tbuckley/cabot-search huggingface dataset:
Comparison of immunisation rates in general practice and child health clinics.
Authors: J Li, B Taylor
Journal: BMJ (1991)

OBJECTIVE--To compare immunisation uptake rates in general practice surgeries and community child health clinics. DESIGN--Cohort study using data from a computerised child health system. SETTING--Four health districts of North East Thames Regional Health Authority. SUBJECTS--3616 children born January to March 1990 and resident in the four districts at the end of January 1991. MAIN OUTCOME MEASURES--Immunisation uptake rates at 10-12 months of age, age at immunisation, scheduling performance at the two locations, and odds ratios of outstanding immunisations. RESULTS--80% of children registered at general practices had completed their third dose of pertussis immunisation compared with 68% of those at health clinics. Median ages at the third dose were 24 weeks and 29 weeks at the two locations respectively. Scheduling was more effective at general practice surgeries. Unscheduled immunisations were more likely to be given after the recommended age. Overall, children resident in rural and suburban areas had greater uptakes than those in inner cities. Odds ratios for not being fully immunised among children registered at health clinics were 1.4 times those among children immunised in general practice and 3.0 times greater among children resident in inner cities than among those in rural and suburban districts. Children who moved into a district, however, were no less likely to be fully immunised than children who were born there. CONCLUSIONS--The immunisation uptake rate was better in general practices than in child health clinics in both inner city and rural and suburban areas. Uptake may be increased with additional support to enable general practitioners to undertake immunisations, especially in inner cities.
STUDIES ON THE OXIDATION-REDUCTION OF HEMOGLOBIN AND METHEMOGLOBIN
Authors: James M. Neill
Journal: The Journal of Experimental Medicine (1925)

It is well known that methemoglobin is gradually formed in sterile blood or hemoglobin solutions which are stored under the usual conditions. If the hemoglobin is reduced by biological agents and stored in the absence of air, the formation of methemoglobin is inhibited, or wholly prevented. The reasons for this are discussed.
ATTENDANCE OF AN EARLY POST-DISCHARGE CLINIC VISIT &amp;ndash; DOES IT REALLY MAKE A DIFFERENCE? NEW INSIGHTS INTO PREDICTING 30 DAY READMISSIONS IN HEART FAILURE
Authors: Redah Zainub Mahmood, Snehalkumar Patel, Sherry Bumpus, Cydni Smith, Reema Hasan, Todd Koelling
Journal: Journal of the American College of Cardiology (2012)
Tonsillectomy Mortality and Asphyxia
Authors: Vincent J. Collins
Journal: JAMA (1966)

<h3>To the Editor:—</h3> The recent editorial "Tonsillectomy Mortality" (<b>194</b>: 824, 1965) is timely and important. However, it still leaves the avenue open to asphyxia: "Virtually all deaths from tonsillectomy result from two preventable causes. The first, inadequate oxygen during surgical procedure, results in cardiac arrest; about one third of the deaths occur in this manner. An adequate airway is essential for proper oxygenation. This can be maintained with or without an endotracheal tube..." In regard to the last statement, for most expert, experienced anesthesiologists, hypoxia does occur without an endotracheal tube. Careful monitoring of patients without endotracheal tubes has revealed that tachycardia andelevation of systolic pressure invariably occur once surgical procedure commences. These responses were established as being asphyxial in nature. Simultaneous oxygen saturation studies revealed that with the cardiovascular responses, a reduction in oxygen values to 68% to 84% of normal occurs. These represent the effects of subtle obstruc
Airway Epithelial Cells From Asthmatic Subjects Produce More Fractalkine (CX3CL1) Than Those Of Healthy Subjects Upon Rhinovirus Infection
Authors: M. Tang, S. Favoreto Jr., J. Fiuk, J. Shen, J. Quraishi, P.C. Avila
Journal: Journal of Allergy and Clinical Immunology (2009)
Gastrointestinal Paramyloidosis in Plasmacytic Myeloma
Authors: P. Philip Scheerer, Dale L. Schwartz, Robert V. Pierre, Ernest C. Reed, James W. Linman
Journal: JAMA (1964)

