tbuckley/cabot-search huggingface dataset:
Fortnightly review: A regular review of the long term follow up of depression
Authors: J Angst
Journal: BMJ (1997)

A regular review of the long term follow up of depression J AngstDepression is a common and disabling psychiatric disorder with a lifetime prevalence in the community estimated at 17%. 1 Outcome studies show that depressive disorders often recur and may become chronic in up to 25% of patients.For these patients the issue is whether they can reasonably expect to recover completely, while the challenge for clinicians is to recognise the course of the disorder and to manage it appropriately.I have reviewed data from long term outcome studies to clarify the issues surrounding recovery from depression and to help identify appropriate management.Studies were selected from a literature search of the full Medline database (1966 to date) and my own collection of publications.
Detection of Hepatic Metastases in Diffuse Fatty Infiltration by CT: The Complementary Role of Imaging
Authors: JOHN C. LIPMAN, PAUL C. STOMPER, WILLIAM D. KAPLAN, SABAH S. TUMEH
Journal: Clinical Nuclear Medicine (1988)

Six patients undergoing computed tomographic (CT) evaluation for possible abdominal and pelvic metastases were shown to have diffuse fatty infiltration of the liver and findings indeterminate for hepatic metastases. In two patients with diffuse fatty infiltration and no focal hepatic lesions on CT, technetium-99m sulfur colloid imaging demonstrated focal hepatic defects confirmed to represent metastases. In four patients with diffuse fatty infiltration and hyperdense liver foci on CT, radionuclide imaging demonstrated normal uptake in the hyperdense foci confirmed to represent areas of normal liver spared by fatty infiltration. In each of the six patients, clinical management was altered by the radionuclide findings.
Abstract 4674: Receptor for advanced glycation endproducts (RAGE) regulates ß-catenin function and chemosensitivity in pancreatic cancer cells
Authors: Rui Kang, Daolin Tang, Michael T. Lotze, Herbert J. Zeh
Journal: Cancer Research (2010)

Abstract β-catenin is a key downstream effector in the Wnt signaling pathway. It is implicated in two major biological processes in vertebrates: early embryonic development and tumorigenesis. The receptor for advanced glycation endproducts (RAGE), a member of the immunoglobulin superfamily of cell membrane receptors, is encoded within the MHC Class III Region. It interacts with various ligands including high mobility group protein 1 [HMGB1], certain S100 protein family members, and advanced glycation endproducts and is involved in cancer, inflammation, diabetes and Alzheimer disease. To evaluate whether treatment with RAGE short hairpin RNA (shRNA) increases chemosensitivity in pancreatic cancers involves β-catenin signaling, we first examined the expression level of β-catenin and its target genes. In normal states, β-catenin and its target genes cyclinD1, c-myc, and Nr-CAM but not L1CAM were decreased when RAGE was depleted in the murine Panc02 cell line by western blot and immunofluorescence analysis. Importantly, RAGE deletion enhanced the suppressive effects of chemotherapy on the expression of β-catenin and its target genes. To evaluate the effects of β-catenin on chemosensitivity in pancreatic cancer cells, we used cells in which the expression of RAGE and/or β-catenin was suppressed by shRNA. Knockdown of β-catenin increased chemosensitivity in pancreatic cancer cells and these effects were enhanced when both β-catenin and RAGE were knocked down. Notably, knockdown of β-catenin had no effect on the commitment of cells to enhanced autophagic flux when assessed by evaluation of microtubule-associated protein 1 light chain 3 (LC3) punctae formation. However, knockdown of β-catenin did significantly increase apoptosis when assayed by increased activity of caspase 3 and cleavage of caspase3. Taken together, these results suggest that RAGE regulates β-catenin transcription function and chemosensitivity in pancreatic cancer cell lines. Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4674.
Endoscopic Removal of an Esophageal Fibrovascular Polyp
Authors: None Burdick, None Seidel, None Lindberg, None Magee
Journal: Endoscopy (1999)

Fibrovascular polyps are intraluminal pedunculated esophageal polyps, which can produce devastating consequences if untreated. Therapy for these lesions is traditionally surgical, with esophagotomy. The present report describes a case of endoscopic removal of a fibrovascular polyp, alleviating the need for hospitalization or further interventions. The natural history, clinical presentation, diagnostic evaluation, and therapies are reviewed.
Clinical Crossroads: A 65-Year-Old Man With an Inguinal Hernia-Reply
Authors: George Wantz
Journal: JAMA (1997)

