tbuckley/cabot-search huggingface dataset:
Sustained virologic response prevents the development of esophageal varices in compensated, Child-Pugh class A hepatitis C virus-induced cirrhosis. A 12-year prospective follow-up study
Authors: Savino Bruno, Andrea Crosignani, Corinna Facciotto, Sonia Rossi, Luigi Roffi, Alessandro Redaelli, Roberto de Franchis, Piero Luigi Almasio, Patrick Maisonneuve
Journal: Hepatology (2010)

The incidence of de novo development of esophageal varices (EV) in patients with compensated liver cirrhosis has been determined by few studies in the short term and never in the long term. The aims of the present study were to determine the incidence and the risk factors associated with the development of EV and to assess whether antiviral treatment and achievement of sustained virologic response (SVR) may prevent de novo EV development in patients with HCV-induced cirrhosis. We studied 218 patients with compensated EV-free, HCV-induced cirrhosis consecutively enrolled between 1989 and 1992 at three referral centers in Milan, Italy. Endoscopic surveillance was performed at 3-year intervals according to international guidelines. SVR was defined as undetectable serum HCV-RNA 24 weeks after treatment discontinuation. During a median follow-up of 11.4 years, 149/218 (68%) patients received antiviral treatment and 34 (22.8%) achieved SVR. None of the SVR patients developed EV compared with 22 (31.8%) of the 69 untreated subjects (P < 0.0001) and 45 (39.1%) of the 115 non-SVR patients (P < 0.0001). On multivariate analysis, HCV genotype 1b (hazard ratio [HR] 2.40; 95% confidence interval [CI] 1.17-4.90) and baseline model for end-stage liver disease (MELD) score (HR 1.20; 95% CI 1.07-1.35 for 1 point increase) were independent predictors of EV. In the long term, the achievement of SVR prevents the development of EV in patients with compensated HCV-induced cirrhosis. Therefore, in these patients, endoscopic surveillance can be safely delayed or avoided. Genotype 1b infection and MELD score identify the subset of patients at higher risk of EV development who need tailored endoscopic surveillance.
Smoking during pregnancy and diabetes mellitus in a British longitudinal birth cohort
Authors: S. M Montgomery, A. Ekbom
Journal: BMJ (2002)

Exposures in utero may increase the risk of type 2 diabetes. 1 2 We tested the hypothesis that maternal smoking during pregnancy increases both the risk of early onset type 2 diabetes3 and non-diabetic obesity in offspring.

We used data are from the British National Child Development Study (NCDS),4 based on the Perinatal Mortality Survey (PMS) of about 17 000 births from 3 to 9 March 1958. The first sweep of the study in 1965 had 15 396 responses. The cohort remained generally representative at age 33 years (n=11 359).5 Missing data reduced the proportion in social class V from 6.4% in sweep 1 to 5.3%. Ethics committee approval was obtained for research involving medical examinations, and cohort members signed consent forms at age 33 years allowing access to medical records. …
THE REMOVAL OF A PAPER FASTENER BY DIRECT PERORAL BRONCHOSCOPY: After its Impaction for Twenty-one Months in the Left Bronchus
Authors: H. Tilley
Journal: BMJ (1922)

MDTHEBIAJOSR 973 glands in the groin, death in some cases being due to haemor- rhage from the external iliac or femoral vessels; in other eases death is due to septic absorption and exhaustion.In only one case of the series was the peritoneum involved; in this case, as the bowel also was affected, it was necessary to do a colostomy.There appears to be little tendency to the formation of metastases in distant organs.
Acute coronary syndrome
Authors: A Khavandi, P R Walker
Journal: BMJ (2007)

Glycoprotein IIb/IIIa inhibitors are still underused, especially in patients at high risk

About 120 000 people are diagnosed with acute coronary syndrome in England and Wales each year, and about 1.5 million people are discharged from hospitals in the United States with the diagnosis.1 Despite the use of standard medical treatment, the risk of death or non-fatal myocardial infarction is about 10% within 30 days, and the proportion of adverse outcomes is about 30% at six months.2

