tbuckley/cabot-search huggingface dataset:
Contact tracing for HIV infection
Authors: M. W Adler, A. M Johnson
Journal: BMJ (1988)

The logistics of contact tracing for human immunodeficiency virus (HIV) are daunting, given that 1-1.5 million people are infected in the US. Early infection is often asymptomatic; the incubation period is uncertain; there is no effective treatment for asymptomatic disease; and diagnosis confers few benefits and several disadvantages on the individual, while the benefits to society depend on the individual's subsequent sexual restraint. In the US, clear guidelines have emerged on contact tracing. The Centers for Disease Control has recommended contact tracing since 1985. An examination of why contact tracing has not developed in Britain inevitably starts to coalesce with the arguments about the benefits and disadvantages of screening. Should infected people be sought when there is no treatment and when a positive test result may lead to anxiety, stigmatization, and discrimination? There is a tension between the interests of the individual and those of the public. Those who represent individuals mostly oppose contacft tracing. Those who believe that the balance must be towards the public health and breaking the chain will argue for it. They also suggest that tested individuals will benefit by learning how to adopt safe sex techniques and altering sexual behavior as a result of their antibody status. 2 factors should sharpen our thinking: the law and therapeutic developments. What will the law say if a patient refuses to tell a contact or allow a health advisor to do so? Most genitourinary physicians would not inform a 3rd party because it would breach confidentiality and drive the disease underground. The law, however, might take a different stance and support spouses or partners who brought a case against doctors, arguing that because they were not informed they became infected. Soon we may also need to consider the increasing complexity of prognostic markers and of treatment of the antibody positive patient to prevent progression of AIDS. This might make doctors think that it would be unethical not to be able to offer such treatments to the unidentified partner.
Lesson of the week: Acute non-cardiogenic lung oedema after platelet transfusion
Authors: A E Virchis, R K Patel, M Contreras, C Navarrete, R S Kaczmarski, R Jan-Mohamed
Journal: BMJ (1997)

Genitourinary prolapse occurs when faults develop in the mechanisms for vaginal and uterine support (fig 1).An understanding of these mechanisms and systematic repair of these faults will restore normal structure and function.Treatment of prolapse comprises about 20% of gynaecological surgical workload, 1 and with an aging, yet more active, population this contribution will increase.Cystourethrocele is seen most commonly, followed by uterine descent and rectocele.After a hysterectomy the vagina may be susceptible to prolapse owing to loss of support of the vaginal vault. MethodsWe conducted a Medline search from January 1966 to July 1996 and identified 8802 references to the term prolapse; these were reduced to 544 when we used the additional terms vagina, surgery, genitourinary, conservative, pessary, randomised, and outcome.We identified further references by hand searching relevant textbooks in the library of the Royal College of Obstetricians and Gynaecologists.We did not find any prospective trials comparing the effect of different treatments on outcome measures for prolapse.Observational studies have been published examining the pathophysiology and anatomy of prolapse, and these have stimulated interest in this subject.
Physiologic Role of Sodium-Potassium-Activated Adenosine Triphosphatase in the Transport of Cations across Biologic Membranes
Authors: Adrian I. Katz, Franklin H. Epstein
Journal: New England Journal of Medicine (1968)

IN the last decade considerable evidence has been accumulated to support the concept that a sodium-potassium-activated adenosine triphosphatase (Na-K-ATPase) is intimately involved in the active tr...
US to encourage more black people to join research trials
Authors: N. Macready
Journal: BMJ (1997)

American researchers and government officials met last week to examine ways to encourage more people from ethnic minority groups to take part in research trials. The meeting took place in Tuskegee, Alabama, the site of one of the most infamous examples of racism and paternalism in American medical history, in a bid to emphasise that such abuses will never be repeated.



Many black Americans are suspicious of the healthcare system.

