tbuckley/cabot-search huggingface dataset:
DIAGNOSIS OF EPIDEMIC AND SPORADIC INTERSTITIAL NEPHRITIS DUE TO HANTAAN-LIKE VIRUS IN BELGIUM
Authors: C. Van Ypersele De Strihou, J.M. Vandenbroucke, M. Levy, C. Doyen, J.P. Cosyns, G. Van Der Groen, J. Desmyter
Journal: The Lancet (1983)
Multiple Uptakes of Technetium-99m Methylene Diphosphonate in a Patient with Metastatic Osteosarcoma
Authors: S AMICO, P LUCAS, J C LIEHN, P HANNEQUIN, J VALEYRE
Journal: Clinical Nuclear Medicine (1985)

Tc-99m MDP bone scan was performed in a patient with metastatic osteosarcoma. Radionuclide uptake was present not only on the primary tumor but also in the thoracic area where metastatic deposits could be determined. The authors believe bone scan is an essential tool for initial evaluation of patients with osteosarcoma, a very helpful method for the patients survey, and a means of appreciating the evolution of the lung metastases and their response to therapy.
PRONOUNCE: Randomized, Open-Label, Phase III Study of First-Line Pemetrexed + Carboplatin Followed by Maintenance Pemetrexed versus Paclitaxel + Carboplatin + Bevacizumab Followed by Maintenance Bevacizumab in Patients ith Advanced Nonsquamous Non–Small-Cell Lung Cancer
Authors: Ralph G. Zinner, Coleman K. Obasaju, David R. Spigel, Robert W. Weaver, J. Thaddeus Beck, David M. Waterhouse, Manuel R. Modiano, Borys Hrinczenko, Petros G. Nikolinakos, Jingyi Liu, Andrew G. Koustenis, Katherine B. Winfree, Symantha A. Melemed, Susan C. Guba, Waldo I. Ortuzar, Durisala Desaiah, Joseph A. Treat, Ramaswamy Govindan, Helen J. Ross
Journal: Journal of Thoracic Oncology (2014)

IntroductionPRONOUNCE compared the efficacy and safety of pemetrexed+carboplatin followed by pemetrexed (Pem+Cb) with paclitaxel+carboplatin+bevacizumab followed by bevacizumab (Pac+Cb+Bev) in patients with advanced nonsquamous non–small-cell lung cancer (NSCLC).MethodsPatients ≥18 years of age with stage IV nonsquamous NSCLC (American Joint Committee on Cancer v7.0), and Eastern Cooperative Oncology Group performance status 0/1 were randomized (1:1) to four cycles of induction Pem+Cb (pemetrexed, 500 mg/m2, carboplatin, area under the curve = 6) followed by Pem maintenance or Pac+Cb+Bev (paclitaxel, 200 mg/m2, carboplatin, area under the curve = 6, and bevacizumab, 15 mg/kg) followed by Bev maintenance in the absence of progressive disease or discontinuation. The primary objective was progression-free survival (PFS) without grade 4 toxicity (G4PFS). Secondary end points were PFS, overall survival (OS), overall response rate (ORR), disease control rate (DCR), and safety. Resource utilization was also assessed.ResultsBaseline characteristics of the patients randomized to Pem+Cb (N = 182) and Pac+Cb+Bev (N = 179) were well balanced between the arms. Median (months) G4PFS was 3.91 for Pem+Cb and 2.86 for Pac+Cb+Bev (hazard ratio = 0.85, 90% confidence interval, 0.7–1.04; p = 0.176); PFS, OS, ORR, or DCR did not differ significantly between the arms. Significantly more drug-related grade 3/4 anemia (18.7% versus 5.4%) and thrombocytopenia (24.0% versus 9.6%) were reported for Pem+Cb. Significantly more grade 3/4 neutropenia (48.8% versus 24.6%), grade 1/2 alopecia (28.3% versus 8.2%), and grade 1/2 sensory neuropathy were reported for Pac+Cb+Bev. Number of hospitalizations and overall length of stay did not differ significantly between the arms.ConclusionsPem+Cb did not produce significantly better G4PFS compared with Pac+Cb+Bev. Pem+Cb was not superior in PFS, OS, ORR, or DCR compared with Pac+Cb+Bev. Both regimens were well tolerated, although, toxicity profiles differed.
Reply to Dr. C. J. B. Williams's Remarks on the Mechanism of the Sounds of the Heart
Authors: A. Leared
Journal: BMJ (1876)

