tbuckley/cabot-search huggingface dataset:
Short- and Long-Term Neuroadrenergic Effects of Moderate Dietary Sodium Restriction in Essential Hypertension
Authors: Guido Grassi, Raffaella Dell’Oro, Gino Seravalle, Gerardo Foglia, Fosca Quarti Trevano, Giuseppe Mancia
Journal: Circulation (2002)

Background— In essential hypertension, marked restrictions in dietary sodium intake cause in the short-term period an increase in muscle sympathetic nerve traffic (MSNA) and a baroreflex impairment. The present study was set out to assess on a long-term basis the neuroadrenergic and reflex effects of moderate sodium restriction. Methods and Results— In 11 untreated mild to moderate essential hypertensive patients (age 42.0±2.6 years, mean±SEM), we measured beat-to-beat blood pressure (Finapres), heart rate (ECG), and MSNA (microneurography) at rest and during stepwise intravenous infusions of phenylephrine and nitroprusside. Measurements were performed at regular sodium intake, after 1 and 8 weeks of low-sodium diet (80 mmol NaCl/d), and repeated again at regular sodium intake. After 1 week, urinary sodium excretion was markedly reduced. This was accompanied by a slight blood pressure reduction, no heart rate change, and a significant increase in plasma renin activity, aldosterone, and MSNA (+23.0±4.6% P &lt;0.05). Whereas baroreflex heart-rate control was unchanged, baroreflex modulation of MSNA was reduced by 46.8±5.1% ( P &lt;0.01). At the end of the 8-week low-sodium diet, the neurohumoral and baroreflex responses were similar to the ones observed after 1 week of the dietary intervention. All changes disappeared when regular sodium diet was restored. Conclusions— Thus, a moderate dietary sodium restriction triggers a sympathetic activation and a baroreflex impairment. Maintenance of low-sodium diet for several weeks does not attenuate these adverse adrenergic and reflex effects.
Charity recommends introduction of screening programme for bowel cancer
Authors: A. Iles
Journal: BMJ (2003)

Screening for bowel cancer should be added to current cancer screening programmes, says the charity Cancer Research UK.

The charity has submitted evidence to the government to show the effectiveness of screening in the detection of bowel cancer and is urging that such a scheme be introduced. If its proposal was accepted an estimated 5000 lives a year would be saved, in addition to the 300 now saved through breast cancer screening and 1300 through cervical cancer screening, the charity said. Currently around …
Cimetidine as an Immunomodulator: Chronic Mucocutaneous Candidiasis as a Model
Authors: JOSEPH L. JORIZZO
Journal: Annals of Internal Medicine (1980)

Four adult patients with chronic mucocutaneous candidiasis were studied to establish a possible role for cimetidine as an immunomodulator. These patients had negative baseline in-vivo and in-vitro cell-mediated immune response to candida antigen as measured by intradermal skin tests, lymphocyte transformation, and leukocyte migration inhibitory factor production to candida antigen. Patients were given a 4-week course of cimetidine, 300 mg by mouth, four times daily. Subsequently four of four patients developed strong (> 15 mm) intradermal skin test reactions, and two of four patients produced leukocyte migration inhibitory factor to candida antigen. Skin tests and leukocyte migration inhibitory factor production reverted to baseline negative values when repeated 4 weeks after discontinuation of therapy. After 4 additional weeks on cimetidine, four of four patients showed strong positive skin tests and leukocyte migration inhibitory factor production to candida antigen. Lymphocyte transformation was not affected by therapy.
Effect of Renal Homotransplantation on the Metabolism of the Light Chains of Immunoglobulins
Authors: WALLACE V. EPSTEIN
Journal: Annals of Internal Medicine (1968)

