tbuckley/cabot-search huggingface dataset:
Variceal Bleeding and Portal Hypertension: Still a Therapeutic Challenge?
Authors: S Bohnacker, A Maydeo, N Soehendra
Journal: Endoscopy (2001)

In the primary prevention of variceal hemorrhage, beta-blockers continue to be the first-line treatment. Newer nonselective beta-blockers with anti-alpha1-adrenergic activity, such as carvedilol, appear to have a better impact on reducing the hepatic venous pressure gradient than propranolol. The addition of isosorbide mononitrate appears to improve the effectiveness of beta-blockers in primary prophylaxis, but not that of somatostatin in the treatment of acute variceal hemorrhage. The use of vasoactive drugs alone in acute variceal bleeding has not proved to be more effective than endoscopic treatment. The advent of endoscopic variceal ligation (EVL) has strengthened the role of endoscopy in the management of bleeding esophageal varices. EVL has improved the results, particularly in terms of lowering the treatment-related morbidity, compared with endoscopic variceal sclerotherapy (EVS). However, the variceal recurrence rate after initial eradication with EVL is relatively high. In contrast to synchronous combined therapy with EVL plus EVS, metachronous combination of EVL and low-dose EVS may improve the results of EVL alone. For bleeding fundic varices, obliteration using cyanoacrylate is currently the treatment of choice. Endosonography (EUS) is coming into more widespread use in the assessment of variceal eradication and in further attempts to improve the results of endoscopic injection therapy. According to two meta-analysis studies, transjugular intrahepatic portosystemic shunt (TIPS) is not yet capable of replacing endoscopic treatment in the secondary prevention of variceal bleeding.
TCT-699 MitraClip Therapy In Idiopathic Vs Ischemic Dilated Cardiomyopathy, A Single Center Experience.
Authors: Nicola Buzzatti, Maurizio Taramasso, Micaela Cioni, Paolo Denti, Antonio Colombo, Giovanni La Canna, Ottavio Alfieri, Francesco Maisano
Journal: Journal of the American College of Cardiology (2013)
Society Builds Sustainability in Africa
Authors: Tanya Tillett
Journal: Environmental Health Perspectives (2007)

Society Builds Sustainability in AfricaWith the speed of industrialization in today's global community, the costs of disparities in environmental health and risk assessment can be dangerously high in developing countries without broad, stable regulatory and protective measures in place.Addressing capacity-building problems will depend largely upon the implementation of proactive measures within the borders of these developing nations-measures that participants sought to create at the Risk Assessment and Quality Assurance Training Workshop of the African Society for Toxicological Sciences (ASTS), held 21-28 October 2006 in Limbe, Cameroon.The workshop was cosponsored by the NIEHS as part of its efforts to expand global environmental health initiatives, as outlined in the institute's Strategic Plan.Forty-seven experts in toxicology research, environmental policy, and government from Cameroon, Nigeria, Sudan, South Africa, the United States, and Europe convened for the purpose of generating ideas for new sustainable development initiatives.Attendees also took part in training modules and a site visit to a local oil refinery.Sanmi Areola, a toxicologist with the Metro Nashville/Davidson County (Tennessee) Public Health Department and incoming ASTS president, says that organizations such as the ASTS serve as necessary bridges of communication between developed and developing nations."Continuing and
Muscarinic Receptor Subtypes
Authors: Jeffrey S. Flier, Lisa H. Underhill, Raj K. Goyal
Journal: New England Journal of Medicine (1989)

CHOLINERGIC neurons affect tissues by releasing the neurotransmitter acetylcholine, which stimulates acetylcholine receptors on the cell surface. These receptors are classified as nicotinic or muscarinic receptors on the basis of their response to the alkaloids nicotine and muscarine.1 The nicotinic receptors are widely distributed in tissues and mediate the actions of acetylcholine in the neurons of striated muscles, autonomic ganglia, and the central nervous system.2 Muscarinic receptors are key participants in many physiologic processes, such as nerve-to-nerve transmission, smooth-muscle contraction, and exocrine and endocrine secretion. Clinically, they have a major role in many pathologic processes. Muscarinic agonists and antagonists, popularly . . .
Diminutive submucosally invasive cancers of the colon and rectum
Authors: Kinichi Hotta, Kenichiro Imai, Yuichiro Yamaguchi, Noboru Kawata, Masaki Tanaka, Naomi Kakushima, Kohei Takizawa, Hiroyuki Matsubayashi, Hiroyuki Ono
Journal: Endoscopy (2015)

