tbuckley/cabot-search huggingface dataset:
Clara Cell Protein (CC16) in Pleural Fluids
Authors: C. HERMANS, O. LESUR, B. WEYNAND, TH. PIETERS, M. LAMBERT, A. BERNARD
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

Pleural fluid (PF) proteins either derive from serum by diffusion or are locally secreted within the pleural space. Another hypothetical origin is a leakage of lung secretory proteins across the visceral pleura. To test this hypothesis, we investigated the occurrence, sources, and determinants in PF of CC16, a small-size and readily diffusible protein of 16 kDa secreted by bronchiolar Clara cells. CC16 concentration was determined by a sensitive latex immunoassay in serum and PF of 117 subjects (86 exudates and 31 transudates) and, for purpose of comparison, in ascites samples from another group of 38 subjects (7 exudates and 31 transudates). CC16 was also studied in serum and PF of normal rats and in rats with pleural exudate induced by α -naphthyl-thiourea (ANTU). The levels of CC16 in PF and ascites were highly correlated with that in serum, suggesting a diffusional exchange across the pleural/blood and peritoneal/blood barriers. Whereas CC16 occurs at similar levels in ascites and serum, the protein was found to be more concentrated in PF than in serum in both humans (geometric mean in μ g/L, 26.2 versus 14.6, p < 0.0001) and rats (213 versus 16.2, p < 0.001). A local synthesis of CC16 appeared unlikely in view of the lack of CC16-immunostaining in pleura of both species. The only plausible explanation for these findings is that CC16 in PF originates from two sources: diffusion from plasma and a leakage from the lung into the pleural space across the semipermeable visceral pleura. This interpretation is supported by a markedly increased leakage of CC16 in experimental exudates induced by ANTU and the finding of high CC16 concentrations in human transudates associated with congestive heart failure, two conditions wherein PF has been shown to arise from the interstitial spaces of the lung.
Unusual clinical variants of cutaneous leishmaniasis in Pakistan
Authors: Khalid M. Raja, None Khan, None Hameed, None Ber Rahman
Journal: British Journal of Dermatology (1998)

Cutaneous leishmaniasis is endemic in the Baluchistan province of Pakistan and poses a great risk to non-immune visitors to the area. The wide spectrum of clinical variants of this common disease is at times a diagnostic challenge. A total of 1709 patients with cutaneous leishmaniasis were recorded over a 1-year period. In 37 (2%) patients the lesions were very unusual, and therefore worth reporting. These included acute paronychial, chancriform, annular, palmoplantar, zosteriform and erysipeloid forms. The zosteriform and erysipeloid forms have rarely been reported previously, but to the best of our knowledge, acute paronychial, chancriform, annular and palmoplantar lesions are being reported for the first time. The morphologically unusual lesions may be attributed to an altered host response or involvement of an atypical strain of parasite in these lesions.
Influence of coronary heart disease on morbidity and mortality after lower extremity revascularization surgery: A population-based study in Olmsted County, Minnesota (1970–1987)
Authors: Michael E. Farkouh, Charanjit S. Rihal, Bernard J. Gersh, Thom W. Rooke, John W. Hallett, W.Michael O'Fallon, David J. Ballard
Journal: Journal of the American College of Cardiology (1994)

Objectives. The aim of this study was to evaluate the short- and long-term postoperative cardiac outcome of patients undergoing lower extremity revascularization surgery in a geographically defined patient group. Background. Among patients with peripheral vascular disease, cardiac events have an important effect on long-term outcome after peripheral vascular surgery. However, long-term outcome is poorly documented. Methods. We examined the entire community medical records of 173 residents of Olmsted County, Minnesota, who underwent peripheral artery bypass surgery between 1970 and 1987 and were followed up to January 1, 1991. Patients were allocated to subgroups of 60 patients with and 106 patients without overt coronary artery disease. Results. There were no siginificant differences in perioperative death, myocardial infarction or stroke between subgroups at 30 days after operation. The 5- and 10-year Kaplan-Meier survival rate after operation was 77% and 51% in those without and 54% and 24% in those with overt coronary artery disease (p < 0.001), respectively. For both groups, survival was significantly poorer than that expected for an age- and gender-matched group. Patients undergoing aortoiliac surgery were more likely to be alive at 10 years than those undergoing femoropopliteal surgery (47% vs. 28%, p = 0.001). The 5-year cumulative incidence of cardiac events was greater in those with overt coronary artery disease (10% vs. 28%, p = 0.003). In multivariable analysis, age, coronary artery disease and diabetes were independent predictors of death. Conclusions. Coronary events are the most important cause of long-term morbidity and mortality after peripheral vascular surgery. Patients without overt coronary artery disease are at significant risk for long-term cardiac events.
Raised cord serum immunoglobulin E increases the risk of allergic sensitisation at ages 4 and 10 and asthma at age 10
Authors: A Sadeghnejad
Journal: Thorax (2004)

