tbuckley/cabot-search huggingface dataset:
Demographic shifts and medical training
Authors: S. Ebrahim
Journal: BMJ (1999)

The rapid aging of populations in developing countries as compared to those in the developed world has implications for medical training in these places. Moreover, the growing globalization of employment for many health professionals means that demographic shifts have implications for the training of health professionals worldwide such that curriculums in developing countries may not meet the needs of those who practice in industrialized countries. Chronic and degenerative diseases as well as problems of multiple pathology are likely to increase with an aging population. Consequently, multiple pathology makes current medical training so likely to lead to inappropriate and poor quality of care. In addition, increasing subspecialization in medicine provides doctors who are unable to deal with the complexity of multiple pathology. Undergraduate medical education reforms are also forcing specific training in geriatric medicine out of the curriculums.
Serum interleukin‐17 levels are related to clinical severity in allergic rhinitis
Authors: G. Ciprandi, M. De Amici, G. Murdaca, D. Fenoglio, F. Ricciardolo, G. Marseglia, M. Tosca
Journal: Allergy (2009)

T helper (Th)-17 cells are a subset of T helper lymphocytes that exert regulatory activities. Recently, it has been reported that serum interleukin (IL)-17 levels are high in the most severe cases of birch allergy studied outside the pollen season.The aim of this study was to investigate a possible relationship between serum IL-17 levels and clinical parameters in patients with allergic rhinitis studied during the pollen season.In all, 56 patients with persistent pollen-induced allergic rhinitis were evaluated during the pollen season. Serum IL-17 levels were evaluated by enzyme-linked immunosorbent assay. Symptoms were assessed by visual analogue scale, drug use was monitored and peripheral eosinophils were counted.Serum IL-17 levels were significantly related to clinical symptoms, drug use and peripheral eosinophil counts (P = 0.0001 for all).This study provides evidence that serum IL-17 level assessment might be considered to classify allergy severity.
Comparison of the Efficacy of Local Therapies for Localized Prostate Cancer in the Prostate-Specific Antigen Era: A Large Single-Institution Experience With Radical Prostatectomy and External-Beam Radiotherapy
Authors: Patrick A. Kupelian, Mohamed Elshaikh, Chandana A. Reddy, Craig Zippe, Eric A. Klein
Journal: Journal of Clinical Oncology (2002)

PURPOSE: To review biochemical relapse-free survival (bRFS) rates after either external-beam radiotherapy (RT) or radical prostatectomy (RP) for localized prostate cancer. PATIENTS AND METHODS: All 1,682 patients had pretreatment prostate-specific antigen (PSA) levels and biopsy Gleason scores (bGS) assigned. No adjuvant therapy was administered after local treatment. RP was the treatment in 1,054 patients (63%) and RT in 628 patients (37%). Median follow-up was 51 months (range, 1 to 134). The median follow-up for RP versus RT patients was 50.5 v 51.0 months. Biochemical relapse was considered detectable PSA levels (&gt; 0.2 ng/mL) in RP patients and three consecutive rising PSA levels in RT patients. The analysis was repeated with a more stringent definition of biochemical control after either RP or RT—namely, reaching and maintaining a PSA level ≤ 0.5 ng/mL—and excluding patients receiving any androgen deprivation (AD). RESULTS: Eight-year bRFS rates for RP versus RT were 72% and 70%, respectively (P = .010). Multivariate analysis indicated T stage (P &lt; .001), pretreatment PSA (P &lt; .001), bGS (P &lt; .001), year of therapy (P &lt; .001), and neoadjuvant AD (P = .019) to be the only independent predictors of relapse. Age (P = .78), race (P = .29), prior transurethral resection of prostate (P = .81), and treatment modality (P = .96) were not independent predictors of treatment failure. Fifty-one percent of RP patients had favorable tumors (T1 to T2A, pretreatment PSA ≤ 10 ng/mL, bGS ≤ 7), compared with only 34% of RT patients (P &lt; .001). Repeat analysis with a stringent definition of biochemical failure and excluding patients receiving AD indicated no impact of treatment modality on outcome. CONCLUSION: Eight-year biochemical failure rates were identical between RT and RP in any subgroup. Outcome is determined mainly by pretreatment PSA levels, bGS, clinical T stage, and, for RT patients, radiation dose.
The Nephrotic Syndrome: Current Concepts
Authors: Fred G. Smith, Harvey Gonick, Thomas M. Stanley, Rawle M. Mcintosh
Journal: Annals of Internal Medicine (1972)

