tbuckley/cabot-search huggingface dataset:
An Investigation of Tropical Splenomegaly at Mulago Hospital, Kampala, Uganda
Authors: P. D. Marsden, M. S. R. Hutt, N. E. Wilks, A. Voller, V. Blackman, K. K. Shah, D. H. Connor, P. J. S. Hamilton, J. G. Banwell, H. F. Lunn
Journal: BMJ (1965)

<h3>Abstract</h3> <b>Problem</b> The hospital based musculoskeletal service in northwest Wales was unable to cope with the demand for referrals from general practitioners. Waiting times were long, duplicate referrals to other departments were common, and general practitioners were reluctant to refer patients with common problems because of the perceived lack of service. Many referrals were made to the inappropriate specialty, especially orthopaedics. At least part of this problem was due to a lack of coordination between the four hospital departments providing musculoskeletal services and the emphasis on district general hospital based rather than community provision. <b>Design</b> Review over 18 months of impact of the targeted early access to musculoskeletal services (TEAMS) programme on accessibility to musculoskeletal services. <b>Setting</b> Northwest Wales. <b>Key measures for improvement</b> Number of patients referred and seen with musculoskeletal problems, waiting times, number of duplicate referrals, and surgery conversion rates in orthopaedic clinics. <b>Strategies for change</b> Establishing with central clinical triage a common pathway for all musculoskeletal referrals so that patients attend the appropriate department. A back pain pathway led by extended scope physiotherapists was developed, and general practitioners with special interests and extended scope physiotherapists were trained to provide services for patients with uncomplicated musculoskeletal problems in the community. <b>Effects of change</b> Over 18 months the number of referrals more than doubled. Despite this, waiting times for musculoskeletal services fell; this was noticeable for rheumatology and pain management. Duplicate referrals were abolished. Surgery conversion rates did not, however, change. Questionnaires from the clinics showed a high level of patient satisfaction. <b>Lessons learnt</b> Integration of hospital services that traditionally have worked in isolation can result in greatly improved access to musculoskeletal services. Community based multidisciplinary clinics run by specially trained general practitioners with special interests and extended scope physiotherapists are an effective way of managing patients with uncomplicated musculoskeletal problems and have been well received by patients and general practitioners. The huge unmet burden of need was reflected by the great increase in musculoskeletal referrals. Other approaches are needed to meet this, including better education of general practitioners and methods for identifying and modifying psychosocial risk factors for chronic pain at an early stage.
Health and money
Authors: Laxmi Vilas Ghimire
Journal: BMJ (2006)

A man in his early 30s was admitted for severe head injury after a fall from height. He was brought to Tribhuvan University Teaching Hospital, a tertiary centre for neurosurgical care. During admission he was hemiplegic and had even lost the power of speech. After surgical intervention, his power over his limbs slowly improved and he began speaking a few words. He and his wife were delighted with his improvement, and he was always eager to greet the surgical team during the morning ward round. After four weeks, the neurosurgical team planned to discharge him, and the patient …
Images of Healing
Authors: Daniel F. Battafarano
Journal: Annals of Internal Medicine (2011)

On Being a Doctor6 December 2011Images of HealingDaniel F. Battafarano, DODaniel F. Battafarano, DOFrom Brooke Army Medical Center, San Antonio, TX 78232-6272.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-11-201112060-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail One Sunday morning, I had just completed ward rounds. I heard a page overhead that chapel services would begin in less than 5 minutes. My to-do list was short, so I decided to attend. The chapel at Brooke Army Medical Center is simple, with 10 rows of chairs fanning out on either side and a row along the back wall. When I arrived, the congregation was singing the opening hymn to organ music, and the chaplain was at the altar. Because there were no open seats, I stood by the back entrance. My thoughts were still focused on medical problems ... Author, Article, and Disclosure InformationAffiliations: From Brooke Army Medical Center, San Antonio, TX 78232-6272.Disclaimer: The opinions in this essay do not constitute endorsement by Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Army, Department of Defense, or the U.S. Government of the information contained therein.Corresponding Author: Daniel F. Battafarano, DO, Brooke Army Medical Center, MCHE-MDR, 3851 Roger Brooke Drive, San Antonio, TX 78232-6272; e-mail, daniel.[email protected]army.mil. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 6 December 2011Volume 155, Issue 11Page: 792KeywordsBurnsHispanic peopleInfantsKneesMemoryShouldersSkullSurgeonsWalkingWheelchairs ePublished: 6 December 2011 Issue Published: 6 December 2011 Copyright & PermissionsCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Linus Pauling: A Life in Science and Politics
Authors: M. Teich
Journal: BMJ (1996)

