tbuckley/cabot-search huggingface dataset:
Statistics at square one. XX-Correlation (concluded).
Authors: T D Swinscow
Journal: BMJ (1976)

TREATMENT SUGGESTIONS Twenty-four-hour lifeline-All members of the practice must be aware of the families at risk, even if they are not directly concerned with them.It has been possible to encourage the families to establish links with the whole practice and to use the doctor on duty if a crisis occurs when the primary therapist is absent.Therapeutic relationship-This is provided by the team; the doctor or health visitor acts as the primary therapist and sees the family either at home or in the health centre.In some cases both husband and wife are seen regularly.In others, the mother attends a therapeutic group with an attached playgroup, which has been established recently in the practice.This will be described elsewhere.Child care-The child is seen regularly either at home or in a clinic.Most parents of children at risk have rich fantasies and unrealistic expectations of their child's capabilities and development.These must be gradually and gently brought nearer to reality, which may take weeks or months.Practical help-We have found the most useful form of practical help to be the provision of a playgroup/nursery place.Help with transport, baby-sitting, domestic arrangements, social activities, and, in extreme cases, housing has alleviated family stress and reduced the risks to the child.We try to maintain an honest and realistic approach to these problems to avoid raising false hopes and expectations.Referral to other agencies-Informal discussion with members of the social services is often as important as a formal referral.Even after referral the responsibility for the case is shared.In some cases, psychiatric or paediatric specialist services, or both, are necessary.Each member of the primary health care team has a continuing contribution to make to assessment and management.OUTCOME
Viruses and Progressive Multifocal Leukoencephalopathy
Authors: Paul H. Black, Martin S. Hirsch
Journal: New England Journal of Medicine (1972)

There has recently been an increasing interest in the relation between viruses and chronic degenerative diseases of the brain. Within the past few years, measles virus has been found to be associated with subacute sclerosing panencephalitis and transmissible agents have been isolated from patients with Kuru and Creutzfeldt—Jakob disease (spongiform encephalopathy).Progressive multifocal leukoencephalopathy (PML) is a rare neurological disease characterized by focal demyelinization occurring around blood vessels, particularly veins. A unique feature of this disease is a peculiar reaction on the part of the glial supporting cells of the central nervous system. Individual astrocytes, which from their distribution and . . .
Troponin Elevation After Percutaneous Coronary Intervention Directly Represents the Extent of Irreversible Myocardial Injury
Authors: Joseph B. Selvanayagam, Italo Porto, Keith Channon, Steffen E. Petersen, Jane M. Francis, Stefan Neubauer, Adrian P. Banning
Journal: Circulation (2005)

Background— Although troponin elevation after percutaneous coronary intervention (PCI) is common, uncertainties remain about the mechanisms of its release and its relationship to the volume of myocardial tissue loss. Delayed-enhancement MRI of the heart has been shown to reliably quantify areas of irreversible myocardial injury. To investigate the quantitative relationship between irreversible injury and cardiac troponin release, we studied the incidence and extent of new irreversible injury in patients undergoing PCI and correlated it to postprocedural changes in cardiac troponin I. Methods and Results— Fifty patients undergoing PCI were studied with preprocedural and postprocedural (24 hours) delayed-enhancement MRI for assessment of new irreversible myocardial injury. Cardiac troponin I measurements were obtained before PCI and 24 hours after PCI. Of these 50 patients, 24 underwent a further third MRI scan at a median of 8 months after the procedure. Mean patient age was 64±12 years. After the procedure, 14 patients (28%) had evidence of new myocardial hyperenhancement, with a mean mass of 6.0±5.8 g, or 5.0±4.8% of total left ventricular mass. All of these patients had raised troponin I levels (range 1.0 to 9.4 μg/L). Thirty-four patients (68%) had no elevated troponin I and no evidence of new myocardial necrosis on MRI. There was a strong correlation between the rise in troponin I measurements at 24 hours and mean mass of new myocardial hyperenhancement, both early ( r =0.84; P &lt;0.001) and late ( r =0.71; P &lt;0.001) after PCI, although there was a trend for a reduction in the size of PCI-induced myocardial injury in the late follow-up scan ( P =0.07). Conclusions— In the setting of PCI, patients demonstrating postprocedural elevation in troponin I have evidence of new irreversible myocardial injury on delayed-enhancement MRI. The magnitude of this injury correlates directly with the extent of troponin elevation.
Pilot study of combination therapy with ribavirin and interferon alfa for the retreatment of chronic hepatitis B e antibody-positive patients
Authors: Teresa Cotonat, Juan Antonio Quiroga, Juan Manuel López-Alcorocho, Rosa Clouet, Margarita Pardo, Félix Manzarbeitia, Vicente Carreño
Journal: Hepatology (2000)

