tbuckley/cabot-search huggingface dataset:
High-Dose Chemotherapy With Autologous Bone Marrow Transplantation for Metastatic Breast Cancer
Authors: David M. Eddy, Bruce E. Hillner, Thomas J. Smith, Christopher E. Desch
Journal: JAMA (1992)

<h3>To the Editor.</h3> —The April 15 issue of<i>JAMA</i>contained an evaluation of the cost-effectiveness of high-dose chemotherapy with autologous bone marrow transplantation (ABMT) for metastatic breast cancer.<sup>1</sup>Simultaneously, another article evaluating the same treatment was published in the<i>Journal of Clinical Oncology</i>.<sup>2</sup>At first glance, the two articles appear to reach opposite conclusions. As the authors of the two articles, we thought it would be helpful to reconcile the apparently different conclusions. The<i>Journal of Clinical Oncology</i>article<sup>2</sup>was a comprehensive literature review. Its main conclusions were that (1) there are no well-controlled studies documenting that high-dose chemotherapy with ABMT is superior to conventional care, and (2) a crude comparison of clinical series reveals that the two treatments have essentially the same median survival rates (16.2 months for conventional care vs 16 months for high-dose chemotherapy with ABMT), median disease-free survival rates (8.8 months vs 8.3
The role of Hepassocin in the development of non-alcoholic fatty liver disease
Authors: Hung-Tsung Wu, Feng-Hwa Lu, Horng-Yih Ou, Yu-Chu Su, Hao-Chang Hung, Jin-Shang Wu, Yi-Ching Yang, Chao-Liang Wu, Chih-Jen Chang
Journal: Journal of Hepatology (2013)
Persistence in blood mononuclear cells of hepatitis C virus genotypes undetectable in plasma: Role of dual viral tropism and repeated exposure
Authors: A.M. Roque-Afonso, D. Ducoulombier, R. Kara, M. Gigou, X. Bing, E. Gault, E. Dussaix, C. Feray
Journal: Journal of Hepatology (2003)
Treatment of Meningitis Due to<i>Haemophilus influenzae</i>
Authors: Sidney Ross, E. Clarence Rice, Frederic G. Burke, Joseph J. McGovern, Robert H. Parrott, John P. McGovern
Journal: New England Journal of Medicine (1952)

THE treatment of meningitis due to Haemophilus influenzae has undergone considerable change in the past fifteen years. Prior to the advent of specific therapy, this disease was fatal in 90 to 100 per cent of cases, and in the rare cases in which recovery took place, severe neurologic sequelae were frequently encountered. Wilkes-Weiss and Huntington,1 in a review of the literature in 1936, reported 500 cases in patients of all ages, with a mortality of 92.2 per cent.The introduction of Fothergill's specific antiserum and complement, together with the sulfonamide drugs, represented a considerable advance in the therapy of this . . .
323 DURING PRIMARY EBV INFECTION, THE INTENSITY OF LIVER ABNORMALITIES CORRELATES WITH AGE AND IMMUNE RESPONSE, AND THE USE OF CORTICOSTEROIDS IS NOT DELETERIOUS
Authors: L. Hocqueloux, J. Guinard, J.-C. Jandali, C. Soin, J. Buret, F. Lagarde, E. Legac, A. Guigon, X. Causse
Journal: Journal of Hepatology (2013)
ABC of heart failure: Acute and chronic management strategies
Authors: T Millane
Journal: BMJ (2000)

Acute and chronic management strategies in heart failure are aimed at improving both symptoms and prognosis, although management in individual patients will depend on the underlying aetiology and the severity of the condition. It is imperative that the diagnosis of heart failure is accompanied by an urgent attempt to establish its cause, as timely intervention may greatly improve the prognosis in selected cases—for example, in patients with severe aortic stenosis.

View this table:

Survival rates (%) compared with chronic heart failure



### Assessment

Common presenting features include anxiety, tachycardia, and dyspnoea. Pallor and hypotension are present in more severe cases: the triad of hypotension (systolic blood pressure <90 mm Hg), oliguria, and low cardiac output constitutes a diagnosis of cardiogenic shock. Severe acute heart failure and cardiogenic shock may be related to an extensive myocardial infarction, sustained cardiac arrhythmias (for example, atrial fibrillation or ventricular tachycardia), or mechanical problems (for example, acute papillary muscle rupture or postinfarction ventricular septal defect).

