tbuckley/cabot-search huggingface dataset:
A Study of Normal Bereavement
Authors: PAULA CLAYTON, LYNN DESMARAIS, GEORGE WINOKUR
Journal: American Journal of Psychiatry (1968)

By systematically interviewing relatives of a series of hospital patients who died, the authors have delineated the symptoms of normal bereavement. Only three symptoms—depressed mood, sleep disturbance, and crying—occurred in more than one-half of the subjects. At follow-up two to four months later 81 percent were improved and only four percent were worse. Those improved dated their improvement to six to ten weeks after the death. Ninety-eight percent of these relatives did not seek psychiatric assistance during the bereavement period.
Prediction of sustained response to peginterferon alfa-2b for hepatitis B e antigen-positive chronic hepatitis B using on-treatment hepatitis B surface antigen decline
Authors: Milan J. Sonneveld, Vincent Rijckborst, Charles A. B. Boucher, Bettina E. Hansen, Harry L. A. Janssen
Journal: Hepatology (2010)

Serum hepatitis B surface antigen (HBsAg) levels may reflect the immunomodulatory efficacy of pegylated interferon (PEG-IFN). We investigated within a large randomized trial whether quantitative HBsAg levels predict response to PEG-IFN in patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B. Serum HBsAg was measured in samples taken at baseline and weeks 4, 8, 12, 24, 52, and 78 of 221 patients treated with PEG-IFN alfa-2b with or without lamivudine for 52 weeks. HBsAg decline was compared between treatment arms and between responders and nonresponders. Response was defined as HBeAg loss with HBV DNA &lt; 10,000 copies/mL at 26 weeks after treatment (week 78); 43 of 221 (19%) patients achieved a response. One year of PEG-IFN with or without lamivudine resulted in a significant decline in serum HBsAg, which was sustained after treatment (decline 0.9 log IU/mL at week 78, P &lt; 0.001). Patients treated with combination therapy experienced a more pronounced on-treatment decline, but relapsed subsequently. Responders experienced a significantly more pronounced decline in serum HBsAg compared to nonresponders (decline at week 52: 3.3 versus 0.7 log IU/mL, P &lt; 0.001). Patients who achieved no decline at week 12 had a 97% probability of nonresponse through posttreatment follow-up and no chance of HBsAg loss. In a representative subset of 149 patients similar results were found for prediction through long-term (mean 3.0 years) follow-up. Conclusion: PEG-IFN induces a significant decline in serum HBsAg in HBeAg-positive patients. Patients who experience no decline from baseline at week 12 have little chance of achieving a sustained response and no chance of HBsAg loss and should be advised to discontinue therapy with PEG-IFN. (Hepatology 2010)
Ethics in Vasodilator Therapy
Authors: DAVID SHANDER
Journal: Annals of Internal Medicine (1975)

Comments and Correction1 May 1975Ethics in Vasodilator TherapyDAVID SHANDER, M.D., F.A.C.P.DAVID SHANDER, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-82-5-721_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The article "Chronic Vasodilator Therapy in the Management of Cardiogenic Shock and Intractable Left Ventricular Failure" (Ann Intern Med 81:777-780, 1974) is an interesting, reasonably convincing demonstration of the effects of ventricular unloading on the management of left ventricular dysfunction.I am concerned, however, about an aspect of the paper somewhat removed from the scientific content and which, I believe, is an example of "ethical unloading." Having found both subjective and objective benefits of the therapy in this severely ill patient, I find it difficult to understand why after 6 months of therapy they elected to discontinue... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: DAVID SHANDER, M.D., F.A.C.P.Affiliations: General Rose Memorial Hospital 1050 Clermont Street Denver, Colorado 80220 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1975Volume 82, Issue 5Page: 721-721KeywordsShockVasodilators ePublished: 1 December 2008 Issue Published: 1 May 1975 PDF downloadLoading ...
Gynaecologist cleared in hysterectomy case
Authors: C. Dyer
Journal: BMJ (2000)

A consultant gynaecologist was cleared last week of serious professional misconduct after he admitted removing a patient's ovaries without her consent. Ian Fergusson, a consultant at Guy's and St Thomas's Hospital in London, admitted performing an oophorectomy and salpingectomy on Caroline Richmond without consent but denied that he operated without consent or unnecessarily in carrying out a hysterectomy.

