tbuckley/cabot-search huggingface dataset:
Salvage Therapy in Recurrent Germ Cell Cancer: Ifosfamide and Cisplatin plus Either Vinblastine or Etoposide
Authors: Patrick J. Loehrer
Journal: Annals of Internal Medicine (1988)

Study Objective: To determine the efficacy of the addition of ifosfamide to cisplatin plus etoposide (VIP), or vinblastine (VeIP), in patients with recurrent germ cell tumors. Design: Nonrandomized, prospective phase II trial. Setting: Tertiary referral university hospital. Patients: Fifty-six of fifty-eight entered patients with measurable and progressive recurrent germ cell tumors of testicular (46 patients), ovarian (1 patient), and extragonadal (9 patients) origin were evaluable for response after not being cured with cisplatin, vinblastine, and etoposide regimens. Interventions: Patients were administered cisplatin (20 mg/m2 body surface area daily for 5 days), ifosfamide (1.2 g daily for 5 days), plus either etoposide (75 mg daily for 5 days) or vinblastine (0.11 mg/kg body weight on days 1 and 2). In addition, vigorous intravenous hydration therapy with normal saline (100 to 125 mL/h) was administered during the treatment course. Uroepithelial protective agents, N-acetylcysteine (orally) or mesna (intravenously), were administered. Four courses were administered to responding patients every 3 weeks. When complete excision was feasible, surgical resection of residual tumor was done approximately 6 to 8 weeks after chemotherapy. Measurements and Main Results: Twelve of fifty-six evaluable patients had a complete remission with chemotherapy alone, whereas 8 additional patients were free of disease after resection of teratoma (3 patients) or carcinoma (5 patients) for a total disease-free rate of 36% (95% CI, 23.4 to 49.6). The 95% CI median duration of remission for these patients is 34 months (range, 3 to more than 42; 95% CI, 9 months to ∞), and the median survival for all eligible patients is 12.7 months (95% CI, 10 months to 26 months), with 15 of the 20 patients who achieved disease-free status alive 18 to 53 months or more. Nine of fifty-eight patients remain free of disease, including 7 patients for 2 years or longer. Hematologic and nephrotoxicity were the predominant drug-related toxicities, with one drug-related death secondary to pneumonia. Conclusions: Ifosfamide combination chemotherapy as third-line or greater therapy can produce durable complete remissions in heavily pretreated patients with recurrent germ cell tumors.
A routine immuno-electron microscopic technique for localizing an auto-antibody on epidermal basement membrane
Authors: C. PROST, L. DUBERTRET, M. FOSSE, J. WECHSLER, R. TOURAINE
Journal: British Journal of Dermatology (1984)

A new diagnostic technique is described, in which 0.7 mm thick slices of skin are freshly cut, thoroughly washed, slightly fixed and directly incubated in peroxidase-labelled antibodies. This easy technique allows routine immuno-electron microscopic diagnosis of subepidermal auto-immune bullous diseases, with excellent morphological results.
Medicine and Stamps
Authors: Samuel Bluefarb
Journal: JAMA (1970)

The late John A. Mirt had an excellent idea—he staged a postage stamp exhibit "Medical Pathfinders on Stamps"; and he followed this with biographical vignettes, with reproductions of the stamps themselves, which were published in the<i>Journal of the American Medical Association</i>. Many of the original vignettes have been rewritten and revised by the present editors, plus new articles which were specially prepared for this volume. The stamps are listed alphabetically but are also catalogued according to country and specialty. France leads with 24 stamps, followed by Austria with 13, Belgium 8, and United States with 6. This is a delightful, small volume and the American Medical Association is to be congratulated, especially Dr. George Fite, for whom this was evidently a labor of love. The price is right and this little volume of medical and paramedical men and women who appear on postage stamps is recommended for all physicians.
The Functions of Sleep
Authors: ISMET Karacan
Journal: JAMA (1974)

This book presents a very readable and relatively comprehensive review of important research on sleep over the past several years. The strong point of the book is its readability and hence its usability by the novice researcher of sleep or the graduate student with interest in this area. It is also an excellent resource book for the sleep research library in that it provides a means whereby technicians and fledgling researchers may efficiently review the current state of knowledge pertaining to the concomitants of sleep. The author has been able to review a vast amount of often confusing research data without becoming disorganized or lost in trivia. He is to be complimented for this. Dr. Hartmann's primary aim in reviewing the data on sleep is to develop a rationale for his theory of the functions of sleep. Although some aspects of his theory are not original, others are, and in
Osteoporosis in the at-risk asthmatic
Authors: S. A. Aljubran, G. J. Whelan, M. C. Glaum, R. F. Lockey
Journal: Allergy (2014)

