tbuckley/cabot-search huggingface dataset:
Effects of topical corticosteroid therapy on Langerhans cell antigen presenting function in human skin
Authors: J. ASHWORTH, JULIE BOOKER, S.M. BREATHNACH
Journal: British Journal of Dermatology (1988)

Journal Article Effects of topical corticosteroid therapy on Langerhans cell antigen presenting function in human skin Get access J. ASHWORTH, J. ASHWORTH Department of Medicine (Dermatology), Charing Cross and Westminster Medical School, Fulham Palace Road, London W6 8RF, U.K. Dr J. Ashworth. Search for other works by this author on: Oxford Academic Google Scholar JULIE BOOKER, JULIE BOOKER Department of Medicine (Dermatology), Charing Cross and Westminster Medical School, Fulham Palace Road, London W6 8RF, U.K. Search for other works by this author on: Oxford Academic Google Scholar S.M. BREATHNACH S.M. BREATHNACH Department of Medicine (Dermatology), Charing Cross and Westminster Medical School, Fulham Palace Road, London W6 8RF, U.K. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 118, Issue 4, 1 April 1988, Pages 457–470, https://doi.org/10.1111/j.1365-2133.1988.tb02453.x Published: 01 April 1988
Where There's Fire, There's Smoke
Authors: Samuel Vaisrub
Journal: JAMA (1974)

The aroma of horse dander and cow manure that often overwhelms a city dweller visiting or passing through cattle ranges of Colorado or Wyoming is never referred to as air "pollution." This dirty word is usually reserved for exhaust fumes of automobiles or for the smoke of factory chimneys. Unlike industrial offenders, the "natural" malodorous emanations tearing at one's olfactory bulbs are presumed to be harmless, even invigorating, unless, of course, the inhaler happens to have asthma, hay fever, or an overly fastidious psyche. The sharp difference in attitude toward by-products of civilization and those of nature is only in part the outcome of genuine and legitimate concern about health. In large measure it is a reflection of the romantic tradition, dating back to Jean Jacques Rousseau, which holds that the "natural" life of primitive man was good and healthy before it became subverted by industrial progress. Civilization is evil,
Deal with a complaint by a patient.
Authors: K M Allsopp
Journal: BMJ (1987)

A complaint is not a claim but may lead to a claim. A claim that a doctor has been negligent, if substantiated, may lead to the payment of damages. A complaint only leads to the provision of an explanation for the patient. Nevertheless, it is important that even a trivial complaint should be given proper consideration. Advice on the handling of a complaint is always available from a doctor's defence organisation. When a mishap befalls a patient he or, if appropriate, his relatives should receive a prompt explanation of the incident. The infor? mation should be given sympathetically by someone of sufficient seniority to deal with a potentially difficult situation. There is no reason why an apology should not be made. Apologising should not be confused with the admission of legal liability.
Impact of Oral Sildenafil on Exercise Performance in Children and Young Adults After the Fontan Operation
Authors: David J. Goldberg, Benjamin French, Michael G. McBride, Bradley S. Marino, Nicole Mirarchi, Brian D. Hanna, Gil Wernovsky, Stephen M. Paridon, Jack Rychik
Journal: Circulation (2011)

Background— Children and young adults with single-ventricle physiology have abnormal exercise capacity after the Fontan operation. A medication capable of decreasing pulmonary vascular resistance should allow improved cardiac filling and improved exercise capacity. Methods and Results— This study was a double-blind, placebo-controlled, crossover trial conducted in children and young adults after Fontan. Subjects were randomized to receive placebo or sildenafil (20 mg three times daily) for 6 weeks. After a 6-week washout, subjects crossed over for an additional 6 weeks. Each subject underwent an exercise stress test at the start and finish of each phase. After taking sildenafil, subjects had a significantly decreased respiratory rate and decreased minute ventilation at peak exercise. At the anaerobic threshold, subjects had significantly decreased ventilatory equivalents of carbon dioxide. There was no change in oxygen consumption during peak exercise, although there was a suggestion of improved oxygen consumption at the anaerobic threshold. Improvement at the anaerobic threshold was limited to the subgroup with single left or mixed ventricular morphology and to the subgroup with baseline serum brain natriuretic peptide levels ≥100 pg/mL. Conclusions— In this cohort, sildenafil significantly improved ventilatory efficiency during peak and submaximal exercise. There was also a suggestion of improved oxygen consumption at the anaerobic threshold in 2 subgroups. These findings suggest that sildenafil may be an important agent for improving exercise performance in children and young adults with single-ventricle physiology after the Fontan operation. Clinical Trial Registration— URL: http://clinicaltrials.gov . Unique identifier: NCT00507819.
Release of endogenous pyrogen-activating factor from concanavalin A-stimulated human lymphocytes.
Authors: H A Bernheim, L H Block, L Francis, E Atkins
Journal: The Journal of Experimental Medicine (1980)

