tbuckley/cabot-search huggingface dataset:
JAMA Editorial Position and US Health System Reform
Authors: John S. Wendt
Journal: JAMA (1994)

<h3>To the Editor.</h3> —In response to Dr Lundberg's Editorial<sup>1</sup>on US health care system reform, his "My Way" seems closest to Senator Gramm's proposal, yet the Gramm proposal received bum marks on both cost control and promoting continuing quality, as well as other areas. Looks to me like we need some new analysts! As I understand it, the Gramm proposal calls for tax reform so that individuals can purchase tax-deductible catastrophic insurance and place the premium savings (catastrophic vs other insurance premiums) in tax-deductible, tax-free MSAs to spend on health care however they wish (including seeing specialists without a referral if they so choose). The policy belongs to the patients and not employers, so they cannot lose it by changing or losing jobs. Employers can still be expected to offer premium contributions, but the individuals choose and control their policies. Administration is a snap: most years, most patients will
Peri-Operative Suppression of Immune-Regulatory Blood Cells Predicts Wound Complications in Breast Cancer Patients.
Authors: B. Hogan, M. Peter, R. Thorpe, R. Achuthan, C. Carter, K. Horgan, T. Hughes
Journal: Cancer Research (2009)

Abstract IntroductionWe have previously demonstrated an association between post-operative wound complications and systemic breast cancer recurrence (p&amp;lt;0.0001), Murthy et al (2007) Br J Cancer 97, 1211-7. The aim of this study was to examine the potential role of the immune system in establishing this association, and therefore whether immune factors might be used to predict either wound complications or cancer recurrences.MethodsPatients with primary operable breast cancer were prospectively recruited to the study. Serial blood investigations were performed pre-operatively, peri-operatively and post-operatively. Absolute numbers of various lymphocyte cell populations were measured using multi-colour flow-cytometry including CD45+lymphocytes, CD19+ B lymphocytes, CD3+ T lymphocytes, CD4+ helper T cells, CD8+ cytotoxic T cells and CD56+ NK cells. We also measured the levels of the NK cytotoxicity receptors NKp30 and NKp46 on the NK cell population.ResultsOne hundred and nine patients were recruited to the study and there was a wound complication rate of 13.4%. Absolute numbers of CD3+ T lymphocytes, CD4+ helper T cells, CD8+ cytotoxic T cells and CD56+ NK cells were significantly lower 4 hours post-operatively compared to pre-operative levels (p&amp;lt;0.05), although levels had typically recovered after 24 hours. However, NKp30 expression remained significantly reduced at 24 hours (p&amp;lt;0.05). Mastectomy patients had a significantly greater fall in T lymphocyte numbers than those having breast conserving surgery (p&amp;lt;0.05). Patients who went on to develop wound complications post-operatively had a significantly greater fall in their CD4+ helper T cells at 4 hours post-operatively, than those patients who did not go on to develop wound complications (p&amp;lt;0.05).ConclusionsBreast cancer surgery results in severe disruption to the immune system, with dramatic changes in levels of immune regulatory blood cells populations. Changes are predominantly immuno-suppressive. The greater the immune disruption as a result of surgery, the more likely the patient is to develop a wound complication. We believe that this peri-operative immuno-suppression may also provide a window of opportunity for the successful dissemination of tumour cells post-operatively thereby increasing the risk of future metastases; we are maintaining follow up on this patient cohort in order to test correlations between peri-operative immuno-suppression and systemic recurrences. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4132.
Laparoscopic Partial Nephrectomy with Clamping of the Renal Parenchyma: Initial Experience
Authors: Grégory Verhoest, Andréa Manunta, Karim Bensalah, Sébastien Vincendeau, Nathalie Rioux-Leclercq, François Guillé, Jean-Jacques Patard
Journal: European Urology (2007)
Down with the Good Lung
Authors: Alfred P. Fishman
Journal: New England Journal of Medicine (1981)

One of the more remarkable features of the lungs is the way in which alveolar ventilation is automatically adjusted to pulmonary-capillary blood flow as body position changes. Through this self-adjusting mechanism, the gaseous composition of arterial blood remains virtually constant. This is no mean feat, since the architecture of the lungs is not uniform: the left lung is smaller than the right, and the heart intrudes more into the left hemithorax than into the right. Moreover, no matter how the body turns, the force of gravity continues to pull on the lungs and the other contents of the thorax.In . . .
Rates of glycolysis and glycogenolysis during ischemia in glucose-insulin-potassium-treated perfused hearts: A 13C, 31P nuclear magnetic resonance study.
Authors: D E Hoekenga, J R Brainard, J Y Hutson
Journal: Circulation Research (1988)

