tbuckley/cabot-search huggingface dataset:
Bariatric Surgery and Cardiovascular Risk Factors
Authors: Paul Poirier, Marc-André Cornier, Theodore Mazzone, Sasha Stiles, Susan Cummings, Samuel Klein, Peter A. McCullough, Christine Ren Fielding, Barry A. Franklin
Journal: Circulation (2011)

of the Council on Nutrition, Physical Activity, and Metabolism T he rate of obesity is rising logarithmically, especially in those with severe obesity (body mass index [BMI] Ͼ40 kg/m 2 ).Cardiologists, endocrinologists, internists, family practitioners, and most healthcare professionals are increasingly confronted with the severely obese patient and with postoperative bariatric patients because obesity is associated with significant morbidity and increased mortality.In addition, more adolescents these days are severely obese.Substantial long-term successes of lifestyle modifications and drug therapy have been disappointing in this population.The National Institutes of Health has suggested that surgical therapy be proposed to those patients with BMI Ͼ40 kg/m 2 or Ͼ35 kg/m 2 with serious obesity-related comorbidities such as systemic hypertension, type 2 diabetes mellitus, and obstructive sleep apnea.When indicated, surgical intervention leads to significant improvements in decreasing excess weight and comorbidities that can be maintained over time.These include diabetes mellitus, dyslipidemia, liver disease, systemic hypertension, obstructive sleep apnea, and cardiovascular dysfunction.Recent prospective, nonrandomized, observational, or case-control population studies have also shown bariatric surgery to prolong survival in the severely obese.Different types of bariatric procedures are being performed.Historically, operative mortality was between 0.1% and 2.0% with more recent data not exceeding 1%.Early complications include pulmonary embolus (0.5%), anastomotic leaks (1.0% to 2.5%), and bleeding (1.0%).Late complications include anastomotic stricture, anasto-motic ulcers, hernias, band slippage, and behavioral maladaptation.The number of bariatric operations being performed is increasing tremendously as a result of increasing medical need and the evolution of safer surgical techniques and guidelines.Currently, bariatric surgery should be reserved for patients who have severe obesity in whom efforts at medical therapy have failed and an acceptable operative risk is present.
From Dr. Woodbridge.
Authors: John Eliot Woodbridge
Journal: JAMA (1894)

Youngstown, Ohio, April 20, 1894. <h3>To the Editor:</h3> —I supposed that when I published my paper, "Can Typhoid Fever be Aborted," that I would immediately be buried under an avalanche of adverse criticism. It was, therefore, a great and very agreeable surprise when letters of commendation and inquiry began to pour in upon me from every part of the United States and Canada. I regret that I can not answer them, and at the same time (in addition to my other duties) prepare a paper for the San Francisco meeting. If the writers will excuse me until I return from the meeting of theAmerican Medical AssociationI will employ a stenographer and will then take pleasure in answering, as far as I am able, every question. Very respectfully,
High frequency of functional anti-YMDD and -mutant cytotoxic T lymphocytes after in vitro expansion correlates with successful response to lamivudine therapy for chronic hepatitis B
Authors: C-L Lin
Journal: Gut (2004)

Many determinants for a sustained response to lamivudine therapy have been reported but the role of T cell responsiveness remains unclear. The finding that tyrosine-methionine-aspartate-aspartate (YMDD) motif of the reverse transcriptase domain of hepatitis B virus (HBV) DNA polymerase carries a HLA-A2 restricted cytotoxic T lymphocyte (CTL) epitope makes quantitative measurement of the numbers of peptide specific CTLs feasible using MHC tetramer-peptide complex staining.To investigate the correlation between anti-YMDD motif CTL activity and the efficacy of lamivudine therapy in HLA-A2 positive patients with chronic hepatitis B (CH-B).The function and phenotype of peptide and interleukin 2 expanded peripheral blood mononuclear cells were quantified by cell lytic assay and immunocytochemical analysis by staining with HLA-A2-peptide tetramer complexes.After in vitro expansion, sustained responders had more potent CTL responses against YMDD, YVDD, and YIDD, as well as other epitopes on HBV antigens than non-responders. The frequency of YMDD/YVDD/YIDD motif specific CTLs increased significantly with an effective cell lytic function during and after therapy in sustained responders but not in non-responders. YMDD specific CTLs cross reacted with YIDD and YVDD mutant epitopes, and shared T cell receptor gene usages with YIDD and YVDD specific CTLs.Sustained responders, at least HLA-A2 patients, elicited a more potent CTL immunity against YMDD and its mutants. YMDD specific CTLs are cross reactive with YVDD and YIDD mutant epitopes, which may further contribute to immune clearance of the mutant viruses and a successful response to lamivudine therapy in CH-B patients.
Allergic Response to Penicillin
Authors: W. R. Welply
Journal: BMJ (1946)

