tbuckley/cabot-search huggingface dataset:
Medical researchers' ancillary clinical care responsibilities
Authors: Leah Belsky, Henry S Richardson
Journal: BMJ (2004)

quality of the evidence for differences in use of resources should be graded by using the approach outlined above for other important outcomes. How it works in practiceTable 2 shows an example of the system applied to evidence from a systematic review comparing selective serotonin reuptake inhibitors with tricyclic antidepressants conducted in 1997. 2 After discussion, we agreed that there was moderate quality evidence for the relative effects of both types of drugs on severity of depression and poisoning fatalities and high quality evidence for transient side effects.We then reached agreement that the overall quality of evidence was moderate and that there were net benefits in favour of serotonin reuptake inhibitors (no difference in severity of depression, fewer transient side effects, and fewer poisoning fatalities).Although we agreed that there seemed to be net benefits, we concluded with a recommendation to "probably" use serotonin reuptake inhibitors because of uncertainty about the quality of the evidence.We had no evidence on relative costs in this exercise.Had we considered costs, this recommendation might have changed. ConclusionsWe have attempted to find a balance between simplicity and clarity in our system for grading the quality of evidence and strength of recommendations.Regardless of how simple or complex a system is, judgments are always required.Our system provides a framework for structured reflection and can help to ensure that appropriate judgments are made, but it does not remove the need for judgment.
Age-Related Differences in Characteristics, Performance Measures, Treatment Trends, and Outcomes in Patients With Ischemic Stroke
Authors: Gregg C. Fonarow, Mathew J. Reeves, Xin Zhao, DaiWai M. Olson, Eric E. Smith, Jeffrey L. Saver, Lee H. Schwamm
Journal: Circulation (2010)

Prior studies have suggested lower use of guideline-recommended therapy and worse poststroke outcomes in older patients. We sought to examine age-related differences in characteristics, performance measures, temporal trends, and early clinical outcomes for acute ischemic stroke in a large contemporary cohort.The relationships between age and clinical characteristics, performance measures, and in-hospital outcomes were analyzed in 502 036 ischemic stroke admissions from 1256 hospitals in the Get With the Guidelines-Stroke program from 2003 to 2009. Data were analyzed by age groups (<50, 50 to 59, 60 to 69, 70 to 79, 80 to 89, and >/=90 years) and with age as a continuous variable. Seven predefined performance measures and 2 summary measures were analyzed. Mean age of ischemic stroke patients was 71.0+/-14.6 years; 52.5% were women. Older patients were more likely to have a history of atrial fibrillation or hypertension and less likely to be black, Hispanic, or current/recent smokers. Although modest age-related differences in each individual performance measure were identified, there were substantial temporal improvements in performance measures from 2003 to 2009 in each age group, and many age-related treatment gaps were narrowed or eliminated over time. Older patients were less likely to be discharged home (adjusted odds ratio, 0.69; 95% confidence interval, 0.68 to 0.69) and more likely to die in hospital (adjusted odds ratio, 1.27; 95% confidence interval, 1.25 to 1.29) for each 10-year age increase.Older patients with ischemic stroke differ in clinical characteristics and experience higher in-hospital mortality than younger patients. Performance measure-based treatment rates improved substantially over time for ischemic stroke patients in all age groups, resulting in smaller age-related treatment gaps.
Psychological treatments for patients with cancer.
Authors: P. Snaith
Journal: BMJ (1992)

Medline search.This showed that during 1982-6 nine papers included the phrase in their titles with a further 59 using it in the abstract.During 1987- 91 these figures jumped to 35 and 373 respectively.These figures do not include other papers that use the phrase elsewhere in the text.A close inspection of these 35 recent publications indicates that the use is subject to considerable criticism.In 19 cases the designation gold standard is questioned in such varied conditions as depres- sion,' left ventricular function,4 osteoporosis,5 and gastro-oesophageal reflux.! This is not surprising, I suppose, as these are clinical conditions that are not amenable to the certainty implied in the term.Because the phrase smacks of dogma its use should be discontinued in medical science.After all, the financiers gave up the idea of a gold standard decades ago.
Razoxane (ICRF 159) in the treatment of psoriasis
Authors: D. J. ATHERTON, R. S. WELLS, M. R. LAURENT, Y. F. WILLIAMS
Journal: British Journal of Dermatology (1980)

