tbuckley/cabot-search huggingface dataset:
The usefulness of microscopic bile examination in patients with suspected microlithiasis: A prospective evaluation
Authors: Jean-Charles Delchier, Paul Benfredj, Anne-Marie Preaux, Jean-Michel Metreau, Daniel Dhumeaux
Journal: Hepatology (1986)

Gallbladder bile collected by duodenal intubation or during surgery was examined microscopically in patients who were free of stones and in patients with proven stones. None of the 16 patients free of stones had cholesterol monohydrate crystals or calcium bilirubinate granules in bile. Among the 17 patients with proven cholelithiasis, 13 with cholesterol stones had cholesterol monohydrate crystals in their bile, but only 2 of the 4 patients with pigment stones had calcium bilirubinate granules. These data confirm that cholesterol monohydrate crystals are sensitive and specific for cholesterol stones, whereas calcium bilirubinate granules lack sensitivity for the diagnosis of pigment stones. From these results, the diagnostic usefulness of microscopic examination of bile collected from the duodenum was studied prospectively in 46 patients with symptoms suggestive of cholelithiasis but in whom stones had not been visualized at cholecystography and ultrasonography. In 15 of them, bile was found to be abnormal: cholesterol monohydrate crystals were seen in 11, cholesterol crystals + calcium bilirubinate granules in 2 and calcium bilirubinate granules in 2. To date, nine of these patients have been operated on: 6 (all with cholesterol monohydrate crystals) had small cholesterol gallstones and 3 (2 with cholesterol monohydrate crystals and 1 with calcium bilirubinate granules) had signs strongly suggestive of the recent migration of gallstones. One patient refused operation, but minute pigment stones were found to be associated with calcium bilirubinate granules at duodenal intubation. In the other 31 patients, bile contained neither cholesterol monohydrate crystals nor calcium bilirubinate granules. They were not operated on and were followed up with repeated investigations for 12 to 24 months.(ABSTRACT TRUNCATED AT 250 WORDS)
England to consider shake-up of medical regulation
Authors: Andrew Cole
Journal: BMJ (2006)

England's chief medical officer, Liam Donaldson, has recommended a radical shake-up of the way doctors' performance is assessed and a substantial reduction in the powers of their regulatory body, the General Medical Council.

The long anticipated review of medical regulation contains 44 recommendations, including lowering the burden of proof in misconduct cases; a rigorous system of revalidation for all doctors; and the devolution of many of the GMC's powers to local hospital level.

The report, prompted by the murder of an estimated 250 patients by the GP Harold Shipman and a subsequent inquiry …
A cholesterol deficiency syndrome in humans.
Authors: W E Connor
Journal: Journal of Clinical Investigation (1995)

A Cholesterol Deficiency Syndrome in Humans Editorial Except in crustaceans and insects, cholesterol is not an essential nutrient.Newborn human infants do very well when fed the usual cholesterol-free formulas.In the current preoccupation about "too much" cholesterol, it is important to recognize that every cell of the body requires cholesterol for membrane structure and, in the case of certain endocrine glands, for steroid hormone synthesis.Cholesterol is supplied to most cells by local synthesis and from the plasma through the LDL receptor.However, brain cells, because of the blood-brain barrier, are unique in obtaining their cholesterol by synthesis within the brain (1, 2).Since the brain has the highest concentration of cholesterol of any organ in the body, this means that brain growth and development might well be affected by a deficiency of cholesterol or by aberrations in cholesterol synthesis.In 1964, Smith, Lemli, and Opitz described a new syndrome characterized in part by microcephaly, severe mental retardation, and hypertonicity (3).The microcephaly indicated impaired brain growth for reasons not appreciated until recently.The biochemical basis for the Smith-Lemli-Opitz syndrome was found to be a block in the synthesis of cholesterol because of a W E.
Determinants of enhanced thromboxane biosynthesis in renal transplantation
Authors: Maurizio Averna, Carlo Maria Barbagallo, Antonina Ganci, Carlo Giammarresi, Angelo Baldassare Cefalù, Vito Sparacino, Flavia Caputo, Stefania Basili, Alberto Notarbartolo, Giovanni Davì
Journal: Kidney International (2001)
OCULAR PHENOMENA PRODUCED BY BASAL LESIONS OF THE FRONTAL LOBE
Authors: WALTER I. LILLIE
Journal: JAMA (1927)

