tbuckley/cabot-search huggingface dataset:
Impaired B cell immunity in IL-22 knock-out mice in collagen induced arthritis
Authors: O. Corneth, A.-M. Mus, P. Asmawidjaja, W. Ouyang, L. Kil, R. Hendriks, E. Lubberts
Journal: Annals of the Rheumatic Diseases (2011)

<h3>Background</h3> The role of IL-22, a cytokine produced by Th17 cells, in autoimmunity is not fully understood. Previous research has shown that IL-22 is important in the development of collagen induced arthritis (CIA). However, the mechanism behind the apparent protection in IL-22 knock-out mice against CIA remains unclear. <h3>Objective</h3> To investigate the mechanisms by which IL-22 knock-out mice are protected against collagen induced arthritis. <h3>Materials and methods</h3> For CIA, IL-22 knock-out and wild type mice were immunised with chicken collagen type II and complete Freud9s adjuvant (CFA) and boosted 21 days later. Antigen specific serum IgG levels were measured by ELISA. Mice were sacrificed 50 days after immunisation. Splenocytes were analysed by flow cytometry and immunohistochemistry. Functional assays were performed with splenic Th17 cells sorted from mice ten days after immunisation. For antigen induced arthritis (AIA), mice were immunised with methylated bovine serum albumin (mBSA) and CFA and triggered seven days later by intra-articular mBSA injection. <h3>Results</h3> In IL-22 knock-out mice, the severity, but not the incidence, of CIA was lower compared to wild type controls. This prompted us to study the pathogenicity of Th17 cells from these mice. Synovial fibroblasts produced higher levels of IL-6 when co-cultured with Th17 cells from IL-22 knock-out mice compared to wild type Th17 cells. To study the pathogenicity in vivo, we made use of the Th17 mediated AIA model. IL-22 knock-out mice developed AIA similarly to wild type controls, showing that Th17 cells without IL-22 function normally in vivo. As CIA is strongly driven by B cells and immune complexes, we investigated whether B cell immunity is normal in IL-22 knock-out mice. Antigen specific serum IgG2a levels were significantly lower in IL-22 knock-out mice at early onset of disease. We observed no significant differences in splenic B cell numbers or activation. However, spleens from IL-22 knock-out mice show no or very small germinal centers and fewer IgG2a plasma cells compared to wild type controls. <h3>Discussion</h3> Here we show that lack of IL-22 production affects B cell immunity in CIA. However, Th17 cells in IL-22 knock-out mice function normally in vitro and in vivo, indicating that lack of IL-22 production does not affect the pathogenicity of Th17 cells. Importantly, germinal center formation, plasma cell formation and IgG2a antibody production are lower in IL-22 knock-out mice in CIA, suggesting that IL-22 has a role in further differentiation of B cells in autoimmunity.
Physiologic Studies Early after Repair of Tetralogy of Fallot
Authors: RICHARD A. THEYE, JOHN W. KIRKLIN
Journal: Circulation (1963)

Physiologic studies have been carried out during the first 3 days after intracardiac repair of tetralogy of Fallot. All patients survived. The ratio between systolic pressure in right ventricle and a systemic artery was 0.7 or less in all cases and did not vary significantly during the period of study. Residual left-to-right shunts of moderate degree were demonstrated in three patients (repaired with Teflon prostheses). In one of these three, no definite evidence of shunt could be found 2 weeks after operation. Additional abnormal circulatory pathways exist in these patients. Clear evidence was obtained of left-to-right shunting through aorticopulmonary collateral connections in one case. Systemic index was usually below normal or in the low normal range. It was usually lower on the second and third postoperative days than on the first postoperative day. Left atrial pressure was sometimes strikingly higher than right atrial pressure 30 minutes after repair, but not thereafter. Pulmonary vascular resistance was normal or slightly elevated. Gas exchange and management were adequate to maintain normal or near normal oxygen and carbon dioxide levels in arterial blood. Mild metabolic acidosis existed on the first 2 days, but had generally cleared by the third day. The implications of these data are discussed relative to ventricular function and performance, adequacy and technic of surgical repair, administration of blood after operation, and the state of preparedness in the lung and left ventricle in patients with tetralogy of Fallot.
Use of Animals in Medical Education
Authors: Samuel Southard
Journal: JAMA (1991)

