tbuckley/cabot-search huggingface dataset:
Fatal Systemic Anaphylaxis in Man
Authors: Lewis P. James, K. Frank Austen
Journal: New England Journal of Medicine (1964)

THE use of diphtheria antitoxin near the turn of the century ushered in a period of serum therapy that accounted for many reports of fatal systemic anaphylaxis in man. Some of these cases were tabulated in 1924 by Lamson1 and in 1930 by Sheppe,2 who noted that autopsy data were obtained in only 15 cases and were not always adequately detailed. With the development of vaccines and normal or immune gamma globulin serum therapy has become less frequent, and penicillin administration is currently the major iatrogenic cause of systemic anaphylaxis.3 , 4 Skin testing,5 insect bites6 and intravenous urography7 less frequently result . . .
Dietary Exposure to 2,2′,4,4′-Tetrabromodiphenyl Ether (PBDE-47) Alters Thyroid Status and Thyroid Hormone–Regulated Gene Transcription in the Pituitary and Brain
Authors: Sean C. Lema, Jon T. Dickey, Irvin R. Schultz, Penny Swanson
Journal: Environmental Health Perspectives (2008)

Polybrominated diphenyl ether (PBDE) flame retardants have been implicated as disruptors of the hypothalamic-pituitary-thyroid axis. Animals exposed to PBDEs may show reduced plasma thyroid hormone (TH), but it is not known whether PBDEs impact TH-regulated pathways in target tissues.We examined the effects of dietary exposure to 2,2',4,4'-tetrabromodiphenyl ether (PBDE-47)-commonly the highest concentrated PBDE in human tissues-on plasma TH levels and on gene transcripts for glycoprotein hormone alpha-subunit (GPHalpha) and thyrotropin beta-subunit (TSHbeta) in the pituitary gland, the auto-induced TH receptors alpha and beta in the brain and liver, and the TH-responsive transcription factor basic transcription element-binding protein (BTEB) in the brain.Breeding pairs of adult fathead minnows (Pimephales promelas) were given dietary PBDE-47 at two doses (2.4 microg/pair/day or 12.3 microg/pair/day) for 21 days.Minnows exposed to PBDE-47 had depressed plasma thyroxine (T(4)), but not 3,5,3'-triiodothyronine (T(3)). This decline in T(4) was accompanied by elevated mRNA levels for TStHbeta (low dose only) in the pituitary. PBDE-47 intake elevated transcript for TH receptor alpha in the brain of females and decreased mRNA for TH receptor beta in the brain of both sexes, without altering these transcripts in the liver. In males, PBDE-47 exposure also reduced brain transcripts for BTEB.Our results indicate that dietary exposure to PBDE-47 alters TH signaling at multiple levels of the hypothalamic-pituitary-thyroid axis and provide evidence that TH-responsive pathways in the brain may be particularly sensitive to disruption by PBDE flame retardants.
John Hilary Ebbetts
Authors: Christine Barlow
Journal: BMJ (2006)

​FormerFormer chiropractor London and Brighton (b 1914; q London 1942; OBE), d 9 May 2005.




Figure 1




After qualifying from Westminster Medical School, London, John Hilary Ebbetts worked as a medical officer in India and Africa during the second world war, and then provided psychiatric counselling to London fire fighters. His mother introduced John to chiropractic. Under her tutelage he began working from her Chelsea practice before establishing his own in Wimpole Street and in Brighton. John's practice was rooted in medical diagnosis. In 1966 he co-founded the British Association of Manipulative Medicine (BAMM). John served as secretary and then president. John became president of the Natural Therapeutic and Osteopathic Society (NTOS) in 1983. He became a link between alternative therapies and the medical profession. He leaves a wife, Ruth.
Tissue and Serum Angiogenic Activity Is Associated With Low Prevalence of Ischemic Complications in Patients With Giant-Cell Arteritis
Authors: Maria C. Cid, José Hernández-Rodríguez, María-José Esteban, Mireia Cebrián, Yong Song Gho, Carme Font, Alvaro Urbano-Márquez, Josep M. Grau, Hynda K. Kleinman
Journal: Circulation (2002)

