tbuckley/cabot-search huggingface dataset:
Why Patients Sock Unproven Cancer Remedies: A Psychological Perspective
Authors: J. C. Holland
Journal: CA A Cancer Journal for Clinicians (1982)

When it is discovered that cancer has recurred, patients experience a period of acute emotional distress, with increased anxiety, fear, helplessness, and depression. Well-meaning colleagues, friends, and relatives feel compelled to tell them about unorthodox cancer "cures." These unproven remedies tend to fit holistic health concepts purporting to enhance the body's own defenses; most involve the use of chemicals or drugs, nutritional supports, vitamins, vaccines, and mind-body techniques. In the past decade, laetrile has been the most popular unorthodox remedy. The distraught patient and family are deluged with information and have trouble evaluating what is valid. Physicians who treat patients with cancer should make sure that they themselves understand the emotional basis for a patient's need to pursue unorthodox remedies. The risk is heightened when the patient senses the doctor has "given up" and has "nothing more to offer." Patients should feel able to ask questions about unproven remedies without fear that the physician will be judgmental or punitive. Participation in a clinical trial of a new and promising treatment under investigation, within the full protection of ethical guidelines, should be suggested as an alternative to unproven treatments outside the medical system that are not subject to the same constraints.
Pennsylvania and North Carolina State Board Examinations in 1904.
Authors: J. Howell Way
Journal: JAMA (1905)

Waynesville, N. C., June 2, 1905. <h3>To the Editor:</h3> —InThe Journal, May 6, is published a very elaborate series of tables exhibiting in detail the results of the examinations held in the year 1904 in the various states for state license to practice medicine. These tables are very instructive, comprehensive and complete, and replete with much valuable information relative to the standards of medical education in the 63 medical colleges of the country whose graduates appeared before the various examining boards of the states. In 1904 there were examined for license in the separate states of the Union 8,034 graduated physicians, of which vast number 5,672 were granted license and 1,365 rejected—the gross percentage of failures being 19.3. Some of these were duplicates, of which the carefully prepared tables make no mention. I know that of recent years it has become more or less a custom for young physicians
Treatment of Graves' Disease
Authors: Robert D. Utiger
Journal: New England Journal of Medicine (1978)

Several forms of therapy are available for the treatment of hyperthyroidism, and judicious use of each is usually accompanied by gratifying relief of symptoms and restoration of the euthyroid state. What factors should be considered in the selection of therapy for an individual patient with hyperthyroidism?The first is its cause. In the vast majority of patients, hyperthyroidism is due to Graves' disease. Other causes include thyroid adenoma, multinodular goiter, subacute thyroiditis, excessive production of thyrotropin from the pituitary or thyrotropin-like substances by chorionic tumors and exogenous thyroid hormone administration, whether factitious or iatrogenic. Differentiating among them is not academic; . . .
SUDDEN PARALYSIS OF PHARYNX.ARTIFICIAL FEEDING FOR FOUR YEARS.
Authors: S. WEIR MITCHELL
Journal: JAMA (1906)

Rarely a single case is so interesting or so illustrative as to make it worth while to report it. The case I now contribute is, however, so extraordinary that I feel it to be a duty to put it on record. <h3>History.</h3> —Mrs. E. S., aged 27, married, of entire health and good personal and family history, had had measles, chickenpox, whooping-cough in childhood; later, several attacks of mild tonsillitis. At 17, it is said that she had a "typho-malarial" fever. None of these left any trace behind them. As to temperament, patient is of a rather quiet, sensible, unemotional nature. About eighteen months after her marriage, on May 18, 1901, she had a healthy confinement at the eighth month, without complications. Between this time and July 21, she declares that her health was absolutely perfect. <h3>Present Illness.</h3> —She went to bed the night of July 21, without sign of
Endothelial Dysfunction and Elevation of <i>S</i> -Adenosylhomocysteine in Cystathionine β-Synthase–Deficient Mice
Authors: Sanjana Dayal, Teodoro Bottiglieri, Erland Arning, Nobuyo Maeda, M. René Malinow, Curt D. Sigmund, Donald D. Heistad, Frank M. Faraci, Steven R. Lentz
Journal: Circulation Research (2001)

