tbuckley/cabot-search huggingface dataset:
Reminiscences from a Fenland practice.
Authors: F E Lodge
Journal: BMJ (1984)

Wisbech, in North Cambridgeshire, is a small market town noted for its splendid Georgian houses on the Brinks beside the River Nene, its apple orchards, and in June and July its fields of straw? berries and roses. It has a population of about 17 000 with a further similar number in local villages depending upon it for shopping and medical services. One of the Georgian buildings houses what is today known as  North Brink Practice. In 1946 it shared with a practice in Cosham, Hants, the temporary notoriety of having the only vacancies in general medical practice at the BMA agency at the particular time I was demobilised from the RNVR. The practice in which I settled was a specialist general practice and had access to the local cottage hospital. Two principals were fellows of the Royal College of Surgeons; another had a special interest in radiology, having the necessary basic equipment in his own home; another had ophthalmic qualifications; another was interested in obstetrics. I had little to offer except some recent knowledge in tropical medicine and venereology but I had given an unusually large number of anaesthetics in my hospital training at Oxford; this, and the wearisome job of sorting out and interviewing a further 69 applicants, turned the tables in my favour. I was to replace one of the surgeons, Edward Bullmore, who had been in the practice over 40 years and who had a reputation as being an ideal country doctor, extremely competent, and everybody's friend. He had, too, a very special knowledge of the history of the town, had been a churchwarden at the parish church, had a special interest in heraldry, and had produced a finely illustrated book about the heraldic devices which abounded in his church. He was a founder member of the local civic society, was a trustee of the Wisbech municipal charities, was a Worshipful Master at his Masonic Lodge, and found time to keep a considerable number of patients?all private?very happy and contented. I recall with pleasure my first few weeks in the town, when Bullmore would take me in his chauffeur driven Austin car to meet as many of his patients as was possible in the time at his disposal. His reputation was such that they were widely scattered and he would think nothing of visiting 18 or 20 miles into Lincolnshire. Forty five years separated us in age, and it was evident that the new youngster he had chosen as his successor was accepted only because Edward Bullmore had so ordained. The details of those precious conversa? tions about the early history of his practice, which was so dear to him, have sadly become dimmed in my memory but he did agree to put some recollections on paper in case some future partner could find time to write a history of the practice. Even these do not tell us of the surgical adventures on many a kitchen table, which he had described with such relish to me on his rounds. Now that I have been put out to grass, it has fallen to my lot to record some fresh notes about this interesting Fenland practice.
PUVA therapy decreases HLA-DR+ CD1a+ Langerhans cells and epidermal cell antigen-presenting capacity in human skin, but flow cytometrically-sorted residual HLA-DR+ CD1a+Langerhans cells exhibit normal alloantigen-presenting function
Authors: J. ASHWORTH, M.C. KAHAN, S.M. BREATHNACH
Journal: British Journal of Dermatology (1989)

Journal Article PUVA therapy decreases HLA‐DR+ CD1a+ Langerhans cells and epidermal cell antigen‐presenting capacity in human skin, but flow cytometrically‐sorted residual HLA‐DR+ CD1a+Langerhans cells exhibit normal alloantigen‐presenting function Get access J. ASHWORTH, J. ASHWORTH Department of Medicine (Dermatology), Charing Cross and Westminster Medical School, Fulham Palace Road, London, U.K. Search for other works by this author on: Oxford Academic Google Scholar M.C. KAHAN, M.C. KAHAN Charing Cross Sunley Research Centre, Lurgan Avenue, London, U.K. Search for other works by this author on: Oxford Academic Google Scholar S.M. BREATHNACH S.M. BREATHNACH Department of Medicine (Dermatology), Charing Cross and Westminster Medical School, Fulham Palace Road, London, U.K. Dr S.M. Breathnach Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 120, Issue 3, 1 March 1989, Pages 329–339, https://doi.org/10.1111/j.1365-2133.1989.tb04157.x Published: 01 March 1989
Attempted Suicides in Adolescence
Authors: Harold Jacobziner
Journal: JAMA (1965)

