tbuckley/cabot-search huggingface dataset:
Drugs and Highway Crashes
Authors: Julian A. Waller
Journal: JAMA (1971)

The use of mind-altering drugs other than alcohol presents a serious contemporary problem. Some people are concerned about the real effects of drugs on users, others about perceived effects which at times seem to bear little relationship to pharmacologic reality. Many are aroused primarily because they see in drug use a symptom of widespread moral and religious decay. A few are worried largely because they fear that drug users may commit acts which harm innocent nonusers. All of these concerns are important in considering the role of mindaltering drugs in the occurrence of highway crashes, because these concerns have largely determined our perception of the problem of drugs and highway crashes. At times, they have led to preventive and corrective actions that not only are inappropriate but often sap away scarce funds and effort that should be devoted to more effective solutions. In this communication the following questions are explored:
A novel lumen-apposing stent for transluminal drainage of nonadherent extraintestinal fluid collections
Authors: K. Binmoeller, J. Shah
Journal: Endoscopy (2011)

See also: Commentaire de travail de K. F. Binmoeller et al., pp. 337Endoscopy 2011; 43(04): 464-464DOI: 10.1055/s-0031-1291799
Agammaglobulinemia and absent B lineage cells in a patient lacking the p85α subunit of PI3K
Authors: Mary Ellen Conley, A. Kerry Dobbs, Anita M. Quintana, Amma Bosompem, Yong-Dong Wang, Elaine Coustan-Smith, Amber M. Smith, Elena E. Perez, Peter J. Murray
Journal: The Journal of Experimental Medicine (2012)

Whole exome sequencing was used to determine the causative gene in patients with B cell defects of unknown etiology. A homozygous premature stop codon in exon 6 of PIK3R1 was identified in a young woman with colitis and absent B cells. The mutation results in the absence of p85α but normal expression of the p50α and p55α regulatory subunits of PI3K. Bone marrow aspirates from the patient showed &amp;lt;0.1% CD19+ B cells with normal percentages of TdT+VpreB+CD19− B cell precursors. This developmental block is earlier than that seen in patients with defects in the B cell receptor signaling pathway or in a strain of engineered mice with a similar defect in p85α. The number and function of the patient’s T cells were normal. However, Western blot showed markedly decreased p110δ, as well as absent p85α, in patient T cells, neutrophils, and dendritic cells. The patient had normal growth and development and normal fasting glucose and insulin. Mice with p85α deficiency have insulin hypersensitivity, defective platelet function, and abnormal mast cell development. In contrast, the absence of p85α in the patient results in an early and severe defect in B cell development but minimal findings in other organ systems.
224 INTEREST OF FIBROTEST-ACTITEST (FT-AT) IN THE FOLLOW-UP OF LIVER TRANSPLANTED (LT) PATIENTS: A PILOT STUDY
Authors: E. Hamelet, M. Munteanu, V. Thibault, F. Imbert-Bismut, R. Morra, F. Charlotte, C. Vezinnet, T. Poynard, L. Hannoun, B. Hainque, D. Eyrauld
Journal: Journal of Hepatology (2008)
Book Review Tropical Infectious Diseases: Principles, Pathogens, and Practice Second edition. Edited by Richard L. Guerrant, David H. Walker, and Peter F. Weller. 1721 pp., plus index, in two volumes, illustrated, with CD-ROM. Philadelphia, Churchill Livingstone, 2006. $329. 0-443-06668-X
Authors: Jeremy Farrar
Journal: New England Journal of Medicine (2006)
Aqueous dispersions of magnetite nanoparticles with NH3+ surfaces for magnetic manipulations of biomolecules and MRI contrast agents
Authors: Dar-Bin Shieh, Fong-Yu Cheng, Chia-Hao Su, Chen-Sheng Yeh, Ming-Ting Wu, Ya-Na Wu, Chiau-Yuang Tsai, Chao-Liang Wu, Dong-Hwang Chen, Chen-Hsi Chou
Journal: Biomaterials (2005)
SHORTENING OF BLEEDING TIME BY 1-DEAMINO-8-D-ARGININE VASOPRESSIN IN VARIOUS BLEEDING DISORDERS
Authors: NathanL Kobrinsky, JonathanM Gerrard, CatherineM Watson, EstherD Israels, MaryS Cheang, AgnesJ Bishop, MarlisL Schroeder
Journal: The Lancet (1984)
Immediate management of injuries.
Authors: L. Walkden
Journal: British Journal of Sports Medicine (1981)

