tbuckley/cabot-search huggingface dataset:
Tissue Engineering of Pulmonary Heart Valves on Allogenic Acellular Matrix Conduits : In Vivo Restoration of Valve Tissue
Authors: G. Steinhoff, U. Stock, N. Karim, H. Mertsching, A. Timke, R. R. Meliss, K. Pethig, A. Haverich, A. Bader
Journal: Circulation (2000)

Tissue engineering using in vitro-cultivated autologous vascular wall cells is a new approach to biological heart valve replacement. In the present study, we analyzed a new concept to process allogenic acellular matrix scaffolds of pulmonary heart valves after in vitro seeding with the use of autologous cells in a sheep model.Allogenic heart valve conduits were acellularized by a 48-hour trypsin/EDTA incubation to extract endothelial cells and myofibroblasts. The acellularization procedure resulted in an almost complete removal of cells. After that procedure, a static reseeding of the upper surface of the valve was performed sequentially with autologous myofibroblasts for 6 days and endothelial cells for 2 days, resulting in a patchy cellular restitution on the valve surface. The in vivo function was tested in a sheep model of orthotopic pulmonary valve conduit transplantation. Three of 4 unseeded control valves and 5 of 6 tissue-engineered valves showed normal function up to 3 months. Unseeded allogenic acellular control valves showed partial degeneration (2 of 4 valves) and no interstitial valve tissue reconstitution. Tissue-engineered valves showed complete histological restitution of valve tissue and confluent endothelial surface coverage in all cases. Immunohistological analysis revealed cellular reconstitution of endothelial cells (von Willebrand factor), myofibroblasts (alpha-actin), and matrix synthesis (procollagen I). There were histological signs of inflammatory reactions to subvalvar muscle leading to calcifications, but these were not found in valve and pulmonary artery tissue.The in vitro tissue-engineering approach using acellular matrix conduits leads to the in vivo reconstitution of viable heart valve tissue.
Reduction of Experimental Renal Hypertension by Kidney Perfusion
Authors: W. J. KOLFF
Journal: Circulation (1958)

Normal kidneys were transplanted to the neck of 15 dogs with experimental renal hypertension. In 6 a reduction of blood pressure of 52 mm. Hg (32-102) took place during the first 2 hours of perfusion. It is hypothesized that renin or angiotonin in minute amounts impairs, blunts or frustrates the normal blood pressure reducing function of the kidney.
Research strategies for behavioral teratology studies.
Authors: L D Grant
Journal: Environmental Health Perspectives (1976)

Several compelling aruguments have been advanced in support of expanding the use of "behavioral teratology" evaluations as routine components of toxicologic screening procedures. As a basis for development of effective behavioral teratology screening approaches, a conceptual framework is presented which interrelates: (1) changes in relative functional brain capacity with age, (2) possible times and durations of exposures to environmental insults, and (3) various types of toxicity testing procedures carried out at appropriate time points in relation to different exposure period. Within the context, several research strategies for behavioral teratology studies are concisely posed and evaluated. These include: (1) clinical hypothesis testing, where particular effect(s) of a given agent are evaluated based on hypotheses derived from clinical or epidemiological observations; (2) comprehensive screening approaches, where multifaceted, long-term longitudinal neurobehavioral evaluations are employed to assess whether any of a large number of possible deletarious effects are exerted by an agent and at what threshold exposure levels; (3) alternative screening heuristics, by which adequate assessments of neurobehavioral toxicity of various agents may be accomplished without completion of more exhaustive, but also more expensive and time-consuming comprehensive screening protocols.
Hypersexual Episodes in Temporal Lobe Epilepsy
Authors: DIETRICH BLUMER
Journal: American Journal of Psychiatry (1970)

The most common sexual abnormality in temporal lobe epilepsy is a marked lack of libidinal and genital arousal. The author documents the occurrence of hypersexual behavior in 50 temporal lobe epileptics, 42 of whom had unilateral temporal lobectomy. Twenty-nine (58 percent) were clearly hyposexual prior to surgery; seven (14 percent) had distinct episodes of hypersexuality. In six patients the hypersexual episodes followed the abrupt cessation of temporal lobe seizure activity following either temporal lobectomy or seizures. These findings document the role of the temporal limbic structures in the regulation of sexual arousal.
Hepatic Metabolism of Estrogens in Health and Disease
Authors: Herman Adlercreutz
Journal: New England Journal of Medicine (1974)