The deposition of paramyloid in mesenchymal tissue occurs in approximately 10% of patients with plasmacytic myeloma. Clinically significant involvement of the gastrointestinal tract by paramyloid is infrequent. A patient with plasmacytic myeloma demonstrated extensive paramyloid deposition which produced both malabsorption and small bowel obstruction. The marked similarity of the paramyloidosis of plasmacytic myeloma and "primary" systemic amyloidosis is contrasted with the dissimilarity of paramyloidosis and the secondary amyloidosis associated with chronic disease. There is emphasis on the necessity of adequate bone marrow examination in patients with the clinical manifestations of "primary" systemic amyloidosis.
Breast-feeding and atopic disease: A cohort study from childhood to middle age
Authors: Melanie Claire Matheson, Bircan Erbas, Aindralal Balasuriya, Mark Andrew Jenkins, Cathryn Leisa Wharton, Mimi Lai-Kuan Tang, Michael John Abramson, Eugene Haydn Walters, John Llewelyn Hopper, Shyamali Chandrika Dharmage
Journal: Journal of Allergy and Clinical Immunology (2007)
THE IDENTIFICATION AND ISOLATION OF TWO MOUSE-TOXIC PROTEIN COMPONENTS IN EXTRACTS FROM PASTEURELLA PESTIS
Authors: Thomas C. Montie, Diane B. Montie, Samuel J. Ajl
Journal: The Journal of Experimental Medicine (1964)

The toxin activity of Pasteurella pestis cells, strain "Tjiwidej," was found to be associated with two proteins. Using a disc electrophoresis technique in conjunction with mouse lethality, two toxic proteins were isolated exhibiting intraperitoneal LD(50)'s of less than 1.0 to 1.5 microg protein. Each produced a single characteristic precipitin band on agar gel diffusion plates. The slower migrating toxin in gel diffusion or disc electrophoresis was designated as toxin A. It was shown to be sensitive to deoxycholate and digitonin, did not accumulate in 5-fluorotryptophan treated cells, and was associated with the membrane fraction of the cell. The faster migrating toxin B, apparently is resistant to surface-active agents, and is not affected by treatment of cells with 5-fluorotryptophan. Toxin B is associated with the soluble or cytoplasmic fraction of the cell. This evidence suggested that each toxin represented a distinctly different molecular species. The possibility is discussed that toxin B is synonymous with the murine toxin previously isolated by paper curtain electrophoresis which revealed only one antigen band in the Oudin precipitin reaction.
Precepts and practice: Charles Hastings's vision and reality.
Authors: A H Grabham
Journal: BMJ (1982)

Charles Hastings created the Association at a time when the country was in a state of flux, both political and social.The year 1832 saw the passage of the Great Reform Bill and the Anatomy Act, the foundation of the first provincial university in Durham, and the operation of the first passenger railways.Medical practice was still not fully recognised as a profession and doctors tended to join together in numerous groups, some centred on the colleges in London, Edinburgh, or Glasgow and others joining together in the large provincial towns and cities.There was, however, no overall organisation or control of the profession and most of those practising medicine held no qualification.Poor patients were treated under the provisions of the Poor Law by the efforts of the Board of Guardians.Medical knowledge itself was obviously limited, and the recording and exchange of knowledge between doctors were primitive.Nevertheless, the Lancet had been founded in 1823, and all over Europe small local journals were beginning to record the development of medicine.One such journal was the Midland Medical and Surgical Reporter or, to give it its full title, the Midland Medical and Surgical Reporter and Topographical and Statistical Journal, which first appeared-with Hastings as its editor-in August 1828.Sixteen issues only were produced, and because of the financial problems of the publishers the last appeared in May 1832.By then, however, Hastings had clearly recognised the need for better organisation of the emerging profession, and having carried out fairly extensive discussions with many colleagues throughout the provinces he published in the last copy of the Reporter the prospectus for a new medical association.He wrote: "A wish has, in consequence, been warmly expressed and widely circulated that the members of the profession residing in the Provinces should unite themselves into an Association friendly and scientific: that this
Kupffer cells and hepatocyte metabolism: A two-way street?
Authors: Elizabeth E. Powell, Michael J. Waters, Julie R. Jonsson, Kris Kowdley, Geoffrey McCaughan, Christian Trautwein
Journal: Hepatology (2009)

