tbuckley/cabot-search huggingface dataset:
A clinicopathological cohort study of liver pathology in 301 patients with human immunodeficiency virus/acquired immune deficiency syndrome
Authors: Mark W. Sonderup, Helen Wainwright, Pauline Hall, Henry Hairwadzi, C. Wendy N. Spearman
Journal: Hepatology (2015)

Liver disease complicates human immunodeficiency virus (HIV)/acquired immune deficiency syndrome; however, liver pathology data are limited, particularly from high HIV prevalence countries. We investigated the spectrum and clinicopathological correlates of liver pathology in a high HIV burden setting. In a single‐center study, all HIV/acquired immune deficiency syndrome patients with complete clinical and demographic data who underwent liver biopsy were analyzed and clinicopathologically assessed by hepatologists and one of two experienced liver pathologists. We evaluated 301 patients, with a median age of 34 (interquartile range 29‐40) years. Women (n = 143) were younger than men (n = 158), with a median age of 33 (interquartile range 28‐37) versus 35 (interquartile range 31‐41) years, P = 0.001. The majority, 76.1%, were black African. Median CD4 at time of biopsy was 127 (52‐260) cells/mm 3 . Drug‐induced liver injury was the predominant finding (42.2%), followed by granulomatous inflammation (29%), steatosis/steatohepatitis (19.3%), hepatitis B (19%), and hepatitis C coinfection (3.3%), with more than one pathology in 16.2%. With granulomatous inflammation, 52% met the criteria for tuberculosis immune reconstitution syndrome. By univariate analysis, cotrimoxazole and antiretroviral therapy conferred risk for drug injury (odds ratio [OR] = 2.78 [1.72‐4.48], P &lt; 0.001; OR = 1.69 [1.06‐2.68], P = 0.027). In multivariate analysis, cotrimoxazole was associated with a cholestatic or ductopenic injury (OR = 7.05 [2.50‐19.89], P &lt; 0.001; OR = 17.6 [3.26‐95.3], P &lt; 0.0001); efavirenz was associated with nonspecific hepatitis or submassive necrosis (OR = 4.3 [1.92‐9.83], P &lt; 0.001; OR = 10.46 [2.7‐40.5], P &lt; 0.001). Cholestatic injury was associated with female gender and a CD4 of &gt;200 cells/mm 3 , and submassive necrosis was associated with younger age. Hepatitis B demonstrated no association. Conclusion : In a high HIV burden area, drug‐induced liver injury due to antiretroviral therapy and cotrimoxazole was a frequent clinicopathological finding; Mycobacterium tuberculosis was the leading opportunistic infection, with more than half of patients fulfilling criteria for tuberculosis immune reconstitution syndrome; liver biopsy remains a useful diagnostic procedure in this setting. (H epatology 2015;61:1721–1729)
Doctors call for guidance on how to prioritise critically ill patients in swine flu pandemic
Authors: R. Coombes
Journal: BMJ (2009)

“Extraordinary pressure” is expected on critical care beds this autumn, as the A/H1N1 influenza pandemic is set to enter a severe phase. However, the Department of Health has yet to clarify how it plans to meet demand, according to a House of Lords report this week.

Peers also questioned whether clinicians felt confident about the legal consequences of making difficult triage decisions as the demand for critical care beds intensifies.

The House of Lords Science and Technology Committee heard in May from the then health secretary, Alan Johnson, who confirmed that strategies would be introduced to boost intensive care capacity, including suspending elective procedures that need intensive care after operation. Ian Dalton, the national director of NHS Flu Resilience, the flu tsar, said that a doubling of critical care facilities would be possible “under a severe attack phase.”

But Bruce Taylor, consultant in intensive care medicine at Portsmouth Hospitals NHS Trust, told the …
Problem based learning has been used for years in general practice in London..
Authors: R. Savage, S. Savage
Journal: BMJ (1995)

Self evaluation and group evaluation also play an important part in the efficient running of a problem based learning group: they allow students to identify their own strengths and weaknesses and thus help to modify individual and group learning processes.Tutors' effectiveness is also scrutinised.Evaluation not only helps to improve individual and group function but also identifies those students who are having difficulties, so that re- medial strategies can be started.Students do learn effectively in a problem based learning system.They learn not only about the basic science of a problem but also about the many ethical considerations of modern medicine and the impact of disease on the family and community.It is thrilling to work with a group of students who enjoy learning medicine: the tutor learns a lot too.
Sunlight as Disinfectant — New Rules on Disclosure of Industry Payments to Physicians
Authors: Meredith B. Rosenthal, Michelle M. Mello
Journal: New England Journal of Medicine (2013)