The effect of inhaled glucocorticosteroids (ICS) on bone metabolism and subsequent osteoporosis is controversial. Explanations for this controversy include various study designs, duration of use, outcome measures, and population demographics of research studies with intranasal or inhalational ICS. Patients with poorly controlled asthma are at greatest risk of osteoporosis because they are commonly treated with intermittent or continuous systemic corticosteroids (SCS) or high-dose ICS. A 45-year-old Caucasian woman presents with moderate-to-severe asthma with frequent albuterol use and nighttime awakenings at least once weekly. She is on fluticasone/salmeterol 500/50 μg one inhalation twice daily and montelukast 10 mg/day. She requires prednisone 15 mg three times per day for 5 days up to three times a year. Is this patient at greater risk of osteopenia, characterized by a T-score between −1.0 and −2.5, and subsequent osteoporosis and an increased risk of fractures? If she has osteopenia, should she be treated with a bisphosphonate? The risk of osteoporosis and fracture increases significantly with frequent administration of SCS, and patients on such medications should undergo preventative measures and treatment. This study discuses factors that contribute to an increased risk of osteoporosis/osteopenia in patients with asthma and suggests recommendations based on the current literature.
The effects of age and liver disease on the disposition and elimination of diazepam in adult man.
Authors: U Klotz, G R Avant, A Hoyumpa, S Schenker, G R Wilkinson
Journal: Journal of Clinical Investigation (1975)

This study investigates the separate effects of age and hepatocellular liver disease on the disposition and elimination of diazepam (Valium) in man. The drug was given either by rapid intravenous injection (0.1 mg/kg) or orally (10 mg) to 33 normal volunteers rnaging in age from 15 to 82 yr as well as to 9 individuals with alcoholic cirrhosis, 8 with acute viral hepatitis, and 4 with chronic active hepatitis. In the normal individuals, the terminal plasma half-life of diazepam, (t 1/2 (B)) exhibited a striking age-dependence; at 20 yr the t 1/2 (beta) was about 20 h, but it increased linearly with age to about 90 h at 80 yr. The plasma clearance of diazepam in the majority of the normal subjects was between 20 and 32 ml/min and showed no significant age-dependence. Cigarette smoking did not affect the half-life or the clearance. Additionally, neither the plasma binding (97.4 plus or minus 1.2%, mean plus or minus SD) nor the blood/plasma concentration ratio (0.58 plus or minus 0.16) of diazepam showed any age-related changes (P greater than 0.05). By contrast, analysis of the intravenous data according to a two-compartment open model indicated that both the initial distribution space (V1) and the volume of distribution at steady state [Vd(ss)] of diazepam increased linearly with age (P less than 0.005). The increase in Vd(ss) was secondary to the change in V1. It appears then that the prolongation of t 1/2 (beta) of diazepam with age is primarily dependent on an increase in the initial distribution volume of the drug. The plasma concentration/time course of the metabolite, desmethyldiazepam, was also affected by age. In older individuals, the initial presence and the peak values of desmethyldiazepam were observed later and the metabolite was present in lower concentrations. Despite the profound prolongation of t 1/2 (theta) with age, the constancy of diazepam clearance indicates that drug plasma concentrations will not accumulate any more in the old than the young, and chronic dosage more in the old than the young, and chronic dosage modifications based on pharmacokinetic considerations are unnecessary. Data obtained in patients with liver disease were compared with those found in age-matched control groups. Patients with cirrhosis showed a more than twofold prolongation in the half-life of diazepam (105.6 plus or minus 15.2 vs. 46.6 plus or minus 14.2 h, P less than 0.001).
Cerebral Infarction: A Disparity Between Tc-99m-pertechnetate and Tc-99m-EHDP Images
Authors: HIROFUMI MORI, TOSHIO MAEDA, KINICHI HISADA, SHIN KOBAYASHI
Journal: Clinical Nuclear Medicine (1980)

