tbuckley/cabot-search huggingface dataset:
Cardiovascular effects of training for a marathon run in unfit middle aged men.
Authors: I N Findlay, R S Taylor, H J Dargie, S Grant, A R Pettigrew, J T Wilson, T Aitchison, J G Cleland, A T Elliott, B M Fisher
Journal: BMJ (1987)

The effects of a 30 week exercise programme on serum lipid values, blood pressure, and cardiac function were assessed in a group of sedentary men aged 35-50 training for their first marathon. Mean serum cholesterol concentration (n = 33) fell by 12% from 6.54 (SE 0.18) to 5.76 (0.15) mmol/l (mean fall 0.78 mmol/l; 95% confidence interval 0.52 to 1.04 mmol/l), serum triglyceride concentration (n = 33) by 22% from 1.56 (0.17) to 1.21 (0.09) mmol/l (mean fall 0.34 mmol/l; 95% confidence interval 0.12 to 0.56 mmol/l), and mean blood pressure (n = 27) by 10% from 102 (2) to 92 (2) mm Hg (mean fall 10 mm Hg; 95% confidence interval 7 to 13 mm Hg). These changes were not explained by changes in body composition. Peak exercise left ventricular end diastolic volume (n = 16) increased with training; as a result of this and an increased exercise left ventricular ejection fraction peak exercise cardiac output increased from 19.9 (1.2) to 23.1 (3.0) l/min (mean rise 3.2 l/min; 95% confidence interval 1.5 to 5.0 l/min). Maximum oxygen consumption increased from 33.9 (1.6) to 39.0 (1.3) ml/kg/min (mean rise 5.0 ml/kg/min; 95% confidence interval 1.8 to 8.2 ml/kg/min). This study showed favourable effects on coronary risk factors and cardiac function and supports the place of regular exercise in coronary prevention programmes.
Effect of Acute Diuresis on Aldosterone Secretion in Edematous Patients
Authors: E. A. Espiner, P. I. Jagger, J. R. Tucci, D. P. Lauler
Journal: New England Journal of Medicine (1969)

In nine separate studies on four patients with severe pitting edema, aldosterone secretion fell during a 24-hour period of acute salt and water depletion induced by diuretics. These results contrast with those on two patients already rendered edema free as well as with previous studies in normal subjects, in whom aldosterone secretion rose during a comparable diuresis. Although other explanations are possible, these results are consistent with the hypothesis that increased delivery of sodium to the distal segments of the nephron may reduce the stimulus to aldosterone secretion, provided the plasma-volume compartment of the extracellular fluid is not greatly depleted.
The Atopic Dermatitis Questionnaire (ADQ): A 5-minute, Easy-to-use Parent Administered Atopic Dermatitis (AD) Scoring Tool For Home-based Follow Up Compares Well With The SCORAD
Authors: K.D. Carel, M.D. Klinnert, K. Kelsay, A. Kelley-Day, N. Miyazawa, E. Gyorkos, K. Walsh, S. Solanyk, E.W. Gelfand, D.L. Bratton
Journal: Journal of Allergy and Clinical Immunology (2007)
Ph‐positive chronic myelogenous leukemia evolving after polycythemia vera
Authors: E. Jantunen, T. Nousiainen
Journal: American Journal of Hematology (1991)

Positive Chronic Myelogenous Leukemia Evolving After Polycythemia VeraTransformation of polycythemia Vera (PV) to chronic myelogenous leukemia (CML) is rare.To the best of our knowledge, only four well-documented cases have been described in the literature [ 1,2].The interesting case reported by Haq [ 11 prompted us to report an additional case, in which Ph-positive CML developed 1.5 years after the diagnosis of PV without previous treatment with alkylating agents.A 68-year-old man came to our hospital in December 1983 because of a high hemoglobin value.He had treated hypertension, itching, night sweats, and mild dizziness at presentation.Hemoglobin was 19.7 g/dl and hematocrit 60%.The white blood cell (WBC) count was 6.8 X lo'/ L and the platelet count was 367 X 109/L.The WBC differential was normal.The leukocyte alkaline phosphatase (LAP) was within normal limits (score 119).Bone marrow examination showed erythroid hyperplasia.Red blood cell mass (RBCM) was 47 ml/kg.Technetium-scintigraphy revealed hepatosplenomegaly .Arterial
312. Clearance of Helper Adenovirus by an AAV1 Clinical Vector Manufacturing Process
Authors: Barb Thorne, Paulene Quigley, Gina Nichols, David Price, Christine Moore, Kristin Parker, Tsering Sangmo, Eric Pastor, Morgan Peterson, Ryan Takeya, Richard Peluso
Journal: Molecular Therapy (2006)