In a series of eighty-six definitely proved lesions of the frontal lobe examined in the Mayo Clinic, thirteen were situated in the basal portion of either one or both frontal lobes. In these thirteen cases a definite ophthalmologic syndrome was revealed. Wilbrand and Saenger<sup>1</sup>reported several cases of tumor of the frontal lobe with unilateral choked disks, but emphasis was not placed on ophthalmologic observations, and unfortunately perimetric fields were not described. They also report having noted a basal lesion of the frontal lobe with a unilateral choked disk, and mention having seen several other similar cases, but again the perimetric fields were not mentioned. It was not until Kennedy,<sup>2</sup>in 1911, reported six cases of basal lesion of the frontal lobe that the value of the ophthalmologic data as an exact diagnostic syndrome was properly emphasized. He found "a true retrobulbar neuritis with the formation of a
A6.39 Dynamic regulation of adenosine receptors determines responses to adenosine in primary cells from healthy donors and rheumatoid arthritis patients
Authors: SA Snoek, C Braam, R Brunekreef, N Broekstra, J van Ittersum, PP Tak, MJ Vervoordeldonk, JD Finn
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background and objectives</h3> Adenosine is an important regulator of immune responses. There is accumulating evidence that methotrexate, the anchor drug for rheumatoid arthritis (RA), mediates its anti-inflammatory effects by increasing adenosine levels at inflamed sites. Adenosine modulates (immune) cell responses through four receptors: ADORA1,-2A, -2B, and -3. ADORAs are linked to different intracellular signalling pathways: ADORA1/3 to pro-inflammatory and ADORA2A/2B to anti-inflammatory pathways. Here, we present data investigating the effects of adenosine and receptor expression in two of the major cell types involved in the pathogenesis of RA, monocytes and fibroblast-like synoviocytes (FLS). <h3>Materials and methods</h3> Primary monocytes were isolated from healthy donors blood (n = 3) and FLS from synovial biopsies of RA patients (n = 6). After stimulation with LPS or TNF/IL-1β, cells were lysed at several time points and ADORA expression was determined by QPCR. Supernatants were taken after O/N stimulation and cytokines (CCL2, IL-6 and TNF) were determined by ELISA. <h3>Results</h3> In resting cells, monocytes and FLS showed a distinct ADORA expression profile, with ADORA1/2B predominant on FLS, and ADORA3/2B predominant on monocytes. After stimulation with LPS or TNF/IL-1β, both cell types showed a striking upregulation of ADORA2A peaking at 4h (monocytes: 90-fold, FLS: 450 fold) but not of ADORA-1, -2B or -3. When monocytes were stimulated with LPS, co-incubation with adenosine significantly reduced pro-inflammatory cytokine production, resulting in a &gt;70% decrease in CCL2 and TNF (p &lt; 0.05). In similar studies using FLS, adenosine was found to have a much more modest effect, showing only a &lt;20% decrease in CCL2 (p &lt; 0.01) and no change in IL-6 production in TNF/IL-1β stimulated cells. In contrast, when no inflammatory stimuli were added to cell cultures, adenosine enhanced CCL2 and IL-6 production in both FLS and monocytes. In RA-FLS, the effect of adenosine was dependent on the dose of TNF/IL-1β. These results indicate that in a pro-inflammatory environment, adenosine will mainly signal through ADORA2A and repress immune responses. Interestingly, in the absence of inflammatory stimuli, adenosine will have pro-inflammatory properties, likely through A1/A3 signalling. <h3>Conclusion</h3> These data show that the primary cells involved in the pathogenesis of RA dynamically change their ADORA expression following inflammatory stimulus, and that this change is reflected in the cells response to adenosine.
Science and the Practice of Medicine in the Nineteenth Century
Authors: George Weisz
Journal: JAMA (1995)

There are no exact statistics on the subject, but it is a safe assumption that a majority of historians of medicine work on the 19th century. It is thus rather surprising that the most recent synthetic full-length study of the development of modern medicine by a professional medical historian was Richard Shryock's<i>The Development of Modern Medicine</i>, first published in 1937. The reason, one suspects, is that historians initially had little to add to received views on the subject. In more recent years, the reverse is true. There is a wealth of recent monographic research in the field, ranging from conventional history of scientific ideas to social and cultural history and extending as well to demography. It is hard to control so much disparate material and even more difficult to give it coherent narrative form. In this excellent synthetic study, William Bynum of the Wellcome Institute in London has dealt
Should we prescribe diuretics for patients with prediabetes and hypertension?
Authors: B. Arroll, T. Kenealy, C R. Elley
Journal: BMJ (2008)

