tbuckley/cabot-search huggingface dataset:
Brain Metastases in Women with Inflammatory Breast Cancer (IBC): Incidence, Treatment and Outcome.
Authors: S. Dawood, N. Ueno, V. Valero, E. Andreopoulou, L. Hsu, J. Lara, W. Woodward, T. Buchholz, G. Hortobagyi, M. Cristofanilli
Journal: Cancer Research (2009)

Abstract Background: Brain metastases are an uncommon metastatic recurrence site in breast cancer with a median incidence of approximately 6% in unselected populations. Inflammatory breast cancer (IBC) is an aggressive disease associated with dismal outcome. The purpose of this study was to determine the incidence of and survival following brain metastases among women with IBC.Material and Methods: Two hundred and six women with newly diagnosed stage III or IV IBC diagnosed between the period of between 2003 and 2008 were identified in a prospectively maintained IBC database at the MD Anderson Cancer Center. Cumulative incidence of brain metastases was computed. Cox proportional hazards models were fitted to explore factors that predict for the development of brain metastases. Survival was computed using the Kaplan-Meier product limit method.Results: Median follow-up was 20 months. Eighty three (40.3%) women had de-novo stage IV disease and 123 (59.7%) had stage III disease at diagnosis. Thirty-three (16%) patients developed brain metastases with a cumulative incidence at 1 and 3 years of 2.7% and 22% respectively. Eleven (5.3%) patients developed brain metastases as the first site of recurrence with cumulative incidence at 1 and 3 years of 1.6% and 6.7% respectively. In the multivariable model, no specific factor was observed to be significantly associated with time to brain metastases, including HER-2 status. Median overall survival for the whole cohort was not reached. 3-year overall survival for the whole cohort was 78% (95% CI 69%-86%). Median survival following a diagnosis of brain metastases for all women who developed brain metastases or those who developed brain metastases as the first site of recurrence was 6 months.Conclusion: In this single-institutional study, women with IBC demonstrated a high early incidence of brain metastases associated with poor survival. As such IBC may be an ideal cohort to target screening procedures for brain metastases and/or enrollment of these women in clinical trials evaluating additional adjuvant preventive strategies. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 2102.
A National Board of Health.
Authors: H. M. Bracken
Journal: JAMA (1899)

Minneapolis, Minn., July 28, 1899. <h3>To the Editor</h3> —An editorial in theJournal(July 22, p. 234), speaking of a national department of health, refers to the endorsement of such by several medical bodies—the American Public Health Association, theAmerican Medical Association, and the Conference of State Boards of Health. In connection with the latter association, it said "recommended with practical unanimity—three delegates not voting." This is a misrepresentation. The question brought to a vote at the Conference at Richmond was<i>not</i>, "Shall we have a<i>national</i>board of health?" but<i>"Shall we endorse the Spooner bill?"</i>Quite a different proposition. I was one of those who put myself on record as<i>not voting</i>, for the motion was so worded that one voting in the negative was made to appear to be voting against a national board of health. I was not willing to vote to endorse the Spooner bill.
Oesophageal symptoms, their causes, treatment, and prognosis in patients with the acquired immunodeficiency syndrome.
Authors: G M Connolly, D Hawkins, J N Harcourt-Webster, P A Parsons, O A Husain, B G Gazzard
Journal: Gut (1989)

