tbuckley/cabot-search huggingface dataset:
The specificity of fatigue in primary biliary cirrhosis: Evaluation of a large clinic practice
Authors: Nadya Al‐Harthy, Teru Kumagi, Catalina Coltescu, Gideon M. Hirschfield
Journal: Hepatology (2010)

Quality of life is an important concern for patients with chronic liver disease. We sought to describe the frequency, severity, and associations of fatigue, in patients with primary biliary cirrhosis (PBC). We performed association testing between PBC-40 multidomain disease-specific quality of life responses and clinical findings. Three hundred twenty-seven patients from a single clinic with PBC (94% female, 92% AMA-positive) were evaluated. The average age was 57 years and average disease duration 7.2 years. Verbally reported fatigue was noted in 48% but present in the overwhelming majority on PBC-40 completion, with 44% having moderate or severe symptoms. Of those not complaining of fatigue clinically, 25% documented moderate or severe fatigue by questionnaire. Age had an inverse relationship with fatigue (P < 0.01), whereas body mass index (BMI) was positively associated (P < 0.01), as was the presence of pruritus (P < 0.001), sicca symptoms (P < 0.001), depression (P < 0.001), fibromyalgia (P < 0.004), and scleroderma (P < 0.05). For those with varices (P < 0.05) or cirrhosis clinically (P < 0.05), higher fatigue scores were noted, although those who initially presented with noncirrhotic disease had higher scores at the time of testing (P < 0.005). Fatigue was associated with greater use of prescription medication (P < 0.01), in particular for antipruritics (cholestyramine: P < 0.001; rifampin: P < 0.001), proton pump inhibitors (P < 0.002), beta-blockers (P < 0.02), and antidepressants (P < 0.001), whereas those taking calcium and vitamin D appeared less fatigued (P < 0.05). In a multivariate model, calcium and vitamin D use, BMI, stage of disease at diagnosis, as well as symptomatic fatigue or pruritus, were significant. Biochemical response to UDCA was not associated with lower fatigue scores.Attempts at defining the biological basis of fatigue in patients with PBC, and improving its treatment, must account for its multifactoral causes.
Histoplasmosis vs Sarcoidosis
Authors: Jack Lieberman
Journal: JAMA (1977)

<h3>To the Editor.—</h3> Walker et al (237:1350-1352, 1977) described a patient with histoplasmosis in whom noncaseating granulomas were seen. They emphasized the fact that it is sometimes difficult to determine the origin of such granulomas or to distinguish between sarcoidosis and disseminated histoplasmosis. This is certainly true, although much assistance can now be obtained by an assay of serum angiotensin-converting enzyme (ACE). The association of elevated serum ACE levels with active sarcoidosis was fully reported in 1975<sup>1-3</sup>and has since been confirmed by a number of authors. Elevated levels as seen in sarcoidosis do not usually occur in patients with those mycobacterial or fungal lung diseases that enter into the differential diagnosis of sarcoidosis. For example, we found only one of 15 patients with disseminated coccidiodomycosis to have an elevation of serum ACE,<sup>4</sup>and this one case brings under consideration the possibility of coexistent sarcoidosis and pulmonary fungal
REVERSIBILITY OF ENZYMES, AND ITS APPLICATION TO PHYSIOLOGIC AND PATHOLOGIC PROCESSES.
Authors: H. GIDEON WELLS
Journal: JAMA (1902)

Ordinary chemical reactions with which we are most familiar are usually considered as occurring in a very definite manner, the addition of one substance to another leading to the formation of one or more new substances. But it is also a fact that if the proper conditions are produced such a reaction can be made to take place in a reverse manner, the resulting substance or substances being made to yield the substances from which they were originally produced. Recent work has developed the fact that enzyme action is also capable of reversibility, so that when proper conditions exist the products of the hydrolytic splitting, if such has been the change, are reunited by the same enzyme that separated them into the original, more complex molecule. This newly observed property is probably destined to explain many important problems in physiology and pathology, and as so far the literature dealing with
Abstract 581: Surfactant-free PLGA encapsulation facilitates delivery of LY294002 to endoplasmic reticulum and enhances its cytotoxicity.
Authors: Chia-Cheng Hou
Journal: Cancer Research (2013)

