tbuckley/cabot-search huggingface dataset:
Investigation of cutaneous photoadaptation to narrowband ultraviolet B
Authors: S. Darné, L.C. Stewart, P.M. Farr, P.J. Hampton
Journal: British Journal of Dermatology (2013)

Photoadaptation describes the skin's ability to withstand an increased dose of ultraviolet (UV) radiation with repeated exposure, and this is the reason for exposure doses being increased during a course of phototherapy. However, directly measured data on photoadaptation are available only for broadband (BB) and not narrowband (NB)‐UVB. To measure photoadaptation to narrowband UVB. We measured the degree of photoadaptation in patients with psoriasis during a standard course of NB‐UVB phototherapy. The minimal erythemal dose (MED) was measured before and towards the end of a course of phototherapy. An adaptation factor (AF) was calculated for each patient using the ratio of final MED to initial MED. Sigmoid dose–response curves were also constructed. MED results were available for 50 patients (mean age 44 years, 28 female). The mean AF was 2·7 (95% confidence interval 2·4–3·0). There was no significant correlation between AF and skin type or initial MED. Dose–response curves were right shifted and parallel after phototherapy, and there was no significant difference in the maximum slope (P = 0·73). The photoadaptation caused by NB‐UVB is considerably less than that reported for BB‐UVB. The variation in photoadaptation between patients was not explained by skin type or baseline MED. Physical factors (such as tanning and epidermal thickening) are probably sufficient to account for photoadaptation, rather than downregulation of the inflammatory response. These data should help in the design of phototherapy protocols for NB‐UVB to achieve optimal clearance of psoriasis.
UK drinking guidelines are better for the alcohol industry than the public
Authors: M. A. Bellis
Journal: BMJ (2011)

Barely a month passes without debate over illness relating to alcohol consumption, or its health benefits when consumed in moderation ( BMJ 2011;342:d671, doi:10.1136/bmj.d671; BMJ 2011;342:d3950, doi:10.1136/bmj.d3950; BMJ 2010;341:c5957, doi:10.1136/bmj.c5957). Health professionals as well as members of the public could be forgiven for being confused about how much to drink or how to advise others. For drinkers who wish to protect their own health one of the first ports of call is national drinking guidance (www.drinkaware.co.uk). Recent presentations of such guidance, however, are more likely to increase harms to health.

Many variations of this guidance can already be found on leaflets and websites. Typically it is stated that “men should not regularly drink more than 3-4 units of alcohol per day, and women should not regularly drink more than 2-3 units of alcohol per day. Regularly means drinking these amounts every day or most days of the week.” In supermarkets and on the national “drink aware” website you can find this guidance contorted from a daily maximum into a recommended …
Choosing treatment for metastatic breast cancer
Authors: R Stuart-Harris, A L Harris, I E Smith
Journal: BMJ (1983)

The membrane-associated palmitoylated protein 5 (MPP5 or PALS1) is thought to organize intracellular PALS1-CRB-MUPP1 protein scaffolds in the retina that are involved in maintenance of photoreceptor–Müller glia cell adhesion. In humans, the Crumbs homolog 1 (<i>CRB1</i>) gene is mutated in progressive types of autosomal recessive retinitis pigmentosa and Leber congenital amaurosis. However, there is no clear genotype–phenotype correlation for <i>CRB1</i> mutations, which suggests that other components of the CRB complex may influence the severity of retinal disease. Therefore, to understand the physiological role of the Crumbs complex proteins, especially PALS1, we generated and analyzed conditional knockdown mice for <i>Pals1</i>. Small irregularly shaped spots were detected throughout the PALS1 deficient retina by confocal scanning laser ophthalmoscopy and spectral domain optical coherence tomography. The electroretinography a- and b-wave was severely attenuated in the aged mutant retinas, suggesting progressive degeneration of photoreceptors. The histological analysis showed abnormal retinal pigment epithelium structure, ectopic photoreceptor nuclei in the subretinal space, an irregular outer limiting membrane, half rosettes of photoreceptors in the outer plexiform layer, and a thinner photoreceptor synaptic layer suggesting improper photoreceptor cell layering during retinal development. The PALS1 deficient retinas showed reduced levels of Crumbs complex proteins adjacent to adherens junctions, upregulation of glial fibrillary acidic protein indicative of gliosis, and persisting programmed cell death after retinal maturation. The phenotype suggests important functions of PALS1 in the retinal pigment epithelium in addition to the neural retina.
Serum Isoform [−2]proPSA Derivatives Significantly Improve Prediction of Prostate Cancer at Initial Biopsy in a Total PSA Range of 2–10 ng/ml: A Multicentric European Study
Authors: Massimo Lazzeri, Alexander Haese, Alexandre de la Taille, Joan Palou Redorta, Thomas McNicholas, Giovanni Lughezzani, Vincenzo Scattoni, Vittorio Bini, Massimo Freschi, Amy Sussman, Bijan Ghaleh, Philippe Le Corvoisier, Josep Alberola Bou, Salvador Esquena Fernández, Markus Graefen, Giorgio Guazzoni
Journal: European Urology (2013)
The Ideal Oncology Curriculum for Medical Students
Authors: Bogda Koczwara, Michael B. Barton
Journal: Journal of Clinical Oncology (2006)

