tbuckley/cabot-search huggingface dataset:
Endothelium-dependent vascular responses. Mediators and mechanisms.
Authors: B M Brenner, J L Troy, B J Ballermann
Journal: Journal of Clinical Investigation (1989)

The nonthrombogenic and high solute and water permeability properties of the vascular endothelium have long been recog- nized as essential components of normal microvascular integ- rity.In addition to the more recent recognition of other hemo- static as well as proproliferative and cytoadhesive properties, the past decade has witnessed a growing awareness that this endothelial monolayer is also capable of intrinsic modulation of vascular tone by elaborating several potent vasoactive sub- stances.Two impressive vasorelaxants are prostacyclin and endothelium-derived relaxation factor (EDRF),' the latter at least in part composed of nitric oxide (NO).In addition, vascu- lar endothelium has been shown recently to synthesize a novel polypeptide, termed endothelin, which exhibits potent vaso- constrictor properties.Prostacyclin, a major metabolite of the cyclooxygenase pathway in vessel walls and the subject of in- tense study for more than a decade, has recently been reviewed (1).Due to space constraints, this brief review2 will therefore focus on other recently described endothelium-dependent va- soactive mediators, particularly NO and endothelin. Endothelium-dependent vasorelaxationVasodilator drugs containing oxides of nitrogen (termed "ni- trovasodilators' by Murad [2]), including sodium nitroprus- side, glyceryl trinitrate, and various inorganic and organic ni- trates have been widely used in the clinical management of angina pectoris and systemic hypertension.In vascular smooth muscle (VSM) cells, these agents activate soluble guanylate cyclase to generate intracellular cGMP (2).Chemically pure NO also activates soluble guanylate cyclase in VSM and in- duces marked but transient cGMP accumulation and concurrent relaxation of bovine coronary arteries.These responses
Augmentation of Atrial Contribution to Left Ventricular Filling in IDDM Subjects as Assessed by Doppler Echocardiography
Authors: K E Juhani Airaksinen, M Juhani Koistinen, Markku J Ikäheimo, Heikki V Huikuri, Ulla Korhonen, Heikki Pirttiaho, Markku K Linnaluoto, Juha T Takkunen
Journal: Diabetes Care (1989)

Left ventricular diastolic function was assessed by pulsed Doppler echocardiography in 21 subjects (mean age 48 yr) with insulin-dependent diabetes mellitus (IDDM) and without evidence of ischemic heart disease and in 21 healthy control subjects of similar age and sex distribution. The peak mitral valve flow velocities during the early rapid filling phase (E) and during late atrial filling (A) were measured, and the ratio of these peak flow velocities (E:A) was calculated. E was similar in both groups, but A was higher (P less than .01) in the diabetic group. Thus, E:A was lower (1.19 +/- 0.24 vs. 1.65 +/- 0.67; P less than .01) in the diabetic subjects than in the control subjects. On subgroup analysis, 6 patients with cardiac autonomic neuropathy had lower E:A than the patients with no such disorder (0.99 +/- 0.15 vs. 1.29 +/- 0.25; P less than .05). E:A was not related to the duration of diabetes, presence of retinopathy, HbA1, or blood glucose levels. In conclusion, the atrial contribution to left ventricular filling seems to be augmented in diabetic subjects. This finding indirectly supports the view that left ventricular compliance is already reduced in asymptomatic diabetic subjects.
Effect of Anti-Macrophage Migration Inhibitory Factor Antibody on Lipopolysaccharide-induced Pulmonary Neutrophil Accumulation
Authors: HIRONI MAKITA, MASAHARU NISHIMURA, KENJI MIYAMOTO, TSUYOSHI NAKANO, YOSHINORI TANINO, JUNICHI HIROKAWA, JUN NISHIHIRA, YOSHIKAZU KAWAKAMI
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

