tbuckley/cabot-search huggingface dataset:
The age threshold for isoniazid chemotherapy
Authors: Lee B. Reichman
Journal: JAMA (1987)

<h3>To the Editor.—</h3> Congratulations to Rose et al<sup>1</sup>for their article entitled "The Age Threshold for Isoniazid Chemoprophylaxis." This sorely needed analysis points out that, for all age groups, the benefits of isoniazid in the prevention of tuberculosis outweigh the risks. Publication of this article inThe Journalwill, I hope, counter some of the destructive effects on tuberculosis control in the United States caused by the 1981 publication of the article by Taylor et al<sup>2</sup>entitled: "Should Young Adults With a Positive Tuberculin Test Take Isoniazid?" Even though an accompanying editorial by Comstock<sup>3</sup>pointed out that the assumptions of Taylor et al were severely limited and therefore misleading, that article's effect on tuberculosis control in the United States was dramatic. The Centers for Disease Control continually report that preventive isoniazid therapy is completed by only 75% of high-risk patients for whom it is prescribed.<sup>4</sup>However,
Goiter in Childhood and Adolescence
Journal: JAMA (1963)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Diabetologia, Berlin
Journal: JAMA (1969)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
An Overview of Rodent Toxicities: Liver and Kidney Effects of Fumonisins and Fusarium moniliforme
Authors: Kenneth A. Voss, Ronald T. Riley, W. P. Norred, Charles W. Bacon, Filmore I. Meredith, Paul C. Howard, Ronald D. Plattner, Thomas F. X. Collins, Deborah K. Hansen, James K. Porter
Journal: Environmental Health Perspectives (2001)
Editorial Board
Authors: Stephen Mcleod, San Francisco, Daniel Albert, George Bartley, Creig Hoyt, Andrew Schachat, Anita Agarwal, T Iqbal, Ike Ahmed, Canada Aung, Singapore Bengtsson, Wiley Chambers, Balwantray Chauhan, Emily Chew, Michael Chiang, Mary Cotch, Marjan Farid, Steven Gedde, Lynn Gordon, Los Angeles, Mingguang He, Henry Jampel, Bennie Jeng, Tianjing Li, Thomas Lietman, Sue Lightman
Journal: Ophthalmology (2017)
异位性皮肤压力源对NMF和皮肤细胞因子的作用
Authors: K.A. Engebretsen, S. Kezic, I. Jakasa, A. Hedengran, A. Linneberg, L. Skov, J.D. Johansen, J.P. Thyssen
Journal: British Journal of Dermatology (2018)

异位性皮炎(AD)是一种常见的湿疹。来自皮肤中丝聚蛋白的NMF(天然保湿因子)存在缺陷通常会增加患上AD的风险。丝聚蛋白是皮肤中的一种蛋白质,在保持皮肤屏障功能以及释放有助于保持水分的酸类方面发挥至关重要的作用。虽然目前知道AD是由丝聚蛋白的基因突变造成的,但是很少有人研究会造成体内丝聚蛋白出现缺陷的环境因素。本项丹麦研究由Lundbeck Foundation资助,试图发现哪些类型的环境皮肤压力源会影响NMF和细胞因子的水平。细胞因子是刺激细胞向炎症、感染和创伤移动的细胞分子。在该研究中,40名健康的志愿者(18‐49岁)分别接触硬水、软水和加氯水、十二醇硫酸钠(SLS,洗发水等起泡产品中的一种化学物质)、尘螨、猫过敏原、葡萄球菌肠毒素B(SEB,通常与食物中毒有关的一种蛋白质)、冷却介质和组胺(由免疫系统生成的一种化学物质)。志愿者接受胶带试验(即在皮肤上贴上胶带,然后移除并在显微镜下观察胶带),然后分别记录NMF(24小时和48小时后)和细胞因子(24小时后)的生物学变化。24小时后,与对照试验相比,接触硬水、软水、尘螨和SEB的志愿者的NMF明显降低,细胞因子增加。本项研究得出结论,健康人群接触皮肤压力源会导致NMF水平下降,各类细胞因子增加。这些数据凸显出,环境数据可能在AD病理生理学中发挥作用。
OPERATIVE TREATMENT OF EPILEPSY.
Journal: JAMA (1903)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Matrix Metalloproteinase Inhibitor COL-3 in the Treatment of AIDS-Related Kaposi’s Sarcoma: A Phase I AIDS Malignancy Consortium Study
Authors: Mary Cianfrocca, Timothy P. Cooley, Jeannette Y. Lee, Michelle A. Rudek, David T. Scadden, Lee Ratner, James M. Pluda, William D. Figg, Susan E. Krown, Bruce J. Dezube
Journal: Journal of Clinical Oncology (2002)

