tbuckley/cabot-search huggingface dataset:
Evidence not ideology
Authors: L S Lewis
Journal: BMJ (2005)

Editor—I agree with Hart's contention that all evidence is conceived and perceived through an “ideology” (previous letter). Reading Marx made this clear to me, but other philosophers might use the more acceptable phrase “theory of knowledge.” The term “ideology” is currently (mis)used to imply a left wing or right wing political mindset that somehow prevents people from seeing the “objective evidence” for what it is—with the corollary (to which Godlee subscribes1) that those “neutrals” unencumbered by ideology could somehow be the more objective.

My political ideology is socialist. I prefer the NHS to the US system. But I believe that other systems—for example, the Swedish system—have some better features.

If the NHS contracts for secondary care—for example, cataract surgery—through self employed doctors in wholly owned secondary care doctor cooperatives, or private hospitals, how shall we describe it?

With regard to privatisation or subcontracting, the general practitioner subcontractor model was a very efficient saving grace of the state run NHS. I prefer that “socialised health care” should proceed in fair competition in the mixed economy of a free society, rather than the Stalinist alternative. I am certain that we are succeeding at it—which is the main reason why the new right is still scratching around for alternatives. It is still working.
Intense F-18 FDG Accumulation in Idiopathic Tumoral Calcinosis
Authors: Chio Okuyama, Takao Kubota, Shigenori Matsushima, Yo Ushijima, Tsunehiko Nishimura
Journal: Clinical Nuclear Medicine (2009)

An elderly Japanese woman presented to our hospital with a 5-month history of a growing mass on her right cheek. She did not complain of local pain, headache, hearing difficulty, or tinnitus. CT and MRI showed a dense calcified mass and F-18 fluorodeoxyglucose (FDG) PET demonstrated intense accumulation in the mass. Resection of the mass was performed and it was histologically diagnosed as idiopathic tumoral calcinosis.
SIXTEEN YEARS' EXPERIENCE WITH FORMIC ACID AS A THERAPEUTIC AGENT.
Authors: HEINRICH STERN
Journal: JAMA (1906)

My attention was first drawn to the medicinal qualities of formic acid by a semi-secret preparation styled by its manufacturer, Hensel, "Ferrum formicarum oxidatum oxydulatum." This was in 1888. The same or a similar preparation is now sold by a homeopathic drug house under the name of "Hensel's tonicum." <h3>HISTORICAL REVIEW.</h3> There is no doubt in my mind that Hensel's formic acid compound is a latter-day transformation of Hoffmann's "Vinegar of Magnanimity," in which a preparation of ants played the leading rôle. In the seventeenth century this famous vinegar had found entrance in all European courts and was employed by men and women as a general tonic, stomachic and diuretic, and probably also as an aphrodisiac. For formic acid seems to possess certain qualities stimulating sexual appetite (in South America a species of large ants are consumed), and the proprietary tonics demanding a good sale, as a general rule, are
HCV kinetics, quasispecies, and clearance in treated HCV-infected and HCV/HIV-1-coinfected patients with hemophilia
Authors: Norah J. Shire, Paul S. Horn, Susan D. Rouster, Sandra Stanford, M. Elaine Eyster, Kenneth E. Sherman
Journal: Hepatology (2006)

Hepatitis C virus (HCV) treatment response rates remain low in HCV/HIV-1-coinfected individuals compared with those with HCV alone. Persons with inherited coagulation disorders have high rates of HCV and HIV-1 infection, but HCV treatment trials in this patient population are scarce. We hypothesized that differences by infection status in HCV viral kinetics would be associated with differences in HCV quasispecies complexity over time and with treatment response disparities. Coinfected and monoinfected patients were enrolled in a treatment trial for pegylated-interferon alpha-2a (peg-IFN) + ribavirin. Patients were treated for 48 weeks and followed for an additional 24. Quantitative HCV RNA was tested at multiple times during and after treatment. Viral kinetic parameters associated with response were estimated with a mathematical model. Quasispecies emergence was determined via heteroduplex complexity assay. Twenty-two patients were HCV RNA-positive at baseline, with no significant demographic or virological differences by infection status. Five of eleven (45%) of monoinfected and 3 of 11 (27%) of coinfected patients achieved sustained viral response (SVR). Peg-IFN efficacy (ε) of 90% or greater was associated with probability of end-of-treatment response (ETR) (P = .001) and SVR (P = .06). Patients with SVR had lower baseline quasispecies complexity than those without SVR (P = .07). Those with ε of 90% or greater also had lower baseline complexity (P = .07). Coinfection status mediated changes in complexity over time (P = .04). In conclusion, low pretreatment quasispecies complexity may predict peg-IFN response; early peg-IFN response is critical for sustained HCV clearance and is altered in coinfection. Further studies are warranted. (HEPATOLOGY 2006;44:1146–1157.)
Impact of sending email reminders of the legal requirement for posting results on ClinicalTrials.gov: cohort embedded pragmatic randomized controlled trial
Authors: A. Maruani, I. Boutron, G. Baron, P. Ravaud
Journal: BMJ (2014)