Macrophage migration inhibitory factor (MIF) is a recently rediscovered pro-inflammatory cytokine that has the unique potential to override the anti-inflammatory action of glucocorticoids. Since recent reports suggest the pivotal role of MIF in acute lung injury, we examined the protective effect of anti-MIF antibody on lipopolysaccharide (LPS)-induced acute lung injury in rats. Rats were injected with LPS (7 mg/kg) intraperitoneally with or without pretreatment with anti-MIF antibody. The anti-MIF antibody significantly attenuated LPS-induced migration of neutrophils to the lungs at 4 and 24 h as demonstrated by observation of the number of neutrophils per alveolus, the activity of myeloperoxidase of the lung tissue, and cell differentiation of neutrophils in bronchoalveolar lavage (BAL) fluid. The increased level of macrophage inflammatory protein-2, a powerful neutrophil chemokine, in BAL fluid was also significantly attenuated by pretreatment with the anti-MIF antibody as compared with the control group. Additionally, positive immunostaining for MIF was observed in bronchial epithelial cells and alveolar macrophages, and Northern blot analysis of lung tissues demonstrated increased MIF mRNA 24 h after LPS injection. These data suggest that the anti-MIF antibody has therapeutic potential for the treatment of acute lung injury by suppressing the level of neutrophil chemokine in the lungs.
Continuing medical education: Global health, global learning
Authors: D. Davis
Journal: BMJ (1998)

CME—continuing medical education—has become an international discipline. Defined as any and all ways by which doctors learn after the formal completion of their training,1 CME is being shaped by several forces. Foremost among these are the globalisation of health2; cross disciplinary movements such as evidence based medicine; common trends in medical education and the assessment of professional competence; and the impact on health care and professional education of the identification of the determinants of health.3 4 Add to these electronic mail and the internet allowing instant global communication and virtually unlimited access to medical information and it is not hard to see why CME has become an international concern.5 This paper reviews the main published work on CME, identifies major themes in its development, and points to ways that may help standardise and support the provision of CME internationally.

To gather information for this article, I searched the Research and Development Resource Base in CME extensively for articles (published 1986-96) that describe CME activities worldwide, excluding North America and the United Kingdom.6 At the time this article was written, it contained references to over 7000 articles and monographs devoted to continuing health professional education. I also searched Medline, eric, embase, and other databases for articles (published 1986-96), using terms and phrases such as world health, global health, international cooperation, and international educational exchange and continuing medical education terms combined with geographical names. Then I circulated the results of the literature searches and a brief questionnaire to key informants in the field, to identify other articles and to add their opinions about forces for and trends in continuing medical education.

#### Summary points

Health is a global issue; hence continuing medical education is an integral phenomenon

International CME is more than conferences and courses—it includes projects in needs …
Renal Transplant Evaluation???Another Potential Pitfall
Authors: PENELOPE GALBRAITH, LEONIE GORDON
Journal: Clinical Nuclear Medicine (1989)

An Interesting appearance was produced on initial transplant evaluation with Tc-99m diethylenetriaminepentaacetic acid (DTPA). An area of abnormal activity was originally thought to represent a urine leak. However, it was subsequently proven to be residual function in the patient's native pelvic kidney.
France split on pardons over tainted blood
Authors: A Dorozynski
Journal: BMJ (1994)

France's scientific community is divided over whether President Francois Mitterand should pardon Dr Michael Garetta and Dr Jean Pierre Allain, who were sentenced to prison last year for allowing the distribution in 1985 of blood products that were contaminated with HIV. About 100 French doctors and scientists petitioned the president last week, asking for pardons for the two men. Coincidentally, 33 Nobel prize winners wrote to the president last week asking him to pardon Dr Allain. So far about 400 people have died in France after being given blood products contaminated with HIV.

Dr Francoise Barre-Sinoussi, who with Professor Luc …
Hugh Alexander Evans
Authors: P. C. G. E. R. Evans
Journal: BMJ (2014)

Hugh Alexander Evans was born in Brundall, Norfolk, the son of a local doctor. His father died when Hugh was only 2 years old (read obituary here: http://www.bmj.com/content/2/3487/850.2, and the family moved to Norwich. Hugh inherited his father’s natural sporting ability and played rugby and most team sports at school and university. He went to Epsom College in 1938, from where he won a place to study medicine at Merton College, Oxford, in 1943. During his undergraduate years he became a member of Vincent’s Club and he was a “centipede” in the Oxford University Athletic Club second team in 1944. He moved to London to St Bartholomew’s Hospital to do his clinical studies. There he met Barbara, a nurse, whom he married in 1950, after which Hugh joined the Royal Army Medical Corps for his national service in Farnham.

