tbuckley/cabot-search huggingface dataset:
Respiratory failure with diffuse bronchiectases and cryoglobulinaemia
Authors: N. Girard, A. Vasiljevic, V. Cottin, L. Falchero, D. Meyronet, F. Thivolet-Bejui, J-F. Cordier
Journal: European Respiratory Journal (2008)

A 48-yr-old nonsmoking female presented with a 5-yr history of recurrent bronchitis with progressive exercise dyspnoea.She had been diagnosed with a small monoclonal gammopathy of undermined significance (MGUS) 6 yrs previously.Inspiratory vital capacity was 4.7 L (125% predicted) and forced expiratory volume in one second/forced vital capacity (FVC) ratio was 79%.Carbon monoxide transfer factor was markedly impaired (35% pred), and arterial oxygen tension (Pa,O 2 ) decreased from 9.2 to 6.0 kPa at exercise (40 W, 10 min).A thoracic computed tomography (CT) scan was performed (fig.1).Fibreoptic bronchoscopy found inflammation of the bronchial mucosa with candle stain-like deposits on the trachea and large bronchi, without any purulent secretion within the respiratory tract (fig.2).The histopathological aspect of bronchial biopsies is shown in figure 3. Blood tests disclosed type I cryoglobulinaemia composed of a 32 g?L -1 monoclonal immunoglobulin (Ig)Mk serum component (at 37uC).Blood cell count was normal.Bone marrow examination showed malignant lymphoplasmacytic cells representing 30% of total cells, with a monotypic surface expression of IgMk.The C-reactive protein level was 21 mg?L -1 .Extensive renal, cardiac and hepatic evaluations were normal.As severe hypoxaemia and reduction of carbon monoxide transfer factor were unexplained, the patient underwent videothoracoscopic lung biopsies.
Effects of a False Neurotransmitter, p-Hydroxynorephedrine, on the Function of Adrenergic Neurons in Hypertensive Patients
Authors: Robert E. Rangno, John S. Kaufmann, John H. Cavanaugh, Donald Island, J. Throck Watson, John Oates
Journal: Journal of Clinical Investigation (1973)

Previous studies have shown that amphetamine and p-hydroxyamphetamine impair adrenergic transmission, and it has been suggested that this effect is mediated by an active metabolite, p-hydroxynorephedrine (PHN). Studies in experimental animals have shown that PHN can deplete and substitute for norepinephrine (NE) in the transmitter pool, thus meeting the criteria of a false neurotransmitter. The pharmacologic effects of PHN on adrenergic function and NE synthesis were studied in eight hypertensive patients and compared with placebo. Mean erect and supine blood pressure (BP) decreased 22/14 and 9/6 mm Hg, respectively, during PHN 600 mg daily. The post-Valsalva diastolic overshoot was abolished. The pressor sensitivity to tyramine decreased whereas the pressor response to NE was enhanced. A mild natriuresis occurred. The 24 h urinary excretion of catecholamines and catecholamine metabolites during the administration of PHN compared with placebo changed as follows: vanillylmandelic acid (VMA), 42% decrease; NE. 42% decrease; normetanephrine (NM), 400% increase: metanephrine, unchanged; dopamine, 40% decrease; while homovanillic acid was unchanged. The sum of VMA, NE, and NM decreased 23%. The posttreatment urinary excretion of PHN was biexponential with first and second phase half-lives of 13 and 55 h. respectively. The time of the second phase closely approximated the recovery of the changes in BP and excretion of VMA. No effects of PHN on the central nervous system were observed. These studies show that PHN acts peripherally to interfere with adrenergic function and NE synthesis in hypertensive patients with a resultant decrease in BP.
MYOCARDIAL BLUSH GRADE AND MORTALITY AFTER PHARMACO INVASIVE THERAPY WITH TENECTEPLASE ADMINISTERED UP TO THREE OR FROM THREE TO SIX HOURS ARE SIMILAR
Authors: Livia N. Matos, Antonio C. Carvalho, Adriano H. Barbosa, Iran Goncalves Jr, Eryca V. Jesus, Juscelio T. Souza Filho, Amaury Amaral, Luiz C. Wilke, Vinicius Vitro, Edson Stefanini, Euclides M. Barros Jr, Claudia M. Alves
Journal: Journal of the American College of Cardiology (2013)
Liver DNA synthesis promoter activity detected in human plasma from subjects with hepatitis
Authors: Juan J. Díaz-Gil, Gonzalo Sánchez, Luis Santamaría, Carolina Trilla, Paloma Esteban, Pedro Escartín
Journal: Hepatology (1986)

