tbuckley/cabot-search huggingface dataset:
Rapidly Progressive Glomerulonephritis Superimposed on Diabetic Glomerulosclerosis
Authors: Scott A. Carstens
Journal: JAMA (1982)

Two patients with long-standing diabetes mellitus and diabetic retinopathy were evaluated for declining renal function and heavy albuminuria. Initially, diabetic glomerulosclerosis was suspected as the cause of progressive glomerulopathy. However, in both patients the rate of loss of glomerular filtration rate was greater than that usually seen in diabetic glomerulosclerosis, and the urine sediment contained many RBC casts. These findings led to renal biopsy, which demonstrated crescentic glomerulonephritis superimposed on diabetic glomerulopathy. Both patients were treated with prednisone and cyclophosphamide and both experienced substantial improvement in renal function. These experiences demonstrate the importance of searching for evidence of a superimposed treatable glomerulopathy in the diabetic patient with glomerulopathy and advancing renal insufficiency.
ABC of Urology: UROLOGICAL TRAUMA AND BLADDER RECONSTRUCTION
Authors: C. Dawson, H. Whitfield
Journal: BMJ (1996)

Ten per cent of patients with blunt or penetrating injuries of the abdomen have associated renal trauma. Evaluation begins with a history of the mechanism of the injury, which is important for predicting the likely complications. Investigations of likely renal injury must go hand in hand with the investigation of other likely injuries, and vigilance should be maintained at all times.

#### Investigating patients with suspected renal trauma

Patients admitted with severe abdominal injury and shock will need immediate laparotomy. In these patients one shot intravenous urography should be performed in theatre to confirm that both kidneys are functioning. Patients found to have either frank haematuria or microscopic haematuria and clinical shock should ideally be investigated with contrast enhanced computed tomography, which is better than urography in patients with suspected renal trauma. In patients with blunt trauma and microscopic haematuria but normal blood pressure, the incidence of important injury is small, and imaging is not needed. If microscopic haematuria persists for more than six weeks then intravenous urography and cystoscopy should be performed to exclude a coincidental tumour.



Angiograms showing renal trauma before embolisation (top) and after embolisation (bottom).



A different approach is needed in children, in whom no correlation between degree of haematuria and severity of injury has been found. Some studies have stated that all children presenting after trauma with haematuria (whether microscopic or macroscopic) should be investigated with computed tomography as the likelihood of important renal injury is greater …
Simple measures could prevent more than two million child deaths from pneumonia and diarrhoea
Authors: A. Gulland
Journal: BMJ (2012)

More than two million child deaths could be prevented if poorer countries implemented cost effective and available strategies to treat and prevent pneumonia and diarrhoea, says a report from the children’s charity Unicef.

Pneumonia and diarrhoea are responsible for 29% of deaths among children under the age of 5 years worldwide, with that figure standing at 49% in sub-Saharan Africa and 39% in South Asia. Nine out of 10 of all deaths from the two diseases among children occur in these two regions.

About half the world’s deaths from the two diseases are concentrated in five countries—India, Nigeria, the Democratic Republic of Congo, Pakistan, and Ethiopia—and deaths are concentrated in the poorest and most deprived people …
Treatment of Boils with Erythromycin and with Antibiotic E 129
Authors: A. Scott, P. M. Waterworth
Journal: BMJ (1958)

