tbuckley/cabot-search huggingface dataset:
The Management of the Anxious Patient.
Authors: Elliot D. Luby
Journal: JAMA (1963)

This volume is directed at the psychiatric education of the generalist. Dr. Meares spends the early chapters discussing the phenomenology of anxiety, its biological and psychological meaning, and the clinical cues which the physician can attend to in order to facilitate his recognition of the anxious patient. Psychoanalytic theory is generously used as an explanatory conceptual framework to enable the clinician to understand how and why anxiety develops. Dr. Meares suggests that the physical examination and a nondirective interview can be skillfully combined to obtain psychologically meaningful information from the patient and to establish a firm therapeutic relationship. It would appear that Dr. Meares' primary form of therapy is a kind of conditioning, in which the anxious patient is gently urged to relax and to experience "atavistic regression." The concept of atavistic regression is fundamental to Dr. Meares' system of therapy and is apparently a state of consciousness in which
How Does the Brain Sense Osmolality?
Authors: Joseph G. Verbalis
Journal: Journal of the American Society of Nephrology (2007)

For nearly 60 years, we have known that the brain plays a pivotal role in regulating the osmolality of body fluids. Over this time period, scientists have determined the structure and function of arginine vasopressin and its receptors, the role of the posterior pituitary as a storage site, and the determinants of vasopressin release. The cellular mechanisms by which the kidney responds to vasopressin are also well understood. One area that remains unclear is the neural mechanisms underlying osmoreception. New findings have implicated the TRPV family of cation channels as osmo-mechanoreceptors that may mediate the neuronal responses to changes in systemic tonicity. This topic is reviewed here.
The significance of microabscesses in liver transplant biopsies: A clinicopathological study
Authors: Laura W. Lamps, Wright C. Pinson, David S. Raiford, Yu Shyr, Margie A. Scott, Mary Kay Washington
Journal: Hepatology (1998)

Parenchymal microabscesses (MA) in liver transplant biopsies are frequently associated with cytomegalovirus (CMV) infection. However, other potential causes of MA have not been fully investigated. We studied additional etiologies for MA via histological evaluation and clinicopathological correlation. Three hundred seventy-two liver transplant biopsies from 97 patients (from 1991 to 1997) were reviewed and stained immunohistochemically for CMV. Numerous histological features were evaluated including size and number of MA, lobular and portal inflammation, and cholestasis. Medical records were reviewed for radiographic, laboratory, and other clinical data from the time of biopsy. The χ2 or Fisher's Exact test and ANOVA with adjusted multiple comparisons were used to determine statistical significance. Sixty-two of 372 biopsies (17%) from 43 patients contained MA. Biopsies were obtained between 4 days and 2.3 years posttransplant (median, 14 days). Nineteen percent of biopsies had CMV infection at the time of biopsy; 27% were associated with other bacterial, viral, or fungal infections; 10% had graft ischemia; 15% had biliary obstruction/cholangitis; 3% had a combination of ischemia and sepsis; and no explanation was found in 26% of biopsies. Numerous MA within a biopsy (>9) correlated with CMV infection (P < .005); no other histological features, including size of MA, correlated with the etiology of MA. Overall, 43 of 97 (44%) liver transplantation patients at our institution had biopsies demonstrating MA at some point in their posttransplantation course. CMV infection appears responsible for only a minority of cases. MA, although nonspecific, are an important histological finding in numerous conditions that may have a significant impact on both graft survival and overall patient morbidity.
Use of nonprescription topical steroids: patients' experiences
Authors: P.J. Rogers, S.M. Wood, E.L. Garrett, S.P. Krykant, N.J. Haddington, J. Hayhurst, G.R.H. Player
Journal: British Journal of Dermatology (2005)

