tbuckley/cabot-search huggingface dataset:
Courageous children: Do we sometimes fail them?
Authors: O. M McKendrick
Journal: BMJ (1998)

Christine died aged 13 from cystic fibrosis. She first came under my care when she was 10 and as well as suffering from advanced lung disease, she had hepatic cirrhosis. Nevertheless, she was coping with ordinary school and a year later won a scholarship to the local convent grammar school. There, with great courage and despite failing health, she managed to keep up with her peer group; something she was determined to do at all costs.

During the last year of her life, Christine's chest deteriorated rapidly and her final month was spent in hospital fighting an uncontrollable infection.

On what turned out to be Christine's last clinic attendance, she asked me if she could see me alone, without her mother. The request surprised me a bit but the reason surprised me even more. She wanted to know …
AMEBIC DYSENTERY.ITS LOCAL LESIONS AND THEATMENT.
Authors: JAMES P. TUTTLE
Journal: JAMA (1904)

Our views of dysentery have greatly altered since the days when we considered it "inflammation of the bowels" without knowing exactly what we meant by the term inflammation. These changes of views are the result of pathologic studies and are in line with the great change made in our views of surgical etiology and pathology. With regard to dysentery they began in the discovery by Losch of the ameba coli, and the association of this germ with the disease by Councilman and Lafleur; for a while after this the profession accepted that ameba coli, afterward called "<i>Amœba dysenteriœ.</i>" as the established cause of the disease. In 1894 and 1895 the reports of Shiga, Flexner, Harris and others, seemed to establish the fact that at least in the epidemics of Japan and the Philippines the ameba was not always present, but there was a bacillus of a peculiar type universally present and to this they gave the name<i>Bacillus dysenteriœ</i>and established its etiologic relations to that form of the disease.
Thyrocalcitonin and the Response to Parathyroid Hormone*
Authors: Constantine Anast, Claude D. Arnaud, Howard Rasmussen, Alan Tenenhouse
Journal: Journal of Clinical Investigation (1967)

1) In the absence of the thyroid gland, the infusion of parathyroid hormone leads to a prompt rise in plasma calcium and to prompt increase in the rate of excretion of calcium in the urine.2) In the presence of the thyroid gland, the parathyroid hormone-induced rise in plasma calcium is less marked; the rate of urinary calcium excretion falls initially and rises only after 20 to 30 hours of continuous parathyroid hormone infusion.3) The infusion of exogenous thyrocalcitonin along with the parathyroid hormone into a thyroparathyroidectomized animal leads to a pattern of response similar to that seen in the animal with an intact thyroid gland.4) Thyrocalcitonin has little apparent effect upon the immediate changes in renal function induced by parathyroid hormone.5) We conclude that bone is a major site of action of thyrocalcitonin and that it probably inhibits bone resorption.
UK access to primary angioplasty services is still highly variable
Authors: C. White
Journal: BMJ (2011)

Most heart attack patients in the UK now receive the preferred treatment for their damaged arteries and undergo primary angioplasty rather than thrombolysis, shows a national clinical audit. But access to these services is still highly variable, the annual audit shows.

Primary angioplasty is the preferred treatment for myocardial infarction if it can be provided promptly, with patients being taken directly to the catheter laboratory of the nearest heart attack centre rather than to a local hospital or emergency care.

The 10th annual Myocardial Ischaemia National Audit Project (MINAP), which is run by the National Institute for Cardiovascular Outcomes Research (NICOR), includes data from all hospitals and ambulance services in England and Wales that cared for patients with a suspected myocardial …
The INNO-LiPA HBV-DR assay is superior to sequencing for the detection of YMDD-mutants
Authors: H.L. Tillmann, H. Wedemeyer, C.T. Bock, A. Finger, I. Glomb, P. Magerstest, C. Trautwein, M.P. Manns
Journal: Journal of Hepatology (2003)
Prevalence, characteristics and severity of non-alcoholic fatty liver disease in patients with chronic plaque psoriasis
Authors: Luca Miele, Selenia Vallone, Consuelo Cefalo, Giuseppe La Torre, Carmine Di Stasi, Fabio M. Vecchio, Magda D’Agostino, Maria L. Gabrieli, Vittoria Vero, Marco Biolato, Maurizio Pompili, Giovanni Gasbarrini, Gianludovico Rapaccini, Pierluigi Amerio, Clara De Simone, Antonio Grieco
Journal: Journal of Hepatology (2009)
Single Photon Emission Computed Tomography and Transmission Computed Tomography in the Evaluation of Liver Disease
Authors: ANTHONY P. YUDD, RONALD L. VAN HEERTUM, JACQUELINE C. BRUNETTI
Journal: Clinical Nuclear Medicine (1988)

