tbuckley/cabot-search huggingface dataset:
AB0453 Presentation and management of granulomatosis with polyangiitis (wegener’s) (gpa) central nervous system (cns) involvement
Authors: G. De Luna, B. Terrier, P. Charles, C. Pagnoux, X. Puéchal, P. Cohen, L. Mouthon, L. Guillevin
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> GPA, a small-sized–vessel vasculitis, commonly involves ear, nose &amp; throat (ENT), lungs and kidneys, and rarely, the CNS. <h3>Objectives</h3> The presentation, management and outcome of GPA CNS involvement were evaluated. <h3>Methods</h3> We retrospectively reviewed the charts of 16 patients (12 men) with: GPA satisfying ACR and/or Chapel Hill criteria; and, after excluding other causes, GPACNS involvement manifesting as pachymeningitis, meningitis, stroke, spinal cord involvement or hypophyseal involvement. <h3>Results</h3> Mean respective ages at GPA diagnosis and onset of CNS involvement were 43 and 47 years. The latter was present in 9 (56%) patients at GPA diagnosis, and appeared in the 7 others after a median follow-up of 24 months. Headache was the main symptom (67%), with motor and sensory impairments noted in 33 and 27%, respectively. CNS involvements were: pachymeningitis (n=8: 7 cranial and 1 spinal cord), ischemic (n=4) or hemorrhagic stroke (n=2), cerebral vasculitis (n=2), and/or hypophyseal involvement (n=2). Extra-CNS manifestations included ENT (75%), lungs (60%), peripheral nerve(s) (40%) and kidneys (33%). ANCA detected in 12/16 (75%) patients had PR3 (n=7) or MPO (n=5) specificity. Induction therapy comprised corticosteroids (CS, 100%) and IV (69%) or oral cyclophosphamide (CYC, 25%) or rituximab (6%). Maintenance therapy consisted of CS (100%) and azathioprine (63%), or methotrexate or rituximab (13% each). CNS involvement responded clinically in 12/16 (75%). Relapsing and/or refractory CNS GPA in 7 patientswas treated with IV CYC or rituximab (43% each) or oral CYC (14%). No patient died during follow-up, but 64% had persistent neurologicalsequelae. <h3>Conclusions</h3> Our series highlights the heterogeneity of CNS involvement in GPA. Despite initial severe disease, conventional therapy obtained clinical improvement in 75% of the patients. Rituximab should be evaluated for refractory and/or relapsing CNS GPA. <h3>Disclosure of Interest</h3> None Declared
JUSTIFIABLE ARTIFICIAL ABORTION AND INDUCED PREMATURE LABOR.
Authors: W. C. BOWERS
Journal: JAMA (1899)

After a number of years of observation and study I am led to believe that abortion, both accidental and criminal, is frightfully common in all grades of society. Justifiable artificial abortion is not comparatively common, neither should it be, but seems sometimes required to save the life of a woman. Induced premature labor is as likely to be required in the interest of the child as of the mother, and in some conditions may be done in the interest of both. Neither should be decided on without honest consultation and serious consideration. "If thorough antisepsis be practiced, therapeutic abortion adds little to the risks of the mother if carefully done. Otherwise it is often more fatal than the disease from which it seeks to deliver her."<sup>2</sup> In any disease of a woman which is aggravated to so great a degree, because of pregnancy, as to endanger her life, and
Endothelial vascular cell adhesion molecule 1 expression is suppressed by melanoma and carcinoma.
Authors: L Piali, A Fichtel, H J Terpe, B A Imhof, R H Gisler
Journal: The Journal of Experimental Medicine (1995)

Vascular cell adhesion molecule 1 (VCAM-1) mediates extravasation of circulating leukocytes into inflamed tissues, and presumably, plays a role in the immigration of cytotoxic effector lymphocytes into tumor metastases. Since metastases are rarely cleared by blood-borne cells from the immune system, we asked whether the tumor may escape host defense by interfering with the mechanism of effector cell extravasation. Here we show that in mice and humans, VCAM-1 expression is repressed on tumor-infiltrating vascular endothelial cells in the lungs. On lung blood vessels distant from the tumor, VCAM-1 is constitutively expressed. When melanoma and endothelioma cells were cultured on either side of a Nucleopore membrane, the expression of VCAM-1 on the endothelioma cells was inhibited and VCAM-1 gene transcription was suppressed. We propose that the downregulation of VCAM-1 is a mechanism by which vascularized melanoma and carcinoma avoid invasion by cytotoxic cells of the immune system.
Regional enteritis leading to carcinoma of the small bowel
Authors: A. P. Wyatt
Journal: Gut (1969)

