tbuckley/cabot-search huggingface dataset:
Supervised fixing rooms, supervised injectable maintenance clinics--understanding the difference
Authors: J. Strang
Journal: BMJ (2004)

Harm reduction policies and practices (where anything goes, if it actually reduces harm) have fundamentally altered our approach to the drugs problem. Two innovations were recently considered by the Home Affairs Select Committee—supervised injecting centres and supervised injectable maintenance clinics—but with unhelpful confusion between the two.1 They have different target populations, potential benefits, and legal obstacles.

Supervised injecting centres (also known as supervised drug consumption rooms or fixing rooms) are essentially public access facilities, perhaps the injecting drug user's equivalent of a pub or bar, where the injection of unknown drugs by unknown persons should be safer by virtue of supervision and consequent speed of response in the event of overdose.2 The target population is all injecting drug misusers—regardless of whether or not they are dependent or wish to change their drug taking habits. Perhaps providing this safer haven may lead some to seek …
FOREIGN BODIES IN THE VERMIFORM APPENDIX
Authors: S. Boyd
Journal: BMJ (1912)

2 TDICAM BJloURNL i PYELONEPHJITIS COMPLICATING PREGNANCY.rAPRIL t3, 1912.part, muclh the same as is seen in an early hydronephrosis dlue to some obstruction to the outflow of the urine from the renal pelvis.The exciting cause of the pyoneplirosis and the period at which the infection occulrred are factors, hiowever, which are miiost difficult, if naot impossible, to determiinie.
Coronary dissection and total coronary occlusion associated with percutaneous transluminal coronary angioplasty: significance of initial angiographic morphology of coronary stenoses.
Authors: T Ischinger, A R Gruentzig, B Meier, K Galan
Journal: Circulation (1986)

Coronary dissection and total coronary occlusion leading to emergency coronary surgery are the most frequent complications of percutaneous transluminal coronary angioplasty (PTCA) and their occurrence usually is unpredictable. To identify angiographic characteristics of coronary stenoses that may affect the incidence of these complications, the diagnostic pre-PTCA coronary angiograms of 38 consecutive patients (group I) undergoing emergency coronary surgery for dissection or occlusion were reviewed and compared with the angiograms of a random sample of 38 patients (stratified for left anterior descending and right coronary arteries) from a group of 1151 who did not need emergency coronary surgery (group II). Stenosis morphology before angioplasty was considered "complicated" if at least one of the following criteria was present: irregular borders, intraluminal lucency, and localization of stenosis in curve or at bifurcation. Baseline characteristics, maximum inflation pressures, types of balloon catheters used, and routinely registered angiographic stenosis properties (severity, length, eccentricity, and calcification) were similar in both groups. Irregular borders before PTCA were present in 22 of 38 patients in group I vs 10 of 38 in group II (p less than .05), intraluminal lucency in 22 of 38 vs nine of 38 (p less than .05), localization in curve in 27 of 38 pts vs 16 of 38 (p less than .05), and localization at bifurcation in 11 of 38 vs 15 of 38 (NS). Complicated angiographic morphology of coronary stenosis may represent a risk factor for dissection or occlusion. Therefore, although the predictive value of these findings is low, detailed evaluation of angiographic morphology of coronary stenoses may improve patient selection and reduce complication rates of PTCA.
Endoscopy in Bleeding Duodenal Varices: A Rare Cause of Massive Upper G-I-Hemorrhage
Authors: H. Kunert, R. Ottenjann
Journal: Endoscopy (1976)

Endoscopic evidence of bleeding duodenal varices in a patient with portal hypertension and severe upper G-I-hemorrhage is given. Review of our own endoscopic experience and literature suggests that these varices occur more frequently than generally realized. Their diagnosis tends to be overlooked. Possible therapy is discussed.
Unusual case of subacute combined degeneration of spinal cord.
Authors: C. J. Riley
Journal: BMJ (1966)

Subacute combined degeneration of the cord classically occurs in association with Addison's pernicious anaemia.Over the years improved haematological and biochemical techniques have shown that it can occur in vitamin-B.2-deficiencystates other than pernicious anaemia: these include cases following gastrectomy, in which most of the intrinsic-factor-producing area may be removed, and in other cases of " malabsorption syndrome."
Hyposensitization in asthmatics with mPEG modified and unmodified house dust mite extract.
Authors: H. MOSBECH, S. DREBORG, L. FRØLUND, I. LJUNGSTEDT‐PÅHLMAN, U. G. SVENDSEN, M. SØBORG, E. TAUDORF, B. WEEKE
Journal: Allergy (1989)

