tbuckley/cabot-search huggingface dataset:
Features and severity of occupational asthma upon diagnosis: an Italian multicentric case review
Authors: G. Moscato, A. Dellabianca, P. Maestrelli, P. Paggiaro, C. Romano, R. De Zotti, A. Marabini, S. Voltolini, M. Crippa, M. Previdi, B. Bramé, R. Benzon, A. Siracusa
Journal: Allergy (2002)

Background. The severity of occupational asthma (OA) at the time of diagnosis is not known. In this study we aimed to evaluate some features of the disease at the time of diagnosis , particularly looking at severity and treatment before diagnosis. Methods: Medical records of subjects ( n = 197) who had received a diagnosis of OA in six specialized centres of Northern and Central Italy in the period 1992–97 were reviewed. The severity of the disease at the time of diagnosis was determined on the basis of symptoms, peak expiratory flow (PEF, percentage predicted), forced expiratory volume in one second (FEV 1 , percentage predicted), and PEF variability, following the criteria of the National Institutes of Health and World Health Organizaton (NIH/WHO) guidelines on asthma. Medications used in the month before diagnosis were recorded. Results: The most common etiological agents were isocyanates (41.6%), flours (19.8%), woods (9.7%) and natural rubber latex (7.6%). The level of asthma severity (AS) was mild intermittent in 23.9% patients, mild persistent in 28.9%, moderate in 41.6%, and severe in 5.6%. Asthma severity was positively associated with current or previous smoking ( P &lt; 0.05), and was not related to atopy and current exposure. A relationship with bronchial reactivity to methacholine was shown in subjects at work. Treatment before diagnosis was consistent with the NIH/WHO guidelines in only 13.2% patients, whereas 75.6% were undertreated and 11.2% were overtreated. Conclusions: In this study we found that the majority of patients had mild asthma at the time of diagnosis and that cigarette smoking was associated with a greater severity. Moreover, the majority of patients were undertreated before etiological diagnosis.
Tissue expression of inducible nitric oxide synthase is closely associated with resistance to Leishmania major.
Authors: S Stenger, H Thüring, M Röllinghoff, C Bogdan
Journal: The Journal of Experimental Medicine (1994)

Previous studies with inhibitors of inducible nitric oxide synthase (iNOS) suggested that high-output production of nitric oxide (NO) is an important antimicrobial effector pathway in vitro and in vivo. Here, we investigated the tissue expression of iNOS in mice after infection with Leishmania major. Immunohistochemical staining with an iNOS-specific antiserum revealed that in the cutaneous lesion and draining lymph nodes (LN) of clinically resistant mice (C57BL/6), iNOS protein is found earlier during infection and in significantly higher amounts than in the nonhealing BALB/c strain. Similar differences were seen on the mRNA level as quantitated by competitive polymerase chain reaction. Anti-CD4 treatment of BALB/c mice not only induced resistance to disease, but also restored the expression of iNOS in the tissue. In situ, few or no parasites were found in those regions of the skin lesion and the draining LN which were highly positive for iNOS. By double labeling experiments, macrophages were identified as iNOS expressing cells in vivo. In the lesions of BALB/c mice, cells staining positively for transforming growth factor beta (TGF-beta), a potent inhibitor of iNOS in vitro, were strikingly more prominent than in C57BL/6, whereas no such difference was found for interleukin 4 or interferon gamma (IFN-gamma). In vitro, production of NO was approximately threefold higher in C57BL/6 than in BALB/c macrophages after stimulation with IFN-gamma. We conclude that the pronounced expression of iNOS in resistant mice is an important mechanism for the elimination of Leishmania in vivo. The relative lack of iNOS in susceptible mice might be a consequence of macrophage deactivation by TGF-beta and reduced responsiveness to IFN-gamma.
Asian patients may receive inferior care
Authors: A. Stewart
Journal: BMJ (2002)

EDITOR—Patel et al report an ecological study which shows that at the practice level the proportion of patients who are South Asian is a significant determinant of the level of prescriptions for lipid lowering drugs.1 Presumably this means that South Asian patients, even though they are more likely either to have heart disease or to be at higher risk of heart disease, are less likely to receive appropriate treatment with lipid lowering drugs.

