tbuckley/cabot-search huggingface dataset:
Clinical and Angiographic Predictors of Restenosis After Percutaneous Coronary Intervention
Authors: Mandeep Singh, Bernard J. Gersh, Robyn L. McClelland, Kalon K.L. Ho, James T. Willerson, William F. Penny, David R. Holmes
Journal: Circulation (2004)

Restenosis prediction from published studies is hampered by inadequate sample size and incomplete angiographic follow-up. The prediction of restenosis with the existing variables is poor. The aim of the present study was to include the clinical and angiographic variables commonly associated with angiographic restenosis and develop a prediction model for restenosis from the PRESTO database.This study included 1312 patients with a single lesion enrolled in the angiographic substudy of the PRESTO trial. We constructed 2 risk scores. The first used preprocedural variables (female gender, vessel size [< or =2.5 mm, 2.5 to 3 mm, 3 to 3.5 mm, 3.5 to 4 mm, >4 mm], lesion length >20 mm, diabetes, smoking status, type C lesion, any previous percutaneous coronary intervention [PCI], and unstable angina) derived from previous studies. Estimated restenosis rates and corresponding variability for each possible level of the resultant risk score were obtained via bootstrapping techniques. The area under the receiver-operator characteristic (ROC) curve was 0.63, indicating modest discriminatory ability to predict restenosis. The second approach constructed a multiple logistic regression model considering significant univariate clinical and angiographic predictors of restenosis identified from the PRESTO database (treated diabetes mellitus, nonsmoker, vessel size, lesion length, American College of Cardiology/American Heart Association type C lesion, ostial location, and previous PCI). The area under the ROC curve for this risk score was also 0.63.The preprocedural clinical and angiographic variables from available studies and from the PRESTO trial have only modest predictive ability for restenosis after PCI.
Pathology of Leukemia
Authors: John M. Bennett
Journal: JAMA (1968)

Kudos! Kudos! For the first time in over a decade appears a book completely devoted to the pathophysiology of leukemia. The author, with the able assistance of four contributors, has utilized the large and personally supervised volume of biopsied and autopsied material from the City of Hope Medical Center. The book has five divisions covering classification, diagnosis and differential diagnosis, systemic organ alterations, physiopathologic changes, and infections. Photomicrographs are of unusually good quality. Each chapter contains extensive references, current through 1966. The section on classification is handled well. In particular, I would agree with the statement regarding low number of true monocytic (histiocytic) leukemias. An unfortunate omission in the technical procedures is the failure to discuss the increasing importance of closed bone marrow biopsies. An excellent chapter on the ultrastructure of leukemic cells is marred only by the inclusion of a discussion of Auer bodies under normal myeloblasts. There is
RISK FACTORS OF SELF-TERMINATING AND PERPETUATING VENTRICULAR TACHYARRHYTHMIAS IN POST-INFARCTION PATIENTS WITH MODERATELY DEPRESSED LEFT VENTRICULAR FUNCTION, A CARISMA SUB-ANALYSIS
Authors: Juha Perkiomaki, Poul-Erik Bloch Thomsen, Marc Messier, Heikki Huikuri
Journal: Journal of the American College of Cardiology (2010)
Thyroid hormone metabolism in primary cultured rat hepatocytes. Effects of glucose, glucagon, and insulin.
Authors: K Sato, J Robbins
Journal: Journal of Clinical Investigation (1981)

