tbuckley/cabot-search huggingface dataset:
The Trouble with Families: Toward an Ethic of Accommodation
Authors: Carol Levine
Journal: Annals of Internal Medicine (1999)

Although some clinicians are extraordinarily sensitive to the legitimate roles of patients' families in medical crises, a persistent tendency to equate families with trouble is evident in both the literature and the practice of medicine. Some negative presumptions about families derive from western medicine's almost exclusive focus on the individual patient in codes of ethics, training, and practice. Modern bioethics has reinforced this individualistic approach. Physicians' primary responsibilities are unequivocally to their patients, but a complete understanding of the patient's personhood must include consideration of the significant persons who help define the patient's core identity. One source of tension between professionals and families lies in differing perceptions of the roles that family members should play and how they should play them. Members of a family may act as advocates, provide or manage care, serve as trusted companions on the journey through illness and death, and make decisions on behalf of an incompetent patient. Each role presents potential conflicts. Other sources of conflict include disagreement within a family; challenges to physician authority; fear of litigation; and differing religious, ethnic, or cultural traditions. An ethic of accommodation emphasizes the need to negotiate care plans that do not compromise patients' basic interests but that recognize the capacities and limitations of family members. Family caregivers want understandable and timely information, better training, compassionate recognition of their anxiety, guidance in defining their roles and responsibilities, and support for the setting of fair limits on their sacrifices. Health care professionals can better meet these needs through education and skills acquisition, the establishment of partnerships with families, and regular dialogue and communication.
Noninvasive and invasive demonstration of spontaneous regression of coronary artery disease.
Authors: D Roth, W J Kostuk
Journal: Circulation (1980)

Spontaneous regression of a left anterior descending coronary artery lesion was diagnosed by noninvasive testing (stress electrocardiography and thallium-201 myocardial imaging) and confirmed on selective coronary angiography in a 46-year-old man. The patient's clinical improvement, normalization of stress ECG and thallium-201 imaging, together with the loss of collateral filling, confirm that the regression is genuine. This case provides evidence that regression of coronary atherosclerosis can occur in man.
771 HEPATITIS C VIRUS ACTIVATES, BUT DOES NOT INFECT, HUMAN HEPATIC STELLATE CELLS/MYOFIBROBLASTS (HSC/MFS) IN PRIMARY CULTURE
Authors: P. Chouteau, A. Florimond, E. Mérour, A. Mallat, S. Lotersztajn, J.-M. Pawlotsky
Journal: Journal of Hepatology (2011)
Biopersistences of man-made vitreous fibers and crocidolite fibers in rat lungs following short-term exposures.
Authors: R P Musselman, W C Miiller, W Eastes, J G Hadley, O Kamstrup, P Thevenaz, T W Hesterberg
Journal: Environmental Health Perspectives (1994)

Biopersistence of commercial man-made vitreous fibers (MMVF) and crocidolite were studied in Fischer 344 rats. MMVF used were size-selected to be rat-respirable, and rats were exposed nose-only 6 h/day for 5 days to gravimetric concentrations (30 mg/m3) of two fiber glass compositions--a rockwool, and a slagwool--or to 10 mg/m3 of long-fibered crocidolite, or to filtered air. Animals were sacrificed at 1 hr, 1, 5, 31, 90, 180, 270, 365, and 545 days after exposure stopped. Fibers were recovered from digested lung tissue to determine changes in concentrations (fibers/mg dry lung) and fiber retentions (expressed as percent of day 1 retention [PR]) for selected dimension categories. One-day average concentrations of lung-retained MMVF and crocidolite fibers, of diameter > or = 0.5 micron or > 20 microns in length, were nearly equal, permitting direct comparisons between MMVF and crocidolite. At 270 days average PR for MMVF > or = 0.5 micron in diameter were from 3 to 6 +/- 2% and 27 +/- 9% for crocidolite. For fibers > 20 microns, PR were 1 to 4 +/- 4% for MMVF and 37 +/- 20% for crocidolite. At 545 days, MMVF > 20 microns in length were at background level while concentration of crocidolite fibers > 20 microns in length remained at 2000 +/- 400 f/mg DL (dry lung), or 38 +/- 9% of day-1 retention. These results suggest strongly that MMVF dissolved or fractured in vivo whereas crocidolite fibers did not change.
Rhesus Isoimmunization after Abortion
Authors: S. Murray, S. L. Barron
Journal: BMJ (1971)

