tbuckley/cabot-search huggingface dataset:
Doctors, Drug Companies, and Gifts
Authors: James Berry
Journal: JAMA (1990)

<h3>To the Editor.—</h3> I disagree with the contention of Chren et al<sup>1</sup>that drug companies' educational gifts are less corrupting than direct gifts to physicians. I view sponsorship of physicians' education by drug companies as having the potential for more subtle influences on our behavior and therefore as being a much more insidious form of influence than direct gifts. Drug companies ostensibly spend money to provide unbiased, scientifically based information to prescribers of drugs, but they are not going to present such information unless it is favorable to their products. In my remote area, outside speakers from university medical centers often are flown up here with drug companies' money. A professor whose plane ticket has been paid for by a pharmaceutical manufacturer is unlikely to trash that company's products. It is hard to believe that the editors of the many throwaway medical journals we receive are unaware of
Transverse Rupture of External Auditory Meatus
Authors: D. R. K. Reid
Journal: BMJ (1946)

sutures.Access to the depth of the wound is made easy, and the insertion of catgut su:ures for the repair of the vaginal mucosa and deep muscles made relatively accurate.After the catgut sutures have been inserted and tied the skin is closed by tying the free ends of the silkworm sutures.
Medical evidence exposes US use of torture
Authors: Peter Moszynski
Journal: BMJ (2008)

The government and the drug industry this week reached an outline agreement on a new contract for drug prices in the United Kingdom over the next five years.It is expected that the deal will cut the annual £9bn (€11bn; $18bn) drug bill in the UK's health services by 5% by 2009.The announcement follows a year of intense and tough negotiations after the Department of Health said it was unilaterally cancelling the current pharmaceutical price regulation scheme (PPRS) halfway through its planned duration (BMJ 2007;335:273).The PPRS, which normally runs for five years, allows companies to set drug prices freely but caps their overall profits.The current scheme began in 2005, with a 7% price cut, and was supposed to end in 2010.Under pressure to cut costs at a time when the growth in the NHS budget is slowing, the government sought a fresh reduction of 10%, arguing that drug prices in Britain were among the highest in Europe.Partly aided by changing exchange rates, the industry claimed instead that British prices were nearer to the European average.It also expressed concerns that the government risked undermining the UK's historical attractiveness for research and development investment by creating instability through reneging on the PPRS deal.The new contract entails a price freeze until the end of this year and then a minimum price cut of 2% in patented drugs at the start of 2009.There will also be bigger reductions in the price of branded drugs no longer on patent, providing an overall reduction of 5%.Further price cuts are possible in future years if the drug bill increases by more than 6.7% annually.In line with recommendations last year from the Office of Fair Trading (BMJ 2007;334:383), the government plans to ensure that prices paid for new drugs more closely reflect the value that they offer.Andrew Jack is the pharmaceuticals correspondent for the Financial Times. Government and industry reach pricing deal to cut drugs bill
Acute myeloblastic leukemia presenting as apparent acute otitis media
Authors: Yves Bertrand, Jean‐Jacques Lefrère, Guy Leverger, Madeleine Bonnet, Hervé Lacombe, Gérard Lasfargues
Journal: American Journal of Hematology (1988)

Abstract Three cases of acute myeloblastic leukemia of FAB‐M2 type revealed by an isolated otitis media are reported. This mean of revelation is valuable for early diagnosis and treatment of the disease. A karyotype was performed in two cases and showed an 8;21 translocation. As far as we know, these are the first acute myeloblastic leukemia cases with otitis media reported in which an 8;21 translocation was detected.
ABC of allergies: Venom allergy
Authors: P. W Ewan
Journal: BMJ (1998)

Stings from bees and wasps, the most common stinging insects in Britain, can cause severe allergic reactions, including anaphylaxis. Coroners’ data suggest that an average of four deaths from bee or wasp stings occur each year in the United Kingdom, but this is almost certainly an underestimate because venom anaphylaxis is not always recognised as the cause of death.
Values in Modern Medicine
Authors: Lester S. King
Journal: JAMA (1973)

