tbuckley/cabot-search huggingface dataset:
Emotional distress in junior doctors
Authors: S. Dowling
Journal: BMJ (1987)

immunisation.This difference was significant (p= <0 005, x2 analysis).While it is assumed that half of those women might have a live birth after numerous additional abortions, these abortions may be prevented by immunotherapy.Moreover, women who have had one spontaneous abortion who have their immune response altered by immunotherapy seem to have second subsequently successful pregnancies.(This has occurred in all five patients who have become pregnant a second time in our series.)Though such women have spontaneously successful pregnancies, however, they seem to revert to their tendency to abort afterwards.Nine patients in our series had two or more abortions after a spontaneously successful pregnancy.Only one patient had two subsequently successful pregnancies after one spontaneous abortion.We therefore consider immunotherapy to be a most effective form of treatment for women who have had missed abortions, and the results of Drs Vlaanderen and Treffers do not convince us other- wise.
Effect of quadrivalent HPV vaccination on HPV related disease in women treated for cervical or vulvar/vaginal disease
Authors: J. J. Kim
Journal: BMJ (2012)

Subsequent disease is reduced in women who undergo treatment post-vaccination

The two most carcinogenic types of human papillomavirus (HPV) types 16 and 18, are responsible for around 70% of cervical cancers, 85% of anal cancers, and a smaller proportion of other anogenital and oral cancers.1 Vaccines that target these two sexually transmitted HPV types have consistently shown high efficacy in preventing disease related to those specific HPV types in people who have not yet been exposed.2 3 4 5 6 In the linked study (doi:10.1136/bmj.e1401), which is a post hoc analysis of the main efficacy trials (FUTURE I and FUTURE II) of the quadrivalent HPV vaccine that also targets non-carcinogenic HPV types 6 and 11 (responsible for most genital warts),2 3 Joura and colleagues show a reduction in subsequent HPV related disease in vaccinated women who received treatment for cervical, vulvar, or vaginal disease (including genital warts) during the course of the trial.7 This protection extended to disease associated with not only the four HPV types targeted by the vaccine but also 10 other HPV types that cause cancer.

The study’s findings—including reductions in any HPV related disease (irrespective of causal HPV type) of 46.2% after cervical surgery and 35.2% after diagnosis of vulvar or vaginal disease—are welcome, but some important caveats …
Do we need more hospices?
Authors: C F Regnard
Journal: BMJ (1993)

corrected for wrong addresses will improve the apparent efficiency of screening while failing to locate those who are being missed.Other methods of improving lists of patients' addresses that we have used in our research studies include periodic mailings to patients, recording an alternative contact address, using Post Office returns (which identified 40% of inaccurate addresses in one mailing in our experience), examining general practices' manual and com- puterised records, and using local telephone books.The relative cost effectiveness of these methods depends on the extent of automation that can be achieved.Direct linkage of computerised records of practices and family health services authorities, with a formal protocol for checking and updating a practice's address records at each contact with a patient, probably holds out the best hope of achieving a register with minimal errors in addresses to optimise uptake of screening.The technology to achieve this has already been adopted in other European countries.
Perinatal Coagulopathies Complicating Fetal Blood Sampling
Authors: M. G. R. Hull
Journal: BMJ (1972)

In a neonatal postmortem histological study of scalp stabs made with a fetal blood sampling blade the aponeurosis was punctured in up to 38% of cases even when it was more than 2 mm deep. This and other indirect and direct evidence discussed suggest that five of the seven reported cases of major bleeding after fetal blood sampling in labour were due to blood clotting defects and that these should be considered urgently in the management of future cases.
Leading German doctors criticise rising use of post-marketing observational studies by drug companies
Authors: A. Tuffs
Journal: BMJ (2009)

Tens of thousands of German patients treated by GPs or in specialist practices are involved in observational studies paid for by the drug industry without ever having given their consent. The companies pay doctors as much as €1000 (£925; $1475) a patient for prescribing a drug and documenting its effects. Critics say this is just a way to push new and expensive drugs that have few innovative qualities onto the market.

