tbuckley/cabot-search huggingface dataset:
Indices of Insulin Action, Disposal, and Secretion Derived From Fasting Samples and Clamps in Normal Glucose-Tolerant Black and White Children
Authors: Gabriel I. Uwaifo, Erica M. Fallon, Jeff Chin, Jane Elberg, Shamik J. Parikh, Jack A. Yanovski
Journal: Diabetes Care (2002)

OBJECTIVE—To validate fasting indices of insulin sensitivity and secretion in a diverse pediatric population against gold standard estimates from euglycemic and hyperglycemic clamps. RESEARCH DESIGN AND METHODS—A total of 31 children (mean BMI 25.1 ± 4.9 kg/m2, mean age 8.7 ± 1.4 years, 15 girls and 16 boys, 12 black and 19 white) underwent euglycemic and hyperglycemic clamps 2–6 weeks apart to derive insulin sensitivity indices (SI Eug clamp and SI Hyper clamp). Fasting samples were used to derive the homeostasis model assessment of insulin resistance index (HOMA-IR), HOMA of percent β-cell function (HOMA-B%), quantitative insulin sensitivity check index (QUICKI), insulinogenic index, antilipolytic insulin sensitivity index (ISI-FFA), and C-peptide–to–insulin ratio. RESULTS—The QUICKI correlated best with SI Eug clamp (r = 0.69, P &amp;lt; 0.05) and had greater correlations to SI Eug clamp than did either SI Hyper clamp (r = 0.45, P &amp;lt; 0.05) or the HOMA-IR (r = −0.51, P &amp;lt; 0.05). Both fasting insulin and the insulinogenic index correlated well with first- and steady-phase insulin secretion (r’s from 0.79 to 0.86, P &amp;lt; 0.05). HOMA-B% was not as highly correlated (r = 0.69–0.72, P &amp;lt; 0.05). Fasting C-peptide–to–insulin ratio was not significantly correlated with clamp-derived metabolic clearance rate of insulin. ISI-FFA was not correlated with the degree of free fatty acid suppression obtained from the clamps. CONCLUSIONS—The QUICKI, fasting insulin, and the insulinogenic index all closely correlate with corresponding clamp-derived indices of insulin sensitivity and secretion in this diverse pediatric cohort. These results, if replicated in similarly diverse populations, suggest that estimates based on fasting samples can be used to rank order insulin secretion and sensitivity in pediatric cohorts.
Lectin-like domain of thrombomodulin binds to its specific ligand Lewis Y antigen and neutralizes lipopolysaccharide-induced inflammatory response
Authors: Chung-Sheng Shi, Guey-Yueh Shi, Hsi-Min Hsiao, Yuan-Chung Kao, Kuan-Lin Kuo, Chih-Yuan Ma, Cheng-Hsiang Kuo, Bi-Ing Chang, Chuan-Fa Chang, Chun-Hung Lin, Chi-Huey Wong, Hua-Lin Wu
Journal: Blood (2008)
Current cytogenetic methods for detecting exposure and effects of mutagens and carcinogens.
Authors: A T Natarajan, J J Boei, F Darroudi, P C Van Diemen, F Dulout, M P Hande, A T Ramalho
Journal: Environmental Health Perspectives (1996)

