tbuckley/cabot-search huggingface dataset:
Aspirin, ibuprofen, and mortality after myocardial infarction: retrospective cohort study
Authors: Jeptha P Curtis, Yongfei Wang, Edward L Portnay, Frederick A Masoudi, Edward P Havranek, Harlan M Krumholz
Journal: BMJ (2003)

<h3>Introduction</h3> The optimal trial design for assessing novel therapies in paediatric IBD (PIBD) is a subject of intense ongoing global discussions and debate among the different stakeholders. However, there is a consensus that the current situation in which most medications used in children with IBD are prescribed as off-label without sufficient paediatric data is unacceptable. Shortening the time lag between adult and paediatric approval of drugs is of the upmost importance. In this position paper we aimed to provide guidance from the global clinical research network (Pediatric Inflammatory Bowel Disease Network, PIBDnet) for designing clinical trials in PIBD in order to facilitate drug approval for children. <h3>Methods</h3> A writing group has been established by PIBDnet and topics were assigned to different members. After an iterative process of revisions among the writing group and one face-to-face meeting, all statements have reached consensus of &gt;80% as defined a priori. Next, all core members of PIBDnet voted on the statements, reaching consensus of &gt;80% on all statements. Comments from the members were incorporated in the text. <h3>Results</h3> The commentary includes 18 statements for guiding data extrapolation from adults, eligibility criteria to PIBD trials, use of placebo, dosing, endpoints and recommendations for feasible trials. Controversial issues have been highlighted in the text. <h3>Conclusion</h3> The viewpoints expressed in this paper could assist planning clinical trials in PIBD which are both of high quality and ethical, while remaining pragmatic.
Intestinal strongyloidiasis as a presenting symptom of HTLV-1–associated adult T-cell leukemia/lymphoma
Authors: M. Grijsen, G. van den Berk, E. Hoekstra, W. Terpstra, S. Veldman, J. Jansen
Journal: Endoscopy (2009)

A 57-year-old man with diabetes presented with dysphagia, severe weight loss, and frequent watery stools. He had emigrated to the Netherlands from Suriname 23 years ago. Apart from a cachectic appearance, the physical examination revealed no abnormalities. Laboratory investigations showed leukocytosis but no eosinophilia, slightly raised lactate dehydrogenase, and mild hypercalcemia. Gastroduodenoscopy revealed pangastritis and duodenitis ([Fig. 1]). Ileocolonoscopy showed a mild, discontinuous colitis, more severe in the proximal colon, and a terminal ileitis ([Fig. 2]). Computed tomography (CT) scanning of the neck, chest, and abdomen showed no lymphadenopathy or splenomegaly. Magnetic resonance imaging (MRI) of the small bowel revealed thickening of the duodenal wall and folds ([Fig. 3]). Stool examinations as well as duodenal biopsy samples were positive for Strongyloides stercoralis ([Fig. 4]), and treatment with oral ivermectin was initiated. Meanwhile, the hypercalcemia worsened, which was suggestive of human T-cell lymphotropic virus type 1 (HTLV-1)-associated adult T-cell leukemia/lymphoma (ATLL). Serological testing for HTLV-1 was positive, and a peripheral blood smear showed the characteristic "flower cells" of ATLL ([Fig. 5]). Bone marrow biopsy and subsequent immunophenotyping were compatible with this diagnosis. The patient was treated with chemotherapy and ritonavir, but died shortly afterwards as a result of Streptococcus milleri sepsis and multiple organ failure.
An Inhibitory Innervation at the Gastroduodenal Junction
Authors: Sinn Anuras, Allan R. Cooke, James Christensen
Journal: Journal of Clinical Investigation (1974)

Transverse muscle strips, 2-mm wide, were cut serially from the gastroduodenal junction in opossums, cats, dogs, and man. Electrical field stimulation with trains of rectangular current pulses of 0.5 ms in all opossums, all cats, some dogs, and the one human specimen induced relaxation in strips from the thickened circular muscle proximal to the mucosal junction. In some opossums weak relaxations also occurred in the first few strips below the mucosal junction. All other strips contracted or showed no response. This relaxation in opossums was abolished by tetrodotoxin but was not affected by antagonists to adrenergic and cholinergic transmission, nor by tripelennamine, methysergide, pentagastrin, secretin, cerulein, or cholecystokinin. Optimal frequency for stimulus-relaxation was 12 Hz. Chronaxie was 0.85 ms. The junctional strips also showed greater resistances to stretch than those remote from the junction. With apparent species variations, the junctional muscle possesses a nonadrenergic inhibitory innervation which is either absent or unexpressed in adjacent muscle of stomach and duodenum. This suggests the existence of a distinctive inhibitory neural control mechanism for pyloric muscle.
Is cold biopsy forceps resection of diminutive polyps really so inadequate?
Authors: F. Froehlich
Journal: Endoscopy (2011)

