tbuckley/cabot-search huggingface dataset:
Diagnostic Testing for 2009 Pandemic Influenza A (H1N1) Virus Infection in Hospitalized Patients
Authors: Tim Uyeki
Journal: New England Journal of Medicine (2009)

Establishing a diagnosis of 2009 pandemic influenza A (H1N1) virus infection in hospitalized patients can be challenging, especially in patients presenting late in their clinical course. Although real-time reverse-transcriptase polymerase chain reaction (RT-PCR) is the most sensitive testing method to detect 2009 H1N1 virus in respiratory specimens,1 results are not accessible right away. Influenza antigen–detection tests produce quick results, but reported sensitivities of rapid influenza diagnostic tests (RIDTs) to detect 2009 H1N1 virus infection in upper respiratory specimens as compared with real-time RT-PCR range from 10 to 70%; therefore, false negative RIDT results are common2 and also occur with direct . . .
Shedding new light on genetic dark matter
Authors: Nadine Melhem, Bernie Devlin
Journal: Genome Medicine (2010)

Discoveries from genome-wide association studies have contributed to our knowledge of the genetic etiology of many complex diseases. However, these account for only a small fraction of each disease's heritability. Here, we comment on approaches currently available to uncover more of the genetic 'dark matter,' including an approach introduced recently by Naukkarinen and colleagues. These authors propose a method for distinguishing between gene expression driven by genetic variation and that driven by non-genetic factors. This dichotomy allows investigators to focus statistical tests and further molecular analyses on a smaller set of genes, thereby discovering new genetic variation affecting risk for disease. We need more methods like this one if we are to shed a powerful light on dark matter. By enhancing our understanding of molecular genetic etiology, such methods will help us to understand disease processes better and will advance the promise of personalized medicine.
A Protest Against Over-Treatment in Eczema
Authors: M. Morris
Journal: BMJ (1895)

TREATMENT IN ECZEMA.[. BoLsm 195 of water were put into test tubes and sterilised in an autoclave.They were then inoculated with cholera microbes that had been cultivated for some days previously in very dilute peptone solutions.Immediately after the addition a test was made to see how many cholera microbes were present in a cubic centimetre of each of the specimens of water.At intervals other similar tests were carried out.The results are shown in the chart.It will be seen that ( 1) in Agra municipal water the cholera microbe nearly or com- pletely dies out within two days, (2) that in Zemzem water on the other hand the cholera microbe reproduces vigorously.
Childhood Asthma and Increased Airway Responsiveness
Authors: Stephen W. Turner, Sally Young, Jack Goldblatt, Louis I. Landau, Peter N. Le Souëf
Journal: American Journal of Respiratory and Critical Care Medicine (2008)

Asthma is associated with increased airway responsiveness (AR), but the age when this relationship becomes established is not clear. The present study tested the hypothesis that the association between increased AR and asthma is established after 1 month of age.To relate AR in infancy to asthma in childhood.As part of a birth cohort study, AR was determined at 1 (early infancy), 6 (mid-infancy), and 12 months of age (late infancy). At 11 years of age (childhood), AR and the presence of asthma symptoms were determined.Of the 253 study subjects enrolled, AR was determined in 202 in early infancy, 174 in mid-infancy, 147 in late infancy, and 176 in childhood. Increased AR in late infancy, but not in early or mid-infancy, was associated with increased wheeze at 11 years of age (P = 0.016). Increased AR in infancy persisted into childhood in association with male gender, early respiratory illness, and maternal smoking and asthma. Among the 116 subjects assessed in late infancy and childhood, recent wheeze was present in 35% of children with increased AR at both ages, 13% with increased AR in childhood only, 12% for those with increased AR in late infancy only, and 0% for those who did not have increased AR at either age (P = 0.023); the proportions of children with diagnosed asthma in the corresponding groups were 27, 20, 12, and 0% (P = 0.038).The association between increased infantile AR and childhood asthma emerges at the end of the first year of life.
Non-surgical management of peripheral vascular disease
Authors: J H Barber
Journal: BMJ (1980)

