tbuckley/cabot-search huggingface dataset:
Immunogenicity of hepatitis A vaccination in decompensated cirrhotic patients
Authors: Miguel R. Arguedas, Anita Johnson, Mohamad A. Eloubeidi, Michael B. Fallon
Journal: Hepatology (2001)

Hepatitis A virus (HAV) vaccination is recommended in chronic liver disease because of an increased morbidity and mortality associated with HAV superinfection. However, data regarding the efficacy of HAV vaccination in patients with advanced chronic liver disease is limited. We assessed the efficacy of a standard HAV vaccination schedule in decompensated chronic liver disease in comparison with compensated disease and defined clinical predictors associated with seroconversion. Eighty–four anti–HAV antibody-negative patients, 49 with compensated liver disease, and 35 with decompensated disease were enrolled. Seroconversion was measured by qualitative and quantitative anti–HAV antibody measurements 1 month after each vaccine dose, and univariate/multivariate analysis was performed to define clinical predictors associated with seroconversion. One month after the primary dose, 71.4% of patients with compensated liver disease had detectable anti–HAV antibody compared with 37.1% with decompensated liver disease ( P &lt; .05). One month after the booster dose, 98% of compensated patients seroconverted compared with 65.7% with decompensated disease ( P &lt; .05). The median serum antibody concentration in compensated liver disease was 76.4 mIU/mL at month 1 and 327.91 mIU/mL at month 7 compared with 20.0 mIU/mL and 102.57 mIU/mL, respectively, in decompensated disease. On multivariate analysis, Child–Pugh class was the only factor predicting response to vaccination. Seroconversion after HAV vaccination was significantly less common in decompensated liver disease and the presence of advanced disease (Child–Pugh class B/C) predicted a lower response rate. These findings indicate that the response to HAV vaccination in chronic liver disease is optimal when targeted to patients before the development of hepatic decompensation.
Healthcare challenges from the developing world: post-immigration refugee medicine
Authors: Kristina M Adams, Lorin D Gardiner, Nassim Assefi
Journal: BMJ (2004)

Worldwide, there are approximately 13 million refugees and asylum seekers.1 Flight of refugees often occurs in the setting of war, famine, or human rights violations, resulting from a “well-founded fear of being persecuted for reasons of race, religion, nationality, membership in a particular social group, or political opinion.”2 Physicians in host countries increasingly encounter refugees in their practices and, owing to inadequate training, may not fully meet their complex medical needs.

Limited evidence exists to support many aspects of refugee health care. When scientific evidence is not available, recommendations stem from our experience in caring for a diverse group of refugees (East African, Balkan, and South East Asian) in a multidisciplinary setting involving primary care physicians, obstetrician-gynaecologists, psychiatrists, nurses, cultural interpreters, and social workers. This article is based on clinical expertise and a review of the literature obtained from a Medline search using the key words “refugee” and “asylum seekers.” We suggest an approach to obtaining the refugee history, screening for infectious diseases and common psychiatric disorders, and dealing with special problems such as ritual female genital surgery (female circumcision).

Refugee camps represent the first point of escape, but continued interethnic strife, sexual violence, and disease epidemics often perpetuate the dangerous environment from which people fled. Although the United Nations High Commission for Refugees promises protection and basic medical care, refugees may actually have higher mortality in camps than in their home country. Major causes of mortality in refugee camps include diarrhoeal diseases, measles, acute respiratory tract infections, tuberculosis, and malaria. Mandated medical screening of refugees before arrival in the United States identifies those with “inadmissible conditions,” including active infections such as tuberculosis, leprosy, and HIV infection. Typical screening of adult refugees involves a physical examination, brief mental health assessment, chest radiograph (sputum testing for tuberculosis if abnormal), …
Right ventricular performance in essential hypertension.
Authors: J Ferlinz
Journal: Circulation (1980)

