tbuckley/cabot-search huggingface dataset:
Caring for the Patient With AIDS
Authors: David E. Rogers
Journal: JAMA (1988)

A physician identifies fear of contracting AIDS as a destructive element in the relationship of physicians and nurses with patients with AIDS. Rogers believes that fear of contagion, coupled with feelings that homosexuals and drug abusers are to blame for their disease, has affected the quality and outcome of patient care. The traditional "samaritanism" of medicine has been replaced by a "guarded, almost adversarial mind set." Health professionals need to find some way to repair the damage done to the bond between care-giver and patient by their initial response to the AIDS epidemic.
The secret of lateralisation is trust
Authors: Chris Knight
Journal: Behavioral and Brain Sciences (2003)

Human right-handedness does not originate in vocalisation as such but in selection pressures for structuring complex sequences of digital signals internally, as if in a vacuum. Cautious receivers cannot automatically accept signals in this way. Biological displays are subjected to contextual scrutiny on a signal-by-signal basis – a task requiring coordination of both hemispheres. In order to explain left cerebral dominance in human manual and vocal signalling, we must therefore ask why it became adaptive for receivers to abandon caution, processing zero-cost signals rapidly and on trust.
Catheter Ablation for Supraventricular Tachycardia
Authors: Jeremy N. Ruskin
Journal: New England Journal of Medicine (1991)

Although its true prevalence in the general population is unknown, supraventricular tachycardia is the most common cause of paroxysmal tachycardia in children and young adults. These arrhythmias are due most frequently to the continuous movement of an electrical wave front over a pathway (reentry) involving the atrioventricular node or accessory atrioventricular connections. In atrioventricular nodal reentry, the reentry circuit comprises a "slow" pathway, which usually functions as the anterograde limb, and a "fast" pathway, which serves as the retrograde limb of the tachycardia circuit. Although the precise structural characteristics of these pathways are not well defined, they have different electrophysiologic . . .
Technetium-99m DISIDA Hepatobiliary Tract Imaging in Pseudotumors of the Liver
Authors: CHANDRAKANT R. PATEL
Journal: Clinical Nuclear Medicine (1987)

Tc-99m sulfur colloid images of the liver are frequently falsely reported as tumor or metastases in certain space occupying lesions of the liver. Whether a primary malignancy is known or not, every suspicious spaceoccupying lesion of the liver should be given the benefit of alternate diagnostic studies before a firm diagnosis of neoplasia is made. This is critical when the decision regarding chemotherapy has to be made. Timely intervention by other diagnostic modalities may obviate the consideration of chemotherapy in cases where there are no liver metastases. The case presented below illustrates the value of hepatobiliary tract imaging in pseudotumors of the liver.
Reduction of Bacteriuria and Pyuria Using Cranberry Juice
Authors: L. M. Katz
Journal: JAMA (1994)

<h3>To the Editor.</h3> —While it is attractive in these high-tech times to embrace low-tech approaches to disease prevention and control, Dr Avorn and colleagues<sup>1</sup>have not made their case for cranberry juice. From data in Table 1 of the article (page 753), it is apparent that their randomization and/or blinding scheme failed and that the two groups were not comparable with regard to previous UTI (Table). Analysis of the history of UTI for the prior 6-month and 12-month periods demonstrates a significant excess in the placebo group during both periods (<i>P</i>=.004, odds ratio [OR]=4.39, 95% confidence interval 1.55 to 12.43, using the approximation of Woolf, and<i>P</i>=.03, OR=2.50, 95% confidence interval 1.15 to 5.42, using the approximation of Woolf, respectively [Fisher's exact test]), suggesting the placebo group was more likely at baseline to experience UTI or bacteriuria/pyuria than the treatment group.
TCT-166 Correlates of High Platelet Reactivity on Clopidogrel in 8,533 Patients: An ADAPT-DES Substudy
Authors: Benjamin J. Vaccaro, Ajay J. Kirtane, Ke Xu, Bernhard Witzenbichler, Giora Weisz, Franz-Josef Neumann, Michael Rinaldi, D. Christopher Metzger, Timothy D. Henry, David Cox, Peter L. Duffy, Bruce R. Brodie, Thomas Stuckey, Ernest L. Mazzaferri, Helen Parise, Roxana Mehran, Gregg Stone
Journal: Journal of the American College of Cardiology (2013)
Monitoring and Regulating Clinical Software
Authors: Randolph A. Miller
Journal: Annals of Internal Medicine (1998)

