tbuckley/cabot-search huggingface dataset:
Aid, aid everywhere but still not a drop in the sink
Authors: H. Watson
Journal: BMJ (2009)

During my time at the government run Ola During Children’s Hospital in Freetown, Sierra Leone, the empty beds were the most bleak and heartbreaking sight of all. It was then that the scale of support this hospital needed hit me. I had been expecting the patients to be camping outside the hospital, as I had seen elsewhere in Africa. In a country where one in four children die before the age of 5 years, the worst child mortality rate in the world, there should be no quiet spells.

A million people live within walking distance of the hospital, but parents just cannot afford to pay for treatment and tests. There may also be a lack of faith in the quality of care provided there. Would you bring your child to a hospital with no running water, sporadic electricity supply, no oxygen, and staff morale ranging from bitter to apathetic? The staff are so …
The Value of Obtaining Renal Images Following Brain Scintigraphy with Technetium-99m Glucoheptonate
Authors: ALBERT J. MORENO, ANA A. RODRIGUEZ, MELVIN J. SPICER, ROBERT E. JACKSON, BILL F. BYRD, GOTTLIEB L. TURNBULL
Journal: Clinical Nuclear Medicine (1986)

The value of adding an extra view of the kidneys immediately following brain imaging with Tc-99m glucoheptonate was investigated in a two-year retrospective study at our institution. Between October 1982 and October 1984, 561 individuals underwent Tc-99m glucoheptonate brain imaging with the added renal view. Twenty-nine of these individuals (5.2%) demonstrated renal abnormalities. The abnormal renal findings were clinically correlated in 24 of these persons. Sixteen (67%) of these 24 individuals were unaware of any renal abnormality. Useful information can be obtained from renal images incidental to brain imaging at no added expense or radiation exposure to the patient, and at a minimal cost in time to the imaging clinic.
Comparison of human bronchiolar smooth muscle responsiveness in vitro with histological signs of inflammation.
Authors: J C de Jongste, H Mons, R Van Strik, I L Bonta, K F Kerrebijn
Journal: Thorax (1987)

A study was carried out to test the hypothesis that chronic inflammation is associated with increased sensitivity or contractility of human airway smooth muscle. Bronchiolar strips from 30 patients, 12 of whom had chronic bronchitis, were examined in the organ bath for their responses to histamine, methacholine, and leukotriene (LT) C4. The same airways were also studied histologically and small airway disease was quantified by subjective grading of the degree of inflammatory cell infiltration, smooth muscle hypertrophy, fibrosis, and goblet cell hyperplasia. The degree of small airway disease varied widely among patients both with and without chronic bronchitis. Multiple regression analysis failed to show increased sensitivity (-log EC50) to histamine, methacholine, or LTC4 in relation to small airway disease. In contrast, the only significant correlations found were between a decreased -log EC50 to histamine and methacholine and an increased small airway disease score. Contractile responses (Tmax) to histamine and methacholine in peripheral airways tended to be higher in patients with chronic bronchitis than in those without. Tmax was not related to small airway disease scores. These results suggest that chronic airway inflammation does not cause in vitro hyperresponsiveness of human small airway smooth muscle.
Innovative Rehabilitation Programs Get 'Them Ol' Bones' Walking Around Again
Authors: Beverly Merz
Journal: JAMA (1988)

TREATING musculoskeletal diseases in the aged is one thing. Rehabilitating elderly patients is another. According to participants at a recent national multidisciplinary conference, the latter is often a greater challenge than the former. At the fifth annual seminar titled "Them Ol' Bones," sponsored by St Luke's Medical Center in Phoenix, specialists in orthopedics, rheumatic diseases, physiatrics, and rehabilitation nursing offered a number of suggestions designed not so much to add years to the patients' lives as to add life to their years. Participants generally agreed that the overall goal of rehabilitation defined by Stanley Wainapel, MD, is to restore the patient to the maximum level of his or her physical, mental, social, and vocational abilities. The hard part is determining these abilities in the individual patient, says Wainapel, who is assistant director of physical medicine and rehabilitation, St Luke's Hospital, New York City. He cites statistics from studies showing that
TOXOPLASMIC ENCEPHALOMYELITIS
Authors: Abner Wolf, David Cowen, Beryl H. Paige
Journal: The Journal of Experimental Medicine (1940)