Vascular inflammatory lesions from patients with giant-cell arteritis show a remarkable amount of neovascularization, but its clinical implications have never been investigated.To assess the clinical relevance of neovascularization in giant-cell arteritis, angiogenesis was measured in temporal artery sections from 31 patients with biopsy-proven giant-cell arteritis by staining endothelial cells with Ulex europaeus lectin. Angiogenesis was highly variable among these patients. Patients without ischemic complications had higher tissue angiogenesis scores than patients with ischemic events (5.69+/-0.6 versus 2.91+/-0.6, P=0.003). Angiogenesis was also more prominent in patients with a strong acute phase response (score: 5.31+/-0.6) compared with those with a weak systemic inflammatory reaction (2.30+/-0.44; P=0.0007). Serum angiogenic activity was studied in an additional series of 38 biopsy-proven patients. Sera from patients without ischemic events tended to be more active in stimulating human umbilical vein endothelial cell growth (optical density x1000, 270+/-15 versus 192+/-14, P=0.065) and differentiation into capillary-like structures (107+/-5 versus 84+/-8 relative units, P=0.0058) than patients with ischemic complications. Sera from patients without ischemic events had more in vivo full angiogenic activity tested in the chick chorioallantoic membrane than sera from patients with ischemic complications.Inflammation-induced angiogenic activity may play a compensatory role for ischemia in patients with giant-cell arteritis.
Percentage of Cancer on Biopsy Cores Accurately Predicts Extracapsular Extension and Biochemical Relapse after Radical Prostatectomy for T1&amp;ndash;T2 Prostate Cancer
Authors: Vincent Ravery, Claude Chastang, Marianne Toublanc, Liliane Boccon-Gibod, Vincent Delmas, Laurent Boccon-Gibod
Journal: European Urology (2000)
Prospective associations of fasting insulin, body fat distribution, and diabetes with risk of ischemic stroke. The Atherosclerosis Risk in Communities (ARIC) Study Investigators.
Authors: A R Folsom, M L Rasmussen, L E Chambless, G Howard, L S Cooper, M I Schmidt, G Heiss
Journal: Diabetes Care (1999)

OBJECTIVE: We tested the hypothesis that diabetes, body fat distribution, and (in nondiabetic subjects) fasting insulin levels are positively associated with ischemic stroke incidence in the general population. RESEARCH DESIGN AND METHODS: As part of the Atherosclerosis Risk in Communities (ARIC) Study, we measured diabetes by using fasting glucose criteria, waist and hip circumferences, and fasting insulin levels with a radioimmunoassay in &amp;gt; 12,000 adults aged 45-64 years who had no cardiovascular disease at baseline. We followed them for 6-8 years for ischemic stroke occurrence (n = 191). RESULTS: After adjustment for age, sex, race, ARIC community, smoking, and education level, the relative risk of ischemic stroke was 3.70 (95% CI 2.7-5.1) for diabetes, 1.74 (1.4-2.2) for a 0.11 increment of waist-to-hip ratio, and 1.19 (1.1-1.3) for a 50-pmol/l increment of fasting insulin among nondiabetic subjects. Ischemic stroke incidence was not statistically significantly associated with BMI (comparably adjusted relative risk = 1.15, 95% CI 0.97-1.36). With adjustment for other stroke risk factors (some of which may mediate the effects of diabetes, fat distribution, and hyperinsulinemia), the relative risks for diabetes, waist-to-hip ratio, and fasting insulin level were 2.22 (95% CI 1.5-3.2), 1.08 (0.8-1.4), and 1.14 (1.01-1.3), respectively. CONCLUSIONS: Diabetes is a strong risk factor for ischemic stroke. Aspects of insulin resistance, as reflected by elevated waist-to-hip ratios and elevated fasting insulin levels, may also contribute to a greater risk of ischemic stroke.
Increased Sensitivity and Confidence of SPECT Over Planar Imaging in Dual-Phase Sestamibi for Parathyroid Adenoma Detection
Authors: Andrew Slater, Fergus V. Gleeson
Journal: Clinical Nuclear Medicine (2004)

