tbuckley/cabot-search huggingface dataset:
Ordering and interpreting ear swabs in otitis externa
Authors: C. Llor, C. A. M. McNulty, C. C. Butler
Journal: BMJ (2014)

The novel immunosuppressive drug O-hydroxyethyl-d(Ser)<sup>8</sup>-cyclosporine (SDZ IMM 125) and cyclosporine A (CyA) were compared in different <i>in vitro</i> models with respect to hepatocellular side effects. SDZ IMM 125 was less lipophilic than CyA and also decreased liposomal membrane anisotropy less. Furthermore, SDZ IMM 125 increased Na<sup>+</sup> and Ca<sup>++</sup> permeability across the liposomal membranes significantly more than CyA. The uptake of CyA and SDZ IMM 125 into freshly isolated rat hepatocytes was neither saturable, Na<sup>+</sup>dependent or temperature sensitive, nor could it be inhibited vice versa, indicating passive diffusion. The diffusion coefficient of CyA was about two times higher than that of SDZ IMM 125, reflecting its higher lipophilicity. In primary hepatocyte monolayers the cellular concentrations of CyA were about two times higher than that of SDZ IMM 125. As an indicator of cholestasis the saturable uptake of cholyltaurine into isolated cells was found to be apparently competitively inhibited to the same extent by both compounds. In isolated perfused rat livers SDZ IMM 125 caused a significantly greater decrease in bile flow than did CyA. Release of lactate dehydrogenase from hepatocyte primary cultures and from isolated perfused livers were determined as parameter of cell damage. In both systems the cytotoxicity of SDZ IMM 125 was significantly higher than that of CyA. The data suggest that SDZ IMM 125 causes greater cholestatic and cytotoxic effects than CyA at equimolar cellular exposure.
Neutrophil accumulation in experimental myocardial infarcts: relation with extent of injury and effect of reperfusion.
Authors: P Chatelain, J G Latour, D Tran, M de Lorgeril, G Dupras, M Bourassa
Journal: Circulation (1987)

The effects of reperfusion on the myocardial accumulation of neutrophils and their role in the extent of injury were investigated in a canine preparation with a 3 hr coronary occlusion followed by 21 hr of reperfusion. The left anterior descending coronary artery (LAD) was permanently occluded in group 1 and reperfused after 3 hr in four others (groups 2 to 5). All but group 5 received lidocaine (1 mg/min over 8 hr). A critical stenosis was produced and left in place at reperfusion only in group 2. In groups 1 and 2, 111In-labeled autologous neutrophils were injected at the time of coronary occlusion. Group 4 animals were rendered leukopenic 2 hr before the coronary ligature and throughout the experiment by injection of an antineutrophil rabbit serum. Quantification of the radioactivity by digitized scintigraphy of the heart slices revealed an 80% (p less than .05) increase in neutrophil accumulation in the infarct region after reperfusion (group 2) as compared with permanent occlusion (group 1). Gamma counting of myocardial tissue samples showed that the neutrophil accumulation ratio in the subendocardial central zone of the infarct was increased five times (p less than .05) by reperfusion, whereas no difference was evident in the subepicardium. Infarct size and myocardial area at risk were not statistically different among the five groups. However LAD flow in the leukopenic group (group 4) was significantly higher (p less than .05) 30 min after reperfusion (40.0 +/- 5 ml/min) when compared with the preocclusion value (21.7 +/- 4 ml/min). In contrast, in a parallel experiment without leukopenia (group 3), LAD flow after reperfusion did not differ from the preocclusion value.(ABSTRACT TRUNCATED AT 250 WORDS)
Congenital Megacalyces Studies With Different Imaging Modalities
Authors: RAJESH SETHI, PARDEEP MITTAL, STEVEN FRIEDMAN, DANIEL CONTRACTOR, JOSEPH GIOVANNIELLO
Journal: Clinical Nuclear Medicine (1997)

Congenital megacalyces is an entity in which more than 12 calyces (polycalyces) are present in a kidney. The authors present a case of congenital megacalyces that has a typical 'Bunch of Grapes' appearance on radionuclide renal imaging. In addition, the patient had an ipsilateral congenital partial uretero-pelvic junction obstruction and congenital absence of the opposite kidney.
Gastric Bypass and Nesidioblastosis — Too Much of a Good Thing for Islets?
Authors: David E. Cummings
Journal: New England Journal of Medicine (2005)

