tbuckley/cabot-search huggingface dataset:
Regarding micro-RNA-181a-5p antisense oligonucleotides attenuate osteoarthritis in facet and knee joints
Authors: Michael R Liebling
Journal: Annals of the Rheumatic Diseases (2019)

I read with considerable interest the paper by Nakamura and colleagues dealing with the potential therapeutic use of a locked nucleic acid, antisense oligonucleotide (LNA ASO) against a micro-RNA in osteoarthritis (OA).1 I was particularly impressed with the Osteoarthritis Research Society International and cellularity scores as well as the data on degenerative markers and chondrocyte apoptosis/death from the in vivo animal models. Nonetheless, I had a couple of questions that I hope the authors can help me with.

First, was the reason you had to employ TransFectin Lipid Reagent to transfect …
Medical care practitioners: a necessary import?
Authors: Toby Reynolds
Journal: BMJ (2006)

To help patients get treated more quickly, Britain's health service wants to hire more workers to take medical histories; do physical examinations; order investigations; and diagnose, manage, and treat illnesses.

Sounds like they want to hire more doctors? Not quite. The planned additions to the workforce will make up an entirely new medical profession, with an idea effectively imported from the United States.

The new role, tentatively titled “medical care practitioner” for the UK, is based on the physician assistants in the US, who operate under the supervision of a doctor but can end up managing care for patients single handedly, particularly in primary care settings.

The move is part of a massive upheaval of who does what in the NHS, which is deeply in debt and short of staff, particularly after the introduction of the European Working Time Directive, which has limited the hours doctors can work. The NHS says that it wants to use each type of worker to the peak of their skills, which means doctors are becoming more specialised, nurses do some jobs once restricted to doctors, and some traditional nursing roles have been handed to healthcare assistants. The new role would fit in somewhere between a nurse and a doctor.

Sharing out work in an expanded medical team is a popular trend in many …
Kiska and Cupcake
Authors: Faith T. Fitzgerald
Journal: Annals of Internal Medicine (2019)

On Being a Doctor7 May 2019Kiska and CupcakeFaith T. Fitzgerald, MDFaith T. Fitzgerald, MDUniversity of California, Davis, Medical Center, Sacramento, California (F.T.F.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-3059 Audio Reading - “Kiska and Cupcake” Audio. Michael A. Lacombe, MD, Annals Associate Editor, reads “Kiska and Cupcake” by Faith T. Fitzgerald, MD Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail I was one of two chief residents in internal medicine at San Francisco General Hospital in the early 1970s. I had functioned as an attending and most enjoyed making rounds with the housestaff and students and seeing the patients in the men's ward there, Ward 4. The ward itself was a very open, large, wide room. It was generally filled with 30 to 40 patients on cots under the windows. Each cot had a lumpy mattress; flat and fitted sheets; a single, old pillow; and a thin blanket. Around the cots were equally thin curtains. A path down the middle ... Author, Article, and Disclosure InformationAffiliations: University of California, Davis, Medical Center, Sacramento, California (F.T.F.)Corresponding Author: Faith T. Fitzgerald, MD, UC Davis Medical Center, C/O Division of General Medicine, 4150 V Street, Suite 2400, Sacramento, CA 95817; e-mail, [email protected]edu. PreviousarticleNextarticle Advertisement Audio Reading - “Kiska and Cupcake” Audio. Michael A. Lacombe, MD, Annals Associate Editor, reads “Kiska and Cupcake” by Faith T. Fitzgerald, MD Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 7 May 2019Volume 170, Issue 9Page: 662KeywordsAlcoholicsEsophagusFearHemorrhageHospital medicineInfectious diseasesMemoryNursesPatientsRenal diseases ePublished: 7 May 2019 Issue Published: 7 May 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Book review: Life and Death in Healthcare Ethics: a short introduction
Authors: Alex Vass
Journal: BMJ (2000)

