tbuckley/cabot-search huggingface dataset:
The tyrosine kinase inhibitor dasatinib (SPRYCEL) inhibits chondrocyte activity and proliferation
Authors: K Vandyke, S Fitter, A C W Zannettino
Journal: Blood Cancer Journal (2011)

Dasatinib (BMS-354825, SPRYCEL, Bristol-Myers Squibb, New York, NY, USA) is an ATP-competitive protein tyrosine kinase inhibitor (TKI), which was originally identified as a potent inhibitor of Src family kinases (including Src, Lck, Hck, Yes, Fgr, Lyn and Fyn) and was subsequently found to have activity against Abl, Kit, the macrophage colony stimulating factor receptor (Fms), the platelet-derived growth factor (PDGF) receptor (PDGFR)-α and -β and the Eph receptor family members EphB1, EphB2 and EphB4.1, 2, 3 Dasatinib is an effective therapy for chronic myeloid leukaemia (CML) in patients who are resistant to front-line imatinib mesylate therapy due to its increased affinity for the CML oncoprotein BCR-Abl and its insensitivity to mutations in the BCR-Abl kinase domain. Furthermore, recent data suggest that dasatinib may be more effective than imatinib as a front-line therapy for chronic phase CML.4
Copeman's Textbook of the Rheumatic Disease
Authors: Thomas G. Benedek
Journal: JAMA (1978)

The fifth edition of the most prestigious English textbook on rheumatology has been published eight years after the fourth. It has been enlarged by one eighth, and its contributors, who have increased from 30 to 39, are mostly internationally recognized authorities. Some of the emphasis has changed, in keeping with what we hope is progress. For example, a chapter on spa therapy has been deleted and an excellent presentation of "present concepts of immunopathology" added. Other particularly useful additions are chapters on electrodiagnosis and on arthrography. All of the most important diseases are presented adequately. However, the inclusion of some topics and the absence or brevity of citation of several others is perplexing. Why is O'nyong-nyong fever allotted as much space as Paget's disease, while relapsing panniculitis is mentioned neither as an independent entity nor as a manifestation of lupus erythematosus? Three fourths of a page seems grossly inadequate to
Leprosy in Norway and America.
Authors: G. A. Hansen
Journal: JAMA (1898)

Bergen, Norway, Feb. 1, 1898.  To the Editor:  —Allow me to make some corrections of Dr. Caldwell's article in the number of December 18, which you have sent me. Dr. Caldwell says that in our hospitals for the confinement and treatment of lepers were domiciled over one thousand unfortunates afflicted with that terrible disease. From where or from whom Dr. Caldwell has obtained this information I can not imagine, for we had last summer not more than about three hundred and fifty lepers in our institutions. Later on Dr. Caldwell says that I, in my visit to the United States found three cases in the hospitals in Chicago and twice as many in New York, as well as encountered several cases of true leprosy upon the streets of each city, all of whom were treated for lupus, syphilis or some other form of skin disease. I regret if any of
Questions raised over use of misoprostol to prevent postpartum haemorrhage in poor countries
Authors: I. Torjesen
Journal: BMJ (2012)

The World Health Organization should reconsider its approval of misoprostol to prevent postpartum haemorrhaging in poorer countries, says a review of the evidence.1

The review concluded that the evidence to support the use of misoprostol in low and middle income countries in home and community settings where parenteral uterotonics were not available was “at best weak and inconclusive.” 

Most maternal deaths relating to pregnancy and childbirth occur in lower income countries, and a quarter of deaths are associated with postpartum haemorrhage, defined as blood loss of more than 500 mL after a vaginal delivery.2

Anaemia is the main risk factor for postpartum haemorrhage and can be treated easily if diagnosed. But in lower income countries without antenatal screening for anaemia WHO guidelines recommend that skilled birth attendants perform active management of the third stage of labour. This consists of three interventions: prophylactic administration of a uterotonic drug, where oxytocin is the drug of choice followed by ergometrine/methylergometrine; early cord clamping and cutting; and controlled cord traction.3

Oxytocin and ergometrine preparations …
All doctors are problem doctors
Authors: R. Smith
Journal: BMJ (1997)

Britain has in the past few weeks heard much about “problem doctors,”1 2 and a book has just been published on the subject.3 The public reaction to the cases reminds us that self regulation for doctors is not a right but a privilege that has to be deserved every day. And the book makes clear that doctors worldwide do badly with managing their problem colleagues. It also shows that in a sense all doctors are problem doctors. That is why we do so badly.

