tbuckley/cabot-search huggingface dataset:
Responsibility to the Patient and to the Patient's Impaired Physician
Authors: Joseph M. Miller
Journal: JAMA (1988)

To the Editor.—  I have considerable empathy with the reluctance of Dr Svenson 1 to report his colleague because of alcoholism. While favoring the physician, I fear that he did a disservice to the patients of an alcoholic surgeon.  The hospital in which these men practiced was indeed fortunate that a malpractice suit was never instituted by a patient of the surgeon. Knowing that a member of the medical staff was drinking while conducting a practice and not taking action would have presented the hospital with a difficult problem of defense against a charge of negligence. The hospital had not exercised the required degree of corporate responsibility to the patients of this physician. The chairman of the department and the quality control and risk management committees should have been deeply concerned with the conduct of the surgeon.  The hospital has a definite duty to every patient to monitor the therapeutic
Impact of TCR status and genotype on outcome in adult T-cell acute lymphoblastic leukemia: a LALA-94 study
Authors: Vahid Asnafi, Agnes Buzyn, Xavier Thomas, Francoise Huguet, Norbert Vey, Jean-Michel Boiron, Oumedaly Reman, Jean-Michel Cayuela, Veronique Lheritier, Jean-Paul Vernant, Denis Fiere, Elizabeth Macintyre, Hervé Dombret
Journal: Blood (2005)
Mortality in Patients with Pituitary Disease
Authors: Mark Sherlock, John Ayuk, Jeremy W. Tomlinson, Andrew A. Toogood, Aurora Aragon-Alonso, Michael C. Sheppard, Andrew S. Bates, Paul M. Stewart
Journal: Endocrine Reviews (2010)

Pituitary disease is associated with increased mortality predominantly due to vascular disease. Control of cortisol secretion and GH hypersecretion (and cardiovascular risk factor reduction) is key in the reduction of mortality in patients with Cushing’s disease and acromegaly, retrospectively. For patients with acromegaly, the role of IGF-I is less clear-cut. Confounding pituitary hormone deficiencies such as gonadotropins and particularly ACTH deficiency (with higher doses of hydrocortisone replacement) may have a detrimental effect on outcome in patients with pituitary disease. Pituitary radiotherapy is a further factor that has been associated with increased mortality (particularly cerebrovascular). Although standardized mortality ratios in pituitary disease are falling due to improved treatment, mortality for many conditions are still elevated above that of the general population, and therefore further measures are needed. Craniopharyngioma patients have a particularly increased risk of mortality as a result of the tumor itself and treatment to control tumor growth; this is a key area for future research in order to optimize the outcome for these patients.
Multidimensional Vector Space Representation for Convergent Evolution and Molecular Phylogeny
Authors: Yasuhiro Kitazoe, Hirohisa Kishino, Takahisa Okabayashi, Teruaki Watabe, Noriaki Nakajima, Yoshiyasu Okuhara, Yukio Kurihara
Journal: Molecular Biology and Evolution (2004)

With growing amounts of genome data and constant improvement of models of molecular evolution, phylogenetic reconstruction became more reliable. However, our knowledge of the real process of molecular evolution is still limited. When enough large-sized data sets are analyzed, any subtle biases in statistical models can support incorrect topologies significantly because of the high signal-to-noise ratio. We propose a procedure to locate sequences in a multidimensional vector space (MVS), in which the geometry of the space is uniquely determined in such a way that the vectors of sequence evolution are orthogonal among different branches. In this paper, the MVS approach is developed to detect and remove biases in models of molecular evolution caused by unrecognized convergent evolution among lineages or unexpected patterns of substitutions. Biases in the estimated pairwise distances are identified as deviations (outliers) of sequence spatial vectors from the expected orthogonality. Modifications to the estimated distances are made by minimizing an index to quantify the deviations. In this way, it becomes possible to reconstruct the phylogenetic tree, taking account of possible biases in the model of molecular evolution. The efficacy of the modification procedure was verified by simulating evolution on various topologies with rate heterogeneity and convergent change. The phylogeny of placental mammals in previous analyses of large data sets has varied according to the genes being analyzed. Systematic deviations caused by convergent evolution were detected by our procedure in all representative data sets and were found to strongly affect the tree structure. However, the bias correction yielded a consistent topology among data sets. The existence of strong biases was validated by examining the sites of convergent evolution between the hedgehog and other species in mitochondrial data set. This convergent evolution explains why it has been difficult to determine the phylogenetic placement of the hedgehog in previous studies.
Perinatal mortality by birth order.
Authors: N Mantel
Journal: BMJ (1979)

