tbuckley/cabot-search huggingface dataset:
G6PD deficiency and stroke in the CSSCD
Authors: Scott T. Miller, Jacqueline Milton, Martin H. Steinberg
Journal: American Journal of Hematology (2010)

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked disorder affecting ∼10% of male African Americans. It is most commonly manifested by acute hemolytic events in the face of an oxidant challenge, classically by ingestion of fava beans but more commonly in the United States by exposure to naphthalene, infection or various pharmaceuticals. It was speculated that G6PD deficiency might impact the clinical manifestations of sickle cell anemia, specifically the "hyperhemolytic" crisis, but in an analysis of data from the Cooperative Study of Sickle Cell Disease (CSSCD), there was no impact of G6PD status on frequency of acute anemic events, infections, pain episodes, or hemolytic rate, as measured by hemoglobin concentration, reticulocyte count, bilirubin, and SGOT levels [1]. While G6PD deficiency is most encountered clinically because of hemolytic episodes, the enzyme is ubiquitous and important in providing protection from oxidant stress in all cells. Neuronal G6PD activity has been found to be protective in mouse models of Parkinson Disease [2] and acute ischemic injury [3], both of which are at least in part mediated by generation of oxygen radicals and potentially attenuable by G6PD activity. G6PD activity in vascular endothelial cells improves levels of endothelial nitric oxide (eNO) [4]; G6PD is required for generation of NADPH from NADP, the former required for synthesis of NO. G6PD deficiency may contribute to cardiovascular and diabetic vascular diseases [5], which bear histopathological similarities to sickle vasculopathy; conversely, G6PD deficiency may attenuate proliferative vascular disease by decreasing the vascular response to angiotensin II [6]. Bernaudin et al. reported that individuals with sickle cell disease and G6PD deficiency are at increased risk for abnormal transcranial Doppler (TCD) examinations [7] and thus at increased risk for cerebral vasculopathy and stroke; this was not confirmed in a smaller group of patients using different criteria for "abnormal" TCD [8]. We speculated that while concurrent G6PD deficiency has negligible impact on hemolytic rate in individuals with sickle cell disease, diminished activity in brain and/or endothelium may increase susceptibility to stroke. To examine this question, we analyzed 800 males in the CSSCD, aged > 2 years who had G6PD isoenzyme analysis and activity performed. Six of 83 G6PD deficient patients were reported to have stroke compared with 40 of 717 patients without G6PD deficiency (X2 with 1 df = 0.3738, P = 0.5410). Although we were unable to reliably differentiate TIAs and hemorrhagic strokes from ischemic stroke [9], these data mitigate against G6PD deficiency contributing to stroke risk in individuals with sickle cell anemia.
Nutrition Therapy in Non-insulin-dependent Diabetes Mellitus
Authors: Dan Streja, Evelyn Boyko, Simon W Rabkin
Journal: Diabetes Care (1981)

The purpose of this study was to evaluate nutritional therapy for non-insulin-dependent diabetic subjects by examining the changes in, and interrelationship of, the outcome criteria of efficacy, namely, blood glucose, body weight and serum lipids, total cholesterol, and triglycerides. Eight-two patients, who represented all those seen by one nutritionist at a diabetic education center, were contacted for long-term follow-up data, which was obtained on 80.5% of the patients. They had short-term follow-up 66.0 +/- 4.5 days after the initial visit and long-term follow-up 31.0 +/- 1.1 mo later. Four treatment groups were defined: group 1, diet only at entry and follow-up; group 2, oral hypoglycemic agents at entry and follow-up; group 3, intensified treatment (diet or oral agents at entry and oral agents or insulin at follow-up; and group 4, decrease in intensity of treatment (oral agents at entry but not at long-term follow-up). Serum glucose fell significantly (P less than 0.05) at short- and long-term follow-up in groups 1, 2, and 3. Body weight reductions were significant at short-term follow-up in all groups and were significant at long-term follow-up only in group 1. Serum cholesterol was significantly reduced at short-term follow-up in group 2. Serum triglyceride changes were significantly reduced at short-term follow-up in groups 1 and 2 and at long-term follow-up in group 1. Serum glucose changes correlated with changes in serum cholesterol and triglycerides but did not correlate with body weight changes. These findings demonstrate the effectiveness of nutritional counseling, show that lowering serum glucose did not correlate with weight reduction, and suggest that more attention should be given to factors reducing serum glucose and less attention to weight loss in the treatment of non-insulin-dependent diabetes.
Pilewort Ointment and Suppository
Authors: J. Sawyer
Journal: BMJ (1904)

