tbuckley/cabot-search huggingface dataset:
Policlinic: Medical Teaching at the Bedside
Authors: G. C. Moss
Journal: BMJ (1967)

Tablets containing 100 mg.sodium ascorb- ate or lactose (flavoured with small amounts of bicarbonate to render them indistinguishable from the ascorbate on chewing) were randomly allocated with instructions to take 5 tablets one hour before the exercise and 4 tablets immediately after.Subjects were only required to fill in a simple questionary.The following morning each recorded the degree of muscle stiffness, if any.Those who had recorded stiffness or discomfort took a further 800 mg. of vitamin C over a period of six hours, recording whether the stiffness subsequently wore off or not.Analysis of results showed that 40 subjects (35 male and 5 female) had ascorbate and 38 (35 male and 3 female) had lactose.Average age of the two groups was 22.8 and 23.7 years.Although the degree of muscle stiffness had been recorded, this purely subjective classification was in fact ignored in the final analysis, as it was felt to be unreli- able.No significant differences were demon- strated between the two groups in respect of either " morning after " discomfort or the subsequent six-hour trend.The trial was carried out with the most helpful co-operation of Col. R. C. Robertson- MacLeod, Commandant of the Police College, and the on-the-spot practical assistance of Sgt.Duff, to whom, together
Endoscopic Mucosal Resection and Full Thickness Resection with Complete Defect Closure for Early Gastrointestinal Malignancies
Authors: H. Suzuki, K. Ikeda
Journal: Endoscopy (2001)

Background and Study Aims: We developed a new endoscopic technique, the endoscopic full-thickness resection (EFTR) and endoscopic complete defect closure (ECDC), for the treatment of early gastrointestinal malignancies.
Factors Associated With Treatment Response to Etanercept in Juvenile Idiopathic Arthritis
Authors: Marieke H. Otten, Femke H. M. Prince, Wineke Armbrust, Rebecca ten Cate, Esther P. A. H. Hoppenreijs, Marinka Twilt, Yvonne Koopman-Keemink, Simone L. Gorter, Koert M. Dolman, Joost F. Swart, J. Merlijn van den Berg, Nico M. Wulffraat, Marion A. J. van Rossum, Lisette W. A. van Suijlekom-Smit
Journal: JAMA (2011)

TUMOR NECROSIS factor ␣ antagonist, was approved a decade ago by the US Food and Drug Administration and the European Medicines Agency for the treatment of juvenile idiopathic arthritis (JIA).The efficacy of etanercept for patients with JIA and a polyarticular course has been established in a randomized placebocontrolled withdrawal trial that showed 30% improvement from baseline according to the American College of Rheumatology (ACRpedi 30) in more than 70% of the patients. 13][4] Since the development of biological agents, the pharmacological treatment approach of JIA is changing rapidly, and synthetic diseasemodifying antirheumatic drugs (DMARDs) are used earlier in the disease course, which seem to provide better long-term outcomes. 5,6As a result
Abnormal Blood Chemistry Values in Hodgkin's Disease
Authors: Peter H. Levine
Journal: JAMA (1972)

Nine of 26patients with Hodgkin's disease had persistent abnormalities of serum alkaline phosphatase or transaminase levels, or sulfobromophthalein retention, and were studied in prospective fashion for evidence of liver or bone disease. Only one case of true stage IV disease could be documented. The serum abnormalities disappeared following radiotherapy in most cases. Abnormal blood chemistry values in Hodgkin's disease should not be assumed to reflect stage IVdisease.
An epidemiological comparison between occupational and non-occupational hand eczema
Authors: C.L. GOH
Journal: British Journal of Dermatology (1989)

