tbuckley/cabot-search huggingface dataset:
Systemic ketoconazole is an effective treatment of atopic dermatitis with IgE‐mediated hypersensitivity to yeasts
Authors: P. Lintu, J. Savolainen, O. Kortekangas‐Savolainen, K. Kalimo
Journal: Allergy (2001)

Background: IgE‐mediated hypersensitivity to yeasts is often seen in atopic dermatitis (AD) patients, especially when dermatitis is located in the head, neck, and shoulder regions. Two studies have shown the efficacy of ketoconazole in the treatment of this type of AD, in contrast to results of topical treatment. The objective was to assess the clinical efficacy of antifungal treatment in AD in a randomized, double‐blind, placebo‐controlled study with oral ketoconazole and yeast‐specific IgE levels and saprophytic yeast growth monitored simultaneously. Methods: Eighty patients with AD and positive P. ovale and/or C. albicans RAST/skin prick test results were randomized to receive ketoconazole or placebo for 30 days. The yeast growth of skin and pharynx; P. ovale , C. albicans , and S. cerevisiae RAST; serum total IgE; and the severity of the eczema (SCORAD) were assessed at day 0 and thereafter at 1 and 3 months. Results: A significant improvement was seen in the SCORAD scale in the ketoconazole group at the second visit in comparison to the first visit ( P &lt;0.0005; n =36), but not in the placebo group ( n =39). Of the individual determinants of the SCORAD, itching ( P &lt;0.005), the extent of dermatitis (area percentage), excoriation, lichenification ( P &lt;0.01), erythema, papulation, and dryness ( P &lt;0.05) improved significantly in the ketoconazole group. In the placebo group, only the extent of dermatitis (area percentage) decreased significantly ( P &lt;0.05). In the ketoconazole group, the number of positive P. ovale cultures decreased from 60% to 31% ( n =35) compared to the placebo group (64% to 56%; n =39). The clinical response was most significant in female patients with positive yeast cultures. Conclusions: Saprophytic yeasts may be a source of allergens in AD. Thus, patients with AD, yeast growth, and elevated IgE levels to yeasts should be offered antifungal treatment.
Should we accept all comers?
Authors: M. Lewis, G. J Elwyn
Journal: BMJ (1999)

In the 1980s, when general practice was popular, selecting applicants to vocational training schemes was a matter of picking the best from an excess of good candidates. If competition raises standards the converse must also be true. So now that fewer doctors want a career in general practice, the overall calibre of applicants is falling, and it is essential that standards be set for accepting doctors on to vocational training schemes.

Training schemes have a dilemma: faced with a palpable need to train more general practitioners, should they accept all comers or apply entry thresholds? If we set thresholds what minimum criteria should we apply? There are two major considerations: clinical competence and communication skills.

General practice should no longer tolerate being perceived as the easy option

General practice accepts entry to training without membership of a professional college—specifically the Royal College of General Practitioners (RCGP). Anyone with full General Medical …
Diuretics, Serum and Intracellular Electrolyte Levels, and Ventricular Arrhythmias in Hypertensive Men
Authors: David Siegel
Journal: JAMA (1992)

To investigate the patterns of electrolyte abnormalities resulting from thiazide administration and whether they cause ventricular arrhythmias, and to help resolve the controversy over whether clinicians should routinely prescribe potassium-conserving therapy to all patients treated with thiazides.Double-blind, randomized controlled trial.A total of 233 hypertensive men aged 35 to 70 years.Participants were withdrawn from prior diuretic treatment and were replenished with oral potassium chloride and magnesium oxide. They were then randomized to 2 months of treatment with (1) hydrochlorothiazide; (2) hydrochlorothiazide with oral potassium; (3) hydrochlorothiazide with oral potassium and magnesium; (4) hydrochlorothiazide and triamterene; (5) chlorthalidone; or (6) placebo.Ventricular arrhythmias on 24-hour Holter monitoring and serum and intracellular potassium and magnesium levels.Of the 233 participants, 212 (91%) completed the study. Serum potassium levels were 0.4 mmol/L lower in the hydrochlorothiazide group than in the placebo group (P less than 0.01), and this mean difference was not affected by supplementation with potassium, with potassium and magnesium, or with triamterene. However, the supplements did prevent the occasional occurrence of marked hypokalemia; all 12 of the men who developed serum potassium levels of 3.0 mmol/L or less were among the 90 who received diuretics without supplementation (P less than 0.01). Similarly, the overall proportion of men with ventricular arrhythmias was not affected by randomized treatment, but there was a twofold increase in the proportion with arrhythmias among the 12 men with serum potassium levels of 3.0 mmol/L or less (P = .02). Serum magnesium and intracellular potassium and magnesium levels were not reduced by hydrochlorothiazide, nor were they related to ventricular arrhythmias.In the majority of hypertensive patients, treatment with 50 mg/d of hydrochlorothiazide does not cause marked hypokalemia or ventricular arrhythmias. However, because some individuals will develop hypokalemia after starting diuretic therapy, serum potassium levels should be monitored and potassium-sparing strategies should be used when indicated.
The Association between Birthplace and Mortality from Cardiovascular Causes among Black and White Residents of New York City
Authors: Jing Fang, Shantha Madhavan, Michael H. Alderman
Journal: New England Journal of Medicine (1996)