The well-known propensity of strains of Staphylococcus atureus to develop resistance to the effects of bactericidal and bacteriostatic drugs has been a major factor in the search for newer antibiotics.E 129, one of the most recently produced of these, has already been described and tested in the laboratory (Garrod and Waterworth, 1956).The present study records the results of a clinical investigation of this alternative therapeutic agent.Its purpose was to compare the efficacy of E 129 in the treatment of a relatively "standard" clinical infection- a furuncle-with that of an established antistaphylo- coccal antibiotic, erythromycin, to which E 129 is related.In addition to judging therapeutic effect by clinical criteria, laboratory studies were carried out to determine the effect on the staphylococcus itself, and in particular on its sensitivity to each of the antibiotics used in treatment.Methods Patients were a consecutive series, 210 in all, who atten- ded the out-patient department of St. Bartholomew's Hos- pital for the treatment of boils.The period of study occupied the year from February, 1957, to February, 1958.No patients under 16 were treated in this series, largely because of the difficulty presented for children by the ingestion of the large quantity of E 129 tablets (12 daily) during their treatment.The ages ranged from 16 to 67 years, with a mean of 27.There was a slight preponderance of males-3: 2.Several criteria were used to decide whether the patient was suitable for inclusion in this series: (1) the lesion must have been fresh, (2) no treatment of the patient with anti- biotics in the preceding six months, and (3) no secondary space infections (such as may be seen on the hand).Classification of Boils.-(I)Localized infection of diameter under 1 cm., and with no surrounding reaction.(2) Localized infection, larger than above, with minimal adjacent reaction. (Neither of these two groups had any systemic symptoms or signs.) (3)Local infection of diameter over 2.5 cm., with marked surrounding cellulitis, moderate regional lymphadenopathy, some tissue destruc- tion, occasional mild fever. (4)Large area of local infec- tion, with marked peripheral cellulitis, regional lymph- adenopathy, and systemic signs-for example, fever, fatigue.The first part of the study included patients with boils of all four types, but the main series included boils of the last- named two groups only.Therapy.-All patients received local applications of mercury perchloride, 0.1% aqueous solution.In approxi- mate consecutive rotation, therapy was conducted in successive patients with (a) local application alone; (b) erythromycin 250 mg.four times daily per os for seven days; (c) E 129,
Liver is the major source of elevated serum lipocalin‐2 levels after bacterial infection or partial hepatectomy: A critical role for IL‐6/STAT3
Authors: Ming‐Jiang Xu, Dechun Feng, Hailong Wu, Hua Wang, Yvonne Chan, Jay Kolls, Niels Borregaard, Bo Porse, Thorsten Berger, Tak W. Mak, Jack B. Cowland, Xiaoni Kong, Bin Gao
Journal: Hepatology (2014)

Lipocalin‐2 (LCN2) was originally isolated from human neutrophils and termed neutrophil gelatinase‐associated lipocalin (NGAL). However, the functions of LCN2 and the cell types that are primarily responsible for LCN2 production remain unclear. To address these issues, hepatocyte‐specific Lcn2 knockout ( Lcn2 Hep–/– ) mice were generated and subjected to bacterial infection (with Klesbsiella pneumoniae or Escherichia coli) or partial hepatectomy (PHx). Studies of Lcn2 Hep–/– mice revealed that hepatocytes contributed to 25% of the low basal serum level of LCN2 protein (∼62 ng/mL) but were responsible for more than 90% of the highly elevated serum LCN2 protein level (∼6,000 ng/mL) postinfection and more than 60% post‐PHx (∼700 ng/mL). Interestingly, both Lcn2 Hep–/– and global Lcn2 knockout ( Lcn2 –/– ) mice demonstrated comparable increases in susceptibility to infection with K. pneumoniae or E. coli . These mice also had increased enteric bacterial translocation from the gut to the mesenteric lymph nodes and exhibited reduced liver regeneration after PHx. Treatment with interleukin (IL)‐6 stimulated hepatocytes to produce LCN2 in vitro and in vivo . Hepatocyte‐specific ablation of the IL‐6 receptor or Stat3 , a major downstream effector of IL‐6, markedly abrogated LCN2 elevation in vivo . Furthermore, chromatin immunoprecipitation (ChIP) assay revealed that STAT3 was recruited to the promoter region of the Lcn2 gene upon STAT3 activation by IL‐6. Conclusion : Hepatocytes are the major cell type responsible for LCN2 production after bacterial infection or PHx, and this response is dependent on IL‐6 activation of the STAT3 signaling pathway. Thus, hepatocyte‐derived LCN2 plays an important role in inhibiting bacterial infection and promoting liver regeneration. (H epatology 2015;61:692‐702)
Re: Michael Mittenberger, Germar M. Pinggera, Rainer Marksteiner, Eva Margreiter, Raffael Plattner, Günter Klima, Georg Bartsch and Hannes Strasser. Functional and Histological Changes after Myoblast Injections in the Porcine Rhabdosphincter. Eur Urol 2007;52:1736–43
Authors: René Yiou
Journal: European Urology (2007)
Drug industry loses bid to block disclosure of doctors' gifts
Authors: Bob Burton
Journal: BMJ (2007)