To assess the relative strengths of hepatic SPECT and transmission computed tomography (TCT), a comparison of these methods was made in 88 patients during a 20-month period. The scans were classified into four categories: normal, solitary focal, multifocal, or diffuse hepatocellular patterns. The final disease category was determined by histologic evaluationbiopsy/autopsy, surgery, or a combination of ultrasound, laboratory, and clinical follow-up for a minimum of 6 months. Both SPECT and TCT were normal in the 47 patients classified as normal. Of the 16 patients with diffuse hepatocellular disease, SPECT correctly identified 16 and TCT identified two patients. Eleven patients had solitary focal disease; 11 were detected by SPECT and 10 by TCT. Fourteen patients were in the multifocal disease group; 13 were detected by SPECT and 10 by TCT. Overall, SPECT and TCT findings were in agreement in 68 (77%) of the cases. This study demonstrates that SPECT is equal to TCT in the assessment of the liver parenchyma in normal and focal disease states and that SPECT is superior in the assessment of diffuse disease.
Press: Bristol fails to ignite
Authors: N. W Goodman
Journal: BMJ (2001)

Big bang report goes out with a whimper

In the end, Professor Ian Kennedy's report on the Bristol paediatric cardiac affair was a damp squib. Long awaited, all the evidence was known, all the solutions already discussed. The report was released, with strict control of the media, on Wednesday 18 July. The broadcast media covered it that afternoon; the newspapers the next day. There were no leaks, but what was there to leak? In marked contrast to his inflammatory response to the report on pathology services at Alder Hey Hospital in Liverpool earlier this year, health secretary Alan Milburn was sombre, thoughtful, and placatory in his address to the House of Commons. Publication late on Wednesday made the report too late for both the main UK general medical journals, but that was the only fuel for the conspiracy theorists.

All the major national newspapers had stories, commentary, and editorials. For most it was front page, but …
Improved Neurologic Function after Long-Term Correction of Vitamin E Deficiency in Children with Chronic Cholestasis
Authors: Ronald J. Sokol, MaryAnne Guggenheim, Susan T. Iannaccone, Paul E. Barkhaus, Christopher Miller, Arnold Silverman, William F. Balistreri, James E. Heubi
Journal: New England Journal of Medicine (1985)

We studied the effect of long-term correction of vitamin E deficiency on neurologic function in 14 children with chronic cholestasis. Vitamin E repletion was achieved in all, either by large oral doses (up to 120 IU per kilogram of body weight per day) or by intramuscular administration of dl-alpha-tocopherol (0.8 to 2.0 IU per kilogram per day). With early institution of therapy, neurologic function remained normal in two asymptomatic children below the age of three years after 15 and 18 months of therapy. Neurologic function became normal in three symptomatic children below age three after 18 to 32 months of therapy. Restitution of neurologic function was more limited in nine symptomatic children 5 to 17 1/2 years old after 18 to 48 months of therapy. We conclude that vitamin E repletion therapy should be initiated at an early age in children with chronic cholestasis complicated by vitamin E deficiency, to prevent irreversible neurologic injury.
The In Thing
Authors: G. G. Liddle
Journal: JAMA (1974)

<h3>To the Editor.—</h3> Readers of medical writings, not necessarily literature, encounter the patient who came "to hospital." The editor chuckles madly, gleefully. With his preferred color of ink, the phrase becomes "to the hospital." Over the weekend, I browsed benignly through a mystery story, balking malignantly when a twin-sister problem appeared half-way through. The twin often appeared to have been "in hospital." In fact, she spent much time in. Although this usage grated, no amount of logic can object to it, because I spent much time in school, in medical school, albeit little in stir. Still, my mystery writer upset me when she had a young man in university! Patients appear in surgery, in intensive care, and in similar discipline. Here I sit in typewriter, beside desk, confused. Soon I leave. Look for me in evening in inn in cups, but not in vain.
The Search for Effective Treatment of<i>Clostridium difficile</i>Infection
Authors: Herbert L. DuPont
Journal: New England Journal of Medicine (2011)

