tbuckley/cabot-search huggingface dataset:
Rethinking childhood depression
Authors: Christopher I Pelton
Journal: BMJ (2005)

Editor—Working in a large urban practice in a new town, I have witnessed a rise in the prevalence of distressed and, according to one's definition, depressed children in the past 15 years.1 I have also been a school medical officer. Over the same period I have seen attention and resources diverted from psychiatric and children's services to chronic disease in elderly people. I have therefore often faced the dilemma of either offering antidepressant drugs or effectively nothing. I welcome the debate in response to this article and sympathise with Timimi's contention, but society has given me the responsibility to “treat” unhappy children without the means.

Politically, I believe that the agenda for the NHS is driven by ageing voters. It is far easier for me to access comprehensive support for someone with Alzheimer's disease than it is for me to help a family with young children. Grandparents, support your grandchildren.
Mitogen responsiveness in viral hepatitis and chronic active hepatitis: the role of reversible suppressive influences.
Authors: C Feighery, J F Greally, D G Weir
Journal: Gut (1980)

Depressed phytohaemagglutinin and concanavalin-A responsiveness was found in patients with acute viral hepatitis (VH) when a suboptimal mitogen stimulus was used. Normal responsiveness was observed with optimal mitogen stimulation. These findings were independent of extrinsic serum inhibitors. When viral hepatitis lymphocytes were preincubated before mitogen addition an enhanced responsiveness similar to the control group occurred. These in vitro findings are in favour of a primary defect in lymphoproliferation in viral hepatitis and do not suggest the presence of reversible suppressive influences such as an excess of short-lived suppressor cells or the presence of cell bound inhibitors. In chronic active hepatitis (CAH) lymphoproliferation induced by immediate mitogen stimulation was similar to control studies. However when CAH cells were preincubated before mitogen addition, enhanced responsiveness significantly greater than in controls occurred. It is suggested that suppressive influences are present in CAH and that their effect can be reversed by cellular preincubation.
The caffeine breath test does not identify patients susceptible to tacrine hepatotoxicity
Authors: R J Fontana, D K Turgeon, T F Woolf, M J Knapp, N L Foster, P B Watkins
Journal: Hepatology (1996)

Therapy with tacrine, a promising new treatment for Alzheimer's disease, must be discontinued in up to 15% of patients because of hepatocellular toxicity. Recent studies using human liver microsomes have suggested that a single liver enzyme, cytochrome P450 1A2 (CYP1A2), catalyzes the major route of metabolism and elimination of tacrine, and also catalyzes the pathway(s) involved in the generation of reactive metabolites capable of covalent protein binding and cytotoxicity. Because CYP1A2 activity has been shown to vary up to 60-fold among patients, we proposed that a convenient measure of CYP1A2 activity, the [(13)C 3-methyl] caffeine breath test (CBT), might be clinically useful in identifying patients most susceptible to tacrine liver toxicity. To test this hypothesis, we administered the CBT to 37 patients with Alzheimer's disease before they began treatment with tacrine. Twenty patients received 2 mg/kg of [(13)C 3-methyl] caffeine. The remaining 17 patients received the commercially available CBT kit, which employs a constant 200-mg dose. The activities of two other major drug-metabolizing enzymes (cytochrome P450 3A4 and 2D6 [CYP3A4 and CYP2D6]) were also measured in these 17 patients. We found that the results obtained from the CBT protocol did not predict the peak serum alanine transaminase (ALT) observed in the patients. The measured CYP3A4 and CYP2D6 activities also failed to predict the susceptible patients. However, the result of the standardized-dose CBT correlated well with the logarithm of the steady-state plasma tacrine level obtained in 10 patients (R(2) = .69, P = .003). We conclude that the CBT will not be clinically useful in determining the subset of patients most susceptible to tacrine hepatotoxicity. However, the correlation we observed between CBT results and tacrine blood levels is the first evidence supporting a critical role for CYP1A2 activity in the disposition of the drug in vivo.
Extraordinarily High F-18 FDG Uptake Caused by Radiation Necrosis in a Patient With Nasopharyngeal Carcinoma
Authors: Guang-Uei Hung, Shih-Chuan Tsai, Wan-Yu Lin
Journal: Clinical Nuclear Medicine (2005)

