tbuckley/cabot-search huggingface dataset:
Eicosanoid Modulation in Advanced Lung Cancer: Cyclooxygenase-2 Expression Is a Positive Predictive Factor for Celecoxib + Chemotherapy—Cancer and Leukemia Group B Trial 30203
Authors: Martin J. Edelman, Dee Watson, Xiaofei Wang, Carl Morrison, Robert A. Kratzke, Scott Jewell, Lydia Hodgson, Ann M. Mauer, Ajeet Gajra, Gregory A. Masters, Michelle Bedor, Everett E. Vokes, Mark J. Green
Journal: Journal of Clinical Oncology (2008)

Increased expression of eicosanoids in cancer has been associated with adverse prognosis. We performed a randomized phase II trial to test the hypothesis that inhibitors of two eicosanoid pathways (cyclooxygenase-2 [COX-2], celecoxib and 5-lipoxygenase [5-LOX], zileuton) added to chemotherapy would improve outcome in advanced non-small-cell lung cancer (NSCLC).Patients with advanced NSCLC, a performance status of 0 to 2, and no prior therapy were eligible. All patients received carboplatin area under the curve (AUC) 5.5 mg/mL x min day 1 + gemcitabine (1,000 mg/m(2)) days 1 and 8. Patients were randomly assigned to: (a) zileuton 600 mg PO qid, (b) celecoxib 400 mg PO bid, or (c) celecoxib and zileuton at the same doses. Immunohistochemical staining for COX-2 and 5-LOX was performed without knowledge of outcomes.One hundred forty patients were entered and 134 were eligible and treated. There was no survival difference between the arms. COX-2 expression was a negative prognostic marker for overall survival (OS; hazard ratio [HR] = 2.51, P = .019 for index >or= 4; HR = 4.16, P = .005 for index = 9) for patients not receiving celecoxib. Patients with increased COX-2 expression (index >or= 4), receiving celecoxib had better survival than did COX-2-expressing patients not receiving drug (HR = .342, P = .005 for OS; HR = .294, P = .002 for failure-free survival). Multivariate analysis confirmed the interaction of COX-2 and celecoxib on survival. 5-LOX expression was neither prognostic nor predictive.This study failed to demonstrate the value of dual eicosanoid inhibition or benefit from either agent alone in addition to chemotherapy. However, a prospectively defined subset analysis suggests an advantage for celecoxib and chemotherapy for patients with moderate to high COX-2 expression.
Cerebrovascular accident in a 14 year old marathon runner.
Authors: J Phillips, B Horner, T Doorly, J Toland
Journal: BMJ (1983)

the second cytotoxic treatment of a pair usually causes less vomiting than the first.About 18 hours after treatment patients assessed nausea by marking a unipolar visual analogue scale 100 mm long at the point most closely equivalent to their experience, 0 mm being equivalent to no nausea at all and 100 mm the worst nausea imaginable.They recorded the number of vomits with a digital counter, and nausea and vomiting were also graded by a ward observer as none, mild, moderate, or severe.To assess tolerance the occur- rence of any side effects was recorded.Data were analysed by non-parametric statistical methods-namely, visual analogue scores by a split plot analysis of variance after application of an arcsine square root transformation to the raw data, and the total number of patients who did not vomit with the Mann-Whitney test.The incidence of vomiting with the MOPP regimen was greater than that with the CHOP regimen (p < 0-05), but there was no significant difference in these groups between the effects of the three antiemetic treatments.The table shows that all three treatments were similarly effective in preventing vomiting.Proportions (and 0,) of patients zwho did not vomit over 18 hoturs Antiemetic Regimen Chlorpromazine Nonabine 99 mg 15 mg Combination MOPP 9/15 (60) 7/16 (44) 9/16 (56) CHOP 25/31 (81) 28132 (88)24)29 (83) MOPP= Mustine, vincristine, procarbazine, and prednisolone.CHOP = Cyclophosphamide, adriamycin, vincristine, and prednisolone.No patients rated their vomiting as severe, and nausea was rated only mild to moderate.In the patients who received the MOPP regimen the mean visual analogue score was significantly lower on the eighth day than on the first day with all three antiemetic treatments (p< 0-01), confirming the impression that the second cytotoxic treatment of a pair causes less nausea than the first.In this group on day 1 nausea was subjectively less after chlorpromazine than after nonabine, but this trend was not significant.
Bidirectional modulation of insulin action by amino acids.
Authors: M E Patti, E Brambilla, L Luzi, E J Landaker, C R Kahn
Journal: Journal of Clinical Investigation (1998)