Since 1996, the incidence of Clostridium difficile infection has more than doubled. Some estimates suggest that there may be up to 3 million cases each year in the United States. If that statistic is correct, it would make C. difficile infection the most common bacterial cause of diarrhea in the United States. With the rising incidence, we are seeing higher mortality associated with the disease, related to at least two factors: increasing virulence of the C. difficile strains and increasing host vulnerability. C. difficile infection is particularly problematic when three factors are aligned: coexisting conditions, including advanced age; disturbed intestinal . . .
THE RELATION OF DEXTROSE TO THE PRODUCTION OF TOXIN IN BOUILLON CULTURES OF THE DIPHTHERIA BACILLUS
Authors: Theobald Smith
Journal: The Journal of Experimental Medicine (1899)

1. Dextrose is not in itself injurious but rather favorable to toxin production. When added in quantities not exceeding 0.2 per cent to peptone bouillon freed from fermentable acid-producing substances (muscle sugar) it leads to a maximum accumulation of toxin by utilizing the available peptone to the best advantage. 2. The different courses taken by cultures of diphtheria bacilli in ordinary unfermented peptone bouillon containing muscle sugar and in peptone bouillon made from fermented infusion to which 0.1 to 0.2 per cent dextrose has been added are manifested by an increased production of toxin in the latter as well as by a rapid return from an acid to an alkaline reaction. In the former an acid reaction may prevail even under most favorable conditions. 3. These differences may be explained by assuming either that the acid products of the muscle sugar are different from those of dextrose and non-utilizable, or else that the bouillon contains certain other unknown inhibitory substances removed during fermentation. The use of synthesized media and an analysis of the acid products in fermented bouillon plus dextrose and in unfermented bouillon would aid in explaining the differences. 4. Among the accessory conditions which favor the toxin production in unfermented bouillon, as pointed out by Park and Williams, are increased quantities of peptone, well developed surface growth of the diphtheria bacilli, and a low initial acid reaction (phenolphthalein). In fermented bouillon these accessory conditions are also favoring, though of legs importance.
Heterophile antibodies in human transplantation
Authors: F. T. Rapaport, K. Kano, F. Milgrom
Journal: Journal of Clinical Investigation (1968)

Sensitization of human recipients with transplantation antigens (leucocytes, skin, or kidney allografts) has resulted in the appearance of serum hemagglutinins directed against sheep, guinea pig, and rat erythrocytes. Such hemagglutinins have been identified as IgG and IgM antibodies. Their appearance was not related to AB0 erythrocyte group incompatibility between donors and recipients, and the antibodies were not of the Forssman or Paul-Bunnel type. The antibody responses appeared to be primarily directed against antigen(s) present on rat erythrocytes, but shared to varying extents by other species. The peak antibody titers occurred in association with allograft rejection. In this regard, they may be of interest as a possible early warning system for the diagnosis and prompt management of rejection crises in clinical organ transplantation.
Correction: Regulating the Market in Human Research Participants
Authors: Trudo Lemmens, Paul B Miller
Journal: PLoS Medicine (2006)

Under the section heading "Expected Death Toll during a Present-Day Mass Vaccination Campaign," the numbers of expected deaths that were computed for a mass vaccination campaign were displayed as per million; they should be absolute numbers.The corrected text should be: "Under those assumptions, in the Netherlands mass vaccination with NYCBH would lead to 9.8 deaths (95% CI [0, 30]), mass vaccination with Lister to 55.1 deaths (95% CI [7, 182]), and mass vaccination with Bern would lead to 303.5 deaths (95% CI [19, 1093]).In Germany mass vaccination with NYCBH would lead to 46.2 deaths (95% CI [6, 142]), mass vaccination with Lister would lead to 268.5 deaths (95% CI [39, 875]), and mass vaccination with Bern would lead to 1,381 deaths (95% CI [94, 4909]).
Serum Chelatable Redox-Active Iron Is an Independent Predictor of Mortality After Myocardial Infarction in Individuals With Diabetes
Authors: Mahmoud Sulieman, Rabea Asleh, Zvi I. Cabantchik, William Breuer, Doron Aronson, Abeer Suleiman, Rachel Miller-Lotan, Haim Hammerman, Andrew P. Levy
Journal: Diabetes Care (2004)