Can a human being cease to be a human person - for example, a foetus in utero or someone in a persist. ent vegetative state? At what point does an embryo attain human status and full human rights of protection? In under 100 pages, but weighing philosophically a hundredweight, The book systematically deconstructs all the possible arguments that can be given in support of euthanasia, “letting die,” abortion, and embryo wastage as a consequence …
Annals Graphic Medicine - Dr. Mom: Haven't Seen the Doc Yet
Authors: Grace E. Farris
Journal: Annals of Internal Medicine (2019)

Web Exclusives7 May 2019Annals Graphic Medicine - Dr. Mom: Haven't Seen the Doc YetFREEGrace E. Farris, MDGrace E. Farris, MDMount Sinai School of Medicine, New York, New York (G.E.F.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/G18-0045 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: Mount Sinai School of Medicine, New York, New York (G.E.F.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=G18-0042.Author/Illustrator Information: Grace E. Farris, MD, is an assistant professor of medicine at Icahn School of Medicine at Mount Sinai and chief of hospital medicine at Mount Sinai West hospital in New York, New York. You can view her work at her Web site: www.farrisgrace.com.About Dr. Mom: In Dr. Mom, physician and cartoonist Grace Farris examines work–life balance while mothering and doctoring. Dr. Mom appears monthly in Annals Graphic Medicine at Annals.org. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 7 May 2019Volume 170, Issue 9Page: W107-W113KeywordsConflicts of interestDisclosureHospital medicineHospitalists ePublished: 7 May 2019 Issue Published: 7 May 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Medical ethics should not be politicised
Authors: Johann Malawana
Journal: BMJ (2005)

The right to a dignified death has been played out across the American media in recent months. Terri Schiavo's case has prompted people to question what they would want done in a similar situation and has been a rallying call to the political and religious “right to life” movement in the United States. The news showed President George Bush flying back from his holiday to sign a bill in the early hours of the morning. The bill was drafted for a single family and signalled the very public intervention of the state in a family's …
Part man, part machine, all doc
Authors: Karen Hebert
Journal: BMJ (2003)

Robodoc, a robot that aids communication with off-site doctors, is now doing the rounds at Johns Hopkins Hospital in Baltimore, United States. Although Robodoc cannot inspect, palpate, percuss, or auscultate, it enables an off-site doctor to have quick and easy access to a patient.

Officially called The Companion, Robodoc resembles a big vacuum …
Extracorporeal Life Support in Cardiogenic Shock Complicating Acute Myocardial Infarction
Authors: Stefan Brunner, Sabina P.W. Guenther, Korbinian Lackermair, Sven Peterss, Martin Orban, Anne-Laure Boulesteix, Sebastian Michel, Jörg Hausleiter, Steffen Massberg, Christian Hagl
Journal: Journal of the American College of Cardiology (2019)
Targeting Mitochondrial Structure Sensitizes Acute Myeloid Leukemia to Venetoclax Treatment
Authors: Xufeng Chen, Christina Glytsou, Hua Zhou, Sonali Narang, Denis E. Reyna, Andrea Lopez, Theodore Sakellaropoulos, Yixiao Gong, Andreas Kloetgen, Yoon Sing Yap, Eric Wang, Evripidis Gavathiotis, Aristotelis Tsirigos, Raoul Tibes, Iannis Aifantis
Journal: Cancer Discovery (2019)