Only a few cases of submucosally invasive colorectal cancer (SM-CRC) in diminutive colorectal polyps of ≤ 5 mm have been described [1], and as yet there is no detailed knowledge of these cancers.
Ectopic LTαβ Directs Lymphoid Organ Neogenesis with Concomitant Expression of Peripheral Node Addressin and a HEV-restricted Sulfotransferase
Authors: Danielle L. Drayton, Xiaoyan Ying, Jason Lee, Werner Lesslauer, Nancy H. Ruddle
Journal: The Journal of Experimental Medicine (2003)

Lymph node (LN) function depends on T and B cell compartmentalization, antigen presenting cells, and high endothelial venules (HEVs) expressing mucosal addressin cell adhesion molecule (MAdCAM-1) and peripheral node addressin (PNAd), ligands for naive cell entrance into LNs. Luminal PNAd expression requires a HEV-restricted sulfotransferase (HEC-6ST). To investigate LTαβ's activities in lymphoid organogenesis, mice simultaneously expressing LTα and LTβ under rat insulin promoter II (RIP) control were compared with RIPLTα mice in a model of lymphoid neogenesis and with LTβ−/− mice. RIPLTαβ pancreata exhibited massive intra-islet mononuclear infiltrates that differed from the more sparse peri-islet cell accumulations in RIPLTα pancreata: separation into T and B cell areas was more distinct with prominent FDC networks, expression of lymphoid chemokines (CCL21, CCL19, and CXCL13) was more intense, and L-selectin+ cells were more frequent. In contrast to the predominant abluminal PNAd pattern of HEV in LTβ−/− MLN and RIPLTα pancreatic infiltrates, PNAd was expressed at the luminal and abluminal aspects of HEV in wild-type LN and in RIPLTαβ pancreata, coincident with HEC-6ST. These data highlight distinct roles of LTα and LTαβ in lymphoid organogenesis supporting the notion that HEC-6ST–dependent luminal PNAd is under regulation by LTαβ.
OPERATIVE TREATMENT OF CIRRHOSIS OF THE LIVER
Authors: T. Tannahill
Journal: BMJ (1930)

CIRRHOSIS OF LIV 'R.I [TErABRJITsON 281 far otit in their estimates, Yet, because the general prac- tit iolner las niot the opportunity to deal wi-itlh lar-ge num1bers., and because grieater accuiracy is (lesirable, if r'eadilY attain- aIle, tle followiing opacity miietlhod is piroposel: Add to 5 .crn. of urine (filtered thjrough tw-o layers of filter r iftd if necessary through saind also') 0.5 c.cni. of 25 per Cet.-t lie l-sultlhonic acid. (It is convenient to hCave a set of tosl ttnbe x with the 5 e.cn.level marked.)If the resultini tai 'idity i's onitside the lange of the standlards of the autlhor's priott`itans ter* leject tlhat test ttube and dilutd , sayd, 1 in 5 \ltli p)hytsiological saliIIe, wheni (alfter' the atdditioil of the pie- Cip)italilt) thle resnltitio tnrhiditv will (unoless the amiiouniit of pjite in coatewitt be unusually h igli) be brought w,ithin tlie ranige oi, tlic stilii (rds.If thte proteiii content is iunniisuallyv liglh, the Ittillit Cii lie dlilutked to 1 in 10 with phiysiological saline.Tlhe
Handbook of Clinical Neurology, vol 1: Disturbances of Nervous Function
Authors: Lewis P. Rowland
Journal: JAMA (1969)

A generation ago, anyone writing a neurological paper began his search of the literature with the Bumke-Foerster Handbuch der Neurologie . That modest compendium filled 18 volumes, and each chapter was a comprehensive monograph. The unmanageable growth of medical literature in the interim has affected neurology as it has all other specialties. A distinguished and international group of neurological leaders apparently decided in 1964 that a new handbook was needed to provide appropriate summaries of basic and clinical knowledge. We now have the first volume. This one differs from its predecessor in several respects. There are more chapters and more authors. The number of volumes will be greater, at least 30. Many continental neurologists contribute, but all the monographs are published in English and the translations seem quite good. The bibliographies are extensive but can not now be all-inclusive. These features are among the virtues of volume 1, and there are
Woodrow Wilson: A Medical and Psychological Biography
Authors: Ralph L. Stevens
Journal: JAMA (1982)

