tbuckley/cabot-search huggingface dataset:
Problems in Liver Diseases
Authors: J. M. Braganza
Journal: Gut (1979)

2-Chloro-4-(ethylamino)-6-(isopropylamino)-<i>s</i>-triazine (atrazine, ATR) is a toxicologically important and widely used herbicide. Recent studies have shown that it can elicit neurological, immunological, developmental, and biochemical alterations in several model organisms, including in mice. Because disposition data in mice are lacking, we evaluated ATR9s metabolism and tissue dosimetry after single oral exposures (5–250 mg/kg) in C57BL/6 mice using liquid chromatography/mass spectrometry (Ross and Filipov, 2006). ATR was metabolized and cleared rapidly; didealkyl ATR (DACT) was the major metabolite detected in urine, plasma, and tissues. Plasma ATR peaked at 1 h postdosing and rapidly declined, whereas DACT peaked at 2 h and slowly declined. Most ATR and metabolite residues were excreted within the first 24 h. However, substantial amounts of DACT were still present in 25- to 48-h and 49- to 72-h urine. ATR reached maximal brain levels (0.06–1.5 μM) at 4 h (5–125 mg/kg) and 1 h (250 mg/kg) after dosing, but levels quickly declined to &lt;0.1 μM by 12 h in all the groups. In contrast, strikingly high concentrations of DACT (1.5–50 μM), which are comparable with liver DACT levels, were detectable in brain at 2 h. Brain DACT levels slowly declined, paralleling the kinetics of plasma DACT. Our findings suggest that in mice ATR is widely distributed and extensively metabolized and that DACT is a major metabolite detected in the brain at high levels and is ultimately excreted in urine. Our study provides a starting point for the establishment of models that link target tissue dose to biological effects caused by ATR and its in vivo metabolites.
Charles Michael Bromiley Pare
Authors: P. White
Journal: BMJ (2002)

Consultant physician emeritus in psychological medicine St Bartholomew's Hospital, London, and former treasurer of the Royal College of Psychiatrists (b 1925; q Cambridge 1948; MD, FRCP, Hon FRCPsych), d 3 July 2002.

Michael Pare trained in psychiatry at the Maudsley Hospital. Although a promising academic, he chose a more clinical career at Barts. He had both charm and patience, whether treating his patients or teaching his students, often through a haze of pipe smoke. Michael was the first college director of public education, successfully persuading psychiatrists to take public education seriously. He was awarded an honorary fellowship in 1987. He enjoyed both going to the opera and playing golf. In spite of developing lymphoma, he saw his last patient in May. He leaves a wife, Barbara; and three children.
Draining loop colostomy.
Authors: W. R. Thomas
Journal: BMJ (1969)

his loss of time and waste of hospital time could have been avoided.Also the expenses of the numerous tribunals would have been lessened.The second example concerns a man whose carcinoma of the colon I removed several years ago.About two years before death, I re- moved the prostate.About two months before death he was readmitted with urinary infection.Cystoscopy, after dilating a urethral stricture, showed that the bladder was so inflamed that an accurate diagnosis was not possible.Urine was sent for examination and after treatment he was discharged to await the report.Later he was
Shoulder-Hand Syndrome Following Myocardial Infarction with Special Reference to Prognosis
Authors: JOSEPH EDEIKEN
Journal: Circulation (1957)

Shoulder-hand syndrome occurs in approximately 10 to 15 per cent of patients following acute myocardial infarction. Sympathectomy, sympathetic block, cortisone, and various other therapies have been advocated. In the present communication the results of simple measures such as local heat, analgesics, and the regimen of active use of the affected extremity are described in treating 47 attacks in 42 patients with acute myocardial infarction.
Is carvedilol a more potent cure for patients with left ventricular dysfunction after acute myocardial infarction when compared with metoprolol?
Authors: Z. Cirovic, N. Karanovic, T. Stanojlovic, S. Nagorni, M. Radosavljevic, S. Apostolovic, G. Koracevic, M. Pavlovic
Journal: European Journal of Heart Failure (2000)
Effects of Dorso-lumbar Sympathectomy on Peptic Ulceration
Authors: I. MacPherson, A. A. F. Peel
Journal: BMJ (1955)