TO THE EDITOR: We have read with interest the article by Gaffan and colleagues on educating undergraduate medical students about oncology. The authors focus on teaching methodology rather than curriculum content and comment that there is no consensus on what should be learned. The readers of the Journal of Clinical Oncology may be interested to know of the Ideal Oncology Curriculum, which provides some progress toward the consensus of what the content of cancer education should be. The Ideal Oncology Curriculum was developed in 1999 by an Oncology Education Committee of the Cancer Council of Australia—a multidisciplinary group of cancer clinicians and educators representing all medical schools in Australia, whose objectives are monitoring and improvement of standards of cancer education in Australian medical schools. The development of this consensusbased curriculum involved extensive consumer consultation across the country. Since then, the Ideal Oncology Curriculum has served as a basis of newly developed medical school curricula and as a guide to development of cancer teaching in other areas, for example, nurse practitioner training and professional development of cancer professionals. As Gaffan and colleagues point out, cancer teaching can be fragmented across disciplines with resulting risk of duplication or omission of cancer knowledge and skills. An Ideal Oncology Curriculum provides a comprehensive checklist for course design that allows adaptation to local conditions, as well as a checklist against which outcomes can be monitored. Perhaps evidence for the value of the Ideal Oncology Curriculum lies in its endorsement by the International Union Against Cancer and in the Curriculum’s similarities (albeit in the more limited version) to the recently developed American Society of Clinical Oncology Core Curriculum.
The Baseline ECG in the Evaluation of Acute Cardiac Complaints
Authors: Laurence Z. Rubenstein
Journal: JAMA (1980)

One reason for performing the ECG routinely on asymptomatic persons is to assist the physician in determining the need for hospitalization should acute cardiac symptoms later develop. To establish how often baseline ECGs are actually useful in this situation, we reviewed the records of 236 patients presenting to two emergency departments with the complaint of chest pain. Of these patients, 195 (82.7%) had clinical or ECG findings sufficiently diagnostic that the baseline ECG could not have affected the decision to hospitalize or discharge. For 11 patients (4.7%) with equivocal clinical and ECG findings, a baseline ECG (if it was available) might have been useful in avoiding an unnecessary hospitalization. There was no patient for whom a baseline ECG would have aided in avoiding an inappropriate discharge. The routine ECG has little value as a baseline for emergency comparison when patients later experience acute cardiac symptoms. Routine ECGs as baselines for future comparison should be reconsidered. (<i>JAMA</i>1980;244:2536-2539)
Inhibition of antibody-dependent lymphocyte cytotoxicity by homologous restriction factor incorporated into target cell membranes.
Authors: L S Zalman, L M Wood, H J Müller-Eberhard
Journal: The Journal of Experimental Medicine (1987)

