tbuckley/cabot-search huggingface dataset:
Immune mechanisms in tienilic acid associated hepatotoxicity.
Authors: J Neuberger, R Williams
Journal: Gut (1989)

In order to investigate the mechanisms underlying the hepatotoxicity associated with tienilic acid (Ticrynafen) ingestion we have looked for evidence of sensitisation to drug altered liver cell determinants using an indirect antibody dependent, cell mediated cytotoxicity assay (ADCC). As targets, hepatocytes were isolated from rabbits pretreated with either tienilic acid or its isomer with or without previous enzyme induction with either phenobarbitone or B-naphthoflavone (BNF). Sera from 16 of 36 patients with presumed tienilic acid hepatotoxicity induced significant cytotoxicity to hepatocytes isolated from rabbits pretreated with BNF and subsequently tienilic acid. Three of 10 sera from patients receiving tienilic acid but without overt liver damage also induced significant cytotoxicity to these hepatocytes, however, although none of 20 normal controls or of 16 patients with other liver diseases did so. Non-organ specific autoantibodies, classified as anti-LKM2, were also detectable. These were present in association with tienilic acid associated antibodies: of the 36 patients with presumed tienilic acid hepatotoxicity, 38% had both antibodies, 18% had only anti-LKM2 antibodies and 9% only tienilic acid associated antibodies. These results suggest that this drug reaction is associated with sensitisation to drug altered liver cell antigens and autoantigens. If ticrynafen associated hepatotoxicity is immune mediated, then one possible mechanism is that the drug induced antigens break tolerance, leading to an immune attack on normal liver cell components.
Warthin's Tumor and I-131 Body Scan
Authors: SEYFETTIN ILGAN, YAVUZ NARIN, NURI ARSLAN, AZIZ AKSU, HIKMET BAYHAN
Journal: Clinical Nuclear Medicine (1999)

The authors report a case of histologically proved Warthin's tumor of the parotid gland that caused a false-positive result of an I-131 body scan. Because patients with distant metastases that concentrate I-131 should receive I-131 therapy, it is extremely important to properly distinguish false-positive sites of I-131 localization to avoid unnecessary therapeutic intervention. Warthin's tumor should be included in the differential diagnosis when nonphysiologic radioiodine accumulation is encountered in the region of the salivary glands.
Effects of Prenatal Exposure to Polychlorinated Biphenyls and Dioxins on Mental and Motor Development in Japanese Children at 6 Months of Age
Authors: Sonomi Nakajima, Yasuaki Saijo, Shizue Kato, Seiko Sasaki, Akiko Uno, Nobuo Kanagami, Hironori Hirakawa, Tsuguhide Hori, Kazuhiro Tobiishi, Takashi Todaka, Yuji Nakamura, Satoko Yanagiya, Yasuhito Sengoku, Takao Iida, Fumihiro Sata, Reiko Kishi
Journal: Environmental Health Perspectives (2005)

Several studies have shown that prenatal and/or postnatal background-level exposure to environmental chemicals, such as polychlorinated biphenyls (PCBs) and dioxins, induces adverse effects on the neurodevelopment of children. However, other studies have not detected any harmful influences on neurodevelopment. Furthermore, except in western countries, no developmental tests have been carried out in relation to detailed assessment of exposure to PCBs and dioxins. In this study (the Hokkaido Study on Environment and Children's Health), the effect of prenatal exposure to background levels of PCBs and dioxins on infant neurodevelopment in Japan/Sapporo was elucidated. The associations between the total or individual isomer level of PCBs and dioxins in 134 Japanese pregnant women's peripheral blood and the mental or motor development of their 6-month-old infants were evaluated using the second edition of the Bayley Scales of Infant Development. The mean level of total toxicity equivalency quantity (TEQ) was 18.8 (4.0-51.2) pg/g lipid in blood of 134 mothers. After adjustment for potential confounding variables, the total TEQ value was shown not to be significantly associated with mental developmental index (MDI) or psychomotor developmental index (PDI). However, the levels of one polychlorinated dibenzo-p-dioxin (PCDD) isomer, total PCDDs, and total PCDDs/polychlorinated dibenzofurans (PCDFs) were significantly negatively associated with MDI, and the levels of two PCDD isomers and three PCDF isomers were significantly negatively associated with the PDI. In conclusion, the background-level exposure of several isomers of dioxins during the prenatal period probably affects the motor development of 6-month-old infants more than it does their mental development.
Direct activation of natural killer T cells induces airway hyperreactivity in nonhuman primates
Authors: Ponpan Matangkasombut, Muriel Pichavant, Takahiro Yasumi, Carrie Hendricks, Paul B. Savage, Rosemarie H. DeKruyff, Dale T. Umetsu
Journal: Journal of Allergy and Clinical Immunology (2008)
A New Technique in Endoscopic Ultrasonography of the Upper Gastrointestinal Tract
Authors: M. Tanaka, T. Bandou, A. Watanabe, H. Sasaki
Journal: Endoscopy (1990)

