tbuckley/cabot-search huggingface dataset:
Psoriasis: Psychosomatic Aspects
Authors: Jacob Shanon
Journal: Psychotherapy and Psychosomatics (1979)

On the basis of the findings of this study it could be concluded that the hereditary proneness alone is not sufficient to cause the breakout of psoriasis. Only when additional causes intervene, the disease breaks out. The importance of stress and emotional factors in causation and precipitation of the disease is discussed. The traumatic emotional experience and the aggravation of disease as result of improper approach of the society towards the patient's illness is reviewed. The impact of the disease on the treating doctor and the doctor-patient relationship is reported. Means of prevention of the breakout of the disease and the proper approach of the doctor in treating his patient is suggested and specified.
THE IMPACT OF WORSENING RENAL DYSFUNCTION ON THE COMPARATIVE EFFICACY OF BIVALIRUDIN AND PLATELET GLYCOPROTEIN IIBIIIA INHIBITORS: INSIGHTS FROM BLUE CROSS BLUE SHIELD OF MICHIGAN CARDIOVASCULAR CONSORTIUM (BMC2)
Authors: Emily Perdoncin, Min Zhang, Arthur Riba, Thomas LaLonde, Cindy Grines, David Share, Hitinder Gurm
Journal: Journal of the American College of Cardiology (2013)
Emotional Aspects of Estrogen Therapy in Men with Coronary Atherosclerosis
Authors: Benjamin M. Kaplan, Jerome Grunes
Journal: JAMA (1963)

A study was carried out on a group of men under the age of 50 who had suffered myocardial infarction and who were receiving estrogens. The primary purpose was to determine whether long-term estrogen therapy with associated feminization would adversely affect the psyche of these men, hence outweighing the physiological benefits of the drug. The findings indicate that long-term estrogen therapy was tolerated in most patients with regard to the emotional aspects. The stress of the coronary disease was greater than the stress of feminization. There were no significant psychiatric or emotional disturbances attributed to estrogens. The gravity of the coronary disease, role of group psychotherapy, and special interest evinced by the cardiologists were the important motivating factors in the patients who remained throughout the study.
Simvastatin shows promise in treating progressive multiple sclerosis, study finds
Authors: Z. Kmietowicz
Journal: BMJ (2014)

High doses of the cholesterol lowering drug simvastatin over two years led to reduced brain shrinkage in people with secondary progressive multiple sclerosis when compared with placebo, a study has found, and the researchers have called for trials to investigate the drug’s effect on disability.

Ten years ago clinical studies of 80 mg simvastatin in people with early multiple sclerosis showed significant reductions in brain lesions, but more recent studies of simvastatin and atorvastatin have produced mixed results.

To investigate the potential of simvastatin in treating multiple sclerosis, researchers from University College London Hospitals and University College London randomly assigned …
Coronary Heart Disease Incidence in NIDDM Patients In The Helsinki Heart Study
Authors: Pekka Koskinen, Matti Mänttäri, Vesa Manninen, Jussi K Huttunen, Olli P Heinonen, M Heikki Frick
Journal: Diabetes Care (1992)

Objective To determine coronary heart disease (CHD) incidence among dyslipidemic subjects with non-insulin-dependent diabetes mellitus (NIDDM) and to assess the effect of lipid-modifying treatment on serum and lipoprotein lipids and the CHD incidence in these patients. Research Design and Methods Of the 4081 men participating in the Helsinki Heart Study, a coronary primary prevention trial with gemfibrozil in middle-aged men with high non-high-density lipoprotein (HDL) cholesterol (&amp;gt; 5.2 mM; 200 mg/dL), 135 had NIDDM at entry. The incidence of definite myocardial infarction and cardiac death and changes in serum and lipoprotein lipids were determined during the 5-yr trial in the NIDDM patients and compared with those observed in nondiabetic trial participants. Results Compared with nondiabetic subjects, NIDDM patients had lower HDL cholesterol (P &amp;lt; 0.001), higher triglyceride concentration (P &amp;lt; 0.0001), and greater body mass index (P &amp;lt; 0.001), there were more hypertensive patients (P &amp;lt; 0.001) among them. The incidence of myocardial infarction and cardiac death was significantly higher among diabetic than nondiabetic participants (7.4 vs. 3.3%, respectively, P &amp;lt; 0.02). CHD incidence in the gemfibrozil-treated diabetic men (n = 59) was 3.4% compared with 10.5% in the placebo group (NS). In multivariate analysis, diabetes (P &amp;lt; 0.05), age (P &amp;lt; 0.0001), smoking (P &amp;lt; 0.0001), low HDL cholesterol (P &amp;lt; 0.05), and high low-density lipoprotein cholesterol (P &amp;lt; 0.005) were independently related to CHD incidence. Gemfibrozil-induced serum and lipoprotein lipid changes in diabetic patients were similar to those observed in nondiabetic subjects. Conclusions Compared with similarly dyslipidemic nondiabetic subjects, patients with NIDDM are at markedly increased risk of CHD. This elevated risk can be somewhat reduced by gemfibrozil.
Transferrin and Its Receptor: Their Roles in Cell Function
Authors: Adrian B. Bomford, Hamish N. Munro
Journal: Hepatology (1985)

