tbuckley/cabot-search huggingface dataset:
Integration of hepatitis B vaccination into rural African primary health care programmes.
Authors: B D Schoub, S Johnson, J M McAnerney, N Blackburn, M C Kew, J P McCutcheon, N D Carlier
Journal: BMJ (1991)

OBJECTIVE--To determine the efficacy of hepatitis B vaccine when added to the routine expanded programme on immunisation under field conditions in rural Africa. DESIGN--Infants were immunised according to two schedules--an early schedule at birth, 3 months, and 6 months and a later schedule to correspond with routine vaccination in the expanded programme on immunisation at 3 months, 4 1/2 months, and 6 months. SETTING--Venda, northern Transvaal, South Africa, a self governing region of 7460 square kilometers varying from rural villages to small towns. SUBJECTS--The 1989 birth cohort of Venda. MAIN OUTCOME MEASURES--Coverage for hepatitis B vaccine at first, second, and third doses; serological assessment of vaccine efficacy by prevalence of antibodies to hepatitis B surface antigen in infants who had completed the three dose course of immunisation; antibodies to hepatitis B core antigen to determine if natural infection occurred. RESULTS--Vaccine coverage for hepatitis B dropped sharply from 99% to 53% to 39% for the first, second, and third dose respectively. In contrast, vaccine coverage was maintained at 97-99% for the three doses of poliomyelitis vaccine. Serological evaluation of vaccine efficacy showed that only 3.5% of recipients of all three doses failed to develop antibodies to hepatitis B surface antigen. Only 6.6% of vaccine recipients were vaccinated according to either the early or later schedules whereas 93.4% received their doses of vaccine at intervals beyond the limits of either of the planned schedules. There was, however, no significant difference in seroconversion to the surface antigen between the "unscheduled" or scheduled groups of those who were vaccinated according to the early or late schedules. The pattern of prevalence of antibodies to hepatitis B core antigen, which showed a sharp fall in children aged over 7 months, suggested that the antibodies were acquired passively rather than by active infection. CONCLUSIONS--Supplementation of the present expanded programme on immunisation with hepatitis B vaccine in rural Africa is fraught with difficulties. However, the vaccine was effective within a fairly wide spacing of dosage. Adding hepatitis B vaccine to diphtheria, tetanus, and pertussis as a tetravalent vaccine is proposed as a means of effectively integrating it into the expanded programme on immunisation in Third World settings.
Effects of inhaled budesonide on spirometric values, reversibility, airway responsiveness, and cough threshold in smokers with chronic obstructive lung disease.
Authors: B Auffarth, D S Postma, J G de Monchy, T W van der Mark, M Boorsma, G H Koeter
Journal: Thorax (1991)

Inhaled corticosteroids are known to reduce respiratory symptoms and airway responsiveness in allergic patients with asthma. The aim of the present randomised, double blind study was to assess the effect of eight weeks9 treatment with inhaled budesonide in non-allergic smokers with chronic obstructive lung disease. Twenty four subjects (23 male) entered the study. Their ages ranged from 40 to 70 (mean 57) years, with a mean of 35 (range 9-80) pack years of smoking; the mean FEV1 was 53% (range 32-74%) predicted and geometric mean PC20 (histamine concentration causing a 20% fall in FEV1) 0.96 (range 0.07-7.82) mg/ml. After a two week washout, single blind, placebo period, 12 patients were allocated to treatment with budesonide 1600 microgram/day and 12 to placebo for eight weeks. The only additional drug to be taken was ipratropium bromide "if needed." Twenty one patients completed the study, 10 in the budesonide group and 11 in the placebo group. The standard deviation of the difference between duplicate measurements of PC20 histamine and citric acid cough threshold made two weeks apart was below one doubling dose step. There was a significant reduction in dyspnoea in the budesonide group, but otherwise no change in symptom scores or use of ipratropium bromide over the eight weeks of treatment within or between the two groups. No significant differences in spirometric values, peak expiratory flow, PC20 histamine, or citric acid cough threshold were found between the groups. Although differences were not significant, some of the changes showed a trend in favour of budesonide. Whether a longer observation period would show a significant influence of inhaled corticosteroids in patients with chronic obstructive lung disease remains to be determined.
Effects of Inhaled Brevetoxins in Allergic Airways: Toxin–Allergen Interactions and Pharmacologic Intervention
Authors: William M. Abraham, Andrea J. Bourdelais, Ashfaq Ahmed, Irakli Serebriakov, Daniel G. Baden
Journal: Environmental Health Perspectives (2005)

