tbuckley/cabot-search huggingface dataset:
Unraveling the Mystery of Idiopathic Anaphylaxis
Authors: Albert L. Sheffer
Journal: New England Journal of Medicine (1984)

Anaphylaxis, often explosive in onset, is one of the most serious emergencies in medical practice. It is usually attributed to the antigen-induced release of biologically active substances by IgE-sensitized mast cells, but identical clinical manifestations can be induced by activation of the complement pathway, as well as the arachidonate–prostaglandin pathway. Certain agents may act directly on the mast cell, with similar pharmacologic effects.1 The sites of clinical expression of such mast cell–mediated reactions include the skin, the respiratory and gastrointestinal tracts, and the cardiovascular system. Urticaria–angioedema, respiratory obstruction due to laryngeal edema or bronchospasm, and hypotension may occur singly or . . .
The Hypercoagulable States
Authors: ANDREW I. SCHAFER
Journal: Annals of Internal Medicine (1985)

Patients are considered to have hypercoagulable states if they have laboratory abnormalities or clinical conditions that are associated with an increased risk of thrombosis (prethrombotic states) or if they have recurrent thrombosis without recognizable predisposing factors (thrombosis-prone). The number of specific primary hypercoagulable states that are recognized is growing. These disorders are generally inherited abnormalities of coagulation in which a physiologic anticoagulant mechanism is defective: for example, antithrombin III deficiency, protein C and protein S deficiency, abnormalities of the fibrinolytic system, and dysfibrinogenemias. Secondary hypercoagulable states are generally acquired disorders in patients with underlying systemic diseases or clinical conditions known to be associated with an increased risk of thrombosis: for example, malignancy, pregnancy, use of oral contraceptives, myeloproliferative disorders, hyperlipidemia, diabetes mellitus, and abnormalities of blood vessels and rheology. The complex pathophysiologic features of these secondary hypercoagulable states are discussed, and a framework is provided for the laboratory investigation and systematic clinical approach to the patient.
Follicular pustulous granuloma annulare
Authors: None Vargas-DIez, None Feal-Cortizas, None Fraga, None FernAndez-Herrera, None GarcIA-DIez
Journal: British Journal of Dermatology (1998)

We report a 73-year-old woman presenting with recurrent eruptions of generalized follicular pustules. Histological examination revealed several palisading necrobiotic granulomas with mucin deposits, with a perifollicular distribution. A dense neutrophilic infiltrate in the upper portion of affected follicular structures gave rise to pustulous lesions. Scaly papules and pseudovesiculous lesions over the palms with deeper necrobiotic granulomas involving sweat glands and epidermal perforation coexisted in some of the eruptions with generalized pustules. We propose the term follicular pustulous granuloma annulare for this peculiar form of granuloma annulare, which widens the clinicopathological spectrum of presentation of this disease.
Evaluation of dynamic changes in microvascular flow during ischemia-reperfusion by myocardial contrast echocardiography
Authors: Leonarda Galiuto, Anthony N DeMaria, Karen May-Newman, Ughetta del Balzo, Koji Ohmori, Valmik Bhargava, Stephen F Flaim, Sabino Iliceto
Journal: Journal of the American College of Cardiology (1998)
Standard Medical Terminology
Authors: Burgess L. Gordon
Journal: JAMA (1965)

The language of medicine is essential for the furtherance of scientific knowledge and the exchange of clinical data. Indeed, the linking together of the laboratory and practice through effective communication permits the educator, investigator and physician to follow the developments of practice, the physical sciences, technology, and the special systems of action. However, there is a basic problem: the pipelines are choked with obsolescence, complexities, and conflicts of terminology, as the perimeters of research and clinical investigation expand at a breathless rate.<sup>1</sup>The problems must be resolved; otherwise, practice and the basic sciences will become stagnant and detached, recalling a passage paraphrased from Matthew: "Let not thy left hand know what thy right hand doeth." The history of medical terminology is the history of scholastic-humoralistic medicine, colored with hearsay and superstition, tangled and distorted in whimsical narrative. Successively, the frustrations recall the confusion of tongues in ancient Babylonia: "Therefore
The Individual Mandate — An Affordable and Fair Approach to Achieving Universal Coverage
Authors: Linda J. Blumberg, John Holahan
Journal: New England Journal of Medicine (2009)

