tbuckley/cabot-search huggingface dataset:
Westminster Medical Society: Paralysis of the Portio Dura
Authors: H. J. Johnson
Journal: BMJ (1842)

There being no paper to be brought forward for discussion Mr. STREETER drew the attention of members present, to some cases of paralysis of the portio dura from cold; he had on a former occasion brought three cases of the same kind before the society.Since Christmas, he had been called in to attend another case of a similar nature; it was very sin- gular that many of these cases recovered by and attention.The caseto which he had alluded, had occurred in a child five years of age, who been subject to fits.There was some swelling of the right side, and the nervous branches of the orbicularis palpebrarum were slightly affected.When called in, he at once gave his opinion that the cause of the affectionwas from cold.There was no pain car, nor any cerebral disturbance.He viewed the case as one of inflammation of the nervous sheath, and treated it by leeches, poultices, fomentations, warmth.The muscles had now recovered their tions.Many of these cases did not, however, as favourably.If the inflammation of the nervous sheath was in that part of it enclosed within canal, it might be permanent.The childhad niow recovered for about five weeks, and for the
Generalized Lymphadenopathy and Syphilis
Authors: Michael Bornemann
Journal: JAMA (1979)

To the Editor.—  The article by Greenfield and Jordan (240:1388, 1978) presents a logical and thorough approach to the patient with either localized or generalized lymphadenopathy. Although consideration is given to syphilis in the patient with localized inguinal adenopathy, no mention is made of the generalized adenopathy frequently seen with secondary syphilis. The importance of obtaining a VDRL in the evaluation of generalized lymphadenopathy was emphasized by Nayeem and Bernhardt (239:495, 1978). Obtaining a VDRL in such a patient may avoid the expense, delay, and inconvenience of lymph node biopsy.
Generic waiting lists for routine spinal surgery
Authors: P Leach, S. Rutherford, A. King, J. Leggate
Journal: Journal of the Royal Society of Medicine (2004)

National Health Service Hospitals are under pressure to reduce waiting lists within the constraints of a limited infrastructure. We implemented two systems to reduce waiting times for elective non-complex spinal surgery. The first of these was the introduction of managed generic waiting lists for both initial outpatient appointments and subsequent surgery. Thereafter, the MRI booking system was integrated with outpatient review appointments. Times from referral to first outpatient appointment and from scan to outpatient review and time on waiting list for surgery were analysed before and after implementation of these changes. Despite constant unit capacity there was a global decrease in waiting times. Before introduction of the generic waiting list, 37% of listed patients waited for more than 9 months; this figure fell to zero. Time from scan to outpatient review was 185 days before integration, 30 days after. Changes of this sort demand a quorum of consultants who will accept each others' recommendations. The generic waiting list will have impact only when there are large disparities in waiting times for different consultants. Targets are met at the expense of continuity of care.
Interactive Effect of Heart Rate and Muscle Sympathetic Nerve Activity on Blood Pressure
Authors: Krzysztof Narkiewicz, Virend K. Somers
Journal: Circulation (1999)

Background —Sympathetic traffic to the peripheral vasculature and sympathetic discharge to the heart have complementary effects on blood pressure. Although faster heart rates have been linked to higher blood pressures, the relationship between muscle sympathetic nerve activity (MSNA) and long-term regulation of blood pressure is not clear. We tested the hypothesis that MSNA and heart rate are linked to blood pressure levels in normotensive subjects. Methods and Results —We studied normal young male (n=120) and female (n=48) subjects subdivided according to tertiles of heart rate and MSNA distributions. Systolic, diastolic, and pulse pressures were significantly different across the heart rate tertiles in male subjects, with the highest blood pressure values in the upper tertile of heart rate. No significant differences in blood pressure across the tertiles of MSNA were found. The relationship between MSNA and blood pressure, however, was affected by heart rate. MSNA did not influence blood pressure in the first and second heart rate tertiles. However, within the upper heart rate tertile, subjects with higher levels of MSNA had significantly higher systolic ( P =0.02) and pulse ( P =0.004) pressures than subjects with lower levels of MSNA. In female subjects, blood pressure was not different across the tertiles of heart rate or MSNA. Conclusions —MSNA and heart rate have interactive effects on systolic blood pressure and pulse pressure in normotensive male but not female subjects. No relationship between MSNA and blood pressure or pulse pressure is evident in subjects with slower heart rate. In male subjects with faster heart rates, higher levels of MSNA are associated with higher systolic and pulse pressures.
Pulmonary Embolism
Authors: Klaus Dehlinger, Paul Riemenschneider
Journal: New England Journal of Medicine (1949)

