tbuckley/cabot-search huggingface dataset:
Prognostic value of bronchoalveolar lavage in sarcoidosis: the critical influence of disease presentation.
Authors: K Ward, C O'Connor, C Odlum, M X Fitzgerald
Journal: Thorax (1989)

There has been considerable disagreement about the prognostic value of bronchoalveolar lavage lymphocyte measurements in patients with sarcoidosis. This study looks at the influence of the type of disease presentation and the time since onset of symptoms on lavage fluid lymphocyte profiles in 99 patients studied at the time of their initial diagnosis. Patients who had an acute inflammatory onset of disease with erythema nodosum (n = 32) or acute uveitis (n = 17) almost invariably had high T lymphocyte helper:suppressor (TH:TS) ratios (mean 10.1, 95% confidence interval 7.7-12.5) and had a higher proportion of T lymphocytes in cells obtained at lavage (40%, 35-46%) than patients with a pulmonary presentation (n = 38) (TH:TS 2.9, 0.2-5.7; T lymphocytes 21%, 15-27%) or those studied after resolution of erythema nodosum (n = 12). The patients with recent erythema nodosum had the highest TH:TS ratios of any group (10.4, 8.1-12.7). Thus lavage T lymphocyte percentage and TH:TS are highest in patients with sarcoidosis studied soon after an acute onset with an inflammatory condition such as erythema nodosum or uveitis. Patients with an acute onset of sarcoidosis have a better prognosis than those with a more insidious presentation. The major influence of type of disease presentation and, in the case of patients with erythema nodosum, of time since onset of symptoms may in part explain why different centres have reported such diverse results regarding the value of bronchoalveolar lavage in predicting outcome in sarcoidosis. Studies where the case mix of patients includes a high proportion of patients with acute onset will not find a high TH:TS ratio or increased numbers or proportions of lavage lymphocytes to be indicators of a poor prognosis.
Nitric Oxide Synthase Is the Mediator of Late Preconditioning Against Myocardial Infarction in Conscious Rabbits
Authors: Hitoshi Takano, Srinivas Manchikalapudi, Xian-Liang Tang, Yumin Qiu, Ali Rizvi, Asad K. Jadoon, Qin Zhang, Roberto Bolli
Journal: Circulation (1998)

Background —Despite intense investigation, the effector of the infarct-limiting protection observed during the late phase of ischemic preconditioning (PC) remains unknown. The goal of this study was to test the hypothesis that late PC against myocardial infarction is mediated by the activity of nitric oxide synthase (NOS). Methods and Results —Conscious rabbits underwent a 30-minute coronary occlusion followed by 3 days of reperfusion. In group I (control group, n=10), infarct size (tetrazolium staining) averaged 56.8±5.3% of the risk region, which was decreased to 27.6±2.5% ( P &lt;0.05) in rabbits preconditioned 24 hours earlier with a sequence of six 4-minute occlusion/4-minute reperfusion cycles (group II, n=10). When preconditioned rabbits were given the nonselective NOS inhibitor N ω -nitro- l -arginine (L-NA, 13 mg/kg IV [group III, n=8]) or the selective iNOS inhibitor aminoguanidine (AG, 150 mg/kg SC [group V, n=7]) before the 30-minute occlusion, the protective effect of late PC was completely abrogated; that is, infarct size (59.9±4.5% and 65.8±3.3%, respectively) was similar to that measured in the control group. Measurements of systolic wall thickening (sonomicrometry) demonstrated that L-NA and AG also abolished the improved recovery of myocardial function effected by late PC in group II. When rabbits were given L-NA or AG without prior PC (group IV [n=8] and group VI [n=6], respectively), infarct size did not differ from that observed in controls (53.8±4.3% and 59.8±4.3%, respectively), demonstrating that L-NA and AG do not increase the extent of cell death in nonpreconditioned myocardium. Conclusions —Taken together, these results indicate that in the conscious rabbit, the infarct-sparing effect of the late phase of ischemic PC is mediated by the activity of NOS and suggest that the specific isoform primarily responsible for this cardioprotective phenomenon is iNOS. Thus, NO appears to be a pivotal component of the pathophysiological cascade of late PC.
Effect of Luteinizing Hormone–Releasing Hormone Agonist on Ovarian Function After Modern Adjuvant Breast Cancer Chemotherapy: The GBG 37 ZORO Study
Authors: Bernd Gerber, Gunter von Minckwitz, Heinrich Stehle, Toralf Reimer, Ricardo Felberbaum, Nikolai Maass, Dorothea Fischer, Harald L. Sommer, Bettina Conrad, Olaf Ortmann, Tanja Fehm, Mahdi Rezai, Keyur Mehta, Sibylle Loibl
Journal: Journal of Clinical Oncology (2011)

