tbuckley/cabot-search huggingface dataset:
Extended Antiretroviral Prophylaxis to Reduce Breast-Milk HIV-1 Transmission
Authors: Newton I. Kumwenda, Donald R. Hoover, Lynne M. Mofenson, Michael C. Thigpen, George Kafulafula, Qing Li, Linda Mipando, Kondwani Nkanaunena, Tsedal Mebrahtu, Marc Bulterys, Mary Glenn Fowler, Taha E. Taha
Journal: New England Journal of Medicine (2008)

Effective strategies are urgently needed to reduce mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) through breast-feeding in resource-limited settings.Women with HIV-1 infection who were breast-feeding infants were enrolled in a randomized, phase 3 trial in Blantyre, Malawi. At birth, the infants were randomly assigned to one of three regimens: single-dose nevirapine plus 1 week of zidovudine (control regimen) or the control regimen plus daily extended prophylaxis either with nevirapine (extended nevirapine) or with nevirapine plus zidovudine (extended dual prophylaxis) until the age of 14 weeks. Using Kaplan-Meier analyses, we assessed the risk of HIV-1 infection among infants who were HIV-1-negative on DNA polymerase-chain-reaction assay at birth.Among 3016 infants in the study, the control group had consistently higher rates of HIV-1 infection from the age of 6 weeks through 18 months. At 9 months, the estimated rate of HIV-1 infection (the primary end point) was 10.6% in the control group, as compared with 5.2% in the extended-nevirapine group (P<0.001) and 6.4% in the extended-dual-prophylaxis group (P=0.002). There were no significant differences between the two extended-prophylaxis groups. The frequency of breast-feeding did not differ significantly among the study groups. Infants receiving extended dual prophylaxis had a significant increase in the number of adverse events (primarily neutropenia) that were deemed to be possibly related to a study drug.Extended prophylaxis with nevirapine or with nevirapine and zidovudine for the first 14 weeks of life significantly reduced postnatal HIV-1 infection in 9-month-old infants. (ClinicalTrials.gov number, NCT00115648.)
Reduced Connexin43 Expression Limits Neointima Formation After Balloon Distension Injury in Hypercholesterolemic Mice
Authors: Christos E. Chadjichristos, Christian M. Matter, Isabelle Roth, Esther Sutter, Graziano Pelli, Thomas F. Lüscher, Marc Chanson, Brenda R. Kwak
Journal: Circulation (2006)

Reducing the expression of the gap junction protein connexin43 (Cx43) inhibits the progression of atherosclerosis, a chronic inflammatory disease. Furthermore, acute vascular injury induced by percutaneous coronary interventions is associated with increased Cx43 expression in neointimal smooth muscle cells (SMCs). However, the relevance of Cx43 after acute vascular injury remains unclear.To investigate whether reducing Cx43 expression would affect neointima formation in vivo, we subjected hypercholesterolemic Cx43+/- LDL receptor-deficient (LDLR-/-) mice and Cx43+/+LDLR-/- control littermates to carotid balloon distension injury, which induced marked endothelial denudation and activation of medial SMCs. We observed decreased macrophage infiltration in Cx43+/-LDLR-/- mice 7 days after injury. Similarly, peritoneal macrophages isolated from Cx43+/-LDLR-/- mice showed reduced migration in vitro compared with Cx43+/+LDLR-/- macrophages. Interestingly, Cx43+/-LDLR-/- macrophages also displayed decreased chemotactic activity for SMCs. In addition, we observed less SMC infiltration and proliferation in Cx43+/-LDLR-/- mice 7 and 14 days after balloon angioplasty. Likewise, Cx43+/-LDLR-/- SMCs showed decreased proliferation and migration in vitro compared with Cx43+/+LDLR-/- cells. All these events resulted in a reduction of neointimal thickening after vascular injury in Cx43+/-LDLR-/- mice.The present study shows for the first time that reducing Cx43 limits neointima formation after acute vascular injury by decreasing the inflammatory response and reducing SMC migration and proliferation. Thus, decreasing Cx43 expression may offer a novel therapeutic strategy for reducing restenosis after percutaneous coronary intervention.
Death following the Inhalation of Chloroform in Surgical Operations
Authors: T. Holmes
Journal: BMJ (1857)

