tbuckley/cabot-search huggingface dataset:
What are the effects of the fifth revision of the Declaration of Helsinki? Fair partnerships support ethical research Gains and losses for rights of consumer and research participants Research will be impeded Some clauses will hinder development of new drugs and vaccines
Authors: S. M Tollman, H. Bastian, R. Doll, L. J Hirsch, H. A Guess
Journal: BMJ (2001)

# What are the effects of the fifth revision of the Declaration of Helsinki? {#article-title-2} The World Medical Association's fifth revision of the Declaration of Helsinki strives to strike a balance between ensuring high ethical standards and retaining sufficient sensitivity to local circumstances, especially in developing world research, to avoid thwarting research with bureaucracy. Has the balance been achieved? We asked researchers working in the developing world, the developed world, and the pharmaceutical industry, as well as a patient representative, to comment. # Fair partnerships support ethical research {#article-title-3} The World Medical Association describes the Declaration of Helsinki as a statement of ethical principles to guide physicians and other participants in medical research involving human subjects, including identifiable human tissue or data.1 When producing the fifth revision, representatives of the 71 affiliated medical associations were especially concerned that research in developing settings—and particularly clinical trials—meet the highest ethical standards of conduct. However, despite the increasingly inclusive aspirations of the revised declaration, some of the absolute and exclusionary language could unintentionally endanger research in developing countries. One of the fundamental changes to the declaration is clause 29. This states that new treatments should be tested against best current treatment rather than placebo (box). The clause was formulated in response to sustained criticism of field trials in developing countries that tested short course therapies aimed at preventing vertical transmission of HIV using placebo controls.2–4 It implies that local circumstances—sociopolitical, financial, infrastructural, cultural—can never justify failure to use the best known drugs or technologies in the control arm. Its intention is clear: #### Clause 29 of the Declaration of Helsinki The benefits, risks, burdens and effectiveness of a new method should be tested against those of the best current prophylactic, diagnostic, and therapeutic methods. This does not exclude the use of placebo, or no treatment, in studies where no proven prophylactic, diagnostic or therapeutic method exists. Correspondence to: L J Hirsch
Prophylactic mastectomy of contralateral breast only marginally improves survival, study shows
Authors: S. Mayor
Journal: BMJ (2014)

Contralateral prophylactic mastectomy improves life expectancy only marginally in women with breast cancer that is diagnosed in one breast, shows a new large modelling study based on US registry data and meta-analyses.1

This type of surgery has increased rapidly in the United States and Europe over the past decade. “But this may reflect an exaggerated perceived benefit from the procedure,” say the study’s authors, led by Pamela Portschy, general surgery resident …
Modern mRNA Proofreading and Repair: Clues that the Last Universal Common Ancestor Possessed an RNA Genome?
Authors: Anthony M. Poole, Derek T. Logan
Journal: Molecular Biology and Evolution (2005)

RNA repair has now been demonstrated to be a genuine biological process and appears to be present in all three domains of life.In this article, we consider what this might mean for the transition from an early RNA-dominated world to modern cells possessing genetically encoded proteins and DNA.There are significant gaps in our understanding of how the modern protein-DNA world could have evolved from a simpler system, and it is currently uncertain whether DNA genomes evolved once or twice.Against this backdrop, the discovery of RNA repair in modern cells is timely food for thought and brings us conceptually one step closer to understanding how RNA genomes were replaced by DNA genomes.We have examined the available literature on multisubunit RNA polymerase structure and function and conclude that a strong case can be made that the Last Universal Common Ancestor (LUCA) possessed a repair-competent RNA polymerase, which would have been capable of acting on an RNA genome.However, while this lends credibility to the proposal that the LUCA had an RNA genome, the alternative, that LUCA had a DNA genome, cannot be completely ruled out.
Endocrine Exophthalmos
Authors: Denis A. McGill, Samuel P. Asper
Journal: New England Journal of Medicine (1962)

IN recent years great advances have been made in the diagnosis and treatment of thyroid disease, but the cause of the exophthalmos that often accompanies disordered thyroid function remains an enigma. Investigations into the etiology of endocrine exophthalmos have been hampered by the confusion arising out of many apparently conflicting observations and reports. In such a circumstance periodic review and analysis of the known facts are justified, and in a condition in which, as Brain1 has observed, "There is an exception to every statement that can be made," a reappraisal of current thoughts may serve to delineate areas for future . . .
Coronary CT Angiography for Acute Chest Pain
Authors: Rita F. Redberg
Journal: New England Journal of Medicine (2012)