We reported …
Effect of Hydroxymethyl Glutaryl Coenzyme A Reductase Inhibitor Therapy on High Sensitive C-Reactive Protein Levels
Authors: I. Jialal, D. Stein, D. Balis, S. M. Grundy, B. Adams-Huet, S. Devaraj
Journal: Circulation (2001)

Background —Prospective studies indicate that baseline levels of C-reactive protein (CRP), the prototypic marker of inflammation, are associated with an increased risk for cardiovascular events. Limited studies have examined therapies that influence high-sensitive CRP (hs-CRP) levels, especially in hyperlipidemic patients. Thus, we tested the effects of 3 hydroxymethyl glutaryl coenzyme A reductase inhibitors (statins), simvastatin (20 mg/d), pravastatin (40 mg/d), and atorvastatin (10 mg/d), on levels of hs-CRP in a randomized, double-blind, crossover trial of 22 patients with combined hyperlipidemia (LDL cholesterol &gt;130 mg/dL and triglycerides of 200 to 600 mg/dL). Methods and Results —After 6 weeks of an American Heart Association Step 1 diet, fasting blood samples were drawn at baseline and after 6 weeks of therapy with each drug. hs-CRP levels were significantly decreased after treatment with all 3 statins compared with baseline (median values: baseline, 2.6 mg/L; atorvastatin, 1.7 mg/L; simvastatin, 1.7 mg/L; and pravastatin, 1.9 mg/L; P &lt;0.025). The reductions obtained with the 3 statins were similar. In addition, there was no significant effect on either plasma interleukin-6 or interleukin-6 soluble receptor levels. There was no relationship between reductions in hs-CRP and LDL cholesterol. Conclusions —Pravastatin, simvastatin, and atorvastatin significantly decreased levels of hs-CRP. These data support an anti-inflammatory effect of these drugs.
Travelers' Diarrhea and Toxigenic<i>Escherichia coli</i>
Authors: Sherwood L. Gorbach, Ben H. Kean, Dolores G. Evans, Doyle J. Evans, David Bessudo
Journal: New England Journal of Medicine (1975)

In a group of 133 United States students studied for 18 days after arriving in Mexico, diarrhea developed in 38 (29 per cent). Diarrhea rarely began before the fourth day, and the mean onset was 13 days after arrival. Symptoms lasted an average of 3.4 days but persisted in 21 per cent of sick students. Heat-labile enterotoxin-producing Escheria coli was found in the stools of 72 per cent of sick and 15 per cent of healthy students. None had heat-labile Esch. coli when they entered Mexico. The incubation period was short, generally 24 to 48 hours, and the carrier state was five days or less in 82 per cent of students surveyed. Entamoeba histolytica was found in 6 per cent of cases of diarrhea, but not salmonella, shigella or penetrating Esch. coli. These studies suggest that approximately 70 per cent of travelers' diarrhea in Mexico is associated with heat-labile toxigenic strains of Esch. coli.
Accessibility of trial reports for drugs stalling in development: a systematic assessment of registered trials
Authors: A. Hakala, J. Kimmelman, B. Carlisle, G. Freeman, D. Fergusson
Journal: BMJ (2015)

<b>Objective</b> To quantify the proportion of trials for unsuccessfully licensed drugs that are not published. <b>Design</b> A systematic assessment of the availability of published research reports for publicly registered trials testing drugs stalling in clinical development ("stalled drugs") and drugs receiving regulatory licensure in the same time period ("licensed drugs"). <b>Data sources</b> Searches of clinicaltrials.gov, Google Scholar, PubMed, Embase, and electronic query of contacts in registries to identify trials and assess publication status. <b>Eligibility criteria</b> The cohort of licensed drugs consisted of all disease modifying drugs in cancer, cardiovascular disease, or neurological disorders that received Food and Drug Administration licensure during 2005 to 2009 inclusive. The cohort of stalled drugs included unlicensed drugs in the same disease areas that had at least one completed phase III trial before 2009 and no evidence of any clinical trial activity after 31 December 2009. Inclusion criteria for registered trials advanced into publication searching were an intervention tested in a disease modifying, phase II, III, or IV trial registered on clinicaltrials.gov, with enrolment of at least one patient, that reported primary outcome collection end date between 1 January 2006 and 31 December 2008. <b>Results</b> The unadjusted publication proportion for registered trials of licensed drugs was 75% (72/96) versus 37% (30/81) for stalled drugs. The adjusted hazard ratio for publication was 2.7 (95% confidence interval 1.7 to 4.3) in favour of licensed drug trials. Higher publication rates for licensed drug trials were observed regardless of disease type, sponsorship, trial phase, and geography. The rate of non-publication of stalled drug trials was significantly higher for studies that did not complete enrolment compared with licensed drug trials. A total of 20&nbsp;135 patients participated in trials of stalled drugs that were never published. <b>Conclusions</b> Much of the information collected in unsuccessful drug trials is inaccessible to the broader research and practice communities. These findings provide an evidence base and rationale for policy reforms aimed at promoting transparency, ethics, and accountability in clinical research.
Systemic failings in NHS contributed to death of Baby P
Authors: J. Wise
Journal: BMJ (2009)

