tbuckley/cabot-search huggingface dataset:
German ethics council demands opt-out system for transplants
Authors: Annette Tuffs
Journal: BMJ (2007)

An influential German advisory body is proposing a change in the law on organ donation so that it is assumed that everyone in the country has agreed to be a donor after death unless they have specifically opted out by registering their objection to donation. 

The proposal from the German National Ethics Council has had a mixed reception, with opposition coming from politicians and a doctors' organisation.

The council's paper, published in April, was designed as an urgent response to the plight of the 12 000 German patients waiting for organs by asking for a change in legislation. Every year about 1000 patients die while awaiting a transplant.

The council, which is independent, issues regular statements and opinion papers on important ethical topics (www.ethikrat.org). It has up …
Dissociation of bradykinin-induced plasma exudation and reactivity in the peripheral airways.
Authors: A R Berman, M C Liu, E M Wagner, D Proud
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

To determine if bradykinin, a potential mediator of asthma, acts, at least in part, at the level of the peripheral airways, we used a wedged bronchoscope technique to study asthmatic and normal subjects. Baseline peripheral airways resistance (Rp) was measured in the right upper lobe. Subjects then received saline, followed by increasing doses of bradykinin, aerosolized through the bronchoscope. Rp was measured after each challenge. At the end of the procedure, bronchoalveolar lavage was performed in both the challenged and a control segment. Fibrinogen content of recovered lavage fluids was measured as an index of plasma exudation. Bradykinin induced a dose-dependent increase in Rp in the asthmatics, but did not effect Rp in normal subjects. In asthmatics, there was no significant correlation between peripheral airways reactivity and whole lung reactivity to bradykinin. Fibronogen increased significantly in both groups after bradykinin challenge, and there was no significant difference between postchallenge levels for the two groups. Thus, hyperreactivity of the peripheral airways in asthmatics is not directly due to plasma exudation. The ability of bradykinin to increase peripheral airways resistance in asthmatic, but not in normal, subjects is consistent with a role of this peptide as a mediator of asthma.
A Further Fond Farewell to Shy and Drager
Authors: W. King Engel
Journal: Annals of Internal Medicine (1997)

Letters15 February 1997A Further Fond Farewell to Shy and DragerW. King Engel, MDW. King Engel, MDUniversity of Southern California School of Medicine, Los Angeles, CA 90017-1912.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-4-199702150-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The recent editorial, “Farewell to the ‘Shy-Drager Syndrome’” [1], prompts this brief illumination of the men involved in the discovery of the syndrome. I was in the group at the time of the syndromogenesis and knew the three participants-G. Milton Shy, Glenn A. Drager, and their patient-very well.Milton Shy was a brilliant clinical investigator with a remarkable capacity to sense a new syndrome. He had recently described “central core disease” (I encouraged him to publish that name, which he had been using informally). Although the day's two muscle-pathology pundits believed the lesions were artifacts, Dr. Shy ...REFERENCE1. Schatz IJ. Farewell to the “Shy-Drager” syndrome [Editorial]. Ann Intern Med. 1996; 124:74-5. Google Scholar Author, Article, and Disclosure InformationAuthors: W. King Engel, MDAffiliations: University of Southern California School of Medicine, Los Angeles, CA 90017-1912. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 February 1997Volume 126, Issue 4Page: 334KeywordsBrainBrain diseasesCentral nervous systemHyperthermiaHypotensionLesionsMuscle tissueNeuromuscular diseasesNeuropathologySpinal cord ePublished: 15 August 2000 Issue Published: 15 February 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Prediction of the Depressive Effects of Interferon Alfa Therapy by the Patient's Initial Affective State
Authors: Lucile Capuron, Alain Ravaud
Journal: New England Journal of Medicine (1999)