Evidence is presented that the mitogen concanavalin A stimulates human lymphocytes to produce a nonpyrogenic lymphokine (LK) that is capable of activating human monocytes but not granulocytes to produce endogenous pyrogen (EP) in vitro. The potency of this preparation should facilitate further studies to purify and characterize this agent and determine its relation to other know LK. It seems likely that this factor, which we have called EP-activating factor (EPAF), plays a significant role in the development of fever in states of delayed hypersensitivity in man.
An Autopsy Study of Cancer Patients
Authors: Frederick W. Bauer
Journal: JAMA (1973)

We reported previously that 41% of all cancers in a large autopsy series were incorrectly diagnosed before death. We have now detected a direct association between accurate clinical diagnoses of cancer and increasing length and number of hospital admissions. The prevalence of incorrectly diagnosed cancer progressively decreased from a high of 53% to a low of 30% when both the number and length of hospitalizations increased. However, these relationships were limited to the first five hospital admissions and the first 20 hospital days. Beyond these limits, no further improvement in diagnostic accuracy was noted. Undiagnosed cancer caused 11% of the deaths of patients with more than 40 days of hospitalization as well as the deaths of those with more than one hospital admission. Accurate clinical diagnoses of diseases such as cancer can be associated with an optimum length and number of hospitalizations, beyond which little or no improvement in diagnostic accuracy occurs.
Combination Therapy for Uncomplicated Falciparum Malaria in Ugandan Children
Authors: Grant Dorsey, Sarah Staedke, Tamara D. Clark, Denise Njama-Meya, Bridget Nzarubara, Catherine Maiteki-Sebuguzi, Christian Dokomajilar, Moses R. Kamya, Philip J. Rosenthal
Journal: JAMA (2007)

ContextCombination therapy is now widely advocated as first-line treatment for uncomplicated malaria in Africa. However, it is not clear which treatment regimens are optimal or how to best assess comparative efficacies in highly endemic areas.ObjectiveTo compare the efficacy and safety of 3 leading combination therapies for the treatment of uncomplicated malaria.Design, Setting, and ParticipantsSingle-blind randomized clinical trial, conducted between November 2004 and June 2006, of treatment for all episodes of uncomplicated malaria in children in an urban community in Kampala, Uganda. A total of 601 healthy children (aged 1-10 years) were randomly selected and were followed up for 13 to 19 months, receiving all medical care at the study clinic.InterventionsStudy participants were randomized to receive 1 of 3 combination therapies (amodiaquine plus sulfadoxine-pyrimethamine, amodiaquine plus artesunate, or artemether-lumefantrine) when diagnosed with their first episode of uncomplicated malaria. The same assigned treatment was given for all subsequent episodes.Main Outcome Measure28-Day risk of parasitological failure (unadjusted and adjusted by genotyping to distinguish recrudescence from new infection) for each episode of uncomplicated malaria treated with study drugs.ResultsOf enrolled children, 329 of 601 were diagnosed with at least 1 episode of uncomplicated malaria, and 687 episodes of Plasmodium falciparum malaria were treated with study drugs. The 28-day risk of treatment failure (unadjusted by genotyping) for individual episodes of malaria were 26.1% (95% CI, 21.1%-32.1%) for amodiaquine plus sulfadoxine-pyrimethamine, 17.4% (95% CI, 13.1%-23.1%) for amodiaquine plus artesunate, and 6.7% (95% CI, 3.9%-11.2%) for artemether-lumefantrine (P&lt;.05 for all pairwise comparisons). When only recrudescent treatment failures were considered, the risks of failure were 14.1% (95% CI, 10.3%-19.2%), 4.6% (95% CI, 2.5%-8.3%), and 1.0% (95% CI, 0.3%-4.0%) for the same order of study drugs, respectively (P≤.008 for all pairwise comparisons, except amodiaquine plus artesunate vs artemether-lumefantrine, P = .05). There were no deaths or cases of severe malaria. Significant reductions in anemia (9.3% [95% CI, 7.0%-12.0%] at enrollment vs 0.6% [95% CI, 0.1%-2.2%] during the last 2 months of follow-up; P&lt;.001) and asymptomatic parasitemia (18.6% [95% CI, 15.5%-22.1%] at enrollment vs 2.3% [95% CI, 1.5%-3.5%] during the last 2 months of follow-up; P&lt;.001) were observed according to routine testing.ConclusionsArtemether-lumefantrine was the most efficacious treatment for uncomplicated malaria in the study population. With all study regimens, the provision of prompt and reasonably effective facility-based treatment was associated with good outcomes in long-term health measures.Trial Registrationisrctn.org Identifier: ISRCTN37517549
Correlations between chemically related site-specific carcinogenic effects in long-term studies in rats and mice.
Authors: J K Haseman, A M Lockhart
Journal: Environmental Health Perspectives (1993)

