tbuckley/cabot-search huggingface dataset:
Reversible causes of altered consciousness after spontaneous subarachnoid haemorrhage
Authors: M G Bamber
Journal: BMJ (1982)

demyelinating disorders.In the two cases documented the encephalopathy which occurred appeared to be secondary to an anaphylactic reaction.It is likely, however, that an Arthus reaction was also involved.Individuals may become allergic to insect bites without their knowledge, either through inhalation of dried excreta or other material or because of an unremarked sting.Necropsies of patients who have died shortly after an insect bite have revealed cerebral oedema and widespread cerebral congestion.'These findings are the same as those in acute serum sickness.2One of us (POB) has studied the case of a man who developed bilateral optic neuritis, multiple sclerosis, and hypertrophic neuropathy after a bee sting.3Indeed, multiple sclerosis, optic neuritis, and the Guillain-Barre syndrome, all of which are presumed to be allergic demyelinating disorders, have been recorded as starting after bee stings.3-8Neuralgic amyotrophy, another postulated allergic disease, may also be a complication of such stings.5At present we are studying the effect of vascular factors in the demyelinating illnesses because of the strong circumstantial evidence supporting such a role10 (also paper by Poser and Behan in press).Anaphylactic and Arthus- type immune reactions underlie the pathological features of bee stings, so that post- mortem study of cases like the two reported here is of more than academic interest.
REHABILITATION OF THE AMPUTEE
Authors: Henry H. Kessler
Journal: JAMA (1952)

Proper management of the amputee patient demands more of the physician than surgery alone. The physician's responsibility includes supervision of a complete and integrated rehabilitation program embracing psychological preparation, adequate surgery, after-care of the stump and preprosthetic training, and provision of the prosthesis and training in its use. Only through this type of three dimensional care can the amputee be provided with the physical and psychological equipment he requires for adjustment to his social and vocational environment. It should never be forgotten that the amputee patient has a psychological problem which, if allowed to go unrecognized and untreated, may become more disabling to the patient than the amputation itself. The emotion experienced at the loss of a limb has been very well compared to the grief one feels at the death of a loved one. A part of one's body has been permanently lost. The bewilderment and desolation common among
Histological and virological features and follow-up of hepatitis C virus carriers with normal aminotransferase levels: the Italian prospective study of the asymptomatic C carriers (ISACC)
Authors: Claudio Puoti, Roberto Castellacci, Fabrizio Montagnese, Serena Zaltron, Gianfranca Stornaiuolo, Nicoletta Bergami, Lia Bellis, Davide F Precone, Paolo Corvisieri, Massimo Puoti, Eliseo Minola, Giovanni Battista Gaeta
Journal: Journal of Hepatology (2002)
The effects of PPAR-? ligand pioglitazone on platelet aggregation and arterial thrombus formation
Authors: D LI, K CHEN, N SINHA, X ZHANG, Y WANG, A SINHA, F ROMEO, J MEHTA
Journal: Cardiovascular Research (2004)

It has been suggested that peroxisome proliferator-activated receptor (PPAR)-gamma ligands reduce the development of atherosclerosis and myocardial ischemia-reperfusion injury; both of these phenomena are associated with platelet activation. We postulated that PPAR-gamma activation would inhibit platelet activation and intra-arterial thrombus formation.Sprague-Dawley rats were fed chow mixed with pioglitazone (1 or 10 mg/kg/day) for 7 to 10 days. A filter soaked in 30% FeCl(3) was applied around the abdominal aorta to study the patterns of arterial thrombogenesis. The aortic blood flow was continuously monitored using an ultrasonic Doppler flow probe. ADP and arachidonic acid-induced platelet aggregation and the expression of constitutive nitric oxide synthase (cNOS) and thrombomodulin in aorta were measured. Pioglitazone feeding delayed the time to occlusive thrombus formation by 40% (P<0.01 vs. control, n=9) without affecting the weight of the thrombus. ADP- as well as arachidonic acid-induced platelet aggregation was also inhibited by pioglitazone feeding (P<0.01 vs. control, n=9). Pioglitazone feeding also upregulated the aortic expression of cNOS and thrombomodulin; both are considered important factors in platelet aggregation and thrombus formation in vivo. The effect of a high dose (10 mg/kg/day) of pioglitazone was not more potent than that of a low dose (1 mg/kg/day).These results indicate that pioglitazone administration decreases platelet aggregation and delays intra-arterial thrombus formation in rats, at least partially, by an increase in the expression of cNOS and thrombomodulin.
IMMEDIATE AFTER-TREATMENT OF PATIENTS OPERATED ON FOR CATARACT (WITH BANDAGE).
Authors: WILLIAM H. WILDER
Journal: JAMA (1907)

