tbuckley/cabot-search huggingface dataset:
Drinking water and pregnancy outcome in central North Carolina: source, amount, and trihalomethane levels.
Authors: D A Savitz, K W Andrews, L M Pastore
Journal: Environmental Health Perspectives (1995)

In spite of the recognition of potentially toxic chemicals in chlorinated drinking water, few studies have evaluated reproductive health consequences of such exposure. Using data from a case-control study of miscarriage, preterm delivery, and low birth weight in central North Carolina, we evaluated risk associated with water source, amount, and trihalomethane (THM) concentration. Water source was not related to any of those pregnancy outcomes, but an increasing amount of ingested water was associated with decreased risks of all three outcomes (odds ratios around 1.5 for 0 glasses per day relative to 1-3 glasses per day, falling to 0.8 for 4+ glasses per day). THM concentration and dose (concentration x amount) were not related to pregnancy outcome, with the possible exception of an increased risk of miscarriage in the highest sextile of THM concentration (adjusted odds ratio = 2.8, 95% confidence interval = 1.1-2.7), which was not part of an overall dose-response gradient. These data do not indicate a strong association between chlorination by-products and adverse pregnancy outcome, but given the limited quality of our exposure assessment and the increased miscarriage risk in the highest exposure group, more refined evaluation is warranted.
Prophylaxis for Infective Endocarditis: An Update.
Authors: DONALD KAYE
Journal: Annals of Internal Medicine (1986)

The American Heart Association has updated its recommendations for prevention of bacterial endocarditis. The major changes are less emphasis on administration of parenteral agents and a reduction of the period of prophylaxis. The simplified new recommendations should make compliance easier and should be assiduously implemented by dental and medical practitioners. However, several changes are suggested for possible consideration: Because of the relatively low risk, prophylaxis may not be needed for persons with mitral valve prolapse (unless there is a holosystolic murmur) or for most gastrointestinal endoscopic procedures. Consideration should be given to using a single oral 3-g dose of amoxicillin for dental procedures in all patients at risk and for genitourinary and gastrointestinal tract procedures in patients at risk who have natural cardiac valves. Vancomycin should probably be the agent of choice for prophylaxis in cardiac valve surgery.
Trick Cyclists, Domestics and Golf
Authors: John Lister
Journal: New England Journal of Medicine (1958)

IT has been argued that a nickname that is not positively offensive may constitute the first step on the road to acceptance if not popularity. Certainly, the British Army psychiatrists in the last war were well and truly plagued with the nickname trick cyclists. In a book just published (Psychiatry in the British Army in the Second World War) the author, Dr. R. H. Ahrenfeldt, calls the term half friendly, half doubtful. In reviewing the book in the Daily Telegraph, Dr. E. B. Strauss, of St. Bartholomew's Hospital, has said that jokes about trick cyclists never got under his . . .
An indestructible patient
Authors: A. Stedeford
Journal: BMJ (2001)

Recently I had the painful privilege of staying close to a friend—I shall call her M—through her final illness. M was 62 and suffering from lymphoma, diagnosed within a year of apparently successful treatment of carcinoma of the colon. Initial chemotherapy gave her a good remission, but when the lymphoma recurred it became clear that further aggressive treatment was inappropriate, and the decision was made to change to palliative care. After she confided this in me, I saw her regularly until her death five months later.

> “It seems she was crying out to die and we missed it” 

