tbuckley/cabot-search huggingface dataset:
Hit for six: Summary of rapid responses
Authors: Birte Twisselmann
Journal: BMJ (2004)

Future of Kerala depends on its willingness to learn from pastEditor-The Kerala model in health, cited by Bhutta et al in the theme issue on health in South Asia as replicable for South Asian countries, 1 is facing serious threats.The state has a triple burden of communicable, non-communicable, and traumatic diseases.Stupendous growth of the private sector has resulted in skyrocketing healthcare costs.Lured by the hi tech sophistication of the private sector, people are abandoning basic principles of primary health care.Even poor people prefer private hospitals, and a major reason for sustaining poverty is healthcare cost. 2 The government is reducing its investments in health and education due to fiscal crises and pressure from funding and lending agencies.The opening up of the medical education sector to private entrepreneurs, lack of guidelines for the private practice of government doctors, and shortage of doctors for rural areas are all disturbing developments.Transfer of healthcare institutions under local self-governments is yet to show the desired benefits.The state is developing a long term plan, "Health Vision Kerala 2025," and a health policy.To equip the primary healthcare workforce to face the emerging challenges, 3 job responsibilities were redefined recently.Factors that determined the successful Kerala model, among others, include historically prevalent social justice, commitment of governments to health and education, land reforms, an organised public distribution system, streamlined primary health care, and an organised labour sector.Deterioration in these determinants is likely to have strong negative impact.Kerala should learn from its past to avoid the sad plight of some other Indian states.
Case 16-1982
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, Betty U. McNeely
Journal: New England Journal of Medicine (1982)

Presentation of Case A 63-year-old man was admitted to the hospital because of flank pain. He was well until 13 years earlier, when peripheral edema developed. One month later he noticed impaired vision. On the following day he had a grandmal seizure and was brought to the hospital. Physical examination showed that the blood pressure was 230/110 mm Hg. No peripheral edema was evident. Neurologic examination revealed signs of cortical blindness and confusion; no focal neurologic defect was apparent. The urine gave a ++++ test for protein; the sediment contained 4 white cells, 6 red cells, and rare coarsely granular . . .
Promoter polymorphism of the CD14 endotoxin receptor gene as a risk factor for alcoholic liver disease
Authors: Harri A. Järveläinen, Arto Orpana, Markus Perola, Vesa T. Savolainen, Pekka J. Karhunen, Kai O. Lindros
Journal: Hepatology (2001)

Twin concordance studies indicate that genetic factors influence the individual susceptibility for alcoholic liver disease (ALD). Both clinical and experimental data suggest that Kupffer cell activation by gut–derived endotoxins and other bacterial products is an important pathogenic factor. Activated Kupffer cells release proinflammatory cytokines, a process that is regulated by the CD14 endotoxin receptor (CD14). Recently, a C→T (-159) polymorphism in the promoter region of the CD14 gene was detected and found to confer increased CD14 expression. In the present study, the association of CD14 promoter polymorphism with different forms of ALD was examined in 3 separate autopsy series. Among 442 men with valid alcohol–consumption data, 381 men had been moderate or heavy alcohol consumers. The allele frequency of the CD14 promoter genotype, determined by a modified cycle minisequencing technique, was 0.34 (CC), 0.51 (CT), and 0.16 (TT). The T allele was found to be associated with advanced ALD, i.e. , with alcoholic hepatitis (odds ratio [OR]: 2.48; P = .018), and especially with cirrhosis (OR: 3.45; P = .004), but not with fatty liver, periportal fibrosis, or bridging fibrosis. The overall age–adjusted risk for cirrhosis was 3.08 ( P = .01) for the carriers of the CT genotype, and 4.17 ( P = .005) for the homozygous TT genotype. These results suggest that in the relatively isolated Finnish population, the T allele confers increased risk of alcoholic liver damage. In particular, TT homozygotes are at a high risk to develop cirrhosis.
Can medical education be fun as well as educational?
Authors: G. Howarth-Hockey
Journal: BMJ (2002)

