tbuckley/cabot-search huggingface dataset:
Thromboelastography in patients with severe sepsis: a prospective cohort study
Authors: Nicolai Haase, Sisse Rye Ostrowski, Jørn Wetterslev, Theis Lange, Morten Hylander Møller, Hamid Tousi, Morten Steensen, Frank Pott, Peter Søe-Jensen, Jonas Nielsen, Peter Buhl Hjortrup, Pär Ingemar Johansson, Anders Perner
Journal: Intensive Care Medicine (2014)
The Ultrasonically Guided Puncture of the Gallbladder in Animals: A New Methodological Procedure for a Simple and Non-Surgical Collection of Gallbladder Bile
Authors: R. Klapdor, K. Scherer, H. Sepehr, G. Klöppel
Journal: Endoscopy (1977)

In 4 piglets the gallbladder was punctured under sonographic control threetimes during a period of 46 days. Each puncture was proved by X-ray controls after application of 2-4 ml of a water soluble contrast medium. One day after the third puncture all animals were killed in order to look for macroscopic or microscopic lesions of the gallbladder, the adjacent liver tissue and the peritoneum resulting from the experimental procedure. The results indicate that the ultrasonically guided puncture of the gallbladder represents a procedure to obtain pure bile samples in the piglet or animals of similar size in a simple and non surgical and, therefore, most physiological manner.
Role of Lung Pericytes and Resident Fibroblasts in the Pathogenesis of Pulmonary Fibrosis
Authors: Chi Hung, Geoffrey Linn, Yu-Hua Chow, Akio Kobayashi, Kristen Mittelsteadt, William A. Altemeier, Sina A. Gharib, Lynn M. Schnapp, Jeremy S. Duffield
Journal: American Journal of Respiratory and Critical Care Medicine (2013)

The origin of cells that make pathologic fibrillar collagen matrix in lung disease has been controversial. Recent studies suggest mesenchymal cells may contribute directly to fibrosis.To characterize discrete populations of mesenchymal cells in the normal mouse lung and to map their fate after bleomycin-induced lung injury.We mapped the fate of Foxd1-expressing embryonic progenitors and their progeny during lung development, adult homeostasis, and after fibrosing injury in Foxd1-Cre; Rs26-tdTomato-R mice. We studied collagen-I(α)1-producing cells in normal and diseased lungs using Coll-GFP(Tg) mice.Foxd1-expressing embryonic progenitors enter lung buds before 13.5 days post-conception, expand, and form an extensive lineage of mesenchymal cells that have characteristics of pericytes. A collagen-I(α)1-expressing mesenchymal population of distinct lineage is also found in adult lung, with features of a resident fibroblast. In contrast to resident fibroblasts, Foxd1 progenitor-derived pericytes are enriched in transcripts for innate immunity, vascular development, WNT signaling pathway, and cell migration. Foxd1 progenitor-derived pericytes expand after bleomycin lung injury, and activate expression of collagen-I(α)1 and the myofibroblast marker αSMA in fibrotic foci. In addition, our studies suggest a distinct lineage of collagen-I(α)1-expressing resident fibroblasts that also expands after lung injury is a second major source of myofibroblasts.We conclude that the lung contains an extensive population of Foxd1 progenitor-derived pericytes that are an important lung myofibroblast precursor population.
Recognition of the Major Histocompatibility Complex Restriction Element Modulates CD8+ T Cell Specificity and Compensates for Loss of T Cell Receptor Contacts with the Specific Peptide
Authors: Johan K. Sandberg, Klas Kärre, Rickard Glas
Journal: The Journal of Experimental Medicine (1999)

Triggering of a T cell requires interaction between its specific receptor (TCR) and a peptide antigen presented by a self–major histocompatibility complex (MHC) molecule. TCR recognition of self-MHC by itself falls below the threshold of detection in most systems due to low affinity. To study this interaction, we have used a read-out system in which antigen-specific effector T cells are confronted with targets expressing high levels of MHC compared with the selecting and priming environment. More specifically, the system is based on CD8+ T cells selected in an environment with subnormal levels of MHC class I in the absence of β2-microglobulin. We observe that the MHC restriction element can trigger viral peptide-specific T cells independently of the peptide ligand, provided there is an increase in self-MHC density. Peptide-independent triggering required at least four times the natural in vivo level of MHC expression. Furthermore, recognition of the restriction element at expression levels below this threshold was still enough to compensate for lack of affinity to peptides carrying alanine substitutions in major TCR contact residues. Thus, the specificity in TCR recognition and T cell activation is fine tuned by the avidity for self-MHC, and TCR avidities for peptide and MHC may substitute for each other. These results demonstrate a functional role for TCR avidity for self-MHC in tuning of T cell specificity, and support a role for cross-reactivity on “self” during T cell selection and activation.
A case of sudden ankle pain
Authors: D. Yue, J. Ho, N. Al-Hadithy
Journal: BMJ (2012)