Each year, more than 6 million people in the United States go to emergency departments because of acute chest pain. Some of them have coronary artery disease, but most have diseases that are unrelated to the heart or they have no discernible physiological conditions. The vast majority will undergo various diagnostic tests, and many will be held for observation and may be admitted to the hospital. This approach, however, is guaranteed to lead to unnecessary stays in the emergency department and to overtreatment. More disturbingly, it is unclear whether this approach actually results in better outcomes than a more conservative . . .
PROPHYLAXIS OF IMPETIGO NEONATORUM
Authors: W. H. Guy
Journal: JAMA (1934)

In 1928 Chadwell<sup>1</sup>reported three years of extraordinary success in the prevention of impetigo among the new-born in a large maternity service. The method hinged on a single inunction of each infant with 5 per cent ointment of ammoniated mercury following an initial soap and water bath. On the following days sterile cottonseed oil was applied to impregnate all follicles completely with the drug. While numerous other institutions have adopted the plan, we feel that the success of the method in our hands merits a report urging a more widespread adoption of this simple and inexpensive procedure. At the Elizabeth Steel Magee Hospital there are between two and three thousand births annually. Impetigo has been present intermittently and at times in epidemic form in the nurseries since the opening of the institution. From reports and observation of other large maternity services, we feel that the incidence of impetigo mentioned
Multiplex Protein Analysis to Determine Fibrosis Stage and Progression in Patients With Chronic Hepatitis C
Authors: Keyur Patel, Katja S. Remlinger, Terence G. Walker, Peter Leitner, Joseph E. Lucas, Stephen D. Gardner, John G. McHutchison, Will Irving, Indra Neil Guha
Journal: Clinical Gastroenterology and Hepatology (2014)
ΔNp63α Confers Tumor Cell Resistance to Cisplatin through the AKT1 Transcriptional Regulation
Authors: Tanusree Sen, Nilkantha Sen, Mariana Brait, Shahnaz Begum, Aditi Chatterjee, Mohammad Obaidul Hoque, Edward Ratovitski, David Sidransky
Journal: Cancer Research (2011)

Strategies to address resistance to platin drugs are greatly needed in human epithelial cancers (e.g., ovarian, head/neck, and lung) where platins are used widely and resistance occurs commonly. We found that upon ΔNp63α overexpression, AKT1 and phospho-AKT1 levels are upregulated in cancer cells. Investigations using gel-shift, chromatin immunoprecipitation and functional reporter assays implicated ΔNp63α in positive regulation of AKT1 transcription. Importantly, we found that ΔNp63α, AKT1, and phospho-AKT levels are greater in 2008CI3 CDDP-resistant ovarian cancer cells than in 2008 CDDP-sensitive cells. siRNA-mediated knockdown of ΔNp63α expression dramatically decreased AKT1 expression, whereas knockdown of either ΔNp63α or AKT1 decreased cell proliferation and increased death of ovarian and head/neck cancer cells. Conversely, enforced expression of ΔNp63α increased cancer cell proliferation and reduced apoptosis. Together, our findings define a novel ΔNp63α-dependent regulatory mechanism for AKT1 expression and its role in chemotherapeutic resistance of ovarian and head/neck cancer cells.
A prospective study of the histological changes in the skin in patients receiving bone marrow transplants
Authors: ROSEMARY LEVER, MARLYN TURBITT, RONA MACKIE, I. HANN, B. GIBSON, A. BURNETT, M. WILLOUGHBY
Journal: British Journal of Dermatology (1986)

Fourteen patients who received a bone marrow transplant (BMT) as treatment for leukaemia were included in a prospective study of the histological changes in the skin. The aim of this study was to improve the early diagnosis of graft-versus-host disease (GVHD). It was found that the clinically 'normal' pre-transplant skin was in some cases histologically abnormal on H & E examination in patients who were on regular maintenance cytotoxic chemotherapy. These changes were similar to some of the features of GVHD. Immunocytochemistry, although not specific, was found to be helpful in the diagnosis of some cases of GVHD. Suggestive features included a reduction in the numbers of Langerhans cells, an increase in the number of suppressor (OKT8+) cells in the dermal infiltrate and the presence of Ia positivity of the keratinocytes in the epidermis.
IB-07 * HISTOPLASMOSIS WITH CNS INVOLVEMENT: CASE PRESENTATION WITH DISCUSSION AND LITERATURE REVIEW
Authors: T. Minasian, O. Hariri, A. Dyurgerova, D. Miulli, J. Siddiqi
Journal: Neuro-Oncology (2014)