NHS Employers, the organisation responsible for employment procedures in the NHS, defended its vetting practices this week after seven doctors and medical students-six in the United Kingdom and one in Australia-were held by police in connection with the failed car bombings in London and Glasgow.One doctor, Iraqi born Bilal Abdullah, who worked as a locum doctor at the Royal Alexandra Hospital, in Paisley, near Glasgow, was arrested at the scene of Saturday's attempt to blow up a jeep packed with gas cylinders at Glasgow airport.Another man detained at the scene with 90% burns is thought to be a junior hospital doctor.He is in the Royal Alexandra Hospital.Later that day, the 26 year old Jordanian born doctor Mohammed Asha and a 27 year old woman, thought to be his wife, were arrested in Sandbach, Cheshire, northwest England.Dr Asha, whose family comes originally from Palestine, had worked as a junior doctor at the Royal Shrewsbury Hospital and the Princess Royal Hospital, in Telford.In a statement NHS Employers said that all NHS hospitals "carry out rigorous checks before they appoint any member of staff, including verification of identity, qualifications, registration, and eligibility to work in the UK."The nature of their work means that staff are dealing with people who are vulnerable, and we need to be confident that patients are safe."It added, "While doing all they can to prevent unsuitable people taking up employment in the NHS, employers also have a duty to look after the rights of their staff, and this includes not discriminating against employees in any way on the grounds of their religion or belief." NHS defends vetting after doctors held for bombing bidsUK NEWS Economist says NICE should approve fewer costly drugs, p11 World NEWS �ost US surgeons in training get needlestic�� in�uries, few report them, p1� �ost US surgeons in training get needlestic�� in�uries, few report them, p1� , p1� bm�.comEgypt tightens ban on female genital mutilation after 1�� year old girl dies Egypt tightens ban on female genital mutilation after 1�� year old girl dies
Antigenic variation of cloned Plasmodium fragile in its natural host Macaca sinica. Sequential appearance of successive variant antigenic types.
Authors: S M Handunnetti, K N Mendis, P H David
Journal: The Journal of Experimental Medicine (1987)

The course of infection of Plasmodium fragile in its natural host, the toque monkey Macaca sinica, consists of a primary peak of parasitemia followed by several distinct, successive peaks of lower parasitemia. In the S+ host, the late intraerythrocytic asexual developmental stages of P. fragile induce the expression of antigens on the surface of infected erythrocytes, which could be detected using the technique of surface immunofluorescence. Immunofluorescence using unfixed erythrocytes in suspension has shown that antigens are recognized by immune serum on the surface of the erythrocytes infected with more mature stages of the parasite. These antigens undergo variation, each successive peak of parasitemia being characterized by a different variant antigenic type (VAT). The appearance of the successive VATs occurs in a sequential manner, following the same order in different sets of animals. This constitutes the first example of a sequential expression of antigens in a malaria parasite; it indicates that, in P. fragile, antigenic variation is not the result of random mutations selected by antibody. Parasite-induced antigens on the surface of infected erythrocytes could not be detected in the S- host. However, when nonexpressing parasites from the S- host were transferred by blood passage into a naive S+ animal, they began to express antigens on the surface of infected erythrocytes within two erythrocytic cycles. We have demonstrated that the ability of S- parasites to switch to a particular VAT when passaged into a S+ animal changes during the course of an infection in the S- animal, indicating that, although surface antigens are not expressed, the processes leading to antigenic variation occurs even in the S- host. Antibodies directed against these surface antigens inhibit the growth of intra-erythrocytic parasites. The growth inhibition effects of antibodies are also variant specific, indicating that these variant surface antigens are functionally important for parasite survival.
Importance of Functional Measures in Predicting Mortality Among Older Hospitalized Patients
Authors: Sharon K. Inouye
Journal: JAMA (1998)

