tbuckley/cabot-search huggingface dataset:
The working day in general medicine
Authors: George I Varughese, Sanjaya U Dissanayake
Journal: Journal of the Royal Society of Medicine (2005)

Professor Vallance (May 2005 JRSM1) comments on the decline in status of general medicine by comparison with the 'organ-based silos'. Part of the explanation for its slip down the hierarchy lies in the pressures put upon today's general physicians by other specialties. For example, during our last 'take' day, we had to admit two patients with fractures who would not be needing urgent operation; then casualty asked us to take a patient with acute abdomen into the medical admissions unit, because the surgical registrar was in theatre; then there was a request from the maxillofacial team to admit 'under the medics' a patient who had bled excessively after an extraction; and an hour later surgical colleagues asked us to take over the conservative care of a patient with cholecystitis because they were uncertain how to manage her atrial fibrillation (which she had had for ten years and was well controlled). The continued spate of referrals included a request from a general practitioner to admit a patient with diverticulitis, because he felt that the surgeons would not buy his story. The psychiatry team then wanted to transfer to the medical team a patient on warfarin therapy, which they would find difficult to monitor over the weekend. At the end of the shift the site manager was trying to convince us to discharge two elderly patients to their own homes despite the fact that they lived alone and it was 9 o'clock at night. This was all amidst the five patients who needed decisions on resuscitation status despite the fact that they had been in hospital for more than two weeks under our own medical colleagues. One can only guess how difficult it would be to convince the juniors on the team to pursue general medicine as a career 'full of challenges and variety'.
Stroke Care Projected to Add Up to More Than Previously Thought
Authors: Rita Rubin
Journal: JAMA (2014)

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Abstract 4836: RB/E2F1 in the crossroad of autophagy and apoptosis
Authors: Hong Jiang, Vanesa Martin, Candelaria Gomez-Manzano, David G. Johnson, Marta Alonso, Erin J. White, Jing Xu, Timothy J. McDonnell, Naoki Shinojima, Juan Fueyo
Journal: Cancer Research (2010)

Abstract Autophagy is a protective mechanism that renders cells viable in stressful conditions. Mounting evidence suggests that this cellular process is also a tumor suppressor pathway. We hypothesized that retinoblastoma protein (RB), a key tumor suppressor, induces autophagy. To test this hypothesis, we first transduced RB into RB-defective human cancer cells: sarcoma osteogenic (Saos-2) cells, hepatoma (Hep3B) cells, and brain tumor stem cells (MDNSC23). The ectopic RB induced autophagy as demonstrated by significantly increased percentage of cells with acidic vesicular organelles (from less than 10% to more than 30%, P &amp;lt; 0.05), and the lipidation of LC3-I leading to the formation of autophagosomes/autolysosomes that were visualized by EGFP-LC3 punctation (from less than 20% to more than 80%, P = 0.003). These double-membraned vesicles were clearly shown by ultrastructural study via transmission electron microscopy. However, when Beclin 1 was silenced with siRNA in Saos-2 cells, the RB-mediated autophagy was blocked. In addition, study of autophagy flux with Saos-2 cells expressing double-tagged mRFP-EGFP-LC3 fusion protein revealed that RB stimulated the formation and maturation of autophagosomes. Consistently, RB activators p16INK4a and p27/kip1 caused autophagy in an RB-dependent manner. Importantly, we found RB mutants Delta-22 and R661W deficient for binding E2F failed to induce autophagy. Moreover, E2F1 overexpression antagonized RB-mediated autophagy, leading to apoptosis in Saos-2 cells. In agreement with the above observations, silencing E2F1 with siRNA resulted in autophagy in U-87 MG cells; and autophagy levels increased from 4% in wild-type MEFs to 40% in E2F1 knockout MEFs (P = 0.002). Collectively, our data reveal that RB/E2F1 plays a key role in the decision of a cell to undergo autophagy or apoptosis. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4836.
Effect of Antibiotics on the Serum Cholesterol Concentration of Patients with Atherosclerosis
Authors: ALFRED STEINER, ELLIOTT HOWARD, SUAT AKGUN
Journal: Circulation (1961)