Estrogens are secreted mainly by the gonads and to a very small extent by the adrenals. In addition, they are formed to an important degree from peripheral conversion of adrenal and gonadal androgens, mainly androstenedione and testosterone, to estrogens. They circulate in both unconjugated and conjugated form in the blood with the unconjugated estrogens either free (minimal amounts) or bound to proteins, mainly to albumin and to the specific sex-hormone-binding globulin (SHBG), which shows a great affinity for estradiol, but even greater for testosterone.The estrogens are metabolized mainly in the liver, but other organs also contribute. Regarding liver disease . . .
Impact of Stepping Stones on incidence of HIV and HSV-2 and sexual behaviour in rural South Africa: cluster randomised controlled trial
Authors: R. Jewkes, M Nduna, J Levin, N Jama, K Dunkle, A Puren, N Duvvury
Journal: BMJ (2008)

<b>Objective</b> To assess the impact of Stepping Stones, a HIV prevention programme, on incidence of HIV and herpes simplex type 2 (HSV-2) and sexual behaviour. <b>Design</b> Cluster randomised controlled trial. <b>Setting</b> 70 villages (clusters) in the Eastern Cape province of South Africa. <b>Participants</b> 1360 men and 1416 women aged 15-26 years, who were mostly attending schools. <b>Intervention</b> Stepping Stones, a 50 hour programme, aims to improve sexual health by using participatory learning approaches to build knowledge, risk awareness, and communication skills and to stimulate critical reflection. Villages were randomised to receive either this or a three hour intervention on HIV and safer sex. Interviewers administered questionnaires at baseline and 12 and 24 months and blood was tested for HIV and HSV-2. <b>Main outcome measures</b> Primary outcome measure: incidence of HIV. Other outcomes: incidence of HSV-2, unwanted pregnancy, reported sexual practices, depression, and substance misuse. <b>Results</b> There was no evidence that Stepping Stones lowered the incidence of HIV (adjusted incidence rate ratio 0.95, 95% confidence interval 0.67 to 1.35). The programme was associated with a reduction of about 33% in the incidence of HSV-2 (0.67, 0.46 to 0.97; P=0.036)—that is, Stepping Stones reduced the number of new HSV-2 infections over a two year period by 34.9 (1.6 to 68.2) per 1000 people exposed. Stepping Stones significantly improved a number of reported risk behaviours in men, with a lower proportion of men reporting perpetration of intimate partner violence across two years of follow-up and less transactional sex and problem drinking at 12 months. In women desired behaviour changes were not reported and those in the Stepping Stones programme reported more transactional sex at 12 months. <b>Conclusion</b> Stepping Stones did not reduce incidence of HIV but had an impact on several risk factors for HIV—notably, HSV-2 and perpetration of intimate partner violence. <b>Trial Registration</b> Clinical Trials NCT00332878.
Injuries to common bile duct during laparoscopic cholecystectomy.
Authors: R Smith
Journal: BMJ (1991)

and that associations with low infant growth rates are partly determined before birth.' It is not clear what D P Davies and J Matthes mean by "nutritional and metabolic stress."Whatever it is, for their explanation to be correct it would have to be independent of social class to explain our observations.In the Hertfordshire study birth weight and plasma glucose, insulin, and proinsulin concentrations were not related to social class, either at birth or currently.
The Value of 18F-FDG PET/CT after Autologous Stem Cell Transplantation (ASCT) in Patients Affected by Multiple Myeloma (MM)
Authors: Cristina Nanni, Elena Zamagni, Monica Celli, Paola Caroli, Valentina Ambrosini, Paola Tacchetti, Annamaria Brioli, Beatrice Zannetti, Annalisa Pezzi, Lucia Pantani, Giulia Perrone, Maurizio Zompatori, Michele Cavo, Patrick M. Colletti, Domenico Rubello, Stefano Fanti
Journal: Clinical Nuclear Medicine (2012)

