tbuckley/cabot-search huggingface dataset:
Diabetics, children, and pregnant women.
Authors: E Walker, G Williams
Journal: BMJ (1983)

Diabetes meilitusFor short trips such as package holiday tours diet can be selected from normal menus.Emergency carbohydrate (sweets and starch) must be always available.Ample supplies of personal drugs, insulin, and testing equipment should be taken since new supplies obtained abroad may be Cf ; s>> initially difficult to identify because of different names, tablet sizes, and _ G a ~~~~~~~~~~strengths.Patients taking oral hypoglycaemic agents need not to change their <* s L;; j+3t1 1 schedules even when crossing time zones.Patients on insulin should have individual schedules worked out by their doctor.The following are general guidelines.'C r Y s t _ a .vN ';;>*s IWWhen crossing many time zones it is convenient for the diabetic to remain on home time for injections and carbohydrate intake until arrival.After that each insulin injection can be altered by two to three hours until
Risk of Therapy-Related Secondary Leukemia in Hodgkin Lymphoma: The Stanford University Experience Over Three Generations of Clinical Trials
Authors: Michael Zach Koontz, Sandra J. Horning, Raymond Balise, Peter L. Greenberg, Saul A. Rosenberg, Richard T. Hoppe, Ranjana H. Advani
Journal: Journal of Clinical Oncology (2013)

Purpose To assess therapy-related acute myeloid leukemia/myelodysplastic syndrome (t-AML/MDS) risk in patients treated for Hodgkin lymphoma (HL) on successive generations of Stanford clinical trials. Patients and Methods Patients with HL treated at Stanford with at least 5 years of follow-up after completing therapy were identified from our database. Records were reviewed for outcome and development of t-AML/MDS. Results Seven hundred fifty-four patients treated from 1974 to 2003 were identified. Therapy varied across studies. Radiotherapy evolved from extended fields (S and C studies) to involved fields (G studies). Primary chemotherapy was mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) or procarbazine, mechlorethamine, and vinblastine (PAVe) in S studies; MOPP, PAVe, vinblastine, bleomycin, and methotrexate (VBM), or doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in C studies; and VbM (reduced dose of bleomycin compared with VBM) or mechlorethamine, doxorubicin, vinblastine, vincristine, bleomycin, etoposide, and prednisone (Stanford V) in G studies. Cumulative exposure to alkylating agent (AA) was notably lower in the G studies compared with the S and C studies, with a 75% to 83% lower dose of nitrogen mustard in addition to omission of procarbazine and melphalan. Twenty-four (3.2%) of 754 patients developed t-AML/MDS, 15 after primary chemotherapy and nine after salvage chemotherapy for relapsed HL. The incidence of t-AML/MDS was significantly lower in the G studies (0.3%) compared with the S (5.7%) or C (5.2%) studies (P &lt; .001). Additionally, in the G studies, no t-AML/MDS was noted after primary therapy, and the only patient who developed t-AML/MDS did so after second-line therapy. Conclusion Our data demonstrate the relationship between the cumulative AA dose and t-AML/MDS. Limiting the dose of AA and decreased need for secondary treatments have significantly reduced the incidence of t-AML/MDS, which was extremely rare in the G studies (Stanford V era).
Further Evidence for Expression and Function of the VEGF-C/VEGFR-3 Axis in Cancer Cells
Authors: Jen-Liang Su, Pai-Sheng Chen, Ming-Hsien Chien, PoShen B. Chen, Ya-Huey Chen, Chien-Chen Lai, Mien-Chie Hung, Min-Liang Kuo
Journal: Cancer Cell (2008)
Difficulties Surround Fiber
Authors: Hugh Trowell
Journal: JAMA (1976)

<h3>To the Editor.—</h3> I enjoyed your editorial on fiber feeding (235:182, 1976), but there was no mention of the five basic difficulties. First, crude fiber is the residue of plant food not hydrolyzed by dilute acid or dilute alkali. Food tables report crude fiber. The term dietary fiber was introduced and defined as the residue of plant cells not hydrolyzed by human alimentary enzymes.<sup>1</sup>In most foods, dietary fiber is three to five times the amount of crude fiber. Dietary fiber is derived from (1) structural polymers of plant cell walls, cellulose, the socalled hemicelluloses, and pectic substances, also lignin, and (2) storage nonhydrolyzed polysaccharides within the cell, such as galactomannans in leguminous seeds. No food table reports these constituents. Second, van Soest's detergent method of fiber analysis is preferred in the United States; it was elaborated to analyze ruminant foods. Southgate's chemical fractionation method of fiber analysis is
Phosphorous 32 Eye Tumor Identification Test
Authors: James H. Larose
Journal: JAMA (1976)