The couple moved on to …
Adrenal enlargement and insufficiency: A common presentation of intravascular large B-cell lymphoma
Authors: Farhad Askarian, Dongsheng Xu
Journal: American Journal of Hematology (2006)

Intravascular large B-cell lymphoma (IVLL) is a rare subtype of extranodal diffuse large B-cell lymphoma and is very difficult to diagnose in patients antemortem due to nonspecific presentation of the disease. We report a case of IVLL in a 68-year-old white female who presented with 3-month history of fever of unknown origin (FUO), night sweat, and weight loss. Laboratory tests revealed bilateral adrenal enlargement and adrenal insufficiency. IVLL was diagnosed only at autopsy. A review of the English language medical literature indicates that it is not uncommon for IVLL presented initially with FUO, bilateral adrenal enlargement, and adrenal insufficiency. We present this case to call for heightened awareness of the possibility of IVLL, particularly in an elderly woman who presents with FUO, bilateral adrenal enlargement, and adrenal insufficiency. The pathophysiologic mechanisms of adrenal insufficiency in IVLL are also discussed.
Treatment of Malaria-Reply
Authors: Carlos C. Campbell
Journal: JAMA (1983)

In Reply.—  The comments by Dr Watt raise several important points. As he notes correctly, since the publication of our case report, it has been documented that a loading dose (20 mg/ kg) of quinine sulfate results in a more rapid, sustained blood level required for schizonticidal action against P falciparum in Thailand. 1 However, the loading dose can only be advocated for treating P falciparum strains derived from Thailand or Kampuchea, and then only for severe infections.  While both the therapy and prophylaxis of P falciparum in Thailand, Kampuchea, and contiguous areas of Southeast Asia are difficult problems, it would be extremely unwise to advocate withholding prophylaxis from nonimmune persons. To date, the geographical distribution or prevalence of pyrimethamine-sulfadoxine resistance has not been defined. We believe that the drug may provide a degree of suppression against strains with low degrees of resistance and would, of course, provide greater degrees
The Normal Orthogonal Electrocardiogram and Vectorcardiogram
Authors: HUBERT V. PIPBERGER
Journal: Circulation (1958)

Preliminary standards for the normal orthogonal electrocardiogram and vectorcardiogram were established as a basis for further studies on pathologic series. Schmitt's corrected lead system (SVEC III) was used. The statistical analysis of electrocardiographic and vectorcardiographic data revealed some intrinsic shortcomings of commonly used analytic criteria. As the orthogonal electrocardiogram and vectorcardiogram are interchangeable, inherent advantages and disadvantages of the 2 methods of display could be evaluated in a quantitative fashion.
Relationship Between Preventability of Death After Coronary Artery Bypass Graft Surgery and All-Cause Risk-Adjusted Mortality Rates
Authors: Veena Guru, Jack V. Tu, Edward Etchells, Geoffrey M. Anderson, C. David Naylor, Richard J. Novick, Christopher M. Feindel, Fraser D. Rubens, Kevin Teoh, Avdesh Mathur, Andrew Hamilton, Daniel Bonneau, Charles Cutrara, Peter C. Austin, Stephen E. Fremes
Journal: Circulation (2008)

Background— The goal of this study was to determine the relationship between all-cause, risk-adjusted, in-hospital mortality after coronary artery bypass graft surgery and the proportion of preventable in-hospital deaths as a measure of quality of care at an institution level. Methods and Results— We conducted a retrospective analysis of 347 randomly selected in-hospital deaths after isolated coronary artery bypass graft surgery at 9 institutions in Ontario over the period of 1998 to 2003. Nurse-abstracted chart summaries were reviewed by 2 experienced cardiac surgeons who were blinded to patient, surgeon, and hospital and used a standardized implicit tool to identify preventable death. A third reviewer reassessed all cases in which the first 2 reviewers disagreed. Rates of preventable deaths were estimated for each hospital and compared with all-cause mortality rates. A structured adverse event audit completed by each surgeon-reviewer was used to identify quality improvement opportunities for the preventable deaths. A total of 111 of 347 deaths (32%) were judged preventable despite a low risk-adjusted mortality range (1.3% to 3.1%) across hospitals. No significant correlation was found between all-cause, risk-adjusted in-hospital mortality rates and the proportion of preventable deaths at the hospital level (Spearman coefficient, −0.42; P =0.26). A large proportion of preventable deaths were related to problems in the operating room (86%) and intensive care unit (61%). Many deaths were associated with deviations in perioperative care (32% based on concurrence of 2 reviewers, and another 42% in cases in which 1 reviewer reached that opinion). Conclusions— Approximately one third of in-hospital coronary artery bypass graft deaths were judged preventable by surgeon reviewers. All-cause risk-adjusted mortality rates are convenient measures of institutional quality of care but were not correlated with preventable mortality in our jurisdiction. Providers should conduct detailed adverse event audits to drive meaningful improvements in quality.
Abnormal Protein Loss after Thoracic-Duct Ligation in Dogs
Authors: William H. Marshall, Toshihiko Neyazaki, Herbert L. Abrams
Journal: New England Journal of Medicine (1965)

