tbuckley/cabot-search huggingface dataset:
Emergency caesarian section and symptomatic immune thrombocytopenic purpura
Authors: Lucille Wood, Peter Jacobs
Journal: American Journal of Hematology (1989)

A 24-year-old woman presented in labour with profound purpuric bleeding due to idiopathic immune thrombocytopenia. She was assessed as requiring immediate caesarean section for cephalopelvic disproportion and foetal distress. In view of her platelet count of 21 x 10(9)/L she was prepared with intravenous methylprednisolone, isovolaemic plasma exchange, and infusion of 400 mg/kg of gammaglobulin and 5 x 10(11) allogeneic platelets. Six hours after commencing the procedure, at a time when her platelet count was 97 x 11(9)/L, she went uneventful operation and with no further therapy this level subsequently reached 175 x 10(9)/L, at which time an uneventful operation was performed. The mother and her normal, full-term infant have been discharged; both are well and at follow-up have normal platelet counts. This experience illustrates that major surgery can safely be undertaken in severely thrombocytopenic patients, even as an emergency procedure, using this regimen.
Well man clinic in general practice.
Authors: G N Marsh, C Chew
Journal: BMJ (1984)

The establishment of a well man clinic run entirely by a nurse in general practice showed an appreciable number of men to be hypertensive, smokers, or overweight; it also showed some previously undetected disease. Efforts were made either to treat or to counsel men in whom these findings were made. A well man clinic may have greater value than a well woman clinic.
An apple a day keeps Newton away
Authors: B. Williams
Journal: BMJ (1979)

depot hyperplastic obesity in studies in which visceral fat mass and adipocytes are not available for measurement.With the above background it does not seem too inappropriate to delete the word subcutaneous and instead use the more convenient term of hyperplastic obesity.We agree with the authors that hyperplastic obesity is a rare condition constituting perhaps only a small proportion of adult, middle-aged populations.It is nevertheless a significant problem in obesity clinics, where these patients tend to "sediment" because they are, according to our experience, very difficult to treat by conventional therapy.PER
Health care screening for people with mental handicap living in the community.
Authors: D N Wilson, A Haire
Journal: BMJ (1990)

OBJECTIVE--To determine what contact people with mental handicap had had with their general practitioner in the previous year; what prescribed drugs they were taking and whether these had been reviewed; when hearing and vision had last been screened; and what medical problems were found on examination. DESIGN--Case series. SETTING-Day centre for adults with mental handicap. SUBJECTS--A balanced sample of 75 of the 150 people attending the day centre. 10 Were excluded because consent was not given. RESULTS--The subjects did not consult their general practitioners more frequently than the general population but were more likely to be taking prescribed drugs, and 57% of these prescriptions had not been reviewed by a doctor. Thirty three people failed vision screening, including 13 who wore glasses. Twenty seven of the 62 who were testable had a hearing impairment. CONCLUSIONS--As only eight out of 65 people examined in the study did not have an appreciable problem brought to light, screening seems to be worth while. Whether such screening needs to be done by a medically qualified person needs further research.
Erdheim-Chester disease with early onset atherosclerosis and a pseudo-malignant phase
Authors: R L Neame
Journal: Annals of the Rheumatic Diseases (2003)

reuil et al reported on a patient with Erdheim-Chester disease. 1 We would like to add our experience in a patient who had a good response to steroids.A 46 year old housewife, born in Maceio (Brazil), complained of pain in her legs for a period of eight months, which interfered with her sleep; there were no constitutional symptoms, such as weight loss, asthenia, or fever.On physical examination, there was no systemic involvement or bone inflammation, except for tenderness on palpation of both tibiae.An x ray examination showed bilateral and symmetrical cortical osteosclerosis of the diaphysial regions of the tibiae, which was better illustrated with magnetic resonance imaging (MRI) which showed a low signal on T 1 and a high signal on T 2 of the medullar canal (fig 1).Bone scintigraphy showed intense hypercapitation at the upper and medial regions of the right tibia and the medial region of the left tibia (fig 2).Other MR images (brain, thorax, and abdomen) were normal.A bone biopsy showed only osteosclerosis, which has been described in this disease. 2 She was treated with steroids for six months (prednisone 20 mg/day) and responded well, being asymptomatic and receiv-ing no treatment since December 2000.As bone pain is the first symptom of this xanthogranulomatosis, rheumatologists should be able to recognise the disease in an early phase when treatment gives a better outcome.. . . .
Clinical Evidence of Sustained Chronic Inflammatory Reaction in Retinitis Pigmentosa
Authors: Noriko Yoshida, Yasuhiro Ikeda, Shoji Notomi, Keijiro Ishikawa, Yusuke Murakami, Toshio Hisatomi, Hiroshi Enaida, Tatsuro Ishibashi
Journal: Ophthalmology (2012)
Absence of “Original Antigenic Sin” in Autoimmunity Provides an Unforeseen Platform for Immune Therapy
Authors: Lawrence Steinman
Journal: The Journal of Experimental Medicine (1999)