I read with great interest the elegant albeit small study by Efthymiou et al. [1], suggesting that cold biopsy forceps resection of diminutive polyps was complete in only 39 %. It remains difficult to understand why neither polyp size (< 3 mm vs. > 3 mm) nor the number of bites (< 2 vs. > 2) influenced the completeness of resection. One would expect that polyps of < 3 mm would be resected easily by forceps of 7 mm if the endoscopist targets the resection correctly.
THE ADMINISTRATION OF ANESTHETICS.
Authors: DAVID H. GALLOWAY
Journal: JAMA (1898)

A man who desires to study medicine can find many places in Chicago where they will undertake to teach him, but I do not know of any place where they will teach him to administer anesthetics. There are many places where he may learn but no place where any provision is made for properly teaching the subject. The student is not left to his own resources in the treatment of cases which come to the dispensary, but such treatment is always under the supervision of a teacher. The administration of anesthetics, however, is one thing which he is called upon to do practically without any instruction. This is one of the most difficult tasks to satisfactorily accomplish, one where skill, experience and personal judgment are required in the very highest degree and where rules are so obscured by exceptions as to be nearly useless. Yet such is the inertia of
Exogenously Provided Peptides of a Self-antigen Can Be Processed into Forms that Are Recognized by Self–T Cells
Authors: Avlin K. Barlow, Xin He, Charles Janeway
Journal: The Journal of Experimental Medicine (1998)

Major histocompatibility complex (MHC) class II molecules can present peptides derived from two different sources. The predominant source of peptide in uninfected antigen presenting cells (APCs) is from self-proteins that are synthesized within the cell and traffic through the MHC class II compartment. The other source of antigen is endocytosed proteins, which includes both self- and foreign proteins. Foreign protein antigens generate adaptive immune responses, whereas self-peptides stabilize the MHC class II heterodimer on the cell surface, allowing positive and negative selection of thymocytes. Therefore, self-antigens play an important normal role in shaping the T cell receptor repertoire as well as a pathological role in autoimmunity. To determine whether processing and presentation of self-antigens by MHC class II molecules differs depending on whether the antigen is supplied through synthesis within the cell or by endocytosis, we used a T cell clone against an Eα peptide presented by I-Ab to show that processing through these two routes can differ. We also show that mice can be tolerant to the epitope formed through the endogenous route, but responsive to the epitope that can be formed through endocytosis. This suggests that negative selection occurs primarily against antigens that are synthesized within the APC, and that endocytosed self-antigens could serve as autoantigens. Finally, we also demonstrate that lipopolysaccharide-activated B cells are defective for uptake, processing, and presentation of this self-antigen, and that this correlates with the increased expression of the costimulatory molecules B7.1 and B7.2. This may provide a model for studying the onset of an autoimmune response.
Hepatic Stem-like Phenotype and Interplay of Wnt/β-Catenin and Myc Signaling in Aggressive Childhood Liver Cancer
Authors: Stefano Cairo, Carolina Armengol, Aurélien De Reyniès, Yu Wei, Emilie Thomas, Claire-Angélique Renard, Andrei Goga, Asha Balakrishnan, Michaela Semeraro, Lionel Gresh, Marco Pontoglio, Hélène Strick-Marchand, Florence Levillayer, Yann Nouet, David Rickman, Frédéric Gauthier, Sophie Branchereau, Laurence Brugières, Véronique Laithier, Raymonde Bouvier, Françoise Boman, Giuseppe Basso, Jean-François Michiels, Paul Hofman, Francine Arbez-Gindre, Hélène Jouan, Marie-Christine Rousselet-Chapeau, Dominique Berrebi, Luc Marcellin, François Plenat, Dominique Zachar, Madeleine Joubert, Janick Selves, Dominique Pasquier, Paulette Bioulac-Sage, Michael Grotzer, Margaret Childs, Monique Fabre, Marie-Annick Buendia
Journal: Cancer Cell (2008)
Termination of sustained ventricular tachycardia by ultrarapid subthreshold stimulation in humans.
Authors: M Shenasa, R Cardinal, T Kus, P Savard, M Fromer, P Pagé
Journal: Circulation (1988)