Macrophage infiltration and activation in metabolic tissues underlie obesity-induced insulin resistance and type 2 diabetes. While inflammatory activation of resident hepatic macrophages potentiates insulin resistance, the functions of alternatively activated Kupffer cells in metabolic disease remain unknown. Here we show that in response to the Th2 cytokine interleukin-4 (IL-4), peroxisome proliferator-activated receptor δ (PPARδ) directs expression of the alternative phenotype in Kupffer cells and adipose tissue macrophages of lean mice. However, adoptive transfer of PPARδ−/− (Ppard−/−) bone marrow into wild-type mice diminishes alternative activation of hepatic macrophages, causing hepatic dysfunction and systemic insulin resistance. Suppression of hepatic oxidative metabolism is recapitulated by treatment of primary hepatocytes with conditioned medium from PPARδ−/− macrophages, indicating direct involvement of Kupffer cells in liver lipid metabolism. Taken together, these data suggest an unexpected beneficial role for alternatively activated Kupffer cells in metabolic syndrome and type 2 diabetes.
Islet transplantation under the kidney capsule fully corrects the impaired skeletal muscle glucose transport system of streptozocin diabetic rats.
Authors: R Napoli, A M Davalli, M F Hirshman, R Weitgasser, G C Weir, E S Horton
Journal: Journal of Clinical Investigation (1996)

Chronic insulin therapy improves but does not restore impaired insulin-mediated muscle glucose uptake in human diabetes or muscle glucose uptake, transport, and transporter translocation in streptozocin diabetic rats. To determine whether this inability is due to inadequate insulin replacement, we studied fasted streptozocin-induced diabetic Lewis rats either untreated or after islet transplantation under the kidney capsule. Plasma glucose was increased in untreated diabetics and normalized by the islet transplantation (110 +/- 5, 452 +/- 9, and 102 +/- 3 mg/dl in controls, untreated diabetics, and transplanted diabetics, respectively). Plasma membrane and intracellular microsomal membrane vesicles were prepared from hindlimb skeletal muscle of basal and maximally insulin-stimulated rats. Islet transplantation normalized plasma membrane carrier-mediated glucose transport Vmax, plasma membrane glucose transporter content, and insulin-induced transporter translocation. There were no differences in transporter intrinsic activity (Vmax/Ro) among the three groups. Microsomal membrane GLUT4 content was reduced by 30% in untreated diabetic rats and normal in transplanted diabetics, whereas the insulin-induced changes in microsomal membrane GLUT4 content were quantitatively similar in the three groups. There were no differences in plasma membrane GLUT1 among the groups and between basal and insulin stimulated states. Microsomal membrane GLUT1 content was increased 60% in untreated diabetics and normalized by the transplantation. In conclusion, an adequate insulin delivery in the peripheral circulation, obtained by islet transplantation, fully restores the muscle glucose transport system to normal in streptozocin diabetic rats.
PD4-2-3: Global Lung Oncology Branch trial 3 (Glob 3): final results of a randomised multinational Phase III study of oral and i.v. vinorelbine (NVB) plus cisplatin (CDDP) versus docetaxel (DTX) plus CDDP as first-line treatment for advanced Non-Small Cell Lung Cancer (NSCLC)
Authors: Eng-Huat Tan, Tomasz Grodzki, Claus-Peter Schneider, Peter Zatloukal, Martin Reck, Enrico Aitini, Janusz Rolski
Journal: Journal of Thoracic Oncology (2007)
Activation of pregnane X receptor inhibits experimental dermal fibrosis
Authors: Christian Beyer, Alla Skapenko, Alfiya Distler, Clara Dees, Helena Reichert, Louis Munoz, Jan Leipe, Hendrik Schulze-Koops, Oliver Distler, Georg Schett, Jörg H W Distler
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Objective</h3> To assess the antifibrotic effects of pregnane X receptors (PXRs) in experimental dermal fibrosis. <h3>Methods</h3> The antifibrotic effects of PXR activation by 5-pregnen-3β-ol-20-one-16α-carbonitrile (PCN) were studied in the bleomycin model for prevention of dermal fibrosis and the modified bleomycin model for the treatment of established bleomycin-induced dermal fibrosis. Activation of canonical transforming growth factor (TGF)β signalling was analysed by immunofluorescence staining for phosphorylated smads. The antifibrotic effects of PXR activation were further studied in murine fibroblasts and murine T cells under Th2 conditions. In the T cell experiments, synthesis of the profibrotic cytokines, interleukin (IL)-4 and IL-13, was assessed by quantitative PCR, and IL-13 levels in the murine skin were determined by multiplex bead array technology. <h3>Results</h3> Activation of PXR effectively inhibited the development of bleomycin-induced dermal fibrosis and induced the regression of established dermal fibrosis as assessed by skin thickening, hydroxyproline content and myofibroblasts. Reduced levels of phosphorylated smad2 and smad3 suggested that the antifibrotic effects of PXRs were mediated by inhibition of canonical TGFβ signalling. While PXR activation appeared to have no direct effects on fibroblasts, it potently inhibited the release of the profibrotic cytokine, IL-13, from Th2 cells. Consistent with these findings, IL-13 levels were reduced in bleomycin-challenged murine skin upon PXR activation. <h3>Conclusions</h3> Our findings demonstrate a novel antifibrotic role for PXRs in inflammatory dermal fibrosis. The antifibrotic effects of PXRs appear to be indirect: PXR activation reduces the release of the Th2 cytokine, IL-13, from T cells resulting in decreased canonical TGFβ signalling.
Immunosuppressive Drugs for Kidney Transplantation
Authors: Philip F. Halloran
Journal: New England Journal of Medicine (2004)

