tbuckley/cabot-search huggingface dataset:
Efficacy of Cognitive Behavioural Therapy for the Treatment of Chronic Stress in Patients with Lupus Erythematosus: A Randomized Controlled Trial
Authors: N. Navarrete-Navarrete, M.I. Peralta-Ramírez, J.M. Sabio-Sánchez, M.A. Coín, H. Robles-Ortega, C. Hidalgo-Tenorio, N. Ortego-Centeno, J.L. Callejas-Rubio, J. Jiménez-Alonso
Journal: Psychotherapy and Psychosomatics (2010)

&lt;i&gt;Background:&lt;/i&gt; Chronic stress worsens the quality of life (QOL) of lupus patients by affecting their physical and psychological status. The effectiveness of a cognitive-behavioural intervention in a group of patients with lupus and high levels of daily stress was investigated. &lt;i&gt;Methods:&lt;/i&gt; Forty-five patients with lupus and high levels of daily stress were randomly assigned to a control group (CG) or a therapy group (TG); they received cognitive behavioural therapy (CBT) which consisted of ten consecutive weekly sessions. The following variables were evaluated at baseline and at 3, 9 and 15 months: (1) stress, anxiety, depression, (2) Systemic Lupus Erythematosus Disease Activity Index, somatic symptoms, number of flares, (3) anti-nDNA antibodies, complement fractions C3 and C4 and (4) QOL. A multivariate analysis of repeated measures and various analyses of variance were carried out. &lt;i&gt;Results:&lt;/i&gt; We found a significant reduction in the level of depression, anxiety and daily stress in the TG compared to the CG and a significant improvement in QOL and somatic symptoms in the TG throughout the entire follow-up period. We did not find any significant changes in the immunological parameters. &lt;i&gt;Conclusions:&lt;/i&gt; CBT is effective in dealing with patients suffering from lupus and high levels of daily stress as it significantly reduces the incidence of psychological disorders associated with lupus and improves and maintains patients’ QOL, despite there being no significant reduction in the disease activity index.
Proinsulin: a unique autoantigen triggering autoimmune diabetes
Authors: Sylvaine You, Lucienne Chatenoud
Journal: Journal of Clinical Investigation (2006)

In healthy individuals the immune system does not react aggressively toward host cells, a phenomenon defined as self tolerance. If self tolerance is broken autoimmune disease can develop, during which autoreactive lymphocytes are directed to a variety of autoantigenic epitopes. However, researchers have yet to determine whether immune responses to multiple autoantigens develop independently of each other or are the result of the response "spreading" from one autoantigen to another. In a study of NOD mice in this issue of the JCI, Krishnamurthy et al. show that the autoreactive T cell response to the autoantigen proinsulin lies upstream of that to islet-specific glucose-6-phosphatase catalytic subunit-related protein, suggesting that the pathogenic autoimmune response to proinsulin subsequently spreads to other antigens (see the related article beginning on page 3258). These data support the current view that this pancreatic beta cell hormone is the first autoantigen targeted by the immune response in autoimmune diabetes.
Use of the Artificial B-Cell (Biostator) in Improving Insulin Therapy in Unstable Insulin-dependent Diabetes
Authors: Klaus Peter Ratzmann, Waldemar Bruns, Bernd Schulz, Eckhard Zander
Journal: Diabetes Care (1982)

The present study was designed to improve the conventional subcutaneous insulin treatment of labile insulin-dependent diabetic patients by means of the artificial B-cell (Biostator) during a combination of conventional treatment and a glucose-controlled insulin infusion. Eleven patients with no residual B-cell function and poor metabolic control were studied. All patients were treated as effectively as possible by conventional methods using a combination of regular and intermediate insulin under clinical conditions. In order to determine the inadequacy of previous insulin treatment, all patients were connected to the Biostator, and the profile of daily physical activity was simulated using a bicycle ergometer. Metabolic control was compared during a 6-day period before and after a 30–50-h connection to the artificial B-cell. Using a preselected blood glucose level of 80 mg/dl (4.44 mmol/L), the additional insulin requirement amounted to 45.5 ± 11.1 U/24 h (N = 6). The day after connection to the artificial B-cell, the patients received a new insulin regimen according to the additional insulin delivery determined by the Biostator. No better metabolic control was achieved and frequent hypoglycemic episodes occurred in this group. Another group (N = 5) was therefore studied at a preselected blood glucose level of 130 mg/dl (7.22 mmol/L). The mean additional insulin delivery by the Biostator was lower (17.2 ± 2.1 U/24 h; P &amp;lt; 0.05) and all patients were significantly better equilibrated after the new insulin regimen derived from data given by the Biostator. The ratio of short-acting to intermediate-acting insulin was 3:1; 40% of the total dosage was given in the morning. This study demonstrates that using the Biostator in addition to subcutaneous insulin allows determination of the amount of additional regular insulin that should be administered to improve glycemic control in labile diabetes.
Management of hepatitis C virus genotype 4: Recommendations of An International Expert Panel
Authors: Mahmoud A. Khattab, Peter Ferenci, Stephanos J. Hadziyannis, Massimo Colombo, Michael P. Manns, Piero L. Almasio, Rafael Esteban, Ayman A. Abdo, Stephen A. Harrison, Nazir Ibrahim, Patrice Cacoub, Mohammed Eslam, Samuel S. Lee
Journal: Journal of Hepatology (2010)