Interview with Prof. Meredith Rosenthal on the trend toward greater transparency regarding physicians’ relationships with industry. (08:52)Download Will new rules requiring drug and device companies to disclose payments to physicians and teaching hospitals have the intended effects? Disclosure's benefits are unlikely to be realized without the activation of “learned intermediaries,” such as health insurers.
Ultrastructure of Fertilization
Authors: Robert H. Davis
Journal: JAMA (1969)

Dr. Austin's skill gives us today's most descriptive and extensive account on fertilization. He presents detailed current research on the diverse ultrastructure of gametes and fertilization, from protozoa to man as well as complex members of the plant kingdom. A collection of 127 micrographs and 48 diagrams vividly show the comparative changes that occur when the sperm passes through the egg investments. The reader can actually see the very heart of fertilization—the union of nuclei. Compact, well-defined, descriptive writing makes a complicated subject highly readable and very interesting without creating a massive volume. Our attention focuses directly on the fundamental nature of the cell membrane and a variety of enzymemediated processes by Dr. Austin's ultrastructural studies of the sperm acrosome reaction, union of gametes, breakdown of egg cortical granules, and extrusion of polar bodies. Some mechanisms were quite similar in several invertebrate species and in mammals, despite the many noted
Alcohol Dependence and Use of Treatment Services Among Women in the Community
Authors: L.-T. Wu
Journal: American Journal of Psychiatry (2004)

OBJECTIVE: This study examined the extent and characteristics of alcohol dependence and the perceived need for and use of alcohol treatment services among women compared with men in a nonclinical sample of adults 18–64 years of age. METHOD: Data were drawn from the 1999 National Household Survey on Drug Abuse. The authors calculated rates and correlates of alcohol dependence and treatment among adult alcohol users in this sample. RESULTS: About 3% of the women in the survey met criteria for DSM-IV alcohol dependence in the previous year. About 13% of these women received alcohol treatment services in the same period. Only 8% of the women who did not receive treatment perceived a need for treatment. Younger women—those who were 18–25 years of age—were more likely to be dependent on alcohol but less likely to perceive a need for treatment or to use treatment services. Among alcohol-dependent women who received no treatment, those with a family income of $75,000 or more, those who had two or more children living with them, and those who were not dependent on psychotherapeutic medications were less likely to perceive a need for help. CONCLUSIONS: There were no significant differences between men and women in use of treatment services, location of services received, and perceived need for treatment. However, correlates of treatment service use varied somewhat by gender. These findings suggest that the goal of efforts to reduce barriers to alcohol treatment services should be to change people’s attitudes toward alcohol abuse and seeking professional help.
Correlation Between lodine-131 MIBG Imaging and Biological Markers in Advanced Neuroblastoma
Authors: SAMUEL D. J. YEH, LAWRENCE HELSON, RICHARD S. BENUA
Journal: Clinical Nuclear Medicine (1988)

I-131 metaiodobenzylguanidine (MIBG) imaging was performed in 38 patients with advanced neuroblastoma. Abnormal images were found in patients with elevations of urinary vanillylmandelic acid and dopamine and high serum neuron-specific enolase levels. Normal or minimal elevation of markers was seen in patients with negative images. In follow-up studies after chemotherapy, the disappearance of abnormal uptake was noted in those patients with normal marker values. A persistently abnormal uptake occurred in patients with high marker values. Conversion from a normal image to an abnormal image also occurred in patients whose markers became elevated. I-131 MIBG imaging is sensitive in detecting active foci of a neuroblastoma and is useful in monitoring chemotherapy in these patients.
Diabetes-Related Behaviors in Latinas and Non-Latinas in California
Authors: Matthew J. O’Brien, Adam Davey, Victor A. Alos, Robert C. Whitaker
Journal: Diabetes Care (2012)

