tbuckley/cabot-search huggingface dataset:
Textbook of Tropical Surgery
Authors: A. L Pahor
Journal: Journal of the Royal Society of Medicine (2004)

Imre Loefler (September 2004 JRSM1) compares the new Textbook of Tropical Surgery unfavourably with Principles of Medicine in Africa. However, the latter is in its third edition whereas, as he acknowledged, the editors of the surgical textbook had 'embarked on a task never undertaken before'. I write as one of the 265 contributors from thirty-nine countries. Some of Mr Loefler's points require attention and we are grateful for the critique; others stem from the editors' aim to bridge the gap between developed and developing countries. This mammoth surgical work has no rivals, and doubtless when the time comes for second and third editions it will withstand better comparison with the medical book.
Blood Pressure Control, Proteinuria, and the Progression of Renal Disease
Authors: John C. Peterson
Journal: Annals of Internal Medicine (1995)

Objective: To examine the relations among proteinuria, prescribed and achieved blood pressure, and decline in glomerular filtration rate in the Modification of Diet in Renal Disease Study. Design: 2 randomized trials in patients with chronic renal diseases of diverse cause. Setting: 15 outpatient nephrology practices at university hospitals. Patients: 840 patients, of whom 585 were in study A (glomerular filtration rate, 25 to 55 mL/min·1.73 m2) and 255 were in study B (glomerular filtration rate, 13 to 24 mL/min·1.73 m2). Diabetic patients who required insulin were excluded. Interventions: Patients were randomly assigned to a usual blood pressure goal (target mean arterial pressure, less than equals 107 mm Hg for patients less than equals 60 years of age and less than equals 113 mm Hg for patients more than equals 61 years of age) or a low blood pressure goal (target mean arterial pressure, less than equals 92 mm Hg for patients less than equals 60 years of age and less than equals 98 mm Hg for patients more than equals 61 years of age). Main Outcome Measures: Rate of decline in glomerular filtration rate and change in proteinuria during follow-up. Results: The low blood pressure goal had a greater beneficial effect in persons with higher baseline proteinuria in both study A (P = 0.02) and study B (P = 0.01). Glomerular filtration rate declined faster in patients with higher achieved blood pressure during follow-up in both study A (r = −0.20; P < 0.001) and study B (r = −0.34; P < 0.001), and these correlations were stronger in persons with higher baseline proteinuria (P < 0.001 in study A; P < 0.01 in study B). In study A, the association between decline in glomerular filtration rate and achieved follow-up blood pressure was nonlinear (P = 0.011) and was stronger at higher mean arterial pressure. In both studies, the low blood pressure goal significantly reduced proteinuria during the first 4 months after randomization. This, in turn, correlated with a slower subsequent decline in glomerular filtration rate. Conclusions: Our study supports the concept that proteinuria is an independent risk factor for the progression of renal disease. For patients with proteinuria of more than 1 g/d, we suggest a target blood pressure of less than 92 mm Hg (125/75 mm Hg). For patients with proteinuria of 0.25 to 1.0 g/d, a target mean arterial pressure of less than 98 mm Hg (about 130/80 mm Hg) may be advisable. The extent to which lowering blood pressure reduces proteinuria may be a measure of the effectiveness of this therapy in slowing the progression of renal disease. *For a list of MDRD participants, see reference 10.
Words, words, words
Authors: D. Maxwell
Journal: BMJ (1989)

An excellent discussion of cervical cancer is emphatically entitled "The one we needn't have" for reasons that are well explained.Women thinking that they should have annual smear tests after reading the check list on page 137 should be warned that their local pathology departments, already struggling to cope with demand, might not process a smear if the woman has had a normal result within the past five years unless she actually has symptoms which
Herpes zoster: A possible early clinical sign for development of acquired immunodeficiency syndrome in high-risk individuals
Authors: A.E. Friedman-Kien, F.L. Lafleur, E. Gendler, N.P. Hennessey, R. Montagna, S. Halbert, P. Rubinstein, K. Krasinski, E. Zang, B. Poiesz
Journal: Journal of the American Academy of Dermatology (1986)

