tbuckley/cabot-search huggingface dataset:
The phosphatidylethanolamine N-methyltransferase gene V175M single nucleotide polymorphism confers the susceptibility to NASH in Japanese population
Authors: Hang Dong, Jianjie Wang, Chunmei Li, Akira Hirose, Yasuko Nozaki, Masaya Takahashi, Masafumi Ono, Naoaki Akisawa, Shinji Iwasaki, Toshiji Saibara, Saburo Onishi
Journal: Journal of Hepatology (2007)
Report may lead to population collection by the back door
Authors: J. Kaye
Journal: BMJ (2001)

EDITOR—Ferriman reported on the report by the House of Lords Select Committee on Science and Technology into human genetic databases.1 Only after reading the report in depth does it become clear that the recommendations would lead to the establishment of a British national population collection, which would link identifiable NHS clinical information on the 58 million people in the United Kingdom for genetic research. The proposed British biomedical population collection of 500 000 volunteers being established by …
Hepatic Artery Infusion Chemotherapy in Hepatoma
Authors: J. L. Provan, J. F. Stokes, D. Edwards
Journal: BMJ (1968)

Three patients with inoperable malignant hepatomas were treated by intra-arterial infusion of fluorouracil. In each case the treatment gave relief of symptoms: there was striking relief of pain in two cases.Preoperative angiography is essential, but the technical problems are relatively minor.The response of the tumours to chemotherapy is sufficiently encouraging to justify greater efforts for early diagnosis.
The Ecology of the Human Skin
Authors: George L. Fite
Journal: JAMA (1965)

The skin separates man's biological self from his immediate animal and vegetable environment. It is interesting to take a microbe's eye view of the skin as a suitable home.  A good many arthropods successfully inhabit skin with establishment of life cycles essential to their existence. The creation of geophilic strains of fungi of man begets an idealized existence for dermatophytes capable of one form of life on the skin, and another in the soil. Some interesting problems exist with such organisms as Myco leprae , which inhabits the subepidermal skin, yet seems more closely related to soil mycobacteria than to animal pathogens. Herpesviruses, poxviruses, and papovaviruses, all have a home in the  Tracking down these relations shows the skin to be a part of several ecosystems, the subject which has been awkwardly styled ecology of the skin.  The author's approach is both valid and entertaining, although from the academic standpoint
Quantitative differences in biosynthesis and extracellular deposition of fibrillin in cultured fibroblasts distinguish five groups of Marfan syndrome patients and suggest distinct pathogenetic mechanisms.
Authors: T Aoyama, U Francke, H C Dietz, H Furthmayr
Journal: Journal of Clinical Investigation (1994)

Pulse-chase studies of [35S]cysteine-labeled fibrillin were performed on fibroblast strains from 55 patients with Marfan syndrome (MFS), including 13 with identified mutations in the fibrillin-1 gene and 10 controls. Quantitation of the soluble intracellular and insoluble extracellular fibrillin allowed discrimination of five groups. Groups I (n = 8) and II (n = 19) synthesize reduced amounts of normal-sized fibrillin, while synthesis is normal in groups III (n = 6), IV (n = 18), and V (n = 4). When extracellular fibrillin deposition is measured, groups I and III deposit between 35 and 70% of control values, groups II and IV < 35%, and group V > 70%. A deletion mutant with a low transcript level from the mutant allele and seven additional patients have the group I protein phenotype. Disease in these patients is caused by a reduction in microfibrils associated with either a null allele, an unstable transcript, or an altered fibrillin product synthesized in low amounts. In 68% of the MFS individuals (groups II and IV), a dominant negative effect is invoked as the main pathogenetic mechanism. Products made by the mutant allele in these fibroblasts are proposed to interfere with microfibril formation. Insertion, deletion, and exon skipping mutations, resulting in smaller fibrillin products, exhibit the group II phenotype. A truncated form of fibrillin of 60 kD was identified with specific fibrillin antibodies in one of the group II cell culture media. Seven of the nine known missense mutations, giving rise to abnormal, but normal-sized fibrillin molecules, are in group IV.
Right and left ventricular volume characteristics in common atrioventricular canal.
Authors: B D Thanopoulos, E A Fisher, I W DuBrow, A R Hastreiter
Journal: Circulation (1978)

