tbuckley/cabot-search huggingface dataset:
Performance on the NBME Part I Examination-Reply
Authors: Beth Dawson
Journal: JAMA (1995)

<h3>In Reply.</h3> —The statement referenced by Dr Nickens follows our description of various programs under way at some medical schools to assist students with relatively poor academic backgrounds and our subsequent suggestion that research investigating the effectiveness of these programs is needed. Some programs focus on helping students improve skills so they become more successful candidates for medical school. For instance, over the past 20 years, more than 600 students have participated in the Medical/Dental Education Preparatory Program at Southern Illinois University School of Medicine, and 60% of them have been admitted to health professions schools. Other programs, such as the one at the University of Hawaii John A. Burns School of Medicine, work with students to improve study skills after they have matriculated. We recognize that<i>Project 3000 by 2000</i><sup>1</sup>aims to increase the number of minority students actually enrolled in medical schools and did not intend to
EXPERIMENTAL INFECTION WITH INFLUENZA A VIRUS IN MICE
Authors: R. M. Taylor
Journal: The Journal of Experimental Medicine (1941)

Following intranasal inoculation of influenza A virus (strain PR8) there is a rapid increase of the virus in the lungs which with large doses reaches a maximum within 24 hours. With smaller doses, although the proportional increase is greater, the maximum concentration is not reached until 48 hours following inoculation. If a lethal dose is administered, the ultimate concentration of the virus in the lungs is the same, irrespective of the size of the dose. If a sublethal dose is given, the titer of the virus in the lungs does not achieve the titer reached in mice receiving a lethal dose. Within 48 hours following inoculation of a sublethal dose the lungs of a mouse may contain at least 76,000 M.L.D., yet the mouse survives. The intranasal instillation of sterile fluid (distilled water, varying concentrations of NaCl, broth, or 10 per cent normal serum) into a mouse sublethally infected produces a sharp rise in the virus content of the lung usually followed by death within 3 to 8 days. If, however, the instillate consists of 10 per cent immune serum, there is no rise in the virus titer, and no apparent harm results from the instillation. The implications of these phenomena are discussed and an hypothesis presented to explain their occurrence.
Stage at Diagnosis and Management of Breast Cancer in Men and Women – A Population-Based Study (Sweden).
Authors: C. Nilsson, C. Nilsson, M. Holmqvist, C. Blomqvist, C. Blomqvist, L. Bergkvist, M. Lambe, M. Lambe, M. Fjällskog
Journal: Cancer Research (2009)

Abstract Background: Male breast cancer is an uncommon disease, representing less than 1% of all breast cancer. Due to the rareness of the disease there is a lack of prospective randomized studies to guide treatment decisions. While current guidelines recommend that male breast cancer should be treated in the same way as female breast cancer, concerns have been raised regarding the quality of management in men. Results from earlier studies indicate that men with breast cancer are not as aggressively treated as women and that outcomes are worse. The aim of this population based study was to assess and compare stage at presentation and management of breast cancer in men and women in Sweden.Material and methods: In a case-control approach, we identified male and female patients with a record of a breast cancer diagnosis in the Breast Cancer Register of Central Sweden between 1993 and 2007. 99 men (cases) with breast cancer were matched on age at and time of diagnosis to four women with breast cancer (controls). Data on tumor characteristics and treatment were retrieved from the Breast Cancer Register.Results: There was no difference in the distribution of stage at diagnosis between men and women; stage I (33% and 36%, respectively), stage II (42% and 41%), stage III (6% and 4%) and stage IV (3% and 4%,). At the time of diagnosis 31% of male patients and 32% of female patients were node positive. Men underwent mastectomy more often than women (95% versus 45%). The proportion of men receiving loco-regional radiotherapy postoperatively was lower compared to women (44% vs. 58%). There were no proportional differences regarding adjuvant chemotherapy (16% vs. 18%) and adjuvant hormonal therapy (60% vs. 55%).Conclusion: At the time of diagnosis, men and women presented with a similar distribution of stage of disease. Our concerns regarding less extensive treatment in male breast cancer patients were not supported by our findings. Additional data including survival analyses will be added and presented at SABCS.Clinical VariablesMale breast cancer patients (cases) N=99Female breast cancer patients (controls) N=396Stage I33%36%II42%41%III6%4%IV3%4%Missing16%15%N+31%32%M13%4%Mastectomy95%45%Partial mastectomy5%54%No surgery2%4%No axillary surgery11%12%Preoperative radiotherapy1%1%Preoperative chemotherapy5%2%Preoperative hormonal treatment2%3%Chemotherapy16%18%Radiotherapy44%58%Tamoxifen58%45%Aromatase inhibitor2%10%No treatment21%14% Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 2111.
Polypharmacy in Skilled-Nursing Facilities
Authors: Judith K. Jones
Journal: Annals of Internal Medicine (1993)

