tbuckley/cabot-search huggingface dataset:
Immune Serum Globulin Therapy for Polymyositis
Authors: Harry B. Burke
Journal: JAMA (1988)

<h3>To the Editor.</h3> —The CASE REPORT by Roifman et al<sup>1</sup>regarding the use of immune serum globulin in the treatment of chronic polymyositis requires clarification. The authors describe a patient with "normal immunity," but they did not provide any information regarding what this means. We need to know what immunologic studies were performed (eg, measurement of immunoglobulin, complement, and rheumatoid factor levels and antibody titers) and the results of those studies if we are going to understand what the authors mean by normal immunity. This knowledge is important because the intravenous infusion of γ-globulin has been associated with the death of a patient with abnormal immunoglobulins.<sup>2</sup>If there is the slightest doubt regarding the patient's immunologic status, the prudent course is to begin with a test dose of immune globulin before proceeding to a therapeutic regimen. Finally, since spontaneous remission is possible in polymyositis, it is difficult to
U.K. Controlled Trial of Intrapleural Streptokinase for Pleural Infection
Authors: Nicholas A. Maskell, Christopher W.H. Davies, Andrew J. Nunn, Emma L. Hedley, Fergus V. Gleeson, Robert Miller, Rhian Gabe, Glyn L. Rees, Timothy E.A. Peto, Mark A. Woodhead, Donald J. Lane, Janet H. Darbyshire, Robert J.O. Davies
Journal: New England Journal of Medicine (2005)

Intrapleural fibrinolytic agents are used in the drainage of infected pleural-fluid collections. This use is based on small trials that did not have the statistical power to evaluate accurately important clinical outcomes, including safety. We conducted a trial to clarify the therapeutic role of intrapleural streptokinase.In this double-blind trial, 454 patients with pleural infection (defined by the presence of purulent pleural fluid or pleural fluid with a pH below 7.2 with signs of infection or by proven bacterial invasion of the pleural space) were randomly assigned to receive either intrapleural streptokinase (250,000 IU twice daily for three days) or placebo. Patients received antibiotics and underwent chest-tube drainage, surgery, and other treatment as part of routine care. The number of patients in the two groups who had died or needed surgical drainage at three months was compared (the primary end point); secondary end points were the rates of death and of surgery (analyzed separately), the radiographic outcome, and the length of the hospital stay.The groups were well matched at baseline. Among the 427 patients who received streptokinase or placebo, there was no significant difference between the groups in the proportion of patients who died or needed surgery (with streptokinase: 64 of 206 patients [31 percent]; with placebo: 60 of 221 [27 percent]; relative risk, 1.14 [95 percent confidence interval, 0.85 to 1.54; P=0.43), a result that excluded a clinically significant benefit of streptokinase. There was no benefit to streptokinase in terms of mortality, rate of surgery, radiographic outcomes, or length of the hospital stay. Serious adverse events (chest pain, fever, or allergy) were more common with streptokinase (7 percent, vs. 3 percent with placebo; relative risk, 2.49 [95 percent confidence interval, 0.98 to 6.36]; P=0.08).The intrapleural administration of streptokinase does not improve mortality, the rate of surgery, or the length of the hospital stay among patients with pleural infection.
Collagen polymorphism in normal and cirrhotic human liver.
Authors: J M Seyer, E T Hutcheson, A H Kang
Journal: Journal of Clinical Investigation (1977)

Collagens in normal human liver and in alcoholic cirrhotic liver were investigated. Collagens were solubilized by limited proteolysis with pepsin under nondenaturing conditions, and after purification, were fractionated into types I and III by selective precipitation with NaCl. After carboxymethyl cellulose and agarose chromatography, the resulting alpha-chains from each of the collagen types were analyzed with respect to their amino acid and carbohydrate compositions. A comparison of the results obtained from normal liver with those from the diseases organ revealed no significant differences. The isolated human liver alpha1(I) and alpha1(III) chains were digested with CNBr and the generated peptides were separated and purified by a combination of ion-exchange and molecular sieve chromatography. The molecular weight and the amino acid and the carbohydrate compositions of each of the peptides were identical to those of the corresponding human skin peptides except for the slightly higher content of hydroxylysine in some of the peptides. The relative content of type III in relation to type I collagen in both normal anc cirrhotic liver was determined by digesting washed liver homogenates directly with CNBr and quantitating the resultant alpha1(I) and alpha 1(III) peptides after chromatographic separation. The relative quantities of these peptides indicated that normal human liver contained an average of 47% type III, with the remainder being type I. Cirrhotic liver, on the other hand, contained a significantly smaller proportion of type III, ranging from 18 to 34% in different samples, with a corresponding increase in type I. These findings indicate that although the amino acid and carbohydrate compositions of collagens deposited in cirrhotic liver are normal, the fibrotic process of alcoholic liver disease in humans is accompanied by an alteration in tissue collagen polymorphism, and suggest that the observed alterations may have pathogenetic implications.
World's poorest countries can improve access to medicines through local production, says United Nations
Authors: J. Zarocostas
Journal: BMJ (2011)

