tbuckley/cabot-search huggingface dataset:
Beclomethasone Dipropionate and Oropharyngeal Candidiasis
Authors: L. J. R. Milne, G. K. Crompton
Journal: BMJ (1974)

A survey of 936 patients attending a respiratory diseases unit outpatient department was performed to assess the incidence of oropharyngeal candidiasis in patients inhaling beclomethasone dipropionate in daily doses of 400 μg or less. Throat swabs from 209 (41%) patients treated with beclomethasone were positive on culture for yeasts compared with positive swabs from 77 (27·2%) patients not receiving corticosteroid therapy either orally or by inhalation. Clinical oropharyngeal thrush, confirmed by culture, was detected in 28 (5·5%) patients inhaling beclomethasone, one (0·7%) patient receiving treatment with oral prednisolone, and two (0·7%) patients not being treated with corticosteroids.
The Diagnosis of Pulmonary Embolism
Authors: Izzie Boxen
Journal: JAMA (1990)

<h3>To the Editor.—</h3> The PIOPED (Prospective Investigation of Pulmonary Embolism Diagnosis) study,<sup>1</sup>being a large, multicenter study, will undoubtedly have an effect on the use of lung ventilation/perfusion scans by many other physicians. However, the conclusions of the study are seriously flawed. All ventilation imaging was done only in posterior view and with xenon 133. Ventilation imaging is best done in the views that show perfusion defects. If aerosol is used, then the same six views as on perfusion imaging can be obtained. The drawback to this is the limitation of aerosol imaging to assessing only early or wash-in ventilation. Xenon 127 gives images with much better resolution than does xenon 133 and, unlike xenon 133, can be used after perfusion imaging without interference from technetium Tc 99m photons. Computer subtraction of the perfusion images is therefore not necessary, as it is if xenon 133 is used after technetium
Cost Containment and the Physician
Authors: Paul Ross
Journal: JAMA (1986)

<h3>To the Editor.—</h3> Dr Angell<sup>1</sup>provides thought-provoking, practical analysis and advice in her article, "Cost Containment and the Physician." She suggests that the profession support the revision of fee schedules so that they no longer reward the use of tests and procedures as the single most important reform to be made in the present system. This general statement could have been strengthened by examples, and I offer an important one. Perhaps half of all radiological examinations in the United States are performed in the primary physician's office. In this self-referral situation it is clearly impossible for the physician to be unbiased in deciding what needs to be done for the patient. A substantial reduction in the fee schedule for examinations performed in this setting would undoubtedly help to resolve this problem.
436. Coxsackievirus A21 Has Potent Oncolytic Activity in Multiple Myeloma
Authors: Elizabeth M. Hadac, Stephen J. Russell
Journal: Molecular Therapy (2006)

The Enterovirus, Coxsackievirus A21 (CVA21) has been shown to have a significant oncolytic effect on melanoma tumors grown in mice (Shafren et al. Clin Cancer Res, 2004). CVA21 binds to decay-accelerating factor (DAF) and requires a second receptor intercellular adhesion molecule 1 (ICAM-1) for entry into cells. We wanted to explore the effect of CVA21 on multiple myeloma cell lines and xenografts. CVA21 was propagated and titered on H1-HeLa cells. FACScan analysis was performed with human multiple myeloma cell lines (KAS6/1, MM1, JJN-3, ARH-77). All the cell lines tested were found to express surface receptors for both DAF and ICAM-1, making them viable candidates for CVA21 infection. We continued with in vitro studies and found cell lines that were incubated with decreasing amounts of CVA21, showed rapid cytopathic effect in doses as low as MOI = 0.0014 for three of the cell lines tested (dose for CPE with JJN-3 was MOI = 0.028). With in vivo studies in SCID mice bearing human myeloma xenografts, tumors quickly and completely responded to CVA21 (both IV and IT administration). However, as promptly as the tumors regressed the mice became sick with hind-limb paralysis and quickly died. Pathology reports showed complete ablation of all tumor tissue but also signs of widespread myositis in muscle tissues. CVA21 virus was recovered from muscle biopsies but there was no evidence of CNS infection. Toxicity was observed in tumor bearing animals with a CVA21 dose as low as 560 TCID50. In an attempt to ameliorate the myositis, adenoviruses coding for mouse IFN-|[alpha]| was administered prior to CVA21 therapy. Blood levels of IFN-|[alpha]| were measured by ELISA and were 1500-3000 pg/ml compared to 150 pg/ml in untreated control mice. However, there was little impact on tumor response or survival. CVA21 is a promising anti-myeloma agent but its associated toxicity in SCID mice is a major concern. Potential solutions to this problem are currently under investigation.
Diabetes in Relation to Serum Levels of Polychlorinated Biphenyls and Chlorinated Pesticides in Adult Native Americans
Authors: Neculai Codru, Maria J. Schymura, Serban Negoita, Robert Rej, David O. Carpenter
Journal: Environmental Health Perspectives (2007)

