tbuckley/cabot-search huggingface dataset:
Antitoxin treatment for liver abscess caused by<i>Clostridium perfringens</i>
Authors: Toru Hifumi, Yuichi Koido, Motohide Takahashi, Akihiko Yamamoto
Journal: Clinical and Molecular Hepatology (2013)

To the Editor,

We read with great interest the article 'A case of emphysematous hepatitis with spontaneous pneumoperitoneum in a patient with hilar cholangiocarcinoma' by Jung Ho Kim et al.1

The authors described fatal case of emphysematous hepatitis caused by C. perfringens, but did not mention the hemolysis or disseminated intravascular coagulopathy (DIC) during hospital course. Laboratory data on admission revealed anemia (hemoglobin 9.3 mg/dL), severely elevated aspartate transaminase (AST) level (882 IU/L), and high total bilirubin level (17.9 mg/dL), but alanine transaminase (ALT) level was elevated moderately (257 IU/L). Although clinical data was limited, this disproportion between AST and ALT may suggest the intravascular haemolysis caused by C. perfringens.

Van Bunderen et al retrospectively reviewed 40 cases of C. perfringens septicaemia that rapidly progressed to intravascular haemolysis and metabolic acidosis and led to death within a few hours after admission.2 The mortality rate was >80% despite treatments with high-dose intravenous penicillin and surgical debridement to eliminate the focus of infection. Therefore, we must redefine conventional treatments by reexamining the pathophysiology of such infections.

Alpha toxin secreted by C. perfringens is responsible for intravascular haemolysis followed by severe anemia, acute renal failure, DIC and multi-organ failure. Therefore, specific antitoxic globulins (antitoxin) should be administered with antibiotics as early as possible to neutralise the toxin. In fact, the antitoxin against the alpha toxin of C. perfringens has been used for decades for the treatment for gas gangrene (myonecrosis) caused by C. perfringens.3 However, this product is no longer available in the United States because of poor efficacy and severe allergic reactions.4 Aggressive surgery, including amputation and repeated debridement, constitute the mainstay of treatment of myonecrosis caused by C. perfringens.

On the other hand, the efficacy of antitoxin treatment for liver abscess caused by C. perfringens has not been evaluated. Unlike gas gangrene, C. perfringens septicaemia rapidly causes haemolysis followed by multi-organ failure; therefore, surgical intervention is not attempted in many cases. We recently introduced the use of the antitoxin against the C. perfringens alpha toxin to cease haemolysis and prevent multi-organ failure.5 Here we confirmed that the antitoxin effectively neutralises the alpha toxin secreted by C. perfringens; however, it does not possess antibacterial activity or the capacity to prevent bacterial growth and cannot restore organ function. Therefore, we propose that the optimal treatment for C. perfringens septicaemia should combine the antitoxin, antibiotics and surgical intervention.
Effect of Acetylator Phenotype on the Rate at Which Procainamide Induces Antinuclear Antibodies and the Lupus Syndrome
Authors: Raymond L. Woosley, Dennis E. Drayer, Marcus M. Reidenberg, Alan S. Nies, K. Carr, John A. Oates
Journal: New England Journal of Medicine (1978)