The use of live adenovirus (Ad) to supply essential helper functions provides a readily scaleable method for producing recombinant adeno-associated viral vectors (rAAV). One of the primary objectives for recovery and purification operations in an Ad-based manufacturing process is therefore effective and robust clearance of this raw material. For clinical vector, absence of infectious adenovirus is an important quality attribute of final product, and the ICH Q5A guidance on viral safety provides a framework for meeting regulatory expectations. A clinical manufacturing process for rAAV1 pseudotyped vectors was developed based on Ad/AAV-hybrid production technology1,2. Multiple orthogonal separation methods were incorporated into the harvest and purification processes to achieve overall log reduction values (LRV) for adenovirus significantly greater than the inputlevels of Ad. Analytic challenges for assessing clearance include identifying and quantifying matrix interference effects in cell-basedassays. The first major clearance step provides 6 LRV and occurs in the vector production room. This provides a layer of process control by physically segregating Ad from rAAV1 purification, which occurs in a separate dedicated room. Spike-and-remove studies were performed to characterize adenovirus clearance by various subsequent operations. From ICH Q5A, clearance of a 'relevant virus' should include both removal and inactivation steps. For Ad inactivation, the relative thermostability of AAV and Ad were exploited. Operational tolerances for both temperature and time were defined in the relevant matrix to develop a robust heat inactivation unit operation. Data characterizing and quantitating removal of Ad from AAV, as well as approaches suitable for routine in process monitoring of Ad clearance, will be discussed. 1Liu et al (1999) Gene Therapy 6(2): 293 2Gao et. al. (1998) Human Gene Therapy 9(16): 2353
Primary care groups: Progress in partnerships
Authors: C. Glendinning
Journal: BMJ (2001)

valid reason for attendance at a clinic?Assessment of menstrual complaints needs to be improved, and further research is required to understand the part played by the cultural beliefs of both women and clinicians.The comorbidity of menstrual complaints shows that the conventional partitioned thinking about menstrual problems will be unhelpful in most cases.We thank the study research nurses Elaine Kacser and Dorothy Lyons, Robbie Foy for discussions about the findings, and the participants.Contributors: PW had the original idea for the study and design and led the
The Failure of Organized Health System Reform—Now What?
Authors: George D. Lundberg
Journal: JAMA (1995)

As regular<i>JAMA</i>readers know, we editors have been working seriously on American health system reform since at least 1987. Our early efforts emphasized volunteerism and the absolute responsibility of physicians as learned professionals to deliberately give away free care to those in need, following a 1847 American Medical Association (AMA) tenet: "To individuals in indigent circumstances, professional services should be cheerfully and freely accorded."<sup>1</sup> In 1990, the AMA approved as policy "Health Access America," a 16-point, middle-of-the-road, honest effort at fixing the system's many problems.<sup>2</sup>In 1991,<i>JAMA</i>and the nine AMA Archives journals launched the "Caring for the Uninsured and Underinsured" campaign, spearheading a major professional effort at much-needed reform. Since then, we have published literally hundreds of articles, featuring research, analysis, history, proposals, and passionate rhetoric calling for reform and pointing the way.<sup>3</sup> With the 1992 election results and the public mood, national reform
Newcastle-on-Tyne Infirmary: Two Operations on the Jaw and Bones of the Face, Recently Performed by Sir John Fife
Authors: F. A. Gibb
Journal: BMJ (1846)

ing over the whole frame; and tea: analogous effects may -be produced by a reEtected action; the prick of a pin in the vicinity of the eye will produce sengstioB, redness, lacbrymatipn, as fully stated beforehand.These circumstanpes indicate that the nervous currents which accompany tlie phenomena of emotion, sensation, and capillary circulation belong to the same ner-.vous tract, and that they may be either direct or excited.These views are in complete harmony with the principes regulating motion, in which there is a voluh-' tary-tract the currents 'of which proceed from thE brain to the muscles; an excito-motor tract incident, upon the spinal cord reflected upon the muscles.In botk cases too sensation may be excited at the same time that reflex action is set up.(7b be continued.)NEWCASTLE-ON-TYNE INFIRMARY.
Retrograde Oesophagoscopy via Gastrostomy
Authors: E. Hentschel, H. Dittrich, W. Weiss
Journal: Endoscopy (1976)