crania."Mr. B. obtained medical aid, for the first time since the injtury, upon the 3rd of July-eight days afterwards.On July 12th I saw the case in consuiltation: the patient said that the eye felt distended, and that the eyelids seemed to press upon the globe, althoughl neither spasm of the orbicularis muscle nor chemosis of the conjunctiva were present.In the left temple a sense of pressure was experienced, which de- scended to the upper wisdom tooth of the same side; and thence pain of a more acute character spread over the corre- sponding half of the face and head.'rhe scalp was so sore that the sligl0test touch was insupportable.The pains under- went considerable aggravation at night.Mr. B. had hitherto used linen, dipped from time to time in cold water, as a local application to the painful parts, with the effect of inducing, perfect ease so long as the temiiperature of the surface was maintained at a low degree.Darkness was indispensable for the comfort of the eye, which presented, on examination, in- tense conjunctival redniess, and iritis with watery discharge.HISToRY.Nine years before, the patient met with a similar accident fiom the gold solution: it was followed by ophtlialmia, intolerance of light, and hemicrania, for which he used poultices only, andl in a week resumed his avocations.A year and nine months since, he was laid up two months and nine days with acute rheumnatismn, whiclh affected the head, and the joints botl large and small.He got out of doors on the 2nd of December, but was not free from pain.At Christmas the disease again detained him within doors five weeks.It wouldl be foreign to my object to relate t.he treatment I recommended for the ophthalmia; it will suffice to say that, in less than three weeks, the eye was healthy functionally and organically, and the patient able to walk several miles. CASE OF SWALLOWING AN ARTIFICIAL TOOTH,WITH ITS PLATE.By EDWVARD LISTEn, Esq., Livelpool.ON the 22nd October, 1855, I wvas requested to visit a lady, aged 26, who hIad swallowed a mouthfiul of pancake, and suplposed that a portioni of it ha(d remained in the throat.The probang was introdulced, and removed the obstruction.Her husbau(l called upon me the following morning, and said that his wife had been in the habit of wearing a false tooth attache(l to a gold plate for several years; and that, about half an houir after my departure, she had missed it, and felt certain that slhe mutst have swallowed it.Oct. 23rd.She passed a very restless night, and complained of pain on th3e left side of thle epigastrium, which increased * I find no deaths from chloroform reported in the Lancet, vol.i, for last year; and do not remember to have heard of any lately, except the case at St. Thomas's Hospital, a short time ago.
Enhanced prostaglandin synthesis after ultraviolet injury is mediated by endogenous histamine stimulation. A mechanism for irradiation erythema.
Authors: A P Pentland, M Mahoney, S C Jacobs, M J Holtzman
Journal: Journal of Clinical Investigation (1990)

Acute ultraviolet light B (UVB) injury is associated with dermal mast cell histamine release. The possibility that histamine-stimulated prostaglandin (PG) synthesis could be a mechanism for irradiation erythema was therefore examined using human skin explants. Explants responded to UV irradiation (120 mJ/cm2) with a fivefold increase in synthesis of prostaglandins E2, F2 alpha and 6-keto PGF1 alpha. Incubating explants with the H1 antihistamines brompheniramine (50 microM) or pyrilamine (30 microM) inhibited PG release from irradiated explants 63 +/- 4.9% (mean +/- SEM) 6 h after UV exposure. Antihistamines did not affect PG synthesis in control explants. Irradiation increased the histamine concentration in explant conditioned medium only 50% over basal values, suggesting that irradiation enhanced histamine responsiveness. Explants were therefore incubated with exogenous histamine. In irradiated explants, PG synthesis was stimulated threefold by 3 microM histamine. Unirradiated explants' PG synthesis was unaffected by histamine. Enhanced histamine sensitivity was also examined in epidermal cell cultures. In irradiated cultures, histamine sensitivity was again markedly potentiated: as little as 1 microM histamine stimulated significant PGE2 release and the response to 10-30 microM histamine was increased six to eight times compared with that of unirradiated cultures. These studies demonstrate that endogenous histamine stimulates PG synthesis in human skin after UV injury by potentiation of histamine-induced prostaglandin release. Potentiated agonist responses induced by UV exposure may contribute to the effects of UVB irradiation injury and in particular to irradiation erythema.
S42 Safety And Acceptability Of Bedside Ultrasound-guided Transthoracic Lung Needle Aspiration (tlna) In Pneumonia
Authors: J. Wrightson, D. Crook, N. Rahman, S. Chapman
Journal: Thorax (2014)

