tbuckley/cabot-search huggingface dataset:
Stereotactic Radiosurgery for the Definitive, Noninvasive Treatment of Brain Metastases
Authors: E. Alexander, T. M. Moriarty, R. B. Davis, P. Y. Wen, H. A. Fine, P. M. Black, H. M. Kooy, J. S. Loeffler
Journal: JNCI Journal of the National Cancer Institute (1995)

Background: The spread of systemic cancer to the brain is a common complication for cancer patients. Conventional radiotherapy offers modest palliation, and surgery is helpful only for the patient with a single metastasis in an accessible location. Stereotactic radiosurgery, a technique that permits the precise delivery of a high dose of radiation to a small in-tracranial target while sparing the surrounding normal brain, has been used as an alternative treatment for brain metastases. Purpose: Our medical center's 7-year experience with radiosurgery for metastases was reviewed to establish the effectiveness of the treatment and to understand the prognoses in patients so treated. Methods: Retrospective analysis of hospital records, from 248 consecutive patients (421 lesions) that were treated with radiosurgery between May 1986 and May 1993, was performed. Patients were only excluded for a Karnofsky performance score of less than 70, evidence of acute neurologic deterioration, or tumor diameter more than 4 cm. Median follow-up was 26.2 months. Seventy-six percent of patients had recurrent disease, 69% had evidence of systemic disease, 69% had a single metastasis. Treatment was performed using a 6-MeV linear accelerator. The median tumor volume was 3 cm 3 . The median treatment dose was 1500 cGy. Whole brain radiotherapy was given to all newly diagnosed patients. Patients were followed by neurological examination and neuroimaging at regular intervals. Local control of disease was defined as a lack of progression of solid-contrast enhancement on computed tomography scan or magnetic resonance imaging. Results: Median overall survival from radiosurgery was 9.4 months. The absence of active systemic disease, younger than 60 years of age, two or fewer lesions, and female sex were significantly associated with increased survival (two-sided P<.05). Actuarial local control rates were approximately 85% at 1 year and 65% at 2 years. Factors associated with a significantly decreased local control rate were location below the tentorium, recurrent tumor, and larger tumor volume (two-sided P<.05). Radioresponsive and radioresistant tumor types had similar control rates. The median drop in Karnofsky performance score at 1 year was 10%. Conclusions: The results of this retrospective analysis show that radiosurgery is an effective, minimalty invasive outpatient treatment option for small intracranial metastases. Results of this study also indicate that radiosurgery not only provides local control rates equivalent to these from surgical series but is also effective in treating patients with surgically inaccessible lesions, with multiple lesions, or with tumor types that are resistant to conventional treatment. [J Natl Cancer Inst 87: 34-40, 1995]
An explorative study of low levels of allergen-specific IgE and clinical allergy symptoms during early childhood
Authors: L. Söderström, G. Lilja, M. P. Borres, C. Nilsson
Journal: Allergy (2011)

To cite this article: Söderström L, Lilja G, Borres MP, Nilsson C. An explorative study of low levels of allergen-specific IgE and clinical allergy symptoms during early childhood. Allergy 2011; 66: 1058–1064. Background: Early identification of children at risk for later development of allergic disease is essential for early intervention and initiation of proper treatment and management. Objective: To investigate the relationship between low levels (0.1–0.7 kUA/l) of IgE sensitization to food and inhalant allergens and symptoms of eczema, rhinitis, and asthma from birth to 5 years of age. Methods: Children (268) were followed prospectively from birth to 5 years of age with physical examinations and measurements of s-IgE at 6, 12, 24, and 60 months of age. Results: Seventy-four percent of the children with low levels of s-IgE to egg and/or milk at the age of 6 months were still sensitized to one or more allergens at age 2 years. Eighty-four percent of the children with low levels of s-IgE to any of the studied allergens at 12 months of age were still sensitized at age 5. The low levels of egg and milk s-IgE also significantly increased the risk for eczema at the same age and also increased the risk for eczema at 2 years of age. Conclusion: Low levels of s-IgE can be detected from the age of 6 months and are related to further IgE sensitization. The low levels seem to be of importance for both the association to present symptoms and for prediction of future allergic symptoms, especially eczema during early infancy. A detectable s-IgE level, albeit low, could be a clear signal that the immune system is alerted and should be followed.
BOSTON'S CAMPAIGN FOR CLEAN MILK.
Authors: JAMES O. JORDAN
Journal: JAMA (1907)

