tbuckley/cabot-search huggingface dataset:
THE ADRENAL HORMONES IN MEDICAL PRACTICE
Authors: FRANK A. HARTMAN
Journal: JAMA (1941)

Not only are adrenal preparations widely used in the treatment of Addison's disease but workers are finding application for their use in other clinical conditions. Unfractionated extract from which the epinephrine has been removed possesses the advantage that the hormones exist in as nearly a natural state as it is possible to obtain them. Fractionation modifies some of the hormones and may decrease their potency. The crystalline products probably are not the original hormones but are more stable forms derived from them. Desoxycorticosterone, the only compound that has, been synthesized, represents only one substance from the adrenal which can cause sodium retention. Sodium factor is another. Although the number and nature of the original hormones are not clear, their functions are beginning to be understood. A knowledge of the latter is necessary for rational therapy. <h3>FUNCTIONS</h3><h3>Permeability.—</h3> The adrenal plays an important part in the regulation of membrane permeability. Winter
Synergistic effects of self-assembling peptide and neural stem/progenitor cells to promote tissue repair and forelimb functional recovery in cervical spinal cord injury
Authors: Motoyuki Iwasaki, Jared T. Wilcox, Yusuke Nishimura, Klaus Zweckberger, Hidenori Suzuki, Jian Wang, Yang Liu, Spyridon K. Karadimas, Michael G. Fehlings
Journal: Biomaterials (2014)
Prevention of hepatocarcinogenesis and increased susceptibility to acetaminophen-induced liver failure in transaldolase-deficient mice by N-acetylcysteine
Authors: Robert Hanczko, David R. Fernandez, Edward Doherty, Yueming Qian, Gyorgy Vas, Brian Niland, Tiffany Telarico, Adinoyi Garba, Sanjay Banerjee, Frank A. Middleton, Donna Barrett, Maureen Barcza, Katalin Banki, Steve K. Landas, Andras Perl
Journal: Journal of Clinical Investigation (2009)

Although oxidative stress has been implicated in acute acetaminophen-induced liver failure and in chronic liver cirrhosis and hepatocellular carcinoma (HCC), no common underlying metabolic pathway has been identified. Recent case reports suggest a link between the pentose phosphate pathway (PPP) enzyme transaldolase (TAL; encoded by TALDO1) and liver failure in children. Here, we show that Taldo1–/– and Taldo1+/– mice spontaneously developed HCC, and Taldo1–/– mice had increased susceptibility to acetaminophen-induced liver failure. Oxidative stress in Taldo1–/– livers was characterized by the accumulation of sedoheptulose 7-phosphate, failure to recycle ribose 5-phosphate for the oxidative PPP, depleted NADPH and glutathione levels, and increased production of lipid hydroperoxides. Furthermore, we found evidence of hepatic mitochondrial dysfunction, as indicated by loss of transmembrane potential, diminished mitochondrial mass, and reduced ATP/ADP ratio. Reduced β-catenin phosphorylation and enhanced c-Jun expression in Taldo1–/– livers reflected adaptation to oxidative stress. Taldo1–/– hepatocytes were resistant to CD95/Fas-mediated apoptosis in vitro and in vivo. Remarkably, lifelong administration of the potent antioxidant N-acetylcysteine (NAC) prevented acetaminophen-induced liver failure, restored Fas-dependent hepatocyte apoptosis, and blocked hepatocarcinogenesis in Taldo1–/– mice. These data reveal a protective role for the TAL-mediated branch of the PPP against hepatocarcinogenesis and identify NAC as a promising treatment for liver disease in TAL deficiency.
Maturation of B‐lineage blast crisis cells in chronic myeloid leukemia
Authors: C. S. Ng, M. Arnold, John K. C. Chan
Journal: American Journal of Hematology (1987)

Abstract A 44 year‐old Chinese male presented with lymphoid blast crisis of chronic myeloid leukemia, in which the blast cells exhibited a pre‐pre‐B cell phenotype (B4 + B1 − J5 + 12 + smIg − ). There was a phenotypic transition during the course of the disease to a more mature B cell phenotype (B4 + B1 − J5 + 12 + smIgGλ + ). The maturation of blast crisis cells may be related to the chemotherapeutic agents used in the treatment of the disease.
Placebo-Controlled Trials and Active-Control Trials in the Evaluation of New Treatments. Part 2: Practical Issues and Specific Cases
Authors: Susan S. Ellenberg
Journal: Annals of Internal Medicine (2000)