IPILEWORT OINTMENT.PJ&N. 2,-104.considered by the husband and wife to lead to atrophy of the testis with consequent unsexing of the individual.'After experimenting I carritd oiut the following method of uniting the vas deferens.An oblique incision was made along the course of the in- guinal canal similar to that used in the operation for the radical cure of -an inguinal hernia, the spermatic cord was ex- posed, and the testis dislodged through the wound; carrying with.ittheismall swelling described above as being the, size of a large pea.This, turned out to be a-colIlection of semen con- fined in a-fascial shOath between the ends of the divided vas deferens.The vas waki found to be eompletely divided and its ends were separ&ted for-about half an inch..The following diagrarmnill assist in-elucidating the method adopted for the anastomosis.Very small curved needles had to be used for-applying finb sillk suturesin the operation per- formed.
Relationship of <i>Chlamydia pneumoniae</i> Infection to Severity of Human Coronary Atherosclerosis
Authors: Katharina Ericson, Tom G. P. Saldeen, Olle Lindquist, Carl Påhlson, Jawahar L. Mehta
Journal: Circulation (2000)

Infection with Chlamydia pneumoniae has been postulated to play a pathogenic role in atherosclerosis. We examined the role of infection with C pneumoniae in relation to the extent of coronary atherosclerosis.Coronary atherosclerosis was graded microscopically on a postmortem basis in a blinded fashion in 60 subjects as mild (n=18) or severe (n=42) atherosclerosis. Serum antibodies to C pneumoniae were measured by microimmunofluorescence test. Paraffin-embedded coronary artery specimens were examined for the presence of chlamydia by use of a genus-specific direct immunofluorescence monoclonal antibody. Frozen coronary artery specimens were examined by immunoperoxidase for the presence of C pneumoniae by use of a specific monoclonal antibody RR-402. Direct immunofluorescence was reactive in 86% of cases with severe atherosclerosis but in only 6% of cases with mild atherosclerosis (P<0.01), whereas immunoperoxidase staining was reactive in 80% and 38% of cases with severe and mild atherosclerosis, respectively (P<0. 01). Elevated IgG and IgA levels against C pneumoniae were not different in cases with severe and mild atherosclerosis (61% and 30% for severe atherosclerosis and 67% and 42% for mild atherosclerosis, respectively).This study supports the hypothesis that intracellular infection with C pneumoniae may relate to the severity of atherosclerosis in some subjects. Serum antibody titers against C pneumoniae do not differentiate between severe and mild atherosclerosis.
Effect of Nonoxynol-9 Gel on Urogenital Gonorrhea and Chlamydial Infection
Authors: Ronald E. Roddy, Léopold Zekeng, Kelley A. Ryan, Ubald Tamoufé, Kathryn G. Tweedy
Journal: JAMA (2002)

ContextNonoxynol-9 has been suggested as a vaginal microbicide to protect against common sexually transmitted infections.ObjectiveTo compare nonoxynol-9 gel and condom use (gel group) vs condom use alone (condom group) for the prevention of male-to-female transmission of urogenital gonococcal and chlamydial infection.Design and SettingRandomized controlled trial conducted at 10 community clinics and 10 pharmacies in Yaoundé, Cameroon, between October 1998 and September 2000, with 6 months of follow-up.ParticipantsHigh-risk population of 1251 women (excluding sex workers) being treated for or who had symptoms of sexually transmitted infections. Three were excluded from the gel group (0.5%) and 7 from the condom group (1%) because of no follow-up data.InterventionsNonoxynol-9 gel (100 mg) and condoms or condoms only.Main Outcome MeasureA positive test result for gonococcal or chlamydial infection by the ligase chain reaction assay; secondary outcome measure was a positive test result for human immunodeficiency virus (HIV).ResultsThe rate ratio (RR) for new urogenital infections was 1.2 for the gel group vs condom group (95% confidence interval [CI], 0.9-1.6; P = .21). The gel group had 116 diagnosed gonococcal infections, chlamydial infections, or both for a rate of 43.6 per 100 person-years, and the condom group had 100 infections for a rate of 36.6 per 100 person-years. The RR for gonococcal infection in the gel group vs the condom group was 1.5 (95% CI, 1.0-2.3) and for chlamydial infection was 1.0 (95% CI, 0.7-1.4). There were 5 new cases of HIV infections in the gel group and 4 in the condom group. Three women in each group became pregnant during the study.ConclusionNonoxynol-9 gel did not protect against urogenital gonococcal or chlamydial infection.
Paradoxical gas embolism in a scuba diver with an atrial septal defect.
Authors: P T Wilmshurst, B G Ellis, B S Jenkins
Journal: BMJ (1986)