Primary cultured adult rat hepatocytes were used to study regulation of thyroid hormone deiodination. Control studies showed that these cells survived for at leas 4 d, during which time they actively deiodinated both the phenolic (5'-) and non-phenolic (5-) rings of L-thyroxine (T4),3,5,3'-triiodo-L-thyronine, and 3,3',5'-triiodothyronine. Increasing the substate concentration caused a decrease in fractional iodide release and a corresponding increase in conjugation with sulfate and glucuronide. Propylthiouracil strongly inhibited the 5'-deiodinase activity and caused only a slight decrease in 5-deiodinase activity. Thus, these monolayer-cultured cells preserved many of the properties of normal hepatocytes. Incubation with combinations of insulin, glucagon, and/or glucose for 5 h showed that insulin stimulated T4 5'-deiodination, whereas glucagon inhibited the insulin stimulation but had no effect in the absence of insulin. Glucose had no effect and did not alter the effect of the hormones. The insulin-enhanced deiodination increased between 1 and 5 h, which suggests that the previous inability to demonstrate an insulin effect was due to the short survival of the in vitro liver systems used in those studies. The present data suggest that the inhibition of T4 5'-deiodination observed during fasting, and its restoration by refeeding, may be related to the effects of feeding on insulin and glucagon release rather than on glucose per se.
Pathologic shear triggers shedding of vascular receptors: a novel mechanism for down-regulation of platelet glycoprotein VI in stenosed coronary vessels
Authors: Mohammad Al-Tamimi, Chee Wee Tan, Jianlin Qiao, Gabrielle J. Pennings, Ashkan Javadzadegan, Andy S. C. Yong, Jane F. Arthur, Amanda K. Davis, Jing Jing, Fi-Tjen Mu, Justin R. Hamilton, Shaun P. Jackson, Andreas Ludwig, Michael C. Berndt, Christopher M. Ward, Leonard Kritharides, Robert K. Andrews, Elizabeth E. Gardiner
Journal: Blood (2012)
US anaesthesiologists are told not to take part in executions by lethal injection
Authors: J. H. Tanne
Journal: BMJ (2010)

The American Board of Anesthesiology, which certifies anaesthesiologists, has unanimously ruled that anaesthesiologists may not participate in capital punishment by lethal injection if they want to maintain their board certification.

Major hospitals and medical centres require anaesthesiologists to be certified by the board, so loss of certification would make it difficult for many anaesthesiologists to work. The board has about 42 000 members.

Mark Rockoff, the board’s secretary and spokesman, told the BMJ that the board issued its ruling in February after judges in some states suggested that they needed help from anaesthesiologists in preventing botched executions.

There is no way of knowing whether …
Inflammasomes: too big to miss
Authors: Andrea Stutz, Douglas T. Golenbock, Eicke Latz
Journal: Journal of Clinical Investigation (2009)

Inflammation is the coordinated immune response to harmful stimuli that appear during infections or after tissue damage. Cells of the innate immune system are the central players in mediating inflammatory tissue responses. These cells are equipped with an array of signaling receptors that detect foreign molecular substances or altered endogenous molecules that appear under situations of stress. This review provides an overview of recent progress in elucidating the molecular mechanisms that lead to inflammatory reactions. We discuss the current knowledge of the mechanisms leading to the activation of cytoplasmic, multimolecular protein complexes, termed "inflammasomes," which regulate the activity of caspase-1 and the maturation and release of IL-1β.
Langerhans cell induced cytotoxic T-cell responses against normal human epidermal cell targets: in vitro studies
Authors: M. FAURE, C. DEZUTTER-DAMBUYANT, D. SCHMITT, M. GAUCHERAND, J. THIVOLET
Journal: British Journal of Dermatology (1985)

We investigated the role of class II MHC (HLA-DR la-like) antigen-bearing Langerhans cells in the in vitro generation of human alloreactive cytotoxic T lymphocytes (CTL) directed against epidermal cells (EC). Normal EC in suspensions (from reconstructive surgery specimens) and anti-DR monoclonal antibody plus complement (C')-treated EC were used to stimulate peripheral blood (PB) T cells (T cells allogeneic or autologous to EC) in a classical 6-day human mixed skin cell-lymphocyte culture reaction (MSLR). CTL responses were then tested in 51Cr release assays against cultured EC (EC grown on collagen-coated plates in parallel to MSLR). CTL responses to EC were observed only after allogeneic MSLR and when targets and EC used in MSLR were from the same donor. They were comparable in magnitude to those seen in parallel studies using PBL from the same donor as the stimulating EC as target cells. They were abolished when EC used in MSLR were depleted in class II MHC Langerhans cells (preincubation of EC suspensions with anti-DR + C). These data show: (a) alloreactive CTL to human normal EC may be generated in MSLR, as previously shown in animals; (b) the MSLR is an in vitro model of primary immunization against EC; (c) Langerhans cells are necessary for the generation of cell-mediated cytotoxicity reactions occurring against epidermal cells.
Autoantibodies against modified apolipoprotein B-100 in relation to low-density lipoprotein size and the metabolic syndrome in otherwise healthy men
Authors: Per Sjögren, Gunilla N. Fredrikson, Magdalena Rosell, Ulf de Faire, Anders Hamsten, Jan Nilsson, Mai-Lis Hellenius, Rachel M. Fisher
Journal: Metabolism (2008)
Burkitt lymphoma of the breast
Authors: Isao Miyoshi, Kensuke Yamamoto, Tsuyako Saito, Hirokuni Taguchi
Journal: American Journal of Hematology (2006)