Rodney Yates, chairman of the General Medical Council's professional conduct committee, said the case was one of the most difficult the committee had encountered. It had to …
Do Antidepressants Cure or Create Abnormal Brain States?
Authors: Joanna Moncrieff, David Cohen
Journal: PLoS Medicine (2006)

The term antidepressant refers to a drug that helps to rectify specific biological abnormalities that give rise to the symptoms of depression. This exemplifies what we have called the “disease-centred” model of psychotropic drug action [ 1]. Modelled on paradigmatic situations in general medicine—such as the use of insulin in diabetes, antibiotics in infectious disease, chemotherapy in cancer—the disease-centred model suggests that antidepressants help restore normal functioning by acting on the neuropathology of depression or of depressive symptoms. 

In contrast, we propose in this Essay that an alternative “drug-centred” model can better explain observed drug effects in psychiatric conditions. This drug-centred model suggests that instead of relieving a hypothetical biochemical abnormality, drugs themselves cause abnormal states, which may coincidentally relieve psychiatric symptoms ( Table 1). Alcohol's disinhibiting effects may relieve symptoms of social phobia, but that does not imply that alcohol corrects a chemical imbalance underlying social phobia. Sedation may lessen high arousal, present in many acute psychiatric situations. Drugs that induce indifference, such as neuroleptics or opiates, may help reduce the distress of acute psychotic symptoms. Low-dose stimulants may help improve attention and concentration in the short term. 



Table 1

Main Assumptions of Two Models of Psychotropic Drug Action



The disease-centred model in psychiatry leads researchers to infer antidepressant effects from patients' scores on symptom rating scales presumed to assess the manifestations of the disease. The drug-centred model, on the other hand, suggests that physiological and subjective effects of drugs should be examined in their own right. These effects include various forms of sedation, stimulation, and a plethora of biopsychological states. Depending on individual inclination and context (including a person's emotional state upon drug ingestion), intoxication with some drugs produces euphoria or mood elevation. Because tolerance develops, however, euphoriant effects do not persist with long-term use. If antidepressants or any other psychotropic drugs could be shown to have mood-elevating effects that were long-term and not diminished by being in a depressed emotional state, this would distinguish them from psychotropic drugs that cause euphoria and might prove uniquely useful in depressed patients (see Sidebar).
Hepatobiliary Imaging of Common Bile Duct Obstruction by a Hydronephrotic Kidney
Authors: ELCON D. LEVINSON, E MARVIN HENKEN, RICHARD P. SPENCER
Journal: Clinical Nuclear Medicine (1982)

A patient with intermittent right upper quadrant abdominal pain thought to represent acute cholecystitis had common bile duct obstruction due to an enlarged right renal pelvis. A Tc-99m-HIDA scan provided the first clue to the diagnosis. The case reinforces the value of cholescintigraphy in diagnosing pathology outside the biliary system.
Global alliance of funders of public health research agrees top priorities
Authors: S. Mayor
Journal: BMJ (2009)

An alliance of the world’s leading funders of public health research has agreed three targets for its first jointly funded research programmes to reduce the prevalence of chronic non-communicable diseases, after its inaugural scientific summit in New Delhi earlier this month. The targets are to lower the prevalence of high blood pressure, reduce smoking, and eliminate indoor pollution.

The Global Alliance for Chronic Disease (www.globalallianceforchronicdiseases.org), which was set up in June last year, is made up of research institutions that together manage 80% of the world’s funding of public health research. Members include leading national health research organisations from Australia, Canada, China, India, the United Kingdom, and the United States. The alliance aims to support coordinated research to reduce non-communicable diseases, including cardiovascular diseases, chronic respiratory conditions, type 2 diabetes, and common cancers, which …
ATROPHIC PYELONEPHRITIS VERSUS CONGENITAL RENAL HYPOPLASIA
Authors: John L. Emmett
Journal: JAMA (1952)

