tbuckley/cabot-search huggingface dataset:
Do Parents Have the Right to Refuse Standard Treatment for Their Child With Favorable-Prognosis Cancer? Ethical and Legal Concerns
Authors: Jeffrey D. Hord, Waqas Rehman, Patricia Hannon, Lisa Anderson-Shaw, Mary Lou Schmidt
Journal: Journal of Clinical Oncology (2006)

A 7-year-old boy presenting with bone pain and fever was found to have standard-risk pre–B-cell precursor acute lymphoblastic leukemia (ALL). Parental written consent was obtained to begin a standard 3.5-year chemotherapy treatment regimen with an estimated 85% chance of long-term survival. Induction chemotherapy was successful in producing remission; however, after 3 months of chemotherapy, the parents opposed continuation of the standardtreatment,citingconcerns thatchemotherapy would damage their son’s immune system and cause other long-term problems. As a replacement for standard treatment, the parents elected to pursue alternative holistic approaches including nutritional supplements, dietary changes, and stress reduction techniques. The parents transferred the care of their child to a licensed family medicine physician who was board certified in holistic medicine. The new physician agreed to monitor the patient’s blood counts to monitor the leukemia, and if the patient’s blood counts suggested relapse, he would refer him back to a pediatric oncologist. The Department of Job and Family Services in the patient’s county of residence was notified, and a hearing was held in the county Court of Common Pleas (family court division) to determine whether the parents were guilty of neglect and whether standard therapy should be mandated. The pediatric oncologist involved with this case testified that he believed that stopping standard therapy at this point would almost certainly result in a return of the leukemia. Furthermore, he testified that the child’s likelihood of being cured would be significantly less on relapse. The court dismissed the case stating that the parents’ “concerns about long-term effects of chemotherapy” did not qualify as neglect. Furthermore, the court recognized that the patient was under the care of a licensed physician and refused to judge the relative merits of the two different treatment options recommended by two different physicians licensed to practice medicine in the state. After the hearing, the holistic physician was reported to the State Medical Board to determine whether he had “departed from or failed to conform to minimal standards of care.” After an investigation, the Secretary and Supervising Member of the State Medical Board determined that formal disciplinary charges were not warranted. Approximately 4 months after the court’s decision, the patient experienced a recurrence of acute leukemia.
Thyroid Function and Psychotherapeutic Drugs
Authors: J. L. Bennett
Journal: JAMA (1963)

<h3>To the Editor:—</h3> Four patients were reported as showing progressive elevation of serum proteinbound iodine (PBI) during treatment with perphenazine (Trilafon) and it was suggested that such changes might be quite common (<i>JAMA</i><b>181</b>:554 [Aug 11] 1962). We have studied 42 patients treated for at least 6 weeks with a combination of perphenazine and amitryptiline, and have obtained determinations of PBI at various time periods. Dosages up to 64 mg of perphenazine and 200 mg of amitryptiline hydrochloride daily were used. Although the effect of the latter drug on PBI levels is unknown, it should not be expected to mask any effect that perphenazine alone might have. All PBI levels fell within the ordinary ranges of normal (4.0 to 8.0μg/100 ml). Mean levels for PBI were 5.7μg/100 ml at the beginning of treatment and 5.4μg/100 ml at the end of 6 weeks. Data from shorter time periods showed a
Excision of selected skin tumours using Mohs' micrographic surgery with horizontal paraffin-embedded sections
Authors: R.J. BARLOW, N. RAMNARAIN, N. SMITH, B. MAYOU, A.C. MARKEY, N.P.J. WALKER
Journal: British Journal of Dermatology (1996)

Histological interpretation of frozen sections made during Mohs' micrographic surgery may be difficult, depending on the morphological and staining characteristics of the tumour and on the nature of the associated inflammatory infiltrate. We have employed an adaptation of micrographic surgery in which horizontal, formalin-fixed, paraffin-embedded sections were used to improve histological assessment in the excision of 18 non-melanoma skin tumours in which frozen sections had been or were likely to be unsatisfactory. We describe our experience of this method in the management of squamous cell carcinomas (11), extramammary Paget's disease (two), microcystic adnexal cell carcinomas (two), dermatofibrosarcoma protuberans (two), and primary cutaneous neuroendocrine carcinoma (Merkel cell carcinoma) (one). The use of horizontal paraffin-embedded sections lengthens the duration of the procedure but facilitates accurate assessment of histological sections in selected tumours.
Constrictive Pericarditis Complicating Disseminated Lupus Erythematosus
Authors: PETER M. YURCHAK, SAMUEL A. LEVINE, RICHARD GORLIN
Journal: Circulation (1965)