<h3>To the Editor.</h3> —The AMA Council's report on use of animals<sup>1</sup>and the survey that preceded it<sup>2</sup>are examples of a pragmatic approach that extinguishes the moral issue that prompted the report. Majority opinions are presented from a survey of what is without reference to what ought to be. The article discussed cost factors and student compliance apart from personal preference or moral imperatives. Reporting or surveying out of moral context is a tried, but not necessarily true, way to solve issues that intrude on professional prerogatives. I first met this complacent myopia as a first-year medical student in 1945. There was a woman in our class! Most of us made a pragmatic conclusion: no patient will have confidence in a female physician, so why is she here? Ten years later I found a similar "factual" approach in literature I used for a course on medical ethics in
Can Atrial to Total Tricuspid Annular Plane Diastolic Excursion Ratio be a Preload Independent Predictor of Right Ventricular Diastolic Function?
Authors: Cansın Tulunay Kaya, Aydan Ongun, Mustafa Kılıçkap, Başar Candemir, Ali Timuçin Altın, Demet Menekşe Gerede, Özgür Ulaş Özcan, Çetin Erol
Journal: Journal of the American College of Cardiology (2013)
The Symbol of Modern Medicine: Why One Snake Is More Than Two*
Authors: Robert A. Wilcox, Emma M. Whitham
Journal: Annals of Internal Medicine (2003)

Today, two serpent motifs are commonly used to symbolize the practice and profession of medicine. Internationally, the most popular symbol of medicine is the single serpententwined staff of Asklepios (Latin, Aesculapius), the ancient Greco-Roman god of medicine. However, in the United States, the staff of Asklepios (the Asklepian) and a double serpententwined staff with surmounting wings (the caduceus) are both popular medical symbols. The latter symbol is often designated as the medical caduceus and is equated with the ancient caduceus, the double serpententwined staff of the Greco-Roman god Hermes (Latin, Mercury). Many physicians would be surprised to learn that the medical caduceus has a quite modern origin: Its design is derived not from the ancient caduceus of Hermes but from the printer's mark of a popular 19th-century medical publisher. Furthermore, this modern caduceus became a popular medical symbol only after its adoption by the U.S. Army Medical Corps at the beginning of the 20th century. This paper describes the ancient origin of the Asklepian and how a misunderstanding of ancient mythology and iconography seems to have led to the inappropriate popularization of the modern caduceus as a medical symbol. *In this paper, nomenclature of Greek origin is translated into English such that it more closely transliterates the original Greek spellings. Thus, for example, Asklepios, Hygieia, Hippokrates, and Epidavros are used rather than Asclepius, Hygeia, Hippocrates, and Epidaurus.
Cimetidine and serum prolactin.
Authors: S K Majumdar, A D Thomson, G K Shaw
Journal: BMJ (1978)

Percentage incidences of toxic effects of chemotherapy Symptoms Marrow depressionNausea or vomiting or both Mild 38 WBC 2 5-4O0 x 10;/1 46 ~~~~~~~~Svr 5 WBC <2-5 x 1091..2Oral ulceration .4
Electronic Nicotine Delivery Systems: Executive Summary of a Policy Position Paper From the American College of Physicians
Authors: Ryan A. Crowley
Journal: Annals of Internal Medicine (2015)

Electronic nicotine delivery systems (ENDS), which include electronic cigarettes, or e-cigarettes, are growing in popularity, but their safety and efficacy as a smoking cessation aid are not well understood. Some argue that they have the potential to reduce tobacco-related morbidity and mortality and could be a useful tool for reducing tobacco-related harm. Others express concern that the health effects of ENDS use are unknown, that they may appeal to young people, and that they may encourage dual use of ENDS and traditional tobacco products. Although ENDS are a new and unregulated product, the U.S. Food and Drug Administration has proposed regulations that would deem ENDS to be subject to the Family Smoking Prevention and Tobacco Control Act, which regulates cigarettes and other tobacco products. In this position paper, the American College of Physicians offers policy recommendations on ENDS regulation and oversight, taxation, flavorings, promotion and marketing, indoor and public use, and research. This paper is not intended to offer clinical guidance or serve as an exhaustive literature review of existing ENDS-related evidence but to help direct the College, policymakers, and regulators on how to address these products.
Why Isn't Bariatric Surgery for Adolescents Catching On?
Authors: Kimberley Eden Steele
Journal: JAMA Surgery (2013)