As the obesity pandemic continues to worsen and medical interventions remain only moderately effective, bariatric surgery is at present the only method that reliably results in major, long-term weight loss.1,2 The most successful procedures durably reduce body weight by about one third and ameliorate nearly all obesity-related complications, most notably — almost miraculously — type 2 diabetes mellitus.2 Not surprisingly, bariatrics is the fastest-growing surgical subspecialty. The number of bariatric surgeons registered with the American Society for Bariatric Surgery increased by almost 50 percent per year during the past several years, and the number of bariatric operations nearly doubles . . .
Dutch doctor refuses to treat smokers
Authors: T. Sheldon
Journal: BMJ (1998)

A doctor in the Netherlands who has said that he will refuse to treat smokers has been warned by the government supervisory body that it is unacceptable to exclude patients on the basis of their behaviour.

The Health Care Inspectorate wrote to Dr Cees van Bunningen saying that when a doctor offers a public service it should be available to everyone. The inspectorate has warned that it will ask him to explain his actions if …
P18 How effective is the recommended staging for latent TB follow-up?
Authors: D. Thomas, M. Jarvis, A. Williams
Journal: Thorax (2011)

<h3>Introduction</h3> NICE (2011) recommends that patients with latent TB infection who are eligible for but decline treatment are followed up with a chest x-ray (CXR) at 3 and 12 month intervals to assess for TB reactivation. The aim of this study was to assess the effectiveness of this strategy in detecting reactivation of TB. <h3>Method</h3> A retrospective case note analysis of 146 latent TB patients (2006–2011) of all ages. Mode age range 16–35 (46%). Follow-up attendance, clinical presentation, CXR appearances and patient demographics were recorded. <h3>Results</h3> 47% (n=69) attended for follow-up at 3 and 12 months. 18% DNA at 3 months, 35% DNA at 12 months. 13% moved away. 98.6% of patients showed no evidence of TB reactivation in a 12-month period. 52% of patients were under 35. 2 (1.4%) patients developed active TB within a 12-month period. One was found to have CXR changes at the 3-month follow-up, and was later admitted with TB meningitis. The other was symptomatic (no CXR changes) and was treated empirically for active TB. 63% were new entrants; 41% had been in the UK &lt;1 year. 1 patient was immunosuppressed. Common risk factors for LTBI were ethnicity (73%) and occupational exposure (19%). Only 12% recalled previous TB contact. <h3>Discussion</h3> 3 and 12-month follow-up had a very low yield of detecting TB reactivation in this sample (1.4%). It cost £16 000 (based on current PbR tariff) to screen the 69 patients who attended at 3 and 12 months. Use of limited resources must be justified. Are there better staging intervals for follow-up? Follow-up is also associated with a high DNA rate, particularly at 12 months, further stretching resources. However, follow-up allows health promotion regarding TB symptoms and the role of chemoprophylaxis. <h3>Conclusion</h3> These results question the validity of following up LTBI patients at 3 and 12 months after diagnosis. Further longitudinal studies are needed to determine the optimum intervals for follow-up.
ABSORPTION FROM THE PERICARDIAL CAVITY
Authors: Cecil K. Drinker, Madeleine E. Field
Journal: The Journal of Experimental Medicine (1931)

1. Physiological salt solution is absorbed from the pericardial cavity of medium-sized rabbits at a rate of approximately 1.3 cc. per hour. This absorption is via the subepicardial blood capillaries. 2. Rabbit serum and horse serum are absorbed extremely slowly-an indication of the low-grade lymphatic drainage of the pericardial sac. 3. Graphite particles of bacterial dimensions are also removed very slowly. Such particles enter lymphatics only after phagocytosis. The lymphatics in the basal part of the pericardium are the principal source of drainage. Subepicardial lymphatics are entered with difficulty from the pericardial cavity.
Acceptability of A/H1N1 vaccination during pandemic phase of influenza A/H1N1 in Hong Kong: population based cross sectional survey
Authors: J. T F Lau, N. C Y Yeung, K C Choi, M. Y M Cheng, H Y Tsui, S. Griffiths
Journal: BMJ (2009)

