tbuckley/cabot-search huggingface dataset:
Hyperpigmentation of Nails From Doxorubicin
Authors: Charles B. Pratt
Journal: JAMA (1974)

<h3>To the Editor.—</h3> Doxorubicin (adriamycin) an antitumor antibiotic,<sup>1-3</sup>is used widely in the treatment of childhood and adult tumors and leukemias. Its reported toxic side effects include alopecia, hematopoietic depression, nausea, vomiting, mucosal ulcerations, weight loss, urticaria, electrocardiographic changes, and fatal and nonfatal cardiomyopathy. Recently, we have noticed an additional side effect of this drug, an increase in melanin pigmentation in the nails, nailbeds, phalangeal, and other dermal creases, as shown in the Figure. These changes appear six or more weeks following initiation of doxorubicin administration and have been observed more frequently in black than in white children. Of 13 black children who received doxorubicin alone or in combination with other agents for six weeks or more, five showed increased pigmentation in the nails and nailbeds; three of these five children also had changes in the interphalangeal and palmar creases. In 39 white children, increased pigmentation was seen in
Laws Mandating Reporting of Domestic Violence
Authors: Ariella Hyman
Journal: JAMA (1995)

DOMESTIC violence is increasingly recognized as a major public health problem, affecting individuals of all ethnic and socioeconomic backgrounds. Domestic violence has been defined as a pattern of coercive control consisting of physical, sexual, and/or psychological assaults against current or former intimate partners.<sup>1</sup>Batterers also commonly use economic abuse, isolation, and intimidation to exert power over their partners. This article often refers to the battering of women, since 90% to 95% of domestic violence victims are women.<sup>2</sup>Domestic violence also can occur against men and in homosexual as well as heterosexual relationships.<sup>3,4</sup> Approximately 4 million women are believed to be battered every year by their partners.<sup>5</sup>At least one fifth of all women will be physically assaulted by a partner or ex-partner during their lifetime.<sup>6</sup>Domestic violence is believed to be the most common cause of serious injury to women<sup>7</sup>and accounts for more
Abstract P6-07-05: Prognosis of 368 women with primary breast cancer during pregnancy: results from an international collaborative trial
Authors: F Amant, G von Minckwitz, SN Han, M Bontenbal, A Ring, J Giermek, T Fehm, H Wildiers, SC Linn, B Schlehe, P Neven, PJ Westenend, V Müller, K Van Calsteren, B Rack, V Nekljudova, N Harbeck, M Lenhard, PO Witteveen, M Kaufmann, B Van Calster, S Loibl
Journal: Cancer Research (2012)

Abstract Objective: We aimed to add to the limited outcome data on breast cancer during pregnancy (BCP), and compared disease-free survival (DFS), and overall survival (OS) between patients with BCP and breast cancer not diagnosed during pregnancy, adjusted for known prognostic factors. Methods: We analyzed a pro- and retrospectively compiled multi-centric registry of BCP patients (www.cancerinpregnancy.org and GBG/BIG 0203). Outcome was compared to a control group of patients who did not have associated pregnancies. The main analysis is a Cox proportional hazards regression of disease free survival (DFS) and overall survival (OS) on exposure (pregnant or not). The analysis was weighted by propensity score matching to correct for any bias that may have been associated with differences in baseline characteristics, with the following set of covariates: age, stage, grade, hormone receptor status, HER2 status, histology, type of chemotherapy and trastuzumab. Sensitivity analysis was also performed on age only, and also on chemotherapy only. Results: From April 2003-December 2011, 447 women with BCP were registered, 368 women with BCP were eligible for this analysis. The control group consisited of 2739 women (ratio 1:7.44). Median age was 33 years (interquartile range 30–36) for the cases and 41 years (interquartile range 37–43) for the controls. Median follow-up was 57 months. There were no statistically significant differences noted for DFS and OS studied after propensity-score matching, and sensitivity analysis. Conclusion: Patients diagnosed with breast cancer during pregnancy do not have a worse prognosis compared to patients who are not pregnant after matching for prognostic factors and treatment. This information is important when BCP patients are counseled regarding prognosis and adds to the possibility of treatment during pregnancy. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P6-07-05.
Breast MRI Scans Need Standards, Experts Say
Authors: K. Hede
Journal: JNCI Journal of the National Cancer Institute (2007)