The free light (L) polypeptide chains of human immunoglobulins were measured in the serum and the urine of 14 uremic patients before bilateral nephrectomy, during an anephric period, and after 16 renal homotransplantation procedures. Markedly elevated serum and urine concentrations were found in all azotemic patients, and serum levels in general rose further after bilateral nephrectomy. Stable, elevated serum L-chain concentrations declined suddenly in two instances on institution of immunosuppressive therapy before homotransplantation. After successful homotransplantation serum levels became less than 0.02 mg/ml as L-chain diuresis occurred. Immediate failure of graft function was characterized by continued elevation of serum and urine concentrations of L chains in a pattern similar to the prenephrectomy stage. In the period from 7 to 25 days posttransplantation two groups of patients could be distinguished: those with elevated serum and urine L-chain concentrations and those who returned serum and urine L-chain concentrations to normal or near-normal. The first group was found to have a significantly higher prevalence of irreversible renal homograft rejections subsequently when compared to the second group. Homograft rejection was associated with a rise in the urine L-chain concentration. Successful treatment of a rejection episode was followed by the reverse series of events, with urine L-chain concentrations slowly returning to normal. Such measurements appear to provide an additional parameter of renal function and, as such, to serve as a prognostic and diagnostic guide in the course of renal homotransplantation.
Refractory pancreatitis associated with graft-versus-host disease in Fanconi anemia
Authors: Masuji Yamamoto, Yoshimi Hiraumi, Noriko Ichimura, Fumiko Ohtsuki, Makiko Nakagawa, Yoshitoshi Ohtsuka, Yoshiaki Tsujino, Aiichiro Tanaka, Takashi Kamiya, Hiroyoshi Wada
Journal: American Journal of Hematology (1996)
Cost-effectiveness and the Management of Pharyngitis
Authors: Gary N. Fox
Journal: JAMA (1987)

<h3>To the Editor.—</h3> Cebul and Poses,<sup>1</sup>in their article on cost-effective pharyngitis management, state that Tompkins et al<sup>2</sup>proposed decision rules "with the performance of throat cultures reserved<i>for patients</i>whose probabilities of streptococcal disease Were between 5% and 20%" [italics added]. In contrast, the recommendations of Tompkins et al deal with treatment based on the rate of positive cultures for streptococcal pharyngitis<i>in the community</i>. To quote Tompkins et al, "The recommended management of patients in the general population might also be revised. One can select the most cost-effective penicillin strategy for a<i>patient population</i>whose approximate throat culture rate is known... if the rate is less than 5%,<i>no</i>intervention is appropriate" [italics added]. Therefore, application of the rules of Tompkins et al to Cebul and Poses' population (with a positivity rate of &lt;5%) would dictate that the most cost-effective strategy is<i>no</i>cultures or antibiotics.
Can a vitamin prevent hepatocellular carcinoma?
Authors: Alan P. Venook
Journal: Hepatology (1997)

A VITAMIN PREVENT HEPATOCELLULARHCC is rarely identified when still in limited stage.Also, CARCINOMA?following the rare resection for cure, patients will remain at lifelong risk of new primary HCCs developing in the ''precan-Muto Y, Moriwaki H, Ninomiya M, Adachi S, Saito A, Tacerous'' setting of cirrhosis. kasaki KT, Tanaka T, et al. Prevention of second primaryThese obstacles explain why only about 15% of patients tumors by an acyclic retinoid, polyprenoic acid, in patients with HCC will have long-term survival. 1A variety of screenwith hepatocellular carcinoma.N Engl J Med 1996; 334:1561ing protocols has been developed to detect preclinical HCC 1567.in high-risk patients, such as those with hepatitis B surface antigenemia or chronic hepatitis C; however, despite strate-ABSTRACT gies involving a-fetoprotein monitoring, ultrasound, and newer biological markers, there is no clear evidence that sur-Background.In patients with hepatocellular carciveillance and early intervention leads to an increased cure noma (hepatoma), the rate of recurrent and second prirate for HCC. 2,3The expense and difficulty in finding and mary hepatomas is high despite surgical resection and
A therapeutic role for matrix metalloproteinase inhibitors in lung diseases?
Authors: R.E. Vandenbroucke, E. Dejonckheere, C. Libert
Journal: European Respiratory Journal (2011)

Disruption of the balance between matrix metalloproteinases (MMPs) and their endogenous inhibitors is considered a key event in the development of pulmonary diseases such as chronic obstructive pulmonary disease, asthma, interstitial lung diseases and lung cancer. This imbalance often results in elevated net MMP activity, making MMP inhibition an attractive therapeutic strategy. Although promising results have been obtained, the lack of selective MMP inhibitors, together with limited knowledge regarding the exact functions of a particular MMP, hampers clinical application. This review discusses the involvement of different MMPs in lung disorders and future opportunities and limitations of therapeutic MMP inhibition.
Transcriptome and Proteome Expressions Involved in Insulin Resistance in Muscle and Activated T-Lymphocytes of Patients with Type 2 Diabetes
Authors: Frankie B. Stentz, Abbas E. Kitabchi
Journal: Genomics Proteomics & Bioinformatics (2007)