A false-positive F-18 FDG PET scan caused by osteoradionecrosis and inflammation in patients with nasopharyngeal carcinoma (NPC) has been reported. The standard uptake values (SUVs) in these false-positive cases are always below 6 and decrease with time. This report is concerned with a false-positive result with extraordinarily high F-18 FDG uptake, which increased on the delayed 3-hour image. A 63-year-old man with NPC underwent surgical removal and radiotherapy (7400 cGy) in July 2003. In October 2003, the CT scan showed a large soft tissue mass over the nasopharynx. Tumor recurrence was suspected. F-18 FDG PET scan showed an FDG-avid lesion over the nasopharyngeal region with a maximum SUV of 28.8 at 1 hour that increased to 30.4 at 3 hours. Biopsy was performed and the histopathologic examination showed only necrotic tissue and no evidence of tumor cells. Radiation necrosis was diagnosed. No evidence of tumor recurrence was noted during the 10-month follow-up period.
Apoptosis in Ischemic and Reperfused Rat Myocardium
Authors: Henry Fliss, Deborah Gattinger
Journal: Circulation Research (1996)

Apoptosis has been observed previously in hearts subjected to either continuous ischemia or ischemia followed by reperfusion. The purpose of this study was to compare the timing and extent of apoptosis in both continuously ischemic and reperfused myocardium. We show that rats subjected to continuous coronary artery occlusion display characteristic signs of apoptosis solely in the ischemic myocardium after only 2.25 hours of ischemia, as illustrated by positive in situ end labeling (ISEL) of apoptotic cardiomyocyte nuclei in tissue sections and/or the presence of DNA “ladders” in agarose gels. In contrast, reperfusion after a 45-minute occlusion accelerated the process, with apoptosis becoming evident solely in the reperfused myocardium after only 1 hour of reperfusion. ISEL and DNA ladder intensity increased with duration of ischemia or reperfusion. The volume of myocardium in which ISEL was observed was smaller in the reperfused hearts, and the ISEL-stained nuclei represented 23% and 33% of the total nuclei in the reperfused and permanently occluded myocardium, respectively. Therefore, the data suggest that reperfusion lowers the extent of apoptosis in ischemic myocardium but, paradoxically, accelerates the residual apoptosis, possibly because of reperfusion injury. A large accumulation of neutrophils was observed in both the permanently occluded and reperfused myocardium, suggesting that the inflammatory response may have contributed to apoptosis in both settings. This study therefore confirms that both ischemic and reperfused rat myocardium can undergo apoptotic cell death. However, the data suggest that although reperfusion lowers the number of myocytes undergoing apoptosis, it accelerates apoptosis in the nonsalvageable cells.
Dose De-escalation Chemoprevention Trial of -Difluoromethylornithine in Patients With Colon Polyps
Authors: F. L. Meyskens, S. S. Emerson, D. Pelot, H. Meshkinpour, L. R. Shassetz, J. Einspahr, D. S. Alberts, E. W. Gerner
Journal: JNCI Journal of the National Cancer Institute (1994)