Certain dietary and physical activity behaviors have been associated with the risk of developing type 2 diabetes, yet little is known about the prevalence of these behaviors among Latinas (Latino women). The purpose of this cross-sectional study was to compare the prevalence of diabetes-related behaviors in Latinas and non-Latinas.Using data from the 2009 California Health Interview Survey, we compared self-reported diabetes-related behaviors of Latinas (n = 4,321) to non-Latinas (n = 21,112) after excluding women who were pregnant or had diabetes. For six behaviors, we determined the cut point for the least healthy tertile: walking, doing moderate to vigorous physical activity, and consuming fried potatoes, sugar-sweetened beverages (SSBs), desserts, and fast food. We used logistic regression to examine the association between Latina ethnicity and being in the least healthy tertile compared with the other two tertiles for each of these behaviors.In multivariate models adjusted for age, income, education, marital status, health status, smoking, and acculturation, Latinas had a higher risk (odds ratio [95% CI]) of being in the least healthy tertile for the consumption of fast food (1.94 [1.63-2.31]), SSBs (1.53 [1.29-1.82]), and fried potatoes (1.32 [1.18-1.67]), and lower risk for desserts (0.82 [0.70-0.95]). Latinas and non-Latinas had similar physical activity levels.Dietary differences between Latinas and non-Latinas (particularly in the consumption of fast food and SSBs) may be the focus of interventions to prevent diabetes in Latinas. Further research among Latinas is needed to understand and modify these dietary behaviors.
Inspiratory dynamic obstruction detected by forced oscillation during CPAP. A model study.
Authors: R Farré, R Peslin, M Rotger, D Navajas
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

Assessment of upper airway mechanics in patients with obstructive sleep apnea/hypopnea (OSA) can be carried out qualitatively from indirect signals (flow pattern, snoring, strain gauges, inductance plethysmography) or quantitatively by means of invasive estimation of esophageal pressure. The forced oscillation technique (FOT) is a noninvasive method of potential interest for quantitatively assessing airway obstruction in the sleeping patient. The aim of this work was to ascertain in a model study whether FOT could provide an index of airway obstruction when applied at the conditions of total and partial occlusions similar to the ones found in patients with OSA. An airway analog closely mimicking upper airway collapsibility was constructed and mechanically characterized by the relationship between its flow, upstream and downstream pressures as well as by means of FOT. We simulated total collapse (apnea), different levels of partial collapse with flow limitation (hypopnea), and release of airway obstruction when the collapsible analog was used as an artificial upper airway in a spontaneously breathing subject submitted to continuous positive airway pressure (CPAP) up to 14 cm H2O.s/L. The results showed that the amplitude of airway impedance measured by FOT was a suitable index to detect obstruction in collapsible segments. We concluded from this realistic model study that FOT could be a valuable tool for quantitatively assessing airway obstruction in patients with OSA treated with CPAP. This noninvasive technique is potentially useful both in studying upper airway mechanics in detail and in automatically monitoring airway obstruction in routine studies.
SET oncoprotein overexpression in B-cell chronic lymphocytic leukemia and non-Hodgkin lymphoma: a predictor of aggressive disease and a new treatment target
Authors: Dale J. Christensen, Youwei Chen, Jessica Oddo, Karen M. Matta, Jessica Neil, Evan D. Davis, Alicia D. Volkheimer, Mark C. Lanasa, Daphne R. Friedman, Barbara K. Goodman, Jon P. Gockerman, Louis F. Diehl, Carlos M. de Castro, Joseph O. Moore, Michael P. Vitek, J. Brice Weinberg
Journal: Blood (2011)
Emergency Tracheotomy for the "Café Coronary"
Authors: Helen A. Horn
Journal: JAMA (1963)

<h3>To the Editor:</h3> —As a pathologist I am accustomed to making rather generous incisions in my patients and therefore, from time to time, I reacquaint myself with the surgical technique involved in performing the emergency tracheotomy. "The Café Coronary" by R. K. Haugen (<i>JAMA</i><b>186</b>:142 [Oct 12] 1963) reaffirmed my belief that this effort is not wasted. I would like to add to Dr. Haugen's special report one minor point. While you rush the maître d'hôtel to the kitchen for the sharp paring knife, steal a glance at the progress of the victim's meal. If he or she is on the soup course or downing the parfait dessert, it might be wise to reconsider the diagnosis of impacted food in the hypopharynx.
Effects of noise and electromagnetic fields on reproductive outcomes.
Authors: R E Meyer, T E Aldrich, C E Easterly
Journal: Environmental Health Perspectives (1989)