To investigate the relation between acetvlator phenotype and the development of procainamide-induced lupus, we determined the rate of development of antinuclear antibodies in 20 patients of known acetylator phenotype receiving chronic procainamide therapy. The duration of therapy required to induce antibodies in 50 per cent of slow (11) and rapid (nine) acetylators was 2.9 and 7.3 months respectively. The median total dose that produced ant;bodies was 1.5 g per kilogram and 6.1 g per kilogram respectively. After one year antibodies had developed in 18 patients. Retrospective studies of patients in whom procainamide lupus had developed revealed that the duration of therapy required for induction in 14 slow and seven rapid acetylators was 12 +/- 5 and 48 +/- 22 months respectively (P less than 0.002). We conclude that acetylator phenotype influences the rate at which procainamide induces antinuclear antibodies and probably the lupus syndrome. Antibody production is probably related to the parent compound or a non-acetylated metabolite.
Reply to Dr Özdemir’s Letter to the Editor re: Burcin Tuna, Kutsal Yorukoglu, Mehtat Unlu, M. Ugur Mungan and Ziya Kirkali, Association of Mast Cells with Microvessel Density in Renal Cell Carcinomas. Eur Urol. 2006;50:530–34
Authors: Burcin Tuna, Kutsal Yorukoglu, Mehtat Unlu, M. Ugur Mungan, Ziya Kirkali
Journal: European Urology (2006)
Induction of B7-H1 and B7-DC expression on airway epithelial cells by the Toll-like receptor 3 agonist double-stranded RNA and human rhinovirus infection: In vivo and in vitro studies
Authors: Lowella Heinecke, David Proud, Scherer Sanders, Robert P. Schleimer, Jean Kim
Journal: Journal of Allergy and Clinical Immunology (2008)
ADHESIVE RUBBER DAM FOR THE PREVENTION OF POSSIBLE INFECTION AT THE SITE OF OPERATION.
Authors: J. B. MURPHY
Journal: JAMA (1901)

Infection of wounds during operation may always be traced to contact with materials, and is probably rarely if ever due to contamination from the atmosphere (Dr. P. L. Friedrich,<i>Arch. für Klin. Chir.</i>, B. 59.). The common sources of infection of operation wounds are as follows: 1. Instruments. 2. Sponges and dressings. 3. The hands of the operator or assistants. 4. The skin of the patient. 5. Towels, sheets, etc., used about the wound. The exhaustive researches of Fürbinger, Ahlfeld, Koch and others emphasize the difficulty of rendering the hands aseptic, for after a short period of exposure they again become septic from their own secretions, as has been shown by cultures made for the inner surface of rubber gloves. We have been able to overcome this difficulty by the use of such gloves. The sterilization of the skin surface in the field of operation is practically as difficult and
Hypertension: Evaluation and Treatment
Authors: Keith McLean
Journal: Annals of Internal Medicine (1998)

Medical Writings15 August 1998Hypertension: Evaluation and TreatmentKeith McLean, MDKeith McLean, MDLoyola University Medical Center, Maywood, IllinoisSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-4-199808150-00030 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Hypertension: Evaluation and Treatment; Frohlich ED. 212 pages. Baltimore: Williams & Wilkins; 1998. $45.00. ISBN 0683303430. Order phone 800-638-0672.Field of medicine: Cardiology and primary care medicine.Format: Hardcover book.Audience: Primary care physicians, cardiologists, medical students, residents, and fellows interested in a clear, concise description of hypertension and its treatment.Purpose: To explain the causes, pathophysiology, and treatment of hypertension.Content: This book provides a concise yet thorough summary of the subject of hypertension. It begins with basic pathophysiology and proceeds through clinical evaluation of the disease. It covers current guidelines for the treatment of hypertension with emphasis on ... Author, Article, and Disclosure InformationAffiliations: Loyola University Medical Center, Maywood, Illinois PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 August 1998Volume 129, Issue 4Page: 340KeywordsAlgorithmsChartsHypertensionLeft ventricular hypertrophyMedical risk factorsPrimary care physiciansRenal diseasesRenal failureStrokeTreatment guidelines ePublished: 15 August 2000 Issue Published: 15 August 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
FDA Panel Seeks to Balance Risks in Warnings for Antidepressants
Authors: Bridget M. Kuehn
Journal: JAMA (2007)

NEWER GENERATION ANTIDEPRESsants should carry a broader warning of an increased risk of suicidal thoughts and behaviors in not only children and adolescents, but also young adults, recommended a US Food andDrugAdministration(FDA)advisory committee after considering new data fromtheagency.Butinanunprecedented step,thepanelalsorecommendedthatthe warningsincludeinformationonthebenefitsof treatingdepressionandtheriskof suicideassociatedwithuntreateddepression, based on emerging data that warnings about potential adverse effects of medicationsmayleadtoundertreatment and subsequent suicides. ThecommitteemetDecember13and voted 6 to 2 in favor of extending the existingblackboxwarnings,althoughmembers alsoagreed that thewarningshould address thebenefitsof treatmentand the risksassociatedwithdecliningtreatment, said Daniel S. Pine, MD, acting chair of thecommitteeandchiefofchildandadolescent researchat theNational Institute ofMentalHealth.TheFDAhasyet todecidewhether toaccept therecommendations, but typically the agency does follow its committees’ advice.
A patient who changed my practice: Truth so bitter
Authors: O. Penney
Journal: BMJ (2002)