Endoscopic ultrasonography (EUS) of the upper GI tract was unsuccessful in 42 out of 274 patients (15%) due to inaccurate guidance of the probe to small, shallow lesions, or to difficulty in clearly demonstrating the surrounding layer structure and boundary of the lesion. We applied the saline injection technique in these 42 patients. Saline was injected into the submucosal layer of the esophagogastric wall. The ultrasonographic image of adjacent saline accurately guided the probe to the lesion. Injected saline enabled the mucosal layer to be distinguished from the muscularis propria surrounding the lesion and provided clear ultrasonographic imaging of the boundary between the lesion and the surrounding layer structure. This new method was found to be effective in 38 out of 42 patients in whom EUS was unsuccessful. A study comparing the depth of tumor invasion diagnosed by the saline injection technique with histological findings obtained in 12 cases showed good correlation. These results indicate that the saline injection technique would seem to be very useful as an adjuvant to conventional EUS.
Xpert MTB/RIF as a Measure of Sputum Bacillary Burden. Variation by HIV Status and Immunosuppression
Authors: Colleen F. Hanrahan, Grant Theron, Jean Bassett, Keertan Dheda, Lesley Scott, Wendy Stevens, Ian Sanne, Annelies Van Rie
Journal: American Journal of Respiratory and Critical Care Medicine (2014)

Xpert MTB/RIF cycle threshold values are a measure of sputum mycobacterial burden. Data on the impact of HIV infection and immunosuppression on this measure are limited.Examine the impact of HIV status and level of immunosuppression on the distribution of mean cycle threshold values, and the correlation of cycle threshold values and smear microscopy grade with time to culture positivity.Paired sputum samples from 2,406 individuals with suspected pulmonary tuberculosis in South Africa were tested by Xpert MTB/RIF, concentrated smear microscopy, and liquid culture to quantify bacterial burden using cycle threshold values, smear grading, and time to culture positivity.Cycle threshold values were lower in HIV-uninfected versus HIV-infected individuals (22.9 vs. 26.6; P < 0.001). Among HIV-infected, CD4 count was an independent predictor of cycle threshold value, with an average increase of 1.50 cycles for CD4 count greater than or equal to 200 (P 0.071) and 3.66 cycles for CD4 count less than 200 (P < 0.001) compared with HIV-uninfected individuals. Correlation between cycle threshold value and time to culture positivity was similar to that between smear status and time to culture positivity (both Spearman ρ 0.58). The strength of correlation between measures decreased as the level of immunosuppression increased. A cycle threshold value cutoff of 28 had good predictive value for smear positivity.We observed decreasing bacillary burden with increasing level of immunosuppression as measured by Xpert MTB/RIF cycle threshold values. A cycle threshold value of 28 can be used as a measure of bacterial burden and smear status in a high HIV burden setting.
The PATHWAYS Church-Based Weight Loss Program for Urban African-American Women at Risk for Diabetes
Authors: Wylie McNabb, Michael Quinn, Jean Kerver, Sandy Cook, Theodore Karrison
Journal: Diabetes Care (1997)