Ted Goertzel, Ben Goertzel Basic Books (Harper Collins) £18.99, pp 300 ISBN 0 465 00672 8

Among 20th century scientists Linus Pauling (1901-94) occupies a conspicuous position. For one thing, he was a recipient of two Nobel prizes, for chemistry (1954) and peace (1962), and the authors of this highly readable, unauthorised, biography tell us that “he felt he deserved a third.”

It is also a useful book for understanding the politics—in the broadest sense of the word—of the Nobel prize awards. Pauling was given the Nobel prize in chemistry for “research into the nature of the chemical bond and its application to …
Let psychiatric and biomedical lobbies be heard equally in CFS/ME research
Authors: C. Davis
Journal: BMJ (2011)

Raised voices don’t help,1 but they are understandable when the Medical Research Council has funded no biomedical research into chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) for 30 years. For most patients, ME means several decades of just surviving, achieving nothing, and being ridiculed by the media and often by friends and family simply for being ill.

You talk …
Regulation of Renal Cortex Ammoniagenesis I. STIMULATION OF RENAL CORTEX AMMONIAGENESIS IN VITRO BY PLASMA ISOLATED FROM ACUTELY ACIDOTIC RATS
Authors: George A. O. Alleyne, Anne Roobol
Journal: Journal of Clinical Investigation (1974)

We studied the acute renal metabolic response in rats made acidotic by a single oral dose of ammonium chloride. Cortical slices from acutely (2-h) acidotic rats utilized more glutamine and produced more ammonia and glucose from glutamine than slices from normal animals. When cortical slices from normal rats were pretreated in vitro with plasma isolated from acutely acidotic rats, they achieved similar increases in glutamine utilization, ammonia formation, and gluconeogenesis from glutamine. We did not observe such stimulation in normal cortical slices pretreated in a low pH-low bicarbonate medium. Our data show that a nondialysable factor is present in plasma from acutely acidotic rats that may be responsible for the early increase in the urinary ammonia observed in such animals.
Effect of the prokinetic agent, erythromycin, in the richardson ground squirrel model of cholesterol gallstone disease
Authors: Qi-Wei Xu, Brent R. Scott, Daimen T. M. Tan, Eldon A. Shaffer
Journal: Hepatology (1998)

Impaired gallbladder motility and delayed intestinal transit contribute to cholesterol gallstone formation by impeding the enterohepatic circulation of bile salts and causing gallbladder stasis. The therapeutic value of erythromycin, a prokinetic motilin analog, was evaluated in an animal model of gallstone formation. Eighty ground squirrels were fed either a trace- (control) or a high- (1%) cholesterol diet. Half of each diet group received either erythromycin stearate or placebo orally twice daily for 4 weeks. Biliary lipid secretion and bile salt pool size were determined via common duct cannulation. Gallbladder contractile response to cholecystokinin (CCK) was studied in vitro . Intestinal transit was evaluated in vivo by 51 Cr marker. In the placebo-treated group, fed the high- versus the trace-cholesterol diet, bile salt secretion decreased (trace-cholesterol + placebo, 21.0 ± 1.8 nmol/min/g liver vs. high-cholesterol + placebo, 9.3 ± 1.4 nmol/min/g liver), cholesterol saturation index (CSI) doubled (trace-cholesterol + placebo, 0.61 ± 0.06 vs. high-cholesterol + placebo, 1.30 ± 0.04), nucleation time shortened (trace-cholesterol + placebo, &gt;21 days vs. high-cholesterol + placebo, 6.4 ± 1.0 days), cholesterol crystals formed, gallbladder contractility diminished, and intestinal transit was delayed (each P &lt; .05). Erythromycin treatment of animals on the high-cholesterol diet restored gallbladder contractility and intestinal transit to control levels, increased bile salt secretion, reduced the total bile salt pool, lowered the cholesterol saturation of bile, lengthened the nucleation time, and so reduced crystal formation (each P &lt; .05). Erythromycin enhances gallbladder motility and hastens intestinal transit, promoting more rapid enterohepatic cycling of bile salts. This increases bile salt secretion, improves cholesterol solubility, and reduces crystal development.
Cardiomyocytes Obtained From Induced Pluripotent Stem Cells With Long-QT Syndrome 3 Recapitulate Typical Disease-Specific Features In Vitro
Authors: Daniela Malan, Stephanie Friedrichs, Bernd K. Fleischmann, Philipp Sasse
Journal: Circulation Research (2011)

