tbuckley/cabot-search huggingface dataset:
Mindfulness and monetarised health services don’t mix
Authors: Noel Thomas
Journal: BMJ (2016)

McCartney’s reservations about the growth of the mindfulness industry are understandable.1 An approach that is said to help the mentally ill, increase life skills in the healthy, and even improve the aim of army snipers needs careful examination.

If she had been given space to put the practice in its historical and ethical context, readers would …
Sins of the Fathers
Authors: Jeffrey Walden
Journal: JAMA (2016)

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Differential Chemotherapeutic Susceptibility of Human T-Lymphocytes and B-Lymphocytes in Culture2
Authors: Takao Ohnuma, Hadara Arkin, Jun Minowada, James F. Holland
Journal: JNCI Journal of the National Cancer Institute (1978)

After previous work from this laboratory revealed that asparaginase was 800–2,000 times more inhibitory against human T-lymphocytes In culture than against B-lymphocytes, a similar further study of 13 chemotherapeutic and immunosuppressive agents was done. Cytosine arabinoside and 5-fluorouracil also had differential inhibitory activities on human T- and B-cells in culture. On the basis of the dose producing 50% inhibition of viable cell growth on day 5, cytosine arabinoside had 45–80 times more Inhibitory activity against T-cells than against B-cells. In contrast to asparaginase and cytosine arabinoside, 5-fluorouracil had 10–20 times more inhibitory activity against B-cells. The rest of the chemotherapeutic and immunosuppressive agents tested had minor or no differential activity. These findings indicated that T-cell response to asparaginase and cytosine arabinoside and B-cell response to 5-fluorouracil may be exploitable for the differential immunosuppressive effects presumed to be active in vivo. In addition, such differential responses may predict differential tumor cell behavior against these chemotherapeutic agents by T- and B-cell neoplasms in vivo.
Wound dressings
Authors: Vanessa Jones, Joseph E Grey, Keith G Harding
Journal: BMJ (2006)

Traditionally wet-to-dry gauze has been used to dress wounds.Dressings that create and maintain a moist environment, however, are now considered to provide the optimal conditions for wound healing.Moisture under occlusive dressings not only increases the rate of epithelialisation but also promotes healing through moisture itself and the presence initially of a low oxygen tension (promoting the inflammatory phase).Gauze does not exhibit these properties; it may be disruptive to the healing wound as it dries and cause tissue damage when it is removed.It is not now widely used in the United Kingdom.Occlusive dressings are thought to increase cell proliferation and activity by retaining an optimum level of wound exudate, which contains vital proteins and cytokines produced in response to injury.These facilitate autolytic debridement of the wound and promote healing.Concerns of increased risk of infection under occlusive dressings have not been substantiated in clinical trials.This article describes wound dressings currently available in the UK. Low adherent dressingsLow adherent dressings are cheap and widely available.Their major function is to allow exudate to pass through into a secondary dressing while maintaining a moist wound bed.Most are manufactured in the form of tulles, which are open weave cloth soaked in soft paraffin or chlorhexidine; textiles; or multilayered or perforated plastic films.They are designed to reduce adherence at the wound bed and are particularly useful for patients with sensitive or fragile skin.
Methylnaltrexone potentiates the antiangiogenic effects of the mTOR inhibitor, temsirolimus
Authors: P. A. Singleton, J. Moss, J. G. Garcia
Journal: Journal of Clinical Oncology (2009)