THE BRITISh MEDICAL _OURNAL.707 caused such an idea not to be dwelt on, was the fear that malignant disease was present.It was remarkable how little disturbance there was to the general health while this great collection was fornming, and how it continued to augment the strength of its walls and fill the abdo- men, and not come in the least to work towards the surface.The his- tory of this other, somewhat similar tumour, I have not got.24.A middle-aged thin weak woman came under my charge in the hospi.al in 1872, with a deep fluctuant tumour over the caput ctecum.She hacl suffered pain in the part for some months, and had not been laid up till a few days before her admission, when the size of the swelling, the pain, and a feelinqg as if it would burst, caused her for the first timiie to keep her bed.She could bear no pressure over the swelling, and she kept her thigh bent on the pelvis to relieve it.There was some pain down the front and inner side of the thiglh, but no swvelling of the limb.Her bowels were very sluggish, but never wholly closel.Pus wxas clearly recogniised and its evacuation deter- mined on; but I bad to leave "own for a day, and the operatioin w-as delayed.The nurse had given her, at her own request, a dose of castor-oil, and, when she got up to stool during the night, she passed, witlhout effort or pain, about a quart of ill-smelliing pus and a little bloo(l.The swelling at once disappeared and the normal action of the bowel was restored.Pus continued to come witlh each motion during all her residence in the lhouse ; but, as the swelling did not reappear, and the pain and discomfcrt had ceased, she insisted on going home.25.A female past middle age sought advice at the dispensary of the Royal Infirmary during my service there, on accounlt of a fistulous orifice in her right groin, from which pus escaped freely.Slhe said it had resulted from the bursting of a large abscess which had formed (she believed following a kick) within her belly, deep in the right iliac fossa a year before, and whIich for sixteen days had caused her much suffering, and, as she alleged, entire constipation for nearly a week of that time.She stated that fxces had at first come away
Sex and haemodynamics in pulmonary arterial hypertension
Authors: C. E. Ventetuolo, A. Praestgaard, H. I. Palevsky, J. R. Klinger, S. D. Halpern, S. M. Kawut
Journal: European Respiratory Journal (2013)

Female sex is a risk factor for pulmonary arterial hypertension (PAH), yet females have better survival than males. We sought to determine if sex was associated with baseline haemodynamics in subjects with PAH, and whether age modified these relationships. We conducted a pooled analysis from 11 randomised trials submitted to the US Food and Drug Administration. The study sample included 1211 subjects with idiopathic PAH, 25% of whom were males, and 489 subjects with connective tissue disease-associated PAH, 13% of whom were males. After multivariable adjustment, right atrial pressure was 1.36 mmHg higher (95% CI 0.44–2.27, p=0.004), cardiac index was -0.14 L·min<sup>−1</sup>·m<sup>−2</sup> lower (95% CI -0.23–0.04, p=0.01) and pulmonary vascular resistance was 1.23 Wood units higher (95% CI 0.18–2.27, p=0.02) in males compared with females. Younger males had 5.43 mmHg (95% CI 2.20–8.66, p=0.001) higher mean pulmonary arterial pressures than younger females, but these relationships were attenuated after age 45 years. In the subgroup of connective tissue disease-associated PAH, males may have had higher right atrial pressure. These findings implicate age as a modifier and provide further evidence of sexual dimorphism in PAH.
Role of leukocytes in coronary vascular endothelial injury due to ischemia and reperfusion.
Authors: F M Sheridan, I M Dauber, I F McMurtry, E J Lesnefsky, L D Horwitz
Journal: Circulation Research (1991)

