tbuckley/cabot-search huggingface dataset:
Scene in Print: Plus Ça Change . . .
Authors: Sarah Winstedt
Journal: Annals of Internal Medicine (1973)

Letters, Comments, and Corrections1 January 1973Scene in Print: Plus Ça Change . . .Sarah Winstedt, M.B., Ch.B.Sarah Winstedt, M.B., Ch.B.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-78-1-157_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptLady Sarah Winstedt, who began her medical career at the Royal Free Hospital in 1912, died on 9 September. She was 86.. . . She was always keen to do surgery and acquired it by any method. I remember well how she anticipated the Mohel and circumcised a Jewish child without the appropriate prayers. The consequent row lasted a long time, but seemed to give her great joy. She had a quick speech and an Irish brogue, and a ready sense of humour. Decidedly risqué for those early days, her remarks amused the men and outraged the women. She... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Sarah Winstedt, M.B., Ch.B.Affiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 January 1973Volume 78, Issue 1Page: 157-157KeywordsSurgery ePublished: 1 December 2008 Issue Published: 1 January 1973 PDF downloadLoading ...
The Role of the Hippocampus in Feedback Regulation of the Hypothalamic-Pituitary-Adrenocortical Axis*
Authors: LAUREN JACOBSON, ROBERT SAPOLSKY
Journal: Endocrine Reviews (1991)

THE hippocampus has received considerable attention as a potential regulator of the hypothalamic-pituitary-adrenocortical (HPA) axis. After the demonstration by Harris' laboratory (1) that the hypothalamus could affect adrenocortical function, investigation extended to identifying other brain areas that might influence hypothalamic activity. Early evidence for hippocampal projections to the hypothalamus and the role of the limbic system in emotions made the hippocampus a likely component of a stress-activated system such as the adrenocortical axis (2,3). This hypothesis has been borne out not only by physiological studies but also by pharmacological evidence that the hippocampus contains corticosteroid receptors. This review will focus solely on the physiological data for, and the possible mechanisms underlying, the hippocampal regulation of HPA sensitivity to corticosteroid feedback. This subject has been addressed by McEwen et al. (4) and more recently by Canny (5). However, the literature has expanded since the former review, and considerable controversy remains regarding the role of hippocampal corticosteroid receptors following the latter review; we believe these issues merit further attention. In focusing on the hippocampus, we do not intend to imply that it is the only brain corticosteroid feedback site, nor that it plays a more important role than the hypothalamus. However, the hippocampus is one of the regions most susceptible to damage by insults such as ischemia, hypoglycemia, and seizure (6). Consequently, the hippocampus is of particular interest among potential glucocorticoid feedback sites not only because of the considerable and varied evidence for its influence on HPA activity, but also because that influence may be so easily disrupted.
Implementing Antibiotic Practice Guidelines through Computer-Assisted Decision Support: Clinical and Financial Outcomes
Authors: Stanley L. Pestotnik
Journal: Annals of Internal Medicine (1996)

