tbuckley/cabot-search huggingface dataset:
Easy Bruising, Thrombocytopenia, and Elevated Platelet Immunoglobulin G in Graves' Disease and Hashimoto's Thyroiditis
Authors: KENNETH HYMES
Journal: Annals of Internal Medicine (1981)

Platelet IgG levels, count, and function and easy bruising or bleeding were studied in 25 patients with Graves' disease and 12 with Hashimoto's thyroiditis (normal value for platelet IgG 10.7 +/- 4.5 ng [SD]/10(6) platelets). Eight of 22 patients with Graves' disease and normal platelet counts had elevated platelet IgG averaging 38 +/- 4.0 ng (SEM) (range, 24 to 60). Four of 10 patients with Hashimoto's thyroiditis and normal platelet counts ahd elevated platelet IgG averaging 45 +/- 7.2 ng (range, 27 to 66). Five patients with thrombocytopenia had platelet counts averaging 53000 +/- 12000/microL (SEM) and elevated platelet IgG averaging 154 +/- 40 ng (range, 27 to 300). Twelve of 15 patients with a history of easy bruising or bleeding had elevated platelet IgG compared to five of 22 without easy bruising (p < 0.001). Four of six with elevated platelet IgG had one or more abnormal in-vitro platelet aggregation measurements (particularly with epinephrine) compared to none of six with normal platelet IgG levels (p = 0.03). We conclude that elevated platelet IgG is associated with easy bruising and thrombocytopenia in about half of patients with Graves' disease or Hashimoto's thyroiditis.
Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome secondary to pancreatitis
Authors: Victor A. Silva
Journal: American Journal of Hematology (1995)

Abstract Pancreatitis is a rare (∼2.0%) complication of thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS). The opposite finding has rarely been reported. We present a case of an 18 years old obese male with alcohol associated pancreatitis (amylase 840 IU/L) who three days after onset, as the pancreatitis subsided (amylase 341 U/L), developed TTP/HUS. The TTP/HUS was marked by oliguria and severe renal failure (creatinine 1,326 μmol/L), was treated with daily plasma exchanges, obtained a complete response, and recovered renal function (creatinine 115 μmol/L). Similarly, in six of seven other cases from the medical literature the TTP/HUS occurred within 2–3 days of the onset of pancreatitis.
Phenotypic and functional properties of murine thymocytes. I. Precursors of cytolytic T lymphocytes and interleukin 2-producing cells are all contained within a subpopulation of "mature" thymocytes as analyzed by monoclonal antibodies and flow microfluorometry
Authors: R Ceredig, AL Glasebrook, HR MacDonald
Journal: The Journal of Experimental Medicine (1982)

The correlation between surface phenotype and function in subpopulations of murine thymocytes has been investigated using flow microfluorometry (FMF). C57BL/6 thymocytes stained with monoclonal antibodies directed against Lyt-2, H-2K(b), and Thy-l.2 and passed on an FACS II flow cytometer could be resolved into at least four distinct subpopulations on the basis of fluorescence and forward light scatter (FLS) measurements. (a) Medium-sized Lyt-2(+) cells that stained strongly with H-2K(b) and weakly with Thy-l.2 (5 percent of total cells); (b) medium-sized Lyt-2(-) cells with other properties as in (a) (10 percent); (c) small Lyt-2(+) cells that stained weakly with H-2K(b) and strongly with Thy-l.2 (60 percent); and (d) large Lyt-2(+) cells that stained weakly with H-2K(b) and very strongly with Thy- 1.2 (23 percent). Cortisone-resistant thymocytes (CRT) were found to correspond phenotypically to populations (a) and (b). The distribution of cytolytic T lymphocyte precursors (CTL-P) directed against H-2(d) alloantigens in subpopulations of C57BL/6 thymocytes that had been sorted according to the phenotypic criteria described above was then investigated. CTL-P in sorted and control populations were quantitated by limiting dilution analysis of mixed leukocyte microcultures established in an excess of interleukin 2 (IL-2). These studies established that all thymus CTL-P could be quantitatively recovered in a subpopulation of cells that was cortisone-resistant, medium-sized, Lyt-2(+), H-2K(b+), and weakly stained with Thy-l.2. In parallel studies, the production of IL-2 by subpopulations of C57BL/6 thymocytes was quantitatively assessed using a recently developed sensitive microassay system. Graded numbers of sorted or control thymocytes were stimulated with irradiated T cell-depleted allogeneic cells and assayed for their ability to support the growth of an IL-2-dependent cytolytic T lymphocyte clone. Using this method, IL-2 production was found to reside entirely in a subpopulation of cortisone-resistant, medium-sized Lyt-2(-) thymocytes. Further phenotypic analysis of this subpopulation of cells indicated that it was homogeneously H-2K(b+) and weakly staining with Thy- 1.2. Taken together with the CTL-P results, these data directly demonstrate that a subpopulation of thymocytes with a mature phenotype (i.e., cortisone- resistant, medium-sized, H-2K(b+), and weakly staining with Thy-l.2) accounts for all the functional activity in the thymus. Reasons for the apparent discrepancy between these results and other recent studies will be discussed.
Prevalence of chronic kidney disease in an urban Mexican population
Authors: Dante Amato, Cleto Alvarez-Aguilar, Rutila Castaneda-Limones, Ernesto Rodriguez, Marcela Avila-Diaz, Francisco Arreola, Anel Gomez, Hiram Ballesteros, Raquel Becerril, Ramon Paniagua
Journal: Kidney International (2005)
Dactylolysis Spontanea (Ainhum)
Authors: Burton Allyn
Journal: JAMA (1963)