During a Florida red tide, brevetoxins produced by the dinoflagellate Karenia brevis become aerosolized and cause airway symptoms in humans, especially in those with pre-existing airway disease (e.g., asthma). To understand these toxin-induced airway effects, we used sheep with airway hypersensitivity to Ascaris suum antigen as a surrogate for asthmatic patients and studied changes in pulmonary airflow resistance (R(L) after inhalation challenge with lysed cultures of K. brevis (crude brevetoxins). Studies were done without and with clinically available drugs to determine which might prevent/reverse these effects. Crude brevetoxins (20 breaths at 100 pg/mL; n = 5) increased R(L) 128 +/- 6% (mean +/- SE) over baseline. This bronchoconstriction was significantly reduced (% inhibition) after pretreatment with the glucocorticosteroid budesonide (49%), the beta(2) adrenergic agent albuterol (71%), the anticholinergic agent atropine (58%), and the histamine H1-antagonist diphenhydramine (47%). The protection afforded by atropine and diphenhydramine suggests that both cholinergic (vagal) and H1-mediated pathways contribute to the bronchoconstriction. The response to cutaneous toxin injection was also histamine mediated. Thus, the airway and skin data support the hypothesis that toxin activates mast cells in vivo. Albuterol given immediately after toxin challenge rapidly reversed the bronchoconstriction. Toxin inhalation increased airway kinins, and the response to inhaled toxin was enhanced after allergen challenge. Both factors could contribute to the increased sensitivity of asthmatic patients to toxin exposure. We conclude that K. brevis aerosols are potent airway constrictors. Clinically available drugs may be used to prevent or provide therapeutic relief for affected individuals.
On the Threshold — A Diagnosis of Exclusion
Authors: Peter Clarke, Susan Glick, Brendan M. Reilly
Journal: New England Journal of Medicine (2005)

A 48-year-old airline mechanic from Belize presented to the emergency department with fever and altered mental status. Two weeks earlier, fever, myalgias, and dry cough had developed. Maximal daily temperatures reached 41.1°C, and one week later he awakened unable to speak.
Can a Dietary Supplement Prevent Gestational Diabetes Mellitus?
Authors: Donald R. Coustan
Journal: Diabetes Care (2013)

Gestational diabetes mellitus (GDM), glucose intolerance with onset or first recognition during pregnancy, has been increasing (1) and will increase further with widespread adoption of new diagnostic criteria recommended by the American Diabetes Association (ADA) (2). GDM, even at the milder end of the diagnostic spectrum, is associated with fetal macrosomia, neonatal adiposity, preeclampsia, and cesarean section (3), which can be reduced by diagnosis and treatment (4,5). Such treatment is not without cost (6), and an effective, relatively simple, inexpensive approach to prevention could result in significant savings to the health care system, not to mention decreasing morbidity. In this issue of Diabetes Care , D’Anna et al. (7) describe a randomized controlled trial (RCT) of such a potential prevention strategy.

Insulin resistance is characteristic of human pregnancy and may have evolved to ensure the fetus a continued supply of nutrients even in times of famine. Most gravidas increase insulin release and maintain euglycemia, while those with GDM are unable to do so adequately. While metformin, an insulin-sensitizing drug, initially appeared to prevent GDM in nonrandomized cohort studies, a double-blind RCT did not demonstrate efficacy (8). Inositol, present in many foods, is a component of inositolphosphoglycans, a second messenger for insulin action (9) (Fig. 1), and two of its nine isoforms, myo -inositol and chiro -inositol, have been used as insulin-sensitizing agents to treat insulin-resistant states such as polycystic ovary syndrome (PCOS) in doses ranging from 200 mg/day to 4 g/day (10–12). The authors of the current study have also demonstrated in an RCT a beneficial effect of myo -inositol in treating the metabolic syndrome in postmenopausal women (13). These same authors (14) reported a lower incidence of GDM (17 vs. 54%) among …
Multiepitope peptide-loaded virus-like particles as a vaccine against hepatitis B virus-related hepatocellular carcinoma
Authors: Fei-Xiang Ding, Fang Wang, Yi-Ming Lu, Ka Li, Kai-Hui Wang, Xiao-Wen He, Shu-Han Sun
Journal: Hepatology (2009)

