tbuckley/cabot-search huggingface dataset:
Is concordance the primrose path to health?
Authors: R. E Ferner
Journal: BMJ (2003)

It might not make much difference 

The concept of concordance—consensual prescribing—emerged after an inquiry “into the causes and consequences of non-compliance with medicines.”1 The notion of “doctor's orders,” where the passive patient is given treatment by the authoritarian and supposedly knowledgeable doctor is replaced by the idea of discussion and agreement between patient and prescriber before treatment. The final aim is “to optimise the potential benefits of medical care.”1 Two thirds of older patients prescribed a statin for coronary artery disease will have given up treatment within two years.2 Concordance implies that these patients are denied real benefits if they do not take treatment as prescribed, and informed discussion should improve matters. Constructive dialogue between patient and prescriber is ethically and professionally desirable, even if the public good sometimes demands an authoritarian approach, as with directly observed treatment for tuberculosis or methadone maintenance. Usually, however, the patient, who has most to gain by success and the most to lose from …
Tumors of Childhood: A Clinical Treatise
Authors: William P. Barba
Journal: JAMA (1960)

This book is written primarily for the pediatrician. The presentation is generally that of the classical textbook which requires careful study rather than casual reading. Each chapter is followed by a reasonably complete bibliography. The illustrations and tables are plentiful, clear, and helpful. There is an excellent index. The age group covered ranges from birth to 14 years, inclusive.  Part 1 presents a general survey of the subject. The problem and significance of tumors in children are defined, and basic and experimental data are concisely evaluated. The general clinical findings are summarized. The various general and specific problems of management and therapy are delineated, with special emphasis on the experience and philosophy of the Memorial Hospital group. A discussion of how to deal with the older child who is aware of the significance of his or her disease is not included, except as it pertains to amputation. This part of
Simulated swimming: a useful tool for evaluation the VO2 max of swimmers in the laboratory.
Authors: Y Kimura, R A Yeater, R B Martin
Journal: British Journal of Sports Medicine (1990)

This study was designed to develop a simulated swimming exercise (SS) so that peak VO2 would be assessed on swimmers in a laboratory setting. The subjects assumed a prone position on an incline bench and performed arm cranking on a Monark Rehab Trainer while performing a flutter kick against tension supplied by elastic cords. The SS test was compared to four peak VO2 tests: treadmill running (RN), tethered swimming (TW), bicycle ergometry (B), and arm cranking (AC). Eleven male varsity swimmers underwent each of the five VO2 max tests, and maximal cardiorespiratory indicators (HR, VE, VO2, O2 pulse, and RQ) were measured. The percentage of peak VO2 obtained during SS was compared to RN, TW, B, and AC. The SS test achieved 78 percent of RN, 91 percent of TW, 81 percent of B, and 124 percent of AC. There were no significant differences in VO2 in ml/kg.min between SS and TW. As expected, RN and B were significantly higher, while AC was lower. Ten subjects performed the SS test twice on two separate days within one week. The reliability of VO2 max in ml/kg.min was 0.95. the validity of VO2 max in ml/kg.min in the SS test vs. RN was 0.68. The SS test is reliable and can be used as effectively as TW to assess the VO2 max of swimmers in a laboratory setting.
BMA secretary responds to news story
Authors: J. Strachan
Journal: BMJ (2003)

EDITOR—That your news story about the way in which I responded to a motion about staff pay at the BMA's Torquay annual representative meeting presents a partial view of the episode is not surprising.1 I was given no opportunity to explain myself at the meeting; neither did your correspondent feel it necessary to talk to me before going into print.

What on earth, your readers and BMA members may ask, was the BMA secretary doing deploying legal threats to suppress legitimate debate when everyone else was having such a good time at the seaside? Who does he think he is?

Let us be clear: the …
What's wrong with the wards?
Authors: Katherine Teale
Journal: BMJ (2007)

One of the more depressing moments in my week came when I overheard a conversation between two surgical trainees. “I'm covering the ward today,” said one disgruntled young man. “I always get the crap jobs.” His colleague was suitably sympathetic at this terrible misfortune. When I teach the medical students they seem fired up with the desire to help people. When does this become limited to wanting to cut bits out of people, send them back to the ward, and forget about them? 

