tbuckley/cabot-search huggingface dataset:
Number needed to harm should be measured for treatments
Authors: A. Zermansky
Journal: BMJ (1998)

EDITOR—The concept of number needed to treat was an attempt to introduce both simplicity and objectivity into the evaluation of treatment. It is helpful both on a large scale when treatments are compared and care is commissioned and on the personal level when doctor and patient choose the management for the individual. The number needed to treat gives a comparison of treatments and outcomes that both doctors and patients should understand.

One problem of this unimodal numerical scale for measuring the likely outcome of a treatment is that it …
Correction: Prolonged Grief Disorder: Psychometric Validation of Criteria Proposed for DSM-V and ICD-11
Authors: Holly G. Prigerson, Mardi J. Horowitz, Selby C. Jacobs, Colin M. Parkes, Mihaela Aslan, Karl Goodkin, Beverley Raphael, Samuel J. Marwit, Camille Wortman, Robert A. Neimeyer, George A. Bonanno, Susan D. Block, David Kissane, Paul Boelen, Andreas Maercker, Brett T. Litz, Jeffrey G. Johnson, Michael B. First, Paul K. Maciejewski
Journal: PLoS Medicine (2013)
Micro-editing mistake translates into a devastating brain tumor
Authors: Dan Dominissini, Ninette Amariglio, Gideon Rechavi
Journal: Journal of Clinical Investigation (2012)

RNA modifications are increasingly being recognized as critical players in cancer. While adenosine-to-inosine RNA editing is consistently deregulated in cancer, we are still unable to draw a straight line connecting transcript-specific editing and carcinogenesis. The findings by Choudhury et al. in this issue of the JCI bridge this gap by mechanistically implicating underediting of miR-376a* in promoting glioma invasiveness through redirection of its mRNA targets. Moreover, RAP2A and AMFR convincingly emerge as key regulators of glioma migration and invasion affected by deregulated microRNA editing. Being inherently malleable, epigenetic mechanisms may provide feasible targets for therapeutic benefit.
Findings from COX 2 studies are released
Authors: Scott Gottlieb
Journal: BMJ (2005)

Results from recent studies that raised concerns about the cardiovascular safety of cyclo-oxygenase-2 (COX 2) inhibitors have been made available early, in advance of hearings on the drug class by the US Food and Drug Administration.

All the studies have been published online in the New England Journal of Medicine (http://nejm.org/), and the journal lifted its normal embargo date for the studies because of what it described as the “possible public health implications.”

The results come immediately before a three-day hearing looking into the benefits and risks of COX 2 inhibitors …
Objective Structured Assessment of Technical Skills in Elliptical Excision Repair of Senior Dermatology Residents
Authors: Murad Alam, Michael Nodzenski, Simon Yoo, Emily Poon, Diana Bolotin
Journal: JAMA Dermatology (2014)

Surgical training in dermatology residencies has increased, and there is growing interest in measuring resident competence more precisely. This study applies the use of the objective structured assessment of technical skills (OSATS) to measure competence in dermatologic surgery.To evaluate the utility of OSATS as a tool for measuring surgery skills during dermatology residency training.Multirater, blinded review and ratings of taped video recordings of elliptical excisions performed by senior dermatology residents applying for procedural or Mohs surgery fellowships.Ratings on a specific OSATS measure, including global rating scale and task checklist.Twelve videos, representing approximately 20% of fellowship applicants during 2009-2010, were rated. Raters agreed on 272 of 288 subscore ratings (94.4%). Mean global ratings were 4 or 5 for all categories, except time and motion, which had a rating of 3. Task checklist ratings had a mean of 14.5 and a mode of 16 (perfect score), with eversion least often performed successfully. No association was found between a resident's scores and the number of surgical rotation months or between scores and the number of Mohs surgeons at the home institution.Senior dermatology residents preparing for surgery fellowships are highly skilled in performing elliptical excisions and bilayered repairs. The OSATS appears useful and reliable for the evaluation of dermatologic surgery skills.
Pathologic Physiology: Mechanisms of Disease
Authors: Daniel L. Weiss
Journal: JAMA (1974)