Current approaches for the investigation of long-QT syndromes (LQTS) are mainly focused on identification of the mutation and its characterization in heterologous expression systems. However, it would be extremely helpful to be able to characterize the pathophysiological effects of mutations and to screen drugs in cardiomyocytes.The aim of this study was to establish as a proof of principle the disease-specific cardiomyocytes from a mouse model with LQTS 3 by use of induced pluripotent stem (iPS) cells and to demonstrate that the mutant cardiomyocytes display the characteristic pathophysiological features in vitro.We generated disease-specific iPS cells from a mouse model with a human mutation of the cardiac Na(+) channel that causes LQTS 3. The control and LQTS 3-specific iPS cell lines were pluripotent and could be differentiated into spontaneously beating cardiomyocytes. Patch-clamp measurements of LQTS 3-specific cardiomyocytes showed the biophysical effects of the mutation on the Na(+) current, with faster recovery from inactivation and larger late currents than observed in controls. Moreover, LQTS 3-specific cardiomyocytes had prolonged action potential durations and early afterdepolarizations at low pacing rates, both of which are classic features of the LQTS 3 mutation.We demonstrate that disease-specific iPS cell-derived cardiomyocytes from an LQTS 3 mouse model with a human mutation recapitulate the typical pathophysiological phenotype in vitro. Thus, this method is a powerful tool to investigate disease mechanisms in vitro and to perform patient-specific drug screening.
Physical criteria for measurement of left ventricular pressure and its first derivative
Authors: B. J. Gersh, C. E. W. Hahn, C. Prys-Roberts, J. Cashion
Journal: Cardiovascular Research (1971)

The desirable physical characteristics are theoretically defined for catheter-manometer systems and analogue differentiating circuits used for the measurement of left ventricular pressure and its first derivative (Max dP/dt). A modified analogue differentiating circuit is described, and its performance in differentiating a complex pressure wave has been assessed by Fourier series analysis.
The HBV trimera mouse: a model for human HBV infection and evaluation of anti-viral agents
Authors: Ehud Ilan, Ofer Nussbaum, Ido Lubin, Rachel Eren, Ofer Ben-Moshe, Joseph Arazi, Shoshana Berr, Lewis Neville, Daniel Shouval, Orit Nahor, Yair Reisner, Shlomo Dagan, Eithan Galun
Journal: Journal of Hepatology (1998)
Genome-Wide Survey for Genes Horizontally Transferred from Cellular Organisms to Baculoviruses
Authors: A. L. Hughes
Journal: Molecular Biology and Evolution (2003)

The phylogeny of 13 viral species in the genera Granulovirus and Nucleopolyhedrovirus (family Baculoviridae) was reconstructed on the basis of 22 conserved protein families shared by all species, and a comprehensive homology search and phylogenetic analysis of the complete genomes of these viruses was used to test for horizontal gene transfer from cellular organisms. Statistically significant evidence of horizontal transfer was found in the case of six protein families (DNA ligase, ribonucleotide reductase 1, SNF2 global transactivator, inhibitor of apoptosis, chitinase, and UDP-glucosyltransferase). Three of these families are known to play key roles in the infection of insect hosts by these viruses. There was evidence that two of these (inhibitor of apoptosis and UDP-glucosyltransferase) were derived from the insect host. By contrast, the gene encoding chitinase in these viruses was evidently derived from a group of bacteria (the gamma subdivision of proteobacteria), which use chitinase to break down fungal chitins.
Rational Design of Phosphorescent Chemodosimeter for Reaction‐Based One‐ and Two‐Photon and Time‐Resolved Luminescent Imaging of Biothiols in Living Cells
Authors: Wenjuan Xu, Xin Zhao, Wen Lv, Huiran Yang, Shujuan Liu, Hua Liang, Zhenzhen Tu, Hang Xu, Weili Qiao, Qiang Zhao, Wei Huang
Journal: Advanced Healthcare Materials (2013)

