tbuckley/cabot-search huggingface dataset:
Inactivated Hepatitis A Vaccines
Authors: Stanley M. Lemon
Journal: JAMA (1994)

In this issue of<i>JAMA</i>, Innis and colleagues<sup>1</sup>describe a remarkable clinical trial of a new, formalin-inactivated hepatitis A vaccine performed among 40 119 children in Thailand. An impressive effort, this study compared the frequency of hepatitis A in children aged 1 to 16 years after two or three doses of either the hepatitis A vaccine developed by SmithKline Beecham Biologicals, Rixensart, Belgium, or a recombinant hepatitis B vaccine. The hepatitis A vaccine was found to be highly effective in preventing symptomatic illness associated with elevated serum alanine aminotransferase and positive IgM antibodies to hepatitis A virus (HAV). No serious adverse reactions were noted after administration of more than 109 000 doses. This is the second clinical trial to document efficacy of an investigational, formalin-inactivated hepatitis A vaccine; it follows the 1992 report of a similar vaccine developed by Merck Research Laboratories, West Point, Pa, See also p 1328.
Quality of Life Changes in Patients with Neurogenic versus Idiopathic Detrusor Overactivity after Intradetrusor Injections of Botulinum Neurotoxin Type A and Correlations with Lower Urinary Tract Symptoms and Urodynamic Changes
Authors: Vinay Kalsi, Apostolos Apostolidis, Roshni Popat, Gwendoline Gonzales, Clare J. Fowler, Prokar Dasgupta
Journal: European Urology (2006)
Relative hypercalciuria in nephrolithiasis.
Authors: L. C. Isaacson, M. Modlin, W. P. Jackson
Journal: BMJ (1966)

Hypercalciuria has long been suspected of being of importance in the pathogenesis of renal calculi. Several studies, however (Hodgkinson and Pyrah, 1958 ; Boyce and King, 1959 ; Gershoff and Prien, 1960 ; Litin et al., 1961; Lathem and King, 1963 ; Modlin, 1965), have shown no consistent differences in either the 24-hour output or the concentration of urinary calcium in stone-forming and normal subjects..
Coffee Intake and Serum Lipids in Men
Authors: Frank H. Zeller
Journal: JAMA (1985)

To the Editor.—  When a local radio station reported that a recent medical report stated that drinking more than two or three cups of coffee a day is associated with increased cholesterol levels, I decided that I had to indicate my displeasure in seeing another JAMA article 1 that should have died under the editor's pen.  Several much larger studies than this 77-man study found no significant coffee-cholesterol association (p 1410) (although a few studies suggest an association). I believe that this study was too small and followed up subjects for too short a time. The scattergrams on page 1410 show three things: (1) Not enough people who drink more than four cups of coffee a day were included (skewness). (2) A linear relationship was made from nonlinear data and, therefore, Pearson's correlation coefficient, r , should not have been used; rather, a non-parametric correlation method, such as Spearman's ρ or Kendall's
Erythropoietic protoporphyria.
Authors: D.M. MACDONALD, D.C. NICHOLSON
Journal: British Journal of Dermatology (1976)

The terminal stages of erythropoietic protoporphyria are recorded. The observations are related the site of the fundamental lesion and the nature of the biochemical defect. The possibly ominous prognosis in this usually mild condition is emphasized. Apart from congenital porphyria, the porphyrias do not usually confer severe cutaneous lesions. These diseases present to dermatologists because of moderate photosensitivity and are not usually regarded as a risk to life. Dangerous central nervous system involvement may occur, however, acute intermittent, variegate and hereditary coproporphyrias, while in acquired symptomatic por-phyria severe underlying liver dysfunction may occur. Probably the most common familial photosensitizing porphyria is erythropoietic protoporphyria. Recently some deaths from severe liver involvement have been reported in this disease.
A History of Neglect: Health Care for Blacks and Mill Workers in the Twentieth Century South
Authors: Richard Allen Williams
Journal: JAMA (1989)