Life expectancy is shorter and mortality from cardiovascular disease higher among blacks than among whites in the United States. We studied whether place of birth was associated with mortality from cardiovascular causes among non-Hispanic black and white residents of New York City.
Pure red cell aplasia in a Sjögren's syndrome/lupus erythematosus overlap patient
Authors: Clio P. Mavragani, Eythymia Vlachaki, Michalis Voulgarelis
Journal: American Journal of Hematology (2003)

Hematological complications of systemic lupus erythematosus usually include anemia of chronic disease and peripheral destruction of blood cells. We describe the case of a young woman with Sjögren's syndrome'lupus erythematosus overlap, mother of infant with congenital heart block, complicated by pure red cell aplasia. The patient was asymptomatic until the onset of severe anemia. A serum inhibitor of erythropoiesis was detected before the onset of immunosuppression. Bone marrow examination showed a low CD4:CD8 ratio, an immune defect possibly linked with the unrestrained production of antibodies against erythroid progenitor cells.
Smoke cardiomyopathy: disturbance of oxidative processes in myocardial mitochondria
Authors: A GVOZDJAKOVA, V BADA, L SANY, J KUCHARSKA, F KRUTY, P BOZEK, L TRSTANSKY, J GVOZDJAK
Journal: Cardiovascular Research (1984)

The effect of inhalation of cigarette smoke (passive smoking) on the oxidative and phosphorylating processes of rabbit myocardial mitochondria was studied in three experimental models after a single smoke lasting 30 min, after 2 weeks smoking twice daily and after 8 weeks smoking twice daily. A significant decrease in respiration as well as in the phosphorylation rate of mitochondria was found; whereas the respiratory control index and coefficient of oxidative phosphorylation did not change. Both factors of cigarette smoke (carbon monoxide and nicotine) participate in the metabolic injury of mitochondria. Long term cigarette smoking causes considerable metabolic and morphological alterations to the heart muscle which can be characterised as smoke cardiomyopathy.
Experimental HBV and δ infections of chimpanzees: Occurrence and significance of intrahepatic immune complexes of HBcAg and δ antigen
Authors: Mario Rizzetto, Maria G. Canese, Robert H. Purcell, William T. London, David L. Sly, John L. Gerin
Journal: Hepatology (1981)

The occurrence and pathogenetic role of intrahepatic deposits of immunoglobulins in experimental viral infection have been evaluated by determining with immunofluorescence their capacity to fix complement in vitro [ in vitro complement fixation (VCF)]. Liver biopsies from chimpanzees chronically or acutely infected with hepatitis B virus or the hepatitis B surface antigen (HBsAg)-associated δ agent were used in the study. VCF was observed in each animal expressing hepatitis B core antigen (HBcAg) or δ antigen in the liver and concurrently circulating the homologous antibody in the blood. In acutely infected animals, VCF appeared at the same time that the homologous serum antibody appeared, and the intensity of VCF staining was proportional to the antibody titer in the serum. In animals expressing sequentially the HBcAg/antibody system and then δ antigen and antibody to δ, VCF was first observed in HBcAg-containing nuclei and then in nuclei expressing δ antigen. There was no relationship between VCF and intrahepatic expression of HBsAg or serologic expression of hepatitis B e antigen (HBeAg). A positive VCF reaction appears related to the formation of intrahepatic immune complexes between HBcAg or δ antigen and the homologous antibody. Although acute hepatitis developed in parallel with the occurrence of VCF in two animals, strong VCF fluorescence was also observed in each of the asymptomatic carriers of HBsAg, and, in one of them, preexisting VCF staining of HBcAg disappeared in parallel with development of acute hepatitis. In experimentally infected chimpanzees, the finding in liver biopsies of immune complexes detectable by VCF appears to be a common epiphenomenon without pathogenic significance.
Survival Variability by Race and Ethnicity in Childhood Acute Lymphoblastic Leukemia
Authors: Nina S. Kadan-Lottick
Journal: JAMA (2003)

