tbuckley/cabot-search huggingface dataset:
Reactivation of cytomegalovirus in patients with cirrhosis: Analysis of 122 cases
Authors: Shinji Tanaka, Yasushi Toh, Hiroko Minagawa, Ryoichi Mori, Keizo Sugimachi, Yoichi Minamishima
Journal: Hepatology (1992)

Human cytomegalovirus causes severe and often fatal infections in immunocompromised patients. After organ transplantation cytomegalovirus in peripheral blood mononuclear cells is thought to be activated by alloreaction and to spread because of immunosuppression, and it may cause endogenous cytomegalovirus diseases. Patients with cirrhosis, one group of candidates for liver transplantation, often show various grades of immunosuppression before transplantation. To evaluate the status of cytomegalovirus infection in cirrhotic patients and its relevance to the degree of immunosuppression, we examined the presence of cytomegalovirus in mononuclear cells by polymerase chain reaction and immunocytochemical analysis. We studied 122 patients with definite cirrhosis and 43 normal volunteers. All cirrhotic patients (100%) and 40 (93%) of 43 normal controls were seropositive for cytomegalovirus. Cytomegalovirus DNA was detected by polymerase chain reaction in 77 (63.1%) of 122 seropositive cirrhotic patients, but in only 1 (2.5%) of 40 seropositive normal controls (p < 0.01). Cytomegalovirus antigen could not be detected in mononuclear cells by immunocytochemical staining with monoclonal antibodies. Cytomegalovirus DNA—positive patients have a greater impairment of liver function than do cytomegalovirus DNA—negative patients; this fact is manifested by delayed indocyanine green retention rates and elevated serum bilirubin levels (p < 0.05). Lymphocyte proliferative response induced by phytohemagglutinin and natural killer cell activity were also significantly lower in cytomegalovirus DNA—positive patients as compared with cytomegalovirus DNA—negative patients (p < 0.01). Our data suggest that the reactivation of cytomegalovirus may have already occurred in patients with cirrhosis before transplantation.
sn-1,2-Diacylglycerols and phorbol diesters stimulate thromboxane synthesis by de novo synthesis of prostaglandin H synthase in human promyelocytic leukemia cells.
Authors: M Goerig, A J Habenicht, R Heitz, W Zeh, H Katus, B Kommerell, R Ziegler, J A Glomset
Journal: Journal of Clinical Investigation (1987)

We studied the regulation of thromboxane (TX) synthesis in promyelocytic leukemia cells during macrophage differentiation. Cells treated with 12-O-tetradecanoylphorbol-13-acetate (TPA) showed rates of TXB2 synthesis from exogenous arachidonic acid that exceeded that of control cells by a factor of up to 81. Cells treated with sn-1,2-dioctanoylglycerol (diC8) showed similarly high TXB2 synthesis rates when diC8 was added concomitantly with a subthreshold concentration of TPA or when given in multiple doses. These activities depended on de novo synthesis of prostaglandin H (PGH) synthase because: microsomal PGH synthase activity showed large increases in Vmax values, and mass measurements of PGH synthase revealed the presence of PGH synthase in differentiating cells whereas the enzyme was undetectable in control cells. These results indicate that macrophage differentiation is associated with stimulation of TXB2 synthesis that requires both activation of protein kinase C and de novo synthesis of PGH synthase.
HIV-Specific T-Helper Activity in Seronegative Health Care Workers Exposed to Contaminated Blood
Authors: Mario Clerici, James M. Levin, Harold A. Kessler, Alan Harris, Jay A. Berzofsky, Alan L. Landay, Gene M. Shearer
Journal: JAMA (1994)