THE presence of intestinal protein loss in some cases of constrictive pericarditis has been well documented.1 2 3 4 5 It has not been clearly demonstrated whether the elevated venous pressure per se or the consequent interference with the normal return of lymph to the venous system is the major factor underlying the increased permeability of the bowel. It occurred to one of us (H.L.A.) that thoracic-duct ligation might provide a model for a study of the effect of lymphatic obstruction dissociated from venous hypertension on protein loss.Methods and MaterialsInitial control studies were performed on 4 large adult mongrel dogs with the . . .
A randomized double-blind comparative study of terbinafine for 1, 2 and 4 weeks in tinea capitis
Authors: T.S. HAROON, I. HUSSAIN, S. AMAN, M. JAHANGIR, A.H. KAZMI, A.R. SAMI, A.H. NAGI, K.H. ALVI, N. IQBAL, K.A. KHAN, R. AZIZ
Journal: British Journal of Dermatology (1996)

We report a randomized, double-blind study, comparing the relative efficacy and tolerability of oral terbinafine, given for 1, 2 or 4 weeks, in tinea capitis. Of 161 evaluable patients, 53 were treated with terbinafine for 1 week, 51 for 2 weeks and 57 for 4 weeks. Isolated pathogens included Trichophyton violaceum (71.5%), T. tonsurans (14.9%), T. verrucosum (4.3%), Microsporum audouinii (4.3%), M. canis (2.5%), T. schoenleinii (1.9%) and T. mentagrophytes (0.6%). The final evaluation, at 12 weeks, showed cure rates of 73.6, 80.4 and 85.9%, in the respective groups. The adverse effects noted, were not drug related. In our opinion, terbinafine given for 1, 2 or 4 weeks, is equally effective for most cases of tinea capitis.
385 CONTROLLED ATTENUATION PARAMETER: A NOVEL FIBROSCAN®-BASED TOOL TO DETECT AND QUANTIFY STEATOSIS. PRELIMINARY STUDY IN PATIENT WITH ALCOHOLOC AND NON ALCOHOLIC FATTY LIVER DISEASE
Authors: M. Beaugrand, M. Ziol, V. de Ledinghen, C. Douvin, C. Fournier, L. Sandrin, V. Miette, M. Sasso
Journal: Journal of Hepatology (2010)
Deep sequencing of the T-cell receptor repertoire in CD8+ T-large granular lymphocyte leukemia identifies signature landscapes
Authors: Michael J. Clemente, Bartlomiej Przychodzen, Andres Jerez, Brittney E. Dienes, Manuel G. Afable, Holleh Husseinzadeh, Hanna L. M. Rajala, Marcin W. Wlodarski, Satu Mustjoki, Jaroslaw P. Maciejewski
Journal: Blood (2013)
Choice: a tale of two hospitals
Authors: Mary E Black
Journal: BMJ (2011)

My daughter’s classmate, a 16 year old fencing champion with a torn knee meniscus, was admitted to hospital the night before planned surgery in Belgrade, Serbia, and sent to bed in pyjamas. Her operation was cancelled; to keep her place on the waiting list she was admitted to hospital for a week. After a successful procedure under general anaesthetic she was confined to hospital for a further five days and was eventually allowed home on crutches.[f1]

My 85 year old mother, a retired doctor with ocular lens implants, bilateral hearing aids, arthritic knees, …
Utility of the Direct Basophil Activation Test in Predicting Tolerance to Dietary Milk Protein in Children With a History of Cow's Milk Allergy
Authors: N. Wanich, A. Nowak-Wegrzyn, S. Walsh, B. Robinson, S. Noone, H.A. Sampson, W.G. Shreffler
Journal: Journal of Allergy and Clinical Immunology (2007)
Updated Hodgkin's disease. Value of immunologic testing
Authors: A. C. Aisenberg
Journal: JAMA (1972)