The nephrotic syndrome, an entity of multiple causes, is characterized by edema, proteinuria, hypercholesterolemia, and hypoalbuminemia. It occurs in the child or adult with primary renal disease or a systemic disease involving the kidney. The percutaneous renal biopsy has enabled clinicians to study the natural history of the underlying renal disease and to prognosticate more carefully the outcome of therapies. Other clinical features—age of onset, urinary protein selectivity, urinary enzyme concentrations—have been helpful as prognostic indexes. Immunofluorescent studies of renal tissue are valuable in diagnosis, prognosis, and patient management. Immunologic and inflammatory mechanisms are involved with the glomerular basement membrane, and further study of them may provide more specific and effective therapies. Corticosteroids are effective in the management of the nephrotic syndrome in children and, to a lesser degree, in adults. Azathioprine, cyclophosphamide, and methotrexate appear to be valuable in steroid-resistant and relapsing cases, although long-term experience with toxicity and survival time is limited at present.
US doctors say unnecessary tests and procedures are a serious concern
Authors: M. McCarthy
Journal: BMJ (2014)

Nearly three quarters of US doctors responding to a new poll said that ordering unnecessary tests and procedures was a serious problem.1 And 91% said that an effective way to reduce the ordering of such procedures and tests would be through changes to malpractice law.

The survey was commissioned by the American Board of Internal Medicine (ABIM) Foundation and funded by the Robert Wood Johnson Foundation.

The ABIM Foundation sponsors the “Choosing Wisely” campaign, which seeks to identify commonly ordered tests and procedures that offer little benefit or pose unnecessary risks.2 

The initiative publishes lists of questionable tests and procedures prepared by various medical specialty groups. It aims to encourage patients to question, and doctors to discuss, whether these are needed for patient …
Characterization of soluble factors that induce the cytolytic activity and the expression of T cell growth factor receptors of a T cell hybrid.
Authors: F Erard, P Corthesy, K A Smith, W Fiers, A Conzelmann, M Nabholz
Journal: The Journal of Experimental Medicine (1984)

A rat X mouse T cell hybrid (PC60) proliferates in the absence of T cell growth factor (TCGF) and its cytolytic activity can be induced by culture in mixed leukocyte culture supernatants or concanavalin A-activated rat spleen cell supernatant (CS) to lyse 51Cr-labeled tumor target cells. To characterize the factor(s) responsible for this reversible induction, serum-free CS was fractionated by reverse phase high performance liquid chromatography and by phenyl-Sepharose chromatography. A cytotoxicity-inducing activity (CIA) was separated from TCGF and macrophage-activating factor/interferon-gamma. CIA was found to be a macromolecule with an apparent molecular weight of 12,000-18,000 and a pI of 5.0 and 6.2. Its activity on PC60 cells depended on the addition of TCGF. Thus TCGF may have other effects on T cells than the induction of entry into cell cycle. The number of TCGF surface receptors on PC60 cells was measured using purified 3H-TCGF. TCGF receptors were undetectable on noninduced cells but appeared during induction. The expression of TCGF receptors was not induced either by TCGF or by CIA-containing supernatants or fractions alone, only by a combination of both. These results show that TCGF plays a role in the regulation of the expression of its own receptors.
The Aurora Kinase Inhibitor VX-680 Induces Endoreduplication and Apoptosis Preferentially in Cells with Compromised p53-Dependent Postmitotic Checkpoint Function
Authors: Farid Gizatullin, Yao Yao, Victor Kung, Matthew W. Harding, Massimo Loda, Geoffrey I. Shapiro
Journal: Cancer Research (2006)