The personality of Woodrow Wilson has always been a controversial subject, one that prompted a psychological study by Freud himself. Edwin Weinstein, professor of neurology at Mt Sinai Medical School and a fellow of the William Alanson White Institute of Psychoanalysis, has written a superb book analyzing the influence of Wilson's neurological and psychological health on his political life. Weinstein presents persuasive evidence that Wilson suffered from mixed cerebral dominance, with consequent childhood dyslexia and lifelong difficulties with reading and factual recall, in marked contrast to his mastery of rhetoric and imagery. Wilson's early career as an academic was interrupted by severe bouts of "the blues," headaches, and gastrointestinal disturbances at times of psychic stress. Wilson also suffered from hypertension and cerebral arteriolosclerosis, and experienced his first stroke at age 39, which left his right hand partially paralyzed. Another, larger stroke while president of Princeton University left him blind in
Get real medicine
Authors: D. Spence
Journal: BMJ (2009)

The kids have used the bed as a trampoline at 4 am for the past 10 Christmases, with elbows and knees as triggers of our wrath. They have squabbled over toys as the dogs chewed the legs off dollies, toys that require an engineer to build, all strewn across the floor, lying in wait to test my yelling withdrawal reflex. We get presents from everyone we have ever met. There is too much food, too much drink, too much to choose from on television—too …
BONE ABSCESSES DUE TO BRUCELLA MELITENSIS
Authors: A. D. Gardner, G. R. Girdlestone, N. A. Gillespie
Journal: BMJ (1932)

JULY9, 192 L HYPO-AND HYPER-GLYCAEMIA Insulin reactions are occasionally reported by patients, but, with rare exceptions, they have not been serious, and, patients are instructed to reduce the dose at once.Four patients have, however, had hypoglycaemic coma, and in one of these the onset was so rapid that she fell, and a fracture of the olecranon resulted.In one of -these cases death resulted, in spite of the fact that on admissioil to hospital the blood sugar was restored to normal by glucose intravenously.A large dose of insulin had been given before admission, because the case was mistaken for one of hyperglycaemic coma.The patient was a woman of 20 years-asevere diabetic-and a necropsy showed an enlarged thymus, with thymus tissue on section.Three patients with hyperglycaemia have been re- admitted to the ward in coma, in one case brought on by influenza, in another by an alveolar abscess.Both these recovered, but the third died.Other cases of coma may, however, have been treated at some other hospitals and have continued attending there.BLOOD PRESSURE Joslin" found the blood pressure to be lower thlan normal in patients under 35, but above normal after that, and Koopman's"2 view is somewlhat similar.Adams" found that, altlough more cases have a systolic blood pressure above 150 than is the case in normal subjects, more cases have a svstolic blood pressure un:der 110 than is seen in normal subjects.In Major'S4 cases the peak of a graplh fell between 135 and 150, w-hile in normals it fell between 120 aild 135.Katz Klein,'5 Kramer," Bell and Clawson,"7 all found an inlcreased blood pressure to be common.Elliottl" considered that it was normal, and Nathanson"' sta.ted that the incidence of hypertensive hypertrophy of the heart at post-mortem in(licates that hypertension is only slightly more common in diabetics than in non-diabetics.
THE SUMMER CAMP AS A FACTOR IN CONTROL OF DIABETIC CHILDREN
Authors: LEONARD F. C. WENDT
Journal: JAMA (1931)

A summer camp for the diabetic child is no longer unique. Several such camps have been organized and have been in operation for from one to five successful seasons. As we x have stated before, every large city is a potential field for the development of such a camp, which exerts a powerful influence on the morale and physical fitness of this special group. After an experience of five summers in the management of a camp for diabetic children, which has grown from a makeshift affair with four patients to the rather complicated organization of 1930, which was capable of caring for fifty children, we feel that this type of organization fulfils a definite need and that the development of other camps for diabetic children is to be encouraged. The aim of all camps has been to get the child outdoors for a time and away from the parents, who
TREATMENT OF NASOPHARYNGEAL ADENOIDS.
Authors: LOUIS J. LAUTENBACH
Journal: JAMA (1899)

Last year at our Section meeting at Denver, during the discussion on the methods of removal of adenoid growths from the vault of the pharynx, I gave my views on the subject at considerable length, but somehow, although referred to in Dr. Mayer's closing remarks, they were not printed at all in the proceedings of our Section, and yet, since that time, I have learned of a number of operators, who, having heard of the discussion, have modified their methods, following in my footsteps. Especially in consequence of this omission, do I desire to present the matter to you in a more formal manner. These adenoid growths vary considerably in size and consistency, at times occupying the posterior vault only; again the entire central region or extending laterally into the fossæ of Rosenmüller, and even over the Eustachian orifice—in consistency varying from a very soft, spongy, friable mass, to one
Diagnostic Problems Resulting from Improper Electrocardiographic Technique
Authors: Joseph E. F. Riseman
Journal: JAMA (1961)

