tbuckley/cabot-search huggingface dataset:
INTRAMUSCULAR USE OF CONVALESCENT SERUM IN TREATMENT OF POLIOMYELITIS
Authors: E. B. SHAW
Journal: JAMA (1928)

In a previous communication, 1 the use of convalescent serum intramuscularly in the treatment of a small series of cases of early poliomyelitis was reported. Our purpose in this paper is to report the results of such treatment as employed in a series of eighty-one cases.  There is enough evidence 2 at hand to support the view that convalescent serum has definite therapeutic usefulness in poliomyelitis. Most observers, however, have emphasized the value of using such serum intraspinally, with intravenous or intramuscular injection as a less valuable adjuvant. The late E. Charles Fleischner, on the other hand, insisted that on both theoretical and practical grounds the intramuscular route was to be preferred as a means of making the serum quickly and safely available to the early lesion.  Certainly there are definite difficulties in the use of serum intraspinally against which the value of the method must be weighed. It has
India proposes free primary care to help achieve universal healthcare coverage
Authors: M. Kay
Journal: BMJ (2012)

The Indian government has proposed an end to charging patients who use government hospitals for primary care services, such as investigative tests, in a move towards achieving universal healthcare coverage.

The revised draft of the health chapter of India’s 12th five year plan (for 2012-17) says that “no fee of any kind would be levied on primary healthcare services with the prime source of financing being from general taxation/public exchequer.”

General practice is a dying specialty in India, and those doctors who do work in the …
Stimulation of DNA synthesis in hepatocytes by kupffer cells after partial hepatectomy
Authors: Fujio Katsumoto, Kohji Miyazaki, Fumio Nakayama
Journal: Hepatology (1989)

The role of Kupffer cells during reparative regeneration of rat liver was investigated with an in vitro experimental model. Conditioned media from primary cultures of Kupffer cells isolated from intact and regenerating liver were added to primary cultures of hepatocytes, and [3H]thymidine incorporation into DNA was studied. Kupffer cell-conditioned media from intact liver and regenerating remnant liver significantly stimulated DNA synthesis in hepatocytes as compared with control media (p less than 0.05). Moreover, the stimulating activity of Kupffer cells prepared from regenerating liver at 6 and 12 hr after partial hepatectomy was significantly higher than that of Kupffer cells from untreated rats (p less than 0.05). The activity was found in serum-free conditioned media. This stimulating activity exponentially increased as the increase of the number of the cultured cells, indicating that the stimulating activity was released directly by cultured Kupffer cells. These results suggest that Kupffer cells stimulate DNA synthesis in hepatocytes by producing and releasing certain factor(s) at an early stage of liver regeneration after partial hepatectomy.
PTH-050 What do Endoscopists do When no Cancer is Found on Gastroscopy Done Following an Upper Gastrointestinal two Week-Wait Referral with Weight Loss?
Authors: R Thomas, K Carney, W S Ngu, J Ljevar, D Dwarakanarth, A Agarwal
Journal: Gut (2013)