The following case-report shows that oesophagoscopy can be performed by introducing a flexible fiberscope through a gastrostomy. Conditions and indications for this unusual procedure are discussed. Applying this method of oesophagoscopy the natural form of the cardia can be observed, and the so-called cardiac lip well known to any endoscopist is shown to be an artefact.
Gastrocolic Fistula and Gastric Ulcer With Prolonged Glucocorticoid Therapy
Authors: Robert N. Hoffman
Journal: JAMA (1966)

GASTROCOLIC FISTULAE result primarily from perforations through carcinomas of the colon or stomach. In the majority of cases the primary lesion is a far-advanced colon neoplasm. Rare causes of gastrocolic fistulae are benign gastric ulcers, carcinoid tumor of the colon,<sup>1</sup>and chronic ulcerative colotis.<sup>2,3</sup> Verbrugge<sup>4</sup>reviewed the literature up to 1925 and found only 25 cases of benign gastric ulcer perforating into the colon. Gray<sup>5</sup>found four additional cases listed up to 1955 and added one of her own. Bachman and Rogers<sup>6</sup>in the same year reported a case of benign gastric ulcer with gastrocolic fistula. The patient was a 33-year-old woman who had been on corticosteroid therapy for three years for psoriasis and psoriatic arthritis. Until the gastrocolic fistula had occurred with resultant diarrhea, the patient had no apparent signs or symptoms of gastrointestinal difficulty. Bosien and Tyson,<sup>7</sup>in 1952, reported a patient
A Tuberculostearic Acid Assay in the Diagnosis of Sputum Smear-Negative Pulmonary Tuberculosis
Authors: Joseph A. Pang
Journal: Annals of Internal Medicine (1989)

To determine whether the detection of tuberculostearic acid (TBSA) in bronchial aspirate and bronchoalveolar lavage specimens is useful for the rapid diagnosis of active pulmonary tuberculosis in patients suspected of having the disease.A pulmonary clinic in a teaching hospital.Forty patients suspected of active pulmonary tuberculosis but who failed to produce sputum or whose sputum smears were negative for acid-fast bacilli on at least 3 occasions, 29 of whom were subsequently confirmed to have tuberculosis. A group of 13 patients who were having fiberoptic bronchoscopy for other reasons served as controls.All patients had fiberoptic bronchoscopy; bronchial aspirate, bronchoalveolar lavage, and sputum specimens were obtained when possible.All specimens were examined microscopically for acid-fast bacilli, cultured for mycobacteria, and assayed for TBSA by gas chromatography and mass spectrometry with selected ion monitoring. Only 4 of the 29 patients with tuberculosis were diagnosed by direct microscopy compared with 26 by TBSA assay. In 2 patients who required surgical biopsy for conventional diagnosis, the TBSA test was positive. There were no false-positive TBSA results in the 13 controls, but 2 of 5 sputum specimens from the 11 test patients in whom tuberculosis was excluded were falsely positive, probably because of contamination with mouth flora. Because sputum can rarely be obtained from these patients and may give false-positive results, it is not a good specimen for TBSA assay. Sensitivities and specificities of the test for the other specimens were as follows: aspirate, 0.52 (CI, 0.32 to 0.71) and 1.00 (CI, 0.75 to 1.00); lavage, 0.68 (CI, 0.46 to 0.85) and 1.00 (CI, 0.84 to 1.00); aspirate and lavage combined, 0.79 (CI, 0.60 to 0.92) and 1.00 (CI, 0.86 to 1.00).The TBSA assay for bronchial aspirate and bronchoalveolar lavage fluid is useful for rapidly diagnosing "smear-negative" pulmonary tuberculosis. In these specimens it is highly specific and more sensitive than microscopy. This assay could be used to diagnose other mycobacterial infections, however, it cannot distinguish among species.
PTH-027 Stopping Proton Pump Inhibitors to Prevent Clostridium Difficile: Is it Possible and Does it Help?
Authors: M Popescu, K Welch, R Cunninghan, S Lewis
Journal: Gut (2013)

