tbuckley/cabot-search huggingface dataset:
Recognition and management of genital chlamydial infection.
Authors: S J Richmond, J D Oriel
Journal: BMJ (1978)

Chlamydia trachomatis is widely prevalent.It is an obligate intracellular bacterial parasite whose genital strains (genital chlamydiae) are immunologically and epidemiologically distinct from the ocular strains that cause classical trachoma.'These are transmitted from eye to eye in hot, dry climates, particularly when standards of hygiene are low, but genital chlamydiae are sexually transmitted, and can often be isolated from patients attending venereal disease (VD) clinics in Western countries.Although the conjunctivae may be infected by genital chlamydiae both in neonates, who acquire the infection during parturition, and in adults, through the accidental transfer of infected material to the eye, eye-to-eye infections are rare."Non-specific" genital infection-that is, non-gonococcal urethritis (NGU) in men, and the various syndromes in both sexes associated with it-is now a major health problem in Western society.2The role of genital chlamydiae in the pathogenesis of these diseases has now been recognised,3 and the development of sensitive and reliable cell-culture methods for isolating them4-' has led to intensive reseprch into their epi- demiology and pathogenicity in the human gea.;al tract.As a result, groups particularly prone to infection have been identified.This knowledge has produced a dilemma for both the venereologist and the medical microbiologist, partly because the isolation technique, though feasible in specialist centres, is time-consuming and labour-intensive, and therefore unsuitable for widespread screening of patients attending VD clinics.Nevertheless, genital chlamydiae have been implicated as an important cause of "non-specific" genital infections which should therefore be identified and treated in the interests of patients and the community as a whole.Although much still needs to be learnt about these infections, enough information is available to allow us to try to define where available diagnostic facilities should be concentrated, and also to rationalise the management and treatment of these infections.We also aimed at highlighting particular difficulties in management and treatment.
A real country herbalist
Authors: L. Farrell
Journal: BMJ (2008)

My Auntie Mamie was a real countrywoman. A farmer’s daughter, she married a farmer and spent her whole life milking cows, feeding pigs, growing vegetables, spreading manure (you can never have too much manure, she once told me), and smuggling petrol and cigarettes. We were a tactile family, and when she hugged you to her ample bosom both oxygen and light would be temporarily blocked out.

What she couldn’t tell you about the earth didn’t matter. She could identify every bird …
Divergent views of hospital staff on detecting and managing hypertension.
Authors: L Taylor, M C Foster, D G Beevers
Journal: BMJ (1979)

A questionnaire about detecting and managing hypertension was answered by 76 out of 110 (69%) doctors and 116 out of 195 (63%) qualified nurses in a large hospital. There was no general agreement on the method of taking diastolic blood pressures or on the level of hypertension requiring treatment. Most of the clinicians treated mild hypertension, although no proof exists that such treatment is beneficial. Almost everyone questioned agreed that measuring blood pressure in all patients attending hospital is important. Agreement should be reached, however, on which phase of diastolic blood pressure should be used.
Impairment of the autologous mixed lymphocyte reaction in atopic dermatitis.
Authors: D Y Leung, J A Saryan, R Frankel, M Lareau, R S Geha
Journal: Journal of Clinical Investigation (1983)

The T cell proliferative response to autologous non-T cells is termed the autologous mixed lymphocyte reaction (AMLR). Recent studies have suggested that the AMLR represents an inducer circuit for the activation of T8+ suppressor/cytotoxic effector cells. Since atopic dermatitis (AD) patients are deficient in T8+ cytolytic T cell function, we investigated the AMLR in AD. When sheep erythrocytes were used to separate T cells from non-T cells, the AMLR was found to be significantly decreased (P less than 0.001) in AD patients (n = 11; delta cpm = 1,550 +/- 393) when compared with normal control subjects (n = 13; delta cpm = 25,819 +/- 4,609). To exclude the possibility that these results were an artifact of the sheep erythrocyte separation, T cells were also separated on a fluorescence-activated cell sorter after treatment of peripheral blood lymphocytes with the OKT3 monoclonal antibody. AD T cells separated by the latter method were also found to have a significantly reduced AMLR response when compared with similarly treated normal T cells. Co-culture studies using cells from AD patients and their HLA identical siblings indicated that the defect resided at the responder T cell level rather than at the stimulator non-T cell level. Co-culture studies revealed no evidence for excessive suppressor cell activity resulting in the decreased AMLR. However, enumeration of T cells reactive with the monoclonal antibody T29, which recognizes a subset of T cells proliferating in the AMLR, demonstrated that AD patients (n = 8; % T29 = 2.5 +/- 0.7) had a significantly decreased (P less than 0.001) number of circulating T29+ T cells when compared with normal controls (n = 8; % T29 = 10.4 +/- 0.8). These studies suggest that a deficiency of T4+ T29+ cells contributes to the deficient AMLR in AD and possibly underlies the abnormalities of T8+ effector cells present in this disease.
Abstract 1885: Malignancies associated with immune thrombocytopenic purpura
Authors: Karim Arnaout, Mustapha Khalife, Amr Hanbali
Journal: Cancer Research (2011)

