query: Cancer did not cause deaths.

pos: Acute lymphoblastic leukemia Acute lymphoblastic leukemia , also known as acute lymphocytic leukemia or acute lymphoid leukemia ( ALL ) , is an acute form of leukemia , or cancer of the white blood cells , characterized by the overproduction and accumulation of cancerous , immature white blood cells , known as lymphoblasts . In persons with ALL , lymphoblasts are overproduced in the bone marrow and continuously multiply , causing damage and death by inhibiting the production of normal cells ( such as red and white blood cells and platelets ) in the bone marrow and by spreading ( infiltrating ) to other organs . ALL is most common in childhood , with a peak incidence at 2 -- 5 years of age and another peak in old age .   The symptoms of ALL are indicative of a reduced production of functional blood cells , because leukemia wastes the resources of the bone marrow that are normally used to produce new , functioning blood cells . These symptoms can include fever , increased risk of infection ( especially bacterial infections like pneumonia , due to neutropenia ; symptoms of such an infection include shortness of breath , chest pain , cough , vomiting ) , increased tendency to bleed ( due to thrombocytopenia ) , and signs indicative of anemia , including pallor , tachycardia ( high heart rate ) , fatigue , and headache .   About 6,000 cases are reported in the United States every year . Internationally , ALL is more common in Caucasians than in Africans ; it is more common in Hispanics and in Latin America . Cure is a realistic goal and is achieved in more than 80 % of affected children , although only 20-40 % of adults are cured . `` Acute '' is defined by the World Health organization standards , in which greater than 20 % of the cells in the bone marrow are blasts . Chronic lymphocytic leukemia is defined as having less than 20 % blasts in the bone marrow .   ALL was one of the first cancers for which an effective chemotherapeutic treatment was developed . Antifolates like aminopterin and methotrexate were developed in the late 1940s by Sidney Farber and Yellapragada Subbarow . At that time , a doctor did not need a patient 's or parent 's consent to try an experimental treatment as the Nuremberg code had not yet been signed . Desperate to save his patients , Farber initially tried folic acid supplementation as a treatment for ALL . This had disastrous consequences and he likely accelerated the children 's deaths .

pos: Breast cancer Breast cancer is cancer that develops from breast tissue . Signs of breast cancer may include a lump in the breast , a change in breast shape , dimpling of the skin , fluid coming from the nipple , or a red scaly patch of skin . In those with distant spread of the disease , there may be bone pain , swollen lymph nodes , shortness of breath , or yellow skin .   Risk factors for developing breast cancer include being female , obesity , lack of physical exercise , drinking alcohol , hormone replacement therapy during menopause , ionizing radiation , early age at first menstruation , having children late or not at all , older age , and family history . About 5 -- 10 % of cases are due to genes inherited from a person 's parents , including BRCA1 and BRCA2 among others . Breast cancer most commonly develops in cells from the lining of milk ducts and the lobules that supply the ducts with milk . Cancers developing from the ducts are known as ductal carcinomas , while those developing from lobules are known as lobular carcinomas . In addition , there are more than 18 other sub-types of breast cancer . Some cancers , such as ductal carcinoma in situ , develop from pre-invasive lesions . The diagnosis of breast cancer is confirmed by taking a biopsy of the concerning lump . Once the diagnosis is made , further tests are done to determine if the cancer has spread beyond the breast and which treatments it may respond to .   The balance of benefits versus harms of breast cancer screening is controversial . A 2013 Cochrane review stated that it is unclear if mammographic screening does more good or harm . A 2009 review for the US Preventive Services Task Force found evidence of benefit in those 40 to 70 years of age , and the organization recommends screening every two years in women 50 to 74 years old . The medications tamoxifen or raloxifene may be used in an effort to prevent breast cancer in those who are at high risk of developing it . Surgical removal of both breasts is another preventative measure in some high risk women . In those who have been diagnosed with cancer , a number of treatments may be used , including surgery , radiation therapy , chemotherapy , hormonal therapy and targeted therapy . Types of surgery vary from breast-conserving surgery to mastectomy . Breast reconstruction may take place at the time of surgery or at a later date . In those in whom the cancer has spread to other parts of the body , treatments are mostly aimed at improving quality of life and comfort .   Outcomes for breast cancer vary depending on the cancer type , extent of disease , and person 's age . Survival rates in the developed world are high , with between 80 % and 90 % of those in England and the United States alive for at least 5 years . In developing countries survival rates are poorer . Worldwide , breast cancer is the leading type of cancer in women , accounting for 25 % of all cases . In 2012 it resulted in 1.68 million new cases and 522,000 deaths . It is more common in developed countries and is more than 100 times more common in women than in men .

pos: Colorectal cancer Colorectal cancer ( CRC ) , also known as bowel cancer and colon cancer , is the development of cancer from the colon or rectum ( parts of the large intestine ) . A cancer is the abnormal growth of cells that have the ability to invade or spread to other parts of the body . Signs and symptoms may include blood in the stool , a change in bowel movements , weight loss , and feeling tired all the time .   Most colorectal cancers are due to old age and lifestyle factors with only a small number of cases due to underlying genetic disorders . Some risk factors include diet , obesity , smoking , and lack of physical activity . Dietary factors that increase the risk include red and processed meat as well as alcohol . Another risk factor is inflammatory bowel disease , which includes Crohn 's disease and ulcerative colitis . Some of the inherited genetic disorders that can cause colorectal cancer include familial adenomatous polyposis and hereditary non-polyposis colon cancer ; however , these represent less than 5 % of cases . It typically starts as a benign tumor , often in the form of a polyp , which over time becomes cancerous .   Bowel cancer may be diagnosed by obtaining a sample of the colon during a sigmoidoscopy or colonoscopy . This is then followed by medical imaging to determine if the disease has spread . Screening is effective for preventing and decreasing deaths from colorectal cancer . Screening is recommended starting from the age of 50 to 75 . During colonoscopy , small polyps may be removed if found . If a large polyp or tumor is found , a biopsy may be performed to check if it is cancerous . Aspirin and other non-steroidal anti-inflammatory drugs decrease the risk . Their general use is not recommended for this purpose , however , due to side effects .   Treatments used for colorectal cancer may include some combination of surgery , radiation therapy , chemotherapy and targeted therapy . Cancers that are confined within the wall of the colon may be curable with surgery while cancer that has spread widely are usually not curable , with management being directed towards improving quality of life and symptoms . Five year survival rates in the United States are around 65 % . This , however , depends on how advanced the cancer is , whether or not all the cancer can be removed with surgery , and the person 's overall health . Globally , colorectal cancer is the third most common type of cancer making up about 10 % of all cases . In 2012 , there were 1.4 million new cases and 694,000 deaths from the disease . It is more common in developed countries , where more than 65 % of cases are found . It is less common in women than men .

pos: Cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body . Not all tumors are cancerous ; benign tumors do not spread to other parts of the body . Possible signs and symptoms include a lump , abnormal bleeding , prolonged cough , unexplained weight loss and a change in bowel movements . While these symptoms may indicate cancer , they may have other causes . Over 100 types of cancers affect humans .   Tobacco use is the cause of about 22 % of cancer deaths . Another 10 % is due to obesity , poor diet , lack of physical activity , and excessive drinking of alcohol . Other factors include certain infections , exposure to ionizing radiation and environmental pollutants . In the developing world nearly 20 % of cancers are due to infections such as hepatitis B , hepatitis C and human papillomavirus ( HPV ) . These factors act , at least partly , by changing the genes of a cell . Typically many genetic changes are required before cancer develops . Approximately 5 -- 10 % of cancers are due to inherited genetic defects from a person 's parents . Cancer can be detected by certain signs and symptoms or screening tests . It is then typically further investigated by medical imaging and confirmed by biopsy .   Many cancers can be prevented by not smoking , maintaining a healthy weight , not drinking too much alcohol , eating plenty of vegetables , fruits and whole grains , vaccination against certain infectious diseases , not eating too much processed and red meat , and avoiding too much sunlight exposure . Early detection through screening is useful for cervical and colorectal cancer . The benefits of screening in breast cancer are controversial . Cancer is often treated with some combination of radiation therapy , surgery , chemotherapy , and targeted therapy . Pain and symptom management are an important part of care . Palliative care is particularly important in people with advanced disease . The chance of survival depends on the type of cancer and extent of disease at the start of treatment . In children under 15 at diagnosis the five-year survival rate in the developed world is on average 80 % . For cancer in the United States the average five-year survival rate is 66 % .   In 2015 about 90.5 million people had cancer . About 14.1 million new cases occur a year ( not including skin cancer other than melanoma ) . It caused about 8.8 million deaths ( 15.7 % ) of human deaths . The most common types of cancer in males are lung cancer , prostate cancer , colorectal cancer and stomach cancer . In females , the most common types are breast cancer , colorectal cancer , lung cancer and cervical cancer . If skin cancer other than melanoma were included in total new cancers each year it would account for around 40 % of cases . In children , acute lymphoblastic leukaemia and brain tumors are most common except in Africa where non-Hodgkin lymphoma occurs more often . In 2012 , about 165,000 children under 15 years of age were diagnosed with cancer . The risk of cancer increases significantly with age and many cancers occur more commonly in developed countries . Rates are increasing as more people live to an old age and as lifestyle changes occur in the developing world . The financial costs of cancer were estimated at $ 1.16 trillion US dollars per year as of 2010 .

