tbuckley/cabot-search huggingface dataset:
Endothelium-derived relaxing factor modulates platelet aggregation in an in vivo model of recurrent platelet activation.
Authors: P Golino, M Cappelli-Bigazzi, G Ambrosio, M Ragni, E Russolillo, M Condorelli, M Chiariello
Journal: Circulation Research (1992)

It has been shown that endothelium-derived relaxing factor (EDRF) may inhibit platelet aggregation in vitro through activation of platelet-soluble guanylate cyclase. To assess whether EDRF may also affect platelet function in vivo, intravascular platelet aggregation was initiated by placing an external constrictor around endothelially injured rabbit carotid arteries. Carotid blood flow velocity was measured continuously by a Doppler flow probe placed proximal to the constrictor. After placement of the constrictor, cyclic flow reductions (CFRs), due to recurrent platelet aggregation, developed at the site of the stenosis. After CFRs were observed for 30 minutes, a solution of authentic nitric oxide (NO, n = 10) was infused into the carotid artery via a small catheter placed proximally to the stenosis. Before infusion of NO, CFR frequency averaged 18.3 +/- 2.9 cycles per hour, and CFR severity (lowest carotid blood flow as percentage of baseline values) was 6 +/- 1%. NO completely inhibited CFRs in all animals, as shown by the normal and constant pattern of carotid blood flow (CFR frequency, 0 cycles per hour, p &lt; 0.001; carotid blood flow, 92 +/- 5%, p = NS versus baseline). These effects were transient; CFRs were restored spontaneously within 10 minutes after cessation of NO infusion. After CFRs returned, S-nitroso-cysteine (S-NO-cys), a proposed form of EDRF, was infused into the carotid artery. S-NO-cys also abolished CFRs in all animals but at a significantly lower dose than NO (0.3 +/- 0.1 versus 12 +/- 4 nmol/min). The role of endogenously released EDRF in modulating in vivo platelet function was then tested in additional experiments. In 10 animals, endogenous release of EDRF was stimulated by infusing acetylcholine into the aortic root during CFRs. Infusion of acetylcholine was also associated with a complete inhibition of CFRs, similar to that observed during exogenous infusion of NO or S-NO-cys. These antithrombotic effects of acetylcholine were completely lost when EDRF synthesis was prevented by administration of the L-arginine analogue NG-monomethyl L-arginine (L-NMMA). Furthermore, in six additional rabbits the basal release of EDRF was blocked by L-NMMA after CFRs had been previously abolished with aspirin or the combination of aspirin and ketanserin, a serotonin S2 receptor antagonist. L-NMMA caused restoration of CFRs in all animals, indicating that even the basal release of EDRF is important in modulating platelet reactivity in vivo. Taken together, the data of the present study demonstrate that endogenous EDRF might importantly contribute to the modulation of platelet function in vivo.
AFTERMATH OF OPERATIONAL FATIGUE IN COMBAT AIRCREWS
Authors: MILTON L. MILLER
Journal: American Journal of Psychiatry (1944)

Observation of over 800 cases seen at a redistribution station show uniformity of symptoms of operational fatigue varying from mild to severe in about 30 percent of aircrew returning from combat areas to this country. Three main sources of operational fatigue were observed: (1) Excessive combat and harrowing experiences. (2) Previously masked psychoneurosis which breaks out when the defenses against anxiety become inadequate. (3) Guilt, excessive mourning and unconscious self-destructive reactions after the death of close friends toward whom there has been intense emotional conflict. Attitudes toward further flying, toward civilian life and toward the family, may be profoundly affected by operational fatigue.
The Need for a National Policy on Injury Reparations
Authors: Eli P. Bernzweig
Journal: New England Journal of Medicine (1977)