e14636 Background: Angiogenesis is important in cancer growth and metastasis. Recent therapeutic interventions cancer, include drugs such as temsirolimus that target both tumor growth and angiogenesis including the mammalian target of rapamycin (mTOR) inhibitor. Previously, we have demonstrated that the peripheral opioid antagonist methylnaltrexone (MNTX) potentiates the effects of bevacizumab and 5FU on endothelial cell (EC) migration and proliferation. Since mTOR inhibitor therapy is also associated with significant side effects, we examined potential adjunctive agents that could reduce the therapeutic dose and improve the therapeutic window for this approach. Methods: We determined the effect(s) of MNTX, naloxone and/or temsirolimus on VEGF-induced human pulmonary microvascular EC proliferation and migration assays. We used siRNA and specific inhibitors to analyze Src, Akt and mTOR regulation. Results: MNTX inhibited EC VEGF-induced proliferation and migration with an IC50 of ∼100 nM. Adding 10 nM MNTX to EC shifted the IC50 of temsirolimus inhibition of VEGF-induced proliferation from ∼10 nM to ∼1 nM. Further, adding 10 nM MNTX shifted the IC50 of temsirolimus on inhibition of EC migration from ∼50 nM to ∼10 nM. These synergistic effects were not observed with naltrexone, a tertiary mu opioid receptor antagonist. On a mechanistic level, we observed that treatment of human EC with MNTX, but not naltrexone, increased protein tyrosine phosphatase (PTP) activity which was independent of mu opioid receptor expression. Treatment of human EC with the PTP inhibitor, 3,4-Dephostatin, inhibited both the synergy between MNTX and temsirolimus and increased VEGF-induced tyrosine phosphorylation of Src with enhanced PI3 kinase and mTOR complex 2-dependent phosphorylation of Akt and subsequent activation of mTOR complex 1 (temsirolimus target), while silencing Src, Akt or mTOR complex 2 components blocked VEGF-induced angiogenic events. Conclusions: Synergy of MNTX with mTOR inhibitors may have therapeutic implications which await clinical proof-of-concept. [Table: see text]
In Vitro Platelet Phagocytosis by Splenic Leukocytes in Idiopathic Thrombocytopenic Purpura
Authors: Robert McMillan, Robert L. Longmire, Mehdi Tavassoli, Samuel Armstrong, Robert Yelenosky
Journal: New England Journal of Medicine (1974)

The ability of splenic leukocytes from 12 patients with idiopathic thrombocytopenic purpura to phagocytose normal, labeled homologous platelets was determined with an in vitro assay technic. The degree of in vitro platelet phagocytosis by these splenic cells correlated inversely with the clinical response to corticosteroids. Mean (± S.D.) per cent leukocyte phagocytic activity from five control spleens was 17.6 ± 5.3. Splenic cells, from four purpuric patients showing no response and five with a partial response to corticosteroids, demonstrated accelerated in vitro phagocytosis, with mean values of 50.6 ± 17.8 and 38.5 ± 17 per cent, respectively; cells from three patients responding completely to corticosteroids had phagocytic values within the normal range of 18.0 ± 2.4 per cent. Platelet phagocytosis by washed splenic cells occurred in the absence of added patient plasma, suggesting concurrent antiplatelet antibody production. These results provide evidence that the spleen is a site of both platelet sequestration and anti-platelet antibody production. Although the effect of corticosteroids could result from either depression of antiplatelet antibody production or inhibition of splenic phagocytic cells, present evidence is more consistent with inhibition. (N Engl J Med 290:249–251, 1974)
Losartan-Induced Azotemia in a Diabetic Recipient of a Kidney Transplant
Authors: Linda S. Cohen, Eli A. Friedman
Journal: New England Journal of Medicine (1996)

