before entry he was discharged on erythromycin therapy. Four days later fever developed, and the cough and respiratory difficulty . . .
Letter: Removal of potassium from fruit juices by ion exchange.
Authors: G J Van Kamp, W Bakker, J G Rosier
Journal: BMJ (1975)

<h3>Abstract</h3> TENT4A (PAPD7) is a non-canonical poly(A) polymerase, of which little is known. Here we show that TENT4A regulates multiple biological pathways, and focus on its multilayer regulation of translesion DNA synthesis (TLS), in which unrepaired DNA lesions are bypassed by error-prone DNA polymerases. We show that TENT4A regulates mRNA stability and/or translation of DNA polymerase η and RAD18 E3 ligase, which guides the polymerase to replication stalling sites, and monoubiquitinates PCNA, thereby enabling recruitment of error-prone DNA polymerases to damaged DNA sites. Remarkably, in addition to the effect on RAD18 mRNA stability via controlling its poly(A) tail, TENT4A indirectly regulates RAD18 via the tumor suppressor CYLD, and via the long non-coding antisense RNA <i>PAXIP1-AS2</i>, which had no known function. Knocking down the expression of <i>TENT4A</i> or <i>CYLD</i>, or overexpression of <i>PAXIP1-AS2</i> led each to reduced amounts of the RAD18 protein and DNA polymerase η, leading to reduced TLS, highlighting <i>PAXIP1-AS2</i> as a new TLS regulator. Bioinformatics analysis revealed that TLS error-prone DNA polymerase genes and their <i>TENT4A</i>-related regulators are frequently mutated in endometrial cancer genomes, suggesting that TLS is dysregulated in this cancer.
Edema and Telangiectasia of the Chest Caused by Neuroendocrine Carcinoma
Authors: Francesco Lacarrubba, Maria Rita Nasca, Barbara Cammisuli, Giuseppe Micali
Journal: JAMA Dermatology (2015)

Superior vena cava (SVC) syndrome includes a constellation of signs and symptoms resulting from SVC obstruction that produces elevated pressure in the afferent veins and increased blood flow through collateral vessels.
The Year Book of Drug Therapy (1960-1961 Year Book Series)
Authors: John R. Lewis
Journal: JAMA (1961)

This book, one of a series of annual publications, contains 2 sections, the first of which is entitled "A Critical Evaluation of The Year's New Drugs," and includes comments on more than 200 new drugs. The title of this section is somewhat misleading since only the composition of some drugs is given and the comments on many others are based primarily on analogies with similar drugs; thus, although the book is written primarily for the practicing physician, this section would be of limited value to him as a source of "critical" information on the efficacy of a new drug. The second section consists of abstracts of selected articles published during the preceding year. These articles report comparative effectiveness, evaluation, side effects, and toxic reactions of drugs or new treatments. The abstracts are occasionally followed by pertinent comments of the editor. This section would be of interest to physicians, pharmacologists or
Novel Minicircle Vector for Gene Therapy in Murine Myocardial Infarction
Authors: Mei Huang, ZhiYing Chen, Shijun Hu, Fangjun Jia, Zongjin Li, Grant Hoyt, Robert C. Robbins, Mark A. Kay, Joseph C. Wu
Journal: Circulation (2009)