View this table:

Killip classification





Chest × ray film in patient with acute pulmonary oedema



Severe acute heart failure is a medical emergency, and effective management requires an assessment of the underlying cause, improvement of the haemodynamic status, relief of pulmonary congestion, and improved tissue oxygenation. Clinical and radiographic assessment of these patients provides a guide to severity and prognosis: the Killip classification has been developed to grade the severity of acute and chronic heart failure.

### Treatment

Basic measures should include sitting the patient in an upright position with high concentration oxygen delivered via a face mask. Close observation and frequent reassessment are required in the early hours of treatment, and patients with acute severe heart failure, or refractory symptoms, should be monitored in a high dependency unit. Urinary catheterisation facilitates accurate assessment of fluid balance, while arterial blood gases provide valuable information about oxygenation and acid-base balance. The …
William Burbridge-James
Authors: W. Burbridge-James
Journal: BMJ (2013)

Born in Allahabad, India, William Burbridge-James (“Bill”) qualified from Madras Medical College in Chennai in 1934. Passionate about medicine he worked first as a pathologist in the Indian Army Medical Corps, stationed on the North West Frontier and later setting up field labs for General Slim’s 14th Army in the Burma campaign.

He returned to the UK after the war, where he took English finals at the London Hospital in Whitechapel in 1947. Not having connections in the UK and with a young family, he decided …
Hand Carriage of Gram-negative Bacilli and Staphylococcus aureus
Authors: J. N. Bruun, C. O. Solberg
Journal: BMJ (1973)

The influence of hexachlorophane disinfection on the bacterial hand flora of hospital personnel has been examined. Hexachlorophane effectively reduced the total number of bacteria and the staphylococcal carriage. Gram-negative bacilli were isolated from 18·8% of the personnel, and 13% of the carriers continued to carry Gram-negative bacilli for more than six months. The carrier rate was significantly higher among those using hexachlorophane detergents (20·8%) than among those using plain soap (14·1%). Prolonged hand carriage of Gram-negative bacilli was often associated with skin irritation, especially of the nailfolds. Hand carriage may be an important source of Gram-negative infections in hospital, and the increase in these infections may partly be due to extensive use of hexachlorophane preparations.
Worker exposure to vinyl chloride and poly(vinyl chloride).
Authors: J H Jones
Journal: Environmental Health Perspectives (1981)

The National Institute for Occupational Safety and Health (NIOSH) in early 1974 began industrial hygiene studies of vinyl chloride exposed workers. Three VC monomer plants, three VC polymerization plants, and seven PVC fabrication plants were surveyed. V polymerization plant workers and workers in one job category in VC monomer plants were exposed to average levels above 1 ppm. The highest average exposure was 22 ppm. NIOSH health hazard evaluation studies since these initial surveys have primarily shown nondetectable levels of vinyl chloride. A NIOSH control technology study in 1977 showed that exposure levels in VC polymerization plants had been drastically reduced but exposure levels above 1 ppm were still found in several cases.
848 RELATIONSHIP BETWEEN LIVER BIOPSY AND NON-INVASIVE BIOCHEMICAL METHODS IN DETERMINATION OF LIVER FIBROSIS IN TREATMENT-NAIVE CHRONIC HEPATITIS C PATIENTS; A MULTICENTRE STUDY
Authors: I. Koksal, G. Yilmaz, M. Parlak, T. Demirdal, S. Kinikli, M. Candan, A. Kaya, S. Akhan, O. Aydogdu, H. Turgut, Y. Gurbuz, O. Dagli, A.A. Gokal, R. Guner, Z. Kuruuzum, H. Tarakci, N. Beslen, E. Duyar, D. Inan, H. Leblebicioglu, E. Sehmen, Z. Yulugkural, M. Namiduru, O.F. Kokoglu, N. Baykam, O. Ural, F. Bostanci, S. Kaya, S. Kilic, Y. Onlen, D. Ozdemir, F. Tabak, T. Yamazhan
Journal: Journal of Hepatology (2012)
Breast Cancer: Treatment Differences and Survival
Authors: Theodore J. Williamson
Journal: JAMA (1994)

