tbuckley/cabot-search huggingface dataset:
If a Child Must Die
Authors: Audrey E. Evans, S. Edin
Journal: New England Journal of Medicine (1968)

HOW CAN I HELP?THE care of a child who is dying and the support of his family through the tragic episode are trying and difficult for the physician, but there are compensations. The aim of anybody caring for such a child is not only to help the child, but also to help the family accept the loss of a child, surely the most profound of griefs for a parent. The way this attempt is made varies and depends in large part upon the beliefs of the physician and of the family. To do it well, one must have the . . .
Palestinian mothers' perceptions of child mental health problems and services.
Authors: Abdel Aziz Thabet, Hossam El Gammal, Panos Vostanis
Journal: World Psychiatry (2006)

The aim of this study was to explore Palestinian mothers' perceptions of child mental health problems and their understanding of their causes; to determine Palestinian mothers' awareness of existing services and sources of help and support; to identify professionals in the community whom Palestinian mothers would consult if their child had mental health problems; and to establish their views on ways of increasing awareness of child mental health issues and services. Checklists exploring the above issues were completed by 249 Palestinian mothers living in refugee camps in the Gaza Strip. Palestinian mothers equally perceived emotional, behavioural and psychotic symptoms as suggestive of mental ill health in childhood. Mothers perceived multiple causes of child mental health problems, including family problems, parental psychiatric illness and social adversity. A substantial proportion (42.6%) had knowledge of local child mental health care services. Overall, mothers preferred Western over traditional types of treatment, and were keen to increase mental health awareness within their society. Despite a different cultural tradition, Palestinian mothers appear open to a range of services and interventions for child mental health problems. As in other non-Western societies, child mental health service provision should be integrated with existing primary health care, schools, and community structures.
Laws Regulating Practice—American Academy of Medicine.
Authors: Charles McIntire
Journal: JAMA (1905)

Easton, Pa., Nov. 18, 1905. <h3>To the Editor:</h3> —I regret that an error of statement has crept in the otherwise most excellent synopsis of the report on the Laws Regulating the Practice of Medicine, read by the undersigned at the meeting of the American Academy of Medicine, as found in your issue of Nov. 18, p. 1596. The last sentence, reading: "The report favored having osteopaths represented on state medical examining boards," has its foundation in the discussion of the report. The report made no reference to the personality of a board of examiners. Its contention was that the general law should provide a test for all who wish to practice medicine, under this or that vagary, whether osteopathy, psychopathy, or what not, instead of, as at present, permitting special legislation, or special exemption; that this test should be on certain foundation subjects, and a special and limited license be
Structural basis for the recognition of mutant self by a tumor-specific, MHC class II–restricted T cell receptor
Authors: Lu Deng, Ries J Langley, Patrick H Brown, Gang Xu, Leslie Teng, Qian Wang, Monica I Gonzales, Glenda G Callender, Michael I Nishimura, Suzanne L Topalian, Roy A Mariuzza
Journal: Nature Immunology (2007)
Not the usual suspects: the unexpected sources of tissue regeneration
Authors: Matthew L. Springer, Timothy R. Brazelton, Helen M. Blau
Journal: Journal of Clinical Investigation (2001)

It used to be simple. Regenerating liver was made only by liver cells, skin begat skin, endothelium begat endothelium, skeletal muscle came from skeletal muscle precursors, and brain and heart simply did not regenerate. Moreover, new cells made in regenerating tissues like endothelium and smooth muscle were derived from reserve cells in the vicinity of the damage within a given tissue. In the last several years, virtually all of these long-held assumptions have come into question. There has been a plethora of reports that bone marrow‐derived cells can differentiate in vivo into cells with properties characteristic of muscle, endothelium, liver, heart, and neuronal cells of the brain. Moreover, even cells derived from some non‐bone marrow tissues appear to change their identities and to give rise to cells of other tissues. These transformations from one cell type into another suggest a novel level of complexity. Indeed, very little is known about the cells that serve as the “stem
Are the odds stacked against today's young researchers?
Authors: M. Oliver
Journal: BMJ (2010)

Is the original thinker encouraged in medicine any more? How do young and excited potential clinical scientists get going? We have no reason to think that there is any paucity of original ideas, and many young medical students and doctors will still be thinking about unresolved medical and scientific problems.