Oral neomycin, at the dose level of 0.5 to 2 Gm. daily, produced a significant fall in the level of serum cholesterol in all of 29 periods in 20 patients studied. The effect reached a maximum in approximately 2 weeks and persisted for the duration of the experiments up to 9 months. After the medication was discontinued, the serum cholesterol levels returned to control values within 2 weeks. No significant toxic reaction to oral neomycin was discernible. Neomycin by injection in excess of the amount calculated to be absorbed from the gastrointestinal tract failed to lower the serum cholesterol level. The mechanism of action of neomycin was not determined, but it is thought to be a local effect in the gastrointestinal tract or its contents. Oral aureomycin and oral kanamycin had a similar but less marked and less consistent effect on the level of serum cholesterol in a number of patients. In a limited number of patients, oral achromycin, bacitracin, chloromycetin, streptomycin, and mycostatin did not have a significant effect on the serum cholesterol level; likewise, intramuscular penicillin and streptomycin failed to alter the serum cholesterol level. The prior lowering of the serum cholesterol concentration by a low-fat diet did not prevent a further decrease in the serum cholesterol by oral neomycin.
DYSTROPHIN GENOTYPE-CARDIAC PHENOTYPE CORRELATIONS IN DUCHENNE AND BECKER MUSCULAR DYSTROPHY USING CARDIAC MAGNETIC RESONANCE IMAGING
Authors: Animesh Tandon, John Jefferies, Kan Hor, Brenda Wong, Stephanie Ware, Wojciech Mazur, Robert Fleck, Zhiqian Gao, Joshua Sticka, D. Woodrow Benson, Michael Taylor
Journal: Journal of the American College of Cardiology (2014)
Chemoimmunotherapy for relapsed/refractory and progressive 17p13‐deleted chronic lymphocytic leukemia (CLL) combining pentostatin, alemtuzumab, and low‐dose rituximab is effective and tolerable and limits loss of CD20 expression by circulating CLL cells
Authors: Clive S. Zent, Ronald P. Taylor, Margaret A. Lindorfer, Paul V. Beum, Betsy LaPlant, Wenting Wu, Timothy G. Call, Deborah A. Bowen, Michael J. Conte, Lori A. Frederick, Brian K. Link, Sue E. Blackwell, Suresh Veeramani, Nisar A. Baig, David S. Viswanatha, George J. Weiner, Thomas E. Witzig
Journal: American Journal of Hematology (2014)

Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) patients with purine analog refractory disease or TP53 dysfunction still have limited treatment options and poor survival. Alemtuzumab‐containing chemoimmunotherapy regimens can be effective but frequently cause serious infections. We report a Phase II trial testing the efficacy and tolerability of a short‐duration regimen combining pentostatin, alemtuzumab, and low‐dose high‐frequency rituximab designed to decrease the risk of treatment‐associated infections and to limit the loss of CD20 expression by CLL cells. The study enrolled 39 patients with progressive CLL that was either relapsed/refractory ( n = 36) or previously untreated with 17p13 deletion (17p13−) ( n = 3). Thirteen (33%) patients had both 17p13− and TP53 mutations predicted to be dysfunctional, and eight patients had purine analog refractory CLL without TP53 dysfunction. Twenty‐six (67%) patients completed therapy, with only five (13%) patients having treatment‐limiting toxicity and no treatment‐related deaths. Twenty‐two (56%) patients responded to treatment, with 11 (28%) complete responses (four with incomplete bone marrow recovery). Median progression‐free survival was 7.2 months, time to next treatment was 9.1 months, and overall survival was 34.1 months. The majority of deaths (82%) were caused by progressive disease, including transformed diffuse large B‐cell lymphoma ( n = 6). Correlative studies showed that low‐dose rituximab activates complement and natural killer cells without a profound and sustained decrease in expression of CD20 by circulating CLL cells. We conclude that pentostatin, alemtuzumab, and low‐dose high‐frequency rituximab is a tolerable and effective therapy for CLL and that low‐dose rituximab therapy can activate innate immune cytotoxic mechanisms without substantially decreasing CD20 expression. Am. J. Hematol. 89:757–765, 2014. © 2014 Wiley Periodicals, Inc.
THE DIAGNOSIS AND TREATMENT OF A COMMON FORM OF DYSPEPSIA AND OF EARLY TUBERCULOUS INFECTION IN CHILDREN
Authors: A. Dingwall-Fordyce
Journal: BMJ (1910)

