tbuckley/cabot-search huggingface dataset:
Thanks From US Forces in the Gulf
Authors: Richard A. Mayo
Journal: JAMA (1991)

To the Editor. —  On behalf of Fleet Hospital FIVE in Saudi Arabia, my staff and I would like to express our sincere appreciation for providing us with weekly issues ofThe Journal. Your enthusiastic support is extremely reassuring to those deployed.  Fleet Hospital FIVE is a 500-bed shore-based navy medical treatment facility in Saudi Arabia. The staff is composed of corpsmen, nurses, physicians, dentists, medical service officers, and the construction battalion. We have been kept busy with the treatment of personnel from all branches of the armed services as well as allied forces. The medical staff have been completing various training courses and have been doing quite a lot of reading to stay on top of our respective specialties. Issues ofThe Journalwill be a well-received addition to our medical library.  Once again, thanks to you and the American Medical Association for your support and thoughtfulness.
1α-25-dihydroxyvitamin D3 increases intracellular free calcium in murine B16 melanoma
Authors: S.E. HILL, S.S. BLEEHEN, S. MACNEIL
Journal: British Journal of Dermatology (1989)

Vitamin D3 and its active metabolite 1α-25-dihydroxyvitamin D3 (1α-25-(OH)2D3) have been reported to play a role in melanogenesis. Physiological concentrations of 1α-25-(OH)2D3) were found to acutely elevate intracellular free calcium (using Fura 2) in B16 primary (1°) cells. Membrane phosphoinositide turnover was unaffected by 1α-25-(OH)2D3. The rise in intracellular free calcium was entirely dependent on extracellular calcium and was not mimicked by vitamin D3. However, in neither B16-1° nor B16-F1 melanoma cells did vitamin D3 or 1α-25-(OH)2D3 increase melanin production.
Quality of Care Before and After Implementation of the DRG-Based Prospective Payment System
Authors: William H. Rogers
Journal: JAMA (1990)

In this series we have described changes in the quality of care that have occurred in the treatment of hospitalized elderly Medicare patients with one of five conditions between 1981-1982 and 1985-1986. In this article we report on a mortality analysis, patient and hospital subgroup comparisons, and time series studies we have conducted in an attempt to determine whether changes in quality of care can be linked causally to the introduction of the prospective payment system. Based on these analyses we conclude that (1) mortality following hospitalization has been unaffected by the introduction of the prospective payment system, and improvements in in-hospital processes of care that began prior to the prospective payment system have continued after its introduction, but (2) the prospective payment system has increased the likelihood that a patient will be discharged home in an unstable condition. We recommend that efforts to correct this problem be intensified and that clinical monitoring of the impact of the prospective payment system continue as hospital cost-containment pressures intensify.
Abstract 415: Identification of colon cancer recurrence related CNVs using array-CGH
Authors: Chan Hee Park, Sun Young Rha, Hei-Cheul Jeung, Nam Kyu Kim, Jae Kyung Roh, Hyun Cheol Chung
Journal: Cancer Research (2010)

Abstract Colon cancer is one of the leading causes for cancer-related death in the Western world. The most important factor in colon cancer-related death is recurrence. Recently, many studies have reported that copy number variation (CNV) is related to genetic diseases such as cancer and Alzheimer's disease. In this study, we selected the different aberration CNVs from non-tumor colon tissues by comparing recurred and non-recurred colon cancer patients using 44K oligonucleotide microarray. We selected 1359 different aberration probes, which contained cancer-, neurological disease- and cell signaling-related pathway genes between 22 non-recurred and 19 recurred patients. In 1359 probes, Ingenuity Pathway Analysis software showed that 89 genes composed of cell to cell signaling, cellular movement, and nervous system developmental pathway. In these 89 genes, LIMS2 was known as ILK-related molecular function of cancer cell migration and invasion. ILK-related pathway had important role in cancer cell migration and invasion through function of secretory protein such as MMP9, MMP11. LIMS2 showed copy number amplification and up-regulation of mRNA expression in non-recurrence patient group. In vitro experiment, protein and mRNA of LIMS2 were down-expressed in 5 colon cancer cell lines compared to 3 normal epithelial colon cell lines. In LIMS2 siRNA treated HCT-116 colon cancer cell, protein level of LIMS2 was decreased about 90%, while MMP9, MMP11 protein expression increased. Also, migration and invasion rate of HCT-116 cell increased in LIMS2 siRNA treated group and LIMS2 siRNA treated condition media compared to the control group using wound-healing and trans-well assay. According to array-CGH and in vitro experiment, we found that LIMS2 could play an important role in colon cancer metastasis through paracrine effect. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 415.
Antiphospholipid Antibodies Accelerate Plasma Coagulation by Inhibiting Annexin-V Binding to Phospholipids: A “Lupus Procoagulant” Phenomenon
Authors: Jacob H. Rand, Xiao-Xuan Wu, Harry A.M. Andree, J.B. Alexander Ross, Elena Rusinova, Mayra G. Gascon-Lema, Cesare Calandri, Peter C. Harpel
Journal: Blood (1998)
Hepatic resection versus radiofrequency ablation for very early stage hepatocellular carcinoma: A Markov model analysis
Authors: Yun Ku Cho, Jae Kyun Kim, Wan Tae Kim, Jin Wook Chung
Journal: Hepatology (2009)