Recent research suggests that diabetes, a condition whose incidence is increasing, is associated with exposure to polychlorinated biphenyls (PCBs) and chlorinated pesticides.We investigated the potential association between diabetes and serum levels of PCBs, dichlorodiphenyldichloroethylene (DDE), hexachlorobenzene (HCB), and mirex in a cross-sectional study of an adult Native-American (Mohawk) population.Through a standardized questionnaire we collected demographic, medical, and lifestyle information from 352 adults, > or =30 years of age. We collected fasting serum samples that were analyzed for 101 PCB congeners, DDE, HCB, and mirex along with fasting glucose, triglycerides, and cholesterol. Participants who had fasting-glucose values > 125 mg/dL and/or who were taking antidiabetic medication were defined as persons with diabetes. We conducted logistic regression to assess the potential association between organochlorine serum levels and diabetes, while controlling for the potential confounding variables of age, body mass index (BMI), smoking, sex, and serum lipid levels. Organochlorine serum levels were categorized in tertiles, and the lowest tertile was used as the reference category.The prevalence of diabetes was 20.2%. The odds ratio (OR) of having diabetes for participants in the highest tertile of total PCB concentration compared with the lowest tertile was 3.9 (95% confidence interval, 1.5-10.6). The corresponding ORs for DDE and HCB were even higher. Elevated serum mirex was not associated with diabetes. After adjustment for other analytes, the OR for HCB remained significant, whereas ORs for PCBs and DDE remained elevated but not statistically significant. In contrast, after adjustment for other analytes, the OR for mirex became statistically significant and indicated an inverse association.In this study of adult Native Americans, elevated serum PCBs, DDE, and HCB were positively associated with diabetes after controlling for potential confounders, whereas a negative association was observed for mirex.
AKT induces erythroid-cell maturation of JAK2-deficient fetal liver progenitor cells and is required for Epo regulation of erythroid-cell differentiation
Authors: Saghi Ghaffari, Claire Kitidis, Wei Zhao, Dragan Marinkovic, Mark D. Fleming, Biao Luo, Joseph Marszalek, Harvey F. Lodish
Journal: Blood (2005)
The Great American Roundup
Authors: Harold M. Visotsky
Journal: New England Journal of Medicine (1987)

During the 1960s and 1970s, custodial care for the severely mentally ill in large state hospitals was abandoned and replaced by care in the community. Four influences lay behind this shift.The first was the introduction of the phenothiazine drugs into the treatment of hospitalized patients with mental illness. The second was an increased investment in the community mental health movement, which promoted a continuum of psychiatric services at the community level. The third influence was the civil rights movement, which prompted litigation for less restrictive sites for the confinement and treatment of mentally ill patients. The "least restrictive alternative . . .
Activation of the RAF/Mitogen-Activated Protein/Extracellular Signal-Regulated Kinase Kinase/Extracellular Signal-Regulated Kinase Pathway Mediates Apoptosis Induced by Chelerythrine in Osteosarcoma
Authors: Rui Yang, Sajida Piperdi, Richard Gorlick
Journal: Clinical Cancer Research (2008)