Topical steroids became available, without prescription, in the U.K. in 1987, with hydrocortisone 1% cream first being licensed for irritant contact dermatitis and reactions to insect bites. Since then the number of indications for nonprescription hydrocortisone use has increased and clobetasone has also become available as an over-the-counter (OTC) medicine. Little has been reported about how OTC steroids are used by community pharmacy clients.We determined how OTC topical steroids are applied by patients, their demographic profile, the products used and the conditions treated, how frequently products were applied and how regularly purchased. The extent to which off-label use takes place was explored.A patient-completed questionnaire study was used in 100 branches of a national pharmacy in Great Britain.Questionnaires were completed and returned by 315 clients (16%). Eczema (192 cases, 61%) and dermatitis (66 cases, 21%) were the conditions most frequently treated. Nottingham Eczema Severity Scores calculated for 228 eczema and dermatitis sufferers shows that 164 patients (72%) had mild eczema. Those with more severe eczema were more likely to use clobetasone than hydrocortisone. The use of topical steroids outside OTC marketing authorization guidelines was widespread; however, no patient reported any adverse effects or deterioration in condition following steroid use.OTC topical steroids are used mainly to treat eczema and dermatitis. Almost 50% of users treating these conditions exceed the limits of the rather restrictive OTC marketing authorization. Clinicians should be aware of the potential for adverse effects as a result of patients self-medicating with hydrocortisone or clobetasone for an extended period.
Cellular and genetic control of antibody responses in vitro. III. Immune response gene regulation of accessory cell function
Authors: A Singer, C Cowing, KS Hathcock, HB Dickler, RJ Hodes
Journal: The Journal of Experimental Medicine (1978)

The possibility was investigated that Ir genes regulate the function of cells other than T or B cells in the primary IgM responses to the synthetic antigens trinitrophenylated poly-L-(Tyr,Glu)-poly-D,L-Ala--poly-L-Lys [TNP-(T,G)-A--L]and trinitrophenylated poly-,-(His,Glu)-poly-D, L-Ala--poly-L-Lys [TNP-(H,G)-A--L]. The primary responses of (B10 x B10.A)F(1) spleen cells to both antigens were abrogated by Sephadex G-10 passage, and restored by the addition of spleen adherent cells. The cell type in the spleen adherent cell population active in reconstituting the responses to TNP-(T,G)-A--L and TNP-(H,G)-A--L was a non-T, non-B, radiation-resistant, glass-adherent spleen cell. The responses of Sephadex G-10-passed (responder x nonresponder)F(1) spleen cells to TNP-(T,G)-A--L or TNP-(H,G)-A--L were reconstituted by spleen adherent cells from only responder strains. Spleen adherent cells from F(1) mice reconstituted the responses to both antigens. Spleen adherent cells from each of the strains tested reconstituted the non- Ir gene-controlled response to a third antigen, TNP-keyhole limpet hemocyanin. The inability of spleen adherent cells from nonresponder strains to reconstitute the responses to either TNP-(T,G)-A--L or TNP-(H,G)-A--L was not a result of active suppression induced by the presence of nonresponder adherent cells, since a mixture of responder and nonresponder spleen adherent cells reconstituted the responses to both antigens. The use of spleen adherent cells from recombinant strains demonstrated that the autosomal dominant genes controlling the ability of spleen adherent cells to function as accessory cells in the responses to TNP-(T,G)-A--L and TNP-(H,G)-A--L are located in the K or I-A regions of the responder H-2 complex, the same region(s) of H-2 as the Ir genes controlling overall in vitro and in vivo responsiveness to these antigens.
PWE-112 Maternal Obesity Promotes Offspring Non-Alcoholic Fatty Liver Disease (Nafld) Through Disruption of Endoplasmic Reticulum Homeostasis
Authors: J Soeda, A Mouralidarane, S Ray, R Carter, G Fusai, M Novelli, J Pombo, A Bocioanowska, D Sugden, L Poston, P Taylor, J Oben
Journal: Gut (2013)