This paper describes our experience with the use of razoxane (ICRF 159), a new anti-mitotic drug, in the treatment of thirty-six patients with severe psoriasis. The drug has proven highly effective both in cutaneous and in arthropathic disease. The drug is well tolerated by patients and appears to be free of hepatotoxicity. However, it causes depression of the neutrophil leukocyte count, an effect which is entirely dose-dependent; the hazard to patients can be minimized by careful supervision of therapy.
Traumatic Situations in Obesity
Authors: M. Rotmann, D. Becker
Journal: Psychotherapy and Psychosomatics (1970)

Thirty-three case histories of extremely obese patients (38–161% overweight) were reviewed in respect to meaningful biographical events coinciding with the onset of obesity. All patients had psychoanalytically oriented interviews. No specific intrapsychic conflict could be discovered as being etiologically connected with the onset of obesity. Overeating was used as a defence mechanism against the unconscious affects of helplessness and hopelessness arising mainly in situations of object loss.
Characteristics of autoimmune hepatitis in patients who are not of European Caucasoid ethnic origin
Authors: T Zolfino, M A Heneghan, S Norris, Phillip Harrison, B C Portmann, I G McFarlane
Journal: Gut (2002)

Background: Significant diversity in disease severity has been identified for autoimmune disorders among different ethnic groups but there is a lack of data on autoimmune hepatitis (AIH) in populations other than those of European Caucasoid (EC) or Japanese extraction. Aims: To assess the clinical features, response to therapy, and eventual outcome in AIH patients of non-EC ethnicity. Methods: A retrospective review of a regularly updated database of patients with AIH referred to liver outpatient clinics at King9s College Hospital, London, since 1983. Results: Twelve patients were identified (10 female; six African, five Asian, one Arabic; median age at presentation 30 years (range 12–58)) who satisfied international criteria for type 1 (11 cases) or type 2 (one case) AIH. Nine (75%) had cholestatic serum biochemistry and three (25%) had mild biliary changes on liver biopsy without definitive features of primary biliary cirrhosis or cholangiographic evidence of primary sclerosing cholangitis. Four showed a complete biochemical response to standard prednisolone with or without azathioprine therapy, three partial, and five no response. Four have required liver transplantation for intractable disease. By comparison with 180 EC patients with definite AIH attending during the same period, the non-EC patients were younger (p&lt;0.05), presented with cholestatic biochemistry (p=0.014), and morphological biliary features more frequently (p&lt;0.0005) and showed a poorer initial response to standard therapy (p&lt;0.0005). Conclusions: Clinical expression of AIH in non-EC patients seems to differ in important respects from that in EC or Japanese patients. Management of such patients is challenging and may require alternative or more aggressive treatment strategies.
The Journal of Clinical Ethics
Authors: Carson Strong
Journal: JAMA (1993)

This publication germinated from a perceived need for a journal aimed at front-line health care providers that applies medical ethics to clinical practice. In the inaugural issue the editor-in-chief, a physician-lawyer, stated two goals: to provide state-of-the-art information to clinicians and to advance the field. The journal pursues these goals by publishing up-to-date reviews, case reports and analyses, research reports, discussions of ethical theory as it relates to practice, discussions of recent legal events and trends, editorials, and letters. These components are organized under separate section headings in the table of contents, giving a user-friendly format. To meet the goal of "advancing the field," articles frequently are accompanied by several commentaries critiquing the authors' arguments and positions from various perspectives. Several special sections have appeared containing multiple articles and commentaries on a focused topic. The journal is peer reviewed and included in<i>Index Medicus</i>and MEDLINE. The editorial board of
Molecular Pathways: Autophagy in Cancer—A Matter of Timing and Context
Authors: Michelle Cicchini, Vassiliki Karantza, Bing Xia
Journal: Clinical Cancer Research (2014)

