tbuckley/cabot-search huggingface dataset:
Non-Addisonian Megaloblastic Anaemia, Complicated by Subacute Combined Degeneration of the Cord
Authors: W. A. Nicol
Journal: BMJ (1960)

GASTRECTOMY MEDICALBOURNAL IV).The differences were found to be slight, but the following were statistically significant: a,-globulin in the gastrectomy group is lower than in the other groups (P<0.0l), and a2-globulin is lower in both gastrectomy and ulcer groups than in the control group (P<0.01).TABLE IV.-Electrophoresis of Plasma Proteins-Mean Values (g./100 Ml.) Globulins Group a, a2 a Y Gastrectomy .. 0-23 0 39 0 56 0-96 Ulcer .. 025 0 50 060 0 90 Control .. .. 0-29 0 54 0-63 0-84Discussion Improvement in post-gastrectomy symptoms is common in the early months (Muir, 1949), and these results show that late improvement is also possible in mild cases, though less likely when symptoms are severe.Late deterioration as described by Wells and MacPhee (1954) was found in one patient.The majority, however, show little change over the five-year period, and the weight of each patient has been remarkably stable, though weight normally tends to increase with advancing years.Johnston et al. (1958) showed that gastrectomy patients gained weight with intensive dietary supervision, but the increase was small and not necessarily maintained when the diet returned to normal.In our patients whose symptoms improved there was no corresponding rise in weight.While none of our cases showed levels comparable with the low serum albumin described by Forshaw (1958), the significant difference between the total protein and globulin mean values of the three groups is interesting.This may indicate a poorer absorption of protein or merely reflect a lower intake by gastrectomy patients; the intermediate position of the ulcer cases may bear a relation to altered diet.The significant, or probably significant, difference in the group comparison tends to confirm the view.An attempt to relate this to weight was unsuccessful.The significance of the alteration in a2-globulin fraction is not apparent.In another investigation (Walker et al., 1958) it was found that the serum lipoproteins of gastrectomy patients did not differ to any significant extent from those of ulcer and other patients.Summary Studies of 40 patients 10 years after Polya gastrectomy showed relatively little change in post-gastrectomy symptoms, weight, or work records between 1952 and 1957, though late symptomatic improvement occurred in four cases and late deterioration occurred in one.Improvement in symptoms was not associated with a gain in 'weight or haemoglobin.Measurements of total plasma protein, albumin, and globulin, and electrophoresis of plasma proteins indicate that total protein and et2-globulin may be lower after Polya gastrectomy, but no gross deviations from normal were found.Our thanks are due to Professor C. F. W. Illingworth for the facilities granted, and to Dr. R
Naming of drugs: pass the epinephrine, please
Authors: C. George
Journal: BMJ (1996)

its mechanisms for collecting, recording, and using data and is developing a programe for training staff in crosscultural awareness.It also plans to commission a prospective study to try to explain the rising proportion of overseas qualified doctors within the complaints procedure.A major challenge remains: how to balance the need for more accountability and visible uniformity in decision making with the need to leave room for interpretation and unforeseen circumstance.The GMC is right to resist imposing a rigid, all embracing definition of serious professional misconduct: this could never be flexible enough to cope with all eventualities.An alternative approach might be the one developed by the GMC for assess- ing seriously deficient professional performance.4This would still be based in case law, allowing interpretation within the light of current circumstances, but it would provide clearer articulation of the types of cases to be considered.The GMC should be praised for proving its commitment to openness, both in commissioning and publishing this report.But it cannot afford to sit on its laurels.The report does not find it guilty of racial bias, but neither does it find it not guilty-it cannot because of the parlous state of the organisation's records.Public bodies have a clear responsibility to maintain records that will allow their processes to be independently monitored.Otherwise how can an organisation be held accountable to its members or to the public?As the authors of the report make clear, inadequate records and obscure decision making processes will leave the GMC open to accusations ofbias until such accusations can be positively disproved.
Resting electrocardiographic abnormalities suggestive of asymptomatic ischemic heart disease associated with non-insulin-dependent diabetes mellitus in a defined population.
Authors: C Scheidt-Nave, E Barrett-Connor, D L Wingard
Journal: Circulation (1990)

