tbuckley/cabot-search huggingface dataset:
Vitamin B6 repletion in cirrhosis with oral pyridoxine: Failure to improve amino acid metabolism
Authors: Michael J. Henderson, Steven S. Scott, Alfred H. Merrill, Bettye Hollins, Michael H. Kutner
Journal: Hepatology (1989)

This study evaluated the effect of daily oral pyridoxine supplementation in patients with cirrhosis. Eight subjects were treated with 25 mg of pyridoxine for 28 days. Before and after the supplementation period, B 6 status was assessed by measuring fasting plasma vitamer levels and response to a 25 mg oral pyridoxine load. In addition, a 24-hr urine collection was analyzed during each load study for B 6 metabolites. The data indicated that supplementation achieved repletion of peripheral B 6 stores, as evidenced by: (i) a significant (p &lt; 0.005) rise in fasting plasma pyridoxal phosphate after supplementation (mean ± S.D. = 56.8 ± 30.5 nmoles per liter) as compared to initial levels (17.0 ± 17.8 nmoles per liter); (ii) a higher (p &lt; 0.05) percentage excretion of the pyridoxine load as urinary 4-pyridoxic acid (31.0 ± 9.3%) compared to the initial load (19.6 ± 5.8%), and (iii) a postsupplementation area under the plasma concentration vs. time curve for pyridoxal phosphate (377 ± 529 nmoles·hr per liter), which was decreased (p &lt; 0.005) from the presupplementation value (934 ± 756 nmoles·hr per liter). The postsupplementation fasting plasma pyridoxal phosphate concentrations were within the normal range. The consequences of B 6 repletion on amino acid metabolism were measured by oral protein loads (n = 4) or oral methionine loads (n = 4). No significant changes were observed for methionine or any other amino acid in regard to plasma fasting concentration, peak concentration or AUC. Although the vitamin B 6 deficiency of cirrhosis was corrected by daily oral pyridoxine supplementation, there was apparently no improvement in the deranged amino acid metabolism.
Hierarchical Authorship-Reply
Authors: Annette Flanagin, Drummond Rennie
Journal: JAMA (1995)

In Reply.  —We thank Dr Cates for his letter describing the problems with hierarchical authorship, and we appreciate the opportunity to address this subject again. 1,2   Cates poses several questions regarding his scenario. To answer his first question,  one who has offered no input into a manuscript should be considered an author and given a guest position in the byline, regardless of position in the hierarchy. When a senior-level manager provides little input, then perhaps that person could be considered an author if she or he has participated sufficiently in the work to take public responsibility for it and made substantial contributions in each of the following three areas: (1) conception and design or analysis and interpretation of data; (2) drafting the article or revising it critically for important intellectual content; and (3) final approval of the version to be published. 3   Cates also asks how the colleague who
Contemporary Unorthodox Treatments in Cancer Medicine
Authors: BARRlE R. CASSILETH
Journal: Annals of Internal Medicine (1984)

Public education, legislative action, and medical advances have failed to deter patients from seeking unorthodox treatments for cancer and other diseases. To study this phenomenon, we interviewed 304 cancer center inpatients and 356 patients under the care of unorthodox practitioners. A concomitant survey of unorthodox practitioners documented their backgrounds and practices. Eight percent of all patients studied never received any conventional therapy, and 54% of patients on conventional therapy also used unorthodox treatments. Forty percent of patients abandoned conventional care entirely after adopting alternative methods. Patients interviewed did not conform to the stereotype of poorly educated, end-stage patients who had exhausted conventional treatment. Practitioners also deviated from the traditional portrait: Of 138 unorthodox practitioners studied, 60% were physicians(M.D.s). Patients are attracted to therapeutic alternatives that reflect social emphasis on personal responsibility, pollution and nutrition, and that move away from perceived deficiencies in conventional medical care.
An Essential Switch in Subunit Composition of a Chromatin Remodeling Complex during Neural Development
Authors: Julie Lessard, Jiang I. Wu, Jeffrey A. Ranish, Mimi Wan, Monte M. Winslow, Brett T. Staahl, Hai Wu, Ruedi Aebersold, Isabella A. Graef, Gerald R. Crabtree
Journal: Neuron (2007)
Francis won't be drawn on resignation of NHS head in wake of Mid Staffordshire inquiry
Authors: M. Limb
Journal: BMJ (2013)

Robert Francis QC, whose inquiry into Mid Staffordshire NHS Foundation Trust damned systemwide failings in care, has refused to be drawn into calls for the resignation of the head of the NHS.