JONAL185MAY~~~~~~~~~~~~~~~~~~~~~~~~~~EIA JOURNAL55 routes, have come to the same conclusion-that vagotomy and Billroth I resection should be tried further.Vagotomy and limited partial gastrectomy has been very successful in the hands of Johnson and Orr (1953).Summary For duodenal ulcer, excluding cases of acute bleeding but including a few perforated cases which required more than simple closure, the operation of abdominal vagotomy combined with a low gastro-jejunostomy is a very safe procedure and appears to produce good results lasting four to six years in 88%.The failures (7%) were submitted to a further opera- tion without mortality: all except one case have been relieved.A Billroth I conversion was the most satisfactory secondary procedure; also, vagotomy combined with a Billroth I partial gastrectomy may prove to be the best primary procedure.Vagotomy should be included in the treatment of duodenal ulcer because only 50% of permanent good results can be expected from gastro-enterostomy alone.We now regard vagotomy combined with gastro- jejunostomy to be at least the best second-choice operation.Most of the follow-up work was done by S. O'D., but we are indebted to Mr. Harral Thompson for following up the cases at the Royal Southern Hospital during his tenure of the post of surgical registrar
Long-term cyclosporin for psoriasis
Authors: C.E.M. GRIFFITHS, A.V. POWLES, J. McFADDEN, B.S. BAKER, H. VALDIMARSSON, L. FRY
Journal: British Journal of Dermatology (2006)

Thirteen patients with severe persistent psoriasis, intolerant of, or unresponsive to, other current treatments have been treated with cyclosporin (Cys) for periods varying from 12–25 (mean 18) months. The dose ranged from 1–4 mg/kg/day (mean 2.8 mg). There was a 72% reduction in the mean PASI score at 4 weeks, and at the end of the study, an 81% reduction. Adjuvant therapy with topical steroids was used in 11 of the 13 patients after the first 3 months of Cys treatment to persistent patches on an intermittent basis with beneficial effect. Six patients developed mild to moderate hypertension, in three this was controlled by a reduction in the dose of Cys, and in the other three by hypotensive agents. The mean serum creatinine rose from 72 to 90μM/1 during the study. Hypertrichosis occurred in seven of the 13 patients. Low dosage Cys is an effective treatment for clearing psoriasis and maintaining improvement on a long‐term basis.
Failure to Diagnose Colorectal Carcinoma at Colonoscopy
Authors: P. Fracasso, S. Scanni, L. Di Iorio, O. A. Paoluzi
Journal: Endoscopy (2004)

We read with interest the paper by Leaper et al. on ”Reasons for failure to diagnose colorectal carcinoma at colonoscopy” [1], and would like to discuss certain issues raised by the paper. The authors regard both incomplete examinations and missing lesions as causes of failure in colorectal cancer diagnosis. However, one has the impression that the gastroenterologists in the study conducted incomplete examinations more frequently, whereas general surgeons appeared to be more likely to miss lesions. We would be interested to know whether Leaper et al. would agree with this impression.
PAF, PIP3 and NO: emerging role in reperfusion injury
Authors: A GODECKE
Journal: Cardiovascular Research (2003)

Phosphatidylinositol 3-kinases (PI3Ks) constitute a ubiquitously expressed family of lipid kinases that phosphorylate the membrane lipid phosphatidylinositol 4,5-bisphosphate on position D3 of the inositol moiety, leading to formation of the second messenger phosphatidylinositol 3,4,5-trisphosphate (PIP3) [1]. PI3Ks are heterodimeric enzymes that are composed of a catalytic and a regulatory subunit. PI3Kα, -β, and -δ (class Ia enzymes) respond to activated receptor tyrosine kinases like the insulin and PDGF receptors either by direct interaction of the regulatory subunit with phosphorylated receptor tyrosine residues or via adaptor molecules. In contrast, PI3Kγ (the only member of the class Ib family) is activated by βγ subunits of heterotrimeric G proteins in response to stimulation of heptahelical G-protein-coupled receptors (GPCRs). In addition, activated RAS may exert a direct stimulatory effect on the catalytic subunit of PI3Ks. In response to receptor activation, cytosolic PI3Ks are recruited to the cell membrane, the site of their catalytic action. Membrane-localized PIP3, together with its primary metabolite PI-3,4P2 formed at the cell membrane, allows binding and activation of numerous signal transduction molecules predominantly via their plecstrin homology (PH) domain including protein kinase B (PKB/Akt), phosphoinositide-dependent kinase 1 (PDK1), tyrosine-kinases of the tek family, or GDP exchange factors for rac [2]. In line with the activation of these downstream targets, PI3Ks have been shown to regulate glucose metabolism, promote cell growth and proliferation, protect against apoptosis, and may mediate reorganization of the cytoskeleton, a process required for cell migration.

