tbuckley/cabot-search huggingface dataset:
Pulmonary function and sputum characteristics predict computed tomography phenotype and severity of COPD
Authors: Gianna Camiciottoli, Francesca Bigazzi, Matteo Paoletti, Lucia Cestelli, Federico Lavorini, Massimo Pistolesi
Journal: European Respiratory Journal (2012)

Airway obstruction and parenchymal destruction underlie phenotype and severity in chronic obstructive pulmonary disease (COPD). We aimed to predict, by clinical and pulmonary function data, the predominant type and severity of pathological changes quantitatively assessed by computed tomography (CT). Airway wall thickness (AWT-Pi10) and percentage of lung area with X-ray attenuation values &lt;-950 HU (%LAA -950 ) were measured in 100 (learning set) out of 473 COPD outpatients undergoing clinical and functional evaluation. Original CT measurements were translated by principal component analysis onto a plane with the novel coordinates CT1 and CT2, depending on the difference (prevalent mechanism of airflow limitation) and on the sum (severity) of AWT-Pi10 and %LAA -950 , respectively. CT1 and CT2, estimated in the learning set by cross-validated models of clinical and functional variables, were used to classify 373 patients in the testing set. A model based on diffusing capacity of the lung for carbon monoxide, total lung capacity and purulent sputum predicted CT1 (r = 0.64; p&lt;0.01). A model based on forced expiratory volume in 1 s/vital capacity, functional residual capacity and purulent sputum predicted CT2 (r = 0.77; p&lt;0.01). Classification of patients in the testing set obtained by model-predicted CT1 and CT2 reflected, according to correlations with clinical and functional variables, both COPD phenotype and severity. Multivariate models based on pulmonary function variables and sputum purulence classify patients according to overall severity and predominant phenotype of COPD as assessed quantitatively by CT.
THE PHOSPHOLIPID COMPOSITION OF GUINEA-PIG SKIN IN RELATION TO ENDOGENOUS RESPIRATION
Authors: V. J. W. LONG, K. M. BOYCE
Journal: British Journal of Dermatology (2006)

Summary.— The content and composition of phospholipids in fresh and cultured guinea‐pig skin have been determined. Following culture, it was confirmed that the phospholipid concentration decreased, particularly when glucose was omitted from the culture medium. There was no change in the relative proportions of the phospholipids of the skin.
'Tin-tack' sign in localized pemphigus foliaceus
Authors: Y. PARAMSOTHY, C.M. LAWRENCE
Journal: British Journal of Dermatology (1987)

Two patients with localized pemphigus foliaceus are described, in whom a positive 'tin-tack' sign was a significant feature; this is the appearance of small horny plugs attached to the under-surface of the scale removed from the affected site. This report is intended as a reminder that a positive 'tin-tack' sign is not exclusively a feature of discoid lupus erythematosus but is also seen in localized pemphigus foliaceus. Localized pemphigus foliaceus or pemphigus erythematosus1 is characterized by well demarcated erythematous areas of scaling and crusting which on the face may adopt a butterfly distribution,2 thus resembling discoid lupus erythematosus (DLE). Removal of these scales reveals the presence of small horny plugs attached to the under-surface, thus resembling 'tin-tacks' or 'carpet tacks' penetrating the under-surface.2 Whilst a positive 'tin-tack' sign is a well described clinical feature of DLE, it is not diagnostic. The same appearance is seen in localized pemphigus foliaceus,2 although this physical sign has received little attention in the literature or standard textbooks. We report two patients with localized pemphigus foliaceus, both of whom demonstrated a positive 'tin-tack' sign.
Clinical trials evaluating platelet-modifying drugs in patients with atherosclerotic cardiovascular disease and thrombosis.
Authors: L A Harker
Journal: Circulation (1986)