Attempted suicide is not uncommon among adolescents. The ratio of attempted suicides to actual suicides is in the magnitude of 100:1. This is in contrast to quoted figures of 5:1. While actual suicides are more common in the male and in the white, attempted suicides are more frequent in the female, the Puerto Rican, and in the low socioeconomic groups. Another pertinent finding was the high percentage of suicides among adolescents from unstable and disorganized homes. Early identification of the high-risk group is essential. Intensive "after care" for all such individuals should be made mandatory. A prevention center is of value in the control of suicides. The accumulation of epidemiological data is a prerequisite to a clearer identification of the problem and in formulation of sound countermeasures.
Assessment of Renal Artery Stenosis Severity by Pressure Gradient Measurements
Authors: Bernard De Bruyne, Ganesh Manoharan, Nico H.J. Pijls, Katia Verhamme, Juraj Madaric, Jozef Bartunek, Marc Vanderheyden, Guy R. Heyndrickx
Journal: Journal of the American College of Cardiology (2006)
Myocardial damage in patients with sarcoidosis and preserved left ventricular systolic function: an observational study
Authors: Amit R. Patel, Michael R. Klein, Sonal Chandra, Kirk T. Spencer, Jeanne M. DeCara, Roberto M. Lang, Martin C. Burke, Edward R. Garrity, D. Kyle Hogarth, Stephen L. Archer, Nadera J. Sweiss, John F. Beshai
Journal: European Journal of Heart Failure (2011)
Prevention and Reversal of Cholera Enterotoxin Effects in Rabbit Jejunum by Nicotinic Acid
Authors: Nabila Turjman, Gerald S. Gotterer, Thomas R. Hendrix
Journal: Journal of Clinical Investigation (1978)

The cholera enterotoxin produces intestinal secretion associated with an elevation of tissue levels of cyclic adenosine 3',5'-monophosphate levels of cyclic adenosine 3',5'-monosphosphate (cAMP). The objectives of this study were to determine whether intestinal secretion and cAMP elevation induced by cholera toxin could be prevented, or once initiated, reversed by nicotinic acid, an agent known to lower tissue levels of cAMP. In rabbits, four jejunal loops were constructed as alternating control (3-ml isotonic electrolyte solution) and cholera toxin (same solution containing 50 mug purified cholera toxin) loops. Net intestinal secretion was determined by measuring fluid accumulation, after which intestinal biopsies were taken for cAMP assay. The animals were pretreated either subcutaneously with 50 mg/kg nicotinic acid in saline 3 h and 1 h before the introduction of cholera toxin, or intraluminally with 200 mg/kg nicotinic acid in Ringer's lactate solution 15 min before the instillation of cholera toxin. Under these conditions, nicotinic acid blocked the cholera toxin-induced secretion and the rise in cAMP measured 3 h after the loops were exposed to cholera toxin. The effect of the nicotinic acid administered within the lumen on net intestinal secretion was studied. Maximal inhibition of net intestinal secretion was achieved with an intraluminally administered dose of nicotinic acid of 100 mg/kg. This dose was chosen for testing the ability of nicotinic acid to reverse the effects of cholera toxin. When nicotinic acid was instilled into a fifth loop constructed distally to the four experimental loops 3 h after exposure of these loops to cholera toxin, both intestinal secretion and elevation of cAMP were reversed. These results suggest that nicotinic acid can prevent and reverse the secretory effects of cholera toxin and may have a role in the therapy of cholera and other cAMP-associated diarrheal diseases.
Female Mixed Urinary Incontinence
Authors: Deborah L. Myers
Journal: JAMA (2014)

