tbuckley/cabot-search huggingface dataset:
Myocardial Response to Cigarette Smoking in Normal Subjects and Patients with Coronary Disease
Authors: T. J. REGAN, M. J. FRANK, J. F. MCGINTY, E. ZOBL, H. K. HELLEMS, R. J. BING
Journal: Circulation (1961)

The myocardial and peripheral hemodynamic effects of cigarette smoking have been assessed during a steady state situation in a group of normal subjects, and compared with a group of patients with coronary artery disease. During smoking, in both groups there was augmentation of heart rate, systemic arterial pressure, and left ventricular work, this response being somewhat greater in the coronary patients. Despite these hemodynamic alterations, neither group had a significant change in coronary blood flow, so that myocardial oxygen usage remained virtually identical with the value before smoking. There was no evidence of myocardial ischemia in the coronary subjects during smoking. The various factors, potentially responsible for the lack of myocardial blood flow increment are considered.
Paraneoplastic pityriasis lichenoides in cutaneous lymphoma: case report and review of the literature on paraneoplastic reactions of the skin in lymphoma and leukaemia
Authors: W. Kempf, H. Kutzner, N. Kettelhack, G. Palmedo, G. Burg
Journal: British Journal of Dermatology (2005)

Paraneoplastic dermatoses are non-neoplastic skin disorders which occur in the context of an underlying malignant neoplasm. The classic paraneoplastic dermatoses are mostly associated with solid internal malignancies. They only rarely occur in the context of nodal or primary cutaneous lymphomas. Apart from these classic paraneoplastic dermatoses, there are additional skin disorders reported to occur in close association with haematological and lymphoproliferative disorders which can thus be regarded as paraneoplastic manifestations. We report for the first time two patients with pityriasis lichenoides et varioliformis acuta in association with mycosis fungoides. In addition, we review the literature on paraneoplastic dermatoses of the skin which have been described in patients with leukaemias and primary cutaneous lymphomas.
Prise en charge endoscopique des collections pancréatiques post-opératoires
Authors: C Subtil, V Moutardier, V Vitton, M Gasmi, A Desjeux, JC Grimaud, C Brunet, S Berdah, M Barthet
Journal: Endoscopy (2008)

Introduction: Le traitement des collections survenant après une chirurgie pancréatique relève d'une prise en charge multidisciplinaire. La place et le temps d'un traitement endoscopique conservateur restent discutés.
A British Medical Association Lecture ON THE DIAGNOSIS AND TREATMENT OF INTRATHECAL TUMOURS OF THE SPINAL CORD
Authors: W. Thorburn
Journal: BMJ (1922)

ME1}AL 49 a rmild enteritis, however produced, is sufficient to produce an attack.It would appear that in suclh cases the absorption of poisonous cleavage-products of proteins .maybe the exciting cause, and even histamine has been held by some writers to be responsible.If you have in mind wlhat I stated, in dealing with experimental anaphylaxis, concernina the gencrally enhanced sensitiveness of the anapliylactic animal to poisons of this type, you will find no difficultv in reconciling the occurrence of such attacks witlh a specific, anaplhylactic origin of the asthmatic condition, in the patient in wlhom tlley occur.Nor slhould the evidence brought forward by Auld and others, as to tlhe improvement of SLichl patients under treatment witlh small injections of poisonous protein clerivatives, sucll as Witte's peptone.present muclh difficulty of interpretatioii, if you remember my statement that the anaphiylactic guinea-pig can be partially desensitized by a similar noln-specific initoxication.I am by no means suggesting that every case of so called astlhma is of the anaphylactic type.Even if the so-called cardiac asthma and renal dyspnoea are excluded, I imagine that tlhere are many cases in wlhiclh the symptonms are asthrmatic, but wllichll ave a different origin altogether.Whlen the question is raised of sensitization to the proteins of in- fecting organismns, the distinction between a primary toxic action of thieiu produLcts and an anaphylactic reaction to their proteins becomes difficult to draw.Especially is this tlle case witlh an infectioni of the respiratory passages themselves.There seem to be some clear cases; lhowever, of infection at a distant site, causing, not a local trouble, but a genuine general aiiaplhylactic reaction.But the discussion of the relation of anaphylaxis to bacterial proteins, full of suggestion tlhoughl it is for a rational conception of the genesis of certain clhronic morbid conditions, would lead us into suclh inadequately clharted waters tljat I slhall not attempt tlle role of pilot.My object lhas been to provide, from the experimental side.a more definite conception of the nature of those conditions in whichl sensitization to foreign proteins is clearly established; such a conception as may lhelp to focus ideas, to stimulate observation, and even to rationalize treatment.
Multiple myeloma: A patient with unusual features including intracranial and meningeal involvement, testicular involvement, organomegaly, and plasma cell leukemia
Authors: Nazim Turhal, M. Deirdre Henehan, Karen L. Kaplan
Journal: American Journal of Hematology (1998)

