tbuckley/cabot-search huggingface dataset:
Algae kills dialysis patients in Brazil
Authors: J. Dunn
Journal: BMJ (1996)

After the initial drama will there be a bed available?NHS managers meet over beds crisis Senior NHS managers called a crisis meet- ing last week to discuss the nationwide shortage of beds in accident and emergency departments.A hundred and sixty delegates attended the one day conference, which was arranged jointly by the British Association of Medical Managers and the National Association of Health Authorities and Trusts.John Watkinson, chief executive of the King's Mill Centre for Healthcare Services NHS Trust and conference chairman, spoke of the need for better liaison between general practitioners and hospital doctors.He said: "The problem manifests itself at the point of admission to hospital, but it cannot be solved by hospitals alone.It relies on hospitals working with the primary sector and the community and also on cooperation between purchasers and providers to balance supply and demand all year round."Inappropriate use of beds, difficulty in recruiting medical and nursing staff, and the growing numbers. of elderly people, are seen by'senior NHS managers as major problems.Care in the community is also a contributory factor.
Mass polio vaccination
Authors: J. Chander, S. Subrahmanyan
Journal: BMJ (1996)

Albert Sabin always emphasised that the global eradication of wild poliovirus was possible but that to achieve eradication in developing countries would require mass administration of oral polio vaccine. Experiences in Cuba and Czechoslovakia have proved the effectiveness of this approach, but it was only with its deployment in Brazil in the 1980s that its role in eradicating the virus from a broad geographical area was realised.1 After 40 years of mass administration of oral and inactive poliovirus vaccines a pattern of impact is emerging. Both the vaccines have proved records of safety and efficacy, and there is now no doubt that applying oral polio vaccine over short periods and on a mass scale can control poliomyelitis in any country, irrespective of its geographical location or level of sanitation.

The World Health Organisation has played a vital part in the development and use of polio vaccines since their inception. Since 1973 it has been directly responsible for the custody and distribution of the Sabin strains of the oral polio vaccine and has supervised the production laboratories.2 In 1974 it started the expanded programme on immunisation covering six childhood diseases, including poliomyelitis, and progress has been such that in 1988 the organisation declared its commitment to the goal of global eradication of poliomyelitis by 2000.3

Eradication is defined as zero cases of paralytic poliomyelitis due to wild …
Patients not paper?
Authors: T. Greenhalgh
Journal: BMJ (1998)

Dear Mr Dobson,



Thanks for your letter, postmarked 1 April, asking me for my good ideas for improving the NHS. I gather you sent a copy to every member of staff to mark the 50th anniversary of this great institution. Considering that the NHS is the biggest employer in the world apart from the Russian army and Indian railways, you must have licked a lot of stamps.

As you indicated in your letter, this exercise is highly likely to generate thousands of sensible and practicable ideas, which nobody in any strategic position has previously thought of. I was impressed with your promise to keep your civil servants …
Cyclosporine-induced autoimmunity. Conditions for expressing disease, requirement for intact thymus, and potency estimates of autoimmune lymphocytes in drug-treated rats.
Authors: R Sorokin, H Kimura, K Schroder, D H Wilson, D B Wilson
Journal: The Journal of Experimental Medicine (1986)

These studies explore the phenomenon of cyclosporine-induced autoimmunity in irradiated Lewis rats. We show that (a) the presence of a thymus is required, and autoimmune precursors develop in and exit from this organ to the peripheral lymphocyte pool within a 2-wk period after the initiation of cyclosporine treatment; (b) adoptive transfers of drug-induced autoimmunity to irradiated secondary recipients can be accomplished with relatively few cells of the Th subset, and these transfers of autoimmunity can be blocked by cotransfer of normal lymphoid cells; and (c) potency estimates, using popliteal lymph node assays in syngeneic and F1 recipients indicate similar levels of auto- and alloreactivity by cells from drug-induced autoimmune donors. These various findings indicate that this particular animal model may be useful for studies of the onset and control of autoimmunity, and they raise the possibility that the lack of autoimmunity in normal animals and its induction with cyclosporine may involve similar cellular mechanism as have been found to be operative in GVH reactions and specifically induced immunologic resistance to GVHD.
Geographic differences in digoxin inactivation, a metabolic activity of the human anaerobic gut flora.
Authors: V I Mathan, J Wiederman, J F Dobkin, J Lindenbaum
Journal: Gut (1989)