Zoster is uncommon before the age of 50 years in immunologically normal individuals, but it occurs with increased frequency in people who are immunosuppressed. A retrospective review of 300 patients with acquired immunodeficiency syndrome associated with Kaposi's sarcoma, revealed that 8% had prior zoster, a rate that is sevenfold greater than historic controls of the same age. We prospectively examined forty-eight patients, with no known immunodeficiency or signs of AIDS or AIDS related complex (ARC), who presented with zoster localized to the thoracic region. Forty-one patients had known risk factors for AIDS and thirty-five had antibody to the AIDS-associated virus (AAV) at the time of presentation. One seropositive subject had no known risk factors. Absolute lymphocyte counts, lymphocyte OKT4/OKT8 ratios, and lymphocyte mitogen responses were all depressed in subjects with antibody to AAV when compared with seronegative individuals. Seven of thirty-three AAV antibody-positive subjects, who could be followed longitudinally, developed AIDS from 1 to 28 months (mean = 13) after zoster. One antibody-negative subject seroconverted to become AAV seropositive 16 months after zoster and developed Kaposi's sarcoma 1 month later. These eight subjects had persistently low lymphocyte OKT4/OKT8 ratios and elevated beta-2 microglobulin. In patients at risk for AIDS, the occurrence of zoster may be one sign that heralds the marked depression of cellular immunity associated with AIDS or ARC.
Gallium Scans for Staging Small Cell Lung Cancer
Authors: Harmar D. Brereton
Journal: JAMA (1978)

The high incidence of gallium 67 accumulation in lung cencer has made radioistope scanning with this agent useful in identifying the extent of cancer locally. However, we investigated the usefulness of whole-body gallium 67 scanning, compared with physical examination, bone, liver and brain scans, and bone marrow aspirate and biopsy, in detecting metastases outside the chest in 47 patients with small cell lung cancer. In each case whole-body scanning with gallium 67 was inferior to the other methods used to detect extrathoracic tumor deposits.
Recent Mortality from Bronchitis in London
Authors: R. M. F. Picken
Journal: BMJ (1941)

Prolonig,d wound sepsis, as iindicated by delayed healing, favours the subsequent onset of epilepsy botlh in cases in which the dura has been penetrated and in those in which t'le integritv of the dura lhas been preserved.Epilepsy is more common after wounds affecting the sensori- motor cortex than after wounds of the polar regions of the cerebral hemisplhere.The presence or absence of concussion (immediate uniconsciousness) alter gunsthot wound does not influence the suiIsequent liability to epilepsy.The first fit may occur within a few hours after injury or mav be delayed at least as long as twenty years.Epilepsy begins miore often in the first two weeks, and thereafter the liability to develop epilepsy progressively diminishes.In 30 of the 96 cases in wlhich the course of the epilepsy is known fits ceased some years before the patient was last exaninled.This subsidence of epilepsy occurred most often in cases in whiclh fits began in the first fortnight after injury, less frequently wvhen fits began withini the first two years, and never wvhen the first fit occurred more than two years after the injury.It is a pleasure to record my thanks to Dr. Prideaux of the Ministry of Pensions for his kindness in arranging-for examination of the case records, and for much help in their interpretation.I am especially indebted to Colonel hIugl Cair-ns for his constanit advice and great help in revisionl of this paper.
Fibrinogen deficiency, but not plasminogen deficiency, increases mortality synergistically in combination with sickle hemoglobin SAD in transgenic mice
Authors: Nancy J. Roszell, Mary Jo Danton, Maorong Jiang, David Witte, Cynthia Daugherty, Timothy Grimes, Benjamin Girdler, Kathleen P. Anderson, Robert S. Franco, Jay L. Degen, Clinton H. Joiner
Journal: American Journal of Hematology (2007)

Patients with sickle cell disease exhibit both acute and chronic activation of the coagulation and fibrinolytic systems. To test the relationship between sickle cell pathology and activation of the hemostatic system, mice with targeted deletions of plasminogen (Plg) or fibrinogen (Fib) were crossed with transgenic mice expressing Hb SAD [beta(6Glu-Val) (HbS), beta(23Val-Ile) (HbAntilles), and beta(121Glu-Gln) (HbD-Punjab)]. Fibrinogen deficiency dramatically reduced the survival of mice with Hb SAD to a much greater degree than mice with normal hemoglobin. The combination of Hb SAD and fibrinogen deficiency had a greater effect on mortality than that obtained by adding the mortality risks of each defect alone. The deleterious effect of the combination of Hb SAD and fibrinogen deficiency on mortality was accelerated by hypoxia. The excess mortality associated with plasminogen deficiency was identical in SAD and control mice. The adverse effect of fibrinogen deficiency on mortality in SAD mice is not consistent with the simple hypothesis that fibrin deposition is uniformly deleterious in the context of vaso-occlusive sickle cell disease. Rather, our findings suggest that the contribution of fibrinogen to tissue repair may in some contexts limit sickle cell disease pathophysiology.
Epithelial Barriers, Microbiota, and Colorectal Cancer
Authors: Awen M. Gallimore, Andrew Godkin
Journal: New England Journal of Medicine (2013)