In this issue of The Journal of Experimental Medicine , Tuohy et al. study the spreading of the autoimmune response to myelin antigens in experimental autoimmune encephalomyelitis (EAE) and its likely human counterpart, multiple sclerosis (MS) (([1][1])). They demonstrate that as disease develops in
Presentation of Study Results: Kalkbrenner et al. Respond
Authors: Amy E. Kalkbrenner, Joe M. Braun, Maureen S. Durkin, Matthew J. Maenner, Christopher Cunniff, Julie L. Daniels
Journal: Environmental Health Perspectives (2012)

Table 1.Meta-analytic perspective showing adjusted prevalence ratios (95% confidence limits).ASD subclassification
Long-Term Correction of Ornithine Transcarbamylase Deficiency by WPRE-Mediated Overexpression Using a Helper-Dependent Adenovirus
Authors: Asad Mian, W.Michael McCormack, Viraj Mane, Soledad Kleppe, Philip Ng, Milton Finegold, William E. O'Brien, John R. Rodgers, Arthur L. Beaudet, Brendan Lee
Journal: Molecular Therapy (2004)

The urea cycle disorders (UCDs) are important models for developing gene replacement therapy for liver diseases. Long-term correction of the most common UCD, ornithine transcarbamylase (OTC) deficiency, has yet to be achieved in clinical or preclinical settings. The single human clinical trial using early-generation adenovirus (Ad) failed to show any biochemical correction. In adult OTC-deficient mice, an E1/E2-deleted Ad vector expressing the mouse OTC gene, but not the human, was only transiently therapeutic. By using post-transcriptional overexpression in the context of the less immunogenic helper-dependent adenoviral vector, we achieved metabolic correction of adult OTC-deficient mice for >6 months. Demonstrating this result were normalized orotic aciduria, normal hepatic enzyme activity, and elevated OTC RNA and protein levels in the absence of chronic hepatotoxicity. Overexpressing the human protein may have overcome two potential mechanisms accounting for poor cross-species complementation: a kinetic block at the level of mitochondrial import or a dominant negative effect by the mutant polypeptide. These data represent an important approach for treating human inborn errors of hepatocyte metabolism like the UCDs that require high-level transduction and gene expression for clinical correction.
Association of insertion/deletion polymorphism of the angiotensin-converting enzyme gene with psoriasis
Authors: M. Ozkur, Z. Erbagci, M. Nacak, A.A. Tuncel, B. Alasehirli, A.S. Aynacioglu
Journal: British Journal of Dermatology (2004)

Genetic factors are likely to be of fundamental importance in the pathogenesis of psoriasis. There are reports concerning the induction or/and exacerbation of psoriasis by angiotensin-converting enzyme (ACE) inhibitors, which have been attributed to the ACE inhibitor-induced augmentation of kinin levels in skin. However, to the best of our knowledge there has been no molecular genetic study investigating whether ACE insertion/deletion (I/D) polymorphism may contribute to the genetic background in psoriasis.To assess the role of ACE I/D polymorphism in psoriasis.A group of 86 patients with psoriasis and 154 control subjects were analysed for ACE I/D polymorphism by polymerase chain reaction.The distribution of ACE I/D polymorphism and allele frequencies in psoriatic patients was not significantly different from controls. Further analyses of psoriasis patients showed that ACE I/D polymorphism was not associated with age at onset of disease, clinical type of psoriasis or gender. However, the frequency of the I allele was significantly higher in patients with a positive family history of psoriasis than in those with no family history (sporadic psoriasis) (48% vs. 32%; P =0.03). In addition, the I allele was found significantly more frequently in type I psoriasis patients (onset < 40 years and positive family history) than in type II psoriasis patients (onset >/= 40 years, no family history) (48% vs. 27%; P = 0.04).Our results suggest that the presence of the I allele may confer susceptibility to development of psoriasis in individuals from psoriatic families.
Urokinase has direct catalytic activity against fibrinogen and renders it less clottable by thrombin.
Authors: J I Weitz, B Leslie
Journal: Journal of Clinical Investigation (1990)