A case of carcinoma of the small bowel intimately associated with long-standing regional enteritis (Crohn9s disease) is described. Sixteen similar cases reported in the literature are briefly reviewed. This neoplasm presents at a younger age than other small bowel carcinomas and there seems little doubt that it is causally related to the inflammatory bowel lesion.
Public perceptions of a radioactively contaminated site: concerns, remediation preferences, and desired involvement.
Authors: D L Feldman, R A Hanahan
Journal: Environmental Health Perspectives (1996)

A public attitudes survey was conducted in neighborhoods adjacent to a radioactively contaminated site whose remediation is now under the auspices of the U.S. Department of Energy's Formerly Utilized Sites Remedial Action Program (FUSRAP). The survey's purpose was to ascertain levels of actual and desired public involvement in the remediation process; to identify health, environmental, economic, and future land-use concerns associated with the site; and to solicit remediation strategy preferences. Surface water and groundwater contamination, desire for public involvement, and potential health risks were found to be the most highly ranked site concerns. Preferred remediation strategies included treatment of contaminated soil and excavation with off-site disposal. Among on-site remediation strategies, only institutional controls that leave the site undisturbed and do not require additional excavation of materials were viewed favorably. Cost of remediation appeared to influence remediation strategy preference; however, no strategy was viewed as a panacea. Respondents were also concerned with protecting future generations, better assessment of risks to health and the environment, and avoiding generation of additional contaminated materials.
Wrong Answers in Self-Assessment II
Authors: TSUNG O. CHENG
Journal: Annals of Internal Medicine (1971)

Letters, Comments, and Corrections1 August 1971Wrong Answers in Self-Assessment IITSUNG O. CHENG, M.D., F.A.C.P.TSUNG O. CHENG, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-75-2-323_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: I have reviewed the results of my Medical Knowledge Self-Assessment Program II, but I would like to differ with the Test Committee on Cardiovascular Disease in the answers to the following two questions.Question 491 obviously refers to the billowing posterior leaflet of the mitral valve, that is, answer D, not your "correct" answer, E, which is myocardial infarction with papillary muscle dysfunction. Both your bibliography and my writings (Amer J Med 47:924, 1969; Circulation 42:111-143, 1970; Amer Heart J 80:716, 1970; Medical Times 99:127, 1971) make it abundantly clear what the correct answer is.Question 525... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: 7508 Cayuga Avenue Bethesda, Md. 20034 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 August 1971Volume 75, Issue 2Page: 323-323KeywordsCardiovascular diseasesHeartMyocardial infarctionPapillary muscles Issue Published: 1 August 1971 PDF DownloadLoading ...
The hepatitis B virus X protein up-regulates tumor necrosis factor α gene expression in hepatocytes
Authors: Enrique Lara-Pezzi, Pedro L. Majano, Marta Gómez-Gonzalo, Carmelo García-Monzón, Ricardo Moreno-Otero, Massimo Levrero, Manuel López-Cabrera
Journal: Hepatology (1998)

Human hepatocytes infected by hepatitis B virus (HBV) produce the proinflammatory cytokine, tumor necrosis factor α (TNF-α). In this study, we explored the mechanism of induction of TNF-α synthesis by HBV. We found that the stable HBV-transfected hepatoma cell line, 2.2.15, expressed high-molecular-weight (HMW) TNF-α mRNAs, which were absent in the parent HepG2 cells. Treatment of 2.2.15 cells with interferon alfa (IFN-α) and/or interleukin-1β (IL-1β) reduced both viral gene transcription and TNF-α mRNA expression. Transient or stable transfection of hepatocyte-derived cell lines with HBV X protein (HBx) expression vectors induced the production of biologically active TNF-α. In these cells, the HBx-induced TNF-α was detected both as cell-associated and soluble forms. Luciferase gene-expression assays showed that the TNF-α gene promoter contained target sequences for HBx trans-activation within the proximal region of the promoter. These results indicate that the hepatocyte TNF-α synthesis induced by HBV is transcriptionally up-regulated by HBx. Thus, HBx may have a role in the induction of the intrahepatic inflammatory processes that take place during acute and chronic hepatitis B.
E.C.H.O. Type 9 Infection in 1960
Authors: J. B. Landsman, E. J. Bell
Journal: BMJ (1962)