In a 2‐year study, 46 asthmatics with verified allergy to the house dust mite D. pteronyssinus (Dp) were included either as controls (Ctls) or receiving hyposensitization (HS) with unmodified or monomethoxypolyethylene glycol (mPEG) modified Dp‐extract. Patients were monitored by annual challenges with histamine in bronchi, and Dp allergen in bronchi, nose and conjunctiva. mPEG‐modified extract was not inferior to unmodified Dp‐extract; both were to some extent able to improve tolerance to Dp and histamine in bronchi and to Dp in nose and eyes. During the 1st year, the bronchial sensitivity to Dp decreased significantly in the HS groups but not in the Ctls. During the 2nd year, improvement was more pronounced in the Ctl group. The relative increase in Dp or histamine tolerance did not differ significantly between groups after either 1 or 2 years; the only exception was conjunctival sensitivity, which in the Ctl group was unchanged, and a 10‐fold increase in tolerance in the HS groups. No direct benefit was seen on late‐phase bronchial reactions. In patients with improved pulmonary symptoms a tendency was seen towards reduced sensitivity to histamine and Dp. Variation within groups was extensive.
Lymphatic transport of high-density lipoproteins and chylomicrons
Authors: Gwendalyn J. Randolph, Norman E. Miller
Journal: Journal of Clinical Investigation (2014)

The life cycles of VLDLs and most LDLs occur within plasma. By contrast, the role of HDLs in cholesterol transport from cells requires that they readily gain access to and function within interstitial fluid. Studies of lymph derived from skin, connective tissue, and adipose tissue have demonstrated that particles as large as HDLs require transport through lymphatics to return to the bloodstream during reverse cholesterol transport. Targeting HDL for therapeutic purposes will require understanding its biology in the extravascular compartment, within the interstitium and lymph, in health and disease, and we herein review the processes that mediate the transport of HDLs and chylomicrons through the lymphatic vasculature.
Acute gastrointestinal bleeding due to oesophageal varices: an unusual case of a thoracic spleen
Authors: Gerrit C. Hagenah, Jens-Gerd Scharf, Alexander Emmert, B. Michael Ghadimi, Friedrich A. Schöndube, Bernhard C. Danner
Journal: Intensive Care Medicine (2009)

Upper gastrointestinal bleeding is often seen in patients admitted to intensive care units. Ulcers are the most common cause of these haemorrhages, but other factors such as oesopageal varices or malignancy may also be sources [1]. We report a 36-year-old male patient (BMI  30 kg/m) admitted to hospital because of a first session of haematemesis and recurrent dyspnoea only days before. Patient’s history revealed only 15 years of nicotine abuse and an undefined infection episode 17 years ago. On admission, clinical examination, vital parameters, chest X-ray and ECG findings were unremarkable. Initial laboratory tests revealed no pathologic coagulation tests, but impaired hemoglobin levels (12.3 g/dl). An oesophagoscopy was performed and revealed varices grade 3 [2]. Nine consecutive ligatures were placed. Furthermore, since there was no history or ultrasonic findings of liver disease, a thoracic CT scan was performed, revealing a large retrocardial mass (12 9 12 9 6 cm, Fig. 1) between the main bronchi displacing the oesophagus. An endosonography excluded an infiltration of the oesophagus, and a pathological specimen taken by video-assisted thoracoscopy showed a vascularised tumor without malignancy. Meanwhile, an emergency oesophagoscopy was indicated due to another session of haematemesis with need for mass transfusion. In the following days, an anterolateral rightsided thoracotomy with tumor resection followed. The arterial delivery was provided by a number of bronchial arteries of both main bronchi. The cause of the paraoesophageal plexus varices was more likely the tumorous venous drainage than the compression by the tumour itself (Fig. 2). Histological examination and further immunohistochemical differentiation of the resected mass revealed an ectopic accessory spleen confirmed by a second, independent pathologist. A deep venous thrombosis occurred preoperatively promoted by lack of anticoagulation despite immobilization. Because postoperatively the thrombosis reached the pelvic vessels, a venous thrombectomy was also performed. The postoperative oesophagoscopy showed varices decreased to grade 2, and anticoagulation with coumadin was started.
Tissue content of dihydrotestosterone in human prostatic hyperplasis is not supranormal.
Authors: P C Walsh, G M Hutchins, L L Ewing
Journal: Journal of Clinical Investigation (1983)

