tbuckley/cabot-search huggingface dataset:
Remarks on the Prevention of Hydrophobia by M. Pasteur's Treatment
Authors: M. A. Ruffer
Journal: BMJ (1889)

THE disease which is popularly called hydrophobia is one which from the days of Aristotle has attracted the attention of medical men.They, as well as the general public, had been struck by its remarkable peculiarities, and, during many centuries, popular credulity surrounded the disease with fabulous stories, some of which are believed even now, whilst others have left their trace as popular sayings and proverbs.And yet hydrophobia is in some parts of the country by no means frequently met with.There are many medical men who have never seen a case, or who have seen one or two at most, in the course of a long and busy lifetime, during which they may have watched hundreds die of typhoid fever, phthisis, and other infectious diseases.The chief interest of hydrophobia, however, lies in the fact that the fate of human beings inoculated with the hydrophobic virus remains doubtful for some considerable time after the bite.The friends and the me- dical attendant of a patient bitten by a hydrophobic animal know that the life of that man may suddenly come to an end.During a period extending over many months-over a year even -that man has to wait, believing that nothing can be done for him to prevent the breaking out of the disease.He knows, of course, that he has many chances of escaping, but that,-if the first symptoms make their appearance, he is hopelessly doomed to a most painful and horrible death.The medical man who may have cauterised or even sucked the wound, until recently believed that so far his work was at an end, and that all he could do was to wait, and, if the symptoms set in, to mitigate as much as he was able the sufferings preceding the ineviuable end.We need not wonder, then, that when in 1885 M. Pasteur stated, at the Acad6mie des Sciences de Paris, that he had dis- covered a method to prevent the occurrence of hydrophobia after a bite, the medical and public press rang with the news.But although patients flocked from all parts of the world to the Laboratory of M. Pasteur, in the Rue d'Ulm, many scientiflc men openly expressed their doubts as to the value of the treat- ment.Since 1885, however, the number of people who have sub- mitted themselves to the preventive tileatment for hydrophobia exceeds 9,000.Over twenty antirabic institutes have been built in various parts of the world, in which patients have been inocu- lated by independent observers.From the data collected in the
Microsatellite polymorphism in heme oxygenase-1 gene promoter is associated with susceptibility to oxidant-induced apoptosis in lymphoblastoid cell lines
Authors: Hisao Hirai, Hiroshi Kubo, Mutsuo Yamaya, Katsutoshi Nakayama, Muneo Numasaki, Seiichi Kobayashi, Satoshi Suzuki, Shigeki Shibahara, Hidetada Sasaki
Journal: Blood (2003)
Myeloid-related protein-14 deficiency promotes inflammation in staphylococcal pneumonia
Authors: Ahmed Achouiti, Thomas Vogl, Anne J. Van der Meer, Ingrid Stroo, Sandrine Florquin, Onno J. de Boer, Johannes Roth, Sacha Zeerleder, Cornelis van ’t Veer, Alex F. de Vos, Tom van der Poll
Journal: European Respiratory Journal (2015)

Staphylococcus aureus has evolved as an important cause of pneumonia in both hospital and community settings. Staphylococcal lung infection can lead to overwhelming pulmonary inflammation. During infection, neutrophils release complexes of myeloid-related protein (MRP)8 and MRP14 (MRP8/14). MRP8/14 has been shown to exert pro-inflammatory and chemotactic activity, and to assist in the killing of S. aureus. In the current study we sought to determine the role of MRP8/14 in the host response during S. aureus pneumonia.Pneumonia was induced in wildtype and MRP14-deficient mice (mice unable to form MRP8/14) by intranasal inoculation of 1×10(7) CFU of S. aureus USA300. Mice were sacrificed at 6, 24, 48 or 72 h after infection for analyses.S. aureus pneumonia was associated with a strong rise in MRP8/14 in bronchoalveolar lavage fluid and lung tissue. Surprisingly, MRP14 deficiency had a limited effect on bacterial clearance and was associated with increased cytokine levels in bronchoalveolar lavage fluid and aggravated lung histopathology. MRP14 deficiency in addition was associated with a diminished transmigration of neutrophils into bronchoalveolar lavage fluid at late time-points after infection together with reduced release of nucleosomes.MRP8/14 serves in an unexpected protective role for the lung in staphylococcal pneumonia.
I am a good patient, believe it or not
Authors: A. R Jadad
Journal: BMJ (2003)

As clinicians and medical researchers, we have been taught and socialised to think, write, and act as physicians, but we, and our friends and families, have also been patients. We all try to be good patients. Our experiences as patients and our perceptions of those experiences have sometimes differed radically from what we would have expected from our medical perspectives. Our recent, real, and personal experiences illustrate the different ways in which we try to be “good patients.” But what does that term really mean? In the past the good patient was passive and did not dare to challenge the judgment or recommendations of the physician. The good patient of the future might be the very opposite.



