tbuckley/cabot-search huggingface dataset:
Sausage Cyanosis — Acquired Methemoglobinemic Nitrite Poisoning
Authors: Suraj P. Bakshi, John L. Fahey, Lawrence E. Pierce
Journal: New England Journal of Medicine (1967)

KISZKA (kish-ke), or blood sausage, is a common table food among Polish nationals in western New York. It is composed of fresh pork and a coarse cereal filler to which beef blood, seasonings and both sodium nitrite and nitrate are added before the mixture is stuffed into casing. Five patients with unexplained sudden cyanosis with "cardiovascular collapse" shortly after ingestion of sausage have been admitted to regional hospitals. The purpose of this report is to describe another patient in whom more intensive investigation gave indirect evidence that nitrite poisoning was responsible for methemoglobinemic cyanosis.Case ReportA 48-year-old factory worker . . .
THE EXPANSION OF GYNECOLOGY, AND A SUGGESTION FOR THE SURGICAL TREATMENT OF INCONTINENCE OF URINE IN WOMEN.
Authors: E. C. DUDLEY
Journal: JAMA (1905)

The general law that progress in any direction is characterized by specialization, with its attendant classification and simplicity, has been exemplified in no great movement more strongly than in the development of the medical profession during the last three decades. The late Samuel D. Gross, foremost general surgeon of his day, after a long period of active service as author, teacher and practitioner, writing the preface to the sixth edition of his System of Surgery in October, 1882, thus early gives credit to specialization for the unparalleled advances in modern surgery. Specialization, he says in substance, has penetrated with its methods and instruments of research the innermost recesses of the human body, and in a comparatively brief period has achieved triumphs which general surgery perhaps never would have accomplished. In the earlier period when the specialist confined himself to a particular organ, disregarding its relations to the general system, when
Target for Thyroid Cancer
Authors: Tracy Hampton
Journal: JAMA (2012)

Thyroid tumors carrying mutations in the BRAF gene depend on the mutant protein produced by the gene, and inhibiting the gene leads to tumor regression in mice, a new study shows (Chakravarty D et al. J Clin Invest. doi:10.1172/JCI46382 [published online November 21, 2011]).
Opposing Actions of Glucagon and Insulin on Splanchnic D Cell Function
Authors: Koichi Kawai, Roger H. Unger
Journal: Journal of Clinical Investigation (1983)

The effect of glucagon at various infusion rates on plasma levels of somatostatin-like immunoreactivity (SLI) was examined in conscious normal and chronic alloxan diabetic dogs. In normal dogs glucagon infused at 6, 36, and 120 ng/kg per min did not affect the peripheral venous plasma SLI levels. In diabetic dogs, however, peripheral venous plasma SLI levels in inferior vena cava rose significantly from a mean base-line value of 181±9 pg/ml to a peak value of 279±38 pg/ml during the infusion of 120 μg/kg per min of glucagon, which raised plasma immunoreactive glucagon to >5,000 pg/ml. This glucagon-mediated increase was completely abolished by coinfusion of 7 mU/kg per min of insulin, a rate that maintained the ratio of insulin to glucagon at approximately the baseline value.
The Survivors of Cardiac Arrest
Authors: Richard G. Druss
Journal: JAMA (1967)

Ten survivors of a cardiac arrest who had been treated in a cardiac monitor unit were studied by psychiatric interviews six weeks or more after arrest. Not a single patient could face the full implications of the arrest and called forth various defense mechanisms to control the anxiety evoked by this experience. Frightening and violent dreams belied their often tranquil appearance. The patients developed various theories and explanations to enable them to integrate the experience of "having been dead and reborn." The arrest survivors as well as ten comparative patients without arrest who had been treated in the same monitor unit showed long-standing emotional problems including insomnia, irritability, and a restriction of their activities often beyond what was medically appropriate.
NPARM in PHOX2B: why some things just should not be expanded
Authors: Michael D. Gershon
Journal: Journal of Clinical Investigation (2012)