In the new edition of this standard American classic, massively rewritten, a large group of authorities have produced a fascinating book with a new outlook. The opening section deals with the scientific foundations of medicine, metabolic biochemistry, molecular biology, medical genetics, immunobiology, immunodeficiencies, and tumor immunobiology. These subjects are treated in an up-to-date manner, with a clear purpose of assessing their relevance to clinical pathophysiology. They are succinct and informative. The only criticism that can be leveled is that biochemistry is too wide a subject to be treated in 24 pages, but the selection of material in this chapter is a credit to Drs. Toporek and Maurer. The following sections cover the cardiorenal and respiratory systems; rheumatology, allergy, infectious disease, and hematology; gastroenterology, endocrinology, and metabolism; and toxic and physical agents. Each area is presented systematically, clearly, tending to avoid controversy, and in many instances brilliantly developed. To pick just
All About Myelomatosis
Authors: C. V. Harrison
Journal: BMJ (1971)

<b>Background:</b> This study was undertaken to determine the usefulness, safety, and most appropriate timing of open lung biopsy in infants and children considered for and on extracorporeal membrane oxygenation (ECMO) for respiratory failure. <b>Methods:</b> A retrospective review of children referred for consideration of and placed on ECMO in our institution in the period 1996–2002. <b>Results:</b> 506 patients were referred, 15 (3%) of whom underwent antemortem open lung biopsy (eight neonatal, four paediatric, and three cardiac patients). In the neonatal group open lung biopsy contributed to clinical decision making in all patients. Four neonates had a fatal lung dysplasia (three alveolar capillary dysplasia and one surfactant protein B deficiency) and treatment was withdrawn. Of the other four neonates, two had pulmonary hypoplasia, one had pulmonary lymphangiectasia, and one had meconium aspiration with mild barotrauma. Treatment was continued in these four patients and two survived. In the paediatric group the biopsies were of clinical relevance in two infants with pertussis who had lung infarction on biopsy in whom treatment was withdrawn. In the other two paediatric patients the biopsies were equivocal, treatment was continued, but both patients died. In the cardiac group, who presented perioperatively with pulmonary hypertension, the biopsies excluded a fatal lung dysplasia and severe pulmonary vascular disease but all three infants died. One patient had non-fatal bleeding complications. <b>Conclusion:</b> Open lung biopsy is clinically most useful when performed to diagnose fatal lung dysplasias in neonates and to confirm the presence of viable lung tissue in patients with acute lung injury due to pertussis infection.
FDA bars own expert from evaluating risks of painkillers
Authors: Jeanne Lenzer
Journal: BMJ (2004)

<b>Background: </b>SARS-CoV-2, a novel coronavirus from the same family as SARS-CoV and Middle East Respiratory Syndrome coronavirus, has overrun worldwide leading the World Health Organization to declare a pandemic. The aim of study was to clarify high-risk factors for COVID-19 with multivariate analysis and establish a predictive model of disease progression to help clinicians better choose a therapeutic strategy. With the latest in technology and research, and further studies into the pathogenesis Evaluate, clinical implications, identification, diagnosis, and treatment of COVID-19 will push society past this pandemic. <b>Methods: </b>A comprehensive search of PubMed, MEDLINE, UptoDate, Natural MEDLINE, Embase, and Web of Science electronic databases was made, using the following search terms: COVID-19，COVID-19 SCORE，COVID-19 diagnosis，COVID-19 management, coronavirus, and SARS-CoV-2 as keywords for our search. We included scientific publications from December 1, 2019 to April 30, 2021 which focused on clinical characteristics of and treatments for SARS-CoV-2 were eligible for inclusion. We screened all reference lists of relevant studies in order to identify any missing publications. <b>Results: </b>A total of 31 articles. We found that the main symptoms of COVID-19 are fever, cough, fatigue, dyspnea, sore throat, headache, diarrhea, and gastrointestinal issues. Realtime PCR is used as a diagnostic tool using nasal swab, tracheal aspirate or bronchoalveolar lavage samples. Computed tomography findings are important for both diagnosis and follow-up. To date, there is no evidence of any effective treatment for COVID-19. <b>Conclusions: </b>Prognosis scores routinely using the COVID score model, this guideline is not to replace clinical professional judgment or expert advice. Even in countries with adequate levels of vaccination, the epidemic could recur if indoor ventilation is not properly addressed. Governments should acknowledge scientific evidence and take steps to develop official regulations and guidelines for indoor space ventilation to reduce the spread of COVID-19.
The Role of Radiation Therapy in Malignant Thymoma: A Surveillance, Epidemiology, and End Results Database Analysis
Authors: Annemarie T. Fernandes, Eric T. Shinohara, Mengye Guo, Nandita Mitra, Lynn D. Wilson, Ramesh Rengan, James M. Metz
Journal: Journal of Thoracic Oncology (2010)
The Pericardial Effusion Pattern on Phase Images
Authors: C M PAVEL, J KAHN, S RICH, P GONZALEZ, S TURNER, D G PAVEL
Journal: Clinical Nuclear Medicine (1984)