Abstract —Hyperhomocysteinemia is associated with increased risk for cardiovascular events, but it is not certain whether it is a mediator of vascular dysfunction or a marker for another risk factor. Homocysteine levels are regulated by folate bioavailability and also by the methyl donor S -adenosylmethionine (SAM) and its metabolite S -adenosylhomocysteine (SAH). We tested the hypotheses that endothelial dysfunction occurs in hyperhomocysteinemic mice in the absence of folate deficiency and that levels of SAM and SAH are altered in mice with dysfunction. Heterozygous cystathionine β-synthase–deficient (CBS +/– ) and wild-type (CBS +/+ ) mice were fed a folate-replete, methionine-enriched diet. Plasma levels of total homocysteine were elevated in CBS +/– mice compared with CBS +/+ mice after 7 weeks (27.1±5.2 versus 8.8±1.1 μmol/L; P &lt;0.001) and 15 weeks (23.9±3.0 versus 13.0±2.3 μmol/L; P &lt;0.01). After 15 weeks, but not 7 weeks, relaxation of aortic rings to acetylcholine was selectively impaired by 35% ( P &lt;0.05) and thrombomodulin anticoagulant activity was decreased by 20% ( P &lt;0.05) in CBS +/– mice. Plasma levels of folate did not differ between groups. Levels of SAH were elevated ≈2-fold in liver and brain of CBS +/– mice, and correlations were observed between plasma total homocysteine and SAH in liver ( r =0.54; P &lt;0.001) and brain ( r =0.67; P &lt;0.001). These results indicate that endothelial dysfunction occurs in hyperhomocysteinemic mice even in the absence of folate deficiency. Endothelial dysfunction in CBS +/– mice was associated with increased tissue levels of SAH, which suggests that altered SAM-dependent methylation may contribute to vascular dysfunction in hyperhomocysteinemia.
Ventricular Rate During Atrial Fibrillation Before and After Slow-Pathway Ablation
Authors: S. Adam Strickberger, Raul Weiss, Emile G. Daoud, Rajiva Goyal, Frank Bogun, K. Ching Man, Fred Morady
Journal: Circulation (1996)

Background Radiofrequency catheter modification of AV conduction can be used to control the ventricular rate during atrial fibrillation both in the baseline state and during exercise. Slow-pathway ablation has been suggested to be the mechanism for this response. The purpose of this study was to determine the effect of slow-pathway ablation on the ventricular rate in atrial fibrillation during autonomic blockade and sympathetic stimulation in patients with AV nodal reentrant tachycardia (AVNRT). Methods and Results Thirty-five patients undergoing slow-pathway radiofrequency ablation for AVNRT were assigned to autonomic blockade (0.2 mg/kg propranolol and 0.04 mg/kg atropine; n=14) or isoproterenol (2 μg/min; n=21). Atrial fibrillation was induced before and after slow-pathway radiofrequency ablation. During autonomic blockade, the mean ventricular cycle length (448±34 versus 525±103 ms, P &lt;.01) and maximum ventricular cycle length (640±105 versus 798±226 ms, P =.04) were prolonged after ablation, whereas the minimum ventricular cycle length did not change significantly (361±42 versus 403±83 ms, P =.05). During isoproterenol infusion, the mean ventricular cycle length (375±52 versus 390±61 ms, P =.2), maximum ventricular cycle length (520±88 versus 537±106 ms, P =.3), and minimum ventricular cycle length (307±59 versus 298±33 ms, P =.4) did not change significantly after slow-pathway ablation. Conclusions Slow-pathway ablation slows the ventricular rate during atrial fibrillation under conditions of autonomic blockade but not during sympathetic stimulation. Therefore, slow-pathway ablation alone cannot account for the clinical results obtained with radiofrequency modification of AV conduction in patients with atrial fibrillation.
Gonococcal Pharyngitis and Arthritis
Authors: Frank La Luna, Bertrand Agus
Journal: Annals of Internal Medicine (1971)