The effects of 11.7 mM glucose, insulin, and potassium (GIK) on metabolism during ischemia were investigated in the perfused guinea pig heart using magnetic resonance spectroscopy. Intracellular metabolites, primarily glycogen and glutamate, were labeled with 13C by addition of [1-13C]glucose to the perfusate during a normoxic, preischemic period. 13C and 31P NMR spectroscopy was used to observe the metabolism of 13C-labeled metabolites simultaneously with high-energy phosphorus metabolites and pH. The extent of acidosis and the rate and amount of labeled lactate accumulation during ischemia were the same in control (3 mM glucose + insulin) and GIK-treated hearts. In contrast, the rate of labeled glycogen mobilization during ischemia in GIK-treated hearts was one third the rate observed in control hearts. These observations suggest that GIK decreased the rate of glycogenolysis during ischemia without affecting the rate of glycolysis. We propose that glucose contributed as a glycolytic substrate to a greater extent during ischemia in GIK-treated hearts than in hearts perfused with 3 mM glucose and insulin. The glycogen-sparing effect of GIK demonstrated in these studies could delay the onset of ischemic damage in a clinical setting by prolonging the availability of glycolytic substrate necessary for production of high-energy phosphate.
Broaden your mind about death and bereavement in certain ethnic groups in Britain.
Authors: J Black
Journal: BMJ (1987)

A British physician maintains that physician ignorance of the religious beliefs and needs of dying patients and their relatives is "unforgivable." He provides his colleagues with brief descriptions of the attitudes and practices of Hindu, Sikh, and Moslem residents of Asian origin in Britain regarding the death of adults, young children, and fetuses; mourning; autopsies; organ donation and transplantation; abortion; and prenatal testing and genetic counseling.
P731 CANNABINOID RECEPTOR 2-63 QQ VARIANT IS ASSOCIATED WITH PERSISTENTLY NORMAL AMINOTRANSFERASE SERUM LEVELS IN CHRONIC HEPATITIS C
Authors: N. Coppola, R. Zampino, C. Sagnelli, G. Bellini, A. Marrone, M. Stanzione, N. Capoluongo, A. Boemio, C. Minichini, L.E. Adinolfi, S. Maione, E. Miraglia Del Giudice, E. Sagnelli, F. Rossi
Journal: Journal of Hepatology (2014)
Effects of post-mastectomy radiotherapy on breast reconstruction
Authors: M. R. Kell, M. Barry
Journal: BMJ (2013)

Breast reconstruction is challenging to optimise in the face of optimum adjuvant therapy and we commend Thiruchelvam and colleagues on their recent review.1 However, one of their summary points says: “If radiotherapy is needed, delayed reconstruction minimises the risk of complications and improves aesthetic outcomes,” yet no …
'Tis Better to Have Loafed and Lost
Authors: Samuel Bigg
Journal: JAMA (1966)

<h3>To the Editor:—</h3> I could not help thinking, as I was swaying in my patented electric rocking chair, that we doctors have gone too far in our assault on pleasure. It is not enough to have proscribed tobacco, alcohol, and good rich food. Must the most cherished pleasure of blissful inactivity be also put on the banned list? Your editorial on "Hazards of Leisure" (<b>196</b>:1083, 1966) leads me to believe that this is indeed the intent of the medical profession. Before irrevocably committing ourselves to this new prohibition, let us be reminded that some things are sacred. "It is far better to have loafed and lost, than never to have loafed at all."
Safety of Systemic Chemotherapy in a Patient With Mitochondrial Myopathy and Non–Small-Cell Lung Cancer
Authors: Chiara Catania, Gianluca Spitaleri, Angelo Delmonte, Monica Giovannini, Francesca Toffalorio, Cristina Noberasco, Nereo Bresolin, Giacomo Comi, Tommaso De Pas
Journal: Journal of Clinical Oncology (2012)
Acute exacerbation of idiopathic pulmonary fibrosis associated with air pollution exposure
Authors: Kerri A. Johannson, Eric Vittinghoff, Kiyoung Lee, John R. Balmes, Wonjun Ji, Gilaad G. Kaplan, Dong Soon Kim, Harold R. Collard
Journal: European Respiratory Journal (2013)