The dihydrotestosterone content of normal peripheral and benign hyperplastic prostates was measured in tissue obtained at open surgical procedures on 29 men of ages 36 to 82 yr. The dihydrotestosterone content in normal prostates (mean +/- SE, 5.1 +/- 0.4 ng/g tissue) and in benign hyperplastic prostates (5.0 +/- 0.4) was similar. In 11 patients in whom both normal and hyperplastic prostatic tissue was harvested simultaneously at the same operation, there was no significant difference in the content of dihydrotestosterone in the two types of tissue. These findings fail to confirm the widespread belief that dihydrotestosterone content is elevated in benign hyperplastic prostates. Our data differ from the reported literature in one major respect: the dihydrotestosterone content of normal peripheral prostate in this study is three to four times higher than previously reported. This difference between the present and earlier studies was resolved by experiments performed on cadavers, which were the source of normal prostatic tissue used by other investigators. Dihydrotestosterone content was measured in seven cadavers ranging in age from 19 to 82 yr of age. The results of this experiment indicate that the dihydrotestosterone content of prostatic tissue removed at autopsy is factitiously low (0.7-1.0 ng/g tissue). This finding was confirmed by in vitro incubations of fresh prostatic tissue at 37 degrees C that demonstrated reduction of dihydrotestosterone content to low levels within 2 h. When taken together, these results indicate that when prostatic tissue is harvested appropriately, the dihydrotestosterone content of normal peripheral and hyperplastic tissues is the same. This finding should influence future research into the etiology of benign prostatic hyperplasia.
Role of CD4 in thymocyte selection and maturation.
Authors: J C Zuñiga-Pflücker, S A McCarthy, M Weston, D L Longo, A Singer, A M Kruisbeek
Journal: The Journal of Experimental Medicine (1989)

We examined the possible role of CD4 molecules during in vivo and in vitro fetal thymic development. Our results show that fetal thymi treated with intact anti-CD4 mAbs fail to generate CD4 single-positive T cells, while the generation of the other phenotypes remains unchanged. Most importantly, the use of F(ab')2 and Fab anti-CD4 mAb gave identical results, i.e., failure to generate CD4+/CD8- T cells, with no effect on the generation of CD4+/CD8+ T cells. Since F(ab')2 and Fab anti-CD4 fail to deplete CD4+/CD8- in adult mice, these results strongly argue that the absence of CD4+/CD8- T cells is not due to depletion, but rather, is caused by a lack of positive selection, attributable to an obstructed CD4-MHC class II interaction. Furthermore, we also observed an increase in TCR/CD3 expression after anti-CD4 (divalent or monovalent) mAb treatment. The TCR/CD3 upregulation occurs in the double-positive population, and may result from CD4 signaling after mAb engagement, or may be a consequence of the blocked CD4-class II interactions. One proposed model argues that the CD3 upregulation occurs in an effort to compensate for the reduction in avidity or signaling that is normally provided by the interaction of the CD4 accessory molecule and its ligand. As a whole, our findings advocate that CD4 molecules play a decisive role in the differentiation of thymocytes.
Induction of Glutathione Synthesis in Macrophages by Oxidized Low-Density Lipoproteins Is Mediated by Consensus Antioxidant Response Elements
Authors: Florian Bea, Francesca N. Hudson, Alan Chait, Terrance J. Kavanagh, Michael E. Rosenfeld
Journal: Circulation Research (2003)