ZEFA



In 1932 government …
Transmission of Hepatitis C Virus to Spouses
Authors: Yoshihiro Akahane
Journal: Annals of Internal Medicine (1995)

Letters15 January 1995Transmission of Hepatitis C Virus to SpousesYoshihiro Akahane, Fumio Tsuda, and Hiroaki OkamotoYoshihiro AkahaneSearch for more papers by this author, Fumio TsudaSearch for more papers by this author, and Hiroaki OkamotoSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-122-2-199501150-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:No HCV infection developed in any of seven spouses of patients with chronic hepatitis C during the first 10 years after marriage in our study. This finding is in agreement with the observation of Mauser-Bunschoten and colleagues that persons with hemophilia who were positive for HCV RNA did not transmit HCV to their 50 heterosexual partners within a mean duration of 13 years. The absence of transmission within the first decade of a heterosexual relationship, however, does not guarantee that transmission will not occur in the future. Our principal message is that spouses of patients with chronic hepatitis ...References1. Oshita M, Hayashi N, Kasahara A, Yuki N, Takehara T, Hagiwara H, et al. Prevalence of hepatitis C virus in family members of patients with hepatitis C. J Med Virol. 1993; 41:251-5. Google Scholar2. Hino K, Sainokami S, Shimoda K, Iino S, Wang Y, Okamoto H, et al. Genotypes and titers of hepatitis C virus for predicting response to interferon in patients with chronic hepatitis C. J Med Virol. 1994; 42:299-305. Google Scholar3. Masuko K, Okuda K, Meguro T, Murayama N, Mitsui T, Ohmori T, et al. Hepatitis C virus antibodies, viral RNA and genotypes in sera from patients on maintenance haemodialysis. J Viral Hepatitis. 1994; 1:65-71. Google Scholar4. Aach RD, Stevens CE, Hollinger FB, Mosley JW, Peterson DA, Taylor PE, et al. Hepatitis C virus infection in post-transfusion hepatitis. An analysis with first- and second-generation assays. N Engl J Med. 1991; 325:1325-9. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited BySexual Transmission of Two Different HCV Types Causing Acute Hepatitis C 15 January 1995Volume 122, Issue 2Page: 154-155KeywordsAntibodiesChronic hepatitis CHepatitis CHepatitis C virusHeterosexualsInfectious hepatitisMedical risk factorsRNASpecificityViremia Issue Published: 15 January 1995 CopyrightCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Acquired Expression of NFATc1 Downregulates E-Cadherin and Promotes Cancer Cell Invasion
Authors: Tsukasa Oikawa, Atsuko Nakamura, Nobuyuki Onishi, Taketo Yamada, Koichi Matsuo, Hideyuki Saya
Journal: Cancer Research (2013)

NFATc1 is a transcription factor that regulates T-cell development, osteoclastogenesis, and macrophage function. Given that T cells, osteoclasts, and macrophages in the tumor microenvironment are thought to modulate tumor progression, tumor cells may acquire NFATc1 expression through fusion with these NFATc1-expressing normal cells. We here revealed that a small proportion of tumor cells in human carcinoma specimens expressed NFATc1. To investigate the consequences of NFATc1 acquisition by tumor cells, we established A549 and MCF7 cell lines expressing a constitutively active form of NFATc1 (NFATc1CA) in an inducible manner. The expression of NFATc1CA promoted cancer cell invasion in association with changes in cell morphology. Analysis of gene expression and RNA interference experiments revealed that NFATc1CA suppressed E-cadherin expression by upregulating the transcriptional repressors Snail and Zeb1 in a manner independent of TGF-β signaling. Induced expression of NFATc1CA also downregulated E-cadherin expression and increased invasive activity in tumor xenografts in vivo. Our results thus suggest that the acquisition of NFATc1 expression contributes to tumor progression.
Benefits and Limitations of Very-Low-Calorie Diet Therapy in Obese NIDDM
Authors: Robert R Henry, Barry Gumbiner
Journal: Diabetes Care (1991)