Aspirin has been convincingly shown to reduce stroke and death in men with transient ischemic attacks (it may possibly be beneficial to women also), myocardial infarction and death in patients with unstable angina, thromboembolic complications associated with artificial heart valves in patients receiving oral anticoagulants (although gastrointestinal bleeding is prohibitive with this combination), and thrombotic occlusion of silicone rubber arteriovenous cannulae in uremic patients undergoing hemodialysis. In addition, aspirin may possibly decrease occlusion of saphenous vein aortocoronary grafts and venous thrombosis in men after hip replacement, although these reports require confirmation. Aspirin is ineffective in the secondary prevention of stroke and has unproven benefit in the secondary prevention of myocardial infarction. Dipyridamole in combination with oral anticoagulation decreases the thromboembolic complications associated with mechanical heart valves. The combination of aspirin and dipyridamole prevents both early and late occlusion of saphenous vein aortocoronary bypass grafts and protects renal function in patients with membranoproliferative glomerulonephritis. The relative importance of combining aspirin and dipyridamole compared with either agent used singly remains to be established. Sulfinpyrazone reduces the thrombotic occlusion of arteriovenous cannulae and early occlusion of saphenous vein aortocoronary grafts. The reported benefit in the secondary prevention of myocardial infarction is controversial.
Detection of precore/core-mutant hepatitis B virus genome in patients with acute or fulminant hepatitis without serological markers for recent HBV infection
Authors: Toshikazu Uchida, Thein Thein Aye, Sven O. Becker, Masanori Hirashima, Toshio Shikata, Fumihiko Komine, Mitsuhiko Moriyama, Yasuyuki Arakawa, Shyujirou Takase, Satoaki Mima
Journal: Journal of Hepatology (1993)
Five- to fifteen-year follow-up after Fontan operation.
Authors: D J Driscoll, K P Offord, R H Feldt, H V Schaff, F J Puga, G K Danielson
Journal: Circulation (1992)

The purpose of this study was to estimate survival and quality of outcome and assess factors associated with outcome for patients out 5 to 15 years from their Fontan operation.We studied 352 patients who had the Fontan operation prior to 1985. The overall 1-, 5-, and 10-year survival was 77%, 70%, and 60%, respectively. The following factors were significantly associated with lower survival: univentricular heart or complex congenital anomalies other than tricuspid atresia, early calendar year of operation, heterotaxia syndromes, early age at operation, increased pulmonary artery pressure, atrioventricular valve dysfunction, and higher (worse) New York Heart Association class. Reoperations were necessary for 103 of the 352 patients. At least 20% of the survivors have or have had cardiac arrhythmias requiring antiarrhythmic medication or mechanical pacemaker insertion. Between 7% and 10% of the patients have had or had protein-losing enteropathy/hypoproteinemia. At 5 years postoperatively, 122 patients (34.7%) were alive with a better New York Heart Association functional classification than preoperatively. Fifty-eight patients (16.5%) were alive and in the same functional classification, but 126 (35.8%) died within the first 5 years or were in a worse functional classification. Thirty-nine patients were doing excellently and 29 patients poorly 5 years after the operation. Of the surviving patients, 43% can do as much exercise as their peers, whereas 3% are incapable of exercise.To assure good functional long-term outcome in addition to survival, clinicians must exclude from selection for Fontan operation patients known to be at high risk for death or poor outcome.
The new World Health Organization classification of haematopoietic and lymphoid tumours: a dermatopathological perspective
Authors: D.N. Slater
Journal: British Journal of Dermatology (2002)

The World Health Organization (WHO) has published a new consensus classification of tumours of haematopoietic and lymphoid tissue, based on recognizable disease entities defined by clinical and scientific criteria. The WHO does not support the use of stand-alone organ-related classifications, such as for skin. The Royal College of Pathologists (London) has adopted the WHO classification in its minimum dataset for the histopathological reporting of lymphoma and this will be used in the National Health Service Skin Cancer Dataset. The purpose of this review is to highlight the principal primary and secondary cutaneous haematopoietic and lymphoid tumours that are defined in the WHO classification. The review also discusses selected problematical areas in the WHO classification relevant to the skin and contains suggestions to encourage a unified approach in the use of the WHO coded summary. These represent an attempt to facilitate future progress and research in the field of cutaneous lymphoma. They are perceived as possible building-blocks for wider discussion and not as alterations to the classification. The WHO classification has been compared with a road map that indicates directions for future clinical and scientific research.
Women in Rwanda
Authors: Mardge H. Cohen, Anne-Christine d’Adesky, Kathryn Anastos
Journal: JAMA (2005)