Effects of systemic hypertension on right ventricular (RV) performance have not been previously investigated.In this study, 10 normal patients were compared to 20 patients with uncomplicated, asymptomatic essential hypertension (defined as cuff diastolic blood pressure 2 100 mm Hg) after a complete hemodynamic and RV cineangiographic evaluation.The mean intra-arterial pressure in the normal group was 93 ± 11 vs 120 ± 13 mm Hg in the essential hypertension group (p < 0.01).All right-sided pressures were sub- stantially higher in the hypertensive than in the normal patients (mean right atrial pressure: 2 ± 1 mm Hg for normals, 5 ± 3 mm Hg for hypertensives,p < 0.01; RV end-diastolic pressure: 3 ± 2 mm Hg for normals, 5 ± 2 mm Hg for hypertensives, p < 0.05; mean pulmonary artery pressure: 12 ± 3 mm Hg for normals, 17 ± 5 mm Hg for hypertensives, p < 0.01; mean pulmonary capillary wedge pressure: 6 ± 1 mm Hg for normals, 9 ± 3 mm Hg for hypertensives, p < 0.01.Cardiac index in normal and hypertensive patients was nearly iden- tical (2.93 ± 0.80 1/min/m2 in normals, 3.11 ± 0.67 1/min/m2 in hypertensives, NS).In contrast, a markedly lower cineangiographic RV ejection fraction was present in the hypertensive compared with the normal patients (68 ± 6% vs 59 ± 7%, p < 0.01).The lower RV ejection fraction was due to the proportionately greater increase in the RV end-systolic volume index (22 ± 5 mI/M2 for normals, 34 ± 8 mI/m2 for hypertensives, p < 0.01) than in the end-diastolic volume index (69 ± 13 ml/m2 for normals, 82 ± 16 mI/M2 for hypertensives, p < 0.04) in the hypertensive patients.It is concluded that 1) hypertensive patients have higher right-sided pressures than normals, and 2) RV performance in essential hypertension may be characterized by a lower RV ejection fraction than in normal subjects.
So-Called Bartter's Syndrome
Authors: Frederic C. Bartter
Journal: New England Journal of Medicine (1969)

Since the description in 1962 of a syndrome of "hyperplasia of the juxtaglomerular complex with hyperaldosteronism and hypokalemic alkalosis"1 a number of reports of the same and of similar syndromes have made it possible to define it as a specific entity and thus to add certain features not then appreciated and to exclude others that are clearly not representative.The diagnosis of "renal tubular acidosis sine acidosis" was first entertained for the original case, in view of the numerous features the syndrome shares with renal tubular acidosis (RTA). Thus, in both disorders there is evidence that sodium deprivation induces excessive . . .
Sterile Serous Effusions in Cases of Lobar Pneumonia Treated with Sulphonamides
Authors: R. C. Nairn
Journal: Thorax (1949)

Deficiency of dehydroepiandrosterone (DHEA) is associated with lupus erythematosus, diabetes mellitus, Alzheimer disease, and some cancers, but we are not yet ready to conclude that prescribing supplemental DHEA is helpful in these or any other conditions. DHEA shows some promise in observational clinical studies and laboratory experiments, but we still need large-scale human studies to answer key questions. For now, we do not have enough evidence to recommend routine treatment with DHEA. As with other supplements, quality control is always a concern, and different brands may contain different amounts of active ingredient.
Medical Landmarks USA: A Travel Guide
Authors: Claude E. Welch
Journal: JAMA (1991)

New concepts in publications related to medicine are rare; this book is one. The author describes his project as "really four volumes in one: it is at once a travel guide, a reference work, an anthology of stories and a history text on health care in the United States." Remarkably enough, the author has achieved his goal and even more. He has recognized the increasing interest both by doctors and the public in medicine, and therefore has produced a volume that not only is brief but also is a pleasure to read. The book is packed with facts that range from historical vignettes to detailed directions for visiting sites of interest. For physicians who already believe they know all such material, the author has elucidated the intricate history of the evolution of such puzzles as the development of New York City and Chicago hospitals. For the public, he has written
Physician, Know Thyself
Authors: George S. Sigel
Journal: New England Journal of Medicine (1967)

THE idea that people should not talk to themselves is generally accepted. And yet one wonders if medical students, physicians or, for that matter, anyone called upon to deal intimately with people might not perform more successfully if each could cultivate the habit of talking to himself in the performance of his duties. Medical people, whether they like it or not, are the product of many things, including their times and their own internal conflicts, conscious and subconscious. It is the resolution of these conflicts, whether successful or not, that has such a determining role when one person deals with . . .
Points from Letters: "No Smoking" Ignored
Authors: S. M. Richards
Journal: BMJ (1973)

