tbuckley/cabot-search huggingface dataset:
Scottish royal colleges ask Blair to do more for Iraq's medical services
Authors: B. Christie
Journal: BMJ (2003)

The Scottish royal medical colleges have appealed to the British government to do more to restore medical services in war torn Iraq.

The three colleges—the Royal College of Physicians of Edinburgh, the Royal College of Surgeons of Edinburgh, and the Royal College of Physicians and Surgeons of Glasgow—have written to Prime Minister Tony Blair expressing their concern at the lack of a coordinated programme to help medical staff who are struggling to provide services in …
An annoying sound
Authors: J. McKay
Journal: BMJ (1999)

Apathy is an under-recognised and underestimated problem for people with chronic neurological disorders. Despite being common and disabling, it is seldom volunteered as a symptom by patients or even their caregivers. Yet apathy undoubtedly has an important impact on caregiver stress, functional disability and quality of life. A detailed clinical assessment can distinguish apathy from depression and allow clinicians to make practical suggestions to reduce the impact of symptoms on individual patients and their families. Pharmacological approaches to treatment include cholinesterase inhibitors, dopamine agonists and stimulants. CASE 1 A 66-year-old man with progressive supranuclear palsy returned to clinic for review. His wife was upset and finding it difficult to cope. She described him as ‘completely lazy’, as he just sat in his chair all day watching television, even though he could still do things for himself. She felt that he could not be bothered to speak to her anymore because he was ‘obsessed with TV’. He did not seem to engage with the visits to the grandchildren that she arranged. He said that he felt fine apart from the problems with his walking. The neurologist was confident that the patient was not depressed, and that the wife9s concerns reflected the apathy that is often very pronounced in progressive supranuclear palsy. By explaining to the man9s wife that these problems were due to his disease, their relationship improved and she felt more able to cope with caring for him. CASE 2 A 75-year-old man attended clinic with his wife. She had worried about him for over a year, as he had become increasingly withdrawn. He used to enjoy going to the local pub but now stayed at home all day. He seemed less concerned about his personal appearance, about which he used to be meticulous. More recently, she had noticed that he had become forgetful. On examination, he had a mild episodic memory deficit but no impairments in other domains. He was diagnosed with mild cognitive impairment but the presence of apathy suggested a high risk of him developing Alzheimer9s disease. He did not improve with a trial of antidepressant treatment but had useful input from an occupational therapist. His apathy improved after he started a cholinesterase inhibitor a year later, when his cognitive symptoms had progressed.
Internal Medicine in the National Resident Matching Program 1978-1989
Authors: John S. Graettinger
Journal: Annals of Internal Medicine (1989)

Editorials1 May 1989Internal Medicine in the National Resident Matching Program 1978-1989John S. Graettinger, MDJohn S. Graettinger, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-110-9-682 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe results of the match for internal medicine in the National Resident Matching Program over the past decade were described in the January 1988 issue (1). These data can now be updated with the results of the 1988 and 1989 matches. Detailed analyses on these matches will be published (2, 3).In Table 1 the results for each type of program are presented. The number of categorical programs has decreased slightly as has the number of positions: 5% fewer positions were offered in 1989 than in 1985. U.S. students matched have decreased in each year since 1985; 21% fewer matched...References1. Graettinger J. Internal Medicine in the National Resident Matching Program 1987: the Ides of March. Ann Intern Med. 1988;108:101-15. LinkGoogle Scholar2. Graettinger J. Datagram: results of the NRMP for 1989. Acad Med. 1989 (In press). CrossrefMedlineGoogle Scholar3. Data. April 1989. Evanston, Illinois: National Resident Matching Program; 1989 (In press). Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: John S. Graettinger, MDAffiliations: National Resident Matching Program Evanston, Illinois PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDemographic and clinical characteristics of patients admitted to medical departmentsIntern candidates who withdraw from contractsRheumatologists as an endangered species: A proposal for changeGeneral internal medicine practice trends in large multispecialty clinicsMedical Student Attitudes about Internal Medicine: A Study of U.S. Medical School Seniors in 1988David Babbott, MD, Gerald S. Levey, MD, Sheila O. Weaver, MS, Charles D. Killian, MANational Study of Internal Medicine Manpower: XVII.Changes in the Characteristics of Internal MedicineResidents and Their Training Programs, 1988-1989Ronald M. Andersen, PhD, Christopher Lyttle, MA, Claire H. Kohrman, PhD, Gerald S. Levey, MD, Kristen Neymarc, MA, Christian Schmidt, BAPrimary Care Internal Medicine: A Challenging Career Choice for the 1990sMack Lipkin Jr., MD, Wendy Levinson, MD, Randol Barker, MD, David Kern, MD, Wylie Burke, MD, John Noble, MD, Steven Wartman, MD, Thomas L. Delbanco, MDUnified general internal medicine training programsMedical Residencies: Quantity or Quality?Frank Davidoff, MD 1 May 1989Volume 110, Issue 9Page: 682-682KeywordsInterleukins ePublished: 1 December 2008 Issue Published: 1 May 1989 PDF downloadLoading ...
Iatrogenic Perforation at Therapeutic Colonoscopy: Should the Endoscopist Attempt Closure Using Endoclips or Transfer Immediately to Surgery?
Authors: K. Taku, Y. Sano, K. Fu, Y. Saito
Journal: Endoscopy (2006)