for cure of hypertension, and a further 48% and 30°' respectively for improvement (for example, easier medical control of blood pressure).We have recently performed percutaneous dilatation in two patients with severe renal artery stenosis, one a 37-year-old female with a two-year history of poorly controlled hypertension, and the other a 50-year-old female with a similar five-year history.They have since been normotensive on no treatment after six and three months respectively, and there were no complications.Clearly, long-term follow-up is needed; but it does appear that in selected cases trans- luminal angioplasty is a very effective technique.Advantages include avoidance of general anaesthetic and a major surgical procedure, shortened hospital stay, and decreased cost.It can be repeated if necessary, and in the event of failure surgical treatment is not precluded.In the future, therefore, the method will probably receive more than a passing mention in articles on the treatment of arterial disease.
ENTEROPTOSIS—THE PHYSICIAN'S VIEWPOINT
Authors: J. H. MUSSER
Journal: JAMA (1910)

It is possible that there has been an exaggeration of the importance of congenital gastroenteroptosis as a factor in the production of symptoms. Investigations by modern methods, as the<i>x</i>-ray, show that this ptosis is of frequent occurrence when not suspected. The individual is without symptoms unless some complication, as an inflammatory lesion, arises. Independently of such complication, if symptoms are present, they can be demonstrated to be due to other factors. These factors of ill health in the large proportion of cases are the result of antagonistic environmental conditions, which in an individual handicapped by congenital insufficiencies, are not met by healthful reactions of the organism. In consequence the organism is overwhelmed. The environmental conditions are those which make for effeminacy in our life. Modern types of living, overstimulation of the nervous system by all forms of excitement, improper diet, foolish amusements, excesses and irregularities of all kinds
Electrocardiographic Interpretation: A Self-Study Approach to Electrocardiography
Authors: Bernard A. Kats
Journal: JAMA (1992)

In 1903, in Batavia, Java, Dutch East Indies, Willem Einthoven devised the first string galvanometer. It enabled him to measure electrical action currents (potential differences) of cyclical depolarization and repolarization waves of contracting heart muscle and to record them graphically from the surface of the body. He hypothesized that the heart constitutes an electrical dipole, lying at the center of an equilateral triangle. This hypothesis was supported by R. P. Grant, the father of spatial vector cardiography, but has been proved wrong since. Little did Einthoven know the extent to which his new invention would alter the practice of medicine. Electrocardiography has become an indispensable tool for all clinicians. Einthoven served as professor of physiology at my alma mater, the Rijksuniversiteit of Leiden in the Netherlands. When he applied his invention to the first actual patient at the Academic Hospital at the edge of the city and laid a cable
Renin and acute renal failure.
Authors: D E Barnardo
Journal: BMJ (1970)

culation is indicated by our findingsl 2 that in blood obtained from the uterine veins this factor was greater than that in the arterial blood.Plasminogen activator levels were estimated by the euglobulin lysis time (E.L.T.) method.3Evidence supporting our findings is provided by the observations published by bination of phenformin-stanozolol is as Maki et al.4These workers, investigating the fibrinolytic activity in blood from the vasa efferentia of the uterus and comparing it with that in blood from a cubital vein, found that this activity was considerably increased in the blood from the uterus.They suggested that this constituted indirect evidence that the uterus contributed activators to the systemic circulation.Moreover, in a comparative study of blood from a uterine vein and a uterine artery in 14 patients, Cash,5 using the E.L.T. method, found marked increased fibrinolytic activity in the former.-Iam, etc.,
Assessment of brain tissue injury after moderate hypothermia in neonates with hypoxic–ischaemic encephalopathy: a nested substudy of a randomised controlled trial
Authors: Mary Rutherford, Luca A Ramenghi, A David Edwards, Peter Brocklehurst, Henry Halliday, Malcolm Levene, Brenda Strohm, Marianne Thoresen, Andrew Whitelaw, Denis Azzopardi
Journal: The Lancet Neurology (2009)