On Admis8ion.-Thetemperature was 1020 F., and pulse 130.She looked ver.V ill.The `abdomen was rigid and tender, very much distended and tympanitic.Liver dullness was absent.Previous History.-Pain and vomiting after food for some considerable time.Operation twenty-seven hours after perforation.On opening the abdomen above the umbilicus, gas and free fluid escaped.On the anterior wall of the stomacb, near the pylorus, a per- for$tion was found in the centre of a sloughy area of con- siderable extent.The stomach was markedly enlarged.'The perforation and slough were infolded with layers of Lembert sutures, and on account of the narrowing of the pyloric aperture I performed a posterior gastro-enterostomy at the same time.Drainage tubes were inserted locally, as well as above the pubes .and in the right flank.Recovery.Dismissed June 13th.CASE VI.W. J., a man aged 45, was admitted on September 10th, 1908.This patient was seen by Dr. Halkett, and sent in within a few hours of perforation.On Admission.-Histemperature was 96.40 F., pulse 64, respiratioius 28.He complained of dull aching pain in the left lhypochondrium.There was absolute rigidity of both sides of the abdomen, with great tenderness in the epigastrium.No ,vomiting.P-revious History.-Heaviness in the stomach, and slight pain ,two hours after food, for the past week.Operation four hours after perforation.On opening the ,abdomen both gas and fluid escaped.The pyloric end of the ,stomach was bound down by adhesions, and could not be raised up.A small perforation was found in the anterior wall of the duodenum, quite close to the pylorus.This was closed with a double layer of catgut sutures.Drainage tubes were inserted -above the pubes and in both flanks, and a small gauze drain in ,the upper wound.Recovery.CASE VII.P. W., a man aged 29, was admitted on September 15th, 1908, -as a case of peritonitis of fouir days' duration.On Sep- tember 10th, after a meal of cornflour, he was seized with sudden severe paip in the epigastrium, which doubled him up.The pain gradually got easier, but recurred on September 12th, -and extended to the lower abdomen.Since September 13th pain had been constant under the right costal margin.He has not been sick nor vomited.On Admission.-Temperature101.40 F., pulse 100, respirations :22.He felt fairly comfortable but for the epigastric pain.The upper part of the right rectus is rigid, and here there is marked ,tenderness, and dullness to percussion.Previous History.-Forfive years he has had discomfort and ,pain two hours after food, and three years ago had an attack ,similar to the present, but not so severe.
Effect of global vs regional ischaemia upon myocardial contractility and oxygen balance
Authors: E. FURMAN, B.-A. ACAD, J. SONN, A. RAUL, J. KEDEM
Journal: Cardiovascular Research (1985)

The possible role of catecholamines upon the nature of myocardial response to regional and global left ventricular ischaemia was investigated. Global ischaemia was accomplished by temporary occlusion of the left main coronary artery and regional ischaemia by temporary ligation of the left anterior descending coronary artery. Isometric force of contraction was measured with strain gauge arches, regional blood flow by a thermistor technique and intracellular NADH redox level by a fluorometric technique. These measurements were made simultaneously in two areas on the left ventricular myocardium: one immediately below the bifurcation of the LAD and the other immediately below the circumflex coronary artery. Following LAD occlusion a variable inotropic response was observed in the ischaemic area. A decrease in contractile tension was found in 19 of the dogs (44%), no change in 23% and an increase was found in 33%. Global ischaemia invariably resulted in a decrease in contractile tension. NADH redox state was markedly higher during global than during regional ischaemia. Propranolol administration blocked the positive inotropic response to regional ischaemia. It is concluded that endogenous catecholamine release may be responsible for increased contractile force during regional ischaemia. This response is apparently limited by the oxygen availability to the tissue.
Abstract 1854: Metabolic cross talk between omental derived adipose stromal cells from lean and obese patients with ovarian cancer cells.
Authors: Bahar Salimian Rizi, Alexandra Nowicka, Ann H. Klopp, Deepak Nagrath
Journal: Cancer Research (2013)