The NHS must accept its share of responsibility for the death of Baby P, the 17 month old boy who died at the hands of his mother, her partner, and their lodger, the new independent regulator of health and social care in England has said.

A report by the Care Quality Commission found systemic failings in the health care provided by NHS trusts to Baby P, whose first name has been revealed as Peter. 

Excluding his birth, Peter had 34 contacts with health professionals at North Middlesex University Hospital NHS Trust and Haringey Teaching Primary Care Trust, in north London. Paediatric staff in these hospitals was provided by Great Ormond Hospital for Children NHS Trust.

The commission said it was concerned that the boards of all the trusts with which the baby had contact had previously declared themselves as complying with all the core standards related to safeguarding children.

The commission’s chief executive, Cynthia Bower, said, “There were clear reasons to have concern for this child, but the response was simply not fast enough or smart enough. The NHS must accept its share of …
Beyond the Basal Ganglia
Authors: Svjetlana Miocinovic
Journal: JAMA Neurology (2013)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Neurology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Neurology journal
The Treatment of Diabetic Gastroparesis With Botulinum Toxin Injection of the Pylorus
Authors: Brian E. Lacy, Michael D. Crowell, Ann Schettler-Duncan, Carole Mathis, Pankaj J. Pasricha
Journal: Diabetes Care (2004)

OBJECTIVE—Gastroparesis is a disorder of delayed gastric emptying that is often chronic in nature. Up to 50% of type 1 diabetic subjects have symptoms of gastroparesis, which include nausea, vomiting, and early satiety. Elevated pyloric pressures may be responsible for delayed gastric emptying in diabetic subjects. Botulinum toxin inhibits the release of acetylcholine and produces transient paralysis when injected into smooth muscle. The aim of this study was to determine whether injection of the pylorus with botulinum toxin in patients with diabetic gastroparesis improves symptoms of gastroparesis, alters gastric emptying scan time, and/or changes weight and insulin use. RESEARCH DESIGN AND METHODS—This was an open-label trial with age- and sex-matched control subjects from a tertiary care referral center for patients with gastroparesis. Eight type 1 diabetic subjects (six women and two men; mean age 41 years; mean years with diabetes 25.3) who had failed standard therapy were enrolled. Intervention consisted of injection of the pylorus with 200 units of botulinum toxin during upper endoscopy. Symptoms, antropyloric manometry, gastric emptying scan times, weight, and insulin use were all recorded before intervention and during a 12-week follow-up period. RESULTS—Seven of the eight patients completed the full 12-week follow-up period. No complications were noted. Mean symptom scores declined from 27 to 12.1 (P &amp;lt; 0.01), whereas the SF-36 physical functioning domain also improved (P &amp;lt; 0.05). Four patients noted an increase in insulin use of &amp;gt;5 units/day. Six of the seven patients gained weight (P = 0.05). Gastric emptying scan time improved in four patients. CONCLUSIONS—Botulinum toxin injection of the pylorus is safe and improves symptoms in patients with diabetic gastroparesis. These results warrant further investigation with a large, double-blind, placebo-controlled trial.
HISTOLOGY AND CYTOCHEMISTRY OF HUMAN SKIN XXXV. THE NIPPLE AND AREOLA
Authors: WILLIAM MONTAGNA
Journal: British Journal of Dermatology (1970)

