tbuckley/cabot-search huggingface dataset:
STUDIES ON THE MECHANISM OF THE SHWARTZMAN PHENOMENON
Authors: Chandler A. Stetson
Journal: The Journal of Experimental Medicine (1951)

Evidence is presented to indicate that a profound thrombocytopenia and granulocytopenia occur during the second stage of the Shwartzman phenomenon, prior to the actual onset of hemorrhage in the prepared skin areas. These hematologic alterations appear to be due to accumulation of the cells mentioned in the capillary bed of the lungs and perhaps other internal organs. This seems to be consequent on certain changes in the platelets and polymorphonuclear leucocytes, which result in the formation of clumps of these elements. In skin areas prepared for the Shwartzman phenomenon, the capillaries and small veins become occluded by masses of platelets and granulocytes after the intravenous challenging injection has been given. Following the interruption of blood supply necrosis of the involved vessels takes place, and hemorrhage occurs later where the vessel walls have lost their integrity.
Sliding Hernias Through the Oesophageal Hiatus
Authors: G. Rios-Solans
Journal: BMJ (1953)

ANNULAR PANCREASBoH 1029ulceration may indeed have peptic ulcers as in the present case.Eight additional cases associated with peptic ulcers have been recorded (gastric 3, duodenal 5).Four further patients had a history of haematemesis or melaena.Acute haemorrhagic pancreatitis is a rare presentation, but has been recorded. DifferentialDiagnosis.-Thediagnosis has been suggested pre-operatively in eight cases.It will be considered only when there is a sufficient degree of deformity or obstruction to be shown by a barium-meal examination.Other possibilities to consider include congenital bands associated with malrotation, tumours of the pancreas or sphincter of Oddi, ulcer and rarely primary or secondary cancer of the second part of the duodenum, and pressure by enlarged glands from without.Treatment.-Ifsurgical treatment is indicated the choice of procedure lies between section of the ring and some form of by-pass operation.The former carries some risk of fistula formation, and so the site of division should be protected by a drain to the exterior.This may be combined with longitudinal division and transverse suturing of the duodenum, the suturing being made in such a way as to drain the cut ends of the pancreatic annulus into the lumen.This duodenoplasty overcomes any intrinsic duodenal narrowing and the possibility of recurrent obstruction.Partial gastrectomy is a somewhat severe method of dealing with an annular pancreas unassociated with other gastroduodenal disease.Gastro-jejunostomy introduces an undoubted risk of stomal ulceration, and, if feasible, duodeno- jejunostomy would be preferable."1 Summary A case of annular pancreas is reported.The finding was an incidental one at operation for chronic duodenal ulcer.No obstruction of the duodenum was produced, and the presence of the condition did not affect the operative treatment of the ulcer.We are indebted to Drs.R. Quilliam and A. Jenkins for the radiological reports and to Mrs. Mace for the picture.
Diuretic-associated hypomagnesaemia.
Authors: J Sheehan, A White
Journal: BMJ (1982)

Clinically suspected hypomagnesaemia was confirmed in 21 patients over 12 months; all patients had been exposed to either short-term vigorous diuretic treatment or moderate-dosage long-term treatment. Magnesium depletion was compounded by a hospital diet surprisingly low in magnesium, a local soft water supply, and, in some patients, high alcohol intake. Common presenting symptoms included depression, muscle weakness, refractory hypokalaemia, and atrial fibrillation refractory to digoxin treatment. The administration of magnesium supplements resulted in prompt improvement of all symptoms particularly in the case of refractory atrial fibrillation. Chronic low-grade magnesium deficiency from diuretic treatment is more common than published reports suggest. Older patients are at risk, particularly those who have excessive alcohol intake, a diet low in magnesium, or a soft water supply.
Normal values of laboratory tests in elderly onset psoriatic arthritis
Authors: A. NAVA;
Journal: Annals of the Rheumatic Diseases (2000)

I read with interest the article recently published by Punzi et al .1 The results shown in this study demonstrate higher levels of acute phase reaction markers such as ESR and CRP in elderly onset psoriatic arthritis patients (EOPsA) than those displayed by young onset psoriatic arthritis patients (YOPsA). The authors included 16 EOPsA (>60 years) and 50 YOPsA (<60 years). I would like to comment that the information regarding normal values was restricted to the following words “CRP, normal values <0.6 mg/dl”, no other information is given. It is not possible to know how and from whom these normal values were obtained. Even if a commercial test that includes their own controls was used, it is clear that you will need to test groups of normal subjects that cover the age spectrum of both … Dr L Punzi, Cattedra e Divisione di Reumatologia, Policlinico Università, via Giustiniani 2, 35128 Padova, Italy
Treatment of Nocturnal Enuresis by the Electric Alarm
Authors: T. H. Gillison, J. L. Skinner
Journal: BMJ (1958)