Our purpose was to investigate the efficacy, safety, and electrophysiological mechanism of ultrarapid subthreshold electrical stimulation in terminating sustained ventricular tachycardia (VT) in humans. Fifteen patients with inducible sustained hemodynamically stable VT and whose VT cycle length ranged between 295 and 440 msec (337 +/- 60 msec) were included in this study. The stimulation threshold and ventricular myocardial effective refractory period were determined during VT, and the values ranged between 0.4 and 1.2 mA (mean, 0.7 +/- 0.3 mA) and between 185 and 245 msec (mean, 225 +/- 20 msec), respectively. Trains of ultrarapid subthreshold stimulation were delivered with cycle lengths of 100 to 10 msec in decremental steps of 10 msec. A 5-second pause was allowed between each step (decrement). A 2-msec pulse width was used in all patients, and a 4-msec pulse width was also tested in eight patients. Any apparent captured beat was disregarded. In eight (53%) patients, ultrarapid subthreshold stimulation terminated VT, and in the remaining seven (47%) patients, it did not. The lowest subthreshold stimulation that effectively terminated VT was 0.05 mA. In 10 patients, the site of early activity during VT was determined by endocardial catheter mapping, and subthreshold stimulation more effectively terminated VT in eight patients when it was applied close to the site of early activity. In seven patients who underwent mapping-guided arrhythmia surgery, subthreshold stimulation was applied close to the site of early activity and successfully terminated VT. In no patient did subthreshold stimulation produce acceleration of VT or induce ventricular fibrillation.(ABSTRACT TRUNCATED AT 250 WORDS)
Critical Role of Donor Tissue Expression of Programmed Death Ligand-1 in Regulating Cardiac Allograft Rejection and Vasculopathy
Authors: Jun Yang, Joyce Popoola, Shakila Khandwala, Nidyanandh Vadivel, Vijay Vanguri, Xueli Yuan, Shirine Dada, Indira Guleria, Chaorui Tian, M. Javeed Ansari, Tahiro Shin, Hideo Yagita, Miyuki Azuma, Mohamed H. Sayegh, Anil Chandraker
Journal: Circulation (2008)

Background— Allograft vasculopathy is a major limiting factor in the long-term success of cardiac transplantation. T cells play a critical role in initiation of cardiac allograft rejection and allograft vasculopathy. The negative T-cell costimulatory pathway PD-1:PDL1/PDL2 (programmed death-1:programmed death ligand-1/2) plays an important role in regulating alloimmune responses. We investigated the role of recipient versus donor PD-1 ligands in the pathogenesis of allograft rejection with emphasis on the role of tissue expression in regulating this alloimmune response in vivo. Methods and Results— We used established major histocompatibility complex class II– and class I–mismatched models of vascularized cardiac allograft rejection, blocking anti-PDL1 and anti-PDL2 antibodies, and PDL1- and PDL2-deficient mice (as donors or recipients) to study the role of the PD-1:PDL1/PDL2 pathway in chronic rejection. We also used PDL1-deficient and wild-type mice and bone marrow transplantation to generate chimeric animals that express PDL1 exclusively on either hematopoietic or parenchymal cells. PDL1 but not PDL2 blockade significantly accelerated cardiac allograft rejection in the bm12-into-B6 and B6-into-bm12 models. Although wild-type cardiac allografts survived long term, PDL1 −/− donor hearts transplanted into wild-type bm12 mice exhibited accelerated rejection and vasculopathy associated with enhanced recipient T-cell alloreactivity. Interestingly, PDL1 −/− recipients did not exhibit an accelerated tempo of cardiac allograft rejection. Using chimeric animals as donors, we show that PDL1 expression on cardiac tissue alone significantly prolonged graft survival compared with full PDL1 −/− donor grafts in transplanted wild-type recipients. Conclusions— This is the first report to demonstrate that expression of the negative costimulatory molecule PDL1 on donor cardiac tissue regulates recipient alloimmune responses, allograft rejection, and vasculopathy.
Applicability of BARD score to Japanese patients with NAFLD
Authors: H Fujii, M Enomoto, W Fukushima, A Tamori, H Sakaguchi, N Kawada
Journal: Gut (2009)

