tbuckley/cabot-search huggingface dataset:
Circumcision and Urinary Tract Infection
Authors: David H. Barnhouse
Journal: JAMA (1992)

<h3>To the Editor.</h3> —Drs Spach, Stapleton, and Stamm<sup>1</sup>reported in the February 5 issue ofThe JOURNALthat "lack of circumcision increases the risk of urinary tract infection [UTI] in young men." Although their series was controlled within their population sample, it is not representative. Each of these men presented at a sexually transmitted disease clinic. This means that each person who presented had urinary symptoms whether or not they were circumcised. It would be better had the authors' conclusion read "lack of circumcision increases the risk of urinary tract infection in young adult males who present to sexually transmitted disease clinics."
Poisons Information Centre
Authors: A. G. Freeman
Journal: BMJ (1965)

Birefringence is, of course, exhibited by both urate and calcium pyrophosphate crystals.Differentiation between the two requires identification of the sign of birefringence, urate being strongly negative, calcium pyro- phosphate weakly positive.Proof of the identity of urate crystals is by uricase digestion.We have had the opportunity of examin- ing synovial fluids from 22 patients with radiological calcification of joint cartilage.In general our findings have given less clear-cut answers than anticipated, and a number of specimens contained more than one type of crystal.In one patient with associated hyperparathyroidism the synovial fluid on two occasions was found to contain crystals which exhibited strong positive birefringence and had an extinction angle of 30°.Histochemical studies showed the presence of calcium.The other radical has not yet been positively identified, but we are impressed with the resemblance of these crystals to calcium oxalate.It may well be that gout and pseudogout can co-exist in the same person.One patient in this series is regarded as suffering from classical uric-acid gout, yet on one occasion fluid from his inflamed knee-joint yielded typical calcium pyrophosphate crystals.-Weare, etc.,
Commission focuses on early childhood development to improve health in US
Authors: B. Roehr
Journal: BMJ (2009)

“For the first time in our history, the United States is raising a generation of children who may live sicker, shorter lives than their parents. We must act now to reverse this trend,” said the Commission to Build a Healthier America in a report issued on 2 April.

The commission was formed in early 2008 to look at ways outside health care to change that trend. It was backed by the Robert Wood Johnson Foundation, whose aim is to improve the health of all Americans.

“Healthcare reform is not going to be enough to close the gap between how healthy Americans are and how healthy they could be,” said Mark McClellan, commission co-chairman and former head of the …
Tobacco Coupons and Teenagers
Authors: Adam O. Goldstein, Jonathan D. Klein, John W. Richards, Paul M. Fischer
Journal: JAMA (1991)

<h3>To the Editor.—</h3> Despite mounting scientific evidence suggesting a causal relationship between tobacco advertising and increased consumption of tobacco products, particularly among adolescents,<sup>1-3</sup>promotion of tobacco products by tobacco manufacturers continues to increase.<sup>4,5</sup>The distribution of coupons redeemable for free tobacco products is a major focus for tobacco industry advertising. In 1988, $876 million of the $3 billion spent by US tobacco manufacturers on tobacco advertising was spent on free coupon promotions.<sup>4</sup>This study addresses the effects of tobacco coupon promotions on adolescents' ability to obtain tobacco products. <h3>Study.—</h3> Two male and two female adolescent volunteers (aged 14 and 20 years and 15 and 19 years, respectively) were given either seven or eight coupons for the discounted purchase of cigarettes. These coupons had been promoted nationally by various tobacco manufacturers and obtained from local newspapers. The coupons stated that the cigarette discount was restricted to "smokers 21
Life, Death, and In Between: Tales of Clinical Neurology
Authors: Terrence Riley
Journal: JAMA (1993)

The experiences Harold Klawans describes in this collection of essays and recollections will be familiar to most doctors: the fears and insecurities of the new intern with a dying patient, the mature specialist discarded by a family who close their minds about an old man's independence, arrogant medical colleagues who get off the reality track. These are a few of the situations we have all encountered in some form. "It is not that some doctors see more interesting cases, but that they see more in those cases." It is not that some doctors see more interesting cases, but that they see more in those cases. Some people can hear a gallop, because they know how to listen. Others don't hear it the first time, but after the professor shows how to listen and maybe mimics the sound, then they can hear. So it is in this collection. These are essays
P07.03 * RECURRENT MEDULLOBLASTOMA AND CNS PNET IN ADULTS - RESULTS OF VIP CHEMOTHERAPY
Authors: L. A. Gravendeel, M. J. van den Bent, W. Taal, C. C. D. van der Rijt, J. E. C. Bromberg
Journal: Neuro-Oncology (2014)