Carl-Heinz Muller, a GP and one …
Hypersensitivity reactions from metallic implants: a future challenge that needs to be addressed
Authors: J.P. Thyssen, J.D. Johansen, T. Menné, C. Lidén, M. Bruze, I.R. White
Journal: British Journal of Dermatology (2010)

Prolonged or repeated skin exposure to jewellery, buttons, clothing fasteners, mobile phones and leather may result in metal sensitization.Also, oral exposure to dental restorations may lead to cobalt or gold sensitization.It is estimated that up to 17% of women and 3% of men are nickel sensitized and that 1-3% are sensitized to cobalt and chromate. 1Regulatory interventions have proven successful in decreasing the prevalence of contact sensitization and allergic contact dermatitis (ACD), e.g.nickel sensitization and dermatitis have decreased significantly among ear-pierced women following the Danish nickel regulation. 2 In its acute form, ACD is characterized by pruritus, erythema, papules and possibly vesicles whereas chronic ACD may be dry, scaly and fissured.In rare instances, localized or generalized eruptions mimicking ACD may be seen in patients on their skin overlying the site of a metallic implant. 3Localized eruptions are typically associated with static implants such as plates, nails, screws, endovascular devices (stents, abdominal aortic aneurysm endografts and patent foramen ovale occluders) and pacemakers, whereas they rarely occur in association with dynamic joint prostheses.If a patient displays a strong positive patch test reaction to one of the metals in the alloy, implant removal will often result in resolution of their eruption. 3Generalized eruptions due to nickel release (lg) from small metallic eyelets at the base of polyurethane peripheral intravenous catheters have been observed. 4This underscores that low systemic nickel concentrations may activate the immune system.Subjects with or without metal sensitization may also develop other unwanted delayed-type hypersensitivity reactions following insertion of metallic implants.In the 1960s and 1970s, the early prostheses used for total hip arthroplasty were metal-on-metal.Their use was gradually abandoned (and replaced by metal-on-polyethylene prostheses) as they resulted in release of cobalt and chromium into the blood, hair and urine as well as metal sensitization and prosthesis loosening. 5,6ecently, second-generation metal-on-metal bearings have become popular following substantial improvements in manufacturing.However, there is again increasing evidence and concern about the biological consequences of metal release from such bearings.A review found that the prevalence of metal sensitization was approximately 25% among patients with well-functioning hip arthroplasties and 60% among patients with a failed or a poorly functioning implant.
Mutations in linker histone genes HIST1H1 B, C, D, and E; OCT2 (POU2F2); IRF8; and ARID1A underlying the pathogenesis of follicular lymphoma
Authors: Hongxiu Li, Mark S. Kaminski, Yifeng Li, Mehmet Yildiz, Peter Ouillette, Siân Jones, Heather Fox, Kathryn Jacobi, Kamlai Saiya-Cork, Dale Bixby, Daniel Lebovic, Diane Roulston, Kerby Shedden, Michael Sabel, Lawrence Marentette, Vincent Cimmino, Alfred E. Chang, Sami N. Malek
Journal: Blood (2014)
Human T-Cell Lymphotropic Virus Type I—Associated Adult T-Cell Leukemia
Authors: Thomas A. Waldmann
Journal: JAMA (1995)

<h3>SELECTED CASE</h3> A 37-year-old Jamaican woman developed a generalized erythematous maculopapular rash. She had a peripheral white blood cell (WBC) count of 37×10<sup>9</sup>/L, 75% of which were malignant T cells with convoluted nuclei. The diagnosis of human T-cell lymphotropic virus type I (HTLV-I)—related adult T-cell leukemia/lymphoma (ATL) was supported by high titers of antibodies to HTLV-I in the peripheral blood. The patient was referred to the National Institutes of Health for treatment. Results of physical examination on admission were normal, with the exception of a generalized nonpuritic maculopapular skin rash. The patient manifested overt leukemia with a peripheral WBC count of 32.6 ×10<sup>9</sup>/L, 83% of which were malignant T cells. The phenotype of the malignant cells was CD3<sup>+</sup>, CD4<sup>+</sup>, CD8<sup>-</sup>, CD7<sup>-</sup>, and CD25<sup>+</sup>. The serum concentration of soluble CD25 was elevated to 3645 units (normal geometric mean 235, with 95% confidence interval of 112 to 502
The Treatment of Obesity in Adults
Authors: Kenneth B. Jones
Journal: JAMA (1989)

