tbuckley/cabot-search huggingface dataset:
Intravenous Heparin for the Prevention of Stroke Progression in Acute Partial Stable Stroke: A Randomized Controlled Trial
Authors: ROBERT J. DUKE
Journal: Annals of Internal Medicine (1986)

In a double-blind, placebo-controlled trial, 225 patients with acute partial stable thrombotic stroke were randomly assigned to receive continuous intravenous heparin therapy or placebo for 7 days for the prevention of stroke progression or death. No statistically significant difference between the two groups was found in degree of neurologic change; incidence of stroke progression after 7 days; or functional activity level of survivors at 7 days, 3 months and at 1 year after treatment. Compared with controls, a statistically significant greater number of patients in the group receiving heparin died in the year after the stroke. These deaths occurred 3 to 12 months after the initial stroke and probably were not related to treatment. Results of this study do not support the use of intravenous heparin to treat patients who have had acute partial stroke.
The Pasteurization of France
Authors: Guenter B. Risse
Journal: JAMA (1989)

For Bruno Latour, a historian interested in the philosophy of science and sociology of knowledge, "science and society are both explained more adequately by an analysis of the relations between forces." Instead of a history of great scientists revolutionizing society or a description of their ideas, the author provides us with a penetrating study of the social realignments required by the rise of the germ theory of disease. Latour makes no a priori decisions about the relations between French science and society from the 1860s onward to the turn of the 19th century. Instead, he uses an empirical approach—the study of certain contemporary medical periodicals—to provide him with the content and context of the emerging science of microbiology. Only in the second half of the book does Latour turn philosopher, reflecting on the definitions of "forces," "theory and practice," "networks," and the "sciences." Thus, Pasteur's bacteriology becomes a convenient case
Effects of exercise on transmitral gradient and pulmonary artery pressure in patients with mitral stenosis or a prosthetic mitral valve: A doppler echocardiographic study
Authors: Jeffrey I. Leavitt, Mary H. Coats, Rodney H. Falk
Journal: Journal of the American College of Cardiology (1991)

Doppler echocardiography was used to determine changes in transmitral gradient and pulmonary artery pressure after exercise in 12 patients with mitral stenosis and 11 patients with a prosthetic mitral valve. The mean transmitral gradient in the mitral stenosis group was 9 ± 7 mm Hg at rest and increased to 17 ± 8 mm Hg after exercise. In patients with a prosthetic mitral valve, exercise resulted in an increase in mean transmitral gradient from 5 ± 2 to 8 ± 3 mm Hp. Calculated pulmonary artery systolic pressure increased with exercise from 41 ± 19 to 70 ± 32 mm Hg in the mitral stenosis group and from 28 ± 8 to 39 ± 15 mm Hg in patients with a prosthetic valve. Exercise Doppler echocardiographic evaluation of changes in transmitral gradient and pulmonary artery systolic pressure was found to be technically simple and an important addition to the noninvasive evaluation of patients with mitral valve disease.
A maths student with psychiatric symptoms
Authors: J. Morris
Journal: BMJ (2009)

A 19 year old maths student was referred to the early psychosis clinic. Her flatmate, a medical student, feared the patient was hallucinating, paranoid, and suicidal. She had dropped out of lectures, constantly muttered to herself, and avoided standing near windows. She felt urges to throw herself off a high building and described visions of her own body “spread eagled in a pool of blood.” She vehemently refused a general practitioner’s emergency prescription of antipsychotic medication and would not attend the clinic.