Acute exacerbations of idiopathic pulmonary fibrosis are associated with high mortality and are of unknown cause. The effect of air pollution on exacerbations of interstitial lung disease is unknown. This study aims to define the association of air pollution exposure with acute exacerbation of idiopathic pulmonary fibrosis. Patients with idiopathic pulmonary fibrosis and corresponding air pollution data were identified from a longitudinal cohort. Air pollution exposures were assigned to each patient for ozone, nitrogen dioxide, particulate matter, sulfur dioxide and carbon monoxide based on geo-coded residential addresses. Cox proportional hazards models were used to estimate the association of air pollution exposures and acute exacerbations. Acute exacerbation was significantly associated with antecedent 6-week increases in mean level, maximum level and number of exceedances above accepted standards of ozone (hazard ratio (HR) 1.57, 95% CI 1.09-2.24; HR 1.42, 95% CI 1.11-1.82; and HR 1.51, 95% CI 1.17-1.94, respectively) and nitrogen dioxide (HR 1.41, 95% CI 1.04-1.91; HR 1.27, 95% CI 1.01-1.59; and HR 1.20, 95% CI 1.10-1.31, respectively). Increased ozone and nitrogen dioxide exposure over the preceding 6 weeks was associated with an increased risk of acute exacerbation of idiopathic pulmonary fibrosis, suggesting that air pollution may contribute to the development of this clinically meaningful event.
Angiography in Management of Carotid Body Tumors
Authors: William N. Hanafee
Journal: JAMA (1965)

THE PREOPERATIVE diagnosis of a carotid body tumor may tax the acumen and ingenuity of the most experienced and careful surgeon. Symptoms and signs are rarely specific, and often misleading. An extensive review of the literature indicates a correct preoperative diagnosis in only 10% of the reported cases. Recent reports<sup>1,2</sup>stress the potential malignancy of carotid body tumors. Fanning, Woods and Christian<sup>2</sup>list 25 malignant cases with proved metastases to the regional lymph nodes or to distant sites. This awareness of malignant changes along with advances in anesthesia and surgical technique, has directed fresh attention to the surgical management of these tumors. The indications for surgical removal of a carotid body tumor, and the selection of a specific surgical technique call for a thorough angiographic investigation. The value of carotid angiography was first mentioned by Engström and Hamberger<sup>3</sup>in 1957, for the diagnosis of a bilateral carotid
Remarks on Antiseptic Midwifery: Experiments with Lochial Fluid
Authors: N. Macleod
Journal: BMJ (1882)

THE results of the following experiments with lochial discharge con- trast so strikingly with those of Braidwood and Vacher, detailed in their "Reports to the Scientific Grants Committee of the British Medical Association, Third Contribution to the Life History of Con- tagium," that I hope they are of sufficient interest to obstetricians to justify publication, few though they may be in number.
Doctor Dock: Teaching and Learning Medicine at the Turn of the Century
Authors: Lester S. King
Journal: JAMA (1987)

George Dock, a leading internist in the first quarter of this century, had left us an unexpected legacy, but only now has it come to light. For eight years, from about 1900 to 1908, he had taught medical diagnosis to fourth-year students at the University of Michigan. This he did through clinics and small-group instruction. In these weekly exercises a stenographer made verbatim transcripts of everything said—by Dock, the patients, and the students. These records fill some 6800 pages. Dr Davenport, emeritus professor of physiology, has sifted this material and thereby given us an unusual picture of medical instruction, as provided some 80 years ago. Davenport first discusses briefly the medical school and its outstanding place in medical education. Then he takes up the material presented in the conferences, which, in the aggregate, covered virtually all of internal medicine. Davenport makes his presentation not by taking up individual cases in
What Remedies for the Ailing Autopsy?
Authors: Alfred Angrist
Journal: JAMA (1965)

The autopsy introduced the modern era of enlightenment in medicine, and for 100 years it was the most important instrument in the investigation of disease and its clinical manifestations. Other fields are now making more dramatic and more significant contributions to the therapy and the understanding of disease. This will continue as long as the autopsy limits itself to correlating symptoms and signs with morphologic entities. It is difficult for one who has devoted his professional life to the autopsy to admit that this procedure is no longer as important as it was heretofore, yet it is true. Further deterioration can be arrested by a better realization of the autopsy for what it is now and a better appreciation of what it can become if properly supported. With adequate support, the autopsy will not be found wanting in its contribution to research, patient and hospital service, and medical education. The
The Theoretical Basis of Transcriptional Therapy of Cancer: Can It Be Put Into Practice?
Authors: Ari M. Melnick, Kerin Adelson, Jonathan D. Licht
Journal: Journal of Clinical Oncology (2005)

