tbuckley/cabot-search huggingface dataset:
Effects of postganglionic nerve stimulation in oesophageal achalasia: an in vitro study.
Authors: A Tlottrup, A Forman, P Funch-Jensen, U Raundahl, K E Andersson
Journal: Gut (1990)

The functional postganglionic innervation of isolated smooth muscle strips from the oesophagogastric junction was examined in specimens taken from six achalasia patients and seven controls. Muscle strips representing either the longitudinal or the circular layer were prepared and mounted in organ baths and isometric tension was recorded. Electrical field stimulation, selectively exciting nerves, was applied. Strips from the circular layer from controls relaxed during field stimulation, an effect that was the result of stimulation of noncholinergic, non-adrenergic, inhibitory nerves. Circular muscle strips from achalasia patients contracted during field stimulation, an effect that was caused by muscarinic receptor activation. In one patient, atropine reversed the contraction to a relaxation. Longitudinal muscle strips contracted in response to stimulation in both controls and achalasia patients. This response was abolished by atropine. In conclusion the function of postganglionic inhibitory nerve fibres to the circular layer of the oesophagogastric junction is severely impaired in achalasia, while there is a conspicuous, functional cholinergic innervation.
REGIONAL (TERMINAL) ILEITIS: ITS ROENTGEN DIAGNOSIS
Authors: JOHN L. KANTOR
Journal: JAMA (1934)

This is a preliminary communication based on a review of six private cases<sup>1</sup>that came to surgical exploration in the last six years. In four of these the operation was performed by Dr. A. A. Berg and the pathologic examination was made by Dr. Paul Klemperer at the Mount Sinai Hospital. All these cases were finally diagnosed nonspecific ulcerative granulomatous inflammation of the terminal ileum according to the criteria presented by Crohn and his collaborators in 1932.<sup>2</sup>In the remaining cases operation was done elsewhere and before the term "regional (terminal) ileitis" was introduced in the literature. Nevertheless, these descriptions also agree on the presence of ileac thickening and ulceration, and on the absence of new growth, tuberculosis and other known specific inflammation or tumefaction. It therefore seems fair to assume, at least for the purpose of this preliminary communication, that a homogeneous group of cases is being
Ruth Pauline Rickett (nee Armstrong)
Authors: S. Reynolds
Journal: BMJ (2003)

General practitioner who showed that shingles was caused by reactivation of the chickenpox virus Edgar Hope Simpson was one of the outstanding general practitioner researchers of the 20th century.In addition to working full time in family practice he charted precisely the pattern of the common diseases that he saw clinically.In 1940 his wife gave him Wensleydale general practitioner William Pickles' then new book Epidemiology in Country Practice.Hope-Simpson modelled his approach on this, and he exchanged visits with Pickles.Eventually he surpassed even Pickles' work.The bulk of his interest was in infectious diseases.He was self taught and without any formal epidemiological or research training, but he learnt fast.He established a small epidemiological research unit around his practice in 1946 and chaired a Medical Research Council committee.He started to write papers, particularly on chickenpox and herpes zoster, in the 1940s and 1950s, which were published in the Lancet and the BMJ, and he produced a series of publications of which many professors would be proud.Chickenpox and shingles were known to be related, but how?Experts at the time were suggesting that two different viruses existed.Hope-Simpson increasingly believed there was only one, but how to prove it?In the end, he took his small team of research colleagues to the Island of Yell in the Shetlands in 1953 and literally followed up every known case in a much closed community.He was empowered by local islanders' memories for occurrences and dates.By 1962, new microbiological techniques enabled him to prove his point.Only a great intellect could have conceived this possibility-that, remarkably, a virus could commonly lie dormant in the human body, for years, indeed decades, and then reappear in another form.Only an
P407 HBeAg INDEX AND HBVDNA REDUCTION CAN PREDICT LONG TERM RESPONSE OF CHRONIC HEPATITIS B, HBeAg POSITIVE PATIENTS TREATED WITH PEGINTERFERON ALPHA-2a: A THREE-YEAR FOLLOW-UP
Authors: P. Phisalprapa, P. Charatcharoenwitthaya, S. Chainuwatti, W. Chotiyaputta, S. Nimanong, T. Tanwandee
Journal: Journal of Hepatology (2014)
Hepatobiliary Scintigraphy Monitoring Patency of Partial External Biliary Diversion in a Patient With Progressive Familial Intrahepatic Cholestasis
Authors: Onikepe Adegbola, Hua Yang, Hongming Zhuang
Journal: Clinical Nuclear Medicine (2006)