Specific injuries are not confined to any particular sport, but regular injury patterns will occur among the players of any given sport. Emphasis is placed on the need for primary treatment facilities, the experience of the attendant, and the importance of a working knowledge of the sport involved. Diagnostic difficulties are described with reference to cervical oral, ocular and other injuries. Immediate and long-term management of injuries to the lower limbs is considered.
Factors affecting long term survival following resection for lung cancer.
Authors: K. al-Kattan, E. Sepsas, E. R. Townsend, S. W. Fountain
Journal: Thorax (1996)

Survival following pulmonary resection for primary lung cancer is considered to be principally dependent on the clinical stage of the disease. A study was undertaken to verify this and to identify other contributing factors.The case records of all patients who underwent surgery for lung cancer over a two year period between January 1987 and December 1988 were reviewed retrospectively.One hundred and forty-seven lobectomies and 60 pneumonectomies were performed with 2.8% and 5.3% operative mortality, respectively. Squamous carcinoma was the commonest pathology (60%) followed by adenocarcinoma (30%). The overall five year survival was 45.5% (95% CI 44.1% to 57.9%). There were 123 patients with stage I disease, 40 with stage II, and 37 in stage IIIa with five year survival of 59.4% (95% CI 50.8% to 68%), 30% (95% CI 15.9% to 44.1%), and 16.2% (95% CI 3.5% to 31%), respectively. There were no differences in survival with respect to sex, extent of resection, or cell type. In patients with stage II disease the five year survival of those with T1 lesions (50%, 95% CI 37.3% to 62.9%) was better than those with T2 (28.1%, 95% CI 16.9% to 39.3%). Of eight patients over the age of 70 with stage IIIa disease none survived more than 24 months.Stage at operation is the most accurate predictor of long term survival in early lung cancer and surgery remains an effective treatment, particularly in stage I and II disease. Further study is needed to assess the prognostic value of subdividing stage II disease into T1 and T2 lesions. Major resection for locally advanced disease in older patients may be relatively ineffective.
Liver Imaging During Reticuloendothelial Failure
Authors: MOHAMED A. ANTAR, JOHN J. SZIKLAS, RICHARD P. SPENCER
Journal: Clinical Nuclear Medicine (1977)

Two cases are described of men with hepatic cirrhosis. The liver could not be visualized by means of intravenously administered99M Tc-sulfur colloid. There was thus hepatic “reticuloendothelial failure.” Despite this, in one case the liver could be imaged following intravenous administration of 67 Ga-citrate. In the second case, the liver retained some ability to accumulate 131I-rose bengal. These cases point out the disassociation of hepatic functions, and the ability to call upon one class of radiopharmaceuticals when another is not accumulated.
Molecular aspects of iron absorption: Insights into the role of HFE in hemochromatosis
Authors: Caroline C. Philpott
Journal: Hepatology (2002)

Hereditary hemochromatosis is the most common genetic disorder occurring in persons of northern European descent, and the clinical hallmark of the disease is the gradual accumulation of iron in internal organs, especially the liver, heart, and pancreas, which ultimately leads to organ failure. HFE, the gene that is defective in the majority of cases, was identified in 1996 and, although the exact role that HFE plays in the uptake and utilization of iron is not yet clear, important aspects of HFE function are emerging. Identification and studies of new proteins involved in the absorption of iron in the gut and in somatic cells has led to a clearer picture of how humans absorb iron from the diet and regulate this absorption to meet metabolic needs and to balance body iron stores. This review focuses on the molecular aspects of iron absorption and the role that HFE may play in these processes.
Representation of Elderly Persons and Women in Published Randomized Trials of Acute Coronary Syndromes
Authors: Patrick Y. Lee
Journal: JAMA (2001)