Recently, we demonstrated that tissue plasminogen activator directly releases fibrinopeptides A and B (FPA and FPB) from fibrinogen. The purpose of this study was to determine whether urokinase has similar activity. Incubation of urokinase with fibrinogen or heparinized plasma results in concentration-dependent FPB release unaccompanied by FPA cleavage. For equivalent amidolytic activity, high molecular weight urokinase releases twofold more FPB than the low molecular weight species. In contrast, prourokinase does not release FPB until activated to urokinase. Contaminating thrombin or plasma is not responsible for urokinase-mediated FPB release because this activity is unaccompanied by FPA or B beta 1-42 cleavage, and is unaffected by heparin, hirudin, a monospecific antibody against thrombin, aprotinin, or alpha 2-antiplasmin. FPB release reflects a direct action of urokinase on fibrinogen because release is completely inhibited by a monospecific antibody against the enzyme. Further, urokinase releases FPB from the FPB-containing substrate B beta 1-42, thus confirming its specificity for the B beta 14 (Arg)-B beta 15 (Gly) bond. In addition to FPB release, SDS-PAGE analysis of the time course of urokinase-mediated fibrinogenolysis indicates progressive proteolysis of both the A alpha- and B beta-chains of fibrinogen that occurs after FPB release is completed. As a consequence of urokinase-mediated fibrinogenolysis, there is progressive prolongation of the thrombin clotting time. These studies indicate that urokinase has direct catalytic activity against fibrinogen. By releasing FPB, a potent chemoattractant, and by rendering fibrinogen less clottable by thrombin, urokinase may participate in processes extending beyond fibrinolysis.
Pulmonary tuberculosis: diagnosis and treatment
Authors: Ian A Campbell, Oumou Bah-Sow
Journal: BMJ (2006)

Tuberculosis remains a worldwide problem despite well documented, well publicised methods of prevention and cure. Poverty and HIV infection are major reasons for its persistence.1 2 We review the diagnosis, treatment, and prevention of tuberculosis.

### Symptoms and signs

Literature, opera, and art have popularised the traditional symptoms and signs of pulmonary tuberculosis (box): cough, sputum, haemoptysis, breathlessness, weight loss, anorexia, fever, malaise, wasting, and terminal cachexia figure in various combinations, not only in the descriptions of the heroes, heroines, and villains but also among the artists, poets, and musicians themselves.3 However, none of these symptoms is peculiar to tuberculosis. Nowadays, patients with pulmonary tuberculosis who present the full spectrum of symptoms and signs are unusual in developed countries, but doctors and health workers often see such patients in developing countries. Lung cancer has become a more common cause of some or all of these symptoms in developed countries, and, as cigarette smoking increases, this may well become the case in developing countries.

### Epidemiological clues to diagnosis

Among immigrants to the West from the Indian subcontinent, sub-Saharan Africa, South East Asia, the Baltic states and Russia (especially if they were previously imprisoned4), the prevalence of tuberculosis is much higher than among the native white population.2 5 In the native population, tuberculosis is most commonly found among people living in poor conditions and in deprived areas, especially in elderly people and those with unstable social or psychiatric backgrounds, such as hostel dwellers, street dwellers, alcoholics, and drug misusers, as well as in immunocompromised patients.6–8 In developing countries, tuberculosis is most common among very poor people, especially those who are severely malnourished or HIV positive.1 8 9 Awareness, in both primary and secondary care, of these epidemiological facts increases the chances of prompt diagnosis of tuberculosis. Whereas postviral cough, asthma, reflux oesophagitis, …
Secretion of proinflammatory cytokines by epithelial cells in response to Chlamydia infection suggests a central role for epithelial cells in chlamydial pathogenesis.
Authors: S J Rasmussen, L Eckmann, A J Quayle, L Shen, Y X Zhang, D J Anderson, J Fierer, R S Stephens, M F Kagnoff
Journal: Journal of Clinical Investigation (1997)