<h3>In Sickness and in Health: Reflections on the Medical Profession,</h3> by Earle P. Scarlett (Charles G. Roland, ed), 253 pp, $10, McClelland &amp; Stewart, 1972. Dr. Middleton, now 82, has had an illustrious career in medicine as a practicing physician, teacher, and administrator, and his long connection with the University of Wisconsin has been honored by the new medical library building that bears his name. Moreover, he is a humanist, historian, and philosopher whose views not only have current interest but will continue to interest future generations of physicians. Dr. Middleton has participated in the great formative years of modern medicine. He has personally known many of the leading medical figures, including several whose heyday was in the late 19th century. His experiences and descriptions help recreate the environment in which medical progress flourished. In the many essays here reprinted —almost all of them written in the 1950s and 1960s—he shows himself a literate figure who has a keen eye for the problems of the past and their relevance to the present. The essays deal
Endothelial shear stress in the evolution of coronary atherosclerotic plaque and vascular remodelling: current understanding and remaining questions
Authors: J. J. Wentzel, Y. S. Chatzizisis, F. J. H. Gijsen, G. D. Giannoglou, C. L. Feldman, P. H. Stone
Journal: Cardiovascular Research (2012)

The heterogeneity of plaque formation, the vascular remodelling response to plaque formation, and the consequent phenotype of plaque instability attest to the extraordinarily complex pathobiology of plaque development and progression, culminating in different clinical coronary syndromes. Atherosclerotic plaques predominantly form in regions of low endothelial shear stress (ESS), whereas regions of moderate/physiological and high ESS are generally protected. Low ESS-induced compensatory expansive remodelling plays an important role in preserving lumen dimensions during plaque progression, but when the expansive remodelling becomes excessive promotes continued influx of lipids into the vessel wall, vulnerable plaque formation and potential precipitation of an acute coronary syndrome. Advanced plaques which start to encroach into the lumen experience high ESS at their most stenotic region, which appears to promote plaque destabilization. This review describes the role of ESS from early atherogenesis to early plaque formation, plaque progression to advanced high-risk stenotic or non-stenotic plaque, and plaque destabilization. The critical implication of the vascular remodelling response to plaque growth is also discussed. Current developments in technology to characterize local ESS and vascular remodelling in vivo may provide a rationale for innovative diagnostic and therapeutic strategies for coronary patients that aim to prevent clinical coronary syndromes.
PCB and PCDF congeners in the blood and tissues of yusho and yu-cheng patients.
Authors: Y Masuda, H Kuroki, K Haraguchi, J Nagayama
Journal: Environmental Health Perspectives (1985)

Polychlorinated biphenyl (PCB) poisonings occurred in western Japan, where it is called yusho, in 1968, and in central Taiwan, where it is called yu-cheng, in 1979. The average concentrations of PCBs in the adipose tissue, liver and blood of yusho patients and in the blood of yu-cheng patients were 1.9 ppm, 0.08 ppm, 6.7 ppb and 99 ppb, respectively. Seven PCB congeners, such as 2,4,5,3',4'-pentachloro-, 2,3,4,3',4'-pentachloro-, 2,4,5,2',4',5'-hexachloro-, 2,3,4,2',4',5'-hexachloro-, 2,3,4,5,3',4'-hexachloro-, 2,3,4,5,2',4',5'-heptachloro- and 2,3,4,5,2',3',4'-heptachloro biphenyls were identified in the blood and tissues of patients with yusho and yu-cheng and controls. The concentration of 2,3,4,5,3',4'-hexachlorobiphenyl was comparatively higher in the patients than in controls. The concentrations of polychlorinated dibenzofurans (PCDFs) in the adipose tissue and liver of yusho patients were 6 to 13 ppb and 3 to 25 ppb, respectively, while no PCDFs were detected in the controls. Major PCDF congeners identified in the tissues and blood of yusho and yu-cheng patients were the 2,3,6,8-tetrachloro-, 2,3,7,8-tetrachloro-, 1,2,4,7,8-pentachloro-, 2,3,4,7,8-pentachloro- and 1,2,3,4,7,8-hexachlorodibenzofurans (DFs), of which the 2,3,4,7,8-pentachloro compound was predominant. The concentrations of methylthio-PCB in the liver, lung and adipose tissue of yusho patients were 0.1 to 0.5, 0.2 to 1.4 and 0.5 to 1.0 ppb, respectively, and those of methysulfone PCBs were 0.3 to 0.7, 1.0 to 2.5 and 0.7 to 1.0 ppb, respectively. Some of the major peaks of the PCB methylthio and methylsulfone derivatives were identical in gas chromatographic retention times with those of 4-methylthio- and 4-methylsulfone-2,5,2',5'-tetrachlorobiphenyl PCDFs, especially 2,3,4,7,8-pentachloro DF, appear to be mainly responsible in the poisonings.
Insomnia: Principles and Management
Authors: N. Zisapel
Journal: BMJ (2004)