The 65 kD homologous restriction factor (HRF) was isolated from normal human erythrocytes (E) by immunoadsorption using rabbit anti-human HRF. The protein was radiolabeled and incorporated into the membrane of sheep erythrocytes (Es). Es bearing HRF exhibited a markedly reduced susceptibility to reactive lysis by C5b-9. Es-HRF with 1,000-3,000 HRF molecules per cell and sensitized with rabbit IgG anti-Es also were less susceptible to lysis by human large granular lymphocytes (LGL) than untreated Es sensitized with IgG antibody. Similarly, human E of a patient with paroxysmal nocturnal hemoglobinuria (PNH), lacking HRF and sensitized with IgG antibody underwent lysis by human LGL. Lysis was abrogated by incorporation of isolated human HRF. Incorporation of human decay-accelerating factor (DAF) into sensitized Es had no effect on antibody-dependent, cell-mediated cytotoxicity. Furthermore, lysis of Es by the isolated cytolytic C9-related protein (C9RP) of human cytotoxic lymphocytes could be inhibited by cell bound human HRF. These results suggest that HRF inhibits channel formation not only by C5b-9, but also by cytotoxic lymphocytes.
A silk platform that enables electrophysiology and targeted drug delivery in brain astroglial cells
Authors: Valentina Benfenati, Stefano Toffanin, Raffaella Capelli, Laura M.A. Camassa, Stefano Ferroni, David L. Kaplan, Fiorenzo G. Omenetto, Michele Muccini, Roberto Zamboni
Journal: Biomaterials (2010)
Clinical Lecture on Chronic Basilar Meningitis
Authors: W. A. Hammond
Journal: BMJ (1873)

Much, therefore, as we may be tempted to adduce variations in the muscular system as additional arguments in favour of the evolution of ma and animals from a common origin, it is perhaps more philo- sophical to refrain for the present, and to leave the mind unfettered by the bias attendant upon the consideration of this great subject, which, in the present epoch of scientific inquiry, tends rather too much to engross the thoughts, and which sometimes casts too strong a shadow upon the work, and too obviously obscures the view, of the investigators of Nature. MUSCLES OF ABDOMEN.I will consider, first, the varieties in the muscles of the trunk, com- mencing with those of the abdomen.They are few and infrequent, in accordance with the simple disposition of these muscles, with their comparatively slight deviation from the primitive, unstratified, or par- tially stratified, transversely segmented layer, which we find in the Cryptobranch, and with the little variation in structure, associated with little variation in function, which they present in different animals.The most noteworthy varieties are the occasional persistence of in- scriptions in the obliquus externus in the neighbourhood of the lower ribs, and contiguous with their cartilages.In one of these inscriptions a piece of cartilage was found by Hence.It may seem rather remarkable that such inscriptions are not more frequently met with in this
Th-17, Monokines, Collagen Type V, and Primary Graft Dysfunction in Lung Transplantation
Authors: Joseph L. Bobadilla, Robert B. Love, Ewa Jankowska-Gan, Qingyong Xu, Lynn D. Haynes, Ruedi K. Braun, Mary S. Hayney, Alejandro Munoz del Rio, Keith Meyer, Daniel S. Greenspan, Jose Torrealba, Kathleen M. Heidler, Oscar W. Cummings, Takekazu Iwata, David Brand, Robert Presson, William J. Burlingham, David S. Wilkes
Journal: American Journal of Respiratory and Critical Care Medicine (2008)

Rationale: The pathogenesis of primary graft dysfunction (PGD), a serious complication of lung transplantation, is poorly understood. Human studies and rodent models have shown that collagen type V (col[V]), stimulates IL-17–dependent cellular immunity after lung transplantation.Objectives: To determine whether patients with end-stage lung disease develop pretransplant col(V)-specific cellular immunity, and if so, the impact of this response on PGD.Methods: Trans-vivo delayed-type hypersensitivity (TV-DTH) assays were used to evaluate memory T-cell responses to col(V) in 55 patients awaiting lung transplantation. PaO2/FiO2 index data were used to assess PGD. Univariate risk factor analysis was performed to identify variables associated with PGD. Rats immunized with col(V) or irrelevant antigen underwent lung isografting to determine if prior anti-col(V) immunity triggers PGD in the absence of alloreactivity.Measurements and Main Results: We found that 58.8% (10/17) of patients with idiopathic pulmonary fibrosis, and 15.8% (6/38) of patients without idiopathic pulmonary fibrosis tested while on the wait list for a lung transplant were col(V) DTH positive. Col(V) reactivity was CD4+ T-cell and monocyte mediated, and dependent on IL-17, IL-1β, and tumor necrosis factor (TNF)-α. PaO2/FiO2 indices were impaired significantly 6–72 hours after transplantation in col(V)-reactive versus nonreactive patients. Univariate risk factor analysis identified only preoperative TV-DTH to col(V) and ischemic time as predictors of PGD. Finally, in a rat lung isograft model, col(V) sensitization resulted in significantly lower PaO2/FiO2, increased local TNF-α and IL-1β production, and a moderate-to-severe bronchiolitis/vasculitis when compared with control isografts.Conclusions: The data suggest that activation of innate immunity by col(V)-specific Th-17 memory cells represents a novel pathway to PGD after lung transplantation.
Problems With Incentives
Authors: James S. Todd
Journal: JAMA (1990)