The activity of PI3Ks … 

*Tel.: +49-211-8112675; fax: +49-211-8112675. Email address: Axel.Goedecke{at}uni-duesseldorf.de
Letter: Aspiration of thermometer fragment.
Authors: G J Dhar, C A Pierach
Journal: BMJ (1973)

first discovered to be hypertensive two months before her myocardial infarction.The third patient was a single girl from the Continent who had taken oral contraceptives for three years.We have no previous medical records about her.We do not consider that our report of 22 women under the age of 45 years with acute myocardial infarction represents "a small amount of inadequate information" upon which to base recommendations.It is the largest series yet assembled and we were particularly careful not to draw over- emphatic conclusions.-Weare, etc.,
A testing time for doctors: counselling patients before an HIV test.
Authors: R Bor, R Miller, M Johnson
Journal: BMJ (1991)

There have been considerable advances in the diagnosis, assessment, treatment, and prevention of HIV infection since AIDS was first described in 1981.Because of these advances HIV testing will inevitably become more widespread and a more routine part of clinical investigation and diagnosis.Up to now, however, doctors have often been deterred from testing patients for HIV.This may be due in part to the apparent mystique that surrounds pre-HIV test counselling.
Anesthesia in Centenarians
Authors: Patricia A. Ward
Journal: JAMA (1972)

<h3>To the Editor.—</h3> The LETTER "Centenarian Surgery" (<b>218</b>:1435, 1971) is certainly of interest to the practicing anesthetist. However, it was disturbing to note the literature on which the authors apparently based their rationale for the selection of spinal anesthesia in the geriatric patient. The statement, "A spinal anesthetic was chosen for this patient because mortality statistics indicate that regional anesthesia is superior to general anesthesia in a general population,"<sup>1-3</sup>was apparently the authors' opinion formed after the review of articles based on material that is now 7 to 23 years old. Nothing speaks so well for a technique as a successful case; surely, however, the selection of a spinal anesthetic for a patient with no cardiac reserve and a confused mental state could well be debated.<sup>4</sup> The newer anesthetic agents now available, specifically the neurileptanalgesics and dissociative anesthetics which offer the poor risk surgical patient excellent cardiovascular
The Malpractice Suit: A Survival Guide for Physicians and Their Families
Authors: Laurence R. Tancredi
Journal: JAMA (1989)

In recent years there has been an extraordinary amount of national attention to issues of physician negligence and medical malpractice. Reports on malpractice suits have not been limited to professional journals but have found their way into the public press and television programs. The focus of public reporting on medical malpractice has been from the perspectives of the patient who is injured by negligent care and the health care system, which is being economically compromised by the increase in medical malpractice compensation. Few reports have viewed the malpractice problem from the perspectives of physicians who have been sued and their families, who have had to absorb the emotional stress of malpractice cases. This videotape does a superb job of examining the impact of malpractice suits on both groups. It also provides useful advice to physicians undergoing suits on how to evaluate their lawyers, survive conflicts with their insurers who generally
Prosthetic Valve Endocarditis
Authors: WILLIAM E. DISMUKES, ADOLF W. KARCHMER, MORTIMER J. BUCKLEY, W. GERALD AUSTEN, MORTON N. SWARTZ
Journal: Circulation (1973)

In 38 cases of prosthetic valve endocarditis, 19 were early cases (onset ≦ 60 days after insertion of prosthesis) and 19, late cases (onset ≧ 60 days). Nine late cases had onsets 12 to 53 months after surgery. The sources or predisposing factors in late cases included dental disease or manipulation; genitourinary tract procedures; and skin, urinary, or wound infections. In contrast, most early cases were secondary to complications of operation. Streptococci were the most common organisms causing late endocarditis, whereas staphylococci were most common among early cases. Four of the six patients who survived early onset were treated with antibiotics alone; the others, with antibiotics plus reoperation. In contrast, seven of the 11 late cases that survived were treated with antibiotics alone; the other four, with antibiotics plus reoperation. The lower mortality (42% vs 68%) in the late group probably reflects the less virulent infecting organisms and the better clinical condition of the hosts. Regardless of whether prosthetic valve endocarditis occurs early or late , intensive and prolonged administration of appropriate antibiotics together with aggressive surgical reintervention in selected situations appears necessary for cure. Any patient who has a prosthetic valve and undergoes any procedure likely to produce bacteremia should receive antibiotic prophylaxis in an attempt to prevent late endocarditis.
Dr. John Parsons
Authors: Roy J. Popkin
Journal: New England Journal of Medicine (1957)