A 27-year-old Chinese male presented with multiple myeloma. Over his 18-month course he manifested a number of unusual features of his disease including his young age, marked organomegaly, a testicular plasmacytoma, multiple intracranial extraskeletal plasmacytomas and meningeal involvement, and peripheral blood plasmacytosis. The case is described and recent literature on these rare manifestations is reviewed.
Defining the Future of Primary Care: What Can We Learn from Patients?
Authors: Dana Gelb Safran
Journal: Annals of Internal Medicine (2003)

From the earliest definitions of the term primary care to the most recent, all have stressed that primary care is predicated on a sustained relationship between patients and the clinicians who care for them. Primary care differentiates itself from other areas of medicine by attending to the whole person, in the context of the patient's personal and medical history and life circumstances, rather than focusing on a particular disease, organ, or system. Finally, the primary care physician plays a distinctive role in integrating the care that patients receive from within and outside of the primary care setting. Data obtained from patients over the past 15 years demonstrate that most Americans have a physician whom they consider to be their primary physician. This was the case well before the rules of managed care plans required patients to align themselves with a particular primary care physician and to allow that physician to coordinate all of their medical care. However, information from patients indicates that despite primary care relationships that endure over several years, the ideals of whole-person, integrated care are largely unmet in patients' primary care experiences. Moreover, considerable evidence indicates that the quality of primary care relationships has eroded over the past several years. This article highlights the relative strengths and weaknesses of primary care, as experienced and reported by patients, and posits three areas that must be addressed for primary care to live up to the ideals of sustained partnerships providing whole-person, integrated care. These three areas involve the use of teams in medicine, the establishment of meaningful primary care partnerships, and integration of care in a delivery system that patients experience as increasingly fragmented.
Immunodominance of a low-affinity major histocompatibility complex-binding myelin basic protein epitope (residues 111-129) in HLA-DR4 (B1*0401) subjects is associated with a restricted T cell receptor repertoire.
Authors: P A Muraro, M Vergelli, M Kalbus, D E Banks, J W Nagle, L R Tranquill, G T Nepom, W E Biddison, H F McFarland, R Martin
Journal: Journal of Clinical Investigation (1997)

The pathogenesis of multiple sclerosis (MS) is currently ascribed in part to a T cell-mediated process targeting myelin components. The T cell response to one candidate autoantigen, myelin basic protein (MBP), in the context of HLA-DR15Dw2, has been previously studied in detail. However, the characteristics of cellular immunity in the context of other MS-associated HLA-DR haplotypes are scarcely known. MBP-specific T cell lines (TCL) were generated from HLA-DR4 (B1*0401)-positive MS subjects. Out of 275 MBP-specific TCL, 178 (64. 7%) specifically recognized region MBP(111-129), predominantly in the context of DRB1*0401. The major T cell epitope for MBP recognition corresponded to residues MBP(116-123). These TCL expressed disparate profiles of cytokine secretion and cytotoxicity. T cell receptor analysis, on the other hand, revealed a strikingly limited heterogeneity of rearrangements. In contrast to MBP(81-99), which binds with high affinity to HLA-DR15 and is recognized by a diverse T cell repertoire, MBP(111-129) binds weakly to DRB1*0401, suggesting that only high affinity T cell receptors might be able to efficiently engage such unstable MHC/peptide complexes, thus accounting for the T cell receptor restriction we observed. This study provides new insight about MBP recognition and proposes an alternative mechanism for immunodominance of self-antigen T cell epitopes in humans.
How doctors' anonymity in family courts is under threat
Authors: Sarah Harman
Journal: BMJ (2006)