Abstract LY294002 (LY) is a potent inhibitor of phosphatidylinositol 3-kinases (PI3Ks); however, bio-applications of LY are limited by its poor solubility and pharmacokinetic profile. Poly(lactic-co-glycolic acid) (PLGA) is a biodegradable nanomaterial that can be used as a carrier for drug delivery. Although LY-loaded polyvinyl alcohol (PVA)-containing PLGA nanoparticles (PVA-LY NPs) have been developed to improve LY solubility, the ratio of NP internalization is unsatisfactory and the cytotoxicity of PVA-LY NPs is inferior to that of free LY. LY-loaded surfactant-free PLGA nanoparticles (SF-LY NPs) were developed to improve the therapeutic efficacy of LY. The size of SF-LY NPs was in the range of 80-100 nm, the shape was spherical and the NPs were monodispersed. The loading capacity of LY in SF NPs was 7.4μg/mg with a sustained-released pattern. In four lung cancer cell lines, SF-LY NPs showed a stronger growth inhibitory effect, sustained suppression of the serine/threonine kinase AKT activation, and increased intracellular uptake of LY compared with PVA-LY NPs or free LY. In addition, it was observed that SF NPs tend to accumulate in the endoplasmic reticulum (ER) and subsequently induce pronounced ER stress. After injection into tumors, SF-LY NPs exhibited a stronger antitumor effect than free LY. These findings indicated that the surfactant-free formulation of PLGA is an ideal vector to carry LY and that SF-LY NPs possess promising anticancer activity. Citation Format: Chia-Cheng Hou. Surfactant-free PLGA encapsulation facilitates delivery of LY294002 to endoplasmic reticulum and enhances its cytotoxicity. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 581. doi:10.1158/1538-7445.AM2013-581
My most unfortunate mistake: A memorable viva
Authors: C. McCartney
Journal: BMJ (1997)

Third year at medical school at Edinburgh university in the 1980s was not a stressful year. We had just passed the notoriously difficult second MB and were floating on a wave of success. Several of my contemporaries did not attend classes at all in the first term. l usually managed to attend once or twice a week. This sabbatical period was put to good …
Efficacy and safety of carvedilol in patients with severe chronic heart failure and low systolic blood pressure: results of the COPERNICUS study
Authors: Jean L. Rouleau, Michael B. Fowler, Henry Krum, Hugo A. Katus, Andrew J. Coats, Michal Tendera, Paul Mohacsi, Ildiko Amann-Zalan, Terry L. Holcslaw, Ellen B. Roecker, Milton Packer
Journal: Journal of the American College of Cardiology (2002)
Chronic incomplete atrioventricular block induced by radiofrequency catheter ablation.
Authors: S K Huang, S Bharati, A R Graham, G Gorman, M Lev
Journal: Circulation (1989)

To determine if catheter ablation of the atrioventricular (AV) junction with radiofrequency energy can induce chronic incomplete (first- and second-degree) AV block to avoid the need for a permanent pacemaker, 20 closed-chest dogs were studied. Group 1 (10 dogs) received radiofrequency energy (750 kHz) with a fixed power setting (5 or 10 W) while increasing the pulse duration from 10 to 50 seconds for each application. Group 2 (10 dogs) received energy with a fixed pulse duration (20 or 30 seconds) while increasing the power setting from 5 to 10 W or from 10 to 20 W during each energy delivery. Radiofrequency energy was delivered between a chest-patch electrode and the distal electrode of a regular 7F tripolar His bundle catheter. For each application, the energy delivery was interrupted when 1) the PR interval prolonged (greater than 50%) or 2) second-degree or complete AV block occurred and persisted up to 5 seconds. The ablation procedure ended when there was 1) persistent PR prolongation (greater than 50%) or persistent second-degree AV block (lasting greater than 30 minutes) after ablation, 2) occurrence of two consecutive transient (less than 1 minute) complete AV blocks after each energy delivery, or 3) complete AV block (lasting greater than 2 minutes) after ablation. Of seven dogs in group 1 and five dogs in group 2 in which incomplete AV block was achieved 1 hour after the procedure, six in group 1 and five in group 2 remained in incomplete AV block 2-3 months after ablation. One dog in group 1 progressed into complete AV block. Of the remaining three dogs in group 1 and five dogs in group 2 in which complete AV block was initially achieved 1 hour after ablation, two in group 1 and four in group 2 continued to have complete AV block, whereas one in each group had AV conduction returned to incomplete at 1-2 months of follow-up. Thus, a total of 13 dogs had chronic incomplete AV block induced by radiofrequency catheter ablation. Pathologic examination of the conduction system in two dogs with first-degree AV block, two dogs with second-degree AV block, and one dog with complete AV block showed discrete scars involving the approaches to the AV node and the AV node itself. It is concluded that, in most dogs studied, chronic incomplete AV block could be achieved by careful titration of the dosage of radiofrequency energy and by regulation of the ablation end points.
World Trade Organization finally agrees cheap drugs deal
Authors: F. Fleck
Journal: BMJ (2003)

A long awaited trade deal to give poor nations access to cheap lifesaving drugs for diseases such as AIDS, malaria, and tuberculosis was agreed on 30 August after eight months of stalling—which was mainly due to US objections.