Evidence suggests that a raised level of cord serum IgE (CS-IgE) is a risk factor for allergic sensitisation. However, whether CS-IgE is a risk for asthma is controversial. A study was undertaken to investigate the association between CS-IgE levels and allergic sensitisation at 4 and 10 years of age and asthma at ages 1-2, 4 and 10.CS-IgE was available for 1358 of 1456 children born between 1989 and 1990. The cohort was evaluated for allergic diseases at ages 1, 2, 4 and 10 years. Skin prick tests for six allergens were performed on 981 children at age 4 and 1036 at age 10. Asthma was defined based on a physician's diagnosis. Using logistic regression analysis, the risk of asthma and allergic sensitisation for raised levels of CS-IgE (> or =0.5 kU/l) was estimated.At ages 4 and 10 years 20.2% and 27.0% of children, respectively, had allergic sensitisation. The risk of allergic sensitisation was significantly associated with raised CS-IgE levels at ages 4 (OR 2.29) and 10 years (OR 1.73). The prevalence of asthma was 10.3% at age 1-2, 15.2% at age 4, and 12.8% at age 10. CS-IgE was not associated with asthma at age 1-2 and 4 but showed an increased relative risk at age 10 (OR 1.66, 95% CI 1.05 to 2.62). The association was stronger in children who did not develop allergic sensitisation at age 4 or 10 (OR 3.35, 95% CI 1.41 to 7.93).Raised cord serum IgE is a risk factor for allergic sensitisation at ages 4 and 10 years. This is the second study suggesting that CS-IgE is also a risk factor for asthma at age 10, probably related to the late onset of asthma. This association is not necessarily mediated by allergic sensitisation.
MicroRNA-146a regulates survival and maturation of human plasmacytoid dendritic cells
Authors: Julien J. Karrich, Loes C. M. Jachimowski, Marion Libouban, Anand Iyer, Kim Brandwijk, Esther W. Taanman-Kueter, Maho Nagasawa, Esther C. de Jong, Christel H. Uittenbogaart, Bianca Blom
Journal: Blood (2013)
A CASE OF BLASTOMYCOSIS WITH LARYNGEAL INVOLVEMENT
Authors: E. D. Downing
Journal: JAMA (1918)

This case is reported because the primary lesion, as far as could be determined, was in the larynx, and treatment with potassium iodid, and later with Koga's "cyanocuprol," failed to stop the progress of the disease. <h3>History.</h3> —A man (Case 2960, Modern Woodman Sanatorium), aged 37, laborer in a grain elevator in Kansas, was sent to the sanatorium with a diagnosis of tuberculous laryngitis. His family physician noted on the admission application that the patient had no definite lung trouble and that tubercle bacilli had not been found. In August, 1916, the patient cleaned out some old wood from the bottom of the grain elevator shaft. A few days after this, he developed a severe cold and tonsillitis which "settled" in his larynx. He coughed and sneezed during this attack, but did not raise any sputum. He continued work in the elevator until Oct. 15, 1916, when he had to
Parents' Understanding of Genetic Risk Data in Genetic Counseling
Authors: David W. Garrison
Journal: JAMA (1978)