Sleep—a state marked by lessened consciousness, lessened movement of the skeletal muscles, and slowed-down metabolism—has an essential restorative function and an important role in memory consolidation. It is an orchestrated neurochemical process involving sleep promoting and arousal centres in the brain. Sleep propensity depends on two main factors: the amount of accumulated sleep deprivation and the circadian clock phase enhancing sleep at night.

Insomnia is a symptom, resulting from insufficient sleep or sleep of poor quality, with negative effects on subsequent daytime functioning. The prevalence of insomnia increases steeply during the fifth decade of …
CD4+CD25+Foxp3+ Tregs resolve experimental lung injury in mice and are present in humans with acute lung injury
Authors: Franco R. D’Alessio, Kenji Tsushima, Neil R. Aggarwal, Erin E. West, Matthew H. Willett, Martin F. Britos, Matthew R. Pipeling, Roy G. Brower, Rubin M. Tuder, John F. McDyer, Landon S. King
Journal: Journal of Clinical Investigation (2009)

Acute lung injury (ALI) is characterized by rapid alveolar injury, inflammation, cytokine induction, and neutrophil accumulation. Although early events in the pathogenesis of ALI have been defined, the mechanisms underlying resolution are unknown. As a model of ALI, we administered intratracheal (i.t.) LPS to mice and observed peak lung injury 4 days after the challenge, with resolution by day 10. Numbers of alveolar lymphocytes increased as injury resolved. To examine the role of lymphocytes in this response, lymphocyte-deficient Rag-1-/- and C57BL/6 WT mice were exposed to i.t. LPS. The extent of injury was similar between the groups of mice through day 4, but recovery was markedly impaired in the Rag-1-/- mice. Adoptive transfer studies revealed that infusion of CD4+CD25+Foxp3+ Tregs as late as 24 hours after i.t. LPS normalized resolution in Rag-1-/- mice. Similarly, Treg depletion in WT mice delayed recovery. Treg transfer into i.t. LPS-exposed Rag-1-/- mice also corrected the elevated levels of alveolar proinflammatory cytokines and increased the diminished levels of alveolar TGF-beta and neutrophil apoptosis. Mechanistically, Treg-mediated resolution of lung injury was abrogated by TGF-beta inhibition. Moreover, BAL of patients with ALI revealed dynamic changes in CD3+CD4+CD25hiCD127loFoxp3+ cells. These results indicate that Tregs modify innate immune responses during resolution of lung injury and suggest potential targets for treating ALI, for which there are no specific therapies currently available.
Heterogeneity in breast cancer
Authors: Kornelia Polyak
Journal: Journal of Clinical Investigation (2011)

Breast cancer is a heterogeneous disease. There is a high degree of diversity between and within tumors as well as among cancer-bearing individuals, and all of these factors together determine the risk of disease progression and therapeutic resistance. Advances in technologies such as whole-genome sequencing and functional viability screens now allow us to analyze tumors at unprecedented depths. However, translating this increasing knowledge into clinical practice remains a challenge in part due to tumor evolution driven by the diversity of cancer cell populations and their microenvironment. The articles in this Review series discuss recent advances in our understanding of breast tumor heterogeneity, therapies tailored based on this knowledge, and future ways of assessing and treating heterogeneous tumors.
Does meditation swamp working memory?
Authors: Ilkka Pyysiäinen
Journal: Behavioral and Brain Sciences (2006)