The yeast phase of <i>P. brasiliensis</i> is poorly phagocytosed by "stimulated" mouse peritoneal macrophages in culture. However, either heterologous (sera from patients with South American Blastomycosis) or homologous antibodies (sera from mice chronically infected with <i>P. brasiliensis</i>) greatly enhanced the phagocytosis of <i>P. brasiliensis</i> organisms by macrophages. The same effect was observed when guinea-pig, mouse, or human sera were added to the fungus-macrophage cultures. Heating of the sera at 56°C or the addition of EDTA to the system completely abolished this effect. Conversely, EGTA had no effect. These data indicate that the alternative pathway of complement activation is involved in the expression of this phenomenon. This conclusion is further supported by the fact that Cobra venom Factor (CoF) treated serum, properdin, or factor B depleted serum had no opsonic properties. When yeast cells of <i>P. brasiliensis</i> were incubated with fresh normal serum, the third component of the complement system changed its electophoretic mobility of β1C to β1A.
Delayed-Type Hypersensitivity Skin Testing: Variance Among Candida albicans Extracts
Authors: Chitra Kuthiala
Journal: JAMA (1989)

<h3>To the Editor. —</h3> Accurate assessment of cellular immune response by delayed hypersensitivity skin testing requires skin-test materials of defined quality. This type of skin testing provides important information about cellular aspects of the immune system and the ability to process and present antigen to cellular effector cells. Certain delayedtype skin-testing materials are regulated by the Center for Biologics Evaluation and Research of the Food and Drug Administration to ensure consistent potency.<i>Candida albicans</i>is an important antigen, but only one product with guaranteed potency exists, the Merieux "Multi-Test CMI." This product delivers<i>Candida</i>and other extracts by multiple percutaneous puncture. Many physicians have preferred standard intradermal techniques because more predictable amounts of antigen are delivered intradermally. Extracts of fungal species contain diverse antigens and may differ substantially in content. Thus, equivalence is difficult to ensure. With antigens not licensed for delayed-type hypersensitivity skin testing, practitioners generally select materials licensed
Cash strapped NHS trust will be first to be placed in administration
Authors: I. Torjesen
Journal: BMJ (2012)

England’s health secretary, Andrew Lansley, has begun the process of putting South London Healthcare NHS Trust, which has debts of £150m (€190m; $235m), into administration. This is the first time that a health secretary has implemented failure powers against an NHS trust, and it is effectively the first step to declaring the trust bankrupt.

South London Healthcare Trust, which controls three hospitals in southeast London, reported a £65m deficit in 2011-12 and is on course to run up a similar deficit for 2012-13 because it is losing £1.3m a week. The trust’s financial difficulties are the result of two private finance initiative (PFI) deals it signed that have left the trust with debt repayments believed to be around £61m a year. The trust is just one of 22 NHS trusts facing serious financial difficulties because of expensive PFI schemes.1

Under the 2009 Health Act the health secretary has the power to suspend the …
Blinding of Clinical Trials With Concurrent Economic Analysis-Reply
Authors: Nick Freemantle
Journal: JAMA (1997)

<h3>In Reply.</h3> —We provided 2 examples of nonblinded real-world studies in our article, but we agree that it is artificial to consider a divide between real-world trials and those with high construct validity. Economic analyses require real-world estimates of effect (ie, what will be achieved), rather than the estimates of what can be achieved in the context of doubleblind phase 3 clinical trials. In phase 3 trials, artificial circumstances often may be required to ensure that the trial is estimating what the investigators hope to measure. It is more helpful to consider the degree to which the real world is lost in trials. We are describing a continuum rather than a dichotomy. Standard phase 3 trials ask, "Will it work?" whereas an economic trial asks, "Is it worth doing?" These questions have different design implications, and it is rarely possible to answer both with high validity in the same trial. It may
Validity of Reported Genetic Risk Factors for Acute Coronary Syndrome
Authors: William Y.S. Wang
Journal: JAMA (2007)