Right (RV) and left (LV) ventricular volume characteristics were determined from biplane cineangiography in 29 patients with atrioventricular canal (AVC). The patients were classified into two groups: group I (N = 19), uncomplicated AVC; group II (N = 10), AVC associated with RV obstruction. In group I, LV end-diastolic volume (EDV) [177 +/- 9 (SEM)% of normal] and RVEDV (125 +/- 9%) both were greater than normal (P is less than 0.001 and less than 0.01, respectively). LV ejection fraction (EF) was decreased (0.59 +/- 0.02, P is less than 0.001) but RVEF was normal (0.58 +/- 0.03). LV stroke volume index (SVI) was increased (48 +/- 3 ml/m2, P is less than 0.005), and RVSVI was normal (34 +/- 3 ml/m2). One patient had a markedly small RVEDV (45%). In group II, LVEDV and RVEDV were not different from normal (119 +/- 11% and 97 +/- 15%, respectively). LVEF was depressed (0.52 +/- 0.04, P is less than 0.001) and RVEF was normal (0.55 +/- 0.05). LVSVI was normal (38 +/- 5 ml/m2) and RVSVI was slightly decreased (29 +/- 4 ml/m2, P is less than 0.025). Two patients had a markedly small RVEDV (31%, 55%). EDV correlated with the pulmonary-to-systemic flow ratio (LV, r = 0.71; RV, r = 0.68). The data show that in most patients with AVC, LV and RV are enlarged in the uncomplicated form but not in the form with RV obstruction. LV function is more compromised than RV in both groups. RV hypoplasia is rare but was documented in both uncomplicated forms and forms with RV obstruction.
The Birmingham Consultative Institution
Authors: T. Wilson
Journal: BMJ (1900)

<h3>Introduction</h3> How the UNAIDS 90-90-90 targets for ending HIV/AIDS by 2030 progressing have not yet been assessed in many countries including Ethiopia. We assessed HIV care continuum outcomes as a complex surrogate markers for the 90-90-90 targets. <h3>Methods</h3> Data were collected from 12 years anti-retroviral therapy (ART) records. For UNAIDS diagnosis target, early HIV diagnosis was considered as a surrogate marker. For treatment target, number of people on ART, number of people who discontinued from ART or transferred out, and number of people who had fair or poor adherence were used as surrogates. For viral suppression target, number of people with treatment success (combination of immunological and clinical) was used as a surrogate marker. <h3>Results</h3> 8172 patients were enrolled for HIV cares in the period between 2003–2015. For the diagnosis target, 34.5% patients knew their status early (43%-children, 33%-adults). For the treatment target, 65% patients received ART, 1154 (21.9%) patients discontinued from ART, 1015 (19.3%) patients on ART transferred out to other sites, 916 (17%) of patients on ART had fair or good adherence. For the virological suppression target, 80.7, 80.3% and 65.8% of patients had immunological, clinical and treatment success displaying an estimated 66% of patients achieved the target. <h3>Conclusion</h3> The finding reflects that an estimated 35% of patients knew their status timely, 65% of diagnosed patients received treatment and 66% of patients on ART achieved viral suppression. This is very far from the UNAIDS 90-90-90 targets underscoring the need for rigorous innovative methods such as unmanned aerial systems (or drones) for transporting laboratory specimens, immediate or same day ART initiation, community distribution of ART, runaway packs during conflict, and use of GenXpert for HIV viral load testing would significantly help to hit the target. <b>Question:</b> How resource constraint countries attain the 90-90-90 targets?
Health Values of Hospitalized Patients 80 Years or Older
Authors: J Tsevat, N V Dawson, A W Wu, J Lynn, J R Soukup, E F Cook, H Vidaillet, R S Phillips
Journal: JAMA (1998)

