tbuckley/cabot-search huggingface dataset:
The Patient-Physician Covenant
Authors: John J. Ring
Journal: JAMA (1995)

<h3>To the Editor.</h3> —<i>JAMA</i>will never print a more important article than the patient-physician covenant.<sup>1</sup>It strikes to the very heart of our professional being and to the core of our relationship with those we serve. It is correct and timely. The physician-patient relationship is indeed based on trust. Other models that postulate a business, contractual, or other basis ignore the moral nature of our profession and the role it has played down through the centuries. De facto reform of the health care system is now taking place. It is based not on the principles espoused by Hillary Rodham Clinton and Ira Magaziner, those of Health Access America, or the myriad other proposals put forward in recent years. It is being reformed by the reckless and ruthless application of raw economics to a system that deserves more thoughtful modification. The concepts embodied in the covenant constitute the last
Welsh health service faces overwhelming demand for services, says report
Authors: R. Dobson
Journal: BMJ (2003)

Demand for health and social care services in Wales could overwhelm the system, a review commissioned by the Welsh Assembly has said.

Services need to modernise and change or face being overwhelmed: “The overall conclusion is that the current position is not sustainable,” the review says.

The review, led by Derek Wanless, the former chief executive of NatWest bank, who was commissioned last year after completing a review of the NHS in the United Kingdom, says that immediate action needs to be taken in several areas, including developing alternatives to hospital admissions.

Although hospital activity has grown by more than 33% over the past …
The “Stop Asthma” Clinical System: A novel computer-based decision-support program to enhance implementation of pediatric asthma management guidelines and promote communication skills
Authors: SL Abramson, R Shegog, LK Bartholomew, MM Sockrider, PD Mullen, J Craver, S Pilney, P Koeppl, DI Czyzewski, RS Gold
Journal: Journal of Allergy and Clinical Immunology (2002)
Association between maternal anxiety in pregnancy and increased uterine artery resistance index: cohort based study
Authors: J. M A Teixeira, N. M Fisk, V. Glover
Journal: BMJ (1999)

<h3>Abstract</h3> <b>Objective:</b> To investigate whether maternal anxiety in the third trimester is associated with an increased uterine artery resistance index. <b>Design:</b> Cohort based study. <b>Subjects:</b> 100 pregnant women, with a mean gestation of 32 weeks. <b>Outcome measures:</b> Self rating Spielberger questionnaire for state anxiety and trait anxiety, and uterine blood flow waveform patterns as assessed by colour Doppler ultrasound. <b>Results:</b> A significant association was found between uterine artery resistance index and scores for both Spielberger state anxiety and trait anxiety (<i>r</i><b>s</b>=0.31, P&lt;0.002 and 0.28P&lt;0.005 respectively). Women with state anxiety scores &gt;40 (n=15) had a higher mean uterine resistance index than those with scores —40 (mean difference with mean resistance index 24%, 95% confidence interval 12% to 38%; P&lt;0.0001). Similarly, women with trait anxiety scores &gt;40 (n=32) had a higher mean resistance index than those with scores —40, although to a lesser extent. The presence of notches in the waveform pattern produced by uterine artery blood flow was found in 4/15 (27%) women with high state anxiety scores compared with 4/85 (5%) with low anxiety scores (P&lt;0.02). <b>Conclusions:</b> This study shows an association between maternal anxiety in pregnancy and increased uterine artery resistance index. It suggests a mechanism by which the psychological state of the mother may affect fetal development, and may explain epidemiological associations between maternal anxiety and low birth weight. The influence of maternal anxiety may be one mechanism by which the intrauterine environment contributes to later disease in offspring.
Heartburn. The role of radiology
Authors: B. S. Wolf
Journal: JAMA (1976)

