tbuckley/cabot-search huggingface dataset:
NIDDK International Conference Report on Diabetes and Depression: Current Understanding and Future Directions
Authors: Richard I.G. Holt, Mary de Groot, Irwin Lucki, Christine M. Hunter, Norman Sartorius, Sherita H. Golden
Journal: Diabetes Care (2014)

Comorbid diabetes and depression are a major clinical challenge as the outcomes of each condition are worsened by the other. This article is based on the presentations and discussions during an international meeting on diabetes and depression convened by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) in collaboration with the National Institute of Mental Health and the Dialogue on Diabetes and Depression. While the psychological burden of diabetes may contribute to depression in some cases, this explanation does not sufficiently explain the relationship between these two conditions. Shared biological and behavioral mechanisms, such as hypothalamic-pituitary-adrenal axis activation, inflammation, autonomic dysfunction, sleep disturbance, inactive lifestyle, poor dietary habits, and environmental and cultural risk factors, are important to consider in understanding the link between depression and diabetes. Both individual psychological and pharmacological depression treatments are effective in people with diabetes, but the current range of treatment options is limited and has shown mixed effects on glycemic outcomes. More research is needed to understand what factors contribute to individual differences in vulnerability, treatment response, and resilience to depression and metabolic disorders across the life course and how best to provide care for people with comorbid diabetes and depression in different health care settings. Training programs are needed to create a cross-disciplinary workforce that can work in different models of care for comorbid conditions.
Silver-coated megaendoprostheses in a rabbit model—an analysis of the infection rate and toxicological side effects
Authors: Georg Gosheger, Jendrik Hardes, Helmut Ahrens, Arne Streitburger, Horst Buerger, Michael Erren, Andreas Gunsel, Fritz H Kemper, Winfried Winkelmann, Christof Von Eiff
Journal: Biomaterials (2004)
Long-Term Clinical and Echocardiographic Follow-Up of the Freestyle Stentless Aortic Bioprosthesis
Authors: Siamak Mohammadi, Vincent Tchana-Sato, Dimitri Kalavrouziotis, Pierre Voisine, Daniel Doyle, Richard Baillot, Sandro Sponga, Jacques Metras, Jean Perron, François Dagenais
Journal: Circulation (2012)

Background— Stentless aortic bioprostheses were designed to provide enhanced hemodynamic performance and potentially greater longevity. The present report describes the outcomes of patients with the Freestyle stentless bioprosthesis followed for ≤18 years. Methods and Results— Between 1993 and 2011, 430 patients underwent primary aortic valve replacement with a Freestyle bioprosthesis in the subcoronary position. Mean age was 68.2±8.2 years. All of the clinical and echocardiographic data were collected prospectively. Mean overall follow-up was 9.1±4.4 years and was complete in all of the patients. In-hospital mortality was 3.5% (n=15). Overall, 10- and 15-year survival were 60.7% and 35.0%, respectively. Fifty-one patients required reoperation during follow-up, including 27 for structural valve deterioration (SVD). Overall, freedom from reoperation was 91.0% and 75.0% at 10 and 15 years, whereas freedom from reoperation for SVD was 95.9% and 82.3%, respectively. At 10 and 15 years, freedom from reoperation for SVD was 94.0% and 62.6% for patients &lt;60 years of age and 96.3% and 88.4% for patients ≥60 years of age ( P =0.002). The median time to explant for SVD was 10.7 years. SVD presented mostly as acute, severe aortic insufficiency attributed to leaflet tear (77.8%). The independent risk factors for reoperation for SVD were age &lt;60 years ( P =0.001) and dyslipidemia ( P =0.02). Conclusions— Aortic valve replacement with the Freestyle bioprosthesis in a subcoronary position provides good long-term clinical and echocardiographic outcomes for patients &gt;60 years of age. Severe aortic insufficiency with leaflet tear is the major mode of SVD leading to reoperation in these patients.
Doctors and Patients: A Relationship Examined
Authors: Keith Greenlaw
Journal: BMJ (2008)