Letters15 April 1993Polypharmacy in Skilled-Nursing FacilitiesJudith K. Jones, MDJudith K. Jones, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-8-199304150-00026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Terplan is rightly concerned that attention to the patient's welfare might be lost as computer technology enters the health care setting. Computerized methods for drug utilization review generate information applicable to individual patient care decisions. The computer print-out, which temporally arrays drug and clinical data, provides an overview of patient status not reproduced in patient charts.Further, direct entry of drug orders into a computer provides safeguards to prevent problems such as overuse of drugs. While overuse was not the point of the editorial, it represents a major focus of geriatricians, most drug utilization review organizations, and, ...References1. Jones JK. Drugs in the elderly. In: Reichel W; ed. Clinical Aspects of Aging-3. Baltimore: Williams & Wilkins; 1989:41-60. Google Scholar2. Atkinson AJ, Nadzam DM, Schaff RL. An indicator-based program for improving medication use in acute care hospitals. Clin Pharmacol Ther. 1991; 50:125-8. Google Scholar3. Shortliffe EH, Detmer DE. Patient records and computers. Ann Intern Med. 1991; 115:979-81. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 April 1993Volume 118, Issue 8Page: 649-651KeywordsChartsComputersDatabasesDrugsHealth careHealth care facilitiesHealth care utilizationPatients ePublished: 15 August 2000 Issue Published: 15 April 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Methadone treatment for opiate addicts
Authors: J. L Sorensen
Journal: BMJ (1996)

We report a case that developed watershed infarcts after undergoing carotid endarterectomy. Our patient had been having episodes of transient ischaemic attacks before admission. Carotid Doppler scan before admission showed severe unilateral carotid stenosis on left side. She underwent a carotid endarterectomy procedure. Her continuous blood pressure monitoring stayed normal during and after the procedure. One and half hour after the procedure, she developed right arm weakness. CT scan later revealed watershed infarcts in left cerebral hemisphere. The pathogenesis of watershed infarcts remain debated despite haemodynamic and embolic mechanisms being postulated.
Megakaryocyte dysplasia in primary myelofibrosis
Authors: Barbara J. Bain
Journal: American Journal of Hematology (2010)

In the 2008 WHO classification of tumors of hematopoietic and lymphoid tissues, primary myelofibrosis is classified as a myeloproliferative neoplasm (MPN) rather than as a myelodysplastic/myeloproliferative neoplasm. This is appropriate since it shares molecular abnormalities (mutations in JAK2 and MPL) with polycythaemia vera and essential thrombocythaemia, and since morphologically similar myelofibrosis can occur following these two MPN. Nevertheless, dysplastic features are common in primary myelofibrosis, at presentation as well as during disease progression. This image illustrates megakaryocyte dysplasia during disease progression is a 75-year-old man who had required a splenectomy for progressive splenomegaly and anemia. His full blood count showed: white cell count 3.3 × 109/l, hemoglobin concentration 88 g/l, mean cell volume 110 fl (attributable to hydroxycarbamide therapy) and platelet count 381 × 109/l. His blood film showed megakaryoblasts (top left), micromegakaryocytes (top right and bottom left), and giant fragments of megakaryocyte cytoplasm (bottom right). Circulating megakaryoblasts and micromegakaryocytes in MPN can often be recognized, as in this patient, by their irregular cytoplasmic margins and cytoplasmic blebs. Some micromegakaryocytes have hyperchromatic lobulated nuclei (bottom left). It is to some extent arbitrary whether fragments of megakaryocyte cytoplasm are regarded as megakaryocyte fragments or giant platelets. The fragment shown (bottom right) has a recognizable granulomere and hyalomere so could reasonably be regarded as a giant platelet despite its enormous size. In primary myelofibrosis dysplastic features can occur in all lineages, but megakaryocyte dysplasia is particularly common. Dysplasia at presentation may indicate that the disease has already progressed from a purely myeloproliferative preclinical phase. With disease progression, dysplasia can be very prominent.
Systemic Efficacy with Oncolytic Virus Therapeutics: Clinical Proof-of-Concept and Future Directions
Authors: Ta-Chiang Liu, David Kirn
Journal: Cancer Research (2007)