The uptake of oxidized low-density lipoproteins (oxLDL) by macrophages leading to conversion into foam cells is a seminal event in atherogenesis. Excessive accumulation of oxLDL can cause oxidative stress in foam cells leading to cell death and the progression and destabilization of atherosclerotic lesions. Oxidative stress induces a protective compensatory increase in the synthesis of the endogenous antioxidant glutathione (GSH). Glutamate-cysteine ligase (GCL) is the rate-limiting enzyme in GSH synthesis and is composed of a catalytic subunit (GCLC) and a modifier subunit (GCLM), which are products of separate genes. Treatment of RAW 264.7 mouse macrophages and mouse peritoneal macrophages with oxLDL (30 μg/mL) induces increased expression of both Gclc and Gclm in vitro. The increase in mRNA occurs in part via increased transcription as demonstrated with luciferase reporter constructs. The promoters for both GCLC and GCLM contain consensus antioxidant response elements (AREs). Electrophoretic mobility shift assays revealed induction of nuclear factor binding to these AREs after treatment of RAW 264.7 cells and mouse peritoneal macrophages with oxLDL. Nuclear factor binding to the AREs is diminished by a single base pair substitution in the core sequence. Site-directed mutagenesis of the AREs within the Gclc and Gclm promoters resulted in a decrease of oxLDL-induced luciferase activity. Supershift analyses revealed that oxLDL stimulates binding of the transcription factors Nrf1, Nrf2, and c-jun to the AREs. These data suggest that AREs play a direct role in mediating the induction of GSH synthesis by oxLDL and in protecting macrophages against oxidized lipid-induced oxidative stress.
A Psychiatric Contribution to Alleviating Hard-Core Unemployment
Authors: JOHN S. VISHER, M. ROBERT HARRIS
Journal: American Journal of Psychiatry (1968)

The authors report on a program of mental health consultation to personnel at eight youth and adult opportunity centers offering job placement and other vocational services to clients in poverty areas of San Francisco. In addition to its benefit for the consultees, the program has been a useful field experience for trainee mental health consultants. Trainees are given an opportunity to observe one method of assistance for a population of individuals who often have severe emotional problems but are not ordinarily seen in traditional mental health settings.
Prognostic features of large cell anaplastic carcinoma of the bronchus.
Authors: D M Mitchell, P G Morgan, J B Ball
Journal: Thorax (1980)

The clinical features of 208 patients with large cell anaplastic carcinoma of the bronchus are reviewed. Of the sample 47.6% had disseminated disease at presentation, and 95% were cigarette smokers. The median survival was 6.0 months and five-year survival was 5.9%. Twenty-seven per cent of the patients had surgical resection of tumour. The median survival of resected patients was 13.0 months and five-year-survival was 21%. Radiotherapy was ineffective in controlling the disease in this series.
Risk stratification using a combination of cardiac troponin T and brain natriuretic peptide after optimized treatment in patients with advanced heart failure
Authors: Junnichi Ishil, Masanori Nomura, Yuu Nakamura, Hiroyuki Naruse, Yoshihisa Mori, Toshikazu Ando, Hiroshi Kurokawa, Takeshi Kondo, Hitoshi Hishida
Journal: Journal of the American College of Cardiology (2002)
Sulphapyridine Anuria successfully Treated by Ureteric Catheterization
Authors: J. P. Cunniffe
Journal: BMJ (1943)

MEDICAL MEMORANDA MEDBRAILTOSL 1Lcortical atrophy on encephalography would certainly favour a vascular lesion and exclude encephalitis.To speculate on the occurrence of air embolism in other cases of whooping-cough complicated by convulsions, pareses, amaurosis, etc., both in those which recover and in those which are permanent, does not seem to us to be far-fetched.Small emboli may produce ischaemic effects which result in transient symptoms, and are comparable to the transient effects seen in the milder cases of caisson disease or in the pilots of rapidly climbing aircraft (Armstrong, 1939).Larger and more numerous emboli may produce permanent lesions by means of the focal infarctions which result, as in the more serious effects of caisson disease.We would suggest that the diagnosis of air embolism be more frequently entertained in cases of neuro- logical complications of whooping-cough, particularly those which follow severe spasms of coughing and are likely to be associated with a ruptured alveolus; furthermore, that the diagnosis of encephalitis be reserved for cases in which the spinal fluid shows some evidence of inflammatory change or the cerebral histopathology is undoubtedly encephalitic. SummaryA case of whooping-cough complicated by hemiplegia is presented.An interesting feature of the case was the occurrence of severe subcutaneous emphysema some days before the onset of the hemiplegia.The two phenomena are correlated, and the hemiplegia is con- sidered to be possibly due to air embolism.A brief summary of the literature is given.We should like to express our thanks to Dr. Norman Begg, medical superintendent of the Eastern Hospital, for his encourage- ment and critical help with this case; to Dr. T. V. L.
Aqueous Levels of Fluocinolone Acetonide after Administration of Fluocinolone Acetonide Inserts or Fluocinolone Acetonide Implants
Authors: Peter A. Campochiaro, Quan Dong Nguyen, Gulnar Hafiz, Steven Bloom, David M. Brown, Miguel Busquets, Thomas Ciulla, Leonard Feiner, Nelson Sabates, Kathleen Billman, Barry Kapik, Ken Green, Frances E. Kane
Journal: Ophthalmology (2012)
Informed Consent and Standard of Care: What Must Be Disclosed
Authors: Ruth Macklin, Lois Shepherd
Journal: The American Journal of Bioethics (2013)

