tbuckley/cabot-search huggingface dataset:
Adrenal Cortex in Tumors and Hypertension
Authors: John Nichols
Journal: JAMA (1965)

An abundant literature indicates that diverse L clinical conditions and therapy are associated with hypertrophy, or atrophy of the adrenal gland. Weights of uncertain accuracy or a subjective evaluation of a few microscopical preparations, or both, are usually given. Measurements of the gland or its various zones are mentioned in only a few instances. However, conclusions drawn from changes measured in the focal plane of a microscope are inadequate or even misleading. Nichols and Hennigar,<sup>1</sup>converting thickness to mass in a derived sphere, demonstrated, in dogs with pulmonary hypertension, that a 9% increase in peripheral radius of the gland results in a 96% increase in mass of zona glomerulosa, a relationship not obvious in the plane of a microscopical field. This communication will show that the zona glomerulosa has a mass disproportionately larger than indicated by linear measurements and that increases in zona fasciculata, without change in thickness of
OBSERVATIONS ON THE RADICAL CURE OF HERNIA.Read in the Section on Surgery and Anatomy, at the Forty-fifth Annual Meeting of the American Medical Association, held at San Francisco, June 5-8, 1894.
Authors: A. E. ROCKEY
Journal: JAMA (1894)

The individual opportunity of a surgeon practicing in the larger cities to recommend and perform operations for the radical cure of hernia, is certainly greater than that of a surgeon in general practice in the smaller cities and towns. It is consequently to the former class that we owe the evolution of the present operations, but as a whole by far the larger number of cases come under the observation of the latter class, and until recently and at the present time too frequently relegated by them to an indifferent palliative treatment, or worse, advised against operation and turned adrift, only to fall into the hands of some charlatan who "cures without detention from business." As a representative of surgeons in general practice, I I desire to speak in favor of reform. Instead of regarding only cases of strangulated hernia or those of exceedingly difficult retention as proper ones for
IMPROVED HYPODERMIC SYRINGE AND REMEDY CASE.
Authors: ELMER LEE
Journal: JAMA (1896)

In these utilitarian days, that which comes the nearest to the urgent requirements of the practicing physician during the hours of the day and the visits of the night, in the way of supplying remedies for emergencies, is the desire of practical physicians. There are times when drug stores are inaccessible, and there are times when there is not a minute to spare between the arrival of the doctor and the demand for immediate action, which make it imperative that remedies should be carried by the physician. The present hypodermic case, which is for the first time brought before your attention, is not only a hypodermic case, but is also an<i>emergency case</i>. It contains a hypodermic syringe of the simplest, and, in my opinion, the best pattern that has ever been made. The syringe is light, it is cleanable, it is inexpensive, it is effective. These are qualities that
On Confidentiality and Data Banks
Authors: Lendon Snedeker
Journal: New England Journal of Medicine (1969)

Confidentiality to some is a frightening word hill of awesome implications. There always might be a lawsuit just around the corner. The very word serves to produce in young professionals a near panic state little conducive to simple straight thinking. The same reaction is observed when policemen, lawyers and process servers appear on the hospital scene. This is due to a failure to analyze the specific situation and determine the legal rights and processes involved. There is almost always a reasonable solution to the problem.In our experience, hospital workers tend to be extremely conscious of the confidential nature of . . .
Hearing loss in adults
Authors: R. Edmiston, C. Mitchell
Journal: BMJ (2013)

A 60 year old former steelworker mentions to his general practitioner that his family is complaining that the television is too loud. ### Hearing difficulties ### Associated ear, nose, and throat (ENT) symptoms ### Risk factors for otological disease ### Red flags #### Box 1 Red flags ##### Sudden onset or rapidly progressive hearing loss
GMC is to instruct all GPs to talk to dying patients about organ donation
Authors: M. Gould
Journal: BMJ (2009)

The General Medical Council is to tell GPs that they should initiate discussions with dying patients and their relatives about organ donation in a bid to cut the United Kingdom’s chronic shortage of donor organs.

Revised guidance from the GMC on care at the end of life, due to be published in January, is expected to feature a clause obliging all doctors to raise the question of organ donation with appropriate patients.