INTRODUCTION: Medulloblastoma and central nervous system (CNS) primitive neuroectodermal tumor (PNET) are rare embryonal brain tumors in adults. Surgery and radiotherapy are an important part of the initial treatment, however, the role of (neo)adjuvant chemotherapy or chemotherapy at relapse is still unclear. In our center, etoposide/ifosfamide/cisplatin (VIP) chemotherapy is the standard of care for patients with a first relapse of medulloblastoma or CNS PNET. We reviewed the outcome in a consecutive series of patients treated with VIP chemotherapy at first relapse in our center between 2004 and 2012. MATERIALS AND METHODS: Patients were treated with 3 weekly cycles consisting of etoposide 75 mg/m2 d1-5, ifosfamide 1200 mg/m2 d1-5, and cisplatin 20 mg/m2 d1-5, followed by pegfilgrastim 6 mg s.c. d6, for a maximum of 4 cycles. We assessed toxicity using the CTCAE version 4 criteria (CTC), response, progression-free survival and overall survival measured from the day of start of chemotherapy. RESULTS: Twelve adult patients diagnosed with medulloblastoma (n = 6) and CNS PNETs (n = 6) were treated. The median age at first diagnosis was 34.6 years. After resection of the tumor eleven patients received craniospinal radiotherapy with a boost on the primary tumor site(n = 11); One patient received craniospinal radiation only because of adverse side effects. One patient had been treated with (neo)adjuvant chemotherapy (vincristine/carboplatin/cyclophosphamide) at the time of first diagnosis. The median time from diagnosis until time of first relapse was 18.5 months. At start of VIP, the median performance score was WHO 1. Nine patients were treated with the maximum number of 4 cycles VIP, in 3 patients VIP was stopped prematurely because of progressive disease (PD). Grade 3-4 CTC adverse effects were described in 8 patients: thrombocytopenia (n = 6); anemia (n = 6); leukopenia (n = 4); neutropenia (n = 4), and ototoxicity (n = 2). Three patients showed a partial response (PR) after VIP, 5 patients showed stable disease (SD) and 4 patients PD. After treatment with VIP chemotherapy median progression-free survival (PFS) was 5.3 months (medulloblastoma 10.5 months; CNS PNET 4.3 months) and median overall survival (OS) was 7.5 months (medulloblastoma 27 months; CNS PNET 5.3 months). These differences are not significant. Five of all patients (42%) were still alive one year after receiving VIP therapy. CONCLUSION: The results of this study underline the poor prognosis of adult patients with recurrent medulloblastoma or CNS PNETs. VIP chemotherapy accomplishes a disease stabilization or response in 75% of the patients but of short duration. There is a trend showing a better response to VIP therapy in medulloblastoma patients compared to CNS PNETs.
Recombinant human stem cell factor (kit ligand) promotes human mast cell and melanocyte hyperplasia and functional activation in vivo.
Authors: J J Costa, G D Demetri, T J Harrist, A M Dvorak, D F Hayes, E A Merica, D M Menchaca, A J Gringeri, L B Schwartz, S J Galli
Journal: The Journal of Experimental Medicine (1996)

