tbuckley/cabot-search huggingface dataset:
Clinical Course and Corticosteroid Excretion of Patients with Rheumatoid Arthritis During Long-term Treatment with Corticotropin
Authors: O. Savage, P. Davis, L. Chapman, A. J. Popert, J. D. Robertson, W. S. C. Copeman
Journal: BMJ (1957)

1954, 1955) and by the Empire Rheumatism Council (1955, 1957) that the average case of rheuma- toid arthritis fares as well with aspirin as with cortisone.However, there are certain cases which remain active in spite of treatment with rest in hospital and salicylates or gold, and some of these we have treated with cortico- steroids, a number of them continuously for six years.In the early days we gave oral cortisone for preference, but owing to the shortage of supplies we sometimes used corticotropin (A.C.T.H.) as an alternative.When reporting to the Medical Research Council three years ago we found that we had then treated 50 cases with cor- tisone, and in only two had we been able to stop the drug on account of a remission; whereas of 42 who had received corticotropin we had been able to withdraw the drug in 12.Treatment with cortisone, its newer analogues pred- nisone and prednisolone, or corticotropin is not in- frequently associated with serious side-effects.The suggestion, therefore, that clinical remission occurred in more cases treated with corticotropin than with corti- sone indicated that further observations might give valu- able information, though the disadvantages of daily in- jection had to be accepted.Since the original report of Hench, Kendall, Slocumb, and Polley (1949) on the clinical effects of cortisone and corticotropin, efforts have been made to discover methods of measuring adrenocortical activity.In 1950 Porter and Silber reported studies on urinary steroids, whilst in 1955 Appleby, Gibson, Norymberski, and Stubbs published a method of estimating total 17- hydroxycorticosteroids (17-(OH)CS) in urine which could be carried out as a routine laboratory procedure.Since this method is a measure of glucocorticoid metabolism it
No One an Island: The Geography of the Whole Patient
Authors: Jodi Elgart Paik
Journal: JAMA (2000)

IT HAS BECOME COMMONPLACE TO BEMOAN THE PASSING OF THE OLDfashioned good family doctor. There is widespread concern about the lack of attention paid to the art of medicine for, despite the evolution of scientific medicine, the human heart remains the same. Thus, there is a heightened awareness of the need for physicians to address not only the biological but also the psychological, social, and cultural factors that contribute to the development and continuation of disease. Is the growing attention paid to psychosocial issues a worthwhile endeavor, or is it, as some have argued, too much for one physician to undertake in these days of 15-minute office visits? In this issue, David Sobel gives us an answer, describing how attention to the whole patient not only yields better outcomes, but is also cost-effective. Most medical students are well-versed in pathology, but their familiarity with life on the other side of the stethoscope often lags behind their scientific knowledge. Beyond cell counts and viral loads, what does it mean to be the person with the illness? Jane van Dis, whose stark photographs of South Dakota grace the cover of this issue, introduces us to a woman who is living with the human immunodeficiency virus in this remote locale. More than two thirds of US citizens belong to a church or synagogue, and even more incorporate some spiritual practice into their lives. Yet the medical literature has only recently begun to include spiritual practices in its assessment of psychosocial issues. What is a physician’s role in this arena? Harold G. Koenig offers some practical suggestions for how physicians might integrate what they know about their patients’ religious beliefs into the effective practice of medicine. Managing patients with chronic disease is the single largest source of cost for the health care system, but despite its prevalence chronic disease often receives little attention in the medical classroom. How can tomorrow’s physicians learn to share in the partnership that such patients will need? The answer, according to Martha Funnell and Robert Anderson, involves a change of perspective. Their work suggests an example of how addressing the psychosocial issues of patient care makes for better, more effective medicine. Reflecting on his own experience as a patient, essayist Anatole Broyard observed, “Not every patient can be saved, but his illness may be eased by the way the doctor responds to him—and in responding to him, the doctor may save himself.” As they continue their training, medical students would be well advised to remember that treating a disease and caring for a patient are not necessarily the same activity.
The secret technical defence: a case for changing the law
Authors: D J Gee, M A Green
Journal: BMJ (1982)

irresponsible journalists, not medical scientists, who cry "Wolf."Rubella, thalidomide, and alcohol were identified as teratogens by alert clinicians who shared their concerns with their professional colleagues through the medium of professional journals.If the relevance of rubella and alcohol to fetal health had received a fraction of the footage devoted to Debendox there would be fewer handicapped children.
Regression of High-Grade Gastric B-Cell Lymphoma After Eradication of Helicobacter Pylori
Authors: S. Gretschel, M. Hünerbein, H. D. Foss, M. Krause, P. M. Schlag
Journal: Endoscopy (2001)

