tbuckley/cabot-search huggingface dataset:
The Greatest Benefit to Mankind
Authors: M. FitzPatrick
Journal: BMJ (2010)

A true medical classic should read as if the author wrote the book with your exact needs in mind, and when my interest in medical history burgeoned at medical school I found such a book in The Greatest Benefit to Mankind . Roy Porter, then professor of social history at the Wellcome Institute, said in his introduction that he wrote the book because when “[I am asked] to recommend an up-to-date and readable single-volume history of medicine, I have felt at a loss to know what to suggest. Writing it has made it clear why so few …
S25 Incidence of surgically treated patients with chronic thromboembolic pulmonary hypertension in the UK during the last decade
Authors: C. M. Treacy, J. Colledge, D. P. Jenkins, K. Page, K. Sheares, S. Tsui, J. Dunning, N. Screaton, D. Gopalan
Journal: Thorax (2011)

<h3>Introduction</h3> Pulmonary endarterectomy (PEA) is the treatment of choice for patients with proximal chronic thromboembolic pulmonary hypertension (CTEPH). The UK has a single centre performing this operation and the program became nationally funded since 2000. Patients are referred from seven specialist pulmonary hypertension centres. <h3>Method</h3> All 625 patients treated with PEA from 2000 to 2010 were mapped according to their home postcode at the time of PEA surgery. Primary care trusts (PCT9s) were assigned from these home postcodes. The incidence rate of each PCT and overall incidence were analysed. Mapinfo software was used to generate the referral maps. <h3>Results</h3> The new patient incidence ranges from no referrals in 123 PCT9s in 2000–2002 to 90 in 2008–2010. The most recent period shows highest referral rates for PEA. From our PEA data mapping analysis we have calculated that the incidence of operated patients was 0.4 million population in 2000 (n=22) and 2 per million population in 2010 (n=122). <h3>Conclusion</h3> There has been a fivefold increase in PEA activity in the UK over the last decade. The analysis of our data are limited to surgical cases. The current incidence of PEA in the UK is already higher than historical estimation of the incidence of all CTEPH (0.1–0.5/million, Fedullo, <i>N Engl J Med 2001</i>). Since 30% of patients with CTEPH have distal disease distribution and some patients with proximal CTEPH do not proceed to surgery due to choice or comorbidities, the overall incidence of CTEPH is likely to be significantly higher than 2 per million/year and higher than previously suspected.
STRANGULATED FEMORAL HERNIA IN A MAN OF SEVENTY-FIVE.RESECTION. RECOVERY.
Authors: CHARLES S. WHITE
Journal: JAMA (1905)

The following case presents some unusual features that seem worthy of notice: <h3>Patient.</h3> —C. P., aged 75, male, white, farmer, widower, born in Virginia. <h3>Family History.</h3> —Parents died, after short illness, of cerebral hemorrhages, but at an advanced age. One brother died of intestinal obstruction, one of sunstroke. Two sisters are dead, but cause of death unknown. Of six brothers, five had acquired hernias. None, except this patient, has been operated on. He has a nephew who is ruptured. <h3>Previous History.</h3> —The patient has had the usual infectious diseases of childhood. In 1895 he had cellulitis in his arm, following a wound of the hand, and he was disabled for four weeks. In 1898, he had a mild attack of pneumonia. With these exceptions, he has been unusually well, and until the present time he has been doing farm work every day. <h3>Present Illness.</h3> —On May 17, about 8 a.
Evidence of MEN-2 in the Original Description of Classic Pheochromocytoma
Authors: Hartmut P.H. Neumann, Alexander Vortmeyer, Dieter Schmidt, Martin Werner, Zoran Erlic, Alberto Cascon, Birke Bausch, Andrzej Januszewicz, Charis Eng
Journal: New England Journal of Medicine (2007)

The first description of pheochromocytoma in 1886 has been attributed to Felix Fränkel, who described an 18-year-old woman with bilateral adrenal "sarcoma and angio-sarcoma." We reviewed the publication and then approached and assessed relatives of the patient to update the findings with the use of current technology. In-depth review revealed that the histopathological findings were consistent with pheochromocytoma. Because the proband was young and had bilateral disease at diagnosis, we hypothesized that she had an inherited condition. The presence of germ-line RET mutations in four living relatives demonstrates that the original patient and her family had multiple endocrine neoplasia type 2 and provides molecular evidence that she had pheochromocytoma.
Umbilical cord clamping in preterm infants.
Authors: D Elbourne
Journal: BMJ (1993)

