tbuckley/cabot-search huggingface dataset:
Bullous systemic contact dermatitis caused by an intra-articular steroid injection
Authors: P.V. Gumaste, D.E. Cohen, J.A. Stein
Journal: British Journal of Dermatology (2014)

Funding sources: J.A.S. was supported by the Irwin I. Lubowe Fellowship in Dermatology. Conflicts of interest: none declared. Dear Editor, Corticosteroids are commonly used for a variety of dermatological and systemic conditions due to their strong anti‐inflammatory and immunosuppressive properties. Hypersensitivity reactions to corticosteroids are generally rare, but are not uncommon in high‐risk patient populations such as those chronically treated with steroids.1 Allergic contact dermatitis is the most common form of steroid hypersensitivity, with a prevalence ranging from 0·2% to 6%.2 There have also been reports of systemic allergic contact dermatitis to systemic and intra‐articular steroids presenting as generalized maculopapular eruptions. Herein, we present a unique case of bullous systemic contact dermatitis (SCD) after a routine corticosteroid injection for chronic joint pain. A 71‐year‐old white woman with a history of biopsy‐proven urticaria pigmentosa presented with a 1‐week history of a pruritic eruption under her breasts. The episode began shortly after she received a triamcinolone injection in her hands for treatment of joint pain. She reported two prior episodes with similar clinical presentations, the first during a warm day and the second when using a hot tub. She reported infrequent use of topical corticosteroids and no complaint of intolerance in the past. Physical examination revealed coalescing pink–brown papules in the inframammary folds, medial thighs (Fig. 1) and ankles bilaterally. Biopsy of the left thigh revealed a superficial and midperivascular mixed‐cell infiltrate of lymphocytes, histiocytes and eosinophils, with overlying spongiosis and parakeratosis. Treatment with fluocinonide 0·05% cream twice daily, fexofenadine hydrochloride 180 mg daily and diphenhydramine nightly resulted in a complete response.
Balanced Regulation of mRNA Production for Fas and Fas Ligand in Lymphocytes From Centenarians
Authors: Marcello Pinti, Leonarda Troiano, Milena Nasi, Cristian Bellodi, Roberta Ferraresi, Chiara Mussi, Gianfranco Salvioli, Andrea Cossarizza
Journal: Circulation (2004)

Background— The functionality of the immune system during aging is crucial for protection against the most common age-related diseases. Apoptosis plays a central role in the senescence of the immune system, as evidenced by the increased plasma membrane expression of a key molecule like Fas protein. We analyzed the mRNA levels of different forms of Fas (total [tFas] and membrane [mFas]) and of its ligand (FasL) in peripheral blood lymphocytes from centenarians, the best example of successful aging, who were compared with young and middle-aged donors. Methods and Results— Using real-time polymerase chain reaction, we quantified mRNA for different forms of Fas and for FasL. In resting lymphocytes, mRNA for tFas, but not for mFas, significantly increases with age, whereas FasL mRNA significantly decreases. In vitro production of Fas/FasL mRNA after different stimuli was similar in cells from the 3 groups. Even if the percentage of Fas + cells was higher than in the other groups, peripheral blood lymphocytes from centenarians had normal Fas-induced apoptosis, as revealed by flow cytometry. By ELISA, we observed that cells from centenarians showed normal in vitro production of the soluble form of Fas (sFas) and that plasma levels of such molecule were significantly higher in centenarians than in the other groups. Conclusions— Lymphocytes from centenarians are able to balance the production of proapoptotic (mFas and FasL) and antiapoptotic (sFas) molecules, whose proportions are likely crucial for the well-preserved immune functionality at the extreme limits of human life.
Changes in haemostasis after stopping the combined contraceptive pill: implications for major surgery.
Authors: G E Robinson, T Burren, I J Mackie, W Bounds, K Walshe, R Faint, J Guillebaud, S J Machin
Journal: BMJ (1991)

