tbuckley/cabot-search huggingface dataset:
Spiritual Values in the Art of Medicine
Authors: Joseph H. Toomey
Journal: JAMA (1963)

To the Editor:  —In a plea for better recognition of the significance of spiritual values inherent in the art of medicine, a place can be found for the interpolation of something that may be regarded as having both a scientific and a spiritual aspect. In the impressive communication entitled Science is Not Enough, in the Aug 17 issue ofThe Journal( 185 :582), this is referred to somewhat obliquely when the author speaks about the genetic codes of cells. In that connection he could have spoken also of the fact that the genetic system of any living thing is the central and pivotal problem in biology and hence, in a sense, in medicine, because of its individuating activity and because its resistance to scientific analysis intimates the presence of some irreducible entity.  The genetic system, through which the ontogenetic development of the individual is achieved, is also the instrumentality that
Insurance Reports as a Threat to Confidentiality
Authors: MAURICE GROSSMAN
Journal: American Journal of Psychiatry (1971)

With the growth of health insurance coverage of mental disorders, the danger of breach of confidentiality in reports made in connection with insurance claims has increased. The author describes various kinds of abuse of confidentiality, citing some examples. He recommends more stringent application of the APA insurance guidelines to meet some of the problems and also advances other suggestions for corrective action.
Selective blockade of the antigen-receptor-mediated pathway of T cell activation in patients with impaired primary immune responses.
Authors: S C Meuer, M Hauer, P Kurz, K H Meyer zum Büschenfelde, H Köhler
Journal: Journal of Clinical Investigation (1987)

We investigated impaired cellular immune responses of individuals on chronic hemodialysis by using monoclonal antibodies that trigger differential pathways of T cell activation. Reduced cellular reactivity, which exists in a high proportion of such patients, can be attributed to a failure of the monocyte population to support the process of primary T cell activation in vitro. This defect results in a lack of interleukin 2 production, which is critically dependent on a monocyte-derived signal. In contrast, T lymphocyte function was found to be physiologic. Perhaps more important, the degree of monocyte dysfunction in vitro correlated with the same patients' in vivo responses to hepatitis B vaccination. Addition of recombinant human interleukin 2 fully reconstituted their deficient immune response in vitro.
Surgical management of portal hypertension in Felty’s syndrome: A case report and literature review
Authors: Heather Stock, Zakiyah Kadry, Jill P. Smith
Journal: Journal of Hepatology (2009)

Background/AimsBleeding esophageal varices are a common complication of portal hypertension in patients with underlying liver disease. Often patients with hepatic cirrhosis have hypersplenism with thrombocytopenia and leukopenia. Felty's syndrome is a disorder where patients with rheumatoid arthritis develop splenomegaly, neutropenia, and on rare occasions, portal hypertension without underlying cirrhosis.MethodsWe present a case of a patient with portal hypertension secondary to Felty's syndrome and discuss the importance of recognizing this condition since the treatment of choice is surgical management with splenectomy. A review of the literature and underlying liver histologic features are discussed.ResultsMedical and surgical management of patients with Felty's syndrome is different from those with portal hypertension due to cirrhosis.ConclusionSplenectomy is the treatment of choice for complications of portal hypertension in patients with Felty's Syndrome. Bleeding esophageal varices are a common complication of portal hypertension in patients with underlying liver disease. Often patients with hepatic cirrhosis have hypersplenism with thrombocytopenia and leukopenia. Felty's syndrome is a disorder where patients with rheumatoid arthritis develop splenomegaly, neutropenia, and on rare occasions, portal hypertension without underlying cirrhosis. We present a case of a patient with portal hypertension secondary to Felty's syndrome and discuss the importance of recognizing this condition since the treatment of choice is surgical management with splenectomy. A review of the literature and underlying liver histologic features are discussed. Medical and surgical management of patients with Felty's syndrome is different from those with portal hypertension due to cirrhosis. Splenectomy is the treatment of choice for complications of portal hypertension in patients with Felty's Syndrome.
Intimal thickening of the coronary arteries in infants in relation to family history of coronary artery disease.
Authors: J Kaprio, R Norio, E Pesonen, S Sarna
Journal: Circulation (1993)