<h3>Introduction</h3> For patients referred with suspected upper gastrointestinal (UGI) cancer under the 2 week-wait (2WW), it has been shown that 10.5% will have endoscopic evidence of malignancy, whilst 6.5% of patients may harbour malignancy elsewhere.<sup>1</sup> For those patients with weight loss, a negative gastroscopy for cancer poses an important clinical question for the endoscopist. There are no consensus guidelines advising the most appropriate ‘next-step’ the endoscopist should make following patients referred with weight loss but have a negative endoscopy for malignancy. <h3>Aim</h3> To evaluate local and national practise in endoscopist decisions when no UGI cancer is found on gastroscopy in 2WW referrals with weight loss. <h3>Methods</h3> All 2WW referrals for suspected UGI cancer with weight loss were identified from the 2WW office over a 6 month period at a district general hospital. Endoscopy and imaging results were obtained from the respective computer software packages. Questionnaires were made available to British Society of Gastroenterologists members asking them to reveal their initial management preference at endoscopy in patients referred under the 2WW with weight loss where no upper GI cancer was found. <h3>Results</h3> Of the 639 2WW referrals in 6 months, 140 (22%) had weight loss. 6/140 (4%) were found to have either oesophageal or gastric malignancy. 134/140 (96%) did not have cancer, whilst 91 (65%) revealed benign pathologies such as gastritis, duodenitis and hiatus herniae and 43 (31%) were normal. Of the 134 negative endoscopies, the endoscopist took the following actions; 16 (12%) had urgent CT abdomen/chest organised (1 lung malignancy identified), 61 (46%) referred to an urgent Outpatient clinic and 40 (30%) were discharged back to GP. 17 (12%) follow up was to be determined by the list consultant. 71% questionnaire responses received were from consultants. 46% of responders’ preference was to follow up in clinic, 39% organised an urgent CT scan, 18% an ultrasound scan and the rest a brief history to ascertain their preference. 10% discharged the patient back to the GP. 100% of responders had no local guidelines at their trust with regards to this group of patients, whilst 54% felt formal guidelines were warranted. <h3>Conclusion</h3> Our study shows a large variation in practise amongst endoscopists and hence the potential to over or under investigate and its consequences. Formal guidelines seem warranted. <h3>Disclosure of Interest</h3> None Declared. <h3>Reference</h3> Wireko MB, Subramanian V, Ragunath K. The two week WAIT (2WW) referral for upper gastrointestinal cancer: predictors and prevalence of non-upper gastrointestinal cancers in those with negative gastroscopy. Gut 2011; 60:A47
A New Look at Hospital Clinical Privileges as They Apply to Radiology
Authors: Harold A. Baltaxe
Journal: JAMA (1983)

THE HOSPITAL medical staff has the overall professional responsibility for the quality of all medical care provided to patients and for the ethical conduct and professional practices of its members. It must be accountable to the governing body, which, by virtue of applicable statutes, regulations, and judicial decisions, bears ultimate legal responsibility for the quality of care provided in the hospital. One of the greatest concerns of an industrial society is the establishment of quality-assurance programs, which when lacking may be the primary cause for its downfall. Industry is spending what seems to be a large amount of time and money on quality-assurance programs such as passenger safety by the airline industry. The health industry cannot and should not deviate from this direction; it has to institute quality-assurance programs for patient safety. The hospital must demonstrate a consistent endeavor to provide patient care that is optimal within available resources and
Mississippi Valley Medical Association.
Authors: W. N. Wishard
Journal: JAMA (1895)

Indianapolis, May 27,1895. <h3>To the Editor:</h3> —Will you kindly mention in the next issue of ourJournalthat the twenty-first annual meeting of the Mississippi Valley Medical Association will occur at Detroit, Mich., on Sept. 3, 4, 5 and 6, 1895, and that assurances have been received from the railroad companies that one fare for the round trip will be the rate? Wm. Pepper, M.D., LL.D., of Philadelphia, Pa., will read the Annual Address on Medicine on the evening of September 4. Dr. H. O. Walker, of Detroit, the Chairman of the Committee on Arrangements, says that the local profession of that city is prepared to entertain the society handsomely, and the indications thus far point to a very large and successful meeting. Sincerely yours,
Trafficking experiences and psychological dysfunction among female trafficking survivors returning to Vietnam
Authors: PhuongThao D Le
Journal: The Lancet Global Health (2014)