To evaluate human immunodeficiency virus (HIV) type 1-specific cellular immune responses in HIV-seronegative health care workers with occupational high-risk exposures to HIV-infected (HIV-positive) patients.Peripheral blood mononuclear cells (PBMCs) were obtained after occupational exposures to HIV, and PBMCs from health care workers exposed to HIV-negative patients served as controls. The PBMCs were stimulated in vitro with HIV envelope synthetic peptides. Interleukin 2 (IL-2) production was measured in a bioassay. The HIV antibody status was determined by standard enzyme-linked immunosorbent assays. Exposed individuals were also evaluated for HIV proviral DNA by polymerase chain reaction techniques.The PBMCs from eight health care workers with high-risk exposures and nine control health care workers were studied.The PBMCs from all individuals showed strong IL-2 production to control antigens, indicating intact T-helper function. Interleukin 2 production to HIV peptides was detected in PBMCs from six of eight HIV-exposed individuals, but in only one of the nine health care workers exposed to HIV-negative body fluids (P < .008). None of the HIV-exposed health care workers became infected as determined by negative HIV antibody and polymerase chain reaction analysis after follow-up evaluation that ranged from 8 to 64 weeks.Human immunodeficiency virus-specific T-helper activity was detected in six (75%) of eight HIV-negative health care workers with exposure to HIV-positive body fluids. Potent HIV-specific T-helper activity was detectable 4 to 8 weeks after the exposure and was lost in individuals followed up for 8 to 64 weeks. Three health care workers remained responsive at 8, 19, and 24 weeks. Exposure to HIV without evidence of subsequent infection appears to result in activation of cellular immunity without activation of antibody production.
Periodontal Microbiota and Carotid Intima-Media Thickness
Authors: Moïse Desvarieux, Ryan T. Demmer, Tatjana Rundek, Bernadette Boden-Albala, David R. Jacobs, Ralph L. Sacco, Panos N. Papapanou
Journal: Circulation (2005)

Background— Chronic infections, including periodontal infections, may predispose to cardiovascular disease. We investigated the relationship between periodontal microbiota and subclinical atherosclerosis. Methods and Results— Of 1056 persons (age 69±9 years) with no history of stroke or myocardial infarction enrolled in the Oral Infections and Vascular Disease Epidemiology Study (INVEST), we analyzed 657 dentate subjects. Among these subjects, 4561 subgingival plaque samples were collected (average of 7 samples/subject) and quantitatively assessed for 11 known periodontal bacteria by DNA-DNA checkerboard hybridization. Extensive in-person cardiovascular risk factor measurements, a carotid scan with high-resolution B-mode ultrasound, white blood cell count, and C-reactive protein values were obtained. In 3 separate analyses, mean carotid artery intima-media thickness (IMT) was regressed on tertiles of (1) burden of all bacteria assessed, (2) burden of bacteria causative of periodontal disease (etiologic bacterial burden), and (3) the relative predominance of causative/over other bacteria in the subgingival plaque. All analyses were adjusted for age, race/ethnicity, gender, education, body mass index, smoking, diabetes, systolic blood pressure, and LDL and HDL cholesterol. Overall periodontal bacterial burden was related to carotid IMT. This relationship was specific to causative bacterial burden and the dominance of etiologic bacteria in the observed microbiological niche. Adjusted mean IMT values across tertiles of etiologic bacterial dominance were 0.84, 0.85, and 0.88 ( P =0.002). Similarly, white blood cell values increased across tertiles of etiologic bacterial burden from 5.57 to 6.09 and 6.03 cells ×10 9 /L ( P =0.01). C-reactive protein values were unrelated to periodontal microbial status ( P =0.82). Conclusions— Our data provide evidence of a direct relationship between periodontal microbiology and subclinical atherosclerosis. This relationship exists independent of C-reactive protein.
Increased thrombin levels during thrombolytic therapy in acute myocardial infarction. Relevance for the success of therapy.
Authors: D C Gulba, M Barthels, M Westhoff-Bleck, S Jost, W Rafflenbeul, W G Daniel, H Hecker, P R Lichtlen
Journal: Circulation (1991)

BACKGROUND It has been suggested that thrombolysis in a feedback reaction may generate pro-coagulant activities. METHODS AND RESULTS Fifty-five patients were treated with urokinase-preactivated prourokinase (n = 35) or tissue-type plasminogen activator (n = 20) for acute myocardial infarction and underwent coronary angiography at 90 minutes and at 24-36 hours into thrombolysis, and fibrinogen (Ratnoff-Menzie), D-dimer (ELISA) and thrombin-antithrombin III complex levels (ELISA) were measured. Primary patency was achieved in 39 patients (70.9%), 13 of whom (33.3%) suffered early reocclusion. Nonsignificant decreases in fibrinogen levels were observed while D-dimer levels increased +3,008 +/- 4,047 micrograms/l (p less than 0.01), differences not being significant in respect to the thrombolytic agents or to the clinical course. In contrast, while thrombin-antithrombin III complex levels decreased -4.4 +/- 13.0 micrograms/l in patients with persistent patency, they increased +7.5 +/- 13.6 micrograms/l in case of nonsuccessful thrombolysis (p less than 0.02) and +11.9 +/- 23.8 micrograms/l in case of early reocclusion (p less than 0.001). For patients with thrombin-antithrombin III complex levels greater than 6 ng/l 120 minutes into thrombolysis, the unfavorable clinical course was predicted with 96.2% sensitivity and 93.1% specificity. CONCLUSION Generation of thrombin, occurring during thrombolysis, is a major determinant for the success of therapy and thrombin-antithrombin III levels may serve as predictors for the short-term prognosis.
Additional Prognostic Value of Bone Marrow Histology in Patients Subclassified According to the International Prognostic Scoring System for Myelodysplastic Syndromes
Authors: E. Verburgh, R. Achten, B. Maes, A. Hagemeijer, M. Boogaerts, C. De Wolf-Peeters, G. Verhoef
Journal: Journal of Clinical Oncology (2003)