The uncertainty arises from the findings of the large randomised controlled ALLHAT 2002 trial (31 512 people 55 years or older with hypertension and one other risk factor for cardiovascular disease), in which the thiazide-like diuretic chlortalidone seemed to increase some cardiac risk factors, including the rate of developing diabetes. After four years of follow-up in those who had a normal fasting blood glucose at baseline, 302 (11.6%) people taking chlortalidone, 154 (9.8%) of those taking amlodipine (a calcium channel blocker), and 119 (8.1%) of those taking lisinopril (an angiotensin converting enzyme inhibitor) had fasting blood glucose concentrations of ≥7 mmol/l (P<0.001).1 Diuretics are known to achieve long term cardiovascular results as good as, or better than, alternative antihypertensives—at least in people aged 55 years or older. But clinicians may not initially treat patients with prediabetes and hypertension with a diuretic because they worry that the induced diabetes might result in a worse outcome than if they prescribed a different class of antihypertensive. 

International guidelines give conflicting advice, presumably because of this uncertainty. The National Institute for Health and Clinical Excellence (NICE) advises general practitioners in the United Kingdom to use diuretics and calcium channel blockers as first line treatments in patients over 55 years and angiotensin converting enzyme inhibitors in those under 55. Diuretics are not recommended in the younger group partly because of concern about …
FDA Approval of New Drugs
Authors: Jill Jin
Journal: JAMA (2014)

Any new prescription drug in the United States must go through an extensive review and approval process by the US Food and Drug Administration (FDA) before it can be prescribed to patients.

A drug is any product that is meant to be used in diagnosing, treating, or preventing diseases by affecting the structure or function of the body. Prescription drugs, which must be obtained with the written authorization of a licensed health care professional, are regulated by the FDA, and some over-the-counter drugs are regulated by the FDA as well. The following information does not relate to most vitamins, minerals, and herbal supplements.
Moderate drinking can help women with type II diabetes, says study
Authors: D. Josefson
Journal: BMJ (2002)

Moderate alcohol intake may help control blood sugar in postmenopausal women with type II diabetes and may prevent the development of the disease and its cardiovascular sequelae in women at risk, a new report says ( JAMA 2002;287:2559).

Researchers from the US Department of Agriculture's Beltsville Human Nutrition Research Center in Beltsville, Maryland, decided to study the effect of alcohol intake in postmenopausal women because alcohol has hypoglycaemic effects and the postmenopausal state is associated with an increased prevalence of insulin resistance, with resultant relative hyperglycaemia.

The insulin resistance or reduced insulin sensitivity leads to hyperinsulinaemia, high concentrations of circulating blood glucose, and a greater risk of cardiovascular disease risk than in the premenopausal state. Moderate alcohol intake has also been …
Antipyrin for Diabetes.
Authors: Fred'k F. C. Demarest
Journal: JAMA (1892)

<h3>To the Editor of the Journal of the American Medical Association:</h3> I read with much interest the article on the treatment of Diabetes Mellitus, in your issue of May 28, 1892, and take the liberty of adding a drug to Dr. Riggs' list of four, because it has recently served me so signally. Sometime since I was called upon to treat a lady who had been suffering from this trouble for five previous years. When I took charge of her case she was passing a large amount of urine containing 20 per cent. of sugar. In treating the case I used all the regulation drugs, among them the four that are the basis of the aforementioned article, but was unable to make any definite impression in her case. In despair, partly, and on theoretical grounds I put the patient on antipyrin for one week, and was much delighted to find
The Insidious Advertisement.
Authors: Edward Jackson
Journal: JAMA (1897)