A selective phosphorescent biothiols probe is synthesized based on Ir(III) complex 1, which has 2,2'-biquinoline as the N^N ligand for realizing the satisfied two-photon absorption cross-section and two-functionalized 2-phenylpyridine ligands with an α,β-unsaturated ketone moiety as the thiol reaction site. The one- and two-photon optical properties of 1 are investigated through UV-vis absorption spectrum and photoluminescence spectrum. This Ir(III) complex can act as an excellent one- and two-photon excited "OFF-ON" phosphorescent probe for biothiols based on the 1,4-addition of biothiol to α,β-unsaturated ketones. Moreover, one- and two-photon-induced luminescent imagings of biothiols in living cells are also realized. Furthermore, the experiments of time-resolved photoluminescence technique and fluorescence lifetime imaging microscopy demonstrate that 1 is able to detect biothiols in the presence of strong background fluorescence. In addition, probe 1 is adsorbed into the shell of mesoporous silica nanoparticles with core-shell structure to form a nanoprobe, which can realize the ratiometric detection of biothiols in absolute water solution and living cells based on two phosphorescent signals.
Effectiveness of Shoulder Belts
Authors: Thomas G. Dickinson
Journal: JAMA (1982)

<h3>To the Editor.—</h3> The greatest single automotive safety development to attenuate the carnage caravan of our highways is the three-point suspension, lap belt-shoulder harness. When properly used, it affords tremendous protection. A point of concern: I have noted a defect in the slack adjustment of the cross shoulder-chest strap in a large percentage of vehicles I have driven in the past two to three years. The harness locks are vehicleimpact actuated, and these devices apparently work well. But for the locked harness to be effective, it must be in close proximity to the chest. The slack reel was designed to allow people to move about and adjust instrument dials in greater comfort. If, when returning to the upright position, the slack in the shoulder strap is not automatically taken up, then this leaves approximately 13 to 20 cm of slack for forward travel of the torso. This can allow the
Validation of Genomics-Based Prognostic Tests in Malignant Pleural Mesothelioma
Authors: Gavin J. Gordon, Graham N. Rockwell, Paul A. Godfrey, Roderick V. Jensen, Jonathan N. Glickman, Beow Y. Yeap, William G. Richards, David J. Sugarbaker, Raphael Bueno
Journal: Clinical Cancer Research (2005)

Abstract Purpose: Malignant pleural mesothelioma (MPM) is a highly lethal neoplasm with limited pretreatment prognostication strategies. In this report, we examine the accuracy of a previously proposed prognostic test in an independent cohort of MPM patients. This test uses simple ratios of gene expression levels to provide a novel prognostication scheme. Experimental Design: Gene expression data using high-density oligonucleotide microarrays (∼22,000 genes) were obtained for a new cohort of human MPM tumors from patients undergoing similar treatments (n = 39). The relative expression levels for specific genes were also determined using real-time quantitative reverse transcription-PCR. We also used a subset of these tumors associated with widely divergent patient survival (n = 23) as a training set to identify new treatment-specific candidate prognostic molecular markers and gene ratio–based prognostic tests. The predictive nature of these newly discovered markers and gene ratio–based prognostic tests were then examined in an independent group of tumors (n = 52) using microarray data and quantitative reverse transcription-PCR. Results: Previously described MPM prognostic genes and gene ratio–based prognostic tests predicted clinical outcome in 39 independent MPM tumor specimens in a statistically significant manner. Newly discovered treatment-specific prognostic genes and gene ratio–based prognostic tests were highly accurate and statistically significant when examined in an independent group of 52 tumors from patients undergoing similar treatment. Conclusions: The data support the use of gene ratios in translating gene expression data into easily reproducible, statistically validated clinical tests for the prediction of outcome in MPM.
Humanistic Qualities of Physicians
Authors: GREG SIMON
Journal: Annals of Internal Medicine (1987)