Amino acids have been shown to stimulate protein synthesis, inhibit proteolysis, and decrease whole-body and forearm glucose disposal. Using cultured hepatoma and myotube cells, we demonstrate that amino acids act as novel signaling elements in insulin target tissues. Exposure of cells to high physiologic concentrations of amino acids activates intermediates important in the initiation of protein synthesis, including p70 S6 kinase and PHAS-I, in synergy with insulin. This stimulatory effect is largely due to branched chain amino acids, particularly leucine, and can be reproduced by its transamination product, ketoisocaproic acid. Concurrently, amino acids inhibit early steps in insulin action critical for glucose transport and inhibition of gluconeogenesis, including decreased insulin-stimulated tyrosine phosphorylation of IRS-1 and IRS-2, decreased binding of grb 2 and the p85 subunit of phosphatidylinositol 3-kinase to IRS-1 and IRS-2, and a marked inhibition of insulin-stimulated phosphatidylinositol 3-kinase. Taken together, these data support the hypothesis that amino acids act as specific positive signals for maintenance of protein stores, while inhibiting other actions of insulin at multiple levels. This bidirectional modulation of insulin action indicates crosstalk between hormonal and nutritional signals and demonstrates a novel mechanism by which nutritional factors contribute to insulin resistance.
Blinding in Placebo-Controlled Trials
Authors: Ananda S. Prasad
Journal: Annals of Internal Medicine (2001)

Letters19 June 2001Blinding in Placebo-Controlled TrialsAnanda S. Prasad, MD, PhDAnanda S. Prasad, MD, PhDWayne State University; Detroit, MI 48201 (Prasad)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-134-12-200106190-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The points raised in the editorial by Desbiens (1) concerning the problems of maintaining proper blinding in a randomized, double-blind, placebo-controlled trial are valid. In our article (2), to which the editorial refers, we stated that the zinc and placebo lozenges were identical in flavor and texture. This statement was based on our observation that in 20 healthy volunteers who received zinc, only 1 guessed correctly that it was zinc, and that in 20 participants who received placebo, only 2 guessed correctly that they received placebo. We interpreted this to mean that the healthy volunteers could not ...References1. Desbiens NA. Lessons learned from attempts to establish the blind in placebo-controlled trials of zinc for the common cold [Editorial]. Ann Intern Med. 2000;133:302-3. [PMID: 10929173] LinkGoogle Scholar2. Prasad AS, Fitzgerald JT, Bao B, Beck FW, Chandrasekar PH. Duration of symptoms and plasma cytokine levels in patients with the common cold treated with zinc acetate. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 2000;133:245-52. [PMID: 10929163] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Wayne State University; Detroit, MI 48201 (Prasad) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDuration of Symptoms and Plasma Cytokine Levels in Patients with the Common Cold Treated with Zinc Acetate Ananda S. Prasad , James T. Fitzgerald , Bin Bao , Frances W.J. Beck , and Pranatharthi H. Chandrasekar Lessons Learned from Attempts To Establish the Blind in Placebo-Controlled Trials of Zinc for the Common Cold Norman A. Desbiens Blinding in Placebo-Controlled Trials George E. Ehrlich Blinding in Placebo-Controlled Trials Norman A. Desbiens Metrics 19 June 2001Volume 134, Issue 12Page: 1150KeywordsTasteZinc ePublished: 19 June 2001 Issue Published: 19 June 2001 CopyrightCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Correlation of the Extent and Severity of Atherosclerosis in the Coronary and Cerebral Arteries
Authors: K. S. MATHUR, S. K. KASHYAP, V. KUMAR
Journal: Circulation (1963)