Twenty-four patients with chronic hepatitis B virus (HBV), antibody to hepatitis B e antigen (anti-HBe), HBV DNA positivity, and alanine transaminase (ALT) elevation who failed previous interferon alfa (IFN-α) therapy were included in a pilot study of combination therapy with ribavirin and IFN-α. The patients received daily oral ribavirin (1,000-1,200 mg according to body weight) plus 5 million units (MU) IFN-α2b three times a week for 12 months and were followed-up for 12 months. The median viremia level decreased significantly at the end of treatment (1.2 × 10 3 copies/mL) and follow-up (4.0 × 10 2 copies/mL) compared with the baseline (3.0 × 10 6 copies/mL; P &lt; .05). After 12 months, 8 of 24 (33%) patients had cleared HBV DNA and 12 (50%) had normal ALT levels. At the end of the study virological and biochemical response was 50% and 21%, respectively. Thus, virological and biochemical response sustained in 5 of 24 (21%) patients retreated with ribavirin and IFN-α; none of them lost hepatitis B surface antigen (HBsAg). Liver histology improved in 2 of 4 sustained responders but in none of the 12 nonresponders with paired biopsies ( P = .05). The response was independent of dose and duration of previous treatment, viral load, or the distribution of HBV precore wild-type/mutant variants. However, sustained responders had significantly higher necroinflammation ( P = .036) and fibrosis ( P = .007) scores. IFN-α-related side effects were mild and reversible on discontinuation. In 4 (17%) patients who suffered nausea and diarrhea the ribavirin dosage was reduced by 50% after 1 month of therapy and finally discontinued in all of them. No patient had liver disease decompensation. In summary, combination therapy with ribavirin and IFN-α may be efficacious to treat viremic anti-HBe-positive patients with chronic hepatitis B who have failed previous IFN therapy.
Sequential targeting of the genes encoding immunoglobulin-μ and prion protein in cattle
Authors: Yoshimi Kuroiwa, Poothappillai Kasinathan, Hiroaki Matsushita, Janaki Sathiyaselan, Eddie J Sullivan, Makoto Kakitani, Kazuma Tomizuka, Isao Ishida, James M Robl
Journal: Nature Genetics (2004)
Role of nutrition in inflammatory bowel disease: an overview.
Authors: M L Clark
Journal: Gut (1986)

Although many patients with inflammatory bowel disease are malnourished, the role of nutritional support is still controversial. It is universally accepted that with adequate nutritional support patients will put on weight and that their biochemical functions may improve; the question nevertheless remains: does this help the patient get over his or her disease more quickly and, more importantly, does this affect morbidity and mortality? There are several ways of providing nutritional support and all need careful evaluation.
Non-alcoholic fatty liver disease: The mist gradually clears
Authors: Nimantha Mark Wilfred de Alwis, Christopher Paul Day
Journal: Journal of Hepatology (2008)

Non-alcoholic fatty liver disease (NAFLD) is now the commonest liver disorder in the developed world affecting up to a third of individuals. It is closely associated with features of the metabolic syndrome, particularly obesity and diabetes. It can progress to cirrhosis, hepatocellular carcinoma and liver failure and is an increasing indication for transplantation. Dietary and genetic factors determine susceptibility to NAFLD and its progression. NAFLD may also be involved in the pathogenesis of cardiovascular disease. Most patients present with incidentally found abnormal liver blood tests. Diagnosis is usually one of exclusion. Liver biopsy is required for disease staging, but new imaging modalities and biomarkers are emerging which may eventually fulfil this role. There is, as yet no firm evidence-based treatment for NAFLD. Therapy is currently directed at treating components of the metabolic syndrome which may also be beneficial for the liver. The recent elucidation of the mechanisms leading to progressive disease suggests a variety of novel targets worthy of testing in animal models of NAFLD and subsequently in pilot studies in humans. Non-alcoholic fatty liver disease (NAFLD) is now the commonest liver disorder in the developed world affecting up to a third of individuals. It is closely associated with features of the metabolic syndrome, particularly obesity and diabetes. It can progress to cirrhosis, hepatocellular carcinoma and liver failure and is an increasing indication for transplantation. Dietary and genetic factors determine susceptibility to NAFLD and its progression. NAFLD may also be involved in the pathogenesis of cardiovascular disease. Most patients present with incidentally found abnormal liver blood tests. Diagnosis is usually one of exclusion. Liver biopsy is required for disease staging, but new imaging modalities and biomarkers are emerging which may eventually fulfil this role. There is, as yet no firm evidence-based treatment for NAFLD. Therapy is currently directed at treating components of the metabolic syndrome which may also be beneficial for the liver. The recent elucidation of the mechanisms leading to progressive disease suggests a variety of novel targets worthy of testing in animal models of NAFLD and subsequently in pilot studies in humans.
Effect of Lower Dose of Oral Conjugated Equine Estrogen on Size and Oxidative Susceptibility of Low-Density Lipoprotein Particles in Postmenopausal Women
Authors: Akihiko Wakatsuki, Yuji Okatani, Nobuo Ikenoue, Koichi Shinohara, Kazushi Watanabe, Takao Fukaya
Journal: Circulation (2003)