The result of cataract operation is so frequently dependent on the skillful after-treatment of the case that the importance of this subject can not be overestimated. It is my purpose in considering it to limit whatever I have to say to the results I have had and the judgments I have formed from a fairly large experience, rather than to quote from literature the conclusions of others whose larger experience gives them claim to authority. To begin, the after-treatment should be started before the operation by preparing the patient in much the same way as for operation under a general anesthetic. A thorough bath, shampoo of the head and cleansing of the face and field of operation are, of course, necessary, but, in addition to this, a complete emptying of the bowels by a good cathartic the night before and an enema on the morning of the operation is a
Trends in Frequency of Latent Prostate Carcinoma in Japan from 1965-1979 to 1982-1986
Authors: R. Yatani, T. Shiraishi, K. Nakakuki, I. Kusano, H. Takanari, T. Hayashi, G. N. Stemmermann
Journal: JNCI Journal of the National Cancer Institute (1988)

By analyzing serial step-sections of whole prostate obtained at autopsy, we determined the chronologic change of the frequency of latent prostate tumor in Japan in two periods: 1965–1979 and 1982–1986. Methods of specimen preparation and examination were identical for both periods. The frequency with which latent prostate carcinoma was found in the 660 samples for 1982–1986 was 34.6% and was significantly higher than the 22.5% seen in the 576 observed for 1965–1979 (P<.0001). This significant finding can be attributed to an increase in the frequency of latent infiltrative tumor (LIT). However, the increase in the frequency of noninfiltrative tumor (LNT) was less significant (P=.045). Both sets of specimens were subsequently combined and reanalyzed according to the year of birth of the decedents. The LIT has progressively increased in frequency in each age-specific category. By morphometry, we determined that the mean tumor volume decreased due to an increase in the number of smaller tumors during the study periods. Although the frequency of latent prostate carcinoma and the LIT: LNT in the samples obtained most recently were comparable to those of U.S. whites, cancer incidence and mortality rates remain lower in Japan. Apparently, the initial step in the induction of prostate carcinoma in indigenous Japanese is now similar to that in U.S. whites. The rates of clinical carcinoma in Japan are still low when compared with those in the United States and countries in Western Europe, but our findings may presage a time when these differences may be greatly reduced or nonexistent. [J Natl Cancer Inst 1988; 80: 683–687]
John Gordon Uvedale Okeden Alexander
Authors: Rosemary Alexander
Journal: BMJ (2005)

Former consultant microbiologist Hull and East Riding hospitals (b Caterham, Surrey, 1918; q Middlesex Hospital 1942; FRCPath), d 29 September 2004.​2004.




Figure 1




After serving in the army, working in Italy and north Africa, Gordon became a pathology registrar in Liverpool. He was appointed consultant pathologist in the Hull area at the age of 32, and he designed and built the first virology laboratory there with the aid of his senior technician. In the late 1960s he developed a miniaturising technique of the serological testing of viral antibody titres (Journal of Clinical Pathology 1969;22: 505 [PMC free article] [PubMed]), which is now common practice. He had several other publications relating to the diagnosis of enterovirus infections and described a new salmonella species isolated in a baby. He leaves a wife, June; three children; and four grandchildren.
Thromboembolic disease due to thermolabile conformational changes of antithrombin Rouen-VI (187 Asn--&gt;Asp)
Authors: D Bruce, D J Perry, J Y Borg, R W Carrell, M R Wardell
Journal: Journal of Clinical Investigation (1994)