Letters1 August 1998Monitoring and Regulating Clinical SoftwareRandolph A. Miller, MD and Reed M. Gardner, MDRandolph A. Miller, MDVanderbilt University Medical Center; Nashville, TN 37232University of Utah; Salt Lake City, UT 84132Search for more papers by this author and Reed M. Gardner, MDVanderbilt University Medical Center; Nashville, TN 37232University of Utah; Salt Lake City, UT 84132Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-3-199808010-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Our consortium's primary objective was to provide a general overview of the potential hazards posed by clinical software systems and to suggest responsible approaches [1]. Our proposed monitoring strategy, based on categories of risk, goes far beyond the ability of an individual competent practitioner to detect software problems. Local software oversight committees and the careful testing of software during and after development are integral parts of our recommendations. In 1988, U.S. Food and Drug Administration Commissioner Frank Young recognized the safeguards provided by competent human users of clinical software systems [2]. Dr. Berner questions whether clinicians can detect ...References1. Miller RA, Gardner RM. Recommendations for responsible monitoring and regulation of clinical software systems. American Medical Informatics Association, Computer-based Patient Record Institute, Medical Library Association, Association of Academic Health Science Libraries, American Health Information Management Association, American Nurses Association. J Am Med Informat Assoc. 1997; 4:442-57. Google Scholar2. Young FE. Validation of medical software: present policy of the Food and Drug Administration. Ann Intern Med. 1987; 106:628-9. Google Scholar3. Evans RS, Pestotnik SL, Classen DC, Clemmer TP, Weaver LK, Orme JF Jr, et al. A computer-assisted management program for antibiotics and antiinfective agents. N Engl J Med. 1998; 338:232-8. Google Scholar4. Garibaldi RA. Computers and the quality of care-a clinician's perspective. N Engl J Med. 1998; 338:259-60. Google Scholar Author, Article, and Disclosure InformationAffiliations: Vanderbilt University Medical Center; Nashville, TN 37232University of Utah; Salt Lake City, UT 84132 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited BySoftware, risks, and liabilities: ongoing and emergent issues in 3D bioprinting 1 August 1998Volume 129, Issue 3Page: 254KeywordsBehaviorFood and Drug AdministrationSoftware developmentSurgeons Issue Published: 1 August 1998 CopyrightCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
F-18 Fluorodeoxyglucose PET/CT as an Imaging Tool for Staging and Restaging Cutaneous Angiosarcoma of the Scalp
Authors: Minal S. Vasanawala, Yingbing Wang, Andrew Quon, Sanjiv S. Gambhir
Journal: Clinical Nuclear Medicine (2006)

Cutaneous angiosarcoma of the scalp is a rare highly aggressive malignant tumor that typically afflicts elderly patients and commonly presents with extensive local spread and distant metastasis. Distant metastases favor lung, liver, lymph nodes, and skin. Overall, the prognosis is poor. It differs from other soft tissue sarcomas in that the size of the lesion at presentation instead of tumor grade is the important prognostic factor. Optimal treatment is yet to be determined. Wide-margin complete excision with postoperative radiotherapy has been the most effective therapy. Chemotherapy and gene therapy have been used with some success. Local extent is critical in surgical planning, especially in the head and face, and is difficult to determine accurately with clinical examination and morphologic imaging tools. We report the case of a 70-year-old man diagnosed with multifocal angiosarcoma of the scalp. PET/CT imaging with F-18 2-fluoro-2-deoxyglucose (F-18 FDG) not only showed avid FDG uptake by an angiosarcoma (SUVmax = 10.7), but also simultaneously showed local extension of multifocal lesions with periosteal involvement and excluded metastatic abdominal nodal disease. PET/CT imaging after chemotherapy and before radiation therapy showed complete resolution of FDG uptake in the scalp and osseous lesions. Evaluation of more cases of this subset of soft tissue sarcoma with FDG PET/CT may suggest a possible role in not only staging angiosarcomas to determine the extent of local as well as distant disease, but also to potentially help determine response to therapy and early recognition of local or distant recurrence.
Appearance of Fibrous Dysplasia on ln-111 Labeled Leukocyte Scintigraphy
Authors: ALFRED J. SWYER, CHRISTOPHER J. PALESTRO, CHUN K. KIM, STANLEY J. GOLDSMITH
Journal: Clinical Nuclear Medicine (1991)