PURPOSE: Matrix metalloproteinases (MMPs) are involved in tumor invasion and metastasis and are overexpressed in Kaposi’s sarcoma (KS) cells. The primary aim was to define the safety and toxicity of the MMP inhibitor COL-3 in patients with AIDS-related KS. Secondary aims were to evaluate tumor response, pharmacokinetics, and changes in blood levels of MMP-2, MMP-9, vascular endothelial growth factor (VEGF), and basic fibroblast growth factor (bFGF). PATIENTS AND METHODS: COL-3 was administered orally once daily, and doses were escalated in cohorts of three to six subjects. Patients with symptomatic visceral KS or severe tumor-associated edema were excluded. Antiretroviral therapy was permitted but not required. Study end points were grade 3 or 4 toxicity or progressive KS. Serial blood specimens were obtained for pharmacokinetics and levels of MMP-2, MMP-9, VEGF, and bFGF. RESULTS: Eighteen patients received COL-3 in dosing cohorts of 25, 50, and 70 mg/m 2 /d. Prior KS therapy was reported by 17 patients (94%). COL-3–related grade 3 or 4 adverse events were reported by six patients and included photosensitivity, rash, and headache. There was one complete response and seven partial responses, for an overall response rate of 44%, with a median response duration of 25+ weeks. The median COL-3 half-life was 39.3 hours (range, 4.1 to 251.1 hours). There was a significant difference between responders and nonresponders with respect to the change in MMP-2 serum levels from baseline to minimum value on treatment (P = .037). CONCLUSION: COL-3 administered orally once daily to patients with AIDS-related KS is reasonably well tolerated. The most common adverse event was dose-related photosensitivity. Antitumor activity was noted. Further evaluation of COL-3 for the treatment of KS is warranted.
Malignant Hypertension
Authors: Stina Björk
Journal: JAMA (1963)

<h3>To the Editor:</h3> —In the Aug 18, 1962, issue ofThe Journal(<b>181</b>:571) there appears an article, "The Long-Term Follow-Up of Malignant Hypertension" by Kinsey et al, on which we would like to comment. On page 573 there is reference to a paper published by Sannerstedt, Angervall, Hood, and myself, "Treatment and Prognosis in Malignant Hypertension" (<i>Acta Med Scand</i><b>166</b>:175-187, 1960). We are sorry to learn that the authors found our method for presenting the material unclear and misguiding. In fact, when illustrating the numbers of survivors and of dead patients by white and striated columns, we were conscious of the fact that the resulting charts would give rates of survival directly only for such durations for which the material in its totality had been under observation. For longer durations, rates of survival cannot be obtained directly from charts of this kind, but it is possible to calculate
Arteriography in splenic and hepatic disease.
Journal: BMJ (1969)

tors in some unique, recognizable, and durable way; and young people at school, college, or university should be approached to obtain their consent to the use of their organs after death.Good results from transplantation depend on good tissue matching, and this can be achieved only if there is an adequate supply of donor organs and some registry for potential recipients and donors.Many family doctors would like to be able to tell their patients whom to contact if they wish to donate their organs after their death.This may be a task that could be tackled by one or more voluntary organizations, but it is likely to be expensive, and experience in Europe4 suggests that a computer is essential if the system is to be efficient.Can a voluntary organization provide a complex service of this kind ?It would seem to be a task more suit- ably undertaken by the Department of Health and Social Security.But on the question of individual consent the Government is right to postpone changes in the law until public opinion is clearly in their favour.
Association of induced abortion with subsequent pregnancy loss
Authors: A. A. Levin
Journal: JAMA (1980)

We compared prior pregnancy histories of two groups of multigravidas—240 women having a pregnancy loss up to 28 weeks' gestation and 1,072 women having a term delivery. Women who had had two or more prior induced abortions had a twofold to threefold increase in risk of first-trimester spontaneous abortion, loss between 14 to 19 and 20 to 27 weeks. The increased risk was present for women who had legal induced abortions since 1973. It was not explained by smoking status, history of prior spontaneous loss, prior abortion method, or degree of cervical dilatation. No increase in risk of pregnancy loss was detected among women with a single prior induced abortion. We conclude that multiple induced abortions do increase the risk of subsequent pregnancy losses up to 28 weeks' gestation. (<i>JAMA</i>243:2495-2499, 1980)
MICROBIOLOGIC POISONS.
Journal: JAMA (1893)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
A phase I trial of the histone deacetylase inhibitor panobinostat (LBH589) and epirubicin in patients with solid tumor malignancies.
Authors: P. N. Munster, P. Petrou, C. J. Ryan, T. M. Jahan, S. G. DuBois, H. S. Rugo, J. K. Chan, K. T. Thurn, A. Reinert, A. Daud
Journal: Journal of Clinical Oncology (2010)