Objective: To determine the clinical and financial outcomes of antibiotic practice guidelines implemented through computer-assisted decision support. Design: Descriptive epidemiologic study and financial analysis. Setting: 520-bed community teaching hospital in Salt Lake City, Utah. Patients: All 162 196 patients discharged from LDS Hospital between 1 January 1988 and 31 December 1994. Intervention: An antibiotic management program that used local clinician-derived consensus guidelines embedded in computer-assisted decision support programs. Prescribing guidelines were developed for inpatient prophylactic, empiric, and therapeutic uses of antibiotics. Measurements: Measures of antibiotic use included timing of preoperative antibiotic administration and duration of postoperative antibiotic use. Clinical outcomes included rates of adverse drug events, patterns of antimicrobial resistance, mortality, and length of hospital stay. Financial and use outcomes were expressed as yearly expenditures for antibiotics and defined daily doses per 100 occupied bed-days. Results: During the 7-year study period, 63 759 hospitalized patients (39.3%) received antibiotics. The proportion of the hospitalized patients who received antibiotics increased each year, from 31.8% in 1988 to 53.1% in 1994. Use of broad-spectrum antibiotics increased from 24% of all antibiotic use in 1988 to 47% in 1994. The annual Medicare case-mix index increased from 1.7481 in 1988 to 2.0520 in 1993. Total acquisition costs of antibiotics (adjusted for inflation) decreased from 24.8% ($987 547) of the pharmacy drug expenditure budget in 1988 to 12.9% ($612 500) in 1994. Antibiotic costs per treated patient (adjusted for inflation) decreased from $122.66 per patient in 1988 to $51.90 per patient in 1994. Analysis using a standardized method (defined daily doses) to compare antibiotic use showed that antibiotic use decreased by 22.8% overall. Measures of antibiotic use and clinical outcomes improved during the study period. The percentage of patients having surgery who received appropriately timed preoperative antibiotics increased from 40% in 1988 to 99.1% in 1994. The average number of antibiotic doses administered for surgical prophylaxis was reduced from 19 doses in the base year to 5.3 doses in 1994. Antibiotic-associated adverse drug events decreased by 30%. During the study, antimicrobial resistance patterns were stable, and length of stay remained the same. Mortality rates decreased from 3.65% in 1988 to 2.65% in 1994 (P < 0.001). Conclusions: Computer-assisted decision support programs that use local clinician-derived practice guidelines can improve antibiotic use, reduce associated costs, and stabilize the emergence of antibiotic-resistant pathogens.
English law on assisted suicide needs updating, commission hears
Authors: C. Dyer
Journal: BMJ (2011)

The current law in England on assisted suicide is not fit for the 21st century, the lead on dementia and end of life care for West Midlands strategic health authority has told the Commission on Assisted Dying.

Pauline Smith said the health authority could be neither for nor against assisted dying but it was responsible for representing the public voice and needed to make sure that voice was heard. “Our view is that the current law doesn’t match the requirements of the 21st century,” she told the commission, chaired by former lord chancellor and Labour peer Charles Falconer.

“We really do need to look …
Effect of arterial stiffness on platelet activation
Authors: Fumiyasu Yamasaki, Takashi Furuno, Masanori Nishinaga, Kyoko Sato, Dongmei Zhang, Misa Nakagawa, Tadashi Ueta, Takayuki Sato, Yoshinori Doi, Tetsuro Sugiura
Journal: Journal of the American College of Cardiology (2002)
The Wound That Killed Lincoln
Authors: John K. Lattimer
Journal: JAMA (1964)

NINETY-NINE YEARS AGO, on the evening of April 14, 1865, Washington was aglow with happy hysteria over the surrender of Lee at Appomattox five days earlier. Grant, the conquering hero, was in town and the newspapers had suggested that he might accompany President and Mrs. Lincoln to Ford's Theatre that evening.<sup>1,2</sup>People flocked to the theatre. Just after the second intermission, at about 10 PM, a dashing, compulsive young actor named John Wilkes Booth entered the front door of the theatre, bantered with the ticket taker, who knew this popular actor well, and ascended rapidly to the dress circle. There he paused for a moment while he selected a letter or visiting card from several in his pocket, to show to anyone who might challenge him, and advanced toward the door of the presidential box, which was at the right side of the theatre and built partly out onto
Extracellular matrix regulation of hepatic transcription factors is dependent on cell structure
Authors: Erin G. Schuetz
Journal: Hepatology (1992)

The extracellular matrix (ECM) promotes tissue morphogenesis, cell migration, and the differentiation of a variety of cell types. However, the mechanisms by which ECM causes differentiated gene expression have been unknown. In this report, we show that culturing the hepatocyte–derived cell line H2.35 on an ECM gel changes cell morphology and selectively stimulates the transcription of a subset of liver–specific genes, including serum albumin. Transcriptional activation by ECM also occurs with transfected plasmids bearing the transcriptional enhancer of the albumin gene. ECM substrates of different composition activated the albumin enhancer only when the ECM promoted a cuboidal, differentiated cell morphology. Enhancer activation by the ECM was mediated by two liver transcription factors, HNF3α and eH–TF, which appear to be regulated differently by matrix. Specifically, we found that a collagen gel substratum caused a selective increase in the factor HNF3α at the levels of mRNA accumulation and DNA–binding activity in nuclear extracts, both in H2.35 cells and in the hepatoma cell line HepG2. We conclude that the ECM can stimulate cell differentiation by selectively activating transcriptional regulatory factors and that such regulation occurs coordinately with ECM–promoted changes in cell shape.
Selective Induction of Apoptosis in Mature T Lymphocytes by Variant T Cell Receptor Ligands
Authors: Behazine Combadière, Caetano Reis e Sousa, Ronald N. Germain, Michael J. Lenardo
Journal: The Journal of Experimental Medicine (1998)