To develop a hepatitis B virus (HBV) therapeutic vaccine that can induce a broad but specific immune response and significant antitumor effects both in vivo and in vitro, we inserted HBV X protein (HBx)-derived epitopes HBx(52-60), HBx(92-100), and HBx(115-123); a novel subdominant cytolytic T lymphocyte (CTL) epitope HBx(140-148); and the universal T helper epitope pan human leukocyte antigen DR-binding epitope into HBV core protein to form multiepitope peptide-loaded virus-like particles (VLPs). CTL responses against epitope-loaded VLPs were elicited by priming with VLP-pulsed dendritic cells in both HLA-A*0201 transgenic (Tg) mice and peripheral blood lymphocytes from HLA-A2(+)/HBx(+) HBV-infected hepatocellular carcinoma (HCC) patients. The multiepitope peptide-loaded VLPs demonstrated significantly higher immunogenicity in Tg mice than any single responsive epitope. Significant antitumor effects were demonstrated both with primary cultured autologous HCC cells in vitro and tumor-bearing Tg mice in vivo in an HLA-A2-restricted and epitope-specific fashion.The significant antitumor effects both in vivo and in vitro demonstrate the potential of multiepitope peptide-loaded VLPs as a vaccine against HCC.
Invasive Giant Prolactinoma with Loss of Therapeutic Response to Cabergoline: Expression of Angiogenic Markers
Authors: María Susana Mallea-Gil, Carolina Cristina, María Inés Perez-Millan, Ana M. Rodriguez Villafañe, Carolina Ballarino, Graciela Stalldecker, Damasia Becu-Villalobos
Journal: Endocrine Pathology (2009)
Review: New oral factor Xa inhibitors reduce DVT compared with standard thromboprophylaxis after THR or TKR
Authors: Sudeep Shivakumar, James Douketis
Journal: Annals of Internal Medicine (2014)

Source Citation Adam SS, McDuffie JR, Lachiewicz PF, Ortel TL, Williams JW. Comparative effectiveness of novel oral anticoagulants and standard thromboprophylaxis in patients having total hip or knee replacement: a systematic review. Ann Intern Med. 2013;159:275-84. 24026260
Asthma in children: epidemiology
Authors: P D Phelan
Journal: BMJ (1994)

Asthma is one of the commonest childhood illnesses, and its prevalence and severity may be increasing. Determining whether this is so has been difficult, however, because of the lack of a widely accepted epidemiological definition of asthma and an objective measure of asthma that is applicable to children and is reasonably sensitive and specific. Furthermore, many studies purporting to show an increase in prevalence have used different measures and studied far from comparable populations over the period of the suggested increase.

Several valid studies have now reported a substantial increase in the prevalence of asthma in some countries. In 1991 Robertson and colleagues in Melbourne showed a doubling over 26 years, to 46%, in the prevalence of children with wheeze on one or more occasions before the age of 7; 21- 23% had wheezed in the previous 12 months.1 These findings have been confirmed by Peat and colleagues, who studied children aged 8-10 in two country towns in New South Wales (p 1591).2 They found about a doubling over 10 years, to 23-27%, in the prevalence of children reporting wheeze in the previous 12 months. This is not solely an Australian phenomenon - Anderson et al report a more modest increase over 13 years, to 13%, in …
Health, wealth, and politics
Authors: Trish Groves
Journal: BMJ (2008)

The idea that, in a developed country, more equal distribution of wealth is associated with better health is remarkably provocative. Can it be true? Is it a scientific or political theory? Does it have any place in a general medical journal?

The BMJ pitched into this debate more than 10 years ago with a series of articles introduced by Richard Wilkinson, currently professor of social epidemiology in Nottingham (www.bmj.com/cgi/content/full/314/7080/591). Now Tony Blakely and colleagues shed further light on the Wilkinson hypothesis (doi: 10.1136/bmj.39455.596181.25). They examined trends in mortality in a natural experiment in New Zealand during the l980s and 1990s, when economic reforms led …
PLACENTA PRÆVIA, OR TWO CASES OF CENTRALLY IMPLANTED PLACENTAS IN SUCCESSION.
Authors: D. C. DAVIES
Journal: JAMA (1883)

[Read before the Wisconsin State Medical Society September 15, 1883.] By placenta prævia we mean the real position of the placenta and placental seat, it being situated over some portion of the lower segment of the uterus instead of at the fundus or side walls of that viscus. When the placenta is implanted so as to completely cover the internal mouth of the womb, it is called placenta prævia centralis, but when it only dips down to the margin of the os internum it is called placenta prævia lateralis or partialis. It is said that normally the placenta is attached to the fundus or side walls of the womb, and the usual position is to the right or left, generally to the right; but that in certain cases it is growing to that portion close to, or immediately over the internal mouth of the organ which constitutes the abnormal condition
A novel lamin A/C missense mutation in a family with autosomal dominant dilated cardiomyopathy with conduction abnormalities
Authors: Ryuichiro Anan, Hideshi Niimura, Takeshi Sasaki, J.G. Seidman, Christine E. Seidman, Shinichi Minagoe, Chuwa Tei
Journal: Journal of the American College of Cardiology (2002)
Herpes gestationis.
Authors: T. REUNALA, J. KARVONEN, A. TIILIKAINEN, O.P. SALO
Journal: British Journal of Dermatology (1977)