To the Editor: The study by Leon et al. (Dec.3 issue) 1 comparing three antithrombotic-drug regimens -aspirin alone, aspirin and warfarin, and aspirin and ticlopidineafter coronary stenting showed a lower rate of stent thrombosis with aspirin and ticlopidine, although there were more hemorrhagic complications than with aspirin alone.By contrast, there were no significant differences in the incidence of neutropenia or thrombocytopenia among the three regimens (overall incidence, 0.3 percent).Despite the absence of severe hematologic dyscrasias in the study, the authors refer to reports of the risk of serious hematologic complications, such as thrombotic thrombocytopenic purpura, among patients who received ticlopidine after coronary stent placement.However, they did not mention the risk of aplastic anemia, a life-threatening condition that may be induced by ticlopidine.Recently, Yeh et al. reviewed the cases of ticlopidine-induced aplastic anemia published in the English literature, 2 and four other cases have been reported 3,4 (including one case reported by us).Ten of 23 patients died (43 percent): 7 because of infection (candidal and gram-negative sepsis) and 1 from massive gastrointestinal bleeding.The only factor significantly correlated with survival was the patients' age.Other factors, such as sex, duration of ticlopidine use, and the presence of agranulocytosis at onset, had no prognostic value. 2 Although the pathogenesis of marrow toxicity related to this drug is still unclear, both direct toxicity and immunologic effects have been proposed. 2The therapeutic use of hematopoietic growth factors has been suggested, 4 but this treatment seems to have little effect on survival. 2,3n summary, although it is an infrequent event, ticlopi-dine-induced marrow aplasia is possible, and patients and doctors should be aware of it.However, aplastic anemia, like other hematologic dyscrasias induced by ticlopidine, appears after 2 weeks of treatment, 2-4 whereas stent thrombosis generally occurs within the first 14 days after coronary stenting (a mean of 0.7 day in the study by Leon et al.). 1 So, we agree with the suggestion made by Leon et al.to shorten the duration of ticlopidine therapy after stenting to two weeks.
Abstract A56: Spontaneous aggregation and novel signalosome organization of BENTA-associated gain-of-function CARD11 mutants in lymphocytes
Authors: Jeffrey Richard Stinson, Andrew L. Snow
Journal: Cancer Research (2013)

Abstract Antigen receptor (AgR)-induced NF-κB activation is a critical determinant of lymphocyte growth and survival. However, constitutive NF-κB activity can drive excessive lymphoproliferation and oncogenesis. We recently described a novel human lymphoproliferative disorder designated as BENTA (B cell Expansion with NF-κB and T cell Anergy), caused by germline gain-of-function mutations in the lymphocyte-specific scaffolding protein CARD11. Similar, somatic CARD11 mutations are found in ~10% of activated B cell-type diffuse large B cell lymphomas (ABC-DLBCL). Normally, AgR ligation converts CARD11 into an active conformation that nucleates a large multi-protein signalosome incorporating BCL10, MALT1, and other components that ultimately facilitate activation of IκB kinase (IKK) and nuclear translocation of NF-κB. We have now identified four different heterozygous CARD11 missense mutations (E134G, G123S, G123D, C49Y) in affected patients. Similar to BENTA patient cells and DLBCL tumors, ectopic expression of each mutant triggers constitutive NF-κB activation in B and T cell lines without AgR stimulation. Using confocal microscopy, we now demonstrate that these CARD11 mutants form large, spontaneous perinuclear aggregates with a novel, shell-like substructure. While BCL10 is largely excluded, other signaling components such as MALT1 and phospho-IκB kinase (IKK) are found within or closely colocalized with CARD11 shells, suggesting these aggregates are sites of active signaling. Our results provide the first evidence that gain-of-function CARD11 mutants assemble into a compartmentalized, active signalosome with a distinct structural organization. Further imaging and biochemical analysis of these aggregates will provide new insights into aberrant CARD11 signaling in BENTA patient lymphocytes and DLBCL tumors harboring active CARD11 mutations. Citation Format: Jeffrey Richard Stinson, Andrew L. Snow. Spontaneous aggregation and novel signalosome organization of BENTA-associated gain-of-function CARD11 mutants in lymphocytes. [abstract]. In: Proceedings of the Third AACR International Conference on Frontiers in Basic Cancer Research; Sep 18-22, 2013; National Harbor, MD. Philadelphia (PA): AACR; Cancer Res 2013;73(19 Suppl):Abstract nr A56.
Modulation of myocardial relaxation by basal release of endothelin from endocardial endothelium
Authors: H. G Evans, M. J Lewis, A. M Shah
Journal: Cardiovascular Research (1994)

