tbuckley/cabot-search huggingface dataset:
Prevention of Acute Mountain Sickness by Dexamethasone
Authors: T. Scott Johnson, Paul B. Rock, Charles S. Fulco, Laurie A. Trad, Richard F. Spark, John T. Maher
Journal: New England Journal of Medicine (1984)

Acute mountain sickness is a syndrome that occurs when unacclimatized persons ascend rapidly to high altitudes. It is postulated that cerebral edema causes its symptoms. Since dexamethasone is useful in treating some forms of cerebral edema, we investigated its role in the prevention of acute mountain sickness. Using a double-blind crossover design, we exposed eight young men to a simulated altitude of 4570 m (15,000 ft) on two occasions. By random assignment, each subject received dexamethasone (4 mg every 6 hours) or placebo for 48 hours before and throughout the 42-hour exposure. The presence of symptoms of acute mountain sickness was established by two methods: a questionnaire and an interview by a physician. Dexamethasone significantly reduced the symptoms of acute mountain sickness. During dexamethasone treatment, the cerebral-symptom score (mean +/- S.E.) decreased from 1.09 +/- 0.18 to 0.26 +/- 0.08, and the respiratory-symptom score decreased from 0.64 +/- 0.09 to 0.31 +/- 0.06 (both, P less than 0.05). As judged by the interviewing physician, the symptom score decreased from 1.10 +/- 0.11 to 0.28 +/- 0.07 (P = 0.01). We conclude that dexamethasone may be effective in preventing the symptoms of acute mountain sickness.
Large Intestinal Carcinogenesis. I. Promotional Effect of Dietary Fatty Acid Isomers in the Rat Model&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;&lt;xref ref-type="fn" rid="FN3"&gt;3&lt;/xref&gt;
Authors: Marian L. Hogan, M.S., Abulkalam M. Shamsuddin, M.D., Ph.D.
 6
Journal: JNCI Journal of the National Cancer Institute (1984)

For evaluation of the promotional effects of dietary trans-fatty acids on large intestinal carcinogenesis, 120 inbred female F344 rats were divided into 6 groups and fed a 25% elaidic acid diet, a 25% oleic acid diet, or a regular (4.5% fat) chow diet. Ninety animals, 30 per dietary group, received weekly im injections of azoxymethane (2 mg/kg; CAS: 25843-45-2). None of the 30 saline-injected control animals, 10 per dietary group, fed any of the three diets developed tumors. There were twice as many animals with adenocarcinoma of the large intestine from the trans-fatty acid diet group as compared with either the cis-fatty acid diet group or regular diet groups. Chi-square analysis showed that the difference between the incidence of large intestinal carcinomas was not significant between the cis- and trans-fatty acid diets. The difference between the regular diet and trans-fatty acid diet groups was not significant at the 5% level (P = . 08). A higher, but nonstatistically significant, incidence of nephroblastomas and squamous ear duct neoplasms was also observed in carcinogen-treated animals maintained on each of the high-fat diets as compared with the incidence of both in treated animals fed the regular chow diet.
Impact and prognostic role of single-neucleotide polymorphisms (SNPs) in thymic lesions
Authors: M. Torniai, R. Berardi, A. Brunelli, S. Pagliaretta, V. Paolucci, A. Conti, G. Goteri, M. Refai, C. Pompili, G. Marcantognini, F. Morgese, A. Savini, M. Caramanti, M. Santoni, A. Zizzi, P. Mazzanti, A. Onofri, A. Sabbatini, M. Scarpelli, S. Cascinu
Journal: Annals of Oncology (2015)
Development of Medical Ethics
Authors: Lester S. King
Journal: New England Journal of Medicine (1958)

MEDICAL ethics, so-called, had very earthy origins. It stemmed not from theorists who speculated airily on the nature of the good, but from hardheaded, practical men who faced ugly, concrete situations. The framework of medical ethics lay not in philosophy but in sociologie phenomena, especially those leading to guild organization.A guild was an association of workers banded together to protect their common interests and to destroy competition. The technic was to obtain a strict monopoly enforced by the powers of the state. The guild in return for this monopolistic position guaranteed the competence of the workmen, established standards of . . .
Skeletal muscle action of estrogen receptor α is critical for the maintenance of mitochondrial function and metabolic homeostasis in females
Authors: Vicent Ribas, Brian G. Drew, Zhenqi Zhou, Jennifer Phun, Nareg Y. Kalajian, Teo Soleymani, Pedram Daraei, Kevin Widjaja, Jonathan Wanagat, Thomas Q. de Aguiar Vallim, Amy H. Fluitt, Steven Bensinger, Thuc Le, Caius Radu, Julian P. Whitelegge, Simon W. Beaven, Peter Tontonoz, Aldons J. Lusis, Brian W. Parks, Laurent Vergnes, Karen Reue, Harpreet Singh, Jean C. Bopassa, Ligia Toro, Enrico Stefani, Matthew J. Watt, Simon Schenk, Thorbjorn Akerstrom, Meghan Kelly, Bente K. Pedersen, Sylvia C. Hewitt, Kenneth S. Korach, Andrea L. Hevener
Journal: Science Translational Medicine (2016)

