tbuckley/cabot-search huggingface dataset:
Reduced Albuminuria After Dietary Protein Restriction in Insulin-Dependent Diabetic Patients With Clinical Nephropathy
Authors: Adolfo Ciavarella, Gianfranco Di Mizio, Sergio Stefoni, Luigi C Borgnino, Pietro Vannini
Journal: Diabetes Care (1987)

Recent clinical investigations have demonstrated that an early restriction of dietary protein intake may reduce the rate of progression of chronic renal failure in humans. In this study the effects of a restricted-protein diet on kidney function in type I diabetic patients with clinical nephropathy were evaluated. Sixteen patients (9 men, 7 women) with mean age 37.1 ± 9.8 yr, mean duration of diabetes 17.7 ± 6.6 yr, proteinuria &amp;gt; 0.5 g/24 h, and serum creatinine concentration of 0.7−1.9 mg/dl were studied. Patients were randomly divided into two groups. The low-protein diet (LPD) group comprised seven patients who were kept for 4.5 ± 1 mo on a diet containing 0.71 ± 0.12 g × kg−1 × day−1 protein. The normal-protein diet (NPD) group comprised nine patients as controls maintained for 11.7 ± 7 mo on their usual diabetic diet containing 1.44 ± 0.12 g × kg−1 × day−1 protein. All patients were studied every 1–2 mo. Metabolic control was assessed by evaluation of 5–8 blood glucose determinations/day and by glycosylated hemoglobin, whereas renal function was evaluated by albumin, IgG and β2-microglobulin urinary excretion rates, serum creatinine concentration, and creatinine clearance. At each visit, serum concentrations of total protein, albumin, phosphate, calcium, and electrolytes and weight and blood pressure were also measured. A significant reduction (434 ± 244 to 205 ± 212 μg/min, mean ± SD) in albumin excretion rate was found in all LPD patients after dietary protein restriction, with a significant reincrease (689 ± 201 μg/min) in the same patients several months after interruption of diet. In contrast, a significant increase in albumin (452 ± 200 to 850 ± 288 μg/min) and IgG (82 ± 63 to 129 ± 79 μg/min) urinary excretion rates was found in NPD patients. No significant variations were noticed during the study regarding creatinine clearance, serum creatinine, urinary β2-microglobulin, arterial blood pressure, and other parameters. Mean daily insulin requirements remained unchanged in all patients. We conclude that our study supports the hypothesis that diabetic nephropathy, like other forms of chronic renal disease, might benefit from an early restriction of dietary protein intake.
Response of the gullet to gastric reflux in patients with hiatus hernia and oesophagitis
Authors: D. A. K. Woodward
Journal: Thorax (1970)

The variability of reflux symptoms in patients with hiatus hernia is well known, and a poor correlation between the symptoms of oesophagitis and appearances at oesophagoscopy has been noted. A study has been made of the relationship between four variables. These are the acid reflux occurring in the oesophagus, the peristaltic clearance, the oesophagitis present and the symptoms from which the patients are suffering. Symptoms were found only in patients with oesophageal <i>p</i>H levels below 4. However, such acid levels could occur in the absence of significant symptoms and there was a poor correlation between symptoms and various levels of <i>p</i>H below this. Poor motor function in the oesophagus was associated with poor clearance of acid from it. Patients with poor clearance show a greater tendency to have oesophagitis, but, despite this correlation, in the group as a whole, there was no clear relationship between the results of the tests and the severity of symptoms.
Vasoconstriction and Medial Hypertrophy in Pulmonary Hypertension
Authors: C. A. WAGENVOORT
Journal: Circulation (1960)