Tc-99m disofenin (DISIDA) hepatobiliary scintigraphy is an excellent imaging modality in the evaluation of cholecystitis, gallbladder dyskinesia, bile leak, and common bile duct obstruction. Partial external biliary diversion is an emerging surgical technique used in recent years in the management of patients with cholestasis caused by different etiologies, especially those with progressive familial intrahepatic cholestasis, which is fatal without treatment. We report a case in which cholescintigraphy was performed in assessing the patency of a partial external biliary diversion.
Preventing Lethal Hospital Outbreaks of Antibiotic-Resistant Bacteria
Authors: Thomas J. Sandora, Donald A. Goldmann
Journal: New England Journal of Medicine (2012)

The threat of infections due to multidrug-resistant organisms is increasing, and multidrug-resistant gram-negative rods are the most menacing such organisms. Reliable adherence to basic practices is the key to interrupting transmission in our hospitals.
Letter: Single-dose tinidazole therapy for giardiasis.
Authors: T Pettersson
Journal: BMJ (1975)

HBAg in Papular Acrodermatitis of Childhood SIR,-Your leading article on Australia antigen in papular acrodermatitis of childhood (9 March, p. 407), criticizing Gianotti's' hypothesis that serum hepatitis and papular acrodermatitis of childhood (P.A.C.) are the same disease or are closely related, prompts us to report our own ex- perience in the matter.We have recently seen three children with the characteristic picture of P.A.C. as described by C&anotti.Their serum bilirubin was normal and transaminases were at the upper end of the normal range.Using radioimmunoassay as described by Ling and Overby2 we found that all three children were HBAg positive.None were living in any institution.Their parents were HBAg negative.We agree that the presence of HBAg in cases of P.A.C. needs further investigation, and the most sensitive method available for this is radioimmunoassay.If such studies confirm previous reports they will provide strong support for Gianotti's theory of a close relationship between serum hepatitis and P.A.C. P.A.C. would then be the only disease other than serum hepatitis to be consistently associated with HBAg.Con- sidering the prevalence of anicteric hepatitis in children P.A.C. might be a peculiar formn of hepatitis in childhood due to a particular reactivity of the reticulohistiocytic system to the viral infection.-Weare, etc.,
Eosinophils in the zebrafish: prospective isolation, characterization, and eosinophilia induction by helminth determinants
Authors: Keir M. Balla, Geanncarlo Lugo-Villarino, Jan M. Spitsbergen, David L. Stachura, Yan Hu, Karina Bañuelos, Octavio Romo-Fewell, Raffi V. Aroian, David Traver
Journal: Blood (2010)
Maternal Heat Exposure and Neural Tube Defects
Authors: Aubrey Milunsky
Journal: JAMA (1992)

To determine if exposure to hot tub, sauna, fever, or electric blanket during early pregnancy was associated with an increased risk for neural tube defects (NTDs).Prospective follow-up study.Mostly private obstetric practices, primarily in New England.A cohort of 23,491 women having serum alpha-fetoprotein screening or an amniocentesis were identified. Complete exposure and outcome information was available for 97% of these women.Relative risks (RRs) were used to compare incidence of NTD in those exposed to heat with those who were not exposed to any heat. Crude RRs were calculated directly from the data. Unconfounded RRs were calculated using logistic regression.Women reporting any heat exposure (sauna, hot tub, fever, or electric blanket) in early pregnancy had a crude risk of their fetuses developing NTD of 1.6 (95% CI [confidence interval], 0.9 to 2.9). Women reporting exposure to sauna, hot tub, or fever in early pregnancy had a crude risk of their fetuses developing NTD 2.2 times that of women without heat exposure (95% CI, 1.2 to 4.1). For hot tub use, the crude RR was 2.9 (95% CI, 1.4 to 6.3); for sauna, 2.6 (95% CI, 0.7 to 10.1); for fever, 1.9 (95% CI, 0.8 to 4.1); and for electric blanket, 1.2 (95% CI, 0.5 to 2.6). Multivariate adjusted RRs for individual heat sources, after controlling for maternal age, folic acid supplements, family history of NTD, and exposure to other heat sources, were for hot tub use, 2.8 (95% CI, 1.2 to 6.5); sauna, 1.8 (95% CI, 0.4 to 7.9); fever, 1.8 (95% CI, 0.8 to 4.1); and electric blanket, 1.2 (95% CI, 0.5 to 2.6). When only hot tub, sauna, and fever were considered and the women's exposure to each tallied, compared with no heat exposure, the RR for NTDs increased from 1.9 (95% CI, 0.9 to 3.7) after one type of heat exposure to 6.2 (95% CI, 2.2 to 17.2) after two types of heat exposure.Exposure to heat in the form of hot tub, sauna, or fever in the first trimester of pregnancy was associated with an increased risk for NTDs. Hot tub exposure appeared to have the strongest effect of any single heat exposure. Exposure to electric blanket was not materially associated with increased risk for NTDs.
Anti-CD8 impairs clearance of herpes simplex virus from the nervous system: implications for the fate of virally infected neurons.
Authors: A Simmons, D C Tscharke
Journal: The Journal of Experimental Medicine (1992)