Religionists often presuppose that “mysticism” aims at somehow emptying the mind. In the light of evidence, however, meditation seems rather to consist of ritualized action without an explicit emphasis on subjective experience. Boyer &amp; Lienard's (B&amp;L's) theory of ritualized action as “swamping” working memory thus might help explain the effects of meditation without postulating experiential goals the “mystics” obviously do not have.
Anti-p53 Antibodies in Sera of Workers Occupationally Exposed to Vinyl Chloride
Authors: G. E. Trivers, H. L. Cawley, V. M. G. DeBenedetti, M. Hollstein, M. J. Marion, W. P. Bennett, M. L. Hoover, C. C. Prives, C. C. Tamburro, C. C. Harris
Journal: JNCI Journal of the National Cancer Institute (1995)

Background : The p53 tumor suppressor gene (also known as TP53) is often mutated in a wide variety of cancers, including angiosarcoma of the liver (ASL). Anti-p53 antibodies have been detected in the sera of patients with leukemia, childhood lymphoma, or cancers such as those of the breast, lung, colon, esophagus, and liver (hepatocellular carcinoma). Purpose : The objective of this study was to determine the prevalence and time of appearance of serum anti-p53 antibodies during the pathogenesis of ASL associated with occupational exposure to vinyl chloride. Methods : Enzyme-linked immunoassay (EIA) was used to detect anti-p53 antibodies in 148 serum samples from 92 individuals occupationally exposed (in France or in Kentucky) to vinyl chloride; 15 of these individuals (six from France and nine from Kentucky) had ASL. A subset of coded EIA–positive and EIA-negative sera was further analyzed for anti-p53 antibodies by immunoblotting and immunoprecipitation. Nucleotide sequence analysis of exons 5–8 of the p53 gene was conducted on ASL DNA from six patients. We tested sera from 31 men who had no occupational exposure to vinyl chloride; they made up the control group. Statistical analyses were done using the Kruskal-Wallis chi-squared approximation and the Wil-coxon two-sample test for normal approximation. All P values result from two-sided tests. Results: Fourteen serum samples (from nine individuals) were positive in the EIA. Five of the 15 individuals with ASL were positive for anti-p53 antibodies by EIA, immunoblotting, and immunoprecipitation: one individual at 11.3 and 10.8 years before diagnosis, another at 4 months before and shortly after diagnosis, and three when diagnosed or shortly thereafter. Four of the 77 vinyl chloride-exposed workers without diagnosed ASL were positive for anti-p53 antibodies; two of the four had symptoms related to vinyl chloride toxicity. Tumors from three of the six vinyl chloride-exposed workers from which sufficient DNA for analysis was obtained had A:T to T:A missense mutations of the p53 gene. Anti-p53 antibodies were detected in two of these individuals. Among the control group, two of 15 serum samples from 15 lung cancer patients and zero of 15 serum samples from control subjects without cancer had anti-p53 antibodies at substantially lower levels than the nine (10%) of 92 vinyl chloride-exposed workers who were positive for anti-p53 antibodies. Conclusions and Implications : Serum anti-p53 antibodies can predate clinical diagnosis of certain tumors, such as ASL, and may be useful in identifying individuals at high cancer risk, such as workers with occupational exposure to vinyl chloride. [J Natl Cancer Inst 1995;87:1400-7].
Can children be protected from the effects of war?
Authors: D. Southall, M. Carballo
Journal: BMJ (1996)

The 1989 Convention on the Rights of the Child is one of the most important steps that the United Nations has taken to address the needs of children throughout the world. It reflects a growing concern about the adverse conditions that children are being increasingly exposed to and recognises the threat that these conditions constitute for the future of society as a whole. Article 6 of the convention refers to the inherent right of all children to life.

Improving the health of children has been the focus of international effort for many years and progress has been made. But, as we approach the end of a century which has been endowed with advances in medical science and technology, article 6 stands out as an unmet challenge.