BACKGROUND Intimal thickenings of the coronary arteries of newborn children are composed mainly of smooth muscle cell proliferations. To investigate whether thickening of the intima in infants is associated with a family history of coronary artery disease (CAD), we studied the relation of coronary death of grandparents to intimal thickening of 136 infants. METHODS AND RESULTS The length of internal elastic lamina of the artery and the areas of arterial layers in cross section were measured, and the arteries were transformed to idealized round circles. Intimal thickening was assessed as the degree of luminal narrowing (ratio of intimal area to the area on the luminal side of the arterial media). Among 136 infants, luminal narrowing varied between 0% and 58%. CAD deaths accounted for 108 of the total 281 deaths among the grandparents of the infants. Family history of CAD (defined as at least one CAD death among the four grandparents) was positive for 77 infants. Family history of CAD was significantly more common in the infants with luminal narrowing of both the left and right coronary arteries compared with the infants with no narrowing in at least one artery (odds ratio adjusted for sex, infection status, and age of infant, 5.69; 95% confidence interval, 1.46-22.2). After adjustment for sex and age, infants with both a positive family history and presence of infection had an increased degree of luminal narrowing compared with infants with a negative family history and no infection. CONCLUSIONS The association of coronary artery intimal thickening in infancy with family history of CAD suggests that intimal thickening is a morphological manifestation of predisposition to CAD.
Report on the Revision of the Code of Ethics.
Authors: Leartus Connor
Journal: JAMA (1894)

Detroit, Mich., April, 1894. <h3>To the Editor:</h3> —Through theJournal of the Associationthis report has been laid before the profession. Already it has been repudiated in several quarters. The cry is raised "Vote it down! Vote it down!" From the language of Dr. N. S. Davis in theJournal of the Associationand the<i>Occidental Medical Journal</i>; of the " Conservative Member;" of Dr. Gould in the<i>Medical News</i>, the reader would infer that the authors of the proposed revision were denizens of the infernal regions and had made a special trip to the world for the purpose of working injury to the medical profession. Satire, invective, ridicule, suspicion, etc., are variously combined in these several communications, but in no one of them is a single reason given to support the belief that the adoption of the Committee's report would fail to benefit the profession. It is interesting to inquire
THE DEVELOPMENT OF THE CUTANEOUS MICROVASCULAR SYSTEM IN THE NEWBORN
Authors: P. PERERA, A. K. KURBAN, T. J. RYAN
Journal: British Journal of Dermatology (1970)

SUMMARY.– The development of the cutaneous capillaries has been studied in 40 infants aged 1 day to 17 weeks. At birth there is a disorderly capillary network. There is a gradual development to an orderly subpapilliary plexus and papillary loops by 14th–17th week of life. In areas of creases this development is delayed, while in the palms, soles and nail folds there is an early development of capillary loops. An attempt has been made to correlate this development with certain dynamic physiological processes during the neonatal period as well as with exposure to the cold environment. These physiological processes are: (a) increase in skin surface area (b) increased blood viscosity related to (i) increased haematocrit (ii) decreased oxygen tension (iii) low blood pressure (iv) increased transudation of fluid from blood vessels (v) decreased sedimentation rate (vi) decreased red cell flexibility.
High incidence of hepatitis C virus reinfection in a cohort of injecting drug users
Authors: Campbell Kynoch Aitken, Jennifer Lewis, Samantha Lilly Tracy, Timothy Spelman, David Scott Bowden, Mandvi Bharadwaj, Heidi Drummer, Margaret Hellard
Journal: Hepatology (2008)

Abstract An estimated 170 million people worldwide carry the hepatitis C virus (HCV), and in more developed countries the prevalence and incidence of HCV is particularly high among injecting drug users (IDUs). Spontaneous clearance of HCV infection and reinfection is well recognized but the level of protection against further infection conferred by HCV infection and clearance remains uncertain. We conducted a prospective study of HCV infection in IDUs recruited in Melbourne, Australia, using a much shorter median testing interval than in previous studies. Incidences of naive infection and reinfection were calculated by the person-year method and Cox proportional hazards regression used to adjust for covariates. A significantly higher HCV incidence rate was measured in previously infected IDUs (46.8% per year) compared with HCV-naive IDUs (15.5% per year). The hazard ratio for previously infected IDUs compared to HCV-naive IDUs, after adjustment for time-dependent covariates, was 2.54 (95% confidence interval, 1.11–5.78, P &gt; |z| &lt; 0.05). Viral persistence after reinfection appeared similar to that following naive infection. Conclusion: Our data suggest that HCV infection in IDUs is more likely following prior infection and clearance than in HCV-naive individuals, implying no increased immunity against further infection. This result has important implications for the future development of an HCV vaccine. (Hepatology 2008;48:1746-1752.)
Abstract 1004: Hedgehog signaling promotes tumor vascularization, growth and metastasis of breast cancer via upregulation of CYR61
Authors: Lillianne G. Harris, Lewis K. Pannell, Rajeev S. Samant, Lalita A. Shevde
Journal: Cancer Research (2011)

