tbuckley/cabot-search huggingface dataset:
Etiology of Pneumonia.
Authors: Edward F. Wells
Journal: JAMA (1894)

Chicago, Aug. 8,1894. <h3>To the Editor:</h3> —The elaborate and valuable paper of Dr. Richter on the "Influence of Atmospheric Pressure on the Prevalence of Pneumonia," published in theJournalfor Aug. 4, 1894, I have read with great interest. One of the statements made by this writer requires explanation, that error may not be promulgated. I refer to that on page 189, second column, where it is stated that "Wells and Hirsch and every other writer on the subject discards air pressure as a causative factor." This would lead the reader to infer that the subject had been carefully investigated by these authors and that they had arrived at the conclusion that atmospheric pressure was not a factor in the etiology of pneumonic fever. Speaking only for myself I will say that in the series of articles to which Dr. Richter refers, expression has been given to the following opinion:
Subcellular Localization of Cyclic AMP-Responsive Element Binding Protein-Regulated Transcription Coactivator 2 Provides a Link between Obesity and Breast Cancer in Postmenopausal Women
Authors: Kristy A. Brown, Kerry J. McInnes, Nicole I. Hunger, Jonathan S. Oakhill, Gregory R. Steinberg, Evan R. Simpson
Journal: Cancer Research (2009)

Epidemiologic evidence supports a correlation between obesity and breast cancer in women. AMP-activated protein kinase plays an important role in energy homeostasis and inhibits the actions of cyclic AMP-responsive element binding protein-regulated transcription coactivator 2 (CRTC2). In postmenopausal women, the cyclic AMP-responsive element binding protein-dependent regulation of aromatase is a determinant of breast tumor formation through local production of estrogens. The present work aimed to examine the effect of adipokines on aromatase expression and identify additional mechanisms by which prostaglandin E(2) causes increased aromatase expression in human breast adipose stromal cells. Treatment of human adipose stromal cells with forskolin and phorbol 12-myristate 13-acetate (PMA), to mimic prostaglandin E(2), resulted in nuclear translocation of CRTC2. Aromatase promoter II (PII) activity assays showed that CRTC2 in addition to forskolin/PMA treatment significantly increased PII-induced activity. CRTC2 binding to PII was examined by chromatin immunoprecipitation, and forskolin/PMA treatment was associated with increased binding to PII. Treatment of human adipose stromal cells with leptin significantly up-regulated aromatase expression associated with nuclear translocation of CRTC2 and increased binding of CRTC2 to PII. Adiponectin treatment significantly decreased forskolin/PMA-stimulated aromatase expression, consistent with the decreased nuclear translocation of CRTC2 and the decreased binding of CRTC2 to PII. The expression and activity of the AMP-activated protein kinase LKB1 was examined and found to be significantly decreased following either forskolin/PMA or leptin treatment. In contrast, adiponectin significantly increased LKB1 expression and activity. In conclusion, the regulation of aromatase by CRTC2, in response to the altered hormonal milieu associated with menopause and obesity, provides a critical link between obesity and breast cancer.
It could happen to anybody: why 20 mph speed limits matter
Authors: N. Foreman
Journal: BMJ (2010)

This is what happens and this is how it feels. I was driving along a well lit suburban street with my two small stepchildren in the back of the car. We were on the way to pick up my wife who had been working away for a few days, and we were all excited about seeing her. At the last minute we had arranged to meet at a different station from usual. It was 18.35 on a dark February evening and I had some rather gloomy Radiohead music on the CD player.

In an instant, a few yards in front of me was a small child. He was followed by an adult. I remember thinking “WHAT THE…” and then reflexly hit my brakes. The car skidded a short distance and I ran into both of them. The child flew through the air, caught in the beam of my headlights. I didn’t see the adult.

I got out of the car leaving the engine running and the door open. Traffic had stopped behind me and on the other side of the road ahead of me. For a very few seconds everything was still. The child, who looked about 3 years old and was well wrapped in an anorak, was crying in a heap a few yards in front of my car; the adult had been thrown further. Neither seemed to have any obvious injuries. At this point I stopped thinking normally. I had no idea what to do. It …
Sentinel node biopsy for melanoma: unnecessary treatment?
Authors: I. Torjesen
Journal: BMJ (2013)