Measures of physical and cognitive function are strong prognostic predictors of hospital outcomes for older persons, but current risk adjustment and burden of illness assessment indices do not include these measures.To evaluate and validate the contribution of functional measures to the ability of 5 standard burden of illness indices (Charlson, Acute Physiology and Chronic Health Evaluation [APACHE] II, Disease Staging, All Patient Refined Diagnosis Related Groups, and a clinician's subjective rating) in predicting 90-day and 2-year mortality among older hospitalized patients.Two prospective cohort studies.General medicine service, university teaching hospital.For the development cohort, 207 consecutive patients aged 70 years or older, and for the validation cohort, 318 comparable patients.Death within 90 days and 2 years from the index admission.In the development cohort, 29 patients (14%) and 81 patients (39%) died within 90 days and 2 years, respectively. A functional axis was developed using 3 independent risk factors: impairment in instrumental activities of daily living, Mini-Mental State Examination score of less than 20, and shortened Geriatric Depression Scale score of 7 or higher, creating low-, intermediate-, and high-risk groups with associated mortality rates of 20%, 32%, and 60%, respectively (P<.001); the C statistic for the final model was 0.69. The corresponding mortality rates in the validation cohort, in which 59 (19%) and 138 (43%) died within 90 days and 2 years, respectively, were 24%, 45%, and 60% (P<.001); the C statistic for the final model was 0.66. For each burden of illness index, the functional axis contributed significantly to the predictive ability of the model for both 90 days and 2 years. When the functional axis and each burden of illness measure were analyzed in cross-stratified format, mortality rates increased progressively from low-risk to high-risk functional groups within strata of burden of illness indices (double-gradient phenomenon). The contributions of functional and burden of illness measures were substantive and interrelated.Functional measures are strong predictors of 90-day and 2-year mortality after hospitalization. Furthermore, these measures contribute substantially to the prognostic ability of 5 burden of illness indices. Optimal risk adjustment for older hospitalized patients should incorporate functional status variables.
Proposed American Medical Insurance Company.
Authors: W. P. Whery
Journal: JAMA (1905)

Fort Wayne, Ind., June 1, 1905. <h3>To the Editor:</h3> —In view of the approaching meeting of the American Medical Association, I wish to make a suggestion in regard to the relief of the "wounded soldiers of the war"—that is, those of our profession who, through age, illness, accident or other not discreditable cause, have been reduced to exiguous circumstances at the closing of their careers. Probably the best way by which this philanthropic purpose can be accomplished is by the organization of an American medical insurance company. We note many large companies handling vast sums of money and making immense profits. If members of the Association were generally interested in an insurance company of their own they could make it a great success, as they have accumulated a great fund of valuable experience relating to insurance matters. Part of the profits of the company might be used in paying small
Diagnostic Reliability of Radionuclide Ventriculography in Detecting Left Ventricular Hypertrophy Echocardiographic and ECG Correlations
Authors: WILLIAM T. POCHIS, B. DAVID COLLIER, ALI T. ISITMAN, ROBERT S. HELLMAN, DAVID W. PALMER, ARTHUR Z. KRASNOW, L SAM WANN, JANET M. KNOBEL
Journal: Clinical Nuclear Medicine (1992)

Left ventricular hypertrophy (LVH) is frequently present in patients referred for radionuclide ventriculography (RVG) for evaluation of left ventricular function. During interpretation of these studies, the nuclear medicine physician may have the subjective impression that increased septal thickening is present because of the abnormally prominent separation of the right and left ventricular blood pools. To examine the diagnostic reliability of this finding, we retrospectively reviewed the RVG studies of 43 consecutive patients and correlated the finding of subjectively increased septal thickness with established echocardiographic (ECHO) criteria and commonly used electrocardiographic (ECG) indices of LVH. Using standard ECHO measurements of septal thickness as a gold standard, RVG interpretation of septal thickening demonstrated a sensitivity of 0.69, specificity of 0.70, and accuracy of 0.70. When compared with standard ECG criteria for LVH, RVG performed quite favorably in the diagnosis of LVH confirmed by ECHO left ventricular mass index. We conclude that scintigraphic evidence of LVH should be reported when RVG studies are interpreted.
Heme Oxygenase-1 Expression in Human Lungs with Cystic Fibrosis and Cytoprotective Effects against <i>Pseudomonas Aeruginosa In Vitro</i>
Authors: Hailan Zhou, Fuhua Lu, Christopher Latham, Dani S. Zander, Gary A. Visner
Journal: American Journal of Respiratory and Critical Care Medicine (2004)