A case of cerebral infarction that showed a disparity between Tc-99m-pertechnetate and Tc-99m-EHDP brain images is presented. Serial Tc-99m-ertechnetate and Tc-99m-EHDP brain images showed not only different lesion-to-nonlesion ratios but different distribution patterns. Tc-99m-labeled phosphate compounds may be useful in the estimation of prognosis in cerebral infarction as well as in differential diagnosis between cerebral infarction and cerebral tumors.
Runx1-mediated hematopoietic stem-cell emergence is controlled by a Gata/Ets/SCL-regulated enhancer
Authors: Wade T. Nottingham, Andrew Jarratt, Matthew Burgess, Caroline L. Speck, Jan-Fang Cheng, Shyam Prabhakar, Eddy M. Rubin, Pik-Shan Li, Jackie Sloane-Stanley, John Kong-a-San, Marella F. T. R. de Bruijn
Journal: Blood (2007)
Primum non nocere
Authors: Laura Wilkins
Journal: BMJ (2006)

I was sitting in the outpatients clinic of the cardiology department the other day. A little boy in a wheelchair came in with his father. His father was greeted by the receptionist and whisked off for echocardiography. The little boy stayed in the waiting room and cruised around skilfully in his wheelchair. He had both legs partly encased in plaster …
Lineage-instructive function of C/EBPα in multipotent hematopoietic cells and early thymic progenitors
Authors: Albert Wölfler, Astrid A. Danen-van Oorschot, Jurgen R. Haanstra, Marijke Valkhof, Claudia Bodner, Eric Vroegindeweij, Paulette van Strien, Alexandra Novak, Tom Cupedo, Ivo P. Touw
Journal: Blood (2010)
ICE-like protease (caspase) is involved in transforming growth factor ?1-mediated apoptosis in FaO rat hepatoma cell line
Authors: Kyeong Sook Choi, In Kyoung Lim, John N. Brady, Seong-Jin Kim
Journal: Hepatology (1998)

Transforming growth factor-β 1 (TGF-β 1 ) arrests growth and/or stimulates apoptosis of a variety of cells. The biochemical pathways involved in the apoptotic processes, however, remain poorly defined. TGF-β 1 induces DNA fragmentation together with morphological changes, which are characteristic of apoptosis in the FaO rat hepatoma cell line. Histones were remarkably enriched in lysates of these cells during TGF β 1 -induced apoptosis. We identified U1-70 kd as a death substrate which is cleaved following TGF-β 1 treatment. The tetrapeptide caspase inhibitor carbobenzoxy-valyl-alanly-aspartyl-(β- O -methyl)-fluoromethyl ketone (ZVAD-FMK) prevented TGF β 1 -induced apoptotic DNA fragmentation and cleavage of the U1-70 kd protein, showing that caspase(s) are involved in TGF β 1 -mediated apoptosis. To identify specific caspases involved in apoptosis induced by TGF-β 1 in FaO cells, proteolytic activation of several of these caspases and their substrates were studied as a function of time following TGF β 1 -treatment. TGF β 1 -treatment induced the progressive proteolytic processing of caspase-2 (ICH-1L/Nedd-2), whereas caspase-1 itself did not show any cleavage from the precursor. Pre-treatment with ZVAD-FMK abrogated the maturation of caspase-2 and blocked the apoptotic progress. These results suggest that caspase-2, but not caspase-1, may play a crucial role in TGF β 1 -induced apoptosis in these cells.
In Silico Prescription of Anticancer Drugs to Cohorts of 28 Tumor Types Reveals Targeting Opportunities
Authors: Carlota Rubio-Perez, David Tamborero, Michael P. Schroeder, Albert A. Antolín, Jordi Deu-Pons, Christian Perez-Llamas, Jordi Mestres, Abel Gonzalez-Perez, Nuria Lopez-Bigas
Journal: Cancer Cell (2015)
Provision of hearing aids: does specialist assessment cause delay?
Authors: C. Watson, J. A. Crowther
Journal: BMJ (1989)

OBJECTIVE--To identify the main delay in the provision of hearing aids for people with impaired hearing and identify possible problems and short-comings caused by a community based hearing aid dispensing service. DESIGN--Prospective cohort analysis based on data collected from patients on the duration of hearing impairment, from the referral letters in respect of the general practitioners9 findings on otoscopy, and from the ear, nose, and throat assessment in the clinic with respect to the outcome of specialist otoscopy and management of the hearing impairment. SETTING--General ear, nose, and throat outpatient clinic. PATIENTS--100 Consecutive patients aged 19-94 referred by general practitioners for the provision of hearing aids or for assessment and treatment of impaired hearing. RESULTS--Most patients with impaired hearing did not seek medical advice for at least a year. The time from referral by the general practitioner to the provision of a hearing aid was under two months. General practitioners consistently recognised normality on otoscopy but failed to recognise abnormality in eight of 45 cases. Seven patients required further investigation to exclude serious disease and nine had conditions amenable to surgery. CONCLUSIONS--The main cause of delay in treating impaired hearing is failure by patients to seek help promptly. Specialist assessment of patients with impaired hearing is preferable and does not necessarily cause delay in providing hearing aids. The provision of hearing aids should remain a hospital based service.
FDA is urged to reverse its approval of new pain drug Zohydro ER
Authors: M. McCarthy
Journal: BMJ (2014)