Most mutagens and genotoxic carcinogens are efficient inducers of chromosomal alterations in exposed cells. Two important classes of aberrations, namely structural and numerical, are recognized and both types of aberrations are associated with congenital abnormalities and neoplasia in humans. These alterations can be easily detected and quantified in human peripheral blood lymphocytes. Conventional staining techniques can be used to detect these aberrations; this technique was used to estimate absorbed dose in the case of a radiation accident in Goiania, Brazil. A recently introduced fluorescent in situ hybridization technique (FISH) using DNA probes has increased the sensitivity and ease of detecting chromosome aberrations, especially stable chromosome aberrations. This technique allows, to some extent, the estimation of absorbed radiation dose from past exposures. Numerical aberrations can be directly estimated in metaphases by counting the number of FISH-painted chromosomes. Micronuclei are formed by lagging chromosome fragments or whole chromosomes during the anaphase stage of cell division. The nature of micronuclei as to whether they possess a centromere can be determined either by CREST staining (calcinosis, Raynoud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia) or FISH with centromere-specific DNA probes. In several carcinogen-exposed populations, such as heavy smokers or people exposed to arsenic, aneuploidy appears to be more common than structural aberrations. In victims of radiation accidents, aneuploidy (hyperploidy) has been found to be common in addition to structural aberrations.
GUIDELINE-BASED STATIN ALLOCATION TO DISTINGUISH BOTH CARDIOVASCULAR EVENTS AND CORONARY ARTERY CALCIFICATION IN THE COMMUNITY: A COMPARISON OF THE 2004 NCEP ATP III AND 2013 ACC/AHA CHOLESTEROL TREATMENT GUIDELINE
Authors: Amit Pursnani, Joseph Massaro, Ralph D’Agostino, Christopher O’Donnell, Udo Hoffmann
Journal: Journal of the American College of Cardiology (2015)
S65 Early supported discharge scheme (ESDS) for pneumonia &amp; lower respiratory tract infection (LRTI): are there enough suitable patients?
Authors: A. Collins, S. Wilks, D. Wootton, A. Wright, L. Davies, J. Hadcroft, S. Gordon
Journal: Thorax (2011)

<h3>Background</h3> Despite the fact that ∼75% of community acquired pneumonia (CAP) is managed in the community, admissions for pneumonia, influenza &amp; LRTI account for more than 2.3 million bed days/yr in England alone. Strategies to enable increased outpatient care must be safe, acceptable to patients &amp; potentially reduce costs &amp; improve patient outcomes. Current guidelines suggest that patients with CURB-65 &gt;2 require hospitalisation, but up to 70% of pneumonia admissions are CURB-65 =2. Median length of stay (LOS) for CAP is 6–12.9 days. Despite low risk-scores patients may have a prolonged hospital admission due to other reasons for example, comorbidities &amp; social issues. <h3>Aim</h3> To retrospectively investigate the number of patients that could potentially be discharged with an ESDS, akin to current COPD schemes. <h3>Method</h3> We performed a retrospective audit of 54 case-notes randomly selected from 462 admissions (with J-codes 10–18) over a 2-month period. Certain inclusion &amp; exclusion criteria were used to assess scheme eligibility (appropriate diagnosis) &amp; scheme suitability. <h3>Results</h3> Mean age=70 yrs old (range 18–96). Mean CURB-65=1.93 (range 0–4). Of CAP pts (n=38) CURB 0–1=32%, 2=26%, 3–5=34%. Comorbidities were common; COPD (16/54), cancer (13/54), IHD (10/54), dementia (8/54). Eligible for ESDS n=46, suitable n=22/46 (48%). 84% of those eligible for ESDS had comorbidities, but these did not necessarily make patients unsuitable for ESDS. The total potential reduction in LOS with ESDS is 2.75 (1–7) days. With a conservative estimate of 2400 pneumonia admissions annually &amp; a 10-day mean LOS, (a total of 24 000 bed days/yr), 6600 bed days/yr could be saved in our hospital trust alone. Using HES data for annual admissions with pneumonia and influenza (∼150 000/yr), this amounts to a potential saving of 412 500 bed days annually in England alone. <h3>Conclusions</h3> This retrospective audit suggests that a proactive ESDS scheme could enable patients to be provided with high-quality safe, effective, efficient patient-centred care, tailored to their needs, in their own home. This is an opportunity to improve health policy, healthcare delivery/services &amp; reduce admission rates; an area of major strategic importance to the NHS.
Individualized developmental care. An emerging new standard for neonatal intensive care units?
Authors: G. B. Merenstein
Journal: JAMA (1994)