Mixed urinary incontinence, a condition of both stress and urge urinary incontinence, is prevalent in 20% to 36% of women and is challenging to diagnosis and treat because urinary symptoms are variable and guidelines for treatment are not clear. To review the diagnosis and management of mixed urinary incontinence in women, with a focus on current available evidence. MEDLINE was searched from January 1, 1992, to December 31, 2013. Additional citations were obtained from references of the selected articles and reviews. Articles that discussed the prevalence, diagnosis, results, and treatment of mixed urinary incontinence were selected for review. Evidence was graded using Oxford Centre for Evidence-Based Medicine levels of evidence for treatment recommendations. The MEDLINE search resulted in 785 articles. After selection and obtainment of additional citations, a total of 73 articles were reviewed. There is high-quality (level 1) evidence for treating urinary incontinence with weight loss, for treating stress urinary incontinence by performing anti-incontinence procedures of both traditional and mid-urethral slings and retropubic urethropexies, and for managing urge urinary incontinence with anticholinergic medications. However, direct high-quality evidence for treatment of women with mixed urinary incontinence is lacking, as are clear diagnostic criteria and management guidelines. High-quality, level 1 evidence for urinary incontinence therapy can guide clinicians in the treatment of the components of mixed urinary incontinence. Because high-quality evidence is lacking regarding the treatment of mixed urinary incontinence, treatment generally begins with conservative management emphasizing the most bothersome component. Randomized trials in women with mixed urinary incontinence populations are needed.
Managing diabetic retinopathy
Authors: Z. Ockrim, D. Yorston
Journal: BMJ (2010)

#### Summary points 

Diabetic retinopathy is the most common cause of blindness in working age people in England, Wales, and Scotland. Despite the availability of effective treatment, the prevalence of blindness as a result of diabetic retinopathy is increasing. Between February 1999 and March 2000, the number of patients on the blind register as a result of diabetic retinopathy in this age group was 2.05 per 100 000 population compared with 1.26 per 100 000 population in 1990-1.1

The global prevalence of diabetes in adults will rise from 171 million in 2000 to 366 million in 2030.2 Increased visual impairment as a result of diabetic retinopathy will impose a human and economic cost on entire communities, particularly in middle income countries.

Diabetic retinopathy is a chronic yet treatable condition. Primary prevention by improved medical management of diabetes, early detection, and timely treatment all reduce the risk of visual loss. In addition, the emergence of new treatments will change the management of retinopathy.

#### Sources and selection criteria

We searched Medline and Embase with the keywords “diabetic macular oedema”, “diabetic maculopathy”, “diabetic retinopathy”, and “controlled clinical trials”. We used evidence from published abstracts from major international scientific meetings and from the UK National Institute for Health and Clinical Excellence. We gave priority to evidence from well conducted systematic reviews and large well …
Clinical Issues in the Management of Early Lung Cancer
Authors: James L. Mulshine
Journal: Clinical Cancer Research (2005)

Abstract Lung cancer is commonly diagnosed after metastatic spread, when therapies are rarely curative, providing an impetus for continued research directed at exploring approaches for cost-effective early lung cancer detection. Recently published pilot studies across three continents support a benefit of spiral computed tomography (CT) in detecting earlier stage non–small cell lung cancer. Improved resolution of early lung cancer is a result of significant changes in CT imaging hardware and software. The status and implications of these developments are reviewed. Many aspects of the management of screening for early lung cancer could be informed by optimizing the downstream clinical management of potential lung cancers identified by CT screening. The first and most critical issue is whether or not this improved detection rate is clearly associated with a reduction in lung cancer–related mortality. However, other related issues such as cost-benefit evaluations are also considered. If smaller, truly localized primary cancer can be routinely detected, then options for less morbid interventions would also be desirable. The rapid improvement in resolution and cost of spiral CT has provided a powerful impetus to reconsider the possibilities for achieving safe, economical, and meaningful early lung cancer detection.
Skin ulceration caused by Salmonella dublin.
Authors: W Carswell, I T Magrath
Journal: BMJ (1973)

Clinical and radiological examinations on admission showed a large, left-sided pleural effusion.The abdomen was not tender and no mass could be felt.The serum amylase was 816 Somogyi U/ 100 ml, the urine amylase 237 Somogyi U/ 100 ml, and the pleural fluid, which was haemorrhagic, contained amylase 33,500 Somogyi U/100 ml.Radiography showed a large filling defect in the second part of the duodenum.Lipiodol 6 ml was injected into the pleural space and the progress of the contrast medium followed by fluoroscopy.When the examination table was inclined to about
Expression of Autocrine Motility Factor Correlates with the Angiogenic Phenotype of and Poor Prognosis for Human Gastric Cancer
Authors: Weida Gong, Yixing Jiang, Liwei Wang, Daoyan Wei, James Yao, Suyun Huang, Shengyun Fang, Keping Xie
Journal: Clinical Cancer Research (2005)