<h3>To the Editor.—</h3> Relatively little has been published on the parents' ability to grasp the importance of empirical risk data and Mendelian-type probabilities. Check (240:819,1978) cites the noteworthy articles to date. Unpublished data that I have collected involving 38 families with living cystic fibrotic children reflect the same type of results obtained by Leonard et al<sup>1</sup>and Carter et al.<sup>2</sup>Obtaining information only from the biological mothers, since 29% had been divorced, I found that when asked the probability of having another affected child with cystic fibrosis, 23% gave a correct response, 58% gave an incorrect response, and 19% said they did not know. Overall, 77% do not know the probability of having another affected child. As pointed out by Check, the level of uncertainty varies from one genetic disease to another. The basic problem is that for many reasons, consumers do not know what the recurrent risks
THE USE OF INFRA-RED LIGHT THERAPY
Authors: Frank Thomas Woodbury
Journal: JAMA (1924)

<h3>To the Editor:</h3> —The publication of a number of imitation medical journals by commercial firms prompts me to comment on one which urges us to believe that infra-red therapy is something special and to be obtained in its most efficient form only by using a special and expensive generator of these rays. All heated substances give off electromagnetic radiations. The hotter they are, the greater the total volume of radiation and the greater the proportion of infra-red rays, although the smaller wave lengths increase more rapidly until we get luminous rays and finally incandescence. The fact that the rays are visible or invisible is unimportant from a therapeutic point of view. The important point is that such radiations penetrate tissue directly as the wave length and wattage and indirectly as the square of the distance and the angle of obliquity from the vertical. Luminous rays are reflected from white skins.
A review of 436 cases of intestinal obstruction in Ibadan
Authors: G. J. Cole
Journal: Gut (1965)

EDITORIAL SYNOPSIS The pattern of intestinal obstruction differs remarkably in various parts of the world, and this is a study of the surgical experience in Ibadan where intussusception is a parti- cularly common cause.In Ghana, only 400 miles away to the west, the high incidence of intus- susception is not found but is replaced by volvulus of the sigmoid colon.Such studies will be of importance ultimately in unravelling the different aetiologlcal mechanisms which may predispose towards obstruction.
How to Use Electronic Health Records to Achieve the Quadruple Aim
Authors: James B. Couch
Journal: JAMA Internal Medicine (2013)

I applaud the Research Letter by Quinn et al. 1 It provides a welcome counterpoint to previous reports raising fears that electronic health records (EHRs) may result in increased errors and patient injury. My colleagues at Princeton Insurance Company and I undertook a comprehensive study to determine what care gaps most often associated with litigation could be minimized by the appropriate use of EHRs and their safetyenhancing functionalities. We analyzed 7000 closed and open claims over a 6-year period at Princeton Insurance Company. The Harvard Risk Management Foundation provided coding books and trained abstractors to identify hundreds of potential care gaps associated with these lawsuits. These care gaps were grouped into 4 broad categories of errors that could be addressed by the appropriate use of EHRs: clinical judgment errors; communication gaps (between physicians and patients and between physicians and other health care providers); documentation discrepancies (as to the mechanics and sufficiency of documentation); and office systems deficiencies (concerning tracking of patients’ tests ordered, results, and follow-up). We interviewed in person top executives from 5 leading EHR companies and had them submit hundreds of screen shots to demonstrate how appropriate use of their products could address these most common care gaps associated with litigation. On site, we interviewed physicians and practice managers using these products to validate these companies’ claims. For further validation, we interviewed defense attorneys who represented physicians in cases, where appropriate use of EHRs was at issue. We compiled all this information into a guide concerning how to use EHRs to improve quality, while minimizing the risks of patient injury and litigation. We are confident that as health care providers implement EHRs throughout the remainder of this decade, using all of the safety enhancing functionalities of these products will result in their meeting the quadruple aim of improving care, enhancing population health, decreasing costs, and minimizing litigation.
NICE: faster access to modern treatments? Analysis of guidance on health technologies
Authors: J. Raftery
Journal: BMJ (2001)