Although the neural crest and its derivatives have been studied for a very long time, disorders of derivatives of the crest, the neurocristopathies, are not well understood. In this issue of the JCI, Nagashimada et al. provide an elegant analysis of one neurocristopathy, the association of neuroblastoma (NB) with Hirschsprung disease (HSCR) (aganglionosis of the terminal bowel) and congenital central hypoventilation syndrome (CCHS) (also known as NB-HSCR-CCHS), linked to mutations in PHOX2B. In a mouse model, Nagashimada et al. demonstrate that a disease-linked mutation promotes tumorigenesis and disrupts neurogenesis, sympathetic gangliogenesis, and crest cell colonization of the terminal bowel. They also show that mutant PHOX2B results in decreased proliferation of crest-derived cells and the development of glia at the expense of neurons. The work raises intriguing issues about the possible common origin of sympathetic and enteric nervous systems and provides new hope that we may someday understand the vexing abnormalities in gastrointestinal function that persist after the surgical treatment of HSCR.
Variation within Genes Encoding Interleukin-1 and the Interleukin-1 Receptor Antagonist Influence the Severity of Meningococcal Disease
Authors: Robert C. Read, Chris Cannings, Simone C. Naylor, Janine M. Timms, Ravi Maheswaran, Raymond Borrow, Edward B. Kaczmarski, Gordon W. Duff
Journal: Annals of Internal Medicine (2003)

Background: Genetically determined variation in proinflammatory cytokine release influences severity of meningococcal disease and other serious infections. Objective: To ascertain the relative frequencies of single nucleotide polymorphisms within the interleukin-1 gene locus among patients who survived and those who died of meningococcal disease and a control population of blood donors. Design: Association study. Setting: England and Wales. Patients: 1106 consecutively received blood samples from persons with microbiologically confirmed meningococcal disease and 839 samples from blood donors. Measurements: Patient demographic and outcome data, infecting meningococcal serogroups, and genotype at the IL1B(511) and IL1RN(+2018) loci of patients and blood donor controls. Results: Genotype frequency did not differ between patients with meningococcal disease and blood donor controls. Logistic regression analysis revealed that the likelihood of death was significantly influenced by age but not socioeconomic status and was higher in patients who were infected with serogroup C (odds ratio for survival, 0.50 [95% CI, 0.33 to 0.78]). Patients carrying the common allele at IL1B(511) were more likely to survive (odds ratio, 2.01 [CI, 1.11 to 3.79]). Patients with this allele were less likely to survive if they also carried the rare allele at IL1RN(+2018) (odds ratio, 0.61 [CI, 0.38 to 0.993]). Conclusion: Genotype at the interleukin-1 gene locus influences likelihood of survival of meningococcal disease but has no effect on susceptibility to the infection. Increasing age and infection with serogroup C also influence the likelihood of death.
Transfusion of Hepatitis B Surface Antigen—Positive Plasma
Authors: Massumeh Telischi
Journal: JAMA (1980)

A STUDY by Seeff and colleagues<sup>1</sup>established the effectiveness of hepatitis B immune globulin (HBIG) for immune prophylaxis in persons exposed to known infectious inocula. Studies in other laboratories<sup>2-4</sup>also showed effective protection by HBIG in preventing or delaying overt viral hepatitis B after accidental exposure to hepatitis B virus (HBV). Accordingly, prophylactic injection of HBIG for persons working in high-risk environments was recommended. The Public Health Service Advisory Committee on Immunization Practice recommended a two-dose schedule of HBIG treatments for individuals exposed to a single inoculum of hepatitis B surface antigen (HBsAg)-contaminated material.<sup>5</sup>A study by Klein et al<sup>6</sup>supported the two-dose schedule, rather than a single dose, when the initial dose of globulin was the same. We describe a patient who was effectively treated with HBIG after being accidentally transfused with a unit of HBsAg-positive plasma. At the time we were not aware of a
THE SOURCE OF THE LYMPHOCYTOSIS INDUCED BY MEANS OF HEAT
Authors: Waro Nakahara
Journal: The Journal of Experimental Medicine (1919)

A striking number of mitotic figures have been observed in the germinal center of the spleen and lymph glands during the regeneration of the cellular elements of these organs after the destructive effect of heat. This enhanced cell proliferation is interpreted as more than compensating for the degenerated cells, because of the subsequent enlargement of the organs. It has also been pointed out that the characteristic decrease in the number of lymphocytes immediately after the heat treatment is always accompanied by an extensive cell degeneration in spleen and lymph glands at the corresponding period. On this basis it seems evident that the pronounced lymphocytosis induced by means of heat treatment of the animal is due, at least in part, to the enhanced proliferative activity of germinal centers in the spleen and lymph glands, reacting to the destructive effect of heat upon lymphoid cells.
Hemostatic Function and Coronary Artery Disease
Authors: Anders Hamsten
Journal: New England Journal of Medicine (1995)

