tbuckley/cabot-search huggingface dataset:
A REPORT ON ANTIMENINGITIS VACCINATION AND OBSERVATIONS ON AGGLUTININS IN THE BLOOD OF CHRONIC MENINGOCOCCUS CARRIERS
Authors: Frederick L. Gates
Journal: The Journal of Experimental Medicine (1918)

1. A meningococcus vaccine suspended in salt solution has been given subcutaneously as a prophylactic to about 3,700 volunteers in three injections of 2,000 million, 4,000 million, and 4,000 or 8,000 million cocci at weekly intervals. 2. These doses rarely caused more than the mildest local and general reactions. Exceptionally a more severe reaction emphasized the presence of an unusual individual susceptibility to the vaccine. In such instances the symptoms were in part those of meningeal irritation and sometimes simulated the onset of meningitis. 3. Specific meningococcus agglutinins have been demonstrated in the blood serum of vaccinated men as compared with normal controls. 4. Moreover, agglutinins have been demonstrated in the blood serum of chronic carriers of the meningococcus. Evidence is thus brought forward that the relative immunity of chronic carriers to epidemic meningitis may be due to the presence of specific antibodies in the blood stream.
Withholding Information from Patients — When Less Is More
Authors: Ronald M. Epstein, David N. Korones, Timothy E. Quill
Journal: New England Journal of Medicine (2010)

As clinicians who strongly value truth telling and active patient involvement in medical decision making,1 we have lately been reflecting on the circumstances in which physicians consciously (and sometimes unconsciously) withhold from patients information about their conditions, treatments, and outcomes. The ethical principle of autonomy would suggest that patients should always be fully informed, not only so that they can make the best possible decisions, but also because information helps them to make sense of and cope with illness. However, since information can sometimes increase patients' cognitive and emotional burden and lead to greater confusion rather than clarity, the right . . .
The phosphoserine-585–dependent pathway of the GM-CSF/IL-3/IL-5 receptors mediates hematopoietic cell survival through activation of NF-κB and induction of bcl-2
Authors: Mark A. Guthridge, Emma F. Barry, Fernando A. Felquer, Barbara J. McClure, Frank C. Stomski, Hayley Ramshaw, Angel F. Lopez
Journal: Blood (2003)
India concerned at export of genetic material
Authors: G. Mudur
Journal: BMJ (1996)

Indian geneticists have asked their government to regulate the flow of human genetic material, blood samples, and tissues flown out of India under joint research projects with foreign institutions. The geneticists are worried that biological samples from Indian patients are being siphoned out of the country for genetic studies without adequate guarantees that India will derive commercial benefits that might spring from such research.

The Indian Society for Human Genetics is drafting guidelines instructing scientists to sign formal agreements before entering into research collaborations that involve the transfer of …
Hepatotoxicity Associated With Antiretroviral Therapy in Adults Infected With Human Immunodeficiency Virus and the Role of Hepatitis C or B Virus Infection
Authors: Mark S. Sulkowski
Journal: JAMA (2000)