OBJECTIVE This study was carried out to test the effectiveness of PATHWAYS, a weight loss program designed specifically for urban African-American women, when administered in urban churches by trained lay facilitators. RESEARCH DESIGN AND METHODS Thirty-nine obese women were recruited from three urban African-American churches. After randomization and the collection of baseline data on weight and lifestyle practices, subjects in the experimental group (n = 19) were assigned to receive a 14-week weight loss program (PATHWAYS) conducted by trained lay volunteers; control group subjects (n = 20) were put on a waiting list to receive the program at the conclusion of the study period. RESULTS Of the 39 women enrolled, 15 experimental group subjects and 18 control group subjects were available for posttreatment data collection. After completing the program, PATHWAYS participants lost an average of 10.0 lb, and the control group subjects gained an average of 1.9 lb. Posttreatment difference in weight loss between the groups was statistically significant (P &amp;lt; 0.0001). Waist circumference among PATHWAYS participants decreased 2.5 inches, while waist circumference among control group subjects remained relatively the same. This difference between the groups was statistically significant (P &amp;lt; 0.05). CONCLUSIONS A weight loss program administered by trained lay volunteers was effective in producing significant and clinically meaningful weight loss among African-American women who often do not benefit from typical weight loss programs. Ongoing research is focusing on whether the weight loss can be maintained or enhanced through monthly reinforcement sessions.
Reduction in Hospitalization of Schizophrenics
Authors: JAMES L. CLAGHORN, JOHN KINROSS-WRIGHT
Journal: American Journal of Psychiatry (1971)

During 1964 and 1965 schizophrenic patients treated with phenothiazines as clinic outpatients following hospitalization were studied at six-month intervals by means of a questionnaire. They were compared to a control group of schizophrenics who did not maintain contact with the clinic. The experimental group was rehospitalized significantly less often than the control group, and the decrease in the rate of rehospitalization has continued to the present. The authors believe that adequate and continuing follow-up should be provided for all discharged patients.
Haemodynamic effects of terbutaline in chronic obstructive airways disease.
Authors: G J Teule, P A Majid
Journal: Thorax (1980)

Terbutaline, a cardioselective beta-adrenoceptor agonist, administered intravenously (250 micrograms) to seven patients with chronic obstructive airways disease (mean FEV1 0.99 l) resulted in reduction of mean pulmonary artery pressure (resting 23 +/- 2 to 19 +/- 2 mmHg, p < 0.05; exercise 43 +/- 3 to 35 +/- 3 mmHg, p < 0.05) and calculated pulmonary vascular resistance (resting 168 +/- 27 to 109 +/- 17 dyne s cm-5, p < 0.01; exercise 170 +/- 30 to 119 +/- 18 dyne s cm-5, p < 0.01) accompanied by an increase in heart rate (resting 86 +/- 5 to 96 +/- 4 per min, p < 0.01; exercise 108 +/- 2 to 114 +/- 2 per min, p < 0.01) and cardiac output (resting 3.7 +/- 0.4 to 4.1 +/- 0.4, p < 0.05; exercise 4.9 +/- 0.06 to 6.1 +/- 6 l, min-1 m-2, p < 0.05). The haemodynamic changes were associated with an increase in resting peak expiratory flow rate (184 +/- 20 to 216 +/- 25 l/min, p < 0.01), while the calculated indices of ventilation/perfusion relationship remained essentially unchanged. The reduction in mean pulmonary artery pressure after terbutaline observed in the present studies was probably the result of a combination of simple vasodilator effect, the reduction in airways resistance, and increase in the ventilation.
Dissecting Hematoma of the Coronary Artery
Authors: Wilson A. Heefner
Journal: JAMA (1973)

A dissecting hematoma of the coronary artery occurred in a 27-year-old woman taking an oral contraceptive. A possible relationship between the dissecting hematoma and the use of oral contraceptives is postulated on the basis of histologic vascular changes similar to those previously described in cases of dissecting hematoma of the coronary artery, in pregnant humans and animals, and in humans and experimental animals receiving oral contraceptives.
Popliteus tendon rupture: a case report and review of the literature
Authors: A R Guha, K A Gorgees, D I Walker
Journal: British Journal of Sports Medicine (2003)

Isolated rupture of the popliteus musculotendinous unit is an uncommon injury. A case is here reported of a semiprofessional athlete with a ruptured popliteus tendon without significant instability of the knee. The diagnosis was made by magnetic resonance imaging and confirmed by arthroscopy.
Leg length and risk of cancer in the Boyd Orr cohort
Authors: D J Gunnell, G D. Smith, J M P Holly, S Frankel
Journal: BMJ (1998)

Height is directly associated with mortality from cancer, 1 but the explanation for this association is unclear.Whereas adult height is a marker of nutrition and health throughout childhood, most growth before puberty is due to increases in leg length.Leg length can therefore be used as a marker for exposures that generate the association between adult height and cancer. 1 2 We examined the association between prepubertal leg length and mortality from cancer in the Boyd Orr cohort. 2 3
Clearing a roadmap
Authors: Laurie Goodman
Journal: Journal of Clinical Investigation (2004)