DR. John Parsons was just another practitioner of medicine in pre-Civil War days in Illinois. For the first half century of his life, he was little known outside his own community. He was born in Indiana in 1806. The Parsons family was a large and important group in the State, with many prominent educators among them. Since formal medical education was lacking in early Indiana, John Parsons obtained his medical training under the preceptorship system. It is known that he practiced medicine in Quincy, Illinois, for over a decade before 1859. Owing to poor health, he was forced to give . . .
EXAMINATION FOR AMEBIASIS
Authors: Wilmot C. Townsend
Journal: JAMA (1934)

To the Editor:—  In the recent articles and discussions on amebiasis appearing inThe Journal, no mention is made of a valuable aid in the detection of the organisms. In 1929 at the Boston City Hospital, under the care of Dr. George C. Shattuck, chief of the tropical service, there were sixteen patients with active amebiasis, practically all being residents of the city. The diagnosis was quickly and easily made by examining the bloody mucus or liquid stool, with the microscope in a hot box, which keeps it indefinitely at body temperature. The amebas at body temperature are actively motile, and if blood is present the red cells are easily seen in the cytoplasm. As soon as the temperature falls, activity ceases, and then their detection is extremely difficult. It is not necessary for the specimen to be collected in a warm container or that it be kept warm after
Inhibition of human factor VIIIa by anti-A2 subunit antibodies.
Authors: P Lollar, E T Parker, J E Curtis, S L Helgerson, L W Hoyer, M E Scott, D Scandella
Journal: Journal of Clinical Investigation (1994)

Human inhibitory alloantibodies and autoantibodies to Factor VIII (FVIII) are usually directed toward the A2 and/or C2 domains of the FVIII molecule. Anti-C2 antibodies block the binding of FVIII to phospholipid, but the mechanism of action of anti-A2 antibodies is not known. We investigated the properties of a patient autoantibody, RC, and a monoclonal antibody, 413, that bind to the region which contains the epitopes of all anti-A2 alloantibodies or autoantibodies studied to date. mAb 413 and RC were noncompetitive inhibitors of a model intrinsic Factor X activation complex (intrinsic FXase) consisting of Factor IXa, activated FVIII (FVIIIa), and synthetic phospholipid vesicles, since they decreased the Vmax of intrinsic FXase by > 95% at saturating concentrations without altering the Km. This indicates that RC and mAb 413 either block the binding of FVIIIa to FIXa or phospholipid or interfere with the catalytic function of fully assembled intrinsic FXase, but they do not inhibit the binding of the substrate Factor X. mAb 413 did not inhibit the increase in fluorescence anisotropy that results from the binding of Factor VIIIa to fluorescein-5-maleimidyl-D-phenylalanyl-prolyl-arginyl-FIXa (Fl-M-FPR-FIXa) on phospholipid vesicles in the absence of Factor X, indicating it does not inhibit assembly of intrinsic FXase. Addition of Factor X to Fl-M-FPR-FIXa, FVIIIa, and phospholipid vesicles produced a further increase in fluorescence anisotropy and a decrease in fluorescence intensity. This effect was blocked completely by mAb 413. We conclude that anti-A2 antibodies inhibit FVIIIa function by blocking the conversion of intrinsic FXase/FX complex to the transition state, rather than by interfering with formation of the ground state Michaelis complex.
The management of diabetes
Authors: S. J Griffin
Journal: BMJ (2001)

Primary Care p 970 

Over the past 30 years care of diabetes has been in the vanguard of the change in the management of chronic diseases from specialties based in hospital outpatient clinics to a more primary care led service. The specialist versus generalist debate is sterile; there is greater variation in outcomes within than between traditional disciplinary boundaries. Effective delivery of care to people with diabetes over this period has depended on the three Rs of management of chronic diseases—registration, recall, and regular review.1

A well conducted trial from Danish general practice published in this issue (p 970) underlines this and supports the findings of a subsequent Cochrane review that multifaceted interventions to improve the performance of practitioners, and organisational interventions to improve recall and review, can enhance the care of diabetes. 2 3 Three hundred and twelve practices were randomised to intervention and routine care groups. In the intervention group 243 general practitioners (practice nurses are scarce in Denmark) were given leaflets for patients, guidelines, annual seminars, and feedback and were prompted to review patients and …
Take a stand against "the mayhem of modern psychiatry"
Authors: P. P. Ramanuj
Journal: BMJ (2012)

I read with a now familiar dread Spence’s article on the Diagnostic and Statistical Manual of Mental Disorders , fifth edition (DSM-V).1 The consequences for the NHS, as it uses an ever more diagnosis defined approach to divide mental health services, will extend beyond psychiatry’s confines and affect everything from prison care to public health policy. …
Charity sets up fund to defend researcher being sued for libel
Authors: C. Dyer
Journal: BMJ (2008)

The registered charity HealthWatch has set up a fund to support Peter Wilmshurst, a consultant cardiologist who is facing a libel action in the High Court in London over comments he made to a US based medical website about a trial in which he was the joint principal investigator ( BMJ 2008;337:a2412, 3 Nov, doi:10.1136/bmj.a2412).

