tbuckley/cabot-search huggingface dataset:
Managing drug resistant tuberculosis
Authors: A. Grant, P. Gothard, G. Thwaites
Journal: BMJ (2008)

#### Summary points Antituberculosis drug resistance is increasing both in the United Kingdom and internationally.1 2 It has come to greater public attention with the emergence of extensively drug resistant tuberculosis (box 1) in South Africa, where an outbreak proved rapidly fatal among people with advanced HIV infection.3 In this article we review recent global and UK trends in drug resistant tuberculosis and summarise its diagnosis, treatment, and control. Few data are available from randomised controlled trials to guide treatment of drug resistant tuberculosis, and none for multidrug resistant tuberculosis; this review is based primarily on data from observational epidemiological studies and on national and international guidelines. #### Box 1 Definitions relating to tuberculosis and drug resistance
To the Class of 1986
Authors: Roy B. Lacoursiere
Journal: JAMA (1983)

<h3>To the Editor.—</h3> To rekindle the memories of medical school (McGill, class of 1966) I read "Dean's Welcome Remarks to the Class of 1986" (1983; 249:1589) of Dr John Bernard Henry of Georgetown University. With the hoped-for rekindling, the following comments were also stimulated. Dean Henry specifically identifies the "drug addicted" and the "drug and alcohol addicted" (p 1589), grouping such patients with those in especial need or those treated when a physician has a "calling." Drug- and alcohol-addicted patients are on all of our wards and in all of our clinics and offices, and we cannot leave the treatment of this major health problem to physicians with a "calling." I hope Dean Henry will agree that all students in the class of 1986 are called to treat or, at the very least, meaningfully refer any problem as serious as drug and alcohol addiction. If these students do not learn
Exposure to PAH compounds among cokery workers in the oil shale industry.
Authors: T Kuljukka, R Vaaranrinta, T Veidebaum, M Sorsa, K Peltonen
Journal: Environmental Health Perspectives (1996)

The exposure of Estonian cokery workers to polynuclear aromatic hydrocarbons at an oil shale processing plant was assessed by occupational hygiene and biomonitoring measurements. To assess the external dose of exposure to polynuclear aromatic hydrocarbons, pyrene and benzo[a]pyrene concentrations were measured from the breathing zone of workers during a workshift. Skin contamination with pyrene and benzo[a]pyrene was assessed by skin wipe sampling. As a biomarker of exposure to polynuclear aromatic hydrocarbons and as an integral of all possible absorption routes of pyrene, 1-hydroxypyrene concentration was measured from post-shift urine samples. Eighteen percent of the personal air samples exceeded the Finnish threshold limit value of benzol[a]pyrene (10 micrograms/m3). Mean values for benzo[a]pyrene and pyrene were 5.7 micrograms/m3 and 8.1 micrograms/m3, respectively. Based on skin wipe sample analyses, the skin contamination was also obvious. The mean value of benzo[a]pyrene on the samples collected after the shift was 1.2 ng/cm2. In control samples, benzo[a]pyrene was not found. The mean value of urinary 1-hydroxypyrene concentration was 6.0 nmol/mmol creatinine for the exposed workers and 0.5 nmol/mmol creatinine for the controls. This study showed the usefulness of 1-hydroxypyrene as an indicator of internal dose of polynuclear aromatic hydrocarbons. We concluded that the cokery workers at the Kohtla-Järve plant are exposed to high concentrations of polynuclear aromatic compounds.
TCT-687 One year outcomes of transfemoral transcatheter versus surgical aortic valve replacement in patients with intermediate surgical risk: the italian OBSERVANT study
Authors: Marco Barbanti, Paola D'Errigo, Claudio Grossi, Francesco Onorati, Stefano Rosato, Francesco Santini, Fulvia Seccareccia, Corrado Tamburino, Remo D. Covello
Journal: Journal of the American College of Cardiology (2014)
High-Dose Cytarabine for High Blast Counts
Authors: MAURIE MARKHAM
Journal: Annals of Internal Medicine (1984)