No adequate randomized trials have been reported for a comparison between hepatic resection (HR) versus radiofrequency ablation (RFA) for the treatment of patients with very early stage hepatocellular carcinoma (HCC), defined as an asymptomatic solitary HCC <2 cm. For compensated cirrhotic patients with very early stage HCC, a Markov model was created to simulate a randomized trial between HR (group I) versus primary percutaneous RFA followed by HR for cases of initial local failure (group II) versus percutaneous RFA monotherapy (group III); each arm was allocated with a hypothetical cohort of 10,000 patients. The primary endpoint was overall survival. The estimates of the variables were extracted from published articles after a systematic review. In the parameter estimations, we assumed the best scenario for HR and the worst scenario for RFA. The mean expected survival was 7.577 years, 7.564 years, and 7.356 years for group I, group II, and group III, respectively. One-way sensitivity analysis demonstrated that group II was the preferred strategy if the perioperative mortality rate was greater than 1.0%, if the probability of local recurrence following an initial complete ablation was <1.9% or if the positive microscopic resection margin rate was >0.3%. The 95% confidence intervals for the difference in overall survival were −0.18–0.18 years between group I and II, 0.06–0.36 years between group I and III, and 0.13–0.30 years between group II and III, respectively. Conclusion: Primary percutaneous RFA followed by HR for cases of initial local failure was nearly identical to HR for the overall survival of compensated cirrhotic patients with very early stage HCC. (HEPATOLOGY 2010.)
Autoimmune liver disease for the non-specialist
Authors: S. Decock, P. McGee, G. M Hirschfield
Journal: BMJ (2009)

#### Summary points

Autoimmune hepatitis, primary biliary cirrhosis, and sclerosing cholangitis represent perhaps 5% of all liver diseases, although no registries exist to estimate the true prevalence. They are presumed autoimmune conditions, usually considered as a diagnosis after viral, metabolic, and drug induced liver injuries have been excluded. The combination of medical and surgical treatments means that, if appropriately diagnosed and managed, these diseases overall have an excellent prognosis. We review these conditions for non-specialists and refer to available guidelines and clinical trial data.1 2 3 

Autoimmune liver diseases are chronic, slowly progressive, inflammatory liver diseases that may have overlapping features.4 (fig 1⇓, table 1⇓).



Fig 1 Characteristic histological and radiological features of autoimmune liver diseases



View this table:

Table 1 
 Summary features of autoimmune liver disease



### Autoimmune hepatitis

Autoimmune hepatitis is a relapsing idiopathic hepatitis, encountered more often in women than men across all ages and ethnicities. Ascertainment biases limit available epidemiology; a Swedish study put the annual incidence as 8.5 per 1 000 000 population and point prevalence as 107 per 1 000 000.5 Patients present clinically with arthralgias and fatigue if symptomatic, and a third of patients present with cirrhosis.w1 Raised liver enzymes (transaminases) characterise initial laboratory abnormalities.

