tbuckley/cabot-search huggingface dataset:
War Syndromes and Their Evaluation: From the U.S. Civil War to the Persian Gulf War
Authors: Kenneth C. Hyams
Journal: Annals of Internal Medicine (1996)

Purpose: To better understand the health problems of veterans of the Persian Gulf War by analyzing previous war-related illnesses and identifying possible unifying factors. Data Source: English-language articles and books on war-related illnesses published since 1863 that were located primarily through a manual search of bibliographies. Data Extraction: Publications were assessed for information on the clinical characteristics of war-related illnesses and the research methods used to evaluate such illnesses. Data Synthesis: Poorly understood war syndromes have been associated with armed conflicts at least since the U.S. Civil War. Although these syndromes have been characterized by similar symptoms (fatigue, shortness of breath, headache, sleep disturbance, forgetfulness, and impaired concentration), no single recurring illness that is unrelated to psychological stress is apparent. However, many types of illness were found among evaluated veterans, including well-defined medical and psychiatric conditions, acute combat stress reaction, post-traumatic stress disorder, and possibly the chronic fatigue syndrome. No single disease is apparent, but one unifying factor stands out: A unique population was intensely scrutinized after experiencing an exceptional, life-threatening set of exposures. As a result, research efforts to date have been unable to conclusively show causality, have been subject to reporting bias, and have lacked similar control populations. In addition to research limitations, war syndromes have involved fundamental, unanswered questions about the importance of chronic somatic symptoms and the factors that create a personal sense of ill health. Conclusion: Until we can better understand what constitutes health and illness in all adult populations, we risk repeated occurrences of unexplained symptoms among veterans after each war.
Ultrasonographic prognostic factors in patients with hepatocellular carcinoma
Authors: S.Ricca Rosellini, V. Arienti, O. Nanni, M. Tassinari, F. Ugenti, C. Camporesi, L. Boriani, P.L. Costa, D. Amadoris, F. Miglio, G. Gasbarrini
Journal: Journal of Hepatology (1991)
Bicozamycin, A Poorly Absorbable Antibiotic, Effectively Treats Travelers' Diarrhea
Authors: Charles D. Ericsson, Herbert L. DuPONT, Peggy Sullivan, Emma Galindo, Dolores G. Evans, Doyle J. Evans
Journal: Annals of Internal Medicine (1983)

The efficacy of bicozamycin, a poorly absorbable antibiotic, in the treatment of acute diarrhea was assessed in a prospective, double-blind study of 140 adults from the United States visiting Guadalajara, Mexico. Patients randomly received bicozamycin (500 mg orally four times daily) or placebo for 3 days. The mean duration of illness was shorter in the bicozamycin than the placebo treatment groups for patients with diarrhea due to Shigella (37 versus 90 hours; p = 0.01), toxigenic Escherichia coli (31 versus 60 hours; p = 0.003), and unknown pathogens (18 versus 41 hours; p = 0.02). Cramps were significantly relieved by bicozamycin in all patients. Treatment failed in significantly fewer patients treated with bicozamycin than those treated with placebo when diarrhea was associated with Shigella, Salmonella or toxigenic E. coli. Bicozamycin was well tolerated and appears to be effective therapy for acute travelers' diarrhea of diverse causes. These data show the value of an antibiotic in the therapy of toxigenic E. coli infection and indicate a need to reevaluate the clinical dictum that nonabsorbable antibiotics are ineffective against invasive enteropathogens.
Familial lichen sclerosus et atrophicus in association with CREST syndrome: a case report
Authors: E.A. FITZGERALD, C.S. CONNELLY, S.M. PURCELL, G.R. KANTOR
Journal: British Journal of Dermatology (1996)

Lichen sclerosus et atrophicus is an uncommon disease which appears to be multifactorial in aetiology. We describe a case of a young woman with CREST syndrome (calcinosis, Raynaud's phenomenon, oesophageal dysfunction, sclerodactyly and telangiectasia) who has a documented family history of two sisters with lichen sclerosus et atrophicus. She presented with vulvar pruritus in association with dyspareunia, and biopsy of atrophic white vulvar lesions was consistent with lichen sclerosus et atrophicus. Lichen sclerosus et atrophicus has been previously noted to occur in association with morphoea and lichen planus, although it has never been reported in conjunction with CREST syndrome.
Role of intracellular Na+ in Ca2+ overload and depressed recovery of ventricular function of reperfused ischemic rat hearts. Possible involvement of H+-Na+ and Na+-Ca2+ exchange.
Authors: M Tani, J R Neely
Journal: Circulation Research (1989)