Regression of high-grade gastric B-cell lymphoma after eradication of Helicobacter pylori with antibiotic therapy has recently been shown in a very small number of patients. We describe here a patient with a 5-cm polypoid gastric lymphoma, who received a 7-day course of triple therapy when the histopathology was unknown. A second endoscopic examination 4 weeks later showed partial tumor regression without biopsy evidence of malignancy. Endoscopic mucosectomy was performed 8 weeks after the initial diagnosis. Again, in the histological analysis of the specimen, no evidence of B-cell lymphoma could be found. To confirm that the original biopsies were from the same patient, DNA analyses were carried out which gave identical results. This case suggests that a subgroup of primary gastric B-cell lymphomas responds to eradication of H. pylori with antibiotic therapy.
891. Correction of Established Neurologic Disease and Evidences of In Vivo Cross Correction in the Mouse Model of Metachromatic Leukodystrophy
Authors: Alessandra Biffi, Alessia Capotondo, Stefania Fasano, Ubaldo del Carro, Sergio Marchesini, Hisaya Azuma, Riccardo Brambilla, Markus Grompe, Claudio Bordignon, Angelo Quattrini, Luigi Naldini
Journal: Molecular Therapy (2006)

Metachromatic Leukodystrophy (MLD) is a demyelinating lysosomal storage disorder with an urgent medical need. We previously showed that transplantation of lentiviral vector- transduced Hematopoietic Stem Cells (HSC) targets therapeutic genes to the CNS and PNS and prevents functional and pathological manifestations of MLD in the mouse model, when applied at early pre-symptomatic stage (Biffi A. et al., JCI 2004). We now report that the HSC-based approach can also correct already established neurologic functional deficits and neuronal damage when applied to symptomatic animals. These new data, considering the poor or null outcome of hematopoietic stem cell transplant on symptomatic patients, provide a strong rationale for testing gene therapy in MLD patients. To this regard, we showed that the degree of efficacy of gene therapy is dependent on the levels of enzyme activity in HSC and in target organs, thus strengthening the concept that the major advantage of gene therapy might be related to the possibility to express the functional enzyme largely above normal donor's levels in HSC and in their progeny. As far as the mechanism of disease correction and the biodistribution of the functional enzyme are concerned, we demonstrated the role of gene corrected, ARSA over- expressing microglia as unique and efficacious source of bioavailable enzyme in the brain. Further, we provided a long-sought proof of the direct in vivo occurrence of active enzyme secretion by HSC- derived microglia and of enzyme transfer to other neural and non- neural cells in the brain. Interestingly, by establishing a sustained hepatic source of ARSA in chimeric mice harboring ARSA over- expressing hepatocytes from transgenic donors, we failed to deliver the enzyme to the CNS. These new findings highlight the role of microglia as exclusive source of bioavailable enzyme to the brain, and most importantly challenge the potential efficacy of newly developed enzyme replacement strategies for CNS targeting in lysosomal disorders. Finally, the detection of ARSA in the peripheral nervous system of treated mice underlines, together with correction of PNS neurophysiological and histopathological abnormalities, underlines the relevance of this approach in targeting not only the CNS, but also the widespread distributed PNS network, whose involvement is critical for patient's prognosis.
Inadequate sanitation in Kenyan slums threatens women's health and security
Authors: P. Moszynski
Journal: BMJ (2010)

Women and girls in Nairobi’s slums are living under the constant threat of sexual violence, which often leaves them too scared to leave their houses to use communal toilet and bathroom facilities and puts their health in danger, says a new report by Amnesty International.

The failure to incorporate the slums in urban plans and budgets has resulted in poor access to services like sanitation with the result that “women in Nairobi’s settlements become prisoners in their own homes at night,” said Godfrey Odongo, Amnesty’s East Africa researcher.