Histoplasma capsulatum is one of the most common fungal respiratory infections in the world. CNS histoplasmosis is rare and difficult to diagnose because it is often overlooked or mistaken for other pathologies due to its non-specific symptoms. Failure to quickly diagnose CNS histoplasmosis leads to a poor prognosis. A 32-year-old homosexual Hispanic male with advanced AIDS presented with an altered mental status and reported confusion for the past three months. He had a GSC scale of 12, repetitive non-fluent speech, and a disconjugate gaze with a right gaze preference. Lung-CT findings indicated a pulmonary histoplasmosis infection. An MRI of the brain revealed a ring-enhancing lesion in the left caudate nucleus. A CT guided left retroperitoneal node biopsy was performed and indicated a benign inflammatory process with organisms compatible with fungal yeast. Treatment with amphotericin B followed by itraconazole was initiated in spite of negative CSF cultures and proved effective in mitigating associated CNS lesions and resolving neurologic deficits. The patient was discharged three weeks later in stable condition. Six weeks later, his left basal ganglia mass decreased from 30 x 36.9mm to 28.3 x 23.3mm. Early recognition of symptoms and proper steps are key in improving outcomes of CNS histoplasmosis. Aggressive medical management is possible in treatment of intracranial deep mass lesions, and disseminated histoplasmosis with CNS involvement can be appropriately diagnosed and treated, despite negative CSF and serology studies.
The Oliver-Sharpey Lectures ON THE FEEDING OF NATIONS: A STUDY IN APPLIED PHYSIOLOGY: Delivered before the Royal College of Physicians of London, June 3rd and 5th
Authors: E. H. Starling
Journal: BMJ (1919)

PoFESSOR 'STARLING remarked that although man's first care had always been to provide *his daily bread, the science of dietetics was of comparatively recent origin, .and the problems involved were at first tackled -exclusively from tlle standpoint of the individual.In a few instances only were the results utilized for practical pur- poses connected with society as a whole or with large sections of the community.The .proviioning of a nation was reg,arded as an economic question to be sOlved by the laws of supPly and demand.It was -not Uitil the great war broke oUt that any Of the nations awoke -to the fact that efforts to provision a community would be disastrous unless based uponp plysiological principles.
Minocycline in Rheumatoid Arthritis
Authors: Harold E. Paulus
Journal: Annals of Internal Medicine (1995)

Letters1 September 1995Minocycline in Rheumatoid ArthritisHarold E. Paulus, MDHarold E. Paulus, MDUniversity of California, Los Angeles; Los Angeles, CA 90024-1670Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-123-5-199509010-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate the comments of Drs. Galland and Clark. The space constraints of my brief editorial precluded an in-depth review of all aspects of the subject, and their comments provide useful insights into the historical and scientific background in which the recent controlled clinical trials of minocycline were done.Dr. Galland hypothesizes that rheumatoid arthritis is caused by sensitization to bacterial antigens, the absorption of which through the intestinal mucosa is enhanced by NSAID-induced hyperpermeability and inflammation of the bowel. He also suggests that the benefit of minocycline is caused by its antibacterial action on the gut flora. ...References1. Tilley BC, Alarcon GS, Heyse SP, Trentham DE, Neuner R, Kaplan DA, et al. Minocycline in rheumatoid arthritis. A 48-week, double-blind, placebo-contrrolled trial. Ann Intern Med. 1995; 122:81-9. Google Scholar Author, Article, and Disclosure InformationAuthors: Harold E. Paulus, MDAffiliations: University of California, Los Angeles; Los Angeles, CA 90024-1670 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 September 1995Volume 123, Issue 5Page: 393KeywordsAntibioticsAntigensClinical trialsInflammationMucous membranesPilot studiesRheumatoid arthritisTetracyclines ePublished: 15 August 2000 Issue Published: 1 September 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
A NEW UNIVERSAL DOUBLE-ACTING SNARE.
Authors: CHARLES A. BUCKLIN
Journal: JAMA (1891)