A new variant of antithrombin (Rouen-VI, 187 Asn-+Asp) with increased heparin affinity was shown to have normal inhibitory activity which decreased slowly at 4°C and rap- idly at 41°C.On electrophoresis the freshly isolated variant had an anodal shift relative to native antithrombin due to the mutation.A further anodal transition occurred after either prolonged storage at 4°C or incubation at 41°C due to the formation of a new inactive uncleaved component with properties characteristic of L-form (latent) antithrom- bin.At the same time, polymerization also occurred with a predominance of di-, tri-, and tetra-mers.These findings fit with the observed mutation of the conserved asparagine (187) in the F-helix destabilizing the underlying A-sheet of the molecule.Evidence of A-sheet perturbation is provided by the increased rate of peptide insertion into the A-sheet and by the decreased vulnerability of the reactive loop to proteolysis.The spontaneous formation of both L-anti- thrombin and polymers is consistent with our crystal struc- ture of intact antithrombin where L-form and active anti- thrombin are linked together as dimers.The nature of this linkage favors a mechanism of polymerization whereby the opening of the A-sheet, to give incorporation of the reactive center loop, is accompanied by the bonding of the loop of one molecule to the C-sheet of the next.The accelerated lability of antithrombin Rouen-VI at 41 versus 37°C pro- vides an explanation for the clinical observation that episodes of thrombosis were preceded by unrelated pyrexias.
ORIFICIAL IRRITATION IN RELATION TO NEURAL DISTURBANCES.
Authors: GEO. V. I. BROWN
Journal: JAMA (1898)

sister.The boy, as soon as he is old enough to be around, is dressed so that he can run, jump or turn heels over head; in fact, his movements are not inter- fered with in any way, either by dress or custom, but how is it with his sister?Whatever of liberty there is left after the method of dressing is taken from her by custom and the fear of being considered immod- est.I think the little girl was right, who, when re- proved for turning heels over head in the front yard, said, " if people did not want to see her, they must not go by when she was turning heels over head."She had the true sense of woman's rights-the right to be healthy and enjoy health in physical recreation.Children should be well fed, and these neurotic children, as a rule, are poor eaters, both in quality and quantity.They should be confined to plain, nourishing food, and then forced to eat it.People often tell us they cannot get their children to eat, and are surprised when you insist upon their being made to eat; but I have had the pleasure of seeing several of these rapidly improve under judicious feeding.One case I will briefly describe: She was a delicate, nervous little girl, who was thin and anemic, unable to sleep at night because of nervousness.She wanted no breakfast, unless it were a cracker or a cookie, scarcely any dinner excepting dessert, but at supper she generally did eat a little better.She was abso- lutely forced to eat a large dish of oatmeal and milk, without sugar, each morning; a dinner of bread and butter, potatoes and eggs or meat, and drink a glass of milk, no dessert; for supper, she had a dish of oat- meal and milk, bread and butter and some kind of sauce, generally stewed fruit, either dried or fresh.Besides this diet she was allowed plenty of fruit, Hnd was sent early to bed.She has been on this stuffing
Research recommendations toward a better understanding of the causes of childhood leukemia
Authors: G Ziegelberger, C Baum, A Borkhardt, C Cobaleda, C Dasenbrock, A Dehos, B Grosche, J Hauer, S Hornhardt, T Jung, T Kammertoens, I Lagroye, H Lehrach, T Lightfoot, M P Little, C Rossig, I Sanchez-Garcia, M Schrappe, J Schuez, S Shalapour, R Slany, M Stanulla, W Weiss
Journal: Blood Cancer Journal (2011)

A small expert group met in conclave in July 2010 to define a long-term strategic research agenda toward further clarification of the etiology of childhood leukemia (CL). The motivation and invitation for this project came from the German Office for Radiation Protection (BfS) because radiation experts have been puzzled for some time by epidemiological findings of an increased incidence of CL near German nuclear facilities,1 as well as by a statistical association with exposure to residential low-frequency magnetic fields.2 Both findings are difficult to explain given the current knowledge of the biological mechanisms of ionizing or non-ionizing radiation, as both types of exposure deposit far too little energy in cellular DNA and other likely targets to be considered directly causative. A previous workshop on risk factors held in May 20083 and a follow-up meeting led to the conclusion that understanding of the causes of CL development requires a broadened, interdisciplinary approach.
ABC of Atrial Fibrillation: INVESTIGATION AND NON-DRUG MANAGEMENT OF ATRIAL FIBRILLATION
Authors: G. Y H Lip, S P Singh, R D S Watson
Journal: BMJ (1995)

Certain points should be considered when deciding how to manage patients with atrial fibrillation. Firstly, is the diagnosis of atrial fibrillation certain? It is also important to distinguish between chronic and paroxysmal atrial fibrillation as the two conditions have to be managed differently. Secondly, the underlying aetiological or predisposing factor should be sought. Finally, in acute presentations of atrial fibrillation the presence of any acute precipitating factors—for example, infection—should be considered.