Weight reduction is one of the most effective therapies for obese non-insulin-dependent diabetes mellitus (NIDDM), but the success rate with conventional diets has been disappointing. The development of very-low-calorie diets (VLCDs) over the last two decades has provided an alternative approach to the treatment of uncomplicated obesity and is increasingly being used to treat obese NIDDM. This review focuses on the role of VLCDs in the treatment of obese NIDDM, the mechanisms underlying their efficacy, and the controversies surrounding their use. VLCDs provide 400–800 cal/day of high-quality protein and carbohydrate fortified with vitamins, minerals, and trace elements. Weight loss is initially very rapid, followed by steady reduction at a rate of 1–3 kg/wk. Metabolic benefits occur quickly with only modest weight reduction, suggesting that caloric restriction plays a more critical role. Multiple mechanisms account for improved glycemic control, including reduced hepatic glucose output, increased insulin action in the liver and peripheral tissues, and enhanced insulin secretion. VLCDs have the added benefit of rapid improvement in concomitant medical problems, particularly hypertension and hyperlipidemia, that could otherwise accelerate the development of some diabetic complications. Numerous controversies surround VLCD therapy, the most critical of which is its safety. However, recent studies indicate that VLCDs are safe for use by obese NIDDM patients in a medical setting closely supervised by an experienced physician. Contraindications to the diet, side effects, and recommended management are reviewed, as well as the role of adjunctive treatments, including behavioral modification and exercise. We present the perspective that, in most cases, the numerous metabolic benefits derived from VLCD therapy by the obese NIDDM patient outweigh its risks. Furthermore, recent data suggest that VLCD therapy may provide long-term benefits to the obese diabetic patient, despite weight regain.
Measles Vaccination in Pediatric Emergency Departments During a Measles Outbreak
Authors: Mary Lou Lindegren
Journal: JAMA (1993)

To determine the proportion of preschool-aged patients attending two inner-city hospital pediatric emergency departments (EDs) who were eligible for measles vaccination, to describe their demographic and clinical characteristics, and to assess the performance of the ED immunization programs that were implemented during a measles outbreak in vaccinating eligible children.Cross-sectional study.Pediatric EDs of two urban hospitals in Chicago, Ill, in 1989.Children 6 months to 5 years of age seen in the EDs.None.The proportion of preschool-aged patients attending the two EDs who were eligible for measles vaccination and the proportion of vaccine-eligible children who were given measles vaccine.Of 508 ED patients at hospital A and 255 patients at hospital B, 18% and 29%, respectively, were considered to be vaccine eligible. The most common discharge diagnoses of eligible patients were viral syndrome, otitis media, and minor trauma. Of vaccine-eligible patients, 59% at hospitals A and B were not vaccinated in the ED. At hospital B, patients with an infectious or respiratory disease diagnosis were less likely to be vaccinated than those with other diagnoses (P < .05).Many children seen in these EDs were eligible for measles vaccination, and many eligible patients were not vaccinated. During community outbreaks of measles, optimal vaccination programs in pediatric EDs could increase vaccination coverage among inner-city preschool-aged children who may have limited access to health care.
One in 10 Irish GPs work every weekend
Authors: D. Payne
Journal: BMJ (1998)

Almost one in 10 GPs in the Republic of Ireland are forced to work every weekend, and GPs now work an average of 81 hours a week, including on call work, according to the national general practice survey--the most comprehensive survey of its kind ever carried out in Ireland.

The survey, the fourth and final part of which is …
B Lymphocytes Producing Demyelinating Autoantibodies: Development and Function in Gene-targeted Transgenic Mice
Authors: Tobias Litzenburger, Reinhard Fässler, Jan Bauer, Hans Lassmann, Christopher Linington, Hartmut Wekerle, Antonio Iglesias
Journal: The Journal of Experimental Medicine (1998)

We studied the cellular basis of self tolerance of B cells specific for brain autoantigens using transgenic mice engineered to produce high titers of autoantibodies against the myelin oligodendrocyte glycoprotein (MOG), a surface component of central nervous system myelin. We generated “knock-in” mice by replacing the germline JH locus with the rearranged immunoglobulin (Ig) H chain variable (V) gene of a pathogenic MOG-specific monoclonal antibody. In the transgenic mice, conventional B cells reach normal numbers in bone marrow and periphery and express exclusively transgenic H chains, resulting in high titers of MOG-specific serum Igs. Additionally, about one third of transgenic B cells bind MOG, thus demonstrating the absence of active tolerization. Furthermore, peritoneal B-1 lymphocytes are strongly depleted. Upon immunization with MOG, the mature transgenic B cell population undergoes normal differentiation to plasma cells secreting MOG-specific IgG antibodies, during which both Ig isotype switching and somatic mutation occur. In naive transgenic mice, the presence of this substantial autoreactive B cell population is benign, and the mice fail to develop either spontaneous neurological disease or pathological evidence of demyelination. However, the presence of the transgene both accelerates and exacerbates experimental autoimmune encephalitis, irrespective of the identity of the initial autoimmune insult.
Sterility after Vasectomy
Authors: G. Foss
Journal: BMJ (1973)