Placebo controls are commonly used in clinical trials of investigational treatments because they have important advantages. In recent years, some have criticized the use of placebo-controlled trials when effective alternative therapy exists, regardless of the expected effect of the therapy. In part 1 of this paper, ethical arguments are addressed and the interpretive problems inherent in the use of active-control equivalence trials to establish efficacy of a new treatment are clarified. However, uncertainties may complicate decisions about appropriate use of placebo controls in some situations. Part 2 discusses more fully the ethical considerations for using placebo controls in particular medical settings. The value and relevance of placebo-controlled trials of new agents in situations in which proven effective therapy is available are also explored.
Follow up study of 70 patients with renal artery stenosis treated by percutaneous transluminal dilatation.
Authors: G G Geyskes, C B Puylaert, H Y Oei, E J Mees
Journal: BMJ (1983)

Between April 1978 and April 1981, 70 patients with hypertension and renal artery stenosis were treated by percutaneous transluminal arterial dilatation. Selection of the patients was based solely on arteriographic criteria. Arteriography after dilatation showed considerable widening of the stenosed area in all patients. In 65 patients the effect of treatment on the blood pressure was assessed during follow up periods of one to four years. In 14 of these patients the hypertension was cured, in 29 it was improved, and in 22 there was no change. Patients with fibromuscular lesions benefited distinctly more than did those with atheromatous stenosis, only one of the 21 patients with fibromuscular lesions showing no change as compared with 21 of the 44 patients with atheromatous lesions. The only serious complication encountered was microcholesterol emboli, which developed in two patients with severe atheromatous lesions of the aorta. In the atheromatous group age and overall renal function had no influence on the blood pressure response. In the subgroup of patients with a unilateral lesion the renal vein renin ratios and asymmetrical curves obtained by renography had only a very limited predictive value. In experienced hands percutaneous transluminal arterial dilatation is relatively safe, and this study suggests that it should be attempted in all patients with renal artery stenosis. Only in patients with severe atheromatosis of the aorta should the risk associated with the catheterisation be weighed against the 50% or so chance of benefit from the procedure.
Extending medical professionalism
Authors: Eric Will
Journal: Journal of the Royal Society of Medicine (2011)

While it is tempting to extend the obligations of a contemporary medical professional there may be inadvertent consequences in the real world.1 The RCP definition of professionalism of 2005 focused on public trust as the major issue.2 This has always felt rather lacking in principle and inspiration, not least because the public attitude could be read as the sole arbiter of professional attributes. More important is that both the public acceptance and duties of the profession are expressed through the surrogacy of the media and Government/NHS organizations, which have economic and social conflicts of interest to declare. An extension from individual to population issues, as subsequently negotiated with CMOs, or when ‘Quality Improvement’ becomes involved, compounds those conflicts. This rather abstract reality is set to become more parochial as Trusts and Consortia compete to sustain their business models and economic viability in a more granular NHS. The progressive embedding of the profession in the NHS over six decades makes it difficult to examine how far desirable medical attributes are matters of an employment contract as well as an abstract professionalism.

The recently reported official approach to ‘disruptive’ behaviour suggests where the confusion of such categories may lead.3 A plausible preoccupation with ‘safety’ is used to assert a stance of ‘zero tolerance’. However, the criteria of disruption have always been subject to context and opinion. When clinicians resist local management decisions for professional reasons in future what label will that earn if employment and professional standards are viewed as identical? Those colleagues known as whistleblowers visited such conflicts even in the less competitive years of the NHS. Professional identity appears vulnerable to manipulation in a climate of business interests, ambivalent professional associations and semi-prescriptive formal authorities. Are all the universals that professionals owe to Apollo truly owed to Caesar?
When the Doctor Needs A Doctor: Special Considerations for the Physician-Patient
Authors: ALAN STOUDEMIRE
Journal: Annals of Internal Medicine (1983)