SUMMARY.— The undersurface of the epidermis covering the tip of the nipple resembles that found in tactile surfaces; at the sides of the nipple the undersurface is more shallow, and in the areola it has an even, honeycombed appearance. These are distinctive structural signatures of the areas. The nipple is glabrous and the areola largely so. Lactiferous ducts and sebaceous and apocrine glands open only at the tip of the nipple, mostly grouped toward the centre. Glands of Montgomery (accessory mammary glands), clusters of large sebaceous glands, a few scattered eccrine sweat glands, some apocrine glands, and a few vellus hairs toward the periphery are the appendages of the areola. Lactiferous ducts and sebaceous glands contain numbers of melanotic melanocytes among their epithelial cells. Sensory nerve end-organs are found only at the tip of the nipple; there are practically none demonstrable at the sides of the nipple or at the areola. Many nerves are loosely wrapped around the lactiferous ducts, from the lactiferous sinus to the surface. These are probably afferent nerve fibres that convey sensory impulses. Nipples and areolae have a bountiful framework of elastic fibres that give these structures rigidity and support, anchor smooth muscle fibres, keep the lactiferous ducts and sinuses from collapsing, and attach the epidermis. The nipples and areolae of women, men, girls, and boys are qualitatively identical hut quantitatively very different.
Serum bilirubin and hepatic enzyme induction.
Authors: B F Allam
Journal: BMJ (1979)

menopausal bleeding from which the women workers suffered.Finally, the criticism of the inappropriate use of the unpaired t test in the statistical analysis is groundless because, firstly, there is no obvious violation of the assumptions of the t test and, secondly, the robustness of the t statistic secures its use in comparing two groups.We have no doubt therefore about the significance of our findings.
Regulation of factor XIa activity by platelets and alpha 1-protease inhibitor.
Authors: P N Walsh, D Sinha, F Kueppers, F S Seaman, K B Blankstein
Journal: Journal of Clinical Investigation (1987)

We have studied the complex interrelationships between platelets, Factor XIa, alpha 1-protease inhibitor and Factor IX activation. Platelets were shown to secrete an inhibitor of Factor XIa, and to protect Factor XIa from inactivation in the presence of alpha 1-protease inhibitor and the secreted platelet inhibitor. This protection of Factor XIa did not arise from the binding of Factor XIa to platelets, the presence of high molecular weight kininogen, or the inactivation of alpha 1-protease inhibitor by platelets. The formation of a complex between alpha 1-protease inhibitor and the active-site-containing light chain of Factor XIa was inhibited by activated platelets and by platelet releasates, but not by high molecular weight kininogen. These results support the hypothesis that platelets can regulate Factor XIa-catalyzed Factor IX activation by secreting an inhibitor of Factor XIa that may act primarily outside the platelet microenvironment and by protecting Factor XIa from inhibition, thereby localizing Factor IX activation to the platelet plug.
Direct evidence for the role of COOH terminus of mouse mammary tumor virus superantigen in determining T cell receptor V beta specificity.
Authors: K Yazdanbakhsh, C G Park, G M Winslow, Y Choi
Journal: The Journal of Experimental Medicine (1993)

It has recently been shown that open reading frames in the 3' long terminal repeats of mouse mammary tumor viruses encode superantigens. These viral superantigens (vSAGs) stimulate most T cells expressing appropriate V beta s almost regardless of the rest of the variable components of the T cell receptors (TCR) expressed by those cells. vSAGs produce a type II integral membrane protein with a nonessential short cytoplasmic domain and a large glycosylated extracellular COOH-terminal domain, which is predicted to interact with major histocompatibility complex class II molecules and the TCR. The transmembrane region of vSAG also has an internal positively charged lysine residue of unknown significance. A set of chimeric and mutant vSAG genes has been used in transfection experiments to show that only the extreme COOH-terminal portion of vSAGs determine their TCR V beta specificities, and to show that the lysine residue in the transmembrane domain is not essential for the function of vSAG.
601 The role of HCV viremia and GBV-C viremia in the response to highly active antiretroviral therapy (HAART) in a cohort of HIV-infected subjects
Authors: G ANTONUCCI, A LEPRI, E GIRARDI, M CAPOBIANCHI, M SOLMONE, F CARLETTI, A MONFORTE
Journal: Hepatology (2003)

