tbuckley/cabot-search huggingface dataset:
Prediction of poor outcome in CLL patients following first-line treatment with fludarabine, cyclophosphamide and rituximab
Authors: A M Fink, S Böttcher, M Ritgen, K Fischer, N Pflug, B Eichhorst, C-M Wendtner, D Winkler, A Bühler, T Zenz, P Staib, J Mayer, M Hensel, G Hopfinger, M Wenger, G Fingerle-Rowson, H Döhner, M Kneba, S Stilgenbauer, R Busch, M Hallek
Journal: Leukemia (2013)

Chemoimmunotherapies like the combination of fludarabine, cyclophosphamide, and rituximab (FCR) achieve response rates as high as 95% in patients with previously untreated chronic lymphocytic leukemia (CLL).1 Further improvements in clinical outcome will therefore mainly depend on attaining more durable remissions in those responders who suffer an early relapse. In general, progression of disease within 24 months after intensive chemoimmunotherapy is regarded as unsatisfactory2 and might be associated with a shortened overall survival (OS).3
Delayed colonic perforation after metal stent placement for malignant colorectal obstruction
Authors: C. Trovato, G. Fiori, D. Ravizza, D. Tamayo, M. Zampino, R. Biffi, C. Crosta
Journal: Endoscopy (2006)

A 72-year-old woman with known liver metastases was admitted to our Institute with an acute malignant colorectal obstruction. Colonoscopy revealed a serrated neoplastic stenosis at the splenic flexure and left-sided diverticular disease, with a narrowed, fixed and acute-angled sigmoid colon. An uncovered Wallstent Enteral endoprosthesis (Boston Scientific, Galway, Ireland) was successfully placed (Figure [1]), which led to immediate relief of the patient’s obstructive symptoms. A radiological control was performed 24 hours later which confirmed satisfactory stent placement.
Paying the Doctors — Sir Robert Hutchison — Walking the Wards
Authors: John Lister
Journal: New England Journal of Medicine (1960)

THE publication of the report of the Royal Commission on doctors' and dentists' pay in the National Health Service will doubtless be another important landmark in the relations between the medical and dental professions and their monopoly employers, the Government. Appointed three years ago because of mounting discontent on matters relating to pay, the Commission, with Sir Harry Pilkington as chairman, has thoroughly investigated most aspects of the problem. Career prospects for doctors in the National Health Service have been compared with those in other professions, and considerable advances in pay are recommended. For general practitioners and hospital consultants the . . .
ACE Inhibitors and Congenital Anomalies
Authors: J.M. Friedman
Journal: New England Journal of Medicine (2006)

Angiotensin-converting–enzyme (ACE) inhibitors are among the most widely prescribed antihypertensive agents in the United States, but when used in the second half of pregnancy, they can cause oligohydramnios, fetal growth retardation, pulmonary hypoplasia, joint contractures, hypocalvaria and neonatal renal failure, hypotension, and death.13 These effects result from blockade of the conversion of angiotensin I to angiotensin II in the developing fetal kidneys.3 A strikingly similar pattern of fetal anomalies has been reported after treatment of women in the second or third trimester of pregnancy with angiotensin II–receptor antagonists,1,4 drugs that block the fetal renin–angiotensin system at a different . . .
Lack of transmission of viral hepatitis type B after oral exposure to HBsAg-positive saliva.
Authors: M T Osterholm, E R Bravo, J T Crosson, H F Polisky, M Hanson
Journal: BMJ (1979)

Oblique views showed osteophyte encroachment on the left exit foramina of C3-4 and C4-5.No appreciable disc-space narrowing was noted and there was no evidence of cervical ribs.He was given a course of intensive physiotherapy and fitted with a wrist splint.Six months after myelography, however, there was still pronounced weakness in the left forearm with associated reflex emphasis.
Visualization of a Postoperative Bile Leak During Cholescintigraphy Morphine Augmentation Prevents a False-Negative Study
Authors: ROBERT T. ANDREWS, DAWN A. BOVA
Journal: Clinical Nuclear Medicine (1995)