Philadelphia, March 20, 1897. <h3>To the Editor:</h3> —Probably no one knows better than a medical editor that eternal vigilance is the price of other things beside liberty; and nowhere is vigilance more essential than in guarding against the schemes of the manufacturer of proprietary preparations. TheJournal, with its settled and well understood policy of refusing reading notices, offers an attractive field in which to spread advertisements disguised as regular scientific communications. Many of the weekly medical journals of the Eastern cities and Europe, lend their aid to such schemes, some of them, perhaps, by inadvertence, others apparently with full intention. But this will not justify theJournal of the American Medical Associationin lowering its standard of requirements in the least. It is perhaps impossible to judge when the eulogy of a special preparation is entirely sincere on the part of a writer, whose judgment and originality may be
Shall The Journal be Removed to Washington?
Authors: John M. Batten
Journal: JAMA (1891)

<h3>To the Editor:</h3> —IfThe Journalis to be removed from Chicago I am in favor of removing it to Pittsburgh. Next to Chicago Pittsburgh is the greatest railroad centre in the country, and this is a very important consideration in these times of blizzards and railroad obstructions; besides among our more than two hundred physicians, any one of whom is just as capable to edit a medical journal as any one of a like number of physicians in any other locality in the country, either North or South, East or West. But ifThe Journalcannot come to Pittsburgh, then I am in favor of it remaining in Chicago, for it was born, cradled and grew to be a man there, and there is where it ought to stay. It is also ably edited there, besides, Chicago is the most central place in the country. Transplanting sometimes does well,
Induction of Ovulation in Primate Models
Authors: DANIEL KENIGSBERG, BURT A. LITTMAN, GARY D. HODGEN
Journal: Endocrine Reviews (1986)

IN 1958, Gemzell first described the use of a crude pituitary gonadotropin preparation in conjunction with human CG (hCG) for ovulation induction in anovulatory women. Two years later, Lunenfeld achieved a similar goal using human menopausal gonadotropin (hMG) plus hCG. Initially, fixed dose regimens were employed. Increasing experience with these agents soon demonstrated a considerable clinical and biochemical variation in response among patients undergoing ovulation induction therapy. Early on, this was attributed to the lack of consistency among preliminary gonadotropin preparations and to the different pathophysiological processes underlying the anovulatory state of such patients. The former's concern was addressed with the advent of highly purified preparations of gonadotropin. Indeed, owing to the limited availability of pituitary material, hMG containing an LH/FSH ratio of 1:1 (Pergonal, Serono, Randolph, MA) has emerged as the most widely used gonadotropin preparation. However, as endocrinologically normal women undertook treatment as in vitro fertilization and embryo transfer (IVF/ET) with this now standardized gonadotropin extract, the previously noted variation in response was seen to persist. This was manifest in the hormonal patterns which ensued as well as in the quantity and quality of oocytes recovered for IVF/ET.
Routine Use of Pulse Oximetry and Supplemental Oxygen During Endoscopic Procedures Under Conscious Sedation: British Beef or Common Sense?
Authors: G. D. Bell, J. G. Jones
Journal: Endoscopy (1996)

See also: Arterial Oxygen Desaturation Following Sedated Endoscopic ExaminationEndoscopy 1997; 29(07): 689-689DOI: 10.1055/s-2007-1004282
No experience necessary?
Authors: R J Stone
Journal: BMJ (1990)

When faced with advertisements for astronauts my reaction is to look for their date.This not being the first of a particular rnonth, however, I was intrigued to read further.Medic, scientist, or engineer required, aged 21 to 40, with proved foreign language ability.It seems many, many months since I replied to this curious challenge.In that time I have reflected more than once (although usually momentarily) if the decision to reply was not a rash one.
Closing the Chapter on Maharishi Ayur-Veda
Authors: Wiliam E. Crist
Journal: JAMA (1992)

To the Editor.  —Regarding the article in your October 2, 1991, issue entitled Maharishi Ayur-Veda: Guru's Marketing Scheme Promises the World Eternal Peace,1 as the media coordinator for the Tucson, Ariz, press conference that you mentioned on page 1749, I would like to correct two misrepresentations the author made.  First, the press conference was not set up to announce a meeting with the director of the ADC as the article claimed. The press conference was sponsored by the Tucson TM professionals association to increase public awareness about the results of the use of the TM program in corrections. These good results have been validated by peer-reviewed scientific research, including a study published in the Journal of Criminal Justice  2 that found (among other benefits) that a group of 259 male felon offenders who learned the TM program in California prisons had 35% less recidivism 5 years after parole, compared
Implementation of the Global Strategy for Health for All by the Year 2000: Second Evaluation; Health and Social Change in International Perspective
Authors: R. G Wilkinson
Journal: BMJ (1995)

