tbuckley/cabot-search huggingface dataset:
Interleukin 1 is released by murine macrophages during apoptosis induced by Shigella flexneri.
Authors: A Zychlinsky, C Fitting, J M Cavaillon, P J Sansonetti
Journal: Journal of Clinical Investigation (1994)

Peritoneal macrophages undergoing apoptosis induced by Shigella flexneri infection release the inflammatory cytokine interleukin 1 (IL-1), but not IL-6 or tumor necrosis factor alpha (TNF alpha). Wild type shigella causes a very fast and significant release of IL-1 from prestimulated peritoneal macrophages, before the cell's integrity is compromised. Both IL-1 alpha and IL-1 beta are released, IL-1 beta in its mature processed form. IL-1 is released from presynthesized cytoplasmic pools. These results demonstrate that bacteria-induced apoptosis of macrophages may play an active role in vivo by releasing IL-1, which in turn mediates an early inflammatory response in epithelial tissues.
Treating inguinal hernias
Authors: Andrew Kingsnorth
Journal: BMJ (2004)

Editor—Oberg and Rosenberg are keen protagonists of the laparoscopic operation for treating inguinal hernias and propose the establishment of dedicated laparoscopic hernia centres. To train surgeons in one operation in specialised units is clearly impracticable and is not cost effective.

It will take a long time to train a cohort of surgeons proficient in laparoscopic herniorrhaphy on the basis of the data of Bittner et al, who reported over 8000 laparoscopic repairs in eight years, during which they were able to train only eight junior surgeons.1 The average general surgeon will repair only 30-40 inguinal hernias yearly. Enthusiastic laparoscopic surgeons, however, are strident in their demands for other surgeons to be converted to this operation with its long learning curve.

DeTurris et al, in analysing 38 randomised trials, concluded that their analysis failed to make a convincing case for the superiority of either open or laparoscopic herniorrhaphy, which includes operative time, postoperative pain, return to work, complications, and recurrences.2

Peyser's letter is riddled with misleading and inaccurate information. Laparoscopic herniorrhaphy has been largely dismissed by the surgical community: 96% of UK surgeons, 86% of US surgeons, and virtually all Japanese surgeons use open repair.3-5 There are no hard data for European countries, but in France laparoscopic repair is rapidly declining following guidance from the French equivalent of the National Institute for Clinical Excellence.

Regarding chronic groin pain, the EU Hernia Trials Collaboration has pointed out the large confidence intervals in its analysis and has indicated that a large randomised controlled trial is needed, with specific end points to arrive at definitive conclusions.




Figure 1



Placement of mesh into the periperitoneal space with wide overlap to prevent recurrence




The illustration in my editorial and here is for an open mesh placed by the preperitoneal route, as described by Stoppa (figure). The Plymouth Hernia Service not only supports my practice of open inguinal herniorrhaphy but also that of three of my colleagues who undertake laparoscopic repair for bilateral and recurrent inguinal hernias and incisional hernias.
Isolated Trigeminal Neuropathy
Authors: Peyton Delaney
Journal: JAMA (1977)

The occurrence of isolated metastasis to the trigeminal nerve or ganglion from a distant, solid tumor is rare. This communication describes a patient with carcinoma of the lung; an isolated trigeminal neuropathy developed and at autopsy proved to be secondary to metastasis to the trigeminal ganglion. The appearance of a trigeminal neuropathy in a patient with an active solid tumor elsewhere in the body is most likely due to metastasis. (<i>JAMA</i>237:2522-2523, 1977)
Honorary registrar posts in the NHS
Authors: L P Le Quesne
Journal: BMJ (1978)