But now the odds are stacked against them. Fifty and more years ago it was possible to embark on a research project with advice from one’s seniors and without much, if any, peer review interference, bureaucratic resistance, or obligatory referral to various ethics committees. There are many other reasons now why opportunities for initiating new ideas are limited. Perhaps the chief is cost, although the initial cost of many of the key discoveries (sympathin (adrenaline), insulin, penicillin, fibrates, lipoprotein receptors) in the last century was not high. Now universities cannot afford to initiate a new project unless funded by a charity or government, and most research developments are undertaken by the big pharmaceutical consortiums. Without the infusion of …
Cystic fibrosis of the pancreas: structural changes in peripheral airways
Authors: J. R. Esterly, E. H. Oppenheimer
Journal: Thorax (1968)

Emphysema and bronchiolar obstruction were found in the necropsy specimens from 42 of 84 patients with cystic fibrosis of the pancreas. Significant parenchymal destruction could be demonstrated in only three cases. In contrast, widespread severe dilatation of respiratory bronchioles and alveolar ducts was present in 29 of the older infants and children, and less extensive, moderate dilatation was seen in an additional 13 cases. Eleven patients also had morphological evidence of bronchiolar scarring and stenosis. Because of the chronic pulmonary infection in these patients, it is unlikely that the structural changes in peripheral airways are clinically significant. Nevertheless, this widespread dilatation may be responsible for the physiological and radiographic evidence of emphysema. Furthermore, the lobular dilatation in these young patients may be an antecedent of destructive emphysema in the adult.
Changing incidence of non-accidental injury to children in South Glamorgan.
Authors: J Jenkins, O P Gray
Journal: BMJ (1987)

Changing incidence of non-accidental injury to children in South GlamorganThe increasing number of reports in the media of severe or sometimes fatal non-accidental injury to children suggests that the incidence of this problem may have increased.A previous paper examined the incidence of child abuse in South Glamorgan from 1970 to 1981,' and this report is an update of that study.1
Associations of Dietary Fat, Regional Adiposity, and Blood Pressure in Men
Authors: Paul T. Williams
Journal: JAMA (1987)

Mediterranean populations have low incidence rates of cardiovascular disease and hypertension that may be due, in part, to dietary factors, particularly a relatively high intake of monounsaturated fat as olive oil. In this study, nutritional components (as grams per 4200 kJ) (1 kcal = 4.2 kJ) from three-day food records were examined in association with resting blood pressure in a cross-sectional survey of 76 sedentary middle-aged American men, aged 30 to 55 years, with resting blood pressures below 160/100 mm Hg. Systolic and diastolic blood pressures correlated significantly and inversely with monounsaturated fat consumption. Polyunsaturated fat consumption also correlated inversely with diastolic blood pressure; however, this relationship became nonsignificant when adjusted for an index of regional adiposity that characterizes the male-type obesity pattern. Detailed analyses of specific fatty acids showed that the correlations with monounsaturates were specific to oleic acid, and the correlation with polyunsaturates was specific to linoleic acid. Multiple regression analysis suggested that 18.2% of the variance in systolic blood pressure and 23.2% of the variance in diastolic blood pressure were related to monounsaturated and polyunsaturated fat consumption and regional adiposity. Thus, increased consumption of monounsaturated fat is related inversely to resting blood pressure, although causality remains to be determined. (<i>JAMA</i>1987;257:3251-3256)
Late Effects of Gastrectomy
Authors: Claude E. Welch
Journal: JAMA (1974)