<b>Objective</b> To evaluate the impact of sending an email to responsible parties of completed trials that do not comply with the Food and Drug Administration Amendments Act 801 legislation, to remind them of the legal requirement to post results. <b>Design</b> Cohort embedded pragmatic randomized controlled trial. <b>Setting</b> Trials registered on ClinicalTrials.gov. <b>Participants</b> 190 out of 379 trials randomly selected by computer generated randomization list to receive the intervention (personalized emails structured as a survey and sent by one of us to responsible parties of the trials, indirectly reminding them of the legal requirement and potential penalties for non-compliance). <b>Main outcome measures</b> The primary outcome was the proportion of results posted on ClinicalTrials.gov at three months. The secondary outcome was the proportion posted at six months. In a second step, two assessors blinded to the intervention group collected the date of the first results being received on ClinicalTrials.gov. A post hoc sensitivity analysis excluding trials wrongly included was performed. <b>Results</b> Among 379 trials included, 190 were randomized to receive the email intervention. The rate of posting of results did not differ at three months between trials with or without the intervention: 36/190 (19%) <i>v</i> 24/189 (13%), respectively (relative risk 1.5, 95% confidence interval 0.9 to 2.4, P=0.096) but did at six months: 46/190 (24%) <i>v</i> 27/189 (14%), 1.7, 1.1 to 2.6, P=0.014. In the sensitivity analysis, which excluded 48/379 trials (13%), 26/190 (14%) and 22/189 (12%), respectively, results were significant at three months (relative risk 5.1, 1.1 to 22.9, P=0.02) and at six months (4.1, 1.3 to 10.6, P=0.001). <b>Conclusions</b> Sending email reminders about the FDA’s legal requirement to post results at ClinicalTrials.gov improved significantly the posting rate at six months but not at three months. <b>Trial registration</b> ClinicalTrials.gov NCT01658254.
P08.26 * CEREBRAL DEEP WHITE MATTER - PROTECTED FROM BRAIN METASTASES?
Authors: C. Seidel, P. Hambsch, F. Friedrich, S. Rohde, R. Kortmann, C. Gaudino
Journal: Neuro-Oncology (2014)

INTRODUCTION: Brain metastases occur in up to 25% of patients with cancer. If there is a non-random intracerebral distribution is under debate. From pathoanatomic studies well vascularised areas at the border of white and grey matter are thought to be locations of preference of cerebral metastases. Vascular or nutritional constraints might restrict the origin of metastases in deep cerebral white matter. In our study we aimed to analyse if and how often brain metastases arise in deep white matter. METHODS: Pre-therapeutic MRI scans of patients with brain metastases from two different centres were analysed. MRI scans were screened by two experienced independent investigators (CS: Neurooncologist, CG: Neuroradiologist) for metastases that appeared to originate from regions of deep white matter (corpus callosum, semioval center). Metastases extending from grey substance, superficial gyrus or ventricles/ventricular lining into white matter were not classified as deep white matter metastases. RESULTS: MRI scans from 198 consecutive patients examined between 2004-2014 in both centres were analysed. 85 patients suffered from non-small-cell lung cancer (NSCLC), 32 patients from small-cell lung cancer (SCLC), 20 patients from breast cancer (BC), 19 from malignant melanoma (MM), 17 from renal cell carcinoma (RC), 10 from colorectal cancer (CRC) and 15 from other tumors. 70% of scans were performed in 3 Tesla scanners with a 3D dataset and slice thickness of 1-1,5 mm. Overall, 29 of 198 patients (14,6%) showed white matter metastases (WMM). 76 patients showed 1-2 metastases, 79 patients showed 3-9 metastases (oligometastatic) and 43 patients showed > 9 metastases (polymetastatic). In the group with 1-2 metastases only 3/76 patients (4%) had WMM, in the oligometastatic group 14/79 (18%) and in the polymetastatic group 12/43 (28%), p = 0,001, chi square). According to primary tumor the rates of patients with WMM were: RC (6/17, 35%), MM (3/19, 16%), SCLC (5/32, 16%), NSCLC (11/85, 13%), BC (1/20, 5%), CRC (0/10, 0%). In direct comparisons (chi-square) the rate in patients with RC was significantly higher than that of NSCLC (p = 0,024), BC (p = 0,019) and CRC (p = 0,033). Between the other entities there were no significant differences. Discussion: Metastasis in deep white matter appears relatively rare in mono-oligo intracerebral metastasis but gets more propable with increasing number of cerebral metastases. Even in polymetastatic cerebral disease only about one quarter of patients show deep white matter metastasis. This might be due to vascular constraints in deep white matter. Interestingly, patients with renal cell carcinoma had more often white matter metastasis, whereas in breast- or colorectal cancer WMM did very rarely occur. If differences in involvement of deep cerebral white matter reflect different vasculogenic mechanisms can only be speculated from our study.
Montefiore: The Hospital as Social Instrument, 1884-1984
Authors: William K. Beatty
Journal: JAMA (1985)