THAT PECULIAR CONDITION which consists of the development of a constricting band around a digit, usually of a toe and most usually of a small toe, and which leads to eventual withering of the part, was first described more than 100 years ago as "dry gangrene" by Clarke.<sup>1</sup>In 1867, da Silva Lima<sup>2</sup>applied to the phenomenon the word "ainhum" (meaning "to saw") taken from the Yoruba language spoken by the people indigenous to the west coast of Africa where, amongst other places, the condition is common. We do not know when the term "dactylolysis spontanea" was coined, but it too is apt in its literal statement of spontaneous separation of a digit. By now several hundred cases of what conforms to the concept of an inherently painless withering and spontaneous amputation of a digit as described above have been reported. When pain is prominent in the process,
Human seminal plasma inhibition of antibody complement-mediated killing and opsonization of Neisseria gonorrhoeae and other gram-negative organisms.
Authors: G F Brooks, C J Lammel, B H Petersen, D P Stites
Journal: Journal of Clinical Investigation (1981)

Seminal plasma diluted 1:5-1:1,000 gave marked inhibition of serum antibody complement-mediated bactericidal and opsonic effects against Neisseria gonorrhoeae and other gram-negative organisms. Serum that was bactericidal at a dilution of 1:5,120 was not bactericidal at a dilution of 1:10 when seminal plasma was added. Bactericidal action of immune human or rabbit sera, or purified immunoglobulin (Ig)G or IgM plus complement for six strains of N. gonorrhoeae, serogroups A, B, C, and Y of Neisseria meningitidis, Escherichia coli and other gram-negative rods was inhibited by seminal plasma. Using C8- or C7-deficient sera as antibody and complement sources, opsonization, phagocytosis, and killing of N. gonorrhoeae and E. coli 014-K7 were inhibited by seminal plasma. Opsonization, phagocytosis, and killing of Staphylococcus aureus 502A was not inhibited. For the gram-negative organisms, the early phase of the opsonization process, probably complement activation, appeared to be inhibited rather than the ingestion or polymorphonuclear leukocyte killing steps; addition of seminal plasma yielded a significant reduction in the percentage of polymorphonuclear cells with associated bacteria. Seminal plasma did not prevent attachment of IgG, IgM, or IgA antibodies to gonococci. It reduced serum hemolytic whole complement activity by 25%. The seminal plasma inhibitor was of low molecular weight and was stable at 56 degrees C for 30 min, but inhibitory activity was lost after heating to 100 degrees C for 10 min. It is likely that the inhibitory factor(s) is a low-molecular weight protease or protease inhibitor. Seminal plasma probably has an important role in inhibition of complement and antibody functions in the genital tract. It may enhance pathogenesis of agents of sexually transmitted diseases.
Endoscopic Injection of Mitomycin Adsorbed on Carbon Particles for Advanced Esophageal Cancer: a Pilot Study
Authors: M.-A. Ortner, A. Taha, S. Schreiber, J. Wirth, J. Weber-Eibl, H. Ernst, H. Lochs
Journal: Endoscopy (2004)