M was a woman with a great zest for living. On the day that palliative care was decided on, she began to plan a party, which she said would be “more important than my funeral.” Two months later this took place, bringing together her family, friends she had made through her professional life and her artistic interests, and neighbours. She had required several transfusions to keep her going. More blood two …
A7.1 A new technique for the follow-up of patients with immune complex-mediated diseases
Authors: A Sohrabian, B Persson, V Anand Manivel, S Elbagir, K Fromell, V Malmström, I Gunnarsson, J Rönnelid
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background and objectives</h3> Immune complexes (IC) and autoantibodies against nuclear antigens are associated with systemic lupus erythematosus (SLE). Autoantibodies are suggested to have a pathogenetic impact by participating in IC formation. Few studies have however focused on studying autoantibody content in SLE IC, and the relative appearance of autoantibodies in IC versus in (IC-depleted) sera. By using polyethylene glycol (PEG) precipitation, we have studied how individual autoantibodies accumulate to different extents in SLE IC. PEG precipitation is however a crude technique by also precipitating other high molecular weight proteins. Here we have developed a technique to isolate pure IC from serum to enable detailed characterisation of autoantibody content individually in pure IC and IC-depleted serum. <h3>Material and methods</h3> IC in SLE sera were adsorbed to C1q-coated magnetic beads and thereafter eluted. Autoantibodies against dsDNA, Ro52, Ro60, SSB, Sm, Sm/RNP, ribosomal P antigen, histones and PCNA were determined by addressable laser bead immunoassay in serum, IC-depleted serum and purified IC. Circulating IC levels were determined by C1q binding. The levels of autoantibodies were normalised in relation to IgG levels. The C1q binding system was verified in real-time on a fully automated Quartz Crystal Microbalance with Dissipation Monitoring (QCM-D) system. Levels of autoantibodies in IC, IC-depleted serum and full serum were followed in five SLE patients during one year after treatment with anti-CD20 therapy. <h3>Results</h3> Adsorption of sera resulted in a 97.2%–99.5% reduction in circulating IC. QCM-D analyses showed the importance of each step in the adsorption/elution process. Serum samples and eluted IC showed different temporal patterns, and there were also strikingly different patterns between total amounts and concentrations related to total IgG levels in IC eluates. In some patients, anti-dsDNA levels and concentrations in IC eluates dropped sharply after anti-CD20 therapy whereas the corresponding levels for anti-Ro60/Ro52/SSB increased. All patients regained circulating B cells during the follow-up, and in at least 3/5 patients a transient or remaining increase in autoantibody concentration in eluted IC heralded the re-appearance of B cells. <h3>Conclusions</h3> We have developed a method to carefully quantify autoantibody content in circulating IC. Measurement of autoantibody amount and concentration in circulation SLE IC show individual temporal patterns that do not parallel serum autoantibody levels. Changes in autoantibody IC content/concentration might precede the re-occurrence of B-cells in rituximab-treated SLE patients.
Apolipoprotein E genotypes and neuropsychiatric symptoms and syndromes in late-onset Alzheimer's disease
Authors: Francesco Panza, Vincenza Frisardi, Davide Seripa, Grazia D’Onofrio, Andrea Santamato, Carlo Masullo, Giancarlo Logroscino, Vincenzo Solfrizzi, Alberto Pilotto
Journal: Ageing Research Reviews (2011)
Eliminating Chagas disease: challenges and a roadmap
Authors: R. Reithinger, R. L Tarleton, J. A Urbina, U. Kitron, R. E Gurtler
Journal: BMJ (2009)

Millions of people in Central and Southern America are affected by Chagas disease.Richard Reithinger and colleagues explain the difficulties of elimination and suggest a strategy In 2007, the World Health Organization announced a renewed strategy to eliminate Chagas disease in the Americas by 2010.1 The intention was "to answer key questions about the treatment and control of Chagas disease, and to coordinate global efforts towards the prevention of transmission through a new Global Network for Chagas Elimination."1The announcement was welcome because it put the spotlight on Chagas disease, which has been overshadowed by other priorities, such as HIV and malaria, in recent years.However, two years later, WHO has yet to produce a clear strategy for elimination and we are unaware of any new operational activities to eliminate the disease.Too many challenges remain.
Pretibial dystrophic epidermolysis bullosa: a recessively inherited COL7A1 splice site mutation affecting procollagen VII processing
Authors: C.M. Betts, P. Posteraro, A.M. Costa, C. Varotti, M. Schubert, L. Bruckner-Tuderman, D. Castiglia
Journal: British Journal of Dermatology (1999)

Pretibial epidermolysis bullosa (PEB) is a rare form of localized epidermolysis bullosa dystrophica (EBD), a heterogeneous group of inherited, blistering diseases characterized by scarring, loss of dermal–epidermal adhesion and altered anchoring fibrils (AF). Mutations in the type VII collagen gene (COL7A1) underlie EBD and in a dominant PEB family a glycine substitution mutation has been identified. We report a 33-year-old man affected by PEB showing abnormal AF and reduced immunostaining for type VII collagen. Mutation search in the COL7A1 gene revealed a 14 bp deletion in the 115 exon–intron boundary (33563del14), which resulted in the in-frame skipping of exon 115 with elimination of 29 amino acids from the pro-α1(VII) polypeptide chain. As a consequence, procollagen VII failed to be processed to mature collagen VII and accumulated at the dermal–epidermal junction, as revealed by immunofluorescence staining using a NC-2 domain-specific antibody. The proband's father was a clinically unaffected heterozygous carrier of mutation 33563del14, whereas the maternal pathogenetic mutation has still not been identified. This represents the first report of a recessive deletion mutation in PEB and extends the range of EBD phenotypes associated with mutation 33563del14.
Metabolic effects of successful intraportal islet transplantation in insulin-dependent diabetes mellitus.
Authors: L Luzi, B J Hering, C Socci, G Raptis, A Battezzati, I Terruzzi, L Falqui, H Brandhorst, D Brandhorst, E Regalia, E Brambilla, A Secchi, G Perseghin, P Maffi, E Bianchi, V Mazzaferro, L Gennari, V Di Carlo, K Federlin, G Pozza, R G Bretzel
Journal: Journal of Clinical Investigation (1996)

