tbuckley/cabot-search huggingface dataset:
Natural history of inoperable hepatocellular carcinoma: Estrogen receptors' status in the tumor is the strongest prognostic factor for survival
Authors: Erica Villa, Anna Moles, Ilva Ferretti, Paola Buttafoco, Antonella Grottola, Mariagrazia Del Buono, Mario De Santis, Federico Manenti
Journal: Hepatology (2000)

Clinical course in hepatocellular carcinoma may be very different. We prospectively evaluated 96 patients with hepatocellular carcinoma unsuitable for radical therapy to investigate factors that could influence survival. Clinical, pathologic, and molecular data of patients were analyzed by univariate and multivariate analysis. The overall actuarial probability of survival at year 1, 2, 3, 4, 5, and 6 was 72%, 41%, 38%, 24%, 20%, and 9%. At univariate analysis, alpha-fetoprotein (AFP) ( P = .0082); alkaline phosphatase ( P = .0281); bilirubin ( P = .0076); etiology ( P = .0001); increment of tumor mass at month 3 ( P = .0051); type of estrogen receptor (ER) in the tumor ( P = .0000); prothrombin time ( P = .0003); and portal vein thrombosis ( P = .0000) had prognostic significance. At multivariate analysis, only type of ER ( P = .0000) and bilirubin ( P = .0030) showed independent predictive value for mortality. Survival was significantly longer in patients with wild-type estrogen receptors ( P = .0000). Cumulative probability of survival at year 1, 2, 3, 4, 5, and 6 was 94%, 66%, 52%, 43%, 35%, and 18% for wild-type and 51%, 21%, 16%, and 9% for variant estrogen receptors (no patients alive after 4 years). Hepatitis B surface antigen (HBsAg)-positive patients with variant ERs had a median survival of 8 months versus 45 months in anti-hepatitis C virus-positive patients with wild-type ERs ( P = .0001). In conclusion, (1) the presence of variant liver ER transcripts in the tumor was the strongest negative predictor of survival in inoperable hepatocellular carcinoma; (2) their presence was associated with spontaneous survival significantly worse than in patients with wild-type estrogen receptors; and (3) HBsAg-positive patients with variant receptors were characterized by the worst survival.
THE SYMPTOMATIC RELIEF OF ANXIETY WITH MEPROBAMATE, PHENOBARBITAL AND PLACEBO
Authors: E. H. UHLENHUTH, ARTHUR CANTER, JOHN O. NEUSTADT, HENRY E. PAYSON
Journal: American Journal of Psychiatry (1959)

Fifty-two pychoneurotic outpatients with anxiety symptoms were treated in a controlled clinical study with meprobamate 400 mg. q.i.d., phenobarbital 16 mg. q.i.d. and placebo q.i.d. The patients were divided into 2 comparable groups of 26, each group treated by a different psychiatrist. In the combined population of 52 patients, no significant differences appeared in the effectiveness of the 3 agents. The data then were analyzed for each psychiatrist's group separately. In one psychiatrist's group, the 3 agents were equally effective. In the other psychiatrist's group, the 2 active drugs were equally effective, but superior to placebo. Differences in the expectations of the 2 psychiatrists are discussed as a possible factor in these results, despite successful operation of the "double-blind" technique.
Global road safety and the contribution of big business
Authors: D. Mohan, I. Roberts
Journal: BMJ (2001)

Every day about 3000 people die and 30 000 are seriously injured on the world's roads.1 Most casualties are in countries that the World Bank classes as low and middle income countries, and a large proportion are vulnerable road users—pedestrians, cyclists, and riders of motorcycles and scooters. The World Bank believes that a partnership between business, non-governmental organisations, and governments in these countries can deliver improvements in road safety.2

In 1999, while announcing the global road safety partnership, James Wolfensohn, president of the World Bank, described road safety as “an issue of immense human proportions, an issue of economic proportions, an issue of social proportions and an issue of equity. Road safety very much affects poor people.”