To the Editor: In patients with diabetic nephropathy, angiotensin-converting–enzyme (ACE) inhibitors reduce blood pressure and the progression of nephropathy,1 but approximately 10 percent of patie...
Randomized Phase Ii Trial of Hange-Shasin-To Versus Placebo to Prevent Diarrhea in Patients with Metastatic Colorectal Cancer Under Iris+Bev Second-Line Treatment (Hgcsg1301)
Authors: H. Fukushima, S. Yuki, H. Nakatsumi, H. Hayashi, K. Harada, T. Muranaka, M. Nakamura, Y. Kawamoto, Y. Kobayashi, S. Sogabe, T. Miyagishima, M. Tateyama, K. Eto, K. Hatanaka, A. Ishiguro, H. Okuda, Y. Takahashi, I. Iwanaga, Y. Sakata, Y. Komatsu
Journal: Annals of Oncology (2014)
THU0059 Citrullinated Fibrinogen Promotes Bone Marrow Mesenchymal Stem Cells to Assume a Pro-inflammatory Phenotype
Authors: Y. Sun, W. Deng, W. Chen, G. Yao, X. Feng, L. Sun
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Mesenchymal stem cells (MSC) are not only immune-inhibitory cells, and may act as pro-inflammatory cells due to lack of a proper "licensing". The role of MSC in autoimmune settings of rheumatoid arthritis (RA) has remained to be elucidated. Citrullinated fibrinogen (cfb) has been considered as one of the important autoantigens in RA and contributes to perpetuate the disease. <h3>Objectives</h3> Our study aimed to analyze the responses of bone marrow derived MSC (BMSC) to cfb. <h3>Methods</h3> BMSC were isolated from RA and osteoarthritis (OA) patients and exposed to cfb or native fibrinogen (fb). Pro-inflammatory cytokines stimulated by cfb were determined by quantitative PCR and ELISA. To evaluate the role of the toll-like receptor 4 (TLR4)-NFκB pathway in the induction of cytokines by cfb, parallel experiments were performed using inhibitors of TLR4 or NFκB pathway. To investigate whether BMSC retain their immunosuppressive properties after exposure to cfb, we detected the effects of cfb primed BMSC on proliferation of peripheral blood mononuclear cells (PBMC). <h3>Results</h3> The autoantigen cfb increased the gene expression and protein production of IL-6, IL-8 and CCL2 in BMSC from both RA and OA patients. However, the production of IL-1β and TNFα were unaffected by cfb. Compared with fb, cfb induced significantly higher expression of the pro-inflammatory cytokines (IL-6, IL-8 and CCL2) in these cells. Blocking experiments showed the participation of TLR4-NFκB pathway in the induction of these cytokines. The autoantigen cfb also compromised the ability of BMSC to inhibit PBMC proliferation, as well as, impaired the potency of BMSC to produce the key immunomodulatory molecule indoleamine dioxygenase (IDO). <h3>Conclusions</h3> Our results suggest that cfb promotes pro-inflammatory responses in BMSC and negatively affects their immunomodulatory functions. Citrullinated fibrinogen may act as a dangerous "licensing" for BMSC and thereby contributing to the propagation of inflammation in RA. <h3>Disclosure of Interest</h3> None declared
The Efficacy in Navajo Infants of a Conjugate Vaccine Consisting of<i>Haemophilus influenzae</i>Type b Polysaccharide and<i>Neisseria meningitidis</i>Outer-Membrane Protein Complex
Authors: Mathuram Santosham, Mark Wolff, Raymond Reid, Matt Hohenboken, Massee Bateman, Julius Goepp, Margaret Cortese, David Sack, Janné Hill, Wendy Newcomer, Linda Capriotti, Jeanne Smith, Marjorie Owen, Sheila Gahagan, Diana Hu, Renee Kling, Linda Lukacs, Ronald W. Ellis, Philip P. Vella, Gary Calandra, Holly Matthews, Vincent Ahonkhai
Journal: New England Journal of Medicine (1991)

Several conjugate vaccines against Haemophilus influenzae type b have been developed in the search for one that induces protection even in young infants. We evaluated the safety and efficacy of a conjugate vaccine that links the H. influenzae type b capsular polysaccharide to the outer-membrane protein complex (OMPC) of Neisseria meningitidis serogroup B. We conducted a double-blind, placebo-controlled trial in Navajo infants, who are at high risk for systemic infections caused by H. influenzae type b. The infants were randomly assigned to receive the first dose of vaccine or placebo at 42 to 90 days of age and the second at 70 to 146 days of age.
Insertion of Femoral-Vein Catheters for Practice by Medical House Officers during Cardiopulmonary Resuscitation
Authors: Lauris C. Kaldjian, Barry J. Wu, James F. Jekel, Eric P. Kaldjian, Thomas P. Duffy
Journal: New England Journal of Medicine (1999)

