tbuckley/cabot-search huggingface dataset:
The Lille model: A new tool for therapeutic strategy in patients with severe alcoholic hepatitis treated with steroids
Authors: Alexandre Louvet, Sylvie Naveau, Marcelle Abdelnour, Marie-José Ramond, Emmanuel Diaz, Laetitia Fartoux, Sébastien Dharancy, Frédéric Texier, Antoine Hollebecque, Lawrence Serfaty, Emmanuel Boleslawski, Pierre Deltenre, Valérie Canva, François-René Pruvot, Philippe Mathurin
Journal: Hepatology (2007)

Early identification of patients with severe (discriminant function ≥ 32) alcoholic hepatitis (AH) not responding to corticosteroids is crucial. We generated a specific prognostic model (Lille model) to identify candidates early on for alternative therapies. Three hundred twenty patients with AH prospectively treated by corticosteroids were included in the development cohort and 118 in its validation. Baseline data and a change in bilirubin at day 7 were tested. The model was generated by logistic regression. The model combining six reproducible variables (age, renal insufficiency, albumin, prothrombin time, bilirubin, and evolution of bilirubin at day 7) was highly predictive of death at 6 months ( P &lt; 0.000001). The area under the receiver operating characteristic (AUROC) curve of the Lille model was 0.89 ± 0.02, higher than the Child-Pugh (0.62 ± 0.04, P &lt; 0.00001) or Maddrey scores (0.66 ± 0.04, P &lt; 0.00001). In the validation cohort, its AUROC was 0.85 ± 0.04, still higher than the other models, including MELD (0.72 ± 0.05, P = 0.01) and Glasgow scores (0.67 ± 0.05, P = 0.0008). Patients above the ideal cutoff of 0.45 showed a marked decrease in 6-month survival as compared with others: 25% ± 3.8% versus 85% ± 2.5%, P &lt; 0.0001. This cutoff was able to identify approximately 75% of the observed deaths. Conclusion: In the largest cohort to date of patients with severe AH, we demonstrate that the term “nonresponder” can now be extended to patients with a Lille score above 0.45, which corresponds to 40% of cases. Early identification of subjects with substantial risk of death according to the Lille model will improve management of patients suffering from severe AH and will aid in the design of future studies for alternative therapies. (Hepatology 2007.)
Severe Neutropenia Associated with Sustained-Release Procainamide
Authors: A. GRAY ELLRODT
Journal: Annals of Internal Medicine (1984)

Neutropenia is a rare complication of procainamide therapy. However, over a period of 20 months, 8 patients developed severe neutropenia while taking a sustained-release preparation of the drug. Seven patients presented with fever and constitutional symptoms and one patient was asymptomatic. Bone marrow examinations showed myeloid aplasia or maturation arrest in 5 patients and myeloid hyperplasia in 1. Neutropenia resolved within 30 days of drug withdrawal, and all patients survived. A case-control study showed a significant association between sustained-release procainamide therapy and severe neutropenia in 5 of 114 patients (4.4%) recovering from open-heart surgery (Mantel-Haenszel chi square = 13.84; p less than 0.001). Thus, life-threatening neutropenia may be common with sustained-release procainamide preparations.
Allopurinol treatment for protozoan infections?
Authors: Phil Gunby
Journal: JAMA (1978)

The newest antiprotozoan agent on the horizon may be allopurinol, an oral xanthine oxidase inhibitor already widely used clinically for treating hyperuricemia. So far, it has been shown to be effective in culture against species of<i>Leishmania</i>and against<i>Trypanosoma cruzi</i>. Investigators say the drug works because these protozoa have a fatal flaw—unique enzyme systems that transform allopurinol into a toxic adenine analogue. J. Joseph Marr, MD, of St Louis concedes that leishmaniasis and trypanosomiasis are likely to be diagnosed only in newcomers to the United States. But he points out that they "affect several hundred million people around the world and are two of the five diseases that the World Health Organization says are in most urgent need of attention." Marr is director, Section of Infectious Diseases, in the Department of Medicine at St Louis University School of Medicine. His interest in exploring the antiprotozoan effects of allopurinol began
Importance of including <i>Blomia tropicalis</i> in the routine diagnosis of Venezuelan patients with persistent allergic symptoms
Authors: F. A. Puccio, N. R. Lynch, O. Noga, A. Noda, I. Hagel, E. López, R. López, L. Caraballo, D. Mercado, M.C. DiPrisco
Journal: Allergy (2004)