How doctors' anonymity in family courts is under threat Gornall is way out of dateEditor-Gornall is embarrassingly out of date in his detailed analysis of the B case (which was dealt with by the family courts nearly three years ago), and its relevance to proposed changes in the law to make the English family court system more transparent. 1 Since then, notwithstanding the ever increasingly exaggerated claims from some quarters that opening the family courts would harm children and deter court experts, the courts themselves are acknowledging the need for English family courts to do their business in the more transparent way that courts in Canada, Australia, and of course Scotland have done without apparent difficulty for years.Several High Court judgments have recorded judicial support for more openness to increase public confidence, and Gornall fails to mention that the president and many of his senior judges are in favour of change in this direction.In a landmark case which was decided on 3 November, Munby J agreed that an ongoing case where parents dispute expert evidence that they injured their child should be open to the media.The local authority concerned issued a "position statement" to the press and the reporting in the Times, Guardian, and the Mail on Sunday set out both sides' cases, as did the broadcasting media.A BBC "Real Story" programme on the case allowed a senior official from the local authority ample time to put their case.No vilification of any experts involved was reported.It is likely that more judges will follow Munby J's example and more public interest cases will be opened to the media pending any change in the law.Will the skies fall in?I doubt it, but your readers can judge for themselves.Hopefully they will understand that in complex childcare cases where expert evidence may be tenuous and the stakes for children are very high, public debate can stimulate awareness of the problems faced by all professionals involved in child protection.It's difficult getting the balance right, but doing it in secret doesn't help.
C-Reactive Protein and the 10-Year Incidence of Coronary Heart Disease in Older Men and Women
Authors: Mary Cushman, Alice M. Arnold, Bruce M. Psaty, Teri A. Manolio, Lewis H. Kuller, Gregory L. Burke, Joseph F. Polak, Russell P. Tracy
Journal: Circulation (2005)

High C-reactive protein (CRP) is associated with increased coronary heart disease risk. Few long-term data in the elderly are available.Baseline CRP was measured in 3971 men and women > or =65 years of age without prior vascular diseases; 26% had elevated concentrations (>3 mg/L). With 10 years of follow-up, 547 participants developed coronary heart disease (CHD; defined as myocardial infarction or coronary death). With elevated CRP, the 10-year cumulative CHD incidences were 33% in men and 17% in women. The age-, ethnicity-, and sex-adjusted relative risk of CHD for CRP >3 mg/L compared with <1 mg/L was 1.82 (95% CI, 1.46 to 2.28). Adjusting for conventional risk factors reduced the relative risk to 1.45 (95% CI, 1.14 to 1.86). The population-attributable risk of CHD for elevated CRP was 11%. Risk relationships did not differ in subgroups defined by baseline risk factors. We assessed whether CRP improved prediction by the Framingham Risk Score. Among men with a 10-year Framingham-predicted risk of 10% to 20%, the observed CHD incidence was 32% for elevated CRP. Among women, CRP discriminated best among those with a 10-year predicted risk >20%; the incidences were 31% and 10% for elevated and normal CRP levels, respectively.In older men and women, elevated CRP was associated with increased 10-year risk of CHD, regardless of the presence or absence of cardiac risk factors. A single CRP measurement provided information beyond conventional risk assessment, especially in intermediate-Framingham-risk men and high-Framingham-risk women.
Efficacy of Granulocyte–Macrophage Colony-Stimulating Factor in Acquired Alveolar Proteinosis
Authors: John F. Seymour, Ashley R. Dunn, Janette M. Vincent, Jeffrey J. Presneill, Michael C. Pain
Journal: New England Journal of Medicine (1996)