Out of 177 Rh(D)-negative patients studied, 96 were successfully followed-up after spontaneous or therapeutic abortion. Rh antibodies were detected by the indirect Coombs test in two patients and by an enzyme technique only in a further seven, an overall incidence of 9·4%. The prophylactic use of anti-D immunoglobulin is now recommended for Rh-negative non-immunized patients undergoing abortion, but the dose could be less than 75 μg. The Kleihauer test was of no value in predicting the risk of isoimmunization.
Treatment of Primary Sjögren Syndrome
Authors: Manuel Ramos-Casals, Athanasios G. Tzioufas, John H. Stone, Antoni Sisó, Xavier Bosch
Journal: JAMA (2010)

A variety of topical and systemic drugs are available to treat primary Sjögren syndrome, although no evidence-based therapeutic guidelines are currently available.To summarize evidence on primary Sjögren syndrome drug therapy from randomized controlled trials.We searched MEDLINE and EMBASE for articles on drug therapy for primary Sjögren syndrome published between January 1, 1986, and April 30, 2010.Controlled trials of topical and systemic drugs including adult patients with primary Sjögren syndrome were selected as the primary information source.The search strategy yielded 37 trials. A placebo-controlled trial found significant improvement in the Schirmer and corneal staining scores, blurred vision, and artificial tear use in patients treated with topical ocular 0.05% cyclosporine. Three placebo-controlled trials found that pilocarpine was associated with improvements in dry mouth (61%-70% vs 24%-31% in the placebo group) and dry eye (42%-53% vs 26%). Two placebo-controlled trials found that cevimeline was associated with improvement in dry mouth (66%-76% vs 35%-37% in the placebo group) and dry eye (39%-72% vs 24%-30%). Small trials (<20 patients) found no significant improvement in sicca outcomes for oral prednisone or hydroxychloroquine and limited benefits for immunosuppressive agents (azathioprine and cyclosporine). A large trial found limited benefits for oral interferon alfa-2a. Two placebo-controlled trials of infliximab and etanercept did not achieve the primary outcome (a composite visual analog scale measuring joint pain, fatigue, and dryness); neither did 2 small trials (<30 patients) testing rituximab, although significant results were observed in some secondary outcomes and improvement compared with baseline.In primary Sjögren syndrome, evidence from controlled trials suggests benefits for pilocarpine and cevimeline for sicca features and topical cyclosporine for moderate or severe dry eye. Anti-tumor necrosis factor agents have not shown clinical efficacy, and larger controlled trials are needed to establish the efficacy of rituximab.
Optical coherence tomography: a reliable alternative to invasive histological assessment of acute wound healing in human skin?
Authors: N.S. Greaves, B. Benatar, S. Whiteside, T. Alonso-Rasgado, M. Baguneid, A. Bayat
Journal: British Journal of Dermatology (2013)

Gold-standard assessment of acute wound healing has traditionally been through histological analysis of biopsied tissue. However, this process is invasive with recognized side-effects. Optical coherence tomography (OCT) is a noninvasive technique generating high-resolution real-time images of cutaneous architecture.To compare OCT with histological assessment of in vivo acute wound healing and ascertain the level of agreement between modalities for measurement of defined cutaneous structures.Punch biopsies (5 mm) were harvested from 50 healthy volunteers. Wounds healed by secondary intention until they were re-excised 7, 14, 21 or 28 days later depending on random group allocation. Wounds were assessed weekly for 6 weeks using OCT and compared with histological findings derived from time-matched biopsies. Dimensions of four cutaneous structures were measured using both modalities and the level of agreement was established by Bland-Altman analysis. The mean greyscale value (MGV) of the upper reticular dermis was derived from OCT images at all time points.Both techniques showed anatomical congruity in normal and wounded skin with correlating architectural changes associated with inflammatory, proliferative and remodelling wound healing phases. MGV was significantly increased 6 weeks after wounding (P = 0·001) and may represent a novel measure of wound fibrosis. Despite good association of histomorphometric values with low but consistent bias (range -4·181 to 0·431 μm), Bland-Altman plots demonstrated poor agreement between OCT and histology.Optical coherence tomography enabled accurate assessment of healing tissue comparable with histological analysis of biopsy specimens. This noninvasive tool is highly suited to wound assessment and may represent a diagnostic alternative to punch biopsies.
Science Advice — A Return to the White House
Authors: Daniel S. Greenberg
Journal: New England Journal of Medicine (1975)