Francis was asked directly at a King’s Fund conference of health experts in London on 27 February whether David Nicholson, chief executive of the NHS Commissioning Board, should resign.

The question was put by Nick Timmins, a senior fellow at the Institute for Government and the King’s Fund, who noted that the inquiry had insisted that there should be no “scapegoats” while demanding greater accountability in the NHS.

Francis said that he would not answer the question as it was not the job of a public inquiry to “put someone on trial” or “pronounce sentence” on individuals.

He said, “Had that approach been adopted, this inquiry would have lasted …
The doctrine of early intervention
Authors: K. Sweeney, D. P. Gray, P. Evans, R. Steele
Journal: BMJ (1996)

The principle of early intervention in a disease process is intuitively appealing. Clearly, where early intervention is synonymous with primary prevention, the principle is sound. You need only to look at the fall in recorded cases of poliomyelitis or meningitis caused by Haemophilus influenzae type B after the introduction of their respective vaccines for confirmation of the value of appropriate early intervention.1 But when early intervention means secondary prevention the issue is less clear. We know now that a combination of exercise, diet, and intensive treatment with insulin can delay the start of microvascular complications in patients with insulin dependent diabetes mellitus.2 On the other hand, considerable debate surrounds the treatment and surveillance of patients diagnosed with ductal carcinoma of the breast,3 prostate cancer,4 or malignant melanoma.5

A recent editorial in the New England Journal of Medicine appraising a paper by Weinberger et al6 presented what its author called the …
Symptomatic gastric heterotopic pancreas: Clinical presentation and review of the literature
Authors: Debesh Rimal, Sonu R. Thapa, Namal Munasinghe, Vivek V. Chitre
Journal: International Journal of Surgery (2007)

Heterotopic pancreas is usually asymptomatic. Associated complications include ulceration, bleeding and obstruction, especially gastric outlet obstruction. Acute and chronic pancreatitis including malignant change have been reported. These lesions are often difficult to differentiate clinically from other gastrointestinal diseases including primary gastric malignancy. Histological examination is mandatory to make a correct diagnosis. Limited surgical excision has been shown to be safe and adequate for heterotopic pancreas. We present a patient with heterotopic pancreas who presented with a non-healing gastric ulcer.
Patterns of Genetic Variation Within and Between Gibbon Species
Authors: S. K. Kim, L. Carbone, C. Becquet, A. R. Mootnick, D. J. Li, P. J. de Jong, J. D. Wall
Journal: Molecular Biology and Evolution (2011)

Gibbons are small, arboreal, highly endangered apes that are understudied compared with other hominoids. At present, there are four recognized genera and approximately 17 species, all likely to have diverged from each other within the last 5–6 My. Although the gibbon phylogeny has been investigated using various approaches (i.e., vocalization, morphology, mitochondrial DNA, karyotype, etc.), the precise taxonomic relationships are still highly debated. Here, we present the first survey of nuclear sequence variation within and between gibbon species with the goal of estimating basic population genetic parameters. We gathered ∼60 kb of sequence data from a panel of 19 gibbons representing nine species and all four genera. We observe high levels of nucleotide diversity within species, indicative of large historical population sizes. In addition, we find low levels of genetic differentiation between species within a genus comparable to what has been estimated for human populations. This is likely due to ongoing or episodic gene flow between species, and we estimate a migration rate between Nomascus leucogenys and N. gabriellae of roughly one migrant every two generations. Together, our findings suggest that gibbons have had a complex demographic history involving hybridization or mixing between diverged populations.
Do It to Yourself Section
Authors: Drummond Rennie
Journal: JAMA (1987)

THIS editor was intrigued and felt he could help. "The photo" Dr Hirsch had enclosed was a photocopy of a faded photograph from some unnamed newspaper. Elsewhere on the clipping was a reference to "Snoops applaud showgirls, hoist highballs, then raid lavish Club Calais on W. 51st St." That and an item about a Brooklyn sheriff who had allowed the county interest money to accrue to his private thrift account induced a comfortable feeling of déjà vu, and then a sad feeling of plus ça change, but it also suggested a place and therefore a paper:<i>The New York Times</i>. <i>The New York Times</i>of Feb 16,1921,<sup>1</sup>carried this "special": KANE. Pa, Feb. 15.—Dr. Evan O'Neill Kane, chief surgeon of Kane Summit Hospital, performed an operation upon himself for chronic appendicitis this forenoon. Sitting on the operating table propped up by pillows and with a nurse holding his head
Just Fading Away? The Closing of Walter Reed
Authors: Howard Markel
Journal: New England Journal of Medicine (2005)