Much public health research has been directed to studies of cancer risks due to chemical agents. Recently, increasing attention has been given to adverse reproductive outcomes as another, shorter-term biologic indicator of public health impact. Further, several low-level ubiquitous physical agents have been implicated recently as possibly affecting human health. These physical factors (noise and electromagnetic fields) represent difficult topics for research with epidemiologic study methods. This paper provides a brief review of the published data related to the risk of adverse reproductive outcomes and exposure to noise or electromagnetic fields. The discussion includes ideas for possible biologic mechanisms, considerations for exposure assessment, and suggestions for epidemiologic research.
Dopaminergic regulation of circadian rhythms of blood pressure, renin and aldosterone in essential hypertension
Authors: J. R SOWERS, N. STERN, M. D NYBY, K. A JASBERG
Journal: Cardiovascular Research (1982)

This study examines the influence of bromocriptine, a dopamine agonist, circadian mean arterial blood pressure (MAP) levels and circadian secretory patterns of plasma renin activity (PRA) and plasma aldosterone in essential hypertension. Nine patients with sustained essential hypertension were studied after they had reached metabollic equilibrium on a constant 100 mmol sodium and 80 mmol potassium intake. MAP measurements and PRA and aldosterone determinations were made at 30 min intervals over 24 h during a control (no medication) and a bromocriptine period (bromocriptine, 2.5 mg three times a day for 5 days). In the control period there was a clear circadian rhythm in blood pressure in these hypertensive patients with lowest MAP occurring during sleep. Bromocriptine treatment was associated with a depression in MAP throughout the 24 h cycle. Circadian patterns for both PRA and plasma aldosterone were observed in all patients before and after bromocriptine treatment. PRA demonstrated peaks between 1600 and 2000 h and again between 2400 and 0600 h. Peak aldosterone occurred in the late hours of sleep, 0400 to 0630 h, and shortly after awakening, 0800 to 0900 h. Although bromocriptine did not significantly affect the circadian rhythm of PRA and aldosterone it did decrease (P<0.05) mean 24 h recumbent PRA from 2.3±0.1 ng/cm3·h−1 to 1.40±0.1 ng/cm3·h−1 and plasma aldosterone from 8.5±0.3 ng·dl−1 to 6.8±0.2 ng·dl−1. 24 h recumbent blood pressures were not correlated with PRA or plasma aldosterone, and PRA and aldosterone were not correlated. These observations suggest that hour-to-hour maintenance of blood pressure is not dependent on the renin-angiotensin-aldosterone system in patients with essential hypertension. Dopaminergic mechanisms do not appear to account for the circadian periodicity of renin and aldosterone secretion.
Safeguards to restrict foundation hospitals will not be effective, conference told
Authors: A. McGuaran
Journal: BMJ (2003)

Foundation trusts possess the attitude of private companies with regard to income generation and are a serious threat to equitable front line health services, a conference heard last week.

The Society for Social Medicine conference (“Developing a framework for equity in the new NHS”) was told of doubts about the effectiveness of safeguards that the government claims to have built into the bill to set up foundation hospitals.

Professor Allyson Pollock of the public health policy unit at University College London questioned whether the …
Diagnosis and management of ANCA associated vasculitis
Authors: A. Berden, A. Goceroglu, D. Jayne, R. Luqmani, N. Rasmussen, J. A. Bruijn, I. Bajema
Journal: BMJ (2012)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following Diagnosis and management of ANCA associated vasculitis Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Breast-feeding: Time to Teach What We Preach
Authors: Thomas M. Ball
Journal: JAMA (1993)

To the Editor.  —I thank Freed1for his review of our dismal support of  Although I agree with his call for improved education of physicians to solve problems with breast-feeding, I do not feel that physicians will ever provide effective counseling and support to increase the incidence and duration of breast-feeding. Our involvement in this area should be limited to supporting lactation consultants, lay groups such as the La Leche League, and other community-based programs, especially prenatally, and decreasing interventions that lead to iatrogenic decrease in  Primary care physicians cannot be all things to all people— this is one area we'd be better off leaving to others.  The study by Kistin et al2that Freed refers to demonstrated the effect of a 15-minute to 30-minute prenatal visit, concerning breast-feeding issues only, by one of the authors with women prior to the 30th week of gestation. There
Cortical Blindness and Tourniquet Subclavian Steal
Authors: Andrew L. Carney
Journal: JAMA (1981)

