tbuckley/cabot-search huggingface dataset:
Caution: Conscience is the Limb on Which Medical Ethics Sits
Authors: Farr A. Curlin
Journal: The American Journal of Bioethics (2007)

conscientious refusal. However, the fact that there is a non-zero probability of something immoral happening is not all we can know about a given situation, and certainly not all the conscientiously-objecting pharmacist can know about the use of EC. We can know that the immoral thing is more or less likely to occur — often our approximation will be considerably more specific than merely non-zero. We can know whether or not the immoral thing is intended, by whom, and for what reasons. We can know whether the immoral thing is a more or less direct causal result of the professional’s actions. We can know that the immoral thing is a more or less seriously wrong. We can know roughly on a scale whether the immoral thing is widely understood as such or whether it is uniquely understood that way by the individual professional. Each of these is necessary for evaluating the reasonableness of the professional’s refusal to participate. In fact, we assume there are other categories relevant to the comprehensive ethical evaluation of contributing to an unethical act. It seems clear from these observations that Card (2007) uses the zero probability argument as a bit of a straw man. The conscientious objector does not rely on such a simplistic claim. In fact, conscientious objection can and should be evaluated in light of a variety of components, rather than the mere possibility that one’s actions will contribute to an unethical result. Specifically, conscientious objection appears to be made more plausible by a variety of factors, including the likelihood, intentionality, causal directness, degree of consensus, and not least, the severity of the unethical action.
Nursing dependency in registered nursing homes and long term care geriatric wards in Edinburgh.
Authors: A E Capewell, W R Primrose, C MacIntyre
Journal: BMJ (1986)

There has been growing interest and public investment in registered nursing homes, apparently based on the assumption that these homes are the private equivalent of hospital long term care. We have tested this hypothesis in a survey comparing 400 patients in 18 registered nursing homes with 217 patients in 11 geriatric long term care wards in Edinburgh. The nursing home patients formed a distinct and separate group: 362 (92%) were women, 392 (98%) were single or widowed, and 358 (90%) were self financing, whereas in the geriatric long term care group 148 (68%) were women and 35 (16%) were still married. Patients in nursing homes were also far less dependent than those in geriatric long term care wards (p less than 0.005). This study suggests that there may be large differences between the patients in these two types of institution, particularly with regard to nursing dependency. This finding has important implications in the future planning of long term places for the dependent elderly.
Myocardial Infarction After Normal Responses to Maximal Exercise
Authors: ROBERT A. BRUCE, TOM R. HORNSTEN, JOHN R. BLACKMON
Journal: Circulation (1968)

The unexpected occurrence of acute myocardial infarction shortly after performance of a multistage test of maximal exercise by a normal 42-year-old subject is described. There was no evidence of infarction after this exhausting effort, but symptoms occurred immediately on exposure to hot water while he was taking a shower a few minutes later. Cardiac arrest from ventricular fibrillation occurred after ECG evidence of acute infarction. Following successful defibrillation and coronary care, there was satisfactory recovery from massive anterior wall infarction. Incidence, possible pathophysiological mechanisms, and precautions are cited.
Socioeconomic Differences in Patient Survival Are Increasing for Acute Myeloid Leukemia and Multiple Myeloma in Sweden
Authors: Sigurdur Yngvi Kristinsson, Åsa Rangert Derolf, Gustaf Edgren, Paul W. Dickman, Magnus Björkholm
Journal: Journal of Clinical Oncology (2009)