The effect of pericardial effusion on phase images of gated studies was investigated. Twenty-six patients with suspected or known pericardial effusion were correlated with echocardiography and/or clinical and other laboratory data to ascertain the presence and size of effusion. The phase image pattern and parameters were compared to the results previously obtained in seven normal patients, and in 26 patients with documented regional wall motion abnormalities but no evidence of pericardial effusion. The phase pattern was graded into five categories: typical (IV) (wide histogram, well defined concentric convex pattern, progressive delay toward the inferolateral area, identifiable also over the right ventricle); less pronounced (III); atypical (II); ill defined changes (I); and normal (0). Results: Group L (large pericardial effusion): four of six had pattern (IV) and the left ventricular histogram showed abnormal parameters. These patients had large free effusions in the pericardial sac and none had regional wall motion abnormalities. Two of six had pattern (III) and (II) but also had ancillary pericardial pathology and/or decreased ejection fraction. Group M (moderate pericardial effusion), S (small pericardial effusion), and A (absent pericardial effusion, but not normal) had variable phase images and numeric parameters. After therapeutic drainage of pericardial fluid two patients changed pattern from IV and III to 0 and a third from III to I. Category IV pattern is 100% specific for pericardial effusion; the combination of category IV or III is 87.5% specific and 61% sensitive for large and moderate pericardial effusion. The specificity of the combination of grades IV and III rose to 97% when the suspected pericardial effusion group was compared to 26 patients with well documented regional wall motion abnormality but no pericardial effusion. A good correlation was found between category III and IV pericardial effusion pattern and the presence of swinging motion as documented by echocardiography. In conclusion, the phase changes can be useful in detecting large or moderate pericardial effusion due to the high specificity of patterns IV and III. More importantly, awareness of this phase pattern is useful in avoiding misinterpretations when evaluating the phase image for regional wall motion abnormalities or for consequences of electrical disturbances.
Effects of Coronary Collateral Circulation on Tp-e interval, Tp-e/QT and Tp-e/QTc Ratios in Coronary Artery Disease Patients
Authors: Hakan Taşolar, Ömür Otlu, Adil Bayramoğlu, Mehmet Ballı, Mustafa Çetin, Burak Altun, Hasan Pekdemir, Ramazan Özdemir
Journal: Journal of the American College of Cardiology (2013)
Director of mental health trust made suggestive remarks to patients and trainees, GMC hears
Authors: C. Dyer
Journal: BMJ (2010)

The former medical director of a mental health trust offered to suck a patient’s nipples and asked a trainee whether she had ever had sexual contact with her brother, the General Medical Council alleged this week.

Andrew Clayton, who was joint medical director at Derbyshire Mental Health Services NHS Trust between 1993 and 2006, also faces being struck off the medical register as a result of being found guilty at Derby Crown Court on charges relating to child pornography.

The consultant psychiatrist, who practised in south Derbyshire …
Remarks on Animal Vaccination
Authors: E. Hart
Journal: BMJ (1881)

when he began to lose flesh and strength, was always hungry, and suffered much from diarrhcea.His legs began to swell, and he gradually became worse, until, finally, he gave up work and came under medical treatment.lie had never noticed anything wrong with his water, and did not know that he passed an unusually large quantity.There was no history of syphilis.On admission, he was found to be much emaciated, his weight being only a little over eight stone.He was curiously apathetic, and rarely volunteered any statement as to his feelings or sensations.On ex- amination of the chest, it was found that there was dulness at both apices, with a little fine crepitation.The bowels were regular, and the motions were passed without difficulty.The urine was always acid, and free from albumen.It contained a large amount of sugar, the quantity passed in the twenty-four hours varying from one to two pounds.His appetite was voracious, and it was difficult to satisfy his hunger.He suffered from time to time from boils, which usually gave a great deal of trouble.His sight was good, and there was no cata- ract.He had been for some time under the care of Dr. Netherclift, who had treated him with liquid extract of opium with marked benefit.With the view of giving the Bethesda water a fair trial, it was deter- mined to divide the observations on the urine into four series; I. Patient on ordinary diet ; 2. Patient on ordinary diet plus Bethesda water; 3. Patient on restricted diet; 4. Patient on restricted diet plus Bethesda water.The result will be seen from the accompanying table. FluidUrine spc Grains Date.taken in passed in Speific of Sugar 288x.h4kenours.24 hs 1 Gravity, in 24 24 hours, h~~~~~lours.
Abnormal Menstrual Bleeding
Authors: David A. Krause
Journal: JAMA (1975)