Abstract Advanced-stage ovarian cancers have been shown to be metastatic in peritoneal cavity. Ovarian cancer metastasis is diagnosed primarily in omentum which is a soft fatty pad that extends from stomach and covers the bowel. The location of excess adipose tissue appears to be an important factor which influences the effect of obesity on cancer incidence. For example, increased total body obesity is associated with relative risk of 1.14 of developing ovarian cancer. However, a waist to hip circumference ratio of &amp;gt;0.85 is associated with a much higher 8-fold increased risk of developing ovarian cancer. Individuals with greater waist to hip ratio generally have more visceral adipose including omental adipose. The tumor promoting effects of regional adipose may be attributed, at least in part, to the presence of a population of mesenchymal stem cells (MSC) in adipose tissue. Adipose stem cells or adipose derived stromal cells (ASCs) are a multi-potent population of mesenchymal stem cells, which support cancer progression in many models. These cells are uniquely tumor tropic, migrating into tumor stroma from regional sources where they support formation of tumor stroma elements and promote tumor progression. Here, we use metabolic foot-printing approach to dissect the metabolic networks regulated by ASCs and ACs, as well as their role in imparting drug resistance to tumors by deregulating metabolic pathways in ovarian cancer cells. Importantly, we found that O-ASCs from obese patients differentially induce metabolic reprogramming in cancer cells and that cancer cells induce reciprocal metabolic alterations and phenotypic changes in O-ASCs from lean patients. Citation Format: Bahar Salimian Rizi, Alexandra Nowicka, Ann H. Klopp, Deepak Nagrath. Metabolic cross talk between omental derived adipose stromal cells from lean and obese patients with ovarian cancer cells. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1854. doi:10.1158/1538-7445.AM2013-1854
Quinidine-induced action potential prolongation, early afterdepolarizations, and triggered activity in canine Purkinje fibers. Effects of stimulation rate, potassium, and magnesium.
Authors: J M Davidenko, L Cohen, R Goodrow, C Antzelevitch
Journal: Circulation (1989)

Early afterdepolarization (EAD)-induced triggered activity is thought to contribute to the cardiac arrhythmogenic effects of several class I antiarrhythmic agents. The combination of quinidine therapy, bradycardia, and hypokalemia is known to predispose to torsade de pointes, which is a form of atypical polymorphous ventricular tachycardia commonly associated with long QT intervals. Recent clinical reports have shown suppression of quinidine-induced torsade de pointes with intravenous administration of magnesium sulfate. To provide further understanding of these relations, we used standard microelectrode techniques to examine the time course of quinidine-induced action potential prolongation, EAD, and triggered activity development and the dependence of these changes on [K+]0, [Mg2+]0, and stimulation frequency in isolated Purkinje fiber preparations exposed to low concentrations of the drug. At slow stimulation rates, the quinidine-induced increase of action potential duration was slow to develop and failed to reach a steady state after 3 hours of exposure to the drug. EAD and EAD-induced triggered activity generally became apparent 70-90 minutes after adding the drug. Quinidine produced triggered activity in 10 of 22 preparations superfused with Tyrode's solution containing normal [K+]0 (3.5-4.0 mM) and in six other preparations when [K+]0 was reduced. In the presence of normal [K+]0, two types of EAD and triggered activity were distinguished. In four of 10 preparations, this activity arose from phase 2 of the action potential; in eight of 10, it was associated with phase 3; and in two experiments, both types were present in the same preparation. The incidence of both forms of triggered responses depended greatly on the rate of stimulation. Triggered activity arising from phase 3 was always manifest at rates considerably slower than those giving rise to phase 2 activity. Both forms of triggered activity were sensitive to changes in the extracellular concentration of potassium and magnesium. Lower-than-normal levels of these electrolytes facilitated the manifestation of triggered activity, whereas elevated levels suppressed or caused a shift in the frequency-dependence of the activity. Phase 2, but not phase 3, EADs were abolished in response to increased [Mg2+]0. The data show a clear congruity between the conditions that predispose to torsade de pointes in the clinic and the conditions under which quinidine may induce triggered activity and marked action potential prolongation in isolated Purkinje fibers.(ABSTRACT TRUNCATED AT 400 WORDS)
Inhibitory effect of 9-(2-phosphonyl-methoxyethyl) adenine (PMEA) on hepatitis B virus replication in vitro
Authors: Z.J. Gong, S. De Meyer, C. Verslype, T. Coopmans, A. Soumillion, J. Neyts, E. De Clerq, S.H. Yap
Journal: Journal of Hepatology (1998)
Preventing Severe Heat Injury in Runners: Suggestions from the 1979 Peachtree Road Race Experience
Authors: Albert C. England, David W. Fraser, Allen W. Hightower, Rosemary Tirinnanzi, Daniel J. Greenberg, Kenneth E. Powell, Corey M. Slovis, Robert A. Varsha
Journal: Annals of Internal Medicine (1982)

