tbuckley/cabot-search huggingface dataset:
Letter: IUD and congenital malformation.
Authors: J Guillebaud
Journal: BMJ (1976)

The author considers that the 2 cases, described in a previous article, do not provide an adequate cause-and-effect link between copper-containing IUDs and limb-reduction defects. Conception in 1 of the cases may have occurred after expulsion of the IUD, and the lead content of the Grafenberg ring may have been the cause. No congenital abnormalities were reported in another series of 317 pregnancies occurring during use of IUDs and reaching viability. In 2 international studies there were 20,684 insertions of the copper-T (Gravigard) device and 714 pregnancies resulted with the devices in place. Of these 167 reached viability, 8% were lost to follow-up, and the others were ectopic or ended in abortion. Normal babies followed in 159. The incidence of congenital defects was 8 (4.8%) which was near the expected rate. No limb-reduction defects were found in this series. In a report of 23 other pregnancies going to term with an IUD in place, 19 normal infants and 4 with congenital abnormalities were reported. Of the abnormalities, 1 had multiple limb-reduction deformities. This is the only such case reported in Britain since the Gravigard was marketed in 1972. Since then 376,000 of these devices have been sold in the British Isles. The likelihood of spontaneous abortion and of other dangerous complications of pregnancy and delivery is such that pregnancy might best be terminated when an IUD is present. However, a copper-T device is not considered an added teratogenic risk.
Barbara's bowel
Authors: Brian Witcombe
Journal: BMJ (2004)

Data relating to aggregate anonymised tissue and other samples-These will not normally be considered to be personal information relating to a particular patient, and publication of research findings connected with such samples does not require patient consent.Genetic pedigrees-These represent a special problem.The committee is preparing a paper on this.Medical error-One particularly intriguing type of case is medical error.Consider, for example, a recent published case report on "wrong side" surgery. 11The surgeon is at greater risk than the patient in relation to publication of this information.Publications about error should be encouraged as they are core to improvements in patient safety in both relation to analysis of root causes and engendering a culture of openness about error.If a patient refused consent to publish, perhaps because of anger at the physician, should that preclude publication?If you might publish even if the patient refused, should you even ask permission?
Long-term follow-up of chronic active hepatitis of moderate severity.
Authors: J De Groote, J Fevery, L Lepoutre
Journal: Gut (1978)

A group of patients with only moderately active chronic hepatitis has been studied. The follow-up was long (mean 87 months). All patients except one were treated with prednisone and/or azathioprine. Of the hepatitis B virus positive patients two-thirds developed cirrhosis between the second and fifth year of evolution, while in the hepatitis B negative group this occurred in less than one-third. The transition to cirrhosis was clinically silent. The patients were all allowed to do their normal work except in the terminal stages of cirrhosis. Five patients died of causes related to the disease: three patients with cirrhosis and hepatocellular carcinoma, one with gallbladder carcinoma, and one from bleeding varices. The high incidence of tumour, especially liver-cell carcinoma, may be due to a cumulative effect of the presence of hepatitis B virus, cirrhotic transformation, and immuno-suppression. The other patients are currently in apparently good health.
Molecular Origins of Cancer
Authors: Harold J. Burstein, Robert S. Schwartz
Journal: New England Journal of Medicine (2008)

Over the past decade, insights into the origins and behavior of human cancers have reshaped our understanding of these diseases and have generated advances in clinical care. The seminal feature of this research is the focus on human cancers. By using ideas and technologies originally derived from basic science laboratories, investigators have shifted the forefront of cancer research from in vitro models of tumor growth to the characterization and treatment of cancers in humans.This issue of the Journal launches a series of reviews on the molecular origins of cancer. The goal of this series is to highlight advances in . . .
Accuracy of Hemodynamic Measurements during Partial Liquid Ventilation with Perflubron
Authors: HENRY E. FESSLER, DAVID PEARSE
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Patients undergoing partial liquid ventilation (PLV) are often monitored with pulmonary artery catheters and receive positive end-expiratory pressure (PEEP). PEEP can dissociate wedge pressure (Pcw) from transmural left atrial pressure (Platm) by elevating pleural pressure and can dissociate Pcw from Pla by elevating alveolar pressure, PLV, like PEEP, also elevates pleural and alveolar pressures. However, the artifacts PLV may cause in measured vascular pressures are unknown. In 6 anesthetized, paralyzed healthy adult sheep, we compared effects of gas ventilation (GV) and PLV with 10 and 30 ml/kg perflubron on pericardial pressure (Pperi), Pcw, Pla, thermodilution cardiac output, and pulmonary artery flow measured with a doppler probe. PEEP was applied from 0–15 mm Hg during GV and PLV. PLV changed pericardial pressure or cardiac output minimally (at PEEP0, GV: Pperi = − 1.7 ± 0.6 mm Hg, CO = 3.2 ± 0.1 L/m; 10 ml/kg perflubron: Pperi = − 1.3 ± 0.6 mm Hg, CO = 3.4 ± 0.2 L/m; 30 ml/kg perflubron: Pperi = − 1.6 ± 0.7 mm Hg, CO = 3.4 ± 0.2 L/m; all mean ± SEM). On PEEP, Pcw agreed with Pla and Platm as well or better during PLV as during gas ventilation. Cardiac output by thermodilution and probe agreed equally well under all conditions. We conclude that hemodynamic values are as accurate during PLV as during gas ventilation.
BMA and ambulance service call on government to delay roll out of non-emergency number 111
Authors: I. Torjesen
Journal: BMJ (2012)

