tbuckley/cabot-search huggingface dataset:
A swollen leg in the middle of the night
Authors: D. W. Randall, W. E. Fickling
Journal: BMJ (2012)

A 47 year old man, who had recently experienced an exacerbation of inflammatory bowel disease, which had resolved after administration of infliximab, was admitted to hospital with abdominal pain and severe bloody diarrhoea. On the night of his readmission, he developed painful swelling of the right thigh. After an initial assessment the on call doctor thought that the likely diagnosis was deep vein thrombosis, and a therapeutic dose of low molecular weight heparin was given pending venous Doppler ultrasound evaluation. No mention was made in the patient’s healthcare records of any findings on physical examination. During the evening, the pain and swelling in his leg rapidly became more severe, and two hours later a second doctor was called to review him. On examination at this point he seemed unwell, with cool peripheries, tachycardia, and hypothermia. His right leg was extremely swollen and very tender to palpation, with an area of violaceous discoloration on the lateral aspect of the thigh. In addition, a resonant note was elicited on percussion of this area. Urgent portable radiography was arranged to evaluate the soft tissue planes of his right leg (figure⇓).
George Bryan Gillett
Authors: David Wilkinson
Journal: BMJ (2006)

​ConsultantConsultant anaesthetist St Bartholomew's and Homerton Hospitals, London (b 1931; q St Bartholomew's Hospital 1956; DA, FRCA), d 15 April 2006.




Figure 1




Bryan started anaesthesia in Bromley before moving to Barts in 1958, where he joined the staff in 1965. A four month sabbatical in Scandinavia engendered a love for Engstrom ventilators and Volvo cars. An outstanding clinical anaesthetist with a flair for teaching both undergraduates and postgraduates, he found time to publish research through three decades. His work to prevent acid aspiration in obstetric practice by the use of ranitidine and sodium citrate treatment saved many lives. He leaves a wife, Margaret; two daughters; and three granddaughters.
TOLERANCE TO AMINO ACID MIXTURES AND CASEIN DIGESTS GIVEN INTRAVENOUSLY
Authors: S. C. Madden, R. R. Woods, F. W. Shull, J. H. Remington, G. H. Whipple
Journal: The Journal of Experimental Medicine (1945)

Several synthetic mixtures of natural and racemic crystalline amino acids suitable for the daily nitrogen requirement are tested in dogs for their tolerance upon intravenous injection. Certain mixtures of the ten essential amino acids plus non-essential amino acids exclusive of glutamic acid are accepted without any obvious sign of disturbance even at rates above 10 mg. nitrogen per kilo per minute for quantities greater than 300 mg. per kilo. One such mixture consists in parts per 100 of dl-threonine 7, dl-valine 15, l(-)-leucine 10.9, dl-isoleucine 9.9, l(+)-lysine. HCl.H(2)O 10.9, dl-tryptophane 3, dl-phenylalanine 9.9, dl-methionine 6, l(+)-histidine.HCl.H(2)O 5, l(+)-arginine-HCl 5, glycine 9.9, dl-alpha-alanine 4, dl-serine 2, l(-)-cystine 0.5, and l(-)-tyrosine 1. In addition other well tolerated mixtures included the prolines. When glutamic acid, natural or racemic, is included in similar mixtures vomiting reactions frequently occur at nitrogen rates above 4 mg. per kilo per minute. Vomiting almost always occurs on the first daily injection containing glutamic acid and usually on any subsequent injection containing more than 100 mg. glutamic acid per kilo unless given very slowly. Upon the addition of glycine certain mixtures of the ten essential amino acids show an improved tolerance. Two casein digests tested usually produced vomiting at injection rates above 2 mg. nitrogen per kilo per minute, probably because of their glutamic acid content. No serious reaction has ever occurrred to any mixture of amino acids or casein digest tested. Elimination of minor reactions such as vomiting appears possible and desirable for greater usefulness of these solutions in parenteral feeding.
Book Review Textbook of Cardiovascular Medicine Edited by Eric J. Topol, with eight others. 2732 pp., illustrated. Philadelphia, Lippincott–Raven, 1998. $125. 0-397-51592-8 Comprehensive Cardiovascular Medicine Edited by Eric J. Topol, with eight others. 3153 pp., illustrated. Philadelphia, Lippincott–Raven, 1998. $275. 0-7817-1596-2
Authors: Christoph A. Nienaber
Journal: New England Journal of Medicine (1998)
“An unwarrantable impertinence”
Authors: John F. Kihlstrom
Journal: Behavioral and Brain Sciences (2004)

