tbuckley/cabot-search huggingface dataset:
Book Review The Interpretation of Dreams By Sigmund Freud. Translated by Joyce Crick. 458 pp. New York, Oxford University Press, 1999. $27.50. 0-19-210049-1 Dreaming Souls: Sleep, dreams, and the evolution of the conscious mind By Owen Flanagan. 210 pp. New York, Oxford University Press, 2000. $25. ISBN-0-19-512687-4.
Authors: Robert Stickgold
Journal: New England Journal of Medicine (2000)
Medical Practices Committee.
Authors: W B Whowell
Journal: BMJ (1981)

Though it affects all general practitioners, the Medical Practices Committee and its workings are little understood. It was set up to implement the principle of the National Health Service that there should be adequate numbers of family doctors throughout the country, and the way it classifies an area may affect con? siderably the general practitioners practising there. In areas considered to be overdoctored, for example, it may prevent doctors taking a partner or setting up in practice, while doctors in severely underdoctored areas may be entitled to substantial financial allowances. The MPC's principal function is to control the distribution of GPs in England and Wales (there is a separate MPC for Scotland, and Northern Ireland has different arrangements). It does this by considering all applications for inclusion on the medical lists kept by family practitioner committees and by reviewing the need to fill practice vacancies. Its actual controls are negative ones: the MPC cannot tell doctors where to go, but it can tell them where they may not practise. The MPC also acts as an appeal body on decisions by FPCs to refuse the employment of assistants or allow the use of surgeries that have been used by another GP. Doctors may also apply to the MPC for a certificate to show that partnership arrangements do not include the sale of goodwill (which is forbidden in the NHS).
Is Graded Prognostic Assessment an Improvement Compared With Radiation Therapy Oncology Group's Recursive Partitioning Analysis Classification for Brain Metastases?
Authors: Marc C. Chamberlain, Daniel L. Silbergeld
Journal: Journal of Clinical Oncology (2012)

With respect to equivocal cases, Christgen et al had only one IHC/FISH equivocal case that was also equivocal by ODX.In our study, 2 23 IHC/FISH equivocal cases were all negative by ODX.We have previously suggested that dilution of invasive tumor with noninvasive tissue may have resulted in discordant results.Christgen et al mentioned that this might not be the only cause, and we do not completely disagree.Apart from the dilution artifact, one should also question the primers, probes, and failure of the reverse transcriptase polymerase chain reaction process, especially when HER2 FISH shows increased gene copies and HER2 IHC shows protein overexpression.The ODX HER2 assay fails to identify a significant number of unequivocal IHC 3ϩ and FISH-amplified cases and almost always produces a negative result in FISH equivocal cases. 2 Therefore, we do not see a role for the ODX HER2 assay (or other mRNA-based assays) as an adjunct to the current IHC/FISH-based approach for HER2 assessment.
Double blind, placebo controlled study of metronidazole as a disease modifying agent in the treatment of rheumatoid arthritis.
Authors: D A Marshall, J A Hunter, H A Capell
Journal: Annals of the Rheumatic Diseases (1992)

Anecdotal reports suggest that metronidazole may have disease modifying activity in the treatment of rheumatoid arthritis. To assess possible beneficial effects a double blind, comparative trial of metronidazole and placebo was performed. Fifty patients with active rheumatoid arthritis were randomly allocated to receive active drug (n = 24) or placebo (n = 26) and reviewed at weeks 0, 1, 4, 8, 12, 16, and 24. Detailed assessment of drug safety, biochemical and haematological parameters, and efficacy was made at these dates. Dose regimen was 400 mg twice daily from weeks 0 to eight, increasing to 400 mg three times a day from weeks nine to 24 provided that no adverse effects were recorded. Most patients were unable to tolerate metronidazole because of side effects or lack of efficacy, with only five (21%) continuing to take the drug at 24 weeks. For those patients attaining 12 weeks of treatment an overall improvement in articular index and morning stiffness was found. No improvement in laboratory indices of disease activity was seen, however. In this study metronidazole did not have disease modifying properties and was unacceptably toxic.
Activation of T cells by carbamazepine and carbamazepine metabolites
Authors: Ying Wu, Joseph P. Sanderson, John Farrell, Nicola S. Drummond, Anita Hanson, Elizabeth Bowkett, Neil Berry, Andrew V. Stachulski, Stephen E. Clarke, Werner J. Pichler, Munir Pirmohamed, B. Kevin Park, Dean J. Naisbitt
Journal: Journal of Allergy and Clinical Immunology (2006)
Evidence based medicine: Socratic dissent
Authors: D. Grahame-Smith
Journal: BMJ (1995)

SOCRATES: Tell me, Enthusiasticus (Meta-analyticus), they say you are espousing a new form of medical practice. Is that so?