Impaired estrogen receptor α (ERα) action promotes obesity and metabolic dysfunction in humans and mice; however, the mechanisms underlying these phenotypes remain unknown. Considering that skeletal muscle is a primary tissue responsible for glucose disposal and oxidative metabolism, we established that reduced ERα expression in muscle is associated with glucose intolerance and adiposity in women and female mice. To test this relationship, we generated muscle-specific ERα knockout (MERKO) mice. Impaired glucose homeostasis and increased adiposity were paralleled by diminished muscle oxidative metabolism and bioactive lipid accumulation in MERKO mice. Aberrant mitochondrial morphology, overproduction of reactive oxygen species, and impairment in basal and stress-induced mitochondrial fission dynamics, driven by imbalanced protein kinase A-regulator of calcineurin 1-calcineurin signaling through dynamin-related protein 1, tracked with reduced oxidative metabolism in MERKO muscle. Although muscle mitochondrial DNA (mtDNA) abundance was similar between the genotypes, ERα deficiency diminished mtDNA turnover by a balanced reduction in mtDNA replication and degradation. Our findings indicate the retention of dysfunctional mitochondria in MERKO muscle and implicate ERα in the preservation of mitochondrial health and insulin sensitivity as a defense against metabolic disease in women.
Medical Management of Steroid-Induced Epidural Lipomatosis
Authors: Wilburn E. George, Michael Wilmot, Arnold Greenhouse, Michael Hammeke
Journal: New England Journal of Medicine (1983)

The characteristic features of excess adrenal corticosteroid, including truncal obesity, were first described in 1932 by Cushing.1 Subsequently, others noted steroid-induced fat deposition in the central body axis, particularly in the episternal area,2 mediastinum,3 4 5 6 7 8 and epicardium.3 4 5 6 7 8 9 In 1975 Lee et al.10 reported neurologic symptoms due to extradural fat in a renal-transplant recipient who was receiving prednisone. Since then, there have been seven similar cases associated with exogenous steroid administration.11 12 13 14 15 All the patients had signs suggesting a myelopathy and confirmatory radiologic findings, and all underwent decompressive laminectomy performed in an attempt to remove the extradural mass. We describe an additional case . . .
Basic Lead Acetate: Promoting Effect on the Development of Renal Tubular Cell Tumors in Rats Treated With <italic>N</italic>-Ethyl-<italic>N</italic>-hydroxyethylnitrosamine
Authors: Y Hiasa, M Ohshima, Y Kitahori, T Fujita, T Yuasa, A Miyashiro
Journal: JNCI Journal of the National Cancer Institute (1983)

The development of renal tubular cell tumors by the end of experimental week 32 was studied in inbred Wistar male rats fed a diet containing 1,000 or 500 ppm N-ethyl-N-hydroxyethylnitrosamine (EHEN) for 2 weeks and then given 1,00 ppm basic lead acetate (LA) for 20 weeks. A low dose of LA enhanced the development of renal tubular cell tumors in rats treated with EHEN and increased the number and size of the tumors. The incidence of renal tubular cell tumors at the end of week 32 was 50% in rats treated with 1,000 ppm EHEN for 2 weeks and 100% in rats treated with 1,000 ppm EHEN for 2 weeks and then given 1,000 ppm LA for 20 weeks. The incidences of renal tumors of more than 3 mm in diameter were 70% in rats treated with 1,000 ppm EHEN plus LA and 0% in rats treated with EHEN or LA alone. The low dose of LA showed the enhancing effect of the development of renal tubular cell tumors in rats treated with a subthreshold dose of 500 ppm EHEN.
Effect of Antibiotic Therapy in Acute Salmonellosis on the Fecal Excretion of Salmonellae
Authors: Bernard Aserkoff, John V. Bennett
Journal: New England Journal of Medicine (1969)