A case of constrictive pericarditis complicating disseminated lupus erythematosus is reported in a 58-year-old man. Hemodynamic studies documented the diagnosis and also confirmed the clinical suspicion of coexistent atrial septal defect. Measurement of left ventricular volume by a thermodilution technic augmented information available from routine studies. Pericardiectomy and closure of the atrial septal defect relieved the mechanical lesion. The case is also unique in its documentation of the coexistence of three different forms of heart disease—congenital atrial septal defect, pericardial constriction from lupus erythematosus, and rheumatic valvular disease.
Prolonged Disease-Free Survival in Hodgkin's Disease with MOPP Reinduction After First Relapse
Authors: RICHARD I. FISHER
Journal: Annals of Internal Medicine (1979)

Thirty-two patients with Hodgkin's disease who relapsed after a first complete remission induced by nitrogen mustard, vincristine, procarbazine, and prednisone (MOPP) were retreated with MOPP chemotherapy. Nineteen patients achieved a second complete remission. Median duration of the second complete remission was 21 months. The likelihood of achieving a second complete response could be predicted by the duration of the first response. Fourteen of 15 patients whose first complete remission was longer than 12 months achieved a second complete response in contrast to five of 17 patients whose initial complete remission lasted less than 12 months (P less than 0.001). Median survival of all patients in this study who were re-treated with MOPP was longer than 4 years after their first relapse. We conclude that patients with Hodgkin's disease who relapse after a first complete remission induced by MOPP are not necessarily resistant to further MOPP therapy and can achieve long-term survival with MOPP reinduction.
Abortion Mortality Trends
Authors: Sidney C. Roberts
Journal: JAMA (1993)

<h3>To the Editor.</h3> —I find it distressing when I see blatantly political articles clothed in "scientific" sheepskin. The purpose of the Council Report<sup>1</sup>on abortion was none other than the promotion of continued use—no, the increasingly unrestricted use—of abortion on demand. The "implications" of the article are political opinions that are not substantiated by the article itself. Abortion has always been unethical, and no amount of justification or "scientific" endorsement will change that.
The heart and pulmonary vasculature of the llama (Lama glama)
Authors: D. Heath, P. Smith, D. Williams, P. Harris, J. Arias-Stella, H. Kruger
Journal: Thorax (1974)

<b>Heath, D., Smith, P., Williams, D., Harris, P., Arias-Stella, J., and Krüger, H. (1974).</b><i>Thorax</i>, <b>29</b>, 463-471. <b>The heart and pulmonary vasculature of the llama</b> (<i>Lama glama</i>). A qualitative and quantitative histological study was made of the pulmonary trunk and muscular pulmonary arteries of a male and a pregnant female llama born and living at an altitude of 4,720 m above sea-level in the Peruvian Andes. A similar study was made on the fetal llama. The individual cardiac chambers of the two adults were weighed. Our results show that in the adult llama there is no hypertrophy of the right ventricle or of the media of the pulmonary trunk or small pulmonary arteries. This appears to be of evolutionary significance in respect of survival at high altitude and suggests that the llama does not have a sustained significant pulmonary hypertension. The pulmonary arteries of the fetal llama are thick-walled and we associate this with the physiological pulmonary hypertension of fetal life.
EFFECTS OF INTENSIFIED PULMONARY HYPERTENSION SPECIFIC VASODILATOR THERAPY ON MYOCARDIAL OXIDATIVE METABOLISM AASSESSED USING C-11 ACETATE PET IN PATIENTS WITH PULMONARY HYPERTENSION
Authors: Keiichiro Yoshinaga, Hiroshi Ohira, Ichizo Tsujino, Osamu Manabe, Takahiro Sato, Chietsugu Katoh, Katsuhiko Kasai, Yuuki Tomiyama, Noriko Oyama-Manabe, Masaharu Nishimura, Nagara Tamaki
Journal: Journal of the American College of Cardiology (2013)
Characterization of an abnormal species of apolipoprotein B, apolipoprotein B-37, associated with familial hypobetalipoproteinemia.
Authors: S G Young, S J Bertics, L K Curtiss, J L Witztum
Journal: Journal of Clinical Investigation (1987)