ContextElderly persons and women were underrepresented in randomized controlled trials (RCTs) prior to 1990. Since then, efforts have been made to correct these biases, but their effect is unclear.ObjectiveTo determine whether the percentage of elderly persons and women in published clinical trials of acute coronary syndromes has increased and how this enrollment compared with disease prevalence.Data SourcesThe MEDLINE and Cochrane databases were searched for English-language articles from January 1966 to March 2000 regarding myocardial infarction, unstable angina, or acute coronary syndromes. Additional data sources included meta-analyses, review articles, and cardiology textbooks. Estimates of community-based myocardial infarction rates came from the National Registry of Myocardial Infarction and the Worcester Heart Study.Study SelectionPublished RCTs of acute coronary syndrome patients were included and trials enrolling 50 patients or fewer, those without clinical end points, papers published in a language other than English, and unpublished manuscripts were excluded. Of 7645 studies identified, 593 RCTs were selected for review.Data ExtractionThe RCTs were abstracted by 2 of the authors for year of publication, source of support (ie, funding), pharmacotherapy, study phase, number of study sites, trial location, number of patients, mean age of the study population, and any age exclusion criteria for enrollment.Data SynthesisThe number of published RCTs with explicit age exclusions has declined from 58% during 1966-1990 to 40% during 1991-2000. Trial enrollment of patients aged 75 years or older increased from 2% for studies published during 1966-1990 to 9% during 1991-2000, but remains well below their representation among all patients with myocardial infarction (37%) in the United States. Enrollment of women has risen from 20% for studies published between 1966-1990 to 25% during 1991-2000, but remains well below their proportion of all patients with myocardial infarction (43%) in the United States.ConclusionsAttempts at making cardiovascular RCTs more inclusive appear to have had limited success; thus, women and elderly persons remain underrepresented in published trial literature relative to their disease prevalence. Because safety and efficacy can vary as a function of sex and age, these enrollment biases undermine efforts to provide evidence-based care to all cardiac patients.
Nodular regenerative hyperplasia of the liver: An under‐recognized cause of portal hypertension in hematological disorders
Authors: Khalid A. Al‐Mukhaizeem, Arthur Rosenberg, Averell H. Sherker
Journal: American Journal of Hematology (2004)

Abstract Portal hypertension has been described in a wide variety of hematological disorders, especially myeloproliferative and lymphoproliferative disorders. Its clinical manifestations may include bleeding esophageal varices, ascites, or hepatic encephalopathy. In patients with hematological disorders, there are a number of potential causes of portal hypertension, including nodular regenerative hyperplasia of the liver (NRH). This lesion is characterized by diffuse replacement of normal hepatic parenchyma by multiple small nodules composed of regenerating hepatocytes with minimal or no fibrosis. This lack of fibrosis distinguishes NRH from cirrhosis. Unlike cirrhosis, NRH only rarely results in compromised hepatic synthetic function. The major manifestation is portal hypertension related to increased resistance to blood flow within hepatic sinusoids. NRH has been linked to a variety of systemic diseases including collagen vascular diseases, myeloproliferative and lymphoproliferative disorders, as well as various medications. Although NRH is commonly associated with blood dyscrasias, the diagnosis is overlooked because of the complexity and wide differential diagnosis of liver diseases in the setting of hematological malignancy. We review herein nodular regenerative hyperplasia of the liver, including aspects of epidemiology, pathogenesis, differential diagnosis, clinical course, and treatment. We highlight its association with different forms of hematological disease, aiming to increase the awareness of this entity to the internist and the treating hematologist/oncologist. Am. J. Hematol. 75:225–230, 2004. © 2004 Wiley‐Liss, Inc.
Junior doctor charged with manslaughter after medical error
Authors: C. Dyer
Journal: BMJ (2002)

<h3>Background</h3> Clear epidemiological data regarding rhythm disturbances in 12-lead ECGs is lacking. Rhythm disturbances in the Holter recordings of healthy subjects are well described. This study analyses 12-lead ECGs of patients who present to their General Practitioner complaining of palpitation to determine the frequency of rhythm disturbances. The presence of multifocal atrial rhythm and its distinction from sinus arrhythmia was a particular area of investigation. <h3>Methods</h3> 500 ECGs were studied. Rhythms were categorised as supraventricular rhythm disturbances, ventricular rhythm disturbances, multifocal atrial rhythm, sinus arrhythmia, and sinus rhythm. Multifocal atrial rhythm was diagnosed either if there were a minimum of 2 complexes of each of 3 or more distinct P wave shapes, none of which were obvious atrial ectopics, or if an ectopic atrial rhythm morphed into an ectopic atrial rhythm from another atrial focus. <h3>Results</h3> Supraventricular rhythm disturbances (8.6%) were more common than ventricular rhythm disturbances (5.2%). Multifocal atrial rhythm was found in 12.7% of ECGs and sinus arrhythmia in 4.0%. The relative frequency of the rhythms varied significantly with age, but not by gender or by ethnicity. <h3>Conclusions</h3> Approximately a quarter of the subjects with palpitation had a rhythm disturbance on a 10 s 12-lead ECG. Multifocal atrial rhythm was found in many subjects with palpitation and so should be considered as potential cause of palpitation.
Bone Marrow Transplantation after the Chernobyl Nuclear Accident
Authors: Alexandr Baranov, Robert Peter Gale, Angelina Guskova, Evgeny Piatkin, George Selidovkin, Ludmila Muravyova, Richard E. Champlin, Natalia Danilova, Leonora Yevseeva, Ludmila Petrosyan, Svetlana Pushkareva, Michail Konchalovsky, Ada Gordeeva, Tatiana Protasova, Yair Reisner, M. Ray Mickey, Paul Terasaki
Journal: New England Journal of Medicine (1989)