Many factors have improved the infant and neonatal mortality in this country. The evolution of nurseries for premature newborns into modern neonatal intensive care units (NICUs) and technological advances used in NICUs have certainly contributed to the reduction in mortality for all birth-weight/gestational-age categories. This reduction in mortality has been most dramatic in recent years for very low-birth-weight (  See also p 853.  The acceptance of new innovations in care in perinatal medicine has an unfortunate history. Unproven therapies or therapies with inappropriate risks have been adopted, while proven therapies remain underused. In the 1940s and 1950s, an epidemic of blindness, due to retinopathy
Hepatitis C virus infection enhances TNFα-induced cell death via suppression of NF-κB
Authors: Junseong Park, Wonseok Kang, Seung-Wook Ryu, Woo-Il Kim, Dong-Yeop Chang, Dong Ho Lee, Do Youn Park, Youn-Hee Choi, Kyungsun Choi, Eui-Cheol Shin, Chulhee Choi
Journal: Hepatology (2012)

Hepatitis C virus (HCV) infection results in liver injury and long-term complications, such as liver cirrhosis and hepatocellular carcinoma. Liver injury in HCV infection is believed to be caused by host immune responses, not by viral cytopathic effects. Tumor necrosis factor-alpha (TNF-α) plays a pivotal role in the inflammatory processes of hepatitis C. TNF-α induces cell death that can be ameliorated by nuclear factor kappaB (NF-κB) activation. We investigated the regulation of TNF-α signal transduction in HCV-infected cells and identified HCV proteins responsible for sensitization to TNF-α-induced cell death. We studied the effect of HCV infection on TNF-α signal transduction using an in vitro HCV infection model (JFH-1, genotype 2a) with Huh-7 and Huh-7.5 cells. We found that TNF-α-induced cell death significantly increased in HCV-infected cells. HCV infection diminished TNF-α-induced phosphorylation of IκB kinase (IKK) and inhibitor of NF-κB (IκB), which are upstream regulators of NF-κB activation. HCV infection also inhibited nuclear translocation of NF-κB and expression of NF-κB-dependent anti-apoptotic proteins, such as B-cell lymphoma—extra large (Bcl-xL), X-linked inhibitor of apoptosis protein (XIAP), and the long form of cellular-FLICE inhibitory protein (c-FLIP). Decreased levels of Bcl-xL, XIAP, and c-FLIP messenger RNA and protein were also observed in livers with chronic hepatitis C. Transfection with plasmids encoding each HCV protein revealed that core, nonstructural protein (NS)4B, and NS5B attenuated TNF-α-induced NF-κB activation and enhanced TNF-α-induced cell death. Conclusion : HCV infection enhances TNF-α-induced cell death by suppressing NF-κB activation through the action of core, NS4B, and NS5B. This mechanism may contribute to immune-mediated liver injury in HCV infection.
Anisocoria From Jimsonweed
Authors: Daniel L. Savitt
Journal: JAMA (1986)

<h3>To the Editor.—</h3> The original article by Price<sup>1</sup>and the recent exchange of letters in<i>JAMA</i>concerning anisocoria from scopolamine patches emphasize an interesting addition to the differential diagnosis of a fixed and dilated pupil. We report a similar case in which we identified an isolated peripheral anticholinergic effect from local contact with jimsonweed. The jimsonweed plant,<i>Datura stramonium</i>, grows wild throughout the United States, and ingestion of any part of the plant produces a characteristic syndrome of systemic anticholinergic poisoning.<sup>2</sup> <h3>Report of a Case.—</h3> A 38-year-old man presented to the emergency department complaining of blurred vision and a dilated pupil. He had spent the morning trimming weeds with a mechanical weed trimmer. He felt otherwise normal and specifically denied headache, nausea, or a stiff neck. His mental status was normal. The right pupil was fully dilated at 6 mm and nonreactive to light, while the left pupil was
Identification of three new Ig lambda-like genes in man.
Authors: H Chang, E Dmitrovsky, P A Hieter, K Mitchell, P Leder, L Turoczi, I R Kirsch, G F Hollis
Journal: The Journal of Experimental Medicine (1986)