The care of patients in teaching hospitals presents a persistent challenge: a primary commitment to the health of patients must be combined with the educational goals of the teaching institution. These goals include the mastery of procedural skills by house officers. When a medical novice attempts to perform an invasive procedure, the risk of harm to the patient increases, even when the novice is under expert supervision. This risk is accepted for several reasons: it is in society's interest to train physicians to perform procedures; the inexperience of house officers is accepted by patients (or their surrogates) through explicit or . . .
Case 25-1975
Authors: W. Davies Sohier, Eugene J. Mark
Journal: New England Journal of Medicine (1975)

Presentation of CaseA 59-year-old man entered the hospital because of dyspnea.He was well until two and a half years previously, when edema of the penis and scrotum developed, and evaluation at another hospital revealed a tumor of the bladder. At operation prominent retroperitoneal lymph nodes were observed, and a biopsy revealed a poorly differentiated lymphocytic lymphoma of nodular type. He was transferred to this hospital for further treatment. Enlarged cervical, axillary, epitrochlear, inguinal and para-aortic lymph nodes were found. The spleen was felt 4 cm below the left costal margin. Review of the biopsy specimen of the bladder . . .
Minimal Residual Disease in Childhood B-Lineage Lymphoblastic Leukemia
Authors: Masao Yamada, Robert Wasserman, Beverly Lange, Betty Anne Reichard, Richard B. Womer, Giovanni Rovera
Journal: New England Journal of Medicine (1990)

Whether patients in clinical remission for acute lymphoblastic leukemia (ALL) continue to harbor leukemic cells is not known, because methods of detecting residual malignant cells have not been sufficiently sensitive. This information might be useful for predicting recurrence and determining the duration of therapy.
Uneven Pattern of Dopamine Loss in the Striatum of Patients with Idiopathic Parkinson's Disease
Authors: S J Kish, K Shannak, O Hornykiewicz
Journal: New England Journal of Medicine (1988)

Autografting of dopamine-producing adrenal medullary tissue to the striatal region of the brain is now being attempted in patients with Parkinson's disease. Since the success of this neurosurgical approach to dopamine-replacement therapy may depend on the selection of the most appropriate subregion of the striatum for implantation, we examined the pattern and degree of dopamine loss in striatum obtained at autopsy from eight patients with idiopathic Parkinson's disease. We found that in the putamen there was a nearly complete depletion of dopamine in all subdivisions, with the greatest reduction in the caudal portions (less than 1 percent of the dopamine remaining). In the caudate nucleus, the only subdivision with severe dopamine reduction was the most dorsal rostral part (4 percent of the dopamine remaining); the other subdivisions still had substantial levels of dopamine (up to approximately 40 percent of control levels). We propose that the motor deficits that are a constant and characteristic feature of idiopathic Parkinson's disease are for the most part a consequence of dopamine loss in the putamen, and that the dopamine-related caudate deficits (in "higher" cognitive functions) are, if present, less marked or restricted to discrete functions only. We conclude that the putamen--particularly its caudal portions--may be the most appropriate site for intrastriatal application of dopamine-producing autografts in patients with idiopathic Parkinson's disease.
Association of Antibodies to Ribonucleoprotein and Sm Antigens with Mixed Connective-Tissue Disease, Systemic Lupus Erythematosus and Other Rheumatic Diseases
Authors: Gordon C. Sharp, William S. Irvin, Charles M. May, Halsted R. Holman, Frederic C. McDuffie, Evelyn V. Hess, Frank R. Schmid
Journal: New England Journal of Medicine (1976)

Original Article from The New England Journal of Medicine — Association of Antibodies to Ribonucleoprotein and Sm Antigens with Mixed Connective-Tissue Disease, Systemic Lupus Erythematosus and Other Rheumatic Diseases
P137 ‘I really live for coming here’. The effect of a long-term singing group on control of breathlessness, social empowerment and psychological wellbeing of patients with respiratory disease: a qualitative study
Authors: R Thomas, H Williams, M Stern
Journal: Thorax (2015)