Letters and Corrections1 September 1984High-Dose Cytarabine for High Blast CountsMAURIE MARKHAM, M.D.MAURIE MARKHAM, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-101-3-398_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The use of leukapheresis in patients with acute myeloblastic leukemia and extreme leukocytosis has been shown to quickly decrease blast counts and improve symptoms in patients developing the hyperleukocytic syndrome, characterized by respiratory insufficiency, central nervous system dysfunction, hemorrhage, and peripheral ischemic events (1-4). We report the case of a patient with acute myeloblastic leukemia and high blast counts who had rapid lowering of blast numbers without the development of the tumor-lysis syndrome after the institution of high-dose cytarabine therapy.A 70-year-old man with acute myeloblastic leukemia in relapse was admitted to the University of California, San...References1. LICHTMANROWE MJ. Hyperleukocytic leukemias: rheological, clinical, and therapeutic considerations. Blood. 1982;60:279-83. CrossrefMedlineGoogle Scholar2. EISENSTAEDTBERKMAN RE. Rapid cytoreduction in acute leukemia: management of cerebral leukostasis by cell pheresis. Transfusion. 1978;18:113-5. CrossrefMedlineGoogle Scholar3. KARPBECKCORNELL DJC. Chronic granulocytic leukemia with respiratory distress: efficacy of emergency leukapheresis. Arch Intern Med. 1981;141:1353-4. CrossrefMedlineGoogle Scholar4. CUTTNERHOLLANDNORTONAMBINDERBUTTONMEYER JJLEGR. Therapeutic leukapheresis for hyperleukocytosis in acute myelocytic leukemia. Med Pediatr Oncol. 1983;11:76-8. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byLeukocytapheresis for patients with acute myeloid leukemia presenting with hyperleukocytosis and leukostasis: a contemporary appraisal of outcomes and benefits 1 September 1984Volume 101, Issue 3Page: 398-399KeywordsAcute myeloid leukemiaCentral nervous systemHemorrhageLeukocytosisRespiratory failure Issue Published: 1 September 1984 PDF downloadLoading ...
Alpha 1-antitrypsin deficiency. Impact of genetic discovery on medicine and society
Authors: E. A. Wulfsberg
Journal: JAMA (1994)

An increasing body of molecular information resulting from advances in basic research is being incorporated into clinical practice by medical genetics. The process by which these research advances progress from the laboratory to the bedside and their medical, social, and legal impact is a topic of intense current interest. Some authors have claimed that new genetic information may lead to discrimination in insurance and employment; change the way courts allocate responsibility for injury and resultant damages; and be inappropriately interpreted by the medical profession. To address some of these issues, we chose, as a model, to review alpha 1-antitrypsin deficiency, described over 30 years ago. At this time, such concerns with respect to alpha 1-antitrypsin deficiency have not yet been realized, perhaps for the following reasons: (1) knowledge of alpha 1-antitrypsin deficiency, while common among geneticists and pulmonologists, has not been well disseminated in the medical community; (2) insurers, employers, lawyers, and judges are not generally aware of the deficiency and its implications; (3) insurers, if they are aware of the deficiency, have not found it cost-effective to screen for the condition; and (4) in the legal context, case law involving other types of preexisting conditions is being applied to genetic predispositions.
Postnatal development of the pig heart
Authors: D. GUERREIRO, S. C LENNOX, R. H ANDERSON
Journal: Cardiovascular Research (1980)

The small amount of data concerning the normal postnatal development of the pig heart has prompted us to study and quantify these changes from birth to the sixth month of postnatal life. The method used consisted of separation of the various cardiac components. Their individual weights were assessed, and width and length of both ventricles were determined. The free wall myocardial thickness of both ventricles was also measured. Major differences in the growth pattern of the ventricles were clearly shown. At birth the free wall of the left ventricle was already thicker than that of the right ventricle. This difference became more accentuated with growth. Similar findings in terms of mass were found, but the difference between the two free walls was reduced. There was disproportionate postnatal growth in favour of the left ventricle in all measurements taken except length. The right ventricle was longer in the newborn period.
Cellular Site for Fibrinogen Synthesis
Authors: Walter B. Forman, Marion I. Barnhart
Journal: JAMA (1964)