Umbilical cord clamping in preterm infantsEDITOR,-The possibility that late clamping of the umbilical cord may lead to a reduction in respiratory distress syndrome is not a particularly new finding, but S Kinmond and colleagues offer a more scientific approach in evaluating this phenomenon.'However, they give little information about the obstetric features of their cases, which might be quite important since matching is essential with such small numbersfor example, were the babies predominantly born during preterm labour or were they delivered electively for some obstetric complication?Also not clear is whether any of the mothers received steroids to accelerate fetal maturity before delivery.Although these matters may not be particularly important as far as the haematological features are concerned, they certainly are with respect to ventilation.I believe that more information on them would be helpful in the interpretation of the paper.
Ga-67 Imaging of Thiamazole-Induced Agranulocytosis Associated With Multiple Focal Infections
Authors: EISUKE GOTOH, TAKEHIKO OHSAWA, KAZUNOBU KATO, KENJI KAWAKAMI
Journal: Clinical Nuclear Medicine (1998)

Thyreostatic drugs for hyperthyroidism sometimes cause complications, the most serious of which is agranulocytosis. Agranulocytosis has been more curable since the introduction of granulocyte stimulating factor (G-CSF) treatment; however, other complications such as focal infections still occur. In this report, a patient with hyperthyroidism was treated with thiamazole, which resulted in agranulocytosis combined with severe pneumonia and multiple infection sites. The patient had persistent muscle pain after recovery from agranulocytosis using G-CSF therapy. CT scans and Ga-67 scintigraphy were carried out to survey the inflamed areas, and Ga-67 scintigraphy successfully revealed the location of the infection.
Robert Sidney Winwood
Authors: R. S Winwood, P. J Winwood
Journal: BMJ (2009)

Immediately after pre-registration house jobs, Robert Sidney Winwood (“Bob”) enjoyed a four year short service commission in the Royal Army Medical Corps with postings in London (Millbank) and Singapore, during which he achieved distinctions and prizes in medicine, pathology, army health, and military surgery . This led to his appointment as junior specialist in …
Peripheral T cell lymphoma: new model + new insight
Authors: James C. Mulloy
Journal: The Journal of Experimental Medicine (2010)

The nonreceptor tyrosine kinase SYK has recently received a good deal of attention as a critical oncogene in various hematologic malignancies. A newly developed model of peripheral T cell lymphoma (PTCL) using the ITK-SYK fusion gene should serve as a powerful tool to dissect the signaling cascades important for SYK-associated malignancy in the context of t(5;9) PTCL.
Neutrophils, Unopposed Neutrophil Elastase, and Alpha<sub>1</sub>-Antiprotease Defenses Following Human Lung Transplantation
Authors: KEITH C. MEYER, DAVID R. NUNLEY, JAMES H. DAUBER, ALDO T. IACONO, ROBERT J. KEENAN, RICHARD D. CORNWELL, ROBERT B. LOVE
Journal: American Journal of Respiratory and Critical Care Medicine (2001)

Neutrophils are sequestered in the newly transplanted lung after reperfusion or with infection, rejection, and chronic graft dysfunction. Because unopposed (free) neutrophil elastase (NE) released into bronchoalveolar secretions may injure the lung allograft and impair bacterial clearance, we assessed total neutrophil numbers, myeloperoxidase activity as an index of neutrophil influx and degranulation, alpha1-antiprotease ( α1-AP) concentrations, and unopposed NE activity in bronchoalveolar secretions from lung transplant recipients. Unopposed NE activity was present in bronchoalveolar lavage fluid (BALF) from recipients transplanted for emphysema associated with α1-AP deficiency as well as recipients without such deficiency (171 of 2,137 BALF; 8%). Ten of 17 (59%) recipients with α1-AP deficiency who were followed for at least 1 yr after transplant with multiple surveillance and diagnostic bronchoscopies had at least one BALF containing unopposed NE, usually associated with the presence of ⩾ 105 colony forming units/ml BALF of aerobic bacteria. In contrast, 19 of 58 (33%) with emphysema not associated with α1-AP deficiency, 8 of 32 (25%) recipients with cystic fibrosis (CF), 6 of 16 (38%) with idiopathic pulmonary fibrosis (IPF), and 11 of 36 (31%) with other indications for transplant had unopposed NE in BALF. α1-AP levels were significantly elevated in the early posttransplant time period and could be augmented considerably in α1-AP-deficient recipients with episodes of infection or rejection. Our findings indicate that unopposed NE activity can be found in both α1-AP-deficient and α1-AP-sufficient recipients after transplantation, usually in association with endobronchial bacterial infection.Keywords: bronchoalveolar lavage; lung transplantation; neutrophil; neutrophil elastase; α1-antiprotease
Long-term decline in lung function, utilisation of care and quality of life in modified GOLD stage 1 COPD
Authors: P-O Bridevaux, M W Gerbase, N M Probst-Hensch, C Schindler, J-M Gaspoz, T Rochat
Journal: Thorax (2008)