TotheEditor:Thestudyofgeneticriskfactorsforacutecoronarysyndrome(ACS)byDrMorganandcolleagues 1 callsinto seriousquestionnumerousreportedassociationsbetweenspecificgenesandACS.Ratherthanfindingthisareasontolose hopeofidentifyinggeneticcontributionstoACSorothercommon diseases, we consider it a guide to improving such efforts, serving as a powerful reminder both of the limitations inherentto“candidategene”approachesandtheneedforrigorous replication of research findings before clinical application. This article indicates the maturation of the study of the genetics of common complex disease. Many of the studies that Morgan et al cite relied on educated but inherently biased guesses about genes that might beinvolvedinACS(candidategenes).Thesecandidategenes were then used to look for associations between gene variants and disease in small populations. Although state-ofthe-art a few years ago, the candidate gene approach has yielded few concrete results in complex disease and underscores a fundamental reason that biomedical research is so important: the complexity of human biology often defeats a priori efforts to predict its pathways and only betrays its secrets when we have, in an unbiased fashion, accumulated and properly interpreted sufficient data. Over the next few years, in a largely unbiased way, genomewide association studies will amass a wealth of data on genetic variation associated with common complex disease. The recent discoveries of 5 new loci associated with breast cancer (including 4 genes: FGFR2, TNRC9, MAP3K1, and LSP1), 2 a region of chromosome 8q24 associated with prostate cancer, 3 a region of 9p21 associated with coronary heart disease, 4 and of multiple new genes associated with type 2 diabetes, 5 offerearlyexamplesofhowsuchstudiesmaytransformunderstandingofpathogenesisandofpathwaystotreatment. The genetics community will likely find that a substantial amount of what we thought we understood about complex disease was wrong or at least woefully incomplete. The clinical community will likely find that correct identification of the genes involved will change the way we diagnose, treat, and prevent many common diseases.
Treatment for the Disuse Phenomenon
Authors: Edward A. Talmage
Journal: JAMA (1964)

<h3>To the Editor:—</h3> Inthe Journalcommunication, "Disuse Phenomenon of Lower Extremity: Diagnosis and Treatment" (<b>186</b>:1129 [Dec 28] 1963), the authors describe the course of nine patients with severe disuse phenomenon who underwent sympathectomy. While I heartily agree with the vigorous use of sympathetic nerve blocks as a therapeutic measure in this condition, I advise extreme caution in subjecting many of these patients with chronic disability to sympathectomy until it is well proved that orthostatic hypotension does not develop in the face of a fully effective sympathetic block of the lower extremity. The superimposition of orthostatic hypotension upon an already partially disabled patient seems only to worsen an already bad situation. It should be pointed out that hypertensive subjects are particularly prone to have this disorder after sympathectomy. It would seem more appropriate to reserve sympathectomy for only those patients who fail to respond to a course of repeated
HIV antibodies in babies.
Authors: J. A. Connell, J. V. Parry, P. P. Mortimer, S. M. Burns, A. Klokke, A. De Rossi, C. Giaquinto
Journal: BMJ (1992)

Smith and Taylor as the intravenous route mav be useful in certain circumstances.Until conclusivle advantages have been shown for the intravenous route in allergic emergencies, however, we recominend adherence to the guidelines in the British ANationial Forniularv and preferential use of the intramuscular route.2
Carnival: Putting Away the Flesh and Restoring the OED
Authors: John H. Dirckx
Journal: JAMA (1994)

<h3>To the Editor.</h3> —Dr Murphy's<sup>1</sup>remarks on the etymology of<i>carnival</i>should not be allowed to stand unchallenged. <i>Carnival</i>denotes an orgy of gluttony and revelry celebrated just before the beginning of Lent, the season of penance observed by some Christians in preparation for Easter. Modern linguistic authorities agree in tracing carnival to medieval Latin<i>carnilevaria</i>, "taking away the meat"; abstinence from flesh meats was for many centuries a principal feature of the Lenten observance. The existence and purport of the Latin word are beyond dispute, and its evolution into English<i>carnival</i>and kindred words in other modern languages is well attested, in the opinion of linguists, by intermediate forms. Dr Murphy, branding this etymology "far-fetched and ludicrous," derives carnival instead from a phrase meaning "naval carriages" and referring to wheeled ships or shiplike wagons drawn in procession during spring festivals in honor of the Phoenician love goddess Astarte.
Adding clopidogrel to proton-pump inhibitors was not associated with increased CV risk after MI
Authors: Herbert D. Aronow
Journal: Annals of Internal Medicine (2010)