<b>Objective</b> To investigate the intention of the Hong Kong general population to take up vaccination against influenza A/H1N1. <b>Setting </b>Cross sectional population based anonymous survey. <b>Participants R</b>andom sample of 301 adults interviewed by telephone (response rate 80%). <b>Main outcome measure</b> Intention to take up vaccination against influenza A/H1N1 under five hypothetical scenarios: vaccination is free; vaccination per dosage costs less than $HK100 (£8; €9; $13), $HK101-200, or more than $HK200; and no data are available on the efficacy and safety of the vaccine. <b>Results </b>45% (n=135) of the participants reported that they would be highly likely take up vaccination if it was free. When vaccination incurred a cost, however, the prevalence of uptake decreased: 36% (n=108) would take up vaccination if it cost less than $HK100, 24% (n=72) if it cost $HK101-200, and 15% (n=45) if it cost more than $HK200; and in absence of proved efficacy and safety decreased to 5% (n=14). Moreover, 32% (n=95) considered universal A/H1N1 vaccination unnecessary. Overall, 39% (n=117) of participants believed that A/H1N1 vaccination would prevent the virus being contracted; 63% (n=189) erroneously believed that efficacy of the vaccine had been confirmed by clinical trials, and 16% (n=49) believed that it is necessary for everyone in Hong Kong to take up vaccination against influenza A/H1N1. <b>Conclusions </b>The uptake of vaccination against influenza A/H1N1 by the general population of Hong Kong is unlikely to be high and would be sensitive to personal cost. Evidence about safety and efficacy is critical in determining the prevalence of uptake of vaccination.
Prognostic implications of functional mitral regurgitation according to the severity of the underlying chronic heart failure: a long‐term outcome study
Authors: Francesca Bursi, Andrea Barbieri, Francesco Grigioni, Letizia Reggianini, Vera Zanasi, Chiara Leuzzi, Caterina Ricci, Giulia Piovaccari, Angelo Branzi, Maria Grazia Modena
Journal: European Journal of Heart Failure (2010)
Metaphysical Symbolism in 16th- and 17th-Century Medicine
Authors: Peter Krivatsy
Journal: JAMA (1970)

The connections of man and nature have engaged the attention of physicians and philosophers from earliest times. One of the seminal ideas in the history of thought is the relationship expressed by the terms "macrocosm" and "microcosm," the great universe and the individual small universe which mirrors the great one. A world soul was considered to animate the universe, and the human body, with its own soul, was a miniature universe. The events which take place in the great universe found a reflection in the individual man. The ancient Greeks thought much about the problem. Ionian philosophers speculated about the multiplicity of things in nature, and the Pythagoreans and others concluded that a kinship between man and nature must be close, since the universe was one, divine, and eternal. The parallel between man and the cosmos was mentioned by Anaximenes and Democritus. The idea of the macrocosm and the microcosm
Modern Pain Relief: Percutaneous Chordotomy
Authors: Hubert L. Rosomoff
Journal: JAMA (1966)

A new technique for the interruption of spinal-pain pathways has been developed. Percutaneous cervical radiofrequency chordotomy allows easy, efficient, lowrisk relief of pain in an extended range of intractable conditions, both benign and malignant. A group of 100 patients, ranging in age from 30 to 85 years, has undergone a total of 154 percutaneous chordotomies. Almost half had high thoracic, arm, shoulder, or neck pain. Thirty-three with visceral pain required bilateral chordotomies. Initial results indicate complete or satisfactory relief in 92% of the patients. Follow-up examinations show sustained levels of analgesia and continuing "permanent" effect. Complications include transient bladder dysfunction in seven patients, temporary motor weakness in eight, and permanent paresis in one. All indications suggest replacement of standard laminectomy and surgical section by this method.
Bradykinin-Mediated Angioedema
Authors: Juerg Nussberger, Massimo Cugno, Marco Cicardi
Journal: New England Journal of Medicine (2002)

To the Editor: Correction of X-linked severe combined immunodeficiency by infusion of autologous CD34+ stem cells transduced with retrovirus containing common g chain, reported by Hacein-Bey-Abina et al. (April 18 issue), 1 is a milestone in medicine.We used a different therapy with a similarly good outcome.X-linked severe combined immunodeficiency was diagnosed in two patients after the initiation of mechanical ventilation for pulmonary failure caused by infections.Immediately after the diagnosis had been made, haploidentical CD34+ peripheral progenitor cells mobilized with granulocyte colony-stimulating factor were isolated to a purity of more than 99 percent. 2 These cells were infused with no preparative regimen and no prophylaxis against graft-versus-host disease.Both patients showed signs of T-cell reconstitution beginning three weeks after the CD34+ infusion and were weaned from the ventilator.They are in excellent health, without graft-versus-host disease, 34 and 68 months after transplantation.Patient 1 does not need replacement immune globulin.Patient 2 received a "booster" infusion of CD34+ stem cells from the original donor one year later to improve B-cell function and now receives immune globulin every three months.Our experience indicates that purified haploidentical CD34+ progenitor cells reconstitute the T-cell compartment and can correct the B-cell defect.Given the possibility of long-term risks 3,4 and the availability of effective alternatives, we think that broader application of gene therapy for the treatment of patients with severe combined immunodeficiency or strategies for the correction of persistent B-cell deficiency after successful allogeneic transplantation 5 are premature and warrant longer follow-up.
Egil's or Paget's disease?
Authors: T. Hardarson, E. Snorradottir
Journal: BMJ (1996)