IN 2003 RWANDAN WOMEN’S ASSOCIATIONS ISSUED AN international call to aid women who had been raped and infected with human immunodeficiency virus (HIV) during the genocide and who were becoming sick and dying. As difficult as it was for the world to comprehend the tragedy of the 1994 events it was even more incomprehensible that while women with HIV were not receiving antiretroviral medications alleged perpetrators were receiving treatment in prison. The associations often led by survivors themselves care for thousands of widows rape survivors and orphans some specifically caring for those infected with HIV. The leaders of these associations knew their members needed antiretroviral therapy immediately to survive. However they also understood the physical emotional familial and economic struggles caused by the civil war and genocide that continued to traumatize these women and knew that successful management of HIV infection would require more than medications. Rwandan women with HIV infection needed counselors and therapy for posttraumatic stress support groups food housing education about their illness and treatment and job training as well as income for their children’s food school fees uniforms and pencils.  (excerpt)
Fatal Epstein-Barr-Virus-Associated Proliferation of Donor B Cells After Treatment of Acute Graft-Versus-Host Disease with a Murine Anti-T-Cell Antibody
Authors: Martin Pj, Shulman Hm, Schubach Wh, Hansen Ja, Fefer A, Miller G, Thomas Ed
Journal: Annals of Internal Medicine (1984)

Two patients with acute leukemia were treated with chemoradiotherapy and allogeneic bone marrow transplantation. Despite the prophylactic use of methotrexate after grafting, both patients developed severe graft-versus-host disease that was refractory to treatment with methylprednisolone. The graft-versus-host disease was then treated with a monoclonal antibody, 64.1, that reacts with a p19 antigen on human T cells. The disease responded dramatically to this treatment, but both patients subsequently developed a fatal polyclonal lymphoproliferative disorder arising in donor-derived B cells. Hybridization studies showed Epstein-Barr virus in both tumors. The combined effect of severe end-stage graft-versus-host disease and potent immunosuppressive therapy probably resulted in a progressive immunodeficiency syndrome that abrogated the T-cell-mediated surveillance mechanism that normally modulates the proliferation of Epstein-Barr-virus-infected B lymphocytes.
Endothelin action in rat liver. Receptors, free Ca2+ oscillations, and activation of glycogenolysis.
Authors: C Serradeil-Le Gal, C Jouneaux, A Sanchez-Bueno, D Raufaste, B Roche, A M Préaux, J P Maffrand, P H Cobbold, J Hanoune, S Lotersztajn
Journal: Journal of Clinical Investigation (1991)

High affinity binding sites for endothelin (ET) were identified on rat liver plasma membranes. Binding of 125I-ET-1 with its site was specific, saturable, and time dependent (kobs = 0.019 +/- 0.001 min-1), but dissociation of receptor-bound ligand was minimal. A single class of high affinity binding sites for 125I-ET-1 was identified with an apparent Kd of 32.4 +/- 9.8 pM and a Bmax of 1084 +/- 118 fmol/mg protein. ET-3 and big-ET-1 (1-38) (human) inhibited 125I-ET-1 binding with IC50 values of 1.85 +/- 1.03 nM and 43 +/- 6 nM, respectively. Aequorin measurements of cytosolic free Ca2+ in single, isolated rat hepatocytes showed that ET-1 at subnanomolar concentrations induced a series of repetitive, sustained Ca2+ transients. ET-1 had no effect on cAMP production. Finally, ET-1 caused a rapid and sustained stimulation of glycogenolysis in rat hepatocytes. A 1.8-fold maximal increase in glycogen phosphorylase alpha was observed at 1 pM ET-1, with an EC50 of 0.03 pM. Stimulation of the enzyme was specific for ET-1 since the order of potency of related peptides was similar to that in binding experiments (ET-1 greater than ET-3 greater than big ET-1). These data constitute the first demonstration of the presence of ET-1 binding sites in liver which is associated with a rise in cytosolic free Ca2+ and a potent glycogenolytic effect. We conclude that ET-1 behaves as a typical Ca2+ mobilizing hormone in liver.
Recent advances: General medicine
Authors: L. A Petersen
Journal: BMJ (1998)