In a prospective study of 154 AIDS patients, 48 (31%) complained of pain on swallowing both liquids and solids and 32 (21%) of these also had dysphagia. While candidiasis was the most common cause of symptoms (26 patients), discrete ulceration of the oesophagus occurred in 12 instances in 10 patients (four cytomegalovirus, four herpes simplex virus, three aphthous ulcer, one peptic ulcer). One patient had a diffuse oesophagitis caused by Mycobacterium avium intracellulare. No cause was found for the oesophageal symptoms in four patients. Kaposi's sarcoma (KS) was found in seven patients associated with other pathology in four. All 26 patients with oesophageal candidiasis only, also had oral involvement. All the patients with herpes simplex virus (four) and aphthous ulcers (three) had obvious perioral involvement. Three of the four patients with cytomegalovirus ulceration had evidence of disease elsewhere (colon or retina). All patients with Kaposi's sarcoma lesions had skin and buccal cavity involvement. The cause of oesophageal disease was usually obvious at endoscopy. The appearance of candidiasis was typical and the various ulcerating lesions also had different macroscopic configurations. Cytomegalovirus infection produced deep linear ulcers in the distal oesophagus, herpes simplex oesophagitis is similar in appearance to the typical perioral lesions of fluid filled vesicles. Diagnostic radiology was not helpful in most patients. In nine of 17 patients with candidiasis, the barium swallow examination performed within 24 hours of presentation was normal. In only three of seven patients with oesophageal ulceration (three cytomegalovirus, two herpes simplex virus, one aphthous, one peptic) was there evidence of an abnormality. Treatment produces symptomatic relief. All patients with candidiasis responded to ketoconazole, the four with herpes simplex virus to acyclovir and one of three with aphthous ulceration had a dramatic response to thalidomide. The three patients with cytomegalovirus infection who were treated with foscarnet had a prolonged remission of symptoms. The overall prognosis of patients with oesophageal symptoms is poor, with an average survival time from a definitive diagnosis of five months (range one to 13).
Carbetocin versus oxytocin for prevention of postpartum haemorrhage: a randomised controlled trial
Authors: Sergio Rosales-Ortiz, Rogelio Pérez Aguado, Roberto Sanchez Hernandez, Maria Castorena, Flor Lucas Cristobal, Miriam Carbajal González, Ioannis Gallos, Arri Coomarasamy
Journal: The Lancet (2014)
International protocols are needed to boost public confidence in universal HIV testing
Authors: P. Moszynski
Journal: BMJ (2008)

Fewer than 75 000 people in Lesotho were screened for HIV out of a target of 1.3 million, a study of the country’s universal HIV counselling and testing campaign has found. It concludes that for people to come forward for testing, international guidelines are needed to create sufficient confidence that rights will be respected.

Lesotho’s Know Your Status campaign aimed to test all citizens aged 12 or older and ran from 2005 until December 2007. Yet the drive fell far short of its goals, “both in carrying out the programme and in safeguarding the rights of those tested,” according to a joint report by Human Rights Watch and the …
Immobilization for Infected Wounds
Authors: R. Hare
Journal: BMJ (1940)

Communications between clinicians and patients with idiopathic pulmonary fibrosis (IPF) have the potential to be challenging. The variable course and poor prognosis of IPF complicate discussions around life expectancy but should not prevent clinicians from having meaningful conversations about patients’ fears and needs, while acknowledging uncertainties. Patients want information about the course of their disease and management options, but the provision of information needs to be individualised to the needs and preferences of the patient. Communication from clinicians should be empathetic and take account of the patient9s perceptions and concerns. Models, tools and protocols are available that can help clinicians to improve their interactions with patients. In this article, we consider the difficulties inherent in discussions with patients with IPF and their loved ones, and how clinicians might communicate with patients more effectively, from breaking the news about the diagnosis to providing support throughout the course of the disease.
"Diuretic escape" and "rebound oedema".
Authors: L E Ramsay
Journal: BMJ (1979)

severe, even fatal, pelvic actinomycosis can develop in association with usage of the IUCD.3Further investigation and follow-up of asymptomatic patients with actinomycespositive smears may provide some answers concerning the role of anaerobic bacteria in the pathogenesis of pelvic inflammation.Studies with these aims are being conducted in centres in the United Kingdom and the United States.
Comparative values of the precordial and transesophageal approaches in the echocardiographic evaluation of atrial baffle function after an atrial correction procedure
Authors: Renate Kaulitz, Oliver F.W. Stümper, Rene Geuskens, Narayanswami Sreeram, Nynke J. Elzenga, Chen K. Chan, Janet E. Burns, Michael J. Godman, John Hess, George R. Sutherland
Journal: Journal of the American College of Cardiology (1990)
The Effects of Learning on the Ventilatory Responses to Inspiratory Threshold Loading
Authors: PETER R. EASTWOOD, DAVID R. HILLMAN, ALAN R. MORTON, KEVIN E. FINUCANE
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