Source Citation Charlot M, Ahlehoff O, Norgaard ML, et al. Proton-pump inhibitors are associated with increased cardiovascular risk independent of clopidogrel use: a nationwide cohort study. Ann Intern Med. 2010;153:378-86. 20855802
Connective Tissue Growth Factor Is Increased in Plasma of Type 1 Diabetic Patients With Nephropathy
Authors: Peggy Roestenberg, Frans A. van Nieuwenhoven, Lotte Wieten, Peter Boer, Theo Diekman, Anna M. Tiller, Wilmar M. Wiersinga, Noelynn Oliver, William Usinger, Stephen Weitz, Reinier O. Schlingemann, Roel Goldschmeding
Journal: Diabetes Care (2004)

OBJECTIVE—Connective tissue growth factor (CTGF) is strongly upregulated in fibrotic disorders and has been hypothesized to play a role in the development and progression of diabetes complications. The aim of the present study was to investigate the possible association of plasma CTGF levels in type 1 diabetic patients with markers relevant to development of diabetes complications. RESEARCH DESIGN AND METHODS—Plasma CTGF levels (full-length and NH2-terminal fragments) were determined in 62 well-characterized patients with type 1 diabetes and in 21 healthy control subjects. Correlations of these plasma CTGF levels with markers of glycemic control, platelet activation, endothelial activation, nephropathy, and retinopathy were investigated. RESULTS—Elevated plasma NH2-terminal fragment of CTGF (CTGF-N) levels were detected in a subpopulation of type 1 diabetic patients and were associated with diabetic nephropathy. Stepwise regression analysis revealed contribution of albuminuria, creatinine clearance, and duration of diabetes as predictors of plasma CTGF-N level. Elevation of plasma CTGF-N levels in patients with retinopathy was probably due to renal comorbidity. CONCLUSIONS—Plasma CTGF-N levels are elevated in type 1 diabetic patients with nephropathy and appear to be correlated with proteinuria and creatinine clearance. Further studies will be needed to determine the relevance of plasma CTGF as a clinical marker and/or pathogenic factor in diabetic nephropathy.
Reply to Gurdarshan S. Sandhu, Youssef S. Tanagho and Sam B. Bhayani's Letter to the Editor re: Maxine Sun, Quoc-Dien Trinh, Marco Bianchi, et al. A Non-Cancer-Related Survival Benefit Is Associated With Partial Nephrectomy. Eur Urol. 2012;61:725–31
Authors: Quoc-Dien Trinh, Maxine Sun, Pierre I. Karakiewicz
Journal: European Urology (2012)
THE END-RESULTS OF ABDOMINAL CESAREAN SECTION
Authors: E. L. KING
Journal: JAMA (1922)

The gradual extension of the indications for abdominal cesarean section and the growing popularity of this method of operative delivery justify an occasional review of our cases and an inquiry into the ultimate results. Many studies along these lines have been published, but the question as to the proper care at a subsequent labor of the patient who has had a cesarean section is still open for discussion.      It is generally conceded that the immediate results vary according to the previoushandling of the case, and that the chief risk is that of infection following vaginal examinations and manipulations. The mortality and morbidity percentages under ideal conditions should be very low, but these ideal conditions are not encountered in every case. Thus, in 117 abdominal cesarean sections at the Charity Hospital of New Orleans (excluding the Porro cases), there were twelve deaths from peritonitis and two from sepsis; all of these
The illusion of explanation: The experience of volition, mental effort, and mental imagery
Authors: Zenon Pylyshyn
Journal: Behavioral and Brain Sciences (2004)

This commentary argues that the “illusion” to which Wegner refers in The Illusion of Conscious Will is actually the illusion that our conscious experience of mentally causing certain behaviors explains the behavior in question: It is not the subjective experience itself that is illusory, but the implied causal explanation. The experience of “mental effort” is cited as another example of this sort of illusion. Another significant example is the experience that properties of the representation of our mental images are responsible for certain patterns of behavior observed in mental imagery experiments. Examples include the increase in reaction time found when details are reported from smaller images or when attention is switched between different places and features (imagined as further apart than they are) within a single image. These examples illustrate the nature of the “illusion” involved: It is the illusion that certain observed regularities occur because of the content of the experience, as opposed to the converse – that experience has the content it does because of what the person figures out would happen in the imagined situation.
Endothelial Dysfunction in the Microcirculation of Patients with Obstructive Sleep Apnea
Authors: Brian T. Patt, David Jarjoura, Diane N. Haddad, Chandan K. Sen, Sashwati Roy, Nicholas A. Flavahan, Rami N. Khayat
Journal: American Journal of Respiratory and Critical Care Medicine (2010)