A study of correlation of the extent and severity of atherosclerosis in the coronary and cerebral arteries and between their individual branches has been undertaken in 200 consecutive medicolegal autopsies. The coronary atherosclerosis developing first in the second decade appears about 20 years earlier than the cerebral atherosclerosis. There is, however, a significant correlation between the coronary and cerebral arterial beds. There is a significant interbranch relationship within the coronary system. The atherosclerotic process starts earliest in the left anterior descending branch of the coronary arteries. The extent of correlation is more marked between the two branches of the left coronary artery than that of either of them with the right coronary artery. The interbranch relationship in the cerebral arterial bed also shows a significant correlation. Basilar artery shows the maximum atherosclerosis, next in order being middle cerebral artery; the postcerebral artery shows much less affliction to the atheroma and the anterior cerebral artery exhibits a high degree of freedom.
Premorbid Determinants of Left Ventricular Dysfunction in a Novel Model of Gradually Induced Pressure Overload in the Adult Canine
Authors: Masaaki Koide, Masayoshi Nagatsu, Michael R. Zile, Masayoshi Hamawaki, M. Michael Swindle, George Keech, Gilberto DeFreyte, Hirofumi Tagawa, George Cooper, Blase A. Carabello
Journal: Circulation (1997)

When a pressure overload is placed on the left ventricle, some patients develop relatively modest hypertrophy whereas others develop extensive hypertrophy. Likewise, the occurrence of contractile dysfunction also is variable. The cause of this heterogeneity is not well understood.We recently developed a model of gradual proximal aortic constriction in the adult canine that mimicked the heterogeneity of the hypertrophic response seen in humans. We hypothesized that differences in outcome were related to differences present before banding. Fifteen animals were studied initially. Ten developed left ventricular dysfunction (dys group). Five dogs maintained normal function (nl group). At baseline, the nl group had a lower mean systolic wall stress (96 +/- 9 kdyne/cm2; dys group, 156 +/- 7 kdyne/cm2; P < .0002) and greater relative left ventricular mass (left ventricular weight [g]/body wt [kg], 5.1 +/- 0.36; dys group, 3.9 +/- 0.26; P < .02). On the basis of differences in mean systolic wall stress at baseline, we predicted outcome in the next 28 dogs by using a cutoff of 115 kdyne/cm2. Eighteen of 20 dogs with baseline mean systolic stress > 115 kdyne/cm2 developed dysfunction whereas 6 of 8 dogs with resting stress < or = 115 kdyne/cm2 maintained normal function.We conclude that this canine model mimicked the heterogeneous hypertrophic response seen in humans. In the group that eventually developed dysfunction there was less cardiac mass despite 60% higher wall stress at baseline, suggesting a different set point for regulating myocardial growth in the two groups.
Surgical Excision of Nevi
Authors: J. Richard Allison
Journal: JAMA (1961)

<h3>To the Editor:—</h3> In reference to Dr. Gordon McNeer's article on melanomas (<i>JAMA</i><b>176</b>:1-4 [April 8] 1961), I would like to ask the basis for his statement that surgical removal is recommended for moles, situated at anatomic pressure points. Such a statement in a summary is misleading since the author in his paragraph on trauma concludes with the statement that "It is therefore difficult for us to concede the possibility of the relationship of trauma to the growth and dissemination of melanoma." In addition, the article is further confusing in that his third sentence states that in reference to pigment "This very fact makes one suspect that the presence of pigment is of little or no importance in the pathogenesis of this disease." And later he suggests that all black moles in children be surgically excised. There is much that we do not know about melanomas and many of
Government sets 75 000 cap on social care in England
Authors: I. Torjesen
Journal: BMJ (2013)

The government has agreed to cap the lifetime costs that anyone would have to pay for social care in England at £75 000 (€87 000; $117 000), more than double the £35 000 recommended by Andrew Dilnot’s review of social care.1

Anyone with assets worth less than £123 000 would immediately be eligible for free residential care when the changes were introduced in 2017, the health secretary for England, Jeremy Hunt, announced to parliament on 11 February. The threshold is currently £23 250.

Under the new system, local authorities would assess eligibility for residential care or home services. To ensure a fair system, where people qualified for the same level of services regardless of where they lived, the Department of Health would introduce national eligibility standards in 2015.

