tbuckley/cabot-search huggingface dataset:
Case 40-1981
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, Betty U. McNeely, Cecil H. Coggins, George F. Murphy
Journal: New England Journal of Medicine (1981)

Presentation of Case First admission. A 43-year-old woman was admitted to the hospital because of an infected amputation stump.She was well until nine months earlier, when transient right-sided weakness developed, and she entered another hospital. Diazepam and phenytoin sodium were administered by vein, but a slough developed adjacent to an intravenous line in the left hand and was followed by septic thrombophlebitis. Several surgical procedures were performed, with eventual amputation of the terminal phalanx of the left third finger. During a hospital stay of 4 1/2 months pain developed in the right lower extremity, and a diagnosis of thrombophlebitis . . .
Anastomotic Leak of Pancreatic Transplant Demonstrated by Radionuclide Cystography
Authors: BILL MOURATIDIS, FRED LOMAS, BRIAN HURLEY
Journal: Clinical Nuclear Medicine (1995)

A 37-year-old woman presented 2 months after combined pancreatic-renal allograft transplantation for diabetes mellitus, with right iliac fossa pain of several days' duration. Abdominal ultrasound examination revealed a moderate amount of free fluid particularly in the paracolic, perihepatic, and perisplenic regions suggesting an anastomotic leak between the duodenal stump of the pancreatic graft and bladder. A direct (catheter) radionuclide cystogram demonstrated communication between urinary bladder and peritoneal cavity. The anastomotic leak at the level of the transplanted duodenum was confirmed surgically and repaired.
Achieved platelet aggregation inhibition after different antiplatelet regimens during percutaneous coronary intervention for ST-segment elevation myocardial infarction
Authors: Nicolette M.S.K.J. Ernst, Harry Suryapranata, Kor Miedema, Robbert J. Slingerland, Jan Paul Ottervanger, Jan C.A. Hoorntje, A.T.Marcel Gosselink, Jan-Henk E. Dambrink, Menko-Jan de Boer, Felix Zijlstra, Arnoud W.J. van’t Hof
Journal: Journal of the American College of Cardiology (2004)
Disposable heat exchanger.
Authors: A. Roberts, J. L. Robinson
Journal: BMJ (1970)

The estimation of the transfer of heat between two flowing media separated by a solid wall consists essentially in computing the resis- tance to heat transfer (1) within the fluid in the tube, (2) across the wall of the tube, and (3) within the fluid on the outside of the tube. CONVENTIONAL HEAT ExCHANGERSIn the normally constructed heat exchanger made of stainless steel factor 2 is reduced to a minimum.Though this makes Insulatin4 'T-piec" tube 'T.I ece Blood inlet temperature 37'C.Blood flow 10 ml./minute.Tube length for increased flow rate rises in direct proportion.Coolant temperature less, than 0 5'C.Coolant flow 18 litres/minute.Coolant tube bore 25-4 mm.Outer diameter 31 75 mm.NT/24.Outer insulating tube bore 38 1 mm.Outer diameter 47-62 mm.NT/26.The lengths of tubing required are, if anything, overestimated.Disposable Heat Exchanger tube
Occupational Medicine: Too Much Expected?
Authors: Howard M. Kipen
Journal: Annals of Internal Medicine (1991)

Letters15 May 1991Occupational Medicine: Too Much Expected?Howard M. Kipen, MD, MPHHoward M. Kipen, MD, MPHSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-114-10-915_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors: The recent position paper (1) represents a valuable advance toward defining a role that has so far eluded any comfortable categorization or implementation. However, as a practitioner and consultant in occupational and environmental medicine as well as an internist, I am uncomfortable with the breadth of the role that has been outlined. This is especially true in light of the current lack of relevant training opportunities for internists.Risk assessment and risk characterization are formidable tasks that depend on familiarity with both a broad literature and specific case examples. This is also true for evaluation of the...References1. . Occupational and environmental medicine: the internist's role. Ann Intern Med. 1990;113:974-82. LinkGoogle Scholar2. Rutstein D, Mullan R, Frazier T, Halperin W, Melius J, and Sestito J. Sentinel health events (occupational): a basis for physician recognition and public health surveillance. Am J Public Health. 1983; 73:1054-62. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Howard M. Kipen, MD, MPHAffiliations: University of Medicine & Dentistry of New Jersey Piscataway, NJ 08854-5635 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byOccupational and environmental exposure to lead and Paget's disease of boneSentinel pathophysiologic conditions: An adjunct to teaching occupational and environmental disease recogniton and history takingWhat is a specialist? The role of board certification in occupational medicine 15 May 1991Volume 114, Issue 10Page: 915-915KeywordsRisk assessments ePublished: 1 December 2008 Issue Published: 15 May 1991 PDF downloadLoading ...
Outcomes in Catheter Ablation of Ventricular Tachycardia in Dilated Nonischemic Cardiomyopathy Compared With Ischemic Cardiomyopathy
Authors: Borislav Dinov, Lukas Fiedler, Robert Schönbauer, Andreas Bollmann, Sascha Rolf, Christopher Piorkowski, Gerhard Hindricks, Arash Arya
Journal: Circulation (2013)

