tbuckley/cabot-search huggingface dataset:
Psychiatric view of the intensive care unit.
Authors: D. S. Kornfeld
Journal: BMJ (1969)

Priorities in Medicine BRASH city and even from hospital to hospital in the frequency with which certain routine operations are performed, in the mortality from standard surgical procedures, and in the duration of stay in hospital of patients with similar diseases ?Do long-stay patients with hernias or varicose veins really fare better or worse than short-stay or outpatient cases respectively, or do the more economical methods of treatment demand differently trained surgeons ?Does the patient with cardiac infarction do better under the continuous monitoring of the specialist hospital unit or in bed at home with simple nursing care ?At what point does population screening cease to pay dividends and become counter-productive ?These questions and many like them require answers.The answers are needed to support our demand for the facilities we need to give our patients the best that modern medicine can offer.They cannot be furnished by a Government department.Justified or not, it would almost certainly face the charge of encroaching on the doctors' clinical freedom and of special pleading in the cause of economy.The answers can come only from the profession.
Radiation-induced squamous carcinoma arising within a seborrhoeic keratosis
Authors: S.K. SUVARNA, M. BAGARY, G. GLAZER
Journal: British Journal of Dermatology (1993)

Seborrhoeic keratoses (SK) are common skin tumours. They are benign, and present little difficulty in management. However, rare malignant transformation is recognized. We report a case of a squamous cell carcinoma arising from dysplastic changes within a long‐standing SK on the chest wall of a 75‐year‐old retired radiologist, and consider the role of radiation in inducing malignant change within SKs.
Blood flow in sequential vein grafts.
Authors: J J McNamara, H S Bjerke, G K Chung, C R Dang
Journal: Circulation (1979)

In 69 patients undergoing coronary artery bypass grafting for complete coronary revascularization, blood flow was measured in 140 grafts with 243 distal anastomoses (3.52 bypasses/patient). Total blood flow in single grafts and double and triple sequential grafts did not differ significantly, although mean distal flow decreased successively with single (85 cc/min), double (51 cc/min), and triple (32 cc/min) sequential grafts. Total myocardial flow did not vary significantly regardless of the number of grafts placed. Flow measurements in patients with double sequential grafts showed greater than 20% overlay in flow between the two distal anastomoses. The data suggest significant but incomplete collateral supply between adjacent coronary beds consistent with the concept of any individual area of myocardium being a capacitance bed supplied in part by a number of adjacent coronary branches.
Some Current Issues Relating to Rubella Vaccine
Authors: Stephen R. Preblud
Journal: JAMA (1985)

At the time of licensure in 1969, available data indicated that rubella vaccines were safe, noncommunicable, and effective. Since vaccine virus could cross the placenta and infect the fetus, cautious use of the vaccines in childbearing-age women was recommended. Over the past 15 years, additional information about the vaccines has been accumulated. This article provides an update of data on (1) the risk and degree of joint symptoms following vaccination and revaccination, (2) the duration of vaccine-induced immunity, (3) the protective effect of low levels of vaccine-induced antibody, and (4) the risks to the fetus following maternal vaccination. The data support continued vaccination of all young children as well as increased efforts to vaccinate susceptible adolescents and young adults, especially women. Only by more effective vaccination of the latter can elimination of congenital rubella syndrome be hastened. (<i>JAMA</i>1985;254:253-256)
Identifying patients at high risk of emergency hospital admissions: a logistic regression analysis
Authors: Alex Bottle, Paul Aylin, Azeem Majeed
Journal: Journal of the Royal Society of Medicine (2006)

ObjectiveTo use routine data to identify patients at high risk of future emergency hospital admissions. DesignDescriptive analysis of inpatient hospital episode statistics. Predictive model developed using multiple logistic regression. ParticipantsAll patients with an emergency admission to an NHS hospital between 1 April 2000 and 31 March 2001. Main outcome measures'High-impact users' were defined as patients who had at least one emergency inpatient admission and who then went on to have at least two further emergency hospital admissions in the 12 months following the start date of that index admission. Results2 895 234 patients were admitted as emergencies in 2000/2001, of whom 147 725 (5.1%) did not survive their first spell. Of the 2 747 509 surviving patients, 269 686 (9.8%) subsequently had at least two or more emergency admissions within 365 days of the index date of admission. A further 236 779 (8.6%) died during this period. Risk factors for becoming a high-impact user included the number of emergencies in the 36 months before index spell, comorbidity, age, an admission for an ambulatory care sensitive condition, ethnicity, area-level socio-economic data, local admission rates, the number of episodes in the index spell, sex and the source of admission. The predictive model based on all emergency admissions produced a receiver operating characteristic curve score of 0.72. ConclusionsRoutine hospital episode statistics can be used to identify patients who are at high risk of suffering future multiple emergency hospital admissions. The potential cost savings in preventing a proportion of these subsequent admissions need to be compared with the costs of case management of these patients.
Mechanism of decreased vascular reactivity to angiotensin II in conscious, potassium-deficient rats.
Authors: M S Paller, J G Douglas, S L Linas
Journal: Journal of Clinical Investigation (1984)