<h3>Background:</h3> Little is known about the long-term outcomes of individuals with mild chronic obstructive pulmonary disease (COPD) as defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD). <h3>Methods:</h3> A population cohort of 6671 randomly selected adults without asthma was stratified into categories of modified GOLD-defined COPD (prebronchodilator spirometry). Further stratification was based on the presence or absence of respiratory symptoms. After 11 years, associations between baseline categories of COPD and decline in forced expiratory volume in 1 s (FEV<sub>1</sub>), respiratory care utilisation and quality of life as measured by the SF-36 questionnaire were examined after controlling for age, sex, smoking and educational status. <h3>Results:</h3> At baseline, modified GOLD criteria were met by 610 (9.1%) participants, 519 (85.1%) of whom had stage 1 COPD. At follow-up, individuals with symptomatic stage 1 COPD (n = 224) had a faster decline in FEV<sub>1</sub> (−9 ml/year (95% CI −13 to −5)), increased respiratory care utilisation (OR 1.6 (95% CI 1.0 to 2.6)) and a lower quality of life than asymptomatic subjects with normal lung function (n = 3627, reference group). In contrast, individuals with asymptomatic stage 1 COPD (n = 295) had no significant differences in FEV<sub>1</sub> decline (−3 ml/year (95% CI −7 to +1)), respiratory care utilisation (OR 1.05 (95% CI 0.63 to 1.73)) or quality of life scores compared with the reference group. <h3>Conclusions:</h3> In population-based studies, respiratory symptoms are of major importance for predicting long-term clinical outcomes in subjects with COPD with mild obstruction. Population studies based on spirometry only may misestimate the prevalence of clinically relevant COPD.
CASUALTY INCIDENCE AT THE WORLD TRIATHLON CHAMPIONSHIPS: ARE AGE, GENDER AND EVENT TYPE ASSOCIATED WITH INCREASED RISK?
Authors: M Walker, V Vleck, M Ussher, S Sanjay
Journal: British Journal of Sports Medicine (2014)

Background Despite the growing popularity of triathlon, very few studies have assessed the casualty incidence and profile during races. The World Triathlon Championships in London offered the opportunity to observe this at the largest triathlon ever held. Objective This study describes the profile of casualties sustained across a five day triathlon event. It is hypothesised that an association exists between casualty risk and the variables of age, gender, event standard and distance. Design Observational data was collected on all participants who were entered to compete in the event, and whom sought medical aid either during the event or after the finish of the event. Casualty nature was categorised into topical, musculoskeletal and constitutional. Setting The World Triathlon Championship Grand Final was held in Hyde Park, London over five consecutive days in September 2013, comprising both elite and non-elite fields. Participants A total of 6 103 inidviduals participated from 84 countries. Age ranged from 16 to 80 years. Risk factor assessment Independent variabales included: age; gender; event standard, event distance and event type. Main outcome measurements 1) Total casualty incidence for age, gender and standard. 2) Casualty incidence difference by gender for each event type 3) Nature of casualty incidence for age, gender and event type. Results Females had a higher casualty rate than males, across majority of event types. Elite athletes had a higher casualty rate. Topical casualties were highest in 40–49 age group, and for sprint distances, musculoskeletal casualties were highest in 50–59 age group. For the Olympic distance, constitutional casualties were highest for females, the oldest and the youngest. Conclusions In a large world triathlon championship event, the incidence and nature of participant casualties is associated with age, gender, event distance and standard. These findings could support organisers seeking to plan effective medical resourcing and injury prevention strategies for such future events, and help inform triathletes of their risk of injury during races.
Spotlight on microcirculation: an update
Authors: Isabella Tritto, Giuseppe Ambrosio
Journal: Cardiovascular Research (1999)

Time for primary review 30 days.