A mother with herpes gestationis and her child without cutaneous lesions had analogous immunohistological findings. In the skin they had deposits of IgG and C3 component of complement at the basement membrane zone. Circulating IgG antibody to the basement membrane was also demonstrated in both. The mother also had a high titre of anti-HLA antibody against a histocompatibility antigen (HLA-B8) present in the child. A possible role of this HLA antibody in the pathomechanism of herpes gestationis is discussed.
Acute hypotension due to platelet serotonin-induced chemoreflexes after intravenous injection of dextran sulfate in the rabbit.
Authors: R C Wiggins, A Glatfelter, A M Campbell, R G Kunkel, R J Ulevitch
Journal: Circulation Research (1985)

The hypotension and bradycardia observed after intravenous injection of dextran sulfate in rabbits was prevented by prior depletion of circulating platelets, but was not prevented by depletion of the third component of complement or Hageman factor. Dextran sulfate injection caused immediate thrombocytopenia with temporary localization of platelets within lungs. Morphological analysis revealed platelet aggregates in lung capillaries. The platelets had changed shape and were in the process of degranulating. Serotonin and histamine levels in blood increased approximately 5-fold and 7-fold, respectively, after dextran sulfate injection. The cardiovascular events following dextran sulfate injection were mimicked by intravenous serotonin but not by intravenous histamine injection, although a combination of serotonin and histamine reproduced the pattern of blood pressure changes better than did either agent alone. Quantification of platelets trapped in lung revealed that the potential release of serotonin from trapped platelets could account for the rise in plasma serotonin concentration and the hemodynamic changes observed. Both the dextran sulfate-induced cardiovascular effects and serotonin-induced hypotension were markedly diminished by cutting vagus and depressor nerves, and were virtually abolished by carotid ligation in addition to nerve section. These results support the concept that platelet activation within rabbit lungs may cause hypotension via serotonin-induced chemoreflexes.
Depression in a Latino Man in New York
Authors: Renato D. Alarcón, María A. Oquendo, Milton L. Wainberg
Journal: American Journal of Psychiatry (2014)

This case illustrates some of the issues that may affect a Latino patient's presentation. Although the patient's constellation of symptoms are classically representative of major depression, the patient also raises themes regarding the process of immigration, subsequent challenges in acculturation and identification with the host culture versus the culture of origin, and culture-specific notions about causes of symptoms. In addition to some of the special features of stigma in Latino cultures, the prominence of physical concerns in the presentation and the use of traditional healers contribute to the complexity of selecting appropriate interventions for this young man.
STUDIES OF LUNG VOLUME
Authors: A. Garvin, Christen Lundsgaard, Donald D. Van Slyke
Journal: The Journal of Experimental Medicine (1918)

1. The total capacity, middle capacity, and residual air have been determined in 31 adult male patients suffering from tuberculosis of the lungs. 2. The chest volumes have been determined in each case and the normal lung volumes calculated by means of the ratios worked out in a previous paper. 3. In nine patients with incipient tuberculosis, the total lung volume was found within normal limits, whereas the vital capacity was diminished as a result of an increased residual air. The increase in the residual air was due to less complete expiration, caused partly by diminished movement of the diaphragm, partly by diminished compression of the chest wall. The diminished movement of the diaphragm was, as a rule, most marked on the most affected side. Whether these decreased movements are due to a reflex or to stiffness of the lung tissue we could not determine. The middle capacity was found practically normal. 4. In twenty-two cases of moderately advanced, and advanced tuberculosis, the total lung volume was in most cases markedly decreased. The vital capacity was substantially decreased, principally as a result of the diminished total capacity. The residual air was, as a rule, normal, although in a few cases an increase in residual air also contributed to the decrease in the vital capacity. The middle capacity, on which we do not want to put too much stress, was normal in some patients and considerably diminished in others.
Expression of cyclooxygenase-2 in human hepatocellular carcinoma: Relevance to tumor dedifferentiation
Authors: Hironori Koga, Shotaro Sakisaka, Masahito Ohishi, Takumi Kawaguchi, Eitaro Taniguchi, Kurumi Sasatomi, Masaru Harada, Taku Kusaba, Masatoshi Tanaka, Rina Kimura, Yutaka Nakashima, Osamu Nakashima, Masamichi Kojiro, Toshihiko Kurohiji, Michio Sata
Journal: Hepatology (1999)