Abstract The BCL2 family plays important roles in acute myeloid leukemia (AML). Venetoclax, a selective BCL2 inhibitor, has received FDA approval for the treatment of AML. However, drug resistance ensues after prolonged treatment, highlighting the need for a greater understanding of the underlying mechanisms. Using a genome-wide CRISPR/Cas9 screen in human AML, we identified genes whose inactivation sensitizes AML blasts to venetoclax. Genes involved in mitochondrial organization and function were significantly depleted throughout our screen, including the mitochondrial chaperonin CLPB. We demonstrated that CLPB is upregulated in human AML, it is further induced upon acquisition of venetoclax resistance, and its ablation sensitizes AML to venetoclax. Mechanistically, CLPB maintains the mitochondrial cristae structure via its interaction with the cristae-shaping protein OPA1, whereas its loss promotes apoptosis by inducing cristae remodeling and mitochondrial stress responses. Overall, our data suggest that targeting mitochondrial architecture may provide a promising approach to circumvent venetoclax resistance. Significance: A genome-wide CRISPR/Cas9 screen reveals genes involved in mitochondrial biological processes participate in the acquisition of venetoclax resistance. Loss of the mitochondrial protein CLPB leads to structural and functional defects of mitochondria, hence sensitizing AML cells to apoptosis. Targeting CLPB synergizes with venetoclax and the venetoclax/azacitidine combination in AML in a p53-independent manner. See related commentary by Savona and Rathmell, p. 831. This article is highlighted in the In This Issue feature, p. 813
Single pill could reduce risk of cardiovascular disease by over 80%
Authors: Krishna Chinttapalli
Journal: BMJ (2003)

A combination pill containing six different drugs could reduce mortality from strokes and myocardial infarctions by 88%, according to a recent study in the BMJ (2003;326:1419-22). Dubbed the “polypill,” it would be intended as a preventive measure and be taken once daily by everyone over 55 years of age and younger people with a clinical history of cardiovascular disease.

The researchers, Nicholas Wald and Malcolm Law, from Queen Mary's School of Medicine and Dentistry, London, performed a series of meta-analyses of existing data on the …
Testing students for bloodborne viruses: the problems
Authors: James Hare
Journal: BMJ (2009)

At first glance, testing medical students for bloodborne viruses sounds like a good idea. Protect the students and protect the patients—right? On closer inspection, however, there are problems that need to be resolved. In the United Kingdom, bloodborne virus testing for all new healthcare workers was recommended in a best practice guideline published by the Department of Health in March 2007.1

Unexpectedly, this policy of testing has had an impact on me. I am in the last cohort of students not to have been screened for HIV and hepatitis C on entrance to …
Insect bite and arrows
Authors: Stephen J Goldie, Glyn R Williams
Journal: BMJ (2006)

A 68 year old man was noted by his wife to have an “insect bite” on the pinna of his left ear. The lesion was red and swollen like a blister. The patient described shooting pains “like arrows” originating from his left ear and radiating over the top of his head. On the morning of presentation he was unable to close his left eye, and his wife noticed that the left corner of his mouth was drooping. Examination of the ear showed several crusted lesions and blisters in the left external acoustic meatus and pinna (fig 1).



Fig 1 
Left external acoustic meatus and pinna



The patient was asked to close his eyes firmly and attempt to smile. Fig 2 shows that he was unable to close his left eye and the left side of his mouth remained motionless. While forcing his right eyelid shut against resistance, the left eye rolled upwards. When asked to raise his eyebrows, the left side remained motionless. Oral examination was normal.



Fig 2 
Unilateral facial palsy



1.  Which sign is shown when the patient's eye rolls upwards?

2.  What condition is this patient likely to have?

3.  How should this patient be managed?

1.  This is a positive Bell's sign (see discussion).

2.  These signs and symptoms are pathognomonic of …
Cosmetic procedures now available on the high street
Authors: Roger Stevens
Journal: BMJ (2002)

Cosmetic procedures are now available in the British high street chemist, Boots, which launched the services on a trial basis in four stores recently--two in London (Kensington and Oxford Street), Milton Keynes in Buckinghamshire, and Manchester. The procedures available are for facial rejuvenation--Botox injection of forehead frown lines and crow's feet (from £200) and injections of hyaluronic acid for lip enhancement (from £230) and …
Book: The Mindful Medical Student
Authors: Oliver Ellis
Journal: BMJ (2009)

Spoofs can be difficult to detect, which is why I’m a bit hesitant to criticise this book. I have half a feeling that I’ll end up on someone’s website, on a roster of dupes who were foolish enough to take it seriously.