There is currently controversy as to the importance of the radiologic demonstration of a hiatal hernia, reflux, or both as the explanation of heartburn. It is clear, however, that clinical-radiologic correlation requires additional observations such as the straightness of the potential path for reflux, the presence of a contractile esophagogastric region, the degree of extrinsic compression of the cuff of the stomach within the hiatus, the size of the hernia, and the peristaltic activity of the body of the esophagus. Vigorous or water-swallowing maneuvers to demonstrate reflux are unreliable in individual cases. Of importance is the concept that the so-called patulous cardia, or effaced abdominal esophagus or widened or absent "submerged segment," is a variety of sliding hiatal hernia that is often neglected radiologically but may be of considerable clinical significance.
89 DELETION OF TRAIL ON NK CELLS IS ASSOCIATED WITH EXCESSIVE HEPATIC ISCHEMIA-REPERFUSION INJURY IN MICE
Authors: R. Fahrner, M. Trochsler, N. Corazza, T. Brunner, N. Graubardt, A. Keogh, D. Candinas, D. Stroka, G. Beldi
Journal: Journal of Hepatology (2012)
NHS family planning services
Authors: A Templeton, P. Henderson, N Hassan, F Johnstone, J D Keeping, K J Starr, I. A. Treharne, P Chng, M. H Hall, W J Fullerton, V Jandial, P. M Fisher
Journal: BMJ (1975)

NHS family planning services SIR,-In the BM7 (19 July, p 185) it is re- ported that "the profession's negotiators [our italics] and the DHSS have agreed a scheme for the provision of family planning services through the hospital service, for all FP work, whether of medical or social origin."We are astonished that there has been, as yet, minimal medical or public reaction to this retrograde proposal.It is the feeling of the undersigned staff of the obstetrical and gynaecological department in Aberdeen that this scheme is indisputably bad.The reasons for its introduction are far from obvious and the advantages in terms of patient care are difficult to define.Furthermore, it may turm out to have a dangerously disruptive effect among different grades of staff in many gynaecological and anaesthetic departments, including theatre staff and porters.It seems ludicrous for a health service short of money in a time of rapid inflation to put out extra money to its highest paid workers.This is all apart from the questionable morality of the scheme and the inevitable difficulties it will present in the counselling of patients who seek unbiased family planning advice.
Safety and efficacy of total body irradiation, cyclophosphamide, and cytarabine as a conditioning regimen for allogeneic hematopoietic stem cell transplantation in patients with acute lymphoblastic leukemia
Authors: Takehiko Mori, Yoshinobu Aisa, Jun Kato, Akiko Yamane, Tomonori Nakazato, Naoyuki Shigematsu, Shinichiro Okamoto
Journal: American Journal of Hematology (2011)

Disease relapse still greatly interferes with the success of allogeneic hematopoietic stem cell transplantation (HSCT) for acute lymphoblastic leukemia (ALL). This study retrospectively evaluated the long-term safety and efficacy of a conditioning regimen consisting of total body irradiation (TBI; 12 Gy), cyclophosphamide (CY; 60 mg kg(-1) , two doses), and high-dose cytarabine (Ara-C; 2 g m(-2) ; four doses) for patients with ALL. Fifty-five patients (median age: 31-years old) were evaluated. Stem cells were from human leukocyte antigen-identical siblings in 22 patients and from alternative donors in 33. There were no cases of early death before engraftment, and 100-day transplant-related mortality was 7.3%. With a median follow-up period of 9.6 years, 5-year overall and disease-free survival were 63.2% (95% CI: 46.5-79.9%) and 63.6% (95% CI: 47.1-80.1%) in patients with complete remission, respectively, both of which were significantly higher than the values of 27.3% (95% CI: 8.7-46.0%) and 22.7% (95% CI: 5.3-40.1%) for patients in advanced stages (P < 0.01). These results suggest that TBI and CY (TBI-CY) plus Ara-C could be a feasible and effective conditioning regimen for adult patients with ALL both in remission and in advanced stages, and a future study to compare this combination therapy with TBI-CY is required.
Systemic and mucosal humoral responses to Helicobacter pylori in gastric cancer.
Authors: J E Crabtree, J I Wyatt, G M Sobala, G Miller, D S Tompkins, J N Primrose, A G Morgan
Journal: Gut (1993)