There is an established link between the inflammation process and the genesis of colorectal cancer. A recent study suggests that intestinal microbiota may have a mediatory role between the initial steps of tumorigenesis and the initiation of an immune response that influences clinical outcome.
Roberts syndrome is caused by mutations in ESCO2, a human homolog of yeast ECO1 that is essential for the establishment of sister chromatid cohesion
Authors: Hugo Vega, Quinten Waisfisz, Miriam Gordillo, Norio Sakai, Itaru Yanagihara, Minoru Yamada, Djoke van Gosliga, Hülya Kayserili, Chengzhe Xu, Keiichi Ozono, Ethylin Wang Jabs, Koji Inui, Hans Joenje
Journal: Nature Genetics (2005)
Neighbours complain about Dignitas clinic's bodies in lift
Authors: Clare Chapman
Journal: BMJ (2006)

Residents of a block of flats in Zurich who are fed up with the assisted suicide group Dignitas taking dead bodies out of the building in body bags are asking the local council to act.

The controversial clinic that has helped more than 450 people, including more than 30 British people, to end their lives since it opened in 1998 administers its lethal injections in rooms in a residential apartment block on Gloria Street in Zurich's Wiedikon district.

But people living in the block say they have had enough of the stream of bodies being …
A Jaundiced Eye
Authors: John K. Amory, Henry Rosen, Chadd Sukut, Findlay Wallace, Sanjay Saint
Journal: New England Journal of Medicine (2006)

A previously healthy 27-year-old man presented to his primary care physician six days after the onset of a nonproductive cough, sore throat, and a feeling of being “run down.” During the preceding week, he had also begun to have a fever and diffuse abdominal pain of mild-to-moderate intensity. Two days before presentation, he noticed that his urine was dark-colored and his eyes were red and itchy, with a clear, thick discharge.
Emerging Potential of Therapeutic Targeting of Ubiquitin-Specific Proteases in the Treatment of Cancer
Authors: Anupama Pal, Matthew A. Young, Nicholas J. Donato
Journal: Cancer Research (2014)

Abstract The ubiquitin–proteasome system (UPS) has emerged as a therapeutic focus and target for the treatment of cancer. The most clinically successful UPS-active agents (bortezomib and lenalidomide) are limited in application to hematologic malignancies, with only marginal efficacy in solid tumors. Inhibition of specific ubiquitin E3 ligases has also emerged as a valid therapeutic strategy, and many targets are currently being investigated. Another emerging and promising approach in regulation of the UPS involves targeting deubiquitinases (DUB). The DUBs comprise a relatively small group of proteins, most with cysteine protease activity that target several key proteins involved in regulation of tumorigenesis, apoptosis, senescence, and autophagy. Through their multiple contacts with ubiquitinated protein substrates involved in these pathways, DUBs provide an untapped means of modulating many important regulatory proteins that support oncogenic transformation and progression. Ubiquitin-specific proteases (USP) are one class of DUBs that have drawn special attention as cancer targets, as many are differentially expressed or activated in tumors or their microenvironment, making them ideal candidates for drug development. This review attempts to summarize the USPs implicated in different cancers, the current status of USP inhibitor–mediated pharmacologic intervention, and future prospects for USP inhibitors to treat diverse cancers. Cancer Res; 74(18); 4955–66. ©2014 AACR.
Sexual expression in paraplegia.
Authors: G. S. Brindley, B. P. Gardner
Journal: BMJ (1991)

in 20 000 live births and this includes both familial and non-familial cases.There were 1068 children born in Seascale between 1950 and 1983.2There would have to be a 20-fold increase in incidence before a single case was expected in this population.It is nonsense to state that retinoblastoma should be "generally more common in Seascale."Similar arguments apply to Millom rural district.It is the extreme rarity of retinoblastoma that makes the observation of five cases linked to Seascale so extraordinary and noteworthy.The ideas in our paper are neither confusing nor contradictory.The data, in fact, strongly suggest a link between retinoblastoma and residence in Seascale.The nature of the association remains to be determined, but it is wrong to imply that radiation can be excluded as the causative agent.
Guidelines, polypharmacy, and drug-drug interactions in patients with multimorbidity
Authors: A. Marengoni, G. Onder
Journal: BMJ (2015)