Two years ago the Institute of Medicine’s National Cancer Policy Board recommended uniform standards for all forms of breast imaging — not just mammography. That advice seems all the more important now that the American Cancer Society is recommending yearly magnetic resonance imaging (MRI) screening for women at high risk of breast cancer. Yet uniform standards for performing breast MRI scans have yet to be developed. “I would say right now that breast MRI is in the situation that mammography was in the late 1980s,” said Edward Hendrick, Ph.D., director of breast imaging research at the Northwestern University School of Medicine in Chicago. “There are places that do very good breast MRI and there are places that do not-so-good breast
How to Write and Publish a Scientific Paper
Authors: Lawrence D. Grouse
Journal: JAMA (1984)

It might be better if editors wrote about auto mechanics or the assembly of children's toys. Both of these subjects are in great need of additional editorial expertise, whereas writing scientific papers, which is what editors do write about, does not need it. After reading several books about preparing manuscripts, one realizes that there are as many right ways to proceed as there are editors writing.  This little volume—one of many books by editors on how to write and publish scientific papers—has little to recommend itself over its competitors. It's a pity, because the volume has been prepared with care and is clearly the product of years of experience. It is best when presenting practical suggestions:  The smart author writes out references (on 3×5 cards, usually) in full (p 43).  The data [in a table] should be organized so that the like elements read down , not across (p 51).  Be
Functional Proteomic Analysis of Protein Kinase C ε Signaling Complexes in the Normal Heart and During Cardioprotection
Authors: Peipei Ping, Jun Zhang, William M. Pierce, Roberto Bolli
Journal: Circulation Research (2001)

Abstract— Using two-dimensional electrophoresis, mass spectrometry, immunoblotting, and affinity pull-down assays, we found that myocardial protein kinase C ε (PKCε) is physically associated with at least 36 known proteins that are organized into structural proteins, signaling molecules, and stress-responsive proteins. Furthermore, we found that the cardioprotection induced by activation of PKCε is coupled with dynamic modulation and recruitment of PKCε-associated proteins. The results suggest heretofore-unrecognized functions of PKCε and provide an integrated framework for the understanding of PKCε-dependent signaling architecture and cardioprotection.
Inpatient Treatment of Conversion Disorder: A Clinical Investigation of Outcome
Authors: Friedrich Krull, Michael Schifferdecker
Journal: Psychotherapy and Psychosomatics (1990)

In a retrospective survey, a group of 220 patients with conversion symptoms was subdivided according to clinical findings at the time of discharge. The longer the duration of the symptom and the older the patient, the less was the beneficial effect of treatment. One particular problem with therapy for conversion symptoms lies in the fact that, in his own eyes, the patient is not psychologically ill, but physically ill. Time and again, it proved a therapeutic blind alley to try and convince the patient that the cause of his conversion symptoms was 'purely psychological'. Special guidelines for therapy of conversion symptoms are derived.
Human chorionic gonadotrophin and sport.
Authors: A T Kicman, R V Brooks, D A Cowan
Journal: British Journal of Sports Medicine (1991)

Human chorionic gonadotrophin (hCG) is a glycoprotein hormone which is produced in large amounts during pregnancy and also by certain types of tumour. The biological action of hCG is identical to that of luteinizing hormone, although the former has a much longer plasma half-life. Some male athletes use pharmaceutical preparations of hCG to stimulate testosterone production before competition and/or to prevent testicular shutdown and atrophy during and after prolonged courses of androgen administration. Testosterone administration can be detected by measuring the ratio of concentrations of testosterone to epitestosterone (T/E). An athlete is often considered to have failed a drug test if the urinary T/E ratio is greater than 6. In contrast, hCG administration stimulates the endogenous production of both testosterone and epitestosterone without increasing the urinary T/E ratio above normal values. Although the administration of hCG was banned by the International Olympic Committee (IOC) in 1987, no definitive test for hCG has been approved by the IOC. Currently, the only way of measuring small concentrations of hCG is by immunoassay, and this does not have a discriminating power as great as gas-liquid chromatography with mass-spectrometry which is necessary to satisfy IOC requirements. Extraction procedures and chromatographic steps could be introduced before using a selected immunoassay for hCG to meet these requirements.
ENHANCEMENT OF HEME AND GLOBIN SYNTHESIS IN CULTURED HUMAN MARROW BY CERTAIN 5ß-H STEROID METABOLITES
Authors: Hideaki Mizoguchi, Richard D. Levere
Journal: The Journal of Experimental Medicine (1971)