Treatment of patients with acute salmonella gastroenteritis with either chloramphenicol or ampicillin prolonged the period of postconvalescent excretion of salmonellae. Of 185 patients treated with antibiotics, 65.4 per cent were still positive for Salmonella typhimurium 12 days after exposure, and 27.0 per cent were positive at 31 days. In contrast, of 87 who were not treated, only 42.5 per cent and 11.5 per cent were positive at 12 and 31 days, respectively. Therapy also favored the in vivo acquisition of antibiotic resistance by the infecting strain, which was initially susceptible to multiple antibiotics. Salmonella strains resistant to one or more antibiotics were isolated from 9.7 per cent of patients treated with antibiotics, whereas no resistant strains were obtained from untreated patients. Resistance transfer factor was demonstrated in nine of 12 strains with acquired multiple resistances that were studied. Thus, antibiotic therapy increases the opportunity not only for person-to-person spread of infection, but also for dissemination of resistant organisms.
Anti-Rationing Group also wants to contribute to the debate
Authors: C J Roberts, D L Crosby
Journal: BMJ (1996)

EDITOR,—The Rationing Agenda Group 1 2 seems to be a counterpart to the Anti-Rationing Group, which was founded more than 18 months ago and has published a series of articles in the Health Service Journal.3 4 5

The Anti-Rationing Group is multidisciplinary, currently some 30 people strong, with over 500 person years of experience in the delivery, management, and evaluation of clinical services. It began as a think tank promoting and publishing views about clinical resource management in …
S76 “Straight to CT” in Primary Care – Improving the Lung Cancer Patient Journey
Authors: A Nanapragasam, N Maddock, A McIver, C Smyth, MJ Walshaw
Journal: Thorax (2015)

<h3></h3> Although the advent of rapid access secondary care services has shortened the wait to timely diagnosis in lung cancer, significant delays and congestion can still occur through patients needing to attend clinic before appropriate investigations are organised. To circumvent this, with primary care colleagues we designed a “straight to CT” system where if a general practitioner is concerned about a patient, or a chest X-ray in the community or emergency department shows suspicious changes, the radiology department automatically offers the patient a CT scan to be performed within 72 h with a same day report. This allows the primary care clinician to reassure patients with normal scans, or where necessary direct appropriately patients with scans showing non-malignant abnormalities. Patients with scans showing possible malignancy are intercepted by the lung cancer team who then organise appropriate further management. We replaced our one stop rapid access lung cancer clinic with this new service in January 2014 and have now reviewed its use one year on. 468 patients from the local community were eligible for the “straight to CT” service. Of the 246 with a coded X-ray, 222 underwent a 72-hour CT scan (18 of the reminder declined or were not contactable), and of these 127 (57%) showed suspicious abnormalities and were intercepted by the lung cancer team. Of the 222 referred by a concerned clinician, 177 underwent a 72-hour scan (of the remainder 19 were not contactable or declined and the rest were deemed inappropriate) and 60 of these (34%) showed suspicious changes and were intercepted by the lung cancer team. Overall, 401 72-hour scans were performed in 2014: this is similar to the number of scans performed (402) in 2013 using the traditional rapid access clinic model. As well as empowering primary care, by preventing unnecessary clinic attendance this innovative service has significantly reduced costs and by bringing forward investigations has reduced the lead time to diagnosis (to a mean of 19 days) in our patients. Furthermore, fears that such a service might increase unnecessarily the number of CT scans performed have proved groundless. We recommend the use of such a service to colleagues to aid timely and economical investigation of patients with a suspected diagnosis of lung cancer.
Malabsorption of Iron Secondary to Iron Deficiency
Authors: Carlien Kimber, Lewis R. Weintraub
Journal: New England Journal of Medicine (1968)

Intestinal absorption of 59Fe-labeled hemoglobin was measured in children with severe dietary iron deficiency and in iron-replete controls. Absorption was impaired in all the iron-deficient children and returned to normal after iron repletion. Studies of hemoglobin iron and inorganic iron were also performed in newly weaned dogs on an iron-deficient diet. A striking biphasic response was noted. Absorption of both forms of iron was initially increased over the control animals, reaching a maximum value at five months of age. Thereafter, there was a fall in absorption of both forms despite increasing severity of iron deficiency. Decreased levels of cytochrome oxidase and lactase were noted in the mucosa of the iron-deficient dogs. A decrease in iron-containing or iron-dependent enzymes in the mucosa of iron-deficient subjects may be responsible for a secondary malabsorption phenomenon.
Cardiac Structure and Function in Children with Human Immunodeficiency Virus Infection Treated with Zidovudine
Authors: Steven E. Lipshultz, E. John Orav, Stephen P. Sanders, Andrea Rubin Hale, Kenneth McIntosh, Steven D. Colan
Journal: New England Journal of Medicine (1992)