The systemic IgG response to Helicobacter pylori was examined in 70 patients with gastric cancer. H pylori IgG antibodies were assayed by enzyme linked immunosorbent assay (ELISA), and serological recognition of H pylori antigens was characterised by western blotting. A percentage of 78.5 were seropositive by ELISA. Two of five patients under age 50 were seronegative. Positivity was unrelated to age, sex, tumour type, or site. Ninety one per cent of ELISA positive cancer patients recognised the H pylori cytotoxin associated 120 kilodalton (kD) protein, significantly more than a control group of 47 ELISA positive patients with non-ulcer dyspepsia (72%). Four of 15 ELISA negative cancer patients also showed recognition of this protein in western blots. Mucosal IgA responses to H pylori were examined by immunoblotting supernatants of in vitro cultured resected antral mucosa in an overlapping group of 19 gastric cancer patients. Eighteen had a positive response, including 10 of 11 negative for H pylori by biopsy urease testing. The systemic and local immunoblotting results show that the high seroprevalence of H pylori antibodies detected by ELISA is nevertheless an underestimate of past infection. Dyspepsia screening policies based solely on H pylori ELISA would miss some young patients with gastric cancer. Further study of the relation of the H pylori cytotoxin to gastric precancerous lesions is warranted.
Calcium Signaling through CaMKII Regulates Hepatic Glucose Production in Fasting and Obesity
Authors: Lale Ozcan, Catherine C.L. Wong, Gang Li, Tao Xu, Utpal Pajvani, Sung Kyu Robin Park, Anetta Wronska, Bi-Xing Chen, Andrew R. Marks, Akiyoshi Fukamizu, Johannes Backs, Harold A. Singer, John R. Yates, Domenico Accili, Ira Tabas
Journal: Cell Metabolism (2012)
Investigating and managing chronic dysphagia: Dysphagia should prompt urgent gastroenterological referral
Authors: H. L Spencer
Journal: BMJ (2003)

EDITOR—Leslie et al reviewed the investigation and management of chronic dysphagia well from an ear, nose, and throat stand-point,1 but we think that an article directed at a general readership should have emphasised gastroenterological causes more.

From a gastrointestinal perspective, dysphagia is an alarm symptom that should prompt urgent referral to exclude cancer. Government directives have led …
Mucosal tears at the oesophagogastric junction (the Mallory-Weiss syndrome)
Authors: M. Atkinson, M. B. Bottrill, A. T. Edwards, W. M. Mitchell, B. G. Peet, R. E. Williams
Journal: Gut (1961)

This is a re-appraisal of the supposedly rare Mallory-Weiss syndrome in which 11 patients with mucosal tears at the oesophagogastric junction are described. The fact that these cases were collected from general hospitals within a short period suggests that the condition is more common than supposed and may account for a considerable proportion of the 20 to 25% of patients with upper gastrointestinal bleeding in whom no radiological abnormality can subsequently be found. Of the 11 patients, eight presented with gastrointestinal bleeding, two with mediastinitis, and one without relevant symptoms. The classical history of antecedent vomiting before the bleeding was obtained in only four patients, its absence not excluding the diagnosis. The presence of a small hiatal hernia in four patients appeared to predispose to mucosal tears as did mucosal atrophy occurring with advancing age. Some experimental findings pertaining to the mechanism of the tears are presented.
PRODUCTION OF HETEROGENETIC ANTIBODIES WITH MIXTURES OF THE BINDING PART OF THE ANTIGEN AND PROTEIN
Authors: K. Landsteiner, S. Simms
Journal: The Journal of Experimental Medicine (1923)

1. The alcohol-soluble extract of heterogenetic antigen, which possesses the specific chemical structure of the entire antigen, has a detectable but generally very slight power to increase the amount of heterogenetic antibodies, when injected into rabbits. 2. This substance can be transformed into an efficient antigen by mixing it with protein solutions such as diluted normal serum. 3. Such mixtures are considerably more active than the same substances injected separately. Therefore, the effect of the serum is probably due to the formation in vitro of a loose compound between the alcohol-soluble substance and protein, the compound acting as a complete antigen. 4. It may be supposed that there exists a group of natural antigens which are built up of one specifically reacting part that is almost or entirely devoid of antigenic properties, and another part, a protein, responsible for the immunizing effect.
The Neglected Cause of Stroke: Occlusion of the Smaller Intracranial Arteries and Their Diagnosis by Cerebral Angiography
Authors: Bernard S. Epstein
Journal: JAMA (1970)