After a persistent and successful contest against adulterated skimmed and preserved milk, covering a period of over twenty years, the city of Boston, in 1904, through its Board of Health, laid the foundation for further improvement by inaugurating a campaign having for its ultimate aim the application of cleanly conditions and refrigeration of its milk supply. An account of this movement, as well as that of its influence on the inception of new methods governing the production and traffic in milk, is the province of this paper. The initiatory step was the adoption of a standard limiting the number of bacteria in milk to 500,000 per cubic centimeter, and prohibiting the sale of milk having a temperature higher than 50 F. Other regulations looking to a betterment of the milk supply were adopted at the same time, and these, together with such changes as seemed advisable from observation and progress,
Dismantling the signposts to public health? No, satnav has arrived
Authors: M. Soljak
Journal: BMJ (2012)

Some of the concerns raised by Pollock and colleagues about the implications of the Health and Social Care Act 2012 for public health information are wrong.1

Practice registrations may be unreliable for population estimates because list sizes are inflated, but census based estimates are not a gold standard. For example, estimated 2010 resident populations of London boroughs from the Office for National Statistics and the Greater London Authority vary by up to 18%. …
Editor’s Comment: “It Ain’t Necessarily So”
Authors: Mayer B. Davidson
Journal: Diabetes Care (2002)

Comment -I interpret these results to support the recommendation of both the American Kidney Foundation and the American Diabetes Association that ACR can be used instead of a timed collection.Timed collections, 24 h or otherwise, are very inconvenient and often not collected accurately.Since albumin excretion is highly variable from day to day (up to 25%), a repeat ACR to fulfill the criterion of two of three positive values within a 3-to 6-month period as recommended for the diagnosis of microalbuminuria would very likely have reduced the false-positive rate of 6%.Mogensen CE: Microalbuminuria predicts clinical proteinuria and early mortality in maturity-onset diabetes.
Israeli surgeon accused of killing two patients
Authors: J. Siegel-Itzkovich
Journal: BMJ (2000)

A 63 year old Israeli surgeon has been indicted for allegedly killing two 80 year old patients in 1995 and on more than a dozen counts of alleged medical negligence, bribe taking, and extortion while working as chief of cardiothoracic surgery at Tel Aviv's Ichilov Hospital. It is the first time in Israel that a doctor has been brought to trial on charges of killing his patients.

The health ministry set up a committee to decide whether to suspend …
Sites of Serum α-Fetoprotein Synthesis in the Human and in the Rat*
Authors: David Gitlin, Mary Boesman
Journal: Journal of Clinical Investigation (1967)

Selected tissues from human embryos of 6 to 9 weeks' gestation, from rat fetuses of 15 days' gestation, and from rats 2 days of age were incubated with (14)C-labeled amino acids. Immunoelectrophoresis of the culture fluid after incubation, using rabbit antisera against human and rat fetal serum proteins, followed by radioautography revealed that: 1) Radioactive alpha-fetoprotein was present in cultures of human liver, rat liver, and rat yolk sac, but not in cultures of human or rat brain, lung, heart, kidney, intestines, skeletal muscle, skin, or placenta; human yolk sac was not studied. 2) Radioactive transferrin was also present in rat yolk sac cultures, and the same protein was found in rat liver cultures as well. 3) Rat liver and rat placenta cultures both produced radioactive serum Ralpha(2)-globulin. Serum alpha-fetoprotein concentrations in the rat declined abruptly after birth to approximately half of the prenatal level by 2 to 3 days of age, in accord with the loss of the fetal membranes at delivery; the alpha-fetoprotein level then remained relatively constant until the rat was 6 to 8 days of age, after which synthesis of the protein was increasingly suppressed.
Inconsistency in Evidentiary Standards for Medical Testimony
Authors: Jerome P. Kassirer, Joe S. Cecil
Journal: JAMA (2002)