Staff arranged a domiciliary assessment and were surprised when the patient let them in quite cheerfully. She had moved her wardrobe to block the window “as a safeguard.” The university maths department was a tower block, and the patient had horrified herself by thinking “what if I were to jump through a window?” She managed to distract herself by reciting tables and mathematical formulae, and spent her time at home catching up on lecture handouts via the maths department’s intranet. She avoided alcohol and medication in case her vigilance was reduced and avoided anywhere with stairs or …
The evidence base for shaken baby syndrome: Competing interest declaration of the 106 authors and an editorial explanation
Authors: Robert M Reece
Journal: BMJ (2004)

NICE and its value judgments Option of safe "understudy" treatments should be availableEditor-The National Institute for Clinical Excellence (NICE) aims for the highest attainable standards of care. 1 The bedrock of its advice is published evidence of benefits from treatment (mainly pharmaceuticals).In the report accepted in May consideration of safety issues focused on invasive surgical and diagnostic procedures, and the "judgment" on risk assumed that such risks are small and calculable. 2 In economic terms, to distinguish between real risk (calculable and potentially manageable) and uncertainty, where judgment of costs is purely subjective, is important.In July the new health service director of research and development announced a forthcoming national programme of research on drug treatment in children.Given the serious and quite common adverse consequences of paediatric treatment reported, 3 a fundamental reassessment of child health interventions is warranted.Adverse drug reactions or interactions between new and existing drug treatments are uncertain in caring for children aged 0-16 years.NICE has hitherto sought to judge the best treatment (singular), but in an uncertain interaction between doctor and child simultaneous identification of "good enough" second line treatments that can understudy for the "best" treatment when the safety of an individual child may preclude using the most cost effective drug may make good economic sense.This "good enough for some children" standard is not currently in the expertise of the licensing authorities, but it could become a feature of NICE expertise.In the absence of safe treatment alternatives, the long term costs to some children and families (and the health service) of adverse drug reactions could be heavy.For adult health care the burden of adverse drug reactions is 6.5% of hospital admissions. 4 For childhood drug treatment, what will be our options?
SAFETY AND EFFICACY OF DRUG ELUTING STENTS AND BARE METAL STENTS FOR SAPHENOUS VEIN GRAFT INTERVENTIONS- COMPREHENSIVE META-ANALYSIS OF RANDOMIZED TRIALS AND OBSERVATIONAL STUDIES COMPRISING 7994 PATIENTS
Authors: Abdul Hakeem, Siddharth Munsif, Sabha Bhatti, Mohamed Effat, Massoud Leesar, Tarek Helmy, Imran Arif
Journal: Journal of the American College of Cardiology (2010)
Atlas of Hepatic Tumors and Focal Lesions: Arteriographic and Tomographic Diagnosis. by Oscar H. Gutierrez and Seymour I. Schwartz. pp. × + 187. Illustrated. New York: Mcgraw–Hill Co., 1984. $80.00
Authors: James M. Phillips
Journal: Hepatology (1986)

They should focus primarily on the contents and significance of the book, but may comment on any aspect of the book, such as style, appearance, type size, quality of illustrations, adequacy of index, cost or any other feature.
Abstract 2193: Application of a novel cell-based dual luciferase assay to identify inducers of the tumor suppressor RhoB
Authors: Barbara Saber, Chunyu Zhang, WIllie Wilson, Joell Gills, Phillip Dennis
Journal: Cancer Research (2011)

Abstract RhoB is a small GTPase tumor suppressor whose expression is commonly repressed during tumorigenesis by mechanisms such as Akt activation, HDAC1-mediated histone modification and/or specific microRNAs such as miR-21 overexpression. Forced expression of RhoB inhibits cell proliferation, survival, invasion and metastasis. Because RhoB is rarely mutated or deleted in human tumors, its restoration may have therapeutic benefit. Therefore, a dual-luciferase high throughput assay was developed to monitor induction of RhoB transcription. Four different cancer cell lines were stably transfected with a single vector in which firefly luciferase and a fusion protein of renilla luciferase/neomycin resistant gene were driven by RhoB or CMV promoters, respectively. These cell lines were screened in 96-well format with the NCI Diversity Set II library (1364 compounds). Induction of RhoB activity was compared to that caused by a known RhoB inducer (NSC126188), an HDAC inhibitor (TSA), a farnesyltransferase inhibitor (L744832), and an Akt inhibitor (PIA23). Seven compounds were identified, and induction of RhoB transcription and translation was validated under different serum conditions at several time points. They were also screened in secondary assays that included inhibition of Akt, induction of protein acetylation, and screening in a cancer cell line that cannot induce endogenous RhoB due to a homozygous deletion of chromosome region 2p24. One compound caused sustained induction of endogenous RhoB in multiple cell lines under different conditions, and inhibited cellular proliferation and migration. These studies show that this assay system can identify specific RhoB inducers with potential anticancer activity, and suggest that it can be expanded to screen larger compound libraries, or be adapted to monitor transcriptional activation of other tumor suppressor genes. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 2193. doi:10.1158/1538-7445.AM2011-2193
Health Care Actors: The Patients' Feet Are Tied-Reply
Authors: Thomas Bodenheimer, Kevin Grumbach
Journal: JAMA (1995)