Chaos caused by maternity leave regulations SIR,-Doctors, like other NHS employees, are potentially eligible for both Whitley Council maternity leave and Employment Protection Act maternity leave.The conditions which have to be fulfilled for entitlement are different for the two sets of provisions.This means that some employees are eligible for both types of leave, some for Whitley Council, some for EPA provisions, and some for none.Routine intervention by "expert" advisers should not be necessary to interpret maternity regulations, but it is necessary at the moment.To avoid this the Medical Women's Federation proposes that the Whitley Council regulations be amended, as a matter of urgency, so that they do not conflict with EPA provisions.
Reverse pharmacological effect of loop diuretics and altered rBSC1 expression in rats with lithium nephropathy
Authors: Mari Michimata, Sayuri Fujita, Tsutomu Araki, Kazuhiko Mizukami, Itsuro Kazama, Yasuko Muramatsu, Michiko Suzuki, Tokihisa Kimura, Sei Sasaki, Yutaka Imai, Mitsunobu Matsubara
Journal: Kidney International (2003)
Controlling the controls: GAD65 autoreactive T cells in type 1 diabetes
Authors: Åke Lernmark
Journal: Journal of Clinical Investigation (2002)

The clinical onset of autoimmune (type 1) diabetes is associated with multiple immune abnormalities. First, the islets of Langerhans are infiltrated with macrophages and CD4 and CD8 T lymphocytes. This islet inflammation, or insulitis, is related to a major loss of islet β cells. In addition, the onset is strongly associated with autoantibodies against specific islet cell autoantigens. In particular, autoantibodies against the smaller isoform of glutamic acid decarboxylase (GAD65), the islet antigen-2 (IA-2, also known as ICA512), or insulin are common at the day of clinical onset. The simultaneous presence of all three autoantibodies is highly predictive of type 1 diabetes (1).
Effects of stressful life events on bowel symptoms: subjects with irritable bowel syndrome compared with subjects without bowel dysfunction.
Authors: W E Whitehead, M D Crowell, J C Robinson, B R Heller, M M Schuster
Journal: Gut (1992)

A standardised inventory of stressful life events and a bowel symptom questionnaire were administered at three month intervals for one year to 383 women who were unselected with respect to bowel symptoms. A NEO Personality Inventory was given initially to assess neuroticism. Subjects who satisfied restrictive diagnostic criteria for irritable bowel syndrome were compared with those who complained of abdominal pain plus altered bowel habits but who did not meet restrictive diagnostic criteria (functional bowel disorder) and with controls without bowel dysfunction. The irritable bowel group showed significantly higher levels of stress than the other two groups even when the confounding effects of neuroticism were statistically controlled for. Time lagged correlations showed that stress in one three month interval was significantly correlated with bowel symptoms in the subsequent three month interval for all groups. The slope of the regression line relating stress to bowel symptoms was significantly steeper for the irritable bowel group than for the other two groups at three and six months, suggesting that subjects with irritable bowel syndrome show a greater reactivity to stress. Stress scores were also significantly correlated with the number of disability days and the number of medical clinic visits for bowel symptoms.
Combined Etoposide, Ifosfamide, and Cisplatin in the Treatment of Patients with Advanced Thymoma and Thymic Carcinoma. A French Experience
Authors: Frédéric Grassin, Nicolas Paleiron, Michel André, Raffaele Caliandro, Jean-Jacques Bretel, Philippe Terrier, Jacques Margery, Thierry Le Chevalier, Pierre Ruffié
Journal: Journal of Thoracic Oncology (2010)
Maintenance of canine coronary artery patency following thrombolysis with front loaded plus low dose maintenance conjunctive therapy. A comparison of factor Xa versus thrombin inhibition
Authors: J. J Lynch, G. R Sitko, M. J Mellott, E. M Nutt, E D. Lehman, P. A Friedman, C. T Dunwiddie, G. P Vlasuk
Journal: Cardiovascular Research (1994)