We read the important article by Heldwein et al. [1] with interest. This prospective study confirms that more than 90 % of complications encountered in colonoscopic polypectomy, including perforation, can be managed conservatively if adequate endoscopic expertise is available. Perforation is the most serious complication during endoscopic treatment, and requires rapid and appropriate management. In this study, there were 26 cases of perforation among which nonsurgical management succeeded in 12 cases, five with endoscopic clipping and seven with conservative treatment only.
Boxing, Personal Freedom and the Right of Lions to Christians-Reply
Authors: Russel H. Patterson
Journal: JAMA (1986)

<h3>In Reply.—</h3> The position of John Stuart Mill that the state should only interfere in the activities of consenting adults when they pose a threat of harm to an innocent victim is an extreme position in that it would seem to justify such things as duels to the death. However, nowadays dueling with pistols has been outlawed, and dueling with swords has been reduced to fencing with blunted weapons and adequate defensive padding on the participants. Mill's position, restated in the context of our times, might be that the state should only resort to banning the activities of an adult when there is no other way to reduce to acceptable levels the risk of serious injury or death to someone else. In the case of boxing, I believe that the sport can be made sufficiently safe by appropriate regulation, including periodic medical examination of the participants as is currently being
The Spontaneous Regression of Cancer
Authors: MILTON G. BOHROD
Journal: JAMA (1966)

More than 30 years ago it was said that we may never be able to<i>cure</i>most cancers, but that we may some day<i>prevent</i>them or<i>arrest</i>them for long periods. Boyd's little book is aimed in this direction. It consists of a collection from the literature and from Boyd's own experience of instances of spontaneous disappearances of cancers, or in some cases, very long inactivity. Then there follows a chapter of speculation, by far the most interesting and important part of the book. Fortunately, we no longer think speculation can be neglected in science. Boyd thinks that regressions have to do with the effects of therapy, the influence of hormones, the action of immune bodies—all of them susceptible to manipulation by man. The book is written in Boyd's usual clear language, so understandable that you may even be able sometimes to disagree with him, also in his usual
Disseminated extramedullary myeloid tumor of the gallbladder without involvement of the bone marrow
Authors: Angela N. Bartley, Craig L. Nelson, Donald H. Nelson, Deborah A. Fuchs
Journal: American Journal of Hematology (2006)

Abstract Extramedullary myeloid tumors (myeloid sarcomas) are rare neoplasms that are composed of myeloid precursors. They usually arise concurrently with a diagnosis of acute myeloid leukemia, chronic myeloid leukemia, or other myeloproliferative disorders. They may also indicate relapsing disease in a patient with a prior history of leukemia or myeloproliferative disorder. We present our findings of a 63‐year‐old female diagnosed with extramedullary myeloid tumor first presenting in the gallbladder. She subsequently developed respiratory failure; pre‐ and postmortem bone marrow studies were negative for leukemia by morphology, flow cytometry, and karyotypic analysis. However, the myeloid neoplasm was disseminated throughout most of her remaining organs. Immunohistochemical stains of the cells indicated a neoplasm of myelomonocytic derivation (CD4, CD43, CD45, CD68, myeloperoxidase, and lysozyme positive). To our knowledge, this is the first report of an extramedullary myeloid neoplasm of the gallbladder with disseminated disease without involvement of the bone marrow. Am. J. Hematol., 2006. © Wiley‐Liss, Inc.
The heart in liver transplantation
Authors: Cristina Ripoll, Raquel Yotti, Javier Bermejo, Rafael Bañares
Journal: Journal of Hepatology (2010)