A possible cause of the coronary endothelial injury that occurs with ischemia and reperfusion is the local accumulation of leukocytes during these events. To investigate the role of leukocytes in coronary endothelial injury, we tested the effect of leukocyte removal by filtering on coronary endothelial function in a canine model of regional myocardial ischemia and reperfusion. Blood was supplied to the left anterior descending and circumflex arteries of anesthetized dogs via an extracorporeal circulation. A 60-minute left anterior descending occlusion was followed by 120 minutes of reperfusion either with (n = 6) or without (n = 6) leukocyte filters in the extracorporeal circuit. Regional myocardial blood flow was measured with radiolabeled microspheres. Radiolabeled autologous transferrin (113mIn) and erythrocytes (99mTc) were given intravenously during reperfusion for assessment of microvascular permeability. Left anterior descending and circumflex coronary artery rings were assessed in vitro for endothelium-dependent dilation to acetylcholine, ADP, and thrombin. In unfiltered dogs, ischemia and reperfusion increased the protein leak index of ischemic myocardium 2.3-fold compared with that of nonischemic myocardium (2.3 +/- 0.5 to 5.2 +/- 1.6, p less than 0.05). In filtered dogs, there was no difference in the protein leak index of nonischemic versus ischemic myocardium (1.5 +/- 0.4 versus 1.9 +/- 0.5, p = NS). There was impaired left anterior descending coronary artery relaxation (versus circumflex) in response to endothelium-dependent vasodilators in vitro. However, relaxation was not consistently improved by leukocyte filtering. We conclude that leukocytes are responsible for the endothelial injury secondary to ischemia and reperfusion in the coronary microvasculature but have little or no effect on the endothelial injury in epicardial coronary arteries.
Reply to Chandra Shekhar Biyani, Andy Myatt, Victor Palit, Neil Burgess and Adrian D. Joyce's Letter to the Editor re: Jean J.M.C.H. de la Rosette, Dedan Opondo, Francisco P.J. Daels, et al., on behalf of the CROES PCNL Study Group. Categorisation of Complications and Validation of the Clavien Score for Percutaneous Nephrolithotomy. Eur Urol 2012;62:246–55
Authors: Jean J.M.C.H. de la Rosette, Dedan Opondo
Journal: European Urology (2012)
GSK set aside $3.4bn in last quarter of 2010 to cover legal costs
Authors: J. H. Tanne
Journal: BMJ (2011)

GlaxoSmithKline has set aside $3.4bn (£2.1bn; €2.5bn) to cover legal costs in the fourth quarter of last year. That amount wipes out the company’s profit for the fourth quarter, the news agency Reuters has reported. However, a GSK spokeswoman said that she could not give sales projections as they would be reported on 3 February.

In July the company set aside $2.36bn to cover costs related to product liability cases settled or received at that time and other problems, bringing the …
Hereditary somnambulism in Dracula
Authors: E. L. Altschuler
Journal: Journal of the Royal Society of Medicine (2003)

I have noticed that Bram Stoker's Dracula1 (1897), a multifaceted classic, contains the first known discussion of hereditary somnambulism. Lucy Westenra (who eventually is killed, after becoming a vampire subsequent to having been bitten by Count Dracula) long had a habit of sleep-walking. Moreover Lucy's mother, Mrs Westenra, tells Mina Murray ‘... that her husband, Lucy's father, had the same habit [sleep-walking], that he would get up in the night and dress himself and go out, if he were not stopped.’ Sleep-walking runs in the Westenra family. The next2 description of a hereditary component of somnambulism is not until nearly a half century later. More recent studies (e.g. Ref. 3 and references therein) continue to find a hereditary component in somnambulism, though no gene for somnambulism has yet been found.