Sarah was worried about three pea sized lumps on her anterior chest wall. She had noticed them about three weeks before and felt embarrassed about coming with something so trivial. As I examined her, we chatted about the children. She was six months younger than me, with a son six days younger than my daughter (aged 8) and a daughter two years older. Blond and vivacious, Sarah was always a pleasant patient to have on the morning list. Like any intelligent parent, she had her anxieties about her children, and I knew them well.

The lumps she showed me were so small and insignificant that …
Medicaid Enrollment and Health Services Access by Latino Children in Inner-city Los Angeles
Authors: Neal Halfon, David L. Wood, R. Burciaga Valdez, Margaret Pereyra, Naihua Duan
Journal: JAMA (1997)

<h3>Objectives.</h3> —To understand the role of parental immigration status on Medicaid enrollment and access to health services for young Latino children. <h3>Design.</h3> —A cross-sectional household survey of the parents of inner-city Latino children. <h3>Setting.</h3> —South Central and East Los Angeles, Calif, 1992. <h3>Population.</h3> —Children 12 to 36 months old and their parents from 817 Latino families. <h3>Main Outcome Variables.</h3> —Continuous Medicaid enrollment, continuity of care, deferral of care, and number of visits. <h3>Methods.</h3> —Univariate analysis, logistic and linear regression by demographic and socioeconomic characteristics, residency status, and language use. <h3>Results.</h3> —Children were primarily born in the United States (96%), but most parents were not citizens (80%). Only 40.0% of eligible children had continuous Medicaid coverage since birth, 18.6% had never been insured, and 20.7% had received episodic Medicaid coverage. Continuous Medicaid coverage was negatively associated with either the caregiver (odds ratio [OR],0.32; 95% confidence interval [CI], 0.19-0.56) or their partner (OR=0.33, 95% CI=0.20-0.55) working. Residency status, language preference, and length of US residency were not associated with continuous Medicaid enrollment. Insurance coverage was associated with more physician visits, greater continuity of care, and fewer deferrals of care. <h3>Conclusion.</h3> —While most (84%) young Latino children in inner-city Los Angeles were eligible for Medicaid, a substantial proportion (39.3%) have episodic or no coverage. Insurance status and provider type were more consistently associated with access rather than residency and language preference. In the aftermath of California's Proposition 187 and federal welfare reform, insurance status and access are likely to worsen for these young children unless the wave of anti-immigration sentiments is held in check.
Dual Phase Bone Scintigraphy in Iliotibial Band Friction Syndrome
Authors: Lode Goethals, Frank De Geeter, Skrolan Bogaerts, Natascha Walgraeve
Journal: Clinical Nuclear Medicine (2008)

Although the diagnosis of iliotibial band friction syndrome can often be made on clinical grounds, imaging may be helpful to confirm the diagnosis and to exclude other differential diagnoses. We and others have previously reported the findings on planar and tomographic bone scintigraphy. We report the findings on dual phase bone scintigraphy in a man with long-standing iliotibial band friction syndrome, in whom the findings on blood flow imaging were more conspicuous than those on static imaging. We discuss the significance of these findings in relation to the pathogenetic mechanism of the syndrome and to other imaging findings.
Transplanted Nitroglycerin Disk
Authors: Everett C. Perlman
Journal: JAMA (1984)

ABSTRACT To the Editor.— A man in his late 60s awakened with severe headache and chest pain. He saw his physician, and an ECG was done, which was read as normal. The physician then asked him to take off his shirt to listen to his chest. To the physician's amazement, there was a nitroglycerin disk stuck onto his side. The patient's wife has angina and uses the disk, which apparently had come loose and dropped into the bed, where it became attached to her husband's abdomen, giving him the aforementioned symptoms.
Abstract 3481: Establishment of preclinical models to identify clinically useful combinations of trifunctional antibodies with chemotherapy
Authors: Kirsten Dettmar, Judith Atz, Carsten Lindemann, Petra Schroeder, Andrea Eberhardt, Michael Kluge
Journal: Cancer Research (2010)

