tbuckley/cabot-search huggingface dataset:
What Is the Best Way to Predict Disease-Free Survival After Preoperative Radiochemotherapy for Rectal Cancer Patients: Tumor Regression Grading, Nodal Status, or Circumferential Resection Margin Invasion?
Authors: Jean-Pascal Machiels, Selda Aydin, Marie-Alix Bonny, Fatima Hammouch, Christine Sempoux
Journal: Journal of Clinical Oncology (2006)
The Duty to Attend Upon the Sick-Reply
Authors: Joyce V. Kelly
Journal: JAMA (1992)

<h3>In Reply.</h3> —We appreciate the survey evidence reported by Imperato supporting our finding that New York City experienced a greater decline in house staff recruitment than did the four comparison low-AIDS cities or the nation during the 1980s.<sup>1</sup>Indeed, we cited that work and considered it when we suggested that AIDS may have contributed to the trends we observed. We also agree that it is possible, as Clarke and Conley suggest, that match applicants did not distinguish between high- and low-AIDS programs but "chose to avoid the city entirely."<sup>2</sup> However, if, as Dr Imperato suggests, AIDS primarily accounted for our findings, we would not have expected to find as we did that New York City municipal hospitals alone accounted for the overall drop in matches to New York City. During the study period, both high-AIDS and low-AIDS voluntary residency programs experienced no absolute decline in number of matches
Expression cloning of a human granulocyte colony-stimulating factor receptor: a structural mosaic of hematopoietin receptor, immunoglobulin, and fibronectin domains.
Authors: A Larsen, T Davis, B M Curtis, S Gimpel, J E Sims, D Cosman, L Park, E Sorensen, C J March, C A Smith
Journal: The Journal of Experimental Medicine (1990)

We report the isolation from a placental library, of two cDNAs that can encode high affinity receptors for granulocyte colony-stimulating factor (G-CSF) when expressed in COS-7 cells. The cDNAs are predicted to encode integral membrane proteins of 759 and 812 amino acids in length. The predicted extracellular and membrane spanning sequences of the two clones are identical, as are the first 96 amino acids of their respective cytoplasmic regions. Different COOH termini of 34 or 87 residues are predicted for the two cDNAs, due apparently to alternate splicing. The receptor with the longer cytoplasmic domain is the closest human homologue of the murine G-CSF receptor recently described by Fukunaga et al. (Fukunaga, R., E. Ishizaka-Ikeda, Y. Seto, and S. Nagata. 1990. Cell. 61:341). A hybridization probe derived from the placental G-CSF receptor cDNA detects a approximately 3-kb transcript in RNAs isolated from placenta and a number of lymphoid and myeloid cells. The extracellular region of the G-CSF receptors is composed of four distinct types of structural domains, previously recognized in other cell surface proteins. In addition to the two domains of the HP receptor family-defining region (Patthy, L. 1990. Cell. 61:13) it incorporates one NH2-terminal Ig-like domain, and three additional repeats of fibronectin type III-like domains. The presence of both an NH2-terminal Ig-like domain and multiple membrane-proximal FN3-like domains suggests that the G-CSF receptor may be derived from an ancestral NCAM-like molecule and that the G-CSF receptor may function in some adhesion or recognition events at the cell surface in addition to the binding of G-CSF.
Turbuhaler®: a new device for dry powder terbutaline inhalation
Authors: C. R. Johnsen, E. Rung Weeke
Journal: Allergy (1988)

The aim of this study was to compare bronchodilator response and adverse effects of terbutaline when administered with the metered dose inhaler (MDI) Bricanyl® and with the dry powder inhaler Bricanyl Turbuhaler® (BT). Nine adult patients with bronchial asthma participated. The study was of an open crossover design. At 30–min intervals the patients inhaled increasing doses of terbutaline (0.25 mg to 5.0 mg cumulated) from either the conventional MDI or from the BT. After each inhalation FEV 1 , FVC, heart rate, muscle tremor and adverse effects were recorded. Both treatments, BT and MDI, resulted in a dose‐related increase in lung function, without any statistical difference. Taste sensation, muscle tremor and increase in heart rate were observed in both groups. Because of the design of the BT one may assume that inhalation failure can be avoided.
Residual Left Ventricular Pump Function After Acute Myocardial Infarction in NIDDM Patients
Authors: T Iwasaka, N Takahashi, S Nakamura, T Sugiura, N Tarumi, Y Kimura, N Okubo, H Taniguchi, Y Matsui, M Inada
Journal: Diabetes Care (1992)