Patients with advanced, unresectable esophageal carcinoma have an extremely poor prognosis, with dysphagia being the major problem. The aim of this prospective pilot study was to evaluate the efficacy of local injections of mitomycin adsorbed onto activated carbon particles (MMC-CH) in advanced unresectable esophageal squamous-cell carcinoma. The primary outcome parameter was survival time; secondary parameters were dysphagia and quality of life.Ten consecutive patients with stage IV esophageal carcinoma (age: median 58, range 32 - 78), median tumor length 11 cm (range 5 - 15) received four weekly injections of 15 mg (10 ml) MMC-CH into the endoscopically visualized tumor, via a 5-mm sclerotherapy needle. The tumor stage, symptom score, and quality of life (measured using the Karnofsky index) were assessed before and after therapy and every 2 months thereafter.The median survival time after MMC-CH therapy was 16 weeks (95 % CI, 11.7 to 20.4). Dysphagia was reduced ( P < 0.001) in parallel with the reduction in the tumor mass ( r = 0.82, P = 0.01). The Karnofsky index ( P < 0.01) also improved after MMC-CH treatment. MMC-CH was well tolerated, and no side effects were observed.Endoluminal MMC-CH therapy appears to be an effective, inexpensive, and well-tolerated treatment for unresectable advanced squamous-cell esophageal carcinoma.
Predictors and Variability of Urinary Paraben Concentrations in Men and Women, Including before and during Pregnancy
Authors: Kristen W. Smith, Joe M. Braun, Paige L. Williams, Shelley Ehrlich, Katharine F. Correia, Antonia M. Calafat, Xiaoyun Ye, Jennifer Ford, Myra Keller, John D. Meeker, Russ Hauser
Journal: Environmental Health Perspectives (2012)

Parabens are suspected endocrine disruptors and ubiquitous preservatives used in personal care products, pharmaceuticals, and foods. No studies have assessed the variability of parabens in women, including during pregnancy.We evaluated predictors and variability of urinary paraben concentrations.We measured urinary concentrations of methyl (MP), propyl (PP), and butyl paraben (BP) among couples from a fertility center. Mixed-effects regression models were fit to examine demographic predictors of paraben concentrations and to calculate intraclass correlation coefficients (ICCs).Between 2005 and 2010, we collected 2,721 spot urine samples from 245 men and 408 women. The median concentrations were 112 µg/L (MP), 24.2 µg/L (PP), and 0.70 µg/L (BP). Urinary MP and PP concentrations were 4.6 and 7.8 times higher in women than men, respectively, and concentrations of both MP and PP were 3.8 times higher in African Americans than Caucasians. MP and PP concentrations were slightly more variable in women (ICC = 0.42, 0.43) than men (ICC = 0.54, 0.51), and were weakly correlated between partners (r = 0.27-0.32). Among 129 pregnant women, urinary paraben concentrations were 25-45% lower during pregnancy than before pregnancy, and MP and PP concentrations were more variable (ICCs of 0.38 and 0.36 compared with 0.46 and 0.44, respectively).Urinary paraben concentrations were more variable in women compared with men, and during pregnancy compared with before pregnancy. However, results for this study population suggest that a single urine sample may reasonably represent an individual's exposure over several months, and that a single sample collected during pregnancy may reasonably classify gestational exposure.
Should depression be managed as a chronic disease?
Authors: G. Andrews
Journal: BMJ (2001)

In 1970 L G Kiloh and I finished recruiting patients for a prospective study of depression in admissions to a new general hospital psychiatric unit. When we published the 15 year follow up we discovered that our patients had not done at all well.1 Only a fifth recovered and remained continuously well, three fifths recovered but had further episodes, and a fifth either committed suicide or were always incapacitated. An English 15 year follow up study published at the same time showed identical results.2 The obvious conclusion was that people admitted to hospital in the 1970s with a depressive illness did not have a good prognosis. In retrospect, I ask why more of those who relapsed did not return to us for treatment. These results are not atypical. A detailed 12 year follow up in US specialist care showed that patients on average had symptoms in 59% of weeks and met full criteria for a depressive episode in 15% of weeks.3

Depression seems to be a chronic recurring disorder, seldom well managed if one simply waits for the patient to initiate further consultations.