Transferrin, its receptor and the entry of iron into the cell have sprung into prominence because of recent evidence that proliferation of various cell types involves regulation of this sequence of events, as evidenced especially by changes in receptor number. A third component functionally linked to transferrin and its receptor is the intracellular iron-storage protein, ferritin, which ensures against toxic levels of free ferrous iron, which might otherwise cause peroxidative damage to cell membranes and other cell structures (1). In this article, we shall focus on interactions between these three proteins of iron exchange, their roles in homeostasis and especially their role in relation to the liver which is a major organ of iron storage.
Patients' sense of completion
Authors: R Morrison
Journal: BMJ (1994)

Once upon a time when people gave up the ghost that was it. Now they are at serious risk from the enthusiastic bystander keen to pummel the ghost back into the body. If you want to die choose your place of departure with care. Even castaways will soon find life support machines already installed with resuscitation officers on call to parachute in. This is great if it is what you want but not if you do not.

Resuscitation is the prolongation of life at its most dramatic. Hippocrates would have cheered. Or would he? I have observed a more subtle version of the Hippocratic tradition that is far more worrying. This is to be seen in wards where the elderly are being cared for. From antibiotics to tube feeding, the professionals have an armamentarium of treatments to keep the very old and infirm alive a few days longer. Fair enough, if this is what the patient wants. But how often are the doctors right in their judgment of what the patient wants? How often are they swayed by thoughts of dissatisfied relatives or predatory lawyers? Their Hippocratic oath states that a doctor should do no harm …
P118 Abrams-Needle Pleural Biopsy Remains a Useful Investigation in Suspected Pleural Tuberculosis
Authors: JP Brown, WM Ricketts, GH Bothamley
Journal: Thorax (2012)

Current British Thoracic Society guidelines suggest that Abrams needle biopsy is only useful in areas of high incidence of tuberculosis and suggest that thoracoscopic pleural biopsy or image guided cutting-needle biopsies may be preferable.[1] A recent study suggested that the low yield of culture of pleural fluid may have improved with advancing culture techniques, perhaps reducing any advantage of pleural biopsy.[2] We therefore sought to establish whether or not Abrams-needle pleural biopsies contribute to the diagnosis of pleural tuberculosis in an urban UK setting with an annual incidence of tuberculosis between 60 and 125/100,000. <h3>Methods</h3> We reviewed all cases treated for pleural tuberculosis in two inner-city hospitals between 2006 and 2011. The yield of culture of pleural fluid was determined, and for those who underwent a pleural biopsy the yield from culture or typical histological changes was determined. <h3>Results</h3> We identified 150 patients with pleural tuberculosis since 2006. In our series, a positive culture from pleural fluid was achieved in 45 of 148 where pleural fluid was send without biopsy at the same procedure (30%; upper 95% confidence interval 39% using Wilson’s procedure with continuity correction). 44 patients underwent a pleural biopsy, of which 28 had positive histology or culture (63%; 95% confidence interval 48%-76%). The difference in sensitivity of these tests was statistically significant (p = 0.0002). <h3>Conclusion</h3> The management of a unilateral pleural effusion where tuberculosis is a likely diagnosis poses a clinical dilemma. Empirical treatment for tuberculosis risks the mismanagement of drug-resistant disease or missing alternative diagnoses, and yet thorascopic pleural biopsy is an invasive procedure with significant potential complications. Our data suggest that the yield from culture of pleural fluid alone remains poor and there remains a place for the Abrams-needle biopsy in these circumstances. Investigation of a unilateral pleural effusion in adults – British Thoracic Society Pleural Disease Guideline 2010 Clare Hooper, YC Gary Lee, Nick Maskell <i>Thorax</i>, Vol 65, Suppl 2. Ruan SY <i>et al.</i> Revisiting tuberculous pleurisy: pleural fluid characteristics and diagnostic yield of mycobacterial culture in an endemic area. <i>Thorax</i>. 2012 Mar 21
THE UNIFORM SUCCESS OF SEGREGATION MEASURES IN ERADICATING KALA-AZAR FROM ASSAM TEA GARDENS: ITS BEARING ON THE PROBABLE MODE OF INFECTION
Authors: J. D. Price, L. Rogers
Journal: BMJ (1914)