pos: Palliative care Palliative care is a multidisciplinary approach to specialized medical care for people with life-limiting illnesses . It focuses on providing people with relief from the symptoms , pain , physical stress , and mental stress of the terminal diagnosis . The goal of such therapy is to improve quality of life for both the person and their family . Evidence as of 2016 supports improvement in quality of life .   Palliative care is provided by a team of physicians , nurses , physiotherapists , occupational therapists and other health professionals who work together with the primary care physician and referred specialists ( or , for patients who do n't have those , hospital or hospice staff ) to provide additional support . It is appropriate at any age and at any stage in a serious illness and can be provided as the main goal of care or along with curative treatment . Although it is an important part of end-of-life care , it is not limited to that stage . Palliative care can be provided across multiple settings including in hospitals , in the patient 's home , as part of community palliative care programs , and in skilled nursing facilities . Interdisciplinary palliative care teams work with patients and their families to clarify goals of care and provide symptom management , psycho-social , and spiritual support .   Physicians sometimes use the term palliative care in a sense meaning palliative therapies without curative intent , when no cure can be expected ( as often happens in late-stage cancers ) . For example , tumor debulking can continue to reduce pain from mass effect even when it is no longer curative . A clearer usage is palliative , noncurative therapy when that is what is meant , because palliative care can be used along with curative or aggressive therapies .   Medications and treatments are said to have a palliative effect if they relieve symptoms without having a curative effect on the underlying disease or cause . This can include treating nausea related to chemotherapy or something as simple as morphine to treat the pain of broken leg or ibuprofen to treat aching related to an influenza ( flu ) infection . Although the concept of palliative care is not new , most physicians have traditionally concentrated on trying to cure people .

pos: Skin cancer Skin cancers are cancers that arise from the skin . They are due to the development of abnormal cells that have the ability to invade or spread to other parts of the body . There are three main types of skin cancers : basal-cell skin cancer ( BCC ) , squamous-cell skin cancer ( SCC ) and melanoma . The first two , along with a number of less common skin cancers , are known as nonmelanoma skin cancer ( NMSC ) . Basal-cell cancer grows slowly and can damage the tissue around it but is unlikely to spread to distant areas or result in death . It often appears as a painless raised area of skin , that may be shiny with small blood vessel running over it or may present as a raised area with an ulcer . Squamous-cell cancer is more likely to spread . It usually presents as a hard lump with a scaly top but may also form an ulcer . Melanomas are the most aggressive . Signs include a mole that has changed in size , shape , color , has irregular edges , has more than one color , is itchy or bleeds .   Greater than 90 % of cases are caused by exposure to ultraviolet radiation from the Sun . This exposure increases the risk of all three main types of skin cancer . Exposure has increased partly due to a thinner ozone layer . Tanning beds are becoming another common source of ultraviolet radiation . For melanomas and basal-cell cancers exposure during childhood is particularly harmful . For squamous-cell cancers total exposure , irrespective of when it occurs , is more important . Between 20 % and 30 % of melanomas develop from moles . People with light skin are at higher risk as are those with poor immune function such as from medications or HIV/AIDS . Diagnosis is by biopsy .   Decreasing exposure to ultraviolet radiation and the use of sunscreen appear to be effective methods of preventing melanoma and squamous-cell cancer . It is not clear if sunscreen affects the risk of basal-cell cancer . Nonmelanoma skin cancer is usually curable . Treatment is generally by surgical removal but may less commonly involve radiation therapy or topical medications such as fluorouracil . Treatment of melanoma may involve some combination of surgery , chemotherapy , radiation therapy , and targeted therapy . In those people whose disease has spread to other areas of their bodies , palliative care may be used to improve quality of life . Melanoma has one of the higher survival rates among cancers , with over 86 % of people in the UK and more than 90 % in the United States surviving more than 5 years .   Skin cancer is the most common form of cancer , globally accounting for at least 40 % of cases . The most common type is nonmelanoma skin cancer , which occurs in at least 2-3 million people per year . This is a rough estimate , however , as good statistics are not kept . Of nonmelanoma skin cancers , about 80 % are basal-cell cancers and 20 % squamous-cell cancers . Basal-cell and squamous-cell cancers rarely result in death . In the United States they were the cause of less than 0.1 % of all cancer deaths . Globally in 2012 melanoma occurred in 232,000 people , and resulted in 55,000 deaths . Australia and New Zealand have the highest rates of melanoma in the world . The three main types of skin cancer have become more common in the last 20 to 40 years , especially in those areas which are mostly Caucasian .

neg: Fritz Lickint Fritz Balduin Lickint ( 1 October 1898 -- 7 July 1960 ) was a German internist and social democrat , who investigated scientifically health problems and social problems related to alcohol and tobacco , described in the 1920s cancer of the lung from smoking and the cancer pathway alongside the respiratory and upper digestive tract . In 1925 he published about an increase of gastric ulcer and stomach cancer in smokers . All his life Lickint was an engaged social democrat and member of the union `` social democratic physicians '' . Because of his political attitude he lost his job at the Chemnitz hospital in 1934 , shortly after the Nazis came into power , and was convened to military service in 1939 as a basic aidman . Not before 1945 he was able to return to his work as a hospital physician and later became hospital director .  Lickint was one of the first physicians describing physical and psychological tobacco dependence as a disease , which needs treatment , suggesting a number of therapies ( part of them still in use ) . He also pointed to the `` anti-social behavior of many smokers , polluting ambient air recklessly and harming health of other people '' . Lickint created the term `` passive smoking '' . The Nazis usurped these thoughts , but simultaneously supplied soldiers with cigarettes and cooperated with the German tobacco industry Reemtsma , also in Austria .  Later the propaganda of the tobacco industry in Austria and Germany traced the origin of the non-smoking movement back to the Nazi time , when actually more cigarettes were smoked than ever before . In fact the movement against alcohol and nicotine had started in the social democratic party at the beginning of the 20th century , even though research and ideas of Fritz Lickint were also used in the anti-tobacco movement in Nazi Germany . Though he was not the first to publish statistical evidence suggesting a link between cancer and tobacco consumption , in 1929 Lickint published the most thorough case-series study at the time . In 1939 , Lickint in collaboration with The Reich 's Committee for the Struggle against Addictive Drugs and the German Antitobacco League published Tobak and Organisms , a 1200-page volume covering 8000 publications which is considered to be the largest scholarly compilation on the ills of tobacco at the time . This in turn earned him the title as the physician `` most hated by the tobacco industry . '' Lickint argued that tobacco was highly addicitive and that its usage was responsible for thousands of cancers in Nazi Germany .   Like other doctors at the time , Lickint also experimented with radical approaches to cure cancer such as x-raying the spleens of cancer patients in hopes of producing cancer-fighting hormones . He also coined the term `` passive smoking '' .

neg: Cancer prevention Cancer prevention is defined as active measures to decrease the risk of cancer . The vast majority of cancer cases are due to environmental risk factors , and many , but not all , of these environmental factors are controllable lifestyle choices . Greater than 30 % of cancer deaths could be prevented by avoiding risk factors including : tobacco , overweight / obesity , an insufficient diet , physical inactivity , alcohol , sexually transmitted infections , and air pollution . Not all environmental causes are controllable , such as naturally occurring background radiation , and other cases of cancer are caused through hereditary genetic disorders , and thus it is not possible to prevent all cases of cancer .

neg: Biosimilar A biosimilar ( also known as follow-on biologic or subsequent entry biologic ) is a biologic medical product which is almost an identical copy of an original product that is manufactured by a different company . Biosimilars are officially approved versions of original `` innovator '' products , and can be manufactured when the original product 's patent expires . Reference to the innovator product is an integral component of the approval .   Unlike with generic drugs of the more common small-molecule type , biologics generally exhibit high molecular complexity , and may be quite sensitive to changes in manufacturing processes . Follow-on manufacturers do not have access to the originator 's molecular clone and original cell bank , nor to the exact fermentation and purification process , nor to the active drug substance , although they do have access to the commercialized innovator product . Overall , it is harder to ascertain fungibility between generics and innovators among biologics than it is among totally synthesized and semisynthesized drugs , which is why the name `` biosimilar '' was coined to differentiate these drugs from small-molecule generics . A simple analogy is that it is harder to say that two wines are `` sufficiently interchangeable '' , because of differences in yeast strain , weather , grape harvest , or terroir , than it is to say that two soda pops are `` sufficiently interchangeable '' because they contain the same flavoring powder and salts .   Drug related authorities such as European Medicines Agency ( EMA ) , Food and Drug Administration ( FDA ) , and Health Canada hold their own guidance on requirements for demonstration of the similar nature of two biological products in terms of safety and efficacy . According to them , analytical studies that demonstrate that the biological product is highly similar to the reference product notwithstanding minor differences in clinically inactive components , animal studies ( including the assessment of toxicity ) , and a clinical study or studies ( including the assessment of immunogenicity and pharmacokinetics or pharmacodynamics ) are sufficient to demonstrate safety , purity , and potency in one or more appropriate conditions of use for which the reference product is licensed and intended to be used and for which licensure is sought for the biological product .   In case of a monoclonal antibody-containing medicinal product , such as Remsima , extensive physicochemical and biological characterization for it and its reference product Remicade was conducted in order to demonstrate their highly similar properties . Consequently , EMA has granted a marketing authorisation for only a few biosimilars since 2006 including a monoclonal antibody which is recently approved . Meanwhile , on March 6 , 2015 , the FDA approved the United States 's first biosimilar product , the biosimilar of filgrastim called filgrastim-sndz ( trade name Zarxio ) by Sandoz .

