tbuckley/cabot-search huggingface dataset:
Selection of mutations in the hepatitis B virus polymerase during therapy of transplant recipients with lamivudine
Authors: R Ling, D Mutimer, M Ahmed, E H Boxall, E Elias, G M Dusheiko, T J Harrison
Journal: Hepatology (1996)

We describe mutations in the hepatitis B virus (HBV) polymerase gene in viruses which reactivated in two patients during therapy with –2′–deoxy– 3′–thiacytidine, or lamivudine (3TC), and following orthotopic liver transplantation for chronic hepatitis B. Virus resistance to 3TC is associated with mutations which lead to amino acid substitutions in the highly conserved tyr–met–asp–asp (YMDD) motif, part of the active site of the polymerase, and which parallel those seen in resistant human immunodeficiency virus (HIV). Substitutions of valine and isoleucine for methionine were found in the two cases. The significance of single secondary mutations, which differ between viruses from the two patients, remains to be determined. Thus, viral resistance to lamivudine of hepatitis B virus mimics that of HIV and can occur in the setting of immunosuppression after liver transplantations.
Homeopathy vs. Rational Practice.
Authors: Chas. L. Mack
Journal: JAMA (1897)

To the Editor:\p=m-\The"Code" is noble, a law irrevocable, supreme wherever the doctor wends his way, ruling an army of learned and cultured men.Its genesis is lost in antiquity.It is noble, but not more so than the unified profession whose ethics it formulates, failing only in so far as those whom it would govern are human, and to be human is to fail as well as to succeed.The " Sermon on the Mount " has been attacked, so has the Code.It has been said that a gentleman requires no "rule of conduct;" true, but all are not gentlemen, and so
Psychosomatic and Psychosocial Symptoms Are Associated with Low Blood Pressure in Swedish Schoolchildren
Authors: Magnus P. Borres, Hidetaka Tanaka, Olav Thulesius
Journal: Psychotherapy and Psychosomatics (1998)

&lt;b&gt;Background:&lt;/b&gt; The relation between psychosomatic and psychosocial symptoms and blood pressure was studied in Swedish schoolchildren. &lt;b&gt;Methods:&lt;/b&gt; Blood pressure was measured in 122 healthy Swedish schoolchildren, aged 6–16 years. Psychosomatic and psychosocial symptoms, delinquent behaviour, parental health and employment status were assessed. &lt;b&gt;Results:&lt;/b&gt; Children with systolic blood pressure above +1 SD of mean reported significantly less symptoms (x&amp;#773; = 1.4) than children with blood pressure below –1 SD of the mean (x&amp;#773; = 2.7; p &lt; 0.05). Children with three or more self-reported symptoms had significantly lower blood pressure than children without symptoms both in the supine (110 ± 12 vs. 120 ± 18 mm Hg; p &lt; 0.05) and in the standing position (117 ± 17 vs. 127 ± 18 mm Hg; p &lt; 0.05). &lt;b&gt;Conclusions:&lt;/b&gt; We conclude that psychosomatic and psychosocial symptoms in children might be associated with low blood pressure.
P220 Evolving Set-Up Practises at a Respiratory Ward-Based Non-Invasive Ventilation (NIV) Unit
Authors: S Agarwal, B Beauchamp, B Chakraborty, K Morley, A Oakes, S Ejiofor, E Gallagher, R Mukherjee
Journal: Thorax (2012)

<h3>Introduction</h3> NIV for acute hypercapnic respiratory failure (AHRF) in COPD, obesity related morbidity, chest wall and neuromuscular conditions has become widespread in the UK over the past decade. In terms of acute NIV set up, the BTS/Royal College of Physicians/Intensive Care Society 2008 guidance recommends starting with an inspiratory positive airway pressure (IPAP) of 10 cm H<sub>2</sub>O and expiratory positive airway pressure(EPAP) of 4–5 cmH<sub>2</sub>O, with small increments in IPAP aiming for apressure target of 20 cm H<sub>2</sub>O or until therapeutic response is achieved. We felt it necessary to analyse trends in maximum pressures achieved in the evolution of a respiratory ward-based NIV Unit (established2004). <h3>Methods</h3> Comparison of the in-house NIV registry data01/08/2004 –31/01/2006(Period 1) with 01/01/2011–30/06/2012 (Period 2) at an 11-bedded ward-based NIV unit within a1000-bedded hospital Trust in central England, looking at maximum IPAP and maximum EPAP achieved. There were 281 episodes of AHRF treated in Period 1 and 240 in Period 2 with similar distribution of gender. <h3>Results</h3> Maximum IPAP achieved for period 2 was significantly higher than period 1 (median IPAP max achieved=20 cmH2O vs. 14 cmH2O; Wilcox on rank sum test p=2.2 × 10–16) and the maximum EPAP achieved for period 2 was higher than period 1 (median EPAP max achieved=5 cmH2O vs. 14 cmH2O; Wilcoxonrank sum test p=8.068 × 10–6). <h3>Discussion</h3> We have previously shown that we achieved adequate therapeutic response with median IPAP max of 16.7 and median EPAP max of 5.2 cmH2O (Ali A <i>et al</i>. Pressure support in acute hypercapnic respiratory failure in an acute clinical setting. <i>European Respiratory Journal</i> 2011;<b> 38</b>:55. 683s.). However, as the ward-based, physiotherapy-intensive, multidisciplinary NIV service matures over an 8-year period, we are achieving significantly higher maximum IPAP and maximum EPAP. This is probably (a) in keeping with the increasing severity of AHRF that is being treated in the unit with similar in-hospital mortality (around 22%) and (b) demonstrates a learning curve. Further analysis of population characteristics and comparison with units of similar size may give further insights intoorganisational learning in relation to NIV.
Researchers Push Back Against Overhauling Clinical Trials
Authors: S. Jenks
Journal: JNCI Journal of the National Cancer Institute (2014)