Early disclosure of possible concussive symptoms has the potential to improve concussion-related clinical outcomes. The objective of the present consensus process was to provide useful and feasible recommendations for collegiate athletic departments and military service academy leaders about how to increase concussion symptom disclosure in their setting. Consensus was obtained using a modified Delphi process. Participants in the consensus process were grant awardees from the National Collegiate Athletic Association and Department of Defense Mind Matters Research &amp; Education Grand Challenge and a multidisciplinary group of stakeholders from collegiate athletics and military service academies. The process included a combination of in-person meetings and anonymous online voting on iteratively modified recommendations for approaches to improve concussion symptom disclosure. Recommendations were rated in terms of their utility and feasibility in collegiate athletic and military service academy settings with a priori thresholds for retaining, discarding and revising statements. A total of 17 recommendations met thresholds for utility and feasibility and are grouped for discussion in five domains: (1) content of concussion education for athletes and military service academy cadets, (2) dissemination and implementation of concussion education for athletes and military service academy cadets, (3) other stakeholder concussion education, (4) team and unit-level processes and (5) organisational processes. Collectively, these recommendations provide a path forward for athletics departments and military service academies in terms of the behavioural health supports and institutional processes that are needed to increase early and honest disclosure of concussion symptoms and ultimately to improve clinical care outcomes.
Noninvasive diagnosis of nonalcoholic fatty liver disease using serum biomarkers
Authors: Ragai R. Mitry, Ruth De Bruyne, Alberto Quaglia, Robin D. Hughes, Anil Dhawan
Journal: Hepatology (2007)

We read with interest the recent review by Wieckowska et al. on noninvasive diagnosis and monitoring of nonalcoholic fatty liver disease (NAFLD) by measuring biomarkers and correlating their values with the severity of the liver disease.1 In 2006, a well-designed study by Wieckowska and colleagues showed that measuring the level of caspase 3–generated cytokeratin-18 (CK-18) fragments in plasma of adults with NAFLD could potentially be used as a noninvasive diagnostic technique to predict the severity of the disease. They showed that the level of CK-18 fragments is markedly increased in patients with nonalcoholic steatohepatitis (NASH), confirming their histological findings.2 Lack of similar data in children led us to study the value of CK-18 fragments in pediatric NAFLD. We measured the level of CK-18 fragments in serum samples obtained from 21 children (14 male; median age 13.3 years [range: 4.5-16.8 years]) with biopsy-proven NAFLD and 13 normal control children (11 male; median age 14.4 years [range: 8.4-18.6 years]) using the M30-Apoptosense enzyme-linked immunosorbent assay (ELISA) kit (Peviva AB, Bromma, Sweden).2 The diagnosis of NAFLD was established by clinical, biochemical, and liver histology analysis while other causes of liver disease were excluded. The control samples were retrieved from our research bank obtained from normal children. A single hepatopathologist (A.Q.) scored liver tissue steatosis (0-3), inflammation (0-3), hepatocellular ballooning (0-2), and fibrosis (0-4), and calculated NAFLD activity score (NAS) for each patient.3 CK-18 fragments values were correlated with NAS to predict the severity of liver disease. We found that children with NAFLD had median body mass index z-score of 2.8 standard deviations (range: −0.67 to 5 standard deviations), serum aspartate aminotransferase levels of 64 U/L (25-175 IU/L), and NAS of 3 (0-6). Median serum level of CK-18 fragments was 255 U/L (range: 148-2614 U/L) in children with NAFLD compared to controls with 172 U/L (83-238 U/L; P = 0.002). There was a statistically significant correlation between level of CK-18 fragments and steatosis (P = 0.001, Spearman's test). Serum CK-18 levels in patients with NAS of ≥4 (median: 477 U/L; range: 157-2614 U/L) were significantly higher than patients with NAS of ≤3 (median: 209 U/L; range: 148-494 U/L; P = 0.049 Mann-Whitney test). Our data support the findings of Wieckowska et al.2 in demonstrating that measuring serum CK-18 fragments level could potentially be used as a noninvasive diagnostic test to predict the severity of NAFLD; however, before the liver biopsy is abandoned altogether, verification of the noninvasive diagnostic in a bigger cohort of children is warranted. Ragai R. Mitry Ph.D.*, Ruth De Bruyne M.D.*, Alberto Quaglia Ph.D.*, Robin D. Hughes Ph.D.*, Anil Dhawan M.D.*, * Institute of Liver Studies, King's College London School of Medicine at King's College Hospital, Denmark Hill, London, UK.
Pancreatico-pleural Fistula
Authors: H. K. Shah, S. R. Shah, A. P. Maydeo, C. S. Pramesh
Journal: Endoscopy (1998)

See also: Endoscopic Treatment of Fistulas and Abscesses in Pancreatitis: Three Case ReportsEndoscopy 1996; 28(09): 776-779DOI: 10.1055/s-2007-1005604
Suspension of doctors
Authors: D. Empey
Journal: BMJ (2004)

The process is badly handled at present, and new guidance is welcome 

For any employee to be excluded from work is a devastating blow, whatever the circumstances. In the case of doctors the safety of patients may be a justifiable reason, but the process that leads to that decision is not straightforward and in many cases the individuals concerned, their colleagues, and the patients feel confused and uninformed.