The conclusion reached by Bakketeig and Hoffman in an article published in the September 22, 1979 issue of the British Medical Journal that when sibship size is fixed, perinatal mortality declines with increasing parity, is erroneous since it is based on a statistical artefact. The positive association between increased perinatal mortality and parity observed in cross-sectional surveys may reflect either that more high risk women were included in the higher parity pregnancy group or that the risk of perinatal mortality actually does increase with parity.
CLINICAL EVALUATION OF SU-10704 IN ANXIOUS PATIENTS
Authors: E. RAAB, K. RICKELS, F. ROBINSON
Journal: American Journal of Psychiatry (1965)

In this preliminary study, SU-10704 proved to be effective in decreasing the level of psychopathology in chronic, primarily anxious clinic patients. The therapeutic effect was most marked in those patients in whom the "emotional" symptoms predominated over the "somatic" ones and was obtained through amelioration of the emotional symptom components of their illness. Side effects were minimal and apparently dose/weight related. In most patients, side reactions did not require discontinuation of medication, but disappeared after a few days or after reduction of dosage. No effects on blood pressure were noticed and only a mild bradycardic effect was seen. The question has to be left open whether placebo alone would also have affected emotional symptoms more than somatic ones. On the basis of this preliminary single-blind study, it appears recommendable to evaluate SU-10704 in a more rigorous double-blind study.
ACCIDENTAL DEATH FROM ABSORPTION OF HEATLESS PERMANENT WAVE SOLUTION
Authors: Allen H. Bunce
Journal: JAMA (1941)

On March 19 a healthy young married woman, mother of three children, drove her car, accompanied by a woman friend, from her home to Atlanta—a distance of 40 miles—where she had an appointment for 10: 30 a. m. at a beauty shop for a heatless permanent wave. She arrived a little late, had her hair cut by the proprietor, an oil treatment and her hair prepared for the heatless permanent wave.  Her friend went by the beauty shop about 2:30 p. m. She told her friend to go to a movie or do anything else she had to do, since the treatment would require more time than she had anticipated. A few minutes later, after the preliminary preparations had been completed, the treatment was started by a trained operator. He had planned to continue it for seven minutes. The procedure consisted in spraying the wave solution through a closed circuit
Local platelet activation causes vasoconstriction of large epicardial canine coronary arteries in vivo. Thromboxane A2 and serotonin are possible mediators.
Authors: P Golino, J H Ashton, L M Buja, M Rosolowsky, A L Taylor, J McNatt, W B Campbell, J T Willerson
Journal: Circulation (1989)

The goal of the present study was to demonstrate that intracoronary platelet deposition may trigger intense vasoconstriction of large epicardial coronary arteries in vivo and that this is largely mediated by thromboxane A2 and serotonin released by activated platelets. Cyclic flow variations (progressive declines in blood flow followed by sudden restorations of flow) due to recurrent intracoronary platelet activation and thrombus formation were induced by damaging the endothelium and placing a cylindrical constrictor on the left anterior descending coronary artery (LAD) in open-chest, anesthetized dogs. Coronary diameters were measured in vivo by means of ultrasonic crystals sutured on the LAD immediately distal to the constrictor (LAD1) and 1 cm below (LAD2) and on the circumflex coronary artery (Cx). Coronary artery diastolic diameters were measured continuously before and during cyclic flow variations and after they were abolished by administration of LY53857, a serotonin-receptor antagonist (group 1, n = 7), or SQ29548, a thromboxane-receptor antagonist (group 2, n = 7). During cyclic flow variations, at the nadir of coronary flow, LAD1 (a site of maximal platelet accumulation) cross-sectional area decreased by 52 +/- 10% and 38 +/- 6% in group 1 and 2 animals, respectively (p less than 0.001 compared with values recorded during a brief LAD occlusion obtained by a suture snare), whereas LAD2 (a site of minimal or no platelet accumulation) cross-sectional area did not differ from that recorded during the brief LAD occlusion. SQ29548 abolished cyclic flow variations in seven of seven dogs and LY53857 in six of seven, but they affected the increased coronary vasoconstriction differently: LAD1 cross-sectional area increased by 32 +/- 6% of the control value in SQ29548-treated animals, whereas it returned to baseline dimension values in the LY53857-treated group as these interventions also abolished the cyclic flow variations. We conclude that a marked coronary vasoconstriction may be triggered by local platelet deposition and that thromboxane A2 and serotonin are mediators of this vasoconstriction.
Critical Appraisal of Sulfonylurea Therapy of Diabetes Mellitus
Authors: Samuel B. Beaser
Journal: JAMA (1960)