To the Editor: Acquired alveolar proteinosis is a rare lung disease of adults characterized by excessive accumulation of surfactant.1 Standard therapy is whole-lung lavage, which usually provides t...
Use of an islet cell antibody assay to identify type 1 diabetic patients with rapid decrease in C-peptide levels after clinical onset. Belgian Diabetes Registry.
Authors: K Decochez, B Keymeulen, G Somers, H Dorchy, I H De Leeuw, C Mathieu, R Rottiers, F Winnock, K ver Elst, I Weets, L Kaufman, D G Pipeleers, R Rottiers
Journal: Diabetes Care (2000)

OBJECTIVE: To investigate whether the presence of antibody markers at diagnosis could help predict the rapid decrease in residual beta-cell function noted in some, but not all, patients with recent-onset type 1 diabetes. RESEARCH DESIGN AND METHODS: We measured random C-peptide levels (radioimmunoassay); islet cell cytoplasmic antibodies (ICA) (indirect immunofluorescence); and antibodies against IA-2 protein, 65-kDa glutamate decarboxylase, and insulin (liquid-phase radiobinding assays) in 172 patients &amp;lt;40 years of age with type 1 diabetes. The patients had been consecutively recruited at diagnosis by the Belgian Diabetes Registry and were followed for 2 years. RESULTS: Two years after diagnosis, random C-peptide levels had decreased significantly (P &amp;lt; 0.001) in ICA+ patients but not in ICA- patients. C-peptide values &amp;lt;50 pmol/ were noted in 88% of patients diagnosed before 7 years of age, in 45% of patients diagnosed between ages 7 and 15 years, and in 29% of patients diagnosed after 15 years of age (P &amp;lt; 0.001). In cases of clinical onset before age 15 years, a rapid decline in random C-peptide values was observed almost exclusively in patients with high-titer ICA (&amp;gt; or =50 Juvenile Diabetes Foundation [JDF] units) at diagnosis (69 vs. 17% in patients with lower ICA titers, P &amp;lt; 0.001). In patients diagnosed after 15 years of age, 36% of patients with ICA titers &amp;gt; or =12JDF units developed low C-peptide levels compared with 14% of patients with ICA titers &amp;lt; 12 JDF units (P &amp;lt; 0.03). Multivariate analysis confirmed that C-peptide levels after 2 years were inversely correlated with ICA levels (P &amp;lt; 0.001) and to a lesser degree positively correlated with age at diagnosis (P &amp;lt; 0.02), regardless of the levels or number of molecular autoantibodies. CONCLUSIONS: Young age at diagnosis and high-titer ICA identify a group of type 1 diabetic patients at high risk of rapidly losing residual beta-cell function. Using these selection criteria, it is possible to better target beta-cell-preserving interventions to patients with or without such rapid progression, depending on the nature of the tested substance. The ICA assay measures clinically relevant antibodies not detected in antibody assays that use recombinant human autoantigens for substrate.
Haematology and Biochemistry of Ankylosing Spondylitis
Authors: M. J. Kendall, D. S. Lawrence, G. R. Shuttleworth, A. G. W. Whitfield
Journal: BMJ (1973)

Forty men with ankylosing spondylitis have been reviewed clinically, radiologically, haematologically, and biochemically, and the results of the last two compared with a male group of rheumatoid patients and a control group. In the patients with ankylosing spondylitis the haemoglobin levels were much higher and the E.S.R. significantly lower than in the rheumatoid group, and the E.S.R. in the patients with ankylosing spondylitis was unrelated to disease activity as evidenced by pain. The alkaline phosphatase level was raised in 19 cases and in most was derived from bone. Though 10 patients had abnormal globulin levels, the albumin levels were normal, as was renal function in all cases.
Abnormalities of the Digital Vasculature as Related to Ulceration and Gangrene
Authors: MARGARET C. CONRAD
Journal: Circulation (1968)