Our experiences

Murray: My dentist's receptionist stopped me last week with a question as I was leaving her desk. “You used to be an obstetrician,” she said, and explained her problem to me in uncomfortable detail. Her current obstetrician had suggested an operation to prevent miscarriage, and she was not confident that it would be safe or effective. To my suggestion that she request a second opinion, she responded that she couldn't even dream of doing so. Her doctor, she feared, would consider that as lack of respect for his opinion, and he might not continue to look after her.

Carlos: The health professional who catheterised me after my recent appendectomy used the anaesthetic gel simply as lubricant, without waiting for the anaesthetic to take effect. Neither I nor my wife, who is also a doctor, openly questioned the neglect of this simple precaution, which converted an unpleasant procedure into an unnecessarily painful one. Why did we let that happen? Did we think that being passive and compliant made me a good patient? Or were we just too afraid to question the authority of our caregiver?

Alejandro: At 18 months of age, my youngest daughter had a small lesion around her anus. Our family physician at the time quickly diagnosed it as a sexually transmitted disease and suggested a referral to a child abuse specialist. Horrified, my wife and I asked him to confirm the diagnosis, but he dismissed us, saying he was sure. On the internet we found over 50 articles that contradicted him. We brought this evidence back and expressed our deep dissatisfaction. A dermatologist reassessed the case thoroughly and proved that it was just a common wart.





The good patient of the future will:



Bring lists of questions to the consultation and will expect answers in clear terms


Know how involved they want to be in decisions about their health care; most will choose to share decisions with their healthcare providers


Have free access to their health record on paper or through electronic means and will use it or share it as they see fit


Request and receive a second opinion whenever they face a major diagnosis or decisions about treatment


Use telephone, internet, and other forms of communication to complement personal visits with members of the healthcare team
An adherent subline of a unique small-cell lung cancer cell line downregulates antigens of the neural cell adhesion molecule.
Authors: L A Doyle, M Borges, A Hussain, A Elias, T Tomiyasu
Journal: Journal of Clinical Investigation (1990)

Small-cell lung cancer (SCLC) lines are distinguished from non-small-cell lung cancer (NSCLC) lines by their growth in floating aggregates, in contrast to the adherent monolayers formed by NSCLC cells in culture. Of 50 well-characterized SCLC lines recently described by the National Cancer Institute (NCI)-Navy Medical Oncology Branch, only four variant cell lines (SCLC-v) grew as adherent monolayers. One line, NCI-H446, was unique in growing long-term with coexisting floating and surface adherent subpopulations. We have physically segregated these two populations over many passages in vitro to enrich for relatively pure cultures of floating and adherent cells. No differences in c-myc expression, keratin pattern, or cytogenetic appearance were found between the adherent and floating sublines. However, expression of the neuroendocrine marker neuron-specific enolase in the floating cells was three times that found in the adherent cells. The floating subline also had much greater surface expression of neuroendocrine tumor antigens detected by monoclonal antibodies UJ13A and HNK-1, which have been recently shown to detect the neural cell adhesion molecule (NCAM) on SCLC cells. Two other adherent SCLC-v lines were also found to be unreactive with UJ13A and HNK-1, generalizing the association between NCAM expression and the growth of most SCLC cultures as floating aggregates. In conclusion, we have an interesting model to study expression of NCAM as related to the adhesive properties of SCLC cells.
Childbirth Following Breast Cancer: An Evaluation of the 'Healthy Mothers' Excess Mortality Risk.
Authors: M. Hartman, M. Hartman, G. Lim, K. Czene, V. Bhalla, K. Chow, K. Yap, K. Chia, K. Chia, H. Verkooijen, H. Verkooijen, H. Verkooijen
Journal: Cancer Research (2009)