The role of CD8+ T cells in resistance to herpes simplex virus (HSV) was examined. After cutaneous inoculation, HSV spreads to the peripheral nervous system (PNS) where it replicates in ganglionic neurons. In normal mice, replication of virus in the PNS was rapidly terminated and evidence of neuronal destruction, assessed by a quantitative histological assay, was sparse. Clearance of infectious virus was impaired, and a strikingly high proportion of ganglionic neurons was killed, in mice treated with an antibody that depleted them of CD8+ T cells. These results suggest that CD8+ T cells play an important role in maintaining the integrity of the sensory nervous system during primary infection with HSV. Therefore, viral epitopes recognized by CD8+ T cells and restricting class I major histocompatibility complex genes are, in principle, implicated as interacting genetic determinants of neurovirulence.
Toronto strives for normality after WHO lifts travel warning
Authors: D. Spurgeon
Journal: BMJ (2003)

Canada is making huge efforts to recover Toronto's prominence as a tourist destination and commercial centre after the World Health Organization's reversal last week of its earlier advice to travellers to consider postponing all but essential travel there because of the outbreak of severe acute respiratory syndrome (SARS).

The WHO announcement came after a meeting in Geneva between health officials from WHO and Canada. It was “based on consideration of three criteria: a decrease to below the defined threshold level of 60 prevalent SARS cases and five new SARS cases per day, a period of 20 days since the last case of community transmission occurred, and no new confirmed cases of exportation.”

Dr Guenael Rodier, WHO's director of communicable disease surveillance and response, added in a letter on 30 April posted on the …
Variants in interferon-alpha pathway genes and response to pegylated interferon-Alpha2a plus ribavirin for treatment of chronic hepatitis C virus infection in the hepatitis C antiviral long-term treatment against cirrhosis trial
Authors: Tania Mara Welzel, Timothy R. Morgan, Herbert L. Bonkovsky, Deepa Naishadham, Ruth M. Pfeiffer, Elizabeth C. Wright, Amy A. Hutchinson, Andrew T. Crenshaw, Arman Bashirova, Mary Carrington, Myhanh Dotrang, Richard K. Sterling, Karen L. Lindsay, Robert J. Fontana, William M. Lee, Adrian M. Di Bisceglie, Marc G. Ghany, David R. Gretch, Stephen J. Chanock, Raymond T. Chung, Thomas R. O'Brien
Journal: Hepatology (2009)

Combination treatment with pegylated-interferon-alpha (PEG IFN-alpha) and ribavirin, the current recommended therapy for chronic hepatitis C virus (HCV) infection, results in a sustained virological response (SVR) in only about half of patients. Because genes involved in the interferon-alpha pathway may affect antiviral responses, we analyzed the relationship between variants in these genes and SVR among participants in the Hepatitis C Antiviral Long-Term treatment Against Cirrhosis (HALT-C) trial. Patients had advanced chronic hepatitis C that had previously failed to respond to interferon-based treatment. Participants were treated with peginterferon-alpha2a and ribavirin during the trial. Subjects with undetectable HCV RNA at week 72 were considered to have had an SVR. Subjects with detectable HCV RNA at week 20 were considered nonresponders. We used TaqMan assays to genotype 56 polymorphisms found in 13 genes in the interferon-alpha pathway. This analysis compares genotypes for participants with an SVR to nonresponders. The primary analysis was restricted to European American participants because a priori statistical power was low among the small number (n = 131) of African American patients. We used logistic regression to control the effect of other variables that are associated with treatment response. Among 581 European American patients, SVR was associated with IFNAR1 IVS1-22G (adjusted odds ratio, 0.57; P = 0.02); IFNAR2 Ex2-33C (adjusted odds ratio, 2.09; P = 0.02); JAK1 IVS22+112T (adjusted odds ratio, 1.66; P = 0.04); and ADAR Ex9+14A (adjusted odds ratio, 1.67; P = 0.03). For the TYK2-2256A promoter region variant, a borderline association was present among European American participants (OR, 1.51; P = 0.05) and a strong relationship among African American patients; all 10 with SVR who were genotyped for TYK2 -2256 carried the A variant compared with 68 of 120 (57%) nonresponders (P = 0.006).Genetic polymorphisms in the interferon-alpha pathway may affect responses to antiviral therapy of chronic hepatitis C.
Commentary: Controversies in NICE guidance on familial hypercholesterolaemia
Authors: D. Wald
Journal: BMJ (2008)