When Senators Kennedy, Goldwater, and Javits line up with Vice-President Rockefeller in support of a proposal by President Ford, it may be concluded that the matter at hand is of an inconsequential ceremonial nature or that something with a lot of power potential is stirring interest across the political spectrum.The aforementioned Senators and Vice-President did gather on June 6 in a Senate hearing room to speak kindly of Mr. Ford's intention to re-equip the White House with a science advisory office, thus reversing Mr. Nixon's decision to do away with that function. But the circumstances surrounding Mr. Ford's plan . . .
A nonsense mutation in the erythrocyte band 3 gene associated with decreased mRNA accumulation in a kindred with dominant hereditary spherocytosis.
Authors: P B Jenkins, G K Abou-Alfa, D Dhermy, E Bursaux, C Féo, A L Scarpa, S E Lux, M Garbarz, B G Forget, P G Gallagher
Journal: Journal of Clinical Investigation (1996)

We studied a French kindred with typical hereditary spherocytosis (HS). Studies of erythrocytes and erythrocyte membranes from HS individuals revealed abnormal erythrocyte membrane mechanical stability as well as 15-20% deficiency of band 3, the anion transporter. Anion transport studies of red cells from two affected individuals revealed decreased sulfate flux. Nucleotide sequence of cDNA encoding the distal third of the cytoplasmic domain and the entire transmembrane domain of band 3 obtained by RT-PCR of reticulocyte RNA of an affected family member was normal. Sequence analysis of genomic DNA from an HS individual identified a nonsense mutation of the band 3 gene, Q330X, near the end of the band 3 cytoplasmic domain. This mutation was present in genomic DNA of all HS family members and absent in DNA of unaffected family members. Using an RT-PCR-based assay, a marked quantitative decrease in accumulation of the mutant band 3 RNA was detected. Thus the codon 330 nonsense mutation is responsible for the decreased accumulation of mutant band 3 RNA and the deficiency of band 3 protein in this kindred. These results have important implications for the role of band 3 defects in the membrane pathobiology of HS as well as for the techniques used in detection of HS mutations.
Phase II Study of Preoperative Pemetrexed, Carboplatin, and Radiation Followed by Surgery for Locally Advanced Esophageal Cancer and Gastroesophageal Junction Tumors
Authors: Aminah Jatoi, Gamini Soori, Nathan R. Foster, Bradley K. Hiatt, James A. Knost, Tom R. Fitch, Matthew D. Callister, Francis C. Nichols, Tim M. Husted, Steven R. Alberts
Journal: Journal of Thoracic Oncology (2010)
Post‐transfusion purpura and isoimmune neonatal thrombocytopenia in the same family
Authors: Everardo Cobos, David R. Gandara, Larry J. Geier, Saeeda Kirmani
Journal: American Journal of Hematology (1989)

Abstract Post‐transfusion purpura and isoimmune neonatal thrombocytopenia are rare and unusual syndromes leading to severe thrombocytopenia. In both disorders the PL A1 platelet antigen is involved in the pathogenesis. A 41‐year‐old woman with an obstetrical history of isoimmune neonatal thrombocytopenia in two of her children developed post‐transfusion purpura following a transfusion of packed red blood cells. Despite the apparent link in these two disorders associated with the PL A1 platelet antigen, this is the first reported case of post‐transfusion purpura and isoimmune neonatal thrombocytopenia occurring in the same family.
Staff suspended at Ashworth secure hospital
Authors: J. Warden
Journal: BMJ (1997)

Serious irregularities at one of Britain's secure hospitals, Ashworth on Merseyside, has led to the appointment of new management and four staff suspensions, including the chief executive and a senior psychiatrist.

