tbuckley/cabot-search huggingface dataset:
Novel role for specialist nurses in managing diabetes in the community.
Authors: M. MacKinnon, R. M. Wilson, C. A. Hardisty, J. D. Ward
Journal: BMJ (1989)

To develop care of diabetes further a specialist nurse established contact with general practices in Sheffield Health District and identified difficulties in providing a service for diabetics. One hundred and thirty practices were visited, and full data were collected from 104. Each practice agreed to establish a register of diabetics, and information and support were subsequently provided to help in developing services. In collecting information from each practice the nurse covered specific points on staff, facilities, and organisation. Over two years the service offered in 60 practices considerably improved, allowing a minimum standard of diabetic care to be achieved. This allowed coordinated and effective referral of certain patients from hospital diabetic clinics and improved services to those not attending any clinics.
Impaired cellular contractile function in thiamine‐deficient rat cardiomyocytes
Authors: Carolina Rosa Gioda, Danilo Roman‐Campos, Miguel Araújo Carneiro‐Júnior, Karina Ana da Silva, Matheus Ornelas de Souza, Liliane Jorge Mendes, Antônio José Natali, Jader Santos Cruz
Journal: European Journal of Heart Failure (2009)
Of mice and molecular mimicry: Modeling autoimmune hepatitis
Authors: David G. Bowen
Journal: Hepatology (2008)

Autoimmune liver diseases, such as autoimmune hepatitis (AIH) and primary biliary cirrhosis, often have severe consequences for the patient. Because of a lack of appropriate animal models, not much is known about their potential viral etiology. Infection by liver-tropic viruses is one possibility for the breakdown of self-tolerance. Therefore, we infected mice with adenovirus Ad5 expressing human cytochrome P450 2D6 (Ad-2D6). Ad-2D6-infected mice developed persistent autoimmune liver disease, apparent by cellular infiltration, hepatic fibrosis, “fused” liver lobules, and necrosis. Similar to type 2 AIH patients, Ad-2D6-infected mice generated type 1 liver kidney microsomal-like antibodies recognizing the immunodominant epitope WDPAQPPRD of cytochrome P450 2D6 (CYP2D6). Interestingly, Ad-2D6-infected wild-type FVB/N mice displayed exacerbated liver damage when compared with transgenic mice expressing the identical human CYP2D6 protein in the liver, indicating the presence of a stronger immunological tolerance in CYP2D6 mice. We demonstrate for the first time that infection with a virus expressing a natural human autoantigen breaks tolerance, resulting in a chronic form of severe, autoimmune liver damage. Our novel model system should be instrumental for studying mechanisms involved in the initiation, propagation, and precipitation of virus-induced autoimmune liver diseases.
Enhancing therapeutic vaccination by blocking PD-1–mediated inhibitory signals during chronic infection
Authors: Sang-Jun Ha, Scott N. Mueller, E. John Wherry, Daniel L. Barber, Rachael D. Aubert, Arlene H. Sharpe, Gordon J. Freeman, Rafi Ahmed
Journal: The Journal of Experimental Medicine (2008)

Therapeutic vaccination is a potentially promising strategy to enhance T cell immunity and viral control in chronically infected individuals. However, therapeutic vaccination approaches have fallen short of expectations, and effective boosting of antiviral T cell responses has not always been observed. One of the principal reasons for the limited success of therapeutic vaccination is that virus-specific T cells become functionally exhausted during chronic infections. We now provide a novel strategy for enhancing the efficacy of therapeutic vaccines. In this study, we show that blocking programmed death (PD)-1/PD-L1 inhibitory signals on exhausted CD8+ T cells, in combination with therapeutic vaccination, synergistically enhances functional CD8+ T cell responses and improves viral control in mice chronically infected with lymphocytic choriomeningitis virus. This combinatorial therapeutic vaccination was effective even in the absence of CD4+ T cell help. Thus, our study defines a potent new approach to augment the efficacy of therapeutic vaccination by blocking negative signals. Such an approach may have broad applications in developing treatment strategies for chronic infections in general, and perhaps also for tumors.
Circadian rhythms and affective disorder.
Authors: J P Crawford
Journal: BMJ (1977)

