tbuckley/cabot-search huggingface dataset:
Emil Kraepelin: Icon and Reality
Authors: Eric J Engstrom, Kenneth S Kendler
Journal: American Journal of Psychiatry (2015)

In the last third of the 20th century, the German psychiatrist Emil Kraepelin (1856–1926) became an icon of postpsychoanalytic medical-model psychiatry in the United States. His name became synonymous with a proto-biological, antipsychological, brain-based, and hard-nosed nosologic approach to psychiatry. This article argues that this contemporary image of Kraepelin fails to appreciate the historical contexts in which he worked and misrepresents his own understanding of his clinical practice and research. A careful rereading and contextualization of his inaugural lecture on becoming chair of psychiatry at the University of Tartu (known at the time as the University of Dorpat) in 1886 and of the numerous editions of his famous textbook reveals that Kraepelin was, compared with our current view of him, 1) far more psychologically inclined and stimulated by the exciting early developments of scientific psychology, 2) considerably less brain-centric, and 3) nosologically more skeptical and less doctrinaire. Instead of a quest for a single “true” diagnostic system, his nosological agenda was expressly pragmatic and tentative: he sought to sharpen boundaries for didactic reasons and to develop diagnoses that served critical clinical needs, such as the prediction of illness course. The historical Kraepelin, who struggled with how to interrelate brain and mind-based approaches to psychiatric illness, and who appreciated the strengths and limitations of his clinically based nosology, still has quite a bit to teach modern psychiatry and can be a more generative forefather than the icon created by the neo-Kraepelinians.
P166 Temporal dynamics of polymicrobial communities in the lower respiratory tract of patients with cystic fibrosis
Authors: A. Nelson, S. J. Bourke, J. D. Perry, A. De-Soyza, S. P. Cummings
Journal: Thorax (2011)

<h3>Introduction and Objectives</h3> The microbial communities present in CF sputum are polymicrobial and consist of bacteria, viruses and fungi. Although stratified studies have demonstrated a change in the CF bacterial microbiota with increasing age, individual patients have not been followed longitudinally across stable phases and exacerbation episodes period of time. The aim of this study was to follow CF patients who were either homo- or heterozygous for the F508del mutation over a period of up to 20 months to assess how the bacterial and fungal communities fluctuate over this period to determine whether a shift in the microbiota could be linked with acute pulmonary exacerbations. <h3>Methods</h3> Adult CF patients were recruited and spontaneously expectorated sputum samples were collected. DNA was extracted from the samples and PCR-DGGE was used to analyse the bacterial and fungal communities using universal primer sets. <h3>Results</h3> Routine microbial culture identified a mean of 1.52 bacterial species and 0.62 fungal species, whereas molecular analysis found a mean of 12.24 bacterial species and 1.41 fungal species across the cohort. The composition of the bacterial communities between patients varied significantly according to gender and being culture positive for <i>P aeruginosa</i>. Patients homozygous for the F508del mutation had more rich fungal communities than heterozygotes. However, a bacterial or fungal community characteristic for pulmonary exacerbations was not observed. <h3>Conclusions</h3> Our data clearly demonstrates that bacterial and fungal communities in the CF lower respiratory tract are more diverse than previously thought. Furthermore, the microbial communities in the lower respiratory tract of CF patients are subject are selected by predisposing factors such as gender but still remain unique to individual patients. Monitoring the microbial communities has found that although they are subject to some fluctuation a characteristic community does not assemble to cause acute pulmonary exacerbations. Furthermore, particular bacterial taxa were present throughout the sampling period, suggesting that current antimicrobial therapies are not adequate at removing these taxa.
Radioisotope study of small joint inflammation in rheumatoid arthritis.
Authors: K E Collins, S Deodhar, G Nuki, K Whaley, W W Buchanan, W C Dick
Journal: Annals of the Rheumatic Diseases (1971)

Technetium scintiphotography of finger and wrist joints and knees in rheumatoid arthritis has shown increased uptake in the joints which reflected the degree of inflammatory involvement at the time of study (Weiss and others, 1966; Alarcon-Segovia and others, 1967; McCarty and others, 1970a), and Whaley and others (1968) have described a tech- nique for quantitating the joint scintiphotographs.Scintiphotography of joints has the major disadvantage of requiring doses of the order of over one millicurie of 99mTc to obtain adequate contrast between inflamed and normal joints (Whaley and others, 1968; McCarty and others, 1970a) and quantitation of the scintiphotographs is tedious and time-
Varus–valgus motion and functional ability in patients with knee osteoarthritis
Authors: M van der Esch, M Steultjens, J Harlaar, N Wolterbeek, D Knol, J Dekker
Journal: Annals of the Rheumatic Diseases (2007)