Chronic potassium deficiency in the rat results in a decrease in the pressor sensitivity to exogenous angiotensin II (AII). To define the mechanism of this resistance to AII, studies were performed in conscious rats after 14-21 d of dietary potassium deficiency. The pressor response to graded doses of AII was 50% less in potassium-deficient than control animals. In contrast, the pressor response to graded doses of norepinephrine was preserved in potassium-deficient rats; therefore, the decreased response to AII was not due to a generalized defect in vascular reactivity. Pretreatment with either the converting enzyme inhibitor, teprotide, or the prostaglandin synthesis inhibitor, indomethacin, failed to normalize the response to AII. Thus, neither prior receptor occupancy with endogenous AII nor the presence of vasodilatory prostaglandins caused the decreased AII response in potassium deficiency. Since the pressor response to AII involves angiotensin interaction with its vascular receptor, binding studies of mesenteric artery and uterine smooth muscle AII receptors were performed. Scatchard analysis showed that potassium deficiency resulted in a decrease in binding affinity (50% increase in Kd) in both uterine (6.00 vs. 3.82 nM; P less than 0.05) and vascular (1.39 vs. 0.973 nM; P less than 0.005) smooth muscle. Furthermore, despite increased circulating AII, there was an increase in AII receptor number in potassium-deficient uterine (308 vs. 147 fmol/mg protein; P less than 0.005) and vascular (470 vs. 316 fmol/mg protein; 0.05 less than P less than 0.1) smooth muscle. Although potassium deficiency resulted in alterations in receptor-binding parameters, the changes in binding affinity and number were directionally opposite, so that in potassium deficiency there was either no change or an increase in total AII binding. We conclude that the decrease in angiotensin pressor sensitivity in potassium-deficient rats is mediated by a postreceptor defect since it occurs subsequent to the binding of AII to its vascular smooth muscle receptor.
Injury to murine airway epithelial cells by pollen enzymes
Authors: Z. Hassim, S. E Maronese, R. K Kumar
Journal: Thorax (1998)

<h3>BACKGROUND</h3> Pollens are important triggers for asthma but the mechanism of sensitisation to their proteins remains poorly understood. The intrinsic protease activity of some allergens may contribute to sensitisation by disrupting the integrity of the airway epithelial barrier. Pollens release a variety of enzymes, including proteases, upon hydration. The hypothesis that such enzymes might be able to damage airway epithelial cells was therefore tested. <h3>METHODS</h3> Diffusates from pollens of<i>Lolium perenne </i>(ryegrass), <i>Poa pratensis</i>(Kentucky bluegrass), <i>Acacia longifolia</i> (Sydney golden wattle), or <i>Casuarina distyla</i> (she-oak) were incubated with mouse tracheal epithelial cells in culture and cellular detachment was quantified using a methylene blue dye binding assay. <h3>RESULTS</h3> Diffusates prepared using 100 mg/ml of pollen caused detachment of 30–90% of airway epithelial cells in separate experiments. Within each experiment comparable detachment was observed with all diffusates tested, although total protein in the diffusates varied markedly between species. Viability of the cells recovered after exposure to <i>Acacia</i> diffusate was higher than after detachment by exposure to <i>Lolium</i>diffusate. Cellular detachment by all of the diffusates could be almost completely inhibited by addition of 10% serum. Aprotinin, an inhibitor of serine proteases, partially blocked activity in diffusates of<i>Lolium</i> pollen but not of<i> Acacia</i> pollen. In contrast, α<sub>1</sub>-protease inhibitor and secretory leucocyte protease inhibitor (SLPI) were not able to block the activity of either diffusate at concentrations which inhibited cellular detachment by trypsin. <h3>CONCLUSIONS</h3> Proteases released by pollens are able to cause detachment of airway epithelial cells from their substratum in vitro and may not be effectively inhibited by endogenous antiproteases.
Spring's Here; Can End of Present Influenza Season in United States Be Far Behind?
Authors: Adam Ritt
Journal: JAMA (1988)