These studies demonstrate that certain sex steroid metabolites are capable of significantly stimulating the synthesis of both heme and globin in cultured human bone marrow cells. These compounds, which are maximally effective at a concentration of 3 x 10(-8)M, are steroids of the C(19) and C(21) neutral type; share a common 5beta-H (A:B cis) configuration; and are derived from the in vivo biotransformation of testosterone or progesterone, or their intermediates, in man. Since these steroid metabolites have been shown to be capable in other systems of inducing the synthesis of delta-aminolevulinic acid synthetase, the limiting enzyme in the heme biosynthetic pathway, it is hypothesized that their action on human erythroid precursor cells is directed similarly at this enzymatic step leading thereby to increased heme production with consequent stimulation of globin synthesis. This steroid action is independent of erythropoietin, and since these compounds are effective at extremely low concentrations, it is suggested that they may play a physiologic role in the regulation of human erythropoiesis.
I-123 Diagnostic Thyroid Tumor Whole-Body Scanning with Imaging at 6, 24, and 48 Hours
Authors: STEPHEN K. GERARD, RALPH R. CAVALIERI
Journal: Clinical Nuclear Medicine (2002)

Purpose The use of I-123 in lieu of I-131 for diagnostic whole-body thyroid tumor scanning (DxRaI) in patients with differentiated thyroid cancer obviates the risk for stunning and affords significantly improved image quality. Because of the shorter half-life (13 hours) of I-123, images have been acquired primarily 6 or 24 hours after injection, potentially decreasing the sensitivity for detecting weakly avid thyroid tumor or remnant. Materials and Methods The authors evaluated the use of 111 to 185 MBq (3 to 5 mCi) I-123 for DxRaI under withdrawal conditions, imaging at 6, 24, and, in most cases, 48 hours. DxRaI with I-123 was compared in 13 evaluations performed in 10 patients, with post–I-131 treatment scans acquired early (2 to 3 days) and late (7 to 10 days) in all cases but one. Results Of 37 sites of tumor or remnant identified in post-treatment scans, 26 were found in the DxRaI I-123 scan (sensitivity, 70%). Of the 11 sites missed by I-123, 7 were seen only in the late post-treatment scans. Therefore, the sensitivity of I-123 imaging compared with the early post–I-131 treatment scans was 26 of 30, or 86.7%. In 10 cases, 48-hour I-123 imaging was attempted, yielding images of acceptable quality in eight of them. Lesion identification was improved on the 48-hour images; in one case, this allowed the identification of a site of tumor recurrence that was confirmed positive on the I-131 post-treatment scan. Conclusions I-123 doses of 111 to 185 MBq for DxRaI provide acceptable levels of sensitivity overall and may permit 48-hour imaging for improved detection of weakly avid tumor or remnant without any risk for “stunning.”
The Pre-Excitation Syndrome: Facts and Theories
Authors: Charles Fisch
Journal: JAMA (1979)

These authors have spent many years studying this, one of the most fascinating ECG and clinical syndromes. The authors succeed in offering a scholarly in-depth review of the theories, major manifestations, and minor nuances of Wolff-Parkinson-White syndrome. The carefully selected bibliography is the best currently available on this subject. A minor drawback is a lack of His bundle electrograms, but even this is well compensated for with diagrams and a clear discussion of this technique. The text is recommended to all students of cardiology.
Sodium depletion in patients in clinical trials may account for the increased cardiovascular risk of dual blockade of the renin-angiotensin system
Authors: J. H. Laragh, J. E. Sealey
Journal: BMJ (2013)

Makani and colleagues’ meta-analysis of clinical trials of cardiovascular patients found that giving one renin-angiotensin system blocker reduces cardiovascular mortality but adding a second fails to reduce mortality and increases the frequency of hypotension, hyperkalaemia, and renal failure.1 We suspect that most adverse events occurred in sodium depleted patients who reactively increase plasma renin levels to vasoconstrict arterioles to …
Nonresolving pneumonia and rash in an adult: pulmonary involvements in Kawasaki's disease
Authors: J. Ugi, P. M. Lepper, M. Witschi, V. Maier, T. Geiser, S. R. Ott
Journal: European Respiratory Journal (2010)

To the Editors :

Slowly resolving or nonresolving pneumonia is a challenge for physicians. The most common clinical error when approaching these patients is to subsequently treat the patient with different antibiotics over an extended period of time, without questioning the cause of treatment failure. Mostly, slowly resolving pneumonias are due to host defence or infectious causes. Nonresolving pneumonias are usually of noninfectious origin and, in the majority of cases, require invasive diagnostic techniques to be confirmed. Nonresolving or slowly resolving pneumonia should direct the clinician to a critical re-evaluation of the possible causes of the disease.