It's not just the doctors' problem. The Royal College of Nursing recently warned that cuts in nursing jobs are putting patients' lives at risk. Certainly understaffing is a serious issue—but my experience of many wards is that there seems to be an invisible barrier between the nursing station and the patient areas. Nurses only cross this to do a specific task, and then scurry back to the paperwork as quickly as possible. Recent figures show that three of the four …
Aquagenic Wrinkling of the Palms in a Patient with Cystic Fibrosis
Authors: Hartmut Grasemann, Felix Ratjen, Melinda Solomon
Journal: New England Journal of Medicine (2013)

In this case report, ivacaftor was used as therapy and as an indicator to show that aquagenic wrinkling of the palms in a patient with the G551D cystic fibrosis mutation is related to the presence of this cystic fibrosis transmembrane conductance regulator variant.
Promiscuous Mutations Activate the Noncanonical NF-κB Pathway in Multiple Myeloma
Authors: Jonathan J. Keats, Rafael Fonseca, Marta Chesi, Roelandt Schop, Angela Baker, Wee-Joo Chng, Scott Van Wier, Rodger Tiedemann, Chang-Xin Shi, Michael Sebag, Esteban Braggio, Travis Henry, Yuan-Xiao Zhu, Homer Fogle, Tammy Price-Troska, Gregory Ahmann, Catherine Mancini, Leslie A. Brents, Shaji Kumar, Philip Greipp, Angela Dispenzieri, Barb Bryant, George Mulligan, Laurakay Bruhn, Michael Barrett, Riccardo Valdez, Jeff Trent, A. Keith Stewart, John Carpten, P. Leif Bergsagel
Journal: Cancer Cell (2007)
Development of Clinical Trials in a Cooperative Group Setting: The Eastern Cooperative Oncology Group
Authors: David M. Dilts, Alan Sandler, Steven Cheng, Joshua Crites, Lori Ferranti, Amy Wu, Robert Gray, Jean MacDonald, Donna Marinucci, Robert Comis
Journal: Clinical Cancer Research (2008)

Abstract Purpose: We examine the processes and document the calendar time required to activate phase II and III clinical trials by an oncology group: the Eastern Cooperative Oncology Group (ECOG). Methods: Setup steps were documented by (a) interviewing ECOG headquarters and statistical center staff, and committee chairs, (b) reviewing standard operating procedure manuals, and (c) inspecting study records, documents, and e-mails to identify additional steps. Calendar time was collected for each major process for each study in this set. Results: Twenty-eight phase III studies were activated by ECOG during the January 2000 to July 2006 study period. We examined a sample from 16 of those studies in detail. More than 481 distinct processes were required for study activation: 420 working steps, 61 major decision points, 26 processing loops, and 13 stopping points. Median calendar days to activate a trial in the phase III subset was 783 days (range, 285-1,542 days) from executive approval and 808 days (range, 435-1,604 days) from initial conception of the study. Data were collected for all phase II and phase III trials activated and completed during this time period (n = 52) for which development time represented 43.9% and 54.1% of the total trial time, respectively. Conclusion: The steps required to develop and activate a clinical trial may require as much or more time than the actual completion of a trial. The data shows that to improve the activation process, research should to be directed toward streamlining both internal and external groups and processes.
Cardiogenesis of Embryonic Stem Cells with Liquid Marble Micro‐Bioreactor
Authors: Fatemeh Sarvi, Kanika Jain, Tina Arbatan, Paul J. Verma, Kerry Hourigan, Mark C. Thompson, Wei Shen, Peggy P. Y. Chan
Journal: Advanced Healthcare Materials (2014)

A liquid marble micro‐bioreactor is prepared by placing a drop of murine embryonic stem cell (ESC) (Oct4B2‐ESC) suspension onto a polytetrafluoroethylene (PTFE) particle bed. The Oct4B2‐ESC aggregates to form embryoid bodies (EBs) with relatively uniform size and shape in a liquid marble within 3 d. For the first time, the feasibility of differentiating ESC into cardiac lineages within liquid marbles is being investigated. Without the addition of growth factors, suspended EBs from liquid marbles express various precardiac mesoderm markers including Flk‐1, Gata4, and Nkx2.5. Some of the suspended EBs exhibit spontaneous contraction. These results indicate that the liquid marble provides a suitable microenvironment to induce EB formation and spontaneous cardiac mesoderm differentiation. Some of the EBs are subsequently plated onto gelatin‐coated tissue culture dishes. Plated EBs express mature cardiac markers atrial myosin light chain 2a (MLC2a) and ventricular myosin light chain (MLC2v), and the cardiac structural marker α‐actinin. More than 60% of the plated EBs exhibit spontaneous contraction and express mature cardiomyocyte marker cardiac troponin T (cTnT), indicating that these EBs have differentiated into functional cardiomyocytes. Together, these results demonstrate that the liquid‐marble technique is an easily employed, cost effective, and efficient approach to generate EBs and facilitating their cardiogenesis.
Scared to death?
Authors: G. Smith
Journal: BMJ (2002)