In a water pipe (also called a hookah, narghile, shisha, goza, or hubble-bubble), smoke produced by burning flavored tobacco with charcoal or embers is drawn through a pipe connected to a liquid-filled base. The smoke passes through the liquid before users inhale through a hose and mouthpiece, which is often shared. The result is a smooth, easily tolerated, and social smoking experience. According to CDC, hookah tobacco comes in flavors, including apple, mint, cherry, chocolate, coconut, licorice, cappuccino, and watermelon. Djordjevic was appalled to hear a TV announcer describe a visit to a hookah bar with her children: “She said it smelled like baked apples!” “It doesn’t make sense that a package of cigarettes has warning labels regarding their harmful effects, yet none of the same warnings apply to hookah tobacco,” Schivo said. “Given that water pipe use has the potential to be the next big tobacco epidemic, education efforts should focus on informing the public of its harms and
Streptococcus agalactiae left-sided infective endocarditis. Analysis of 27 cases from a multicentric cohort
Authors: R. Ivanova Georgieva, M.V. García López, J. Ruiz-Morales, F.J. Martínez-Marcos, J.M. Lomas, A. Plata, M. Noureddine, C. Hidalgo-Tenorio, J.M. Reguera, J. De la Torre Lima, J. Gálvez Aceval, M. Márquez, A. de Alarcón
Journal: Journal of Infection (2010)
Diabetes and appendicectomy: testing a hypothesis.
Authors: J P Corridan, J P O'Regan, D J O'Sullivan
Journal: BMJ (1977)

1135 treating epilepsy and trigeminal neuralgia.The measurement of plasma sodium concentrations, blood concentrations of the drug, and AVP (if the assay is available), may improve the management of an individual patient and prevent the rare complication of water intoxication.
Ankylosing Spondylitis: A Review of 184 Cases
Authors: F. D. Hart, N. F. Maclagan
Journal: Annals of the Rheumatic Diseases (1955)

Some 5 years ago (Hart, Robinson, Allchin and Maclagan, 1949) we published a study of 73 patients with ankylosing spondylitis.In a follow-up study of these patients I have reviewed an additional 111 cases, personally examined, since that time.A study of these 184 patients (18 female, 166 male) forms the basis of this communication.Symptomatology.-In this series of 184 cases the initial symptom was as follows: Symptom No. Low backache .. Low back stiffness without pain Low back stiffness with slight pain Buttock pains ..
THE INFLUENCE OF LIGHT ON THE REACTION TO INFECTION IN EXPERIMENTAL SYPHILIS
Authors: Wade H. Brown, Louise Pearce
Journal: The Journal of Experimental Medicine (1927)

A series of experiments was carried out for the purpose of determining whether the reaction of rabbits inoculated with Treponema pallidum might be influenced by their light environment. The conditions compared were (1) diffuse sunlight filtered through window glass and subject to variations due to natural causes, (2) constant and continuous exposure to artificial light with a wave-length of from 3022 to 5790 Angström units (Cooper Hewitt), and (3) complete exclusion of light. The results showed clearly that each of these conditions produced a distinctive effect and that the effect tended to conform to the nature of the environmental condition. In general, the efficiency of the reaction to infection increased with the amount of light received and with the constancy of the exposure.
Congress Moves to Regulate Self-Referral and Physicians' Ownership of Clinical Laboratories
Authors: John K. Iglehart
Journal: New England Journal of Medicine (1990)

Responding to the rapidly changing nature of the delivery and financing of medical care, the federal government has enacted a new law that prohibits (as of 1992) physicians who own, invest in, or have certain compensation arrangements with clinical laboratories from referring Medicare patients to those facilities for laboratory-testing services. At the same time, the law directs the Department of Health and Human Services to create new reporting requirements — with which all providers of Medicare services must comply — regarding patterns of patient referral and the ownership of facilities. Information gleaned from these reports, plus a congressionally mandated study . . .
From Elizabeth Bennet to Barbie
Authors: Laura Fitzpatrick
Journal: JAMA Dermatology (2014)