OBJECTIVE Left ventricular remodeling occurs immediately after MI, involving structural changes in noninfarcted segment. However, the residual left ventricular pump function in NIDDM patients after acute MI has not been clarified. The purpose of this study was to evaluate the difference in the process of left ventricular remodeling between NIDDM and nondiabetic patients. RESEARCH DESIGN AND METHODS Left ventricular regional EF images obtained by radionuclide angiography were investigated in 20 NIDDM and 29 nondiabetic patients the 3rd wk after acute MI. RESULTS Regional EF of the noninfarcted area and P/V had a significant hyperbolic relation with left ventricular EDV in both groups of patients. Despite no difference in the extent of myocardial necrosis and the number of coronary vessels diseased between NIDDM and nondiabetic patients, regional EF of the noninfarcted area and P/V were significantly lower when left ventricular EDV increased in NIDDM patients compared with nondiabetic patients. CONCLUSIONS Pathogenetic changes of the residual myocardium associated with NIDDM may adversely influence the process of left ventricular remodeling after MI, especially in patients with increased left ventricular EDV.
American Board of Internal Medicine Maintenance of Certification Program — Polling Results
Authors: Patricia A. Kritek, Jeffrey M. Drazen
Journal: New England Journal of Medicine (2010)

In early March, we presented the case of a physician who had certificates of unlimited duration from the American Board of Internal Medicine (ABIM) in both internal medicine and endocrinology, in Clinical Decisions,1 an interactive feature designed to assess how readers would manage an issue for which there may be more than one appropriate recommendation. The physician was active at an academic teaching center, although the majority of his time was spent delivering care in the outpatient setting. Readers were asked to advise him to either enroll or not enroll in the ABIM's current maintenance of certification (MOC) program.A . . .
Letter: Drugs for gastric ulceration.
Authors: T L Cleave
Journal: BMJ (1974)

561 maternal intoxication and therefore the lack of maternal clinical hypervitaminosis has little relevance to the discussion of the terateg.nicpotential of vitamin A.1 It is evident that the conclusion of Mrs. Wild and her colleagues that "it seems unlikely that women who conceive soon after dis- continuing oral cont,raception run any teratogenic risk from increased vitamin A levels" may yet be more definite than is warranted by their data and should not be accepted as final.Further work is required.-I am, etc.,
Immunity to hepatitis B among health care workers performing exposure prone procedures
Authors: C J M Poole, S Miller, G Fillingham
Journal: BMJ (1994)

Health care workers who are in direct contact with blood are at increased risk of acquiring hepatitis B infection.The Department of Health recommends vaccination against hepatitis B for people at special risk.'We report a case of Reiter's syndrome after the second dose of Engerix B vaccine and a case of reactive arthritis after the first, both occurring in health care workers. Case reports CASE 1A 29 year old health care worker developed polyarthritis four weeks after the second injection in a course of hepatitis B immunisation.Initially, he had developed pain, stiffness, and swelling in his left wrist and his knees and had been unable to walk.He had also developed bilateral conjuctivitis and dysuria.There had been no prodromal illness.On examination he was not feverish, and he had bilaterial conjunctivitis with scanty purulent dis- charge.His right knee was hot, swollen, and tender but no effusion was detectable.He had a normal full blood count with a raised plasma viscosity (1 -90, normal range 1 5-1 72).Liver enzyme activities were normal, and screening for rheumatoid factor and autoanti- bodies gave negative results.Urine cultures were sterile; a urethral swab was not taken.He improved with bed rest and splinting and was discharged from hospital taking indomethacin.Over the next six months he had intermittent dysuria but urine cultures remained sterile.He subsequently developed persistent swelling in his wrists and knees.Enteric coated prednisolone 5 mg daily was added, and his symptoms improved gradually over the next four months, when all drugs were withdrawn.He was observed for a further four months with no recurrence in his symptoms and remained well during the following year.
Cycling the Simpson Desert
Authors: John R Sutton
Journal: British Journal of Sports Medicine (1996)