To determine whether thickening of the media of pulmonary muscular arteries in cases of pulmonary hypertension is the result of vasoconstriction or of hypertrophy or of both, a method for calculating the amount of arterial muscular tissue per unit of pulmonary tissue was devised. Comparison of the mean medial thickness, expressed as a percentage of the diameters of the arteries, with the amount of arterial muscular tissue per unit of lung, will give an impression as to whether vasoconstriction or hypertrophy prevails in a certain case. This method was applied to sections of pulmonary tissue from 10 normal controls and 17 patients with congenital cardiac disease with pulmonary hypertension. Medial hypertrophy was present in all cases of congenital heart disease studied as compared with controls, and was more pronounced in severe than in moderate pulmonary hypertension. In some cases also vasoconstriction appeared to play an important or even a dominant role in the thickening of the medial layer. In 2 cases of atrial septal defect with large pulmonary flow, hypertrophy was masked by dilatation of the vessels resulting in a relatively thin media.
FDA Poster Campaign Targets Teen Smoking
Authors: Andrew A. Skolnick
Journal: JAMA (1997)

IN RESPONSE to requests from retailers, community groups, and others, the Food and Drug Administration (FDA) has designed and is distributing a set of posters for display in stores to help explain the agency's new tobacco rule that prohibits the sale of cigarettes or smokeless tobacco to anyone younger than 18 years and requires retailers to check proof of age for purchasers younger than 27 years.   purpose of the poster campaign is to remind retailers of their legal responsibilities and to provide them with an aid for communicating the new requirements to customers, said Sharon Natanblut, the FDA's associate commissioner for strategic initiatives.  posters are aimed at helping customers understand that retailers are simply doing their job as required by law when they request proof of age. The posters should help create an environment where refusing to sell tobacco to minors is the norm.  The FDA has printed
Relapse of acute B viral hepatitis--role of delta agent.
Authors: S Govindarajan, B Valinluck, L Peters
Journal: Gut (1986)

Serologic markers for delta agent were evaluated in 39 patients with acute hepatitis B and clinical relapse within 30 days from the initial episode. Eighteen of the 39 patients (46%) had evidence of acute delta infection. Delta antigenaemia preceded the appearance of antibodies in seven of these 18 patients; delta antigenaemia occurred during the initial episode of illness and the appearance of the antibody coincided with the relapse. Eight of these patients developed severe relapse with fulminant course which resulted in two deaths. This study reveals that delta infection is one of the important causes of severe relapse in cases of acute B viral hepatitis.
The threshold concept in food safety and its applicability to food allergy
Authors: Jonathan O'B Hourihane
Journal: Allergy (2001)

Down the years there have been many clinical reports of exquisite sensitivity to low doses of food allergens. There are many factors that may contribute to a variation of threshold in an individual exposed to an allergen during the course of his or her daily life. Some of these factors are intrinsic and unavoidable. Other factors may be predictable but not easily controllable, such as asthma, exposure to allergens during the pollen season and predicting situations that may be risky. Other factors may be out of the control of the individual. The most important one of these is the adequate training and awareness of manufacturers and caterers who aim to provide safe and nutritious meals to their allergic and non‐allergic customers alike. Clinical histories of reactions in the community and the use of labial exposure during food challenge show that most non‐ingestion exposures to peanut usually result in easily treated minor reactions. Formal, oral food challenges have shown that low dose reactivity is relatively common but studies have not yet had the power to investigate whether peanut allergy is more commonly associated with very low dose reactivity than other foods. This means that industry must not concentrate only on peanut and tree nuts when looking at issues of contamination just because they are associated with the majority of severe reactions. There are more milk and egg allergic children in the general population and they deserve the same protection from allergen exposure as sufferers of peanut or tree nut allergies.
Investigations of genes encoding proteins within the inflammatory pathway provides insight into the genetic susceptibility of achilles tendinopathy
Authors: A V September, E-M Nell, K O Connell, J Cook, C J Handley, M P Schwellnus, M Collins
Journal: British Journal of Sports Medicine (2011)