Wegner's many examples of illusory involuntariness do not warrant the conclusion that the experience of voluntariness is also an illusion. His arguments appear to be related to the contemporary emphasis on automaticity in social cognition and behavior; both appear to represent a revival of situationism in social psychology.
Nucleotide Excision DNA Repair Is Associated With Age-Related Vascular Dysfunction
Authors: Matej Durik, Maryam Kavousi, Ingrid van der Pluijm, Aaron Isaacs, Caroline Cheng, Koen Verdonk, Annemarieke E. Loot, Hisko Oeseburg, Usha Musterd Bhaggoe, Frank Leijten, Richard van Veghel, René de Vries, Goran Rudez, Renata Brandt, Yanto R. Ridwan, Elza D. van Deel, Martine de Boer, Dennie Tempel, Ingrid Fleming, Gary F. Mitchell, Germaine C. Verwoert, Kirill V. Tarasov, Andre G. Uitterlinden, Albert Hofman, Henricus J. Duckers, Cornelia M. van Duijn, Ben A. Oostra, Jacqueline C.M. Witteman, Dirk J. Duncker, A.H. Jan Danser, Jan H. Hoeijmakers, Anton J.M. Roks
Journal: Circulation (2012)

Vascular dysfunction in atherosclerosis and diabetes mellitus, as observed in the aging population of developed societies, is associated with vascular DNA damage and cell senescence. We hypothesized that cumulative DNA damage during aging contributes to vascular dysfunction.In mice with genomic instability resulting from the defective nucleotide excision repair genes ERCC1 and XPD (Ercc1(d/-) and Xpd(TTD) mice), we explored age-dependent vascular function compared with that in wild-type mice. Ercc1(d/-) mice showed increased vascular cell senescence, accelerated development of vasodilator dysfunction, increased vascular stiffness, and elevated blood pressure at a very young age. The vasodilator dysfunction was due to decreased endothelial nitric oxide synthase levels and impaired smooth muscle cell function, which involved phosphodiesterase activity. Similar to Ercc1(d/-) mice, age-related endothelium-dependent vasodilator dysfunction in Xpd(TTD) animals was increased. To investigate the implications for human vascular disease, we explored associations between single-nucleotide polymorphisms of selected nucleotide excision repair genes and arterial stiffness within the AortaGen Consortium and found a significant association of a single-nucleotide polymorphism (rs2029298) in the putative promoter region of DDB2 gene with carotid-femoral pulse wave velocity.Mice with genomic instability recapitulate age-dependent vascular dysfunction as observed in animal models and in humans but with an accelerated progression compared with wild-type mice. In addition, we found associations between variations in human DNA repair genes and markers for vascular stiffness, which is associated with aging. Our study supports the concept that genomic instability contributes importantly to the development of cardiovascular disease.
Mind and Immunity: Behavioral Immunology—An Annotated Bibliography 1976-1982
Authors: Charles M. Poser
Journal: JAMA (1984)

As psychoanalysis gained its ascendency and moved the study of the mind away from biologic principles, a parallel movement was taking place: the application of new and exciting discoveries in a completely different field, immunology, to behavioral phenomena. Few of us who completed medical training 20 or more years ago understood that lymphocytes, antigens, antibodies, immune complexes, and other such components of immunologic equations would have an illuminating influence on our understanding of how the mind and brain respond to both internal and external factors. The very fact that Locke and Hornig-Rohan were able to gather close to 1,500 references from the world literature in this new and no longer exotic field of neuropsychoimmunology is a tribute to its growing importance and timeliness. This compendium is conveniently divided into several sections dealing with the neuroanatomy of the immune system and the immunology of the nervous system, including neurochemical influences on
The differentiation and proliferation of newly formed epidermis on wounds treated with cultured epithelial allografts
Authors: ANNE M. OLIVER, W. KAAWACH, EVA WEILER MITHOFF, ALISON WATT, D.R. ABRAMOVICH, C.R. RAYNER
Journal: British Journal of Dermatology (1991)