Abstract The trifunctional bispecific antibodies catumaxomab (anti-EpCAM x anti-CD3) and ertumaxomab (anti-HER-2/neu x anti-CD3) exert their mechanism of action by simultaneous recruitment and activation of two different types of immune effector cells at the tumor site. The interaction of different immune effector cells results in efficient elimination of tumor cells by several killing mechanisms including T-cell cytotoxic responses and direct effects mediated by accessory cells. Effective treatment of cancer is essentially based on cytotoxic drugs that kill tumor cells or inhibit their proliferation. However, the commonly observed hematotoxicity of chemotherapeutics is regularly associated with some degree of immunosuppression. On the other hand, some of these chemotherapeutic agents are reported to support or even enhance the anti-tumoral effect of immunotherapeutic drugs in certain doses. A largely intact immune system is the key for trifunctional antibodies to exhibit their full mode of action. Since chemotherapy might impact the number and function of immune effector cells, we evaluated in different preclinical in vitro models whether the efficacy of trifunctional bispecific antibodies would be influenced when combined with chemotherapeutic drugs (5-FU and cisplatin). The preclinical studies performed included in vitro cytotoxicity assays with established tumor cell lines evaluating potential synergy by using the method of Chou and Talalay. Furthermore, results from 3D tumor spheroids and from an autologous human ex vivo setting are presented. In addition, immune cells from cancer patients were obtained at different time points during and after chemotherapy and were assessed for their in vitro cytotoxicity mediated by trifunctional antibodies. So far the results from the different in vitro assay systems used indicate synergy for the combination of the trifunctional antibodies with 5-FU and cisplatin. Furthermore, no negative influence of these chemotherapeutic drugs was observed on the trifunctional mode of action in vitro. These results provide a basis for the possible combination of these drugs with trifunctional antibodies in the clinical setting. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3481.
Cytokine profiles in relation to acute liver transplant rejection
Authors: M.C. Warlé, H.J. Metselaar, A.J. van der Plas, M. Kap, W.C.J. Hop, S. de Rave, J. Kwekkeboom, P.E. Zondervan, J.N.M. Ijzermans, H.W. Tilanus, G.J. Bouma
Journal: Journal of Hepatology (2000)
Chemotherapeutic agents circumvent emergence of dasatinib-resistant BCR-ABL kinase mutations in a precise mouse model of Philadelphia chromosome–positive acute lymphoblastic leukemia
Authors: Nidal Boulos, Heather L. Mulder, Christopher R. Calabrese, Jeffrey B. Morrison, Jerold E. Rehg, Mary V. Relling, Charles J. Sherr, Richard T. Williams
Journal: Blood (2011)
Chronic cobalamin inactivation impairs folate polyglutamate synthesis in the rat.
Authors: J Perry, I Chanarin, R Deacon, M Lumb
Journal: Journal of Clinical Investigation (1983)

Nitrous oxide, by inactivating cobalamin in vivo, produces a suitable animal model for cobalamin 'deficiency.' The synthesis of folate polyglutamate with tetrahydrofolate as substrate is severely impaired in the N2O-treated rat, but is normal with formyltetrahydrofolate as substrate. Methionine restores the capacity of the N2O-treated rat to utilize tetrahydrofolate the minimum effective dose being 16 mumol. S-Adenosylmethionine was somewhat less effective than methionine but 5'methylthioadenosine, a product of S-adenosylmethionine metabolism, was significantly more effective than methionine in correcting the defect in folate polyglutamate synthesis. 5'Methylthioadenosine is metabolised to yield formate. It is suggested that these compounds have their effect in correcting folate polyglutamate synthesis by supplying formate for the formylation of tetrahydrofolate. Formyltetrahydrofolate, at least in the cobalamin-inactivated animal, is the required substrate for folate polyglutamate synthesis. Cobalamin is concerned with the maintenance of normal levels of methionine and this in turn is a major source of formate through S-adenosylmethionine and 5'methylthioadenosine.
Nonlinear Association Between Cerebrospinal Fluid and Florbetapir F-18 β-Amyloid Measures Across the Spectrum of Alzheimer Disease
Authors: Jon B. Toledo, Maria Bjerke, Xiao Da, Susan M. Landau, Norman L Foster, William Jagust, Clifford Jack, Michael Weiner, Christos Davatzikos, Leslie M. Shaw, John Q. Trojanowski
Journal: JAMA Neurology (2015)