The heart and liver are organs that are closely related in both health and disease. Patients who undergo liver transplantation may suffer from heart disease that is: (a) related to the original cause of the liver disease such as hemochromatosis, (b) related to the liver disease itself, or (c) related to other associated conditions. Furthermore, liver transplantation is one of the most cardiovascular stressful events that a patient with cirrhosis may undergo. After liver transplantation, the progression of pre-existing or the development of new-onset cardiac disease may occur. This article reviews the relationship between the heart and liver transplantation in the pre-transplant, intra-operative, and post-transplant periods.
Self-inactivating Gammaretroviral Vectors for Gene Therapy of X-linked Severe Combined Immunodeficiency
Authors: Susannah I Thornhill, Axel Schambach, Steven J Howe, Meera Ulaganathan, Elke Grassman, David Williams, Bernhard Schiedlmeier, Neil J Sebire, H Bobby Gaspar, Christine Kinnon, Christopher Baum, Adrian J Thrasher
Journal: Molecular Therapy (2008)

Gene therapy for X-linked severe combined immunodeficiency (SCID-X1) has proven highly effective for long-term restoration of immunity in human subjects. However, the development of lymphoproliferative complications due to dysregulated proto-oncogene expression has underlined the necessity for developing safer vector systems. To reduce the potential for insertional mutagenesis, we have evaluated the efficacy of self-inactivating (SIN) gammaretroviral vectors in cellular and in vivo models of SCID-X1. Vectors incorporating an internal human elongation factor-1α regulatory element were capable of fully restoring the lymphoid differentiation potential of γc-deficient lineage negative cells. Multilineage lymphoid reconstitution of a murine model was achieved at a similar level to that achieved by a conventional long-terminal repeat (LTR)-regulated vector used in previous clinical trials. Functional proliferative responses to mitogenic stimuli were also restored, and serum immunoglobulin levels were normalized. The reduced mutagenic potential conferred by SIN vector configurations and alternative non-LTR-based regulatory elements, together with proven efficacy in correction of cellular defects provides an important platform for development of the next phase of clinical trials for SCID-X1. Gene therapy for X-linked severe combined immunodeficiency (SCID-X1) has proven highly effective for long-term restoration of immunity in human subjects. However, the development of lymphoproliferative complications due to dysregulated proto-oncogene expression has underlined the necessity for developing safer vector systems. To reduce the potential for insertional mutagenesis, we have evaluated the efficacy of self-inactivating (SIN) gammaretroviral vectors in cellular and in vivo models of SCID-X1. Vectors incorporating an internal human elongation factor-1α regulatory element were capable of fully restoring the lymphoid differentiation potential of γc-deficient lineage negative cells. Multilineage lymphoid reconstitution of a murine model was achieved at a similar level to that achieved by a conventional long-terminal repeat (LTR)-regulated vector used in previous clinical trials. Functional proliferative responses to mitogenic stimuli were also restored, and serum immunoglobulin levels were normalized. The reduced mutagenic potential conferred by SIN vector configurations and alternative non-LTR-based regulatory elements, together with proven efficacy in correction of cellular defects provides an important platform for development of the next phase of clinical trials for SCID-X1.
Utilization of individual lecithins in intestinal lipoprotein formation in the rat.
Authors: G M Patton, S B Clark, J M Fasulo, S J Robins
Journal: Journal of Clinical Investigation (1984)

