tbuckley/cabot-search huggingface dataset:
Risk of epilepsy after febrile convulsions: a national cohort study.
Authors: C M Verity, J Golding
Journal: BMJ (1991)

OBJECTIVE--To identify children with febrile convulsions, classify their febrile convulsions into simple and complex, and determine the number and type of subsequent afebrile seizures in those children. DESIGN--National population based study. SETTING--United Kingdom. SUBJECTS--16,004 neonatal survivors born during one week in April 1970. MAIN OUTCOME MEASURES--Information about febrile and afebrile seizures obtained from questionnaires at 5 and 10 years of age and from hospital records. RESULTS--Information was available for 14,676 of the cohort children. 398 (2.7%) of them had had at least one febrile convulsion. 16 children were known to be neurologically or developmentally abnormal before the first attack. Of the remaining 382 children, 305 had had a simple first febrile convulsion and 77 a complex first febrile convulsion. Thirteen of the 382 had had one or more afebrile seizures, nine of whom had developed epilepsy (recurrent afebrile seizures). A higher proportion of children with complex febrile convulsions (6/95) rather than simple febrile convulsions (3/287) developed epilepsy, the risk being highest for those who had had focal febrile convulsions (5/17; chi 2 = 39.9, p less than 0.001). Three of the 32 children who had prolonged febrile convulsions developed afebrile complex partial seizures. CONCLUSIONS--The risk of epilepsy after febrile convulsions is much less than reported in many hospital studies, and if febrile convulsions cause brain damage that leads to later epilepsy this is a rare occurrence.
Interhemispheric Transfer in Alexithymia: A Transcallosal Inhibition Study
Authors: Hans Joergen Grabe, Bertram Möller, Carsten Willert, Carsten Spitzer, Tim Rizos, Harald Juergen Freyberger
Journal: Psychotherapy and Psychosomatics (2004)

This study investigates the hypothesis that alexithymia is associated with an interhemispheric transfer deficit via the corpus callosum (CC).The transcallosal inhibition paradigm was used to assess interhemispheric transfer. Transcranial magnetic stimulation (TMS) and peripheral electromyographic recordings were performed in 10 right-handed male and 10 female students with Toronto Alexithymia Scale (TAS-20) scores of > or = 61 and controls (TAS-20 scores of < 61). The transcallosal conduction time (TCT) reflects the TMS-induced inhibitory cortical activity that is mediated via the CC.There was a significant interaction between gender and alexithymia (Wilks lambda = 0.89; F = 3.4; d.f. = 2, 57; p = 0.04) indicating that alexithymic males had shorter bidirectional TCTs than controls and a significantly shorter left to right TCT than controls (p = 0.002). However, the left to right TCT was not significantly different from the right to left TCT in alexithymic males (p = 0.39). Alexithymic females were not different from controls.Our results clearly stand in contrast to the hypothesis of a transfer deficit due to a dysfunction of the CC in alexithymia. Facilitated, bidirectional transcallosal inhibition of the contralateral motor activity is associated with alexithymia in males. Facilitated cortical inhibition may be a neurobiological correlate of alexithymia.
Prognostic indicators in primary biliary cirrhosis: significance of revised IAHG (International Autoimmune Hepatitis Group) score
Authors: Ho Eun Jung, Jae Young Jang, Soung Won Jeong, Jin Nyoung Kim, Hee Yoon Jang, Yun Ju Cho, Sung Ae Woo, Sae Hwan Lee, Sang Gyune Kim, Sang-Woo Cha, Young Seok Kim, Young Deok Cho, Hong Soo Kim, Boo Sung Kim
Journal: Clinical and Molecular Hepatology (2012)