ENTHUSIASTICUS: Indeed Socrates, and very effective it is.

SOCRATES: Does it have a name or description?

ENTHUSIASTICUS: Yes, we have called it evidence based medicine.

SOCRATES: How very interesting, albeit unaesthetic. But I do find the title that you have given this new form of medical practice rather alarming. I thought that all doctors were trained in the scientific tradition, one tenet of which is to examine the evidence on which their practice is based. How then does this new evidence based medicine differ from traditional medicine?

ENTHUSIASTICUS: Well, Socrates, one problem is that most doctors have a very narrow perspective, limiting themselves to their own experience and that of a relatively few colleagues with whom they exchange views. This sometimes leads them to make erroneous conclusions.

SOCRATES: Do you imply that in their narrowness they fail to search for evidence which might cause them to reach a different conclusion or allow them to come to a more balanced decision?

ENTHUSIASTICUS: Precisely, Socrates, you have hit it in one.

SOCRATES: How do you, Enthusiasticus, manage to gain access to this evidence which more ordinary doctors find inaccessible? Is it hidden away?

ENTHUSIASTICUS: Sometimes it is. We have sophisticated methods, using information technology, for searching out and recording information about the efficacy of treatments and case management from all over the world. Also scientists and doctors do not always publish the results of their studies, particularly if they have been negative. I and my colleagues have ways of unearthing such results, …
Granulomatous Myositis and Myopathy Associated with Crohn's Colitis
Authors: Daniel B. Ménard, Henry Haddad, J.G. Blain, René Beaudry, Ghislain Devroede, Serge Massé
Journal: New England Journal of Medicine (1976)

Extraintestinal complications of inflammatory bowel disease are well recognized, but extraintestinal primary Crohn's lesions are less common. Unusual bone1, synovial2 and vulvar3 granulomatous involvement has recently been described. Granulomatous myositis and myopathy may also accompany Crohn's colitis.Case ReportA 44-year-old man was admitted to the hospital with a six-week history of non-bloody diarrhea, crampy abdominal pain, arthralgia, fever and a 4.5-kg weight loss. Physical examination was unremarkable. Proctoscopy was normal to a level of 20 cm from the anal margin, at which point multiple ulcerations, 2 to 3 mm, extended to the length of the proctoscope. Biopsies showed . . .
Direct suppression of CNS autoimmune inflammation via the cannabinoid receptor CB1 on neurons and CB2 on autoreactive T cells
Authors: Katarzyna Maresz, Gareth Pryce, Eugene D Ponomarev, Giovanni Marsicano, J Ludovic Croxford, Leah P Shriver, Catherine Ledent, Xiaodong Cheng, Erica J Carrier, Monica K Mann, Gavin Giovannoni, Roger G Pertwee, Takashi Yamamura, Nancy E Buckley, Cecilia J Hillard, Beat Lutz, David Baker, Bonnie N Dittel
Journal: Nature Medicine (2007)
Treatment of Vasomotor Symptoms of Menopause with Black Cohosh, Multibotanicals, Soy, Hormone Therapy, or Placebo
Authors: Katherine M. Newton, Susan D. Reed, Andrea Z. LaCroix, Louis C. Grothaus, Kelly Ehrlich, Jane Guiltinan
Journal: Annals of Internal Medicine (2006)