Blomia tropicalis is a common mite found in the house dust of many tropical countries including Venezuela. The prevalence of skin test and specific serum immunoglobulin (Ig)E reactivity to B. tropicalis in Venezuela has not been previously evaluated.In the present study we evaluated the skin reactivity by skin prick test and specific IgE by a multiple antigen blot assay, against B. tropicalis and Dermatophagoides pteronyssinus, in a group of 115 subjects who attended the Allergy Clinic of the Institute of Biomedicine, Caracas, Venezuela, and we studied possible cross reactions between similar proteins of these two mites.One hundred and six patients with persistent allergic respiratory symptoms showed a positive skin prick test to at least one of the mite extracts, with the frequency of positive reactions to B. tropicalis being as high as to D. pteronyssinus. Twelve patients reacted only to D. pteronyssinus and 13 different patients only to B. tropicalis. Specific IgE to each of the mite extracts was found with similar frequency, and the results coincided with the skin test reactivity.The study indicated the importance of including B. tropicalis in routine diagnostic testing in tropical and sub-tropical situations.
Coffee, cholesterol, and coronary heart disease.
Authors: D S Thelle
Journal: BMJ (1991)

prevent weight gain when the wires are removed is necessary. 14 Probably the main obstacle to successfully treating obesity is the social attitudes of obese patients and their doctors.Severely obese people often have low self esteem and excessively optimistic expectations of each new treatment.This attitude sets traps for the doctor, who may say that the problem is trivial or easily solved or incurable, none of which is true.Virtually all obese patients can be restored to normal body composition by a normal reducing diet, but this takes time, patience, and an intelligent application of the laws of thermodynamics.
Take back your mink, take back your pearls
Authors: R. Smith
Journal: BMJ (2002)

News p 1053 Reviews p 1120 

> ”Take back your mink, take back your pearls

> What made you think that I was one of those girls?”

> From the musical Guys and Dolls 

English and Welsh consultants last week rejected the new consultant contract by two to one.1 Specialist registrars, the consultants of the future, rejected it by more than five to one. But consultants from Scotland and Northern Ireland voted for the contract, hastening the pace of devolution. The contract had been negotiated over two years and endorsed by the BMA's central consultants and specialists committee. Peter Hawker, chairman of the committee, resigned when the vote was announced. The resounding rejection of the contract in England and Wales raises difficult questions for the NHS, the government, and the BMA and probably starts a new era of local negotiation and possibly of a junior consultant grade.

In essence, the new contract offered more money in return for accepting greater managerial control and the potential to be obliged to work unsocial hours.2 Although those who negotiated the contract urged consultants to accept it, the junior doctors committee immediately rejected it.3 Feedback from consultants to the BMJ and other publications and websites was consistently negative, 4 5 and it was no surprise when the contract was rejected.

It wasn't rejected because of money. Consultants famously had their mouths “stuffed with gold” at the start of the NHS, but this time they've sent back the mink and the pearls. Nor was it rejected because of minor restrictions on private practice. It was rejected primarily because it gave more control to managers, people who in many hospitals are neither trusted nor respected. This might be seen as a simple power struggle, with consultants refusing to be told what …
REMARKS CONCERNING THE MANAGEMENT AND TREATMENT OF RHINOPHARYNGEAL TONSILS BY THE GENERAL PRACTITIONER.
Authors: ROBERT C. MYLES
Journal: JAMA (1903)

As teachers in the graduate schools of general medicine we should endeavor to give that instruction which our matriculants can safely make use of after returning to their homes. I know that they receive no more enthusiastic nor more frequent instruction than that concerning adenoids. I wish to address you in behalf of those children who live in the country districts, far from the larger towns, from whence it is either impossible or inexpedient for them to be taken in order that a specialist may treat them according to some of the many vaunted methods. It is possible to teach the general practitioner to perform the various operations suggested for the removal of adenoids, but the time required for the proper instruction in the delicate practical manipulative technic of certain methods of procedure makes many of them unfeasible. Operations with the Lowenberg's forceps or some of its modifications should not
Women forced into sterilisation protest to UN
Authors: K. Krosnar
Journal: BMJ (2006)

A group of Czech Roma women who said that they were forcibly sterilised have, on 17 August, outlined their stories in person to a United Nations committee in New York. They hope this will exert pressure on the Czech government to apologise.