A 55 year old man presented with a sudden onset sharp pain in his right lower calf. It occurred while he was lunging forward in a game of tennis, and he had to stop playing. The initial pain, described as “like a hammer blow,” subsided, and on admission to hospital his only symptom was discomfort around the posterior aspect of his right ankle. He was able to weight bear and mobilise with some difficulty. He had no other injuries, had not previously experienced trauma to the area, and was fit and well apart from taking allopurinol for gout. There was no family medical history of note. He is a non-smoker and drank alcohol occasionally.

On examination, the right lower calf area was swollen and mildly tender. A depression was palpable along the Achilles tendon about 3 cm proximal to the site of tendon insertion at the calcaneus. He was neurovascularly intact and the range of movement was unaffected. The Simmonds-Thompson test was positive. Routine blood tests were unremarkable and a radiograph of the ankle showed no evidence of bony injuries.



### 1 What is the most likely diagnosis?

#### Short answer

Spontaneous rupture of the Achilles tendon. 

#### Long answer

The Achilles tendon, also known as the tendocalcaneus, is formed from the fibres of the soleus and gastrocnemius muscles and inserts into the calcaneus. Despite being the largest and strongest tendon in the body, it is the most commonly ruptured tendon in the lower limbs and comprises around 20% of all large tendon ruptures.1 2 Spontaneous rupture has an incidence of 0.02% in the general population.

It most commonly occurs in active people, …
Emergency cardiac photoscan
Authors: R. J. Lewis
Journal: JAMA (1968)

The cardiac photoscan is a helpful diagnostic tool for the evaluation of suspected pericardial effusion, particularly with critically ill patients who cannot tolerate angiography. This innocuous procedure can be performed in a few minutes with the use of sodium pertechnetate Tc 99m as the source of radioactivity. In one study, a life-threatening, loculated pericardial effusion was demonstrable only by the photoscan.
Age- and Gender-Specific Familial Risks for Venous Thromboembolism
Authors: Bengt Zöller, Xinjun Li, Jan Sundquist, Kristina Sundquist
Journal: Circulation (2011)

This nationwide study sought to determine age- and gender-specific familial risks in siblings hospitalized for venous thromboembolism (VTE).The Swedish Multigeneration Register on 0- to 75-year-old subjects was linked to the Hospital Discharge Register for the years 1987-2007. Standardized incidence ratios were calculated for individuals whose siblings were hospitalized for VTE compared with those whose siblings were not affected. Among a total of 45 362 hospitalized cases with VTE, 2393 affected siblings were identified, with a familial standardized incidence ratio of 2.45 (95% confidence interval [CI], 1.66 to 3.61). Gender-specific differences in incidence rates were observed. The familial risks were significantly increased from the age of 10 to 69 years, with a familial standardized incidence ratio of 4.77 (95% CI, 1.96 to 10.83) at ages 10 to 19 years, which decreased to 2.08 (95% CI, 1.35 to 3.20) at ages 60 to 69 years, although the absolute risk increased with age. The familial standardized incidence ratios for siblings with 2 and ≥3 affected probands were 51.87 (95% CI, 31.47 to 85.00) and 53.69 (95% CI, 25.59 to 108.50), respectively. Spouses had low familial risks (standardized incidence ratio=1.07; 95% CI, 1.04 to 1.10; observed spouse cases=3900).Familial factors, although influenced by age and gender, are important risk factors for VTE. The present study shows that VTE is aggregated in families and suggests that uncovering the sources of familial aggregation (genetic and nongenetic) may be worthwhile. Moreover, in a small fraction of siblings, the familial risk was very high, suggesting segregation of rare but strong genetic risk factors.
New international health partnership is set up to improve delivery of aid
Authors: Owen Dyer
Journal: BMJ (2007)