PHENELZINE AND DEXAMPHETAMINEMEDITISRNHL is, in terms of better, equal, or worse-was much higher than agreement between actual rating scores.This suggests that, for the purposes of a clinical trial, it may be more reliable for a clinician to assess a patient's state in relative terms (as being better or worse than before) than to rate his condition in absolute terms on different occasions. SummaryA self-controlled comparative trial of phenelzine (30 mg.b.d.), dexamphetamine sulphate (5 mg.b.d.), and lactose in the treatment of depressive illness is reported.The drugs were given consecutively, each for a fortnight, in randomized order.The results are based on the study of 43 patients.In their effect on the clinical manifestation of depression neither phenelzine nor dexamphetamine was significantly better than lactose.On the clinical manifestation of agitation and anxiety, however, phenelzine was significantly better than both dex- amphetamine and lactose; dexamphetamine was again no better than lactose.Independent ratings were made by two observers of the changes in intensity of the clinical manifestations.For depression and agitation there was fairly good agreement between the observers; for anxiety the agreement was poor.The findings suggest that the beneficial effect of pheneizine in depressive illness is due more to a sedative action in relieving anxiety than to a specific anti- depressive action.We
QOF and consent
Authors: F. Godlee
Journal: BMJ (2010)

There’s no shortage of critics of the Quality and Outcomes Framework (QOF), by which general practitioners in England are paid more for meeting a range of performance targets. Six years after its launch, Steve Gillam now thinks it should be scrapped. In a head to head debate this week (doi:10.1136/bmj.c2710), he argues that the clinical improvements credited to QOF are in line with predicted secular trends, that “commercially constructed evidence” has pushed up prescribing rates, that pay for performance brings with it a “corrosive cynicism,” and that single disease based guidelines, implemented mainly by nurses, have eroded the deeper professional relationships that patients want.

Niroshan Siriwardena …
Task force hopes to deliver affordable cancer drugs to developing countries
Authors: Z. Kmietowicz
Journal: BMJ (2009)

An international task force has been launched to expand the detection and treatment of cancer in less developed countries, where death rates from some cancers can be more than double those in richer nations.

A team of experts led by doctors from Harvard Medical School, Harvard School of Public Health, and the Dana-Farber Cancer Institute, hopes that the initiative will do for cancer patients what affordable drug pricing has achieved for people with HIV/AIDS, tuberculosis, polio, trachoma, and malaria in the developed world.

Felicia Knaul, head of the Harvard Global Equity Initiative, says that the task force will help to procure drugs for various cancers at affordable prices, expand the diagnosis and treatment of cancer, and improve survival.

Paul Farmer, from Harvard Medical School, who has been involved in building hospitals in developing countries, …
P333 HUMAN HEPATIC HepaRG CO-CULTURE MODEL AS A SENSITIVE AND NON-INVASIVE TOXICOLOGICAL PLATFORM USING ECIS (ELECTRICAL CELL-SUBSTRATE IMPEDANCE SENSING) BIOSENSORS
Authors: W. Gamal, P. Treskes, C. Chesne, J.N. Plevris, P.-O. Bagnaninchi, L.J. Nelson
Journal: Journal of Hepatology (2014)
An Assessment of the Safety of Pediatric Ibuprofen
Authors: Samuel M. Lesko
Journal: JAMA (1995)

