tbuckley/cabot-search huggingface dataset:
Notes of a Case of Carbonic Acid Poisoning, Treated by Inhalation of Oxygen: With a Description of a New Apparatus for Rendering Impure Air Respirable
Authors: C. B. Ball
Journal: BMJ (1878)

drachms of greenish pus.The interior of the cavity consisted entirely of white brain-substance, and was of a firmer consistence than the rest of the brain.There were also in the cavity two small blood-clots, partially organised.The right lobe of the cerebellum was, compara- tively speaking, a mere shell; and the left lobe, as well as the pons Varolii, was to a small extent also implicated.The membranes were perfectly healthy, and there was no apparent communication between the abscess and the suppurating ear.
Histopathological algorithm and scoring system for evaluation of liver lesions in morbidly obese patients
Authors: Pierre Bedossa, Christine Poitou, Nicolas Veyrie, Jean-Luc Bouillot, Arnaud Basdevant, Valerie Paradis, Joan Tordjman, Karine Clement
Journal: Hepatology (2012)

Nonalcoholic fatty liver disease (NAFLD) is highly prevalent and being overweight is a significant risk factor. The aim was to build an algorithm along with a scoring system for histopathologic classification of liver lesions that covers the entire spectrum of lesions in morbidly obese patients. A cohort of 679 obese patients undergoing liver biopsy at the time of bariatric surgery was studied. An algorithm for segregating lesions into normal liver, NAFLD, or nonalcoholic steatohepatitis (NASH) was built based on semiquantitative evaluation of steatosis, hepatocellular ballooning, and lobular inflammation. For each case, the SAF score was created including the semiquantitative scoring of steatosis (S), activity (A), and fibrosis (F). Based on the algorithm, 230 obese patients (34%) were categorized as NASH, 291 (43%) as NAFLD without NASH, and 158 (23%) as not NAFLD. The activity score (ballooning + lobular inflammation) enabled discriminating NASH because all patients with NASH had A ≥ 2, whereas no patients with A < 2 had NASH. This score was closely correlated with both alanine aminotransferase (ALT) and aspartate aminotransferase (AST) (P < 0.0001, analysis of variance [ANOVA]). Comparison of transaminase levels between patients with normal liver and pure steatosis did not reveal significant differences, thus lending support to the proposal not to include steatosis in the activity score but to report it separately in the SAF score. In the validation series, the interobserver agreement for the diagnosis of NASH was excellent (κ = 0.80) between liver pathologists. There was no discrepancy between the initial diagnosis and the diagnosis proposed using the algorithm. We propose a simple but robust algorithm for categorizing liver lesions in NAFLD patients. Because liver lesions in obese patients may display a continuous spectrum of histologic lesions, we suggest describing liver lesions using the SAF score.
Stolen Innocence: A Mother's Fight for Justice—The Story of Sally Clark
Authors: Kevin Barraclough
Journal: BMJ (2004)

This book is a disturbing read. It is a terrible indictment of the criminal system, the legal profession, and our own experts.

Solicitor Sally Clark was convicted in November 1999 of the murder of her two children, purely on the basis of medical expert testimony, and sentenced to life imprisonment. The case attracted a high media profile, but since her conviction, later overturned on appeal, it is the role of the medical experts that has been on trial. As witnesses for the prosecution, they described retinal haemorrhages, bruises, broken bones, and injuries to the spinal cord. These were either seen in …
CENTRAL AND OBSTRUCTIVE SLEEP APNOEA ARE ASSOCIATED WITH INCREASED MORTALITY IN PATIENTS WITH LONG-TERM CARDIAC RESYNCHRONIZATION THERAPY
Authors: Olav Oldenburg, Thomas Bitter, Juergen Vogt, Thomas Fischbach, Zisis Dimitriadis, Kevin Bullert, Dieter Horstkotte
Journal: Journal of the American College of Cardiology (2011)
Acyclovir prophylaxis against herpes virus infections in severely immunocompromised patients: randomised double blind trial.
Authors: I M Hann, H G Prentice, H A Blacklock, M G Ross, D Brigden, A E Rosling, C Burke, D H Crawford, W Brumfitt, A V Hoffbrand
Journal: BMJ (1983)

