tbuckley/cabot-search huggingface dataset:
Illness as metaphor
Authors: Theodore Dalrymple
Journal: BMJ (2007)

Not long ago, I published a short article in which I mentioned that some of the best people I had ever known—the only ones who seemed to me genuinely to love humanity—were nuns working in Africa. Not being religious myself, I had no particular axe to grind, and was surprised by the vehemence of the hostility my remark gave rise to. I hadn't realised that so many people loathed nuns with a terrible, if somewhat forced, loathing. But how could anyone loathe people who had devoted their lives to looking after people with leprosy, I wondered?

In Graham Greene's novel, A Burnt-Out Case , a man called Querry (a composite …
Effects of short-chain fatty acids on human rectosigmoid mucosal colonocyte brush-border enzymes
Authors: M.D. Basson, S.A. Sgambati
Journal: Metabolism (1998)

Short-chain fatty acids produced by bacterial fermentation of dietary fiber may provide a tonic stimulus to colonocyte differentiation that contributes to the protective effect of fiber against colorectal malignancy.Since brush-border enzymes are common markers of colonocytic differentiation, we compared the effects of equimolar (10 mmol/L) concentrations of the three most common short-chain fatty acids, acetate, butyrate, and propionate, on the alkaline phosphatase and dipeptidyl dipeptidase specific activity of human colonic mucosal biopsies obtained from normal volunteers.Only butyrate significantly stimulated alkaline phosphatase specific activity (50.4% -+ 18.6%, P < .05).Short-chain fatty acid stimulation of dipeptidyl dipeptidase did not achieve statistical significance, Fibers yielding high colonic butyrate levels could have different effects on human colonic mucosal differentiation.
Microvascular oxygen consumption during sickle cell pain crisis
Authors: Carol A. Rowley, Allison K. Ikeda, Miles Seidel, Tiffany C. Anaebere, Matthew D. Antalek, Catherine Seamon, Anna K. Conrey, Laurel Mendelsohn, James Nichols, Alexander M. Gorbach, Gregory J. Kato, Hans Ackerman
Journal: Blood (2014)
Prevalence of Heparin-Associated Antibodies Without Thrombosis in Patients Undergoing Cardiopulmonary Bypass Surgery
Authors: Thomas L. Bauer, Gowthami Arepally, Barbara A. Konkle, Bernadette Mestichelli, Sandor S. Shapiro, Douglas B. Cines, Mortimer Poncz, Stephen McNulty, Jean Amiral, Walter W. Hauck, Richard N. Edie, John D. Mannion
Journal: Circulation (1997)

Patients with cardiovascular disease almost invariably receive heparin before cardiopulmonary bypass surgery, which places them at risk of developing heparin-associated antibodies with a risk of thromboembolic complications. This study was designed to determine the prevalence of heparin-induced antibodies in patients before and after cardiopulmonary bypass surgery.Plasma from 111 patients was tested before surgery and 5 days after surgery for heparin-dependent platelet-reactive antibodies with a 14C-serotonin-release assay (SRA) and for antibodies to heparin/platelet factor 4 complexes with an ELISA. Heparin exposure after surgery was minimized. Heparin-dependent antibodies were detected before surgery in 5% of patients with SRA and 19% of patients with ELISA. By the fifth postoperative day, there was a marked increase in patients positive on the SRA or ELISA (13% and 51%, respectively; P < .01 for each). Patients who had received heparin therapy earlier in their hospitalization were more likely to have a positive ELISA before surgery (35%; P = .017) and a positive ELISA (68%; P = .054) or SRA (30%; P = .002) after surgery. However, there was no difference in the prevalence of thrombocytopenia or thromboembolic events between the antibody-positive and-negative groups.Approximately one fifth of patients undergoing cardiopulmonary bypass surgery have heparin-induced platelet antibodies detectable before the procedure as a result of prior heparin exposure, and many more develop antibodies after surgery. The absence of an association between these antibodies and thromboembolic complications in this study may be, in part, attributable to careful avoidance of heparin after surgery. The high prevalence of heparin-induced antibodies in this setting suggests that these patients may be at risk of developing thrombotic complications with additional heparin exposure.
Trial of Calcium to Prevent Preeclampsia
Authors: Richard J. Levine, John C. Hauth, Luis B. Curet, Baha M. Sibai, Patrick M. Catalano, Cynthia D. Morris, Rebecca DerSimonian, Joy R. Esterlitz, Elizabeth G. Raymond, Diane E. Bild, John D. Clemens, Jeffrey A. Cutler, Marian G. Ewell, Steven A. Friedman, Robert L. Goldenberg, Sig-Linda Jacobson, Gary M. Joffe, Mark A. Klebanoff, Alice S. Petrulis
Journal: New England Journal of Medicine (1997)

Previous trials have suggested that calcium supplementation during pregnancy may reduce the risk of preeclampsia. However, differences in study design and a low dietary calcium intake in the populations studied limit acceptance of the data.
Links with leukaemia confirmed for French nuclear plant
Authors: A. Dorozynsky
Journal: BMJ (1997)

An international committee has validated a report suggesting a causal relation between the incidence of leukaemia and exposure to low doses of radiation near the La Hague nuclear waste processing plant in Normandy.