To the Editor.—  In Dr Altcheck's reply in the QUESTIONS AND ANSWERS section (233:182, 1975), I think the author should have also included an ultrasound examination of the pelvis as one of the procedures to be recommended if no cause of bleeding can be visualized on speculum examination. We have been able to discover unsuspected pregnancy, masses, pelvic inflammatory disease, and other findings quickly and noninvasively.
791-4 Prospective Assessment of Revascularization Appropriateness Scoring Systems: A Comparison of RAND Expert Panel Ratings, ACC/AHA Guidelines, and the University of Maryland Revascularization Appropriateness Score
Authors: Michael A. Lauer, Andrew A. Ziskind, Cynthia C. Lemmon, Robert A. Vogel
Journal: Journal of the American College of Cardiology (1995)
Long-term, multilineage hematopoiesis occurs in the combined absence of β-catenin and γ-catenin
Authors: Grégoire Jeannet, Marina Scheller, Léonardo Scarpellino, Stéphane Duboux, Noemie Gardiol, Jonathan Back, Fabien Kuttler, Ilaria Malanchi, Walter Birchmeier, Achim Leutz, Joerg Huelsken, Werner Held
Journal: Blood (2007)
Cancer-Specific High-Throughput Annotation of Somatic Mutations: Computational Prediction of Driver Missense Mutations
Authors: Hannah Carter, Sining Chen, Leyla Isik, Svitlana Tyekucheva, Victor E. Velculescu, Kenneth W. Kinzler, Bert Vogelstein, Rachel Karchin
Journal: Cancer Research (2009)

Large-scale sequencing of cancer genomes has uncovered thousands of DNA alterations, but the functional relevance of the majority of these mutations to tumorigenesis is unknown. We have developed a computational method, called Cancer-specific High-throughput Annotation of Somatic Mutations (CHASM), to identify and prioritize those missense mutations most likely to generate functional changes that enhance tumor cell proliferation. The method has high sensitivity and specificity when discriminating between known driver missense mutations and randomly generated missense mutations (area under receiver operating characteristic curve, >0.91; area under Precision-Recall curve, >0.79). CHASM substantially outperformed previously described missense mutation function prediction methods at discriminating known oncogenic mutations in P53 and the tyrosine kinase epidermal growth factor receptor. We applied the method to 607 missense mutations found in a recent glioblastoma multiforme sequencing study. Based on a model that assumed the glioblastoma multiforme mutations are a mixture of drivers and passengers, we estimate that 8% of these mutations are drivers, causally contributing to tumorigenesis.
Membrane markers, target cell specificity, and sensitivity to biological response modifiers distinguish human natural cytotoxic from human natural killer cells.
Authors: M Rola-Pleszczynski, H Lieu, A K Sullivan, M Girard
Journal: Journal of Clinical Investigation (1985)

In the present report, we provide evidence for the distinct existence of a human natural cytotoxic (HNC) cell. This HNC cell can be identified by the monoclonal antibody HNC-1A3 and by the absence of the T10 antigen, other antigenic markers being shared, at least in part, with natural killer (NK) cells, T cells, or monocytes. In addition, the HNC cell preferentially kills the MA-160 target, the herpes simplex virus-1-infected MA-160 cell line, and the two human tumor cell lines HEp-2 and HF-2. It has weak lytic activity against the NK-sensitive K562 cell line or its relatively NK-resistant clone I subline. The cytotoxic activity of the HNC cell is not augmented by interferon but is markedly enhanced by interleukin 2 and by a measles-virus-induced factor (MVF). Furthermore, it is not inhibited by cyclosporin A (CsA), in contrast to NK cell cytotoxicity against the K562 target cell line which is augmented by interferon, inhibited by CsA, and not affected by MVF. These data suggest that spontaneously cytotoxic cells may belong to more than one subset of human lymphocytes, and that HNC cells may be defined in man using membrane markers, target cell specificity, and sensitivity to biological response modifiers.
Hepatic fibrosis as a predictor of hepatic regenerative activity after partial hepatectomy in the rat
Authors: Ethel L. Macintosh, Tony Gauthier, Norman M. Pettigrew, Gerald Y. Minuk
Journal: Hepatology (1993)