More than 40 consumer groups, addiction treatment organizations, and healthcare agencies have called on the US Food and Drug Administration to reverse its recent approval of a potent oral opioid drug that they say threatens to worsen a widespread addiction to prescription drugs. Those who wrote to the FDA included the American Society of Addiction Medicine, Physicians for Responsible Opioid Prescribing, and the consumer advocacy group Public Citizen.

The drug, Zohydro ER, is an extended release formulation of hydrocodone bitartrate that was approved last year and is scheduled to go on sale this month.

Critics have said …
Intestinal Bypass for Obesity-Reply
Authors: Daniel J. O'Reilly
Journal: JAMA (1982)

<h3>In Reply.—</h3> Wieland et al should be applauded for the completeness of their follow-up of patients with jejunoileal bypass (94% of 84 patients for a mean of 4.5 years).<sup>1</sup>It is not surprising that granulomas may appear and disappear despite continuation of the bypass state, as the list of causes for hepatic granulomata is quite extensive and includes a substantial idiopathic and drug-related group.<sup>2</sup>In addition, the demonstration of granulomas on liver biopsy is frought with sampling effect.<sup>3</sup>We agree, therefore, that reanastomosis should be reserved for patients with extensive hepatic necrosis or progressive fibrosis. The team approach advocated by Wieland et al (surgical, medical, and psychosocial) has been accompanied by a 7% mortality (3% in a more recent subset). However, one questions whether similar results are obtainable in an unsupervised setting. In addition to the surgically related deaths (at least three of six occurred in the
Acquired Mucocele of Gall-bladder in Childhood
Authors: R. J. Williams
Journal: BMJ (1958)

Mnm 1047 obvious promontory permitted the axis of the expulsive forces to lie nearly vertical, thus resulting in increase in the lateral flexion of the head (see Fig. 2). ( 5 The antero- posterior depth of the cavity was such that the deflection of the head by the sacral curve and consequent correction of asynclitism could not take place until the posterior shoulder was impacted-against the sacrum.By this time the head was so wedged against the lateral pelvic walls that spontaneous correction and delivery had become impossible.COMMENT That the malpresentation described above is extremely rare seems to be due to the factors involved in its production.These are: -(1) the relatively small baby; (2) a rela- tively roomy pelvis, particularly in the antero-posterior diameter; and (3) a low angle of inclination of the pelvic brim.No opinion can be formed concerning the part played by the musculature of the pelvic floor in the mechanism of this presentation, since in the case described by Walker (1928) the mother was a 2-para.It is not certain that there is any significance in the lateral siting of the placenta.The manipulation described, carried oXj under general anaesthesia, resulted in the effortless forces delivery of a live infant.I am indebted to
Observation Care — High-Value Care or a Cost-Shifting Loophole?
Authors: Christopher W. Baugh, Jeremiah D. Schuur
Journal: New England Journal of Medicine (2013)

Protocolized observation care in dedicated hospital units can result in higher-value care for some conditions, but by treating observation billing for inpatient care the same as for observation-unit care, current policy promotes cost shifting without rewarding higher value.
A Good Death: Conversations with East Londoners
Authors: J. Barraclough
Journal: BMJ (1996)

Michael Young, Lesley Cullen Routledge, (poounds sterling)13.99, pp 249 ISBN 0 415 13797 7

Within the palliative care movement, concepts of a “good death” from cancer include relief of physical symptoms, psychological adjustment to being terminally ill, harmonious resolution of personal relationships, fulfilment of goals, maintaining a sense of dignity and control, and achievement of spiritual equilibrium.