Under the altar some human bones were found, much bigger than ordinary human bones, and people are confident that these were Egil's because of the stories told by old men. Skapti Thorarinsson, the Priest, a man of great intelligence, was there at the time. He picked up Egil's skull and placed it on the fence of the churchyard. The skull was an exceptionally large one and its weight was even more remarkable. It was ridged all over on the outside like a scallop shell, and Skapti wanted to find out just how thick it was, so he picked up a heavy axe, swung it in one hand and struck as hard as he was able with the reverse side of the axe, trying to break the skull. But the skull neither broke nor dented on impact, it simply turned white, and from that anybody could guess that the skull wouldn't be easily cracked by small fry while it still had skin and flesh on it.1

This somewhat irreverent exhumation of a legendary Viking takes place at the end of Egil's Saga, one of the most widely read and popular of the medieval Icelandic sagas. Egil Skallagrimsson whose bones these were believed to be is one of the saga's most colourful characters: a vicious killer (from the age of 6), a violent drunkard, a gifted and sensitive poet, a farmer, and a lawyer. He died in his 80s—an extraordinary age for a man of his times and lifestyle—and was buried in a pagan grave mound.

About a decade later his son in law was converted to Christianity and built a church at his farm. Egil's bones were then disinterred and moved to the church. About 150 years later a new church was built, and again Egil's bones were exhumed to …
Cardiac Arrest and Blood Ionized Calcium Levels
Authors: Philip Urban
Journal: Annals of Internal Medicine (1988)

Blood ionized and total calcium levels, and pH values were obtained in 12 patients who were being ventilated and given external cardiac massage after having had an out-of-hospital cardiac arrest. On admission they had marked ionized hypocalcemia, with mean ionized calcium levels of 0.67 +/- 0.22 mmol/L, (range, 0.26 to 0.89), but normal total calcium levels. There was a positive correlation between pH and ionized calcium levels (r = 0.71). Of the six patients who were successfully resuscitated, four were discharged and two died; the other six could not be resuscitated and died. By comparison, ionized and total calcium levels obtained within 3 minutes of cardiac arrest were normal in 9 patients who had cardiac arrests in the intensive care unit or during surgery. All were discharged. These data are the first to document the occurrence of severe ionized hypocalcemia after out-of-hospital cardiac arrest. Hypocalcemia appears to be time-dependent and due essentially to extracellular complexing of calcium. Further work is needed to determine whether patients who have out-of-hospital cardiac arrests can benefit from calcium administration.
The common TEL/AML1 rearrangement does not represent a frequent event in acute lymphoblastic leukaemia occurring in children with Down syndrome
Authors: C Lanza, G Volpe, G Basso, E Gottardi, F Perfetto, V Cilli, M Spinelli, E Ricotti, A Guerrasio, E Madon, G Saglio
Journal: Leukemia (1997)
Controversies in the surgical management of thyroid follicular neoplasms. Retrospective analysis of 721 patients
Authors: Giovanni Conzo, Pietro Giorgio Calò, Claudio Gambardella, Ernesto Tartaglia, Claudio Mauriello, Cristina Della Pietra, Fabio Medas, Rosa Santa Cruz, Francesco Podda, Luigi Santini, Giancarlo Troncone
Journal: International Journal of Surgery (2014)
The lung vascular filter as a site of immune induction for T cell responses to large embolic antigen
Authors: Monique A.M. Willart, Hendrik Jan de Heer, Hamida Hammad, Thomas Soullié, Kim Deswarte, Björn E. Clausen, Louis Boon, Henk C. Hoogsteden, Bart N. Lambrecht
Journal: The Journal of Experimental Medicine (2009)