<h3>To the Editor.—</h3> I read with interest the article entitled "Treatment of Obesity in Adults,"<sup>1</sup>which was a report from the Council on Scientific Affairs in the November 4 issue of<i>JAMA</i>. The title would indicate that this is the state of the art in 1988 according to the American Medical Association. I realize that the report was concerned with the obese patient in general, who by definition is at least 20% overweight according to the Metropolitan Life Insurance medium-frame scale, as was mentioned in the article. The report goes on to talk about various dietary therapies, which is all well and good. However, I think that it is remiss not even to mention the severe problem of morbid obesity. As a charter member of the American Society for Bariatric (Obesity) Surgery, and as a surgeon who has been involved in this field for a number of years, I
Wnt3a deficiency irreversibly impairs hematopoietic stem cell self-renewal and leads to defects in progenitor cell differentiation
Authors: Tiago C. Luis, Floor Weerkamp, Brigitta A. E. Naber, Miranda R. M. Baert, Edwin F. E. de Haas, Tatjana Nikolic, Sjanneke Heuvelmans, Ronald R. De Krijger, Jacques J. M. van Dongen, Frank J. T. Staal
Journal: Blood (2008)
Duffy Antigen Receptor for Chemokines Mediates trans-Infection of HIV-1 from Red Blood Cells to Target Cells and Affects HIV-AIDS Susceptibility
Authors: Weijing He, Stuart Neil, Hemant Kulkarni, Edward Wright, Brian K. Agan, Vincent C. Marconi, Matthew J. Dolan, Robin A. Weiss, Sunil K. Ahuja
Journal: Cell Host & Microbe (2008)
Constitutive class I-restricted exogenous presentation of self antigens in vivo.
Authors: C Kurts, W R Heath, F R Carbone, J Allison, J F Miller, H Kosaka
Journal: The Journal of Experimental Medicine (1996)

Ovalbumin (OVA)-specific CD8+ T cells from the T cell receptor-transgenic line OT-I (OT-I cells) were injected into unirradiated transgenic RIP-mOVA mice, which express a membrane-bound form of OVA (mOVA) in the pancreatic islet beta cells and the renal proximal tubular cells. OT-I cells accumulated in the draining lymph nodes (LN) of the kidneys and pancreas and in no other LN. They displayed an activated phenotype and a proportion entered cell cycle. Unilateral nephrectomy 7-13 d before inoculation of OT-I cells into RIP-mOVA mice allowed the injected T cells to home only to the regional LN of the remaining kidney (and pancreas), but when the operation was performed 4 h before injecting the T cells, homing to the LN of the excised kidney was evident. When the bone marrow of RIP-mOVA mice was replaced with one of a major histocompatibility haplotype incapable of presenting OVA to OT-I cells, no homing or activation was detectable. Therefore, OT-I cells were activated by OVA presented by short-lived antigen-presenting cells of bone marrow origin present in the draining LN of OVA-expressing tissue. These results provide the first evidence that tissue-associated "self" antigens can be presented in the context of class I via an exogenous processing pathway. This offers a constitutive mechanism whereby T cells can be primed to antigens that are present in nonlymphoid tissues, which are not normally surveyed by recirculating naive T cells.
Overuse of antibiotics in pets must be tackled to reduce resistance, conference hears
Authors: R. S. Bhumbra
Journal: BMJ (2012)

The overuse of antibiotics in domestic animals, and not just livestock, needs to be considered if antibiotic microbial resistance is to be tackled in the long term, a conference of doctors and veterinary surgeons was told this week.

Prescribing of antibiotics across Europe is returning to the high levels of the 1990s, Peter Hawkey, from the Public Health Laboratory in the University of Birmingham, told the conference in London, which was organised jointly by the Royal College of Physicians and the Royal College of Veterinary Surgeons.

Susan Dawson, head of the School of Veterinary Science at the University of Liverpool, said that half of all …
Reframing Gun Violence
Authors: Philip L. Mendell
Journal: Annals of Internal Medicine (1998)