Background— Data on the outcomes of ventricular tachycardia (VT) ablation in nonischemic dilated cardiomyopathy (NIDCM) are insufficient. The Heart Center of Leipzig VT (HELP-VT) study was conducted prospectively to compare outcomes after radiofrequency catheter ablation of VT in patients with NIDCM compared with ischemic cardiomyopathy (ICM). Methods and Results— Two hundred twenty-seven patients, 63 with NIDCM and 164 with ICM, presenting with sustained VT were ablated with radiofrequency catheter ablation. Noninducibility of any clinical and nonclinical VT was achieved in 66.7% of NIDCM and in 77.4% of ICM patients. Ablation of the clinical VT only was achieved in 18.3% of ICM and in 22.2% of NIDCM patients. There was no statistically significant difference in short-term outcomes between the 2 groups. At the 1-year follow-up, VT-free survival in NIDCM was 40.5% compared with 57% in ICM. In univariate analysis, the hazard ratio for VT recurrence was significantly higher for NIDCM (1.62; 95% confidence interval, 1.12– 2.34; P =0.01). In both the ICM and NIDCM subgroups, procedure failure and incomplete procedural success were independent predictors of VT recurrence. Conclusions— Although the short-term success rates after VT ablation in NIDCM and ICM patients were similar, the long-term outcomes in NIDCM patients were significantly worse. Complete VT noninducibility at the end of the ablation is associated with beneficial long-term outcome in NIDCM. Pursuing compete elimination of all inducible VTs is desirable and may improve the long-term success in NIDCM.
292 IMPACT OF HIGHER DOSES OF PEGINTERFERON ALFA-2A AND RIBAVIRIN ON RVR, CEVR AND SVR IN HCV G1 PATIENTS WITH VIRAL LOADS ≥400,000 IU/ML WEIGHING ≥85 kg
Authors: K.R. Reddy, M.L. Shiffman, M. Rodriguez-Torres, D. Abdurakhmanov, I. Bakulin, G.F. Silva, H. Cheinquer, M. Rabbia, M. McKenna, A. Tietz, S.A. Harrison
Journal: Journal of Hepatology (2010)
Peripheral but not hepatic insulin resistance in mice with one disrupted allele of the glucose transporter type 4 (GLUT4) gene.
Authors: L Rossetti, A E Stenbit, W Chen, M Hu, N Barzilai, E B Katz, M J Charron
Journal: Journal of Clinical Investigation (1997)