A fatal accident inquiry in Scotland heard how surgeon Gerald Davies operated on patients when he had a blood alcohol concentration that was probably twice the legal limit for driving1; while Britain's General Medical Council struck off obstetrician and gynaecologist Patrick Ngosa for continuing to treat patients when he was infected with HIV.2 Both cases led to calls for compulsory testing of doctors for alcohol or HIV, and the sheriff hearing the Scottish case observed: “There appears to be a culture among members of the medical profession where it is regarded as inappropriate … to report on certain matters, including in particular a colleague's apparent excessive drinking.”1 Sun columnist Anne Robinson put it more starkly: “In truth there is not a single reason to suppose these days that doctors can be trusted any more than you can trust British Gas, double glazing salesmen, or the man in the pub.”

We shouldn't be surprised by problem doctors. Why wouldn't they exist? Think how surprised we would be by a community of 130 000 people (the number of doctors in Britain) where nobody …
Detecting bladder cancer.
Authors: A Schattner
Journal: BMJ (1990)

several Gram positive bacteria but that other factors must also play a part, an observation consistent with our findings in Gram negative shock.6Nevertheless, if these results can be confirmed in vivo it will give added impetus to the trials of antibody to tumour necrosis factor as empirical treatment in septic shock.7We thank A Wienecke and Dr R Gilbert of the Food Hygiene Laboratory, CPHL Colindale, for toxin analysis of some of our strains.
Medical advances in the treatment of congestive heart failure.
Authors: P W Armstrong, G W Moe
Journal: Circulation (1993)

The increased incidence and prevalence of congestive heart failure place a high priority on novel treatment strategies. Left ventricular ejection fraction remains the single most valuable measurement providing both diagnostic and prognostic insights. The most systematic approach to heart failure involves an objective assessment of functional disability, to include exercise tests such as a 6-minute walk under standardized conditions. Left ventricular dysfunction incites a host of neurohumoral compensations that are of fundamental importance in the heart failure syndrome expression. Both vasoconstrictor and vasodilator neurohormones are stimulated and provide new therapeutic opportunities. The therapeutic approach to heart failure begins with a strong emphasis on prevention, patient education, and self-participation in therapy with respect to both its monitoring and adjustment. Diuretics remain a mainstay of therapy but, in the face of severe heart failure, may become ineffectual, requiring constant infusion of loop-active diuretics, combination diuretics, or diuretics in association with concomitant low-dose dopamine infusion. Vasodilator therapy has been an important advance: combination hydralazine and nitrate therapy was initially shown to be efficacious in improving survival, and more recently, angiotensin-converting enzyme (ACE) inhibitors, in the form of enalapril, have shown incremental benefit on survival over this combination. Interestingly, there is now evidence from both SOLVD and SAVE to demonstrate an unexpected and, as yet, unexplained reduction in the frequency of both unstable angina and myocardial infarction. Although, on balance, the weight of evidence concerning the long-term efficacy of inotropic agents has been disappointing, especially as it relates to their unfavorable effects on survival, recent information on vesnarinone, an agent with a complex and diversified mechanism of action, suggests that with appropriate doses, improved symptoms and survival are possible. A substantial amount of new information from randomized placebo-controlled trials attests to the symptomatic relief, hemodynamic improvement, and gain in exercise performance achieved by digoxin. A long-term survival study is ongoing to assess its effects on mortality. beta-Blockers, especially metoprolol, appear beneficial in some patients with heart failure, possibly related to their reduction in sympathetic nervous activity and restoration of beta-receptor population, with resultant improved contractile performance, enhanced myocardial relaxation, and overall increase in cardiac efficiency. Based on available evidence, the best contemporary approach to treatment involves the use of ACE inhibitors coupled with diuretic therapy, either continuous or intermittent, to relieve central or peripheral congestion. The addition of digoxin or a hydralazine nitrate combination is a logical next step, with commencement of low-dose beta-blocker a reasonable option.(ABSTRACT TRUNCATED AT 400 WORDS)
Health of indigenous people suffers modern world ills
Authors: Peter Moszynski
Journal: BMJ (2007)

The impact of the modern world continues to wreak havoc with the health of indigenous people, centuries after entire civilisations of native Americans were first wiped out by diseases introduced by outsiders, according to a report launched this week by the pressure group Survival International.