Letters15 August 1998Reframing Gun ViolencePhilip L. Mendell, MDPhilip L. Mendell, MDStuart, FL 33494Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-4-199808150-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Dr. Davidoff reproaches internists for not treating their patients like children [1].In my understanding of medical tradition, it is not for physicians to judge or mandate but simply to advise. We can inform our patients of a general medical consensus, but it is up to our adult patients, who pay us for the advice, to decide what is right for them. It is for us to respect their decision and even the consequences.There is another reason to give our advice with humility. We physicians have often been wrong in the past. In the light of ...References1. Davidoff F. Reframing gun violence [Editorial]. Ann Intern Med. 1998; 28:234-5. Google Scholar2. Firearm injury prevention. American College of Physicians. Ann Intern Med. 1998; 28:236-41. Google Scholar Author, Article, and Disclosure InformationAuthors: Philip L. Mendell, MDAffiliations: Stuart, FL 33494 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 August 1998Volume 129, Issue 4Page: 337-338KeywordsAppendectomyChildrenDrugsFeversPatient advocacyViolent crime ePublished: 15 August 2000 Issue Published: 15 August 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Hundreds die in northern Iraq from land mines and unexploded munitions
Authors: O. Dyer
Journal: BMJ (2003)

Nearly two months after the capture of Iraq by US and British forces dozens of civilians are still dying every day from mines and unexploded munitions, and the death toll is likely to stay high for years to come, according to the UK based Mines Advisory Group.

Sean Hutton, a spokesman for the group, who recently returned from the north of the country, said that hospitals serving the area around …
Effect of age on the conversion of 25-hydroxyvitamin D3 to 1,25-dihydroxyvitamin D3 by kidney of rat.
Authors: H J Armbrecht, T V Zenser, B B Davis
Journal: Journal of Clinical Investigation (1980)

The decreased absorption of calcium by the small intestine of the adult may reflect changes in vitamin D metabolism with age. The purpose of this study was to compare the capacity of young (1.5 mo of age) and adult (12 mo of age) vitamin D-deficient rats to convert 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D, the physiologically active form of vitamin D. Young rats responded to an oral dose of 25-hydroxyvitamin D3 with significantly increased intestinal absorption of calcium and a three-fold increase in the intestinal content of vitamin D-stimulated calcium-binding protein. Adult rats showed no significant increase in these parameters. The conversion of 25-hydroxyvitamin D3 to 1,25-dihydroxyvitamin D3 was measured in the whole animal by administering a dose of tritiated 25-hydroxyvitamin D3 and determining the appearance of tritiated metabolites in plasma and small intestine. In the adult rat, only 2.1 +/- 0.6% of the plasma radioactivity was in the form of 1,25-dihydroxyvitamin D3 after 24 h compared with 20.8 +/- 3.0% in the young. The conversion of tritiated 25-hydroxyvitamin D3 to its products was also measured directly in isolated slices of renal cortex. 1,25-Dihydroxyvitamin D3 production by adult renal slices was found to be less than one-tenth that of slices from the young. These results indicate that there is a marked decrease in the capacity of the vitamin D-deficient adult rat to convert 25-hydroxyvitamin D3 to 1,25-dihydroxyvitamin D3. This is probably due to the decreased capacity of the adult kidney to 1-hydroxylate 25-hydroxyvitamin D3. These studies also demonstrate the usefulness of renal slices in measuring changes in the renal conversion of 25-hydroxyvitamin D3 to 1,25-dihydroxyvitamin D3 in the mammal.
Effects on Coagulation and Fibrinolysis Induced by Influenza in Mice With a Reduced Capacity to Generate Activated Protein C and a Deficiency in Plasminogen Activator Inhibitor Type 1
Authors: Tymen T. Keller, Koen F. van der Sluijs, Martijn D. de Kruif, Victor E. A. Gerdes, Joost C. M. Meijers, Sandrine Florquin, Tom van der Poll, Eric C. M. van Gorp, Dees P. M. Brandjes, Harry R. Büller, Marcel Levi
Journal: Circulation Research (2006)

Influenza infections increase the risk of diseases associated with a prothrombotic state, such as venous thrombosis and atherothrombotic diseases. However, it is unclear whether influenza leads to a prothrombotic state in vivo. To determine whether influenza activates coagulation, we measured coagulation and fibrinolysis in influenza-infected C57BL/6 mice. We found that influenza increased thrombin generation, fibrin deposition, and fibrinolysis. In addition, we used various anti- and prothrombotic models to study pathways involved in the influenza-induced prothrombotic state. A reduced capacity to generate activated protein C in TM(pro/pro) mice increased thrombin generation and fibrinolysis, whereas treatment with heparin decreased thrombin generation in influenza-infected C57Bl/6 mice. Thrombin generation was not changed in hyperfibrinolytic mice, deficient in plasminogen activator inhibitor type-1 (PAI-1(-/-)); however, increased fibrin degradation was seen. Treatment with tranexamic acid reduced fibrinolysis, but thrombin generation was unchanged. We conclude that influenza infection generates thrombin, increased by reduced levels of protein C and decreased by heparin. The fibrinolytic system appears not to be important for thrombin generation. These findings suggest that influenza leads to a prothrombotic state by coagulation activation. Heparin treatment reduces the influenza induced prothrombotic state.
Biochemical markers associated with the stages of promotion and progression during hepatocarcinogenesis in the rat.
Authors: H C Pitot, Y Dragan, L Sargent, Y H Xu
Journal: Environmental Health Perspectives (1991)