IF ONLY A FEW influenza cases are reported in the next few days, the nation's 1987-1988 flu season may go into the records as notable but not notorious. As a rule of thumb, say officials at the Centers for Disease Control (CDC), Atlanta, if there haven't been unusual numbers of influenza cases reported from all over the nation by this time, it is cause for some optimism. But every season is unique, and the possibility of major outbreaks still exists. "There have been years where things have been puttering along, and then late in the season it picks up," says the CDC's Nancy Arden, MN, who is a nurse. Even during a slow season, increased awareness and improved diagnosis have led to more states reporting isolates of influenza than in the past, says Alan Kendal, PhD, of the CDC's Influenza Branch. Many hospital laboratories are now able to identify influenza
Blood-Gas and Hemodynamic Responses to Oxygen in Acute Myocardial Infarction
Authors: ROBERT M. DAVIDSON, BARRY W. RAMO, ANDREW G. WALLACE, ROBERT E. WHALEN, C. FRANKLIN STARMER
Journal: Circulation (1973)

Blood-gas (Pa o o2 ) and hemodynamic responses to the inhalation of oxygen were studied in 60 patients with acute myocardial infarction. Patients who were not in heart failure on admission and did not develop signs of heart failure within the next 5 days achieved the same Pa o o2 level while breathing 100% oxygen as did patients without acute myocardial infarction. Patients with pulmonary edema or cardiogenic shock had a very poor Pa o o2 response to oxygen inhalation. Patients in mild heart failure at the time of study and patients who developed heart failure subsequent to the study had a Pa o o2 response intermediate between the other two groups. This rise of Pa o o2 with oxygen correlated with the cardiac index and right atrial oxygen prior to inhalation of oxygen. Uncomplicated patients responded to inhalation of oxygen with a decrease of heart rate, cardiac index, stroke index, and cardiac work, and an increase of peripheral resistance. Patients in pulmonary edema or cardiogenic shock or with a low cardiac index or low Pa o o2 responded with only a slight increase in peripheral resistance. The Pa o o2 achieved while breathing oxygen appeared to determine the type of hemodynamic response to oxygen. Administration of oxygen to patients with acute myocardial infarction is useful in identifying latent heart failure and in predicting the subsequent clinical course of these patients.
Expression of EVI1 and the retinoblastoma genes in acute myelogenous leukemia with t(3;13)(q26;q13–14)
Authors: Yuji Yufu, S. Sadamura, H. Ishikura, Y. Abe, M. Katsuno, J. Nishimura, H. Nawata
Journal: American Journal of Hematology (1996)

The EVI1 DNA-binding protein gene on chromosome 3q26 has been reported to be activated in some leukemia cells with alterations in 3q26. We present an acute myelogenous leukemia (AML) patient with a rare chromosomal translocation, t(3;13)(q26.2;q13–14). By reverse transcription- polymerase chain reaction, we detected active transcription of the EVI1 gene in the patient's leukemia cells. The retinoblastoma susceptibility (Rb) gene, a tumor-suppressor gene, is located at chromosome 13q14 and is within the other translocation breakpoint in this patient. The expression of the Rb gene product was found to be substantially decreased in the patient's leukemia cells by Western blotting. Southern blot analysis, however, revealed no gross abnormalities of the Rb gene. Although it is unlikely that the Rb gene is directly involved in this translocation, the loss of the Rb gene product combined with the activation of the EVI1 gene may have led to the development of leukemia. © 1996 Wiley-Liss, Inc.
1169-158 Magnetic resonance imaging can reliably identify heart iron overload in patients with B-thalassemia major
Authors: Sophie Mavrogeni, L Kaklamanis, D Tsiapras, I Paraskevaidis, G Karavolias, V Markussis, M Karagiorga, M Douskou, D.V Cokkinos, D.T Kremastinos
Journal: Journal of the American College of Cardiology (2004)
Abstract B14: Activin A regulates cell interactions in the microenvironment of oral squamous cell carcinomas
Authors: Ricardo D. Coletta, Andreia Bufalino, Lays M. Sobral, Priscila C. Rodrigues, Edgard Graner, Luis P. Kowalski, Tuula Salo
Journal: Cancer Research (2015)