neg: Testosterone and the cardiovascular system The predominant androgen in men , testosterone , has shown to substantially decline throughout the aging process . The decline in both serum and total testosterone with age have been linked to several disease states in men . In particular , cardiac failure and ischemic heart disease have been linked to this natural biochemical decline in testosterone . Previously , the higher cardiovascular risk in men has been attributed in part to the negative effects of systemic testosterone , however , more recent research has highlighted the protective nature of testosterone against cardiovascular disease . The magnitude and mechanism of action by which low testosterone in men is influential in the pathogenesis of cardiovascular risk and the potential benefits of testosterone therapy has yet to be fully determined .

neg: Liver cancer Liver cancer , also known as hepatic cancer and primary hepatic cancer , is cancer that starts in the liver . Cancer which has spread from elsewhere to the liver , known as liver metastasis , is more common than that which starts in the liver . Symptoms of liver cancer may include a lump or pain in the right side below the rib cage , swelling of the abdomen , yellowish skin , easy bruising , weight loss , and weakness .   The leading cause of liver cancer is cirrhosis due to hepatitis B , hepatitis C , or alcohol . Other causes include aflatoxin , non-alcoholic fatty liver disease , and liver flukes . The most common types are hepatocellular carcinoma ( HCC ) , which makes up 80 % of cases , and cholangiocarcinoma . Less common types include mucinous cystic neoplasm and intraductal papillary biliary neoplasm . The diagnosis may be supported by blood tests and medical imaging with confirmation by tissue biopsy .   Preventive efforts include immunization against hepatitis B and treating those infected with hepatitis B or C. Screening is recommended in those with chronic liver disease . Treatment options may include surgery , targeted therapy , and radiation therapy . In certain cases ablation therapy , embolization therapy , or liver transplantation may be used . Small lumps in the liver may be simply closely followed .   Primary liver cancer is globally the sixth most frequent cancer ( 6 % ) and the second leading cause of death from cancer ( 9 % ) . In 2012 it occurred in 782,000 people and in 2015 resulted in 810,500 deaths . In 2015 , 263,000 deaths from liver cancer were due to hepatitis B , 167,000 to hepatitis C , and 245,000 to alcohol . Higher rates of liver cancer occur where hepatitis B and C are common , including Asia and sub-Saharan Africa . Males are more often affected with HCC than females . Diagnosis is most frequent among those 55 to 65 years old . Five-year survival rates are 18 % in the United States . The word `` hepatic '' is from the Greek hêpar , meaning `` liver . ''

neg: Surrogate endpoint In clinical trials , a surrogate endpoint ( or marker ) is a measure of effect of a specific treatment that may correlate with a real clinical endpoint but does not necessarily have a guaranteed relationship . The National Institutes of Health ( USA ) defines surrogate endpoint as `` a biomarker intended to substitute for a clinical endpoint '' .   Surrogate markers are used when the primary endpoint is undesired ( e.g. , death ) , or when the number of events is very small , thus making it impractical to conduct a clinical trial to gather a statistically significant number of endpoints . The FDA and other regulatory agencies will often accept evidence from clinical trials that show a direct clinical benefit to surrogate markers .   Surrogate endpoints can be obtained from different modalities , such as , behavioural or cognitive scores , or biomarkers from Electroencephalography ( qEEG ) , MRI , PET , or biochemical biomarkers .   A correlate does not make a surrogate . It is a common misconception that if an outcome is a correlate ( that is , correlated with the true clinical outcome ) it can be used as a valid surrogate end point ( that is , a replacement for the true clinical outcome ) . However , proper justification for such replacement requires that the effect of the intervention on the surrogate end point predicts the effect on the clinical outcome -- a much stronger condition than correlation .   The term `` surrogate '' should not be used in describing end points . Instead , descriptions of results and interpretations should be formulated in terms that designate the specific nature and category of variable assessed .   A surrogate endpoint of a clinical trial is a laboratory measurement or a physical sign used as a substitute for a clinically meaningful endpoint that measures directly how a patient feels , functions or survives . Changes induced by a therapy on a surrogate endpoint are expected to reflect changes in a clinically meaningful endpoint .   A commonly used example is cholesterol . While elevated cholesterol levels increase the likelihood for heart disease , the relationship is not linear - many people with normal cholesterol develop heart disease , and many with high cholesterol do not . `` Death from heart disease '' is the endpoint of interest , but `` cholesterol '' is the surrogate marker . A clinical trial may show that a particular drug ( for example , simvastatin ( Zocor ) ) is effective in reducing cholesterol , without showing directly that simvastatin prevents death . Proof of Zocor 's efficacy in reducing cardiovascular disease was only presented five years after its original introduction , and then only for secondary prevention . In another case , AstraZeneca has been accused of marketing rosuvastatin ( Crestor ) without providing hard endpoint data , relying instead on surrogate endpoints . The company counters that it had been tested on larger groups of patients than any other drug in the class , and that its effects should be comparable to the other statins .

neg: Fluoroquinolone-associated disability Fluoroquinolone-Associated Disability ( `` FQAD '' ) is an FDA formal review identification for a constellation of symptoms that have been identified in the FDA 's Adverse Event Reporting System ( FAERS ) in review of data in the fluoroquinolone safety reports . This identification was formally published as a Briefing document for a joint meeting of the Antimicrobial Drugs Advisory Committee and the Drug Safety and Risk Management Advisory Committee . These Adverse Reactions have been identified as leading to disability . Individuals with FQAD are defined as `` U.S. patients who were reported to be previously healthy and prescribed an oral fluoroquinolone antibacterial drug for the treatment of uncomplicated sinusitis , bronchitis , or urinary tract infection ( UTI ) . ''   Fluoroquinolone-Associated Disability is identified with the following Quinolone drugs : Avelox ( Moxifloxacin ) Cipro , Cipro XR , Proquin XR ( Ciprofloxacin ) , Factive ( gemifloxacin ) , Levaquin ( Levofloxacin ) , Floxin ( ofloxacin )   Criteria that the FDA is using for this class of adverse events are :  US Cases  Outcome : Disability only  Oral dosage forms  In the report on FQAD , the FDA has used the regulatory definition of disability as `` a substantial disruption of a person 's ability to conduct normal life functions '' ( 21 CFR 314.80 ) . However this judgment review is not meant to represent a legal definition of this disruption . The FDA identifies a `` healthy patient '' as a person `` able to perform all of the usual activities of daily living without significant restrictions prior to taking the fluoroquinolone . ''   Adverse Reactions and events associated with FQAD that have been reported and documented are : Tendonitis and tendon rupture , Central Nervous System effects , Peripheral Neuropathy , Myasthenia Gravis Exacerbation , QT Prolongation Torsades de Pointes ( TdP ) , Phototoxicity , Hypersensitivity , Arthritis , Brain Fog and Anxiety .   November 5 , 2015 : A meeting was conducted by FDA regarding the risk - benefits while the affected speakers presented their cases .   Note : FQAD is not a diagnosis but a cluster of symptoms post dosage of quinolones .   The U.S. FDA added a black box warning for fluoroquinolone antibiotics pertaining to peripheral nerve damage . In a communication dated 15 August 2013 , the following warning was posted on the FDA website : `` FDA Drug Safety Communication : FDA requires label changes to warn of risk for possibly permanent nerve damage from antibacterial fluoroquinolone drugs taken by mouth or by injection . ''   FDA Discussion on FQAD :   On Thursday , November 5 , 2015 , there was a meeting convened by the FOOD AND DRUG ADMINISTRATION CENTER FOR DRUG EVALUATION AND RESEARCH . JOINT MEETING OF THE ANTIMICROBIAL DRUGS ADVISORY COMMITTEE AND THE DRUG SAFETY AND RISK MANAGEMENT ADVISORY COMMITTEE . Meeting was held on Thursday , November 5 , 2015 8:01 a.m. to 6:05 p.m. FDA White Oak Campus Building 31 , The Great Room , White Oak Conference Center , in Silver Spring , Maryland . Present were representatives from the FDA , The Pharmaceutical industry , and members of the general public , offering testimony regarding the use of fluoroquinolone antibiotics along with the subsequent risks and benefits of the `` systemic fluoroquinolone antibacterial drugs for the treatment of acute bacterial sinusitis , acute bacterial exacerbation of chronic bronchitis in patients who have chronic obstructive pulmonary disease , and uncomplicated urinary tract infections in the context of available safety information and the treatment effect of antibacterial drugs in these clinical conditions . '' Presiding was Captain Monica Parise , the chairperson for the Antimicrobial Drugs Advisory Committee . This was a joint meeting of the Antimicrobial Drugs Advisory Committee and Drug Safety and Risk Management Advisory Committee of the FDA . After lengthy testimony and discussion , the committees decided that the current labeling for these drugs was unacceptable , recommending additional study , discussion and action to make both patient and practitioners aware of the potential for both temporary and permanent adverse reactions to the drugs , particularly requiring physicians to be more completely informed that fluoroquinolones are not to be used as a first line of defense against the three maladies discussed . The additional use of `` REMS '' ( Risk Evaluation and Mitigation Strategy ) to require practitioners to review the potential consequences of using these medicines with their patients was recommended as well . There are 476 pages of testimony and discussion in the record . ( see reference for complete transcript )

