tbuckley/cabot-search huggingface dataset:
Methylprednisolone Prevention of Increased Lung Vascular Permeability following Endotoxemia in Sheep
Authors: Kenneth L. Brigham, Ronald E. Bowers, Charles R. McKeen
Journal: Journal of Clinical Investigation (1981)

To see whether methylprednisolone would affect the pulmonary vascular response to endotoxemia, we studied responses to endotoxemia in the presence and absence of methylprednisolone in the same chronically instrumented, unanesthetized sheep. Infusion of Escherichia coli endotoxin (0.70-1.33 μg/kg) caused an initial period of marked pulmonary hypertension followed several hours later by a long period of increased vascular permeability when pulmonary vascular pressures were near base line (base-line pulmonary artery pressure (PPa) = 21±1 cm H2O SE, left atrial pressure (Pla) = 1±3; experimental PPa = 20±3, Pla = 3±4; P = NS), lung lymph flow (˙Qlym) was high (base-line ˙Qlym = 7.2±0.2 ml/h; experimental ˙Qlym = 23.2±1.0; P < 0.05) and lymph/plasma protein concentration (L/P) was high (base-line L/P = 0.65±0.04; experimental L/P = 0.79±0.05; P < 0.05). When methylprednisolone (1.0 g + 0.5 g/h i.v.) was begun 30 min before the same dose of endotoxin was infused, the initial pulmonary hypertension was less and the late phase increase in lung vascular permeability was prevented (experimental PPa = 24±1, Pla = 1±1, ˙Qlym = 10.0±0.4; L/P = 0.56±0.03). ˙Qlym and L/P were significantly (P < 0.05) lower than with endotoxin alone. Methylprednisolone began during the initial pulmonary hypertensive response to endotoxin also prevented the late phase increase in lung vascular permeability, but the drug had no effect once vascular permeability was increased. We conclude that large doses of methylprednisolone given before or soon after endotoxemia prevent the increase in lung vascular permeability that endotoxin causes, but do not reverse the abnormality once it occurs.
Urethro-Scrotal Fistula Presenting as Massive Scrotal"Bladder" on Radionuclide Bone Scan
Authors: NICHOLAS J. BOHNEN, BRAHM SHAPIRO
Journal: Clinical Nuclear Medicine (1997)

A 74-year-old man underwent Tc-99m MDP bone scintigraphy for evaluation of rheumatoid arthritis. Tc-99m MDP images demonstrated a large area of sharply demarcated, abnormally increased activity in the scrotal region and mildly increased tracer uptake in both knees and right ankle. Physical inspection revealed a very large, fluid-filled scrotum. The patient had sustained a pelvic fracture nearly 40 years earlier. This resulted in a prostatomembranous urethral disruption with subsequent unsuccessful attempts at repair. Recent urethrocystoscopic examination revealed a ventral urethral opening with passage into a capacious scrotal pouch, which was epithelialized. The patient had also been treated for recurrent urethral strictures. The patient normally voided by emptying his bladder into the scrotum and then manually decompressing the scrotum to void the urine via the urethra. This represents a different mechanism from previous reports of inguinoscrotal bladder herniation.
UK review of overseas aid prioritises health, hunger, girls' education, and conflict prevention
Authors: P. Moszynski
Journal: BMJ (2011)

The UK Department for International Development has announced a major shake up of its aid programme in the wake of a comprehensive review of existing expenditure. Overall the aid budget will continue to rise, but the number of countries receiving aid directly will drop from 43 to 27, and assistance channelled through aid organisations will be reallocated to “bring maximum value” for UK taxpayers.

This means major boosts in funding for several organisations that deal with global health issues, including the Global Alliance for Vaccines and Immunisation (GAVI), the Global Fund to Fight AIDS, Tuberculosis and Malaria, and Unicef.

Next year’s total aid budget is £8.4bn (€9.8bn; $13.7bn), and the annual figure is due to rise by 42% between now and 2014-15 in line with the government’s commitment to spend 0.7% of gross national income on official development assistance by 2013. …
Prenatal X-Ray Exposure and Twins
Authors: Brian MacMahon
Journal: New England Journal of Medicine (1985)

Nearly 30 years after Stewart and colleagues presented data showing an increased risk of cancer for children who were exposed to diagnostic x-rays while in utero,1 the meaning of this association remains unclear. Although the observation has not been reproduced in a few smaller studies, the larger studies and the bulk of the evidence suggest that the association exists.2 The uncertainty concerns its explanation. Bithell and Stewart express the view that it is evidence of a causal connection between the radiation exposure and increased cancer risk.3 Others are more inclined to look for some characteristic of the mother, the child, . . .
Lovastatin: Follow-up Ophthalmologic Data
Authors: Donald B. Hunninghake
Journal: JAMA (1988)