The prevalence of ischemic heart disease (IHD) in older adults by glucose tolerance status was evaluated in 2,223 white men and women, aged 50-89 years, in the Rancho Bernardo cohort who were studied between 1984 and 1987. Impaired glucose tolerance (IGT) and non-insulin-dependent diabetes mellitus (NIDDM) were classified according to World Health Organization criteria. End points of ischemic heart disease were defined by Rose Questionnaire and resting electrocardiogram (ECG) according to the Minnesota Code. IHD by electrocardiographic changes was classified as asymptomatic (without history of chest pain or overt IHD) or symptomatic (with history). IHD by all criteria combined was significantly more common in men and women with NIDDM, and in women with IGT, than in those with normal glucose tolerance. The prevalence of myocardial infarction, defined by major Q wave, Rose Questionnaire chest pain criteria, or personal history, was higher in persons with NIDDM than in persons without; the difference was highly significant in women (odds ratio, 2.08 [1.22, 3.56]; p = 0.009). Angina pectoris was not significantly related to NIDDM or IGT in either sex. Electrocardiographic evidence of asymptomatic IHD was significantly more prevalent in both men and women with NIDDM as compared with those with normal glucose tolerance (odds ratios, 1.75 [1.10, 2.81] for men and 1.80 [1.07, 3.01] for women; p less than 0.05). This significant association persisted after excluding persons on digitlis or diuretic therapy and, in women, was also independent of the effect of major known IHD risk factors. These population-based data are consistent with clinical reports suggesting an association of diabetes with silent myocardial infarction or ischemia. The presence of ischemic resting electrocardiographic abnormalities in the asymptomatic diabetic patient is likely to have prognostic and therapeutic implications.
Neil Harrison Cox
Authors: C. Munro
Journal: BMJ (2010)

Neil Cox was a precocious student at Leeds Grammar School, taking A levels two years early. He went on to qualify in medicine at Liverpool University, having taken 1st class honours for his BSc in cell biology. From boyhood he was also an avid collector of stamps, for example, and of fossils or small animal bones and skulls. With the training in visual skills these hobbies encouraged, it is perhaps not surprising that, among all of the medical specialties, he was drawn to dermatology. In this field his acute eye and prodigious memory made him one of the most outstanding clinical dermatologists of his time.

Neil trained in dermatology in Liverpool, Glasgow, and Newcastle. Even as a junior registrar, his diagnostic expertise exceeded that of some of his supervising consultants, who having presented him with an unusual case on one day, would find a fully referenced case report on their desk the following morning. In the Newcastle department under Sam Shuster, rigorous measurement of skin physiology was prized over taxonomic niceties. Nonetheless, Neil impressed by his ability not only to recognise a rare entity at the weekly clinical meeting but to reach for the exact volume of the journal in which it was previously described.

He used to worry that his inability to resist an informative case report had diverted him from pursuing a narrower programme …
Distribution of lactoferrin and 60/65 kDa heat shock protein in normal and inflamed human intestine and liver.
Authors: E Peen, S Enestrom, T Skogh
Journal: Gut (1996)

