tbuckley/cabot-search huggingface dataset:
Access to Medical Records
Authors: Jermyn F. McCahan
Journal: JAMA (1979)

To the Editor.—  I hope that the letter by David Jacknow, MD (241:2701, 1979), regarding his concern for the preservation of confidentiality of medical records will stimulate other physicians to speak publicly on this issue.  He is concerned that if the Occupational Safety and Health Administration (OSHA) finalizes their proposed regulations permitting access to the complete medical record of workers, a physician in private practice who accepts referrals from industry will have the impossible task of attempting to separate occupational information about patients from nonoccupational information. If the physician were not permitted to do this, Dr Jacknow points out, the patient would be exposed to wide-open scrutiny by OSHA, the National Institute for Occupational Safety and Health (NIOSH), or an authorized representative. Physicians in the full-time practice of occupational medicine are equally concerned about this issue.  Dr Jacknow states he believes this problem has been overlooked, because an article in
Microvascular disease in chronic thromboembolic pulmonary hypertension: a role for pulmonary veins and systemic vasculature
Authors: Peter Dorfmüller, Sven Günther, Maria-Rosa Ghigna, Vincent Thomas de Montpréville, David Boulate, Jean-François Paul, Xavier Jaïs, Benoit Decante, Gérald Simonneau, Philippe Dartevelle, Marc Humbert, Elie Fadel, Olaf Mercier
Journal: European Respiratory Journal (2014)

Limited numbers of operated patients with chronic thromboembolic pulmonary hypertension (CTEPH) are refractory to pulmonary endarterectomy (PEA) and experience persistent pulmonary hypertension (PH). We retrospectively assessed lung histology available from nine patients with persistent PH (ineffective PEA (inPEA) group) and from eight patients transplanted for distal CTEPH inaccessible by PEA (noPEA group). Microscopically observed peculiarities were compared with the histology of a recently developed CTEPH model in piglets. Pre-interventional clinical/haemodynamic data and medical history of patients from the inPEA and noPEA groups were collected and analysed. Conspicuous remodelling of small pulmonary arteries/arterioles, septal veins and pre-septal venules, including focal capillary haemangiomatosis, as well as pronounced hypertrophy and enlargement of bronchial systemic vessels, were the predominant pattern in histology from both groups. Most findings were reproduced in our porcine CTEPH model. Ink injection experiments unmasked abundant venular involvement in so-called small vessel or microvascular disease, as well as post-capillary bronchopulmonary shunting in human and experimental CTEPH. Microvascular disease is partly due to post-capillary remodelling in human and experimental CTEPH and appears to be related to bronchial-to-pulmonary venous shunting. Further studies are needed to clinically assess the functional importance of this finding.
Biliary Stenting in Benign Biliary Stenosis Complicating Chronic Calcifying Pancreatitis
Authors: M. Barthet, J. P. Bernard, J. L. Duval, C. Affriat, J. Sahel
Journal: Endoscopy (1994)

This a retrospective study of 19 patients presenting with chronic pancreatitis and benign stenosis of the common bile duct, who were followed up for periods ranging from 13 months to 48 months after biliary stenting (average 18 months). There were 18 men and one woman, aged between 38 and 65 years (average 49 years). The mean duration of the disease before stenting was seven years (range 1-25 years). Symptoms were present in ten patients: obstructive jaundice in four cases, cholangitis in three cases, and biliary colic in three cases. Nine patients without clinical complaints presented with chronic cholestasis. Endoscopic retrograde cholangiopancreatography (ERCP) showed 15 long, regular stenoses of the intrapancreatic course of the common bile duct, three short stenoses located at the upper margin of the head of the pancreas, and one biliary stenosis associated with peripheral compression by a cyst of the head of the pancreas. Forty endoscopic biliary stenting procedures were performed in the 19 patients over a six-year period. Successful insertion of the prosthesis was achieved in 39 cases. Two complications occurred: one duodenal ulceration and one stent migration into the bile duct. The mean duration of biliary stenting was ten months. Only two patients (10%) had complete clinical, biological, and radiological recovery. Complete failure of biliary stenting was observed in six patients (31%). Eleven patients (59%) had partial results: six (31%) had biological improvement although the biliary stricture persisted, and five were clinically asymptomatic but had cholestasis, and still presented with biliary stenosis in four cases.(ABSTRACT TRUNCATED AT 250 WORDS)
INDURATIVE OR RHEUMATIC HEADACHE
Authors: HUGH T. PATRICK
Journal: JAMA (1918)