Context.-Health values (utilities or preferences for health states) are often incorporated into clinical decisions and health care policy when issues of quality vs length of life arise, but little is known about health values of the very old.Objective.-Toassess health values of older hospitalized patients, compare their values with those of their surrogate decision makers, investigate possible determinants of health values, and determine whether health values change over time.Design.-A prospective, longitudinal, multicenter cohort study.Setting.-Four academic medical centers.Participants.-Fourhundred fourteen hospitalized patients aged 80 years or older and their surrogate decision makers who were interviewed and understood the task.Main Outcome Measures.-Time-trade-offutilities, reflecting preferences for current health relative to a shorter but healthy life.Results.-On average, patients equated living 1 year in their current state of health with living 9.7 months in excellent health (mean [SD] utility, 0.81 [0.28]).Although only 126 patients (30.7%) rated their current quality of life as excellent or very good, 284 (68.6%) were willing to give up at most 1 month of 12 in exchange for excellent health (utility Ն0.92).At the other extreme, 25 (6.0%) were willing to live 2 weeks or less in excellent health rather than 1 year in their current state of health (utility Յ0.04).Patients were willing to trade significantly less time for a healthy life than their surrogates assumed they would (mean difference, 0.05; P=.007); 61 surrogates (20.3%) underestimated the patient's time-trade-off score by 0.25 (3 months of 12) or more.Patients willing to trade less time for better health were more likely to want resuscitation and other measures to extend life.Time-trade-off score correlated only modestly with quality-of-life rating (r=0.28) and inversely with depression score (r=-0.27),but there were few other clinical or demographic predictors of health values.When patients who survived were asked the time-trade-off question again at 1 year, they were willing to trade less time for better health than at baseline (mean difference, 0.04; P=.04).Conclusion.-Very old hospitalized patients who could be interviewed were able, in most cases, to have their health values assessed using the time-trade-off technique.Most patients were unwilling to trade much time for excellent health, but preferences varied greatly.Because proxies and multivariable analyses cannot gauge health values of elderly hospitalized patients accurately, health values of the very old should be elicited directly from the patient.
MSD Italy is criticised for threatening legal action over prescription advice to GPs
Authors: F. Turone
Journal: BMJ (2014)

The Italian branch of the drug company Merck Sharp and Dohme (MSD) has stopped a leading public health doctor and administrator from circulating texts to GPs advising them about the use of one of the company’s drugs. 

In the texts, Alberto Donzelli—the head of education, appropriateness, and evidence based medicine at the public health authority of Milan (Milan Healthcare)—had analysed the published evidence on the cholesterol lowering drug ezetimibe and discouraged its prescription in addition to statins.

A letter telling Donzelli to “cease and desist” was sent in February by MSD’s medical director, Patrizia Nardini, and was cosigned by the company’s director of legal affairs. They accused Donzelli of serious misconduct and a breach of …
Evaluating Coronary Heart Disease Risk
Authors: Jeffrey M. Hoeg
Journal: JAMA (1997)

<h3>SELECTED CASE</h3> An asymptomatic 34-year-old white man was referred to the Lipid Clinic of the National Heart, Lung, and Blood Institute for atherosclerotic cardiovascular disease risk assessment. His father died at the age of 39 years of a myocardial infarction, and his 2 paternal uncles developed symptomatic coronary artery disease by the age of 40 years. The search for conventional cardiovascular disease risk factors was unrevealing. The patient exercised regularly and had never smoked tobacco products. Physical examination revealed a normotensive man within 5% of his ideal body weight. His fasting concentrations of blood glucose (5.33 mmol/L [96 mg/dL]), low-density lipoprotein cholesterol (LDL-C) (1.76 mmol/L [68 mg/ dL]) and high-density lipoprotein cholesterol (HDL-C) (1.06 mmol/L [41 mg/dL]) were all within normal limits. However, his fasting plasma triglyceride concentration was increased (6.64 mmol/L [588 mg/dL]) as was his apolipoprotein B concentration at 3.90 mmol/L (151 mg/dL) (normal range, 1.94-3.33 mmol/L [75-129
Underdiagnosed chronic obstructive pulmonary disease in England: new country, same story
Authors: D M Mannino
Journal: Thorax (2006)

