tbuckley/cabot-search huggingface dataset:
THE TREND OF MODERN SURGERY.
Authors: JAMES E. MOORE
Journal: JAMA (1903)

Westerners as a class have the reputation of thinking well of themselves and of being rather boastful of their achievements. It is very evident that others would not think well of us if we did not think well of ourselves, and it is now conceded by those whose good opinion we prize most highly that western surgeons have accomplished much of which they may be proud and even a little boastful. Most of those present have been obliged to do surgery under a serious handicap. We have had no marble walled operating rooms and no rich endowments. We have been obliged to build our hospitals as we went along and our endowments are yet to come. In short, we have had opportunities only as we have made them. It is this ability to overcome obstacles and to make opportunities that characterizes the western man. Western surgeons are proud of the
Unspecified Reform Tops Agenda
Authors: Paul Cotton
Journal: JAMA (1993)

THOSE WHO SAY managed competition is the wave of the future like to count newly inaugurated President Bill Clinton as one of their own. However, the new President, while repeatedly saying that health care reform is at the top of his agenda, has made no commitments on how to do it. Clinton has said he leans toward a market-based approach like managed competition. This new buzzword describes proposals in which health insurance purchasing cooperatives would broker and referee insurance coverage, with the goal of giving everyone the benefit of large-group rates while trying to promote competition among networks of health care providers. These purchasing cooperatives in theory would promote improved quality and lowered costs by rewarding those insurance plans with the best quality and lowest costs with more subscribers (<i>JAMA</i>. 1991;265:2532-2536). Most versions of such a plan also call for taxing health insurance benefits that go beyond a "basic" level
Calcifying obstructive pancreatitis: a study of intraductal papillary mucinous neoplasm associated with pancreatic calcification
Authors: Mauricio Zapiach, Dhiraj Yadav, Thomas C Smyrk, Joel G Fletcher, Randall K Pearson, Jonathan E Clain, Michael B Farnell, Suresh T Chari
Journal: Clinical Gastroenterology and Hepatology (2004)
Abstract 455: Phospho-ERK as a predictor for different ways of metastasis and / or survival in patients with metastasized colon cancer
Authors: Jens Strohäker, Claudius Falch, Claus Hann von Weyhern, Patrick Adam, Alfred Königsrainer, Falko Fend, Björn LDM Brücher
Journal: Cancer Research (2012)

Abstract Background: Not much is known about different signalling pathways and its influence on metastasis in colon cancer. Phospho-ERK (pERK) is a downstream-target of K-Ras within the EGFR-Pathway. The goal of our investigations was the evaluation of the MAP-Kinase-cascade in regard to different ways of metastasis. Methods: 98 patients with adenocarcinom of the colon and a postoperative pT2/3-status, who underwent surgical resection between 2006 and 2008 at the University of Tübingen had been included within the study collective. 53 patients had no metastasis (control group), while 45 patients revealed primary metastasis: lymphogenetic metastasis (n=20), hepatic spread (n=20) and multiple metastasize (n=5). On a tissue-micro-Array pERK was stained by immunohistochemistry, the analysis was done semiquantitatively. Results: The graduation in immunohistochemistry was done as followed: negative staining (n=31), weak positive staining (n=36), moderate staining (n=20) and strong staining (n=11). 19 out of 31 negative patients (61%) revealed metastasis, while this had been 17 out of 36 weak positive (47%), 6 out of 20 (30%) moderate and 4 out of 11 (36%) strongly positive stained patients (p=0.229). No significant correlation was observed for lypmhogenetic (p=0.683) or multiple metastatic localization (p=0.666) and the pERK-expression. A significant correlation between the pERK-expression and the number of hepatic metastasis was observed (p=0.049). Additionally pERK-negative patients (31/98 = 32%) revealed a significant worse survival compared to those with positive pERK-staining (p=0.003). Conclusion: Our first results show, that a weak pERK-expression is correlated with a higher incidence in patients with liver metastasis. Patients without a pERK-expression revealed a worse survival compared to patients with pERK-expression. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 455. doi:1538-7445.AM2012-455
Nicotine Induces Resistance to Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor by α1 Nicotinic Acetylcholine Receptor–Mediated Activation in PC9 Cells
Authors: Shuo Wang, Koichi Takayama, Kentaro Tanaka, Masafumi Takeshita, Noriaki Nakagaki, Kayo Ijichi, Heyan Li, Yoichi Nakanishi
Journal: Journal of Thoracic Oncology (2013)
Reforming mental health law in England and Wales
Authors: Nigel Eastman
Journal: BMJ (2006)