It is customary for judges to say that if treatment is neces- sary it will be given in prison.I have taken the trouble to inquire from patients I have had who have served sentences for such offences and the reply has always been " None what- soever."A short while ago there was a correspondence in the Journal on the neuroses due to confinement in prisoners of war, and the general opinion appeared to be that being immured did produce abnormal mental states.How much sense is there in putting the already abnormal in a place where-unless they are treated-they will become more so ?-I am, etc., London, W.I.
GYMNASTICS AND MASSAGE IN THE TREATMENT OF NERVOUS DISEASES
Authors: HALDOR SNEVE
Journal: JAMA (1910)

Perhaps the greatest field for gymnastics and massage is in the domain of nervous diseases, because the problem here is generally one of nutrition and restoration of muscular function. Every specialist in these diseases should, in my opinion, have a practical training in these branches of mechanotherapy, because otherwise he cannot intelligently direct such treatment, and a considerable portion of it should be performed with his own hands. I shll not here discuss the technic further than to call attention to a few points and procedures. Nearly all patients with nervous disease suffer from digestive troubles, constipation and poor nutrition, and in abdominal massage which should be performed by the physician, or an experienced masseur or masseuse in exceptional instances, we have, to my mind, the most valuable single remedial agent for these conditions.  ABDOMINAL AND GENERA MASSAGE  Abdominal massage should be performed through a single covering; for instance, the
Aluminium hydroxide versus sucralfate as a phosphate binder in uraemia.
Authors: A C Leung, I S Henderson, D J Halls, J W Dobbie
Journal: BMJ (1983)

In an attempt to discover a phosphate binding agent for use in uraemia that would not lead to appreciable systemic absorption of aluminium the effect of sucralfate was evaluated after three weeks and compared with that of the existing standard agent aluminium hydroxide. Sucralfate caused a decrease in serum phosphate concentration comparable with that obtained with aluminium hydroxide, but similar absorption of aluminium resulted. Sucralfate may be the phosphate binder of choice in patients with uraemia and peptic ulceration; care should be taken in using large doses of the drug in patients with normal renal function.
Cause of Death in Very Old People-Reply
Authors: Robert R. Kohn
Journal: JAMA (1983)

<h3>In Reply.—</h3> Dr Jackson describes important problems in legitimizing the aging syndrome as a disease and cause of death. Perhaps<i>senility</i>should be reserved for behavioral changes, while the aging syndrome, which can be more definitively described than many other pathological conditions accepted as disease, should be referred to as<i>age syndrome</i>or<i>senescence</i>. Although a change in physicians' attitudes is probably not sufficient, it is certainly necessary and perhaps the place to start in attempting to make the<i>Vital Statistics</i>more in accord with the reality of disease. Physicians requiring clinical tests and numbers to document a diagnosis of aging could determine maximal oxygen uptake,<sup>1</sup>renal plasma flow,<sup>2</sup>and arterial stiffness by noninvasive means<sup>3</sup>in their very old patients. Results would indicate without exception that these functions and properties were greatly altered when compared with those in healthy young adults.
Hypoxic Stress Induces Cardiac Myocyte–Derived Interleukin-6
Authors: Keiko Yamauchi-Takihara, Yoshiji Ihara, Atsushi Ogata, Kazuyuki Yoshizaki, Junichi Azuma, Tadamitsu Kishimoto
Journal: Circulation (1995)