Background : α-Difluoromethylornithine (DFMO) is a potent inhibitor of carcinogenesis in experimental animal models. In these animal models, DFMO has been especially active in preventing carcinogen-induced epithelial cancers, including those of the skin, colon, breast, and urinary bladder. Although DFMO is known to exert its diverse biological effects by suppressing intracellular pools of the polyamines putrescine and spermidine, the precise mechanism by which polyamine depletion, induced by DFMO, suppresses carcinogenesis is unknown. Purpose : The specific aim of our study was to determine the lowest dose of DFMO that would deplete target tissue (colorectal mucosa) levels of these polyamines in humans who had undergone prior removal of colon polyps while producing minimal toxic effects. Methods : A dose de-escalation chemoprevention trial of DFMO was conducted in 111 patients (36 female and 75 male) who were in generally good health, aged 39–79, and who had undergone colonoscopy for surgical removal of an adenomatous colon polyp greater than 3 mm within 5 years prior to entering the study. Groups of patients (12–20 patients per group) were orally treated with single, daily doses of DFMO ranging from 3.0 to 0.1 g/m 2 for 4 weeks (28 days). Prior to initiation of DFMO treatment and at the end of treatment, six colorectal biopsy specimens were collected from each patient, along with serum samples. All biopsies were performed between 9 AM and noon to avoid possible effects of diurnal variations in laboratory end points. Samples for analysis of plasma DFMO levels were also collected during this time period on the day after the last day of drug administration. Results : DFMO caused a decrease in both putrescine content and the ratio of spermidine to spermine for all dose groups down to 0.25 g/m 2 . Both putrescine content and the ratio of spermidine to spermine and changes in these parameters as a function of DFMO treatment decreased as a function of donor age. None of the 30 patients receiving either 0.25 or 0.5 g/m 2 experienced any clinical ototoxicity in this trial. Conclusions : DFMO is both safe and effective in reducing colorectal mucosal polyamine contents when it is administered orally to patients at doses as low as 0.25 g/m 2 for 28 days. No ototoxicity was observed at doses up to twice this amount. Implications : If DFMO is also found to be effective in suppressing polyamine contents in other target tissues, it may be useful in preventing a wide range of human epithelial cancers, including those of the prostate and breast.
Medical Economics Encyclopedia of Practice and Financial Management
Authors: Alford C. Diller
Journal: JAMA (1989)

ABSTRACT This 1250 + -page reference on medical practice and financial management contains a storehouse of reliable information comprehensively and efficiently organized. The extensive resources of the Medical Economics Company, drawing on the experiences of leading practice management consultants, attorneys, financial planners, accountants, and other experts familiar with physicians' concerns, were skillfully orchestrated by Lawrence Farber, the senior editor of Medical Economics magazine, in the preparation of this encyclopedia.The book is divided into two parts. Part I, Practice Management, deals with the selection of different types of practice and the establishment, growth, and development of various types of practice, solo and group. Featured are hundreds of proven tips on office facilities and equipment, practice finances, personnel, insurance, and marketing. A worthwhile section on Learning to Live With a Computer is included.Part II, Financial Management, presents a holistic approach to the financial health of the physician, to meet the needs and
Effect of nedocromil sodium on the airway response to inhaled capsaicin in normal subjects.
Authors: L Hansson, N B Choudry, R W Fuller, N B Pride
Journal: Thorax (1988)

In six normal subjects treatment with 4 mg nedocromil sodium failed to alter the cough and bronchoconstriction induced by inhaled capsaicin. Because nedocromil has previously been shown to inhibit reflex bronchoconstriction provoked by inhaled sulphur dioxide and inhaled bradykinin, the results suggest that inhaled capsaicin acts on different nerve fibres.
Some historical aspects of N-aryl carcinogens and their metabolic activation.
Authors: J A Miller, E C Miller
Journal: Environmental Health Perspectives (1983)

This limited review of the early studies on the activation of the N-aryl carcinogens was written to provide a background for the current research to be presented at this conference on carcinogenesis by N-aryl compounds. Since the work of the past 10 years is too recent to be judged in a historical sense and because those data are much better known by current investigators, this review is generally limited to data up to 1972.
ANTITUBERCULOUS IMMUNITY INDUCED BY METHANOL EXTRACTS OF TUBERCLE BACILLI—ITS ENHANCEMENT BY ADJUVANTS
Authors: David W. Weiss, René J. Dubos
Journal: The Journal of Experimental Medicine (1956)