Letters, Comments, and Corrections1 October 1971Gonococcal Pharyngitis and ArthritisFRANK LA LUNA, M.D., BERTRAND AGUS, M.D.FRANK LA LUNA, M.D.Search for more papers by this author, BERTRAND AGUS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-75-4-649_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In the August 1970 issue Metzger described a case of gonococcal arthritis secondary to gonorrheal pharyngitis (Ann Intern Med 73:267-269, 1970). This was the first such case reported in the literature. We would like to add a similar case observed recently at Bellevue Hospital.Patient D.B., a 26-year-old negro woman, was admitted with complaints of fever, sore throat, shaking chills, and a painful, swollen right knee of 2 days' duration. There was a history of recent sexual contact. She denied symptoms of conjunctivitis, genitourinary complaints, previous arthritis, and venereal disease. The temperature was 103.2 F. Physical findings... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: FRANK LA LUNA, M.D.; BERTRAND AGUS, M.D. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byEpidemiology and Treatment of Oropharyngeal GonorrheaDAVID M. HUTT, M.D., FRANKLYN N. JUDSON, M.D.A Report of Four Cases and a Review of the LiteratureGonococcal diseaseClinical Spectrum of Pharyngeal Gonococcal Infection 1 October 1971Volume 75, Issue 4Page: 649-649KeywordsArthritisConjunctivitisFeversKneesPatient advocacyPharyngitisSexually transmitted diseasesTemperature ePublished: 1 December 2008 Issue Published: 1 October 1971 PDF downloadLoading ...
Sex Differences in Endothelial Function Markers Before Conversion to Pre-Diabetes: Does the Clock Start Ticking Earlier Among Women?
Authors: Richard P. Donahue, Karol Rejman, Lisa B. Rafalson, Jacek Dmochowski, Saverio Stranges, Maurizio Trevisan
Journal: Diabetes Care (2007)

We examined whether biomarkers of endothelial function, fibrinolysis/thrombosis and adiponectin, predict the progression from normal to pre-diabetes more strongly among women than men over 6 years of follow-up from the Western New York Health Study.In 2002-2004, 1,455 participants from the Western New York Health Study, who were free of type 2 diabetes and cardiovascular disease at baseline (1996-2001), were selected for reexamination. An incident case of pre-diabetes was defined as fasting glucose <100 mg/dl at the baseline examination and > or =100 and <126 mg/dl at the follow-up examination. Biomarkers of endothelial function (E-selectin and soluble intracellular adhesion molecule-1 [sICAM-1]), fibrinolysis/thrombosis (plasminogen activator inhibitor-1 [PAI-1]), and fasting insulin, adiponectin, and inflammation (high-sensitivity C-reactive protein) were measured in frozen (-190 degrees C) baseline samples.Multivariate analyses revealed higher adjusted mean values of biomarkers of endothelial dysfunction (E-selectin and sICAM-1) and fibrinolysis (PAI-1) and lower mean values of adiponectin only among women who developed pre-diabetes compared with control subjects. Formal tests for interaction between sex and case/control status were statistically significant for E-selectin (P = 0.042), PAI-1 (P = 0.001), sICAM-1 (P = 0.011), and frequency of hypertension (P < 0.001).These results support the concept that women who progressed from normoglycemia to pre-diabetes have greater endothelial dysfunction than men as well as more hypertension and a greater degree of fibrinolysis/thrombosis. Whether this relates to the higher risk of heart disease among diabetic women awaits further study.
Noise: hearing loss and psychological effects.
Authors: D Gloag
Journal: BMJ (1980)

After one of the noisiest nights I have ever spent, one morning in 1957 I saw banners being raised over the streets of Zurich bearing the words "Die riihige Stadt hat wenige kranken."But whether "the quiet city does have few ill people"-or the noisy one many sick-is harder to prove than the effects of noise on hearing.The damage to hearing caused by intense noise has micro- scopically visible effects on the inner ear and is related to the intensity, nature, and duration of the noise.'Studies of occu- pational hearing loss2 have led to scales of maximum noise exposure-for example, in Britain, 90 dB(A) average continuous noise (Leq see box) for eight hours per working day, or 96 dB(A) for two hours: this is known as the equal energy principle.Nevertheless, such levels are not safe especially if they extend over a working lifetime: in particular, individuals vary in their susceptibility to damage, and the effects of age and pathological conditions add substantially to those of noise.3The British code of practice emphasises that the limits are the "maximum on 20 August
When Choosing Statin Therapy
Authors: Jonas B. Green, Joseph S. Ross, Cynthia A. Jackevicius, Nilay D. Shah, Harlan M. Krumholz
Journal: JAMA Internal Medicine (2013)

The development of "Top 5" lists across specialties and at regular intervals can help to remind physicians that optimal care is often possible at a lower cost. For purposes of cardiovascular risk reduction, generic statins, or their brand equivalents if priced similarly, remain the appropriate choice for dyslipidemic patients initiating statin therapy. In this article, we review the evidence supporting the choice of generic statins.
Calcium Gluconate in Severe Verapamil Intoxication
Authors: Thomas F. Luscher, Georg Noll, Til Sturmer, Beat Huser, Markus Wenk
Journal: New England Journal of Medicine (1994)