Background Hypoxic and ischemic stresses cause a series of well-documented changes in myocardial cells and tissues, including loss of contractility, changes in lipid and fatty acid metabolism, and irreversible membrane damage leading to eventual cellular death. Activated neutrophils are considered to be involved in this myocardial cellular injury. By stimulation of the neutrophils with chemotactic factors, canine neutrophils can be induced to adhere to isolated cardiac myocytes only if the myocytes have been previously exposed to cytokines such as tumor necrosis factor–α, interleukin (IL)-1, and IL-6. Methods and Results To examine the possible involvement of IL-6 in ischemia-reperfusion injury, we used cultured rat neonatal cardiac myocytes to study the effects of hypoxic stress on the production of IL-6 by cardiac myocytes. Unstimulated cardiac myocytes (3×10 5 cells per dish) produced 320 pg IL-6 over 4 hours in vitro (ie, biological activity equal to 320 pg recombinant IL-6, as detected by bioassay using the MH-60.BSF2 cell line). The incubation of cardiac myocytes under hypoxic conditions for 4 hours induced significantly increased production of IL-6 compared with normoxic conditions (2.82±0.49 versus 1.64±0.18 U/mL, P &lt;.05). Furthermore, reoxygenation for 2 hours after 2 hours of hypoxic stress significantly augmented the production of IL-6 by cardiac myocytes (4.34±0.52 U/mL, P &lt;.05). These responses to hypoxia and reoxygenation were not observed in fibroblasts isolated from the same tissue. Although unstimulated cardiac myocytes lacked IL-6 mRNA expression detectable by Northern blot analysis, hypoxic stress induced the expression of IL-6 mRNA in the cardiac myocytes. Several pathophysiologically relevant factors also augmented IL-6 release from cultured cardiac myocytes, including IL-1β, ionomycin, and epinephrine. Conclusions Cardiac myocytes respond to hypoxic stress to augment the production of IL-6, and the IL-6 derived from cardiac myocytes may play an important role in the progression of myocardial dysfunction observed in cardiac ischemia-reperfusion injury.
A way forward for whistleblowing
Authors: Kamran Abbasi
Journal: Journal of the Royal Society of Medicine (2011)

Medicine has shed many of its privileges. Some remain and are unlikely to disappear. Knowing which of our colleagues to consult when illness strikes is priceless, if only because we can avoid a colleague who we know poses a risk to patients. This sacred knowledge is guarded by hushed whispers and nods and winks. Medical students know the repute of their teachers; junior doctors share horror stories about their contemporaries and seniors. It seems that to err is human, to blow the whistle is alien: ‘There but for the grace of God go I’.

Nobody likes a whistleblower. They invite snide remarks about their competency and their twisted motives. One man or woman against the medical establishment, albeit locally or nationally, is a minnow waiting to be crushed, shamed and thrashed out of the medical profession. We don't protect whistleblowers in this country; we persecute them, even when they expose issues on the scale of a paediatric surgery department with a high death rate, a dangerous medical ward, or the conflicts of interest that distort the licensing of medical devices.

Less often, but in an equally damaging way, we allow vexatious whistleblowers to flourish especially when the media or public have decided that the doctors are undesirable trouble-makers. In short, our response to whistleblowing is confused, inadequate, and damaging – to whistleblowers, victims of vexatious whistleblowers, and patients.

The United States has a national centre for whistleblowing, and developed systems to protect whistleblowers. Thirty-one percent of US physicians are reluctant to report colleagues, while 12% fear retribution from their colleagues for doing this. Despite the Public Interest Disorder Act passed in 1998 following the Bristol scandal, the comparative UK figures would be higher. Medical managers, Department of Health, General Medical Council, and British Medical Association have all been slow to take a lead on this issue.

Whistleblowers require protection, as do the victims of vexatious whistleblowers, but who can achieve the necessary change? Stephen Bolsin and colleagues, a group of authors with unparalleled experience of whistleblowing, recommend a three-stage solution which begins with a consultation exercise led by the medical profession and ends with an equivalent to the whistleblowing centre of the United States (JRSM 2011;104:278–82).

The world is a dangerous place, said Albert Einstein, not because of those who do evil but because of those who look on and do nothing.
The Clinical, Laboratory and Echocardiographic Findings of Spontaneous Echo Contrast in Patients with Atrial Fibrillation
Authors: Murat Çelik, Uygar Çağdaş Yüksel, Hasan Kutsi Kabul, Yalçın Gökoğlan, Barış Buğan, Emre Yalçınkaya, Kubilay Karabacak, Erkan Kaya, Erkan Yıldırım, Atila İyisoy, Turgay Çelik
Journal: Journal of the American College of Cardiology (2013)
The Evolution of the Heat-Shock Protein GroEL from Buchnera, the Primary Endosymbiont of Aphids, Is Governed by Positive Selection
Authors: Mario Ali Fares, Eladio Barrio, Beatriz Sabater-Muñoz, Andrés Moya
Journal: Molecular Biology and Evolution (2002)