This summer, the Defense Base Reallocation and Closure (BRAC) Commission decided unanimously to close the venerable Walter Reed Army Medical Center in Washington, D.C. Long touted as the nation's flagship military medical center, Walter Reed opened its doors on May 1, 1909. In the 96 years that have passed, it has served hundreds of thousands of soldiers and a veritable parade of U.S. presidents, congressmen, Supreme Court justices, military leaders, and international dignitaries.(Figure)Yet, like many aging medical centers throughout the country, Walter Reed is in need of intensive care. Its main hospital building was built in 1972 . . .
Controlled therapeutic trials in polymorphic light eruption
Authors: M.F. CORBETT, J.L.M. HAWK, A. HERXHEIMER, I.A. MAGNUS
Journal: British Journal of Dermatology (1982)

A series of controlled trials of treatments for polymorphic light eruption (PLE) with oral β‐carotene, ketoprofen and chloroquine, and topical benzimidazole sunscreen cream is described. Clinical features were recorded using diary cards filled out by the patients, and exposure to UVR was measured individually in all patients with film badges. Symptoms were found to be dependent on exposure. None of the treatments proved very effective, but β‐carotene seemed to give significant slight protection against irritation and erythema, though this was not confirmed in a repeat study using a higher dose. Chloroquine seemed to protect slightly against irritation. As the degree of improvement with chloroquine and β‐carotene is quite small, equivalent to a protection factor of 2, it is arguable whether these treatments as used here are worthwhile and in the case of chloroquine, with its risk of adverse side effects, whether it is justifiable. Other treatment; and dose regimes are possible and further trials seem worthwhile. Our studies have helped to define the special difficulties in collecting objective data in PLE and should improve the methods for assessing treatment in the photodermatoses.
THE CIRCULATING RED CELL AND PLASMA VOLUME AND THE DISTRIBUTION OF BLOOD IN LARGE AND MINUTE VESSELS IN EXPERIMENTAL SHOCK IN DOGS, MEASURED BY RADIOACTIVE ISOTOPES OF IRON AND IODINE 1
Authors: John G. Gibson, Arnold M. Seligman, Wendell C. Peacock, Jacob Fine, Joseph C. Aub, Robley D. Evans
Journal: Journal of Clinical Investigation (1947)

repeat cell and a plasma volume were determined at vary- ing intervals after the albumin infusion.Series I. Gross volume studies.Determinations were carried out in dogs in whom shock was experimentally induced as follows:Hemorrhage: Controls-Bled for samples only-2 dogs.Moderate bleeding but not to shock level-1 dog.Severe bleeding to shock levels-10 dogs.Severely bled, treated with dog plasma-2 dogs.Severely bled, treated with bovine albumin-1 dog.Severely bled, treated with whole dog blood trans- fusion-i dog.Muscle trauma:Blalock crusher-3 dogs.Ligation of both gastrocnemii-1 dog.Bilateral occlusion tourniquets-1 dog.Burns: Flame, treated with bovine albumin-3 dogs.Water (98°F.)-1dog.Bacterial toxins: 2 Shiga toxin-2 dogs.Clostridium toxin-1 dog.In all of these experiments, the plasma and red cell volumes were determined prior to the experimental pro- cedure.The total quantity of blood withdrawn, in both sampling and intentional and accidental hemorrhage, and
In Situ and Invasive Carcinoma of the Cervix Uteri
Authors: John T. Godwin
Journal: JAMA (1961)

<h3>To the Editor:—</h3> I am writing in reference to the editorial, "Carcinoma In Situ and Invasive Carcinoma of Cervix Uteri," which appeared inThe Journal, Nov. 5, 1960, page 1323. It is possible that the last paragraph on page 1324 might be misleading, in that removal from the context of the original article, "Progress in Fundamental Medicine," by J. F. A. McManus, in which it appeared gives it a different connotation. Stoddard stated at the outset that "it has been suggested that carcinoma in situ of the cervix is found unusually often in pregnant uteri and that the lesion may regress after parturition. There have been only a few investigations specifically toward verification of these two beliefs, and even tentative conclusions are very likely premature." Also, "as already noted, the question of how often in situ carcinoma becomes invasive is not settled in the nonpregnant or the pregnant state. Moreover,
Huge Necrotic Liver Metastases in Advanced Pancreatic Carcinoma Visualized on Bone Scans
Authors: MARTIN GOTTHARDT, ULRICH WELCKE, HANS-WALTER FRITSCH, BABETTE SIMON, MARC FISCHER, DESIREÉ BRANDT, HELMUT HÖFFKEN, KLAUS JOSEPH
Journal: Clinical Nuclear Medicine (2000)