A 19-yr-old male without known comorbidity reported to a general practitioner with fever, headache, sore throat and diarrhoea. A few days later, after being treated with amoxicillin/clavulanate, he developed a generalised erythema and rash, starting on the abdomen. Already severely impaired, he later went to a primary care centre. Based on his dermatological alterations, staphylococcal toxic shock syndrome was suspected and antibiotics where changed to penicillin and clindamycin. However, the condition worsened; the patient developed dyspnoea, dry cough and bilateral reticulo-nodular infiltrates on chest radiograph. He was transferred to our university hospital because of imminent respiratory failure. On admission he was still febrile (38.5°C), had generalised oedema and required 6 L·min−1 oxygen to achieve a saturation of 96% (arterial blood …
WHAT SHOULD WE TEACH THE PUBLIC REGARDING VENEREAL DISEASE?
Authors: GEORGE WHITESIDE
Journal: JAMA (1906)

Let us briefly consider, first, what we do teach regarding venereal disease; second, what deduction the average layman draws from information received, and, third, in what way our teaching may prevent the spread of infection. As physicians we teach the public by precept and by example; we do not give systematic lectures or demonstrations to laymen; we give brief and fragmentary personal talks to our own sons (generally not to our daughters); to the children of our patients occasionally, but generally after the acquirement of disease and not before; very occasionally a few lectures are given to young men as members of a college or school or church, but never, to my knowledge, to young women. Now and then one learns of a class of men being instructed in methods of prophylaxis. That is all, except such fragmentary individual instruction as the physician gives to his venereal patients. What can
Medicine Keeps Pace as Military Moves From 'Garrison' to 'Expeditionary'
Authors: Phil Gunby
Journal: JAMA (1991)

MILITARY PHYSICIANS from now on may be serving in a US Air Force, Army, or Navy/Marine Corps that is more "expeditionary" than "garrison." As was demonstrated dramatically during the Desert Storm and Just Cause (Panama, 1989) operations, the US military probably no longer needs to keep large forces permanently in place overseas because it can deploy "fast and far" to trouble spots where its presence is deemed to be necessary. Still, US military physicians will have many of the same duties—caring for the troops, their families, and (in some way) for at least some military retirees. And, as a result of Desert Storm, this mix of full-time and reserve military physicians is the most experienced (in terms of combat deployment) in the nation's history. (A physician who in the late 1960s and early 1970s, while serving in the Nixon and Ford administrations, played an important role in developing this "total
Abstract A39: BACH1 and RKIP participate in a bistable network that affects progression to metastasis in breast Cancer
Authors: Jiyoung Lee, Jieun Yun, Kam Yeung, Elena Bevilacqua, Gábor Balázsi, Marsha Rich Rosner
Journal: Cancer Research (2013)

Abstract The sources of nongenetic variability in metastatic progression are largely unknown. To address this question, we characterized a transcriptional regulatory network for the metastasis suppressor Raf Kinase Inhibitory Protein (RKIP). We previously showed that the transcription factor BACH1 is negatively regulated by RKIP, promotes breast cancer metastasis, and negatively correlates with RKIP expression in primary breast tumors. Here we demonstrate that BACH1 acts in a double negative (overall positive) feedback loop to inhibit RKIP transcription in breast cancer cells. BACH1 also negatively regulates its own transcription. HDAC inhibitors increased BACH1 but not RKIP transcription, whereas depletion of polycomb repressor EZH2 induced RKIP transcription. Analysis of the BACH1 network reveals the existence of a bistable, inverse relationship between BACH1 and RKIP that can potentially give rise to nongenetic variability. Together, our results suggest that the balance between RKIP and BACH1 plays a key role in determining metastatic progression in breast cancers. Citation Format: Jiyoung Lee, Jieun Yun, Kam Yeung, Elena Bevilacqua, Gábor Balázsi, Marsha Rich Rosner. BACH1 and RKIP participate in a bistable network that affects progression to metastasis in breast Cancer. [abstract]. In: Proceedings of the Third AACR International Conference on Frontiers in Basic Cancer Research; Sep 18-22, 2013; National Harbor, MD. Philadelphia (PA): AACR; Cancer Res 2013;73(19 Suppl):Abstract nr A39.
Rho GTPase, Rac1, regulates Skp2 levels, vascular smooth muscle cell proliferation, and intima formation in vitro and in vivo
Authors: Mark Bond, Yih-Jer Wu, Graciela B. Sala-Newby, Andrew C. Newby
Journal: Cardiovascular Research (2008)