The report by Professor Jean-Francois Viel, published in the BMJ in January (1997;14:101-6), was initially disparaged by several official bodies, including the National Institute of Health and Medical Research and the Institut de Protection et Surete …
Clinical Trials That Have Influenced the Treatment of Venous Thromboembolism: A Historical Perspective
Authors: Jack Hirsh, Shannon M. Bates
Journal: Annals of Internal Medicine (2001)

In 1960, Barritt and Jordan performed the first randomized trial demonstrating the efficacy of anticoagulant therapy in the treatment of venous thromboembolism. Since then, important therapeutic advances have been made in the treatment of deep venous thrombosis and pulmonary embolism. This paper reviews the important clinical trials involving anticoagulant therapy and vena caval interruption. The studies are discussed from a historical perspective, and an attempt is made to analyze both the thought processes that prompted their design and the reasons why they changed practice.
Treatment of Pinworm Infections With Reduced Single Dose of Pyrvinium Pamoate
Authors: J. Walter Beck
Journal: JAMA (1964)

AS POINTED OUT previously,<sup>1</sup>pinworm infections (enterobiasis) still constitute an important medical problem, particularly for pediatricians. In the earlier study it was shown that pyrvinium pamoate, a well-tolerated drug, when given in a single dose at the level of 5 mg per kilogram of body weight, effected a cure rate of 96%, as indicated by seven consecutive negative cellophanetape slides taken one week after treatment. Other workers<sup>2-4</sup>have reported on the efficacy of this drug. This is the report of a study in which the single-dose level was reduced to 2 mg/kg. In a group of 100 children of mixed races and varying ages, cellophane-tape impressions taken early in the morning before arising were found to be positive for pinworms. A single dose of pyrvinium pamoate in syrup form was administered at the level of 2 mg/kg. Cellophane-taping was initiated one week after therapy and continued for three
Acute oesophageal necrosis: A case report and review of the literature
Authors: Andrew Day, Mazin Sayegh
Journal: International Journal of Surgery (2009)

We discuss a case of acute oesophageal necrosis and undertook a literature review of this rare diagnosis.The literature review was performed using Medline and relevant references from the published literature.One hundred and twelve cases were identified on reviewing the literature with upper gastrointestinal bleeding being the commonest presenting feature. The majority of cases were male and the mean age of presentation is 68.4 years. This review of the literature shows a mortality rate of 38%.Acute necrotizing oesophagitis is a serious clinical condition and is more common than previously thought. It should be suspected in those with upper GI bleed and particularly the elderly with comorbid illness. Early diagnosis with endoscopy and active management will lead towards an improvement in patient outcome.
Diffusion-weighted magnetic resonance imaging for the assessment of fibrosis in chronic hepatitis C
Authors: Maïté Lewin, Armelle Poujol-Robert, Pierre-Yves Boëlle, Dominique Wendum, Elisabeth Lasnier, Magalie Viallon, Jérôme Guéchot, Christine Hoeffel, Lionel Arrivé, Jean-Michel Tubiana, Raoul Poupon
Journal: Hepatology (2007)