Abstract Background: Cancer and Immune thrombocytopenic purpura (ITP) are two common disorders. However, the relationship between these two diseases has rarely been reported in the literature. The purpose of this retrospective study was to determine the association between cancer and ITP. Methods: We retrospectively reviewed the charts of 307 patients diagnosed with ITP in our institution between 2005 and 2009. The diagnosis of ITP was defined by a platelet count less than 140.109/l with normal or increased number of megakaryocytes on bone marrow aspirate, after exclusion of thrombocytopenia-induced medications or disorders, and absence of splenomegaly. Results: 32 patients (10.4 percent) were found to have cancer. Of these 32 patients, breast cancer accounted for 28.1 percent, prostate cancer for 18.8 percent, skin cancer for 15.6 percent, gastrointestinal cancer and multiple cancer history for 12.5 percent each, bladder cancer and lymphoma for 6.25 percent each. 12 patients (37.5 percent) had ITP before cancer diagnosis, and 16 patients (50 percent) after cancer diagnosis. Both diseases were concomitant in 4 patients (12.5 percent). Conclusion: 10.4 percent of patients with ITP have cancer. Breast cancer accounted for most of the cases followed by prostate cancer. Our data suggest an association between cancer and autoimmune platelet destruction, and further investigation is warranted to understand the exact mechanism. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1885. doi:10.1158/1538-7445.AM2011-1885
Effects of Outcome on Physicians' Judgment of Appropriateness of Care
Authors: Karen L. Posner
Journal: JAMA (1991)

<h3>In Reply.</h3> —We wholeheartedly agree with Woods and Cook. Recognizing the presence and potential magnitude of outcome bias in physician judgments creates a healthy stimulus for improving the process of retrospective case review. Such improvements will benefit not only the patient and the physician, but also the much broader group of individuals and institutions who engage in the design, provision, and financing of health care. It is important—and exciting—to recognize that effective remedies may be close at hand. As Woods and Cook point out, some of the fundamental concepts and tools for managing outcome bias have already been explored in the literature of experimental psychology and human performance. The next logical step will be to determine whether this basic knowledge can be effectively adapted and extended to meet the specific needs of health care analysis.
Neovascular Age-related Macular Degeneration: Intraocular Cytokines and Growth Factors and the Influence of Therapy with Ranibizumab
Authors: Marion Funk, David Karl, Michael Georgopoulos, Thomas Benesch, Stefan Sacu, Kaija Polak, Gerhard J. Zlabinger, Ursula Schmidt-Erfurth
Journal: Ophthalmology (2009)
Endocrine Regulation of HOX Genes
Authors: Gaurang S. Daftary, Hugh S. Taylor
Journal: Endocrine Reviews (2006)