ContextUse of antiretroviral drugs, including protease inhibitors, for treatment of human immunodeficiency virus (HIV) infection has been anecdotally associated with hepatotoxicity, particularly in persons coinfected with hepatitis C or B virus.ObjectivesTo ascertain if incidence of severe hepatotoxicity during antiretroviral therapy is similar for all antiretroviral drug combinations, and to define the role of chronic viral hepatitis in its development.DesignProspective cohort study.SettingUniversity-based urban HIV clinic.PatientsA total of 298 patients who were prescribed new antiretroviral therapies between January 1996 and January 1998, 211 (71%) of whom received protease inhibitors as part of combination therapy (median follow-up, 182 days) and 87 (29%) of whom received dual nucleoside analog regimens (median follow-up, 167 days). Chronic hepatitis C and B virus infection was present in 154 (52%) and 8 (2.7%) patients, respectively.Main Outcome MeasureSevere hepatotoxicity, defined as a grade 3 or 4 change in levels of serum alanine aminotransferase and aspartate aminotransferase, evaluated before and during therapy.ResultsSevere hepatotoxicity was observed in 31 (10.4%) of 298 patients (95% confidence interval [CI], 7.2%-14.4%). Ritonavir use was associated with a higher incidence of toxicity (30%; 95% CI, 17.9%-44.6%). However, no significant difference was detected in hepatotoxicity incidence in other treatment groups, ie, nucleoside analogs (5.7%; 95% CI, 1.2%-12.9%), nelfinavir (5.9%; 95% CI, 1.2%-16.2%), saquinavir (5.9%; 95% CI, 0.15%-28.7%), and indinavir (6.8%; 95% CI, 3.0%-13.1%). Although chronic viral hepatitis was associated with an increased risk of severe hepatotoxicity among patients prescribed nonritonavir regimens (relative risk, 3.7; 95% CI, 1.0-11.8), most patients with chronic hepatitis C or B virus infection (88%) did not experience significant toxic effects. Rate of severe toxicity with use of any protease inhibitor in patients with hepatitis C infection was 12.2% (13/107; 95% CI, 6.6%-19.9%). In multivariate logistic regression, only ritonavir (adjusted odds ratio [AOR], 8.6; 95% CI, 3.0-24.6) and a CD4 cell count increase of more than 0.05 × 109/L (AOR, 3.6; 95% CI, 1.0-12.9) were associated with severe hepatotoxicity. No irreversible outcomes were seen in patients with severe hepatotoxicity.ConclusionsOur data indicate that use of ritonavir may increase risk of severe hepatotoxicity. Although hepatotoxicity may be more common in persons with chronic viral hepatitis, these data do not support withholding protease inhibitor therapy from persons coinfected with hepatitis B or C virus.
Of middle years and white coats
Authors: V. S Sankar
Journal: BMJ (2002)

You're told it's important to go for a “medical” when you turn 40. I'm not sure how many do. I guess the reluctance to go is really because you don't want to accept the arrival of your “middle years.” You feel well; you certainly don't feel middle aged (even though your son is getting taller than your shoulders, and recently you've wondered if you need glasses for reading small print and doing procedures like siting an umbilical catheter).

I think what got me moving was the reminder from occupational health that my levels of hepatitis B antibodies needed checking, and I thought, “Why not throw in a few ‘routine' tests?” I was relieved to find none of the numbers was bad except for a highish cholesterol concentration. Then I wondered about the vague, frequent headaches that I seemed to have; I …
Activated Protein C for Sepsis
Authors: Susanne Toussaint, Herwig Gerlach
Journal: New England Journal of Medicine (2009)

A 55-year-old man presents with a small-bowel perforation, and sepsis develops. Treatment with recombinant human activated protein C is recommended. Activated protein C inhibits the procoagulant state in sepsis and may also inhibit the systemic inflammatory response. The clinical benefit and recommendations for use of recombinant human activated protein C are controversial. The risk of bleeding is increased with use of the drug.
Prognostic Impact of Node Involvement Pattern in pN1 Non-small Cell Lung Cancer Patients
Authors: Masayuki Nakao, Junji Yoshida, Genichiro Ishii, Akikazu Kawase, Ryo Maeda, Keiju Aokage, Tomoyuki Hishida, Mitsuyo Nishimura, Kanji Nagai
Journal: Journal of Thoracic Oncology (2010)
Histophysiology of Synapses and Neurosecretion
Authors: L. M. Bach
Journal: JAMA (1965)

Events and structures fundamental to nervous-system function emerge from their previously invisible and unknown state through progress in electron microscopy. It is highly appropriate that this excellent compendium, and also assessment, of our knowledge should be set forth by de Robertis, who, with his colleagues, has pioneered many of these advances in electron microscopy of the central nervous system. The book, which is written in a refreshingly straightforward style, is divided into major sections, the first of which deals with junctional transmission in the motor endplate and in various types of synapses. Fascinating glimpses into the ultrastructure of the transmission process emphasize the relationship of the microvesicles to the acetylcholine choline-acetylase system. Apparently other less-evident transmitter substances, such as norepinephrine, serotonin, and γ-amino butyric acid, as well as some of the enzymes associated with these, are generally related to the mitochondria. The second section of the book is concerned with
The Relationship Between Quality, Spending, and Outcomes Among Women With Breast Cancer
Authors: Michael J. Hassett, Bridget A. Neville, Jane C. Weeks
Journal: JNCI Journal of the National Cancer Institute (2014)

