tbuckley/cabot-search huggingface dataset:
Osteomalacia and Phenytoin Therapy
Authors: Mumtaz A. Siddiqui
Journal: Annals of Internal Medicine (1994)

Letters1 October 1994Osteomalacia and Phenytoin TherapyMumtaz A. Siddiqui, MDMumtaz A. Siddiqui, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-7-199410010-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In her review article [1], Dr. French mentions osteoporosis that is treatable with vitamin D as a long-term consequence of phenytoin therapy. In fact, osteomalacia with hypocalcemia and elevated alkaline phosphatase levels is far more common. This condition is attributed to both altered metabolism of vitamin D and the inhibition of intestinal absorption of Ca++[2]. Phenytoin also increases the metabolism of vitamin K and reduces the concentration of vitamin K-dependent proteins that are important for normal Ca++ metabolism [3]. This may explain why osteomalacia is not always ameliorated by the administration of vitamin D. Phenytoin may block ...References1. French J. The long-term therapeutic management of epilepsy. Ann Intern Med. 1994; 120:411-22. Google Scholar2. Goodman LS, Gilman AG. The Pharmacological Basis of Therapeutics. 8th ed. New York: Macmillan; 1990:442. Google Scholar3. Keith DA, Gundberg GM, Japour A, Aronoff J, Alvarez N, Gallop PM. Vitamin K dependent proteins and anticonvulsant medication. Clin Pharmacol Ther. 1983; 34:529-32. Google Scholar4. Harris M, Goldhaber P. Root abnormality in epileptics and the inhibition of parathroid hormone-induced bone resorption by diphenylhydantoin in tissue culture. Arch Oral Biol. 1974; 19:981. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1994Volume 121, Issue 7Page: 550KeywordsAttentionBoneHypocalcemiaOsteoporosisParathyroid hormonePhosphatasesProtein metabolismPseudohypoparathyroidismVitamin DVitamin K Issue Published: 1 October 1994 CopyrightCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Mona Viviette Rivlin
Authors: J J RIVLIN
Journal: BMJ (2003)

Former consultant in public health medicine Mersey region (b Bootle 1927; q Liverpool 1950; MSc, MA, FFPHM), d 30 August 2003.

Mona joined her father, her husband, and later her brother in her father's general practice. She became interested in computers and management and in the late 1960s came to feel that she was in a rut, since she was working in the building in which she had been born. In 1970 she was appointed to a registrarship at Mersey Regional Health Authority, later becoming a consultant in community medicine. After retirement she took a BA and an MA in art history. She leaves a husband, two children, and three grandchildren.
CNS Manifestations of Malignancies
Authors: Charmaine Hon, Ricky W. Law, Tony W. Shek, Wing Y. Au
Journal: Journal of Clinical Oncology (2005)

A 64-year-old man presented with acute lymphoblastic leukemia (ALL) and achieved complete remission with chemotherapy (doxorubicin, vincristine, prednisolone, and cyclophosphamide). He completed consolidation therapy with cranial radiotherapy, intrathecal methotrexate (MTX 12 mg 6). One year later, while on oral maintenance, he presented with bilateral blurring of vision (visual acuity, 0.2), generalized bone pain, and weight loss. Physical examination showed bilateral lower conjunctiva fleshy “salmon patch” infiltrates, which were biopsied (Fig 1A, arrows). Slit lamp and fundoscopic examinations were normal. A complete blood picture was normal, but a bone marrow biopsy and lumbar puncture showed blast cells. This was followed by sudden development of diabetes insipidus (daily urine output, 6 L) and panhypopituitarism (cortisol, 16nmol/L; thyroxine 7.2 pmol/L; thyroidstimulating hormone, follicle-stimulating hormone, leutenizing hormone, adrenocorticotropic hormone, all undetectable). He was treated with intrathecal MTX (12 mg) and systemic MOD chemotherapy (MTX, 1g; vincristine, 2 mg; and dexamethasone, 40 mg). This resulted in overnight resolution of the conjunctival infiltrate (Fig 1B) and bilateral visual recovery (acuity, 0.9). The conjunctival histology showed extensive
TCT-711 Nicorandil Prevents Microvascular Dysfunction Resulting from Percutaneous Coronary Intervention in Patients with Stable Angina Pectoris
Authors: Atsushi Hirohata, Eiki Hirose, Yuhei Kobayashi, Minako Ohara, Tohru Ohe, Fumihiko Sano, Hiroya Takafuji, Hiroyuki Takinami, Keizo Yamamoto, Ryo Yoshioka
Journal: Journal of the American College of Cardiology (2012)
P3-07-29: Validating the Lymph Node Ratio as a Prognostic Indicator among South East Asian Breast Cancer Patients.
Authors: N Saxena, M Hartman, Pathy N Bhoo, R Aziz, EL Siew, SC Lee, CH Yip, HM Verkooijen
Journal: Cancer Research (2011)

