tbuckley/cabot-search huggingface dataset:
Cyclosporine: A New Immunosuppressive Agent for Organ Transplantation
Authors: DAVID J. COHEN
Journal: Annals of Internal Medicine (1984)

Cyclosporine, a cyclic endecapeptide of fungal origin, has recently been released for use in clinical transplantation. Trials in kidney, heart, liver and bone marrow recipients were encouraging: 1-year graft survival rates were 70% to 80% for kidney and heart recipients, and 60% to 65% for liver allograft recipients. Cyclosporine is also effective in treating bone marrow recipients with acute graft-versus-host disease. The drug selectively inhibits T-helper cell production of growth factors essential for B cell and cytotoxic T-cell differentiation and proliferation, while allowing expansion of suppressor T-cell populations. Drug absorption varies greatly, necessitating monitoring of drug level and individualization of therapy. Nephrotoxicity is the most frequent side effect of cyclosporine. An increased incidence of B-cell lymphomas seen when cyclosporine was used in conjunction with cytotoxic agents or anti-lymphocyte globulin has very rarely been observed when concomitant immunosuppression has been limited to low-dose corticosteroids. Lower initial doses of cyclosporine, followed by more rapid tapering may reduce the incidence of nephrotoxicity without compromising improved graft outcome.
Control of Intractable Ventricular Tachycardia by Coronary Revascularization
Authors: ROGER R. ECKER, CHARLES B. MULLINS, JOHN C. GRAMMER, WILLIAM J. REA, JAMES M. ATKINS
Journal: Circulation (1971)

Ventricular tachycardia (VT) is an arrhythmia that has an ischemic origin in up to 74% of cases and results in a 42 to 67% mortality when it is recurrent and paroxysmal. Present therapy is aimed at suppression of the abnormal rhythm but does not alter the prognosis of the underlying ischemic heart disease. A new concept of treatment of VT is introduced that is based on direct coronary revascularization by the aorta to coronary, saphenous vein-bypass technique. The method was successfully applied in a 61-year-old man who developed episodes of VT 2 months after myocardial infarction. Maximal medical therapy in a coronary care unit for 26 days did not abolish the arrhythmia which occurred as frequently as seven times an hour. Coronary angiography and aortocoronary bypass grafting were done when the patient developed electrocardiographic and enzyme evidence of subendocardial myocardial infarction and symptoms of cerebral ischemia. The patient remains free of arrhythmia 1 year later, and his exercise capability is now normal for his age. Follow-up coronary angiography is presented. Coronary revascularization has been shown to abolish angina pectoris. This report demonstrates that aortocoronary bypass grafting can abolish an arrhythmia of ischemic origin. When persistent or recurrent VT fails to respond to all medical therapy, direct coronary revascularization should be considered to control this ischemic arrhythmia.
Getting started as a medical manager
Authors: P J Drew, A Gilbert
Journal: BMJ (1995)

EDITOR,—In their article on getting started as a medical manager J F Riordan and Jenny Simpson comment on several important issues facing senior clinicians involved in management.1 We believe, however, that articles on management for doctors repeatedly omit one factor.

Learning by doing and getting to know your workforce are established methods in management training. In most major companies managers are required to …
Research in the field of psychiatry.
Authors: M Shepherd
Journal: BMJ (1969)

The results of a follow-up study of infants of diabetic mothers are presented. The antenatal care of all such mothers was supervised in a combined clinic by obstetricians and physicians, and good diabetic control was achieved in most of them. 51 mothers delivered 73 infants, all liveborn, between the years 1964 and 1972 inclusive at Hammersmith Hospital. There were no fetal deaths. 66 infants survived the neonatal period, and 63 the first 2 years of life. 51 children, including all those seriously ill in the neonatal period, could be traced. Detailed neurological and general examinations including skinfold measurements were made, and the IQ measured. Four children were found to have major handicaps. These were severe deafness, epilepsy, low IQ, and myopia. No other neurological abnormalities were detected, and the distribution of full-scale IQs was normal. The distribution of height and head circumference centiles was near normal, but an increased number of children had weights above the 90th centile. No significant congenital malformations were found in these 51 survivors, and none has so far developed diabetes.
Preliminary Report of SPECT Imaging with Tc-99m Teboroxime in Ischemic Heart Disease
Authors: WALTER E. DRANE, STEPHEN KEIM, PHILIP STRICKLAND, ALBERTO TINEO, MICHAEL NICOLE
Journal: Clinical Nuclear Medicine (1992)