The number of people killed or injured on the world's roads over the next two decades will depend on the changes that are made to transportation infrastructure …
Rapid Scientific Advances Bring New Ethical Questions
Authors: Eugene D. Robin
Journal: JAMA (1964)

MORALITY is, like other abstractions, difficult to define. In one sense, it may be regarded as the collective conscience of specific groups within human society or of society as a whole. Having no firm operational definition, it has several general characteristics. One is that any attempt to apply it to specific situations by a single individual must necessarily be regarded as personal opinion rather than fact. Secondly, morality must be regarded as an exceedingly dynamic entity with wide variations in time and space. Thus, as society evolves, it is to be expected that what is moral at one time may become quite immoral at another. What is appropriate for one human group may be quite inappropriate for another. Human sacrifice was once a moral form of behavior; it is now generally unacceptable. The exhibition of the female breast may be unacceptable to one group while the exhibition of the female
Increased allergen concentration enhances IFN‐γ production by allergic donor T cells expressing a peripheral tissue trafficking phenotype
Authors: L. M. Gardner, L. Spyroglou, R. E. O'Hehir, J. M. Rolland
Journal: Allergy (2004)

Background: Clinically effective allergen‐specific immunotherapy correlates with decreased circulating allergen‐specific IL‐4 + T cells but increased IFN‐ γ + cells at sites of allergen challenge. Whether immunotherapy promotes trafficking of IFN‐ γ + T cells to peripheral tissues is unknown. As aeroallergen is administered at higher concentrations during immunotherapy than those encountered naturally, the effect of allergen concentration on adhesion molecule (CD62L and CD49d) and chemokine receptor (CCR3 and CCR5) expression by peripheral‐blood T cells was analysed in parallel with cytokine production. Methods: House dust mite‐allergic donor peripheral blood mononuclear cells were cultured for 14 days with different allergen concentrations. Cytokine profiles of were analysed by flow cytometry. Results: Cultures stimulated with 100 μ g/ml house dust mite extract compared with 1 μ g/ml had increased proportions and numbers of CD62L lo , CD49d hi or CCR5 + T cells expressing IFN‐ γ . CCR3‐positive CD4 + and CD8 + T cell numbers were very low and did not differ between cultures. In contrast the proportions of ‘peripheral tissue trafficking’ CD4 + T cells expressing IL‐4 were decreased in cultures stimulated with high in comparison with low allergen concentration. Conclusion: These results indicate the importance of achieving high allergen doses during immunotherapy to promote IFN‐ γ production and expression of a ‘peripheral tissue trafficking’ phenotype by allergen‐specific CD4 + and CD8 + T cells. The net change in cytokine milieu at sites of allergen encounter would then down‐regulate clinical manifestations of allergic disease.
Avoidable factors contributing to death of children with head injury.
Authors: P M Sharples, A Storey, A Aynsley-Green, J A Eyre
Journal: BMJ (1990)

OBJECTIVE--To assess the incidence of potentially avoidable complications contributing to death of children with head injuries. DESIGN--Retrospective review of children who died with head injuries from 1979 to 1986 from data of the Office of Population Censuses and Surveys, Hospital Activity Analyses, case notes, coroners9 records, and necropsy reports. SETTING--District general hospitals and two regional neurosurgical centres in Northern region. RESULTS--255 Children died from head injury in the region, the mortality being 5.3 per 100,000 children per year. Head injury was the single most important cause of death in children aged greater than 1 year, accounting for 15% of deaths in children aged 1-15 years and a quarter for those aged 5-15 years. 121 Potentially avoidable factors possibly or probably contributing to death occurred in 81 children (32%). Half the children (125) died before admission, 27 of whom (22%) had potentially avoidable factors possibly or probably contributing to death, and 130 died after admission, 54 of whom (42%) had 93 such factors, which included failure of diagnosis or delayed recognition of intracranial haemorrhage or associated injury, inadequate management of the airways, and poor management of the transfer between hospitals. IMPLICATIONS--Regions should revise urgently their guidelines for optimal management and indications for neurosurgical referral to include children with severe head injuries and audit their systems of care for all patients with head injuries.
Access to Health Care for Hispanics
Authors: Eli Ginzberg
Journal: JAMA (1991)