In 1970 340 of strains were resistant to tetracycline, in 1971 46%, in 1972 54%, and in 1973 to date 35°%.It would seem there- fore that in this area, at least, there has been no fall in the level of tetracycline-resistant Strep.pyogenes over the past four years.The majority of strains isolated continue to come from throat swabs, though many also come from skin sepsis and abscesses.Group B haemolytic streptococci show an even higher prevalence of tetracycline resistance- 580% of 74 strains isolated so far this year (mainly from vaginal swabs) were resistant to this drug.Whether the difference between Dr. Robertson's findings and mine is due to differences in the usage of tetracyclines in the two areas is something on which I cannot comment, but our results illustrate how widely divergent antibiotic sensitivity patterns may 'be observed in different areas of the couniry.-Iam, etc.,
Advances in studying of the pharmacological activities and structure–activity relationships of natural C-glycosylflavonoids
Authors: Peng Zeng, Yong Zhang, Chen Pan, Qi Jia, Fujiang Guo, Yiming Li, Weiliang Zhu, Kaixian Chen
Journal: Acta Pharmaceutica Sinica B (2013)

C-glycosylflavonoids are characterized by a bond between the anomeric carbon of a sugar moiety and the C-6 or C-8 position of a flavonoid A ring. These compounds are widespread in nature and have become the subject of increasing research interest due to their high biological potential. This review focuses on the biological effects of various C-glycosylflavonoids and their structure–activity relationships (SAR) as elucidated over the last 5 years.
Xenotransmission of the socioeconomic gradient in health? A population based study
Authors: J. Moloo, K. L Jackson, J. L Waller, R. E McKeown, C. L Addy, S. P Cuffe, C. Z Garrison
Journal: BMJ (1998)

The presence of a socioeconomic gradient in health has been documented extensively in humans. 1 2 Social hierarchy has also been found to be associated with the health of non-human species, as in a study of macaques, in which development of coronary artery occlusion was associated with social hierarchy. 3However, to our knowledge, transmission of the social gradient in health across species has never been reported.We investigated whether the socioeconomic gradient in health could be transmitted from humans to their pets.
Psychological stress in IBD: new insights into pathogenic and therapeutic implications
Authors: J E Mawdsley
Journal: Gut (2005)

Psychological stress has long been reported anecdotally to increase disease activity in inflammatory bowel disease (IBD), and recent well designed studies have confirmed that adverse life events, chronic stress, and depression increase the likelihood of relapse in patients with quiescent IBD. This evidence is increasingly supported by studies of experimental stress in animal models of colitis. With the evolving concept of psychoneuroimmunology, the mechanisms by which the nervous system can affect immune function at both systemic and gut mucosal levels are gradually becoming apparent. Recent data suggest that stress induced alterations in gastrointestinal inflammation may be mediated through changes in hypothalamic-pituitary-adrenal (HPA) axis function and alterations in bacterial-mucosal interactions, and via mucosal mast cells and mediators such as corticotrophin releasing factor (CRF). To date, the therapeutic opportunities offered by stress reduction therapy remain largely unexplored, in part because of methodological difficulties of such studies. This paper reviews recent advances in our understanding of the pathogenic role of psychological stress in IBD and emphasises the need for controlled studies of the therapeutic potential of stress reduction.
Two Waves of Nuclear Factor κb Recruitment to Target Promoters
Authors: Simona Saccani, Serafino Pantano, Gioacchino Natoli
Journal: The Journal of Experimental Medicine (2001)

Proinflammatory stimuli induce the rapid and transient translocation of nuclear factor (NF)-kappaB to the nucleus, where it activates transcription from several genes, including those encoding inflammatory cytokines and chemokines, adhesion molecules, and cytoprotective proteins. Using chromatin immunoprecipitation, we show that after an acute stimulation two distinct waves of NF-kappaB recruitment to target promoters occur: a fast recruitment to constitutively and immediately accessible (CIA) promoters and a late recruitment to promoters requiring stimulus-dependent modifications in chromatin structure to make NF-kappaB sites accessible (promoters with regulated and late accessibility [RLA]). Our results suggest that a mechanism of specificity in NF-kappaB-dependent transcriptional responses relies on the ability of individual stimuli to make RLA promoters accessible to NF-kappaB before its rapid extrusion from the nucleus.
Resting heart rate as a low tech predictor of coronary events in women: prospective cohort study
Authors: J. Hsia, J. C Larson, J. K Ockene, G. E Sarto, M. A Allison, S. L Hendrix, J. G Robinson, A. Z LaCroix, J. E Manson
Journal: BMJ (2009)