Immunisation against the mycobacterial heat shock protein (hsp-65) has been proposed to lead to production of autoantibodies against human lactoferrin. Such antibodies occur in ulcerative colitis and in primary sclerosing cholangitis. This study analysed the distribution of hsp-65 and lactoferrin in biopsy specimens from patients with inflammatory bowel disease and primary sclerosing cholangitis and studied whether immunisation against mycobacterial hsp-65 resulted in production of antilactoferrin antibodies and vice versa. Polyclonal rabbit antihuman lactoferrin and monoclonal mouse anti-hsp-65 (ML30) were used for immunohistochemistry on biopsy specimens from patients with inflammatory bowel disease and primary sclerosing cholangitis. Rats were immunised against human lactoferrin and mycobacterial hsp-65 respectively. Antibody measurements were done by enzyme immunosorbent assays. It was found that lactoferrin and hsp-60/65 were not codistributed. Lactoferrin was found on vascular endothelium and in nonparenchymal liver cells both in inflamed and uninflamed tissues, but only in the hepatocytes of inflamed liver. ML30 reactivity was not inhibited by antilactoferrin antibodies. Rat anti-hsp-65 serum had no detectable antilactoferrin antibodies. In conclusion, antilactoferrin antibodies probably do not arise by immunisation against mycobacterial hsp-65. Both nonparenchymal cells and hepatocytes probably participate in clearance of lactoferrin. Endothelial exposure of lactoferrin may have pathogenic implications in diseases with antilactoferrin autoantibodies.
Diaphragm performance during maximal voluntary ventilation in chronic obstructive pulmonary disease.
Authors: M I Polkey, D Kyroussis, C H Hamnegard, G H Mills, P D Hughes, M Green, J Moxham
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

In normal subjects 2 min of maximal voluntary hyperventilation results in failure of tension generation and low-frequency fatigue of the diaphragm. Patients with severe chronic obstructive pulmonary disease (COPD) do not develop diaphragm fatigue during exhaustive treadmill exercise despite excessive inspiratory muscle loading and we hypothesized that they might be relatively resistant to the development of diaphragm fatigue during maximal ventilation. In six patients with severe COPD (mean FEV1 0.671) we therefore loaded the diaphragm using 2 min of maximal isocapnic ventilation (MIV). Initial mean ventilation was 28.6 L/min and diaphragm pressure-time product (PTPdi) 602 cm H2O x s/min; these values were sustained throughout MIV without significant decline. Mean twitch transdiaphragmatic pressure (Tw Pdi) was 19.7 cm H2O 25 min after a control run and 20.5 cm H2O at the same time after MIV [corrected]. Compared with normal subjects previously studied in our laboratory (Hamnegard, C.-H., et al. Eur. Respir. J. 1996;9:241-247) the reduction in PTPdi was disproportionately greater than the reduction in Tw Pdi. We conclude that, unlike normal subjects, 2 min of MIV causes neither failure of diaphragm performance nor low-frequency diaphragm fatigue in patients with severe COPD. It is likely that the diaphragm makes a relatively limited contribution to the generation of maximal levels of ventilation in severe COPD.
A new rat bile ductular epithelial cell culture model characterized by the appearance of polarized bile ductsin vitro
Authors: A E Sirica, T W Gainey
Journal: Hepatology (1997)

The rat treated with bile duct ligation (BDL) and furan is a unique animal model of massive bile ductular hyperplasia in which normal liver parenchyma is largely replaced with well-differentiated proliferated bile ductules. We have now developed a simple cell isolation procedure to obtain and culture viable bile ductular epithelial cells in high numbers and with a high degree of purity from the livers of BDL/furan-treated rats. Primary monolayer cell cultures were readily established when the isolated bile ductular epithelial cells were cultured in plastic tissue culture wells coated with rat tail tendon type I collagen plus bovine plasma fibronectin. Under these conditions, epidermal growth factor (EGF) was mitogenic for the cultured cells, and they retained phenotypic features typical of hyperplastic bile ductular epithelium but did not show evidence of ductal morphogenesis in vitro . In contrast, when the isolated bile ductular cells were cultured for 7 to 16 days in the presence of 25 ng EGF/mL and 10% fetal bovine serum on type I collagen gels, they formed into branching ductal structures whose ultrastructural features very closely resembled those of polarized hyperplastic bile ductules/ducts in vivo. Histological preparations of these gel cultures further showed that numerous ductal structures with defined lumens were present. Phenotypically, these ductal structures were completely surrounded by a thickened basement membrane that was strongly immunoreactive for laminin. Like their in vivo biliary cell counterparts, the epithelial cells comprising these ductal structures in culture also exhibited strong immunocytochemical staining reactions for cytokeratins 8 and 19, for glutathione S-transferase pi 7, and for luminal gamma-glutamyl transpeptidase, but they did not express immunoreactive albumin or α-fetoprotein. Occasional epithelial cells of the ductal structures, when examined in 10-day-old primary gel culture, showed strong nuclear staining for incorporated 5-bromo-2′deoxyuridine, indicating active cell proliferation. Our results support the development of a novel biliary epithelial cell culture model that has the potential of serving as a powerful tool for investigation of factors that regulate hyperplastic bile ductular morphogenesis, cell proliferation, and polarized cell functions in a structural form in vitro that mimics that of hyperplastic bile ductules induced in vivo.
Ticlopidine-Associated Thrombotic Thrombocytopenic Purpura
Authors: Kenneth J. Mukamal, Barry Wu, Peter McPhedran
Journal: Annals of Internal Medicine (1998)