Estrogen replacement therapy (ERT) has an antioxidant effect that opposes the oxidation of LDL. Oral ERT-induced increases in plasma triglyceride, however, are associated with decreased LDL size, which may counteract this antioxidant effect. Because lower doses of oral estrogen do not affect plasma triglyceride concentrations, LDL size might not change, and the antioxidant effect of estrogen might be preserved. We investigated whether a lower dose of oral estrogen could eliminate the adverse effects of high-dose oral ERT on the size and oxidative susceptibility of LDL in postmenopausal women.Postmenopausal women received no treatment or were treated with oral conjugated equine estrogen (CEE) 0.625 or 0.3125 mg/d for 3 months. CEE at a dose of 0.625 mg/d significantly increased plasma triglyceride concentrations and decreased LDL diameter, but the concentrations of LDL-derived thiobarbituric acid reactive substances (TBARS) and lag time for conjugated diene formation did not change. In contrast, 0.3125 mg of CEE did not affect plasma triglyceride concentrations or LDL diameter and significantly decreased LDL-derived TBARS concentrations and significantly prolonged LDL lag time. Estrogen-induced changes in LDL diameter correlated negatively with changes in plasma triglyceride (r=-0.44, P<0.01) and LDL-derived TBARS (r=-0.57, P<0.001) but positively with changes in LDL lag time (r=0.42, P<0.01).Because oral CEE at a dose of 0.3125 mg/d does not elevate plasma triglyceride, resulting in unchanged size of LDL particles that are resistant to oxidation, the antioxidant effect of estrogen can be preserved.
Arthritis of the middle ear in ankylosing spondylitis.
Authors: M Magaro, G Ceresia, A Frustaci
Journal: Annals of the Rheumatic Diseases (1984)

A case of ankylosing spondylitis with aortic valve disease and hearing loss is described. A series of radiographic and audiometric investigations showed the hearing loss to be of a conductive type. It seemed most likely that the hearing loss was related to an inflammatory involvement of the ossicular joints due to the primary disease. No other case of conductive hearing loss has previously been reported due to otoarthritis in ankylosing spondylitis. This is important both theoretically and practically.
Epstein-Barr virus-associated hemophagocytic syndrome and fatal infectious mononucleosis
Authors: Motohiko Okano, Thomas G. Gross
Journal: American Journal of Hematology (1996)

Virus-associated hemophagocytic syndrome (VAHS) has been thought to be a distinct clinical entity, characterized by intermittent fever, enlarged liver and spleen, and the appearance of hemophagocytosis. Hemopoietic cells are actively ingested by monocytes/macrophages in various organs, including lymph nodes, bone marrow, liver, and spleen. Epstein-Barr virus (EBV) is now thought to be one of the major causes for the development of this unique syndrome. Additionally, VAHS is often associated with fatal infectious mononucleosis (IM). The relationship between EBV-associated VAHS and fatal IM is discussed in this concise review. © 1996 Wiley-Liss, Inc.
Regulation of norepinephrine release from cardiac sympathetic fibers in the dog by presynaptic alpha- and beta-receptors.
Authors: N Yamaguchi, J de Champlain, R A Nadeau
Journal: Circulation Research (1977)