A recent GMC consultation on revising its guidance on end of life care saw wide support for measures to encourage more people to join the organ donor register. “The consultation revealed …
Superantigen-induced corticosteroid resistance of human T cells occurs through activation of the mitogen-activated protein kinase kinase/extracellular signal-regulated kinase (MEK-ERK) pathway
Authors: Ling-bo Li, Elena Goleva, Clifton F. Hall, Liang-Shiou Ou, Donald Y.M. Leung
Journal: Journal of Allergy and Clinical Immunology (2004)
Andrew Robert Gibbons
Authors: C Bamford
Journal: BMJ (2003)

General practitioner Halesowen, West Midlands (b Ealing, London, 1947; q Birmingham 1971; MRCP), died from ischaemic and hypertensive heart disease on 19 February 2003.​2003.




Figure 1




After junior hospital posts in Birmingham and Portsmouth, Andrew joined a well established general practice in Halesowen in 1978, becoming senior partner in 1990. He also enjoyed working as a hospital practitioner in the local chest clinic, specialising in tuberculosis. Holidays were spent caravanning with the family through France enjoying local food and wines. He was a great reader, and music, the theatre, and dog walking figured highly in his life. He leaves a wife, Heather, and three children.
AIDS-Associated Primary Central Nervous System Lymphoma
Authors: Giorgio Galetto
Journal: JAMA (1993)

A CLINICAL and scientific impasse in the area of primary central nervous system (P-CNS) lymphoma related to the acquired immunodeficiency syndrome (AIDS) has provoked this commentary from the Oncology Committee of the AIDS Clinical Trials Group (ACTG), a national cooperative group for the treatment of human immunodeficiency virus (HIV) infection and its associated illnesses. We believe that progress in this area has been impeded because of two unwarranted assumptions: first, the fear of contagion, which has prevented some neurosurgeons from obtaining biopsy specimens from HIV-infected patients with intracerebral mass lesions<sup>1</sup>; and second, the belief that treatment would be ineffective, which has prevented many primary practitioners from referring such patients, and many oncologists from treating them, even in the setting of prospective protocols. These attitudes have impeded attempts to obtain primary tissues from which to make appropriate diagnoses, or to develop improved therapeutic strategies, serving to fulfill existing negative expectations.
Prevalence of Psychosomatic Symptoms in Children
Authors: S.-L. Linna, I. Moilanen, H. Keistinen, M.-L. Ernvall, M.-M. Karppinen
Journal: Psychotherapy and Psychosomatics (1991)

Somatic symptoms reflecting psychic components were recorded in connection with the Finnish National Epidemiological Study of Psychiatric Disorders. In the present work, according to the parents' concerns, frequent headache was found in 2.8%, recurrent abdominal pain in 2.4%, asthma in 0.7%, enuresis in 1.5% and soiling in 0.3% of the children. Children complaining frequently of different pains were reported in 1.0% by the teachers. Distributions by sex, population density areas and family structure are also given.
A Randomized Clinical Trial Evaluating Tamoxifen in the Treatment of Patients with Node-Negative Breast Cancer Who Have Estrogen-Receptor–Positive Tumors
Authors: B Fisher, J Costantino, C Redmond, R Poisson, D Bowman, J Couture, N V Dimitrov, N Wolmark, D L Wickerham, E R Fisher
Journal: New England Journal of Medicine (1989)

We conducted a randomized, double-blind, placebo-controlled trial of postoperative therapy with tamoxifen (10 mg twice a day) in 2644 patients with breast cancer, histologically negative axillary nodes, and estrogen-receptor-positive (greater than or equal to 10 fmol) tumors. No survival advantage was observed during four years of follow-up (92 percent for placebo vs. 93 percent for tamoxifen; P = 0.3). There was a significant prolongation of disease-free survival among women treated with tamoxifen, as compared with those receiving placebo (83 percent vs. 77 percent; P less than 0.00001). This advantage was observed in both the patients less than or equal to 49 years old (P = 0.0005) and those greater than or equal to 50 (P = 0.0008), particularly in the former, among whom the rate of treatment failure was reduced by 44 percent. Multivariate analysis indicated that all subgroups of patients benefited. Tamoxifen significantly reduced the rate of treatment failure at local and distant sites, tumors in the opposite breast, and the incidence of tumor recurrence after lumpectomy and breast irradiation. The benefit was attained with a low incidence of clinically appreciable toxic effects. The magnitude of the improvement obtained does not preclude the need for future trials in which patients given tamoxifen could serve as the control group in an evaluation of potentially better therapies. Tamoxifen treatment is justified in patients who meet the eligibility criteria of the present study and who refuse to participate in those trials. Since patients with tumors too small for conventional analysis of estrogen-receptor and progesterone-receptor concentrations were not eligible for this study, no information is available to indicate that such patients should receive tamoxifen.
The Ets-1 transcription factor controls the development and function of natural regulatory T cells
Authors: Enguerran Mouly, Karine Chemin, Hai Vu Nguyen, Martine Chopin, Laurent Mesnard, Maria Leite-de-Moraes, Odile Burlen-defranoux, Antonio Bandeira, Jean-Christophe Bories
Journal: The Journal of Experimental Medicine (2010)