OBJECTIVE--To investigate the changes in haemostasis in the three months immediately after stopping the combined contraceptive pill. DESIGN--Prospective randomised study. SETTING--Family planning centre in London. SUBJECTS--24 women aged 35-45 investigated before, during, and after six months9 use of combined oral contraceptives containing 30 micrograms ethinyl oestradiol together with the progestogens desogestrel or gestodene. MAIN OUTCOME MEASURES AND RESULTS--Blood samples were taken immediately before and after six months of oral contraceptive use and one, two, four, six, eight, and 12 weeks after the pill had been stopped. During the six months of oral contraceptive use the plasma concentration of factor X and fibrinogen increased and that of antithrombin III decreased. Between two and six weeks after stopping the pill a rebound phenomenon occurred with plasma concentrations of antithrombin III increasing (mean change from baseline at two weeks 0.06 IU/l and at six weeks 0.10 IU/l) and fibrinogen decreasing (0.26 g/l change at two weeks and 0.40 g/l at six weeks). Factor X concentrations fell gradually and the values at eight weeks were not significantly different from those found before the combined pill was started. CONCLUSION--The combined pill should be stopped at least four weeks before major surgery, which carries the risk of postoperative thrombosis, to allow the potentially prothrombotic haemostatic changes that occur during its use to be corrected.
Raised serum prolactin levels in amenorrhoea.
Authors: M Seppala, E Hibroven, T Ranta, P Virkkunen, J Leppaluoto
Journal: BMJ (1975)

Serum prolactin levels measured by specific radio-immunoassay were over 30 mug/l in seven out of 25 women with amenorrhoea and in eight women with the amenorrhoe-galactorrhoea syndrome. There was no apparent relationship between these levels and levels of follicle-stimulating hormone, luteinizing hormones, and thyroid-stimulating hormone. Bromocriptine caused a transient fall in the proclatin levels in six out of seven cases, and in three menstruation and ovulation were restored. Estimation of serum prolactin may become important in assessing the degree of hypothalamic-pituitary dysfunction in amenorrhoea, and it may help in identifying a subgroup of patients at risk of developing a pituitary tumour or patients who may respond to specific treatment.
Cell-specific activation profile of extracellular signal-regulated kinase 1/2, Jun N-terminal kinase, and p38 mitogen-activated protein kinases in asthmatic airways
Authors: Weimin Liu, Qiaoling Liang, Silvana Balzar, Sally Wenzel, Magdalena Gorska, Rafeul Alam
Journal: Journal of Allergy and Clinical Immunology (2008)
Polyneuropathy After Mechanical Ventilation
Authors: James W. Teener
Journal: JAMA (1996)

<h3>To the Editor.</h3> —The article by Dr Leijten and colleagues<sup>1</sup>merits comment. The authors studied 50 patients receiving mechanical ventilation for more than 7 days and reported a high incidence of what they define as critical illness polyneuropathy. However, it is likely that a subset of the patients they reported actually had acute quadriplegic myopathy, which is an increasingly recognized disorder that produces prolonged neuromuscular weakness in the intensive care unit and may be confused with critical illness polyneuropathy. Some of the reported patients received prolonged neuromuscular blockade (vecuronium up to 21 days) and a small number received prednisolone. Both drugs are linked with acute quadriplegic myopathy.<sup>2</sup>In two of nine postmortem studies, the authors report that myopathy was present that had not been detected by electromyography (EMG). One of the features of acute quadriplegic myopathy that has made it difficult to distinguish from neuropathy is the low
Regular versus as-needed budesonide and formoterol combination treatment for moderate asthma: a non-inferiority, randomised, double-blind clinical trial
Authors: Alberto Papi, Brunilda Marku, Nicola Scichilone, Piero Maestrelli, Pierluigi Paggiaro, Marina Saetta, Stefano Nava, Ilenia Folletti, Giuseppina Bertorelli, Stefano Bertacco, Marco Contoli, Mario Plebani, Maria Pia Foschino Barbaro, Antonio Spanevello, Maria Aliani, Marco Pannacci, Paolo Morelli, Bianca Beghé, Leonardo M Fabbri
Journal: The Lancet Respiratory Medicine (2014)
Evaluation of an Antiasthmatic Agent Cromolyn Sodium (Aarane, Intal)
Authors: Michael H. M. Dykes
Journal: JAMA (1974)

Cromolyn sodium is a unique and effective antiasthmatic agent that has been used widely throughout the world. Its continuous prophylactic use will benefit a large proportion of asthmatic patients. In many it will be most effective when administered with other standard drugs. Cromolyn has no place in the treatment of acute asthmatic attacks. When inhaled orally in therapeutic doses, it appears to have no generalized pharmacologic activity and causes few significant adverse effects.
Policy needs to be revisited
Authors: A. M. Bal, A. Collier, A. Dowie, S. Ghosh
Journal: BMJ (2010)

Consent should be obtained before publishing case reports.1 Signed consent forms include patient’s name and the manuscript title, which often states the illness. Several UK journals insist that consent forms are sent to their editorial offices.