There has been much discussion in the urological and pathological literature regarding the unilateral, abnormally small kidney. Many confusing terms have arisen to describe it, such as atrophic kidney, contracted kidney, atrophic pyelonephritis, congenital hypoplasia, infantile kidney, aplastic kidney, and agenesia. Some statements in the literature tend to leave one with the impression that these various terms describe separate clinical and pathological entities that may be distinguished easily clinically, urographically, or by gross or microscopic examination. The two descriptive terms that have become most widely used are "chronic atrophic pyelonephritis" and "congenital hypoplasia." Contrary to general opinion, it has been our impression that it is usually difficult, if not impossible, to distinguish these two entities, if in reality two such separate entities actually exist. A cursory review of the literature will reveal the great confusion that exists on this subject. Most standard American textbooks on urology base their classification and
Human hibernating myocardium is jeopardized by apoptotic and autophagic cell death
Authors: Albrecht Elsässer, Achim M Vogt, Holger Nef, Sawa Kostin, Helge Möllmann, Woitek Skwara, Christoph Bode, Christian Hamm, Jutta Schaper
Journal: Journal of the American College of Cardiology (2004)
Understanding noncirrhotic portal hypertension: Ménage à FOIS
Authors: Ian R. Wanless
Journal: Hepatology (1988)

Twenty-six patients with the clinical and histologic diagnosis of primary biliary cirrhosis were reviewed. Nodular hyperplasia of the liver without fibrous rims, not reported hitherto in patients with primary biliary cirrhosis, was found in several patients with early histological stages. These changes resembled “nodular regenerative hyperplasia of the liver” and were usually present as multicellular thickness in zones 1 and 2 of the hepatic lobules. Such lesions were preferentially found in patients with esophageal varices, suggesting that the nodular hyperplasia may occur in relation to a disturbance of portal venous blood flow within the liver in primary biliary cirrhosis in early histological stages.
Community-Acquired Acinetobacter calcoaceticus var anitratus Pneumonia
Authors: Glenn L. Goodhart
Journal: JAMA (1977)

Two patients had community-acquired Acinetobacter calcoaceticus var anitratus pneumonia. Both patients were alcoholic and one was cirrhotic. One patient died and the other received two weeks of gentamicin therapy and survived. Misinterpretation of the sputum Gram stain delayed diagnosis and institution of proper therapy in both cases. In addition to organisms sensitive to penicillins such as Neisseria or Haemophilus, Acinetobacter must be considered in the differential diagnosis of community-acquired Gram-negative coccobacillary pneumonia.
Allelic Exclusion and Peripheral Reconstitution by TCR Transgenic T Cells Arising From Transduced Human Hematopoietic Stem/Progenitor Cells
Authors: Francesca Giannoni, Cinnamon L Hardee, Jennifer Wherley, Eric Gschweng, Shantha Senadheera, Michael L Kaufman, Rebecca Chan, Ingrid Bahner, Vivian Gersuk, Xiaoyan Wang, David Gjertson, David Baltimore, Owen N Witte, James S Economou, Antoni Ribas, Donald B Kohn
Journal: Molecular Therapy (2013)

Transduction and transplantation of human hematopoietic stem/progenitor cells (HSPC) with the genes for a T-cell receptor (TCR) that recognizes a tumor-associated antigen may lead to sustained long-term production of T cells expressing the TCR and confer specific antitumor activity. We evaluated this using a lentiviral vector (CCLc-MND-F5) carrying cDNA for a human TCR specific for an HLA-A*0201-restricted peptide of Melanoma Antigen Recognized by T cells (MART-1). CD34+ HSPC were transduced with the F5 TCR lentiviral vector or mock transduced and transplanted into neonatal NSG mice or NSG mice transgenic for human HLA-A*0201 (NSG-A2). Human CD8+ and CD4+ T cells expressing the human F5 TCR were present in the thymus, spleen, and peripheral blood after 4–5 months. Expression of human HLA-A*0201 in NSG-A2 recipient mice led to significantly increased numbers of human CD8+ and CD4+ T cells expressing the F5 TCR, compared with control NSG recipients. Transduction of the human CD34+ HSPC by the F5 TCR transgene caused a high degree of allelic exclusion, potently suppressing rearrangement of endogenous human TCR-β genes during thymopoiesis. In summary, we demonstrated the feasibility of engineering human HSPC to express a tumor-specific TCR to serve as a long-term source of tumor-targeted mature T cells for immunotherapy of melanoma. Transduction and transplantation of human hematopoietic stem/progenitor cells (HSPC) with the genes for a T-cell receptor (TCR) that recognizes a tumor-associated antigen may lead to sustained long-term production of T cells expressing the TCR and confer specific antitumor activity. We evaluated this using a lentiviral vector (CCLc-MND-F5) carrying cDNA for a human TCR specific for an HLA-A*0201-restricted peptide of Melanoma Antigen Recognized by T cells (MART-1). CD34+ HSPC were transduced with the F5 TCR lentiviral vector or mock transduced and transplanted into neonatal NSG mice or NSG mice transgenic for human HLA-A*0201 (NSG-A2). Human CD8+ and CD4+ T cells expressing the human F5 TCR were present in the thymus, spleen, and peripheral blood after 4–5 months. Expression of human HLA-A*0201 in NSG-A2 recipient mice led to significantly increased numbers of human CD8+ and CD4+ T cells expressing the F5 TCR, compared with control NSG recipients. Transduction of the human CD34+ HSPC by the F5 TCR transgene caused a high degree of allelic exclusion, potently suppressing rearrangement of endogenous human TCR-β genes during thymopoiesis. In summary, we demonstrated the feasibility of engineering human HSPC to express a tumor-specific TCR to serve as a long-term source of tumor-targeted mature T cells for immunotherapy of melanoma.
A COMPARISON OF THE METABOLISM OF FRUCTOSE AND GLUCOSE IN HEPATIC DISEASE AND DIABETES MELLITUS 1
Authors: Lloyd H. Smith, Richard H. Ettinger, David Seligson, Sara Lightcap
Journal: Journal of Clinical Investigation (1953)