Over the past 3 decades there has been an increasing interest in the better understanding of the role of microcirculation under a variety of conditions. Therefore, in 1996 Cardiovascular Research devoted the whole October issue to microcirculation. Two years later the interest in this field is far from being reduced, as the number of articles published has remained high, with over 800 papers per year. The purpose of this article is to review several major studies which have appeared over the last 2 years in this field, which update the various key areas of research that were extensively reviewed in the 1996 issue.

Oxygen delivery to tissue has long been considered to take place almost exclusively at the capillary level. However, it has progressively become appreciated that tissue oxygenation is the result of a complex process in which a substantial amount of oxygen is exchanged through arterioles, which in some tissues may be a greater oxygen source than capillaries (see review article by Intaglietta et al. [1]). Very recently, gas diffusion in postcapillary venules has also been supposed to occur, and it has been hypothesized that gas diffusive transfer may play an important role in regulating tissue oxygenation. Given the parallel arrangement of small arteries and veins in several tissues, oxygen transfer from arterial to venous vessels may result in diffusion shunting of oxygen, which may be detrimental to tissue oxygenation; on the other hand, diffusive transfer from arterioles to capillaries and among capillaries might contribute to homogeneous tissue oxygenation. Diffusion of CO2 might also improve tissue oxygenation, since CO2 diffusion from venules to arterioles would reduce pH in arterial blood and thus increase O2 release from hemoglobin. In this regard, it has recently been shown that in rat skeletal muscle … 

* Corresponding author. Tel.: +39-75-585-5842; fax: +39-75-585-5840
TCTAP A-086 Quantitative Comparison of Vessel Dimensions Measured by Optical Coherence Tomography and Intravascular Ultrasound in Coronary Atherosclerotic Plaques
Authors: Yosuke Katayama, Takashi Yamano, Takashi Tanimoto, Yoshiki Mathuo, Tomoyuki Yamaguchi, Yasushi Ino, Atsushi Tanaka, Kumiko Hirata, Takashi Kubo, Toshio Imanishi, Takashi Akasaka
Journal: Journal of the American College of Cardiology (2014)
Long-term results of patients undergoing liver transplantation for primary sclerosing cholangitis
Authors: Ivo W. Graziadei, Russell H. Wiesner, Paul J. Marotta, Michael K. Porayko, J. Eileen Hay, Michael R. Charlton, John J. Poterucha, Charles B. Rosen, Gregory J. Gores, Nicholas F. LaRusso, Ruud A. F. Krom
Journal: Hepatology (1999)

Liver transplantation is the only effective therapeutic option for patients with end-stage liver disease due to primary sclerosing cholangitis (PSC). In this study, we analyzed a single center's experience with 150 consecutive PSC patients who received 174 liver allografts. Mean follow-up was 55 months. Actuarial patient survival at 1, 2, 5, and 10 years was 93.7%, 92.2%, 86.4%, and 69.8%, respectively, whereas graft survival was 83.4%, 83.4%, 79.0%, and 60.5%, respectively. The main indication for retransplantation was hepatic artery thrombosis, and the major cause of death was severe infection. Patients with PSC had a higher incidence of acute cellular and chronic ductopenic rejection compared to a non-PSC control group. Chronic ductopenic rejection adversely affected patient and graft survival. Biliary strictures, both anastomotic and nonanastomotic, were frequent and occurred in 16.2% and 27.2% of patients, respectively. The incidence of recurrent PSC was 20%. A negative impact on patient survival was not seen in patients with either postoperative biliary strictures or recurrence of PSC. Six patients (4%) had cholangiocarcinoma and 1 patient died related to recurrence of malignant disease. Seventy-eight percent of PSC patients had associated inflammatory bowel disease, most commonly chronic ulcerative colitis, which did not adversely impact patient outcome posttransplantation. Nine patients required proctocolectomy after liver transplantation; 5 because of intractable symptoms related to inflammatory bowel disease and 4 due to the development of colorectal carcinoma/high-grade dysplasia. Our data show that liver transplantation provides excellent long-term patient and graft survival for patients with end-stage PSC.
A new method for noninvasive quantification of valvular regurgitation based on conservation of momentum. In vitro validation.
Authors: E G Cape, E G Skoufis, A E Weyman, A P Yoganathan, R A Levine
Journal: Circulation (1989)