Background— Conventional plasmids for gene therapy produce low-level and short-term gene expression. In this study, we develop a novel nonviral vector that robustly and persistently expresses the hypoxia-inducible factor-1 alpha (HIF-1α) therapeutic gene in the heart, leading to functional benefits after myocardial infarction. Methods and Results— We first created minicircles (MC) carrying double-fusion reporter gene consisting of firefly luciferase and enhanced green fluorescent protein (Fluc-eGFP) for noninvasive measurement of transfection efficiency. Mouse C2C12 myoblasts and normal FVB/N mice were used for in vitro and in vivo confirmation, respectively. Bioluminescence imaging showed stable MC gene expression in the heart for &gt;12 weeks and the activity level was 5.6±1.2-fold stronger than regular plasmid at day 4 ( P &lt;0.01). Next, we created MC carrying HIF-1α (MC-HIF-1α) therapeutic gene for treatment of myocardial infarction. Adult FVB/N mice underwent left anterior descending ligation and were injected intramyocardially with: (1) MC-HIF-1α; (2) regular plasmid carrying HIF-1α (PL-HIF-1α) as positive control; and (3) PBS as negative control (n=10/group). Echocardiographic study showed a significantly greater improvement of left ventricular ejection fraction in the MC group (51.3%±3.6%) compared to regular plasmid group (42.3%±4.1%) and saline group (30.5%±2.8%) at week 4 ( P &lt;0.05 for both). Histology demonstrated increased neoangiogenesis in both treatment groups. Finally, Western blot showed MC express &gt;50% higher HIF-1α level than regular plasmid. Conclusion— Taken together, this is the first study to our knowledge to demonstrate that MC can significantly improve transfection efficiency, duration of transgene expression, and cardiac contractility. Given the serious drawbacks associated with most viral vectors, we believe this novel nonviral vector can be of great value for cardiac gene therapy protocols.
Halothane-Induced Liver Damage — An Entity
Authors: Burton Combes
Journal: New England Journal of Medicine (1969)

THERE is considerable controversy about whether hepatic injury is induced by exposure to halothane. In support of the existence of such an entity are reports in the literature by 1967 of approximately 400 cases of liver damage after halothane anesthesia.1 In general, the reaction was severe, with death the outcome in approximately a third of the patients. Symptoms and signs, with fever a prominent feature, usually appeared within the first week after the most recent exposure to the anesthetic, but at times delayed for two or three weeks. Physical findings and results of laboratory tests resembled those found in many . . .
Epigenetic Changes Induced by Air Toxics: Formaldehyde Exposure Alters miRNA Expression Profiles in Human Lung Cells
Authors: Julia E. Rager, Lisa Smeester, Ilona Jaspers, Kenneth G. Sexton, Rebecca C. Fry
Journal: Environmental Health Perspectives (2010)

BackgroundExposure to formaldehyde, a known air toxic, is associated with cancer and lung disease. Despite the adverse health effects of formaldehyde, the mechanisms underlying formaldehyde-induced disease remain largely unknown. Research has uncovered microRNAs (miRNAs) as key posttranscriptional regulators of gene expression that may influence cellular disease state. Although studies have compared different miRNA expression patterns between diseased and healthy tissue, this is the first study to examine perturbations in global miRNA levels resulting from formaldehyde exposure.ObjectivesWe investigated whether cellular miRNA expression profiles are modified by formaldehyde exposure to test the hypothesis that formaldehyde exposure disrupts miRNA expression levels within lung cells, representing a novel epigenetic mechanism through which formaldehyde may induce disease.MethodsHuman lung epithelial cells were grown at air–liquid interface and exposed to gaseous formaldehyde at 1 ppm for 4 hr. Small RNAs and protein were collected and analyzed for miRNA expression using microarray analysis and for interleukin (IL-8) protein levels by enzyme-linked immunosorbent assay (ELISA).ResultsGaseous formaldehyde exposure altered the miRNA expression profiles in human lung cells. Specifically, 89 miRNAs were significantly down-regulated in formaldehyde-exposed samples versus controls. Functional and molecular network analysis of the predicted miRNA transcript targets revealed that formaldehyde exposure potentially alters signaling pathways associated with cancer, inflammatory response, and endocrine system regulation. IL-8 release increased in cells exposed to formaldehyde, and results were confirmed by real-time polymerase chain reaction.ConclusionsFormaldehyde alters miRNA patterns that regulate gene expression, potentially leading to the initiation of a variety of diseases.
Yersinia and chronic glomerulopathy in the savannah region of Nigeria.
Authors: J Vandepitte, G Wauters
Journal: BMJ (1983)