To the Editor: Intoxication with verapamil is a serious and often fatal condition, complicated by severe hypotension and cardiac-conduction abnormalities1–4. The current therapeutic approach involves intravenous atropine, catecholamines, ventilation, and the insertion of a pacemaker. A 65-year-old woman treated with sustained-release verapamil for hypertension was admitted to our hospital in a coma (Glasgow coma score, 4). The blood pressure was 83/63 mm Hg, and the heart rate was 42 beats per minute (atrioventricular nodal rhythm with right bundle-branch block). The results of a routine drug screening were negative. Verapamil overdose was suspected, and gastric lavage was performed. The . . .
Respiratory Disease in the Immunosuppressed Host
Authors: Harry B. Greenberg
Journal: JAMA (1991)

Don't delay. Treat the patient empirically. Prompt antibacterial therapy, according to Walsh, Rubin, and Pizzo, is essential in granulocytopenic, immunosuppressed patients who have become febrile. Delaying their treatment may lead to septic shock and acute respiratory failure. The same contributors provide tables of appropriate antibiotics for monotherapy and for combined therapy. If the initial workup is not contributory and the patient does not respond favorably within two or three days, they propose invasive procedures such as bronchoalveolar lavage and transbronchial biopsy to make a specific bacterial diagnosis. When necessary, they advocate open lung biopsy. The 68 contributors to<i>Respiratory Disease in the Immunosuppressed</i>Host give a lot of attention to our defenses not only against bacterial and viral infection but also against the helminths, fungi, and protozoans in our environment. Masur cites the increasing incidence of<i>Pneumocystis carinii</i>pneumonia. Human<i>Pneumocystis</i>, he writes, has not been reproducibly cultured in vitro.
Pharmacists may be allowed to change prescriptions without consulting prescriber
Authors: M. McCartney
Journal: BMJ (2011)

The UK Medicines and Healthcare Regulatory Agency has announced a 12 week formal public consultation on the consolidation of UK drug legislation.

The agency says that current legislation is “outdated and fragmented” and that a simplified version is needed to replace the roughly 200 statutory instruments currently contained within the 850 pages of the Human Medicines Act 1968.

The consultation proposes policy changes “to ensure that medicines legislation remains fit for purpose and reflects modern practice.” Other drivers for the consultation include the government, which the agency has said “has made it a priority to minimise regulatory burdens …
Onan's Act
Authors: Gary D. Waldman
Journal: JAMA (1984)

To the Editor.—  Jorizzo et al 1 described an eczematous eruption of the penis attributable to increased frequency of masturbation. They called the condition frictional dermatitis of Onan .  In Genesis, Onan, son of Judah, failed to perform the duty of the levirate marriage, an ancient custom by which the brother-in-law must marry the childless widow. The eldest son of such a marriage would inherit the name and birthright of the deceased brother. And it came to pass when [Onan] went in unto his brother's wife that he spilled [his semen] on the ground lest he should give seed to his brother (Genesis 38:9). The Hebrew text implies that Onan practiced coitus interruptus, not masturbation.  A nosological entity may be associated with the name of the physician who described it (Porokeratosis of Mibelli) or, less commonly, with a patient afflicted by it (Hartnup disease). Although he was slain by the Lord for
Authors' reply to Laragh and Sealey
Authors: F. H. Messerli, H. Makani, S. Bangalore
Journal: BMJ (2013)

We agree with Laragh and Sealey that sodium and volume depletion increase the risk of adverse events of renin-angiotensin system blockade. Indeed, protection against hypotension due to volume depletion is one of the main physiological functions of the renin-angiotensin system in people with normal and high blood pressure.1 2

As the …
CLINICAL TRIAL OF A POTENTIATED DIKETOPIPERAZINE DERIVATIVE AS A PSYCHOPHARMACOLOGICAL AGENT FOR THE TREATMENT OF PSYCHOTIC PATIENTS
Authors: I. M. GERSON, E. CHAT, N. A. TWIGGER
Journal: American Journal of Psychiatry (1964)

