tbuckley/cabot-search huggingface dataset:
What the Good Book Says about Doctors.
Authors: C. M. Fenn
Journal: JAMA (1896)

San Diego, Cal., May 26, 1896. <h3>To the Editor:</h3> —In these days of Christian science, substitution(?), faith healing, proprietary medicines,<i>et id genus omne</i>, it is refreshing to recall the language of our ancient friend Ecclesiasticus, quoted verbatim from the 38th chapter of his sensible treatise. (I know not why it was relegated to the apocrypha.) Hear him. Honor a physician with the honor due unto him for the uses which ye may have of him; for the Lord hath created him. For of the Most High cometh healing, and he shall receive honor of the King. The skill of the physician shall lift up his head: and in the sight of great men he shall be in admiration. The Lord hath created medicines out of the earth: and he that is wise will not abhor them. Was not the water made sweet with wood that the virtue thereof might
Ultrafine Particles: Geiser et al. Respond
Authors: Marianne Geiser, Barbara Rothen-Rutishauser, Nadine Kapp, Peter Gehr, Samuel Schürch, Wolfgang Kreyling, Holger Schulz, Manuela Semmler, Joachim Heyder, Vinzenz Im Hof
Journal: Environmental Health Perspectives (2006)
Antigen Receptor Engagement Turns off the V(D)J Recombination Machinery in Human Tonsil B Cells
Authors: Eric Meffre, Fotini Papavasiliou, Paul Cohen, Odette de Bouteiller, Diana Bell, Hajime Karasuyama, Claudine Schiff, Jacques Banchereau, Yong-Jun Liu, Michel C. Nussenzweig
Journal: The Journal of Experimental Medicine (1998)

The germinal center (GC) is an anatomic compartment found in peripheral lymphoid organs, wherein B cells undergo clonal expansion, somatic mutation, switch recombination, and reactivate immunoglobulin gene V(D)J recombination. As a result of somatic mutation, some GC B cells develop higher affinity antibodies, whereas others suffer mutations that decrease affinity, and still others may become self-reactive. It has been proposed that secondary V(D)J rearrangements in GCs might rescue B cells whose receptors are damaged by somatic mutations. Here we present evidence that mature human tonsil B cells coexpress conventional light chains and recombination associated genes, and that they extinguish recombination activating gene and terminal deoxynucleotidyl transferase expression when their receptors are cross-linked. Thus, the response of the recombinase to receptor engagement in peripheral B cells is the opposite of the response in developing B cells to the same stimulus. These observations suggest that receptor revision is a mechanism for receptor diversification that is turned off when antigen receptors are cross-linked by the cognate antigen.
THE MATAS OPERATION FOR THE RADICAL CURE OF ANEURISM, AS APPLIED IN TWO CASES OF RUPTURED ANEURISM.
Authors: J. A. DANNA
Journal: JAMA (1905)

The procedure described by Dr. Rudolph Matas<sup>1</sup>has attracted widespread attention, and has been tried in a number of successful cases, recently reported, sufficiently to prove its merit as a permanent and notable advance in the surgical treatment of aneurism. It is still, however, a comparatively new and untried method, and all clinical reports which bear on its application in atypical conditions should be instructive and profitable to the practical surgeon. Presuming that the reader is familiar with the original procedure described by Dr. Matas, I will limit my remarks to two cases of aneurism of the fusiform type which came under my observation in the Charity Hospital. In each instance, the aneurism had ruptured into the subcutaneous and intermuscular spaces before I was called to operate on the patient. On account of existing conditions, I deemed it expedient to depart in some details from the technic recommended by the
THE SURGICAL TREATMENT OF CROUP.Read in the Section of Laryngology and Otology, at the Fort-first Annual Meeting of the American Medical Association, Nashville, Tenn, May, 1890.
Authors: F. E. WAXHAM
Journal: JAMA (1890)

When medical treatment has been thoroughly tested and it is evident that the patient must die from asphyxia unless relieved, then we must meet the emergency by surgical measures. A nice question of judgment often arises as to the proper time for interfering surgically. When shall we abandon all hope of saving the patient by medical means, and when shall we know that the child will perish unless given prompt relief? In answer to these queries I would say that when the voice becomes whispering, when the cough becomes suppressed, when in addition the dyspnœa becomes urgent, and the loud stridor heard both on inspiration and expiration, and when there is marked recession at the base of the sternum and above the clavicles—when all these symptoms are present and continuous, and not relieved by the use of emetics, it is certainly time to operate. I do not advise and do
Doctors furious at plans to transfer them to non-NHS provider
Authors: M. Gould
Journal: BMJ (2009)

The BMA and health unions have criticised plans to “privatise” frontline primary and community services, which would see 1500 workers lose NHS employee status, including doctors, nurses, and dentists.

