tbuckley/cabot-search huggingface dataset:
Marfan syndrome. Demonstration of abnormal elastin in aorta.
Authors: P A Abraham, A J Perejda, W H Carnes, J Uitto
Journal: Journal of Clinical Investigation (1982)

Aortae from three patients with classic presentation of Marfan syndrome, who died of vascular complications, were subjected to biochemical analyses of the connective tissue; for comparison, aortae from eight age-matched controls, without evidence of connective tissue abnormalities, were examined. Elastin was prepared from the aortae by two techniques. First, the tissues were extracted with 5 M guanidine-HCl, bacterial collagenase digestion and reduction with dithiothreitol (elastin I preparation). Secondly, this material was further purified by extraction with 0.1 M NaOH at 99 degrees C (elastin II preparation). Amino acid analyses of both elastin preparations indicated that the values for desmosine and isodesmosine were reduced in Marfan cases to approximately one-half of the control values. A corresponding increase in lysyl residues was noted in elastin II preparations. Also, the concentration of elastin per milligram dry weight of tissue was reduced in Marfan cases. The hydroxyproline content of elastin was increased in two cases with the Marfan syndrome. Recoveries indicated that the alkali treatment solubilized 46.2% of the elastin I preparations in Marfan aortae compared with 23.7% in controls. In contrast to elastin, the concentration and solubility of collagen were unchanged; the amino acid composition and the genetic types of insoluble collagen isolated by limited pepsin proteolysis were the same in both Marfan and control aortae. The results of our study demonstrate that the cross-linking of aortic elastin is reduced in the three patients with Marfan syndrome. Thus, a defect in elastin could explain the vascular fragility observed clinically in these patients.
Neighborhood Health Centers as Providers of Primary Mental-Health Care
Authors: Jonathan F. Borus
Journal: New England Journal of Medicine (1976)

The 19 Boston neighborhood health centers with mental-health programs were studied to investigate the delivery of mental-health services as part of a primary health-care system. Staff-time utilization data show these programs focus on the provision of primary mental-health services to neighborhood residents and indirect consultative and collaborative services to general health staff to co-ordinate health care. Forty-eight per cent of referrals for mental-health services were patients first identified and referred by general health staff. Children constituted a disproportionately high percentage of the patients served (43 per cent), and 22 per cent of the services were outreach visits, primarily in patients' homes. Quantitative studies are necessary to confirm my qualititative findings that the conjoint health and mental-health delivery site at the neighborhood level increases the accessibility and psychologic acceptability of mental-health services and enhances case finding, successful referral, and co-ordination of primary health care.
Efficacy, Safety, and Long-term Results of Endoscopic Treatment for Early Stage Adenocarcinoma of the Esophagus With Low-risk sm1 Invasion
Authors: Hendrik Manner, Oliver Pech, Yvonne Heldmann, Andrea May, Juergen Pohl, Angelika Behrens, Liebwin Gossner, Manfred Stolte, Michael Vieth, Christian Ell
Journal: Clinical Gastroenterology and Hepatology (2013)
Incidence and clinical impact of extended-spectrum-β-lactamase (ESBL) production and fluoroquinolone resistance in bloodstream infections caused by Escherichia coli in patients with hematological malignancies
Authors: Enrico M. Trecarichi, Mario Tumbarello, Teresa Spanu, Morena Caira, Luana Fianchi, Patrizia Chiusolo, Giovanni Fadda, Giuseppe Leone, Roberto Cauda, Livio Pagano
Journal: Journal of Infection (2009)
Lung function in primary Sjogren's syndrome: a cross sectional and longitudinal study.
Authors: C Kelly, P Gardiner, B Pal, I Griffiths
Journal: Thorax (1991)

Clinical and radiological assessment of 100 patients (97 female) with primary Sjögren's syndrome was performed within six months of diagnosis in conjunction with spirometry and measurement of transfer factor for carbon monoxide (TLCO). This was repeated in an unselected subgroup of 30 patients after a mean interval of four years. On initial assessment, 43 patients had symptoms of lung disease and 10 had related physical signs; the chest radiograph was abnormal in five. There was a significant reduction (more than 2 standardised residuals) in forced expiratory volume in one second (FEV1), vital capacity (VC), and TLCO in 14, 12, and 10 patients, 24 patients overall having a significant reduction in one or more of these measures. There was a strong relation between reduction in lung function and both pulmonary symptoms and a lip biopsy specimen positive for Sjögren's syndrome. Lung function at the initial assessment in the 30 patients who were restudied was almost identical to that of the group as a whole. Seventeen now had symptoms and nine had related physical signs. The chest radiograph was abnormal in four patients. More patients had a significant reduction in FEV1, VC, and TLCO. Lung disease is sometimes an early feature of primary Sjögren's syndrome and may progress over a relatively short period.
Clinical Neurosurgery. Vol 9. Proceedings of the Congress of Neurological Surgeons, New York, N.Y.
Authors: Oscar Sugar
Journal: JAMA (1963)