The roles of H+-Na+ and Na+-Ca2+ exchange in the depression of ventricular function were studied in the reperfused isolated ischemic rat heart. Zero-flow global ischemia was induced for either 15 or 30 minutes and was followed by 30 minutes of aerobic reperfusion. Intracellular Na+ (Na+i) and 45Ca2+ uptake were measured during ischemia and reperfusion. Accumulation of Na+i was modified by prior glycogen depletion and by treatment with amiloride, a H+-Na+ exchange inhibitor, or monensin, a Na+ ionophore. Na+i rose continuously during ischemia and rapidly during the first two minutes of reperfusion. The larger inhibitory effect of amiloride and preischemic glycogen depletion was on Na+i accumulation during reperfusion; this finding suggests that the uptake occurs by H+-Na+ exchange. Reduction of Na+i accumulation by glycogen depletion was associated with less lactate and, presumably, H+ production and accumulation during ischemia. The rapid increase in Na+i during early reperfusion may reflect the readjustment of the low intracellular pH resulting from ischemia. The level of Na+i at the end of ischemia and especially after two minutes of reperfusion were linearly correlated with 45Ca2+ uptake and depression of ventricular function during subsequent reperfusion. This highly significant correlation between Na+i and 45Ca2+ uptake when Na+i was varied by several independent procedures, including monensin, strongly suggests that reperfusion 45Ca2+ uptake occurs at least in part by Na+-Ca2+ exchange. The rate of 45Ca2+ uptake during reperfusion was linearly and highly significantly correlated with elevation of diastolic pressure, reduced developed pressure, and decreased recovery of ventricular function. The data strongly support a mechanism of ischemic cell damage that involves excessive production and accumulation of H+ during ischemia that exchanges for extracellular Na+ during ischemia and rapidly during the first few minutes of reperfusion. Increased Na+i then causes excessive 45Ca2+ uptake and depressed recovery of cellular functions with continued reperfusion. Increased levels of Na+i may be a major event that couples a decreased intracellular pH during ischemia to excessive 45Ca2+ uptake and depressed recovery of cellular function with reperfusion.
The Sedoheptulose Kinase CARKL Directs Macrophage Polarization through Control of Glucose Metabolism
Authors: Arvand Haschemi, Paul Kosma, Lars Gille, Charles R. Evans, Charles F. Burant, Philipp Starkl, Bernhard Knapp, Robert Haas, Johannes A. Schmid, Christoph Jandl, Shahzada Amir, Gert Lubec, Jaehong Park, Harald Esterbauer, Martin Bilban, Leonardo Brizuela, J. Andrew Pospisilik, Leo E. Otterbein, Oswald Wagner
Journal: Cell Metabolism (2012)

Immune cells are somewhat unique in that activation responses can alter quantitative phenotypes upwards of 100,000-fold. To date little is known about the metabolic adaptations necessary to mount such dramatic phenotypic shifts. Screening for novel regulators of macrophage activation, we found nonprotein kinases of glucose metabolism among the most enriched classes of candidate immune modulators. We find that one of these, the carbohydrate kinase-like protein CARKL, is rapidly downregulated in vitro and in vivo upon LPS stimulation in both mice and humans. Interestingly, CARKL catalyzes an orphan reaction in the pentose phosphate pathway, refocusing cellular metabolism to a high-redox state upon physiological or artificial downregulation. We find that CARKL-dependent metabolic reprogramming is required for proper M1- and M2-like macrophage polarization and uncover a rate-limiting requirement for appropriate glucose flux in macrophage polarization.
Marginating Dendritic Cells of the Tumor Microenvironment Cross-Present Tumor Antigens and Stably Engage Tumor-Specific T Cells
Authors: John J. Engelhardt, Bijan Boldajipour, Peter Beemiller, Priya Pandurangi, Caitlin Sorensen, Zena Werb, Mikala Egeblad, Matthew F. Krummel
Journal: Cancer Cell (2012)
The Safety-Razor Blade as a Scalpel
Authors: J. C. O'Day
Journal: JAMA (1913)