The UK government's announcement that it has abandoned its eight year attempt to achieve a new Mental Health Act for England and Wales1 is an apparent victory for patients, professionals, and liberal democracy. Faced with vehement, sustained, and almost unanimous opposition from those with an interest in mental health care, the government has stated that it will instead introduce a shortened and streamlined bill amending the 1983 Mental Health Act. This amending legislation will replace a draft mental health bill that had been described as a “public order bill,” which would be “unethical, unworkable, and also ineffective,” even in enhancing public safety.w1

The draft bill had succeeded in turn an earlier draft bill,w2 a white paper,w3 a green paper,w4 and an expert scoping report.w5 Its most contentious proposals included widening the criteria for compulsory detention and treatment; removing exclusion clauses in the current law that prevent compulsion for people with disorders of substance misuse and sexual deviance; removing the “treatability test” for personality disorder (so that those with dangerous and severe personality disorder could be detained by doctors when not capable of being sentenced by criminal courts); and extending compulsion beyond detention in hospital, thus creating a community treatment order.

The bill was also attacked in relation to the proposed new system for mental health tribunals. These tribunals would not merely have reviewed but would also have made all orders for care and treatment. The greatly increased number of hearings would have made them wholly unworkable given current manpower resources, as well as further diverting participating clinicians away from clinical care. Indeed, it seems to have been internal opposition from the Lord Chancellor's Department—which would have had to administer the new tribunals—that finally killed the bill.
Celiac Disease
Authors: John H. Yardley, Theodore M. Bayless, James H. Norton, Thomas R. Hendrix
Journal: New England Journal of Medicine (1962)

DICKE1 first described over a decade ago the dramatic improvement that occurs in childhood celiac disease after elimination of dietary wheat and rye. It was later shown that the offending agent in wheat is confined to the protein moiety, gluten, and more specifically to its gliadin fraction.2 Oats are believed to contain a similar offending protein.2 Many observers, beginning with McIver,3 have confirmed the effectiveness of a gluten-free diet in the treatment of adults with celiac disease ("nontropical sprue" or "idiopathic sprue") as well as patients with childhood celiac disease. Furthermore, peroral biopsy4 , 5 has made possible repeated demonstration of a . . .
Magnesium in acute myocardial infarction
Authors: S. Yusuf, M. Flather
Journal: BMJ (1995)

Magnesium in acute myocardial infarctionISIS 4 provides no groundsfor its routine use Clinical investigators have long pursued the elusive dream of finding a cheap, safe treatment that reduces mortality and morbidity in a common condition.Many investigators had hoped that magnesium given intravenously to patients with acute myocardial infarction might be such a treatment.Were they justified?Small trials reporting the use of magnesium in acute myocardial infarction have been reported intermittently for 20 years.The rationale for these studies came partly from observations of differences in heart attack rates associated with geographical variations in magnesium in the water supply and partly from laboratory studies showing that magnesium had cardioprotective effects during ischaemia and that myocardial magnesium concentrations were relatively low during acute ischaemia.' Research on animals has shown that magnesium is a peripheral and coronary vasodilator, has antiarrhythmic effects, decreases reperfusion injury, and has antiplatelet effects in some species.'The clinical importance of these findings is, however, still uncertain.Experimental studies often do not have the same rigorous design, conduct, and analysis that are now expected from clinical research.Few experimental studies are randomised or blinded.Further- more, publication bias is likely, with positive results being more likely to be reported than negative ones-especially when the subject is a relatively new hypothesis.An informal review of the results of the early clinical trials in acute myocardial infarction indicated a trend towards a lower mortality with intravenous magnesium, with this
Death of surgeon from AIDS raises controversy
Authors: J Siegel-Itzkovich
Journal: BMJ (1994)

The sudden death from AIDS of an orthopaedic surgeon in Israel last week has triggered arguments over whether all health workers should undergo an HIV test. The Israel Medical Association, which represents 12 000 Israeli doctors, opposes the suggestion for “professional” reasons, and the health ministry insists its money is better spent on blood testing and educational campaigns.