Aim The objective of this study was to analyze the prognostic value of 18F-FDG PET/CT after therapy in patients with multiple myeloma (MM). Patients and Methods One hundred seven patients prospectively recruited with MM had FDG PET/CT at staging 3 months after therapy (autologous stem cell transplantation) and every 6 to 12 months during the follow-up (mean 41 months). Patients were divided into group 1 (relapsed) and group 2 (nonrelapsed). In group 1, PET results and SUVmax were compared to the time to relapse (TTR). In group 2, the presence of PET finding changes during follow-up was analyzed to identify typical patterns of disease behavior (ie, late responders or stabilized disease). Patients with a negative PET at staging were excluded from further evaluation. Results Forty-seven out of 107 (44%) patients relapsed: 10 were excluded because of a negative PET at staging. In group 1, 22 patients had a negative posttherapy PET (59%, mean TTR = 27.6 months) and 15 had a positive posttherapy PET (41%, mean TTR = 18 months). There was a significant difference between the TTR of the two subgroups (t test P = 0.05). In patients with a positive posttherapy PET, the SUVmax was inversely correlated to the TTR (correlation coefficient = −0.7; P < 0.01). Sixty out of 107 (56%) patients did not relapse. Twenty patients were excluded because of a negative PET at staging. In group 2, 27 patients had a negative posttherapy PET (68%) and 13 had a positive posttherapy PET (32%). None of nonrelapsed patients showed a progressive increase in SUVmax during the follow-up. There was no significant difference between relapsed and nonrelapsed patients in terms of SUVmax at posttherapy PET/CT (t test P = 0.7). Conclusion In our series of MM patients, a negative posttherapy PET was predictive for nonrelapse or a long disease-free survival. In contrast, a persistent significantly increased SUVmax after therapy was correlated to a short TTR.
P170 A cost-effectiveness analysis of respiratory syncytial virus (RSV) prophylaxis in infants in the UK
Authors: A. Bentley, I. Filipovic, K. Gooch, K. Buesch
Journal: Thorax (2011)

<h3>Background and Aim</h3> RSV is the most common cause of lower respiratory tract infection in young children and may result in hospitalisations, long-term sequelae, such as recurrent wheeze and/or asthma, and possibly death. Palivizumab is a prophylaxis against severe RSV infection and has been shown to reduce RSV-related hospitalisations, and provides a preventative option for high-risk infants. The aim of this study is to demonstrate the cost-effectiveness of RSV prophylaxis compared to no prophylaxis in the following high-risk infants groups: infants with chronic lung disease (CLD) and premature babies (&lt;29, 29–32 and 33–35 weeks gestational age (wGA)). <h3>Methods</h3> A decision-tree model was developed to reflect the clinical pathway of infants at high-risk of severe RSV infection. Baseline risk of RSV-hospitalisations and efficacy data were taken from palivizumab clinical trials and published meta-analysis. Cost data were obtained from national databases and published literature using an NHS perspective. The main outcome was presented as the incremental costs per Quality-Adjusted Life-Year (QALY) gained (ICER). The base-case analysis considered a lifetime horizon to capture the impact of long-term morbidity and mortality associated with RSV hospitalisations. <h3>Results</h3> Prophylaxis against severe RSV infection resulted in ICERs of £19 168, £18 174 &amp; £1185 per QALY for high-risk infants with, CLD and the premature infant groups, &lt;29 wGA and 29–32 wGA respectively compared to no prophylaxis. All results are below the accepted NICE threshold of £30 000 /QALY thus demonstrating cost-effectiveness. The baseline ICER for the 33–35 wGA subgroup was above this threshold however, sensitivity analysis considering risk-factors in this subgroup showed that an increase in baseline risk of hospitalisation, from 7.2% to 11.24%, led to palivizumab becoming a cost-effective option. <h3>Conclusions</h3> Severe RSV infection in high-risk infants represents a significant cause of morbidity and mortality and is associated with a high economic burden. Palivizumab was found to be cost-effective compared to no prophylaxis in the UK in all of the subgroups considered, demonstrating a good use of NHS resources.
Re-emergence of leishmaniasis in Spain: community outbreak in Madrid, Spain, 2009 to 2012
Authors: A Arce, A Estirado, M Ordobas, S Sevilla, N García, L Moratilla, S de la Fuente, A M Martínez, A M Pérez, E Aránguez, A Iriso, O Sevillano, J Bernal, F Vilas
Journal: Eurosurveillance (2013)