The most recent and powerful prognostic instrument established for myelodysplastic syndromes (MDS) is the International Prognostic Scoring System (IPSS), which is primarily based on medullary blast cell count, number of cytopenias, and cytogenetics. Although this prognostic system has substantial predictive power in MDS, further refinement is necessary, especially as far as lower-risk patients are concerned. Histologic parameters, which have long proved to be associated with outcome, are promising candidates to improve the prognostic accuracy of the IPSS. Therefore, we assessed the additional predictive power of the presence of abnormally localized immature precursors (ALIPs) and CD34 immunoreactivity in bone marrow (BM) biopsies of MDS patients.Cytogenetic, morphologic, and clinical data of 184 MDS patients, all from a single institution, were collected, with special emphasis on the determinants of the IPSS score. BM biopsies of 173 patients were analyzed for the presence of ALIP, and CD34 immunoreactivity was assessable in 119 patients. Forty-nine patients received intensive therapy.The presence of ALIP and CD34 immunoreactivity significantly improved the prognostic value of the IPSS, with respect to overall as well as leukemia-free survival, in particular within the lower-risk categories. In contrast to the IPSS, both histologic parameters also were predictive of outcome within the group of intensively treated MDS patients.Our data confirm the importance of histopathologic evaluation in MDS and indicate that determining the presence of ALIP and an increase in CD34 immunostaining in addition to the IPSS score could lead to an improved prognostic subcategorization of MDS patients.
896 INHIBITORY MECHANISM OF PEPTIDE POOLS ON THE PROLIFERATION OF ANTIGEN-SPECIFIC CD8+ T CELLS
Authors: P.V. Suneetha, V. Schlaphoff, C. Wang, K.A. Stegmann, P. Fytili, S.K. Sarin, M.P. Manns, M. Cornberg, H. Wedemeyer
Journal: Journal of Hepatology (2009)
Visual outcome of a cohort of children with neurofibromatosis type 1 and optic pathway glioma followed by a pediatric neuro-oncology program
Authors: Paola Dalla Via, Enrico Opocher, Maria Luisa Pinello, Milena Calderone, Elisabetta Viscardi, Maurizio Clementi, Pier Antonio Battistella, Anna Maria Laverda, Liviana Da Dalt, Giorgio Perilongo
Journal: Neuro-Oncology (2007)

We evaluated the visual outcome of a cohort of children with neurofibromatosis type 1 (NF1) and optic pathway glioma (OPG) treated according to standardized therapeutic guidelines. The study population consisted of all consecutive patients with NF1 and OPG referred to a specialized pediatric neuro-oncology program between 1994 and 2004. Treatment was instituted only in cases of progressive disease or clinical deterioration. Treatment modalities were chemotherapy (based on vincristine/carboplatin) for children younger than 5 years and radiotherapy for all others. Ten boys and 10 girls (seven with a positive family history) entered the trial (median age at diagnosis of OPG, 29 months). At a median follow-up time of 78 months, seven patients had been treated with chemotherapy only, four with radiotherapy, and four with chemotherapy plus radiotherapy. Five patients were observed only. Currently, 18 are alive and two have died. Eight patients were treated for progressive visual loss in the face of stable disease, five for tumor volume increase without visual deterioration, and two for symptomatic tumor volume increase. At referral, six children had a visual acuity (VA) of < 30% in both eyes; eight children had 100% VA bilaterally. At referral, the visual field (VF) could be assessed in three children: One had VF loss in both eyes, one had VF loss in one eye, and one had normal VF. At last follow-up, eight children had VA < 20% in both eyes; only two children had 100% VA in both eyes. Among 11 children who had some visual function, three had VF loss in one eye and three in both eyes, and five had an intact VF. Contrast and color sensitivity were abnormal in seven and six patients, respectively. Thirteen children fell into the WHO hypovision category. In summary, among the 15 children treated, one had a definitive and two a mild improvement in VA. In conclusion, the visual outcome of this selected cohort of NF1 patients with OPG is unsatisfactory. A critical reappraisal of the therapeutic strategy adopted is needed.
IMPACT OF CMS COVERAGE DECISION ON ACCESS TO TRANSCATHETER AORTIC VALVE REPLACEMENT
Authors: Brian O'Neill, William O'Neill, Donald Williams, Mauricio Cohen, Alan Heldman, Claudia Martinez, Carlos Alfonso, Pedro Martinez–Clark, Mauro Moscucci, Omaida Velazquez, David Seo, Pascal Goldschmidt–Clermont
Journal: Journal of the American College of Cardiology (2013)
STUDIES ON THE COMBINED USE OF MEASUREMENTS OF SWEAT ELECTROLYTE COMPOSITION AND RATE OF SWEATING AS AN INDEX OF ADRENAL CORTICAL ACTIVITY 1
Authors: William Locke, Nathan B. Talbot, Helen S. Jones, Jane Worcester
Journal: Journal of Clinical Investigation (1951)

