tbuckley/cabot-search huggingface dataset:
Case 44-1965
Authors: Daniel D. Federman, Robert E. Scully
Journal: New England Journal of Medicine (1965)

Presentation of Case First admission. A fifty-one-year-old man entered the hospital because of a cough.He had been well until the age of twenty-eight years, when he had an attack of "bronchitis." During the next twenty-three years he had repeated bronchopulmonary infections and was told that he had asthma. He had a chronic cough productive of sputum. Six years before entry hemoptysis occurred, but an x-ray examination was reported to be negative. An x-ray film of the chest taken one year later revealed hyperaeration of both lungs, with slight cystic changes, linear and nodular densities throughout the lungs, particularly in . . .
THE DIAGNOSIS AND TREATMENT OF INJURIES OF THE HEAD.
Authors: JAMES H. DUNN
Journal: JAMA (1901)

Injuries of the head are frequent, exceedingly variable in character, notably uncertain of prognosis, and often disastrous in their immediate or remote results. There is considerable difficulty in classifying serious lesions of this region to the greatest practical advantage. The usual tendency to place special emphasis upon the presence or absence of fracture of the bones is misleading clinically, because, for the most part, fracture when recognizable is of entirely secondary importance to injury of the cranial contents, because fracture is not always recognizable or treatable, and because in any event the treatment of skull fractures has little in common with that of other bones. It is exceedingly helpful to study head injuries from a distinctly clinical standpoint somewhat after the manner in vogue in the presence of injuries to the other great cavities, the adbomen and thorax. In the one case as in the others, the chief rôle of
Survival in infection-related acute-on-chronic liver failure is defined by extrahepatic organ failures
Authors: Jasmohan S. Bajaj, Jacqueline G. O'Leary, K. Rajender Reddy, Florence Wong, Scott W. Biggins, Heather Patton, Michael B. Fallon, Guadalupe Garcia-Tsao, Benedict Maliakkal, Raza Malik, Ram M. Subramanian, Leroy R. Thacker, Patrick S. Kamath, None the North American Consortium for t
Journal: Hepatology (2014)

Infections worsen survival in cirrhosis; however, simple predictors of survival in infection-related acute-on-chronic liver failure (I-ACLF) derived from multicenter studies are required in order to improve prognostication and resource allocation. Using the North American Consortium for Study of End-stage Liver Disease (NACSELD) database, data from 18 centers were collected for survival analysis of prospectively enrolled cirrhosis patients hospitalized with an infection. We defined organ failures as 1) shock, 2) grade III/IV hepatic encephalopathy (HE), 3) need for dialysis and mechanical ventilation. Determinants of survival with these organ failures were analyzed. In all, 507 patients were included (55 years, 52% hepatitis C virus [HCV], 15.8% nosocomial infection, 96% Child score ≥ 7) and 30-day evaluations were available in 453 patients. Urinary tract infection (UTI) (28.5%), and spontaneous bacterial peritonitis (SBP) (22.5%) were the most prevalent infections. During hospitalization, 55.7% developed HE, 17.6% shock, 15.1% required renal replacement, and 15.8% needed ventilation; 23% died within 30 days and 21.6% developed second infections. Admitted patients developed none (38.4%), one (37.3%), two (10.4%), three (10%), or four (4%) organ failures. The 30-day survival worsened with a higher number of extrahepatic organ failures, none (92%), one (72.6%), two (51.3%), three (36%), and all four (23%). I-ACLF was defined as ≥ 2 organ failures given the significant change in survival probability associated at this cutoff. Baseline independent predictors for development of ACLF were nosocomial infections, Model for Endstage Liver Disease (MELD) score, low mean arterial pressure (MAP), and non-SBP infections. Independent predictors of poor 30-day survival were I-ACLF, second infections, and admission values of high MELD, low MAP, high white blood count, and low albumin.Using multicenter study data in hospitalized decompensated infected cirrhosis patients, I-ACLF defined by the presence of two or more organ failures using simple definitions is predictive of poor survival.
Invalidity benefit has been superseded by incapacity benefit
Authors: D. Snell
Journal: BMJ (1996)

It is not necessary for Toozs-Hobson and Car- dozo to claim that the whole female population is diseased in order to recommend prophylaxis; we recommend supplementation with folic acid for women before conception and in the first trimester without believing that they all have a dietary deficiency.There may well be a very good argu- ment for all postmenopausal women to take hormone replacement therapy, based on evidence of a favourable ratio of benefits to risks.For the women who are being recommended lifelong hormone replacement therapy, convincing arguments of this sort will be more persuasive than labelling a universal life event as a disease.
UK strategy is "opportunity to see health as a bridge to peace," says chief medical officer
Authors: C. White
Journal: BMJ (2008)

Doctors in the United Kingdom will find it easier to train and work in developing countries, if the government fulfils the remit of its ambitious global health strategy published this week. Furthermore, restrictions on the rights of overseas doctors to train in the UK could be relaxed.

