tbuckley/cabot-search huggingface dataset:
ABC of child abuse. Emotional abuse and neglect.
Authors: D. H. Skuse
Journal: BMJ (1989)

Dr David H Skuse, MRCP, is Wellcome Trust senior lecturer in the academic department of child psychiatry at the Institute of Child Health, London. The ABC of Clinical Genetics will continue next week. The ninth article in this series, which has been edited by Professor Roy Meadow, will appear on 8 July. Emotional abuse and neglect of children may take many forms from a lack of care for their physical needs, through a failure to provide consistent love and nurture, to overt hostility and rejection. Deleterious effects upon developing children are correspondingly diverse and tend to vary with age. In infancy neglect of physical care is likely to produce the most obvious consequences and developmental delays are also found. Preschool children may additionally present with disorders of social and emotional adjustment. Older children are likely to show behavioural problems at school, which are often accompanied by extensive learning difficulties. Emotional abuse is rarely the sole reason for seeking child protection through legal action, yet evidence is accumulating that its long term consequences upon social, emotional, and cognitive development may be far reaching and profound.
Polyostotic Fibrous Dysplasia
Authors: GARY S. GREENE
Journal: Clinical Nuclear Medicine (1984)

Fibrous dysplasia, a bone dysplasia of unknown pathogenesis, may be either monostotic or polyostotic. Not only is the femur involved in nearly all cases of the polyostotic form, but a distinct unilateral predilection is often noted. The following case illustrates the classic polyostotic changes.
Automated Echocardiographic Measures of Right Ventricular Area as an Index of Volume and End-Systolic Pressure-Area Relations to Assess Right Ventricular Function
Authors: Masahiro Oe, John Gorcsan, William A. Mandarino, Akihiko Kawai, Bartley P. Griffith, Robert L. Kormos
Journal: Circulation (1995)

Background On-line determination of right ventricular (RV) volume to assess its function is clinically difficult. Echocardiographic automated border detection measures of left ventricular (LV) cavity area have been shown to reflect changes in volume, and pressure-area relations have been used to estimate LV contractility. The potential for RV cavity area to estimate changes in volume and to assess RV function, however, has not been evaluated. Accordingly, the objective of this study was to determine the relation between echocardiographic automated border-detected RV cross-sectional area and true volume and to assess the potential for end-systolic pressure-area relations to estimate RV function in an isovolumically contracting isolated canine heart preparation. Methods and Results Eight excised dog hearts with both right and left intraventricular balloons were perfused in an ex vivo apparatus in which both ventricular volumes were controlled independently. RV area data from the level of the left midventricular short-axis plane and pressure data were recorded on a computer through a customized hardware and software interface with the ultrasound system. RV volumes were varied from 9.4±3.9 to 43.8±6.9 mL at each of three different LV volume ranges (low range, 12.5±3.8 mL; medium range, 23.9±5.6 mL; and high range, 37.5±5.4 mL). The variation of RV area during isovolumic contraction, which we called deformational area change, was considerable (1.49±0.68 cm 2 mean±SD) but did not change significantly with changing RV and LV volumes. Linear regression analysis correlated the maximum, minimum, and mean automated border-detected RV area during isovolumic contraction with absolute volume. A predominantly linear relation was observed, with the group mean r =.98 ( y =0.16 x +0.97; SEE=0.21 cm 2 ). The effect of LV volume on RV area-volume relation was a significant parallel downward shift ( P &lt;.05) by increases in LV volume. End-systolic pressure-area and pressure-volume relations using simultaneously RV pressure were both highly linear and covaried with changing LV volume. Conclusions Echocardiographic automated border-detected RV area reflects changes in RV volume under a constant LV volume, and the derived end-systolic pressure-area relation has potential for on-line assessment of RV function.
Gut microbiota and development of atopic eczema in 3 European birth cohorts
Authors: Ingegerd Adlerberth, David P. Strachan, Paolo M. Matricardi, Siv Ahrné, Lia Orfei, Nils Åberg, Michael R. Perkin, Salvatore Tripodi, Bill Hesselmar, Robert Saalman, Anthony R. Coates, Carmen L. Bonanno, Valentina Panetta, Agnes E. Wold
Journal: Journal of Allergy and Clinical Immunology (2007)
Is cyclophilin involved in the immunosuppressive and nephrotoxic mechanism of action of cyclosporin A?
Authors: N H Sigal, F Dumont, P Durette, J J Siekierka, L Peterson, D H Rich, B E Dunlap, M J Staruch, M R Melino, S L Koprak
Journal: The Journal of Experimental Medicine (1991)