Phillips et al report a “Hound of the Baskervilles effect” among Chinese-Americans andJapanese-Americans, who have abnormally high cardiac mortality on the fourth day of each month because they think the number 4 is unlucky.1 Is it plausible that the number 4 is regarded with the same terror that the fictional Charles Baskerville felt as he was pursued in the dark by a huge hound “with its flaming jaws and blazing eyes”? We encounter the number 4 every day. Could one more 4, the fourth day of a month, be fatal?

A natural test is to compare deaths on the third, fourth, and fifth days of each month. A longer horizon is flawed because a systematic cycle that causes deaths to peak near day 4 may show statistical significance that reflects a bulge near …
A Pill for Old People
Authors: Roger M. Cass
Journal: Annals of Internal Medicine (1994)

On Being a Doctor1 November 1994A Pill for Old PeopleRoger M. Cass, MDRoger M. Cass, MDUniversity of Rochester; Rochester, NY 14620Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-9-199411010-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail She was coming up on her 92d birthday. After two lens implants, her eyesight was good and her hearing was, well, selective. She had had a few Stokes-Adams attacks, a bit of angina, and mild hypertension treated with diltiazem, but her mind and her Irish wit, every bit of it, were all there.She had told me when I was a boy, “When people get old they ought to give them a pill”. This went right by me, as did her casual remark 50 years later that she was never going to Hebron Hall, the skilled nursing home in her ... Author, Article, and Disclosure InformationAffiliations: University of Rochester; Rochester, NY 14620 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByFrance 1 November 1994Volume 121, Issue 9Page: 717KeywordsFatigueHearingHematologic testsHypertensionMyocardial infarctionNursesNursing homesOilsRespirationStroke Issue Published: 1 November 1994 CopyrightCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Uric Acid Promotes Tumor Immune Rejection
Authors: De-En Hu, Alistair M. Moore, Lindy L. Thomsen, Kevin M. Brindle
Journal: Cancer Research (2004)

Uric acid released from dying cells has been shown recently to act as a danger signal for the immune system, stimulating dendritic cell maturation and enhancing T-cell responses to foreign antigens. Stimulation of dendritic cell maturation by uric acid has been proposed as a mechanism by which the immune system could generate responses against tumors. We show here that uric acid levels are elevated in tumors undergoing immune rejection and that the inhibition of uric acid production, by systemic administration of allopurinol, or the removal of uric acid, by administration of uricase, delayed tumor immune rejection, whereas subcutaneous administration of crystalline uric acid enhanced the rejection process.
Acute improvement of pulmonary hemodynamics does not alleviate Cheyne-Stokes respiration in chronic heart failure - a randomized, controlled, double-blind, crossover trial
Authors: Thomas Bitter, Andrea Zwenke, Zisis Dimitriadis, Thomas Fischbach, Markus Möllenberg, Jelena Dohrmann, Christian Prinz, Maryam Afsah, Dieter Horstkotte, Olaf Oldenburg
Journal: European Respiratory Journal (2013)