The bloodstream is an important route of dissemination of invading pathogens. Most of the small bloodborne pathogens, like bacteria or viruses, are filtered by the spleen or liver sinusoids and presented to the immune system by dendritic cells (DCs) that probe these filters for the presence of foreign antigen (Ag). However, larger pathogens, like helminths or infectious emboli, that exceed 20 µm are mostly trapped in the vasculature of the lung. To determine if Ag trapped here can be presented to cells of the immune system, we used a model of venous embolism of large particulate Ag (in the form of ovalbumin [OVA]-coated Sepharose beads) in the lung vascular bed. We found that large Ags were presented and cross-presented to CD4 and CD8 T cells in the mediastinal lymph nodes (LNs) but not in the spleen or liver-draining LNs. Dividing T cells returned to the lungs, and a short-lived infiltrate consisting of T cells and DCs formed around trapped Ag. This infiltrate was increased when the Toll-like receptor 4 was stimulated and full DC maturation was induced by CD40 triggering. Under these conditions, OVA-specific cytotoxic T lymphocyte responses, as well as humoral immunity, were induced. The T cell response to embolic Ag was severely reduced in mice depleted of CD11chi cells or Ly6C/G+ cells but restored upon adoptive transfer of Ly6Chi monocytes. We conclude that the lung vascular filter represents a largely unexplored site of immune induction that traps large bloodborne Ags for presentation by monocyte-derived DCs.
European regulatory aspects on new medicines targeted at treatment of rheumatoid arthritis
Authors: G. Kreutz
Journal: Annals of the Rheumatic Diseases (1999)

Within the European Union a remarkable change has been taking place within the past five years that greatly influences the development of new medicines to become marketed products in the whole region or in some of their member states.

It is important for clinicians and basic scientists to realise these changes so that actual requirements be fulfilled by the documents supporting an application for approval in one, several, or all member states.

For this reason the idea of the organisers of this conference was welcomed to provide a forum for discussion between those professionals involved in clinical trials and those who are involved in regulatory decisions by setting up standard requirements or deciding on whether results presented by the applicant are meeting these requirements.

Understanding the organisational structure of the European regulatory house for the evaluation of medicines, …
p38 Mitogen-Activated Protein Kinase–Driven MAPKAPK2 Regulates Invasion of Bladder Cancer by Modulation of MMP-2 and MMP-9 Activity
Authors: Binod Kumar, Sweaty Koul, Jane Petersen, Lakshmipathi Khandrika, Jeong S. Hwa, Randall B. Meacham, Shandra Wilson, Hari K. Koul
Journal: Cancer Research (2010)

Abstract In transitional cell carcinoma, the most common form of bladder cancer, overexpression of the matrix metalloproteinases MMP-2 and MMP-9 offers prognostic value as markers of disease-specific survival. These molecules have been implicated in metastasis of bladder cancer, but the underlying mechanisms through which they are controlled are poorly defined. In this study, we investigated a role of p38 mitogen-activated protein kinase (MAPK) in this process, using bladder cancer cell lines HTB9 and HTB5 that were derived from different tumor stages. p38 MAPK modulated MMP-2/9 mRNA levels at the levels of transcript stability and MMP-2/9 activity along with invasive capacity. We defined a downstream effector of p38 MAPK, MAPK-activated protein kinase 2 (MAPKAPK2), that was associated with MMP-2/9 activation. Ectopic expression of wild-type or constitutively active forms of MAPKAPK2 increased MMP-2/9 activities and invasive capacity. Conversely, p38 MAPK inhibition blocked the MAPKAPK2-mediated increase in MMP-2/9 activities and the invasive capacity of the cancer cells. Our findings implicate p38 MAPK and MAPKAPK2 in mediating bladder cancer invasion via regulation of MMP-2 and MMP-9 at the level of mRNA stability. Cancer Res; 70(2); 832–41
Surveys of patient satisfaction: II--Designing a questionnaire and conducting a survey.
Authors: R Fitzpatrick
Journal: BMJ (1991)

100%.Retrieval rates were less from undergraduate teaching hospitals than from other hospitals.The retrieval rate was lower from one region than from the other, independent of the proportion of patients treated at teaching hospitals.-> / For deceased patients the retrieval of case notes varied with district of residence but no association was found with the region of residence, the year of death, or the teaching status of the hospital.Of 223 patients recorded as having had radiotherapy, 184 were deceased.Records were retrieved from 11 centres treating 216 patients.The overall response rate was 172/216 (80%), but response ranged from 50% to 100% for the individual centres.The retrieval rate was lower from one region than from the other, but retrieval of records was similar for surviving and deceased patients and did not vary by year of death, district of residence, or the teaching status of the hospital.I 'ariables associated with retrieval ofhospital case notes and radiotherapy records ofsurviving and deceased patients No retrieved/ Relative odds of retrieval Degree of \'ariable No sought (95"%0 confidence intcrval) f/ freedom p Value 5