Progressive threshold loading (PTL) is frequently used to assess inspiratory muscle endurance in health and disease. We and others have noted a systematic increase in endurance with the first few exposures to the task in subjects previously naïve to PTL, which may not be related to conditioning of the muscles themselves. The purpose of this study was to investigate the mechanisms responsible for this increased endurance by examining the ventilatory responses to 3 PTL tests, each > 24 h apart, in 18 healthy subjects. During PTL, threshold pressure (Pth) was increased by approximately 10% every 2 min until task failure. Subjects were allowed to adopt any breathing pattern. Respiratory muscle strength (maximal inspiratory pressure [PImax]) was unchanged over successive tests while maximal Pth (Pthmax) during PTL increased (69 +/- 17, 77 +/- 16, and 86 +/- 11% of PImax, respectively, p < 0.05) (mean +/- SD), indicating that the increased Pthmax could not be attributed to improved respiratory muscle strength. Breathing pattern changed with successive tests, so that for comparative loads inspiratory time (TI), respiratory frequency (f ), and duty cycle (TI/Ttot) decreased. This change in breathing pattern did not alter respiratory muscle efficiency (respiratory muscle V O2/work), which was similar in each test (2.4 +/- 2.2%), but perceived effort (Borg Score), which was maximal at task failure in each test, decreased at comparative loads with successive tests. Thus, Pthmax during initial tests appeared to be limited by discomfort rather than respiratory muscle function. These findings suggest that the increased Pthmax with successive tests is a consequence of differences in the breathing pattern adopted, reflecting neuropsychological rather than respiratory muscle conditioning. Measurements from PTL should only be used to assess respiratory muscle performance after allowing time for learning.
Effect of Hydroxyethylrutosides on Blood Oxygen Levels and Venous Insufficiency Symptoms in Varicose Veins
Authors: A. J. McEwan, C. S. McArdle
Journal: BMJ (1971)

Oxygen levels (tension, saturation, and content) in blood from varicose leg veins were found to be significantly lower than those in blood from normal leg veins at the same site on the limb under the same laboratory conditions. Treatment with hydroxyethylrutosides significantly increased the oxygen levels in blood from varicose veins, and this was associated with an improvement in leg symptoms attributable to venous insufficiency. Hydroxyethylrutosides have been shown to have a beneficial effect on capillary dysfunction in venous stasis.
Changing Over-the-Counter Drugs While Retaining the Brand Name
Authors: James R. Merikangas
Journal: Annals of Internal Medicine (1993)

Letters15 June 1993Changing Over-the-Counter Drugs While Retaining the Brand NameJames R. Merikangas, MDJames R. Merikangas, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-12-199306150-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:There is a new hazard in over-the-counter medication. Apparently, drug companies can change the ingredients of a brand name product without any notice to the consumer. Until recently, Anusol suppositories (Warner-Lambert, Morris Plains, New Jersey) contained bismuth subgallate, bismuth resorcin, and pramoxine hydrochloride, a local anesthetic, in a base of zinc oxide and coconut oil.Now labeled identically except for the very fine print, Anusol is totally different, containing phenylephrine (0.25%), hard fat (88.7%), cornstarch, methylparaben, and propylparaben; it no longer contains bismuth. Phenylephrine is a sympathomimetic drug. It is contraindicated for patients receiving monoamine oxidase inhibitors ... Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 June 1993Volume 118, Issue 12Page: 988KeywordsBismuthDrug regulationDrugsFood and Drug AdministrationOilsPhenylephrinePrimary hypertensionStarchesSuppositoryZinc Issue Published: 15 June 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Lessons from developing nations on improving health care
Authors: Donald M Berwick
Journal: BMJ (2004)

ConclusionThe scientific arguments for a national screening programme for aneurysms are cogent.We believe that the United Kingdom's family doctor based health system puts it in an ideal position to be the first country to start national screening.The final decision is now political.It is a shame that aneurysm disease lacks a cohesive pressure group to encourage the process.Contributors and sources: BPH designed and started the Gloucestershire aneurysm screening programme.JJE, MRW,
Development of Quantitative Gastrointestinal Carcinoma (GEC and CRC) SRM Assays for Use in FFPE Tumor Tissues
Authors: T.A. Hembrough, D. V. T Catenacci, W.L. Liao, S. Thyparambil, P. Xu, L. Henderson, J. Burrows
Journal: Annals of Oncology (2013)
PERSISTENCE OF HAPTEN-ANTIBODY COMPLEXES IN THE CIRCULATION OF IMMUNIZED ANIMALS AFTER A SINGLE INTRAVENOUS INJECTION OF HAPTEN
Authors: Donald H. Schmidt, Bette M. Kaufman, Vincent P. Butler
Journal: The Journal of Experimental Medicine (1974)