Abstract Background: Several studies in Caucasian settings have suggested that the lymph node ratio (LNR, i.e. the ratio of the number of positive nodes to the total number of nodes excised) is a superior prognostic indicator for breast cancer as compared to the absolute number of nodes involved (pN stage). This study validates the prognostic performance of LNR in the South East Asian setting. Methods: All patients diagnosed with non-metastatic invasive breast cancer at the National University Hospital (Singapore) or University of Malaya Medical Center (Kuala Lumpur) between 1990 and 2007 and with information on axillary nodes removed and involved were included for analysis (n = 1589). Multivariate Cox regression analysis was performed to evaluate the prognostic value of the LNR [low (&amp;gt; 0 and &amp;lt;0.2), intermediate (0.2 to 0.65) and high risk (&amp;gt;0.65 to 1)] and pN staging [pN1, pN2 and pN3] for all cause mortality. Patients staged pN0/LNR 0 were excluded from analysis. Results: According to the LNR classification, 758 patients were categorized as low risk, 574 as intermediate risk and 257 as high risk LNR. For classic pN staging, 879 were pN1, 447 pN2 and 263 pN3. Women in the intermediate risk category (0.2 to 0.65) had a 1.5 fold increased risk of death [Adjusted hazard ratio [HRadj] of 1.5 (95%CI, 1.2 to 1.9]), and women with high risk (&amp;gt;0.65 to 1) LNR had a 3.2 fold increased risk of death [HRadj of 3.2 (95%CI, 2.6 to 4.1)] as compared to the low risk women (&amp;gt;0 and &amp;lt;0.2). Similarly, women with pN2 disease had a 1.9 fold increased risk of death [HRadj of 1.9 (95%CI, 1.5 to 2.4)], and women with pN3 disease had 3.1 fold increased risk of death [HRadj 3.1 (95%CI, 2.5 to 3.9)] compared to pN1 patients. Conclusion: Among South East Asian breast cancer patients, both the Lymph Node Ratio and the pN Staging system seem to be equally good at predicting all cause mortality. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P3-07-29.
PSYCHIATRIC RE-EXAMINATION OF UNSUITABLE NAVAL RECRUITS: A TWO-YEAR FOLLOW-UP
Authors: JOHN A. PLAG, RANSOM J. ARTHUR
Journal: American Journal of Psychiatry (1965)

In 1960 and 1961, of 216 recruits adjudged unsuitable by aptitude boards at two naval recruit training commands, 134 were deliberately graduated from training in order to assess their adjustment in the fleet. Two years subsequent to graduation, 97 of these sailors were still on active duty in the Navy and their over-all adjustments, evaluated on the basis of psychiatric follow-up examinations, were not demonstrably different from those of a matched control group. It is suggested that the unexpected high rate of fleet retention among enlistees judged to be unsuitable as recruits occurred because a) many subjects were able to achieve emotional growth and maturity in the supportive and stable environment of the military, despite their pathological backgrounds; b) the fleet was able to utilize the services of some marginally performing enlistees, at least during the first several years of their enlistments; and c) initial training and adjustment problems were, for some youths, merely transitory.
Switch to Inactivated Polio Vaccine Recommended
Authors: Charles Marwick
Journal: JAMA (1996)