He added, “They [women] need more privacy than men when going to the toilet or taking a bath and the inaccessibility of facilities …
Reducing errors in the accident and emergency department: using radiographers
Authors: L. Berman
Journal: BMJ (1985)

<h3>Abstract</h3> Respiration can induce motion and CO<sub>2</sub> fluctuation during resting-state fMRI (rsfMRI) scans, which will lead to non-neural artifacts in the rsfMRI signal. In the meantime, as a crucial physiologic process, respiration that can directly drive neural activity change in the brain, and may thereby modulate the rsfMRI signal. Nonetheless, this potential neural component in the respiration-fMRI relationship is largely unexplored. To elucidate this issue, here we simultaneously recorded the electrophysiology, rsfMRI and respiration signals in rats. Our data show that respiration is indeed associated with neural activity changes, evidenced by a phase-locking relationship between slow respiration variations and the gamma-band power of the electrophysiologic signal recorded in the anterior cingulate cortex. Intriguingly, slow respiration variations are also linked to a characteristic rsfMRI network, which is mediated by gamma-band neural activity. In addition, this respiration-related brain network disappears when brain-wide neural activity is silenced at an iso-electrical state, while the respiration is maintained, further confirming the necessary role of neural activity. Taken together, this study identifies a respiration-related brain network underpinned by neural activity, which represents a novel component in the respiration-rsfMRI relationship that is distinct from respiration-related rsfMRI artifacts. It opens a new avenue for investigating the interactions between respiration, neural activity and resting-state brain networks in both healthy and diseased conditions.
Remarks on Ophthalmic Therapeutics and the Treatment of the Commoner Diseases of the Eye
Authors: T. Jones
Journal: BMJ (1877)

Cremer's pomade: an ointment composed, like Pagenstecher's, of precipitated yellow oxide of mercury, and preserved for use in compressible tin tubes furnished with cannulm.throusrh which the ointment c-3n he re-adilv sanueezed between the lids.
Pleuropericardial Reaction to Treatment With Dantrolene
Authors: Mitchell L. Petusevsky
Journal: JAMA (1979)

Chronic pleural effusion occurred in three patients, one of whom also developed acute pericarditis. A fourth patient developed both pleural and pericardial effusions. All patients had been receiving dantrolene sodium for at least two months. The pleural fluid was a sterile exudate with pleural and peripheral blood eosinophilia in all patients. No pulmonary parenchymal involvement was apparent. Pleural biopsy specimens showed nonspecific inflammation. Resolution of the pleural process was prolonged after dantrolene therapy was discontinued. Although a causal relationship between dantrolene and serosal inflammation remains unproved, this association in four patients warrants careful observation of others receiving long-term dantrolene therapy. (<i>JAMA</i>242:2772-2774, 1979)
Smad2 and Smad3 Phosphorylated at Both Linker and COOH-Terminal Regions Transmit Malignant TGF-β Signal in Later Stages of Human Colorectal Cancer
Authors: Koichi Matsuzaki, Chiaki Kitano, Miki Murata, Go Sekimoto, Katsunori Yoshida, Yoshiko Uemura, Toshihito Seki, Shigeru Taketani, Jun-ichi Fujisawa, Kazuichi Okazaki
Journal: Cancer Research (2009)

Abstract Transforming growth factor (TGF)-β initially inhibits growth of mature epithelial cells. Later, however, autocrine TGF-β signaling acts in concert with the Ras pathway to induce a proliferative and invasive phenotype. TGF-β activates not only TGF-β type I receptor (TβRI) but also Ras-associated kinases, which differentially phosphorylate the mediators Smad2 and Smad3 to create distinct phosphorylated forms: COOH-terminally phosphorylated Smad2/3 (pSmad2C and pSmad3C) and both linker and COOH-terminally phosphorylated Smad2/3 (pSmad2L/C and pSmad3L/C). In this study, we investigated actions of pSmad2L/C and pSmad3L/C in cancer progression. TGF-β inhibited cell growth by down-regulating c-Myc oncoprotein through the pSmad2C and pSmad3C pathway; TGF-β signaling, in turn, enhanced cell growth by up-regulating c-Myc through the cyclin-dependent kinase (CDK) 4–dependent pSmad2L/C and pSmad3L/C pathways in cell nuclei. Alternatively, TβRI and c-Jun NH2-terminal kinase (JNK) together created cytoplasmic pSmad2L/C, which entered the nucleus and stimulated cell invasion, partly by up-regulating matrix metalloproteinase-9. In 20 clinical samples, pSmad2L/C and pSmad3L/C showed nuclear localization at invasion fronts of all TGF-β–producing human metastatic colorectal cancers. In vitro kinase assay confirmed that nuclear CDK4 and cytoplasmic JNK obtained from the tumor tissue could phosphorylate Smad2 or Smad3 at their linker regions. We suggest that CDK4, together with JNK, alters tumor-suppressive TGF-β signaling to malignant characteristics in later stages of human colorectal cancer. The linker phosphorylation of Smad2 and Smad3 may represent a target for intervention in human metastatic cancer. [Cancer Res 2009;69(13):5321–30]
A Convenient Test for Color Blindness.
Authors: Geo. F. Keiper
Journal: JAMA (1895)