Autophagy is an intracellular self-digestion mechanism, by which cellular components are sorted into double-membrane autophagosomes and delivered to lysosomes for degradation. Cells use autophagy to dispose of wastes and eliminate hazards, while recycling nutrients and tuning metabolism in the process. Through these functions, autophagy promotes cell fitness, genome integrity, tissue homeostasis, and cell survival and growth under stress. Both autophagy upregulation and downregulation have been found in human cancers, suggesting a complex role in tumor development. Accumulating results from autophagy-deficient mice and mouse models of human cancers have demonstrated that autophagy generally suppresses tumor initiation, but promotes tumor progression, in a manner that is dependent on timing and context and modified by specific tumorigenic events. Given the role of autophagy in facilitating tumor growth, autophagy inhibition has gained wide attention as a potential anticancer therapy. Here, we summarize relevant genetic, preclinical, and clinical studies and discuss the multifaceted role of autophagy in cancer, as well as the prospects of autophagy inhibition for cancer therapy.
Diethylstilbestrol in breast cancer: dose-response analysis
Authors: J. T. Wittes
Journal: JAMA (1977)

<h3>To the Editor.—</h3> Carter et al have recently published in this journal (237:2079, 1977) the results of a cooperative, prospective, double-blind study that attempted to assess the role of diethylstilbestrol (DES) in the treatment of postmenopausal women with metastatic breast cancer. These investigators studied the dose-response characteristics of this drug over a fourlog dosage range. The data obtained in the study, when analyzed according to a mathematical model of doseresponse, led to the following conclusions: The response rate to DES is a function not only of the dose but also of menopausal age and dominant site of metastases. However, the results within menopausal age group and within dominant metastatic site category do not conform to a simple, uniformly increasing dose-response relationship. In particular, for the postmenopausal age group of ≥5 and ≤10 years the analysis led to a complex relationship in which the "best treatment" varied according to site
Abstract 4929: Dissection of protein-protein interaction-mediated cross-talk pathways in hepatocellular carcinoma
Authors: Tzu-Chi Chen, Chia-Hung Liu, Pei-Ying Lee Lee, Kuan-Ting Lin, Yu-Wen Liu, Chi-Ying Huang
Journal: Cancer Research (2011)

Abstract Multiple dys-regulated cell signaling pathways and extensive cross-talks, which can be depicted via protein-protein interactions (PPIs), among individual signaling pathways, characterize cancer development and progression. However, systematic analysis of the cross-talk events from distinct pathways via PPIs remains fragmentary, and the reliability of PPI datasets, particularly at the cellular level, remains to be vigorously examined. Here, we first build the cross-talk pathway map of heptocellular carcinoma (HCC) through overexpression patterns in HCC among 23 pathways. By detecting endogenous PPIs in two HCC cell lines, Huh7 (low invasive cells) and Mahlavu (high invasive cells), we validate 50 PPI events within pathway and 19 PPI-mediated cross-talk events among 23 pathways in HCC. Not surprisingly, many distinct PPIs are present between Huh7 and Mahlavu, providing the opportunity to characterize tumor invasion. By analyzing topology of cross-talk PPI network, CRKL has a pivotal role in cross-talk pathway. This initial attempt to map the cross-talk pathways in HCC may represent the first step in deciphering hepatocarcinogenesis at the systems level and might reveal a novel strategy for HCC treatment. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 4929. doi:10.1158/1538-7445.AM2011-4929
Regenerative Response in Ischemic Brain Restricted by p21cip1/waf1
Authors: Jianhua Qiu, Yasushi Takagi, Jun Harada, Neil Rodrigues, Michael A. Moskowitz, David T. Scadden, Tao Cheng
Journal: The Journal of Experimental Medicine (2004)