<h3></h3> Given the increasing importance of establishing a microbiological aetiology in pneumonia, we undertook a study assessing the safety and acceptability of bedside ultrasound-guided TLNA (REC No. 09/H0605/12). TLNA has previously reported to have been predominantly undertaken without radiological control. <h3>Methods</h3> Participants with community- or hospital-acquired pneumonia completed a baseline assessment of chest pain and pain associated with phlebotomy using a 10 cm visual analogue scale (VAS). Post procedure, participants assessed pain associated with TLNA, and undertook a Likert-based evaluation of the procedure. Up to 3 mg/kg lidocaine was used to anaesthetise the skin and pleura. An ultrafine 25G needle, attached to a 20 ml luer lock syringe containing 3.5 ml 0.9% sodium chloride solution was inserted into consolidated lung under direct ultrasound guidance by a Respiratory Physician. 0.5 ml of the sodium chloride was injected followed by aspiration with gentle agitation (3 mL of sodium chloride remaining in the syringe as a carrier solution). The needle was then withdrawn. Any pleural fluid present was also aspirated separately. Samples underwent culture and 16S rRNA gene analysis. All participants had follow-up chest X-rays post procedure to evaluate for pneumothorax. Participants were systematically assessed while inpatient, and again at 30 days, to assess for any adverse events. <h3>Results</h3> 28 participants underwent TLNA, 27 using ultrasound (and one using CT-guidance). No patients experienced haemoptysis or pneumothorax. All patients either ‘strongly agreed’ (most commonly) or ‘agreed’ with the statements: ‘The lung fluid sample to diagnose your pneumonia was tolerable’; and ‘I would have the lung fluid sample again if my doctors thought it was essential’. The VAS-assessed pain of TLNA was significantly lower than any pre-existing chest pain, being similar to any pain associated with venesection (see Figure). At day 30, one patient had mild ongoing pain at the site of both TLNA and subsequent chest tube insertion, although the relative contribution of each procedure to this pain was unclear. TLNA increased culture or sequencing-based aetiological diagnosis from 3/28 to 14/28 (18/28 when including pleural fluid analysis). <h3>Conclusions</h3> Physician-performed bedside ultrasound-guided TLNA appears safe and well-tolerated.
Use of <sup>75</sup>se‐labeled methionine to study the sequestration of senescent red blood cells
Authors: Bård Smedsrød, David Aminoff
Journal: American Journal of Hematology (1985)

Abstract Labeling red blood cells with Na 2 51 CrO 4 enabled us to study certain aspects of red cell survival and sequestration from the circulation. As a random labeling procedure, however, the 51 Cr method has certain limitations. Therefore, we developed a cohort labeling method using 75 Se‐methionine as a two‐rat procedure. This gives us a clear pulse‐labeled population of rat red cells to study the dynamics of sequestration. With this labeling procedure, it was possible to demonstrate that 1) there is an increase in the density of red cells with age, 2) a significant sequestration of red cells from the circulation is apparent at the end of 48 days and essentially is complete at the end of 60 days, 3) there is a corresponding uptake of senescent red cells in the spleen, which peaks at 55 days, and 4) the 60‐day end point is sharper and is more definitive when the “specific activity” (cpm per red blood cell) of the labeled red cells in the spleen is compared to that of the red cells still in the circulation. Asialo red cells, obtained by removal of sialic acid with sialidase, frequently have been used as a model for the study of sequestration of senescent red cells. With the technique herein described, it was possible to show that while asialo red cells will inhibit the uptake of labeled asialo red cells, they have no effect on the sequestration of senescent red cells. Presumably, different sites and mechanisms of sequestration are involved.
The Professional Testing Center
Authors: Rebecca D. Elon
Journal: Annals of Internal Medicine (2009)