Abstract Although the molecular mechanisms by which carcinoma-associated fibroblasts (CAFs) influence oral squamous cell carcinomas (OSCC) remain largely unknown, previous studies demonstrated that presence of CAFs in the stroma of OSCCs is an important risk factor of patient's shortened survival. Here we showed that activin A is produced in higher levels by CAFs compared to normal oral fibroblasts, and that activin A released by CAFs significantly increases OSCC cell proliferation and xenograft tumor volume, whereas down-regulation of activin A decreases OSCC proliferation. Furthermore, activin A reduced OSCC cell death even when challenged by staurosporine, and promoted migration, invasion and the expression of epithelial-mesenchymal transition (EMT) markers (decreases E-cadherin and increases vimentin and N-cadherin) of OSCC cells. Immunohistochemical analysis of 115 OSCC samples revealed that increased activin A expression is significantly correlated with presence of regional metastasis (N stage, p=0.034), poorly differentiated tumors (p=0.013) and shown to be predictive of a shortened disease-free survival (HR: 1.74, 95% CI: 1.39-2.97, p=0.016). Importantly, immunohistochemical expression of activin A was significantly associated with presence of occult lymph node metastasis (p=0.006), which has an important impact on clinical management and prognostication of patients with OSCCs. In conclusion, our data demonstrate that activin A is an important molecule for OSCCs, and its pleiotropic effects on proliferation and invasion are important on control of the aggressiveness of OSCCs. Citation Format: Ricardo D. Coletta, Andreia Bufalino, Lays M. Sobral, Priscila C. Rodrigues, Edgard Graner, Luis P. Kowalski, Tuula Salo. Activin A regulates cell interactions in the microenvironment of oral squamous cell carcinomas. [abstract]. In: Abstracts: AACR Special Conference on Cellular Heterogeneity in the Tumor Microenvironment; 2014 Feb 26-Mar 1; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2015;75(1 Suppl):Abstract nr B14. doi:10.1158/1538-7445.CHTME14-B14
Effect of hypertension and hypertrophy on coronary microvascular pressure.
Authors: M Fujii, D W Nuno, K G Lamping, K C Dellsperger, C L Eastham, D G Harrison
Journal: Circulation Research (1992)

We tested the hypothesis that transmural differences in coronary microvascular pressures may be greater in the setting of hypertension and left ventricular hypertrophy. Epicardial and endocardial microvascular pressures were measured in isolated lidocaine-arrested hearts during adenosine vasodilation. In both normotensive (n = 19) and hypertensive (one clip, one kidney, n = 10) dogs, microvascular pressures in endocardial arterioles at 60, 70, 80, 90, and 100 mm Hg of left main coronary perfusion pressures were lower than in epicardial arterioles (p less than 0.05 at all perfusion pressures). The pressures in epicardial arterioles as a percentage of the left main coronary perfusion pressure were similar in normotensive versus hypertensive hearts at all perfusion pressures. In contrast, the pressures in endocardium at 90 and 100 mm Hg of perfusion pressure were significantly (p less than 0.05) lower in dogs with hypertension and hypertrophy than in the controls (41 +/- 4 versus 50 +/- 2 and 40 +/- 4 versus 50 +/- 3 mm Hg at 90 and 100 mm Hg of perfusion pressure, respectively). Thus, there is a greater transmural resistance to microvascular perfusion in hearts with myocardial hypertrophy secondary to hypertension. This is likely due to differences in the vascular anatomy, secondary to hypertension and hypertrophy, and may contribute to vulnerabilities in subendocardial ischemia encountered in this condition.
The global impact of income inequality on health by age: an observational study
Authors: Danny Dorling, Richard Mitchell, Jamie Pearce
Journal: BMJ (2007)