We examined a database of 379 long-term carcinogenicity studies in rats and mice to evaluate sex and species correlations in site-specific carcinogenic responses. Within a species, most target sites showed a strong correlation between males and females. For example, chemicals producing forestomach or liver tumors in males were likely to produce these same types of tumors in females. There was also a significant correlation between species for certain site-specific carcinogenic effects, most notably tumors of the forestomach, liver, and thyroid gland. In contrast, adrenal pheochromocytoma, preputial/clitoral gland neoplasms, and lung tumors showed no significant interspecies correlation. Many chemicals produced a syndrome of carcinogenic effects involving tumors of the skin, Zymbal gland, preputial/clitoral gland, mammary gland, and/or oral cavity. Regarding different target sites, there appeared to be a correlation between thyroid and liver tumors both within and between species. Further, all chemicals producing mesotheliomas in male rats also produced mammary gland neoplasms in female rats. In contrast, kidney and urinary bladder tumors showed no significant association with any other tumor type in rats or mice. If a chemical produced a site-specific carcinogenic effect in female rats or mice, there was approximately a 65% probability that the chemical would also be carcinogenic at that same site in males. The interspecies correlation was somewhat lower: approximately 36% of the site-specific carcinogenic effects observed in one species (rats or mice) were also observed in the other species.(ABSTRACT TRUNCATED AT 250 WORDS)
NIH Panel Tackles Lactose Intolerance
Authors: Rebecca Voelker
Journal: JAMA (2010)

should review their protocols and ensure proper doses of radiation for their patients,” he said. Recently, an FDA investigation revealed that more than 250 patients treated at 4 or more facilities in 2 states received up to 8 times the expected dose of radiation during CT perfusion scans (Kuehn BM. JAMA. 2010;303[2]:124). “Physicians also need to know the cumulative history of radiation that patients have already received, and that’s something that isn’t available yet,” said Shuren. To address this, the FDA is collaborating with other organizations to develop a patient medical imaging history card that will allow patients to track their own medical imaging history and share it with their physicians. The FDA also plans to issue requirements for manufacturers regarding necessary safeguards when designing their machines and when training practitioners in their use. In addition, the agency is working to incorporate key quality assurance practices into the mandatory accreditation of imaging facilities and hospitals.
A genome-wide association study for celiac disease identifies risk variants in the region harboring IL2 and IL21
Authors: David A van Heel, Lude Franke, Karen A Hunt, Rhian Gwilliam, Alexandra Zhernakova, Mike Inouye, Martin C Wapenaar, Martin C N M Barnardo, Graeme Bethel, Geoffrey K T Holmes, Con Feighery, Derek Jewell, Dermot Kelleher, Parveen Kumar, Simon Travis, Julian RF Walters, David S Sanders, Peter Howdle, Jill Swift, Raymond J Playford, William M McLaren, M Luisa Mearin, Chris J Mulder, Ross McManus, Ralph McGinnis, Lon R Cardon, Panos Deloukas, Cisca Wijmenga
Journal: Nature Genetics (2007)
Abnormal bone composition in female juvenile American alligators from a pesticide-polluted lake (Lake Apopka, Florida).
Authors: P Monica Lind, Matthew R Milnes, Rebecca Lundberg, Dieldrich Bermudez, Jan A Orberg, Louis J Guillette
Journal: Environmental Health Perspectives (2003)