The present experiments were designed to quantitate the rate of utilization of fructose in normal subjects and in patients with the decreased glucose tolerance of parenchymal liver disease and diabetes. The results indicate that fructose is utilized rapidly in normal subjects and at a nearnormal rate in the presence of marked impairment of glucose tolerance. Characteristic differences in the response of serum inorganic phosphate and of intermediary compounds of carbohydrate metabolism are demonstrated.
Needle Biopsy of the Parietal Pleura
Authors: Nicholas DeFrancis, Emanuel Klosk, Edwin Albano
Journal: New England Journal of Medicine (1955)

THE entity of serofibrinous pleurisy presents many obstacles to diagnosis. Difficulties are often encountered in the isolation of the Mycobacterium tuberculosis from the sputum, gastric washings and pleural fluid in the tuberculous patient. In addition, aspiration biopsy of pleural fluids frequently yields samples consisting of distorted cells that may not be sufficiently representative pathologically for definitive microscopical diagnosis. Often, specific therapy must be instituted before definitive bacteriologic diagnosis can be established.The purpose of this report is to describe a simple method for needle biopsy of the parietal pleura that may obviate prolonged and costly diagnostic procedures and even, in . . .
Deadweight? — The Influence of Obesity on Longevity
Authors: Samuel H. Preston
Journal: New England Journal of Medicine (2005)

Obesity has clearly become a major personal and public health problem for Americans; it affects many aspects of our society. In this issue of the Journal, Olshansky et al.1 make an important contribution to national discussions of the future of longevity by calling attention to the very substantial increase in the prevalence and severity of obesity since 1980 and its consequences on health and mortality. They estimate that the current life expectancy at birth in the United States would be one third to three quarters of a year higher if all overweight adults were to attain their ideal weight.Although . . .
Anatomy and physiology of the enteric nervous system
Authors: M Costa
Journal: Gut (2000)

The enteric nervous system (ENS) is a quasi autonomous part of the nervous system and includes a number of neural circuits that control motor functions, local blood flow, mucosal transport and secretions, and modulates immune and endocrine functions. Although these functions operate in concert and are functionally interlinked, it is useful to consider the neural circuits involved in each separately.1 This short summary will concentrate mainly on the neural circuits involved in motor control.2 The enteric neural circuits are composed of enteric neurones arranged in networks of enteric ganglia connected by interganglionic strands. Most enteric neurones involved in motor functions are located in the myenteric plexus with some primary afferent neurones located in the submucous plexus. As in all nervous systems involved in sensory-motor control, the ENS comprises primary afferent neurones, sensitive to chemical and mechanical stimuli, interneurones and motorneurones that act on the different effector cells including smooth muscle, pacemaker cells, blood vessels, mucosal glands, and epithelia, and the distributed system of intestinal cells involved in immune responses and endocrine and paracrine functions.