Summary Fifteen patients, eight with burn or scald wounds and seven with split-thickness donor sites. were treated with cultured epithelial allografts. Skin was obtained from HIV-negative donors undergoing circumcision and sheets of epitheliliun were cultured using the 3T3 feeder method. Multiple postoperative biopsies were performed at various time intervals and stained with a panel of monoclonal antibodies against cytokeratins. involucrin. transferrin receptor and epidermal growth factor receptor. Fresh cultured epithelial sheets. normal skin, standard treated donor sites and burns treated with autografts were also studied. Cytokeratin-10 expression was not observed at treated sites until 4 weeks post-grafting, when normal suprabasal levels were observed. Cytokeratins 1 3 and 16. usually observed in highly proliferative states such as psoriasis. were observed in epithelial-treated sites for up to 6 months, Other proliferation markers such as Ki67 and transferrin receptor were only expressed 2–3 weeks post-operatively. Involuerin, a marker of keratinocyte terminal differentiation, was expressed throughout newly formed epidermis until 1 5 weeks, when the normal pattern of granular expression was observed. These results indicate that although the cultured ‘allograft’ does not survive. it may modulate the proliferation and differentiation of spontaneously regenerating epithelium.
Diagnostic and therapeutic technology assessment. Radiofrequency catheter ablation of aberrant conducting pathways of the heart
Authors: J. B. Vatz
Journal: JAMA (1992)

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Response of fibrinolytic activity to venous occlusion.
Authors: A G Shaper, N A Marsh, I Patel, F Kater
Journal: BMJ (1975)

Resting fibrinolytic activity and the response of the fibrinolytic system to venous occlusion were studied in a group of healthy middle-aged men. All subjects showed increased fibrinolytic activity but of varying degrees. There was a linear relationship between resting and occluded levels of fibrinolytic activity but many subjects with lower levels of fibrinolytic activity showed an anomalous response. Responses over the expected level were more common than unexpectedly low levels of response. Fibrinogen and plasminogen concentrations were inversely correlated with fibrinolytic activity.
Night sweats. A dominant symptom in diabetes insipidus
Authors: S. B. Raff
Journal: JAMA (1975)

A PATIENT had night sweats following an intracranial infection. The sweats were not accompanied by nocturia and were believed to be caused by recurrence of infection. The diagnosis of diabetes insipidus was subsequently established and the night sweats responded to injections of pitressin. The absence of nocturia was attributable to dilatation of the urinary collecting system.  Report of a Case  A 10-year-old boy was admitted to Long Island Jewish Hospital complaining of lethargy, visual hallucinations, and neck pain. He was transferred to New York University Hospital because of decreasing sensorium. On arrival, he had low-grade fever, lack of response to painful stimuli, generalized lymphadenopathy, and signs of cerebral dysfunction (right greater than left) with no papilledema. The cerebrospinal fluid was lymphocytic, with no organisms seen on microscopic examination. There was moderate peripheral leukocytosis, but cultures of all blood, urine, and cerebrospinal fluid specimens were normal. Carotid angiography was compatible with
Src Tyrosine Kinase and Multidrug Resistance Protein-1 Inhibitions Act Independently but Cooperatively to Restore Paclitaxel Sensitivity to Paclitaxel-Resistant Ovarian Cancer Cells
Authors: Jessica A. George, Ting Chen, Christopher C. Taylor
Journal: Cancer Research (2005)

Abstract Src tyrosine kinase has been found to be overexpressed in both mouse and human ovarian cancer cells as well as in human primary ovarian cancers. Furthermore, Src inhibition sensitizes ovarian cancer cells to chemotherapeutic agents such as paclitaxel and cisplatin. Interestingly, Src inhibition has also been shown to resensitize paclitaxel-resistant cells to the cytotoxic effects of paclitaxel. The current study was undertaken in an effort to determine the mechanism by which Src resensitizes drug-resistant ovarian cancer cells. The paclitaxel-resistant human (CaOV3TaxR) and mouse (ID8TaxR) ovarian cancer cell lines express large amounts of the multidrug resistance-1 (MDR-1) protein compared with the paclitaxel-sensitive parent cell lines. Src inhibition had no effect on MDR-1 protein expression. Furthermore, Src inhibition did not affect MDR-1 function as determined by rhodamine 123 and paclitaxel uptake or retention. Coinhibition of both Src and MDR-1 synergistically enhanced paclitaxel-induced cytotoxicity in paclitaxel-resistant ovarian cancer cell lines. Inhibition of Src enhanced microtubule stabilization in paclitaxel-resistant ovarian cancer cells treated with paclitaxel without affecting expression of β-tubulin isotypes and resulted in multipolar spindle formation and apoptosis. These results show that Src inhibition restores paclitaxel sensitivity to paclitaxel-resistant ovarian cancer cells by an MDR-independent mechanism, possibly by decreasing the critical intracellular concentration at which paclitaxel induces tubulin stabilization and bundling. Src tyrosine kinase may provide a viable target for therapeutic intervention in drug-resistant ovarian cancer.
The Morphology of the QT Interval Predicts Torsade de Pointes During Acquired Bradyarrhythmias
Authors: Ian Topilski, Ori Rogowski, Rafael Rosso, Dan Justo, Yitschak Copperman, Michael Glikson, Bernard Belhassen, Marek Hochenberg, Sami Viskin
Journal: Journal of the American College of Cardiology (2007)
Dueling Ethical Frameworks for Allocating Health Resources
Authors: Dorothy E. Vawter, J. Eline Garrett, Karen G. Gervais, Angela Witt Prehn, Debra A. DeBruin
Journal: The American Journal of Bioethics (2010)