Can medical education benefit from “lightening up”? Two Australian health professionals have turned education sessions into lively quiz shows 

Today's challenge to medical educators is to provide continuing education that supports excellence in clinical practice while finding new approaches to make learning more stimulating, motivating, and entertaining. At our hospital we are experimenting with innovative teaching techniques, incorporating games and debate, which encapsulate core concepts of the theory of adult learning: active participation by learners, application of knowledge, informal presentation, and feedback.1

#### Summary points

Medical education needs to support excellence in clinical practice while finding new approaches to teaching and learning

Imagination and creativity help planning and teaching in medical education

Games and debates can make a valuable contribution to teaching techniques

The games currently used in medical education at our hospital are “You too can become a physician” and “Medi-team challenge.” All games sessions are run …
Endoscopic resection of a large colonic leiomyosarcoma
Authors: R. Di Mitri, F. Mocciaro, G. Lipani, A. Marino
Journal: Endoscopy (2012)

Leiomyosarcoma of the colon is a rare tumor (330 reported cases [1]) which can mimic an adenocarcinoma [2]. Contrast-enhanced computed tomography (CT) is the imaging method of choice in the diagnostic work-up, though magnetic resonance imaging may be useful. Endoscopy and endoscopic ultrasonography (EUS) are also useful for further characterizing the lesion, and are helpful in distinguishing a benign lesion from a malignant one [3]. Positron emission tomography can be used to monitor the response to therapy or detect local recurrence [2]. The management of leiomyosarcomas involving the gastrointestinal tract depends on the confidence in the preoperative diagnosis, and the treatment of choice is radical surgical excision [4]. No data are available on endoscopic treatment in patients who cannot undergo surgery.
Endothelial mitochondria and heart disease
Authors: S. M. Davidson
Journal: Cardiovascular Research (2010)

The endothelium is vital to the proper functioning in the heart, in particular due to its production of nitric oxide (NO) which regulates vascular tone. Damage to the endothelium contributes to the development of atherosclerosis, and hence to possible myocardial infarction and subsequent heart failure. Like most cells, endothelial cells contain mitochondria, despite their having relatively little dependence on oxidative phosphorylation for ATP production. However, endothelial mitochondria are centrally involved in maintaining the fine regulatory balance between mitochondrial calcium concentration, reactive oxygen species (ROS) production, and NO. This raises the question of whether damage to endothelial mitochondria would have repercussions in terms of the development of heart disease. In fact, increasingly nuanced techniques enabling restricted transgenic expression of antioxidant proteins in mice has demonstrated that mitochondrial ROS do contribute to endothelial damage. New pharmaceutical approaches designed to target protective molecules such as ROS scavengers to the mitochondria promise to be effective in preventing heart disease. As well as protecting cardiomyocytes, these drugs may have the added benefit of preventing damage to the endothelial mitochondria. However, much remains to be done in understanding the contribution that mitochondria make to endothelial function.
Hepatic Vascular Lesions in AIDS
Authors: Jean-François Devars du Mayne
Journal: JAMA (1985)

<h3>To the Editor.—</h3> In their article entitled "Autopsy Findings in the Acquired Immune Deficiency Syndrome," Dr Welch and associates<sup>1</sup>always found hepatic lesions that were sinusoidal dilatations. As the pathogenesis of these lesions is not discussed by the authors, I would like to describe our very similar findings.<sup>2</sup> We performed systematic liver biopsies in 20 patients with documented acquired immunodeficiency syndrome (AIDS). Eighteen of 20 biopsies yielded abnormalities that could be related to diverse opportunistic infections and consisted of granulomatous and/or necrotizing lesions. However, prominent vascular lesions were observed in seven of these cases, with sinusoidal dilatations in two, peliosis hepatis in four, and angiosarcomatous changes in one. In the absence of a hepatic outflow obstruction, sinusoidal dilatations and peliosis hepatis are known to be associated with many hepatic and extrahepatic diseases.<sup>3</sup>However, I speculate that the striking vascular changes found in these series could be directly
Elemental diet in the management of Crohn's disease during pregnancy.
Authors: K Teahon, M Pearson, A J Levi, I Bjarnason
Journal: Gut (1991)