Background: Herbal supplements are widely used for vasomotor symptoms. Objective: To test the efficacy of 3 herbal regimens and hormone therapy for relief of vasomotor symptoms compared with placebo. Design: 1-year randomized, double-blind, placebo-controlled trial conducted from May 2001 to September 2004. Setting: Group Health, Washington State. Participants: 351 women age 45 to 55 years with 2 or more vasomotor symptoms per day; 52% of the women were in menopausal transition and 48% were postmenopausal. Measurements: Rate and intensity of vasomotor symptoms (1 = mild to 3 = severe), and Wiklund Vasomotor Symptom Subscale. Interventions: 1) Black cohosh, 160 mg daily; 2) multibotanical with black cohosh, 200 mg daily, and 9 other ingredients; 3) multibotanical plus dietary soy counseling; 4) conjugated equine estrogen, 0.625 mg daily, with or without medroxyprogesterone acetate, 2.5 mg daily; or 5) placebo. Results: Vasomotor symptoms per day, symptom intensity, Wiklund Vasomotor Symptom Subscale score did not differ between the herbal interventions and placebo at 3, 6, or 12 months or for the average over all the follow-up time points (P > 0.05 for all comparisons) with 1 exception: At 12 months, symptom intensity was significantly worse with the multibotanical plus soy intervention than with placebo (P = 0.016). The difference in vasomotor symptoms per day between placebo and any of the herbal treatments at any time point was less than 1 symptom per day; for the average over all the follow-up time points, the difference was less than 0.55 symptom per day. The difference for hormone therapy versus placebo was −4.06 vasomotor symptoms per day for the average over all the follow-up time points (95% CI, −5.93 to −2.19 symptoms per day; P < 0.001). Limitations: The trial did not simulate the whole-person approach used by naturopathic physicians. Differences between treatment groups smaller than 1.5 Vasomotor symptoms per day cannot be ruled out. Conclusion: Black cohosh used in isolation, or as part of a multibotanical regimen, shows little potential as an important therapy for relief of vasomotor symptoms. Clinical Trials Registration number: NCT00169299.
Cardiac dysfunction associated with a nucleotide polymerase inhibitor for treatment of hepatitis C
Authors: Tariq Ahmad, Philip Yin, Jeffrey Saffitz, Paul J. Pockros, Jacob Lalezari, Mitchell Shiffman, Bradley Freilich, Joann Zamparo, Kyle Brown, Dessislava Dimitrova, Monica Kumar, Doug Manion, Margo Heath‐Chiozzi, Robert Wolf, Eric Hughes, Andrew J. Muir, Adrian F. Hernandez
Journal: Hepatology (2014)

Treatment for chronic hepatitis C virus (HCV) infection is evolving from interferon (IFN)‐based therapy to direct‐acting antiviral (DAA) agents, yet some safety concerns have arisen involving cardiac toxicity. In this study, we sought to better understand the potential off‐target toxicities of new DAAs. We retrospectively evaluated the clinical and pathological findings of the sentinel case in a phase II study that led to clinical development discontinuation for BMS‐986094, an HCV nucleotide polymerase (nonstructural 5B) inhibitor. We also report on outcomes from other patients in the same study, including electrocardiogram changes, cardiovascular biomarkers, and transthoracic echocardiograms. Thirty‐four patients received IFN‐free BMS‐986094 regimens. Six patients had left ventricular ejection fractions (LVEFs) &lt;30%, 8 had LVEFs 30%‐50%, and 11 required hospitalization for suspected cardiotoxicity. Of the patients with LVEF &lt;50%, 6 had normalization of systolic function after a median of 20 days. T‐wave inversions were the most sensitive predictor of LVEF dysfunction. B‐type natriuretic peptide levels increased over time and correlated with the degree of LVEF dysfunction. Pathological analysis of cardiac tissue revealed severe myocyte damage with elongated myofibrils without gross necrosis. These findings were consistent with some results of recent primate studies that were conducted to further investigate the potential mechanisms of BMS‐986094 toxicity. Conclusion : A novel nucleotide analog polymerase inhibitor developed for HCV treatment may cause a toxic cardiomyopathy. Ongoing surveillance of DAAs for cardiotoxicities may be beneficial, especially among patients at higher risk for cardiovascular disease. (H epatology 2015;62:409–416
Ballistocardiographic Evaluation of the Cardiovascular Aging Process
Authors: ARTHUR J. MOSS
Journal: Circulation (1961)

A clinically adaptable, ultra-low frequency acceleration ballistocardiograph that met all theoretic considerations of biophysical design was used to evaluate the cardiovascular aging process in 307 overtly healthy men aged 18 to 54. A new practical method for quantitative ballistocardiographic analysis is described, and the changing ballistocardiographic pattern with advancing age is elucidated. Criteria for ballistocardiographic abnormality are established in terms of accelerated cardiovascular aging, and the degree of abnormality is graded (I-III). The initial appearance of accelerated cardiovascular aging (grade-I abnormality) was present on the ballistocardiogram in 16 per cent of the population by age 35. A more severe degree of aging (grade II) was evident in 16.5 per cent of the individuals by age 50. There was a rather constant attack rate for the initial development of an abnormal ballistocardiogram (grade I) during the 20 to 39 age period, and an accelerated attack rate after age 40. The rate of conversion to a more severe grade of ballistocardiographic abnormality increased significantly in the fifth decade. The relationship between an abnormal ballistocardiogram, accelerated cardiovascular aging and coronary artery disease is discussed.
Comparative Mortality for 621 Second Cancers in 29356 Testicular Cancer Survivors and 12420 Matched First Cancers
Authors: C. Schairer, M. Hisada, B. E. Chen, L. M. Brown, R. Howard, S. D. Fossa, M. Gail, L. B. Travis
Journal: JNCI Journal of the National Cancer Institute (2007)