1. Infected material from the brain and spinal cord of an infant suffering from a recently recognized form of granulomatous encephalomyelitis was inoculated into rabbits and mice and produced an experimental disease which was readily transmissible in series. 2. A parasite identical with that in the lesions of the human case was found in the lesions of the experimental animals. 3. The morphology of this microorganism, the course of the disease and the lesions produced in the animals inoculated with it, the wide host range of this parasite, and the results of cross immunity experiments, establish its identity as a Toxoplasma. It is suggested that the microorganism be designated Toxoplasma hominis. 4. The clinical and pathologic features of the infection produced in animals by this Toxoplasma are described. 5. The infection in the infant is the first proved instance of human toxoplasmosis. Since the lesions were confined to the central nervous system the disease is termed toxoplasmic encephalomyelitis. 6. The first experimental transmission of human toxoplasmosis to animals is recorded.
Viral hepatitis appears on World Health Assembly agenda for first time
Authors: J. Parry
Journal: BMJ (2010)

The World Health Organization is being urged to step up the fight against viral hepatitis and develop a comprehensive approach to its prevention and treatment, with a resolution on the disease to be presented to the 63rd World Health Assembly later this month.

This will be the first time that the assembly has considered viral hepatitis, despite the huge burden of disease worldwide, said Steven Wiersma, medical officer and hepatitis focal point at WHO’s headquarters in Geneva.

“One in 12 people in the world are chronically infected with hepatitis B [and] the burden is extraordinarily high, yet somehow it’s been left off the world’s public health agenda,” he …
56. The Efficacy of Replicating Virotherapy for Tumors Involves a Complex Equilibrium between Virus, Tumor and the Immune System
Authors: Rosa Maria Diaz, Feorilo Galivo, Jian Qiao, Jill Thompson, Timothy Kottke, John Bell, Glen Barber, Richard Vile
Journal: Molecular Therapy (2006)

Killing of tumor cells by replicating oncolytic viruses should provide an abundant source of tumor antigens for cross priming of host immune cells. However, anti-viral immune responses will also be induced. Therefore, it is unclear whether the local killing of tumors by oncolytic viruses will be of immunotherapeutic benefit, or hindrance, to the generation of effective anti tumor immunity. We investigated where the equilibrium between viral replication, tumor cell killing and immune reactivity (to both tumor and viral antigens) lies when tumors are undergoing effective oncolytic virotherapy. Using a model in which direct intratumoral injection of established B16ova melanomas with replicating Vesicular Stomatitis Virus cures about 50% of C57BL/6 immunocompetent mice (n=8-10), extensive anti viral immune responses were generated. However, using ELISPOT, intracellular cytokines and in vivo CFSE T cell proliferation assays, we observed that intratumoral virotherapy can indeed prime naive T cells against a defined tumor antigen. These data suggest that additional approaches designed to increase the frequency of activated T cells against the tumor would increase the efficiency of oncolytic virotherapy. Therefore, we combined oncolytic virotherapy with either depletion of CD4+CD25+ regulatory T cells or with adoptive transfer of activated T cells specific for a tumor antigen. We observed decreased therapy in the absence of Treg, associated with a more rapid clearance of virus replication in the treated tumor. In contrast, ongoing local virotherapy increases the attraction of activated T cells to the tumor site by over 4 fold relative to control tumors, translating into significant improvement in therapy of established disease over either virotherapy or adoptive T cell transfer therapy, alone. Taken together, our data show that immune interventions which prolong local viral replication, and/or enhance frequencies of tumor specific T cells, should have significant therapeutic impacts both against the local, injected tumor and against systemic metatstatic disease not accessible to direct viral injection.
Pilot study shows cost effective approach to enable people to die at home
Authors: Susan Mayor
Journal: BMJ (2008)

Considerably more people have been able to die at home at no additional cost to the NHS by means of a pilot programme designed to improve liaison between hospitals and community services, according to an assessment published this week.

The UK cancer charity Marie Curie started the Delivering Choice programme in 2004 in Lincolnshire, in the east of England, to overcome many of the barriers that currently prevent terminally ill people from dying in their own homes.