To test the hypothesis that ibuprofen increases the risk of hospitalization for gastrointestinal bleeding, renal failure, or anaphylaxis among febrile children.Randomized double-blind acetaminophen-controlled trial.Outpatient pediatric and family medicine practices.A total of 84,192 children.Patients were randomly assigned to receive 12 mg/kg of acetaminophen, 5 mg/kg of ibuprofen, or 10 mg/kg of ibuprofen.Hospitalizations for acute gastrointestinal bleeding, acute renal failure, and anaphylaxis.A total of 277 patients (0.3%) were unavailable for follow-up. Overall, 795 participants (1%) were hospitalized, primarily for infectious diseases; hospitalization rates did not differ according to treatment group. Four children had diagnoses of acute, nonmajor gastrointestinal bleeding (two in each ibuprofen dosage group); among ibuprofen-treated children, the observed risk of gastrointestinal bleeding, 7.2 per 100,000 (95% confidence interval, 2 to 18 per 100,000), was not significantly different from the risk among acetaminophen-treated children (P = .31). There were no hospitalizations for acute renal failure or anaphylaxis; the upper 95% confidence bound for the risk of either of these outcomes was 5.4 per 100,000 ibuprofen-treated children. Among a number of other possibly serious adverse drug events, low white blood cell count was marginally associated with ibuprofen treatment. Because this association was observed in the setting of multiple comparisons and white blood cell counts may have been low before treatment, causation is unclear.The risk of hospitalization for gastrointestinal bleeding, renal failure, or anaphylaxis was not increased following short-term use of ibuprofen in children. These data, however, provide no information on the risks of less severe outcomes or the risks of prolonged ibuprofen use.
Molecular characterization of the idiopathic hypereosinophilic syndrome (HES) in 35 French patients with normal conventional cytogenetics
Authors: C Roche-Lestienne, S Lepers, V Soenen-Cornu, J-E Kahn, J-L Laï, E Hachulla, F Drupt, A-L Demarty, A-S Roumier, M Gardembas, M Dib, N Philippe, N Cambier, S Barete, C Libersa, O Bletry, P-Y Hatron, B Quesnel, C Rose, K Maloum, O Blanchet, P Fenaux, L Prin, C Preudhomme
Journal: Leukemia (2005)
Sodium Bicarbonate in Respiratory Acidosis
Authors: Hurley L. Motley
Journal: JAMA (1964)

<h3>To the Editor:—</h3> Readers may get the wrong impression from Dr. Plum's letter. The primary approach is to improve the airways and increase alveolar ventilation. A very low arterial blood pH is incompatible with life if allowed to persist; hence it is desirable to elevate the pH out of the low critical range as rapidly as possible. In such cases sodium bicarbonate can be added to a continuous intravenous drip, using at least 10 to 20 gm of sodium bicarbonate in a liter of fluid. Arterial blood pH should be used to monitor the amount of bicarbonate administered, since it is possible to overshoot the normal pH range and produce a significant alkalosis. I have been using this procedure for over 15 years with no adverse effects. Procedures to increase the alveolar ventilation are instituted as rapidly as possible once the diagnosis is made. When the initial pH is below
Homeopathy in Sports Injury
Authors: H. Selcon
Journal: British Journal of Sports Medicine (1983)

<h3>Introduction</h3> Learning health systems (LHS) is a multifaceted subject. This paper reviewed current concepts as well as real-world experiences of LHS, drawing on published and unpublished knowledge in order to identify and describe important principles and practices that characterise LHS in low/middle-income country (LMIC) settings. <h3>Methods</h3> We adopted an exploratory approach to the literature review, recognising there are limited studies that focus specifically on system-wide learning in LMICs, but a vast set of connected bodies of literature. 116 studies were included, drawn from an electronic literature search of published and grey literature. In addition, 17 interviews were conducted with health policy and research experts to gain experiential knowledge. <h3>Results</h3> The findings were structured by eight domains on learning enablers. All of these interact with one another and influence actors from community to international levels. We found that learning comes from the connection between information, deliberation, and action. Moreover, these processes occur at different levels. It is therefore important to consider experiential knowledge from multiple levels and experiences. Creating spaces and providing resources for communities, staff and managers to deliberate on their challenges and find solutions has political implications, however, and is challenging, particularly when resources are constrained, funding and accountability are fragmented and the focus is short-term and narrow. Nevertheless, we can learn from countries that have managed to develop institutional mechanisms and human capacities which help health systems respond to changing environments with ‘best fit’ solutions. <h3>Conclusion</h3> Health systems are knowledge producers, but learning is not automatic. It needs to be valued and facilitated. Everyday governance of health systems can create spaces for reflective practice and learning within routine processes at different levels. This article highlights important enablers, but there remains much work to be done on developing this field of knowledge.
Daily cannabis smoking as a risk factor for progression of fibrosis in chronic hepatitis C
Authors: Christophe Hézode, Françoise Roudot-Thoraval, Son Nguyen, Pascale Grenard, Boris Julien, Elie-Serge Zafrani, Jean-Michel Pawlostky, Daniel Dhumeaux, Sophie Lotersztajn, Ariane Mallat
Journal: Hepatology (2005)