The effect of phenoxybenzamine (PBA), desmethylimipramine (DMI), clonidine (CLND), sotalol (STL), and isoproterenol (ISPR) on the release of endogenous norepinephrine (NE) from the heart on right cardioaccelerator nerve stimulation was studied in anesthetized dogs. Under control conditions, the catecholamine levels in coronary sinus blood increased linearly with increasing frequencies of stimulation up to 10 Hz and did not increase further at 30 Hz. The release of NE was markedly enhanced after PBA (1 mg/kg, iv) and DMI (1 mg/kg, iv). The enhanced release of NE after DMI, but not after PBA, was associated with a prolonged response in heart rate. In contrast, NE release was reduced after CLND (15 microgram/kg, iv) at stimulation frequencies of 1 and 2 Hz and this was associated with reduced responses in heart rate and left ventricular dtp/dt. STL (5 mg/kg, iv) reduced significantly the release of NE at stimulation frequencies of 1-5 Hz, whereas ISPR enhanced NE outflow at frequencies of 1-4 Hz. These results support the existence of both negative and positive feedback mechanisms on the release of norepinephrine by cardiac sympathetic fibers mediated through presynaptic alpha- and beta-adrenoreceptors, respectively. The functional significance of these mechanisms is also suggested by the correlation found between changes in NE release and variations in cardiac responses under the various drug treatements.
PROTEIN-LOSING ENTEROPATHY ASSOCIATED WITH CLOSTRIDIUM DIFFICILE INFECTION
Authors: AnnH. Rybolt, BarbaraE. Laughon, WilliamB. Greenough, RichardG. Bennett, DavidR. Thomas, JohnG. Bartlett
Journal: The Lancet (1989)

<h2>Abstract</h2> A commercially available radial immunodiffusion assay was used to measure serum alpha-1-antitrypsin levels in stool samples from subjects aged over 60 years as a marker of protein-losing enteropathy. α<sub>1</sub>-antitrypsin was found in all of 12 patients with colonoscopy-confirmed pseudomembranous colitis, 6 of 14 (43%) patients with <i>Clostridium difficile</i>diarrhoea without pseudomembranes, 6 of 12 (50%) nursing-home patients culture-positive for <i>Cl difficile</i> but negative for its cytotoxin, and none of 15 healthy control subjects. It is concluded that serum protein loss into the gastrointestinal tract can occur as a result of <i>Cl difficile</i>infection, that its presence correlates with the severity of disease, and that it may occur even in the absence of diarrhoea. The diagnosis of protein-losing enteropathy should be considered for all patients with <i>Cl difficile</i>infection, particularly elderly nursing-home patients, in whom the risk of <i>Cl difficile</i> disease and the frequency of severe malnutrition are high.
Recurrent Falls Resulting in Pseudoaneurysm of a Calcified Femoral Artery
Authors: Payam S. Pahlavan, William D. Leslie
Journal: Clinical Nuclear Medicine (2009)

Femoral pseudoaneurysm is a well-recognized complication of direct vascular injury from penetrating trauma, skeletal fractures or invasive catheter-based procedures. We report the unexpected diagnosis of a large femoral artery pseudoaneurysm that developed after recurrent falls led to disruption of the heavily calcified vessel wall. The pseudoaneurysm was originally missed by duplex ultrasound and CT, and incidentally detected on bone scintigraphy. Pseudoaneurysms arising spontaneously or from minor trauma such as a simple falls are infrequent. Underlying brittleness of the arterial wall due to extensive calcification may predispose to this condition.
Prostaglandin B <sub>2</sub> -Induced Cutaneous Vasoconstriction of the Canine Hind Paw
Authors: STANLEY GREENBERG, JAMES A. ENGELBRECHT, WILLIAM R. WILSON
Journal: Circulation Research (1974)

The cutaneous vascular effects of prostaglandin B 2 (PGB 2 ) were studied in dogs during constant-flow perfusion of the hind paw. The effects of PGB 2 (50-800 ng/kg min -1 , ia) on systemic pressure, hind-paw perfusion pressure, and responses to local heating at 45°C (30 seconds) and cooling at 4°C (90 seconds) were measured in 44 dogs. PGB 2 increased perfusion pressure by 50 ± 19 mm Hg to 218 ± 21 mm Hg without any effect on systemic arterial blood pressure. The pressor response to cooling increased from 34 mm Hg to 53 mm Hg (50 ng/kg min -1 PGB 2 ), but the dilator response to heating was reduced significantly during infusions of PGB 2 (50 and 100 ng/kg). Acute denervation and reserpine treatment (0.5 mg/kg dog -1 for 2 days) reduced the constrictor responses to PGB 2 . The abilities of PGB 2 to produce intense vasoconstriction, which is blocked by acute denervation and reserpine, to enhance responses to cooling, and to antagonize responses to heating make this preparation a useful model for the study of Raynaud's phenomenon and suggest that a prostaglandin, perhaps PGB 2 ss, may participate in cutaneous vasospastic disorders.
Assessing the Phylogenetic Utility of Four Mitochondrial Genes and a Nuclear Intron in the Asian Pit Viper Genus, Trimeresurus: Separate, Simultaneous, and Conditional Data Combination Analyses
Authors: S. Creer
Journal: Molecular Biology and Evolution (2003)