Background/Aims Primary biliary cirrhosis (PBC) is a slowly progressing autoimmune disease of the liver that is characterized by portal inflammation and immune-mediated destruction of the intrahepatic bile ducts. Serum total bilirubin is one of the various prognostic factors that have been proposed. A recent study found that PBC with accompanying autoimmune hepatitis (AIH) carries a negative prognosis. This study examined the clinical characteristics of PBC and analyzed the factors that affect its prognosis. Methods Patients diagnosed with PBC between January 1998 and December 2010 based on clinical and histopathological findings were compiled and analyzed retrospectively. Results Among 27 patients, 24 (1 male and 23 females, ages 50.0±9.3 years) were followed up. The follow-up period was 8.6±0.9 years. Of the 24 patients, 9 patients progressed to liver cirrhosis (LC). Comparison between patients who did and did not progress to LC revealed statistically significant differences in the patients' serum total bilirubin (2.7±1.8 vs. 0.8±0.4, P=0.012), the Mayo risk score (5.1±0.7 vs. 3.9±0.6, P=0.001), the revised IAHG (International Autoimmune Hepatitis Group) score (9.2±2.3 vs. 5.4±3.0, P=0.004) and frequency of AIH overlap (5/9 [55.6%] vs. 0/15 [0%], P=0.001) at the time of diagnosis. Conclusions We propose that serum total bilirubin, the Mayo risk score, and the revised IAHG score at the time of diagnosis are helpful for predicting PBC prognosis. In particular, since all of the patients with accompanying AIH progressed to LC, the presence of overlap syndrome at the time of diagnosis is helpful for predicting PBC prognosis and providing an adequate treatment. Keywords: Primary biliary cirrhosis; Prognosis; Overlap syndrome
Clinical Pharmacology of Learning and Memory
Authors: Thomas T. Tourlentes
Journal: JAMA (1984)

The title of this slender volume promises more than it delivers, because it is really only intended to be a reference guide for interested researchers and clinicians. The author has succeeded, to a fair degree, in satisfying this more specific need, particularly for researchers. This is a rather extensive bibliography (more than 550 items) organized along 15 pharmacologically relevant chapter headings. The author's brief comments help tie together the various citations, and this tends to give the information a somewhat more cohesive quality. However, the author also assumes a substantial amount of previous technical knowledge and understanding. There is a wealth of condensed information here, laboriously collected throughout many years, but this is not likely to be useful to the average curious clinician. Incidentally, a majority of citations are older than five years. This presumably reflects limited current work in the field, certainly a worthwhile subject for additional new research
Serum trypsin concentrations in diabetes mellitus.
Authors: P Dandona, E Elias, A G Beckett
Journal: BMJ (1978)

Serum trypsin concentrations in diabetes mellitusAbnormalities in exocrine pancreatic function occur in patients with diabetes mellitus and their prevalence is particularly high in insulin- dependent diabetics.'Measurement of serum trypsin is a relatively simple test of exocrine pancreatic function.2We therefore undertook a study of serum trypsin concentrations in diabetic patients.
Inhibition of cell surface mediated plasminogen activation by a monoclonal antibody against α‐Enolase
Authors: Roser López‐Alemany, Colin Longstaff, Stephen Hawley, Massoud Mirshahi, Pere Fábregas, Merce Jardí, Elizabeth Merton, Lindsey A. Miles, Jordi Félez
Journal: American Journal of Hematology (2003)

Abstract Localization of plasmin activity on leukocyte surfaces plays a critical role in fibrinolysis as well as in pathological and physiological processes in which cells must degrade the extracellular matrix in order to migrate. The binding of plasminogen to leukocytic cell lines induces a 30‐ to 80‐fold increase in the rate of plasminogen activation by tissue‐type (tPA) and urokinase‐type (uPA) plasminogen activators. In the present study we have examined the role of α‐enolase in plasminogen activation on the cell surface. We produced and characterized a monoclonal antibody (MAb) 11G1 against purified α‐enolase, which abrogated about 90% of cell‐dependent plasminogen activation by either uPA or tPA on leukocytoid cell lines of different lineages: B‐lymphocytic, T‐lymphocytic, granulocytic, and monocytic cells. In addition, MAb 11G1 also blocked enhancement of plasmin formation by peripheral blood neutrophils and monocytes. In contrast, MAb 11G1 did not affect plasmin generation in the presence of fibrin, indicating that this antibody did not interact with fibrinolytic components in the absence of cells. These data suggest that, although leukocytic cells display several molecules that bind plasminogen, α‐enolase is responsible for the majority of the promotion of plasminogen activation on the surfaces of leukocytic cells. Am. J. Hematol. 72:234–242, 2003. © 2003 Wiley‐Liss, Inc.
Immunodeficiency without HIV Clinical presentations vary
Authors: M A Monteil, D C Henderson, S Obaro, D Dev, G S Basran, D Slater, P Taylor, M Wood
Journal: BMJ (1994)