They say that NHS Hull, which runs primary care services in the city, has forced through plans to turn the entire provision part of its work over to City Health Care Partnership, a community interest company, which is run commercially.

Laurence Buckman, chairman of the BMA’s General Practitioners Committee, said, “Hull GPs are extremely concerned that patient services are going to be undermined by backdoor privatisation.”

A BMA survey shows that nine out …
Comparison of the fetal and adult functional B cell repertoires by analysis of VH gene family expression.
Authors: H D Jeong, J M Teale
Journal: The Journal of Experimental Medicine (1988)

The functional B cell repertoire in BALB/c mice was assessed at various stages in ontogeny. This was done by analyzing VH gene family expression using the sensitive technique of in situ hybridization. The B cell repertoire was probed with the mitogen, LPS, and the antigen DNP. DNP was chosen because B cells responsive to this hapten appear very early in ontogeny. The APCs that developed after stimulation with LPS or DNP were analyzed for VH gene expression by in situ hybridization of individual cells using radiolabeled VH gene family probes. The results indicated that VH gene expression in fetal B cells after stimulation was distinct from adult B cells in that there was a biased expression of D proximal families. The results indicated that this bias was associated with developmental age and not a given differentiation stage in the B cell lineage. In addition, stimulation of fetal B cells with DNP resulted in a large increase in expression of member(s) of VH 36-60, suggesting that the early appearance of DNP-responsive B cells is not strictly correlated with preferential rearrangement of D proximal families, VH 7183 and VH Q52. However, the results suggested that a large proportion of pre-B cells that preferentially rearrange D proximal families early in ontogeny become part of the functional developing repertoire.
MicroRNA Regulation of Glycoprotein B5R in Oncolytic Vaccinia Virus Reduces Viral Pathogenicity Without Impairing Its Antitumor Efficacy
Authors: Mina Hikichi, Minoru Kidokoro, Takeshi Haraguchi, Hideo Iba, Hisatoshi Shida, Hideaki Tahara, Takafumi Nakamura
Journal: Molecular Therapy (2011)

Vaccinia virus, once widely used for smallpox vaccine, has recently been engineered and used as an oncolytic virus for cancer virotherapy. Their replication has been restricted to tumors by disrupting viral genes and complementing them with products that are found specifically in tumor cells. Here, we show that microRNA (miRNA) regulation also enables tumor-specific viral replication by altering the expression of a targeted viral gene. Since the deletion of viral glycoprotein B5R not only decreases viral pathogenicity but also impairs the oncolytic activity of vaccinia virus, we used miRNA-based gene regulation to suppress B5R expression through let-7a, a miRNA that is downregulated in many tumors. The expression of B5R and the replication of miRNA-regulated vaccinia virus (MRVV) with target sequences complementary to let-7a in the 3'-untranslated region (UTR) of the B5R gene depended on the endogenous expression level of let-7a in the infected cells. Intratumoral administration of MRVV in mice with human cancer xenografts that expressed low levels of let-7a resulted in tumor-specific viral replication and significant tumor regression without side effects, which were observed in the control virus. These results demonstrate that miRNA-based gene regulation is a potentially novel and versatile platform for engineering vaccinia viruses for cancer virotherapy.
Shortage of junior staff
Authors: P. Hawker
Journal: BMJ (1986)

<h3>Background:</h3> Disturbance of the sleep–wake cycle is a characteristic of delirium. In addition, changes in melatonin rhythm influence the circadian rhythm and are associated with delirium. We compared the effect of melatonin and placebo on the incidence and duration of delirium. <h3>Methods:</h3> We performed this multicentre, double-blind, randomized controlled trial between November 2008 and May 2012 in 1 academic and 2 nonacademic hospitals. Patients aged 65 years or older who were scheduled for acute hip surgery were eligible for inclusion. Patients received melatonin 3 mg or placebo in the evening for 5 consecutive days, starting within 24 hours after admission. The primary outcome was incidence of delirium within 8 days of admission. We also monitored the duration of delirium. <h3>Results:</h3> A total of 452 patients were randomly assigned to the 2 study groups. We subsequently excluded 74 patients for whom the primary end point could not be measured or who had delirium before the second day of the study. After these postrandomization exclusions, data for 378 patients were included in the main analysis. The overall mean age was 84 years, 238 (63.0%) of the patients lived at home before admission, and 210 (55.6%) had cognitive impairment. We observed no effect of melatonin on the incidence of delirium: 55/186 (29.6%) in the melatonin group v. 49/192 (25.5%) in the placebo group; difference 4.1 (95% confidence interval −0.05 to 13.1) percentage points. There were no between-group differences in mortality or in cognitive or functional outcomes at 3-month follow-up. <h3>Interpretation:</h3> In this older population with hip fracture, treatment with melatonin did not reduce the incidence of delirium. Trial registration: Netherlands Trial Registry, NTR1576: MAPLE (Melatonin Against PLacebo in Elderly patients) study; www.trialregister.nl/trialreg/admin/rctview.asp?TC=1576
Reduction of gastric hyperemia by glypressin and vasopressin administration in cirrhotic patients with portal hypertensive gastropathy
Authors: Julián Panés, Josep M. Piqué, Josep M. Bordas, Josep Llach, Jaime Bosch, Josep Terés, Juan Rodés
Journal: Hepatology (1994)