Moderate hypothermia in neonates with hypoxic-ischaemic encephalopathy might improve survival and neurological outcomes at up to 18 months of age, although complete neurological assessment at this age is difficult. To ascertain more precisely the effect of therapeutic hypothermia on neonatal cerebral injury, we assessed cerebral lesions on MRI scans of infants who participated in the Total Body Hypothermia for Neonatal Encephalopathy (TOBY) trial.In the TOBY trial hypoxic-ischaemic encephalopathy was graded clinically according to the changes seen on amplitude integrated EEG, and infants were randomly assigned to intensive care with or without cooling by central telephone randomisation. The relation between allocation to hypothermia or normothermia and cerebral lesions was assessed by logistic regression with perinatal factors as covariates, and adjusted odds ratios (ORs) were calculated. The TOBY trial is registered, number ISRCTN 89547571.325 infants were recruited in the TOBY trial between 2002 and 2006. Images were available for analysis from 131 infants. Therapeutic hypothermia was associated with a reduction in lesions in the basal ganglia or thalamus (OR 0.36, 95% CI 0.15-0.84; p=0.02), white matter (0.30, 0.12-0.77; p=0.01), and abnormal posterior limb of the internal capsule (0.38, 0.17-0.85; p=0.02). Compared with non-cooled infants, cooled infants had fewer scans that were predictive of later neuromotor abnormalities (0.41, 0.18-0.91; p=0.03) and were more likely to have normal scans (2.81, 1.13-6.93; p=0.03). The accuracy of prediction by MRI of death or disability to 18 months of age was 0.84 (0.74-0.94) in the cooled group and 0.81 (0.71-0.91) in the non-cooled group.Therapeutic hypothermia decreases brain tissue injury in infants with hypoxic-ischaemic encephalopathy. The predictive value of MRI for subsequent neurological impairment is not affected by therapeutic hypothermia.UK Medical Research Council; UK Department of Health.
Folate Absorption and Malabsorption
Authors: Howard L. Bleich, Emily S. Boro, Irwin H. Rosenberg
Journal: New England Journal of Medicine (1975)

FOLATE deficiency, probably the most common vitamin deficiency in this country, often occurs as a complication of gastrointestinal disease or of therapy with certain drugs. Like several other vitamins, folate exists in a variety of natural forms, and the study of folic acid represents a fascinating chapter in medical history. After its basic structure was described in 1945,1 more than a dozen previously identified and seemingly unrelated growth principles or antianemia factors, including Wills's "new hematopoietic principle," observed in 1931, factors R and S and vitamins M, Bc, B10 and B11, were recognized as free . . .
Physician Shortage in Occupational and Environmental Medicine
Authors: Joseph S. Castorina
Journal: Annals of Internal Medicine (1990)

Objective: To determine future training needs for physicians in occupational and environmental medicine based on goals established by the Institute of Medicine (IOM) for clinical practice in the field. Design: A critical review of previously published estimates of the need and supply of physicians with clinical training in occupational and environmental medicine with the application of currently available data to produce revised estimates. Measurements and Main Results: Need estimates reviewed from the National Institute for Occupational Safety and Health, the Graduate Medical Education National Advisory Committee (GMENAC), and the Bureau of Health Professions. Supply figures reviewed from GMENAC, the American Medical Association, the American College of Occupational Medicine, and the American Board of Preventive Medicine. Revised need figures are based on the estimated number of occupational and environmental physicians needed to provide adequate nationwide coverage as full-time academic faculty, community-based specialists, and public health physicians in state and local agencies. Revised supply estimates are based on review of available data. Need is estimated at 4600 to 6700 physicians (board-certified or eligible or with special competence in occupational and environmental medicine). Supply is estimated at 1200 to 1500. Conclusions: This review identified a deficit of 3100 to 5500 physicians in this newly evolving specialty. In order to address this shortfall in the next decade, graduate specialty training would need to be increased to about 3 to 5 times the current maximum capacity.
Antibiotic treatment in Reiter's syndrome.
Authors: D K Ford
Journal: Annals of the Rheumatic Diseases (1979)