Since July 2009, there has been a community outbreak of leishmaniasis in the south-west area of the Madrid autonomous community, Spain, affecting residents from four towns that are geographically close together and share extensive park areas. As of December 2012, 446 cases were reported (6 in 2009, 97 in 2010, 196 in 2011 and 147 in 2012), a mean incidence rate of 22.2 per 100,000 inhabitants during July 2009 and December 2012. The mean age was 44 years (range: 2 months to 95 years); 61.0% were male. A total of 68 (15.2%) had immunosuppressive conditions; 160 (35.9%) had visceral leishmaniasis and 286 (64.1%) cutaneous. A total of 421 (94.4%) cases were confirmed. Leishmania infantum was identified as the agent. Monitoring revealed high densities of the vector Phlebotomus perniciosus. The surveillance system for canine leishmaniasis did not detect any increase in prevalence during the period. Environmental control measures have been taken, such as improvements in sanitation and disinsection in the risk areas and control of the overpopulation of Leporidae, as xenodiagnosis studies have shown that hares play a role as active reservoirs. This is the largest reported community outbreak of leishmaniasis in Europe. The discovery of the new reservoir stands out in the multifactorial aetiology of the outbreak. Epidemiological research and environmental intervention measures are continuing.
Chylothorax and Portal Cirrhosis
Authors: Eduardo J. Yunis
Journal: JAMA (1965)

THE FINDINGS of right-sided chylothorax and portal cirrhosis without chylous ascites in a recent autopsy raised the questions of a causative association of the two conditions and the possible mechanisms of such an association. Chylothorax is usually due to trauma or to metastatic malignancy. Tuberculous involvement of the thoracic duct and a variety of other diseases have also been known to produce chylothorax. Many cases, however, are classified as idiopathic with no clear-cut explanation for the presence of the chylothorax. We are not aware of reports in which chylothorax was explained on the basis of portal cirrhosis. One of the case reports of the Massachusetts General Hospital1may be an example of this association, although, in the discussion of that case, no correlation between chylothorax and portal cirrhosis was made. The present communication reports a case of chylothorax with portal cirrhosis in which an autopsy was performed and suggests a
Epithelial-to-mesenchymal transitions in the liver
Authors: Steve S. Choi, Anna Mae Diehl
Journal: Hepatology (2009)

The outcome of liver injury is dictated by the effectiveness of repair. Successful repair (i.e., regeneration) results in replacement of dead epithelial cells with healthy epithelial cells, and reconstructs normal hepatic structure and function. Liver regeneration is known to involve replication of surviving mature hepatocytes and bile duct cells. This review discusses recent evidence for other mechanisms that might also replace dead hepatic epithelial cells and repair liver damage, particularly during chronic injury. According to this theory, certain epithelial cells in developing livers and/or injured adult livers undergo epithelial-to-mesenchymal transition (EMT) and move into the hepatic mesenchyme where they exhibit fibroblastic features. Some of these epithelia-derived mesenchymal cells, however, may be capable of undergoing subsequent mesenchymal-to-epithelial transition (MET), reverting to epithelial cells that ultimately become hepatocytes or cholangiocytes. Although these concepts remain to be proven, the theory predicts that the balance between EMT and MET modulates the outcome of chronic liver injury. When EMT activity outstrips MET, repair is mainly fibrogenic, causing liver fibrosis. Conversely, predominance of MET favors more normal liver regeneration. In this review, we summarize evidence that certain resident liver cells are capable of EMTs in vitro and during chronic liver injury. (HEPATOLOGY 2009.)
The Effect of Granulocyte Transfusions on the Incidence of Cytomegalovirus Infection After Allogeneic Marrow Transplantation
Authors: JOHN HERSMAN
Journal: Annals of Internal Medicine (1982)

The association of granulocyte transfusions with cytomegalovirus infection and interstitial pneumonitis in allogeneic marrow transplant recipients was reviewed. Data from 387 patients with aplastic anemia or acute leukemia receiving transplants from human leukocyte antigen-matched siblings were analyzed. Acquisition of cytomegalovirus infection was higher in recipients of prophylactic and therapeutic granulocytes than in control subjects. The incidence was significantly different, however, only in cytomegalovirus seronegative patients who received granulocytes from seropositive granulocyte donors. There was no significant increase in the total incidence of or mortality from all forms of interstitial pneumonitis.
Crushed Aspirin Tablets
Authors: Andre J. Bruwer
Journal: JAMA (1975)