In the past 10 years over one and a half million children have died in war zones. Another four million have been permanently disabled. Some estimates place the number of people, a large proportion of them children, who have been forced from their homes at over 50 million. Over one million children have been orphaned and countless millions have been so badly traumatised that they are psychologically scarred for life. The rights of …
Bronchogenic carcinoma, stages 3 and 4. Palliation by surgery
Authors: A. Ochsner
Journal: JAMA (1966)

Although surgeons hope that excisional treatment of cancer of the lung will be curative in many instances, far too frequently it proves to be only palliative. At one time, I believed that the curability rate of surgical extirpation of cancer of the lung would be higher if the diagnosis were made earlier. Further experience has demonstrated, however, that it is extremely difficult to make an early diagnosis, probably because carcinoma of the lung is early angio-invasive in character. Hurst Hatch, MD, who is in charge of our Pulmonary Function Laboratory, conceived the idea that routine cytological study of peripheral arterial blood of patients with carcinoma of the lung should yield a higher percentage of positive neoplastic cells than examination of the systemic venous blood. Of all patients who had pulmonary function studies in our laboratory during a period of more than three years, none without cancer of the lung had
Anticoagulant Studies with "Marcoumar," A New Coumarin Derivative
Authors: I. A. M. Prior
Journal: BMJ (1955)

TREATMENT OF ASTHMA MBICpALJOU out, has not been given in detail because the number of the severe asthmatics under treatment is not large enough for statistical evaluation.Even so, among the severe asth- matics no greater number were helped by an autogenous vaccine than by the carbol-saline.This is further evidence that, under the conditions in which the vaccine was given, any benefit obtained is apparently non-specific in effect.The trial shows that the ordinary palliative measures, combined with the psychological support supplied by a weekly visit to and injection by the patient's own doctor, are capable of giving prolonged benefit to half the patients.It may therefore be assumed that in asthma any result that does not show a statistically significant improvement on a figure of 50% relieved does not support the value of any allegedly specific therapy.It must, however, be pointed out that although this trial did not show any statistically significant difference between autogenous vaccine therapy and saline injections in the treatment of asthma, it does not necessarily follow that bacterial vaccines may not be of specific benefit in the treat- ment of asthma.No attempt was made here to compare different strengths or qualities of vaccines or the spacing of the injections, or other possible variables in vaccine therapy. SummaryIn a controlled trial in some 200 cases of intrinsic (infective) asthma, kept under observation for one year or more and given general supportive treatment, regular injections of autogenous bacterial vaccines produced no greater benefit to the patients than similar injections of carbol-saline.In both groups oyer 50% of the patients benefited from the treatment received.
ATP-dependent K+ channels modulate vasoconstrictor responses to severe hypoxia in isolated ferret lungs.
Authors: C M Wiener, A Dunn, J T Sylvester
Journal: Journal of Clinical Investigation (1991)

In normo- and hypoglycemic ferret lungs, the pulmonary vascular response to severe hypoxia (PiO2 less than or equal to 10 mmHg) is characterized by an initial intense vasoconstriction followed by marked vasodilation, whereas in hyperglycemic lungs, vasodilation is minimal, causing vasoconstriction to be sustained. In contrast, the response to moderate hypoxia is characterized by a slowly developing sustained vasoconstriction which is unaffected by glucose concentration. To determine the role of ATP-dependent K+ (KATP) channels in these responses, we examined the effects of cromakalim, which opens KATP channels, and glibenclamide, which closes them. During steady-state vasoconstriction induced in isolated ferret lungs by moderate hypoxia, cromakalim caused dose-dependent vasodilation (EC50 = 7 x 10(-7) M) which was reversed by glibenclamide (IC50 = 8 x 10(-7) M), indicating that KATP channels were present and capable of modulating vascular tone. During severe hypoxia in hypoglycemic lungs [( glucose] less than 1 mM), glibenclamide markedly inhibited the secondary vasodilation. Raising perfusate glucose concentration to 14 +/- 0.4 mM had the same effect. As a result, initial vasoconstrictor responses were well sustained. However, neither glibenclamide nor hyperglycemia affected vasoconstrictor responses to moderate hypoxia or KCl, indicating that effects during severe hypoxia were not due to nonspecific potentiation of vasoconstriction. These findings suggest that in the ferret lung (a) severe hypoxia decreased ATP concentration and thereby opened KATP channels, resulting in increased K+ efflux, hyperpolarization, vasodilation, and reversal of the initial vasoconstrictor response; and (b) hyperglycemia prevented this sequence of events.