tbuckley/cabot-search huggingface dataset:
Rituximab for Refractory Wegener's Granulomatosis
Authors: Karina A. Keogh, Steven R. Ytterberg, Fernando C. Fervenza, Kimberly A. Carlson, Darrell R. Schroeder, Ulrich Specks
Journal: American Journal of Respiratory and Critical Care Medicine (2005)

Rationale: Standard therapy for Wegener's granulomatosis is fraught with substantial toxicity and not always effective. B lymphocytes have been implicated in the pathogenesis of Wegener's granulomatosis. Their depletion has been proposed as salvage therapy for refractory disease. Earlier encouraging reports are confounded by concomitant immunosuppressive medications and include only limited available biomarker data.Objectives: To evaluate the efficacy and safety of rituximab for remission induction in refractory Wegener's granulomatosis.Methods: A prospective open-label pilot trial was conducted with 10 patients monitored for 1 yr. Included were patients with active severe antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis, ANCA positivity, and resistance to (or intolerance of) cyclophosphamide. The remission induction regimen consisted of oral prednisone (1 mg/kg/d) and four weekly infusions of rituximab (375 mg/m2). Prednisone was tapered and discontinued over 5 mo. Failure to achieve remission, a clinical flare in the absence of B lymphocytes, and inability to complete the glucocorticoid taper were considered treatment failures.Main Results: Three women and seven men (median age, 57 yr; range, 25–72 yr) were enrolled. All had ANCA reacting with proteinase-3. The median activity score at enrollment was 6 (range, 5–10). All patients tolerated rituximab well, achieved swift B-lymphocyte depletion and complete clinical remission (activity score, 0) by 3 mo, and were tapered off glucocorticoids by 6 mo. Five patients were retreated with rituximab alone for recurring/rising ANCA titers according to protocol. One patient experienced a clinical flare after B lymphocyte reconstitution.Conclusion: In this cohort, rituximab was a well-tolerated and effective remission induction agent for severe refractory Wegener's granulomatosis.
A Wind in Africa: A Story of Modern Medicine in Mali
Authors: Marjorie C. Meehan
Journal: JAMA (1976)

That smallpox was caused by an evil genie who sent the illness out with the wind was what most of the 4.8 million inhabitants of the west African country, Mali, believed in 1966. This belief was but one of the many factors that made Dr Imperato's task difficult when the US Agency for International Development and the Center for Disease Control sent him to Mali to eradicate smallpox and control measles. One fourth of the people of Mali were wandering nomads of three different racial and cultural groups. The remainder were mainly subsistence farmers and small traders of several racial groups, with minimal education and varying religious backgrounds— animist, Moslem, or Christian. The annual average income was $60. The climate varied between hot and humid and hot and dry, with some cold nights. The government of this newly independent country was Marxist, with strong ties to mainland China and considerable
Understanding the psychological processes involved in the demobilizing effects of positive cross-group contact
Authors: Nicole Tausch, Julia C. Becker
Journal: Behavioral and Brain Sciences (2012)

A theoretical framework is required that explains why and how cross-group contact reduces collective action and how the demobilizing effects can be counteracted. We propose that at least two mechanisms are involved: an affective process whereby the positive affect created offsets negative emotions and action tendencies, and a more strategic process whereby individual advancement comes to seem like a possibility.
TCT-434 Implantation of Sirolimus-Eluting Stent in Patients with Vasospastic Angina Deteriorates Late Catch-Up Phenomenon
Authors: Naoki Oka, Kazushige Kadota, Tsuyoshi Goto, Yasushi Fuku, Hiroyuki Tanaka, Seiji Habara, Tahei Ichinohe, Kazuaki Mitsudo
Journal: Journal of the American College of Cardiology (2012)
Dominance, sexual activity, and sexual emotions
Authors: John Marshall Townsend
Journal: Behavioral and Brain Sciences (1998)

Men's interest in sex partners' status traits and commitment (investment thoughts) declines with number of sex partners and permissiveness of attitudes; women's investment thoughts do not seem to decline. Testosterone, dominance, sexual attractiveness, and number of sex partners are correlated in men but not in women. It is plausible that these sex differences are part of sexually dimorphic feedback systems. This type of feedback is consistent with both reciprocal and basal models of testosterone.
An “Inexcusable” Case of Muscle Rigidity and Shortness of Breath
Authors: Stuart Smalheiser, Deborah A. Levine
Journal: Annals of Internal Medicine (2004)