One review could not encompass all the noteworthy recent advances in general medicine, but research findings relevant to the treatment of HIV, congestive heart failure, prostatic hypertrophy, hypertension, hypercholesterolaemia, oestrogen replacement, osteoporosis, cancer screening, and symptoms of the common cold have generated particular interest. For this review, I defined advances in general medicine as research that might change the management of chronic disease or the strategies to prevent disease. Given the breadth of the subject, I asked colleagues to nominate the three to five articles published in the previous 18 months that they believed had been most important to the practice of general medicine. Advances in understanding of the pathogenesis and treatment of HIV related illness have resulted in new recommendations for antiretroviral treatment and disease monitoring. Plasma HIV RNA concentrations are now thought to be the most important predictor of outcome,1–3 and reductions in the viral load are associated with a reduced risk of disease progression.4 Concerns that treatment with only one agent is associated with rapid selection of resistant virus variants have led to the current recommendation of a regimen incorporating three drugs—two nucleoside analogue reverse transcriptase inhibitors and a protease inhibitor. All patients with plasma HIV RNA concentrations >5000 to 10 000 copies/ml should be given triple therapy, regardless of their CD4+ cell count. Triple therapy is also recommended for patients with symptomatic HIV disease or with CD4+ cell counts below 0.50 × 109/l.5 Unfortunately, these regimens are costly, complicated, and require great commitment on the part of both patients and health care providers. Lack of diligence in adhering to the complex drug regimen may result in emergence of drug resistant strains. #### Recent advances
Manufacturing defects in bronchoscopes can lead to nosocomial infections
Authors: S Wharton
Journal: Thorax (2003)

▴ Kirschke DL, Jones TF, Craig AS, et al . Pseudomonas aeruginosa and Serratia marcescens contamination associated with a manufacturing defect in bronchoscopes. N Engl J Med2003;348:214–20 [OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] ▴ Feigal DW, Gardner SN, McClellan M. Ensuring safe and effective medical devices (editorial). N Engl J Med2003;348:191–2 [OpenUrl][5][CrossRef][6][PubMed][7][Web of Science][8] This paper describes the investigation of an unexpected rise in the number of bronchoscopic cultures growing Pseudomonas and Serratia spp in a community hospital. Over a 4 month period 20 of 43 samples … [1]: {openurl}?query=rft.jtitle%253DNew%2BEngland%2BJournal%2Bof%2BMedicine%26rft.stitle%253DNEJM%26rft.issn%253D0028-4793%26rft.aulast%253DKirschke%26rft.auinit1%253DD.%2BL.%26rft.volume%253D348%26rft.issue%253D3%26rft.spage%253D214%26rft.epage%253D220%26rft.atitle%253DPseudomonas%2Baeruginosa%2Band%2BSerratia%2Bmarcescens%2BContamination%2BAssociated%2Bwith%2Ba%2BManufacturing%2BDefect%2Bin%2BBronchoscopes%26rft_id%253Dinfo%253Adoi%252F10.1056%252FNEJMoa021791%26rft_id%253Dinfo%253Apmid%252F12529461%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1056/NEJMoa021791&link_type=DOI [3]: /lookup/external-ref?access_num=12529461&link_type=MED&atom=%2Fthoraxjnl%2F58%2F4%2F293.atom [4]: /lookup/external-ref?access_num=000180390600005&link_type=ISI [5]: {openurl}?query=rft.jtitle%253DNew%2BEngland%2BJournal%2Bof%2BMedicine%26rft.stitle%253DNEJM%26rft.issn%253D0028-4793%26rft.aulast%253DFeigal%26rft.auinit1%253DD.%2BW.%26rft.volume%253D348%26rft.issue%253D3%26rft.spage%253D191%26rft.epage%253D192%26rft.atitle%253DEnsuring%2BSafe%2Band%2BEffective%2BMedical%2BDevices%26rft_id%253Dinfo%253Adoi%252F10.1056%252FNEJMp020170%26rft_id%253Dinfo%253Apmid%252F12529457%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [6]: /lookup/external-ref?access_num=10.1056/NEJMp020170&link_type=DOI [7]: /lookup/external-ref?access_num=12529457&link_type=MED&atom=%2Fthoraxjnl%2F58%2F4%2F293.atom [8]: /lookup/external-ref?access_num=000180390600001&link_type=ISI
One-Second Biopsy of the Liver — Problems of Its Clinical Application
Authors: Giorgio Menghini
Journal: New England Journal of Medicine (1970)

IN the course of the last few years, over 300,000 liver biopsies have probably been performed in all countries by the rapid method described in 1958.1 This assessment is necessarily approximate since the published statistics constitute only a fraction of the total number. At any rate, it is now a fact that liver biopsy is no longer confined to specialized centers, but has become an almost routine procedure in liver diagnosis for inpatients and even for outpatients. . . .
Bridging the gap after vocational training
Authors: J. Harrison, T. van Zwanenberg
Journal: BMJ (1998)

A step? Or a quantum leap?((1)) The transition from GP registrar to principal is a big one. Jamie Harrison and Tim van Zwanenberg describe the schemes designed to ease the transition

General practice used to be the most popular medical career choice, and attracted the brightest and the best of medical graduates. In recent years, however, there has been a fall in the number of doctors enrolling for vocational training and real difficulty in recruiting general practitioners to some parts of the country. The explanations extended to explain this loss of popularity include higher patient expectations, low general practitioner morale, increased workload, and expanding bureaucracy and out of hours work.