Dracula abounds with medical content and allusions—e.g. blood transfusions, diagnosis-based treatment, David Ferrier (1843-1928), and J-M Charcot (1825-1893). Also, two important figures in the book, John Seward and Professor Abraham Van Helsing, are physicians. Even the vampire legend itself, in Dracula and other stories, may well have a medical basis4,5 (both vampirism and rabies are infectious conditions characterized by general limbic system derangement in affected individuals, as well as biting and blood-seeking behaviour). Stoker spent orders of magnitude longer on Dracula than on any of his other literary projects—six years compared with a couple of months—and read widely. Besides being an author, Bram Stoker graduated from Trinity College Dublin with honours in mathematics, and worked as a civil servant and a manager for stage actors (Bram is short for Abraham, and one suspects that Stoker portrays himself in the eccentric, eclectic, and peripatetic genius Professor Van Helsing, who has not only an MD but also a DPh and a DLit and is a lawyer). Also, in writing Dracula Stoker was greatly influenced by Mary Shelley's Frankenstein which was itself imbued with the medical and scientific spirit of James Lind, MD, FRS (1736-1812) via his lectures and contact with Shelley and her husband6. It is not known whence or how Stoker came to appreciate the hereditary nature of somnambulism, or why he chose to include the seemingly non-essential detail in Dracula.
“Designed” grafts for HLA-haploidentical stem cell transplantation
Authors: Massimo F. Martelli, Mauro Di Ianni, Loredana Ruggeri, Antonio Pierini, Franca Falzetti, Alessandra Carotti, Adelmo Terenzi, Yair Reisner, Franco Aversa, Brunangelo Falini, Andrea Velardi
Journal: Blood (2013)
The Gift of Life: Recent Paintings by Sir Roy Calne (catalog with essays)
Authors: R. Dale Liechty
Journal: JAMA (1992)

A blend of science and art, The Gift of Life tells the story of Roy Calne, pioneer British transplant surgeon and artist. Only 70 pages long and with less text than the typical JAMA article is this catalog of Calne's paintings. (All proceeds go to the Children's Liver Fund at the University of Cambridge.)  Four countrymen—a medical editor and historian, a psychiatrist, an art curator, and the renowned artist John Bellany—pool their talents in a minibiography. But The Gift of Life is much more. Its pages sparkle with the vivid colors of Calne's paintings, from a still life to the icy, stark reality of patients recovering from liver transplantations.  What motivated this gifted surgeon to become an artist? Why did Calne, at the peak of his surgical career, commit himself to the brush and easel? Throughout medical school and his early years as a surgeon, Calne painted and sketched, although
NHS national programme for information technology
Authors: John Powell
Journal: BMJ (2004)

Editor—The resignation of Peter Hutton, from his position as chairman of the National Clinical Advisory Board of the National Programme for Information Technology (NPfIT), has highlighted the lack of clinicians' engagement with this £6bn project.

The advisory board represents a much needed injection of resources to NHS information technology systems, which could bring many benefits to care for patients and clinicians' working practices. The Wanless reports have emphasised the importance of information technology in the future of healthcare in the United Kingdom.1 A national programme could avoid the problems around interoperability associated with past failures in NHS information technology systems.

However, the secrecy surrounding the procurement phase of the programme has led to an increasing feeling of unease among clinician end users. Anxieties prevail about changes in working practices, usability of systems, training needs, and the possibility that political expediency will overshadow clinical needs.