Obstructive sleep apnea (OSA) is a risk factor for cardiovascular disease. We hypothesized that patients with OSA and no cardiovascular disease have oxidant-related microcirculatory endothelial dysfunction.To evaluate the microcirculation in OSA.This study included seven patients with OSA and seven age- and weight-matched control subjects (mean age, 38 yr; mean body mass index, 32.5 kg/m²). All participants were free of cardiovascular risk factors. Participants received measurement of brachial artery flow-mediated dilation and forearm subcutaneous biopsy. Patients underwent repeated tests 12 weeks after treatment. Microcirculatory endothelial cells were isolated, and immunohistochemistry staining for peroxynitrite in the microcirculation was performed.Flow-mediated dilation was lower in patients than in control subjects at baseline (mean ± SEM: 5.7 ± 0.5 vs. 9.5 ± 0.6; P = 0.02) and increased after treatment (5.7-7.3; change, 1.7 ± 0.6; P = 0.04). Microcirculatory peroxynitrite deposit was higher in patients compared with control subjects (44.0 ± 1.6 vs. 21.8 ± 1.9 stain density units; P < 0.001) and decreased after treatment from 44.0 to 30.5 stain density units (change, -13.5 ± 2.9; P = 0.009). In patients, transcription of endothelial nitric oxide synthase decreased from 5.2 to -1.3 after treatment (change, 6.5 ± 2.5; P = 0.05), and transcription of superoxide dismutase1 decreased from -4.0 to -12.3 after treatment (change, -8.3 ± 2.1; P = 0.01). These changes persisted after adjustment for weight and underlying severity of OSA.This is the first direct evaluation of the microcirculation in OSA. Patients with OSA with low cardiovascular risk status had increased oxidant production in the microcirculation and endothelial dysfunction, both of which improved with treatment. Endothelial nitric oxide synthase transcription decreased with treatment.
Modern Governmental Medical Problems
Authors: R. W. Bliss
Journal: New England Journal of Medicine (1946)

MY brief remarks will be made from the viewpoint of one who has spent his life in the Army Medical Corps. This viewpoint, however narrow, has been broadened by the experience of two wars and the intimate association in them with mobilized civilian medicine and, between wars, a more limited association with my civilian colleagues. This country has just been through not only the biggest war in its history but also the biggest medical operation in the history of the world. I believe that everyone can profit by reviewing this experience. My comments will be limited to a review of . . .
114. Efficient Arterial Formation at the Sites of Adult Neo-Angiogenesis Requires the Recruitment of Bone Marrow Cells through the Neuropilin-1 (NP-1) Receptor
Authors: Serena Zacchigna, Nikola Arsic, Lucia Pattarini, Silvia Moimas, Alessandro Carrer, Lorena Zentilin, Alessandro Salvi, Gianfranco Sinagra, Mauro Giacca
Journal: Molecular Therapy (2005)

The potential use of bone marrow-derived cells (BMCs) to promote new blood vessel formation, recapitulating vasculogenesis in the adult, has recently aroused much excitement, and a rapid transposition to the clinic. However, new experimental evidence has challenged this notion, demonstrating that BMCs transplanted into ischemic tissues still adopt mature hematopoietic fates and do not transdifferentiate into vascular structures. To better define the actual role of bone marrow-derived cells in the formation of new blood vessels, we developed a series of AAV vectors to drive the persistent expression of several factors, differing in their capacity to promote angiogenesis and to recruit BMCs.
A clinical and immunological study of Netherton's syndrome
Authors: M.R. JUDGE, G. MORGAN, J.I. HARPER
Journal: British Journal of Dermatology (1994)

Netherton's syndrome is a rare genodermatosis of unknown cause, which is classified as an ichthyosiform syndrome. A clinical and immunological study of seven patients with Netherton's syndrome illustrates the clinical spectrum of this disorder, the frequent association with atopy, and the absence of consistent immunological abnormalities. Failure to thrive in infancy was a feature in six of the seven patients, and was considered to be life-threatening in three. The skin disease evolved into ichthyosis linearis circumflexa in four of the seven, and the remaining three patients suffered from persistent or recurrent ichthyosiform erythroderma.