Abstract Several clinical trials have used chemotherapeutic drugs that specifically target vascular endothelial cell growth factor (VEGF). Although these trials have demonstrated significant improvements in response rates, findings to date have not indicated substantial benefits in terms of survival. This is likely to be due to the ability of tumor cells to utilize several alternative pathways to establish vasculature. Hence, there is an urgent need to define and target other active pathways that contribute to angiogenesis, such that the vascularity of the tumor can be effectively reduced. Hedgehog (Hh) signaling, which promotes cell growth and vascularization during fetal development, is activated in several cancers and has been implicated to play a role in promoting cancer progression. We have investigated the role of Hh signaling in impacting tumor malignancy by promoting tumor vascularity. We engineered sonic hedgehog (SHH)-deficient, tumorigenic breast cancer lines, MDA-MB-231 and MCF10AT, to ectopically express the Hh activating ligand, SHH such that the pathway is constitutively activated. Upregulation of SHH-mediated signaling results in the acquisition of enhanced malignant behavior in vitro (increased growth, invasion, migration, and anchorage independent growth) and in vivo (increased tumor take rate and rapidly growing tumors). Furthermore, the SHH expressing cells are able to enhance migration, invasion and network formation of endothelial cells in vitro and elicit increased vasculature in tumor xenografts, in vivo. Using mass spectrometry-mediated analysis of the secretome of the breast cancer cells with constitutive Hh signaling, we identified CYR61 (cysteine-rich angiogenic inducer 61) as a potential mediator of the angiogenic effects of breast cancer cells. Further, our studies show that CYR61 plays a critical role in mediating the vasculature-enhancing effects of breast cancer cells. Taken together, our lab has identified a robust contributor of tumor vascularization which may be an effective VEGF-independent anti-vascularization therapeutic target. We acknowledge grant support from the Department of Defense-Breast Cancer Research Program (07-1-0400). Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1004. doi:10.1158/1538-7445.AM2011-1004
Evidence for a Red Cell Shunting Mechanism in the Kidney
Authors: LAWRENCE S. LILIENFIELD, JOHN C. ROSE, FRANK A. PORFIDO
Journal: Circulation Research (1957)

Simultaneous tagged red cell and tagged plasma albumin concentration-time curves were obtained from the renal vein without recirculation, following rapid injection of the indicators into a renal artery. The mean transit time of the red cells was consistently faster than that of the plasma albumin, but the washout downslopes of the indicators was found to be identical. This is interpreted as indicating that some red cells are shunted through those pathways of shortest length. The dynamic circulating hematocrit of the kidneys averaged 89 per cent of the large vessel hemato-crit. Intrarenal circulating blood volume averaged 24 ml./100 Gm. of dog kidney
Pulmonary function in aluminium smelters.
Authors: G B Field
Journal: Thorax (1984)

Two studies were conducted at an aluminum smelter employing 113 male workers in the smelting process. Twenty one of the 111 men in the first study experienced chest tightness more often than once a week and had a higher prevalence of cough, dyspnoea, and nasal symptoms but not of positive skin test responses than symptomless men. Lung function in these men did not differ significantly from that in the symptomless men at the beginning of the working week and only marginal deterioration occurred over the week. In the second study serial spirometric measurements were obtained over several shifts in a subset of 31 men from the first study. Impairment of ventilatory function on exposure to smelting fumes was demonstrated in 18 men. Analysis of all data from the 31 subjects revealed that ventilatory function varied significantly in association with heavy exposure to potfumes and a history of recurrent chest tightness. The findings of these two studies indicate that aluminum smelting fumes can cause bronchoconstriction in susceptible individuals. The reaction is dose dependent and is more severe in those with a history of recurrent chest tightness.
Sigmoidoscopic and Complemental Cervical-Vaginal Examination
Authors: Daniel J. Abramson
Journal: JAMA (1976)