ITN 1906-7 we investigatecl togethier the problem epidemiology of kala-azar on tea gardens in the Nowgong district of Assam under very favourable conditions for obtaining accturate data.Previous to that tirie Price had for several years wvatched tlhe insidious of the coolie lines of the tea estates from tlhe bouring villages by the terrible epidemic of lala-azar lwhich w%as tlhen sweeping through tlle Nowgolna district in a wave of suich relentless severity that it caused actual decrease of nio less than 31.5 per cent.the population dtring the decade 1891-1901, against increase of 16.3 per cent. in the uinaffected Lakllinpur (listrict.As a result of a sad experience lhe had comiie to the concltusion that the disease was certainly comi- ll-unicable, ald lilad consequlently arranged early in for niew lines to be built for a number of freshly inlported coolics arriving on tlle Rangamati tea estate.Rogers coliimenced hlis investigations in the Nowgong district April, 1896, and as the result of detailed inquiiries he ilndependently arrived at the conclusion tlhat tlle infection w-as a louse one, as fully recorded in his original report 1897 and inFcrcrs in the Tropics.On investigatinig togetlher, in 1897, the effects of bringilina ito use thenewv hies atlRangamati, we fouind tllatl1o ease of kala-azar liad occurred among 150 coolies whlolhad then resided there for-two years.Yet out of 50 coolies tlhe same batchl wiho had been living in the old infected Iiiies, for wanit of rooinl in tlhe newoiies, no fewer tliaii 16 per cenit.were already dead ofliala-azar, whlie others we-cre su4ffering fromt tile disesee, and that in spite tlhe fact that tle new lines were~sitnated only 300 yards from tloe old ones.lt was tllereforedeccided to carry out a furtlher experiiieilt, suggested by Rogers, to ascertaini if the disease cotuld be stamped otut of already infected coolie lines Illoving out alltille iealtily persons intO newly built andI segregating tile remaininga infected families.was tllenimpossible to diagnosetloe disease in its early stages from ordinary mualarial fever (kala-azar beiug
High Frequency of <i>LMAN1</i> Abnormalities in Colorectal Tumors with Microsatellite Instability
Authors: Nina Roeckel, Stefan M. Woerner, Matthias Kloor, Yan-Ping Yuan, Georgios Patsos, Roland Gromes, Juergen Kopitz, Johannes Gebert
Journal: Cancer Research (2008)

Abstract Glycosyl epitopes have been identified as tumor-specific markers in colorectal tumors and various lines of evidence indicate the significance of altered synthesis, transport, and secretion of glycoproteins in tumorigenesis. However, aberrant glycosylation has been largely ignored in microsatellite unstable (MSI-H) colorectal tumors. Therefore, we analyzed mutation frequencies of genes of the cellular glycosylation machinery in MSI-H tumors, focusing on frameshift mutations in coding MNRs (cMNRs). Among 28 candidate genes, LMAN1/ERGIC53, a mannose-specific lectin mediating endoplasmatic reticulum (ER)-to-Golgi transit of glycosylated proteins, showed high mutation frequency in MSI-H colorectal cancer cell lines (52%; 12 of 23), carcinomas (45%; 72 of 161), and adenomas (40%; 8 of 20). Biallelic mutations were observed in 17% (4 of 23) of MSI-H colorectal cancer cell lines. LMAN1 was found to be transcribed but truncated protein remained undetectable in these LMAN1-mutant cell lines. Immunohistochemical and molecular analysis of LMAN1-mutated carcinomas and adenomas revealed regional loss of LMAN1 expression due to biallelic LMAN1 cMNR frameshift mutations. In LMAN1-deficient colorectal cancer cell lines, secretion of the LMAN1 client protein α-1-antitrypsin (A1AT), an inhibitor of angiogenesis and tumor growth, was significantly impaired but could be restored upon LMAN1 re-expression. These results suggest that LMAN1 mutational inactivation is a frequent and early event potentially contributing to MSI-H tumorigenesis. [Cancer Res 2009;69(1):292–9]
Autopsies using MRIs in babies and infants could help improve uptake rates
Authors: Z. Kmietowicz
Journal: BMJ (2013)

A large study has found that postmortem examinations in fetuses and infants up to 12 months using a combination of magnetic resonance imaging (MRI) and blood tests are as accurate as conventional methods.