Eyebrows are raised right from Bernie Siegel’s foreword, in which he reprints letters that he has sent off to two deans of his former medical school. In these, he suggests that medical students should spend a week in hospital attached to a drip to find out what it’s like and asserts that most physicians have post-traumatic stress disorder. He gravely reports, “Neither dean wrote back.”

The book is largely based on theories of psychoanalysis and as such doesn’t really make a lot of sense: “If …
The philosophy of the medical case
Authors: Hemang Yadav
Journal: BMJ (2006)

I once met a girl with six toes. Rather, she had five and a half toes— a toe-ette emerged innocuously from her otherwise normal hallux. Was I surprised by this medical curiosity? Certainly. Was I disturbed? Of course. Did I rush and document my finding in peer reviewed journals? Definitely not. To me such an activity seems, frankly, quite dull. Yet that is precisely what many doctors around the world regularly seem to do. The collection of case reports they produce is a who's who of the wild and the wacky in our wards today. What are these reports and why are they written?

Published case reports originate from the days when you described something; you got a disease named after you. Along the way, the authors may criticise the lesser mortals who preceded them, but lacked their superior skills of deduction. They then reveal their earth shattering diagnosis. “This patient has the first recorded case of Zollinger-Ellinson syndrome presenting as gallstone ileus impacting in a Meckel's diverticulum,” or …
Wales needs additional places for medical students
Authors: Jason O'Neale Roach
Journal: BMJ (2000)

The National Assembly for Wales is working on a proposal for a second medical school campus in Wales. The proposal is the result of a collaborative approach between the University of Wales College of Medicine (UCWM) and the University of Wales Swansea.

Dai Lloyd, a member of the Plaid Cymru Assembly and general practitioner, who proposed the campus in a debate of the assembly, said that Wales was now facing a recruitment crisis for doctors. The British government announced last year that …
Reappraisal of Ventilator-Free Days in Critical Care Research
Authors: Nadir Yehya, Michael O. Harhay, Martha A. Q. Curley, David A. Schoenfeld, Ron W. Reeder
Journal: American Journal of Respiratory and Critical Care Medicine (2019)

Ventilator-free days (VFDs) are a commonly reported composite outcome measure in acute respiratory distress syndrome trials. VFDs combine survival and duration of ventilation in a manner that summarizes the "net effect" of an intervention on these two outcomes. However, this combining of outcome measures makes VFDs difficult to understand and analyze, which contributes to imprecise interpretations. We discuss the strengths and limitations of VFDs and other "failure-free day" composites, and we provide a framework for when and how to use these outcome measures. We also provide a comprehensive discussion of the different analytic methods for analyzing and interpreting VFDs, including Student's
The Promise of Neoadjuvant Immunotherapy and Surgery for Cancer Treatment
Authors: Jake S. O'Donnell, Esmée P. Hoefsmit, Mark J. Smyth, Christian U. Blank, Michele W.L. Teng
Journal: Clinical Cancer Research (2019)

Cancer immunotherapies utilizing immune checkpoint inhibitors (ICI) have demonstrated durable efficacy in a proportion of patients with advanced/metastatic cancers. More recently, the use of ICIs for the adjuvant treatment of patients with surgically resectable melanoma has also demonstrated efficacy by improving relapse-free survival and in the case of ipilimumab (anti-CTLA-4) also improving overall survival. Although promising, the effective scheduling of surgery and immunotherapy and its duration is not well elucidated. Recent preclinical studies suggest that surgery followed by adjuvant therapy might be suboptimal as compared with an approach in which immunotherapy is applied before surgery (neoadjuvant immunotherapy). Encouraging findings from early-phase clinical trials in melanoma, non-small cell lung carcinoma, and glioblastoma support the idea that neoadjuvant immunotherapy might have improved clinical efficacy over an adjuvant application. In this review, we discuss the existing rationale for the use of neoadjuvant immunotherapy, its apparent strengths and weaknesses, and implications for the design of future clinical trials.
Towards precision oncology for HER2 blockade in gastroesophageal adenocarcinoma
Authors: V. Gambardella, T. Fleitas, N. Tarazona, J.M. Cejalvo, F. Gimeno-Valiente, C. Martinez-Ciarpaglini, M. Huerta, S. Roselló, J. Castillo, D. Roda, A. Cervantes
Journal: Annals of Oncology (2019)
Accidental acne cure
Authors: Sally Morrison–Griffiths
Journal: BMJ (2001)