New roads and development schemes not only increase the risks of HIV and the spread of infectious diseases, but people are often forced into a sedentary life and become dependent on processed foods, it says.

“This change in lifestyle and diet—from high protein …
18F-FDG PET/CT and Contrast-Enhanced CT in a One-Stop Diagnostic Procedure
Authors: Renaud Guignard, Marija Simukoniene, Valentina Garibotto, Osman Ratib
Journal: Clinical Nuclear Medicine (2012)

Effective management of patients affected by retroperitoneal fibrosis (RPF) is an important issue because of lack of relevant parameters to objectively assess the degree of inflammation. We evaluated added value of contrast-enhanced computed tomography (CE-CT) combined with fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) as a one-stop diagnostic procedure for the assessment and follow-up of patients with RPF.(18)F-FDG PET and CE-CT findings were reviewed in 10 patients suffering from RPF. Maximum standard uptake values (on native and contrast-enhanced [ESUV(max)] CT) were calculated. Dimensions of periaortitis were measured on CT scans. Observed clinical changes between baseline PET scan (T0) and at 6 months follow-up (T6) were analyzed regarding differences of initial values for clinic and paraclinic parameters.Patients still suffering from pain 6 months after baseline PET scan had initially higher FDG uptake (ESUV(max): 5.7 ± 0.9 vs. 2.4 ± 0.9, P < 0.01). Unlike biologic and CT parameters, FDG uptake was the most relevant parameter to measure severity of inflammation (ESUV(max) threshold: 4.3; Se = Sp = 1.0). CE-CT exclusively allowed better delineation and more accurate assessment of FDG uptake of periaortitis and its extension to adjacent structures.Our results clearly show the usefulness of PET/CT for better evaluation and management of patients with fibroblast proliferation disease. Accurate determination of inflammation level is significantly improved when PET/CT and CE-CT are performed in the same study and used for better delineation of areas of residual inflammation.
LATERAL CURVATURE OF THE SPINE (SCOLIOSIS): ANALYSIS OF TWO THOUSAND CONSECUTIVE CASES
Authors: P. B. Roth
Journal: BMJ (1912)

Initial Potenzcy.During, the tlhree years ending December, 191, I ex- anPiiied 23 samiples of tincture of digitalis freshly made by chemists of repute.The standardl employed wiLs tht ; min;ms of the tincture shoould kill a frog weighing 20 grams within-four hours.Only male frogs were used, as tlle weight of ova may vitiate results.Of the 23 samples 12 were of average potency, 6 were under the aver'age andl 5 were over the average strength.The actuLal streingth of eachl may be indicated by stating the dose equivalent to the maximum pharimacopoeial dose of 15 minims.Average potency.. 12.Under average ...
Mortality in sodium chlorate poisoning.
Authors: M Helliwell, J Nunn
Journal: BMJ (1979)

Mortality in sodium chlorate poisoningSodium chlorate poisoning is rare but is associated with a high mortality rate,' death occurring from massive intravascular haemolysis and acute renal failure.We report the outcome in 14 patients poisoned by sodium chlorate, with special regard to the amount ingested and subsequent management.
Drug-Eluting or Bare-Metal Stents for Acute Myocardial Infarction
Authors: Laura Mauri, Treacy S. Silbaugh, Pallav Garg, Robert E. Wolf, Katya Zelevinsky, Ann Lovett, Manu R. Varma, Zheng Zhou, Sharon-Lise T. Normand
Journal: New England Journal of Medicine (2008)