A 27-year-old woman in the last trimester of pregnancy noted a 3-cm lump adjacent to the nipple in the right breast.Biopsies had to be performed 3 times before the histological diagnosis of Burkitt lymphoma could finally be established.Two months later, the tumor had grown rapidly to an enormous size with formation of a large ulcer (see Image 1), and large masses were also readily palpable in the right axilla and left breast.Cesarean section gave rise to a normal female infant who weighed 2,900 g.The delivery was followed by right radical mastectomy along with surgical resection of the right axillary and left breast masses.The mastectomy site was grafted with skin taken from the right thigh.Histology of the resected tumor revealed sheets of primitive lymphoid cells interspersed with macrophages.This specimen demonstrated the Image 1.
Gallium-67 Scintigraphy as an Aid in the Detection of Spinal Epidural Abscess
Authors: MARTINE KLEIN, CHANG-SOO AHN, DAVID E. DRUM, DONALD E. TOW
Journal: Clinical Nuclear Medicine (1994)

Gadolinium-enhanced MRI is considered the study of choice for diagnosing spinal epidural abscess (SEA). Most of such cases, however, are not suspected initially, and thus do not benefit from the procedure. A case of SEA is described in which positive Ga-67 scintigraphy shortly before onset of lower extremity dysfunction was instrumental in obtaining an emergency gadolinium-enhanced MRI and establishing the diagnosis.
Assessment of the severity of asthma by an expert system. Description and evaluation.
Authors: H Redier, J P Daures, C Michel, H Proudhon, D Vervloet, D Charpin, J Marsac, D Dusser, C Brambilla, B Wallaert
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Asthmaexpert, an expert system (ES), was produced at the special request of several clinicians in order to better understand the medical decisions made clinical experts in managing an asthmatic patient. We describe and evaluate this knowledge base, focusing mainly on assessment of the severity of asthma. After compiling data from a patient, Asthmaexpert assesses the severity of the disease and identifies the trigger factors involved, suggests any further investigations that may be required, and offers a treatment strategy. Implemented with Nexpert and Hypercard, it runs on a MacIntosh personal computer. The validation stage involved eight clinical experts who provided 20 case report forms (CRF) with their conclusions about management of asthma. The CRF were then programmed into the ES, which provided its own conclusions about the same subjects. Afterward, all the experts evaluated the conclusions given by ES or by their colleagues in a double-blind manner. One hundred twenty-seven CRF were available. The reliability of the experts' opinions was good, with a substantial consensus between them when assessing severity scores (kappa = 0.27 to 0.54). There was no difference in concordance of opinions on severity scores either between the experts who designed the system and ES or between the other experts and ES (weighted kappa = 0.72 and 0.69, respectively). Experts judged that the severity scores given by ES were as good as those proposed by their colleagues, and that the overall conclusions given by ES were as good as or better than those given by their colleagues. The conclusions drawn by ES were given a good rating.(ABSTRACT TRUNCATED AT 250 WORDS)
Multilevel Care
Authors: John Mulhearn
Journal: JAMA (1979)

The Veterans Administration's (VA) Department of Medicine and Surgery, the largest of the civilian federal health care systems, is under continuous White House, congressional, and public pressure to provide greater accountability and increased cost-effectiveness for its $5 billion-plus annual budget. Responding to these pressures, the VA is evaluating in ten of its 172 medical centers a new system of resource allocation and financial management known as a multilevel care system. This is a major VA intiative with highly important implications for both the VA and the private health care sector.
DIPHTHERIA; ITS ETIOLOGY, CHEMIC PATHOLOGY AND TREATMENT.Read in the Section on Laryngology and Otology, at the Forty-fifth Annual Meeting of the American Medical Association, held at San Francisco, June 5-8, 1894.
Authors: M. M. JOHNSON
Journal: JAMA (1894)