In this report we have approached two questions relating to the mechanism of action of cyclosporin A (CsA). First, we address whether the major cytosolic protein for CsA, cyclophilin, is directly involved in mediating the immunosuppressive activity of this drug, and, in particular, whether inhibition of this protein's peptidyl-prolyl cis-trans isomerase (PPIase) activity results in inhibition of murine T cell activation. Second, we ask whether the nephrotoxicity observed with CsA is related to inhibition of PPIase-dependent pathways in cells other than lymphocytes. Using a series of 61 cyclosporin analogues, we generally found a good correlation between cyclophilin binding and immunosuppressive activity for the majority of analogues analyzed. However, a number of compounds of distinct structural classes were found that could interact with cyclophilin but were much less immunosuppressive than expected. The inability of these analogues to inhibit lymphocyte activation could not be explained by their failure to enter the cell and bind to cyclophilin under the conditions used in the cellular assays. Surprisingly, a nonimmunosuppressive analogue, MeAla-6, which bound well to cyclophilin and was active as a PPIase inhibitor, did not induce renal pathology in vivo. Furthermore, another analogue, MeBm2t, which was immunosuppressive in vitro, possessed little or no activity as a PPIase inhibitor. These findings pose serious questions concerning a direct role of cyclosporin in mediating CsA's immunosuppressive and nephrotoxic activities. In addition, they raise doubts about whether PPIase has a direct function in lymphocyte signal transduction.
Coronary Thrombolysis: Streptokinase or Recombinant Tissue-Type Plasminogen Activator?
Authors: Désiré Collen
Journal: Annals of Internal Medicine (1990)

In patients with acute myocardial infarction, intravenous streptokinase therapy recanalizes 40% to 45% of occluded coronary arteries and reduces mortality by 25%. Recombinant tissue-type plasminogen activator (rt-PA) therapy is more potent for coronary arterial thrombolysis, producing both more rapid and more frequent (65% to 70%) reperfusion. Side effects (mainly reocclusion and bleeding) of streptokinase and rt-PA therapy are not markedly different. Whether the higher efficacy of rt-PA therapy will translate into a comparably larger reduction of morbidity and mortality remains to be determined in large comparative clinical trials. Both agents are available for clinical use. At present, the choice of agent for treating acute myocardial infarction must be based on consideration of the lower cost of streptokinase therapy compared with the established higher efficacy of rt-PA therapy for coronary recanalization.
Who should treat patients with primary melanoma?: reply from authors
Authors: D.B. McKenna, J.C. Marioni, R.J. Lee, R.J. Prescott, V.R. Doherty
Journal: British Journal of Dermatology (2005)

Journal Article Who should treat patients with primary melanoma?: reply from authors Get access D.B. McKenna, D.B. McKenna Department of Dermatology, Royal Infirmary of Edinburgh, Edinburgh EH3 9YW, U.K. *Medical Statistics Unit, University of Edinburgh, Edinburgh EH8 9AG, U.K E‐mail: dermotbmckenna@hotmail.com Search for other works by this author on: Oxford Academic Google Scholar J.C. Marioni, J.C. Marioni Department of Dermatology, Royal Infirmary of Edinburgh, Edinburgh EH3 9YW, U.K. *Medical Statistics Unit, University of Edinburgh, Edinburgh EH8 9AG, U.K Search for other works by this author on: Oxford Academic Google Scholar R.J. Lee, R.J. Lee Department of Dermatology, Royal Infirmary of Edinburgh, Edinburgh EH3 9YW, U.K. *Medical Statistics Unit, University of Edinburgh, Edinburgh EH8 9AG, U.K Search for other works by this author on: Oxford Academic Google Scholar R.J. Prescott, R.J. Prescott Department of Dermatology, Royal Infirmary of Edinburgh, Edinburgh EH3 9YW, U.K. *Medical Statistics Unit, University of Edinburgh, Edinburgh EH8 9AG, U.K Search for other works by this author on: Oxford Academic Google Scholar V.R. Doherty V.R. Doherty Department of Dermatology, Royal Infirmary of Edinburgh, Edinburgh EH3 9YW, U.K. *Medical Statistics Unit, University of Edinburgh, Edinburgh EH8 9AG, U.K Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 153, Issue 2, 1 August 2005, Pages 458–459, https://doi.org/10.1111/j.1365-2133.2005.06774.x Published: 01 August 2005
Molecular loci for potential drug toxicity in ovaries.
Authors: J S Richards
Journal: Environmental Health Perspectives (1986)