Activation, anergy, and apoptosis are all possible outcomes of T cell receptor (TCR) engagement. The first leads to proliferation and effector function, whereas the others can lead to partial or complete immunological tolerance. Structural variants of immunizing peptide-major histocompatibility complex molecule ligands that induce selective lymphokine secretion or anergy in mature T cells in association with altered intracellular signaling events have been described. Here we describe altered ligands for mature mouse CD4(+) T helper 1 cells that lead to T cell apoptosis by the selective expression of Fas ligand (FasL) and tumor necrosis factor (TNF) without concomitant IL-2, IL-3, or interferon gamma production. All ligands that stimulated cell death were found to induce FasL and TNF mRNA expression and TCR aggregation ("capping") at the cell surface, but did not elicit a common pattern of tyrosine phosphorylation of the TCR-associated signal transduction chains. Thus, TCR ligands that uniquely trigger T cell apoptosis without inducing cytokines that are normally associated with activation can be identified.
Reviews and Notes: Oncology: Clinical Oncology
Authors: John A. Glaspy
Journal: Annals of Internal Medicine (1996)

Literature of Medicine1 February 1996Reviews and Notes: Oncology: Clinical OncologyJohn A. Glaspy, MDJohn A. Glaspy, MDUniversity of California, Los Angeles, School of Medicine Los Angeles, CA 90095Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-124-3-199602010-00035 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail MD Abeloff, JO Armitage, AS Lichter, and JE Niederhuber; eds. 2350 pages. New York: Churchill Livingstone; 1995. $199.00. ISBN 0443089418. Order phone 800-553-5426.When I was a resident considering a fellowship in oncology, no comprehensive textbook reviewed the state of knowledge about the biology and treatment of cancer. Happily, several excellent books, usually edited and written by multidisciplinary teams of experts and organized into general concepts and tumor site-specific sections, have since appeared to fill this void. Clinical Oncology is a new member of this genre, which already includes Cancer: Principles and Practice of Oncology (DeVita et al., eds.), The ... Author, Article, and Disclosure InformationAffiliations: University of California, Los Angeles, School of Medicine Los Angeles, CA 90095 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1996Volume 124, Issue 3Page: 376-377KeywordsCancer treatmentChemotherapeutic agentsFellowshipsHypercalcemiaMeningitisPatientsPharmacologyPrimary care physiciansScientistsSub-specialty care ePublished: 15 August 2000 Issue Published: 1 February 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Abstract 5545: Functional antagonism between vorinostat and temozolomide when combined with ionizing radiation (IR) in glioblastoma
Authors: Yaacov R. Lawrence, Yi Liu, Barbara Andersen, Xu Xia, Adam P. Dicker, Phyllis Wachsberger
Journal: Cancer Research (2010)