Health is Global sets out how the government intends to improve the health and economic and political security of Britain’s citizens by tackling key health problems elsewhere in the world over the next five years.

The result of extensive collaboration among a wide range of domestic and international agencies …
<i>In Utero</i> and Lactational Exposures to Low Doses of Polybrominated Diphenyl Ether-47 Alter the Reproductive System and Thyroid Gland of Female Rat Offspring
Authors: Chris E. Talsness, Sergio N. Kuriyama, Anja Sterner-Kock, Petra Schnitker, Simone Wichert Grande, Mehdi Shakibaei, Anderson Andrade, Konstanze Grote, Ibrahim Chahoud
Journal: Environmental Health Perspectives (2007)

Polybrominated diphenyl ethers (PBDEs) are capable of disrupting thyroid hormone homeostasis. PBDE-47 (2,2',4,4'-tetrabromodiphenyl ether) is one of the most abundant congeners found in human breast adipose tissue and maternal milk samples.We evaluated the effects of developmental exposure to low doses of PBDE-47 on the female reproductive system.Pregnant Wistar rats were administered vehicle (peanut oil) or PBDE-47 [140 or 700 microg/kg body weight (bw)] on gestation day (GD) 6, or 5 mg 6-n-propyl-2-thiouracil (PTU)/L in the drinking water from GD7 through postnatal day (PND) 21.In female offspring sacrificed on PND38, there was a significant decrease in ovarian weight after exposure to PTU or 140 microg/kg PBDE-47. Alterations in folliculogenesis were apparent: we observed a decrease in tertiary follicles and serum estradiol concentrations in the offspring exposed to either PTU or 700 microg/kg PBDE-47. PTU exposure also resulted in a decrease in primordial follicles. On PND100, persistent effects on the thyroid glands included histologic and morphometric changes after exposure to either PTU or PBDE-47. No relevant changes in reproductive indices were observed after mating the exposed F1 females with nontreated males.Administration of PBDE-47 at doses relevant to human exposure led to changes in the rat female reproductive system and thyroid gland.
Puerperal Thromboembolism in Relation to the Inhibition of Lactation by Oestrogen Therapy
Authors: T. N. A. Jeffcoate, J. Miller, R. F. Roos, V. R. Tindall
Journal: BMJ (1968)

An analysis was made of 111 consecutive cases of puerperal thromboembolism by the age, parity, mode of delivery, and lactation habit of the women concerned, and the findings were compared with those from control groups. The statistics show that inhibition of lactation by means of ethinyloestradiol is associated with a threefold increase in thromboembolism, although the effect is seen mainly in women who have an operative delivery and who are aged more than 25 years. Among women aged more than 35 years who have an assisted delivery, inhibition of lactation is accompanied by a tenfold increase in the incidence of puerperal thromboembolism. Advancing age and operative intervention (especially caesarean section) are in themselves predisposing causes of deep venous thrombosis and embolism. They can also constitute indications for inhibiting lactation. This makes it difficult to assess whether the relation of thromboembolism to inhibition of lactation or to the administration of oestrogen is real or apparent. Doubts on the interpretation of the findings are raised by the fact that the number of fatal cases of puerperal thromboembolism in England and Wales, and of non-fatal cases in the hospitals under review, has not increased in recent years despite a progressive decrease in breast-feeding. Nevertheless, the evidence suggests that although the administration of ethinyloestradiol is not by itself enough to cause puerperal thromboembolism, it may be a factor which can tip the scales in women who are already predisposed to suffer this condition. Any thromboembolic hazard associated with administration of oestrogens for inhibiting lactation is probably acceptable except in women known to be at special risk by reason of age, operative delivery, obesity, and a past history of thromboembolic episodes.
Between Two Worlds: Filipinos in the U. S. Navy
Authors: DONALD F. DUFF, RANSOM J. ARTHUR
Journal: American Journal of Psychiatry (1967)