The National Institutes of Health Roadmap was unveiled last September (1) and has created a mix of interest, concern, and confusion in the scientific community. Much of the concern and confusion relates to the uncertainty of how the Roadmap initiatives will impact a researcher’s ability to be funded if his or her work is not directly related to the missions highlighted in the initiatives. NIH Director Elias Zerhouni underscored these concerns in his presentation April 20 at Experimental Biology, “Will You Still Fund Me Tomorrow? The Deficit, Biodefense, and the NIH Roadmap.” He told the audience, “These initiatives are not top down; they are investigator initiated.”
Exercise responses and psychiatric disorder in chronic fatigue syndrome
Authors: R. J M Lane, A. P Burgess, J. Flint, M. Riccio, L. C Archard
Journal: BMJ (1995)

Fatigue, exercise intolerance, and myalgia are cardinal symptoms of the chronic fatigue syndrome, but whether they reflect neuromuscular dysfunction or are a manifestation of depression or other psychiatric or psychological disorders diagnosed in a high proportion of fatigued patients in the community is unclear.1 In previous studies patients with the chronic fatigue syndrome showed exercise intolerance in incremental exercise tests, which seemed to be related to an increased perception of effort; also, blood lactate concentrations in some patients tended to increase more rapidly than normal at low work rates, implying inefficient aerobic muscle metabolism.2 We examined venous blood lactate responses to exercise at a work rate below the anaerobic threshold in relation to psychiatric disorder.

We studied 96 consecutive patients meeting the Oxford criteria for diagnosis of the chronic fatigue syndrome3 by using the subanaerobic threshold exercise …
Immunity to Trichinella spiralis infection in vitamin A-deficient mice.
Authors: J A Carman, L Pond, F Nashold, D L Wassom, C E Hayes
Journal: The Journal of Experimental Medicine (1992)

Vitamin A-deficient (A-) mice make strikingly poor IgG responses when they are immunized with purified protein antigens. Previously, we showed that A- T cells overproduce interferon gamma (IFN-gamma), which then could inhibit interleukin 4 (IL-4)-stimulated B cell IgG responses. To determine if the altered IFN-gamma regulation pattern and its immunological consequences would extend to a natural infection, we studied mice infected with the parasitic helminth Trichinella spiralis. The course of the infection was similar in A- and A-sufficient (A+) mice. These mice did not differ with respect to newborn larvae/female/hour produced in the intestine, or muscle larvae burden 5 wk postinfection. They also did not differ in the intestinal worm expulsion rate until day 15, when A- mice still harbored parasites, whereas A+ mice had cleared intestinal worms. Vitamin A deficiency reduced both the frequency of B lymphocytes secreting IgG1 antibodies to parasite antigens, and the bone marrow eosinophilia associated with helminth infection. The cytokine secretion patterns in infected mice were consistent with these observations and with previous studies. Mesenteric lymph node cells from infected A- mice secreted significantly more IFN-gamma, and significantly less IL-2, IL-4, and IL-5 than infected A+ controls. A- splenocytes secreted significantly more IFN-gamma, and equivalent amounts of IL-2, IL-4, and IL-5 compared with A+ controls. Interestingly, CD4-CD8- cells secreted the majority of the IL-4 produced in the spleen. The IL-2, IL-4, and IL-5 steady-state transcript levels correlated with secreted protein levels, but IFN-gamma transcripts did not. Although they secreted more protein, A- cells contained fewer IFN-gamma transcripts than A+ cells. These results suggest two vitamin A-mediated regulation steps in IFN-gamma gene expression: positive regulation of IFN-gamma transcript levels, and negative regulation posttranscriptionally. The essentially unaltered outcome of T. spiralis infection in vitamin A-deficient mice probably reflects a balance between cellular and humoral responses. The IFN-gamma overproduction might have a positive effect on the gut inflammatory response, but the decrease eosinophilia, cytokine production in mesenteric lymph node, and IgG1-secreting cell frequency might have a negative effect on T. spiralis immunity.
Regional Effects and Mechanism of Positive End-Expiratory Pressure in Early Adult Respiratory Distress Syndrome
Authors: Luciano Gattinoni
Journal: JAMA (1993)