When a new patient apparently has atrial fibrillation

Is it atrial fibrillation?

Why did the patient develop it? (What is the underlying cause?)

Why does the patient have it now? (Are any precipitating factors present?)

The investigation of a patient with atrial fibrillation requires taking a careful clinical history (including medical history), with emphasis on certain clinical features—for example, whether the symptoms are sustained or intermittent and whether any complications, such as heart failure, stroke, or thromboembolism, are present. At the first consultation basic blood tests should be done, including full blood count and tests of renal function, electrolytes, and thyroid function.

Diagnosing and assessing atrial fibrillation

Recording of patient's history and clinical features—for example, paroxysmal atrial fibrillation

Documentation of the arrhythmia—for example, with a 24 hour Holter monitor

Echocardiography, especially in young patients

Exercise testing if ischaemic heart disease is present (caution needed in interpreting result if patient is taking digoxin)

The arrhythmia should then be documented, firstly with a conventional 12 lead electrocardiogram. This may provide a clue to the aetiology or electrophysiological features that may cause arrhythmia—for example, ischaemic heart disease (previous myocardial infarction), left ventricular hypertrophy, or a pre-excitation syndrome ((delta) wave in the Wolff-Parkinson-White syndrome if in sinus rhythm).



Demonstration of 24 hour Holter monitor.



A 24 hour Holter monitor may be needed to document paroxysmal atrial fibrillation or the sick sinus syndrome. This …
The role of human glutathione transferases and epoxide hydrolases in the metabolism of xenobiotics.
Authors: J Seidegård, G Ekström
Journal: Environmental Health Perspectives (1997)

Human glutathione transferases (GSTs) are a multigene family of enzymes that are involved in the metabolism of a wide range of electrophilic compounds of both exogenous and endogenous origin. GSTs are generally recognized as detoxifying enzymes by catalyzing the conjugation of these compounds with glutathione, but they may also be involved in activation of some carcinogens. The memmalian GSTs can be differentiated into four classes of cytosolic enzymes and two membrane bound enzymes. Human epoxide hydrolases (EHs) catalyze the addition of water to epoxides to form the corresponding dihydrodiol. The enzymatic hydration is essentially irreversible and produces mainly metabolites of lower reactivity that can be conjugated and excreted. The reaction of EHs is therefore generally regarded as detoxifying. The mammalian EHs can be distinguished by their physical and enzymatic properties. Microsomal EH (mEH) exhibits a broad substrate specificity, while the soluble EH (sEH) is an enzyme with a "complementary" substrate specificity to mEH. Cholesterol EH and leukotriene A4 hydrolase are two EHs with very limited substrate specificity. The activities of either GSTs or EHs expressed in vivo exhibit a relatively large interindividual variation, which might be explained by induction, inhibition, or genetic factors. These variations in levels or activities of individual isoenzymes are of importance with respect to an individual's susceptibility to genotoxic effects. This article gives a general overview of GSTs and EHs, discussing the modulation of activities, determination of these enzymes ex vivo, and the polymorphic expression of some isoenzymes.
Indicator-Dilution Curves During Methoxamine Infusion jn Patients with Mitral Valvular Disease
Authors: PAUL N. YU, JAMES K. FINAYSON, MILTON N. LURIA
Journal: Circulation Research (1961)