#### Summary points

The burden of depression is not being reduced

The episodic nature of depression and the acute response to treatment means that episodes seem easy to treat

They can be if patients comply with drug and cognitive therapy regimens

The main problem is the next recurrence, if patients do not to come for treatment at all

To reduce the burden of depression, we argue for a chronic disease management model

We should manage depression proactively to ensure long term compliance with treatment

I identified references to remission and relapse of depression during the writing up of the Australian national mental health survey. References to long term prognosis came from my earlier work. A conference question, …
Evolutionary and functional relationships revealed by the dha regulon predicted by genomic context analysis
Authors: Marinalva Martins-Pinheiro, Wanessa Cristina Lima, Cláudio A Oller, Carlos FM Menck
Journal: Genome biology (2011)

Deep exome resequencing is a powerful approach for delineating patterns of protein-coding variation among genes, pathways, individuals and populations.We analyzed exome data from 2,440 individuals of European and African ancestry as part of the National Heart, Lung, and Blood Institute's Exome Project, the aim of which is to discover novel genes and mechanisms that contribute to heart, lung and blood disorders.Each exome was sequenced to a mean coverage of 116×, allowing detailed inferences about the population genomic patterns of both common variation and rare coding variation.We identifi ed more than 500,000 single nucleotide variations, the majority of which were novel and rare (76% of variants had a minor allele frequency of less than 0.1%), refl ecting the recent dramatic increase in the size of the human population.The unprecedented magnitude of this dataset allowed us to rigorously characterize the large variation in nucleotide diversity among genes (ranging from 0 to 1.32%), as well as the role of positive and purifying selection in shaping patterns of proteincoding variation and the diff erential signatures of population structure from rare and common variation.This dataset provides a framework for personal genomics and is an important resource that will allow inferences of broad importance to human evolution and health.
Protamine releases endothelium-derived relaxing factor from systemic arteries. A possible mechanism of hypotension during heparin neutralization.
Authors: P J Pearson, P R Evora, K Ayrancioglu, H V Schaff
Journal: Circulation (1992)

BACKGROUND When used to reverse the anticoagulant effect of heparin, protamine sulfate often causes vasodilation that can lead to systemic hypotension. Protamine is rich in the basic amino acid arginine, which is the precursor of endothelial cell synthesis of nitric oxide, and nitric oxide is the active component of endothelium-derived relaxing factor (EDRF). METHODS AND RESULTS To determine whether the hypotensive effect of protamine could be due to stimulated release of EDRF, we studied rings (4-5 mm) of canine coronary, femoral, and renal artery suspended in organ chambers containing physiological salt solution (37 degrees C and 95% O2-5% CO2). Arterial rings with and without endothelium were contracted with prostaglandin F2 alpha (2 x 10(-6) M) and exposed to increasing concentrations of protamine (final organ bath concentration, 40-400 micrograms/ml). In arterial segments without endothelium, protamine caused only a modest decrease in tension. However, protamine induced concentration-dependent relaxation in all arterial segments with endothelium, which was significantly greater than in segments without endothelium (p less than 0.05). The endothelium-dependent relaxation induced by protamine was inhibited by NG-monomethyl-L-arginine (L-NMMA) (10(-5) M), but L-NMMA had no effect on rings without endothelium. The action of L-NMMA could be reversed by L-arginine (10(-4) M) but not D-arginine (10(-4) M). CONCLUSIONS This study demonstrates that protamine stimulates the release of EDRF from arterial endothelium, and that endothelium-dependent vasodilation may be an important cause of systemic hypotension during protamine infusion.
The Australian Eunuchs.
Authors: William Hessert
Journal: JAMA (1898)