BackgroundStudies have shown high levels of depression and post-traumatic stress disorder in female trafficking survivors and that mental disorders might be associated with factors such as pretrafficking childhood abuse, trafficking trauma, and unmet needs at post-trafficking. No study has provided comparisons of trafficking experiences and subsequent psychological dysfunction between individuals trafficked for different types of exploitation.MethodsA cross-sectional convenience sample of trafficked women and girls returning to and receiving assistance through a post-trafficking project in Vietnam's northern border region were recruited for the study. Participants who provided informed consent were interviewed about demographic characteristics, trafficking experiences including trafficking trauma, and self-reported health. Psychological dysfunction was assessed by a score on the self-reporting questionnaire-20 items. Univariate and bivariate statistics were done to examine distributions of trafficking experience and psychological dysfunction between women trafficked into sex work, marriage, and domestic servitude. Multivariate regression analyses were done to determine predictive factors of psychological status in this sample of returning trafficking survivors.Findings80 of 92 participants who agreed to participate in the study had complete data for the dependent variable; of whom 23 reported being trafficked into sex work, 15 into marriages, 12 into domestic servitude, and 30 in other/missing category. In the sample, age at trafficking averaged at 21·0 years (SD 5·5, range 14–45), duration of trafficking averaged at 7·9 months (SD 12·2, range 0–58), and most (n=57) were rescued by the police. Participants reported an average of 5·5 trauma items (of 18, SD 3·9, range 0–14). Individuals in domestic servitude reported the most amount of trauma (mean 8·4, SD 2·7, range 4–12), followed by those in sex work (mean 6·1, SD 3·9, range 0–14), and then those in marriages (mean 4·8, SD 2·7, range 0–10). The sample averaged a self-reporting questionnaire-20 score of 7·2 (SD 3·8, range 0–20). Regression analysis showed that individuals trafficked into marriages and domestic servitude reported significantly more psychological dysfunction than those trafficked into sex work, when adjusted for age, marital status, trafficking duration, and trafficking trauma (marriage: b=3·02, SE 1·17, p=0·012; domestic servitude: b=2·47, SE 1·21, p=0·045).InterpretationTrafficking trauma and post-trafficking psychological dysfunction might be different between women trafficked into sex work, marriages, or domestic servitude. Provision of services for trafficking survivors should assess the types and severity of trauma and mental health status while remaining cognisant of the specific type of exploitation. Further evidence is needed to determine if these patterns are present in other samples of trafficking survivors.FundingNone.
A dichotomy between the expression of IgD on B cells and its requirement for triggering such cells with two T-independent antigens
Authors: LB Buck, D Yuan, ES Vitetta
Journal: The Journal of Experimental Medicine (1979)

The majority of adult B lymphocytes in the mouse bear two immunoglobulin isotypes, IgM and IgD (μ(+)δ(+) cells) (1). A small population of IgM-bearing cells lacks, or expresses very low levels of IgD (μ- predominant [μp] cells) (1). These cells are believed to constitute a less mature subset of B cells analogous to neonatal B cells (2). Based on the time during ontogeny when responses to T-independent (TI) and T-dependent (TD) antigens appear (3, 4) and the ability to block in vitro responses with anti- μ or anti-δ (5, 6, D. Mosier, personal communication), it has been suggested that the precursors of two TI-1 responses, trinitrophenyl (TNP)- Brucella (TNP-BA) and TNP-lipopolysaccharide (TNP-LPS) are μp cells (5, 6), whereas the precursor for a TD response, TNP-sheep erythrocytes (TNP-SRBC), bears both IgM and IgD (6). However, the possibility cannot be excluded that IgD is present on some or all of the TI precursors, but that it is not obligatory for triggering. In the present experiments we have examined the phenotypes of TI and TD precursors by treating cells with C' and either anti-μ or anti-δ before stimulation with antigen. Our results suggest that the majority of B cells that respond to TNP-BA, TNP-LPS, and TNP-SRBC bear IgD, even though in the case of the two TI antigens, IgD is not required for triggering.
Cell culture-produced hepatitis C virus does not infect peripheral blood mononuclear cells
Authors: Svetlana Marukian, Christopher T. Jones, Linda Andrus, Matthew J. Evans, Kimberly D. Ritola, Edgar D. Charles, Charles M. Rice, Lynn B. Dustin
Journal: Hepatology (2008)

Hepatitis C virus (HCV) replicates primarily in the liver, but HCV RNA has been observed in association with other tissues and cells including B and T lymphocytes, monocytes, and dendritic cells. We have taken advantage of a recently described, robust system that fully recapitulates HCV entry, replication and virus production in vitro to re-examine the issue of HCV infection of blood cell subsets. The HCV replicase inhibitor 2'C-methyl adenosine was used to distinguish HCV RNA replication from RNA persistence. Whereas cell culture-grown HCV replicated in Huh-7.5 hepatoma cells, no HCV replication was detected in B or T lymphocytes, monocytes, macrophages, or dendritic cells from healthy donors. No blood cell subset tested expressed significant levels of Claudin-1, a tight junction protein needed for HCV infection of Huh-7.5 cells. A B cell line expressing high levels of Claudin-1, CD81, and scavenger receptor BI remained resistant to HCV pseudoparticle infection. We bypassed the block in HCV entry by transfecting HCV RNA into blood cell subsets. Transfected RNA was not detectably translated and induced high levels of interferon-alpha. Supernatants from HCV RNA-transfected macrophages inhibited HCV replication in Huh-7.5 cells.We conclude that multiple blocks prevent blood cells from supporting HCV infection.
Ethics in Diabetic Clinical Trials
Authors: David S. H. Bell
Journal: Diabetes Care (2001)

It is time for the diabetes community to take action regarding the conduct of clinical trials on diabetic patients in the U.S.