Aidan Halligan, the deputy chief medical officer, has been charged with ensuring clinical engagement with the programme.2 The good news for the Department of Health comes from its survey, carried out by Medix, which shows that many doctors are enthusiastic about the potential of the national programme, with three quarters of respondents endorsing it as an important NHS priority.3

Only 4% of respondents thought, however, that they had been adequately consulted. The recently announced new Front Line Support Academy aims to correct omissions at the leadership level.4 But any programme of change management requires the involvement and commitment of all stakeholders. Consultation should not be limited to the select group of doctors with technical skills. The programme requires major changes in the ways all NHS professionals work, and the promised engagement should involve the “average” clinician in the “average” clinic.​clinic.




Figure 1



Credit: SOTIRIS ZAFERIS/SPL




There seem to be few plans to evaluate the programme, yet the required commitment from doctors will depend on showing benefits to patient care and the working lives of professionals. NHS workers “at the coalface” need to be convinced of the added value of electronic booking, electronic prescribing, and a national care records service.
502. GFP-Tagged Adeno-Associated Viral (AAV) Particles Allow the Study of Cytosolic and Nuclear Trafficking
Authors: Kerstin Lux, Stefanie Schlemminger, Luca Perabo, Daniela Goldnau, Jan Endell, Michael Hallek, Hildegard Buening
Journal: Molecular Therapy (2005)

In order to allow the direct visualization of the cellular trafficking of AAV and thereof derived vectors, we genetically incorporated enhanced green fluorescent protein (GFP) into the AAV capsid by substitution of wild-type VP2 with GFP-VP2 fusion proteins. Our cloning strategy resulted in highly infectious viral preparations minimizing thereby the risk of artefacts. In a first study GFP-VP2-AAV particles were used to investigate nuclear entry. A fast intracellular trafficking was observed and GFP-tagged virions were detected within minutes in the nuclear area of infected cells. In the absence of adenovirus 5 (Ad5) coinfection nuclear translocation was slow and inefficient: no GFP-VP2-AAV particles were detected within the nucleus at 2 hours (h) and 4 h post infection (p.i.). They remained in the perinuclear area and in nuclear membrane invaginations. The colocalization with nuclear invaginations is a phenomenon that was previously observed by Single Virus Tracing measurements (Seisenberger et al. 2001, Science 294. 1929-1932). Nuclear invaginations are long, tubular channels, derived from the nuclear envelope, which extend deeply into the nucleoplasm and are continuous with the cytoplasm. A plausible function of such invaginations is to increase the surface of the nuclear membrane and thereby facilitating the transport through nuclear pores. We are currently investigating the significance of this interesting localization for the AAV infection.
Public Accountability and Reporting Systems in Medicare and Other Health Programs
Authors: Paul M. Densen
Journal: New England Journal of Medicine (1973)

Abstract Public accountability embodies, in health care as in other fields, the principle that a government should be responsible to its constituency. The ability to meet that responsibility depends on the extent to which the government possesses information from which determinations about program operation and effectiveness can be made. The data must facilitate an accounting to various sectors of the public that bear the costs and feel the impacts of public programs. These data should reflect distributional and performance aspects of the system, and quality of services provided. Care must be exercised in determining which data are to be collected routinely and which are to be developed from special studies. Of equal importance are decisions about how and by whom data are to be collected. The experience gained in rendering a proper public accounting of the Medicare program should prove valuable for future programs of national health insurance. (N Engl J Med 289:401–406, 1973)
Questing for Circadian Dependence in ST-Segment–Elevation Acute Myocardial Infarction
Authors: Enrico Ammirati, Nicole Cristell, Domenico Cianflone, Anna-Chiara Vermi, Giancarlo Marenzi, Monica De Metrio, Neal G. Uren, Dayi Hu, Timothy Ravasi, Attilio Maseri, Carlo V. Cannistraci
Journal: Circulation Research (2013)