### Primary biliary cirrhosis 

Primary biliary cirrhosis is a slowly progressive, chronic cholestatic disease affecting primarily middle aged women (female:male ratio 9 to 1) and is characterised by …
Draft bill aims at improving confidentiality
Authors: D Beales
Journal: BMJ (1994)

Doctors, nurses, lawyers, and other professionals have joined forces to try to tighten the law governing patient confidentiality. At present patients in the NHS have no legal protection if personal health details are disclosed without their consent. A group including the British Medical Association, the Royal College of Nursing, and 10 other interested organisations has drawn up a draft bill to protect patients' personal health information. Dr John Chisholm, a general practitioner who helped to prepare the bill, …
Why we don't want to be GPs: the student perspective
Authors: G. Chater, O. Brewster, H. Dambha
Journal: BMJ (2014)

The current GP recruitment crisis has prompted speculation about why students are avoiding primary care,1 2 but there has been little mention of the students’ perspective. Some have pointed to bias in recruitment websites, a lack of exposure, and disproportional representation from the Medical Schools Council,2 but from our perspective the attractiveness of the job is the most important factor when choosing …
Randomised, double blind, placebo controlled clinical trial of efficacy of vitamin A treatment in non-measles childhood pneumonia
Authors: L. C Nacul, B. R Kirkwood, P. Arthur, S. S Morris, M. Magalhaes, M. C D S Fink
Journal: BMJ (1997)

<h3>Abstract</h3> <b>Objective:</b> To evaluate the impact on clinical recovery and severity of the addition of large doses of vitamin A to the standard treatment for childhood pneumonia. <b>Design:</b> A randomised, double blind, placebo controlled trial. <b>Setting:</b> Study children were recruited at a public hospital in Recife, north east Brazil, an area of marginal vitamin A deficiency. <b>Subjects:</b> 472 children aged 6 to 59 months with clinical diagnosis of pneumonia. <b>Interventions:</b> 200 000 IU (infants) or 400 000 IU (1-4 year olds) of vitamin A in oil or similar capsules of placebo divided into two daily oral doses, in addition to the standard treatment. <b>Main outcome measures:</b> Duration of the episode and incidence of adverse outcomes. <b>Results:</b> The groups were similar with respect to overall duration of pneumonia and incidence of adverse outcomes. Children who received vitamin A, however, were less likely to have fever by day 3 (P=0.008) and were 29% less likely to fail to respond to the first line antibiotic (P=0.054). <b>Conclusion:</b> There was little evidence for an effect of vitamin A treatment on the immediate outcome of the pneumonia episode. <h3>Key messages</h3> Pneumonia is a leading cause of childhood mortality in developing countries Vitamin A supplementation has no impact on mortality from pneumonia even though it reduces overall mortality Treatment of measles pneumonia with vitamin A reduces case fatality and severity of disease This study showed that vitamin A treatment has no impact on the recovery from non-measles pneumonia, despite some suggestion that severely affected patients may benefit The addition of vitamin A for treatment protocols for childhood pneumonia is not recommended for clinical cure, although it maybe a useful contact to improve vitamin A status
Cheating at medical school
Authors: S. M Glick
Journal: BMJ (2001)

Papers p 274 

The BMJ recently featured a strong response to what was judged an inappropriately lenient reaction by a medical school to a student cheating in an examination.1 Reviews of the literature suggest that we have insufficient reliable data about the extent of this phenomenon, its rate of change, its pathogenesis, its prevention, or its effective management.2–4 Furthermore, because of the nature of cheating and the methodological difficulties entailed in its study, the requisite evidence based conclusions will probably never be available. Yet, much can be concluded and acted upon on the basis of common sense and concepts with face validity, even without double blind studies.

There is general agreement that there should be zero tolerance of cheating in a profession based on trust and one on which human lives depend. It is reasonable to assume that cheaters in medical school will be more likely than others to continue to act dishonestly with patients, colleagues, insurers, and government. Given the enormous power …
Ebola vaccines based on adenovirus vectors and risk of HIV
Authors: E. J. Kremer, P. Van de Perre
Journal: BMJ (2015)

Under intense pressure to react, WHO is set to fast track phase II-III evaluation of candidate Ebola virus vaccines based on adenovirus vectors in west and central Africa.1 