RESISTING what has been described as unprecedented pressure to retain the present schedule of poliomyelitis immunization, which relies entirely on the live virus oral poliomyelitis vaccine (OPV), the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) has voted to recommend switching to enhanced inactivated poliomyelitis vaccine (IPV) for the first 2 doses of the childhood polio immunization schedule. The oral vaccine will continue to be recommended for the remaining 2 doses of the schedule. The decision, arrived at after prolonged deliberations (6 public meetings and 2 previous ACIP votes) marks "the most significant change in policy since the introduction of the oral polio vaccine in 1961," says the draft statement on the new recommendations for poliovirus immunization that was approved by the committee. Its recommendation must be accepted by CDC Director David Satcher, MD. Physicians are free to continue using an all-OPV schedule if they wish.
A3.25 systemic sclerosis patients exhibit an increased frequency of T cells and NK cells with effector/cytotoxic phenotype
Authors: Tiago Carvalheiro, Ângela Andrade, Magda Lemos, Mariana Galante Santiago, Cláudia Silva, Maria João Salvador, José António Pereira da Silva, Artur Paiva
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Systemic sclerosis (SSc) is an inflammatory and fibrotic disease characterised by inflammation, immune dysregulation and excessive extracellular matrix deposition. T cell and NK cell disturbance have already been described in SSc and implicated in its establishment. <h3>Aims</h3> Determine the frequency of different subpopulations of T cells (CD4+, CD8+ and CD4+ /CD8+) among the functional compartments and the percentage of T cell subsets and NK cells (CD56<sup>bright</sup> and CD56<sup>dim</sup> subpopulations) expressing cytolytic markers. <h3>Materials and Methods</h3> The study enrolled 43 SSc patients, 30 with limited cutaneous subtype (lSSc) and 13 with diffuse cutaneous subtype (dSSc) according to LeRoy et al. classification and 20 healthy individuals as control group. A further subdivision was made based upon clinical parameters of disease duration and clinical manifestations. Immunophenotyping characterisation of peripheral blood T cells was performed by flow cytometry. T cells functional compartments (naïve, central memory, effector memory and terminal effector) were defined based on CD45Ra and CD27 phenotype. Cytotoxic activity was assessed by the intracellular expression of granzyme B and perforin. <h3>Results</h3> We observed a lower frequency of T cells in SSc, particularly in dSSc and in patients with pulmonary fibrosis and digital ulcers. Moreover, SSc patients presented a decreased frequency and absolute numbers of CD8+ T cells (mainly in dSSc patients, and SSc patients with pulmonary fibrosis and digital ulcers). We also observed a lower absolute value of double positive CD4+/CD8+ cells in SSc patients. Regarding NK cells, SSc patients with pulmonary fibrosis exhibit a lower absolute value of both CD56<sup>bright</sup> and CD56<sup>dim</sup> subsets. Among functional compartments, we found a higher frequency of CD8+ and CD4+ T cells with terminal effector and memory effector phenotype, closely related to a decreased frequency of cells with central memory and naïve phenotype. This reached statistical significance for CD8+ T cells. In line with these observations, we demonstrated an increased frequency of T CD4+ and CD8+ cells expressing granzyme B and perforin, particularly in patients with the disease for longer than one year. An increased frequency of CD56<sup>bright</sup> NK cells expressing perforin or granzyme B was also observed in SSc patients. <h3>Conclusions</h3> Our results indicate an increased frequency of CD4+ and CD8+ T cells and CD56<sup>bright</sup> NK cells with an effector/cytotoxic phenotype in the peripheral blood from SSc patients. These changes seem to be related with the presence of pulmonary fibrosis or digital ulcers.
Comparing alternative approaches to establishing regulatory levels for reproductive toxicants: DBCP as a case study.
Authors: W Pease, J Vandenberg, K Hooper
Journal: Environmental Health Perspectives (1991)

This paper compares four alternative approaches for deriving regulatory levels for reproductive toxicants by applying them to the available data on the human spermatotoxicant 1,2-dibromo-3-chloropropane (DBCP). The alternatives examined include the Proposition 65 approach (application of a mandatory 1000-fold uncertainty factor to a no-observed-adverse-effect level [NOAEL]), the Environmental Protection Agency (EPA) approach (application of flexible uncertainty factors to a NOAEL), the Benchmark Dose approach (application of flexible uncertainty factors to a dose associated with a known level of change in a reproductive parameter), and the Quantitative Risk Estimation approach (using low-dose linear extrapolation and a model of the relationship between sperm count and infertility). Applied to DBCP, these approaches do not produce substantially different estimates of allowable exposure levels. However, the approaches do have different data requirements and provide different amounts of information on reproductive hazards to risk managers and the public. Neither the Proposition 65 nor the EPA approach provides information about the extent of health risk remaining at a regulatory level. In contrast, the Benchmark Dose approach can provide estimates of the magnitude of sperm count reduction at a regulatory level, and the Quantitative Risk Estimation approach can provide estimates of exposure-induced infertility.
Combining mTor Inhibitors With Rapamycin-resistant T Cells: A Two-pronged Approach to Tumor Elimination
Authors: Leslie E Huye, Yozo Nakazawa, Mayuri P Patel, Eric Yvon, Jiali Sun, Barbara Savoldo, Matthew H Wilson, Gianpietro Dotti, Cliona M Rooney
Journal: Molecular Therapy (2011)