The Declaration of Helsinki, an international document that describes ethical principles to be used in clinical investigations, states that “In any medical study, every patient, including those of a control group, if any, should be assured of the best proven diagnostic and therapeutic method” (1). I believe that many of the placebo-controlled trials currently being performed to assess new oral diabetic therapies do not meet this ethical standard. Comparing an experimental drug with a placebo is perfectly ethical when no proven effective therapy exists and when the risk-to-benefit ratio needs to be assessed. However, when effective therapy exists, the use of placebo control subjects does not meet the ethical …
Renal Changes After Cholecystography
Authors: Boris Gueft
Journal: JAMA (1963)

To the Editor:  —The article titled Acute Renal Failure Following Cholecystography, by Dr. J. G. Setter and others in the April 13 issue ofThe Journal( 184: 102) was of great interest to me, since I encountered three similar cases of renal tubulorrhexis in autopsy cases at the Bronx Municipal Hospital Center in 1960.  Dr. Yutaka Kikkawa, Albert Hanok, and I have found that the kidneys in these patients with unexpected uremia contained at least twice the iodine concentration found in kidneys from control patients given bunamiodyl sodium before death. X-ray micrographs of paraffin sections showed that the large tubular casts contained a material opaque to 3-to-5 kv x-rays, and with appropriate histochemical tests these casts showed no calcium or iron. In one case a half kidney had been preserved. From this material, large casts were picked out by hand, using a dissecting microscope. With a micro-modification of the starch
Biopsy versus partial versus gross total resection in older patients with high-grade glioma: a systematic review and meta-analysis
Authors: S. A. Almenawer, J. H. Badhiwala, W. Alhazzani, J. Greenspoon, F. Farrokhyar, B. Yarascavitch, A. Algird, E. Kachur, A. Cenic, W. Sharieff, P. Klurfan, T. Gunnarsson, O. Ajani, K. Reddy, S. K. Singh, N. K. Murty
Journal: Neuro-Oncology (2015)

Optimal extent of surgical resection (EOR) of high-grade gliomas (HGGs) remains uncertain in the elderly given the unclear benefits and potentially higher rates of mortality and morbidity associated with more extensive degrees of resection. We undertook a meta-analysis according to a predefined protocol and systematically searched literature databases for reports about HGG EOR. Elderly patients (≥60 y) undergoing biopsy, subtotal resection (STR), and gross total resection (GTR) were compared for the outcome measures of overall survival (OS), postoperative karnofsky performance status (KPS), progression-free survival (PFS), mortality, and morbidity. Treatment effects as pooled estimates, mean differences (MDs), or risk ratios (RRs) with corresponding 95% confidence intervals (CIs) were determined using random effects modeling. A total of 12 607 participants from 34 studies met eligibility criteria, including our current cohort of 211 patients. When comparing overall resection (of any extent) with biopsy, in favor of the resection group were OS (MD 3.88 mo, 95% CI: 2.14–5.62, P < .001), postoperative KPS (MD 10.4, 95% CI: 6.58–14.22, P < .001), PFS (MD 2.44 mo, 95% CI: 1.45–3.43, P < .001), mortality (RR = 0.27, 95% CI: 0.12–0.61, P = .002), and morbidity (RR = 0.82, 95% CI: 0.46–1.46, P = .514) . GTR was significantly superior to STR in terms of OS (MD 3.77 mo, 95% CI: 2.26–5.29, P < .001), postoperative KPS (MD 4.91, 95% CI: 0.91–8.92, P = .016), and PFS (MD 2.21 mo, 95% CI: 1.13–3.3, P < .001) with no difference in mortality (RR = 0.53, 95% CI: 0.05–5.71, P = .600) or morbidity (RR = 0.52, 95% CI: 0.18–1.49, P = .223). Our findings suggest an upward improvement in survival time, functional recovery, and tumor recurrence rate associated with increasing extents of safe resection. These benefits did not result in higher rates of mortality or morbidity if considered in conjunction with known established safety measures when managing elderly patients harboring HGGs.
Trimethoprim and sulphamethoxazole.
Authors: D W Dawson, R C Routledge
Journal: BMJ (1971)