This is a dichotomous book with many comparisons and contrasts. The author, Edward H. Beardsley, a history professor at the University of South Carolina, set for himself the rather interesting and unprecedented task of performing a side-by-side analysis of two very disparate groups, blacks and the so-called poor white trash who worked in the textile mills of the South. In doing so, he attempted to show that blacks and white Southern mill workers were in a sense connected by a common bond, ie, poor health, and it was his purpose to "join the health histories of the two populations in a single narrative." Professor Beardsley begins his analysis in the preface by making the provocative statement, "Mill workers confronted health problems equal in magnitude to those borne by blacks." Many have long believed that blacks have always been the worst cared-for population group in the country, and it induces such
Treatment of<i>Pneumocystis carinii</i>Pneumonitis
Authors: Walter T. Hughes
Journal: New England Journal of Medicine (1976)

Before a satisfactory treatment became available, the outlook for patients with Pneumocystis carinii pneumonitis was bleak. This illness, unique to the compromised host, proved fatal in 50 per cent of infantile cases during European epidemics and in about 100 per cent of affected children and adults who were immunodeficient because of neoplasia, anticancer therapy, organ transplantation or congenital immune deficiency disorders. In 1958 Ivády and Páldy, in Budapest, successfully treated the infection with pentamidine isethionate, a diamidine with antiprotozoal and antifungal activity. They were eventually able to reduce the mortality from infantile P. carinii pneumonitis from 50 per cent to . . .
Polyarthritis and Neutropenia Associated with Circulating Large Granular Lymphocytes
Authors: WAYNE JACK WALLIS
Journal: Annals of Internal Medicine (1985)

Five patients with polyarthritis and neutropenia had numerous circulating large granular lymphocytes with a phenotype attributed to immature natural killer cells. All five had splenomegaly and recurrent infections. Arthritis was most prominent at the wrists and hands, and all patients were considered to have atypical cases of Felty's syndrome. Antinuclear antibodies, rheumatoid factor, antineutrophil antibodies, and immune complexes were detected in most patients. Bone marrow biopsies revealed a maturation arrest at the myelocyte stage and lymphoid infiltrates. Large lymphocytes with azurophilic cytoplasmic granules were found on peripheral blood smears and showed a characteristic reactivity pattern with monoclonal antibodies suggesting a natural killer cell lineage. Peripheral blood mononuclear cells showed less than normal natural killer activity against K562 target cells. Increased numbers of large granular lymphocytes with a phenotype of immature natural killer cells may be important in the pathogenesis of neutropenia, humoral immune disturbances, and synovitis in a subset of patients with Felty's syndrome.
Infection of peripheral blood mononuclear cells by herpes simplex and Epstein-Barr viruses. Differential induction of interleukin 6 and tumor necrosis factor-alpha.
Authors: J Gosselin, L Flamand, M D'Addario, J Hiscott, J Menezes
Journal: Journal of Clinical Investigation (1992)

Infection by herpesviruses can result in profound immunosuppressive or immunomodulatory effects. However, no significant information is available on the effect of such infections on the production of immunoregulatory cytokines. We studied the kinetics of production of two monocyte-derived cytokines, interleukin 6 (IL-6) and tumor necrosis factor-alpha (TNF alpha), induced by Epstein-Barr virus (EBV) and herpes simplex virus type 1 (HSV-1) in peripheral blood mononuclear cell cultures and in fractionated cell populations. We observed that, when compared to HSV-1, EBV is a stronger inducer of IL-6. In EBV-infected cultures, IL-6 protein was detected at day 1 postinfection and gradually increased with time. In contrast, lower amounts of IL-6 were detected 5 d postinfection in HSV-1-infected cultures. HSV-1-infected cultures secreted significant amounts of TNF alpha protein after 5 d of culture and reached a maximal level of production at day 7, whereas EBV inhibited TNF alpha production. In fractionated cell populations, monocytic cells were found to be the main source of IL-6 synthesis after EBV or HSV-1 infection. However, TNF alpha synthesis in HSV-1-infected cultures was from both B and monocytic cells. By using the polymerase chain reaction technique we show that, after infection by these two herpesviruses, differences in cytokine gene products are also observed at the transcriptional level. These observations demonstrate that EBV and HSV-1 exert differential effects on IL-6 and TNF alpha gene transcription and on the resulting protein secretion in human mononuclear blood cells.
Acute appendicitis: Acute appendicitis or acute appendicectomy?
Authors: John G R Howie
Journal: BMJ (2006)