Reproductive disorders have been found in pesticide-exposed alligators living in Lake Apopka, Florida (USA). These disorders have been hypothesized to be caused by exposure to endocrine- disruptive estrogen-like contaminants. The aim of this study was to expand our analysis beyond previous studies by investigating whether bone tissue, known to be affected by sex steroid hormones, is a potential target of endocrine disruptors. Long bones from 16 juvenile female alligators from Lake Apopka (pesticide-contaminated lake) and Lake Woodruff (control lake) were evaluated by peripheral quantitative computed tomography. We observed significant differences in bone composition, with female alligators from the contaminated lake having greater trabecular bone mineral density (BMD), total BMD, and trabecular mineral content compared with females from the control lake (p < 0.05). Increased trabecular and total BMD measurements suggest that juvenile female alligators from Lake Apopka were exposed to contaminants that created an internal environment more estrogenic than that normally observed. This estrogenic environment could be caused by both natural and anthropogenic compounds. Effects on BMD indicate interference with bone homeostasis. We hypothesize that contaminants present in the lake inhibit the natural and continuous resorption of bone tissue, resulting in increased bone mass. Although this is the only study performed to date examining effects of environmental estrogenic compounds on alligator bones, it supports previous laboratory-based studies in rodents. Further, this study is important in demonstrating that the alterations in morphology and physiology induced in free-ranging individuals living in environments contaminated with endocrine-active compounds are not limited to a few systems or tissues; rather, effects can be observed in many tissues affected by these hormones.
A History of Endocrinology
Authors: Walter E. Szpunar
Journal: JAMA (1983)

This is a comprehensive, informative, and generally well-written account of the history of endocrinology. The tour of endocrine history begins in prehistoric times with brief visits to ancient China, Egypt, and Greece before leading us to the modern period of endocrinology. Numerous anecdotes and important events relating to endocrinology are presented in a well-organized and interesting manner.  Because of our special interest in thyroidology, we were especially interested in some of these fascinating tidbits. In 1600 BC the Chinese used burnt sponge and seaweed for the treatment of goiter. The cause of this malady was unknown, however. The followers of Hippocrates regarded goiter solely as a deformity attributed to the drinking of snow-water. In 1811 Bernard Courtois discovered that iodine was an ingredient of seaweed, and nine years later, Jean Francois Coindet first used iodine in the treatment of goiter. Paul Julius Moebius in 1886 stated that the primary factor
Helicobacter pylori infection in long-term and short-term Japanese visitors to Peru
Authors: A. Ramirez-Ramos, R.H. Gilman, J. Watanabe, A.S. Recavarren, W. Spira, J. Miyagui, U.C. Rodríguez, C. Ramírez-Icaza
Journal: The Lancet (1994)
Cat-Scratch Disease as a Cause of Lymphadenopathy of Long Duration
Authors: Bernard M. Rosof
Journal: JAMA (1961)

IT IS THE PURPOSE of this paper to present a well-documented case of cat-scratch disease with lymphadenopathy of 18 months' duration. Since the first description of cat-scratch disease as a disease entity in the English literature by Greer and Keefer<sup>1</sup>more than 1,000 cases have been presented. Although a further case report of catscratch disease is not warranted, one with lymphadenitis of long duration is indeed unusual. It thus adds another disease to be considered in the differential diagnosis of chronic adenitis. <h3>Report of a Case</h3> The patient is a 25-year-old male who was first seen in January, 1960, with the chief complaint of a swelling in his right axilla. Pertinent history revealed the occurrence of several scratches on his right hand of 2 weeks' duration and the fact that he had 2 cats at home. Physical examination revealed a temperature of 99.6° F. (37.7° C.) and several enlarged,
Urine pH and Salicylate Therapy
Authors: Jack R. Leonards
Journal: JAMA (1971)

<h3>To the Editor.—</h3> The pronounced effect of urine pH on the renal clearance of salicylate is well known. Renal excretion is, however, only one of several pathways by which salicylate is eliminated from the body. The recently accomplished total characterization of the pharmacokinetics of salicylate elimination in man<sup>1,2</sup>has made it possible to carry out computer simulations of the time course of salicylate levels in the body during long-term drug administration under different conditions. These simulations predicted that relatively small changes in urine pH can cause a very marked change of salicylate concentrations in the plasma when relatively large doses of salicylate are used. We carried out a clinical study which confirmed this prediction. One gram of aspirin was given four times a day for seven days to 13 normal ambulatory adult volunteers, either with or without sufficient sodium bicarbonate ( about 4 gm/day) to increase urine pH somewhat (without
909 CHARACTERISTICS OF HBeAg-POSITIVE PATIENTS WITH HBsAg LOSS/SEROCONVERSION FOLLOWING TREATMENT WITH TENOFOVIR DISOPROXIL FUMARATE (TDF)
Authors: E.J. Heathcote, G. Germanidis, G. Dusheiko, I. Jacobson, R. deMan, P. Nikolaidis, P. Marcellin, J. Sorbel, J. Anderson, E. Mondou, J. Quinn, F. Rousseau
Journal: Journal of Hepatology (2009)
Pathophysiology of spontaneous hypercalciuria in laboratory rats. Role of deranged vitamin D metabolism.
Authors: K Lau, D Thomas, C Langman, B Eby
Journal: Journal of Clinical Investigation (1985)