Glucose transporter type 4 (GLUT4) is insulin responsive and is expressed in striated muscle and adipose tissue. To investigate the impact of a partial deficiency in the level of GLUT4 on in vivo insulin action, we examined glucose disposal and hepatic glucose production (HGP) during hyperinsulinemic clamp studies in 4-5-mo-old conscious mice with one disrupted GLUT4 allele [GLUT4 (+/-)], compared with wild-type control mice [WT (+/+)]. GLUT4 (+/-) mice were studied before the onset of hyperglycemia and had normal plasma glucose levels and a 50% increase in the fasting (6 h) plasma insulin concentrations. GLUT4 protein in muscle was approximately 45% less in GLUT4 (+/-) than in WT (+/+). Euglycemic hyperinsulinemic clamp studies were performed in combination with [3-3H]glucose to measure the rate of appearance of glucose and HGP, with [U-14C]-2-deoxyglucose to estimate muscle glucose transport in vivo, and with [U-14C]lactate to assess hepatic glucose fluxes. During the clamp studies, the rates of glucose infusion, glucose disappearance, glycolysis, glycogen synthesis, and muscle glucose uptake were approximately 55% decreased in GLUT4 (+/-), compared with WT (+/+) mice. The decreased rate of in vivo glycogen synthesis was due to decreased stimulation of glucose transport since insulin's activation of muscle glycogen synthase was similar in GLUT4 (+/-) and in WT (+/+) mice. By contrast, the ability of hyperinsulinemia to inhibit HGP was unaffected in GLUT4 (+/-). The normal regulation of hepatic glucose metabolism in GLUT4 (+/-) mice was further supported by the similar intrahepatic distribution of liver glucose fluxes through glucose cycling, gluconeogenesis, and glycogenolysis. We conclude that the disruption of one allele of the GLUT4 gene leads to severe peripheral but not hepatic insulin resistance. Thus, varying levels of GLUT4 protein in striated muscle and adipose tissue can markedly alter whole body glucose disposal. These differences most likely account for the interindividual variations in peripheral insulin action.
Iron overload in the Asian community
Authors: Chun Yu Lok, Alison T. Merryweather-Clarke, Vip Viprakasit, Yingyong Chinthammitr, Somdet Srichairatanakool, Chanin Limwongse, David Oleesky, Anthony J. Robins, John Hudson, Phyu Wai, Anuja Premawardhena, H. Janaka de Silva, Anuradha Dassanayake, Carole McKeown, Maurice Jackson, Rousseau Gama, Nasaim Khan, William Newman, Gurvinder Banait, Andrew Chilton, Isaac Wilson-Morkeh, David J. Weatherall, Kathryn J.H. Robson
Journal: Blood (2009)
Australian doctors fight over HIV testing
Authors: C Zinn
Journal: BMJ (1994)

In July 2009, the Irish Blood Transfusion Service replaced cryoprecipitate with fibrinogen concentrate to reduce the potential risk of pathogen transmission. Fibrinogen concentrate appears to have similar efficacy in treatment of major haemorrhage but there is limited data about its use in major obstetric haemorrhage (MOH).We aimed at assessing the impact of this change on estimated blood loss (EBL) and blood products use in MOH. <h3>Methodology</h3> Prospective detailed audit of MOH began at our institution in January 2009. Cases are defined by EBL of ≥2.5 l, transfusion of ≥5 units of red cell concentrate (RCC) or treatment of a coagulopathy. EBL and blood products use were compared between those treated for secondary hypofibrinogenemia before and after cryoprecipitate was replaced with fibrinogen. <h3>Results</h3> 59 cases of MOH were identified in 2 years (3.3/1000 deliveries) (table 1). 29 required treatment for hypofibrinogenemia; cryoprecipitate (14) and fibrinogen concentrate (15). Both groups had similar demographics and gestation at delivery. The main causes of bleeding were uterine atony and retained placental tissue. Medical management was similar. Haemostasis was achieved in all cases. <h3>Conclusion</h3> Fibrinogen concentrate in MOH was associated with a reduction in EBL, the use of RCC and octaplas. These cases, however, were diverse and complex and fibrinogen replacement was only one factor in the overall management, but replacement with a small volume bolus that is administered rapidly without thawing may facilitate rapid correction of coagulopathy and earlier haemostasis.
Methotrexate‐induced subacute neurotoxicity in a child with acute lymphoblastic leukemia carrying genetic polymorphisms related to folate homeostasis
Authors: Jose Manuel Vagace, Cristina Caceres‐Marzal, Mercedes Jimenez, Maria Soledad Casado, Silvia Gonzalez de Murillo, Guillermo Gervasini
Journal: American Journal of Hematology (2010)

Subacute methotrexate neurotoxicity (MTX-NT) may occur days to weeks after systemic or intrathecal (IT) MTX administration and is often manifest by stroke-like symptoms. The pathogenesis of MTX-NT has mainly been associated with cerebral folate homeostasis, but the specific mechanism leading to the development of this complication is mostly unknown and is likely to be multifactorial. Most of studies aimed to determine putative genetic determinants of this syndrome have been focused on the methylenetetrahydrofolate reductase (MTHFR) C677T single nucleotide polymorphism (SNP). However, there are other functional polymorphisms that have also been identified in enzymes and transporters related to MTX and folate homeostasis. In this context, we carried out an extensive genetic analysis through the screening of 21 SNPs in 11 relevant genes in a five-year-old girl with acute lymphoblastic leukemia (ALL) who developed MTX-NT. The analysis revealed the presence of numerous genetic variants that may have accounted for the neurotoxicity observed. We discuss the putative role of MTX pharmacogenetics in the pathogenesis of MTX-NT.
Personal health budgets are to be piloted in England this summer
Authors: J. Wise
Journal: BMJ (2009)

The government has announced new legislation that will allow funds to be given to patients so that they can directly purchase their own healthcare services. Pilot schemes of personal health budgets are due to start this summer in selected areas in England.