In the UK, processing of personal data is governed by the Data Protection Act …
The pathology and treatment of peripheral nerve tumors and tumor-like conditions
Authors: J. M. Woodruff
Journal: CA A Cancer Journal for Clinicians (1993)

Peripheral nerves are subject to a wide array of inflammatory, degenerative, hyperplastic, and neoplastic processes. Accurate pathologic assessment is essential for appropriate treatment. This article reviews the pathology and treatment of tumors and tumor-like conditions of the peripheral nerves.
Altered Platelet Function in Patients with Prosthetic Mitral Valves Effects of Sulfinpyrazone Therapy
Authors: HUGH S. WEILY, EDWARD GENTON
Journal: Circulation (1970)

Platelet survival time and platelet adhesiveness and aggregation were examined in 16 patients with prosthetic mitral valves. Subsequently, nine patients were treated with sulfinpyrazone in doses of 400 mg and 800 mg/day, and the studies were repeated after a treatment period of 5 to 8 weeks. 51 Chromium survival time was shortened in 15 of 16 patients, and the mean value for the entire group was 5.49 ± 0.23 days (normal, 6.73 ± 0.21 days; P &lt; 0.001). Mean platelet adhesiveness in glass bead columns was 53 ± 5% (normal, 30 to 60%). Platelet aggregation (turbidometric technic of Born) was normal. Treatment with 400 mg of sulfinpyrazone daily reduced platelet adhesiveness to 40 ± 5% ( P &lt; 0.05), but effected no change in platelet survival time or platelet aggregation. Therapy with 800 mg of sulfinpyrazone daily corrected platelet survival time to normal, 6.68 ± 0.57 days ( P &lt; 0.01), but it produced no further decrease in adhesiveness and no change in aggregation. It is concluded that platelet abnormalities regularly occur in patients with prosthetic mitral valves and may contribute to thromboembolism in this group. Platelet survival time is a more sensitive measure of altered platelet kinetics than platelet adhesiveness or platelet aggregation. Therapy with 800 mg of sulfinpyrazone per day corrects demonstrated abnormalities and may be useful for prevention of thromboembolism in patients with prosthetic mitral valves.
Effect of calcitriol on the production of T-cell-derived cytokines in psoriasis
Authors: M. BARNA, J.D. BOS, M.L. KAPSENBERG, F.G.M. SNIJDEWINT
Journal: British Journal of Dermatology (1997)

Although the use of vitamin D analogues in the treatment of psoriasis has been an important new development, the mechanisms of action of these drugs are not fully understood. Psoriasis results from hyperproliferation of keratinocytes, and various studies attribute a crucial role to the locally infiltrating T lymphocytes. In an attempt to add to the understanding of the mechanisms of calcitriol therapy, we determined the effect of this drug on T cells by studying its effect on proliferation and on the production of various cytokines by T-cell clones prepared from psoriatic skin after non-specific activation with the combination of phytohaemagglutinin (PHA) and phorbol myristate acetate (PMA). The addition of increasing doses (10(-9)-10(-5) mol/l) of calcitriol to these T cells resulted in a dose-dependent inhibition in lymphocyte proliferation and in production of the type 1 cytokines IFN-gamma and IL-2, the type 2 cytokines IL-4 and IL-5. The general cytokines TNF-alpha and GM-CSF were not significantly inhibited. These data suggest that calcitriol is involved in the treatment of psoriasis via inhibition of the expansion, and cytokine production, of skin-infiltrating T lymphocytes.
Principles of Nuclear Medicine
Authors: James L. Quinn
Journal: JAMA (1968)