A liver DNA synthesis promoter activity was detected in human plasma from subjects with hepatitis. The assay procedure consisted of intraperitoneal injection into mice of aliquots of plasma, previously chromatographed on Sephadex G-25. After 24 hr, [3H]thymidine was injected and its incorporation into liver DNA measured. The increase in [3H]thymidine uptake of injected mice was not detected in those administered plasma from normal subjects (basal [3H]thymidine incorporation was that corresponding to saline-injected mouse values). At a maximal effective dose (0.3 mg protein per mouse), plasma from subjects with hepatitis increased the mitotic index of mouse liver hepatocytes; at the same dose, plasma from normal subjects had no effect. This DNA synthesis promoter activity appears to be a protein, as it is sensitive to trypsin digestion and heat.
Reviews, Notes, and Listings: Primary Care: Concept, Evaluation, and Policy
Authors: James F. Cawley
Journal: Annals of Internal Medicine (1993)

Literature of Medicine1 March 1993Reviews, Notes, and Listings: Primary Care: Concept, Evaluation, and PolicyJames F. Cawley, MDJames F. Cawley, MDThe George Washington University, Washington, DC 20037.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-5-199303010-00031 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Primary Care: Concept, Evaluation, and PolicyBarbara Starfield. 262 pages. New York: Oxford University Press; 1992. $39.95.In the past, primary care often received more lip service than meaningful effort in the delivery of health services. Lately, however, there has been a resurgence of interest in primary care, focusing on strategies to correct the imbalance between generalists and specialists. Many now recognize that some of American medicine's most troublesome problems (for example, spiraling costs) may be at least partially attributable to an excess of specialists. A health system with too many specialists, because of its consequent inattention to primary care, tends to ... Author, Article, and Disclosure InformationAffiliations: The George Washington University, Washington, DC 20037. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 March 1993Volume 118, Issue 5Page: 399KeywordsHealth careHealth care policyHealth care qualityHealth services researchMedical servicesPrimary care ePublished: 15 August 2000 Issue Published: 1 March 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Disabled Children — Free Contraception for All? — More Liberal Liquor Laws?
Authors: John Lister
Journal: New England Journal of Medicine (1973)

The history of thalidomide has risen many moral issues which have come to the foreground once more. Presently they are being debated in the British Parliament. No satisfactory financial arangement has been made for the children who have been born defective because their mothers had taken thalidomide during pregnancy. The Secreatary of State for the Department of Health and Social Security asserted that there is no legal liability on the part of the government and no implication about a drug since it had been prescribed under the National Health Service. The government, however, decided to make 3 million pounds available for defective children be it a result of thalidomide or some other drug. The special case of the thalidomide children remains the same however. Not only is the cause different in the case of these children, but also there is a greater stress on the mother because of guilt feelings. The above normal intelligence of the children themselves is another factor that make their case unique. This article also includes comments on 2 other areas. 1 is the fact that family planning advice will be free to all patients when the National Health Service is reorganized in 1974. The Times, in an article, put forth the view that free contraception for all is a good idea.
TCT-71 Outcomes of Transcatheter Aortic Valve Replacement (TAVR) in Patients Presenting with Circulatory Shock Secondary to Inoperable Aortic Stenosis
Authors: Akram W. Ibrahim, Vinod Thourani, Vasilis Babaliaros, Sebastian Iturra-Urriola, Kreton Mavromatis, Bradley G. Leshnower, Ayaz Rahman, James Stewart, Eric Sarin, John Merlino, Stamatios Lerakis, Chandan Devireddy
Journal: Journal of the American College of Cardiology (2014)
THE DEVELOPMENT OF LEISHMANIA DONOVANI IN VITRO AT 37°C
Authors: William Trager
Journal: The Journal of Experimental Medicine (1953)