Having spent most of my professional life in Canada and enjoyed challenges such as the Canadian Ski Marathon, the Nahanni River and climbing Mt Logan -almost annually in the 1970s -it was hard to work out an appropriate substitute upon our return to Australia.The cross-country skiing is, nevertheless, quite extensive, the rivers - especially in Tasmania -can also be challenging.But the mountains are no match for Mt Logan.Still what I needed was something unique.It was then that I learned of the crazy idea to cycle across the driest, harshest and hottest desert in Australia -the Simpson Desert.The plan was to start on its western edge -almost in the centre of Australia, and travel east to the frontier town of Birdsville in far western Queensland.Yvonne, my travelling companion of nearly 30 years, was again on the go as my support team.How to prepare?Well that wasn't that easy living in Sydney -a most inhospitable
The Risk of Atrial Fibrillation Following Radiofrequency Catheter Ablation of Atrial Flutter
Authors: François Philippon, Vance J. Plumb, Andrew E. Epstein, G. Neal Kay
Journal: Circulation (1995)

Background Although radiofrequency catheter ablation of atrial flutter is associated with a high rate of initial success, several clinical issues regarding this therapy remain to be defined. For example, the risks of recurrent atrial flutter and of developing atrial fibrillation after flutter ablation are unknown. In addition, it is not known whether elimination of atrial flutter will modify the natural history of atrial fibrillation in patients who experience both of these arrhythmias. The purpose of the present study was to determine the actuarial freedom from recurrent or new atrial arrhythmias in patients with atrial flutter undergoing catheter ablation. Methods and Results The study population consisted of 59 consecutive patients (mean age, 61.9±12.6 years) with typical atrial flutter who underwent catheter ablation of the reentrant circuit. Catheter ablation was not advised for patients in whom paroxysmal atrial fibrillation had been a major clinical problem. The inducibility of atrial fibrillation and atrial flutter was assessed after successful atrial flutter ablation with programmed atrial stimulation and rapid atrial pacing to a cycle length of 180 ms or 2:1 atrial capture. Atrial flutter was successfully ablated and rendered noninducible in 53 of 59 patients (90%). Over a mean follow-up period of 13.2±6.6 months, atrial flutter recurred in 5 patients (9.4%). Atrial fibrillation occurred in 14 of 53 patients after successful ablation (26.4%). Four clinical variables were associated by univariate analysis with the late occurrence of atrial fibrillation: (1) the presence of structural heart disease, (2) a history of atrial fibrillation before ablation of atrial flutter, (3) inducible sustained atrial fibrillation after ablation, and (4) a greater number of failed antiarrhythmic drugs. By multivariate analysis, only the persistent inducibility of sustained atrial fibrillation predicted the later development of atrial fibrillation. Conclusions Although atrial flutter ablation is highly effective and associated with a low risk of recurrent atrial flutter, atrial fibrillation continues to be a long-term risk for individuals undergoing this procedure. The risk of later atrial fibrillation is especially high for patients in whom sustained atrial fibrillation remains inducible after ablation of atrial flutter.
Psychological factors in asthma control and attack risk
Authors: L M Osman
Journal: Thorax (2002)

The risk of asthma episodes may depend on a complex relationship between psychological factors and the experience of a recent attack.

In a series of Australian studies Yellowlees,1 Ruffin,2 and Campbell3 have found high rates of anxiety and panic disorder among patients who have suffered near fatal asthma episodes. In the UK Ayres and coworkers have found a high lifetime prevalence of psychiatric symptoms and psychiatric morbidity in patients with brittle asthma.4,5 Both the Australian studies and that by Ayres et al report a consistent pattern of high levels of denial of asthma and delay in seeking help in acute attacks. The confidential enquiries into asthma deaths6–8 suggest that psychological factors including denial and delay contribute to some deaths. Patients who had died from asthma were more likely to be those who found it difficult to cooperate with medical management.

However, these studies only refer to a small minority of asthma patients, are post hoc, and may be relevant only to a special group of asthmatic subjects. It is not easy to translate these findings for very severe high risk subjects to moderate asthmatics in general practice.