Abstract Autocrine motility factor (AMF) is a cytokine known to regulate tumor cell motility. Recent studies have extended its role to many other aspects of cancer biology. In the present study, we examined the level of AMF expression and its relationship with vascular endothelial growth factor (VEGF) expression and the angiogenic phenotype in human gastric cancer and their effect on survival. The AMF and VEGF expression level and tumor microvessel density (MVD) status in archived tissue specimens from 86 resected gastric cancer cases were determined. AMF expression was significantly higher in both primary tumors and lymph node metastases than in adjacent normal gastric mucosa and normal gastric mucosa from individuals without gastric cancer. In univariate survival analyses, strong AMF expression was associated with inferior survival (P = 0.028). In a Cox proportional hazards model, strong AMF expression (P = 0.019) was independently prognostic of poor survival. Strong AMF expression in the lymph node metastases was associated with poor survival (P = 0.011). Furthermore, AMF expression in the primary tumors was directly correlated with VEGF expression and MVD status. We found the first clinical evidence that AMF expression is directly correlated with VEGF expression and MVD status and predicts clinical outcome in patients with gastric cancer, supporting the hypothesis that the AMF/AMF receptor pathway plays an important role in multiple aspects of cancer biology.
Apixaban reduced VTE and did not increase major bleeding compared with enoxaparin in hip replacement
Authors: James Douketis
Journal: Annals of Internal Medicine (2011)

ACP Journal Club17 May 2011Apixaban reduced VTE and did not increase major bleeding compared with enoxaparin in hip replacementJames Douketis, MDJames Douketis, MDSt. Joseph’s Hospital, Hamilton, Ontario, Canada (J.D.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-154-10-201105170-02007 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationLassen MR, Gallus A, Raskob GE, et al. Apixaban versus enoxaparin for thromboprophylaxis after hip replacement. N Engl J Med. 2010;363:2487-98. https://pubmed.ncbi.nlm.nih.gov/21175312Clinical Impact RatingsHematology: References1 Frydman A. Low-molecular-weight heparins: an overview of their pharmacodynamics, pharmacokinetics and metabolism in humans. Haemostasis. 1996;26 Suppl 2:24-38. [PMID: 8707165] Google Scholar2 Eriksson BI, Quinlan DJ, Weitz JI. Comparative pharmacodynamics and pharmacokinetics of oral direct thrombin and factor Xa inhibitors in development. Clin Pharmacokinet. 2009;48:1-22. [PMID: 19071881] Google Scholar3 Kearon C, Kahn SR, Agnelli G, et al. Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edition). Chest. 2008;133:454S-545S. [PMID: 18574272] Google Scholar4 Lassen MR, Raskob GE, Gallus A, et al. Apixaban or enoxaparin for thromboprophylaxis after knee replacement. N Engl J Med. 2009;361:594-604. [PMID: 19657123] Google Scholar5 Douketis JD. Pharmacologic properties of the new oral anticoagulants: a clinician-oriented review with a focus on perioperative management. Curr Pharm Des. 2010;16:3436-41. [PMID: 20858185] Google Scholar Author, Article, and Disclosure InformationAuthors: James Douketis, MDAffiliations: St. Joseph’s Hospital, Hamilton, Ontario, Canada (J.D.)This article was published at Annals.org on 3 May 2011. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRivaroxaban was noninferior to enoxaparin for preventing short-term recurrent VTE and superior to placebo in continued treatment James Douketis Metrics 17 May 2011Volume 154, Issue 10Page: JC5-7KeywordsAnticoagulantsApixabanDeep vein thrombosisHemorrhageHipPulmonary embolismSafetySurgeryTotal hip replacementVenous thromboembolism ePublished: 17 May 2011 Issue Published: 17 May 2011 Copyright & PermissionsCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Phosphohexosyl recognition is a general characteristic of pinocytosis of lysosomal glycosidases by human fibroblasts.
Authors: A Kaplan, D Fischer, D Achord, W Sly
Journal: Journal of Clinical Investigation (1977)

