tbuckley/cabot-search huggingface dataset:
Illness and the Family
Authors: CAROL M. HUTH
Journal: Annals of Internal Medicine (1978)

Editorial Notes1 July 1978Illness and the FamilyCAROL M. HUTH, PH.D.CAROL M. HUTH, PH.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-89-1-132 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe medical technology that has developed so rapidly during the past 20 years has brought new solutions to old problems but also a new array of emotional difficulties for patients. Physicians may now have to deal with extreme anxiety and sometimes psychosis in patients after heart surgery (1), or anger, dependency, depression, even suicide attempts in patients undergoing hemodialysis for renal failure (2). These problems join those in patients terminally ill with cancer (3) as major challenges in care of the whole person. They are most apparent to those physicians who work largely in hospital practice. But with the decline...References1. ABRAM H: Adaptation to open heart surgery: a psychiatric study of response to the threat of death. Am J Psychiatry 122:659-668, 1965 CrossrefMedlineGoogle Scholar2. ABRAM H: Survival by machine. The psychological stress of chronic hemodialysis, in Coping with Physical Illness, edited by MOOS RH. New York, Plenum Publishing Corp., 1977, pp. 295-309. Google Scholar3. GARFIELD C: Elements of psychosocial oncology: doctor-patient relationships in terminal illness, in Psychosocial Care of the Dying Patient, edited by GARFIELD CA, New York, McGraw-Hill Book Company, 1978, pp. 102-118 Google Scholar4. Listen to the Children! A Study of the Impact on the Mental Health of Children of a Parent's Catastrophic Illness. New York, Cancer Care, Inc. and the National Cancer Foundation, Inc., 1977 Google Scholar5. BINGERABLINFEUERSTEINKUSHNERZOGERMIKKELSEN CARJSC: Childhood leukemia. Emotional impact on patient and family. N Engl J Med 280:414-418, 1969 CrossrefMedlineGoogle Scholar6. TAUBMAN R: The physician and the dying patient and his family. See Reference 3, pp. 258-269 Google Scholar7. CAPLAN G: Principles of Preventive Psychiatry, New York, Basic Books, Inc., 1964, pp. 39-54 Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: CAROL M. HUTH, PH.D.Affiliations: Delaware Guidance Services for Children and Youth Wilmington, Delaware PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byA psychological analysis of cancer patients and their next-of-kinFamily reactions and coping strategies in response to the physically ill or handicapped child: A reviewFamily therapy and psychosomatic illness 1 July 1978Volume 89, Issue 1Page: 132-133KeywordsAnxietyCardiac surgeryEmotionsRenal failureSuicide ePublished: 1 December 2008 Issue Published: 1 July 1978 PDF downloadLoading ...
Testing histologically negative lymph nodes for papillomavirus when evaluating metastasis in cervical cancer
Authors: Akihiro Nawa, Yukihiro Nishiyama, Fumitaka Kikkawa, Osamu Kurauchi, Setsuko Goto, Nobuhiko Suganuma, Sigehiko Mizutani, Yutaka Tomoda
Journal: The Lancet (1992)
Bone Scintiscanning in Osteolytic Lesions
Authors: Shrikant Solav
Journal: Clinical Nuclear Medicine (2004)

Osteolytic lesions seen on plain radiographs can be caused by various disorders of the bones such as simple bone cyst, aneurysmal bone cyst, plasmacytoma, giant cell tumor, eosinophilic granuloma and tuberculosis. We studied prospectively Tc-99m-methylene diphosphonate bone scan findings in osteolytic lesions seen radiologically and followed them to histopathology. Interestingly, the scans in these patients helped to show if the lesions were monoostotic or polyostotic and, in some cases, ruled out malignant or infective etiology.
Psychiatric Factors in Security Screening
Authors: LOUIS LINN
Journal: American Journal of Psychiatry (1973)

In screening an individual for a security clearance, there are two possible categories of mental disorder: one requiring an adverse opinion and the other a favorable opinion in spite of the presence of such a disorder. In this study of 85 evaluations, symptoms not associated with acting out such as anxiety, depression, and psychosomatic disorders were rarely a basis for an adverse opinion. Nor did hospitalization, electroshock therapy, or prolonged intensive psychotherapy in themselves constitute a basis for an adverse opinion. The author points out that the psychiatric factor is but a single element in the overall determination of eligibility to have access to classified information.
Disseminated Intravascular Coagulation in Heat Stroke
Authors: Jeffrey S. Perchick
Journal: JAMA (1975)