Aberrant gene silencing is a frequent event in cancer and plays a critical role in the molecular pathogenesis of malignant transformation. The two major mechanisms of silencing in cancer include transcriptional repression by mutated or aberrantly expressed transcription factors, and aberrant epigenetic silencing by hypermethylation of tumor suppressor or DNA repair–related genes. Both of these mechanisms require the activities of multiprotein chromatin remodeling and modifying machines, several of which may be mutated in cancer. The end result is genetic reprogramming of cells to express combinations of genes that confer the neoplastic phenotype. Recent discoveries in transcriptional biochemistry and gene regulation indicate that therapeutic agents can be engineered to specifically target these mechanisms. We provide a framework for the clinical or translational scientist to consider how such drugs might be developed and what their impact might be on restoring cells to normal genetic programming.
Limitations of the Electrocardiographic Diagnosis of Ventricular Hypertrophy
Authors: Arthur Selzer
Journal: JAMA (1966)

Electrocardiography provides the clinician with an important tool, permitting the diagnosis of hypertrophy of either or both cardiac ventricles. Such information is of particular importance in patients with chronic cardiac overload, in whom the severity and the stage of the disease can be estimated. Thus, in systemic or pulmonary hypertension, in aortic or pulmonary stenosis, and in many other cardiac lesions, the development of ventricular hypertrophy indicates a serious degree of increased cardiac workload and often provides a reason for more agressive therapy. In the clinical application of electrocardiography, the clinician is encouraged by many writings crediting this procedure with extraordinary accuracy, up to a point of predicting the hemodynamic status of the patient from the tracing. It is often overlooked, however, that the bases for such claims are statistical correlations, which, as in all biological relationships, apply more to groups of cases than to individual examples. The unavoidable scatter
A Therapeutic Antibody Targeting BACE1 Inhibits Amyloid-β Production in Vivo
Authors: Jasvinder K. Atwal, Yongmei Chen, Cecilia Chiu, Deborah L. Mortensen, William J. Meilandt, Yichin Liu, Christopher E. Heise, Kwame Hoyte, Wilman Luk, Yanmei Lu, Kun Peng, Ping Wu, Lionel Rouge, Yingnan Zhang, Robert A. Lazarus, Kimberly Scearce-Levie, Weiru Wang, Yan Wu, Marc Tessier-Lavigne, Ryan J. Watts
Journal: Science Translational Medicine (2011)

A human antibody inhibits BACE1 activity and Aβ peptide production in cultured neurons and in the central nervous system of mouse and monkey.
MYOSITIS IN MICE FOLLOWING INTRAMUSCULAR INJECTION OF VIRUSES OF THE MOUSE ENCEPHALOMYELITIS GROUP AND OF CERTAIN OTHER NEUROTROPIC VIRUSES
Authors: Robert Rustigian, Alwin M. Pappenheimer
Journal: The Journal of Experimental Medicine (1949)

A study has been made of the local effects following intramuscular injection of various neurotropic viruses. Early massive necrosis of muscle fibers accompanied by edema and acute inflammatory reaction is produced by Jungeblut's SK virus even in low concentrations. Similar but more slowly developing lesions follow the introduction of mouse encephalomyelitis GD-VII and FA strains. Strain 4727 (TO type) produces inflammatory changes with fibrosis in the intermuscular septa and necrosis of scattered individual fibers. The relatively avirulent FV strain (TO type) was not pathogenic for skeletal muscle. The Mitchell strain of lymphocytic choriomeningitis virus gives rise to a profuse lymphocytic and monocytic infiltration of the fat and connective tissue but does not cause necrosis of muscle fibers. No significant lesions resulted from intramuscular injection of the murine-adapted human poliomyelitis Lansing virus, the HF strain of herpes, a strain of Eastern equine encephalitis virus, or a still unidentified demyelinating mouse virus. Evidence is presented that the mouse encephalomyelitis virus GD-VII and Jungeblut's SK virus multiply locally in the injected limb. The GD-VII virus has been passed through four muscle to muscle passages and muscle lesions have been elicited at the same time. Specific and complete protection against myositis was obtained by anti-GD-VII and anti-SK rabbit sera.
Government injects cash to reduce winter crisis in NHS
Authors: J. Warden
Journal: BMJ (1997)

The British government is preparing to inject an extra £300m ($480m) into the NHS for this winter in a tacit admission that patient care will deteriorate at current funding levels.