It is possible to prepare from tubercle bacilli a fraction soluble in methanol which is capable of eliciting in mice a marked degree of resistance against virulent tuberculous infection. The immunity was evident whether the infective dose was large and caused a disease with a rapid course, or was very small and caused a disease of many months duration. Active material has been obtained by extraction with methanol at 55 degrees C. of bacterial cells killed with 2 per cent phenol, and washed with acetone. The methanol extracts used in the present study have been prepared from the phenol-killed cells of a culture of BCG, and of the avirulent culture H37Ra. Vaccination of mice bas been carried out by the intraperitoneal route, and the challenge infection (with a highly virulent bovine culture), by the intravenous route. Weight for weight, the protective activity of the methanol extract is smaller than that of the bacterial cells from which it is extracted, but its primary toxicity for mice is also considerably lower. The protective activity can be increased, and the immunity prolonged, by using certain adjuvants as vehicle for injection of the vaccine. An oil adjuvant mixture, and small amounts of a highly purified preparation of the somatic antigen of typhoid bacilli, have been found capable of enhancing and prolonging the antituberculous immunity induced by the methanol extract. Under appropriate conditions the resistance resulting from intraperitoneal injection of the methanol extract is of the same order as that which follows vaccination with whole killed tubercle bacilli or with living BCG.
Histochemical Studies of Rheumatic Conditions: II. The Nodule of Rheumatoid Arthritis
Authors: H. T. Fawns, J. W. Landells
Journal: Annals of the Rheumatic Diseases (1954)

Mallory bleach: 5 minutes each in Lugol's iodine, sodium thiosulphate 5 per cent., potassium permanganate 025 per cent., oxalic acid 5 per cent., with intermediate washings.30
Calcipotriol vs. tazarotene as combination therapy with narrowband ultraviolet B (311 nm): efficacy in patients with severe psoriasis
Authors: R. Schiener, S.C. Behrens‐Williams, H. Pillekamp, P. Kaskel, R.U. Peter, M. Kerscher
Journal: British Journal of Dermatology (2000)

Background Phototherapy has been shown to be one of the most effective treatment modalities for patients with psoriasis. Nevertheless, photocombination therapies capable both of reducing cumulative ultraviolet (UV) doses and of accelerating clearance of skin lesions are important and of high interest. There have been no published studies comparing the effect of narrowband UVB irradiation in combination with topical application of tazarotene vs. calcipotriol. Objectives To determine, in a half‐side manner, whether a combination of UVB (311 nm) and tazarotene is superior to UVB (311 nm) plus calcipotriol or vice versa. Methods Ten patients suffering from widespread symmetrical psoriasis were treated for at least 4 weeks with topical calcipotriol and tazarotene in a half‐side distribution. Additionally, the whole body was irradiated with narrowband UVB (311 nm) four times a week. Before treatment and once weekly during therapy a modified Psoriasis Area and Severity Index was estimated for each body half. The total treatment time, number of treatment sessions and cumulative UVB dose necessary for clearance of skin lesions were determined in an observer‐blind fashion for each patient. Furthermore, all patients completed a quality of life questionnaire. Results Clearance of psoriasis was observed after a median of 19 treatment sessions (range 14–28) and a median cumulative UVB dose of 22·98 J cm−2 (range 9·24–58·22) simultaneously for both body halves. On the side treated with topical tazarotene gel, four patients complained of itching and dryness of the skin, and skin irritation was observed in three of them. Six patients preferred the application of tazarotene gel, while four preferred calcipotriol. Conclusions Our clinical comparison of narrowband UVB with either topical calcipotriol or topical tazarotene revealed no significant therapeutic difference between both regimens. Although these results need to be confirmed in larger patient groups, we feel that both photocombination therapies can broaden the therapeutic options for moderate to severe psoriasis vulgaris and may reduce the cumulative UVB dose during therapy.
Lidocaine in the Common Bile Duct
Authors: Jack D. McCarthy
Journal: JAMA (1969)

The injection of lidocaine, under pressure, into the biliary tree has been suggested as a maneuver to relax the sphincter of Oddi and to facilitate the passage of a retained calculus. A study of three cases, in which this technique was used, produced results not only contrary to that hypothesis; but the drug was associated with hepatic toxic effects in two of the three patients and resulted in the death of one. The use of lidocaine for this purpose should be discontinued.
Ventricular Function in Cardiac-Denervated and Cardiac-Sympathectomized Conscious Dogs
Authors: HUBERT L. STONE, VERNON S. BISHOP, E. DONG
Journal: Circulation Research (1967)