<h3>To the Editor.</h3> —The recent review of breast cancer treatment and end results in Orange County by Dr Lee-Feldstein and colleagues<sup>1</sup>may be shy on answers, but certainly raises provocative questions and broad new avenues for clinical investigation. We are heartened by evidence that shows superior survival in patients managed conservatively outside of the clinical trial environment. The implication that survival may relate to the type of treatment facility, while based on rather soft data, presents an opportunity for some interesting speculation. The radiation therapy component of conservative breast cancer management is in fact quite simple and straightforward with relatively little variation in practice around the country, and we doubt that it would be a significant factor. At least two other possible explanations exist. In our institution, as in many others, we are very quick to return the patient to the surgeon for reexcision at the primary site if
Mechanisms of melanogenesis inhibition by 2,5-dimethyl-4-hydroxy-3(2H)-furanone
Authors: J. Lee, E. Jung, J. Lee, S. Huh, Y.C. Boo, C.G. Hyun, Y-S. Kim, D. Park
Journal: British Journal of Dermatology (2007)

Increased production and accumulation of melanin is characteristic of a large number of skin diseases, including acquired hyperpigmentation such as melasma, postinflammatory melanoderma and solar lentigo. Thus, there is a increasing need for the development of depigmenting agents.To evaluate the depigmenting capacity of 2,5-dimethyl-4-hydroxy-3(2H)-furanone (DMHF) and to elucidate the mechanisms by which it inhibits alpha-melanocyte-stimulating hormone (alpha-MSH)-induced melanogenesis in B16 melanoma cells in vitro.Several experiments were performed in B16 melanoma cells. We studied melanin content, tyrosinase activity and cAMP production, and performed cAMP response element (CRE) luciferase reporter assay and Western blots for proteins involved in melanogenesis.The melanin content and tyrosinase activity induced by alpha-MSH were inhibited significantly by DMHF. To clarify the mechanism of the depigmenting property of DMHF, we examined the involvement of DMHF in cAMP signalling induced by alpha-MSH. In CRE luciferase reporter assay, CRE reporter activation induced by alpha-MSH was inhibited by DMHF. Additionally, although DMHF did not inhibit cAMP production by alpha-MSH, both CRE binding protein (CREB) phosphorylation and the reduction of glycogen synthase kinase-3beta phosphorylation by alpha-MSH were blocked by DMHF. These data suggest that DMHF inhibits the downstream step of cAMP production induced by alpha-MSH, consequently inhibiting melanogenesis. This suggestion was further confirmed by the fact that the increased production levels of microphthalmia-associated transcription factor, tyrosinase and tyrosinase-related protein-1 induced by alpha-MSH were all reduced by DMHF in B16 melanoma cells.Our study shows that DMHF inhibits alpha-MSH-induced melanogenesis by suppressing CREB phosphorylation, which is induced by protein kinase A, and suggests that DMHF may be an effective inhibitor of hyperpigmentation.
β2-Microglobulin Promotes the Growth of Human Renal Cell Carcinoma through the Activation of the Protein Kinase A, Cyclic AMP–Responsive Element-Binding Protein, and Vascular Endothelial Growth Factor Axis
Authors: Takeo Nomura, Wen-Chin Huang, Haiyen E. Zhau, Daqing Wu, Zhihui Xie, Hiromitsu Mimata, Majd Zayzafoon, Andrew N. Young, Fray F. Marshall, M. Neale Weitzmann, Leland W.K. Chung
Journal: Clinical Cancer Research (2006)

Abstract Purpose: β2-Microglobulin (β2M), a soluble protein secreted by cancer and host inflammatory cells, has various biological functions, including antigen presentation. Because aberrant expression of β2M has been reported in human renal cell carcinoma, we investigated the effects of β2M overexpression on cancer cell growth and analyzed its molecular signaling pathway. Experimental Design: We established clonal cell lines that overexpressed β2M in human renal cell carcinoma (SN12C) cells and then examined cell growth in vitro and in vivo and studied the β2M-mediated downstream cell signaling pathway. Results: Our results showed that β2M expression positively correlates with (a) in vitro growth on plastic dishes and as Matrigel colonies, (b) cell invasion and migration in Boyden chambers, and (c) vascular endothelial growth factor (VEGF) expression and secretion by cells. We found, in addition, that β2M mediates its action through increased phosphorylation of cyclic AMP–responsive element-binding protein (CREB) via the protein kinase A-CREB axis, resulting in increased VEGF expression and secretion. In convergence with this signal axis, β2M overexpression also activated both phosphatidylinositol 3-kinase/Akt and mitogen-activated protein kinase pathways. β2M overexpression induced accelerated growth of SN12C in mouse subcutis and bone. Interrupting the β2M signaling pathway using small interfering RNA led to apoptosis with increased activation of caspase-3 and caspase-9 and cleaved poly(ADP-ribose) polymerase. Conclusions: Our results showed for the first time that the β2M-protein kinase A-CREB-VEGF signaling axis plays a crucial role in support of renal cell carcinoma growth and progression and reveals a novel therapeutic target.
Lead Exposures in U.S. Children, 2008: Implications for Prevention
Authors: Ronnie Levin, Mary Jean Brown, Michael E. Kashtock, David E. Jacobs, Elizabeth A. Whelan, Joanne Rodman, Michael R. Schock, Alma Padilla, Thomas Sinks
Journal: Environmental Health Perspectives (2008)