<h3>Introduction</h3> Hypochlorhydydria due to proton pump inhibitor (PPI) therapy is associated with increased susceptibility and propensity to relapse from infection due to <i>C difficile</i>. The Health Protection Agency guidance advises review of PPI use in patients with CDAD. We have done a retrospective audit of patients with CDAD examining PPI use and any benefit achieved by stopping the PPI. <h3>Methods</h3> All patients with CDAD between 2010–12 were reviewed by infection control nurses and advised the attending doctors to stop any PPI therapy where a clear indication was not obvious. We have retrospectively audited patient’s relevant baseline characteristics, clinical outcome, length of hospital stay and PPI prescription at hospital discharge. In addition we followed patients up for 90days post discharge recording PPI prescription and further CDAD. <h3>Results</h3> 75 patients, 38 taking a PPI (mean age 77 stD) and 37 not taking a PPI (mean age 72 StD). No difference was seen for antibiotic use, co morbidity, immunosuppression, recent surgery, enteral feeding or dependency. At hospital discharge of those taking a PPI 12/38 (32%) had died. The PPI was stopped in 17/26 (65%), further CDAD occurred in 3 taking a PPI and 5 not. Of those not taking a PPI on hospital admission 16/37 (43%) died by hospital discharge and at 90days 4 developed further CDAD. <h3>Conclusion</h3> It was possible to stop PPI prescription in 65% of patients presenting with CDAD. We found no evidence that CDAD was more severe in patients taking a PPI or that there was reduced recurrence of CDAD in patients who had stopped taking their PPI or had never taken it. <h3>Disclosure of Interest</h3> None Declared.
Coping With Chemotherapy
Authors: Ramona M. Chapman
Journal: JAMA (1985)

Doctors nowadays are blamed for failure to communicate. The patient's questions are somehow not asked or answered. Problems that the doctor perceives are described incomprehensibly. A barrier of frustration and anger impairs our ability to heal and comfort. Is the problem more common and severe in oncology? Ms Bruning, a woman who underwent adjuvant chemotherapy for breast cancer, quotes her oncologist: "Taking care of dying patients tends to have a chilling effect on the doctor. It is very easy to be very cold and unable to hear about the aspects of life that are difficult. It's extremely important for the oncologist to be available and willing to hear about the aspect of human existence. There are other people to whom the patient can talk, but it's difficult if the doctor is just writing the prescription and coldly looking at the size of the tumor." This oncologist says he feels "tremendous
The prevalence of cirrhosis and hepatocellular carcinoma in patients with human immunodeficiency virus infection
Authors: George N. Ioannou, Christopher L. Bryson, Noel S. Weiss, Richard Miller, John D. Scott, Edward J. Boyko
Journal: Hepatology (2012)

Cirrhosis is a leading cause of death among patients infected with human immunodeficiency virus (HIV). We sought to determine risk factors for and time trends in the prevalence of cirrhosis, decompensated cirrhosis, and hepatocellular carcinoma (HCC) among patients diagnosed with HIV who received care in the Veterans Affairs (VA) health care system nationally between 1996 and 2009 (n = 24,040 in 2009). Among patients coinfected with HIV and hepatitis C virus (HCV), there was a dramatic increase in the prevalence of cirrhosis (3.5%-13.2%), decompensated cirrhosis (1.9%-5.8%), and HCC (0.07%-1.6%). Little increase was observed among patients without HCV coinfection in the prevalence of cirrhosis (1.7%-2.2%), decompensated cirrhosis (1.1%-1.2%), and HCC (0.03%-0.13%). In 2009, HCV infection was present in the majority of patients with HIV who had cirrhosis (66%), decompensated cirrhosis (62%), and HCC (80%). Independent risk factors for cirrhosis included HCV infection (adjusted odds ratio [AOR], 5.82; 95% confidence interval [CI], 5.0-6.7), hepatitis B virus (HBV) infection (AOR, 2.40; 95% CI, 2.0-2.9), age (AOR, 1.03; 95% CI, 1.02-1.04), Hispanic ethnicity (AOR, 1.76; 95% CI, 1.4-2.2), diabetes (AOR, 1.79; 95% CI, 1.6-2.1), and alcohol abuse (AOR, 1.78; 95% CI, 1.5-2.1), whereas black race (AOR, 0.56; 95% CI, 0.48-0.64) and successful eradication of HCV (AOR, 0.61; 95% CI, 0.4-0.9) were protective. Independent risk factors for HCC included HCV infection (AOR, 10.0; 95% CI, 6.1-16.4), HBV infection (AOR, 2.82; 95% CI, 1.7-4.7), age (AOR, 1.05; 95% CI, 1.03-1.08), and low CD4+ cell count (AOR, 2.36; 95% CI, 1.3-4.2). Among 5999 HIV/HCV-coinfected patients, 994 (18%) had ever received HCV antiviral treatment, of whom 165 (17%) achieved sustained virologic response.The prevalence of cirrhosis and HCC has increased dramatically among HIV-infected patients driven primarily by the HCV epidemic. Potentially modifiable risk factors include HCV infection, HBV infection, diabetes, alcohol abuse, and low CD4+ cell count.
Promotion of collateral growth (arteriogenesis) by granulocyte-macrophage colony-stimulating factor (GM-CSF) in patients with coronary artery disease
Authors: Christian Seller, Tilmann Pohl, Kerstin Wustmann, Damian Hutter, Pierre-Alain Nicolet, Stephan Windecker, Franz R. Eberli, Bernhard Meier
Journal: Journal of the American College of Cardiology (2002)
Glomerulotubular Junction Abnormalities Are Associated with Proteinuria in Type 1 Diabetes
Authors: Behzad Najafian, John T. Crosson, Youngki Kim, Michael Mauer
Journal: Journal of the American Society of Nephrology (2006)