ETIOLOGY. The century which has just passed has been fertile in scientific researches. The etiology of diphtheria has engaged the attention of many of the ablest workers of our profession. Atmospheric conditions, peculiarities of soil, miasmatic conditions and filth have each in their turn been investigated to account for the origin of this most fatal disease. The symptoms accompanying this disease as conditions of the throat, with all its clinical peculiarities; the onset fever; the sequelæ of paralysis, have long been known and accounted for by a poison absorbed in some way into the system. In 1841 Henle expressed his belief in a contagium animatum. Schwann demonstrated the presence of lower organisms in fermentation and putrefaction. The teachings of Pasteur, "concerning the conditions under which putrefaction occurs, all tend to explain the various contagious and infectious diseases by analogy, and stimulated the search for a vegetable organism in diphtheria." Huter
A1.41 Effect of multiple cycles of B-cell depletion therapy in patients with rheumatoid arthritis on serological evidence of plasmablast activation, serum baff levels and autoantibody specificity
Authors: G Cambridge, H C Perry, L Nogueira, G Serre, H M Parsons, I De La Torre, M C Dickson, M J Leandro, J C W Edwards
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background and Objectives</h3> Rituximab induces clinical remission in a majority of seropositive patients with Rheumatoid arthritis (RA), however, all patients eventually relapse. Although B cell return precedes clinical relapse absolute B cell numbers are not predictive of relapse. The aim of this study was to determine whether there were any consistent dynamic changes in combinations of serological parameters following up to 3 cycles of B cell depletion therapy based on rituximab (RTX). <h3>Materials and Methods</h3> We included 23 RA patients (all clinical responders in each cycle) over 1, 21 over 2, and 15 over 3 cycles of RTX followed for up to 108 months and analysed in relation to B cell kinetics at 4 key points within each cycle of therapy. Serum analytes including Rheumatoid factors (RhF) and anti-citrullinated protein/peptide antibodies (ACPA), BAFF, serum free light chains (SFLC), soluble CD23 (sCD23 - cleaved from naïve B cells coincident with CD27 expression), antibodies to tetanus toxoid (TT) and pneumococcal capsular polysaccharide (PCP) were measured by ELISA at 4 key points in each cycle: Baseline (pre-RTX in each cycle); when B-cell depleted (CD19<sup>+</sup> B-cells&lt;5/ml); at B-cell return (CD19<sup>+</sup> B-cells ≥5/ml); and at clinical relapse (ΔDAS28&gt;1.2). <h3>Results</h3> Comparing levels of analytes at relapse after 3 cycles with baseline values before 1<sup>st</sup> Cycle, BAFF levels were higher, anti-microbial remained relatively unchanged and IgM-RhF and IgM-CCP and IgG-CCP autoantibodies had decreased (p&lt;0.05). The most consistent changes between baseline to B cell depletion in each cycle, over all 3 cycles, were in lSFLC, sCD23 and IgM-RhF which fell and BAFF levels which rose (p&lt;0.05). Incremental rises in sCD23 levels in Cycles 2 and 3 were associated with time to relapse. In patients with relapse &gt;5 months after B-cell return, significant rises in IgM-RhF, lSFLC and sCD23, and falls in BAFF, occurred between B cell return until clinical relapse. <h3>Conclusions</h3> Dynamic changes in the serum analytes IgM-RhF, λSFLC, sCD23 and BAFF were consistent over 3 cycles of rituximab and closely associated with clinical response/relapse. This suggests that the clinical response to RTX involves interuption of the genesis of short-lived immunoglobulin-secreting cells. Resumption of this process at relapse involved maturation of B-cell clones associated with sCD23 cleavage and of immunoglobulin-secreting cells accompanied by lSFLC release and IgM-RhF specificity. In patients with the longer periods of remission after B cell return the 'delay' in re-starting the inflammatory process may be due to a slower rate of selection and/or maturation of autoreactive B cell clones, despite raised serum BAFF.
Media criticism of doctors: review of UK junior doctors' concerns raised in surveys
Authors: M. J Goldacre
Journal: BMJ (2003)