Substantial shortcomings in the quality of breast cancer (BC) care have been identified. While breast cancer is responsible for the largest share of cancer care spending, little is known about the value of care provided to US women with BC.For women aged 65 to 70 years diagnosed July 1997 through December 2005 with stage 0-III BC who were continuously enrolled in fee-for-service Medicare, we evaluated performance relative to 20 measures recommending for proven therapies and seven measures recommending against unnecessary therapies. Using health care service area as the unit of analysis, we characterized quality for recommended and unnecessary therapies, median per-patient cost in the year after diagnosis for Medicare parts A and B, and five-year overall survival. We analyzed the relationships between quality, cost, and survival. All statistical tests were two-sided.We assessed the care provided to 15357 women and compiled quality, cost, and outcomes data for 99 regions. The median number of patients/region was 85 (interquartile range = 47-158); the five-year overall survival was 87.5%. Part B expenditure correlated positively with measures of recommended therapy (P = .027) and negatively with measures of unnecessary therapy (P = .004). Survival did not correlate with quality or cost. Regions demonstrating lower quality for both recommended and unnecessary therapy measures exhibited higher part A expenditure.BC patients experience wide variation in quality, cost, and survival. Process measures that assess recommended and unnecessary therapies did not correlate with survival, but did shed light on spending for related and unrelated services. Additional efforts to identify factors that impact the relationships between quality, cost, and outcomes are needed.
Authors' response to editorial
Authors: M. J. Bolland, A. Grey, I. R. Reid
Journal: BMJ (2011)

We disagree with the editorial accompanying our recent paper on calcium, vitamin D, and cardiovascular risk.1 2

The primary analyses in our 2010 meta-analysis counted people not events.3 The increased risk of myocardial infarction should not be discounted because the P value for the increased risk of the composite cardiovascular end point was 0.057. Analysis by fifths of dietary calcium intake …
ANTIBODY-MEDIATED SUPPRESSION OF GRAFTED LYMPHOMA CELLS
Authors: Hyun S. Shin, Nathan Kaliss, David Borenstein, Maurice K. Gately
Journal: The Journal of Experimental Medicine (1972)

Specific alloantibody admixed with a grafted murine lymphoma is suppressive of the graft in mice of the inbred strain native to the tumor. Suppressive capacity of the host is obviated in mice given 500 R whole body irradiation before tumor inoculation but is restored when normal peritoneal macrophages are admixed with the tumor-antibody inoculum. Other normal cell types admixed with the tumor-antibody inoculum are not effective in restoring suppressive capacity.
The effects of postnatal health education for mothers on infant care and family planning practices in Nepal: a randomised controlled trial
Authors: A. Bolam, D. S Manandhar, P. Shrestha, M. Ellis, A. M d. L Costello
Journal: BMJ (1998)

<h3>Abstract</h3> <b>Objectives:</b> To evaluate impact of postnatal health education for mothers on infant care and postnatal family planning practices in Nepal. <b>Design:</b> Randomised controlled trial with community follow up at 3 and 6 months post partum by interview. Initial household survey of study areas to identify all pregnant women to facilitate follow up. <b>Setting:</b> Main maternity hospital in Kathmandu, Nepal. Follow up in urban Kathmandu and a periurban area southwest of the city. <b>Subjects:</b> 540 mothers randomly allocated to one of four groups: health education immediately after birth and three months later (group A), at birth only (group B), at three months only (group C), or none (group D). <b>Interventions:</b> Structured baseline household questionnaire; 20 minute, one to one health education at birth and three months later. <b>Main outcome measures:</b> Duration of exclusive breast feeding, appropriate immunisation of infant, knowledge of oral rehydration solution and need to continue breast feeding in diarrhoea, knowledge of infant signs suggesting pneumonia, uptake of postnatal family planning. <b>Results:</b> Mothers in groups A and B (received health education at birth) were slightly more likely to use contraception at six months after birth compared with mothers in groups C and D (no health education at birth) (odds ratio 1.62, 95% confidence interval 1.06 to 2.5). There were no other significant differences between groups with regards to infant feeding, infant care, or immunisation. <b>Conclusions:</b> Our findings suggest that the recommended practice of individual health education for postnatal mothers in poor communities has no impact on infant feeding, care, or immunisation, although uptake of family planning may be slightly enhanced. <h3>Key messages</h3> Health education is widely promoted in primary care, but there have been few rigorous evaluations of its impact, especially in developing countries A randomised controlled trial of postnatal individual health education for mothers given by trained female health workers showed no significant impact on maternal knowledge and practices of child care or on infant health outcomes, but there was a small improvement in uptake of family planning at six months after birth The efficacy of health education interventions that rely solely on giving people information to bring about a change in health behaviour is unproved; interventions should be evaluated before being implemented on a large scale Alternative strategies for health promotion in developing countries such as interactions within families, peer groups, or communities may be more effective but are costly and difficult to implement on a large scale
Activation of HIV expression by CD30 triggering in CD4+ T cells from HIV-infected individuals
Authors: Enrico Maggi, Francesco Annunziato, Roberto Manetti, Roberta Biagiotti, Maria Grazia Giudizi, Adriana Ravine, Fabio Almerigognat, Norman Soiani, Mark Alderson, Sergio Romagnani
Journal: Immunity (1995)
Low dose methotrexate pneumonitis in rheumatoid arthritis.
Authors: S Louie, G A Lillington
Journal: Thorax (1986)