Doctors who deal with acute medical admissions are well accustomed to the diagnosis and initial medical management of acute coronary syndromes. However, many doctors are less confident about the use of glycoprotein IIb/IIIa inhibitors, such as eptifibatide and tirofiban, in these patients and often await a cardiology review.3 This may be less important in tertiary centres where a specialist opinion is prompt and patients at high risk are quickly identified and stratified to invasive strategies or coronary care units. In district general hospitals, however, the admitting doctor decides which patients could benefit from more aggressive strategies. This is especially true out of normal working hours, when the cardiology team is not available. Moreover, recent data from the myocardial infarction national audit project suggest that most patients with acute coronary syndrome are initially managed by non-cardiologists on acute wards.4

Glycoprotein IIb/IIIa inhibitors inhibit the final common pathway of platelet aggregation, so they …
Inoculation of Leprosy
Authors: W. K. Hatch
Journal: BMJ (1886)

c'Yine 26, 188&] HRBRITISH MEDICALItOrURBYAl.113 than natural, but fairly distinct.The cedema is more marked about the face and hands than,elsewhere.Tbhe patient was very thin till her last pregnancy.The skin is dry and harsh, and the hair thin and apt to fall out.The thyroid gland is atrophied.Temperature, axillary, 980 F. Pulse, 74.Sense of touch and pain is diminished; she can hardly pick up a pin, and can only sew soft material ; she com- plains of numbness.There is no paralysis, but the patient frequently staggers when walking, and all her movements are slow.The intellectual changes consist of slowness of thought, and increased irritability; she dreams more than usual, and has loss of memory.
SELECTIVE DRUG-ELUTING STENT USE IN ELDERLY PATIENTS: IMPACT ON PERCUTANEOUS CORONARY INTERVENTION MORTALITY AND BLEEDING RISK
Authors: Samip Vasaiwala, Daniel Forman, Robert Yeh, Treacy Silbaugh, Ann Lovett, Sharon-Lise Normand, Laura Mauri
Journal: Journal of the American College of Cardiology (2012)
Platelet function abnormalities in Gaucher disease patients
Authors: Shmuel Gillis, Esti Hyam, Aya Abrahamov, Deborah Elstein, Ari Zimran
Journal: American Journal of Hematology (1999)

Bleeding manifestations are common in Gaucher disease patients. Although usually attributed to thrombocytopenia, some patients with relatively high platelet counts and normal coagulation tests have hemorrhagic phenomena. To investigate whether perturbed platelet function could explain these bleeding manifestations we performed platelet aggregation tests on 32 type I adult Gaucher patients who were not severely thrombocytopenic (platelet counts >50 × 109/L). Seven patients (22%) had abnormal platelet aggregation. In five, platelet aggregation was markedly reduced in response to collagen and ADP and virtually absent in response to epinephrine, whereas two patients had isolated severely impaired epinephrine-induced aggregation. In one patient platelet aggregation markedly improved following one year of enzyme replacement therapy. Incubating normal platelets with high concentrations of glucocerebroside did not impair their ability to aggregate, suggesting that plasma glucocerebroside does not directly interfere with platelet function. Platelet dysfunction is a hithero unrecognised, relatively common cause of excessive bleeding in Gaucher patients. Am. J. Hematol. 61:103–106, 1999. © 1999 Wiley-Liss, Inc.
TB and HIV services must be fully integrated, says WHO
Authors: A. Gulland
Journal: BMJ (2012)

Patients with suspected or diagnosed tuberculosis should routinely be offered testing for HIV, the World Health Organization has said.

In new guidance on the treatment of HIV and TB, WHO calls for the full integration of services for the two diseases, with treatment and care at the same time and in the same place. The policy talks about the “three Is”: intensive screening for TB; isoniazid preventive treatment; and infection control.

As well as calling for routine tests for TB among all people with HIV and their families and partners, WHO says that all HIV patients with TB should be started on antiretrovirals …
INTRARENAL COMPLEMENT FIXATION BY CYTOTOXIC ANTIBODIES
Authors: D. Sellin, M. Kövary, U. Rother, K. Rother
Journal: The Journal of Experimental Medicine (1970)