Of an estimated 17 632 participants of the 1979 Peachtree Road Race, a 10-km race held at 0800 on 4 July in Atlanta, Georgia, 29 had severe heat injury (collapse with altered mental status and rectal temperature of 39.7 °C or greater); all 29 recovered promptly. The temperature was 24.0 °C; the relative humidity, 83%; and the wet bulb-globe index, 23.0 °C. Compared with unaffected participants matched by age, sex, and predicted finishing time, case-runners were taller, had slower best recent 1.6-km and 10-km times, had run less in June, were more likely to achieve 89% of estimated maximum aerobic capacity during the race, less often splashed with water, were more likely to have underestimated their predicted finishing times based on their best recent 10-km times, and were more likely to live in Georgia. Height, sprinkler use, and underestimating predicted finishing times were each significant in the presence of the others. These observations suggest that participants of similar races, particularly those taller than 179.2 cm, should splash with water at least twice and base their predicted finishing times on their best recent 10-km times; adherence to these recommendations by runners at risk should reduce their severe heat injury risk at least 8.1 times.
Prospective feasibility analysis of reduced-intensity conditioning (RIC) regimens for hematopoietic stem cell transplantation (HSCT) in elderly patients with acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS)
Authors: Elihu Estey, Marcos de Lima, Raoul Tibes, Sherry Pierce, Hagop Kantarjian, Richard Champlin, Sergio Giralt
Journal: Blood (2006)
Expression of the myelomonocytic antigens L1 and CD36 in human epidermis
Authors: J.N.W.N. Barker, M.H. Allen, C.E.M. Griffiths, B.J. Nickoloff, D.M. MacDonald
Journal: British Journal of Dermatology (2006)

Erosive pustular dermatosis of the leg-a definitionSIR, We enjoyed the letter on 'Erosive pustular dermatosis of the scalp-a definition',' but we are sorry that Burton and his colleagues think we have scalped their clinical entity.This was never our intention.One of the reasons for presenting our patients was to try and cast a little light on the pathogenesis of erosive pustular dermatosis whatever its site.It is our experience that erosive pustular dermatosis of the scalp in the U.K. almost always occurs on previously damaged and clinically atrophic skin.Common forms of preceding damage to the scalp include excessive ultraviolet light, shingles, or even physical trauma sufficient to produce scarring.Exactly the same situation holds good for the legs, so it is not surprising that dermatoliposclerosis was quite often present on our patients.Another feature in common between scalp and shin is that the skin in both these areas is fairly tightly applied to underlying bone.We quite agree that our patients with erosive pustular dermatosis of the leg are not cases of erosive pustular dermatosis of the scalp, but nevertheless they do show the changes of erosive pustular dermatosis clinically.However, we concede that a scalp, even to a Northerner, looks quite different to a leg.In the meantime, we suggest that erosive pustular dermatosis of the leg should be defined as follows: chronic erosive pustulation confined to the legs of patients with a long-standing history of gravitational ulceration, dermatoliposclerosis and associated skin atrophy.No currently recognized cause of pustulation is present and the histology is non-specific.
Response to organ shortage: kidney retrieval programme using non-heart beating donors
Authors: K Varty, P S Veitch, J D T Morgan, E O Kehinde, P K Donnelly, P R F Bell
Journal: BMJ (1994)

The dwindling number of organ donors is a major concem in transplantation.'As a result there has been a renewed interest in retrieving kidneys from asystolic or "non-heart beating" donors using in situ renal perfusion.'3This report details our experience and results after one year in Leicester following the introduction of a dedicated programme to retrieve kidneys from non-heart beating donors.