Abstract Background: Glioblastoma is the most common primary adult brain tumor. Surgery followed by radiation therapy in combination with temozolomide (Tmz) produces a median survival of 14.6 months. Tmz is a DNA akylating agent that leads to the mispairing of guanine residues with thymine. An intact mismatch-repair mechanism (MMR) converts the mispaired thymine into a lethal double-strand DNA break. Vorinostat (SAHA), an HDAC inhibitor, has been shown to act as a radiosensitizer, possibly through inhibition of DNA repair. SAHA has successfully been combined with a number of cytotoxic agents. We hypothesized that SAHA would further potentiate the radiosensitizing properties of Tmz in glioblastoma. Materials/Methods: Experiments were performed with 2 glioblastoma cell lines (U87, LN18). DNA double strand breaks were quantified by both neutral comet assay and gamma-H2AX immunohistochemistry. Assays were performed immediately, and 24 hours after IR to assess DNA damage and repair respectively. For the neutral comet assay the dose of radiation was 30 Gy and the ‘olive moment’ was scored. The magnitude of the olive moment correlates with increasing DNA damage. For gamma-H2AX assay, the dose of radiation was 2 Gy and the percentage of cells with more than 3 foci was scored. Quantitative PCR and clonogenic cell survival were performed using standard techniques. Results: In the absence of drug, radiation induced DNA-double strand breaks were almost completely repaired within 24-hours. In U87 both Tmz + IR, and SAHA + IR increased the olive moment compared to IR alone (24 hour post IR time-point). When Tmz and SAHA were combined together with IR, the olive moment decreased to 6.5 as compared to Tmz + IR alone 8.7 (p&amp;lt;0.05). Similarly, in the absence of IR, SAHA was found to decrease Tmz induced DNA damage. Comparable results were obtained with gamma-H2AX assay and with the LN18 cell line. Clonogenic radiation survival assay demonstrated Tmz + SAHA to be no more effective than Tmz alone in potentiating the cytotoxic effect of IR. On qPCR, SAHA was found to down-regulate MLH1, MLH3, MSH2 and MSH 3, key genes involved in MMR. Conclusions: Both Tmz and SAHA individually potentiated the effect of IR, inhibiting the repair of DNA double strand breaks. However, when cells were exposed to both drugs together less DNA damage was seen than with Tmz alone. Based upon qPCR data we hypothesize that SAHA down regulates the MMR pathway. Our work demonstrates that the addition of an HDAC inhibitor to cytotoxic agents may produce unexpected antagonism. Research sponsored by Merck. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 5545.
A Lecture on the Accumulative Action of Medicines, with Some Remarks on Slow Poisoning
Authors: J. Johnstone
Journal: BMJ (1847)

In the lectures on therapeutics which, during the last fifteen years, I have delivered at this Institution, I have frequently spoken of the accumulative action of medi- cines, or that power which they exercise over the animal economy by their continued operation when adminis- tered at short intervals, even in portions so small that no effect whatever would be produced by a single dose.To this subject, which has received less notice than it deserves from medical authors, I beg to call your attention.
1416 FALDAPREVIR PLUS PEGYLATED INTERFERON ALFA-2A AND RIBAVIRIN IN CHRONIC HCV GENOTYPE-1 TREATMENT-NAÏVE PATIENTS: FINAL RESULTS FROM STARTVERSO1, A RANDOMISED, DOUBLE-BLIND, PLACEBO-CONTROLLED PHASE III TRIAL
Authors: P. Ferenci, T. Asselah, G.R. Foster, S. Zeuzem, C. Sarrazin, C. Moreno, D. Ouzan, M. Maevskaya, F. Calinas, L.E. Morano, J. Crespo, J.-F. Dufour, M. Bourliere, K. Agarwal, D. Forton, M. Schuchmann, E. Zehnter, S. Nishiguchi, M. Omata, J.O. Stern, Y. Datzenko, J. Scherer, A.-M. Quinson
Journal: Journal of Hepatology (2013)
Patients' understanding of randomised controlled trials depends on their education
Authors: E Pucci, N Belardinelli, M Signorino, F Angeleri
Journal: BMJ (1999)

EDITOR—We appreciated Featherstone and Donovan's report about patients' perspectives of participation in a randomised controlled trial.1 We recently investigated the ability of 40 middle aged and elderly caregivers to understand and retain information about randomised controlled trials in patients with Alzheimer's disease.

Eighteen caregivers were men and 22 women, and their mean age was 64 (SD 6) (range 50-76). They had had …
Mutations in the human δ-sarcoglycan gene in familial and sporadic dilated cardiomyopathy
Authors: Shinichi Tsubata, Karla R. Bowles, Matteo Vatta, Carmelann Zintz, Jack Titus, Linda Muhonen, Neil E. Bowles, Jeffrey A. Towbin
Journal: Journal of Clinical Investigation (2000)