<h3>Importance</h3> Cerebrospinal fluid (CSF) and positron emission tomographic (PET) amyloid biomarkers have been proposed for the detection of Alzheimer disease (AD) pathology in living patients and for the tracking of longitudinal changes, but the relation between biomarkers needs further study. <h3>Objective</h3> To determine the association between CSF and PET amyloid biomarkers (cross-sectional and longitudinal measures) and compare the cutoffs for these measures. <h3>Design, Setting, and Participants</h3> Longitudinal clinical cohort study from 2005 to 2014 including 820 participants with at least 1 florbetapir F-18 (hereafter referred to as simply florbetapir)–PET scan and at least 1 CSF β-amyloid 1-42 (Aβ1-42) sample obtained within 30 days of each other (501 participants had a second PET scan after 2 years, including 150 participants with CSF Aβ1-42 measurements). Data were obtained from the Alzheimer's Disease Neuroimaging Initiative database. <h3>Main Outcomes and Measures</h3> Four different PET scans processing pipelines from 2 different laboratories were compared. The PET cutoff values were established using a mixture-modeling approach, and different mathematical models were applied to define the association between CSF and PET amyloid measures. <h3>Results</h3> The values of the CSF Aβ1-42 samples and florbetapir-PET scans showed a nonlinear association (<i>R</i><sup>2</sup> = 0.48-0.66), with the strongest association for values in the middle range. The presence of a larger dynamic range of florbetapir-PET scan values in the higher range compared with the CSF Aβ1-42 plateau explained the differences in correlation with cognition (<i>R</i><sup>2</sup> = 0.36 and<i>R</i><sup>2</sup> = 0.25, respectively). The<i>APOE</i>genotype significantly modified the association between both biomarkers. The PET cutoff values derived from an unsupervised classifier converged with previous PET cutoff values and the established CSF Aβ1-42 cutoff levels. There was no association between longitudinal Aβ1-42 levels and standardized uptake value ratios during follow-up. <h3>Conclusions and Relevance</h3> The association between both biomarkers is limited to a middle range of values, is modified by the<i>APOE</i>genotype, and is absent for longitudinal changes; 4 different approaches in 2 different platforms converge on similar pathological Aβ cutoff levels; and different pipelines to process PET scans showed correlated but not identical results. Our findings suggest that both biomarkers measure different aspects of AD Aβ pathology.
Treatment of Chronic Hepatitis C in a State Correctional Facility
Authors: Scott A. Allen, Anne C. Spaulding, Albert M. Osei, Lynn E. Taylor, Asya M. Cabral, Josiah D. Rich
Journal: Annals of Internal Medicine (2003)

Background: Approximately 1 in 4 of the nearly 2 million individuals in state and federal correctional facilities are infected with hepatitis C virus (HCV). Currently, there are few reports of treatment outcomes of this common infection in this setting. Objective: To describe HCV therapy in the incarcerated setting. Design: Retrospective, descriptive observational study. Setting: Rhode Island Department of Corrections, Cranston, Rhode Island. Patients: 93 inmates with chronic HCV infection. Intervention: Interferon- with ribavirin. Measurements: HCV RNA levels 6 months after treatment. Results: Response rates are similar to previously published rates achieved in the community; 63% (50 of 79) of patients achieved viral clearance after 6 months of therapy, and 46% (26 of 57) achieved sustained response 6 months after treatment. Conclusion: The incarcerated population (which is disproportionately affected by addiction and psychiatric illness) can be effectively treated for HCV infection with interferon and ribavirin. The correctional setting may provide an opportunity to safely treat patients with these two challenging comorbid conditions.