Tc-99m teboroxime (Cardiotec®) is one member of a new class of radiopharmaceuticals, the BATO agents (boronic acid adducts of technetium dioxime). This agent is a small, neutral, lipophilic compound with a high myocardial extraction (≈ 85% to 90%), and its uptake in the heart is directly related to myocardial perfusion. Tc-99m teboroxime washes out rapidly from the heart, and its potential for SPECT imaging has therefore been questioned. Tc-99m teboroxime SPECT imaging was compared prospectively with thallium SPECT (20 of 20 patients) and coronary arteriography (17 of 20 patients) suspected of having coronary artery disease. In this small preliminary series, both Tc-99m teboroxime and thallium SPECT detected all abnormal patients (12 of 12) and predicted correctly the site of critical stenosis in 20 of 24 diseased arteries (83%). Tc-99m teboroxime SPECT was normal in 5 of 6 patients without evidence of disease. Several cases occurred of clearly different radiotracer distribution (not related to obvious artifacts) with teboroxime compared with thallium, and lesion size was significantly larger on teboroxime compared with thallium SPECT. The clinical significance of these differences is not yet clear. Tc-99m teboroxime SPECT is possible with imaging times less than half those of thallium SPECT. Though much work remains to be done, teboroxime, because of its unique kinetics, creates many new possibilities for the evaluation of ischemic heart disease.
Principles and Practice of Geriatric Psychiatry
Authors: Leslie Hartley Gise
Journal: Annals of Internal Medicine (2007)

Medical Writings: Book Notes3 April 2007Principles and Practice of Geriatric PsychiatryLeslie Hartley Gise, MDLeslie Hartley Gise, MDFrom the John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawaii.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-146-7-200704030-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Agronin ME, Maletta GJ, eds. 800 pages. Philadelphia: Lippincott, Williams & Wilkins; 2005. $149.00. ISBN 0781748100. Order at www.lww.com.Fields of medicine: Primary care and specialities.Format: Hardcover book.Audience: Clinicians treating older people. Selected chapters may be worthwhile for ethicists, lawyers, and clergy.Purpose: To review what is currently known, both clinical and scientific, about behavioral and psychological dysfunction in older people, and to foster continued advocacy for the new field of geriatric psychiatry.Content: Forty-three chapters cover such topics as forensics, palliative care, spirituality, ethics, sex, intellectual disabilities, and pain. The 104 authors include well-known leaders in the ... Author, Article, and Disclosure InformationAffiliations: From the John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawaii. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 3 April 2007Volume 146, Issue 7Page: 543KeywordsAgingElderlyForensicsGeriatric psychiatryHealth careIntellectual disabilityLong-term carePalliative careSexual identitySoftware tools ePublished: 3 April 2007 Issue Published: 3 April 2007 Copyright & PermissionsCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Essential Role for Vascular Gelatinase Activity in Relaxin-Induced Renal Vasodilation, Hyperfiltration, and Reduced Myogenic Reactivity of Small Arteries
Authors: Arundhathi Jeyabalan, Jacqueline Novak, Lee A. Danielson, Laurie J. Kerchner, Shannon L. Opett, Kirk P. Conrad
Journal: Circulation Research (2003)