The inactivation of digoxin by conversion to reduced metabolites (digoxin reduction products, or DRP), a function of the anaerobic gut flora, was studied in normal volunteers from southern India and the United States. Digoxin was metabolised to DRP by 28 (13.7%) of 204 healthy south Indians in contrast to 67 (36.0%) of 186 New Yorkers (p less than 1 X 10(-6)). Only 1.0% of Indians compared with 14.0% of Americans excreted large amounts of metabolites (greater than 40% DRP) in the urine (p less than 1 X 10(-5)). Of 104 urban Indians, 23 (22.1%) were metabolisers, in contrast with five of 100 rural villagers (p less than 0.001). Within the urban group, digoxin metabolism correlated with education, frequency of animal protein intake, and most significantly, personal income. Organisms capable of reducing digoxin in vitro were found with similar frequencies in stool cultures from Indians and Americans. In the cultures of some subjects, DRP production was inhibited at lower dilutions but expressed at higher dilutions. We conclude that variations in drug metabolism between population groups may result from differences in the metabolic activity of the anaerobic gut flora probably mediated by environmentally determined factors.
Abstract IA7: Regulation of myeloid-derived suppressor cells in tumor micro-environment.
Authors: Dmitry Gabrilovich
Journal: Cancer Research (2013)

Abstract Myeloid-derived suppressor cells (MDSC) is a major factor responsible for tumor escape. These cells accumulate in large numbers in tumor-bearing hosts and are characterized by their myeloid origin, immature state, and, most importantly, by their potent ability to suppress different aspects of immune responses, primarily T-cell proliferation and cytokine production. This heterogeneous group of cells, consists of immature myeloid cells (IMC) with morphological and phenotypic characteristics, similar to that of monocytes (M-MDSC) and polymorphonuclear neutrophils (PMN-MDSC). However, MDSC have a distinct gene expression profile and a number of biochemical, and functional, differences from monocytes (Mon) and neutrophils (PMN). In tumor-bearing hosts, there is a constant influx of myeloid cells from the bone marrow to other peripheral organs. Soluble growth factors and certain cytokines produced by tumor cells modulate, expand and differentiate these immature myeloid cells by interacting with the receptors on their surface and converting them to a suppressive phenotype. Recently, “two-signal” model of MDSC accumulation was proposed. This model suggests that accumulation of MDSC can be separated into two processes governed by different signal transduction pathways. One pathway is predominantly responsible for MDSC expansion and the second one for driving MDSC activation. The fate of MDSC remains poorly understood. We found, contrary to our initial expectations, that MDSC, in tumor-bearing mice and cancer patients, have a substantially lower survival than their control counterparts, Mon and PMN. We have identified possible mechanism of this phenomenon and suggested that it can be used for selective elimination of MDSC in tumor-bearing hosts. Citation Format: Dmitry Gabrilovich. Regulation of myeloid-derived suppressor cells in tumor micro-environment. [abstract]. In: Proceedings of the AACR Special Conference on Tumor Immunology: Multidisciplinary Science Driving Basic and Clinical Advances; Dec 2-5, 2012; Miami, FL. Philadelphia (PA): AACR; Cancer Res 2013;73(1 Suppl):Abstract nr IA7.
Alcohol guidelines are not working, says UK charity
Authors: J. Wise
Journal: BMJ (2014)

Two thirds of adults in the United Kingdom do not know how many units of alcohol they can drink to stay within government guidelines or how many units a glass of wine or a pint of beer contains, says a survey carried out for Drinkaware, the alcohol education charity.