The intraportal injection of human pancreatic islets has been indicated as a possible alternative to the pancreas transplant in insulin-dependent diabetic patients. Aim of the present work was to study the effect of intraportal injection of purified human islets on: (a) the basal hepatic glucose production; (b) the whole body glucose homeostasis and insulin action; and (c) the regulation of insulin secretion in insulin-dependent diabetes mellitus patients bearing a kidney transplant. 15 recipients of purified islets from cadaver donors (intraportal injection) were studied by means of the infusion of labeled glucose to quantify the hepatic glucose production. Islet transplanted patients were subdivided in two groups based on graft function and underwent: (a) a 120-min euglycemic insulin infusion (1 mU/kg/min) to assess insulin action; (b) a 120-min glucose infusion (+75 mg/di) to study the pattern of insulin secretion. Seven patients with chronic uveitis on the same immunosuppressive therapy as grafted patients, twelve healthy volunteers, and seven insulin-dependent diabetic patients with combined pancreas and kidney transplantation were also studied as control groups. Islet transplanted patients have: (a) a higher basal hepatic glucose production (HGP: 5.1 +/- 1.4 mg/kg/ min; P < 0.05 with respect to all other groups) if without graft function, and a normal HGP (2.4 +/- 0.2 mg/kg/min) with a functioning graft; (b) a defective tissue glucose disposal (3.9 +/- 0.5 mg/kg/min in patients without islet function and 5.3 +/- 0.4 mg/kg/min in patients with islet function) with respect to normals (P < 0.01 for both comparisons); (c) a blunted first phase insulin peak and a similar second phase secretion with respect to controls. In conclusion, in spite of the persistence of an abnormal pattern of insulin secretion, successful intraportal islet graft normalizes the basal HGP and improves total tissue glucose disposal in insulin-dependent diabetes mellitus.
Outbreak of Invasive Mycoses Caused by Paecilomyces lilacinus from a Contaminated Skin Lotion
Authors: Bernd Orth
Journal: Annals of Internal Medicine (1996)

Invasive mycoses are an important cause of illness and death in immunocompromised patients. Infections with molds other than aspergilli have been increasingly seen in patients with hematologic cancers, but epidemics of these infections have not yet been reported.To describe an outbreak of invasive mycoses with Paecilomyces lilacinus in severely neutropenic patients.An outbreak investigation.The hematology-oncology isolation and bone marrow transplantation unit of the University Hospital, Basel, Switzerland.25 consecutive patients admitted between 17 August 1993 (the date of the first manifestation of P. lilacinus infection) and 31 October 1993 (when the unit was closed).Clinical and microbiological data, including histologic findings; cultures from several patient sites; and environmental examinations of potential airborne, parenteral, enteric, and horizontal routes of transmission. Infections were defined by the isolation of P. lilacinus from clinically evident skin eruptions.12 of the 25 patients (48%) were infected or colonized. Nine patients (36%), including all bone marrow transplant recipients, had documented invasive P. lilacinus infections. All 9 infected patients had papular, pustular, or necrotic skin eruptions. Two patients with severe graft-versus-host disease died with refractory fungal disease; 1 also had microbiologically documented endophthalmitis and kidney infiltrates. Seven affected patients no longer had P. lilacinus after recovery of bone marrow function. The organism was resistant in vitro to amphotericin B, itraconazole, and fluconazole. Patients did not respond clinically to these agents. The outbreak was ultimately traced to a contaminated, commercially available, pharmaceutically prepared skin lotion. The outbreak ended after the skin lotion was recalled and has not recurred after a follow-up period of 2 years.Contaminated skin lotion is a potential cause of opportunistic fungal infections in immunocompromised hosts. Paecilomyces lilacinus is a common saprophytic mold that can cause, by direct cutaneous inoculation, invasive infections associated with illness and death.
Follies and Fallacies in Medicine
Authors: Philip Steer
Journal: BMJ (2008)

Petr Skrabanek, a Czech, was in Ireland when the Soviets invaded his country, so he stayed, publishing many criticisms of medical humbug while working with James McCormick in the Department of Community Health at Trinity College, Dublin, until his premature death in 1994. The book has been translated into six languages and is on the reading list of medical schools around the world, to encourage an appropriate scepticism about medical dogma.