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Washington demonstrators stage a mass “die in” earlier this year in protest at the US resistance to a cheap drugs deal

Credit: AP PHOTO/EVAN VUCCI

Negotiators from the 146 member nations of the World Trade Organization (WTO) who hammered out the deal hailed it as a major breakthrough.

“All people of good will and good conscience will be very happy today with the decision …

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OC-159 Content analysis of illness blogs posted online by patients with IBD
Authors: N Tshuma, S Aboulela, F Chowdhury, L Macken, N Kamperidis, J Goodhand, J Lindsay
Journal: Gut (2012)

<h3>Introduction</h3> Illness blogs are online accounts of the course of a disease: they are unsolicited first person narratives, that are publicly accessible allowing author-reader interactivity. Expressive writing improves quality of life and scores in patients with irritable bowel syndrome. We sought to compare the accessibility and contents of illness blogs written by patients with ulcerative colitis (UC) and Crohn9s disease (CD): hypothesising that psychological distress, reportedly more common in IBD than the general population, and active disease would be the key reasons for a post. <h3>Methods</h3> Using the search terms “Crohn9s* and Ulcerative colitis* with Blog” and the internet search engine Google, we identified 12 consecutive UC and Crohn9s disease illness narratives. All posts written in the preceding year were included. We then undertook a structured quantitative analysis; including an assessment of the readability of posts using the Flesch reading ease (FRE) score and author-reader interactivity. Semi-qualitative analyses of excerpts of the contents of each post were undertaken using Dedoose software to identify narrative themes: wherever possible, for each post, disease activity was recorded. <h3>Results</h3> 1297 and 1009 excerpts were made from 642 and 499 posts from the illness blogs written by patients with UC and CD, respectively. There were no differences in the mean [SD] number of posts in 1 year (UC: 68.6 [47.5] vs CD: 42.2 [29.6], p=0.12) or in the number of words per post (UC: 449 [149] vs CD: 475 [263], p=0.76) between groups. Overall, there was no difference in the mean [SD] readability (FRES) scores (UC: 71 [7.0] vs CD: 67.9 [11.0], p=0.39): reportedly, easily understood by students aged between 13 and 14 years. No differences were seen in the median number of comments or links per post between groups. Overall, the majority of posts detailed personal experiences of IBD, with no differences between groups (UC: 51% [326/642] CD: 53% [264/499], p=0.51). Active disease was more frequently coded as a precipitant reason for making an entry in UC 25% [159/642] vs CD 17% [84/499], p=0.001. Patients with CD more frequently made entries in order to offer IBD related advice, including recent research advances, than patients with UC (UC: 4% [26/649] vs CD: 24% [118/499], p&lt;0.0001): whereas patients with UC were more likely to use entries for non-IBD related social networking (UC: 24% 153/642 vs CD 14% [72/499], p&lt;0.0001). In total, only 6 % (63/1141) of posts referred to psychological distress, with no differences between groups. <h3>Conclusion</h3> The content of blogs differs according to disease type, but relatively few bloggers refer to psychological distress in their posts. Online platforms, such as a blogs, may however be a new way of providing patients with IBD psychological support. <h3>Competing interests</h3> None declared.
Medical Technology Watchdog Plays Unique Role in Quality Assessment
Authors: Joan Stephenson
Journal: JAMA (1995)

LAST FALL, when medical science and politics clashed over whether health insurers should be required to pay for high-dose chemotherapy plus autologous bone marrow transplants (ABMT) for patients with advanced breast cancer, a nonprofit independent technology assessment group called ECRI weighed in with something no one else had provided: a careful analysis of all the available published data. ECRI's report, which came on the heels of a federal directive ordering government employees' insurance carriers to cover the costs of the controversial treatment, analyzed 40 studies of ABMT and similar procedures and 61 studies of patients receiving conventional chemotherapy. The group's analysts concluded that the available data suggest that ABMT not only fails to extend the lives of women with advanced, metastatic breast cancer, but also is likely to be life shortening—although they cautioned that their findings reflect only the current state of the technology and are subject to revision as
High Baseline Vitamin C Levels Do Not Prevent a Positive Outcome of a Lifestyle Intervention
Authors: Matthias Blüher, Michael Stumvoll, C. Ronald Kahn, Michael Ristow
Journal: Diabetes Care (2009)

In a recent issue of Diabetes Care , Thamer et al. (1) addressed the question of whether baseline plasma vitamin C levels influence the outcome of a dietary and exercise intervention in 86 individuals at increased risk for developing type 2 diabetes.