Existing resources have already been diverted to ease winter pressures (30 August, p 501), but ministers have concluded that more is needed. Previously they had said that no additional money would be released until the new financial year next April.

Chancellor of the Exchequer Gordon Brown now says that …
Abstract 2260: Novel molecular therapy targeting Mcl-1 and modulating autophagy in castration-resistant prostate cancer
Authors: Wenhua Tang, Yang Qu, Lan Lan, Daocheng Wu, Liang Xu
Journal: Cancer Research (2012)

Abstract Chemo/radioresistance markedly impair the efficacy of cancer therapy. Anti-apoptotic Bcl-2 family proteins such as Bcl-xL, Bcl-2 and Mcl-1 are overexpressed in castration-resistant prostate cancer (CRPC) and contribute to prostate tumor initiation, progression and resistance to radiotherapy. A natural BH3-mimetic small molecule inhibitor of Bcl-2, (-)-gossypol, shows promise in ongoing Phase II clinical trials for human prostate cancer. We have recently shown that (-)-gossypol preferentially induces autophagy in CRPC cells that have high levels of Bcl-2 and are resistant to apoptosis, both in vitro and in vivo, but not in androgen-dependent cells with low Bcl-2 and sensitive to apoptosis. We have explored a series of gossypol derivatives and identified two novel BH3-mimetic lead compounds that are more potent than the parental compound in inducing autophagic cell death in CRPC. A novel pan-Bcl-2 inhibitor, apogossypolone (ApoG2), a derivative of (-)-gossypol, has a better binding affinity to Mcl-1 and an improved antitumor activity, and shows promising efficacy on a variety of cancers in vitro and in vivo. Treatment with the ApoG2 prior to radiotherapy enhances cell death via autophagic pathway in cancer cells which have high Mcl-1 and resistant to apoptosis. In addition to abrogating Bcl-2/Mcl-1–Beclin1 interactions, ApoG2 activates the autophagic pathway Atg5-dependently which synergizes with the effect of radiation. We further investigated the precise mechanism governing the influence of ApoG2 on IR-induced cell death. Our data suggest that, ApoG2 pretreatment suppresses IR induced Akt activation and mTOR phosphorylation. In this way, it serves as a potent radiosensitizer to affect autophagic cell death in cancer cells. Administration of ApoG2 prior to IR further delayed tumor growth of castration resistant prostate cancer xenograft model and increased autophagic cell death in vivo. Together, our data demonstrate a novel mode of action of ApoG2 as an enhancer of radiation induced autophagic cell death and provide mechanistic details of its tumor cell killing activities. These new insights into different modes of cell death induced by Mcl-1 inhibitors may facilitate the rational design of clinical trials by selecting patients most likely to benefit from the Mcl-1-targeted molecular therapy. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2260. doi:1538-7445.AM2012-2260
Surgical Management of Left-Sided Carcinoid Heart Disease
Authors: Heidi M. Connolly, Hartzell V. Schaff, Charles J. Mullany, Joseph Rubin, Martin D. Abel, Patricia A. Pellikka
Journal: Circulation (2001)

Carcinoid involvement of left-sided heart valves has been reported in patients with a patent foramen ovale, carcinoid tumor of the lung, and active carcinoid syndrome with high levels of serotonin. The present study details the clinical features and surgical management of patients with carcinoid heart disease affecting both left- and right-sided valves.Eleven patients (7 men, 4 women) with symptomatic carcinoid heart disease underwent surgery for left- and right-sided valve disease between 1989 and 1999. Mean age was 57+/-9 years, and median preoperative NYHA class was 3. All patients had metastatic carcinoid tumors and were on somatostatin analog. Of 11 patients, 5 (45%) had a patent foramen ovale; 1 of these also had a primary lung carcinoid tumor. Surgery included tricuspid valve replacement in all patients, pulmonary valve replacement in 3 and valvectomy in 7, mitral valve replacement in 6 and repair in 1, aortic valve replacement in 4 and repair in 2, CABG in 2, and patent foramen ovale closure in 5. One myocardial metastatic carcinoid tumor was removed. There were 2 perioperative deaths. At a mean follow-up of 41 months, 4 additional patients were dead. All but 1 surgical survivor initially improved >/=1 functional class. No patient required reoperation.Carcinoid heart disease may affect left- and right-sided valves and occurred without intracardiac shunting in 55% of this surgical series. Despite metastatic disease that limits longevity, operative survivors had improvement in functional capacity. Cardiac surgery should be considered for select patients with carcinoid heart disease affecting left- and right-sided valves.