The substitution of sulfonylurea drugs in the treatment of diabetes demands even more careful observation of the patient than may be required with the use of insulin. It is especially important to recognize that patients tend to regard a disorder, even diabetes, as minor when oral medication is employed, and omission of the drug may be looked upon as relatively unimportant. With the use of the sulfonylurea drugs the dynamic qualities of the diabetes should be appreciated, also an intimate knowledge of the pharmacology. It is emphasized that the sulfonylurea drugs have a maximum of effectiveness. Accordingly, a higher dosage beyond a given limit does not increase their value. Thoughtful cooperation of the patient as to diet and medication is essential.
Health Insurance Is Not Health Care
Authors: Mitchell H. Katz
Journal: JAMA Internal Medicine (2014)

Thanks to theAffordableCareAct (ACA), low-incomeAmericans (thoseearning less than 139%of the federal poverty level) living in 25 states and theDistrict of Columbia gained eligibility to Medicaid on January 1, 2014.1 The Congressional Budget Office estimates that by 2022 there will be 12 mill ion new enrollees into Medicaid.2 Although this is anunprecedented leap forward in providing low-income Americans with health insurance, it is important to remember thathealth insurance isnothealthcare. Health insurance is a financialmechanismforpaying forhealth care. It is not the care itself, or even a guarantee of care.
P4-07-11: Circulating Tumor Cells after Neoadjuvant Therapy Predict Outcome in Stage I to III Breast Cancer.
Authors: S Gainer, S Krishnamurthy, A Bhattacharyya, A Lodhi, C Hall, H Kuerer, I Bedrosian, A Anderson, B Singh, A Lucci
Journal: Cancer Research (2011)

Abstract Introduction: Circulating tumor cells (CTCs) predict outcome in metastatic breast cancer, but their significance is unclear in non-metastatic patients. Furthermore, it is unclear if the presence of CTCs after completion of neoadjuvant chemotherapy (NACT) predicts worse outcome. The purpose of this study was to determine if CTCs after NACT predicts worse outcome. Methods: Clinical stage I-III breast cancer patients seen at a single tertiary cancer center provided informed consent to participate in an IRB-approved study involving collection of blood (7.5 ml x 2 tubes) at the time of surgery for their primary breast cancer. CTCs were detected using the Cell SearchTM system. A positive result was defined as the presence of one or more cells per 7.5 ml blood since the threshold for positivity has not been established in non-metastatic breast cancer. Statistical analyses used chi-square and Fischer's exact test. Results: One hundred and twenty patients were prospectively enrolled. Median age was 50 years and median follow-up was 33 months. Eight percent of patients had T1 disease, 35% T2, 18% T3, and 39% T4. Fifty-three percent of patients (63/120) had hormone receptor positive disease. Thirty-two percent of patients (38/120) were HER-2 positive. Thirty percent (36/120) were triple negative. Seventy-eight percent (91/120) had lymph node positive disease. Two or more CTCs were present in 9% of patients (11/120). Of the 11 patients who died, 3 had 2 or more CTCs (P=0.08). Of the 20 who relapsed, 6 had 2 or more CTCs (P=0.0019). Conclusions: Presence of two or more CTCs after NACT predicted worse relapse free survival in patients with stage I-III breast cancer. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-07-11.
Neural Network Modulation by Trauma as a Marker of Resilience
Authors: Lisa M. James, Brian E. Engdahl, Art C. Leuthold, Scott M. Lewis, Emily Van Kampen, Apostolos P. Georgopoulos
Journal: JAMA Psychiatry (2013)