To assess the relationship between knee varus-valgus motion and functional ability, and the impact of knee varus-valgus motion on the relationship between muscle strength and functional ability in patients with osteoarthritis (OA) of the knee.Sixty-three patients with knee OA were tested. Varus-valgus motion was assessed by optoelectronic recording and three-dimensional motion analysis. Functional ability was assessed by observation, using a 100 m walking test, a Get Up and Go test, and WOMAC questionnaire. Muscle strength was measured by a computer-driven isokinetic dynamometer. Regression analyses were performed to assess the relationships between varus-valgus motion and functional ability, and to assess the impact of varus-valgus motion on the relationship between muscle strength and functional ability.In patients with high varus-valgus range of motion, muscle weakness was associated with a stronger reduction in functional ability (ie, longer walking time and Get Up and Go time) than in patients with low varus-valgus range of motion. A pronounced varus position and a difference between the left and right knees in varus-valgus position were related with reduced functional ability.In patients with knee OA with high varus-valgus range of motion, muscle weakness has a stronger impact on functional ability than in patients with low varus-valgus range of motion. Patients with knee OA with more pronounced varus knees during walking show a stronger reduction in functional ability than patients with less pronounced varus knees or with valgus knees.
Slow Gastric Emptying in Type I Diabetes: Relation to Autonomic and Peripheral Neuropathy, Blood Glucose, and Glycemic Control
Authors: René Merio, Andreas Festa, Helmar Bergmann, Thomas Eder, Nicole Eibl, Giselheld Stacher-Janotta, Ute Weber, Christine Budka, Andrea Heckenberg, Peter Bauer, Mario Francesconi, Guntram Schernthaner, Georg Stacher
Journal: Diabetes Care (1997)

OBJECTIVE To investigate whether autonomic neuropathy or hyperglycemia plays a crucial etiological role in gastric retention of ingesta frequently found in type I diabetic patients. RESEARCH DESIGN AND METHODS We investigated the gastric emptying of a radiolabeled semisolid 1,168 kJ meal in 38 female and 45 male patients (age 18–75 years; illness duration 3–46 years). None took drugs affecting gastrointestinal motility. Fasted patients underwent tests of cardiovascular autonomic and peripheral nerve function. Blood glucose levels were determined before and after the scintigraphic recording of gastric emptying. RESULTS The percentage of meal remaining in the stomach at the end of the 50-min recording time was related significantly to the patients' degree of cardiovascular autonomic neuropathy [r (81) = 0.235, P &amp;lt; 0.028] but not to their degree of peripheral neuropathy, preprandial blood glucose level, HbA1c indicative of glycemic control, diabetes duration, and age. The patients' mean residual percentage of meal was significantly &amp;gt; that of 48 healthy subjects, that is, 71.1 ± 15.1 vs. 53.5 ± 13.1% [means ± SD; t (129) = 6.48, P &amp;lt; 0.0001]. The healthy individuals' mean residual percentage + 2 SD was exceeded in 22 patients. CONCLUSIONS Slow gastric emptying in patients with type I diabetes seems related to the degree of autonomic neuropathy but not to peripheral neuropathy, actual blood glucose, and glycemic control.
Validation of PCR–reverse line blot, a method for rapid detection and identification of nine dermatophyte species in nail, skin and hair samples
Authors: A.M.C. Bergmans, L.M. Schouls, M. van der Ent, A. Klaassen, N. Böhm, R.G.F. Wintermans
Journal: Clinical Microbiology and Infection (2008)
The game has changed… but it still needs to be played: the role of imaging tests using ionising radiation in the practice of sports medicine
Authors: Bruce B Forster
Journal: British Journal of Sports Medicine (2013)

The editorial by Orchard et al 1 is a timely reminder of the mounting evidence of the negative bioeffects of imaging studies utilising ionising radiation in paediatric populations. This applies especially to CT and nuclear medicine, in which the doses are higher than X-rays, and which are much more commonly performed than in fluoroscopy. As the authors point out, these considerations are highly relevant to the practice of sports medicine, as the patients are often young, and bony injuries are commonly investigated using CT and nuclear medicine. So how are clinicians to integrate data from these increasingly well-designed studies2 into recommendations that will still allow accurate and timely diagnosis of sports-related pathology? As a professor of musculoskeletal radiology, I share the following thoughts: 