Twenty patients undergoing allogeneic bone marrow transplantation and 39 patients receiving remission induction chemotherapy for acute leukaemia were entered into a double blind, placebo controlled stratified trial of acyclovir prophylaxis against herpes group virus infections. Within the transplant group intravenous acyclovir 5 mg/kg twice daily given throughout the period of granulocytopenia completely prevented oropharyngeal herpes simplex virus infection compared with a 50% incidence in the placebo arm (p = 0.033). The acyclovir group also had fewer days of fever during the trial and a shorter duration of leukopenia, possibly because of the prevention of herpes simplex virus infections. There was a high incidence of herpes infections after the trial in patients who received either acyclovir or placebo. In the non-transplant group there was also a significant reduction of herpes simplex virus infection in the oropharynx and oesophagus (two out of 19 patients as compared with 10 out of 20; p = 0.018). Herpes simplex virus was isolated in the acyclovir arm within a day after starting the trial in one patient, and the other failure was due to a virus with reduced sensitivity to acyclovir in a patient who had had several previous courses of the drug. The incidence of herpes infections after stopping treatment was low. The influence of acyclovir on excretion of Epstein-Barr virus in saliva in either group was inconclusive. One patient (transplant group) developed a cytomegalovirus infection while receiving acyclovir. Acyclovir provides effective prophylaxis against oropharyngeal and oesophageal herpes simplex virus infection in severely immunocompromised seropositive (greater than or equal to 1/8) patients. In patients given bone marrow transplants this may have the additional benefit of reducing the time to recovery of an adequate blood count and the number of days of fever.
Abstract 5263: Src inhibition enhances BMP receptor antagonists downregulation of Id1 and growth suppression of lung cancer cells with a K-Ras mutation.
Authors: John E. Langenfeld, Elaine Langenfeld
Journal: Cancer Research (2013)

Abstract The bone morphogenetic protein 2 (BMP2) is aberrantly expressed in 98% of non-small cell lung carcinomas. Our studies show that selective antagonists (DMH1, DMH2, and LDN) of the type I BMP receptors inhibit the proliferation and induce cell death of lung cancer cell lines, which is mediated at least in part by downregulating the expression of Id1 and Id3. The Id proteins are known to regulate essential aspects of tumorigenesis in many carcinomas. The Src signaling pathway has been shown to increase the expression of Id1 in A549 cells. Src regulation of Id1 is mediated through the BMP pathway. Src binds to pSmad 1/5, which enhances its translocation into the nucleus. Src also mediates activity of response elements on the Id1 promoter that also bind pSmad 1/5. The BMP signaling pathway suppresses Src signaling, suggesting feedback inhibition. We examined the ability of a BMP receptor antagonist (DMH2) and a Src antagonist (PP2) to regulate Id1 and Id3 expression in three lung cancer cell lines with a K-Ras mutation (A549,H157,H727) and 3 without a K-Ras mutation (H1299,H865,U1752). PP2 caused a reduction in Id1 and/or Id3 in 2 of the 3 cell lines with a K-Ras mutation (A549,H157). PP2 had no effect or increased the expression of Id1 and Id3 in cell lines without a K-Ras mutation. DMH2 decreased expression of Id1 and Id3 and caused growth suppression of all the cell lines. In the A549 cells, the combination of DMH2 and PP2 caused significantly greater reduction in Id1 promoter activity and growth inhibition than either agent alone. Inhibition of BMP signaling caused an increase in the expression of phosphorylated Src, suggesting feedback regulation. The data suggests that Src inhibition leads to the downregulation of Id expression predominately in lung cancer cells with a K-Ras mutation. Inhibition of BMP signaling with receptor antagonists causes significant downregulation of Id1/Id3 and growth inhibition even in lung cancer cell lines with K-Ras mutations. Inhibition of BMP signaling may activate Src, suggesting that both BMP and Src antagonists are needed to suppress Id expression and inhibit tumor growth. Citation Format: John E. Langenfeld, Elaine Langenfeld. Src inhibition enhances BMP receptor antagonists downregulation of Id1 and growth suppression of lung cancer cells with a K-Ras mutation. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 5263. doi:10.1158/1538-7445.AM2013-5263
The Management of Uremia by Perfusion of an Isolated Jejunal Segment: With Observations of the Dynamics of Water and Electrolyte Exchange in the Human Jejunum1
Authors: Paul R. Schloerb
Journal: Journal of Clinical Investigation (1958)

The patient2 was an 18 year old rancher's son who, five years prior to admission, had acute glomerulonephritis and since that time had had slowly progressive hypertension, azotemia, albuminuria, weight loss and anemia.
Concerns about privacy in research may be exaggerated
Authors: M. Tondel, O. Axelson
Journal: BMJ (1999)

EDITOR—The risk of misusing electronic patient records has been pointed out,1 and there is also justified professional concern about privacy in medical research. We have enrolled 1.14 million people in a register based cancer study in the seven counties of Sweden that were most contaminated after the Chernobyl accident.