On April 26, 1986, an accident at the Chernobyl nuclear power station in the Soviet Union exposed about 200 people to large doses of total-body radiation. Thirteen persons exposed to estimated total-body doses of 5.6 to 13.4 Gy received bone marrow transplants. Two transplant recipients, who received estimated doses of radiation of 5.6 and 8.7 Gy, are alive more than three years after the accident. The others died of various causes, including burns (the cause of death in five), interstitial pneumonitis (three), graft-versus-host disease (two), and acute renal failure and adult respiratory distress syndrome (one). There was hematopoietic (granulocytic) recovery in nine transplant recipients who could be evaluated, six of whom had transient partial engraftment before the recovery of their own marrow. Graft-versus-host disease was diagnosed clinically in four persons and suspected in two others. Although the recovery of endogenous hematopoiesis may occur after exposure to radiation doses of 5.6 to 13.4 Gy, we do not know whether it is more likely after the transient engraftment of transplanted stem cells. Because large doses of radiation affect multiple systems, bone marrow recovery does not necessarily ensure survival. Furthermore, the risk of graft-versus-host disease must be considered when the benefits of this treatment are being weighed.
Drug Therapy of Dissecting Aortic Aneurysms
Authors: JOSEPH LINDSAY, J. WILLIS HURST
Journal: Circulation (1968)

The records of 56 patients with proved acute aortic dissection were studied for factors bearing on the applicability of vigorous drug therapy to reduce arterial pressure. Fourteen patients had an arterial pressure of 120 mm Hg systolic or less. Fifteen additional patients had evidence of occlusion of a major branch of the aorta. More than half of the 56 patients, therefore, could not have received antihypertensive drugs. The presence of a contraindication to drug therapy marked a patient for an early death. All 29 died within 2 weeks. Twelve of the 27 in whom no contraindications to drug therapy were observed survived more than 2 weeks and six survived more than a year even though none were placed on a vigorous antihypertensive regimen. Assessment of the efficacy of drug therapy of dissecting aortic aneurysm should take into account these facets of the natural history.
"SURGICAL MOTION PICTURES"
Authors: Henry W. Cattell
Journal: JAMA (1926)

<h3>To the Editor:</h3> —The reason surgical motion pictures are not more used is that they are not properly made, and in my opinion the reason they are not produced in a workmanlike manner and have thus fallen into innocuous desuetude is that they are not adequately paid for in the making. There is no better method today of showing surgical technic to a large audience than by motion pictures when accompanied by animated diagrams prepared by a competent artist, as were put out during the war by the late Col. W. O. Owen, Paul Terry of Æsop fable fame, Col. L. H. Jones, myself, and many others. Talking motion pictures of surgical operations —and they may be easily colored ones as well—such as were shown last spring by Gaumont in Paris are here to stay, and the earlier the Committee on Scientific Exhibit of the American Medical Association gets hold
t(11;19)(q21;p13) translocation in mucoepidermoid carcinoma creates a novel fusion product that disrupts a Notch signaling pathway
Authors: Giovanni Tonon, Sanjay Modi, Lizi Wu, Akihito Kubo, Amy B. Coxon, Takefumi Komiya, Kevin O'Neil, Kristen Stover, Adel El-Naggar, James D. Griffin, Ilan R. Kirsch, Frederic J. Kaye
Journal: Nature Genetics (2003)
Randomized Phase II Study of Two Gemcitabine Schedules for Patients With Impaired Performance Status (Karnofsky performance status ≤ 70) and Advanced Non–Small-Cell Lung Cancer
Authors: S. Baka, L. Ashcroft, H. Anderson, M. Lind, P. Burt, R. Stout, I. Dowd, D. Smith, P. Lorigan, N. Thatcher
Journal: Journal of Clinical Oncology (2005)