Purpose Observational studies suggested that luteinizing hormone–releasing hormone agonists (LHRHa) might prevent premature ovarian failure resulting from adjuvant chemotherapy in premenopausal patients. We aimed to test the efficacy of ovarian function preservation with the LHRHa goserelin in patients with breast cancer. Patients and Methods In a prospective, randomized, open-label, controlled multicenter study, 60 patients younger than age 46 years with hormone-insensitive breast cancer were allocated to receive anthracycline/cyclophosphamide (with or without taxane) –based neoadjuvant chemotherapy with or without goserelin. The first goserelin injection was administered at least 2 weeks before the first chemotherapy cycle, continuing at 3.6 mg subcutaneously every 4 weeks until the end of the last cycle. The primary objective was the reappearance of normal ovarian function, defined as two consecutive menstrual periods within 21 to 35 days at 6 months after end of chemotherapy. Results Fifty-three patients (88.3%) experienced temporary amenorrhea (93.3% with v 83.3% without goserelin). No significant difference was observed regarding the reappearance of menstruation at 6 months after chemotherapy (70.0% with v 56.7% without goserelin; difference of 13.3%; 95% CI, −10.85 to 37.45; P = .284). All but one evaluable patient reported regular menses at 2 years after chemotherapy. Time to restoration of menstruation was 6.8 months (95% CI, 5.2 to 8.4) with goserelin and 6.1 months (95% CI, 5.3 to 6.8) without goserelin (P = .304). Chemotherapy resulted in a decreased ovarian reserve measured by inhibin B and anti-Müllerian hormone during follow-up, supporting the other findings. Conclusion Premenopausal patients with breast cancer receiving goserelin simultaneously with modern neoadjuvant chemotherapy did not experience statistically significantly less amenorrhea 6 months after end of chemotherapy compared with those receiving chemotherapy alone.
Progression-Free and Overall Survival in ALK-Positive NSCLC Patients Treated with Sequential Crizotinib and Ceritinib
Authors: Justin F. Gainor, Daniel S.W. Tan, Tomasso De Pas, Benjamin J. Solomon, Aziah Ahmad, Chiara Lazzari, Filippo de Marinis, Gianluca Spitaleri, Katherine Schultz, Luc Friboulet, Beow Y. Yeap, Jeffrey A. Engelman, Alice T. Shaw
Journal: Clinical Cancer Research (2015)

Anaplastic lymphoma kinase (ALK) rearrangements are important therapeutic targets in non-small cell lung cancer (NSCLC) that confer sensitivity to the ALK inhibitors crizotinib and ceritinib. To determine the outcome of sequential treatment with crizotinb and ceritinib, we retrospectively evaluated a cohort of ALK-positive patients treated with both agents.
Simultaneous Occurrence of Acute Myeloblastic Leukaemia and Multiple Myeloma without Previous Chemotherapy
Authors: T. Tursz, G. Flandrin, J.-C. Brouet, J. Briere, M. Seligmann
Journal: BMJ (1974)