Gastric mucosal perfusion is increased in portal-hypertensive gastropathy, and this may contribute to gastric bleeding from these lesions. Therefore drugs reducing gastric mucosal perfusion may be beneficial in the treatment of overt bleeding from portal-hypertensive gastropathy. In this study gastric mucosal perfusion was assessed in 28 cirrhotic patients with portal-hypertensive gastropathy under basal conditions and after double-blind intravenous administration of vasopressin (0.4 U/min), glypressin (2-mg injection) or placebo, with laser-Doppler flowmetry and reflectance spectrophotometry. Vasopressin and glypressin induced a significant increase in blood pressure and a decrease in heart rate. These effects were more pronounced in the vasopressin group. Both vasopressin and glypressin induced a sustained and similar reduction in gastric mucosal perfusion as assessed by laser-Doppler flowmetry (-36% +/- 8% and -34% +/- 6%, respectively; p < 0.05 with respect to basal values and with respect to the control group), whereas placebo had no effect. Both drugs significantly reduced the oxygen content of the gastric mucosa; however, the impairment in mucosal oxygenation was greater (p < 0.05) in the vasopressin group (-17% +/- 3%) than in the glypressin group (-6% +/- 0.1%). We conclude that the increased gastric perfusion in cirrhotic patients with portal-hypertensive gastropathy may be reduced by either vasopressin or glypressin. These findings support the use of these drugs in clinical trials treating bleeding portal-hypertensive gastropathy. The lower reduction in gastric mucosal oxygen content observed with glypressin could decrease the incidence of ischemic adverse events associated with the use of vasopressin.
Nonsteroidal Antiinflammatory Drugs, Acetaminophen, and the Risk of Cardiovascular Events
Authors: Andrew T. Chan, JoAnn E. Manson, Christine M. Albert, Claudia U. Chae, Kathryn M. Rexrode, Gary C. Curhan, Eric B. Rimm, Walter C. Willett, Charles S. Fuchs
Journal: Circulation (2006)

Although randomized trials of cyclooxygenase-2 (COX-2) inhibitors have shown increased cardiovascular risk, studies of nonselective, nonsteroidal antiinflammatory drugs (NSAIDs) and acetaminophen have been inconsistent.We examined the influence of NSAIDs and acetaminophen on the risk of major cardiovascular events (nonfatal myocardial infarction, fatal coronary heart disease, nonfatal and fatal stroke) in a prospective cohort of 70,971 women, aged 44 to 69 years at baseline, free of known cardiovascular disease or cancer, who provided medication data biennially since 1990. During 12 years of follow-up, we confirmed 2041 major cardiovascular events. Women who reported occasional (1 to 21 d/mo) use of NSAIDs or acetaminophen did not experience a significant increase in the risk of cardiovascular events. However, after adjustment for cardiovascular risk factors, women who frequently (> or =22 d/mo) used NSAIDs had a relative risk (RR) for a cardiovascular event of 1.44 (95% CI, 1.27 to 1.65) compared with nonusers, whereas those who frequently consumed acetaminophen had a RR of 1.35 (95% CI, 1.14 to 1.59). The elevated risk associated with frequent NSAID use was particularly evident among current smokers (RR=1.82; 95% CI, 1.38 to 2.42) and was absent among never smokers (Pinteraction=0.02). Moreover, we observed significant dose-response relations: Compared with nonusers, the RRs for a cardiovascular event among women who used > or =15 tablets per week were 1.86 (95% CI, 1.27 to 2.73) for NSAIDs and 1.68 (95% CI, 1.10 to 2.58) for acetaminophen.Use of NSAIDs or acetaminophen at high frequency or dose is associated with a significantly increased risk for major cardiovascular events, although more moderate use did not confer substantial risk.
Reply to M.C. Chamberlain et al
Authors: Paul W. Sperduto, Norbert Kased, David Roberge, Zhiyuan Xu, Ryan Shanley, Xianghua Luo, Penny K. Sneed, Samuel T. Chao, Robert J. Weil, John Suh, Amit Bhatt, Ashley W. Jensen, Paul D. Brown, Helen A. Shih, John Kirkpatrick, Laurie E. Gaspar, John B. Fiveash, Veronica Chiang, Jonathan P.S. Knisely, Christina Maria Sperduto, Nancy Lin, Minesh Mehta
Journal: Journal of Clinical Oncology (2012)