Inflammation and oxidative stress play important roles in cystic fibrosis (CF) lung disease. Inflammatory/oxidant-mediated induction of heme oxygenase-1 (HO-1) is believed to be a cytoprotective response. This study examined HO-1 expression in lung samples from patients with CF using immunohistochemistry and quantitative reverse transcription-polymerase chain reaction. In addition, we evaluated myeloperoxidase staining as a marker of acute inflammation and potentially an increase in oxidant stress and Prussian blue and ferritin staining to assess iron status of the lung. Macrophage HO-1 staining was increased in diseased lungs as compared with normal control subjects and correlated with myeloperoxidase staining. Quantitative reverse transcription-polymerase chain reaction further supported an increase in HO-1 expression in CF lung disease. Although iron staining was minimal, ferritin staining was increased in diseased lungs in concert with HO-1 staining. To determine whether HO-1 induction was cytoprotective, we evaluated a CF airway epithelial cell line, IB3.1, in response to Pseudomonas aeruginosa–induced injury/apoptosis in cells overexpressing HO-1 by either transient or stable transfection of pcDNA3.1/HO-1 construct. Overexpression of HO-1 resulted in protection against P. aeruginosa–induced injury/apoptosis. This suggests that the induction of HO-1 in patients with CF is a cytoprotective event and that augmenting its expression is a potential therapy against bacterial injury.
Morphology of the Human Mitral Valve
Authors: N. RANGANATHAN, J. H. C. LAM, E. D. WIGLE, M. D. SILVER
Journal: Circulation (1970)

Fifty normal mitral valves from adults were studied. Commissures, identified by commissural chordae tendineae and the tips of papillary muscles, partition the mitral valvular tissue into anterior and posterior leaflets. This definition incorporates into the posterior leaflet the structures formerly regarded as accessory leaflets. The posterior leaflet is further divided into scallops by clefts in its tissue. Cleft chordae provide a guide to these interscallop indentations or clefts. Partitioned this way, the posterior leaflet was tri-scalloped in 46 hearts. In 42, a large middle scallop was present with two smaller scallops on either side. Rough and clear zones can be defined on the anterior leaflet and rough, clear, and basal zones on the posterior leaflet.
Short-contact modification of the Ingram regime
Authors: K.S. RYATT, B.N. STATHAM, N.R. ROWELL
Journal: British Journal of Dermatology (1984)

"Minutes' (30 minutes) and "short-contact' (2 hours) therapy with dithranol in Lassar's paste were compared (using a paired comparison method) with the Ingram regime in twenty-one and twelve patients respectively. Both "minutes' and "short-contact' regimes were effective in clearing psoriasis; the latter was the more effective of the two and proved just as good as the standard Ingram regime of 24-hour application. "Short-contact' therapy with dithranol in Lassar's paste should therefore reduce out-patient attendance and time off work, save valuable nursing time and allow a more social life.
Clearance of severe psoriasis after allogenic bone marrow transplantation.
Authors: D J Eedy, D Burrows, J M Bridges, F G Jones
Journal: BMJ (1990)

Case report A 36 year old white man had a 20 year history of severe intractable psoriasis that required numerous admissions to hospital for inpatient treatment. He had long periods of erythrodermic psoriasis and underwent many forms of treatment, including psoralens and ultraviolet A, methotrexate, razoxane, and etretinate, in an attempt to control his psoriasis. In November 1984 he developed acute myelomonocytic leukaemia; remission was speedily induced using combined chemotherapy with cytarabine, daunorubicin, and thioguanine. His leukaemia remitted, but he continued to suffer severe psoriasis requiring treatment with methotrexate. In August 1985 he was conditioned for an allogenic bone marrow transplant with cyclophosphamide 60 mg/kg twice and total body irradiation with 14 Gy given in seven fractions. He received a bone marrow transplant from his brother, who did not suffer from psoriasis. The bone marrow T cells in this transplant were depleted using monoclonal antibodies MBG6 and RFT8, and depletion was greater than 99%. Immediately after the bone marrow transplantation his psoriasis disappeared entirely, and he remained free of it despite cessation of cytotoxic and immunosuppressive therapy. In October 1986 he suffered a relapse of acute myelomonocytic leukaemia. He received a further bone marrow transplant from his brother (this time without depletion of T cells) without induction of remission after chemotherapy with cytarabine and cyclophosphamide. He received cyclosporin at a dose of 400 mg/day after the transplant; the dose was tapered gradually and stopped after 10 months. Since the initial bone marrow transplant he has remained completely free of psoriasis, and he has had no further relapse of his myelomonocytic leukaemia. DNA tvping performed on peripheral lymphocvtes confirmed chimerism, with the DNA type being that of donor.