Abstract Background: The favorable outcome of mothers giving birth after breast cancer compared to those who do not, has been attributed to a healthy mother effect. Mainly former breast cancer patients with excellent health status and outlook proceed to having children after their disease. This study evaluates the excess mortality risk among these 'healthy mothers' and factors modifying this risk.Methods: By linking the Singapore Birth Registry (319'437 individuals) and Swedish Multi-Generation Cohort (11 million women) with the respective national cancer registries we identified all 509 women who gave birth &amp;gt;12 months after a breast cancer diagnosis. We calculated excess absolute mortality risks and Standardized Mortality Ratios (SMRs). We used Poisson regression analysis to calculate relative risks of death by country, period of follow up and interval between cancer diagnosis and subsequent birth.Results: The overall 15-year cumulative mortality was 18.2% (95% CI: 13.3 – 20.7%) which is substantially higher than that of the background population (SMR 13.3, 95%CI: 10.4-16.9). Excess mortality risks remained constant over follow up time and were comparable between Sweden and Singapore. Mortality risks decreased significantly with increasing interval between diagnosis and subsequent birth.Conclusion: Despite being 'healthy mothers', women who give birth after a diagnosis of breast cancer have a substantially higher risk of death than the background population. This information may be useful in a woman's decision whether to have a(another) child after breast cancer. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3173.
Accuracy of mean arterial pressure and blood pressure measurements in predicting pre-eclampsia: systematic review and meta-analysis
Authors: Jeltsje S Cnossen, Karlijn C Vollebregt, Nynke de Vrieze, Gerben ter Riet, Ben W J Mol, Arie Franx, Khalid S Khan, Joris A M van der Post
Journal: BMJ (2008)

<b>Objective</b> To determine the accuracy of using systolic and diastolic blood pressure, mean arterial pressure, and increase of blood pressure to predict pre-eclampsia. <b>Design</b> Systematic review with meta-analysis of data on test accuracy. <b>Data sources</b> Medline, Embase, Cochrane Library, Medion, checking reference lists of included articles and reviews, contact with authors. <b>Review methods</b> Without language restrictions, two reviewers independently selected the articles in which the accuracy of blood pressure measurement during pregnancy was evaluated to predict pre-eclampsia. Data were extracted on study characteristics, quality, and results to construct 2×2 tables. Summary receiver operating characteristic curves and likelihood ratios were generated for the various levels and their thresholds. <b>Results</b> 34 studies, testing 60 599 women (3341 cases of pre-eclampsia), were included. In women at low risk for pre-eclampsia, the areas under the summary receiver operating characteristic curves for blood pressure measurement in the second trimester were 0.68 (95% confidence interval 0.64 to 0.72) for systolic blood pressure, 0.66 (0.59 to 0.72) for diastolic blood pressure, and 0.76 (0.70 to 0.82) for mean arterial pressure. Findings for the first trimester showed a similar pattern. Second trimester mean arterial pressure of 90 mm Hg or more showed a positive likelihood ratio of 3.5 (95% confidence interval 2.0 to 5.0) and a negative likelihood ratio of 0.46 (0.16 to 0.75). In women deemed to be at high risk, a diastolic blood pressure of 75 mm Hg or more at 13 to 20 weeks' gestation best predicted pre-eclampsia: positive likelihood ratio 2.8 (1.8 to 3.6), negative likelihood ratio 0.39 (0.18 to 0.71). Additional subgroup analyses did not show improved predictive accuracy. <b>Conclusion</b> When blood pressure is measured in the first or second trimester of pregnancy, the mean arterial pressure is a better predictor for pre-eclampsia than systolic blood pressure, diastolic blood pressure, or an increase of blood pressure.
A friend in need
Authors: D. Spence
Journal: BMJ (2010)

He offered me a cigarette. “It’s only bloody ophthalmology; you could get the whole course on a postage stamp.” We both laughed drunkenly. But at 3 am I sat bolt upright, letting out a gasp. I leapt to my desk and opened my “pocket guide” to ophthalmology. The exam was at 9 am. This wasn’t revision, because I hadn’t ever opened the book before. Unblinking and wide eyed I poured knowledge into my hungover, …
Myosin heavy chain gene expression in human heart failure.
Authors: K Nakao, W Minobe, R Roden, M R Bristow, L A Leinwand
Journal: Journal of Clinical Investigation (1997)