<h3>Introduction</h3> We have previously shown that maternal obesity (MO) programmes offspring obesity and consequent liver disease (non-alcoholic fatty liver disease, NAFLD) but involved mechanisms are unclear. Accumulating evidence suggests endoplasmic reticulum (ER) stress induced unfolded protein response (UPR) plays a central role in the pathogenesis of steatosis and subsequent non-alcoholic steatohepatitis (NASH). However, little is known about the role of UPR in developmentally programmed NAFLD. <h3>Methods</h3> C57BL6 mice were fed standard or obesogenic diet (OD) for 6 weeks prior to pregnancy and throughout pregnancy and lactation. Litters were weaned onto standard or OD to produce 4 groups. Animals were sacrificed at 6 months. Blood and tissue samples were collected to assess the liver phenotype and expression analysis of UPR related proteins and genes. <h3>Results</h3> Offspring exposed to MO and a post-weaning OD (OffOb-OD) developed profound NAFLD compared to those exposed to post-partum (OffCon-OD) or the control group (OffCon-SC), as assessed by raised ALT (p &lt; 0.001) and NAFLD Activity Score (p &lt; 0.01). Among 3 proximal sensors of ER stress, PERK protein expression and phospho eIF-2alpha were specifically increased in OffOb-OD (p &lt; 0.05). ATF6 cleavage and spliced form of XBP-1 were observed in all groups except for OffCon-SC. Phopho SAPK/JNK, CHOP, and LC3BII protein expression were significantly increased in OffOb-OD. Furthermore, hepatocytes apoptosis as detected by TUNEL and active capase-3 staining in OffOb-OD. These results indicate that unresolved UPR is significantly activated in OffCon-OD. However, GRP78, a major ER chaperone and central regulator for ER stress, was significantly downregulated in OffOb-OD. UPR induced chaperon (GRP94) and ER-associated protein degradation related gene (HERP and EDEM) were downregulated in OffCon-OB and OffOb-OD. Furthermore rhythmic expression of GRP78 and HERP were blunted in OffOb-OD. <h3>Conclusion</h3> MO and a post-natal obesogenic diet profoundly disrupted ER homeostasis in offspring. Disrupted ER homeostasis may be involved in the propagation of NAFLD. <h3>Disclosure of Interest</h3> None Declared.
Manpower Problems in the Allied Health Field
Authors: Harry I. Greenfield
Journal: JAMA (1968)

In a recent study of American science policy by the Organization for Economic Cooperation and Development (OECD), the following statement appeared: "This [referring to the United States] is a new country looking for a better division of labor and constantly growing productivity; one agricultural worker for 6.95 people in 1900, one for 39.97 in 1964" (<i>New York Times</i>[Jan 13, 1963] p 10). In other words, the agricultural worker of 1964 was about six times more productive than his 1900 counterpart. How has the health worker fared by comparison? In 1900, there were about 200,000 health workers in a total population of some 76 million or one health worker for 380 people; in 1964 there were roughly 3 million health workers and a population of approximately 197 million or one health worker for 66 people.<sup>1-3</sup>If the 1964 health worker was as productive as the 1964 agricultural worker, we
Lithium Information Center
Authors: MARGARET BAUDHUIN
Journal: Annals of Internal Medicine (1981)

Letters and Corrections1 March 1981Lithium Information CenterMARGARET BAUDHUIN, M.L.S.MARGARET BAUDHUIN, M.L.S.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-94-3-417_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: I recently read Beatty's article about computerized medical information services (1). He mentions several computer data bases currently available to clinicians (MEDLINE, BIOSIS, AND EMBASE), and he describes methods for searching such systems. I was particularly interested in his article because I am the information specialist for the Lithium Information Center (another computer-based information service available to clinicians and researchers).The Lithium Information Center maintains a computer registry (Lithium Library) of citations to the literature dealing with the biological uses of lithium. The system currently includes more than 7300 citations, and it is continually updated with citations...Reference1. BEATTY W. Searching the literature and computerized services in medicine. Ann Intern Med. 1979;91:326-32. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 March 1981Volume 94, Issue 3Page: 417-417KeywordsComputersLibraries Issue Published: 1 March 1981 PDF DownloadLoading ...
Immunoglobulin light chain variable region gene sequences for human antibodies to Haemophilus influenzae type b capsular polysaccharide are dominated by a limited number of V kappa and V lambda segments and VJ combinations.
Authors: E E Adderson, P G Shackelford, R A Insel, A Quinn, P M Wilson, W L Carroll
Journal: Journal of Clinical Investigation (1992)