Oxidative stress caused by increased formation of reactive oxygen species during physical exercise has previously been proposed to be an important mediator of insulin sensitivity. In a prospective intervention study (2), we have recently shown that regular intake of combined …
Pulmonary mechanics and surfactant following re-implantation of dog's lung.
Authors: J C Lincoln, N Barnes, T Gould, E O Reynolds
Journal: Thorax (1970)

Recurrent respiratory infection may be a feature of patients who have deficiency of humoral or antibody response to some respiratory pathogens and to some antibody challenge tests whilst maintaining apparently normal levels of immunoglobulins (dysgammaglobulinaemia).Other patients may lack cellular immunity.The conditions mentioned above are illustrated by reference to case histories.
Primary cutaneous aspergillosis in a premature neonate
Authors: RICHARD D. GRANSTEIN, LEWIS R. FIRST, ARTHUR J. SOBER
Journal: British Journal of Dermatology (1980)

A case of primary cutaneous aspergillosis in a 3-week-old premature infant is reported. The lesion, which presented as a solitary nodule surmounted by three pustules, occurred following the use of elasticized and cloth adhesive tape and was cured by surgical excision. Factors predisposing to this infection included maceration, antibiotic usage, and prematurity.
Cerebellar Ataxia with Mycoplasma Pneumonia
Authors: ALLEN R. WYLER
Journal: Annals of Internal Medicine (1974)

Letters1 April 1974Cerebellar Ataxia with Mycoplasma PneumoniaALLEN R. WYLER, M.D., A. BASIL HARRIS, M.D.ALLEN R. WYLER, M.D.Search for more papers by this author, A. BASIL HARRIS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-80-4-556 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Central nervous system complications of mycoplasma pneumonia infection are relatively rare, and acute cerebellar ataxia associated with mycoplasma pneumonia is even more uncommon. Steele and his associates (3) reported three cases in children, and Endtz and Hers (4) reported one case in an adult. Because of the paucity of reports of this association, we describe this case:A 15-year-old white man had been in good health until 2 weeks before admission to the hospital, when he had rhinorrhea, sore throat, and cough for 3 days. On the morning of admission he presented with progressive vertigo, ataxia, diplopia,...References1. STEELEGLADSTONETHANASOPHON JRS: Acute cerebellar ataxia and concomitant infection with Mycoplasma pneumoniae. J Pediatr 80:467-469, 1972 CrossrefMedlineGoogle Scholar2. ENDTZHERS LJ: Ataxia cerebelleuse aiguë causée par Mycoplasma pneumoniae. Rev Neurol (Paris) 122:52-54, 1970 MedlineGoogle Scholar3. BIBERFELD G: Antibodies to brain and other tissues in cases of Mycoplasma pneumoniae infection. Clin Exp Immunol 8:319-333, 1971 MedlineGoogle Scholar4. COLLIERCLYDE AW: Relationships between Mycoplasma pneumoniae and human respiratory epithelium. Infect Immun 3:694-698, 1971 CrossrefMedlineGoogle Scholar5. POLLACKSOMERSONSENTERFIT JNL: Isolation characterization and immunogenicity of Mycoplasma pneumoniae membranes. Infect Immun 2:326-334, 1970 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ALLEN R. WYLER, M.D.; A. BASIL HARRIS, M.D.Affiliations: Department of Neurological Surgery University of Washington School of Medicine Seattle, Washington 98195 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCerebellar syndrome with hydrocephalus due to Mycoplasma pneumoniae infectionThe Cerebellum and CNS Infection 1 April 1974Volume 80, Issue 4Page: 556-557KeywordsAtaxiaCentral nervous systemChildrenMycoplasmaPharyngitisPneumoniaVertigo ePublished: 1 December 2008 Issue Published: 1 April 1974 PDF downloadLoading ...
Battle against poverty hampered by sex discrimination
Authors: Owen Dyer
Journal: BMJ (2005)

The world's failure to confront discrimination against women is undermining efforts to fight poverty and storing up problems for the future, a report by the United Nations' Population Fund says.