Letters20 July 2004An “Inexcusable” Case of Muscle Rigidity and Shortness of BreathStuart Smalheiser, MD and Deborah A. Levine, MDStuart Smalheiser, MDFrom University of Alabama at Birmingham, Birmingham, AL 35243.Search for more papers by this author and Deborah A. Levine, MDFrom University of Alabama at Birmingham, Birmingham, AL 35243.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-2-200407200-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Editor's Note:The lead author of the following Clinical Observation was one of a dozen Associates of the American College of Physicians selected to present a clinical vignette at the 2003 Annual Session in Philadelphia. We are proud to present this case report through a special arrangement with the Council of Associates of the College.TO THE EDITOR:A 60-year-old man reported to the emergency department with shortness of breath. Three weeks before admission, the patient was in his usual state of good health when he sustained a left arm laceration from barbed wire trauma. The wound became red, hot, and ...References1. Pascual FB, McGinley EL, Zanardi LR, Cortese MM, Murphy TV. Tetanus surveillance–United States, 1998–2000. MMWR Surveill Summ. 2003;52:1-8. [PMID: 12825541] MedlineGoogle Scholar2. Edsall G. Editorial: The inexcusable disease. JAMA. 1976;235:62-3. [PMID: 946007] CrossrefMedlineGoogle Scholar3. Centers for Disease Control. Influenza, pneumococcal, and tetanus toxoid vaccination of adults–United States, 1993–1997. MMWR Surveill Summ. 2000;49:39-62. Google Scholar4. Gergen PJ, McQuillan GM, Kiely M, Ezzati-Rice TM, Sutter RW, Virella G. A population-based serologic survey of immunity to tetanus in the United States. N Engl J Med. 1995;332:761-6. [PMID: 7862178] CrossrefMedlineGoogle Scholar5. McQuillan GM, Kruszon-Moran D, Deforest A, Chu SY, Wharton M. Serologic immunity to diphtheria and tetanus in the United States. Ann Intern Med. 2002;136:660. [PMID: 11992301] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Stuart Smalheiser, MD; Deborah A. Levine, MDAffiliations: From University of Alabama at Birmingham, Birmingham, AL 35243. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSerologic Immunity to Diphtheria and Tetanus in the United States Geraldine M. McQuillan , Deanna Kruszon-Moran , Adamadia Deforest , Susan Y. Chu , and Melinda Wharton Metrics 20 July 2004Volume 141, Issue 2Page: 162-163KeywordsDyspneaMusclesRespiratory rateStiffnessTemperatureTetanusToxoidsVaccination and immunizationVaccinesVentilators ePublished: 20 July 2004 Issue Published: 20 July 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Peptides Naturally Presented by MHC Class I Molecules
Authors: H G Rammensee, K Falk, O Rötzschke
Journal: Annual Review of Immunology (1993)

Exhausted CD8 T (Tex) cells are a distinct cell lineage that arise during chronic infections and cancers in animal models and humans. Tex cells are characterized by progressive loss of effector functions, high and sustained inhibitory receptor expression, ...Read More
What Atul Gawande teaches us about dying
Authors: N. Ladher
Journal: BMJ (2014)

Doctors and the public need to discuss ageing and death more openly

In the wake of the Black Death guides to ars moriendi— the art of dying—became popular across Europe.1 These manuals gave practical instructions for death in keeping with the Christian values of the time: how to prepare for dying stoically and unafraid, and how to resist the temptations of despair and a lack of faith. There were even sections for friends and family providing guidance on deathbed etiquette and prayers for the bereaved.

In his most recent book, Being Mortal , surgeon, writer, and researcher Atul Gawande turns his attention to the modern experience of ageing and dying.2 Through interviews, studies, and stories—some deeply personal—he examines what it is like to grow old and face death at a time when medicine has more tools than ever to help us live longer. In his recent Reith lectures (a series of lectures broadcast annually on the BBC, listened to by millions) Gawande discussed the “great unfixables” of ageing …
Treated and Untreated Recurrent Calcium Nephrolithiasis in Patients with Idiopathic Hypercalciuria, Hyperuricosuria, or No Metabolic Disorder
Authors: FREDRIC L. COE
Journal: Annals of Internal Medicine (1977)