Editor-Last year Hern et al published an editorial on knife crime and clearly the problem has not gone away. 1 A quick search of the Times website finds 90 hits on the single search term "stabbing" in the past three months alone.Several recent deaths have fuelled the perception that forensic knife injuries have become an epidemic, resulting in a knife amnesty and government discussion of new punitive measures.An increase in such injuries is supported by data from regional police forces and the Home Office, with 1200 reported attacks in London last year and 30% of homicides caused by knife injury. 2 Crimes defined as "more serious wounding or other act endangering life" almost doubled nationally from 1995 to 2005. 3 We audited forensic knife injuries at this hospital, one of Europe's busiest emergency departments, to establish the size of this problem in a representative urban area (east London).We extracted data on forensic knife injuries (excluding deliberate self harm) from a detailed prospectively recorded database of all trauma calls from July 2004 to June 2006 (these reflecting more severe injuries).Overall there were 309 forensic knife injuries; 259 patients were admitted, 184 were operated on, and eight died.The chest was the most common area injured (183/309 patients, 6/8 deaths).Most patients were men (297/309), and mean age was 28 (range 15-74).To give a measure of changing incidence over a longer time of a greater range of severity of injury, we also performed an audit of all cases coded as "stabbing" on the patient administration system during the 10 year period from July 1997 to June 2006 (figure).Over both periods, the data show an increase in the overall incidence of stabbings.Furthermore, increased need for surgical intervention in the prospective study may reflect increasing severity of injury.These data therefore seem to support the general perception that knife injuries are increasing.
Tar yield of cigarettes and risk of acute myocardial infarction. GISSI-EFRIM Investigators.
Authors: E Negri, M G Franzosi, C La Vecchia, L Santoro, A Nobili, G Tognoni
Journal: BMJ (1993)

OBJECTIVE--To analyse the relation between tar and nicotine yield of cigarettes smoked in the recent past and the risk of myocardial infarction. DESIGN--Multicentre case-control study conducted between September 1988 and June 1989. SETTING--Over 80 coronary care units in various Italian regions. SUBJECTS--916 patients with acute myocardial infarction without history of ischaemic heart disease and 1106 controls admitted to hospital for acute conditions not related to known or suspected risk factors for ischaemic heart disease. MAIN OUTCOME MEASURES--Relative risk of myocardial infarction according to type of cigarette smoked adjusted for identified potential confounding factors. Brands of cigarettes classified according to yield of tar and nicotine. RESULTS--Patients with acute myocardial infarction were more often smokers and among smokers they tended to smoke more cigarettes. Compared with non-smokers their estimated relative risks were 3.8, 4.3, 3.2, and 3.7 in the four categories of tar yield (&lt; 10, 10-15, &gt; 15-20, and &gt; 20 mg, respectively). No trend in risk across yields was evident when analysis was restricted to smokers and allowance was made for number of cigarettes. Compared with risks in subjects in the lowest category of tar yield the relative risks were 1.2, 0.8, and 1.0 for the subsequent yields. Compared with risks in non-smokers the relative risks ranged from 9.3 to 12.6 below the age of 50 but no trend was observed with increasing yield. CONCLUSIONS--Changing to cigarettes with a lower tar yield is not an effective means of reducing tobacco related morbidity from myocardial infarction.
Guidelines for the Management of Patients with Chronic Stable Angina: Treatment
Authors: Stephan D. Fihn
Journal: Annals of Internal Medicine (2001)