As a result of its strong oxidative activity, iron (1) has been hypothesized to be of importance in morbidity and mortality from atherosclerotic cardiovascular disease (CVD) (2). Numerous studies (3) have failed to show a relationship between total body iron and CVD. However, total iron may not be reflective of the risk of oxidative damage mediated by iron. A linkage between iron and CVD is more likely to be found in the amount of iron available for participating in oxidative reactions (4). Labile serum iron or labile plasma iron (LPI) represents iron bound to serum albumin, citrate, and other undefined, negatively charged ligands (5). Iron bound as LPI is associated with reactive oxygen species formation and increased oxidative stress (6).

LPI is elevated in only a small fraction of ambulatory diabetic individuals (<3%) and has not been seen in individuals without diabetes. However, LPI may become increased when large fluxes in iron occur, as in acute myocardial infarction (AMI) (7,8). We have therefore proposed that LPI is increased in the setting of AMI and that it is associated with mortality. We tested this hypothesis prospectively in individuals presenting with AMI.

All patients presenting to the coronary care unit with AMI from July 2001 to July 2003 were eligible for the study ( n = 1,156). The investigational review committee on human research approved …
Ciliary disorientation in patients with chronic upper respiratory tract inflammation.
Authors: C F Rayner, A Rutman, A Dewar, P J Cole, R Wilson
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Random ciliary orientation was recently described as a possible variant of primary ciliary dyskinesia (PCD). The cilia have normal ultrastructure and nearly normal ciliary beat frequency (CBF) but lack efficacy because the beat direction is disoriented. However, delayed mucociliary clearance (MCC), transitory changes in ultrastructure, and slowed CBF can all occur in the presence of inflammation. This study investigated groups of patients with upper respiratory tract inflammation caused by infection to assess whether ciliary disorientation was present and its relation to MCC. The study population consisted of 10 healthy nonatopic nonsmoking volunteers, 15 patients with idiopathic bronchiectasis and chronic mucopurulent sinusitis, 12 patients with cystic fibrosis, and two patients with the clinical features of PCD but normal CBF and ciliary ulstrastructure. Ciliary disorientation was significantly (p < 0.05) increased in the three patient groups compared with the volunteers, being greatest in the two patients with the clinical features of PCD and in bronchiectasis patients with P. aeruginosa, and was positively correlated (r = 0.9) with MCC but not with CBF. Treatment of one patient with antibiotics and topical corticosteroids for a prolonged period resulted in ciliary disorientation returning to normal. Ciliary disorientation may therefore occur secondary to inflammation caused by infection, and the study suggests that ciliary disorientation rather than ultrastructural abnormalities or slow CBF results in delayed MCC.
Osmotic diarrhoea and skeletal muscle protein synthesis in vivo.
Authors: H Ansell, J S Marway, A B Bonner, J R Salisbury, D C Candy, V R Preedy
Journal: Gut (1996)

The pathogenic nature of the wasting seen in diarrhoea is unknown. This study measured protein synthesis in an established model of diarrhoea using lactose for seven days. Comparisons were also made with data obtained from rats fed an identical diet in which lactose was replaced by isocaloric glucose ad libitum (that is, the control diet). To account for diarrhoea induced anorexia, a third group of rats were included, which were fed identical amounts of the control diet as the rats with diarrhoea inducing diet. Comparisons of the diarrhoea induced group with rats fed the control diet ad libitum showed that diarrhoea caused a significant reduction in body weights. Type I and type II muscles showed significant reductions in protein, RNA, and DNA contents, as well as a fall in the derived parameters, RNA/DNA, protein/DNA, and RNA/protein. Fractional rates of protein synthesis (ks) were also reduced. However, synthesis rates of type I and II muscles relative to RNA (kRNA) were unchanged in these muscles in diarrhoea induced rats compared with ad libitum fed controls. In the jejunum there was an increase in the RNA/DNA ratio, and reductions in ks and kRNA. Comparisons were also made between rats with diarrhoea and rats pair fed the control diet. There were no changes in total muscle protein, RNA or DNA contents. This suggests that an important feature of body wasting in diarrhoea is the element of anorexia, which induces severe metabolic changes. The comparison between rats with diarrhoea and the pair fed group showed that histological features of the plantaris were not overtly changed, though diarrhoea caused significant reductions in RNA/DNA, protein/DNA, ks, and kRNA. Similar changes were seen for the soleus; though the reduction in ks failed to attain statistical significance. In the jejunum a comparison of diarrhoea induced rats with pair fed controls, showed increases in the ratios of RNA/DNA and protein/DNA.
Burning Mouth Syndrome
Authors: David Mock, Deepika Chugh
Journal: International Journal of Oral Science (2010)