<h3>To the Editor.—</h3> Female patients are often seen in consultation by a surgeon or proctologist for rectal problems or for sigmoidoscopic examination. Some may not have had a pelvic examination or Papanicolaou smear in many months or even years. Inspection of the cervix and vagina can be done easily in the standard proctoscopic positions with the usual proctologic equipment. With the emphasis on early cancer detection, this additional procedure could lead to earlier discovery of cancer of the cervix or uterus. More frequently, benign pathologic lesions will be noted. The end result will be earlier treatment by a gynecologist or surgeon. The usual procedure for a sigmoidoscopic examination is followed. The patient is placed in an appropriate position. Then, without the use of lubricants, a Welch-Allyn fiberoptic proctoscope or sigmoidoscope is inserted into the vagina. An excellent view of the cervix and vagina is obtained. A Papanicolaou smear is made
Top European Commission health official resigns
Authors: R. Watson
Journal: BMJ (2014)

Paola Testori Coggi, a long serving Italian official in the European Commission, resigned on 15 October as director general of the health and consumer protection department. She will leave the post she has held for the past four years at the end of October. 

The reason, said a commission spokesman, was for “non-compliance with the rules” on tenders. It is understood that she had personally telephoned a non-governmental organisation in 2012 to alert it to a call …
Evaluation of mycophenolate mofetil for initial treatment of chronic graft-versus-host disease
Authors: Paul J. Martin, Barry E. Storer, Scott D. Rowley, Mary E. D. Flowers, Stephanie J. Lee, Paul A. Carpenter, John R. Wingard, Paul J. Shaughnessy, Marcel P. DeVetten, Madan Jagasia, Joseph W. Fay, Koen van Besien, Vikas Gupta, Carrie Kitko, Laura J. Johnston, Richard T. Maziarz, Mukta Arora, Pamala A. Jacobson, Daniel Weisdorf
Journal: Blood (2009)
Apo A-I inhibits foam cell formation in apo E–deficient mice after monocyte adherence to endothelium
Authors: Hayes M. Dansky, Sherri A. Charlton, Courtenay B. Barlow, Minna Tamminen, Jonathan D. Smith, Joy S. Frank, Jan L. Breslow
Journal: Journal of Clinical Investigation (1999)

We have previously shown that expression of the human apo A-I transgene on the apo E–deficient background increases HDL cholesterol and greatly diminishes fatty streak lesion formation. To examine the mechanism, prelesional events in atherosclerotic plaque development were examined in 6- to 8-week-old apo E–deficient and apo E–deficient/human apo A-I transgenic mice. A quantitative assessment of subendothelial lipid deposition by freeze-fracture and deep-etch electron microscopy indicated that elevated apo A-I did not affect the distribution or amount of aortic arch subendothelial lipid deposits. Immunohistochemical staining for VCAM-1 demonstrated similar expression on endothelial cells at prelesional aortic branch sites from both apo E–deficient and apo E–deficient/human apo A-I transgenic mice. Transmission electron microscopy revealed monocytes bound to the aortic arch in mice of both genotypes, and immunohistochemical staining demonstrated that the area occupied by bound mononuclear cells was unchanged. Serum paraoxonase and aryl esterase activity did not differ between apo E–deficient and apo E–deficient/human apo A-I transgenic mice. These data suggest that increases in apo A-I and HDL cholesterol inhibit foam cell formation in apo E–deficient/human apo A-I transgenic mice at a stage following lipid deposition, endothelial activation, and monocyte adherence, without increases in HDL-associated paraoxonase.
Association of Serum Proinsulin With Hormone Replacement Therapy in Nondiabetic Older Women
Authors: Dong-Jun Kim, Elizabeth Barrett-Connor
Journal: Diabetes Care (2006)