The Office for Human Research Protections (OHRP) was correct in determining that the consent forms for the National Institutes of Health (NIH)-sponsored SUPPORT study were seriously flawed. Several articles defended the consent forms and criticized the OHRP's actions. Disagreement focuses on three central issues: (1) how risks and benefits should be described in informed consent documents; (2) the meaning and application of the concept of “standard of care” in the context of research; and (3) the proper role of OHRP. Examination of the consent forms reveals that they failed to disclose the reasonably foreseeable risks of the experimental interventions in the study, as well as the potential for differences in the degree of risk between these interventions. Although the concept of “standard of care” may be helpful in determining the ethical acceptability of other aspects of research, such as clinical equipoise, it is not helpful in discussing consent requirements.
Withdrawal from Glucocorticoid Therapy
Authors: Jan Koch-Weser, Richard L. Byyny
Journal: New England Journal of Medicine (1976)

Glucocorticoids, such as hydrocortisone, cortisone, prednisone, prednisolone and dexamethasone, are commonly used systemically for the treatment of a wide variety of illnesses, including asthma, sarcoidosis, nephrotic syndrome, ulcerative colitis, collagen-vascular disorders, chronic active hepatitis, thrombocytopenia, hypersensitivity and rheumatoid arthritis.1 They may be of great benefit, but their long-term use is often limited by the well known Cushingoid side effects of obesity, hypertension, osteoporosis, renal lithiasis, infections, poor healing, cataracts, diabetes, ecchymosis, phlebitis, hirsutism, activation of tuberculosis and other complications. Whether or not the disorder being treated has responded, the clinician frequently attempts to withdraw his patient from glucocorticoid therapy.During . . .
Still More on Breast Implants and Connective-Tissue Diseases
Authors: Howard Fuchs, John S. Johnson, John S. Sergent
Journal: New England Journal of Medicine (1995)

To the Editor: The study by Perriëns et al. (March 23 issue) 1 demonstrates that extending antituberculous treatment from 6 to 12 months reduces the rate of relapse in patients infected with the human immunodeficiency virus (HIV) who have pulmonary tuberculosis.In spite of this, the authors considered the six-month program to be an acceptable alternative because the longer-term therapy did not prolong survival.We question the validity of their survival analysis and therefore their recommendations for treatment.The short follow-up after treatment (1 year for patients in the 12-month treatment group) along with the unacceptable percentage of patients lost to follow-up (34 percent) lessens the statistical power of the study to reach that conclusion.The authors argue that most relapses could be successfully retreated.As shown in Table 2 of the article, only 20 of 335 patients (6 percent) died of tuberculosis in the first episode, as compared with 3 of 9 patients (33 percent) who relapsed (P ϭ 0.01 by Fisher's exact test).We also doubt that the patients who were lost to follow-up and those who are not enrolled in carefully controlled studies have the same opportunities for diagnosis and treatment as the patients who completed follow-up in the study by Perriëns et al.This point is even more important if patients are treated for only six months, because such patients have a greater risk of relapse.The theoretical savings afforded by a shorter course of thera-py may be counteracted by the need for closer follow-up.Furthermore, close follow-up is not an easy matter in HIV-infected patients, as reflected by the 34 percent rate of loss to follow-up.We believe that treatment of tuberculosis in HIV-infected patients must be continued for at least 9 months 2 as long as subsequent studies confirm that regimens lasting 6 months or 9 to 12 months are associated with the same rates of survival.