Dr Gabi Ben-Meir of Kaplan Hospital in Rehovot was the first doctor known to die of AIDS in Israel. The 42 year old man took a voluntary HIV test earlier this year; the result was negative. …
Hypoxic Respiratory Response during Acute Stable Hypocapnia
Authors: Stephen Corne, Kim Webster, Magdy Younes
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

The hypoxic ventilatory response during hypocapnia has been studied with divergent results. We used volume-cycled ventilation in spontaneously breathing normal subjects to study their hypoxic ventilatory response under conditions of stable hypocapnia. Subjects were studied at three different levels of end-tidal (partial) carbon dioxide pressure (PETCO2), eucapnia and 6 and 12 mm Hg below eucapnia (mild and moderate hypocapnia, respectively). The response to hypoxia was assessed by changes in muscle pressure output (Pmus) and respiratory rate. Compared with the Pmus response at eucapnia (0.53 +/- 0.59 cm H2O/percentage oxygen saturation [% O2sat]), the response at mild hypocapnia was attenuated (0.26 +/- 0.33 cm H2O/% O2sat), whereas the response at moderate hypocapnia was negligible (0.003 +/- 0.09 cm H2O/% O2sat). Similar reductions were seen with the respiratory rate (eucapnia, 0.17 +/- 0.2 breaths/minute/% O2sat; mild hypocapnia, 0.11 +/- 0.11 breaths/minute/% O2sat; moderate hypocapnia, 0.01 +/- 0.06 breaths/minute/% O2sat). The Pmus and respiratory rate responses at the three levels of PETCO2 were significantly different (p < 0.05, analysis of variance). The responses at moderate hypocapnia were not significantly different from zero. We conclude that when apnea occurs under conditions in which central PCO2 is well below the CO2 setpoint, subjects are at risk of developing dangerous hypoxemia due to absence of a hypoxic ventilatory response.
Electrocardiography during Manual Dilatation of the Anus
Authors: R. E. C. Collins, R. H. Fell, P. H. Lord
Journal: BMJ (1973)

Manual dilatation of the anus was carried out on 50 unpremedicated outpatients under propanidid, nitrous oxide, and halothane anaesthesia with E.C.G.monitoring. About half of the patients received intravenous atropine with the propanidid. The operation induced a variety of changes in heart rate but in the whole experiment only two isolated cardiac arrhythmic complexes were seen—a single defect of conduction and a solitary ventricular extrasystole. Changes in rate were not modified by atropine. It is concluded that manual dilatation of the anus is a safe procedure when carried out under the anaesthetic described and that prior medication with atropine is not necessary. This work supports the view that propanidid protects patients from most abnormalities of heart action which result from intense visceral stimulation.
Blast Cells with Monoclonal Surface Immunoglobulin in Two Cases of Acute Blast Crisis Supervening on Chronic Lymphocytic Leukaemia
Authors: J.-C. Brouet, J.-L. Preud'homme, M. Seligmann, J. Bernard
Journal: BMJ (1973)

Acute blast crisis occurred in two patients with previously well-confirmed chronic lymphocytic leukaemia. The finding by direct immunofluorescence of membrane-bound monoclonal immunoglobulins on the surface of the blast cells showed that they were related to B cells in the same way as the proliferating lymphocytes in most patients with chronic lymphocytic leukaemia. In one patient the surface monoclonal IgM detected on both the lymphocytes and the blast cells had the same rheumatoid antibody activity, supporting the concept that the leukaemic cells found during the acute and chronic phases of the disease originated from the same clone.
Transjugular liver biopsy.
Authors: I T Gilmore, R D Bradley, R P Thompson
Journal: BMJ (1977)