Psychiatric illness among Filipinos in the U. S. Navy usually appears as a stereotyped clinical syndrome in which hypochondriasis and paranoia are prominent. The authors suggest that the distinctive Filipino child-rearing practices and certain cultural concepts related to feelings of obligation and shame are crucial in the determination of this clinical picture. A better understanding of the cultural factors in psychiatric symptomatology may help the therapist to establish a more effective relationship with such patients.
PMO-056 Laparoscopic banded (silastic ring) sleeve gastrectomy: medium term outcomes
Authors: M Clarke, L Pearless, M Booth
Journal: Gut (2012)

<h3>Introduction</h3> Placement of a band of human dermis around the sleeve gastrectomy (SG) has previously been described to prevent late dilatation and weight regain. The aim of this study was to report our experience using a silastic ring placed around the SG. <h3>Methods</h3> 53 patients (male 15%, female 85%) with a mean (range) age of 46 (23–65) years and mean (SD) preoperative BMI of 37.6 (5.3) kg/m<sup>2</sup> underwent surgery between November 2006 and February 2010. The stomach was divided 3cm proximal to the pylorus. Orogastric bougie diameter was 36 French (November 2006–June 2008) or 32 Fr (thereafter). A 6.5–7 cm diameter silastic ring was placed around the mid-portion of the SG. A retrospective analysis was performed. <h3>Results</h3> All procedures were completed laparoscopically. Follow-up at 6 months, 1, 2 and 3 years was 96%, 92%, 87% and 47% respectively. Mean (SD) % excess weight loss at these time periods was 81.4 (25.6), 102.1 (27.3), 108.7 (38.2) and 97.5 (29.1) respectively. Mean (SD) weight loss at 2 years was 34.2(19.3) kg. 83% of patients demonstrated partial or complete resolution of their preoperative comorbidities including hypertension, diabetes, sleep apnoea and hyperlipidaemia. 17% developed new-onset reflux. 53% of patients required vitamin supplementation. Complications: Wound infection (1.8%), food bolus obstruction requiring endoscopy (3.8%) and silastic ring removal for food intolerance (7.5%). There were no deaths. <h3>Conclusion</h3> While the banded (silastic ring) SG is a safe procedure with good medium term excess weight loss and comorbidity resolution, around 11% of patients required endoscopic or surgical reintervention within 3 years. <h3>Competing interests</h3> None declared.
<sup>137</sup> Cesium Exposure and Spirometry Measures in Ukrainian Children Affected by the Chernobyl Nuclear Incident
Authors: Erik R. Svendsen, Igor E. Kolpakov, Yevgenia I. Stepanova, Vitaliy Y. Vdovenko, Maryna V. Naboka, Timothy A. Mousseau, Lawrence C. Mohr, David G. Hoel, Wilfried J.J. Karmaus
Journal: Environmental Health Perspectives (2010)

BackgroundAfter the Chernobyl accident in 1986, children of the contaminated Narodichesky region of Ukraine were obliged to participate in a yearly medical screening. They have been exposed to 137cesium (137Cs; half-life = 30 years) in contaminated soils, air, and food.ObjectiveUsing a "natural experiment" approach and a longitudinal prospective cohort study design, we investigated the association of soil 137Cs and spirometry measures for 415 children using 1,888 repeated measurements from 1993 to 1998.MethodsMean baseline village soil 137Cs measurements, which varied from 29.0 to 879 kBq/m2, were used as exposure indicators. A standardized spirometry protocol and prediction equations specific to Ukrainian children were used by the same pulmonologist in all screenings.ResultsChildren living in villages with the highest quintile of soil 137Cs were 2.60 times more likely to have forced vital capacity (FVC) < 80% of predicted [95% confidence interval (CI), 1.07–6.34] and 5.08 times more likely to have a ratio of forced expiratory volume in 1 sec (FEV1) to FVC% < 80% (95% CI, 1.02–25.19). We found statistically significant evidence of both airway obstruction (FEV1/FVC%, peak expiratory flow, and maximum expiratory flow at 25%, 50%, and 75% of FVC) and restriction (FVC) with increasing soil 137Cs.ConclusionsThese findings are unique and suggest significant airway obstruction and restriction consequences for children chronically exposed to low-dose radioactive contaminants such as those found downwind of the Chernobyl Nuclear Power Plant.
McDONAGH METHOD DISAVOWS MICRO-DYNAMICS
Authors: J. E. R. McDonagh
Journal: JAMA (1934)