There have been a number of studies that correctly point out the need …
Lysophosphatidylcholine, a component of atherogenic lipoproteins, induces mononuclear leukocyte adhesion molecules in cultured human and rabbit arterial endothelial cells.
Authors: N Kume, M I Cybulsky, M A Gimbrone
Journal: Journal of Clinical Investigation (1992)

Accumulation of monocyte-derived foam cells in focal areas of the arterial intima is one of the key events in early atherogenesis. We have examined the effect of lysophosphatidylcholine (lyso-PC; lysolecithin), a major phospholipid component of atherogenic lipoproteins, on the expression of adhesion molecules for monocytes, such as vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1), in cultured human and rabbit arterial endothelial cells. Cultured rabbit aortic endothelial cells treated with lyso-PC showed increased mRNA and cell surface expression of VCAM-1 and ICAM-1, which was associated with increased adhesion of monocytes and monocyte-like cells (THP-1, U937). In cultured human iliac artery endothelial cells, lyso-PC similarly induced both VCAM-1 and ICAM-1, whereas in umbilical vein endothelial cells only ICAM-1 was up-regulated. In all endothelial cells examined, the effect of lyso-PC on E-selectin (endothelial-leukocyte adhesion molecule-1) expression was negligible, thus differentiating this stimulus from other endothelial activators, such as interleukin 1, tumor necrosis factor, or lipopolysaccharide. We conclude that lyso-PC can selectively induce VCAM-1 and ICAM-1 in arterial endothelial cells and that this action, in addition to its monocyte chemoattractant activity, may play an important role in monocyte recruitment into atherosclerotic lesions.
Office spirometry: (Un)reliability of some handheld spirometers
Authors: Kevin De Soomer, Lutje Claus, Ria Heyndrickx, Wilfried De Backer, Ellie Oostveen
Journal: European Respiratory Journal (2013)

Spirometry is considered the gold standard to diagnose COPD and several handheld spirometers were introduced for use by general practitioners. We tested 13 commonly available handheld spirometers and compared their performance to a Jaeger Masterscreen PFT being considered the gold standard. Spirometry was performed according to ATS-ERS criteria and was recorded twice with handheld and Masterscreen (in random order) on 17 to 27 patients referred for routine spirometry testing. Bland-Altman analysis and comparison of FEV1/VC ratios were the main outcome variables. Results: Two devices overestimated FVC significantly and one device underestimated FVC and FEV1 (see Table). Only 5 out of 13 handheld spirometers measured all FEV1/VC ratios within 10% of those measured by the gold standard. We conclude that some handheld devices unreliably measure FEV1 and/or FVC resulting in a false positive detection of airway obstruction or a false negative result.
The Natural History of Febrile Seizures
Authors: D G Hirtz, K B Nelson
Journal: Annual Review of Medicine (1983)

Febrile seizures are a common occurrence in early childhood and most children who experience them do well. This article reviews the clinical characteristics of febrile seizures, and summarizes the relevant clinical and laboratory research. The natural history of febrile seizures, the recurrence rate, and frequency of later epilepsy or intellectual handicap is presented, and controversies in evaluation and treatment are discussed.
Peptic ulcer surgery: selection for operation by `earning'
Authors: W. P. Small, E. L. Cay, P. Dugard, W. Sircus, C. W. A. Falconer, A. N. Smith, J. P. A. McManus, J. Bruce
Journal: Gut (1969)

Two groups of patients with chronic peptic ulcer were studied to determine the influence of duration of symptoms and age at operation on the result of surgical treatment. Independent physical and psychiatric assessments were made. Statistical analysis of the findings indicates that selection for operation by ;earning' is unreliable in that it fails to identify that group of patients liable to do badly. In its place, a combined physical and psychiatric preoperative assessment of the peptic ulcer patient is recommended.
Spontaneous Tumors of the Thyroid Gland in Mice&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: E. Elizabeth Jones, Jane Parker, Sarah Deitrich
Journal: JNCI Journal of the National Cancer Institute (1966)