MRI of an adult volunteer showing examples of the structures visible through imaging

The authors believe that the results provide sufficient evidence for minimally invasive autopsies to be offered routinely to parents whose babies have died, and that this could help to improve autopsy rates that have been falling for the past 40 years.

The use of postmortem examinations using MRI scans is currently restricted to only a handful of centres worldwide. Small scale studies have been reporting for more than a decade, but the accuracy of the method is uncertain. 

Researchers from University College London and Great Ormond …
Endothelial-dependent relaxation induced by leukotrienes C4, D4, and E4 in isolated canine arteries.
Authors: R J Secrest, B M Chapnick
Journal: Circulation Research (1988)

Leukotriene D4 has been shown to possess the capacity to relax canine superior mesenteric and renal arterial rings in an endothelial-dependent manner. The present study was designed to determine if the remaining peptidoleukotrienes, leukotrienes C4 and E4, share this property. In addition, influences of atropine and of inhibitors of cyclooxygenase and lipoxygenase activities on relaxation produced by leukotriene D4 and acetylcholine were determined to characterize further leukotriene D4-induced relaxation and to compare these properties with those of acetylcholine. Vasomotor tone was measured with isometric force transducers. Following induction of tone with norepinephrine, leukotriene C4 and acetylcholine produced concentration-dependent relaxation of renal and superior mesenteric arterial rings in which the endothelium was intact. Only minimal decreases in tone were produced in response to leukotriene E4. Neither acetylcholine nor leukotriene C4 altered tone after endothelium had been intentionally disrupted. Nitroglycerin relaxed rings both before and after rubbing the endothelium. These results demonstrate that, similar to leukotriene D4, leukotriene C4 possesses the capacity to produce endothelial-dependent relaxation in canine renal and superior mesenteric arteries. Relaxation of the superior mesenteric artery produced in response to acetylcholine, but not leukotriene D4, was inhibited in presence of atropine. Incubation of the rings with meclofenamate had no effect on relaxation induced by either acetylcholine or leukotriene D4. Thus, it appears that endothelial-dependent relaxation induced by leukotriene D4 is neither dependent on muscarinic receptor activation nor related to generation of cyclooxygenase metabolites of arachidonic acid. In contrast, 5,8,11,14-eicosatetraynoic acid and nordihydroguaiaretic acid attenuated relaxation in response to leukotriene D4 and acetylcholine, suggesting that lipoxygenase-derived products may participate in leukotriene D4-induced as well as acetylcholine-induced relaxation.
Management of Herpes Simplex Infections of the Skin
Authors: Edgar B. Smith
Journal: JAMA (1976)

MANY REMEDIES, folk, over-the-counter, and prescribed, are recommended for treatment of cold sores and fever blisters. This immediately suggests two possibilities: either everything is effective in the management of the troublesome skin lesions of herpes simplex infection, or no treatment is really very effective. A brief review of the course and pathogenesis of herpetic infections will explain why both of these possibilities may be true and will give insight into the problems confronting both patient and physician. There are two variants of herpes simplex virus that affect man—type 1, which is most commonly isolated from facial lesions, and type 2, which normally causes herpes infections of the genitalia. Other than the differences in location and the earlier appearance of clinical and serological evidence of infection with herpesvirus type 1, the course of the disease caused by the two variants is quite similar. Most persons contract infection with herpesvirus type 1
Hepatitis C virus induces interferon-λ and interferon-stimulated genes in primary liver cultures
Authors: Svetlana Marukian, Linda Andrus, Timothy P. Sheahan, Christopher T. Jones, Edgar D. Charles, Alexander Ploss, Charles M. Rice, Lynn B. Dustin
Journal: Hepatology (2010)