Some of the most prominent shortcomings of the U.S. health insurance market are rooted in the fact that the system is a voluntary one. Outside the state of Massachusetts, which recently instituted broad-based health care reform, no one under the age of 65 years is required to obtain health insurance coverage of any kind. Voluntary insurance markets have led to a system centered on segmenting health risk instead of one whose primary mission is ensuring affordable access to necessary and efficiently provided high-quality medical services. But the past need not be prologue. The orientation of our system and the distorted . . .
Metabolic Effects of Carvedilol vs Metoprolol in Patients With Type 2 Diabetes Mellitus and Hypertension
Authors: George L. Bakris, Vivian Fonseca, Richard E. Katholi, Janet B. McGill, Franz H. Messerli, Robert A. Phillips, Philip Raskin, Jackson T. Wright, Rosemary Oakes, Mary Ann Lukas, Karen M. Anderson, David S. H. Bell, for the GEMINI Investigators
Journal: JAMA (2004)

ATA FROM LARGE OUTCOMEtrials indicate that the level of glycemic control predicts cardiovascular events. 1,2n the UK Prospective Diabetes Study (UKPDS), 2 patients with lower initial glycemia had fewer adverse clinical outcomes despite similar glycemic progression.Taken together with data from the National Health and Nutrition Examination Survey IV (NHANES IV), that only 37% of adults with diabetes mellitus (DM) attain recommended levels of glycosylated hemoglobin (HbA 1c ), achieving better glycemic control should further reduce the risk of cardiovascular events. 3andomized trials comparing reninangiotensin system (RAS) blockers with ␤-blockers demonstrate that cardiovascular outcomes are improved by RAS blockers, which maintain or improve
Estimation of the Glomerular Filtration Rate in NIDDM Patients From Plasma Creatinine Concentration After Cimetidine Administration
Authors: Frits AW Kemperman, Joseph Silberbusch, Eduard H Slaats, Ariël M Prins, Joop A Weber, Raymond T Krediet, Lambertus Arisz
Journal: Diabetes Care (1998)

OBJECTIVE Glomerular filtration rate (GFR) can be estimated in patients with renal disease from plasma creatinine concentration, age, sex, and body weight according to the formula of Cockcroft and Gault. The hypothesis that this method can be improved when tubular secretion of creatinine is inhibited by cimetidine was studied in NIDDM patients. RESEARCH DESIGN AND METHODS In 30 outpatients with NIDDM and normo-(n = 10), micro- (n = 9), or macroalbuminuria (n = 11), GFR was measured as the urinary clearance during continuous infusion of 125I-labeled iothalamate. Plasma creatinine concentration was analyzed with an enzymatic assay before and after 800 mg t.i.d. oral cimetidine was given during a 24-h period. RESULTS Plasma creatinine rose in all patients after cimetidine administration and, as a consequence, the clearance calculated with the Cockcroft-Gault formula fell. The ratio of this formula and GFR decreased from 1.16 ± 0.20 to 0.97 ± 0.16 (means ± SD). This ratio tended to be smaller in the normo- (0.93) than in the micro- (0.98) and macroalbuminuric (1.00) groups. Also, 20 patients with a BMI &amp;lt; 30 kg/m2 had a smaller ratio than those with a BMI &amp;gt; 30 kg/m2 (0.92 vs. 1.07; P &amp;lt; 0.05). Bland and Altman analysis showed a difference of the Cockcroft-Gault formula and GFR of 12.0 ± 17.4 ml · min−1 · (1.73 m2)−1, which decreased to −3.8 ± 14.8 ml · min−1 · (1.73 m2)−1. The same analysis of 24-h creatinine clearance with urine collection and GFR showed larger standard deviations. CONCLUSIONS GFR can be estimated in an acceptable way from plasma creatinine concentration after cimetidine administration in outpatients with NIDDM. Despite a nonsignificant underestimation in normoalbuminuric and overestimation in overweighted patients, this method is superior to 24-h creatinine clearance with outpatient urine collection.
Meckel's Diverticulum Findings on Tc-99m Red Blood Cell Scintigraphy in a Bleeding Leukemic Patient Confirmed by Tc-99m Pertechnetate Scintigraphy
Authors: L Ciccoritti, V Valenza, F Pierconti, D Di Giuda, G D'Errico, A Antinori, A Crucitti
Journal: Clinical Nuclear Medicine (2007)