The honored guest at the 1961 meeting of the Congress was Professor Eduard Busch of Copenhagen, who contributed three lectures: (1) indications for surgery in glioblastomas; (2) brain-stem contusions: differential diagnosis, therapy, and prognosis; (3) structure and organization of a neurosurgical department. The remainder of the volume deals with the cerebral vascular system, beginning with anatomy (Kaplan), through circulation physiology (Kety) and nervous control (White), and ending with radiology (Taveras). The clinical aspects of occlusive disease are discussed by Fisher; of hemorrhage, by Magladery and by Richardson and Einhorn. Anticoagulant therapy is proposed (Siekert) for intermittent insufficiency, progressing stroke, cerebral emboli, and arteritis. The surgical treatment of stroke by arterial reconstruction is described by Crawford and DeBakey. Wright and Sweet cover occlusion of carotid and vertebral arteries for intracranial aneurysms, while Lougheed, Botterell, and Morley in one chapter and Norlén in another give the results of direct intracranial attack. Selverstone
Radiation Injury in Man: Its Chemical and Biological Basis, Pathogenesis and Therapy
Authors: Marshall Brucer
Journal: JAMA (1961)

There are three concepts of radiation injury. A radical group in Oak Ridge believes that it takes a large amount of radiation to cause clinical (as opposed to political) damage. A moderate group in Los Alamos believes moderate exposure causes injury, and a conservative group represented by the authors (Brookhaven) believes that an exposure of only a few hundred roentgens can cause clinical damage. There are also three concepts of therapy for radiation injury. One group, mainly European, uses drugs in profusion. A second group is looking for "pie in the sky." They believe in imminent "breakthroughs"—tomorrow. A third group believes that therapy is only symptomatic and palliative. The authors of<i>Radiation Injury in Man</i>belong with these but emphasize that some of the symptomatic therapy is lifesaving when given at the proper time for the proper purpose. The book is primarily a monograph on the effects of radiation as
AB0317 Association of ACR clinical responses with CDAI (clinical disease activity index) and RAPID3 (routine assessment of patient index data 3) indices of disease activity in rheumatoid arthritis patients treated with certolizumab pegol plus methotrexate:
Authors: M. Schiff, K. Luijtens, O. Davies, Y. Yazici
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> CDAI (clinical disease activity index) and RAPID3 (routine assessment of patient index data 3) cut points defining responses that best match ACR20/50/70 response in rheumatoid arthritis (RA) patients (pts), are unknown. <h3>Objectives</h3> To evaluate cut points in a study population treated with certolizumab pegol (CZP) plus methotrexate (MTX).<sup>1</sup> <h3>Methods</h3> ACR responders through Week (Wk) 12 from 393 CZP treated pts (400 mg at Wks 0, 2 and 4 then 200 mg every 2 Wks) plus MTX in RAPID 1 (NCT00152386) were categorized by proposed response (R) cut points in CDAI (change from baseline [CFB] ≥6.7, ≥10.0, ≥13.9) and RAPID3 (CFB ≥1.8, ≥3.6). ACR20/50/70 responses were compared with proposed categorizations using cross-tabulations, AUC under the ROC curve (AUC-ROC), % correctly classified (%CC) pts and kappa statistics. CART<sup>2</sup> (classification and regression trees) modeling identified CDAI and RAPID3 cut points defining responses most closely associated with ACR20/50/70 responses. <h3>Results</h3> Sensitivities were very high; at Wk 12, 93–100% ACR20/50/70 responders achieved CFB in CDAI (≥6.7,≥10.0,≥13.9). Positive predictive value [PPV] was lower indicating CDAI-R is not as strongly associated with ACR-R as ACR-R is with CDAI-R; lower specificities indicate that ACR nonresponse (NR) does not correspond well to CDAI-NR (particularly for ACR50/70). However, CDAI-NR predicts well ACR-NR (very high negative predictive value [NPV]) (Table). CFB in CDAI≥13.9 was most closely associated with ACR20-R (κ=0.57). Association between proposed CDAI categorizations and ACR50/70 was weak (κ=0.05–0.29). A similar trend was observed for RAPID3. CART modeling identified CFB in CDAI ≥13.80/≥20.15/≥20.15 and CFB in RAPID3 ≥5.46/≥7.28/≥5.53 as categorizations most closely associated with ACR20/50/70 responses. <h3>Conclusions</h3> CDAI and RAPID3 CFB thresholds were identified that defined the closest associations with ACR responses in pts with inadequate response to MTX and high disease activity at baseline (mean DAS28 6.9). Sensitivities/NPVs were very high overall. Association with ACR20 was relatively strong. Association with ACR50/70 was weaker. Further studies are needed to analyze different pt populations, including those with lower disease activity at baseline. <h3>References</h3> Arthritis Rheum 2008; 58(11):3319–29. Classification And Regression Trees (CART) software, Salford Systems, CA, USA <h3>Disclosure of Interest</h3> M. Schiff Grant/Research support from: UCB Pharma, Consultant for: UCB Pharma, K. Luijtens Employee of: UCB Pharma, O. Davies Employee of: UCB Pharma, Y. Yazici Consultant for: UCB Pharma
Prevention of Postoperative Pulmonary Complications
Authors: William H. Anderson
Journal: JAMA (1963)