Hepatitis C virus (HCV) replication in primary liver cells is less robust than that in hepatoma cell lines, suggesting that innate antiviral mechanisms in primary cells may limit HCV replication or spread. Here we analyzed the expression of 47 genes associated with interferon (IFN) induction and signaling following HCV infection of primary human fetal liver cell (HFLC) cultures from 18 different donors. We report that cell culture-produced HCV (HCVcc) induced expression of Type III (λ) IFNs and of IFN-stimulated genes (ISGs). Little expression of Type I IFNs was detected. Levels of IFNλ and ISG induction varied among donors and, often, between adapted and nonadapted HCV chimeric constructs. Higher levels of viral replication were associated with greater induction of ISGs and of λ IFNs. Gene induction was dependent on HCV replication, as ultraviolet light-inactivated virus was not stimulatory and an antiviral drug, 2'-C-methyladenosine, reduced induction of λ IFNs and ISGs. The level of IFNλ protein induced was sufficient to inhibit HCVcc infection of naïve cultures. Together, these results indicate that despite its reported abilities to blunt the induction of an IFN response, HCV infection is capable of inducing antiviral cytokines and pathways in primary liver cell cultures. Induction of ISGs and λ IFNs may limit the growth and spread of HCV in primary cell cultures and in the infected liver. HCV infection of HFLC may provide a useful model for the study of gene induction by HCV in vivo.
Teng Chia-Tung
Authors: Geoffrey Dean
Journal: BMJ (2005)

Former chief physician and professor of medicine Peking University Medical College, China (b 1906; q Beijing 1933), d 22 May 2004.​2004.




Figure 1




Professor Teng Chia-Tung, known as CT to his close English speaking friends, came from a farming family in a poor mountainous district of southern China. He won a scholarship to study medicine at the American supported Peking University Medical College (PUMC). In 1939 he was awarded a research fellowship at the Thorndyke Memorial Laboratory in Boston, United States. During the second world war PUMC was closed and it was difficult to obtain enough food in Beijing to keep alive. When it was reopened in 1948, CT became chief physician and later professor of medicine. He wrote The Theory of Clinical Haematology, which became the standard textbook on haematology for doctors in China and was translated into English and several other languages. During the cultural revolution when the young students in China deprived many senior doctors of their posts CT was forbidden to undertake any professional work and was allowed only to undertake menial activities. He was not reinstated in the medical school until the death of Chairman Mao and the end of the cultural revolution. His wife, Professor Yao Yun Wang, predeceased him. They had four children and seven grandchildren.
Are Pay-for-Performance Programs a Threat to Medical Professionalism?
Authors: Richard L. Neubauer, Lois Snyder
Journal: Annals of Internal Medicine (2008)

Letters15 April 2008Are Pay-for-Performance Programs a Threat to Medical Professionalism?Richard L. Neubauer, MD and Lois Snyder, JDRichard L. Neubauer, MDFrom Alaska Native Medical Center, Anchorage, AK 99508, and American College of Physicians, Philadelphia, PA 19106.Search for more papers by this author and Lois Snyder, JDFrom Alaska Native Medical Center, Anchorage, AK 99508, and American College of Physicians, Philadelphia, PA 19106.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-148-8-200804150-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate Dr. Metoyer's thoughtful comments, many of which the American College of Physicians Ethics, Professionalism, and Human Rights Committee agree with in the College's pay-for-performance position paper. We do not agree, however, with her conclusion that, in some regards, pay-for-performance programs are inherently unethical. Every payment system creates incentives and potential conflicts of interest, such as the incentives in fee-for-service payment to increase care or the incentives under capitation to do less rather than more. The College believes pay-for-performance programs have promise if they can be focused on patient perspectives on care and professionalism, including the duty ...References1. Ethics and Human Rights Committee, American College of Physicians. Ethics manual: fifth edition. Ann Intern Med. 2005;142:560-82. [PMID: 15809467] LinkGoogle Scholar2. Rosenthal MB, Landon BE, Normand SL, Frank RG, Ahmad TS, Epstein AM. Employers' use of value-based purchasing strategies. JAMA. 2007;298:2281-8. [PMID: 18029832] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Alaska Native Medical Center, Anchorage, AK 99508, and American College of Physicians, Philadelphia, PA 19106.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPay-for-Performance Principles That Promote Patient-Centered Care: An Ethics Manifesto Lois Snyder , Richard L. Neubauer , and Are Pay-for-Performance Programs a Threat to Medical Professionalism? Paulette Metoyer Are Pay-for-Performance Programs a Threat to Medical Professionalism? Christopher M. Lowther Are Pay-for-Performance Programs a Threat to Medical Professionalism? Howard Brody Metrics 15 April 2008Volume 148, Issue 8Page: 630-631KeywordsConflicts of interestHealth care qualityMedical ethicsMedicareMotivationPatients ePublished: 15 April 2008 Issue Published: 15 April 2008 CopyrightCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...