Purpose An association between socioeconomic status (SES) and survival in acute myeloid leukemia (AML) and multiple myeloma (MM) has not been established in developed countries. We assessed the impact of SES on survival in two large population-based cohorts of AML and MM patients diagnosed in Sweden 1973 to 2005. Patients and Methods The relative risk of death (all cause and cause specific) in relation to SES was estimated using Cox's proportional hazards regression. We also conducted analyses stratified by calendar periods (1973 to 1979, 1980 to 1989, 1990 to 1999, and 2000 to 2005). Results We identified a total of 9,165 and 14,744 patients with AML and MM, respectively. Overall, higher white-collar workers had a lower mortality than other SES groups for both AML (P = .005) and MM (P &lt; .005). In AML patients, a consistently higher overall mortality was observed in blue-collar workers compared with higher white-collar workers in the last three periods (hazard ratio [HR], 1.26; 95% CI, 1.05 to 1.51; HR, 1.23; 95% CI, 1.05 to 1.45; HR, 1.28; 95% CI, 1.04 to 1.57, respectively). In MM, no difference was observed in the first two calendar periods. However, in 1990 to 1999, self-employed (HR, 1.18; 95% CI, 1.02 to 1.37), blue-collar workers (HR, 1.18; 95% CI, 1.04 to 1.32), and retired (HR, 1.45; 95% CI, 1.16 to 1.80) had a higher mortality compared to higher white-collar workers. In 2000 to 2005, blue-collar workers had a higher mortality (HR, 1.31; 95% CI, 1.07 to 1.60) compared with higher white-collar workers. Conclusion SES was significantly associated with survival in both AML and MM. Most conspicuously, a lower mortality was observed among the highest SES group during more recent calendar periods. Differences in management, comorbidity, and lifestyle, are likely factors to explain these findings.
Transformed lymphocytes from Abelson-diseased mice express levels of a B lineage transformation-associated antigen elevated from that found on normal lymphocytes.
Authors: G F Tidmarsh, M O Dailey, C A Whitlock, E Pillemer, I L Weissman
Journal: The Journal of Experimental Medicine (1985)

Animals injected with Abelson murine leukemia virus (A-MuLV) rapidly develop fatal bone marrow-derived lymphosarcomas. In all such diseased animals tested, a subpopulation of bone marrow cells expressed a monoclonal antibody-defined, B lineage transformation-associated antigen (6C3 Ag) at levels increased from that detected on normal lymphocytes. Cells bearing a high level of this antigen were found to be transformed as measured by clonal growth in agar, and they expressed surface antigen markers characteristic of early pre-B cells. High-level antigen-expressing cells were found in the bone marrow, lymph nodes, and spleen, but never in the thymus of diseased animals. This distribution agrees with the published pathology of Abelson disease.
Physiological Transgene Regulation and Functional Complementation of a Neurological Disease Gene Deficiency in Neurons
Authors: Pier Paolo Peruzzi, Sean E Lawler, Steve L Senior, Nina Dmitrieva, Pauline AH Edser, Davide Gianni, E Antonio Chiocca, Richard Wade-Martins
Journal: Molecular Therapy (2009)

The microtubule-associated protein tau (MAPT) and α-synuclein (SNCA) genes play central roles in neurodegenerative disorders. Mutations in each gene cause familial disease, whereas common genetic variation at both loci contributes to susceptibility to sporadic neurodegenerative disease. Here, we demonstrate exquisite gene regulation of the human MAPT and SNCA transgene loci and functional complementation in neuronal cell cultures and organotypic brain slices using the herpes simplex virus type 1 (HSV-1) amplicon-based infectious bacterial artificial chromosome (iBAC) vector to express complete loci >100 kb. Cell cultures transduced by iBAC vectors carrying a 143 kb MAPT or 135 kb SNCA locus expressed the human loci similar to the endogenous gene. We focused on analysis of the iBAC-MAPT vector carrying the complete MAPT locus. On transduction into neuronal cultures, multiple MAPT transcripts were expressed from iBAC-MAPT under strict developmental and cell type–specific control. In primary neurons from Mapt−/− mice, the iBAC-MAPT vector expressed the human tau protein, as detected by enzyme-linked immunosorbent assay and immunocytochemistry, and restored sensitivity of Mapt−/− neurons to Aβ peptide treatment in dissociated neuronal cultures and in organotypic slice cultures. The faithful retention of gene expression and phenotype complementation by the system provides a novel method to analyze neurological disease genes. The microtubule-associated protein tau (MAPT) and α-synuclein (SNCA) genes play central roles in neurodegenerative disorders. Mutations in each gene cause familial disease, whereas common genetic variation at both loci contributes to susceptibility to sporadic neurodegenerative disease. Here, we demonstrate exquisite gene regulation of the human MAPT and SNCA transgene loci and functional complementation in neuronal cell cultures and organotypic brain slices using the herpes simplex virus type 1 (HSV-1) amplicon-based infectious bacterial artificial chromosome (iBAC) vector to express complete loci >100 kb. Cell cultures transduced by iBAC vectors carrying a 143 kb MAPT or 135 kb SNCA locus expressed the human loci similar to the endogenous gene. We focused on analysis of the iBAC-MAPT vector carrying the complete MAPT locus. On transduction into neuronal cultures, multiple MAPT transcripts were expressed from iBAC-MAPT under strict developmental and cell type–specific control. In primary neurons from Mapt−/− mice, the iBAC-MAPT vector expressed the human tau protein, as detected by enzyme-linked immunosorbent assay and immunocytochemistry, and restored sensitivity of Mapt−/− neurons to Aβ peptide treatment in dissociated neuronal cultures and in organotypic slice cultures. The faithful retention of gene expression and phenotype complementation by the system provides a novel method to analyze neurological disease genes.
Systemic photodynamic therapy with aminolaevulinic acid delays the appearance of ultraviolet-induced skin tumours in mice
Authors: S. Sharfaei, G. Viau, H. Lui, D. Bouffard, R. Bissonnette
Journal: British Journal of Dermatology (2001)