Disciplinary attitudes and cigarette smoking: a comparison of two schools SIR,-I agree with Dr Alan Porter's suggestion (1 1 December, p 1725) that measures that reduce the exposure of an uncommitted adolescent to peer group smoking may de- crease the chances of tobacco dependence in childhood.The recognition of the immediate rather than long term harmful effects of smoking is an important consideration in persuading patients not to smoke, and parental attitudes and smoking behaviour influence a child's propensity to smoke.'Most smokers begin smoking before the age of 20, and those who have not smoked before this age are un- likely to begin.2 3 Our unpublished data on the effects of smoking on cardiorespiratory dis- orders suggest that smoking does much more harm to younger patients than to middle aged patients and that-over the age of 60 there is no difference between smokers and non-smokers.This suggests that a preventive approach must be directed at those in the first two decades of life and "no smoking" should become a family affair in view of the fact that young people are much less likely to smoke when neither parent does.
Androgen insufficiency in women: diagnostic and therapeutic implications
Authors: L.M. Rivera-Woll, M. Papalia, S.R. Davis, H.G. Burger
Journal: Human Reproduction Update (2004)

The proposed key symptoms of the female androgen insufficiency syndrome (FAIS) include reduced libido, diminished well being and lowered mood. The diagnosis of FAIS is made on the basis of these symptoms in the setting of a low serum free testosterone level. However, there is currently no readily available inexpensive assay which reliably measures free testosterone levels in the female range. The diagnosis of FAIS is further complicated by the lack of data demonstrating a minimum serum free testosterone level which, if below this, correlates with the symptoms of FAIS. Despite the complexities involved with defining FAIS, the symptoms have been reported to respond well to testosterone replacement. There is a need for formulations of testosterone therapy specifically designed for use in women, along with clear guidelines regarding optimal therapeutic doses and long-term safety data.
Rare hemoglobinopathy presenting as progressive dyspnea: Response to letter
Authors: Yin Wu, Maria R. Baer
Journal: American Journal of Hematology (2011)

To the Editor: We thank Professor Bain for her comments on our report of our patient with hemoglobin Louisville presenting as progressive dyspnea [1]. Professor Bain is of course correct that the diagnosis was made by DNA sequencing and not by high-performance liquid chromatography. Professor Bain's observation of the small irregular peak representing degraded variant hemoglobin is informative, and this will be something to look for in future patients. By way of update, our patient has continued red blood cell exchange therapy approximately every 2 months for the last 2 years and her dyspnea has completely resolved. Her 6-month-old grandson, son of her son with hemoglobin Louisville, was recently hospitalized for hypoxemia in the setting of a respiratory syncytial virus infection, and was also found to have a microcytic anemia. Hemoglobin electrophoresis showed 89% hemoglobin A, 6% hemoglobin F, and 5% hemoglobin A2 and was interpreted as consistent with beta thalassemia minor. We are certain that this baby also has hemoglobin Louisville, and hemoglobin DNA sequencing is in progress. Yin Wu*, Maria R. Baer*, * Department of Medicine Greenebaum Cancer Center University of Maryland Baltimore, Maryland 21201.
Rheumatoid Arthritis: Evolving Concepts of Pathogenesis and Treatment
Authors: JOHN L. DECKER
Journal: Annals of Internal Medicine (1984)

Rheumatoid arthritis is a chronic inflammatory synovitis that primarily involves peripheral diarthrodial joints. Immunohistologic analysis of diseased synovium has shown a spectrum of abnormalities that resemble various stages of a cell-mediated, or delayed-type, immune reaction. The infiltrating mononuclear cells produce various factors that modulate adjacent tissues and appear to produce the characteristic destructive features of the disorder. Our understanding of the mechanisms of action of various therapeutic modes also indicates that the disease is primarily mediated by activated mononuclear cells. All effective therapies have been shown to affect either mononuclear cell function or the rates of production or elimination of these cells. The disorder likely represents the pathologic expression of a genetically controlled host immune response to an undefined causative stimulus. The stimulus could be an infectious agent(s), a product(s) derived from an infectious agent(s), a constituent(s) of synovial or connective tissue, or a combination of these.
PRIMARY MALIGNANT ENDOTRACHEAL TUMOR.PRELIMINARY REPORT.
Authors: JUDSON DALAND
Journal: JAMA (1904)