Un plongeur experimente (100 plongees) presente apres une plongee un peu plus profonde (38 m) et une remontee lente mais sans arret de decompression des douleurs abdominales, une paresthesie unilaterale et un etourdissement; il perd conscience ensuite pour 30 mn. 6 h plus tard les 2 jambes presentent asthenie et paresthesie. Plus tard une communication interauriculaire de type secundum est diagnostiquee, puis traitee chirurgicalement efficacement. Les plongees sont deconseillees par la suite
NASO-PHARYNGEAL BLADES AND UNIVERSAL HANDLES.
Authors: J. E. SCHADLE
Journal: JAMA (1896)

This instrument has many advantages other than its<i>"e pluribus unnum"</i>construction, which is, perhaps, the first thing that appeals to one upon inspecting it. By means of the ball and socket joint, effected by the union of the different blades with the holder, the operator is enabled to fix his instrument at any angle he desires to fit the exigencies of the case presenting, and to hold it perfectly firm—as firm as a needle is held in a Hagedorn needle-holder. The handle is made sufficiently heavy to have it balanced well, and to be of utility in cutting where force is required in a small space. Inasmuch as many of these blades are new, I would like to describe them briefly so that they may be better understood. The first and second blades (see cut farthest to right and immediately over the handle) are designed to be used in
At least 25% with a mental health problem is a conservative estimate
Authors: D. Goldberg, P. Huxley
Journal: BMJ (2012)

There are enormous problems in deciding what counts as a mental disorder,1 but most epidemiologists use an official classification such as the international classification of diseases.

We were responsible for providing evidence that the one year prevalence of mental disorders in community samples is about 250/1000.2 We obtained this figure by combining figures for cross sectional …
Treating childhood asthma in Singapore: when West meets East
Authors: G J Connett, B W Lee
Journal: BMJ (1994)

Though Western medicines and ideas about asthma have become popular in many Asian nations, local beliefs about treatment prevail. The multiracial society of Singapore shows a variety of beliefs about causes of asthma attacks (for example, the balance of yin and yang) and types of treatment--herbal remedies, inhaled versus eaten medicines, the influence of Ramadan. Many of the cultural practices mentioned are probably preserved among south east Asian minorities residing in the United Kingdom. Eastern treatments typically take a holistic approach to asthma and do not ignore the psychosomatic component of the disorder.
High prevalence of systemic disease and mortality in Asian subjects with systemic lupus erythematosus.
Authors: A Samanta, J Feehally, S Roy, F E Nichol, P J Sheldon, J Walls
Journal: Annals of the Rheumatic Diseases (1991)

All patients with systemic lupus erythematosus (SLE) (American Rheumatism Association criteria with positive antinuclear antibody titre) and who attended any of the three general hospitals in Leicester over a 10 year period were ascertained using several complementary sources. Eighty seven subjects (26 Asian, 61 white) were identified. The estimated prevalence of SLE in Leicester is 0.4/1000 for Asian and 0.2/1000 for white subjects. Mean age of onset of the disease was 24 years in Asian and 31 years in white subjects, with both groups showing a female preponderance. Proteinuria (greater than 1 g/24 h) was noted in 15 (58%) Asian and 21 (35%) white subjects; neuropsychiatric disease in 10 (38%) Asian and 8 (13%) white subjects; myalgic symptoms with raised muscle enzymes in 9 (35%) Asian and 3 (5%) white subjects. Nineteen (73%) Asian subjects were positive for extractable nuclear antigens as well, at some stage of their disease, compared with 6 (10%) white subjects. Immunosuppressive treatment was required in 12 (46%) Asian and 12 (20%) white subjects, and deaths of seven Asian and five white subjects were attributed to SLE. These findings show that Asian subjects have a higher prevalence of SLE with greater systemic disease and mortality.
All IVF embryos should be checked for genetic defects, conference is told
Authors: Rebecca Coombes
Journal: BMJ (2005)

All embryos resulting from in vitro fertilisation (IVF) should be routinely checked for genetic abnormalities before implantation, a conference on human genetics heard this week.

New evidence indicates that screening embryos vastly improves the chances of producing a healthy baby in women aged over 35 who undergo IVF.

Dr Yury Verlinsky, a leader in the field of preimplantation genetic diagnosis and director of the Reproductive Genetics Institute, Chicago, told the sixth international symposium on preimplantation genetic diagnosis in London that the findings should lead to only normal embryos being used in treatment.