La Fayette, Ind., Oct. 14, 1895. <h3>To the Editor:</h3> —Being called upon frequently to make color tests for railroad employes, I have been using a method which Dr. Carrow of Ann Arbor gave us in a course on ophthalmology. Whether it has been published or not, I can not say. If it has, this will emphasize its importance and convenience, and if not, will describe it for the first time. The skeins of wool have been abandoned as consuming too much time and occupying too much space. The test consists of a sample card of Corticelli embroidery silk. On the folding card are 269 colors all named. Over the names must be pasted blank paper to hide them. These colors may now be numbered consecutively. In testing, we direct the patient's attention to one of the colors; blue, green or red. We will take, for example, blue, and ask him
Moses Montefiore on Thomas Hodgkin
Authors: Benjamin Lieberman
Journal: JAMA (1966)

To the Editor:—  Dr. William Bean pays due homage to the memory of Dr. Thomas Hodgkin on the centenary of his death ( JAMA  196 :299, 1966; Arch Intern Med  177 :145, 1966).  I recently discovered an equally deserved tribute by his devoted friend and grateful patient, Sir Moses Montefiore, who was his travel companion to the Orient when Dr. Hodgkin died. This appears in Diaries of Sir Moses and Lady Montefiore edited by Dr. L. Loewe and published in Chicago in 1890. In volume 2, page 173, Sir Moses writes as follows:  While at Jaffa I had frequently expressed my strong desire either to remain there with my lamented friend, to take him with me to Jerusalem, or to relinquish my journey thither, and return with him to Europe; but all my friends assured me that it would be most imprudent for Dr. Hodgkin to travel at that time, and
EFFECT OF ALTERING PEPTIDE TO INDIUM RATIOS ON SPECIFIC BINDING OF 111IN-PENTETREOTIDE
Authors: C. T. Anthony, S. H. Hughey, G. J. Drouant, J. A. Fuselier, T. Maloney, E. A. Woltering
Journal: Clinical Nuclear Medicine (1999)

Scientific Abstracts And Posters From The 44Th Annual Meeting Of The Southwestern Chapter Of The Society Of Nuclear Medicine, And From The 12Th Northeastern Regional Scientific Meeting Of The New England And New York Chapters Of The Society Of Nuclear Medicine
Genital Herpes Infections in Private Practice in the United States, 1966 to 1981
Authors: Thomas M. Becker
Journal: JAMA (1985)

We analyzed data on genital herpes infections in the United States from 1966 to 1981 collected by the National Disease and Therapeutic Index survey. The number of private physician-patient consultations for genital herpes increased tenfold during this period. The number of patient visits for newly diagnosed infections increased 7.5-fold. Women aged 20 to 24 years and men aged 25 to 29 years were more likely to consult a private physician for genital herpes than were patients in other age brackets. Our analysis suggests an increasing national incidence of genital herpes infections and supports the concept that genital herpes infections are epidemic in the United States.
Treatment of childhood asthma
Authors: L. Osman, S. Ross
Journal: BMJ (1995)

EDITOR,--The study of Fiona Bryce and colleagues is elegantly designed to test the effects of an audit facilitator on treatment and diagnosis of childhood asthma by randomising within practices.1

It is a pity, however, given the large number of time related significant changes in treatment found for both intervention and control groups, …
Unusual Case of Weil's Disease
Authors: H. Jackson, S. Oleesky
Journal: BMJ (1946)