Case reportA 26-year-old man was admitted to hospital with a five-day history of a mild influenza-like illness and sudden onset of three grand mal convulsions.He was found to have a mild fever, absent reflexes, and extensor plantar responses.The cerebrospinal fluid was normal.His fever subsided spon- taneously after three days but he remained areflexive.A diagnosis of influenzal encephalitis was made, which was supported by virological and electro- encephalographic (EEG) findings.At that time he was found to have raised serum levels of aspartate amino- transferase (SGOT), lactate dehydrogenase (LDH), aldolase, and creatine phosphokinase (CPK).The CPK level was initially 7000 IU/I (normal < 90 IU/1), and it remained raised when the patient became asymptomatic.The peripheral blood film showed acanthocytes.Other routine investigations gave normal results.He was treated with phenytoin 100 mg three times a day and discharged.Eight months later he was readmitted after he had had two grand mal fits.Clinical examination showed the same abnormalities as before.The fever again subsided spontaneously and he became asymptomatic.SGOT, LDH, and aldolase levels were raised.The CPK was 2130 IU/I and was identified electrophoretically as the muscle isoenzyme.Serum lipoprotein concentra- tions were repeatedly normal.The EEG was abnormal with generalised slow-wave activity.An EMI scan and the CSF were normal.Electromyo- graphy showed evidence of a mild axonal neuropathy.Routine blood film examinations showed that half of all red cells were acanthocytes.Incubation studies showed that the red-cell changes were not reversed in normal serum.Normal red cells became acanthocytes in the patient's serum.Red-cell osmotic fragility was normal but there was increased autohaemolysis, which was corrected by glucose.The patient's daughter, mother, and brother were asymptomatic but had acanthocytes, absent reflexes, raised CPK levels, and normal fasting lipoproteins.His sister had normal reflexes, CPK and lipoprotein levels, and red cells.The patient was the only member of the family to have had convulsions.
Uncommon Hematologic Malignancies
Authors: Brian R. Bird, Peter A. Daly
Journal: Journal of Clinical Oncology (2003)

Article Tools DIAGNOSIS IN ONCOLOGY Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2003.03.027 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 14615457 Uncommon Hematologic Malignancies CASE 3. PAROTID SWELLING DURING TREATMENT FOR TRANSFORMED MYCOSIS FUNGOIDES Brian R. BirdxBrian R. BirdSearch for articles by this author , Peter A. DalyxPeter A. DalySearch for articles by this author Show More St. James’s Hospital and Trinity College, Dublin, Ireland https://doi.org/10.1200/JCO.2003.03.027 First Page Full Text PDF Figures and Tables © 2003 by American Society of Clinical Oncology
Plasmacytoid dendritic cells prime alloreactive T cells to mediate graft-versus-host disease as antigen-presenting cells
Authors: Motoko Koyama, Daigo Hashimoto, Kazutoshi Aoyama, Ken-ichi Matsuoka, Kennosuke Karube, Hiroaki Niiro, Mine Harada, Mitsune Tanimoto, Koichi Akashi, Takanori Teshima
Journal: Blood (2009)
Prevention of Cardiovascular Events after Percutaneous Coronary Intervention
Authors: Howard C. Herrmann
Journal: New England Journal of Medicine (2004)

Cardiologists agree that the best and safest percutaneous coronary intervention is the one that never becomes necessary. In this regard, new therapies that prevent restenosis and retard or reverse atherosclerosis are welcomed by noninvasive and interventional cardiologists alike. However, clinically important coronary stenoses and acute coronary syndromes will develop in many patients despite our best efforts at prevention. In such cases, interventionalists may fix the culprit lesion mechanically, but treatment should not end when patients leave the catheterization laboratory (Figure 1).In this issue of the Journal, Lange et al. report that oral supplementation with a combination of folic acid . . .
Germline Mutations of hMLH1 and hMSH2 Genes in Korean Hereditary Nonpolyposis Colorectal Cancer
Authors: H.-J. Han, Y. Yuan, J.-L. Ku, J.-H. Oh, Y.-J. Won, K. J. Kang, K. Y. Kim, S. Kim, C. Y. Kim, J.-P. Kim, N.-G. Oh, K. H. Lee, K. J. Choe, Y. Nakamura, J.-G. Park
Journal: JNCI Journal of the National Cancer Institute (1996)

Some four-year-olds have never eaten a salad.That's one of the reasons there's Head Start.We give low-income preschool children the chance to grow up healthy.And happy.But we need health care volunteers.Especially nutritionists like you.Come show a child what strong bodies are made of.Because if you change the world of a child, you change the world.
Initial Serum Ferritin Levels in Patients with Multiple Trauma and the Subsequent Development of Acute Respiratory Distress Syndrome
Authors: ROSE A. SHARKEY, SEAMAS C. DONNELLY, KEVIN G. CONNELLY, COLIN E. ROBERTSON, CHRISTOPHER HASLETT, JOHN E. REPINE
Journal: American Journal of Respiratory and Critical Care Medicine (1999)