The noninvasive Doppler assessment of regurgitant volume from jet size is limited by the fundamental inequality of jet volume and regurgitant volume and by the dependence of jet dimensions on driving pressure and instrument settings for a given flow volume. Therefore, this study addresses the hypothesis that an equation could be derived from basic physical principles to quantify regurgitant volume with velocities that can be directly measured by Doppler echocardiography. The principle of conservation of momentum for free turbulent jets resembling many cardiac lesions yields an equation for regurgitant volume as a function of maximum jet velocity, a distal centerline velocity, and the intervening distance. This theory was tested throughout a range of physiologic flow rates and pressures (orifice velocities) in steady flow for 0.08-0.40 cm2 circular orifices and a noncircular orifice and in physiologic pulsatile flow for 0.08 and 0.20 cm2 circular orifices. Plots of centerline velocities versus axial distance coincided with those expected for such jets. Calculated and actual volumetric flows agreed well by linear regression in the turbulent jet: for steady flow rates, y = 0.98x + 0.09 (r = 0.99, SEE = 0.14 l/min), with similar correlations for circular and noncircular orifices; for pulsatile flow, y = 1.02x + 0.03 for peak flow rate (r = 0.98, SEE = 0.18 l/min) and y = 1.02x + 0.58 for total regurgitant volume (r = 0.95, SEE = 0.81 ml). There was no significant effect of orifice size or location of velocity measurement within the turbulent jet. Therefore, for free jets resembling many clinical lesions, regurgitant flow rate and volume can be calculated noninvasively from Doppler velocities without planimetry of jet area. Because the required information is intrinsic to the jet, this method should apply regardless of associated valvular lesions. It should also apply to orifices of variable shape because turbulent eddies obliterate the details of flow at the orifice. The special case of jets impinging on walls must be considered separately for both this technique and flow mapping.
Articular chondrocytes and mesenchymal stem cells seeded on biodegradable scaffolds for the repair of cartilage in a rat osteochondral defect model
Authors: Rebecca L. Dahlin, Lucas A. Kinard, Johnny Lam, Clark J. Needham, Steven Lu, F. Kurtis Kasper, Antonios G. Mikos
Journal: Biomaterials (2014)
Inhibition of Mediator Release in Azatadine
Authors: Joel F. Lehrer
Journal: JAMA (1986)

To the Editor.—  Togias et al, 1 in their Jan 10 article, demonstrate that azatadine base inhibits mediator release from human mast cells but state that the mechanism of this inhibition is unknown.  I would like to suggest that the mechanism in question is the prevention of calcium entry into the mast cell through voltage-dependent calcium channels. The similarity in structure of azatadine to cyproheptadine has been noted by Lichtenstein and Gillespie 2 and by the Schering Corporation in its Basic Data Book . Donatsch et al 3 concluded that cyproheptadine inhibited depolarization-dependent calcium entry into rat pancreatic B cells. Lowe et al 4 concluded that cyproheptadine reduced the flow of calcium ion through the voltage-dependent calcium channels in guinea pig smooth muscle. Ishizaka and Ishizaka 5 concluded that entry of calcium into rat mast cells triggers histamine release. Togias et al postulate that the interaction of azatadine with H 1
Acute tumor lysis syndrome in non‐Hodgkin lymphoma induced by dexamethasone
Authors: Kapil Dhingra, Samuel R. Newcom
Journal: American Journal of Hematology (1988)

Abstract Acute tumor lysis syndrome developed in a 30‐year‐old man with non‐Hodgkin lymphoma after dexamethasone administration. To the best of our knowledge this case is the first one reported following single agent corticosteroid treatment.
The Appropriateness of Tympanostomy Tubes for Children
Authors: Steven K. Dankle
Journal: JAMA (1995)

To the Editor.  —Although the criteria that I have used for recommending tympanostomy tubes are virtually identical to those summarized in the conclusion of the report by Dr Kleinman and colleagues, 1 I found much to take issue with in their article. Although they made reference to the likelihood that acute otitis media is overdiagnosed, which I believe to be true based on my experience as an otolaryngologist, they failed to make mention of the equally probable underdiagnosis by primary care physicians of symptomatic chronic otitis media with effusion.  The justification for using antimicrobial prophylaxis for recurrent acute otitis media, a treatment that has been shown to reduce the frequency of acute infection in the past, has not been entirely resolved. The relationship between prolonged antibiotic usage and the development of resistant strains of bacteria has not been clarified. While the risks of a surgical procedure such as tympanostomy and