<h3>In Reply.</h3> —Dr Hamlin is correct in pointing out that herniography may be an useful method of demonstrating groin hernias when they are otherwise undetectable. I included this technique in early drafts of Clinical Crossroads, but removed it from the text on the request of a surgical peer reviewer who alleged, I believe correctly, that herniography was so infrequently done in North America that it should not be cited. This imaging technique was first popularized in Sweden.<sup>1</sup>I do not deny the importance of herniography and believe that for completeness' sake it should have been included along with the other radiologic techniques, none of which is frequently done. For the record, I have used herniography only once—on which occasion the patient disliked it. Dr Vander Veer's points are well taken. Patients about to undergo a groin hernioplasty should have a history taken and physical examination. However, only those laboratory studies needed
General practitioner budget holding
Authors: I. Cocks
Journal: BMJ (1990)

accordingly.The advent of HIV infection has obviously forced a reappraisal of this, but as yet we see no reason to alter a system that is working very well.In our experience, people who inject opiates can, and do, change their behaviour for the better, and our philosophy is to enhance and encourage this process; prescribing street drugs inhibits it and hinders the formation of useful therapeutic relationships.Prescribing also creates a situation in which it becomes very difficult or impossible to distinguish between reported and actual behavioural change.It is completely misleading and unjustified, therefore, to infer that, simply because a medical practitioner does not unquestioningly embark on Dr Greenwood's commonsense approach of prescribing maintenance drugs, there is no medical intervention or that no useful therapeutic work is being done.Quite the opposite, in fact.
First- and Second-Degree A-V Heart Block with Rapid Eye Movement Sleep
Authors: DONALD B. NEVINS
Journal: Annals of Internal Medicine (1972)

A 56-year-old man with acute congestive heart failure was noted to have episodes of heart block in sleep that were associated with dreaming. He was studied with simultaneous electroencephalographs, electrooculographic, electrocardiographic, and respiratory measurements for a period of 52 consecutive hours. There was a statistically significant relationship between the REM (rapid eye movement) stage of sleep and brief episodes of first- and second (2:1) degree A-V heart block but none with other forms of observed arrhythmias (premature atrial and ventricular contractions). Periods of arousal from REM sleep, but not from non-REM sleep, were also significantly related to heart block. A follow-up study 7 months later showed no cardiac arrhythmias during sleep or wakefulness.
Has nursing lost its way? Dual perspective
Authors: J. A Short
Journal: BMJ (1995)

National Institute for Nursing, Radcliffe Infirmary, Oxford OX2 6HE, Ann Bradshaw, Macmillan lecturer in palliative nursing. Faculty of Health Studies, University of Wales, Bangor LL57 2EF, Mike Nolan, senior lecturer in nursing research. Merton, Sutton and Wandsworth Health Commission, London SW15 2SW, Heidi Lempp, primary health care facilitator for HIV/AIDS and sexual health.

It was with a mixture of pride and trepidation that I rounded the final bend and drove up to the same psychiatric hospital that had seen my arrival as a student nurse 17 years previously. I was back again, but this time as a senior registrar in psychiatry. Would anyone recognise me? Would my nursing colleagues welcome me or treat me with suspicion for defecting to the other side? The moment of truth was looming.

At the age of 18 I surprised myself and disappointed my school by deciding to train as a nurse. What a waste of a grammar school education! In a misguided attempt to combine my chosen career with travelling the world, I joined the Queen Alexandra's Royal Naval Nursing Service. The defence cuts had started. By the time I had become a state registered nurse three years later, I had seen Portsmouth, Plymouth, and Southampton. It was while on secondment with the army at the Royal Victoria Hospital, Netley, however, that my initiation into psychiatry started. That initiation became a baptism of fire when I began further training to become a registered mental nurse, but this time, as …
Pregnancy after Primary Infertility Investigation
Authors: J. F. B. Wyper
Journal: BMJ (1962)

In the 21-year period 1937-57 inclusive, 1,182 cases of primary infertility were admitted to the Aberdeen Royal Infirmary for investigation.This, at the minimum, involved a pelvic examination under anaesthesia in the premenstrual phase, with tubal insufflation, dilatation of the cervix.and endometrial biopsy.In the event of apparent tubal blockage or unsatisfactory endometrium,
Studies on the interaction of rheumatoid factor with monosodium urate crystals and case report of coexistent tophaceous gout and rheumatoid arthritis.
Authors: T P Gordon, M J Ahern, C Reid, P J Roberts-Thomson
Journal: Annals of the Rheumatic Diseases (1985)