Recent changes in the NHS brought to mind this remarkable book, which describes in critical detail the personal and professional relationship between doctors and patients. Hodson wanted to call it I Swear by Apollo (the opening of the Hippocratic oath), but that title was already in use. This book is not based on Michael Balint’s teachings, which were popular at the time; it is an intelligent and humane examination of what is possible when general practitioners know their patients and ask themselves, “What help is this person seeking?” It is based on the author’s open …
The effect of vagus nerve stimulation upon vulnerability of the canine ventricle: role of sympathetic-parasympathetic interactions.
Authors: B S Kolman, R L Verrier, B Lown
Journal: Circulation (1975)

The effect of vagus nerve stimulation (VNS) upon ventricular vulnerability was studied in 30 mongrel dogs subjected to varying levels of adrenergic stimulation. Vulnerability was assessed both by determining the minimum current required to produce ventricular fibrillation (VF threshold) and by plotting VF threshold throughout the vulnerable period (VF zone). Chloralose-anesthetized animals were studied by means of sequential pulses applied to the apex of the right ventricular endocardium. Testing was carried out in closed-chest dogs, in open-chest dogs with and without left stellate ganglion stimulation (LSGS), and in open- and closed-chest dogs pretreated with propranolol. In the absence of adrenergic stimulation. VNS was without significant effect on either the VF threshold or the VF zone under closed- or open-chest conditions. During LSGS, however, VNS was associated with a 93 +/- 22% (mean +/- SE) increase in VF threshold (P less than 0.01) and constriction of the VF zone. Vagus nerve stimulation combined with LSGS raised VF threshold to the control value, but not beyond. After beta-adrenergic blockade with propranolol, VNS was without effect on VF threshold in either open- or closed-chest animals. It is concluded that augmented sympathetic tone is a precondition for a VNS-induced elevation in VF threshold. The vagal effect is indirect and is expressed by opposing the effects of heightened adrenergic tone on ventricular vulnerability.
A STUDY OF THE CAUSE AND EFFECT OF URIC ACID IN DISEASE, WITH SPECIAL REFERENCE TO ALKALINE DRINKING WATER.
Authors: W. W. REED
Journal: JAMA (1897)

I have been incited to an investigation of this subject by the great frequency with which I have met with cases of various manifestations of uric acid in the Arkansas valley, where the drinking water is almost universally impregnated with alkali, and where the people partake largely of a meat diet. Since reading Professor Haig's little book, "Uric Acid in the Causation of Disease," I have become extremely interested in the subject, and find in it a wide field for study and investigation. That the alkali water is in some way accountable for so many cases, I am fully persuaded, but in so far as I have ransacked the authorities and the literature on the subject, I have failed to find any satisfactory explanation of the phenomenon. In this paper I do not presume to advance anything new, but only offer a few facts gleaned from a study of my
A Controlled Clinical Trial of High-Dose Methylprednisolone in the Treatment of Severe Sepsis and Septic Shock
Authors: Roger C. Bone, Charles J. Fisher, Terry P. Clemmer, Gus J. Slotman, Craig A. Metz, Robert A. Balk
Journal: New England Journal of Medicine (1987)

The use of high-dose corticosteroids in the treatment of severe sepsis and septic shock remains controversial. Our study was designed as a prospective, randomized, double-blind, placebo-controlled trial of high-dose methylprednisolone sodium succinate for severe sepsis and septic shock. Diagnosis was based on the clinical suspicion of infection plus the presence of fever or hypothermia (rectal temperature >38.3°C [101°F] or <35.6°C [96°F]), tachypnea (>20 breaths per minute), tachycardia (>90 beats per minute), and the presence of one of the following indications of organ dysfunction: a change in mental status, hypoxemia, elevated lactate levels, or oliguria. Three hundred eighty-two patients were enrolled. Treatment — either methylprednisolone sodium succinate (30 mg per kilogram of body weight) or placebo — was given in four infusions, starting within two hours of diagnosis. No significant differences were found in the prevention of shock, the reversal of shock, or overall mortality. In the subgroup of patients with elevated serum creatinine levels (>2 mg per deciliter) at enrollment, mortality at 14 days was significantly increased among those receiving methylprednisolone (46 of 78 [59 percent] vs. 17 of 58 [29 percent] among those receiving placebo; P<0.01). Among patients treated with methylprednisolone, significantly more deaths were related to secondary infection. We conclude that the use of high-dose corticosteroids provides no benefit in the treatment of severe sepsis and septic shock. (N Engl J Med 1987; 317:653–8.)
Long acting 2 agonists in adult asthma
Authors: G. P. Currie, I. Small, G. Douglas
Journal: BMJ (2013)