The role of race/ethnicity in survival of children with acute lymphoblastic leukemia (ALL) is unclear, with some studies reporting poorer survival among minority children and others reporting equivalent survival across race/ethnicity in the modern, risk-stratified treatment era.To investigate the relation between race/ethnicity and survival in a large, population-based analysis of incident ALL cases in the United States. DESIGN, POPULATION, AND SETTING: This study included 4952 individuals diagnosed with ALL between 1973 and 1999 at age 19 years or younger. ALL cases were identified from 9 population-based registries of the National Cancer Institute's Surveillance, Epidemiology, and End Results program.Survival probabilities were compared among white, black, Hispanic, Asian/Pacific Islander, and American Indian/Alaskan Native children. Kaplan-Meier curves and proportional hazard ratios from Cox regression analysis were calculated, accounting for treatment era (1973-1982, 1983-1989, and 1990-1999), age at diagnosis (<1, 1-9, and 10-19 years), and sex.Although overall 5-year survival probabilities improved with each successive treatment era, differences according to race/ethnicity persisted. For 1990-1999, 5-year survival was 84% for white children, 81% for Asian/Pacific Islander children, 75% for black children, and 72% for both American Indian/Alaskan Native children and Hispanic children. The largest difference by race/ethnicity was observed among children diagnosed between ages 1 and 9 years. Compared with white children, after adjusting for treatment era, age at diagnosis, and sex, children of black, Hispanic, and American Indian/Alaskan Native descent had hazard ratios of 1.50 (95% CI, 1.0-2.2; P =.03), 1.83 (95% CI, 1.4-2.4; P<.001), and 1.90 (95% CI, 0.8-4.6; P =.16).Black, Hispanic, and American Indian/Alaskan Native children with ALL have worse survival than white and Asian/Pacific Islander children, even in the contemporary treatment era. Future work must delineate the social and biological factors, including any differences in pharmacokinetics associated with chemotherapeutic agents, that account for disparities in outcome.
DERMATITIS FROM ANTIFAT REMEDY
Authors: Sigmund S. Greenbaum
Journal: JAMA (1926)

<h3>To the Editor:</h3> —I am reporting another proprietary, pleasantly flavored, fat reducing medicament as causing dermatitis. Like them all, it is guaranteed to contain no harmful ingredients. It is is but another argument against the permission to patent drugs without the investigation of a nonbiased group. A solution made of a small portion of the substance, to which was added a few drops of 10 per cent sodium hydroxide, gave the typical color reaction of phenolpthalein. The patient is a young man who had five previous attacks of a similar eruption. The peculiarity of the eruption was its recurrence in the same sites as on each previous attack and its appearance in the form of an intense inflammatory reaction, with redness, swelling and bullae. The picture was that of erythema multiforme, with coin-sized areas of pigment on the site of each bleb. In each instance the reaction was limited to
Specific detection of Mycobacterium paratuberculosis DNA associated with granulomatous tissue in Crohn's disease.
Authors: H M Fidler, W Thurrell, N M Johnson, G A Rook, J J McFadden
Journal: Gut (1994)

The role of mycobacteria, specifically Mycobacterium paratuberculosis, in Crohn9s disease has aroused considerable controversy for many years. Using the ultra sensitive polymerase chain reaction some studies have reported detection of M paratuberculosis DNA in as many as 65% of Crohn9s disease patients but also in patients without disease. Other studies have been negative for both groups. We therefore designed a double blind control trial to investigate the presence of mycobacterial DNA in age, sex, and tissue matched paraffin wax embedded tissues from 31 Crohn9s disease tissues, 20 diseased gut control tissues, and 10 ulcerative colitis tissues. The specimens were coded and analysed blind with three separate polymerase chain reactions (PCR) based on DNA sequences specific for M paratuberculosis (IS900), M avium (RFLP type A/1) (IS901), and the Mycobacterium genus (65 kDa gene, TB600). The number of granulomata and presence of acid fast bacilli in each Crohn9s disease tissue was also investigated. The sensitivity of the system was determined using similarly prepared gut tissue from an animal infected with M paratuberculosis. Four of 31 Crohn9s disease tissues and none of the 30 control and ulcerative colitis derived tissues amplified M paratuberculosis DNA. Crohn9s disease tissues containing granulomata were significantly more likely to amplify M paratuberculosis specific DNA on PCR than the non-Crohn9s disease tissues (p = 0.02). All the positive Crohn9s disease tissues contained granulomata, and none contained acid fast bacilli. Equivalent numbers of Crohn9s and non-Crohn9s disease tissues amplified the region of the 65 kD gene on PCR for non-specific mycobacterial DNA (11/31 and 9/30 respectively). No sections produced an amplified product with the IS901 PCR. These results suggest that few Crohn9s disease gut biopsy sections contain M paratuberculosis DNA in association with granulomata. The absence of such DNA in any control and ulcerative colitic tissue strengthens the case for it having a specific association, which may be pathogenic, with Crohn9s disease in this minority of patients.
SERUM THERAPY IN PULMONARY TUBERCULOSIS, WITH AN EXPLANATION OF SECONDARY SYMPTOMS FOLLOWING THE ADMINISTRATION OF ANTITOXIN.
Authors: CHARLES WILSON INGRAHAM
Journal: JAMA (1895)