OBJECTIVE—One putative benefit of hormone replacement therapy (HRT) is a reduced risk of diabetes or reduced fasting glucose level. We report here the association of HRT with proinsulin, insulin, and fasting and postchallenge glucose levels in older adults. RESEARCH DESIGN AND METHODS—Current HRT use was validated and cross-sectionally compared with diabetes-related variables in 785 women without diabetes by history or glucose tolerance test. RESULTS—Median age was 72 years (range 50–97); median value of fasting plasma glucose, postchallenge plasma glucose, and proinsulin was 5.08 mmol/l, 6.93 mmol/l, and 9.3 pmol/l, respectively. In age-adjusted comparisons, current HRT use was associated with significantly lower fasting plasma glucose and higher postchallenge plasma glucose compared with never/previous HRT use, as well as with lower LDL and higher HDL cholesterol and higher triglycerides. Fasting and postchallenge intact insulin did not differ by HRT group, but proinsulin was significantly lower in current HRT users than in previous and never HRT users. The significant association between proinsulin and HRT status persisted after adjustment for age, waist-to-hip ratio, pulse pressure, LDL-to-HDL cholesterol ratio, triglycerides, fasting and postchallenge glucose, and intact insulin. CONCLUSIONS—Reduced fasting and increased 2-h glucose replicate findings in a randomized clinical trial. The proinsulin effect has not been previously reported. Decreased fasting glucose and proinsulin levels in current HRT use suggest a potential antidiabetes effect of HRT. Increased postchallenge glucose in HRT, however, suggests insulin resistance and would be expected to increase the risk of heart disease.
Lung elastic recoil in normal young adult Chinese compared with Caucasians
Authors: CC Chan, TH Cheong, SC Poh, YT Wang
Journal: European Respiratory Journal (1995)

Chinese people have smaller total lung capacity (TLC) compared with Caucasians of similar age, sex and height. One possible reason would be a higher lung elastic recoil in Chinese. Most published values for lung elastic recoil viz static lung compliance (CLst), shape constant K, and maximal static transpulmonary pressure (PLmax) have been from Caucasian subjects. The aim of our study was to obtain values for lung elastic recoil in normal young adult Chinese subjects. Static expiratory pressure-volume (P-V) curves were studied in 22 healthy Chinese subjects (12 males and 10 females). The P-V curve was fitted using an iterative least mean squares regression on a computer, according to an exponential equation: V = A-Be-KP, where V is lung volume, P is transpulmonary pressure, and A, B and K are constants. Mean values +/- SD for K, CLst and PLmax were 0.12 +/- 0.04, 230 +/- 103 ml.cmH2O-1 and 27.5 +/- 7.5 cmH2O, respectively. The values of CLst and K were similar to that of normal Caucasian subjects, whereas values of PLmax were lower. We attributed the lower PLmax partly to weaker inspiratory muscles in Chinese compared with Caucasians. We conclude that lung elastic recoil in normal young adult Chinese is similar to that of healthy young adult Caucasians. Hence, lung elasticity is unlikely to explain the racial differences in static lung volumes.
Characterization of the Functional and Growth Properties of Cell Lines Established from Ileal and Rectal Carcinoid Tumors
Authors: Gail A. Stilling, Heyu Zhang, Katharina H. Ruebel, Alexey A. Leontovich, Long Jin, Yoshinori Tanizaki, Shuya Zhang, Lori A. Erickson, Timothy Hobday, Ricardo V. Lloyd
Journal: Endocrine Pathology (2007)
Economic institutions as ecological niches
Authors: Samuel Bowles
Journal: Behavioral and Brain Sciences (2000)

Economic institutions governing such activities as food sharing among non-kin, the accumulation and inheritance of wealth, and the division of labor and its rewards are human-constructed environments capable of imparting distinctive direction and pace to the process of biological evolution and cultural change. Where differing structures of these institutions take the form of distinct conventions sustained by (near) mutual adherence, small initial differences may support divergent evolutionary trajectories even in the absence of conformist behaviors.
Levosimendan allows detection of contractile reserve in patients with chronic ischaemic left ventricular dysfunction and non‐diagnostic dobutamine echocardiography
Authors: Cinzia Cianfrocca, Francesco Pelliccia, Antonio Auriti, Vincenzo Guido, Vincenzo Pasceri, Xue Li, Giuseppe Richichi, Giuseppe Mercuro, Massimo Santini
Journal: European Journal of Heart Failure (2007)