On the same day, many Roma women staged a protest outside a hospital in the east of the Czech Republic to raise awareness for their cause. About 30 women carrying banners stating “we want children” and “sterilise gherkins not women” protested outside …
Abstract 3466: Mediated by cancer cell and stroma cell TGF-β signaling, the periostin / β-Ig-H3 expression ratio is altered during breast cancer progression
Authors: Michelle M. Coleman, Anindita Das Burman, Amanda L. Lance, Didier Dreau
Journal: Cancer Research (2014)

Abstract Involved in the maintenance of normal breast tissue, the extracellular matrix (ECM) also supports the progression of several human cancers. In particular, both periostin and TGF-β-induced (β-Ig-H3) whose expression is regulated by transforming growth factor-β (TGF-β) signaling, are differentially expressed in many human cancers. While a link between increased periostin expression and poor breast cancer outcomes has been shown, our recent data suggest that overall periostin expression is variable and is poorly correlated with human breast cancer progression. Therefore, in this study we investigated the ratio between periostin and β-Ig-H3 expression and the relationship between TGF-β signaling and expression of these ECM proteins by cancer cells and stromal cells during human breast cancer progression. Expressions of periostin and β-Ig-H3 were determined in biopsy specimens collected from 61 breast cancer patients by immunohistochemistry and correlated with clinico-pathologic features. Additionally, periostin, β-Ig-H3, and TGF-β expression in multiple stroma and tumor cells were evaluated in vitro using western-blots and ELISAs. Increases in the periostin / ß-Ig-H3 ratio correlated with increased the AJCC stage and progesterone positive status of the breast cancer specimens tested (p&amp;lt;0.05). In vitro, murine L929 fibroblasts and 4T1 mammary cancer cells secreted higher periostin concentrations compared to J774 and RAW macrophages (p&amp;lt;0.05). Furthermore, the periostin / ß-Ig-H3 protein expression ratio of 4T1 cells was higher than those of J774 and RAW cells. Following treatment with TGF-ß that activated the SMAD pathway, L929 and 4T1 cells expressed higher periostin concentrations (p&amp;lt;0.05). In contrast, the high ß-Ig-H3 secretion by L929 fibroblasts and J774 macrophages remained unchanged following TGFß treatment (n.s.). These observations support a role for TGF-ß and periostin signaling loops between stroma and cancer cells in the microenvironment and may indicate a role of the periostin / ß-Ig-H3 ratio as a predictor of breast cancer aggressiveness. [This works was supported by grants from the Department of Defense Era of Hope research program (BC044778) and the National Science Foundation EFRI program (CBE0736007)] Citation Format: Michelle M. Coleman, Anindita Das Burman, Amanda L. Lance, Didier Dreau. Mediated by cancer cell and stroma cell TGF-β signaling, the periostin / β-Ig-H3 expression ratio is altered during breast cancer progression. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3466. doi:10.1158/1538-7445.AM2014-3466
Spina Bifida and Potatoes
Authors: C. A. Clarke, O. M. McKendrick, P. M. Sheppard
Journal: BMJ (1973)

The results of a retrospective survey of the dietetic and other habits of the mothers of 83 children with spina bifida (mostly schoolchildren with meningomyelocele) were compared with 85 carefully matched controls. The survey was particularly concerned with the consumption of or contact with potatoes by the mothers. No significant differences were found in the amount of potatoes eaten as reported by the mothers (mean for spina bifida group 3.60 1b (1630 g), and for controls 3.98 1b (1800 g) per week). Of the seven other comparisons associated with potatoes only one (obtaining them from the chip shop or restaurant) was significant, the mothers of the children with spina bifida being more likely to obtain some of them from this source.When examining other aspects of diet it was found that the mothers of spina bifida children reported a lower consumption of a number of important foods, though the deficiency was not significant in any instance. These mothers were also significantly more likely to have been prescribed drugs other than iron and vitamins early in pregnancy and to have reported a wider variety of illnesses.The results in general do not support the hypothesis that the quantity of potatoes taken is important. They do lend support to the view that poor dietary habits are associated with a higher incidence of spina bifida irrespective of social class. Furthermore, general ill health in the mother may be implicated.
THE ASSOCIATION BETWEEN LESION LOCATION AND FUNCTIONAL SIGNIFICANCE OF INTERMEDIATE CORONARY LESIONS
Authors: Hiroaki Takashima, Akiyoshi Kurita, Katsuhisa Waseda, Tomofumi Mizuno, Kenji Asai, Yasuo Kuroda, Takashi Kosaka, Yasushi Kuhara, Hirohiko Ando, Kazuyuki Maeda, Yoshitaka Ito, Shinichiro Sakurai, Daiki Kato, Toru Niwa, Yusuke Nakano, Kentaro Mukai, Shigeko Sato, Masanobu Fujimoto, Tetsuya Amano
Journal: Journal of the American College of Cardiology (2013)
Enhanced Gi-protein-mediated mitogenesis following chronic ethanol exposure in a rat model of experimental hepatocellular carcinoma
Authors: Iain H. McKillop, Nilesh Vyas, Max C. Schmidt, Paul A. Cahill, James V. Sitzmann
Journal: Hepatology (1999)