We analyzed the genes expressed (transcriptomes) and the proteins translated (pro- teomes) in muscle tissues and activated CD4(+) and CD8(+) T-lymphocytes (T-cells) of five Type 2 diabetes (T2DM) subjects using Affymetrix microarrays and mass spectrometry, and compared them with matched non-diabetic controls. Gene expressions of insulin receptor (INSR), vitamin D receptor, insulin degrading enzyme, Akt, insulin receptor substrate-1 (IRS-1), IRS-2, glucose transporter 4 (GLUT4), and enzymes of the glycolytic pathway were decreased at least 50% in T2DM than in controls. However, there was greater than two-fold gene upregulation of plasma cell glycoprotein-1, tumor necrosis factor alpha (TNFalpha, and gluconeogenic enzymes in T2DM than in controls. The gene silencing for INSR or TNFalpha resulted in the inhibition or stimulation of GLUT4, respectively. Proteome profiles corresponding to molecular weights of the above translated transcriptomes showed different patterns of changes between T2DM and controls. Meanwhile, changes in transcriptomes and proteomes between muscle and activated T-cells of T2DM were comparable. Activated T-cells, analogous to muscle cells, expressed insulin signaling and glucose metabolism genes and gene products. In conclusion, T-cells and muscle in T2DM exhibited differences in expression of certain genes and gene products relative to non-diabetic controls. These alterations in transcriptomes and proteomes in T2DM may be involved in insulin resistance.
IgA deficiency in one of identical twins.
Authors: R M Lewkonia, D Gairdner, W F Doe
Journal: BMJ (1976)

one case there were seven entrance wounds and five exit wounds, only two ballbearings, being recoved.from the body.One had lodged 'in the aniterior; abdominal wall, and the other in the body ofthe fifth lurnbar yertebra.In a second.case"a 'bilbearing had entered through the ninth rib in the mid-axillary r'line and, flying throutgh the dome of the diaphragm and the.liver,-had torn across the right ventricle to be recovered from.theleft chest.A second ballbearing ha<d entered through the right buttock, had shattered the ilium, and was recovered from the thickness of the left acetabulum (fig 3).These missiles were about 6 mm in diameter.The one in the acetabulum was extremely difficult to identify owing to the thickness of the acetabulum (about 7 mm).X-ray pictures are essential in such cases, and usually the bomb squad require every piece of metal to be recovered.Furthermore, such missiles may be carried by the blood stream from one part of the body to another (fig 4).In shooting there is generally some aim taken and some expected direction of fire, but in terrorist bomb explosions the direction of flight of objects such as ballbearings is random.IgA Deficiency in one of identical twins
Practical algorithm for diagnosing patients with recurrent wheals or angioedema
Authors: M. Maurer, M. Magerl, M. Metz, F. Siebenhaar, K. Weller, K. Krause
Journal: Allergy (2013)

Abstract Background Chronic urticaria is a common disorder characterized by recurrent wheals, angioedema, or both. Several differential diagnoses need to be considered in patients presenting with wheals and/or angioedema. These include rare diseases such as autoinflammatory syndromes and urticarial vasculitis in patients with recurrent wheals and bradykinin‐mediated angioedema in patients with recurrent swellings. Aim and Result In order to not miss these conditions, we have developed a symptom‐based diagnostic algorithm for the management of patients with wheals and/or angioedema. Discussion and Conclusion By asking the right questions and performing a limited diagnostic workup as suggested here, this algorithm may help to establish the right diagnosis and treat patients early and more effectively.
HPV Vaccine against Anal HPV Infection and Anal Intraepithelial Neoplasia
Authors: Joel M. Palefsky, Anna R. Giuliano, Stephen Goldstone, Edson D. Moreira, Carlos Aranda, Heiko Jessen, Richard Hillman, Daron Ferris, Francois Coutlee, Mark H. Stoler, J. Brooke Marshall, David Radley, Scott Vuocolo, Richard M. Haupt, Dalya Guris, Elizabeth I.O. Garner
Journal: New England Journal of Medicine (2011)