Neural precursor cells from adults have exceptional proliferative and differentiative capability in vitro yet respond minimally to in vivo brain injury due to constraining mechanisms that are poorly defined. We assessed whether cell cycle inhibitors that restrict stem cell populations in other tissues may participate in limiting neural stem cell reactivity in vivo. The cyclin-dependent kinase inhibitor, p21cip1/waf1 (p21), maintains hematopoietic stem cell quiescence, and we evaluated its role in the regenerative response of neural tissue after ischemic injury using the mice deficient in p21. Although steady-state conditions revealed no increase in primitive cell proliferation in p21-null mice, a significantly larger fraction of quiescent neural precursors was activated in the hippocampus and subventricular zone after brain ischemia. The hippocampal precursors migrated and differentiated into a higher number of neurons after injury. Therefore, p21 is an intrinsic suppressor to neural regeneration after brain injury and may serve as a common molecular regulator restricting proliferation among stem cell pools from distinct tissue types.
Open discussion about a problematical eponym
Authors: Thomas Tschernig, Michael Kasper, Reinhard Pabst
Journal: Thorax (2013)

The ‘Clara cell’ was named after the anatomist Max Clara. This cell is localised in the terminal bronchioles of the human lung. It's function in secretion and as a potential progenitor has recently been reviewed by Reynolds and Malkinson.1 Briefly, the morphology is typical and has already been described by Koelliker in 1881. It is …
IX. The AMA Gets a New Code of Ethics
Authors: Lester S. King
Journal: JAMA (1983)

In the celebrations that marked the centennial year 1876, medicine shared in the general self-congratulation; yet despite the rhetoric, a note of caution made itself heard. The president of the American Medical Association commented, in 1876, on the code of ethics. This he called "the best ever given for the government of medical men," and he observed that most of the members might think it "as perfect as the Decalogue, and as incapable of improvement." Nevertheless, it did not seem to work very well. Even eminent physicians, sticklers for the "inviolability of the Code," tried to find the "easiest way of getting round its provisions without a flagrant violation of them." Such physicians "feel that they are hampered by the rules that are unjust and oppressive." The code of ethics was violated every day, "not only by the rank and file, but by men high in the profession." He pointed
Lactational Exposure to Polychlorinated Biphenyls, Dichlorodiphenyltrichloroethane, and Dichlorodiphenyldichloroethylene and Infant Neurodevelopment: An Analysis of the Pregnancy, Infection, and Nutrition Babies Study
Authors: I-Jen Pan, Julie L. Daniels, Barbara D. Goldman, Amy H. Herring, Anna Maria Siega-Riz, Walter J. Rogan
Journal: Environmental Health Perspectives (2008)

BackgroundPolychlorinated biphenyls (PCBs) and dichlorodiphenyltrichloroethane (DDT) are persistent, bioaccumulative, and toxic pollutants that were broadly used in the United States until the 1970s. Common exposure to PCBs, DDT, and dichlorodiphenyldichloroethylene (DDE), the most stable metabolite of DDT, may influence children's neurodevelopment, but study results are not consistent.ObjectivesWe examined the associations between lactational exposure to PCBs, DDT, and DDE and infant development at 12 months, using data from the Pregnancy, Infection, and Nutrition Babies Study, 2004–2006.MethodsWe measured PCBs, DDT, and DDE in breast milk at the third month postpartum. Lactational exposure of these chemicals was estimated by the product of chemical concentrations and the duration of breast-feeding. Infant development at 12 months of age was measured by the Mullen Scales of Early Learning (n = 231) and the Short Form: Level I (infant) of the MacArthur–Bates Communicative Development Indices (n = 218).ResultsNo consistent associations were observed between lactational exposure to PCBs, DDT, and DDE through the first 12 months and the measures of infant development. However, DDE was associated with scoring below average on the gross motor scale of the Mullen among males only (adjusted odds ratio = 1.9; 95% confidence interval, 1.1–3.3).ConclusionInfant neurodevelopment at 12 months of age was not impaired by PCBs, DDT, and DDE at the concentrations measured here, in combination with benefits from long duration of breast-feeding in this population.
Blastic Crisis in Granulocytic Leukaemia
Authors: G. D. Pegrum
Journal: BMJ (1964)