To determine the molecular species composition of lecithins of different nascent lipoproteins, high density lipoproteins (HDL), very low density lipoproteins (VLDL), and chylomicrons (CM) were isolated from the mesenteric lymph of rats. Lymph was collected at 0 degrees C with 5,5'-dithiobis-2-dinitrobenzoic acid added to inhibit lecithin-cholesterol acyl transferase. CM were separated by ultracentrifugation and HDL from VLDL by dextran SO4-MG+2 precipitation. Molecular species of lecithin were directly isolated by reverse phase high performance liquid chromatography. In fasted animals, the lecithin compositions of lymph HDL and VLDL were virtually the same and closely resembled the lecithin composition of intestinal mucosa. When bile lecithin was eliminated (by bile diversion), there was a marked change in lecithin composition of all lipoprotein and mucosal samples, which was most notable for a reduction in 16:0-species (which are predominant in bile) and a relative increase in the corresponding 18:0-species. Feeding unsaturated triglycerides (triolein, trilinolein, or a combination of triolein and trilinolein) also resulted in a change in HDL and VLDL lecithin composition. The effect was similar whether bile lecithin was present or eliminated and was notable for a reduction in 16:0-species, an increase in 18:0-species, and the emergence of large amounts of diunsaturated lecithins that corresponded to the fatty acid composition of the triglycerides fed (i.e., 18:1-18:1, 18:2-18:2, and 18:1-18:2 lecithins). When bile-diverted rats were infused via the duodenum with a mix of [14C]choline-labeled lecithins (isolated from the bile of other rats), the incorporation of infused lecithins into different lymph lipoproteins was distinctly different. Individual lecithins were incorporated to a variable extent into each lipoprotein. In fasted rats the specific activities of all major molecular species of lecithin were relatively greater in VLDL than HDL, indicating that HDL derived proportionately more of its lecithins from an endogenous pool than did VLDL. Feeding triolein changed the specific activities of more of the lecithin species of VLDL than of HDL. The specific activities of lecithins in CM were more similar to VLDL than to HDL after triolein feeding. Results thus indicate that, although the lecithins of different mesenteric lymph lipoproteins are similar and may be derived from membrane sites with the same lecithin composition, lecithins incorporated into different lipoproteins originate from different metabolic pools and/or by different mechanisms.
VERY LATE ABSCESSES IN POSTOPERATIVE SCARS
Authors: WILLIAM A. FISHER
Journal: JAMA (1926)

It is well recognized that tissues which have become infected may be subject to recurrence of acute inflammation for considerable periods after their apparent complete healing. This principle was emphasized by experience with wounds during the war. It soon became apparent that corrective and cosmetic operations on scars of battle wounds that had been originally infected were very apt to relight the previous activity of the infection, sometimes with disastrous results. Accordingly, it became a generally accepted rule to postpone any such contemplated improvement in scars for a period of at least a year after the final healing of the original wound. The same experience has resulted from operative treatment of joints and bones that had formerly been the site of infectious processes. For instance, tuberculosis of the joint may be stirred into renewed virulence by attempts to correct deformities years after all evidence of activity has subsided. This raises
A COMPARISON OF INTRA-LESIONAL TRIAMINOLONE HEXA-CETONIDE AND TRIAMCINOLONE ACETONIDE IN ALOPECIA AREATA
Authors: DAVID PORTER, J.L. BURTON
Journal: British Journal of Dermatology (1971)

SUMMARY.— A comparison of the effects of intralesional triamcinolone acetonide and its less soluble derivative triamcinolone hexacetonide in alopecia areata has shown that both steroids produce a constant linear rate of growth of hair tuft, and the effect of a single injection can persist for at least 9 months.
Plasma fibronectin synthesis in normal and injured humans as determined by stable isotope incorporation.
Authors: C Thompson, F A Blumenstock, T M Saba, P J Feustel, J E Kaplan, J B Fortune, L Hough, V Gray
Journal: Journal of Clinical Investigation (1989)