Posttraumatic stress disorder (PTSD) and resilience reflect 2 distinct outcomes after exposure to potentially traumatic events. The neural mechanisms underlying these different outcomes are not well understood.To examine the effect of trauma on synchronous neural interactions for veterans with PTSD and resilient controls using magnetoencephalography.Participants underwent diagnostic interviews, a measure of exposure to potentially traumatic events, and magnetoencephalography.U.S. Department of Veterans Affairs medical center.Eighty-six veterans with PTSD and 113 resilient control veterans recruited from a large Midwestern Medical Center.Multiple regression analyses were performed to examine the effect of lifetime trauma on global and local synchronous neural interactions. In analyses examining the local synchronous neural interactions, the partial regression coefficient indicates the strength and direction of the effect of trauma on the synchronous interactions between the 2 neural signals recorded by a pair of sensors. The partial regression coefficient, or slope, is the primary outcome measure for these analyses.Global synchronous neural interactions were significantly modulated downward with increasing lifetime trauma scores in resilient control veterans (P = .003) but not in veterans with PTSD (P = .91). This effect, which was primarily characterized by negative slopes (i.e., decorrelations) in small neural networks, was strongest in the right superior temporal gyrus. Significant negative slopes were more common, stronger, and observed between sensors at shorter distances than positive slopes in both hemispheres (P < .001 for all) for controls but not for veterans with PTSD. CONCLUSIONS. Neural modulation involving decorrelation of neural networks in the right superior temporal gyrus and, to a lesser extent, other areas distinguishes resilient veterans from those with PTSD and is postulated to have an important role in healthy response to trauma.
Efficacy and safety of an anti–IL-13 mAb in patients with severe asthma: A randomized trial
Authors: Erika H. De Boever, Claire Ashman, Anthony P. Cahn, Nicholas W. Locantore, Phil Overend, Isabelle J. Pouliquen, Adrian P. Serone, Tracey J. Wright, Mair M. Jenkins, Inderpal S. Panesar, Sivayogan S. Thiagarajah, Sally E. Wenzel
Journal: Journal of Allergy and Clinical Immunology (2014)
The management of post-herpetic neuralgia
Authors: A. L Cunningham
Journal: BMJ (2000)

General practice p 794 

Shingles, or herpes zoster, may occur at any stage in a person's life. Herpes zoster is the clinical manifestation of the reactivation of a lifelong latent infection with varicella zoster virus, usually contracted after an episode of chickenpox in early life.1 Varicella zoster virus tends to be reactivated only once in a lifetime, with the incidence of second attacks being <5%.2 Herpes zoster occurs more commonly in later life (as T cell immunity to the virus wanes) and in patients who have T cell immunosuppression.

Pain persisting after herpes zoster, termed post-herpetic neuralgia, is the commonest and most feared complication. Its definition is controversial, ranging from pain persisting after the rash heals to pain persisting 30 days or 6 months after the onset of herpes zoster. Some experts consider all pain during and after herpes zoster as a continuum. Therefore we have suggested that this total duration of pain and pain at a single time point (3 months after onset) be used as endpoints in clinical studies.3 Post-herpetic neuralgia is associated with scarring of the dorsal root ganglion and atrophy of the dorsal horn on the affected side, which follows the extensive inflammation that occurs during herpes zoster. These and other abnormalities of the peripheral and central …
Arsenic Exposure and Impaired Lung Function. Findings from a Large Population-based Prospective Cohort Study
Authors: Faruque Parvez, Yu Chen, Mahbub Yunus, Christopher Olopade, Stephanie Segers, Vesna Slavkovich, Maria Argos, Rabiul Hasan, Alauddin Ahmed, Tariqul Islam, Mahmud M. Akter, Joseph H. Graziano, Habibul Ahsan
Journal: American Journal of Respiratory and Critical Care Medicine (2013)

Exposure to arsenic through drinking water has been linked to respiratory symptoms, obstructive lung diseases, and mortality from respiratory diseases. Limited evidence for the deleterious effects on lung function exists among individuals exposed to a high dose of arsenic.To determine the deleterious effects on lung function that exist among individuals exposed to a high dose of arsenic.In 950 individuals who presented with any respiratory symptom among a population-based cohort of 20,033 adults, we evaluated the association between arsenic exposure, measured by well water and urinary arsenic concentrations measured at baseline, and post-bronchodilator-administered pulmonary function assessed during follow-up.For every one SD increase in baseline water arsenic exposure, we observed a lower level of FEV1 (-46.5 ml; P < 0.0005) and FVC (-53.1 ml; P < 0.01) in regression models adjusted for age, sex, body mass index, smoking, socioeconomic status, betel nut use, and arsenical skin lesions status. Similar inverse relationships were observed between baseline urinary arsenic and FEV1 (-48.3 ml; P < 0.005) and FVC (-55.2 ml; P < 0.01) in adjusted models. Our analyses also demonstrated a dose-related decrease in lung function with increasing levels of baseline water and urinary arsenic. This association remained significant in never-smokers and individuals without skin lesions, and was stronger in male smokers. Among male smokers and individuals with skin lesions, every one SD increase in water arsenic was related to a significant reduction of FEV1 (-74.4 ml, P < 0.01; and -116.1 ml, P < 0.05) and FVC (-72.8 ml, P = 0.02; and -146.9 ml, P = 0.004), respectively.This large population-based study confirms that arsenic exposure is associated with impaired lung function and the deleterious effect is evident at low- to moderate-dose range.
TRANSMISSION OF NON-A, NON-B HEPATITIS FROM MAN TO CHIMPANZEE
Authors: Edward Tabor, JacquesA. Drucker, JayH. Hoofnagle, Milton April, RobertJ. Gerety, LeonardB. Seeff, DanielR. Jackson, LewellysF. Barker, Geronima Pineda-Tamondong
Journal: The Lancet (1978)
Physical activity is up in the US but so too is obesity
Authors: B. Roehr
Journal: BMJ (2013)