A 49-year-old man had a histologically confirmed pancreatic carcinoma with several huge necrotic metastases in the liver. Many cases of increased radionuclide uptake in liver metastases have been reported, but in this case the radionuclide uptake was missing.
Split in commissioning between local authorities and health bodies is reducing access to sexual health services
Authors: M. Limb
Journal: BMJ (2013)

Sexual health outcomes in England are at risk of deteriorating because of “fragmented” commissioning and lack of leadership in the system, experts told a conference.

Jane Hatfield, chief executive of the Royal College of Obstetricians and Gynaecologists’ Faculty of Sexual and Reproductive Healthcare, said that poor access to contraception services was causing concern and could lead to more unplanned teenage pregnancies and abortions.

She said, “There is a lack of leadership in the current fragmented structures and a lack of a strong patient voice.”

Hatfield said that well supported contraception services were important and offered women a chance to talk to health professionals about wider personal health matters.

She said that her faculty was hearing complaints about local authorities limiting or restricting …
The United States Foreign Medical Aid Program
Authors: John M. Weir
Journal: New England Journal of Medicine (1964)

PHYSICIANS, like all Americans, are preoccupied with the hazards and the exciting challenge of the Atomic Age. The great issues raised by nuclear science obscure the fact that an equally challenging age has developed since the end of World War II: the age of developing nations and technical assistance. In terms of human values and political stability the degree of success of the advanced nations in meeting the challenge of this age may be as important to civilization as the peaceful control of atomic energy and the remarkable advances in biology, medicine and technology that result from the Atomic . . .
Epidermal Growth Factor Receptor Intron-1 Polymorphism Predicts Gefitinib Outcome in Advanced Non-small Cell Lung Cancer
Authors: Marcello Tiseo, Marzia Capelletti, Giuseppe De Palma, Vittorio Franciosi, Andrea Cavazzoni, Paola Mozzoni, Roberta R. Alfieri, Matteo Goldoni, Maricla Galetti, Beatrice Bortesi, Cecilia Bozzetti, Maura Loprevite, Luca Boni, Roberta Camisa, Guido Rindi, Pier Giorgio Petronini, Andrea Ardizzoni
Journal: Journal of Thoracic Oncology (2008)
The Mercurial Lens in Dentistry
Authors: Emanuel Rosen
Journal: JAMA (1971)

<h3>To the Editor.—</h3> The present provocation of mercurial piscatorial pollution appears to have spilled over and intoThe Journal(<b>215</b>:647, 1971), wherein a dentist who, because of his long-term exposure to mercury asked, "Are there any studies that have a bearing upon this problem?" To this no answer appeared. In 1949, a report entitled "A Newly Observed Ophthalmologic Occupational Hazard in Dentistry" described a dentist whose complaints were headache and fatigue (<i>Amer Dental J,</i>1949, p 1044). There was no visual difficulty. He had never worn glasses, nor had he ever had a previous ocular complaint. In his work he had been "pushing amalgams" for many years. He had always mixed the amalgam upon the palms of his hands as is so frequently done by many dentists. His clientele was restricted to persons of a poor economic stratum, which meant that most of his reconstructive work would of necessity
Quantitative trait loci influencing cholesterol and phospholipid phenotypes map to chromosomes that contain genes regulating blood pressure in the spontaneously hypertensive rat.
Authors: A Bottger, H A van Lith, V Kren, D Krenová, V Bílá, J Vorlícek, V Zídek, A Musilová, M Zdobinská, J M Wang, B F van Zutphen, T W Kurtz, M Pravenec
Journal: Journal of Clinical Investigation (1996)