Unfortunately there are virtually no hard data to support a scientific discussion of the place of antibiotic treatment in Reiter's syndrome (RS).Almost inevitably, therefore, such a discussion is susceptible to philosophical analogies, clinical impressions, or emotional beliefs.Nevertheless, it ought to be possible to achieve a consensus on the practical questions ofwhat antibiotic, in what dosage, and for what period of time should be employed, if at all, in the management of cases of the disease.The following points can be made as a basis for a work- shop discussion.(1) All students of RS would probably agree that no antibiotic has a direct effect on the arthritis, and that no discernible change in the arthritis can be attributable to any antibiotic within several weeks of such therapy.This 'fact' does not, however, exclude the use of antibiotics, because one has only to turn to rheumatic fever to appreciate that, while penicillin has no direct effect whatever on the arthritis of rheumatic fever, it has a definite role in the manage- ment of cases.It is in this latter type of usage that antibiotic therapy may be rational.(2) Patients with RS precipitated by intestinal infections such as dysentery or yersinia presumably require a course of antibiotics that would eradicate the responsible pathogen.Preferences might vary between microbiologists, and also might be determined by antibiotic sensitivity testing, but ampicillin or tetracycline would probably be generally acceptable.(3) Patients with RS that has been unquestionably precipitated by a venerally acquired non-gonococcal urethritis would logically receive a course of tetracylcine or erythromycin to eradicate either Chlamydia or Ureaplasmas.One or other of these organisms would be present in the urethra in 70 °/-90% of cases.These organisms might or might not be aetiologically related to the arthritis, but their capacity for causing urethritis is now becoming generally accepted.To eradicate them from the copyright.
Clinical Pharmacology: Basic Principles in Therapeutics
Authors: Ronald C. DeConti
Journal: JAMA (1972)

This text is intended to relate practical therapeutics to the basic sciences of pharmacology, physiology, biochemistry, and pathophysiology. Designed to teach a greater understanding of drug therapy to medical students, house staff, and practicing physicians alike, it demonstrates a consistent approach to the intelligent use of drugs. The beginning unit emphasizes the basic principles of drug administration. The second and major portion of the text considers the use of specific drugs in disorders of various organ systems. Factors of disease and particular drugs are related so that the dynamics of pharmacology and pathophysiology can be formulated in the therapeutic plan. Having recognized the objectives of therapy, the third unit of the text stresses the need for observing, recognizing, and properly evaluating the effects of drug therapy. Finally, the fourth unit utilizes the clinical case method to demonstrate application of the principles discussed throughout the book. This text is not intended
CCR7 and CXCR4 as Novel Biomarkers Predicting Axillary Lymph Node Metastasis in T1 Breast Cancer
Authors: Neslihan Cabioglu, M. Sertac Yazici, Banu Arun, Kristine R. Broglio, Gabriel N. Hortobagyi, Janet E. Price, Aysegul Sahin
Journal: Clinical Cancer Research (2005)

Abstract Purpose: The chemokine receptors CCR7 and CXCR4 have been shown to play an important role in cancer metastasis. We therefore studied the differential expression of CCR7 and CXCR4, along with that of the biomarker HER2-neu, to evaluate whether these biomarkers could predict axillary lymph node metastasis in breast cancer. Experimental Design: Biomarker expression levels were evaluated using paraffin-embedded tissue sections of lymph node–negative (n = 99) and lymph node–positive (n = 98) T1 breast cancer by immunohistochemical staining. Results: Lymph node–positive tumors showed higher rates of high cytoplasmic CCR7 staining (21.5% versus 8.5%, P = 0.013) and HER2-neu overexpression (21.5% versus 9.3%, P = 0.019) than did lymph node–negative tumors. Similarly, high cytoplasmic CXCR4 expression occurred more commonly in lymph node–positive tumors (11.2% versus 5.1%, P = 0.113). In contrast, predominantly nuclear CXCR4 staining was more likely to be found in lymph node–negative tumors (54.5% versus 37.8%, P = 0.018). Furthermore, cytoplasmic CXCR4 coexpressed with HER2-neu was the only factor associated with involvement of four or more lymph nodes (16.7% versus 1.2%, P = 0.04) among lymph node–positive tumors. When all three biomarkers (CCR7, CXCR4, HER2-neu) were utilized together, 50.0% of lymph node–positive tumors highly expressed one of these biomarkers compared with 18.8% of the lymph node–negative tumors (P &amp;lt; 0.0001). Conclusions: Our results suggest that the chemokine receptor CCR7 is a novel biomarker that can predict lymph node metastases in breast cancer. Utilization of additional markers, such as CXCR4 and HER2-neu, further improves the prediction of the presence and extent of lymph node involvement.
Type-IV hypersensitivity to betamethasone valerate and clobetasol propionate: results of a multicentre study
Authors: S. Sommer, S.M. Wilkinson, J.S.C. English, D.J. Gawkrodger, C. Green, C.M. King, S. Powell, J.E. Sansom, S. Shaw
Journal: British Journal of Dermatology (2002)