A group of New York philanthropists, looking for a way to honor Sir Moses Montefiore on his 100th birthday early in 1884, decided to establish the Montefiore Home for Chronic Invalids. This 26-bed home on the upper east side of Manhattan became, in the next century, the Montefiore Medical Center, with 40 buildings and 2,000 patients, located in the northern Bronx and known as a pioneer institution in the social and scientific aspects of medicine. The choice of a medically related institution to honor Sir Moses would have also pleased his friend and physician, Thomas Hodgkin. Montefiore's first medical director, Simon Baruch, added outstanding men to the staff and improved services. Thanks to donations from Jacob Schiff, President of the Board of Trustees, and Lyman Bloomingdale, Montefiore purchased a farm at Bedford Station and turned it into a tuberculosis sanatorium. Another strong director took charge in 1921. Ernst Boas saw
Environmental malignant mesothelioma in southern Anatolia: a study of fifty cases.
Authors: E H Zeren, D Gümürdülü, V L Roggli, S Zorludemir, M Erkişi, I Tuncer
Journal: Environmental Health Perspectives (2000)

Malignant mesothelioma is a highly aggressive tumor of the serous membranes, which in humans results from exposure to asbestos and asbestiform fibers. Although occupational malignant mesothelioma is still the most common form of this lesion, naturally contaminated soil can play an important role in the development of environmental malignant mesothelioma in some parts of the world. Fifty cases of malignant mesothelioma (MM) from southern Turkey with no occupational history of asbestos exposure were reviewed regarding pathologic and clinical features. A case of hyaline fibrous plaque of the pleura was also included in this series. Histologically the cases were classified as epithelial (36 cases); sarcomatous (7 cases); and biphasic (7 cases). One of the sarcomatous cases was desmoplastic. Ultrastructural examination of the tumor tissue in three cases revealed long-surface microvilli in epithelial cells. Interstitial cells of the lung in one case showed electron-dense asbestos fibers in the cytoplasm. Mineralogical analyses of the lung tissue in three cases of MM and the case of pleural plaque showed high amounts of asbestos fibers most consistent with tremolite and actinolite. The clinical and pathologic features of our cases support that the environmental inhalation of asbestos is still a major health problem in some parts of Turkey.
The Acute Abdomen for the Man on the Spot
Authors: John Raffensperger
Journal: JAMA (1969)

We have all been "on the spot" with an acute abdomen. Even though the author says the book is for the inexperienced surgeon, everyone from student to professor will enjoy and learn from this charming volume. It is written in a pleasing, chatty, discursive style. Although it is only 106 pages long, it has more practical clinical advice than many current surgical tomes. He starts off with hysterical patients, and how the patient's personality may obscure the correct diagnosis. He explains with personal insight why many of us don't always approach the patient objectively. He then goes on to describe in detail the clinical aspects of almost all the acute abdominal conditions encountered in adults. In this edition he has also included valuable bits of technical advice. Angell, writing from his own broad experience, emphasizes throughout the importance of the history and physical examination. In doubtful cases he rightfully advises
A PLEA FOE THE INTERNATIONAL STUDY OF CARCINOMA.
Authors: NICHOLAS SENN
Journal: JAMA (1906)