EDITOR, - A McNulty and colleagues reported on seven HIV negative patients with CD4 T lymphocytopenia and clinical disease due to defective cell mediated immunity.1 These cases were found during a national survey in Australia in which 96 practitioners were contacted. We present information on five HIV negative patients (four adults and one child) seen in our department between 1991 and 1993 (table) who meet the criteria set by McNulty and colleagues; two of them also satisfy the Centers for Disease Control's criteria for CD4 T lymphocytopenia as defined by McNulty and colleagues. All patients had been referred to our department of immunology for evaluation of suspected immunodeficiency.

View this table:

Details of HIV negative patients with CD4 lymphocytopenia



In contrast to the Australian group, our patients presented with a diverse range of clinical problems, from planar warts …
Rise and demise of the hospital: Backwards is the new forward: time for the heritage hospital
Authors: Richard Neil Harrison
Journal: BMJ (2006)

The nursing profession's coming of age The end of medicine as a professionEditor-Young describes the coming of age of the nursing profession. 1 All professions and occupations are human creations and therefore are subject to change.With the widening of roles of many professions, it becomes harder to define what a doctor can do that can't be done by an appropriately trained member of another profession.Perhaps major surgery and certifying cause of death are all that remains.With the increasing difficulty of getting junior doctors to do anything that may be regarded as work (rather than education) we doctors may be engineering the abolition of our profession, and we may move from distinct professions to practitioners from varied backgrounds being trained for a particular function.
The quantification of free sphingosine in the stratum corneum of patients with hereditary ichthyosis
Authors: D.G. PAIGE, N. MORSE-FISHER, J.I. HARPER
Journal: British Journal of Dermatology (1993)

Sphingosine is a long‐chain base which provides the back‐bone of all sphingolipid molecules. Free sphingosine is found in normal epidermis, especially in the stratum corneum. As a free molecule it may modify epidermal cell proliferation and differentiation through its inhibition of protein kinase C. Using a thin‐layer chromatography technique we have demonstrated in vitro that the erythrodermic ichthyoses show significantly lower levels of stratum corneum sphingosine than the non‐erythrodermic types. The exact in vivo significance of this finding is unclear, but free sphingosine may have an important role in determining the inflammatory component of the hereditary ichthyoses.
How does progress towards the child mortality millennium development goal affect inequalities between the poorest and least poor? Analysis of Demographic and Health Survey data
Authors: Kath A Moser, David A Leon, Davidson R Gwatkin
Journal: BMJ (2005)

improvements in safe water, sanitation, and indoor air quality, will also impact on child health.A major challenge in the achievement of millennium development goal 4 will be to find a sustainable intersectoral solution to reducing malnutrition in children and to tackle the root causes of poverty, lack of education, and sex inequality.
Increase in resources should lead to reduced waiting times
Authors: S. Martin
Journal: BMJ (2003)

EDITOR—Although highly topical, the paper by Martin et al on NHS waiting lists illustrates the misleading policy signals that can emerge from an inadequate analytic method.1 The paper finds little and inconsistent support for associations of prolonged waiting times with markers of capacity, independent sector activity, or need in the surgical specialties examined. Hard pressed policy makers might therefore infer that …
Reading Disability in Children
Authors: Gerald S. Coles
Journal: JAMA (1991)

<h3>To the Editor. —</h3> The finding that reading disabilities, "among the most common neurobehavioral childhood disorders," are equally prevalent in girls and boys<sup>1</sup>continues a century-long line of quasi-scientific research on "learning disabilities" that has done children more harm than good. As I demonstrate in my book,<i>The Learning Mystique: A Critical Look at 'Learning Disabilities</i>,'<sup>2</sup>the claim that millions of children with reading problems are afflicted with a neurological disorder is more belief than fact. A review of the research reveals that every proposed neurological explanation either has been disproved by replication studies or has been based on spurious investigations. Unfortunately, this fruitless pursuit has not kept youngsters from being branded with a diagnosis that obfuscates any genuine understanding of their problems. The study by Shaywitz et al<sup>1</sup>illustrates the nature of most research on learning disabilities. Although the researchers assert that reading disability is a
910-17 The Appropriate Choice of a Cardiac Valve Prosthesis in Elderly Patients
Authors: Dennis F. Pupello, Luis N. Bessone, Stephen P. Hiro, Enrique Lopez-Cuenca, M.S. Glatterer, William W. Angell, John C. Brock, Mark J. Alkire, Edward G. Izzo, G. Sanabria, George Ebra
Journal: Journal of the American College of Cardiology (1995)
Germany opposes EU plans for regulating clinical trials owing to lack of ethical standards
Authors: A. Tuffs
Journal: BMJ (2012)

