tbuckley/cabot-search huggingface dataset:
Ethical Choices After a Nuclear Attack-Reply
Authors: Christine K. Cassel
Journal: JAMA (1989)

ABSTRACT In Reply.— I appreciate Dr Dawson's clarification that the purpose of the British Medical Association's publication of Selection of Casualties was intentionally to provoke an open public debate on the ethical issues that would face health workers and others after nuclear attack. My concern remains, however, because in the policy circles in the United States at least, and I would suppose this is also true in the United Kingdom, many people may not have such delicate ethical sensibilities and will take these plans at face value, preparing the bureaucratic machinery for the eventuality of nuclear war, which lowers the threshold for starting such a war. In the United States, there also are a few survivalists who believe that nuclear war is inevitable and whose only concern is that they survive and prevail. These people will use the British Medical Association report as a blueprint for eugenics-based triage. I find this
Accuracy of reading liquid based cytology slides using the ThinPrep Imager compared with conventional cytology: prospective study
Authors: Elizabeth Davey, Jefferson d'Assuncao, Les Irwig, Petra Macaskill, Siew F Chan, Adele Richards, Annabelle Farnsworth
Journal: BMJ (2007)

<b>Objective</b> To compare the accuracy of liquid based cytology using the computerised ThinPrep Imager with that of manually read conventional cytology. <b>Design</b> Prospective study. <b>Setting</b> Pathology laboratory in Sydney, Australia. <b>Participants</b> 55 164 split sample pairs (liquid based sample collected after conventional sample from one collection) from consecutive samples of women choosing both types of cytology and whose specimens were examined between August 2004 and June 2005. <b>Main outcome measures</b> Primary outcome was accuracy of slides for detecting squamous lesions. Secondary outcomes were rate of unsatisfactory slides, distribution of squamous cytological classifications, and accuracy of detecting glandular lesions. <b>Results</b> Fewer unsatisfactory slides were found for imager read cytology than for conventional cytology (1.8% <i>v</i> 3.1%; P&lt;0.001). More slides were classified as abnormal by imager read cytology (7.4% <i>v</i> 6.0% overall and 2.8% <i>v</i> 2.2% for cervical intraepithelial neoplasia of grade 1 or higher). Among 550 patients in whom imager read cytology was cervical intraepithelial neoplasia grade 1 or higher and conventional cytology was less severe than grade 1, 133 of 380 biopsy samples taken were high grade histology. Among 294 patients in whom imager read cytology was less severe than cervical intraepithelial neoplasia grade 1 and conventional cytology was grade 1 or higher, 62 of 210 biopsy samples taken were high grade histology. Imager read cytology therefore detected 71 more cases of high grade histology than did conventional cytology, resulting from 170 more biopsies. Similar results were found when one pathologist reread the slides, masked to cytology results. <b>Conclusion</b> The ThinPrep Imager detects 1.29 more cases of histological high grade squamous disease per 1000 women screened than conventional cytology, with cervical intraepithelial neoplasia grade 1 as the threshold for referral to colposcopy. More imager read slides than conventional slides were satisfactory for examination and more contained low grade cytological abnormalities.
Impact of Race on Asthma Treatment Failures in the Asthma Clinical Research Network
Authors: Michael E. Wechsler, Mario Castro, Erik Lehman, Vernon M. Chinchilli, E. Rand Sutherland, Loren Denlinger, Stephen C. Lazarus, Stephen P. Peters, Elliot Israel
Journal: American Journal of Respiratory and Critical Care Medicine (2011)