PURPOSE OF REPORT: To determine the usefulness of SPECT imaging over planar imaging for the detection of parathyroid adenomas using dual-phase Tc-99m sestamibi.The records of patients referred for dual-phase sestamibi scintigraphy for detection of parathyroid adenomas were reviewed retrospectively. The images were reviewed blindly and planar images were compared with SPECT. The imaging results were compared with the operative results to determine the sensitivity, accuracy of localization, and confidence of the reporting radiologist.The records of 37 patients were reviewed. Sensitivity was 62% for planar imaging and 73% for SPECT. There was one false positive. The side of the adenoma was correctly identified in all other patients. Confidence of detection was higher for SPECT than for planar imaging.SPECT imaging increased the sensitivity and confidence of the detection of parathyroid adenomas. The results indicate that SPECT should be used for all preoperative parathyroid localization.
P621 INTEGREN β1 REGULATES HEPATIC STELLATE CELL ACTIVATION VIA THE ACTIN MYOSIN CYTOSKELETON
Authors: K. Martin, J. Pritchett, E. Harvey, V. Athwal, J. Llewellyn, C. Streuli, L. Zeef, N. Hanley, K. Piper Hanley
Journal: Journal of Hepatology (2014)
Dendritic cells present neuromuscular blocking agent‐related epitopes to T cells from allergic patients
Authors: N. Aubert, P. M. Mertes, M. Janaszak, D. A. Moneret‐Vautrin, M. C. Laxenaire, G. Kanny, F. Lavaud, J. Bernard
Journal: Allergy (2004)

Anaphylactic reactions to neuromuscular blocking agents (NMBA) remain a major life-threatening and unpredictable complication during anaesthesia (1). Dendritic cells (DC) are considered to be the most powerful antigen-presenting cells (2). They can skew CD4+ T-cell differentiation towards a Th2 cytokine secretion pattern, which induces humoral responses dominated by an enhanced IgE production such as in allergic diseases. We undertook a case–control study to assess whether DC from patients having presented an anaphylactic reaction to an NMBA during anaesthesia were able to present the incriminated drug and to stimulate T cells. Ten patients sensitized to an NMBA and eight control subjects were involved in the study (Table 1). Monocytes and T lymphocytes were purified from fresh heparinized blood. Monocyte-derived DC (3) were generated in a 5-day culture with GM-CSF and IL-4, then matured for 2 additional days with TNF-α and PGE2 in the presence or absence of NMBA. Both NMBA-pulsed and control DC were co-cultured (ratio 1 : 10) with T lymphocytes from the same donor. After 5 days, proliferative responses were quantified by the mean [3H]-thymidine incorporation. Stimulation indices (SI) were calculated as ‘cpm in coculture with NMBA-pulsed DC/cpm in coculture with unpulsed DC’ and were considered as positive when SI > 2. In addition, lymphocyte transformation tests (LTT) were performed in the presence of the incriminated NMBA for each patient and in the presence of succinylcholine for healthy donors. No proliferative response was observed using LTT either in patients or in healthy donors. In contrast, NMBA-pulsed DC induced a significant proliferative response of T cells in two patients sensitized to succinylcholine and in one patient sensitized to atracurium. These specific responses demonstrate for the first time the capacity of DC to present NMBA-related epitopes that are recognized by T cells. Several mechanisms could explain how DC might process and present the incriminated NMBA (4). The drug might undergo covalent binding to soluble proteins processed by DC and consequently modified peptide might be expressed in association with MHC molecules. Another possibility is a covalent or noncovalent interaction of NMBA with the MHC–peptide complex directly at the surface of the DC. Nevertheless, experimental conditions for optimal NMBA presentation by DC remain to be defined, and this could be of particular importance for the development of DC-based assays for the characterization of NMBA-specific T-cell clones and for the in vitro diagnosis of an allergy to these drugs. This work was supported in part by a grant from the Société française d'Anesthésie et de Réanimation, France.
AN IMPROVED OPERATING PROCTOSCOPE
Authors: Rudolph V. Gorsch
Journal: JAMA (1927)