I am sure that one day I am going to make a really important discovery in medical science. I can feel it in my bones. But then, I am an optimist. I also believe that I am going to win the national lottery. I did, however, come remarkably close to discovering a cure for acne recently.

I was staying at a friend's house and, as I was showering, I noticed the little guest soap in …
Parts of brain responsible for love identified
Authors: Mark Silvert
Journal: BMJ (2000)

The British Medical Association, Medact, and the Medical Students International Network (MedSIN) launched a campaign last month ahead of the G7 summit in Japan to attempt to persuade world leaders to write off all debt owed by the world's poorest countries.

Medical students from around the country created their own unique form of political protest. People signed patient identification bracelets as a gesture of …
Abstract P2-08-45: Malic enzyme 1 is a potential metastasis-related biomarker of breast cancer
Authors: C Liu, Z Tao, X Hu
Journal: Cancer Research (2019)

Abstract Background: Malic enzyme 1 (ME1) catalyzes malate to pyruvate and thus promotes glycolysis, playing a part in the Warburg effect. Recently, several researches have revealed its crucial role in cancer metastasis. KM-plotter, an online analysis tool, showed high ME1 mRNA level was related to poorer RFS and OS. Herein, we explore the prognostic effect of ME1 on invasive breast cancer in Chinese patients and its effect on metastasis in vitro. Methods: 220 patients with early breast cancer were included in this study. ME1 expression was evaluated semi-quantitatively with tissue microarray-based immunohistochemistry. The relationships between ME1 expression level and clinicopathological features were explored. Survival analyses were carried out by Kaplan-Meier test and COX proportional hazard model. MCF-7 and MDA-MB-468 cell lines were then used for in vitro cell migration and invasion assays. Results: High expression of ME1 was observed in 51.5% patients. The median follow-up period was 28.9 months (range 0.5-34.0). In correlation analyses, compared with ME1-low cases, ME1-high cases were significantly associated with larger tumor size (P=0.036), positive lymph nodes (P&amp;lt;0.001) and positive lymph-vascular invasion (P=0.003), and tended to be HER2 positive (P=0.094). Survival analysis by Kaplan-Meier test showed high ME1 expression was significantly correlated with poorer recurrence free survival (RFS) (P=0.015). Multivariate analysis identified high ME1 expression as an independent prognostic factor for RFS (P=0.035, HR=5.072 [1.121, 22.942]). Stratified analysis revealed high ME1 expression was related to poorer RFS among cases more than 45 years old (P=0.029, HR=9.833 [1.269, 76.164]) and among those with Ki67 index ≥20% (P=0.038, HR=3.805 [1.074, 13.486]). In vitro, HER2 positive cell line (SKBR3) and TNBC cell lines (MDA-MB-231, MDA-MB-468) showed high expression of ME1, while luminal cell line (MCF-7) showed low expression of ME1. Upregulation of ME1 in MCF-7 cell line remarkably enhanced its ability in migration and invasion, while knockdown of ME1 in MDA-MB-468 cell line had a profound inhibitory effect on migration and invasion. Conclusions: ME1 enhances migration and invasion of breast cancer cell lines and may be involved in early development of breast cancer metastasis. Thus, ME1 is a promising prognostic indicator and a potential therapeutic target. Citation Format: Liu C, Tao Z, Hu X. Malic enzyme 1 is a potential metastasis-related biomarker of breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-45.