A 30 year old man with asthma, previously well controlled with inhaled beclometasone 100 μg (two puffs twice daily) and salbutamol (as required), presented to his general practitioner with a three month history of increasing breathlessness and wheeze, primarily overnight and in the mornings. He was a non-smoker with no obvious trigger factors. He reported using his inhaler as prescribed, and his technique was satisfactory. He had no other medical history and no symptoms of allergic rhinitis. His general practitioner suggested a further inhaler containing a long acting β2 agonist (LABA), but the patient expressed concerns as he had read that these inhalers were linked to an increased risk of fatal asthma.

LABAs have become an increasingly popular treatment over the past two decades as a supplement to inhaled corticosteroids in the management of persistent asthma.1 They have a bronchodilator effect when bronchomotor tone (the state of airway smooth muscle contraction or relaxation regulating airway calibre) is low, and a protective (or “airway stabilising”) effect with increased bronchomotor tone.2

Salmeterol and formoterol (the two LABAs in widespread clinical use) are lipophilic, bind to airway smooth muscle β2 adrenoceptors and exert effects for approximately 12 hours. Salmeterol has a slower onset of action (10-30 minutes) than formoterol (1-3 minutes). Both drugs can be prescribed in single inhaler devices, but they are commonly given with different inhaled corticosteroids with varying doses in combination inhaler devices (table 1⇓, fig 1⇓).



Fig 1  Examples of different types of inhaler device used to deliver long acting β2 agonists (LABAs) to the airways: (a) Symbicort Turbohaler, (b) Seretide Accuhaler, (c) Seretide metered dose inhaler, (d) Fostair metered dose inhaler, (e) Flutiform metered dose inhaler



View this table:

Table 1 
 Combination inhaled corticosteroid and long acting β2 agonist (LABA) preparations licensed for …
Toxoplasma Antibodies among College Students
Authors: Jack S. Remington, Willard Dalrymple, Leon Jacobs, Maxwell Finland
Journal: New England Journal of Medicine (1963)

ONE of the recognized clinical forms of acute toxoplasmosis is a syndrome resembling infectious mononucleosis.1 , 2 The condition may be differentiated by the presence of pharyngitis and positive heterophil-antibody titers in the latter and by positive toxoplasma serologic findings in the former. In the absence of heterophil antibodies, the demonstration of rising titers by the dye test, hemagglutination (HA) or complement fixation may be accepted as evidence of toxoplasmosis. Isolation of toxoplasma from blood or lymph nodes can confirm the serologic diagnosis. However, in some cases, levels of toxoplasma antibody may already be relatively high and stable when the patient presents . . .
COMPOUND FRACTURE OF THE VAULT WITH LOSS OF BRAIN SUBSTANCE.A REPORT OF TWO CASES WITH RECOVERY.
Authors: MAURICE KAHN
Journal: JAMA (1905)

I feel that no apology is necessary in reporting the following cases, as they are of sufficient rarity to merit attention. Cranial injuries, moreover, occupy a place of the first surgical importance, notwithstanding that only 2 or 3 per cent. of all fractures are found to be of the skull; for the reason that the skull contains so vital an organ, and that there is a mortality of from 20 to 25 per cent. in all vault fractures with or without depression. It behooves us, then, to give our most serious thought to such cases, the treatment of which appears to be not so well comprehended as the treatment of similar injuries to bones in other situations. Why this should be is not easily explained; certainly the brain, so intolerant of violent usage, the one organ above all others that can not be maltreated with impunity, that promptly resents insult,
What we need to know about age related memory loss
Authors: G. W Small
Journal: BMJ (2002)

Memory changes cause concern to many patients as they grow older. Gary Small provides reassurance and gives a strategy for assessing age related memory loss and protecting brain health

As doctors and scientists have focused more attention on Alzheimer's disease and related dementias, patients are expressing greater concern about their common, age related memory changes. When results of new research on early detection and prevention reach a wider audience, our patients often come to the office with questions about what they can do to preserve their memory abilities as they age. Many of today's doctors trained during a time when minimal information was provided on these topics during their medical training. This paper will provide a practical strategy for assessing age related memory loss and will discuss interventions that may or may not protect brain health.