<h3>To the Editor.—</h3> I was interested in the letter by Martin I. Blake, PhD (230:1385, 1974), concerning the proper way of prescribing aspirin tablets. Blake suggests that the patient be instructed to chew the tablets and to then swallow them with an adequate amount of water or to crush the tablets and suspend the powder in orange juice. Anyone who has chewed aspirin knows that this is so unpleasant as to lead to the preference of swallowing the tablets whole. For many years, I have advised patients, when taking aspirin, to place the tablets in the mouth, to follow this with a large mouthful of milk and, while the milk is held in the oral cavity, to chew the tablets. This bolus is then swallowed and followed by two or three mouthfuls of milk. By this method the unpleasant taste is almost completely masked. The only objection to this suggestion
Haemothorax in Haemophilia
Authors: K. E. Barrett, M. C. G. Israels
Journal: Thorax (1965)

<h3>Abstract</h3> There has been a lot of debate about the use of the Adenosine Deaminase (ADA) for tuberculosis (TB) diagnosis. In the present study, to overcome this debate, we have planned a large scale study in all forms of TB to access the performance of ADA for diagnosis of TB. we have also studied the performance of the ADA in the Tb prognosis. ADA activity was evaluated using Guisti and Galanti method. The sensitivity of the ADA test is impressive in all forms of TB clinical samples analysed for the study (PTB [82%], TBM [85%] TBAR [85%]), and (ATB) [84%]. However, the specificity was variable in pulmonary TB, but satisfactory in extrapulmonary TB (EPTB) cases (i.e TBM [89%], (ATB) [88%], TBAR [88%]). In the follow-up samples, ADA value declined drastically after the anti TB medication (ATT). Our study, which consists of a large number of samples, suggests that the ADA has very limited value in the diagnosis of PTB, and hence it is not recommended for PTB diagnosis. We recommend, ADA test is quite useful for EPTB diagnosis along with other clinical correlations and in absence of other advanced diagnostic tests. However, on the other ADA can be used as a prognostic test for all forms of TB.
Reliable and Sustainable Comprehensive Care for Frail Elderly People
Authors: Joanne Lynn
Journal: JAMA (2013)

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Which Surgical Procedure for Uncomplicated Hiatus Hernia
Authors: Beatty H. Ramsay
Journal: JAMA (1965)

<h3>To the Editor:—</h3> One views with alarm the enthusiastic use of vagotomy with pyloroplasty in the treatment of uncomplicated symptomatic hiatus hernia of the esophagus. This is advocated in presentations at surgical and medical meetings, in published papers, and at panel discussions. Some panelists with widespread influence recommend defunctionalizing vagotomy for this entity and either no effort at repair of the hernia or a perfunctory placement of one or two sutures to narrow the hiatus. Surgeons and internists of mature experience know that uncomplicated hiatus hernia, with its usual peptic esophagitis, is cured, unequivocally, by adequate repair of the herniation. Symptomatic relief is immediate. Failure to cure signifies incomplete correction of the herniation. Recurrent herniation is due to technical or tissue failure. Vagotomy bears a long list of significant side effects, including chronic diarrhea (30% among 44 patients undergoing the "balanced" operation for hiatus hernia—Carl Schlicke,<i>Amer J Surg</i><b>106</b>
Result of Experience in Bleeding, not Limited by Particular Organs, Diseases, Classes of Persons, or Seasons
Authors: J. H. James
Journal: BMJ (1866)

In the three cases of diphtheria pub- lished in the BRITISH MEDICAL JOURNAL Of last week, the advance of the local lesion was the cause of death; while, in this case, the throat-affection was comparatively trifling, and the disease proved fatal by the slower process of exhaustion.The hemorrhage from the bowels and the eruption indicated serious blood-change; and there is no doubt that the former, by its amount, accelerated death.It is worth while noting the speedy effect of the Bael wine in arresting the hemorrhage.Dr. Stewart finds it equally useful in all cases of true dysentery.