tbuckley/cabot-search huggingface dataset:
Intrahepatic cholestasis of pregnancy and bile acid levels
Authors: Loïc Sentilhes, Eric Verspyck, Horace Roman, Loïc Marpeau
Journal: Hepatology (2005)

We read with great interest the study reported by Glantz et al.1 Although the authors should be congratulated on the data collected, we would nevertheless like to comment on their conclusions. Because these researchers had prospectively detected no increase of fetal risk in intrahepatic cholestasis of pregnancy (ICP) patients with bile acid levels less than 40 μmol/L, they proposed to manage these women expectantly to reduce the costs of medical care.1 We offer two reasons why this approach should be treated with caution. First, the pathogenesis of intrauterine fetal death (IUFD) in ICP remains unclear.2 It has only been speculated, and never demonstrated, that bile acids may be the cause of IUFD in ICP. Moreover, it has never been demonstrated that they are solely responsible for IUFD in ICP and that other parameters do not play a role.3 Second, among the three IUFDs that were reported by Glantz et al. during the observation period, one occurred while bile acid levels were less than 40 μmol/L (27 μmol/L).1 Moreover, there was a slight increase in meconium staining of amniotic fluid, placenta, and membranes when bile acid levels were between 10 and 39 μmol/L compared with normal controls. Although not statistically significant, these facts may be clinically significant. As the authors themselves report, "the low incidence of IUFD (0.4%) was due to increased attention devoted to ICP and its symptoms during the study which had led to high rates of induction of labor and planned cesarean section" (25% distributed as follows: 21% when bile acid levels were less than 10 μmol/L, 24% when bile acid levels were between 10 and 39 μmol/L, and 32% when bile acid levels were greater than 40 μmol/L).1 Therefore, why should obstetricians abandon active management, which is currently the only method that could reduce IUFD?4 The policy of active management usefulness has been reinforced recently by the findings of Williamson et al.5 These authors assessed the clinical outcome of 227 ICP patients. Among singleton pregnancies, 20 IUFDs were found. The median gestation at which IUFD occurred was 38 weeks, and only two IUFDs occurred before 37 weeks.5 As compared with the risk of required ventilation for respiratory distress syndrome at an earlier gestation (i.e., 1:557 (0.2%) at 37 weeks and 1:1692 at 38 weeks),6 the arguments weigh in favor of active management. We believe that in the absence of a randomized study, it is not a viable approach to propose to ICP patients with bile acid levels less than 40 μmol/L an expectant management based solely on bile acid levels.7 Loïc Sentilhes M.D.*, Eric Verspyck M.D., Ph.D.*, Horace Roman M.D.*, Loïc Marpeau M.D., Ph.D.*, * Department of Obstetrics and Gynecology, Rouen University Hospital–Charles Nicolle, Rouen, France.
Competition rules over merger has cost NHS 1.8m, BMJ probe shows
Authors: G. Iacobucci
Journal: BMJ (2013)

The lengthy battle over the proposed merger of two hospital foundation trusts in England has cost the NHS almost £2m (€2.4m; $3.2m) in legal and consultancy fees, a BMJ investigation has shown.

Plans to merge the Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust and Poole Hospital NHS Foundation Trust, first proposed in 2011, were provisionally blocked by the Competition Commission in July, with a final ruling due by 21 October.

The trusts said that the plans were essential to ensure the sustainability of services in the area, but the commission provisionally ruled that the move would reduce patients’ choice. The plan has been opposed by BMI Healthcare,1 which runs a private hospital in Poole.

In response to a request from the BMJ made under freedom of information legislation, the two …
SYPHILITIC MYOCARDITIS IN THE RABBIT
Authors: Wade H. Brown, Louise Pearce
Journal: The Journal of Experimental Medicine (1926)

In the course of routine postmortem examinations of rabbits infected with Treponema pallidum, six cases of pronounced granulomatous myocarditis were encountered. Treponemata were not demonstrated in the lesions, but the clinical history, and the gross and microscopic appearance of the lesions seemed to warrant a diagnosis of syphilitic myocarditis. The lesions measured 1.0 cm. or more in diameter and histologically were practically identical with those described by Warthin in cases of syphilitic myocarditis in man. These are the first cases of syphilitic myocarditis or of visceral syphilis in the rabbit that have been reported.
Screens to update patients in emergency departments about their progress can help to reduce aggression
Authors: J. Carlowe
Journal: BMJ (2011)

Violence and aggression against staff in emergency departments are massively under-reported, a study has shown, and yet simple measures can prevent flare-ups and save the NHS millions.