The dual aims of treating patients with chronic stable angina are 1) to reduce morbidity and mortality and 2) to eliminate angina with minimal adverse effects and allow the patient to return to normal activities. In the absence of contraindications, β-blockers are recommended as initial therapy. All β-blockers seem to be equally effective. If the patient has serious contraindications to β-blockers, unacceptable side effects, or persistent angina, calcium antagonists should be administered. Long-acting dihydropyridine and nondihydropyridine agents are generally as effective as β-blockers in relieving angina. Long-acting nitrates are considered third-line therapy because a nitrate-free interval is required to avoid developing tolerance. All long-acting nitrates seem to be equally effective. Patients with angina should take 75 to 325 mg of aspirin daily unless they have contraindications. Such risk factors as smoking, elevated low-density lipoprotein cholesterol level, diabetes, and hypertension should be treated appropriately. Coronary revascularization has not been shown to improve survival for most patients with chronic angina but may be required to control symptoms. However, coronary artery bypass grafting (CABG) is often indicated for symptomatic patients with left-main disease, three-vessel disease, or two-vessel disease including proximal stenosis of the left anterior descending coronary artery; it improves their survival. Percutaneous transluminal coronary angioplasty is an alternative to CABG for patients with normal left ventricular function and favorable angiographic features. Coronary artery bypass grafting is initially more effective in relieving angina than medical therapy, but the two procedures yield similar results after 5 to 10 years. Eighty percent of patients who undergo CABG remain angina-free 5 years after surgery. In low-risk patients, percutaneous transluminal coronary angioplasty seems to control angina better than medical therapy, but recurrent angina and repeated procedures are more likely than with CABG. Patient education is an important component of management. Long-term follow-up should be individualized to ascertain clinical stability at regular intervals and to reassess prognosis when warranted.
On the protective mechanisms of nitric oxide in acute pancreatitis
Authors: J Werner, C Fernández-del Castillo, J A Rivera, N Kollias, K B Lewandrowski, D W Rattner, A L Warshaw
Journal: Gut (1998)

Background —Ectopic protease activation, microcirculatory changes, and leucocyte activation are the main events in the pathogenesis of acute pancreatitis. Nitric oxide (NO) is known to be a key mediator in the normal and inflamed pancreas. Aims —To investigate the targets on which NO exerts its effect in caerulein induced pancreatitis. Methods —Acute pancreatitis was induced in rats which additionally received either the NO synthase substrate, l -arginine; the NO donor, sodium nitroprusside; or the NO synthase inhibitor, N-nitro- l -arginine methyl ester ( l -NAME). At six hours, pancreatic injury (oedema, leucocyte content, ectopic trypsinogen activation) was analysed and pancreatic oxygenation and perfusion were determined. A direct influence of NO on amylase secretion and trypsinogen activation was evaluated separately in vitro. Results —Both NO donors reduced the grade of inflammation. l -NAME increased the severity of inflammation, while decreasing pancreatic tissue oxygenation. Although neither amylase secretion nor intracellular trypsinogen activation in caerulein stimulated pancreatic acini was influenced by either NO donors or inhibitors, both NO donors decreased intrapancreatic trypsinogen activation peptide (TAP) and pancreatic oedema in vivo, and l -NAME increased TAP. Conclusions —NO protects against injury caused by pancreatitis in the intact animal but has no discernible effect on isolated acini. It is likely that in pancreatitis NO acts indirectly via microcirculatory changes, including inhibition of leucocyte activation and preservation of capillary perfusion.
Dendritic cell and natural killer cell cross-talk: a pivotal role of CX3CL1 in NK cytoskeleton organization and activation
Authors: Jean R. Pallandre, Konrad Krzewski, Romain Bedel, Bernhard Ryffel, Anne Caignard, Pierre Simon Rohrlich, Xavier Pivot, Pierre Tiberghien, Laurence Zitvogel, Jack L. Strominger, Christophe Borg
Journal: Blood (2008)
Neuropsychological Impairment in Amateur Soccer Players
Authors: Erik J. T. Matser
Journal: JAMA (1999)