Recent data suggest a causal role of deranged 1,25(OH)2D metabolism in the syndrome of idiopathic hypercalciuria. To test this hypothesis, we evaluated if vitamin D availability and/or increased serum 1,25(OH)2D were critical for the expression of hypercalciuria in laboratory rats. Ca balance, serum 25OHD3, and 1,25(OH)2D3 were studied in D-deprived (-D) and D-repleted (+D) male progeny (p) born to normocalciuric (NC) and spontaneously hypercalciuric (SH) rats. 7 of the 14 pSH and 2 of 21 pNC had SH, which was defined as urinary Ca greater than two standard deviations above the mean of values for control animals on days 5 and 6 of a low Ca +D diet (1.19 vs. 0.58 mg/d, P less than 0.001). Fasting serum Ca and 25OHD3 were similar to control. Serum 1,25(OH)2D3 was elevated in these nine SH rats (232 vs. 145 pg/ml, P less than 0.005). However, during vitamin D deprivation, their Ca excretion was also increased (1.53 vs. 0.45 mg/d, P less than 0.001), despite comparably reduced serum 1,25(OH)2D3 (102 vs. 106 pg/ml) and undetectable serum 25OHD3. Net intestinal Ca absorption on a low Ca diet was comparable during D repletion (-0.75 vs. -0.82 mg/d) or D deprivation (-0.80 vs. -2.15 mg/d), excluding primary hyperabsorption as the mediator of the hypercalciuria. Mild hypophosphatemia was present in SH on +D (5.8 vs. 6.9 mg/dl, P less than 0.005) and -D diets (6.2 vs. 7.9 mg/dl, P less than 0.005), and was associated with higher rates of cyclic adenosine monophosphate excretion (32.8 vs. 26.9 and 48.5 vs. 41.0 nmol/mg of creatinine, respectively). Spontaneous hypercalciuria is therefore dissociable from increased Ca absorption, serum levels of 25OHD3, or 1,25(OH)2D3. The data are most compatible with the hypothesis of a renal Ca leak which stimulates parathyroid hormone activity and increases serum 1,25(OH)2D3, if provided adequate 25OHD3 as substrate.
Say it with coffee
Authors: T Greenhalgh
Journal: BMJ (1994)

It is 9.30 on Monday morning. I am alone in a Hampstead bistro. There are Peruvian paintings on the walls and an invisible stereo plays “The Girl from Ipanema.” My cappuccino - oversized, exorbitantly priced, excessively sweet - symbolises perfectly the wicked self indulgence of this unearned respite so early in the working week. Outside, commuter traffic waits at its usual near standstill as I lazily bury sugar crystals one by one in mounds of frothy cream.

The Japanese are renowned for the number of non-verbal messages that can be conveyed in the traditional tea ceremony. I suspect there are at least as many anthropological curiosities in the way …
Changes in the carbon monoxide diffusing capacity of the lung in ulcerative colitis
Authors: M. Marvisi, P.D. Borrello, M. Brianti, G. Fornarsari, G. Marani, A. Guariglia
Journal: European Respiratory Journal (2000)

The aim of this study was to investigate lung function in patients with ulcerative colitis and to assess the incidence of latent pulmonary involvement in subjects with active and inactive disease. After full colonscopic assessment with multiple mucosal biopsy, the clinical disease activity of each patient was quantified, using the simple index of Harvey and Bradshaw. The patients were divided into 2 equal groups: subjects with active disease (group 1; n=16); and those with inactive disease (group 2; n=16). Global spirometry was then performed. A latent pulmonary involvement was found in 17 of 32 patients (53%), the incidence was higher in the group 1 patients (81%). The majority of patients presented a reduction in the carbon monoxide diffusing capacity of the lungs (DL,CO). The mean DL,CO value was 73.87+/-14.87 in group 1 and 87.31+/-11.23 in group 2. The DL,CO and KCO reduction correlated significantly with intestinal histopathological grading in the group of patients with active disease (r=0.87, p<0.001; r=0.603, p=0.015). To conclude, a high incidence of pulmonary function abnormalities were identified, despite the lack of radiological alterations (High Resolution Computed Tomography) and pulmonary symptoms, in ulcerative colitis patients. These alterations were more common in patients with active disease. The strong correlation between DL,CO values and histopathological grading suggests that this test may reflect bowel disease activity.