The antimetabolite drug methotrexate has recently been used in the treatment of rheumatoid arthritis refractory to conventional antirheumatic drugs.1-3 The doses of methotrexate used in such cases are much lower than those used in the treatment of malignancy or skin disorders. Instances of diffuse interstitial pneumonitis apparently related to the use of methotrexate in such low doses are uncommon.45 We report a case in which diffuse pneumonitis developed after low weekly and low accumulative doses of methorexate and which showed spontaneous resolution after the drug had been discontinued.
Points from Letters: Electrocardiography and the Family Doctor
Authors: D. R. Thomas
Journal: BMJ (1970)

<h3>Introduction</h3> Refinement of intracranial aneurysm rupture risk estimations may improve patient selection for preventive treatment. Dynamical scans may highlight reduced stability of the vessel wall. <h3>Aim of Study</h3> The magnitude of pulsations is unknown, but are thought to be smaller than the CT resolution. Noise and artefacts impede reliable measurement. The aim of this study is to quantify the cardiac cycle-related pulsations of intracranial vessels and aneurysms, and to compare patterns of different cardiac cycles. <h3>Methods</h3> 4D CTA scans (Aquilion One PRISM Edition, Canon Medical Systems Corporation, Otawara, Japan) of three consecutive heartbeats were obtained in 15 patients harboring an intracranial aneurysm (rotation time= 0.275s, tube current= 340 mA, tube voltage= 100kV). Reconstructions of every 5% of the R-R interval were obtained using retrospective cardiac gating. A reference mesh was created per subject to compare segmentations of different cardiac phases. A periodogram was created for the mean pulsatile pattern of a vessel and an aneurysm segment. <h3>Results</h3> 15 patients with 19 unruptured and untreated aneurysms with a mean diameter of 5.8 ± 6.3 mm (mean ± std) were scanned, resulting in a mean CTDIvol of 76 [64 94] mGy (mean [min max]). Frequency analysis revealed an artefact with a frequency similar to the gantry rotation frequency. Furthermore, pulsations with frequencies similar to the heart rate were found in the vessel and aneurysm segments. <h3>Conclusions</h3> The role of inter-cardiac cycles comparison and frequency analysis is essential for the differentiation between real pulsations and pulsations induced by noise or artefacts on dynamic CTA. <h3>Disclosure</h3> Nothing to disclose
Accountability and House Staff
Authors: PASCAL JAMES IMPERATO
Journal: Annals of Internal Medicine (1984)