To study the fate of a low molecular weight antigen (hapten) in the circulation of animals whose sera contain antibodies specific for that low molecular weight antigen, a single injection of digoxin-(3)H (0.4 mg/kg) was administered intravenously to 18 rabbits. Thirteen animals (nine nonimmunized and four immunized with bovine serum albumin) served as control animals. In five rabbits which had been immunized with a digoxin-bovine serum albumin conjugate and whose sera contained digoxin-specific antibodies, the mean 12-h serum digoxin concentration was 8,300 ng/ml (control: 92 ng/ml) and the mean serum concentration 12 mo after the single injection of digoxin-(3)H was 85 ng/ml. In digoxin-immunized rabbits, less than 10% of the digoxin-(3)H was excreted in the first 10 days (control: 77% recovered in urine and feces) and the mean biological half-life of digoxin, as calculated from serum digoxin-(3)H disappearance curves, was 72 days (control: 3.4 days). In sera of digoxin-immunized rabbits, more than 90% of the circulating digoxin-(3)H was immunoglobulin bound, as determined by the double-antibody and dextran-coated charcoal methods. The serum disappearance rate of (125)I-antidigoxin antibodies was similar in nonimmunized and in immunized animals and in the presence or absence of digoxin. It is concluded that the biological half-life of a hapten may be markedly prolonged when the hapten is bound to specific antibody. The persistence of antibody-hapten complexes in the circulation suggests that these complexes may not be deposited in tissues and raises the possibility that low molecular weight determinants may be capable of preventing or reversing the deposition of immune complexes, containing macromolecular antigens, in the tissues of experimental animals and man.
Letter: Cryotherapy for piles.
Authors: H D Kaufman
Journal: BMJ (1975)

but the effect on glucose metabolismn of severe intoxication has not been reported.In rodents glucose appears to enhance the toxic effects of fenfluramine, which suggests that it is unlikely to have a therapeutic role in severe intoxication in humans.Although appetite suppressants cost the NHS over £2m in 1973, their efficacy in the long term remains somewhat dubious.Their dangers, however, even when in- dividually wrapped, continue to be demon- strated.
Management of Nonalcoholic Fatty Liver Disease
Authors: Nezam H. Afdhal
Journal: JAMA (2012)

Nonalcoholic fatty liver disease (NAFLD) is one of the most common hepatic disorders in the United States, but uncertainty remains as to the optimal way to manage it. Using the case of Mr T, a 60-year-old man with obesity, diabetes mellitus, and increased serum transaminase levels, an evidence-based approach to diagnosis and treatment is discussed. Diagnosis of NAFLD is based on patient clinical profile and risk factors for metabolic syndrome, the exclusion of other liver diseases, radiologic imaging and sometimes biopsy. At this point in Mr T's disease, the most important step is differentiation between simple steatosis and nonalcoholic steatohepatitis (NASH). Simple steatosis has a benign natural history, but NASH is progressive and may lead to cirrhosis, liver failure, and liver cancer. An evidence-based approach to treatment is limited by lack of large randomized trials, particularly of combinations of therapies, but weight loss, exercise, and medical therapies targeted at the mechanism of liver injury in NASH are recommended. Improved noninvasive diagnostic tests, a clearer understanding of the natural history of NAFLD, and large, well-designed clinical trials are needed.
The dysfunctional innate immune response triggered by Toll-like receptor activation is restored by TLR7/TLR8 and TLR9 ligands in cutaneous lichen planus
Authors: R. Domingues, G. Costa de Carvalho, L.M. da Silva Oliveira, E. Futata Taniguchi, J.M. Zimbres, V. Aoki, A.J. da Silva Duarte, M.N. Sato
Journal: British Journal of Dermatology (2014)