Stem cell factor (SCF), also known as mast cell growth factor, kit ligand, and steel factor, is the ligand for the tyrosine kinase receptor (SCFR) that is encoded by the c-kit proto-oncogene. We analyzed the effects of recombinant human SCF (r-hSCF, 5-50 micrograms/kg/day, injected subcutaneously) on mast cells and melanocytes in a phase I study of 10 patients with advanced breast carcinoma. A wheal and flare reaction developed at each r-hSCF injection site; by electron microscopy, most dermal mast cells at these sites exhibited extensive, anaphylactic-type degranulation. A 14-d course of r-hSCF significantly increased dermal mast cell density at sites distant to those injected with the cytokine and also increased both urinary levels of the major histamine metabolite, methyl-histamine, and serum levels of mast cell alpha-tryptase. Five subjects developed areas of persistent hyperpigmentation at r-hSCF injection sites; by light microscopy, these sites exhibited markedly increased epidermal melanization and increased numbers of melanocytes. The demonstration that r-hSCF can promote both the hyperplasia and the functional activation of human mast cells and melanocytes in vivo has implications for our understanding of the role of endogenous SCF in health and disease. These findings also indicate that the interaction between SCF and its receptor represents a potential therapeutic target for regulating the numbers and functional activity of both mast cells and cutaneous melanocytes.
Aquaporin water channels: atomic structure molecular dynamics meet clinical medicine
Authors: David Kozono, Masato Yasui, Landon S. King, Peter Agre
Journal: Journal of Clinical Investigation (2002)

The movement of water across cell membranes is fundamental to life. Water constitutes roughly 70% of the mass of most living organisms, so the orderly distribution of water is required to maintain proper fluid balance within different anatomic compartments. Although water is known to diffuse through lipid bilayers, diffusion is not sufficiently rapid for many physiological processes. To accommodate these needs, a family of membrane channel proteins evolved for rapid transport of water across biological membranes. These proteins, termed “aquaporins,” are found in all life forms, including archaea, eubacteria, fungi, plants, and all phyla of animals.

Since the discovery of the aquaporins ten years ago (1), researchers around the world have sought to learn how these proteins work. Selectivity, rates of permeation, and gating mechanisms are three properties that characterize channel proteins. Aquaporins are exquisitely selective for the transport of water — even repelling hydronium ions (H3O+). The importance of the latter is emphasized by the normal function of mammalian renal tubules, which reabsorb 99% of the water from glomerular filtrate at the same time that acid is secreted by intercalated cells. Some members of the aquaporin superfamily are permeated by a variety of small neutral solutes such as glycerol or urea (termed “aquaglyceroporins”) (2). The transport of water or glycerol through aquaporins represents facilitated diffusion driven by osmotic or concentration gradients.
Attachment strategies across sex, ontogeny, and relationship type
Authors: Cari D. Goetz, Carin Perilloux, David M. Buss
Journal: Behavioral and Brain Sciences (2009)

Abstract We propose that middle childhood female ambivalent attachment, given the adaptive problem of uncertainty of future investment, is designed to evoke immediate investment from current caregivers, rather than new investment sources. We suggest greater specificity of strategic attachment solutions to adaptive problems that differ by sex, time, and relationship type.
Editorial: Indian's tolerance to ethanol
Authors: H. H. Hussey
Journal: JAMA (1976)

Frontier stories about North American Indians' intolerance to ethanol abound. Thus, legend would favor the notion that Indians are somehow more susceptible than whites to the effects of the drug. The stories tell of Indians more quickly becoming soddenly drunk or dangerously belligerent than white men who consumed equivalent amounts of whisky. In fact, frontier traders were known to have plied Indians with white man's firewater to the end that a handful of seemingly worthless glass beads could be given in exchange for valuable pelts. (It is beyond the scope of this editorial to comment in detail about the extraordinary beauty of beadwork by Indian craftsmen.) The idea that Indians, for ethnic reasons, have an intolerance for ethanol was given credence by a study reported by Fenna et al.<sup>1</sup>Noting that casual reports indicated a longer sobering-up period for Canadian Eskimos and Indians than for whites after an alcoholic
Artificial liver: A forthcoming attraction Shatford RA, Nyberg SL, Meier SJ, White JG, Payne WD, Hu W-S, Cerra FB. Hepatocyte function in a hollow fiber bioreactor: a potential bioartificial liver. J Surg Res 1992; 53: 549–557
Authors: N Sussman
Journal: Hepatology (1993)
Effect of Caffeine on the Recognition of and Responses to Hypoglycemia in Humans
Authors: David Kerr
Journal: Annals of Internal Medicine (1993)