Community link nurses were appointed at two hospitals in the area to help the speedy discharge of palliative care patients to their preferred place of care and to coordinate home care. A community based rapid response team was set up to provide planned and …
RESECTION OF MIDDLE TWO-THIRDS OF STOMACH WITH END-TO-END ANASTOMOSIS.
Authors: W. A. CLARK
Journal: JAMA (1905)

<h3>Patient.</h3> —A carpenter, aged 57, weight 131, was admitted to the County Infirmary July 16, 1904, complaining of a tumor in the abdomen. <h3>History.</h3> —Father died of old age. Mother died during confinement. One sister died of pneumonia. Two sisters and two brothers are alive and well. In 1870 he had typhoid fever; otherwise he has been strong and healthy. He does not use alcohol or tobacco. <h3>Present Illness.</h3> —The present trouble began about two weeks ago, when he accidentally noticed a swelling in the region of the stomach a little to the left of the median line. He has had no pain or tenderness, and has felt the same as usual. During the past four years he has had a sensation of fullness after eating and has raised considerable gas; this latter symptom has not been confined to any definite period during
Relapsing Toxic Shock Syndrome in the Puerperium
Authors: David J. Tweardy
Journal: JAMA (1985)

<h3>To the Editor.—</h3> Recurrence of toxic shock syndrome in cases related to menstruation has been reported to be as high as 34%.<sup>1-3</sup>Retrospective data suggest decreased risk of recurrence with effective antistaphylococcal antibiotic treatment.<sup>1,3</sup>There is little
Critical role for the common cytokine receptor gamma chain in intrathymic and peripheral T cell selection.
Authors: J P DiSanto, D Guy-Grand, A Fisher, A Tarakhovsky
Journal: The Journal of Experimental Medicine (1996)

The common cytokine receptor gamma chain (gammac), which is a functional subunit of the receptors for interleukins (IL)-2, -4, -7, -9, and -15, plays an important role in lymphoid development. Inactivation of this molecule in mice leads to abnormal T cell lymphopoiesis characterized by thymic hypoplasia and reduced numbers of peripheral T cells. To determine whether T cell development in the absence of gammac is associated with alterations of intrathymic and peripheral T cell selection, we have analyzed gammac-deficient mice made transgenic for the male-specific T cell receptor (TCR) HY (HY/gammac- mice). In HY/gammac- male mice, negative selection of autoreactive thymocytes was not diminished; however, peripheral T cells expressing transgenic TCR-alpha and -beta chains (TCR-alphaT/betaT) were absent, and extrathymic T cell development was completely abrogated. In HY/gammac- female mice, the expression of the transgenic TCR partially reversed the profound thymic hypoplasia observed in nontransgenic gammac- mice, generating increased numbers of thymocytes in all subsets, particularly the TCR-alphaT/betaT CD8+ single-positive thymocytes. Despite efficient positive selection, however, naive CD8+ TCR-alphaT/betaT T cells were severely reduced in the peripheral lymphoid organs of HY/gammac- female mice. These results not only underscore the indispensible role of gammac in thymocyte development, but also demonstrate the critical role of gammac in the maintenance and/or expansion of peripheral T cell pools.
EVALUATION OF DRUG-DRUG INTERACTION IN THE HEPATOBILIARY AND RENAL TRANSPORT OF DRUGS
Authors: Yoshihisa Shitara, Hitoshi Sato, Yuichi Sugiyama
Journal: The Annual Review of Pharmacology and Toxicology (2004)

Recent studies have revealed the import role played by transporters in the renal and hepatobiliary excretion of many drugs. These transporters exhibit a broad substrate specificity with a degree of overlap, suggesting the possibility of transporter-mediated drug-drug interactions with other substrates. This review is an overview of the roles of transporters and the possibility of transporter-mediated drug-drug interactions. Among the large number of transporters, we compare the Ki values of inhibitors for organic anion transporting polypeptides (OATPs) and organic anion transporters (OATs) and their therapeutic unbound concentrations. Among them, cephalosporins and probenecid have the potential to produce clinically relevant OAT-mediated drug-drug interactions, whereas cyclosporin A and rifampicin may trigger OATP-mediated ones. These drugs have been reported to cause drug-drug interactions in vivo with OATs or OATP substrates, suggesting the possibility of transporter-mediated drug-drug interactions. To avoid adverse consequences of such transporter-mediated drug-drug interactions, we need to be more aware of the role played by drug transporters as well as those caused by drug metabolizing enzymes.
The Use of Predicted Confidence Intervals When Planning Experiments and the Misuse of Power When Interpreting Results
Authors: Steven N. Goodman
Journal: Annals of Internal Medicine (1994)