During pregnancy, relaxin stimulates nitric oxide (NO)-dependent renal vasodilation, hyperfiltration and reduced myogenic reactivity of small renal arteries via the endothelial ETB receptor subtype. Our objective in this study was to elucidate the mechanisms by which relaxin stimulates the endothelial ETB receptor/NO vasodilatory pathway. Using chronically instrumented conscious rats, we demonstrated that a specific peptide inhibitor of the gelatinases MMP-2 and -9, cyclic CTTHWGFTLC (cyclic CTT), but not the control peptide, STTHWGFTLS (STT), completely reversed renal vasodilation and hyperfiltration in relaxin-treated rats. Comparable findings were observed with a structurally different and well-established, general antagonist of MMPs, GM6001. In contrast, phosphoramidon, an inhibitor of endothelin-converting enzyme, did not significantly change the renal vasodilatory response to relaxin administration. When small renal arteries were incubated with either of the general MMP inhibitors, GM6001 or TIMP-2 (tissue inhibitor of MMP), or with the specific gelatinase inhibitor, cyclic CTT, the reduced myogenic reactivity of these blood vessels from relaxin-treated nonpregnant and midterm pregnant rats was totally abolished. Moreover, a neutralizing antibody specific for MMP-2 completely abrogated the reduced myogenic reactivity of small renal arteries from relaxin-treated nonpregnant and midterm pregnant rats. In contrast, phosphoramidon did not significantly affect the reduction in myogenic reactivity. Using gelatin zymography, we showed increased pro and active MMP-2 activity in small renal arteries from relaxin-treated nonpregnant and midterm pregnant rats relative to the control animals. Thus, inhibitors of MMPs in general and of gelatinases in particular reverse the renal vascular changes induced by pregnancy or relaxin administration to nonpregnant rats. Finally, the typical reduction in myogenic reactivity of small renal arteries from relaxin-treated nonpregnant rats was absent in ETB receptor-deficient rats, despite an increase in vascular MMP-2 activity. These results indicate an essential role for vascular gelatinase, which is in series with, and upstream of, the endothelial ETB receptor/NO signaling pathway in the renal vasodilatory response to relaxin and pregnancy.
Empirical Psychotherapeutic Methods
Authors: Isaac M. Marks
Journal: Psychotherapy and Psychosomatics (1974)

Psychotherapy comprises all forms of psychological treatment. Four aims can be distinguished in various psychotherapeutic procedures – to provide a rewarding experience, to increase self-knowledge, to allow confession, or to effect a lasting change in behaviour. During psychotherapy, the therapist uses his behaviour to change that of his patient. Prediction of therapeutic events requires more knowledge of the periodic table of therapeutic elements than we now possess. Low-order empirical hypotheses are currently possible but unitary theories are too far removed from the data to be of predictive value. ‘Empirical’ implies reliance on observation and experiment, and empirical psychotherapeutic methods start with observation of patients’ behaviour outside and inside therapy. From such observation, ideas are formed about operative variables, and these ideas are tested in larger controlled situations. These in turn, suggest further ideas for pilot study. The dialectic between pilot and larger scale study revolves around clinical observation of patient behaviour in response to events outside and inside treatment. Therapist behaviour flexibly follows inferences about variables maintaining patient behaviour in the short- and the long-term. What the therapist actually <i>does</i> may have little relevance to the theory he espouses. Similar psychotherapeutic procedures can be described in many theoretical languages, and a rose by any other name smells just as sweet. When an existentialist logotherapist shows an obsessive-compulsive patient how to approach contaminated material and requests him to follow suit, he is doing the same as self-styled behaviourists who model with flooding in vivo and response prevention. More important than the global theory is the procedure actually employed. Of course, active therapeutic ingredients of most treatment techniques still have to be dissected. Effective psychotherapeutic methods are valuable tools of experimental psychopathology which advance understanding and efficacy simultaneously. Potent treatment changes certain behaviour and so enables the therapist to detect which pathologies are interlocking and which are independent. This is rather like an ablation experiment in neurophysiology. No one aspect of behaviour can be regarded as primary, and confidence can only be placed in psychotherapeutic results which are consistent across different facets of behaviour. ‘Behaviour’ here denotes any or all aspects of a sequence from its initiation in internal imagery and feelings, to its final execution as overt behaviour, together with its physiological concomitants. An empirical psychotherapeutic approach implies multifactorial mechanisms for aetiology and treatment. It allows active ingredients of treatment to be isolated, and delineation of relationships amongst different psychopathologies. In time, higher-order theories will become possible with greater predictive power than at present.
Shingles vaccination is likely to be cost effective at age 65 or 70
Authors: R. Dobson
Journal: BMJ (2009)

The age at which vaccination against Herpes zoster is most cost effective is 65 or 70 years, a new study indicates. Such protection could mean some 11 000 fewer cases of shingles each year in England and Wales, it estimates.