#### Summary points

Patients with mild memory loss are common in clinical practice; if their symptoms warrant a diagnosis of dementia, treatment with cholinesterase inhibitor drugs is needed

Doctors need to be cautious about unproved treatments for slowing brain ageing because of potential side effects

Lifestyle choices may protect people with mild forms of age related memory loss from future decline: essentially, what is healthy for the body is healthy for the brain

The risks of these interventions are minimal and are not likely to outweigh the many benefits

The viewpoints presented were based on my clinical experience and a databased literature review. I selected articles with Medline searches using key words relevant to the theme of this review, emphasising peer reviewed journals and data from controlled clinical trials or methodologically sound epidemiological studies when available.

With age comes the increasing likelihood of developing memory loss. The mildest form, age associated memory impairment, is characterised by self perception of memory loss and a standardised memory test score …
A case of gastric carcinosarcoma
Authors: R. Kikuyama, K. Tanaka, S. Tano, T. Iguchi, K. Nishikawa, T. Harada, K. Uchida, S. Nagaya, N. Noda, M. Noda, Y. Takei
Journal: Endoscopy (2009)

Carcinosarcoma is a malignant tumor consisting of both epithelial and mesenchymal elements that rarely occurs in the stomach [1]. We present a case of gastric carcinosarcoma presenting as anemia and with interesting endoscopic features.
The Cholesterol Metabolite 27-Hydroxycholesterol Promotes Atherosclerosis via Proinflammatory Processes Mediated by Estrogen Receptor Alpha
Authors: Michihisa Umetani, Pritam Ghosh, Tomonori Ishikawa, Junko Umetani, Mohamed Ahmed, Chieko Mineo, Philip W. Shaul
Journal: Cell Metabolism (2014)
Relative Merits of Techniques for Gastrostomy Tube Removal
Authors: Geoffrey Ayre-Smith
Journal: JAMA (1991)

To the Editor.  —Our experience with percutaneous endoscopic gastrostomy (PEG) tube removal differs from that of Korula and Harma. 1 We have seen instances in which the internal components of the PEG tube remained in the stomach and in which the internal bumper would not pass through a colostomy stoma. Wilson et al 2 have recently reported a perforation at the jejunoileal junction in a patient whose PEG tube was removed in this manner.  If one were to follow the suggestion of using serial radiographs to check for elimination of the severed PEG tube, the cost, including that of transporting the patient for the study, could be considerable. If a PEG tube is in place and cannot be removed by traction, immediate endoscopic removal of the severed bumper should be performed.  At the present time, there are at least three manufacturers that produce a gastrostomy tube that can be removed
An MHC class Ib–restricted CD8 T cell response confers antiviral immunity
Authors: Phillip A. Swanson, Christopher D. Pack, Annette Hadley, Chyung-Ru Wang, Iwona Stroynowski, Peter E. Jensen, Aron E. Lukacher
Journal: The Journal of Experimental Medicine (2008)

Although immunity against intracellular pathogens is primarily provided by CD8 T lymphocytes that recognize pathogen-derived peptides presented by major histocompatibility complex (MHC) class Ia molecules, MHC class Ib–restricted CD8 T cells have been implicated in antiviral immunity. Using mouse polyoma virus (PyV), we found that MHC class Ia–deficient (Kb−/−Db−/−) mice efficiently control this persistently infecting mouse pathogen. CD8 T cell depletion mitigates clearance of PyV in Kb−/−Db−/− mice. We identified the ligand for PyV-specific CD8 T cells in Kb−/−Db−/− mice as a nonamer peptide from the VP2 capsid protein presented by Q9, a member of the β2 microglobulin–associated Qa-2 family. Using Q9-VP2 tetramers, we monitored delayed but progressive expansion of these antigen-specific CD8αβ T cells in Kb−/−Db−/− mice. Importantly, we demonstrate that Q9-VP2–specific CD8 T cells more effectively clear wild-type PyV than a VP2 epitopenull mutant PyV. Finally, we show that wild-type mice also generate Q9-restricted VP2 epitope–specific CD8 T cells to PyV infection. To our knowledge, this is the first evidence for a defined MHC class Ib–restricted antiviral CD8 T cell response that contributes to host defense. This study motivates efforts to uncover MHC class Ib–restricted CD8 T cell responses in other viral infections, and given the limited polymorphism of MHC class Ib molecules, it raises the possibility of developing peptide-based viral vaccines having broad coverage across MHC haplotypes.
Recurrent Spontaneous Pneumothorax
Authors: Arnold S. Roland, Walter F. Merdinger, Herman F. Froeb
Journal: New England Journal of Medicine (1964)

