tbuckley/cabot-search huggingface dataset:
Short-Term Continuous Transperitoneal Dialysis
Authors: Marcel Legrain, John P. Merrill
Journal: New England Journal of Medicine (1953)

SINCE the initial report of Fine, Frank and Seligman,1 , 2 various workers have studied the technic of peritoneal irrigation, both in the laboratory and at the clinical level.3 4 5 6 In addition to its utilization as a procedure for experimental electrolyte depletion,7 it has been employed in the treatment of acute renal insufficiency and chronic edema. The present report deals with the technic for peritoneal irrigation first employed in 1946 by Tanret8 and Dérot9 in Paris. The French experience since that time comprises over 100 clinical procedures.9 10 11 12 Our observations are based on the experience of one of us in the employment of this . . .
Stressful life events and difficulties and onset of breast cancer: case-control study
Authors: D. Protheroe, K. Turvey, K. Horgan, E. Benson, D. Bowers, A. House
Journal: BMJ (1999)

<h3>Abstract</h3> <b>Objective:</b> To determine the relation between stressful life events and difficulties and the onset of breast cancer. <b>Design:</b> Case-control study. <b>Setting:</b> 3 NHS breast clinics serving west Leeds. <b>Participants:</b> 399 consecutive women, aged 40-79, attending the breast clinics who were Leeds residents. <b>Main outcome measures:</b> Odds ratios of the risk of developing breast cancer after experiencing one or more severe life events, severe difficulties, severe 2 year non-personal health difficulties, or severe 2 year personal health difficulties in the 5 years before clinical presentation. <b>Results:</b> 332 (83%) women participated. Women diagnosed with breast cancer were no more likely to have experienced one or more severe life events (adjusted odds ratio 0.91, 95% confidence interval 0.47 to 1.81; P=0.79); one or more severe difficulties (0.86, 0.41 to 1.81; P=0.69); a 2 year severe non-personal health difficulty (0.53, 0.12 to 2.31; P=0.4); or a 2 year severe personal health difficulty (2.73, 0.68 to 10.93; P=0.16) than women diagnosed with a benign breast lump. <b>Conclusion:</b> These findings do not support the hypothesis that severe life events or difficulties are associated with onset of breast cancer. <h3>Key messages</h3> Although there is widespread belief that stress can cause cancer, research evidence is contradictory Stressful life experiences are common; about two thirds of women with a breast lump experienced at least one severe life event or difficulty in the 5 years before presentation Women diagnosed with breast cancer were no more likely to have experienced a severe stressor than women with a benign lesion Knowledge or suspicion of the diagnosis did not influence reporting of severe life events
A message from Holland
Authors: H A Thiadens
Journal: BMJ (2000)

Eleven years ago a lively 85 year old man came to my surgery. He had been a famous violinist and concert leader for most of his professional life and still enjoyed playing music. He asked me if I would “help” him should he find himself the victim of a serious illness. In the Netherlands this really means, “What is your view on euthanasia, Doc?” I replied that given such circumstances I would be prepared to help him.

During the next few years I visited him several times, and then at the age of 95 and still in possession of his mental capacities he was diagnosed with …
A phase I, dose escalation study of lapatinib in combination with carboplatin, paclitaxel, with and without trastuzumab in patients with metastatic breast cancer.
Authors: A Storniolo, P Rubin, G Magrinat, B Parker, A Rush-Tayler, V Sheidler, S Aranjo, C Shaw, N Eldreth, G Lott, J Brechlin, JI Loftiss, RA Fleming, BL Weber
Journal: Cancer Research (2009)