Thirty-four per cent of 2110 patients with eczema attending a contact dermatitis clinic had hand eczema. Fifty-five per cent (395 of 721) had contact dermatitis and 45% (326 of 721) had endogenous/unclassifiable eczema. Thirty-five per cent of cases (217 of 721) were occupational eczema. An epidemiological comparison of patients with occupational and non-occupational hand eczema (defined as eczema occurring on the hands up to the wrist line) was made. Hand eczema was more common in males in both groups, and there was a significantly larger proportion of males in the occupational group (65%) than the non-occupational group (51%) (P<0.001). The prevalence of a personal or family history of atopy was significantly lower in the occupational group (7%) than the non-occupational group (15%) (P<0.005). Irritant contact dermatitis occurred in a larger proportion of patients in the occupational group (76%) than the non-occupational group (39%) (P<0.0001). There was no significant difference between the proportions of patients with positive patch test reactions in the occupational group (34%) and the non-occupational group (41%). Potassium dichromate, and epoxy resin allergy occurred significantly, more frequently, in the occupational group whereas fragrance-mix allergy was significantly more frequent in the non-occupational group.
High rates of disseminated infection due to non-tuberculous mycobacteria among AIDS patients in Finland
Authors: Matti A. Ristola, C.Fordham von Reyn, Robert D. Arbeit, Hanna Soini, Jukka Lumio, Annamari Ranki, Suvi Bühler, Richard Waddell, Anna N.A. Tosteson, J.O. Falkinham, Carol H. Sox
Journal: Journal of Infection (1999)
977. CD4+ T Cell Independent DNA Vaccination Against Pneumocystis Carinii in Mice
Authors: Mingquan Zheng, Myle Robicchaux, Christoph Kliment, Judd E. Shellito, Jay K. Kolls
Journal: Molecular Therapy (2005)

Host defenses are profoundly compromised in HIV infection and other immunocompromised states due to progressive depletion of CD4+ T-lymphocytes. Deficient CD4+ T lymphocytes impair vaccination approaches to prevent opportunistic infection. CD40 ligand (CD40L) is expressed on activated CD4+ T cells and is critical for host defense against Pneumocystis carinii (PC) as well as bacterial pneumonia. Our lab has demonstrated that 25 kDa and 55 kDa antigens of PC generate antigen specific B-cell responses in dendritic cell (DC) vaccination. Using 2-D gel electrophoresis and N-terminal sequencing, we have shown that one of these antigens has a high degree of homology to Kexin, a protease encoded in the PC genome. Therefore we investigated a CD4+ T-cell independent CD40L DNA vaccine approach to a prototypic AIDS-defining infection, PC pneumonia. Plasmids encoding the control antigen, OVA (pACCOVA) , CD40L (pACCCD40L), OVA plus CD40L (pACCOVA-CD40L), Kexin (pACCKexin) and Kexin plus CD40L(pACCKexin-CD40L) driven by the CMV promoter were injected intramuscularly into control or CD4-depleted BALB/c mice 3 times. At specific time points, sera was collected and assayed for anti-OVA and anti-PC antibodies by ELISA. Antigen specific CD8 T cells response were analyzed by IFN-g secretion and dimer OVA-antigen specific positive cells in splenocytes. For adoptive transfer experiments, sera and B cells from vaccinated mice were transferred to na|[iuml]|ve severe combined immunodeficient (SCID) mice followed by challenge with PC. To asses the affect of adoptively transferred sera or cells on PC infection, SCID mice were sacrificed at 28 days and PC burden was determined by real-time PCR. ACCOVA alone resulted in the induction of anti-OVA IgG1 and IgG2a in control mice but this response was significantly attenuated in CD4- depleted mice. Co-administration of pACCCD40L with pACCOVA resulted in similar levels of anti-OVA IgG1 and IgG2a despite the absence of CD4+ T -cells. pACCKexin-CD40L significantly induced a higher titer of anti-PC (IgG1 and IgG2a) then pACCKexin alone. Moreover, the induced anti-PC Ab showed significant opsonic-mediated PC killing in an in vitro killing assay. SCID mice that received either sera or CD19+ splenocytes from pACCKexin + pACCCD40L were significantly protected from PC challenge compared to the OVA or pACCKexin alone control groups. These studies show the promise of proteomic screening to identify antigens for vaccination and the addition of CD40L in DNA vaccine protocols enhances antibody responses in CD4-defecint hosts. Taken together, these data support the rationale for CD4-independent antigen specific antigen DNA vaccines against HIV-related opportunistic infection.
Human Tissue Bill is modified because of research needs
Authors: Clare Dyer
Journal: BMJ (2004)

The UK government has caved in to the demands of biomedical researchers and watered down controversial measures in its Human Tissue Bill that would have required the consent of patients for the storage and use for research of any human tissue or bodily fluids taken from living persons.

Scientists had warned that the requirements of the bill, introduced in response to an outcry over the widespread retention of children's organs without parents' consent, could prevent potentially life saving research.