Abstract VX-680 is a potent inhibitor of Aurora kinases that induces the accumulation of cells with ≥4N DNA content, followed by cell death. Here, we define the role of p53 and p21Waf1/Cip1 in cell cycle perturbations following exposure to VX-680. Endoreduplication and apoptosis in response to VX-680 are limited in A549 and MCF-7 cells expressing wild-type p53, and markedly enhanced in cells lacking p53, including those engineered to express the HPV16-E6 oncoprotein or short interfering RNA pools targeting p53. In contrast, endoreduplication and apoptosis occur in the p53 wild-type cell lines, RKO and U2OS. The difference in response to VX-680 among these cell lines correlates with the timing of induction of p21Waf1/Cip1 and its ability to inhibit cyclin E-cdk2 activity. In A549 cells, VX-680 induces the expression of p53 and p21Waf1/Cip1 within 24 hours, with consequent inhibition of cyclin E-cdk2, and reduction of retinoblastoma protein phosphorylation, limiting endoreduplication. In RKO and U2OS cells, the induction of p21Waf1/Cip1 is delayed and associated with higher residual cyclin E-cdk2 kinase activity and retinoblastoma protein phosphorylation, followed by progressive endoreduplication and apoptosis. Abrogation of p21Waf1/Cip1 expression by short interfering RNA targeting in A549 cells results in a substantial increase in the degree of endoreduplication, whereas inducible expression of p21Waf1/Cip1 in p53-negative NCI-H1299 cells inhibits VX-680-induced endoreduplication and cell death. These data suggest that the integrity of the p53-p21Waf1/Cip1–dependent postmitotic checkpoint governs the response to Aurora kinase inhibition. Although cells with intact checkpoint function arrest with 4N DNA content, those with compromised checkpoint function are more likely to undergo endoreduplication followed by eventual apoptosis. (Cancer Res 2006; 66(15): 7668-77)
Ethics of Research Involving Mandatory Drug Testing of High School Athletes in Oregon
Authors: Adil E. Shamoo, Jonathan D. Moreno
Journal: The American Journal of Bioethics (2004)

There is consensus that children have questionable decisional capacity and, therefore, in general a parent or a guardian must give permission to enroll a child in a research study. Moreover, freedom from duress and coercion, the cardinal rule in research involving adults, is even more important for children. This principle is embodied prominently in the Nuremberg Code (1947) and is embodied in various federal human research protection regulations. In a program named "SATURN" (Student Athletic Testing Using Random Notification), each school in the Oregon public-school system may implement a mandatory drug-testing program for high school student athletes. A prospective study to identify drug use among student-athletes, SATURN is designed both to evaluate the influence of random drug testing and to validate the survey data through identification of individuals who do not report drug use. The enrollment of students in the drug-testing study is a requirement for playing a school sport. In addition to the coercive nature of this study design, there were ethically questionable practices in recruitment, informed consent, and confidentiality. This article concerns the question of whether research can be conducted with high school students in conjunction with a mandatory drug-testing program, while adhering to prevailing ethical standards regarding human-subjects research and specifically the participation of children in research.
Effect of Clozapine and Adjunctive High-Dose Glycine in Treatment-Resistant Schizophrenia
Authors: Steven G. Potkin, Yi Jin, Blynn G. Bunney, Jerome Costa, Bala Gulasekaram
Journal: American Journal of Psychiatry (1999)

The focus of this study was the systematic evaluation of the clinical effects of glycine as an adjunct to the atypical antipsychotic clozapine in the treatment of schizophrenia.In a double-blind, placebo-controlled study, 19 patients with chronic, treatment-resistant schizophrenia who were maintained on optimal doses of clozapine (400-1200 mg/day) were administered either 30 g/day of glycine (N=9) or placebo (N=10) for 12 weeks. Clinical evaluations with the Brief Psychiatric Rating Scale, the Scale for the Assessment of Negative Symptoms, and the Simpson-Angus movement scale were completed biweekly.The use of glycine as an adjunct to clozapine was not effective in decreasing positive or negative symptoms. In contrast, the patients treated with clozapine without glycine had a 35% reduction in positive symptoms.These preliminary data suggest that glycine may interfere with the antipsychotic efficacy of atypical neuroleptics such as clozapine.
THE EFFECT OF ULTRAVIOLET IRRADIATION ON VARIOUS PROPERTIES OF INFLUENZA VIRUSES
Authors: Werner Henle, Gertrude Henle
Journal: The Journal of Experimental Medicine (1947)

The effect of ultraviolet irradiation on various properties of the influenza viruses Types A and B has been analyzed. The studies involved propagation and interference in the allantoic sac of the chick embryo, inhibition of embryonic development, toxicity for white mice, hemagglutination including the adsorption-elution mechanism, immunizing capacity for mice and, finally, complement fixation activities in the presence of antibodies to the 600S antigen (human convalescent and postvaccination sera) and the 30S antigen (convalescent sera only). It has been shown that the various activities of the influenza viruses were affected by irradiation at different rates, indicating that they are based, at least in part, on different constituents of the virus particle. On account of these differences in the susceptibility of the various properties to ultraviolet light it was possible (a) to differentiate between the interference phenomenon as observed in the allantoic sac, and the development of non-agglutinability in red cells by either homologous or heterologous fresh virus, and (b) to separate individual steps involved in the mechanism of infection of susceptible host cells. The implications of these findings are discussed.
Sequential Injury of the Rabbit Abdominal Aorta Induces Intramural Coagulation and Luminal Narrowing Independent of Intimal Mass
Authors: David W. Courtman, Stephen M. Schwartz, Charles E. Hart
Journal: Circulation Research (1998)