The simultaneous detection of multiple myeloma and acute myeloblastic leukaemia is reported in two patients who had not undergone chemotherapy. Histological examinations confirmed the infiltration by both myeloblasts and plasma cells. Only the latter contained monoclonal immunoglobulin chains at immunofluorescent studies. The possible relation between the two distinct proliferative processes is briefly discussed.
OC-014 High definition colonoscopes cause more pain and require more sedation than the standard video endoscope: Abstract OC-014 Table 1
Authors: Y C Lim, G D Corbett, E Cameron, M Parkes
Journal: Gut (2012)

<h3>Introduction</h3> It has been anecdotally observed in this centre, a tertiary teaching hospital, that high definition colonoscopes (HDC) seem to be more difficult to manoeuvre and cause more pain to the patient. Although studies have been reported that HDC may have a higher polyp detection rate compared to standard video colonoscopy<sup>1</sup> (SVC) there is very little data on the tolerability and comfort of HDC. To our knowledge this is the first study to assess the tolerability of HDC against SVC. The colonoscopy score used in this centre is a five point score which is documented by the assisting nurse and used to assess patient experience. No pain 1 or 2 Episodes of mild discomfort 2 or More episodes of discomfort Significant discomfort Extreme discomfort. <h3>Methods</h3> All colonoscopies between 1 April 2010 and 31 March 2011 were identified from the endoscopy database and the reports were retrieved and reviewed for quality indicators (sedation dosing, caecal intubation and polyp detection). Separate pain score records documented by the endoscopy nurses were also retrieved. When analysing the pain score, it was divided into two groups (1 and 2 vs 3, 4 and 5) as a score of 3 and above describes markedly worse pain for the patient. These results were analysed for significance using appropriate statistical tests (Fishers and Mann–Whitney U). <h3>Results</h3> A total of 4401 colonoscopies were performed by 33 endoscopists during the study period. 611 of these were excluded due to incomplete data. Of the remaining 3790 procedures, 902 procedures were performed with HDC and 2888 with SVC. There were no demographic differences between the two groups. 5% more patients had a pain score of 3 or more when using the HDC (p=0.01). Their use was also associated with a marginal but significant increase in the dose of midazolam and fentanyl (p&lt;0.001 and p=0.04 respectively). Polyp detection was significantly lower in the HDC group (p=0.01). The results are shown in Abstract OC-014 table 1. <h3>Conclusion</h3> This is the first study evaluating tolerability of HDC. In this large cohort of patients performed by a large number of endoscopists, tolerability and polyp detection were worse with HDC. <h3>Competing interests</h3> None declared. <h3>Reference</h3> 1. <b>Subramanian V</b>, Mannath J, Hawkey CJ, <i>et al.</i> High definition colonoscopy vs standard video endoscopy for the detection of colonic polyps: a meta-analysis. <i>Endoscopy</i> 2011;<b>43</b>:499–505.
Use of Coronary Angiography Wires As Guide Wires to Avoid Iatrogenic Perforation During Stenting of Oesophageal Cancers
Authors: P. Modi, J. Rahamim
Journal: Endoscopy (2006)

Oesophageal perforation remains a devastating event that is difficult to diagnose and manage, especially in the presence of malignancy. In 59 % to 81 % of all cases the injury is iatrogenic, and the increasing use of endoscopic procedures can be expected to lead to an even higher incidence of perforation in coming years [1] [2]. Over the past 30 years, the actual risk of perforation during diagnostic flexible oesophagoscopy has remained low, and is estimated to occur at a frequency of 0.03 % compared with 0.11 % during rigid endoscopy [3]. However, during instrumental procedures with obstructing oesophageal tumours, such as dilation and stenting, perforation rates of 1 % - 10 % have been reported with mortality rates of up to 60 % despite treatment [4] [5].
Plasmid-Mediated Quinolone Resistance Genes and Antibiotic Residues in Wastewater and Soil Adjacent to Swine Feedlots: Potential Transfer to Agricultural Lands
Authors: Juan Li, Thanh Wang, Bing Shao, Jianzhong Shen, Shaochen Wang, Yongning Wu
Journal: Environmental Health Perspectives (2012)