THROMBOSIS as a major medical disorder has received much attention because of the great morbidity and mortality rates with which it is associated. Recently, anticoagulants and fibrinolytic drugs have been used to suppress formation of clots or to dissolve those clots already formed. In either situation fibrinogen occupies a central position as the precursor of fibrin in the thrombus. Examination of the literature provides very little information on the normal physiology of fibrinogen. Furthermore, the specific cell type responsible for fibrinogen synthesis has remained obscure. This paper directly approaches the question of the cellular site of fibrinogen production and attempts to study mechanisms which affect fibrinogen turnover, synthesis, storage, and release. The hepatic parenchymal cell was revealed as the place where fibrinogen is produced and may be stored when conditions are favorable. The fluorescent antibody technique and highly specific antifibrinogen sera were used for cellular localizations. The rate of fibrinogen
A curious case of facial swelling in the night-time
Authors: J. Quinn, S. Todd, S. Agrawal, D. A. Tsitsikas
Journal: BMJ (2015)

A 57 year old woman presented to the emergency department with swelling of the lips and oropharynx of one hour’s duration. Treatment for anaphylaxis was started but 30 minutes later she was much worse. After intubation, she was taken to the intensive care unit for airway management.

She had attended the emergency department with similar symptoms one month earlier and had been treated with chlorphenamine and discharged home with an EpiPen. A referral to the allergy clinic was made.

Her medical history included hypertension, although she had never received an angiotensin converting enzyme inhibitor. In addition, two years earlier she had been diagnosed with a B lymphoproliferative disorder, which was asymptomatic and under surveillance. She had no history of asthma but had reported facial swelling as a child after a bee sting. She had no known allergies, no family history of note, and took no regular drugs.

Blood tests showed haemoglobin 91 g/L (reference range 130-180), mean cell volume 78.4 fL(80-98), platelets 159×109/L (150-400), total white cell count 21.9×109/L(4.0-11.0), lymphocytes 8.5×109/L (1.0-4.0), and tryptase 1.45 µg/L (0-11.4).

A complement screen showed C1q 49 mg/L (50-250), C2 2.0 mg/L (14-25), C3 0.8 g/L (0.88-2.01), C4 <0.03 g/L (0.16-0.47), and C1 esterase inhibitor 54 mg/L (220-390).



### 1. How would you interpret the blood results?

#### Answer

The low C2, C4, and C1q values are indicative of complement C1 esterase inhibitor deficiency. She also had microcytic anaemia.

#### Discussion

Complement is a major component of innate immunity. It mediates various pathways involved in the immune response, including the classical, alternative, and lectin pathways, which are activated in various inflammatory or infective processes.

C1-C4 are components of the classical pathway and are often low when …
Cumulative Dietary Energy Intake Determines the Onset of Puberty in Female Rats
Authors: Jenny Odum, Helen Tinwell, Graham Tobin, John Ashby
Journal: Environmental Health Perspectives (2004)

Laboratory animal diets for studies to determine the endocrine-disrupting potential of chemicals are under scrutiny because they can affect both assay control values and assay sensitivity. Although phytoestrogen content is important, we have previously shown that a phytoestrogen-rich diet and a phytoestrogen-free diet were equally uterotrophic to rats and advanced vaginal opening (VO) when compared with the standard diet RM1. Abolition of the effects by the gonadotrophin-releasing hormone antagonist Antarelix indicated that these effects were mediated through the hypothalamus-pituitary-reproductive organ axis. In the present study, we investigated the relationship between cumulative energy intake and sexual maturation in female rats. Infant formula (IF) at different concentrations and synthetic diets, with a wide range of metabolizable energy (ME) values, were used to modulate energy intake. Increasing energy intake was associated with an increase in uterine weight (absolute and adjusted for body weight) for both IF and the synthetic diets. In both cases, the increased uterine weight was directly proportional to energy intake. Body weight was unaffected by IF consumption but, in the case of the diets, was increased proportionally with energy consumption. Antarelix abolished the uterine weight increases with both formula and the diets, whereas body weight was unaffected. The mean day of VO was also advanced by high-ME diets and IF, whereas body weight at VO was unaffected. VO occurred at an energy intake of approximately 2,300 kJ/rat determined by measuring total food intake from weaning to VO, indicating that this cumulative energy intake was the trigger for puberty. ME is therefore a critical factor in the choice of diets for endocrine disruption studies.
Sickle Cell Anemia and Iron Deficiency
Authors: Martin H. Steinberg
Journal: JAMA (1982)