<h3>To the Editor.</h3> —About a year ago, we reported in these pages that lovastatin, an inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase that is now available for prescription in the United States, was well tolerated and very effective as a lipid-lowering drug.<sup>1</sup>However, among the 101 patients in our 18-week study, 13 were found to have lens opacities at the poststudy examination that had not been reported at baseline. As we commented in our article, these data were difficult to interpret because of the subjective nature of slit-lamp examination for the detection of small opacities and the fact that all patients took lovastatin at some point during the study, so that there was no parallel control group. We are now able to provide further information. <h3>Study.</h3> —On completion of the double-blind part of the study, most patients continued taking lovastatin in an open extension of the study, which is ongoing.
Incidence of phenotypic aberrations in a series of 467 patients with B chronic lymphoproliferative disorders: basis for the design of specific four-color stainings to be used for minimal residual disease investigation
Authors: ML Sánchez, J Almeida, B Vidriales, MC López-Berges, MA García-Marcos, MJ Moro, A Corrales, MJ Calmuntia, JF San Miguel, A Orfao
Journal: Leukemia (2002)
Sleep Epilepsy: Its Pattern and Prognosis
Authors: F. B. Gibberd, M. C. Bateson
Journal: BMJ (1974)

In a series of 645 patients with epilepsy only 38 had attacks exclusively during sleep. A further 111 had attacks while waking and sleeping. The total number of patients whose epilepsy started with sleep attacks and who later developed attacks when waking increased with each successive year. The prognosis of sleep epilepsy is important in relation to the granting of driving licences.
Fc gamma RIIA alleles are heritable risk factors for lupus nephritis in African Americans.
Authors: J E Salmon, S Millard, L A Schachter, F C Arnett, E M Ginzler, M F Gourley, R Ramsey-Goldman, M G Peterson, R P Kimberly
Journal: Journal of Clinical Investigation (1996)

Allelic variants of Fc gamma R confer distinct phagocytic capacities providing a mechanism for heritable susceptibility to immune complex disease. Human Fc gamma RIIa has two codominantly expressed alleles, R131 and H131, which differ substantially in their ability to ligate human IgG2. The Fc gamma RIIa-H131 is the only human Fc gamma R which recognizes IgG2 efficiently and optimal IgG2 handling occurs only in the homozygous state. Therefore, since immune complex clearance is essential in SLE, we hypothesized that Fc gamma RIIA genes are important disease susceptibility factors for SLE, particularly lupus nephritis. In a two-stage cross-sectional study, we compared the distribution of Fc gamma RIIA alleles in African Americans with SLE to that in African American non-SLE controls. A pilot study of 43 SLE patients and 39 controls demonstrated a skewed distribution of Fc gamma RIIA alleles, with only 9% of SLE patients homozygous for Fc gamma RIIa-H131 compared with 36% of controls (odds ratio, 0.18; 95% CI, 0.05-0.69, P = 0.009). This was confirmed with a multicenter study of 214 SLE patients and 100 non-SLE controls. The altered distribution of Fc gamma RIIA alleles was most striking in lupus nephritis. Trend analysis of the genotype distribution showed a highly significant decrease in Fc gamma RIIA-H131 as the likelihood for lupus nephritis increased (P = 0.0004) consistent with a protective effect of the Fc gamma RIIA-H131 gene. The skewing in the distribution of Fc gamma RIIA alleles identifies this gene as a risk factor with pathophysiologic importance for the SLE diathesis in African Americans.
Therapeutic Approaches to Postoperative Contracture of the Vesical Neck
Authors: U. Seppelt
Journal: Endoscopy (1981)

Postoperative contracture is a rare cause of the secondary obstructions of the vesical neck, besides remnants of prostatic adenomas, recurrent adenoma and prostatic cancer. It appears morphologically either as circumscribed sclerosis, as so-called sphincter sclerosis, or as extensive contracture of the entire prostatic urethra. Severe postoperative contracture with an iris-shaped membrane at the site of the internal sphincter is the most frequent form up to one year after primary surgery. The overall incidence has been given as 1.37%, of which 13.6% were refractory to therapy and recurred. Special forms of therapy are discussed.
Anti‐Anaphylactic and Bronchodilating Action of a Beta‐Adrenoceptor Stimulator, KWD 2131, in Human Lung Tissue
Authors: K. Strandberg, K‐O. Pegelow, C. G. A. Persson, L. Sörenby
Journal: Allergy (1979)