THE DIFFERENTIAL diagnosis of choroidal tumor masses presents a continuing challenge to the ophthalmologist. Two major types of neoplasms involve the uveal tract of the eye, namely primary malignant melanoma of the choroid and metastatic lesions from some primary site elsewhere in the body. However, a number of benign lesions, compatible with long life and good vision, can mimic potentially lethal choroidal tumors, and differentiating one from the other can be extremely difficult. Studies in the ophthalmologic literature<sup>1,2</sup>show that mistakes in diagnosis are frequently made, and that approximately one eye of every five enucleated with the diagnosis of malignancy of the choroid does not, in fact, contain a malignant lesion. On the other hand, some eyes that contain potentially lethal tumors are not removed, again because the diagnosis is either delayed or missed. Biopsy of lesions in the wall of the eye is not recommended because (1) biopsy
Interleukin-17 and Prostaglandin E2 Are Involved in Formation of an M2 Macrophage-Dominant Microenvironment in Lung Cancer
Authors: Lunxu Liu, Dongxia Ge, Lin Ma, Jiandong Mei, Sen Liu, Qiuyang Zhang, Fuqiang Ren, Hu Liao, Qiang Pu, Tao Wang, Zongbing You
Journal: Journal of Thoracic Oncology (2012)
Loss-of-function mutations in the gene encoding filaggrin cause ichthyosis vulgaris
Authors: Frances J D Smith, Alan D Irvine, Ana Terron-Kwiatkowski, Aileen Sandilands, Linda E Campbell, Yiwei Zhao, Haihui Liao, Alan T Evans, David R Goudie, Sue Lewis-Jones, Gehan Arseculeratne, Colin S Munro, Ann Sergeant, Gráinne O'Regan, Sherri J Bale, John G Compton, John J DiGiovanna, Richard B Presland, Philip Fleckman, W H Irwin McLean
Journal: Nature Genetics (2006)
Abstract PD5-8: Phase I clinical trial of neoadjuvant BIBF1120 plus weekly paclitaxel (P) in early HER-2 negative breast cancer. CNIO-BR-01-2010/GEICAM 2010-10 study
Authors: M Quintela-Fandino, A Urruticoechea, J Guerra, M Gil, A González-Martin, R Marquez, E Hernandez-Agudo, C Rodríguez-Martin, M Gil, R Bratos, MJ Escudero, R Colomer
Journal: Cancer Research (2013)

Abstract Background: BIBF1120 has shown promising preclinical efficacy in breast cancer, and weekly paclitaxel (P) is a standard of care in BC. We designed a phase I/II trial of BIBF 1120 plus weekly P in early breast cancer, and report here the phase I part of the trial. The recommended dose has been determined and, additionally, efficacy has been assessed. Methods: Eligible patients had pathologically confirmed HER2 negative stage II or IIIA untreated breast cancer. BIBF1120 and P were administered at the following dose levels (DL): DL1: BIBF1120 150 mg bid p.o. days 1-21 plus P 80 mg/ m2 iv on days 1, 8 and 15 q21 days; DL2: BIBF1120 200 mg bid p.o. days 1-21 plus P same dose as level 1, q21 days. On the P-infusion day, the morning BIBF1120 dose was skipped to avoid potential PK interactions. A 3+3 escalation scheme with common dose-limiting toxicity (DLT) definitions was adopted. Four three-week cycles of BIBF1120 plus P followed by 4 AC cycles were administered. Surgery was planned 4-5 weeks after the last AC dose. We report the phase I part results of the phase I/II trial. Results: 9 patients have been evaluated for toxicity (6 patients in DL1 and 3 in DL2). Median age was 47.6 years (38.1-66.7) and 8 patients (89%) were premenopausal; median tumour size was 3.0 cm (2.7-6.5), 6 patients (66.7%) had stage II disease and 3 patients (33.3%) stage III. Seven cases (78%) were hormone-receptor (HR) positive and 2 (22%) negative. Two patients had DLT at DL2: ALT grade 3 (one patient); and ALT grade 4, AST grade 3 and GGT grade 3 (one patient). One case was reduced to DL1 and one withdrew consent after 7 days of treatment. Main related toxicities during treatment: DL1 GGT grade 2 (16.7%), hypertension grade 2 (50%), DL2 ALT grade 3 (33.3%), AST grade 3 (33.3%), bilirubin grade 2 (33.3%), GGT grade 2/3 (100%). Toxicities observed at DL2 were reversible by withholding BIBF1120 administration. Eight patients were evaluable for efficacy after surgery and have been assessed for pathological response: 2/2 (100%) HR(-) and 2/6 (33%) HR(+) patients, for a total of 4/8 (50%) patients, pCR defined as Miller&amp;Payne score scale of 5. Three of these received DL1 and 1 DL2. A total of 6 patients (75%) underwent conservative surgery. Conclusions: Concomitant administration in early stage HER-2 negative breast cancer of BIBF1120 plus P at DL1 was manageable and had mild toxicity, showing remarkable efficacy specially in triple-negative breast cancer. BIBF1120 150 mg bid plus weekly P 80mg/m2 is the recommended dose for the ongoing phase II part of study CNIO-BR-01-2012/GEICAM 2010-10 with an enrolment target of 130 patients, of which 81 have been already recruited. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr PD5-8.
A primer on leading the improvement of systems
Authors: D. M Berwick
Journal: BMJ (1996)