In a study of 709 couples Dr Verlinsky's team found that the percentage of couples who …
STAT1 Drives Tumor Progression in Serous Papillary Endometrial Cancer
Authors: Budiman Kharma, Tsukasa Baba, Noriomi Matsumura, Hyun Sook Kang, Junzo Hamanishi, Ryusuke Murakami, Melissa M. McConechy, Samuel Leung, Ken Yamaguchi, Yuko Hosoe, Yumiko Yoshioka, Susan K. Murphy, Masaki Mandai, David G. Hunstman, Ikuo Konishi
Journal: Cancer Research (2014)

Abstract Recent studies of the interferon-induced transcription factor STAT1 have associated its dysregulation with poor prognosis in some cancers, but its mechanistic contributions are not well defined. In this study, we report that the STAT1 pathway is constitutively upregulated in type II endometrial cancers. STAT1 pathway alteration was especially prominent in serous papillary endometrial cancers (SPEC) that are refractive to therapy. Our results defined a “SPEC signature” as a molecular definition of its malignant features and poor prognosis. Specifically, we found that STAT1 regulated MYC as well as ICAM1, PD-L1, and SMAD7, as well as the capacity for proliferation, adhesion, migration, invasion, and in vivo tumorigenecity in cells with a high SPEC signature. Together, our results define STAT1 as a driver oncogene in SPEC that modulates disease progression. We propose that STAT1 functions as a prosurvival gene in SPEC, in a manner important to tumor progression, and that STAT1 may be a novel target for molecular therapy in this disease. Cancer Res; 74(22); 6519–30. ©2014 AACR.
Relative increase of Langerhans cells in 'banal' and dysplastic melanocytic naevi
Authors: W. STERRY, T. HENSELER, F-W. PEHLEMANN, DAGMAR SCHLEGEL
Journal: British Journal of Dermatology (1987)

Langerhans cell counts were carried out in 16 normal or banal melanocytic naevi and 22 dysplastic naevi, and the numbers in the naevi compared with Langerhans cell numbers in perilesional, clinically normal, epidermis. Langerhans cell numbers were found to be raised in both types of naevi, but no significant difference between Langerhans cell numbers in the two types of naevi was found.
Electrocardiographic Studies of Cardiac Orthotopic Allotransplantation: 2. The Post-operative Puppy
Authors: J. Cabasson, H. A. Joos, G. Khalil, G. Dureau, W. Schilt, A. Kantrowitz
Journal: Cardiovascular Research (1969)

The importance of including precordial leads in evaluating donor atrial activity and QRS voltage variations after cardiac allotransplantation in puppies was established. Double atrial activity appeared early and consistently post-operatively. Reduced maximal QRS vector was a sign of rejection. Earlier rejection signs included sinus bradycardia, transient sinus arrest, and nodal rhythm.
Malignant Degeneration in Dyschondroplasia
Authors: Meyer Alpert
Journal: JAMA (1962)

<h3>To the Editor:—</h3> In the question and answer section ofThe Journal(<i>JAMA</i><b>178</b>:784 [Nov. 18] 1961) a letter was published requesting information concerning dyschondroplasia. In his reply Dr. A. B. Hayles stated: "Malignant degeneration of the chondromas is a rare complication." It should be pointed out that Dr. Hayles' views are not in agreement with those of such eminent authorities as Drs. Jaffe and Dahlin. Dr. Jaffe estimates the incidence of chondrosarcoma to be 50%, while Dr. Dahlin states that "approximately onethird of the cases of multiple chondroma are complicated by chondrosarcoma."
Mental health consequences of overstretch in the UK armed forces: first phase of a cohort study
Authors: Roberto J Rona, Nicola T Fear, Lisa Hull, Neil Greenberg, Mark Earnshaw, Matthew Hotopf, Simon Wessely
Journal: BMJ (2007)