HCV has been classified into no fewer than six major genotypes and a series of subtypes. Each HCV genotype is unique with respect to its nucleotide sequence, geographic distribution, and response to therapy. Genotypes 1, 2, and 3 are common throughout North America and Europe. HCV genotype 4 (HCV-4) is common in the Middle East and in Africa, where it is responsible for more than 80% of HCV infections. It has recently spread to several European countries. HCV-4 is considered a major cause of chronic hepatitis, cirrhosis, hepatocellular carcinoma, and liver transplantation in these regions. Although HCV-4 is the cause of approximately 20% of the 170 million cases of chronic hepatitis C in the world, it has not been the subject of widespread research. Therefore, this document, drafted by a panel of international experts, aimed to review current knowledge on the epidemiology, natural history, clinical, histological features, and treatment of HCV-4 infections. HCV has been classified into no fewer than six major genotypes and a series of subtypes. Each HCV genotype is unique with respect to its nucleotide sequence, geographic distribution, and response to therapy. Genotypes 1, 2, and 3 are common throughout North America and Europe. HCV genotype 4 (HCV-4) is common in the Middle East and in Africa, where it is responsible for more than 80% of HCV infections. It has recently spread to several European countries. HCV-4 is considered a major cause of chronic hepatitis, cirrhosis, hepatocellular carcinoma, and liver transplantation in these regions. Although HCV-4 is the cause of approximately 20% of the 170 million cases of chronic hepatitis C in the world, it has not been the subject of widespread research. Therefore, this document, drafted by a panel of international experts, aimed to review current knowledge on the epidemiology, natural history, clinical, histological features, and treatment of HCV-4 infections.
Rowlandson's Death in the Nursery
Authors: F. Haslam
Journal: BMJ (1996)

medicide proving once again that modern axiom about the big lie being easier to sell than the small one.And to those who argue only doctors should do it, Uncle Eddie simply asks them Why?If unlicensed pathologists, why not retired clergy, or victualers short on cash, or rehabilitated serial killers, or veterans of foreign wars.We're not talking, as the overworked idiom holds, brain surgery here.Most of the species knows how to kill.Nor should this right to die and right to assistance with one's death be limited to the terminally ill.Pain is the problem, suffering.Do jilted lovers suffer less than cancer patients?Who's to say?Is heartbreak more bear- able than congestive heart failure?Is perfect memory less painful than senility?And if the teen girl who gets pregnant at the prom is as entitled to an abortion as the child raped by mannish violence; so too, the teen who doesn't get a prom date is as entitled to her assisted suicide as is her grandparent with Alzheimer's.
XXIV. The Continuity of History
Authors: Lester S. King
Journal: JAMA (1984)

History has two basic aspects. It describes the events of the past and tries to explain them. The descriptive aspect is principally narration—it tells "what happened." Then, if we find out enough details and learn their relationship to each other as well as to abstract concepts, we may understand why the event happened. We then have an explanation. Usually we think of narration as taking place through words and we may not appreciate a more direct pictorial representation. Many events in antiquity have been preserved for us in stone. Much ancient statuary, especially in bas relief, narrates the triumphs of ancient rulers. A successful military campaign, the capture and razing of an enemy city, the slaughter of an opposing army, and deeds of special heroism seemed most worthy of commemoration. Numerous monuments and artifacts from the ancient world—from Egypt, Assyria, Persia, Greece, and Rome—preserve for us in stone the details
Primary Prevention of Bleeding from Esophageal Varices
Authors: Andrew K. Burroughs, David Patch
Journal: New England Journal of Medicine (1999)