The heat-shock protein GroEL is a double-ring–structured chaperonin that assists the folding of many newly synthesized proteins in Escherichia coli and the refolding in vitro, with the cochaperonin GroES, of conformationally damaged proteins. This protein is constitutively overexpressed in the primary symbiotic bacteria of many insects, constituting approximately 10% of the total protein in Buchnera, the primary endosymbiont of aphids. In the present study, we perform a maximum likelihood (ML) analysis to unveil the selective constraints in GroEL. In addition, we apply a new statistical approach to determine the patterns of evolution in this highly interesting protein. The main conclusion derived from our analysis is that GroEL has suffered an accelerated rate of amino acid substitution upon the symbiotic integration of Buchnera into the aphids. It is most interesting that the ML analysis of codon substitutions in the different branches of the phylogenetic tree strongly supports the action of positive selection in the different lineages of Buchnera. Additionally, the new sliding window analysis of the complete groEL sequence reveals different regions of the molecule under the action of positive selection, mainly located in the apical domain, that are important for both peptide and GroES binding.
Hypercalcemia in childhood acute lymphoblastic leukemia: frequent implication of parathyroid hormone-related peptide and E2A-HLF from translocation 17;19
Authors: T Inukai, K Hirose, T Inaba, H Kurosawa, A Hama, H Inada, M Chin, Y Nagatoshi, Y Ohtsuka, M Oda, H Goto, M Endo, A Morimoto, M Imaizumi, N Kawamura, Y Miyajima, M Ohtake, R Miyaji, M Saito, A Tawa, F Yanai, K Goi, S Nakazawa, K Sugita
Journal: Leukemia (2006)
DIABETES INSIPIDUS AND OSTEITIS FIBROSA POLYCYSTICA
Authors: Abraham Sophian
Journal: JAMA (1930)

In the case of diabetes insipidus here recorded, the following rare and interesting features deserve emphasis: (1) the exceedingly rare complication of an extensive osteitis fibrosa polycystica; (2) a most unusual degree of uniform pulmonary fibrosa of interesting origin. <h3>REPORT OF CASE</h3> A man, aged 39, American, had apparently been well until the age of 25, when an excessive thirst developed; at times the patient drank as much as 15 gallons (60 liters) of water a day with corresponding polyuria. This condition continued uncontrolled until he reported to me seven years later. With the establishment of diabetes insipidus, pituitary extract (posterior lobe) therapy was stated with complete control of the symptoms. Impotence developed shortly after the onset of the polydipsia and has continued unimproved. The patient showed steady loss of vigor, strength and weight to a total of 60 pounds (27 Kg.). An extensive generalized eczema developed early and has
A non-sense mutation in the corneodesmosin gene in a Mexican family with hypotrichosis simplex of the scalp
Authors: N.O. Davalos, A. Garcia-Vargas, J. Pforr, I.P. Davalos, V.J. Picos-Cardenas, D. Garcia-Cruz, R. Kruse, L.E. Figuera, M.M. Nothen, R.C. Betz
Journal: British Journal of Dermatology (2005)

Hypotrichosis simplex of the scalp (HSS; MIM 146520) is a rare autosomal dominant form of non-syndromic alopecia that affects men and women equally. Up to now, only a small number of families with HSS have been reported. The affected individuals experience a diffuse progressing hair loss from childhood to adulthood that is confined to the scalp. Recently, HSS has been mapped to the short arm of chromosome 6 (6p21.3), allowing mutations in the corneodesmosin gene (CDSN) to be identified as the cause of the disorder. To date, two stop mutations have been found in three unrelated families with HSS of different ethnic origin.To describe the first HSS-family with Latin American (Mexican) background comprising 6 generations and to identify a mutation in the CDSN gene.The patients were examined by a clinician and blood samples were taken. After DNA extraction, sequencing analysis of the CDSN gene and restriction enzyme analysis with PsuI were performed.By direct sequencing of the two exons of the CDSN gene, a nonsense mutation was identified in the index patient in exon 2, resulting in a premature stop codon (Y239X). The mutation co-segregates perfectly in the family with the disease and was not found in 300 control chromosomes using a restriction enzyme analysis with PsuI.A nonsense mutation was identified in the first family with HSS of Latin American ethnical background. Our data provide molecular genetic evidence for a 3rd stop mutation in exon 2 of the CDSN gene being responsible for HSS. All to date known nonsense mutations responsible 3 for HSS are clustered in a region of 40 amino acids which is in accordance with a dominant negative effect conferred by aggregates of truncated CDSN proteins.
Haemorrhage Due to Erosion of a Metal Biliary Stent through the Duodenal Wall
Authors: H. Ee, B. H. Laurence
Journal: Endoscopy (1992)