AimsVascular smooth muscle cell (VSMC) proliferation contributes to intima formation after angioplasty or venous by-pass grafting, and during atherosclerosis. VSMC proliferation requires degradation of p27Kip1 promoted by S-phase kinase-associated protein-2 (Skp2), an F-box protein component of the Skp-Cullin-F-boxSkp2 ubiquitin-ligase. We investigated the role of Rac1 in the regulation of Skp2 in rat VSMC.
Two Cases of Colotomy: with Remarks
Authors: J. Walters
Journal: BMJ (1879)

lapsed, and it was only by means of hot bottles, blankets, enemata of beef-tea and brandy, and very assiduous attention that he could be rallied.He was then kept under the influence of opium, in pills containing one-third of a grain, when he could swallow, and hypodermic injections when he could not.January 30th.He had passed a good night.The bowels were moved at 9.30 A.M.There was some vomiting.The temperature had gone up to I03.There was still coldness of the extremities and some degree of collapse, from which the patient never rallied, but died at 9 P.M. the same evening.No post mortem examination was allowed.
Single-Center Trials Show Larger Treatment Effects Than Multicenter Trials: Evidence From a Meta-epidemiologic Study
Authors: Agnes Dechartres, Isabelle Boutron, Ludovic Trinquart, Pierre Charles, Philippe Ravaud
Journal: Annals of Internal Medicine (2011)

Background: A recent study suggested that results of single-center trials are frequently contradicted when similar trials are performed in multicenter settings. Purpose: To perform a meta-epidemiologic study to evaluate whether estimates of treatment effect differ between single-center and multicenter randomized, controlled trials (RCTs). Data Sources: MEDLINE was searched via PubMed for meta-analyses of RCTs with binary outcomes that were published between August 2008 and January 2009 and in the first 6 months of 2010 in the 10 leading journals of each medical specialty. One issue of the Cochrane Database of Systematic Reviews was also searched. Study Selection: All individual RCTs included in the meta-analyses were selected. Data Extraction: Data were extracted and their quality was assessed by use of the risk of bias tool of the Cochrane Collaboration. Data Synthesis: The primary outcome was the ratio of odds ratios (ROR), used to quantify the difference in estimated intervention effect between single-center and multicenter RCTs. An ROR less than 1 would indicate larger estimates of the intervention effect in single-center trials. Sensitivity analyses were performed with adjustment for sample size, risk of bias within RCTs, and variance of the log odds ratio to take publication bias into account. Forty-eight meta-analyses were selected, including 421 RCTs (223 were single-center and 198 were multicenter). Single-center RCTs showed a larger intervention effect than did multicenter RCTs (combined ROR, 0.73 [95% CI, 0.64 to 0.83]), with low heterogeneity across individual meta-analyses (I 2 = 12.0%; P = 0.24). Adjustment for sample size yielded consistent results (ROR, 0.85 [CI, 0.74 to 0.97]), as did adjustment for risk of bias within RCTs, such as allocation concealment (ROR, 0.76 [CI, 0.67 to 0.86]), and variance of log odds ratio (ROR, 0.83 [CI, 0.72 to 0.96]). Limitation: Despite sensitivity analyses, meta-confounding cannot be fully excluded. Conclusion: Single-center RCTs showed larger treatment effects than did multicenter RCTs, a finding that was consistent in all sensitivity analyses. These results suggest that this item should be considered when the results of RCTs and meta-analyses are interpreted. Primary Funding Source: Academic grant Recherche sur la Recherche from the Délégation Interrégionale à la Recherche Clinique (DIRC), Ile de France, Assistance Publique-Hôpitaux de Paris (APHP).
PREVALENCE OF VITAMIN D DEFICIENCY IS MORE COMMON AMONG FRAIL OLDER (≥ 75 YEARS) PATIENTS WITH NON ST-ELEVATION ACUTE CORONARY SYNDROME MANAGED BY INVASIVE STRATEGY
Authors: Murugapathy Veerasamy, Hannah Sinclair, Weiliang Qiu, Dermot Neely, Vijayalakshmi Kunadian
Journal: Journal of the American College of Cardiology (2015)