Suspensions of leishmanias from the spleen of hamsters infected with Leishmania donovani were placed in culture flasks and incubated at 37 degrees C. In a medium of human erythrocyte extract and human serum there appeared within a day or two aflagellate forms resembling leishmanias but larger, as well as other aflagellate forms more nearly resembling rounded leptomonads. These intermediate forms multiplied during the first 4 days of culture. They then slowly died off, despite frequent renewal of the culture medium. Sometimes a small proportion of motile, typical leptomonads also appeared in such cultures. Leptomonads from cultures maintained at 28 degrees C., when placed in the human red cell extract-human serum medium and incubated at 37 degrees C., survived at least 4 days. For both types of effect, human serum could be replaced by normal hamster serum but not by rabbit serum. Nicotinamide, added to the human red cell extract-human serum medium at a concentration of 400 mg. per 100 ml., completely prevented the development of intermediate forms from leishmanias and brought about the rapid death of leptomonads at 37 degrees C.
GMC launches new tribunal service for UK doctors
Authors: C. Dyer
Journal: BMJ (2012)

A new tribunal service to decide doctors’ fitness to practise was launched on 11 June, in the biggest shake up of medical regulation in the United Kingdom since the General Medical Council was set up more than 150 years ago.

The Medical Practitioners Tribunal Service (MPTS), headed by a judge, will be part of the GMC but will operate separately from it and be accountable to parliament. The GMC will continue to investigate and prosecute cases.

The move paves the way for far reaching reforms of the fitness to practise procedures expected to come into force over the next few years.

Pre-hearing case management, better …
Who decides for those who can't?
Authors: C Dyer
Journal: BMJ (1991)

heightened clinical awareness that certain diseases may be related to unrecognised infection with HIV-I.Compared with data for 1984, McCormick found an excess of 295 deaths in 1989 from 11 specified causes (which included deaths from pneumonia, specific neoplasms, and external causes) in men aged 15-54 in England and Wales (p 1365).'3She estimated that if these 295 were infected with HIV-I then in only 40% had the infections been diagnosed.Doctors should therefore consider underlying HIV-I infection in any young or middle aged man in whom either pneumonia or certain malignant neoplasms have been diagnosed.The information provided by the surveillance of cases of AIDS is important for the primary prevention of this fatal disease.Moreover, earmarked funds for direct treatment and care are allocated in proportion to the number of people with 1 Centers for Disease Control.Revision of the CDC surveillance case definition for acquired immunodeficiency syndrome.
Chimeric Antigen Receptor T Cells for Cancer Immunotherapy
Authors: Kevin J. Curran, Renier J. Brentjens
Journal: Journal of Clinical Oncology (2015)

Article Tools UNDERSTANDING THE PATHWAY Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2014.60.3449 Journal of Clinical Oncology - published online before print April 20, 2015 PMID: 25897155 Chimeric Antigen Receptor T Cells for Cancer Immunotherapy Kevin J. CurranxKevin J. CurranSearch for articles by this author , Renier J. BrentjensxRenier J. BrentjensSearch for articles by this author Show More Memorial Sloan Kettering Cancer Center, New York, NY https://doi.org/10.1200/JCO.2014.60.3449 First Page Full Text PDF Figures and Tables © 2015 by American Society of Clinical Oncology
Hepatitis B virus X protein increases expression of p21Cip-1/WAF1/MDA6 and p27Kip-1 in primary mouse hepatocytes, leading to reduced cell cycle progression
Authors: Liang Qiao, Kevin Leach, Robert McKinstry, Donna Gilfor, Adly Yacoub, Jong Sung Park, Steven Grant, Philip B. Hylemon, Paul B. Fisher, Paul Dent
Journal: Hepatology (2001)