Self-expanding, metal biliary stents have recently been used in malignant obstructive jaundice as their large diameter reduces the likelihood of occlusion by biliary sludge and bacterial biofilm. However, there is a significant rate of late obstruction by tumour overgrowth and infiltration through the wire mesh. Our case of stent erosion through the duodenal wall, resulting in massive haemorrhage, is a hitherto unreported serious complication of the Wallstent (Schneider). Its occurrence may be suggested by continuous upper abdominal pain, gastrointestinal bleeding or late expansion of the stent.
Seatone in rheumatoid arthritis: a six-month placebo-controlled study.
Authors: J G Larkin, H A Capell, R D Sturrock
Journal: Annals of the Rheumatic Diseases (1985)

Thirty-five patients with rheumatoid arthritis were randomly allocated to either Seatone (green-lipped mussel extract) or placebo in order to assess the former9s claimed effectiveness in rheumatoid disease. After six months there was no significant improvement in any laboratory or clinical measurement of disease activity in the Seatone group. The patients on active drug fared no better than those on placebo. These results suggest that Seatone is not effective in rheumatoid arthritis.
Maternal Brain Death During Pregnancy-Reply
Authors: David R. Field
Journal: JAMA (1989)

In Reply. —  We agree with Dr Goodlin's statement that an obstetrician's primary obligations are to  mother. In  rare case, such as  one we reported, in which  mother is dead but  fetus remains alive, existing maternal requests should not by themselves dictate management. Fetal and neonatal benefit should be  primary concern. The case that Dr Goodlin cites is one in which refusal of surgical intervention by a living, though terminally ill mother was overridden by  courts.1This represents a clear violation of  autonomy of  pregnant woman.  Two interesting hypothetical scenarios are presented by Drs Wear, Dillon, and Lee. The first of these concerns  case in which the family refuses maintenance when extended support... would markedly enhance... fetal survival. While acknowledging that in most cases  father of  fetus will be  appropriate decision maker after death of
18FDG PET/CT Appearance in Primary Cutaneous Diffuse Large B-Cell Lymphoma, Leg Type
Authors: Amin Samarghandi, Alejandro Ariel Gru, Mona Natwa, David W. Barker
Journal: Clinical Nuclear Medicine (2015)

We report the case of a 70-year-old woman who presented with a small and painless red skin nodule in the right lower leg, which rapidly and significantly increased in size over few weeks and developed a central eschar. Skin biopsy was consistent with primary cutaneous diffuse large B-cell lymphoma, leg type (PCDBCL-LT), an aggressive and rare cutaneous lymphoma. F-FDG PET/CT showed a hypermetabolic soft tissue mass in the right leg with no evidence of systemic involvement of disease.
Patenting the PKU Test — Federally Funded Research and Intellectual Property
Authors: Diane B. Paul, Rachel A. Ankeny
Journal: New England Journal of Medicine (2013)

In 1960, Robert Guthrie invented a new assay to detect phenylketonuria in newborns, inspiring hope for treating mental retardation. But efforts to patent and license the test generated controversy, presaging current debates over commercialization in biomedicine.
Assessing the in vitro biocompatibility of a novel carbon device for the treatment of sepsis
Authors: Susan R. Sandeman, Carol A. Howell, Gary J. Phillips, Andrew W. Lloyd, J. Graham Davies, Sergey V. Mikhalovsky, Steve R. Tennison, Andrew P. Rawlinson, Oleksandr P. Kozynchenko, Hannah L.H. Owen, John D.S. Gaylor, Jennifer J. Rouse, James M. Courtney
Journal: Biomaterials (2005)
Supervised discharge is anachronistic
Authors: T H Turner, E Akuffo, P Caviston, T Dinan, M Deahl, D Kohen, J Lucey, S Murphy, P Nayer, L Petterson, M Salter, R Seifert, N Boast
Journal: BMJ (1996)

EDITOR,—Some readers may be unaware that on 1 April an amendment to the 1983 Mental Health Act came into force. This gives to psychiatrists—known in legislative parlance as the responsible medical officer or, more alarmingly, the community responsible medical officer—new powers for the “supervisions” of mentally ill patients, termed supervised discharge.

This act, however, confers no additional therapeutic powers for treating people with an illness. On the contrary, it gives powers that might …