tbuckley/cabot-search huggingface dataset:
Conservative Management of Esophageal Perforation
Authors: George I. Thomas
Journal: JAMA (1965)

<h3>To the Editor:—</h3> The undue emphasis placed on the "Conservative Management of Esophageal Perforation" following endoscopy (JAMA 193:537, 1965) is seriously questioned. From our experience, based on knowledge and management of 24 cases and supported by the reports of a large number of endoscopists and thoracic surgeons, we feel strongly that: Early closure or attempted closure of a ruptured esophagus with adequate surgical drainage will result in decidedly lower morbidity and mortality rates. The dangers inherent in closed-space infection, particularly of the mediastinum, are too great. Instrumental perforation of the pyriform sinus and cervical esophagus should have immediate cervical mediastinotomy. Intrathorax esophageal tears and ruptures should be treated by thoracotomy with esophageal repair if possible, and with adequate mediastinal and pleural drainage. We must not give the impression to general practitioners and other medical specialists that a ruptured esophagus, like a ruptured appendix, must generally be treated
Platelet-activating factor (PAF) stimulates the production of PAF acetylhydrolase by the human hepatoma cell line, HepG2.
Authors: K Satoh, T Imaizumi, Y Kawamura, H Yoshida, M Hiramoto, S Takamatsu, M Takamatsu
Journal: Journal of Clinical Investigation (1991)

The human hepatoma cell line, HepG2, secreted an activity that degrades platelet-activating factor (PAF) by the hydrolysis of the sn-2 acetyl group. This activity was Ca++ independent, inhibited by diisopropylfluorophosphate but not by p-bromophenacyl bromide, and resistant to treatment with trypsin or pronase. Separation of HepG2-conditioned medium by gel filtration disclosed that the activity was associated with lipoproteins. An antiserum against PAF acetylhydrolase immunoprecipitated this activity. It was not recognized by an antibody against lecithin:cholesterol acyltransferase (LCAT), which also is secreted by HepG2 cells. Therefore the phospholipase A2 activity of LCAT was excluded as a source of the observed activity. PAF added to the culture medium stimulated the secretion of the PAF-degrading activity by HepG2 cells, while lyso-PAF was inactive. Maximal stimulation was observed with 5 ng/ml PAF, which induced a fivefold increase. The presence of 5 ng/ml PAF, enhanced the secretion of [35S]methionine-labeled PAF acetylhydrolase and cycloheximide inhibited both the basal and PAF-stimulated secretion of the labeled enzyme. We conclude that HepG2 cells produce PAF acetylhydrolase. The liver may be a major source of plasma PAF acetylhydrolase, and PAF may induce the production of its inactivating enzyme by the liver.
Perceptions of Breast Cancer Risk and Screening Effectiveness in Women Younger Than 50 Years of Age
Authors: W. C. Black, R. F. Nease, A. N. A. Tosteson
Journal: JNCI Journal of the National Cancer Institute (1995)

Journal Article Perceptions of Breast Cancer Risk and Screening Effectiveness in Women Younger Than 50 Years of Age Get access William C. Black, William C. Black Center for the Evaluative Clinical Sciences, Department of Community and Family Medicine, Dartmouth Medical SchoolHanover, N.HDepartment of Radiology, Dartmouth–Hitchcock Medical CenterLebanon, N.H Correspondence to : William C. Black, M.D., Department of Radiology, Dartmouth–Hitchcock Medical Center, 1 Medical Center Dr., Lebanon, NH 03756. Search for other works by this author on: Oxford Academic PubMed Google Scholar Robert F. Nease, Jr, Robert F. Nease, Jr Center for the Evaluative Clinical Sciences, Department of Community and Family Medicine, Dartmouth Medical School Search for other works by this author on: Oxford Academic PubMed Google Scholar Anna N. A. Tosteson Anna N. A. Tosteson Center for the Evaluative Clinical Sciences, Department of Community and Family Medicine, Dartmouth Medical School, and Department of Medicine, Dartmouth–Hitchcock Medical Center Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 87, Issue 10, 17 May 1995, Pages 720–731, https://doi.org/10.1093/jnci/87.10.720 Published: 17 May 1995
Prevalence of food allergy and its relationship to asthma and allergic rhinitis in schoolchildren
Authors: C. Pénard‐Morand, C. Raherison, C. Kopferschmitt, D. Caillaud, F. Lavaud, D. Charpin, J. Bousquet, I. Annesi‐Maesano
Journal: Allergy (2005)