Poor communication between primary care trusts and GPs is seriously compromising the safety of patients in England, a group of MPs said this week.In its latest report the House of Commons Committee of Public Accounts also warns that 96% of GPs are failing to report dangerous incidents to the National Patient Safety Agency.For its report, which examines the Department of Health's progress in implementing clinical governance in primary care, the committee had taken evidence from the chief executive of the NHS, the deputy chief medical officer, and the NHS's director general of commissioning.Committee chairman Edward Leigh said, "Too many primary care organisations are paying lip service to the principles of the Department of Health's clinical governance agenda.The lines of communication between the primary care trusts, on the one hand, and their GPs and other healthcare contractors, on the other, are defective."He added: "How can we be confident in the NHS's ability to share learning locally and nationally about what can go wrong in health care when only a tiny proportion of GPs-4%-routinely report patient safety events and incidents to the National Patient Safety Agency?"In response to a series of high profile problems in the 1990s, including the Shipman murders and events at the Bristol Royal Infirmary, the health department introduced its 10 year programme to boost patient safety.The centrepiece was the clinical governance system.The new report suggests, however, that clinical governance is not as well established in primary care as in secondary care.The committee says that this is due largely to the complexity of the role of primary care trusts in commissioning and providing care and to the independence of contractors delivering health care, particularly GPs.The Committee of Public Accounts' 47th report of the current session can be found at www. parliament.uk/pac.Primary� care pay�s only� "lip service" to clinical governance, MPs say� UK NEWS Regulator gives green light to research using human-animal embryos, p 531 WoRld NEWS US me�ical authorities are accuse� o�� ��ailing to act over �octors in �uantanamo, p 53� US me�ical authorities are accuse� o�� ��ailing to act over �octors in �uantanamo, p 53� , p 53� bmj.comNumber o�� bipolar �isor�er �iagnoses leaps among US young people Number o�� bipolar �isor�er �iagnoses leaps among US young people
Immunocytochemical Colocalization of Specific Immunoglobulin A with Sendai Virus Protein in Infected Polarized Epithelium
Authors: Hisashi Fujioka, Steven N. Emancipator, Masamichi Aikawa, Dennis S. Huang, Frank Blatnik, Tracy Karban, Kristin DeFife, Mary B. Mazanec
Journal: The Journal of Experimental Medicine (1998)

Immunoglobulin (Ig)A provides the initial immune barrier to viruses at mucosal surfaces. Specific IgA interrupts viral replication in polarized epithelium during receptor-mediated transport, probably by binding to newly synthesized viral proteins. Here, we demonstrate by immunoelectron microscopy that specific IgA monoclonal antibodies (mAbs) accumulate within Sendai virus–infected polarized cell monolayers and colocalize with the hemagglutinin– neuraminidase (HN) viral protein in a novel intracellular structure. Neither IgG specific for HN nor irrelevant IgA mAbs colocalize with viral protein. Treatment of cultures with viral-specific IgA but not with viral-specific IgG or irrelevant IgA decreases viral titers. These observations provide definitive ultrastructural evidence of a subcellular compartment in which specific IgA and viral envelope proteins interact, further strengthening our hypothesis of intracellular neutralization of virus by specific IgA antibodies. Our results have important implications for intracellular protein trafficking, viral replication, and viral vaccine development.
Atherosclerotic Risk Factors in Japanese Subjects With Isolated Impaired Fasting Glucose and Those With Isolated Impaired Glucose Tolerance According to 1997 and 2003 American Diabetes Association Criteria
Authors: Shinya Morita, Soji Kasayama, Michio Otsuki, Nobuyuki Asanuma, Hiroshi Saito, Mikio Mukai, Masafumi Koga
Journal: Diabetes Care (2006)

Impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) are different clinical categories of abnormal glucose metabolism (1–3). Both IGT and IFG are similarly associated with increased risk of diabetes, but IGT may be more strongly associated with cardiovascular diseases (4–7). Although insulin secretion and insulin resistance have been shown to differ between these two clinical categories (8,9), mechanisms underlying the differences in the association with cardiovascular diseases are not well determined. There are only a few studies that have tried to identify differences in cardiovascular risk factors among subjects with abnormal glucose metabolism (10–13). The definition of normal glucose tolerance (NGT), IFG, and IGT and the study populations differ among these studies, such that their results do not appear to be uniform.

The aim of this study was to evaluate cardiovascular risk factors in Japanese subjects with IFG and IGT. Two diagnostic criteria defined in 1997 and in 2003 by the American Diabetes Association (ADA) (2,3) were used for the comparison. The measures included pulse-wave velocity (PWV), a noninvasive technique for assessing an aspect of atherosclerosis related to arterial stiffness (14,15).