Until recently, our understanding of the role of hemostatic factors in coronary artery disease was based primarily on cross-sectional studies, epidemiologic observations, and cross-cultural comparisons. In the past several years, however, the information derived from prospective epidemiologic studies has expanded considerably. Simultaneously, cell and molecular biologic studies have revealed some of the mechanisms that regulate the plasma levels and biologic activity of hemostatic proteins.The first two reports from the Northwick Park Heart Study, published in 1980 and 1986,1,2 demonstrated strong, independent associations of base-line plasma fibrinogen concentrations and factor VII coagulant activity with the risk of subsequent coronary . . .
Autoreactive T cells to platelet GPIIb-IIIa in immune thrombocytopenic purpura. Role in production of anti-platelet autoantibody.
Authors: M Kuwana, J Kaburaki, Y Ikeda
Journal: Journal of Clinical Investigation (1998)

T cell proliferative responses to platelet membrane GPIIb-IIIa were examined in 14 patients with chronic immune thrombocytopenic purpura (ITP), 7 systemic lupus erythematosus (SLE) patients with or without thrombocytopenia, and 10 healthy donors. Although peripheral blood T cells from all subjects failed to respond to the protein complex in its native state, reduced GPIIb-IIIa stimulated T cells from three ITP patients and one SLE patient with thrombocytopenia, and tryptic peptides of GPIIb-IIIa stimulated T cells from nearly all subjects. The specificity of the responses for GPIIb-IIIa was confirmed by activation of GPIIb-IIIa-primed T cells by a recombinant GPIIbalpha fragment in secondary cultures. Characterization of T cell response induced by modified GPIIb-IIIa showed that the response was restricted by HLA-DR, the responding T cells had a CD4(+) phenotype, and the proliferation was accelerated only in ITP patients, suggesting in vivo activation of these T cells. In vitro IgG anti-GPIIb-IIIa synthesis in PBMC cultures was induced by modified GPIIb-IIIa specifically in ITP patients with platelet-associated anti-GPIIb-IIIa antibody. Anti-GPIIb-IIIa antibody produced in supernatants was absorbed by incubation with normal platelets. In summary, CD4(+) and HLA-DR-restricted T cells to GPIIb-IIIa are involved in production of anti-platelet autoantibody in ITP patients and are related to the pathogenic process in chronic ITP.
George Felix Macdonald Hall
Authors: Wendy Gray
Journal: BMJ (2006)

​FormerFormer consultant histopathologist Nottingham General Hospital (b 1919; q Bristol 1942; MD, FRCPath), died from cardiovascular disease and heart failure on 3 September 2006.



Figure 1



George Hall's early medical career was interrupted by the second world war, when he was drafted into the Royal Navy as a surgeon lieutenant and served for two years in naval hospitals in north Africa and Malta. After demobilisation he pursued his career interest in pathology, being senior lecturer in morbid anatomy at King's College Hospital, London, until 1953, when he became consultant histopathologist at Nottingham General Hospital. Early interests included a thesis on diabetic nephropathy. He was one of the first to recognise and promote knowledge of the possible risks of deep venous thrombosis with use of the contraceptive pill. Predeceased by his wife, Diana, in 2002, he leaves two children and four grandchildren.
Ordering the chaos for patients with multimorbidity
Authors: J. L. Haggerty
Journal: BMJ (2012)

Building continuity of care takes work but earns trust 

Estimates of the prevalence of multimorbidity vary according to how it is measured, but studies agree that prevalence is rising and that it increases precipitously with age.1 By middle age, multimorbidity is the new normal. The first article in this editorial series on multimorbidity highlighted the difficulty of achieving evidence based targets for multiple diseases in a single patient.2 Treating all of a patient’s diseases optimally represents a considerable management burden for the patient and can result in a chaotic experience of care. Barbara Starfield defined relational continuity in primary care as person focused care over time, and such an approach is needed for patients with multimorbidity, rather than the more traditional one of managing diseases.3 But how can continuity of care be achieved for patients with multimorbidity?