Abstract Abstract #3121 Background: Lapatinib is a selective and highly potent dual, competitive inhibitor of erbB1 and erbB2 tyrosine kinases with clinical activity in erbB2-positive metastatic breast cancer (MBC). The combination of carboplatin, paclitaxel, and trastuzumab has been shown to have significant clinical activity in MBC as well as in the adjuvant setting. Given the synergy of dual inhibition with trastuzumab and lapatinib observed in both the preclinical and clinical settings, we assessed the feasibility, safety, and early clinical activity of paclitaxel, carboplatin, lapatinib with and without trastuzumab in patients (pts) with MBC.&amp;#x2028; Methods: MBC pts previously untreated with trastuzumab or cytotoxic chemotherapy for metastatic or locally recurrent disease were enrolled into either Group (Grp) A (erbB2 positive) or B (erbB2 positive or negative). Escalating doses of lapatinib (planned range of 750-1500 mg/d) were administered in combination with (Grp A) or without (Grp B) trastuzumab (4 mg/kg followed by weekly 2 mg/kg infusions). Paclitaxel (80 mg/m2) and carboplatin (AUC 2 mg/ml*min) were administered on days 1, 8, 15 with cycles repeated every 28 days. Starting doses of lapatinib were 750 mg in Grp A and 1000 mg in Grp B. A standard 3 + 3 Phase I design is being used until the optimally tolerated regimen (OTR) dose level is determined. An additional 14 - 17 pts will be enrolled into each grp at the OTR dose level to further assess safety and tolerability.&amp;#x2028; Results: Fourteen pts (Grp A n=8, Grp B n=6) have been enrolled in the study (median age 42 yrs, range 27-66). A median of 5.5 cycles (range 4-17) in Grp A and 3.5 (range 1-7) in Grp B have been administered. All pts had at least one adverse event (AE). In Grp A, grade 3 toxicities include neutropenia (50%), diarrhea (38%), rash (25%), vomiting (13%), hypokalemia (13%), and syncope (13%). No grade 4 toxicities were reported. In Grp B, grade 3 toxicities include fatigue (33%), hyponatremia (17%), menorrhagia (17%), dermatitis (17%), and rash (17%). One pt (in Grp B) had grade 4 neutropenia. No febrile neutropenia was observed. In Grp A, there was one DLT (Gr 3 diarrhea) at lapatinib 1000 mg. In Grp B, one DLT (Gr 4 neutropenia) at lapatinib 1000 mg has been observed. Clinical activity to date includes 8/8 objective responses in Grp A, (1 CR, 7 PR) and 2/6 objective responses (2 PR) in Grp B (all pts in Grp B were erbB2 negative). Dose escalation continues in both grps.&amp;#x2028; Conclusions: Lapatinib may be administered safely in combination with carboplatin, paclitaxel, with and without trastuzumab at known effective doses for each. Clinical activity has been observed. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3121.
Stage I and II Breast Cancer: What Type of Surgery?-Reply
Authors: DeAnn Lazovich
Journal: JAMA (1992)

In Reply.  —The comment by Dr Quattlebaum regarding recurrence represents a frequent misconception regarding surgical treatment of breast cancer, namely, that more extensive surgery is better than tumor resection with conservation of the breast. However, three large randomized controlled trials comparing BCS and mastectomy have now shown no advantage of mastectomy over BCS for women with tumors up to 4 cm. 1-3   Based on these studies, local recurrence rates 8 to 10 years after treatment range from 2% to 10% among women undergoing BCS and radiation therapy, compared with 2% to 9% chest wall recurrence rates among women with mastectomy. While the US study provides evidence of substantial local recurrence in an unirradiated breast (39%) following BCS, even these women are at no disadvantage for overall survival compared with women undergoing mastectomy. 3   These trials are the basis for the National Institutes of Health recommendation calling for breast preservation for
Regional pulmonary blood flow in sitting and supine man during and after acute hypoxia
Authors: Arthur Dawson
Journal: Journal of Clinical Investigation (1969)

Regional pulmonary blood flow was measured by external counting of intravenously injected (133)Xe during 20 min of breathing 14.2% oxygen and during 20 min of recovery from hypoxia. 16 normal human volunteers were studied, nine sitting and seven supine. During hypoxia there was a slight but significant increase in relative perfusion of the upper portions of the lungs in both the sitting and supine subjects. During recovery from hypoxia, blood flow distribution differed significantly from the control. The erect subjects showed increased relative perfusion of the lung bases and the supine subjects showed increased relative perfusion of the upper zones. Comparison of the distribution of inhaled and intravenously injected isotope showed that in the sitting subjects the altered distribution during hypoxia tended to make alveolar oxygen tension more uniform. In the supine subjects, however, the shift in blood flow increased the perfusion of the regions with the lowest ventilation/perfusion, tending to accentuate uneven alveolar oxygen tension. Therefore it does not seem that the altered blood flow distribution during hypoxia was due to selective vasoconstriction in the regions of lowest alveolar oxygen tension, but rather that vasoconstriction was greatest in the lower lung zones because the vessels there are more responsive to hypoxia. During mild acute hypoxia, vasoconstrictor tone does not seem to effectively match ventilation and perfusion. The altered distribution of pulmonary blood flow during recovery from hypoxia suggests the occurrence of posthypoxic vasodilation. Failure to consider this possibility may lead to erroneous interpretation of pulmonary hemodynamic measurements made after the inspired oxygen concentration has been changed.
Excitation-contraction coupling in normal and myopathic hamster hearts II: changes in contractility and Ca pools associated with development of the cardiomyopathy
Authors: T. S. MA, L. E. BAILEY
Journal: Cardiovascular Research (1979)

