tbuckley/cabot-search huggingface dataset:
Epidemiological factors affecting the severity of hepatitis C virus-related liver disease: A French survey of 6,664 patients
Authors: F Roudot-Thoraval, A Bastie, J Pawlotsky, D Dhumeaux
Journal: Hepatology (1997)

Cirrhosis is a frequent and severe event in the course of chronic hepatitis C, but it is unclear why some patients develop cirrhosis after a given period whereas others do not. We studied a large cohort of patients with chronic hepatitis C to determine the role of the route of transmission of hepatitis C virus (HCV) in the onset of cirrhosis. Six thousand six hundred sixty-four patients were enrolled in a nationwide survey of chronic hepatitis C in France. We first randomly defined a representative sample of 30 hospitals with medical units managing patients with HCV infection. All patients with chronic hepatitis C were enrolled if hepatitis C was diagnosed or treated in these units in 1991, 1992, or 1993. A questionnaire was filled in from the patients' charts and covered demographic data, risk factors for HCV infection, clinical and histological data, hepatitis B virus (HBV) and human immunodeficiency virus status, and alcohol intake. Descriptive statistics were prepared, and factors potentially related to the onset of cirrhosis were identified by means of univariate analysis followed by stepwise logistic regression analysis. Among the patients enrolled, 21.4% had biopsy-proven cirrhosis. Prevalence of cirrhosis markedly varied according to the route of transmission of HCV. It was significantly more frequent in blood recipients (23.4%) than in drug users (7.0%). Although the occurrence of cirrhosis was dependent on disease duration, it remained more frequent in blood recipients than in drug users for a given duration. Apart from the route of transmission, excessive alcohol intake was also associated with a higher risk of cirrhosis (34.9% vs. 18.2%; P &lt; .001), and so was HBV infection (24.6% vs. 21.1%; P &lt; .05). These factors acted independently of the route of transmission. Hepatocellular carcinoma was observed in 3.6% of all patients and in 17.8% of cirrhotic patients, and its occurrence was strongly and mainly related to the presence of cirrhosis. In conclusion, cirrhosis occurred in about 20% of the HCV-infected patients in this study and was more frequent in blood recipients than in drug users, independently of disease duration. Expected changes in the epidemiology of HCV infection might modify the risk of developing cirrhosis and, thereafter, cancer.
Medical Ethics in Antiquity: Philosophical Perspectives on Abortion and Euthanasia
Authors: Bernard Towers
Journal: JAMA (1986)

This is a thorough and scholarly survey of issues in medical ethics that have always provided dilemmas for patients, physicians, and generally, members of the society. It is especially valuable to have this volume now, when lawyers, politicians, and members of the executive branch of government increasingly arrogate decisionmaking powers to themselves over the most personal and intimate aspects of the lives of citizens. The book will serve to correct a multitude of errors we all tend to make concerning ancient ethical beliefs and practices. This reviewer has already placed it in the select bibliography for the UCLA senior elective in "Medical Ethics: The Foundation of Clinical Care." I look forward to its message gradually coming to permeate the American medical-social ethos. Myths abound concerning medical ethics in antiquity and especially about the influence of Hippocrates, who was the authentic father of medicine, but doubtfully the author of the famous
1240 Comparison of posttreatment prognosis between ablation and resection for early-stage hepatocellular carcinoma: standardized analysis of 737 patients by stratification method based on JIS scoring system
Authors: M KUDO, H CHUNG
Journal: Hepatology (2003)

Conjeevaram Natarajan Annadurai was a charismatic orator, actor, literateur, and statesman, who contributed substantially to the growth and modernization of Tamil. As the chief minister of Tamil Nadu, he opposed the imposition of Hindi, favored the continuation of English, and initiated linguistic reforms to protect and nurture Tamil language and culture.
Splenic atrophy in adult coeliac disease: is it reversible?
Authors: P N Trewby, P M Chipping, S J Palmer, P D Roberts, S M Lewis, J S Stewart
Journal: Gut (1981)