Three new human lambda L chain-like Ig genes are identified by restriction enzyme and nucleotide sequence analysis. Two genes, 14.1 and 16.1, have intact J and C regions, and are potentially functional, with open reading frames. A third gene, 18.1, is a pseudogene. The evolutionary lineage of these genes compared to the known functional locus lambda C1-lambda C6 can be surmised from Southern blot and nucleotide homologies. This study demonstrates that the human lambda gene family is more complex than previously recognized.
Questions of sickness certification.
Authors: M Ryan
Journal: BMJ (1980)

should be banned from further contact sports.Murphey and Simmons"8 advised that if head injury was severe enough to produce coma, or if a player has had a craniotomy, then further contact sports should be discouraged.Inevitably, boxing causes repeated minor head injury, and in this sport much attention has been directed towards minimising the effects.Availability of computed tomography may indicate the extent of damage produced by such injuries.19Statutory medical cover and stringent rules regarding further fights after injury have done much to reduce the number of serious head injuries,7 but the number of participants has also declined.The present study has shown that other sports, in particular horse-riding, are now a more frequent cause of severe head injury.More emphasis should be placed on prevention in these sports.The governing bodies of the individual sports should draw up rules to ensure that sports trainers and supervisors are aware of the correct management of head injuries.
Comparison of left and right ventricular end-systolic pressure-volume relations in congestive heart failure
Authors: Marvin A. Konstam, Steven R. Cohen, Deeb N. Salem, Thomas P. Conlon, Jeffrey M. Isner, Dhirendra Das, Michael R. Zile, Herbert J. Levine, Paul C. Kahn
Journal: Journal of the American College of Cardiology (1985)
Perianal hidradenitis suppurativa: early surgical treatment gives good results in chronic or recurrent cases
Authors: None Endo, None Tamura, None Ishikawa, None Miyachi
Journal: British Journal of Dermatology (1998)

Hidradenitis suppurativa (HS) represents a chronic, recurrent, deep-seated folliculitis resulting in abscesses followed by the formation of sinus tracts and scarring. It is an uncommon disorder frequently involving the perianal region. We review the clinical and pathological features of 12 patients (10 men and two women) with perianal HS (PHS). The mean age at presentation was 43 years (range 24-65), and the mean duration of illness was 14 years (range 2-30). Two patients exhibited multiple areas of involvement, including the axilla and the nape of the neck, in addition to the perianal region. Histological examinations showed epidermis-lined sinuses surrounded by dense plasma cell infiltration in four of nine specimens. The complications related with PHS included anal fistula (seven patients), diabetes mellitus (four), malignant tumour (two) and sepsis (one). Three patients died of the complications. Eight patients underwent wide local excision. The defects were managed with a meshed split-thickness skin graft in five patients, and open treatment in the remainder. New lesions developed in untreated skin of two patients. However, no patient relapsed in the surgically treated sites. PHS is frequently complicated with anal fistula and is occasionally life-threatening as a result of the occurrence of malignant tumours or sepsis. Early surgical excision followed by meshed split-thickness skin graft can successfully cure the lesion without functional disturbance.
A novel method to allow noninvasive, longitudinal imaging of the murine immune system in vivo
Authors: Vivienne B. Gibson, Robert A. Benson, Karen J. Bryson, Iain B. McInnes, Catherine M. Rush, Gianluca Grassia, Pasquale Maffia, Eric J. Jenkinson, Andrea J. White, Graham Anderson, James M. Brewer, Paul Garside
Journal: Blood (2012)
Effective Response to Emerging Diseases Called an Essential Priority Worldwide
Authors: Charles Marwick
Journal: JAMA (1995)