Abstract Oncolytic viruses that can destroy cancer cells have been engineered in a variety of ways with the aim of improving their selectivity and efficacy. Here, we review data from clinical investigations of these virotherapeutic agents, specifically those that have shown systemic efficacy: vaccinia, measles, mumps, viruses, Newcastle disease virus, and reovirus. Further directions for optimizing i.v. delivery and efficacy are discussed. [Cancer Res 2007;67(2):429–32]
Osteomalacia with Long-term Anticonvulsant Therapy in Epilepsy
Authors: C. E. Dent, A. Richens, D. J. F. Rowe, T. C. B. Stamp
Journal: BMJ (1970)

The investigation and treatment of osteomalacia are described in four patients with epilepsy treated with long-term anticonvulsant therapy. It is suggested that drug-mediated enzyme induction may be the mechanism responsible by causing a greatly increased inactivation of vitamin D in these patients.
Biomarker Risk Assessment and Bladder Cancer Detection in a Cohort Exposed to Benzidine
Authors: G. P. Hemstreet, S. Yin, Z. Ma, R. B. Bonner, W. Bi, J. Y. Rao, M. Zang, Q. Zheng, B. Bane, N. Asal, G. Li, P. Feng, R. E. Hurst, W. Wang
Journal: JNCI Journal of the National Cancer Institute (2001)

Background: Cancer screening with highly sensitive, specific biomarkers that reflect molecular phenotypic alterations is an attractive strategy for cancer control. We examined whether biomarker profiles could be used for risk assessment and cancer detection in a cohort of Chinese workers occupationally exposed to benzidine and at risk for bladder cancer. Methods: The cohort consisted of 1788 exposed and 373 nonexposed workers, followed from 1991 through 1997. We assayed urothelial cells from voided urine samples for DNA ploidy (expressed as the 5C-exceeding rate [DNA 5CER]), the bladder tumor-associated antigen p300, and a cytoskeletal protein (G-actin). Workers were stratified into different risk groups (high, moderate, and low risk) at each examination based on a predefined biomarker profile. For workers who developed bladder cancer, tumor risk assessment was analyzed from samples collected 6–12 months before the cancer diagnosis. The associations between risk group and subsequent development of bladder cancer were analyzed by Cox proportional hazards regression analysis and logistic analysis, after adjustment. All statistical tests were two-sided. Results: Twenty-eight bladder cancers were diagnosed in exposed workers and two in nonexposed workers. For risk assessment, DNA 5CER had 87.5% sensitivity, 86.5% specificity, an odds ratio (OR) of 46.2 (95% confidence interval [CI] = 8.1 to 867.0), and a risk ratio (RR) of 16.2 (95% CI = 7.1 to 37.0); p300 had 50.0% sensitivity, 97.9% specificity, an OR of 40.0 (95% CI = 9.0 to 177.8), and an RR of 37.9 (95% CI = 16.8 to 85.3). The risk of developing bladder cancer was 19.6 (95% CI = 8.0 to 47.9) times higher in workers positive for either the DNA 5CER or p300 biomarkers than in workers negative for both biomarkers and 81.4 (95% CI = 33.3 to 199.3) times higher in workers positive for both biomarkers. G-actin was a poor marker of individual risk. Conclusions: Occupationally exposed workers at risk for bladder cancer can be individually stratified, screened, monitored, and diagnosed based on predefined molecular biomarker profiles.
P2-182: Feasibility of sleeve lobectomy with induction chemoradiotherapy: Analysis of morbidity and recurrence pattern compared with sleeve lobectomy without induction therapy
Authors: Yuji Hirami, Hiroshi Date, Hiroyuki Tao, Masaomi Yamane, Shinichi Toyooka, Motoi Aoe, Yoshifumi Sano
Journal: Journal of Thoracic Oncology (2007)
Familial Hyperproinsulinemia
Authors: Kenneth H. Gabbay, Krystyna DeLuca, Joseph N. Fisher, Mary E. Mako, Arthur H. Rubenstein
Journal: New England Journal of Medicine (1976)

We describe a genetic defect in a kindred in whom proinsulin or a proinsulin-like material constitutes the major fraction of circulating insulin immunoreactivity in both the fasting and stimulated states. The defect, familial hyperproinsulinemia, affects eight males and 10 females in four generations of the kindred, with an autosomal dominant mode of transmission. Familial hyperproinsulinemia is asymptomatic in the affected progeny, with no apparent relation to hypoglycemia or to the development of diabetes mellitus. This genetic defect may represent either a deficiency in the proinsulin cleaving enzyme (or enzymes) within the beta cell, or more probably, an abnormal species of proinsulin.
OC-043 The Role of the EPS8 Binding Partners Sos1 and Abi1 in Pancreatic Cancer
Authors: P Kiely, J Tod, V Jenei, C Johnson, G J Thomas
Journal: Gut (2013)