Local production of pharmaceuticals in some poor African and Asian countries, such as Ethiopia, Uganda, and Bangladesh, has the potential to improve access to essential drugs for many of the one billion people who live in the world’s least developed countries, says a United Nations expert report.

“A local pharmaceutical industry may contribute to meeting the goal of greater access to medicines,” concludes the study.

The report says that from a public health perspective, gains are greatest if local production increases the supply of the essential medicines for which a shortage exists.

By the same token, Zafar …
Highly Active Antiretroviral Therapy and Sexual Risk Behavior
Authors: Nicole Crepaz, Trevor A. Hart, Gary Marks
Journal: JAMA (2004)

Evidence suggests that since highly active antiretroviral therapy (HAART) became available, the prevalence of unprotected sex and the incidence of sexually transmitted infections (STIs) have increased.To conduct 3 meta-analyses to determine whether (1) being treated with HAART, (2) having an undetectable viral load, or (3) holding specific beliefs about HAART and viral load are associated with increased likelihood of engaging in unprotected sex.A comprehensive search included electronic bibliographic databases, including AIDSLINE, MEDLINE, PubMed, CINHAL, PsycInfo, ERIC, EMBASE, and Sociofile, from January 1996 to August 2003, conference proceedings, hand searches of journals, reference lists of articles, and contacts with researchers.Twenty-five English-language studies (some contributing >1 finding) met the selection criteria and examined the association of unprotected sexual intercourse or STIs with receiving HAART (21 findings), having an undetectable viral load (13 findings), or beliefs about HAART and viral load (18 findings).Reports were screened and information from eligible studies was abstracted independently by pairs of reviewers using a standardized spreadsheet.Random-effects models were used to aggregate data. The prevalence of unprotected sex was not higher among persons with the human immunodeficiency virus (HIV) receiving HAART (prevalence range, 9%-56%; median, 33%) vs those not receiving HAART (range, 11%-77%; median, 44%; odds ratio [OR], 0.92; 95% confidence interval [CI], 0.65-1.31) or among HIV-positive persons with an undetectable viral load (range, 10%-68%; median, 39%) vs those with a detectable viral load (range, 14%-70%; median, 42%; OR, 0.99; 95% CI, 0.82-1.21). The prevalence of unprotected sex was elevated (OR, 1.82; 95% CI, 1.52-2.17) in HIV-positive, HIV-negative, and unknown serostatus persons who believed that receiving HAART or having an undetectable viral load protects against transmitting HIV or who had reduced concerns about engaging in unsafe sex given the availability of HAART (range, 17%-81% [median, 49%] vs 9%-68% [median, 38%] for counterparts).In the studies reviewed, HIV-positive patients receiving HAART did not exhibit increased sexual risk behavior, even when therapy achieved an undetectable viral load. However, people's beliefs about HAART and viral load may promote unprotected sex and may be amenable to change through prevention messages.
Successful treatment of rheumatoid meningitis with cyclophosphamide but not infliximab
Authors: R C Chou, J W Henson, D Tian, E T Hedley-Whyte, A M Reginato
Journal: Annals of the Rheumatic Diseases (2006)

Rheumatoid meningitis is a rare but lethal disorder that occurs in an elderly population with longstanding rheumatoid arthritis (RA).1 Although the majority of patients experience neurological symptoms, up to 26% of the patients were asymptomatic in a case series study as identified by necropsy.1 There is poor correlation between the severity of synovitis and neurological symptoms, which therefore imposes a challenge in the diagnosis of this condition.1 To date there are no established treatment regimens for rheumatoid meningitis, although most patients receive immunosuppressive agents. Although the anti-tumour necrosis factor (TNF) agents have been proved to provide significant relief for the articular manifestations of RA, their effectiveness for rheumatoid meningitis has not been reported.2