The beta‐adrenoceptor stimulating agent KWD 2131 has been studied with regard to inhibitory effect on allergen‐induced histamine release from passively sensitized human lung tissue and relaxing effect on contracted small (diameter= 1 mm) and large (diameter 3 mm) isolated human bronchi. The dose for 50% inhibition of the allergen‐induced histamine release was 2 × 10 −11 M. The potency of KWD 2131 was approximately 0.15 times that of terbutaline and 0.05 times that of isoprenaline in this respect. The bronchodilating potency‐ of KWD 2131 was 0.02–0.03 times that of terbutaline. The data indicate that KWD 2131 is a compound with preferably anti‐anaphylactic potency in the human lung.
History, Applications, and Mechanisms of Deep Brain Stimulation
Authors: Svjetlana Miocinovic, Suvarchala Somayajula, Shilpa Chitnis, Jerrold L. Vitek
Journal: JAMA Neurology (2012)

Deep brain stimulation (DBS) is an effective surgical treatment for medication-refractory hypokinetic and hyperkinetic movement disorders, and it is being explored for a variety of other neurological and psychiatric diseases. Deep brain stimulation has been Food and Drug Administration-approved for essential tremor and Parkinson disease and has a humanitarian device exemption for dystonia and obsessive-compulsive disorder. Neurostimulation is the fruit of decades of both technical and scientific advances in the field of basic neuroscience and functional neurosurgery. Despite the clinical success of DBS, the therapeutic mechanism of DBS remains under debate. Our objective is to provide a comprehensive review of DBS focusing on movement disorders, including the historical evolution of the technique, applications and outcomes with an overview of the most pertinent literature, current views on mechanisms of stimulation, and description of hardware and programming techniques. We conclude with a discussion of future developments in neurostimulation.
Efficacy of high magnification chromoscopic colonoscopy for the diagnosis of neoplasia in flat and depressed lesions of the colorectum: a prospective analysis
Authors: D P Hurlstone, S S Cross, I Adam, A J Shorthouse, S Brown, D S Sanders, A J Lobo
Journal: Gut (2004)

<b>Background:</b> High magnification chromoscopic colonoscopy (HMCC) permits the in vivo examination of the colorectal pit pattern, which has a high correlation with stereomicroscopic appearances of resected specimens. This new technology may provide an “optical biopsy” which can be used to aid diagnostic precision and guide therapeutic strategies. Conflicting data exist concerning the accuracy of this technique when discriminating neoplastic from non-neoplastic lesions, particularly when flat and depressed. <b>Aim:</b> To prospectively examine the efficacy of HMCC for the diagnosis of neoplasia in flat and depressed colorectal lesions using standardised morphological, pit pattern, and histopathological criteria. Clinical recommendations for the use of HMCC are made. <b>Methods:</b> Total colonoscopy was performed on 1850 patients by a single endoscopist from January 2001 to July 2003 using the C240Z magnifying colonoscope. Identified lesions were classed according to the Japanese Research Society guidelines, and pit pattern according to Kudos modified criteria. Pit pattern appearances were then compared with histopathology. <b>Results:</b> A total of 1008 flat lesions were identified. The sensitivity and specificity of HMCC in distinguishing non-neoplastic from neoplastic lesions were 98% and 92%, respectively. However, when using HMCC to differentiate neoplastic/non-invasive from neoplastic/invasive lesions, sensitivity was poor (50%) with a specificity of 98%. Diagnostic accuracy was not influenced by size or morphological classification of lesions. <b>Conclusion:</b> HMCC has a high overall accuracy at discriminating neoplastic from non-neoplastic lesions but is not 100% accurate. HMCC is a useful diagnostic tool in vivo but presently is not a replacement for histology. Requirements for further education and training in these techniques need to be addressed.
The Monster at Our Door: The Global Threat of Avian Flu
Authors: Geoff Watts
Journal: BMJ (2005)

I s the threat of avian flu "the monster at our door" or, to use an alternative and zoologically mixed metaphor, a frightened chicken crying wolf? We need to know. Mike Davis The New Press, £12.99, pp 212 ISBN 1 59558 011 5 Rating: ![Graphic][1]</img>![Graphic][2]</img>![Graphic][3]</img>![Graphic][4]</img> Now, as throughout the past few decades, the health scare industry continues to cut dark swathes through the sunny fields of reason, evidence, and proportionality. The MMR (measles, mumps, rubella) vaccine, mercury in tooth fillings, listeria, mobile phones, microwave ovens, beef, coffee, electromagnetic fields, pesticide residues, and a score of other such items have clawed their way up the news agenda, basked in the media spotlight, then slipped back to their true level in the league table of environmental risk. The number of times that some of these items have made the return trip would lead one to believe they must have purchased a season ticket. In recent weeks, a few world-weary commentators have begun hinting that avian flu will soon be joining that … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif [4]: /embed/inline-graphic-4.gif
Oil Granuloma of the Lung
Authors: A. H. M. Siddons
Journal: BMJ (1958)