We reviewed the sources of lead in the environments of U.S. children, contributions to children's blood lead levels, source elimination and control efforts, and existing federal authorities. Our context is the U.S. public health goal to eliminate pediatric elevated blood lead levels (EBLs) by 2010.
Nicotinic Acid and Serum Lipids
Authors: O. FitzGerald
Journal: BMJ (1964)

Safety of Vinyl EtherSIR,-Some years ago attention was drawn to the safety of vinyl ether as a sole anaes- thetic for short operations,' inasmuch as it appeared that since the war there had been over 500,000 administrations with only one death.Vinyl ether (" vinesthene ") is put up in ampoules of 3 and 5 ml., and in bottles of 25 ml.for longer operations.Thanks to the courtesy of the sole manufacturers in stating the number of ampoules that have been issued it is possible to estimate the number of anaesthetics given with a fair degree of accuracy.This number now stands at over
Placebo controlled trials
Authors: P. Sedgwick, C. Hooper
Journal: BMJ (2014)

Researchers assessed the efficacy of varenicline (a licensed cigarette smoking cessation aid) in helping users of smokeless tobacco to quit. A double blind placebo controlled parallel group randomised controlled trial study design was used. The intervention was varenicline 1 mg twice daily. Treatment was delivered for 12 weeks, with 14 weeks’ follow-up afterwards. Participants were aged 18 years or more. They were also users of smokeless tobacco who wished to quit and had no abstinence period longer than three months during the year before recruitment. In total, 431 participants were recruited and randomised to varenicline (n=213) or placebo (n=218). All participants were offered brief behavioural support or counselling at the discretion of the investigators.1

The primary endpoint was continuous abstinence for four weeks at the end of treatment (weeks 9-12) confirmed by cotinine concentration. A significantly higher rate of abstinence was reported in the varenicline group compared with placebo (59% v 39%; relative risk 1.6, 95% confidence interval 1.32 to 1.87; P<0.001).

Which of the following statements, if any, are true?

Statement b is true, whereas a , c , and d are false.

Smokeless tobacco is often used by smokers trying to quit because it is considered less harmful than …
Diagnosis of Jaundice
Authors: Frederick S. Keller, Charles T. Dotter, Ronald M. Katon, Timothy G. Lee, Sidney C. Henderson
Journal: JAMA (1978)

To the Editor.—  In a recent article, Gray-Scale Ultrasonography and Thin-Needle Cholangiography: Evaluation in the Jaundiced Patient (238:1041, 1977), Goldstein et al conclude that failure to demonstrate a dilated biliary ductal system in a jaundiced patient by gray-scale ultrasonography (GSU) reliably indicates that the cause of the jaundice is  rather than  and that liver biopsy rather than thin-needle cholangiography (TNC) should be the next diagnostic procedure.  Like Goldstein et al, we also have found excellent correlation between GSU and TNC in demonstrating the presence or absence of biliary ductal dilation. However, in our experience we frequently have seen patients with nondilated biliary systems (by both GSU and TNC) who had surgical rather than medical jaundice (Figure). Therefore, we believe that the absence of a dilated biliary ductal system by GSU is not conclusive in defferentiating medical from surgical jaundice and that TNC may indeed be the next diagnostic
Bronchogenic carcinoma, stages 3 and 4. Palliation by chemotherapy
Authors: B. Roswit
Journal: JAMA (1966)

It is no longer possible for the practitioner to plan effective medical care for the patient with advanced lung cancer without a clear understanding of the indications, the rewards, and the risks for the use of radiation therapy and cancer chemotherapeutic agents. Sooner or later in the course of this formidable disease, the majority of patients will require effective palliative measures to relieve distressing symptoms, improve respiratory function, prolong the period of useful activity, and maintain the morale for as long as possible. In our experience with more than 1,500 patients with inoperable lung cancer, radiation therapy was the best single agent for offering relief to the symptomatic individual with an advanced localized tumor, while chemical agents were very helpful adjuncts for the distressed patient with widely disseminated disease.<sup>1-5</sup>They are employed when radiation therapy is not available, no longer feasible, or ineffective. Radiation therapy and certain cancer-inhibiting drugs,
THE TREATMENT OF YAWS (FRAMBŒSIA) WITH ARSENOBENZOL (SALVARSAN)
Authors: Richard P. Strong
Journal: The Journal of Experimental Medicine (1911)