BACKGROUND & AIMS: No conclusive data about GB virus C (GBV-C) tropism are available. We have studied the presence of genomic and antigenomic GBV-C RNA in serum, liver, and peripheral blood cells of 56 patients with chronic hepatitis B, C, or D virus infection.METHODS: Genomic and antigenomic GBV-C RNA were detected by reverse-transcription nested polymerase chain reaction. Specificity was confirmed by sequencing, by chemical modification of the RNA, and by using tagged primers.RESULTS: Genomic GBV-C RNA was found in 10 of 56 (18%) of the sera. In contrast, antigenomic strand was not detected. The sequence of the amplified GBV- C RNA from 3 patients showed a 96% homology among them and from 83% to 88% with previously described isolates. Genomic GBV-C RNA was found in 7 of 7 liver samples of the patients with serum GBV-C RNA. In 6 of these 7 patients (85%), antigenomic strand was found. Genomic RNA was found in 7 of 7 of the peripheral blood cell samples of the same 7 patients. Antigenomic GBV-C RNA was not found in these cells.CONCLUSIONS: These results suggest that GBV-C is a hepatotropic virus that replicates in the human liver. The data do not support a role for GBV-C in chronic liver disease.(Gastroenterology 1997 Aug;113(2):573-8)
Left Ventricular Performance after Myocardial Infarction Assessed by Radioisotope Angiocardiography
Authors: WILLIAM J. KOSTUK, ALI A. EHSANI, JOEL S. KARLINER, WILLIAM L. ASHBURN, KIRK L. PETERSON, JOHN ROSS, BURTON E. SOBEL
Journal: Circulation (1973)

Radioisotope angiocardiography was performed by peripheral venous or pulmonary arterial injection of 99m Tc pertechnetate in 64 patients with acute myocardial infarction. End-diastolic volume determined with this technic averaged 101 ± 7 (± sem ) ml/m 2 and was elevated (&gt; 90 ml/m 2 ) in 47 patients. Initial ejection fraction (EF) averaged 0.38 ± 0.03 and was reduced (&lt;0.52) in 58 patients. The extent of diameter shortening at the minor left ventricular equator determined from the isotope angiocardiograms was depressed in 51 patients, a reduction which was not consistently related to the site of infarction determined electrocardiographically. In 53 survivors EF averaged 0.40 ± 0.02, compared to 0.26 ± 0.07 ( P &lt; 0.05) in 11 patients who died within 1 month. EF correlated inversely with infarct size estimated by analysis of serial changes in serum CPK activity (r = 0.71, n = 42). Of the 64 patients with acute infarction, 47 exhibited abnormal wall motion detectable by the radionuclide technic and confirmed by radarkymography. Serial radioisotope angiocardiograms (6 hours-1 month) showed improvement of cardiac function in 30 of 55 patients, with no change in 12, and deterioration in 13 patients. Results obtained indicate that radioisotope angiocardiography performed by peripheral intravenous injection of 99m Tc pertechnetate can be performed safely, rapidly, and serially without hemodynamic perturbation to assess left ventricular performance in patients critically ill with acute myocardial infarction.
Psoriatic lesions induced by antitumour necrosis factor-alpha treatment: two cases
Authors: O. Dereure, B. Guillot, C. Jorgensen, J-D. Cohen, B. Combes, J-J. Guilhou
Journal: British Journal of Dermatology (2004)

Sir, Both subcutaneously administered soluble receptor to tumour necrosis factor (TNF)‐α (etanercept) and intravenous monoclonal anti‐TNF‐α antibodies (infliximab) have recently been used in severe cutaneous and/or arthropathic psoriasis, with impressive clinical improvement and few side‐effects.1–3 These results suggest that these drugs might soon become an established treatment for severe forms of the disease along with other new, emerging immunotherapies. However, side‐effects of these TNF‐α‐modulating treatments in other indications may be more puzzling than previously assumed. We report two unusual cases of cutaneous psoriatic lesions occurring in patients treated by both categories of anti‐TNF‐α drugs for rheumatoid arthritis (RA). Patient 1 was a 47‐year‐old white woman without personal or family history of psoriasis who had been treated for seronegative RA for the last 20 years with a combination of anti‐inflammatory drugs, chrysotherapy, methotrexate and systemic steroids. Treatment with intravenous infliximab (200 μg every 6 weeks) was implemented, with very good clinical results on joint inflammation which allowed her to stop taking anti‐inflammatory drugs. However, 2 months after the beginning of the anti‐TNF‐α treatment, cutaneous lesions began to appear on anterior aspects of the legs, highly suggestive of psoriasis (Fig. 1a). Histological findings were also consistent with psoriasis, with parakeratosis, hyperkeratosis, acanthosis, lack of granular layer, tortuous dilated capillaries and a lymphocytic infiltrate in the upper dermis (Fig. 1b). Topical treatment with steroids and salicylic acid resulted in limited improvement of lesions and infliximab was continued, without further extension of cutaneous lesions after a 3‐month follow‐up.