In humans, plasma fibronectin decreases early after operative injury, burn, or trauma, followed by a rapid restoration with a secondary decline typically observed if such patients become septic. We determined the rate of plasma fibronectin and plasma fibrinogen synthesis in normal subjects and injured patients using a stable isotope incorporation technique with [15N]glycine. During a constant 14-h infusion of [15N]glycine, the enrichment of [15N]glycine in both the free plasma glycine precursor pool as well as the urinary hippurate pool was determined; the latter used as an estimate of intracellular hepatic precursor enrichment. [15N]Glycine enrichment in both plasma fibronectin and fibrinogen was also quantified. The synthesis rate (Js/V) expressed in micrograms per milliliter of plasma per hour and the fractional synthesis rate (FSR) expressed as percentage of the plasma pool produced per day were determined. In normal subjects, the FSR for plasma fibronectin using 15N enrichment into urinary hippurate was 35.35 +/- 1.46%/d, whereas the Js/V was 4.45 +/- 0.19 micrograms/ml plasma per h. In normal subjects, the FSR for plasma fibronectin using 15N enrichment into free plasma glycine was 14.73 +/- 0.63%/d, whereas the Js/V was 1.98 +/- 0.09 micrograms/ml plasma per h. Early (2-3 d) after burn injury, fibronectin synthesis was increased (Js/V = 5.74 +/- 0.36; P less than 0.05), whereas later after injury, fibronectin synthesis began to decline (Js/V = 3.52 +/- 0.24; P less than 0.05) based on 15N enrichment of urinary hippurate. In contrast, the Js/V and FSR of plasma fibrinogen, a well-documented acute-phase plasma protein, revealed a sustained elevation (P less than 0.05) after injury in both the trauma and burn patients. Thus, plasma fibronectin synthesis is elevated early postinjury, which may contribute to the rapid restoration of its blood level. However, once fibronectin levels have normalized, the synthesis of plasma fibronectin appears to decline.
Arteriohepatic Dysplasia in Infancy and Childhood: A Longitudinal Study of Six Patients
Authors: Beverly Barrett Dahms, Mary Petrelli, Robert Wyllie, Malcolm S. Henoch, Thomas C. Halpin, Stuart Morrison, Moonja Chung Park, Anthony S. Tavill
Journal: Hepatology (1982)

Arteriohepatic dysplasia (syndromatic ductular hypoplasia, Alagille syndrome) is a condition of chronic cholestasis dating from infancy accompanied by characteristic facies, pulmonic stenosis, and other somatic abnormalities. The pathologic hallmark of arteriohepatic dysplasia is a paucity or absence of intrahepatic bile ducts, wildely regarded as a congenital deficiency. We present a longitudinal study of six infants and children with arteriohepatic dysplasia, stressing evolution of the characteristic pathology on liver biopsy. All patients were biopsied twice. All five liver biopsies performed during infancy (&lt;6 months old) showed intrahepatic cholestasis and portal inflammation, and two infants had, in addition, giant cell transformation. No infant showed congenital absence of interlobular bile ducts. Three of five infants had normal numbers of interlobular bile ducts (0.5 to 1.0 interlobular bile ducts per triad) and two infants had a paucity of interlobular bile ducts (&lt;0.5 per triad). Three infants showed focal destructive inflammation of interlobular bile ducts. All biopsies performed later in childhood, between 3 and 20 years of age, showed a paucity or absence of interlobular bile ducts. At this time cholestasis and inflammation had largely resolved but some fibrosis persisted. The number of interlobular bile ducts decreased with age in each patient but there was no characteristic age at which interlobular bile ducts disappeared completely. The presence of interlobular bile ducts in infancy followed later in childhood by paucity or absence of interlobular bile ducts, suggests that intrahepatic bile duct deficiency in some patients with arteriohepatic dysplasia is acquired rather than congenital. The mechanism of bile duct disappearance in these patients may have been destructive inflammation of duct epithelium. Histopathologic diagnosis of arteriohepatic dysplasia may be difficult or impossible in infancy since interlobular bile ducts may be present at that time. However, arteriohepatic dysplasia should be considered in the differential diagnosis of all infants with cholestasis and such infants should have careful clinical evaluation for the syndromatic features of arteriohepatic dysplasia. Evaluation of their liver biopsies should include specific morphometric assessment of interlobular bile ducts.
The treatment of visible signs of senescence: the Asian experience
Authors: S. H. GOH
Journal: British Journal of Dermatology (1990)

Ageing of the skin is of growing concern. People living in the Far East are exposed to bright sunlight all year round so photoageing of exposed skin is inevitable. Visible signs of photoageing include hyperpigmentation, which is an early and prominent feature. In contrast, wrinkling and coarseness are late and inconspicuous features. Tretinoin has been shown to be effective in the improvement of these visible signs. The adverse effects of tretinoin present in the early phase of treatment: with adequate counselling from the dermatologist, and patience and preseverence on the part of the patient, these effects are only temporary and disappear with prolonged treatment. It seems that the longer the treatment and the stronger the concentration of tretinoin, the better the result.