Journal Article Modulation of myocardial relaxation by basal release of endothelin from endocardial endothelium Get access Huw G Evans, Huw G Evans University of Wales College of Medicine, Heath Park, Cardiff CF4 4XN, United Kingdom — Department of Cardiology: A M Shah; Department of Pharmacology and Therapeutics: H C Evans, M J Lewis. Correspondence to Dr Shah. Search for other works by this author on: Oxford Academic PubMed Google Scholar Malcolm J Lewis, Malcolm J Lewis University of Wales College of Medicine, Heath Park, Cardiff CF4 4XN, United Kingdom — Department of Cardiology: A M Shah; Department of Pharmacology and Therapeutics: H C Evans, M J Lewis. Search for other works by this author on: Oxford Academic PubMed Google Scholar Ajay M Shah Ajay M Shah University of Wales College of Medicine, Heath Park, Cardiff CF4 4XN, United Kingdom — Department of Cardiology: A M Shah; Department of Pharmacology and Therapeutics: H C Evans, M J Lewis. Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 28, Issue 11, November 1994, Pages 1694–1699, https://doi.org/10.1093/cvr/28.11.1694 Published: 01 November 1994 Article history Received: 03 March 1994 Accepted: 29 July 1994 Published: 01 November 1994
Use of the Laboratory in a Teaching Hospital
Authors: Paul F. Griner, Benjamin Liptzin
Journal: Annals of Internal Medicine (1971)

Laboratory studies contribute significantly to the cost of hospitalization. Arguments for the liberal use of laboratory tests are countered by concern over costs and the need for young physicians to develop bedside skills. This report reviews the current use of laboratory services for patients hospitalized on the Medical Service of the University of Rochester Medical Center. During a 14-day hospitalization the average patient received 69 tests at a cost of $469, or roughly one fourth of the hospital bill. Patterns of laboratory use may bear little relation to the needs of the patient for optimal care. The data suggest that follow-up laboratory studies are excessive. The house staff has responded to these data by identifying factors contributing to overuse and by developing rational guidelines for the optimal use of laboratory tests. Further studies are necessary to determine how often the results of laboratory tests influence diagnostic or therapeutic decisions or affect the outcome of care.
Phenotypic analysis of alveolar macrophages in normal subjects and in patients with interstitial lung disease.
Authors: D A Campbell, L W Poulter, R M Du Bois
Journal: Thorax (1986)

Cytospin preparations of mononuclear inflammatory cells were made from bronchoalveolar lavage fluid obtained from 15 patients with interstitial lung disease (nine patients with sarcoidosis and six patients with cryptogenic fibrosing alveolitis) and six control subjects. These preparations were examined with a panel of monoclonal antibodies that have been shown to distinguish subpopulations of macrophage like cells in normal tissues. The lysosomal acid phosphatase activity of the cells was also assessed. Phenotypically distinct subpopulations of alveolar macrophages were identified in all samples studied. The results showed that all cell populations identified in bronchoalveolar lavage fluid from the groups with interstitial lung disease could be identified in the lavage fluid from normal volunteers. Some quantitative differences in the proportions of cells identified with particular reagents emerged. In each of the groups with interstitial lung disease increased proportions of cells were identified with RFD1 (interdigitating cell marker; p less than 0.01) and in the cryptogenic fibrosing alveolitis group an increased proportion of alveolar macrophages was identified with RFD7 (tissue macrophage marker; p less than 0.05). The possibility that quantitative changes in alveolar macrophage subsets observed in the interstitial lung disease groups are relevant to the pathogenesis of these conditions is discussed.
TUMOR OF THE CAROTID BODY
Authors: A. Clifford Abbott
Journal: JAMA (1934)