A study of splenic function in 28 patients with adult coeliac disease showed no significant correlation between the half life of heat-damaged red cells and either the duration of pre-treatment exposure to gluten or the length of time on a gluten free diet. A significant correlation was found between splenic size and duration of treatment; those patients who had been taking a gluten free diet for the longest time had the smallest spleens. Blood films from 11 of these 28 patients taken before treatment with a gluten free diet were compared with those taken between two and 15 years after the start of treatment. There was no tendency for the hyposplenic changes to regress. In the majority, the changes became more prominent despite strict adherence to the gluten free diet. These findings suggest that splenic atrophy in adult coeliac disease is not reversed by treatment with a gluten free diet and is unlikely to be related to the state of the jejunal mucosa or the duration of initial exposure to gluten.
A SCARLET FEVER ANTITOXIN
Authors: GEORGE F. DICK
Journal: JAMA (1924)

The first effort to produce a curative serum for streptococcus infections was made by Marmorek<sup>1</sup>in 1895. Since then, many antistreptococcic serums have been produced; notably that of Moser,<sup>2</sup>and recently, that of Dochez.<sup>3</sup> All of these serums have been obtained by immunizing horses with living streptococci. Those who report good results have used the serums in large dosage. Moser recommended from 100 to 200 c.c. of his serum, and Blake<sup>4</sup>used similar quantities of Dochez's serum. The large dosage required indicates that any curative antibodies contained in these antistreptococcic serums are present in low concentration. We have shown that the streptococci which cause scarlet fever produce a toxin, and that this toxin, when injected into susceptible human beings, produces nausea, vomiting, general malaise, fever and a scarlatinal rash.<sup>5</sup>Used in high dilutions, the toxin gives a skin test for susceptibility to scarlet fever.<sup>6</sup>
Partial cloning of the M subunit of laminin from adult rat lipocytes: Expression of the M subunit by cells isolated from normal and injured liver†
Authors: Jacquelyn J. Maher, Christina Tzagarakis
Journal: Hepatology (1994)

Laminin is a heterotrimeric glycoprotein found in the perisinusoidal space of adult rat liver. The principal cellular source of laminin in liver is the lipocyte, with its three subunits measuring 324, 200 and 200 kD. The large subunit of lipocyte-derived laminin is distinct from the A subunit of murine laminin (440 kD); its size suggests that it represents a peptide, called M , recently cloned from human placenta. Using oligonucleotide primers derived from the human M-subunit cDNA, we amplified a 445-bp sequence encoding a fragment of M-laminin from adult rat lipocytes. The rat cDNA is 90% homologous to the human M-subunit cDNA and recognizes an mRNA in lipocytes measuring about 10 kb. M-subunit transcripts were identified only in lipocytes from normal adult liver; they could not be identified in hepatocytes, endothelial cells or Kupffer cells. Lipocytes were screened for M-subunit protein with a polyclonal M antiserum. Cells stained specifically for the M-subunit after 36 hr in primary culture; the protein was also identified in freshly isolated cells by means of immunoblotting. To determine whether lipocytes alter their expression of the laminin M subunit during liver injury, we monitored M-subunit mRNA in these cells at various intervals after carbon tetrachloride administration. M-subunit transcripts increased twofold within 12 hr of toxin exposure, returning to below baseline by 48 hr. The results indicate that lipocytes produce the M subunit of laminin in place of A. Production of this subunit by lipocytes may facilitate cell growth and reorganization during liver regeneration. (Hepatology 1994;19:764-770).
BACTERIUM PNEUMOSINTES IN CLINICAL INFLUENZA IN NEW YORK CITY IN 1926
Authors: Frederick L. Gates
Journal: The Journal of Experimental Medicine (1926)

The presence of Bacterium pneumosintes has been demonstrated in nasopharyngeal washings from 2 patients in a sporadic outbreak of clinical influenza in New York City in March, 1926. 2 strains of bacteria morphologically similar to Bact. pneumosintes, but differing in certain cultural characters, and 2 other anaerobic filter-passing organisms were also isolated from the 9 patients examined. The blood serum of 16 among 17 persons convalescent from clinical influenza, and of 6 among 10 supposedly normal persons, agglutinated 1 or more strains of Bact. pneumosintes.
Effect of Dietary Sodium Intake on the Intrarenal Distribution of Nephron Glomerular Filtration Rates in the Rat
Authors: JAIME B. COELHO
Journal: Circulation Research (1973)