We consider that a self-administered questionnaire can be used to detect depression, although a single direct question such as we asked would not be very sensi- tive.However, it is noteworthy that 29 °/, of the replies to the question were positive.There was no excess of positive replies in patients taking methyldopa compared with patients taking other drugs.Patients who became severely depressed on any treatment regimen would have their treatment altered.These patients, however, represent only a stnall proportion of the patients studied.Drs. R. P. Snaith and M. McCoubrie (personal communication) have given the Wakefield Self-Assessment Depression In- ventory to 134 patients receiving me-thyldopa, and have also failed to demonstrate an increase in depression while taking this drug.-Weare, etc.,
Is Duplex Surveillance of Value After Leg Vein Bypass Grafting?
Authors: A.H. Davies, A.J. Hawdon, M.R. Sydes, S.G. Thompson
Journal: Circulation (2005)

Background— The purpose of this study was to assess the benefits of duplex compared with clinical vein graft surveillance in terms of amputation rates, quality of life, and healthcare costs in patients after femoropopliteal and femorocrural vein bypass grafts. Methods and Results— This was a multicenter, prospective, randomized, controlled trial. A total of 594 patients with a patent vein graft at 30 days after surgery were randomized to either a clinical or duplex follow-up program at 6 weeks, then 3, 6, 9, 12, and 18 months postoperatively. The clinical and duplex surveillance groups had similar amputation rates (7% for each group) and vascular mortality rates (3% versus 4%) over 18 months. More patients in the clinical group had vein graft stenosis at 18 months (19% versus 12%, P =0.04), but primary patency, primary assisted patency, and secondary patency rates, respectively, were similar in the clinical group (69%, 76%, and 80%) and the duplex group (67%, 76%, and 79%). There were no apparent differences in health-related quality of life, but the average health service costs incurred by the duplex surveillance program were greater by £495 (95% CI £183 to £807) per patient. Conclusions— Intensive surveillance with duplex scanning did not show any additional benefit in terms of limb salvage rates for patients undergoing vein bypass graft operations, but it did incur additional costs.
855-1 Effects of off-pump versus on-pump coronary surgery on early and late postoperative left ventricular function: A randomized trial using cardiovascular magnetic resonance imaging
Authors: Joseph B Selvanayagam, Attila Kardos, Jane Francis, Steffen Petersen, Frank Wiesmann, David P Taggart, Stefan Neubauer
Journal: Journal of the American College of Cardiology (2004)
Ventricular Echo Beats in the Human Heart Elicited by Induced Ventricular Premature Beats
Authors: R. M. SCHUILENBURG, D. DURRER
Journal: Circulation (1969)

In three patients, all having as their only hemodynamic abnormality an elevated cardiac index at rest, ventricular echo beats could be elicited by ventricular premature beats induced during regular driving of the ventricle. The occurrence of ventricular echo beats was in each case limited to a small delay-range of the premature beat. Retardation of retrograde conduction of the premature ventricular impulse to the atria appeared to be a necessary condition for the initiation of the echo phenomenon. One of the patients had retardation of antegrade A-V conduction of sinus and premature atrial beats. Atrial echo beats could be elicited in this case. The genesis of the ventricular echo phenomenon in these cases could be explained by the dual conducting system theory.
Association of serum antibodies to heat-shock protein 65 with carotid atherosclerosis
Authors: Q. Xu, G. Wick, J. Willeit, M. Marosi, S. Kiechl, G. Luef, R. Kleindienst, T. Stulnig, G. Wick, F. Oberhollenzer
Journal: The Lancet (1993)
Inhibition by Ketotifen of Idiosyncratic Reactions to Aspirin
Authors: A. Szczeklik, G. Czerniawska‐Mysik, M. Serwoǹgska, P. Kuklińgska
Journal: Allergy (1980)

Ketotifen administered prior to aspirin offered protection against bronchoconstriction in 13 of 14 patients with aspirin‐sensitive asthma. In four other subjects, suffering from urticaria/angioedema following ingestion of aspirin‐like drugs, pretreatment with ketotifen resulted in total prevention of the adverse reactions. These results support the suggestion of a common pathogenetic mechanism operating in two distinct clinical patterns of idiosyncrasy to aspirin and other cyclo‐oxygenase inhibitors. They also indicate that ketotifen might find application in treatment of adverse reactions to aspirin.
Obstructing Subglottic Hemangioma of the Larynx in Infancy
Authors: Paul Doermann, John Lunseth, Richard H. Segnitz
Journal: New England Journal of Medicine (1958)