Few would argue that our current methods of financing and delivering health care are without severe problems and inadequacies. So much so that many (more out of despair than conviction) would scrap the whole model for the unknown consequences of what is perceived to be a more equitable and perhaps less expensive system. Most of those who espouse this concept argue that the only way to gain control of rising expenditures and the uninsured population is by converting to a single-source funding mechanism. This, they believe, will restore equity, equalize incentives, and guarantee health care to all without the interposition of personal financial considerations. Throughout much of these discussions, the issue of incentives and how to manipulate them assumes increasing importance. Some argue that the provision of adequate payment under any system will assure that care, sometimes of marginal value, will be given, but that at least the financial barrier
The Molecular Biology of RU486. Is There a Role for Antiprogestins in the Treatment of Breast Cancer?*
Authors: KATHRYN B. HORWITZ
Journal: Endocrine Reviews (1992)

ENDOCRINE therapy used either prophylactically or therapeutically for the treatment of locally advanced or metastatic breast cancers offers many advantages to patients whose tumors contain functional estrogen and progesterone receptors (ER and PR). The range of treatments defined as endocrine include surgical ablation of endocrine glands, administration of pharmacological doses of steroid hormones, chemical blockade of steroid hormone biosynthesis, and inhibition of endogenous steroid hormone action at the tumor with synthetic antagonists. The last of these approaches is the most widely used, making the antiestrogen tamoxifen the preferred first-line therapeutic agent for treatment of hormone-dependent metastatic breast cancer. The wide-spread use of tamoxifen reflects its efficacy and low toxicity, and the fact that it makes good physiological sense to block the local proliferative effects of estrogens directly at the breast. But are estrogens the only hormones with a proliferative impact on the breast and on breast cancers? This review focuses on evidence that progesterone also has proliferative actions in the breast; on the role of synthetic progestins in breast cancer treatment; on the molecular biology of progesterone antagonists; and on the preliminary data showing that progesterone antagonists may be powerful new tools for the management of metastatic breast cancer, because they block the local effects of endogenous progesterone on breast cell proliferation. The reader is also referred to the excellent general review on progestin regulation of cell proliferation by Clarke and Sutherland (1). The structures of the agonists and antagonists discussed in this review are shown in Fig. 1.
The Guinea Fowl
Authors: Thomas E. Elkins
Journal: JAMA (1985)

Several years ago, at a bush hospital in rural west Africa, a small boy was brought by his worried parents to see the visiting American physician. The child had begun coughing and wheezing during the previous week. Now, his every breath required great effort and resulted in a loud, wheezing, grating sound. Asthma and pneumonia were diagnosed without any trouble, and every available medication (aminophylline, steroids, antibiotics, epinephrine, β-blockers, intravenous fluid) was utilized. For five days, the 6-year-old child lay gasping with pleading eyes and whispered prayers. Nothing seemed to help, and oxygen and respirators were unknown in that part of the world. In a hospital where one nurse is responsible for 80 patients, IVs easily run dry at 2 AM. Even with a full hospital, the doctors come to the bedside two or three times each night to rewrite orders and to be sure that therapy is continuous.  On
Abnormal T cell function in early‐stage chronic lymphocytic leukemia (CLL) patients
Authors: Robert T. Perri, Neil E. Kay
Journal: American Journal of Hematology (1986)