neg: Gross examination Gross examination or `` grossing '' is the process by which pathology specimens are inspected with the bare eye to obtain diagnostic information , while being processed for further microscopic examination .   Gross examination of surgical specimens is typically performed by a pathologist , or by a pathologists ' assistant working within a pathology practice . Individuals trained in these fields are often able to gather diagnostically critical information in this stage of processing , including the stage and margin status of surgically removed tumors .   The initial step in any examination of a clinical specimen is confirmation of the identity of the patient and the anatomical site from which the specimen was obtained . Sufficient clinical data should be communicated by the clinical team to the pathology team in order to guide the appropriate diagnostic examination and interpretation of the specimen - if such information is not provided , it must be obtained by the examiner prior to processing the specimen .   There are usually two end products of the gross examination of a surgical specimen . The first is the gross description , a document which serves as the written record of the examiner 's findings , and is included in the final pathology report . The second product is a set of tissue blocks , typically postage stamp-sized portions of tissue sealed in plastic cassettes , which will be processed into slides for microscopic examination . Since only a minority of the tissue from a large specimen can reasonably be subject to microscopic examination , the success of the final histological diagnosis is highly dependent on the skill of the professional performing the gross examination . The gross examiner may sample portions of the specimen for other types of ancillary tests as diagnostically indicated ; these include microbiological culture , flow cytometry , cytogenetics , or electron microscopy .

neg: Alternative cancer treatments Alternative cancer treatments are alternative or complementary treatments for cancer that have not been approved by the government agencies responsible for the regulation of therapeutic goods . They include diet and exercise , chemicals , herbs , devices , and manual procedures . The treatments are not supported by evidence , either because no proper testing has been conducted , or because testing did not demonstrate statistically significant efficacy . Concerns have been raised about the safety of some of them . Some treatments that have been proposed in the past have been found in clinical trials to be useless or unsafe . Some of these obsolete or disproven treatments continue to be promoted , sold , and used . Promoting or marketing such treatments is illegal in most of the developed world including the United States and European Union .   A distinction is typically made between complementary treatments which do not disrupt conventional medical treatment , and alternative treatments which may replace conventional treatment .  Alternative cancer treatments are typically contrasted with experimental cancer treatments -- which are treatments for which experimental testing is underway -- and with complementary treatments , which are non-invasive practices used alongside other treatment . All approved chemotherapeutic cancer treatments were considered experimental cancer treatments before their safety and efficacy testing was completed .   Since the 1940s , medical science has developed chemotherapy , radiation therapy , adjuvant therapy and the newer targeted therapies , as well as refined surgical techniques for removing cancer . Before the development of these modern , evidence-based treatments , 90 % of cancer patients died within five years . With modern mainstream treatments , only 34 % of cancer patients die within five years . However , while mainstream forms of cancer treatment generally prolong life or permanently cure cancer , most treatments also have side effects ranging from unpleasant to fatal , such as pain , blood clots , fatigue , and infection . These side effects and the lack of a guarantee that treatment will be successful create appeal for alternative treatments for cancer , which purport to cause fewer side effects or to increase survival rates .   Alternative cancer treatments have typically not undergone properly conducted , well-designed clinical trials , or the results have not been published due to publication bias ( a refusal to publish results of a treatment outside that journal 's focus area , guidelines or approach ) . Among those that have been published , the methodology is often poor . A 2006 systematic review of 214 articles covering 198 clinical trials of alternative cancer treatments concluded that almost none conducted dose-ranging studies , which are necessary to ensure that the patients are being given a useful amount of the treatment . These kinds of treatments appear and vanish frequently , and have throughout history .

neg: Kaposi's sarcoma Kaposi 's sarcoma or Kaposi sarcoma ( -LSB- ˈkæpəʃi_sɑrˈkoʊmə -RSB- KS ) is a tumor caused by infection with human herpesvirus 8 ( HHV8 ) , also known as Kaposi sarcoma-associated herpesvirus ( KSHV ) or KS agent . It was originally described by Moritz Kaposi , a Hungarian dermatologist practicing at the University of Vienna in 1872 . It became more widely known as one of the AIDS-defining illnesses in the 1980s . The viral cause for this cancer was discovered in 1994 . Although KS is now well-established to be caused by a viral infection , there is widespread lack of awareness of this even among persons at risk for KSHV/HHV -8 infection .   Kaposi sarcoma ( KS ) is a systemic disease that can present with cutaneous lesions with or without internal involvement . Four subtypes have been described : Classic KS , affecting middle aged men of Mediterranean descent ; African endemic KS ; KS in iatrogenically immunosuppressed patients ; and AIDS-related KS . The erythematous to violaceous cutaneous lesions seen in KS have several morphologies : macular , patch , plaque , nodular , and exophytic . The cutaneous lesions can be solitary , localized or disseminated . KS can involve the oral cavity , lymph nodes , and viscera . Classic KS tends to be indolent , presenting with erythematous or violaceous patches on the lower extremities . African endemic KS and AIDS-related KS tend to be more aggressive . The AIDS-related KS lesions often rapidly progress to plaques and nodules affecting the upper trunk , face , and oral mucosa . The diagnosis can be made with a tissue biopsy and , if clinically indicated , internal imaging should be done .   Once the diagnosis of KS has been made , treatment is based on the subtype and the presence of localized versus systemic disease . Localized cutaneous disease can be treated with cryotherapy , intralesional injections of vinblastine , alitretinoin gel , radiotherapy , topical immunotherapy ( Imiquimod ) , or surgical excision . Extensive cutaneous disease or internal disease may require intravenous chemotherapy and immunotherapy . Discontinuation or reduction of immunosuppressive therapy is recommended when KS arises in the setting of iatrogenic immunosuppression . However , with AIDS-related KS , highly active antiretroviral therapy ( HAART ) has been shown to prevent , or induce regression of , KS . Some AIDS patients have complete resolution of the lesions and prolonged remission while continuing the therapy . Therefore , HAART should be considered first-line treatment for these patients , though they may require other treatments at the same time .

neg: List of women who died in childbirth This is a list of notable women , either famous themselves or closely associated with someone well known , who suffered maternal death as defined by the World Health Organization ( WHO ) :   `` the death of a woman while pregnant or within 42 days of termination of pregnancy , irrespective of the duration and site of the pregnancy , from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes . ''   Note that this wording includes abortion , miscarriage , stillbirth , and ectopic pregnancy . Generally , there is a distinction between a direct maternal death that is the result of a complication of the pregnancy , delivery , or management of the two , and an indirect maternal death that is a pregnancy-related death in a woman with a pre-existing or newly developed health problem unrelated to pregnancy . Fatalities during but unrelated to a pregnancy are termed accidental , incidental , or non-obstetrical maternal deaths .   However , the WHO definition is only one of many ; other definitions may include accidental and incidental causes . Cases with `` incidental causes '' include deaths secondary to violence against women that may be related to the pregnancy and be affected by the socioeconomic and cultural environment . Also , it has been reported that about 10 % of maternal deaths may occur late , that is after 42 days after a termination or delivery ; thus , some definitions extend the period of observation to one year after the end of gestation .

neg: Warburg hypothesis The Warburg hypothesis ( -LSB- ˈvɑrbʊərg -RSB- ) , sometimes known as the Warburg theory of cancer , postulates that the driver of tumorigenesis is an insufficient cellular respiration caused by insult to mitochondria . The term Warburg effect describes the observation that cancer cells , and many cells grown in-vitro , exhibit glucose fermentation even when enough oxygen is present to properly respire . In other words , instead of fully respiring in the presence of adequate oxygen , cancer cells ferment . The Warburg hypothesis was that the Warburg effect was the root cause of cancer . The current popular opinion is that cancer cells ferment glucose while keeping up the same level of respiration that was present before the process of carcinogenesis , and thus the Warburg effect would be defined as the observation that cancer cells exhibit glycolysis with lactate secretion and mitochondrial respiration even in the presence of oxygen .

neg: Parkinson's disease Parkinson 's disease ( PD ) is a long-term degenerative disorder of the central nervous system that mainly affects the motor system . The symptoms generally come on slowly over time . Early in the disease , the most obvious are shaking , rigidity , slowness of movement , and difficulty with walking . Thinking and behavioral problems may also occur . Dementia becomes common in the advanced stages of the disease . Depression and anxiety are also common occurring in more than a third of people with PD . Other symptoms include sensory , sleep , and emotional problems . The main motor symptoms are collectively called `` parkinsonism '' , or a `` parkinsonian syndrome '' .   The cause of Parkinson 's disease is generally unknown , but believed to involve both genetic and environmental factors . Those with a family member affected are more likely to get the disease themselves . There is also an increased risk in people exposed to certain pesticides and among those who have had prior head injuries while there is a reduced risk in tobacco smokers and those who drink coffee or tea . The motor symptoms of the disease result from the death of cells in the substantia nigra , a region of the midbrain . This results in not enough dopamine in these areas . The reason for this cell death is poorly understood , but involves the build-up of proteins into Lewy bodies in the neurons . Diagnosis of typical cases is mainly based on symptoms , with tests such as neuroimaging being used to rule out other diseases .   There is no cure for Parkinson 's disease . Initial treatment is typically with the antiparkinson medication L-DOPA ( levodopa ) , with dopamine agonists being used once levodopa becomes less effective . As the disease progresses and neurons continue to be lost , these medications become less effective while at the same time they produce a complication marked by involuntary writhing movements . Diet and some forms of rehabilitation have shown some effectiveness at improving symptoms . Surgery to place microelectrodes for deep brain stimulation has been used to reduce motor symptoms in severe cases where drugs are ineffective . Evidence for treatments for the non-movement-related symptoms of PD , such as sleep disturbances and emotional problems , is less strong .   In 2015 , PD affected 6.2 million people and resulted in about 117,400 deaths globally . Parkinson 's disease typically occurs in people over the age of 60 , of which about one percent are affected . Males are more often affected than females . When it is seen in people before the age of 50 , it is called young-onset PD . The average life expectancy following diagnosis is between 7 and 14 years . The disease is named after the English doctor James Parkinson , who published the first detailed description in An Essay on the Shaking Palsy , in 1817 . Public awareness campaigns include World Parkinson 's Day ( on the birthday of James Parkinson , 11 April ) and the use of a red tulip as the symbol of the disease . People with parkinsonism who have increased the public 's awareness of the condition include actor Michael J. Fox , Olympic cyclist Davis Phinney , and late professional boxer Muhammad Ali .