Two hundred two recurrent calcium oxalate stone-forming patients with idiopathic hypercalciuria or hyperuricosuria, or both, were treated for an average of 2.91 years (1 to 7 years) with thiazide or allopurinol, or both. The frequency of new stone formation was drastically reduced. During the treatment period of 625 patient years, 220.0 new stones should have occurred, whereas 22 were actually formed (chi-square=178, P less than 0.001). Thirty-four patients without discernible metabolic disturbances and treated only with increased fluid intake and dietary advice formed 29 new stones compared to a predicted 33.2 stones (87.3%). Thirty similar patients treated with thiazide and allopurinol formed six stones compared to a predicted 31.8, P less than 0.001. Chronic reversal of idiopathic hypercalciuria and hyperuricosuria with thiazide and allopurinol is an effective way to prevent recurrent calcium oxalate stones. Conservative measures are only of marginal effectiveness in treating metabolically normal stone forming patients; however, thiazide and allopurinol appear to decrease new stone formation.
Sorbinil and Limited Joint Mobility in Diabetics
Authors: Arlan L. Rosenbloom
Journal: JAMA (1985)

To the Editor.—  It is unfortunate that Eaton et al, 1 having recognized that their patients were remarkably similar to the 23 reported by Jung et al, 2 did not then use the appropriate terminology coined by that group—  hand syndrome. Instead, they chose to use the term limited joint mobility [LJM], which has had a very specific application to a painless and nondisabling condition in young patients with diabetes, typically during and after adolescence and following five years' duration of diabetes. 3 There are a variety of joint syndromes affecting the hand in persons with diabetes, particularly adults. To look at all joint contracture in persons with diabetes as being the same syndrome leads to the sort of muddled hypothesis formation of Eaton et al 1 in their effort to explain what appears to be a neuropathic disorder (the diabetic hand syndrome), which should respond to aldose reductase
Superior vena caval stenosis: a complication of transvenous endocardial pacing.
Authors: D M Matthews, J C Forfar
Journal: Thorax (1979)

Superior vena caval obstruction is a rare complication of transvenous endocardial pacing and is usually the result of thrombus formation round the pacing electrode (Kosowsky and Barr, 1972). We report a case of superior vena caval obstruction without thrombus formation secondary to localised stenosis at the site of the proximal cut end of a retracted endocardial electrode. This complication of transvenous pacing electrodes has not been described previously.
Arteriographic Changes in Femoropopliteal Arteriosclerosis Obliterans
Authors: Arnold G. Coran, Richard Warren
Journal: New England Journal of Medicine (1966)

Nineteen limbs in 15 patients with atherosclerosis obliterans of the femoral artery causing intermittent claudication were studied by serial arteriography. A total of 109 arteriograms were obtained. The shortest span between the first and last arteriogram in an individual patient was five, and the longest nine years. Progression of symptoms was noted in only 2 limbs. There were 2 deaths, 1 from pulmonary disease and 1 from a cerebrovascular or cardiovascular accident. There were no amputations. Progression of atherosclerotic lesions was seen arteriographically in 14 limbs and was absent in 5. Progression was noted in the upper segment (the one subjected to full arterial pressure) in all the 14 limbs that showed progression. Only 2 limbs showed progression in the lower segment also. It was observed that in the majority of cases, the gradual progression of the atherosclerotic process centripetally from the block in the lower extremity was not dangerous to the limb because of the continuing development of collateral circulation. The suggestion is made that the segment below the block is relatively protected from atherosclerotic progression because it is not accessible to mainstream flow and pressure. It is further theorized (though not proved by these data) that when centrifugal progression occurs, it is, by virtue of its greater opportunity to cut off collateral circulation, more likely than centripetal progression to endanger the limb.
PTH-055 Uss Small Bowel For Crohn’s Disease – Single Centre Experience In Medium Sized Dgh
Authors: M Usman-Saeed, T Skouras, T Patani, J Whalley, S Khalid
Journal: Gut (2014)