The BMA and the Ambulance Service Network have asked the government to put back the April 2013 deadline for the universal roll out of the non-emergency telephone number NHS 111 across England.

NHS 111 is intended to be a 24 hour helpline for urgent but not life threatening health problems and is being piloted in three areas: County Durham and Darlington; Luton; and the East Midlands (Nottingham and Lincolnshire). The telephone number is due to be rolled out nationally by April 2013, when it will replace NHS Direct.

In a letter to the health secretary for England, Andrew Lansley, the BMA makes it clear that it supports the principle behind …
Staphylococcal enterotoxin induced IL‐5 stimulation as a cofactor in the pathogenesis of atopic disease: the hygiene hypothesis in reverse?
Authors: T. Heaton, D. Mallon, T. Venaille, P. Holt
Journal: Allergy (2003)

The incidence of Staphylococcus aureus (S. aureus) colonization on the skin of patients with atopic eczema/dermatitis syndrome (AEDS) is approximately 90% and a variety of evidence implicates epidermal staphylococcal infection as a pathogenic factor in atopic dermatitis. However, the mechanism(s) underlying the effects of this organism in the disease process are unclear. The cellular responses of AEDS suffers and asymptomatic atopic individuals to bacterial superantigens (SAg) were investigated in an attempt to elucidate the role of staphylococcal enterotoxin B (SEB) in atopic disease.Peripheral blood mononuclear cells (PBMC) were isolated from normal nonatopic adults, asymptomatic atopic individuals, patients with active AEDS and patients with active allergic asthma. The cells were cultured for 24 or 96 h with house dust mite (HDM), SEB and phytohaemagluttinin (PHA), and the supernatants were assayed for cytokine levels.Staphylococcal enterotoxin B selectively stimulates the production of interleukin (IL)-5 in AEDS sufferers but not in asymptomatic atopics or nonatopics. Additionally, we observed comparable susceptibility to the IL-5-stimulatory effects of SEB in allergic asthmatics.Given the central role of IL-5-driven eosinophilia in progression from mild atopy to severe disease, these findings provide a plausible mechanism for the AEDS-promoting effects of staphylococcal SAg. Staphylococcal enterotoxin B may also have a similar role in atopic respiratory disease.
Differential Cardiac Remodeling in Preload Versus Afterload
Authors: Karl Toischer, Adam G. Rokita, Bernhard Unsöld, Wuqiang Zhu, Georgios Kararigas, Samuel Sossalla, Sean P. Reuter, Alexander Becker, Nils Teucher, Tim Seidler, Cornelia Grebe, Lena Preuß, Shamindra N. Gupta, Kathie Schmidt, Stephan E. Lehnart, Martina Krüger, Wolfgang A. Linke, Johannes Backs, Vera Regitz-Zagrosek, Katrin Schäfer, Loren J. Field, Lars S. Maier, Gerd Hasenfuss
Journal: Circulation (2010)