Background Achilles tendinopathy (AT) is a multifactorial condition for which genetic risk factors have been identified. The evidence implicating cytokines and inflammatory mediators in the development of tendinopathy is growing. Objective The objective of this study was to identify sequence variants within genes encoding proteins involved in the inflammatory pathway which may modulate risk of developing AT. Methods A case-control genetic association study was conducted and candidate genes within the inflammatory pathway were explored. Functional polymorphisms within interleukin-1 (IL)&lt;beta&gt; (−31T&gt;C and −511C&gt;T), IL-1RN (VNTR) and IL-6 (−172G&gt;C), were investigated for associations with AT in a South African (SA) and Australian (AUS) case-control study. A total of 356 (158 SA and 198 AUS) asymptomatic control participants (CON) and 171 (89 SA and 82 AUS) participants with AT (TEN) were genotyped. Genotype pairs were constructed using the above polymorphisms in combination with the COL5A1BstUI RFLP. Results Risk-reducing genotypes were indentified and these genotypes in combination with the COL5A1BstUI CC genotype were found to significantly modulate risk of AT (p&lt;0.025). No associations were observed for IL-1&lt;beta&gt;−31T&gt;C, IL-1&lt;beta&gt;−511C&gt;T or IL-1RN. The GG genotype (OR=2.1, 95% CI 1.2 to 3.6; p=0.017) and G allele (OR=1.5, 95% CI 1.0 to 2.2; p=0.044) of IL-6-172G&gt;C were significantly over represented in AUS TEN. Conclusion Variations within interleukin genes together with the COL5A1BstUI CC genotype are able to modulate risk of AT. This research emphasises that a pathway-based genetic association study may be a more effective approach to capture and understand the genetic risk factors underlying multifactorial conditions, such as AT. Furthermore, this study provides evidence that injury susceptibility is most likely dependent on the cumulative effect of the interactions of sequence variants in multiple genes within biologically significant pathways.
Common skin infections in children
Authors: Michael J Sladden, Graham A Johnston
Journal: BMJ (2004)

Most children will have a skin infection at some time. Skin infections are a common reason for consultation in primary care and in dermatology practice.1–3 We review four common skin infections in children and describe their epidemiology, clinical features, and treatment, focusing on treatments with best evidence.

We searched Medline and the Cochrane Library using the terms “molluscum,” “warts,” “impetigo,” and “tinea.” We included randomised trials, meta-analyses, and clinical guidelines.

Molluscum contagiosum is a common, benign, self limiting viral infection of the skin. It generally affects children and is caused by a human specific poxvirus. Infection is rare in children under 1 year of age and typically occurs in the 2-5 year age group.4 Although the prevalence of molluscum contagiosum is not known, one of six Dutch children have visited their doctor for the condition.5

Infection follows autoinoculation or contact with affected people.6 The incubation period is from two weeks to six months. The condition is more common in young children and in children who swim, who bathe together, and who are immunosuppressed. Little evidence supports the view that lesions (mollusca) are more common in children with atopic dermatitis.

Mollusca present as multiple dome shaped pearly or flesh coloured papules with a central depression (umbilication), which usually appear on the trunk and flexural areas (fig 1). They vary in size from 1 mm to 10 mm, with growth occurring over several weeks.4 In patients who are immunocompetent, lesions may persist for six to eight weeks. The mean duration is at least eight months when new lesions appear due to continuous autoinoculation.6 Resolution is often preceded by inflammation. Uncomplicated lesions heal without scarring.



Fig 1 
Typical multiple dome shaped pearly or flesh coloured papules of mollluscum contagiosum, with a central depression (umbilication)

Credit: DOIA



Whether …
University drops case against Croatian academic accused of plagiarism
Authors: Zosia Kmietowicz
Journal: BMJ (2007)