Improving the status of women, reducing maternal deaths, and enhancing girls' access to education are among the targets already set out in the UN's millennium development goals. But the report argues that other development goals also depend on women controlling their reproduction and living free of violence and preventable disease. …
Punishment of doctors must fit their crime
Authors: J. F Goodwin, W. Somerville
Journal: BMJ (1998)

EDITOR—All readers, parents of children with congenital heart disease, and paediatric cardiologists will sympathise with the parents of Deborah Jenkins, who had severe complex congenital heart disease and died at the age of 6 after an exploratory operation by Dr James Taylor, a paediatric cardiologist at the Hospital for Sick Children, Great Ormond Street, London. Deborah's parents had consented to cardiac catheterisation but had expressly said that a balloon catheter should not be used. Thus if …
Autoantibodies against the fibrinolytic receptor, annexin 2, in antiphospholipid syndrome
Authors: Gabriela Cesarman-Maus, Nina P. Ríos-Luna, Arunkumar B. Deora, Bihui Huang, Rosario Villa, Maria del Carmen Cravioto, Donato Alarcón-Segovia, Jorge Sánchez-Guerrero, Katherine A. Hajjar
Journal: Blood (2006)
PROGNOSTIC IMPACT OF RED BLOOD CELL TRANSFUSION IN PATIENTS UNDERGOING PRIMARY ANGIOPLASTY FOR STEMI
Authors: Mehmet Ergelen, Huseyin Uyarel, Seref Kul, Servet Altay, Erkan Ayhan, Turgay Isik, Tuba Kemaloglu, Mehmet Gul, Gokhan Cicek, Abdurrahman Tasal, Mehmet Eren
Journal: Journal of the American College of Cardiology (2013)
Gallbladder Visualization on Hepatic Artery Pert u si on Scintigraphy
Authors: JEROLD W. WALLIS, BARRY GUBIN, JAMES C. ANDREWS, RICHARD L. WAHL
Journal: Clinical Nuclear Medicine (1987)

Hepatric artery perfusion scintigraphy can be used to verify the position of catheters used to deliver intrahepatic chemotherapy in the treatment of liver metastases. Determination of extrahepatic perfusion is important in minimizing side effects of chemotherapy. The case presented here illustrates perfusion of the gallbladder, with correlation by other imaging modalities.
Acute Staphylococcal Endocarditis in a Patient with Ventricular Septal Defect
Authors: J. M. S. Pearce
Journal: BMJ (1963)

serum.The Paul-Bunnell test now gave a titre of less than 1 in 4 and the direct Coombs test was negative.During the eighth week bone-marrow biopsy showed a cellular marrow with active normoblastic erythropoiesis.The cells of the myeloid series appeared normal.Mega- karyocytes were extremely scanty.The patient was discharged symptom-free at the end of the eighth week: haemoglobin 15.6 g./100 ml.; W.B.C. 7,800/c.mm.; platelets 70,000/ c.mm. ; reticulocytes 3%.Progress in hospital is summarized in the Chart. DISCUSSIONSince Dameshek (1943) reported acute haemolytic anaemia associated with infectious mononucleosis 26 similar instances have been described in the literature.The serological findings are discussed in detail by Dacie (1962).The direct antiglobulin test on the patient's red cells was positive in nine of these cases.Infectious mononucleosis complicated by thrombo- cytopenia was first described by Minot (1929), and since then numerous reports have appeared in the literature.The majority of these cases recovered from the thrombocytopenia within six weeks.Schumacher (1961) reported a case in which the thrombocytopenia persisted for about a year, but he made no platelet antibody studies.The platelet count of our patient had not risen at discharge sufficiently to permit the discontinuance of steroid therapy.It remains a possibility that the thrombocytopenia may become chronic.Since the paper of Evans and Duane (1949) interest has been shown in the relationship between thrombo- cytopenia and haemolytic anaemia of an auto-immune type.These authors suggest that thrombocytopenia and leucopenia might depend upon the formation of auto-antibodies of a rather wide specificity capable of destroying platelets and leucocytes as well as red cells.The presence of platelet antibodies in our case is indica- ted by a positive indirect platelet antiglobulin consump- tion test.Weak leucocyte agglutinins were also demonstrated.There appears to be strong evidence that the haemolytic anaemia and the thrombocytopenia, and possibly the low white-cell count, occurred as a result of an auto-immune process.