Reptilase test in cirrhosis and hepatocellular carcinoma SIR,-I read with interest the report by Dr P J Johnson and others (1 October, p 869) of their experience with the reptilase test in patients with various liver diseases, in which these authors contrasted their data with those which I had recorded in a group of Africans with primary liver cancer.tPursuing the latter studies on a group of British patients I became aware of striking differences, particularly in regard to dysfibrinogenaemia.Unfortunately Dr Johnson and his colleagues do not appear to have evaluated this phenomenon.In my experience the reptilase test has been con- sistently abnormal in British and African patients with primary liver cancer, with and without coexistent cirrhosis, in contrast to the normal results obtained in patients with carcinoma metastatic to the liver.However, the corresponding information in cirrhosis un- complicated by tumour does indicate that many of these patients do have an abnormal reptilase test in the absence of dysfibrinogenaemia.These data have been presented on a number of occasions,2 X and a detailed account is to appear shortly.5It includes a description of the modified reptilase test and a putative explanation for the racial differences and the apparently discrepant findings in cirrhosis.
Glycemic control was not affected by self-monitoring of blood glucose in type 2 diabetes
Authors: Sumit R. Majumdar
Journal: Annals of Internal Medicine (2008)

Source Citation O’Kane MJ, Bunting B, Copeland M, Coates VE. Efficacy of self monitoring of blood glucose in patients with newly diagnosed type 2 diabetes (ESMON study): randomised controlled trial. BMJ. 2008;336:1174-7. 18420662
Work related upper limb disorders: getting down to specifics
Authors: K. PALMER, D. COGGON, C. COOPER, M. DOHERTY
Journal: Annals of the Rheumatic Diseases (1998)

Musculoskeletal disorders of the upper limb and neck are a common cause of morbidity, and in some occupational groups they contribute importantly to loss of time from work.1-5Community-based surveys have indicated point prevalences of 4–20% for pain at specific sites in the neck and upper limb,6-9with lifetime prevalences as high as 60%. Morbidity surveys in primary care have found an annual incidence of first consultation for upper limb disorders of approximately 25 per 1000 person years, with rates increasing from 25 to 45 years of age and then levelling off.10 

Upper limb pain may arise from discrete pathological conditions, such as adhesive capsulitis, rotator cuff tendinitis, lateral epicondylitis, and tenosynovitis, or as part of non-specific regional pain syndromes. However, few community surveys have included a clinical examination as an integral component, to enable a distinction to be drawn between these very different categories of disorder. Furthermore, the relative contribution of specific and non-specific rheumatic disorders of upper limb and neck to handicap from occupational and leisure activities is not clear (despite the fact that the risk factors may vary substantially between the two groups).

As table 1 illustrates, investigations have differed in their choice of age range, source population, prevalence period, and …
Relationship of severe microvascular injury as assessed based on phasic coronary flow patterns with complications and in-hospital survival after acute myocardial infarction
Authors: Atsushi Yamamuro, Takashi Akasaka, Tsutomu Takagi, Koichi Tamita, Kenji Yamabe, Minako Katayama, Kunihiko Nagai, Tomoko Tani, Kazuaki Tanabe, Shigefumi Morioka
Journal: Journal of the American College of Cardiology (2002)
Ischaemic preconditioning - time course of renewal in the pig
Authors: S. Sack, M. Mohri, M. Arras, E. R Schwarz, W. Schaper
Journal: Cardiovascular Research (1993)

Journal Article Ischaemic preconditioning – time course of renewal in the pig Get access Stefan Sack, Stefan Sack Max-Planck-Institute, Department of Experimental Cardiology, Bad Nauheim, Germany: S Sack, M Mohri, M Arras, E R Schwarz, W Schaper. Correspondence to Dr Sack, at: University of Mainz, I1 Medical Clinic, Langenbeckstrasse 1, D-6500 Mainz, Germany. Search for other works by this author on: Oxford Academic PubMed Google Scholar Masahiro Mohri, Masahiro Mohri Max-Planck-Institute, Department of Experimental Cardiology, Bad Nauheim, Germany: S Sack, M Mohri, M Arras, E R Schwarz, W Schaper. Search for other works by this author on: Oxford Academic PubMed Google Scholar Margarete Arras, Margarete Arras Max-Planck-Institute, Department of Experimental Cardiology, Bad Nauheim, Germany: S Sack, M Mohri, M Arras, E R Schwarz, W Schaper. Search for other works by this author on: Oxford Academic PubMed Google Scholar Ernst R Schwarz, Ernst R Schwarz Max-Planck-Institute, Department of Experimental Cardiology, Bad Nauheim, Germany: S Sack, M Mohri, M Arras, E R Schwarz, W Schaper. Search for other works by this author on: Oxford Academic PubMed Google Scholar Wolfgang Schaper Wolfgang Schaper Max-Planck-Institute, Department of Experimental Cardiology, Bad Nauheim, Germany: S Sack, M Mohri, M Arras, E R Schwarz, W Schaper. Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 27, Issue 4, April 1993, Pages 551–555, https://doi.org/10.1093/cvr/27.4.551 Published: 01 April 1993 Article history Received: 08 September 1992 Accepted: 03 February 1993 Published: 01 April 1993
Treatment of atopic eczema with oral mycophenolate mofetil
Authors: K. Neuber, I. Schwartz, G. Itschert, A.tom Dieck
Journal: British Journal of Dermatology (2000)