To assess the relation between frequency and duration of deployment of UK armed forces personnel on mental health.First phase of a cohort study.UK armed forces personnel.Operational history in past three years of a randomly chosen stratified sample of 5547 regulars with experience of deployment.Psychological distress (general health questionnaire-12), caseness for post-traumatic stress disorder, physical symptoms, and alcohol use (alcohol use disorders identification test).Personnel who were deployed for 13 months or more in the past three years were more likely to fulfil the criteria for post-traumatic stress disorder (odds ratio 1.55, 95% confidence interval 1.07 to 2.32), show caseness on the general health questionnaire (1.35, 1.10 to 1.63), and have multiple physical symptoms (1.49, 1.19 to 1.87). A significant association was found between duration of deployment and severe alcohol problems. Exposure to combat partly accounted for these associations. The associations between number of deployments in the past three years and mental disorders were less consistent than those related to duration of deployment. Post-traumatic stress disorder was also associated with a mismatch between expectations about the duration of deployment and the reality.A clear and explicit policy on the duration of each deployment of armed forces personnel may reduce the risk of post-traumatic stress disorder. An association was found between deployment for more than a year in the past three years and mental health that might be explained by exposure to combat.
‘Top and Tail Endoscopy’ and Follow-up in Peutz-Jeghers Syndrome
Authors: C.B. Williams, M. Goldblatt, P.V. Delaney
Journal: Endoscopy (1982)

Combined gastro-duodenoscopy and colonoscopy ('top and tail' endoscopy) on the same occasion in Peutz-Jeghers patients has allowed multiple endoscopic polypectomies of lesions up to 4.5 cm diameter and up to 40 cm above the ileo-caecal valve. 'Top and tail' endoscopy simplifies the management of Peutz-Jeghers patients and should also be useful in the management of other patients requiring investigation of both ends of the gastro-intestinal tract.
Aspirin for everyone over 50?: The buck stops in the consulting room
Authors: Arunachalam Kumar
Journal: BMJ (2005)

Drug combinations and all cause mortality in heart disease No new insights were gainedEditor-Hippisley-Cox and Coupland conclude that the addition of angiotensin converting enzyme (ACE) inhibitors to combinations of drugs conferred no additional benefit in their study of patients in primary care with ischaemic heart disease. 1 However, such a conclusion should be reached with caution.The drugs were given to the patients with the highest risk of death.A higher percentage of patients who died were treated with ACE inhibitors, and the greatest improvement in risk of death after adjustment for risk factors was seen in the patients treated with these drugs.ACE inhibitors might thus have been given to the patients with the most severe disease in each comorbidity group-for example, to diabetic patients with kidney disease and to patients with the most severe heart failure.Therefore the study can give no indication of the crucial question whether the outcome would have been equally good for the group of 463 patients who probably had the most severe disease and received statins, aspirin, blockers, and ACE inhibitors if they had not been given ACE inhibitors.Replacement of yes or no for comorbidity factors with more discriminating variables, such as presence of microalbuminuria and a severity measure for heart disease, would probably have improved the study.However, this cannot replace the quality of a randomised, placebo controlled study comparing the effect of adding ACE inhibitors to the other study drugs.Therefore the study by Hippisley-Cox and Coupland adds no new knowledge to how patients with ischaemic heart disease in primary care should be treated.
Hyperbaric Oxygen Therapy-Reply
Authors: Pam Grim
Journal: JAMA (1990)

In Reply.—  We share the desire of Dr Ingle for a sober analysis of HBO therapy and cite the review by Gabb and Robin in our article. Oxygen is a toxic substance and its use within a pressurized chamber should not be undertaken lightly.  Some indications for HBO therapy, such as that for problem wounds, are difficult to evaluate because little is known about the pathologenesis of specific wounds, because no good animal model exists, and because HBO therapy is recommended only in patients who have failed conventional therapy, a difficult group to study. However, osteoradionecrosis, a better-defined clinical problem, has been shown to respond to a carefully designed protocol that incorporates HBO. 1   Therapy for carbon monoxide poisoning is particularly difficult to evaluate. In the study by Raphael et al, 2 which Dr Ingle cites, patients with carbon monoxide poisoning were stratified into two groups: those with and
Postexercise peril. Plasma catecholamines and exercise
Authors: J. E. Dimsdale
Journal: JAMA (1984)

Postexercise cardiac morbidity is noted both in the exercise testing laboratory and in the field, but the physiology of this phenomenon has been unclear. Plasma catecholamine levels were studied in ten healthy men at each work load during exercise testing and during the recovery period after exercise. Both norepinephrine and epinephrine levels increased in response to exercise, although the response was much more noteworthy for norepinephrine. In the recovery period after exercise, both catecholamine levels continued to increase, with the norepinephrine level increasing tenfold over baseline. Such increases may have profound effects, particularly for subjects with preexisting coronary disease.
Which groups of patients benefit from helicopter evacuation?
Authors: R. Hotvedt, J. Thoner, S.M. Almdahl, G. Bjørsvik, L. Berge, T. Sparr, K. Ytre-Arne, I.S. Kristiansen, O.H. Førde, A.C. Magnus, K. Mamen
Journal: The Lancet (1996)