The rate of anal cancer is increasing among both women and men, particularly men who have sex with men. Caused by infection with human papillomavirus (HPV), primarily HPV type 16 or 18, anal cancer is preceded by high-grade anal intraepithelial neoplasia (grade 2 or 3). We studied the safety and efficacy of quadrivalent HPV vaccine (qHPV) against anal intraepithelial neoplasia associated with HPV-6, 11, 16, or 18 infection in men who have sex with men.In a substudy of a larger double-blind study, we randomly assigned 602 healthy men who have sex with men, 16 to 26 years of age, to receive either qHPV or placebo. The primary efficacy objective was prevention of anal intraepithelial neoplasia or anal cancer related to infection with HPV-6, 11, 16, or 18. Efficacy analyses were performed in intention-to-treat and per-protocol efficacy populations. The rates of adverse events were documented.Efficacy of the qHPV vaccine against anal intraepithelial neoplasia associated with HPV-6, 11, 16, or 18 was 50.3% (95% confidence interval [CI], 25.7 to 67.2) in the intention-to-treat population and 77.5% (95% CI, 39.6 to 93.3) in the per-protocol efficacy population; the corresponding efficacies against anal intraepithelial neoplasia associated with HPV of any type were 25.7% (95% CI, -1.1 to 45.6) and 54.9% (95% CI, 8.4 to 79.1), respectively. Rates of anal intraepithelial neoplasia per 100 person-years were 17.5 in the placebo group and 13.0 in the vaccine group in the intention-to-treat population and 8.9 in the placebo group and 4.0 in the vaccine group in the per-protocol efficacy population. The rate of grade 2 or 3 anal intraepithelial neoplasia related to infection with HPV-6, 11, 16, or 18 was reduced by 54.2% (95% CI, 18.0 to 75.3) in the intention-to-treat population and by 74.9% (95% CI, 8.8 to 95.4) in the per-protocol efficacy population. The corresponding risks of persistent anal infection with HPV-6, 11, 16, or 18 were reduced by 59.4% (95% CI, 43.0 to 71.4) and 94.9% (95% CI, 80.4 to 99.4), respectively. No vaccine-related serious adverse events were reported.Use of the qHPV vaccine reduced the rates of anal intraepithelial neoplasia, including of grade 2 or 3, among men who have sex with men. The vaccine had a favorable safety profile and may help to reduce the risk of anal cancer. (Funded by Merck and the National Institutes of Health; ClinicalTrials.gov number, NCT00090285.).
Reduced activity of the electron transport chain in liver mitochondria isolated from rats with secondary biliary cirrhosis
Authors: Stefan Krähenbühl, Jörg Stucki, Jürg Reichen
Journal: Hepatology (1992)

Mitochondrial metabolism was studied in liver mitochondria isolated from rats with secondary biliary cirrhosis induced by bile duct ligation for 5 wk. State 3 oxidation rates were decreased in mitochondrial preparations from bile duct—ligated rats as compared with sham–operated control rats by 63% and 42% using β–hydroxybutyrate and succinate as substrates, respectively. In contrast, when the substrate was ascorbate/ N , N , N ′, N ′–tetramethyl– p –phenylenediamine state 3 oxidation rates were not affected by bile duct ligation. Oxidation rates after uncoupling with dinitrophenol were decreased for both β–hydroxybutyrate and succinate as substrates in mitochondria from bile duct—ligated rats. The phosphate potential was reduced in mitochondria from bile duct—ligated rats (12.5 ± 0.5 vs. 13.6 ± 0.2 kcal in control and bile duct—ligated rats, respectively; p&lt;0.05). The inner mitochondrial membrane of liver mitochondria from rats with secondary biliary cirrhosis contained three times more cholesterol as compared with control rats, whereas the phospholipid composition was essentially unchanged. Mitochondrial protein content expressed per liver (calculated on the basis of activities of mitochondrial enzymes determined in liver homogenate and in isolated mitochondria) was increased by 50% in bile duct—ligated rats as compared with control rats. In conclusion, the function of the electron transport chain in liver mitochondria isolated from rats with secondary biliary cirrhosis is impaired. This decrease could be related to altered lipid composition of the inner mitochondrial membrane. (Hepatology 1992;15:1160–1166).
Evaluating Peer Reviews
Authors: Irene D. Feurer, Gary J. Becker, Daniel Picus, Estella Ramirez, Michael D. Darcy, Marshall E. Hicks
Journal: JAMA (1994)

To measure the reliability and preliminary validity of a grading instrument for editors to evaluate the quality of peer reviews.The consecutive sample design included 53 reviews of 23 manuscripts. Reviews were systematically assigned to interrater reliability (n = 41; power greater than 0.90 to detect a difference of greater than one point) and preliminary criterion-related validity (n = 12) subsamples. Content validity was closely examined.Nonclinical.Three graders evaluated reliability. One individual examined content validity and two editors tested preliminary criterion-related validity. INTERVENTION (INSTRUMENT)--Attributes reflecting two basic dimensions, review content and format, were identified and scored (values are possible points/percent contribution): timeliness, 3/21%; grade sheet, 1/7%; etiquette, 1/7%; sectional narratives, 3/21%; citations, 2/14%; narrative summary, 2/14%; and insights, 2/14%. A scoring guide was provided.Statistical analyses used to test the interrater reliability of the total score included the intraclass correlation coefficient and analysis of variance with the expectation to uphold the null hypothesis. Kendall's coefficient of concordance was used to test preliminary criterion-related validity.The intraclass correlation coefficient was .84 (P < .001) and a lack of difference between mean scores was demonstrated by analysis of variance (P = .46). Content validity was confirmed and preliminary criterion-related validity was indicated (Kendall's coefficient of concordance = .94, P = .038).The instrument is reliable. Content validation has been completed, and further criterion-related validation is warranted.
Apoprotein composition of very low density lipoproteins of human serum.
Authors: J P Kane, T Sata, R L Hamilton, R J Havel
Journal: Journal of Clinical Investigation (1975)