A 25-year-old Caucasian woman with a medical history of acute promyelocytic leukemia presented to the emergency department with massive gastrointestinal bleeding. A bone marrow biopsy excluded hemorrhagic leukemia. Esophagogastroduodenoscopy, colonoscopy, emergency abdominal angiography, abdominal CT scan, and wireless capsule endoscopy were performed but no source of bleeding could be detected. Tc-99m RBC scintigraphy was consistent with a small bowel bleeding focus. The persistent and focal images in the right abdomen were suggestive of Tc-99m RBC trapping in the lumen of a Meckel diverticulum (MD). In accordance with this suspicion, successive Tc-99m pertechnetate scintigraphy was performed after 3 days, consistent with the diagnostic hypothesis. Due to the persisting severe bleeding (with a drop in baseline hemoglobin from 10.4 to 7.1 g/dL), despite 8 units of blood transfusion, emergency surgery was performed. Through a minilaparotomy a segmental small bowel resection, including Meckel diverticulum, was performed. The postoperative course was uneventful.
Cigarette smoking on increase.
Authors: W. C. Owen
Journal: BMJ (1989)

haematoma as incidental.There was no computed tomogram before treatment, the aetiology of the haematoma was not discussed, and results of examination of the cerebrospinal fluid were not given.In addition, the second reference is in supplement 1 of Cancer 7reatment Reports 1981 and not in the main journal.Rather than postulate a second, previously un- reported cause of this patient's neurological con- dition it would be simpler to follow Occam's razor and explain that which is obvious.The intracerebral haematoma may have resulted from hypertension, aneurysm, or haemorrhage into a deposit, in which case the administration of metho- trexate would then probably be incidental.
Standards watchdog to get a bigger role in NHS
Authors: R. Dobson
Journal: BMJ (2001)

<b>Background and objective:</b> In developing countries low maternal vitamin A stores combined with increased demands of pregnancy and lactation may lead to its deficiency in breastfed infants. This study evaluates the effects of maternal supplementation with a high dose of vitamin A on the serum retinol levels of exclusively breastfed infants, and their morbidity in the first six months of life. <b>Setting:</b> Hospital based. <b>Study design:</b> Randomised controlled trial. <b>Subjects and methods:</b> Mothers of the test group (n=150) were orally supplemented with a single dose of retinol (209 μmol) soon after delivery and were advised exclusive breastfeeding for six months. Before supplementation retinol levels were estimated in the mothers’ and newborns’ blood, and in colostrum. On follow up, breastmilk and infants’ serum retinol contents were assessed monthly for six months. Retinol level &lt;0.7 μmol/l indicated vitamin A deficiency. Morbidity patterns like vitamin A deficiency, diarrhoea, febrile illnesses, acute respiratory infection, measles, and ear infection were also studied and compared between the two groups. <b>Results:</b> Presupplement mean maternal serum retinol levels were 0.98 and 0.92 μmol/l and mean breastmilk levels were 3.85 and 3.92 μmol/l in the test and control groups respectively (p&gt;0.05). Mean cord blood retinol levels were also comparable (0.68 <i>v</i> 0.64 μmol/l). After supplementation, the test group showed a rise in mean breastmilk retinol content (12.08 <i>v</i> 2.96 μmol/l) which remained significantly higher for four months. The infants’ mean serum retinol level, initially 322.06% of the baseline value, was significantly higher for five months. In the control group, significant numbers of mothers and infants showed deficient breastmilk and serum retinol throughout the follow up (p&lt;0.01). Decreased incidence and duration of various diseases were also found in the test group suggesting lesser morbidity. <b>Conclusion:</b> Maternal supplementation with single megadose vitamin A is an effective strategy for vitamin A prophylaxis of exclusively breastfed infants of 0–6 months.
Angiotensin-Converting Enzyme Inhibition Suppresses Plasminogen Activator Inhibitor-1 Expression in the Neointima of Balloon-Injured Rat Aorta
Authors: Allen D. Hamdan, William C. Quist, Jennifer B. Gagne, Edward P. Feener
Journal: Circulation (1996)