The nurse called me urgently into the room.The child, she said, was in acute respiratory distress.I had never met either Jimmy (the 6 year old boy) or his mother (an inner city single teenage parent) before.His asthma attack was severe, his peak expiratory flow rate only 35% of normal.Twenty years ago my next steps would have been to begin bronchodilator treatment, call an ambulance, and send the boy to hospital.That also would have been the story 10 years ago, or five, or two.But today, when I entered the room, the mother handed me her up to date list of treatments, including nebuliser treatment with P2 agonists, that she had administered with equipment that had been installed in her home.It continued with her graph of Jimmy's slowly improving peak flow levels, which she had measured and charted at home, having been trained by the asthma outreach nurse.She then gave me the nurse's cellular telephone number, along with a specific recommendation on the next medication to try for her son, one that had worked in the past but was not yet available for her to use at home.My reply was interrupted by a knock on my door.It was the chief of the allergy department in my health maintenance organisation.He worked one floor above me in the health centre and, having been phoned by the outreach nurse, had decided to "pop down" to see if he could help.He also handed me a phial of the same new medication that the mother had just mentioned, suggesting that we try it.Two hours later Jimmy was not in a hospital bed; he was at home breathing comfortably.Just to be safe the allergy nurse would be paying him a visit later that afternoon.
835-1 A comparison of adverse events occurring with carvedilol or metoprolol in the treatment of heart failure: Results from COMET
Authors: Philip A Poole-Wilson, Karl Swedberg, John G Cleland, Andrea Di Lenarda, Peter Hanrath, Beatrix Lutiger, Michel Komajda, Marco Metra, Willem J Remme, Armin Scherhag, Andrew Charlesworth, Christian Torp-Pedersen
Journal: Journal of the American College of Cardiology (2004)
Sulphinpyrazone reduces endocardial injury and mural thrombosis
Authors: G. Carter, J. B Gavin
Journal: Cardiovascular Research (1990)

The aim of the study was to investigate the effectiveness of sulphinpyrazone, a drug which stabilises endothelial cell membranes, in reducing endocardial injury and mural thrombosis produced by lactic acid in the left ventricle.The left ventricular endocardium of isolated beating rat hearts, perfused via the aorta with oxygenated Krebs-Henseleit buffer, was exposed for up to 4 h to additional lactic acid (pH 6.4), with and without sulphinpyrazone (100 ng x ml-1). After flushing with buffer, passage of 10 ml blood, and further flushing, the hearts were fixed by coronary perfusion and the endocardium examined by scanning electron microscopy.Hearts from 48 male albino Wistar rats, weight 270-380 g, were used.Morphometric analysis of the surface of the papillary muscles showed that lactic acid caused membrane injury in endothelial cells, up to 30% of which exfoliated. However when sulphinpyrazone was present, endothelial cell damage was reduced and there was up to 75% reduction in the area of exposed basal lamina or connective tissue. This was associated with a corresponding reduction in the extent of platelet adhesion (79%) and thrombus formation (94%).The results show that sulphinpyrazone has the potential to reduce the risk of mural thrombosis following endocardial injury.
THE PREVENTION OF ASIATIC CHOLERA.
Authors: ELMER LEE
Journal: JAMA (1895)