This randomized phase II study compared two treatment schedules of gemcitabine in patients with non-small-cell lung cancer (NSCLC) and impaired Karnofsky performance status (KP). Primary objectives were to record changes from baseline KP and to assess symptom palliation. Secondary objectives were overall survival, tumor response, and toxicity.Patients with stage IIIb and IV NSCLC and KP </= 70 were randomly assigned to receive gemcitabine 1,000 mg/m(2) on days 1, 8, and 15 of each 28-day cycle (3w4) or gemcitabine 1,500 mg/m(2) on days 1 and 8 of each 21-day cycle (2w3), both for up to six cycles. KP, toxicity, and SS14 lung cancer specific questions were recorded before each cycle of treatment. Response was evaluated 4 weeks after the last cycle.One hundred seventy-four patients were enrolled. There was significant early attrition due to disease progression; only 61.5% of patients were alive at 2 months. There was a significant improvement in KP from baseline to pre-cycle 3 in both arms, with a trend in favor of the 3w4 regimen for duration and faster onset of improvement. Eight of the 17 quality-of-life (QOL) variables assessed showed an improvement of more than 10% between baseline and the start of the third cycle of treatment. Response rate, survival, and duration were similar in both arms.There was no significant difference between the two schedules examined in terms of improvement in KP or QOL, but there seemed to be a trend in favor of the 3w4 schedule.
Family practitioner in the United States
Authors: R. L Bishop
Journal: BMJ (1997)

If the thought of working in the United States brings to mind Marcus Welby MD, ER, or Chicago Hope think again: the daily reality for this nation's 650 000 doctors is somewhat different. 

Former president Calvin Coolidge said that “the business of America is business,” and medicine in the United States is a business, on which 15% of the gross domestic product of the world's largest economy is spent. Many American doctors disagree with this philosophy, but no change is foreseen after the Clinton plan to introduce national health care was thrown out by Congress in 1993. For British doctors willing to make the cultural adjustment, opportunities are good: market driven reform of health care is increasing the role of primary care and reducing costs. Making the move is fraught with bureaucratic obstacles but the golden door is still narrowly ajar.

In the United States a family practitioner is defined as a medical doctor who has graduated from a three year residency programme. The family practitioner is a generalist who treats patients of all ages in the office and hospital, but is expected to refer complex cases to specialists. A general practitioner is a doctor who has not graduated from a residency programme. Few such doctors remain in practice, mainly in remote areas, since group practices and employers recruiting new doctors will insist on a residency graduate.

Family practitioners are only one group of doctors who may call themselves primary care providers (PCP) and receive payment from insurance companies. Internists, paediatricians, obstetrician/gynaecologists, and even doctors of osteopathy may also be a patient's PCP.

Medicine is taught as a postgraduate course, so entrants to medical school must already have completed a college degree, which takes three to four years after graduating from high school at age 17-18.

Applicants to medical schools …
Mammography Screening in Women Under Age 50 Years
Authors: Robert E. Brolin
Journal: JAMA (1988)

<h3>To the Editor.—</h3> The article by Eddy and associates<sup>1</sup>represents an invaluable contribution to the medical and epidemiologic literature. As a surgeon who is part of a group that deals with a large number of patients with breast disease, I was pleased to see that the authors demonstrated the cost-ineffectiveness of annual screening mammography examinations in women 40 to 49 years old. The authors cogently discuss the controversies of routine mammography screening, alluding to the lack of hard data that has resulted in recommendations for annual mammograms by such groups as the American College of Radiology and the American Cancer Society.<sup>2,3</sup> Two important issues that are not discussed in detail by the authors are the 70% to 80% incidence of negative (nonmalignant) findings on breast biopsies that result from "suspicious" mammograms.<sup>4-5</sup>There is also tremendous inconsistency in interpretation of mammographic findings by radiologists. It seems likely that
'So You Want to Be a Doctor?': The Realities of Pursuing Medicine as a Career
Authors: Carlotta M. Rinke
Journal: JAMA (1982)

In this survival manual for would-be physicians, Dr Bluestone ambitiously endeavors to trace the conflicts medical students encounter during their journey through the pre-medical years into the house staff apprenticeship. She first identifies the major tasks and conflicts at the various levels of medical education, then examines the overwhelming emotional reactions they unmask. In explicating the pressures and powerful philosophical issues medical students must integrate on both a professional and personal level, the author sets forth on a noble task. She recognizes the need to alert students that they will have to cope with feelings provoked by material that in some cases has stimulated philosophical genius: death, illness, interacting with patients and families, exploring oneself and the true motivations for pursuing medicine, tolerating the limbo between the infantilization of medical education and aspirations of professional maturity, and the self-organization necessary to succeed. Bluestone obviously recognizes the need to survive the