Gout and classical rheumatoid arthritis rarely coexist. We report a patient with strong evidence for both these diseases. Possible reasons for the negative correlation between these diseases are summarised. One hypothesis suggests inhibition of surface activity of monosodium urate crystals (MSU) by binding of rheumatoid factor (RF). This was studied with a purified monoclonal rheumatoid factor (mRF) with specificity for IgG. The mRF bound preferentially to MSU coated with IgG in contrast with the IgM control. Inhibition of the neutrophil chemiluminescence (CL) response to IgG-coated MSU was observed at concentrations of mRF that had no effect on the CL response to uncoated crystals. Neutrophil activation was not altered by coating crystals with an IgM control at the same concentration. These data suggest that RF may bind to antigenic determinants on exposed Fc of adsorbed IgG and block the interaction of crystal-bound IgG with Fc receptors. Although crystal coating by RF may modify the expression of gouty arthritis, it is unlikely to be the sole explanation for the dissociation between gout and RA.
Court dismisses appeals of two mothers
Authors: Clare Dyer
Journal: BMJ (2004)

Two mothers who were trying to get their children back from care have had their appeals dismissed.

But in the first case, two paediatricians who were expert witnesses in a case involving a mother suspected of having Munchausen syndrome by proxy were wrong to conclude, in the absence of a medical explanation, that she had deliberately harmed her child, the Court of Appeal ruled last week.

The child, who had a chromosomal abnormality and was in hospital for failure to thrive, had rigors 11 times while her mother, a paediatric nurse, was in the hospital. Four other experts had …
Urine Bombesin-like Peptide Elevation Precedes Clinical Evidence of Bronchopulmonary Dysplasia
Authors: Anne Cullen, Linda J. Van Marter, Elizabeth N. Allred, Marianne Moore, Richard B. Parad, Mary E. Sunday
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

Bronchopulmonary dysplasia (BPD) is a chronic lung disease of very low birth weight infants, associated with oxygen therapy, barotrauma, and/or infections. Improved medical care has led to a paradoxically increased incidence of BPD due to greater infant survival. Early prediction of BPD has proven challenging. Increased pulmonary neuroendocrine cells containing bombesin-like peptide immunoreactivity occur in infants with BPD. We hypothesized that elevated urine bombesin-like peptide levels precede BPD. One hundred thirty-two infants, 28-weeks gestation or less, were studied. Urine bombesin-like peptide levels, determined by radioimmunoassay, were normalized for creatinine. BPD was defined as oxygen dependence at 36 weeks postmenstrual age. A first urine bombesin-like peptide level greater than 20,000 pg/mg creatinine (12,500 fmol/mg) between postnatal days 1–4 occurred among 54% of the infants who later developed BPD (p ⩽ 0.001), versus 10% among non-BPD infants (specificity 90%). Multivariable logistic regression analyses revealed that elevated urine bombesin-like peptide levels are associated with BPD (odds ratio 9.9, 95% confidence interval: 3.4, 29) (p ⩽ 0.001) after adjusting for all confounding factors. Thus, elevated bombesin-like peptide levels in these infants at 1–4 days after birth are associated with a 10-fold increased risk of developing BPD. Utilizing urine bombesin-like peptide for screening might permit early therapeutic interventions to reduce disease progression and could provide a target for new preventive therapies.
COL3A1 mutations cause variable clinical phenotypes including acrogeria and vascular rupture
Authors: F. M. POPE, P. NARCISl, A.C. NICHOLLS, D. GERMAINE, G. PALS, A. J. RICHARDS
Journal: British Journal of Dermatology (1996)

We have recently analysed by histological, protein and molecular DNA techniques 23 mutations of the collagen III gene (COL3A1), most of which cause premature arterial fragility, thin skin and variants of vascular Ehlers-Danlos syndrome. There were 14 glycine substitutions between residues 637 and 1021, eight exon skips between exons 7 and 45 and one small inframe deletion. The glycine substitutions produce a gradient of increasingly abnormal clinical phenotypes from exons 36 to 49 while the clinical severity of exon skips is much more variable. Each mutation is private for the affected family or individual concerned having the potential for early prenatal diagnosis and prevention.
Aldosteronism in Man
Authors: Jerome W. Conn
Journal: JAMA (1963)