Abstract Purpose: Chelerythrine, a widely used broad-range protein kinase C inhibitor, induces apoptosis in many cell types. In this study, the mechanism of chelerythrine-induced apoptosis in osteosarcoma was investigated. Experimental Design: Signaling pathways activated by chelerythrine in osteosarcoma were detected by Western blots. Impacts of RAF/mitogen-activated protein kinase (MAPK)/extracellular signal-regulated kinase (ERK) kinase (MEK)/ERK MAPK on apoptosis and cell survival were studied using genetic approaches and pharmacologic pathway–specific inhibitors. Results: Osteosarcoma cells underwent apoptosis rapidly after treatment with chelerythrine. Three parallel MAPKs pathways, including the ERKs, c-Jun NH2 kinases, and p38, were activated by chelerythrine in a dose-dependent and time-dependent fashion. For the ERKs, the activation was evident at the earliest time point tested (2 minutes) and sustained for &amp;gt;4 hours. Introduction of a dominant-negative H-RAS mutant (17N) partially attenuated ERK activation and delayed the onset of apoptosis induced by chelerythrine. The ERK activation and apoptotic effects of chelerythrine were greatly abrogated by the pharmaceutical inhibitors of MEK, but not by those of c-Jun NH2 kinase or p38. Moreover, osteosarcoma cells were sensitized to chelerythrine by transient transfection with wild-type MEK1 or constitutively active MEK1 and became resistant with dominant-negative MEK1. Other protein kinase C inhibitors, including GF109203X or Gö6976, did not cause ERK activation or apoptosis in the same timeframe tested. Conclusion: In osteosarcoma, chelerythrine-induced apoptosis is mediated through activation of the RAF/MEK/ERK pathway. These findings suggest that activating the ERK MAPK, as opposed to inhibiting it, may be a therapeutic strategy in osteosarcoma.
Brain scan within 24 hours of mild stroke predicts risk of further stroke, study shows
Authors: S. Mayor
Journal: BMJ (2014)

A computed tomography (CT) scan of the brain within 24 hours of a transient ischaemic attack (TIA) or non-disabling stroke accurately predicts the risk of further stroke within 90 days and provides useful information to guide treatment decisions, a prospective study has found.

Patients who have a TIA generally have their risk of a stroke assessed using a simple scoring system based on age, blood pressure, diabetes status, and …
Assisted suicide: a substitute for a caring doctor?
Authors: B. Livesley
Journal: BMJ (2010)

The 97 year old dying man I was visiting on a hospital ward emitted a piercing scream of pain. I discovered that his intravenous fluids had been stopped, his catheter also unexpectedly removed, a “nil by mouth” notice had appeared by his bedside, and his scream was due to the pain of attempting to pass concentrated and infected urine while he was left unattended. Informed negotiation with the ward sister allowed correction of the deficits and his physical discomfort. When he returned home the causes of his recurring emotional and physical misery were correctly diagnosed, explained to him, and eased by his general practitioner, who also talked to his daughter. He was able to relax and, with his fears assuaged, enjoy relevant and amusing conversations with his daughter and visiting friends over the next few days until, in their presence, he passed away comfortably.

A gentle …
Maintaining standards of medical education. Problems involved while increasing the proportion of students from minority groups
Authors: D. B. Dove
Journal: JAMA (1970)

Under the general topic of "Accreditation and the Public Interest" I have been asked to direct my comments to the problems involved in maintaining appropriate standards for medical education while substantially increasing the number and proportion of medical students from minority groups. I am of the opinion that the title of my topic does severe injustice to the question in that it represents a preconceived bias on the part of the individuals who assigned it and those who concur with it. This bias evidences itself from two assumptions which are to be made from the title: (1) that the standards under which we now operate are absolute, should be maintained, and should not be in any way modified; (2) that the term minority immediately confers upon the individual so blessed the specter of inferiority. However, I submit that not only are our present standards of excellence by no means absolute,
Sildenafil Prevents Endothelial Dysfunction Induced by Ischemia and Reperfusion via Opening of Adenosine Triphosphate–Sensitive Potassium Channels
Authors: Tommaso Gori, Silvia Sicuro, Saverio Dragoni, Giovanni Donati, Sandro Forconi, John D. Parker
Journal: Circulation (2005)

Animal studies have demonstrated that administration of sildenafil can limit myocardial damage induced by prolonged ischemia, an effect that appears to be mediated by opening of adenosine triphosphate-sensitive potassium (K(ATP)) channels. No study has investigated whether sildenafil can also prevent the impairment in endothelium-dependent vasodilatation induced by ischemia-reperfusion (IR) in humans.In a double-blind, placebo-controlled, crossover design, 10 healthy male volunteers (25 to 45 years old) were randomized to oral sildenafil (50 mg) or placebo. Two hours later, endothelium-dependent, flow-mediated dilatation (FMD) of the radial artery was measured before and after IR (15 minutes of ischemia at the level of the brachial artery followed by 15 minutes of reperfusion). Seven days later, subjects received the other treatment (ie, placebo or sildenafil) and underwent the same protocol. Pre-IR radial artery diameter and FMD, as well as baseline radial artery diameter after IR, were similar between visits (P=NS). After placebo administration, IR significantly blunted FMD (before IR: 7.9+/-1.1%; after IR: 1.2+/-0.7%, P<0.01). Importantly, sildenafil limited this impairment in endothelium-dependent vasodilatation (before IR: 7.0+/-0.9%; after IR: 6.2+/-1.1%, P=NS; P<0.01 compared with placebo). In a separate protocol, this protective effect was completely prevented by previous administration of the sulfonylurea glibenclamide (glyburide, 5 mg), a blocker of K(ATP) channels (n=7; FMD before IR: 10.3+/-1.5%; after IR: 1.3+/-1.4%, P<0.05).In humans, oral sildenafil induces potent protection against IR-induced endothelial dysfunction through opening of K(ATP) channels. Further studies are needed to test the potential clinical implications of this finding.
Notes from Manchester and London.
Authors: Henry Ling Taylor
Journal: JAMA (1903)