negative.Results of liver function tests were normal.There was no radiological evidence of oesophageal varices or of gastro-duodenal disease.Study of the patient's haemoglobin revealed 3.1% alkaliresistant pigment (Hb-F).On electrophoresis an increase , .....in Hb-A2 was noted in t h e unstained paper strip (repro-; .W . ^'\.
Effects of Increasing Maintenance Dose of Digoxin on Left Ventricular Function and Neurohormones in Patients With Chronic Heart Failure Treated With Diuretics and Angiotensin-Converting Enzyme Inhibitors
Authors: Mihai Gheorghiade, Veronica B. Hall, Gordon Jacobsen, Mohsin Alam, Howard Rosman, Sidney Goldstein
Journal: Circulation (1995)

Background Despite almost three centuries of use, the appropriate dosage of digitalis in patients with chronic heart failure and normal sinus rhythm has not been well studied. Methods and Results We studied 22 patients with heart failure who were receiving constant daily doses of digoxin, diuretics, and angiotensin-converting enzyme (ACE) inhibitors. In 18 patients, the oral daily dose of digoxin was increased from a mean of 0.20±0.07 to 0.39±0.11 mg/day corresponding to an increase in the serum digoxin concentration from 0.67±0.22 to 1.22±0.35 ng/mL. Radionuclide and echocardiographic left ventricular ejection fraction; maximal treadmill time; heart failure score; serum concentrations of norepinephrine, aldosterone, atrial natriuretic factor, and antidiuretic hormone; and plasma renin activity were obtained before and after the increase in digoxin dose. Subsequently, 9 patients were randomized to receive digoxin and 9 to receive placebo and radionuclide ejection fraction measured after 12 weeks. With the higher dose of digoxin compared with the lower dose, there was a significant increase in radionuclide ejection fraction from 23.7±9.6% to 27.1±11.8% ( P =.007). No significant changes were noted in heart failure score; exercise tolerance; serum concentrations of norepinephrine, atrial natriuretic factor, and antidiuretic hormone; and plasma renin activity. There was, however, an increase in serum aldosterone concentration. Twelve weeks after the patients were randomized to receive digoxin or placebo, there was a significant decrease in ejection fraction (from 29.4±10.4% to 23.7±8.9%) in the placebo group but not in patients who continued to receive digoxin ( P =.002). Conclusions The increase in maintenance digoxin dose, while maintaining serum concentrations within therapeutic range, resulted in a significant increase in left ventricular ejection fraction that was not associated with significant changes in heart failure score, exercise tolerance, and neurohumoral profile.
Insulin Degludec Versus Insulin Glargine in Insulin-Naive Patients With Type 2 Diabetes
Authors: Bernard Zinman, Athena Philis-Tsimikas, Bertrand Cariou, Yehuda Handelsman, Helena W. Rodbard, Thue Johansen, Lars Endahl, Chantal Mathieu
Journal: Diabetes Care (2012)

To compare ultra-long-acting insulin degludec with glargine for efficacy and safety in insulin-naive patients with type 2 diabetes inadequately controlled with oral antidiabetic drugs (OADs).In this 1-year, parallel-group, randomized, open-label, treat-to-target trial, adults with type 2 diabetes with A1C of 7-10% taking OADs were randomized 3:1 to receive once daily degludec or glargine, both with metformin. Insulin was titrated to achieve prebreakfast plasma glucose (PG) of 3.9-4.9 mmol/L. The primary end point was confirmation of noninferiority of degludec to glargine in A1C reduction after 52 weeks in an intent-to-treat analysis.In all, 1,030 participants (mean age 59 years; baseline A1C 8.2%) were randomized (degludec 773, glargine 257). Reduction in A1C with degludec was similar (noninferior) to that with glargine (1.06 vs. 1.19%), with an estimated treatment difference of degludec to glargine of 0.09% (95% CI -0.04 to 0.22). Overall rates of confirmed hypoglycemia (PG <3.1 mmol/L or severe episodes requiring assistance) were similar, with degludec and glargine at 1.52 versus 1.85 episodes/patient-year of exposure (PYE). There were few episodes of nocturnal confirmed hypoglycemia in the overall population, and these occurred at a lower rate with degludec versus glargine (0.25 vs. 0.39 episodes/PYE; P = 0.038). Similar percentages of patients in both groups achieved A1C levels <7% without hypoglycemia. End-of-trial mean daily insulin doses were 0.59 and 0.60 units/kg for degludec and glargine, respectively. Adverse event rates were similar.Insulins degludec and glargine administered once daily in combination with OADs provided similar long-term glycemic control in insulin-naive patients with type 2 diabetes, with lower rates of nocturnal hypoglycemia with degludec.
Increased C1q binding and arthritis in primary biliary cirrhosis.
Authors: J P Crowe, M G Molloy, I Wells, B R Thompson, E J Holborow, E Hamilton, R Williams
Journal: Gut (1980)