Redistribution of single nephron glomerular filtration rate (SNGFR) between superficial (S) and juxtamedullary (JM) nephrons is thought to participate in the renal adaptation to different levels of dietary sodium intake. This possibility was examined using the Hanssen technique which measures SNGFR as the 14 C-ferrocyanide content of microdissected nephrons factored by the mean plasma concentration following a 12-second infusion. Rats from the same litter were placed on a low-sodium (0.8 mEq/day) or a high-sodium (9 mEq/day) diet. The distribution of SNGFR was measured as the S/JM (mean of S nephrons/mean of JM nephrons) SNGFR ratio. In spite of an eightfold change in sodium excretion, there was no significant change in the S/JM SNGFR ratio (low sodium - high sodium: -0.0033 ± 0.048 [ SE ], P &gt; 0.9). Seven rats that were not littermates were maintained on a standard diet but drank saline (13 mEq sodium/day); carotid and ureteral catheterization and the duration of the diet (3-14 weeks) had no effect on the S/JM SNGFR ratio ( P &gt; 0.1), which was similar to that of nine rats maintained on a standard diet with water for drinking (3 mEq sodium/day). The value of the S/JM SNGFR ratios were 0.77 and 0.83, respectively. These variations in dietary sodium intake appeared to have no detectable effect on the intrarenal SNGFR distribution.
Effect of ethanol on airway caliber and nonspecific bronchial responsiveness in patients with alcohol-induced asthma
Authors: S. Myou, M. Fujimura, K. Nishi, K. Watanabe, M. Matsuda, T. Ohka, T. Matsuda
Journal: Allergy (1996)

No study has investigated the effects of ethanol on bronchial responsiveness in patients with alcohol‐induced asthma, although acetaldehyde, which is a metabolite of ethanol and is thought to be a main factor in alcohol‐induced asthma, causes both bronchoconstriction and bronchial hyperresponsiveness. The purpose of this study was to investigate the direct action of ethanol on the airway in patients with alcohol‐induced asthma. First, we investigated the bronchial response to inhalation of ascending doses (5, 10, and 20%) of ethanol in nine patients with alcohol‐induced asthma. Then, the bronchial responsiveness to methacholine was measured in 14 patients who were pretreated with saline or 20% ethanol in a double‐blind, randomized, placebo‐controlled, crossover fashion. Ascending doses of inhaled ethanol caused no significant changes in FEV 1 . The methacholine concentrations producing a 20% fall in FEV 1 (PC 20 ‐MCh) after 20%) ethanol (0.769 mg/ml, GSEM 1.514) were significantly ( P = 0.0357) higher than those after saline (0.493 mg/ml, GSEM 1.368). This indicates that ethanol has a reducing effect on nonspecific bronchial responsiveness in patients with alcohol‐induced asthma; this paper is the first report on the effects of ethanol on bronchial responsiveness.
Meeting Report: The International Conference on Tumor Progression and Therapeutic Resistance
Authors: Wafik S. El-Deiry
Journal: Cancer Research (2005)

A multidisciplinary conference was held November 7 to 9, 2004 in Philadelphia, PA to focus on the problem of drug resistance in cancer. A great deal of knowledge is beginning to unravel the complex molecular and cellular changes associated with malignant tumor progression. With this comes many opportunities for therapeutic development. Featuring the latest tools, models, and research findings, this conference which included over 250 members of both academia and industry was a great opportunity to learn and develop new approaches and collaborations. The Keynote speaker was Dr. Robert Horvitz (Massachusetts Institute of Technology), who won the 2002 Nobel Prize in Medicine for his pioneering work on the cell death pathway in Caenorhabditis elegans. Speakers covered various aspects of tumor progression and therapy from simple models to clinical trials.
Laryngeal Chondrosarcoma After Thyroid Irradiation
Authors: Sami H. Ghalib
Journal: JAMA (1969)