Testicular cancer survivors, many of whom have undergone radiotherapy, are at substantial risk of second cancers. Treatment for testicular cancer may limit treatment options for second cancers, thereby adversely affecting survival after the second cancer. However, no data on outcomes of testicular cancer survivors with second cancers compared to patients with comparable first cancers exist. Among 29356 white testicular cancer patients reported to the Surveillance, Epidemiology, and End Results (SEER) program (1973–2002), 621 developed a second cancer with known stage and were matched to a random sample of 12420 white male first cancer patients in the SEER program by cancer site, stage, diagnosis year, and age at diagnosis. Mortality was ascertained through 2002. Cancer-specific and all-cause mortality following second cancers were compared with those of matched first cancers, and rate ratios (RRs) were estimated using proportional hazards analysis. Survival functions were calculated using product-limit estimates. During the study period, 284 testicular cancer survivors with second cancers died, 191 from their second cancer; 5443 matched first cancer patients died, 3929 from their first cancer. Rate ratios for cancer-specific and all-cause mortality for second cancers compared with matched first cancers were 1.05 (95% confidence interval [CI] = 0.90 to 1.23) and 1.09 (95% CI = 0.96 to 1.23), respectively. However, among testicular cancer patients who were diagnosed during 1973–1979, an era in which radiation therapy was given at high doses and to the chest area, all-cause mortality following second cancers at sites below the diaphragm (79 deaths) and second lung cancers (29 deaths) was statistically significantly higher than that from matched first cancers (RR = 1.44, 95% CI = 1.13 to 1.83, and RR = 1.65, 95% CI = 1.12 to 2.42, respectively). Mortality from second cancers following testicular cancer was similar to matched first cancers, except for selected tumors in the radiotherapy field among testicular cancer patients who were diagnosed during 1973–1979, a time when radiotherapy doses for treatment of testicular cancer were high and chest irradiation was an option in standard practice.
Climate Change and Elderly Americans: Examining Adaptability in an Aging Population
Authors: Tanya Tillett
Journal: Environmental Health Perspectives (2013)

Adults aged 65 and older make up about 13% of the current U.S. population, but by 2040 that number is projected to increase to 20%.One of the most significant public health challenges facing this aging population will be changes in the frequency and/or intensity of climate-related stressors such as hot temperatures and extreme weather events.A new review of the literature provides a comprehensive assessment of the state of the science regarding the impacts of climate change on this segment of the U.S. population and discusses possible adaptation measures [EHP 121(1):15-22; Gamble et al.].The investigators performed PubMed and Google Scholar literature searches for relevant research dating from 2000 through 2011 using three sets of general search terms describing 1) the older adult population; 2) environmental impacts, events, and potentially vulnerable areas related to climate change; and 3) effects of climate change on health and well being.In addition, they polled subject matter experts and reviewed major synthesis reports to identify additional relevant sources.Ultimately they created a list of nearly 100 papers and reports for analysis, including a few seminal articles published earlier than 2000.The number of older adults in the United States is projected to increase to 88.5 million by the year 2050, with 21% of these individuals aged 85 or older.Relatively higher concentrations of older adults live in areas such as coastal zones, large urban areas in the Northeast and Midwest, and in the Southwest, all of which are expected to be especially affected by climate stressors such as heat events, droughts,
63. Long-Term Constitutive Expression of the Therapeutic Gene, IL2RG, Causes T-Cell Lymphomas in a Gene Therapy Model for XSCID
Authors: Niels-Bjarne Woods, Virginie Bottero, Manfred Schmidt, Christof von Kalle, Inder M. Verma
Journal: Molecular Therapy (2006)