A clinical study was made of potentiated diketopiperazine, the main ingredient of which is a new psychopharmocological agent; 4-(3,4-dimethoxyphenethyl)-2,6-piperazinedione, potentiated by a new sedative-hypnotic, 2-methyl-3-orthotolyl-4-quinazinolone. Combined molecules were used to treat 58 patients with non-organic psychoses at the Philadelphia State Hospital, classified with respect to behavioral patterns as agitated, paranoid, depressed or catatonic. A control group consisted of 43 psychotic patients, treated with various psychopharmacological drugs according to their specific clinical needs. The percentage of patients showing improvement was about the same in both groups (83% to 86% respectively) even though the potentiated diketopiperazine was given indiscriminantly without respect to type of cases. The diketopiperazine was most beneficial in the nonagitated cases, the best results obtained in cases classified as depressed or catatonic. This drug seemed to be completely free of untoward side effects. The results with diketopiperazine are highly encouraging, and further study may establish it as a useful drug in the treatment of various psychoses, particularly those which can be benefited by an antidepressant.
Children's heart surgery might restart at Leeds next week
Authors: C. Dyer
Journal: BMJ (2013)

Children’s cardiac surgery at Leeds General Infirmary may resume the week beginning 8 April if a full analysis of data and a review by independent expert clinicians over the weekend indicate that the service is safe.

A joint statement from Leeds Teaching Hospitals NHS Trust and NHS England said that agreement was reached on 4 April “to work together to restart surgery on the site early next week subject to independent assurance of concerns raised.”

The announcement follows a “risk summit” including representatives of the trust, NHS England, the NHS Trust Development Authority, and the Care Quality Commission. All …
Activation of the mammalian target of rapamycin signalling pathway in epidermal tumours and its correlation with cyclin-dependent kinase 2
Authors: S-J. Chen, T. Nakahara, M. Takahara, M. Kido, L. Dugu, H. Uchi, S. Takeuchi, Y-T. Tu, Y. Moroi, M. Furue
Journal: British Journal of Dermatology (2009)

The enzyme mammalian target of rapamycin (mTOR) integrates many different cellular signals to control cell growth and proliferation, protein synthesis and breakdown, and other processes. Dysregulation of mTOR is implicated in a range of human diseases, including cancers and cardiovascular disorders. To date, there has been no report on the expression of protein kinase B (AKT)/mTOR cell signalling in epidermal tumours.This study was designed to investigate the activation of the mTOR signalling pathway in epidermal tumours and to correlate this with cyclin-dependent kinase 2 (CDK2) expression.Immunohistological staining was performed with phosphorylated (p-) AKT, p-mTOR, p-4E-binding protein 1 (p-4EBP1), p-ribosomal protein S6 (p-S6), p-p70 ribosomal protein S6 kinase 1 (p-p70S6K1) and CDK2 in 15 cases each of seborrhoeic keratosis, actinic keratosis, keratoacanthoma and Bowen's disease (BD), and 25 cases of squamous cell carcinoma (SCC). Fifteen normal skin (NS) samples served as control.Among 85 tumours, 40 (47%) were positive for p-AKT, 31 (36%) for p-mTOR, 44 (52%) for p-4EBP1, 38 (45%) for p-S6, and 39 (46%) for p-p70S6K1. CDK2 immunostaining was positive in all cases of SCC and BD, and in 67% of benign tumours. All of these markers were stained much more frequently in malignant tumours than in benign tumours or NS. p-AKT, p-mTOR, p-4EBP1, p-p70S6K1 and p-S6 each showed high correlation with CDK2.Constitutive activation of the AKT/mTOR pathway was frequent in epidermal tumours, especially in malignant tumours. Activation was highly correlated with CDK2 expression, suggesting that the AKT/mTOR pathway may induce the malignant transition through CDK2 in epidermal tumours.
SILDENAFIL IN CONJUNCTION WITH ANGIOTENSIN-CONVERTING ENZYME INHIBITOR IS EFFECTIVE IN LIMITING INFARCT EXPANSION IN A PORCINE MODEL OF ANTERIOR MYOCARDIAL INFARCTION
Authors: Doo Sun Sim, Myung Ho Jeong, Yun Hyeon Kim, Song Choi, Hyun Kuk Kim, Sung Soo Kim, Jum Suk Ko, Min Goo Lee, Keun Ho Park, Hyun Ju Yoon, Nam Sik Yoon, Young Joon Hong, Hyung Wook Park, Ju Han Kim, Youngkeun Ahn, Jeong Gwan Cho, Jong Chun Park, Jung Chaee Kang
Journal: Journal of the American College of Cardiology (2010)