Two isoforms of myosin heavy chain (MyHC), alpha and beta, exist in the mammalian ventricular myocardium, and their relative expression is correlated with the contractile velocity of cardiac muscle. Several pathologic stimuli can cause a shift in the MyHC composition of the rodent ventricle from alpha- to beta-MyHC. Given the potential physiological consequences of cardiac MyHC isoform shifts, we determined MyHC gene expression in human heart failure where cardiac contractility is impaired significantly. In this study, we quantitated the relative amounts of alpha- and beta-MyHC mRNA in the left ventricular free walls (LVs) of 14 heart donor candidates with no history of cardiovascular disease or structural cardiovascular abnormalities. This group consisted of seven patients with nonfailing (NF) hearts and seven patients with hearts that exhibited donor heart dysfunction (DHD). These were compared with 19 patients undergoing cardiac transplantation for chronic end-stage heart failure (F). The relative amounts of alpha-MyHC mRNA to total (i.e., alpha + beta) MyHC mRNA in the NF- and DHD-LVs were surprisingly high compared with previous reports (33.3+/-18.9 and 35.4+/-16.5%, respectively), and were significantly higher than those in the F-LVs, regardless of the cause of heart failure (2.2+/-3.5%, P < 0.0001). There was no significant difference in the ratios in NF- and DHD-LVs. Our results demonstrate that a considerable amount of alpha-MyHC mRNA is expressed in the normal heart, and is decreased significantly in chronic end-stage heart failure. If protein and enzymatic activity correlate with mRNA expression, this molecular alteration may be sufficient to explain systolic dysfunction in F-LVs, and therapeutics oriented towards increasing alpha-MyHC gene expression may be feasible.
Irreversible binding of chlorinated ethylenes to macromolecules
Authors: H. M. Bolt, J. G. Filser
Journal: Environmental Health Perspectives (1977)

Rats have been exposed in a closed system to the chlorinated ethylenes vinyl chloride and trichloroethylene and to carbon tetrachloride as a reference compound. Data of uptake of the compounds, of urinary excretion of metabolites, and of exhalation after exposure show that the chlorinated ethylenes are metabolized much faster than carbon tetrachloride, probably due to their common ethylene structure. To eliminate differences in uptake, calculation of metabolites of the three compounds in tissues was based on the amount actually taken up by the animals. Vinyl chloride, trichloroethylene, and carbon tetrachloride showed irreversible binding of metabolites to tissue proteins, mainly of the liver. Irreversible protein binding of either of these compounds ranged within the same order of magnitude, if related to the amount of compound which had been taken up. Also, no differences in the relative portion of irreversibly bound metabolites were found after exposure to different atmospheric concentrations of the three compounds. As already shown for vinyl chloride, trichloroethylene is metabolized in vitro by rat liver microsomes in presence of NADPH-regenerating system to intermediates that irreversibly bind to proteins. Albumin (bovine and rabbit) was a preferred target for binding. In contrast to vinyl chloride, significant irreversible binding of trichloroethylene metabolites also occurred to non-SH-proteins (gamma-globulin, concanavalin A) and to polylysine. Hence it should be inferred that, unlike vinyl chloride, trichloroethylene metabolites not only bind to sulfhydryl groups but also, to a lesser extent, to free amino groups of proteins.
1163 IMPACT OF HBV AND HCV IN KIDNEY TRANSPLANTED PATIENTS: ACTUALIZATION OF PREVALENCE AND PROGNOSTIC DATA
Authors: R. Boubchir, A. Louvet, M. Hazzan, V. Canva-Delcambre, F. Glowacki, F. Provôt, S. Dharancy, P. Deltenre, C. Noël, P. Mathurin
Journal: Journal of Hepatology (2011)
Cholestyramine in uraemic pruritus.
Authors: D S Silverberg, A Iaina, E Reisin, R Rotzak, H E Eliahou
Journal: BMJ (1977)