the consultant pathologist whose failure to disclose the results of micro biological tests on one of Sally Clark's two baby sons led to the quashing of her murder convictions, lost his High Court appeal last week against a finding of serious professional misconduct.Mrs Clark was convicted in 1999 of kill ing babies Christopher and Harry but was cleared on appeal in 2003 after spending three and a half years in prison.She died earlier this year at the age of 42.A coroner ruled this week that the cause of her death was acute alcohol intoxication.A General Medical Council fitness to practise panel found Dr Williams, aged 58, guilty of serious professional misconduct in 2005 for not disclosing the results of tests on her second son, Harry, at or before her trial.Dr Williams was banned from doing Home Office forensic pathology or coro ners' work for three years, although he was allowed to continue working as a consult ant histopathologist at Macclesfield General Hospital, in Cheshire.His lawyers appealed on a range of issues, including delays in bringing his case before the GMC.But Mr Justice Davis ruled last week, "In my judg ment this appeal fails on essentially every ground advanced.There was no procedural unfairness giving rise to injustice; nor were the findings and conclusions of the panel wrong."Mrs Clark was cleared after a second appeal, when previously unreported micro biological results came to light.They showed the presence of Staphylococcus aureus at eight sites of the baby's body, including cerebro spinal fluid, raising the possibility that Harry died from natural causes.Dr Williams told the GMC panel that he had not considered the tests to be relevant and that if the defence had wished to see them, they should have asked for them. Court upholds GMC decision over Sally Clark case pathologistUK NEWS Charity warns of proposed restrictions to asylum seekers' access to care, p 1012 World NEWS �erck to pay ���n in rofeco�i� claims, p 1011 �erck to pay ���n in rofeco�i� claims, p 1011 , p 1011 �mj.com �o�ernment may lea�e some patients out of 1�� week tar�et �o�ernment may lea�e some patients out of 1�� week tar�et
A prospective, randomized, double‐blind, placebo‐controlled multi‐centre study on the efficacy and safety of sublingual immunotherapy (SLIT) in children with seasonal allergic rhinoconjunctivitis to grass pollen
Authors: C. Rolinck‐Werninghaus, H. Wolf, C. Liebke, J. C. Baars, J. Lange, M. V. Kopp, J. Hammermann, W. Leupold, P. Bartels, A. Gruebl, C. P. Bauer, J. Schnitker, U. Wahn, B. Niggemann
Journal: Allergy (2004)

Especially in childhood, sublingual immunotherapy (SLIT) could offer advantages over subcutaneous therapy. However, limited data on its efficacy is available.In four German centres 97 children (age 3-14 years) with allergic rhinoconjunctivitis to grass pollen were enrolled in a prospective, double-blind trial comparing SLIT (Pangramin SLIT; ALK-SCHERAX, 0.5 microg major allergens, three times per week, 32 months) with placebo. Primary endpoint was a multiple symptom-medication score for changes in seasonal diary entries between the first and third year of the study (SLIT n=39; placebo n=38).The multiple symptom-medication score was significantly reduced by SLIT to 77.3% of the placebo group (P=0.0498). The subsequent analysis of the single endpoints did not reveal significant differences for symptom scores in favour of SLIT (85.1% of placebo group; P=0.22). However, the medication score improved significantly (67.1% of placebo group; P=0.0025). Furthermore, secondary endpoints assessing in vivo immune responses did not differ significantly between the groups. However, retrospective analysis showed some inhomogeneity for clinical and in vitro parameters at the beginning of the study. Allergic side effects with possible relation to the study drug were reported in both groups (SLIT 49%, placebo 27%, P=0.026).Our study indicates that SLIT had a positive effect on the reduction of a multiple symptom-medication score, mainly by significantly reducing rescue medication use, but had no significant effect on symptoms alone in children with rhinoconjunctivitis to grass pollen compared with a placebo.
Resuscitation and patients' views Questioning may be misunderstood by patients
Authors: A Heller, J Potter, I Sturgess, A Owen, P McCormack, J Liddle, F Haas, N J Dudley, J A Carter, C J N Meystre, S Ahmedzai, N M J Burley
Journal: BMJ (1994)