he had a few convulsions but no impaired consciousness or other signs of severe malaria.On day 2 the parasitaemia was 4%.Treatment was changed to mefloquine, which was successful.His 4 year old brother, case 2, was febrile with 0.5% infected erythrocytes.His symptoms resolved with atovaquone and proguanil hydrochloride, and the parasites were cleared after three days.On day 28 he was again febrile with P falciparum parasites and was successfully treated with mefloquine.The mother (case 3), although asymptomatic, had a few P falciparum rings.She was treated with atovaquone and proguanil hydrochloride, which cleared the parasites without recrudescence.Drug concentrations were measured by high pressure liquid chromatography in repeated serum samples.The concentrations of atovaquone (7.6-13.9M), proguanil (300-1200 nM), and cycloguanil (125-400 nM) were all above the levels considered therapeutic in children and adults. 3 Treatment failure could therefore not be attributed to poor bioavailability of the drug.Cases 1 and 3 were infected with single clones whereas case 2 had five genetically diverse parasite populations, detected by analysis of merozoite surface proteins 1 and 2. Mutation A803G (changing tyrosine to serine in 268) in cytochrome b, related to resistance to atovaquone, was detected in cases 2 and 3 by polymerase chain reaction and restriction fragment length polymorphism of loci 133, 268, 272, 275, 280, and 284, and confirmed by sequencing (table). 4However, only wild types were found in case 1. Analyses of loci 51, 59, 108, and 164 in the dihydrofolate reductase gene, related to resistance to proguanil and cycloguanil, revealed wild types in all samples except those from case 2, in which triple mutation were found at recrudescence.
Cytopathogenic mechanisms of Entamoeba histolytica.
Authors: J I Ravdin, B Y Croft, R L Guerrant
Journal: The Journal of Experimental Medicine (1980)

Cinemicrography of Entamoeba histolytica destruction of Chinese hamster ovary (CHO) cells shows that ameba cytopathogenicity consists of separate components: a contact-dependent cytolethal effect, and phagocytosis. Cells not in contact with amebae remain intact. Quantitation of ameba destruction of CHO cells by applying the one-hit hypothesis confirms that the cytoethal effect of amebae is contact dependent. Studies with 111Indium oxine-labeled cells provide further evidence of extracellular killing by E. histolytica and indicate that &amp;gt; 94% of the target cells are killed before phagocytosis. When we examined for a cytotoxin release by E. histolytica, we found no effect on CHO cells with filtrates of amebae, and a nonspecific effect of cell rounding and release with sonicates of amebae. The ameba sonicate effect was time-dose dependent, was not cytolethal, was reversible, and was inhibited by alpha II macroglobulin. Cytochalasin B altered ameba motility and morphology, and monolayer experiments confirmed that cytochalasins A, B, or D inhibited CHO cell destruction by E. histolytica. Cytochalasin D also inhibited extracellular killing of CHO cells by amebae in pellets, apparently independent of effects on ameba motility or phagocytosis. Colchicine and vinblastine, alone or in combination with cytochalasin D, did not inhibit E. histolytica cytopathogenicity, which indicates that microtubule function is not required for target cell killing by amebae.
Sexually transmitted disease surveillance
Authors: B H O'Connor, H. Tillett, J R H Berrie, J. A N Emslie, M W Adler
Journal: BMJ (1982)

cell count is of no value in such situations in evaluating the probability of acute bacterial infection, as in a proportion of patients with infectious mononucleosis the first change evi- dent is a neutrophil leucocytosis.'To put my point in the language of clinical epidemiology, the positive predictive value of a neutrophil leucocytosis in diagnosing bacterial throat infection is low when the prevalence of infectious mononucleosis is high.This has obvious implications for those who care for young populations.Secondly, since this study was presumably designed to emphasise the importance of rational therapy of sore throats, I would like to ponder on the possible importance of irrational therapy in the dramatic reduction in poststreptococcal glomerulonephritis and rheu- matic fever which has taken place in the last three decades.Did wholesale prescription of antibiotics when they were available have a valuable role to play in the virtual dis- appearance of these diseases ?Is it only now that we can afford the luxury of a sophisticated rational therapy ?