The German Medical Association, several German members of parliament (MPs), and the German pharmaceutical industry have criticised the European Union’s (EU) plans for a new directive on clinical drug trials because they exclude the current ethical standards for safeguarding patients’ health. 

The EU directive aims to speed up clinical drug trials by streamlining procedures in the 27 member states. 

The main criticisms are that the proposals do not include the obligatory involvement of an ethics committee for approving a clinical trial, and that once a member state has taken over leadership in a clinical trial, other member states have no say …
Adenosine, a Potent Natural Suppressor of Arachidonic Acid Release and Leukotriene Biosynthesis in Human Neutrophils
Authors: NICOLAS FLAMAND, SYLVIE BOUDREAULT, SERGE PICARD, MICHÈLE AUSTIN, MARC E. SURETTE, HENDRICK PLANTE, ERIC KRUMP, MARIE-JOSÉE VALLÉE, CAROLINE GILBERT, PAUL NACCACHE, MICHEL LAVIOLETTE, PIERRE BORGEAT
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Leukotrienes (LTs) constitute a family of arachidonic acid (AA) metabolites with potent biological activities. Leukotriene B 4  and the cysteinyl-LTs (LTC 4 , -D 4 , and -E 4 ) have now been implicated in a number of physiological processes and inflammatory and allergic diseases (1). The early demonstration of an involvement of the cysteinyl-LTs as mediators of the bronchospasm in asthma has provided the impetus for the development of LT synthesis inhibitors and LT antagonists, and stimulated intensive research toward the understanding of the mechanisms of LT synthesis. While our knowledge of the biochemistry of LT synthesis and the enzymes involved has made remarkable progress, particularly with the identification and cloning of the proteins of the 5-lipoxygenase (5-LO) pathway, much remains to be learned about the complex mechanisms of regulation of the biosynthesis of these important mediators of inflammation and allergy.
Carcinoma of the Esophagus
Authors: S.S.B. GILDER
Journal: Annals of Internal Medicine (1977)

Abroad1 October 1977Carcinoma of the EsophagusS.S.B. GILDER, M.D.S.S.B. GILDER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-87-4-494 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptWhy do members of the black population of South Africa get carcinoma of the esophagus so much more frequently than do members of the white or Indian population? And why has this only happened since about 1940? Why should the eastern section of the country, Transkei, be particularly afflicted, and selectively at that? Why should the carcinoma appear at least 10 years earlier in blacks than in whites? And why should the disease appear to be so much more aggressive in the black man (not necessarily in the woman)?Anyone looking at the above list of questions will appreciate the... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: S.S.B. GILDER, M.D.Affiliations: Cape Town, South Africa PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1977Volume 87, Issue 4Page: 494-494KeywordsEsophagus ePublished: 1 December 2008 Issue Published: 1 October 1977 PDF downloadLoading ...
Intermittent rises in plasma homocysteine in patients with rheumatoid arthritis treated with higher dose methotrexate
Authors: M Hoekstra
Journal: Annals of the Rheumatic Diseases (2004)