The treatment of an ill or impaired physician may present difficulties not typically encountered in other patients. Potential complications arise from the temptation for physicians to diagnose and treat themselves, their tendency to obtain "informal" consultations regarding personal symptoms, their difficult transition from the role of doctor to that of patient, and the inadvertent assumption of a "VIP" status in the hospital. These difficulties may be increased by the denial of illness by the physicians themselves and their families and colleagues. This denial is partially determined by legal, financial, social, professional, and psychological factors. Specific recommendations on caring for an ill physician are presented.
Training for a Psychiatry of International Relations
Authors: BRYANT WEDGE
Journal: American Journal of Psychiatry (1968)

While psychiatry cannot solve all the problems of international relations, it can contribute to better understanding of the nonrational and often unconscious factors that contribute to international friction. The author outlines suggested patterns of training designed to equip a few psychiatrists for a new kind of empirical study of international problems that he feels is necessary to define the distinctive contributions of the psychiatric discipline to a broad science of international relations.
A monoclonal antibody recognizing very late activation antigen-4 inhibits eosinophil accumulation in vivo.
Authors: V B Weg, T J Williams, R R Lobb, S Nourshargh
Journal: The Journal of Experimental Medicine (1993)

Using an in vivo test system, the role of the beta 1 integrin very late activation antigen-4 (VLA-4) in eosinophil accumulation in allergic and nonallergic inflammatory reactions was investigated. Eosinophil infiltration and edema formation were measured as the local accumulation of intravenously injected 111In-labeled eosinophils and 125I-human serum albumin. The inflammatory reactions investigated were a passive cutaneous anaphylaxis (PCA) reaction and responses elicited by intradermal soluble inflammatory mediators (platelet-activating factor, leukotriene B4, C5a des Arg), arachidonic acid, and zymosan particles. The in vitro pretreatment of 111In-eosinophils with the anti-VLA-4 monoclonal antibody (mAb) HP1/2, which crossreacts with guinea pig eosinophils, suppressed eosinophil accumulation in all the inflammatory reactions investigated. Eosinophil accumulation was inhibited to the same extent when mAb HP1/2 was administered intravenously. It is interesting that HP1/2 had no effect on stimulated edema formation. These results suggest a role for VLA-4 in eosinophil accumulation in vivo and indicate a dissociation between the inflammatory events of eosinophil accumulation and edema formation.
CORONARY MICROCIRCULATION DYSFUNCTION IS ACCOMPANIED BY AN IMPAIRMENT OF LEFT VENTRICULAR DIASTOLIC PROPERTIES IN MALE HYPERTENSIVES
Authors: Dimitris Tsiachris, Konstantinos Tsioufis, Dimitris Roussos, Kyriakos Dimitriadis, Kostas Toutouzas, Eleftherios Tsiamis, Dimitris Tousoulis
Journal: Journal of the American College of Cardiology (2010)
Eaton Agent Pneumonia— Clinical Features
Authors: Maurice A. Mufson
Journal: JAMA (1961)

The clinical features of Eaton agent pneumonia, adenovirus pneumonia, and a group of etiologically undiagnosed viral pneumonias were compared. Eaton agent pneumonia was found to be an acute febrile illness characterized by cough, fever, chills, headache, and malaise. The duration of illness in untreated patients averaged between 2 and 3 weeks. Clinical findings in the other viral pneumonias were milder with less systemic symptoms, less pulmonary involvement, and shorter duration. It was not possible to distinguish Eaton agent pneumonia from the other types on the basis of clinical findings alone, without recourse to the fluorescent antibody test. However, the development of cold agglutinins suggested a diagnosis of Eaton agent pneumonia since they appeared in 49 of 109 patients with this illness, but were infrequently found in other viral pneumonias.
Molecular diagnosis of multiple endocrine neoplasia (MEN) in paraffin-embedded specimens
Authors: Paul Komminoth, Seraina Muletta-Feurer, Parvin Saremaslani, Eva K. Kunz, Xavier Matias-Guiu, Olaf Hiort, Sören Schröder, Walter K. F. Seelentag, Jürgen Roth, Philipp U. Heitz
Journal: Endocrine Pathology (1995)
Cytokine and hepatitis B virus DNA Co-immunizations enhance cellular and humoral immune responses to the middle but not to the large hepatitis B virus surface antigen in mice
Authors: Michael Geissler, Reinhold Schirmbeck, Jörg Reimann, Hubert E. Blum, Jack R. Wands
Journal: Hepatology (1998)