A 14-year-old patient with heat stroke, disseminated intravascular coagulation, central nervous system dysfunction, and renal failure was treated, in addition to conventional therapy, with heparin sodium for seven days. Despite very poor prognostic signs on addmission, the patient survived the acute episode and ultimately progressed to a complete recovery.
Post-myocardial infarction mortality in patients with ventricular premature depolarizations. Canadian Amiodarone Myocardial Infarction Arrhythmia Trial Pilot Study.
Authors: J A Cairns, S J Connolly, M Gent, R Roberts
Journal: Circulation (1991)

BACKGROUND Among survivors of acute myocardial infarction, frequent and repetitive ventricular premature depolarizations (VPDs) detected on ambulatory monitoring contribute independently to the risk of all-cause mortality and sudden death. Apart from the beta-blockers, no antiarrhythmic drug has been reliably demonstrated to reduce mortality among patients with VPDs. A pilot study was undertaken to gather data to aid in the design of a multicenter trial of amiodarone for the reduction of mortality from cardiac arrhythmias in such patients. METHODS AND RESULTS Seventy-seven patients with acute myocardial infarction within the previous 6-30 days and 10 or more VPDs/hr or one or more runs of ventricular tachycardia on 24-hour electrocardiographic recording were randomized in a double-blind fashion in a 2:1 amiodarone-to-placebo ratio. The loading dose was 10 mg/kg/day for 3 weeks. The maintenance dose was 300-400 mg/day with reductions at 4-month intervals in response to VPD suppression, excessive plasma levels, or toxicity. VPD suppression at 1 week and 2 weeks was 63% and 85%, respectively, on amiodarone and 17% and 27%, respectively, on placebo. Apart from thyroid-stimulating hormone elevation and skin reactions, no side effects occurred more frequently with amiodarone. The study drug was stopped for side effects or noncompliance in 35% of amiodarone patients and 34% of placebo patients. Patients were followed for a maximum of 2 years (mean, 20 months). Arrhythmic death or resuscitated ventricular fibrillation occurred in two of 48 amiodarone patients (6%) and four of 29 placebo patients (14%), whereas the rates of all-cause mortality were five of 48 (10%) and six of 29 (21%), respectively. CONCLUSIONS Amiodarone, in moderate loading and maintenance dosages with adjustments in response to plasma levels, VPD suppression, and side effects, results in effective VPD suppression and acceptable levels of toxicity.
Ventricular premature contractions: a randomized non-drug intervention trial in normal men.
Authors: G DeBacker, D Jacobs, R Prineas, R Crow, J Vilandre, H Kennedy, H Blackburn
Journal: Circulation (1979)

The influence of a 6-week intervention on factors thought to be related to ectopic cardiac rhythms was tested in normal men with frequent ventricular premature contractions (VPCs), using a randomized, controlled and partial crossover design. The VPC intervention trial experimental regimen included total abstinence from caffeine and smoking, reduction of alcohol intake, and a physical conditioning program. Effects were studied in detail among 81 healthy men with persistent VPCs. VPCs were measured during standard states of rest, dynamic and isometric exercise and other stresses, and 24-hour ambulatory monitoring. Adherence to the treatment was excellent. The experimental group achieved more than 80% of activities asked of them, and little "contamination" occurred in the control group. VPCs were analyzed according to VPC/min, VPC/man and VPC/total number of heart beats. Moderate changes in VPC rates occurred in both experimental and control groups but no significant group differences were found at rest or during any induction test. This 6-week, multiple-factor "hygienic" intervention program had no significant influence on the frequency or occurrence of VPCs in apparently normal men with persistent and frequent VPCs. Because the mechanisms and the significance of VPCs are different in patients with ischemic heart disease, our approach and methods may be useful for similar trials among cardiac patients of adjunct or non-drug therapy for ectopic rhythms.
1105-176 Effect of black tea on aortic stiffness
Authors: Charalambos Vlachopoulos, Nikolaos Alexopoulos, Foteini Kosmopoulou, Dorothea Tsekoura, Georgios Papadopoulos, Konstantina Aggeli, Constantinos Stratos, Christos Pitsavos, Christodoulos Stefanadis
Journal: Journal of the American College of Cardiology (2004)
Demonstration of a Complement‐Dependent Migration Inhibitory Activity in Normal Guinea Pig Serum
Authors: G. Sandru, P. Veraguth
Journal: Allergy (1980)