Most patients with portal hypertension in North America and Europe have cirrhosis. Of those with compensated cirrhosis (i.e., cirrhosis with no ascites, encephalopathy, or severe jaundice), 30 percent have esophageal varices, as compared with 60 percent of those with decompensated cirrhosis.1 The risk of a first episode of bleeding from esophageal varices is higher among patients with cirrhosis who have severe liver dysfunction and those whose varices are large or have red signs — so-called varices on varices — identified endoscopically.2 Patients with cirrhosis may also have bleeding due to portal hypertensive gastropathy, nonvariceal mucosal abnormalities seen on endoscopy. These . . .
Huntington's Disease and Repeating Trinucleotides
Authors: James F. Gusella, Marcy E. MacDonald
Journal: New England Journal of Medicine (1994)

Huntington's disease is an inherited neurodegenerative disease of midlife onset that produces a characteristic, progressive movement disorder with accompanying psychiatric changes. The symptoms result from the selective loss of neurons, most notably in the caudate nucleus and putamen, and there is currently no effective treatment. In 1983 we identified chromosome 4 as the site of the defect in Huntington's disease, triggering a decade-long search for the disease gene itself1. In early 1993 the search ended with the discovery that the defect causing Huntington's disease is an expanded, unstable stretch of DNA with a repeating pattern of three nucleotide bases, . . .
Prophylactic Implantable Defibrillator in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia and No Prior Ventricular Fibrillation or Sustained Ventricular Tachycardia
Authors: Domenico Corrado, Hugh Calkins, Mark S. Link, Loira Leoni, Stefano Favale, Michela Bevilacqua, Cristina Basso, Deirdre Ward, Giuseppe Boriani, Renato Ricci, Jonathan P. Piccini, Darshan Dalal, Massimo Santini, Gianfranco Buja, Sabino Iliceto, N.A. Mark Estes, Thomas Wichter, William J. McKenna, Gaetano Thiene, Frank I. Marcus
Journal: Circulation (2010)

The role of implantable cardioverter-defibrillator (ICD) in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia and no prior ventricular fibrillation (VF) or sustained ventricular tachycardia is an unsolved issue.We studied 106 consecutive patients (62 men and 44 women; age, 35.6±18 years) with arrhythmogenic right ventricular cardiomyopathy/dysplasia who received an ICD based on 1 or more arrhythmic risk factors such as syncope, nonsustained ventricular tachycardia, familial sudden death, and inducibility at programmed ventricular stimulation. During follow-up of 58±35 months, 25 patients (24%) had appropriate ICD interventions and 17 (16%) had shocks for life-threatening VF or ventricular flutter. At 48 months, the actual survival rate was 100% compared with the VF/ventricular flutter-free survival rate of 77% (log-rank P=0.01). Syncope significantly predicted any appropriate ICD interventions (hazard ratio, 2.94; 95% confidence interval, 1.83 to 4.67; P=0.013) and shocks for VF/ventricular flutter (hazard ratio, 3.16; 95% confidence interval, 1.39 to 5.63; P=0.005). The positive predictive value of programmed ventricular stimulation was 35% for any appropriate ICD intervention and 20% for shocks for VF/ventricular flutter, with a negative predictive value of 70% and 74%. None of the 27 asymptomatic patients with isolated familial sudden death had appropriate ICD therapy. Twenty patients (19%) had inappropriate ICD interventions, and 18 (17%) had device-related complications.One fourth of patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia and no prior sustained ventricular tachycardia or VF had appropriate ICD interventions. Syncope was an important predictor of life-saving ICD intervention and is an indication for ICD. Prophylactic ICD may not be indicated in asymptomatic patients because of their low arrhythmic risk regardless of familial sudden death and programmed ventricular stimulation findings. Programmed ventricular stimulation had a low predictive accuracy for ICD therapy.
P1093 CXCL-8 PREDICTS HBeAg SEROCONVERSION AND POST TREATMENT FLARES IN CHRONIC HEPATITIS B (CHB) PATIENTS TREATED WITH INTERFERON (IFN)-ALFA
Authors: S. Le, D. Ratnam, A. Dev, N. Skinner, R. Millen, P. O'Neill, W. Sievert, K. Visvanathan
Journal: Journal of Hepatology (2014)
Resistin is secreted from macrophages in atheromas and promotes atherosclerosis
Authors: H JUNG, K PARK, Y CHO, S CHUNG, H CHO, S CHO, S KIM, S KIM, H LEE, K PARK
Journal: Cardiovascular Research (2005)