Glomerulotubular junction abnormalities, frequent in proteinuric patients with type 1 diabetes, may contribute to the progressive GFR loss in overt diabetic nephropathy. Glomerulotubular junction abnormalities were examined in patients who have type 1 diabetes with a wide range of albumin excretion rates (AER). Renal biopsies from five normoalbuminuric patients, five microalbuminuric patients, six proteinuric patients, and five control subjects were studied by light and electron microscopy. Light microscopy specimens were serially sectioned to find and classify glomerulotubular junctions. Glomerular structural parameters were estimated using stereologic methods. Glomerulotubular junction abnormalities were found in 2% of glomeruli from control and normoalbuminuric patients and in 4% of glomeruli from microalbuminuric patients. In contrast, 71% of glomeruli from proteinuric patients had glomerulotubular junction abnormalities, including five (8%) atubular glomeruli. Electron microscopy findings were typical of diabetic nephropathy. Piece-wise linear regression models with glomerular, glomerulotubular junction, and interstitial parameters as independent variables provided greater GFR (92%; P < 0.005) and AER (95%; P < 0.01) prediction than multiple regression models (81% for GFR and 72% for AER). Thus, glomerular adhesions and glomerulotubular junction abnormalities help to explain the progressive GFR loss that is associated with onset of proteinuria in type 1 diabetes. Moreover, nonlinear models provide better fit for structural-functional relationships in patients with type 1 diabetes.
Pathogenic antibodies are active participants in spinal cord injury
Authors: Gregory A. Dekaban, Sakina Thawer
Journal: Journal of Clinical Investigation (2009)

The role of B cells and autoimmunity as contributing factors to poor neurological outcomes following spinal cord injury (SCI) is poorly understood. The study by Ankeny et al., in this issue of the JCI, identifies a new immunopathological mechanism arising after SCI in mice (see the related article beginning on page 2990). The study shows that B cells produce pathogenic antibodies that impair lesion repair, resulting in worse neurological outcome. This new understanding of SCI disease pathogenesis, if confirmed in humans, reveals potential avenues for the development of novel neuroprotective immunotherapies.
PET, CT, and MR Imaging of Extra-articular Pigmented Villonodular Synovitis
Authors: Ba D. Nguyen
Journal: Clinical Nuclear Medicine (2007)

Pigmented villonodular synovitis is also known as fibrohistiocytic tumor by the World Health Organization classification of bone and soft tissue tumors. Pigmented villonodular synovitis is the name used for intra-articular lesions while diffuse-type giant cell tumor and localized tenosynovial giant cell tumor correspond to the extraarticular soft tissue variants of these benign tumors. The large size of these lesions may mimic malignancy due to aggressive cross-sectional imaging features and false-positive F-18 FDG PET findings. A case of giant extra-articular pigmented villonodular synovitis of the distal thigh with a brief review of its epidemiology and imaging characteristics is presented.
481. Dynamics of Transduction of Human Cells by EIAV Vectors – The Importance of Cell Entry
Authors: Daniel C. Farley, Fraser J. Wilkes, James E. Miskin, Susan M. Kingsman, Kyriacos A. Mitrophanous
Journal: Molecular Therapy (2005)

Recent reports have described some of the underlying components and mechanisms that contribute to the species barrier to retro/lentiviruses, and vectors derived from them. At least part of this blockade is thought to be due to restriction factors, which act to subvert incoming virions down non-replicative pathways. At high multiplicities of infection (MOI) such factors can be titrated away, allowing the cell to be transduced. Elsewhere it has been demonstrated that, similarly to HIV and MLV, Equine Infectious Anaemia virus (EIAV) vectors may also be restricted in a variety of cell types, including human cells. If true, this may have implications regarding EIAV vectors' utility for human gene therapy applications. We have developed highly engineered completely minimal EIAV vectors, and have demonstrated the vectors' potential in a number of pre-clinical models of human disease, including recent studies in models of Parkinson's disease and amyotrophic lateral sclerosis (ALS). We are currently developing the vector system and an associated bank of safety tests, as a prerequisite for treating Parkinson's disease in patients.