Continuity of care is most commonly defined as a connected and coherent series of healthcare events, or seamless care.4 For the healthcare professional, this means having all the necessary information about the patient at the point of care (informational continuity) and coordinating actions with other providers to deliver services in a complementary and timely manner along a recommended care pathway (management continuity). Connectedness matters for healthcare professionals because it translates into technical quality of …
Current Results in Treatment of Tuberculous Meningitis and Miliary Tuberculosis
Authors: J. Lorber
Journal: BMJ (1956)

The purpose of this paper is to present the results of treatment of tuberculous meningitis in children who were admitted to the Children's Hospital, Sheffield, during 1954.Fifteen of these were admitted to the pro- fessorial unit, while five were under the care of Dr. T. Colver.The study is a direct continuation of earlier work (Illingworth and Lorber, 1951 ;Lorber, 1951; Lorber, 1954aLorber, , 1954b).In the last paper I reported the results of a controlled therapeutic trial in which the use of isoniazid was compared with that of streptomycin and P.A.S., and in which all patients received a minimum of 45 intrathecal streptomycin injections.
What Mr. Lansley could have learnt from the past
Authors: Rudolf Klein
Journal: Journal of the Royal Society of Medicine (2012)

There is only one reasonably confident conclusion that can be drawn from the history of the successive waves of reform that have swept over the National Health Service in England in recent decades. This is that both the (few) proponents of Secretary of State for Health, Andrew Lansley’s package and the (many) opponents may well be disappointed in their predictions. Neither Lansley’s vision of a transformed NHS, nor his critics’ nightmare of a service stumbling towards collapse is likely to materialize. For evidence in support of this contention, there is no need to look further than the Journal of Health Services Research and Policy’s latest supplement. This brings together the results of the research, commissioned by the Department of Health’s Health Reform Evaluation Programme (HREP), that explored the impact of Labour’s market reforms in the years from 2002 to 2010. The evidence, as summarized in the introduction to the collection shows that:
Polymorphisms of α-adducin and salt sensitivity in patients with essential hypertension
Authors: Daniele Cusi, Cristina Barlassina, Tiziana Azzani, Girgio Casari, Lorena Citterio, Marcella Devoto, Nicola Glorioso, Chiara Lanzani, Paolo Manunta, Marco Righetti, Rodolfo Rivera, Paola Stella, Chiara Troffa, Laura Zagato, Giuseppe Bianchi
Journal: The Lancet (1997)
THE PRACTICE OF MEDICINE AND SURGERY BY UNQUALIFIED PERSONS
Authors: J. H. Taylor
Journal: BMJ (1911)

THERE probably never was a time when the State through the local health -authorities made more numerous and more praiseworthy efforts for improving the general health of the community, and yet at the same time showed such a curious neglect of a few plain facts that go a long way towards neutralizing its own efforts.One can hardly be much surprised at this after reading the report recently issued from the Privy Council Office as to the " practice of medicine and surgery by unqualified persons in the United Iiingdom."A more incomplete report has rarely been issued from any public department, for, while on the one hand it contains practically but liLle&information as to the extent and effects-of unqualified praotice on.thepublic health beyond what any man of the street could have put together with little trouble,' on the other hand the replies of several of the medical officers of health to the questions addreseed to them were evidently written without havingmade any.aerious attempt to obtain first-hand information.As explained in the preface to the report, it originated in a resolution passed in November, 1908, by the General Medioal -Council to the effect ' that the General Medical Council being of opinion that the present Medioal Acts do not sufficiently enable persons requiring medical-aid distinguish qualified from unqualified practitionere, and that it' is contrary to the interest of the public that medical -and sBurgicl practice should be carried on, with impunity.by persons holding no recognized qualification, request the Government to take steps for the appointmentof dd Royal.Commission to inquire into the evil effects produced by the unrestricted practice of medi- cine and surgery by unqualified persons."-Onreceipt of this resolation thei Privy Council sent copies of it to the Local Governmenti Board, the Scottish Office,-and the Irish Government, and asked that' medical officers of health should be invited to give their opinions as to whether unqualified practice was assuming larger pro- portions and as to the effect on-the public health.Thi% was done and repliesF were received from over 1.600.miedical officers of health in England and Wales and fiom a considerable number in Scotland and Ireland.A more
New drugs in respiratory disorders.
Authors: D J O'Donoghue
Journal: BMJ (1983)