Anxiety is not always found to be higher among patients with poorly controlled asthma. Barboni et al 9 compared patients with near fatal asthma with a group of matched controls and found no difference in psychiatric anxiety scores between the two groups. Boseley et al 10 found no significant difference in anxiety between adherent and non-adherent patients. Some anxiety may be useful in self-management. Spinhoven et al 11 found that anxious subjects were more accurate in detecting a fault in forced expiratory volume in 1 …
Why Treatment Fails in Type 2 Diabetes
Authors: Anders Rosengren, Xingjun Jing, Lena Eliasson, Erik Renström
Journal: PLoS Medicine (2008)

Diabetes mellitus is the most common endocrine disease in the world. The World Health Organization estimates that the disease is responsible for about 5% of all deaths globally each year, a figure that is projected to increase by 50% within a decade (http://www.who.int/diabetes/en/). Diabetes mellitus is easily diagnosed by the characteristic chronic elevation in blood glucose concentration, but is in fact merely an umbrella diagnosis with several disease subtypes.
Uptake of 125I albumin by the endothelial surface of the isolated dog common carotid artery: effect of certain physical factors and metabolic inhibitors
Authors: A. SIFLINGER, K. PARKER, C. G. CARO
Journal: Cardiovascular Research (1975)

A study has been made, under transient conditions, of the uptake of 125I albumin by the endothelial surface of isolated dog carotid arteries. Effective rate constants were determined and the apparent activation energy was calculated to be about 13 kcal/mol in the range 25-37 degrees C. Label uptake was not significantly altered by the presence of 1 mmol/1 potassium cyanide or 10 mmol/1 iodoacetate in the incubating medium, or by the absence of substrate from it, consistent with the process being primarily passive. It appeared that the label entered the wall mainly by other routes than the endothelial inter-cell clefts.
Epithelial expression of angiogenic growth factors modulate arterial vasculogenesis in human liver development
Authors: Luca Fabris, Massimiliano Cadamuro, Louis Libbrecht, Peggy Raynaud, Carlo Spirlì, Romina Fiorotto, Lajos Okolicsanyi, Frederic Lemaigre, Mario Strazzabosco, Tania Roskams
Journal: Hepatology (2007)

Intrahepatic bile ducts maintain a close anatomical relationship with hepatic arteries. During liver ontogenesis, the development of the hepatic artery appears to be modulated by unknown signals originating from the bile duct. Given the capability of cholangiocytes to produce angiogenic growth factors and influence peribiliary vascularization, we studied the immunohistochemical expression of vascular endothelial growth factor (VEGF), angiopoietin-1, angiopoietin-2, and their cognate receptors (VEGFR-1, VEGFR-2, Tie-2) in fetal human livers at different gestational ages and in mice characterized by defective biliary morphogenesis ( Hnf6 −/−). The results showed that throughout the different developmental stages, VEGF was expressed by developing bile ducts and angiopoietin-1 by hepatoblasts, whereas their cognate receptors were variably expressed by vascular cells according to the different maturational stages. Precursors of endothelial and mural cells expressed VEGFR-2 and Tie-2, respectively. In immature hepatic arteries, endothelial cells expressed VEGFR-1, whereas mural cells expressed both Tie-2 and Angiopoietin-2. In mature hepatic arteries, endothelial cells expressed Tie-2 along with VEGFR-1. In early postnatal Hnf6 −/− mice, VEGF-expressing ductal plates failed to incorporate into the portal mesenchyma, resulting in severely altered arterial vasculogenesis. Conclusion: The reciprocal expression of angiogenic growth factors and receptors during development supports their involvement in the cross talk between liver epithelial cells and the portal vasculature. Cholangiocytes generate a VEGF gradient that is crucial during the migratory stage, when it determines arterial vasculogenesis in their vicinity, whereas angiopoietin-1 signaling from hepatoblasts contributes to the remodeling of the hepatic artery necessary to meet the demands of the developing epithelium. (Hepatology 2008.)
Renal vein thrombosis in Chinese patients with systemic lupus erythematosus
Authors: N.-S. Lai, J.-L. Lan
Journal: Annals of the Rheumatic Diseases (1997)