neg: Median follow-up In statistics , median follow-up is the median time between a specified event and the time when data on outcomes are gathered . The concept is used in cancer survival analyses .   Many cancer studies aim to assess the time between two events of interest , such as from treatment to remission , treatment to relapse , or diagnosis to death . This duration is generically called survival time , even if the end point is not death .   Time-to-event studies must have sufficiently long follow-up durations to capture enough events to reveal meaningful patterns in the data . A short follow-up duration is appropriate for studying very severe cancers with poor prognoses , whereas a long follow-up duration is better suited to studying less-severe disease , or participants with good prognoses .   Median follow-up time is included in about half the survival analyses published in cancer journals , but of those , only 31 % specify the method used to compute it .

neg: Xenotransplantation Xenotransplantation ( xenos - from the Greek meaning `` foreign '' ) , is the transplantation of living cells , tissues or organs from one species to another . Such cells , tissues or organs are called xenografts or xenotransplants . It is contrasted with allotransplantation ( from other individual of same species ) , Syngeneic transplantation ( Grafts transplanted between two genetically identical individuals of the same species ) and Autotransplantation ( from one part of the body to another in the same person ) .   Xenotransplantation of human tumor cells into immunocompromised mice is a research technique frequently used in pre-clinical oncology research .   Human xenotransplantation offers a potential treatment for end-stage organ failure , a significant health problem in parts of the industrialized world . It also raises many novel medical , legal and ethical issues . A continuing concern is that many animals , such as pigs , have a shorter lifespan than humans , meaning that their tissues age at a quicker rate . Disease transmission ( xenozoonosis ) and permanent alteration to the genetic code of animals are also causes for concern . A few successful cases of xenotransplantation are published .   It is not uncommon for patients and physicians to use the term `` allograft '' imprecisely to refer to either allograft ( human-to-human ) or xenograft ( animal-to-human ) , but it is helpful scientifically ( for those searching or reading the scientific literature ) to maintain the more precise distinction in usage .

neg: Cure A cure is the end of a medical condition ; the substance or procedure that ends the medical condition , such as a medication , a surgical operation , a change in lifestyle , or even a philosophical mindset that helps end a person 's sufferings ; or the state of being healed , or cured .   A remission is a temporary end to the medical signs and symptoms of an incurable disease . A disease is said to be incurable if there is always a chance of the patient relapsing , no matter how long the patient has been in remission . An incurable disease may or may not be a terminal illness ; conversely , a curable illness can still result in the patient 's death .   The proportion of people with a disease that are cured by a given treatment , called the cure fraction or cure rate , is determined by comparing disease-free survival of treated people against a matched control group that never had the disease .   Another way of determining the cure fraction and/or `` cure time '' is by measuring when the hazard rate in a diseased group of individuals returns to the hazard rate measured in the general population .   Inherent in the idea of a cure is the permanent end to the specific instance of the disease . When a person has the common cold , and then recovers from it , the person is said to be cured , even though the person might someday catch another cold . Conversely , a person that has successfully managed a disease , such as diabetes mellitus , so that it produces no undesirable symptoms for the moment , but without actually permanently ending it , is not cured .   Related concepts , whose meaning can differ , include response , remission and recovery .

neg: Safety of electronic cigarettes The safety of electronic cigarettes is uncertain . There is little data about their safety , and considerable variability among e-cigarettes and in their liquid ingredients and thus the contents of the aerosol delivered to the user . Reviews on the safety of e-cigarettes have reached significantly different conclusions . A 2014 World Health Organization ( WHO ) report cautioned about potential risks of using e-cigarettes . Regulated US Food and Drug Administration ( FDA ) products such as nicotine inhalers are likely safer than e-cigarettes , . A systematic review suggests that e-cigarettes are less harmful than smoking and since they contain no tobacco and do not involve combustion , users may avoid several harmful constituents usually found in tobacco smoke . However , e-cigarettes can not be considered harmless .   E-cigarettes have been found to reduce lung and myocardial function , increase inflammation , and have toxic content including carcinogens , but to a much lower extent than combustible cigarettes in virtually all cases . The long-term effects of e-cigarette use are unknown . A 2015 study found serious adverse events related to e-cigarettes were hypotension , seizure , chest pain , rapid heartbeat , disorientation , and congestive heart failure but it was unclear to the degree they were the result of e-cigarettes . Less serious adverse effects may include abdominal pain , headache , blurry vision , throat and mouth irritation , vomiting , nausea , and coughing . A 2014 WHO report said , `` ENDS -LSB- electronic nicotine delivery system -RSB- use poses serious threats to adolescents and fetuses . '' Aside from toxicity exposure in normal use , there are also risks from misuse or accidents such as nicotine poisoning ( especially among infants and children ) , contact with liquid nicotine , fires caused by vaporizer malfunction , and explosions resulting from extended charging , unsuitable chargers , or design flaws . Battery explosions are caused by an increase in internal battery temperature and some have resulted in severe skin burns . There is a small risk of battery explosion in devices modified to increase battery power .   The cytotoxicity of e-liquids varies , and contamination with various chemicals have been detected in the liquid . Metal parts of e-cigarettes in contact with the e-liquid can contaminate it with metals . Many chemicals including carbonyl compounds such as formaldehyde can inadvertently be produced when the nichrome wire ( heating element ) that touches the e-liquid is heated and chemically reacted with the liquid . Normal usage of e-cigarettes , and reduced voltage ( 3.0 V ) devices generate very low levels of formaldehyde . Later-generation e-cigarettes used with higher power may generate equal or higher levels of formaldehyde than compared to smoking . A 2015 review found that these levels were the result of overheating under test conditions that bear little resemblance to common usage . A 2015 Public Health England ( PHE ) report found that high levels of formaldehyde only occurred in overheated `` dry-puffing '' . Users detect the `` dry puff '' and avoid it , and they concluded that `` There is no indication that EC users are exposed to dangerous levels of aldehydes . '' However , e-cigarette users may `` learn '' to overcome the unpleasant taste due to elevated aldehyde formation , when the nicotine craving is high enough . E-cigarette users who use devices that contain nicotine are exposed to its potentially harmful effects . Nicotine is associated with cardiovascular disease , potential birth defects , and poisoning . In vitro studies of nicotine have associated it with cancer , but carcinogenicity has not been demonstrated in vivo . There is inadequate research to demonstrate that nicotine is associated with cancer in humans . The risk is probably low from the inhalation of propylene glycol and glycerin . No information is available on the long-term effects of the inhalation of flavors .   E-cigarettes create an aerosol that consists of fine and ultrafine particles of particulate matter , with the majority of particles in the ultrafine range . The vapor have been found to contain flavors , propylene glycol , glycerin , nicotine , tiny amounts of toxicants , carcinogens , heavy metals , and metal nanoparticles , and other substances . Exactly what the vapor comprises varies in composition and concentration across and within manufacturers . E-cigarette vapor potentially contains harmful substances not found in tobacco smoke . The majority of toxic chemicals found in tobacco smoke are absent in e-cigarette vapor . E-cigarette vapor contains lower concentrations of potentially toxic chemicals than with cigarette smoke . Those which are present , are mostly below 1 % the corresponding levels permissible by workplace safety standards . But workplace safety standards do not recognize exposure to certain vulnerable groups such as people with medical ailments , children , and infants who may be exposed to second-hand vapor . Concern exists that some of the mainstream vapor exhaled by e-cigarette users may be inhaled by bystanders , particularly indoors . E-cigarette use by a parent might lead to inadvertent health risks to offspring . A 2014 review recommended that e-cigarettes should be regulated for consumer safety . There is limited information available on the environmental issues around production , use , and disposal of e-cigarettes that use cartridges .