Several recent decisions by the US Supreme Court have strengthened the ability of federal courts to consider medical testimony regarding injuries associated with exposure to toxic substances. Judges are expected to examine the basis of all expert testimony before it is introduced at trial to ensure that it meets the same standards of intellectual rigor that professionals use outside the courtroom. However, courts have been inconsistent in measuring this testimony against the standards of medical practice, especially when courts consider testimony that is not supported by clinical trials or epidemiological studies. A number of courts have required standards for expert testimony that exceed those that physicians use in ordinary clinical decision making. In this article, we illustrate such inconsistencies across federal courts by contrasting different decisions in cases involving similar facts and expert testimony. We argue that there may be good reason to require a standard of admissibility that exceeds the standards of ordinary clinical decision making, but such requirements are not faithful to the mandate of the Supreme Court. Courts with especially demanding standards are misled if they believe that they are fairly representing medical practice. Physicians should respond by correcting courts' misinterpretations of medical practice and assisting in the development of legal standards that encourage thoughtful and informed consideration of medical testimony by judges and juries.
Lymphocytotoxic Antibodies and Hodgkin's Disease
Authors: B. LARSEN
Journal: Annals of Internal Medicine (1978)

Letters and Corrections1 May 1978Lymphocytotoxic Antibodies and Hodgkin's DiseaseB. LARSEN, PH.D., C. GOW, B.A., R.T., W.H. MARSHALL, M.D., PH.D., M.R.C.P.B. LARSEN, PH.D.Search for more papers by this author, C. GOW, B.A., R.T.Search for more papers by this author, W.H. MARSHALL, M.D., PH.D., M.R.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-88-5-718_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Lymphocytotoxins have been described in patients with various diseases including systemic lupus erythematosus (1) and Hodgkin's disease (2). Since Mendius and associates (3) found a greatly increased prevalence of lymphocytotoxic antibodies in sera from relatives of patients with Hodgkin's disease (35.5%) compared with controls (8.6%) we hoped to extend their work by studying a familial aggregate of seven cases of Hodgkin's disease in Newfoundland (4, 5).Sera from relatives of the patients were compared with sera from other persons from the same communities, but in this population there was no confirmation of the findings of Mendius and...References1. TERASAKIMOTTIRONIBARNETT PVE: Cytotoxins in disease II. Autocytotoxins in lupus. N Engl J Med 238:724-728, 1970 CrossrefGoogle Scholar2. GRIFONIDEL GIACCOTOGUELLA VGS: Lymphocytotoxins in Hodgkin's disease. Ital J Immunol Immunopathol 1:21-31, 1970 Google Scholar3. MENDIUSDEHORATIUSMESSNERWILLIAMS JRRR: Family distribution of lymphocytotoxins in Hodgkin's disease. Ann Intern Med 84:151-156, 1976 LinkGoogle Scholar4. BUEHLERFIRMEFODORFRASERMARSHALLVAZE SFGGWP: Common variable immunodeficiency, Hodgkin's disease and other malignancies in a Newfoundland family. Lancet 1:195-197, 1975 CrossrefMedlineGoogle Scholar5. LARSENBARNARDBUEHLERMARSHALL BJSW: HLA haplotypes in a genetic isolate in Newfoundland. A population showing 8% homozygosity and a familial aggregate of lymphoma and immunodeficiency cases. Tissue Antigens 8:207-215, 1976 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Memorial University of Newfoundland St. John's, Newfoundland A1B 3V6 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1978Volume 88, Issue 5Page: 718-718KeywordsAntibodiesHodgkin lymphomaLupus erythematosusSystemic lupus erythematosus Issue Published: 1 May 1978 PDF DownloadLoading ...
Effects of Antisense c- <i>myb</i> Oligonucleotides on Vascular Smooth Muscle Cell Proliferation and Response to Vessel Wall Injury
Authors: Augusto E. Villa, Luis A. Guzman, Earl J. Poptic, Vinod Labhasetwar, Stanley D’Souza, Catherine L. Farrell, Edward F. Plow, Robert J. Levy, Paul E. DiCorleto, Eric J. Topol
Journal: Circulation Research (1995)