The digestive tract is unique among internal organs because it is exposed to a large variety of physicochemical stimuli from the external world in the form of ingested food. As a consequence, the intestine has developed a rich repertoire of coordinated movements of its muscular apparatus to ensure the appropriate mixing and propulsion of contents during digestion, absorption, and excretion. The oro-aboral transit of the intestinal contents can be regarded as a form of adaptive locomotion that occurs over a wide range of spatial and temporal domains.3 The movements of the intestine are the result of interaction of the neural apparatus and the muscular apparatus.4 

The muscular apparatus is organised in muscle layers made up of large collections of smooth muscle cells …
The Non-Hodgkin's Lymphomas
Authors: Eric Bernicker
Journal: JAMA (1997)

The oncologist's fascination with the liquid tumors stems in part from the high and visible response rates that many exhibit, in contrast to solid tumors. More-over, the easy accessibility of blood has allowed researchers to unravel many of the cytogenetic abnormalities that trigger carcinogenesis, a field that is now just evolving for solid tumors. This wonderful new textbook on the non-Hodgkin's lymphomas, edited by Dr Ian Magrath, emphasizes many of the other features that have attracted so many physicians to the study of lymphomas—their protean manifestations, effect on many organ systems, and the cutting-edge science behind the therapies. The best chapters are the first two, by editor Magrath, in which he provides a succinct, erudite overview of the history of lymphoma treatment and many current controversies over classification and therapy. The rest of the text is in two sections, the first composed of chapters on pathology and pathogenesis, the
Prenatal Screening for Hepatitis B Antigen
Authors: John W. Ross
Journal: JAMA (1989)

<h3>To the Editor.—</h3> The Centers for Disease Control's Advisory Committee on Immunization Practices (ACIP) recommends universal prenatal screening for hepatitis B antigen (HBsAg) during all pregnancies regardless of risk group and previous HBsAg status.<sup>1</sup>The recommendations state that hospitals where infants are delivered should obtain HBsAg test results within 24 hours since women in labor may not have received the test prenatally. The level of laboratory diagnostic service recommended by the ACIP is not available in the Atlanta metropolitan area, and I suspect that this situation is not unique in the United States. I surveyed the ten not-for-profit hospitals with more than 300 beds (range, 300 to 539) located in the five-county Atlanta metropolitan region, the two medical center institutions in the metropolitan region (918 and 604 beds), and three national commercial laboratories and the blood bank that serve the region. Four of the ten hospitals perform HBsAg testing
607 EFFICACY AND SAFETY OF ESCITALOPRAM FOR PREVENTION OF DEPRESSIVE SYMPTOMS INDUCED BY PEGINTERFERON ALPHA-2A AND RIBAVIRIN IN CHRONIC HEPATITIS C. A DOUBLE-BLIND, RANDOMIZED, PLACEBO-CONTROLLED TRIAL
Authors: C. Diez-Quevedo, H. Masnou, P. Castellví, R.M. Morillas, M.D. Giménez, R. Solá, P. Giner, R. Martín-Santos, M. Diago, R. Planas
Journal: Journal of Hepatology (2009)
Attributable lung cancer risk from radon in homes may be low
Authors: Jerome S Puskin, David J Pawel
Journal: BMJ (2005)

Do selective serotonin reuptake inhibitors cause suicide? Risk of suicide should be assessed for whole class of antidepressantsEditor-Gunnell et al's report on suicide risk with selective serotonin reuptake inhibitors (SSRIs) raises several issues. 1 Firstly, clinicians have observed that the first weeks of treatment of severe depression with an antidepressant are accompanied by a higher risk of suicide because of a drug induced motor disinhibition that is not yet accompanied by mood improvement. 2 Secondly, the authors' finding of a trend towards a protective effect of SSRIs against suicidal thoughts (odds ratio 0.77) compared with a trend towards an increased risk of self harm (odds ratio 1.57) is paradoxical.More surprising is the heterogeneity of results among SSRIs.Why would sertraline show a protective effect for suicidal thoughts and simultaneously increase the risk of self harm?The risk difference between citalopram and its active S-enantiomere, escitalopram, is also strange.No strong biological rationale can explain such heterogeneity among drugs with the same mechanism of action.Thirdly, the authors mention that the Medicine and Healthcare products Regulatory Agency found little evidence for a risk difference between SSRIs and the other antidepressants.The two accompanying papers show that the suicidal risk seems similar for serotoninergic and tricyclic antidepressants. 3 4The risk of suicide must be assessed for the whole class of antidepressants.The next stage would be to measure the risk of suicide according to the time since starting an antidepressant.Initially, the risks are higher than the benefits.To confirm old clinical observations by evidence based methods would be interesting and useful.