This report describes the time-concentration components and the contour of indicator-dilution curves recorded from the femoral artery after injection of radioactive iodinated (I 131 ) human serum albumin into the pulmonary artery before and during methoxamine infusion in nine patients with predominant mitral stenosis, and seven patients with predominant mitral insufficiency. During methoxamine infusion, the changes were as follows: (a) The forward cardiac output was uniformly reduced in both groups. The changes in the total and "central" blood volumes were inconsistent in both groups. In all cases, there was prolongation of the appearance and mean transit times. (b) There was a significantly greater prolongation of the reciprocal of the downslope and the disappearance time in patients with mitral insufficiency than in those with mitral stenosis. By means of a simple formula, we allowed for alteration in forward cardiac output and "central" blood volume during methoxamine infusion, and a satisfactory discrimination between mitral stenosis and mitral insufficiency was achieved by comparing the change in 1/S. Comparison of the ratio of spread time to appearance time (T s /T A ) before and during methoxamine infusion also effected an excellent separation between the two groups. It is postulated that the characteristic changes of the indicator-dilution curves during methoxamine infusion in patients with mitral insufficiency were due to augmentation of regurgitant stroke volume, increase in the force of the regurgitant jet, or both.
Hemodynamic effects of calibrated stenosis of the superior mesenteric artery in conscious rats with portal vein stenosis
Authors: Olivier Soubrane, Alain Braillon, Han-Chieh Lin, Gerhardt Kleber, Didier Lebrec
Journal: Hepatology (1992)

Because superior mesenteric arterial blood flow is increased in portal hypertension and plays a role in elevated portal pressure, mechanical reduction of artery diameter should induce decreases in portal pressure and superior mesenteric arterial blood flow. In this study, calibrated superior mesenteric artery stenosis (induced with a 22-gauge needle) was performed in rats simultaneously with portal vein stenosis or 2 wk after creation of portal vein stenosis. Hemodynamic studies were performed 3 wk after induction of portal vein stenosis in conscious, unrestrained rats. At that time, neither weight loss nor digestive tract alterations were observed in rats with arterial stenosis. In neither group of rats with arterial stenosis was portal tributary blood flow significantly different from that of normal rats; nor was it significantly lower than in rats with portal vein stenosis without arterial stenosis. In both groups of rats with arterial stenosis, portal pressure was significantly lower (12.1 +/- 1.6 mm Hg and 12.5 +/- 1.8 mm Hg, respectively) than in rats subjected to portal vein stenosis (15.4 +/- 1.5 mm Hg) but significantly higher than in controls (7.2 +/- 1.0 mm Hg). In rats with arterial stenosis, cardiac index was also significantly lower than that in rats with portal vein stenosis but higher than that in controls. In conclusion, this study shows that both early and late superior mesenteric artery stenosis significantly reduce the degree of portal hypertension and the hyperkinetic state of rats with extrahepatic portal hypertension. Thus we can speculate that superior mesenteric artery stenosis might provide a new therapeutic approach for portal hypertension.
Australia looks at promoting men's health
Authors: C. Zinn
Journal: BMJ (1994)

Australia's new federal health minister, Dr Carmen Lawrence, has taken over the controversial post with plans to make men's health a priority. Dr Lawrence, who in 1990 became the nation's first woman state premier and is tipped as a future prime minister, has also scotched her predecessor's proposals to introduce a higher Medicare levy for the rich.

The minister is now preparing to deliver her ideas to the country in time for the budget on 10 …
James (“Jake”) Knox Russell
Authors: Derek Tacchi
Journal: BMJ (2007)

James Knox Russell (“Jake” as he was always known) was a former professor of obstetrics and gynaecology who introduced a new medical curriculum that was widely adopted.

In 1958 Jake Russell was appointed the first full time professor in obstetrics and gynaecology in the University of Newcastle upon Tyne to join those already appointed in medicine, surgery, and paediatrics, a post-war policy to replace part-time clinicians who had previously been appointed. He was a good and kind clinician, an astute politician, and a superb undergraduate teacher who promoted and awarded the promise of those he considered worthy. His department was a very happy one.

His early life was in Aberdeen, where he was born, schooled, and attended the university medical school, graduating MB ChB in 1942. There he met a fellow student Cecelia (“Wendy”) Valentine Urquart—they were married in King's College Chapel, Aberdeen, in 1944. Jake was at the time serving with the Royal Air Force Bomber Command based in England and then Holland. After the second world war he returned to a post of registrar to the formidable Dugald Baird, the regius professor of midwifery in Aberdeen, and he took his MRCOG in 1949.

Baird had set up a Medical Research Council unit that worked on problems of human reproduction, physiology, and epidemiology so it was not surprising that Russell's early efforts were similarly directed. He had a particular interest in “teenage pregnancy” and he took his MD in 1954.

In 1950 Russell moved to Newcastle as first assistant to Professor …