Suppression of allograft rejection is central to successful organ transplantation; thus, immunosuppressive agents are crucial for successful allograft function. Immunosuppressive drugs are used for induction (intense immunosuppression in the initial days after transplantation), maintenance, and reversal of established rejection. This review considers the use of immunosuppressive drugs in organ transplantation, focusing on renal transplantation.
A 60s Doctor Enters the 80s
Authors: George Flesh
Journal: JAMA (1985)

JAMA:  Weren't you considered something of a political radical during medical school in the late 60s and early 70s?  Flesh:  In those days, radical became a scare word implying sweeping change and destruction of established structures. In my opinion, a true radical is not committed to turning the world upside down; rather, he is committed to an open search for fundamental causes and disdains the superficial.  I was politically active as a medical student at UCLA. For example, the relationship between the pharmaceutical industry and the medical profession disturbed me a great deal. There was a drug company that gave black leather bags to sophomore medical students all over the country as a promotional device. Some of us felt this was inappropriate. I organized about three fourths of the class and we sent the bags to the Food and Drug Administration with a letter criticizing such gifts. I also wrote
Regional differences in function within noninfarcted myocardium during left ventricular remodeling.
Authors: C M Kramer, J A Lima, N Reichek, V A Ferrari, M R Llaneras, L C Palmon, I T Yeh, B Tallant, L Axel
Journal: Circulation (1993)

BACKGROUND The mechanisms of ventricular enlargement and dysfunction during postinfarct remodeling remain largely unknown. Although global left ventricular architectural changes after myocardial infarction are well documented, differences in function between adjacent and remote noninfarcted myocardium during left ventricular remodeling have not been investigated. These functional differences may relate to regional differences in wall stress during contraction and may contribute to chamber enlargement and global dysfunction after infarction. METHODS AND RESULTS Anteroapical infarcts were produced in seven sheep by ligation of the mid left anterior descending coronary artery and second diagonal branch at thoracotomy. Magnetic resonance short-axis and long-axis images tagged by spatial modulation of magnetization were obtained before and 1 week, 8 weeks, and 6 months after infarction. Left ventricular volumes, mass, ejection fraction, and lengths of infarcted and noninfarcted segments were measured. Circumferential and longitudinal shortening in the subendocardium and subepicardium, wall thickness, and histopathology were assessed in infarcted segments and regions adjacent to and remote from the infarct border. We found that a difference in circumferential and longitudinal segmental shortening between adjacent and remote noninfarcted myocardium present at 1 week persisted up to 6 months after myocardial infarction. However, partial improvement of function in adjacent regions occurred during infarct healing between 1 and 8 weeks after infarction. Left ventricular volume increased up to 6 months after infarction, out of proportion to the concomitant eccentric hypertrophy, whereas the ejection fraction fell. Left ventricular dilatation late in the remodeling process was secondary to lengthening of noninfarcted segments, which were free of significant fibrosis. CONCLUSIONS Left ventricular dilatation and eccentric hypertrophy during remodeling are associated with persistent differences in segmental function between adjacent and remote noninfarcted regions. These functional differences may reflect increased wall stress in adjacent noninfarcted regions and contribute to the global dilatation and dysfunction characteristic of left ventricular remodeling after infarction.
Effect of Strong Directional Selection on Weakly Selected Mutations at Linked Sites: Implication for Synonymous Codon Usage
Authors: Y. Kim
Journal: Molecular Biology and Evolution (2003)