finding is not surprising since elastin is distributed in large measure beyond the alveoli to bronchial and vascular structures.The increased levels of desmosine in the non-emphysematous phenotype indicate that this marker may be useful for detecting tissue degradation in the non-emphysematous COPD phenotype.The improved technical ability to measure desmosine in sputum and plasma, as well as in urine, significantly increases its usefulness as a marker of lung matrix degradation and should be more widely applied in COPD. IMPLICATIONS OF THE STUDYOverall, this study presents several significant insights to delineate phenotypes within the broad category of COPD:N CT scanning is essential for identify- ing COPD patients with and without a significant component of pulmonary emphysema.N Induced sputum can yield character- ising markers for various COPD phenotypes which may vary from the findings in BAL fluid.Where possible, studies should compare findings in sputum with those from BAL fluid in the same patients.N While the patients in this study had moderate to severe COPD, studies in patients with mild or early COPD would be worthwhile to determine whether the same enzymatic and inflammatory mediators are detected in early disease.N The source of increased levels of MMP-9 with respect to neutrophil versus macrophage should be better defined to identify possible therapeutic targets.N The increase in eosinophils in induced sputum in the emphysema phenotype deserves study in larger series of patients to determine its consistency.Also, the significance of eosinophilia immunologically, functionally and pathologically needs to be better understood in COPD, especially in the emphysema phenotype.The findings in this study indicate how much more we still need to learn about the cellular and cytokine reactions of specific phenotypes in COPD, and how they differ from the asthmatic state. 21
Functional MASP2 single nucleotide polymorphism plays no role in psoriasis
Authors: C. Stover, S. Barrett, N.J. Lynch, J.N.W.N. Barker, D. Burden, R. Trembath, W. Schwaeble, C. Veal
Journal: British Journal of Dermatology (2005)

Background Psoriasis is a heritable disease and genome-wide scans have implicated several loci of susceptibility. The gene for MASP-2, a protease involved in complement activation, is located within one of these loci on chromosome 1p. Objectives To assess whether partial or total MASP-2 deficiency is a risk factor for developing psoriasis. Methods We screened a cohort of patients affected by plaque psoriasis and their parents by restriction fragment length polymorphism analyses. Results We detected a single nucleotide polymorphism that leads to an amino acid exchange, which results in dissociation of MASP-2 from a carbohydrate recognition complex. Conclusions We show that this mutant allele is not associated with psoriasis. There was no favoured transmission from parents to affected offspring. The calculated allele frequency in this psoriasis group (Scottish and English) was 0·0326, and in the unaffected group 0·0379.
The Influence of an Intern-Resident Staff on the Quality of Private Patient Care
Authors: John F. Stapleton
Journal: JAMA (1965)

The current numerical disparity between available internships and residencies and available candidates has carried the implication that hospitals less fortunate in recruitment offer less effective medical care to their patients. A good house staff has become a status symbol, indicating superior staff and superior resources. That the teaching hospital offers the best medical care is unchallenged in our day; yet many patients, unaware of this distinction, are hospitalized in institutions without house staff and expect service of high quality. This study presents an attempt to compare objectively the quality of medical care on two geographically separate private medical services in a single community hospital. The same attending physicians admitted similar patients to both sections; the only difference between services lay in the fact that interns and residents were assigned to the one, while on the other the attending physicians practiced medicine unassisted by house staff. <h3>Materials and Methods</h3> The private
Transesophageal versus intracoronary Doppler measurements for calculation of coronary flow reserve
Authors: Manfred Zehetgruber, Gerold Porenta, Gerald Mundigler, Deddo Mörtl, Thomas Binder, Günter Christ, Peter Probst, Helmut Baumgartner, Gerald Maurer, Peter Siostrzonek
Journal: Cardiovascular Research (1997)

Objective: The present study was performed to compare coronary flow reserve by transesophageal Doppler echocardiography and intracoronary Doppler flow wire measurements in patients with LAD disease. Methods: 17 patients with various degree of LAD stenosis were studied. Intracoronary LAD Doppler measurements were performed at baseline and after intracoronary injection of 18 μg adenosine. Transesophageal coronary sinus and LAD Doppler measurements were performed at baseline and after intravenous dipyridamole (0.6 mg/kg/5 min). Coronary flow reserve was calculated as the ratio of hyperemic to baseline average peak velocities. Results: Coronary flow reserve was 2.44±0.62 and 2.19±0.76 for proximal and distal intracoronary measurements and was 2.25±0.64 and 1.74±0.63 for transesophageal LAD- and coronary sinus measurements. Proximal intracoronary flow reserve significantly correlated with transesophageal coronary sinus (r = 0.73, p≤0.001) and LAD (r = 0.70, p≤0.005) measurements, whereas distal intracoronary flow reserve only correlated with transesophageal coronary sinus flow reserve (r = 0.56, p≤0.02). Receiver operating characteristic curve analysis demonstrated similar diagnostic accuracy of all applied techniques for detection of a significant LAD stenosis. Conclusions: Coronary flow reserve by both transesophageal techniques correlated with intracoronary Doppler flow wire measurements, however considerable discrepancies may occur in the individual patient.
BRRSLAU, AS I REMEMBER IT.*
Authors: W. N. GOLDSMITH
Journal: British Journal of Dermatology (1964)