Tumors of the carotid body are so rare that few surgeons see more than one in a lifetime. In 1929, Bevan and McCarthy1collected and tabulated 134 reported cases. From their series it is strikingly apparent that operative removal of these growths is associated with a very high mortality (33 per cent) and a long list of complications (30 per cent).  The following case was attended by one of us:  A woman, aged 53, sought medical advice in April, 1931, because of dyspnea, tachycardia, nervousness, irritability and dizzy spells. There had also been some dysphagia. For nine years she had noticed a small nodule below the angle of the left mandible, and for the last five years the thyroid had been increasing in size. The small nodule at the angle of the mandible had enlarged gradually and at times became very painful. This pain radiated to the left postauricular
Problems of new overseas doctors in the United Kingdom
Authors: M Z Shaheen
Journal: BMJ (1991)

least when temperature has stabilised and temporary disruptions have passed, would be beneficial.Scientific assessments of emotive topics of this kind have in the past been notoriously subject to distortion by public misconceptions.The belief that 100 000 British people died of hypothermia in cold houses every winter persisted for many years, and it still does in some quarters.In fact, recorded deaths from hypothermia never exceeded 500 per year, and such deaths indoors virtually all result from collapse due to other illness.2These mis- apprehensions seriously delayed scientific work on the subject despite longstanding evidence that many deaths in winter are caused by arterial thrombosis.'This arterial mortality has been little affected by home heating and is apparently due mainly to haematological changes produced by excursions outdoors in cold weather."Deaths in winter from respiratory causes, which are less numerous, have by contrast fallen with the increase in central heating in Britain in recent years.Seasonal mortality and age structure of population in England and Wales and Mediterranean countries England and Wales Portugal Greece Increase in mortality January-March vz Julv
Microcirculatory changes in rat skeletal muscle in sepsis.
Authors: R D Piper, M Pitt-Hyde, F Li, W J Sibbald, R F Potter
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

The aim of this study was to confirm that microvascular perfusion was abnormal during the early phases of normotensive sepsis and to determine whether these changes were due to the development of tissue edema. Skeletal muscle red blood cell (RBC) flow was studied in rats made septic by cecal ligation and perforation (CLP). After anesthesia with halothane, arterial and venous cannulae were inserted and, in the treatment group, a CLP performed. At 6, 24, and 48 h after entry into the study, the incidence of microcirculatory absence of flow in the extensor digitorum longus muscle (EDL) was examined with intravital microscopy. The number of capillaries containing RBCs were counted over a 60-s interval, and the flow status of each capillary was recorded. A significant increase in the number of stopped-flow capillaries was observed in the CLP group (p < 0.01) as compared with time-matched controls. In both groups the number of capillaries with stopped flow was greater than in naive animals. The severity of absence of flow was negatively correlated with the systemic hemoglobin concentration. These changes were not associated with an increase in tissue wet/dry weight ratio or albumin flux. This study shows that sepsis was associated with increased RBC flow heterogeneity. These changes, which occur within 24 h of the septic insult, are a persistent feature of the evolving septic process in the absence of tissue edema. These observations support the view that extrinsic compression of the microcirculation by tissue edema is not the primary cause of alterations in microcirculatory flow in sepsis.
TWO CASES OF PARALYSIS
Authors: Daniel H. Kitchen
Journal: American Journal of Psychiatry (1874)

altered by some morbid affections.In consequence of the action of such hardening agents as alcohol, chromic acid, bichromate of potash and ammonia, osmic acid and others, we have to deal with so many changes of the normal structure, that the ti-ue anatomical conditions are demonstrated, sometimes only with great difficulty.
CD40 and OX40 ligand are differentially regulated on asthmatic airway smooth muscle
Authors: D. I. Krimmer, M. Loseli, J. M. Hughes, B. G. G. Oliver, L. M. Moir, N. H. Hunt, J. L. Black, J. K. Burgess
Journal: Allergy (2009)