Young and Cullen's book is based on the views of 14 patients with cancer selected by hospice or hospital staff as having a likely life prognosis of three to four months (one of them lived three …
Measurement of PC<sub>20</sub> histamine with the use of two different nebulizers and measurement of FEV<sub>1</sub> and PEF
Authors: M. Iversen, H. Harving, B. Pedersen
Journal: Allergy (1991)

Histamine challenge was performed in 19 patients using two nebulizers (PARI and Wright) and FEV 1 and PEF were measured to determine PCOT histamine. FEV 1 and PEF gave identical PC20 histamine values. The PARI nebulizer gave PC 20 histamine values that were 2.5 doubling concentrations lower than the Wright nebulizer. The reproducibility of histamine challenge with the PARI nebulizer1 was studied in 15 patients and the results suggested that the challenge was reproducible within one doubling concentration of histamine.
Pseudoepidemics of Tuberculin Skin Test Conversions in the U.S. Army after Recent Deployments
Authors: James D. Mancuso, Steven K. Tobler, Lisa W. Keep
Journal: American Journal of Respiratory and Critical Care Medicine (2008)

The tuberculin skin test (TST) has many sources of error. These can lead to predominantly false-positive reactions when used in low-risk populations. The U.S. Army deploys to areas considered at high risk for tuberculosis (TB) infection, but often has limited contact with the local population.We describe the investigation of eight pseudoepidemics of TST conversions in U.S. Army populations, five of which were associated with overseas deployments.Outbreak investigations of these pseudoepidemics consisted of several components: evaluation of active and latent TB surveillance data, review of medical records, investigation and interviews of active TB cases and their contacts, evaluation of materials and personnel screening procedures, and placement and reading of repeat skin testing.Initially reported risk of conversion in the outbreaks ranged from 1.3 to 15%. Repeat testing of converters (positives) found that 30 to 100% were negative on retesting. Several sources of false-positive results were identified in these pseudoepidemics, including variability in reading and administration, product variability, and cross-reactions to nontuberculous mycobacteria.Pseudoepidemics of TST conversions are a common occurrence after U.S. Army deployments and in U.S. Army populations. U.S. Army forces generally have a low risk of TB infection resulting from deployments due to limited exposure to local nationals with active TB, and universal testing in this population has a low positive-predictive value.
Prevalence of Huntington Chorea
Authors: John R. Whittier
Journal: JAMA (1973)

To the Editor.—  Bell commented in 1934, I think we can have little idea of the true  of the disease in the population as a whole, discussing the results of her study together with Armstead, on incidence of Huntington chorea in Lancashire, England, which was determined to be 0.14 cases in 100,000 inhabitants.1  In an attempt to arrive at  and prevalence figures for this hereditary brain disease, we have reviewed data from 12 countries. The highest prevalence was 17.4/100,000 general population.J Neurol Sci, 1:405-420, 1964) and the lowest, 2.3/100,000 (Med J Aust, 1:351-359, 1958).  The most recent report (Med J Aust, 1:307-310, 1972) gave an  of 5.56/100,000 general population. In certain areas, circumstances have contributed to endemic levels of astonishing magnitude, such as 51.9/100,000 near Maracaibo in Venezuela and 560/100,000 for the Moray Firth area in Scotland.2  This communication is to draw attention to
HYSTERIC LETHARGY WITH REPORT OF CASES.
Authors: G. W. McCASKEY
Journal: JAMA (1900)

A deep interest, both lay and professional, has always been manifested in the various states of morbid unconsciousness, especially when not associated with other obvious disturbances of health. To an involuntary, profound, unaccountable and especially more or less prolonged state of apparent sleep has always been assigned a certain element of mystery. While the mystery, at least in the transcendental sense, has largely faded, the interest and obscurity remain and there is recognized at present a group of cases with every gradation of intensity between moderately excessive somnolence and a stupor from which no amount of stimulation will arouse the patient; and varying in duration from a few minutes to several months. It is understood that the coma of gross brain disease, drug narcosis, etc., is excluded. A considerable number of these cases have been of toxemic origin. The narcotic toxin, in some cases, such as the persistent drowsiness which
THE MODERN UNIVERSITY SCHOOL—ITS PURPOSES AND METHODS.
Authors: JOHN M. DODSON
Journal: JAMA (1902)

The earliest American medical schools were established in connection with institutions of general learning, as would have been expected from the fact that the physicians who founded them had been educated in Great Britain and France, where the medical colleges were, without exception, departments of universities. Only a few of the American schools, however, were established with such a relation, the larger majority being quite independent of any university or college connection, so that in 1877, twenty-five years ago, less than twenty of the sixty-five medical colleges then in existence were connected in any way with institutions of general learning. Subsequent to that date, however, such schools have become much more numerous, and of the one hundred and fifty-eight medical schools at present existing in America, between sixty and seventy are connected with a university or college. These facts suggest some interesting queries. Why were not all of our medical