Cannabinoids present in Cannabis sativa (marijuana) exert biological effects via cannabinoid receptors CB1 and CB2. We recently demonstrated that CB1 and CB2 receptors regulate progression of experimental liver fibrosis. We therefore investigated the impact of cannabis smoking on fibrosis progression rate in patients with chronic hepatitis C (CHC). Two hundred seventy consecutive untreated patients with CHC of known duration undergoing liver biopsy were studied. Demographic, epidemiological, metabolic, and virological data were recorded, and detailed histories of cannabis, alcohol, and tobacco use over the span of hepatitis C virus infection were obtained. Fibrosis stage, steatosis, and activity grades were scored according to Metavir system. Patients were categorized as noncannabis users (52.2%), occasional users (14.8%), or daily users (33.0%), and the relationship between cannabis use and fibrosis progression rate (FPR) or fibrosis stage was assessed. On multivariate analysis, six factors were independently related to a FPR greater than 0.074 (median value of the cohort): daily cannabis use (OR = 3.4 [1.5-7.4]), Metavir activity grade A2 or higher (OR = 5.4 [2.9-10.3]), age at contamination of more than 40 years (OR = 10.5 [3.0-37.1]), genotype 3 (OR = 3.4 [1.5-7.7]), excessive alcohol intake (OR = 2.2 [1.1-4.5]), and steatosis (OR = 2.0 [1.0-4.1]). Daily cannabis use was also an independent predictor of a rapid FPR (>0.15) (OR = 3.6 [1.5-7.5]). Finally, severe fibrosis (> or =F3) was also predicted by daily cannabis use (OR = 2.5 [1.1-5.6]; P = .034), independently of Metavir activity grade, excessive alcohol intake, age at liver biopsy, steatosis, and tobacco smoking. In conclusion, daily cannabis smoking is significantly associated with fibrosis progression during CHC. Patients with ongoing CHC should be advised to refrain from regular cannabis use.
Comparison of the Numerical and Clinical Accuracy of Four Continuous Glucose Monitors
Authors: James Brauker, Bradley Matsubara
Journal: Diabetes Care (2008)

Kovatchev et al. (1) reported anomalous performance results of three continuous glucose monitoring (CGM) sensors during a hypoglycemia clamp study. The authors stated that “all three CGM sensors experienced periods of transient loss of sensitivity, particularly during hypoglycemia, identified as sensor readings holding steady at a very low glucose value (e.g., 2.1 mmol/l) ….”

This study did not evaluate CGM systems per their intended …
It's not WEIRD, it's WRONG: When Researchers Overlook uNderlying Genotypes, they will not detect universal processes
Authors: Lowell Gaertner, Constantine Sedikides, Huajian Cai, Jonathon D. Brown
Journal: Behavioral and Brain Sciences (2010)

Abstract We dispute Henrich et al.'s analysis of cultural differences at the level of a narrow behavioral-expression for assessing a universalist argument. When Researchers Overlook uNderlying Genotypes (WRONG), they fail to detect universal processes that generate observed differences in expression. We reify this position with our own cross-cultural research on self-enhancement and self-esteem.
Training for general practice: a national survey.
Authors: H S Crawley, J B Levin
Journal: BMJ (1990)

OBJECTIVES--(a) To compare current vocational training in general practice with that ascertained by a survey in 1980; (b) to compare the training of trainees in formal training schemes with that of trainees arranging their own hospital and general practice posts. DESIGN--National questionnaire survey of United Kingdom and armed services trainees who were in a training practice on 1 April 1989. Questionnaires were distributed by course organisers. SETTING--Research project set up after an ad hoc meeting of trainees at the 1988 national trainee conference. SUBJECTS--2132 Of the 2281 trainees (93%) known to be in a training practice on 1 April 1989. RESULTS--1657 Trainees returned the questionnaires, representing 73% of all trainees known to be in a training practice on 1 April 1989. Between 1980 and 1989 there were significant improvements in the trainee year, and there was also evidence of improvements in general practice study release courses. There was no evidence of improvement in other aspects of training. General practice trainees spent an average of three years in junior hospital posts, which provided very little opportunity for study related to general practice. Training received during tenure of hospital posts differed significantly between trainees in formal schemes and those arranging their own hospital posts. During the trainee year training was almost the same for those in formal schemes and those arranging their own posts. Regions varied significantly in virtually all aspects of general practice training. CONCLUSIONS--The trainee year could be improved further by enforcing the guidelines of the Joint Committee on Postgraduate Training for General Practice. The poor training in junior hospital posts reflected the low priority that training is generally given during tenure of these posts. A higher proportion of general practice trainees should be attached to vocational training schemes. More hospital trainees could attend general practice study release courses if these were designed specifically with the needs of hospital doctors in mind.