THOUGH infantile hemangiomas of the larynx are uncommon, their treatment under ideal circumstances is relatively simple; yet, of the 14 cases culled from the literature, only 7 were cured. Such poor results are largely due to the fact that it is often extremely difficult to make a definite diagnosis. Analysis of the reported cases (Table 1) reveals that in 6 of the 8 unsuccessful cases the diagnosis was not made until autopsy (and in these 6 cases 5 patients died from complications subsequent to tracheotomy or intubation). In 1 of the successful cases, a definite diagnosis was not made, but . . .
T cell receptor gamma/delta chain diversity.
Authors: F Koning, A M Kruisbeek, W L Maloy, S Marusic-Galesic, D M Pardoll, E M Shevach, G Stingl, R Valas, W M Yokoyama, J E Coligan
Journal: The Journal of Experimental Medicine (1988)

The TCR-gamma and -delta chains of six murine hybridomas were compared by one-dimensional SDS-PAGE and two-dimensional NEPHGE/SDS-PAGE analysis. This allowed the identification of three distinct gamma chains (gamma a, gamma b, and gamma c) and three distinct delta chains (delta a, delta b, and delta c). Four gamma/delta chain combinations (gamma a delta a, gamma b delta b, gamma b delta c, and gamma c delta a) were observed. These results indicate that multiple forms of the delta chain are expressed and suggest that the delta chains are encoded for by an Ig-like rearranging gene. This delta chain polymorphism significantly enhances the potential diversity of TCR-gamma/delta, which may be of importance for a better understanding of the putative ligand(s) recognized by this receptor.
Cutaneous and Ocular Reactions to Practolol
Authors: R. H. Felix, F. A. Ive, M. G. C. Dahl
Journal: BMJ (1974)

A total of 21 patients suffering from drug-induced rashes from practolol have been seen over the past two years. The clinical manifestations varied, with the morphological appearances of the rash resembling those of eczema, lupus erythematosus, lichen planus, and a highly characteristic toxic erythematous psoriasiform eruption. Persistent ocular damage was a feature in three cases.
Vertical Transmission of HIV
Authors: Margarett K. Davis
Journal: JAMA (1988)

<h3>To the Editor.—</h3> Investigators of acquired immunodeficiency syndrome continue to use the term<i>perinatal transmission</i>in referring to the vertical transmission of human immunodeficiency virus (HIV) infection from mother to fetus or mother to infant.<sup>1-3</sup>Use of this term is inaccurate and misleading because<i>perinatal</i>refers to the period shortly before and shortly after birth, and there is no evidence to suggest that transmission occurs only during this period. Use of the term<i>perinatal period</i>was initiated by a German pediatrician named Pfaundler in 1936. The term was useful to describe the peak in mortality that occurs just prior to, during, and after birth.<sup>4</sup>From studies of perinatal mortality, the following terms have emerged: (1)<i>perinatal I</i>, 28 weeks' gestation to less than seven days after birth; (2)<i>perinatal II</i>, 20 weeks' gestation to less than 28 days after birth; and (3)<i>perinatal III</i>, 20 weeks' gestation to
IMMUNOLOGICAL INDUCTION OF INCREASED VASCULAR PERMEABILITY
Authors: P. M. Henson, C. G. Cochrane
Journal: The Journal of Experimental Medicine (1969)

Passive cutaneous anaphylaxis (PCA) reactions were produced in rabbits by antibodies to bovine serum albumin. Two types of antibodies were found, each inducing increased vascular permeability, but by means of different mediation systems. One of these antibodies required the presence of complement, platelets, and neutrophils for the induction of the PCA reaction, which was inhibited by antihistamine. This antibody was heat stable, sedimented in the 7S region, and was found in both fast and slow electrophoretic fractions of rabbit gamma-globulin. Homocytotropic antibody was also detected. The PCA reactions induced by this type of antibody did not require platelets or neutrophils and were not inhibited in rabbits depleted of C3 with cobra venom factor. The lesions were, however, prevented by administration of antihistamine.