However, adenovirus vectors regularly show encouraging preclinical results but disappointing clinical efficacy. Despite the immunogenicity shown in phase II-III studies, two proof of concept HIV vaccine trials (STEP and Phambili) that used an adenovirus vector …
Recurrence of Melanoma Following T Cell Treatment: Continued Antigen Expression in a Tumor That Evades T Cell Recruitment
Authors: Trudy Straetemans, Cor Berrevoets, Miriam Coccoris, Elike Treffers-Westerlaken, Rebecca Wijers, David K Cole, Valerie Dardalhon, Andrew K Sewell, Naomi Taylor, Jaap Verweij, Reno Debets
Journal: Molecular Therapy (2014)

Clinical therapy with T cells shows promise for cancer patients, but is currently challenged by incomplete responses and tumor relapse. The exact mechanisms that contribute to tumor relapse remain largely unclear. Here, we treated mouse melanomas with T cell receptor-engineered T cells directed against a human peptide-major histocompatibility complex antigen in immune-competent mice. T cells resulted in significant tumor regression, which was followed by relapse in about 80–90% of mice. Molecular analysis revealed that relapsed tumors harbored nonmutated antigen genes, not silenced by promoter methylation, and functionally expressed surface antigen at levels equal to nontreated tumors. Relapsed tumors resisted a second in vivo T cell treatment, but regained sensitivity to T cell treatment upon retransplantation in mice. Notably, relapsed tumors demonstrated decreased levels of CD8 T cells and monocytes, which were substantiated by downregulated expression of chemoattractants and adhesion molecules. These observations were confirmed when using T cells specific for a less immunogenic, endogenous mouse melanoma antigen. We conclude that tumors, when exposed to T cell treatment, can relapse without loss of antigen and develop a milieu that evades recruitment of effector CD8 T cells. Our findings support the concept to target the tumor milieu to aid T cell therapy in limiting tumor relapse Clinical therapy with T cells shows promise for cancer patients, but is currently challenged by incomplete responses and tumor relapse. The exact mechanisms that contribute to tumor relapse remain largely unclear. Here, we treated mouse melanomas with T cell receptor-engineered T cells directed against a human peptide-major histocompatibility complex antigen in immune-competent mice. T cells resulted in significant tumor regression, which was followed by relapse in about 80–90% of mice. Molecular analysis revealed that relapsed tumors harbored nonmutated antigen genes, not silenced by promoter methylation, and functionally expressed surface antigen at levels equal to nontreated tumors. Relapsed tumors resisted a second in vivo T cell treatment, but regained sensitivity to T cell treatment upon retransplantation in mice. Notably, relapsed tumors demonstrated decreased levels of CD8 T cells and monocytes, which were substantiated by downregulated expression of chemoattractants and adhesion molecules. These observations were confirmed when using T cells specific for a less immunogenic, endogenous mouse melanoma antigen. We conclude that tumors, when exposed to T cell treatment, can relapse without loss of antigen and develop a milieu that evades recruitment of effector CD8 T cells. Our findings support the concept to target the tumor milieu to aid T cell therapy in limiting tumor relapse
Endothelin- and oxytocin-induced calcium signaling in cultured human myometrial cells.
Authors: E Maher, A Bardequez, J P Gardner, L Goldsmith, G Weiss, M Mascarina, A Aviv
Journal: Journal of Clinical Investigation (1991)

The demonstration that endothelin (ET) induces rat uterine contraction, coupled with the observation that ET is present in human amniotic fluid, suggests that the myometrium may be an important target organ for this hormone. We show that in quiescent human myometrial cells ET produced a dose-dependent increase in cytosolic free Ca2+ (Cai2+), which was markedly attenuated when the cells were studied in Ca2(+)-free media. Preincubation with nicardipine, diltiazem, or verapamil reduced the ET-evoked Cai2+ transient by 30, 40, and 65%, respectively. The presence of voltage sensitive Ca2+ channels was demonstrated by Mn2+ quenching of fura-2. Activation of the Na+/H+ antiport could not be demonstrated with ET stimulation. In nonquiescent cells, the ET-evoked Cai2+ transient was significantly reduced, while the response to oxytocin was retained. This is at least partially explained by a reduction in Bmax (maximal binding capacity) for ET (mean +/- SEM) from 3,506 +/- 268 binding sites/cell in quiescent cells to 2,411 +/- 300 binding sites/cell, as well as 72% increase in Kd (equilibrium dissociation constant), in the nonquiescent cells. We conclude that, in human myometrial cells, ET and oxytocin modulate Cai2+ through independent receptors and propose that ET, like oxytocin, is an important endogenous modulator of uterine contractility.
The law should be changed to allow assisted dying
Authors: R. Scheffer
Journal: BMJ (2013)

It is good that an eminent palliative care physician is encouraging debate on assisted dying,1 but that debate must be evidence based.