Methods for quantitation of the major apoproteins of human serum very low density lipoprotein have been developed employing tetramethylurea, which delipidates the lipoprotein and selectively precipitates apolipoprotein B. Six soluble apoproteins are separated by electrophoresis in polyacrylamide gel. One of these is a previously unrecognized species of R-alanine (R4-alanine), more anionic than the R3-alanine polypeptide. Conditions of staining have been found which yield reproducibly linear chromogenic response with native lipoprotein and with each purified apoprotein. Recovery of protein in the seven species measured accounts for over 97% of the total in the very low density lipoprotein of normolipidemic individuals and in most samples from individuals with endogenous hyperlipemia. The mean content of apolipoprotein B in 43 samples from normolipidemic subjects was 36.9(+/-1.2 SEM)% of total protein, The distribution of the major soluble apoproteins as mean (+/-SEM) percentage of the soluble fraction was : R-serine, 5.3+/-o.5; arginine-rich, 20.6+/-1.0; R-glutamic, 10.6+/-0.4; R2-alanine, 28.3+/-0.7; R3-alanine, 26.9+/-0.5; and R4-alanine, 8.0+/-0.5. Distribution of the apoproteins was a function of particle diameter of very low density lipoprotein in fractions separated by gel permeation chromatography and by density gradient ultracentrifugation. In fractions below 700-800 A, apolipoprotein B comprised an increasing percentage of the total protein with decreasing particle diameter. Among the soluble proteins the percentage of the arginine-rich and R-serine polypeptides increased and that of the R-glutamic polypeptide declined progressively with decreasing particle size. Apoprotein distribution was similar in fractions of similar particle size from normolipidemic and hyperlipemic subjects with the exception that all fractions from the hyperlipemic subjects contained more R-serine and some, more arginine rich polypeptide. Even in the absence of chylomicrons, the distribution of soluble apoproteins in particles of diameters greater than 700-800 A was usually similar to that of the smallest particles. This suggests that the largest particles may include products of the partial catabolism of chylomicrons.
A new scramble for Africa: how rich world donors are damaging healthcare
Authors: John Wright
Journal: BMJ (2012)

“What we need is a national health service,” the doctor said, bemoaning the fragmentation of healthcare in his rural African district hospital. I had left the United Kingdom for southern Africa with the debate still raging on the now passed Health and Social Care Bill, and I wondered if he could have ours: “One NHS, excellent condition, unwanted gift to nation.”

I worked there as a medical officer 20 years earlier, and the hospital showed little signs of change. Gloomy wards filled with the pungent smell of disinfectant and disease. This rural mission hospital was built for a very different age, baked for half a century under the African sun.

Although the buildings remained the same, over the past two decades the health landscape had changed completely. A plague of HIV and tuberculosis had settled on the country and showed little sign of leaving. There were more people living with HIV in the mountains surrounding the hospital than the whole of the UK.

During the 1990s it had taken a while for the rest of the world to wake …
CHRONIC PHLEBITIS OF THE SAPHENOUS VEINS; SAPHENECTOMY.
Authors: E. VIKO
Journal: JAMA (1898)

The pathologic condition of chronic phlebitis is a sclerosis of the veins, similar to atheromatous changes in the arteries; the veins become cord-like All the coats of the veins may be thickened and indurated, or the external coat only may be affected. In chronic phlebitis of the saphenous veins of the leg, the tissues around the veins are also swollen, often several times their natural size. Varices of the adjacent branches sometimes occur. In cases of long standing, eczema and ulcerated patches affect the skin, which becomes hard, thick and glazed. Severe pain, especially on standing or walking, is complained of. Medicinal treatment of chronic phlebitis of the saphenous veins is very unsatisfactory. Drugs may ameliorate the eczema, pain and swelling to a certain extent, but this is only temporary. Surgery promises better results. Lea recommends tying of the veins. The most rational method seems