With the publication of this work, the rapidly growing field of nuclear medicine has its first true textbook. Dr. Wagner has achieved a uniform style and presentation throughout the book, something that has eluded the editors of most multiple author volumes. The basic science as well as clinical aspects of nuclear medicine are handled with suitable depth and clarity. Throughout the book, the presentation of representative cases is quite good, and the discussion of the diagnostic procedures is adequate and objective. The chapter on the diagnostic process is outstanding. Statistics and compartment analysis are, for me, replete with complex equations, but I suppose this is the nature of the discipline. The basic physics and instrumentation sections are excellent and discussed with candid detachment. A minor organization problem concerns the presentation of the more sophisticated metabolic radiotracer procedures, but the difficulty may be due to the emerging stage of these particular
Epidemic Non-A, Non-B Hepatitis in Patients from Pakistan
Authors: KEVIN M. DE COCK
Journal: Annals of Internal Medicine (1987)

Epidemic non-A, non-B hepatitis was diagnosed in three young Pakistani men during a 10-month period at the Los Angeles County-University of Southern California Medical Center. All three patients had recently visited or lived in Karachi, Pakistan. None had serologic markers of hepatitis B virus infection or IgM antibody (acute-phase) to hepatitis A virus. A liver biopsy from one patient showed marked cholestasis and cholangiolar transformation of hepatocytes, a pattern previously described in patients with epidemic non-A, non-B hepatitis. Immune electron microscopy of a stool specimen obtained from this patient 10 days after the onset of symptoms showed virus-like particles, 27 nm in diameter, that were specifically aggregated by antibody contained in acute-phase sera from the three Pakistani patients, from patients with non-A, non-B hepatitis in Burma and Nepal, and from an experimentally infected marmoset. Recognition of three separate cases of probable epidemic-type non-A, non-B hepatitis in patients at one institution during such a short time suggests that Pakistan is endemic for this infection and that the disease may be more commonly spread to the United States than is now presumed.
Exaggerated Radiation-Induced Fibrosis in Patients With Systemic Sclerosis
Authors: John Varga
Journal: JAMA (1991)

Four patients with stable systemic sclerosis and limited skin involvement received radiation for the treatment of solid malignant neoplasms. Following localized irradiation, each patient developed an exaggerated cutaneous and internal fibrotic reaction in the irradiated areas. The surface area of fibrosis extended beyond the radiation portals employed, and the fibrotic process was poorly responsive to antifibrotic therapy. Three of the patients died of complications caused by fibrous encasement of internal organs. The extent and severity of postradiation fibrosis in these patients was distinctly unusual. These observations suggest that patients with systemic sclerosis are particularly susceptible to developing excessive radiation-induced fibrosis.
FETAL CARDIOVASCULAR RESPONSE TO INCREASED AFTERLOAD WITH DUCTAL CONSTRICTION IN THE THIRD TRIMESTER: AN EXPERIMENTAL STUDY IN SHEEP
Authors: David J. Sahn, Juha R. Rasanen, Leah S. Bernard, Roger Hohimer, Muhammad Ashraf, Minjuan Zheng, Petra S. Niemann, Xiaokui Li, Lowell E. Davis
Journal: Journal of the American College of Cardiology (2010)
A novel mechanism of glucocorticoid-induced immune suppression: the inhibiton of T cell-mediated terminal maturation of a murine dendritic cell line.
Authors: T Kitajima, K Ariizumi, P R Bergstresser, A Takashima
Journal: Journal of Clinical Investigation (1996)

Working with the murine epidermal-derived dendritic cell (DC) line XS52, we have observed previously that antigen-specific interaction with T cells stimulates their "terminal maturation" into fully professional DC. In this study we examined the impact of dexamethasone (DEX) on this T cell-induced event. When added to cocultures of XS52 DC and the KLH-specific Th1 clone HDK-1 in the presence of antigen, DEX at relatively low concentrations (10(-9)-10(-7) M) prevented substantially or completely each of the changes that typify terminal maturation, including (a) secretion of relatively large amounts of IL-1beta, IL-6, and TNFalpha; (b) loss of CD115 (colony-stimulating factor-1 receptor) expression and proliferative responsiveness to colony-stimulating factor-1; and (c) elevated expression of CD86 (B7-2). XS52 cells also underwent terminal maturation upon exposure to lipopolysaccharide alone, and DEX also inhibited effectively each of the same changes, indicating that DC can serve as the direct target of DEX. By contrast, DEX inhibited XS52 DC-stimulated IL-2 secretion by HDK-1 T cells, but not other changes that accompany T cell activation, including the secretion of IFNgamma and TNFalpha and the elevated expression of CD25, CD28, and CD44. These results reveal a new immunosuppressive mechanism of glucocorticoid action, that is, direct inhibition of T cell-mediated terminal maturation by DC.
Reliability of Snellen charts for testing visual acuity for driving: prospective study and postal questionnaire
Authors: Z. Currie
Journal: BMJ (2000)