The frequent coincidence of hypertension and dyslipidemia suggests that related genetic factors might underlie these common risk factors for cardiovascular disease. To investigate whether quantitative trait loci (QTLs) regulating lipid levels map to chromosomes known to contain genes regulating blood pressure, we used a genome scanning approach to map QTLs influencing cholesterol and phospholipid phenotypes in a large set of recombinant inbred strains and in congenic strains derived from the spontaneously hypertensive rat and normotensive Brown-Norway (BN.Lx) rat fed normal and high cholesterol diets. QTLs regulating lipid phenotypes were mapped by scanning the genome with 534 genetic markers. A significant relationship (P < 0.00006) was found between basal HDL2 cholesterol levels and the D19Mit2 marker on chromosome 19. Analysis of congenic strains of spontaneously hypertensive rat indicated that QTLs regulating postdietary lipid phenotypes exist also on chromosomes 8 and 20. Previous studies in the recombinant inbred and congenic strains have demonstrated the presence of blood pressure regulatory genes in corresponding segments of chromosomes 8, 19, and 20. These findings provide support for the hypothesis that blood pressure and certain lipid subfractions can be modulated by linked genes or perhaps even the same genes.
Efficacy of the Long-Acting Repeatable Formulation of the Somatostatin Analogue Octreotide in Postoperative Dumping
Authors: Joris Arts, Philip Caenepeel, Raf Bisschops, Dominiek Dewulf, Lieselot Holvoet, Hubert Piessevaux, Stefan Bourgeois, Daniel Sifrim, Jozef Janssens, Jan Tack
Journal: Clinical Gastroenterology and Hepatology (2008)
Possible Dangers of Naloxone Use-Reply
Authors: Ken Kulig
Journal: JAMA (1982)

<h3>In Reply.—</h3> If the literature concerning the alleged adverse effects of naloxone is read carefully, a consistent pattern can be seen. The cases are all anecdotal reports of postoperative patients who have experienced substantial medical complications some minutes after the administration of naloxone during their emergence from anesthesia. The patients, for the most part, underwent major surgery that required large amounts of narcotics and multiple other agents for adequate anesthesia and analgesia. The temporal sequence of events after surgery may implicate naloxone as a causative agent, but the association is weak at best. The conclusion that can be drawn from these cases is only that naloxone should be used judiciously in patients emerging from anesthesia. The use of naloxone as both a diagnostic and therapeutic agent in unconscious patients in the emergency department is not analogous to its use after surgery. When naloxone has been used in acutely poisoned patients,
PSRO. Guidelines for criteria of care
Authors: C. E. Welch
Journal: JAMA (1975)

PRESERVATION of high-quality medical care in the future will depend in an important way on standards set by local Professional Standards Review Organizations (PSROs). Such standards must be based on criteria that are applicable initially to the care of patients in short-term hospitals with specific diagnoses or problems. The development of model criteria was assigned in 1972 by the American Medical Association to a Task Force on Guidelines of Care. A report from this Task Force appeared approximately six months ago.<sup>1,2</sup>It is the purpose of this communication to outline the related activities of the AMA since that date and to indicate future plans. <h3>Historical Note</h3> In June 1974, the AMA House of Delegates directed the Board of Trustees to "exert efforts to insure appropriate regulations and directives of PL 92-603." Meanwhile, the Office of Professional Standards Review-Bureau of Quality Assurance (OPSR-BQA) of the Department of Health, Education, and
Diagnosis and Treatment of Psychiatric Disorders
Authors: Richard M. Glass
Journal: JAMA (1994)

The American Psychiatric Association, the oldest national medical society in the United States, was established in 1844. Known then as the Association of Medical Superintendents of American Institutions for the Insane, the association was founded by 13 physicians from nine states who shared an interest in promoting research on mental illness and better treatment for the mentally ill.<sup>1</sup>The identity of psychiatry as a medical specialty emerged gradually during the second half of the 19th century. In 1892 the name of the organization was changed to the American Medico-Psychological Association. The first half of the 20th century saw two parallel and sometimes conflicting developments: emphasis on descriptive diagnosis (especially the distinction between schizophrenia and affective disorders) and the growing influence of psychoanalysis. In 1921 the current name of the organization, the American Psychiatric Association (APA), was adopted. During the second half of the 20th century, dramatic developments in psychiatric
A Brief Case Report
Authors: Bernard P. Wolff
Journal: JAMA (1979)

To the Editor.—  An 88-year-old man, depressed because of recent illness, shot himself four times in the head at point-blank range with a 32 caliber revolver. Powder burns were noted at the entry wounds that were located above the right and left ears and the vertex (two shots) of the scalp. The bullets were all flattened and located several centimeters beyond the entry site (Fig 1,2).  In the emergency room approximately 1 1/2 hours later, he was alert and fully conscious. There was slight external bleeding and moderate hematoma formation in the scalp. A skull roentgenogram (Fig 3) showed all bullets to be grouped over the upper parietal bone. The skull was not penetrated, and no fracture was present. The bullets were easily removed. The patient subsequently made an excellent physical and mental improvement.  This report is unique in the remarkably minor injury resulting from a powerful weapon. Perhaps the age