Previously, we have linked prolonged intense mitogen-activated protein kinase (MAP kinase; MAPK) signaling in hepatocytes to increased expression of p21 Cip-1/WAF1/MDA6 (p21) and p16 INK4a (p16), that leads to a p21-dependent growth arrest. In this study, we investigated the impact of hepatitis B virus X protein (pX) expression on MAPK-modulated cell cycle progression in primary mouse hepatocytes. In hepatocytes, expression of pX enhanced protein levels of p21 and p27, but not of p16. The elevated levels of p21 and p27 correlated with reduced DNA synthesis in wild-type (+/+) hepatocytes and with a weak stimulation of DNA synthesis in p21 null (−/−) cells. Antisense p27 messenger RNA (mRNA) (p27as) increased DNA synthesis in +/+ and p21 −/− cells, and pX blunted this effect in +/+ cells. In p21 −/− cells, however, p27as permitted pX to further stimulate DNA synthesis. These data argue that a reduced ability to enhance expression of both p21 and p27 is required to fully reveal the growth-potentiating properties of pX. This finding also implies that depending on the functional status of the p21 and p27 genes, expression of pX can have 2 very different effects on hepatocyte proliferation. Prolonged intense MAPK signaling reduced DNA synthesis in +/+ cells and enhanced DNA synthesis in p21 −/− cells. The enhancement of DNA synthesis in p21 −/− cells was blocked by pX, and the effect of pX was abrogated by p27as. Furthermore in p21 −/− cells, overexpression of p16 blocked MAPK-stimulated DNA synthesis, and this effect was partially reversed by p27as. These data argue that p27 can also cooperatively interact with p16 to inhibit DNA synthesis in hepatocytes. Collectively, our findings show that reduced expression of p16, p21, and p27, which can occur during hepatocellular carcinoma, enhances the ability of MAPK signaling and pX to cause proliferation in hepatocytes. Thus loss of cyclin kinase inhibitor function may play an important role in the process of tumor progression after chronic hepatitis B virus infection.
Survival in Severe Congenital Heart Disease
Authors: G. H. Watson
Journal: BMJ (1971)

<h3>Background:</h3> The capacity of general internal medicine (GIM) clinical teaching units has been strained by decreasing resident supply and increasing patient demand. The objective of our study was to compare the number of residents (supply) with the volume and duration of patient care activities (demand) to identify inefficiency. <h3>Methods:</h3> Using the most recently available data from an academic teaching hospital in Toronto, Ontario, we identified each occurrence of a set of patient care activities that took place on the clinical teaching unit from 2015 to 2019. We completed a descriptive analysis of the frequencies of these activities and how the frequencies varied by hour, day, week, month and year. Patient care activities included admissions, rounds, responding to pages, meeting with patients and their families, patient transfers, discharges and responding to cardiac arrests. The estimated time to complete each task was based on the available data in our electronic medical record system and interviews with GIM physicians and trainees. To calculate resident utilization, the person-hours of patient care tasks was divided by the person-hours of resident supply. Resident utilization was computed for 3 scenarios corresponding to varying levels of resident absenteeism. <h3>Results:</h3> During the study period, there were 14 581 consultations to GIM from the emergency department. Patient volumes tended to be highest during January and lowest during May and June, and highest on Monday morning and lowest on Friday night. Daily admissions to hospital from the emergency department were higher on weekdays than on weekends, and hourly admissions peaked at 8 am and between 3 pm and 1 am. Weekday resident utilization was generally highest between 8 am and 2 pm, and lowest between 1 am and 8 am. In a scenario in which all residents were present apart from those who were post-call, resident utilization generally never exceeded 100%; in scenarios in which at least 1 resident was absent owing to illness or vacation, it was common for resident utilization to approach or exceed 100%, particularly during daytime working hours. <h3>Interpretation:</h3> Analyzing supply and demand on a GIM ward has allowed us to identify periods when supply and demand are not aligned and to demonstrate empirically the vulnerability of current staffing models. These data have the potential to inform and optimize scheduling on an internal medicine ward.
Medical Ethics' Assault on Medical Values-Reply
Authors: Roger C. Sider
Journal: JAMA (1984)