We commend Kerstein and Bognar (2010) for advancing the scholarly debate about which principles should guide the allocation of scarce health care resources and for their insightful analysis of Pers...
A microdeletion in cytochrome c oxidase (COX) subunit III associated with COX deficiency and recurrent myoglobinuria
Authors: J. Andrew Keightley, Kristen C. Hoffbuhr, Miriam D. Burton, Virginia M. Salas, Wendy S.W. Johnston, Andrew M.W. Penn, Neil R.M. Buist, Nancy G. Kennaway
Journal: Nature Genetics (1996)
The Devil and William Dabney
Authors: F. J. Spencer
Journal: JAMA (1966)

On Tuesday, June 5, 1888, Dr. William C. Dabney, professor of obstetrics and practice of medicine in the University of Virginia, Charlottesville, saw the first recorded case of pleurodynia in North America.<sup>1</sup> [The patient] had been taken suddenly a few hours before with violent pain in the left side of the chest nearly over the region of the heart. His temperature was 103°, and the skin extremely hot and pungent to the touch; his bowels were rather constipated, but not markedly so; there was no nausea, but very little appetite. His chief complaint was of the pain in the chest, which was excruciating and aggravated by the slightest movement, or by drawing a long breath. Nothing abnormal could be discovered about the thoracic organs, however, on physical examination. Dr. Dabney prescribed rest, antipyrine, mercurous chloride, and a mustard plaster and made another visit the next day. The patient, a
Tumor development in murine ulcerative colitis depends on MyD88 signaling of colonic F4/80+CD11bhighGr1low macrophages
Authors: Gabriela Schiechl, Bernhard Bauer, Ivan Fuss, Sven A. Lang, Christian Moser, Petra Ruemmele, Stefan Rose-John, Markus F. Neurath, Edward K. Geissler, Hans-Jürgen Schlitt, Warren Strober, Stefan Fichtner-Feigl
Journal: Journal of Clinical Investigation (2011)

Patients with prolonged ulcerative colitis (UC) frequently develop colorectal adenocarcinoma for reasons that are not fully clear. To analyze inflammation-associated colonic tumorigenesis, we developed a chronic form of oxazolone-induced colitis in mice that, similar to UC, was distinguished by the presence of IL-13–producing NKT cells. In this model, the induction of tumors using azoxymethane was accompanied by the coappearance of F4/80+CD11bhighGr1low M2 macrophages, cells that undergo polarization by IL-13 and are absent in tumors that lack high level IL-13 production. Importantly, this subset of macrophages was a source of tumor-promoting factors, including IL-6. Similar to dextran sodium sulfate–induced colitis, F4/80+CD11bhighGr1intermediate macrophages were present in the mouse model of chronic oxazolone-induced colitis and may influence tumor development through production of TGF-β1, a cytokine that inhibits tumor immunosurveillance. Finally, while robust chronic oxazolone-induced colitis developed in myeloid differentiation primary response gene 88–deficient (Myd88–/–) mice, these mice did not support tumor development. The inhibition of tumor development in Myd88–/– mice correlated with cessation of IL-6 and TGF-β1 production by M2 and F4/80+CD11bhighGr1intermediate macrophages, respectively, and was reversed by exogenous IL-6. These data show that an UC-like inflammation may facilitate tumor development by providing a milieu favoring development of MyD88-dependent tumor-supporting macrophages.
Cost-effectiveness of a smoking cessation program after myocardial infarction
Authors: Harlan M. Krumholz, Brian J. Cohen, Joel Tsevat, Richard C. Pasternak, Milton C. Weinstein
Journal: Journal of the American College of Cardiology (1993)