London, July, 1903.  To the Editor:  —Mr. George A. Wright, well known through his excellent work on early excision of the hip, is still active at the Royal Infirmary, Manchester, where the writer found him at work in the operating room. His first case was one of infraorbital neuralgia, which he treated by exposing the nerve and injecting into it a 2 per cent, solution of osmic acid; the results of this method, which does not abolish nerve function, are said to be very gratifying. In a case of extensive sinuses of the ilium, the opening was enlarged, and the sinus curetted and flushed out with turpentine, an application of which Mr. Wright thinks very highly. It is not painful, and does not interfere with primary union. The third operation was the opening of a pulmonary abscess in a young child.  In conversation Mr. Wright said he was treating young
New Allied Health Professionals: Implications of the Colorado Child Health Associate Law
Authors: Henry K. Silver
Journal: New England Journal of Medicine (1971)

Abstract Specific regulatory legislation defining the functions, activities and limits of practice for new types of paramedical personnel is deemed highly desirable particularly for the health professionals ("physician's associates") who will make independent value judgments and decisions affecting the health care of their patients. Such legislation will allow the new health professionals maximum potential in their new positions while effectively controlling their practice. The Colorado Child Health Associate Law is a progressive, pioneering and innovative act that should serve as a guide in regulating the practice of various categories of new allied health professionals. It contains necessary safeguards for the joint protection of paramedical personnel, the health profession in which they will be practicing and, most important of all, the public.
1038. Therapy of Cancer by Inhibition of XIAP with RNAi Mediated by Tumor Specific Replicating Adenovirus
Authors: Qiuwei Pan, Rong Cai, Kai Chen, Xubin Wei, Yu Chen, Xinyuan Liu, Cheng Qian
Journal: Molecular Therapy (2006)

RNA interference (RNAi) induces gene silencing at a level of posttranscription mediated by double stranded RNA. Although there are numerous methods for delivery of RNAi to the target cells, the common limitation of these methods is insufficiency for gene delivery. In this study, we explored whether oncolytic adenovirus could be used as a vector to deliver RNAi to tumor cells. We have chosen to target XIAP, because over expression of XIAP has been implicated into resistance of tumor apoptosis. Our result showed that infection of tumor cells with oncolytic adenovirus carrying RNAi could inhibit XIAP expression. This effect was not observed in tumor cells infected with control vector. Furthermore, our result showed that high cytotoxicity could be induced by infection of tumor cells with oncolytic adenovirus carrying RNAi. Infection of normal cells did not induce cytopathic effect. This data indicated that oncolytic adenovirus can be used to deliver RNAi to tumor cells.
Guillain-Barre syndrome and Campylobacter jejuni: a serological study.
Authors: J Kaldor, B R Speed
Journal: BMJ (1984)

The association between Campylobacter jejuni infection and Guillain-Barré syndrome was investigated serologically in a retrospective study of 56 patients admitted to this hospital over four years. Evidence of preceding C jejuni infection was found in 21 (38%) of these patients, indicating that C jejuni was the most common single identifiable pathogen precipitating the disease. Among those patients who had presented with preceding diarrhoea the serum antibody response was similar to that in uncomplicated C jejuni enteritis. Patients with serological evidence of preceding C jejuni infection manifested a significantly more severe form of the disease. In cerebrospinal fluid the predominant specific antibody class was IgG, and this was closely related to the serum titres of specific IgG. IgA and IgM specific antibodies were found only in the cerebrospinal fluid of patients with recent C jejuni infection. These findings support the possibility that humoral immune factors are responsible for the neural damage and demyelination seen in Guillain-Barré syndrome.
Ophthalmic Complications of Sinus Surgery
Authors: Delyse R. Buus, David T. Tse, Bradley K. Farris
Journal: Ophthalmology (1990)