A 58 year old woman with previous diagnoses of fibromyalgia and osteoarthritis was referred to the rheumatology clinic of the Massachusetts General Hospital (MGH) with worsening polyarthritis of both hands, wrists, knees, and ankles while receiving daily rofecoxib, 25 mg. Before the visit she had undergone extensive investigation for a 6 …
Thomas Royle Dawber
Authors: Caroline Richmond
Journal: BMJ (2006)

Founder epidemiologist of the Framingham heart studyIn 1945 the Western world emerged from the second world war, only to be confronted by an epidemic of heart disease.The US government responded by setting up a study to identify the causes and to diagnose and treat early disease, though the latter aim was dropped as there was no treatment available.The town of Framingham in Massachusetts was chosen as the site for this study because it had a stable population of 28 000 and was close to Harvard University.The Framingham study, as it was known, became world famous."Along with Ancel Keys's seven country study, this was the work on which all other epidemiology of heart disease stands.There isn't a study that doesn't owe its origin to Framingham,"
Perception of Lung Cancer (LC) Risk: Impact of Smoking Status and Nicotine Dependence
Authors: L. Greillier, S. Couraud, C. Touboul, J. Viguier, F. Eisinger, J.-F. Morère, X. Pivot, J.-Y. Blay, C. Lhomel, A. Cortot
Journal: Annals of Oncology (2015)
Links need to be maintained with census definitions
Authors: M. R D Johnson
Journal: BMJ (1996)

EDITOR,—The definition and meaning of terms relating to race, ethnicity, and culture are issues to which social scientists have devoted hours and pages of thought. Some doubt whether they are indeed real entities (like “society”), but, as many studies have now shown, they are real in their effects. Kwame McKenzie and N S Crowcroft's editorial and “style guide” are helpful pointers out of the maze.1 2

It is important …
Efficacy and safety of angiotensin receptor blockade are not modified by aspirin in patients with chronic heart failure: a cohort study from the Candesartan in Heart failure – Assessment of Reduction in Mortality and morbidity (CHARM) programme
Authors: Su Min Chang, Christopher B. Granger, Peter A. Johansson, Peter Kosolcharoen, John J.V. McMurray, Eric L. Michelson, David R. Murray, Bertil Olofsson, Marc A. Pfeffer, Scott D. Solomon, Karl Swedberg, Salim Yusuf, Mark E. Dunlap
Journal: European Journal of Heart Failure (2010)
Regional Cerebral Blood Flow Changes in Stroke Imaged by Tc-99m HMPAO SPECT With Corresponding Anatomic Image Comparison
Authors: JAMES M. MOUNTZ, GEORG DEUTSCH, SALMA H. KHAN
Journal: Clinical Nuclear Medicine (1993)

Cerebral infarction is the result of cerebrovascular insufficiency and itself creates complex changes in cerebral hemodynamics. To allow recognition of patterns of change in regional cerebral blood flow (r-CBF) caused by cerebral infarction, the authors present an atlas of Tc-99m hexamethylpropyleneamine oxime (Tc-99m HMPAO) SPECT brain scan sections for a variety of strokes demonstrating typical vascular territorial involvements and evolution of morphologic and r-CBF change. Sections from MRI or CT are shown with SPECT images of the stroke lesion for comparison of the complementary information provided by regional cerebroperfusion and by morphology. Examples of SPECT during acute, subacute, and chronic stages of stroke are provided. To illustrate the temporal evolution of stroke and accompanying changes in the "stroke penumbra," case examples of acute tissue necrosis, luxury perfusion, ischemia, and diaschisis are presented. Methods for semiquantitative analysis of morphologic versus r-CBF defect size after acute stroke are described. How brain SPECT scans conducted during Diamox initiated cerebrovascular stress tests can complement the information obtained from baseline studies and assist in the interpretation of r-CBF abnormalities is also demonstrated.
Cholinesterase inhibitors and memantine for symptomatic treatment of dementia
Authors: J. Rodda, J. Carter
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 Cholinesterase inhibitors and memantine for symptomatic treatment of dementia Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Esmond William Ball
Authors: Keith Shinton
Journal: BMJ (2008)