Specific biochemical changes occurring during hepatocarcinogenesis have been sought by many investigators. The development of multistage models for hepatocarcinogenesis in the rodent has renewed interest in such marker alterations in preneoplastic as well as neoplastic hepatocytes. Preneoplastic altered hepatic foci (AHF) exhibit specific histomorphologic changes as viewed with tinctorial stains and show a variety of biochemical changes as evidenced by enzyme and immunohistochemistry and by other histochemical markers. During the reversible stage of promotion when AHF are scored by multiple markers, the distribution of markers within these lesions differs with the use of different promoting agents. One interpretation of this finding is that each promoting agent stimulates the replication of a set of initiated cells exhibiting the phenotypic characteristics of a specific programmed phenotype. The same markers score AHF during the stage of progression, but many AHF in this stage are phenotypically heterogeneous, exhibiting in tissue sections a "focus-in-focus" pattern of marker alteration. These latter changes can be correlated with the appearance of karyotypic alterations in preneoplastic hepatocytes. On the other hand, it has been difficult to demonstrate the activation, either mutational or transcriptional, of proto-oncogenes until this stage of progression in rat hepatocarcinogenesis. Thus, a study of biochemical and molecular markers during the stages of hepatocarcinogenesis may lead to a better understanding of potential mechanisms involved in the development of neoplasia through the stages of initiation, promotion, and progression.
Global epidemiology of hepatitis C virus infection: New estimates of age-specific antibody to HCV seroprevalence
Authors: Khayriyyah Mohd Hanafiah, Justina Groeger, Abraham D. Flaxman, Steven T. Wiersma
Journal: Hepatology (2012)

In efforts to inform public health decision makers, the Global Burden of Diseases, Injuries, and Risk Factors 2010 (GBD2010) Study aims to estimate the burden of disease using available parameters. This study was conducted to collect and analyze available prevalence data to be used for estimating the hepatitis C virus (HCV) burden of disease. In this systematic review, antibody to HCV (anti-HCV) seroprevalence data from 232 articles were pooled to estimate age-specific seroprevalence curves in 1990 and 2005, and to produce age-standardized prevalence estimates for each of 21 GBD regions using a model-based meta-analysis. This review finds that globally the prevalence and number of people with anti-HCV has increased from 2.3% (95% uncertainty interval [UI]: 2.1%-2.5%) to 2.8% (95% UI: 2.6%-3.1%) and >122 million to >185 million between 1990 and 2005. Central and East Asia and North Africa/Middle East are estimated to have high prevalence (>3.5%); South and Southeast Asia, sub-Saharan Africa, Andean, Central, and Southern Latin America, Caribbean, Oceania, Australasia, and Central, Eastern, and Western Europe have moderate prevalence (1.5%-3.5%); whereas Asia Pacific, Tropical Latin America, and North America have low prevalence (<1.5%).The high prevalence of global HCV infection necessitates renewed efforts in primary prevention, including vaccine development, as well as new approaches to secondary and tertiary prevention to reduce the burden of chronic liver disease and to improve survival for those who already have evidence of liver disease.
Cullen's sign in perforated duodenal ulcer.
Authors: D M Evans
Journal: BMJ (1971)

second possibility arises from its paradoxical effect in preventing implantation in rats, either by accelerated tubal transport of eggs or by counteracting the oestrogen surge at ovulation (Harper and Walpole, 1967b).Probably small doses of ICI 46,474 given continuously to normally ovulating women might prevent implantation without otherwise interfering with the normal menstrual cycle.We would like to acknowledge the kindness of Dr. C. C. Downie and Dr. A. L. Walpole in making the compound available to us, and the financial support of I.C.I.