Background Photodynamic therapy (PDT) with topical aminolaevulinic acid (ALA) has recently been approved by the US Food and Drug Administration for the treatment of actinic keratoses. Objectives To determine whether weekly systemic suberythemogenic ALA‐PDT could prevent the appearance of ultraviolet (UV) ‐induced skin tumours in hairless mice. Methods One group of 20 mice received daily UV radiation from FS 20 tubes, and weekly intraperitoneal injections of ALA 40 mg kg−1, each followed 3 h later by 12 J cm−2 of white light (ALA‐PDT). Control groups consisted of mice exposed only to UV, to UV and ALA without white light, or UV and white light without ALA, as well as untreated mice. Results The tumour‐free survival was significantly longer for mice exposed to daily UV and weekly ALA‐PDT as compared with the control groups. Neither the mortality nor the incidence of large skin tumours was higher in the UV/ALA‐PDT group than in mice exposed only to UV. In vivo fluorescence spectroscopy showed that the 635‐nm fluorescence emission within tumours was lower than in normal skin 3 h after ALA administration. This was also confirmed by quantitative fluorescence microscopy. Conclusions Systemic ALA‐PDT can delay the appearance of UV‐induced skin tumours in mice without increasing mortality or the incidence of large tumours.
Effectiveness of geriatric rehabilitative care: Authors' reply
Authors: D. C Kennie, J. Reid, I. R Richardson, C. Kelt
Journal: BMJ (1988)

criteria be waived because of the urgency of the situation is shared by the gay community.We should not, however, abandon all scientific caution for a treatment that may be worse than the disease.The best way to do this is to encourage enrolment into the trial and to hope that results will become apparent quickly so that the trial need not run its planned course and that publication and dissemination of the results will be rapid so that the usual long delays can be avoided.
Treatment of Chronic Renal Failure: An Update
Authors: Richard B. Freeman
Journal: New England Journal of Medicine (1985)

Twenty-five years ago, almost to the exact date of this publication, the first patient with irreversible chronic renal failure was started on repetitive treatments with an artificial kidney with the goal of extending meaningful life for months or years.1 He lived for 14 years. The second patient started on the treatment that same year is still alive, having received a transplant after seven years of dialysis therapy. In 1972, Congress passed legislation that would cover the cost of treatment for all U.S. citizens with chronic renal failure by extending Medicare benefits to those with documented chronic uremia.2 The evolution of . . .
Many questions, fewer answers, about pot
Authors: John Elliott
Journal: JAMA (1980)

In the emotionally volatile area of marijuana research, a verdict for or against America's favorite recreational drug is still forthcoming. The data, coming mostly from animal studies or anecdotal evidence, are neither definitive nor complete. Moreover, almost all research focuses on heavy, long-term use of marijuana. Nevertheless, a number of physicians and medical researchers are starting to agree that marijuana represents a health hazard in various ways and that its growing use, particularly among the young, is a serious matter for concern. Currently 43 million Americans, roughly 30% of the adult population, are known to have tried marijuana at least once. Sixteen million use it regularly and, most alarming, there are 4 million regular users under age 17. Compared with the heyday of marijuana research in the 60s, research into the biologic effects of the drug today is a mere shadow of its previous self. This stems in part from
Network Organization of the Huntingtin Proteomic Interactome in Mammalian Brain
Authors: Dyna I. Shirasaki, Erin R. Greiner, Ismael Al-Ramahi, Michelle Gray, Pinmanee Boontheung, Daniel H. Geschwind, Juan Botas, Giovanni Coppola, Steve Horvath, Joseph A. Loo, X. William Yang
Journal: Neuron (2012)
Probability of Gallstone Dissolution
Authors: STEVEN J. GRUBER
Journal: Annals of Internal Medicine (1982)