Four patients with Crohn9s disease were treated with an elemental diet during pregnancy. Two had active disease and two also had symptoms of small intestinal obstruction. All went into a clinical remission within a few days of starting treatment. Treatment periods varied from two to four weeks, and were followed by elemental diet as a supplement to normal food in two patients. At term, all delivered a healthy infant. These patients indicate that elemental diet is a safe form of treatment for Crohn9s disease during pregnancy and may be considered as an alternative to conventional drug treatments which carry a theoretical risk of teratogenesis.
TWO CASES OF AMYOTONIA CONGENITA OCCURRING IN THE SAME FAMILY
Authors: Gerald R. Allaben
Journal: JAMA (1924)

These two cases of this rather rare condition are of interest owing to the fact that heredity, or a familial tendency, has not been noted in the cases heretofore reported. <h3>REPORT OF CASES</h3><h3>Case 1.</h3> —M., a boy of normal delivery, born in the summer of 1920, breast fed, at the age of 6 months was brought to the hospital by the mother, who complained that he made no effort to raise himself, and was unable to sit up. She stated that he nursed normally and seemed cheerful, and that he had been gaining rapidly in weight, and had had no digestive disturbance. The baby was large, bright and happy in appearance. There was inability to sit up, or even to hold the head up unsupported. He was able to move the hands and feet a little, but offered no muscular resistance to attempts at passive motion. There existed, apparently,
Is Dose Normalization to Weight or Body Surface Area Useful in Adults?
Authors: L. B. CROCHOW, C. BARALDI, D. NOE
Journal: JNCI Journal of the National Cancer Institute (1990)

Is Dose Normalization to Weight or Body Surface Area Useful in Adults? Get access LOUISE B. CROCHOW, LOUISE B. CROCHOW * The Johns Hopkins Oncology CenterBaltimore, MD *Correspondence to : Louise B. Grochow, M.D., The Johns Hopkins Oncology Center, 600 N. Wolfe St., Baltimore, MD 21205. Search for other works by this author on: Oxford Academic PubMed Google Scholar CAROLE BARALDI, CAROLE BARALDI The Johns Hopkins Oncology CenterBaltimore, MD Search for other works by this author on: Oxford Academic PubMed Google Scholar DENNIS NOE DENNIS NOE The Johns Hopkins Oncology CenterBaltimore, MD Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 82, Issue 4, 21 February 1990, Pages 323–325, https://doi.org/10.1093/jnci/82.4.323 Published: 21 February 1990
THE EFFECTS OF HEPATIC EXTRACT ON HIGH BLOOD PRESSURE
Authors: RALPH H. MAJOR
Journal: JAMA (1925)

In a series of articles appearing during the last two years, attention has been called to the marked pressor effects of the guanidin compounds and to the possibility that these compounds or allied substances may play a rôle in arterial hypertension. In addition to these observations on the pressor activity of guanidin, the action of various substances that lower this experimental hypertension has been studied. We have studied the effect of such substances as calcium chlorid, potassium chlorid, ammonium chlorid and hydrochloric acid, as well as the action of various tissue extracts, particularly those obtained from the thyroid, testis, ovary, muscle, parathyroid and liver on this hypertension. As a logical sequence of this work the effect of some of these substances on arterial hypertension in man has been investigated, and some interesting results have been observed. Some striking effects were obtained by the use of tissue extracts, particularly those of
The study of plaques of psoriasis using a scanning laser-Doppler velocimeter
Authors: E.L. SPEIGHT, T.J.H. ESSEX, P.M. FARR
Journal: British Journal of Dermatology (1993)