This case is of interest from not less than three standpoints: First, that of the physician, because of the importance and extreme difficulty of diagnosis; second, that of the surgeon, because the treatment is purely operative, and third, that of the pathologist, not only because of the rarity of malignant growths in this situation, but because of the histologic structure of this tumor. This paper is directed especially to the pathology. Primary tumor of the trachea is exceedingly rare, and, according to Scheuer,<sup>1</sup>but 22 per cent. of these are primary malignant growths. Sir Morell Mackenzie,<sup>2</sup>after sixteen years of experience, saw but four cases of tracheal tumor, and it is probable that but one or two of these were primary and malignant. Only twenty-eight cases of this disease are reported, most of which were discovered at autopsy in Germany or Austria.
A Critical Overview of Homeopathy
Authors: Giovanni Federspil, Fabio Presotto, Roberto Vettor
Journal: Annals of Internal Medicine (2003)

Letters21 October 2003A Critical Overview of HomeopathyGiovanni Federspil, MD, Fabio Presotto, MD, and Roberto Vettor, MDGiovanni Federspil, MDFrom University of Padua Medical School Padova I-35128, Italy.Search for more papers by this author, Fabio Presotto, MDFrom University of Padua Medical School Padova I-35128, Italy.Search for more papers by this author, and Roberto Vettor, MDFrom University of Padua Medical School Padova I-35128, Italy.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-8-200310210-00026-w3 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Jonas and colleagues (1) sought to critically appraise homeopathy. This issue, along with the spread of other alternative medical therapies in western countries, is very important because it places all of scientific medicine in doubt (2). Jonas and colleagues' paper only partially describes homeopathyit does not define the historical origin of this doctrine and discusses only its pharmacologic and therapeutic aspects.Homeopathy was born in the 18th and 19th centuries, when medical systems, such as the doctrine of John Brown in England, dominated Europe. According to medical systems, each pathologic phenomenon consists of 2 opposing concepts (for ...References1. Jonas WB, Kaptchuk TJ, Linde K. A critical overview of homeopathy. Ann Intern Med. 2003;138:393-9. [PMID: 12614092] LinkGoogle Scholar2. Antiseri D, Federspil G, Scandellari C. 2003 Epistemologia, clinica medica e la questione delle medicine eretiche. Rubettino Editore Catanzaros, Italy. Google Scholar3. Federspil G, Vettor R. [The homeopathy problem in contemporary medicine]. Ann Ital Med Int. 1999;14:172-84. [PMID: 10566183] MedlineGoogle Scholar4. Hempel CG. 1966 Philosophy of Natural Science. Prentice-Hall Englewood Cliffs, NJ. Google Scholar5. Federspil G, Vettor R. Can scientific medicine incorporate alternative medicine? J Altern Complement Med. 2000;6:241-4. [PMID: 10890333] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Padua Medical School Padova I-35128, Italy. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoA Critical Overview of Homeopathy Wayne B. Jonas , Ted J. Kaptchuk , and Klaus Linde A Critical Overview of Homeopathy Flvio Dantas , Peter Fisher , and Hagen Rampes A Critical Overview of Homeopathy Renan M.V.R. Almeida Metrics Cited byMedical Crowdfunding for Scientifically Unsupported or Potentially Dangerous Treatments 21 October 2003Volume 139, Issue 8Page: W-75KeywordsClinical trialsDrug therapyDrugsHomeopathy ePublished: 21 October 2003 Issue Published: 21 October 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Sacredness in an experimental chamber
Authors: Vladimir A. Lefebvre
Journal: Behavioral and Brain Sciences (2006)

I focus on the problem of whether a specific biologic basis exists for reinforcing the power of money. I argue in favor of its existence based on a new interpretation of data obtained in experiments with pigeons and rats in an experimental chamber. The experiments demonstrated that in the animals' behavior we can observe some features that had been considered pertinent to human beings only, such as making certain sources of utility “sacred.”