<h3>In Reply.</h3> —Alas, would that Mr Kessler were right. But wishing something to be true does not make it true. Patients should be the main actors on the health care stage, but they are not. To cite just one example: for decades, the American public has overwhelmingly supported universal health insurance, yet we have no universal health insurance. One way in which patients traditionally exercised individual power was to vote with their feet: if they did not like a physician, they could find another. With many large employers (the major payers of care) now restricting free choice of physician, families are losing even the basic right to choose their own health care provider. The narrowing of individual choice is one side of the loss of patient clout in the health care system. Equally important is the issue of power that patients as a group might hold; for example, in the
European drug regulator is criticised over patient representatives' conflicts of interest
Authors: P. Wilson
Journal: BMJ (2010)

Representatives of patients’ groups sat on the European Medicines Agency’s management board without declaring their ties to the drug industry, an open letter sent to the agency said last week. The agency described the situation as an honest mistake.

The letter, dated 18 June, was sent by the Medicines in Europe Forum and the International Society of Drug Bulletins to the agency’s executive director, Thomas Lonngren. 

It was prompted by a report from the Corporate Europe Observatory, a campaign group that aims to expose the power of corporate …
Anaesthesiology as a model for patient safety in health care
Authors: D. M Gaba
Journal: BMJ (2000)

Although anaesthesiologists make up only about 5% of physicians in the United States, anaesthesiology is acknowledged as the leading medical specialty in addressing issues of patient safety.1 Why is this so?

Firstly, as anaesthesia care became more complex and technological and expanded to include intensive care it attracted a higher calibre of staff. Clinicians working in anaesthesiology tend to be risk averse and interested in patient safety because anaesthesia can be dangerous but has no therapeutic benefit of its own. Anaesthesiology also attracted individuals with backgrounds in engineering to work either as clinicians or biomedical engineers involved in operating room activities. They and others found models for safety in anaesthesia in other hazardous technological pursuits, including aviation. 2 3

Secondly, in the 1970s and ‘80s the cost of malpractice insurance for anaesthesiologists in the United States soared and was at risk of becoming unavailable. The malpractice crisis galvanised the profession at all levels, including grass roots clinicians, to address seriously issues of patient safety. Thirdly, and perhaps most crucially, strong leaders emerged who were willing to admit that patient safety was imperfect and that, like any other medical problem, patient safety could be studied and interventions planned to achieve better outcomes.

#### Summary points

Anaesthesiology is acknowledged as the leading medical specialty in addressing patient safety

Anaesthesia is safer than ever owing to many different types of solutions to safety problems

Solution strategies have included incorporating new technologies, standards, and guidelines, and addressing problems relating to human factors and systems issues

The multidisciplinary Anesthesia Safety Foundation was a key vehicle for promoting patient safety

A crucial step was institutionalising patient safety as a topic of professional concern

Although anaesthesiology has made important strides in improving patient safety, there is still a long way to go

### Anaesthesia: safer than ever

It is widely believed that anaesthesia is …
Improvement and Decline in Vision with Gene Therapy in Childhood Blindness
Authors: Samuel G. Jacobson, Artur V. Cideciyan, Alejandro J. Roman, Alexander Sumaroka, Sharon B. Schwartz, Elise Heon, William W. Hauswirth
Journal: New England Journal of Medicine (2015)