The researchers, at the UK Health Protection Agency and Utrecht University Medical Centre, also found that adding a booster dose of the vaccine at a later stage was unlikely to be cost effective ( Vaccine doi:10.1016/j.vaccine.2008.12.024).

A live attenuated vaccine against Herpes zoster was approved for use in the United Kingdom three years ago. The UK, unlike the …
Narrow-band imaging versus high-definition endoscopy for the diagnosis of neoplasia in ulcerative colitis
Authors: F. van den Broek, P. Fockens, S. van Eeden, P. Stokkers, C. Ponsioen, J. Reitsma, E. Dekker
Journal: Endoscopy (2010)

See also: Commentaire de travail de F. J. C. van den Broek et al., pp. 108Endoscopy 2011; 43(02): 173-173DOI: 10.1055/s-0031-1291815
ANAPHYLAXIS IN THE DIAGNOSIS OF CANCER
Authors: J. LOUIS RANSOHOFF
Journal: JAMA (1913)

Two years ago I published a preliminary report<sup>1</sup>on the experimental study of anaphylaxis in cancer. I showed that there is a decided difference in the anaphylactic reaction when guinea-pigs sensitized with blood-serum from a normal individual and other guinea-pigs sensitized with blood-serum from a cancer-bearing individual are both given a final dose of blood-serum from a cancer-bearing individual. Two series of guinea-pigs were used in each experiment. Pigs of Series A were sensitized with normal blood-serum in doses varying from 0.01 to 0.5 c.c. Series B was sensitized with the same amounts of blood-serum from an individual bearing an advanced cancer. After two weeks, when sensitization was established, each pig, of both Series A and Series B, was given an intraperitoneal injection of 5 c.c. of blood-serum from a cancer-bearing individual. The results were decisive. The pigs of Series A, those pigs sensitized with normal blood-serum, had symptoms
Rectal endometriosis mimicking a large polypoid rectal cancer
Authors: Y. Cho, Y. Jeen, Y. Kim, H. Chun, S. Um, C. Kim, H. Ryu
Journal: Endoscopy (2006)

Endometriosis is a disorder in which endometrial glandular tissue and stroma are found outside the uterus; it involves the colorectum in about 5 % of cases [1] [2]. It can occasionally be difficult to differentiate between colonic endometriosis, usually manifest as strictures or external compression, and colon cancer or colitis [3]. In particular, the rare polypoid endometriosis is hardly distinguishable from colonic neoplasm [4]. More careful inspection and diagnostic methods are therefore required. We report a case of rectal polypoid endometriosis mimicking a large polypoid rectal carcinoma.
NICE advocates community services for skin cancer patients
Authors: Susan Mayor
Journal: BMJ (2006)

Multidisciplinary teams, including community services, should be set up to increase the provision of care for patients with skin cancer, new guidance for the NHS in England and Wales recommends.

The National Institute for Health and Clinical Excellence (NICE) and the National Collaborating Centre for Cancer recommended that, for the first time, community services should join skin cancer care networks to help cope with the rapid increase in skin cancers that has been overwhelming specialist services.

Cancer networks should establish two levels of multidisciplinary teams. Lower level teams would operate in cancer units at district general hospitals, and more specialist teams would be based in larger hospitals, usually cancer centres, plastic surgery centres, or other specialist tertiary services …
Diagnosis of Aneurysmal Bone Cyst of the Mandible
Authors: TAKEO OKUYAMA, HITOSHI SUZUKI, ISAO UMEHARA, YUJI KUWABARA, SOJI SUZUKI, MINORU TAKAGI
Journal: Clinical Nuclear Medicine (1985)