Nine spontaneous tumors of the thyroid gland in mice are reported: 2 in an inbred C3Hf strain and 7 in (C3H or C3Hf × 1) F1 hybrids. Seven tumors arose in females (1 parous, 1 incompletely ovariectomized, 5 ovariectomized) and 2 in intact males (1 bearing a transplanted pituitary tumor). Pituitary and adrenocortical tumors were present in all ovariectomized femalesJ a pituitary tumor was also in the intact untreated male. No thyrotrophic effects of one pituitary tumor could be demonstrated in 15 transplant generations. Three of the thyroid tumors were autonomous and were studied in serial transplantation. Two anaplastic tumors were nonfunctional; a microfollicular tumor was functional. The latent period of the secretory tumor (#64) was significantly shortened by thyroidectomy in both males and Females and significantly lengthened by thyroxine injections in males only. The pathologic effects of this tumor on the untreated host are described. Genetic Factors, hormonal imbalance, and age are discussed as contributory to the development of thyroid neoplasms.
Increasing incidence of contact allergy to the new preservative 1,2-dibromo-2,4-dicyanobutane (methyldibromoglutaronitrile)
Authors: C.J.W. GINKEL, G.J. RUNDERVOORT
Journal: British Journal of Dermatology (2010)

In 1991, only a low frequency (0.5%) of sensitization by the newly introduced preservative 1,2-dibromo-2,4-dicyanobutane (synonym: methyldibromoglutaronitrile; trade names: Euxyl K400, Merquat 2200, Tektamer 38) was encountered in the Netherlands. It has subsequently been increasingly used in our country as a preservative in moistened toilet tissues, and also in cosmetics such as body milk, lotions and creams. This prompted us to re-evaluate the frequency of sensitization. From January 1993 until July 1994, all consecutive patients attending for routine patch testing were also tested with 1,2-dibromo-2,4-dicyanobutane (0.1% petrolatum): one of 281 (0.3%), nine of 281 (3.2%) and six of 247 (2.4%) were found to be positive in the first and second halves of 1993 and the first half of 1994, respectively. In at least 12 of 16 patients this allergy was responsible for their presenting complaint (perianal and facial dermatitis). As 12 of 16 patients had intensively used moistened toilet tissues containing this preservative, this habit is presumably the cause of sensitization. Our data indicate that the frequency of sensitization is approaching that of allergy to methyl(chloro)isothiazolinone (Kathon CG; 1993: 2.3% in our hospital), a well-known allergen, which seems to have been partially replaced in cosmetics and toiletries by this new preservative.
New insights on the pathogenesis of biliary cirrhosis provided by studies in FXR knockout mice
Authors: Michel Fausther, Jonathan A. Dranoff
Journal: Journal of Hepatology (2011)

The nuclear bile acid receptor, farnesoid X receptor (FXR), may play a pivotal role in liver fibrosis. We tested the impact of genetic FXR ablation in four different mouse models. Hepatic fibrosis was induced in wild-type and FXR knock-out mice (FXR((-/-))) by CCl(4) intoxication, 3,5-diethoxycarbonyl-1,4-dihydrocollidine feeding, common bile duct ligation, or Schistosoma mansoni (S.m.)-infection. In addition, we determined nuclear receptor expression levels (FXR, pregnane X receptor (PXR), vitamin D receptor, constitutive androstane receptor (CAR), small heterodimer partner (SHP)) in mouse hepatic stellate cells (HSCs), portal myofibroblasts (MFBs), and human HSCs. Cell type-specific FXR protein expression was determined by immunohistochemistry in five mouse models and prototypic human fibrotic liver diseases. Expression of nuclear receptors was much lower in mouse and human HSCs/MFBs compared with total liver expression with the exception of vitamin D receptor. FXR protein was undetectable in mouse and human HSCs and MFBs. FXR loss had no effect in CCl(4)-intoxicated and S.m.-infected mice, but significantly decreased liver fibrosis of the biliary type (common bile duct ligation, 3,5-diethoxycarbonyl-1,4-dihydrocollidine). These data suggest that FXR loss significantly reduces fibrosis of the biliary type, but has no impact on non-cholestatic liver fibrosis. Since there is no FXR expression in HSCs and MFBs in liver fibrosis, our data indicate that these cells may not represent direct therapeutic targets for FXR ligands.
The effect of in vitro culture methods on corticosteroid sensitivity in COPD alveolar macrophages
Authors: Andrew Higham, Simon Lea, Karen Simpson, Dave Singh
Journal: European Respiratory Journal (2013)

Introduction 

The culture of COPD alveolar macrophages is used to investigate the effects of corticosteroids. The cell culture methods may influence the results obtained. The aim was to investigate the effect of culture time on the corticosteroid sensitivity of COPD alveolar macrophages.