Background— Hemodynamic load regulates myocardial function and gene expression. We tested the hypothesis that afterload and preload, despite similar average load, result in different phenotypes. Methods and Results— Afterload and preload were compared in mice with transverse aortic constriction (TAC) and aortocaval shunt (shunt). Compared with sham mice, 6 hours after surgery, systolic wall stress (afterload) was increased in TAC mice (+40%; P &lt;0.05), diastolic wall stress (preload) was increased in shunt (+277%; P &lt;0.05) and TAC mice (+74%; P &lt;0.05), and mean total wall stress was similarly increased in TAC (69%) and shunt mice (67%) ( P =NS, TAC versus shunt; each P &lt;0.05 versus sham). At 1 week, left ventricular weight/tibia length was significantly increased by 22% in TAC and 29% in shunt mice ( P =NS, TAC versus shunt). After 24 hours and 1 week, calcium/calmodulin-dependent protein kinase II signaling was increased in TAC. This resulted in altered calcium cycling, including increased L-type calcium current, calcium transients, fractional sarcoplasmic reticulum calcium release, and calcium spark frequency. In shunt mice, Akt phosphorylation was increased. TAC was associated with inflammation, fibrosis, and cardiomyocyte apoptosis. The latter was significantly reduced in calcium/calmodulin-dependent protein kinase IIδ-knockout TAC mice. A total of 157 mRNAs and 13 microRNAs were differentially regulated in TAC versus shunt mice. After 8 weeks, fractional shortening was lower and mortality was higher in TAC versus shunt mice. Conclusions— Afterload results in maladaptive fibrotic hypertrophy with calcium/calmodulin-dependent protein kinase II–dependent altered calcium cycling and apoptosis. Preload is associated with Akt activation without fibrosis, little apoptosis, better function, and lower mortality. This indicates that different loads result in distinct phenotype differences that may require specific pharmacological interventions.
Severe α1-antitrypsin deficiency and pregnancy
Authors: O.J. Dempsey, D.J. Godden, P.D. Martin, P.J. Danielian
Journal: European Respiratory Journal (1999)

This case study describes a successful pregnancy in a 27-yr-old patient with severe emphysema, secondary to alpha1-antitrypsin deficiency, genotype PiZZ. Despite significant respiratory compromise, more severe than previously reported, no complications ensued. Maternal pulmonary function did not deteriorate significantly until the 32nd week of pregnancy, with an elective Caesarean section being performed during the 37th week. This experience suggests that even severe maternal airflow obstruction is, in itself, not an absolute contra-indication to pregnancy. Pre-pregnancy multidisciplinary counselling is likely to be helpful in these patients, including frank discussion on the risks of pregnancy, the prospects of successful completion and the mother9s future prognosis in relation to caring for the child.
P106 ADULT HUMAN BILIARY TREE STEM/PROGENITOR CELLS (hbTSCS) ARE EFFICIENTLY REPROGRAMMED TO FUNCTIONAL INSULIN-SECRETING β-PANCREATIC ISLET CELLS BY A NEWLY SYNTHESIZED HUMAN Pdx1 PEPTIDE
Authors: V. Cardinale, G. Scafetta, R. Puca, M. De Canio, F. Sicilia, G. Carpino, D. Casa, G. Federici, P.B. Berloco, E. Gaudio, M. Maroder, D. Alvaro
Journal: Journal of Hepatology (2014)
Listing of Combined Internal Medicine and Pediatric Residencies
Authors: Howard Schubiner
Journal: JAMA (1988)

<h3>To the Editor.</h3> —In reviewing the Aug28 EDUCATION ISSUE of<i>JAMA</i>,<sup>1</sup>I saw that there was no mention of the residency programs in combined Internal Medicine and Pediatrics. These residency programs were approved by a joint agreement between the boards of Internal Medicine and Pediatrics in 1967.<sup>2</sup>Since that time, the number of formal programs has risen to 77,<sup>3</sup>creating approximately 200 internship positions each year. Although these programs do not receive separate review by the American Council for Graduate Medical Education, the boards of Internal Medicine and Pediatrics are now considering closer inspection of the requirements of this training. It was not clear in the Aug 28 issue of<i>JAMA</i>if residents of combined Internal Medicine/Pediatrics were included in the statistics or, if so, in which category. Another training program that combines two fields (General Preventive Medicine/Public Health) is listed, as are several residencies that have
Progenitor-derived hepatocellular carcinoma model in the rat
Authors: Jesper B. Andersen, Roberto Loi, Andrea Perra, Valentina M. Factor, Giovanna M. Ledda‐Columbano, Amedeo Columbano, Snorri S. Thorgeirsson
Journal: Hepatology (2009)