Several improvements have been made in a Yeomans' proctoscope to facilitate operative proctoscopic instrumentation and particularly to simplify and broaden the scope of surgical endothermy, when these are indicated, in the treatment of such conditions as rectocolonic neoplasms, ulcerations and strictures.  The improved proctoscope has been enlarged to a 1½-inch inside diameter, and is 8 inches in length. Anesthesia is obviously necessary in using a proctoscope of these dimensions.  Along the lower wall of the proctoscope a one-fourth inch tube has been introduced extending to within three-eighths inch of its distal end, and projecting one-half inch beyond the proximal end (fig. 1, A-B ). This tube is particularly designed for suction removal of smoke produced during surgical endothermy and cauterization. A tonsil suction apparatus serves this purpose admirably. This tube can be used also for inflation if desired. Its proximal end is corrugated for the reception of a rubber tube.
Dual targeting of the PI3K/Akt/mTOR pathway as an antitumor strategy in Waldenstrom macroglobulinemia
Authors: Aldo M. Roccaro, Antonio Sacco, Emanuel N. Husu, Costas Pitsillides, Steven Vesole, Abdel Kareem Azab, Feda Azab, Molly Melhem, Hai T. Ngo, Phong Quang, Patricia Maiso, Judith Runnels, Mei-Chih Liang, Kwok-Kin Wong, Charles Lin, Irene M. Ghobrial
Journal: Blood (2009)
A Pre-Copernican Tale
Authors: Benjamin Glaser
Journal: JAMA (1971)

To the Editor.—  The inception of bread-buttering recalls an old and ancient story that may be unknown to the authors of the delightful paper on Copernicus ( 214 :2312, 1970). The tale is assigned to an era when people lived in small villages. Neighbors' mutual interests encompassed all events of whatever magnitude as they occurred in their closely knit community. History recalls that two small boys were outdoors. One of these was eating a slice of bread buttered on one side. Now, it was this piece of bread that fell to the ground buttered-side up! It was universally known even in that day that a slice of bread buttered on one side would always fall buttered-side down. This is liberally attested to in the paper on Copernicus.  Whether this was pre-Copernican knowledge or whether a traveler had mentioned this to Glickselig, who in turn told it to Copernicus, is a matter
The Hospitalist Movement
Authors: Lee Goldman
Journal: Annals of Internal Medicine (1999)

Letters5 October 1999The Hospitalist MovementLee Goldman, MDLee Goldman, MDUniversity of California, San Francisco; San Francisco, CA 94143 (Goldman)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-7-199910050-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:As noted by Flansbaum and colleagues, we still have much to learn about hospital medicine as an academic career, especially with regards to teaching and burnout. The University of California, San Francisco, academic hospitalist model emphasizes the concurrent roles of both teaching-attending and physician-of-record for essentially all patients on a ward team (1). Given this key role in education as well as clinical care, burnout would have an academic impact extending well beyond the job satisfaction of the individual hospitalist. Because of these high stakes for our entire program, we believe that 6 months of acute care inpatient ...Reference1. Wachter RM, Goldman L. Implications of the hospitalist movement for academic departments of medicine: lessons from the UCSF experience. Am J Med. 1999;106:127-33. MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of California, San Francisco; San Francisco, CA 94143 (Goldman) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoForeword Robert M. Wachter The Impact of Hospitalists on Medical Education and the Academic Health System Lee Goldman Metrics Cited bySocial Science Insights Into Improving Workforce EffectivenessPreparing for “diastole”: Advanced training opportunities for academic hospitalists 5 October 1999Volume 131, Issue 7Page: 545KeywordsAcademic medicineCardiomyopathiesCatecholaminesDiastoleHospital medicineHospitalistsInpatientsSystoleTachycardia Issue Published: 5 October 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Scots first with drug advice team
Authors: S. Ross
Journal: BMJ (1995)