neg: Chemotherapy Chemotherapy ( often abbreviated to chemo and sometimes CTX or CTx ) is a category of cancer treatment that uses one or more anti-cancer drugs ( chemotherapeutic agents ) as part of a standardized chemotherapy regimen . Chemotherapy may be given with a curative intent ( which almost always involves combinations of drugs ) , or it may aim to prolong life or to reduce symptoms ( palliative chemotherapy ) . Chemotherapy is one of the major categories of the medical discipline specifically devoted to pharmacotherapy for cancer , which is called medical oncology .   By common usage , the term chemotherapy has come to connote the use of rather non-specific intracellular poisons , especially related to inhibiting the process of cell division known as mitosis , and generally excludes agents that more selectively block extracellular growth signals ( i.e. blockers of signal transduction ) . To avoid these connotations for recently developed ( against specific molecular or genetic targets ) therapies which inhibit of growth-promoting signals coming from classic endocrine hormones ( primarily estrogens for breast cancer and androgens for prostate cancer ) is known as hormonal therapy , while the inhibition of other growth-promoting influences ( especially those associated with receptor tyrosine kinases ) is known as targeted therapy .   Importantly , the use of drugs ( whether chemotherapy , hormonal therapy or targeted therapy ) constitutes systemic therapy for cancer in that they are introduced into the blood stream and are therefore in principle able to address cancer at any anatomic location in the body . Systemic therapy is often used in conjunction with other modalities that constitute local therapy ( i.e. treatments whose efficacy is confined to the anatomic area where they are applied ) for cancer such as radiation therapy , surgery and/or hyperthermia therapy .   Traditional chemotherapeutic agents are cytotoxic by means of interfering with cell division ( mitosis ) but cancer cells vary widely in their susceptibility to these agents . To a large extent , chemotherapy can be thought of as a way to damage or stress cells , which may then lead to cell death if apoptosis is initiated . Many of the side effects of chemotherapy can be traced to damage to normal cells that divide rapidly and are thus sensitive to anti-mitotic drugs : cells in the bone marrow , digestive tract and hair follicles . This results in the most common side-effects of chemotherapy : myelosuppression ( decreased production of blood cells , hence also immunosuppression ) , mucositis ( inflammation of the lining of the digestive tract ) , and alopecia ( hair loss ) . Because of the effect on immune cells ( especially lymphocytes ) , chemotherapy drugs often find use in a host of diseases that result from harmful overactivity of the immune system against self ( so-called autoimmunity ) . These include rheumatoid arthritis , systemic lupus erythematosus , multiple sclerosis , vasculitis and many others .

neg: Long-term effects of alcohol consumption The long-term effects of alcohol ( ethanol ) consumption range from cardioprotective health benefits for low to moderate alcohol consumption in industrialized societies with higher rates of cardiovascular disease to severe detrimental effects in cases of chronic alcohol abuse . Health effects associated with alcohol intake in large amounts include an increased risk of alcoholism , malnutrition , chronic pancreatitis , alcoholic liver disease , and cancer . In addition , damage to the central nervous system and peripheral nervous system can occur from chronic alcohol abuse . The long-term use of alcohol is capable of damaging nearly every organ and system in the body . The developing adolescent brain is particularly vulnerable to the toxic effects of alcohol . In addition , the developing fetal brain is also vulnerable , and fetal alcohol spectrum disorders ( FASDs ) may result if pregnant mothers consume alcohol .   The inverse relation in Western cultures between alcohol consumption and cardiovascular disease has been known for over 100 years . Many physicians do not promote alcohol consumption , however , given the many health concerns associated with it , some suggest that alcohol should be regarded as a recreational drug , and promote exercise and good nutrition to combat cardiovascular disease . Others have argued that the benefits of moderate alcohol consumption may be outweighed by other increased risks , including those of injuries , violence , fetal damage , liver disease , and certain forms of cancer .   Withdrawal effects and dependence are also almost identical . Alcohol at moderate levels has some positive and negative effects on health . The negative effects include increased risk of liver diseases , oropharyngeal cancer , esophageal cancer and pancreatitis . Conversely moderate intake of alcohol may have some beneficial effects on gastritis and cholelithiasis . Of the total number of deaths and diseases caused by alcohol , most happen to the majority of the population who are moderate drinkers , rather than the heavy drinker minority . Chronic alcohol misuse and abuse has serious effects on physical and mental health . Chronic excess alcohol intake , or alcohol dependence , can lead to a wide range of neuropsychiatric or neurological impairment , cardiovascular disease , liver disease , and malignant neoplasms . The psychiatric disorders which are associated with alcoholism include major depression , dysthymia , mania , hypomania , panic disorder , phobias , generalized anxiety disorder , personality disorders , schizophrenia , suicide , neurologic deficits ( e.g. impairments of working memory , emotions , executive functions , visuospatial abilities and gait and balance ) and brain damage . Alcohol dependence is associated with hypertension , coronary heart disease , and ischemic stroke , cancer of the respiratory system , and also cancers of the digestive system , liver , breast and ovaries . Heavy drinking is associated with liver disease , such as cirrhosis . Excessive alcohol consumption can have a negative impact on aging .   Recent studies have focused on understanding the mechanisms by which moderate alcohol consumption confers cardiovascular benefit .

neg: David A. Karnofsky David A. Karnofsky ( 1914 -- 1969 ) was an American clinical oncologist . In 1940 , while he was a resident at the Colis P. Huntington Memorial Laboratory for Cancer Research of the Harvard University , David A. Karnofsky began clinical investigation in cancer , and devoted himself to this area throughout his career . He was an internationally recognized specialist in cancer chemotherapy and affiliated with the Division of Experimental Chemotherapy , Sloan-Kettering Institute for Cancer Research .   Karnofsky received his medical degree in 1940 from Stanford University . In the early years of his career at the Collis P. Huntington Memorial Laboratory at Harvard University , he became interested in clinical cancer research . This interest was further fueled by experiments he conducted during World War II as part of the Army Chemical Warfare Service .   Karnofsky is considered one of the pioneer medical oncologists , devoting his 30-year career to the successful use of chemotherapeutic agents to treat cancer . In 1948 Karnofsky , together with Dr. Walter H. Abelmann , Dr. Lloyd F. Craver , and Dr. Joseph H. Burchenal ( the latter also worked in the Sloan-Kettering Institute for Cancer Research ) , described the Karnofsky Performance Status Scale . The primary purpose of the development of the scale was to allow physicians to evaluate a patient 's ability to survive chemotherapy for cancer in a more objective manner . The widely used Karnofsky score runs from 100 to 0 , where 100 is `` perfect '' health and 0 is death . Practitioners occasionally assign performance scores in between standard intervals of 10 .   When Karnofsky died of lung cancer in August 1969 , a group of his friends donated a fund to be used to finance a yearly lecture at the Annual Meeting of the American Society of Clinical Oncology ( ASCO ) . An obituary detailing his works was written by Joseph H. Burchenal .


query: Ron Swanson has two ex-wives that are both named Tammy.

pos: Ron Swanson Ronald Ulysses `` Ron '' Swanson is a fictional character  portrayed by Nick Offerman from the situation comedy television series Parks and Recreation on NBC , created by Greg Daniels and Michael Schur . In the series , Ron is the director of the Parks and Recreation department of fictional Pawnee , Indiana , and the immediate superior of series protagonist Leslie Knope ( Amy Poehler ) until Knope 's election to the Pawnee City Council at the end of Season 4 . In demeanor , political philosophy and work ethic , Knope and Swanson are very nearly polar opposites : where Knope is sunny and outgoing , decidedly liberal and constantly working , Swanson is distant , and as a staunch libertarian , is a strong advocate for small government -- stating his belief that government should be privatized -- and therefore believes that the parks department should not even exist .   Ron , who has an extremely deadpan and masculine personality , actively works to make city hall less effective and despises interacting with the public . He loves meat , woodworking , hunting , whisky , and breakfast foods . He hates and fears his two ex-wives , both named Tammy , one of whom is played by Offerman 's real-life wife , Megan Mullally . Ron claims not to be interested in the personal lives of those around him but actually cares a great deal about his colleagues , and has a particularly strong respect for Leslie .   Conceived by series creators Michael Schur and Greg Daniels , Ron has been a central character since the pilot episode of Parks and Recreation . Offerman had some input into the character 's creation , and some aspects of Ron 's personality were inspired by the actor , like his affinity for woodworking and 16-year-old Lagavulin Single Malt Scotch . The traits of the character were also partially inspired by a real-life Libertarian elected official in Burbank , California .   Offerman 's portrayal of Ron Swanson has received critical acclaim . The character developed a cult following and is widely considered the breakout character of the series . Schur called Ron `` our cast MVP . '' He was described by some critics as one of the best characters in a situation comedy in decades , and has been called the best comedic character on television since Cosmo Kramer of Seinfeld . Ron 's platonic relationship with Leslie has been compared to that of Mary Richards and Lou Grant in The Mary Tyler Moore Show . Offerman received several award nominations for the role , and won the TCA Award for Individual Achievement in Comedy , tying with Ty Burrell of Modern Family .

neg: Frankie Stone Frankie Stone is a fictional character from the American ABC Daytime soap opera , All My Children .   Portrayed by Elizabeth Hendrickson from September 27 to November 28 , 2001 , the character was noted as popular , having gained `` a huge following '' after only three months on the series . When she was killed off , the popularity and loyal following the character had obtained resulted in Hendrickson being brought back as the character 's identical twin sister , Maggie Stone .

neg: Linda Henry Linda Valiris , known professionally by her maiden name , Linda Henry ( born 1 January 1963 ) is an English actress , known for her roles as Yvonne Atkins in the ITV television drama Bad Girls ( 1999 -- 2003 ) and Shirley Carter in the BBC soap opera EastEnders , a role she has played since 2006 . She had previously appeared in EastEnders as the original Lorraine Salter , the mother of Mandy Salter ( Nicola Stapleton ) from 1991 to 1992 . Her other TV credits include Cracker ( 1995 ) , Prime Suspect ( 1997 ) and Trial & Retribution ( 1998 ) . She has also appeared in the films Beautiful Thing ( 1996 ) and The Business ( 2005 ) .