In a year long project, commissioned by the Department of Health and run by the Design Council, designers observed emergency departments to identify the influences that lead to outbursts in normally calm patients and relatives.

It is estimated that such cases account for half of all aggression (or in some cases, violence) against staff, which costs the NHS in excess of £69m (€80m; $109m) a year.

Becky Rowe, research director at research agency ESRO, was the ethnographic research lead on this project. Her team spent more than 300 …
Differences in the effect of metabolic inhibition on action potentials and calcium currents in endocardial and epicardial cells.
Authors: S Kimura, A L Bassett, T Furukawa, N Furukawa, R J Myerburg
Journal: Circulation (1991)

BACKGROUND Ischemia-induced electrophysiological changes are more prominent in epicardial cells than in endocardial cells. Epicardial action potentials shorten more than endocardial action potentials during ischemia. Since the L-type Ca2+ current plays an important role in the maintenance of action potential duration, we hypothesized that the Ca2+ current is affected more in epicardial cells than in endocardial cells during ischemia. METHODS AND RESULTS To test this hypothesis, we examined the effect of metabolic inhibition, a major component of ischemia, on action potentials and the Ca2+ current in single cells isolated from the endocardial and epicardial layers of the feline left ventricle. The membrane voltage and current were measured by using the whole-cell mode of the patch-clamp technique. During control periods, action potentials recorded from epicardial myocytes had lower amplitude, a prominent notch between phases 1 and 2, and shorter action potential duration compared with those recorded from endocardial myocytes. However, the amplitude and current-voltage relation of the Ca2+ current were similar in endocardial and epicardial cells at test potentials of -30 to 60 mV elicited from a holding potential of -40 mV. The time course of inactivation of the Ca2+ current also was identical in the two cell types. After 15 minutes of superfusion with glucose-free Tyrode's solution containing 1 mM CN-, action potential duration was reduced by 13 +/- 7% in endocardial cells and by 80 +/- 9% in epicardial cells (p less than 0.01). The peak Ca2+ current was reduced by 21 +/- 9% in endocardial cells and by 37 +/- 6% in epicardial cells (p less than 0.01). CONCLUSIONS We conclude that enhanced depression of the Ca2+ current may account in part for the greater action potential shortening in epicardial cells during ischemia and metabolic inhibition.
ANAPHYLACTIC SHOCK CAUSED BY ANTIBODY IN ANIMALS SENSITIZED BY ANTIGEN—REVERSED PASSIVE ANAPHYLAXIS
Authors: Eugene L. Opie, J. Furth
Journal: The Journal of Experimental Medicine (1926)

Anaphylactic shock occurs (in rabbits) when the usual procedure for the production of passive anaphylaxis is reversed; that is, when an animal previously treated with antigen receives the corresponding antiserum by way of the circulating blood. This susceptibility to the action of anti-horse serum produced by injection of antigen reaches maximum intensity after an interval of 4 hours presumably required to permit penetration of the antigen in sufficient concentration into the tissues. Desensitization to the action of a shock-producing dose of anti-horse serum can be brought about by repeated small doses of the same antiserum. Anaphylactic shock and local anaphylaxis manifested by the acute inflammation of an immunized animal when injected with the antigen used for immunization (Arthus phenomenon) occur under analogous conditions; that is, when antigen and antibody meet within the tissues. The peculiar characters of these reactions are dependent upon the site of entry of the irritating agent, which is the vascular system in one instance and tissue spaces in the other, and upon the concentration of antigen and antibody within susceptible tissues. Meeting of antigen and antibody within susceptible tissues is sufficient to explain the phenomena of local and general anaphylaxis so that it is unnecessary to assume the sudden formation of a toxic substance (anaphylatoxin).
Reliability assessment and validation of the Melasma Area and Severity Index (MASI) and a new modified MASI scoring method
Authors: Amit G. Pandya, Linda S. Hynan, Rafia Bhore, Fransell Copeland Riley, Ian L. Guevara, Pearl Grimes, James J. Nordlund, Marta Rendon, Susan Taylor, Ronald W. Gottschalk, Nnenna G. Agim, Jean-Paul Ortonne
Journal: Journal of the American Academy of Dermatology (2010)
Origins of the Word "Phrenology"
Authors: PATRICIA S. NOEL, ERIC T. CARLSON
Journal: American Journal of Psychiatry (1970)