In a patient with longstanding severe uraemic pruritus who was undergoing chronic haemodialysis cholestyramine caused the pruritus to disappear completely within a few days. A four-week randomised controlled double-blind study was therefore performed in 10 other patients with uraemic pruritus who were on chronic haemodialysis. The pruritus improved considerably in four of the five treated patients, whereas only one of those treated with placebo experienced relief. The patient who had no relief while on cholestyramine showed a considerable improvement when the dose subsequently doubled. One of the five patients receiving cholestyramine experienced mild and easily reversible constipation, and another suffered nausea. Neither of these complications prevented the patients from continuing treatment. Cholestyramine seems to be useful in treating uraemic pruritus, although it is not known how it acts.
Integration of Three-Dimensional Scar Maps for Ventricular Tachycardia Ablation With Positron Emission Tomography-Computed Tomography
Authors: Timm Dickfeld, Peng Lei, Vasken Dilsizian, Jean Jeudy, Jun Dong, Apostolos Voudouris, Robert Peters, Magdi Saba, Raj Shekhar, Stephen Shorofsky
Journal: JACC. Cardiovascular imaging (2008)
Cardioaortic Fistula
Authors: BERNARD L. BROFMAN, JOHN C. ELDER
Journal: Circulation (1957)

Rupture of a sinus of Valsalva aneurysm into the right ventricle produces a dramatic clinical syndrome characterized by a rapid and relentlessly unfavorable course. Early diagnosis is essential for surgical repair before an irreversible stage is reached. Cardiac catheterization and retrograde aortography confirmed the diagnosis in the case reported. With the aid of temporary circulatory occlusion, the fistula was demonstrated by contrast material injected via an aortic catheter. Although the fistula and the accompanying ventricular septal defect were closed at open-heart surgery, the markedly enlarged heart could not resume its function.
Walking for Pleasure
Authors: Samuel Vaisrub
Journal: JAMA (1980)

A renowned nightclub stripper once made a startling revelation. She maintained that while her admirers were noisily clamoring for further disclosures, they were hardly looking at the unveiled parts of her anatomy. Instead, they were observing her changing facial expressions, as she was peeling off her vestments. We, too, may be well advised to observe facial expression whenever we are after the naked truth.  If the naked truth that we are after is about the joys of jogging, let us observe the faces of joggers. When jogging was in its infancy, these faces were radiant. We can still remember the happily smiling middle-agers and oldsters who suddenly discovered that they were still fleet of foot and young at heart and that the open road and open skies were theirs for the running.  With the passing of years, however, happiness faded from the joggers' faces. Their expressions now border on unremitting
DEPRESSIVE SYMPTOMS ARE COMMON AND ASSOCIATED WITH ADVERSE CLINICAL OUTCOMES IN HEART FAILURE WITH REDUCED AND PRESERVED EJECTION FRACTION: THE DIFFERENTIAL RELEVANCE OF BETA-BLOCKERS FOR REDUCING DEPRESSIVE SYMPTOMS
Authors: Naoko Kato, Koichiro Kinugawa, Taro Shiga, Masaru Hatano, Norihiko Takeda, Yasushi Imai, Masafumi Watanabe, Atsushi Yao, Yasunobu Hirata, Ryozo Nagai
Journal: Journal of the American College of Cardiology (2012)
CDC reports first case of vancomycin resistant Staphylococcus aureus
Authors: S. Gottlieb
Journal: BMJ (2003)

The Centers for Disease Control and Prevention (CDC) has reported that in summer 2002, a 40 year old Michigan woman became the first person worldwide known to have been infected with a strain of Staphylococcus aureus that was resistant to the antibacterial vancomycin.

The Michigan woman developed foot ulcers and other skin infections after becoming infected with the bacterium following an amputation. She …
Pneumoscrotum after colonoscopic polypectomy
Authors: F. Graepler, U. Lauer, M.-S. Horger, R. Ladurner, M. Gregor
Journal: Endoscopy (2007)

Colonoscopy was perfomed in a 65-year-old man for the investigation of obscure gastrointestinal blood loss. A 7-mm sessile polyp was found 40 cm above the anus. During polypectomy the patient noticed a short sensation in his bowels. Because the endoscopic aspect of the very small poypectomy site seemed deeper than normal, two clips were positioned over the polypectomy site in the same session. Some 30 minutes after completion of the procedure, the patient noticed swelling of his scrotum (Figure [1]). A plain abdominal radiograph showed free abdominal air and subcutaneous emphysema (Figure [2]). The subcutaneous emphysema increased further over the next few hours, so it was decided to perform a laparotomy.