Rationale: Four monocentric studies reported that circadian rhythms can affect left ventricular infarct size after ST-segment–elevation acute myocardial infarction (STEMI). Objective: To further validate the circadian dependence of infarct size after STEMI in a multicentric and multiethnic population. Methods and Results: We analyzed a prospective cohort of subjects with first STEMI from the First Acute Myocardial Infarction study that enrolled 1099 patients (ischemic time &lt;6 hours) in Italy, Scotland, and China. We confirmed a circadian variation of STEMI incidence with an increased morning incidence (from 6:00 am till noon). We investigated the presence of circadian dependence of infarct size plotting the peak creatine kinase against time onset of ischemia. In addition, we studied the patients from the 3 countries separately, including 624 Italians; all patients were treated with percutaneous coronary intervention. We adopted several levels of analysis with different inclusion criteria consistent with previous studies. In all the analyses, we did not find a clear-cut circadian dependence of infarct size after STEMI. Conclusions: Although the circadian dependence of infarct size supported by previous studies poses an intriguing hypothesis, we were unable to converge toward their conclusions in a multicentric and multiethnic setting. Parameters that vary as a function of latitude could potentially obscure the circadian variations observed in monocentric studies. We believe that, to assess whether circadian rhythms can affect the infarct size, future study design should not only include larger samples but also aim to untangle the molecular time–dynamic mechanisms underlying such a relation.
New roles for thalidomide
Authors: R J Powell
Journal: BMJ (1996)

A unique anti-inflammatory, but use it only when no alternatives exist 

Thalidomide was synthesised in 1954 at Chemie Grunenthal, Germany. Four years later it was marketed as a sedative. It was considered a particularly safe drug, as even massive doses (up to 10 000 mg/kg) failed to kill laboratory rodents. Recognition in 1960 of its neuropathic potential, and in 1961 of its devastating teratogenic effects, led to the product licence being revoked in many countries, including Britain. However, use has continued in many countries around the world, and in Britain on the “named patient” basis. A clinical guideline for its safe use has been published.1

No single mechanism has been identified which could account for all the clinical effects of thalidomide. It is an anti-inflammatory, immunomodulant drug, not an immunosuppressant. It acts on phagocytic cells and endothelial cells but has no direct effect on T lymphocytes. Specifically it modulates blood monocyte cytokine synthesis, particularly tumour …
IL-21 is the primary common γ chain-binding cytokine required for human B-cell differentiation in vivo
Authors: Mike Recher, Lucinda J. Berglund, Danielle T. Avery, Morton J. Cowan, Andrew R. Gennery, Joanne Smart, Jane Peake, Melanie Wong, Sung-Yun Pai, Sachin Baxi, Jolan E. Walter, Umaimainthan Palendira, Gillian A. Tangye, Michael Rice, Shannon Brothers, Waleed Al-Herz, Hans Oettgen, Hermann Eibel, Jennifer M. Puck, Federica Cattaneo, John B. Ziegler, Silvia Giliani, Stuart G. Tangye, Luigi D. Notarangelo
Journal: Blood (2011)
PERFORATION OF UTERUS BY HYDATIDIFORM MOLE
Authors: H. E. Bowles
Journal: JAMA (1941)

Since perforation of the uterus by a hydatidiform mole is an extremely rare condition, it is felt that the presentation of the following account is justified. In both Lord's<sup>1</sup>case in 1868 and Seitz's<sup>1</sup>in 1904 the outcome was fatal. Then followed a series of cases in which treatment by supracervical hysterectomy was successful. One was reported each by Waldo<sup>2</sup>in 1910, Harkness<sup>1</sup>in 1921, Krellenstein<sup>3</sup>in 1924, Mazet<sup>4</sup>in 1926 and Kallinikoff<sup>5</sup>in 1928. Kallinikoff's patient was a multipara under the age of 25, as was Johannson's<sup>6</sup>patient in 1929, who died after hysterectomy. Bland's<sup>7</sup>patient in 1927, a nullipara aged 30, died fourteen months after the original operation following exploration of a recurrent chorioepithelioma. The first operation was performed at a time when the hydatid mole was undergoing malignant change. Gizowski<sup>8</sup>reported another patient with such a uterine