<h3>To the Editor:—</h3> Your Bureau of Investigation rather belies its title in the reference it made to me and my work inThe Journal, January 6. I am unaware of any investigation it has made of my work, in which I have been engaged for nearly thirty years, and had it done so it would not have made the misstatements it has. Indeed,The Journalhas always steadfastly refused to review my books and has done everything possible to prevent my views from becoming known. Surely, investigation inside medicine would be more fruitful than outside medicine. If medicine rendered the public the service it should, there would be no room for quacks. If my attempts to place medicine on a sounder basis than it now stands are misjudged, it should be your duty to expose them before going further afield. But your refusal to deal with what you fear is
Increased elastin content and decreased elastin concentration may be predisposing factors in dissecting aneurysms of human thoracic aorta
Authors: M A. Cattell, P. S Hasleton, J. C Anderson
Journal: Cardiovascular Research (1993)

Objective: The aim was to investigate whether changes in elastin distribution in the thoracic aorta are associated with occurrence of dissecting aneurysms. Methods: Ten thoracic aortas were obtained at necropsy from dissections (mean patient age 74.3 years, SD 7.3) and from 10 age matched controls (mean age 73.1 years, SD 6.9). Full wall thickness samples (1 cm diameter) were taken at 12 sites between heart and diaphragm from aortas of dissections and controls. Elastin content (total elastin per sample), concentration (mg·mg−1 tissue dry weight), degree of cross linking, and amino acid composition were determined. Results: Comparison of areas of dissected aortas involved in dissection with corresponding areas of controls showed significant increases in content of elastin (p<0.05), content and concentration of proteins other than elastin and collagen (p<0.01), and a decrease in elastin concentration (p<0.01). Comparison of areas remote from dissection with corresponding areas in controls showed no significant differences except for decreased elastin concentration (p<0.05). There were no differences in elastin cross linking. Elastin from dissected aortas had a higher content of aspartate, threonine, serine, glutamate, and lysine and a lower content of glycine, alanine, and valine than elastin from controls (p<0.05). Conclusions: Biochemical changes in dissections are localised to the dissected area, with increased deposition of elastin, collagen, and other proteins. The altered matrix composition is likely to change the mechanical properties, possibly increasing the tendency to rupture. Cardiovascular Research 1993;27:176-181
Thinking About Rumination: The Scholarly Contributions and Intellectual Legacy of Susan Nolen-Hoeksema
Authors: Sonja Lyubomirsky, Kristin Layous, Joseph Chancellor, S. Katherine Nelson
Journal: Annual Review of Clinical Psychology (2015)

Our article reviews and celebrates Susan Nolen-Hoeksema's remarkable contributions to psychological and clinical science, focusing on her vast body of theoretical and empirical work and her influence on colleagues and students. Susan spent her career trying to understand how and why a style of regulating emotions called rumination increases vulnerability to depression and exacerbates and perpetuates negative moods. More broadly, we describe research by Susan and her colleagues on the predictors of depression in childhood and adolescence; gender differences in depression and rumination in adolescence and adulthood; roots, correlates, and adverse consequences of ruminative response styles; and rumination as a transdiagnostic risk factor for not only depression but also a host of psychological disorders, including anxiety, substance abuse, and eating disorders. Susan's intellectual legacy is evident in her impressive publication and citation record, the clinical applications of her work, and the flourishing careers of the students she mentored.
Pediatric severe asthma with fungal sensitization is mediated by steroid-resistant IL-33
Authors: Susana Castanhinha, Rebekah Sherburn, Simone Walker, Atul Gupta, Cara J. Bossley, James Buckley, Nicola Ullmann, Ruth Grychtol, Gaynor Campbell, Marco Maglione, Sergio Koo, Louise Fleming, Lisa Gregory, Robert J. Snelgrove, Andrew Bush, Clare M. Lloyd, Sejal Saglani
Journal: Journal of Allergy and Clinical Immunology (2015)