Chlamydia species infect epithelial cells at mucosal surfaces, and are major causes of sexually transmitted diseases. Infection is characterized by inflammation which is exacerbated upon reinfection, ultimately leading to tissue damage and scarring. Although central for the development of disease manifestations, little is known about the mechanisms that initiate and sustain the inflammatory response to Chlamydia. Infection of cervical and colonic epithelial cells with Chlamydia trachomatis and Chlamydia psittaci is shown in the present studies to upregulate mRNA expression and secretion of the proinflammatory cytokines IL-8, GRO alpha, GM-CSF, and IL-6. In contrast to the rapid, but transient, cytokine induction following infection with other invasive bacteria, the epithelial cytokine response to Chlamydia was delayed until 20-24 h after infection, persisted throughout the chlamydial growth cycle (2-4 d), and required bacterial protein synthesis. Moreover, epithelial cell lines and primary endocervical epithelial cells released IL-1alpha after Chlamydia infection, and increased secretion of the proinflammatory cytokines could be inhibited by anti-IL-1alpha. This suggests that IL-1alpha, released following lysis of infected epithelial cells, may amplify the inflammatory response by stimulating additional cytokine production by noninfected neighboring cells. These findings suggest a novel pathophysiologic concept wherein the acute host response to Chlamydia at mucosal surfaces is primarily initiated and sustained by epithelial cells, the first and major targets of chlamydial infection.
15-Deoxy-Δ12,14-prostaglandin J2 inhibits IL-1β–induced cyclooxygenase-2 expression in mesangial cells
Authors: Hirotaka Sawano, Masakazu Haneda, Toshiro Sugimoto, Ken Inoki, Daisuke Koya, Ryuichi Kikkawa
Journal: Kidney International (2002)
Le travail de groupe dans la formation psychologique du médecin
Authors: A. Ermentini, G. Mascherpa
Journal: Psychotherapy and Psychosomatics (1972)

The author's report is an experience of groupe work in the psychological formation of the physician at the Milan Psychiatric Clinic. Difficulties found in the leadership of the group in various phases of the work are described. Problems connected with some traits of the medical personality are briefly discussed.
Disentangling dynamics, computation, and cognition
Authors: Tim van Gelder
Journal: Behavioral and Brain Sciences (1998)

The nature of the dynamical hypothesis in cognitive science (the DH) is further clarified in responding to various criticisms and objections raised in commentaries. Major topics addressed include the definitions of “dynamical system” and “digital computer”; the DH as Law of Qualitative Structure; the DH as an ontological claim; the multiple-realizability of dynamical models; the level at which the DH is formulated; the nature of dynamics; the role of representations in dynamical cognitive science; the falsifiability of the DH; the extent to which the DH is open; the role of temporal and implementation considerations; and the novelty or importance of the DH. The basic formulation and defense of the DH in the target article survives intact, though some refinements are recommended.
Complementary Examinations-Reply
Authors: Daniel J. Abramson
Journal: JAMA (1976)

My suggestion that female patients scheduled for sigmoidoscopy have a complemental cervicovaginal examination and Papanicolaou smear was intended primarily for those individuals who had not had the latter procedures in many months or years. The examination can be swiftly and easily done and requires no additional equipment. In this study, relatively few patients had not had a recent pelvic examination, but in those examined, a significant number of pathologic lesions were found. For the sake of clarity, my quoted statement referred to a geographic rather than an anatomic location.  The relative merits of sigmoidoscopy added to the gynecologic examination is not a debatable issue. I concur with Dr Burns' suggestion and endorse it. It is clear that a wide segment of the population, male as well as female, is not having routine proctosigmoidoscopic examinations. The importance of proctosigmoidoscopy cannot be overemphasized. If widely performed, it will lead to
Computerized Tomography and Benign Intracranial Hypertension
Authors: Peyton Delaney
Journal: JAMA (1976)

Benign intracranial hypertension (BIH) is a recognized syndrome of unknown origin that conventionally has been diagnosed by excluding an underlying space-occupying lesion using invasive contrast procedures. Computerized tomography (CT) scanning of the head is a safe, accurate method of defining intracranial structures that were previously only discernible by invasive studies. Seven patients with headaches, papilledema, normal mental status, normal brain scan, and normal electroencephalogram had normal CT scans of the head. Patients suspected of BIH can be spared invasive contrast procedures if the CT scan of the head is normal. (<i>JAMA</i>236:951-952, 1976)
Response to Jungheim and Koschinsky
Authors: Andreas Pfützner, Thomas Forst
Journal: Diabetes Care (2002)