Liver biopsy is the gold standard for assessing fibrosis but has several limitations. We evaluated a noninvasive method, so-called diffusion-weighted magnetic resonance imaging (DWMRI), which measures the apparent diffusion coefficient (ADC) of water, for the diagnosis of liver fibrosis in patients with chronic hepatitis C virus (HCV). We analyzed 20 healthy volunteers and 54 patients with chronic HCV (METAVIR: F0, n = 1; F1, n = 30; F2, n = 8; F3, n = 5; and F4, n = 10) prospectively included. Patients with moderate-to-severe fibrosis (F2-F3-F4) had hepatic ADC values lower than those without or with mild fibrosis (F0-F1; mean: 1.10 ± 0.11 versus 1.30 ± 0.12 × 10−3 mm2/s) and healthy volunteers (mean: 1.44 ± 0.02 × 10−3 mm2/s). In discriminating patients staged F3-F4, the areas under the receiving operating characteristic curves (AUCs) were 0.92 (±0.04) for magnetic resonance imaging (MRI), 0.92 (±0.05) for elastography, 0.79 (±0.08) for FibroTest, 0.87 (±0.06) for the aspartate aminotransferase to platelets ratio index (APRI), 0.86 (±0.06) for the Forns index, and 0.87 (±0.06) for hyaluronate. In these patients, the sensitivity, specificity, positive predictive value, and negative predictive value were 87%, 87%, 72%, and 94%, respectively, with an ADC cutoff level of 1.21 × 10−3 mm2/s. In discriminating patients staged F2-F3-F4, the AUC values were 0.79 (±0.07) for MRI, 0.87 (±0.05) for elastography, 0.68 (±0.09) for FibroTest, 0.81 (±0.06) for APRI, 0.72 (±0.08) for the Forns index, and 0.77 (±0.06) for hyaluronate. Conclusion: This preliminary study suggests that DWMRI compares favorably with other noninvasive tests for the presence of significant liver fibrosis. (Hepatology 2007.)
Abstract 4832: Isolation and molecular characterization of circulating melanoma cells
Authors: Xi Luo, Devarati Mitra, Ryan J. Sullivan, Ben S. Wittner, Anya M. Kimura, Shiwei Pan, Mai P. Hoang, Brian W. Brannigan, Donald P. Lawrence, Keith T. Flaherty, Lecia V. Sequist, Shannon L. Stott, David T. Ting, Sridhar Ramaswamy, Mehmet Toner, David E. Fisher, Shyamala Maheswaran, Daniel A. Haber
Journal: Cancer Research (2014)

Abstract Melanoma is a highly invasive malignancy frequently presenting with blood-borne metastases, in which recent breakthroughs in targeted and immunological therapies highlight the need for both early detection of invasion and monitoring of drug responses. We adapted a microfluidic device to capture circulating tumor cells (CTCs) in patients with melanoma and in a mouse model. In eight patients followed longitudinally, CTC numbers were correlated with response and progression on B-RAF/MEK, CDK4/6 and PDL1 inhibitors. Consistent with this trend, in a mouse model of tamoxifen-inducible B-RAF/PTEN-driven melanoma, CTCs declined within four days of treatment with a B-RAF inhibitor. In this model, CTCs are shed very early in tumorigenesis, and a four week course of B-RAF inhibition after resection of the primary tumor is sufficient to prevent the subsequent development of cutaneous metastases. Whereas primary and metastatic mouse melanomas are highly similar, RNA sequencing of CTCs identifies significant differences in expression, generating a signature that is correlated with invasiveness and motility in human melanoma. Citation Format: Xi Luo, Devarati Mitra, Ryan J. Sullivan, Ben S. Wittner, Anya M. Kimura, Shiwei Pan, Mai P. Hoang, Brian W. Brannigan, Donald P. Lawrence, Keith T. Flaherty, Lecia V. Sequist, Shannon L. Stott, David T. Ting, Sridhar Ramaswamy, Mehmet Toner, David E. Fisher, Shyamala Maheswaran, Daniel A. Haber. Isolation and molecular characterization of circulating melanoma cells. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4832. doi:10.1158/1538-7445.AM2014-4832
A moving scalp nodule in a returning traveller!
Authors: S.M. LANGAN, P. DERVAN, S. O'LOUGHLIN
Journal: British Journal of Dermatology (2004)

A 27‐year‐old man presented 2 days following his return from South America, where he had been travelling ‘off the beaten track’ for 3 months. Six weeks previously, a raised lesion had developed on his right upper scalp, which had initially been weeping and tender. Several courses of antibiotics in Peru were without benefit. Multiple insect bites had healed and he specifically denied any bites to his scalp. The patient remained systemically well and was on mefloquine as antimalarial prophylaxis. A dome‐shaped slightly tender boggy plaque was noted on the right side of the scalp measuring 4 cm in diameter with a 4‐mm opening at the apex of the mass where there appeared to be an intermittent protrusion. He had right cervical lymphadenopathy. Full skin examination was otherwise unremarkable. Saline was injected into the base of the lesion: a larva protruded and was extruded (Fig. 1). Oral antibiotics were prescribed with a subsequent uneventful clinical course.
The combined effect of all trans retinoic acid and the glucocorticoid, budesonide, on eosinophil differentiation from cord blood-derived CD34+ progenitor cells in vitro
Authors: Adrian J Baatjes, Lynn Crawford, Michael M Cyr, Sandra Dorman, Ronan Foley, Lisa M Hayes, Roma Sehmi, Judah A Denburg
Journal: Journal of Allergy and Clinical Immunology (2002)
Expression of Oct-6, a POU III Domain Transcription Factor, in Schizophrenia
Authors: Maria Ilia, Clare Beasley, Dies Meijer, Robert Kerwin, David Cotter, Ian Everall, Jack Price
Journal: American Journal of Psychiatry (2002)