Human hepatocellular carcinoma (HCC) is a heterogeneous disease of distinct clinical subgroups. A principal source of tumor heterogeneity may be cell type of origin, which in liver includes hepatocyte or adult stem/progenitor cells. To address this issue, we investigated the molecular mechanisms underlying the fate of the enzyme-altered preneoplastic lesions in the resistant hepatocyte (RH) model. Sixty samples classified as focal lesions, adenoma, and early and advanced HCCs were microdissected after morphological and immunohistochemical evaluation and subjected to global gene expression profiling. The analysis of progression of the persistent glutathione S-transferase (GSTP)+ focal lesions to fully developed HCC showed that approximately 50% of persistent nodules and all HCCs expressed cytokeratin 19 (CK19), whereas 14% of remodeling nodules were CK19+. Unsupervised hierarchical clustering of the expression profiles also grouped the samples according to CK19 expression. Furthermore, supervised analysis using the differentially expressed genes in each cluster combined with gene connectivity tools identified 1308 unique genes and a predominance of the AP-1/JUN network in the CK19+ lesions. In contrast, the CK19-negative cluster exhibited only limited molecular changes (156 differentially expressed genes versus normal liver) consistent with remodeling toward differentiated phenotype. Finally, comparative functional genomics showed a stringent clustering of CK19+ early lesions and advanced HCCs with human HCCs characterized by poor prognosis. Furthermore, the CK19-associated gene expression signature accurately predicted patient survival (P < 0.009) and tumor recurrence (P < 0.006). Conclusion: Our data establish CK19 as a prognostic marker of early neoplastic lesions and strongly suggest the progenitor derivation of HCC in the rat RH model. The capacity of CK19-associated gene signatures to stratify HCC patients according to clinical prognosis indicates the usefulness of the RH model for studies of stem/progenitor-derived HCC. (HEPATOLOGY 2010.)
RÔLE OF UNRESOLVED PNEUMONIA IN BRONCHIAL ASTHMA
Authors: JOSEPH HARKAVY
Journal: JAMA (1922)

During the last few years considerable attention has been paid to the study of asthma, particularly from the allergic point of view. The progress that has been made along these lines has unquestionably added much to our knowledge of the subject. It has enabled us at least to classify between 40 and 50 per cent, of asthmatic cases as being due to sensitization by foreign proteins, so that the outlook for improvement and cure has been increased to that extent. This has largely been due to the work of Schloss,<sup>1</sup>Walker,<sup>2</sup>Cooke<sup>3</sup>and Vander Veer,<sup>4</sup>Longcope,<sup>5</sup>Mackenzie,<sup>6</sup>Rackemann<sup>7</sup>and Talbot.<sup>8</sup>Through the researches of these investigators, especially Walker,<sup>2</sup>Cooke<sup>3</sup>and Vander Veer,<sup>4</sup>it has been established that the majority of sensitive asthmatic patients fall into certain age groups. The greatest incidence of sensitive cases is to be found in
Visualization of Atrial Myocardium with TI-201: Case Report
Authors: AMJAD I. SHEIKH, STEVEN P. SWIRYN, DAN G. PAVEL
Journal: Clinical Nuclear Medicine (1981)

A case of right atrial visualization on Tl-201 imaging in a patient with marked right atrial enlargement secondary to atrial septal defect is described. The misinterpretation of Tl-201 and gated cardiac studies on initial inspection, due to this unusual finding, and the importance of obtaining special lateral and oblique views for correct identification of cardiac chambers are discussed.
Influence of the Direction of the Atrial Wave Front on A-V Nodal Transmission in Isolated Hearts of Rabbits
Authors: Michiel J. Janse
Journal: Circulation Research (1969)

Transmembrane potentials of A-V nodal cells in isolated rabbit hearts were recorded while the route of entry of atrial activity into the A-V node was changed by stimulating the atrium at a high, constant rate on eitherthe crista terminalis or the interatrial septum. Atrial activity arising from the interatrial septum provided a less effective input to the A-V node, as shown by the occurrence of 2 : 1 A-V conduction block, compared to 1 : 1 during driving on the crista terminalis at the same rate. The amplitude and rate of rise of the action potentials of most A-V nodal cells was smaller during driving on the interatrial septum, and many cells developed alarger or smaller "hump" in the repolarization phase, which was absent during stimulation on the crista terminalis. The pattern of A-V nodal excitation during stimulation on the crista terminalis was similar to that during spontaneous sinus rhythm, but was profoundly altered during stimulation on the interatrial septum. The results can be explained by assuming that an atrial wave front coming from the interatrial septum excites the atrial margin of the A-V node asynchronously, resulting in inhoinogeneous conduction within the node, causing longitudinal dissociation. The results show that successful propagation through the A-V node is at least partly determined by the direction of the atrial wave front. This factor may play an important role during atrial fibrillation.
A distinctive subtype of t(14;18)-negative nodal follicular non-Hodgkin lymphoma characterized by a predominantly diffuse growth pattern and deletions in the chromosomal region 1p36
Authors: Tiemo Katzenberger, Jörg Kalla, Ellen Leich, Heike Stöcklein, Elena Hartmann, Sandra Barnickel, Swen Wessendorf, M. Michaela Ott, Hans Konrad Müller-Hermelink, Andreas Rosenwald, German Ott
Journal: Blood (2008)
Women in US academic medicine earn less than male peers
Authors: J. H. Tanne
Journal: BMJ (2010)