Background Plasminogen activator inhibitor-1 (PAI-1), an important regulator of fibrinolysis and extracellular matrix turnover, has been implicated in a number of vascular diseases. Studies demonstrating angiotensin II (Ang II) to be a potent stimulator of PAI-1 expression in cultured vascular cells suggests that the renin-angiotensin system may modulate vascular PAI-1 expression. Methods and Results We examined the effects of the ACE inhibitor captopril on PAI-1 expression in control and balloon-injured rat aorta. Northern blot analysis demonstrated that aortic PAI-1 mRNA expression was 7.6-fold elevated 3 hours ( P &lt;.05) after balloon injury, back to baseline at 2 days, increased again at 4 days, and by 7 days after balloon injury was 3.2-fold elevated ( P &lt;.05) when compared with control. In captopril-treated rats, the induction of PAI-1 expression by balloon injury was significantly suppressed by 44% ( P &lt;.05) in the 7-day group but was not altered in the 3-hour group. Captopril also reduced baseline aortic PAI-1 mRNA. In situ hybridization and immunohistochemistry revealed dense PAI-1 staining of 7-day neointima in untreated rats and a dramatic decrease in PAI-1 in neointima of captopril-treated rats. Conclusions This report demonstrates that balloon injury results in both a rapid ACE inhibitor–independent induction of aortic PAI-1 expression and a later increase in PAI-1 in the neointima that is significantly suppressed by captopril. This provides the first evidence that the renin-angiotensin system regulates neointimal PAI-1 expression and that ACE inhibitors can reduce PAI-1 in the vessel wall in vivo.
Prominent expression of acidic fibroblast growth factor in motor and sensory neurons
Authors: Robert Elde, Yihai Cao, Antonio Cintra, T.Clark Brelje, Markku Pelto-Huikko, Tanja Junttila, Kjell Fuxe, Ralf F. Pettersson, Tomas Hökfelt
Journal: Neuron (1991)
Molecular Virology of Human Cancer.
Authors: S. Spiegelman
Journal: Annals of Internal Medicine (1973)

Meeting Abstracts1 May 1973Molecular Virology of Human Cancer.S. Spiegelman, Ph.D.S. Spiegelman, Ph.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-78-5-813_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe purpose of this lecture is to describe recent efforts to determine how much of the knowledge gained from animal viral oncology is applicable to the etiology and pathogenesis of human cancer. I shall present evidence for the existence in human neoplasias of RNA molecules related in sequence to those found in RNA tumor viruses known to cause corresponding cancers in experimental animals. The diseases studied include human breast cancer, leukemias, lymphomas, and sarcomas. Further experiments showed that the RNA molecules identified in these human neoplasias are viral in size and are associated in a particle with "reverse transcriptase," an... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New York, New York PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1973Volume 78, Issue 5Page: 813-813KeywordsBreast cancerEtiologyLeukemiaLymphomaPathogenesisRNARetrovirusesSarcomaVirology Issue Published: 1 May 1973 PDF downloadLoading ...
Chicken HS4 Insulators Have Minimal Barrier Function Among Progeny of Human Hematopoietic Cells Transduced With an HIV1-based Lentiviral Vector
Authors: Naoya Uchida, Kareem N Washington, Coen J Lap, Matthew M Hsieh, John F Tisdale
Journal: Molecular Therapy (2010)

Position effects limit the curative potential of gene transfer strategies for the hemoglobinopathies by inducing clonal variability of transgene expression. We evaluated the mitigating effects of the chicken hypersensitivity site 4 (HS4) insulator among lentiviral vector-transduced human hematopoietic cells. We constructed various lentiviral vectors using a green fluorescent protein (GFP) reporter under the control of a reverse-oriented murine stem cell virus (MSCV)-long-term repeat (LTR) promoter or a reverse-oriented β-globin expression cassette. A full-length HS4, a tandem HS4 core, and a single core insulator were inserted into the 3′ LTR in both forward and reverse orientation. All but the reverse single core insulator significantly decreased titers. All reduced %GFP without increasing mean fluorescence intensity (MFI) among erythroid progeny of transduced human CD34+ cells. A lower coefficient of variation (CV) was observed only among progeny of the full-length vector-transduced cells, yet a fivefold reduction in transduction efficiency was observed. In xenografted mice, the single core insulator decreased both the %GFP and the MFI at 4 and 8 weeks after transplantation with no difference in CVs. These data demonstrate that the inclusion of HS4 insulator elements lowers viral titers, reduces efficiency of transduction, and produces minimal effects on transgene expression among human hematopoietic cells in vitro and in vivo. Position effects limit the curative potential of gene transfer strategies for the hemoglobinopathies by inducing clonal variability of transgene expression. We evaluated the mitigating effects of the chicken hypersensitivity site 4 (HS4) insulator among lentiviral vector-transduced human hematopoietic cells. We constructed various lentiviral vectors using a green fluorescent protein (GFP) reporter under the control of a reverse-oriented murine stem cell virus (MSCV)-long-term repeat (LTR) promoter or a reverse-oriented β-globin expression cassette. A full-length HS4, a tandem HS4 core, and a single core insulator were inserted into the 3′ LTR in both forward and reverse orientation. All but the reverse single core insulator significantly decreased titers. All reduced %GFP without increasing mean fluorescence intensity (MFI) among erythroid progeny of transduced human CD34+ cells. A lower coefficient of variation (CV) was observed only among progeny of the full-length vector-transduced cells, yet a fivefold reduction in transduction efficiency was observed. In xenografted mice, the single core insulator decreased both the %GFP and the MFI at 4 and 8 weeks after transplantation with no difference in CVs. These data demonstrate that the inclusion of HS4 insulator elements lowers viral titers, reduces efficiency of transduction, and produces minimal effects on transgene expression among human hematopoietic cells in vitro and in vivo.
Indian Medical Association tries to stall rural health course
Authors: G. Mudur
Journal: BMJ (2010)