Letters and Corrections1 June 1987Humanistic Qualities of PhysiciansGREG SIMON, M.D.GREG SIMON, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-106-6-914_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In their paper on the humanistic qualities of physicians, Arnold and associates (1) draw distinctions between humanistic attitudes, knowledge, and behavior. There is a second distinction that they tend to blur that seems more central. They discuss the ethical and the interpersonal aspects of the physician-patient relationship as if the two presented the same difficulties and required the same solutions. Although problematic clinical situations often present ethical and interpersonal difficulties tightly intertwined, solving the problem usually requires their separation.The authors (following the American Board of Internal Medicine) describe "integrity, respect, and compassion" as the central interpersonal...References1. ARNOLDPOVARHOWELL RGJ. The humanities, humanistic behavior, and the human physician: a cautionary note. Ann Intern Med. 1987;106:313-8. LinkGoogle Scholar2. KOHUT H. The Restoration of the Self. Madison, Wisconsin: International Universities Press; 1977. Google Scholar3. BALINT M. The Doctor, His Patient, and the Illness. New York: International Universities Press; 1957. CrossrefGoogle Scholar4. BIBRINGKAHANA GR. Lectures in Medical Psychology. New York: International Universities Press; 1968. Google Scholar5. MESSNER E. Autognosis: diagnosis by use of the self. In: LAZARE A, ed. Outpatient Psychiatry: Diagnosis and Treatment. Baltimore: Williams & Wilkins; 1979. Google Scholar6. CAPLAN G. The Theory and Practice of Mental Health Consultation. New York: Basic Books; 1970. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Massachusetts General Hospital Boston, MA 02114 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1987Volume 106, Issue 6Page: 914-914KeywordsBehaviorProblem solving Issue Published: 1 June 1987 PDF DownloadLoading ...
Exocrine Function of the Pancreas
Authors: Bernard J. Haverback
Journal: JAMA (1965)

A clear understanding of the biochemical and physiological principles regulating the formation and flow of the constituents in pancreatic juice would be helpful in elucidating some aspects of pancreatic diseases. In the consideration of pancreatitis and its complications, in addition to biochemical and physiological principles, certain features of the normal anatomy of the gland should be understood. Because there has been much discussion and controversy concerning the relationship of the "common channel" to pancreatitis, a description of the variations in the anatomy of the intraduodenal bile duct and pancreatic duct (duct of Wirsung) is relevant. In about 30% of people the pancreatic duct is completely separated from the common duct, both ducts opening separately into the duodenum at the ampulla of Vater. In about one third, the two ducts join with 2 mm of a common opening into the duodenum. Such a short common channel is not considered to be
Automated External Defibrillators and Survival from Cardiac Arrest in the Outpatient Hemodialysis Clinic
Authors: Ruediger W. Lehrich, Patrick H. Pun, Nadine D. Tanenbaum, Stephen R. Smith, John P. Middleton
Journal: Journal of the American Society of Nephrology (2006)

Automated external defibrillators (AED) have been recommended for use in outpatient dialysis clinics to improve outcomes from cardiac arrest, the most common cause of death in patients with ESRD. The effectiveness of this policy is unknown. The study cohort consisted of 43,200 hemodialysis patients in the US Gambro Healthcare System from 2002 to 2005. Of these, 729 patients who sustained an in-center cardiac arrest were identified. Baseline characteristics at the time of the event were compared between patients who underwent hemodialysis in clinics with and without an AED on site. Unadjusted survival and survival adjusted for potential confounders was measured using Cox proportional hazards regression models. Unadjusted survival at 30 d was 19 versus 15% (P = 0.12) and 9.5 versus 7.8% at 1 yr (P = 0.39) in the AED-present and AED-absent groups, respectively. AED presence was not associated with outcome in unadjusted analysis (hazard ratio [HR] 0.91; 95% confidence interval [CI] 0.78 to 1.07; P = 0.26). Univariable analysis identified age (HR 1.07 per decade; 95% CI 1.01 to 1.13), serum albumin (HR 0.91 per 0.7-mg/dl increase; 95% CI 0.82 to 1.01), and indwelling dialysis catheters (HR 1.21; 95% CI 1.02 to 1.42) as potential confounders. Medications including angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, beta blockers, calcium channel blockers, other BP medications, aspirin, antibiotics, and antiarrhythmics were associated with survival and considered confounders. After controlling for case mix and confounders, AED presence was not associated with outcome (HR 0.98; 95% CI 0.82 to 1.18; P = 0.83). Presence of AED in the dialysis clinic is not sufficient by itself to improve the abysmal outcome from in-clinic cardiac arrest in hemodialysis patients in the United States.