<h3>To the Editor</h3> —As I have been using safety-razor blades in surgery for three years, I was interested in the article in The Journal, Dec. 14, 1912, p. 2127. The handle portrayed ia an improvement over mine. The use of these blades was suggested to me by Dr. J. T. McDonald of Honolulu. When he was bacteriologist to the territory of Honolulu, he used blades to secure "snips" from those suspected of having leprosy. It came about in this way: Certain people contended that the physicians of the department of health were transmitting the disease by "snipping different persons with the same knife. Of course, the knife had always been sterilized. but this did not satisfy the objectors. To do away with this prejudice, the law was made that every knife should be destroyed after a "snip" had been made with it. Dr. McDonald then hit on the idea of using the
Failure to deliver hepatitis B vaccine: confessions from a genitourinary medicine clinic.
Authors: N Bhatti, R J Gilson, M Beecham, P Williams, M P Matthews, R S Tedder, I V Weller
Journal: BMJ (1991)

OBJECTIVE--To audit hepatitis B immunisation of homosexual or bisexual men in a genitourinary medicine clinic. DESIGN--Retrospective case note review of all homosexual and bisexual men presenting to a genitourinary clinic as new patients during 12 months in 1988 and follow up review of notes to May 1990. SETTING--One department of genitourinary medicine, Middlesex Hospital. PATIENTS--758 homosexual or bisexual men, of whom 207 started a course of hepatitis B vaccine in 1988. Case notes were unavailable for one patient. MAIN OUTCOME MEASURES--The proportion of patients screened for hepatitis B virus markers, the proportion of susceptible patients immunised, the proportion completing the vaccine course, and the proportion rendered immune. RESULTS--25 men had been previously tested for hepatitis markers; of the 732 not previously tested, 440 (60.1%) were screened for hepatitis B markers. 207 (69%) of the 300 patients without hepatitis B serological markers started the vaccine course, and 141 (68%) completed it, with 75 (84%) of the 89 tested after immunisation being immune. An estimated 24% of susceptible new patients were rendered immune as a result of the immunisation policy. Patients who presented with a further episode of a sexually transmitted disease were more likely to have been screened (25% v 12%, p less than 0.0001) and immunised (31% v 18% p = 0.02); those known or found to be positive for HIV antibody were more likely to have been screened (23% v 14%, p = 0.047) but less likely to have been immunised (6% v 17%, p = 0.004). CONCLUSIONS--The major failure was that in not screening; failure to immunise patients found to be susceptible and failure of compliance with the vaccine course contributed. Non-response to the vaccine was of minor importance. Improvements in vaccine delivery are required. IMPLICATIONS--Other providers should be encouraged to review their performance.
English Language Problems
Authors: H. Joshi
Journal: BMJ (1970)

should be mandatory, rather than exploration.Secondly, the aetiological classification suggested in this interesting article should include amoebiasis.This disease is not limited nowadays to tropical areas and it is known to mimic many intra-abdominal emergencies.'It is especially apt to cause colonic dilatation similar to pseudo-obstruction of the large bowel, and we know that exploration in these cases may be associated with high morbidity and mortality, though in cases of toxic megacolon of amoebic ori- gin a caecostomy may be life-saving.This is the only surgical procedure which I think is justified for pseudo-obstruction.If there is acute cholecystitis, then of course cholecys- tectomy or cholecystostomy are justified (Case 2), but then it is no longer pseudo- obstruction but sentinel ileus.-Iam, etc.
A partnership approach to implementing smoke-free prisons
Authors: E. O'Moore, K. Davies, I. Mulholland
Journal: BMJ (2014)

Binswanger and colleagues describe the substantial impact of prison tobacco control policies on smoking attributable mortality.1

In England (and Wales), prisons are commissioned by the National Offender Management Service (NOMS) and healthcare is directly commissioned by NHS England. Nationally, around 80% of prisoners smoke.2 In 2007, a comprehensive national smoke-free policy was introduced in England but adult prisons were exempted. In 2013, Public Health England …
European Society of Gastrointestinal Endoscopy (ESGE) Guidelines: flexible enteroscopy for diagnosis and treatment of small-bowel diseases
Authors: J. Pohl, M. Delvaux, C. Ell, G. Gay, A. May, C. Mulder, M. Pennazio, E. Perez-Cuadrado, P. Vilmann
Journal: Endoscopy (2008)

Until recently, large parts of the small bowel were not accessible with nonsurgical endoscopic techniques. In this scenario, the advent of video capsule endoscopy and balloon-assisted enteroscopy represented a major breakthrough. Although capsule endoscopy is a safe method that may provide imaging of the entire small bowel, major drawbacks are that biopsy sampling and endoscopic treatment cannot be performed; moreover, in many cases interpretation of nonspecific findings remains a concern.
The Operative Treatment of Decubitus Ulcer
Authors: Edmund J. Croce, Charles H. C. Beakes
Journal: New England Journal of Medicine (1947)