Seven patients with orbital complications of sinus surgery seen over a 10-year period are reported. Severe intraoperative orbital hemorrhage occurred in three patients while undergoing external or intranasal ethmoidectomy. In one patient, an avulsed anterior ethmoidal artery was identified as the source of bleeding, whereas in two others bleeding was due to snaring of orbital tissues. In two of these three cases, intraoperative recognition and prompt treatment of the expanding hematoma resulted in preservation of vision. Motility disturbances due to extraocular muscle injury occurred in two patients after intranasal ethmoidectomy and in one patient after a Caldwell-Luc procedure. Bilateral blindness resulted from transection of both optic nerves in one patient during bilateral intranasal endoscopic ethmoidectomies. Recommendations for prevention, intraoperative recognition, and management of such ophthalmic complications of sinus surgery are given.
VARIATION IN MORBIDITY AND MORTALITY OF MURINE TYPHUS INFECTION IN MICE WITH CHANGES IN THE ENVIRONMENTAL TEMPERATURE
Authors: Vicente Moragues, Henry Pinkerton
Journal: The Journal of Experimental Medicine (1944)

Murine typhus rickettsiae injected intraperitoneally in mice of the dba strain caused a uniformly fatal rickettsial peritonitis if the animals were kept at a room temperature ranging from 65-73 degrees F. or from 70-80 degrees F. With an environmental temperature range of 85-98 degrees F., a mortality of less than 25 per cent was observed. By utilizing different strains of mice and controlling the environmental temperature, conditions may be created under which murine typhus will have any desired degree of mortality. Such conditions have obvious advantages for the evaluation of therapeutic measures in typhus infection.
UK government acted “unlawfully” by dropping international doctors scheme claim
Authors: Clare Dyer
Journal: BMJ (2006)

The UK government acted unfairly and unlawfully in abolishing the permit-free training scheme for doctors who qualified outside the United Kingdom or the rest of the European Union without proper consultation, the High Court in London was told last week. 

The court was hearing a challenge by the British Association of Physicians of Indian Origin (BAPIO) to the government's decision earlier this year to scrap permit-free training, which allowed doctors qualified abroad to take up training posts in the NHS without a work permit. 

BAPIO has argued that the decision, announced in March, …
A Review of Events That Expose Children to Elemental Mercury in the United States
Authors: Robin Lee, Dan Middleton, Kathleen Caldwell, Steve Dearwent, Steven Jones, Brian Lewis, Carolyn Monteilh, Mary Ellen Mortensen, Richard Nickle, Kenneth Orloff, Meghan Reger, John Risher, Helen Schurz Rogers, Michelle Watters
Journal: Environmental Health Perspectives (2009)

Concern for children exposed to elemental mercury prompted the Agency for Toxic Substances and Disease Registry and the Centers for Disease Control and Prevention to review the sources of elemental mercury exposures in children, describe the location and proportion of children affected, and make recommendations on how to prevent these exposures. In this review, we excluded mercury exposures from coal-burning facilities, dental amalgams, fish consumption, medical waste incinerators, or thimerosal-containing vaccines.
Constitutive phosphoinositide 3-kinase activation in acute myeloid leukemia is not due to p110δ mutations
Authors: P Cornillet-Lefebvre, W Cuccuini, V Bardet, J Tamburini, L Gillot, N Ifrah, P Nguyen, F Dreyfus, P Mayeux, C Lacombe, D Bouscary
Journal: Leukemia (2005)
The Clinician and the Biologic Clock
Authors: Julius Axelrod, Ira B. Black
Journal: New England Journal of Medicine (1968)

Biologic periodicity has been demonstrated in virtually all plant and animal species, from unicellular organisms to humans.1 Oscillation of a number of biochemical and behavioral functions in man are of diagnostic and therapeutic importance.These rhythms serve to synchronize the activities and capabilities of individuals within a species and synchronize the species itself with the environment. The biologic clocks may have periods varying from minutes, in cyclic ribosomal aggregation, to weeks, as with the menstrual cycle. However, most rhythms described are diurnal, changing over a 24-hour period. Such cycles may be endogenous or may be driven by oscillating environmental cues. . . .