Objective: The aim was to examine the abilities of the direct thrombin inhibitor, recombinant hirudin (rHIR), and the coagulation factor Xa inhibitor, recombinant tick anticoagulant peptide (rTAP), given in combination with rt-PA as high dose front loading plus low dose maintenance infusions, to enhance reperfusion and maintain vessel patency in a canine model of left circumflex coronary artery stenosis and electrolytic lesion. Methods: Occlusive coronary artery thrombosis was induced in anaesthetised dogs by electrical injury (150 μA) of the intimal surface of the vessel. Thirty minutes after occlusive thrombosis, high dose front loading infusions (45 min) of rTAP (200 μg·kg−1·min−1) and rHIR (300 μg·kg−1·mm−1) were initiated concomitant with the start of a 90 min infusion of recombinant tissue-type plasminogen activator (rt-PA). Following the termination of front loading infusions, maintenance infusions of rTAP (10 or 20 μg·kg−1·min−1) or rHIR (20 μg·kg−1·min−1) were initiated and continued for the duration of the protocol (180 min after rt-PA termination). Results: Reperfusion was incomplete in the rHIR group (7/9; 78%), whereas all rTAP-treated preparations reperfused (8/8 per group, aggregate 16/16; 100%). Following thrombolysis, the rHIR group had a high incidence of reocclusion, ranging from intermittent to long periods of occlusion, with only 2/7(29%) of the preparations which initially recanalised remaining patent during the 180 min period following rt-PA termination. In contrast, 5/8 preparations in each of the two rTAP groups [aggregate 10/16; 63%] remained patent during the same period. The greater efficacy of rTAP v rHIR in maintaining vessel patency was also reflected in integrated coronary artery blood flows [91.0(SEM 5.8)% and 84.9(6.1)% of preocclusion flow in rTAP groups v 57.5(12.2)% of preocclusion flow in rHIR group], times to reocclusion [123.3(22.8) and 128.0(6.7) min in rTAP groups v 36.6(23.2) min in rHIR group; p < 0.05], and residual thrombus masses [1.8(0.3) and 2.0(0.3) mg in rTAP groups v 10.4(3.8) mg in rHIR group; p<0.05]. Conclusions: With the present front loading plus low dose maintenance infusions designed to limit the duration of "high dose" conjunctive therapy, rTAP was more effective than rHIR at equimolar plasma concentrations in maintaining post-thrombolysis vessel patency, preserving coronary artery blood flow, and reducing residual thrombus mass. These findings further support the therapeutic potential of inhibiting factor Xa in the setting of coronary artery thrombolysis. Cardiovascular Research 1994;28:78-85
Regulation and patterns of endogenous and exogenous gene expression during differentiation of embryonal carcinoma cells.
Authors: S Astigiano, M I Sherman, P Abarzúa
Journal: Environmental Health Perspectives (1989)

Embryonal carcinoma (EC) cells offer an interesting model system for evaluating differentiation because the cells are pluripotent, thus resembling germ cells and embryonic stem cells, and because a number of agents have been defined that are capable of promoting the differentiation of these cells. This chapter examines how EC cells might be triggered to differentiate, with emphasis on retinoic acid because this compound is a potent, naturally occurring inducer that has been studied extensively in this system. The nature of alterations in gene expression during EC cell differentiation is reviewed from the perspective of evaluating whether these changes are likely to be responsible for, or a result of, the differentiation event. Finally, we consider in molecular terms why EC cells, but not their differentiated derivatives, are refractory to the expression of many viral genomes following infection. Based upon these studies, we propose that fundamental changes in gene expression that are observed when differentiation is triggered in EC cells are likely to be due to the disappearance or neutralization of strong repressor elements.
Fluorodeoxyglucose-positron emission tomography in the detection and staging of lung cancer.
Authors: D A Sazon, S M Santiago, G W Soo Hoo, A Khonsary, C Brown, M Mandelkern, W Blahd, A J Williams
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

Glycolysis is increased in tumor tissues. [18F]fluoro-2-deoxy-D-glucose (FDG) is a glucose analogue radiopharmaceutical used in positron emission tomography (PET) to trace glucose metabolism. We investigated the sensitivity and specificity of FDG-PET imaging in the diagnosis and staging of lung cancer. One hundred and seven patients who had abnormal chest roentgenograms underwent whole-body PET imaging using FDG. PET scan results were classified as positive or negative based on the presence or absence of increased FDG uptake in the lung and/or in the mediastinum. All 82 patients with lung cancer had increased FDG uptake in the lungs, whereas only 12 of 25 patients with nonmalignant diseases had increased FDG uptake. Sixteen lung cancer patients with mediastinal metastases had increased FDG uptake in the mediastinum, of whom three had no lymphadenopathy on computed tomography of the chest. Sixteen lung cancer patients without mediastinal nodal involvement had no FDG uptake in the mediastinum. Seven of these patients had lymphadenopathy on computed tomography. FDG-PET imaging is 100% accurate in predicting mediastinal involvement in patients with lung cancer. It is 100% sensitive and 52% specific in predicting the malignant nature of a chest radiographic abnormality.
Evolutionary Implication of Outer Membrane Lipoprotein-Encoding Genes ompL1, lipL32 and lipL41 of Pathogenic Leptospira Species
Authors: K. Vedhagiri, K. Natarajaseenivasan, P. Chellapandi, S.G. Prabhakaran, Joseph Selvin, S. Sharma, P. Vijayachari
Journal: Genomics Proteomics & Bioinformatics (2009)