The immune repertoire to Haemophilus influenzae type b capsular polysaccharide (Hib PS) appears to be dominated by certain light chain variable region genes (IgVL). In order to examine the molecular basis underlying light chain bias, IgVL genes have been cloned from a panel of heterohybridomas secreting human anti-Hib PS (antibody) (anti-Hib PS Ab). One hybridoma, representative of the predominant serum clonotype of anti-Hib PS Ab in older children and adults following immunization or Hib infection, uses a V kappa II segment identical to the germline gene A2, and a JK3 segment. A second kappa hybridoma uses a member of the V kappa I family and a JK4 segment. Four lambda antibodies, all cross-reactive with the structurally related antigen Escherichia coli K100 PS, use V lambda VII segments which are 96-98% homologous to one another, and may originate from a single germline gene. Two additional lambda antibodies, not K100-cross-reactive, are encoded by members of the V lambda II family. All lambda antibodies use highly homologous J lambda 2 or J lambda 3 segments. The VJ joints of all lambda antibodies and the V kappa II-encoded antibody are notable for the presence of an arginine codon, suggesting an important role in antigen binding. Although more complex than heavy chain variable region gene usage, a significant portion of serum anti-Hib PS Ab is likely to be encoded by a limited number of V kappa and V lambda segments and VJ combinations, which may be selectively expressed during development, or following antigen exposure.
SUCCESSFUL SUTURE OF A PENETRATING WOUND OF THE HEART.
Authors: JOHN H. GIBBON
Journal: JAMA (1906)

Within the past three years I have made two contributions to thesubject of penetrating wounds of the heart, the last of which was read at a meeting of the College of Physicians in May,<sup>1</sup>1904, and it is my intention to briefly relate the details of a case of successful suture of a stab wound of the right ventricle and to make a few comments on the symptoms and treatment. This patient is the second one on whom I have reported, the first having died on the operating table.<sup>2</sup> <h3>Patient.</h3> —A. C., aged 38, a well-developed, healthy, colored man, was admitted to the Bryn Mawr Hospital on July 30, 1905, at 12:20 a. m. <h3>History.</h3> —He had been stabbed with a "penknife" about one hour previous to his admission. Immediately after the stabbing he was able to walk a short distance, but then fell to the ground and
Persistent infiltration of CD45RC?CD4+ T cells, Th2-like effector cells, in prolonging hepatic allografts in rats pretreated with a donor-specific blood transfusion
Authors: N Miyanari, Y Yamaguchi, K Matsuno, A Tominaga, M Goto, O Ichiguchi, K Mori, M Ogawa
Journal: Hepatology (1997)

A single intravenous injection of freshly heparinized blood from a donor-specific blood transfusion (DST) seven days before transplantation significantly prolongs the subsequent survival of hepatic allografts from ACI(RT1a) to LEW(RT1(1)) rats. We used W3/25 (anti-CD4) and OX22 (anti-CD45RC: an isoform of leukocyte-common antigen [CD45R]) monoclonal antibodies to investigate the cellular identity of hepatic allograft infiltrates following transplantation. The number of CD4+ and CD45RC+ cells in untreated allografts increased equally over time by day seven. However, in DST-treated hepatic allografts, CD4+ and CD45RC+ cells also increased over time by day 14, but the increment in the number of CD4+ cells was significantly greater than that in CD45RC+ cells. While the number of CD4+ cells remained persistently elevated in the hepatic allografts of rats pretreated with DST, they did not initiate rejection. Fluorescence-activated cell sorter (FACS) analysis revealed that the accumulated CD4+ T cells could be divided into two subsets, CD45RC- CD4+ and CD45RC+ CD4+ T cells, and that the ratio of CD45RC- CD4+/CD45RC+ CD4+ T cells in the hepatic allografts of recipients pretreated with DST was significantly greater than that in untreated allografts. Reverse-transcriptase polymerase chain reaction (RT-PCR) analysis demonstrated that CD45RC- CD4+ T cells expressed interleukin (IL)-4 and IL-10 messenger RNA (mRNA), but not IL-2 and interferon gamma (IFN-gamma). The pattern of messenger RNA expression in hepatic allograft infiltrates from animals pretreated with DST provides compelling evidence for the selective in vivo preservation of T-helper (Th2)-specific cytokines in the rat system. Our studies show that CD45RC leukocyte-common antigen expression can define different populations of hepatic infiltrating CD4+ T cells. A persistent infiltration of CD45RC- CD4+ T cells, Th2-like effector cells, is characteristic of hepatic allografts with a prolonged survival in DST-pretreated rats.
Benign Esophagorespiratory Fistula Complicated by Deep Impaction of Stent Mesh in the Esophageal Wall
Authors: H. Lang, G. C. Sotiropoulos, F. H. Saner, N. R. Frühauf, K. Radecke, W. Niebel, C. E. Broelsch
Journal: Endoscopy (2005)