ALTHOUGH undesirable symptoms may follow gastrectomy, compensation for induced physiologic abnormalities generally occurs. When the operation is carried out for benign disease, such as duodenal or gastric ulcer, the patient usually judges the results as excellent or highly satisfactory. When cancer of the stomach is considered, there is no reasonable alternative to ablative therapy. This brief summary will not stress the favorable features of gastrectomy such as the elimination of malignant disease and the cure or amelioration of symptoms of other diseases of the stomach and duodenum. Attention will be directed toward the unhappy sequelae. They depend primarily on the physiologic changes that are induced by gastrectomy, and secondarily on clinical factors. <h3>Physiological Sequelae of Gastrectomy</h3> The most important physiological result of gastrectomy is the loss of a food reservoir that discharges intermittently into the intestine. In addition, there are specific losses of hydrochloric acid, intrinsic factor, gastric mucus, and
Immunologic Dysfunction in Infants Infected through Transfusion with HTLV-III
Authors: Randolph F. Wykoff, Elliott R. Pearl, Frank T. Saulsbury
Journal: New England Journal of Medicine (1985)

COMPELLING evidence implicates human T-cell lymphotropic virus Type III (HTLV-III) as the etiologic agent of the acquired immunodeficiency syndrome (AIDS).1 2 3 HTLV-III has also been associated with a syndrome of persistent lymphadenopathy and with mild immune dysfunction in adults.4 We report on three infants with transfusion-acquired HTLV-III infection who had a variety of illnesses. This report confirms that HTLV-III can be transmitted by means of blood transfusion and indicates that infection with the retrovirus can cause a broad spectrum of diseases in infants.Case ReportsPatient 1A 3100-g white male infant was transferred to our Neonatal Intensive Care Unit on . . .
The Failure of Death Certificates to Record the Performance of Autopsies
Authors: R. Gib Parrish
Journal: JAMA (1993)

<h3>To the Editor.</h3> —Recent publications have again shown the inaccuracy of some death certificate information.<sup>1,2</sup>Since some authors claim that reliance on autopsy results could improve the accuracy of cause-of-death information on the death certificate,<sup>3,4</sup>we sought to determine the accuracy of death certificate information regarding whether or not an autopsy was performed. We reviewed death certificates filed with the county registrar for 74 deceased adults whose bodies were consecutively autopsied at Grady Memorial Hospital, a 1000-bed teaching hospital in Atlanta, Ga. Twenty certificates (27%) indicated that an autopsy had not been performed. We reviewed 31 additional death certificates before and after they were filed with the county registrar. Regarding performance of an autopsy, certifiers (clinicians) provided incorrect or insufficient information on 16 certificates (52%); in four cases (13%), the certificate showed that an autopsy had not been performed, and in 12 cases (39%), there was no indication
The Last GASP
Authors: Pricilla Carter-Snodgrass
Journal: JAMA (1990)

To the Editor of NE JAMA . —Dear Madam:  Having been born after the Last GASP, I am naturally a staunch supporter of Organic Rights. As the offspring of two humanistic physicians who trained before the Last GASP, however, I became inured in the cradle to the subversive notion that ours is a particularly valuable species. My unique perspective, formed at the ethical cusp of our profession, may have burdened me with scruples not suffered by younger physicians. I am sworn, perhaps wrongly, to try to prolong my patients' lives and relieve their suffering—yet, as a Last GASP—abiding practitioner, I find it increasingly difficult to do so. Permit me to elaborate.  Who cannot be aware that heroic late—20th-century animal liberationists were the first to bravely strike out against killer scientists to free dogs and cats and later mice, rats, rabbits, hamsters, guinea pigs, turtle bladders, and sea urchin eggs from the
The wildlife/human connection: modernizing risk decisions.
Authors: T Colborn
Journal: Environmental Health Perspectives (1994)

This article proposes that genetic and molecular ecotoxicology can play an important role in making policy and risk assessment decisions concerning xenobiotics. It calls for a greater awareness by ecotoxicologists to the effects in wildlife and humans resulting from transgenerational exposure to synthetic chemicals that interfere with gene expression and differentiation. The difficulty of recognizing these effects on the endocrine, immune, and nervous systems in developing embryos is described and suggests why effects of this nature have traditionally not been addressed when determining risk to synthetic chemicals. Specific examples are cited of environmental effects on hormonally responsive tissue in wildlife populations which could be used as models for assessing human exposure to synthetic chemicals. Evidence is presented that the environmental load of synthetic chemicals has reached critical levels at which wildlife and human health are at risk.
Examination of prognostic factors in patients undergoing surgery for colorectal perforation: A case controlled study
Authors: Tetsuo Sumi, Kenji Katsumata, So Katayanagi, Yuuki Nakamura, Tomohisa Nomura, Kiminori Takano, Kazuhiko Kasuya, Motohide Shimazu, Akihiko Tsuchida
Journal: International Journal of Surgery (2014)
Diffuse interstitial lung disease due to AA amyloidosis.
Authors: C Planes, D Kleinknecht, M Brauner, J P Battesti, J L Kemeny, D Valeyre
Journal: Thorax (1992)