<h3>To the Editor:—</h3> Primary chondrosarcoma of the larynx and lower respiratory tract is rare. Daniels et al<sup>1</sup>found 15 cases of chondrosarcoma of the tracheobronchial tree and lungs and added a case of his own. Brandenburg et al<sup>2</sup>found 150 cases of cartilaginous tumors of the larynx reported until January 1967, only 26 of which were chondrosarcoma. Putney et al<sup>3</sup>and Goethals et al<sup>4</sup>found the cricoid to be the most frequent site of origin of the cartilaginous tumors of the larynx. It is the purpose of this paper to report a fatal primary chondrosarcoma of the laryngeal cartilages in a 74-year-old woman, many years after neck irradiation. <h3>Report of a Case:—</h3> A 74-year-old white woman was admitted to the University of Iowa Hospitals on Dec 1, 1967, with a mass apparently in the left thyroid lobe that had been present for two years. This lump
Routine protein energy supplementation in adults: systematic review
Authors: J. Potter, P. Langhorne, M. Roberts
Journal: BMJ (1998)

<h3>Abstract</h3> <b>Objectives</b> : To determine whether routine oral and enteral nutritional supplementation can improve the weight, anthropometry, and survival of adult patients. <b>Design</b> : Systematic review of randomised controlled trials of oral or enteral protein supplementation in adults. Trials were identified from Medline (Silver Platter 3.11, 1966-96), reference lists of identified studies and review articles, and communication with feed manufacturers. <b>Subjects</b> : Randomised controlled trials comparing oral or enteral protein supplementation with no routine supplementation. All trials of adult subjects were included except those addressing nutrition in pregnancy. <b>Main outcome measures</b> : Change in body weight and anthropometry (mid-arm muscle circumference), and all cause case fatality recorded at the end of scheduled follow up. body weight and anthropometry were analysed as the weighted mean difference and 95%confidence intervals of the percentage change in these variables. Case fatality was analysed with odds ratio and 95% confidence intervals. <b>Results</b> : 32 eligible reports (2286 randomised patients) published between February 1979 and July 1996 were identified, of which 30 (93.8%) (2062 randomised patients) reported outcomes of interest. Case fatality data were available for 1670 (81%) patients, and continuous variable data for up to 1607 (78%) patients. The treatment group receiving routine nutritional supplementation showed consistently improved changes in body weight and anthropometry compared with controls; weighted mean difference 2.06% (95%confidence interval 1.63% to 2.49%) and 3.16% (2.43% to 3.89%)respectively. The pooled odds ratio for death in the treatment group was 0.66 (0.48 to 0.91, 2P&lt;0.01). Apparent benefits were observed in several prespecified subgroups of patients, treatment settings, and interventions, but were not evident if trials with less robust methodology were excluded. <b>Conclusions</b> : Routine oral or enteral supplementation seems to improve the nutritional indices of adult patients, but there are insufficient data in trials which meet strict methodological criteria to be certain if mortality is reduced. Benefits were not restricted to particular patient groups. Further large pragmatic randomised controlled trials of routine nutritional supplementation are justified.
Junior doctors' fears for the future BMA proposes alternative models for the NHS GPs should consider a list of preferred drugs Defence medical services to be halved MPs question whether performance bill will work
Authors: L. Beecham
Journal: BMJ (1995)

# Junior doctors' fears for the future {#article-title-2}

Failling morale among doctors featured widely in the debates at the recent meeting of the BMA's Junior Members Forum. The NHS seems to be attracting more doctors from other European Union states while recruitment in Britain is dropping. One doctor told the forum that 25-30% of the students who graduated with her had gone to Australia, and there were reports of general practitioner vocational training courses being unfilled. The lack of flexible and part time training does not help, particularly for women graduates, who now account for over 50% in most medical schools.

To try to discover future doctors' intentions the BMA is to ask a cohort of final year students what their plans are and to follow them for 10 years.

But it is the lack of progress on the Calman report on specialist medical training that is causing major frustrations, and the meeting condemned the lack of consultant expansion and called on the government for more central funding. “Failure to abide by this commitment must result in the whole profession supporting the juniors in their refusal to continue formal negotiations on the terms and conditions of the unified training grade.”

The forum also resolved that because the overall employment position of doctors in the NHS had deteriorated to such an extent the BMA's health policy unit should investigate alternative ways of employing doctors. “This motion arises out of despair,” one of the Junior Doctors Committee's deputy chairmen, Dr Paul Miller, told the meeting.