Despite the concentration of wealth in the United States and its highly vaunted standard of living, when someone is disabled by injury or disease in this country it can be one of the worst of personal tragedies. The full extent of the tragedy is measured not by the cause of the injury or disease, but by its consequences, which generally include pain and suffering, lost income, impairment of function, loss of wage-earning capacity, diminution of normal social activities and sometimes death. Under the various compensation systems extant, the economic losses suffered by such persons may be compensated by sick pay, . . .
Hepatic and portal vein-thrombosis.
Authors: B J Boughton
Journal: BMJ (1991)

of the forthcoming 10th revision of the International Classification ofDiseases contains a list of reactions to severe stress and adjustment disorders.3 Two examples provide sufficient illustration.Acute stress reaction comprises exposure to an exceptional medical or physical stress followed by the onset, within one hour, of generalised anxiety or any two of the following: social withdrawal, narrowing of attention, apparent disorientation, anger or verbal aggression, despair or hopelessness, inapprop- riate or purposeless overactivity, and uncontrollable and excessive grief.Treatment is supportive and non-specific and the prognosis is favourable.Post-traumatic stress disorder includes brief or prolonged exposure to an exceptional mental or physical stress followed within six months by persistent remembering or reliving of the stress; by intrusive flashbacks, vivid memories, recurring dreams; or by distress when exposed to (or avoiding) circumstances associated with the stressor.These features are accompanied by either psychogenic amnesia or persistent increased psychological sensitivity and arousal with at least two of the following: difficulty in falling or staying asleep, irritability, difficulty concentrating, distractibility or increased restlessness and apprehension.Again, treatment is supportive and non-specific, though the long term outlook is uncertain.Thus at a popular level stress is a vigorous concept that has engendered a prosperous industry dedicated to its relief, while in scientific and medical contexts the concept languishes with dubious reliability and validity.Fifty years ago the stress hypothesis began displacing obscure focuses of infection as an antecedent of a variety of life's ills.As Susser has remarked: "Many excellent sets of teeth and many pairs of tonsils were sacrificed to that hypothesis.We can count ourselves fortunate that the stress hypothesis does not require surgical intervention."'14
Focus: Westminster: Reshuffling the reforms
Authors: J Warden
Journal: BMJ (1994)

Virginia Bottomley stays and Brian Mawhinney goes. The cause and effect of last week's ministerial reshuffle, in as far as it affects the health service, is easily summed up. Dr Mawhinney's promotion to the cabinet as transport secretary ensured that Mrs Bottomley continues as secretary of state for health. For the prime minister to move both the number one and two at the health department would have been taking a gamble. Mawhinney was too good to stay; Bottomley was too valuable to be moved, and it is futile to speculate if some other arrangement should have prevailed. To fill the vacancy for health minister, Mr Major chose a careerist from the Conservative party network, Scots lawyer Gerry Malone, now MP for Winchester. Married …
Using PROMs to improve equity
Authors: M. A. Soljak, A. Majeed
Journal: BMJ (2010)

Neither the report by Judge and colleagues on inequity in access to joint replacement in England1 nor the accompanying editorial2 mentions the role of patient reported outcome measures (PROMs)3 in promoting equity of access to elective health care. Preoperative measurement of PROMs, which is now routine for …
Barium Sulfate and RAI Test
Authors: Richard R. Grayson
Journal: JAMA (1961)

<h3>To the Editor:—</h3> A probably erroneous statement regarding the effect of barium sulfate by ingestion or enema on the radioactive iodine uptake of the thyroid or the protein-bound iodine serum level appeared in the Question and Answer section ofThe Journal(<b>175</b>:1037 [March 18] 1961). The consultant, in response to questions regarding the ingestion of barium or the use of barium sulfate enema on the I<sup>131</sup>uptake, stated that a significant concentration of iodine from the barium sulfate "obtains in the blood stream sufficient to affect the determination of the protein-bound iodine level or uptake of I<sup>131</sup>." In a complete review of this subject (Factors Which Influence Radioactive Iodine Thyroidal Uptake Test,<i>Amer J Med</i><b>28</b>:397-415 [March] 1960), I pointed out that the usual American intake of iodine varies from a calculated amount equivalent to 126 to 760 μgm of iodine per day. It was also
Thymocyte Glucocorticoid Resistance Alters Positive Selection and Inhibits Autoimmunity and Lymphoproliferative Disease in MRL-Mice
Authors: Eva Tolosa, Leslie B King, Jonathan D Ashwell
Journal: Immunity (1998)