American waistlines became as polarized as its politics in the first decade of this century; the fit got fitter and the fat got fatter. The overall level of physical activity increased over that period, while the level of obesity increased as well.

The analysis by the Institute for Health Metrics and Evaluation used data generated by two large state and national surveys: the Behavioral Risk …
Rupatadine in the treatment of chronic idiopathic urticaria: a double‐blind, randomized, placebo‐controlled multicentre study
Authors: A. Gimenez‐Arnau, R. M. Pujol, S. Ianosi, A. Kaszuba, A. Malbran, G. Poop, E. Donado, I. Perez, I. Izquierdo, E. Arnaiz
Journal: Allergy (2007)

Background: Chronic urticaria is one of the most common and disturbing cutaneous condition. The treatment of chronic idiopathic urticaria (CIU) is still a challenge. Antihistamines are recommended as first‐line treatment. Rupatadine is a new potent nonsedative anti‐H 1 . Objective: To study rupatadine efficacy and safety for moderate to severe CIU treatment. Methods: This randomized, double‐blind, placebo‐controlled, parallel‐group, multicentre, study was designed to assess primarily mean pruritus score (MPS) reduction with rupatadine, 10 and 20 mg, administered once daily for 4 weeks. Three hundred and thirty‐three patients with active episodes of moderate‐to‐severe CIU were included. Results: A 57.5% ( P &lt; 0.005) and 63.3% ( P = 0.0001) significative MPS reduction from baseline, was observed at week 4 with 10 and 20 mg rupatadine, respectively, compared with placebo (44.9%). Both doses of rupatadine were not significantly different at any time point, with respect to their effects on pruritus severity, number of wheals and total symptoms scores. Rupatadine 10 mg had an overall better adverse event profile. Conclusion: Rupatadine 10 mg is a fast, long‐acting, efficacious and safe treatment option for the management of patients with moderate‐to‐severe CIU.
THE RELATIVE REACTION WITHIN LIVING MAMMALIAN TISSUES
Authors: Peyton Rous, D. R. Drury, W. W. Beattie
Journal: The Journal of Experimental Medicine (1927)

The changes in blood reaction caused by the injection into a vein of a weak solution of hydrochloric acid are accompanied by extravascular changes of similar magnitude within the subcutaneous tissue. Under the conditions of prolonged general anesthesia with ether or urethane the circulation to this tissue is so interfered with that an "outlying acidosis" may develop in addition to the acidosis immediately consequent on the blood state. Even under the best of circumstances the extravascular acidosis induced with hydrochloric acid affects not merely the tissue fluid but the reaction of the tissue itself. Rabbits in which a widespread extravascular acidosis has been produced, together with a blood acidosis as severe as is compatible with life, remain in good condition during the relatively long period over which this state of affairs persists. There is at no time any sign of capillary dilatation, though the vessels are bathed in relatively add fluid, and none of shock. No edema develops in the acidotic tissues, and the animals void large amounts of urine. The tissue acidosis lessens pari passu with that of the blood.
Primary Endpoint Results of a Phase II Study of Vascular Endothelial Growth Factor Trap-Eye in Wet Age-related Macular Degeneration
Authors: David M. Brown, Jeffrey S. Heier, Thomas Ciulla, Matthew Benz, Prema Abraham, George Yancopoulos, Neil Stahl, Avner Ingerman, Robert Vitti, Alyson J. Berliner, Ke Yang, Quan Dong Nguyen
Journal: Ophthalmology (2011)
PGE2 May Decrease Airway Inflammation and Muscular Hyperplasia in Eosinophilic Bronchitis Patients through Prostanoid Receptors EP2 and EP4
Authors: B. Sastre, M. Fernández-Nieto, E. López, C. Gámez, E. Aguado, S. Quirce, J. Sastre, V. del Pozo
Journal: Journal of Allergy and Clinical Immunology (2010)