Steinberg and colleagues have previously described a unique kindred with normotriglyceridemic hypobetalipoproteinemia (1979. J. Clin. Invest. 64:292-301). In a reexamination of this kindred, we found an abnormal apolipoprotein (apo) B species, apo B-37 (203,000 mol wt), in the plasma lipoproteins of multiple members of the kindred. In affected individuals apo B-37 was found in very low density lipoproteins, along with the normal apo B species, apo B-100 and apo B-48. High density lipoproteins (HDL) also contained apo B-37, but no other apo B species. The first 13 amino-terminal amino acids of apo B-37 were identical to those of normal apo B-100. We utilized a panel of 18 different apo B-specific monoclonal antibodies and polyclonal antisera specific for apo B-37 and the thrombin cleavage products of apo B-100 to map apo B-37 in relation to apo B-100, apo B-48, and the thrombin cleavage products of apo B-100. The results of those immunochemical studies indicated that apo B-37 contains only amino-terminal domains of apo B-100. In affected individuals, the majority of apo B-37 in plasma was contained in the HDL density fraction. Within that fraction apo B-37 was found on discrete lipoprotein particles, termed Lp-B37, that had properties distinct from normal HDL particles containing apo A-I. This report documents for the first time the existence of an abnormal apo B species in humans. Further study of apo B-37 and lipoprotein particles containing apo B-37 should lead to an improved understanding of apo B structure and function.
Normal energy intake in undernourished patients with Crohn's disease.
Authors: L A Jones, A D Harries, J Rhodes, R V Heatley
Journal: BMJ (1984)

reduces the amplitude of miniature end plate potentials.One possibly analogous case in man has been described, in which a patient noted weakness within 24 hours of beginning penicillamine, improving immediately when the drug was stopped.2Equally this binding suggests a mechanism for antigenic alteration of acetylcholine receptor and loss of tolerance.Carbocysteine is structurally similar to penicillamine, and people with a low capacity for producing sulphoxides of carbocysteine may be similarly unable to metabolise penicillamine.Poor sulphoxidisers of carbocysteine are more likely to develop proteinuria or thrombocyto- penia when taking penicillamine.3Our patient was a very poor sulphoxidiser (index 52).Possibly this inability to metabolise the sulphydryl group makes interaction with acetylcholine receptor more likely.Penicillamine toxicity, especially proteinuria or marrow suppression, may be more likely in patients who have had a toxic reaction to gold.4The order of treatment with gold and penicillamine probably makes no difference to recurrence of toxicity.5Caution should be exercised in prescribing gold to a patient who has developed penicillamine induced myasthenia.
Cytomorphological Analysis of Keratinocytes in Oral Smears from Tobacco Users and Oral Squamous Cell Carcinoma Lesions — A Histochemical Approach
Authors: Suneet Khandelwal, Monica Charlotte Solomon
Journal: International Journal of Oral Science (2010)

To analyse the cytomorphological features of keratinocytes in smears obtained from the oral mucosa of tobacco users and from oral squamous cell carcinoma lesions. Oral smears were obtained from clinically, normal appearing mucosa of oral squamous cell carcinoma patients (n=20) and from the mucosa of smokers (n=20), and apparently healthy individuals (n=20) were used as controls. The smears were histochemically stained and cytomorphological assessment of the keratinocytes was carried out. One‐way ANOVA (Analysis of Variance) was used for comparing the parameters among multiple groups and Tukey‐HSD test was used to compare the mean values between groups. The mean nuclear area of keratinocytes from the mucosa of tobacco users was 46 ± 2.57 and that of the oral squamous cell carcinoma lesion was 81.54 ± 4.31. While there was a significant (P=0.001) reduction in the cellular area of keratinocytes from oral squamous cell carcinoma lesion when compared with those from oral smears of tobacco users. Cytomorphometric analysis of keratinocytes can serve as a useful adjunct in the early diagnosis of oral squamous cell carcinomas.
Species, interindividual, and tissue specificity in endocrine signaling.
Authors: C Walker, S A Ahmed, T Brown, S M Ho, L Hodges, G Lucier, J Russo, N Weigel, T Weise, J Vandenbergh
Journal: Environmental Health Perspectives (1999)