Abstract Significant alterations in T cell subpopulations and function occur in chronic lymphocytic leukemia (CLL) patients. We studied whether abnormalities in peripheral blood T cell parameters were present in 15 untreated early stage CLL patients (ie, Rai stage 0, 1, 2). Seven of the nine patients showed decreased T helper support as compared to control T cells for pokeweed mitogen (PWM)‐induced control B cell proliferation (ie, patient 6,063 ± 1,434 cpm vs control 14,894 ± 121 cpm). All stage 0 and 1 patients showed a marked impairment of T helper activity for control B cell proliferation (patient T = 7,752 ± 1,137 cpm vs control T = 14,894 ± 121 cpm). In a separate assay system, six of nine CLL patients showed T suppressor activity for control B cell proliferation greater than control T cell suppressor activity. Four patients were stage 0 and 1. CLL patients demonstrated markedly impaired T cell support for control B cell immunoglobulin synthesis compared to control T cells (188 ± 28 vs 869 ± 56 hemolytic plaque‐forming cells (HePF)/culture, respectively). Control T cells showed increasing support for control B cell immunoglobulin synthesis with increasing T:B cell ratios (869 ± 56 vs 1,265 ± 48 HePFC/culture, at 1:1 and 2:1 T:B cell ratios, respectively). In contrast, five of eight CLL patients' T cells showed no improvement in control B cell immunoglobulin synthesis with increasing T:B cell ratios (795 ± 56 vs 569 ± 48 HePFC/culture, at 1:1 and 2:1 T:B cell ratios, respectively). There was no direct correlation with CLL T cellmediated suppression of B cell proliferation and suppression of B cell immunoglobulin synthesis. These studies suggest there is a complex array of abnormal immunoregulatory T cell function in early stage CLL. These include a prominent T helper dysfunction and more variable excessive suppressor activity. The relationship of these findings to the basic disease process remains to be elucidated.
H. H. HOLMES.
Authors: EUGENE S. TALBOT
Journal: JAMA (1896)

That Herman Webster Mudgett, better known as H. H. Holmes, was a criminal<i>par excellence</i>is beyond doubt, but how far and in what respects he was a degenerate, in the accepted sense of the term, is worthy of serious consideration. Few criminals have received more public attention, but despite this, many essential details of his history are wanting. Very little has been stated as to his heredity. He claims to have come from a respectable New England stock and to have been religiously and carefully brought up. As a boy he does not appear to have been a scapegrace, and no criminal charge is there on record against him. He married at 18 or 20 and commenced the study of medicine at Burlington, Vt. From there he went to the University of Michigan, where he claims to have graduated in medicine in 1884. According to his own account, after
Relation between localization of coronary artery disease and local abnormalities in ventricular activation during exercise tests.
Authors: H Igarashi, M Yamaki, I Kubota, K Ikeda, M Matsui, K Tsuiki, S Yasui
Journal: Circulation (1990)

To examine whether or not the location of local abnormalities on body surface isochrone maps reflects the site of myocardial ischemia, 48 coronary artery disease patients without myocardial infarction were studied. Eighty-seven unipolar electrocardiograms distributed over the anterior chest and the back were recorded simultaneously before and after the submaximal treadmill exercise. For each lead, the duration from the QRS onset to the time of the most rapid decrease in QRS voltage was measured (index of ventricular activation [IVA]). Based o the data provided by these 87 leads, IVA isochrone maps (IVA map) in preexercise and in postexercise, as well as IVA maps showing the difference between preexercise and postexercise, were constructed. The IVA was defined as abnormal when it exceeded (mean + 2 SD) the normal range. We called the area with the abnormal IVA, the "+2SD area." In patients having a stenosis in the left anterior descending artery, the +2SD area in each map was located mainly on the left anterior chest, whereas in patients having a stenosis in the right coronary artery, the +2SD area in each map was located mainly on the right lower thoracic surface. Moreover, the +2SD area of patients with both left anterior descending and right coronary artery disease appeared on both the left anterior chest and the right lower thoracic surface. In patients with left circumflex artery disease, however, the location of the +2SD area did not suggest a stenotic site because of its small population. On the other hand, it was difficult to determine the ischemic site from the body surface distribution of ST segment depression.(ABSTRACT TRUNCATED AT 250 WORDS)
Early Revascularization in Cardiogenic Shock — A Positive View of a Negative Trial
Authors: Thomas J. Ryan
Journal: New England Journal of Medicine (1999)

During the past two decades, revolutionary changes in our understanding of both the pathogenesis and the treatment of acute myocardial infarction have resulted in impressive gains in survival among patients hospitalized for this condition. The notable exception to the overall 25 to 35 percent relative reduction in early mortality that has occurred as a result of myocardial reperfusion1 is among patients in whom myocardial infarction is complicated by cardiogenic shock. Such patients make up 7 to 10 percent of the patients hospitalized for acute myocardial infarction. Characterized by hypotension and organ hypoperfusion, cardiogenic shock has an estimated mortality rate of . . .