The health secretary, Stephen Dorrell, has set up a statutory inquiry by a retired judge, Peter Fallon QC, to review the clinical policies and management of the personality disorder unit at Ashworth, which comprises …
Calcium flux and endothelial dysfunction during acute lung injury: a STIMulating target for therapy
Authors: Eric J. Seeley, Paul Rosenberg, Michael A. Matthay
Journal: Journal of Clinical Investigation (2013)

Bacterial pathogen-associated molecular pattern molecules (PAMPs) such as LPS activate the endothelium and can lead to lung injury, but the signaling pathways mediating endothelial injury remain incompletely understood. In a recent issue of the JCI, Gandhirajan et al. identify STIM1, an ER calcium sensor, as a key link between LPS-induced ROS, calcium oscillations, and endothelial cell (EC) dysfunction. In addition, they report that BTP2, an inhibitor of calcium channels, attenuates lung injury. This study identifies a novel endothelial signaling pathway that could be a future target for the treatment of lung injury.
Targeted Cancer Therapies Lagging
Authors: Tracy Hampton
Journal: JAMA (2006)

Chicago—Scientists have long known that unlocking the mysteries of the human genome would lead to better diagnostics and therapies for a variety of diseases, but they were quick to note that the completion of its sequencing 3 years ago was just the first step toward tailoring medical care to individuals. Now, though, experts are concerned that progress is lagging and that current research strategies and designs are not up to tackling the challenges ahead. “Patients have said that we’ve heard about personalized molecular medicine for the last 5 to 10 years,” said Gordon Mills, MD, PhD, of the University of Texas M.D. Anderson Cancer Center, in Houston. “We’re going to need to move forward more quickly.” At the American Association for Cancer Research’s recent conference on Molecular Diagnostics in Cancer Therapeutic Development, Mills and others in academia, industry, and government discussed hurdles that stand in the way of adoption of this approach to care for patients with cancer.
Regional Variability of Lung Inflammation in Cystic Fibrosis
Authors: KEITH C. MEYER, ANUJA SHARMA, NANCY S. ROSENTHAL, KIMBERLY PETERSON, LYNETTE BRENNAN
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

Chest radiography in patients with cystic fibrosis (CF) frequently shows more severe changes in the upper lobes. We performed bronchoalveolar lavage (BAL) on 12 clinically stable, young adult patients with CF to determine whether inflammation varies significantly among geographically distinct areas of the lung. We found that absolute numbers of neutrophils were generally greater in BAL fluid from the upper lobe (25.7 +/- 7.9 x 10(5) neutrophils/ml [mean +/- SEM]) of the right lung than that obtained from the right lower lobe (6.8 +/- 2.8 x 10(5) neutrophils/ml; p < 0.01). The mean value of unopposed neutrophil elastase activity in upper-lobe BAL fluid (227 +/- 91 nmol peptide hydrolyzed/ml/min) was also significantly greater than that in lower-lobe BAL fluid (84 +/- 43 nmol/peptide hydrolyzed/ml/ min; p < 0.01), and similar differences were found for myeloperoxidase activity and DNA content. Neutrophil influx and unopposed neutrophil elastase for a given region correlated inversely with lung function or percentage of ideal body weight, and upper-versus lower-lobe differences were more pronounced in subjects with better preservation of lung function. Our findings suggest that regional variation in inflammation must be considered when utilizing BAL to study lower respiratory tract inflammation in CF or to monitor responses to therapeutic interventions that can potentially diminish lung inflammation. Our findings may also have implications for the study of the natural history of lung inflammation and infection in neonates, infants, and young children with CF.
THE MACROMOLECULAR NATURE OF THE FIRST COMPONENT OF HUMAN COMPLEMENT
Authors: George B. Naff, Jack Pensky, Irwin H. Lepow
Journal: The Journal of Experimental Medicine (1964)

Kinetic and ultracentrifugal experiments demonstrated that the previously described subcomponents of human C'1, designated C'1q, C'1r, and C'1s, interacted with each other in liquid phase to form a macromolecule which was then capable of converting sensitized erythrocytes (EA) to the state EAC'1. The apparent sedimentation constants of C'1q, C'1r, and C'1s and of the macromolecular product of their interaction were approximately 11S, 7S, 4S, and 18S respectively. Association of C'1 subcomponents was prevented and dissociation of macromolecular C'1 was effected by Na3HEDTA and Na2MgEDTA but not by Na2CaEDTA. The rate of formation of macromolecular C'1 was a function of concentration of subcomponents and temperature of interaction, with an apparent energy of activation of 21,000 calories per mol. Ultracentrifugal studies further indicated the macromolecular nature of C'1 in normal human serum. In the absence of EDTA, C'1 sedimented with the serum macroglobulins and C'1 subcomponents were not detected. Conversely, in the presence of EDTA, macromolecular C'1 was not demonstrable and individual C'1 subcomponents could be measured in lighter fractions. The significance of these observations in relation to previous studies on C'1 subcomponents, the role of Ca++ in C'1 function, and the subunit structure of Enzymes has been discussed.
THE RELATION OF FAULTY NUTRITION TO THE DEVELOPMENT OF THE EPITHELIOMA CONTAGIOSUM OF FOWLS
Authors: R. McCarrison
Journal: BMJ (1923)