Regulatory T cells (T reg cells) constitute a population of CD4(+) T cells that limits immune responses. The transcription factor Foxp3 is important for determining the development and function of T reg cells; however, the molecular mechanisms that trigger and maintain its expression remain incompletely understood. In this study, we show that mice deficient for the Ets-1 transcription factor (Ets-1(-/-)) developed T cell-mediated splenomegaly and systemic autoimmunity that can be blocked by functional wild-type T reg cells. Spleens of Ets-1(-/-) mice contained mostly activated T cells, including Th2-polarized CD4(+) cells and had reduced percentages of T reg cells. Splenic and thymic Ets-1(-/-) T reg cells expressed low levels of Foxp3 and displayed the CD103 marker that characterizes antigen-experienced T reg cells. Thymic development of Ets-1(-/-) T reg cells appeared intrinsically altered as Foxp3-expressing cells differentiate poorly in mixed fetal liver reconstituted chimera and fetal thymic organ culture. Ets-1(-/-) T reg cells showed decreased in vitro suppression activity and did not protect Rag2(-/-) hosts from naive T cell-induced inflammatory bowel disease. Furthermore, in T reg cells, Ets-1 interacted with the Foxp3 intronic enhancer and was required for demethylation of this regulatory sequence. These data demonstrate that Ets-1 is required for the development of natural T reg cells and suggest a role for this transcription factor in the regulation of Foxp3 expression.
Clinical Management of Cancer in Children
Authors: J S Malpas
Journal: BMJ (1976)

Malignancy is now the commonest disease causing death in children over the age of 1 year.At a time when encouraging results in the treatment of some childhood malignancies are being reported this book provides a timely, succinct, but accurate and well- informed survey of the current position.Its authors are distinguished American paediatricians and oncologists, to whom we owe much of the modern concept of a team approach by a paediatrician, oncologist, surgeon, and radiotherapist in the management
A Cigarette Information Program
Authors: Alvin L. Watne, Royce L. Montgomery, Wanda W. Pettit
Journal: JAMA (1964)

WITH THE general public becoming increasingly aware of the scientific investigations linking cigarette smoking with certain diseases, we felt that accurate information regarding cigarette smoking and health should be brought to the attention of the health science students at our medical center. While we did not believe that the students' personal smoking habits were in the realm of our responsibility, we did believe that they would be questioned by their patients or customers about the problems of cigarette smoking and health, and it was part of our teaching obligation to see that their answers and decisions were based upon scientific facts. <h3>Methods</h3> An educational program was devised with the cooperation of members of the National Office and the West Virginia Division of the American Cancer Society and with the Cigarette Cancer Committee of the Roswell Park Memorial Institute, Buffalo. The group receiving the information consisted of 566 students in the
THE EFFECT OF ELECTRICALLY AND CHEMICALLY INDUCED CONVULSIONS ON CONDITIONED REFLEXES
Authors: M. KESSLER, E. GELLHORN
Journal: American Journal of Psychiatry (1943)