Esmond William Ball served in the Royal Army Medical Corps in the Middle East and Kenya before training as a pathologist at Westminster Hospital, London, and North Staffs Royal Infirmary, Stoke on Trent. In 1965 he was appointed consultant pathologist at Selly Oak Hospital, Birmingham, where he remained for the next 20 years, specialising in …
Insulin Secretion in the Diagnosis of Adult-Onset Diabetes Mellitus
Authors: Roger W. Turkington
Journal: JAMA (1978)

The natural history of patients with glucose intolerance was observed in 334 patients during a period of 18 years. Glucose tolerance testing (100 g orally) was characterized by measurement of induced insulin secretion. Diabetic complications of retinopathy, sensory neuropathy, and renal disease developed only in the group of patients in whom the induced serum insulin peak fell below 60 mu U/ml. Preservation of an insulin secretory reserve that permitted serum insulin peaks of 60 muU/ml or greater was not associated with development of these complications or symptoms of insulin deficiency despite the presence of an equal degree of fasting hyperglycemia and glucose intolerance. A critical amount of insulin secretory reserve distinguishes between two qualitatively distinct clinical syndromes: true diabetes mellitus (the development of signs and symptoms of insulin deficiency) and the syndrome of pure resistance to insulin (signs and symptoms of hyperglycemia in the setting of adequate or excessive insulin secretion, frequently with obesity, but without diabetic complication).
Intubation of the Larynx: Report of 100 Cases: 38 Per Cent. Recoveries, with a Run of Seven Consecutive Successful Cases
Authors: W. Hailes
Journal: BMJ (1890)

THE following is a report of 100 cases of intubation of the larynx for diphtheritic croup, with 38 per cent.recoveries, with a run of seven consecutive successful cases.
Hormone therapy increased risk for kidney stones in healthy postmenopausal women
Authors: Donna Fedorkow
Journal: Annals of Internal Medicine (2011)

Source Citation Maalouf NM, Sato AH, Welch BJ, et al. Postmenopausal hormone use and the risk of nephrolithiasis: results from the Women’s Health Initiative hormone therapy trials. Arch Intern Med. 2010;170:1678-85. 20937929
Some aspects of the etiology of non-Hodgkin's lymphoma.
Authors: L Hardell, G Lindström, B van Bavel, M Fredrikson, G Liljegren
Journal: Environmental Health Perspectives (1998)

In epidemiologic studies, non-Hodgkin's lymphoma (NHL) has been associated with exposure to chemicals such as phenoxyacetic acids; chlorophenols; dioxins; organic solvents including benzene, polychlorinated biphenyls, chlordanes; and immunosuppressive drugs. Experimental evidence and clinical observations indicate that these chemicals may impair the immune system. The risk is increased for NHL in persons with acquired and congenital immune deficiency as well as autoimmune disorders. Also, certain viruses have been suggested to be of etiologic significance for NHL. In some cases of NHL the common mechanism for all these agents and conditions may be immunosuppression, possibly in combination with viruses.
Transient Pseudomonas Bacteremia in a Heroin Addict
Authors: Kenneth M. Borow
Journal: JAMA (1978)

INTRAVENOUS drug abuse has been associated with an increased risk of<i>Pseudomonas aeruginosa</i>endocarditis.<sup>1-3</sup>This infection has been particularly noteworthy for the frequency of right-sided (usually tricuspid valve) heart infections and a high incidence of pleuritic chest pain.<sup>3</sup>We report the case of a drug addict in whom a clinical syndrome resembling right-sided<i>Pseudomonas</i>endocarditis developed, which was eventually shown to be only a limited episode of<i>Pseudomonas</i>septicemia. <h3>Report of a Case</h3> A 21-year-old heroin addict came to the Peter Bent Brigham Hospital in April 1976, complaining of pleuritic chest pain associated with mild hemoptysis. Pulmonary scintigraphy and pulmonary angiography showed pulmonary embolism. Catheterization of the right side of the heart showed mild pulmonary hypertension. Blood cultures including those from the right atrium and right ventricle were negative. Despite intravenous heparin sodium therapy, the patient remained intermittently febrile, and she experienced another episode of pleuritic chest pain
Disappearance of Plasma Melatonin after Removal of a Neoplastic Pineal Gland
Authors: Edward A. Neuwelt, Alfred J. Lewy
Journal: New England Journal of Medicine (1983)