A cascade of failure

Polypharmacy, defined as the chronic co-prescription of several drugs, is often the consequence of the application of disease specific guidelines, targeting disease specific goals, to patients with multiple chronic diseases. One common consequence of polypharmacy is the high rate of adverse drug reactions, mainly from drug-drug interactions (the ability of a drug to modify the action or effect of another drug administered successively or simultaneously).1 The risk of a drug-drug interaction in any particular patient increases with the number of co-existing diseases and the number of drugs prescribed.2

In a linked paper, Dumbreck and colleagues (doi:10.1136/bmj.h949) selected three clinical guidelines produced by the National Institute for Health and Care Excellence (NICE)—type 2 diabetes, heart failure, and depression—and systematically looked for possible drug-disease and drug-drug interactions in relation to another 11 NICE guidelines for potentially comorbid chronic conditions.3 Drug-disease interactions were relatively uncommon and mostly occurred between the recommended drug and chronic kidney disease. But the authors identified many potentially serious drug-drug interactions, most of which were overlooked by the index guideline.

In general, few disease specific guidelines consider that target patients can also have other diseases, treated …
Peripheral blood chimerism following human liver transplantation
Authors: J R Jonsson, P G Hogan, R Thomas, C Steadman, A D Clouston, G A Balderson, S V Lynch, R W Strong, E E Powell
Journal: Hepatology (1997)

The aim of this study was to prospectively investigate the peak levels and kinetics of donor leucocyte chimerism in human recipients following liver transplantation. The peak levels of chimerism were observed within the first 48 hours following transplantation and ranged from 0.15% to 20% of total peripheral blood mononuclear cells. In all but one patient, who developed graft versus host disease, there was an early peak level of chimerism that declined over time such that donor leukocytes were only intermittently detectable after 3 to 4 weeks. In 8 patients who had no episodes of graft rejection, the peak level of donor leukocyte chimerism ranged from 1.3% to 20% (mean ± SEM; 5.5% ± 2.1%). In 3 patients who were treated for episodes of acute graft rejection during the first four postoperative weeks, the peak level of donor leukocyte chimerism ranged from 0.15% to 0.2% (0.18 ± 0.02, P = .012). The results demonstrate a marked variation in the total number of donor leukocytes detectable in the peripheral blood early after liver transplantation and also, that lower levels of chimerism may be associated with lower rates of initial graft acceptance and a higher incidence of acute rejection.
High-density lipoprotein cholesterol and prognosis after myocardial infarction.
Authors: K G Berge, P L Canner, A Hainline
Journal: Circulation (1982)

The Coronary Drug Project was a randomized, placebo-controlled trial of lipid-influencing drugs in men who had recovered from one or more documented myocardial infarctions. Determinations of high-density lipoprotein (HDL) cholesterol were made at baseline in a group of 354 men randomized to the placebo group. Five-year mortality was highest (33.0%) in men with baseline serum HDL cholesterol levels of less than 35 mg/dl; it was 15.9%, 17.7%, and 21.8% in men with levels of 35--39, 40--44, and greater than or equal to 45 mg/dl, respectively (for the linear inverse relationship between HDL cholesterol and 5-year mortality, p = 0.029). Adjustment for 40 baseline variables had a minimal effect on this relationship (p = 0.042).
Evaluation of myocardial viability using positron emission tomography in children after kawasaki disease
Authors: Muneo Yoshibayashi, Nagara Tamaki, Kenya Nishioka, Masahiko Matsumura, Tadashi Ueda, Shinji Temma, Kunizo Baba, Yoshiharu Yonekura, Junji Konishi, Haruki Mikawa
Journal: Journal of the American College of Cardiology (1991)
Atrial Activity and Systemic Blood Pressure during Anesthesia in Man
Authors: MYRON B. LAVER, HERMAN TURNDORF
Journal: Circulation (1963)

Atrial contribution to ventricular performance was evaluated during halothane anesthesia in man by a method whereby atrioventricular dissociation is readily induced. Three conditions are outlined that facilitate production of this arrhythmia in man: general anesthesia with a halothane-oxygen mixture by use of an average inspired halothane concentration of 0.5 per cent; controlled ventilation following muscle paralysis with d-tubocurare; and an exogenous stimulus, most easily provided by the onset of surgery. The last factor is probably mediated via direct sympathetic stimuli to the heart. The change from sinoatrial to atrioventricular nodal rhythm was associated with a fall in arterial pressure and a rise in central venous pressure; the heart rate remained unaltered. The changes in the systemic and central venous pressures were attributed to failure of atrial systole to contribute to ventricular filling during diastole. It is suggested that tricuspid regurgitation may occur during nodal rhythm, since synchronous atrioventricular contraction is required for adequate closure of the atrioventricular valve. Further studies of this problem in anesthetized man with this particular pharmacologic tool are indicated.
Sensitive, Noninvasive Detection of Lymph Node Metastases
Authors: Mukesh G Harisinghani, Ralph Weissleder
Journal: PLoS Medicine (2004)