Hepatocellular carcinoma (HCC) is associated with increased expression and function of inhibitory guanine nucleotide regulatory proteins (Gi–proteins). This study addresses the effects of chronic ethanol exposure on the expression and function of adenylyl cyclase (AC)–linked G–proteins (Gs and Gi) and growth in experimental HCC. G–protein expression and function was determined by immunoblot in the hepatic tumorigenic H4IIE cell line and isolated cultured hepatocytes in the absence or presence of ethanol (5–100 mmol/L). Chronic exposure (24 hours) to ethanol dose–dependently increased Giα 1/2 expression in the H4IIE cell line, but not in cultured hepatocytes. Gsα–protein expression remained unchanged in both H4IIE cells and cultured hepatocytes following ethanol treatment. In addition, ethanol directly activated a Gi–protein, because pertussis toxin (PTx)–catalyzed, adenosine diphosphate (ADP)–dependent ribosylation of Giα substrates decreased following ethanol treatment. The increased functional activity of Giα 1/2 –protein expression was confirmed by demonstrating that ethanol dose–dependently inhibited basal and stimulated AC activity in H4IIE cells, while not significantly altering basal AC activity in isolated cultured hepatocytes. Furthermore, while ethanol had no significant effect on basal mitogenesis in H4IIE cells or hepatocytes, increased mitogenesis caused by direct Giα–protein stimulation (mastoparan M7; 10–5,000 nmol/L) was further enhanced in the presence of ethanol, an effect that was completely blocked following Gi–protein inhibition (PTx; 100 ng/mL). In contrast, activation of Gi–proteins using M7 failed to alter cellular mitogenesis in isolated cultured hepatocytes, whether in the absence or presence of ethanol. Finally, analysis of mitogen–activated protein kinase (MAPK) activity demonstrated that chronic ethanol treatment further enhanced Gi–protein-stimulated MAPK activity in hepatic tumorigenic cells. In conclusion, these data demonstrate that ethanol enhances cellular mitogenesis in experimental HCC as a result of, at least in part, a Gi–MAPK-dependent pathway. Furthermore, this effect may be caused by ethanol's direct up–regulation of the expression and activity of Gi–proteins in HCC
Is anti-hbc IgM a useful clinical test in patients with HBsAg-positive chronic hepatitis or primary hepatocellular carcinoma?
Authors: Min Chan Lai, Myron J. Tong, Marek J. Nowicki, Shou-Dong Lee
Journal: Hepatology (1988)

Seventy HBsAg-positive patients, including 24 with primary hepatocellular carcinoma, 34 with chronic active hepatitis, 12 with chronic persistent hepatitis and 30 asymptomatic healthy hepatitis B virus carriers were tested for anti-HBc IgM using the Corzyme-M test. Anti-HBc IgM was detected in 50% of the primary hepatocellular carcinoma patients, 26.5% of the chronic active hepatitis patients, 25% of the chronic persistent hepatitis patients, but in none of the healthy hepatitis B virus carriers. There was no correlation between the presence of anti-HBc IgM and HBeAg, hepatitis B virus DNA, ALT or α-fetoprotein levels in either the chronic active hepatitis or chronic persistent hepatitis patients. However, a significantly higher positive rate of anti-HBc IgM was noted in the HBeAg-positive or HBV DNA-positive primary hepatocellular carcinoma patients than in those with negative markers of viral replication, but no correlation was noted between the presence of anti-HBc IgM and serum ALT or α-fetoprotein levels in these primary hepatocellular carcinoma patients. Also, no differences in positivity for HBeAg, HBV DNA or levels of serum ALT were noted when patients with high titers of anti-HBc IgM were compared to those with low titers. Thus, anti-HBc IgM cannot distinguish between HBsAg-positive patients with chronic active hepatitis, chronic persistent hepatitis or primary hepatocellular carcinoma, does not correlate with serum ALT or α-fetoprotein levels and is only associated with markers for viral replication in primary hepatocellular carcinoma patients. Based on this, anti-HBc IgM appears to have a limited usefulness for diagnosis of either chronic hepatitis B or primary hepatocellular carcinoma. Since anti-HBc IgM was negative in all our asymptomatic healthy hepatitis B virus carriers, its detection in these individuals may indicate an underlying chronic liver disease which would merit further diagnostic investigation.
Electrophysiologic Response to Moricizine in Patients with Sustained Ventricular Arrhythmias
Authors: Anne C. Powell, Michael R. Gold, Ross Brooks, Hasan Garan, Jeremy N. Ruskin, Brian A. McGovern
Journal: Annals of Internal Medicine (1992)