Asiatic cholera is one of the pestilential diseases that remains to menace the happiness and prosperity of the human race. In civilized countries epidemics are more and more rarely occurring, but cholera is still a dreaded and fatal disease in periodical epidemics of wide extent in civilized Europe. Today the disease prevails almost continuously in some portion of southern Europe and western Asia. The people in these countries are of two notable classes; those of the highest, but the majority of the lowest intelligence. Superstitions offer obstacles that so far have prevented the development of prophylactic measures against ravages of epidemic cholera. When a people such as are the occupants of southern Russia, threaten to murder the priest of the parish because he endeavors to introduce, for their use in times of cholera, so simple an agent as carbolic acid, it is not strange that preventive measures make slow headway.
Serum Albumin Level and Physical Disability as Predictors of Mortality in Older Persons
Authors: Maria-Chiara Corti
Journal: JAMA (1994)

To study the relationship between serum albumin level and all-cause mortality in an elderly population and to evaluate the role of albumin level in combination with physical disability status in predicting mortality.Cohort study with a mean follow-up of 3.7 years.Three communities: East Boston, Mass, New Haven, Conn, and Iowa and Washington counties, Iowa.A total of 1486 men and 2630 women aged 71 years and older who consented to have blood drawn.During follow-up, 447 men and 488 women died. In both sexes, there was a graded increase in mortality rate with decreasing albumin level. After adjusting for age, race, education, chronic conditions, and disability status, hypoalbuminemia (< 35 g/L) was associated with a significantly increased risk of mortality in comparison with the reference group (ie, those with albumin levels greater than 43 g/L) (men: relative risk [RR], 1.9; 95% confidence interval [CI], 1.1 to 3.1; women: RR, 3.7; 95% CI, 2.5 to 5.5). Among those with albumin levels in the range usually considered normal (35 g/L to 50 g/L), there was a graded increase in mortality risk from the highest normal to the lowest normal groups. For women, results were similar in separate analyses that considered deaths occurring during the first year and 1 year or more after baseline, while for men the relationship decreased after 1 year. Lower albumin level was associated with an elevated risk of mortality for all categories of causes of death. A 15-level measure that characterized participants according to albumin level and disability status demonstrated that mortality increased with decreasing albumin level and increasing disability level.Serum albumin level is an independent risk factor for all-cause mortality in older persons. A combined measure of albumin and disability reveals a strong gradient in mortality risk and may serve as a simple but useful index of frailty that can identify a high-risk group of older men and women who could be targeted for preventive and treatment efforts.
A Precautionary Approach to Oocyte Donation for Stem Cell Nuclear Transplantation
Authors: Andrea L. Kalfoglou, Mark V. Sauer
Journal: The American Journal of Bioethics (2011)

Ellison and Meliker conclude that oocyte donation for em-bryonic stem cell nuclear transplantation (SCNT) researchis ethically acceptable because the “risk posed by ovar-ian hyperstimulation syndrome (OHSS) is not signiﬁcantenough to warrant undue concern, and much of this canbe eliminated when proper precautions are taken” (Ellisonand Meliker 2011). While we agree that our current knowl-edge base about the acute physical risks to oocyte donorsfrom the donation process should not prevent women fromdonating oocytes for embryo research, there are a numberof ﬂaws and oversights in Ellison and Meliker’s paper thatwe would like to address.First, Ellison and Meliker conduct a literature reviewon OHSS as a basis for their conclusions. The majority ofthis literature is focused on the risk of OHSS in infertilewomen. Within the ﬁeld of reproductive endocrinology, itiswidelyunderstoodthatinfertilewomenareatgreaterriskforOHSSbecausetheygetpregnant(ASRM2008);thus,thisis an inappropriate comparison group.Second, Ellison and Meliker claim this was a thoroughliterature review, but they overlook the growing body ofliterature on the risks of OHSS and
Experimental Studies on the Prevention of Rh Haemolytic Disease
Authors: R. Finn, C. A. Clarke, W. T. A. Donohoe, R. B. McConnell, P. M. Sheppard, D. Lehane, W. Kulke
Journal: BMJ (1961)