Rationale: Recent studies suggest that people with asthma of different racial backgrounds may respond differently to various therapies.Objectives: To use data from well-characterized participants in prior Asthma Clinical Research Network (ACRN) trials to determine whether racial differences affected asthma treatment failures.Methods: We analyzed baseline phenotypes and treatment failure rates (worsening asthma resulting in systemic corticosteroid use, hospitalization, emergency department visit, prolonged decrease in peak expiratory flow, increase in albuterol use, or safety concerns) in subjects participating in 10 ACRN trials (1993–2003). Self-declared race was reported in each trial and treatment failure rates were stratified by race.Measurements and Main Results: A total of 1,200 unique subjects (whites = 795 [66%]; African Americans = 233 [19%]; others = 172 [14%]; mean age = 32) were included in the analyses. At baseline, African Americans had fewer asthma symptoms (P < 0.001) and less average daily rescue inhaler use (P = 0.007) than whites. There were no differences in baseline FEV1 (% predicted); asthma quality of life; bronchial hyperreactivity; or exhaled nitric oxide concentrations. A total of 147 treatment failures were observed; a significantly higher proportion of African Americans (19.7%; n = 46) experienced a treatment failure compared with whites (12.7%; n = 101) (odds ratio = 1.7; 95% confidence interval, 1.2–2.5; P = 0.007). When stratified by treatment, African Americans receiving long-acting β-agonists were twice as likely as whites to experience a treatment failure (odds ratio = 2.1; 95% confidence interval, 1.3–3.6; P = 0.004), even when used with other controller therapies.Conclusions: Despite having fewer asthma symptoms and less rescue β-agonist use, African-Americans with asthma have more treatment failures compared with whites, especially when taking long-acting β-agonists.
REPORT OF A CASE OF PUERPERAL ECLAMPSIA, WITH RECOVERY.
Authors: JAMES E. DAVIS
Journal: JAMA (1901)

There is nothing unusual in this case. It is reported because each experience teaches us lessons which may be mutually profitable. L. S., aged 20, moderately well nourished, and weighing 120 pounds, with previous health good, period of gestation complete and normal, was in labor about fourteen hours. Examination showed dilatation nearly complete, vertex presenting, pains strong; pulse 86, character good, excepting a slight high tension; action regular. After about fifteen minutes, during which time there were some four or five pains, descent had taken place almost to the perineum and the membranes had ruptured, when, without warning, a convulsion lasting about one minute occurred, manifesting about all the classic symptoms. The stertorous respiration, opisthotonus and depression of pulse were very marked. A semi-comatose condition ensued for about forty minutes, when a second convulsion lasting about thirty seconds occurred. This was followed by a condition of extreme irritability with threatening
No time to train the surgeons: Summary of rapid responses
Authors: Birte Twisselmann
Journal: BMJ (2004)

EDITOR—The 35 responses to the editorial by Chikwe et al overwhelmingly agree that surgeons' training in the United Kingdom has suffered under Calmanisation and will suffer more when the European Working Time Directive comes into force.1 Not all respondents find that the time invested in training is at issue (some reckon that the hours presented in the editorial do not quite add up), being more concerned about the …
Changes in Ventilation in Pediatric Patients After Removal of Gastric Contents
Authors: N. Ty Smith, Edwin J. Lilly
Journal: JAMA (1963)

Studies on 100 fasting infants and children anesthetized for elective surgery showed that there was often considerable gas and liquid in the stomach. The total volume of the gastric contents was sufficient to exert mechanical effects on respiratory movements, for removal of these contents led to a clinically significant increase in tidal volume and in pulmonary ventilation per minute. Since it was impossible to predict before surgery the amount of gas or liquid in the stomach, and since complications from passing a gastric tube were rare and usually minor, it is suggested that a gastric tube be passed in pediatric patients as soon as possible after induction of anethesia, and the gastric contents removed.
"Do No Harm"
Authors: MARY E. MOORE
Journal: Annals of Internal Medicine (1970)

Letters and Comments1 May 1970"Do No Harm"MARY E. MOORE, PH.D., M.D.MARY E. MOORE, PH.D., M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-72-5-760_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In your January edition (Ann Intern Med 72:87, 1970) you quote William S. Rowe quoting Hipprocrates—"first, do no harm." The adjacent paper by Drs. Fine and Shedrovilzky (Ann Intern Med 72:89-91, 1970) ironically reports a study that appears to fly in the face of Hipprocrates' dictum.They report the case of a 78-year-old woman in whom severe hyponatremia resulted in coma. After "it appeared possible that chlorpropamide might have been the specific cause of this patient's disorder" (to quote the authors) chlorpropamide was readministered on three separate occasions. These were each followed by an episode of marked... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: MARY E. MOORE, PH.D., M.D.Affiliations: Temple University Hospital 3400 N. Broad St. Philadelphia, Pa. 19132 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySynthesis of Five-Membered Nitroazoles 1 May 1970Volume 72, Issue 5Page: 760-760KeywordsComaHyponatremia ePublished: 1 December 2008 Issue Published: 1 May 1970 PDF downloadLoading ...
Leukocytosis in Acute Appendicitis
Authors: Paul Hyman
Journal: JAMA (1975)