An Accurate and Facile Diagnosis-Specific Tool to Estimate Survival for Patients With Brain Metastases." 2We not only largely agree with their comments but have included them in the article.As we explicitly stated in our article, our analysis was retrospective and has the inherent weaknesses of any retrospective study.We remind readers that the Graded Prospective Assessment (GPA) was originally designed from prospective data from four Radiation Therapy Oncology Group (RTOG) trials, and then was later refined to be diagnosis specific. [3]4][5] Chamberlain and Silbergeld 1 suggest that the survival by treatment in Table 2 of our article is problematic.Point three in our discussion section states: "Indeed, the survival by treatment data shown in Table 2 is certainly fraught with selection bias and should not be blindly applied or expected.Nonetheless, these data reflect patterns of care for patients with brain metastases over the last quarter century." 2(p424) Furthermore, the multivariate Cox regression analysis that we performed for Table 2 was stratified by institution; hence, the treatment differences reflected the average differences across 11 institutions that may have different institutional policies with respect to modality of therapy.Therefore, the result is more generalizable than it would be if the analysis was based on just one institution.We also agree with the comment by Chamberlain and Silbergeld 1 that a retrospective study does not supplant a prospective study, specifically RTOG 9508. 6 We (P.W.S., L.E.G., and M.P.M.) are authors of that study and are familiar with its findings.Furthermore, that study is currently undergoing reanalysis to evaluate whether its conclusions might vary if post stratified by the Diagnosis-Specific Graded Prognostic Assessment (DS-GPA) rather than the Recursive Partitioning Analysis.We would disagree, however, with the contention of Chamberlain and Silbergeld 1 that retrospective data provide "little guidance with respect to the best treatment of BM for specific clinical scenarios."The DS-GPA can aid, but certainly not replace, clinical judgment when a clinician, patient, and family are making treatment choices.Finally, we agree that the DS-GPA is an improvement over the RTOGRecursivePartitioningAnalysisclassificationandthattheDS-GPA should be validated in prospective trials.That validation is already underway.The DS-GPA has been adopted for purposes of stratification in two prospective, randomized, RTOG clinical trials (1118 and 1119).
Mechanistic considerations for carcinogenic risk estimation: chloroform.
Authors: R H Reitz, T R Fox, J F Quast
Journal: Environmental Health Perspectives (1982)

Chloroform has been reported to induce cancer in rodents after chronic administration of high doses by gavage. However, the interpretation of these findings is hampered by a lack of knowledge concerning the relative roles of genetic and nongenetic mechanisms in these bioassays. The present studies were carried out in male B6C3F1 mice in order to investigate the potential of chloroform to induce genetic damage and/or organ toxicity at the sites where tumors have been observed in the various bioassays. These studies revealed that carcinogenic doses of chloroform produced severe necrosis at the sites where tumors later developed. This was demonstrated by light microscopy as well as by determination of the cellular regeneration index following administration of 3H-thymidine. Noncarcinogenic doses of chloroform failed to induce these responses. In contrast, studies of DNA alkylation and DNA repair in vivo failed to give any indication that chloroform had produced the type of genetic alterations associated with known genotoxic chemicals. These data suggest that the primary mechanism of chloroform-induced carcinogenesis is nongenetic in nature. If the same mechanism predominates in man, there should be little to no carcinogenic risk associated with exposure to noncytotoxic levels of chloroform.
Molecular analysis of major histocompatibility complex alleles associated with the lupus anticoagulant.
Authors: F C Arnett, M L Olsen, K L Anderson, J D Reveille
Journal: Journal of Clinical Investigation (1991)