The meeting defeated a proposition that charging patients for general practice consultations would encourage a more responsible use of services. According to Dr Jonathan Reggler, who practises in the Oxford region, patients now saw demands and needs as rights, as the government encouraged them to go to their doctor. “We should be bold and think …
Transactivation of the Metallothionein Promoter in Cisplatin-Resistant Cancer Cells: a Specific Gene Therapy Strategy
Authors: D. Vandier, V. Calvez, L. Massade, A. Gouyette, L. Mickley, T. Fojo, O. Rixe
Journal: JNCI Journal of the National Cancer Institute (2000)

Background: Cisplatin (cis-diamminedichloroplatinum) is one of the most active agents against a broad range of malignancies, including ovarian cancer. Cisplatin resistance appears to be associated with several molecular alterations, including overexpression of metallothionein, a metal-binding protein. In the present study, we attempted to take advantage of metallothionein overexpression to overcome cisplatin resistance. Methods: Using a virus-free system (liposomes), we sought to express the suicide gene, thymidine kinase (TK), driven by the promoter of the human metallothionein IIa (hMTIIa) gene using the pMT-TK plasmid. We used cisplatin-resistant human ovarian carcinoma cells as a model. Results: We first analyzed metallothionein expression using a ribonuclease protection assay. In comparison to parental cells, the cisplatin-resistant cells were found to have increased expression of metallothionein messenger RNA (mRNA). Metallothionein overexpression in these cells was not associated with an increased copy number of the hMTIIa gene or with different transfection efficiencies. Furthermore, we showed by reverse transcription–polymerase chain reaction analysis that transfection of the pMT-TK plasmid results in a 56-fold higher expression of thymidine kinase mRNA in cisplatin-resistant cells compared with parental cells, consistent with increased metallothionein promoter-mediated transactivation in the cisplatin-resistant cells. Transfection of resistant cells with pMT-TK or a control plasmid (pCD3-TK) resulted in a marked sensitization to ganciclovir, with a 50% cell growth-inhibitory concentration (IC50) of 20 μg/mL and 9 μg/mL, respectively. Transfections of the cisplatin-sensitive cells resulted in no sensitization to ganciclovir with pMT-TK (IC50 200 μg/mL) and a high sensitization with pCD3-TK (IC50 = 6 μg/mL). Conclusion: These studies suggest that pMT-TK gene therapy may provide an alternative treatment for cisplatin-refractory ovarian tumors.
Applying quality improvement approaches to health care
Authors: M. Marshall
Journal: BMJ (2009)

The health sector could learn much from industry

People who work in the health system can be resistant to learning from other sectors. They claim that health care is different, and it is hard to argue otherwise when you look at the range and diversity of the stakeholders and the ways in which authority is distributed between them. But some challenges are common to all sectors, and it would be wasteful to ignore transferable solutions.

The manufacturing sector’s approach to improving quality is a case in point. More than half a century has passed since pioneers transformed Japanese industry by applying simple statistical and behavioural principles, by applying simple statistical methods like statistical process control and behavioural practices such as effective teamwork.1 Companies like Toyota and Unipart have adapted these approaches to produce levels of quality and reliability that the health sector can only dream of.2

It is not that the health sector hasn’t tried to apply these techniques. Twenty years ago Berwick described how healthcare providers might learn from industry.3 These ideas were first taken up by a small band of enthusiasts,4 5 and they are …
Long-Term Tetracycline Treatment of Chronic Bronchitis
Authors: Philip S. Norman, Edward W. Hook, Robert G. Petersdorf, Leighton E. Cluff, Malcolm P. Godfrey, Allan H. Levy
Journal: JAMA (1962)

Cultures from patients with chronic bronchitis frequently grow hemophilus or pneumococcus. Thirty-two patients with well established chronic bronchitis were treated for 3 months at a time with 1.0 gm. daily of tetracycline, alternated with 3 months of indistinguishable placebos in a double blind study. About onethird as many exacerbations occurred during tetracycline treatment as during placebo treatment. In some patients, daily cough, sputum volume, and dyspnea were somewhat improved during tetracycline treatment. In individual patients there was a good correlation between eradication of pneumococcus and hemophilus and reduction of acute exacerbations. One patient had a fatal acute bronchitis due to an antibioticresistant staphylococcus during tetracycline therapy; otherwise, there was no evidence of replacement of normal flora during tetracycline treatment.