They should be.This would increase the scope for honest and constructive debate in the medical, scientific, and lay press and would offset the misleading messages in the media.In conclusion, it seems that the main value of the yellow card system is that it shows that something is being done and this affords some protection to the minister.It offers useful information on the less serious adverse reactions, but more often than not misses the big ones.For these, which are infrequent, additional action is needed to protect patients along the lines indicated in my final conclusions to the series.
Colonic bacterial activity and serum lipid risk factors for cardiovascular disease
Authors: David J.A. Jenkins, Vladimir Vuksan, A. Venketeshwer Rao, Edward Vidgen, Cyril W.C. Kendall, Nauman Tariq, Pierre Würsch, Brigitte Koellreutter, Nalini Shiwnarain, Roger Jeffcoat
Journal: Metabolism (1999)
Cyproheptadine Effects on Pituitary Function
Authors: LOREN I. DOLMAN
Journal: Annals of Internal Medicine (1979)

Letters and Corrections1 December 1979Cyproheptadine Effects on Pituitary FunctionLOREN I. DOLMAN, M.D.LOREN I. DOLMAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-91-6-927_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The report of Wortsman and colleagues in the June issue (1) concludes that cyproheptadine in a dose of 16 to 24 mg/d for 8 to 16 weeks can effectively lower serum prolactin (PRL) levels and decrease symptomatic galactorrhea in patients with the galactorrhea-amenorrhea syndrome.In 1976 we were interested in the antiserotonin properties of cyproheptadine, noting evidence that serotonin probably plays a role in the release of pituitary PRL, growth hormone, and ACTH, as well as suppression of thyroid-stimulating hormone, luteinizing hormone, and follicle-stimulating hormone. The effects of the drug in suppressing ACTH release in Cushing's disease...References1. WORTSMANSOLERHIRSCHOWITZ JNJ. Cyproheptadine in the management of the galactorrhea-amenorrhea syndrome. Ann Intern Med. 1979;90:923-5. LinkGoogle Scholar2. KRIEGERAMOROSALINICK DLF. Cyproheptadine-induced remission of Cushing's disease. N Engl J Med. 1975;293:893-6. CrossrefMedlineGoogle Scholar3. DOLMANJUBIZTYLER LWF. Effects on cyproheptadine on hormone levels in normals and patients with hormone overproduction. In: International Society of Psychoneuroendocrinology: VIIth International Congress, July 13-16, 1976, Strasbourg, France, p. 76. Abstract. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: LOREN I. DOLMAN, M.D.Affiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCyproheptadine-Induced Remission of Cushing's Disease Due to Pituitary Basophil AdenomaEffect of cyproheptadine on chlorpromazine stimulation of prolactin in women 1 December 1979Volume 91, Issue 6Page: 927-927KeywordsAdrenocorticotropic hormoneDrugsFollicle-stimulating hormoneGrowth hormoneLuteinizing hormoneProlactinSerotoninThyroid-stimulating hormone ePublished: 1 December 2008 Issue Published: 1 December 1979 PDF downloadLoading ...
Chemical castration for sex offenders
Authors: D. Grubin, A. Beech
Journal: BMJ (2010)

Doctors should avoid becoming agents of social control

In November 2009, in response to several high profile sex offences committed against children, Polish President Lech Kaczynski signed a law allowing for the compulsory treatment of some sex offenders with antiandrogenic drugs, commonly referred to as chemical castration. Following a sexual killing carried out by a repeat sex offender in France, the French National Assembly is considering legislation that would make chemical castration mandatory for some sex offenders. Laws in several American states allow compulsory medical treatment of offenders who have committed serious sex offences. Chemical, as well as physical, castration of sex offenders takes place in psychiatric hospitals in the Czech Republic under the legal framework of “protective treatment.” Meanwhile, in England the Department of Health is supporting an initiative to facilitate the prescription of drugs on a voluntary basis for sex offenders in the criminal justice system.1

Demand for the prescription of antiandrogens or physical castration for sex offenders is a common reaction by lawmakers and politicians when a high profile sexual crime is committed. Although castration is ostensibly for public protection, it also carries with it a sense of symbolic retribution. Whether medical or surgical, the procedure requires the participation of doctors, and this gives rise to questions regarding the basis of medical involvement. Some people …