A recent report from the National Audit Office has confirmed what many suspected and some have suffered at first hand—that the process of suspension has to date been haphazard and badly handled in many NHS organisations.1 Following this report comes new guidance from the Department of Health, contained in a direction to NHS trusts that has to be applied to all suspensions.

The report from the National Audit Office is forthright about the expensive and damaging consequences that result when suspensions are performed badly. The numbers involved are hard to ascertain, but estimates indicate that at any one time in the past three years more than 30 doctors were suspended for six months or more, and between April 2001 and July 2002, 206 doctors were suspended by NHS trusts in England, with 44% (90) of these suspensions said to be related to issues of professional competence. Costs are estimated at around £29m ($54.5m; €42m) each year for the NHS as a whole. …
HOW TO AVOID COMPLICATIONS OF INTRAHEPATIC ARTERIAL INFUSIONS OF CHEMOTHERAPEUTIC AGENTS
Authors: A. C. Civelek, L. Grochow, K. Durski, J. Sitzmann, M. Clausen, P. Cole, H. N. Wagner
Journal: Clinical Nuclear Medicine (1988)

Failure to properly place the intrahepatic arterial catheter or presence of an aberrant artery can result, not only in failure of the therapy, but also may cause serious complications. We have studied 49 consecutive patients with hepatic arterial chemotherapy for metastatic colon carcinoma. All 49 had hepatic arteriograms to aid in placement of the intra-arterial catheters. The pre-infusion findings were: an unusual position of the left hepatic artery (9) the right hepatic artery (5) and the gastroduodenal artery (2). Six patients had left hapatic and gastric artery communications, one an accessory hepatic artery and one celiac axis trifucation. Despite the fact that the catheter position was changed on the basis of these findings, most patients had clinical complications requiring therapeutic interventions. Tc-99m microsphere scintigraphy was performed in all 49 patients; 24 had findings that could have predicted ocmplications, 13 patients had extrahepatic perfusion including stomach, bowel, spleen or pancreas, 11 had liver perfusion abnormalities other than related to metastatic liver disease. Patients with hepatic artery abnormalities seen by hepatic arteriography are at high risk for unsuspected perfusion abnormalities and should be studied with radionuclide studies to avoid serious clinical complications. In the presence of hepatic artery abnormalities, blind reading of radionuclide scintigraphy was 92% accurate in predicting complications of hepatic artery infusion pump.
489 A COMMON HLA-DPA1 VARIANT IS ASSOCIATED WITH HEPATITIS B VIRUS INFECTION BUT FAILS TO DISTINGUISH ACTIVE FROM INACTIVE CAUCASIAN CARRIERS
Authors: J. Vermehren, J. Lötsch, S. Susser, S. Wicker, A. Berger, S. Zeuzem, C. Sarrazin, A. Doehring
Journal: Journal of Hepatology (2012)
Dietary treatment of hyperlipidaemia Diets were poorly evaluated
Authors: L E Ramsay, W W Yeo, P R Jackson, G Riccardi, A A Rivellese, O Vaccaro
Journal: BMJ (1994)

Most suicides are probably not preceded by depressive illness.'When depression is present, antidepressants may not be prescribed3; this may be an appropriate clinical decision in many instances.The likelihood of non-compliance with prescribed drug treatment is high.5It is unfortunate that Isacsson and colleagues did not examine medical records for the people who died, specifically for whether psychotropic drugs had been prescribed to estimate the prevalences of prescribing of antidepressants and non-compliance in this population.The reported data do not support Isacsson and colleagues' conclusion that compounds with lower toxicity were found more commonly than conven- tional tricyclic drugs relative to their overall use.The standardised mortality ratios clearly indicate that lofepramine differs appreciably from the other tricyclic drugs in a favourable manner.Regrettably, no selective serotonin reuptake inhi- bitors are included in this dataset.It is interesting that clomipramine, as Cassidy and Henry found,2 may differ from the other tricyclic drugs with regard to toxicity.Isacsson and colleagues have provided additional support for the proposition that the prescription of non-toxic, newer anti- depressant drugs such as lofepramine is warranted.
Differential regional responses of myocardial interstitial noradrenaline levels to coronary occlusion
Authors: T. Akiyama, T. Yamazaki, I. Ninomiya
Journal: Cardiovascular Research (1993)