We read the article by Harrison et al 1 with great interest. The authors proposed an easily calculated composite score for predicting the risk of advanced fibrosis in patients with non-alcoholic fatty liver disease (NAFLD), called the BARD score: the weighted sum of the three variables (body mass index (BMI) ⩾28 = 1 point, aspartate aminotransferase/alanine aminotransferase ratio (AAR) ⩾0.8 = 2 points, diabetes = 1 point). When a BARD score of 2–4 was used, the area under the receiver operating characteristic curve (AUROC) was found to be 0.81 with an odds ratio (OR) of 17 (95% CI 9.2 to 31.9) for detecting advanced fibrosis. The positive predictive value (PPV) and negative predictive value (NPV) were 43% and 96%, respectively. We studied the reliability of the BARD score for identifying …
Gene transfer into hepatoma cells mediated by galactose-modified α-helical peptides
Authors: Takuro Niidome, Mamiko Urakawa, Haruya Sato, Yoshiyuki Takahara, Toyoaki Anai, Tomomitsu Hatakayama, Akihiro Wada, Toshiya Hirayama, Haruhiko Aoyagi
Journal: Biomaterials (2000)
18F-FDG PET/CT and MRI of Necrobiotic Xanthogranuloma
Authors: Ba Duong Nguyen
Journal: Clinical Nuclear Medicine (2013)

Necrobiotic xanthogranuloma is a non-Langerhans histiocytic disorder characterized by chronic and progressively enlarging cutaneous plaques and nodules predominantly at the head and facial regions. These lesions exhibit increased F-FDG uptake because of their inflammatory and granulomatous nature. The author presents the F-FDG PET/CT and MRI features of such an uncommon disease in a patient with associated monoclonal gammopathy.
Child health clincs and inverse care laws: evidence from longitudinal study of 1878 pre-school children.
Authors: P M Zinkin, C A Cox
Journal: BMJ (1976)

In a longitudinal study it was intended that 1878 children should receive periodic developmental examinations from the age of 6 weeks to 3 years. The children were divided into those with a high or low risk of developmental problems. Although clinic attendance rate of 85-89% were achieved in the catchment area 100% coverage was difficult because of population mobility and non-attendance at clinics. Children in families who moved away from the area were more difficult to trace and thus more likely to miss developmental examinations. This was a greater problem in the high-risk group. Altogether 683 home developmental examinations were carried out on 269 children who did not attend clinics. Thirty-five per cent of these children were in the high-risk group compared with 22% in the study population, and significantly more had developmental problems. Thus one possible way of reaching and helping such children is though home developmental examinations.
Quantitative Hepatic Scintiangiography
Authors: RICHARD O. BOYD, ROBERT C. STADALNIK, CHARLES A. BARNETT, HORACE H. HINES
Journal: Clinical Nuclear Medicine (1978)

A new method has been developed which quantitatively assesses the relative arterial and portal venous blood flow in both normal and diseased liver tissue. Using a standard dedicated computer and routine clinical programs, the hepatic blood flow time/activity curve was analyzed. Specific indices were calculated: alpha1 represents aortic blood flow; alpha2, portal blood flow; alpha1/alpha2, the ratio of arterial to portal blood flow; and delta T, the difference in time between the peak of the arterial curve and the junction of the arterial and portal phases of the hepatic curve. Student's t-tests showed that these indices may be used to differentiate between the normal population and patients who have metastases or moderate to severe hepatocellular disease. Patients with early hepatocellular disease could not be differentiated from the normal population, but they could be separated from patients with more advanced hepatocellular disease. Patients with severe hepatocellular disease could not be separated from those with metastases. The most important uses of this technique may be in following a patient and determining when hepatocellular disease has become irreversible, and in following the course of treatment of a patient with metastatic disease to the liver.
Role of Echocardiography in Diagnostic and Hemodynamic Assessment of Hypertrophic Subaortic Stenosis
Authors: PRAVIN M. SHAH, RAYMOND GRAMIAK, ALLAN G. ADELMAN, E. DOUGLAS WIGLE
Journal: Circulation (1971)

An abnormal sharp anterior motion of the anterior mitral leaflet has been previously described as a diagnostic abnormality in hypertrophic subacute stenosis (HSS). The present prospective study explored the diagnostic sensitivity and specificity of this finding in 26 patients studied without knowledge of clinical diagnosis. When the abnormality observed was complete and persistent, a correct diagnosis of HSS was made in every case. In the absence of systolic abnormality at rest and on provocation, the diagnosis of HSS could be excluded. When the abnormality was small and inconstant (nine patients) two thirds of the patients were shown to have a latent or labile form of outflow obstruction whereas the remaining third had no evidence of HSS. In an extended part of the study on 31 patients with known HSS, comparisons of resting pressure gradients across left ventricular outflow tract were made with the echocardiographic findings at rest. Those with persistently abnormal mitral valve movement had an average pressure gradient of 78 mm Hg, those with inconstant abnormality had an average gradient of 24 mm Hg, and those with no resting abnormality had no gradients at rest.
Coronary Angioplasty Procedure Volume and Major Complications
Authors: Gregg J. Reis
Journal: JAMA (1996)