Yaws is a highly contagious and disfiguring disease very prevalent in the tropics and believed now to be caused by a specific spirochaete--the Treponerna pertenuis of Castellani.Although some writers have held that yaws and syphilis are merely two manifestations of the same disease, it can now be stated that the weight of opinion is against' that view and in favor of the view that they are distinct diseases.With this latter conclusion the experimental work of the last few years is in harmony?Monkeys can be inoculated with yaws as with syphilis; and monkeys which have recovered from syphilitic lesions are still susceptible to inoculation with yaws, although they are not reinoculable with syphilis.Moreover. Treponerna pertenuis is distinguishable morphologically fromTreponerna pallidum; and thus while it can be affirmed that both * The substance of this paper was read at the meeting of the Manila Medical Society, September 5, I9 IO, at which one of the cured patients was exhibited.
Cephalexin for Susceptible Bacteriuria in Afebrile, Long-term Catheterized Patients
Authors: John W. Warren
Journal: JAMA (1982)

Patients with long-term indwelling urethral catheters are subject to acute and long-term complications of bacteriuria. To evaluate the common practice of short-course antibiotic therapy in such patients, we performed a randomized controlled trial of ten-day courses of cephalexin monohydrate repeated whenever a susceptible bacteriuria was present. We observed 17 cephalexin group patients for 545 patient-weeks (160 cephalexin courses) and 18 control group patients for 477 patient-weeks. Throughout the study, the groups were comparable in regard to incidence and prevalence of bacteriuria, number of bacterial strains per weekly urine specimen, incidence of febrile days, and incidence of obstructed catheters. In the cephalexin group, the frequency of fever during periods when antibiotics were being used was similar to that during periods when antibiotics were not being used. More cephalexin-resistant bacteria were isolated from cephalexin group patients. Routine treatment with cephalexin of asymptomatic long-term catheterized patients, even for susceptible organisms, does not seem to be warranted.
Pneumocystis carinii Pneumonia in a Hospital for Children
Authors: David R. Perera
Journal: JAMA (1970)

The first large outbreak ofPneumocystis cariniipneumonia reported in the United States occurred at St. Jude Children's Research Hospital in Memphis. Seventeen cases were documented during 1968 through 1969; only two cases had been identified in the preceding six years. All 19 affected children were being given immunosuppressive drugs for malignant disease; 14 had acute leukemia. A review of 301 consecutive autopsies at St. Jude demonstrated clinically inapparentP cariniiinfection in 40 additional patients. Epidemiologic analysis suggested that more intensive chemotherapy caused the outbreak ofPneumocystispneumonia by activating the inapparentPneumocystisinfection commonly associated with neoplastic disease.
Impaired quality of life of adults with skin disease in primary care
Authors: D. Harlow, T. Poyner, A.Y. Finlay, P.J. Dykes
Journal: British Journal of Dermatology (2000)

Background Although 75% of skin problems are managed exclusively in primary care, most information on the impact of skin disease on quality of life is hospital based. Objectives To examine the ease of use of the Dermatology Life Quality Index (DLQI) in primary care and to measure the handicap levels found, analysed by skin disease, sex and age. Methods The handicap levels identified were compared with those published for patients with the same conditions attending hospital clinics. Some conditions that rarely present in secondary care were also studied. Results The overall mean ± SD DLQI score was 7·37 ± 5·71 (women 7·8 ± 5·8, n = 196; men 6·8 ± 5·6, n = 145). The scores for separate diseases were similar in ranking and only slightly lower than those in hospital-based studies. The possibility of bias towards surveying an unrepresentative sample of patients is discussed. There was no correlation between age and DLQI score. Conclusions The DLQI proved easy to use in general practice. The impact of skin diseases on the quality of life of patients seen in primary care is comparable with that of patients seen in secondary care. This information could be used to inform the planning of services for these patients.
Persistent Treatment Effect Achieved at One Year After 4 Doses of Fel d 1-Derived Peptide Immunotherapy in an Environmental Exposure Chamber (EEC) Model of Cat Allergy
Authors: R.P. Hafner, J. Efthimiou, A. Salapatek, D. Patel, M. Larche
Journal: Journal of Allergy and Clinical Immunology (2012)