Plastic casts were made of digital vessels of 13 extremities amputated for severe atherosclerosis obliterans. Prior to amputation, blood flow averaged 0.02 cc/min/5 cc of digit (normal, 0.5), and digital systolic pressure average 16 mm Hg. There were more occlusions of terminal arteries (&lt;30 µ in diameter) in the first and fifth toes than in the third toes and on the plantar and proximal dorsal surfaces than in the nail bed; this observation suggests relationship to local trauma and shoe pressures. Occlusion was most severe in 30 to 50 µ arteries, decreased with increasing vessel size, and was greater in uninvolved areas of ulcerated toes than in nonulcerated toes. Occluded arteries smaller than the digital artery terminated abruptly; this observation suggests stasis thrombosis; occlusions did not occur preferentially at sites of branchings. In occluded digital arteries, areas of partial occlusion lay adjacent to complete block, reflecting plaque formation. At the rim of an ulcer crater all vessels terminated abruptly which suggests destruction of vasculature secondary to necrosis. The findings suggest the following sequence of events: (1) marked reduction in pressure and flow due to proximal disease, (2) resultant stasis thrombosis accentuated by shoe pressures and local trauma, and (3) death of tissue in ischemic digits leading to further loss of vasculature in the necrotic area.
LITHÆMIA; ITS TREATMENT.Read before the Harvard Medical Society, October, 1, 1892.
Authors: REYNOLD W. WILCOX
Journal: JAMA (1893)

At the present time there is no necessity for an apology for taking up the subject of lithæmia. With the greater acquisition of wealth, and the luxurious habits of living incident thereto, with increased competition in the mercantile and professional world, we meet, more and more frequently, with cases which illustrate the symptom-complex known as lithæmia. The subject is by no means a new one, although with greater and more accurate knowledge of physiological chemistry, with more careful and complete physical examination, we are able to define more clearly the processes which result in this condition, and with even more certitude, proceed to its cure. Not long after the report of that gun was heard at Lexington, which echoed around the world, Scheele, the Swedish chemist, announced that uric acid was a normal constituent of the urine. From that time on, our British cousins, with the exception of a very
Extremely Preterm Birth and Parental Authority to Refuse Treatment — The Case of Sidney Miller
Authors: George J. Annas
Journal: New England Journal of Medicine (2004)

In 1990, a neonatologist resuscitated a severely premature infant against the wishes of the parents. The child survived with severe disabilities. The parents sued the hospital for battery and negligence. In 2003, the Texas Supreme Court ruled in favor of the physicians and hospitals. According to the ruling, physicians who are faced with split-second, life-or-death decisions do not need parental consent to provide life-sustaining treatment to minors.
703 BACTERIAL RECEPTOR NOD1 REGULATES THE NEUTROPHIL MIGRATION MACHINERY DURING LIVER INJURY
Authors: S. Dharancy, M. Body-Malapel, A. Louvet, D. Berrebi, P. Gosset, J. Viala, D. Philpott, E. Gantier, S. Girardin, P. Desreumaux, P. Mathurin, L. Dubuquoy
Journal: Journal of Hepatology (2009)
Impaired Activation and Localization of LAT in Anergic T Cells as a Consequence of a Selective Palmitoylation Defect
Authors: Matthias Hundt, Hiroki Tabata, Myung-Shin Jeon, Keitaro Hayashi, Yoshihiko Tanaka, Roma Krishna, Lauren De Giorgio, Yun-Cai Liu, Masaki Fukata, Amnon Altman
Journal: Immunity (2006)
New Federal Initiatives To Enhance the Medical Treatment of Opioid Dependence
Authors: David A. Fiellin, Patrick G. O'Connor
Journal: Annals of Internal Medicine (2002)

Opioid dependence is a chronic relapsing medical condition with substantial health and societal complications. Recent federal initiatives are designed to enhance the medical treatment of patients with opioid dependence and will expand the role of internists in the care of these patients. These initiatives include a process for federal exemptions to allow for pharmacologic treatment in office settings, waivers for the use of new medications, and new rules governing the oversight and distribution of opioid agonist medications for maintenance treatment. This perspective describes these initiatives and their implications for internists.
Forecast: Heavy Clouds Followed by Migraine Sheets
Authors: René F. Cárdenas
Journal: JAMA (1997)

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