Of 1,934 Japanese subjects who visited the Kinki Central Hospital between April and October 2003 for periodic health examinations, we evaluated 1,541 subjects (955 …
A TYPE OF POSTOPERATIVE FEVER, PROBABLY MALARIAL RELAPSE
Authors: J. S. HORSLEY
Journal: JAMA (1923)

These three cases are typical of a certain group seen at St. Elizabeth's Hospital during the summer and early fall months of each year. <h3>REPORT OF CASES</h3><h3>Case 1.</h3> —W. F. S., a man, aged 28, physician, admitted, Sept. 5, 1922, had always lived in South Carolina. He complained of attacks of gnawing epigastric pain accompanied by nausea and weakness, coming from one to two hours after meals, and relieved by food and soda. These attacks had lasted for six years. One year, and again two weeks, before admission to the hospital he passed large, tarry stools for several days, and on the last occasion he spat up some fresh blood. The family history and past history were irrelevant, except for "malaria" during childhood. The patient was tall and fairly well nourished, with marked pallor and a "washed-out" appearance; the physical examination was otherwise essentially negative. Routine urine, feces, phenolsulphonephthalein
TRENDS IN USE OF ANTI-THROMBOTIC AGENTS IN PATIENTS WITH NON-ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION (NSTEMI) MANAGED WITH AN INVASIVE STRATEGY: ANALYSIS FROM THE NCDR&amp;reg;
Authors: Siddharth A. Wayangankar, Matthew Roe, Anita Chen, Raghav Gupta, Charles Pollack, Robert Giugliano, L. Kristin Newby, James de Lemos, Karen Alexander, Jorge Saucedo
Journal: Journal of the American College of Cardiology (2012)
Venous thrombosis results from some phenol injections
Authors: Catherine Macek
Journal: JAMA (1983)

Injections of dilute phenol solutions to produce either chemical neurolysis or motor point blocks are considered safe and effective methods to control muscle spasticity in some handicapped patients. But most physicians don't realize that deep venous thrombosis is a possible complication of the procedures, say two physicians.  Spasticity is common in patients with spinal cord and brain injuries, multiple sclerosis, cerebral palsy, and after cerebrovascular accidents. Often spasticity is controlled by medications such as diazepam, baclofen, dantrolene sodium, or opiates as well as through range-of-motion exercises, external cooling of the muscles, or even biofeedback ( JAMA MEDICAL NEWS, 1983:249;1533-1536). If these therapies are not successful, then phenol injections can be used as an intermediate step prior to ablative surgical procedures involving the peripheral nerves, spinal cord roots or the cord itself, says Marc S. Kallins, MD, director of physical medicine at the L. W. Blake Memorial Hospital in Bradenton and Happiness
Improving comprehension for cancer patients with low literacy skills: strategies for clinicians
Authors: C. C. Doak, L. G. Doak, G. H. Friedell, C. D. Meade
Journal: CA A Cancer Journal for Clinicians (1998)

This paper provides strategies to improve communication between clinicians and patients, particularly patients who are among the 44 million adult Americans with low literacy skills. Included are insights into the nature of the literacy problem and how it affects patient comprehension of information across the continuum of cancer care. Practical strategies address how to help patients understand medical advice, reduce literacy levels of cancer information, and help patients remember the advice given. A summary of the strategies is included in the Appendix for convenient reference.
Disease-specific analyses of unrelated cord blood transplantation compared with unrelated bone marrow transplantation in adult patients with acute leukemia
Authors: Yoshiko Atsuta, Ritsuro Suzuki, Tokiko Nagamura-Inoue, Shuichi Taniguchi, Satoshi Takahashi, Shunro Kai, Hisashi Sakamaki, Yasushi Kouzai, Masaharu Kasai, Takahiro Fukuda, Hiroshi Azuma, Minoko Takanashi, Shinichiro Okamoto, Masahiro Tsuchida, Keisei Kawa, Yasuo Morishima, Yoshihisa Kodera, Shunichi Kato
Journal: Blood (2008)
The Genesis of Lower Esophageal Sphincter Pressure: Its Identification through the Use of Gastrin Antiserum
Authors: William Lipshutz, William Hughes, Sidney Cohen
Journal: Journal of Clinical Investigation (1972)