To determine whether two effects of acute caffeine ingestion--decrease in cerebral blood flow and increase in brain glucose use--alter the recognition of and physiologic responses to hypoglycemia.On two occasions, a hyperinsulinemic glucose clamp technique (2 mU/kg body weight per minute) was used to maintain plasma glucose at 5 mmol/L for 90 minutes, followed by 60 minutes at 3.8 mmol/L, and then 2.8 mmol/L. After 30 minutes at 5 mmol/L, participants consumed, using a randomized, double-blind design, caffeine-free cola with or without caffeine (400 mg) added.Yale Clinical Research Center.Eight healthy, nonobese volunteers (5 men; age range, 20 to 33 years).Middle cerebral artery velocity (V MCA), counter-regulatory hormone levels, hypoglycemic symptoms, and cognitive function (P300 evoked potentials).Caffeine caused an immediate and sustained 23% decrease in VMCA from 64 to 49 cm/s (point estimate of difference, +15 cm/s [95% CI, 10 to 21 cm/s], P < 0.001). At a glucose level of 3.8 mmol/L, only the participants given caffeine had warning symptoms and "felt hypoglycemic." Moreover, the level of epinephrine was 118% ([CI of point difference, 76% to 158%] [CI, P < 0.001]) higher after caffeine consumption compared with placebo. Similarly, levels of norepinephrine (41% [CI, 26% to 60%], P < 0.002), cortisol (65% [CI, 26% to 78%], P < 0.008), and growth hormone (60% [CI, 16% to 143%], P < 0.05) were higher after caffeine consumption compared with placebo. At 2.8 mmol/L, epinephrine (40% [point estimate of the percentage difference], P < 0.05), norepinephrine (27%, P < 0.05), and cortisol (24%, P < 0.05) levels were higher, participants were more aware (P < 0.02) of hypoglycemia, and P300 latency was prolonged in the group that consumed caffeine (7.2%, P < 0.05).Acute ingestion of caffeine is associated with sympathoadrenal activation and awareness of hypoglycemia at a glucose level not usually considered hypoglycemic. Our data suggest that individuals who ingest moderate amounts of caffeine may develop hypoglycemic symptoms if plasma glucose levels fall into the "low-normal" range, as might occur in the late postprandial period after ingestion of a large carbohydrate load.
Two actions are possible for doctors wanting to promote human welfare in Africa
Authors: G. Johnson
Journal: BMJ (1998)

Editor—Logie and Benatar paint a depressing but accurate picture of the effects of poverty (exacerbated by the trade and aid policies of the rich nations of the world) on health and health care for the vast majority of sub-Saharan Africans.1 Although they end on a note of cautious optimism, thanks to the World Bank's new found commitment to alleviating poverty and the Highly Indebted Poor Countries Initiative, this may leave ordinary doctors in Britain feeling helpless …
Male Victims of Sexual Assault
Authors: Gary H. Lipscomb
Journal: JAMA (1992)

<h3>Objective.</h3> —To compare the demographics, physical findings, and assault characteristics of incarcerated, sexually assaulted men with those of nonincarcerated, sexually assaulted men. <h3>Design.</h3> —Case series of 99 adult male victims of sexual assault evaluated over a 3-year period. <h3>Setting.</h3> —Memphis Sexual Assault Resource Center, a nonhospital-based clinic that serves as the primary resource for sexually assaulted victims in the Memphis and Shelby County, Tennessee, area. <h3>Participants.</h3> —All adult male victims of sexual assault evaluated at the Memphis Sexual Assault Resource Center during the study period were included in the study. Ninety-nine victims were studied, including 80 incarcerated men and 19 men from the community. <h3>Results.</h3> —The victims of sexual assault in the community group were older than the victims in the incarcerated group. Apart from the age difference and weapon use, there were no statistically significant differences between the incarcerated and nonincarcerated victims. <h3>Conclusions.</h3> —The similarities between the two groups suggest that sexual assault of men may not be unique to prisons, and all men are potential victims. Further studies are required to better understand these crimes and to develop education and prevention programs. (<i>JAMA</i>. 1992;267:3064-3066)
Epidemiologic Analysis of Warfare
Authors: Aaron E. Glatt
Journal: JAMA (1991)