The placement of self-expandable metallic stents is widely accepted as a treatment for malignant esophagorespiratory fistulas [1] [2]. In contrast, there is ongoing discussion about the use of metallic stents for temporary treatment of benign and potentially reversible esophageal disorders, because after only a few weeks stent retrieval may already be difficult [2] [3] [4].
Propofol sedation during endoscopy in patients with cirrhosis, and utility of psychometric tests and critical flicker frequency in assessment of recovery from sedation
Authors: P. Sharma, S. Singh, B. Sharma, M. Kumar, H. Garg, A. Kumar, S. Sarin
Journal: Endoscopy (2011)

See also: Commentaire de travail de P. Sharma et al., pp. 400Endoscopy 2011; 43(05): 464-464DOI: 10.1055/s-0031-1291801
"The capability of saving lives" moves to primary care
Authors: B. Christie
Journal: BMJ (2001)

More lives will be saved in future in general practice than in hospitals as the power of family doctors to intervene on behalf of patients increases. That was one of the predictions made by Sir Denis Pereira Gray, a former president of the Royal College of General Practitioners, in wide ranging review of the past, present, and future of general practice in the United Kingdom.

Hospital activity is increasingly focused on the business of repair, Sir Denis argued, whereas family doctors can now prevent premature deaths from conditions such as ischaemic heart disease …
Meeting the ethical needs of doctors
Authors: Daniel K Sokol
Journal: BMJ (2005)

We need clinical ethicists in addition to other measures 

A sound knowledge of medical ethics is essential to the good practice of medicine. This belief underlies the integration of medical ethics into the teaching of medical students, the proliferation of articles and textbooks on the subject, the increasing number of clinical ethics committees in NHS trusts, and the BMJ 's new series on medico-ethical problems in everyday practice.1–5 These are all indications that medical ethics constitutes an important component of medical practice. But even more conclusive evidence exists that doctors need help with ethical problems.

The BMA receives several thousand enquiries each year from concerned doctors confronted with ethical issues.6 No doubt many more doctors do not make use of the BMA's services through lack of time or embarrassment. Some doctors, especially if junior, may not wish to rock the boat by pointing to an ethically dubious practice. House officers, for example, may not feel comfortable obtaining consent from a patient for an unfamiliar procedure, but they may feel even more awkward raising the issue with a consultant. Others simply fail to identify the ethical problems pervading their day to day …
Functionalised polysiloxanes as injectable, in situ curable accommodating intraocular lenses
Authors: Xiaojuan Hao, Justine L. Jeffery, John S. Wilkie, Gordon F. Meijs, Anthony B. Clayton, Jason D. Watling, Arthur Ho, Viviana Fernandez, Carolina Acosta, Hideo Yamamoto, Mohamed G.M. Aly, Jean-Marie Parel, Timothy C. Hughes
Journal: Biomaterials (2010)
Aspergillus oryzae Meningitis
Authors: Morris A. Gordon
Journal: JAMA (1976)

In a patient with only meningitis, a septate hypha was seen in a Langhans giant cell, and the rarely pathogenic<i>Aspergillus oryzae</i>was cultured from the cerebrospinal fluid. Serologic results confirmed the diagnosis. The patient responded to therapy with amphotericin B and flucytosine. (<i>JAMA</i>235:2122-2123, 1976)
Action of MER-25 and of Clomiphene on the Human Ovary
Authors: Olive W. Smith
Journal: JAMA (1963)

IT APPEARS TO BE WELL ESTABLISHED that the synthetic nonsteroidal analogue of chlorotrianisene (Tace), which has been given the generic name of clomiphene citrate (MRL/41)*, is capable of stimulating ovarian secretory activity in women. 1-4 Perhaps the most convincing evidence for this is found in the high incidence of cystic ovaries observed among treated patients, together with the associated microscopic ovarian and endometrial changes, indicating that the cystic structures produced are functional. 2,3 The striking similarity between the histopathology of this response to clomiphene and the ovarian response to administered gonadotropins of both human and animal origin has been pointed out by Southam and Janovski. 2 With both forms of treatment, the degree of ovarian response to a given dosage appears to be unpredictable and all patterns of atypical stimulation have been observed. In view of this analogy, it has been logical to assume that the ovarian response