The purpose of this study was to determine whether the use of intermittent positive pressure breathing during inspiration (IPPB[I]) combined with administration of nebulized isoproterenol (Isuprel) would reduce the incidence of postoperative pulmonary complications. There were 160 patients in the control group and 42 in the group receiving IPPB(I) with isoproterenol. The treated group contained more patients of more than 60 years of age and more with maximum breathing capacities of less than 60% of that predicted; otherwise, the two groups were similar. Significant postoperative pulmonary complications were experienced by 19.5% of the control group and 2.5% of the treated group. The incidence of postoperative pulmonary complications in the control group was 2.5 times as great for those patients who had maximum breathing capacities of less than 60% of that predicted than for those in the same group whose maximum breathing capacities were greater than 60% of that predicted.
Doctor accused of covering up faked rugby injury is suspended by GMC
Authors: C. Dyer
Journal: BMJ (2009)

A rugby match doctor who was accused of cutting a player’s lip with a scalpel to conceal the use of fake blood has been suspended by the General Medical Council, pending investigations.

The suspension means that Wendy Chapman, an accident and emergency consultant at Maidstone Hospital, will not be allowed to work as a doctor while the UK medical regulator considers whether to press misconduct charges.

Dr Chapman was a match doctor for Harlequins rugby club at its Heineken cup match with …
Estrogens in the Menopause and Postmenopause
Authors: Joseph Rogers
Journal: New England Journal of Medicine (1969)

THE basic physiology of the menopause is failure of regular ovulation, followed by decline in estrogen production by the ovary and increase in urinary excretion of gonadotropins. Oligomenorrhea, dysfunctional uterine bleeding or sudden cessation of periods reflect these hormonal changes. The main symptoms are permanent amenorrhea and the hot flash, which may be related to the effect of estrogen on small arterioles. In some women with a history of emotional disturbance depression and anxiety may dominate the clinical picture, but are thought not to be related to estrogen deficit; there is no clear evidence that estrogens alone alleviate depressive symptoms. . . .
TCT-63 Remote Ischemic Perconditioning Improves Long-Term Clinical Outcome in Patients Undergoing Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction
Authors: Astrid D. Sloth, Michael R. Schmidt, Kim Munk, Rajesh K. Kharbanda, Andrew N. Redington, Lars Pedersen, Henrik T. Sørensen, Hans Erik Bøtker
Journal: Journal of the American College of Cardiology (2012)
Zidovudine could stop HIV infection of babies
Authors: O Dyer
Journal: BMJ (1994)

Zidovudine and delivery by caesarean section have a major role in stopping the transmission of HIV from pregnant seropositive mothers to their babies, doctors heard last week. Virologists and obstetricians from Britain met at St Thomas's Hospital, London, to discuss ways of reducing the number of babies born with the viral infection. The conference heard about recent studies of the factors involved in maternofetal transmission and debated ways of improving the …
Autoanalyzer Glucose Problems
Authors: Herbert E. Spiegel
Journal: JAMA (1972)