To evaluate the risk factors associated with renal vein thrombosis (RVT) in Chinese patients with systemic lupus erythematosus (SLE).Data on clinical symptoms, renal biopsy, antiphospholipid antibody syndrome profile, and serological examinations of lupus features were examined retrospectively in six patients with RVT confirmed by angiography from a total of 625 patients with SLE over a 14 year period (1982-1996).The lupus patients with RVT did not have acute symptoms of severe flank pain, haematuria, and oligouria. In contrast, most patients were suspected to have RVT because of peripheral oedema and worsening proteinuria. Roentgenological examinations (including renal sonography, renal computer tomography, or renal Doppler, or all three) were positive only in some patients. Positive antiphospholipid antibody profiles were found in four of six lupus patients. By renal biopsy, only two samples were confirmed as World Health Organisation (WHO) class V lupus membranous glomerulonephritis. The others were class IV in three patients, and class III in the remaining one. No RVT was found in lupus patients without nephrotic syndrome. Peripheral thrombophlebitis was, however, noted in only one patient.Nephrotic syndrome could be a distinct risk factor in the development of RVT in Chinese SLE patients, in contrast with that reported in white populations in whom the peripheral thrombotic events were recognised as a determining factor.
Cogwheel: A physician's view of a local version
Authors: J. S. Stewart
Journal: BMJ (1969)

A preliminary experiment in the divisional system of medical administration has been started in a large regional hospital in the Metropolitan area. This has involved considerable local interpretation of the original proposals in the Joint Working Party's report. The chief benefits of this version as tried so far have been a more effective use of doctors' time at all levels, a more rapid carrying out of practical suggestions, and closer co-operation between different departments. Those who give first administrative place to streamlined efficiency have seen the absence of an authoritative executive committee as the chief defect to date. The main fault in the eyes of those who emphasize the fundamental importance of participation has been the delay in the involvement of the junior medical staff.
Hillsborough television drama
Authors: D. Slater
Journal: BMJ (1997)

Malignant cerebral glioma Modern radiotherapy can give good quality survival for six monthsEditor-We wish to correct misinformation reported by Elizabeth Davies and colleagues in their study of survival after radiotherapy for malignant cerebral glioma. 1 Contrary to their suggestion in the acknowledgements, the study had not been supported by the Medical Research Council Brain Tumour Working Party.As the poor study design indicates, the study had never been officially submitted to the Medical Research Council and had therefore not been subjected to its rigorous protocol review process.For example, Davies and colleagues report that their criteria for assessment of treatment toxicity were derived in a "pragmatic fashion after discussion" by a "process of elimination," without evidence from imaging to exclude tumour progression.This would be totally unacceptable, let alone publishable.The impression that the 105 patients represent an unselected consecutive series is difficult to believe as the seven centres should, over two years, have seen 400-800 eligible patients. 2 The reported adverse prognostic factors in patients with high grade glioma have been known for over 18 years. 3Although the authors appropriately conclude that severely disabled patients have a poor prognosis and may not be suitable for active treatment, the fact that they were considered for intensive treatment at all is surprising.Centres specialised in the treatment of patients with brain tumours would not have accepted patients with such a poor prognosis for high dose radiotherapy.Most of the patients also seemed to receive initial whole brain radiotherapy followed by a radiation boost to the tumour.Whole brain radiotherapy is nothing but toxic and has not been practised in specialist centres for many years.Given the use of outdated and often inappropriate high dose, wide field radiotherapy and the flawed assessment of morbidity from treatment, the conclusion that radiation is of little value and simply results in adverse effects seems ill advised.High grade gliomas are among the most devastating of malignancies, with few useful treatment options.Modern radiotherapy, although not curative, offers a survival benefit of about six months, 3 and for most patients without functional impairment the quality of survival is good.Without com-parative data on the quality of life, how can we decide whether prolongation of survival by six months with clinical deterioration in a small proportion of patients is worse than the alternative of progressive functional decline, which happens in all patients without treatment?Yes, we do need more effective treatments without morbidity, but to throw out a proved treatment on the basis of misinformation is a travesty to evidence based medicine, to which the BMJ claims allegiance.