Intravenous morphine sulfate increases hydrostatic pressure within the biliary tree, latrogenic increases in biliary pressure are commonly used to verify cystic duct obstruction during preoperative cholescintigraphy. Extravasation has occasionally been reported in cases of gallbladder necrosis or rupture. The present case demonstrates an additional application for morphine augmentation in cholescintigraphy. By increasing biliary pressure, morphine sulfate augmentation can be used to reveal an otherwise occult bile leak after trauma or surgery.
Routine Evaluation of Bleeding Tendency in Surgical Patients
Authors: John B. Miale
Journal: JAMA (1963)

The following data are presented: (1) normal values for the partial thromboplastin time (PTT) test, for both the macro and the micro technique; (2) the PTT in various hemorrhagic disorders; and (3) the value of the PTT as a screening test in the evaluation of bleeding tendency in patients requiring surgery. A combined clinical and laboratory approach to presurgery screening is proposed.
Recent developments: Emergency medicine
Authors: D. M Fatovich
Journal: BMJ (2002)

Most people believe that the emergency department is always available to help provide non-elective acute hospital care. Daniel Fatovich explains why this is not necessarily so

Emergency medicine is a field of practice based on the knowledge and skills required for the prevention, diagnosis, and management of the acute and urgent aspects of illness and injury affecting patients of all age groups with a full spectrum of undifferentiated physical and behavioural disorders.1 It is a specialty in which time is critical. Anyone who has been to an emergency department will appreciate that it is a complex and often turbulent environment. The emergency department is like the fire brigade—you hope you won't need it, but if you do, you expect a timely response.


Emergency medicine is a fairly new specialty. Resuscitation, toxicology, and clinical criteria for imaging represent some of the core topics of the practice of emergency medicine. This review focuses on these key areas and underlines the major problem that the specialty faces—namely, overcrowding. 


Summary points


Overcrowding is the most serious issue confronting emergency departments in the developed world, with quality and timeliness of emergency care being compromised


Amiodarone is the antiarrhythmic drug of choice for cardiac arrest due to shock refractory ventricular fibrillation and ventricular tachycardia


For calcium channel blocker toxicity, the induction of hyperinsulinaemia and euglycaemia has striking bemefits


Octreotide prevents the rebound hypoglycaemia of sulphonylurea overdose


Validated clinical criteria for requesting imaging have been developed for cervical spine injury and are being developed for minor head injury
RANDOMISED TRIAL OF PENTOXIFYLLINE VERSUS ACETYLSALICYLIC ACID PLUS DIPYRIDAMOLE IN PREVENTING TRANSIENT ISCHAEMIC ATTACKS
Authors: Ernesto Herskovits, Arturo Famulari, Leopoldo Tamaroff, AnaMaria Gonzalez, Alberto Vazquez, Roberto Smud, Hector Fraiman, José Vila, Vicente Matera
Journal: The Lancet (1981)
The Debate over Physician-Assisted Suicide: Empirical Data and Convergent Views
Authors: Timothy E. Quill
Journal: Annals of Internal Medicine (1998)

The debate over physician-assisted suicide is a small part of the process of improving care for all dying patients and their families. Available data, although limited, can help clarify this narrow debate and can provide a useful context for articulation of the common ground. This paper reviews these data, which suggest that unnecessary end-of-life suffering can be considerably reduced by improving access to and delivery of palliative care and improving recognition and treatment of pain and depression in terminally ill persons. It also sets forth possible areas of common ground between the two sides in the debate. Even with the best of care, a small number of dying patients will still have suffering that cannot be satisfactorily relieved, and some of these patients will request assistance in hastening death. Terminal sedation and the voluntary cessation of eating and drinking may be legally acceptable alternatives to physician-assisted suicide for the few patients whose suffering cannot be made tolerable with standard palliative interventions. Physicians should not violate their fundamental values when faced with such patients but should make patients aware of the full range of available alternatives to prolonged, intolerable distress. Physicians have the responsibility to give comprehensive palliative care to terminally ill patients and their families throughout the dying process and to make every effort to explore, understand, and address suffering that persists despite their best efforts.
Sickle cell patient with an acute chest syndrome and a negative chest X‐ray: Potential role of the ventilation and perfusion (V/Q) lung scan
Authors: Lawrence Feldman, Robert Gross, Jack Garon, Anitha Nallari, Navleen Kaur, Bharat Motwani, Sunitha Sukumaran, Sandra Allen, Maxwell Westerman
Journal: American Journal of Hematology (2003)