lndium-111 labeled leukocytes normally accumulate in the liver, spleen, and bone marrow. Photopenic marrow defects have been observed in tumors, osteomyelitis, avascular necrosis, Paget's disease, and after radiation therapy. This photopenia presumably results from the obliteration or replacement of normal marrow that occurs in these disorders. A patient with polyostotic fibrous dysplasia recently underwent imaging. The dysplastic bones were nearly devoid of activity by leukocyte imaging, probably as a result of the fibrous replacement of marrow characteristic of this condition. Fibrous dysplasia should be included as another cause of bone marrow photopenia during ln-111 labeled leukocyte imaging.
THE DIAGNOSIS AND TREATMENT OF BLACK SPIDER BITE
Authors: J. M. FRAWLEY
Journal: JAMA (1935)

During the last seven years, fifty-two cases of black spider bite have been treated at the Fresno County General Hospital. Most of the cases were admitted during the summer and early fall. The number treated each year was as follows: 1928, 6; 1929, 3; 1930, 3; 1931, 6; 1932, 11; 1933, 12; 1934, 11. In the average case the patient was an adult male who had been bitten on the penis or scrotum while sitting in an outdoor privy. In some cases, however, there was a history of having been bitten on the foot while putting on a shoe in the morning or on the back or arm after getting into the blankets at night. The patient when brought to the hospital shortly after being bitten complains of pain and swelling at the site of the injury with pain throughout the body, particularly in the extremities, which become cramped and
Abstract B32: Preclinical testing of three immune adjuvants in vaccination therapy for invasive canine meningioma.
Authors: Brian M. Andersen, G Elizabeth Pluhar, Charles E. Seiler, Zhengming Xiong, Michelle R. Goulart, Matthew Gerry O'Sullivan, Matthew A. Hunt, Charles E. Schiaffo, David M. Ferguson, John R. Ohlfest
Journal: Cancer Research (2013)

Abstract Malignant and atypical meningiomas are resistant to standard therapies, but therapeutic vaccines have not been tested preclinically or clinically. Pet dogs with naturally occurring meningioma are an underutilized model for aggressive human meningioma and an outstanding opportunity for assessing experimental therapeutic approaches. We treated 11 meningioma-bearing dogs with surgery and vaccine immunotherapy consisting of autologous tumor cell lysate combined with CpG or imiquimod. Interferon gamma-elaborating T cells were detected in the peripheral blood of two of cases, but vaccine-induced tumor-reactive antibody responses were found in the sera of all dogs. Systemic antibody responses were polyclonal, recognizing intracellular and cell surface antigens, and heat shock protein 60 was identified as one common antigen. Tumor-reactive antibodies bound allogeneic canine and human meningiomas, demonstrating common antigens across breed and species. Histological analysis revealed robust infiltration of antibody-secreting plasma cells into the brain around the tumor in treated compared to pre-treatment samples. Tumor-reactive antibodies were capable of inducing antibody dependent cell-mediated cytotoxicity to autologous and allogeneic tumor cells. Moreover, median survival for lysate/CpG and lysate/imiquimod vaccination was 646 days versus 222 days in historic surgery controls (p&amp;lt;0.05). Compared to CpG, a novel imidazoquinoline with TLR7/8 and inflammasome activity, compound 528, was equally potent at activating canine PBMCs. A prospective randomized two-arm trial was recently launched, using lysate—compound 528 vaccines, versus surgery controls. Mean follow-up is 139 days at the time of writing, and recruitment is ongoing. These data demonstrate the feasibility and immunologic efficacy of vaccine immunotherapy for treating a large animal model of human meningioma and warrant further development towards human trials. Citation Format: Brian M. Andersen, G Elizabeth Pluhar, Charles E. Seiler, Zhengming Xiong, Michelle R. Goulart, Matthew Gerry O'Sullivan, Matthew A. Hunt, Charles E. Schiaffo, David M. Ferguson, John R. Ohlfest. Preclinical testing of three immune adjuvants in vaccination therapy for invasive canine meningioma. [abstract]. In: Proceedings of the AACR Special Conference on Tumor Immunology: Multidisciplinary Science Driving Basic and Clinical Advances; Dec 2-5, 2012; Miami, FL. Philadelphia (PA): AACR; Cancer Res 2013;73(1 Suppl):Abstract nr B32.
Physician Self-interest and Medical Ethics
Authors: Stephen E. Silver
Journal: JAMA (1993)