The purpose of this study was to evaluate the cost-effectiveness of a smoking cessation program initiated after acute myocardial infarction.The value of allocating health care resources to smoking cessation programs after myocardial infarction has not been compared with the value of other currently accepted interventions.A model was developed to examine the cost-effectiveness of a recently reported smoking cessation program after an acute myocardial infarction. The cost was estimated by considering the resources necessary to implement the program, and the effectiveness was expressed as discounted years of life saved. Years of life saved were estimated by modeling life expectancy using a single declining exponential approximation of life expectancy based on data from published reports.The cost-effectiveness of the nurse-managed smoking cessation program was estimated to be $220/year of life saved. In a one-way sensitivity analysis, the cost-effectiveness of the program remained < $20,000/year of life saved if the program decreased the smoking rate by only 3/1,000 smokers (baseline assumption 26/100 smokers), or if the program cost as much as $8,840/smoker (baseline assumption $100). In a two-way sensitivity analysis, even if the cost of the program were as high as $2,000/participant, the cost-effectiveness of the program would be < $10,000/year of life saved so long as the program helped an additional 12 smokers quit for every 100 enrolled.Over a wide range of estimates of costs and effectiveness, a nurse-managed smoking cessation program after acute myocardial infarction is an extremely cost-effective intervention. This program is more cost-effective than beta-adrenergic antagonist therapy after myocardial infarction.
Doxepin Overdose
Authors: Paul A. Janson
Journal: JAMA (1977)

DOXEPIN hydrochloride is one of several agents classified as tricyclic antidepressants.<sup>1</sup>Clinical use of these compounds is increasing and subsequently, a number of cases of overdose are being reported.<sup>2,3</sup>We report a case of a polydrug abuser who overdosed with doxepin, and where physostigmine salicylate rapidly reversed the toxic effects. Of added clinical interest was the apparent failure of neostigmine methylsulfate to reverse the CNS and cardiac toxicity seen in this case. <h3>Report of a Case</h3> A 34-year-old man, and a known drug abuser, was brought to the hospital in a stuporous condition. Four hours earlier he had taken pills, subsequently identified as doxepin, approximately 600 mg, which he had received as "sleeping pills" from a community doctor. Initially, he was easily arousable and responded to verbal commands. However, he spoke only in Spanish, whereas normally he spoke fluently in English. Vital signs were weight, 64.5 kg; blood
Familial Thymic Aplasia
Authors: Russell W. Steele, Catherine Limas, Gary B. Thurman, Marianne Schuelein, Heinz Bauer, Joseph A. Bellanti
Journal: New England Journal of Medicine (1972)

A 10-week-old female infant with familial congenital thymic aplasia without delayed hypersensitivity to common skin-test antigens underwent fetal-thymus implantation. Six hours after the implantation of a fetal thymus enclosed in a Millipore chamber phytohemagglutinin responsiveness was demonstrable in the patient's peripheral lymphocytes. The infant's death of aspiration pneumonia nine days after implantation did not allow evaluation of the extent of the immunologic reconstitution. Thymic-cell immunologic function can be induced in man with fetal-thymus humoral factors.
Pericarditis During Long-Term Hemodialysis
Authors: Hugh H. Hussey
Journal: JAMA (1975)

As experience with long-term hemodialysis for patients with end-stage kidney disease has enlarged, rather strange complications have developed in some patients. An earlier editorial inThe Journal(230:1680, 1974) described a group of patients in whom cachexia, ascites, and severe hypertension appeared and the last was intensified during episodes of treatment. All patients died except those who underwent bilateral nephrectomy, in which case ascites disappeared, hypertension subsided, and weight was restored. In the current issue of<i>Archives of Internal Medicine</i>(135:807-810, 1975), Minuth et al give an account of their experience with patients who developed pericarditis— another mysterious complication. Of course, uremic pericarditis was well known before the advent of hemodialysis and signaled that death was near. Now, for patients receiving long-term hemodialysis, the onset of pericarditis, although not so ominous, is nevertheless serious, especially when it causes cardiac compression. Various methods of treatment have been used, including increased frequency