The recommendations from the National Institute for Health and Clinical Excellence (NICE) on the management of familial hypercholesterolaemia give guidance in three general areas: diagnosis, treatment, and screening to identify new cases.1 The guidelines are immediately applicable to diagnosis and treatment, but the way forward on screening will need a new approach.

The guidelines propose cascade testing, a term used to describe searching for affected relatives of an inherited disorder once an affected person is known and repeating this process every time another affected individual is found. This is appropriate in general medical practice as 1 in 2 first degree relatives of someone with familial hypercholesterolaemia will also have the condition. The diagnosis of an index case is initially made clinically, and a gene mutation causing familial hypercholesterolaemia is found in up to about 80% of cases, depending on which test is used.1 

The guidelines recommend that cascade testing include both DNA analysis and cholesterol measurement. If a mutation causing familial hypercholesterolaemia is identified, this …
Molecular biology of natriuretic peptides and nitric oxide synthases
Authors: B Kone
Journal: Cardiovascular Research (2001)

Natriuretic peptides and nitric oxide play important roles in cardiovascular and renal physiology and disease. The natriuretic peptides — atrial natriuretic peptide, brain natriuretic peptide, and C-type natriuretic peptide — comprise a family of proteins that participate in the integrated control of intravascular volume and arterial blood pressure. The natriuretic peptides differentially bind distinct classes of receptors that signal through different mechanisms. Membrane-bound, guanylyl cyclase-coupled natriuretic peptide receptors (A- and B-types) mediate natriuretic peptide effects through the production of 3′,5′-cyclic guanosine monophosphate (cGMP). C-Type natriuretic peptide receptors, which lack the guanylyl cyclase domain, alter target cell function through Gi protein-coupled inhibition of membrane adenylyl cyclase activity, and also serve to clear circulating natriuretic peptides. The expression of the natriuretic peptides and their receptors are subject to complex controls. Similar structural and regulatory diversity exists for the nitric oxide synthases. The three nitric oxide synthase genes are regulated by a variety of mechanisms ranging from alternative splicing and alternative promoter usage to complex post-translational controls. This review highlights the molecular diversity of the natriuretic peptides and nitric oxide synthases and explores recent insights into their regulation.
THE INACTIVATION OF THE VIRUS OF EPIDEMIC INFLUENZA BY SOAPS
Authors: C. Chester Stock, Thomas Francis
Journal: The Journal of Experimental Medicine (1940)

The capacity of certain fatty acids at pH 7.5 to inactivate the virus of epidemic influenza has been demonstrated. Most effective of these are oleic, linolic, and linolenic acids. Studies were made of such variables as pH, rate of inactivation, and ratios of reactant concentrations, using oleic acid as a prototype of the effective acids. Attempts to recover active virus from inactive mixtures by decrease in pH, dialysis, dilution, or addition of calcium chloride solution to inactivated virus have been unsuccessful. The stability of virus at different hydrogen ion concentrations has been determined. Quantitative comparisons have been made of the immunizing capacity of fully active virus and virus rendered non-infectious by treatment with oleic acid. It was found that while the infectious property of the virus is removed the immunogenic capacity is essentially unaltered. The possible mechanism by which the soaps act upon influenza virus has been discussed.
Renal Function and Risk of Coronary Heart Disease in General Populations: New Prospective Study and Systematic Review
Authors: Emanuele Di Angelantonio, John Danesh, Gudny Eiriksdottir, Vilmundur Gudnason
Journal: PLoS Medicine (2007)