A cell migration inhibitory effect was evidentiated in normal guinea pig serum as compared with heat inactivated serum, Granuloeytes when used as target showed a greater sensitivity to this effect than lymphomonocytes or macrophages. The migration inhibitory activity of GPS is abrogated or decreased by using complement destroying agents such as: heating at 56°C for as little as 5 min, absorption on immune complexes in presence of calcium, on zymosan, on Sephadex G‐50 or by adding EDTA or heparin to culture medium. The GPS dialysation fractions while exhibiting neither complement haemolytic effect nor migration inhibitory activity when tested alone, restored these functions by recombination. Absorption of GPS on homologous blood cells abrogated the migration inhibitory effect but retained the complement haemolytic function. When GPS absorbed on homologous blood cells was mixed 1:5 with heat‐inactivated serum (5min at 56°G), the migration inhibitory activity was regained, suggesting that the complement factors from the first sample were necessary for manifestation for the migration inhibitory activity from the heat‐inactivated serum.
Aetiology‐specific patterns in end‐stage heart failure patients identified by functional annotation and classification of microarray data
Authors: Vidar Beisvag, Per Kristian Lehre, Herman Midelfart, Halfdan Aass, Odd Geiran, Arne Kristian Sandvik, Astrid Lægreid, Jan Komorowski, Øyvind Ellingsen
Journal: European Journal of Heart Failure (2006)
Examinations and Competence
Authors: S. Mouchly Small
Journal: JAMA (1981)

To the Editor.—  The letter by Jack R. Harnes, MD (1981;245:342), entitled Seventy Percent Physicians sets up an untenable dichotomy of competence vs incompetence. Attempts to define physician competence show its complexity. We usually deal with varying degrees of competence dependent on the patient, the illness, and the context in which the interaction occurs.  Neither licensure nor certification attests to life-long, unvarying competence of an absolute nature. These credentials should provide some assurance to patients of an expectable degree of relevant knowledge, skills, and judgment, essential for the safe practice of medicine. By no means can we rightfully expect perfection.  The letter further confuses the issue by not recognizing the function of a written, objective, multiplechoice type of examination. No one has ever demonstrated a near-perfect degree of correlation between scores on such examinations and actual clinical performance. However, poor grades that reflect a pervasive lack of knowledge across the
Adjuvant Radioimmunotherapy Trial with Iodine-131–Labeled Anti–Carcinoembryonic Antigen Monoclonal Antibody F6 F(ab′)2 after Resection of Liver Metastases from Colorectal Cancer
Authors: Marc Ychou, David Azria, Cathy Menkarios, Patrick Faurous, François Quenet, Bernard Saint-Aubert, Philippe Rouanet, Monique Pèlegrin, Caroline Bascoul-Mollevi, Dominique Guerreau, Jean-Claude Saccavini, Jean-Pierre Mach, Jean-Claude Artus, André Pèlegrin
Journal: Clinical Cancer Research (2008)