The UK’s chief medical officer, Sally Davies, is reviewing the current guidelines on alcohol consumption, and Drinkaware said that …
Challenge of Penicillin‐Allergic Volunteers with Penicillin‐Contaminated Meat
Authors: H. Lindermayr, R. Knobler, D. Kraft, W. Baumgartner
Journal: Allergy (1981)

In order to obtain information about the clinical course and immunological background of possible allergic reactions due to penicillin‐containing food, nine volunteers with penicillin allergy proved by case history, positive skin tests and/or positive penicilloyl‐specific RAST were exposed to penicillin‐contaminated pork. For this purpose a farm pig from an inbred strain received “therapeutic” doses of benzyl procain penicillin before being slaughtered. Meat samples were taken from muscle tissues, kidney and liver and analyzed by diffusion and extraction methods. Very small amounts of penicillin were detectable in muscle tissue, whereas kidney material contained up to five times as much (0.12 mcg/g). Except two cases which reacted with itchy sensations after ingestion of penicillin contaminated meat “á la tartare”, all probands were clinically free of symptoms. Assaying penicilloyl‐specific IgE antibodies by RAST during the trial, a tendency to increased levels in the serum after 2 and 24 h was noted, whereas the liters of BPO‐specific IgG antibodies measured by the red cell‐linked antigen‐antiglobulin reaction (RCLAAR) remained unchanged. It is concluded from this study that small and hidden amounts of penicillin and its derivatives in food seldom induce anaphylactic reactions in penicillin allergic patients.
Stress Response Protein Cirp Links Inflammation and Tumorigenesis in Colitis-Associated Cancer
Authors: Toshiharu Sakurai, Hiroshi Kashida, Tomohiro Watanabe, Satoru Hagiwara, Tsunekazu Mizushima, Hideki Iijima, Naoshi Nishida, Hiroaki Higashitsuji, Jun Fujita, Masatoshi Kudo
Journal: Cancer Research (2014)

Abstract Colitis-associated cancer (CAC) is caused by chronic intestinal inflammation and is reported to be associated with refractory inflammatory bowel disease (IBD). Defective apoptosis of inflammatory cell populations seems to be a relevant pathogenetic mechanism in refractory IBD. We assessed the involvement of stress response protein cold-inducible RNA-binding protein (Cirp) in the development of intestinal inflammation and CAC. In the colonic mucosa of patients with ulcerative colitis, expression of Cirp correlated significantly with the expression of TNFα, IL23/IL17, antiapoptotic proteins Bcl-2 and Bcl-xL, and stem cell markers such as Sox2, Bmi1, and Lgr5. The expression of Cirp and Sox2 was enhanced in the colonic mucosae of refractory ulcerative colitis, suggesting that Cirp expression might be related to increased cancer risk. In human CAC specimens, inflammatory cells expressed Cirp protein. Cirp−/− mice given dextran sodium sulfate exhibited decreased susceptibility to colonic inflammation through decreased expression of TNFα, IL23, Bcl-2, and Bcl-xL in colonic lamina propria cells compared with similarly treated wild-type (WT) mice. In the murine CAC model, Cirp deficiency decreased the expression of TNFα, IL23/IL17, Bcl-2, Bcl-xL, and Sox2 and the number of Dclk1+ cells, leading to attenuated tumorigenic potential. Transplantation of Cirp−/− bone marrow into WT mice reduced tumorigenesis, indicating the importance of Cirp in hematopoietic cells. Cirp promotes the development of intestinal inflammation and colorectal tumors through regulating apoptosis and production of TNFα and IL23 in inflammatory cells. Cancer Res; 74(21); 6119–28. ©2014 AACR.
Accreditation process for clinical trials in India moves a step closer
Authors: I. Torjesen
Journal: BMJ (2015)

Details of the proposed accreditation process for clinical trial sites, investigators, and ethics committees have been unveiled by the Quality Council of India. The processes are being introduced as part of a move to clamp down on potentially dangerous and unethical clinical trials.

The deaths of hundreds of patients involved in clinical trials prompted the Indian Ministry of Health and Family Welfare to convene an expert group, chaired by Ranjit Roy Chaudhary, a clinical pharmacologist, to formulate policy and guidelines for clinical trials. In 2013 the group …
Not Myositis
Authors: P H Plotz
Journal: JAMA (1992)