Although there is a growing understanding of the importance of statistical power considerations when designing studies and of the value of confidence intervals when interpreting data, confusion exists about the reverse arrangement:the role of confidence intervals in study design and of power in interpretation. Confidence intervals should play an important role when setting sample size, and power should play no role once the data have been collected, but exactly the opposite procedure is widely practiced. In this commentary, we present the reasons why the calculation of power after a study is over is inappropriate and how confidence intervals can be used during both study design and study interpretation.
P203 Lung transplantation and survival in idiopathic pulmonary fibrosis - an Irish perspective
Authors: P Riddell, I Lawrie, S Winward, K Redmond, JJ Egan
Journal: Thorax (2013)

<h3>Introduction and Objectives</h3> Idiopathic pulmonary fibrosis (IPF) is a chronic, fibrosing interstitial pneumonia of unknown aetiology. Its clinical course is unpredictable but invariably leads to progressive respiratory failure and death. Median survival from time of diagnosis, without transplant, is 2–3 years. IPF patients referred for transplantation often suffer from poor outcomes, due to organ shortage and rapid disease progression. In America, the introduction of the lung allocation score has greatly benefited the IPF cohort. Furthermore, an increasing proportion of these transplants have occurred in patients over the age of 65 - an age group that had previously been associated with high post-transplant mortality. Recent data has however contradicted this, showing that surgical outcomes and survival are satisfactory in this age group. In a condition with no disease modifying medical therapy, we reviewed the survival benefit of lung transplantation in age-stratified groups to see if our data matched those seen internationally and to encourage further transplantation in this older population. <h3>Methods</h3> All patients with IPF who received lung transplantation in Ireland, since the beginning of the transplant service in 2005, were included (n = 30). Data collected included patient demographics, lung function, transplant details and survival data. Survival data was compared with IPF patients who had died while awaiting a transplant over the past 3 years (n = 20). <h3>Results</h3> For those patients on the lung transplant waiting list, who did not receive a transplant, survival was unfortunately poor (75% at 6 months, 30% at 12 months, and 15% at 18 months). However, following transplantation, all-age survival was 96.6% at 1 year, 90.1% at 2 years and 78.9% at 5 years. The 5 year survival for those transplanted over the age of 65 was 88.9% (n = 9). <h3>Conclusion</h3> As patients who suffer from IPF commonly present in their 7th decade, the consideration of patient age is pertinent when referring for transplantation. Although, many centres view age greater than 65 as a relative contraindication to lung transplantation, we feel that this data reinforces the alternative viewpoint - that age should not be a limiting factor, in carefully selected candidates.
Henry Greenfield “Bingy” Barnes
Authors: John H Walker
Journal: BMJ (2004)

General practitioner Tynemouth and North Shields 1948-85 (b Isle of Man 1921; q Durham 1943; FRCGP), died from complications of Parkinson's disease on 14 October 2004.​2004.




Figure 1




Bingy played an important role in introducing general practice to the Newcastle undergraduate curriculum in the early 1960s. He was the first general practitioner in the region to hold the post of clinical tutor in a postgraduate centre and played a full part in local medical committee, ethical committee, and BMA affairs. He was a founder member of the Royal College of General Practitioners. He enjoyed fell walking, climbed in the Lake District, Skye, the Pyrenees, and the Alps, and in 1954 reached the summit of the Matterhorn. He leaves a wife, Edith; three children; and seven grandchildren.
Gut Microbiota Promote Hematopoiesis to Control Bacterial Infection
Authors: Arya Khosravi, Alberto Yáñez, Jeremy G. Price, Andrew Chow, Miriam Merad, Helen S. Goodridge, Sarkis K. Mazmanian
Journal: Cell Host & Microbe (2014)