Background Activated T and B lymphocytes are the predominant inflammatory cells in atopic eczema (AE) lesions. Mycophenolic acid, the active form of mycophenolate mofetil (MMF), blocks the proliferative responses of T and B lymphocytes. Objectives In this pilot study, we examined the efficacy of MMF (CellCept®, Hoffman La Roche, Grenzach-Wyhlen, Germany) in severe AE. Methods Ten patients with severe AE (severity index > 50) according to the Severity Scoring of Atopic Dermatitis (SCORAD) index were treated with oral MMF at an initial dose of 1 g daily during the first week and 2 g daily for a further 11 weeks. Laboratory examination including full blood count, lymphocyte subset analysis, serum immunoglobulins (IgE, IgG, IgM, IgA), total bilirubin, alkaline phosphatase, aminotransferases, lactate dehydrogenase and creatinine was performed every 2 weeks. Additionally, interleukin (IL)-10 and interferon (IFN)-γ in serum were measured. Results None of the 10 patients who received MMF discontinued the trial because of lack of efficacy or adverse events. Compared with the baseline, the median scores for disease severity (SCORAD index) improved by 68% during treatment with MMF. The median serum IgE level decreased significantly, from 10,300 kU L−1 before treatment to 7830 kU L−1 after 12 weeks. MMF induced a significant increase in the T-helper (Th)-1-related cytokine IFN-γ and a significant decrease in IL-10, mainly produced by Th2 cells. Conclusions The present study demonstrates that oral MMF at a dose of 2 g daily is an effective, safe and well-tolerated immunosuppressive therapy for severe AE in adults.
Modulation of endothelin and nitric oxide: A rational approach to improve canine hepatic microcirculation
Authors: Dipok Kumar Dhar, Akira Yamanoi, Haruyuki Ohmori, Yuichi Nakashima, Akitaka Yamamoto, El-Assal N. Osama, Hirofumi Kubota, Hitoshi Kohno, Naofumi Nagasue
Journal: Hepatology (1998)

ET receptor blocker (TAK-044) and NO donor (FK409) were used to improve the hepatic microcirculation following ischemia-reperfusion injury. In the first experiment (60 minutes of ischemia), 15 dogs were divided into three groups: group A (control), saline; group B, TAK 5 mg/kg; and group C, FK 0.4 mg/kg. In the second experiment (90 minutes of ischemia), 38 dogs were divided into six groups that underwent 90 minutes of hepatic ischemia followed by reperfusion: group I (control), saline only; group II, TAK 5 mg/kg and FK 3.2 mg/kg; group III, TAK 5 mg/kg and FK 0.4 mg/kg; group IV, TAK 5 mg/kg; group V, FK 0.4 mg/kg; and group VI, FK3.2 mg/kg. All drugs were administered through the portal vein. Following 60 minutes of ischemia, both FK and TAK produced significant improvement in hepatic microcirculation and enzymatic status when compared with the control group. After 90 minutes of ischemia, low doses of FK and TAK significantly improved hepatic microcirculation and reduced portal pressure following reperfusion in group III compared with group I. Leakage of hepatic enzymes was prevented and tissue injury score was significantly lower in group III. In group VI, early protection was obtained to some extent; however, blood pressure was reduced significantly following reperfusion compared with group I. In contrast, hepatocellular function deteriorated and the tissue injury score was higher in group II animals. TAK pretreatment with low doses of FK provided the best protection for the hepatic microcirculation in ischemia-reperfusion injury of the liver.
Effects of Elevated Coronary Sinus Pressure on Coronary Blood Flow and Left Ventricular Function
Authors: Takuya Miura, Takeshi Hiramatsu, Joseph M. Forbess, John E. Mayer
Journal: Circulation (1995)