To the Editor.  —I was extremely dismayed to read the sterilized historical review by Garfield and Neugut 1 on their Epidemiologic Analysis of Warfare. They claim to have assessed risk factors for injury and death, and they discussed the reasons for increased casualties among  during wars of the 20th century. Table 4 of the article details the number of civilian casualties estimated in World War II but contains at least three factual errors when it is compared with their own reference 2 and amounts to a difference of more than 2 million casualties.  More than 6 million civilians were killed in Poland, with millions more killed in Germany and other European countries. The authors then gave percentages of populations who were decimated by this warfare, ie, 20% of Polish people lost their lives.  What the authors in their five pages did not find room to express, however, was that
Observer variance in the qualitative evaluation of left ventricular wall motion and the quantitation of left ventricular ejection fraction using rest and exercise multigated blood pool imaging.
Authors: R D Okada, H D Kirshenbaum, F G Kushner, H W Strauss, R E Dinsmore, J B Newell, C A Boucher, P C Block, G M Pohost
Journal: Circulation (1980)
PTU-089 National study of outcomes for cholangiocarcinoma patients following biliary endoscopy: linkage analysis of administrative data for English hospitals (2006–2008)
Authors: N Polavarapu, K Bowering, E Thompson, R Sturgess, M Pearson, K Bodger
Journal: Gut (2012)

<h3>Introduction</h3> Cholangiocarcinoma (CC) is a rare and challenging cancer with poor prognosis and low operative rate. Early successful biliary drainage is a key determinant of outcome and ERCP is the primary modality. It is unclear whether current care organisation for CC is optimal. We report a national study aimed at describing outcomes for all patients undergoing ERCP for CC in English hospitals and volumes at cancer networks and institutions. <h3>Methods</h3> We built on linkage methods applied to overall ERCP mortality<sup>1</sup> to develop new techniques to map the entire pathway of hospital care for incident cases of CC. 2 years of Hospital Episode Statistics (HES) data were merged (2006–2008) and admissions screened for CC diagnosis. To identify a 1-year incident cohort of CC, we selected only patients with first cancer coding in middle year (October–September), then extracted all admissions within 6 months (before and after) of first cancer coding, ordered chronologically, screened for ERCP, radiological intervention (PTC) and major surgery codes. Identified first and subsequent procedure dates, admission diagnoses and co-morbidity. Linkage to death registry for death date. Cases allocated to cancer networks using provider codes. <h3>Results</h3> Nationally, <b>1211</b> CC patients underwent ERCP with mean age (SD) of <b>72</b> (12) years and 623 male (<b>51.4%</b>). First ERCP was performed during an acute (<b>emergency</b>) hospitalisation in 690 cases (57%). <b>ERCP case volumes</b> for CC ranged from 7 to 79 patients per Cancer Network and 1–57 patients per Trust (n=146 institutions). <b>Outcomes (post-first ERCP): Mortality</b>: 7 day [40 (<b>3.3%</b>)]; 30 day: 172 (<b>14.2%</b>); 365 day: 781 (<b>64.5%</b>). <b>Emergency readmission</b>: 7 day: 110 (<b>9.1%</b>); 30 day: 252 (<b>20.8%</b>). <b>Additional PTC</b>: 213 (<b>17.6%</b>) with poorer 365 d survival in those needing both (ERCP alone: 64.5% vs ERCP+PTC: 73%, p=0.013, non-surgical cases only). Patients requiring first ERCP during an <b>acute hospitalisation</b> had poorer prognosis than those on elective pathway (Log rank, p&lt;0.001). 365 day mortality for surgical <b>42.4%</b> vs non-surgical <b>66.2%</b> (p&lt;0.001). <h3>Conclusion</h3> First endoscopic intervention for this rare form of cancer is undertaken in most English hospitals, often during acute hospitalisation. There is wide variation in institutional case load. These data provide a potential tool for exploring variation in relation to local or network service provision and organisation. <h3>Competing interests</h3> None declared. <h3>Reference</h3> 1. <b>Bodger K</b>, Bowering K, Sarkar S, <i>et al.</i> All-cause mortality after first ERCP in England: clinically guided analysis of hospital episode statistics with linkage to registry of death. <i>Gastrointest Endosc</i> 2011;<b>74</b>:825–33.