OBJECTIVE: Oct-6, a POU-III domain transcription factor, is expressed in embryonic stem cells and Schwann cells and in neuronal subpopulations during early mammalian development, but its relevance to disorders of cerebral development in humans is untested. This study evaluated the expression of Oct-6 in schizophrenia, a disorder that has been linked with neurodevelopmental abnormalities. METHOD: Immunohistochemistry was used to examine Oct-6 expression in the temporal lobe in postmortem tissue from 10 subjects with schizophrenia and 10 matched comparison subjects. Western blot analysis was used to study Oct-6 expression in the frontal and temporal cortex in tissue from an additional three schizophrenic and three matched comparison subjects and in the frontal lobe only in tissue from an additional 10 schizophrenic and 10 matched comparison subjects. RESULTS: Extensive Oct-6 immunoreactivity was present in the temporal lobe in all 10 schizophrenic subjects, while very little or no expression was found in the comparison subjects. In schizophrenic subjects, Oct-6 immunoreactivity was found in a subset of cells in the pyramidal cell layer of the hippocampus and in the granule cell layer of the dentate gyrus. Oct-6 staining was predominantly localized in the cytoplasm. Western blot analysis confirmed the presence of Oct-6 in the frontal and temporal cortex in schizophrenic subjects but not in comparison subjects. CONCLUSIONS: The presence of Oct-6 expression in the schizophrenic subjects but not in the comparison subjects suggests that Oct-6 may provide a marker for the neuropathology associated with schizophrenia. Further, it may provide a clue to the neurodevelopmental basis of the disease and could be a reliable means to examine the developmental brain abnormalities described in this disorder.
Case fatality rates after hospital admission for stroke: Definition of stroke defines stroke mortality
Authors: D. S Liebeskind
Journal: BMJ (2003)

EDITOR—Stroke is a clinical syndrome characterised by rapidly developing clinical signs of focal (or global) disturbance lasting 24 hours or longer or leading to death with no apparent cause other than of vascular origin. The definition of stroke incorporates haemorrhagic and ischaemic lesions, with additional subtypes in both categories. The incidence and mortality vary widely across stroke subtypes, likely reflecting underlying …
"Schmevidence" is hampering benefits of change in the health service
Authors: C. White
Journal: BMJ (2008)

Evidence based change to services is key to improving the quality of care and health outcomes but is often mired in professional politics and “lost in translation” when applied locally, health service strategists said at a conference in London on 25 November.

Niall Dickson, chief executive of the health policy think tank the King’s Fund, told the conference, “The days of plenty are limited, and we can’t afford to waste money on ineffective services. We need to marshal the evidence to convince patients and the wider public of the case for change.”

The conference, organised by …
Effects of nitroglycerin and dipyridamole on acute myocardial infarction: a thermographic study in the dog
Authors: A. MALM, M. ARBORELIUS, B. LILJA, R. L. GIL, S. BORNMYR
Journal: Cardiovascular Research (1979)

The effects on an acute myocardial infarction of equipotent hypotensive doses of nitroglycerin and dipyridamole were studied using the thermographic technique in open-chest dogs. Nitroglycerin did not reduce the cool ischaemic area in any of the nine dogs studied. In six of the dogs, in which the ischaemic region could be properly measured, the cool area slightly grew in size. Dipyridamole reduced the size of the ischaemic area in all the 20 dogs used. In the 19 in which the size could be adequately digitalised, the decrease in infarction size was statistically significant.
MILDEW ON THE LITTLE BLACK BAG
Authors: George M. Fister
Journal: JAMA (1964)

Tradition has associated the physician with a little black bag. His mode of dress, his walk, his horse and buggy, or his automobile does not always notify the neighbors that the doctor is making a house call, but a man carrying a little black bag is the universal signal that here comes, or there goes, the doctor. The bag may be delapidated, stamped with the marks of age, and overworked, but it is equally stamped with the symbol of medicine. No one, not the patient or even the physician, knows exactly what the bag contains. It seems almost a trick of magic, the number and assortment of instruments, medicines, and needles that the doctor can extract one by one, from the bag's interior. The physician and his black bag are a team. Friends, inseparable. A house call without the bag is a disappointment to the patient, the family, and the
Hypogonadism in Elderly Men — What to Do Until the Evidence Comes
Authors: Peter J. Snyder
Journal: New England Journal of Medicine (2004)