Abnormalities of cardiac structure and function are common in children infected with the human immunodeficiency virus (HIV). It is unclear, however, whether these abnormalities are attributable to the disease itself, associated infections, or possible cardiotoxic effects of the most commonly used treatment, zidovudine.
Abstract 3931: Generation of tumorgraft models to characterize novel tumor suppressor genes implicated in lung carcinogenesis
Authors: Carolina Pereira, Pol Gimenez-Xavier, Gonzalo Gomez, Enric Condom, Alberto Villanueva, David Pisano, Montse Sanchez Cespedes
Journal: Cancer Research (2015)

Abstract The extremely poor prognosis and lack of efficient treatments throw lung cancer (LC) to the top of the deadliest types of cancer worldwide. Throughout the years, the role played by host genetic variation has been constantly highlighted as the key in determining tumor onset and progression. In this regard, the discovery of LC-related genes paved the way to the development of targeted therapies that nowadays are benefiting patients harboring specific mutational patterns, such as EGFR mutations or ALK rearrangements. Here, aiming to characterize novel tumor suppressor genes in LC, 8 patient-derived tumors were subcutaneously or orthotopically engrafted in nude mice for growing and subsequently carry out exome and transcriptome sequencing. The strategy avoided the common admixture exhibited by the presence of normal cells in the sample, which were successfully swept away in the engrafting step, as determined by microsatellite analyses. Among the 4430 mutations detected by exome-seq, we focused on the 79 ones that would presumably lead to biallelic gene inactivation, a common feature exhibited by tumor suppressors: homozygous frameshift indels, nonsense and splicing site mutations. We then chose to characterize one particular candidate gene, which codifies for a globular protein that might be involved in the ability of tumors to escape the action of the immune system. The genetic screening performed resulted in a mutation rate of 5.1% in 79 tested LC cell lines and of 3.9% in a panel of 179 lung primary tumors. The complete coding region was cloned in constitutive and inducible systems in order to restore the expression of the protein in gene-depleted LC-cell lines, and preliminary results pinpoint that it may indeed trigger an anti-tumoral effect. This in vitro approach is currently ongoing and hopefully, will enlighten us about its tumor suppressive potential in the near future. Citation Format: Carolina Pereira, Pol Gimenez-Xavier, Gonzalo Gomez, Enric Condom, Alberto Villanueva, David Pisano, Montse Sanchez Cespedes. Generation of tumorgraft models to characterize novel tumor suppressor genes implicated in lung carcinogenesis. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3931. doi:10.1158/1538-7445.AM2015-3931
Case 42-1991
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, D.M. Systrom, K.J. Mark
Journal: New England Journal of Medicine (1991)

Presentation of CaseA 63-year-old woman was admitted to the hospital because of a question of a tumor of the right lung.The patient was in stable health until one year earlier, when a dry cough developed. An x-ray film of the chest, obtained elsewhere, was reported to be normal. The cough soon disappeared. Eight months before admission a nonproductive cough recurred and persisted, and the patient experienced exertional dyspnea. Four months later she began to have pleuritic pain at the upper border of the right scapula. Two months before entry, when she traveled to New Mexico, the pleuritic pain . . .
Reduced Activity of the Red-Cell Sodium-Potassium Pump in Human Obesity
Authors: Mario De Luise, George L. Blackburn, Jeffrey S. Flier
Journal: New England Journal of Medicine (1980)

Looking for evidence of reduced energy use in the cells of obese persons, we measured the numbers of sodium-potassium-pump units in erythrocytes from a group of 21 obese human subjects and found them to be reduced by 22 per cent as compared with those of nonobese controls (P <0.001). The cation-transport activity of the pump, as measured by 86rubidium uptake by the cells, we also reduced in parallel with decrease in pump units. An increased concentration of sodium in the red cells of obese subjectes was also found (9.6 +/- 0.7 vs. 7.1 +/- 0.6 mmol per liter of cells; P<0.01). This finding demonstrates independently the physiologic importance of reduced numbers of sodium-pump units and reduced pump activity as measured by ouabain binding and rubidium transport, respectively. The magnitude of the reduction in the number of pump units was found to be negatively correlated with the percentage of ideal body weight (r = 0.56, P<0.001); this observation suggests a possible role of abnormalities of the sodium pump in the pathophysiology of obesity.
Residual Pulmonary Findings in Clinical Hyaline-Membrane Disease
Authors: Frank M. Shepard, Richard B. Johnston, Eugene C. Klatte, Henry Burko, Mildred Stahlman
Journal: New England Journal of Medicine (1968)