Abstract —We hypothesized that activation of the coagulation cascade is involved in arterial remodeling in response to sequential injury. An active site–inhibited recombinant human factor VIIa (FVIIai) was used to inhibit tissue factor, the primary cofactor in the extrinsic pathway of coagulation, in a sequential balloon injury model of the rabbit abdominal aorta. Single balloon injury produced limited intimal thickening at 3 weeks (intimal area, 0.40±0.05 mm 2 ) and no loss in luminal area (12.2±0.9 mm 2 before injury and 12.1±0.9 mm 2 at 6 weeks after injury). Sequential balloon injury, 3 weeks after the first balloon denudation, produced a progressive loss of lumen, with 22% and 47% loss of luminal area, respectively, at 3 and 6 weeks. Luminal loss could not be accounted for by intimal growth (at 3 weeks after sequential injury, the intimal area was 0.47±0.08 mm 2 , &lt;4% of the initial luminal area). Sequential injury acutely produced extensive mural and intramural fibrin deposition. Treatment with FVIIai inhibited both the fibrin deposition and the chronic loss of lumen. At 3 weeks after sequential injury, luminal cross-sectional areas were 9.8±0.6 mm 2 for control rabbits and 14.3±1.4 mm 2 for FVIIai-treated rabbits. Neither neointimal area nor cell proliferation was reduced by FVIIai treatment. The intimal cell proliferation index 3 days after injury was 7.6±1.1% in control rabbits versus 5.8±1.1% in treated rabbits ( P &gt;0.05). These results indicate that tissue factor is an important mediator of coagulation in repeat injury and implicate the extrinsic coagulation cascade in a blood vessel remodeling response that is independent of neointimal growth but leads to extensive loss of lumen.
Cross-Regulations among NRFs and KEAP1 and Effects of their Silencing on Arsenic-Induced Antioxidant Response and Cytotoxicity in Human Keratinocytes
Authors: Rui Zhao, Yongyong Hou, Qiang Zhang, Courtney G. Woods, Peng Xue, Jingqi Fu, Kathy Yarborough, Dawei Guan, Melvin E. Andersen, Jingbo Pi
Journal: Environmental Health Perspectives (2012)

Nuclear factor E2-related factors (NRFs), including NRF2 and NRF1, play critical roles in mediating the cellular adaptive response to oxidative stress. Human exposure to inorganic arsenic, a potent oxidative stressor, causes various dermal disorders, including hyperkeratosis and skin cancer.
Activation of human complement by immunoglobulin G antigranulocyte antibody.
Authors: P K Rustagi, M S Currie, G L Logue
Journal: Journal of Clinical Investigation (1982)