Background: Food allergy (FA) is an important health problem. However, epidemiological studies at the population level are scarce. We assessed the prevalence of FA and its associations with respiratory manifestations among schoolchildren. Methods: A total of 6672 schoolchildren aged 9–11 years recruited from 108 randomly chosen schools in six French cities underwent a clinical examination including skin prick test (SPT) to common food and aeroallergens and the standardized protocol of the run test to assess exercise‐induced bronchial hyper‐responsiveness (EIB). Asthma, allergic rhinitis (AR) and clinical symptoms of FA were determined using a standardized questionnaire completed by parents. Results: About 2.1% of the children reported symptoms of FA, 1.9% were sensitized to food allergens, and 0.1% had SP‐tested FA. The AR was more prevalent than asthma (20.0% lifetime, 11.9% past year vs 9.8%, 8.7% respectively). Reported FA, food sensitization and SP‐tested FA were all positively associated with asthma and AR ( P &lt; 0.001). These associations persisted also for FA not manifesting as respiratory symptoms ( P &lt; 0.001). Asthma and AR remained significantly associated with reported symptoms of FA and allergic sensitization to food allergens after adjustment for confounders as well as for sensitization to aeroallergens. No relationship existed between EIB (9.0%) and FA. Conclusion: The relationships between FA and asthma and AR could be totally explained neither by the existence of respiratory manifestations of FA nor by sensitization to aeroallergens. The FA might intervene differently in asthma and AR.
Changes in the elastic tissue of the non-sun-exposed skin of cigarette smokers
Authors: C. FRANCES., S. BOISNIC, D. J. HARTMANN, B. DAUTZENBERG, M. C. BRANCHET, Y. LE CHARPENTIER, L. ROBERT
Journal: British Journal of Dermatology (1991)

Biopsies were taken from the upper and inner arm of 10 60-year-old male cigarette smokers and compared with 10 age-matched controls who were non-smokers. The mean relative area, number and thickness of the elastic fibres were significantly increased in the cigarette smokers compared to the controls. These results were confirmed using antibodies to elastin or the microfibrillar component of elastic tissue. In the smokers the broader and more fragmented elastic fibres in the skin were not as intensely stained as those of the non-smokers and the ultrastructural alterations of the elastic fibres were similar to those in solar elastosis.
Physiologic evaluation of a new antihypertensive agent: prazosin HCl.
Authors: M C Koshy, D Mickley, J Bourgiognie, M D Blaufox
Journal: Circulation (1977)

The mechanism of action of prazosin hydrochloride, a new antihypertensive agent was studied in 14 patients with essential hypertension. Mean supine blood pressure for the group fell from 148/102 +/- 3/2 (SE) mm Hg at baseline to 139/91 +/- 5/4 after eight weeks of therapy (P less than 0.05). No significant postural hypotension was noted in the patients who responded to therapy. Glomerular filtration rate (endogenous creatinine or inulin clearance) and effective renal plasma flow (PAH clearance) remained unchanged during therapy as did supine and stimulated peripheral plasma renin activity. Cardiac output did not change significantly although plasma volume increased in ten out of 12 patients in whom it was measured (P less than 0.025). Among the patients whose mean blood pressure fell 10 mm Hg or more, peripheral vascular resistance fell significantly (P less than 0.025), and the change in plasma volume was not statistically significant. Among the patients whose mean blood pressure changed less than 10 mm Hg with therapy, there was no significant change in peripheral vascular resistance and plasma volume increased significantly (P less than 0.025). Prazosin hydrochloride appears to be an effective antihypertensive agent which acts by peripheral vasodilatation. It may cause fluid retention. The drug does not appear to affect renal function or renin secretion.
Cell mediated immunity after measles in Guinea-Bissau: historical cohort study
Authors: S O Shaheen, P Aaby, A J Hall, D J P Barker, C B Heyes, A W Shiell, A Goudiaby
Journal: BMJ (1996)