The activity of endocrine-active agents exhibits specificity at many levels. Differential responsiveness to these agents has been observed between different species and extends to interindividual differences within a species and between different tissues as well. In cases where they have been identified, the biologic and molecular mechanisms underlying this specificity are quite diverse. Determinants of species specificity include differences that exist in receptor binding, gene transcription, and cellular responses to endocrine-active compounds between species. Interindividual differences in responsiveness may be determined at the level of genetic polymorphisms in hormone-metabolizing enzymes, hormone receptors, and in those genes that are transactivated by these receptors, as well as during changing windows of susceptibility that occur as a function of age, such as prenatal and postmenopausal exposures. Extrinsic factors such as diet can also impact individual susceptibility to endocrine-active agents. Tissue-specific determinants of susceptibility are well documented, but little is known regarding the mechanisms underlying these different responses. Differences in the expression of accessory proteins for steroid hormone receptors and different patterns of receptor expression, estrogen receptor alpha and estrogen receptor beta; for example, may contribute to tissue specificity, as may differences in the pattern of expression of other genes such as hormone-metabolizing enzymes. The use of animal model systems and development of appropriate mathematical models has the potential to yield additional valuable information for elucidating the role of these determinants of specificity at low-dose exposures and for improved risk assessments for the adverse health effects of endocrine-active compounds.
The art of replication
Authors: M. Kabesch
Journal: Thorax (2009)

Extensive loss of the ureter is a potential complication of surgery performed to relieve ureteral obstruction caused by retroperitoneal fibrosis. The authors describe four cases in which renal autotransplantation restored normal urinary drainage. The preoperative evaluation and technicalities of renal autotransplantation are reviewed, The advantages of this procedure, as compared to ileal substitution, for patients with extensive ureteral loss are discussed.
Stories for summer: drinking and rioting
Authors: J. Smith
Journal: BMJ (2011)

It’s received wisdom in public health circles that raising the price of things like alcohol and cigarettes reduces their consumption: indeed there’s strong evidence that price rises work, most recently rehearsed in the BMJ in the debate over minimum prices for alcohol ( BMJ 2011;342:d1063, doi:10.1136/bmj.d1063). I was therefore struck by the view of Russian alcohol experts that raising the price of alcohol was not a solution to Russia’s problem of alcohol misuse.

Shaun Walker’s feature describes how alcohol misuse accounts for more than half the deaths of men of working age in Russia “and goes a long way to explaining why the life expectancy for men has hovered around 60 years in the past decade” (doi:10.1136/bmj.d5240 …
Metatheory of storage capacity limits
Authors: Nelson Cowan
Journal: Behavioral and Brain Sciences (2001)

Commentators expressed a wide variety of views on whether there is a basic capacity limit of 3 to 5 chunks and, among those who believe in it, about why it occurs. In this response, I conclude that the capacity limit is real and that the concept is strengthened by additional evidence offered by a number of commentators. I consider various arguments why the limit occurs and try to organize these arguments into a conceptual framework or “metatheory” of storage capacity limits meant to be useful in future research to settle the issue. I suggest that principles of memory representation determine what parts of the representation will be most prominent but that limits of attention (or of a memory store that includes only items that have been most recently attended) determine the 3- to 5-chunk capacity limit.
Continuous versus Pulsatile Pulmonary Hemodynamics in Canine Oleic Acid Lung Injury
Authors: ALBERTO PAGNAMENTA, YVES BOUCKAERT, PIERRE WAUTHY, SERGE BRIMIOULLE, ROBERT NAEIJE
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Pulmonary hypertension occurs commonly in the acute respiratory distress syndrome (ARDS), but associated right ventricular failure is relatively rare. We tested the hypothesis that this apparent contradiction is explained by a peripheral location of the increased pulmonary vascular resistance (Rpva). Experimental ARDS was induced in eight dogs by injection of oleic acid (0.07 ml/kg). Changes in Rpva were evaluated by measurements of pulmonary artery pressure (Ppa) at several levels of flow (Q˙), which was altered by manipulation of venous return. The analysis of Ppa decay curves after arterial balloon occlusion was used to partition Rpva into arterial and venous segments. Right ventricular afterload was evaluated by determination of pulmonary vascular impedance (Zpva), which was calculated from spectral analysis of Ppa and Q˙ waves. Oleic acid lung injury was associated with an increase in both the slope and the extrapolated pressure intercept of Ppa/Q˙ plots, no change in the partitioning of Rpva, no change in time-domain indices in wave reflection or in pulmonary arterial compliance, and a decrease in both the characteristic impedance and pulsatile component of total right ventricular hydraulic load. We conclude that the site of increased Rpva in oleic acid lung injury is the smallest pulmonary arterioles, which, together with a decreased characteristic impedance, contributes to minimize right ventricular afterload.
THE EARLY TREATMENT OF COMPOUND FRACTURE OF THE FEMUR CAUSED BY GUNSHOT WOUND
Authors: R. C. Dun
Journal: BMJ (1917)