Background After the Fontan operation there is elevated systemic venous pressure, and the coronary sinus pressure (CSP) may also be elevated depending on the operative technique. Elevated CSP can potentially alter coronary perfusion and thereby be a cause for postoperative left ventricular (LV) dysfunction. Methods and Results The effects of elevated CSP on coronary blood flow (CBF) and LV function were evaluated in 14 isolated blood-perfused juvenile lamb hearts. After baseline measurements were made, CSP was elevated by a 10-minute inflation of a balloon catheter inserted into the coronary sinus via the hemiazygos vein in 7 hearts (CSHT group) to cause moderate (phase I, ≈15 mm Hg) and severe (phase II, ≈30 mm Hg) elevations of mean CSP at a constant coronary perfusion pressure (80 mm Hg). The results were compared with results from 7 hearts continuously perfused without elevation of CSP (C group). Mean CSP in the CSHT group was elevated from 0.4±1.9 to 16.4±2.4 mm Hg during phase I and to 32.6±3.6 mm Hg during phase II. CBF in the CSHT group decreased to 89.7±5.2% in phase I and to 79.0±13.2% in phase II, and these values were significantly lower than those in the C group (98.5±6.7% in phase I and 106.8±16.0% in phase II; P &lt;.05 each). There were no significant differences in maximum developed pressure (DP), max+dP/dt, max−dP/dt, or LV end-diastolic pressure (LVEDP) at a fixed volume between the CSHT group and the C group either in phase I or phase II. The time constant of pressure decline during LV isovolumic relaxation (tau) showed no significant difference in phase I, but in phase II tau was significantly higher in the CSHT group (116.2±7.8%) than that in the C group (106.3±8.5%; P &lt;.05). Conclusions Elevated CSP on a short-term basis did not affect the LV systolic function indexes (max DP, max+dP/dt), max−dP/dt, or LVEDP at a fixed volume, but tau did appear to worsen and CBF decreased during CSP elevation. These actions might have deleterious effects on the LV over a longer time period.
An Autoantibody Mechanism for Membranous Glomerulonephritis Due to Renal Vein Obstruction.
Authors: Arthur Copek
Journal: Annals of Internal Medicine (1968)

s1 May 1968An Autoantibody Mechanism for Membranous Glomerulonephritis Due to Renal Vein Obstruction.Arthur Copek, Robert C. Muehrcke, M.D., F.A.C.P., Anil Mandal, M.D., Samuel Gotoff, M.D.Arthur CopekSearch for more papers by this author, Robert C. Muehrcke, M.D., F.A.C.P.Search for more papers by this author, Anil Mandal, M.D.Search for more papers by this author, Samuel Gotoff, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-68-5-1179_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptUnilateral renal vein thrombosis produces massive proteinuria and in time the nephrotic syndrome. Bilateral membranous glomerulonephritis and subsequent progressive renal failure may develop as sequels. Serial clinicopathological studies were designed to investigate the pathogenesis of membranous glomerulonephritis due to renal vein occlusion.The pathogenesis and evolution of renal lesions were studied in three patients by serial renal biopsies using light, electron, and immunomicroscopy. Tissue fixed for electron microscopy was cut at 0.5 µ, stained with methylene blue-azure II, and quantitatively analyzed. Individual glomerular cells were counted. Glomerular, Bowman's, and tubular basement membrane thicknesses were measured by electron microscopic analysis.When... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Chicago, Illinois PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByDie experimentelle Nierenvenenthrombose der Ratte und ihre Beziehung zum nephrotischen Syndrom 1 May 1968Volume 68, Issue 5Page: 1179-1180KeywordsBasement membraneBiopsyCellsElectron microscopyGlomerulonephritisLesionsPathogenesisProteinuriaRenal failureVeins Issue Published: 1 May 1968 PDF DownloadLoading ...
Definitions of osteoarthritis in the knee and hand.
Authors: L T Jacobson
Journal: Annals of the Rheumatic Diseases (1996)