<h3>Objective</h3> To systematically review all randomised clinical trials to determine the efficacy of local strengthening exercises compared with other forms of conservative management for adults with posterior tibial tendon dysfunction. <h3>Design</h3> Systematic review. <h3>Data sources</h3> Four electronic databases (Cumulative Index to Nursing and Allied Health Literature, Cochrane, Embase and PubMed) were searched up to June 2018. <h3>Eligibility criteria for selecting studies</h3> The study included randomised clinical trials investigating individuals with posterior tibial tendon dysfunction where local strengthening was compared with other forms of conservative management with respect to pain, function and/or physical impairment outcome measures. Standardised mean differences (SMDs) were used to compare change scores between groups and descriptors of exercise prescription assessed according to the Template for Intervention Description and Replication and the Toigo and Boutellier recommendations. <h3>Results</h3> 3 studies (n=93) were eligible for inclusion in the review. Varying strengthening exercises were compared with stretching and foot orthoses (n=2) or no intervention (n=1). Moderate effects (SMD 0.6–1.2) were found for reducing pain and disability with eccentric strengthening in conjunction with stretching and orthoses compared with concentric exercises, stretching and orthoses combined, and stretching and orthoses alone. Evaluation of exercise prescription parameters demonstrated minimal reporting, with the only consistent parameters being the number of sets and repetitions of the exercises, and the duration of the experimental period. <h3>Conclusion</h3> This review demonstrates the paucity of high-quality research for the conservative management of posterior tibial tendon dysfunction, and highlights the lack of exercise prescription parameters reported in clinical trials. <h3>Trial registration number</h3> CRD42017076156.
A Crisis in Medical Education
Authors: John I. Sandson
Journal: New England Journal of Medicine (1983)

The increasing cost of tuition is causing a crisis in most independent medical schools. The tuition increase has been accentuated by double-digit inflation, especially in health-related areas, and by the elimination of a federal program that provided funds to the schools on a per capita basis — the so-called capitation program. Tuition in independent medical schools averages $10,701 for the 1982–1983 academic year.1 The highest tuition is now $19,000. Total annual costs (tuition plus expenses) for a student attending an independent medical school in 1982–1983 average about $18,000, with the highest annual costs reaching more than $25,000.1 Medical students must . . .
Death Associated with Hexamethonium and 1-Hydrazinophthalazine (Apresoline) Therapy
Authors: Melvin I. Klayman, Norman R. Silberg, William S. Karlen
Journal: New England Journal of Medicine (1953)

HEXAMETHONIUM, a ganglionic blocking agent,1 has recently been introduced in the therapy of hypertension. The effectiveness of sympathetic blockade determines its hypotensive properties; the undesirable side effects result, for the most part, from blockade of parasympathetic ganglions. The present report describes a fatal case that followed hexamethonium administration; the concurrent use of another new hypotensive drug, 1-hydrazinophthalazine (Apresoline) probably militated against successful correction of the autonomic derangement consequent to hexamethonium.Case ReportP. T. (M 37633), a 56-year-old woman, was admitted to the Beth Israel Hospital on January 23, 1953, because of suspected acute mesenteric thrombosis. She had had hypertension . . .
ANOTHER NAME FOR DELIRIUM TREMENS
Authors: B. M. Randolph
Journal: JAMA (1933)

<h3>To the Editor:</h3> —While visiting in rural Virginia last summer, I came on a new name for an old malady. At least I had not encountered it before. Our Negro cook announced deep concern over the illness of her adult son. She called it "mannaprocher." "You know it comes from drinkin'," she said. A brief inquiry as to her son's symptoms showed his trouble to be our old friend the D. T's. Of course it immediately suggested itself that the name was a corruption of mania à potu. Thinking it possible that this version was personal to the cook, I determined to seek confirmation of its position in the local vocabulary. There was in the neighborhood a Negro of 65 or more, intelligent, well informed and reliable. Under pretext of buying eggs from his wife, I called. While exchanging greetings with him I incidentally asked him if he had ever
The effect of oxygen plasma pretreatment and incubation in modified simulated body fluids on the formation of bone-like apatite on poly(lactide-co-glycolide) (70/30)
Authors: Xue Qu, Wenjin Cui, Fei Yang, Changchun Min, Hong Shen, Jianzhong Bei, Shenguo Wang
Journal: Biomaterials (2006)