Inappropriate use of antibiotics in swine feed could cause accelerated emergence of antibiotic resistance genes, and agricultural application of swine waste could spread antibiotic resistance genes to the surrounding environment.We investigated the distribution of plasmid-mediated quinolone resistance (PMQR) genes from swine feedlots and their surrounding environment.We used a culture-independent method to identify PMQR genes and estimate their levels in wastewater from seven swine feedlot operations and corresponding wastewater-irrigated farm fields. Concentrations of (fluoro)quinolones in wastewater and soil samples were determined by ultra-performance liquid chromatography-electrospray tandem mass spectrometry.The predominant PMQR genes in both the wastewater and soil samples were qnrD, qepA, and oqxB, whereas qnrS and oqxA were present only in wastewater samples. Absolute concentrations of all PMQR genes combined ranged from 1.66 × 107 to 4.06 × 108 copies/mL in wastewater and 4.06 × 106 to 9.52 × 107 copies/g in soil. Concentrations of (fluoro)quinolones ranged from 4.57 to 321 ng/mL in wastewater and below detection limit to 23.4 ng/g in soil. Significant correlations were found between the relative abundance of PMQR genes and (fluoro)quinolone concentrations (r = 0.71, p = 0.005) and the relative abundance of PMQR genes in paired wastewater and agricultural soil samples (r = 0.91, p = 0.005).Swine feedlot wastewater may be a source of PMQR genes that could facilitate the spread of antibiotic resistance. To our knowledge, this is the first study to examine the occurrence of PMQR genes in animal husbandry environments using a culture-independent method.
Laetrile: A Survey of Judicial and Administrative Activity
Authors: GERALD M. ROSEN
Journal: Annals of Internal Medicine (1981)

The judicial and executive branches of the federal government, motivated by emotionalism, political pressure, and a self-appointed need to placate the National Cancer Institute, have reached a decision on laetrile that weakens the legal protection of the general public. Recent approval of clinical trials of laetrile by the Food and Drug Administration was not consistent with policies adopted earlier, nor was it warranted by federal court decisions.
Low circulating levels of dehydroepiandrosterone in histologically advanced nonalcoholic fatty liver disease
Authors: Michael Charlton, Paul Angulo, Naga Chalasani, Ralph Merriman, Kimberly Viker, Phunchai Charatcharoenwitthaya, Schuyler Sanderson, Samer Gawrieh, Anuradha Krishnan, Keith Lindor
Journal: Hepatology (2008)

The biological basis of variability in histological progression of nonalcoholic fatty liver disease (NAFLD) is unknown. Dehydroepiandrosterone (DHEA) is the most abundant steroid hormone and has been shown to influence sensitivity to oxidative stress, insulin sensitivity, and expression of peroxisome proliferator-activated receptor alpha and procollagen messenger RNA. Our aim was to determine whether more histologically advanced NAFLD is associated with low circulating levels of DHEA. Serum samples were obtained prospectively at the time of liver biopsy in 439 patients with NAFLD (78 in an initial and 361 in validation cohorts) and in controls with cholestatic liver disease (n = 44). NAFLD was characterized as mild [simple steatosis or nonalcoholic steatohepatitis (NASH) with fibrosis stage 0-2] or advanced (NASH with fibrosis stage 3-4). Serum levels of sulfated DHEA (DHEA-S) were measured by enzyme-linked immunosorbent assay. Patients with advanced NAFLD had lower plasma levels of DHEA-S than patients with mild NAFLD in both the initial (0.25 +/- 0.07 versus 1.1 +/- 0.09 microg/mL, P < 0.001) and validation cohorts (0.47 +/- 0.06 versus 0.99 +/- 0.04 microg/mL, P < 0.001). A "dose effect" of decreasing DHEA-S and incremental fibrosis stage was observed with a mean DHEA-S of 1.03 +/- 0.05, 0.96 +/- 0.07, 0.83 +/- 0.11, 0.66 +/- 0.11, and 0.35 +/- 0.06 microg/mL for fibrosis stages 0, 1, 2, 3, and 4, respectively. All patients in both cohorts in the advanced NAFLD group had low DHEA-S levels, with the majority in the hypoadrenal range. The association between DHEA-S and severity of NAFLD persisted after adjusting for age. A relationship between disease/fibrosis severity and DHEA-S levels was not seen in patients with cholestatic liver diseases.More advanced NAFLD, as indicated by the presence of NASH with advanced fibrosis stage, is strongly associated with low circulating DHEA-S. These data provide novel evidence for relative DHEA-S deficiency in patients with histologically advanced NASH.
Transient Compression of the Left Innominate Vein
Authors: HERBERT L. FRED, DON C. WUKASCH, ZOLTAN PETRANY
Journal: Circulation (1964)