The conventional population paradigm in the United States has distinguished between the white majority and the sizable and easily identified black minority. Until recently, much less attention has been paid to Hispanics (or Latinos), currently 20 million in number, who the Census Bureau projects will increase to 31 million persons of a total population of 283 million by the year 2010. In the next two decades Hispanics will account for one of every three net additions to the US population. The analysis that follows considers the critical factors that collectively will determine the access of Hispanics to the health care system and illuminates the changes that, if introduced, will contribute to its improvement. These issues include the homogeneity or heterogeneity of the Hispanic population; the extent to which socioeconomic status adversely affects Hispanics' access to health care; the influence of demographic and epidemiological factors on their needs for care; the role of neighborhood factors in determining their access to the health and medical infrastructures; the paucity of Hispanic health professionals; and finally, the major reform proposals currently on the nation's health agenda as they relate to the issue of improved access to care for Hispanics.
Prognostic implications of CEBPA mutations in pediatric acute myeloid leukemia: a report from the Japanese Pediatric Leukemia/Lymphoma Study Group
Authors: H Matsuo, M Kajihara, D Tomizawa, T Watanabe, A M Saito, J Fujimoto, K Horibe, K Kodama, M Tokumasu, H Itoh, H Nakayama, A Kinoshita, T Taga, A Tawa, T Taki, S Tanaka, S Adachi
Journal: Blood Cancer Journal (2014)

CCAAT/enhancer-binding protein alpha (CEBPA) mutations are a favorable prognostic factor in adult acute myeloid leukemia (AML) patients; however, few studies have examined their significance in pediatric AML patients. Here we examined the CEBPA mutation status and clinical outcomes of pediatric AML patients treated in the AML-05 study. We found that 47 (14.9%) of the 315 evaluable patients harbored mutations in CEBPA; 26 cases (8.3%) harbored a single mutation (CEBPA-single) and 21 (6.7%) harbored double or triple mutations (CEBPA-double). After excluding core-binding factor-AML cases, patients harboring CEBPA mutations showed better overall survival (OS; P=0.048), but not event-free survival (EFS; P=0.051), than wild-type patients. Multivariate analysis identified CEBPA-single and CEBPA-double as independent favorable prognostic factors for EFS in the total cohort (hazard ratio (HR): 0.47 and 0.33; P=0.02 and 0.01, respectively). CEBPA-double was also an independent favorable prognostic factor for OS (HR: 0.30; P=0.04). CEBPA-double remained an independent favorable factor for EFS (HR: 0.28; P=0.04) in the normal karyotype cohort. These results suggest that CEBPA mutations, particularly CEBPA-double, are an independent favorable prognostic factor in pediatric AML patients, which will have important implications for risk-stratified therapy.
Wheeling and Dealing with Graduate Medical Education
Authors: THOMAS L. DELBANCO
Journal: Annals of Internal Medicine (1986)

Editorials1 December 1986Wheeling and Dealing with Graduate Medical EducationTHOMAS L. DELBANCO, M.D.THOMAS L. DELBANCO, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-105-6-961 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptI found it refreshing in this day and age to read that "cost considerations have been a minor, or absent, concern" in the work of the New York Commission on Graduate Medical Education (1). Led by Alfred Gellhorn, a distinguished medical educator and scholar, the Commission has gained attention for its bold, politically daring recommendations. The group was composed of 27 persons holding widely divergent jobs and perspectives. Only 2 members (one being the representative from the New York State Medical Society and the other being president of a university hospital who, at this writing, is running for the U.S....References1. Report of the New York State Commission on Graduate Medical Education. Albany, New York: New York State Department of Health; 1986. (Available from Alfred Gellhorn, M.D.; NYS Commission on Graduate Medical Education, Tower Building, Room 910, Empire State Plaza; Albany, NY 12237.) Google Scholar2. Foreign medical graduates [Position paper]. Philadelphia: American College of Physicians; 3 March 1986. [A summary of this position paper appears on pages 963-964 of this issue.] Google Scholar3. SINGERCROWLEY MA. Clinical training for students of foreign medical schools in US hospitals. JAMA. 1986;256:1311-4. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Beth Israel Hospital Boston, Massachusetts PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByTime and Medical EducationKenneth M. Ludmerer, MDHealth education in rheumatology.Education: the need for a rethink. 1 December 1986Volume 105, Issue 6Page: 961-962KeywordsGraduate medical educationRunning Issue Published: 1 December 1986 PDF DownloadLoading ...
TCT-12 Long-term Follow-up of Catheter-based Renal Denervation For Resistant Hypertension Confirms Durable Blood Pressure Reduction
Authors: Henry Krum, Markus Schlaich, Paul Sobotka, Murray Esler, Felix Mahfoud, Michael Böhm, Mark Dunlap, Krishna Rocha-Singh, Richard Katholi
Journal: Journal of the American College of Cardiology (2012)
Adrenergic Innervation of Bowel in Hirschsprung's Disease
Authors: B. J. Gannon, H. R. Noblet, G. Burnstock
Journal: BMJ (1969)