Abstract Acute chest syndrome (ACS) in sickle cell disease is caused by thromboemboli in the pulmonary vasculature. The diagnostic criteria include the presence of pulmonary infiltrate(s) on chest x‐ray. This case report suggests that a V/Q scan may play a diagnostic role in sickle cell patients with symptoms of ACS and a negative chest x‐ray. Am. J. Hematol. 74:214–215, 2003. © 2003 Wiley‐Liss, Inc.
A Phase II Study of Perioperative Concurrent Chemotherapy, Gefitinib, and Hyperfractionated Radiation Followed by Maintenance Gefitinib in Locoregionally Advanced Esophagus and Gastroesophageal Junction Cancer
Authors: Cristina P. Rodriguez, David J. Adelstein, Thomas W. Rice, Lisa A. Rybicki, Gregory M.M. Videtic, Jerrold P. Saxton, Sudish C. Murthy, David P. Mason, Denise I. Ives
Journal: Journal of Thoracic Oncology (2010)
Abstract 17290: What Factors are Associated with the Change in Endothelial Function in Patients Who Have Undergone Percutaneous Coronary Intervention?
Authors: Hiroki Teragawa, Yuichi Fujii, Hiroaki Takemoto, Shuichi Nomura, Kenji Nishioka, Yukihito Higashi, Yasuki Kihara
Journal: Circulation (2011)

Background: Endothelial function is one of markers predicting future cardiovascular events, even in patients with coronary artery disease (CAD). Thus, much interest is focused on the change in endothelial function in CAD patients who have undergone percutaneous coronary intervention (PCI). However, factors associated with the change in endothelial function in these patients remain unclear. Therefore, we investigated changes in the endothelial function of the brachial artery in patients who underwent PCI and clarified the factors affecting these changes. Methods: A total of 233 CAD patients (mean age: 66 years; 185 males) who underwent successful PCI for stenotic lesions were enrolled. PCI techniques included plain old balloon angioplasty in 47 patients, stenting with a bare-metal stent in 85 patients and stenting with a drug-eluting stent (DES) in 101 patients. In each patient, the diameter of the brachial artery in response to hyperemic flow (flow-mediated dilatation: FMD) and nitroglycerin spray (nitroglycerin-induced dilation: NID) was measured using high resolution ultrasonography just before and 6-8 months after PCI. The changes in FMD and NID were defined as the differences between follow-up and baseline values. Angiographic restenosis was defined as a &gt;50% diameter reduction at the follow-up coronary angiography. The lesion morphology before PCI was determined according to the American College of Cardiology/American Heart Association classification. Results: In univariate analyses, body mass index (BMI, p = 0.0002), difference in NID (p = 0.0008), use of DES (p = 0.005), lesion morphology (p = 0.0314) were associated with the change in FMD. Multivariate regression analysis demonstrated that use of DES (p&lt;0.0005) was negatively associated whereas BMI (p&lt;0.0001) was positively associated, with the change in FMD. Conclusions: These results suggest that use of DES has a negative impact on the change in endothelial function; however, obesity has a positive impact on the change in endothelial function in CAD patients who underwent PCI. The former may suggest the need for a careful follow-up of patients who underwent PCI with DES and the latter finding may suggest one mechanism of obesity paradox phenomenon in CAD patients who underwent PCI.
Physiology of the Cerebrospinal Fluid
Authors: Edgar A. Bering
Journal: JAMA (1967)

This is a new book by Dr. Davson and not just a new edition of his old book, Physiology of Ocular and Cerebrospinal Fluids . It includes a consideration of the extracellular fluid of the brain and the problem of the blood-brain barriers as well as the physiology of the cerebrospinal fluid.  Dr. Davson brings together much of the new experimental work that has been done in the last 15 years. He demonstrates that both the cerebrospinal fluid (CSF) and the extracellular fluid of the brain are secretions in the sense that they are the products of metabolic effort. He points out that this conclusion means a controlled production of extracellular fluid in the central nervous system as contrasted to simple filtration, which takes place in other tissues. He suggests that the extracellular fluid does indeed drain from the brain into the CSF, and he relates the amount produced to the
After Insurance Issues Are Settled
Authors: Stephen W. Hwang
Journal: Annals of Internal Medicine (2006)