Implementation of the Global Strategy for Health for All by the Year 2000: Second Evaluation , World Health Organisation, Sw fr 55, pp 289 ISBN 92 4 160285 6

Health and Social Change in International Perspective , Ed Lincoln C Chen, Arthur Kleinman, Norma C Ware Harvard University Press, pounds sterling11.95, pp 508 ISBN 0 674 38562 4

Because no one knows why mortality continues to decline in the developed world, doctors, health promotion agencies, experts on economic growth, and governments can all claim the credit. But their claims do not stand up to scrutiny.

As an international non-government agency, the World Health Organisation has the advantage of being able to take a more dispassionate view of the policy options. Its 38 health targets for Europe cover all the recognised health hazards and forms of prevention: behavioural factors, immunisation, screening, safety, environmental health hazards, work, housing, and so on. In this second report on progress towards its “targets,” advances are …
TREATMENT OF DETACHMENT OF THE RETINA.
Authors: CASEY A. WOOD
Journal: JAMA (1896)

Without taking your time with a historical sketch of the various remedies employed in the treatment of detachment of the retina I may say that the earliest efforts of the ophthalmic surgeon were directed to puncturing the subretinal sac, as it was found that this usually brought the displaced membrane into its normal position. As, however, the detachment was found to occur a second or a third time or, indeed in many cases, as often as it was replaced, various expedients were resorted to with the hope of rendering the cure permanent. Before speaking of these matters in detail let me remind you that replacement of the membrane does not necessarily mean a restoration of the lost visual function, although it is a<i>sine qua non</i>of that restoration. Nor do the visual acuity and the extent of the visual field form a proper measure of the success of a
Trusts required to show they are providing NICE approved treatments
Authors: M. Limb
Journal: BMJ (2012)

The government is to insist that NHS organisations that restrict treatments approved by the National Institute for Health and Clinical Excellence (NICE) face public scrutiny.

From this autumn, patients will be able to see whether approved drugs and treatments are being provided in their areas by hospitals and commissioning authorities.

“If they are not, they [NHS organisations] will now be responsible for explaining why not,” health minister Paul Burstow said.

He said the new regime would be a “catalyst for change” that would eradicate variation and uphold standards for all patients. “Being transparent with data like this is the hallmark of a 21st century NHS,” he said.

Under the …
Lung Reimplantation in the Dog
Authors: Eugene J. Linberg
Journal: JAMA (1961)

THE CLINICAL application of lung transplantation awaits the resolution of the immunological mechanism responsible for homograft rejection. Lung transplantation in the dog has become feasible as a result of resolution of technical difficulties.<sup>1,2</sup>In order to study homotransplantation intelligently it would appear necessary to develop techniques for autotransplantation (reimplantation). One is immediately impressed with the dearth of reports in the literature concerning reimplantation of an entire lung in the experimental animal with longterm survival. Borrie<sup>3</sup>has been working with sheep for years and has not yet been able to obtain a long-term survivor with a functional reimplanted lung. In 1951 Juvenelle et al.<sup>4</sup>reported the first successful reimplantation; on sacrifice 35 months later this animal had a functioning lung. Neptune et al.<sup>1</sup>in 1953 described a one-year survivor of lung reimplantation with normal function as determined by bronchospirometry. In 1959 we obtained a successful reimplantation which
Rhesus Diploid Rabies Vaccine (Adsorbed), A New Rabies Vaccine
Authors: Byron S. Berlin
Journal: JAMA (1982)

To meet the need for a safe, efficacious, and low-cost rabies vaccination program, the Michigan Department of Public Health developed a new rabies vaccine: rhesus diploid rabies vaccine, adsorbed (RDRV). Initial clinical studies were conducted in 534 volunteers using preexposure protocols consisting of two injections of RDRV given 1, 2, or 4 weeks apart. This new rabies vaccine induced an excellent rabies virus antibody response two to three weeks after vaccination: antibody levels were superior to those reported after duck embryo rabies vaccine and were similar to those reported with human diploid rabies vaccine. In addition, vaccination with RDRV was associated with an acceptable level of local and constitutional symptoms. (<i>JAMA</i>1982;247:1726-1728)