THERE has been no significant decrease in the percentage of cases in which pulmonary emboli were demonstrated at autopsy at this hospital group since the introduction of definitive and prophylactic treatment of venous thrombosis. This therapy includes venous interruption and the administration of heparin and dicumarol, as well as prophylactic exercises, early ambulation and even paravertebral autonomic block in one case. During the thirteen years from 1928 through 1940 pulmonary emboli were found in 7.5 per cent of all autopsies, whereas the figure became 6.7 per cent during the following six-year period (Table 1). The percentage of operations that were . . .
Adjuvant treatment for breast cancer: the overview.
Authors: R. D. Gelber, A. S. Coates, A. Goldhirsch
Journal: BMJ (1992)

polyposis but not in unaffected relatives or unrelated people.4In some cases DNA isolated from the tumours of patients without familial adenomatous polyposis but with colorectal carcinoma also showed somatic mutations in the gene.4How will these advances affect clinical practice?In people with a family history of familial adenomatous polyposis pre- natal or postnatal testing should be able to identify whether a mutation has been inherited.This will avoid some of the problems of linkage testing which is relevant where incom- plete pedigrees reduce the value of linkage analysis, which occurred in two thirds of the families reported on by MacDonald et al.8 Screening the general population for new mutations is probably impracticable because of the rarity of the condition.The main impact of this work should be on the understand- ing of the pathogenesis of sporadic colorectal carcinoma, although this is more complicated.Other somatic mutations contribute to the development of sporadic colorectal cancer,'°01 including the ras oncogene,'2 the p53 oncosup- pressor gene on chromosome 17, 13 and the gene deleted in colon cancer on chromosome 22.1'Moreover, the effects of mutant oncosuppressor genes, including that coding for familial adenomatous polyposis, are exposed by the loss of the remaining normal version of the gene in the allelic pair. 1113 15 How these genetic abnormalities fit together in the development of the tumour, what the familial adenomatous polyposis protein does in the cell, and why mutations lead to the formation of polyps are all unknown.Different inherited mutations of the gene coding for familial adenomatous polyposis are likely to be found in some people with a family history ofcolonic cancer (but not of adenomatous polyposis). 6Ultimately this research may offer the possibility of pre- symptomatic investigation and intervention in people with an increased risk of sporadic colonic cancer.
Psychiatric and Psychometric Issues in Acn&amp;eacute; excori&amp;eacute;e
Authors: Michael Bach, Doris Bach
Journal: Psychotherapy and Psychosomatics (1993)

Psychiatric and psychometric issues were assessed in 12 acné excoriée patients. Two patients exhibited a DSM-III-R dysthymia and 2 patients a DSM-III-R personality disorder, which were considered as associated comorbidities. Most patients reported concern for being unattractive and a compulsive urge to manipulate their skin. However, 8 out 12 patients did not fulfill criteria for any DSM-III-R disorder. In particular, we could not find evidence for the assumption of underlying obsessive-compulsive disorders or body image disorders in acné excoriée.
PANDAS and immunomodulatory therapy
Authors: Harvey S Singer
Journal: The Lancet (1999)

In today's Lancet Susan Perlmutter and colleagues describe the effect of intravenous immunoglobulin (IVIG) and plasma exchange in a subset of children with post-infectious autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS). These disorders are believed to be mediated by antibodies to neuronal tissue after group A β-haemolytic streptococcal infection (GABHS). What is the basis of this treatment, and how optimistically should the results be viewed? Therapeutic plasma exchange and intravenous immunoglobulin for obsessive-compulsive disorder and tic disorders in childhoodPlasma exchange and IVIG were both effective in lessening of symptom severity for children with infection-triggered OCD and tic disorders. Further studies are needed to determine the active mechanism of these interventions, and to determine which children with OCD and tic disorders will benefit from immunomodulatory therapies. Full-Text PDF
Efficiency of Oxidative Phosphorylation of Heart Muscle Mitochondria from Digitalized Guinea Pigs
Authors: KATHARINE ARMSTRONG PLAUT, MENARD M. GERTLER, G. W. E. PLAUT
Journal: Circulation Research (1957)