In the pathogenesis of stroke, occlusion of smaller intracranial arteries is recognized as one of the important elements in differential diagnosis. Dr. Ring, basing his conclusions on anatomic preparations and angiograms in conjunction with clinical features, makes a useful contribution in stressing this condition. He reviews other causes of stroke, such as extracranial and major vessel intracranial lesions, and places them in juxtaposition with lesser vessel occlusions. Following a brief discussion of the hemodynamics of the circulatory system of the brain is an anatomic analysis of the major intracerebral arteries. Dr. Ring's correlations between radiologic and postmortem anatomy are the result of intensive study. The detailed descriptions of the middle, the anterior cerebral, and pericallosal and the posterior cerebral arteries are particularly good. The anatomic data are utilized in bringing into focus the changes which might be anticipated from cerebral angiograms, particularly insofar as occlusions of secondary branches are concerned.
Measuring the activity of disease in cutaneous lupuserythematosus
Authors: M. Goodfield
Journal: British Journal of Dermatology (2000)

Journal Article Measuring the activity of disease in cutaneous lupuserythematosus Get access M. Goodfield M. Goodfield Skin Research Centre, Leeds General Infirmary, Leeds, U.K. Dr Mark Goodfield, Skin Research Centre, Leeds General Infirmary, Great George St., Leeds LS1 3EX, U.K. Tel.: + 44 113 3923 454, fax: + 44 113 234 1154.E‐mail: markg@dermatology.co.uk Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 142, Issue 3, 1 March 2000, Pages 399–400, https://doi.org/10.1046/j.1365-2133.2000.03402.x Published: 01 March 2000
Case 8-1978
Authors: Richard C. Cabot, Robert E. Scully, James J. Galdabini, Betty U. McNeely, David C. Dahlin, Walter G. J. Putschar
Journal: New England Journal of Medicine (1978)

Presentation of CaseA 68-year-old woman was admitted to the hospital because of vomiting.Seventeen months previously she entered the hospital because of a dry cough and painless erythematous lesions on the right lower extremity. Examination revealed erythema and swelling of both ankles. A nontender, erythematous nodule, 3 by 4 cm, was found on the right lower leg. The hematocrit was 36.5 per cent; the white-cell count was 9800, with 80 per cent neutrophils, 9 per cent lymphocytes, 9 per cent monocytes, 1 per cent eosinophils and 1 per cent basophils. The erythrocyte sedimentation rate was 100 mm per hour. . . .
Management of dyspepsia among Asians by general practitioners in East London
Authors: P. N Malcolm, T. Y K Chan, P.-L. Li, J. Richards, W. Hately
Journal: BMJ (1995)

Cognition is compromised by white matter (WM) injury but the neurophysiological alterations linking them remain unclear. We hypothesized that reduced neural synchronization caused by disruption of neural signal propagation is involved. To test this, we evaluated group differences in: diffusion tensor WM microstructure measures within the optic radiations, primary visual area (V1), and cuneus; neural phase synchrony to a visual attention cue during visual-motor task; and reaction time to a response cue during the same task between 26 pediatric patients (17/9: male/female) treated with cranial radiation treatment for a brain tumor (12.67 ± 2.76 years), and 26 healthy children (16/10: male/female; 12.01 ± 3.9 years). We corroborated our findings using a corticocortical computational model representing perturbed signal conduction from myelin. Patients show delayed reaction time, WM compromise, and reduced phase synchrony during visual attention compared with healthy children. Notably, using partial least-squares–path modeling we found that WM insult within the optic radiations, V1, and cuneus is a strong predictor of the slower reaction times via disruption of neural synchrony in visual cortex. Observed changes in synchronization were reproduced in a computational model of WM injury. These findings provide new evidence linking cognition with WM via the reliance of neural synchronization on propagation of neural signals. <b>SIGNIFICANCE STATEMENT</b> By comparing brain tumor patients to healthy children, we establish that changes in the microstructure of the optic radiations and neural synchrony during visual attention predict reaction time. Furthermore, by testing the directionality of these links through statistical modeling and verifying our findings with computational modeling, we infer a causal relationship, namely that changes in white matter microstructure impact cognition in part by disturbing the ability of neural assemblies to synchronize. Together, our human imaging data and computer simulations show a fundamental connection between WM microstructure and neural synchronization that is critical for cognitive processing.
What's wrong when it isn't right: Situs inversus and genetic control of organ position
Authors: Laurie N. Fishman, Joel E. Lavine
Journal: Hepatology (1994)