Hox genes have a well-characterized role in embryonic development, where they determine identity along the anteroposterior body axis. Hox genes are expressed not only during embryogenesis but also in the adult, where they are necessary for functional differentiation. Despite the known function of these genes as transcription factors, few regulatory mechanisms that drive Hox expression are known. Recently, several hormones and their cognate receptors have been shown to regulate Hox gene expression and thereby mediate development in the embryo as well as functional differentiation in the adult organism. Estradiol, progesterone, testosterone, retinoic acid, and vitamin D have been shown to regulate Hox gene expression. In the embryo, the endocrine system directs axial Hox gene expression; aberrant Hox gene expression due to exposure to endocrine disruptors contributes to the teratogenicity of these compounds. In the adult, endocrine regulation of Hox genes is necessary to enable such diverse functions as hematopoiesis and reproduction; endocrinopathies can result in dysregulated HOX gene expression affecting physiology. By regulating HOX genes, hormonal signals utilize a conserved mechanism that allows generation of structural and functional diversity in both developing and adult tissues. This review discusses endocrine Hox regulation and its impact on physiology and human pathology.
Stromal Cell-Derived Factor-1α Activation of Tissue-Engineered Endothelial Progenitor Cell Matrix Enhances Ventricular Function After Myocardial Infarction by Inducing Neovasculogenesis
Authors: John R. Frederick, J. Raymond Fitzpatrick, Ryan C. McCormick, David A. Harris, Ah-Young Kim, Jeffrey R. Muenzer, Nicole Marotta, Maximilian J. Smith, Jeffrey E. Cohen, William Hiesinger, Pavan Atluri, Y. Joseph Woo
Journal: Circulation (2010)

Myocardial ischemia causes cardiomyocyte death, adverse ventricular remodeling, and ventricular dysfunction. Endothelial progenitor cells (EPCs) have been shown to ameliorate this process, particularly when activated with stromal cell-derived factor-1α (SDF), known to be the most potent EPC chemokine. We hypothesized that implantation of a tissue-engineered extracellular matrix (ECM) scaffold seeded with EPCs primed with SDF could induce borderzone neovasculogenesis, prevent adverse geometric remodeling, and preserve ventricular function after myocardial infarction.Lewis rats (n=82) underwent left anterior descending artery ligation to induce myocardial infarction. EPCs were isolated, characterized, and cultured on a vitronectin/collagen scaffold and primed with SDF to generate the activated EPC matrix (EPCM). EPCM was sutured to the anterolateral left ventricular wall, which included the region of ischemia. Control animals received sutures but no EPCM. Additional groups underwent application of the ECM alone, ECM primed with SDF (ECM+SDF), and ECM seeded with EPCs but not primed with SDF (ECM+SDF). At 4 weeks, borderzone myocardial tissue demonstrated increased levels of vascular endothelial growth factor in the EPCM group. When compared to controls, Vessel density as assessed by immunohistochemical microscopy was significantly increased in the EPCM group (4.1 versus 6.2 vessels/high-powered field; P<0.001), and microvascular perfusion measured by lectin microangiography was enhanced 4-fold (0.7% versus 2.7% vessel volume/section volume; P=0.04). Comparisons to additional groups also showed a significantly improved vasculogenic response in the EPCM group. Ventricular geometry and scar fraction assessed by digital planimetric analysis of sectioned hearts exhibited significantly preserved left ventricular internal diameter (9.7 mm versus 8.6 mm; P=0.005) and decreased infarct scar formation expressed as percent of total section area (16% versus 7%; P=0.002) when compared with all other groups. In addition, EPCM animals showed a significant preservation of function as measured by echocardiography, pressure-volume conductance, and Doppler flow.Extracellular matrix seeded with EPCs primed with SDF induces borderzone neovasculogenesis, attenuates adverse ventricular remodeling, and preserves ventricular function after myocardial infarction.
Distribution of Anopheline Mosquito Bites Among Different Age Groups
Authors: R. C. Muirhead-Thomson
Journal: BMJ (1951)