Fifty-four normal adult male guinea pigs were divided into two groups: (a) a control group of 29 was injected with a carrier solution and (b) an experimental group of 25 was injected with the carrier solution which contained digitoxin nativelle. Serial electrocardiographs revealed no significant changes in the control group; in the experimental group, changes indicated only therapeutic digitalis effect and no toxic phenomena. The efficiency of oxidative phosphorylation of isolated cardiac mitochondria from the digitalized animals has been compared with that from control animals. No significant differences could be observed between the digitalized and non-digitalized animals. It would appear that the administration of therapeutic amounts of digitoxin nativelle does not affect the energy-generating mechanisms of normal guinea pig heart mitochondria.
The 3 mm skin prick test (SPT) threshold criterion is not reliable for <i>Tyrophagus putrescentiae</i>: the re‐evaluation of SPT criterion to dust mites
Authors: B. Kanceljak‐Macan, J. Macan, D. Plavec, T. Klepac, S. Milković‐Kraus
Journal: Allergy (2002)

Background: The mean wheal diameter ≥ 3 mm is the usual criterion for positive skin prick test (SPT) reaction to dust mites. The study assessed the accuracy of this SPT criterion with respect to specific IgE values of above 0.35 kU A /l (+ sIgE). Methods: Specific IgE (ImmunoCAP, Pharmacia AB Diagnostics, Uppsala, Sweden) and standard SPT to Dermatophagoides pteronyssinus (DP) and farinae (DF), Lepidoglyphus destructor (LD) and Tyrophagus putrescentiae (TP) (ALK, Hørsholm, Denmark) were performed in a random sample of 457 subjects, of whom 273 men (mean age 35.3 ± 11.0 years) and 184 women (mean age 37.9 ± 9.5 years). Statistical analysis was performed using the chi‐square test, regression analysis and discriminant analysis. Results: When the mean wheal diameter of ≥ 3 mm was considered positive (+ SPT), the correlation between + SPT and + sIgE was 0.47 for DP ( P &lt; 0.001), 0.43 for DF ( P = 0.004), 0.35 for LD ( P = 0.03) and 0.37 for TP ( P = 0.014). Regarding + sIgE, this SPT criterion has a specificity of 92.2% for DP, 82.3% for DF, 80.8% for LD and 70.1% for TP. When the value 4.5 mm was taken as the threshold for the positive SPT reaction to TP, specificity increased significantly from 70.1% to 86.4% (χ 2 = 32.04, P &lt; 0.001). Conclusions: The 3 mm SPT threshold criterion is not reliable in evaluating sensitization to TP due to an insufficient specificity of the allergen extract to this mite. It is advisable either to re‐evaluate the TP allergen extract or change the threshold criterion for positive SPT reaction to TP.
A critique of team and Stackelberg reasoning
Authors: Herbert Gintis
Journal: Behavioral and Brain Sciences (2003)

Colman's critique of classical game theory is correct, but it is well known. Colman's proposed mechanisms are not plausible. Insufficient reason does what “team reasoning” is supposed to handle, and it applies to a broader set of coordination games. There is little evidence ruling out more traditional alternatives to Stackelberg reasoning, and the latter is implausible when applied to coordination games in general.
Abstract 13529: Non-Invasive Assessment of the Effects of Proximal Tubule and Loop Duiretics on Tubuloglomerular Feedback
Authors: Haiying Liu, Dan Zhou, Michael Klimas
Journal: Circulation (2011)