A patient with left-sided cervical venous distention associated with systemic hypertension and congestive heart failure is presented. Angiographic study showed venous return from the left external jugular veins to be impeded by an elongated but otherwise normal thoracic aorta compressing the left innominate vein. Once the hypertension and cardiac failure were controlled, compression of the left innominate vein regressed and the cervical venous engorgement disappeared.
Why are we complacent about alcohol?
Authors: Richard Smith
Journal: BMJ (2004)

Heart attack patients need better secondary preventionEven though secondary prevention after acute myocardial infarction reduces the risk of recurrence and death, its implementation remains suboptimal.On page 693 Dalal and colleagues describe drug and other treatments available after myocardial infarction.Antiplatelet drugs, statins, angiotensin converting enzyme inhibitors, and blockers are the four main prophylactic drugs.Organisation of care and nurse led clinics for secondary prevention, cardiac rehabilitation, and smoking cessation may improve outcomes, but not all patients receive all the treatment they need.Up to 20% of patients are depressed after myocardial infarction, and this is associated with increased mortality.
Nitric Oxide and VIP as Co-Transmitters of Neurogenic Relaxation of Human Airways: To the Editor
Authors: Hussein D. Foda, Sami I. Said
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

"Nitric Oxide and VIP as Co-Transmitters of Neurogenic Relaxation of Human Airways: To the Editor." American Journal of Respiratory and Critical Care Medicine, 151(5_pt_1), p. 1689
Association of Atopic Dermatitis (AD) Severity to Milk and Egg Allergy Outcomes in a Cohort of Atopic, Food-allergic Children (COFAR)
Authors: A.M. Scurlock, D.Y.M. Leung, H.A. Sampson, R. Lindblad, A.H. Liu, R.A. Wood, S.M. Jones, M. Plaut, W. Burks, D. Stablein
Journal: Journal of Allergy and Clinical Immunology (2011)
Disseminated Histoplasmosis in a Patient with Human Immunodeficiency Virus Infection
Authors: J Manuel Dominguez, Karim Serri
Journal: New England Journal of Medicine (2002)

Figure 1. A 37-year-old man who had emigrated to Montreal in 1990 was hospitalized because of a three-week history of high fever and weight loss. He had been given a diagnosis of human immunodeficiency virus infection five years previously but had declined treatment. The results of a physical examination and initial blood tests were unremarkable, except for the finding of mild microcytic anemia. The CD4 count was 130 cells per cubic millimeter. The results of an extended workup, including multiple imaging studies, were negative. During hospitalization, pancytopenia and markedly elevated lactate dehydrogenase levels (up to 7200 U per liter) developed. . . .
Differential effects of positive end expiratory pressure and cardiac tamponade on left-right ventricular mechanical function in the dog
Authors: T. Nakamoto, K. S Li, W. E Johnston, W. P Santamore
Journal: Cardiovascular Research (1992)