Analysis of 492 electrocardiographic problems submitted by practicing physicians showed that interpretation often was hampered because of improper technique. Difficulties in recognition of the waves arose from artifacts, lack of clarity, shifting of the baseline, and improper standardization. Distortion of the curves resulted from improper stylus adjustment, placement of electrodes, labeling, or mounting. In some instances the full value of the electrocardiogram was not realized because the tracings were not taken at the proper time, the leads were too short, or insufficient clinical information was supplied. Most of the errors could have been avoided by proper preparation of the patient and machine and by inspecting the tracing as it was being recorded. The electrocardiographer must be constantly on guard to recognize such technical errors.
For Debate: 250th anniversary of source document verification
Authors: D. Gibbs
Journal: BMJ (1996)

When the London Infirmary (later The London Hospital and now the Royal London Hospital) was founded in 1740, a physician, a surgeon, and an apothecary were appointed. Dr John Andree (1698-1785), MD Rheims, LRCP, of Huguenot descent, was the first and, for some years, the only physician on the staff. He developed a special interest in epilepsy and what were then considered to be related disorders; in 1746 his …
S115 The effects of hypoxia on neutrophil-mediated tissue damage in the lung
Authors: K Hoenderdos, RA Hirst, L Porter, C Chen, K Lodge, C O’Callaghan, ER Chilvers, AM Condliffe
Journal: Thorax (2013)

<h3></h3> Sites of infection and inflammation are profoundly hypoxic, requiring neutrophils to function under low oxygen tensions. Although neutrophils are well adapted and can rely on glycolytic metabolism, hypoxia still impairs the neutrophil oxidative burst, reduces bacterial killing and delays apoptosis.<sup>1</sup> As neutrophil proteases have been implicated in lung diseases such as COPD, we hypothesised that hypoxia might also promote neutrophil degranulation, with an enhanced potential for neutrophil-mediated tissue injury. Neutrophils isolated from healthy volunteers were subjected to normoxia (20 kPa) or hypoxia (3 kPa) and subsequently activated with GM-CSF (10 ng/ml) and the bacterial tri-peptide fMLP (100 nM). A549 cells and ciliated human primary bronchial epithelial (NHBE) cells were exposed to neutrophil supernatants, the extent of cellular damage was determined by MTT assay (A549 cells), EM ultrastructure and cleaved caspase 3 staining. Ciliary function was also investigated using video microscopy in the ciliated NHBE cells. Hypoxic incubation for 4 hours resulted in a 3–5 fold increase in neutrophil degranulation; this was evident for active elastase, MPO, MMP-9 and lactoferrin and hence occurred from all granule sub-types. Supernatants from hypoxic neutrophils induced 50% more cell death in A549 cells compared to supernatants from normoxic neutrophils. NHBE cells exposed to supernatants from hypoxic versus normoxic neutrophils suffered more cellular damage (EM; images were scored for cytoplasmic blebbing, vacuole formation and dead cells), an increase in LDH activity (from 35.7 ± 6 to 50.2 ± 0.7 nmol/min/ml, was indicative of cell death), increased cleaved caspase 3 staining was shown to be an indicator of apoptosis and there was a substantial increase in the proportion of dyskinetic and immotile cilia. In conclusion; hypoxia induced a destructive neutrophil phenotype with delayed apoptosis, impaired bacterial killing and increased release of histo-cytotoxic proteases. This phenotype may be important for understanding the mechanisms of chronic inflammatory diseases like COPD. Funded by the British Lung Foundation and NIHR Cambridge BRC. <h3>References</h3> McGovern, N. N. <i><i>et al</i>.</i> Hypoxia selectively inhibits respiratory burst activity and killing of Staphylococcus aureus in human neutrophils. <i>J. Immunol. Baltim. Md 1950</i><b>186,</b> 453–463 (2011).
Blood Lead Levels in a Welsh Rural Community
Authors: W. H. Beasley, D. D. Jones, A. Megit, S. G. Lutkins
Journal: BMJ (1973)