Objective: To assess the short-term efficacy and safety of moricizine in patients receiving electrophysiologically guided therapy for sustained ventricular arrhythmias refractory to treatment with class IA antiarrhythmic agents. Design: Uncontrolled clinical trial. Setting: Referral-based teaching medical center. Patients: Twenty-one patients (18 of whom had coronary artery disease) with a mean left ventricular ejection fraction of 32% ± 11% who presented with sustained ventricular tachycardia (13 patients), syncope (4 patients), or cardiac arrest (4 patients). Interventions: Moricizine, 743 ± 85 mg daily. Measurements: Electrophysiologic testing in the drug-free state and after administration of moricizine unless sustained arrhythmias occurred. Main Results: Sustained ventricular tachycardia was inducible in the absence of antiarrhythmic drugs in 20 patients and was not suppressed by moricizine in any patient. Four patients had six episodes of spontaneous ventricular tachycardia while receiving moricizine. A probable proarrhythmic response occurred in four patients. — Conclusion: In patients with compromised left ventricular tricular function caused by coronary artery disease in whom class IA antiarrhythmics were ineffective, moricizine was ineffective in suppressing sustained ventricular arrhythmias and resulted in proarrhythmic effects in some patients.
Open-Flow Microperfusion of Subcutaneous Adipose Tissue for On-Line Continuous Ex Vivo Measurement of Glucose Concentration
Authors: Zlatko Trajanoski, Gernot A Brunner, Lukas Schaupp, Martin Ellmerer, Paul Wach, Thomas R Pieber, Peter Kotanko, Falko Skrabal
Journal: Diabetes Care (1997)

OBJECTIVE To evaluate a novel technique for on-line continuous glucose measurement in subcutaneous adipose tissue, and to investigate its accuracy for detection of hypoglycemia. RESEARCH DESIGN AND METHODS The method combined an open-flow microperfusion of subcutaneous adipose tissue using a double lumen catheter and an extracorporeal sensor cell. An isotonic ion-free solution was perfused through the inner lumen of the catheter, equilibrated with the subcutaneous tissue fluid, and sampled through the outer lumen. The recovery was continuously monitored as the ratio between the measured sampled fluid conductivity and the subcutaneous tissue fluid conductivity (assumed to have a constant value of 1.28 S/m at 25°C). Glucose concentration was calculated on-line from the measured glucose in the sampled fluid and the measured recovery in healthy volunteers during hyperglycemic glucose loads (n = 8), hypoglycemic hyperinsulinemic clamp (n = 6), and a 24-h monitoring period (n = 7). RESULTS Subcutaneous glucose concentrations in the fasting state were 94% of the plasma glucose concentrations in arterialized venous samples. According to the error grid analysis, 96.9% of the on-line measured subcutaneous glucose concentrations during hyperglycemia and 96.3% during hypoglycemia were in accurate or acceptable zones. The mean differences between the measured subcutaneous glucose and the actual plasma glucose concentration were −0.06–3.3 mmol/l (hyperglycemia), and −0.6–1.1 mmol/l (hypoglycemia). CONCLUSIONS By combining open-flow microperfusion, glucose sensor, and conductivity measurement, glucose concentration in the subcutaneous adipose tissue can be monitored on-line, extracorporeally, and continuously without any in vivo calibration, and gives accurate measurements during hyper- and hypoglycemia.
p53 gene (Gendicine) and embolisation overcame recurrent hepatocellular carcinoma
Authors: Y S Guan
Journal: Gut (2005)

Transcatheter arterial chemoembolisation (TACE) has become the standard treatment for unresectable hepatocellular carcinoma (HCC). However, this method is often unsuccessful. The p53 gene, which is present as a mutant form in many human tumours, is known to have broad spectrum antitumour effects when expressed normally. In this study, we report a 23 year old patient with recurrent HCC who was treated with the p53 gene (Gendicine) combining TACE, which resulted in a good clinical prognosis.