To explore whether the apparent impact of income inequality on health, which has been shown for wealthier nations, is replicated worldwide, and whether the impact varies by age.Observational study.126 countries of the world for which complete data on income inequality and mortality by age and sex were available around the year 2002 (including 94.4% of world human population).Data on mortality were from the World Health Organization and income data were taken from the annual reports of the United Nations Development Programme.Mortality in 5-year age bands for each sex by income inequality and income level.At ages 15-29 and 25-39 variations in income inequality seem more closely correlated with mortality worldwide than do variations in material wealth. This relation is especially strong among the poorest countries in Africa. Mortality is higher for a given level of overall income in more unequal nations.Income inequality seems to have an influence worldwide, especially for younger adults. Social inequality seems to have a universal negative impact on health.
Mite serine protease activates protease‐activated receptor‐2 and induces cytokine release in human keratinocytes
Authors: T. Kato, T. Takai, T. Fujimura, H. Matsuoka, T. Ogawa, K. Murayama, A. Ishii, S. Ikeda, K. Okumura, H. Ogawa
Journal: Allergy (2009)

Background: House dust mites produce serine and cysteine proteases. Mite‐derived proteases have been suggested to be involved in the pathogenesis of allergies; however, whether mite‐derived serine protease activity can stimulate keratinocytes remains unknown. Methods: We examined the activation of primary human keratinocytes by serine protease‐rich extract of whole mite culture and compared with that by recombinant group 1 allergens (rDer f 1 and rDer p 1), which exclusively exhibit cysteine protease activity. Results: Protease activity of whole mite culture extract (WCE), rDer f 1 and rDer p 1 induced the release of IL‐8 and granulocyte‐macrophage colony‐stimulating factor. Protease activity of WCEs induced a significant upregulation of their mRNA expression but rDer f 1 had much less effect. Protease activity of the WCE stimulated intracellular Ca 2+ mobilization but rDer f 1 and rDer p 1 did not. The mobilization induced by agonists for the human protease‐activated receptor (PAR)‐2, an agonist peptide or trypsin, was diminished by pre‐incubation of keratinocytes with WCE. rDer f 1 inefficiently cleaved a synthetic N‐terminal peptide of PAR‐2 at different sites from trypsin, but the resultant peptides did not stimulate the release of interleukin‐8. Conclusions: The results suggest that mite‐derived serine protease activity may contribute to the pathogenesis of atopic dermatitis by activating keratinocytes via PAR‐2 activation but cysteine protease activity of Der f 1 and Der p 1 acts via another mechanism.
Popliteal masses masquerading as popliteal cysts.
Authors: H T Griffiths, C W Elston, C L Colton, A J Swannell
Journal: Annals of the Rheumatic Diseases (1984)

Two popliteal swellings, thought initially to be synovial cysts associated with arthritic knees, were found to be unrelated tumours of serious significance. In the presence of neurological signs or a large cyst in association with a noninflammed knee joint a disease other than a simple synovial cyst should be considered.
Referral management schemes are damaging patients' interests
Authors: Peter Lapsley
Journal: BMJ (2007)

Some years ago I visited my GP to ask why the beds of most of my fingernails and toenails were thickening and whitening, raising the nails, which were themselves becoming heavily pitted. She admitted that she did not know and referred me to a consultant dermatologist. 

The consultant diagnosed nail psoriasis, explaining that it was difficult to treat, and prescribed a protracted programme of hand and foot PUVA (psoralen and ultraviolet A treatment). Although this did not cure the psoriasis, it improved it considerably and halted the psoriatic arthritis that was beginning to affect the joints of two of my fingers. 

Had that episode occurred this year in one of the many primary care trusts that have introduced a referral management scheme, it is most unlikely that I would have been granted an appointment with …
Prevention of Recurrent Preterm Delivery by 17 Alpha-Hydroxyprogesterone Caproate
Authors: Paul J. Meis, Mark Klebanoff, Elizabeth Thom, Mitchell P. Dombrowski, Baha Sibai, Atef H. Moawad, Catherine Y. Spong, John C. Hauth, Menachem Miodovnik, Michael W. Varner, Kenneth J. Leveno, Steve N. Caritis, Jay D. Iams, Ronald J. Wapner, Deborah Conway, Mary J. O'Sullivan, Marshall Carpenter, Brian Mercer, Susan M. Ramin, John M. Thorp, Alan M. Peaceman, Steven Gabbe
Journal: New England Journal of Medicine (2003)

Women who have had a spontaneous preterm delivery are at greatly increased risk for preterm delivery in subsequent pregnancies. The results of several small trials have suggested that 17 alpha-hydroxyprogesterone caproate (17P) may reduce the risk of preterm delivery.