that the concentration of chloride or sodium in thermal sweat can be used as an index of that function of the adrenal cortex concerned primarily with electrolyte metabolism, studies concerning the factors which are related to or influence the electrolytic composition of sweat have gained greatly in significance. In the past, several investigators have obtained data which suggested that the concentration of chloride in sweat is positively correlated with the rate of sweating (3, 4) and skin temperature (5). However, the relations of these variables to sweat electrolyte composition have never been defined with precision nor have they been studied in connection with the effect of adrenal cortical activity on the composition of sweat. The present paper is concerned initially with studies which show that certain non-endocrine factors play a major role in the determination of sweat electrolyte composition. A method for taking these factors into consideration in the utilization of sweat electrolyte measurements as an index of hormonal activity is described. Finally investigations of adrenal cortical function based on this newly developed index are presented.
Role of Plasma Proteins in the Binding, Distribution and Metabolism of the Thyroid Hormones
Authors: Jack H. Oppenheimer
Journal: New England Journal of Medicine (1968)

ALTHOUGH it has been recognized for many years that thyroxine is tightly associated with plasma proteins little attention was paid to this phenomenon until the discovery, in 1952, of thyroxine-binding globulin (TBG) by three groups of investigators working independently of each other.1 2 3 Subsequently, Ingbar4 described thyroxine-binding prealbumin (TBPA). These proteins together with serum albumin participate in the peripheral transport of the thyroid hormones. The concept of a multiple equilibrium between thyroxine bound to the plasma proteins and thyroxine in the unbound or "free" state was extensively developed by Robbins and Rall.5 These investigators suggested that the concentration of free thyroxine, . . .
Practice nurses and antismoking education.
Authors: D J Sanders, V Stone, G Fowler, J Marzillier
Journal: BMJ (1986)

A questionnaire on antismoking activities and education was sent to 369 nurses in general practice. The response rate was 80%. Although most of the nurses sometimes advised patients about smoking, routine antismoking education occurred less frequently. Only a few regularly referred smokers to other agencies for help, recommended aids to stop smoking, or used antismoking literature. Although the nurses thought that they had an important role in helping smokers to give up, they expressed little confidence in their effectiveness, believing that advice from the general practitioner and the smoker's personal determination to give up have more impact. The nurses expressed a need for training in antismoking education. Seventy seven per cent were interested in attending seminars and listed information about smoking, techniques for stopping, and counselling skills as priorities. If practice nurses are to use opportunities in primary care to help smokers there is clearly a need to provide further training and to establish the effectiveness of nurses in their role as smoking educators.
Acromegaly Secondary to Growth Hormone-releasing Hormone Secreted by an Incidentally Discovered Pheochromocytoma
Authors: L. Vieira Neto, G. F. Taboada, L. L. Corrêa, J. Polo, A. F. Nascimento, L. Chimelli, K. Rumilla, M. R. Gadelha
Journal: Endocrine Pathology (2007)
A National Health Program
Authors: J. D. McDougall
Journal: JAMA (1990)

<h3>To the Editor.—</h3> The commentary on a national health plan by Drs Woolhandler and Himmelstein was very interesting.<sup>1</sup>It was, however, simplistic and perhaps naive. I have both a personal and a business overview of the American health care provision systems. In addition, after 15 years in private practice in Canada, I believe I know our system well. There is no doubt that America spends too much on health care and has an unwieldy bureaucracy to contend with. There is also no doubt that this increased expenditure does not translate into increased wellness or better mortality and morbidity rates. Changes to America's health care provision systems are overdue and inevitable. The authors of this commentary have suggested a "single tax-funded comprehensive insurer." Presently, in Canada, this insurer is government, which, I assume, would also be Drs Woolhandler and Himmelstein's choice. There is no doubt that this national health program
Antigranulocyte Bone Marrow Scans in Pagetʼs Disease
Authors: G Torres, L Berná, I Carrió, M Estorch, C Díaz, J Farrerons
Journal: Clinical Nuclear Medicine (1994)