Letters and Corrections1 November 1982Probability of Gallstone DissolutionSTEVEN J. GRUBER, B.S., M.S.STEVEN J. GRUBER, B.S., M.S.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-97-5-785_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: I believe I have found an error in one of the calculations reported in The National Cooperative Gallstone Study (1). The probability for a white woman, of ideal body weight, with a high serum cholesterol and several small countable stones, of achieving partial or total dissolution of her radiolucent gallstones is 0.94, not 0.78 as stated on page 272. However,a nonwhite woman with these characteristics would have a 0.78 probability of partial or complete dissolution....Reference1. SCHOENFIELDLACHIN LJ. Chenodiol (chenodeoxycholic acid) for dissolution of gallstones; The National Cooperative Gallstone Study: a controlled trial of efficacy and safety. Ann Intern Med. 1981;95:257-82. LinkGoogle Scholar1. SCHOENFIELDLACHIN LJ. Chenodiol (chenodeoxycholic acid) for dissolution of gallstones; The National Cooperative Gallstone Study: a controlled trial of efficacy and safety. Ann Intern Med. 1981;95:257-82. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Newcastle-upon-Tyne England PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 November 1982Volume 97, Issue 5Page: 785-785KeywordsBody weightHypercholesterolemia Issue Published: 1 November 1982 PDF DownloadLoading ...
Evidence for extrathymic generation of intermediate T cell receptor cells in the liver revealed in thymectomized, irradiated mice subjected to bone marrow transplantation.
Authors: K Sato, K Ohtsuka, K Hasegawa, S Yamagiwa, H Watanabe, H Asakura, T Abo
Journal: The Journal of Experimental Medicine (1995)

In addition to the major intrathymic pathway of T cell differentiation, extrathymic pathways of such differentiation have been shown to exist in the liver and intestine. In particular, hepatic T cells of T cell receptors or CD3 of intermediate levels (i.e., intermediate T cell receptor cells) always contain self-reactive clones and sometimes appear at other sites, including the target tissues in autoimmune diseases and the tumor sites in malignancies. To prove their extrathymic origin and self reactivity, in this study we used thymectomized, irradiated (B6 x C3H/He) F1 mice subjected to transplantation of bone marrow cells of B6 mice. It was clearly demonstrated that all T cells generated under athymic conditions in the peripheral immune organs are intermediate CD3 cells. In the case of nonthymectomized irradiated mice, not only intermediate CD3 cells but also high CD3 cells were generated. Phenotypic characterization showed that newly generated intermediate CD3 cells were unique (e.g., interleukin 2 receptor alpha-/beta+ and CD44+ L-selectin-) and were, therefore, distinguishable from thymus-derived T cells. The precursor cells of intermediate CD3 cells in the bone marrow were Thy-1+ CD3-. The extrathymic generation of intermediate CD3 cells was confirmed in other combinations of bone marrow transplantation, C3H --> C3H and B10.Thy1.1 --> B6.Thy1.2. The generated intermediate CD3 cells in the liver contained high levels of self-reactive clones estimated by anti-V beta monoclonal antibodies in conjunction with the endogenous superantigen minor lymphocyte-stimulating system, especially the combination of B6 --> (B6 x C3H/He) (graft-versus-host-situation).(ABSTRACT TRUNCATED AT 250 WORDS)
A phospholipase A2 inhibitor (Ro 31-4493) prevents protein loss associated with the calcium paradox in isolated guinea pig hearts without effect on contracture, calcium overload, or the currents through L-type calcium channels
Authors: M-S Suleiman, K K Minezaki, K Ban, R A Chapman
Journal: Cardiovascular Research (1994)