ON ALL SIDES, humankind seems besieged by the appearance of new infectious agents and the resurgence of diseases once thought virtually eliminated as public health problems. Official reports caution about neglect of public health warning systems, and hot on their heels have come popular books relating tales of the appearance of new strains of such deadly agents as Ebola virus ready to pounce on susceptible populations.  An expanding number of protective vaccines and therapeutic antibiotics has induced complacency about both age-old infectious diseases and new infectious agents. At the same time, experts maintain, the growing number of other public health needs, such as providing medical care for uninsured people, has led to a shift away from the traditional watchdog public health functions.  See also p 241.  In the last 2 years alone, at least seven infectious agents became the subject of headline news. The events ranged from an outbreak of
Use of anti-idiotypic antibodies to demonstrate rheumatoid factor producing bone marrow cells in essential mixed cryoglobulinaemia.
Authors: A E Gharavi, G Campion, G R Hughes
Journal: Annals of the Rheumatic Diseases (1984)

Specific cells producing rheumatoid factor (RF) were demonstrated in a bone marrow preparation of a patient with essential mixed cryoglobulinaemia. This was achieved by the use of labelled anti-idiotypic antibodies raised against purified RF from the patient9s circulating cryoglobulin. This technique may be applicable to other diseases in which specific antibodies are pathogenetically implicated. The more precise demonstration of specific antibody-producing marrow cells may in addition have therapeutic implications.
Diabetic Peripheral Neuropathy: Effectiveness of electrotherapy and amitriptyline for symptomatic relief
Authors: Dinesh Kumar, Michael S Alvaro, Inderjeet S Julka, Howard J Marshall
Journal: Diabetes Care (1998)

OBJECTIVE To evaluate the efficacy of combining electrotherapy with amitriptyline for the management of chronic painful peripheral neuropathy in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS Patients (n = 26) with peripheral neuropathy were treated with amitriptyline. After 4 weeks, those patients (n = 23) who failed to respond to amitriptyline or who only had partial relief were randomized between a sham treatment group (control) or an electrotherapy group. Transcutaneous electrotherapy was given for 12 weeks by a portable unit (H-wave machine) that generated a biphasic exponentially decaying waveform (pulse width 4 ms, 25–35 V, ≥ 2 Hz). The degree of pain and discomfort was graded on a scale of 0–5. An analog scale was used to record the overall change in symptoms. RESULTS Amitriptyline produced some degree of symptomatic relief in 15 (60%) of the 26 patients by the 4th week; pain scores decreased from 3.8 ± 0.1 to 2.9 ± 0.2 (P &amp;lt; 0.1) and the overall reduction in pain was 26 ± 5% on an analog scale. In the amitriptyline plus sham treatment group (n = 9), pain scores declined from 2.8 ± 0.3 to 1.9 ± 0.5 (P &amp;lt; 0.03) and the overall reduction in pain was 55 ± 12%, suggesting a procedure-related placebo effect. In the group receiving combined electrotherapy and amitriptyline (n = 14), symptomatic improvement occurred in 12 (85%) patients. Five (36%) of the patients in this group became asymptomatic. Pain scores declined from 3.2 ± 0.2 to 1.4 ± 0.4 (P &amp;lt; 0.01) and the overall reduction in pain was 66 ± 10%. The degree of reduction in pain scores and the incremental relief (above the amitriptyline effect) were significantly greater (P &amp;lt; 0.03) with electrotherapy as compared with sham treatment. The outcomes indicate a substantial beneficial effect of electrotherapy over and above any placebo influence. CONCLUSIONS Our clinical observations suggest that transcutaneous electrotherapy is effective in reducing the pain associated with peripheral neuropathy. This form of therapy may be a useful adjunctive modality when it is combined with a pharmacological agent, such as amitriptyline, to augment symptomatic relief.
Diffuse Radioiodine Lung Uptake in Miliary Thyroid Carcinoma Metastases
Authors: STEPHEN M. MANIER, DOUGLAS EGGLI, PETER W. BLUE, DOUGLAS VAN NOSTRAND
Journal: Clinical Nuclear Medicine (1985)