Seventy infants who had clinical hyaline-membrane disease as neonates were followed from two to five years with repeated physical examinations and x-ray films of the chest. Nineteen of them had such severe symptoms that they required mechanical ventilatory assistance for periods ranging from 17 to 116 hours. During the follow-up period six of the 19 had radiologic evidence suggestive of pulmonary fibrosis or overexpansion or both. Only two had clinical evidence of frequent infections and expiratory wheezing that failed to respond to bronchodilator therapy; lung biopsies in these two indicated patchy areas of peribronchial and alveolar fibrosis. Subsequently, both showed clinical improvement. The clinical, radiologic and pathologic sequelae that occurred in these infants surviving clinical hyaline-membrane disease appear to result from the reparative process of the lung to the perinatal insult that produces the original disease.
Assessment of Treatment Response with Fulvestrant (F) 500 Mg in Standard Clinical Practice Through a Retrospective Study: Nct01509625
Authors: I. Blancas, M. Fontanillas, V. Conde Herrero, J. Lao, E. Martinez de Dueñas, M. Sotelo Lezama, A. JaÉn-Morago, J.L. Bayo, F. Carabantes, J.J. Illaramendi, M. Gordón, M. Ruiz-Borrego, J. Cruz, A. García-Palomo, C. Mendiola, E. Perez-Ruiz, J.M. Baena Cañada, N. Martínez, G. Esquerdo, J. Salvador Bofill
Journal: Annals of Oncology (2014)
Mortality inferred from death certificates reflects coroners' practice, not the true mortality
Authors: M. Parker
Journal: BMJ (1996)

EDITOR,—S J Calder and colleagues' conclusion that death certificates do not reflect the true mortality from hip fracture1 is supported by data from Peterborough. Of the 303 patients with hip fracture who were admitted to Peterborough District Hospital during 1995, 17 died within 28 days, of whom 15 died in hospital. Current practice is to discuss all these cases with the coroner. The coroner allowed the death certificate …
P120 Real life distribution of COPD severity in the German DACCORD registry: Lung function is the main driver of classification in GOLD group C and D
Authors: H Worth, R Buhl, C-P Criée, P Kardos, C Mailaender, CF Vogelmeier
Journal: Thorax (2015)

<h3>Introduction</h3> Currently there is limited real-life data available regarding the distribution of COPD patients using the GOLD 2011 criteria. The German DACCORD registry that collects data from a large ‘real life’ population sample was used to categorise COPD patients according to GOLD 2011. <h3>Methods</h3> To be eligible for entry into DACCORD, all patients had to have a diagnosis of COPD (consistent with the German Disease Management Programme definition), and, prior to entry, had to have either newly initiated bronchodilator maintenance medication, or to have a bronchodilator added to their maintenance regimen. No other inclusion criteria were applied, and the only exclusion criterion was a diagnosis of asthma. In primary and secondary care, data were collected from 4,123 COPD outpatients, including spirometry, exacerbations, CAT and mMRC. <h3>Results</h3> The mean age of patients was 65.7 years with 40.3% of patients still working and 73.3% patients with duration of disease ≥1 year. Based on mMRC 0–1, 37.2% of patients had few symptoms (A and C); using CAT &lt;10, only 9.0% were categorised into these two groups. 32.5% of the patients were assigned to C and D groups solely due to FEV1 &lt;50%. After 12 months, 41.4% patients in GOLD A were categorised in a higher GOLD category, while 42.7% of GOLD D patients were categorised in a lower GOLD category (GOLD categorization based on CAT). 67.6% of patients categorised as D at baseline due to exacerbation history alone were categorised as GOLD B after 1 year follow-up. Almost 80% of GOLD B patients were still categorised as GOLD B after the observation period of 12 months and were therefore the most stable subgroup with regards to COPD severity according to GOLD 2011 (Figure 1). <h3>Conclusion</h3> A significant proportion of patients in the DACCORD registry are classified in GOLD C and D groups based solely on airflow limitation, in accordance with previous studies. Patients categorised as GOLD B were the most stable over the observational period of 12 months according to GOLD 2011. With the prospective collection of exacerbations over the second year of follow-up, a clearer picture of progression of GOLD 2011 categorisation might be drawn.