BRIT thought seems to be corroborated by the results of a pilot experiment carried out in collaboration with Dr. C. E. Thornton some years ago.We had the impression that a daily supplement of 40,000-50,000 i.u. of vitamin A given to rheumatic children during the phase of relapse was beneficial (Thornton, 1946).Only scanty information exists regarding the effect of fever on the vitamin-A level in pregnancy.Bicknell (1950) suggested that in those cases of pregnant women suffering from German measles in which the termina- tion of pregnancy was not considered vitamin A should be given.I extended this suggestion, proposing that vitamin A should be administered in every case of pregnancy complicated by infection or fever, especially during the first trimester, which approximately corre- sponds to the organogenic period (Leitner, 1950(Leitner, , 1951)). ConclusionThe work briefly reported here demonstrates the importance of an adequate plasma vitamin-A level during the embryonal development and in some clinical conditions such as ocular, dermatological, hepatic, and febrile diseases.I should like to conclude this report with two sug- gestions which seem to be justified by the present state of vitamin-A research, though their strict therapeutic necessity cannot yet be substantiated.I would advocate supplementing the routine treatment in the acute stage of rheumatic fever with 40,000-50,000 i.u. of vitamin A daily.The same dose of vitamin A should be administered in pregnancy complicated by infection or fever, especially during the first trimester.No special claims are attached to these, as yet tentative, suggestions, and it is hoped that further research will support and possibly amplify them.
2'3'-Dideoxycytidine-induced thymic lymphoma correlates with species-specific suppression of a subpopulation of primitive hematopoietic progenitor cells in mouse but not rat or human bone marrow.
Authors: R D Irons, A T Le, D B Som, W S Stillman
Journal: Journal of Clinical Investigation (1995)

The nucleoside analogue, 2',3'-dideoxycytidine (ddC), is a potent inhibitor of HIV replication, and AIDS patients receiving ddC experience clinical improvement without significant hematologic toxicity. Repeated ddC administration (1,000 mg/kg per day) for 13 wk produces an increased incidence of thymic lymphoma in B6C3F1 mice. Previous studies reveal a common link between chemically induced and genetically associated models of mouse thymic lymphoma that involves a defect in a subpopulation of primitive hematopoietic progenitor cells. This defect is characterized by suppression of a subpopulation of IL-3-responsive cells and ablation of stem cell factor synergy with GM-CSF. The present study was undertaken to ascertain whether ddC produces the same pattern of bone marrow toxicity in mice, and whether this effect is observed in rat and human bone marrow. ddC exposure in vivo and in vitro produced a select suppression of murine CFU identical to that previously described for other models of mouse thymic lymphoma. In contrast, this selective CFU suppression was not observed in rat and human bone marrow or in CD34+ cells. These studies suggest that the mouse may not be a good predictive model for ddC hematotoxicity in humans and that susceptibility to the development of thymic lymphoma may be unique to the mouse.
Allergy management in primary care across European countries – actual status
Authors: I. Agache, D. Ryan, M. R. Rodriguez, O. Yusuf, E. Angier, M. Jutel
Journal: Allergy (2013)

Abstract The standard of care for allergies within a primary care ( PC ) setting has a strong influence on disease prevention and control, quality of life, and patient satisfaction. The level of knowledge of allergic diseases and the accessibility to regular follow‐up are essential. EAACI and IPCRG conducted a survey to evaluate the actual status of care for allergic diseases in PC . Access to allergy and asthma specialist treatment was identified as the greatest ‘unmet need’. The average waiting time between a referral and being seen in a public health service is usually &gt;6 weeks. Referring the patients to an ‘organ’ specialist is much easier compared with referral to an allergist. Most PCP s have access to blood tests for total and specific IgE. Skin prick testing is available in only half of the cases, while provocation tests, allergen quantification in homes, and a dietician service are even less available. 20.6% of practices do not have access to allergy tests at all. Other issues raised were low political or general public awareness, lack of understanding by the patients of their allergic disease, the need to invest in PC , and to achieve sufficient competence at the appropriate level of care.
An Outbreak of Food Poisoning: Being a Report on Thirty-Five Cases of Veal-Pie Poisoning Occurring in Chadderton
Authors: P. Bowes, H. Ashton
Journal: BMJ (1898)