Winter and Smith.The insulin prepared fromu these sources appears to differ from that prepared from panicreas, in that its action in lowering the blood sugar is delayed, sometimes for a day or so, wiich is also the case withl ani inisulin-like substance pr ep)ar(d by Collip from various vegetable sour'ces, and styled by hin, in recognition of these differ-ences, glucokiniin."Best and Scott lhave also suc- ceeded in pr-eparing insulin, or insulin-like substances, from various other sour'ces.It would appear, ther efore, that the distribution of lhormonies capable of accelerating the disappearance of glucose from the blood is widespread, not only in the animal kingdom but in the vegetable as well; it is probable, howevel, that these do not all lhave the same physiological actioni.In the investigationi of this we must bear in mind that maniy substanices have been known for long to be capable of lowerinig tlle blood sugar- for examiiple, peptone, hydrazini, certaini miiineral salts, phloridzin, etc.All of these also cause glycogeii to dis- appear from the liver, and indeed certaini of them cause structural changes in this organ.Althouglh it would cer- tainly be desirable to have substanices like glucokinin havinig a more proloniged action than insulini in depressing the blood sugar, we must exercise some cautioni in recom- mendcing them for cliniical use unitil it is certain that tlhey have no deleterious effects oni the liver.It is possible also that these substances merely stimulate the secretion of insulin from the pancreas of the aniimal into which they are injected, or serve as precursors for its production.If such be the case, theni they cani have little value in diabetes.I have endeavoured in this review to adhere strictly to ascertained facts, and have refrainied from venturing to speculate with regard to the nutmer-ous pr oblems in meta- bolism, both of animals and plan-ts, for the investigation of which insulin may prove a useful instrument.If I have succeeded in giving a bird's-eye view, as it were, of the results that have been obtained, I shall consider that my efforts have not been in vaini, and I shall feel repaid if, as an outcome, others join us in the wor'k oln insulin.
Clifford W. Beers: Advocate for the Insane
Authors: L. D. Hankoff
Journal: JAMA (1981)

This biography of Clifford W. Beers provides a detailed account of a man and an era that have colored most of the progress in mental health in the 20th century. Beers, who was born in 1876, suffered his first depressive symptoms at age 13 years. He made a serious suicide attempt at age 24 years, and was hospitalized for several years as he experienced depressive, delusional, and manic symptoms in the course of a manic-depressive illness. Discharged from the hospital, he set to work writing his catamnesis and critique of hospital care,<i>A Mind That Found Itself</i>, published in 1908, and advancing a movement to improve the care and prevention of mental illness. On the suggestion of Adolf Meyers, the term "mental hygiene" was accepted for the national reform effort that Beers tirelessly championed. While Beers and his wife Clara agreed to a childless marriage because of the blight of
Endoscopic Diagnosis of Early Primary Adenocarcinoma in Barrett's Columnar-Lined Esophagus
Authors: J. L Dupas, J. Capron, A. Lorriaux
Journal: Endoscopy (1975)

A 43-year-old man suffering from longstanding gastroesophageal reflux symptoms was hospitalized because of melena. X-ray examination was normal. Esophagoscopy showed a small, flat and slightly irregular ulceration developed in Barrett's columnar-lined esophagus. Histological examination of biopsies and of the resected segment revealed a well-differentiated adenocarcinoma surrounded by metaplastic columnar epithelium. To our knowledge, it is the first report of endoscopic diagnosis of early primary adenocarcinoma arising from Barrett's epithelium. The potential malignancy of this lesion needs a regular endoscopic follow-up.
Corneal tissue grown in laboratory
Authors: J. Morgan
Journal: BMJ (1997)

Italian researchers have managed successfully to grow replacement corneal tissue in a laboratory. The grafts were used by the team to repair the corneal epithelium of two men whose eyes had been severely damaged by alkali burns.

Two years after the grafts were put in place, the new epithelium was healthy and stable and both patients had an improvement in visual acuity, according to research published in the Lancet (1997;339:990-3). “Our findings …