The ability of antigranulocyte antibody to fix the third component of complement (C3) to the granulocyte surface was investigated by an assay that quantitates the binding of monoclonal anti-C3 antibody to paraformaldehyde-fixed cells preincubated with Felty's syndrome serum in the presence of human complement. The sera from 7 of 13 patients with Felty's syndrome bound two to three times as much C3 to granulocytes as sera from patients with uncomplicated rheumatoid arthritis. The complement-activating ability of Felty's syndrome serum seemed to reside in the monomeric IgG-containing serum fraction. For those sera capable of activating complement, the amount of C3 fixed to granulocytes was proportional to the amount of granulocyte-binding IgG present in the serum. Thus, complement fixation appeared to be a consequence of the binding of antigranulocyte antibody to the cell surface. These studies suggest a role for complement-mediated injury in the pathophysiology of immune granulocytopenia, as has been demonstrated for immune hemolytic anemia and immune thrombocytopenia.
CORONARY CIRCULATORY DYSFUNCTION IS ASSOCIATED WITH DIASTOLIC DYSFUNCTION IN INDIVIDUALS AT CARDIOVASCULAR RISK
Authors: Alessandra Quercioli, Maria Gabriella Vincenti, René Nkoulou, Stephan Dewarrat, Yann Seimbille, Osman Ratib, François Mach, Thomas H. Schindler
Journal: Journal of the American College of Cardiology (2010)
A narrow repertoire of transcriptional modules responsive to pyogenic bacteria is impaired in patients carrying loss-of-function mutations in MYD88 or IRAK4
Authors: Laia Alsina, Elisabeth Israelsson, Matthew C Altman, Kristen K Dang, Pegah Ghandil, Laura Israel, Horst von Bernuth, Nicole Baldwin, Huanying Qin, Zongbo Jin, Romain Banchereau, Esperanza Anguiano, Alexei Ionan, Laurent Abel, Anne Puel, Capucine Picard, Virginia Pascual, Jean Laurent Casanova, Damien Chaussabel
Journal: Nature Immunology (2014)
MST1 mutations in autosomal recessive primary immunodeficiency characterized by defective naive T-cell survival
Authors: Nadine T. Nehme, Jana Pachlopnik Schmid, Franck Debeurme, Isabelle André-Schmutz, Annick Lim, Patrick Nitschke, Frédéric Rieux-Laucat, Patrick Lutz, Capucine Picard, Nizar Mahlaoui, Alain Fischer, Geneviève de Saint Basile
Journal: Blood (2011)
570 Expression of JAK, STAT, SOCS and PIAS in liver biopsies of patients with chronic hepatitis C: Relationship to grading/staging and response to combined interferon therapy
Authors: J. Ehrmann, K. Aiglova, J. Ehrmann, J. Palas, P. Kümpel, T. Olecky, Z. Krcova, M. Jelinkova, E. Pukancikova
Journal: Journal of Hepatology (2006)
Another election pay round
Authors: J. Warden
Journal: BMJ (1987)

With the spring come the first stirrings of the pay reviews.The nurses' award will be the first to emerge and should land on the Prime Minister's desk any day now, if it is not there already, with the doctors' and dentists' award not far behind.They should beat the usual Maundy Thursday deadline this year in time for a Cabinet decision within two or three weeks.The parliamentary rituals in anticipation were performed last week to a doom laden background of the "nursing crisis."This was said to pose a real danger of there not being enough nurses to staff the National Health Service ifthe government did not value them in pay terms more than typists.Ministers know better than to be put on the defensive concerning nurses and made appropriate and positive noises.In the Lords Baroness Trumpington said that the government had done its best to show appreciation of the nurses, with a reduced working week, major proposals for education and training to come, and a commit- ment to the system of the pay review body.This could be taken to mean that the Cabinet is commited to implement the pay review awards in full, subject only to staging the payments-which, of course, can make it a very qualified commit- ment indeed.This is only the fourth report since the nurses were given their own pay review body.The previous three illustrate the variations that are possible.The first report, in 1984, recommended a 7 5% increase and it was implemented in full.The second award was also accepted but staged.
Differentiation of the Atrioventricular Conducting System of the Heart
Authors: Ludwig W. Eichna, ROBERT L. DEHAAN
Journal: Circulation (1961)

The structure and function of the atrioventricular conducting system of the heart, and its relationship to the myocardium, are examined from a developmental point of view. On the basis of information derived from electron micrographic, electrophysiologic, and developmental studies of heart tissue, it is concluded that: (1) The idea of the syncytial nature of the heart lacks a sound anatomic basis. (2) Cytodifferentiation during embryonic cardiogenesis results in the development of at least 2 distinct populations of cells: those comprising the bulk of the myocardium and a second type, the specialized cells of the conductive tissue, which differs in histology, biochemistry, and physiology. (3) The common view of the myocardium as a spontaneously active tissue may require revision, since several lines of evidence appear to indicate that myocardial cells are quiescent until stimulated by an extrinsic source. Under normal circumstances, this stimulus source is the conductive tissue.
Care in the Rochester Experimental Payment Program-Reply
Authors: Donna I. Regenstreif
Journal: JAMA (1987)

<h3>In Reply.—</h3> In response to the letter from Dr Meggs, the following recently available information concerning patient access to Rochester hospitals should prove helpful. With respect to open heart surgery, the surgical rate among Monroe County residents was 33% higher than the New York statewide average in 1984, and in 1985 it was 45% higher. Mortality rates associated with diseases of the heart were 26% lower in Monroe County than statewide. We are not familiar with Dr Meggs' contention that there was "a board that set a cap below... community needs." The hospitals offering this service have made efforts to find a reasonable balance between community need for this service and access for other surgical specialties. Given the above data, it would appear that a reasonable balance has been found. During the period 1980 through 1984, the average annual medical/surgical occupancy level at Rochester's urban hospitals ranged from 83% to