They …
X-Ray Diagnosis of Pulmonary Lesions
Authors: Laurence L. Robbins
Journal: New England Journal of Medicine (1948)

THE roentgenologic examination of the chest readily reveals abnormality, but the determination of the exact nature of the process is more difficult. One way of approaching the diagnosis is dependent upon a knowledge of gross anatomy, pathology, physiology and x-ray shadows, in addition to having available the brief facts concerning the clinical status of the patient. The material collected for this review is presented on this basis.From the anatomic standpoint, the recent studies of Boyden and his associates1 2 3 of the bronchial and vascular structures of the lung, particularly the relation of the various segments, have been of value. Roentgenologically, . . .
Exposure to bacteria in swine-house dust and acute inflammatory reactions in humans.
Authors: W Zhiping, P Malmberg, B M Larsson, K Larsson, L Larsson, A Saraf
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

Inhalation of swine-house dust may cause an acute airway inflammatory condition (organic dust toxic syndrome). Thirty-eight healthy subjects were exposed to swine dust while weighing swine for 3 h. We studied the correlation between acute health effects and the inhaled bacterial exposure markers peptidoglycan (the main constituent of the cell walls of gram-positive bacteria, but also present in lesser amounts in gram-negative bacteria) and lipopolysaccharides (LPS; present only in gram-negative bacteria). LPS activity in airborne dust was measured with the Limulus amebocyte lysate assay (LPS(LAL)), and the total LPS was estimated from 3-hydroxy fatty acids, which were measured with gas chromatography-mass spectrometry (GC-MS) (LPS(GC-MS)). Peptidoglycan was estimated from muramic acid measured with GC-MS. The median (25th to 75th percentile) concentration of inhalable dust was 21 (16 to 25) mg/m3. LPS(LAL) was 1.2 (0.9 to 1.4) microg/m3; LPS(GC-MS) was 3.9 (2.5 to 4.9) microg/m3; and the peptidoglycan concentration in airborne dust was 6.5 (2.7 to 13) microg/m3. All exposure markers correlated significantly with an increase in serum interleukin-6. LPS(LAL) showed the highest correlation (r2 = 0.29) and total inhaled dust the lowest (r2 = 0.09). LPS(LAL) also correlated with symptoms and with an increase in bronchial responsiveness and decrease in vital capacity (VC). Peptidoglycan, but not LPS(LAL), correlated with an increase in the blood granulocyte concentration and in body temperature. The results suggest that several microbial agents in inhaled swine-house dust may contribute to acute systemic health effects.
No relevant effect of ursodeoxycholic acid on cytochrome P450 3A metabolism in primary biliary cirrhosis
Authors: Karin Dilger, Annette Denk, Malte H. J. Heeg, Ulrich Beuers
Journal: Hepatology (2005)

Induction of cytochrome P450 3A (CYP3A) has been suggested as a mechanism of action of ursodeoxycholic acid (UDCA) in cholestasis. CYP3A is of key importance in human drug metabolism, being involved in presystemic extraction of more than 50% of all drugs currently available and of various endogenous compounds. Therefore, we compared the induction potential of UDCA with that of the prototypical inducer rifampicin in a human model study with the CYP3A substrates budesonide and cortisol. Twelve patients with early-stage primary biliary cirrhosis and eight healthy volunteers were treated with UDCA (15 mg/kg daily) for 3 weeks and subsequently with rifampicin (600 mg/d) for 1 week. Extensive pharmacokinetic profiling of oral budesonide (3 mg) was performed by determination of budesonide and phase I metabolites (6β-hydroxybudesonide, 16α-hydroxyprednisolone) in plasma and urine at baseline and at the end of each treatment. In parallel, urinary 6β-hydroxycortisol, a validated marker of CYP3A induction, was determined. UDCA did not affect biotransformation of budesonide and urinary excretion of 6β-hydroxycortisol either in patients or in healthy volunteers. Ratios of areas under plasma concentration-time curves (AUC0-12 h during UDCA/AUC0-12 h before UDCA) of both metabolites were not higher than those of budesonide itself. In contrast, administration of rifampicin markedly induced CYP3A metabolism, resulting in abolished budesonide plasma levels and high urinary excretion of 6β-hydroxycortisol. Metabolite formation was enhanced by rifampicin, but not by UDCA (e.g., AUC16α-hydroxyprednisolone/AUCbudesonide in patients: baseline, 8.6 ± 3.9; UDCA, 10.7 ± 7.1; rifampicin, 527.0 ± 248.7). In conclusion, UDCA is not a relevant inducer of CYP3A enzymes in humans. (HEPATOLOGY 2005;41:595–602.)
Prevention and Control of Hypertension in Different Countries
Authors: Md Mizanur Rahman, Stuart Gilmour
Journal: JAMA (2014)