WEAKNESS, like fever or pain, accompanies so many conditions that the scope of its differential diagnosis is impossibly large. But when the answers to a few questions narrow the field to a complaint of muscle weakness, the differential shrinks (Table). In the illnesses called idiopathic inflammatory myositis—dermatomyositis, polymyositis, inclusion body myositis, and several rarer disorders—the patients are usually middleaged and have noticed the onset of weakness over weeks, months, or even years. The weakness most often affects proximal muscles so that climbing stairs, getting into or out of a car, lifting packages, combing the hair, or lifting the head off the pillow may be difficult. Muscle damage is shown by elevated serum levels of the muscle-associated enzymes, creatine kinase and aldolase; there are abnormalities on the electromyogram (EMG); and the muscle biopsy in most cases shows dying and regenerating muscle cells and an infiltrate of chronic inflammatory cells, predominantly lymphocytes.
1144-103 Chronic infusion of bradykinin preserves vascular nitric oxide-mediated endothelial function and limits the alteration in left ventricular function during pacing-induced heart failure in conscious dogs
Authors: Jinbo Su, Daniel Tonduangu, Bijan Ghaleh, Philippe Le Corvoisier, Fanny Vincent, Thierry Badoual, Lucien Sambin, Alain Berdeaux, Bertrand Crozatier, Luc Hittinger
Journal: Journal of the American College of Cardiology (2004)
Race, Gender, and Partnership in the Patient-Physician Relationship
Authors: Lisa Cooper-Patrick, Joseph J. Gallo, Junius J. Gonzales, Hong Thi Vu, Neil R. Powe, Christine Nelson, Daniel E. Ford
Journal: JAMA (1999)

ContextMany studies have documented race and gender differences in health care received by patients. However, few studies have related differences in the quality of interpersonal care to patient and physician race and gender.ObjectiveTo describe how the race/ethnicity and gender of patients and physicians are associated with physicians' participatory decision-making (PDM) styles.Design, Setting, and ParticipantsTelephone survey conducted between November 1996 and June 1998 of 1816 adults aged 18 to 65 years (mean age, 41 years) who had recently attended 1 of 32 primary care practices associated with a large mixed-model managed care organization in an urban setting. Sixty-six percent of patients surveyed were female, 43% were white, and 45% were African American. The physician sample (n=64) was 63% male, with 56% white, and 25% African American.Main Outcome MeasurePatients' ratings of their physicians' PDM style on a 100-point scale.ResultsAfrican American patients rated their visits as significantly less participatory than whites in models adjusting for patient age, gender, education, marital status, health status, and length of the patient-physician relationship (mean [SE] PDM score, 58.0 [1.2] vs 60.6 [3.3]; P=.03). Ratings of minority and white physicians did not differ with respect to PDM style (adjusted mean [SE] PDM score for African Americans, 59.2 [1.7] vs whites, 61.7 [3.1]; P=.13). Patients in race-concordant relationships with their physicians rated their visits as significantly more participatory than patients in race-discordant relationships (difference [SE], 2.6 [1.1]; P=.02). Patients of female physicians had more participatory visits (adjusted mean [SE] PDM score for female, 62.4 [1.3] vs male, 59.5 [3.1]; P=.03), but gender concordance between physicians and patients was not significantly related to PDM score (unadjusted mean [SE] PDM score, 76.0 [1.0] for concordant vs 74.5 [0.9] for discordant; P=.12). Patient satisfaction was highly associated with PDM score within all race/ethnicity groups.ConclusionsOur data suggest that African American patients rate their visits with physicians as less participatory than whites. However, patients seeing physicians of their own race rate their physicians' decision-making styles as more participatory. Improving cross-cultural communication between primary care physicians and patients and providing patients with access to a diverse group of physicians may lead to more patient involvement in care, higher levels of patient satisfaction, and better health outcomes.
PUDENDAL HÆMATOCELE IN THE NONPUERPERAL STATE, WITH REPORT OF A CASE.
Authors: E. STUVER
Journal: JAMA (1892)

an indigenous product of this country.It is a more common product in countries Avhere the inhabitants thereof eat fish almost exclusively, as in some locali¬ ties of Europe, as Sweden, Russia, East Prussia, Po¬ land and West Switzerland.Man may ordinarily be¬ come infested Avith this parasite by eating insuffi¬ ciently cooked fish.The broad tape Avorm may be three quarters of an inch Avide at its widest part and tAventy-five feet in length.
A Genetic, Clinical, and Psychological Study of Nine Sets of Monozygotic Twins, Discordant for Rheumatoid Arthritis.
Authors: Ralph F. Jacox
Journal: Annals of Internal Medicine (1965)