The fund has been launched with a donation of £5000 (€5900; $7440) from John Garrow, a past chairman of HealthWatch and former professor of nutrition at St Bartholomew’s Hospital in London. The aim is to help indemnify Dr Wilmshurst against legal fees incurred after his employer, Shrewsbury and Telford Hospital NHS Trust, and his defence body, the Medical Defence Union (MDU), refused to …
Frequency of the <i>CHEK2</i> 1100delC Mutation among Women with Breast Cancer: An International Study
Authors: Shiyu Zhang, Catherine M. Phelan, Phil Zhang, Francois Rousseau, Parviz Ghadirian, Andre Robidoux, William Foulkes, Nancy Hamel, David McCready, Maureen Trudeau, Henry Lynch, Douglas Horsman, Maria Lourdes Leon De Matsuda, Zeba Aziz, Magda Gomes, Mauricio Magalhaes Costa, Alexander Liede, Aletta Poll, Ping Sun, Steven A. Narod
Journal: Cancer Research (2008)

Abstract A founder allele in the CHEK2 gene (1100delC) has been associated with an elevated risk of breast cancer. This allele is responsible for the majority of CHEK2-associated breast cancers in women from northern European countries; however, within Europe, it seems to be rare in countries that are close to the Mediterranean. The frequency of the 1100delC allele has not been measured in non-White populations. We measured the frequency of the CHEK2 founder allele in 3,882 breast cancer patients and 8,609 controls from various countries. The allele was not seen among Asian patients (from Pakistan or the Philippines) and was present in 1 of 155 cases from Brazil. Among White women, the allele was present in 1.5% of 825 familial cases of breast cancer and in 0.7% of 1,106 patients with nonfamilial breast cancer. The allele was equally frequent in Jewish and non-Jewish patients. We estimate that the CHEK2 1100delC allele is associated with an odds ratio of 2.6 for breast cancer, which corresponds to a lifetime risk of ∼24% in Ontario. [Cancer Res 2008;68(7):2154–7]
Amiodarone in Patients with Previous Drug-Mediated Torsade de Pointes
Authors: Thomas A. Mattioni
Journal: Annals of Internal Medicine (1989)

The safety and efficacy of long-term amiodarone therapy were examined in 12 patients who had previously developed torsade de pointes as a complication of previous antiarrhythmic therapy. The QTc intervals were determined at the time of torsade de pointes (570 ± 40 ms), after 7 days of amiodarone loading (490 ± 70 ms), and after 3 months of chronic amiodarone administration (580 ± 80 ms). Compared to a drug-free control period, QTc was significantly prolonged (P < 0.05) at the time of torsade de pointes, after amiodarone loading, and after 3 months of amiodarone therapy. The QTc intervals at the time of torsade de pointes and after chronic amiodarone treatment were not significantly different. At 16 ± 7 months of follow-up, all patients remained free of subsequent torsade de pointes, syncope, or sudden death. In addition, 5 of 6 patients with a history of sustained ventricular tachycardia remained free from arrhythmic recurrence despite persistence of inducible ventricular tachycardia during programmed stimulation studies done before discharge. We conclude that amiodarone can often be used safely and effectively in patients who have previously had an episode of drug-mediated torsade de pointes. Amiodarone-induced QTc prolongation, even when marked, does not predict recurrent torsade de pointes. These observations also suggest that the propensity for a drug to produce this arrhythmia is dependent on other electrophysiologic effects in addition to its ability to simply lengthen repolarization.
Samuel Fenwick, M.D., F.R.C.P. (1821-1902): physician and gastroenterologist.
Authors: D D Gibbs
Journal: BMJ (1970)

Samuel Fenwick was a Victorian.In the year of his birth Princess Victoria was aged 2, and he outlived the Queen by one year.He became known as a successful physician and teacher in London.In common with many Victorian physicians he was a morbid anatomist as well as a clinician, and he applied these skills particularly to the study of abdominal diseases.His achievements in clinical gastroenterology were considerable, but his discoveries and contributions in his chosen specialty are not now widely recognized.