e13140 Background: Preclinical cell culture and xenograft studies suggest that pre-exposure of cancer cells to a histone deacetylase inhibitor (HDACi) potentiates topoisomerase (topo) inhibitors. The HDACi-induced histone acetylation and chromatin modulation facilitates DNA access and target recruitment for topo II inhibitors. In vitro data further suggest that effective inhibition of HDAC2 is necessary for enhanced epirubicin-induced apoptosis. Methods: This phase I trial explores the safety, tolerability, and maximum tolerated dose (MTD) of a 3-week cycle of escalating panobinostat doses taken orally on days 1, 3, and 5 followed by epirubicin administered intravenously at 75 mg/m2 on day 5. Histone acetylation and HDAC2 expression are evaluated in pre- and post-treatment peripheral blood mononuclear cells in all patients and in tumor cells of 12 patients treated at the MTD. Results: To date, 10 patients [3M/7F, median age 48 years (range 24- 79)] have been treated in 4 panobinostat cohorts: 20, 30, 40, 50 mg. Tumor types included melanoma (3) and one each of breast, ovarian, neuroblastoma, pancreatic, testicular, sarcoma, and colon cancer. Dose-limiting toxicities included a grade 3 atrial fibrillation with rapid ventricular response at the 50 mg dose. However, no QT interval changes were observed despite extensive electrocardiac monitoring. Non-dose-limiting grade 3 and 4 toxicities include neutropenia (n=6, 60%), thrombocytopenia (n=2, 20%), and fatigue (n=2, 20%). Currently, panobinostat doses of 50 mg are being evaluated. One each of melanoma, ovarian, and neuroblastoma demonstrated stable disease for more than 12 weeks out of 9 evaluable patients. Patients received a median number of 2 (1-6) treatment cycles. H3 and H4 histone acetylation will be correlated with HDAC2 expression, panobinostat dose, and plasma concentration. Conclusions: A sequence-specific combination of panobinostat and epirubicin is tolerable and a dose expansion will be explored. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Novartis Novartis, sanofi-aventis Novartis, Pfizer
Mirvetuximab soravtansine, a folate receptor alpha (FRα)-targeting antibody-drug conjugate (ADC), in combination with bevacizumab in patients (pts) with platinum-agnostic ovarian cancer: Final analysis.
Authors: David M. O'Malley, Ana Oaknin, Ursula A. Matulonis, Gina Mantia-Smaldone, Peter C Lim, Cesar Martin Castro, Diane M. Provencher, Sanaz Memarzadeh, Patrick A. Zweidler-McKay, Jiuzhou Wang, Brooke Esteves, Kathleen N. Moore, Lucy Gilbert
Journal: Journal of Clinical Oncology (2021)

5504 Background: Mirvetuximab soravtansine (MIRV) is an ADC comprising a FRα-binding antibody, cleavable linker, and the maytansinoid DM4, a potent tubulin-targeting agent. As part of the Phase 1b FORWARD II trial (NCT02606305), the combination of MIRV with bevacizumab (BEV) was evaluated in pts with FRα-positive (medium/high expression; ≥50%/ ≥75% of cells with PS2+ staining intensity), platinum agnostic ovarian cancer, defined as pts with either platinum resistant (PROC) (recurrence within 6 months after last platinum dose) or platinum sensitive (PSOC)responded to the last platinum therapy and did not progress within 6 months) for whom a non-platinum based doublet would be appropriate. Methods: Pts received MIRV (6 mg/kg; adjusted ideal body weight) and BEV (15 mg/kg) on Day 1 of a 21-day cycle. Responses were assessed by investigator according to RECIST 1.1 and adverse events (AEs) evaluated by CTCAE v4.03. Results: In total, 60 pts received the combination, with a median age of 60 years, a median of 2 prior lines of systemic therapy (range 1-4) and a median follow-up of 17.5 months. The cohort included 32 pts (53%) with PROC disease and 28 (47%) with PSOC disease. Objective responses were seen in 28 of 60 pts for a confirmed overall response rate (ORR) of 47% (95% CI, 34, 60), median duration of response (mDOR) of 9.7 months (95% CI 6.7, 12.9), and median progression free survival (mPFS) of 8.3 months (95% CI 5.6, 10.6). In pts with high FRα expression (n=33), the confirmed ORR was 64% (95% CI 45, 80), mDOR of 11.8 months (95% CI 6.7, 13.7), and mPFS of 10.6 months (95% CI 8.3, 13.3); efficacy results in PROC and PSOC subsets of pts with high FRα expression are shown in the table below. The most common treatment related AEs (all grade, grade 3+) were diarrhea (68%, 2%), blurred vision (63%, 2%), fatigue (58%, 7%), and nausea (57%, 0%). The most common treatment related grade 3 and 4 AEs were neutropenia and hypertension, (12%, 3% and 13%, 0%, respectively); all other grade 3+ events occurred in ≤ 10% of pts. Conclusions: The combination of MIRV with BEV demonstrates impressive anti-tumor activity with durable responses and favorable tolerability in high FRα recurrent ovarian cancer. These results build on data previously reported for MIRV/BEV in PROC patients ( Gyn Oncology O’Malley, et al 2020), suggesting that MIRV has the potential to be a preferred partner for BEV in patients with high FRα recurrent ovarian cancer regardless of platinum sensitivity. Clinical trial information: NCT02606305. [Table: see text]
Upbeat Nystagmus
Authors: Robert B. Daroff
Journal: JAMA (1973)