Myocardial contractility and Ca exchange in the pool responsible for E-C coupling was studied in cardiomyopathic (B10 14.6) and control (B10.RB) hamster hearts at three stages in the development of the disease. Contractility (dP/dt) was significantly reduced in the B10 14.6 strain at 26 to 30 days of age, and at all subsequent stages of the disease. Reduced contractility was related directly to a reduction in the Ca content of a superficial pool, Ca1, representing Ca contained in the interstitial space and bound to the sarcolemma and other structures in the interstitium. Increased entry of Ca into cellular pools was associated with the reduction of superficial Ca content. The results suggest that the reduction in surface Ca binding sites may be responsible for the reduction in contractility.
The gene for von Hippel-Lindau disease.
Authors: E R Maher
Journal: BMJ (1993)

of prostaglandins by inhibiting cyclo-oxygenase, the enzyme at the first step in the biosynthesis of prostaglandin from arachidonic acid.8Interference with prostaglandin synthesis may prevent cancer by inhibiting cell proliferation, boosting the immune system, or blocking synthesis of tumour promoters.By inhibiting prostaglandin synthesis, non-steroidal anti-inflammatory drugs may reduce ornithine decarboxylase activity and thus slow tumour growth and metabolic activity.8In a few studies, however, aspirin and indomethacin have stimulated ornithine decarboxylase activity and cell proliferation, including proliferation in the colonic mucosa.9Alternatively, by blocking production of immunologically inhibiting prostaglandins by suppressor cells, including that in mitogen stimulated cultures of cells from patients with colorectal cancer,10 non-steroidal anti-inflammatory drugs may activate immune reactions against tumours.These drugs may also inhibit the synthesis of tumour promoters by blocking the prostaglandin dependent co-oxidation of many chemicals to form carcinogens."Although these epidemiological studies are generally consistent and show a strong and biologically plausible relation between use of aspirin and colorectal cancer, they are inconclusive regarding a dose-response effect and a change in risk after exposure has stopped.Further studies, in different populations and with different methods, are required to exclude non-causal explanations and sort out conflicting results.A clinical trial randomising patients to aspirin or placebo would be the definitive test of aspirin's effectiveness in preventing colorectal cancer.Previous trials of aspirin have lacked the large numbers and follow up necessary to evaluate any preventive effect on colorectal cancer.'21'A trial to test whether aspirin can prevent the recurrence of colorectal adenomatous polyps or cause sporadic adenomas to regress is feasible, requiring relatively small numbers and follow up of less than five years.Even if aspirin unambiguously prevented colorectal cancer, other risks should be considered before regular use is begun.Aspirin is nephrotoxic and can produce renal papillary necrosis and renal failure.'4The development of tumours of the urinary tract is another serious long term complication.'4 15Although regular use of aspirin benefits patients with esta- blished coronary heart disease,'6 its effects on the primary prevention of stroke and cardiovascular death remain incon- clusive.4 12 13
Legislative Myopia on Stem Cells
Authors: Jeffrey M. Drazen
Journal: New England Journal of Medicine (2003)

The U.S. House of Representatives has voted to ban research on, and the use of, medical treatments derived from embryonic stem cells. This bill is shortsighted and has the potential to put many critical future advances in medicine beyond the reach of patients in the United States.There are two distinct uses of embryonic stem cells. The first, for which there is no support among members of the scientific and medical communities, is the use of stem cells to create a genetically identical person. There is a de facto worldwide ban on such activities, and this ban is appropriate. The . . .
POLLEN PREVALENCE AND POLLEN-FREE AREAS
Authors: Oren C. Durham
Journal: JAMA (1952)