Methods 

Alveolar macrophages were isolated from resected lung tissue; 10 COPD patients and 10 smokers were recruited. Two different culture methods were compared; (1) cells were rested for 1 hr prior to experiment, and (2) cells were rested overnight prior to experiment. The effect of dexamethasone on LPS-induced TNFα and CXCL8 release after a further 24 hrs culture was investigated. p38 MAPK activation and the effect of dexamethasone and birb-796 on TNFα and CXCL8 release from unstimulated cells was also measured.

Results 

The effect of dexamethasone on LPS-induced TNFα and CXCL8 was significantly reduced in method 1 in both COPD patients and controls (p<0.05).

The basal levels of activated p38 were higher in macrophages cultured using method 1. In addition, dexamethasone was less effective than birb-796 in reducing the basal release of TNFα in condition 1. The level of dexamethasone mediated inhibition reached 37% and 60% for COPD patients and controls respectively, whereas the level of birb-796 mediated inhibition reached 74% and 80% for COPD patients and controls respectively.

Discussion 

We have shown that variations in culture methods can alter the corticosteroid sensitivity of COPD alveolar macrophages in vitro . Activation of p38 MAPK occurs to a greater extent in cells used for culture soon after being extracted from the lungs and appears to contribute to corticosteroid insensitivity.
Inhibition of exercise-induced bronchospasm by zileuton: a 5-lipoxygenase inhibitor.
Authors: S S Meltzer, J D Hasday, J Cohn, E R Bleecker
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

Recent evidence suggests that leukotrienes may have a causative role in exercise-induced asthma. Twenty-four subjects with exercise-induced asthma received either 600 mg zileuton, a 5-lipoxygenase inhibitor, or a placebo four times daily for 2 d prior to exercise challenge (a total of nine doses). The last dose was administered in the laboratory 2 h before the exercise challenge. There was no bronchodilation after nine doses of the 5-lipoxygenase inhibitor (p=0.95). The administration of zileuton inhibited bronchospasm after exercise challenge by 40.75% as compared with placebo. Five minutes after the completion of exercise, the zileuton group's FEV1 was 85.76% of the preexercise value, compared with 73.92% of the preexercise value in the placebo group (p<0.01). The maximum percent change in baseline FEV1 after zileuton was a 15.58% decrement from the preexercise level, as compared with a 28.1% decrease after placebo (p<0.001). Five minutes after exercise, the FVC after zileuton was 92.76% of the preexercise value, as compared with 86.26% after placebo (p<0.05). This is the first study in which a 5-lipoxygenase inhibitor has been shown to attenuate exercise-induced asthma. These results suggest that leukotrienes are important biochemical mediators in the development of exercise-induced bronchospasm, and that leukotriene inhibit may have a role in the treatment of this disorder.
Impact of nurse practitioners on workload of general practitioners: randomised controlled trial
Authors: Miranda G H Laurant, Rosella P M G Hermens, Jozé C C Braspenning, Bonnie Sibbald, Richard P T M Grol
Journal: BMJ (2004)

To examine the impact on general practitioners' workload of adding nurse practitioners to the general practice team.Randomised controlled trial with measurements before and after the introduction of nurse practitioners.34 general practices in a southern region of the Netherlands.48 general practitioners.Five nurses were randomly allocated to general practitioners to undertake specific elements of care according to agreed guidelines. The control group received no nurse.Objective workload, derived from 28 day diaries, included the number of contacts per day for each of three conditions (chronic obstructive pulmonary disease or asthma, dementia, cancer), by type of consultation (in practice, telephone, home visit), and by time of day (surgery hours, out of hours). Subjective workload was measured by using a validated questionnaire. Outcomes were measured six months before and 18 months after the intervention.The number of contacts during surgery hours increased in the intervention group compared with the control group (P < 0.06), particularly for patients with chronic obstructive pulmonary disease or asthma (P < 0.01). The number of consultations out of hours declined slightly in the intervention group compared with the control group, but this difference did not reach significance. No significant changes became apparent in subjective workload.Adding nurse practitioners to general practice teams did not reduce the workload of general practitioners, at least in the short term. This implies that nurse practitioners are used as supplements, rather than substitutes, for care given by general practitioners.