According to the permit from the responsible authority (the Data Inspection Board), we had to inform the public in these counties because of the principle of informed consent. …
The puzzle of endothelial nitric oxide synthase dysfunction in portal hypertension: The missing piece?
Authors: Rajeshwar P. Mookerjee, Balasubramaniyan Vairappan, Rajiv Jalan, Kris Kowdley, Geoffrey McCaughan, Christian Trautwein
Journal: Hepatology (2007)

Asymmetric dimethylarginine (ADMA) and monomethyl arginine (L-NMMA) are endogenously produced amino acids that inhibit all three isoforms of nitric oxide synthase (NOS). ADMA accumulates in various disease states, including renal failure, diabetes and pulmonary hypertension, and its concentration in plasma is strongly predictive of premature cardiovascular disease and death. Both L-NMMA and ADMA are eliminated largely through active metabolism by dimethylarginine dimethylaminohydrolase (DDAH) and thus DDAH dysfunction may be a crucial unifying feature of increased cardiovascular risk. However, despite considerable interest in this pathway and in the role of ADMA as a cardiovascular risk factor, there is little evidence to support a causal role of ADMA in pathophysiology. Here we reveal the structure of human DDAH-1 and probe the function of DDAH-1 both by deleting the DDAH1 gene in mice and by using DDAH-specific inhibitors which, as we demonstrate by crystallography, bind to the active site of human DDAH-1. We show that loss of DDAH-1 activity leads to accumulation of ADMA and reduction in NO signaling. This in turn causes vascular pathophysiology, including endothelial dysfunction, increased systemic vascular resistance and elevated systemic and pulmonary blood pressure. Our results also suggest that DDAH inhibition could be harnessed therapeutically to reduce the vascular collapse associated with sepsis.
Blood lead concentration after a shotgun accident.
Authors: Lars Gerhardsson, Lars Dahlin, Richard Knebel, Andrejs Schütz
Journal: Environmental Health Perspectives (2002)

In an accidental shooting, a man in his late forties was hit in his left shoulder region by about 60 lead pellets from a shotgun. He had injuries to the vessels, the clavicle, muscles, and nerves, with total paralysis of the left arm due to axonal injury. After several surgical revisions and temporary cover with split skin, reconstructive surgery was carried out 54 days after the accident. The brachial plexus was swollen, but the continuity of the nerve trunks was not broken (no neuroma present). We determined the blood lead (BPb) concentration during a follow-up period of 12 months. The BPb concentration increased considerably during the first months. Although 30 lead pellets were removed during the reconstructive surgery, the BPb concentration continued to rise, and reached a peak of 62 microg/dL (3.0 micromol/L) on day 81. Thereafter it started to decline. Twelve months after the accident, BPb had leveled off at about 30 microg/dL. At that time, muscle and sensory functions had partially recovered. The BPb concentration exceeded 30 microg/dL for 9 months, which may have influenced the recovery rate of nerve function. Subjects with a large number of lead pellets or fragments embedded in the body after shooting accidents should be followed for many years by regular determinations of BPb. To obtain a more stable basis for risk assessment, the BPb concentrations should be corrected for variations in the subject's hemoglobin concentration or erythrocyte volume fraction.
Drug firm's legal action against government advisers is described as "intimidation"
Authors: R. Moynihan
Journal: BMJ (2010)

The drug company AstraZeneca has launched legal action against an influential committee of independent advisers to the Australian government.

Documents lodged with a federal court show that the company has begun proceedings against 17 members of the Pharmaceutical Benefits Advisory Committee and the federal health minister.