SINCE the original report on the operative treatment of decubitus ulcer from this hospital,1 considerable experience has been amassed, and a great impetus has occurred in this field in other Army hospitals. Most of the work has been done on paraplegic battle casualties.2 The indications for the operative closure of decubitus ulcers in these patients no longer appear to be disputable. First and foremost, such a procedure effects, with little risk, a tremendous boost in the patient's morale and suddenly terminates the loss of tissue protein from the ulcer surface, thus favoring protein anabolism, increased appetite, strength, weight and general . . .
Cancer unit faces ministerial inquiry
Authors: D. Campbell
Journal: BMJ (1997)

The Department of Health is to conduct a “full and detailed investigation” into the clinical and management practices of a leading gynaecological surgeon after allegations of serious professional misconduct were reported in the House of Commons.

In a debate on NHS whistleblowing on 5 November Jim Cousins, Labour MP for Newcastle Central, complained that Mr John Monaghan had performed radical vulvectomy without previous biopsy on a patient; approved unacceptable standards for cervical smear testing and other pathology services; and was allowed to maintain his own clinical files away from his hospital's central registry and under his sole control.



Mr John Monaghan

NORTH NEWS AND PICTURES



Mr Monaghan has declined to comment, but on his behalf the Medical Defence Union has said that he “denies that there is any truth in the allegations against him in parliament.” The Medical Defence Union also claimed that the allegations are “not new” and had been “considered and dismissed” by the General Medical Council and the then regional health authority. Some complaints about Mr Monaghan were upheld by investigators from the authority, and he was required to change his clinical practices.

The Monaghan case has become the first major …
Genome-wide association study identifies common variants at four loci as genetic risk factors for Parkinson's disease
Authors: Wataru Satake, Yuko Nakabayashi, Ikuko Mizuta, Yushi Hirota, Chiyomi Ito, Michiaki Kubo, Takahisa Kawaguchi, Tatsuhiko Tsunoda, Masahiko Watanabe, Atsushi Takeda, Hiroyuki Tomiyama, Kenji Nakashima, Kazuko Hasegawa, Fumiya Obata, Takeo Yoshikawa, Hideshi Kawakami, Saburo Sakoda, Mitsutoshi Yamamoto, Nobutaka Hattori, Miho Murata, Yusuke Nakamura, Tatsushi Toda
Journal: Nature Genetics (2009)
Why the National Cancer Institute Chooses a Case-Record Review of Laetrile
Authors: Guy R. Newell
Journal: New England Journal of Medicine (1978)

Over a year ago, in response to growing public and professional interest in Laetrile, the National Cancer Institute indicated that it would consider conducting a Phase II clinical trial of the drug, given appropriate indications for such a trial. This possibility is still under consideration. Before deciding on a trial, however, the Institute has sought to evaluate the potential therapeutic efficacy of Laetrile in animal models, as with other new drugs. Thus, the Institute has tested Laetrile in its preclinical screen, and it has reviewed the results of similar tests by several nonfederal institutions.The various preclinical tests of Laetrile . . .
Risk of Brain Tumors in Children and Susceptibility to Organophosphorus Insecticides: The Potential Role of Paraoxonase (PON1)
Authors: Susan Searles Nielsen, Beth A. Mueller, Anneclaire J. De Roos, Hannah-Malia A. Viernes, Federico M. Farin, Harvey Checkoway
Journal: Environmental Health Perspectives (2005)