ALTHOUGH tumors of the pineal gland are not the most common brain tumors, their treatment is among the most controversial. The controversy relates in part to the fact that current neurodiagnostic techniques can detect very small lesions but cannot identify the type of tumor cell.1 Consequently, we2 3 4 and others5 have called into question the standard treatment for lesions of the pineal gland: radiotherapy without a tissue diagnosis.6 In Japan, where the highly radiosensitive germinoma is by far the most common pineal-gland tumor, this controversy may be less pertinent.7 However, in the United States up to 40 per cent of tumors . . .
Perianal abscess: "Have I excluded leukaemia"?
Authors: D N Slater
Journal: BMJ (1984)

Perianal abscess is a common surgical emergency.I describe two patients in whom perianal abscess was the presenting feature of acute myeloblastic leukaemia.The diagnosis of leukaemia was made initially from histological examination of the excised perianal tissue.These cases emphasise the importance of a preoperative diagnosis of leukaemia and the need to request a full blood and differential white cell count. Case reportsCase I-A 46 year old woman presented as an emergency with a small, apparently classic perianal abscess.She was otherwise healthy, and examination showed no additional abnormality apart from a tempera- ture of 37 2°C.The abscess was excised uneventfully under general anaesthesia.Histological examination of the perianal tissue showed a
FGFR4 Arg388 Allele Is Associated With Resistance to Adjuvant Therapy in Primary Breast Cancer
Authors: Christoph Thussbas, Jorg Nahrig, Sylvia Streit, Johannes Bange, Monika Kriner, Ronald Kates, Kurt Ulm, Marion Kiechle, Heinz Hoefler, Axel Ullrich, Nadia Harbeck
Journal: Journal of Clinical Oncology (2006)

A recent study presented first evidence that a single nucleotide polymorphism (SNP) at codon 388 of fibroblast growth factor receptor 4 (FGFR4) gene, causing a transmembrane domain missense mutation (Gly388Arg), is associated with disease outcome in node-positive breast cancer. This article addresses the clinical relevance of this SNP, FGFR4 genotype, phenotype, and HER2 regarding patient outcome and influence of adjuvant systemic therapy in a substantial primary breast cancer collective (n = 372; median follow-up, 94.5 months).Polymerase chain reaction restriction fragment length polymorphism analysis of germ-line polymorphism was performed in uninvolved lymph nodes; FGFR4 and HER2 expression were assessed immunohistochemically in tissue microarrays.In 51% of patients, homo- or heterozygous Arg388 allele was present. No correlation existed between FGFR4 genotype and expression or HER2 status. In node-negative patients, FGFR4 genotype was not correlated with disease outcome. In node-positive patients, however, FGFR4 Arg388 was significantly associated with poor disease-free survival (DFS; P = .02) and overall survival (OS; P = .04). Notably, this association seems to be attributable to relatively poor therapy response in Arg388 carriers, reflected in their significantly shorter DFS (P = .02) and OS (P = .045) among patients receiving adjuvant systemic therapy. It is also seen as a significant interaction term in a multivariate proportional hazards model with Arg388 carriers having only about half as much benefit from adjuvant systemic therapy as wild-type carriers.According to this study, FGFR4 Arg388 genotype is a marker for breast cancer progression in patients with adjuvant systemic therapy, particularly chemotherapy, and thus may indicate therapy resistance.
Photoallergic contact dermatitis to oxybenzone
Authors: P. COLLINS, J. FERGUSON
Journal: British Journal of Dermatology (1994)

Summary A 21-year-old woman developed an erythematous papulovesicular eruption of photo-exposed sites, following the use of an oxybenzone-containing sunscreen. Patch testing, photopatch testing, phototesting, and histology produced findings strongly suggestive of oxybenzone photoallergy. Photopatch testing with a monochromator source showed abnormal UVA responses, with evidence of immediate urticaria, and delayed-onset dermatitis. Sun-barrier use is associated with a risk of the development of contact or photocontact allergic reactions. The benzophenones are frequently used in high-protection factor sun-barrier preparations, and appear to have a particular ability to induce such responses.