Genetic immunization is a potentially useful strategy to prevent or treat hepatitis B virus (HBV) infection. We have previously shown that HBV envelope proteins are highly immunogenic using this technique. The large envelope protein (LHBs), however, induced significantly weaker humoral and cellular immune responses when compared with the middle envelope protein (MHBs). We studied the effect of co-immunizations with cytokine DNA expression constructs encoding for interleukin (IL)-2 and (GM-CSF) on the immunogenicity of LHBs at the B-and T-cell level. Co-immunizations of mice with plasmids encoding for MHBs and IL-2 or GM-CSF increased anti-HBs responses, helper T-cell proliferative activity, and cytotoxic T lymphocyte (CTL) killing. In contrast, co-immunizations of plasmids encoding for LHBs and IL-2 or GM-CSF had no effect on humoral and cellular immune responses. LHBs did not inhibit the production or secretion of IL-2 and GM-CSF. In addition, IL-2, tumor necrosis factor alfa (TNF-α), and interferon gamma (IFN-γ) had no suppressive effect on HBV envelope protein expression in vitro . Based on these data, MHBs, but not LHBs, genetic immunization can be augmented by IL-2 or GM-CSF cytokines.
Consent for autopsy
Authors: R. Khiani, S. Shingler, P. Hasleton
Journal: Journal of the Royal Society of Medicine (2003)

With their postal questionnaire, Dr Williams and colleagues found that just 4% of consultant histopathologists were actively involved in consenting for autopsy and only 20% expressed a willingness to be involved (November 2002, JRSM1). Most histopathologists (89%) felt that the clinician involved in the patient's care should be responsible for obtaining consent. Clinicians have the advantage of knowing the clinical history and indication for post mortem and may have developed a rapport with the relatives. However, clinicians often have a limited understanding of the process of post mortems and the issues surrounding the retention and disposal of organs and tissues. The pathologist performing the post mortem cannot be sure that consent obtained by a clinician is truly informed.

We are conducting research into sudden unexplained death in young adults, aged 16 to 39. Our study involves obtaining informed consent from bereaved families to retain tissues and blood from post mortem for research purposes. To provide a recently bereaved relative with the information required for fully informed consent to a post mortem and the retention of organs or tissues is difficult and time-consuming, taking up to 3 hours. This is logistically impossible for both pathologist and clinicians. The public outcry after the Alder Hey and Bristol enquiries has placed informed consent for autopsy and retention of organs and tissue as a major priority. We feel that each trust should have a dedicated trained bereavement adviser, who would be responsible for obtaining informed consent for autopsy and retention of organs/tissues for diagnostic, research or donation purposes. The bereavement adviser would receive training in bereavement counselling, obtaining informed consent, the process of autopsy and issues surrounding retention and disposal of organs/tissues.

They would be an important point of contact for bereaved relatives and would liaise closely with clinicians, pathologists, the coroner and primary care services (e.g. general practitioners and counsellors). A bereavement adviser seems the sensible way to provide a comprehensive service to bereaved relatives. This can only be achieved if the Department of Health supports trusts with extra funding which is ring-fenced for such a bereavement service.
Effects of lead on neurophysiological and performance measures: animal and human data.
Authors: H Lilienthal, G Winneke, T Ewert
Journal: Environmental Health Perspectives (1990)

This paper reports lead-induced changes in neuropsychological measures and behavioral performance measures in monkeys and children. Monkeys were pre- and postnatally exposed to lead via the diet. Blood lead levels at the time of testing were 9.3, 40.3, and 55.7 micrograms/dL in controls, and animals exposed to 350 ppm or 600 ppm lead acetate, respectively. Flash-evoked and brainstem auditory-evoked potentials were recorded in adult animals. Results indicate latency increases in both measures as well as amplitude decreases in the flash-evoked response. Delayed reaction time and serial choice reaction were determined as measures of behavioral performance in lead-exposed school-age children from two lead smelter areas. In addition, pattern-reversal-evoked potentials and nerve conduction velocity were investigated. Neither nerve conduction velocity nor latency of the pattern-reversal-evoked potential were consistently influenced by lead. Of the behavioral measures, serial choice reaction performance revealed a consistent lead-related deficit, which became more pronounced with increasing task difficulty.
System and market failures: the unavailability of magnesium sulphate for the treatment of eclampsia and pre-eclampsia in Mozambique and Zimbabwe
Authors: E Sevene, S Lewin, A Mariano, G Woelk, A D Oxman, S Matinhure, J Cliff, B Fernandes, K Daniels
Journal: BMJ (2005)