On Being a Doctor18 July 2006After Insurance Issues Are SettledStephen W. Hwang, MD, MPHStephen W. Hwang, MD, MPHFrom Centre for Research on Inner City Health, St. Michael's Hospital and Division of General Internal Medicine, University of Toronto, Toronto, Ontario M5B 1W8, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-145-2-200607180-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail There's a new man here to see you,” said Joyce, the nurse at the Toronto homeless shelter where I see patients once a week. “He just had his leg cut off. Says it hurts a lot.”I stepped out of my small examining room and into the hallway of the shelter. Micah was sitting quietly in a wheelchair, his pants already rolled up to reveal his right leg, which had been amputated below the knee. He was a brown-skinned man in his late 50s. He looked tired, and his black hair and mustache were streaked with advancing lines of gray. ... Author, Article, and Disclosure InformationAffiliations: From Centre for Research on Inner City Health, St. Michael's Hospital and Division of General Internal Medicine, University of Toronto, Toronto, Ontario M5B 1W8, Canada.Corresponding Author: Stephen W. Hwang, MD, MPH, Centre for Research on Inner City Health, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada; e-mail, [email protected]toronto.on.ca. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byFrom Homeless to Housed: Caring for People in Transition 18 July 2006Volume 145, Issue 2Page: 150-151KeywordsAntibioticsEmergency departmentHealth insuranceKneesNursesOrthopedicsOutpatient clinicsShockSurgeonsWheelchairs ePublished: 18 July 2006 Issue Published: 18 July 2006 Copyright & PermissionsCopyright © 2006 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Abstract 4187: A rapid and robust transgenic high-grade glioma mouse model for therapy-intervention studies
Authors: Nienke A. de Vries, Sophia W. Bruggeman, Hilda I. de Vries, John Zevenhoven, Tessa Buckle, Bob C. Hamans, William P. Leenders, Jos H. Beijnen, Maarten van Lohuizen, Anton J.M. Berns, Olaf van Tellingen
Journal: Cancer Research (2010)

Abstract High-grade glioma is a devastating and uniformly fatal disease for which better therapy is urgently needed. Glioma cells extensively infiltrate into surrounding pivotal brain structures, thereby rendering current treatments largely ineffective. Evaluation of novel therapies requires the availability of appropriate glioma mouse models. We here present a novel transgenic mouse model of high-grade glioma that can be conveniently used for testing therapy-intervention strategies. High-grade gliomas were induced by stereotactic intracranial injection of self-deleting lentiviral GFAP-Cre or CMV-Cre vectors into adult immune-competent compound LoxP-conditional mice, resulting in localized expression of K-Rasv12 in conjunction with loss of p16Ink4a/p19Arf with or without concomitant loss of p53 or Pten. Tumors have been characterized by histology, immune-histochemistry and magnetic resonance imaging and reproduced many of the features that are characteristic for human high-grade gliomas, including invasiveness and blood-brain barrier functionality. We are currently assessing which molecular alterations in cell signaling pathways have occurred. Especially CMV-Cre injection into p53;Ink4a/Arf;K-Rasv12 mice resulted in grade IV (glioblastoma multiforme) with a short tumor latency (2-3 weeks) and full penetrance. Early detection and follow-up of tumor growth can be accomplished conveniently by non-invasive bioluminescence imaging and the practical utility for therapy-intervention has been demonstrated in a study with temozolomide. Temozolomide delayed tumor progression modestly but significantly in line with what is observed in patients. Importantly, this novel model can be used with almost the same convenience as traditional xenograft models, thus allowing the implementation of realistic high grade glioma models at the forefront of preclinical evaluation. We expect that this model will be particularly useful to assess the potential clinical utility of agents that may augment temozolomide cytotoxicity, such as PARP-inhibitors or Wee1 kinase inhibitors, but also for agents targeting activated RAS and/or PI3K-Akt-mTor signaling pathways. Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4187.
The James D. Bruce Memorial Lecture: The Clinician in an Overly Traditional Society: A Technologic Misfit.
Authors: Walsh McDermott
Journal: Annals of Internal Medicine (1968)