We recently presented data showing that mannose-6-phosphate was a potent competitive inhibitor of pinocytosis of human platelet beta-glucuronidase, and that treatment of "high-uptake" forms of the enzyme with alkaline phosphatase destroyed the high-uptake property of the enzyme without diminishing its catalytic activity. These data indicate that phosphate is a necessary component of the recognition marker on the enzyme for pinocytosis by human fibroblasts, and suggest that the phosphate on high-uptake forms of the enzyme is present as a phosphohexosyl moiety. Results presented here show that mannose-6-phosphate is also a potent inhibitor of pinocytosis of the following enzyme preparations: (a) beta-glucuronidase from human spleen, liver, placenta, and urine; (b) beta-hexosaminidase and beta-galactosidase from human platelets; (c) beta-hexosaminidase from human fibroblast secretions. Alkaline phosphatase treatment of all these enzymes except beta-galactosidase, which was unstable to the incubation conditions and could not be tested, greatly diminished the uptake activity of the enzymes without diminishing their catalytic activity. These results suggest that phosphohexosyl recognition is a general characteristic of pinocytosis of lysosomal glycosidases.
A Follow-up on Follow-ups
Authors: Samuel Vaisrub
Journal: JAMA (1975)

The naïve notion that early detection of a chronic disease and prompt institution of appropriate treatment ensures a satisfactory outcome has been dispelled by a number of statistical studies. Even the most ardent advocates of mass screening and periodic checkups admit that results of therapy often fall short of the expected optimum. Diagnosis and correct prescription are only the first steps in the difficult ascent to a therapeutic summit. A sobering realization that hypertension is no exception to this rule of imperfection emerges from a number of recent studies. The reported shortcomings of long-range results have been blamed on poor patient compliance, as judged by the failure of patients to return for follow-up. Poor patient compliance in turn has been ascribed to ignorance, lack of motivation, and to economic factors, such as high cost of medical care and transportation. Elsewhere in this issue (p 242), Fletcher and co-workers report a
Immunohistochemical changes in morphologically involved and uninvolved colonic mucosa of patients with idiopathic proctitis.
Authors: K M Das, W F Erber, A Rubinstein
Journal: Journal of Clinical Investigation (1977)

Alterations in secretory component, IgA, IgG, and IgM were studied by immunofluorescent techniques in mucosal biopsy specimens obtained at colonoscopy from inflamed and grossly uninvolved colonic mucosa from 12 patients with idiopathic proctitis. Parotid-salivary secretory component and IgA and serum immunoglobulins were also investigated. Decreased secretory IgA was observed in the epithelium of all grossly involved rectal mucosa and in 40% of proximal normal mucosa. Salivary secretory IgA was not diminished. These observations suggest that a local immune defect may be pathogenetically related to idiopathic proctitis.
Bleeding Watermelon Stomach Treated by Nd-YAG Laser Photocoagulation
Authors: J. Labenz, G. Börsch
Journal: Endoscopy (1993)

We report on five patients with liver disease requiring blood transfusion because of recurrent acute or chronic bleeding from diffuse antral vascular ectasia (watermelon stomach). All were initially misinterpreted as hemorrhagic gastritis. Medical treatment with antiulcer drugs failed to control blood loss. Nd-YAG laser therapy (medium number of sessions: n = 4, range: 1-8) improved the endoscopic appearance of the gastric lesions and effectively controlled blood loss in all patients over a medium follow up period of eight months (range: 2-12 months). Treatment related complications did not occur.
Services for people with haemoglobinopathy
Authors: S Davies
Journal: BMJ (1994)

The Standing Medical Advisory Committee's report Sickle Cell, Thalassaemia and Other Haemoglobinopathies was published, after much delay, in February.1, 2 A month later the report was discussed at a multidisciplinary forum convened by the Royal College of Pathologists. What did the more than 100 health professionals, patients, and representatives of voluntary groups make of it?

Generally, they welcomed the report because it highlights the patchy services for these patients in Britain and should stimulate debate, research, and action. They liked the report's endorsement of multidisciplinary care, with seamless services, good communication, and the involvement of patients. The forum emphasised the importance of accessibility, cultural sensitivity, and the need to overcome language barriers in the provision of all services, including counselling. It concluded that for most areas the most cost effective solution would be the provision of written educational materials in relevant languages and an accessible, informed interpreting service.

The report places “comprehensive centres” at the centre of service provision for patients with haemoglobinopathies. Integral …