Abstract Purpose: To evaluate the feasibility of radioimmunotherapy (RIT) with radiolabeled anti–carcinoembryonic antigen antibodies after complete resection of liver metastases (LM) from colorectal cancer. Patients and Methods: Twenty-two patients planned for surgery of one to four LM received a preoperative diagnostic dose of a 131I-F(ab′)2–labeled anti-carcinoembryonic antigen monoclonal antibody F6 (8-10 mCi/5 mg). 131I-F(ab′)2 uptake was analyzed using direct radioactivity counting, and tumor-to-normal liver ratios were recorded. Ten patients with tumor-to-normal liver ratios of &amp;gt;5 and three others were treated with a therapeutic injection [180-200 mCi 131I/50 mg F(ab′)2] 30 to 64 days after surgery. Results: Median 131I-F(ab′)2 immunoreactivity in patient serum remained at 91% of initial values for up to 96 hours after injection. The main and dose-limiting-toxicity was hematologic, with 92% and 85% grades 3 to 4 neutropenia and thrombocytopenia, respectively. Complete spontaneous recovery occurred in all patients. No human anti-mouse antibody response was observed after the diagnosis dose; however, 10 of the 13 treated patients developed human anti-mouse antibody ∼3 months later. Two treated patients presented extrahepatic metastases at the time of RIT (one bone and one abdominal node) and two relapsed within 3 months of RIT (one in the lung and the other in the liver). Two patients are still alive, and one of these is disease-free at 93 months after resection. At a median follow-up of 127 months, the median disease-free survival is 12 months and the median overall survival is 50 months. Conclusion: RIT is feasible in an adjuvant setting after complete resection of LM from colorectal cancer and should be considered for future trials, possibly in combination with chemotherapy, because of the generally poor prognosis of these patients.
The future of general practice: Personal care or the polyclinic?
Authors: D Keeley
Journal: BMJ (1991)

BMJ 1991;302:1514-6 One set of responses to three key subjects discussed in Building Your Own Future would produce a change from traditional British general practice, based on personal care, towards a system of general practices as polyclinics. At present general practitioners contract to provide services as individuals, their numbers are still intended to expand to achieve average list sizes of 1700, and their role is only gradually expanding into health promotion and into prevention. The strategy document speculates that family health services authorities may in future contract with practices instead of individuals (and that many general practitioners may therefore be salaried); that the role of the general practitioner in prevention, management of chronic disease, and care of patients discharged early from hospital may continue to grow; and that the number of principals may fall, with the possible emergence of a hierarchy among general practitioners. Let us suppose that the profession chooses to endorse policies that encourage further extension of general medical services and the role of the general practitioner, further growth in the size of practices and practice teams, but a reduction in the overall number of principals and an increase in average list sizes. Although the strategy document makes little mention of the contentious issue of fundholding, such larger practices would clearly be likely to hold funds if this option survives. We may imagine what such a practice might be like and then consider what would be gained and what lost should such practices dominate the provision of primary health care services. Firstly, however, it is worth considering in more detail the debate about list sizes.
Metabolic Risk Factors Worsen Continuously across the Spectrum of Nondiabetic Glucose Tolerance: The Framingham Offspring Study
Authors: James B. Meigs
Journal: Annals of Internal Medicine (1998)

Background: Categorical definitions for glucose intolerance imply that risk thresholds exist, but metabolic risk for type 2 diabetes mellitus or cardiovascular disease may increase continuously as glucose intolerance increases. Objective: To examine the distributions of the following metabolic risk factors across the spectrum of glucose tolerance: overall and central obesity, hypertension, low levels of high-density lipoprotein cholesterol, and increased triglyceride and insulin levels. Design: Cross-sectional analysis. Setting: The community-based Framingham Offspring Study. Participants: 2583 adults without previously diagnosed diabetes. Measurements: Clinical data; fasting glucose, insulin, and lipid levels; and glucose and insulin levels taken 2 hours after oral challenge were collected from 1991 to 1993. Glucose tolerance was determined by 1980 World Health Organization criteria. Patients with normal glucose tolerance were categorized into quintiles of fasting glucose. The distributions of each metabolic risk factor and the metabolic sum of the six risk factors were assessed across seven categories from the lowest quintile of normal fasting glucose level through impaired glucose tolerance and previously undiagnosed diabetes. Results: The mean age of patients was 54 years (range, 26 to 82 years); 52.7% of patients were women, Glucose tolerance testing found that 12.7% of patients had impaired glucose tolerance and 4.8% had previously undiagnosed diabetes. Multivariable-adjusted mean measures of risk factors and odds ratios for obesity, elevated waist-to-hip ratio, hypertension, low levels of high-density lipoprotein cholesterol, elevated triglyceride levels, and hyperinsulinemia showed continuous increases across the spectrum of nondiabetic glucose tolerance. Although a threshold effect near the upper range of nondiabetic glucose tolerance could not be ruled out for triglyceride levels in men and for insulin levels 2 hours after oral challenge in men and women, no other metabolic risk factors showed clear evidence of thresholds for increased risk. Conclusions: Metabolic risk factors for type 2 diabetes mellitus and for cardiovascular disease worsen continuously across the spectrum of glucose tolerance categories, beginning in the lowest quintiles of normal fasting glucose level.
Unbiased Compound Screening Identifies Unexpected Drug Sensitivities and Novel Treatment Options for Gastrointestinal Stromal Tumors
Authors: Sergei Boichuk, Derek J. Lee, Keith R. Mehalek, Kathleen R. Makielski, Agnieszka Wozniak, Danushka S. Seneviratne, Nina Korzeniewski, Rolando Cuevas, Joshua A. Parry, Matthew F. Brown, James Zewe, Takahiro Taguchi, Shin-Fan Kuan, Patrick Schöffski, Maria Debiec-Rychter, Anette Duensing
Journal: Cancer Research (2014)