To the Editor.  —In the article by Dr Kimmel and colleagues 1 purporting to show a relationship between institutional angioplasty procedure volume and major complications, a major potential limitation of the study has not been adequately addressed. The authors excluded 2577 procedures that involved devices other than balloon angioplasty, namely, atherectomy, coronary artery stents, and laser procedures. If these procedures were pooled with the 27 110 balloon angioplasties included in the study, they would represent 8.7% of the total procedure volume.  Coronary stenting has been shown to reduce the need for emergency bypass surgery in the setting of acute or threatened arterial closure occurring during coronary angioplasty. 2 In particular, the Gianturco-Roubin stent was specifically approved by the Food and Drug Administration in June 1993 for treatment of acute or threatened arterial closure. The dispersion of this technology was delayed for several months because of the need for operators to
Non-specificity of Laboratory Test for Diagnosis of Multiple Sclerosis
Authors: J. Mertin, D. Hughes, E. A. Caspary, A. M. Thomson, J. B. Foster, E. G. Stewart-Wynne
Journal: BMJ (1974)

It has been claimed that the inhibiting effect of linoleic acid on the macrophage electrophoretic mobility test provides a specific laboratory method for the diagnosis of multiple sclerosis (M.S.) and may also enable susceptible relatives of M.S. patients to be identified. Three trials of the method under double-blind conditions have failed to confirm that the test is diagnostically useful.
Scurvy and Altered Iron Stores in Thalassemia Major
Authors: Alan Cohen, Ian J. Cohen, Elias Schwartz
Journal: New England Journal of Medicine (1981)

SCURVY is a rare disorder in the United States because of the wide availability of fresh fruits and vegetables and the frequent supplementation of common packaged foods with vitamin C. Although vitamin C levels in leukocytes are reduced in many patients with iron overload due to repeated blood transfusions,1 clinical scurvy has not been reported in this group. We have studied a patient with homozygous β-thalassemia and iron overload, who had two episodes of scurvy despite a normal intake of vitamin C. Investigation of iron stores before treatment and during recovery showed that the normal release of iron from tissue . . .
Balancing the risks and benefits of drinking water disinfection: disability adjusted life-years on the scale.
Authors: A H Havelaar, A E De Hollander, P F Teunis, E G Evers, H J Van Kranen, J F Versteegh, J E Van Koten, W Slob
Journal: Environmental Health Perspectives (2000)

To evaluate the applicability of disability adjusted life-years (DALYs) as a measure to compare positive and negative health effects of drinking water disinfection, we conducted a case study involving a hypothetical drinking water supply from surface water. This drinking water supply is typical in The Netherlands. We compared the reduction of the risk of infection with Cryptosporidium parvum by ozonation of water to the concomitant increase in risk of renal cell cancer arising from the production of bromate. We applied clinical, epidemiologic, and toxicologic data on morbidity and mortality to calculate the net health benefit in DALYs. We estimated the median risk of infection with C. parvum as 10(-3)/person-year. Ozonation reduces the median risk in the baseline approximately 7-fold, but bromate is produced in a concentration above current guideline levels. However, the health benefits of preventing gastroenteritis in the general population and premature death in patients with acquired immunodeficiency syndrome outweigh health losses by premature death from renal cell cancer by a factor of > 10. The net benefit is approximately 1 DALY/million person-years. The application of DALYs in principle allows us to more explicitly compare the public health risks and benefits of different management options. In practice, the application of DALYs may be hampered by the substantial degree of uncertainty, as is typical for risk assessment.
Eclampsia During the 16th Gestational Week
Authors: Marshall D. Lindheimer
Journal: JAMA (1974)

Eclampsia occurred in a previously normotensive nullipara, without evidence of hydatiform disease or Rh isoimmunization, during her 16th gestational week. Unawareness that this entity may occur so early in pregnancy led to diagnostic delay, and convulsions continued. Institution of specific therapy resulted in cessation of convulsions and blood pressure decreased immediately after pregnancy interruption. (<i>JAMA</i>230:1006-1008, 1974)