<b>Objective</b> To evaluate resting heart rate as an independent predictor of cardiovascular risk in women. <b>Design</b> Prospective cohort study. <b>Setting</b> The Women’s Health Initiative was undertaken at 40 research clinics in the United States. <b>Participants</b> 129 135 postmenopausal women. <b>Main outcome measure</b> Clinical cardiovascular events. <b>Results</b> During a mean of 7.8 (SD 1.6) years of follow up, 2281 women were identified with myocardial infarction or coronary death and 1877 with stroke. We evaluated associations between resting heart rate and cardiovascular events in Cox regression models adjusted for multiple covariates. Higher resting heart rate was independently associated with coronary events (hazard ratio 1.26, 95% confidence interval 1.11 to 1.42 for highest [&gt;76 beats per minute] <i>v</i> lowest quintile [≤62 beats per minute]; P=0.001), but not with stroke. The relation between heart rate and coronary events did not differ between white women and women from other ethnic groups (P for interaction=0.45) or between women with and without diabetes (P for interaction=0.31), but it was stronger in women aged 50-64 at baseline than in those aged 65-79 (P for interaction=0.009). <b>Conclusion</b> Resting heart rate, a low tech and inexpensive measure of autonomic tone, independently predicts myocardial infarction or coronary death, but not stroke, in women. <b>Trial registration</b> ClinicalTrials.gov NCT00000611.
Heterozygous and Homozygous Alpha1-Antitrypsin Deficiency in Patients with Pulmonary Emphysema
Authors: Jack Lieberman
Journal: New England Journal of Medicine (1969)

Homozygous deficiency of alpha1-atitrypsin is known to predispose to pulmonary emphysema. Measurement of the trypsin inhibitory capacity (TIC) of serum specimens from 28 relatives of a homozygous proband suggested that both heterozygotes and homozygotes may have an increased predisposition to lung disease, and possibly to peptic ulcer. Four of 19 heterozygotes and two homozygotes in this family had definite histories of pulmonary disease. After this family study, the TIC of serum was measured in 66 patients hospitalized for pulmonary emphysema at a Veterans Administration hospital. Of these, 25.8 per cent were found to be deficient; seven were homozygotes, and 10 heterozygotes. Of 23 patients with emphysema under 50 years of age, 48 per cent were deficient. A history of peptic-ulcer disease was obtained from 35.3 per cent of the antitrypsin-deficient, as compared to 28.6 per cent of the nondeficient patients with emphysema, a difference statistically not significant.
Endotoxin Exposure Is a Risk Factor for Asthma
Authors: Peter S. Thorne, Katarina Kulhánková, Ming Yin, Richard Cohn, Samuel J. Arbes, Darryl C. Zeldin
Journal: American Journal of Respiratory and Critical Care Medicine (2005)

Although research has shown that early life exposure to household endotoxin protects against development of allergies, studies are less clear on the relationship between household endotoxin exposure and prevalence of wheezing and asthma. We assayed 2,552 house dust samples in a representative nationwide sam- ple to explore relationships between endotoxin exposures and risk factors for asthma, asthma symptoms, and medication use.House dust was vacuum-sampled from five locations within homes and assayed for endotoxin. Health, demographic, and housing information was assessed through questionnaire and on-site evaluation of 2,456 residents of 831 homes selected to represent the demographics of the United States.Endotoxin concentration (EU/mg) and load (EU/m(2)) were highly correlated (r = 0.73-0.79). Geometric mean endotoxin concentrations were as follows (in EU/mg): bedroom floors, 35.3 (5th-95th percentile, 5.0-260); bedding, 18.7 (2.0-142); family room floors, 63.9 (11.5-331); sofas, 44.8 (6.4-240); and kitchen floors, 80.5 (9.8-512). Multivariate analysis demonstrated significant relationships between increasing endotoxin levels and diagnosed asthma, asthma symptoms in the past year, current use of asthma medications, and wheezing among residents of the homes. These relationships were strongest for bedroom floor and bedding dust and were observed in adults only. Modeling the joint effect of bedding and bedroom floor endotoxin on recent asthma symptoms yielded an adjusted odds ratio of 2.83 (95% confidence interval, 1.01-7.87). When stratified by allergy status, allergic subjects with higher endotoxin exposure were no more likely to have diagnosed asthma or asthma symptoms than nonallergic subjects.This study demonstrates that household endotoxin exposure is a significant risk factor for increased asthma prevalence.
Restriction of interferon gamma responsiveness and basal expression of the myeloid human Fc gamma R1b gene is mediated by a functional PU.1 site and a transcription initiator consensus.
Authors: Q G Eichbaum, R Iyer, D P Raveh, C Mathieu, R A Ezekowitz
Journal: The Journal of Experimental Medicine (1994)