HISTORICAL  Thirty-odd years ago, Scandinavian masseurs discovered that in certain cases of headache there was considerable tenderness in the occipital and suboccipital regions, and sometimes in others, and that many of the patients were relieved by persistent massage. 1 Led by the sense of touch, these therapeutists concluded that the trouble lay in multiform thickenings in the forms of nodes, nodules, strands and more diffuse infiltrations. From the statements of their patients they decided that the lesions were produced by exposure, by catching cold, by the rheumatic diathesis and by other agents still more vague. Gradually recognition of this variety of headache percolated into Germany, France and the United States, but full scientific investigation is still lacking. Our knowledge of the trouble remains nearly where it was thirty years ago, but in the meantime concerning it a lot of nonsense has been perpetrated and perpetuated. Now and again it has
In-flight Emergencies: Doc Riders in the Sky
Authors: Burton J. Glass
Journal: JAMA (1990)

<h3>To the Editor.—</h3> I am writing to you in response to your recent article<sup>1</sup>and editorial<sup>2</sup>on airplane travel emergencies in the March 3 issue. Within a span of approximately 7 months, I was a passenger on two separate international flights. In both cases, the carrier was the national airline of the nation that I was visiting. On each of these flights, I was called on to attend an acutely ill passenger—one suffering an acute myocardial infarction and the second passenger suffering from acute sickle cell crisis. The most striking feature of each episode was the unbelievable deference shown to the attending physician relative to any and all medical decisions made (including emergency landings and the provision of emergency services at the landing site), as well as the disparity in the on-board emergency treatment kits and supplies between airlines. In one case, the airplane carried emergency supplies
A nurse led education and direct access service for the management of urinary tract infections in children: prospective controlled trial
Authors: M. G Coulthard
Journal: BMJ (2003)

To determine whether a nurse led education and direct access service improves the care of children with urinary tract infections.Prospective cluster randomised trial.General practitioners in the catchment area of a UK paediatric nephrology department.88 general practices (346 general practitioners, 107 000 children).Rate and quality of diagnosis of urinary tract infection, use of prophylactic antibiotics, convenience for families, and the number of infants with vesicoureteric reflux in whom renal scarring may have been prevented.The study practices diagnosed twice as many urinary tract infections as the control practices (6.42 v 3.45/1000 children/year; ratio 1.86, 95% confidence interval 1.42 to 2.44); nearly four times more in infants (age < 1 year) and six times more in children without specific symptoms. Diagnoses were made more robustly by study practices than by control practices; 99% v 89% of referred patients had their urine cultured and 79% v 60% had bacteriologically proved urinary tract infections (P < 0.001 for both). Overall, 294 of 312 (94%) children aged under 4 years were prescribed antibiotic prophylaxis by study doctors compared with 61 of 147 (41%) by control doctors (P < 0.001). Study families visited hospital half as much as the control families. Twice as many renal scars were identified in patients attending the study practices. Twelve study infants but no control infants had reflux without scarring.A nurse led intervention improved the management of urinary tract infections in children, was valued by doctors and parents, and may have prevented some renal scarring.
Fumaric acid esters in necrobiosis lipoidica: results of a prospective noncontrolled study
Authors: A. Kreuter, C. Knierim, M. Stucker, F. Pawlak, S. Rotterdam, P. Altmeyer, T. Gambichler
Journal: British Journal of Dermatology (2005)