Much has been written in regard to certain unpleasant and untoward symptoms attending the administration of antitoxin in cases of diphtheria. There has been a disposition on the part of physicians to attribute these symptoms to some peculiarity of antitoxin after its introduction into the system of diphtheritic patients. Some regard them as due to secondary septic infection. I believe, however, that I shall be able to prove substantially that these identical symptoms will follow the administration of pure serum with the same certainty and severity as they follow the use of antitoxin. I base this statement upon the manifestations which I have observed to follow the administration of serum from the blood of the mule in cases of laryngeal and pulmonary tuberculosis. The most constant and unpleasant symptom following the administration of mule serum is the intense eruption which covers every portion of the body and gives rise to
Sirolimus-eluting stents for treatment of in-stent restenosis in the real world: Preliminary results from the Rapamycin-Eluting Stent Evaluated at Rotterdam Cardiology Hospital (RESEARCH) registry
Authors: Francesco Saia, Pedro A. Lemos, Muzaffer Degertekin, Evelyn Regar, Chourmouzios A. Arampatzis, Chi-Hang Lee, Kengo Tanabe, Pim de Feyter, Willem J. van der Giessen, George Sianos, Pieter Smits, Ron T. van Domburg, Patrick W. Serruys
Journal: Journal of the American College of Cardiology (2003)
PREDICTING MAJOR ADVERSE CARDIAC EVENTS AND INFARCT SIZE USING ST-SEGMENT RESOLUTION AS A CONTINUOUS RATHER THAN A DICHOTOMOUS VARIABLE IN PATIENTS ACHIEVING THROMBOLYSIS IN MYOCARDIAL INFARCTION FLOW GRADE III AFTER PRIMARY PERCUTANEOUS CORONARY INTERVENTION FOR ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION
Authors: Wichert J. Kuijt, Andrzej S. Kosinski, Niels J. Verouden, Joost D. Haeck, Matthew T. Roe, Cindy L. Green, Karel T. Koch, Ricardo Baeza, Dan Tzivoni, Robbert J. De Winter, Mitchell W. Krucoff
Journal: Journal of the American College of Cardiology (2010)
Unstable Angina and Elevated C-Reactive Protein Levels Predict Enhanced Vasoreactivity of the Culprit Lesion
Authors: Fabrizio Tomai, Filippo Crea, Achille Gaspardone, Francesco Versaci, Anna S. Ghini, Luigi Chiariello, Pier A. Gioffrè
Journal: Circulation (2001)

Background Because plaque inflammation may modulate coronary vasomotion, the association between systemic levels of C-reactive protein (CRP) and coronary vasoreactivity was assessed in patients with stable or unstable angina. Methods and Results In 31 patients with stable angina and 23 patients with unstable angina undergoing coronary angiography, minimal luminal diameter (MLD) of the culprit lesion was measured by quantitative coronary angiography at baseline, during the cold pressor test (CPT), and after intracoronary administration of nitroglycerin (NTG) and expressed as percent change from baseline. MLD of patients with unstable angina exhibited a greater reduction during CPT and a greater increase after NTG than did patients with stable angina (−17±14% versus −5±12%, P =0.0013, and 34±25% versus 8±20%, P &lt;0.001, respectively). According to preprocedural serum levels of CRP, 36 patients had normal (≤0.5 mg/dL) and 18 patients had elevated CRP levels. MLD of patients with elevated CRP levels exhibited a greater reduction during CPT and a greater increase after NTG than of patients with normal CRP levels (−15±12% versus −7±14%, P =0.037, and 31±23% versus 13±25%, P =0.011, respectively). Both unstable angina and elevated CRP levels resulted in independent predictors of enhanced vasoreactivity at the multivariate analysis. Conclusions This study confirms enhanced vasoreactivity of the culprit lesion in patients with unstable angina compared with those with stable angina. More importantly, it demonstrates that inflammatory mechanisms play a key role in modulating the reactivity of coronary atherosclerotic plaques and may partially account for the enhanced vasoreactivity of the unstable plaques.
The effects of shock energy, propranolol, and verapamil on cardiac damage caused by transthoracic countershock.
Authors: J N Patton, J D Allen, J F Pantridge
Journal: Circulation (1984)