BRrrisH MEDICAL JOURNA1because they seemed to recover in two or three days, had their symptoms attributed by parents to some dietary indiscretion.The fact that so many children in this home fell ill in so short a time, immediately suggested that this outbreak was of an infectious nature.During a period of 16 days 19 cases occurred, 13 of them in the space of six days, but an accurate incubation period cannot be deduced from these figures.So far as the children were concerned, the numbers were too small to detect whether age or sex was associated with susceptibility to the virus.Roller towels were in use by the children, and it is possible that the infection was transmitted in this way.The adults, on the other hand, had their own toilet and washing facilities and so were less liable to this form of contamination.The two adults who were affected were mother and daughter, and the young son of this family was also a case.It is therefore a possibility that transmission could have taken place via a towel, W.C. seat, chain-pull, etc., in this house.On the other hand, the father and other son, who were also similarly exposed, were not affected.Examination of stool specimens suggested that on the average the period of infectivity ceases a fortnight after the patient becomes afebrile, although the two adults affected remained positive for eight and nine weeks respectively after clinical defervescence.With such smat!numb-ers it is impossible to state categorically that adults remain positive excretors for longer than children. SummaryAn outbreak of an enterovirus infection in a clhildren's home is described.Of a total of 27 children, 17 showed clinical signs of infection; and of 10 adults connected with the home two were affected.The 19 cases occurred in a 16-day period, 13 of them within the space of six days.The most common presenting symptom was abdominal pain, although frontal headache, alone or associated with abdominal pain, was fairly common.The average temperature was 1000 F. (37.80 C.) and the duration of pyrexia ranged from two to six days.E.C.H.O.type 9 virus was isolated from the faeces of 12 of the 19 subjects who developed clinical illness.Serum from 14 of the 19 cases was examined, and antibodies were present in all 14.
The Association of American Physicians 1886-1986: A Century of Progress in Medical Science
Authors: Kenneth M. Brinkhous
Journal: JAMA (1987)

This volume, written by one of America's great physicans, is a remarkable contribution to the history of American medicine. It is based on the transactions of a senior medical society, the Association of American Physicians, which celebrated its centennial this year. The kaleidoscopic events reflecting the evolution of the major phases of medicine— medical science, medical education, medical practice, and public health— are skillfully interwoven to provide a readable account of the status of medicine since the Association's first assembly on June 17, 1886. A major theme of the book is the crescendo of advances in the basic sciences and their potential or actual application to clinical medicine. These advances are traced from the first meeting, when most papers were presented by pathologists and bacteriologists, through the period in which pathophysiology and biochemistry were in ascendancy to the present day, when the new biologies—modern immunology and molecular biology—have taken over
Tales of the monsoon season
Authors: C. Douglas
Journal: BMJ (1996)

Every year, for three weeks in late summer, Edinburgh dusts off its recurrent pretensions as the Athens of the North. For three weeks—more precisely, for two editions of the Sunday broadsheets—it basks in the reflected glow of its international festival while many of its more sensible citizens take off for holidays somewhere quiet in the country.

For those who stay, and more so for those who visit, festival and fringe combine in a huge funfair of the arts, variously traditional and experimental, safe and weird, commercial and merely self indulgent, and ranging in scale from the mightiest of operas to the now traditional Shakespeare-in-a-phonebox. Buskers abound. Pubs close …
Checking for pregnancy before surgery: summary of a safety report from the National Patient Safety Agency
Authors: T. Lamont, T. Coates, D. Mathew, J. Scarpello, A. Slater
Journal: BMJ (2010)

Some surgical interventions carried out on pregnant women could harm the fetus. If a previously unknown pregnancy is detected before a procedure, such risks can be discussed with the patient. Where necessary, surgery can be postponed or anaesthetic and surgical approaches modified. At present, despite national guidelines,1 it seems that pregnancy status is not always being checked routinely before surgery.

Although robust processes have been established to check for pregnancy before gynaecological procedures and those involving ionising radiation,2 the same precautions seem not to be in place for general surgery. This is important given the scale of the problem—although no major study has been done in the United Kingdom, estimates from the United States suggest a 0.15-2.2% incidence of previously undiagnosed pregnancy at the point of surgery.3 4

Between October 2003 and November 2009, healthcare staff in England and Wales reported 42 serious incidents in which no documented pregnancy check was carried out before a planned procedure. Three of these cases resulted in spontaneous abortion.

A typical incident report reads: “Patient informed me that she had been admitted post-op with PV [vaginal] bleeding and a miscarriage diagnosed therefore pregnant during surgery. …
Large-scale Digitoxin Intoxication
Authors: A. H. Lely, C. H. J. Van Enter
Journal: BMJ (1970)

Because of an error in the manufacture of digoxin tablets a large number of patients took tablets that contained 0·20 mg. of digitoxin and 0·05 mg. of digoxin instead of the prescribed 0·25 mg. of digoxin. The symptoms are described of 179 patients who took these tablets and suffered from digitalis intoxication. Of these patients, 125 had taken the faultily composed tablets for more than three weeks. In 48 patients 105 separate disturbances in rhythm or in atrioventricular conduction were observed on the electrocardiogram. Extreme fatigue and serious eye conditions were observed in 95% of the patients. Twelve patients had a transient psychosis. Extensive ophthalmological observations indicated that the visual complaints were most probably caused by a transient retrobulbar neuritis.