Necrobiosis lipoidica (NL) is an uncommon granulomatous skin disease with association to diabetes mellitus. To date, no proven effective therapy for NL has been implemented. The standard treatment is topical application of corticosteroids, but numerous agents have been reported for NL, with varying degrees of success. In recent case reports, fumaric acid esters (FAE) have been reported to be effective in granulomatous skin diseases such as granuloma annulare, cutaneous sarcoidosis and NL.We sought to investigate the efficacy of FAE in a larger number of patients with NL.Eighteen patients with histopathologically proven NL were consecutively recruited into a prospective noncontrolled study. Dosage of FAE was given according to the standard therapy regimen for psoriasis. FAE were administered for at least 6 months. The treatment outcome was evaluated by means of clinical and histological scoring and 20-MHz ultrasound assessments.Three patients discontinued therapy with FAE, while the remaining 15 patients finished the study. After a mean +/- SD treatment period of 7.7 +/- 2.9 months, a significant (P < 0.001) decrease in the mean +/- SD clinical score, from 7.4 +/- 1.8 at the beginning to 2.5 +/- 1.3 at the end of therapy, was observed. Significant clinical improvement of NL was accompanied by significant (P = 0.019) increase of dermal density as assessed by means of 20-MHz ultrasound, and significant (P = 0.011) reduction of the histological score. Adverse effects were moderate and consisted mainly of gastrointestinal complaints and flushing. During follow-up of at least 6 months, clinical outcome remained stable in all patients.The results of this study demonstrate that FAE are beneficial and safe in the treatment of patients with NL.
Nosocomial Sepsis Associated with Interleukin-2
Authors: David R. Snydman
Journal: Annals of Internal Medicine (1990)

Study Objective: To determine the incidence, clinical magnitude, and risk factors for nosocomial bacteremia in patients given interleukin-2 with or without (±) lymphokine activated killer (LAK) cells for cancer immunotherapy. Design: Cohort study. Setting: Clinical study unit of tertiary medical center. Patients: All patients entering the interleukin-2 ±LAK cancer immunotherapy protocol during a 28-month period. Control groups were patients in a surgical intensive care unit, patients receiving total parenteral nutrition, and patients with solid tumors. Measurements and Main Results: Twenty of 107 (19%) interleukin-2-treated patients developed sepsis; in 12 of these patients, sepsis was intravenous catheter-associated. The bacteremia rate among patients receiving total parenteral nutrition, in the surgical intensive care unit, or having solid tumors was 2.8%, 4.1%, and 1.9%, respectively. Staphylococcus aureus was the pathogen in 13 courses; Staphylococcus epidermidis, in 5; and Escherichia coli, in 2. Two patients died; three developed suppurative thrombophlebitis; one developed septic arthritis; one, septic arterial aneurysm; and one, peritonitis with probable meningitis. Colonization with S. aureus increased the risk of S. aureus bacteremia 6.3-fold (95% CI, 2.8 to 14.5; P < 0.001); skin desquamation at the catheter site increased the relative risk 2.0-fold (95% CI, 1.3 to 3.1; P = 0.031). Both colonization with S. aureus and skin desquamation increased the relative risk of S. aureus bacteremia 14.5-fold (95% CI, 4.1 to 50.9; P < 0.0001). Conclusions: Staphylococcal bacteremia is more frequent in patients receiving interleukin-2 therapy and is associated with substantial morbidity and toxic skin reactions.
Abstract 818: Modulation of gene expression and cell cycle signaling pathways in Iressa-treated urinary bladder cancer in rats
Authors: Yan Lu, Pengyuan Liu, Clinton Grubbs, Ronald Lubet, Ming You
Journal: Cancer Research (2011)

Abstract The EGFR inhibitor Iressa has demonstrated strong preventive efficacy in the N-butyl-N-(4-hydroxybutyl)-nitrosamine (OH-BBN) model of bladder cancer in the rat. To explore its antitumor mechanism, we implemented a systems biology approach to characterize gene expression and signaling pathways in rat urinary bladder cancers treated with Iressa. Eleven bladder tumors from control rats, seven tumors from rats treated with Iressa and seven normal bladder epithelia were profiled using Affymetrix Rat Exon 1.0 ST Arrays. We identified 713 down-regulated and 641 up-regulated genes in comparing bladder tumors vs. normal bladder epithelia. In addition, 178 genes were down-regulated and 96 genes were up-regulated when comparing control tumors vs. Iressa-treated tumors. Two coexpression modules that were significantly correlated with tumor status and treatment status were identified (r = 0.70, P = 2.80 × 10−15 (bladder tumor vs. normal bladder epithelium) and r = 0.63, P = 2.00 × 10−42 (Iressa-treated tumor vs. control tumor), respectively). Both tumor module and treatment module were enriched for genes involved in cell cycle processes. Twenty-four and twenty-one highly connected hub genes likely to be key drivers in cell cycle were identified in the tumor module and treatment module, respectively. Analysis of microRNA genes on the array chips demonstrated that tumor module and treatment module were significantly associated with expression levels of let-7c (r = 0.54, P = 3.70 × 10−8 and r = 0.73, P = 1.50 × 10−65 respectively). These results suggest that let-7c down-regulation and its regulated cell cycle pathway may play an integral role in governing bladder tumor suppression or collaborative oncogenesis and that Iressa exhibits its preventive efficacy on bladder tumorigenesis by up-regulating let-7 and inhibiting the cell cycle. The identified hub genes may also serve as pharmacodynamic or efficacy biomarkers in clinical trials of chemoprevention in human bladder cancer. 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 818. doi:10.1158/1538-7445.AM2011-818
Changes to India's patent law
Authors: Richard Barker
Journal: BMJ (2005)