Lichen planus (LP) is a chronic inflammatory mucocutaneous disease. Toll-like receptors (TLRs) bind numerous exogenous and endogenous antigens by recognizing conserved pathogen-associated molecular patterns (PAMPs) and have the ability to induce the production of proinflammatory cytokines. Therefore, alterations in innate immunity could explain the inflammation and T-cell autoreactivity leading to the development of LP disease.To evaluate how the host innate immune response to PAMPs is affected by cutaneous LP, primarily by using TLR agonists to induce proinflammatory cytokine secretion from peripheral blood mononuclear cells (PBMCs).PBMCs from patients with LP and healthy control (HC) individuals were stimulated with agonists of TLR2/TLR1 (pam3csk4), TLR3 [poly(I:C)-RIG], TLR4 (lipopolysaccharide), TLR5 (flagellin), TLR7 (imiquimod), TLR7/TLR8 (CL097) and TLR9 (CpG). Cytokines from culture supernatants (n = 10-12) and serum chemokines and cytokines (n = 22-24) were measured using flow cytometry.Activation through the TLR2, TLR4 and TLR5 pathways induced increased tumour necrosis factor (TNF)-α secretion by PBMCs from individuals with LP compared with the HC group. In contrast, activation through TLR3 and TLR7 was impaired in the LP group, leading to decreased TNF-α secretion. Moreover, intracellular TLR activation resulted in reduced interleukin (IL)-1β and IL-6 secretion. Notably, individuals with LP became responders on stimulation with TLR7/TLR8 and TLR9 agonists; responses were measured as increases in interferon (IFN)-α production. Detectable TNF-α and high CXCL9 and CXCL10 serum levels were observed in patients with LP, suggesting their potential use as markers of the inflammatory status in LP.These findings point to a defect in the TLR signalling pathways in cutaneous LP. Agonists of TLR7/TLR8 or TLR9 overcame impaired IFN-α secretion in LP, strategically acting as adjuvants to improve the type I response.
EUSOL AND OTHER METHODS OF WOUND TREATMENT
Authors: C. W. Duggan
Journal: BMJ (1916)

fJULY 15, I9I6 All cases should be treated at the earliest possible moment.Chloroform is better than otlher general anaesthetics for this purpose, because it produces definite stages of anaesthesia wlhiclh can be readily prolonged as required.Cases which have been cured by abnormal experiences, such as an abdominal operation, or a sllipwreck, would probably lhave been cured earlier by suggestion under chloroform.
Cytokines in bronchoalveolar lavage fluid of patients with nocturnal asthma.
Authors: N N Jarjour, W W Busse
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Airflow obstruction can have a circadian pattern with nocturnal worsening. Airway inflammation is a cardinal feature of asthma, and it has been shown to increase at night in association with the decline in pulmonary function. Although the mechanisms regulating enhanced airway inflammation in asthma at night have yet to be ascertained, we hypothesized that circadian variation in cytokine expression or production is an important factor in the development of nocturnal airflow limitation. To investigate this possibility, spirometry and bronchoscopy were performed; the bronchoalveolar lavage (BAL) fluid obtained at 4:00 A.M. and at 4:00 P.M. were measured for IL-1 beta in asthmatics with (n = 5) and without (n = 9) nocturnal asthma. In addition, the activity of IL-3, IL-5, and GM-CSF was measured using a biologic assay (eosinophil survival-enhancing activity). BAL fluid concentrations of IL-1 beta were significantly greater at 4:00 A.M. than at 4:00 P.M. (1.14 +/- 0.6 versus 0.7 +/- 0.6 pg/ml; p = 0.05) in asthmatics with nocturnal airflow obstruction. Moreover, IL-1 beta levels at 4:00 A.M. tended to be higher in subjects with nocturnal asthma than in those without nighttime airflow reduction (1.14 +/- 0.6 versus 0.3 +/- 0.4 pg/ml; p = 0.1). On the other hand, eosinophil survival-enhancing activity in BAL fluid, which is usually associated with IL-3, IL-5, or GM-CSF, was not detected in relationship to nocturnal asthma. Because IL-1 beta can activate air-space cells, particularly alveolar macrophages, we propose that an increased release of this cytokine is a significant contributor to nocturnal airway inflammation and obstruction in asthma.
Comment on Heianza et al. Effect of Postmenopausal Status and Age at Menopause on Type 2 Diabetes and Prediabetes in Japanese Individuals: Toranomon Hospital Health Management Center Study 17 (TOPICS 17). Diabetes Care 2013;36:4007–4014
Authors: Shamima Akter, Kayo Kurotani, Akiko Nanri, Keisuke Kuwahara, Tetsuya Mizoue
Journal: Diabetes Care (2014)

We read with great interest the article by Heianza et al. (1), which showed a higher probability of type 2 diabetes and prediabetes among postmenopausal women than among premenopausal women. It is also suggested that menopause and older age might additively influence the elevated probability of type 2 diabetes. Although not prospective in nature, the finding is important due to little evidence on this topic. The authors, however, seem to overlook some important issues. We would like to draw attention to several …
Unwise words: now that's wasn't very clever
Authors: T. Wells
Journal: BMJ (2009)

When doing an oncology outpatient clinic, I wheeled into the clinic room to see a patient for follow-up of his condition; I use a wheelchair after spinal injury many years ago resulted in permanent paralysis from the chest down. After we had made our introductions, The patient asked, “Why are you in a wheelchair?” 

Whenever my wheelchair is mentioned, …