The National Institute for Clinical Excellence (NICE) was set up as a special health authority for England and Wales in 1999. Its role is to provide patients, health professionals, and the public with authoritative, robust, and reliable guidance on current “best practice.” It has three main functions: to appraise new technologies, to produce or approve guidelines, and to encourage improvement in quality. NICE was first announced in the new Labour government's white paper The New NHS .1 As a special health authority it is part of the Department of Health. NICE marks an innovation internationally in that while some other countries have bodies to provide advice on which new health technologies to use, NICE is the first national body with power to issue guidance covering the full range of health technologies.2 Guidance from NICE applies to the NHS in the same way as guidance from other parts of the Department of Health; while health authorities are required by statute to take account of but not necessarily follow guidance, general practitioners have greater discretion.3

#### Summary points

Of the 22 health technologies on which NICE had issued guidance by March 2001, it recommended against use in three (with a change of judgment on zanamivir)

The guidance recommending use of the 19 other health technologies cited clinical benefit in all instances but could cite cost per QALY in only around half

Restrictions on the recommended use of most health technologies (for instance, in most severely ill patients) helped keep the cost per QALY below around £30 000, with only one exception—riluzole for motor neurone disease, which had a cost per QALY of £34 000 to £44 000

NICE's provisional recommendation against the use of beta interferons or glatiramer acetate for multiple sclerosis cited its high cost per QALY in relation to technologies …
Defective alpha-polymerization in the conversion of fibrinogen Baltimore to fibrin.
Authors: C H Brown, M F Crowe
Journal: Journal of Clinical Investigation (1975)

The subunit structure of fibrinogen Baltimore and fibrin formed from this inherited dysfibrinogenemia was analyzed by polyacrylamide gel electrophoresis in sodium dodecyl sulfate. The molecular weights of the alpha-, b- and gamma-chains of fibrinogen Baltimore were found to be identical to those of normal fibrinogen. Noncross-linked fibrin formed from both purified fibrinogen Baltimore as well as normal fibrinogen contained two alpha-monomers (alpha1 and alpha2). alpha2 was presumed to be alpha-monomer from which fibrinopeptide A had been released. The evolution of alpha2 during clotting of fibrinogen Baltimore was delayed and appeared to be quantitatively reduced when compared to normal. Crosslinked fibrin formed from fibrinogen Baltimore possessed an abnormal subunit structure. alpha-polymers were not generated in thrombin-induced, factor XIII-rich clots of fibrinogen Baltimore under conditions of pH and calcium concentration suitable for complete alpha-polymerization in normal fibrin. If clotting was carried out with calcium concentrations twice that required for normal clots or at pH 6.4, fibrin from fibrinogen Baltimore was completely cross-linked. These structural analyses of fibrin formed from fibrinogen Baltimore substantiate earlier findings that indicate a defect in the alpha-chain of this dysfibrinogenemia.
Location of Adrenal Medullary Pheochromocytoma By l-123 Metaiodobenzylguanidine SPECT
Authors: JØRN T. NIELSEN, BENTE V. NIELSEN, MICHAEL REHLING
Journal: Clinical Nuclear Medicine (1996)

This is a retrospective study evaluating the efficacy of SPECT in the location of pheochromocytoma. Thirty patients with a suspected pheochromocytoma underwent I-123 metaiodobenzylguanidine (I-123 MIBG) SPECT 4 and 22 hours after intravenous injection of 370 MBq I-123 MIBG. SPECT was compared with planar scintigraphy, CT scanning, histology, and clinical course. Twenty-two-hour I-123 MIBG SPECT correctly identified 10 patients with adrenal medullary pheochromocytoma and correctly excluded pheochromocytoma in 19 patients. The sensitivity of the 22-hour MIBG SPECT was 1.00 and the specificity was 0.95. The positive predictive value was 0.95 and the negative predictive value was 1.00. In 16 patients, planar scintigraphy was compared with SPECT. SPECT located normal adrenal glands and tumors with greater confidence in three dimensions, but the patients with adrenal medullary pheochromocytoma were all correctly identified by planar scintigraphy. The results of SPECT and CT agreed in 29 of 30 patients (96.7%). I-123 MIBG SPECT for the location of pheochromocytoma has a high sensitivity, specificity, and positive and negative predictive values. I-123 MIBG SPECT or CT scanning alone were equally good for locating adrenal medullary pheochromocytoma but the combination of MIBG SPECT and CT makes it possible to distinguish between functioning and nonfunctioning adenomas. I-123 MIBG SPECT may be used alone or in combination with planar scintigraphy when three-dimensional location of a lesion is wanted.
Hypolipidemic Drugs in Coronary Artery Disease
Authors: Richard C. Pasternak
Journal: Annals of Internal Medicine (1997)