Abstract The process of restenosis after arterial balloon dilatation has been demonstrated to involve smooth muscle cell hyperplasia. Initial reports with antisense oligonucleotides directed against the proto-oncogene c- myb suggest marked in vitro specificity and in vivo efficacy. In the present study, we sought to confirm and extend the hypothesis that antisense to c- myb results in a specific antiproliferative effect with a comprehensive assessment by using different oligonucleotide preparations, different species, and tissue and cellular uptake experiments. Phosphorothioate-protected oligonucleotides representing the appropriate sequence for antisense to c- myb and multiple controls were used to inhibit proliferation of platelet-derived growth factor– and fetal bovine serum–stimulated rat, dog, and human aortic smooth muscle cells in vitro and neointimal proliferation in the rat carotid injury model. In vitro experiments using identical culture conditions in rat, dog, and human aortic smooth muscle cells failed to show specificity as well as consistency in growth inhibitory effects that could be attributed to an antisense mechanism. Proliferation of smooth muscle cell growth in culture was consistently inhibited with oligomers containing a contiguous 4-guanosine residue motif. In vivo, the rat carotid injury neointimal hyperplasia was similar for antisense c- myb (0.095±0.009 mm 2 ) and sense c- myb (0.090±0.009 mm 2 ). Fluorescent-labeled oligonucleotides were present in tissue after local delivery via pluronic gel, and their activity rapidly declined over a 72-hour period. Our findings point to the potential nonspecificity and lack of consistency of the antisense oligonucleotide to c- myb in vitro and in vivo. An alternative nonantisense mechanism for the inhibition of smooth muscle cell proliferation, involving contiguous 4-guanosine residues, is proposed.
Treating dysentery with metronidazole in Pakistan
Authors: T. I. Bhutta, A. Vitry
Journal: BMJ (1997)

Editor–Carine Ronsmans and colleagues' study of health professionals' knowledge of the treatment of dysentery in Bangladesh showed that less than half chose the correct treatment as recommended by the World Health Organisation in Bangladesh.1 Metronidazole was chosen by 10.9-25.6% of the doctors and by 36.8-47.3% of the drug dispensers. Similar and worrying inappropriate prescribing practices for antiamoebic drugs have been reported recently in Pakistan.2 In an editorial accompanying Ronsmans and colleagues' report Richard Cash points out that inappropriate prescribing and …
Shock: A Physiologic Basis for Treatment
Authors: Robert W. Hopkins
Journal: JAMA (1971)

Shock is not a specific disease; rather, it is a state of disturbed physiology which may supervene in patients with a variety of serious diseases or injuries. It is therefore particularly appropriate that this volume is subtitled "A Physiologic Basis for Treatment." In large measure the monograph is indeed a concise summary of the physiology of major organ systems which are important in the shock state. Both normal physiology and alterations commonly found in shock are presented in sufficient detail to provide the reader with a clear understanding of the problems involved. Included are discussions of the microcirculation, clotting mechanisms, pulmonary function, cardiac function, the adrenal glands, renal physiology, and mechanisms of oxidation and energy metabolism. The emphasis on the need for a clear understanding of normal physiology before discussing the abnormalities in shock distinguishes this volume from most of the recent monographs on shock. Knowledge of normal physiology and
ANTIBODY PRODUCTION IN VITRO
Authors: Gilmour Harris
Journal: The Journal of Experimental Medicine (1968)

The effect of high specific activity thymidme-(3)H on proliferation and antibody production, using the hemolytic plaque-forming technique, by spleen cell suspensions in vitro from rabbits killed after a boost of SRC's has been studied. High specific activity thymidine-(3)H inhibited the proliferative ay well as the antibody response to antigen, and it was conduded that this was the result of the incorporation of radioactive (3)H into the nuclei of dividing cells which were synthesizing antibody in these cultures. The stimulation of the rate of DNA synthesis by specific antigen could be correlated with the ability of antigen to maintain antibody production, as measured by the specific hemolytic plaque-forming technique, above levels found in control cultures, incubated without antigen. Radioautographic studies of PFC's in vitro showed that the majority of the cells arose from the DNA-synthesizing population of cells in these cultures, confirming the conclusions from the results of the inhibitory effects of high specific-activity thymidine-(3)H on PFC's. It was found that these PFC's, labeling with thymidine-(14)C, formed only a small proportion of all the cells labeled in this way in these cultures. The postulation was made that antigen, in vitro, provided a stimulation for cell proliferation in the responsive population of rabbit spleen cells, but that only a small proportion of this population could be induced by antigen to synthesize antibody.
Plasma Pepsinogen in Peptic-Ulcer Disease and Other Gastric Disorders
Authors: Carl S. Hoar, J. R. Browning, Robert G. Simpson
Journal: New England Journal of Medicine (1956)

PEPSIN consists of a protein molecule that may be crystallized out of a solution of crystallin pepsinogen after incubation at pH 4.65. It is a powerful proteolytic enzyme implicated as a causative agent in peptic-ulcer disease, in which it is often associated with an elevated gastric acidity. However, its relation to the chloride ion in gastric juice is not a linear one, and occasionally in ulcer disease the pepsin will be normal or low in the gastric juice when the acidity is high and vice versa. This does not seem remarkable when one considers the various modes of stimulation of . . .
The efficacy of mammography and screening for breast cancer
Authors: P. R. Garver
Journal: JAMA (1995)