EDITOR, - The editorial and papers on decisions regarding cardiopulmonary resuscitation show the importance of involving patients and establishing written policies.*RF 1-3* We agree with these authors' conclusions but would sound a cautionary note. Some months ago we instituted a policy whereby mentally competent patients admitted to the unit were routinely asked whether they would want cardiopulmonary resuscitation. Our experience was similar to that described by Morgan and colleagues,3 with most patients welcoming being involved and wishing to express an opinion. However, on one occasion a relative took exception to the practice and contacted her MP and the local press and television. We were then both accused of running a covert euthanasia policy and attempting to withdraw treatment from elderly patients in order to save money. In the furore that followed we saw how the issue of withholding cardiopulmonary resuscitation is easily confused by the lay public with euthanasia. While it must be ethically right that patients are involved in these decisions, great care needs to be taken in how their views are ascertained. Who asks patients, when and how they are asked, and which patients are excluded? Is the patient's view always binding, or is it to be considered as part of the overall decision making process? These are all vital questions to address when setting up such a policy. Unfortunately, in practice, it is often easier to avoid these difficult and complex issues - to continue with tradition and let the doctor decide. 1. 1.↵1. Florin D. Decisions about cardiopulmonary resuscitation. BMJ 1994;308:1653.(25 June.) [OpenUrl][1][FREE Full Text][2] # Explaining outcomes may change views {#article-title-3} EDITOR, - As mentioned by Dominique Florin in her editorial,1 I found a discrepancy between elderly patients wishing cardiopulmonary resuscitation and their doctors' decisions on cardiopulmonary resuscitation - 78 of 100 patients wished resuscitation but only 11 were designated for resuscitation.2 In view of this, I looked at the effect of giving … [1]: {openurl}?query=rft.jtitle%253DBMJ%26rft.stitle%253DBMJ%26rft.issn%253D0007-1447%26rft.aulast%253DFlorin%26rft.auinit1%253DD%26rft.volume%253D308%26rft.issue%253D6945%26rft.spage%253D1653%26rft.epage%253D1654%26rft.atitle%253DDecisions%2Babout%2Bcardiopulmonary%2Bresuscitation%26rft_id%253Dinfo%253Apmid%252F8025452%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=FULL&journalCode=bmj&resid=308/6945/1653&atom=%2Fbmj%2F309%2F6951%2F408.atom
Leukemia in Survivors of Atomic Bombing
Authors: William C. Moloney
Journal: New England Journal of Medicine (1955)

THE leukemogenic effect of atomic radiation has been well established by investigations on survivors in Hiroshima and Nagasaki.1 From 1948 to 1953, under the auspices of the Atomic Bomb Casualty Commission, observations on 75 verified cases were reported. Subsequently 17 new cases were encountered, bringing to 92 the total number of established cases occurring in survivors up to January 1, 1954 (Table 1). With these additional cases further observations on various aspects of radiation-induced leukemia are presented here.Results of ObservationsRate of OccurrenceThe increased occurrence of leukemia in survivors has been documented by earlier reports.1 , 2 However, the marked . . .
Immune response to JC virus T antigen in patients with and without colorectal neoplasia
Authors: Lindsay D Butcher, Melissa Garcia, Mildred Arnold, Hideki Ueno, Ajay Goel, C Richard Boland
Journal: Gut Microbes (2014)

JC virus (JCV) is a polyomavirus that infects approximately 75% of the population and encodes a T antigen (T-Ag) gene, which is oncogenic and inactivates the p53 and pRb/p107/p130 protein families. Previous work in our lab has identified the presence of T-Ag in colorectal neoplasms. While JCV remains in a latent state for the majority of those infected, we hypothesized that a disturbance in immunological control may permit JCV to reactivate, which may be involved in the development of colorectal neoplasia. Our aim was to determine the cell mediated immune response to JCV T-Ag, and determine if it is altered in patients with colorectal adenomatous polyps (AP) or cancers (CRC). Peripheral blood mononuclear cells (PBMCs) isolated from the blood of patients undergoing colonoscopy or colorectal surgery were stimulated by a peptide library covering the entire T-Ag protein of JCV. Cytokine production and T cell proliferation were evaluated following T-Ag stimulation using Luminex and flow cytometry assays. JCV T-Ag peptides stimulated secretion of IL-2, which induced T cell expansion in all three groups. However, stronger IL-10 and IL-13 production was seen in patients without colorectal neoplasms. IP-10 was produced at very high levels in all groups, but not significantly differently between groups. Most patients exhibited CD4+ and CD8+ T cells in response to stimulation by the T-Ag clusters. The combination of IL-2 and IP-10 secretion indicates the presence of T-Ag-specific Th1 cells in all patients, which is higher in patients without carcinoma.