Abstract Leptospirosis is recognized as the most widespread zoonosis with a global distribution. In this study, the antigenic variation in Leptospira interrogans and Leptospira borgpetersenii isolated from human urine and field rat kidney was preliminarily confirmed by microscopic agglutination test using monoclonal antibodies, and was further subjected to amplification and identification of outer membrane lipoproteins with structural gene variation. Sequence similarity analysis revealed that these protein sequences, namely OmpL1, LipL32 and LipL41, showed no more homologies to outer membrane lipoproteins of non-pathogenic Leptospira and other closely related Spirochetes, but showed a strong identity within L. interrogans, suggesting intra-specific phylogenetic lineages that might be originated from a common pathogenic leptospiral origin. Moreover, the ompL1 gene showed more antigenic variation than lipL32 and lipL41 due to less conservation in secondary structural evolution within closely related species. Phylogenetically, ompL1 and lipL41 of these strains gave a considerable proximity to L. weilii and L. santarosai. The ompL1 gene of L. interrogans clustered distinctly from other pathogenic and non-pathogenic leptospiral species. The diversity of ompL genes has been analyzed and it envisaged that sequence-specific variations at antigenic determinant sites would result in slow evolutionary changes along with new serovar origination within closely related species. Thus, a crucial work on effective recombinant vaccine development and engineered antibodies will hopefully meet to solve the therapeutic challenges.
Vascular endothelial growth factor inhibition is not an effective therapeutic strategy for relapsed or refractory multiple myeloma: a phase 2 study of pazopanib (GW786034)
Authors: H. Miles Prince, Dirk Hönemann, Andrew Spencer, David A. Rizzieri, Edward A. Stadtmauer, Andrew W. Roberts, Nizar Bahlis, Guido Tricot, Bill Bell, Douglas J. DeMarini, A. Benjamin Suttle, Katherine L. Baker, Lini N. Pandite
Journal: Blood (2009)
Rethinking the Use of Physicians as Hired Expert Lecturers
Authors: Abrar Khan
Journal: Annals of Internal Medicine (2015)

Letters17 February 2015Rethinking the Use of Physicians as Hired Expert LecturersAbrar Khan, MDAbrar Khan, MDFrom Banner Health, Glendale, Arizona.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5052-3 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I read Avorn's commentary (1) with great interest. As far I can remember, great ideas didn't come preprinted in journals or textbooks. They come from free minds speaking without restrictions about a subject or an issue while sipping a cup of coffee or sharing lunch or a drink. To suggest that respected, well-paid physicians would change their practicing behavior and put aside their patient care just for a meal is demeaning. It is not relevant who pays for a dinner and who sponsors it. What's more important is that it's an effort to get a few physicians to start talking about clinical care in the context of a new therapy that might help their patients. Thanks to the bureaucracy of a few, this opportunity is now lost.Abrar Khan, MDBanner HealthGlendale, ArizonaReference1. Avorn J. Rethinking the use of physicians as hired expert lecturers. Ann Intern Med. 2014;161:363-4. [PMID: 25178570] doi:10.7326/M14-0847 LinkGoogle Scholar Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: From Banner Health, Glendale, Arizona.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterest Forms.do?msNum=L14-0572. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRethinking the Use of Physicians as Hired Expert Lecturers Jerry Avorn Rethinking the Use of Physicians as Hired Expert Lecturers Jerry Avorn Rethinking the Use of Physicians as Hired Expert Lecturers Marc B. Garnick and Wendy Balter Rethinking the Use of Physicians as Hired Expert Lecturers Kaenat Mulla , Adebusola Shonubi , and Dev Katarey Rethinking the Use of Physicians as Hired Expert Lecturers Jerry Avorn Rethinking the Use of Physicians as Hired Expert Lecturers Kaenat Mulla , Adebusola Shonubi , and Dev Katarey Rethinking the Use of Physicians as Hired Expert Lecturers Jerry Avorn Rethinking the Use of Physicians as Hired Expert Lecturers Marc B. Garnick and Wendy Balter Metrics 17 February 2015Volume 162, Issue 4Page: 321KeywordsBehaviorCoffeeConflicts of interestDisclosurePatients ePublished: 17 February 2015 Issue Published: 17 February 2015 CopyrightCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
The Role of Guidelines in the Practice of Physician-Assisted Suicide
Authors: Arthur L. Caplan, Lois Snyder, Kathy Faber-Langendoen
Journal: Annals of Internal Medicine (2000)