Testosterone treatment for elderly men made the news again recently, when the Institute of Medicine Committee on Assessing the Need for Clinical Trials of Testosterone Replacement Therapy issued its long-awaited report,1 which concluded that there is insufficient evidence that testosterone treatment benefits elderly men. What is the background behind this report, and what are its implications?Many studies document that serum testosterone concentrations in men decrease as they age. In contrast to the precipitous and profound decrease in estradiol concentrations that occur when women enter menopause, the decrease in testosterone in men occurs moderately and gradually over a period of . . .
IS THERE MERIT IN THE SO-CALLED "CEREBRAL PALSY" PROGRAM?
Authors: Winthrop M. Phelps
Journal: JAMA (1949)

To the Editor:—  I question some of Dr. McCarroll's statements. For example, the statement, Much of the improvement which is credited to these specialized training programs may well be due to nothing more than the normal developmental processes which continue without regard to the treatment and the following sentence are both unfounded statements of his opinion. Those who have worked with these specialized institutions over a period of years develop a different opinion in comparing cases treated by this method with cases not so treated.  The Shriners' hospitals do not have long time care as is well known; therefore patients cannot be followed in such a situation long enough to determine what the effects would be.  The conclusions in his last paragraph are based on his previous statements, of which he has no actual proof. He states, Since so little can be accomplished by expensive and extensive training programs... etc.
SPECIAL PSYCHIATRIC PROBLEMS IN CHILDHOOD
Authors: ESTHER L. RICHARDS
Journal: JAMA (1930)

First of all I should like to restate the topic for discussion as "To whom does the health of childhood belong?" The separation of mental health and physical health is a residual of that dark age in the history of medicine when a human organism was divided quite neatly into mind and body. Mind and soul were considered to be the concern of teacher and clergy; body— or everything below the eyebrows—belonged to the physician. It has taken the medical profession decades to realize that a human being functions not in segments of mind and body but as a finely integrated organism; that every instinct and its accompanying emotion affects every cell in the body, making blood circulate faster or slower, gastric juice increase or decrease, glands of internal secretion function or dysfunction. Internal medicine now makes the statement that at least 40 per cent of men and women who
Effect of age on kinetics of nitric oxide release in rat aorta and pulmonary artery.
Authors: M R Tschudi, M Barton, N A Bersinger, P Moreau, F Cosentino, G Noll, T Malinski, T F Lüscher
Journal: Journal of Clinical Investigation (1996)

Aging is an important determinant of vascular disease. Endothelium-derived nitric oxide (NO) is protective as a vasodilator and inhibitor of platelet function. This study was designed to directly measure effects of prolonged aging on endotheliai NO release in isolated blood vessels and to delineate differences between the systemic and pulmonary circulation. Aortas and pulmonary arteries from 5-6-mo-old (young), 18-19-mo-old (middle-aged), and 32-33-mo-old (old) normotensive female rats were used. Blood pressure and plasma estradiol-17beta (E2) remained unchanged. In isolated blood vessels, NO release was induced by the receptor-independent agonist calcium ionophore A23187 (10 micromol/liter) and measured in situ on the endothelial surface of vessels using a porphyrinic microsensor. In vessels suspended in organ chambers isometric tension was recorded. In the aorta, the initial rate of NO release and peak NO concentration were reduced in middle-aged and old rats (P < 0.0006 vs. young rats, n = 6). Furthermore, endothelium-dependent relaxations to calcium ionophore and acetylcholine (both 10(-10) - 10(-5) mol/liter) were also reduced in aortas from old as compared with young rats (n = 6, P < 0.05). The initial rate of NO release and peak NO concentration significantly correlated with maximal relaxation to calcium ionophore A23187 (correlation coefficients r - 0.916, P < 0.0018 and r = 0.961, P < 0.0001, respectively, n = 7). In pulmonary arteries, however, the initial rate of NO release as well as peak NO concentration did not decrease with age (n = 6 for each age group, NS). In both blood vessels, the NO release was unaffected by superoxide dismutase in all age groups (n = 6, NS). Thus, aging specifically reduces initial rate and peak concentrations of endothelial NO release from aorta but not pulmonary artery indicating reduced NO production. As arterial pressure did not change with aging, the chronic exposure of the aorta to higher pressure and/or pulsatility than in the pulmonary artery may be the cause. This appears important as NO plays a protective role by preventing vasoconstriction, thrombosis and atherosclerosis.