The good principles of all similar instruments have been combined in this snare, and their inherent defects have been obviated. The wire is attached to a solid stylet, the objections to which are overcome by the powerful ratchet motion which draws it. A screw motion is also attached to the same stylet, thus enabling the operator to use a very slow-cutting snare, where hæmorrhage is feared, while the ratchet motion provides a rapid-cutting one where there is no reason to expect hæmorrhage. The handle and ratchet motion may be detached at pleasure, leaving an instrument suitable for the slow strangulation of a very vascular growth. The instrument has a straight tip for the nose and curved tips for reaching the larynx and naso-pharynx through the pharynx. In curved canulas all attempts to use flexible stylets under severe traction are dangerous, as they must break sooner or later in making the
Fractal nature of regional myocardial blood flow heterogeneity.
Authors: J B Bassingthwaighte, R B King, S A Roger
Journal: Circulation Research (1989)

Spatial variation in regional flows within the heart, skeletal muscle, and in other organs, and temporal variations in local arteriolar velocities and flows is measurable even with low resolution techniques. A problem in the assessment of the importance of such variations has been that the observed variance increases with increasing spatial or temporal resolution in the measurements. This resolution-dependent variance is now shown to be described by the fractal dimension, D. For example, the relative dispersion (RD = SD/mean) of the spatial distribution of flows for a given spatial resolution, is given by: RD(m) = RD(mref).[m/mref]1-Ds where m is the mass of the pieces of tissue in grams, and the reference level of dispersion, RD(mref), is taken arbitrarily to be the RD found using pieces of mass mref, which is chosen to be 1 g. Thus, the variation in regional flow within an organ can be described with two parameters, RD(mref) and the slope of the logarithmic relationship defined by the spatial fractal dimension Ds. In the heart, this relation has been found to hold over a wide range of piece sizes, the fractal Ds being about 1.2 and the correlation coefficient 0.99. A Ds of 1.2 suggests moderately strong correlation between local flows; a Ds = 1.0 indicates uniform flow and a Ds = 1.5 indicates complete randomness.
Thrombotic risk factors in patients with liver cirrhosis: Correlation with MELD scoring system and portal vein thrombosis development
Authors: Maria Assunta Zocco, Enrico Di Stasio, Raimondo De Cristofaro, Marialuisa Novi, Maria Elena Ainora, Francesca Ponziani, Laura Riccardi, Stefano Lancellotti, Angelo Santoliquido, Roberto Flore, Maurizio Pompili, Gian Lodovico Rapaccini, Paolo Tondi, Giovanni Battista Gasbarrini, Raffaele Landolfi, Antonio Gasbarrini
Journal: Journal of Hepatology (2009)
Growth hormone and tumour recurrence.
Authors: A. L. Ogilvy-Stuart, W. D. Ryder, H. R. Gattamaneni, P. E. Clayton, S. M. Shalet
Journal: BMJ (1992)

OBJECTIVE--To determine whether using growth hormone to treat radiation induced growth hormone deficiency causes tumour recurrence. DESIGN--Comparison of tumour recurrence rates in children treated with growth hormone for radiation induced deficiency and an untreated population. Computed tomograms from children with brain tumours were reviewed when starting growth hormone and subsequently. SETTING--North West region. PATIENTS--207 children treated for brain tumour, 47 of whom received growth hormone and 161 children with acute lymphoblastic leukaemia 15 of whom received growth hormone. MAIN OUTCOME MEASURES--Tumour recurrence and changes in appearances on computed tomography. RESULTS--Among children with brain tumour, five (11%) who received growth hormone had recurrences compared with 42 (26%) who did not receive growth hormone. Also adjusting for other variables that might affect tumour recurrence the estimated relative risk of recurrence was 0.82 (95% confidence interval 0.28 to 2.37). The only child with acute lymphoblastic leukaemia who relapsed while taking growth hormone had relapsed previously before starting treatment. Two of the five children with brain tumours who relapsed had abnormal appearances on computed tomography when growth hormone was started. 14 other children who remained relapse free and had follow up computed tomography showed no deterioration in radiological appearance during treatment. CONCLUSIONS--In this population growth hormone did not increase the risk of tumour recurrence but continued surveillance is essential. Abnormal results on computed tomography are not a contraindication to treatment with growth hormone.
Disseminated Infection Caused by<i>Cunninghamella bertholletiae</i>in a Patient with Beta-Thalassemia
Authors: JEFF M. SANDS
Journal: Annals of Internal Medicine (1985)