Ovarian follicular development is dependent on the actions and interactions of the pituitary gonadotropins, FSH and LH, and the ovarian steroid hormone, estradiol. Agents which might block the effects of these hormones would increase follicular atresia and reduce fertility. In addition, any substance toxic to the oocyte and its normal pattern of growth and meiosis would lead to reduced numbers of oocytes and follicles and impaired fertility. Autoimmune diseases may be one major cause of premature ovarian failure, and such diseases might be triggered by toxic external stimuli.
Examination bar for overseas doctors must rise, researchers say
Authors: T. Moberly
Journal: BMJ (2014)

Pass marks for the examination taken by overseas doctors seeking to work in the United Kingdom should rise to ensure that these doctors meet equivalent standards to UK trained doctors, two studies in The BMJ have concluded.

The pass mark for the General Medical Council’s Professional Linguistic Assessments Board (PLAB) examination should be raised to a level currently achieved by less than 10% of international medical graduates, the researchers calculated. But they acknowledged that the implications of this proposal were “potentially problematic,” given the large numbers of international medical graduates seeking to work in …
NICE proposes incentives to keep addicts free of drugs
Authors: Susan Mayor
Journal: BMJ (2007)

Drug addicts who are receiving methadone maintenance treatment should be given incentives, such as shopping vouchers, each time they test negative for the presence of drugs, to encourage them to keep off drugs, says a draft guideline on the psychosocial management of drug misuse by the NHS in England and Wales. 

The draft guideline recommends that services for drug misusers should introduce contingency management programmes that use incentives to reduce illicit drug use and that improve engagement with those services among people undergoing methadone maintenance treatment. Incentives, which would usually be privileges such as access to a rapid dosing line, or vouchers, would be given each time a patient tests negative for the presence of drugs. 

The guidance suggests that vouchers should have a value of £5 and should increase in value with each additional and continuing(?) period of abstinence. 

Screening—probably by urinalysis—should be carried out three times each …
Study fails to show link previously found between virus and chronic fatigue syndrome
Authors: S. Mayor
Journal: BMJ (2010)

A UK study analysing samples from patients with chronic fatigue syndrome has found no evidence of a link with a retrovirus (XMRV), according to results published this week that question a theory linking the virus to the condition.

Patients with chronic fatigue syndrome, also known as myalgic encephalomyelitis, often report that their condition—a mix of symptoms including extreme fatigue—began after an otherwise normal viral infection. The xenotropic murine leukaemia virus-related virus (XMRV) was found in 67% of patients with chronic fatigue syndrome in a study reported last year ( Science 2009,326:585-9). The retrovirus has also been found in some studies in men with prostate cancer, although …
Endostatin inhibits murine colon carcinoma sinusoidal-type metastases by preferential targeting of hepatic sinusoidal endothelium
Authors: Miren S. Solaun, Lorea Mendoza, Marco De Luca, Virginia Gutierrez, Mari-Paz López, Elvira Olaso, Kim B. Lee Sim, Fernando Vidal-Vanaclocha
Journal: Hepatology (2002)

An angiogenic response originating from peritumoral sinusoids and portal tracts that leads to the formation of metastases with sinusoidal- and portal-type angiogenic patterns, respectively, occurs during the course of liver colonization by murine 51b colon carcinoma (51b-CC) cells. We found a 5-fold increase in endogenous endostatin levels from hepatic blood over baseline (25 ± 6 ng/mL) when micrometastatic foci had a detectable size and a 14-fold increase when macrometastases were developed. Despite this endogenous endostatin production, subcutaneous administration of recombinant human endostatin (rh-E; 50 mg/kg) decreased metastasis number by 60% when dosed from days 1 to 20 after 51b-CC cell injection, by 40% when given from days 10 to 20, and by 30% when administered as a single dose 30 minutes before 51b-CC cell injection compared with controls. In addition, administration of rh-E from days 10 to 20 decreased overall metastasis volume by 90% compared with controls. rh-E increased the number of necrotic sinusoidal-type metastases by 7-fold and decreased their intrametastatic CD31 + -microvessel density by 80% without affecting portal-type metastases. Flow cytometry showed rh-E binding to mouse liver sinusoidal cells but not to CD45 + cells (leukocytes and Kupffer cells) or 51b-CC cells. Furthermore, rh-E induced sinusoidal endothelium cell apoptosis. In conclusion, despite the direct correlation between metastasis development and endogenous endostatin generation in the liver, administration of rh-E inhibited micrometastasis generation and macrometastasis growth very efficiently. The antiangiogenic mechanism was selective for sinusoidal-type metastases, in which the neovasculature originating from sinusoidal endothelium cells was targeted by rh-E.
Effects of exercise stress on left ventricular end diastolic pressure-length strain relations in dogs with and without coronary stenosis
Authors: K. Maehara, Y. Maruyama, S. Yoshikata, T. Takishima
Journal: Cardiovascular Research (1992)