Although the extent of this recruitment crisis has been disputed, several studies report a reluctance among general practitioner registrars to enter general practice partnership immediately on completing vocational training.((2)(3))

The reasons general practitioner registrars fail to make this transition to partnership are complex. Many feel inadequately prepared for the wider dimension of being a general practitioner. While confident about consulting with patients, the business side of practice and general practitioners' growing responsibilities in the NHS are a worry; the registrars perceive a lack of exposure to such issues in their training practices.

There is also a generational factor. The current generation, and this applies not only to doctors, seems less willing to “settle down”. They are less inclined to take on the financial and administrative responsibilities associated with being a partner straight …
Search for the Most Practical Regular/NPH Mixtures for Type I Diabetic Patients
Authors: R Renner, K Vocke, K D Hepp
Journal: Diabetes Care (1982)

After 2 wk of good control 9 type I diabetic patients were hospitalized and treated in a randomized fashion with different human insulin mixtures (regular: NPH), containing 10, 15, or 20% regular insulin. In the case of the 15:85% mixture, mean blood glucose was found to be in the range of 70–150 mg/dl. Significant differences occurred at certain time points between the curves obtained with the 10:90% and the 15:85% mixtures, and the 10:90% and the 20:80% preparations, respectively. Prolongation of the interval between hormone injection and start of breakfast from 30 to 45 min abolished the postprandial glucose excursion in the 15:85% and the 20:80% mixture, but not the 10:90% mixture.
Acute promyelocytic leukaemia presenting with subarachnoid haemorrhage and complicated by central nervous system involvement
Authors: K Bhuller, M Kwan
Journal: Blood Cancer Journal (2011)

Acute promyelocytic leukaemia (APML) is a condition classically characterised by t(15;17) (q22, q21), with disseminated intravascular coagulopathy (DIC) being a major cause of death. Central nervous system (CNS) involvement with APML commonly occurs in relapse; however, it is rarely seen at presentation, with only six reported cases in the literature. This case is the first to describe a patient with APML who presented with a subarachnoid haemorrhage and had CNS involvement early at diagnosis.
Exercise Testing-Reply
Authors: L. Howard Hartley
Journal: JAMA (1979)

In Reply.—  I certainly agree with the limitations imposed on the exercise test by the sensitivity and specificity of the exercise ECG, and I am on record as having so stated ( N Engl J Med 293:400-401, 1975). However, a major objective of a larger scale exercise program would not be to identify coronary heart disease. In fact, even if coronary heart disease were identified, there is little that could be done to treat it with present technology. It is my opinion that the greatest use of exercise testing programs is for screening of persons who wish to begin an activity program.  Of the men noted in the sample under study, 3% had high-grade ventricular ectopy. Also, an additional 2% to 3% had 2 mm or more of horizontal ST segment depression. An ST segment depression of that magnitude is extremely specific for myocardial ischemia. Accordingly, persons who have either high-grade
Preventing incompatible transfusions
Authors: M Contreras, M de Silva
Journal: BMJ (1994)

rather than simply as "highly paid producers of services to be managed like a collective bargaining unit" (as Henry J Kaiser first considered the doctors he hired to provide medical care for his California shipyard workers during the second world war").The Kaiser Health Plan currently offers several million members medical care on a prepaid basis and resembles the NHS in many ways.How a balance of authority and responsibility between doctors and management was fought for and achieved may be of special interest during current efforts to reconcile conflicting interests in the NHS.II Intentions have been expressed and first steps taken.The government states that doctors should participate in manage- ment decisions, and doctors' incorporation as participants in clinical directorates has been debated extensively.'2What remains to be completed is a clear formalisation of lines of authority and responsibility which recognise doctors as equal partners in a collaboration based on respect and trust in pursuit of a mutually agreed objective.7Only then will it be possible to achieve the full benefits that such a partnership can offer to the British public.