used the discovery of staphylococcuskilling products of a fungus to make penicillin which saved millions of lives.Other scientists used the principle of atomic fission to make weapons and bombs.Two of these bombs were dropped in Japan, and killed over 2 million people, and horribly crippled many more, in seconds.Some of the machines invented or made by scientists now spew out pollutants into the air and waters."This, I believe, is the greatest contribution leading scientists can make to the wel- fare of mankind-to admit failures as readily as they admit apparent successes.-Iam, etc., C. DE F. W. GOONARATNA Dundee Anorexia Nervosa SIR,-In the leading article on anorexia nervosa (23 October, p. 183) you state "Though doubts have been expressed about its status as a distinct entity, it is generally regarded as a consistent syndrome."I have been-trying without success to fathom what this means.I think I know what a con- sistent syndrome is; but I have no idea what is meant by "distinct entity," nor how one would decide whether or no "a consistent syndrome" is "a distinct entity."Could you enlighten me ?-I am, etc.,
Prevention of VEGF-mediated microvascular permeability by C-peptide in diabetic mice
Authors: Y.-C. Lim, M. P. Bhatt, M.-H. Kwon, D. Park, S. Lee, J. Choe, J. Hwang, Y.-M. Kim, K.-S. Ha
Journal: Cardiovascular Research (2013)

Human C-peptide has a beneficial effect on the prevention of diabetic neuropathy, nephropathy, and vascular complications; however, its role in protection against increased vascular permeability in diabetes remains unclear. Our purpose was to explore the potential protective role of C-peptide against microvascular permeability mediated by vascular endothelial growth factor (VEGF)-induced reactive oxygen species (ROS) generation in diabetes. Generation of intracellular ROS, real-time changes in intracellular Ca2+, ROS-dependent stress fibre formation, and the disassembly of the adherens junctions were studied by a confocal microscopy in human umbilical vein endothelial cells (HUVECs). VEGF-induced vascular leakage was investigated in the skin of diabetic mice using a Miles vascular permeability assay. Microvascular leakage in the retina of streptozotocin diabetic mice was investigated using a confocal microscopy after left ventricle injection of fluorescein isothiocyanate (FITC)-dextran. C-peptide inhibited the VEGF-induced ROS generation, stress fibre formation, disassembly of vascular endothelial cadherin, and endothelial permeability in HUVECs. Intradermal injection of C-peptide prevented VEGF-induced vascular leakage. Consistent with this, intravitreal injection of C-peptide prevented the extravasation of FITC-dextran in the retinas of diabetic mice, which was also prevented by anti-VEGF antibody and ROS scavengers in diabetic mice. C-peptide prevents VEGF-induced microvascular permeability by inhibiting ROS-mediated intracellular events in diabetic mice, suggesting that C-peptide replacement is a promising therapeutic strategy to prevent diabetic retinopathy.
Epileptic Seizures: Clinical and Electrographic Features, Diagnosis and Treatment
Authors: Frederick E. Jackson
Journal: JAMA (1973)

In 1969, after a lifetime of study of the epilepsies. Dr. Henri Gastaut's clinical work was interrupted by his appointment as Dean of the Faculty of Medicine of Marseille, France. He had been eminently successful in persuading the International League Against Epilepsy and the World Health Organization to create international classifications, first of<i>epileptic seizures</i>and then of the<i>epilepsies</i>, based on his 18,000 clinical cases whose diagnoses were confirmed by 100,000 electroencephalographic tracings. The task, therefore, to bring forth a definitive textbook on epilepsy was assigned to Dr. Roger Broughton, based on Dr. Gastaut's clinical material. This book is both a general review and a personal document reflecting the interests and belief of the authors, and represents the widespread influence of the "Marseille School" of the study and documentation of the epilepsies. They like to study their epileptic patients not only with the EEG but with polygraphic techniques measuring