Background: CD40 and OX40 Ligand (OX40L) are cell‐surface molecules expressed on airway smooth muscle (ASM) that can enhance inflammatory cell activation and survival. The aim of this study was to examine the effect of tumour necrosis factor‐alpha (TNF‐α) and interferon‐gamma (IFN‐γ) on ASM CD40 and OX40L expression. Methods: CD40 and OX40L expression on human ASM cells from asthmatic and nonasthmatic donors following stimulation with TNF‐α and/or IFN‐γ was measured using cell‐surface enzyme‐linked immunosorbent assay (ELISA) and flow cytometry. Involvement of signalling pathway was investigated with pharmacological inhibitors. Soluble TNF receptor levels were quantified by ELISA. Results: Interferon‐γ and TNF‐α synergistically increased CD40 expression to a greater extent on asthmatic than on nonasthmatic ASM. In contrast, IFN‐γ reduced TNF‐α‐induced OX40L expression to a similar extent in both cell types. TNF‐α and IFN‐γ induced CD40 via nuclear factor‐κB (NF‐κB) and signal transducer and activator of transcription‐3 in both cell types and modulated OX40L via NF‐κB and c‐Jun N terminal kinase in nonasthmatic cells. Similar effects on the induction of OX40L in asthmatic cells were seen with NF‐κB, but these were not statistically significant. The reduced OX40L expression with TNF‐α and IFN‐γ involved extracellular regulated kinase 1/2 activation. Conclusion: Asthmatic ASM may modulate airway inflammation locally by increasing CD40 and OX40L expression in response to cytokines. IFN‐γ may regulate ASM pro‐inflammatory actions by differentially modulating ASM CD40 and OX40L expression.
REPORT ON ABDOMINAL AND PELVIC SURGERY.Report of the Chairman of the Committee on Abdominal and Pelvic Surgerys, read before the Kentucky State Medical Society, May 6, 1892.
Authors: WILLIAM H. WATHEN
Journal: JAMA (1892)

There is probably no department of surgery that has been carried to a greater extreme by enthusiasts and record makers than laparotomy. This fact has become so flagrantly manifest that there is a general protest from the honest, learned and conservative abdominal and pelvic surgeons against the unnecessary and sometimes criminal mutilation of women by ignorant and unscrupulous men. At the meeting of the American Gynecological Society at Washington, in September, 1891, composed of men who are as learned and successful surgeons as any in the world, there was a determined and nearly universal effort to impress upon the medical profession the wisdom and benefits of conservative gynecology, and the evil of too much needless mutilation in laparotomy. Dr. A. Doleris has fearlessly discussed the subject "Too many Needless Mutilations—not enough Conservative Gynecology," in the July and August numbers of the Nouv. Arch. d'Obst. et de Gyn. His extensive
Court rules that patients can seek treatment in any EU country
Authors: R. Watson
Journal: BMJ (1998)

British government lawyers are anxiously studying the implications for the National Health Service of two landmark judgments from the European Court of Justice in Luxembourg.

The court — the European Union's highest legal authority — ruled last week that patients could seek medical treatment in another EU country and be reimbursed when they returned home.

The EU judges declared that patients did not need the prior authorisation of their own health authority or health insurance company before seeking treatment elsewhere. They said that such a requirement ran counter to European Union rules which are designed to break down …
Renal Tubular Acidosis in Cirrhosis
Authors: Leroy Shear, Herbert L. Bonkowsky, George J. Gabuzda
Journal: New England Journal of Medicine (1969)

Of 15 patients with hepatic cirrhosis in whom renal acid excretion and potassium conservation were studied, urinary pH fell normally after acid loading in four, and the response was borderline in two and clearly abnormal in nine. Blood pH before acid loading and total hydrogen ion excretion after acidification were normal in most patients. However, titratable acidity of urine was reduced, and ammonium excretion increased. Two patients had a more severe defect with low rates of total hydrogen ion excretion and "spontaneous" metabolic acidosis. Impaired renal potassium conservation accompanied the acidification abnormality in six patients. Hypercalciuria was present in two, and renal glycosuria in one. The coexistence of renal tubular acidosis and cirrhosis may explain why some cirrhotic patients readily become hypokalemic and remain so despite treatment with potassium salts. Renal tubular acidosis, through its effects on ammonium metabolism, may also make some patients susceptible to recurrent episodes of hepatic precoma.