The adrenergic innervation of normal and aganglionic regions of bowel from patients with Hirschsprung9s disease was investigated by a fluorescent histochemical technique. In normal bowel the adrenergic nerves end about intramural ganglion cells. In aganglionic bowel the adrenergic nerves form a dense varicose plexus in both muscularis externa and muscularis mucosae. It is suggested that the cause of megacolon in Hirschsprung9s disease is due to a lack of nervous pathways controlling the intrinsic reflexes, which is probably congenital in origin.
Algorithm for modified alkaline diuresis in salicylate poisoning.
Authors: I J Gordon, C S Bowler, J Coakley, P Smith
Journal: BMJ (1984)

Proliferative glomerulonephritis associated with Crohn's diseaseExtraintestinal manifestations of inflammatory bowel disease are well described and can affect many systems.The suggestion has arisen that circulating immune complexes may be connected with some of these complications, and hence it might be expected that renal complications would be a recognised extraintestinal feature. Case reportA 49 year old woman presented with a three month history of lower abdominal pain, frequency of micturition, and nocturia.Abdominal examination showed a mass in the right iliac fossa.Blood pressure was 120/80 mm Hg.Her urine contained albumin + + + and blood 4-.Haemoglobin concentra- tion was 13-3 g/dl, urea 7-8 mmol/l (46-8 mg/100 ml), and creatinine 0-12 mmol/l (1-4 mg/100 ml), and normal results were obtained on intravenous urography and cystoscopy and on barium enema, at which contrast refluxed into the terminal ileum.She had a coliform urinary tract infection, and treatment with antibiotics produced symptomatic improvement.Nine months after her initial presentation her blood pressure was 200/ 115 mm Hg.During this period she had been tired and anorectic, lost 8 kg in weight, and had occasional pains in the right iliac fossa.Further investi- gations showed haemoglobin concentration 11 9 g/dl; erythrocyte sedi- mentation rate 38 mm in the first hour; urea 13-3 mmol/l (79.9 mg/lO0 ml); creatinine 0-20 mmol/l (2-3 mg/100 ml); calcium and phosphate concentra-
Too much heparin: possible source of error in blood gas analysis.
Authors: A S Hutchison, S H Ralston, F J Dryburgh, M Small, I Fogelman
Journal: BMJ (1983)

Metastatic hepatoma cells are the most dangerous parts in hepatocarcinoma patients.We want to study the mechanism of metastatic hepatoma cells to escaping from host immune attacks. Firstly, we constructed the metastatic hepatoma cell model by using plates pre-coated with Poly-HEMA and found that they were aggregated, proliferation-resistant, apoptosis-resistant, cell cycle arrested and more invasive. These metastatic hepatoma cells could settled down and proliferated again under suitable conditions. Subsequently,we investigated the response of metastatic hepatoma cells to the typical immune surveillant molecule TNF-related apoptosis-inducing ligand (TRAIL). The data indicated that metastatic hepatoma cells not only resist to TRAIL-induced apoptosis, but also express lower membrane binding TRAIL and excrete more soluble TRAIL (sTRAIL) to exert a stealth "tumor counterattack" effect to attack immune effector cells. Deeply study found that the membrane binding death receptors DR4 and DR5 were down-regulated on metastatic BEL7402 and SMMC7721 cells and that their active level of caspase-8,-9,-3 was highly restrained. So we concluded that metastatic hepatoma cells could escape from host immune system by the death receptor pathway. This work was supported by grants from the National Natural Science Foundation of China (No.30873025, No.30700357 and No.30772031), Corresponding author E-mail:WSW@sdu.edu.cn.
THE FIXATION OF COMPLEMENT AND THE ACTIVATED FIRST COMPONENT (C1) OF COMPLEMENT BY COMPLEXES FORMED BETWEEN ANTIBODY AND DIVALENT HAPTEN
Authors: N. E. Hyslop, R. R. Dourmashkin, N. M. Green, R. R. Porter
Journal: The Journal of Experimental Medicine (1970)