<h3>To the Editor.—</h3> I would take issue with some of the evidence and the conclusions reached in the recent article on the interaction of sickle cell anemia (SCA) and iron deficiency by Natta et al (1982;247:1442) and the accompanying editorial by Nalbandian (1982;247:1462). While the patient described by Natta and co-workers has clearly become iron deficient, the data reported by no means establish the etiology as being due to iron loss in urine. Iron deficiency developing from the reported level of urine iron excretion is very unlikely. A yearly urinary loss of about 300 mg of iron would occur, but the patient received at least 10 g of iron via transfusion. Since iron deficiency appeared to develop between ages 19 and 22 years, and as it would take at least 25 to 30 years to lose the transfused iron by the reported rate of urinary excretion, it is very likely
Colorectal Cancer Risk Perception on the Basis of Genetic Test Results in Individuals at Risk for Lynch Syndrome
Authors: Shilpa Grover, Elena M. Stoffel, Rowena C. Mercado, Beth M. Ford, Wendy K. Kohlman, Kristen M. Shannon, Peggy G. Conrad, Amie M. Blanco, Jonathan P. Terdiman, Stephen B. Gruber, Daniel C. Chung, Sapna Syngal
Journal: Journal of Clinical Oncology (2009)

Lynch syndrome is associated with inherited germline mutations in mismatch repair (MMR) genes. Genetic testing in high-risk individuals may yield indeterminate results if no mutation is found or if a mutation of unclear pathogenic significance is observed. There are limited data regarding how well patients with Lynch syndrome understand the clinical implications of genetic test results. This study examines colorectal cancer (CRC) risk perception in individuals tested for MMR mutations and identifies the factors associated with an appropriate interpretation of their cancer risk.A total of 159 individuals who met the Revised Bethesda Guidelines and had previously undergone genetic testing completed a questionnaire eliciting demographic data, cancer history, genetic test results, and an estimate of their CRC risk. Associations between clinical factors, genetic test results, and CRC risk perception were explored using multivariable analyses.Of the 100 individuals with a pathogenic mutation (true positive), 90 (90%) correctly estimated their CRC risk as "high" or "very high" compared with other individuals their age. However, only 23 (62%) of 37 individuals with an indeterminate genetic test result correctly estimated their risk. Individuals with a history of Lynch syndrome-associated cancer (odds ratio [OR], 0.1; 95% CI, 0.1 to 0.6) or indeterminate genetic test results (OR, 0.2; 95% CI, 0.1 to 0.6) were significantly less likely to estimate their CRC risk as increased.Patients at risk for Lynch syndrome with an indeterminate genetic test result may be falsely reassured. It is important that health care providers continue to discuss the implications of uninformative results on lifetime cancer risk.
Secondary prevention of heart disease with statins
Authors: Shah Ebrahim, Li Wei, Peter D Davey, Thomas M MacDonald, Frank M Sullivan
Journal: BMJ (2005)

Secondary prevention of heart disease with statins Groups were as different as chalk and cheeseEditor-Wei et al say that the results of their observational study of treatment with statins in routine clinical practice in Tayside are consistent with, and similar to, those reported in clinical trials. 1 This conclusion is hardly justified.A cohort of patients, defined by a discharge diagnosis of myocardial infarction between January 1993 and December 2001, was studied to compare the outcomes in those treated with statins and those not receiving these drugs.The data clearly show that the two groups differed substantially in terms of age, sex, comorbidity, and other cardiovascular drug treatment-all of these factors were biased in favour of a poorer outcome in patients not given statins.Furthermore, the two groups belonged to different time periods, most of the untreated patients to the earlier part and most of those given statins to the later part of the study.Given the changes between 1993 and 2001-including, for example, those related to the management of acute myocardial infarction and the criteria for diagnosis-it is only to be expected that the untreated group would have a higher risk of subsequent cardiovascular events.Multivariate analysis was reported as showing that statins reduced all cause mortality by 31% and the composite end point of myocardial infarction plus cardiovascular mortality by 18%.These results should be greeted with scepticism.Firstly, many trials of statins have failed to show any reduction whatsoever in all cause mortality. [2]][4][5] Secondly, as observed in other studies, any reduction in all cause mortality would be expected to be much less than that for composite cardiovascular end points. 2 4 5 The two groups in this study were as different as chalk and cheese.It should come as no surprise, therefore, that the results were anomalous.In such circumstances, no amount of statistical trickery could be expected to furnish anything of value.
Novel Small Leucine-Rich Repeat Protein Podocan Is a Negative Regulator of Migration and Proliferation of Smooth Muscle Cells, Modulates Neointima Formation, and Is Expressed in Human Atheroma
Authors: Randolph Hutter, Li Huang, Walter S. Speidl, Chiara Giannarelli, Paul Trubin, Gerhard Bauriedel, Mary E. Klotman, Valentin Fuster, Juan J. Badimon, Paul E. Klotman
Journal: Circulation (2013)