<h3>To the Editor.</h3> —As a physician who has never studied the subject of medical ethics, I was perplexed by the technical language and historical references in the article entitled "The Metamorphosis of Medical Ethics: A 30-Year Retrospective" by Dr Pellegrino.<sup>1</sup> I must admit that I am not at all sure what medical ethics is, but I think that the term must embrace two broad categories of material. The first consists of those ethics that are societal but are specifically related to matters of health, birth, and death. In these areas, physicians have special technical expertise to offer, and they are also the ones who perform the actions expressive of society's values. But these are not specifically medical ethics. They are societal ethics that are carried out by medical personnel. Physicians in these matters can provide advice and consent, but they do not autonomously establish any code of behavior for
Echocardiographic features of a mycotic aneurysm of the left ventricular outflow tract caused by perforation of mitral-aortic intervalvular fibrosa.
Authors: R C Bansal, P M Moloney, R J Marsa, J G Jacobson
Journal: Circulation (1983)

We present the apparently unique M-mode and two-dimensional echocardiographic features of a surgically confirmed pseudoaneurysm of the left ventricular outflow tract, which probably developed as a result of perforation of the mitral-aortic intervalvular fibrosa. Echocardiographic studies revealed an aneurysmal sac situated between the aortic root and the left atrium. The aneurysm expanded in systole and collapsed or emptied in diastole, suggesting direct communication with the left ventricle. Such an aneurysm must be differentiated from various pathologic findings of the aortic root. The location and characteristic motion during the cardiac cycle should alert the clinician to the correct diagnosis of such an aneurysm.
The Practice of Medicine
Authors: Harry A. Lusk
Journal: JAMA (1989)

To the Editor.—  Dr Dandoy1protests that she does indeed practice medicine, and she lists the things she does. Congratulations to her. She thinks that committee meetings qualify. However, I bet it has been some time since she stood at the table of a gravida 5, para 4 woman and found that the neat cephalic presentation suddenly had become mentum posterior and that you and the anesthetist and the patient are the only ones around; it is 4 AM, and after the version the head is still hyperextended and you say to yourself, God, what do I do now, and you remember Paul Titus: At times like this, I put on a regular pair of forceps, flex the head and deliver it through one of the obliques. The boy crowed for an hour from the tight loops of cord, but he was in the other day when he graduated
The hazardous hibachi. Carbon monoxide poisoning following use of charcoal
Authors: E. F. Wilson
Journal: JAMA (1972)

Charcoal briquets burning inside a Volkswagen bus, a trailer, a station wagon and a potato cellar resulted in five fatal carbon monoxide poisonings and two nonfatal poisonings during a 14-month period in Utah. Reports of five similar fatalities resulting from carbon monoxide were found in a review of the literature.
Dietary lactose and the aetiology of human small-intestinal hypolactasia.
Authors: T Sahi
Journal: Gut (1978)