<h3>Introduction</h3> Pancreatic cancer (PC) is an aggressive disease, characterised by marked local invasion, and identification of new molecular targets is critical to improving outcome. Cell motility requires reorganisation of the actin cytoskeleton and several actin-binding proteins have been implicated in PC. EGF receptor pathway substrate 8 (Eps8) is an adapter protein that interacts with a range of intracellular binding partners, including Abi1 and Sos1 (to form a tri-complex), and certain β integrin subunits, in order to regulate cytoskeletal reorganisation. The integrin αvβ6 is overexpressed in approximately 70% of PC and enhances invasion. This study examines the role of the Eps8 binding partners, Abi1 and Sos1, in αvβ6-dependent PC invasion and the significance of their expression on patient survival. <h3>Methods</h3> We used immunochemistry to examine the expression of Eps8, Sos1 and Abi1 in normal pancreas and PC <i>in vivo</i> using tissue microarrays. A retrospective patient database of PC patients operated on between 2000 and 2010 was generated. 33 short ( &lt; 1 year) and 20 long ( &gt; 5 years) survivors were then identified and resection tissue stained as whole sections for Eps8/Sos1/Abi1/αvβ6. We identified three PC cell lines that showed αvβ6-dependent invasion <i>in vitro</i>, and examined the role of Abi1 and Sos1 in Transwell® assays to specifically study motility dependent on this integrin. <h3>Results</h3> Eps8, Sos1 and Abi1 were up-regulated in PC compared with normal tissue. Expression of these proteins in long and short survivors of PC is currently being examined. Expression of Eps8, Sos1, Abi1 and αvβ6 were confirmed in all three PC cell lines tested. Knock-down of Eps8, Sos1 or Abi1 suppressed αvβ6-dependent invasion suggesting that this tri-complex is critical to PC motility. <h3>Conclusion</h3> We have shown that Eps8, Sos1 and Abi1 are up-regulated in PC and regulate αvβ6-dependent function. The Eps8 binding partner Sos1 appears to be critical to αvβ6-dependent PC cell motility. This may be of particular interest as Sos1 expression was previously shown to fall in response to gemcitabine, the current gold standard chemotherapeutic agent for the treatment of PC. Sos1 requires further investigation as a potential molecular target in the treatment of PC. <h3>Disclosure of Interest</h3> None Declared
Black breast milk due to minocycline therapy
Authors: M.J. HUNT, E.L.C. SALSBURY, J. GRACE, R. ARMATI
Journal: British Journal of Dermatology (1996)

We report the unusual case of a 29‐year‐old female who developed black discoloration of breast milk 3 weeks after commencing oral minocycline therapy for acne vulgaris. Histochemical analysis of the breast milk revealed the presence of pigment particles within macrophages with iron staining characteristics. We propose that the pigment may represent an iron chelate of minocycline or one of its derivatives.
New Haemophilus influenzae vaccine licensed
Authors: C. Marwick
Journal: JAMA (1988)

JUST AS QUESTIONS were being raised about the efficacy of the existing vaccine against<i>Haemophilus influenzae</i>disease, the Food and Drug Administration has licensed a new and much more immunogenic vaccine against the disease. It marks the first of a new generation of vaccines that, evidence indicates, provide much broader protection, even in infants, than do the existing vaccines against<i>H influenzae</i>type b. Furthermore, the conjugate vaccine holds out the promise of immunization against a number of other bacterial diseases of infancy. Unlike the current vaccine against<i>H influenzae</i>type b, which uses as the sole immunogen the capsular polysaccharide polyribosyl ribose phosphate, the polysaccharide in the new vaccine is linked to diphtheria toxoid. Such conjugated vaccines, as many studies over the past seven years have shown, effectively stimulate much higher antibody titers than polyribosyl ribose phosphate alone. In addition, also unlike the present vaccine, repeated doses of the
Use of inhaled nitric oxide and acetylcholine in the evaluation of pulmonary hypertension and endothelial function after cardiopulmonary bypass.
Authors: D L Wessel, I Adatia, T M Giglia, J E Thompson, T J Kulik
Journal: Circulation (1993)