"Sed opertet privatis utilitatibus publicas, mortalibus æternas anteferre; multoque diligentius muneri suo consulere, quam facultatibus." <h3>INTRODUCTORY REMARKS.</h3><h3>Humanitarian Service.</h3> —From time immemorial the medical profession has been in search of ways and means to reduce the sum of human suffering in its efforts to prevent and treat disease. The physicians of all times, more than any other class of men, have devoted a large part of their time, talents and energies to promote the happiness, welfare and usefulness of their fellow-beings without any expectation of a pecuniary gain for their unselfish, self-imposed and often arduous task. The philanthropic spirit has always animated medical men and their organizations, large and small. A liberal part of the transactions of the medical societies throughout the entire civilized world is devoted to subjects which have a bearing on the prophylaxis of disease. The public will never realize the vast amount of work that has
New clinical developments in histone deacetylase inhibitors for epigenetic therapy of cancer
Authors: Shundong Cang, Yuehua Ma, Delong Liu
Journal: Journal of Hematology & Oncology (2009)

DNA methylation and histone acetylation are two well known epigenetic chromatin modifications. Epigenetic agents leading to DNA hypomethylation and histone hyperacetylation have been approved for treatment of hematological disorders. The first histone deacetylase inhibitor, vorinostat, has been licensed for cutaneous T cell lymphoma treatment. More than 11 new epigenetic agents are in various stages of clinical development for therapy of multiple cancer types. In this review we summarize novel histone deacetylase inhibitors and new regimens from clinical trials for epigenetic therapy of cancer.
REM and NREM mentation: Nielsen's model once again supports the supremacy of REM
Authors: M. Bosinelli, P.C. Cicogna
Journal: Behavioral and Brain Sciences (2000)

Nielsen's model presents a new isomorphic brain-mind viewpoint, according to which the sole dream generator is found in a REM-on (explicit or covert REM) mechanism. Such a model cannot explain the dreamlike activity during SWS (slow wave sleep), SO (sleep onset) and in the last period of sleep. Moreover the hypothesis contrasts with Solms's data, which show that dreaming is present also in case of destruction of the REM generator. [Nielsen; Solms]
PLASMA ANALYTES PREDICT FATAL CARDIOVASCULAR OUTCOME IN CORONARY ARTERY DISEASE PATIENTS
Authors: Reijo Laaksonen, Kim Ekroos, Matti Suoniemi, Kirill Tarasov, Terhi Vihervaara, Reini Hurme, Marcus Kleber, Winfried März, Efthymia Vlachopoulou, Maisa Lokki, Markku Nieminen, Juha Sinisalo
Journal: Journal of the American College of Cardiology (2014)
Design of a New Surgical Approach for Ventricular Remodeling to Relieve Ischemic Mitral Regurgitation
Authors: Noah Liel-Cohen, J. Luis Guerrero, Yutaka Otsuji, Mark D. Handschumacher, Lawrence G. Rudski, Patrick R. Hunziker, Hiroaki Tanabe, Marielle Scherrer-Crosbie, Suzanne Sullivan, Robert A. Levine
Journal: Circulation (2000)

Mechanistic insights from 3D echocardiography (echo) can guide therapy. In particular, ischemic mitral regurgitation (MR) is difficult to repair, often persisting despite annular reduction. We hypothesized that (1) in a chronic infarct model of progressive MR, regurgitation parallels 3D changes in the geometry of mitral leaflet attachments, causing increased leaflet tethering and restricting closure; therefore, (2) MR can be reduced by restoring tethering geometry toward normal, using a new ventricular remodeling approach based on 3D echo findings.We studied 10 sheep by 3D echo just after circumflex marginal ligation and 8 weeks later. MR, at first absent, became moderate as the left ventricle (LV) dilated and the papillary muscles shifted posteriorly and mediolaterally, increasing the leaflet tethering distance from papillary muscle tips to the anterior mitral annulus (P<0.0001). To counteract these shifts, the LV was remodeled by plication of the infarct region to reduce myocardial bulging, without muscle excision or cardiopulmonary bypass. Immediately and up to 2 months after plication, MR was reduced to trace-to-mild as tethering distance was decreased (P<0.0001). LV ejection fraction, global LV end-systolic volume, and mitral annular area were relatively unchanged. By multiple regression, the only independent predictor of MR was tethering distance (r(2)=0.81).Ischemic MR in this model relates strongly to changes in 3D mitral leaflet attachment geometry. These insights from quantitative 3D echo allowed us to design an effective LV remodeling approach to reduce MR by relieving tethering.
Nonosmolar Factors Affecting Renal Water Excretion
Authors: Robert W. Schrier, Tomas Berl
Journal: New England Journal of Medicine (1975)