The essential objective in atmospheric pollen research is to learn how much of what kinds of allergenic pollen are likely to be inhaled by sensitized persons at any time and in any locality. This objective may be amplified in further detail as follows: (1) to assist in the clinical evaluation, locally and generally, of known allergenic pollens, (2) to discover, identify, and help to evaluate new allergenic pollens, (3) to clarify the role of meteorologic, topographic, and other local factors affecting pollen prevalence and pollen dispersal, and (4) to find areas where, as a result of natural advantages or control measures, or both, the air is relatively or entirely free from pollens of particular species. Obviously, air analysis furnishes an excellent yardstick by which to judge the anti-allergenic value of weed eradication campaigns and to test the truth of advertised claims for pollen-free vacation resorts. At present all routine sampling
Aldehyde Dehydrogenase Is Regulated by β-Catenin/TCF and Promotes Radioresistance in Prostate Cancer Progenitor Cells
Authors: Monica Cojoc, Claudia Peitzsch, Ina Kurth, Franziska Trautmann, Leoni A. Kunz-Schughart, Gennady D. Telegeev, Eduard A. Stakhovsky, John R. Walker, Karl Simin, Stephen Lyle, Susanne Fuessel, Kati Erdmann, Manfred P. Wirth, Mechthild Krause, Michael Baumann, Anna Dubrovska
Journal: Cancer Research (2015)

Radiotherapy is a curative treatment option in prostate cancer. Nevertheless, patients with high-risk prostate cancer are prone to relapse. Identification of the predictive biomarkers and molecular mechanisms of radioresistance bears promise to improve cancer therapies. In this study, we show that aldehyde dehydrogenase (ALDH) activity is indicative of radioresistant prostate progenitor cells with an enhanced DNA repair capacity and activation of epithelial-mesenchymal transition (EMT). Gene expression profiling of prostate cancer cells, their radioresistant derivatives, ALDH(+) and ALDH(-) cell populations revealed the mechanisms, which link tumor progenitors to radioresistance, including activation of the WNT/β-catenin signaling pathway. We found that expression of the ALDH1A1 gene is regulated by the WNT signaling pathway and co-occurs with expression of β-catenin in prostate tumor specimens. Inhibition of the WNT pathway led to a decrease in ALDH(+) tumor progenitor population and to radiosensitization of cancer cells. Taken together, our results indicate that ALDH(+) cells contribute to tumor radioresistance and their molecular targeting may enhance the effectiveness of radiotherapy.
Surgeons swear when operating: fact or myth?
Authors: F F. Palazzo, O. J Warner
Journal: BMJ (1999)

The medical profession is rich with anecdotes about surgeons, many of national and international repute, using colourful language in the operating theatre.Legend has it that the language of the mildest mannered and pious surgeon, once he or she is gowned and gloved, undergoes a transformation.However, a Medline search of the past 20 years using the search words "swear," ''swearing," ''foul language," and "blasphemy" produced no relevant articles on the subject.We therefore assessed to what extent the use of foul language by surgeons is a myth.We also tried to identify the surgical specialties where swearing is most common.
Unusual Serum Lipoprotein Abnormality Induced by the Vehicle of Miconazole
Authors: Adolfo G. Bagnarello, Lena A. Lewis, Martin C. McHenry, Allan J. Weinstein, Herbert K. Naito, Arthur J. McCullough, Richard J. Lederman, Thomas L. Gavan
Journal: New England Journal of Medicine (1977)

Miconazole, a phenethylimidazole,1 is effective in vitro against several pathogenic fungi,1 , 2 and has cured systemic mycoses in man.3 , 5 In contrast to amphotericin B, miconazole does not appear to have renal or hematologic toxicity.3 , 4 On the theory that miconazole might be as effective as and less toxic than amphotericin B, three patients with deep mycotic infections were treated with this drug intravenously after informed consent was obtained. Elevated serum lipid concentrations developed. In Case 1, only serum lipid concentrations were determined; in Cases 2 and 3, an unusual lipoprotein electrophoretic pattern was detected.Case ReportsCase 2. A 44-year-old woman had . . .
Learning Minimally Invasive Mitral Valve Surgery
Authors: David M. Holzhey, Joerg Seeburger, Martin Misfeld, Michael A. Borger, Friedrich W. Mohr
Journal: Circulation (2013)