Using the C1q binding assay, circulating immune complexes were detected in 31 of 50 (62%) patients with primary biliary cirrhosis and 17 of these had arthritis. This took the form of a seropositive inflammatory polyarthritis in 12 of 18 patients with C1q binding greater than or equal to 20%, whereas a milder seronegative arthritis associated with scleroderma and Raynaud's phenomenon was found in five of 13 patients with C1q binding < 20%. Only two of the 19 patients with normal binding had arthritis and this was of a mild and transient nature. There was a positive correlation between C1q binding and the serum concentrations of IgG and IgM. Results also supported the hypothesis that circulating immune complexes may be involved in the development of arthritis in patients with primary biliary cirrhosis.
Validation of two age dependent D-dimer cut-off values for exclusion of deep vein thrombosis in suspected elderly patients in primary care: retrospective, cross sectional, diagnostic analysis
Authors: H. J. Schouten, H. L. Koek, R. Oudega, G.-J. Geersing, K. J. M. Janssen, J. J. M. van Delden, K. G. M. Moons
Journal: BMJ (2012)

<b>Objective</b> To determine whether the use of age adapted D-dimer cut-off values can be translated to primary care patients who are suspected of deep vein thrombosis. <b>Design</b> Retrospective, cross sectional diagnostic study. <b>Setting</b> 110 primary care doctors affiliated with three hospitals in the Netherlands. <b>Participants</b> 1374 consecutive patients (936 (68.1%) aged &gt;50 years) with clinically suspected deep vein thrombosis. <b>Main outcome measures</b> Proportion of patients with D-dimer values below two proposed age adapted cut-off levels (age in years×10 μg/L in patients aged &gt;50 years, or 750 μg/L in patients aged ≥60 years), in whom deep vein thrombosis could be excluded; and the number of false negative results. <b>Results</b> Using the Wells score, 647 patients had an unlikely clinical probability of deep vein thrombosis. In these patients (at all ages), deep vein thrombosis could be excluded in 309 (47.8%) using the age dependent cut-off value compared with 272 (42.0%) using the conventional cut-off value of 500 μg/L (increase 5.7%, 95% confidence interval 4.1% to 7.8%). This exclusion rate resulted in 0.5% and 0.3% false negative cases, respectively (increase 0.2%, 0.004% to 8.6%).The increase in exclusion rate by using the age dependent cut-off value was highest in the oldest patients. In patients older than 80 years, deep vein thrombosis could be safely excluded in 22 (35.5%) patients using the age dependent cut-off value compared with 13 (21.0%) using the conventional cut-off value (increase 14.5%, 6.8% to 25.8%). Compared with the age dependent cut-off value, the cut-off value of 750 μg/L had a similar exclusion rate (307 (47.4%) patients) and false negative rate (0.3%). <b>Conclusions</b> Combined with a low clinical probability of deep vein thrombosis, use of the age dependent D-dimer cut-off value for patients older than 50 years or the cut-off value of 750 μg/L for patients aged 60 years and older resulted in a considerable increase in the proportion of patients in primary care in whom deep vein thrombosis could be safely excluded, compared with the conventional cut-off value of 500 μg/L.
Putative Determinants of Arterial Wall Compliance in NIDDM
Authors: Mark L Wahlqvist, Che Sam Lo, Kenneth A Myers, Richard W Simpson, Judy M Simpson
Journal: Diabetes Care (1988)

Aortoiliac arterial wall compliance was measured in apparently healthy subjects and in patients with noninsulin-dependent diabetes (NIDDM), on diet alone, who had no clinical evidence of peripheral arterial disease. Compliance was significantly lower in patients with diabetes. The two clinical groups were combined to provide as wide a range of blood glucose values as possible. After allowing for the influence of age, there were significant negative correlations between compliance and free fatty acid and insulin levels. These were almost completely accounted for by differences in blood glucose levels. Therefore, arterial compliance was best predicted on the basis of age and the area under the blood glucose curve.