ABSTRACT To the Editor.— The tables in our article Leukocytosis in Acute Appendicitis (229:1630, 1974), incorrectly labeled  error of the mean, should read mean and ± one standard deviation. Furthermore, recalculation from the raw data substantiates that the P value for total white blood cell counts is less than .01 rather than .001.Although these corrections will not change the meaning of our observation, we believe they should be noted.
Abstract 5584: Green tea polyphenols inhibit histone deacetylases and modulate p53 transcriptional activities in human prostate cancer cells
Authors: Karishma Gupta, Vijay S. Thakur, Natarajan Bhaskaran, Sanjay Gupta
Journal: Cancer Research (2011)

Abstract Inhibitors of histone deacetylases (HDACs) are emerging as a promising class of anticancer drugs. HDAC inhibitors have been demonstrated to induce cellular activities similar to p53-mediated responses such as induction of cell cycle arrest and apoptosis in various malignant cells. Green tea polyphenols (GTP) have shown protective effects against development and progression of various human cancers. GTP-mediated cellular responses include p53 activation, cell cycle arrest and induction of apoptosis in cancer cells. In the present study, we sought to determine whether GTP-mediated cellular responses are similar to that elicited by HDAC inhibitors. For these studies, we used human prostate cancer LNCaP cells, possessing wild-type p53, infected with short hairpin (sh) RNA vector and sh-p53 RNA vector to generate isogenic cell lines. Knockdown of p53 in LNCaP cells caused an increase in the activity of class I HDACs with specific increase in the protein expression of HDAC viz. 1 and 8, respectively. Treatment of both cell lines with 20, 40 and 80 mcg/mL doses of GTP for 24 h resulted in dose-dependent decrease in the total HDAC activity and protein expression of HDAC 2, 3 and 8 and HDAC 1, albeit at highest GTP dose. Similar dose-dependent responses were achieved by trichostatin A (TSA), a well known pharmacological inhibitor of class I and II HDACs in these cells. Interestingly, chemosensitization by GTP was more pronounced in the cells expressing p53 than the isogenic cell lines lacking p53 as observed by cell cycle analysis and annexin V flow cytometric analysis. Furthermore, GTP treatment resulted in marked increase in acetylation of p53 at its C-terminal amino acid positions K373 and K382, other than K305 along with increase in the acetylated forms of histone H3 and H4 which correlated with increased p53 expression, cell cycle arrest and apoptosis. Taken together, these results suggest that interaction of HDACs with p53 probably results in p53 deacetylation, thereby reducing the transcriptional activity; whereas GTP has the ability to cause deacetylation of p53 by reducing the levels of class I HDACs. This seems likely to be, in part, the mechanism for GTP-mediated p53 activation, a similar response elicited by HDAC inhibitors, which are developed as a promising class of drugs for the treatment of various human malignancies. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 5584. doi:10.1158/1538-7445.AM2011-5584
Modulation of the Renin-Angiotensin Pathway Through Enzyme Inhibition and Specific Receptor Blockade in Pacing-Induced Heart Failure
Authors: Francis G. Spinale, Marc de Gasparo, Steve Whitebread, Latha Hebbar, Mark J. Clair, D. Mark Melton, R. Stephen Krombach, Rupak Mukherjee, Julie P. Iannini, Seung-Jun O
Journal: Circulation (1997)

Background The goal of this study was to determine the effects of ACE inhibition (ACEI) alone, AT 1 angiotensin (Ang) II receptor blockade alone, and combined ACEI and AT 1 Ang II receptor blockade on LV function, systemic hemodynamics, and neurohormonal system activity in a model of congestive heart failure (CHF). Methods and Results Pigs were randomly assigned to each of 5 groups: (1) rapid atrial pacing (240 bpm) for 3 weeks (n=9), (2) ACEI (benazeprilat, 0.187 mg · kg −1 · d −1 ) and rapid pacing (n=9), (3) AT 1 Ang II receptor blockade (valsartan, 3 mg · kg −1 · d −1 ) and rapid pacing (n=9), (4) ACEI and AT 1 Ang II receptor blockade (benazeprilat/valsartan, 0.05/3 mg · kg −1 · d −1 ) and rapid pacing (n=9), and (5) sham controls (n=10). In the pacing group, LV fractional shortening (LVFS) fell (13.4±1.4% versus 39.1±1.0%) and end-diastolic dimension (LVEDD) increased (5.61±0.11 versus 3.45±0.07 cm) compared with control ( P &lt;.05). With AT 1 Ang II blockade and rapid pacing, LVEDD and LVFS were unchanged from pacing-only values. ACEI reduced LVEDD (4.95±0.11 cm) and increased LVFS (20.9±1.9%) from pacing-only values ( P &lt;.05). ACEI and AT 1 Ang II blockade reduced LVEDD (4.68±0.07 cm) and increased LVFS (25.2±0.9%) from pacing only ( P &lt;.05). Plasma norepinephrine and endothelin increased by more than fivefold with chronic pacing and remained elevated with AT 1 Ang II blockade. Plasma norepinephrine was reduced from pacing-only values by more than twofold in the ACEI group and the combination group. ACEI and AT 1 Ang II receptor blockade reduced plasma endothelin levels by &gt;50% from rapid-pacing values. Conclusions These findings suggest that the effects of ACEI in the setting of CHF are not solely due to modulation of Ang II levels but rather to alternative enzymatic pathways and that combined ACEI and AT 1 Ang II receptor blockade may provide unique benefits for LV pump function and neurohormonal systems in the setting of CHF.
Contraction-excitation feedback in an ejecting whole heart model - dependence of action potential duration on left ventricular diastolic and systolic pressures
Authors: D. S Coulshed, J C. Cowan
Journal: Cardiovascular Research (1991)