Resistin belongs to a family of cysteine-rich secreted polypeptides that are mainly produced by monocytes/macrophages in humans. Recently, high concentrations of resistin were shown to induce vascular endothelial dysfunction and vascular smooth muscle cell proliferation. We examined if resistin was secreted from macrophages locally in atheromas and if it affected vascular cell function in human.Immunohistochemical staining of human vessels showed that aortic aneurysms exhibited resistin-positive staining areas along macrophage infiltration, while normal arteries and veins did not. Co-localization of resistin and CD68 (a marker for macrophages) was observed in immunofluorescent double staining of aneurysms. Resistin mRNA was expressed much higher in cultured monocytes/macrophages than in human vascular smooth muscle cells (VSMCs) and human umbilical venous endothelial cells (HUVECs). This suggested that the resistin in aneurysms originates from macrophages within the vessels. To determine the effects of resistin on atherosclerosis, HUVECs and human VSMCs were incubated with resistin (10-100 ng/mL for 4 approximately 24 h). In HUVECs, plasminogen activator inhibitor (PAI)-1 release was assayed by ELISA, while the PAI-1 and endothelin (ET)-1 mRNA levels were analyzed by Northern blotting. Both were increased significantly with resistin treatment by factors of 1.3-2.5 (p<0.05). Migratory activity of VSMCs measured by scratched wound assay also increased significantly (1.6 times, p<0.05). In summary, macrophages infiltrating atherosclerotic aneurysms secrete resistin, and resistin affects endothelial function and VSMC migration.Resistin secreted from macrophages may contribute to atherogenesis by virtue of its effects on vascular endothelial cells and smooth muscle cells in humans.
Tuberculosis with Atlantoaxial and Craniovertebral Pott's Disease
Authors: Ulrich Weber, Hans Scherübl
Journal: New England Journal of Medicine (2002)

Figure 1. A 17-year-old Ethiopian girl presented with a four-month history of fever, malaise, and weight loss, as well as head, neck, and back pain and a two-week history of dyspnea, odynophagia, and diarrhea. Chest radiography revealed bilateral multinodular pneumonia and pleural effusions; a tuberculin test was positive. The axial sections of a computed tomographic scan revealed a retropharyngeal abscess surrounding the left arch of the atlas and extending into the spinal canal. The dens axis was laterally subluxated (Panel A, arrow) as the result of a fracture of the left lateral atlas. In addition, magnetic resonance imaging revealed tuberculous . . .
Midterm Results of the Ross Procedure Preserving the Patient’s Aortic Root
Authors: Hans- H. Sievers, Gerlinde Dahmen, Bernhard Graf, Ulrich Stierle, Andreas Ziegler, Claudia Schmidtke
Journal: Circulation (2003)

Background— Since the early 1990s, the pulmonary autograft is predominantly implanted as a freestanding root for less aortic valve regurgitation is reported. However, there is a certain risk of dilatation of the root over time potentially impairing valve function. We favor since 8 years the original subcoronary or inclusion technique to preserve the root of the patient as a restrain to dilatation. Methods and Results— Between June 1994 and May 2002 the subcoronary (n=228) and inclusion technique (n=17) were performed in 245 patients (191 male, 54 female), mean age 45.7±13.4 (15–70) years. The underlying aortic valve disease was an aortic insufficiency in n=83, stenosis in n=48, a combined aortic valve disease in n=111 and an acute endocarditis in n=19 patients. Previous aortic valve surgery was performed in n=23. Last follow-up investigations (within last year) including echocardiography was performed at a mean follow-up of 29.4±24.7 months (553.7 patient years). Hospital mortality was n=2, late mortality n=4 (all noncardiac). Two patients were lost to follow-up (99% complete clinical follow-up). Reoperations were necessary in n=7 valves (autograft: endocarditis n=1, malpositioning n=1, leaflet prolapse n=1; homograft: stenosis n=2, insufficiency n=2). Autograft insufficiency (AI) was AI 0 in n=154, AI I n=66, AI II n=8. The maximum/mean pressure gradient across the autograft was 6.6±3.4 (2.1 to 25.9)/3.6±1.8 (1.2 to 13.2) mm Hg, respectively. Homograft insufficiency was 0 in n=167, I in n=54, II in n=9, and III in n=1. Maximum and mean transhomograft pressure gradients were 11.7±6.8 (2.2 to 42.6)/6.2±3.8 (1.2 to 24.5) mm Hg. Most patients were NYHA class I (n=214), class II (n=19), class III (n=2). Significant aortic root dilatation was not observed. Conclusions— Aortic valve replacement with a pulmonary autograft in the subcoronary or inclusion technique provides excellent hemodynamics with no root dilatation at least in a mid term postoperative period. Transhomograft pressure gradients are slightly increased. Longer term results with special emphasis on the pulmonary homograft are necessary.
Bone Marrow and Stem Cell Transplantation Renewing the Stuff of Life: Stem Cells, Ethics, and Public Policy
Authors: Bijay Nair, Paulette Mehta
Journal: JAMA (2007)