Reduction in mortality from breast cancerDecrease with screening was marked in younger age group Editor-Based on a complicated statistical model, Olsen et al reported that the breast cancer mortality in Copenhagen dropped by 25% for women aged 50-79 when comparing mortality in the screening period (1991-2001) with a pre-screening period (1981-91) and claimed that this decrease was caused by screening. 1According to Statistics Denmark, 217 breast cancer deaths occurred in Copenhagen in the age group 35-54 years in the period 1981-90 and 196 deaths in 1991-2000. 2By comparing these data with those in the article by Olsen et al we calculate that less than 5% of the breast cancer mortality in this age group is caused by tumours diagnosed after age 50 years when women were invited to screening.The number of exposure years increased from about 484 000 to about 538 000.This gives a significant 19% (age adjusted) reduction in breast cancer mortality in the age group 35-54 years.No reduction at all occurred in the age group 55-79. 2Our estimates are based on raw and complete data.In contrast, the estimates in the paper by Olsen et al are sensitive to exclusion of data and model choice.In Copenhagen a drop in breast cancer mortality may reflect a higher fertility quotient due to non-Western immigration, fewer nulliparous women, and other non-screening related factors.It is therefore strange that no causal note was made by Olsen et al on the marked decrease in the breast cancer mortality in the age group 35-54 years.
Identification of Conserved Regulatory Elements in Mammalian Promoter Regions: A Case Study Using the PCK1 Promoter
Authors: George E. Liu, Matthew T. Weirauch, Curtis P. Van Tassell, Robert W. Li, Tad S. Sonstegard, Lakshmi K. Matukumalli, Erin E. Connor, Richard W. Hanson, Jianqi Yang
Journal: Genomics Proteomics & Bioinformatics (2008)

Abstract A systematic phylogenetic footprinting approach was performed to identify conserved transcription factor binding sites (TFBSs) in mammalian promoter regions using human, mouse and rat sequence alignments. We found that the score distributions of most binding site models did not follow the Gaussian distribution required by many statistical methods. Therefore, we performed an empirical test to establish the optimal threshold for each model. We gauged our computational predictions by comparing with previously known TFBSs in the PCK1 gene promoter of the cytosolic isoform of phosphoenolpyruvate carboxykinase, and achieved a sensitivity of 75% and a specificity of approximately 32%. Almost all known sites overlapped with predicted sites, and several new putative TFBSs were also identified. We validated a predicted SP1 binding site in the control of PCK1 transcription using gel shift and reporter assays. Finally, we applied our computational approach to the prediction of putative TFBSs within the promoter regions of all available RefSeq genes. Our full set of TFBS predictions is freely available at http://bfgl.anri.barc.usda.gov/tfbsConsSites.
PEPTIC AND DUODENAL ULCER IN TABES DORSALIS
Authors: EDWARD LIVINGSTON HUNT
Journal: JAMA (1931)

Our object in this paper is to report four cases of gastric and duodenal ulcer with tabes dorsalis. In each instance the patient had been under observation, the clinical diagnosis had been agreed on, and the autopsy had been made. The combination of ulcer and tabes is uncommon. Not many cases have been reported and there have been very few in which there has been an autopsy. In this country Crohn has done most of the work on this subject; in France, Roux, Carnot and Bruyere. In Germany, also, a few cases have occurred. Just why a gastric or duodenal ulcer should complicate tabes is not clear. Some one will suggest that it is akin to the ulcer of the foot and therefore a trophic change. The answer is that the ulcers in our four patients showed no evidence either of syphilis or of a malignant condition, but did show
Questions on Genetic Testing Services
Authors: Joan Stephenson
Journal: JAMA (1995)