Smooth muscle cell (SMC) migration and proliferation critically influence the clinical course of vascular disease. We tested the effect of the novel small leucine-rich repeat protein podocan on SMC migration and proliferation using a podocan-deficient mouse in combination with a model of arterial injury and aortic explant SMC culture. In addition, we examined the effect of overexpression of the human form of podocan on human SMCs and tested for podocan expression in human atherosclerosis. In all these conditions, we concomitantly evaluated the Wnt-TCF (T-cell factor) pathway.Podocan was strongly and selectively expressed in arteries of wild-type mice after injury. Podocan-deficient mice showed increased arterial lesion formation compared with wild-type littermates in response to injury (P<0.05). Also, SMC proliferation was increased in arteries of podocan-deficient mice compared with wild-type (P<0.05). In vitro, migration and proliferation were increased in podocan-deficient SMCs and were normalized by transfection with the wild-type podocan gene (P<0.05). In addition, upregulation of the Wnt-TCF pathway was found in SMCs of podocan-deficient mice both in vitro and in vivo. On the other hand, podocan overexpression in human SMCs significantly reduced SMC migration and proliferation, inhibiting the Wnt-TCF pathway. Podocan and a Wnt-TCF pathway marker were differently expressed in human coronary restenotic versus primary lesions.Podocan appears to be a potent negative regulator of the migration and proliferation of both murine and human SMCs. The lack of podocan results in excessive arterial repair and prolonged SMC proliferation, which likely is mediated by the Wnt-TCF pathway.
Gene Therapy for Ocular Disease
Authors: Jean Bennett, Albert M. Maguire
Journal: Molecular Therapy (2000)

The tremendous progress in the past decade in delineating the molecular bases of ocular diseases has been accompanied by the realization that it may be possible to harness this information to generate rational treatment strategies. The concept that treatments might be performed at the genetic level has been a driving force in research involving several blinding ocular diseases. Although there has not, as yet, been a demonstration of cure using gene therapy approaches, proof-of-principle has been established in a number of animal models for a diverse set of ocular diseases.
NOTES ON THE NATURE AND TREATMENT OF CHOREA BASED ON SEVENTY-FIVE CASES IN PRIVATE PRACTICE.
Authors: A. D. ROCKWELL
Journal: JAMA (1895)

If an apology is necessary for presenting for your consideration a subject so hackneyed as chorea, the nature of which so many able and careful observers have attempted to solve and about which discussion and theory have been worn threadbare, it is: 1, that any disease, the source of so much anxiety and distress as chorea, can not be discussed too frequently: 2, that my experience has been somewhat large and has been gleaned entirely in private and not in hospital practice, upon which nearly all considerations in regard to this subject are based; and 3, if I can not offer anything new in regard to medicinal or hygienic methods of treatment, I am in a position to speak with some authority and confidence upon the methods and results of electrical treatment, a subject even yet in its relation to this disease too little understood by the profession in general
New horizons in medical ethics. Priorities in medicine.
Authors: P Rhodes, C Ogg, D Irvine
Journal: BMJ (1973)

This' tape-recorded discussion was devoted to some ethical problems of the selection of patients for difJerent types of treatmentIn their working papers circulated before the discussion Professor Philip Rhodes, professor of obstetrics and gynaecology, asked whether there is a limit to which the weak, the distressed, and the diseased shall be supported; Dr. Chisholm Ogg, renal physician and director of a dialysis and transplantation unit, discussed the conflict between ethics
B1-05: Activity of MAGE-A3 cancer immunotherapeutic as adjuvant therapy in stage IB/II non-small cell lung cancer (NSCLC): final results of a multi-center, double-blind, randomized, placebo-controlled phase II study
Authors: Johan Vansteenkiste, Marcin Zielinksi, Albert Linder, Jubrail Dahabre, Emilio Esteban, Wojciech Malinowski, Jacek Jassem, Bernward Passlick, Frédéric Lehmann, Vincent G. Brichard
Journal: Journal of Thoracic Oncology (2007)