Journal Article Contraction-excitation feedback in an ejecting whole heart model – dependence of action potential duration on left ventricular diastolic and systolic pressures Get access David S Coulshed, David S Coulshed Department of Cardiovascular Studies, University of Leeds, Leeds LS2 9JT, United Kingdom Search for other works by this author on: Oxford Academic PubMed Google Scholar J Campbell Cowan J Campbell Cowan Department of Cardiovascular Studies, University of Leeds, Leeds LS2 9JT, United Kingdom Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 25, Issue 4, April 1991, Pages 343–352, https://doi.org/10.1093/cvr/25.4.343 Published: 01 April 1991 Article history Received: 18 September 1990 Accepted: 11 January 1991 Published: 01 April 1991
Moderators of Interventions Designed to Enhance Physical and Psychological Functioning Among Younger Women With Early-Stage Breast Cancer
Authors: Michael F. Scheier, Vicki S. Helgeson, Richard Schulz, Suzanne Colvin, Sarah L. Berga, Judy Knapp, Kristina Gerszten
Journal: Journal of Clinical Oncology (2007)

To identify factors that condition or moderate the impact of a previously described set of interventions on psychological and physical adjustment after diagnosis and treatment for early-stage breast cancer.Younger women (age < 51 years, N = 252) with early-stage breast cancer within 2 months of having completed active nonhormonal adjuvant therapy were randomly assigned to a three-arm clinical trial, consisting of a control arm, an education arm, and a nutrition arm. Primary end points, assessed before random assignment and 4 and 13 months later, included mental functioning, physical functioning, and depressive symptoms. Four types of moderator variables were identified, including two sets reflecting psychosocial resources, specifically personality factors and factors related to the person's social environment, a set reflecting demographic variables, and a set reflecting treatment and disease variables (including comorbidities).Psychosocial factors were more likely to moderate treatment effects than were demographic and disease-related factors, but the moderating effects of these psychosocial factors were limited to patients receiving the nutrition intervention. Patients with lower psychosocial resources benefited from the nutrition intervention, whereas patients with a greater amount of psychosocial resources did not.Future trials of this type should stratify by or select for the moderating variables identified here (ie, dispositional pessimism, unmitigated communion, and negative social interaction) to establish more firmly their role in responses to psychosocial interventions. Effort should also be made to collect data to inform the delivery of interventions to those who might benefit the most.
Measurement of Arterial Stiffness in Diabetes: A cautionary tale
Authors: Kieren Mather, Richard Lewanczuk
Journal: Diabetes Care (2004)

Diabetes has profound effects on the vasculature, and the major complications of diabetes, accounting for increases in both morbidity and mortality, are diseases of the vasculature. In recent years, a number of techniques have been developed that provide direct in vivo assessments of vascular health in humans. These techniques include measurements of atherosclerotic burden, such as calculations of coronary calcium scores using computed tomography and high-resolution ultrasound measurements of the intima-media thickness of the carotid arteries. Tests of the dynamic properties of the vasculature have most prominently assessed endothelium-dependent vasodilation, using brachial artery ultrasound or more invasive measures such as thermodilution, dye dilution, or plethysmography.