The reactivity of histocompatibility antigens with serum antibodies and complement was studied in a short term model of allotransplantation. Lewis and DA rat kidneys were perfused with cytotoxic antisera and tissue sections analyzed for adsorption of fluorescent antibodies against gamma-globulin and complement (beta(1C) protein). Both, the presumed cytotoxic antibody and C were localized at similar sites in the endothelial lining and in the walls of the arterial vessels and of the larger veins. The pattern of immune globulin deposition was distinct from that observed in glomerulonephritis. It may thus become helpful in the differential diagnosis between graft rejection and glomerulonephritis. At the sites of the deposits, the endothelial cells appeared enlarged and their nuclei protruded into the lumen. The findings are in line with the hypothesis that an antibody-mediated local activation of serum complement may be involved in the destruction of allografted tissue.
Adrenal Structure and Function in Advanced Carcinoma of the Breast
Authors: Richard E. Wilson
Journal: JAMA (1967)

Variations in palliative response of breast cancer to adrenalectomy can be explained either by variations in the glands removed, by variations in the biology of the neoplasm, or by variations in the host herself. Most of the reported studies of this subject have been devoted to the latter two concepts; seeking to discern either in the tumor (the anatomy of its metastases, its growth rate), or in some aspect of the host (the free interval, age, or menopausal status) some indicator of the anticipated response. Recently, attention has been devoted to the urinary hormone excretion as a measure of adrenal function, and subsequent derivation from that information of a discriminant or predictor of clinical response. A previous report compared the extent of adrenal atrophy observed after prolonged corticosteroid treatment with that observed following hypophysectomy in patients with advanced carcinoma of the breast.<sup>1</sup>Hypophysectomy produced a far more profound adrenal
Detection of Type VII Collagen Autoantibodies Before the Onset of Bullous Systemic Lupus Erythematosus
Authors: Daniel A. Grabell, Loderick A. Matthews, Kim B. Yancey, Benjamin F. Chong
Journal: JAMA Dermatology (2015)

Anti-type VII collagen autoantibodies are often detectable in patients with bullous systemic lupus erythematosus (BSLE). However, the timing of their appearance preceding the onset of disease is unknown to date.We report the case of a 50-year-old woman with a history of SLE who was seen with vesicles and bullae around her lips, trunk, axillae, arms, and thighs. Histologic analysis and immunofluorescence and immunoblot studies confirmed the diagnosis of BSLE. Immunoblotting and enzyme-linked immunosorbent assay studies of the patient's serum obtained 3 months before the onset of BSLE showed the presence of anti-type VII collagen autoantibodies. Levels of anti-type VII collagen IgG increased after bullous lesions appeared. Within 1 month after initiating dapsone therapy and increasing the dosage of prednisone, skin lesions promptly resolved. One year after the onset of BSLE, the anti-type VII collagen IgG decreased below levels observed before the inception of the bullous lesions.Anti-type VII collagen autoantibodies can precede the clinical appearance of BSLE. The subsequent increase and decrease in levels of circulating anti-type VII collagen autoantibodies, which mirrored skin disease activity, support a potential role in their initiation of disease.
Cerebral Blood Flow during Carotid Endarterectomy
Authors: ARTHUR G. WALTZ, THORALF M. SUNDT, JOHN D. MICHENFELDER
Journal: Circulation (1972)

Cerebral blood flow (CBF) was measured during 28 carotid endarterectomies in 25 patients, by injection of 133 Xe into the exposed internal carotid artery (ICA). Twenty-three patients had episodic cerebral or retinal ischemia and five had neurologic deficits before operation. Initial CBF values were variable. Increases of Pa Co Co2 caused CBF to increase in four of six patients, to increase slightly in one, and to decrease in one. In each of 19 procedures, CBF decreased during surgical occlusion of the ICA, 11 times to less than 30 ml/100 g/min, but absence of postoperative worsening indicated that decreased ICA blood flow is not a major risk of the procedure; embolization from the site of operation may be a greater threat to the patient. CBF increased after 14 endarterectomies, perhaps due to failure of autoregulation or to reactive hyperemia. Measurements of jugular PV o o2 and lactate concentration were of little value.
Bacterial lipoteichoic acid sensitizes host cells for destruction by autologous complement.
Authors: D S Hummell, J A Winkelstein
Journal: Journal of Clinical Investigation (1986)