Progress report Dietary lactose and the aetiology of human small-intestinal hypolactasiaThe only carbohydrate in milk is lactose, a disaccharide, which is formed of a molecule of glucose and a molecule of galactose.Cow's milk contains about 5 % lactose and human milk about 6'5-7 %.Lactose is hydrolysed to its monosaccharides principally by a specific enzyme, lactase, which is a f-galactosidase.There are also two other enzymes with ,3-galactosidase activitv, lysosomal acid 3-galactosidase and cytoplasmic hetero-/-galactosidase, but their role in the hydrolysis of lactose is very small'.The latter has only in vitro activity. Historical development LOCATION OF LACTASE ENZYMEIt has been known for a long time that milk may produce loose stools or even diarrhoea in some people and therefore many populations considered milk unsuitable for consumption after weaning2.Over 100 years ago it was observed that milk sugar (lactose) produced diarrhoea to the dog3.The pathophysio- logical mechanism of this condition was elucidated in 1903 by Rohmann and Nagano4, who found in dogs that unhydrolysed lactose molecules remained in the lumen of the small intestine for some time producing a strong osmotic effect and diarrhoea.Lactose remained unhydrolysed because very little lactase activity existed in the small intestine.This observation was confirmed later in humans by more sophisticated methods5-7.Soon after the first observations of lactase activity in the small intestine in the 1890s8,9 it was found that, in general, it was possible to demonstrate activity only in young animals'0-12, although some authors found lactase activity also in old animals13.The principal site of activity seemed to be the small-intestinal mucosall 14-47, activity being highest in the jejunum and decreasing toward the ileum.Controversy existed over lactase activity in the small-intestinal juice, succus entericus.Some authors found activity18, while others did not4'19.Although in some studies20, especially in those by Cajori in 193321 and in 193522, it appeared evident that lactose was hydrolysed in the small-intestinal epithelium and only insignificant amounts of activity existed in the succus entericus, many later textbooks stated that the only site of lactase enzyme was the intestinal juice23 2. It was not until the late 1950s and early 1960s with the publications of Borgstrom et al.27 and Dahlqvist et al.28 that it became generally accepted that the hydrolysis of lactose takes place in the outer membrane of the mucosal epithelial cells and not in the small intestinal juice, where lactase activity is very low and of no functional importance.1074
Screening for breast cancer Randomised trials testify to benefit
Authors: J M Dixon
Journal: BMJ (1994)

patients may also be taking an antidepressant with anticholinergic properties and, almost routinely, receive an anticholinergic drug such as procyclidine to prevent or alleviate rigidity.Though some patients with anticholinergic intoxication will be "hot as a hare, blind as a bat, red as beetroot, and mad as a hatter," in psychiatric practice they will more probably be noticed to have a fever and will be diagnosed as having the neuroleptic malignant syndrome.Patients considered to have this syndrome should always be examined for the physical hallmarks of anticholinergic intoxication, particularly pupillary dilatation and dry skin and mucous membranes.The investigation and treatment of this condition are considerably less enigmatic than those of the neuroleptic malignant syndrome and have been well described by Lipowski.3
Treatment INDs: Promising, Problematic
Authors: Beverly Merz
Journal: JAMA (1988)

CONTROVERSY AND CONFUSION surround a new regulation that expands the availability of investigational new drugs (INDs) beyond clinical trials. The rule, known informally as the "Treatment IND," describes procedures for making promising INDs available to patients with serious or immediately life-threatening disease for whom other forms of treatment have been inadequate (<i>JAMA</i>1987;257:1858). In essence an extension of the "Compassionate IND," it is not a new concept or practice, but a codification and extension of existing procedures. Yet many believe that the consequences of its enactment will be far ranging: that it will threaten controlled clinical trials; make untried drugs available; and create a two-tiered system of care for the critically ill. Since the regulation went into effect last June, the Food and Drug Administration (FDA) has made three drugs available under its provisions—cytomegalovirus (CMV) immune globulin to prevent CMV infection in patients with kidney transplants; ifosfamide and mesma for
643. RNA Interference Targeting EP4 Prostanoid Receptor Attenuates Inflammatory Pain in Rats
Authors: Chung-Ren Lin, Haibin Wang, Clifford J. Woolf, Fumimasa Amaya
Journal: Molecular Therapy (2005)

The EP4 prostanoid receptor is one of the four subtypes of receptors for prostaglandin E2. It is coupled to Gs and increasing the cAMP formation. However, the relation between EP4 and pain has not been established. Double stranded, short interfering RNAs (siRNA) of 21-22 nt length initiate a sequence-specific, post-trancriptional gene silencing in animals and plants known as RNA interference (RNAi). Here we show that siRNA against EP4 receptor can block a pathophysiological pain response and provide relief from intradermal capsaicin injection in rats. Rats, intrathecally infused with a 21 nt siRNA perfectly complementary to the EP4, showed diminished pain responses compared to missense (MS) siRNA-treated and untreated controls in capsaicin-evoked response. This form of delivery caused no adverse effects in any of the animals receiving EP4 siRNA, MS siRNA or vehicle. Molecular analysis of tissues revealed that both EP4 mRNA and protein expressed in dorsal root ganglia were significantly diminished. Electrophysiological studies showed that EP4 activation potentiates the capsaicin-elicited current in rat dorsal root ganglion cells. These findings reveal an effective target for EP4 silencing and provide a new possibility for analgesic intervention.