tbuckley/cabot-search huggingface dataset:
Anthony Michael Jelliffe
Authors: Chris Jelliffe
Journal: BMJ (2008)

Anthony Michael Jelliffe, known to friends and family alike as Tony, was born on 29 July 1923 in Malta, the second of three sons, to Dorothy and Reginald (known to all as “Jelly”). Their father realised the vital importance of good education and so, despite the severe financial restrictions of an Admiralty stores officer’s wages, all three boys were educated at the Merchant Taylors School and then went on to complete their medical training at the Middlesex Hospital Medical School in London.

Tony qualified in 1945, and wryly described the challenge of revising for medical exams while sitting on the hospital roof armed with a stirrup pump to extinguish incendiary bombs during the Blitz. He passed the MRCP examination a year …
When Medical Help Really Is Far Away...
Authors: Chris Anne Raymond
Journal: JAMA (1988)

TRAVERSING THE BACK ROADS to some small village in the Appalachians or a remote outpost in the Yukon, the rural physician even today often carries the essential elements of clinical practice in a black leather bag worn by years of faithful service. From the seemingly limitless pharmacopeia at the fingertips of physicians on hospital staffs, the awesome array of diagnostic tools filling the corners of private offices and public health clinics, the far-traveling healer's equipment is reduced to essentials: a stethoscope, a blood pressure cuff, a splint and tourniquet, and a few drugs. The goal: treat the minor ills, stabilize the major ones until the patient can reach a medical facility. Imagine then that the remote practitioner's better-equipped colleagues are a million miles away, and therapy is limited strictly by the supplies foresight prompted this physician to bring along. That's what James Logan, MD, is doing today at the National
Opera: Desire, Disease, Death
Authors: B. Charlton
Journal: BMJ (1996)

Linda Hutcheon, Michael Hutcheon University of Nebraska Press, $40, pp 294 ISBN 0 8032 2367 6

Opera: desire, disease, death—what does that conjure up? For me, it is a matter of crying, uncontrollably, in public. I remember for instance, a few years ago, being led by the hand from a performance of Verdi's La Traviata out on to the streets of Edinburgh, still blinded by tears. Or something similar while watching the closing scenes of La Boheme—caught off guard by the desperately affecting moment when another consumptive heroine quietly dies.



Consumptive heroines: another one bites the dust



Opera performs such punches to the solar plexus more powerfully than any other …
Alterations in Lung Mast Cell Populations in Patients with Chronic Obstructive Pulmonary Disease
Authors: Cecilia K. Andersson, Michiko Mori, Leif Bjermer, Claes-Göran Löfdahl, Jonas S. Erjefält
Journal: American Journal of Respiratory and Critical Care Medicine (2009)

Mast cells have important roles in innate immunity and tissue remodeling but have remained poorly studied in inflammatory airway diseases like chronic obstructive pulmonary disease (COPD).To perform a detailed histological characterization of human lung mast cell populations at different severities of COPD, comparing with smoking and never-smoking control subjects.Mast cells were analyzed in lung tissues from patients with mild to very severe COPD, GOLD I-IV (n = 25, 10 of whom were treated with corticosteroids). Never-smokers and smokers served as controls. The density, morphology, and molecular characteristics of mucosal and connective tissue mast cells (MC(T) and MC(TC), respectively) were analyzed in several lung regions.In all compartments of COPD lungs, especially at severe stages, the MC(TC) population increased in density, whereas the MC(T) population decreased. The net result was a reduction in total mast cell density. This phenomenon was paralleled by increased numbers of luminal mast cells, whereas the numbers of terminal transferase dUTP nick end labeling (TUNEL)(+) apoptotic mast cells remained unchanged. In COPD lungs, the MC(T) and MC(TC) populations showed alterations in morphology and expression of CD88 (C5a-R), transforming growth factor (TGF)-beta, and renin. Statistically significant correlations were found between several COPD-related mast cell alterations and lung function parameters.As COPD progresses to its severe stages, the mast cell populations in the lung undergo changes in density, distribution, and molecular expression. In COPD lungs, these novel histopathological features were found to be correlated to lung function and they may thus have clinical consequences.
Cyclic Nucleotide Phosphodiesterase Type 5 Activity Limits Blood Flow to Hypoperfused Myocardium During Exercise
Authors: Jay H. Traverse, Ying Jie Chen, Ruisheng Du, Robert J. Bache
Journal: Circulation (2000)