A survey of nearly 3000 life science faculty members at the top 50 US medical schools has shown that women members earned just over $13 000 (£8500; €9700) less than their male counterparts with the equivalent career position and professional activity. 

There were no obvious reasons for the difference, concluded the study’s authors, from Harvard Medical School, Massachusetts General Hospital, and Brandeis University in Academic Medicine (2010;85:631-9, doi:10.1097/ACM.0b013e3181d2b095).

They write: “Despite increased national attention to gender inequalities in salary, women in the life sciences at all academic ranks, both PhDs and MDs, continued in 2007 to receive lower annual salaries than did their male …
Filtration Leukapheresis for Granulocyte Transfusion Therapy
Authors: Donald J. Higby, Jerome W. Yates, Edward S. Henderson, James F. Holland
Journal: New England Journal of Medicine (1975)

To study the clinical efficacy of granulocytes obtained by filtration leukapheresis, patients with clinically evident infection and granulocyte counts of < 500 per cubic millimeter were randomly assigned to receive conventional therapy alone or with a granulocyte transfusion obtained from a single donor each day for four days. Five of 19 control patients survived to day 20, and 15 of 17 in the transfused group survived. Comparison of the two populations for variables such as age, disease, and severity and type of infection revealed no other factor that could account for the difference in survival. Outcome was not demonstrated to be related to HL-A match, post-transfusion counts, or presence of leukocyte antibodies. Functional studies of granulocytes obtained by filtration leukapheresis showed only minor differences although appearance was altered. Granulocytes so obtained can be used safely and efficaciously as adjunctive therapy for infection associated with granulocytopenia. (N Engl J Med 292: 761–766, 1975)
Partial-Birth Abortion, Congress, and the Constitution
Authors: George J. Annas
Journal: New England Journal of Medicine (1998)

The political debate over abortion during the past 25 years has shifted among various dichotomous views of the world: life versus choice, fetus versus woman, fetus versus baby, constitutional right versus states' rights, government versus physician, physician and patient versus state legislature. Hundreds of statutes and almost two dozen Supreme Court decisions on abortion later, the core aspects of Roe v. Wade, 1 the most controversial health-related decision by the Court ever, remain substantially the same as they were in 1973. Attempts to overturn Roe in both the courtroom and the legislature have failed. Pregnant women still have a constitutional right . . .
Lymphocyte transformation test in allergic contact nickel dermatitis
Authors: J.M. GIMENEZ-CAMARASA, P. GARCIA-CALDERON, J. ASENSIO, J.M. MORAGAS
Journal: British Journal of Dermatology (2006)

Twenty-five patients with clinically proven, patch test positive nickel dermatitis were studied with the lymphocyte transformation test (LTT). Serial dilutions of NiSO4 were present in the lymphocyte culture. None of the controls showed lymphocyte blast transformation. In fourteen patients maximal incorporation of thymidine occurred at the highest dilutions (I:50,000-I:100,000). In eleven patients the highest incorporation occurred at the lower dilutions. The nature of the antigen responsible for the specific reaction remains unknown.
Focus: Washington: Oregon overwhelmed in its first three weeks
Authors: J Roberts
Journal: BMJ (1994)

While legislators and lobbyists in Washington try to draw a sketch of health care reform, citizens of one state have nearly overwhelmed their new medical shelter that opened on 1 February.

After a struggle of more than five years Oregon has begun its programme to provide every person in the state with medical and dental services. The plan is a trade off: instead of providing complete medical care to the poorest few, the state hopes to cover everyone but provide fewer services for them. As one supporter said, “Instead of rationing people, we are rationing services.” Although Oregon got the necessary approval from the federal government to try the scheme for five years, Washington has been lukewarm, partly because many in congress believe that the “health care crisis” does not need such radical measures.

But when Oregon's …