s1 May 1965A Genetic, Clinical, and Psychological Study of Nine Sets of Monozygotic Twins, Discordant for Rheumatoid Arthritis.Ralph F. Jacox, M.D., F.A.C.P., Sanford Meyerowitz, M.D., D. William Hess, M.D.Ralph F. Jacox, M.D., F.A.C.P.Search for more papers by this author, Sanford Meyerowitz, M.D.Search for more papers by this author, D. William Hess, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-62-5-1096_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptNine sets of monozygotic twins, identified by extensive blood typing and in three instances by a successful skin graft acceptance, have been studied. One individual of each set of twins has rheumatoid arthritis by clinical criteria. In six sets, antinuclear antibodies were also present in the affected member. None of these serological abnormalities existed in the unaffected twins. One affected twin has had rheumatoid arthritis for 24 years, whereas the normal twin has had no disease. These data, along with recent American Indian population studies, provide evidence that rheumatoid arthritis is not an inheritable disease.Psychological data have been collected... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Ralph F. Jacox, M.D., F.A.C.P.; Sanford Meyerowitz, M.D.; D. William Hess, M.D.Affiliations: Rochester, Minnesota PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1965Volume 62, Issue 5Page: 1096-1096KeywordsAntinuclear antibodiesBloodClinical geneticsMonozygotic twinsNative American peopleRheumatoid arthritisTwins ePublished: 1 December 2008 Issue Published: 1 May 1965 PDF downloadLoading ...
MUCOCELE OF THE ETHMOIDAL CELLS SIMULATING AN ORBITAL TUMOR.
Authors: F. C. HOTZ
Journal: JAMA (1899)

If, in the course of an inflammation of the ethmoidal cells, the secretions can not be discharged into the nasal cavity because the natural outlets are blocked up, the imprisoned fluid will after a while begin to exert considerable pressure upon the bony walls and cause them to expand. The very thin orbital wall of these cells is especially apt to yield to this high pressure and to form a round, slowly-growing tumor behind the inner canthus of the eyelids, which causes more or less marked displacement of the eyeball. In some of these cases the cystoid nature of the tumefaction was readily revealed by fluctuation; but in some instances the tumor appeared so firm and hard that in the absence of fluctuation it was mistaken for a solid neoplasm and preparations were made for its extirpation. An exploratory incision into the exposed tumor of course revealed its true nature.
ABC of allergies: Avoiding exposure to indoor allergens
Authors: A. Woodcock, A. Custovic
Journal: BMJ (1998)

The practice of avoiding exposure to allergens (allergen avoidance) for allergic diseases such as asthma is not a new idea. In the 16th century the Archbishop of St Andrews had a miraculous remission of his intractable asthma by getting rid of his feather bedding, and in 1927 Storm van Leeuwen created a “climate chamber” in Holland in an attempt to recreate the beneficial environment of high altitude sanatoriums. This article focuses on how to avoid indoor allergens in homes in temperate climates and the potential benefits for sensitised patients with atopic disorders.



Amount of time that most Americans spend indoors, outdoors, and in transit



Nowadays most people spend more than 90% of their lives indoors. Over the past 30 years, the home environment has changed enormously with the introduction of soft furnishings, fitted carpets, and central heating. Indoor ventilation has decreased—the rate at which indoor air is exchanged for fresh air is now 10 times lower than it was 30 years ago, with a considerable increase both in humidity and in concentrations of indoor pollutants and airborne allergens. As exposure to allergens is an important cause of symptoms in sensitised patients, reducing exposure should improve disease control. In spite of this, few patients in Britain with asthma, eczema, or perennial rhinitis, or any combination of these, are skin tested.

Few patients in Britain with asthma, eczema, or perennial rhinitis receive advice on appropriate avoidance measures 

The predominant indoor allergens in Britain are from mites, cats, and dogs, and they have dramatically different aerodynamic characteristics. Mite allergens are present on large particles in beds, soft furnishings, and carpets, which become airborne only after vigorous disturbance and settle quickly. In contrast, about 25% of cat and dog allergens are associated with small particles <5 µm in diameter, which after disturbance remain airborne …