<h3>Objective.</h3> —To test the hypothesis that positive end-expiratory pressure (PEEP) prevents the collapse of a given lung region when it is equal to or greater than the hydrostatic pressure superimposed (SPL) to that region. <h3>Design.</h3> —Intervention study with sequential levels of PEEP applied in random order to a cohort of patients with adult respiratory distress syndrome (ARDS). <h3>Setting.</h3> —Referral center for ARDS in a university hospital. <h3>Patients.</h3> —Ten ARDS patients (with Murray scores &gt;2.5). <h3>Intervention.</h3> —Basal computed tomographic (CT) section taken at o, 2, 4, 5, 6, 8, 10, 12, 14, 15, and 20 cm H<sub>2</sub>O PEEP. <h3>Main Outcome Measures.</h3> —Basal lung CT sections were divided into 10 equal levels from the ventral to dorsal surfaces. In each level SPL was measured from density and height. The inflation of the level was measured as the gas/tissue ratio (g/t); g/t changes with PEEP were defined as the g/t—P curve. The slope of the g/t—P curve was defined as level compliance (ie, the ratio of change in the g/t of the level to the change in pressure). A linear g/t—P curve was the criterion to detect inflation without recruitment (ie, new pulmonary units opening at a given pressure). A biphasic g/t—P curve (change of compliance after an inflection point) was the criterion to detect recruitment. Pflex was defined as the pressure at which the inflection point occurred. <h3>Results.</h3> —The SPL increased from level 1 (ventral) to level 10 (dorsal) (<i>r</i>=.91;<i>P</i>&lt;.01). The number of linear g/t—P curves decreased from level 1 to level 10 (<i>r</i>=.98;<i>P</i>&lt;.01), while the number of biphasic g/t—P curves increased (<i>r</i>=.95;<i>P</i>&lt;.01). The Pflex increased from level 1 to 10 (<i>r</i>=.97;<i>P</i>&lt;.01) and Pflex was similar to SPL (Pflex=1.05+0.9 SPL;<i>r</i>=.75;<i>P</i>&lt;.01). <h3>Conclusions.</h3> —The increased SPL causes compression atelectasis; this is prevented when PEEP to a given lung region is equal to or greater than the SPL. (<i>JAMA</i>. 1993;269:2122-2127)
Double-outlet right ventricle: Morphologic demonstration using nuclear magnetic resonance imaging
Authors: Jonathan M. Parsons, Edward J. Baker, Robert H. Anderson, Edmund J. Ladusans, Alison Hayes, Nuala Fagg, Andrew Cook, Shakeel A. Qureshi, Philip B. Deverall, Michael N. Maisey, Michael Tynan
Journal: Journal of the American College of Cardiology (1991)
Too much angioplasty
Authors: A. Malhotra
Journal: BMJ (2013)

Stenting offers no prognostic benefit over drugs in stable coronary disease



George W Bush’s recent decision to consent—in the absence of symptoms—to the implantation of a stent by an interventional cardiologist has led to an entirely justifiable debate on how best to treat stable coronary artery disease. Though the clinical benefit of percutaneous coronary intervention (PCI) in managing acute coronary syndromes has been proved,1 2 3 4 many robust randomised studies (which included patients at low and at high risk) have not shown any prognostic value in stenting for stable angina in addition to optimal medical therapy.5

Given the complications related to the procedure, the fact that many serious events result from non-significant lesions,6 the potentially thrombotic milieu created by a metal scaffold apposed to the intima of a coronary artery after it is stretched by a balloon, and the potency of lifestyle interventions and pharmacotherapy, it is perhaps easier to understand that even stenting a 90% stenosed artery for stable angina does not prevent heart attacks or prolong life. Yet such practice continues to contribute to overspending in healthcare in the United States, whose total healthcare spending is predicted to …
Increase in reports of medical errors suggest NHS staff are more confident in reporting problems
Authors: W. Moore
Journal: BMJ (2009)

An increase in reports of medical errors and other adverse events in England and Wales indicates that staff are more confident about registering concerns, according to a report from the National Patient Safety Agency.

For the first time, figures have been released that provide a breakdown of incidents reported by individual NHS trusts. They show that a total of 439 612 events that caused harm or potential harm were recorded between April and September 2008. More than 65% of the incidents resulted in no harm to patients, and only 1% resulted in severe harm …