IN 1940 eosinophilic granuloma of bone was independently described by Otani and Ehrlich1 and Lichtenstein and Jaffe.2 Subsequently, the basic pathological similarity of eosinophilic granuloma, Letterer–Siwe disease and Hand–Schüller–Christian disease was stressed.3 4 5 In 1953 Lichtenstein6 suggested the term "histiocytosis X," the common pathological feature of which is tissue infiltration by histiocytes.Pulmonary involvement in histiocytosis X is not uncommon and, indeed, may be the only apparent manifestation of the disease,7 8 9 which has been termed "primary pulmonary histiocytosis X" or "eosinophilic granuloma of the lung." Both in disseminated histiocytosis X with pulmonary involvement and in the primary pulmonary form of the . . .
Literature for Young Children
Authors: Hugh H. Hussey
Journal: JAMA (1976)

In these days when television viewing has become an addiction among children who find delight in watching inane cartoons that sabotage the English language, the<i>American Journal of Diseases of Children</i>(130:180-183, 1976) carries an important message for parents. The ESSAY in question, "The Bedtime Story and Language Development," by Joy F. Moss, MA, emphasizes the need to read aloud regularly (preferably at a set time each day) to children of preschool and school age. Moss quotes Durkin<sup>1</sup>who found that children who learned to read before entering the first grade had been read to regularly at home where all the children's families had a high regard for books and reading. Such children become involved with written language and the reading process; they not only increase their knowledge store but learn to love books and become highly motivated to read for themselves. Moss notes that a child who shares
"PROPHYLAXIS OF ROENTGEN-RAY OVERDOSAGE"
Authors: Arthur K. Owen
Journal: JAMA (1924)

To the Editor:  —InThe Journal, November 8, R. H. Rulison states that he gave, through error, a dose of 8 inch spark gap, 5 milliamperes, distance 10 inches and with no filtration, and that treatment with a Kromayer lamp prevented untoward results. For four years we have treated from one to six or seven skin epitheliomas a day, with from five to twenty minutes of unfiltered roentgen-ray exposure, with an 8 inch spark gap, 5 milliamperes and 10 inch distance, and in all of these hundreds of cases we have not had one that did not heal promptly without any medication or therapy whatever and in many of them there was no untoward reaction. Five minutes, unfiltered, is our minimum time, and it may go to twenty minutes, depending on the size and duration of the skin lesion.  I do not want to see ultraviolet radiation receive too much
Red Cross accuses Israeli forces of killing two ambulance workers
Authors: Merav Sarig
Journal: BMJ (2006)

The Red Cross has accused the Israel Defense Forces (IDF) of killing two crew members of a Palestinian Red Crescent Society ambulance on 5 November. The incident occurred during an IDF attack on missile launchers while the crew attempted to evacuate wounded civilians in Gaza. 

The statement of censure issued by the International Committee of the Red Cross said that at the time of the incident the members of the ambulance crew “were wearing clearly marked fluorescent jackets” designed to protect them. Moreover, “the ambulance's siren was on and its flashing lights were visible at a great distance,” which should have prevented the IDF from shooting in their direction. …
Case 48-1985
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, Betty U. McNeely, David S. Rosenthal, Nancy L. Harris
Journal: New England Journal of Medicine (1985)

Presentation of CaseA 69-year-old man was admitted to the hospital because of peripheral vascular disease and hypersplenism.There was a long history of atherosclerotic peripheral vascular disease. Twenty-five years before admission the patient underwent a thromboendarterectomy of the left common femoral artery. An x-ray film of the abdomen showed that the spleen was enlarged and extended to the lower border of the second lumbar vertebra; calcifications were seen in the abdominal aorta and iliac arteries. Splenic enlargement was not noted on physical examination. During the next six years the patient underwent four surgical procedures that included endarterectomies, patch, bypass, . . .