coagulant treatment may have differed in some (perhaps complex) way.The protective effect of hospital 6 did not relate to any single factor.While thromboembolic prophylaxis is no panacea, our results suggest that it is associated with reduced deaths from pulmonary embolism.Complacent reliance on anticoagulant treatment-or, for that matter, any drug or procedure-should be avoided.Hospital 6, which among other things routinely used pharmacological anticoagulant prophylaxis (although 14% of this hospital's patients did not receive it), had a much lower 90 day mortality.No single variable (including prophylaxis) explained this, and our audit generated rather than tested hypotheses.We trust that hypotheses generated by the correspondents will be put to the test so that mortality can be reduced and patients' care improved.Clearly, something can be learnt from the package of care at hospital 6. Readers should focus on why differences in mortality occurred among centres and not be distracted by the issue of thromboembolic prophylaxis, a disputed subject that our study was not designed to address.We agree that more detailed and larger scale studies of both prophylaxis and outcome after hip fracture are needed.
Abnormalities of the Peripheral Circulation in Congestive Heart Failure.
Authors: Robert Zelis
Journal: Annals of Internal Medicine (1969)

s1 May 1969Abnormalities of the Peripheral Circulation in Congestive Heart Failure.Robert Zelis, M.D., James F. Spann Jr., M.D., Dean T. Mason, M.D., F.A.C.P.Robert Zelis, M.D.Search for more papers by this author, James F. Spann Jr., M.D.Search for more papers by this author, Dean T. Mason, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-70-5-1082_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSince cardiac output is reduced at rest and fails to rise normally during stress in patients with congestive heart failure, certain adjustments are necessary in the peripheral circulation to maintain circulatory function and redistribute blood flow. Studies in our laboratories have shown that profound sympathetic-mediated systemic, arteriolar, and venous constriction attends congestive heart failure and that the quantity of endogenous norepinephrine available for release by tyramine from sympathetic nerve endings in calf arterioles is elevated. Utilizing plethysmographic techniques and epinephrine iontophoresis, we have shown that early during the course of supine leg exercise patients with congestive heart failure demonstrate an... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Robert Zelis, M.D.; James F. SpannJr., M.D.; Dean T. Mason, M.D., F.A.C.P.Affiliations: Davis, California PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1969Volume 70, Issue 5Page: 1082-1082KeywordsArteriolesBlood flowCardiac outputEpinephrineExerciseHeart failureLongitudinal studiesNerve endingsNorepinephrine ePublished: 1 December 2008 Issue Published: 1 May 1969 PDF downloadLoading ...
THE SALT AND WATER METABOLISM OF ADRENAL INSUFFICIENCY AND PARTIAL STARVATION IN RATS 1
Authors: Mitchell I. Rubin, Elizabeth T. Krick
Journal: Journal of Clinical Investigation (1936)

All recent studies on the salt balance in adrenal insufficiency, both in the experimental animal and in Addison's disease, have shown that during this state sodium and chlorine are lost from the body (1,2,3,4,5).Regarding the potassium balance a difference of opinion has been expressed.Some observers have stressed a retention of potassium (3 ,4), while our studies (5) demonstrated a loss of this salt.A possible explanation of this discrepancy may be found in the fact that the potassium balance is dependent to a great extent upon the food and water consumption during adrenal insufficiency, and that our rats show signs of anorexia earlier than is seen in the larger animals used by other workers.The present study was undertaken to demonstrate the effect of changes in the food consumption on the electro- lytes and nitrogen balances of adrenalectomized rats.Anorexia is an early symptom of insufficiency in the adrenalectomized rat.On the first day that sodium was added to the diet of the animals in adrenal insufficiency, the food intake returned to its original level, making it impossible to de- termine how much of the improvement in the salt balance was due to the added sodium and how much was due to the increased food consumption.For this reason it was found necessary, in an effort to evaluate the dietary factor, to conduct on normal nonadrenalectomized rats an experi- ment to show the influence on the salt and nitrogen balances of similar degrees of food restriction. PROCEDURESThe animals used in these experiments were young white rats of the Wistar strain with an average weight of approximately 75 to 150 grams at the onset of the study.Bilateral adrenalectomy was done in one stage.The op- erations were performed under light ether anesthesia, the 1 Aided by a grant from the Faculty Research Committee of the University of Pennsylvania.complete procedure taking only a few minutes.The ani- mals evidenced no immediate ill effects from the opera- tion and were active after a few moments.The diet employed throughout was Colony Breeder's Diet with the following composition:Whole ground wheat ...........