To determine the current rate of inpatient bariatric surgical procedures among adolescents and to analyze national trends of use from 2000 to 2009. Retrospective cross-sectional study. Discharge data obtained from the Healthcare Cost and Utilization Project Kids' Inpatient Database, 2000 through 2009. Adolescents (defined herein as individuals aged 10-19 years) undergoing inpatient bariatric procedures. Inpatient bariatric surgery. The primary outcome measure was the national population-based bariatric procedure rate. The secondary outcome measures were trends in procedure rates and type, demographics, complication rate, length of stay, and hospital charges from 2000 through 2009. The inpatient bariatric procedure rate increased from 0.8 per 100,000 in 2000 to 2.3 per 100,000 in 2003 (328 vs 987 procedures) but did not change significantly in 2006 (2.2 per 100,000) or 2009 (2.4 per 100,000), with 925 vs. 1009 procedures. The use of laparoscopic adjustable gastric banding approached one-third (32.1%) of all procedures by 2009. The cohort was predominantly female and older than 17 years. The prevalence of comorbidities increased from 2003 (49.3%) to 2009 (58.6%) (P = .002), while the complication rate remained low and the in-hospital length of stay decreased by approximately 1 day (P < .001). Increasing numbers of patients had Medicaid as their primary payer source; however, most (68.3% in 2009) had private insurance. Despite the worsening childhood obesity epidemic, the rate of inpatient bariatric procedures among adolescents has plateaued since 2003. The predominant procedure type has changed to minimally invasive techniques, including laparoscopic adjustable gastric banding and laparoscopic Roux-en-Y gastric bypass. Trends show low complication rates and decreasing length of stay, despite increasing comorbid conditions among patients.
Genetic testing for asthma
Authors: G. H. Koppelman, G. J. te Meerman, D. S. Postma
Journal: European Respiratory Journal (2008)

Asthma is a genetically complex disease caused by multiple genetic and environmental factors. An increasing number of asthma susceptibility genes are currently being identified. The present study addresses the question as to whether this genetic information can be used to predict asthma, particularly in pre-school children. The predictive value of a single gene test in a complex disease is very limited for diagnostic or preventive purposes and thus cannot be recommended. Based on data of simulation studies and other complex diseases, the use of genetic profiling that incorporates multiple genetic risk factors holds promise for clinical application. The results of genome-wide association studies will be crucial in establishing this genetic risk profile for asthma. In the future, asthma prediction may be possible, based on a prediction model that incorporates genes, personal factors and environmental risk factors. Studies in general and at-risk populations are needed to investigate and validate this approach.
The Trials and Difficulties of a Health-Officer
Authors: D. Davies
Journal: BMJ (1871)

bably be regarded as the multiple inguinal adenopathy, always present when infection of the system is about to take place) before commencing a course of mercurial treatment; and, in the second place, it should make us more guarded in prognosticating constitutional infection in cases of hard chancre, and certain immunity from all secondary symptoms in undoubted cases of soft sore.
Tumor endothelin-1 enhances metastatic colonization of the lung in mouse xenograft models of bladder cancer
Authors: Neveen Said, Steven Smith, Marta Sanchez-Carbayo, Dan Theodorescu
Journal: Journal of Clinical Investigation (2010)

Many patients with advanced bladder cancer develop lethal metastases to the lung. The vasoconstricting protein endothelin-1 (ET-1) has been implicated in this process, although the mechanism(s) by which it promotes metastasis remains unclear. Here, we have evaluated whether tumor ET-1 expression can serve as a biomarker for lung metastasis and whether it is required for metastatic disease. Evaluation of ET-1 mRNA and protein expression in four patient cohorts revealed that levels of ET-1 are higher in patients with muscle-invasive bladder cancers, which are associated with higher incidence of metastasis, and that high ET-1 levels are associated with decreased disease-specific survival. Consistent with its proinflammatory activity, we found that tumor-derived ET-1 acts through endothelin-1 receptor A (ETAR) to enhance migration and invasion of both tumor cells and macrophages and induces expression of inflammatory cytokines and proteases. Using human and mouse cancer cells depleted of ET-1 and pharmacologic blockade of ET receptors in lung metastasis models, we found that tumor ET-1 expression and ETAR activity are necessary for metastatic lung colonization and that this process is preceded by and dependent on macrophage infiltration of the lung. In contrast, tumor ET-1 expression and ETAR activity appeared less important in established primary or metastatic tumor growth. These findings strongly suggest that ETAR inhibitors might be more effective as adjuvant therapeutic agents than as initial treatment for advanced primary or metastatic disease.
Recent Advances in Rheumatology, No. 1, part 1: Underlying Mechanisms of Disease, part 2: Clinical Features and Treatment
Authors: Thomas G. Benedek
Journal: JAMA (1976)