Thymus-derived glucocorticoids antagonize T cell receptor (TCR)-induced thymocyte apoptosis, allowing the survival (positive selection) of cells bearing TCRs that recognize self antigens with low-to-moderate avidity. Here we demonstrate that expression of an antisense glucocorticoid receptor transgene in thymocytes of spontaneously autoimmune MRL-lpr/lpr mice causes the loss of specific TCR Vbeta-bearing T cells that are normally positively selected in this strain. These transgenic mice had lower autoantibody production and milder symptoms of autoimmune disease than MRL-lpr/lpr controls and had markedly reduced accumulation of the TCR+Thy-1+CD4-CD8-B220+ T cells that are the hallmark of the lpr mutation. Thus, decreased glucocorticoid signaling in thymocytes alters the T cell repertoire and greatly diminishes autoimmunity in MRL-lpr/lpr autoimmune mice.
YEAST CELLS AS A PROBABLE CAUSE OF ULCERATIVE KERATITIS.PRELIMINARY REPORT.
Authors: GEORGE F. KETPER
Journal: JAMA (1907)

It has long been admitted that flat yeast cells may be recognized as the cause of disease elsewhere in the living body. In 1900 Stoewar and Lundsgaard reported finding yeast cells in corneal abscesses. The following case, with its bacteriologic findings, is submitted in the hope that others may be stimulated to make similar observations. <h3>Patient.</h3> —On Oct. 8, 1906, Mr. J. R. S. was referred to Dr. Keiper by Dr. C. B. Kern, because of ulceration of the right cornea. He was an employé of a company which makes box board out of straw. <h3>Examination.</h3> —Examination showed a spot of ulceration on the right cornea in the upper outer quadrant, of about 2 mm. diameter and circular in outline. The spot was white and raised slightly above the corneal surface. Its duration was one week. The iris was inflamed, the cornea hazy and the vision reduced to 20/c. <h3>Bacteriologic</h3>
The Well Adult
Authors: Charles B. Arnold
Journal: JAMA (1989)

<i>The Well Adult</i>could add clarity to the physician's voice in communication with patients and the worried well. It also offers laypersons an intelligent understanding of disease prevention, as well as insight into medical care, early recognition of clinical conditions, and reasonable self-help advice. As such it joins a spate of recent books by physicians, but it is especially helpful in that it focuses on<i>common, significant clinical conditions</i>. Patients who carefully read<i>The Well</i><i>Adult</i>can, in theory, better utilize their time as well as that of their physician by presenting symptoms more clearly; having increased understanding of medical management; asking relevant questions about therapy; and better appreciating their role in making care effective. After such praise, can there be any drawbacks for the first-time reader? First, one must overlook the publisher's hyperbolic claims on the back cover: "<i>The Well Adult</i>is the most comprehensive and accessible book ever
Aortic Dissection Presenting as Iliac-Artery Occlusion
Authors: Norman C. Amer, Harold C. Schaeffer, Rodolfo T. Domingo, Philip N. Sawyer, Sigmund A. Wesolowski
Journal: New England Journal of Medicine (1962)

MANY clinicians depend upon the presence of a characteristically severe, tearing descending pain to suggest the diagnosis of aortic dissection. If one bears in mind that the bizarre and variable clinical picture of this condition results either from dissection occlusion of the aortic branches to produce ischemic symptoms or from aneurysm formation, which can cause pressure symptoms, or hemorrhage by rhexis, the diagnosis of aortic dissection will be made earlier and more frequently. This communication concerns 4 cases in which the characteristic spreading pain was absent but in which the dominant clinical picture was that of acute iliac-artery occlusion.Clinical . . .
Laryngeal Stridor in Rheumatoid Arthritis
Authors: C. S. Darke, L. Wolman, A. Young
Journal: BMJ (1958)