<h3>Introduction</h3> USS (Ultra sound scan) in experienced hands is good radiological modality in diagnosing, confirming or ruling out Crohn’s disease. USS is easy, cost effective and without risk of radiation as compared to CT (Computerised tomography) or MRI (Magnetic resonance imaging) scans. USS can be particularly useful in younger population with Crohn’s who may require repeated imaging. We were interested to look at outcomes of USS of small bowel performed by dedicated GI (gastrointestinal) radiologist in our hospital. <h3>Methods</h3> We audited efficacy of USS in patients with known, suspected or to exclude Crohn’s disease. A retrospective review of patient records using specialised electronic Medicorr and PACS databases was performed. Demographic information, diagnosis, procedural details and subsequent result of USS was entered into a Microsoft Access database and analysed using Microsoft Excel. <h3>Results</h3> A total of 145 patients underwent USS of small bowel in 18 months. The average age was 40. There were 97 females and 48 males. USS was performed in fifty seven patients with known, twenty four suspected and in 64 patients to exclude Crohn’s disease. In known disease group thirty four (60%) had normal USS (these patients were in remission), and twenty three (40%) had USS findings consistent with active, small or large bowel disease, strictures, fistulating disease and abscesses. For suspected group, 17 patients (70%) had normal and seven (30%) had features consistent with Crohn’s. Five of these positive scan patients had MRI scans. 2 MRI scans confirmed USS findings, 3 were normal and required endoscopic confirmation. In exclusion group 64 had USS with 61 (95%) normal and 3(4%) abnormal. Findings of 3 abnormal scan showed gallbladder polyp, caecal thickening (colonoscopy confirmed caecal tumour) and non- specific ileitis with negative colonoscopy and histology. <h3>Conclusion</h3> Our results show that USS is reliable and as good as other imaging if done by experienced radiologist with special interest in GI radiology. USS is cost effective, readily available and free of radiation. It is cheap, portable, flexible and user- and patient-friendly. It can save cost and time required for CT and MRI scan especially in district general hospital. We recommend utilising USS small bowel to assess disease activity in known cases and also to confirm or exclude the disease provided experienced GI radiologist is available. <h3>References</h3> 1 Nylund K, Ødegaard S <i>et al</i>. Sonography of the small intestine. <i>World J Gastroenterol</i> 2009;15(11):1319–1330 2 Parente F, Greco S <i>et al</i>. Modern Imaging of crohn’s disease using bowel ultrasound. <i>Inflamm Bowel Dis</i> 2004; 10(4):452–461 <h3>Disclosure of Interest</h3> None Declared.
FREQUENCY AND IMPACT OF PRIOR MYOCARDIAL INFARCTION AMONG PATIENTS WITH ACUTE MYOCARDIAL INFARCTION TREATED IN CONTEMPORARY PRACTICE: RESULTS FROM THE NCDR®
Authors: Lan Shen, Bimal Shah, Aro Nam, DaJuanicia Holmes, Karen Alexander, Deepak Bhatt, P. Michael Ho, Eric Peterson, Matthew Roe
Journal: Journal of the American College of Cardiology (2013)
Fractal Analysis of the Vascular Tree in the Human Retina
Authors: Barry R. Masters
Journal: Annual Review of Biomedical Engineering (2004)

▪ Abstract The retinal circulation of the normal human retinal vasculature is statistically self-similar and fractal. Studies from several groups present strong evidence that the fractal dimension of the blood vessels in the normal human retina is approximately 1.7. This is the same fractal dimension that is found for a diffusion-limited growth process, and it may have implications for the embryological development of the retinal vascular system. The methods of determining the fractal dimension for branching trees are reviewed together with proposed models for the optimal formation (Murray Principle) of the branching vascular tree in the human retina and the branching pattern of the human bronchial tree. The limitations of fractal analysis of branching biological structures are evaluated. Understanding the design principles of branching vascular systems and the human bronchial tree may find applications in tissue and organ engineering, i.e., bioartificial organs for both liver and kidney.
Concordant lymphoma of cutaneous anaplastic large cell lymphoma and systemic B-cell leukaemia
Authors: H. Sato, Y. Nakamura, T. Takahashi, F. Otsuka
Journal: British Journal of Dermatology (2007)