Liver regeneration is an essential component of the recovery period after partial hepatectomy. Unfortunately, tests that accurately predict regenerative activity in the postoperative period have yet to be described. This study was designed to determine whether the extent of hepatic fibrosis correlates with liver regeneration activity after partial hepatectomy in rats with carbon tetrachloride-induced liver disease. Two groups of adult male Sprague-Dawley rats (12 to 30/group) were treated for 20 to 22 wk with weekly intragastric doses of carbon tetrachloride or vehicle. All rats then underwent 70% hepatectomy while under ether anesthesia. Liver regeneration activity was determined at 24 and 48 hr by [3H]thymidine incorporation into DNA. Hepatic fibrosis was calculated at the time of partial hepatectomy by automated image analysis on Van Gieson-stained liver tissue. Although a significant inverse correlation was found between the extent of hepatic fibrosis and DNA synthesis when all rats were considered (carbon tetrachloride-treated and vehicle-treated) at 24 and 48 hr after partial hepatectomy (r = -0.4943 and -0.7396, respectively; p < 0.05), no such correlation existed when carbon tetrachloride-treated rats were considered independently (r = -0.3231 and -0.0910 at 24 and 48 hr, respectively). In conclusion, we believe that in diseased livers, preoperative quantitation of hepatic fibrosis on automated image analysis does not serve as a useful predictor of liver regeneration activity.
657. Combination Therapy with Cyclophosphamide and the Oncolytic Herpes Virus Mutant rRp450, Expressing a Cyclophosphamide Prodrug, Is Clinically Safe by Intratumoral, Intravenous, and Intracerebral Administration in an HSV-1 Susceptible Mouse Model
Authors: Mark A. Currier, Yonatan Y. Mahller, Greg Stroup, Hirokazu Kambara, E.A. Chiocca, Timothy P. Cripe
Journal: Molecular Therapy (2006)

PURPOSE: Attenuated Herpes simplex virus (HSV) mutants are being actively pursued for cancer therapy. rRp450 is derived from the HSV-1 strain KOS, but is deleted for the UL39 gene (encoding ICP6, the large subunit of ribonucleotide reductase) and replaced by the rat CYP2B1 gene (encoding a cytochrome P450 enzyme that activates oxazophosphorines, e.g. cyclophosphamide). While cyclophosphamide has been shown to enhance antitumor efficacy of rRp450, safety studies of the combination have not been reported. We tested rRp450 for virus attenuation in primary cells and for toxicity in FVB/N mice following intratumoral, intravenous and intracerebral administration alone or in combination with systemic cyclophosphamide. METHODS: Normal human primary cells were infected with rRp450 or wild-type KOS and virus production measured. FVB/N mice were administered 10^8 pfu rRp450 by intratumoral, intravenous and intracerebral routes alone or in combination with intraperitoneal cyclophosphamide at 50 or 200 mg/kg. Blood was collected to determine early (3 days) and late (28 days) effects on bone marrow function, liver function and renal function. Mice were also followed for survival. Wild-type KOS was administered to validate the susceptibility of FVB/N mice to HSV-1 infection. RESULTS: Relative to wild-type, replication of rRp450 wasattenuated by 3–4 orders of magnitude in primary human hepatocytes, differentiated primary human foreskin keratinocytes and differentiated primary human Schwann cells. Whereas intravenous wild-type virus was uniformly neurotoxic at 10^5 pfu and fatal at 10^6 pfu, and intracerebral virus was 80% and 100% fatal at 10^4 pfu and 10^5 pfu, respectively, intravenous and intracerebral rRp450 at 108 pfu was well tolerated. The combination of intravenous or intracerebral rRp450 with systemic cyclophosphamide was also without untoward effects. Intratumoral or intravenous rRp450, alone or in combination with cyclophosphamide, had no clinically significant effects on blood counts, serum electrolytes, liver function or kidney function compared with cyclophosphamide alone. CONCLUSIONS: In vitro replication studies suggest rRp450 is attenuated by 3–4 orders of magnitude. The FVB/N mouse is highly susceptible to wild type HSV-1 and is therefore a relevant model for preclinical toxicology of HSV-1 mutants. The virus rRp450, expressing the CYP2B1 gene product, was safe at the highest dose tested of 10^8 pfu by intravenous, intracerebral, and intratumoral administration. There were no additional toxicities of combination virus plus cyclophosphamide compared with cyclophosphamide alone. These data suggest the rRp450/prodrug combination is safe for testing in early phase human clinical trials.