A scanning laser‐Doppler velocimeter. able to measure blood flux over a large area without contact with the skin surface, was used for the objective measurement of the vascular changes in psoriasis. Individual plaques were scanned, and tracings of the visible plaque edge taken on to a cellulose‐acetate sheet from which area measurements were made using a digitizing tablet. Mean blood flux within plaques was increased fourfold compared with mean background flux. There was a highly significant linear correlation between plaque area measured by tracing and scanning, but area measured by scanning was greater. Detailed study of blood flux outside the visible plaque edge with the scanner, and with a conventional Iaser‐Doppler instrument, showed this was due to a 2–4 mm rim of increased blood flux around plaques. The scanning laser‐Doppler velocimeter allows rapid measurement of psoriasis in terms of mean blood flux and area of increased blood flux, and should be useful in the assessment of psoriasis severity and the response to treatment.
NO production results in suspension-induced muscle atrophy through dislocation of neuronal NOS
Authors: Naoki Suzuki, Norio Motohashi, Akiyoshi Uezumi, So-ichiro Fukada, Tetsuhiko Yoshimura, Yasuto Itoyama, Masashi Aoki, Yuko Miyagoe-Suzuki, Shin’ichi Takeda
Journal: Journal of Clinical Investigation (2007)

Forkhead box O (Foxo) transcription factors induce muscle atrophy by upregulating the muscle-specific E3 ubiquitin ligases MuRF-1 and atrogin-1/MAFbx, but other than Akt, the upstream regulators of Foxos during muscle atrophy are largely unknown. To examine the involvement of the dystrophin glycoprotein complex (DGC) in regulation of Foxo activities and muscle atrophy, we analyzed the expression of DGC members during tail suspension, a model of unloading-induced muscle atrophy. Among several DGC members, only neuronal NOS (nNOS) quickly dislocated from the sarcolemma to the cytoplasm during tail suspension. Electron paramagnetic resonance spectrometry revealed production of NO in atrophying muscle. nNOS-null mice showed much milder muscle atrophy after tail suspension than did wild-type mice. Importantly, nuclear accumulation of dephosphorylated Foxo3a was not evident in nNOS-null muscle, and neither MuRF-1 nor atrogin-1/MAFbx were upregulated during tail suspension. Furthermore, an nNOS-specific inhibitor, 7-nitroindazole, significantly prevented suspension-induced muscle atrophy. The NF-κB pathway was activated in both wild-type and nNOS-null muscle during tail suspension. We also show that nNOS was involved in the mechanism of denervation-induced atrophy. We conclude that nNOS/NO mediates muscle atrophy via regulation of Foxo transcription factors and is a new therapeutic target for disuse-induced muscle atrophy.
TWO CASES OF FOREIGN BODY IN LEFT BRONCHUS REMOVED ENDOSCOPICALLY
Authors: M. R. Waltz
Journal: JAMA (1922)

Removal of foreign bodies by the endoscopic method is relatively common, but reports of these cases have not entirely lost interest. The cases reported here are of slightly added interest because of the location of the foreign bodies in the left bronchus and not in the right, as we usually expect them to be because of the anatomic configuration of the bronchi; also these cases happened to be consecutive. <h3>Case 1.</h3> —A school girl, aged 7, was playing with some brown beans seven days before I saw her. She had one in her mouth when her cousin suddenly tickled her by "grabbing her ribs," causing her to inhale forcibly, drawing the bean down. She coughed considerably, her respirations had been rapid since then, and she complained of pain in the left side of the chest, and fever. The previous history was generally negative. On examination the temperature was 100, pulse
The Theory of Event Coding (TEC): A framework for perception and action planning
Authors: Bernhard Hommel, Jochen Müsseler, Gisa Aschersleben, Wolfgang Prinz
Journal: Behavioral and Brain Sciences (2001)