Another set of tools has been developed to assess the dynamic physical properties of the vascular tree. Although generally categorized as measures of “stiffness,” these techniques can in fact provide information on a number of specific physical properties, including distensibility, elasticity, and resistance to deformation. These parameters are different aspects of the interrelated features of vessel wall thickness, change in wall thickness, and vessel diameter in response to force and the rates of these changes as well as the rate of return to the nondeformed state. Abnormalities in these parameters can be demonstrated in tissues from diabetic subjects (1–3), and they can also be demonstrated in vivo. The most rigorous measurements of these features necessarily include a measurement of the distending force (i.e., blood pressure), ideally at the site of measurement. This can be achieved in the research setting with invasive techniques that place pressure …
Social workers and the Mental Health Act 1983
Authors: G. J Lodge
Journal: BMJ (1985)

data shows that the prevalence of diabetes mellitus in patients with acute stroke admitted to the Royal Victoria Infirmary and Freeman Hospital, New- castle UpoIn Tyne, was 31I,O (24/78) as defined by a raised stable HbA,, (<7o5%, that is, above the 95'%) confidence limits).There were four patients within this group with previously diagnosed diabetes mellitus, resulting in an overall incidence of unrecognised diabetes mellitus of 26°/., (20/78).There is therefore a significant number of patients with acute stroke presenting with previously un- recognised diabetes mellitus (p<OO5).The group of patients presenting with a raised HbA,, value also, and not surprisingly, had a significantly higher blood glucose concentration than those with a normal HbA,, value.The report fails to emphasise the role of stress hyperglycaemia in predicting outcome, an important omission because our observed mortality rates suggest a higher mortality in those patients with stress hyperglycaemia (normal HbA1, but blood glucose <8 mmol/l (14-4 mg/100 ml)): 42 80% compared with 30% for diabetic patients recognised and unrecognised.We think therefore that undiagnosed diabetes mellitus is a more important factor in acute stroke than reported but that stress hyperglycaemia is more important in predicting early mortality.
Abnormal Liver and Bone Scans in a Case of a Metastatic Neuroblastoma
Authors: VIRGILIO A. VALDEZ, JOSE M. BONNIN, THEODOPHILUS MARTINI, NILO E. HERRERA
Journal: Clinical Nuclear Medicine (1978)

VALDEZ, VIRGILIO A. M.D.; BONNIN, JOSE M. M.D.; MARTINI, THEODOPHILUS; HERRERA, NILO E. M.D. Author Information
Equilibrium Contrast Cardiovascular Magnetic Resonance for the Measurement of Diffuse Myocardial Fibrosis
Authors: Andrew S. Flett, Martin P. Hayward, Michael T. Ashworth, Michael S. Hansen, Andrew M. Taylor, Perry M. Elliott, Christopher McGregor, James C. Moon
Journal: Circulation (2010)

Background— Diffuse myocardial fibrosis is a final end point in most cardiac diseases. It is missed by the cardiovascular magnetic resonance (CMR) late gadolinium enhancement technique. Currently, quantifying diffuse myocardial fibrosis requires invasive biopsy, with inherent risk and sampling error. We have developed a robust and noninvasive technique, equilibrium contrast CMR (EQ–CMR) to quantify diffuse fibrosis and have validated it against the current gold standard of surgical myocardial biopsy. Methods and Results— The 3 principles of EQ–CMR are a bolus of extracellular gadolinium contrast followed by continuous infusion to achieve equilibrium; a blood sample to measure blood volume of distribution (1−hematocrit); and CMR to measure pre- and postequilibrium T1 (with heart rate correction). The myocardial volume of distribution is calculated, reflecting diffuse myocardial fibrosis. Clinical validation occurred in patients undergoing aortic valve replacement for aortic stenosis or myectomy in hypertrophic cardiomyopathy (n=18 and n=8, respectively). Surgical biopsies were analyzed for picrosirius red fibrosis quantification on histology. The mean histological fibrosis was 20.5±11% in aortic stenosis and 17.1±7.4% in hypertrophic cardiomyopathy. EQ–CMR correlated strongly with biopsy histological fibrosis: aortic stenosis, r 2 =0.86, Kendall Tau coefficient (T)=0.71, P &lt;0.001; hypertrophic cardiomyopathy, r 2 =0.62, T=0.52, P =0.08; combined r 2 =0.80, T=0.67, P &lt;0.001. Conclusions— We have developed and validated a new technique, EQ–CMR, to measure diffuse myocardial fibrosis as an add-on to a standard CMR scan, which allows for the noninvasive quantification of the diffuse fibrosis burden in myocardial diseases.