<h3>Abstract</h3> <b>Objective</b>: To investigate whether children who have had measles have reduced general cell mediated immunity three years later compared with vaccinated children who have not had measles. <b>Design</b>: Historical cohort study. <b>Setting</b>: Bissau, Guinea-Bissau. <b>Subjects</b>: 391 children aged 3–13 years who were living in Bissau during a measles epidemic in 1991 and still lived there. These included 131 primary cases and 139 secondary cases from the epidemic and 121 vaccinated controls with no history of measles. <b>Main outcome measures</b>: General cell mediated immunity assessed by measurement of delayed type hypersensitivity skin responses to seven recall antigens. Anergy was defined as a lack of response to all antigens. <b>Results</b>: 82 out of 268 cases of measles (31%) were anergic compared with 20 of the 121 vaccinated controls (17%) (odds ratio adjusted for potential confounding variables 2.2 (95% confidence interval 1.2 to 4.0); P = 0.009). The prevalence of anergy was higher in secondary cases (33% (46/138)) than in primary cases (28% (36/130)), although this difference was not significant. Anergy was more common in the rainy season (unadjusted prevalence 31% (91/291)) than in the dry season (11% (11/98)) (adjusted odds ratio 4.8 (2.2 to 10.3)). This seasonal increase occurred predominantly in the cases of measles. <b>Conclusions</b>: Reduced general cell mediated immunity may contribute to the higher long term mortality in children who have had measles compared with recipients of standard measles vaccine and to the higher child mortality in the rainy season in west Africa. <h3>Key messages</h3> The mechanisms underlying delayed mortality are not understood In Guinea-Bissau children who were tested three years after having had measles had lower general cell mediated immunity than vaccinated children Reduced cell mediated immunity was more common in the rainy season than in the dry season, particularly in cases of measles A reduction in cell mediated immunity may, by increasing susceptibility to other infections, contribute to delayed mortality after measles and to the higher death rates during the rainy season in west African children
987. A Cautionary Tale for Immunotherapy Using Genetically Modified Dendritic Cells; Implications for the Future Design of Vaccines
Authors: PengH. Tan, GeorgeJ.T. George
Journal: Molecular Therapy (2006)

Background: The use of genes to modify dendritic cell (DC) function is an attractive approach to treat many diseases; either using mature DCs (mDCs) to immunize patients, or immature DCs (iDCs) to induce tolerance. Methods & Results: First, a variety of non-viral vectors (including chemical and physical methods) were tested for their ability to transfect DC. They included commercially available chemical methods, for example, polymers, such as PEI, ExGene 500 and SuperFect, liposomes such as LipofectinTM, DOTAP, FuGENE 6, LipofectAMINE, Tfx-50 and CLONfectin® and the conventional chemical methods such as calcium phosphate. In addition, electroporation-based method was also tested. Transfection with chemical and physical methods caused insignificant changes in DC, but they are less efficient at mediating gene expression. While viral vectors are efficient at transducing DCs, their effect on the phenotype and function of DCs is less well characterised. We have investigated the effect of transduction with a variety of viral vectors. We show that adenovirus (Ad), human immunodeficiency virus (HIV), equine anaemia virus (EIAV) and Moloney murine leukemia virus (MMLV) can upregulate co-stimulatory molecules and MHC class II expression on DC, as well as inducing production of Th1 and proinflammatory cytokines. Following viral transduction, there is upregulation of dsRNA-triggered pathways, which result in IFNα/β production, an established component of innate antiviral immunity. Viral transductions also upregulate PI3-kinase pathway and its downstream NFκB pathways of DC. Both the PKR and the PI3-K pathways were associated with cytokine production (IFN-α/β for PKR and TNF-α/IL-1α/β for PI3-K), serving as positive feedback loops that might help 'lock' the DCs into an activated phenotype. In addition, the function of virally-infected DCs is also altered; the ability of iDCs to stimulate a mixed lymphocyte reaction (MLR) was increased and ability of mDCs to stimulate a MLR was decreased. We have shown that viral transduction of mDC results in upregulation of the indoleamine 2,3-dioxygenase (IDO) enzyme, which downregulates T cell responsiveness. Inhibition of the activity of IDO blocks the reduction in the MLR seen with mDC following viral transduction, indicating that this enzyme is responsible for the modulation of mDC function. Conclusion: We have shown that transduction with viral vectors, in particular Ad and lentiviral vectors, has dramatic consequences for DCs in terms of their phenotype, the activation pathways induced and their function. Of particular interest in the context of immunomodulation is the activation of IDO, which in mDCs, blocks their ability to stimulate T cell responses. These data are important not only in the context of genetic manipulation of DC for immunotherapy, but also in our understanding of the response of DC to viral infection.
Characteristics of an Adult Population With Newly Diagnosed Type 2 Diabetes
Authors: Teresa A. Hillier, Kathryn L. Pedula
Journal: Diabetes Care (2001)