Journal Article BRRSLAU, AS I REMEMBER IT. Get access W. N. GOLDSMITH W. N. GOLDSMITH Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 76, Issue 11, 1 November 1964, Pages 453–458, https://doi.org/10.1111/j.1365-2133.1964.tb15483.x Published: 01 November 1964
PSYCHIATRY IN THE DEEP SOUTH
Authors: ROBERT W. DALY
Journal: American Journal of Psychiatry (1964)

The practice of psychiatry cannot be fully understood unless one is acquainted with the trends and traditions of the society in which this art is exercised. Without forsaking the notion that the psychiatrist influences the society in which he lives, I have stressed that general social factors of a socio-geographical region are reflected on the psychiatric scene. In the Deep South, tradition, economic patterns, caste-class divisions, poverty and migration are related to the structure and staffing of psychiatric institutions and to the varieties of psychopathology and treatment.
An Ethical Debate Financial ties as part of informed consent to postmarketing research: Defining surveillance
Authors: M. Vandenburg, I. Dews
Journal: BMJ (1995)

The authors of this study seem to confuse postmarketing surveillance and phase IV trials. Phase IV trials are interventional studies yielding efficacy, dosage, safety, and pharmacoeconomic data to supplement those available at the time of licensing. They are analogous to phase II and III studies and raise no separate ethical or financial issues; the doctor who had received $5000 per patient was doubtless undertaking such a study.

Postmarketing surveillance, in contrast, uses non-interventional cohort observation to collect large scale safety data from routine clinical use. Patients are accumulated through normal prescribing, not actively recruited. No special examinations or tests are performed. The doctor's work is limited to passive …
ABC of heart failure: Aetiology
Authors: G Y H Lip
Journal: BMJ (2000)

### Causes of heart failure

#### Coronary artery disease

#### Hypertension Cardiomyopathy

##### Valvar and congenital heart disease

##### Arrhythmias

##### Alcohol and drugs

##### “High output” failure

##### Pericardial disease

##### Primary right heart failure

The relative importance of aetiological factors in heart failure is dependent on the nature of the population being studied, as coronary artery disease and hypertension are common causes of heart failure in Western countries, whereas valvar heart disease and nutritional cardiac disease are more common in the developing world. Epidemiological studies are also dependent on the clinical criteria and relevant investigations used for diagnosis, as it remains difficult, for example, to distinguish whether hypertension is the primary cause of heart failure or whether there is also underlying coronary artery disease.

Coronary heart disease is the commonest cause of heart failure in Western countries. In the studies of left ventricular dysfunction (SOLVD) coronary artery disease accounted for almost 75% of the cases of chronic heart failure in male white patients, although in the Framingham heart study, coronary heart disease accounted for only 46% of cases of heart failure in men and 27% of chronic heart failure cases in women. Coronary artery disease and hypertension (either alone or in combination) were implicated as the cause in over 90% of cases of heart failure in the Framingham study.

Recent studies that have allocated aetiology on the basis of non.invasive investigations-such as the Hillingdon heart failure study-have identified coronary artery disease as the primary etiology in 36% of cases of heart failure. In the Hillingdon study, however, researchers were not able to identify the primary aetiology in …
Free Thyroxine Concentrations in Thyroid Storm
Authors: MARION H. BROOKS
Journal: Annals of Internal Medicine (1980)

Total serum thyroxine concentrations, the dialyzable fractions of total thyroxine, and absolute free thyroxine concentrations were measured in six patients with thyroid storm, in 15 patients with uncomplicated thyrotoxicosis, and in 19 normal subjects. Total thyroxine concentrations were similar in both thyrotoxic groups. However, the mean dialyzable fraction of thyroxine and the mean free thyroxine concentration was significantly higher in patients with thyroid storm than in patients with uncomplicated thyrotoxicosis (0.060 +/- 0.017% versus 0.026 +/- 0.006% and 10.9 +/- 3.8 ng/dL versus 4.7 +/- 1.4 ng/dL, respectively). These findings suggest that events precipitating thyroid storm may act with thyrotoxicosis to decrease thyroxine binding markedly and result in a sharp increase in free thyroxine concentration. These phenomena may play a role in the pathogenesis of thyroid storm.