Summary Background Most studies investigating steroid allergy have been performed with tixocortol pivalate, hydrocortisone butyrate and budesonide. Betnovate® and Dermovate® are widely prescribed in the U.K. but little is known about the frequency of sensitization to them. Objectives To determine the optimum method to detect contact allergy to betamethasone valerate (BV) and clobetasol propionate (CP). Methods Seven centres tested consecutive patients attending for investigation of suspected allergic contact dermatitis to these steroids at a range of concentrations in different vehicles. Results Of 1562 patients tested, 16 (1%) reacted to either BV or CP. Ten patients (0·7%) reacted to BV and 13 (0·8%) to CP. Two patients of a further centre were included in analysis of dilutions and vehicles. Sixteen of a total of 25 reactions (64%) were identified with a 1% dilution in ethanol. Conclusions Consideration should be given to adding BV and CP to a standard allergy series, given that both are frequently used in the treatment of eczema and that most patients sensitized to them are not identified with currently used markers of steroid allergy. If patch tests to BV and CP are initially negative, but an allergy is suspected, the patient should be further investigated. Further studies are required to identify the ideal patch test material.
1055 Health-related quality of life assessment in hereditary hemochromatosis
Authors: J TALWALKAR, H TORGERSON, M MALINCHOC, D BRANDHAGEN
Journal: Hepatology (2003)

Mitochondrial dysfunction and oxidative damage, often accompanied by elevated intracellular iron levels, are pathophysiological features in a number of neurodegenerative processes. The question arises as to whether iron dyshomeostasis is a consequence of mitochondrial dysfunction. Here we have evaluated the role of Iron Regulatory Protein 1 (IRP1) in the death of SH-SY5Y dopaminergic neuroblastoma cells subjected to mitochondria complex I inhibition. We found that complex I inhibition was associated with increased levels of transferrin receptor 1 (TfR1) and iron uptake transporter divalent metal transporter 1 (DMT1), and decreased levels of iron efflux transporter Ferroportin 1 (FPN1), together with increased 55Fe uptake activity and an increased cytoplasmic labile iron pool. Complex I inhibition also resulted in increased oxidative modifications and increased cysteine oxidation that were inhibited by the iron chelators desferoxamine, M30 and Q1. Silencing of IRP1 abolished the rotenone-induced increase in 55Fe uptake activity and it protected cells from death induced by complex I inhibition. IRP1 knockdown cells presented higher ferritin levels, a lower iron labile pool, increased resistance to cysteine oxidation and decreased oxidative modifications. These results support the concept that IRP1 is an oxidative stress biosensor that mediates iron accumulation and cell death when deregulated by mitochondrial dysfunction. IRP1 activation, secondary to mitochondrial dysfunction, may underlie the events leading to iron dyshomeostasis and neuronal death observed in neurodegenerative disorders with an iron accumulation component.
Fatal primary pulmonary hypertension in a 30‐yr-old female with APECED syndrome
Authors: L. Korniszewski, M. Kurzyna, B. Stolarski, A. Torbicki, A. Smerdel, R. Ploski
Journal: European Respiratory Journal (2003)

Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) is caused by mutations in the autoimmune regulator (AIRE) gene, which has a central function in maintaining immunological tolerance. A number of conditions with proven or likely autoimmune pathogenesis occur in APECED: hypoparathyroidism, adrenocortical insufficency, candidiasis, hypogonadism, type 1 diabetes, hypothyroidism, hypophysitis, hepatitis, malabsorption, nail dystrophy, enamel hypoplasia and keratopathy. It is not clear which factors are responsible for variation in clinical picture of APECED, but human leukocyte antigen (HLA) genotype may be important. The authors report the first description of a case of primary pulmonary hypertension (PPH) in patient with APECED, caused by R257X mutation in AIRE. The HLA genotype of the patient (DRB1*01/DRB1*11, DQB1*0301/DQB1*0501) has been previously reported as a predisposing factor to PPH. The findings from this study, provided that other similar cases are reported, suggest that immune deregulation plays a role in the pathogenesis of primary pulmonary hypertension.