The vast majority of patients with active Hodgkin's disease display a defect in cell-mediated immunity. The defect is progressive, and in the patient with advanced disease it contributes to the variety of common bacterial and unusual viral, fungal, and protozoal infections<sup>60</sup>to which these patients are prone. In experimental animals, small lymphocytes of thymic origin are concerned with cell-mediated immunity, and the deficiency of the thymectomized animal closely resembles that of the individual with Hodgkin's disease.<sup>61,62</sup>The class of immune reactions mediated by antibody is relatively unimpaired, in Hodgkin's disease. Cell-mediated immune responses include bacterial (delayed) hypersensitivity, contact sensitivity, graft vs host phenomena, and the homograft reaction. The very use of the word anergy to denote a defect in cellular immunity in man attests to the imperfect and qualitative nature of tests available to evaluate this type of immunity. Methods of assessing delayed hypersensitivity are listed in Table
Row over breast cancer screening shows that scientists bring "some subjectivity into their work
Authors: S. Mayor
Journal: BMJ (2001)

The difficulty of getting scientists to reach a consensus on their interpretations of trial data was illustrated last week when two reviewers for the Cochrane Breast Cancer Group published their own review of mammography screening trials after editors from the group had disagreed with some of their conclusions.

The review claimed that there was no reliable evidence to support the value of mammo-graphy screening in reducing deaths from breast cancer and alleged an association with increased rates of breast surgery.

Ole Olson and Peter Gotsche from the Nordic Cochrane Centre, Righospitalet, Copenhagen, Denmark, reassessed—as part of a Cochrane review—a meta-analysis of seven randomised trials of screening mammography which they had previously carried out. This confirmed their original conclusion, they said, that there was no evidence of a reduction in either total or breast cancer mortality in two of the trials that they considered to be of sufficient quality to analyse.

They added: “We have also confirmed, with additional data, which the editors of the Cochrane Breast Cancer Group have elected to defer from publication until further editorial review has been completed, our earlier finding that screening leads to more …
Functional Rescue of Dystrophin-deficient mdx Mice by a Chimeric Peptide-PMO
Authors: HaiFang Yin, Hong M Moulton, Corinne Betts, Thomas Merritt, Yiqi Seow, Shirin Ashraf, QingSong Wang, Jordan Boutilier, Matthew JA Wood
Journal: Molecular Therapy (2010)

Splice modulation using antisense oligonucleotides (AOs) has been shown to yield targeted exon exclusion to restore the open reading frame and generate truncated but partially functional dystrophin protein. This has been successfully demonstrated in dystrophin-deficient mdx mice and in Duchenne muscular dystrophy (DMD) patients. However, DMD is a systemic disease; successful therapeutic exploitation of this approach will therefore depend on effective systemic delivery of AOs to all affected tissues. We have previously shown the potential of a muscle-specific/arginine-rich chimeric peptide-phosphorodiamidate morpholino (PMO) conjugate, but its long-term activity, optimized dosing regimen, capacity for functional correction and safety profile remain to be established. Here, we report the results of this chimeric peptide-PMO conjugate in the mdx mouse using low doses (3 and 6 mg/kg) administered via a 6 biweekly systemic intravenous injection protocol. We show 100% dystrophin-positive fibers and near complete correction of the dystrophin transcript defect in all peripheral muscle groups, with restoration of 50% dystrophin protein over 12 weeks, leading to correction of the DMD pathological phenotype and restoration of muscle function in the absence of detectable toxicity or immune response. Chimeric muscle-specific/cell-penetrating peptides therefore represent highly promising agents for systemic delivery of splice-correcting PMO oligomers for DMD therapy.
Psychedelic Effect of<i>Pholiota spectabilis</i>
Authors: Robert W. Buck
Journal: New England Journal of Medicine (1967)

Pholiota spectabilis (Gymnopilus spectabilis) is a well known and recognizable wild mushroom that is generally considered inedible only because of its bitter taste, although attention has recently been called to its hallucinogenic properties.1 , 2 Other species of pholiota (P. marginalis, or Galerina venenata) have caused fatalities.Case ReportOn September 9, 1966, at about 9 a.m., a 56-year-old retired mechanical engineer of Harvard, Massachusetts, picked a batch of mushrooms growing in a clump by the side of a road in front of his house. Under the mistaken impression that they were honey mushrooms (Armillaria mellea, an . . .