Neither AstraZeneca nor the government will comment on the nature of the case against the powerful committee, which makes recommendations on which drugs attract subsidies—and the conditions attached to those subsidies—in Australia’s £4bn (€4.7bn; $6.4bn) publicly …
Factors That Influence Parathyroid Hormone Half-life
Authors: Andrew J. Leiker, Tina W. F. Yen, Dan C. Eastwood, Kara M. Doffek, Aniko Szabo, Douglas B. Evans, Tracy S. Wang
Journal: JAMA Surgery (2013)

Minimally invasive parathyroidectomy using intraoperative parathyroid hormone monitoring remains the standard approach to the majority of patients with primary hyperparathyroidism. This study demonstrates that individual patient characteristics do not affect existing criteria for intraoperative parathyroid hormone monitoring.To identify patient characteristics, such as age, sex, race, body mass index (BMI), and renal function, that may affect existing criteria for intraoperative parathyroid hormone (IOPTH) levels during minimally invasive parathyroidectomy.Retrospective review of a prospectively collected parathyroid database populated from August 2005 to April 2011.Academic medical center.Three hundred six patients with sporadic primary hyperparathyroidism who underwent initial parathyroidectomy between August 2005 and April 2011.All patients underwent minimally invasive parathyroidectomy with complete IOPTH information.Individual IOPTH kinetic profiles were fitted with an exponential decay curve and individual IOPTH half-lives were determined. Univariate and multivariate analyses were performed to determine the association between patient demographics or laboratory data and IOPTH half-life.Mean age of the cohort was 60 years, 78.4% were female, 90.2% were white, and median BMI was 28.3. Overall, median IOPTH half-life was 3 minutes, 9 seconds. On univariate analysis, there was no association between IOPTH half-life and patient age, renal function, or preoperative serum calcium or parathyroid hormone levels. Age, BMI, and an age × BMI interaction were included in the final multivariate median regression analysis; race, sex, and glomerular filtration rate were not predictors of IOPTH half-life. The IOPTH half-life increased with increasing BMI, an effect that diminished with increasing age and was negligible after age 55 years (P = .001).Body mass index, especially in younger patients, may have a role in the IOPTH half-life of patients undergoing parathyroidectomy. However, the differences in half-life are relatively small and the clinical implications are likely not significant. Current IOPTH criteria can continue to be applied to all patients undergoing parathyroidectomy for sporadic primary hyperparathyroidism.
Morphoea associated with B-cell Lymphoma
Authors: O. Ishikawa, S. Akimoto, C. Iijima, Y. Takeuchi, Y. Miyachi, Y. Nagai, M. Kojima
Journal: British Journal of Dermatology (1997)

Journal Article Morphoea associated with B–cell Lymphoma Get access O. Ishikawa, O. Ishikawa Department of Dermatology, Gunma University School of Medicine, 3–39–22, Showamachi, Maebashi, Gunma, Japan Search for other works by this author on: Oxford Academic Google Scholar S. Akimoto, S. Akimoto Department of Dermatology, Gunma University School of Medicine, 3–39–22, Showamachi, Maebashi, Gunma, Japan Search for other works by this author on: Oxford Academic Google Scholar C. Iijima, C. Iijima Department of Dermatology, Gunma University School of Medicine, 3–39–22, Showamachi, Maebashi, Gunma, Japan Search for other works by this author on: Oxford Academic Google Scholar Y. Takeuchi, Y. Takeuchi Department of Dermatology, Gunma University School of Medicine, 3–39–22, Showamachi, Maebashi, Gunma, Japan Search for other works by this author on: Oxford Academic Google Scholar Y. Miyachi, Y. Miyachi Department of Dermatology, Gunma University School of Medicine, 3–39–22, Showamachi, Maebashi, Gunma, Japan Search for other works by this author on: Oxford Academic Google Scholar Y. Nagai, Y. Nagai Division of Dermatology, Tone Central Hospital Search for other works by this author on: Oxford Academic Google Scholar M. Kojima M. Kojima Division of Pathology, Ashikaga Red Cross Hospital Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 136, Issue 2, 1 February 1997, Pages 294–295, https://doi.org/10.1111/j.1365-2133.1997.tb14926.x Published: 01 February 1997
Relevance of experimental studies to human risk.
Authors: F K Dietz, J C Ramsey, P G Watanabe
Journal: Environmental Health Perspectives (1983)