<h3>To the Editor.—</h3> The development of cardiorespiratory crisis in a young girl after tourniquet release on the left arm and the resulting cortical blindness merit further comment. Both the consultants' analyses (1980;243:1187) and subsequent comments (1980;244:1319) neglect the more plausible hemodynamic mechanism—subclavian steal caused by reflex hyperemia. The author of the original query, E. Steckiw, MD, has been kind enough to provide me with further detail surrounding the case presented that was correct in essence. It is my belief that the brainstem and occipital cortical ischemia resulted from subclavian steal precipitated by the release of the tourniquet on the left arm. Consider the following data that support this position: (1) cortical blindness has been reported caused by subclavian steal in a girl with Blalock's procedure<sup>1</sup>; (2) arm hyperemia after tourniquet release can substantially reduce the measured vertebral artery blood flow in the adult<sup>2</sup>; and (3) the same
Book Review Essentials of Pediatric Surgery By Marc I. Rowe, James A. O'Neill, Jr., Jay L. Grosfeld, Eric W. Fonkalsrud, and Arnold G. Coran. 899 pp., illustrated. St. Louis, Mosby, 1995. $99. 0-8016-7472-7
Authors: Robert C. Shamberger
Journal: New England Journal of Medicine (1995)
Incidence of Hypertension
Authors: William O. Phillips
Journal: JAMA (1976)

<h3>To the Editor.—</h3> There appears to be an error in a recent editorial (235:2327, 1976). The statement is made that "55% of the population suffers from some degree of hypertension." The cross-referenced study (235:2299, 1976) shows 21% as the more accurate figure. Also, if 24 million (estimate) Americans are said to have hypertension, then the percentage estimate would be closer to 10% or 15% of the general population. The 55% figure cited comes from the total of uncontrolled, untreated, and undetected persons<i>with</i>hypertension (first part of the referenced study). Therefore, the actual total percentage of people with uncontrolled, untreated, and undetected hypertension would be closer to 11% or less, as cited in the study on page 2304.
Rectal Nonsteroidal Anti-inflammatory Drugs Are Superior to Pancreatic Duct Stents in Preventing Pancreatitis After Endoscopic Retrograde Cholangiopancreatography: A Network Meta-analysis
Authors: Ali Akbar, Barham K. Abu Dayyeh, Todd H. Baron, Zhen Wang, Osama Altayar, Mohammad Hassan Murad
Journal: Clinical Gastroenterology and Hepatology (2013)
Dietary effects on liver tumor burden in mice treated with the hepatocellular carcinogen diethylnitrosamine
Authors: Marin E. Healy, Jenny D.Y. Chow, Frances L. Byrne, David S. Breen, Norbert Leitinger, Chien Li, Carolin Lackner, Stephen H. Caldwell, Kyle L. Hoehn
Journal: Journal of Hepatology (2014)
Unexpected cardiac arrest in patients after surgical correction of tetralogy of Fallot.
Authors: F W James, S Kaplan, T C Chou
Journal: Circulation (1975)

Four of 220 patients without bifasicular block (complete right bundle branch block and left anterior hemiblock) or transient complete heart block immediately after surgery had an unexpected cardiac arrest one to 15 years after satisfactory surgical repair of tetralogy of Fallot. The postoperative electrocardiograms (ECG) revealed complete right bundle branch block in two patients and no intraventricle conduction abnormality in two patients. Each of the four patients had premature ventricular contractions on previous postoperative ECG. The cardiac arrest occurred during normal activity in three patients and mild exercise in one. Following the cardiac arrest, three patients died and one patient survived. Eighteen months before the cardiac arrest, the survivor had a stress test which revealed multifocal premature ventricular contractions with short bursts of ventricular tachycardia after exercise. This ventricular arrhythmia was suppressed with quinidine therapy. Although complete heart block cannot be excluded in these four patients, we reasoned that the cardiac arrests were probably preceded by ventricular tachyarrhythmia. Because of this experience, we believe that any patient who has had intraventricular surgery should be evaluated for ventricular arrhythmia. If frequent premature ventricular contractions or serious ventricular arrhythmias are documented, we seriously consider antiarrhythmic therapy in an attempt to prevent ventricular tachyarrhythmias and sudden death.