OUR INTEREST in aldosterone goes back many years before the hormone was actually discovered. During those years were referred to it as a "desoxycorticosterone-like steroid" produced by the adrenal cortex.<sup>1-6</sup>I have chosen, therefore, to review first some of our older work dealing with the mechanisms by which men adapt to work in the heat, and then to make some comments about things we have learned about primary aldosteronism during the past few years. Although these two areas appear to be related only casually, to me they are very intimately related, for our thinking had been so conditioned by the work on acclimatization that it led us to interpret as primary aldosteronism<sup>7,8</sup>a fascinating combination of circumstances. <h3>Some Aspects of the Physiology of Acclimatization to Heat</h3> In the light of recent advances in knowledge of the physiology of aldosterone secretion, as well as of the activities of
Chromium Deficiency During Total Parenteral Nutrition
Authors: Herbert Freund
Journal: JAMA (1979)

Chromium is required for maintenance of normal glucose tolerance. After complete bowel resection and five months of total parenteral nutrition, severe glucose intolerance, weight loss, and a metabolic encephalopathylike confusional state developed in a patient. Serum chromium levels were at the lowest normal level. Supplementation of 150 μg of chromium per day reversed the glucose intolerance, reduced insulin requirements, and resulted in weight gain and the disappearance of encephalopathy. The low levels of chromium and response to chromium supplementation suggest that chromium deficiency can arise in long-term total parenteral nutrition. (<i>JAMA</i>241:496-498, 1979)
Re-evaluation of the techique of organ culture for studying gluten toxicity in coeliac disease.
Authors: H P Hauri, M Kedinger, K Haffen, H Gaze, B Hadorn, W Hekkens
Journal: Gut (1978)

In vitro cytotoxicity of four different gluten fractions was tested in organ culture for up to 48 hours using flat intestinal biopsies from children with coeliac disease. The fractions were (1) a peptic-tryptic digest of gliadin containing a moderate amount of alpha-gliadin, (2) a peptic-tryptic digest of gluten (Frazer fraction III) froma strain of wheat with a high content of alpha-gliadin, (3) alpha-gliadin, and (4) alpha-GT-18,000, a tryptic fragment of alpha-gliadin. The latter three fractions were toxic to coeliac patients in vivo. In vitro, however, none of these fractions proved to be cytotoxic. When added to the culture medium they were not capable of inhibiting the regeneration of the surface epithelium as visualised by histology and electron microscopy. The only difference between cultures with and without gluten fractions was that the former produced slightly more mucus when maintained in vitro as observed in the dissecting microscope. Furthermore, for Frazer fraction III the absence of apparent toxicity was confirmed by the behaviour of brush border enzyme activities during culture. Our results are not in accordance with those reported in the literature. We believe that the criteria used at the present time for the assessment of gluten toxicity in vitro should be extended to include the process of enterocyte desquamation.
EFFECT OF A PHENYLBUTAZONE ANALOG (4-[PHENYLTHIOETHYL]-1,2-DIPHENYL 3,5-PYRAZOLIDINEDIONE) ON URATE CLEARANCE AND OTHER DISCRETE RENAL FUNCTIONS IN GOUTY SUBJECTS. EVALUATION AS URICOSURIC AGENT 1
Authors: T. F. Yü, Bruce C. Paton, Theodore Chenkin, J. J. Burns, Bernard B. Brodie, Alexander B. Gutman
Journal: Journal of Clinical Investigation (1956)

A number of phenylbutazone derivatives and metabolites are under study (1-4) in a joint effort to develop an analog possessing the marked anti-rheumatic properties but not the undesirable side effects of the parent compound.In the course of testing the anti-rheumatic effects in acute gouty arthritis of one of these compounds, G-25671, in which a phenylthioethyl group replaces the butyl side chain of phenylbutazone, marked uricosuric activity was noted (1, 2).The interesting properties of this substance suggested further study and a clinical trial in the management of gout.N (Xi} N C=O O= -CH2-CH2-CH2-CH3 H Phenylbutazone
Chronic Adenovirus Type 2 Keratitis in Man
Authors: Milton Boniuk, C. Alan Phillips, Jack B. Friedman
Journal: New England Journal of Medicine (1965)