Background Many primary malignancies spread via lymphatic dissemination, and accurate staging therefore still relies on surgical exploration. The purpose of this study was to explore the possibility of semiautomated noninvasive nodal cancer staging using a nanoparticle-enhanced lymphotropic magnetic resonance imaging (LMRI) technique. Methods and Findings We measured magnetic tissue parameters of cancer metastases and normal unmatched lymph nodes by noninvasive LMRI using a learning dataset consisting of 97 histologically proven nodes. We then prospectively tested the accuracy of these parameters against 216 histologically validated lymph nodes from 34 patients with primary cancers, in semiautomated fashion. We found unique magnetic tissue parameters that accurately distinguished metastatic from normal nodes with an overall sensitivity of 98% and specificity of 92%. The parameters could be applied to datasets in a semiautomated fashion and be used for three-dimensional reconstruction of complete nodal anatomy for different primary cancers. Conclusion These results suggest for the first time the feasibility of semiautomated nodal cancer staging by noninvasive imaging.
A POINT IN THE MANAGEMENT OF UVEAL SARCOMAS.
Authors: BROWN PUSEY
Journal: JAMA (1906)

Usually sarcomas arising in the uveal tract are slow in perforating the sclera and experience has taught us that, in their clinical course, they usually give rise to symptoms—interference with vision or glaucoma and the pain which goes with it—which attract attention to the condition before perforation of the sclera and extension to the orbital tissues take place. Accordingly the ophthalmic surgeon, as a rule, when he sees no gross perforation of the sclera, contents himself in dealing with uveal sarcomas by enucleating the affected eyeball. And this is good practice; for enucleation of the globe usually suffices, and the more radical procedure of exenterating the orbital contents, which theoretically, of course, would be more proper, is a far more serious operation and leaves the patient more deformed. Sometimes, however, these growths go through the sclera comparatively early and sometimes macroscopically such extensions can not be made out. An experience
Renin in Aldosteronism
Authors: Harriet P. Dustan
Journal: JAMA (1985)

A REREADING of the LANDMARK ARTICLE by Conn et al<sup>1</sup>reprinted in the current issue of<i>JAMA</i>watered my nostalgia plant because it reminded me of the intense interest in the renin-angiotensin-aldosterone system that characterized that time. Knowing what we know now, we find it hard to realize that 20 years ago the clinical relationships of the kidney and the adrenal gland were far from clear. By that time the differentiation of primary and secondary aldosteronism had been established, but a way to discriminate between them was not available. Conn and colleagues showed the way with their demonstration that plasma renin activity was suppressed in patients with primary aldosteronism (which came to be known as "Conn's syndrome") in contrast to the secondary aldosteronism of renal artery stenosis in which it was elevated. This demonstration was a fine example of "technology transfer," although not recognized as such at the time.
Common variants at five new loci associated with early-onset inflammatory bowel disease
Authors: Marcin Imielinski, Robert N Baldassano, Anne Griffiths, Richard K Russell, Vito Annese, Marla Dubinsky, Subra Kugathasan, Jonathan P Bradfield, Thomas D Walters, Patrick Sleiman, Cecilia E Kim, Aleixo Muise, Kai Wang, Joseph T Glessner, Shehzad Saeed, Haitao Zhang, Edward C Frackelton, Cuiping Hou, James H Flory, George Otieno, Rosetta M Chiavacci, Robert Grundmeier, Massimo Castro, Anna Latiano, Bruno Dallapiccola, Joanne Stempak, Debra J Abrams, Kent Taylor, Dermot McGovern, Melvin B Heyman, George D Ferry, Barbara Kirschner, Jessica Lee, Jonah Essers, Richard Grand, Michael Stephens, Arie Levine, David Piccoli, Johan Van Limbergen, Salvatore Cucchiara, Dimitri S Monos, Stephen L Guthery, Lee Denson, David C Wilson, Struan F A Grant, Mark Daly, Mark S Silverberg, Jack Satsangi, Hakon Hakonarson
Journal: Nature Genetics (2009)