Background —Nitric oxide (NO) causes vasodilation by stimulation of guanylate cyclase in vascular smooth muscle to produce cGMP. The resultant vasodilator effect is regulated by a family of cGMP phosphodiesterases (PDEs). Sildenafil, a selective inhibitor of PDE5 used for treatment of erectile dysfunction, has been found to cause relaxation of isolated epicardial coronary artery segments. The present study examined the effects of sildenafil on coronary blood flow and hemodynamics during exercise in normal and ischemic heart. Methods and Results —In chronically instrumented normal dogs, sildenafil 2 mg/kg PO caused a slight but significant increase in left anterior descending (LAD) coronary blood flow during resting conditions, with a nonsignificant trend toward increased coronary flow during treadmill exercise. Exercise in the presence of LAD stenosis that decreased distal coronary pressure to 57±2 mm Hg reduced LAD flow during exercise from 69±8 to 41±7 mL/min ( P &lt;0.05), with hypoperfusion most severe in the subendocardium. At the same distal coronary pressure, sildenafil increased LAD flow in the ischemic region to 50±11 mL/min ( P &lt;0.05). Increase in ischemic region blood flow produced by sildenafil was uniform across the LV wall, given that no change occurred in the transmural distribution of perfusion. Conclusions —Inhibition of PDE5 with sildenafil caused vasodilation of coronary resistance vessels with an increase of blood flow into an ischemic myocardial region during exercise in the presence of coronary artery stenosis.
Histopathological Classification of Nonneoplastic and Neoplastic Gastrointestinal Submucosal Lesions
Authors: T. Wiech, A. Walch, M. Werner
Journal: Endoscopy (2005)

This article provides an overview of the histopathologically defined nonneoplastic and neoplastic entities involved in submucosal lesions (SMLs) of the gastrointestinal tract, particularly those in the upper gastrointestinal tract. The gross appearance and the histomorphological and cytomorphological features of the most frequent SMLs are described, including gastrointestinal stromal tumor (GIST), leiomyoma, lipoma, carcinoid, granular-cell tumor, glomus tumor, schwannoma, submucosal metastases, Brunner’s gland hamartoma, pancreatic rests, and cysts. The current state of important technical aspects of biopsy processing and the role of histology and cytology in the diagnosis of SMLs are discussed.
Lateral Cervical and Preauricular Sinuses: Their Transmission as Dominant Characters
Authors: A. G. Martins
Journal: BMJ (1961)

HYPERPARATHYROIDISMBEDITmJsUL 255rare and we have been able to discover only one case (Bogdonoff et al., 1956).It is therefore not surprising that evidence of histological calcification is also uncommon.SummaryA patient with primary hyperparathyroidism and renal damage had the radiological picture of "rugger jersey" spine due to zones of osteosclerosis.This appearance does not, as has been stated, show that the hyperparathyroidism is secondary to renal damage, but merely that renal damage coexists.We thank Drs.
Breathlessness and portable oxygen in chronic obstructive airways disease.
Authors: J C Waterhouse, P Howard
Journal: Thorax (1983)

Breathlessness was measured in 20 patients with severe chronic obstructive lung disease by the use of a visual-analogue scale. Severe resting arterial hypoxaemia was not a feature. The severity of breathlessness measured in this way did not correlate well with the results of spirometric tests or with walking ability. The use of portable oxygen was studied during simple walking tests for its effect on walking ability and the sensation of breathlessness. Portable oxygen improved exercise capacity but a placebo effect of the system probably accounted for some of the improvement. A clear improvement of distressing breathlessness was observed and represented a useful therapeutic response. Breathlessness and simple exercise ability were shown to respond independently to oxygen breathing. The value of short-term intermittent oxygen in patients with severe chronic obstructive lung disease needs to be evaluated in terms of both exercise ability and breathlessness.
WHO calls for registration of all clinical trials
Authors: Rory Watson
Journal: BMJ (2006)

The World Health Organization is calling for all medical research involving humans to be registered at the earliest possible stage of its development. It is also calling for 20 key features of the research project to be made publicly available.

WHO made the recommendation as the world's first international clinical trials day was held in Brussels on 19 May. Organised by the European clinical research infrastructures network, the European Commission, and WHO, the annual event is designed to raise general awareness about the methods and challenges of such research.