OBJECTIVE—To determine whether adults diagnosed with type 2 diabetes at 18–44 years of age (early type 2 diabetes) have different metabolic profiles at diagnosis than adults diagnosed at ≥45 years of age (usual type 2 diabetes). RESEARCH DESIGN AND METHODS—Within a health maintenance organization, we studied characteristics among 2,437 adults newly diagnosed with type 2 diabetes between 1996 and 1998 who had measured weight, HbA1c, blood pressure, and cholesterol within 3 months of diagnosis. We abstracted clinical data from electronic medical records. We compared mean and proportional differences with parametric t tests and χ2 analyses, respectively. We used multiple logistic regression to identify the factors independently associated with the onset group (early vs. usual type 2 diabetes). RESULTS—There was an inverse linear relationship between BMI and age at diagnosis of type 2 diabetes (P &amp;lt; 0.001). On univariate analysis, adults with early type 2 diabetes were more obese (BMI 39 vs. 33 kg/m2, P &amp;lt; 0.001), were more likely to be female (P = 0.04), had slightly worse glycemic control (HbA1c 7.7 vs. 7.5%, P = 0.03), had a higher prevalence of diastolic hypertension (37 vs. 26%, P &amp;lt; 0.001), despite a lower prevalence of systolic hypertension (34 vs. 55%, P &amp;lt; 0.001), and had an equally high rate of abnormal lipids (82 vs. 78%, P = 0.13) than adults with usual type 2 diabetes. BMI, female gender, cholesterol, and diastolic and systolic blood pressure remained independently associated with onset group at multivariate analysis. CONCLUSIONS—Although both onset groups were on average obese, the inverse linear relationship of obesity and age of diabetes onset that we observed suggests that obesity is a continuous risk rather than a threshold risk for diabetes onset. Both onset groups had a high prevalence of cardiovascular disease risk factors.
Seeking to end smoking's appeal to women, youth
Authors: Phil Gunby
Journal: JAMA (1985)

This will be the first year in US history in which more women will die of carcinoma of the lung than of any other form of cancer. That is the prediction of the president of the American Cancer Society, Robert J. McKenna, MD, clinical professor of surgery, University of Southern California School of Medicine, Los Angeles, and surgical oncologist in private practice. He told a San Diego seminar that the American Cancer Society is going to Congress, the Federal Trade Commission, business and industry, and the public in an intensified campaign against tobacco. Using data from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute, Bethesda, Md, the society is projecting 38,600 deaths from carcinoma of the lung in American women this year. For the first time, this figure is higher than the projected number of deaths (38,400) among US women from carcinoma of the breast.
HER2 Therapy — An Abundance of Riches
Authors: William J. Gradishar
Journal: New England Journal of Medicine (2011)

Human epidermal growth factor receptor 2 (HER2)-positive breast cancer is a distinct subset of breast cancer characterized by overexpression of the HER2 protein. Clinically, HER2-positive tumors are associated with a more aggressive phenotype and poor outcomes. With the introduction of trastuzumab, a humanized monoclonal antibody targeting HER2, significant improvements in survival were observed in patients with HER2-positive metastatic breast cancer and in patients with early-stage disease.1,2 Despite the practice-changing impact of trastuzumab and the substantial improvement in outcomes, patients with HER2-positive metastatic breast cancer ultimately die from the disease.A number of strategies have been developed to deal with . . .
The Chair of Physic in Trinity College, Dublin, 1662 to 1962
Authors: F. J. E. Hurst
Journal: BMJ (1962)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following The Chair of Physic in Trinity College, Dublin, 1662 to 1962 Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Against Fetishism About Egalitarianism and in Defense of Cautious Moral Bioenhancement
Authors: Ingmar Persson, Julian Savulescu
Journal: The American Journal of Bioethics (2014)

We respond to Sparrow's (2014) criticisms of our support for a project of moral bioenhancement. We distinguish between a confident and cautious proposal, arguing that his objections only apply to a...
Complications of Oral Contraception
Authors: F. Hartveit
Journal: BMJ (1965)