Journal Article Concordant lymphoma of cutaneous anaplastic large cell lymphoma and systemic B‐cell leukaemia Get access H. Sato, H. Sato Department of Dermatology, University of Tsukuba, 1‐1‐1 Ten‐nodai, Tsukuba, Ibaraki 305‐8575, Japan Search for other works by this author on: Oxford Academic Google Scholar Y. Nakamura, Y. Nakamura Department of Dermatology, University of Tsukuba, 1‐1‐1 Ten‐nodai, Tsukuba, Ibaraki 305‐8575, Japan Search for other works by this author on: Oxford Academic Google Scholar T. Takahashi, T. Takahashi Department of Dermatology, University of Tsukuba, 1‐1‐1 Ten‐nodai, Tsukuba, Ibaraki 305‐8575, Japan Search for other works by this author on: Oxford Academic Google Scholar F. Otsuka F. Otsuka Department of Dermatology, University of Tsukuba, 1‐1‐1 Ten‐nodai, Tsukuba, Ibaraki 305‐8575, Japan E‐mail: c0530311@md.tsukuba.ac.jp Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 157, Issue 5, 1 November 2007, Pages 1060–1061, https://doi.org/10.1111/j.1365-2133.2007.08174.x Published: 01 November 2007
Improved tumor-targeting drug delivery and therapeutic efficacy by cationic liposome modified with truncated bFGF peptide
Authors: Xiang Chen, Xianhuo Wang, Yongsheng Wang, Li Yang, Jia Hu, Wenjing Xiao, Afu Fu, Lulu Cai, Xia Li, Xia Ye, Yalin Liu, Wenshuang Wu, Ximing Shao, Yongqiu Mao, Yuquan Wei, Lijuan Chen
Journal: Journal of Controlled Release (2010)
Medical Efforts Intensify in Desert Storm's Fourth Week
Authors: Phil Gunby
Journal: JAMA (1991)

THE SPECTER of Desert Storm ground combat is intensifying military medical efforts. The surgeons general of the US Air Force, Army, Navy, and the medical officer of the US Marine Corps say they are pleased with the quantity, quality, and mix of skills of physicians and other medical team members in the theater of operations and in follow-up care facilities. But they emphasize that they are continuing to assess the medical situation day by day. Like all physicians involved, these military medical leaders are aware of the 3-km-wide obstacle course of 5-m-high sand-berm barriers, coiled razor-sharp wire, 7-m-deep antitank ditches, barbed wire, mine fields, and dug-in armored vehicles and artillery along the 180-km front that faces coalition ground forces. They and their Desert Storm physicians have spent the time available to them in preparing for how to treat wounds inflicted by the Soviet-made AK-47 weapons (with which the world's fourth-largest
Phase-trafficking reagents and phase-switching strategies for parallel synthesis
Authors: Daniel L. Flynn
Journal: Medicinal Research Reviews (1999)

Strategies for the parallel synthesis of small molecule arrays are reviewed with an emphasis on those approaches that integrate the sciences of organic synthesis and product purification. The use of phase-trafficking reagents (PTRs) and phase-switching strategies are highlighted, which allow the rapid, parallel synthesis of small molecule arrays with built-in purification determinants. © 1999 John Wiley & Sons, Inc. Med Res Rev, 19, No. 5, 408–431, 1999.
Dexamethasone in Tuberculous Meningitis
Authors: RICHARD D. O'TOOLE
Journal: Annals of Internal Medicine (1969)

Dexamethasone was administered for 4 weeks in a double-blind manner as an adjunct to isoniazid and streptomycin treatment in 11 of 23 patients with moderately advanced or severe tuberculous meningitis. Five of 11 steroid-treated patients and 3 or 12 concurrent control patients survived. Serial observation of cerebrospinal fluid (CSF) changes showed that significantly fewer steroid-treated patients exhibited elevated pressures by the fourth day of therapy. This improvement in pressures was associated clinically with a decreased incidence of the herniation syndrome during the first 72 hr in hospital. CSF leukocyte counts and CSF sugar and protein concentrations returned toward normal values more rapidly in steroid-treated patients; however, it was not possible to correlate these findings with improvement in morbidity or mortality. Gastrointestinal blood loss and hypothermia were encountered more frequently among patients treated with steroids. It was concluded that, despite the striking impact of dexamethasone on CSF, the only CSF effect that could be related to improved survival was attenuation of cerebral edema. The administration of steroids in high doses appears to be clearly indicated in the management of cerebral edema associated with tuberculous meningitis.
Abstract 11262: Dutch Phospholamban Founder Mutation Associated with Left-Dominant Arrhythmogenic Phenotype
Authors: Judith A Groeneweg, Paul A van der Zwaag, Jan D Jongbloed, Moniek G Cox, Jeroen F van der Heijden, Maarten J Cramer, Pieter A Doevendans, J. P van Tintelen, Dennis Dooijes, Richard N Hauer
Journal: Circulation (2011)

Introduction: Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is considered to be an inherited, primarily right ventricle (RV) disease due to desmosomal gene mutations. However, ...