The Health Bill 2009 will pass through the House of Lords over the next few months and is the next step in the implementation of the health minister Ara Darzi’s review of the NHS ( BMJ 2008;337:a645, doi:10.1136/bmj.a645). 

Commenting on the bill Lord Darzi said, “Building on the experience of social care, the bill allows the further development of ways to give patients greater personalisation and control over the health care services they receive.”

The Department of Health said that there will be three broad categories of personal budget. The first is a notional personal budget where patients are given a …
UK senior doctors' career destinations, job satisfaction, and future intentions: questionnaire survey * Commentary: Are contented doctors good doctors?
Authors: J. M Davidson
Journal: BMJ (2002)

# UK senior doctors' career destinations, job satisfaction, and future intentions: questionnaire survey {#article-title-2}

Doctors' career choices, destinations, and views about their jobs provide useful insights for workforce planning. We report a survey of all traceable graduates from UK medical schools in 1974.

We mailed questionnaires in 1998, asking about employment history and current job. In all, 77% (1717/2217) replied (72% (1223) of men and 80% (494) of women). Of respondents, 97% (1673) were in medical employment in the United Kingdom or abroad, and 85% (1460) worked in the UK NHS. The table shows the distribution of their specialties. In NHS general practice, 98% (488) of men and 85% (183) of women were principals; of these, 39% (72) of women and 5% (25) of men worked part time. In NHS hospital practice, 97% (469/485) of men and 76% (114/150) of women whose main paid post was in the NHS (not in a university) were consultants; of these, 26% (30) of women and 11% (50) of men worked part time.

View this table:

Profile of 1673 respondents (graduates from 1974) in medical employment in 1998: specialty and job satisfaction. Values are numbers (percentages of all medical posts) unless stated otherwise 



We asked respondents to score five statements about job satisfaction, from “strongly agree” (score 1) to “strongly disagree” (5). The statements were “I find enjoyment in my current post”; “I am doing interesting and challenging work”; “I feel dissatisfied in my current post”; “most days I am enthusiastic about my work”; “I am often bored with my work”).1 We calculated a job satisfaction score by totalling the scores for all five statements: 20 or more represented a positive response, on average, to all statements, and we suggest that this …
Short-Term Human Prostate Primary Xenografts
Authors: Danny R. Gray, Wendy J. Huss, Jeffrey M. Yau, Lori E. Durham, Eric S. Werdin, William K. Funkhouser, Gary J. Smith
Journal: Cancer Research (2004)

Abstract Transgenic spontaneously occurring and transplantable xenograft models of adenocarcinoma of the prostate (CaP) are established tools for the study of CaP progression and metastasis. However, no animal model of CaP has been characterized that recapitulates the response of the human prostate vascular compartment to the evolving tumor microenvironment during CaP progression. We report that primary xenografts of human CaP and of noninvolved areas of the human prostate peripheral zone transplanted to athymic nude mice provide a unique model of human angiogenesis occurring in an intact human prostate tissue microenvironment. Angiogenesis in human kidney primary xenografts established from human renal cell carcinoma and noninvolved kidney tissue, a highly vascular organ and cancer, was compared with angiogenesis in xenografts from the relatively less vascularized prostate. Immunohistochemical identification of the human versus mouse host origin of the endothelial cells and of human endothelial cell proliferation in the human prostate and human kidney xenografts demonstrated that: (a) the majority of the vessels in primary xenografts of benign and malignant tissue of both organs were lined with human endothelial cells through the 30-day study period; (b) the mean vessel density was increased in both the CaP and benign prostate xenografts relative to the initial tissue, whereas there was no significant difference in mean vessel density in the renal cell carcinoma and benign kidney xenografts compared with the initial tissue; and (c) the number of vessels with proliferating endothelial cells in primary xenografts of CaP and benign prostate increased compared with their respective initial tissue specimens, whereas the number of vessels with proliferating endothelial cells decreased in the benign kidney xenografts. Short-term primary human prostate xenografts, therefore, represent a valuable in vivo model for the study of human angiogenesis within a human tissue microenvironment and for comparison of angiogenesis in CaP versus benign prostate.
Detection of bile salt-dependent lipase, a 110 kDa pancreatic protein, in urines of healthy subjects
Authors: B. Comte, C. Franceschi, M.-O. Sadoulet, F. Silvy, D. Lafitte, L. Benkoel, A. Nganga, L. Daniel, J.-P. Bernard, D. Lombardo, E. Mas
Journal: Kidney International (2006)
John Dermot McCaldin
Authors: G. Cunningham
Journal: BMJ (2002)