To assess the ability of patients with binocular 6/9 or 6/12 vision on the Snellen chart (Snellen acuity) to read a number plate at 20.5 m (the required standard for driving) and to determine how health professionals advise such patients about driving.Prospective study of patients and postal questionnaire to healthcare professionals.50 patients with 6/9 vision and 50 with 6/12 vision and 100 general practitioners, 100 optometrists or opticians, and 100 ophthalmologists.Ophthalmology outpatient clinics in Sheffield.Ability to read a number plate at 20.5 m and health professionals' advice about driving on the basis of visual acuity.26% of patients with 6/9 vision failed the number plate test, and 34% with 6/12 vision passed it. Of the general practitioners advising patients with 6/9 vision, 76% said the patients could drive, 13% said they should not drive, and 11% were unsure. Of the general practitioners advising patients with 6/12 vision, 21% said the patients could drive, 54% said they should not drive, and 25% were unsure. The level of acuity at which optometrists, opticians, and ophthalmologists would advise drivers against driving ranged from 6/9(-2) (ability to read all except two letters on the 6/9 line of the Snellen chart) to less than 6/18.Snellen acuity is a poor predictor of an individual's ability to meet the required visual standard for driving. Patients with 6/9 vision or less should be warned that they may fail to meet this standard, but those with 6/12 vision should not be assumed to be below the standard.
Confusing drug packaging contributes to death of 15 children
Authors: Neil Pakenham-Walsh, Joseph Ana
Journal: The Lancet Global Health (2014)

At least 15 children have died after being vaccinated against measles in northern Syria, owing to accidental injection of atracurium.1Cousins S Contaminated vaccine deaths a serious setback for Syria.Lancet. 2014; 384: 1172Summary Full Text Full Text PDF PubMed Scopus (5) Google Scholar The seriousness of this particular event is compounded by the fact that the deaths were associated with vaccination in a population in the midst of civil war whose trust in western medicine is already fragile. It was an accident waiting to happen. 5 years ago a problem was reported with the packaging of atracurium, a deadly muscle relaxant used in surgery. “In a pediatric ICU, a respiratory therapist obtained what he thought was a sterile water vial to prepare a nebulizer treatment. As he was piercing the stopper, he fortunately noticed that he had accidentally grabbed a vial of atracurium that someone had inadvertently returned to a respiratory box in the refrigerator. The atracurium and sterile water vials both had similar purple color accents.”2Grissinger M Paralyzed by mistakes, part 1: preventing errors with neuromuscular blocking agents.Pharm Therapeu. 2009; 34: 466-481Google Scholar Reports suggest that the current accident was caused by the same confusing drug packaging: “‘While someone was preparing the vaccines, instead of putting the regular diluent for the vials, he mixed it with atracurium, which has the same colour bottle and same patch on it’, said Khaled Almilaji, health department manager…”1Cousins S Contaminated vaccine deaths a serious setback for Syria.Lancet. 2014; 384: 1172Summary Full Text Full Text PDF PubMed Scopus (5) Google Scholar WHO made a formal statement on Sept 27. It read: “The Atracurium ampoules were incorrectly added to vaccination packs prepared in one District Vaccine Distribution Centre in Idleb Governorate and distributed to four vaccination teams on the second day of the measles campaign.”3WHOStatement regarding interim findings of WHO assessment of deaths of children in Idleb Governorate, Syria.http://www.who.int/mediacentre/news/statements/2014/interim-findings-idleb-syria/en/Google Scholar Curiously, the statement does not acknowledge that atracurium and sterile water vials both have similar purple colour labels. We call on WHO and the pharmaceutical industry to take urgent action to ensure that packaging of dangerous drugs such as atracurium is strikingly different from packaging of innocuous diluents such as sterile water. This kind of mistake has happened too often in the past. It should not happen again. We declare no competing interests.