Noble acknowledges that palliative care cannot relieve all suffering but offers no help to those whose suffering is unendurable. Oregon figures (0.2% of deaths are by assisted dying2) suggest that about 1000 assisted deaths would occur each year in England …
Heterogeneous Connexin43 distribution in heart failure is associated with dispersed conduction and enhanced susceptibility to ventricular arrhythmias
Authors: Mohamed Boulaksil, Stephan K.G. Winckels, Markus A. Engelen, Mèra Stein, Toon A.B. van Veen, John A. Jansen, André C. Linnenbank, Marti F.A. Bierhuizen, W. Antoinette Groenewegen, Matthijs F.M. van Oosterhout, Johannes H. Kirkels, Nicolaas de Jonge, András Varró, Marc A. Vos, Jacques M.T. de Bakker, Harold V.M. van Rijen
Journal: European Journal of Heart Failure (2010)
Gallium Scintigraphy in the Tumor Stage of Mycosis Fungoides
Authors: NAOYUKI WATANABE, TETSUO NAKAJIMA, TOMOKO KAZUMOTO, SHIGERU YANAGAWA, KEIGO ENDO
Journal: Clinical Nuclear Medicine (1994)

Galllum-67 is a non-specific tumor seeker and a good guide to the activity of a lymphoma. The appearance on gallium-67 imaging in mycosis fungoides has so far demonstrated either no tracer uptake or increased tracer uptake at the lesion. A 78-year-old woman presented with erythroderma of 20 years duration and a skin tumor in the left hip area, which became ulcerated. Gallium-67 imaging revealed increased uptake in the left hip lesion. A biopsy demonstrated mycosis fungoides. A case of mycosis fungoides with increased gallium-67 uptake in an ulcerating skin tumor lesion is reported.
Efomycine M, a new specific inhibitor of selectin, impairs leukocyte adhesion and alleviates cutaneous inflammation
Authors: Michael P. Schön, Thomas Krahn, Margarete Schön, Maria-L. Rodriguez, Horst Antonicek, Jeanette E. Schultz, Ralf J. Ludwig, Thomas M. Zollner, Erwin Bischoff, Klaus-D. Bremm, Matthias Schramm, Kerstin Henninger, Roland Kaufmann, Harald P. M. Gollnick, Christina M. Parker, W.-Henning Boehncke
Journal: Nature Medicine (2002)
THE INTERNAL SECRETIONS IN RELATION TO DERMATOLOGY
Authors: M. Morris
Journal: BMJ (1913)

NEARLY twenty years have passed since Byrom Bramiwell reported to the Newcastle iieeting of the Britisl Medical Association. ( 1893 the results wlhich he lhad obtained in cases of psoriasis, lupus vulgaris, and acute eczema by tlle internal administration of tlhyroid extract.'This was the beginning of organotlierapy in connexion witli dernlatology.Thyroid treatment lhad already been successfully u-sed in myxoedema by G. R. Murray, Hector Mackenzie, Arthur T. Davies, and otlhers; and it was now employed on an extensive scale in the therapeutics of skin affec- tions.But, as was perhaps inevitable, it was administered witlh too little discrimination, and, though it found enthusiastic advocates, signs of reaction were not long in declaring themselves, and after a while it was neglected and almost forgotten.Of late years, owing in part to the light that has been thrown upon the physiology and pathology of the ductless glands by a mulhitude of investigators, there has been a retival of interest in the subject, and the more discriminating use of animal extracts in many chronic skin diseases has yielded results more favourable than those at first obtained.The tinle seenms, therefore, to be appropriate for considering in some detail the influence of the internal secretions upon the skin and its appendages, and attemptina an estimate of the value of organotherapy in the treatment of-cutaneous affectiolns.