Oregon has legalized and implemented physician-assisted suicide, while observers argue about the moral import of attempting to formulate guidelines; the utility any set of guidelines can have for physician practice, health care providers, patients, or families; and whether guidelines can really protect against harm or abuse. What were once theoretical questions have taken on new urgency. The debate over the value and power of guidelines includes the following questions: What has been the experience of efforts to implement physician-assisted suicide using consensus guidelines? What goals are guidelines intended to serve? Who should formulate guidelines? What features should be reflected in any proposed guidelines to make them practical and to permit achievement of their goals? Are there any fundamental obstacles to the creation or implementation of guidelines? Is dying a process that is amenable to direction under guidelines, be they issued by physicians, departments of health, blue ribbon panels, or other regulatory bodies? This paper explores these questions as physician-assisted suicide becomes legal.
Doctors' knowledge about evidence based medicine terminology
Authors: J. D Woodcock
Journal: BMJ (2002)

Primary care p 950 

In a report published in this issue (p 950) Australian general practitioners rated themselves and were then tested on their evidence based medicine skills.1 The results are not encouraging. Fifty general practitioners in Australia rated their understanding of seven common terms from evidence based medicine from “It would not be helpful for me to understand this term” to “I understand this and could explain it to others.” On average, only 22% said they understood each term and could explain it to others. Worse still, in the subsequent structured interview only one general practitioner could provide a fully satisfactory explanation of any of the terms, and many of the explanations revealed considerable misunderstanding. The authors of the study argue that general practitioners need to understand these terms to practise evidence based medicine and that there is little good research on how this can be done. …
Changes to GP funding could force 98 practices to close, BMA warns
Authors: A. Rimmer
Journal: BMJ (2014)

Changes to funding of general practices in England could force 98 practices to close and hundreds more to lose “noticeable” levels of funding, the BMA has warned. Rural practices are likely to be especially affected, it said.

In 2013, as part of the agreement on the GP contract in England for 2013-14, the government decided to begin phasing out the minimum practice income guarantee (MPIG) over a seven year period starting in April 2014.1

The government said that annual MPIG correction factor payments would decrease each year by a seventh of their current value until they were reduced to zero. The money released by this process will be reinvested into global sum payments.

NHS England has identified 98 practices that, because …
Role of ineffective erythropoiesis in the anaemia of rheumatoid arthritis.
Authors: D Samson, D Halliday, J M Gumpel
Journal: Annals of the Rheumatic Diseases (1977)

The importance of inadequate haemoglobin synthesis and ineffective erythropoiesis in the anaemia of rheumatoid arthritis was studied by measuring the incorporation of 15N glycine into haemoglobin haem and early labelled bilirubin in a patient with severe anaemia before and after response to gold therapy. Initially, total erythroid haem turnover was decreased but haem turnover due to ineffective erythropoiesis was markedly increased, accounting for 29% of total erythroid haem turnover. Gold therapy resulted in marked clinical improvement, accompanied by a rise in haemoglobin to normal. Total erythroid haem turnover increased and the percentage ineffective erythropoiesis fell to normal. Ineffective erythropoiesis may thus be an important reversible factor in the production of the anaemia of rheumatoid arthritis.