Letters15 November 1998Ticlopidine-Associated Thrombotic Thrombocytopenic PurpuraKenneth J. Mukamal, MD, Barry Wu, MD, and Peter McPhedran, MDKenneth J. Mukamal, MDBeth Israel Deaconess Medical Center; Boston, MA 02215Yale University School of Medicine; New Haven, CT 06520Search for more papers by this author, Barry Wu, MDBeth Israel Deaconess Medical Center; Boston, MA 02215Yale University School of Medicine; New Haven, CT 06520Search for more papers by this author, and Peter McPhedran, MDBeth Israel Deaconess Medical Center; Boston, MA 02215Yale University School of Medicine; New Haven, CT 06520Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-10-199811150-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Bennett and colleagues [1] present a comprehensive review of currently identified cases of thrombotic thrombocytopenic purpura (TTP) associated with use of ticlopidine. Given the high case-fatality rate of TTP and the increasing use of ticlopidine, their description of this possible association is welcome and important. However, as with any case-series, the absence of a denominator (patient-years of exposure) makes assessment of the strength of this association difficult. In addition, as the authors note, an antiplatelet agent such as ticlopidine seems an unlikely culprit to cause a disease characterized by intravascular platelet thrombi. In fact, we have previously ...References1. Bennett CL, Weinberg PD, Rozenberg-Ben-Dror K, Yarnold PR, Kwaan HC, Green D. Thrombotic thrombocytopenic purpura associated with ticlopidine: a review of 60 cases. Ann Intern Med. 1998; 128:541-4. Google Scholar2. McPhedran P, Mukamal K. Ticlopidine for relapsing TTP [Abstract]. Blood. 1994; 84(suppl 1):80a. Google Scholar3. Vianelli N, Catani L, Belmonte MM, Sermasi G, Cascione ML, Gianni L, et al. Ticlopidine in the treatment of thrombotic thrombocytopenic purpura: report of two cases. Haematologica. 1990; 75:274-7. Google Scholar Author, Article, and Disclosure InformationAuthors: Kenneth J. Mukamal, MD; Barry Wu, MD; Peter McPhedran, MDAffiliations: Beth Israel Deaconess Medical Center; Boston, MA 02215Yale University School of Medicine; New Haven, CT 06520 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byImaging and Histopathologic Features of HIV-related Renal DiseaseTiclopidine-Induced Interstitial Pulmonary DiseaseUnstable Angina Pectoris and Non-Q-Wave Myocardial InfarctionPlatelet Disorders in Autoimmune Diseases 15 November 1998Volume 129, Issue 10Page: 837KeywordsPlateletsThrombotic thrombocytopenic purpura ePublished: 15 August 2000 Issue Published: 15 November 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Alexithymia and the Counter-Transference
Authors: Graeme J. Taylor
Journal: Psychotherapy and Psychosomatics (1977)