Each of these volumes contains seven review articles on important rheumatologic topics. They are the work of 26 contributors from the British Commonwealth and the United States under the editorship of two distinguished rheumatologists at the University of Glasgow and range in length from 69 pages ("Systemic Lupus Erythematosus in Man and Animals") to 15 pages ("Surgery of the Weight-Bearing Joints"). The authors are to be commended for the clarity and fairness with which they organize and present a voluminous literature, some of which is controversial or technically difficult. The division of the subject matter according to the subtitles of the volumes seems somewhat forced. Thus, the article "Polymyositis and Dermatomyositis," a slight revision of a review that appeared under the same title in the<i>New England Journal of Medicine</i>in February 1975, is almost entirely clinical, even though it is in part 1, which centers on pathophysiology. Several essays
CARDIOVASCULAR RESPONSE TO PSYCHOLOGICAL STRESS COMPARED TO EXERCISE AS EVALUATED BY RADIONUCLIDE VENTRICULOGRAPHY
Authors: G. Ironson, GM. Segall, C. Dennis, M. Boltwood, T. Bartzokis, M. Chesney, B. Taylor
Journal: Clinical Nuclear Medicine (1989)

Ironson, G.; Segall, GM.; Dennis, C.; Boltwood, M.; Bartzokis, T.; Chesney, M.; Taylor, B. Author Information
Facilities not as Gazetted
Authors: M. G. Wright, P. Allen, C. Battersby, F. M. Davis, D. M. de Lacey, P. Edwards, R. Elliott, N. Fahmy, E. Fonseca, T. Harris, A. J. W. Hilson, A. V. Hirsh, J. Hughes, H. James, T. Kelly, C. T. Lewis, R. Lewis, M. R. Lock, M. J. McEwen, D. M. Moorsom, T. Priestman, I. Prossor, R. D. Rosin, L. Small, C. Stray, M. G. Tweeddale, M. Webley
Journal: BMJ (1968)
Osteophytes in the osteoarthritic hand: their incidence, size, distribution, and progression.
Authors: J C Buckland-Wright, D G Macfarlane, J A Lynch
Journal: Annals of the Rheumatic Diseases (1991)

Quantitative microfocal radiographic assessment of osteophytes in osteoarthritic hands showed that their number and area were greatest at joint margins, in the dominant hand, in the second and third compared with fourth and fifth phalanges, in the third phalanx, and in the second distal interphalangeal joint respectively. These sites correspond with those for the largest forces exerted in the hand: the dominant side, the finger tripod used in the precision grip, power grip, and pulp-pinch respectively. The greater osteophytosis on the trapezium of the nondominant first carpometacarpal joint was probably related to forces exerted during power grip. Osteophytes increased significantly in number and area during the 18 month study period.
Low Birth Weight: A Medical, Psychological, and Social Study
Authors: Robert T. Brouillette
Journal: JAMA (1985)

This book reports the findings of a multidisciplinary, longitudinal study that attempts to answer the question: "Do low birth weight babies perform less well in later life than heavier babies, either in physical development and health or in intellectual abilities?" The study was based on 149 low-birth-weight infants born in Aberdeen, Scotland, between July 1969 and June 1970. Case-control infants were matched on five variables known to affect outcome: sex, the neonate's ordinal position in the family, maternal smoking, social class, and maternal height. Medical examinations of infants in the study and control groups were performed in the newborn period, at ten months, and at ten years. Sociological data were obtained by interviewing the mothers three weeks after delivery. A psychological examination of the children was performed at ten years. Despite matching cases and controls on social class by father's occupation, it was found that the low-birth-weight infants were born
Open letter to prime minister David Cameron and health secretary Andrew Lansley
Authors: D. J. Nicholl, D. Hilton-Jones, J. Palace,, S. Richmond, S. Finlayson, J. Winer, A. Weir, P. Maddison, N. Fletcher, J. Sussman, N. Silver, J. Nixon, D. Kullmann, N. Embleton, D. Beeson, M. E. Farrugia, M. Hill, C. McDermott, G. Llewelyn, J. Leonard, M. Morris
Journal: BMJ (2010)