Experiments are reported in which a conditioned response to the sound of a bell was established in 18 male rats. This response was then inhibited by lack of reenforcement with the unconditioned stimulus. Although control experiments showed that conditioned responses thus inhibited do not recover spontaneously it was found that the application of one or more metrazol convulsions or of electrically induced convulsions restored temporarily the inhibited conditioned response. The experimentally proved removal of inhibition by "shock treatment" is of interest in view of the effects of the shock treatment in psychoses.
RELATIONSHIP BETWEEN CIRCULATING PROGENITOR CELLS AND MYOCARDIAL ISCHEMIA DURING MENTAL STRESS
Authors: Ronnie Ramadan, David Sheps, Ibhar Al Mheid, Malik Obideen, Fabio Esteves, J. Douglas Bremner, Viola Vaccarino, Arshed Quyyumi
Journal: Journal of the American College of Cardiology (2013)
DETECTION OF IgG ANTIBODIES TO LYMPHADENOPATHY-ASSOCIATED VIRUS IN PATIENTS WITH AIDS OR LYMPHADENOPATHY SYNDROME
Authors: F. Brun-Vezinet, F. Barre-Sinoussi, A.G. Saimot, D. Christol, L. Montagnier, C. Rouzioux, D. Klatzmann, W. Rozenbaum, J.C. Gluckmann, J.C. Chermann
Journal: The Lancet (1984)
Lead shot passed per urethram
Authors: C A Hajivassiliou, C S Moore
Journal: BMJ (1994)

EDITOR, - David Vicary's short item addresses an interesting question.1 Assuming that the patient definitely passed the lead shot per urethram and had definitely never been shot, four unlikely possibilities might explain the passage of lead shot per urethram: the presence of an occult enterovesical fistula; a ureteroenteric fistula secondary to ureterolithiasis; the gradual migration of previously ingested lead shot from the …
The contribution of endoplasmic reticulum stress to liver diseases
Authors: Lily Dara, Cheng Ji, Neil Kaplowitz
Journal: Hepatology (2011)

Abstract The unfolded protein response (UPR) is an evolutionarily conserved cell signaling pathway that is activated to regulate protein synthesis and restore homeostatic equilibrium when the cell is stressed from increased client protein load or the accumulation of unfolded or malfolded proteins. Once activated, this signaling pathway can either result in the recovery of homeostasis or can activate a cascade of events that ultimately result in cell death. The UPR/endoplasmic reticulum (ER) stress response spectrum and its interplay with other cellular organelles play an important role in the pathogenesis of disease in secretory cells rich in ER, such as hepatocytes. Over the past 2 decades, the contribution of ER stress to various forms of liver diseases has been examined. Robust support for a contributing, as opposed to a secondary role, for ER stress response is seen in the nonalcoholic steatohepatitis, alcoholic liver disease, ischemia/reperfusion injury, and cholestatic models of liver disease. The exact direction of the cause and effect relationship between modes of cell injury and ER stress remains elusive. It is apparent that a complex interplay exists between ER stress response, conditions that promote it, and those that result from it. A vicious cycle in which ER stress promotes inflammation, cell injury, and steatosis and in which steatogenesis, inflammation, and cell injury aggravate ER stress seems to be at play. It is perhaps the nature of such a vicious cycle that is the key pathophysiologic concept. Therapeutic approaches aimed at interrupting the cycle may dampen the stress response and the ensuing injury. (hepatology 2011;)
Specific erythrocyte binding is an additional nutrient acquisition system for Trichomonas vaginalis.
Authors: M W Lehker, T H Chang, D C Dailey, J F Alderete
Journal: The Journal of Experimental Medicine (1990)

Specific receptor-mediated binding by Trichomonas vaginalis of human erythrocytes was demonstrated. The ability of live parasites to internalize erythrocytes was also documented. In vitro growth assays during lipid-free and iron-limiting conditions that do not support the survival of T. vaginalis organisms showed that purified erythrocyte lipids and hemoglobin were each able to provide lipids and/or hemoglobin iron for trichomonal growth and multiplication. Parasites bound hemoglobin in a highly specific receptor-mediated fashion, and only the homologous unlabeled hemoglobin, but not lactoferrin and transferrin, competed with iodinated hemoglobin binding. Two antibody-crossreactive surface proteins of the parasites were identified as adhesins, and antibody to the individual adhesins inhibited T. vaginalis recognition and binding of erythrocytes. Finally, patient sera possessed antibody to the adhesins, showing the immunogenic nature and in vivo relevance of the trichomonad proteins during infection.
Organophosphorus poisoning: Authors' reply
Authors: T J Hodgetts, L Karalliedde
Journal: BMJ (1991)

methanesulphonate (P2S)) in a dose of 30 mg/kg body weight intravenously every four to six hours until full recovery.Although the importance of supportive measures and atropine cannot be underestimated, adults severely poisoned with organophosphorus com- pounds are likely to need 8-12 g pralidoxime daily for as long as the features of poisoning are present.So called "treatment failures" and "clinical re- lapses" after initial treatment with pralidoxime may well be due to inadequate oxime regimens, such as that proposed by Dr Hodgetts of only 2 g pralidoxime daily.Sustained therapeutic oxime concentrations could never be achieved in an adult by such a dosage regimen.In contrast, Dr Hodgetts advocates that very large doses ofatropine (2-4 mg every five to 10 minutes) should be given.Even in severe cases such high doses are likely to be required for only a short period if the patient is receiving adequate supportive care and effective oxime therapy.The contents of this lettcr represent the authors' views alone and in no wax commit the Department of Health.
Iron and zinc deficiency in children in developing countries
Authors: Zulfiqar A Bhutta
Journal: BMJ (2007)