If someone were deemed eligible for free residential care they …
The Radcliffe Infirmary: Two Hundred Years
Authors: ROBIN M. BANNERMAN
Journal: Annals of Internal Medicine (1970)

Editorial Notes1 December 1970The Radcliffe Infirmary: Two Hundred YearsROBIN M. BANNERMAN, D.M., M.R.C.P., F.A.C.P.ROBIN M. BANNERMAN, D.M., M.R.C.P., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-73-6-1039 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptOn St. Luke's day, 18 October 1770, the Radcliffe Infirmary first opened its doors to patients. This event was commemorated at Oxford 2 months ago, on 16 to 20 October. The ceremonies began with a ball at Blenheim Palace, seat of the Dukes of Marlborough and birthplace of Winston Churchill, a magnificent and also an appropriate setting, an earlier Duke and Duchess of Marlborough having headed the Infirmary's original list of subscribers. There followed among other happenings, a choral service at the University Church of St. Mary, where Radcliffe may have worshipped and where he is buried, a performance of...References1. GIBSON A: The Radcliffe Infirmary. London, Oxford University Press, 1926 Google Scholar2. ROBB-SMITH A: A Short History of the Radcliffe Infirmary. Oxford, Church Army Press for the United Oxford Hospitals, 1970 Google Scholar3. ACLAND H: Memoir on the Cholera at Oxford, in the year 1854, with considerations suggested by the epidemic. London, John Churchill, 1856 CrossrefGoogle Scholar4. ELLIOTT-SMITH A: Twenty years after. Oxford Med School Gazette 13:9-11, 1961 Google Scholar5. ROBB-SMITH A: The Oxford medical school and its graduates. Oxford Med School Gazette 11:15-20, 1959 Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Department of Medicine State University of New York at Buffalo Buffalo General Hospital Buffalo, N. Y. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 December 1970Volume 73, Issue 6Page: 1039-1040 Issue Published: 1 December 1970 PDF DownloadLoading ...
Hospital admissions for alcoholic liver disease vary threefold across England
Authors: Z. Kmietowicz
Journal: BMJ (2014)

Some areas of England saw three times the rate of emergency hospital admissions for alcohol related liver disease in the past year as other areas, new figures have shown.

At 45.8 admissions per 100 000 population Greater Manchester recorded the highest rate of emergency admissions between April 2013 and March 2014, showed data from the Health and Social Care Information Centre (HSCIC).1 It …
Polycystic Kidney Disease and Seatbelts
Authors: William J. Amend, Malcolm Galen
Journal: Annals of Internal Medicine (1973)

Comments and Corrections1 August 1973Polycystic Kidney Disease and SeatbeltsWILLIAM J. AMEND, M.D., MALCOLM GALEN, M.D.WILLIAM J. AMEND, M.D.Search for more papers by this author, MALCOLM GALEN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-79-2-287_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: With the increased availability of dialysis treatment many of our previously restricted patients have been allowed to travel for business and vacation. Recently a preventable complication occurred in one of our patients.A 55-year-old home dialysis patient has polycystic kidney disease. On several occasions, once while riding in the back of a rough bus, she has had unilateral flank pain and hematuria that were consistent with a cyst rupture. She carefully avoided using car seatbelts after these incidents (not at physician's direction).Within 24 hours of a recent plane trip to Florida... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByAutosomal dominant polycystic kidney disease and minimal trauma: medical review and case reportA Prospective Study on Clinical Profile of Autosomal Dominant Polycystic Kidney Disease (ADPKD) in Jammu for a Period of 1 YearRenal Cystic DiseasePolycystic kidney disease: Etiology, pathogenesis, and treatmentRenal Cystic DisordersManagement of Renal Cystic DisordersTHAW-SIPHON TECHNIQUE FOR FACTOR-VIII CRYOPRECIPITATESEAT BELTS AND POLYCYSTIC KIDNEYS 1 August 1973Volume 79, Issue 2Page: 287-287KeywordsLower back painMedical dialysisPolycystic kidney disease Issue Published: 1 August 1973 PDF DownloadLoading ...
Repetitive 4-Week Periods of Atrial Electrical Remodeling Promote Stability of Atrial Fibrillation
Authors: Derick M. Todd, Simon P. Fynn, Andrew P. Walden, W. Julian Hobbs, Sanjay Arya, Clifford J. Garratt
Journal: Circulation (2004)