Neurologists and paediatricians call for action on “massive” rises in the prices of orphan drugs

We are writing to you as a group of clinicians treating patients with so called “orphan” diseases (and one representative of a patients’ group) to express our concern at an unintended effect of the European Union’s regulations on orphan drugs. The original purpose of this legislation, passed in 1999, was to encourage drug companies to conduct research into rare diseases and develop novel treatments. However, as the rules are currently enacted, many drug companies merely address their efforts to licensing drugs that are already available rather than developing new treatments. Once a company has obtained a licence, the legislation then gives the company sole rights to supply the drug. This in turn allows the company to set an exorbitant price for this supply and effectively to bar previous suppliers of the unlicensed preparation from further production and distribution. 

We believe that this behaviour is not in the best interests of patients or the NHS but is undoubtedly significantly advantageous to drug companies. We have made representations to …
The role of protein kinase C activation in diabetic nephropathy
Authors: H. Noh, G.L. King
Journal: Kidney International (2007)

Diabetic nephropathy is the leading cause of end-stage renal disease worldwide and an independent risk factor for all-cause and cardiovascular mortalities in diabetic patients. New insights into the molecular mechanisms that underlie the development and progression of microvascular complications of diabetes including nephropathy are emerging rapidly from experimental and clinical studies. Chronic hyperglycemia is a major initiator of diabetic microvascular complications. Activation of diacylglycerol (DAG)-protein kinase C (PKC) pathway, enhanced polyol pathway, increased oxidative stress, and overproduction of advanced glycation end products have all been proposed as potential cellular mechanisms by which hyperglycemia induces diabetic vascular complications. The DAG-PKC pathway contributes to vascular function in many ways such as the regulation of endothelial permeability, vasoconstriction, extracellular matrix synthesis/turnover, cell growth, angiogenesis, cytokine activation, and leukocyte adhesion. We will briefly review the current knowledge base regarding the pathogenic role for the activation of DAG-PKC pathway in diabetic nephropathy and other microvascular complications of diabetes. The results from animal studies and key clinical studies investigating specific effects of the PKC isoforms on the renal and other vascular tissues to induce diabetic complications are also reviewed.
Lessons from a Patient
Authors: William Rifkin
Journal: Annals of Internal Medicine (2005)

On Being a Doctor16 August 2005Lessons from a PatientWilliam Rifkin, MDWilliam Rifkin, MDFrom Waterbury Hospital, Waterbury, CT 06721.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-143-4-200508160-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Lisa was a young woman in her 20s. I thought she might have had bipolar disorder. Early on, after offering my diagnosis, I seemed to have time for her. She received my counsel with appreciation. I listened with at least some attention as she described the horrors of her brief life, which, needless to say, had not been improved by her psychiatric diagnosis. Whenever a patient like Lisa shares with me her tale of misery, I experience the following arc, perhaps common to most doctors: first, horror at how cruel and harsh the world can be, then appreciation of the ... Author, Article, and Disclosure InformationAuthors: William Rifkin, MDAffiliations: From Waterbury Hospital, Waterbury, CT 06721.Corresponding Author: William Rifkin, MD, Department of Medicine, Waterbury Hospital, 64 Robbins Street, Waterbury, CT 06721. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 16 August 2005Volume 143, Issue 4Page: 307-308KeywordsAddictsBipolar disorderComputed axial tomographyEmergency departmentEmotionsHeartHospital medicineKidney stonesRiversUltrasound imaging ePublished: 16 August 2005 Issue Published: 16 August 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Endemic Goiter in Southeast Asia
Authors: V. RAMALINGASWAMI
Journal: Annals of Internal Medicine (1973)

Endemic goiter is widely prevalent in the countries of Southeast Asia; the Himalayan endemic is one of the world's most extensive and severe endemics. It is accompanied in many areas of this region by endemic cretinism, deaf-mutism, and other developmental disorders and thus constitutes a significant health problem. For many years the etiology and pathogenesis of goiter in the Himalayas had remained obscure. Studies of the problem indicate that the endemic in Southeast Asia is primarily the result of environmental iodine deficiency. The thyroid makes a series of finely balanced adjustments to chronic iodine deprivation. We have shown that the Indian endemic can be controlled successfully by the administration of physiological doses of iodine in the form of either potassium iodide or iodate added to domestic salt.