Chicago, Feb. 10, 1898. <h3>To the Editor:</h3> —In an article on "The Oriental Eunuchs," by Dr. Edmund Andrews, in the issue of January 22, in the paragraph on "Australia" the author refers to the natives limiting "the increase of families by crushing the testicles of the father after his first child is born." Referring to this point the facts below are not entirely relevant, but may prove of interest in this connection. My brother, Mr. Fred Hessert, who has for over a year been sojourning in West Australia, has in his letters to me described some of the customs of the barbaric natives. Owing to the barren desert condition of the country, the natives prevent a too great increase in their number by certain surgical operaations performed on the penis. When a boy reaches the age of puberty he is taken in hand by a number of old "bucks," who
PCDDs, PCDFs, and PCBs in human blood in relation to consumption of crabs from a contaminated Fjord area in Norway.
Authors: H R Johansen, J Alexander, O J Rossland, S Planting, M Løvik, P I Gaarder, W Gdynia, K S Bjerve, G Becher
Journal: Environmental Health Perspectives (1996)

Consumption of fish and shellfish from contaminated areas may be an important source of human exposure to persistent organohalogen compounds such as polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins (PCDDs), and polychlorinated dibenzofurans (PCDFs). We determined concentrations of 2,3,7,8-substituted PCDDs and PCDFs and 19 PCB congeners in whole blood samples from three groups of men, 40-54 years of age, with different consumption levels of crabs from a fjord area in southern Norway polluted with organochlorine compounds from a magnesium production plant. A significant increase of many PCDD/PCDF congeners was found in the blood when comparing the referents, moderate-, and high-intake groups. The greatest difference was observed for several of the PCDFs that are characteristic for the contamination of the marine biota of the fjord. PCBs, in general, play a minor role in the contamination of the fjord by the magnesium production process, except for the highly chlorinated congeners such as PCB-209. Nevertheless, almost all PCBs increased from the referents to the high-intake group. However, the relative concentrations of several highly chlorinated PCBs (particularly PCB-209) in blood are unexpectedly low compared to their abundance in crabs, indicating low uptake of these congeners. The exposure to PCDDs/PCDFs from crab consumption calculated from individual body burdens of these compounds were in good agreement with the intake estimated from previously measured concentrations in crabs, reported fishing sites, and consumption. Almost all subjects in the high-intake group exceeded the tolerable weekly intake of 35 pg TEQ/kg body weight/week proposed by a Nordic Expert Group.
Attending Rounds in the Current Era
Authors: Chad Stickrath, Melissa Noble, Allan Prochazka, Mel Anderson, Megan Griffiths, Jonathan Manheim, Stefan Sillau, Eva Aagaard
Journal: JAMA Internal Medicine (2013)

General medicine rounds by attending physicians provide the foundation for patient care and education in teaching hospitals. However, the detailed activities of these rounds in the current era are not well characterized.To describe the characteristics of attending rounds for internal medicine inpatients in a large teaching hospital system.A cross-sectional observational study of attending rounds in internal medicine. Rounds were observed directly by research assistants.Four teaching hospitals associated with a large public medical school.Fifty-six attending physicians and 279 trainees treating 807 general medicine inpatients.Duration and location of rounds, composition of teams, and frequency of 19 potential activities during rounds.We observed 90 days of rounds. A typical rounding day consisted of 1 attending with 3 trainees visiting a median of 9 (range, 2-18 [SD, 2.9]) patients for a median of 2.0 hours (range, 25-241 [SD, 2.7] minutes). On rounds, teams most frequently discussed the patient care plan (96.7% of patients), reviewed diagnostic studies (90.7%), communicated with patients (73.4%), and discussed the medication list (68.8%). Teams infrequently discussed invasive lines or tubes (9.3%) or nursing notes (6.2%) and rarely communicated with nurses (12.0%) or taught physical examination skills (14.6%), evidence-based medicine topics (7.2%), or learner-identified topics (3.2%). Many commonly performed activities occurred infrequently at the bedside.Most activities on attending rounds do not take place at the bedside. The teams discuss patient care plans and test results most of the time but fail to include many items that may be of significant value, including specific aspects of patient care, interprofessional communication, and learner-centered education. Future studies are needed to further assess the implications of these observations.