Abstract A man developed interstitial lung disease and nephrotic syndrome due to AA amyloidosis. There was no evidence of an underlying disease predisposing to amyloidosis.
A Mathematical Approach to Medical Diagnosis
Authors: Homer R. Warner
Journal: JAMA (1961)

An equation of conditional probability is derived to express the logical process used by a clinician in making a diagnosis from clinical data. Solutions of this equation take the form of a differential diagnosis. The probability that each disease represents the correct diagnosis in any particular patient may be calculated. Sufficient statistical data regarding the incidence of clinical signs, symptoms, and electrocardiographic findings in patients with congenital heart disease have been assembled to allow application of this approach to differential diagnosis in this field. This approach provides a means by which electronic computing equipment may be used to advantage in clinical medicine.
Effects of a Quality Improvement Collaborative on the Outcome of Care of Patients with HIV Infection: The EQHIV Study
Authors: Bruce E. Landon, Ira B. Wilson, Keith McInnes, Mary Beth Landrum, Lisa Hirschhorn, Peter V. Marsden, David Gustafson, Paul D. Cleary
Journal: Annals of Internal Medicine (2004)

Background: Multi-institution collaborative quality improvement programs are a well-established and broadly applicable quality improvement strategy, but there is little systematic assessment their effectiveness. Objective: To evaluate the effectiveness of a quality improvement collaborative in improving the quality of care for HIV-infected patients. Design: Controlled pre- and postintervention study. Setting: Clinics receiving funding from the Ryan White Comprehensive AIDS Resources Emergency Act. Participants: 44 intervention clinics and 25 control clinics matched by location (urban or rural), region, size, and clinic type. Measurements: Changes in quality-of-care measures abstracted from medical records of pre- and postintervention samples of patients at each study clinic. Measures examined included use and effectiveness of antiretroviral therapy, screening and prophylaxis, and access to care. Intervention: A multi-institutional quality improvement collaborative (the "Breakthrough Series"). Results: 9986 patients were studied. Clinical and sociodemographic characteristics of the intervention and control patients were similar (P > 0.05). Differences in changes in the quality of care were not statistically significant. The proportion of patients with a suppressed viral load increased by 11 percentage points (from 40.1% to 51.1%) in the intervention group compared with 5.3 percentage points (from 43.6% to 48.8%) in the control group, but this difference was not statistically significant (P = 0.18). In addition, rates of appropriate screening tests and prophylaxis did not differ between intervention and control sites. Limitations: It was not possible to perform a pure randomized trial of the intervention or to assess other measures of quality, such as adherence and satisfaction. Conclusions: This prospective, matched study of almost 10 000 patients found that a quality improvement collaborative did not significantly affect the quality of care. Additional research is needed to improve methods of teaching and implementing quality improvement programs to achieve better results.
Neonatal and maternal fibrinolysis: Activation at time of birth
Authors: Carlos R. Suarez, Jeanine Walenga, Lynn C. Mangogna, Jawed Fareed
Journal: American Journal of Hematology (1985)