Letters and Corrections1 March 1984Accountability and House StaffPASCAL JAMES IMPERATO, M.D.PASCAL JAMES IMPERATO, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-100-3-456_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In its position paper on evaluation of humanistic qualities in the internist (1), the Subcommittee on Evaluation of Humanistic Qualities in the Internist of the American Board of Internal Medicine states, "Reimbursement regulations shift responsibility for patients from residents to attending physicians and other faculty physicians. Although this shift may create better role models in faculties, residents may lose a sense of accountability."There is no law of nature that decrees that residents cannot learn accountability in the presence of responsible supervision. Too often the alleged need to teach accountability and the development of self-confidence to residents...References1. . Evaluation of humanistic qualities in the internist. Ann Intern Med. 1983;99:720-4. LinkGoogle Scholar2. . Part B Payments for Services of Supervising Physicians in a Teaching Setting, Bureau of Health Insurance Intermediary Letter No. 372. Baltimore: Department of Health, Education and Welfare; 1969. Google Scholar3. Medicare program; payment for physician services furnished in hospitals, skilled nursing facilities, and comprehensive outpatient rehabilitation facilities; combined billing; final rule. Federal Register. 1983;48, 171:39740-4. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: PASCAL JAMES IMPERATO, M.D.Affiliations: Downstate Medical Center Brooklyn, N.Y. 11203 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 March 1984Volume 100, Issue 3Page: 456-457 ePublished: 1 December 2008 Issue Published: 1 March 1984 PDF downloadLoading ...
Transcriptional control of myocardial connexins
Authors: B Teunissen
Journal: Cardiovascular Research (2004)

Rapid spreading of the electrical impulse throughout the heart is essential for coordinated contraction and is mediated by electrical coupling of cardiomyocytes through gap junction channels composed of connexin40 (Cx40), connexin43 (Cx43) or connexin45 (Cx45). Each of these connexin proteins has a characteristic developmental and regional expression pattern in the heart. Alterations in this pattern may result in abnormal cellular coupling and consequently contribute to irregularities in cardiac rhythm. Indeed, alterations in cardiac connexin expression have been correlated with cardiovascular disease for which the molecular mechanisms, however, are largely unknown. Transcription factors and their target elements in the genome regulate the expression of genes during development and in response to extracellular signals in a cell type-specific and quantitative manner. Altered transcriptional regulation of gene expression is a characteristic feature in the development of cardiac disease which may influence the connexin expression pattern as well. In this review, we will summarize what is known on transcriptional regulation of the Cx40, Cx43 and Cx45 genes in general, with an emphasis on the heart.
Renal dysfunction in chronic hepatitis B patients treated with adefovir dipivoxil
Authors: Nghi B. Ha, Nghiem B. Ha, Ruel T. Garcia, Huy N. Trinh, Andrew A. Vu, Huy A. Nguyen, Khanh K. Nguyen, Brian S. Levitt, Mindie H. Nguyen
Journal: Hepatology (2009)

Renal dysfunction has been reported in patients treated with adefovir dipivoxil (ADV); however, its incidence and clinical importance may be underappreciated given the lack of long-term follow-up and data outside of a clinical trial setting. Our goal was to examine the severity and incidence of renal dysfunction in a real-life setting for patients treated with ADV and whose baseline estimated glomerular filtration rate (eGFR) was >50 mL/minute. We performed a cohort study of 290 chronic hepatitis B patients: 145 patients treated with 10 mg ADV and 145 patients unexposed to ADV at two community clinics, who were matched for age (+/-10 years), sex, and baseline eGFR. The exposed and unexposed populations were well-matched with a similar mean age (46-47 years), proportion of male patients (76.5%), baseline serum creatinine (0.97-0.99 mg/dL), and baseline creatinine clearance (85.0-85.4 mL/minute). The incidence density for renal dysfunction defined by treatment termination and/or development of eGFR < or =50 mL/minute was five cases per 100 patient-years in the exposed group compared with 1.36 cases per 100 patient-years in the unexposed group (P = 0.02). The relative risk of exposed to unexposed was 3.68 (95% confidence interval 1.1-19.3). On Cox proportional hazard analysis also inclusive of sex, ADV was a significant predictor of significant renal dysfunction (hazard ratio [HR] 3.94, P = 0.03). There were also significant trends for age >50 years (HR 3.49, P = 0.087), mild renal impairment at baseline (HR 4.49, P = 0.073), and hypertension and/or diabetes mellitus (HR 2.36, P = 0.074).ADV is an independent predictor for significant deterioration of renal function. Patients on ADV should be monitored, especially patients who are older, have baseline renal insufficiency, or have hypertension and/or diabetes mellitus.