<b>Objectives:</b> To investigate the effect of higher weekly maintenance dose methotrexate (MTX) (⩾25 mg/week) on plasma homocysteine concentrations in adults with RA. <b>Methods:</b> Patients with RA were treated with high doses of MTX with adjuvant folic acid. Plasma homocysteine was determined at baseline and 1, 2, 4, 8, 12, and 48 hours after subcutaneous MTX administration. Maximum homocysteine concentrations after MTX administration were compared with baseline concentrations. <b>Results:</b> Fifteen patients with RA (11 women) were included, with a median age of 61 years (range 31–72) and median disease duration 7 years (range 2–32). Median MTX dose was 30 mg (range 25–40). All patients received folic acid supplementation (5–30 mg/week). Median plasma homocysteine concentration at baseline was 10.1 μmol/l (range 6.6–12.7; normal 6–15). Homocysteine concentrations increased after MTX administration by a median of 2.5 μmol/l (range 0.7–5.1). Median maximum plasma homocysteine was significantly higher than at baseline. Peak homocysteine was reached after 12 hours. No relation between serum folate concentrations and plasma homocysteine concentrations was found. <b>Conclusions:</b> In patients with RA higher MTX doses with adjuvant folic acid do not increase baseline concentrations of homocysteine. An intermittent significant rise in plasma homocysteine occurs in the 48 hours after MTX administration.
Human piebaldism: relationship between phenotype and site of kit gene mutation
Authors: K.A. WARD, C. MOSS, D.S.A. SANDERS
Journal: British Journal of Dermatology (2010)

Human piebaldism is a rare autosomaal dominant disorder characterized by congenital depigmented patches of skin and hair. Piebaldism results from mutations of the kit proto‐oncogene, which encodes a cell‐surface receptor, tyrosine kinase, whose ligand is the stem/mast cell growth factor. We report four unrelated patients with piebaldism and consider the variations in phenotype in relation to the site of the kit gene mutation.
Primary Care Closed Claims Experience of Massachusetts Malpractice Insurers
Authors: Gordon D. Schiff, Ann Louise Puopolo, Anne Huben-Kearney, Winnie Yu, Carol Keohane, Peggy McDonough, Bonnie R. Ellis, David W. Bates, Madeleine Biondolillo
Journal: JAMA Internal Medicine (2013)

Despite prior focus on high-impact inpatient cases, there are increasing data and awareness that malpractice in the outpatient setting, particularly in primary care, is a leading contributor to malpractice risk and claims.To study patterns of primary care malpractice types, causes, and outcomes as part of a Massachusetts ambulatory malpractice risk and safety improvement project.Retrospective review of pooled closed claims data of 2 malpractice carriers covering most Massachusetts physicians during a 5-year period (January 1, 2005, through December 31, 2009). Data were harmonized between the 2 insurers using a standardized taxonomy. Primary care practices in Massachusetts. All malpractice claims that involved primary care practices insured by the 2 largest insurers in the state were screened. A total of 551 claims from primary care practices were identified for the analysis.Numbers and types of claims, including whether claims involved primary care physicians or practices; classification of alleged malpractice (eg, misdiagnosis or medication error); patient diagnosis; breakdown in care process; and claim outcome (dismissed, settled, verdict for plaintiff, or verdict for defendant).During a 5-year period there were 7224 malpractice claims of which 551 (7.7%) were from primary care practices. Allegations were related to diagnosis in 397 (72.1%), medications in 68 (12.3%), other medical treatment in 41 (7.4%), communication in 15 (2.7%), patient rights in 11 (2.0%), and patient safety or security in 8 (1.5%). Leading diagnoses were cancer (n = 190), heart diseases (n = 43), blood vessel diseases (n = 27), infections (n = 22), and stroke (n = 16). Primary care cases were significantly more likely to be settled (35.2% vs 20.5%) or result in a verdict for the plaintiff (1.6% vs 0.9%) compared with non-general medical malpractice claims (P < .001).In Massachusetts, most primary care claims filed are related to alleged misdiagnosis. Compared with malpractice allegations in other settings, primary care ambulatory claims appear to be more difficult to defend, with more cases settled or resulting in a verdict for the plaintiff.
Mortality in Persons With Multiple Sclerosis in the Seattle and Los Angeles Areas
Authors: Roberta M. Malmgren
Journal: JAMA (1981)

Case-mortality and survival rates of more than 2,000 prevalent cases of multiple sclerosis (MS) residing in either Los Angeles County, California, or King and Pierce Counties, Washington, and followed up for 105 months, are reported. Case-mortality at the end of the 105 months was 16.9% of the total group. All age and sex groups had a lower survival rate than the US general population; this difference was especially pronounced in the high-disability groups. There was a trend toward higher case-mortality in high-disability Los Angeles County patients when compared with high-disability patients from King and Pierce Counties. (<i>JAMA</i>1981;246:2042-2045)