Objective: The aim was to investigate the influence of coronary occlusion on myocardial interstitial noradrenaline levels in the ischaemic and non-ischaemic regions, using the dialysis technique. Methods: In nine anaesthetised cats, regional ischaemia was produced by occlusion of the left anterior descending coronary artery for 90 min. Using the dialysis technique, dialysates were sampled from both the ischaemic region and the non-ischaemic left circumflex coronary artery region. Dialysate noradrenaline concentrations, as an index of myocardial interstitial noradrenaline content, were measured by high performance liquid chromatography. Myocardial blood flows in the ischaemic and non-ischaemic regions were measured by the hydrogen clearance method. Results: In the non-ischaemic region, neither myocardial blood flow nor dialysate noradrenaline concentration showed significant change. In the ischaemic region, myocardial blood flow decreased significantly, from 117(SEM 12) at control to 23(3) ml·min−1·100 g−1, and dialysate noradrenaline concentration increased significantly, from 56.8(4.5) pg·ml−1 at control to 528.8(155.4) pg·ml−1 at 0-30 min of occlusion, 4212.0(1447.7) pg·min−1 at 30-60 min, and 4179.8(1668.5) pg·ml−1 at 60-90 min. At 0-30 min of the reperfusion period, dialysate noradrenaline concentration in the postischaemic region decreased significantly to 420.2(152.1) pg·ml−1. Conclusions: Coronary occlusion increased myocardial interstitial noradrenaline levels in the ischaemic region, but not in the non-ischaemic region. Cardiovascular Research 1993;27:817-822
Ambroxol and reduction of COPD exacerbations
Authors: W R Perera
Journal: Thorax (2004)

▴ Malerba M, Ponticiello A, Radaeli A, et al . Effect of twelve months therapy with oral ambroxol in preventing exacerbations in patients with COPD. Double-blind, randomized, multicenter, placebo-controlled study (the AMETHIST trial). Pulm Pharmacol Ther2004;17:27–34 [OpenUrl][1][PubMed][2] This prospective, randomised, double blind, multicentre, placebo controlled study examined the effect of ambroxol (an agent stimulating mucociliary clearance and surfactant production) in preventing acute exacerbations of COPD. 242 patients with GOLD stage IIa COPD, a … [1]: {openurl}?query=rft.jtitle%253DPulmonary%2Bpharmacology%2B%2526%2Btherapeutics%26rft.stitle%253DPulm%2BPharmacol%2BTher%26rft.aulast%253DMalerba%26rft.auinit1%253DM.%26rft.volume%253D17%26rft.issue%253D1%26rft.spage%253D27%26rft.epage%253D34%26rft.atitle%253DEffect%2Bof%2Btwelve-months%2Btherapy%2Bwith%2Boral%2Bambroxol%2Bin%2Bpreventing%2Bexacerbations%2Bin%2Bpatients%2Bwith%2BCOPD.%2BDouble-blind%252C%2Brandomized%252C%2Bmulticenter%252C%2Bplacebo-controlled%2Bstudy%2B%2528the%2BAMETHIST%2BTrial%2529.%26rft_id%253Dinfo%253Apmid%252F14643168%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=14643168&link_type=MED&atom=%2Fthoraxjnl%2F59%2F4%2F336.atom
Characterization of monocyte subtypes in the allergic form of atopic eczema/dermatitis syndrome
Authors: N. Novak, P. Allam, E. Geiger, T. Bieber
Journal: Allergy (2002)