The restricted expression of the human Fc gamma R1b gene to myeloid cells is likely to be regulated by a combination of transcription factors that may not be solely expressed in myeloid cells, but act together to restrict the expression of the gene to myeloid cells. Low basal expression of the human Fc gamma R1b gene is specifically upregulated by interferon gamma (IFN-gamma). A 181-bp region of 5' flanking sequence contains several key regulatory motifs that include the extended gamma response region (XGRR) and the PIE region. The XGRR contains the 39-bp gamma response region originally defined in the highly homologous Fc gamma R1a gene. The XGRR is in close proximity to the 21-bp PIE motif that is conserved in the promoters of some other myeloid genes. The PIE motif contains a consensus site for the macrophage and B cell transcription factor, PU.1, and is adjacent to the cluster of transcription start sites. An active transcription initiator, Inr, consensus spans the start sites and appears to direct transcription initiation of this TATA-less gene. In this study, we demonstrate that the PIE region contains a functional PU.1 site that binds a human PU.1-like protein and that associated factors present in myeloid extracts also bind in this PIE region. Mutational analysis reveals an absolute requirement for an intact PU.1 box for both basal and IFN-gamma inducible expression of this gene. In addition, mutations in the Inr greatly reduce basal and inducible transcription. Insertion of a strong TATA box downstream from the Inr or at -30 bp from the transcription start sites restores basal and inducible activity in the presence of a mutated PU.1 site. We also demonstrate that indeed, when the XGRR is positioned in the context of a heterologous TATA containing promoter, it is able to respond equivalently to either IFN-alpha or IFN-gamma. However, IFN-alpha responsiveness does not occur in the context of the physiological Fc gamma R1b TATA-less basal promoter. Our results suggest that a human PU.1-like factor acts as a "bridging factor" between the upstream IFN-gamma enhancer and the Inr dependent preinitiation complex. These findings indicate that the structure of the basal promoter in combination with restricted activators like PU.1 are important in regulating the expression of this gene.
Unmet need in chronic disability
Authors: D. Gloag
Journal: BMJ (1984)

How do all the data on the presence of a circulating inhibitor of the sodium pump in essential hypertension fit in with the action of ANF,4455 or are the two concepts independent?Is the low kallikrein excretion in patients with essential hypertensions6 and their normotensive children57 a limiting factor in natriuresis, entailing an alternative natriuretic mechanism which is related to the hypertension?Un- doubtedly there will be an enormous surge in physiological and clinical research and much work will have to be carried out before these interesting results are established on a scientific basis and the clinical questions can be answered.
COMPARISON OF XENON-133 VENTILATION AND AEROSOL INHALATION IMAGING USING A NEW COMMERCIAL GENERATOR SYSTEM IN PULMONARY EMBOLISM (PE)
Authors: Lalitha Ramanna, Alan D. Waxman, Mary E. Chappel, Michael B. Brachman, Doina E. Tanasescu, Daniel S. Berman
Journal: Clinical Nuclear Medicine (1983)

Ramanna, Lalitha; Waxman, Alan D.; Chappel, Mary E.; Brachman, Michael B.; Tanasescu, Doina E.; Berman, Daniel S. Author Information
Complication of endoscopic ultrasound-guided celiac plexus neurolysis
Authors: N. Muscatiello, C. Panella, L. Pietrini, P. Tonti, E. Ierardi
Journal: Endoscopy (2006)

We performed endoscopic ultrasound (EUS-)guided celiac plexus neurolysis (CPN), because of recurrent abdominal pain resistant to analgesic drugs, in a 39-year-old woman with a diagnosis of pancreatic cancer that was unamenable to surgical treatment [1] [2] [3] [4] [5]. No immediate complications occurred. The patient was referred 7 days later, because of persistent abdominal pain radiating through the back, associated with night fever. Transabdominal echo tomography showed a hypoechogenic area 60 mm in diameter with small internal hyperechogenic spots, that was located between the pancreatic body and the celiac tripod and suggestive of an abscess.