The aim was to examine the hypothesis that an increased coupling occurs between the ventricles during tamponade via a ventricular-pericardial-ventricular interaction, but that ventricular coupling would be unaltered or reduced with positive end expiratory pressure (PEEP).An in situ arrested, canine heart preparation was used. Changes in left and right ventricular pressure (dPl, dPr) and volume (dVl, dVr) caused by increasing the volume of the other ventricle were measured at normal and at matched levels of raised pericardial pressures (Pp) caused by 20 cm H2O PEEP and by tamponade.With PEEP, the coupling between the ventricles was unaltered when compared to control. With tamponade, dPl/dPr, dVl/dPr, dPr/dPl, and dVr/dPl increased significantly (p less than 0.05) by 0.21 (SEM 0.03, unitless), 0.45(0.04) ml.mm Hg-1, 0.18(0.03), and 0.28(0.04) ml.mm Hg-1 respectively.Augmented ventricular interdependence occurs during tamponade but not with PEEP, which may help to explain the different haemodynamic patterns observed under these conditions.
INTERMITTENT HYPOTHERMIA WITH DISABLING HYPERHIDROSIS
Authors: Arthur M. Hoffman
Journal: JAMA (1942)

In 1934 Hines and Bannick<sup>1</sup>described a clinical entity of recurrent hypothermia associated with disabling sweating. It is the only case reported in the literature to date. In 1935 we were privileged to observe a patient with apparently the identical condition. We have studied him during approximately yearly attacks since that date and feel that the observations on this prolonged study and treatment are worth recording as the second instance in the literature. The patient of Hines and Bannick, a man aged 22, was hospitalized because of intermittent attacks of sweating, chills and subnormal temperature. He had had these attacks for ten years. They would begin each year in December or January and would continue for from four to six weeks. "At the onset of each attack there had been a period of nausea and vomiting of from five to seven days; following this gastric upset the usual cycles
Psoriasis and its management
Authors: Catherine H Smith, J N W N Barker
Journal: BMJ (2006)

Behcet (1935) referred to the highly stigmatising and common inflammatory skin disease psoriasis (derived from the Greek word psora meaning itch) as “the antidote to a dermatologist's ego,” and although in some respects this is still true, major progress has been made in several important areas. Psoriasis occurs worldwide and affects about 2% of the population in the United Kingdom.

A great deal is known about the genetic and immunological mechanisms underlying the pathogenesis of psoriasis. Some of the new biological treatments recently licensed for psoriasis have been developed as a result of this improved understanding, whereas others have been contributory—for example, the profound efficacy of agents that block the actions of cytokine tumour necrosis factor highlighted the key role of tumour necrosis factor in the disease's pathogenesis. Evidence is also accumulating that psoriasis is not just associated with skin disease. Epidemiological studies have shown an increased standardised mortality in patients with psoriasis, particularly related to cancer and heart disease. Clinically relevant psychological and psychiatric comorbidity are also common and potentially amenable to therapeutic intervention. This article presents an overview of these developments and their implications for clinical practice.

### Genetic factors

Scans of the human genome reveal at least nine different loci with susceptibility to psoriasis (PSORS1-9). PSORS-1, a region of the major histocompatibility complex on chromosome 6p2, is the major genetic determinant of psoriasis, and accounts for up to 50% of genetic susceptibility to the disease,1 w1 although the definitive gene has not yet been identified.

Several of the implicated loci are shared by other autoimmune and inflammatory diseases such as inflammatory bowel disease, type1 diabetes, multiple sclerosis, and atopic dermatitis, suggesting that similar mechanisms underlie many common genetically complex inflammatory diseases.

#### Summary points

Psoriasis is a common, disfiguring, and stigmatising skin disease associated with profound impaired quality of life

The gene …