For example, could strict adherence to evidence based practice be harmful to patients? This is the intriguing hypothesis suggested in the first section of this subversive book. It points out that although the placebo effect is very powerful, to work best it requires both the patient and the doctor to believe in it. As …
A FLOW–CYTOMETRIC ANALYSIS OF THE INHIBITION OF PLATELET REACTIVITY WITH NITRITE REDUCTION BY DEOXYGENATED ERYTHROCYTES
Authors: Krittapoom Akrawinthawong, Jiwon Park, Barbora Piknova, Nathawut Sibmooh, Suthat Fucharoen, Alan N. Schechter
Journal: Journal of the American College of Cardiology (2013)
THE USE OF VASCULAR CLOSURE DEVICES REDUCES THE RISK OF MAJOR ACCESS SITE COMPLICATIONS IN PATIENTS WITH CHRONIC KIDNEY DISEASE UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION VIA FEMORAL ROUTE
Authors: Oscar Prada-Delgado, Rodrigo Estevez-Loureiro, Ramon Calvino-Santos, Eduardo Barge-Caballero, Jorge Salgado-Fernandez, Pablo Pinon-Esteban, Jose M. Vazquez-Rodriguez, Guillermo Aldama-Lopez, Xacobe Flores-Rios, Maria R. Soler-Martin, Nicolas Vazquez-Gonzalez, Alfonso Castro-Beiras
Journal: Journal of the American College of Cardiology (2011)
Effect of submaximal exercise on vulnerability to fibrillation in the canine ventricle.
Authors: A K Dawson, A S Leon, H L Taylor
Journal: Circulation (1979)

The risk of instantaneous death due to ventricular fibrillation was compared in resting and exercised dogs. Three weeks before testing, all dogs had bipolar left ventricular stimulating electrodes implanted and a reversible snare was placed around the anterior descending coronary artery. The dogs were randomly assigned to either an exercise (13 dogs) or a control (12 dogs) group. We measured ventricular fibrillation thresholds (VFTs) in all dogs before and after inducing ischemia by tightening the snare while the dogs stood at rest. The next day, nonischemic and ischemic VFTs were redetermined for control dogs at rest and for the exercise group during a treadmill run. No statistically significant changes were noted within and between groups in nonischemic or in ischemic VFTs at rest. In five exercise dogs, spontaneous ventricular fibrillation occurred during the first 8 minutes of the ischemic run, For the eight other exercise dogs, running increased the mean drop in VFTs during coronary occlusion by 23% (p less than 0.01). These data suggest that moderate dynamic exercise may greatly enhance the risk of ventricular fibrillation and sudden death in the presence of myocardial ischemia. In the absence of ischemia, exercise does not appear to increase vulnerability to ventricular fibrillation.
Principal role of adenylyl cyclase 6 in K+ channel regulation and vasodilator signalling in vascular smooth muscle cells
Authors: Carl P. Nelson, Richard D. Rainbow, Jennifer L. Brignell, Matthew D. Perry, Jonathon M. Willets, Noel W. Davies, Nicholas B. Standen, R.A. John Challiss
Journal: Cardiovascular Research (2011)

Membrane potential is a key determinant of vascular tone and many vasodilators act through the modulation of ion channel currents [e.g. the ATP-sensitive potassium channel (K(ATP))] involved in setting the membrane potential. Adenylyl cyclase (AC) isoenzymes are potentially important intermediaries in such vasodilator signalling pathways. Vascular smooth muscle cells (VSMCs) express multiple AC isoenzymes, but the reason for such redundancy is unknown. We investigated which of these isoenzymes are involved in vasodilator signalling and regulation of vascular ion channels important in modulating membrane potential.AC isoenzymes were selectively depleted (by >75%) by transfection of cultured VSMCs with selective short interfering RNA sequences. AC6 was the predominant isoenzyme involved in vasodilator-mediated cAMP accumulation in VSMCs, accounting for ∼60% of the total response to β-adrenoceptor (β-AR) stimulation. AC3 played a minor role in β-AR signalling, whereas AC5 made no significant contribution. AC6 was also the principal isoenzyme involved in β-AR-mediated protein kinase A (PKA) signalling (determined using the fluorescent biosensor for PKA activity, AKAR3) and the substantial β-AR/PKA-dependent enhancement of K(ATP) current. K(ATP) current was shown to play a vital role in setting the resting membrane potential and in mediating the hyperpolarization observed upon β-AR stimulation.AC6, but not the closely related AC5, plays a principal role in vasodilator signalling and regulation of the membrane potential in VSMCs. These findings identify AC6 as a vital component in the vasodilatory apparatus central to the control of blood pressure.
2-Amino-4-hydroxy-6-7-Dimethyltetrahydropteridine In Parkinson's Disease
Authors: Robert Stock
Journal: JAMA (1969)