Rare cases of acute mucormycosis in immunocompromised persons have been attributed to Cunninghamella bertholletiae. We report the first known case of this organism causing a chronic, indolent, systemic disease clinically similar to entomophthoramycosis. Cunninghamella bertholletiae is an opportunistic pathogen whose morbidity may be underappreciated because it is usually considered to be a laboratory contaminant.
Abstract 2052: WNT/beta-catenin signaling inhibitors improve the anti-proliferative effect of sorafenib against hepatocellular carcinoma (HCC) cells.
Authors: Hsiao-Hui Lin, Wen-Chi Feng, Li-Chun Lu, Yu-Yun Shao, Ann-Lii Cheng, Chih-Hung Hsu
Journal: Cancer Research (2013)

Abstract [Background] Sorafenib, a multikinase inhibitor targeting Raf kinase and vascular endothelial growth factor receptor, is currently the only indicated therapy for patients with advanced hepatocellular carcinoma (HCC). The aberrant activation of WNT/β-catenin signaling pathway, which is associated with the carcinogenetic process of HCC, has been shown to mediate the resistance to various types of anti-cancer therapy. We hypothesized that inhibition of WNT/β-catenin signaling pathway might improve the anti-tumor effect of sorafenib in HCC. [Materials and Methods] Huh7, HepG2, PLC5, and Hep3B HCC cells were treated with sorafenib with or without inhibitors of WNT/β-catenin pathway, and evaluated for viability in vitro. WNT/β-catenin signaling inhibitors included ICG-001 which down-regulates β-catenin/TCF signaling by specifically binding to cyclic AMP response element-binding protein, and XAV939 which targets tankyrases and facilitates degradation of β-catenin. [Results] Sorafenib induced an anti-proliferative effect in HCC cells, with IC50s of 3.5±0.3 μM, 3.7±0.4 μM, 7.7±0.8 μM and 14±0.3 μM for HepG2, Huh7, PLC5, and Hep3B cells, respectively. Upon treated with 10 μM sorafenib for 24 hours, the total cellular amounts of β-catenin were significantly decreased in HepG2 and Huh7 cells, moderately decreased in PLC5 cells, and unchanged in Hep3B cells. In all HCC cells, XAV939 or ICG-001 enhanced the anti-proliferative effect of sorafenib dose-dependently. The median effect analysis showed a synergistic anti-proliferative effect for the combination of ICG-001 plus sorafenib in all HCC cells. [Conclusion] Inhibitors of WNT/β- catenin signaling pathway in combination with sorafenib resulted in an improved anti-tumor effect against HCC in vitro. (The study was supported by the grant NSC 100-2325-B-002-043 from National Science Council of Taiwan) Citation Format: Hsiao-Hui Lin, Wen-Chi Feng, Li-Chun Lu, Yu-Yun Shao, Ann-Lii Cheng, Chih-Hung Hsu. WNT/beta-catenin signaling inhibitors improve the anti-proliferative effect of sorafenib against hepatocellular carcinoma (HCC) cells. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 2052. doi:10.1158/1538-7445.AM2013-2052
Medical Journals Online
Authors: Saty Satya-Murti
Journal: JAMA (1997)

For many of us, keeping up with scientific advances is a failing endeavor. Paid abstracting services, personal subscriptions, and assiduous library visits might fulfill the needs of some. Still, the effort wears out all but the most ardent of us. Fortunately, there might be a partial solution on the horizon in the form of journals that have recently established World Wide Web (Web) sites. These are journals we turn to for oftcited reviews, analyses, and original articles. They have become accessible, gratis so far, on the Web in an electronic format. This is a review of the Web pages of these medical journals. I have not included specialty journals, but have focused only on major peerreviewed journals of general medical interest. Five general interest journals, the<i>Journal of the American Medical Association (JAMA), New England Journal of Medicine (NEJM), British Medical Journal (BMJ), Lancet</i>, and the<i>Canadian Medical Association Journal</i>