Letters1 June 1997Hypolipidemic Drugs in Coronary Artery DiseaseRichard C. Pasternak, MD and Frank M. Sacks, MDRichard C. Pasternak, MDHarvard Medical School, Boston, MA 02114Search for more papers by this author and Frank M. Sacks, MDHarvard Medical School, Boston, MA 02114Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-11-199706010-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate the comments of Drs. Isley and Bittar. Both are correct in pointing out an error in our citation of the work of Stein and colleagues [1], which, in fact, compared simvastatin with cholestyramine and did not study the combination of the two drugs. We regret the misunderstanding.With regard to Dr. Isley's other comments, we recognize that simvastatin is, in general, more potent than the statins that we had available at the time our study began. However, at the 40-mg pravastatin dose, the incremental effect of 40 mg of simvastatin on LDL cholesterol levels would be ...References1. Stein E, Kreisberg R, Miller V, Mantell G, Washington L, Shapiro DR, et al. Effects of simvastatin and cholestyramine in familial and nonfamilial hypercholesterolemia. Multicenter Group I. Arch Intern Med. 1990; 150:3401-5. Google Scholar2. Sacks FM, Pfeffer MA, Moye LA, Rouleau JL, Rutherford JD, Cole TG, et al. The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. N Engl J Med. 1996; 335:1001-10. Google Scholar Author, Article, and Disclosure InformationAffiliations: Harvard Medical School, Boston, MA 02114 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1997Volume 126, Issue 11Page: 917KeywordsCholesterolClinical trialsDrugsEmotionsHigh density lipoproteinLipidsLow density lipoproteinMyocardial infarctionStable coronary artery diseaseStatins Issue Published: 1 June 1997 CopyrightCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
A Comprehensive Review of Retinal Gene Therapy
Authors: Shannon E Boye, Sanford L Boye, Alfred S Lewin, William W Hauswirth
Journal: Molecular Therapy (2013)

Blindness, although not life threatening, is a debilitating disorder for which few, if any treatments exist. Ocular gene therapies have the potential to profoundly improve the quality of life in patients with inherited retinal disease. As such, tremendous focus has been given to develop such therapies. Several factors make the eye an ideal organ for gene-replacement therapy including its accessibility, immune privilege, small size, compartmentalization, and the existence of a contralateral control. This review will provide a comprehensive summary of (i) existing gene therapy clinical trials for several genetic forms of blindness and (ii) preclinical efficacy and safety studies in a variety of animal models of retinal disease which demonstrate strong potential for clinical application. To be as comprehensive as possible, we include additional proof of concept studies using gene replacement, neurotrophic/neuroprotective, optogenetic, antiangiogenic, or antioxidative stress strategies as well as a description of the current challenges and future directions in the ocular gene therapy field to this review as a supplement. Blindness, although not life threatening, is a debilitating disorder for which few, if any treatments exist. Ocular gene therapies have the potential to profoundly improve the quality of life in patients with inherited retinal disease. As such, tremendous focus has been given to develop such therapies. Several factors make the eye an ideal organ for gene-replacement therapy including its accessibility, immune privilege, small size, compartmentalization, and the existence of a contralateral control. This review will provide a comprehensive summary of (i) existing gene therapy clinical trials for several genetic forms of blindness and (ii) preclinical efficacy and safety studies in a variety of animal models of retinal disease which demonstrate strong potential for clinical application. To be as comprehensive as possible, we include additional proof of concept studies using gene replacement, neurotrophic/neuroprotective, optogenetic, antiangiogenic, or antioxidative stress strategies as well as a description of the current challenges and future directions in the ocular gene therapy field to this review as a supplement.