Hypertension is the leading risk factor for death and disability worldwide. Dr Chow and colleagues1 provided statistics on prevalence, awareness, treatment, and control of hypertension among selected high-, middle-, and low-income countries. The proportions of hypertension, awareness, treatment, and control reported in this article were strikingly different from other studies.2- 4
Influence of azathioprine on hepatic reserve in chronic active liver disease.
Authors: L Rikkers, S Sherlock
Journal: Gut (1975)

The kinetics of hepatic indocyanine green (ICG) uptake have been analysed in 14 patients with chronic active liver disease.The removal of incremental, submaximal ICG doses were compatible with Michaelis-Menten kinetics in approximately 80% of studies in patients allowing the calculation of the maximal rate of removal (Rmax) and the Michaelis constant (Km).Neither of these variables correlated with other laboratory indices of liver function.Although determinations of Rmax before and after a two-weeks trial of azathioprine therapy were not significantly different, in two patients Rmax was markedly reduced by treatment.It is concluded that azathioprine over the short term does not improve the liver's reserve for ICG removal; in fact, in isolated cases this drug may be detrimental.
Memories aren't made of this: amnesia at the movies
Authors: Sallie Baxendale
Journal: BMJ (2004)

<i>Most amnesic conditions in films bear little relation to reality. Since movies both inform and reflect public opinion, doctors should be aware of the prevalent myths about amnesia. This could be invaluable when informing patients and their relatives of a diagnosis of an amnesic condition and its likely prognosis</i>
The Cholera Years: The United States in 1832, 1849 and 1866
Authors: James P. Morgan
Journal: JAMA (1988)

In 1988 when one thinks of  diseases, the first to come to mind is the acquired immunodeficiency syndrome (AIDS). It is therefore instructive to recall that,  Cholera was the classic epidemic disease of the nineteenth century, as plague had been in the fourteenth. When cholera first appeared in the United States in 1832, yellow fever and smallpox, the great epidemic diseases of the previous two centuries, were no longer truly national problems. Yellow fever had disappeared from the North, and vaccination had deprived smallpox of much of its menace. Cholera, on the other hand, appeared in almost every part of the country. It flourished in the great cities, New York, Cincinnati, Chicago; it crossed the continent with the forty-niners; its victims included Iowa dirt farmers and New York longshoremen, Wisconsin lead miners and Negro field hands.  Rosenberg has chosen New York City as the focus of his work and
Mixed adenoneuroendocrine carcinoma (MANEC) of the esophagogastric junction predominantly consisting of poorly differentiated neuroendocrine carcinoma
Authors: L. Veits, C. Lang-Schwarz, H. Volkholz, C. Falkeis, M. Vieth, H. Schulz
Journal: Endoscopy (2013)