Studies comparing percutaneous coronary intervention (PCI) with drug-eluting and bare-metal coronary stents in acute myocardial infarction have been limited in size and duration.We identified all adults undergoing PCI with stenting for acute myocardial infarction between April 1, 2003, and September 30, 2004, at any acute care, nonfederal hospital in Massachusetts with the use of a state-mandated database of PCI procedures. We performed propensity-score matching on three groups of patients: all patients with acute myocardial infarction, all those with acute myocardial infarction with ST-segment elevation, and all those with acute myocardial infarction without ST-segment elevation. Propensity-score analyses were based on clinical, procedural, hospital, and insurance information collected at the time of the index procedure. Differences in the risk of death between patients receiving drug-eluting stents and those receiving bare-metal stents were determined from vital-statistics records.A total of 7217 patients were treated for acute myocardial infarction (4016 with drug-eluting stents and 3201 with bare-metal stents). According to analysis of matched pairs, the 2-year, risk-adjusted mortality rates were lower for drug-eluting stents than for bare-metal stents among all patients with myocardial infarction (10.7% vs. 12.8%, P=0.02), among patients with myocardial infarction with ST-segment elevation (8.5% vs. 11.6%, P=0.008), and among patients with myocardial infarction without ST-segment elevation (12.8% vs. 15.6%, P=0.04). The 2-year, risk-adjusted rates of recurrent myocardial infarction were reduced in patients with myocardial infarction without ST-segment elevation who were treated with drug-eluting stents, and repeat revascularization rates were significantly reduced with the use of drug-eluting stents as compared with bare-metal stents in all groups.In patients presenting with acute myocardial infarction, treatment with drug-eluting stents is associated with decreased 2-year mortality rates and a reduction in the need for repeat revascularization procedures as compared with treatment with bare-metal stents.
Glucocorticoid Therapy in the Preleukemic Syndrome (Hemopoietic Dysplasia)
Authors: GROVER C. BAGBY, JOHN D. GABOUREL, JAMES W. LINMAN
Journal: Annals of Internal Medicine (1980)

Bone marrow cells from 54 patients with the preleukemic syndrome were cultured in agar (granulocyte colony forming units) in the presence and absence of cortisol. Thirty-four patients were given trials of prednisone therapy after the initial culture was performed. Cortisol (in vitro) failed to enhance colony growth in 29 of these 34 cases, and none of the 29 patients responded to prednisone therapy. Cortisol enhanced colony growth in five patients and three of these responded favorably to prednisone therapy. The correlation of in-vivo with in-vitro events is significant (P < 0.005). Glucocorticoid therapy is of value in the management of a small number of patients with the preleukemic syndrome but is hazardous in those who fail to respond. These preliminary observations suggest that bone marrow cell culture techniques may aid in the identification of those patients who will and those who will not respond favorably to such therapy.
Renal Vein Thrombosis and Nephrotic Syndrome-Reply
Authors: Friedrich C. Luft
Journal: JAMA (1976)

<h3>In Reply.—</h3> Drs Duffy and Letteri raise an important point, and their contentions are correct. A more appropriate statement on our part would have been "The association between nephrotic syndrome and renalvein thrombosis is well recognized." A recent publication by Llach et al<sup>1</sup>sheds additional light on this problem.
Ockham's razor
Authors: John Grimley Evans
Journal: Journal of the Royal Society of Medicine (2008)

Douglas Wardrop (JRSM 2008;101:50–1) is right in commenting that the scholastic logic of Ockham's razor is of limited relevance to geriatric medicine. Geriatricians have long taught their students that if an old person admitted to hospital has less than 5.5 or 6.5 diagnoses he or she (respectively) may have been inadequately assessed. But I was surprised to see so little deference to probability in the Editorial. It is not the number of different ‘entities’ – a fine scholastic concept – but their probabilities that matters. One of my patients with ulcerative colitis developed a peripheral arthropathy that the literature claimed as a rare complication of chronic bowel disease. Calculation revealed that it was much more likely that she had rheumatoid arthritis as well as her bowel disease rather than the single diagnosis decreed by Ockhamism. Conversely, decades before Lewy Body Disease was defined it was obvious that Parkinsonism (clinically diagnosed) and dementia (also clinically diagnosed) occurred together far more often than was compatible with independent incidence. This prophesied the existence of at least one unrecognised unifying ‘entity’. But probabilities varying with sex, age and other demographic factors can be difficult to estimate from conventional medical literature. How much easier both clinical diagnosis and research would be if the NHS had an accessible system of epidemiologically structured medical records matching that of an American Health Maintenance Organization. We could then forget the scholastics.
Dornase Aerosol Effect on Sputum Viscosity in Cases Of Cystic Fibrosis
Authors: Jack Lieberman
Journal: JAMA (1968)