Dilated cardiomyopathy (DCM) is a major cause of morbidity and mortality. Two genes have been identified for the X-linked forms (dystrophin and tafazzin), whereas three other genes (actin, lamin A/C, and desmin) cause autosomal dominant DCM; seven other loci for autosomal dominant DCM have been mapped but the genes have not been identified. Hypothesizing that DCM is a disease of the cytoskeleton and sarcolemma, we have focused on candidate genes whose products are found in these structures. Here we report the screening of the human δ-sarcoglycan gene, a member of the dystrophin-associated protein complex, by single-stranded DNA conformation polymorphism analysis and by DNA sequencing in patients with DCM. Mutations affecting the secondary structure were identified in one family and two sporadic cases, whereas immunofluorescence analysis of myocardium from one of these patients demonstrated significant reduction in δ-sarcoglycan staining. No skeletal muscle disease occurred in any of these patients. These data suggest that δ-sarcoglycan is a disease-causing gene responsible for familial and idiopathic DCM and lend support to our "final common pathway" hypothesis that DCM is a cytoskeletalopathy.
Intralesional Steroid Injections for Corrosive Induced Pyloric Stenosis
Authors: R. Kochhar, P. V. J. Sriram, J. D. Ray, S. Kumar, B. Nagi, K. Singh
Journal: Endoscopy (1998)

Gastric outlet obstruction is a well-recognized sequela of corrosive ingestion. Such patients are traditionally treated surgically. We have treated three such patients with intralesional steroid injections combined with through-the-scope balloon dilation. All three patients responded well and are asymptomatic after 12 months, 14 months and 3 years and 3 months of follow-up, respectively. Endoscopic balloon dilation combined with intralesional steroid may be an effective alternative to surgery in such patients.
External Validation of Diagnostic Models to Estimate the Risk of Malignancy in Adnexal Masses
Authors: Caroline Van Holsbeke, Ben Van Calster, Tom Bourne, Silvia Ajossa, Antonia C. Testa, Stefano Guerriero, Robert Fruscio, Andrea Alberto Lissoni, Artur Czekierdowski, Luca Savelli, Sabine Van Huffel, Lil Valentin, Dirk Timmerman
Journal: Clinical Cancer Research (2011)

To externally validate and compare the performance of previously published diagnostic models developed to predict malignancy in adnexal masses.We externally validated the diagnostic performance of 11 models developed by the International Ovarian Tumor Analysis (IOTA) group and 12 other (non-IOTA) models on 997 prospectively collected patients. The non-IOTA models included the original risk of malignancy index (RMI), three modified versions of the RMI, six logistic regression models, and two artificial neural networks. The ability of the models to discriminate between benign and malignant adnexal masses was expressed as the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and likelihood ratios (LR(+), LR(-)).Seven hundred and forty-two (74%) benign and 255 (26%) malignant masses were included. The IOTA models did better than the non-IOTA models (AUCs between 0.941 and 0.956 vs. 0.839 and 0.928). The difference in AUC between the best IOTA and the best non-IOTA model was 0.028 [95% confidence interval (CI), 0.011-0.044]. The AUC of the RMI was 0.911 (difference with the best IOTA model, 0.044; 95% CI, 0.024-0.064). The superior performance of the IOTA models was most pronounced in premenopausal patients but was also observed in postmenopausal patients. IOTA models were better able to detect stage I ovarian cancer.External validation shows that the IOTA models outperform other models, including the current reference test RMI, for discriminating between benign and malignant adnexal masses.
Massive redeployment or distributed modularity?
Authors: Alexia Toskos Dils, Stephen J. Flusberg
Journal: Behavioral and Brain Sciences (2010)

Abstract In distinguishing itself from other distributed approaches to cognition, Anderson's theory of neural reuse is susceptible to some of the same criticisms that have been leveled at modular approaches. Specifically, neural reuse theories state that: (1) the “working” of a given brain circuit is fixed, rather than shaped by its input, and (2) that high-level cognitive behaviors can be cleanly mapped onto a specific set of brain circuits in a non-contextualized manner.
Photorefractive keratectomy for low-to-moderate myopia and astigmatism with a small-beam, tracker-directed excimer laser☆
Authors: Marguerite B McDonald, Michael R Deitz, Jonathan M Frantz, Manus C Kraff, Ronald R Krueger, James J Salz, Colman R Kraff, Ezra Maguen, Camille S Matta, Anthony B Nesburn
Journal: Ophthalmology (1999)