Most clinicians dread seeing the patient presenting with a primary complaint of a burning pain on one or more oral mucosal surfaces. Unlike most other clinical conditions presenting in a dental office, burning mouth syndrome is poorly understood with few evidence based remedies. More recently, advances have been made towards clarifying the possible etiology of the disorder and testing the possible therapeutic modalities available. This article attempts to summarize the "state of the art" today.
Acetylcholine receptor δ subunit mutations underlie a fast-channel myasthenic syndrome and arthrogryposis multiplex congenita
Authors: Sharon Brownlow, Richard Webster, Rebecca Croxen, Martin Brydson, Brian Neville, Jean-Pierre Lin, Angela Vincent, John Newsom-Davis, David Beeson
Journal: Journal of Clinical Investigation (2001)

Limitation of movement during fetal development may lead to multiple joint contractures in the neonate, termed arthrogryposis multiplex congenita. Neuromuscular disorders are among the many different causes of reduced fetal movement. Many congenital myasthenic syndromes (CMSs) are due to mutations of the adult-specific ε subunit of the acetylcholine receptor (AChR), and, thus, functional deficits do not arise until late in gestation. However, an earlier effect on the fetus might be predicted with some defects of other AChR subunits. We studied a child who presented at birth with joint contractures and was subsequently found to have a CMS. Mutational screening revealed heteroallelic mutation within the AChR δ subunit gene, δ756ins2 and δE59K. Expression studies demonstrate that δ756ins2 is a null mutation. By contrast, both fetal and adult AChR containing δE59K have shorter than normal channel activations that predict fast decay of endplate currents. Thus, δE59K causes dysfunction of fetal as well as the adult AChR and would explain the presence of joint contractures on the basis of reduced fetal movement. This is the first report of the association of AChR gene mutations with arthrogryposis multiplex congenita. It is probable that mutations that severely disrupt function of fetal AChR will underlie additional cases.
C-Reactive Protein Concentration and Cardiovascular Disease Risk Factors in Children
Authors: Earl S. Ford
Journal: Circulation (2003)

C-reactive protein is an emerging risk factor for cardiovascular disease. Although the relations between C-reactive protein and other risk factors for cardiovascular disease have been extensively studied in adults, the relations in children are not well understood.Data from 2846 boys and girls 3 to 17 years of age who participated in the National Health and Nutrition Examination Survey, 1999 to 2000, a cross-sectional survey of the US population, were used. In univariate analyses, significant associations were observed between C-reactive protein concentration--measured with a high-sensitivity assay--and age, body mass index, systolic blood pressure, and triglyceride concentrations in both sexes. In multiple linear regression analyses, body mass index was the best predictor of C-reactive protein concentration. Age was positively associated with C-reactive protein concentration among boys 3 to 17 years of age. Some race or ethnic differences were present as well among boys 8 to 17 years of age and girls 8 to 11 years of age. Systolic blood pressure was positively associated with C-reactive protein among girls 12 to 17 years of age.Among the sociodemographic and cardiovascular disease risk factors, body mass index was the best predictor of C-reactive protein concentration in children.
848 THE EVALUATION OF MULTISPECIES PROBIOTICS IN PORTAL HYPERTENSION – CYTOKINES INVOLVED IN THE PATHOGENESIS OF HEPATO-RENAL SYNDROME ARE NOT MANIPULATED
Authors: W.M. Marlicz, E. Wunsch, M. Mydlowska, J. Czyszek, M. Milkiewicz, P. Milkiewicz
Journal: Journal of Hepatology (2010)