Case Reports| February 16 2010 Alexithymia and the Counter-Transference Subject Area: Psychiatry and Psychology Graeme J. Taylor Graeme J. Taylor Toronto, Ontario Search for other works by this author on: This Site PubMed Google Scholar Psychother Psychosom (1977) 28 (1-4): 141–147. https://doi.org/10.1159/000287056 Article history Published Online: February 16 2010 Content Tools Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Graeme J. Taylor; Alexithymia and the Counter-Transference. Psychother Psychosom 31 December 1977; 28 (1-4): 141–147. https://doi.org/10.1159/000287056 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll JournalsPsychotherapy and Psychosomatics Search Advanced Search This content is only available via PDF. 1977Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. Article PDF first page preview Close Modal You do not currently have access to this content.
FDG PET Imaging of Myxofibrosarcoma on the Sphenoid Sinus
Authors: Keisuke Enomoto, Hidenori Inohara, Kenichiro Hamada, Manabu Tamura, Yasuhiko Tomita, Takeshi Kubo, Jun Hatazawa
Journal: Clinical Nuclear Medicine (2008)

Myxofibrosarcoma (MFS), also known as a myxoid subtype of malignant fibrous histiocytoma, is one of the most common sarcomas in the extremities of elderly people and is characterized by a high frequency of local recurrence. Recent reports have shown that positron emission tomography using 2-deoxy-[F-18]fluoro-d-glucose (F-18 FDG PET) imaging is useful in the detection of local recurrence and distant metastases of sarcoma, but there have been few reports of FDG PET for MFS. We report a case of MFS infiltrating the skull base, and FDG PET showed a heterogeneous uptake pattern at the tumor site.
Does US health reform reduce hospital readmission rates?
Authors: A. Steventon, H. Krumholz
Journal: BMJ (2014)

Not in Massachusetts—insurance expansion alone won’t be enough

In 2012, after the 2010 Affordable Care Act became law but before its full implementation, around 47 million people in the United States were without healthcare insurance. The sweeping provisions of the Affordable Care Act were primarily focused on expanding insurance coverage. An open question is whether such provisions will also affect healthcare utilization and health outcomes.

In a linked paper (doi:10.1136/bmj.g2329), Lasser and colleagues studied the effect of reforms in Massachusetts, which passed legislation before the Affordable Care Act and similarly sought to broaden insurance coverage.1 After reform, the proportion of adults of working age in Massachusetts who were uninsured decreased from 12.5% in 2006 to 5.2% in 2012.2 Lasser and colleagues examined whether the Massachusetts reforms were associated with favourable changes in readmission rates. Readmissions represent an outcome that imposes a burden on individuals and the healthcare system, which are also amenable to improvements in healthcare quality.

Studying the effect of healthcare insurance strategies on population health and healthcare utilization is challenging. A few investigators have had the opportunity to do so using randomized controlled trials.3 4 5 The RAND Health Insurance Experiment of the mid-1970s recruited more than 2000 households and found that higher co-payments within insurance products reduced resource use without large impacts on health or quality of care for …
Medical management of Duchenne muscular dystrophy.
Authors: C S Galasko
Journal: BMJ (1993)

been carried out for phenylketonuria since the mid-1970s and testing for hypothyroidism since the mid-'80s.Our recent data on new mothers' knowledge of these tests suggests that ignomce is widespread.As part of the Cambridge prenatal screening study, 1387 women from nine hospitals in four regions completed a postal questionnaire six weeks after giving birth.2All but eight women knew where the test had been done (1209 at home and 163 in hospital, with more primiparous women tested in hospital).Most women (951) said that the test had been fully explained and 222 "knew about it already."The extent to which women thought that they were informed, however, was not reflected in the answers to a question about which disorders this blood sample was tested for (table ).Mothers' responses to question "Which of the following was your baby testedfor?" Don't YesNo knowCystic fibrosis (n=1232)