PLAGUE. News, evidently of a confirmatory character, has been re- ceived in St. Petersburg that plague has appeared in the Iskander region of the Samarkand district.Although it is declared by Reuter's telegrams "that the district has been declared to be suspected" merely, the Russian Government have already despatched 3o doctors and io lady doctors to the district.It is improbable that they would have sent so large a staff had the information been based on suspicion merely, and it may be almost taken for granted that plague is actually present there.The Iskander district is some 300 miles northwards from the Hindu Kush Mountains, from which it is separated by Bokara and the lofty range of the Alai Tagh.It is difficult to conceive how the plague can have spread thence from the Indian centre; there is little communication be- tween Samarkand and India.Moreover, we have had no information that plague has existed in the Russian province of Bokara, which intervenes between the in- fected region and the Indian frontier.The nearest point in India where plague has appeared is some 700 miles distant from Samarkancd as the crow flies.Jullundur, in the Punjab, and the Hill States of Kumaon and (Ghurwal, are the regions furthest north in India in which plague has been reported, and between these and the Samarkand district the Kashmir and the Chitral district.In neither of these has plague been met 'with recently, and it would seem improbable that plague reached Samarkand from India directly. PLAGUE CASE REPORTED IN WARSAW.From Warsaw there is a report to hand that a woman, aged 56, died in the Infant Jesus Hospital, and that medical opinion ascribes her death to plague.This may or may not be the case, but it is not essy to understand the meaning of the further announcement is that "the physicians have decided that it was a case of Siberian plague.'This is the first state- ment we have heard that there is such a disease as " Siberian plague."We are acquainted with the disease "plague," and if it exists in Siberia in endemic form, it is not generally understood that such is the case.
The Heart and Pulmonary Circulation at High Altitudes
Authors: Dante Penaloza, Javier Arias-Stella
Journal: Circulation (2007)

More than 140 million people worldwide live &gt;2500 m above sea level. Of them, 80 million live in Asia, and 35 million live in the Andean mountains. This latter region has its major population density living above 3500 m. The primary objective of the present study is to review the physiology, pathology, pathogenesis, and clinical features of the heart and pulmonary circulation in healthy highlanders and patients with chronic mountain sickness. A systematic review of worldwide literature was undertaken, beginning with the pioneering work done in the Andes several decades ago. Original articles were analyzed in most cases and English abstracts or translations of articles written in Chinese were reviewed. Pulmonary hypertension in healthy highlanders is related to a delayed postnatal remodeling of the distal pulmonary arterial branches. The magnitude of pulmonary hypertension increases with the altitude level and the degree of exercise. There is reversal of pulmonary hypertension after prolonged residence at sea level. Chronic mountain sickness develops when the capacity for altitude adaptation is lost. These patients have moderate to severe pulmonary hypertension with accentuated hypoxemia and exaggerated polycythemia. The clinical picture of chronic mountain sickness differs from subacute mountain sickness and resembles other chronic altitude diseases described in China and Kyrgyzstan. The heart and pulmonary circulation in healthy highlanders have distinct features in comparison with residents at sea level. Chronic mountain sickness is a public health problem in the Andean mountains and other mountainous regions around the world. Therefore, dissemination of preventive and therapeutic measures is essential.
Response from the BMA
Authors: Sam Everington, Jonathan Fielden, Michael Rees, Jo Hilborne, Hamish Meldrum, Chris Spencer-Jones
Journal: BMJ (2007)

The MTAS debacle is the worst insult visited on the profession by any government in many years.1 The priority now is to get as fair and transparent a solution as possible, which minimises further damage while also protecting patients.

The BMA can and will support the estimated 18 000 applicants now left hunting for jobs in round 2. We have achieved a small number of extra posts to increase the chances in some of the most competitive areas, but we will lobby the government to find some more. These must be …
Brain Matters: Stories of a Neurologist and His Patients
Authors: George W. Paulson
Journal: JAMA (1987)

Bruce Dobkin joins the legion of physicians and recent sprinkling of neurologists (Sacks, Klawans) who have incorporated their professional experience into a popular account. Dobkin's effort is unique but perhaps not destined to be as popular as the writings of Dr Sacks. This work is not truly autobiographical and is written with restraint regarding Dobkin's own personal history, but the entire book consists of descriptions of his patients and their illnesses linked together by his response to them and to the disease. It reads like a physician's flip answer to soap operas but is full of accurate neurological details about diseases. The patients, particularly the author's father "Duke," reappear as disease forces change with time. Individual cases—clearly delineated persons—are presented as examples of normal-pressure hydrocephalus, Guillain-Barré syndrome, hypoxic brain damage, Gilles de la Tourette syndrome, epileptic seizures with bizarre personality, and particularly the sneaky devastation of a brain tumor in