Paget's disease of bone is a disorder of bone remodeling in which excessive production of structurally abnormal bone occurs, with the primary and fundamental abnormality residing in the osteoclast. To evaluate further the jeopardized bone marrow in Paget's disease, the authors studied 29 skeletal lesions by means of conventional bone imaging and antigranulocyte antibody bone marrow imaging in eight consecutive patients affected by Paget's disease. Bone scans showed abnormal tracer uptake in the 29 skeletal sites (11 pelves, 10 vertebrae, 5 extremities, 2 skulls, and 1 rib). Antigranulocyte antibody bone marrow scans showed decreased uptake of radiopharmaceutical in 16 (55%) of those 29 areas (8 pelves, 7 vertebrae, and 1 rib). Lesions appeared to be more extensive on bone scans than on bone marrow scans. It was concluded that antigranulocyte bone marrow scans may show focal defects in hematopoietic bone marrow in patients with Paget's disease. Paget's disease affects the cortical bone more severely than the bone marrow.
Carbohydrate Reserves in the Newborn Infant
Authors: H. J. Shelley
Journal: BMJ (1964)

<b>Objective.</b> To design and evaluate the use of simulations in preparing students to identify and reduce medication errors and promote patient safety. <b>Methods.</b> Third-year pharmacy students used methods of root cause analysis (RCA) to determine the cause of a medication error in three simulated pharmacy settings. Before and after the activity, students completed an anonymous survey. They also completed a modified Healthcare Professionals Patient Safety Assessment instrument to measure changes in their knowledge, skills, and attitudes. <b>Results.</b> Ninety out of 165 students submitted complete data sets for analysis. Students demonstrated significant changes in knowledge, skills, and attitudes regarding medication errors. They felt they could find the cause of an error, identify factors leading to an error, and work with a team to prevent error recurrence. They also demonstrated an increase in knowledge about medication-related errors and the root cause analysis process. <b>Conclusion.</b> Students used RCA methods to discover medication errors in three simulated pharmacy settings. Students improved their knowledge, skills, and attitudes regarding medication errors through this process.
Phase II Randomized Trial of Temozolomide and Concurrent Radiotherapy in Patients With Brain Metastases
Authors: D. Antonadou, M. Paraskevaidis, G. Sarris, N. Coliarakis, I. Economou, P. Karageorgis, N. Throuvalas
Journal: Journal of Clinical Oncology (2002)

To determine the efficacy, tolerability, and safety of concurrent temozolomide and radiotherapy in patients with previously untreated brain metastases.Fifty-two patients with brain metastases from solid tumors were randomized to oral temozolomide (75 mg/m(2)/d) concurrent with 40-Gy fractionated conventional external-beam radiotherapy (2 Gy, 5 d/wk) for 4 weeks versus 40-Gy radiotherapy alone. The group receiving temozolomide and radiotherapy continued temozolomide therapy (200 mg/m(2)/d) for 5 days every 28 days for an additional six cycles. The primary end points were radiologic response and neurologic symptom evaluation.The objective response rate was significantly (P =.017) improved in patients receiving temozolomide and radiotherapy versus radiotherapy alone. Among 24 patients assessable for response in the temozolomide group, 23 (96%) of 24 responded, including nine (38%) patients with a complete response and 14 (58%) patients with a partial response. With radiotherapy alone, 14 (67%) of 21 assessable patients responded, including seven (33%) complete responses and seven (33%) partial responses. There was marked neurologic improvement in the group receiving temozolomide, and the proportion of patients requiring corticosteroids 2 months after treatment was lower in the temozolomide group compared with radiotherapy alone (67% v 91%, respectively). Daily temozolomide concurrent with radiotherapy was generally well tolerated; however, grade >or= 2 nausea (48% v 13%, P =.13) and vomiting (32% v 0%, P =.004) were significantly increased in the temozolomide group. Hematologic toxicity was predictable and reversible.Temozolomide is safe, and a significant improvement in response rate was observed when administered in combination with radiotherapy in patients with previously untreated brain metastases. A larger randomized trial is warranted to verify these results.