This review concerns 2 books on stem cell transplantation: one on the molecular methods for various protocols and the other on public policy as it relates to embryonic stem cell transplantation. Both relate to different aspects of stem cell transplantation, from basic biology to public policy.
Fibrin regulates neutrophil migration in response to interleukin 8, leukotriene B4, tumor necrosis factor, and formyl-methionyl-leucyl-phenylalanine.
Authors: J D Loike, J el Khoury, L Cao, C P Richards, H Rascoff, J T Mandeville, F R Maxfield, S C Silverstein
Journal: The Journal of Experimental Medicine (1995)

We have examined the capacity of four different chemoattractants/cytokines to promote directed migration of polymorphonuclear leukocytes (PMN) through three-dimensional gels composed of extracellular matrix proteins. About 20% of PMN migrated through fibrin gels and plasma clots in response to a gradient of interleukin 8 (IL-8) or leukotriene B4 (LTB4). In contrast, &amp;lt; 0.3% of PMN migrated through fibrin gels in response to a gradient of tumor necrosis factor alpha (TNF) or formyl-methionyl-leucyl-phenylalanine (FMLP). All four chemoattractants stimulated PMN to migrate through gels composed of collagen IV or of basement membrane proteins (Matrigel), or through filters to which fibronectin or fibrinogen had been adsorbed. PMN stimulated with TNF or FMLP adhered and formed zones of close apposition to fibrin, as measured by the exclusion of a 10-kD rhodamine-polyethylene glycol probe from the contact zones between PMN and the underlying fibrin gel. By this measure, IL-8- or LTB4-treated PMN adhered loosely to fibrin, since 10 kD rhodamine-polyethylene glycol permeated into the contact zones between these cells and the underlying fibrin gel. PMN stimulated with FMLP and IL-8, or FMLP and LTB4, exhibited very little migration through fibrin gels, and three times as many of these cells excluded 10 kD rhodamine-polyethylene glycol from their zones of contact with fibrin as PMN stimulated with IL-8 or LTB4 alone. These results show that PMN chemotaxis is regulated by both the nature of the chemoattractant and the composition of the extracellular matrix; they suggest that certain combinations of chemoattractants and matrix proteins may limit leukocyte movements and promote their localization in specific tissues in vivo.
Clinical Trial of Inhaled Ergotamine Tartrate in Migraine
Authors: J. Crooks, S. A. Stephen, W. Brass
Journal: BMJ (1964)

Periodic Migrainous Neuralgia-Balla and Walton MEBITALJOSHRNAL (921 Ekbom (1947) using " gynergen "1 reported results similar to our own.It has been our impression that gastro-intestinal side-effects were less marked with migril than with other preparations, but we have no statistically valid evidence to support this view.We are unable to throw any light on the aetiology of this condition.We see no reason why it should be attributed to histamine allergy and it is also difficult to relate it to migraine.In our cases a family history of migraine was rarely obtained, and this would be unexpected if this condition was indeed a variant of the migraine syndrome in which a positive family history is the rule rather than the exception.The age and sex distribution is also somewhat different from that of migraine, many of our patients having had their first symptoms in their forties.Though these are only two facets of the clinical picture, they may be of possible significance in distinguishing this syndrome from migraine. SummaryTwenty-eight cases of periodic migrainous neuralgia are reviewed.The cermical picture is described.The average time which elapsed between the onset of symptoms and accurate I Known in Great Britain as " femergen."diagnosis was 6.5 years.Our experiences of treatment using prophylactic migril in 20 patients are discussed.In 14 the response was satisfactory and in six relief was only slight.Two of these patients showed further improvement on prophylactic ergotamine injections.Three patients who failed to respond to oral ergotamine or relapsed responded to methyser- gide.A plea is made for early diagnosis in this eminently treatable condition.We are grateful to Dr. Henry Miller for allowing us to review a number of patients who were under his care.