Osteoarthritis is the most common joint disor- der, with a prevalence that increases with age.In 80 year old women radiologically defined osteoarthritis is found in over 70% in the distal interphalangeal joints (DIP) and in approxi- mately 50% in the knees.'Osteoarthritis is characterised by pain on movement, and the pathophysiological processes can be visualised radiologically.Radiographic findings include degenerative features (marginal osteophytes, subchondral cysts, loose bodies), reparative features (marginal osteophytes, subchondral sclerosis), and inflammatory features (oint effusions, bursar extension).Based on these features several radiological criteria have been developed for both the knees23 and hands.2 5 Recently the American Colleges ofRheumatol- ogy also have suggested clinical criteria for osteoarthritis of the knee,6 hip,7 and hand.8The clinical criteria were chiefly developed to enable correct classification of patients in clini- cal studies, whereas radiological criteria can be used both for diagnosis and evaluation of disease progress.In most published reports, a rating of grade 2 or more (definite osteophytes and possible joint space narrowing) on the 0-4 graded radiographic scale developed by Kellgren and Lawrence2 has been used as the gold standard for diagnosis.Despite a positive correlation between the Kellgren-Lawrence scale and pain, only 55-85% and 11-28% of those with grade 3-4 changes in the knees and hands, respectively, have symptoms of pain.9When reviewing and developing criteria for diagnosis and progression in osteoarthritis sev- eral characteristics should be considered.The criteria should be associated with symptoms, reflect the disease process, and predict long term outcome.For scientific studies they should also be accurate, reproducible, conven- ient to use, and relatively inexpensive.
Last on the list
Authors: A. Rosen
Journal: BMJ (1998)

As I lay on the hospital bed during the scan for my fourth child I was full of apprehension. The doctor was moving the probe around for a long time and the image on the screen did not resemble anything identifiable. Eventually he spoke.

“Are you sure about your dates—around 16 weeks?”

“Absolutely,” I replied.

“The picture I'm getting isn't very clear. We'll have to scan it from another angle.”

The second scan showed a mass of deformed cells, no identifiable embryo or definite organs.

“I'm sorry,” he said. “You'll have to stay in hospital for a dilatation and curettage. One of my colleagues will come and deal with you shortly.”

My husband held my hand reassuringly and asked if I was okay. I was fine, disappointed, of course, but these things happen and we were blessed with three healthy children.

Eventually, I was admitted to a ward and told that the operation would be done at …
Points: Kielland's forceps
Authors: G M Stephen
Journal: BMJ (1979)

This would perhaps bring home to the DHSS the extent to which the consultants are financ- ing the Health Service by running their own cars.I personally as a consultant manage to run one mini.My wife wonders why I spend all this money running a car for the sake of the NHS when she never has the use of it.I feel that the time has come now for my wife to have the use of our car and to insist that the hospital provides transport when it is needed.
Generalized lichenoid juvenile xanthogranuloma
Authors: G. KOLDE, GISELA BONSMANN
Journal: British Journal of Dermatology (1992)

A generalized eruption of small, flat and shiny papules was observed in an otherwise healthy 6-month-old baby. The light and electron microscopical and immunohistological features of the selfhealing lesions were consistent with juvenile xanthogranuloma and suggested an atypical lichenoid variant of this non-Langerhans cell histiocytosis.
Food Supply, Body Weight, and Activity in Great Britain, 1943-9
Authors: J. M. Harries, D. F. Hollingsworth
Journal: BMJ (1953)

The acute pain of the dissecting aneurysm and the leak- ing saccular aneurysm is the pain most likely to be mis- diagnosed as one of the more usual types of acute abdo- minal emergency.The intense abdominal pain may mimic that of acute pancreatitis, perforated peptic ulcer, or mesen- teric vascular occlusion.In such a case radiation of the pain into the loins, neck, or lower extremities may be signi- ficant.Previous symptoms of cardiovascular disease are usually absent, although the presence of hypertension may be suggestive.Tlhe problem of the case which presents with extravasation at the hernial orifices is well illustrated in our two cases.The concomitant occurrence of severe abdominal pain, lower-limb pain, and the presence of lower-limb vascular insufficiency may indicate a dissecting aneurysm, although similar signs may occur in a case of abdominal embolism. SummaryTwo cases of ruptured abdominal aortic aneurysm are recorded which presented clinically as incarcerated herniae.The pathological and clinical features of abdominal aortic aneurysms are discussed.The diverse modes in which these aneurysms, both ruptured and unruptured, may present are stressed and the differential diagnosis is indicated.Our thanks are due to Mr. Clifford Jones
Established and New Practitioners
Authors: G. A. Powell-Tuck
Journal: BMJ (1948)

JOURINALwith the strings attached to the unhappy basic salary.But the salary remains-a noxious thing.Obviously there must be something given for that £300 or the Treasury would veto a waste of public funds.Direction, or negative direction, seems indicated.Freedom of speech and publication, though again assured verbally by the present Minister, are still not to be incorporated in the Act and so made binding on his successors.Ownership of goodwill, which would\.solve so many other problems (and make " concessions " Nos. 2 and 3 unnecessary) and for which no detailed, equitable, workable alternative has yet been put forward, has not yet been conceded.The powers of the " un- official G.M.