neg: Joyce Ricketts Joyce Ricketts -LSB- ״ Rick ״ -RSB- ( April 25 , 1933 -- May 8 , 1992 ) was a right fielder who played from through in the All-American Girls Professional Baseball League . She batted left-handed and threw right-handed .   Born in Oquawka , Illinois , Joyce Ricketts barely got a chance to play before the All-American Girls Professional Baseball League folded after the 1954 season . An All-Star for the two years she played in the league , Ricketts ranked high in several offensive categories , which combined with a fine defense and a strong and secure throwing arm , to help the Grand Rapids Chicks win the league championship in the 1953 season .   In 1953 Ricketts played all 114 games for the Chicks , batting a .288 average and five home runs , while ranking fourth in runs batted in ( 71 ) and fifth in hits ( 120 ) , doubles ( 19 ) and total bases ( 164 ) , being selected for the All-Star Team . Grand Rapids , with Woody English at the helm , swept the Kalamazoo Lassies in the final best-of-three series .   In the series opening , Ricketts hit an RBI-single in the bottom of the fourth to put his team up ( 3 -- 2 ) , an advantage that never lost and ended up winning the game , 5 -- 2 . Mary Lou Studnicka earned the victory , while Eleanor Moore was credited with a save . In the next game , Ricketts smashed a go-ahead , two-RBI double in the sixth inning , to give the Chicks a 4 -- 3 lead for the rest of the game . Late in the inning , she used her strong arm from right field to throw out the potential tying run at home plate . Pitcher Earlene Risinger went the distance and stroke out nine Lassies players , including a bases loaded strikeout to retire slugger Doris Sams for the last out of the game . In the series , Ricketts went 4-for-6 ( .667 ) with a pair of doubles and four RBI to lead all hitters .   In 1954 Ricketts hit .317 and clobbered 15 home runs in 92 games , ending fourth in RBI ( 72 ) and eight in total bases ( 159 ) . She also finished ninth in average and tied for second in doubles ( 14 ) , while joining the All-Star Team for the second time .   Joyce Ricketts is part of Women in Baseball , a permanent display based at the Baseball Hall of Fame and Museum in Cooperstown , New York , which was unveiled in 1988 to honor the entire All-American Girls Professional Baseball League . She died in Oquawka , Illinois , at the age of 59 .

neg: Linda Ronstadt Linda Maria Ronstadt ( born July 15 , 1946 ) is an American popular music singer . She has earned 11 Grammy Awards , three American Music Awards , two Academy of Country Music awards , an Emmy Award , and an ALMA Award , and many of her albums have been certified gold , platinum or multiplatinum in the United States and internationally . She has also earned nominations for a Tony Award and a Golden Globe award . She was inducted into the Rock and Roll Hall of Fame in April 2014 . On July 28 , 2014 , she was awarded the National Medal of Arts and Humanities .   In total , she has released over 30 studio albums and 15 compilation or greatest hits albums . Ronstadt charted 38 Billboard Hot 100 singles , with 21 reaching the top 40 , 10 in the top 10 , three at number 2 , and `` You 're No Good '' at number 1 . This success did not translate to the UK , with only her single `` Blue Bayou '' reaching the UK Top 40 . Her duet with Aaron Neville , `` Do n't Know Much '' , peaked at number 2 in December 1989 . In addition , she has charted 36 albums , 10 top-10 albums and three number 1 albums on the Billboard Pop Album Chart . Her autobiography , Simple Dreams : A Musical Memoir , was published in September 2013 . It debuted in the Top 10 on The New York Times Best Seller list .   Ronstadt has collaborated with artists in diverse genres , including Bette Midler , Billy Eckstine , Frank Zappa , Rosemary Clooney , Flaco Jiménez , Philip Glass , Warren Zevon , Emmylou Harris , Gram Parsons , Dolly Parton , Neil Young , Johnny Cash , and Nelson Riddle . She has lent her voice to over 120 albums and has sold more than 100 million records , making her one of the world 's best-selling artists of all time . Christopher Loudon , of Jazz Times , wrote in 2004 that Ronstadt is `` blessed with arguably the most sterling set of pipes of her generation . ''   After completing her last live concert in late 2009 , Ronstadt retired in 2011 . She was diagnosed as having Parkinson 's disease in December 2012 , which left her unable to sing .

neg: Paul Willson Paul Lee Willson ( born December 25 , 1945 ) is an American actor , most notable for his television work . He was born in Fairmont , Minnesota , the son of Doris Geraldine and Lee Wilford Willson .   Willson has played numerous guest characters on a variety of shows including Full House as Stu in episode `` Crimes and Michelle 's Demeanor '' in 1990 , Curb Your Enthusiasm , Boston Public , Caroline in the City , The Newsroom and Star Trek : Voyager . He is perhaps most famous for his repeated guest character of `` Paul Krapence '' on the television show Cheers ( which he also reprised in an episode of the Cheers spin-off , Frasier ) . His character was originally called `` Gregg '' because Paul Vaughn was already playing a character named `` Paul '' on Cheers . For five years ( 1986-1990 ) he was Garry Shandling 's neighbor `` Leonard Smith '' on It 's Garry Shandling 's Show . Willson also appeared on Garry Shandling 's The Larry Sanders Show playing Larry 's accountant , and the brother of Sid the cue card holder . He played Ed , a neighbor , in a few episodes of Malcolm in the Middle . His film appearances include The Pack ( 1977 ) , The Devonsville Terror ( 1983 ) , My Best Friend Is a Vampire ( 1987 ) , Moving ( 1988 ) , 976-EVIL ( 1988 ) , Problem Child 2 ( 1990 ) , Circuitry Man ( 1990 ) , Plughead Rewired : Circuitry Man II ( 1994 ) and the comedy film Office Space ( 1999 ) as one of `` The Bobs '' . Willson also appeared on the CBS sitcoms The King of Queens and The Big Bang Theory . He was recently in a promotional video for the Nintendo DS game Personal Trainer : Cooking with Fred Willard .   Although primarily recognized for his television work , he has been noted as a `` great improv player '' by Garry Shandling as a result of their time working together doing improv in the late 1970s . Cheers producer Ken Levine has also acknowledged Willson as `` one of the greatest improv artists I have EVER seen . ''   Since 2012 he has appeared in television ads for Safeco Insurance .

neg: April Ludgate April Roberta Ludgate-Dwyer ( portrayed by Aubrey Plaza ) is a fictional character in the NBC comedy Parks and Recreation . She is first seen as an apathetic college student working as an intern in the Pawnee Department of Parks and Recreation , before being hired as Ron Swanson 's assistant . She later becomes the Deputy Director of Animal Control . April , along with Plaza 's performance , garnered universal acclaim and has gained popularity for her goth-like behavior and deadpan-style comedy .

neg: Joyce Jillson Joyce Jillson ( December 26 , 1945 -- October 1 , 2004 ) was a syndicated newspaper columnist , best-selling author , actress , and astrologer , whose column was syndicated worldwide in more than 200 papers and magazines .   Born Joyce Twichell in Cranston , Rhode Island , she attended Boston University on an opera scholarship . She began her acting career in New York City , where she appeared on Broadway in the Anthony Newley musical , The Roar of the Greasepaint -- The Smell of the Crowd . She starred as Jill Smith in ABC Television 's top rated series Peyton Place . She played the lead role in the 1973 cult action spoof Superchick , and also had a small role in the 1976 exploitation film Slumber Party ' 57 .   She began presenting horoscope reports on Los Angeles in 1973 , and was the official astrologer for Twentieth Century Fox Studios , suggesting the most astrologically favorable dates for movie openings , including Star Wars on May 25 , 1977 . She was the official astrologer for the Los Angeles Dodgers as well as a media consultant to the Ford Motor Company on the launch of the Ford Taurus .   She was also an author , writing Real Women Do n't Pump Gas , The Fine Art of Flirting , `` A Year of Good Luck '' , and Joyce Jillson 's Lifesigns . Her final manuscripts , Astrology for Dogs and Astrology for Cats were published posthumously .

neg: A. L. Swanson Arthur Leonard `` Red '' Swanson Sr. ( April 19 , 1905 -- November 4 , 1987 ) was an American football , basketball , and baseball coach . He served as the head football coach at Southeastern Louisiana College -- now known as Southeastern Louisiana University -- from 1931 to 1937 and at Southwestern Louisiana Institute of Liberal and Technical Learning -- now known as the University of Louisiana at Lafayette -- in 1950 compiling career college football coaching record of 46 -- 21 -- 4 .   From 1943 to 1945 he served as head coach of the LSU Tigers baseball team . His record as LSU 's baseball coach was 28 -- 23 and led the 1943 team to an Southeastern Conference ( SEC ) championship . During the 1944 -- 45 LSU Tigers basketball season , he served as head coach for the final six games , compiling a 4 -- 2 record .   Swanson son , also nicknamed Red Swanson , was a pitcher for the Pittsburgh Pirates of Major League Baseball from 1955 to 1957 . The elder Swanson was married to Billie Hightower and died in 1987 .