A 68-year-old man presented with a rapidly growing mass at the esophagogastric junction. The tumor was initially biopsied and diagnosed as well-differentiated Barrett's carcinoma. Subsequently the tumor was resected with endoscopic submucosal dissection ([Fig. 1]). On histopathological examination, the tumor showed two distinct components with abrupt transition ([Fig. 2]). The part of the tumor in the superficial mucosal layer was a well-differentiated adenocarcinoma, resembling common Barrett's carcinoma. The underlying component consisted of a poorly differentiated small round blue cell tumor that made up about 80 % of the entire tumor mass. On immunohistochemistry this component was strikingly positive for synaptophysin and showed a Ki67 proliferation rate of > 95 %, which confirmed it as poorly differentiated neuroendocrine carcinoma. Within the adenocarcinoma, only a scattering of synaptophysin-positive cells were visible. The results for CK7 were exactly the opposite as the adenocarcinoma was strongly positive for it and the neuroendocrine carcinoma almost negative ([Fig. 3]), with the neuroendocrine carcinoma infiltrating at least the lower third of the submucosal layer (sm3) and reaching the basal resection margin. Therefore, according to the current World Health Organization (WHO) criteria the final pathological diagnosis was poorly differentiated mixed adenoneuroendocrine carcinoma (MANEC) of the esophagogastric junction.
Passive Motion of the Extremities Modifies Alveolar Ventilation during Sleep in Patients with Congenital Central Hypoventilation Syndrome
Authors: DAVID GOZAL, NARONG SIMAKAJORNBOON
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Passive motion of lower extremities (PMLE) elicits significant increases in alveolar ventilation (V˙ a) in awake children with congenital central hypoventilation syndrome (CCHS), who have absent or near absent ventilatory responses to hypercapnia. We hypothesized that PMLE would improve V˙ a during non-rapid eye movement (NREM) sleep. To study this, six patients with CCHS (0.2 to 7 yr of age) were disconnected from mechanical ventilatory support during Stage III-IV NREM, and their feet were passively moved at the ankle, either manually or with a motorized device strapped to their feet at 40 to 50 strokes/min. Holding of the feet without motion served as control (C). From a total of 74 successful trials not associated with sleep state changes, Pet CO2 decreased from 58.9 ± 3.5 to 40.9 ± 2.6 mm Hg with PMLE (n = 58; p < 0.001), whereas end-tidal carbon dioxide (Pet CO2 ) increased in C (n = 16; 58.8 ± 3.1 to 60.3 ± 3.7 mm Hg; PMLE versus C: p < 0.001). PMLE increased respiratory frequency from 10.2 ± 1.9 to 21.2 ± 2.7 breaths/min (p < 0.0001). We conclude that PMLE during NREM increases V˙ a possibly via activation of mechanoreceptor-afferent pathways rather than by respiratory entrainment. We speculate that such effect may provide future noninvasive ventilatory support strategies in patients with CCHS and mild phenotypic expression of their disease.
752-5 Dose the “No Reflow” Phenomenon Immediately After Successful Direct Angioplasty Always Indicate Poor Functional Recovery?
Authors: Hirofumi Kajiyama, Hironori Hirai, Makolo Suzuki, Tetsuo Lee, Yuko Sugiyama, Atsushi Tokuyama, Masahiko Harada, Toshiyuki Degawa, Shigeki Nishizawa, So Yabuki, Tetsu Yamaguchi
Journal: Journal of the American College of Cardiology (1995)
Adrenergic regulation of blood pressure in chronic renal failure.
Authors: J J Lilley, J Golden, R A Stone
Journal: Journal of Clinical Investigation (1976)

Previous investigations have suggested that significant hypotension during hemodialysis may result from abnormalities of sympathetic nervous system activity. To further evaluate these phenomena, plasma dopamine beta-hydroxylase (D beta H) and cold pressor test (proposed indexes of efferent sympathetic nervous system activity) and amyl nitrite inhalation (an index of the entire baroreceptor reflex arc) were studied in two groups of patients: group I, patients exhibiting a mean arterial pressure decrease to less than 70 mm Hg during less than 10% of dialyses; group II (hemodialysis hypotension), patients with a mean arterial pressure decrease to less than 70 mm Hg during more than 90% of dialyses. The groups were similar with respect to plasma renin activity, renin response to ultrafiltration, age, duration of dialysis, nerve conduction velocity, plasma protein concentration, hematocrit, dialysis weight change, resting heart rate, sex, race, blood pressure and heart rate response to cold pressor test, and 125I-albumin plasma volume. Supine mean arterial pressure was higher in patients with hemodialysis hypotension than in patients without hemodialysis hypotension (group I) both before and after dialysis. Plasma D beta H activity was significantly higher in patients with hemodialysis hypotension (group II) than in group I both before and after dialysis. Amyl nitrite inhalation, expressed as change in delta R-R interval/mean arterial pressure decrease, was less in hemodialysis hypotension patients. These results suggest that hemodialysis hypotension may result from a lesion in the baroreceptors, cardiopulmonary receptors, or visceral afferent nerves. Furthermore, elevated mean arterial pressure in patients with hemodialysis hypotension may be neurogenic in origin, as reflected by plasma D beta H activity, and appears similar to the hypertension that follows baroreceptor deafferentation of experimental animals.