Journal Article A phospholipase A2 inhibitor (Ro 31-4493) prevents protein loss associated with the calcium paradox in isolated guinea pig hearts without effect on contracture, calcium overload, or the currents through L-type calcium channels Get access M-S Suleiman, M-S Suleiman British Heart Foundation Research Group in Cellular Cardiology, Department of Physiology, School of Veterinary Science, University of Bristol, Southwell Street, Bristol BS2 8EJ, United Kingdom: M-S Suleiman, K K Minezaki, K Ban, R A Chapman. Correspondence to Professor Chapman. Search for other works by this author on: Oxford Academic PubMed Google Scholar K K Minezaki, K K Minezaki British Heart Foundation Research Group in Cellular Cardiology, Department of Physiology, School of Veterinary Science, University of Bristol, Southwell Street, Bristol BS2 8EJ, United Kingdom: M-S Suleiman, K K Minezaki, K Ban, R A Chapman. Search for other works by this author on: Oxford Academic PubMed Google Scholar K Ban, K Ban British Heart Foundation Research Group in Cellular Cardiology, Department of Physiology, School of Veterinary Science, University of Bristol, Southwell Street, Bristol BS2 8EJ, United Kingdom: M-S Suleiman, K K Minezaki, K Ban, R A Chapman. Search for other works by this author on: Oxford Academic PubMed Google Scholar R A Chapman R A Chapman British Heart Foundation Research Group in Cellular Cardiology, Department of Physiology, School of Veterinary Science, University of Bristol, Southwell Street, Bristol BS2 8EJ, United Kingdom: M-S Suleiman, K K Minezaki, K Ban, R A Chapman. Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 28, Issue 5, May 1994, Pages 650–655, https://doi.org/10.1093/cvr/28.5.650 Published: 01 May 1994 Article history Received: 08 September 1993 Accepted: 23 December 1993 Published: 01 May 1994
Use of general practitioner computerised records to create a population based twin sample: pilot study based on Parkinson's disease
Authors: C H Hawkes, A M Macdonald, A H V Schapira
Journal: BMJ (1997)

Objectives:To measure patients' expectations of receiving prescriptions and general practitioners' perceptions of these expectations and to determine the factors most closely associated with the decision to prescribe.Design: Questionnaires were completed by patients waiting to see their general practitioners, and by their doctors immediately after the consultations.Setting: Four non-fundholding group practices in southeast London.Subjects: 544 unselected patients consulting 15 general practitioners.Main outcome measures: Doctors' perceptions of patients' expectations; doctors' decisions to prescribe.Results: 67% (354/526) of patients hoped for a prescription; doctors perceived that 56% (305/542) of patients wanted prescriptions; and doctors wrote prescriptions in 59% (321/543) of consultations.Despite the close agreement between patients' hopes and doctors' perceptions, 25% (89/353) of patients hoped for a prescription but did not receive one.In 22% (68/313) of consultations in which prescriptions were written, they were not strictly indicated on purely medical grounds, and in only 66% (202/306) of consultations in which prescriptions were written were they both indicated and hoped for.Doctors' perceptions of patients' expectations were the strongest predictor of the decision to prescribe, but the final regression model also included patients' hopes and ethnic group, and the doctor's feeling of being pressurised.Conclusions: In an area of low prescribing and high expectations the decision to prescribe was closely related to actual and perceived expectations, but the latter was the more significant influence.
Warfarin Therapy for an Octogenarian Who Has Atrial Fibrillation
Authors: Brian F. Gage, Stephan D. Fihn, Richard H. White
Journal: Annals of Internal Medicine (2001)

In North America, atrial fibrillation is associated with at least 75 000 ischemic strokes each year. Most of these strokes occur in patients older than 75 years of age. The high incidence of stroke in very elderly persons reflects the increasing prevalence of atrial fibrillation that occurs with advanced age, the high incidence of stroke in elderly patients, and the failure of physicians to prescribe antithrombotic therapy in most of these patients. This failure is related to the increased risk for major hemorrhage with advanced age, obfuscating the decision to institute stroke prophylaxis with antithrombotic therapy. This case-based review describes the risk and benefits of prescribing antithrombotic therapy for a hypothetical 80-year-old man who has atrial fibrillation and hypertension, and it offers practical advice on managing warfarin therapy. After concluding that the benefits of warfarin outweigh its risks in this patient, we describe how to initiate warfarin therapy cautiously and how to monitor and dose the drug. We then review five recent randomized, controlled trials that document the increased risk for stroke when an international normalized ratio (INR) of less than 2.0 is targeted among patients with atrial fibrillation. Next, we make the case that cardioversion is not needed for this asymptomatic patient with chronic atrial fibrillation. Instead, we choose to leave the patient in atrial fibrillation and to control his ventricular rate with atenolol. Later, when the INR increases to 4.9, we advocate withholding one dose of warfarin and repeating the INR test. Finally, when the patient develops dental pain, we review the analgesic agents that are safe to take with warfarin and explain why warfarin therapy does not have to be interrupted during a subsequent dental extraction.