The commensal microbiota impacts specific immune cell populations and their functions at peripheral sites, such as gut mucosal tissues. However, it remains unknown whether gut microbiota control immunity through regulation of hematopoiesis at primary immune sites. We reveal that germ-free mice display reduced proportions and differentiation potential of specific myeloid cell progenitors of both yolk sac and bone marrow origin. Homeostatic innate immune defects may lead to impaired early responses to pathogens. Indeed, following systemic infection with Listeria monocytogenes, germ-free and oral-antibiotic-treated mice display increased pathogen burden and acute death. Recolonization of germ-free mice with a complex microbiota restores defects in myelopoiesis and resistance to Listeria. These findings reveal that gut bacteria direct innate immune cell development via promoting hematopoiesis, contributing to our appreciation of the deep evolutionary connection between mammals and their microbiota.
Intravenous nitroglycerin infusion inhibits cyclic blood flow responses caused by periodic platelet thrombus formation in stenosed canine coronary arteries.
Authors: J D Folts, J Stamler, J Loscalzo
Journal: Circulation (1991)

BACKGROUND Nitroglycerin and other clinically relevant organic nitrate derivatives have been shown to inhibit platelet aggregation in vitro. This antithrombotic effect of nitrates is potentiated by reduced thiol. To determine the potential relevance of this mechanism of action in vivo, we examined the effect of intravenous nitroglycerin infusion on periodic platelet thrombus formation in a canine model of coronary artery stenosis. METHODS AND RESULTS We used a canine model of coronary artery stenosis associated with cyclic reductions in coronary blood flow that have been shown to depend on periodic platelet thrombus formation. We quantified the frequency of cycles per 40-minute observation period and monitored the effect of a continuous infusion of intravenous nitroglycerin on the cycle frequency. The administration of 10-15 micrograms/kg/min nitroglycerin reduced cyclic platelet thrombus formation significantly and did so without a significant change in coronary artery blood flow. Pretreatment with the reduced thiol, N-acetylcysteine (100 mg/kg during 30 minutes), led to inhibition of cyclic platelet thrombus formation by intravenous nitroglycerin at doses that alone had no such effect (5 micrograms/kg/min). CONCLUSION These data suggest that one mechanism by which intravenous nitroglycerin improves ischemia in acute coronary artery disease syndromes may be by inhibition of platelet thrombus formation and may highlight the potential importance of reduced thiol in this mechanism.
The Recognition and Control of Occupational Disease
Authors: Philip J. Landrigan
Journal: JAMA (1991)

Occupational diseases account each year in the United States for an estimated 50,000 to 70,000 deaths and 350,000 new cases of illness. Often, however, occupational diseases are not correctly diagnosed, because they mimic diseases due to other causes and because most physicians are not well trained in their recognition. Opportunities for prevention and treatment are therefore lost. The occupational history is the most effective means for proper diagnosis of occupational illness. It should routinely be obtained for every patient. A brief but systematic guide for obtaining an occupational history is presented in this report. Also, approaches are summarized for the recognition and diagnosis of such important occupational diseases as occupational cancer, asbestosis and other respiratory disorders, and occupational neuropsychologic disorders. The management and prevention of occupational diseases depend on reduction of hazardous exposures in the workplace and better education of workers, industrial managers, and physicians. This report outlines a program for the control of occupational disease based on (1) preventing exposures in the workplace, (2) premarket toxicity testing of new chemicals and technologies, and (3) astute clinical diagnosis.
Intramural Hematoma of Duodenum and Jejunum
Authors: Rhoda N. Bruck, Bernerd Caplan
Journal: JAMA (1964)

ROENTGENOGRAPHIC DIAGNOSIS of intramural hematoma of the duodenum or jejunum, due either to trauma or to hemorrhagic states, is being made with increasing frequency. Many of the cases reported have not been proved except by followup course and subsequent studies showing a disappearance of the roentgenographic signs pari passu with the improved situation and disappearance of symptoms.<sup>1-3</sup> The most skeptical can hardly doubt the validity and significance of the roentgenographic signs when the condition is confirmed by surgery. The following case is being reported inasmuch as it presents the characteristic roentgenographic signs, was diagnosed prior to, and proved by, surgery, as well as by a postoperative followup examination. <h3>Report of a Case</h3> A 20-year-old white male was admitted to the hospital, with the chief complaint of nausea and vomiting for five days. One day before the onset of symptoms, his hand had been injured in an automobile accident. He