neg: Roneeka Hodges Roneeka Hodges ( born July 19 , 1982 ) is an American professional basketball player for the San Antonio Stars of the WNBA ( WNBA ) . Born in New Orleans , Louisiana , she is the twin sister of former WNBA player Doneeka Hodges .   A 5 ' 11 '' guard , Hodges played for three seasons with the Houston Comets , who selected her from the 2005 WNBA Draft in the second round , 15th overall . After the Comets folded in the fall of 2008 , the Lynx selected Hodges as the fourth pick in the dispersal draft for former Comets players .   On February 6 , 2008 , Hodges was selected by the Atlanta Dream in the expansion draft . She was then traded to the Seattle Storm with the fourth pick for Seattle 's eighth pick and Iziane Castro Marques . She was signed a contract once again to the Houston Comets .   Through three seasons with the Comets , Hodges scored 382 points , collected 112 rebounds , 66 assists , 32 steals , and 4 blocks . In 2006 , she scored a career high 247 points , with her career high of 21 coming against the Washington Mystics .

neg: Ron Stone (reporter) Ron Stone ( April 6 , 1936 -- May 13 , 2008 ) was an American news anchor at KPRC-TV in Houston , Texas for 20 years from 1972 to 1992 . He was called `` the most popular and revered news anchor the city has ever known '' by  the Houston Chronicle . He was president of Stonefilms , Inc. , a Texas production company .

neg: Tammy Smith Tammy Smith ( born c. 1963 ) is a Major General of the U.S. Army Reserve . She received her confirmation to Major General on July 13th , 2016 and was formally promoted to the position in a ceremony at the U.S. Army Garrison Yongsan in Seoul , Korea . Major General Smith is the Deputy Commanding General-Sustainment for Eighth Army . She also became the first female general officer to serve in an Eighth Army headquarters-level position . Prior to this position , she served as the Commanding General of the 98th Training Division ( Initial Entry Training ) , and served for a year in the Afghanistan War .

neg: Tammy Baldwin Tammy Suzanne Green Baldwin ( born February 11 , 1962 ) is the junior United States Senator from Wisconsin and a member of the Democratic Party . She previously served as the U.S. Representative from Wisconsin 's 2nd congressional district from 1999 to 2013 , as well as serving three terms in the Wisconsin Assembly representing the 78th district .   Baldwin defeated her Republican opponent , former Wisconsin governor Tommy Thompson , in the 2012 U.S. Senate election . She is the first woman elected to represent Wisconsin in the Senate and the first openly gay U.S. Senator in history .

neg: Sally Struthers Sally Anne Struthers ( born July 28 , 1947 ) is an American actress , spokeswoman and activist best known in the United States for her roles as Gloria Stivic , the daughter of Archie and Edith Bunker ( played by Carroll O'Connor and Jean Stapleton ) on All in the Family , for which she won two Emmy awards , and as Babette on Gilmore Girls . She was the voice of Charlene Sinclair on the ABC sitcom Dinosaurs and Rebecca Cunningham on the Disney animated series TaleSpin .

neg: Ron Perry (basketball, born 1958) Ronald K. `` Ron '' Perry ( born March 20 , 1958 ) is an American former basketball and baseball player . He is known particularly for his standout college career at Holy Cross .   Perry , the son of former Holy Cross athletic director Ron S. Perry , was a high school star at Catholic Memorial in West Roxbury , Massachusetts . While there , Perry set a Massachusetts state scoring record with 2,481 points in his career , averaging 35 points per game as a senior .   He followed in his father 's footsteps , playing both basketball and baseball at Holy Cross . As a freshman shooting guard for the Crusaders , Perry led all freshmen nationally in scoring , netting 23 points per game . Over the course of his four-year career , Perry set the school scoring record with 2,524 points ( 23.2 per game ) . He was named ECAC North co-Player of the Year with Maine 's Rufus Harris as a senior and earned All-American recognition in all four of his varsity seasons .   In addition to his basketball career , Perry also excelled as a baseball player for the Crusaders at shortstop . He was also recognized for his achievements in the classroom , earning first team Academic All-American honors in each of his last three seasons in both baseball and basketball . He was inducted into the Academic All-American Hall of Fame in 1996 .   Following his graduatiuon from Holy Cross , perry was drafted by both the Chicago White Sox in the 1980 Major League Baseball Draft and by the Boston Celtics in the third round ( 54th pick overall ) of the 1980 NBA draft . After failing to make the Celtics ' roster , Perry opted to try his hand at baseball , playing for the White Sox ' AA affiliate in Glens Falls , New York . He hit .260 in his two seasons with the club .

neg: Alain-Philippe Malagnac d'Argens de Villèle Alain-Philippe Malagnac ( 1951 -- 2000 ) was the adopted son of French writer Roger Peyrefitte , their relationship being a subject of several of the latter 's works . Malagnac was also an art collector and the husband of singer Amanda Lear .   Scion of a French aristocratic family , 12-year-old Alain-Philippe had a minor role in the film Les Amitiés particulières ( English title : This Special Friendship ) , released in 1964 , based on the award-winning autobiographical novel by Roger Peyrefitte . Malagnac met Peyrefitte , from when they started a long association professionally and personally . This formed the background to Peyrefitte 's novel , Notre Amour ( Éd . Flammarion , 1967 ) and to L'Enfant de cœur , ( an allusion to Malagnac 's role as a choirboy ( Enfant de Choeur ) in the film ) .   At the age of sixteen Malagnac became Peyrefitte 's personal secretary , and as a young man Malagnac was eventually adopted by Peyrefitte .   As an adult Malagnac 's career ( often financed by Peyrefitte ) included proprietorship of Le Bronx , one of the first openly gay night clubs in Paris , and briefly managing French singer Sylvie Vartan , a disastrous undertaking which almost bankrupted Peyrefitte , who was forced to sell artworks and erotic antiquities to pay the resulting debts .   In 1978 Malagnac met Amanda Lear in Paris , and in April 1979 , while on a trip to the United States , they married . Their marriage lasted twenty one years , until his death .  On Saturday , December 16 , 2000 , Malagnac was killed by smoke in a fire at his recently-bought farm house in Saint-Étienne-du-Grès . He died just six weeks after Peyrefitte .

neg: The Swan (TV series) The Swan was a 2004 American reality television program broadcast on Fox in which women who were judged to be ugly were given `` extreme makeovers '' that included several forms of plastic surgery . The title of the series refers to the fairy tale The Ugly Duckling , in which a homely bird matures into a swan .   Each contestant was assigned a panel of specialists -- a coach , therapist , trainer , cosmetic surgeons , and a dentist -- who together designed a program of total transformation . The contestants ' work ethic , growth , and achievement was monitored over the course of three months . Each week , two women were featured , and at the episode 's conclusion , one went home while another was selected to move to compete in the Swan pageant at the end of the season for a chance to be deemed The Swan .   The first two seasons both aired in 2004 . A third season was tipped to happen , but the show was cancelled in early 2005 after ratings continued to drop .   The plastic surgeons on the team were chosen for their ability to perform often startling transformations . Drs. Terry Dubrow and Randal Haworth , both board certified by the American Board of Plastic Surgery , were selected by the producers of the show to perform the multiple plastic surgical operations for each of the two aired seasons .

neg: Duets (Linda Ronstadt album) Duets is a compilation album by Linda Ronstadt . It was released on the Rhino Records label in April 2014 , a few days before Ronstadt 's induction into the Rock & Roll Hall of Fame .   The album peaked at number 32 on the Billboard album chart - Ronstadt 's highest charting album in 24 years . The songs on the album were all previously released with the exception of `` Pretty Bird '' . In his review for AllMusic critic Stephen Thomas Erlewine states that `` generally , this Duets emphasizes the sweeter , softer , and slower side of Ronstadt , a move that makes for pleasant listening '' .   As of December , 2016 , this release had sold a total of 81,316 copies per Nielsen SoundScan .

neg: Susan Olsen Susan Marie Olsen ( born August 14 , 1961 ) is an American former child actress , animal welfare advocate , artist , and former radio host . Olsen is known for her role as Cindy Brady , the youngest Brady child in the sitcom The Brady Bunch for the full run of the show , from 1969 to 1974 .

neg: Ron Taylor (actor) Ronald James `` Ron '' Taylor ( October 16 , 1952 -- January 16 , 2002 ) was an American actor , singer and writer . He grew up in Galveston , Texas and later moved to New York City to attend the American Academy of Dramatic Arts . After graduating , Taylor began working in musical theater , appearing in The Wiz ( 1977 ) , before getting his break with the 1982 off-Broadway production Little Shop of Horrors . Taylor voiced the killer plant Audrey II in the show , which ran for five years and over 2,000 performances .   Taylor created and starred in the musical revue It Ai n't Nothin ' But the Blues , which charted the history of blues music from its African origin to American success . Originally performed at high schools in Denver as a 45-minute piece , the revue was expanded to two hours , played around the country and opened on Broadway in 1999 . It was met with critical acclaim , ran for eight months , and saw Taylor receive two Tony Award nominations .   He also had numerous television roles , appearing in The Simpsons , Twin Peaks , Ally McBeal and L.A. Law . His performance in the latter , as a singer who performed the American national anthem `` The Star-Spangled Banner '' at baseball games , led him to perform the anthem at several real-life sporting events . Taylor was married and had one son . He died in January 2002 after suffering a heart attack .