A diffuse pattern of homogeneous tracer uptake is seen by 1-131 scintigraphy in a patient with widespread miliary lung metastases due to papillary thyroid carcinoma. This case report emphasizes the need to include metastatic thyroid carcinoma in the differential diagnosis of miliary lung nodules.
Bone marrow trephine biopsy findings in a case of myeloma with large immunoblast‐like cells
Authors: Saeed Al‐Shieban, Zaid Abboudi, Kikkeri N Naresh
Journal: American Journal of Hematology (2011)

The diagnosis of myeloma requires the presence of 10% or more clonal plasma cells on bone marrow examination or of a biopsy-proven plasmacytoma along with evidence of end-organ damage that can be attributed to the underlying plasma cell disorder [1]. The above-mentioned case had >90% neoplastic plasma cells in the bone marrow and a significant anaemia as a result of the bone marrow infiltration. Cytological features of myeloma cells can be highly variable. They include tumors with mature and benign appearing plasma cells; small lymphoid-like cells; atypical but differentiated plasmacytic cells; blastic cells with high nucleus: cytoplasmic ratio and fine chromatin; large cells with immunoblastic features and highly pleomorphic forms. The current case showed immunoblastic features and pleomorphism. Differential diagnosis varies as per the cytological features and includes benign/reactive plasma cell infiltrates, small cell lymphomas, large cell lymphomas, metastatic carcinomas, and other metastatic tumors. Documentation of the expression of immunoglobulin either at protein level or at RNA level confirms the B-cell/plasma cell lineage of these tumors. Expression of CD138, CD79a, and CD56 is helpful in the diagnosis of myeloma, though carcinomas can express CD138 and those with neuroendocrine features can express CD56. Expression of cyclin D1 is noted in ∼40% of cases and is a very helpful feature in the diagnosis and follow-up of myeloma on bone marrow trephine biopsies [2]. Cases with uniform and strong expression of cyclin D1 are associated CCND1 translocation. 1 [Figure is appearing on following page]. A man in his seventies presented with anemia, pyrexia, and chest symptoms. His hemoglobin was 7 g/dL and white cell count 7.7 × 109/L, neutrophils 5.08 × 109/L and platelets 87 × 109/L. His globulin was 105 g/L, and further evaluation of serum proteins showed that he had an IgG Kappa paraprotein of 84 g/L. The urine revealed the presence of an IgG Kappa paraprotein of 5.3 g/L and presence of Bence-Jones protein. On the skeletal survey, there were no osteolytic lesions. Bone marrow aspirate revealed sheets of large abnormal cells with large nuclei and prominent nucleoli. The cytoplasm was basophilic with perinuclear halo (a–c; MGG, × 10000. Bone marrow trephine biopsy showed hypercellular marrow (d; H&E, ×100), and was entirely replaced by sheets of atypical large cells with large nuclei having relatively fine chromatin and prominent nucleoli, which were often single and centrally located; they had moderate amounts of cytoplasm and the plasmacytic features with eccentric placement of nuclei being subtle (e; H&E, ×600). The neoplastic cells were positive for CD138 (f), CD56 (g) and a proportion of cells expressed cyclin D1 at variable intensities (h). In-situ hybridization for light chains showed kappa light chain restriction [kappa (i) and lambda (j)] (magnifications of e–j ×400).
THE DIAGNOSIS OF GONORRHEA BY CULTURE
Authors: R. B. H. Gradwohl
Journal: JAMA (1926)

The clinical pathologist, the urologist and the gynecologist are frequently consulted in obscure and uncertain cases of urethral, vaginal and uterine discharges. The time-honored method has been to make one stain with ordinary methylene blue and another by the gram stain. If gram negative diplococci are found, some have had the temerity to call them gonococci. I myself have always been averse to doing so, making my reports read "gram-negative diplococci found, resembling gonococci." This, of course, is an inconclusive and often useless report. In order to make a proper bacteriologic diagnosis, I have from time to time attempted to cultivate the organism present and prove its identity. I have used a number of mediums recommended by various authorities, such as blood serum and ascitic fluid agar and milk agar. Success has not always attended my efforts. The gonococcus does not grow readily on ordinary mediums. It does not