Myocardial damage by transthoracic countershocks was assessed by observation for electrocardiographic loss of R waves and elevation of ST segments, creatine kinase depletion, and histologic evidence of necrosis in damaged areas, and by excision and examination, 3 days later, of all tissue macroscopically observed to be damaged. When 4000 J of stored energy was passed across the chest of dogs anesthetized with pentobarbital sodium (30 mg/kg), more damage was caused when the energy was divided among 10 shocks than when it was applied in 20 or 40 shocks (at intervals of 0.5 min). The prior intravenous administration of verapamil (1 mg/kg) reduced the weight of damaged shocks. Propranolol (0.4 mg/kg) had no effect. These results give further evidence for the role of calcium accumulation in cardiac necrosis after direct current countershocks. Multiple low-energy shocks cause less cardiac damage than do a few high-energy shocks of similar total energy.
Most screening tests do not save lives, researchers argue
Authors: J. Wise
Journal: BMJ (2015)

Few of the currently available screening tests for major diseases show documented reductions in disease specific mortality, and reductions in all cause mortality are very rare or non-existent, a systematic review in the International Journal of Epidemiology has concluded.1

The issue of screening asymptomatic adults for disease remains controversial. Researchers from the Stanford School of Medicine in California evaluated evidence …
Human Serum in Yellow Fever.
Authors: C. C. Stockard
Journal: JAMA (1898)

Atlanta, Ga. <h3>To the Editor:</h3> —During the Yellow fever epidemic of 1897, while regretting that Sanarelli had not been able to put out his serum for the treatment of this disease, the thought occurred to me that the blood of a person having had the disease should answer all the purposes as well as the serum prepared by the tedious process through animals. It would be a simple matter to take blood from the vein of an immune, preferably one recently recovered from the disease, and immediately inject it into the patient affected or one to be protected. It would certainly be as safe as to use serum prepared through animals, which is bottled and kept some time before using, and I believe, would be fully as effective. I made this suggestion to the Boards of Health of New Orleans, Mobile and Montgomery, but it was late in the epidemic
Cobalamin Binding and Cobalamin-Dependent Enzyme Activity in Normal and Mutant Human Fibroblasts
Authors: Ira Mellman, Huntington F. Willard, Leon E. Rosenberg
Journal: Journal of Clinical Investigation (1978)

We have studied the intracellular binding of radioactive cobalamin by normal cultured human fibroblasts grown in medium containing [57Co]-cobalamin. We have also assessed the significance of defects in this binding activity exhibited by two classes of human mutants (cbl C and cbl D) each characterized by pleiotropic deficiencies in the accumulation and retention of cobalamin, in the synthesis of cobalamin coenzymes, and accordingly, in the holoenzyme activities of both cobalamin-dependent enzymes, 5-methyltetrahydrofolate:homocysteine methyltransferase and methylmalonyl-CoA mutase. Based on the coincidence of [57Co]cobalamin binding and cobalamin-dependent enzyme activities after Sephadex G-150 chromatography and polyacrylamide gel electrophoresis, we conclude that, as in rat liver, the intracellular binding of labeled cobalamin by normal fibroblasts reflects the attachment of the vitamin to the cobalamin-dependent methyltransferase and mutase. Whereas cbl C cells are completely deficient in the binding of [57Co]cobalamin to either enzyme, fibroblasts which bear the phenotypically similar but genetically distinct cbl D mutation retain some binding activity, and accordingly, have higher holomethyltransferase and holomutase activities than do cbl C cells. The defect in [57Co]-cobalamin binding exhibited by both cbl C and cbl D fibroblasts is almost certainly not a result of mutations which affect the methyltransferase or mutase apoenzymes, since the electrophoretic mobilities and the affinities of these enzymes for their respective cobalamin coenzymes are indistinguishable from those in control cell extracts. These results suggest that both the cbl C and cbl D mutations affect some enzymatic step(s) which converts newly taken up cobalamin to a form capable of being bound by the two cobalamin-dependent enzymes.