BrDI&soHNAL 1279 "calcium " appeared within a few days of the administra- tion of mercury.This is in marked contrast with our experience in producing experimental nephrocalcinosis, which was usually found to take 10 to 14 days.Since von Kossa's stain for calcium is not specific it is possible that at least some of the stainable "calcium" reported by these authors was in fact a phosphate mercury complex.Specific glomerular changes other than the accumulation of eosinophilic material in Bowman's space have not been described following the administration of mercurial diuretics.However, shrunken glomeruli of the type described earlier were found in the kidneys of rabbits which had received mercuric chloride (Edwards, 1942).These shrunken' glomeruli may be of considerable importance in this case, since it is recognized that in the nephrotic syndrome there is not only tubular dysfunction with some resultant failure to reabsorb protein, but also increased permeability of the capillary tufts in the glomerulus (Hardwicke and Squire, 1955).The nephrotic syndrome has not been a feature of previously recorded cases of fatal renal damage following mercurial diuretics, and this might be explained by the fact that the glomerular lesion is not a constant feature in these cases.From the clinical angle mercurial diuretics are now widely used.The possible action of this drug as a nephrotoxin does not seem to be as fully recognized as it should.In this case the renal tubular damage had apparently become irreversible before steps to institute an alternative diuretic could be arranged.It is not easy to suggest methods for the recognition of the onset of renal failure.The one sign which may be of value is the onset of increasing proteinuria. SummaryA case of the nephrotic syndrome following the administration of a mercurial diuretic is described.The salient histological feature was necrosis and fatty degeneration without calcification of the epithelium in the convoluted tubules.In addition a number of the glomeruli were shrunken.The significance of the dual lesion in the production of the nephrotic syndrome is discussed.The observation of increasing proteinuria in patients under treatment with mercurial diuretics suggests that renal damage may be occurring, and that prompt steps should be taken to institute alternative diuretics.Our thanks are due to the Medical Research Council for an expenses grant.We are grateful to Dr.
Unibody core–shell smart polymer as a theranostic nanoparticle for drug delivery and MR imaging
Authors: Lin-Chen Ho, Chao-Hsiung Hsu, Chung-Mao Ou, Chia-Wei Wang, Tsang-Pai Liu, Lian-Pin Hwang, Yung-Ya Lin, Huan-Tsung Chang
Journal: Biomaterials (2014)
The strange world of private medicine
Authors: Peter Kandela
Journal: BMJ (2004)

To build a flourishing private practice is the dream of most hospital consultants, but to achieve this they are almost totally reliant on the goodwill of general practitioner colleagues. There is nothing new in this, except that increasingly I hear GPs complaining about being the poor relation in this lucrative business. To put it bluntly, Mrs Smith may be worth several hundred or even several thousand pounds as she trots up to a private consulting suite underwritten by her health insurance company, but to her GP she can never be worth more than £20.05 per year. GPs know that this is the way of the world, although many are not happy about it. What price ethical purity in an increasingly market driven health service? However, if GPs cannot reap financial benefit from private referrals, they do at least have the ability to decide which of their consultant colleagues will benefit, and some are enjoying the power that this gives them.

It used to be much simpler. When I joined general practice nearly 30 years …
HCN channelopathy in external globus pallidus neurons in models of Parkinson's disease
Authors: C Savio Chan, Kelly E Glajch, Tracy S Gertler, Jaime N Guzman, Jeff N Mercer, Alan S Lewis, Alan B Goldberg, Tatiana Tkatch, Ryuichi Shigemoto, Sheila M Fleming, Dane M Chetkovich, Pavel Osten, Hitoshi Kita, D James Surmeier
Journal: Nature Neuroscience (2010)
LSD: My Problem Child—Reflections on Sacred Drugs, Mysticism, and Science
Authors: Donald W. Goodwin
Journal: JAMA (1983)

Along with watches and cuckoo clocks, the Swiss produce drugs. They have been doing it for a long time— since Paracelsus of Basel, a contemporary of Columbus. On April 16, 1943, another Basel chemist, Albert Hofmann, was working in his laboratory at Sandoz. His specialty was ergot, a fungus that grows on grains. Starting with lysergic acid, the ergot nucleus, Hofmann had synthesized several medically useful drugs that made Sandoz a great deal of money. On this fateful day, while working with the 25th substance in his series of lysergic acid derivatives (LSD-25), Hofmann began to feel odd. "I sank into a not unpleasant intoxicated-like condition," he writes, and perceived an "uninterrupted stream of fantastic pictures, extraordinary shapes with intense, kaleidoscopic play of colors." Unwittingly, not knowing how he had absorbed the stuff, Hofmann had just taken the first LSD trip. Sandoz, alas, would not make a franc. Later Hofmann
Early influences on blood pressure: a study of children aged 5-7 years.
Authors: P. H. Whincup, D. G. Cook, A. G. Shaper
Journal: BMJ (1989)