Despite activity as single agent cancer therapies, Rapamycin (rapa) and its rapalogs may have their greatest effects when combined with other therapeutic modalities. In addition to direct antitumor activity, rapalogs reverse multiple tumor-intrinsic immune evasion mechanisms. These should facilitate tumor-specific T cell activity, but since rapa directly inhibits effector T cells, this potential immune enhancement is lost. We hypothesized that if T cells were rendered resistant to rapa they could capitalize on its downregulation of tumor immune evasion. We therefore modified T cells with a rapa-resistant mutant of mTor, mTorRR, and directed them to B lymphomas by coexpressing a chimeric antigen receptor (CAR) for CD19 (CAR.CD19-28ζ). T cells expressing transgenic mTorRR from a piggyBac transposon maintain mTor signaling, proliferate in the presence of rapa and retain their cytotoxic function and ability to secrete interferon-γ (IFNγ) after stimulation, effector functions that were inhibited by rapa in control T cells. In combination, rapa and rapa-resistant-CAR.CD19-28ζ-expressing T cells produced greater antitumor activity against Burkitt's lymphoma and pre-B ALL cell lines in vitro than CAR.CD19-28ζ T cells or rapa alone. In conclusion, the combination of rapa and rapa-resistant, CAR.CD19-28ζ-expressing T cells may provide a novel therapy for the treatment of B cell malignancies and other cancers. Despite activity as single agent cancer therapies, Rapamycin (rapa) and its rapalogs may have their greatest effects when combined with other therapeutic modalities. In addition to direct antitumor activity, rapalogs reverse multiple tumor-intrinsic immune evasion mechanisms. These should facilitate tumor-specific T cell activity, but since rapa directly inhibits effector T cells, this potential immune enhancement is lost. We hypothesized that if T cells were rendered resistant to rapa they could capitalize on its downregulation of tumor immune evasion. We therefore modified T cells with a rapa-resistant mutant of mTor, mTorRR, and directed them to B lymphomas by coexpressing a chimeric antigen receptor (CAR) for CD19 (CAR.CD19-28ζ). T cells expressing transgenic mTorRR from a piggyBac transposon maintain mTor signaling, proliferate in the presence of rapa and retain their cytotoxic function and ability to secrete interferon-γ (IFNγ) after stimulation, effector functions that were inhibited by rapa in control T cells. In combination, rapa and rapa-resistant-CAR.CD19-28ζ-expressing T cells produced greater antitumor activity against Burkitt's lymphoma and pre-B ALL cell lines in vitro than CAR.CD19-28ζ T cells or rapa alone. In conclusion, the combination of rapa and rapa-resistant, CAR.CD19-28ζ-expressing T cells may provide a novel therapy for the treatment of B cell malignancies and other cancers.
Mycoplasma pneumoniae pneumonia. Symptoms mimicking pulmonary embolism with infarction
Authors: Bryan P. Simmons, Robert C. Aber
Journal: JAMA (1979)

PNEUMONIA and pulmonary embolism may present clinically in a similar fashion.<sup>1</sup>Hemoptysis, dyspnea, tachypnea, pleuritic chest pain, hypoxemia, respiratory alkalosis, and fever are features commonly seen in both diseases. Usually a careful history in combination with a chest roentgenogram and other clinical findings, including purulent sputum production, will allow differentiation. <i>Mycoplasma pneumoniae</i>infections in adults may have a variety of clinical presentations, including pneumonia.<sup>2</sup>Despite these protean manifestations, pleuritic chest pain and hemoptysis are distinctly unusual in<i>M pneumoniae</i>pneumonia.<sup>2,3</sup>A patient was believed to have had mycoplasmal pneumonia that closely mimicked the syndrome produced by pulmonary embolism <h3>Report of a Case</h3> A 58-year-old man was transferred to Hershey Medical Center, complaining of hemoptysis and pleuritic chest pain. He had been in good health until two weeks before his transfer, when he began having shaking chills, fevers, and sweats. He was admitted to another hospital three days later,
Pathology Annual: 1968
Authors: Richard L. Reece
Journal: JAMA (1968)