End-stage chronic kidney disease is associated with striking excesses of cardiovascular mortality, but it is uncertain to what extent renal function is related to risk of subsequent coronary heart disease (CHD) in apparently healthy adults. This study aims to quantify the association of markers of renal function with CHD risk in essentially general populations.Estimated glomerular filtration rate (eGFR) was calculated using standard prediction equations based on serum creatinine measurements made in 2,007 patients diagnosed with nonfatal myocardial infarction or coronary death during follow-up and in 3,869 people without CHD in the Reykjavik population-based cohort of 18,569 individuals. There were small and nonsignificant odds ratios (ORs) for CHD risk over most of the range in eGFR, except in the lowest category of the lowest fifth (corresponding to values of <60 ml/min/1.73 m2), in which the OR was 1.33 (95% confidence interval 1.01-1.75) after adjustment for several established cardiovascular risk factors. Findings from the Reykjavik study were reinforced by a meta-analysis of six previous reports (identified in electronic and other databases) involving a total of 4,720 incident CHD cases (including Reykjavik), which yielded a combined risk ratio of 1.41 (95% confidence interval 1.19-1.68) in individuals with baseline eGFR less than 60 ml/min/1.73 m2 compared with those with higher values.Although there are no strong associations between lower-than-average eGFR and CHD risk in apparently healthy adults over most of the range in renal function, there may be a moderate increase in CHD risk associated with very low eGFR (i.e., renal dysfunction) in the general population. These findings could have implications for the further understanding of CHD and targeting cardioprotective interventions.
High-Risk Use by Patients Prescribed Opioids for Pain and Its Role in Overdose Deaths
Authors: Jane A. Gwira Baumblatt, Caleb Wiedeman, John R. Dunn, William Schaffner, Leonard J. Paulozzi, Timothy F. Jones
Journal: JAMA Internal Medicine (2014)

From January 1, 2003, through December 31, 2010, drug overdose deaths in Tennessee increased from 422 to 1059 per year. More of these deaths involved prescription opioids than heroin and cocaine combined.To assess the contribution of certain opioid-prescribing patterns to the risk of overdose death.We performed a matched case-control study that analyzed opioid prescription data from the Tennessee Controlled Substances Monitoring Program (TNCSMP) from January 1, 2007, through December 31, 2011, to identify risk factors associated with opioid-related overdose deaths from January 1, 2009, through December 31, 2010. Case patients were ascertained from death certificate data. Age- and sex-matched controls were randomly selected from among live patients in the TNCSMP.We defined a high-risk number of prescribers or pharmacies as 4 or more per year and high-risk dosage as a daily mean of more than 100 morphine milligram equivalents (MMEs) per year. The main outcome was opioid-related overdose death.From January 1, 2007, through December 31, 2011, one-third of the population of Tennessee filled an opioid prescription each year, and opioid prescription rates increased from 108.3 to 142.5 per 100 population per year. Among all patients in Tennessee prescribed opioids during 2011, 7.6% used more than 4 prescribers, 2.5% used more than 4 pharmacies, and 2.8% had a mean daily dosage greater than 100 MMEs. Increased risk of opioid-related overdose death was associated with 4 or more prescribers (adjusted odds ratio [aOR], 6.5; 95% CI, 5.1-8.5), 4 or more pharmacies (aOR, 6.0; 95% CI, 4.4-8.3), and more than 100 MMEs (aOR, 11.2; 95% CI, 8.3-15.1). Persons with 1 or more risk factor accounted for 55% of all overdose deaths.High-risk use of prescription opioids is frequent and increasing in Tennessee and is associated with increased overdose mortality. Use of prescription drug–monitoring program data to direct risk-reduction measures to the types of patients overrepresented among overdose deaths might reduce mortality associated with opioid abuse.
Richard Hefin Trefor Jones
Authors: P. Edwards
Journal: BMJ (2003)

Consultant paediatrician Bridgend 1972-2000 (b Penrhyndeudraeth, Meirionydd, 1934; q Liverpool 1958; FRCPCH, FRCP, DCH), died from a heart attack on 3 May 2003.​2003.




Figure 1




Trefor did national service in Canada before returning to Wales as a paediatric registrar in Bangor. After a spell as research fellow at Alder Hey he returned to Canada as associate professor of paediatrics at the University of Saskatchewan. In 1972 he came back to Wales to become the first consultant paediatrician based at Bridgend. He remained singlehanded for the first seven years and laid the foundations of a modern paediatric department. He was a founder member of the Welsh Paediatric Society and served as medical director of the Bridgend and District NHS Trust. He leaves a wife, Peggy, and three daughters.