OBJECTIVE--To examine factors that influence blood pressure in children. DESIGN--Cross sectional study of children aged 5.0-7.0 years who had blood pressure measurements and for whom parental questionnaires were completed. SETTING--School based survey. SUBJECTS--3591 Children aged 5.0-7.5 years selected by stratified random sampling of primary schools in nine British towns (response rate 72%); 3591 were examined and their parental questionnaires were completed. Data were complete for birth rank in 3559, maternal age in 3542, maternal history of hypertension in 3524, and paternal history in 2633. RESULTS--Birth weight was inversely related to mean systolic blood pressure but only when standardised for current weight (weight standardised regression coefficient -1.83 mm Hg/kg (95% confidence interval -1.31 to -2.35). Mean diastolic pressure was similarly related to birth weight. Maternal age, birth rank, and a parental history of hypertension were all related to blood pressure. After standardisation for current weight a 10 year increase in maternal age was associated with a 1.0 mm Hg (0.4 to 1.6) rise in systolic pressure; first born children had systolic blood pressure on average 2.53 mm Hg (0.81 to 4.25) higher than those whose birth rank was greater than or equal to 4; and a maternal history of hypertension was associated with a systolic pressure on average 0.96 mm Hg (0.41 to 1.51) higher than in those with no such history. The effects described were largely independent of one another and of age and social class. The relation for birth rank was, however, closely related to that for family size. CONCLUSIONS--Influences acting in early life may be important determinants of blood pressure in the first decade. The relation between birth weight and blood pressure may reflect the rate of weight gain in infancy. The reasons for the relation with birth rank and maternal age are unknown; if confirmed they imply that delayed motherhood and smaller family size may be associated with higher blood pressure in offspring.
Should physicians routinely be involved in the care of elderly surgical patients? Yes
Authors: K. Wilkinson, H. Wilson
Journal: BMJ (2011)

Standards of care for elderly people in hospital have come under the spotlight. <b>Kathy Wilkinson</b> and <b>Helen Wilson </b>believe that geriatricians can help improve the management of surgical patients, but <b>Barbara Herd</b> (doi:10.1136/bmj.d1072) is concerned that the dilution of resources will harm those who most need specialist attention
Acute effects of nitrates on exercise testing in patients with syndrome X. Clinical and pathophysiological implications.
Authors: G A Lanza, A Manzoli, E Bia, F Crea, A Maseri
Journal: Circulation (1994)

Sublingual nitrates are much more effective in relieving angina pectoris in patients with coronary artery disease than in patients with syndrome X, but it is not known whether their effect on exercise tolerance is also different in these two groups of patients.Treadmill exercise testing was performed before and after administration of sublingual isosorbide dinitrate (ISDN, 5 mg) in 18 patients with syndrome X (effort angina and normal coronaries, group X) and in 33 patients with documented coronary artery disease (group C). As a selection criterion, all patients had ST-segment depression > or = 1 mm on the control exercise test. Compared with the control test, the main differences in the two groups observed during the exercise test after administration of ISDN were (1) heart rate at 1-mm ST-segment depression was higher (126 +/- 25 versus 104 +/- 15 beats per minute [bpm], P < .01) in group C, whereas it was not different (125 +/- 15 versus 126 +/- 16 beats per minute) in group X; (2) the rate-pressure product at 1-mm ST-segment depression, the time to 1-mm ST-segment depression, and the exercise duration were significantly improved in group C (P < .01 for all) but were worsened in group X (18,047 +/- 4159 versus 20,535 +/- 4507 bpm . mm Hg, P = .014; 268 +/- 312 versus 429 +/- 214 seconds, P < .01; 494 +/- 279 versus 622 +/- 194 seconds, P = .013, respectively); (3) a normalization of the ECG (no ST-segment depression) was obtained in 10 patients (30%) of group C but in only 1 (5%) of group X (P < .01); (4) angina was prevented in 10 of 19 patients of group C but in no patient of group X (P < .01).In patients presenting with anginal chest pain, the effects of sublingual nitrates on exercise testing appear to be clinically useful to distinguish patients with coronary artery stenoses from patients with syndrome X. Indeed, worsening of exercise tolerance is highly predictive of normal coronary arteries. Furthermore, the failure of nitrates to improve exercise tolerance in patients with syndrome X suggests that a deficiency in coronary prearteriolar nitric oxide production is unlikely to play a key role in the pathophysiology of the syndrome.