Introduction:  Tubuloglomerular feedback (TGF) is a mechanism by which the kidney uses to regulate its glomerular filtration rate (GFR). When the macula densa (MD) detects elevated luminal sodium level via NKCC2 in the early distal convoluted tubule (DCT), it releases signaling molecules to decrease renal blood flow and GFR. The purpose of the study was to evaluate the feasibility of assessing changes in TGF activity with an imaging based approach.   Hypothesis:  Intact TGF activity attenuates any change in luminal sodium concentration in DCT. Since the DCT segment of the nephron is located in cortical region of the kidney, an increase in its luminal sodium concentration will result in an apparent increase in overall cortical sodium content. It is expected that furosemide, a NKCC2 blocker, will attenuate the TGF activity and allow cortical sodium content to rise to a higher level than acetazolamide, which is not a NKCC2 blocker.   Methods:  We quantified the effect of two different diuretics (furosemide, acetazolamide) on the cortical renal sodium contents in SD rats. 23Na-MRI was used to monitor cortical sodium contents in rat kidneys following administration of diuretics for > 2 hours on a Bruker 9.4T MRI scanner.   Results:  Normally, the renal medullary and cortical sodium contents were kept at different constant levels, establishing a large corticomedullary sodium concentration gradient. Sodium content in the renal cortical region was found to rise reproducibly in response to both diuretic injections. The induced increases in sodium content were eventually clamped to different asymptotic plateaus, which were determined to be 1.40±0.02 and 1.23±0.02 times of their respective baselines for furosemide and acetazolamide (p   Conclusions:  A set of in vivo pharmacological data were obtained from intact animals regarding renal cortical sodium contents following injections of two different diuretics. The significantly larger increase in cortical sodium content induced by furosemide than acetazolamide is consistent with the fact that the negative feedback activity of TGF is attenuated by furosemide, not by acetazolamide. Monitoring renal cortical sodium content with 23Na-MRI offers a means of direct assessment of TGF activity in vivo.
Loss of SPARC-mediated VEGFR-1 suppression after injury reveals a novel antiangiogenic activity of VEGF-A
Authors: M. Nozaki
Journal: Journal of Clinical Investigation (2006)

VEGF-A promotes angiogenesis in many tissues. Here we report that choroidal neovascularization (CNV) incited by injury was increased by excess VEGF-A before injury but was suppressed by VEGF-A after injury. This unorthodox antiangiogenic effect was mediated via VEGFR-1 activation and VEGFR-2 deactivation, the latter via Src homology domain 2-containing (SH2-containing) tyrosine phosphatase-1 (SHP-1). The VEGFR-1-specific ligand placental growth factor-1 (PlGF-1), but not VEGF-E, which selectively binds VEGFR-2, mimicked these responses. Excess VEGF-A increased CNV before injury because VEGFR-1 activation was silenced by secreted protein, acidic and rich in cysteine (SPARC). The transient decline of SPARC after injury revealed a temporal window in which VEGF-A signaling was routed principally through VEGFR-1. These observations indicate that therapeutic design of VEGF-A inhibition should include consideration of the level and activity of SPARC.
Glove Tears and Sharp Injuries in Surgical Personnel
Authors: William C. Beck
Journal: JAMA (1992)

<h3>To the Editor.</h3> —The study by Wright et al<sup>1</sup>should command widespread attention. However, further analysis is warranted. In their definition of "tears" they include what are usually described as "holes."<sup>2</sup>The Food and Drug Administration (FDA) and the American Society for Testing and Materials accept a current quality level of 1.5% for holesby a 1000-mL water test. Thus, some of the barrier breaches found by Wright et al might have been present in the new unused gloves. Pate<sup>3</sup>has recently reported that 5% to 81% of gloves contain holes after each of 50 coronary bypass operations. This includes any holes existing preoperatively. In the series of Wright et al, assuming that there were three potentially vulnerable persons at each of the 2292 operations each wearing two gloves means that at least 13 752 gloves would be at risk. They discovered, by the presence of a bloody spot
An Address on THE INFLUENCE OF INDUSTRIAL POISONS UPON THE DIFFERENT ORGANS
Authors: T. Oliver
Journal: BMJ (1928)

ERms 835 the presence of calculi.Green anid Mellaniby 2" have recently substantiated the frequent occurrenice of calculi in rats on diets deficient in vitamin A, anid have shown that when ergot, which is rich in vitamini D, is given along wvith this diet the incidence of calculi rises.Iin other w-ords, with a satisfactory diet containling amiiple accessory factors, stone formation is difficult to produce with a very large excess of irradiated ergosterol; whereas when the diet is defective stone formation is relatively easy to produce, anid it may well be that a dose of irradiated ergosterol which is without effect on a well-niourished animal may give rise to urinary calculi in one which is badly nourished.The nativei of certain tropical countries are kniown to live on diets -which are ofteii defective in several ways, particularly in regard to vitamins, and it is suggested that they must maniufacture large amounts of active ergosterol in their widely exposed epidermis, since the solar rays have high actinic value.The two factors, perhaps, are sufficient to cause the p'hos- phatic conicretions in the urinary tract wllich are known to occur with great frequency among such, populations.24.The results found by the German workers have a much more seriouis significalnce than those recorded here.The Germans claim their resuslts to be a " hypervitaminosis."It is evident, lhowever, that our failure to -confirm their work throws doubt on this assumption, and suggests that some independenit toxic factor complicated their experi- meats.They do niot state any details about their method of irradiatinig ergosterol.This may well be a crucial factor, particularlv as regards the solvent used during irradiationi; anid there is evidenice to show that whlen irradiated in alcolhol the product is toxic.CQN CLUISIONSS. 1. Irradiated ergosterol administered by the moutlh in very laige doses causes tlhe formilationi of urinary calculi.2. It is suggested that this is dependent upon an increased absorptioni of calciumi-i alnd phosphate from the gut and their excretioii by tlh6 kidnieys.3. No confirmiation hias beeni obtained of the pathological changes found to occur with similar doses by certain German observers.The present work was done during the tenure by one of us (J.C, .
Toxic Epidermal Necrolysis
Authors: Irwin M. Freedberg, Robert B. Berg
Journal: New England Journal of Medicine (1964)