<h3>To the Editor:—</h3> Deoxyribonucleic acid is not normally present in mucoid respiratory secretions but is a product of pulmonary inflammatory cellular debris.<sup>1,2</sup>The DNA in mucopurulent secretions seems to contribute to the chronicity of respiratory disease by increasing the viscosity of such secretions. A therapeutic attack upon the DNA content of purulent respiratory secretions would therefore appear to be worthwhile in an attempt to reduce morbidity from respiratory infection and to enhance the effectiveness of antibiotics.<sup>3</sup> Pancreatic dornase is a commercially available enzyme preparation which liquifies purulent sputum in vitro.<sup>4,5</sup>The reduction in viscosity occurs rapidly due to depolymerization of DNA<sup>5</sup>and the induction of intrinsic proteolysis.<sup>6-8</sup>Dornase aerosols have also been found to be useful in the evacuation of viscous mucopurulent secretions in bronchopulmonary disease.<sup>9-13</sup>I recently described a method for measuring the viscosity of sputum with a coneplate viscosimeter, thereby providing a
UN policy fails to tackle health needs of indigenous people
Authors: U. Tayal
Journal: BMJ (2003)

Indigenous people worldwide are unable to access routine health care and are dying prematurely, despite efforts by the United Nations in the past decade to raise awareness.

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San bushmen making fire in Namibia

Credit: PAUL WEINBERG/PANOS

This is a finding of a report published jointly by Health Unlimited (a British …

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Controlled trial of respiratory health worker visiting patients with chronic respiratory disability.
Authors: A Cockcroft, P Bagnall, A Heslop, N Andersson, R Heaton, J Batstone, J Allen, P Spencer, A Guz
Journal: BMJ (1987)

Seventy five patients with chronic respiratory disability were randomised to a group visited by a respiratory health worker (42) or control group (33). The first group was visited monthly by a respiratory nurse, who gave education and support. The effect of the intervention was assessed in terms of quality of life (by questionnaires), the number and duration of admissions to hospital, and the number of deaths. The questionnaires on quality of life showed no changes in either group during the study, but nearly all of the group visited by a respiratory health worker said that they valued the visits and wished them to continue. Their knowledge about their condition also improved compared with that of the controls. The duration of stay in hospital for respiratory reasons in the group visited by a respiratory health worker was longer than that of control patients. This was explained by their being scored as more ill than the controls on admission. Fewer patients died in the group visited by a respiratory health worker than in the control group (p = 0.11). The patients in the group visited by respiratory health workers may have survived longer because they sought help rather than dying at home. If confirmed this could have implications for the cost of their care.
Impaired myogenic responsiveness of renal microvessels in Dahl salt-sensitive rats.
Authors: T Takenaka, H Forster, A De Micheli, M Epstein
Journal: Circulation Research (1992)

The mechanisms mediating abnormal renal autoregulation in Dahl salt-sensitive (DS) rats have not been fully defined. In the present study, we assessed myogenic responsiveness of interlobular arteries (ILAs), afferent arterioles (AAs), and efferent arterioles in isolated perfused hydronephrotic Dahl rat kidneys. Dahl rats were divided into four groups according to strain (Dahl salt-resistant [DR] or DS rats) and dietary sodium manipulation (rats fed low or high salt diets). Systolic blood pressure was elevated only in DS rats fed the high salt diet (202 +/- 4 mm Hg, p less than 0.05). Myogenic responses were obtained by stepwise elevation of renal arterial pressure. Vessel diameters were determined by computer-assisted videomicroscopy. Preglomerular microvessels of DS and DR rats responded differently to changes in renal arterial pressure. AAs and ILAs manifested diminished myogenic responsiveness to increasing renal arterial pressure in DS rats compared with DR rats (p less than 0.05). Both AAs and ILAs in DS rats manifested a higher threshold pressure for eliciting myogenic responses and a decrease in maximal pressure-induced vasoconstriction. The sensitivity of the AA myogenic response to nifedipine was enhanced in DS rats compared with DR rats (p less than 0.05). For rats fed the high salt diet, preglomerular vessels exhibited reduced myogenic responsiveness in both strains. In contrast to preglomerular microvessels, efferent arterioles from all four groups of rats failed to exhibit pressure-induced vasoconstriction. Our data suggest that diminished myogenic responsiveness of AAs and ILAs in DS rats contributes to impaired renal autoregulation in this strain.