Background— Episodes of atrial fibrillation (AF) are known to cause both a rapid reduction in atrial refractoriness (atrial electrical remodeling) and a more delayed increase in AF stability thought to be due to a so-called “second factor.” The aim of this study was to quantify the effects and time course of such a factor on AF stability in the chronic goat model. Methods and Results— AF was maintained in 6 goats by burst atrial pacing for 3 consecutive 4-week periods separated a mean of 6±2.1 days of sinus rhythm. Six days of sinus rhythm was just sufficient for refractoriness changes to reverse fully in all goats. Atrial effective refractory period, AF inducibility, and duration of individual episodes of AF were assessed at regular intervals. There was a progressive reduction from month 1 to 2 to 3 in the mean duration of burst pacing required to induce individual episodes of AF of 60 seconds (178±251, 110±102, and 21±30 hours), 1 hour (229±224, 136±104, and 68±51 hours), and 24 hours (277±218, 192±190, and 102±75 hours; P &lt;0.03). The frequency with which AF was induced during extrastimulus pacing increased progressively from 16.7% in month 1 to 31.7% in month 2 and 46.9% in month 3 ( P &lt;0.001). Conclusions— Sequential 4-week periods of atrial fibrillation result in a progressive increase in AF stability independent of baseline atrial refractory period. This finding suggests the presence of a second factor in the self-perpetuation of AF with a time course comparable to that of AF-induced ultrastructural changes in the atria.
An Ethical Debate Financial ties as part of informed consent to postmarketing research: From the patient's perspective
Authors: J. Neuberger
Journal: BMJ (1995)

Payment for phase IV research was a major issue when I was surveying the work of research ethics committees in the United Kingdom. Many doctors argued that patients need not be told if the researchers were being paid. This was on the assumption, within hospital based research, that the money earned would go into institutional or research funds. Lay members of research ethics committees were less clear, arguing that it might be right for research subjects to be told, but the fact that research funds would be enriched by the individual patient's participation might be felt as additional pressure to …
The Doctor of Pharmacy
Authors: John A. Biles
Journal: JAMA (1983)

THE DOCTOR of pharmacy degree is the highest award given in recognition of academic preparation for pharmacy practice. A majority of schools or colleges of pharmacy offer a baccalaureate degree, and this program should, as a minimum standard, produce practitioners for the contemporary practice of pharmacy. In comparison with the baccalaureate program, standards for the doctor of pharmacy program clearly indicate a different level of expectation and professional competence. A person who holds the doctor of pharmacy degree (PharmD) is educated and trained as a drug specialist. Physicians often identify the PharmD as a pharmacologist or an applied pharmacologist. He or she is called a "clinical pharmacist"—one who is skilled in the clinical requirements of pharmacy practice—and must pass a state board of pharmacy examination to be licensed to practice. A majority of the graduates practice in a hospital or community setting; some teach in schools of pharmacy and medicine,
Pulmonary oedema, pneumonia and mortality in submersion victims; a retrospective study in 125 patients
Authors: M. van Berkel, J. J. L. M. Bierens, R. L. K. Lie, T. P. W. de Rooy, L. J. S. Kool, E. A. van de Velde, A. E. Meinders
Journal: Intensive Care Medicine (1996)
Respirators and Tuberculosis
Authors: William S. Beckett
Journal: Annals of Internal Medicine (1995)

Letters1 January 1995Respirators and TuberculosisWilliam S. Beckett, MD, MPHWilliam S. Beckett, MD, MPHYale University School of Medicine; New Haven, CT 06510Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-122-1-199501010-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Nettleman and colleagues [1] presented concerns about the high costs of using particulate respirators in preventing transmission of tuberculosis (including multidrug-resistant tuberculosis) to health care workers exposed to patients with tuberculosis in health care facilities.Despite infection control measures, some health care workers have already died from multidrug-resistant tuberculosis. As the number of cases of AIDS and multidrug-resistant tuberculosis increases, we expect to see more deaths among both immunosuppressed and immunocompetent health care workers. In this context, the effectiveness of high-efficiency particulate respirators certainly bears scrutiny. Neither the Centers for Disease Control and Prevention nor the National ...Reference1. Nettleman MD, Fredrickson M, Good NL, Hunter SA. Tuberculosis control strategies: the cost of particulate respirators. Ann Intern Med. 1994; 121:37-40. Google Scholar Author, Article, and Disclosure InformationAffiliations: Yale University School of Medicine; New Haven, CT 06510 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByInstitutional Control Measures for Tuberculosis in the Era of Multiple Drug Resistance 1 January 1995Volume 122, Issue 1Page: 70-71KeywordsHealth care facilitiesHealth care providersMultidrug resistant tuberculosisParticulatesPrevention, policy, and public healthPulmonary diseasesRespiratorsSkin testsTuberculinTuberculosis Issue Published: 1 January 1995 CopyrightCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...