In Reply.—  All three letters share incorrect assumptions about our position and misunderstandings of ethical theory.   Churchill and Cross confuse political choice with philosophic autonomy. Value theory is not the same as political ideology, nor do the social conventions of the last two decades reflect the complexity of the citizen's life. Steffen also confuses Mill's political writing with his ethical theory. Mill's universal ethical principle is utility , and on that he is a formalist, as modern interpreters such as D. H. Hodgson 1 indicate. Mill himself was too smart to make autonomy a universal ethical principle. He saw it as limited and as a tool for achieving the utility principle. However, medical ethicists have associated his name with autonomy ethics in their confusion of politics for ethics.  It makes no sense to separate experience into subjective or objective components and do no such thing ourselves. But Churchill and
Comparison of Pulmonary Ga-67 and Tc-99m MAA Imaging in a Patient With Primary Amyloidosis
Authors: M. BANCI, W. GIANNI, O. SCHILLACI, F. VETTA, F. SCOPINARO, V. MARIGLIANO
Journal: Clinical Nuclear Medicine (1994)

Scintigraphic images with Ga-67 accumulated in amyloid substance in a sensitive, but nonspecific way. On the contrary, Tc-99m MAA is able to show hypoperfusion resulting from mechanical damage. The authors describe a case of pulmonary amyloidosis in a patient with primary amyloidosis with accumulation of Ga-67 in the areas where Tc-99m MAA shows strongly hypoactive areas.
THU0003 Effect of Renal Damage on Extra-Renal Organ Damage and Mortality in Patients with Systemic Lupus Erythematosus (SLE): A Longitudinal Cohort Study of 756 Patients
Authors: C.C. Mok, K.L. Chan, C.H. To, L.Y. Ho
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Objectives</h3> To study the effect of renal damage on extra-renal organ damage and mortality in patients with SLE. <h3>Methods</h3> Patients who fulfilled ≥4 ACR criteria for SLE between 1995 and 2011 were longitudinally followed. Organ damage in 12 systems was assessed by the ACR SLICC damage scores (SDI). The cumulative rate of survival was studied by Kaplan-Meier9s plot. For those who died during the disease course, data were censored at the time of death. For those who were lost follow-up, data were censored at the time of last clinic visits. Comparison of extra-renal organ damage and survival rate was made between patients with and without renal damage during the course of SLE. <h3>Results</h3> 756 SLE patients were studied (696 women, 92%). All were ethnic Chinese. The mean age of onset of SLE was 32.7±13.6 years and the mean follow-up time of the entire cohort of patients was 9.4±7.4 years. 76 (10%) patients died during the course of illness and 34 (4.5%) patients were lost to follow-up. 26 (3.4%) patients developed end stage renal failure (ESRF). The main contributing causes of death in those 76 patients were: infection (49%), cardiovascular events (12%), cerebrovascular events (13%), cancer (11%), suicide (3%) and others (13%). Overall, renal damage occurred in 84 (11%) patients (64% with impaired glomerular filtration rate; 6% persistently heavy proteinuria; 30% ESRF). Compared with patients without renal damage (renal SDI=0), those with renal damage had significantly higher incidence of damage in the eyes, central nervous system, pulmonary system, cardiovascular system, musculoskeletal system, gonads and the endocrine system (P&lt;0.001 in all). The corresponding mean SDI scores in these systems were also significantly higher in patients with renal damage than those without. The cumulative survival rates of our patients were 94% at 5 years, 90% at 10 years and 86% at 15 years. Patients with renal damage had significantly higher mortality than those without (log rank test; p&lt;0.001). The age and sex adjusted hazard ratio for mortality in patients with renal damage relative to those without renal damage was 3.55 (95% CI 2.22-5.66; &lt;0.001). <h3>Conclusions</h3> In patients with SLE, renal damage significantly and adversely affects survival. The presence of renal damage significantly increases the incidence of extra-renal organ damage, particularly in the cardiovascular, pulmonary, neuropsychiatric, ophthalmological, musculoskeletal, gonadal and endocrine systems. <h3>Disclosure of Interest</h3> : None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.2634
Patient Ownership and Conflict in the Intensive Care Unit
Authors: Susan Galandiuk
Journal: JAMA Surgery (2013)

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