In a study of the blood lead levels of 626 healthy blood donors no differences were found between men and women, but there was a significant increase with age. Resident donors had a higher blood lead than students, and the level in residents increased with living in the Aberystwyth area up to about 20 years. The levels in the students did not increase with residence in Aberystwyth. No differences were found in the blood lead of donors living in different wards of Aberystwyth and none between the blood lead of donors living in the rural area and those in the town. Almost half of the local resident donors had a level above the "normal" range.
Hemolytic Anemia in Wilson's Disease
Authors: A. DEISS
Journal: Annals of Internal Medicine (1970)

Penicillamine therapy was discontinued for a period of 200 days in a patient with Wilson's disease. Copper reaccumulated in the body at the rate of about 0.43 mg/day. Urinary copper remained normal for 180 days and then increased rapidly. Simultaneously with the onset of hypercupriuria serum copper, ceruloplasmin, and erythrocyte copper increased, and hemolytic anemia associated with the formation of Heinz bodies on exposure to acetylphenylhydrazine developed. Addition of copper to normal erythrocytes led to increased autohemolysis, thermolability of hemoglobin, increased sensitivity to acetylphenylhydrazine, decreased erythrocyte glutathione, decreased glutathione stability, and inhibition of glucose-6-phosphate dehydrogenase and glutathione reductase. The hemolytic anemia was due to increased oxidative stress on the erythrocytes as a consequence of the accumulation of copper within the cells.
Answer Sought for 'Tobacco Giant' China's Problem
Authors: Andrew A. Skolnick
Journal: JAMA (1996)

Shanghai, China ON APRIL 1, Shanghai Medical University held a ceremony to mark the end of smoking throughout its campus. That this is the first medical school in China to ban smoking is not surprising considering the prevalence of cigarette use among health professionals here. According to a 1989 survey, 68% of male physicians in Beijing, the capital, were smokers—which is even higher than the national rate of 61% for males 15 years of age and older (from a 1984 survey that represents the most reliable data available). Smoking prevalence for women in China was 7% in 1984. However, tobacco control experts believe that number has climbed substantially under the influence of China's rapidly expanding economy and the increasing popularity of Western ways. Altogether, about one third of Chinese adults smoke—more than 300 million persons, or one fourth of the world's smokers. <h3>Problem Largest in World</h3> The seriousness of China's
A large fraction of human peripheral blood gamma/delta + T cells is activated by Mycobacterium tuberculosis but not by its 65-kD heat shock protein.
Authors: D Kabelitz, A Bender, S Schondelmaier, B Schoel, S H Kaufmann
Journal: The Journal of Experimental Medicine (1990)

We report that M. tuberculosis organisms, but neither PHA nor allogeneic stimulator cells, preferentially activate gamma/delta+ cells within E rosette-purified peripheral blood T cells. gamma/delta+ T cells from purified protein derivative (PPD)-nonimmune healthy donors were enriched by depletion of CD4+ and CD8+ cells; double-negative (DN) cells contained 65-92% gamma/delta+ T cells. Limiting dilution (LD) analyses revealed that 1 of 2-19 purified DN cells proliferated in response to mycobacteria, while frequencies of DN cells proliferating in response to a recombinant 65-kD heat shock protein (hsp 65) of M. tuberculosis/M. bovis were 10-20-fold lower. Established clones of mycobacteria-reactive gamma/delta+ T cells specifically recognized mycobacteria, but neither PPD nor hsp 65. Restimulation of these clones required the presence of PBMC feeder cells; EBV-transformed lymphoblastoid cell lines could not substitute for PBMC. Mycobacteria-reactive gamma/delta+ clones proliferated equally well in the presence of autologous or allogeneic (HLA-DR-different) PBMC feeder cells and thus were not MHC class II restricted. Taken together, these results demonstrate that mycobacteria-reactive gamma/delta+ T cells are present in high frequency in the peripheral blood of healthy individuals, and suggest that hsp 65 of mycobacteria is not a major antigen for gamma/delta+ T cells of normal PPD-nonimmune blood donors.
Comments on the Pharmacologic Woof, Warp and Web
Authors: Irvine H. Page
Journal: New England Journal of Medicine (1968)

THERE is a small segment of medicine called pharmacology. Why should pharmacologists be of any special concern to physicians? Many years ago they chiefly studied mechanisms of the actions of drugs, some useful, most not. Then came a professor of therapeutics who taught medical students what they thought they really wanted to know. But by the nineteen twenties times had changed, and medicine was swept by a wave of therapeutic nihilism. The professor of therapeutics disappeared, and pharmacologists nearly met the same fate. The great wave of chemotherapy saved them, and with the avalanche of new remedies along with the . . .