WHO's proposal for voluntary registration …
GENETIC CONTROL OF THE IMMUNE RESPONSE TO STAPHYLOCOCCAL NUCLEASE
Authors: Eugene C. Lozner, David H. Sachs, Gene M. Shearer
Journal: The Journal of Experimental Medicine (1974)

A number of inbred and congenic resistant strains of mice were immunized with staphylococcal nuclease (Nase). Antibody responses were measured in the sera of the animals by a sensitive method involving inhibition of enzymatic hydrolysis of DNA, High responder strains included A/J, DBA/2, BALB/c, AKR/J, C57BR, and SJL/J. DBA/1 and C57BL/6 mice were low responders. The strain distribution of anti-Nase response potential was compatible with the relevant immune response gene(s) being linked to the murine major histocompatibility complex. Linkage of this response to H-2 was demonstrated by the findings that: (a) the congenic C3H/HeJ and C3H.SW mice were respectively high and low responders; (b) the congenic lines B10.A and B10.D2 were high responders, whereas the C57BL/10 strain was a poor responder; and (c) anti-Nase response potential of F2 progeny from DBA/1 x SJL/J matings correlated with their H-2 type. Three B10.A recombinant lines were used to map this Ir gene within H-2. B10.A(4R) was a high responder to Nase, whereas B10.A(2R) and B10.A(5R) were both low responders. We wish to propose the name Ir-Nase for the gene(s) controlling antibody responsiveness to this immunogen. Our data indicate that Ir-Nase is located within the same chromosomal segment of the H-2 complex as is Ir-IgG.
Recurrent<i>PRKAR1A</i>Mutation in Acrodysostosis with Hormone Resistance
Authors: Agnès Linglart, Christine Menguy, Alain Couvineau, Colette Auzan, Yasemin Gunes, Mathilde Cancel, Emmanuelle Motte, Graziella Pinto, Philippe Chanson, Pierre Bougnères, Eric Clauser, Caroline Silve
Journal: New England Journal of Medicine (2011)

The skeletal dysplasia characteristic of acrodysostosis resembles the Albright's hereditary osteodystrophy seen in patients with pseudohypoparathyroidism type 1a, but defects in the α-stimulatory subunit of the G-protein (GNAS), the cause of pseudohypoparathyroidism type 1a, are not present in patients with acrodysostosis. We report a germ-line mutation in the gene encoding PRKAR1A, the cyclic AMP (cAMP)-dependent regulatory subunit of protein kinase A, in three unrelated patients with acrodysostosis and resistance to multiple hormones. The mutated subunit impairs the protein kinase A response to stimulation by cAMP; this explains our patients' hormone resistance and the similarities of their skeletal abnormalities with those observed in patients with pseudohypoparathyroidism type 1a.
The performance of expansile nanoparticles in a murine model of peritoneal carcinomatosis
Authors: Yolonda L. Colson, Rong Liu, Emily B. Southard, Morgan D. Schulz, Jacqueline E. Wade, Aaron P. Griset, Kimberly Ann V. Zubris, Robert F. Padera, Mark W. Grinstaff
Journal: Biomaterials (2010)
Asphyxiation Following Thermal Burns of the Face
Authors: Richard Ford
Journal: New England Journal of Medicine (1949)

ASPHYXIATION FOLLOWING THERMAL BURNS OF THE FACEPersons trapped in conflagrations may die as a result of damage to the respiratory tract without injury to the surface of the body.1 The problem of whether smoke and irritant gases or tremendously heated air is the responsible agent has often been discussed.2 In 1945 Moritz, Henriques and McLean3 reported an experimental study of the effects of inhaled heat, which showed that only when the original temperature of heated air is high enough to produce instantaneous burning of the skin and upper respiratory mucosa is there thermal damage to the pulmonary parenchyma. The . . .
Estimating pulmonary artery pressures by echocardiography in patients with emphysema
Authors: M. R. Fisher, G. J. Criner, A. P. Fishman, P. M. Hassoun, O. A. Minai, S. M. Scharf, and H. E. Fessler
Journal: European Respiratory Journal (2007)

In patients with emphysema being evaluated for lung volume reduction surgery, Doppler echocardiography has been used to screen for pulmonary hypertension as an indicator of increased peri-operative risk. To determine the accuracy of this test, the present authors compared the results of right heart catheterisations and Doppler echocardiograms in 163 patients participating in the cardiovascular substudy of the National Emphysema Treatment Trial. Substudy patients had both catheterisation and Doppler echocardiography performed before and after randomisation. In 74 paired catheterisations and echocardiograms carried out on 63 patients, the mean values of invasively measured pulmonary artery systolic pressures and the estimated right ventricular systolic pressures were similar. However, using the World Health Organization's definitions of pulmonary hypertension, echocardiography had a sensitivity of 60%, specificity of 74%, positive predictive value of 68% and a negative predictive value of 67% compared with the invasive measurement. Bland–Altman analysis revealed a bias of 0.37 kPa with 95% limits of agreement from -2.5–3.2 kPa. In patients with severe emphysema, echocardiographic estimates of pulmonary artery pressures correlate very weakly with right heart catheterisations, and the test characteristics ( e.g. sensitivity, specificity, etc .) of echocardiographic assessments are poor.
Angiotensin-converting enzyme and angiotensin II receptor 1 polymorphisms: association with early coronary disease
Authors: Ruth Álvarez, Julián R Reguero, Alberto Batalla, Gustavo Iglesias-Cubero, Arturo Cortina, Victoria Álvarez, Eliecer Coto
Journal: Cardiovascular Research (1998)