A RARE CONDITION?REDITISURNAL 813 was granted a considerable sum in compensation for the loss of her husband.In two subsequent fatal cases, and under almost identical circumstances, it appears that the insurance companies concerned do not prQpose to question their liability, though a careful scrutiny of the cases has been made from the diagnostic aspect.Thus the need for solid and unquestionable diagnosis in these cases becomes of more than purely medical and scientific interest.Since the writing of this paper Williams has treated a severe case of Weil's disease in a man of 53, deeply jaundiced, oliguric, and with a blood urea of over 300 mg. per 100 ml.,
Verapamil in angina: a double-blind trial.
Authors: D. N. Phear
Journal: BMJ (1968)

Three cases of multiple sclerosis are reported, all of which developed chorea, choreo-athetosis, or athetosis during the course of their illness.The diagnoses were based on the asso- ciation of diffuse and disseminated neurological lesions, a history of remission and relapse, a strongly paretic Lange curve in the C.S.F. with a negative Wassermann reaction, together with marked increase in the gammaglobulin fraction.Two cases responded well to corticotrophin and one improved spontaneously.Follow-up showed satisfactory remission of the whole clinical picture and of voluntary movements in particular.I am grateful to Dr. J. MacDonald Holmes for permission to report his cases.
Hypothermia and Adrenocortical Function
Authors: JAMES V. FELICETTA
Journal: Annals of Internal Medicine (1979)

Letters and Corrections1 May 1979Hypothermia and Adrenocortical FunctionJAMES V. FELICETTA, M.D., WILLIAM L. GREEN, M.D.JAMES V. FELICETTA, M.D.Search for more papers by this author, WILLIAM L. GREEN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-90-5-855_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In his review of hypothermia in the October 1978 issue, Reuler (1) includes a diagram that suggests cold exposure stimulates the pituitary gland, which in turn stimulates secretion by the thyroid and adrenal glands. Although increased thyroid-stimulating hormone output in response to cold has been demonstrated in other species and in the human neonate, several investigators have been unable to document this phenomenon in the adult human (2).Acute cold exposure does stimulate cortisol secretion. In hypothermic patients, however, we have found (3) that adrenal responsiveness to ACTH is lost and cortisol levels may be in the...References1. REULER J: Hypothermia: pathophysiology, clinical settings, and management. Ann Intern Med 89:519-527, 1978 LinkGoogle Scholar2. WOOLFHOLLANDERMITSUMALEESCHALCH PCTLD: Accidental hypothermia: endocrine function during recovery. J Clin Endocrinol Metab 34:460-466, 1972 CrossrefMedlineGoogle Scholar3. FELICETTA J: False diagnosis of decreased adrenal reserve in the hypothermic subject (abstract). Clin Res 27:20A, 1979 Google Scholar4. GANONGBERNHARDMCMURRAY WWJ: The effect of hypothermia on the output of 17-hydroxycorticosteroids from the adrenal vein in the dog. Surgery 38:506-512, 1955 MedlineGoogle Scholar5. SWANJENKINSHELMREICH HDM: The adrenal cortisol response to surgery. III. Changes in plasma corticosteroid levels during hypothermia in man. Surgery 42:202-217, 1957 MedlineGoogle Scholar6. EXTON-SMITH A: Accidental hypothermia. Br Med J 4:727-729, 1973 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JAMES V. FELICETTA, M.D.; WILLIAM L. GREEN, M.D.Affiliations: University of Washington Seattle, WA 98195 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byIpotermia accidentale nell’anziano 1 May 1979Volume 90, Issue 5Page: 855-855KeywordsAdrenal glandsAdrenocorticotropic hormoneAdultsCortisolHypothermiaInfantsPituitary glandThyroidThyroid-stimulating hormone ePublished: 1 December 2008 Issue Published: 1 May 1979 PDF downloadLoading ...
Most statins prescribed in the UK go to the wrong patients, study finds
Authors: Z. Kmietowicz
Journal: BMJ (2013)

Fewer than half the patients who are started on a statin by their general practitioner in the United Kingdom are at high risk of heart disease and eligible for treatment under current guidelines, a study has found.

The research, published online in PLoS One , found that over a two year period only about one in three patients who should be taking statins were prescribed them but meanwhile the drugs were prescribed inappropriately to one in 10 low risk patients.1

The …