Prior research suggests that childhood brain tumors (CBTs) may be associated with exposure to pesticides. Organophosphorus insecticides (OPs) target the developing nervous system, and until recently, the most common residential insecticides were chlorpyrifos and diazinon, two OPs metabolized in the body through the cytochrome P450/paraoxonase 1 (PON1) pathway. To investigate whether two common PON1 polymorphisms, C-108T and Q192R, are associated with CBT occurrence, we conducted a population-based study of 66 cases and 236 controls using DNA from neonatal screening archive specimens in Washington State, linked to interview data. The risk of CBT was nonsignificantly increased in relation to the inefficient PON1 promoter allele [per PON1(-108T) allele, relative to PON1(-108CC): odds ratio (OR) = 1.4; 95% confidence interval (CI), 1.0-2.2; p-value for trend = 0.07]. Notably, this association was strongest and statistically significant among children whose mothers reported chemical treatment of the home for pests during pregnancy or childhood (per PON1(-108T) allele: among exposed, OR = 2.6; 95% CI, 1.2-5.5; among unexposed, OR = 0.9; 95% CI, 0.5-1.6) and for primitive neuroectodermal tumors (per PON1(-108T) allele: OR = 2.4; 95% CI, 1.1-5.4). The Q192R polymorphism, which alters the structure of PON1 and influences enzyme activity in a substrate-dependent manner, was not associated with CBT risk, nor was the PON1(C-108T/Q192R) haplotype. These results are consistent with an inverse association between PON1 levels and CBT occurrence, perhaps because of PON1's ability to detoxify OPs common in children's environments. Larger studies that measure plasma PON1 levels and incorporate more accurate estimates of pesticide exposure will be required to confirm these observations.
Fetal Alcohol Syndrome in Adolescents and Adults-Reply
Authors: Ann Pytkowicz Streissguth
Journal: JAMA (1991)

In Reply.  —Dr Mueller's letter raises a very important point that we have always tried to emphasize in our own work. Fetal alcohol syndrome is a specific disorder and is clinically recognizable. To this date, we have never seen a child with the full-blown features of FAS who did not have a positive history of maternal alcohol exposure during pregnancy. There is no question that someday a child with FAS will be described who has not been exposed to alcohol. Phenocopies occur in every disorder but, to date, the relationship of this syndrome to that etiology remains fixed. In clinical work the probable fetal alcohol effect can be used as a differential diagnosis. It is not a diagnosis of its own.  There are many children with phenotypes that look in some way like FAS who have other disorders such as Blume syndrome, Dubowitz syndrome, Noonan's syndrome, and a multitude of
Analyses of Extravascular Fluids
Authors: William H. Shafer
Journal: JAMA (1969)

The examination of fluid collections from the pericardial, pleural, and abdominal cavities and the joints remains a frequent adjunct to other diagnostic techniques.1Normally these serous cavities contain only small amounts of fluid for lubrication. A wide variety of pathologic conditions may cause abnormal collections of fluid which are classified according to composition as transudate or exudate.  Atransudateis formed by an alteration in the normal mechanisms that regulate the exchange of fluid between the vascular and extravascular compartments. This interchange of fluid between the blood and the tissue spaces is controlled by the balance between the capillary blood pressure forcing fluid into the tissue spaces and the osmotic pressure of the plasma proteins which returns fluid into the vascular compartment. The protein molecules diffuse to a limited extent. The small molecules, such as water, electrolytes, and crystalloids, diffuse back and forth rapidly. The concentration of the small
Clinical Trials of Hepatitis B Immune Globulin
Authors: D. Mac N. Surgenor, Thomas C. Chalmers, Marcel E. Conrad, William T. Friedewald, George F. Grady, Michael Hamilton, James W. Mosley, Alfred M. Prince, James M. Stengle
Journal: New England Journal of Medicine (1975)

Plasma from persons with high titers of hepatitis B antibody (anti-HBs) was used to manufacture one lot of hepatitis B "immune" globulin sufficient for four interlocking clinical trials of prevention or modification of hepatitis B infections. The trials were carried out in renal dialysis units, in medical personnel with accidental exposures to hepatitis B, in transfused patients, and in patients with fulminant hepatitis. A single policy board developed protocols that allowed comparisons among the four studies while respecting the unique requirements of each. (N Engl J Med 293: 1060–1062,1975)
Self-administered Heimlich Maneuver
Authors: Thomas Carlile
Journal: JAMA (1983)

<h3>To the Editor.—</h3> I had a recent personal experience in self-administration of the Heimlich maneuver. I was attending a meeting in Bethesda, Md, and, on retiring one evening in the hotel, I took my usual arthritis medication. This is an aspirin-antacid combination in the form of a capsuleshaped tablet. While attempting to swallow the elongated tablet, I aspirated it and immediately became severely short of breath and then could not breathe. I instinctively clasped my left wrist with my right hand and forced them vigorously into the substernal region. The tablet was forcefully expelled across the small bathroom and shattered on the lavatory mirror into a powder. I immediately regained my breathing capacity but was afflicted with a severe chemical laryngitis that lasted three to four days. The Heimlich maneuver can be self-administered—I was there!