<h3>To the Editor.—</h3> We have investigated the observations reported by Zileli et al, in a letter which appeared in<i>JAMA</i>(215:1986, 1971). They indicated that a tablet containing 10 mg of oxazepam (Serapax), suspended in 2 ml of water, resulted in a level of glucose greater than 500 mg/100 ml by the autoanalyzer FeCN method and the glucose oxidase method. Our efforts have resulted in a confirmation of the results reported by Zileli with the use of oxazepam (Serax) tablets and capsules suspended in water. However, a pure oxazepam (10 mg/ml) suspension did<i>not</i>give the glucose reaction when tested by the auto-analyzer FeCN procedure,<sup>1</sup>the Hoffman modification of the Somogyi procedure,<sup>2</sup>the glucose oxidase (glucostat),<sup>3</sup>the hexokinase (glucostrate),<sup>4</sup>and the SMA 12/60 procedure (neocuproine).<sup>5</sup>In the case of oxazepam, it would seem that one of the excipients is interfering with the analysis. Although it
Thiazolidinediones and hepatic fibrosis: don't wait too long
Authors: F Marra
Journal: Gut (2006)

Lack of effect of delayed thiazolidinedione treatment may imply that these drugs are of limited efficacy in hepatic fibrosis, and that treatment of chronic liver disease might be successful only if the therapy were started very early

Liver tissue scarring, or fibrosis, is considered a common pathway leading to the alterations typical of cirrhosis, and delaying its progression likely results in longer patient survival and reduced need for liver transplantation. The past 15 years have witnessed a tremendous advance in our understanding of the cellular and molecular mechanisms responsible for the fibrogenic response in the liver (reviewed by Bataller and Brenner1). Damage to hepatocytes, or alterations in the biliary tree, activate mesenchymal cells that acquire a myofibroblastic phenotype, actively proliferate, produce extracellular matrix components, and secrete soluble mediators that contribute to maintenance of a chronic “wound healing” response, resulting in progressive scarring and alteration of the microvascular architecture. Activation of hepatic stellate cells (HSC) is considered a major source of myofibroblast-like cells during liver injury, together with the contribution of other myofibroblasts, such as those originating from the portal tracts.2 In spite of the clinical need for antifibrotic therapies, and a detailed knowledge of the processes of fibrogenesis in cellular and animal models, to date no drugs have been approved for the treatment of hepatic fibrosis.

A number of studies have recently suggested that antidiabetic thiazolidinediones (TZDs) or “glitazones” (from the prototype troglitazone, withdrawn from the market, and currently comprised of pioglitazone and rosiglitazone) may represent a possible novel pharmacological treatment for liver fibrosis. TZDs are employed for the treatment of insulin resistance in patients with type 2 diabetes and are selective ligands for the nuclear transcription factor peroxisome proliferator activated receptor (PPAR)γ.3 PPARs, which include PPARα, PPARβ (or -δ), and PPARγ belong to the nuclear receptor …
Poor sterilisation of instruments leads to infection outbreak in Paris
Authors: Alexander Dorozynski
Journal: BMJ (1997)

Poor sterilisation of surgical instruments in a Parisian clinic has led to an outbreak of a tuberculosis-like infection of the spine caused by Mycobacterium xenopi , a usually harmless bacterium often present in the water supply.

The 31 patients who have so far been diagnosed as having the spinal infection were operated on between 1988 and 1993 for intervertebral disc prolapse, either by percutaneous or arthroscopic techniques. …
Hepatocellular enzyme patterns and hepatitis b virus exposure in multitransfused young and very young hemophilia patients
Authors: E. D. Gomperts, J. Lazerson, D. Berg, D. Lockhart, E. Sergis‐Deavenport
Journal: American Journal of Hematology (1981)

Abstract Thirty‐eight children with severe hemophilia A, 11 years of age and under, were evaluated by initial and follow‐up liver function tests (LFTs) in relation to age of onset of transfusion therapy. Each child had at least two complete evaluations within one year for a follow‐up period of at least one year. The mean number of exposure days was 36 with a mean of 275 units of factor VIII per exposure day prior to initial LFTs. At initial testing, 30% of patients demonstrated antibody to HBsAg and 39–51% at least one abnormal serum enzyme level (AST, ALT, LDH). During an average follow‐up period of 34.8 months, two children developed HBsAg‐positive icteric hepatitis. Of those initially serologically negative for HBsAg or antibody, 44% became antibody‐positive. Intermittent abnormalities of at least one serum enzyme were observed in 79% of the patient group, with 13% and 8% being persistently normal and abnormal. Eleven children born after January 1976, receiving only third‐generation RIA‐tested products for HBsAg, constituted a subgroup. Although only one child at first assessment had evidence of hepatitis B virus exposure, 55% had elevated ALTs, indicating considerable frequency of non‐A, non‐B hepatitis in this very young group.
Telomere length, TERT and shelterin complex proteins in hepatocellular carcinomas expressing “stemness”-related markers
Authors: Haeryoung Kim, Jeong Eun Yoo, Jai Young Cho, Bong-Kyeong Oh, Yoo-Seok Yoon, Ho-Seong Han, Hye Seung Lee, Ja June Jang, Sook Hyang Jeong, Jin Wook Kim, Young Nyun Park
Journal: Journal of Hepatology (2013)
Effect of Antihypertensive Drugs on Insulin Absorption
Authors: Jan Veenstra, Jan P van der Hulst, Ingrid H Wildenborg, Suzy F Njoo, Wim P Verdegaal, Joseph Silberbusch
Journal: Diabetes Care (1991)