Despite increasing provision of school sex education, teenage sexual health in the United Kingdom is in overall decline, with increasing rates of terminations and sexually transmitted infections in under 18s outweighing recent modest reductions in conception rates in this age group. 1 2 w1 Counterintuitively, rather than improving sexual health, sex behaviour interventions can make it worse.w2 Most studies on sex education programmes in schools examine intermediate outcomes only, such as pupil satisfaction or reported condom use.This often facilitates premature false claims of success, whereas more robust outcome measures such as rates of terminations, unplanned conceptions, and sexually transmitted infections show no benefit.In this week's BMJ Henderson and colleagues report the effect of a theoretically based teacher delivered sex education programme (SHARE) on registered conceptions and terminations. 3 The trial found no significant difference between the intervention and control groups in National Health Service registered conceptions (per 1000 pupils: 300 SHARE v 274 control; difference 26, 95% confidence interval 33 to 86) or terminations (127 SHARE v 112 control; difference 15, 13 to 42) between ages 16 and 20.The results should stimulate urgently needed change from previous ineffective approaches to school sex education for which, as the authors admit, "evidence of effectiveness is mixed."Evidence shows that increased knowledge is a necessary but insufficient cause of change in sexual behaviour.w3 It is also clear that strategies such as promoting availability and correct use of condoms and increasing use of the emergency pill do not necessarily lead to a reduction in sexually transmitted disease rates, 1 pregnancies, w4 or terminations. 4 So what needs to happen next?Henderson and colleagues stress the need for more comprehensive approaches that incorporate the influence of parents on sexual experience in teenagers, and to improve the future life opportunities for vulnerable young people.The false assumption that "young teens will have sex anyway" is an insult to many young people who have the capacity to rise to a far more effective challenge than just "use a condom every time."Delaying first intercourse is recognised as an important outcome measure of sex education programmes, and teenagers are more likely to save sex (a more positive and helpful term than "abstinence") when their parents communicate the importance of doing so. 5 Of course, to be involved in this way, parents have to be with their RESEARCH p133
Common genetic variants of the human uromodulin gene regulate transcription and predict plasma uric acid levels
Authors: Jia Han, Ying Liu, Fangwen Rao, Caroline M. Nievergelt, Daniel T. O'Connor, Xingyu Wang, Lisheng Liu, Dingfang Bu, Yu Liang, Fang Wang, Luxia Zhang, Hong Zhang, Yuqing Chen, Haiyan Wang
Journal: Kidney International (2013)
UKPDS and the Legacy Effect
Authors: John Chalmers, Mark E. Cooper
Journal: New England Journal of Medicine (2008)

The United Kingdom Prospective Diabetes Study (UKPDS) continues to produce important evidence concerning the evolution of type 2 diabetes and its management. Two studies published in this issue of the Journal provide some answers to two questions of fundamental importance to patients with diabetes and to physicians alike. In one article, Holman et al. (UKPDS 80)1 provide data that confirm a so-called legacy effect associated with intensive glucose control in patients with type 2 diabetes, long after the cessation of randomized intervention. This finding provides a fitting parallel to the observations of the Diabetes Control and Complications Trial/Epidemiology of Diabetes . . .
College of Medicine replies to its critics
Authors: G. T. Lewith, G. Catto, M. Dixon, C. Glover, A. Halligan, I. Kennedy, C. Manning, D. Peters
Journal: BMJ (2011)

Cassidy’s article and the rapid responses contain errors and misunderstandings.1 2 3 4

The college aims to promote a more politically and professionally transparent, patient centred, and sustainable approach to healthcare, using whatever social or therapeutic approaches are safe, effective, and empowering for patients. The college is calling for a more compassionate NHS, where practice based on good evidence has …