Acute respiratory distress syndrome (ARDS) represents a catastrophic form of inflammatory lung injury that occurs unpredictably in some, but not all, at-risk patients. In this study, we investigated serum ferritin as a marker for ARDS development in a homogenous group of patients at-risk because of multiple trauma. We hypothesized that since ferritin synthesis is increased by proinflammatory cytokines, which are increased and implicated in ARDS, that ferritin levels would increase and that ferritin increases would correlate with the degree of inflammation and therefore the development of ARDS. We studied 42 patients (25 male, 17 female) who as a consequence of multiple trauma became at-risk for developing ARDS. Using the European/American Consensus definition for ARDS, 16 (38%) patients subsequently developed ARDS (11 male and five female). We found that initial serum ferritin levels correlated with the subsequent development of both ARDS (progression to ARDS, median = 638 ng/ml; (range, 70 to 4,500) versus nonprogression to ARDS = 185 ng/ml; range, 12 to 2,850) (p = 0.02, r = − 0.27) and multiple organ failure (p < 0.05, r = 0.39). Using our previously established cutoff points for serum ferritin, the positive predictive value was 62% for men and 75% for women. Initial serum ferritin levels also correlated with a measurement of the degree of initial trauma injury, i.e., the injury severity score (ISS) (p < 0.05, r = 0.37). However, there was no correlation between serum ferritin levels and other markers of clinical injury, namely, lowest PaO2 /Fi O2 ratio (p = 0.67), days requiring ventilation (p = 0.09), or mortality (p = 0.42). A significant association existed between serum ferritin levels and products of endothelial activation, i.e., sE-selectin (p < 0.04, r = 0.37) and sICAM-1 (p < 0.01, r = 0.21). In the future, with the development of novel anti-inflammatory therapies, early identification of specific high-risk patients would allow the institution of these therapies and thereby increase the chances of reducing ARDS morbidity and mortality.
Decreased FOXP3 protein expression in patients with asthma
Authors: S. Provoost, T. Maes, Y. M. Van Durme, P. Gevaert, C. Bachert, C. B. Schmidt‐Weber, G. G. Brusselle, G. F. Joos, K. G. Tournoy
Journal: Allergy (2009)

T-regulatory cells (T(reg)) are important in balancing immune responses and maintaining peripheral tolerance. Current evidence suggests that asthma is characterized by a relative deficiency in T(reg), allowing T helper 2 cells to expand. In this study, we aimed to evaluate circulating T(reg), defined by the protein FOXP3, in both control subjects and patients with stable asthma.Peripheral blood mononuclear cells (PBMC) of control (n = 14) and asthmatic patients (n = 29) were labeled for CD4, CD25, and intracellular FOXP3 and analyzed using flow cytometry. In CD3/CD28 stimulated PBMC, the effects of dexamethasone on the transcription factors T-bet, GATA-3, FOXP3, and RORc2 and representative cytokines were studied.In control subjects and asthmatic patients, numbers of peripheral blood CD4(+)CD25(high) and CD4(+)CD25(high)FOXP3(+) T-cells were similar. However, FOXP3 protein expression within CD4(+)CD25(high) T-cells was significantly decreased in asthmatic patients. There was a tendency for increased FOXP3 expression within CD4(+)CD25(high) T-cells in glucocorticosteroid-treated patients when compared to steroid-naive asthmatic patients. In stimulated PBMC, dexamethasone treatment increased the anti-/proinflammatory transcription ratios of FOXP3/GATA-3, FOXP3/T-bet, and FOXP3/RORc2.Asthmatic patients have decreased FOXP3 protein expression within their CD4(+)CD25(high) T(reg). Our findings also suggest that treatment with inhaled glucocorticosteroids in asthmatics might increase this FOXP3 protein expression within the CD4(+)CD25(high) T-cell population.
Sexual Abuse of Children
Authors: John A. Tilelli, Dianne Turek, Arthur C. Jaffe
Journal: New England Journal of Medicine (1980)

To increase understanding of childhood sexual abuse, we reviewed the hospital records of 113 girls and 17 boys who were the victims of sexual offenses. They were two to 16 years of age and seen in an 18-month period. Thirty had had medical or social problems. Four had previously been raped. Children under eight years old were more likely to know the assailant, to be victims of recurrent sexual or physical abuse, to report crimes without intercourse, and to present with an abused sibling (P less than 0.05). Incest victims were younger than other victims (P less than 0.05). Forty-three children had physical trauma. No pregnancies occurred, although diethylstilbestrol was not routinely used. Three girls had gonorrhea. Seventy-two patients were referred to hospital social services, and 41 to 17 other agencies. Victims and their siblings are at high risk of repeated abuse. Antibiotics and diethylstilbestrol are not routinely indicated. Follow-up may be best achieved by a central agency.