Soccer players incur concussions during matches and training sessions, as well as numerous subconcussive blows to the head from impacts with the soccer ball (headers). The combination of soccer-related concussions and the number of headers may be a risk for chronic traumatic brain injury (CTBI).To determine whether amateur soccer players have evidence of CTBI.Cross-sectional study of 33 amateur soccer players and 27 amateur athletes involved in swimming and track (controls) in the Netherlands who underwent interviews and neuropsychological testing.Performance of soccer players vs controls on 16 neuropsychological tests having 27 outcomes.Compared with control athletes, amateur soccer players exhibited impaired performance on tests of planning (39% vs 13%; P=.001) and memory (27% vs 7%; P=.004). Among soccer players, 9 (27%) had incurred 1 soccer-related concussion and 7 (23%) had had 2 to 5 concussions during their career. The number of concussions incurred in soccer was inversely related to the neuropsychological performance on 6 of the neuropsychological tests.Our results indicate that participation in amateur soccer in general and concussion specifically is associated with impaired performance in memory and planning functions. Due to the worldwide popularity of soccer, these observations may have important public health implications.
Late Repair of Ischemic Mitral Regurgitation Does Not Prevent Left Ventricular Remodeling
Authors: Jonathan Beaudoin, Robert A. Levine, J. Luis Guerrero, Chaim Yosefy, Suzanne Sullivan, Susan Abedat, Mark D. Handschumacher, Catherine Szymanski, Dan Gilon, Nicholas O. Palmeri, Gus J. Vlahakes, Roger J. Hajjar, Ronen Beeri
Journal: Circulation (2013)

Background— Ischemic mitral regurgitation (MR) is a frequent complication of myocardial infarction associated with left ventricular (LV) dilatation and dysfunction, which doubles mortality. At the molecular level, moderate ischemic MR is characterized by a biphasic response, with initial compensatory rise in prohypertrophic and antiapoptotic signals, followed by their exhaustion. We have shown that early MR repair 30 days after myocardial infarction is associated with LV reverse remodeling. It is not known whether MR repair performed after the exhaustion of compensatory mechanisms is also beneficial. We hypothesized that late repair will not result in LV reverse remodeling. Methods and Results— Twelve sheep underwent distal left anterior descending coronary artery ligation to create apical myocardial infarction and implantation of an LV-to-left atrium shunt to create standardized moderate volume overload. At 90 days, animals were randomized to shunt closure (late repair) versus sham (no repair). LV remodeling was assessed by 3-dimensional echocardiography, d P /d t , preload-recruitable stroke work, and myocardial biopsies. At 90 days, animals had moderate volume overload, LV dilatation, and reduced ejection fraction (all P &lt;0.01 versus baseline, P =NS between groups). Shunt closure at 90 days corrected the volume overload (regurgitant fraction 6±5% versus 27±16% for late repair versus sham, P &lt;0.01) but was not associated with changes in LV volumes (end-diastolic volume 106±15 versus 110±22 mL; end-systolic volume 35±6 versus 36±6 mL) or increases in preload-recruitable stroke work (41±7 versus 39±13 mL mm Hg) or d P /d t (803±210 versus 732±194 mm Hg/s) at 135 days (all P =NS). Activated Akt, central in the hypertrophic process, and signal transducer and activator of transcription 3 (STAT3), a critical node in the hypertrophic stimulus by cytokines, were equally depressed in both groups. Conclusions— Late correction of moderate volume overload after myocardial infarction did not improve LV volume or contractility. Upregulation of prohypertrophic intracellular pathways was not observed. This contrasts with previously reported study in which early repair (30 days) reversed LV remodeling. This suggests a window of opportunity to repair ischemic MR after which no beneficial effect on LV is observed, despite successful repair.