Hapten-antibody complexes prepared at equivalence with the bivalent hapten bis-DNP-octamethylene-diamine and purified rabbit anti-DNP antibody were fractionated by Sepharose gel-filtration and the fractions examined by electron microscopy. Individual fractions were tested for whole-complement fixation and C1 fixation. Dimer forms did not show this type of biological activity, while fractions containing tetramers and larger polymers exhibited both C and C1 fixation, which could be inhibited by prior exposure of the complexes to the univalent hapten epsilon-DNP-caproic acid. The dose-response result indicated that the C-fixation observed was not due to interpolymeric cooperative effects. It was concluded that in the generation of biological activity by soluble antigen-antibody complexes made with complement-fixing antibody, quaternary structural changes following specific combination with antigen may be as important as any tertiary structural alterations that occur in the individual immunoglobulin molecule.
A TISSUE FACTOR INFLUENCING SUCCINIC DEHYDROGENASE ACTIVITY IN TUBERCULOUS GUINEA PIGS
Authors: S. P. Martin, C. D. Cooper, S. N. Chaudhuri, R. Green
Journal: The Journal of Experimental Medicine (1955)

The alterations in succinic dehydrogenase activity during the course of infection with Mycobacterium tuberculosis strains H37Rv and BCG, as well as with dead bacilli, has been described. A tissue factor has been described which is prepared from normal bovine kidney and will restore enzyme activity in vitro. This factor is prepared by chromatographic analysis and contains a nucleotide with an ultraviolet absorption maxima at 250 mmicro (pH 3) and a free sulfhydryl group. The role of this factor in the response to tuberculosis is discussed.
Hospitals improve on “door to needle” time
Authors: Susan Mayor
Journal: BMJ (2004)

More than three quarters of patients having a heart attack are given thrombolytic drugs within 30 minutes of reaching a hospital, according to results from an audit of hospitals in England and Wales published last week.

The third public report of the Myocardial Infarction National Audit Project (MINAP)—a regular audit assessing the care of patients taken to hospital after a myocardial infarction—showed that most hospitals were now reaching the “30-minute door-to-needle” goal for giving patients thrombolytic drugs.

When the project started, in 2000, few hospitals reached the goal that 75% of eligible patients should receive thrombolytic drugs within 30 minutes of arriving at hospital. In the first six months of 2001, fewer than 50% of patients received treatment in 30 minutes. However, new data for the first three months of …
Microdistribution of MC1R-targeted polyplexes in murine melanoma tumor tissue
Authors: Mikhail O. Durymanov, Tatiana A. Slastnikova, Alexey I. Kuzmich, Yuri V. Khramtsov, Alexey V. Ulasov, Andrey A. Rosenkranz, Sergey Y. Egorov, Eugene D. Sverdlov, Alexander S. Sobolev
Journal: Biomaterials (2013)
Recurrent hyperinfestation with Strongyloides stercoralis in a renal allograft recipient
Authors: B J Gatus
Journal: BMJ (1983)

follow up show only a marginal difference in survival, while those from an incomplete (five year) follow up show a greater difference.It would be interesting to know if the four year difference is statistically significant.We will all wait with interest to see the results of longer, complete, follow up, but in the meantime we must reserve judgment about the impact of chemotherapy on survival in this study.Finally, the point of systemic chemotherapy is to prolong survival by delaying or preventing systemic relapse, which is likely to be fatal.Of course, many patients with local relapse will quickly develop systemic recurrence.The success of chemotherapy will, however, be judged by survival, and it is at least arguable that patients who relapse locally should not be counted as failures unless and until they relapse systemically.The study of Dr Rossi and others has led some groups to believe that they should abandon untreated controls in studies of adjuvant chemotherapy.The data presented do not in our opinion support this point of view, and the incorrect randomisation raises serious questions whether the final results can be accepted unless there is a very large differ- ence in the two groups.
Foundation is laid for the "end of AIDS," says UN report
Authors: Z. Kmietowicz
Journal: BMJ (2012)

Global solidarity in responding to AIDS has led to such “extraordinary health gains” that the 2012 annual update on the epidemic from UNAIDS, the joint United Nations programme on HIV and AIDS, has said that it “has enabled the foundation to be laid for the eventual end of AIDS.”1

However, although much of the report signalled progress, there were still some countries where the number of people affected by HIV was expanding, and to tackle these national epidemics in the next few years would require “significant effort,” it says.

The report shows that the rate of new HIV infections more than halved in 25 low income and middle income countries. More than half these countries are in Africa, the region most affected by HIV. In some of the countries with the highest prevalence of HIV the rate of new …