The fixation of weakly selected mutations can be greatly influenced by strong directional selection at linked loci. Here, I investigate a two-locus model in which weakly selected, reversible mutations occur at one locus and recurrent strong directional selection occurs at the other locus. This model is analogous to selection on codon usage at synonymous sites linked to nonsynonymous sites under strong directional selection. Two approximations obtained here describe the expected frequency of the weakly selected preferred alleles at equilibrium. These approximations, as well as simulation results, show that the level of codon bias declines with an increasing rate of substitution at the strongly selected locus, as expected from the well-understood theory that selection at one locus reduces the efficacy of selection at linked loci. These solutions are used to examine whether the negative correlation between codon bias and nonsynonymous substitution rates recently observed in Drosophila can be explained by this hitchhiking effect. It is shown that this observation can be reasonably well accounted for if a large fraction of the nonsynonymous substitutions on genes in the data set are driven by strong directional selection.
Halitosis From Isosorbide Dinitrate
Authors: Dennis Bauman
Journal: JAMA (1975)

To the Editor.—  Several of my patients who have been taking the sublingual form of isosorbide dinitrate have complained of halitosis that appeared with the onset of therapy, was reversible after discontinuing use of the medication, and recurred when therapy was resumed.  The 1975 edition of the Physicians' Desk Reference makes no mention of this possible side effect that has been of great concern to the patients involved. It might be well to warn patients being started on such therapy that halitosis might possibly occur.
Effect of chemotherapy on the outcome of self-expandable metallic stents in gastric cancer patients with malignant outlet obstruction
Authors: C. Kim, S. Park, I. Choi, J. Lee, S. Cho, Y. Park, B. Nam, Y. Kim
Journal: Endoscopy (2012)

Chemotherapy has been suggested to affect the outcome of pyloric stent placement. This study aimed to investigate the association between the response to chemotherapy and pyloric stent outcome.Data from 113 patients with inoperable gastric cancer who received chemotherapy after pyloric stent placement at the National Cancer Center hospital were analyzed retrospectively. Chemotherapy response was assessed using the Response Evaluation Criteria in Solid Tumors. A Cox proportional hazards model was used to evaluate the effect of chemotherapy response on the complications of stents.The stent migration rate was 15.9% (18/113) and the re-stenosis rate was 30.1% (34/113). The response rates to chemotherapy were higher in the first-line group than in the salvage chemotherapy group (second-line or more) (44.8% [26/58] vs. 3.6% [2/55], respectively; P < 0.001). The proportion of patients with long time-to-progression (> 8 weeks) was also higher in the first-line than the salvage chemotherapy group (81.0% [47 /58] vs. 61.8% [34 /55], respectively; P = 0.036). Although, the response to chemotherapy was not associated with stent migration or re-stenosis, a long time-to-progression (adjusted hazard ratio [aHR] = 0.29, 95% confidence interval [CI] 0.13-0.67) and first-line chemotherapy (aHR = 0.45, 95%CI 0.22-0.93) were protective factors against re-stenosis in the multivariate analysis. In patients who received first-line chemotherapy, the median duration of patency of covered and uncovered stents was 20 weeks (95%CI 11-29) and 33 weeks (95 %CI 18-48), respectively (P = 0.317).A long time-to-progression and first-line chemotherapy were significant protective factors against re-stenosis. In chemotherapy-naïve gastric cancer patients with pyloric obstruction, placement of an uncovered stent followed by chemotherapy can be considered to increase stent patency.