THE pioneering work of Verney and his co-workers1 defined a very delicate mechanism that maintains the constancy of the osmotic pressure of body fluids by regulating the release of vasopressin. These investigators clearly showed that an increase in plasma osmotic pressure as small as 1 to 2 per cent by the intracarotid injection of hypertonic saline causes the release of an amount of vasopressin capable of dramatically decreasing renal water excretion.1 Conversely, the injection of a hypotonic solution into the carotid circulation has been shown to cause a prompt diuresis.2 These results have been used to . . .
ANTE-NATAL, NATAL, AND POST-NATAL PROBLEMS
Authors: W. H. F. Oxley
Journal: BMJ (1930)

and middle finigers in the vagina, touch the presciiting head.With the other hand the head should ld e str ongly pressed (downi illto the pelvis.If the head fits the pelvits it.will be felt to descen-d oin to the vaginal fingers, w-hile if there is jit]st a little tight fit there will be Ino (lescent.If the pelv-is should, however-, be defin-itelv con-tr-acted or the Itead enlarged, as in hydroceplialus, it will not only fail to descend, but on pressure fr-om abov-e will impinge oa the thuimb placed oni the pubis, thlus indicating the presence of definite overlapping.Sonietiinies, hiGowever, it will be difficult or even impossible to feel the pwresenting part at all, and in such a case, and especially in conjuinctionl with abdominal findings, the suspicion1 of a malpresentation is greatly strengtlhenied.Finallv, in the ciase in which a head appeared to be palpate( at the fundlus, a lhead may also be palpated below'.There are two possible explanations here: the first iml)ression may have beeni a mistaken one, and it may be a normal -ertex, or, again, it may be a case of twins.This may be the only sign of twini pregnancy, as in a lairge proportioni of these cases no un(lutie abdoininal distension is to be found.In such a case it may he that two fectal hearts beatinig at different speeds can be auscultated, and this should always be souglht for.In douibt in a case of this kind, or in othler cases sueli as suslected breech or suspected extended legs, ani x-ray plate should be ordeered.X rays constitute an everyd(lay and valTable adjunct to the othier form.s of plhsical diagnosis, but it must be used as an a(ljunic(t ancd never as a quick means of seeing that all is well witholt the trouble of detailed phvsical examiinationi.
The Place of Liver-Spleen Scanning in the Workup of Giant Secondary Cysts of the Spleen
Authors: MICHAEL F. HARTSHORNE, WILLIAM D. HEGGEN, LIDA CROOKS, MICHAEL A. CAWTHON, JOHN M. BAUMAN
Journal: Clinical Nuclear Medicine (1986)

An unusual, benign lesion of the spleen, the giant secondary cyst can be diagnosed by many imaging modalities, but the most helpful single test may be the liver-spleen scan. This study allows intelligent preoperative planning and postoperative assessment when splenic salvage is contemplated. Two cases illustrate this point.
Varying Carbohydrate Intake in NIDDM
Authors: Stephen Inkeles
Journal: JAMA (1994)

<h3>To the Editor.</h3> —The study design and results in the article by Dr Garg and colleagues<sup>1</sup>do not support their conclusion that most patients with NIDDM would benefit, at least in the short term, by preferentially consuming a diet high in monounsaturated fatty acids (45% of energy from fat, 40% from carbohydrate) in lieu of a diet high in complex carbohydrates (30% of energy from fat, 55% from carbohydrates). The uncontrolled energy manipulations in the middle of the trial vitiated the original experiment. In light of the changes in energy intake required of the study participants in order to maintain constant body weight, it is reasonable and more parsimonious to speculate that the plasma triglyceride changes observed in this trial might be attributed largely to energy restriction (especially carbohydrate energy restriction) in the higher-fat condition<sup>2</sup>and/or consumption of energy (specifically, the carbohydrate energy) in excess of appetite in
Stomach Wall Slough and Ulcer Perforation Following Endoscopic Injection Hemostasis with Polidocanol
Authors: K. Meissner, B. Jirikowski
Journal: Endoscopy (1993)

A case is reported of progressive inner layer slough of the stomach antrum resulting in free perforation following endoscopic injection hemostasis of ulcer bleeding using a total of 5 ml polidocanol. This rare complication necessitated gastric resection. Relevant etiologic factors favoring this type of tissue response to endoscopic treatment are discussed.
TCT-456 The Impact of Atherogenic Neointima on Long-term Clinical Outcomes: An Observational Study from the Optical Coherence Tomography Registry
Authors: Masaru Kuroda, Toshiro Shinke, Hiromasa Otake, Tomofumi Takaya, Masayuki Nakagawa, Hirotoshi Hariki, Tsuyoshi Ohsue, Yu Taniguchi, Masamichi Iwasaki, Ryo Nishio, Akihide Konishi, Hiroto Kinutani, Hachidai Takahashi, Daisuke Terashita, Ken-ichi Hirata
Journal: Journal of the American College of Cardiology (2013)