To examine the effects of antihypertensive drugs on the absorption of subcutaneously injected insulin.Eleven healthy volunteers (group 1) were given 1 mg/kg body wt propranolol three times a day during 48 h and a single dose on the morning of investigation. Seven other healthy volunteers (group 2) were given 10 mg nifedipine 30 min before subcutaneous injection of 10 U 125I-labeled soluble insulin. Absorption was measured by counting radioactivity externally. In both groups, control experiments were conducted under the same conditions without administration of propranolol or nifedipine.Propranolol usage was associated with higher mean percentages of remaining activity (P less than 0.05 by analysis of variance [ANOVA]) than in the control experiment. In the nifedipine experiment, mean percentages were significantly lower compared with the control experiment (P less than 0.02 by ANOVA). The mean decline in activity of all 30-min periods was 6.8 +/- 3.5 vs. 3.6 +/- 3.7% for control versus propranolol (group 1) (P less than 0.05) and 6.3 +/- 1.8 vs. 9.6 +/- 3.2% for control versus nifedipine (group 2) (NS).Antihypertensive drugs can influence insulin absorption. Propranolol (a peripheral vasoconstrictor) decreases insulin absorption, whereas nifedipine (a vasodilatator) increases insulin absorption.
Mortality from Primary Tumours of Bone in England and Wales
Authors: A. Mackenzie, W. M. C. Brown, R. Doll, H. A. Sissons
Journal: BMJ (1961)

CORONARY INSUFFICIENCY BRITISHforced to stand to obtain relief from pain.Sedatives were given as required, and pethidine was sometimes administered in the early stages when pain was severe.Contributory factors, such as diabetes mellitus, hyper- tension, and obesity, were corrected so far as was possible.Cases with serious hypertension, however.were not included in the series analysed.The only coronary vasodilators that were used in this study were trinitrin, p.r.n., and pentaerythritol tetra- nitrate, in the form either of "peritrate" (10 mg.) or of " myocardol " (30 mg.), in doses of one or two tablets three times a day, one hour before meals.Adverse blood lipid patterns that did not respond to diet alone were countered with 40-50 oz. of corn oil daily or with nicotinic acid, the dose of which was gradually increased from 100 mg.t.d.s. to 500 t.d.s., if well tolerated.Such treatment was rarely given unless the serum cholesterol remained obstinately high, between 350 and 700 mg./100 ml., and was uninfluenced by the decision to give anticoagulants or,, not.Neither triparanol (" MER-29 ") nor oestrogens were used in this series.During 1958 iproniazid (" marsilid ') proved helpful in relieving intractable cardiac pain in states of coronary insufficiency, but did not influence the fundamental course of the disease (Towers and Wood, 1958).The hypotensive, anabolic, hepatotoxic, and neuromuscular side-effects of iproniazid, however, limited its use.During the last two years other mono-amine oxidase inhibitors relatively free from these side-effects have been tried, particularly isocarboxazid (" marplan "), but on the whole they have been less effective.It is repeated for emphasis that these substances do not alter the fundamental course of the disease.They are best used temporarily, to overcome undue suffering when the patient is incapacitated, and should usually be with- held before he returns to work, for masking angina
A PHARMACOGENOMIC APPROACH TO ANTIPLATELET THERAPY IN STEMI PATIENTS: REASSESSMENT OF ANTI-PLATELET THERAPY USING AN INDIVIDUALIZED STRATEGY IN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION (THE RAPID STEMI STUDY)
Authors: Derek Yiu Fai So, George Wells, Ruth McPherson, Marino Labinaz, Chris Glover, Michel Le May, Alexander Dick, Michael Froeschl, Jean-Francois Marquis, Nitan Garg, Jordan Bernick, Luan Tran, Benjamin Hibbert, Jason Roberts
Journal: Journal of the American College of Cardiology (2013)