BACKGROUND Increased pulmonary vascular resistance is common in congenital heart disease and is exacerbated by cardiopulmonary bypass (CPB). We investigated whether CPB is responsible for pulmonary endothelial dysfunction and contributes to postoperative pulmonary hypertension. METHODS AND RESULTS We infused the endothelium-dependent vasodilator acetylcholine (ACH) into the pulmonary circulation of pulmonary hypertensive children with congenital heart disease either before (n = 12) or after (n = 22) surgical repair on CPB. The dose response to ACH (10(-9) to 10(-6) M) was recorded for all hemodynamic variables. Nine additional postoperative patients were studied with ACH followed by inhalation of 80 ppm nitric oxide, an endothelium-independent smooth muscle relaxant. Plasma levels of cyclic GMP (cGMP) were measured before and after ACH and nitric oxide administration. Pulmonary vasodilation with 10(-6) M ACH was seen in all preoperative patients but was markedly attenuated in postoperative patients. Baseline pulmonary vascular resistance (5.6 +/- 1.0 U x m2) fell 46 +/- 5% in preoperative patients but declined only 11 +/- 4% from baseline (5.8 +/- 0.9 U x m2) in postoperative patients (P &lt; .002). However, inhalation of 80 ppm nitric oxide after ACH infusion in postoperative patients lowered pulmonary vascular resistance by 33 +/- 4% (P &lt; .0002 compared with postoperative ACH response) with minimal effects on the systemic circulation. This finding suggests that the capacity for smooth muscle relaxation and pulmonary vasodilation was present in postoperative patients but could not be induced by ACH. Plasma levels of cGMP in postoperative patients were unchanged after acetylcholine infusion but rose more than threefold during pulmonary vasodilation with nitric oxide (P &lt; .0001). This finding is consistent with the purported role of cGMP as the second messenger effecting smooth muscle relaxation in this process. CONCLUSIONS CPB may be responsible for postoperative dysfunction of the pulmonary endothelial cell and may contribute to postoperative pulmonary hypertension in children. Inhaled nitric oxide is a potent pulmonary vasodilator after CPB with minimal systemic circulatory effects. It may have important diagnostic and therapeutic applications in patients with congenital heart disease.
On the Structure of the Ovary in Relation to Certain Forms of Disease of the Organ
Authors: J. Foulis
Journal: BMJ (1875)

insufficient number of observations.As a conjecture supported by some instances, I would suggest that these are stretched bands often broken off at one end, and lying parallel on the cell-wall.They are beautifully seen with careful oblique illumination under high powers.This peculiar cell-structure which we have been describing may, then, be supposed to originate in this sort of way.In the lowest cell-layer of epithelium, there are found the newly grown, long, vertically placed MMM Fig 2. -Conjoired Epithelium.-,oooDiameters.cells, side by side in contact.When these have a somewhat perma- nent character, as in many fishes, the next layer of cells consists of spheroidal cell-forms which have resulted from division or budding, and consequent "fissiparous" multiplication or budding of a nze7l progeny.In all this there is a tendency of dividing cells to remain, at points, united by threads of formed material of hard cell-wall; e. S., amongst these very layers are often found large and branched pigmentcells united by long delicate threads.Thus I imagine the cells of rete MUCoSUM, in multiplying originally by subdivision, retain numerous points of incomplete severance, and these points of cohesion are dragged out and become the uniting bands.These, when severed by any acci- dent, assume the characteristic form of " prickles".In the normal ascending series, these cells, becoming older and flatter, lose all surface-connection, and in the cuticle are simple polyhedral horny blocks.The uniting agency of these cells is a firm one; for in a scraping from a tumour-section, as noticed by Ranvier, they almost always hold together strongly in groups.It is a firmer union than I should expect from any interlocking teeth, but of course one which would naturally result from uniting bands.
A Rapid Chemical Assay for Gentamicin
Authors: David H. Smith, Barbara Van Otto, Arnold L. Smith
Journal: New England Journal of Medicine (1972)

GENTAMICIN is bactericidal for many of the aerobic gram-negative bacilli that produce serious human infection. Unfortunately, it is also relatively toxic: it causes ototoxicity in approximately 2.3 per cent of patients, and renal damage somewhat less commonly.1 The ototoxicity is correlated with previous otologic status, prior therapy with ototoxic drugs, age and serum concentrations.1 Since gentamicin is excreted primarily by the kidneys, serum concentrations reflect the dosage, route of administration and interval between doses and renal function of the patient.The therapeutic index of this antibiotic is moderately narrow: most dosage schedules aim to attain 4 μg per milliliter of . . .