The purpose of this study was to evaluate the role of gastrin in the genesis of lower esophageal sphincter (LES) pressure by the use of a high titer gastrin antiserum. Intravenous infusions of increasing amounts of rabbit gastrin antiserum, but not control antiserum, produced graded reductions in the resting LES pressure in anesthetized opossums. A maximal inhibition in LES pressure of 80.0±3.1% (mean ±SE) was achieved when gastrin antiserum was administered in an amount estimated to bind almost all endogenous circulating gastrin in the opossum. Gastrin antiserum also inhibited the LES response to endogenous gastrin release (gastric deacidification) and to exogenous intravenous administration of gastrin I. The inhibition of the LES response to exogenous gastrin I by gastrin antiserum could be eliminated by giving excess gastrin I. Studies performed in vitro showed that gastrin antiserum inhibited the contractile response of LES circular muscle to gastrin I, but not to acetylcholine. These studies indicate that gastrin antiserum: (a) specifically antagonized the response of LES circular muscle to gastrin, in vitro; (b) diminished the LES response to the endogenous release and to the exogenous administration of gastrin; and (c) markedly reduced the resting level of LES pressure. We conclude that endogenous gastrin is the major determinant of resting LES pressure.
Home accidents in older people: role of primary health care team.
Authors: H. J. Graham, J. Firth
Journal: BMJ (1992)

OBJECTIVES--To determine the incidence and nature of unreported and reported home accidents in older people and to investigate associated environmental factors. DESIGN--Postal questionnaire requesting information on home accidents in the preceding month. SETTING--Inner London general practice. SUBJECTS--All registered patients aged over 65 years (n = 1662), of whom 120 were inappropriately registered and 1293 responded. MAIN OUTCOME MEASURE--Circumstances and consequences of accidents in the home. RESULTS--108 accidents were recorded in 100 patients, giving a home accident rate of 84/1000 patients, equivalent to an annual rate of 1002/1000. 73 accidents were falls, and 83 were unreported. Of the 25 reported accidents, 19 were reported to general practice and six to accident and emergency departments (5.6% of all events). Rates of home accidents increased with age and were higher in women than men (79/819 upsilon 29/474; chi 2 = 4.5, df = 1, p less than 0.05). CONCLUSIONS--The incidence of home accidents in people aged over 65 years was high but few events were reported to medical services. General practice provided the main contact for patients who reported home accidents, and primary care workers have important opportunities for advising elderly patients on home accident prevention. Improved publicity on home safety targeted at older people and their carers would support the primary health care team in this role.
Functional Asplenia after Bone Marrow Transplantation
Authors: Peter Kalhs
Journal: Annals of Internal Medicine (1988)

Study Objective: To evaluate splenic function in bone marrow transplant recipients, with relation to chronic graft-versus-host disease and infections. Design: Survey, outpatients geographically accessible for voluntary participation. Setting: Bone marrow transplantation referral center. Patients: Fifteen bone marrow graft recipients (13 allogeneic, 2 autologous), out of a total of 33 patients who received transplants at the center and survived more than 6 months after grafting. Measurements and Main Results: In 6 of 15 patients impaired splenic function (functional asplenia) was indicated by the presence of Howell-Jolly bodies in peripheral blood smears, reduced spleen size (P < 0.001), higher platelet counts (P < 0.01), higher indium-111 labeled autologous platelet recovery (P < 0.005), reduced splenic blood flow (P < 0.001), and reduced accumulation of radioactivity at the splenic site (P < 0.001). All patients with functional asplenia but only 2 patients without functional asplenia had extensive chronic graft-versus-host disease. The incidence of bacterial infections was four times higher in patients with impaired splenic function. Conclusions: Functional asplenia is a late complication after allogeneic bone marrow transplantation and contributes to the high susceptibility to bacterial infections in patients with extensive chronic graft-versus-host disease.
Two foundation trusts make joint bid to take over struggling acute trust
Authors: I. Torjesen
Journal: BMJ (2011)

Newcastle upon Tyne Hospitals Foundation Trust and Cumbria Partnership Foundation Trust have put in a joint bid to take over a struggling acute trust—the debt ridden North Cumbria University Hospitals Trust.

The board of directors of North Cumbria University Hospitals Trust, which runs acute hospitals in Carlisle and Whitehaven, realised that it would be impossible to achieve foundation status by 2013-14—the government’s proposed deadline for all acute trusts to become foundation trusts—because of longstanding financial pressures. So it agreed that the best option would be to seek a merger with, or an acquisition by, an existing foundation trust.

Mike Little, the trust’s chair said: “The trust board acknowledges that the only way to maintain …