Top of pageAbstract
The successful gene therapy clinical trials, where the immune function of patients with X-linked severe combined immune deficiency (XSCID) was restored, demonstrated the utility for vector mediated gene transduction of hematopoietic stem cells in the treatment of a life threatening disease. However, the occurrence of T-cell leukemias in three patients, with the suspected oncogenic event resulting from upregulation of expression of the known oncogene, LMO2, by insertional mutagenesis, has led to the re- evaluation of the safety of this procedure. To model the gene therapy adverse events and to better understand the mechanism of generation of leukemia in the patients, we expressed the therapeutic gene, IL2RG, used to treat XSCID patients, in combination with and without LMO2 in a murine model of XSCID, and followed the fates of transplanted mice up to 1.8 years post transplantation. In this study, we unexpectedly found that the therapeutic gene IL2RG alone is a major contributor to the genesis of T-cell lymphomas in mice, with a prevalence of 33%, n=15. We found that IL2RG|[minus]|/|[minus]| mice transplanted with IL2RG vector transduced IL2RG|[minus]|/|[minus]| cells or similarly transduced wild type cells developed the T-cell lymphomas. As expected, T-cell lymphomas were also detected in the positive control LMO2 transduced mice with a prevalence of 50%, n=12, with cell phenotype similar to those previously published. In contrast, none of the mock transduced mice (n=16) nor LV-GFP vector transduced mice (n=17) developed the T-cell lymphoma in this study. These findings were generated from 7 independent experiments totaling 99 mice ranging from 71 to 91 weeks posttransplant. Interestingly, the average time of onset of the T-cell lymphomas in IL2RG transduced mice was faster than the LMO2 transduced mice, 10.1 months versus 12.2 months post transplant, p=0.034. The T-cell lymphoma manifested itself as a gross thymic mass, which showed neoplastic cells with a CD3/B220 double positive phenotype, as well as larger CD4|[minus]|/CD8+ blast-like cells, which were also predominant in the spleen. Vector integration site analysis showed lymphomic cells to be of clonal origin with similar integration site profiles being present in the thymuses, bone marrow cells, and spleens of individual mice. Dual transgene expression of IL2RG and LMO2 did not significantly accelerate lymphomagenesis. Our results suggest a re-evaluation of the current view that IL2RG has minimal oncogenic properties and offer caution that current gene therapy trials for XSCID may pose increased risks to patients than previously anticipated. Furthermore, these results may explain why leukemia has been seen with such prevalence in XSCID trials when gene therapy trials for other diseases have not shown any such side effects.
OUTCOMES OF ATRIO-ESOPHAGEAL FISTULA FOLLOWING CATHETER ABLATION OF ATRIAL FIBRILLATION TREATED WITH SURGICAL REPAIR VERSUS ESOPHAGEAL STENTING
Authors: Sanghamitra Mohanty, Pasquale Santangeli, Prasant Mohanty, Luigi Di Biase, Chintan Trivedi, Rong Bai, Rodney Horton, John Burkhardt, Javier Sanchez, Jason Zagrodzky, Shane Bailey, Joe Gallinghouse, Patrick Hranitzky, Albert Sun, Richard Hongo, Salwa Beheiry, Andrea Natale
Journal: Journal of the American College of Cardiology (2014)
A New Test for Pheochromocytoma
Authors: Karl Engelman, Albert Sjoerdsma
Journal: JAMA (1964)

Enhanced pressor reponses to intravenous doses of tyramine were found in five patients with pheochromocytoma in comparison with 21 subjects with essential hypertension and 11 with normal blood pressure. In two patients with pheochromocytoma who had curative surgery, the tyramine sensitivity returned to normal. The mechanism of the enhanced tyramine sensitivity may be related to increased stores of tyramine-releasable catechol amine at sympathetic nerve endings. The recommended conditions for tyramine testing are discussed, with emphasis on avoidance of its usage in patients receiving monoamine oxidase (MAO) inhibitors. While further evaluation is required, tyramine appears to be a suitable substitute for histamine in the pharmacological diagnosis of pheochromocytoma.
P1071 HIGH HBeAg SEROCONVERSION RATE INDUCED BY PEGINTERFERON ALFA IN NUCLEOS(T)IDE ANALOG TREATED PATIENTS WITH VIROLOGICAL RESPONSE AND LOW HBeAg LEVEL
Authors: J. Yu, X.S. Liang, C.Z. Li, Z.H. Chen, J.Y. Xue, M.B. Wan
Journal: Journal of Hepatology (2014)
Book Review Who Lives? Who Dies?: Ethical criteria in patient selection By John F. Kilner. 359 pp. New Haven, Yale University Press, 1990. $29.95 Strong Medicine: The ethical rationing of health care By Paul T. Menzel. 234 pp. New York, Oxford University Press, 1990.
Authors: Judith Wilson Ross, Martin F. Shapiro
Journal: New England Journal of Medicine (1991)
780 UPTAKE OF HCV NON-ENVELOPED PARTICLES FROM HUMAN PERIPHERAL BLOOD MONONUCLEAR CELLS (PBMCS) LEADS TO MODULATION OF THE IMMUNE RESPONSE
Authors: P.P. Doumba, E. Serti, M. Boutsikou, M.M. Konstandoulakis, U. Georgopoulou, J. Koskinas
Journal: Journal of Hepatology (2011)