Abstract Utilizing chromogenic synthetic substrate‐based methods, determination of the plasma concentration of plasminogen, α‐antiplasmin, α‐macroglobulin, and Bβ15‐42‐related peptides were made at the time of birth in both newborns and mothers. Plasminogen levels were increased in the maternal group (150 ± 26%), and markedly decreased in the newborn group (67 ± 14%). The major inhibitors of fibrinolysis, α 2 ‐antiplasmin and α 2 ‐macroglobulin, were within normal range in both groups. Determination of Bβ15‐42‐related peptide showed markedly increased levels in the maternal group above control values (115 ± 102, normal 29 ± 12); the newborn group showed values only mildly elevated above control values (39 ± 21). The results demonstrate increased fibrinolytic activity in both groups, though the degree of activation is significantly higher in the maternal group, as reflected by the higher levels of Bβ15‐42‐related peptides. Fibrinopeptide A levels confirm an activation of coagulation in both maternal and newborn groups (22 ± 4 ng/ml and 138 ± 22 ng/ml, respectively) with a significantly increased level in newborns (2‐5 ng/ml normal).
ABC of clinical haematology: Bone marrow and stem cell transplantation
Authors: A. Duncombe
Journal: BMJ (1997)

Experiments in the 1950s showed that haemopoiesis could be restored in irradiated animals by engraftment of transfused marrow.Attempts to translate this into clinical practice were hindered by immunological problems of transfer between individuals which we now recognise as rejection and graft versus host disease.With further understanding of the human leucocyte antigen system, rapid clinical progress was made during the 1970s such that bone marrow transplantation soon became an established treatment for some immune deficiency and malignant diseases.
Peter Camper (1722-1789)
Authors: I. Snapper
Journal: JAMA (1965)

<h3>To the Editor:—</h3> As a physician born and bred in the Netherlands, I was thrilled to read the life story of Petrus Camper published in the Sept 14, 1964, issue ofThe Journal(<b>189</b>:852). Perhaps a few supplementary remarks would be appropriate to accentuate not only the scientific accomplishments but also the human side of this scientist. <h3>The Investigator.—</h3> Camper's originality is perhaps best illustrated by an article written in reaction to the complaint of one of his students that all interesting research problems had been solved. Camper retorted that to the expert the investigation of any simple object could be interesting. When the student dared him to write an article about an old shoe, which was lying around, Camper wrote an orthopedic classic about "the optimal shoe." Using special anatomic studies as a basis, he concluded that the right and left shoes must have different lasts, and he
Loss of MDA-7 Expression With Progression of Melanoma
Authors: Julie A. Ellerhorst, Victor G. Prieto, Suhendan Ekmekcioglu, Lyle Broemeling, Sandra Yekell, Sunil Chada, Elizabeth A. Grimm
Journal: Journal of Clinical Oncology (2002)

PURPOSE: Ectopic transfer of the melanoma differentiation-associated gene-7 (mda-7) has been shown in vitro to suppress growth and induce apoptosis in a variety of human tumor cell lines; similar effects are not elicited in normal cells. Thus, the mda-7 gene seems to function as a novel tumor suppressor, and there is interest in the potential of mda-7 gene transfer as cancer therapy. The objective of this study was to determine if MDA-7 protein is lost during primary melanoma progression from superficial to invasive stages and from localized to metastatic tumor. As a secondary objective, we analyzed MDA-7 protein expression in primary melanomas for correlation with predictors of outcome and with survival. MATERIALS AND METHODS: MDA-7 protein expression was evaluated by immunohistochemistry in 41 primary melanomas and 41 metastases, including 24 paired samples. Each sample was scored for the percentage of positive cells and the overall intensity of immunolabeling. RESULTS: Significant decreases in MDA-7 immunostaining, reflected in both number and intensity scores, were observed when comparing the intraepidermal and superficially invasive portions with the deeply invasive portions of primary tumors. Significant differences were also observed when comparing primary tumors to paired metastases. CONCLUSION: Downregulation of MDA-7 expression in primary melanomas facilitates progression to invasive and metastatic stages. These data support the development of Ad-mda7 as gene therapy for advanced melanoma.
Research in nursing, midwifery, and the allied health professions
Authors: Anne Marie Rafferty, Michael Traynor, David R Thompson, Irene Ilott, Elizabeth White
Journal: BMJ (2003)

the risks beforehand.Equally we need to ensure that patients at higher risk are not denied surgery because no one is willing to operate on them.We need to work collectively to develop a truly open system that limits the incidence of error, recognises risk, allows surgeons (and all healthcare professionals) to learn from mistakes, and replaces blame and retribution with an opportunity for learning and training.