Traditional approaches to human information processing tend to deal with perception and action planning in isolation, so that an adequate account of the perception-action interface is still missing. On the perceptual side, the dominant cognitive view largely underestimates, and thus fails to account for, the impact of action-related processes on both the processing of perceptual information and on perceptual learning. On the action side, most approaches conceive of action planning as a mere continuation of stimulus processing, thus failing to account for the goal-directedness of even the simplest reaction in an experimental task. We propose a new framework for a more adequate theoretical treatment of perception and action planning, in which perceptual contents and action plans are coded in a common representational medium by feature codes with distal reference. Perceived events (perceptions) and to-be-produced events (actions) are equally represented by integrated, task-tuned networks of feature codes – cognitive structures we call event codes. We give an overview of evidence from a wide variety of empirical domains, such as spatial stimulus-response compatibility, sensorimotor synchronization, and ideomotor action, showing that our main assumptions are well supported by the data.
Asthma and a lump in the breast.
Authors: J W Smith, C H Goodliffe, F R Hurford
Journal: BMJ (1972)

because corticosteroid treatment has, for some reason, been omitted, or because the dose has not been sufficiently increased during an intercurrent illness.It can also arise during an attempted withdrawal of glucocorticoid therapy.The clinical features are those of glucocorticoid deficiency, and treatment is with high doses of cortisol, which usually have to be given parenterally. References
Human immune response to group A streptococcal carbohydrate (A-CHO). I. Quantitative and qualitative analysis of the A-CHO-specific B cell population responding in vitro to polyclonal and specific activation.
Authors: F Emmrich, B Schilling, K Eichmann
Journal: The Journal of Experimental Medicine (1985)

The immune response to the group-specific carbohydrate of group A streptococci (A-CHO) provides an informative in vitro model for the investigation of several aspects of human anticarbohydrate immune responses. A-CHO-specific B cells can be polyclonally activated by pokeweed mitogen (PWM), and, specifically, by in vitro immunization with streptococcal vaccine. High levels of A-CHO-specific antibodies, mainly directed to the immunodominant side chain N-acetyl-D-glucosamine (GlcNAc), occur in healthy adult individuals. Serum antibody levels are reflected in high frequencies of precursor B cells among peripheral blood lymphocytes. In one particular case, greater than 15% of all B cells activated by PWM for IgM production were found to produce IgM anti-A-CHO antibodies, as determined in limiting dilution experiments, as well as by analyzing Ig concentrations in bulk culture experiments. The case with the lowest proportion observed had 0.3% A-CHO-specific B cells among IgM-producing B cells. Preferential PWM activation of anti-A-CHO-producing B cells could be excluded. The comparison of the proportions of anti-A-CHO IgM produced in vivo, and of B cells producing antibodies of this specificity in peripheral blood, suggests a similar distribution of specific precursor B cells in the antibody-producing lymphoid tissue compartments and in peripheral blood. However, nearly all specific antibodies produced in vitro belong to the IgM isotype, whereas IgG anti-A-CHO in high amounts, mostly exceeding the specific IgM, was found only among anti-A-CHO antibodies produced in vivo. Low anti-A-CHO IgG production was seen in polyclonally activated as well as in antigen-activated cultures, whereas, in contrast, total IgG was produced in considerable amounts after polyclonal activation. This suggests a different distribution pattern, and/or diverse differentiation requirements for anti-A-CHO-producing B cells, compared with other B cell species.
"Osteoarthritis" on imaging may be normal wear and tear
Authors: S. T. Donell
Journal: BMJ (2012)

Bennell and colleagues’ clinical review on the management of knee osteoarthritis describes a sensible and measured approach based on the evidence.1 The recent access of general practitioners and triage staff to magnetic resonance images has resulted in a flood of patients referred to hospital for arthroscopy for tears of the posterior horn of the medial …
The Man with Stars Inside
Authors: Jack Coulehan
Journal: Annals of Internal Medicine (1997)

Public opinion polls show that a large percentage of persons in the United States currently favor the legalization of professionally assisted death.This support reflects wide-spread fear and confusion over the tortuously prolonged and painful process of dying countenanced by contemporary medicine. Physician-assisted suicide and euthanasia are complex moral issues. The current drive to translate them into debates about “rights” and public policy is curious: Does the energy directed toward “palliation-by-death” mean that our society is more compassionate now, or more just, than in the past? To the contrary, I believe that the movement toward assisted death reflects inadequate palliative care, poor patient–physician communication, great confusion about the right to refuse treatment, and profound inequity in U.S. health care. Legalization of assisted death diverts us from addressing these problems. Palliation-by-death will drive us farther apart, not closer together.