Lipoteichoic acids (LTA) released by gram-positive bacteria can spontaneously bind to mammalian cell surfaces. In the present study, erythrocytes (E) sensitized with pneumococcal LTA (LTA-E) were used as a model system to determine if LTA could render host cells susceptible to damage by autologous complement. Complement (C)-mediated lysis of LTA-E from normal rats and normal humans occurred when these cells were incubated in their respective autologous sera in vitro. In addition, when LTA-E from a C2-deficient human and from C4-deficient guinea pigs were incubated in their autologous sera, there was significant lysis in vitro, demonstrating a role for the alternative pathway. The in vivo survival of 51Cr-labeled autologous LTA-E was also studied. Only 2.9% of autologous LTA-E remained in the circulation of normal rats after 90 min. In contrast, 31.2% of autologous LTA-E remained in the circulation of rats depleted of C3. Intravascular hemolysis accounted for the clearance of LTA-E in the normal rats, whereas liver sequestration was responsible for clearance in the C3-depleted rats. These results demonstrate that LTA can render the host's cells susceptible to damage by its own complement system, establishing this as a possible mechanism of tissue damage in natural bacterial infections.
Multiple thoracotomy for metastatic pulmonary neoplasm
Authors: P. Marks
Journal: Thorax (1974)

<b>Marks, P. (1974).</b><i>Thorax</i>, <b>29</b>, 248-251. <b>Multiple thoracotomy for metastatic pulmonary neoplasm.</b> Surgical excision of solitary, metastatic, malignant lesions of the lung is reported as of benefit in certain cases in which the primary tumour apparently has been completely removed and in which there is no evidence of further metastatic spread. It has been shown that in a few instances survival for many years may be expected to follow such a procedure, while at other times the degree of palliation of pulmonary symptoms makes the operation worthwhile. Two patients who had metastatic lung deposits successfully removed are described. Further pulmonary metastases, without evidence of metastases elsewhere or recurrence of the original lesion, were resected. In both cases remarkable palliation of symptoms was afforded and both are alive at the time of writing (1 November 1973).
Points from Letters: Femoral Artery Complications after Diagnostic Procedures
Authors: J. K. Johnson
Journal: BMJ (1973)

relevant to the choice of treatment and might explain why the pseudomonas in the sputum of one patient "showed no sign of suppression by colistin aerosol."Also, many pseudomonas (60%) are sensitive to tetra- cydline and this might explain the finding that tetracycline is "less likely to be interfered with by pseudomonas" in the treatment of underlying infection.I would question the presumption that pseudomonas can reach the pharynx by ascending the oesophagus.Though I have cultured many different organisms from the small intestine, I have never found pseudomonas as high as the duodenum in the gastrointestinal tract.There are many other more likely sources of infection, as pseudomonas conmnonly contaminates hospital equipment (especially ventilators, humidifiers, and suction apparatus), contaminates hos- pital food,' and is carried on the hands of staff, contaminated by an infected patient.-I
Reply to Grubel et al.
Authors: M. Philipper, B. Schumacher
Journal: Endoscopy (2010)

We greatly appreciate the conclusive technique called the endoscopic ultrasonography (EUS) keyhole biopsy technique proposed by Peter Grubel. Facing the situation of suboptimal EUS-guided fine needle aspirates, as we have shown in our series with a miss rate of up to 40 % for the additional immunocytochemical analysis, new techniques are crucial to overcome this situation.
Hemoglobinopathy With Prolonged Bacteremia
Authors: Richard A. Finley
Journal: JAMA (1975)

Prolonged<i>Escherichia coli</i>bacteremia occurred as a complication of pyelonephritis in two patients with abnormal hemoglobins (SC and SS), despite "appropriate" antibiotic therapy. Careful investigation in each case failed to account for the persistent sepsis. Pyogenic arthritis ultimately developed in both patients. (<i>JAMA</i>234:718-721, 1975)
Hereditary amyloidosis in early childhood associated with a novel insertion-deletion (indel) in the fibrinogen Aα chain gene
Authors: Hee Gyung Kang, Alison Bybee, Il Soo Ha, Moon Soo Park, Janet A. Gilbertson, Hae Il Cheong, Yong Choi, Philip N. Hawkins
Journal: Kidney International (2005)
Mechanism of Psychogenic Asthmatic Attack in Children
Authors: Aman U. Khan
Journal: Psychotherapy and Psychosomatics (1974)