Objective: to examine the association between coronary artery disease and polymorphisms at the angiotensin-converting enzyme (ACE) and angiotensin II type 1 receptor (AT1R) genes. Methods: A total of 181 patients younger than 50 years and 240 controls from the same homogeneous Caucasian population (Asturias, Northern Spain) were genotyped (using polymerase chain reaction) for the ACE insertion/deletion (ACE-I/D) and the AT1R A/C transversion (AT1R-A/C) (3′-untranslated region) polymorphisms. Results: The DD-genotype was at a non-significant higher frequency among patients (50%) than in controls (41%). No difference between the two groups was found for the AT1R-genotypes. Distribution of ACE-genotypes according to AT1R-genotypes showed a significant association between ACE-DD and AT1R-CC and early coronary disease. Among the CC patients 58% were DD, compared to 21% among the controls (p=0.02; OR=5.32, 95%CI=1.45, 19.51). We determined the distribution of these genotypes among the hypertensive and non-hypertensive patients. Frequencies of ACE- or AT1R-genotypes did not differ between the two groups. However, we found an interaction between the DD- and CC-genotypes in the group of normotensives. Among the CC patients, 13% of the hypertensives and 75% of the normotensives were DD (p=0.014). Conclusions: Our results indicate a synergistic contribution of ACE and AT1R polymorphisms to the risk of coronary artery disease. This gene–gene interaction could have clinical implications. Approximately 2% of individuals in our population are CC+DD, and the genotyping of both polymorphisms could identify those with a high relative risk for coronary artery disease.
House Dust Mite Sublingual Immunotherapy
Authors: Robyn E. O'Hehir, Leanne M. Gardner, Maria P. de Leon, Belinda J. Hales, Mark Biondo, Jo A. Douglass, Jennifer M. Rolland, Alessandra Sandrini
Journal: American Journal of Respiratory and Critical Care Medicine (2009)

Sublingual allergen-specific immunotherapy is gaining popularity for treatment of allergic diseases, but underlying immunological mechanisms are unresolved.To perform detailed immunological investigation of sublingual house dust mite (HDM) immunotherapy.A 12-month randomized double-blind placebo-controlled study of sublingual HDM immunotherapy in 30 HDM-allergic subjects was performed, with 1-year open extension in 9 patients on active treatment. HDM-stimulated blood mononuclear cells were analyzed for proliferation, cytokines, and regulatory T cells (Tregs) by flow cytometry and ELISA. Effects of blocking transforming growth factor (TGF)-beta and IL-10 on proliferation were determined. Treg suppressor function and allergen-specific antibody levels were measured. Clinical efficacy was assessed by symptom, medication, and Juniper quality-of-life scores.Allergen-induced CD4(+) T-cell division and IL-5 production were significantly decreased after 6- and 12-months' active treatment but not placebo. sTGF-betaRII blocked immunotherapy-induced suppression of allergen-specific T-cell proliferation, maximal at 6 months. Decreased allergen-specific CD4(+) T-cell proliferation and increased IL-10 secretion and serum Der p 2-specific IgG(4) were maximal at 24 months' active treatment. Treg (CD4(+)CD25(+)CD127(lo)/Foxp3(+)) function was demonstrated by suppression of allergen-specific effector T-cell (CD4(+)CD25(-)CD127(hi)) proliferation and cytokine production. Clinical efficacy of immunotherapy was supported by significantly decreased rhinitis symptom score, total asthma score, and Juniper quality-of-life score.This study establishes the novel finding that TGF-beta mediates the immunological suppression seen early in clinically effective sublingual HDM immunotherapy in addition to an increase in Tregs with suppressor function. Clinical trial registered with www.clinicaltrials.gov (NCT00250263).
Normal distribution of peripheral blood mononuclear cell (PBMC) subsets from birth to 18 years: The NIH NIAID DAIDS pediatric AIDS clinical trial group P-1009 protocol
Authors: W.T. Shearer, H.M. Rosenblatt, S.A. Spector, E.R. Stiehm, D.W. Wara, S.D. Douglas, K. Luzuriaga, E.J. McFarland, R. Yogev, M.H. Rathore, W. Levy, B.L. Graham, R. Oyomopito, R.S. Gelman
Journal: Journal of Allergy and Clinical Immunology (2003)
Health and safety at work.
Authors: G M Prentice
Journal: BMJ (1979)