Retinal gene therapy for Leber's congenital amaurosis, an autosomal recessive childhood blindness, has been widely considered to be safe and efficacious. Three years after therapy, improvement in vision was maintained, but the rate of loss of photoreceptors in the treated retina was the same as that in the untreated retina. Here we describe long-term follow-up data from three treated patients. Topographic maps of visual sensitivity in treated regions, nearly 6 years after therapy for two of the patients and 4.5 years after therapy for the third patient, indicate progressive diminution of the areas of improved vision. (Funded by the National Eye Institute; ClinicalTrials.gov number, NCT00481546.).
Myocardial metabolism in cyanotic congenital heart disease studied by arteriovenous differences of lactate, phosphate, and potassium at rest and during atrial pacing.
Authors: B Friedli, B Haenni, P Moret, L H Opie
Journal: Circulation (1977)

To study myocardial metabolism in chronic hypoxia due to cyanotic congenital heart disease, coronary arteriovenous differences of lactate (L), pyruvate (P), inorganic phosphate (Pi) and potassium (K) were measured in 14 cyanotic patients and seven controls, at rest and during atrial pacing. At rest, there was no difference in any parameter between cyanotic and noncyanotic patients. During atrial pacing (150-175/min) for 10 min, a moderate drop in L-extraction occurred in the control patients with some increase in L/P ratio in coronary venous blood. Cyanotic patients fell into two groups: in nine (group I), the arterial oxygen saturation (SaO2) dropped with pacing. Their L-extraction fell sharply, from 28.1 +/- 3.12 to --2.8 5.51 and L production occurred in five. There was a significance increase in coronary venous L/P ratio. Five cyanotic patients (group II) showed no drop in SaO2 with pacing, and L extraction as well as L/P ratio remained stable. Uptake of Pi was noted in all patients at rest, during pacing this disappeared in controls and group I cyanotics but not in group II. No K changes were seen in any patient. Thus, myocardial metabolism is normal at rest in patients with cyanotic CHD; during atrial pacing, a shift toward anaerobic metabolism occurs if SaO2 drops; cyanotic patients whose SaO2 remains stable appear to withstand pacing better than controls.
Neuroprotection for Premature Infants?
Authors: Nathalie L. Maitre, Ann R. Stark
Journal: JAMA (2012)

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Association of non-wheezing lower respiratory tract illnesses in early life with persistently diminished serum IgE levels. Group Health Medical Associates.
Authors: F D Martinez, D A Stern, A L Wright, L M Taussig, M Halonen
Journal: Thorax (1995)

BACKGROUND--The role of lower respiratory tract illnesses (LRIs) in the development of allergies is not well understood. The relation of wheezing and non-wheezing LRIs to serum IgE levels and atopy was studied in 888 children. METHODS--Total serum IgE levels were measured at birth, nine months and six years of age; and interferon gamma production by blood mononuclear cells was measured at birth and nine months. Atopy was determined by skin prick tests at age six. Wheezing and non-wheezing LRIs up to age three were diagnosed by a physician. RESULTS--Cord serum IgE levels were similar between all LRI groups and the no LRI group. Children who had wheezing LRIs until the age of three had IgE levels at nine months and at six years within normal ranges for age. In contrast, children who had a non-wheezing LRI before the nine month IgE sample had lower IgE levels at nine months and six years (geometric mean 1.8 IU/ml and 9.9 IU/ml, respectively) compared with children who had no LRIs (3.9 IU/ml and 38.3 IU/ml, respectively). Children who had non-wheezing LRIs after the nine month IgE sample had normal nine month IgE levels (3.2 IU/ml) but decreased IgE levels at six years of age (15.7 IU/ml). Children with more than one non-wheezing LRI before the age of three were less likely to be atopic than those with no LRI (odds radio 0.2). Interferon gamma production was higher in the non-wheezing LRI group at nine months than in the no LRI or wheezing LRI groups. CONCLUSIONS--Non-wheezing LRIs are associated with subsequent depression of IgE levels and reduced skin test reactivity.
Steroid induced osteoporosis: an opportunity for prevention?
Authors: I D Peat, S Healy, D M Reid, S H Ralston
Journal: Annals of the Rheumatic Diseases (1995)