Low cost and effective drugs, such as magnesium sulphate, need to be included in initiatives to improve access to essential medicines in Africa 

Ensuring the availability of effective drugs for priority health problems remains a key public health issue in many African countries.1 Market deficiencies in ensuring drug development for “neglected” diseases affecting developing countries are well described,2 3 w1 and several global initiatives are attempting to tackle this.4 w2 Even when low cost, effective treatments exist, however, drug availability for many common health problems remains poor in many settings, limiting progress towards achieving the millennium development goals.5

One such health problem is the management of pre-eclampsia and eclampsia, important causes of maternal and infant morbidity and mortality. Over 63 000 women die annually after eclamptic convulsions, with 99% of these deaths occurring in low and middle income countries.6 7 w3

Evidence is strong for the effectiveness of magnesium sulphate in treating and preventing eclampsia.8–10 w4 w5 Magnesium sulphate costs $0.35 (£0.19; €0.29) per ampoule (40 ml of 10% magnesium sulphate; Central Medical Stores, Mozambique, April 2005) and has appeared on the World Health Organization's essential medicines list since 1996.11 It is of great concern that this effective and low cost drug is still unavailable in many countries.12 13 w6 w7 We describe problems with the registration, approval, acquisition, and distribution of magnesium sulphate, and hence its availability to clinicians, in Mozambique and Zimbabwe, two countries with high maternal mortality ratios (table).14–16 We draw on a range of sources, including a bibliographical review of policies concerning magnesium sulphate over the past 25 years and qualitative data collected as part of a case study of policy making and procurement for magnesium sulphate in the two countries (box …
Morphologic Changes in Branch Duct Intraductal Papillary Mucinous Neoplasms of the Pancreas: A Midterm Follow-Up Study
Authors: P RAUTOU, P LEVY, M VULLIERME, D OTOOLE, A COUVELARD, D CAZALSHATEM, L PALAZZO, A AUBERT, A SAUVANET, P HAMMEL
Journal: Clinical Gastroenterology and Hepatology (2008)
Spare the television and improve the child
Authors: S. Gottlieb
Journal: BMJ (2001)

Reducing the amount of time that primary school children spend watching television and playing video games can make them less aggressive towards their peers, a new study has reported.

Although many studies have correlated exposure to violent media with aggressive behaviour in children, the researchers say that theirs is the first to show that such behaviour can be unlearned by reducing the exposure.

In the study the researchers, led by Dr Thomas Robinson, assistant professor of paediatrics at Stanford University in Palo Alto, California, looked at 225 third and fourth grade children (9 and 10 year olds) at two similar public elementary schools in San Jose, California. The schools were selected because they …
Effect of loperamide and naloxone on gastric acid secretion in healthy man.
Authors: R Caldara, M Cambielli, E Masci, M Guslandi, C Barbieri, C Ferrari
Journal: Gut (1981)

The effect of acute oral administration of three different doses (4, 8, and 16 mg) of loperamide, a peripheral opiate agonist, on basal and submaximal pentagastrin-stimulated gastric acid secretion was evaluated in healthy volunteers. Both basal and stimulated gastric secretion were significantly lowered by 8 and 16 mg of the drug in comparison with a control study, while 4 mg was ineffective. Naloxone, a specific opiate antagonist, decreased slightly but not significantly both basal and pentagastrin-stimulated gastric acid secretion, when infused intravenously at the rate of 30 micrograms/kg/h, but completely abolished the inhibitory effect of loperamide on gastric acidity. These data also suggest that opiates may be involved in the regulation of gastric acid secretion in man by acting at a peripheral site, as loperamide does not cross the blood-brain barrier.
Congenital Postural Scoliosis
Authors: G. C. Lloyd-Roberts
Journal: BMJ (1965)

were blocked by the Thorotrast particles (size about 20 By) in the reticulo-endothelial cells, leading often to thrombosis.Although no changes could be found in the peripheral blood during the observation period of 18 to 24 months, the probability of radiation damage to the bone-marrow and to other storage organs was emphasized as the y- irradiation for the usual 100 ml.Thorotrast amounted to 1.24 Mg. of radium (near the toxic dose), persisting for an unlimited