On Being a Doctor3 March 2009The Professional Testing CenterRebecca D. Elon, MD, MPHRebecca D. Elon, MD, MPHFrom Johns Hopkins University School of Medicine, Baltimore, MD 21205.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-5-200903030-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail 17 November 2008Letter to the EditorAnnals of Internal MedicineToday I took my ABIM 10-year recertification examination in geriatric medicine at a computerized professional testing center. Ten years ago, when I took my last recertification exam, I gathered with 100 or more internists taking either the general internal medicine or a subspeciality recertification exam. We were all together at a conference center taking our tests the old-fashioned way, with paper examination booklets and answer sheets with dots to fill in. There was a collegiality in gathering all together. There were proctors in the room, but they were relatively ... Author, Article, and Disclosure InformationAffiliations: From Johns Hopkins University School of Medicine, Baltimore, MD 21205.Corresponding Author: Rebecca D. Elon, MD, MPH, Erickson Health Medical Group, 6334 Cedar Lane, Suite 103, Columbia, MD 21044; e-mail, Rebecca.[email protected]com. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Professional Testing Center: Past and Present Christine K. Cassel Metrics Cited byThe Professional Testing Center: Past and PresentChristine K. Cassel, MD 3 March 2009Volume 150, Issue 5Page: 357KeywordsBehaviorComputersComputing systemsEmotionsGeriatricsMemory ePublished: 3 March 2009 Issue Published: 3 March 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
High-Dose Epinephrine in Adult Cardiac Arrest
Authors: Ian G. Stiell, Paul C. Hebert, Brian N. Weitzman, George A. Wells, Sankaranarayanan Raman, Ryan M. Stark, Lyall A.J. Higginson, Jan Ahuja, Garth E. Dickinson
Journal: New England Journal of Medicine (1992)

Recent studies suggest that doses of epinephrine of 0.1 mg per kilogram of body weight or higher may improve myocardial and cerebral blood flow as well as survival in cardiac arrest. Such studies have called into question the traditional dose of epinephrine (0.007 to 0.014 mg per kilogram) recommended for advanced cardiac life support.
Recurrence of "Benign" Intrathoracic Fibromas
Authors: W. F. Kerr, H. C. Nohl
Journal: Thorax (1961)

Intrathoracic fibromas are uncommon but distinctive tumours.They are usually considered to be benign.The origin of these growths, which appear to be primary pleural tumours, has given rise to a diversity of opinion.The literature is confusing, for essentially similar tumours are reported by a variety of names, of which the most common are intrathoracic fibroma, pleural fibroma, and benign localized mesothelioma of the pleura.For purposes of orientation, the subject will be briefly reviewed.The primary concern of this paper, however, is with the liability of these " benign " tumours to recur, an aspect of their behaviour not widely appreciated.Late recurrence especially as a complication is seldom mentioned.Below we detail the histories of six patients who developed local recurrence after removal of tumours diagnosed as benign fibromas.Every patient with a recurrence has been operated on, examined histologically, and compared with its antecedent tumour.The recurrences have ranged from a pedicled, encapsulated, cellular fibroma to a highly malignant fibrosarcoma.In patients with a succession of recurrences the clinical and pathological pattern has been one of progression towards greater malignancy.CASE HISTORIES CASE 1 (Case 2 of Price Thomas and Drew (1953) brought up to date).In 1944 V. S. M., a woman aged 56 years, began to suffer from pains in the ankles and wrists, accompanied by episodes of fever.A chest radiograph was reported as showing no abnormality.Three years later a large round opacity was apparent in the left lower zone (Fig. 1).She was referred to Mr. N. R. Barrett at the Brompton Hospital.First Operation.-On
Ap53genetic polymorphism as a modulator of hepatocellular carcinoma risk in relation to chronic liver disease, familial tendency, and cigarette smoking in hepatitis B carriers
Authors: Ming-Whei Yu, Shi-Yi Yang, Yueh-Hsia Chiu, Yi-Ching Chiang, Yun-Fan Liaw, Chien-Jen Chen
Journal: Hepatology (1999)