In a recent letter of observation, Jungheim and Koschinsky (1) reported on their findings about a risky delay of hypoglycemia detection by glucose monitoring at the arm. Given the possible significant implications of their findings, we repeated their experiment in our own clinical unit in an institutional review board (IRB)-approved study. We would hereby like to report on our results with 10 patients (4 women, 6 men, 6 type 1 diabetic, and 4 type 2 diabetic subjects; age [mean ±SD] 49 ±14 years, mean disease duration: 50 ±14 years). During an oral glucose tolerance test (OGTT) phase, results obtained from the arm with no rubbing (Soft-Sense; Abbott Medisense) were lower than the results obtained with our reference …
Limitations of Electrocardiographic Exercise Testing
Authors: Stephen E. Epstein
Journal: New England Journal of Medicine (1979)

The Coronary Artery Surgery Study on exercise stress testing, discussed this week in the Journal,1 is an important addition to a recent series of articles exploring the reliability and limitations of exercise testing in the detection of underlying coronary-artery disease.2 3 4 5 6 In particular, the results of the study demonstrate that clinicians must be just as cognizant of the important diagnostic implications of Bayes' theorem of conditional probability as are statisticians.Bayes' theorem states that, although the reliability of a diagnostic test is defined by the test's sensitivity* and specificity,* a test cannot be adequately interpreted without reference to the prevalence . . .
Time for case-control studies of NSAIDs and oseltamivir
Authors: A. Herxheimer, M. Clarke, R. Edwards, T. Jefferson, Y. Loke
Journal: BMJ (2009)

Hama highlights our ignorance about the harmful effects of oseltamivir (Tamiflu) and the non-steroidal anti-inflammatory drugs (NSAIDs) commonly used in flu.1 Shimazu suggests that aspirin enhanced virulence in the 1918 epidemic,2 and, as Hama notes, the effects of NSAIDs should be studied in Mexico now.3

We need these data to decide in what circumstances these drugs are worth …
Health bill changes may restrict public access to information, campaign group warns
Authors: S. Mayor
Journal: BMJ (2011)

<h3>Abstract</h3> COVID-19 pandemic has caused millions of death globally and caused huge impact on the health of infected patients. Shift in the lung microbial ecology upon such viral infection often worsens the disease and increases host susceptibility to secondary infections. Recent studies have indicated that bacterial coinfection is an unignorable factor contributing to the aggravation of COVID-19 and posing great challenge to clinical treatments. However, there is still a lack of in-depth investigation on the coinfecting bacteria in COVID-19 patients for better treatment of bacterial coinfection. With the knowledge that <i>Pseudomonas aeruginosa</i> is one of the top coinfecting pathogens, we analyzed the adaptation and convergent evolution of nosocomial <i>P. aeruginosa</i> isolated from two critical COVID-19 patients in this study. We sequenced and compared the genomes and transcriptomes of <i>P. aeruginosa</i> isolates longitudinally and parallelly for its evolutionary traits. <i>P. aeruginosa</i> overexpressed alginate and attenuated Type VI secretion system (T6SS) during coinfection for excessive biofilm formation and suppressed virulence. Results of bacterial competition assay and macrophage cytotoxicity test indicated that <i>P. aeruginosa</i> reduced its virulence towards both prokaryotic competitors and eukaryotic host through inhibiting its T6SS during evolution. <i>P. aeuginosa</i> T6SS is thus one of the reasons for its advantage to cause coinfection in COVID-19 patients while the attenuation of T6SS could cause a shift in the microecological composition in the lung. Our study will contribute to the development of therapeutic measures and the discovery of novel drug target to eliminate <i>P. aeruginosa</i> coinfection in COVID-19 patient.
THE TREATMENT OF PSORIASIS WITH METHOTRKXATE
Authors: P. F. BORRIE, T. W. E. ROBINSON, I. B. MACKAY
Journal: British Journal of Dermatology (1967)

Journal Article THE TREATMENT OF PSORIASIS WITH METHOTRKXATE Get access P. F. BORRIE, M.D. F.R.C.P., P. F. BORRIE, M.D. F.R.C.P. The Departments of Dermatology St. Bartholomew's and Barnet General Hospitals Search for other works by this author on: Oxford Academic Google Scholar T. W. E. ROBINSON, M.B., M.R.C.P., T. W. E. ROBINSON, M.B., M.R.C.P. The Departments of Dermatology St. Bartholomew's and Barnet General Hospitals Search for other works by this author on: Oxford Academic Google Scholar I. B. MACKAY, M.B., B.Chir. I. B. MACKAY, M.B., B.Chir. The Departments of Dermatology St. Bartholomew's and Barnet General Hospitals Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 79, Issue 2, 1 February 1967, Pages 73–77, https://doi.org/10.1111/j.1365-2133.1967.tb11458.x Published: 01 February 1967