To the Editor.  —Dr Kerlikowske and colleagues 1 unfortunately add to the prevailing confusion regarding the utility of mammographic screening in women 40 to 50 years of age by jumping to an unfounded conclusion at the end of their article.  Their analysis indicates that screening between 40 and 50 years of age does not show a demonstrable improvement in mortality until women are followed up for 10 to 12 years. They propose that this is merely because after 10 years, women who are initially 40 to 50 years of age ineluctably become a 50- to 60-year-old age group, for which mammography is efficacious. In the body of the article they observe, The findings suggest that it might be possible to wait to begin screening when women become 50 years old or menopausal, and achieve the same benefit in mortality reduction as beginning screening at 40 years of age. However, in
Angiotensin II Induces Tumor Necrosis Factor Biosynthesis in the Adult Mammalian Heart Through a Protein Kinase C–Dependent Pathway
Authors: Dinesh Kalra, Natarajan Sivasubramanian, Douglas L. Mann
Journal: Circulation (2002)

Background — Previous studies suggest that angiotensin II (Ang II) upregulates the expression of tumor necrosis factor (TNF) in nonmyocyte cell types; however, the effect of Ang II on TNF expression in the adult mammalian heart is not known. Methods and Results — To determine whether Ang II was sufficient to provoke TNF biosynthesis in the adult heart, we examined the effects of Ang II in isolated buffer-perfused Langendorff feline hearts. Ang II (10 −7 mol/L) treatment resulted in a time- and dose-dependent increase in myocardial TNF mRNA and protein biosynthesis in the heart as well as in cultured adult cardiac myocytes. The effects of Ang II on myocardial TNF mRNA and protein synthesis were mediated through the angiotensin type 1 receptor (AT 1 R), insofar as an AT 1 R antagonist (AT 1 a) blocked the effects of Ang II, whereas an angiotensin type 2 receptor (AT 2 R) antagonist (AT 2 a) had no effect. Stimulation with Ang II led to the activation of nuclear factor-κB and activator protein-1 (AP-1), two transcription factors that are important for TNF gene expression. Nuclear factor-κB activation was accompanied by phosphorylation of IκBα on serine 32 as well as degradation of IκBα, suggesting that the effects of Ang II were mediated through an IκBα-dependent pathway. The important role of protein kinase C (PKC) was suggested by studies in which a phorbol ester triggered TNF biosynthesis, and a PKC inhibitor abrogated Ang II–induced TNF biosynthesis. Conclusions — These studies suggest that Ang II provokes TNF biosynthesis in the adult mammalian heart through a PKC-dependent pathway.
Roflumilast as a treatment for COPD
Authors: E Nash
Journal: Thorax (2005)

▴ Rabe KF, Bateman ED, O’Donnell D, et al . Roflumilast—an oral anti-inflammatory treatment for chronic obstructive pulmonary disease: a randomised controlled trial. Lancet2005;366:563–71 [OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] Chronic inflammation is the key pathophysiological mechanism in the development of COPD and there is increasing interest in the potential role of novel anti-inflammatory treatments. This phase III multicentre double blind study focuses on roflumilast, an oral phosphodiesterase 4 inhibitor. 1411 patients with stable moderate … [1]: {openurl}?query=rft.jtitle%253DLancet%26rft.stitle%253DLancet%26rft.aulast%253DRabe%26rft.auinit1%253DK.%2BF.%26rft.volume%253D366%26rft.issue%253D9485%26rft.spage%253D563%26rft.epage%253D571%26rft.atitle%253DRoflumilast--an%2Boral%2Banti-inflammatory%2Btreatment%2Bfor%2Bchronic%2Bobstructive%2Bpulmonary%2Bdisease%253A%2Ba%2Brandomised%2Bcontrolled%2Btrial.%26rft_id%253Dinfo%253Adoi%252F10.1016%252FS0140-6736%252805%252967100-0%26rft_id%253Dinfo%253Apmid%252F16099292%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1016/S0140-6736(05)67100-0&link_type=DOI [3]: /lookup/external-ref?access_num=16099292&link_type=MED&atom=%2Fthoraxjnl%2F60%2F11%2F908.atom [4]: /lookup/external-ref?access_num=000231227300028&link_type=ISI