Objective: The aim was to elucidate the alterations of left ventricular diastolic properties, taking into account changes in unstressed length during exercise stimuli with and without coronary stenosis. Methods: Left ventricular end diastolic pressure-length strain relations using segment length normalised to Lagrangian strain, and the rate of relaxation, were studied in seven open chest anaesthetised dogs with and without coronary stenosis on both left anterior descending and circumflex coronary arteries (approximately 30% resting flow reduction) during simulated dynamic exercise. Regional segment length was measured with ultrasonic crystals placed in the left anterior descending subendocardial region, and unstressed segment length at zero transmural pressure was obtained by occluding the vena cava. Results: Peak negative dP/dt was decreased and isovolumetric left ventricular relaxation time constant increased by coronary stenoses; however neither changed significantly during simulated exercise. Left ventricular end diastolic pressure was significantly increased by coronary stenoses, from 3.1(SEM 0.8) to 7.0 (0.9) mm Hg (p<0.05), and further increased to 15.5(1.1) mm Hg (p<0.01) during simulated exercise, although right ventricular end diastolic pressure did not change. Unstressed length was increased in coronary stenoses from 9.03(0.08) to 9.89(0.13) mm (p<0.01), and further increased to 10.34(0.14) mm (p<0.01) during exercise, whereas it tended to decrease without coronary stenosis, from 9.03(0.08) to 8.79(0.11) mm during exercise. Left ventricular end diastolic pressure-length strain relations progressively shifted upward and leftward with coronary stenoses and subsequent exercise, but shifted downward and rightward during exercise without coronary stenosis. Conclusions: The increase in unstressed length or volume may contribute to exercise induced left ventricular dilatation observed in patients in effort angina. End diastolic distensibility decreases in both mild supply induced and exercise induced ischaemia, whereas in the normal heart, left ventricular end diastolic distensibility increases during exercise.
Working time directive shift patterns may improve care
Authors: J F Cosgrove, D Saunders, A Terblanche, S Bolton, C Snowden
Journal: BMJ (2005)

EDITOR—The reports of the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) focus on reducing surgical morbidity and mortality through minimising out of hours operating, limiting “after midnight” operating to absolute emergencies and increasing senior input into cases.1 Acceptable waiting times for such surgery also exist2—that is, emergencies (American Society of Anesthesiologists (ASA) score of 4-5) < 1 h, urgent (ASA score 1-3) < 24 h. Rota changes as a result of the European working time directive potentially influence efficiency in theatre.

Our institution provides a 24 hour emergency operating theatre for urgent or emergency surgery. Anaesthetic cover during daytimes, Monday to Friday, is by consultants. Out of hours and weekend cover is from a two tier trainee rota (compliant with the directive) with on-call support from consultants. Before March 2004 the trainees worked a non-resident 24 hour on-call rota.

To assess emergency theatre use we …
Intermittent treatment of duodenal ulcer with cimetidine.
Authors: K D Bardhan
Journal: BMJ (1980)

Intermittent treatment with short courses of cimetidine given only when symptoms recurred was assessed in patients with duodenal ulcer as an alternative to maintenance treatment. Their progress was followed up for up to 22 months. Gastroscopy was carried out in most attacks to confirm recurrence of the ulcer and subsequent healing. Out of 125 patients treated, 83 relapsed, of whom 21 defaulted. After retreatment 36 patients relapsed again. The pattern of relapse and remission for the group as a whole was similar after both courses of treatment, indicating an unchanged natural history. Nevertheless, wide variation occurred in individual patients, so that the pattern of relapse could not be predicted by the duration of the initial remission. Most patients had one or two or rarely three symptomatic relapses a year, which were rapidly treated successfully with cimetidine. Therefore, unless the necessity for long-term maintenance treatment is established, intermittent treatment provides an adequate alternative in most patients with duodenal ulcer.
Evaluation of Inner Retinal Layers in Patients with Multiple Sclerosis or Neuromyelitis Optica Using Optical Coherence Tomography
Authors: Danilo B. Fernandes, Ali S. Raza, Rafael G.F. Nogueira, Diane Wang, Dagoberto Callegaro, Donald C. Hood, Mario L.R. Monteiro
Journal: Ophthalmology (2012)
Drug-Induced Nephropathy
Authors: Stephen N. Cohen
Journal: JAMA (1974)