Cyclooxygenase (COX) is a key enzyme in the synthesis of prostanoids. Two isoforms of this enzyme have been identified: COX-1 and COX-2. Recent studies have suggested that COX-2, but not COX-1, may play a role in colorectal tumorigenesis. In the present study, we investigated the expression of COX-2 as well as COX-1 in human hepatocellular carcinoma (HCC) tissues using immunohistochemistry and immunoblotting. Forty-four surgically resected HCC tissues with adjacent nontumorous livers (NTs), involving 17 cases of chronic viral hepatitis and 27 cases of cirrhosis, and 7 surgically resected, histologically normal liver tissues were used. The well-differentiated HCC expressed COX-2 more frequently and strongly than less-differentiated HCC or hepatocytes of NTs. Less-differentiated HCCs expressed less COX-2 than hepatocytes of NTs, which showed scattered, strong COX-2 expression. Histologically normal liver was weakly positive for COX-2. The expression of COX-1 was weaker than that of COX-2 in hepatic neoplastic and non-neoplastic parenchymal cells. An enhanced expression of COX-1 was not observed in well-differentiated HCCs. Immunoblotting also confirmed up-regulation of COX-2, but not COX-1, in well-differentiated HCCs. The present study is the first to demonstrate a high expression of COX-2 in well-differentiated HCC and a low expression in advanced HCC, in contrast to its continuous expression during colorectal carcinogenesis. These findings suggested that COX-2 may play a role in the early stages of hepatocarcinogenesis, but not in the advanced stages, and may consequently be related to HCC dedifferentiation.
Abstract 2357: Prognostic value of placental growth factor expression in patients with metastatic or recurrent non-small cell lung cancer.
Authors: Jung Hoon Kim, Tae Jung Kim, Kyu Sang Lee, Yun Hwa Jung, In Sook Woo, Sook Hee Hong, Chi Wha Han, Jae Kil Park, Jae Ho Byun
Journal: Cancer Research (2013)

Abstract Background: Placental growth factor (PIGF) is a proangiogenic factor, belonging to the VEGF family. It binds to VEGF receptor 1(VEGFR-1) and stimulates the growth, migration and survival of endothelial cells. PIGF also activates and attracts macrophages that release angiogenic molecules. Increased expression of PIGF has correlated with poor survival of patients in several solid tumors. However, PIGF expression is not consistently elevated in all malignancies. No reports on the clinical implications of PIGF expression in metastatic or recurrent non-small cell lung cancer (NSCLC) are currently available. We investigate the clinical significance of PIGF expression in metastatic or recurrent NSCLC. Patients and methods: A retrospective review was done for seventy four patients with metastatic or recurrent NSCLC. Immunohistochemical staining for PIGF and its receptor VEGF-R1, neurophilin-1 was performed. Results: Of 74 patients with NSCLC, 73 patients were positive for PIGF, and 72 patients were positive for neurophilin-1. For PIGF expression, significant correlations were demonstrated with female (p=0.007) and nonsquamous histology (p=0.045). Thirty five patients (47%) were classified into low PIGF expression groups, whereas 38 patients (51%) were grouped as showing high PIGF expression. Survival time for patients with high PIGF expressing NSCLC was significantly longer than that for patients displaying low PIGF expression (median survival time, 15.1 months vs. 9.0 months[log-rank, p=0.01]). However, the difference in time to progression between two groups was not statistically significant (median time to progression, 5.1 months vs. 3.9 months [log-rank, p=0.24]). Conclusions: Low expression of PIGF is associated with poor prognosis in patients with metastatic or recurrent NSCLC. Further studies on larger patients populations are warranted to validate the utility of PIGF as a prognostic biomarker in lung cancer. Citation Format: Jung Hoon Kim, Tae Jung Kim, Kyu Sang Lee, Yun Hwa Jung, In Sook Woo, Sook Hee Hong, Chi Wha Han, Jae Kil Park, Jae Ho Byun. Prognostic value of placental growth factor expression in patients with metastatic or recurrent non-small cell lung cancer. [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 2357. doi:10.1158/1538-7445.AM2013-2357