Both types of conditioning, classical as well as instrumental, contribute to the occurrence of psychogenic asthmatic attacks. The classical conditioning contributes to the development of hypersensitivity of respiratory passages to non-allergic stimuli, which are associated with recurrent experiences of bronchial irritation caused by infection or allergies. The instrumental learning appears to be related to the conditioning of certain emotional reactions (e.g. fear of separation, feeling of rejection). A psychogenic asthmatic attack is produced by the simultaneous influence of a number of factors, e.g. presence or absence of local irritation of bronchial mucosa, general state of child's health, amount of conditioning to non-allergic stimuli and arousal of certain emotional states. In other words, an asthmatic child, in good physical health and without respiratory infection or irritation, is less likely to have a psychogenic asthmatic attack while enjoying his play activities.
CARDIAC CAUSES OF ONE-YEAR READMISSION FOLLOWING PERCUTANEOUS CORONARY INTERVENTION (PCI) FOR ISCHEMIC HEART DISEASE: RETROSPECTIVE ANALYSIS OF A SINGLE-SYSTEM PATIENT COHORT
Authors: Vipul Gupta, Anwar Tandar, Harpreet Bhutani, Dmitriy Kireyev, Clifford Graves, William E. Boden
Journal: Journal of the American College of Cardiology (2010)
Long-term vasectomy: effects on the occurrence and extent of atherosclerosis in rhesus monkeys.
Authors: T B Clarkson, N J Alexander
Journal: Journal of Clinical Investigation (1980)

We demonstrated previously that atherosclerosis develops more extensively in vasectomized cynomolgus macaques fed an atherogenic diet and speculated that the immunologic response to sperm antigens may have exacerbated the atherosclerosis. We report here that rhesus monkeys vasectomized for 9-14 yr and fed monkey chow (devoid of cholesterol and low in fat) rather than an atherogenic diet also had more extensive and severe atherosclerosis than did control animals of the same age. The extent of atherosclerosis was considered as the percentage of intimal surface with plaques. No control animals were found to have plaques in the thoracic aorta, but 7 of 10 vasectomized monkeys were affected. The plaques in the vasectomized monkeys occupied about 13% of the intimal surface. In 4 of 7 control monkeys and 7 of 10 vasectomized monkeys there were lesions in the abdominal aortas; the lesions were considerably more extensive and severe in the vasectomized animals. Lesions were also more common in iliac arteries of vasectomized animals, and the extent was increased about threefold. Plaques were seen at the carotid bifurcation in all of the animals of both the control and vasectomized groups. The carotid bifurcation plaques of the vasectomized monkeys were larger than those of the control animals on the right but not on the left side. Histologically, the lesions of vasectomized monkeys did not appear to be qualitatively different from those of control animals, even though they were larger and contained more collagen, lipid, and mucopolysaccharides. Grossly, the distribution of the lesions in the vasectomized animals was different from that in the control animals, and that of lesions induced by atherogenic diets, i.e., the lesions were distributed randomly within the artery rather than around bifurcations. More extensive atherosclerosis was noted among vasectomized animals that were found to lack demonstrable circulating free antisperm antibodies. On the basis of the observations made in this study, we suggest that the antisperm antibodies that form after vasectomy may result in circulating immune complexes that exacerbate atherosclerosis.
It's official: family doctors are good for your health
Authors: Roger Dobson
Journal: BMJ (2005)

Contrary to a widespread belief that doctors do more harm than good—borne out by declines in mortality during doctors' strikes—a new study shows that doctors actually do save lives. Its results show that one additional primary care doctor in an area can lower mortality in that area by around 2%.

The authors, from Johns Hopkins University, Baltimore, the US Department of Health and Human Services at Bethesda, Maryland, and New York University, say that their results indicate that increasing resources for primary care may be one way to help offset the effects of disadvantage on health and that primary care can help reduce socioeconomic disparities. …
Infections after Cardiac Transplantation: Relation to Rejection Therapy
Authors: JAY W. MASON
Journal: Annals of Internal Medicine (1976)

We have analyzed the relation of the treatment of 76 acute graft rejection episodes in 45 late postoperative cardiac transplant patients to the 56 infections occurring in these patients. Intensification of immunosuppressive therapy for acute rejection greatly increased the occurrence of infection from a control incidence of 1.3 infections per 1000 patient-days to a posttreatment incidence of 3.6. Two modes of treatment, increased oral prednisone and high-dose methylprednisolone plus antithymocyte globulin, were further analyzed. Actuarial analysis of infections after these two treatment modes showed that the treatment-related increase in infection was nearly exclusively due to the latter form of therapy. Invasive cardiac procedures did not appear to be causally related to infections in these immuno-compromised patients.