<h3>To the Editor.—</h3> We have only recently seen the letter published from our unit regarding "Nafcillin Nephritis" (225:178, 1973). Because of a regrettable lack of communication among ourselves, we never saw the final revised copy which, as published, is distinctly misleading in failing to make one of the most important points of the original letter—that nephropathy was exacerbated not only by nafcillin, but also by cephalothin administration. Anyone reading the article would presume that cephalothin could be safely administered to an individual who had experienced methicillin or nafcillin nephritis, whereas on the contrary, exactly the same objective findings of proteinuria, hematuria, and eosinophilia recurred on administration of cephalothin. We have seen such recurrence in another similar patient and, therefore, strongly believe that cephalosporins are contraindicated following nephropathy due to penicillin derivatives.
Cash Limits and the Rebels of Lambeth — Private Medicine for Trade Unionists — Postscript on a Plague of Greenfly
Authors: John Lister
Journal: New England Journal of Medicine (1979)

ALTHOUGH the National Health Service did not suffer any absolute financial cuts when the new Conservative government embarked on a firm policy of reducing public expenditure, Mr. Patrick Jenkin, the Secretary of State at the Department of Health and Social Security made it clear that there must be no overspending on existing budgets. Hospital authorities were therefore instructed that they would have to contain the cost of inflation and the cost of the recent increase in value-added tax by making economies elsewhere, although some adjustments were promised to take account of the salary increases resulting from recent pay awards.This . . .
Novel vitamin D3 analog, 21-(3-methyl-3-hydroxy-butyl)-19-nor D3, that modulates cell growth, differentiation, apoptosis, cell cycle, and induction of PTEN in leukemic cells
Authors: Jun-ichi Hisatake, James O'Kelly, Milan R. Uskokovic, Shigeru Tomoyasu, H. Phillip Koeffler
Journal: Blood (2001)
Mechanisms of insulin resistance in experimental hyperinsulinemic dogs.
Authors: P D Miles, S Li, M Hart, O Romeo, J Cheng, A Cohen, K Raafat, A R Moossa, J M Olefsky
Journal: Journal of Clinical Investigation (1998)

This study was undertaken to characterize the insulin resistance and the mechanism thereof caused by chronic hyperinsulinemia produced in dogs by surgically diverting the veins of the pancreas from the portal vein to the vena cava. Pancreatic venous diversion (PVD, n = 8) caused a sustained increase in arterial insulin and decrease in portal insulin concentration compared with the control group (n = 6). Hyperinsulinemic euglycemic clamps were conducted 4 wk after surgery. The increase in the glucose disposal rate (GDR) was significantly less in the PVD group (39.0+/-5.0 vs. 27.9+/-3.2 micromol/kg/min, P < 0.01) compared with the control group, but the suppression of hepatic glucose production by insulin was similar for both groups. Muscle insulin receptor tyrosine kinase activity (IR-TKA) increased from 6.2+/-0.4 to 20.3+/-2.7 in the control group, but from 5.8+/-0.5 to only 12.7+/-1.7 fmol P/fmol IR in the PVD group (P < 0.01). With respect to the periphery, the time to half-maximum response (t1/2a) for arterial insulin was the same for both groups, whereas the t1/2a for lymph insulin (30+/-3 vs. 40+/-4 min, P < 0.05) and GDR (29+/-3 vs. 66+/-10 min, P < 0.01) were greater for the PVD group. Chronic hyperinsulinemia led to marked peripheral insulin resistance characterized by decreased insulin-stimulated GDR, and impaired activation of GDR kinetics due, in part, to reduced IR-TKA. Transendothelial insulin transport was impeded and was responsible for one third of the kinetic defect in insulin-resistant animals, while slower intracellular mechanisms of GDR were responsible for the remaining two thirds.