Phrenology is defined as the study of the conformation of the skull as indicative of mental faculties and character. The authors trace the development of this definition from Benjamin Rush, who meant phrenology to describe faculty psychology, through Franz Joseph Gall, who linked faculty psychology and craniology, to Thomas Forster and Johann Spurzheim, who gave the word its present meaning.
Tuberculosis in Students and Nurses
Authors: C. C. Downie, A. Wilkinson
Journal: BMJ (1955)

We investigated the optimal scan time for obtaining the maximal signal-to-noise (S/N) ratio in cerebral blood flow (CBF) measured by PET imaging following <sup>15</sup>O-water bolus injection. We performed sequential measurements with dynamic scans of six subjects injected at rest while listening to white noise. Each dynamic data set was edited into images corresponding to different scan times and were calibrated to CBF images by the table look-up method. For each scan time, we evaluated a pixel-by-pixel standard deviation of the CBF for sequential measurements. The S/N-ratio of CBF in the gray matter was 10.2 ± 1.7 and 13.6 ± 2.9 at a 40 and 120 sec scan time, respectively. The gain of the 120-sec over 40-sec scan time corresponds to an 80% increase in the number of trials to reach the same S/N-ratio in a stimulation-activation study. The simulation study supported the results, in which the maximal S/N-ratio of the CBF was demonstrated to be 90 and 120 sec at a CBF of 80 and 60 ml/100 ml/min, respectively. It is concluded that the optimal scan time of the <sup>15</sup>O-water bolus injection method is in the interval from 90 to 120 sec.
Methadone prescribing should continue in Scotland, says review
Authors: B. Christie
Journal: BMJ (2013)

An inquiry has concluded that prescribing methadone to drug users should remain a central part of treatment in Scotland, despite claims that the policy had proved a failure.

It said that the evidence of the benefits of replacement therapy was strong, but it recommended that the therapy should be part of a full range of treatment options aimed at promoting recovery. It also recommended a greater role for family doctors and pharmacists in deciding how drug treatment services should be delivered locally.

The review was ordered after political and media opposition to the methadone programme, which has …
Abstract P1-01-06: Elaboration of a nomogram to predict the non sentinel node status (NSN) in breast cancer (BC) patients with positive SN, intra-operatively assessed with OSNA (one step nucleic acid amplification) method
Authors: F Di Filippo, D Gianarelli
Journal: Cancer Research (2013)

Abstract BACKGROUND Diagnostic axillary lymph node dissection (ALND) has been replaced by sentinel node biopsy (SNB) in nodal staging. Tumor-positive SNB results in a risk of NSN metastases in case of micro and macro metastases ranging from 10 to 50% respectively. Therefore most of the patients are submitted to an unnecessary ALND. Therefore the development of a mathematical model for predicting patient-specific risk of non sentinel node metastases is strongly warranted. We have developed an European Database with positive SN detected by OSNA molecular method, able to identify intra-operatively patients with micro (CK19 mRNA copies 250-5000) or macrometastases (number of copies &amp;gt; 5000). MATERIAL AND METHODS European OSNA database has been developed, only patients whose SN was totally assessed with OSNA were included. The following parameters were recorded: - Clinical: hospital, age, record number - Bio-patological: tumor size, grading, multifocality, histological type, LVI, ER-PR status, HER-2, KI67, molecular classification (luminal A, luminal B, HER2 like, triple negative) - Sentinel and non-sentinel lymph node related: number of removed SNs, number of positive and negative SNs, copy number of positive sentinel node, ratio: number of positive SN to number of removed SN number of removed and number of positive nodes after ALND. A total of 2351 patients have been included in the database (938 micrometastases and 1413 macrometastases) with the collaboration of 20 European and Italian OSNA centers. Univariate analysis was performed to determine factors associated with NSN metastases. Chi-square test was used for categorigal variables. All variables with p values less than 0.05 were included in the logistic analysis using backward stepwise method. RESULTS Univariate and multivariate analysis for micro and macro metastases are reported. In patients with SN micrometastases, multivariate analysis showed that grading (p&amp;lt;0.006), Tsize (p&amp;lt;0.04) and the number of CK19 mRNA copies (p&amp;lt;0.0001) are strictly related with positivity of NSN status. In patients with macrometastases multivariate analysis selected KI 67 (p&amp;lt;0.04), Tsize (p&amp;lt;0.002), number ofcopies (p&amp;lt;0.0001) and multifocality (p&amp;lt;0.007) as parameters significantly correlated with NSN positivity. CONCLUSIONS In our analysis we have evaluated only parameters available at the time of operation because the final nomogram has to be employed by the surgeons as a guide for the surgical decision-making whether to perform or not ALND in BC women. The large population employed and the power of number of copies are the right prerequisites for a reliable nomogram that will be presented at the Meeting. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-01-06.
Blood loss after fractures of the hip. Results of ten high femoral osteotomies using a radioactive tracer and an electronic blood volume computer
Authors: R. C. Gardner
Journal: JAMA (1969)