Background: Studies confirmed Cheyne-Stokes respiration (CSR) to be associated with elevated pulmonary capillary wedge pressure (PCWP) in chronic heart failure (CHF). This study aimed to investigate the acute effects of lowering PCWP and pulmonary artery pressure (PAP) on CSR severity.  Methods: 21 consecutive patients with CHF and CSR (apnea-hypopnea-index (AHI≥15/h)) underwent right heart catheterization, followed by infusion of glyceryltrinitrate (GTN), and inhalation of iloprost. Throughout the procedure PAP and PCWP was measured invasively. Afterwards maximum tolerable dosage of GTN and iloprost were randomly applied in 2 split-night procedures versus i.v. or inhalative NaCl 0.9% under full polysomnography monitoring.  Results: Mean (m)PAP was significantly reduced by GTN (20.1±9.0 to 11.6±4.2mmHg, p  Conclusion: GTN and Iloprost led to a significant reduction in PAP, whereas PCWP was lowered by GTN exclusively. However, acute improvement of pulmonary congestion had no impact on CSR severity. Extended treatment periods appear crucial for successful causal therapies.
Lymphomatoid papulosis: ultrastructural, immunohistochemical and gene analytical studies
Authors: N. MATSUYOSHI, Y. HORIGUCHI, T. TANAKA, K. TAKAHASHI, N. DOSAKA, M. FUJITA, Y. MIYACHI, S. IMAMURA
Journal: British Journal of Dermatology (1989)

Journal Article Lymphomatoid papulosis: ultrastructural, immunohistochemical and gene analytical studies Get access N. MATSUYOSHI, N. MATSUYOSHI Department of Dermatology, Faculty of Medicine, Kyoto University, Kyoto, Japan Dr Norihisa Matsuyoshi, Department of Dermatology, Faculty of Medicine, Kyoto University, Shogoin, Sakyo‐ku, Kyoto, Japan. Search for other works by this author on: Oxford Academic Google Scholar Y. HORIGUCHI, Y. HORIGUCHI Department of Dermatology, Faculty of Medicine, Kyoto University, Kyoto, Japan Search for other works by this author on: Oxford Academic Google Scholar T. TANAKA, T. TANAKA Department of Dermatology, Faculty of Medicine, Kyoto University, Kyoto, Japan Search for other works by this author on: Oxford Academic Google Scholar K. TAKAHASHI, K. TAKAHASHI Department of Dermatology, Faculty of Medicine, Kyoto University, Kyoto, Japan Search for other works by this author on: Oxford Academic Google Scholar N. DOSAKA, N. DOSAKA Department of Dermatology, Faculty of Medicine, Kyoto University, Kyoto, Japan Search for other works by this author on: Oxford Academic Google Scholar M. FUJITA, M. FUJITA Department of Dermatology, Faculty of Medicine, Kyoto University, Kyoto, Japan Search for other works by this author on: Oxford Academic Google Scholar Y. MIYACHI, Y. MIYACHI Department of Dermatology, Faculty of Medicine, Kyoto University, Kyoto, Japan Search for other works by this author on: Oxford Academic Google Scholar S. IMAMURA S. IMAMURA Department of Dermatology, Faculty of Medicine, Kyoto University, Kyoto, Japan Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 121, Issue 3, 1 September 1989, Pages 381–389, https://doi.org/10.1111/j.1365-2133.1989.tb01433.x Published: 01 September 1989
Novel exon 12 mutations in the HIF2A gene associated with erythrocytosis
Authors: Melanie J. Percy, Philip A. Beer, Gavin Campbell, Ad W. Dekker, Anthony R. Green, David Oscier, M. Glenn Rainey, Richard van Wijk, Marion Wood, Terence R. J. Lappin, Mary Frances McMullin, Frank S. Lee
Journal: Blood (2008)
Abstract 3510: Fluvastatin enhances sorafenib cytotoxicity in melanoma cells via modulation of AKT and JNK signaling pathways
Authors: Nicole A. Doudican, Shali Zhang, Ellinor Quay, Seth J. Orlow
Journal: Cancer Research (2011)