A recessive mutation was identified in a family of transgenic mice that resulted in a reversal of left-right polarity (situs inversus) in 100 percent of the homozygous transgenic mice tested. Sequences that flanked the transgenic integration site were cloned and mapped to mouse chromosome 4, between the Tsha and Hxb loci. During early embryonic development, the direction of postimplantation turning, one of the earliest manifestations of left-right asymmetry, was reversed in homozygous transgenic embryos. This insertional mutation identifies a gene that controls embryonic turning and visceral left-right polarity.
A Case of Evulsion of the Iris
Authors: W. H. Folker
Journal: BMJ (1872)

result being the precipitation of minute globules of chloroform and the simultaneous formation of formiate of the base that is added C2 C13H O KtI-J O = C C13JI + CO-1I Chloial Chloroform.Formiate of Potassium.7/ic p/iiSio7oWc>.a/(aci/oiz (of ani ac^/i'i snbs/ailce 010al' ik accolol/aniad wi//I olmi'ois tcitX'oiical i-a-(7c/ionzs li/wacs zi/ia and ĉar/iain of t/e conisti/ucn/s
Kidney Cancer Is Characterized by Aberrant Methylation of Tissue-Specific Enhancers That Are Prognostic for Overall Survival
Authors: Caroline Y. Hu, Davoud Mohtat, Yiting Yu, Yi-An Ko, Niraj Shenoy, Sanchari Bhattacharya, Maria C. Izquierdo, Ae Seo Deok Park, Orsolya Giricz, Nishanth Vallumsetla, Krishna Gundabolu, Kristin Ware, Tushar D. Bhagat, Masako Suzuki, James Pullman, X. Shirley Liu, John M. Greally, Katalin Susztak, Amit Verma
Journal: Clinical Cancer Research (2014)

Even though recent studies have shown that genetic changes at enhancers can influence carcinogenesis, most methylomic studies have focused on changes at promoters. We used renal cell carcinoma (RCC), an incurable malignancy associated with mutations in epigenetic regulators, as a model to study genome-wide patterns of DNA methylation at a high resolution.Analysis of cytosine methylation status of 1.3 million CpGs was determined by the HELP assay in RCC and healthy microdissected renal tubular controls.We observed that the RCC samples were characterized by widespread hypermethylation that preferentially affected gene bodies. Aberrant methylation was particularly enriched in kidney-specific enhancer regions associated with H3K4Me1 marks. Various important underexpressed genes, such as SMAD6, were associated with aberrantly methylated, intronic enhancers, and these changes were validated in an independent cohort. MOTIF analysis of aberrantly hypermethylated regions revealed enrichment for binding sites of AP2a, AHR, HAIRY, ARNT, and HIF1 transcription factors, reflecting contributions of dysregulated hypoxia signaling pathways in RCC. The functional importance of this aberrant hypermethylation was demonstrated by selective sensitivity of RCC cells to low levels of decitabine. Most importantly, methylation of enhancers was predictive of adverse prognosis in 405 cases of RCC in multivariate analysis. In addition, parallel copy-number analysis from MspI representations demonstrated novel copy-number variations that were validated in an independent cohort of patients.Our study is the first high-resolution methylome analysis of RCC, demonstrates that many kidney-specific enhancers are targeted by aberrant hypermethylation, and reveals the prognostic importance of these epigenetic changes in an independent cohort.
Cause of death in hemophilia a patients in the United States from 1968 to 1979
Authors: David L. Aronson
Journal: American Journal of Hematology (1988)

Abstract Death data on 949 hemophiliacs for the years 1968–1979 have been analyzed. The median age at death has increased from 33 to 55 years. There was no evidence of new diseases caused by the more intensive therapy during this time interval. The leading infectious disease was hepatitis, accounting for eight deaths. Only one acute hepatitis death was listed after 1974, when sensitive tests for hepatitis B antigen screening of plasma were implemented. Cirrhosis was a primary or associated cause of death in 76 cases (8%) and pneumonia was a primary or associated cause of death in 62 deaths (6.5%). The types of malignancies in hemophiliacs were similar to those in the male US population with no evidence of excessive retrovirus malignancies prior to infection with HIV‐1.
Attending Rounds: Where Do We Go From Here?
Authors: John Amoss
Journal: JAMA Internal Medicine (2013)

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