AS SCIENTISTS pinpoint genes that underlie such diseases as cystic fibrosis and breast cancer, commercial and academic laboratories are scrambling to provide genetic testing services aimed at diagnosing gene-related disorders and assessing future disease risk. The problem with this development, according to a new survey, is that some of the laboratories offering genetic testing are bypassing the admittedly vague regulatory controls or other less formal measures that exist to help assure test validity. Some are also failing to make it clear to physicians and patients that many such procedures are still investigational in nature. "These findings raise questions of whether the quality of labs providing genetic tests can currently be assured," said Neil A. Holtzman, MD, MPH, of Johns Hopkins Medical School in Baltimore, Md, who reported the results of the survey in Minneapolis, Minn, at the annual meeting of the American Society of Human Genetics (ASHG). The survey of
Reduced-intensity conditioning lowers treatment-related mortality of allogeneic stem cell transplantation for chronic lymphocytic leukemia: a population-matched analysis
Authors: P Dreger, R Brand, D Milligan, P Corradini, J Finke, G Lambertenghi Deliliers, R Martino, N Russell, A van Biezen, M Michallet, D Niederwieser
Journal: Leukemia (2005)
CHEMICAL STUDIES IN HOST-VIRUS INTERACTIONS
Authors: Seymour S. Cohen, Rachel Arbogast
Journal: The Journal of Experimental Medicine (1950)

Three mutant pairs of bacterial viruses T2r+ and T2r, T4r+ and T4r, T6r+ and T6r, have been concentrated by differential centrifugation and analyzed. Under conditions of prolonged lysis of organisms grown on broth-agar, the virus concentrates frequently contained phosphorus (P) other than that contained in desoxyribose nucleic acid (DNA). These concentrates reacted with antisera to the host organism, E. coli, specifically precipitating the non-DNA-P but not virus activity or DNA. The amounts of nitrogen precipitated in the virus concentrates by antisera were related to their content of non-DNA-P. These viruses could be purified by differential centrifugation after such treatment to yield preparations apparently free of P other than DNA-P. It has been concluded that there is no satisfactory evidence for the presence of ribose nucleic acid as a constituent part of these viruses.
BMA meeting: representatives say medical associations should speak out against denial of medical services to civilians
Authors: D. Cohen
Journal: BMJ (2009)

The BMA will consider suspending contact with any national medical association that does not speak out against the military targeting of healthcare staff and hospitals or the denial of medical services, representatives at the annual BMA conference have voted.

Although it was made clear that no race, nationality, or faith was favoured, reference was made to humanitarian crises in Darfur, Gaza, and Sri Lanka.

Speaking for the motion (to suspend contact), …
Methods to assess reproductive effects of environmental chemicals: studies of cadmium and boron administered orally.
Authors: R L Dixon, I P Lee, R J Sherins
Journal: Environmental Health Perspectives (1976)

Results of a U.S.S.R.--U.S. cooperative laboratory effort to improve and validate experimental techniques used to assess subtle reproductive effects in male laboratory animals are reported. The present studies attempted to evaluate the reproductive toxicity of cadmium as cadmium chloride and boron as borax (Na2B4O7) and to investigate the mechanism of toxicity in the rat following acute and subchronic oral exposure. In vitro cell separation techniques, in vivo serial mating tests, and plasma assays for hormones were utilized. Effects on the seminal vesicle and prostate were evaluated with chemical and enzyme assays. Clinical chemistry was monitored routinely. Acute oral doses, expressed as boron were 45, 150, and 450 mg/kg while doses for cadmium equivalent were 6.25, 12.5, and 25 mg/kg. Rats were also allowed free access to drinking water containing either boron (0.3, 1.0, and 6.0 mg/l.) or cadmium (0.001, and 0.l mg/l.) for 90 days. Randomly selected animals were studied following 30, 60, and 90 days of treatment. These initial studies, utilizing a variety of methods to assess the reproductive toxicity of environmental substances in male animals, suggest that cadmium and boron at the concentrations and dose regimens tested are without significant reproductive toxicity.