General practitioner Nairobi, Kenya, 1957-81 (b Nairobi 1931; q Cambridge/University College Hospital, London, 1955; FRCGP), died from heart failure on 22 December 2001.

After house jobs in the United Kingdom, he joined his father's practice in Nairobi. As his father and other partners retired following Kenyan independence, the burden of maintaining the kind of service that the old settler community was used to fell on John's shoulders. He was a natural athlete, but a year after winning the Kenya squash championship at the age of 41 he had an extensive myocardial infarction, from which he never fully recovered. In 1981 he moved to South Natal, where he built a beautiful home with 25 acres of private nature reserve. He leaves a wife Barbara; and two sons.
How to run an induction meeting for house officers.
Authors: R. Gale, G. Jackson, M. Nicholls
Journal: BMJ (1992)

This article is based on the experiences of the authors in designing and running induction courses at Lewisham Hospital.The induction process was studied as a component in a counselling, monitoring, and support system for doctors in training.Our methods are based on needs assessments of three separate cohorts of house officers and have been refined through continuous feedback and evaluation.
Both the variability and level of mouse allergen exposure influence the phenotype of the immune response in workers at a mouse facility
Authors: Roger D. Peng, Beverly Paigen, Peyton A. Eggleston, Karol A. Hagberg, Mary Krevans, Jean Curtin-Brosnan, Cristy Benson, Wayne G. Shreffler, Elizabeth C. Matsui
Journal: Journal of Allergy and Clinical Immunology (2011)
Emerging insights into Transforming growth factor Smad signal in hepatic fibrogenesis
Authors: Y Inagaki, I Okazaki
Journal: Gut (2007)

Irrespective of initial stimuli, increased production of type I collagen is a common hallmark of fibrotic diseases in various organs including the liver.A dynamic balance between the production and degradation of collagen is seen, which is rigorously controlled by several growth factors and cytokines.Of these, transforming growth factor b (TGFb) is the most potent factor in stimulating type I collagen gene transcription.It also regulates expression of matrix metalloproteinases and their inhibitors, and modulates inflammatory reactions by influencing T cell functions.Therefore, TGFb is considered to be the major factor accelerating liver fibrosis.Identification and characterisation of Smad proteins, intracellular mediators of the signal transduction of TGFb, have led to a better understanding of the precise mechanisms of TGFb functions from the viewpoint of its intracellular signalling pathway and crosstalk with other factors.Several studies have focused on the suppression of TGFb activation and intervention of the TGFb/Smad signalling pathways to treat liver fibrosis.However, as generalised blockade of TGFb activity may result in the promotion of carcinogenesis and excessive immune reactions, much attention has to be paid to selective intervention of the TGFb/ Smad signal specifically in collagen-producing cells in the fibrotic tissue.TGFb also affects the growth and differentiation of stem and progenitor cells.From this point of view, a new concept of the treatment for liver fibrosis may arise from the discipline of stem cell biology by modulating TGFb and Smad signalling in stem/progenitor cells.
SWEAT DUCTS AND THE POMPHOLYX VESICLE
Authors: HAROLD WILSON, A. C. THACKRAY
Journal: British Journal of Dermatology (1952)

Journal Article SWEAT DUCTS AND THE POMPHOLYX VESICLE Get access HAROLD WILSON, M.D., M.R.C.P., HAROLD WILSON, M.D., M.R.C.P. Dermatologist, Central Middlesex Hospital; First Assistant, Skin Department, Middlesex Hospital, W.1 Search for other works by this author on: Oxford Academic Google Scholar A. C. THACKRAY, M.A., M.D. A. C. THACKRAY, M.A., M.D. Reader in Morbid Anatomy and Histology, Middlesex Hospital Medical School, W.1 Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 64, Issue 11, 1 November 1952, Pages 402–407, https://doi.org/10.1111/j.1365-2133.1952.tb15875.x Published: 01 November 1952