ADENOVIRUSES have been associated with a wide variety of clinical entities in man, including respiratory diseases, ocular infections, rashes, gastroenteritis and, less commonly, intussusceptions, mesenteric adenitis, myocarditis, nephritis, encephalitis and swelling and cyanosis of the hands and feet in infants, leading to gangrene.1 A number of different adenovirus serotypes have been associated with conjunctivitis (particularly follicular conjunctivitis) without keratitis, including Types 1, 2, 3, 4, 6, 7, 9, 10, 11, 15, 16, 17, 20 and 22. In keratoconjunctivitis, however, only Types 3, 8 and 9 have been associated with cases in human beings. This report describes the isolation and identification . . .
Molecular basis of selective IgG2 deficiency. The mutated membrane-bound form of gamma2 heavy chain caused complete IGG2 deficiency in two Japanese siblings.
Authors: H Tashita, T Fukao, H Kaneko, T Teramoto, R Inoue, K Kasahara, N Kondo
Journal: Journal of Clinical Investigation (1998)

Patients with IgG2 deficiency have recurrent sinopulmonary infections caused by Pneumococcus and Hemophilus. Hereditary and selective IgG2 deficiency was suspected in two Japanese siblings whose serum IgG2 levels were under detection limits, while other serum levels of immunoglobulin subclasses were within normal ranges. Expression level of spontaneous germline Cgamma2 transcript was normal, but that of the spontaneous mature Cgamma2 transcript was greatly decreased in the patients' PBMCs, suggesting the presence of a defect at or after the class switch to Cgamma2. We sequenced the Cgamma2 gene region, and in both patients a homozygous one-base insertion (1793insG) was present in exon 4 of the Cgamma2 gene, just upstream from the alternative splice site for M exons. The mutant membrane-bound gamma2 heavy chain loses the transmembrane domain and the evolutionarily conserved cytoplasmic domain. Considering several lines of evidence showing that intact expression of the membrane-bound heavy chain is essential for a normal response of B cells and production of secreted immunoglobulin in mice, we concluded that 1793insG is responsible for selective and complete IgG2 deficiency in these two siblings. This is the first documentation of a mutation in human selective IgG2 deficiency.
Of no fixed abode: homeless house officers
Authors: S. Pembrey
Journal: BMJ (1995)

Many years ago when I was first a ward sister a young house surgeon committed suicide and I became aware of how vulnerable we all are. Last year I had the opportunity to talk individually with 10 house officers in a provincial teaching hospital six months after they qualified. These doctors were caring, able people committed to providing a good service to patients and they were some of the most thoughtful, sensitive, lively, and intelligent human beings I have met. Most of them loved medicine—the challenge, the autonomy, and helping people to get better—and they hoped to be rewarded by belonging to the medical team, practising and learning medicine, and “being the patient's doctor.” Instead they were commonly exhausted, stressed, and frustrated, and they felt themselves to be unproductive; on the whole, as they looked at their seniors, they could not see it getting better. What had gone wrong?

“I never have more patients on one ward than any other … mostly I have patients on over 10 wards, very rarely less than 10. I have no ward … I would not know where to leave a coat if I brought one with me.” All the house physicians, and to a lesser degree, the house surgeons, were homeless; trailing all day throughout the hospital like itinerant travellers. This homelessness was a striking change to the traditional pattern of medical firms attached to designated wards. It was caused by a policy of bed scatter, through which a patient was admitted not to a designated ward but to any …
Overdistension of the Gastric Balloon
Authors: Michael D. Nickell
Journal: JAMA (1978)

HEMORRHAGE from gastric or esophageal varices often necessitates the use of a Sengstaken-Blakemore tube for variceal tamponade. Although complications may occur with its use, safety and effectiveness following proper placement and monitoring have been demonstrated in 91% of patients.<sup>1,2</sup>We report a case of overinflation of the Sengstaken-Blakemore gastric balloon while following optimal recommended inflation and pressure monitoring techniques. <h3>Report of a Case</h3> A 51-year-old woman was admitted to Fitzsimons Army Medical Center with upper gastrointestinal hemorrhage from esophageal varices confirmed by emergency esophagogastroduodenoscopy. A new Sengstaken-Blakemore tube with Boyce<sup>1</sup>modification was inflated and inspected under water to ensure competency of both esophageal and gastric balloons and was then inserted through the mouth without difficulty. The gastric balloon was filled with 100 ml of air, and firm traction was applied on the tube at the mouth to position the gastric balloon against the diaphragm at the gastric cardia. An