Most gastrointestinal stromal tumors (GIST) are caused by oncogenic KIT or platelet-derived growth factor receptor activation, and the small molecule kinase inhibitor imatinib mesylate is an effective first-line therapy for metastatic or unresectable GIST. However, complete remissions are rare and most patients ultimately develop resistance, mostly because of secondary mutations in the driver oncogenic kinase. Hence, there is a need for novel treatment options to delay failure of primary treatment and restore tumor control in patients who progress under therapy with targeted agents. Historic data suggest that GISTs do not respond to classical chemotherapy, but systematic unbiased screening has not been performed. In screening a compound library enriched for U.S. Food and Drug Administration (FDA)-approved chemotherapeutic agents (NCI Approved Oncology Drugs Set II), we discovered that GIST cells display high sensitivity to transcriptional inhibitors and topoisomerase II inhibitors. Mechanistically, these compounds exploited the cells' dependency on continuous KIT expression and/or intrinsic DNA damage response defects, explaining their activity in GIST. Mithramycin A, an indirect inhibitor of the SP1 transcription factor, and mitoxantrone, a topoisomerase II inhibitor, exerted significant antitumor effects in mouse xenograft models of human GIST. Moreover, these compounds were active in patient-derived imatinib-resistant primary GIST cells, achieving efficacy at clinically relevant concentrations. Taken together, our findings reveal that GIST cells have an unexpectedly high and specific sensitivity to certain types of FDA-approved chemotherapeutic agents, with immediate implications for encouraging their clinical exploration.
The Retinoic Acid Synthesis Gene <i>ALDH1a2</i> Is a Candidate Tumor Suppressor in Prostate Cancer
Authors: Hanna Kim, Jacques Lapointe, Gulsah Kaygusuz, David E. Ong, Chunde Li, Matt van de Rijn, James D. Brooks, Jonathan R. Pollack
Journal: Cancer Research (2005)

Abstract Prostate cancer is the most common cancer among men in the United States, and aberrant DNA methylation is known to be an early molecular event in its development. Here, we have used expression profiling to identify novel hypermethylated genes whose expression is induced by treatment of prostate cancer cell lines with the DNA methyltransferase inhibitor 5-Aza-2′-deoxycytidine (5-aza-dC). Of the 271 genes that were induced by 5-aza-dC treatment, 25 also displayed reduced expression in primary prostate tumors compared with normal prostate tissue, and the decreased expression of only one gene, aldehyde dehydrogenase 1 family, member A2 (ALDH1a2), was also associated with shorter recurrence-free survival. ALDH1a2 encodes an enzyme responsible for synthesis of retinoic acid (RA), a compound with prodifferentiation properties. By immunohistochemistry, we observed that ALDH1a2 was expressed in epithelia from normal prostate but not prostate cancer. Using bisulfite sequencing, we determined that the ALDH1a2 promoter region was significantly hypermethylated in primary prostate tumors compared with normal prostate specimens (P = 0.01). Finally, transfection-mediated reexpression of wild-type ALDH1a2 (but not a presumptive catalytically dead mutant) in the prostate cancer cell line DU145 resulted in decreased colony growth (P &amp;lt; 0.0001), comparable with treatment with either 5-aza-dC or RA. Taken together, our findings implicate ALDH1a2 as a candidate tumor suppressor gene in prostate cancer and further support a role of retinoids in the prevention or treatment of prostate cancer.
Preseason football may be lengthened
Authors: C. B. Fagan
Journal: JAMA (1966)

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