s1 May 1968The James D. Bruce Memorial Lecture: The Clinician in an Overly Traditional Society: A Technologic Misfit.Walsh McDermott, M.D., F.A.C.P.Walsh McDermott, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-68-5-1140_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptWhat would happen if it were possible to introduce modern, university-based clinical medicine on a wide basis to a community with the disease pattern of an overly traditional society? Such an experiment was conducted for a 6-year period in the heart of the Navajo reservation in northern Arizona. A summary report of the major findings of this experiment and the interpretation and the lessons to be derived therefrom were presented.... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New York, New York PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1968Volume 68, Issue 5Page: 1140-1140KeywordsHeartTraditional medicine Issue Published: 1 May 1968 PDF DownloadLoading ...
Alcohol marketing to children
Authors: G. Hastings, N. Sheron
Journal: BMJ (2011)

A new UK private member’s bill provides a simple, clear, and effective way forward

A private member’s bill on alcohol marketing to be put forward by Sarah Wollaston on 30 March tackles two pressing and uncontested problems: the excessive drinking of young people and their massive exposure to alcohol advertising.

The most recent European school survey project on alcohol and other drugs (ESPAD) of 35 European countries shows that only Denmark and the Isle of Man have higher levels of binge drinking and drunkenness in schoolchildren than the United Kingdom.1 In 2008, 2843 deaths occurred in 15-24 year olds in England and Wales, and almost one in four (23%) of these was attributable to alcohol2; that is, more than 600 deaths—almost two a day—significantly more than the combined toll from cancer, heart disease, and respiratory disease in this age group. In addition, alcohol is linked to antisocial behaviour, unwanted pregnancies, and sexually transmitted disease.3 Alcohol marketing not only facilitates these problems but also seems to suspend critical analysis: the ESPAD survey asked schoolchildren to rate five positive aspects (such as “feel happy,” “feel relaxed,” and “forget my problems”) and six negative aspects of drinking (such as “harm my health,” “do something I would regret,” and “get into trouble with the police”). UK schoolchildren reported the highest positive and least negative expectations for drinking alcohol of any country in Europe.1 4

The Cabinet Office estimates that £800m (€920m; $1300m) is spent on alcohol marketing each year,5 far more than …
Epiluminescence microscopy in clinical diagnosis of pigmented skin lesions?
Authors: Darrell S Rigel
Journal: The Lancet (1997)

Melanoma is also one of the clearest cases of a cancer for which early detection and treatment are critical. The ABCD (Asymmetry, Border irregularity, Colour variegation, Diameter >6 mm) criteria for assisting the visual recognition of early melanoma were introduced in 1985. 1 Friedman RJ Rigel DS Kopf AW Early detection of malignant melanoma: The role of physician examination and self examination of the skin. Ca. 1985; 35: 130-151 Google Scholar However, there have since been limited attempts to develop non-invasive tools to improve early diagnosis. One such tool is epiluminescence microscopy (ELM), first described in 1987. 2 Steiner A Pehamberger H Wolff K Improvement of diagnostic accuracy in pigmented skin lesions by epiluminescent light microscopy. Anticancer Res. 1987; 7: 433-434 PubMed Google Scholar Also known as skin-surface microscopy and dermatoscopy, ELM is a non-invasive method that, by employing the optical properties of oil immersion, makes subsurface structures of the skin accessible for in-vivo examination. Initially designed to be used with complex microscopic equipment, ELM can now be easily used in the general clinical setting with an inexpensive hand-held otoscope-like unit.
Too Few Human Organs for Transplantation, Too Many in Need... and the Gap Widens
Authors: Teri Randall
Journal: JAMA (1991)

THE ORGAN SHORTAGE problem has been called "a public health crisis with a cure." Each year, however, the "crisis" becomes more critical, and the "cure," although supported in concept by health professionals and the American public, loses ground in practice. In the last few years, organ donation has leveled off and even decreased for some organs. At the same time, the waiting list for organ transplantation has been increasing by thousands of individuals each year. As lengthy as this list may be, it represents only a fraction of the actual numbers of people who could be rehabilitated with an organ transplant. As of a month ago, 22 340 individuals were waiting for a transplant; of these, 18 163 were waiting for a kidney. And yet in 1989 (the most recent year for which transplantation statistics are available), just 8905 kidney transplants were performed—7063 from cadaveric donors and 1842 from living-related