COMPOUND FRACTURE OF FEMUR.|AUG.i8, i9iTwhilst the case looked a malignant one, the opinion expressed was that he lhad a double infection of tertian ague.This con- dition seemed to settle after a course of quinine, followed by olne of liq.arsellicalis.Previous History.The patient bad served in Inidi'a for three years.There he had " an od(l (lay or two " with attacks of malaria, but was never in lhospital, anid no blood examiiation was madie.From.November, 1915, to December, 1916, he was at Saloniica.In August, 1916, he had an attackl of malaria for which he was detainedl five days in hospital anid then attended for three weeks, takinig quininie.He was invalided honme after an operation for appendicitis.From the beginning of 1917 he began to notice that heavy work and " jumpinlg about " gave hiim a feeling of discomfort in his stomach, and after such exercise lhe vomited on several occasions.He was not short of breath, and thought hiis discomfort was (lue to his appendix op)eration.He arrived in Franice the dav before hiis admission to hospital.He had beeni uncomfortable for five days before that, but lhad suffered no special trauma on land or sea during that time.He miarbhed to hiis dedpt took illiwitlh bad abdominal pains during the night, and, when seen by his medical officer, was imme- diately sent to hospital.The spleen after removal was about eight times the size of the normal organ; it mtust have been much larger before it ruptured.The patient was transferred to England very well on May 14th, 1917.
THE USE OF IODIN IN THE PREPARATION OF THE PATIENT FOR DELIVERY
Authors: I. S. Stone
Journal: JAMA (1918)

<h3>To the Editor:</h3> —In connection with the communication by Dr. Thorns (The Journal, April 13, 1918, p. 1115), I wish to say that while I agree that his technic is effective, it is possible to obtain equally good results with weaker solutions than he uses. Lambert of New York has shown us that an aqueous solution of iodin (1:2,000) will prove effective against the<i>Staphylococcus pyogenes</i>, and that it will not prevent cell growth. Alcohol alone is an irritant, and any diluted tincture of iodin may cause pain and irritation when used on delicate or sensitive surfaces. After anesthesia has been induced, we use the diluted tincture, U. S. P., 1 part to 3, of 95 per cent, alcohol. This is perfectly satisfactory in skin sterilization of any part of the body or any mucous surface. After an experience of many years I have had no reason to return to
Novel coumarin–benzimidazole derivatives as antioxidants and safer anti-inflammatory agents
Authors: Radha Krishan Arora, Navneet Kaur, Yogita Bansal, Gulshan Bansal
Journal: Acta Pharmaceutica Sinica B (2014)

Inspired from occurrence of anti-inflammatory activity of 3-substituted coumarins and antiulcer activity of various 2-substituted benzimidazoles, novel compounds have been designed by coupling coumarin derivatives at 3-position directly or through amide linkage with benzimidazole nucleus at 2-position. The resultant compounds are expected to exhibit both anti-inflammatory and antioxidant activities along with less gastric toxicity profile. Two series of coumarin–benzimidazole derivatives (4a–e and 5a–e) were synthesized and evaluated for anti-inflammatory activity and antioxidant activity. Compounds 4c, 4d and 5a displayed good anti-inflammatory (45.45%, 46.75% and 42.85% inhibition, respectively, versus 54.54% inhibition by indomethacin) and antioxidant (IC50 of 19.7, 13.9 and 1.2 µmol/L, respectively, versus 23.4 µmol/L for butylatedhydroxytoluene) activities. Evaluation of ulcer index and in vivo biochemical estimations for oxidative stress revealed that compounds 4d and 5a remain safe on gastric mucosa and did not induce oxidative stress in tissues. Calculation of various molecular properties suggests the compounds to be sufficiently bioavailable.