This study evaluated whether the codon 72 p53 polymorphism was related to hepatocellular carcinoma (HCC). Genotypes of p53 were determined in 80 incident cases of HCC and 328 controls nested in a cohort study of 4,841 male chronic hepatitis B carriers. No overall increase in HCC risk with the Pro variant allele of the p53 polymorphism was apparent. However, there were synergistic effects on HCC development for the Pro allele with chronic liver disease and family history of HCC in first–degree relatives. Compared with subjects without the Pro allele and chronic liver disease, the increase in HCC risk associated with chronic liver disease among those without the Pro allele was only threefold. Subjects with both chronic liver disease and the Pro allele were at an increased risk of 7.60 (95% CI = 2.28–25.31). When subjects without family history of HCC and the Pro allele were considered as the reference group, there was no apparent increased risk of HCC for those without the Pro allele who had family history of HCC. Among those with both factors, there was a significantly increased risk of 3.29 (95% CI = 1.10–9.85). Both cigarette smoking and glutathione S –transferase M1 genotype modified the risk of HCC associated with the p53 polymorphism. Significantly increased risk associated with the p53 genotype was observed only among smokers who were glutathione S –transferase-null ( Pro/Pro vs. Arg/Arg : odds ratio = 6.46; 95% CI = 1.55–26.94). The p53 polymorphism also interacted with the cytochrome P450 1A1 and carotenoid levels in smoking–related hepatocarcinogenesis.
A Review of Dyspepsia in the Army
Authors: C. A. Hinds-Howell
Journal: BMJ (1941)

The question whether this is so or not depends entirely on the number of functional glomeruli present in the hypo- plastic kidneys.The normal kidney has an enormous reserve, and kidneys which possess at least a minimum number of functional glomeruli will certainly be compatible with life, just as. the grossly damaged kidneys of polycystic disease or of Bright's disease may be able to support life for a number of years.Among the other remarkable features of this case is the maintenance of reasonably good health with grossly ineffi- cient kidneys.This suggests that a tolerance has been established to a high non-protein nitrogen in the blood over a number of years.It may here be remarked that this is good evidence that hypertension is more unfavourable to the patient with Bright's disease than is the glomerulotubular damage.Other points to be noted are the absence of any sign of renal infection and the relatively unchanged blood chemistry, apart from the blood urea.The latter findings also support the conclusion that the condition in this case is a congenital one. SummaryA review of the literature on congenital developmental anoma- lies of the kidneys is given, with particular reference to hypo- plasia, aplasia, and agenesis.A case of congenital bilateral renal hypoplasia is described; this is believed to be the first one recorded in the literature.Certain unusual aspects of the case, and the differential diagnosis, are discussed.Comparison is made with congenital poly- cystic kidneys, to which the condition bears considerable clinical resemblance.It is recorded that bilateral congenital hypoplasia of the kidneys is compatible with a reasonably healthy adult life.We are much indebted to Dr. W.
Results of a European Comparative Randomized Study Comparing Oral Bropirimine versus Intravesical BCG Treatment in BCG-Naive Patients with Carcinoma in situ of the Urinary Bladder
Authors: Wim P.J. Witjes, Mark K&ouml;nig, Frank P. Boeminghaus, Reg R. Hall, Claude C. Schulman, Maristella Zurlo, Alberto Fittipaldo, Marcello Riggi, Frans M.J. Debruyne
Journal: European Urology (1999)
Antiarrhythmic effects of aspirin during nonthrombotic coronary occlusion.
Authors: C B Moschos, B Haider, C De La Cruz, M M Lyons, T J Regan
Journal: Circulation (1978)

To study the action of aspirin upon the myocardium per se, independent of thrombosis, coronary occlusion with a balloon catheter was induced in 53 anesthetized dogs divided into two groups. One group (N = 20) was treated daily with aspirin (600 mg/dog) for seven days and another (N = 33) was untreated. Left ventricular hemodynamics and precordial ECG mapping were used to assess the influence of myocardial ischemia over a four hour period. There were no significant differences in left ventricular function or extent of injury as judged by ECG mapping between the two groups. However, there was a significant decrease in the incidence of ventricular fibrillation in the treated dogs (5% vs 39%). Serial plasma samples for free fatty acid determination showed a significant rise in the untreated group. Aspirin blocked the FFA increment in the treated animals. Tissue samples from the ischemic area of left ventricle exhibited a significant reduction of the sodium and water increments, as well as a lesser potassium loss in the treated animals compared to the controls and may have been the basis for the lower incidence of arrhythmias. Since infusion of 51Cr labelled platelets showed no myocardial accumulation of platelets in either group, microthrombi did not appear to contribute to the observed differences.