BmmIn late 1963 I started to use prilocaine only for all kinds of local analgesic tech- niques at the county hospital in Vaxjb, Sweden.Like many others I soon discovered that it was necessary to increase its concentration to 3% for satisfactory caudal and other forms of epidural analgesia comparable to that after 2% mepivacaine (carbocaine) and 2% lignocaine.Indeed, after I learned that the curious cyanosis noted at least twice by me represented the invariable methaemoglobinaemia accompanying the use of prilo- caine' 2 I used only mepivacaine during the last months before coming to this country.I have available an impressive list of publications supporting my present conviction that mepivacaine is the best available local analgesic.It is worth noting that already eight years ago it was found that " under the (dental) conditions described carbocaine gave 82.8%,t and lignocaine 48.3% of successful anaesthesias."'Most important of all, the use of mepivacaine allows the omission of adrenaline, and this avoids the high mass- volume-time action by which adrenaline per- mits a 1°% or 2% local-analgesic concentra- tion to act, in reality, as a 6% or even higher concentration.'The grand old man of local analgesia, Professor Hans Killian, is de- servedly respected in central Europe for his opinion that most of the unpleasant effects of local analgesics are in fact due to the added adrenaline.-I am, etc.,
A fifth of children with epilepsy miss out on specialist input, UK audit shows
Authors: S. Mayor
Journal: BMJ (2012)

One in five children with epilepsy don’t see a paediatrician with specialist training in childhood epilepsy, despite this being recommended by national guidelines, show the results from the United Kingdom’s first national audit of care for children with epilepsy.1

The Royal College of Paediatrics and Child Health commissioned the audit, which was published this week, to assess the provision of healthcare for young people with suspected epileptic seizures against 12 standard measures recommended by the National Institute for Health and Clinical Excellence and the Scottish Intercollegiate Guidelines Network.

Local paediatricians and nurses from 186 paediatric units (of the 197 units contacted) caring for children with suspected or confirmed epilepsy collected data on nearly 5000 children during the first 12 months after first presentation to district level health services during …
AN OCULAR POLYPUS.
Authors: S. POLLAK
Journal: JAMA (1883)

A lady of 74 years presented herself with a “bleeding eye.” Blood was oozing from beneath the upper lid constantly when the lids were open. The eye was perfectly sound, vision good, except when obscured by the blood. The upper lid was somewhat conical, and of a light bluish tint. On everting it, the conjunctiva was found perfectly smooth, but on pressure, directly on the superior orbital margin, a racemous, painless tumor was extruded from the sulcus, of the size, shape, and color of a Lawton black-berry, which was bleeding profusely on the lightest touch. It was very brittle and friable, and could have been crushed with ease. It was difficult to determine the nature of it. Was it benign or malignant? Was it an angiectasia, an erectile tumor, or a polypus? I am inclined to think it was the last. Though a very confined space for a polyp to
Revised guidelines on preoperative autologous blood donation.
Authors: H Hambley
Journal: BMJ (1993)

can't be that bad or surely the government wouldn't allow advertising."When the problem is so serious and the benefit of banning promotion so clear we are inevitably left to wonder what it is that stops Mrs Bottomley from acting.Natural civil service inertia, a libertarian distaste for advertising bans, and some economic anxiety may have marginal importance, but direct political pressure from the tobacco industry and those who benefit from advertising is likely to be much more important.The tobacco industry contributes generously to the Conservative party's funds; some members of parliament are consul- tants to the industry or to advertisers; and in the last election the tobacco industry made many advertising hoardings available to the Conservative party at very short notice.A debt may have to be repaid.Mrs Bottomley could do a great deal for the health of Europeans and to restore her credibility by voting next week for the directive to ban tobacco promotion.If she doesn't she is literally making murder respectable.
Explicitness and predication: A risky linkage
Authors: Andrew Carstairs-McCarthy
Journal: Behavioral and Brain Sciences (1999)

Dienes &amp; Perner (D&amp;P) link explicit knowledge of facts to predication. But predication is basically a linguistic notion. Their approach therefore makes it difficult to attribute knowledge of facts to non- language-users, such as animals. The explicit/implicit distinction, as D&amp;P formulate it, is accordingly of little use for exploring the cognitive capacities of nonhuman primates – despite the increasing evidence for sophisticated social awareness among apes, implying mental representations of events in which participants are clearly distinguished. A revised formulation, less biased toward syntax as it happens to have evolved in humans, could avoid this drawback.