Background— Learning curves are vigorously discussed and viewed as a negative aspect of adopting new procedures. However, very few publications have methodically examined learning curves in cardiac surgery, which could lead to a better understanding and a more meaningful discussion of their consequences. The purpose of this study was to assess the learning process involved in the performance of minimally invasive surgery of the mitral valve using data from a large, single-center experience. Methods and Results— All mitral (including tricuspid, or atrial fibrillation ablation) operations performed over a 17-year period through a right lateral mini-thoracotomy with peripheral cannulation for cardiopulmonary bypass (n=3907) were analyzed. Data were obtained from a prospective database. Individual learning curves for operation time and complication rates (using sequential probability cumulative sum failure analysis) and average results were calculated. A total of 3895 operations by 17 surgeons performing their first minimally invasive surgery of the mitral valve operation at our institution could be evaluated. The typical number of operations to overcome the learning curve was between 75 and 125. Furthermore, &gt;1 such operation per week was necessary to maintain good results. Individual learning curves varied markedly, proving the need for good monitoring or mentoring in the initial phase. Conclusions— A true learning curve exists for minimally invasive surgery of the mitral valve. Although the number of operations required to overcome the learning curve is substantial, marked variation exists between individual surgeons. Such information could be very helpful in structuring future training and maintenance of competence programs for this kind of surgery.
Identification of potential candidates for varicella vaccination by history: questionnaire and seroprevalence study
Authors: Eithne MacMahon, Lisa J Brown, Sarah Bexley, David C Snashall, Dipti Patel
Journal: BMJ (2004)

Guidance from the Joint Committee on Vaccination and Immunisation regarding varicella vaccination of workers in healthcare settings is imminent.1 The new recommendations will advise that all those with a negative or uncertain history of chickenpox or shingles at pre-employment assessment should be tested for varicella zoster virus IgG. Vaccination with the newly licensed varicella vaccine will be advised for those with a seronegative result.

A history of chickenpox has a high positive predictive value for immunity among healthcare workers in Europe, where the seroprevalence is as high as 98.5%.2 The validity of a history of chickenpox is unknown in those from tropical countries, however, where the mean age of infection is in early adulthood.3 Guy's and St Thomas' Hospital NHS Trust in inner London has some 8000 staff and 4700 healthcare students of increasingly heterogeneous origins.4 5 We conducted a questionnaire and seroprevalence study at the hospital to ascertain the relations between history of chickenpox, countries …
Complement Activation Is Critical to Airway Hyperresponsiveness after Acute Ozone Exposure
Authors: Jung-Won Park, Christian Taube, Anthony Joetham, Katsuyuki Takeda, Taku Kodama, Azzeddine Dakhama, Glen McConville, Corrie B. Allen, Georgia Sfyroera, Lenny D. Shultz, John D. Lambris, Patricia C. Giclas, V. Michael Holers, Erwin W. Gelfand
Journal: American Journal of Respiratory and Critical Care Medicine (2004)

Ozone (O3) can induce airway hyperresponsiveness (AHR) and neutrophilic inflammation. We evaluated the role of complement in development of AHR and inflammation after acute O3 exposure in mice. Mice were exposed to O3 at 2 ppm for 3 hours, and airway responsiveness to methacholine was measured 8 hours after O3 exposure. Complement was depleted or inhibited by intraperitoneal injection of cobra venom factor (CVF) or complement receptor–related gene y (Crry)–Ig, a potent C3 convertase inhibitor; neutrophils were depleted using an antineutrophil monoclonal antibody. CVF attenuated the development of AHR by O3. Administration of Crry–Ig also prevented the development of AHR. Bronchoalveolar lavage (BAL) fluid neutrophilia after O3 exposure was significantly decreased by administration of either CVF or Crry–Ig. Increased BAL fluid total protein after O3 exposure was lowered by depletion or inhibition of complement. In contrast to the effects of complement inhibition or depletion, depletion of BAL neutrophil counts by more than 90% with the monoclonal antibody did not affect the development of AHR after O3 exposure. These data indicated that activation of the complement system follows acute O3 exposure and is important to the development of AHR and airway neutrophilia. However, this neutrophil response does not appear necessary for the development of AHR.