In ten patients undergoing high femoral trochanteric osteotomy, operative blood loss was measured by radioactive labeling and an automatic blood volume computer. Average blood loss was 1,295 cc, with a range of 500 to 2,650 cc. Average blood loss estimated by the surgeon during the operation was 590 cc. The average percent of preoperative blood volume lost was 25.7% (in females 34.5% and in males 19.8%). Estimates of blood loss by the surgeon were highly underestimated since much of the loss occurred by continued loss of blood in the postoperative period. The results stress the importance of the availability of adequate blood for patients undergoing proximal femoral osteotomy or those with acute trochanteric fractures of the hip.
Exceptional Blood Loss Anemia
Authors: George B. Hart
Journal: JAMA (1974)

TREATMENT of blood loss anemia in patients who, for religious beliefs, refuse blood transfusion is vexing. Three schools of thought exist. The "aggressive" school would remove from the patient, by court order, the right to refuse transfusion. The "passive" school would let the patient lapse into coma, whereupon the nearest of kin would adjudicate the application of blood products. The third school would give blood to the patient when unconscious, but deny the fact if he or his family inquires. Damage to the central nervous system could occur from lack of oxygen if the last two approaches are adopted. Philosophically, the author agrees with Fitts et al,<sup>1</sup>who advocate the exploration of alternative treatment methods. Boerema et al<sup>2</sup>demonstrated that when treated with hyperbaric oxygen, pigs could survive otherwise intolerable reduction of red blood cell (RBC) mass for brief periods without neurological deficits. Lambertsen et al<sup>3</sup>observed
GASTRIC EMPTYING IN DIABETICS USING CONTINUOUS ACQUISITION IN THE LAO VIEW
Authors: HA Ziessman, FH Fahey, C Herring, w Deschner, M Collen, R Vigersky
Journal: Clinical Nuclear Medicine (1989)

Ziessman, HA; Fahey, FH; Herring, C; Deschner, w; Collen, M; Vigersky, R Author Information
The percentage of myeloperoxidase-positive blast cells is a strong independent prognostic factor in acute myeloid leukemia, even in the patients with normal karyotype
Authors: T Matsuo, K Kuriyama, Y Miyazaki, S Yoshida, M Tomonaga, N Emi, T Kobayashi, S Miyawaki, T Matsushima, K Shinagawa, S Honda, R Ohno
Journal: Leukemia (2003)
MULTIPLICATION AND SPREAD OF THE VIRUS OF ST. LOUIS ENCEPHALITIS IN MICE WITH SPECIAL EMPHASIS ON ITS FATE IN THE ALIMENTARY TRACT
Authors: John L. Peck, Albert B. Sabin
Journal: The Journal of Experimental Medicine (1947)