<h3>To the Editor.—</h3> Nystagmus, defined as a to-and-fro ocular oscillation of one or both eyes in which each phase is of equal or near-equal amplitude, is often a nonspecific sign of dysfunction "somewhere" in the posterior fossa (brain stem and cerebellum). Certain nystagmus patterns, however, are quite specific and permit reasonably accurate neuro-anatomical or etiological diagnosis or both.<sup>1,2</sup>Thus, nystagmus types such as circular, elliptical, and latent are congenital. See-saw nystagmus represents diencephalic dysfunction, while convergence-retraction nystagmus reflects a dorsal midbrain lesion. Dissociated nystagmus limited to the abducting eye, when not produced by myasthenia gravis, indicates a lesion in or around the medial longitudinal fasciculus. Downbeat nystagmus strongly suggests a low medullary or cranial-cervical junction lesion, as does, to a lesser degree, periodic alternating nystagmus. Gaze-evoked, coarse, slow nystagmus in one direction and faster small-amplitude nystagmus in the other, is the usual pattern of an extraaxial mass (acoustic neuroma,
Amphotericin Pharmacophobia
Authors: W. S. C. Symmers
Journal: BMJ (1973)

Five cases are described in which fear of the possibly hazardous effects of giving amphotericin to patients with kidney disease resulted in death from progressive infection by an amphotericin-sensitive fungus (Cryptococcus neoformans in three cases, Blastomyces dermatitidis in one case, and Histoplasma capsulatum in one case).
Arthritis Prevalence and Activity Limitations— United States, 1990
Journal: JAMA (1994)

Arthritis is a leading cause of work-related disability and the leading cause of disability among persons aged > or = 65 years in the United States (1). However, there are few national or state-specific estimates and no projections of arthritis prevalence or its impact (2). To develop national and state estimates of arthritis prevalence and physical activity limitation for 1990 and to project these measures through 2020, rates derived from household interview data from the 1989-1991 National Health Interview Survey (NHIS) were applied to the 1990 census population and to census population projections. This report presents the results of that analysis.
Pericarditis
Authors: Louis Wolff, Oscar Grunfeld
Journal: New England Journal of Medicine (1963)

THE increasing number of papers on diseases of the pericardium attests to the growing interest in this subject. Pericarditis occurs in a wide variety of infections of bacterial, viral, rickettsial and protozoal origin, a fact that must be recognized when one is planning the therapy of pericarditis or the management of the general infection of which the pericarditis is but one manifestation. Tuberculosis, toxoplasmosis or histoplasmosis, for example, may be uncovered by the etiologic investigation of pericarditis. Pericarditis, with or without other serous-membrane involvement, may implicate a long list of underlying diseases: rheumatic fever; rheumatoid arthritis; systemic lupus erythematosus or . . .
Children, Inc.: The Post-War "Administration" of the Whole Child Life of One Baltic State in Its Critical Period. A Factual Narrative
Journal: JAMA (1934)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
The Forensic Pathologist: "Family Physician" to the Bereaved-Reply
Authors: Lester Adelson
Journal: JAMA (1977)

<h3>In Reply. —</h3> My thanks to Drs Mayhew and Gillette for their kind words. I certainly did not wish to imply "that the forensic pathologist must or should stand alone in his role of comforting the bereft." I have frequently referred the bereaved to ministers, "real" family physicians, social workers, and others who can give solace and comfort at these trying moments, and I accept completely the concept that other persons (ie, nonforensic pathologists) can provide "continuing support to the bereaved." However, when death occurs, as the phrase has it, "suddenly, unexpectedly, or while the person is in apparent good health," there is frequently no clinical attendant to take up the burden, and the responsibility of talking to the family falls, by default if you will, on the shoulders of the postmortem anatomic investigator. My major thesis was (and is) that the forensic pathologist is in the strategic position of