The mechanism underlying severe asthma with fungal sensitization (SAFS) is unknown. IL-33 is important in fungus-induced asthma exacerbations, but its role in fungal sensitization is unexplored.We sought to determine whether fungal sensitization in children with severe therapy-resistant asthma is mediated by IL-33.Eighty-two children (median age, 11.7 years; 63% male) with severe therapy-resistant asthma were included. SAFS (n = 38) was defined as specific IgE or skin prick test response positivity to Aspergillus fumigatus, Alternaria alternata, or Cladosporium herbarum. Clinical features and airway immunopathology were assessed. Chronic exposure to house dust mite and A alternata were compared in a neonatal mouse model.Children with SAFS had earlier symptom onset (0.5 vs 1.5 years, P = .006), higher total IgE levels (637 vs 177 IU/mL, P = .002), and nonfungal inhalant allergen-specific IgE. Significantly more children with SAFS were prescribed maintenance oral steroids (42% vs 14%, P = .02). SAFS was associated with higher airway IL-33 levels. In neonatal mice A alternata exposure induced higher serum IgE levels, pulmonary IL-33 levels, and IL-13(+) innate lymphoid cell (ILC) and TH2 cell numbers but similar airway hyperresponsiveness (AHR) compared with those after house dust mite exposure. Lung IL-33 levels, IL-13(+) ILC numbers, TH2 cell numbers, IL-13 levels, and AHR remained increased with inhaled budesonide during A alternata exposure, but all features were significantly reduced in ST2(-/-) mice lacking a functional receptor for IL-33.Pediatric SAFS was associated with more oral steroid therapy and higher IL-33 levels. A alternata exposure resulted in increased IL-33-mediated ILC2 numbers, TH2 cell numbers, and steroid-resistant AHR. IL-33 might be a novel therapeutic target for SAFS.
Diabetes Genes in Non-Insulin-Dependent Diabetes Mellitus
Authors: Jack L. Leahy, Aubrey E. Boyd
Journal: New England Journal of Medicine (1993)

Despite decades of investigation, the pathogenesis of non-insulin-dependent diabetes mellitus (NIDDM) remains one of the great mysteries of medicine. During the 1970s and 1980s there was substantial progress toward unraveling one part of the puzzle, the cellular mechanisms that cause the hyperglycemia. The answer has turned out to be surprisingly complex. Under normal circumstances, glucose homeostasis is a balance between glucose production by the liver and glucose clearance into peripheral tissues, primarily muscle. The beta cell is the regulator of the system; insulin release is constantly adjusted so that glucose production and clearance change in ways that maintain normoglycemia. In . . .
Dynamic Responses of Single Cardiomyocytes to Graded Ischemia Studied by Oxygen Clamp in On-Chip Picochambers
Authors: Vladimir Ganitkevich, Sibylle Reil, Brigitta Schwethelm, Thomas Schroeter, Klaus Benndorf
Journal: Circulation Research (2006)

Single mouse cardiomyocytes were exposed to defined ischemia. We designed chambers on glass chips with a volume of 192 pL (picochambers). After a picochamber was loaded with a single cardiomyocyte, P o 2 in the picochamber was equilibrated with that in the headspace, where it was controlled in the critical range between &lt;0.2 and 10 mm Hg. Because the extracellular fluid volume in a picochamber was restricted, these conditions are close to tissue ischemia. Responses of the sarcolemmal K ATP -channel current ( I KATP ), the production of reactive oxygen species (ROS), and the mitochondrial membrane potential (Δψ) of single cardiomyocytes to graded ischemia and, in particular, to rapid changes of the ischemic grade by defined oxygen steps were studied. The results show that I KATP is readily activated during ischemia and that the grade of ischemia tightly controls the amplitude of I KATP . Furthermore, maximal ischemia-induced I KATP was similar when it followed either reoxygenation or reperfusion, suggesting that there is no major autocrine modulation of maximal I KATP during ischemia. A P o 2 staircase from &lt;0.2 to 10 mm Hg increased the ROS signal, starting already at a P o 2 of ≈0.3 mm Hg. With a similar P o 2 staircase, Δψ first hyperpolarized and then, above 1 mm Hg, depolarized. The depolarizing response of Δψ at a P o 2 of &gt;1 mm Hg could be blocked by increasing the antioxidant defense with glutathione–monoethyl ester. It is concluded that in an ischemic cardiomyocyte I KATP is essentially controlled by P o 2 and that at low P o 2 Δψ is balanced by oxygen-induced hyperpolarization and ROS-induced depolarization.