Abstract Background: Most metastatic melanomas are refractory to current available therapy, underscoring the need to identify new effective treatments. Sorafenib, a multikinase inhibitor of the RAF/RAS/MEK pathway, showed promise in earlier stages of clinical development, but ultimately failed to demonstrate efficacy as a single agent in the treatment of melanoma. In order to enhance the efficacy of sorafenib in the treatment of melanoma, we tested over 2,000 naturally occurring compounds and marketed drugs in the presence of a sorafenib in two chemoresistant human melanoma cell lines (M14 and SKM-173) resistant to sorafenib-induced apoptosis. Of the 9 compounds identified as sorafenib sensitizers, we prioritized the cholesterol lowering agent fluvastatin based on its favorable pharmacokinetics and safety profile. Methodology: Growth inhibition was examined by MTT assay in a panel of 6 human melanoma cell lines. Drug interaction was analyzed by Calcusyn software which determines the effects of two drugs (i.e., synergy, antagonism, or additivity) through calculations of the combination index (CI). The effect of combination therapy on cellular signaling and induction of apoptotic pathways was evaluated by immunoblotting techniques. Results: Our results demonstrate that fluvastatin at 1µM, a level which is safely achieved through oral administration, dramatically enhances the growth inhibitory activity of clinically achievable concentrations of sorafenib in M14 and SKM-173 melanoma cells with a 3.2 and 3.6-fold reduction in the sorafenib GI50, respectively, with similar effects observed in other melanoma cell lines. Combination indices analysis revealed a synergistic relationship between the two agents. Fluvastatin enhances sorafenib-mediated apoptosis as revealed through enhanced cleavage of PARP. In combination with sorafenib, fluvastatin treatment results in reduced levels of activated AKT along with enhanced levels of activated JNK. Sensitization to sorafenib is unique to fluvastatin as other statins (ie. pravastatin and simvastatin) do not enhance sorafenib-mediated growth inhibition. Conclusions: These promising results warrant further investigation into the clinical applicability of fluvastatin as an agent for enhancing the efficacy of sorafenib in the treatment of melanoma. Fluvastatin sensitization to sorafenib will be further addressed through follow-up studies in mouse melanoma xenograft models. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3510. doi:10.1158/1538-7445.AM2011-3510
Endoventricular porcine autologous myoblast transplantation can be successfully achieved with minor mechanical cell damage
Authors: B Chazaud
Journal: Cardiovascular Research (2003)

Transplantation of skeletal myogenic precursor cells (mpc) into the myocardium using a non-surgical procedure.Closed-chest mpc transplantation was assessed in pigs using the NOGA-Biosense device allowing both electromechanical mapping of the left ventricle (LV), and guided mpc injections through endocardium.We successively established that: (1) adequate preimplantation handling of mpc can be achieved when mpc are kept in 0.1% serum albumin-containing medium until implantation; (2) mpc are neither retained nor destroyed in the catheter or the needle and their passage does not affect their survival, growth and differentiation; (3) large numbers of autologous mpc can be actually transplanted in the LV myocardium by transendocardial route, as assessed by post-mortem examination of pigs injected with iron-loaded mpc; (4) cell injection into the myocardium does not induce conspicuous cell mortality since more than 80% of mpc recovered from LV tissue are alive 15 min after injection; (5) mpc injections can be guided into circumscribed LV targets such as infarcted areas, as assessed by comparison of map injection sites with location of iron-loaded mpc at post-mortem examination of LV myocardium.This new approach may pave the way for a large spectrum of cell therapies targeting myocardial diseases.
Essential care after an inpatient fall: summary of a safety report from the National Patient Safety Agency
Authors: F. Healey, A. Darowski, T. Lamont, S. Panesar, S. Poulton, J. Treml, M. Wiese
Journal: BMJ (2011)

As many as one million patient falls are estimated to occur in hospitals each year in the United States, with similar rates reported from most other developed countries.1 In England and Wales about 280 000 patient falls are recorded annually from acute hospitals, community hospitals, and mental health units.2 This is likely to be an underestimate, as all reporting systems are known to under-report.3 Although over 96% of these falls result in only minor or no physical harm, 1390 caused fractures (including 840 hip fractures) and 30 led to intracranial injuries (mostly subdural haematomas).2

Inpatients are particularly vulnerable to falling owing to acute medical problems such as delirium, stroke, systemic infections, and cardiovascular and musculoskeletal conditions and to adverse effects from medications. In addition, the unfamiliar hospital environment may exacerbate the impact of conditions such as dementia and problems with continence, balance, strength, mobility, or eyesight.1

Prevention of falls is a crucial element of patient safety, and resources to help identify and reduce risk factors for falls are widely available.4 However, what happens after a fall is equally important. In particular, early detection and treatment of any injuries sustained, such as subdural haematoma5 and hip fracture,6 may affect outcome critically.

Twelve months of reports to the National Patient Safety Agency before 25 March 2010 indicate that about 200 patients who sustained fractures or intracranial injuries after a fall in hospital experienced some shortfalls of care after their fall. This is likely to be an underestimate owing to under-reporting and minimal detail in many reports on care after the fall. The reviewed incidents suggest that failure to recognise the risks …