<h3>Introduction</h3> Community singing programs may improve quality of life for breathless people with long-term respiratory disease but there has been limited formal exploration of its social and psychological importance. This qualitative study aimed to investigate the impact of a long-term weekly singing group on empowerment, breathlessness, psychological wellbeing and social engagement of respiratory patients at an inner city London hospital. <h3>Methods</h3> Patients attending a weekly, 1-hour singing group led by a music therapist and open to all patients with respiratory disease were recruited. Demographic, disease severity and self reported health care resource utilisation data were collected from those who consented to participate. Semi-structured interviews (Figure 1), were used to collect qualitative data which were analysed using grounded theory methodology. <h3>Results</h3> 16 patients (4M:12F, mean (range) age 72.6 (50–92) years) were interviewed. Diagnoses included COPD (11/16), asthma (2/16), bronchiectasis (2/16) and fibrosis (1/16) with mean (±SD, range) FEV1 1.31(± 0.54, 0.69–2.58,) litres, FEV1 54% predicted (± 22.01 range 26% - 96%). All were non-smokers (ex-smokers 12/16); 12/16 (75%) had previously attended pulmonary rehabilitation. 10/16 lived alone and 8/16 had a history of mental health comorbidity requiring treatment. Duration of singing group attendance (mean±SD) was 15.3 ± 6.5 months. Four themes were identified from the qualitative analysis of the semi-structured interviews: 1. ‘Control of Symptoms’, 2. ‘Community and Friendship’, 3. ‘Psychological Benefits’, 4. ‘Mastery of Illness’. The singing group improved breathlessness symptoms, enabled access to further sources of support and formed new friendships. Self reported primary care (GP) visits were (non-significantly) fewer in the year following commencement of singing. There was no difference in hospital admissions in the year after starting singing compared to the year before. <h3>Conclusion</h3> The singing group had a profound impact on this group of patients with moderate chronic respiratory disease, a high prevalence of anxiety and depression and social isolation. The dominant effects were improving mood, providing a sense of mastery (control) over breathing to better cope with breathlessness, and tackling social isolation. These findings should help to inform commissioners of the value of singing groups as an effective, low-cost, non-pharmacological long-term therapy for patients with chronic respiratory disease.
Cutaneous Disease and Drug Reactions in HIV Infection
Authors: Serge A. Coopman, Richard A. Johnson, Richard Platt, Robert S. Stern
Journal: New England Journal of Medicine (1993)

Skin diseases, including adverse reactions to drugs, are thought to be more common among patients with human immunodeficiency virus (HIV) infection and the acquired immunodeficiency syndrome (AIDS) than among other persons. These skin conditions can be disabling or disfiguring and may require discontinuation of essential drugs.
Management of Acquired Bullous Skin Diseases
Authors: J D Fine
Journal: New England Journal of Medicine (1995)

A variety of skin diseases, autoimmune and inherited, are characterized by the presence of blisters. In some, such as pemphigus vulgaris, blistering is the primary manifestation. In others, such as lichen planus, blisters are infrequent. Most of these diseases are associated with substantial morbidity; a few may result in death. Although the general approach to the treatment of these diseases is similar, the diagnosis of the specific disease is important, because the most appropriate dosage and timing of some commonly used medications vary considerably. This review covers the management of the major acquired bullous diseases; diseases only rarely associated with . . .
Results of Treatment of Childhood Localized Non-Hodgkin's Lymphoma with Combination Chemotherapy with or without Radiotherapy
Authors: Michael P. Link, Sarah S. Donaldson, Costan W. Berard, Jonathan J. Shuster, Sharon B. Murphy
Journal: New England Journal of Medicine (1990)

Combined radiotherapy and intensive chemotherapy have led to improved prognosis in children with non-Hodgkin's lymphoma, but the toxic effects of these forms of treatment are additive and seriously limit the benefits of their use. In an effort to limit the adverse acute and late effects of treatment, we conducted a randomized, controlled trial to determine whether irradiation of primary sites of involvement could safely be omitted from the treatment of children with localized non-Hodgkin's lymphoma (Stages I and II) who have a favorable prognosis. In addition, the chemotherapy regimen was less intense and shorter (eight months) than usual.