A number of methods have been proposed for addressing how to optimize the analysis of multiple data sets from diverse mitochondrial and nuclear gene partitions in the pursuit of robust organismal phylogenies. The present study used separate, simultaneous, and conditional data combination methods to analyze 3,135 bp of data from four mitochondrial partitions and the seventh intron of the β fibrinogen gene in the Asian pit viper genus, Trimeresurus sensu stricto. The phylogenetic utility and homogeneity of all partitions were estimated via a combination of homogeneity partition tests, homoplasy indices, and partitioned Bremer support. Despite the detection of significant heterogeneity of phylogenetic signal between the mitochondrial and nuclear partitions, the simultaneous analysis represented the best-supported topology of all the data. The relatively slow rate (approximately one quarter of the rate of mtDNA) and functionally unconstrained molecular evolution of the intron resulted in much lower levels of homoplasy compared with the mitochondrial partitions. This was further shown via partitioned Bremer support, which, when considered throughout hierarchical clade levels, highlighted the phylogenetic strength and limitations of the intron at deeper and shallower phylogenetic levels, respectively. The simultaneous analysis helped to resolve the phylogenetic relationships of taxa that were unresolved throughout all individual gene trees and tentatively supports the existence of morphologically and genetically distinct clades within the genus. Topological appraisals of the mitochondrial gene partitions suggest that the cytochrome b and the NADH subunit 4 gene partitions are better estimators of phylogenetic relationships than are the 12S and 16S ribosomal RNA partitions at the taxonomic levels under consideration.
Effect of prior bronchoconstriction on the airway response to histamine in normal subjects.
Authors: K F Chung, P D Snashall
Journal: Thorax (1984)

We have examined the effect of prior bronchoconstriction on the bronchial responsiveness to inhaled histamine in nine normal subjects. The airway response to increasing concentrations of histamine aerosol was assessed by measurement of specific airways conductance (sGaw) in a body plethysmograph. The threshold provocative dose of histamine needed to cause a 35% fall in starting sGaw (PD35) and the steepest slope of the response were measured from cumulative log dose response curves. Histamine challenges were performed in duplicate after premedication with 0.9% sodium chloride (control) or methacholine aerosol on separate days. The mean starting sGaw did not change significantly after inhalation of 0.9% sodium chloride but methacholine caused a mean reduction in sGaw of 42%. Mean control PD35 values did not differ significantly from mean PD35 values after methacholine. The mean steepest slope of the response after methacoline was 47% lower than the mean control value. There was a significant linear relationship between starting sGaw and the steepest slope for the control and for the methacholine premedicated challenges. The reduction in slope after methacholine was accounted for by the fall in starting sGaw. Because histamine PD35 was not altered by prior bronchoconstriction, it is concluded that the bronchial hyperresponsiveness of asthmatic subjects to non-specific bronchoconstrictor stimuli is unlikely to be a direct consequence of their low starting airway calibre.
Comparison of three oxygen delivery systems during exercise in hypoxemic patients with chronic obstructive pulmonary disease.
Authors: E M Hagarty, M S Skorodin, W E Langbein, C I Hultman, J A Jessen, K C Maki
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

Oxygen therapy improves submaximal exercise tolerance in hypoxemic patients with chronic obstructive pulmonary disease (COPD). This study compared the standard nasal cannula, reservoir nasal cannula, and a demand flow device in 15 male hypoxemic patients with COPD. On six separate occasions each subject used, in a randomized order, all three systems while completing incremental cycle ergometry and a test circuit composed of tasks that simulate activities of daily living. Oxygen flow required during exercise was 1.8 +/- 0.9 and 2.8 +/- 0.7 L/min for reservoir nasal cannula and standard nasal cannula use, respectively (p < 0.0001). The effect of the three oxygen delivery systems on oxygen saturation (Spo2) during the last 30 s of exercise varied with type of activity. Only during demand flow device use while undressing and dressing was the subjects' Spo2 (90 +/- 3%) significantly lower (p = 0.019). There was a trend toward lower Spo2 with the demand flow device (p = 0.103) during arm work above shoulder level. Although not statistically significant, reservoir nasal cannula use resulted in consistently lower tidal volume and minute ventilation during test circuit activities. Exercise tolerance was not significantly different between the three oxygen delivery systems.