India’s largest association of doctors has renewed its campaign to scuttle a proposal by the Indian government to introduce an alternative programme of medical education to create a cadre of healthcare providers exclusively for the country’s villages.

The Indian Medical Association has called on India’s health ministry and other arms of the government to abandon the proposal, once again iterating its longstanding argument that the alternative programme would deliver substandard levels of healthcare to the rural population.

The Medical Council of India, after consultations with the health ministry, had earlier this year announced features of the proposed four year course, leading to a bachelor of rural healthcare degree, that would accept only rural students and train them in clinical examination, medicine, obstetrics and gynaecology, orthopaedics, paediatrics, general surgery, and public health ( BMJ 2010;340:c817, doi:10.1136/bmj.c817). Graduates of the course would be allowed to practise only in rural areas.

The Indian Medical Association, which has a membership of 80 000 doctors, had appeared to support the proposal in February this year after it was made …
Transient Severe Myopia
Authors: Frank J. Weinstock
Journal: JAMA (1971)

To the Editor.—  Sudden loss of vision is always alarming. For a physician with an obstetrical practice of young healthy women it is especially distressing to have a patient call to say that she cannot see.  Report of a Case.—  A 27-year-old woman in the seventh month of pregnancy was alarmed that during the evening of May 13, 1971, her vision began to blur. She still could see to drive at midnight. The next morning her vision became much worse, until she could only see objects a few inches distant.  The history revealed that she took one chlorthalidone (Hygroton) tablet about 10 AM on May 7, 11, and 13. In addition she had been taking calcium, iron, and isoniazid tablets.  At 4 PM on May 14 her vision was finger counting at 2 feet but could be corrected to 20/30-1 in each eye with a strong myopic lens, OD —6.00S
Cervical smear histories of 500 women with invasive cervical cancer in Yorkshire.
Authors: M E Paterson, K R Peel, C A Joslin
Journal: BMJ (1984)

The smear histories of 312 women with cancer of the cervix have been determined. Eighty nine women had had at least one negative smear reported in the 10 years before a diagnosis of cancer and 14 had had more than one negative smear. Fifty six of the 89 women had had a negative smear in the three years preceding the diagnosis of cancer. The highest number of negative smears (61) reported was among the 115 women aged under 45. Fifty eight slides reported as negative were submitted to independent review; 13 were subsequently reported as negative, 11 as unsatisfactory, and 34 as abnormal. These findings may in part explain why in this region there has been a disappointing reduction in the incidence of clinically invasive cervix cancer, and our findings may also apply elsewhere. Nevertheless, the confirmed negative smears chiefly occurred within three years of clinical cancer, particularly in the younger women, and this finding suggests that these women may have a short preinvasive phase.
Differences between healthy hematopoietic progenitors and leukemia cells with respect to CD44 mediated rolling versus adherence behavior on hyaluronic acid coated surfaces
Authors: Maximilian Hanke, Isabel Hoffmann, Christof Christophis, Mario Schubert, Van T. Hoang, Abraham Zepeda-Moreno, Natalia Baran, Volker Eckstein, Patrick Wuchter, Axel Rosenhahn, Anthony D. Ho
Journal: Biomaterials (2013)
Australia launches inquiry into treatment of overseas trained doctors
Authors: R. Moynihan
Journal: BMJ (2010)

A parliamentary inquiry in Australia launched this week will examine whether registration processes for overseas trained doctors could be improved, after calls for a public review from the Australian Doctors Trained Overseas Association.

The announcement of an inquiry follows mounting public concern in Australia that new assessment procedures may have been causing unfair deregistrations of some overseas born doctors working in areas of high need.

Those procedures were introduced in the wake of the long-running Jayant Patel case, the foreign trained surgeon recently jailed in Australia after being found guilty of manslaughter.

Under the changed procedures introduced in 2008, the failure to …