1. Beginning at 24 hours after intravenous injection of about 10 million intracerebral LD50 of virus there was evidence of simultaneous, progressive multiplication in the brain and intestinal tract. 2. When the virus was introduced directly into the brain or the nasal cavities and mouth, none was found in the intestinal tract until there was general centrifugal spread from the central nervous system during the last stages of the infection at 96 or 120 hours after inoculation when the virus in the entire brain had reached a concentration of about 3 billion LD50. 3. Centrifugal spread began when the virus in the brain reached a concentration of about 400 million LD50 and virus appeared in the pharynx, tongue, and adrenals before it was demonstrable in the intestinal tract, blood, or viscera such as the spleen, liver, and kidneys. 4. Despite the high concentrations of virus which developed in the intestinal tract following intravenous inoculation, it was not demonstrable in the stools, differing in this respect from Theiler's virus in mice and poliomyelitis virus in human beings and monkeys. 5. No antiviral agent was found in the stools, but the urine of normal mice having a pH of 5.6, inactivated large amounts of St. Louis encephalitis virus. 6. There was no evidence of multiplication in the nasal mucosa of mice which succumbed with encephalitis following nasal instillation of the virus, the course of events being comparable in this respect to the behavior of the M.V. poliomyelitis virus in rhesus monkeys. 7. At the terminal stage of infection the virus content per milligram of tissue was as great in the leg muscles as in the sciatic nerves. Since this was also true for the urinary bladder, heart, lungs, and tongue among other tissues, and since the amount in the blood was too negligible to account for it, it would appear that the virus either accumulated in these tissues by diffusion from the nerve fibers, along which it was spreading from the central nervous system, or that it multiplied in some constituent other than the nerve fibers.
Functional role of antibody against "core" glycolipid of Enterobacteriaceae.
Authors: L S Young, P Stevens, J Ingram
Journal: Journal of Clinical Investigation (1975)

Antibodies against the "core" glycolipid of Enterobacteriaceae (2-keto, 3-deoxyoctonate-Lipid A) have been associated with protection against the sequelae of gram-negative rod bacteremia. To investigate the nature of this protection, dogs and rabbits were immunized with purified glycolipid prepared by phenol-chloroform-petroleum ether extraction of the "Re" mutant of Salmonella minnesota 595 and opsonophagocytic and bactericidal tests were carried out using lapine peritoneal granulocytes and serum factors. Whereas 1-4 mug/kg of glycolipid i.v. produced hypotension in dogs and 8 mug/kg i.v. was lethal, a rising dosage schedule of immunization with an average total dose of 1 mg/kg produced striking protection against shock and death against challenge with heterologous organisms. 20 control dogs, given approximately 10(10) live, serum-resistant Escherichia coli 0.85:H9 or Serratia marcescens 03 during a continuous intra-arterial pressure transducer recording, showed a drop in mean systolic pressure from 186 (+/- 6 SE) to 101 (+/- 12 SE) MM Hg and a fall in mean diastolic pressure from 118 (+/- 3 SE) to 64 (+/- 8 SE) mm Hg within 60-120 min. Minor pressure changes (average less than 12% of prechallenge levels) were seen in the same number of immunized dogs. In contrast, no significant difference was noted in the bloodstream clearance of these serum-resistant organisms over a period of 4-6 h between immunized and control dogs. Intravascular clearance was greater in animals immunized with the challenged strain or in glycolipid-immunized animals challenged with highly serum-sensitive E. coli 0.14:K7. Antibody against core glycolipid protected against the hemodynamic sequelae of bacillemia, augmented intravascular clearance of serum-sensitive organisms, and abrogated the pyrogenic response to enteric bacilli, but did not enhance clearance of serum-resistant organisms. Although canine and lapine antiserum against core glycolipid passively protected mice against a heterologous challenge, opsonophagocytic and bactericidal activity was at least 100-fold less than type-specific antiserum.
Human fertilisation and embryology bill goes to report stage.
Authors: P Braude, M H Johnson, R J Aitken
Journal: BMJ (1990)

drug.'3A recent review of experience with azathioprine in 27 patients over a median duration of seven years suggested that side effects were few, and treatment had had to be discontinued in only four patients'4; all of the others improved and were able to take lower dosages of anticholinesterase drugs and corticosteroids.It has been argued that corticosteroids and immunosuppressants do not diminish the already low mortality from myasthenia gravis,j but there is little doubt that they improve the quality of life. 4espite the lack of evidence from rigorous controlled trials the conclusion must be that the outlook for patients with myasthenia gravis has improved considerably over the past 1 Walker M. Treatment of myasthenia gravis with physostigmine.
MRC cleared of unethical research practices
Authors: Z. Kmietowicz
Journal: BMJ (1998)

Eight studies carried out in the 1950s and 1960s which entailed the use of radiation and in which the investigators were accused of exploiting and possibly harming those who took part have been deemed ethical by an independent Medical Research Council (MRC) inquiry, the same body that funded the research.

The MRC launched its inquiry into the radiation experiments after a Channel 4 documentary Deadly Experiments , broadcast in July 1995, raised concerns about the way this and other research had been conducted. The programme asserted that many people who took part in the studies, including pregnant women and Asian …