OBJECTIVE--To determine the frequency with which osteoporosis prophylaxis is given to corticosteroid treated hospital inpatients. METHODS--All patients receiving systemic corticosteroids in a large teaching hospital over a three month period were identified through routine prescription monitoring by hospital ward pharmacists. Coprescription of antiosteoporotic therapy was recorded, along with other relevant details such as steroid dose, actual, or intended duration of therapy, and indication for therapy. RESULTS--Corticosteroids were prescribed to 214 patients over the study period, giving an average rate of 2.5 new prescriptions each day. Indications included: chest disease (n = 84; 39.2%), cancer (n = 17; 7.9%), inflammatory bowel disease (n = 16; 7.5%), rheumatoid arthritis/connective tissue disease (n = 16; 7.5%), and renal diseases (n = 7; 3.3%). One hundred and twelve patients (52.3%) were receiving short term steroid therapy (less than four months); 66 (37%) were receiving medium/long term steroid therapy (four months or more). In 36 cases (16.8%) the duration of therapy was unknown. Only 12 of the 214 patients (5.6%) received any form of osteoporosis prophylaxis. The prevalence of prophylaxis was similarly low in postmenopausal women (six of 93; 6.4%) and in patients receiving high dose long term steroid therapy (two of 25; 8%). CONCLUSIONS--Systemic corticosteroids are used frequently in hospital practice for a wide range of indications, but few patients receive co-prescription of prophylaxis against osteoporosis. This is true even in high risk groups such as postmenopausal women and those on high dose long term steroid therapy. Identification of individuals by the mechanism used in this study provides an opportunity by which all corticosteroid treated patients could be detected and offered osteoporosis prophylaxis before serious loss of bone density has occurred.
Gene Researchers Work to Engineer HIV-Resistant Cells
Authors: Tracy Hampton
Journal: JAMA (2014)

Ever since the evolution of the HIV/ AIDS pandemic, researchers have long sought effective strategies to preventHIV infectionorhelp thebodykeep the virus in check after infection has occurred. In addition to a decades-long effort todevelopaneffectivevaccineandcontinuing researchto find less toxicdrugs, someresearchersare focusingonanother strategy— modifying the genes of host cells to make them resistant to infection. “To date, vaccines and current drug therapies have shown a limited ability to achieve functional control of HIV infection, as definedby a statewhere patients no longerare requiredtotakemedicationonadaily basis,” saidCarl June,MD, aprofessor of immunology at the University of Pennsylvania’s Perelman School of Medicine. He and others hope that gene editing strategies may someday help patients attain suchcontrol.Various strategies that target certain receptors for HIV that are expressed on immune cells are now being developed in the laboratory and in some cases are already being tested in early clinical trials.
DIAGNOSTIC ERRORS LEADING TO UNCALLED FOR APPENDECTOMY
Authors: HENRY WALD BETTMANN
Journal: JAMA (1924)

Ten years ago, many surgeons and the directors of surgical services in our large hospitals had become painfully aware that they were getting too many unfavorable results from their operations for chronic appendicitis. They set about to clean house. A more critical study of their cases was made before the operation; a larger incision was made at the operation, and the exploration of the abdominal cavity was more thorough. In several hospitals, decided improvement was accomplished. This progress, however, has been far from universal or even general. In 1920, Hugh Cabot stated that, in large surgical clinics, hardly a day passes on which patients who have had their appendixes removed without relief do not present themselves. The following year, O'Neil<sup>1</sup>informed us that about 25 per cent, of the patients in the Massachusetts General Hospital who had ureteral calculi had had operations on their appendixes or the abdominal organs
The distribution of individual threshold doses eliciting allergic reactions in a population with peanut allergy
Authors: Marjolein Wensing, André H. Penninks, Susan L. Hefle, Stef J. Koppelman, Carla A.F.M. Bruijnzeel-Koomen, André C. Knulst
Journal: Journal of Allergy and Clinical Immunology (2002)