Aneurysmal bone cyst is rarely found in the mandible, and roentgenographic diagnosis of this condition is not easily made. In this report, the diagnostic value of bone scintigraphy and radionuclide angiography and CT imaging in two cases of aneurysmal bone cyst of the mandible are discussed. Bone scintigraphy with Tc-99m MDP demonstrated ring-like or doughnut-pattern accumulation of radioactivity, which corresponded to the expansile character of the bony lesion. The accumulation of radioactivity was intensive in the peripheral region despite the fact that the lesion was benign. Furthermore, the central rarefaction showed that the lesion was cystic. Radionuclide angiography with Tc-99m HSA, including blood pool scan, did not detect radioactive concentration. Thus bone scintigraphy and radionuclide angiography were found to be essential in the differential diagnosis of aneurysmal bone cyst from other forms of tumor, especially hypervascularized tumor and central hemangioma of the mandible.
<i>In Vitro</i> Screening of Environmental Chemicals for Targeted Testing Prioritization: The ToxCast Project
Authors: Richard S. Judson, Keith A. Houck, Robert J. Kavlock, Thomas B. Knudsen, Matthew T. Martin, Holly M. Mortensen, David M. Reif, Daniel M. Rotroff, Imran Shah, Ann M. Richard, David J. Dix
Journal: Environmental Health Perspectives (2009)

Chemical toxicity testing is being transformed by advances in biology and computer modeling, concerns over animal use, and the thousands of environmental chemicals lacking toxicity data. The U.S. Environmental Protection Agency's ToxCast program aims to address these concerns by screening and prioritizing chemicals for potential human toxicity using in vitro assays and in silico approaches.This project aims to evaluate the use of in vitro assays for understanding the types of molecular and pathway perturbations caused by environmental chemicals and to build initial prioritization models of in vivo toxicity.We tested 309 mostly pesticide active chemicals in 467 assays across nine technologies, including high-throughput cell-free assays and cell-based assays, in multiple human primary cells and cell lines plus rat primary hepatocytes. Both individual and composite scores for effects on genes and pathways were analyzed.Chemicals displayed a broad spectrum of activity at the molecular and pathway levels. We saw many expected interactions, including endocrine and xenobiotic metabolism enzyme activity. Chemicals ranged in promiscuity across pathways, from no activity to affecting dozens of pathways. We found a statistically significant inverse association between the number of pathways perturbed by a chemical at low in vitro concentrations and the lowest in vivo dose at which a chemical causes toxicity. We also found associations between a small set of in vitro assays and rodent liver lesion formation.This approach promises to provide meaningful data on the thousands of untested environmental chemicals and to guide targeted testing of environmental contaminants.
Standardization of multiple spirometers at widely separated times and places.
Authors: W S Linn, J C Solomon, H Gong, E L Avol, W C Navidi, J M Peters
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

We designed a system for a multiyear longitudinal study of lung function in 12 widely separated communities, intending to minimize variation in instrument-related data. We used multiple rolling-seal spirometer/personal computer systems. Calibrations were checked before, during, and after each day's field testing, using multiple calibration syringes with electronic readouts. The syringes were rotated to obtain data for each syringe-spirometer combination. Before and after each annual field testing season, a laboratory reference spirometer system was calibrated against a water-displacement device and an electronic frequency counter, and then compared against each field spirometer and syringe. Field equipment consistently met American Thoracic Society (ATS) specifications. Variance among spirometers exceeded variance among syringes. A spirometer occasionally changed its volume readout by approximately 1 to 2 %. More rarely, a syringe changed its delivered volume by approximately 1%. Syringes' electronic readouts tracked changes in delivered volume. Syringe readouts were the most stable component of the system, and were more reproducible than the laboratory water-displacement calibration. We conclude that variation in spirometers may limit the reliability of epidemiologic findings, even when these spirometers meet ATS specifications. Frequent calibration checks traceable to an independent standard, and adjustment of individual test results, can reduce measurement error.
Ski Injuries in 1972-1973
Authors: Joshua Gutman
Journal: JAMA (1974)

During the 1972-1973 season, 792 consecutive skiing injuries were observed at a Vermont ski area. Injury data included type and site of injury, age, sex, and skiing ability. The estimated injury rate, 3.4/1,000 skier-days, was consistent with a 12-year rate. Ankle fractures and sprains have decreased, but upper extremity injuries have shown a corresponding increase. Intermediate and expert skiers were involved in a higher proportion of total injuries. These trends are explained by basic principles of energy transfer and improved ski equipment and education. (<i>JAMA</i>230:1423-1425, 1974)