Confidence in the extrapolation of animal toxicity data to humans can be enhanced by the application of pharmacokinetic concepts integrated with chronic toxicity data and knowledge of a chemical's mechanism(s) of toxicity. Basic pharmacokinetic concepts (including dose-dependent or Michaelis-Menten kinetics) and their relationship to the risk estimation process are discussed using vinyl chloride and styrene as specific examples. Species differences in metabolic rates must be considered in order to arrive at realistic estimates of human risk to vinyl chloride-induced liver angiosarcomas utilizing vinyl chloride toxicity data observed in rats. Because small animal species generally metabolize chemicals more rapidly than larger species on a body surface area basis, small animals should be more sensitive to chemicals (such as vinyl chloride) that exert their toxicities via the metabolic formation of toxic products. Inhaled styrene is a chemical whose clearance from the blood at low exposure levels in both rats and humans follows first-order kinetics. However, at higher exposure levels, the pharmacokinetic fate of styrene in rats is dose-dependent, suggesting a saturation of styrene metabolism. These data indicate that any extrapolation of observable toxicity at elevated exposure levels in rats to anticipated responses at lower levels in either rats or humans may be invalid. An integration of the foregoing concepts provides a sound scientific basis for the use of experimental animal data to predict the risk to humans from chemical exposure.
Prevalence of Antibody to HIV-1 Among Entrants to US Correctional Facilities
Authors: D Vlahov, T F Brewer, K G Castro, J P Narkunas, M E Salive, J Ullrich, A Muñoz
Journal: JAMA (1991)

Prevalence of antibody to the human immunodeficiency virus type 1 (HIV-1) was assessed among 10,994 consecutive male and female entrants to 10 correctional systems in the United States. The HIV-1 seroprevalence for the 10 systems ranged from 2.1% to 7.6% for men and 2.5% to 14.7% for women; seroprevalence among women was higher than among men across nine of 10 systems. Using age 25 years to divide the population, HIV-1 prevalence among young women (5.2%) was significantly higher than among young men (2.3%), but similar to that in both older women (5.3%) and older men (5.6%). Overall, HIV-1 rates for nonwhites (4.8%) were higher than those for whites (2.5%). Although categories were identified across correctional systems, which may serve to focus prevention programs, variability in rates among correctional systems indicates that program planning must take local conditions into consideration.
Re-examining crude coal tar treatment for psoriasis
Authors: R. E. A. WILLIAMS, D. M. TILLMAN, S. I. WHITE, E. L. BARNETT, R. M. MACKIE
Journal: British Journal of Dermatology (2008)

Two separate. double‐blind, randomized, half‐and‐half body comparisons, each involving 20 inpatients with psoriasis, were conducted to compare the effect of different concentrations of crude coal tar in yellow soft paraffin. The therapeutic effect of 1% crude coal tar used twice daily for 10 days was significantly less than that achieved with an incremental regimen starting at 5% and increasing by 5% every second day to a maximum of 25%. No such difference was seen when a steady concentration of 5% was compared with the same incremental regimen. We conclude that there appears to be no benefit from exceeding a concentration of 5% crude coal tar in yellow soft paraffin in the treatment of patients with psoriasis and that the plateau in the dose‐response curve for the action of crude coal tar in psoriasis begins at a point between 1 and 5%.
Injury from lightning strike while using mobile phone: Statistics and physics do not suggest a link
Authors: Ramsey M Faragher
Journal: BMJ (2006)

EDITOR—The letter by Esprit et al reporting a case of injury from lightning strike while using a mobile phone required some better research into the physics of lightning, conductors, and statistics.1

Firstly, the statistics are few. Three mentions of people using a mobile phone while being hit by a lightning strike is by no means compelling evidence for a correlation for either …
Book Review Deglutition and Its Disorders: Anatomy, physiology, clinical diagnosis, and management Edited by Adrienne L. Perlman and Konrad S. Schulze-Delrieu. 522 pp. San Diego, Calif., Singular Publishing Group, 1997. $75. 1-56593-621-3
Authors: Brian F. Humphreys
Journal: New England Journal of Medicine (1997)
Medical heresy: ditch the eponyms
Authors: Des Spence
Journal: BMJ (2012)

There are hundreds of eponymous medical syndromes and signs, often with fantastic double barrelled names with exotic connections to central Europe. It is odd that there are few signs named after Smith, Jones, or Brown. I like to imagine that the eponyms were made up by Victorian doctors who lived in smoggy and grim towns like Sheffield, Sunderland, and Middlesbrough to give the signs more gravitas. 

Today, MacLeod’s Clinical Examination is still the bible of clinical examination and heaves with these signs. In timeless tradition the medical gunners still squeal …