With this, the third edition, Dr. Sheldon Sommers becomes a tradition. And a welcome one, too. For each year he has had to recruit pathologists—from universities, from the armed services, from citadels of health in Washington, and from community hospitals—to inform practicing pathologists on new approaches to disease. As in the last two years, this year's crop of authors carefully sift and organize their material, illustrate their messages well, and amply document their points of view. What distinguishes this volume and the two that preceded it? The answer, I think, is that Dr. Sommers advises his writers not to bite off more than the readers can chew. Also, by limiting the contents to about 14 timely subjects, he gives readers enough substance to sink their teeth into, but a varied enough fare so they will enjoy it. The book, then, has range and depth. For surgical pathologists there are articles
Neutrophil chemotaxis in rheumatoid arthritis. Effect of D-penicillamine, gold salts, and levamisole.
Authors: A G Mowat
Journal: Annals of the Rheumatic Diseases (1978)

The effect of therapeutic concentrations of D-penicillamine, sodium aurothiomalate, and levamisole on in vitro neutrophil chemotaxis and random migration in normal subjects and patients with rheumatoid arthritis was studied. D-penicillamine produced no changes. Sodium aurothiomalate produced dose-related reductions in chemotaxis in normal subjects and in patients who had a good clinical response to gold therapy, while patients who had failed to respond to gold showed a minimal nondose dependent reduction. Levamisole produced dose-dependent stimulation of chemotaxis, a greater effect found with the patients cells. Neutrophil chemotaxis improved to normal values in most patients responding to several months of D-penicillamine treatment but showed an immediate and marked stimulation in patients treated with levamisole.
Association of Cysteine-Rich Secretory Protein 3 and β-Microseminoprotein with Outcome after Radical Prostatectomy
Authors: Anders S. Bjartell, Hikmat Al-Ahmadie, Angel M. Serio, James A. Eastham, Scott E. Eggener, Samson W. Fine, Lene Udby, William L. Gerald, Andrew J. Vickers, Hans Lilja, Victor E. Reuter, Peter T. Scardino
Journal: Clinical Cancer Research (2007)

Abstract Purpose: It has been suggested that cysteine-rich secretory protein 3 (CRISP-3) and β-microseminoprotein (MSP) are associated with outcome in prostate cancer. We investigated whether these markers are related to biochemical recurrence and whether addition of the markers improves prediction of recurring disease. Experimental Design: Tissue microarrays of radical prostatectomy specimens were analyzed for CRISP-3 and MSP by immunohistochemistry. Associations between marker positivity and postprostatectomy biochemical recurrence [prostate-specific antigen (PSA) &amp;gt;0.2 ng/mL with a confirmatory level] were evaluated by univariate and multivariable Cox proportional hazards regression. Multivariable analyses controlled for preoperative PSA and pathologic stage and grade. Results: Among 945 patients, 224 had recurrence. Median follow-up for survivors was 6.0 years. Patients positive for CRISP-3 had smaller recurrence-free probabilities, whereas MSP-positive patients had larger recurrence-free probabilities. On univariate analysis, the hazard ratio for patients positive versus negative for CRISP-3 was 1.53 (P = 0.010) and for MSP was 0.63 (P = 0.004). On multivariable analysis, both CRISP-3 (P = 0.007) and MSP (P = 0.002) were associated with recurrence. The hazard ratio among CRISP-3–positive/MSP-negative patients compared with CRISP-3–negative/MSP-positive patients was 2.38. Adding CRISP-3 to a base model that included PSA and pathologic stage and grade did not enhance the prediction of recurrence, but adding MSP increased the concordance index minimally from 0.778 to 0.781. Conclusion: We report evidence that CRISP-3 and MSP are independent predictors of recurrence after radical prostatectomy for localized prostate cancer. However, addition of the markers does not importantly improve the performance of existing predictive models. Further research should aim to elucidate the functions of CRISP-3 and MSP in prostate cancer cells.
COST EFFECTIVENESS OF EVEROLIMUS- VS. PACLITAXEL-ELUTING STENTS FOR PATIENTS UNDERGOING PERCUTANEOUS CORONARY REVASCULARIZATION. 2-YEAR RESULTS FROM THE SPIRIT-IV TRIAL
Authors: Amit P. Amin, Matthew R. Reynolds, Yang Lei, Elizabeth M. Mahoney, Katherine Robertus, Amy J. Durtschi, Charles A. Simonton, Gregg W. Stone, David J. Cohen
Journal: Journal of the American College of Cardiology (2011)