<h3>To the Editor:—</h3> Levodopa and 5-hydroxytryptophan have been reported to be of benefit to people with Parkison's disease, and 2-amino-4-hydroxy - 6 - 7 - dimethyltetrahydropteridine has been found to be a cofactor required by tryptophan and tyrosin hydroxylase (Hosada, A., and Glick, D.:<i>J Biol Chem</i><b>241</b>:192, 1966; Nagatin, F., et al:<i>J Biol Chem</i><b>239</b>: 2810, 1964). It has been suggested that this co-factor may be deficient in people with Parkinson's disease (Kuehl, et al:<i>Nature</i><b>217</b>:1368, 1967). Wouldn't this cofactor be a likely prospect as a drug for parkinsonism?
Occupational hypersensitivity to metal salts, including platinum, in the secondary industry
Authors: A. Cristaudo, F. Sera, V. Severino, M. De Rocco, E. Di Lella, M. Picardo
Journal: Allergy (2004)

Background: Exposure to platinum group elements (PGEs) – platinum (Pt), palladium (Pd), rhodium (Rh) and iridium (Ir) – may cause acute toxicity or hypersensitivity with respiratory symptoms, urticaria and (less frequently) contact dermatitis. Our aim was to determine the prevalence and the clinical characteristics of hypersensitivity to platinum salts and to other elements of the platinum group. Methods: A total of 153 subjects working in a catalyst manufacturing and recycling factory were examined. The examination consisted of a work exposure and medical questionnaire, physical examination, skin prick test for PGEs and other common aeroallergens, and patch tests for PGEs. Skin prick tests and patch tests were performed with H 2 [PtCl 6 ], K 2 [PtCl 4 ], Na 2 [PtCl 6 ], IrCl 3 , RhCl 3 , PdCl 2 , aqueous solutions at different concentrations. Results: Positive prick test reactions to Pt‐salts at various concentrations were found in 22 (14.4%) of 153 workers; eight had simultaneous reactions to all Pt‐salts tested; seven had positive responses to H 2 [PtCl 6 ] only; four had simultaneous positive reactions to both H 2 [PtCl 6 ] and K 2 [PtCl 4 ]; three had positive reactions to H 2 [PtCl 6 ] and Na 2 [PtCl 6 ]. Three of 22 had positive reactions to H 2 [PtCl 6 ] and IrCl 3 solutions, two of these had positive reactions to H 2 [PtCl 6 ], IrCl 3 and RhCl 3 solutions. Positive patch test reactions to platinum salts at day 2 were seen in two of 153 subjects. Conclusions: The results of this study demonstrate that Pt‐salts are important allergens in the catalyst industry and that the clinical manifestations involve both the respiratory system and the skin. Hexachloroplatinic acid should be considered the most important salt to use for skin prick tests.
Letter: Induction of labour and perinatal mortality.
Authors: R H Tipton, B V Lewis
Journal: BMJ (1975)

Because it has been suggested that induction of labor results in increased perinatal mortality, 1972-1974 statistics from the Maternity Unit, Watford, England, General Hospital, are presented. Perinatal mortality was reduced from 22/1000 in 1972 to 11/1000 in 1974 while the induction of labor rate increased from 28% to 55%. 4 major contributory factors for the fall in perinatal mortality are noted: 1) 70% of all the patients in the unit have continuous fetal heart rate monitoring; 2) the cervix of all patients whose previous pregnancy was terminated is examined at each visit, and when there is early dilatation or effacement of the cervix, cervical circumsuture is inserted; 3) amniocentesis is performed on at risk patients, and abortion may be performed in some cases where there would have otherwise been a stillbirth; and 4) there has not been an increased number of premature babies or of operative deliveries because of precautions taken, and the use of oxytocin has resulted in short labors and healthy babies. It is suggested that obstetric units in Britain publish their perinatal mortality figures and their induction of labor rates along with the units' policies concerning fetal monitoring and the use of ultrasound confirmation of dates.