A DIFFUSE bullous eruption of acute onset associated with marked skin tenderness was described in 1956 by Lyell1 as well as Lang and Walker.2 Subsequently, Beare3 reviewed the literature and described. the clinical and histologic manifestations of 10 cases observed in Irish adults and children. Although many similar reports have appeared in the literature4 only a few such cases have been reported from America, and these have all been in specialty journals.5 It is likely that the syndrome has not been widely recognized in the United States. Therefore, the following classic example of toxic epidermal necrolysis has been annotated for . . .
Dietary Calcium Supplementation and Blood Pressure
Authors: Francesco P. Cappuccio
Journal: JAMA (1996)

<h3>To the Editor.</h3> —The article by Dr Bucher and colleagues<sup>1</sup>adds more confusion and raises more questions than ever on the issue of whether calcium supplementation lowers blood pressure. Yet again, the new meta-analysis claims better quality of methods as compared with previous ones,<sup>2,3</sup>while at the same time, another meta-analysis is published in a different medical journal.<sup>4</sup>Is there any value in overloading the scientific literature with reiterated attempts to reanalyze the evidence, agreeing that the effect is small, if any, and that the results do not have any practical importance to justify recommendations to the public at large? The article by Bucher et al contains a number of errors and misquotes. The statement that "[p]revious overviews of randomized trials of calcium supplementation and blood pressure were not comprehensive" is incorrect. Neither previous overviews nor the study by Bucher et al has included all potential
Steroid Injection Improves Outcome in Crohn's Disease Strictures
Authors: M. D. Alesandra Lavy
Journal: Endoscopy (1994)

See also: Endoscopic Treatment of Anastomotic Strictures in Crohn's DiseaseEndoscopy 1991; 23(04): 195-198DOI: 10.1055/s-2007-1010654
Reasoning asymmetries do not invalidate theory-theory
Authors: Karen Bartsch, Tess N. Young
Journal: Behavioral and Brain Sciences (2010)

Abstract In this commentary we suggest that asymmetries in reasoning associated with moral judgment do not necessarily invalidate a theory-theory account of naïve psychological reasoning. The asymmetries may reflect a core knowledge assumption that human nature is prosocial, an assumption that heightens vigilance for antisocial dispositions, which in turn leads to differing assumptions about what is the presumed topic of conversation.
Combined use of high‐sensitivity ST2 and NTproBNP to improve the prediction of death in heart failure
Authors: Antoni Bayes‐Genis, Marta de Antonio, Amparo Galán, Héctor Sanz, Agustin Urrutia, Roser Cabanes, Lucía Cano, Beatriz González, Cristanto Díez, Teresa Pascual, Roberto Elosúa, Josep Lupón
Journal: European Journal of Heart Failure (2011)
Clinicians and epidemiologists view crude death rates differently
Authors: T. Nakayama, N. Yoshiike, T. Yokoyama
Journal: BMJ (1999)

EDITOR—We agree with Tunstall-Pedoe that crude death rates are misleading in comparisons.1 However, clinicians and epidemiologists have different attitudes towards these health indicators.

Mortality from ischaemic heart disease has been low in Japan.2 None the less, its recent trends were interpreted differently by clinicians and epidemiologists. On the basis of their experience, clinicians believed that mortality from ischaemic heart disease was on the rise. Trends in crude rates were compatible with their belief. Epidemiologists argued that to see the secular trend …