The role of the autonomic nervous system in ventricular function was studied in conscious animals when either the cardiac nerves or the sympathetic nerves to the heart had been eliminated. Regional neural ablation was used to denervate the heart, and blockade of the cardiac sympathetic nerves was performed with propranolol. A reduction in the plateau of the ventricular output was seen in the cardiac-denervated animals (263 ml/min per kg) and in animals with beta-blockade (240 ml/min per kg) as compared with 318 ml/min per kg for the control curves. The difference in stroke volume in the cardiac-denervated animals and the beta-blocked animals at the plateau demonstrates that the chronically cardiac-denervated animal changes its ventricular output solely by a change in stroke volume, whereas the animal with beta-blockade changes heart rate and stroke volume in response to stress. Thus the beta-blocked animals increased their heart rate by a decrease in parasympathetic activity.
Medical school applicants from ethnic minority groups: identifying if and when they are disadvantaged
Authors: I C McManus, P Richards, B C Winder, K A Sproston, V Styles
Journal: BMJ (1995)

<h3>Abstract</h3> <b>Objective</b>: To assess whether people from ethnic minority groups are less likely to be accepted at British medical schools, and to explore the mechanisms of disadvantage. <b>Design</b>: Prospective study of a national cohort of medical school applicants. <b>Setting</b>: All 28 medical schools in the United Kingdom. <b>Subjects</b>: 6901 subjects who had applied through the Universities9 Central Council on Admissions in 1990 to study medicine. <b>Main outcome measures</b>: Offers and acceptance at medical school by ethnic group. <b>Results</b>: Applicants from ethnic minority groups constituted 26.3% of those applying to medical school. They were less likely to be accepted, partly because they were less well qualified and applied later. Nevertheless, taking educational and some other predictors into account, applicants from ethnic minority groups were 1.46 times (95% confidence interval 1.19 to 1.74) less likely to be accepted. Having a European surname predicted acceptance better than ethnic origin itself, implying direct discrimination rather than disadvantage secondary to other possible differences between white and non-white applicants. Applicants from ethnic minority groups fared significantly less well in 12 of the 28 British medical schools. Analysis of the selection process suggests that medical schools make fewer offers to such applicants than to others with equivalent estimated A level grades. <b>Conclusions</b>: People from ethnic minority groups applying to medical school are disadvantaged, principally because ethnic origin is assessed from a candidate9s surname; the disadvantage has diminished since 1986. For subjects applying before A level the mechanism is that less credit is given to referees9 estimates of A level grades. Selection would be fairer if (a) application forms were anonymous; (b) forms did not include estimates of A level grades; and (c) selection took place after A level results are known. <h3>Key messages</h3> Key messages Applicants from ethnic minority groups continue to fare less well in being selected for medical school, although the extent of disadvantage is reduced in comparison with previous studies Since surname is a better predictor of disadvantage than ethnic origin as such, discrimination could be reduced by making application forms anonymous The locus of disadvantage in applicants is principally that estimated A level grades on application forms are given less weight in ethnic minority applicants—the problem could be circumvented by selecting medical students after they have their A level results No disadvantage was experienced by female applicants, mature applicants, or those from public sector schools, and no advantage was shown for those from medical families
Feeling for First
Authors: Woods Nash
Journal: JAMA (2013)

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901-38 New Image Processing, Segmentation, Extraction and Display Algorithms Allow Easier and More Versatile Dynamic Volume-rendered Three-dimensional Echocardiographic Examination: Application in Experimental and Clinical Studies
Authors: Lissa Sugeng, Alain Delabays, Qi-Ling Cao, Giusepplna Magni, Michael Krauss, Natesa Pandian
Journal: Journal of the American College of Cardiology (1995)