apparent fall in LAA concentration was simply due to the increasing proportion of granulo- cytes in the differential white blood cell count, and that a true fall in LAA concentration had not occurred.After the acute "stress" had subsided and the leucocytosis returned to normal, however, the LAA concentration and serum ascorbic acid concentration remained low, presumably because of tissue depletion of ascorbic acid.Both may remain low for up to 56 days.2We also found that tissue damage is pro- bably necessary to produce the long-term depletion of LAA and serum ascorbic acid concentrations since the acute changes in LAA only can be produced by tetracosactrin infusions in normal subjects.2
Cardiopulmonary toxicity after three courses of ABVD and mediastinal irradiation in favorable Hodgkin’s disease
Authors: P. Brice, J. Tredaniel, J. J. Monsuez, J. P. Marolleau, C. Ferme, C. Hennequin, J. Frija, C. Gisselbrecht, M. Boiron
Journal: Annals of Oncology (1991)
IMPACT OF MITRAL ANNULAR CALCIFICATION ON OUTCOMES OF AORTIC VALVE SURGERY
Authors: Ratna Priya Gangi, Abhilash Akinapelli, Sushma Koneru, Abhishek Matta, Saraschandra Vallabhajosyula, Pallavi Bellamkonda, Venkata Alla, Aryan Mooss, Chandra Nair, Mark Holmberg, Jeffrey Sugimoto
Journal: Journal of the American College of Cardiology (2014)
Immunosuppressive factor(s) extracted from lymphoid cells of nonresponder mice primed with L-glutamic acid60-L-alanine30-L-tyrosine10 (GAT) II. Cellular source and effect on responder and nonresponder mice.
Authors: J A Kapp, C W Pierce, B Benacerraf
Journal: The Journal of Experimental Medicine (1977)

The synthetic terpolymer of L-glutamic acid60-L-alanine30-L-tyrosine10 (GAT) fails to stimulate development of GAT-specific antibody responses in nonresponder strains of mice, but does stimulate the development of GAT-specific suppressor T cells that inhibit the development of normal anti-GAT antibody responses to GAT complexed to methylated bovine serum albumin (GAT-MBSA). Furthermore, extracts prepared from lymphoid cells of GAT-primed, but not control, nonresponder mice inhibit the development of antibody responses to GAT-MBSA by normal nonresponder mice. This suppression is specific, dose-dependent, and can be readily analyzed in vitro. The suppressive factor is a T-cell product. An extract from GAT-primed DBA/1 mice inhibits the response to GAT-MBSA by spleen cells from histoincompatible strains of mice that are nonresponders to GAT, but not strains that are responders to GAT.
Does This Patient With Diabetes Have Large-Fiber Peripheral Neuropathy?
Authors: Jamil N. Kanji
Journal: JAMA (2010)

Diabetic peripheral neuropathy predisposes patients to foot ulceration that heals poorly and too often leads to amputation. Large-fiber peripheral neuropathy (LFPN), one common form of diabetic neuropathy, when detected early prompts aggressive measures to prevent progression to foot ulceration and its associated morbidity and mortality.To systematically review the literature to determine the clinical examination findings predictive of asymptomatic LFPN before foot ulceration develops.MEDLINE (January 1966-November 2009) and EMBASE (1980-2009 [week 50]) databases were searched for articles on bedside diagnosis of diabetic peripheral neuropathy. Included studies compared elements of history or physical examination with nerve conduction testing as the reference standard.Of 1388 articles, 9 on diagnostic accuracy and 3 on precision met inclusion criteria. The prevalence of diabetic LFPN ranged from 23% to 79%. A score greater than 4 on a symptom questionnaire developed by the Italian Society of Diabetology increases the likelihood of LFPN (likelihood ratio [LR], 4.0; 95% confidence interval [CI], 2.9-5.6; negative LR, 0.19; 95% CI, 0.10-0.38). The most useful examination findings were vibration perception with a 128-Hz tuning fork (LR range, 16-35) and pressure sensation with a 5.07 Semmes-Weinstein monofilament (LR range, 11-16). Normal results on vibration testing (LR range, 0.33-0.51) or monofilament (LR range, 0.09-0.54) make LFPN less likely. Combinations of signs did not perform better than these 2 individual findings.Physical examination is most useful in evaluating for LFPN in patients with diabetes. Abnormal results on monofilament testing and vibratory perception (alone or in combination with the appearance of the feet, ulceration, and ankle reflexes) are the most helpful signs.