Autoantibodies to phospholipids (APA) occur frequently in systemic lupus erythematosus (SLE) and other autoimmune disorders and predispose to intravascular thromboses. Major histocompatibility complex (MHC) class II alleles (HLA-DR and DQ) were determined by restriction fragment length polymorphisms (RFLP) in 20 patients with APA (lupus anticoagulant). HLA-DQw7 (DQB1*0301), linked to HLA-DR5 and -DR4 haplotypes, occurred in 70% and was significantly increased compared to 139 race-matched normal controls (P = 0.002, P corrected [pc] = 0.05, odds ratio [OR] = 5.1). Moreover, the frequency of HLA-DQw7 was significantly higher in SLE patients with APA as compared with patients without APA but with other autoantibodies, including anti-Ro and La (P = 0.0001, pc = 0.002, OR = 10.7), anti-Ro alone (P = 0.001, pc = 0.02, OR = 11.2), anti-dsDNA (P = 0.001, pc = 0.02, OR = 7.1), and possibly anti-Sm (P = 0.04, pc = NS, OR = 6.8) and anti-nRNP (U1-RNP) (P = 0.01, pc = NS, OR = 7.8). The DQB1*0301 allele of DQw7 showed the strongest association, while the frequencies of the DQA1*0301 (45%) and DQA1*0501 (50%) alleles did not differ from the controls. Among the HLA-DQB1*0301 (DQw7) negative patients, all possessed HLA-DQw8 (DQB1*0302) and/or HLA-DQw6 (DQB1*0602 or DQB1*0603) alleles. The HLA-DQB1*0301 chain shares an identical seven amino acid sequence with DQB1*0302, *0602, and *0603 chains in the third hypervariable region of the HLA-DQ molecule. This candidate "epitope" may play a role in mediating an autoimmune response to APA.
Pyelonephritis in Young Women
Authors: John Parker
Journal: JAMA (1973)

Follow-up was conducted on 74 of 163 women admitted to hospitals in Madison, Wis, for pyelonephritis. Admission occurred between 1950 and 1960 when the women were from 15 to 35 years old. Clinical illness in most patients began in association with marriage, pregnancy, or the postpartum period. Repeat episodes of infection occurred within three years of follow-up in 29 (40%) of the patients and within six months in 16 (23%). Twelve (17%) were bacteriuric at the time of follow-up. Twenty-one (28%) had had an operative urologic procedure; 17 (23%) had a history of renal stone. Elevated blood pressure was found in only 10 (14.5%). One patient had died of complications of pyelonephritis, one had required renal transplantation for end-stage renal disease, and two other patients had azotemia. Seven patients had undergone unilateral nephrectomy for pyelonephritis, but most were doing well at the time of follow-up.
In-Patient Treatment of Mothers with Depressive Disorders – Does Joint Admission of Their Children Have a Negative Effect on the Results of Treatment?
Authors: Marius Nickel, Cerstin Nickel, Karin Tritt, Claas Lahmann, Peter Leiberich, Moritz Muehlbacher, Christoph Egger, Wolfhardt Rother, Thomas Loew
Journal: Psychotherapy and Psychosomatics (2005)

&lt;i&gt;Background:&lt;/i&gt; There is disagreement whether in-patient psychotherapeutic treatment results for women whose children are cohospitalised with them would be better if the mothers were hospitalised without children. The purpose of this study was to examine this question in the case of mothers with depressive symptoms. &lt;i&gt;Methods:&lt;/i&gt; The treatment results for 43 female in-patients (21 with and 22 without accompanying children) in a prospective, randomised, controlled study were compared. The period of observation was 6 weeks. The Beck Depression Inventory (BDI) and the Changes in Experience and Behaviour Questionnaire (VEV) were used for outcome measures. &lt;i&gt;Results:&lt;/i&gt; At 6 weeks, according to the intent-to-treat principle, neither the VEV (p = 0.58) nor the BDI (p = 0.57) yielded significant differences between mothers whose children were admitted jointly and mothers whose children were not.&lt;i&gt; Conclusion:&lt;/i&gt; The treatment results for patients with depressive symptoms whoare accompanied by their children for the duration of their in-patient psychotherapy treatment are just as good as those for mothers whose children are not jointly admitted. Additionally, the data have further implications that lend themselves to discussion regarding support for this type of facility.
The Care of the Elderly — The Royal Commission and the Role of the Doctor — A Jubilee Postscript
Authors: John Lister
Journal: New England Journal of Medicine (1977)

The care of the elderly is becoming a major problem in all countries where an increased life expectancy is causing a steady rise in the proportion of elderly persons in the community. Thus, in England and Wales, the number of people over the age of 65 has nearly quadrupled in this century and is expected to increase from the present total of 7,000,000 to 7,500,000 in the 1990's. Furthermore, within this group the proportion 75 years of age and over will increase from 35 per cent to 40 per cent in 1990 and thereafter is expected to continue to rise . . .