Background: Monocyte (Mo) subsets exhibiting distinct phenotypic and functional properties identified in peripheral blood are assumed to be under the control of soluble factors from their surrounding micromilieu. Atopic eczema/dermatitis syndrome (AEDS) is accompanied by humoral and cellular alterations among which an increased expression of the high‐affinity receptor for IgE ( Fcε RI) on antigen presenting cells, like Mo, could be found. Therefore we analyzed the assembly of circulating Mo populations and their Fcε RI surface expression during the course of AEDS. Methods: Blood samples were taken from AEDS patients before and after topical treatment as well as from psoriasis patients and healthy control donors. Detailed analysis of Mo subsets was done by flow cytometry. Meticulous clinical scoring included quantification of the surface damage using the eczema area and severity index (EASI score) as well as evaluation of the serum level of thymus‐ and activation‐regulated chemokine (TARC); this was done before and after 2 weeks of topical treatment with tacrolimus ointment 0.1%. Results: During the exacerbation phase of AEDS, patients harboured a different assembly of Mo subtypes from normal nonatopic individuals and patients with psoriasis with a significant increased population of CD14 + CD64 – CD16 + Mo. Clinical improvement led to a significant decrease of this subpopulation in favor of CD14 + CD64 + CD16 – Mo, leading to a composition of Mo subsets similar to the state found in healthy donors. Interestingly, Fcε RI expression was confined to the CD14 + CD64 + CD16 – Mo subpopulation and the percentage of this Fcε RI + Mo subset increased significantly in the peripheral blood after topical treatment. Conclusion: Our data provide for the first time clear evidence that fluctuations of Mo subsets in AEDS might reflect qualitatively and quantitatively distinct contributions of Mo subsets to the development of AEDS.
Plague in India
Authors: D T Dennis
Journal: BMJ (1994)

After decades with no confirmed human plague in India, health authorities there are simultaneously responding to outbreaks of bubonic and pneumonic plague in rural and urban populations of the south central and southwestern states of Maharashtra and Gujurat. A major concern is the spread of disease by travellers from these epidemic foci.1 Worldwide, public health authorities have been trying to prevent the introduction of pneumonic plague within their borders, requiring national disease surveillance and quarantine offices to operate on emergency schedules dealing with a situation with which almost none has any first hand experience.2

Public fascination, confusion, and incredulity have been fuelled by press reports. A mass exodus including hospital patients and even staff themselves has occurred from the epicentre of the outbreak of pneumonic plague despite regular pronouncements by the medical community that plague is readily treated with antibiotics. Assurances of the effectiveness of public health measures have seemed incongruous given the explosive spread of disease, which authorities have been slow to confirm and explain. Doctors and public health workers have quickly tried to educate themselves about a disease they had long considered in the past tense. And everyone asks, “How could this happen?”

Plague is caused by infection with Yersinia pestis, a bacterium carried by rodents and transmitted by fleas in parts of Asia, Africa, and the Americas.2 India was one of the countries most affected by the pandemic of plague that began in the latter half of the 19th century, experiencing an estimated 12.5 million deaths during 1889-1950.4 In recent decades plague in India and elsewhere has retreated to rural, natural foci of infection involving …
Effect of nebulised recombinant DNase on neutrophil elastase load in cystic fibrosis.
Authors: C M Costello, C M O'Connor, G A Finlay, P Shiels, M X FitzGerald, J P Hayes
Journal: Thorax (1996)

BACKGROUND: DNA released by degenerating inflammatory neutrophils contributes to mucous plugging of airways in patients with cystic fibrosis. Neutrophil elastase, a major effector of tissue destruction in the lungs of patients with cystic fibrosis, is a highly cationic molecule which is bound and inhibited by negatively charged polyanions such as mucin and DNA in purulent sputum. Thus, the solubilisation of DNA in the airways by aerosolised recombinant DNase may remove a source of neutrophil elastase inhibition, effectively increasing elastase load. The aim of this study was to assess the effect of rhDNase therapy on neutrophil elastase load in patients with cystic fibrosis. METHODS: Blood and sputum were collected from 15 patients with cystic fibrosis before initiation of nebulised DNase therapy and at 12 weeks following therapy. The long term effects of continuous rhDNase administration were evaluated at 52 weeks for 11 of these patients. Plasma was analysed for neutrophil elastase, interleukin (IL)-8 and neutrophil elastase in complex with alpha 1-protease inhibitor (alpha 1PI). Sputum was assessed for neutrophil elastase, IL-8, and active elastase. At each visit spirometric measurements were carried out. RESULTS: Sputum elastase activity decreased at 12 weeks and was maintained at 52 weeks when a decline in total plasma elastase was also observed. Although, as expected, there was a correlation between plasma levels of total elastase and neutrophil elastase/alpha 1PI complex, the decrease in the levels of the complex at 52 weeks did not reach statistical significance. CONCLUSIONS: This study indicates that prolonged daily administration of rhDNase results in a reduction in elastase load in patients with cystic fibrosis.