Never mind the little black dress; Coco Chanel’s most lasting contribution to theworldof style—and,unfortunately, todermatology—maywell be the suntan. For centuries, in a fashion statement freighted with racialundertones,womenaroundtheworldcoveteda fair complexion.AncientEgyptians lightenedtheir skinwithmyrrhandfrankincense.Eighthcentury Japanese women risked death, using lead and mercury as whiteners. Intenton showing theyhadneverneeded to laborunder the sun, 18th-century Europeans followed suit, adding whale blubber for goodmeasure. TheCastilian nobles cultivated skin so translucent their veins showed through, making them the original “blue bloods.” The beauty and privilege connoted by porcelain skinwas immortalized again and again in the Western canon: Shakespeare’s Othello strangles Desdemona, lest a bloodiermurdermethod “scar that whiter skin of hers than snow.” Pride and Prejudice’s aristocratic Miss Bingley snubs Elizabeth Bennet for looking “brown and coarse” from traveling in the summer—an epithet with most unladylike connotations. Then came Coco, sashaying back from the French Riviera with the bronzage that launched a thousandmelanomas. Her tanwas of a piece withher leisure-class image:with the industrial revolution,workers had moved from the fields into factories, reversing centuries of epidermal symbolism. Pallor was for the indoor-dwelling poor; only those with means could toast themselves golden-brown. Physicians, meanwhile, touted sunbathing as a cure for everything fromtuberculosis to acne, ushering in theeraof the “healthyglow.” Sunscreen gained popularity among World War II soldiers, who protected themselves in the Pacific theater with foul-smelling red veterinary petroleum, originally intended for animals. Airman andpharmacist BenjaminGreencombined“redvetpet”withcocoabutter andcoconutoil and peddled it to civilians aswhatwould becomeCoppertone. In 1953, the Coppertone girl—with her cocker spaniel famously tugging at her bathing suit bottom to reveal her deep tan lines—debuted with the slogan “Don’t beapaleface!”Herolder cousin,MalibuBarbie, followed in 1971— followedbySunLovin’MalibuBarbie,SunsationalMalibuBarbie, andSun Gold Malibu Barbie. (The first Hispanic and African American Barbies appeared in 1980.) Itwasnotuntil 1978 that theUSFoodandDrugAdministration, amid rising concernabout skin cancer, standardized sunprotection factor ratingsonsunscreen.Tanningboothsarrived in theUnitedStates the same year. Sadly, it was a head-to-head battle with a clear victor: since then, of course,melanoma incidence has skyrocketed. Fortunately, there are glimmersofpop-culturebacklash, fromghostlyTwilightvampires to the ladies of Downton Abbey. In 2006, Cosmopolitan launched a “Practice SafeSun”campaign,with instructionsoneverythingfromself–skinchecks to “6sexy sunscreenmassages for yourman.” Surely, evenChanelwould approve.
289 DISCREPANCIES BETWEEN DEFINITIONS OF NULL RESPONSE TO TREATMENT WITH PEGINTERFERON-ALFA-2A AND RIBAVIRIN: IMPLICATIONS FOR NEW HCV DRUG DEVELOPMENT
Authors: G. Picchio, D. Luo, S. George, A. Kwong, T. Kieffer, J. Mc Hutchison, J.-M. Pawlotsky
Journal: Journal of Hepatology (2010)
Discovery at the Bedside
Authors: Ohad Oren
Journal: Annals of Internal Medicine (2011)

On Being a Doctor1 November 2011Discovery at the BedsideOhad Oren, BSOhad Oren, BSFrom The Ruth and Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, 31096, Israel.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-9-201111010-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Recently, I was assigned to care for a 15-year-old girl with ataxia telangiectasia, the debilitating neurodegenerative disease that lacks an adequate DNA repair mechanism. The girl's documents revealed a history of repeated hospitalizations for pulmonary infections. Most recently, during a 10-day course of unremitting pneumonia, ciprofloxacin-resistant Pseudomonas aeruginosa was cultured from her sputum. This time, the patient's symptoms included a temperature up to 39.5 °C accompanied by greenish productive cough, shortness of breath, and pleuritic chest pain for the past 3 days. On auscultation of her lungs, I noticed decreased breath sounds on the right, and wet rales could be heard ... Author, Article, and Disclosure InformationAffiliations: From The Ruth and Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, 31096, Israel.Acknowledgment: The author thanks Dr. Yoav Turgeman for the unparalleled dedication and teaching that inspired him to write this essay.Corresponding Author: Ohad Oren, BS, The Ruth and Bruce Rappaport Faculty of Medicine, Efron Street, P.O.B. 9649 Bat Gaim, Haifa 31096 Israel; e-mail, [email protected]com. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byIs Nephrology Fellowship Training on the Right Track? 1 November 2011Volume 155, Issue 9Page: 643KeywordsAtaxiaHospitalizationsLibrariesLungsNeurodegenerative diseasesPneumoniaPulmonary diseasesRibsSputumThorax ePublished: 1 November 2011 Issue Published: 1 November 2011 Copyright & PermissionsCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
972 SERUM CONCENTRATION OF FAS, FASL, CYTOCHROME C AND M30-NEOEPITOPE OF CYTOKERATIN-18 IN CHRONIC HEPATITIS C
Authors: A. Parfieniuk-Kowerda, T.W. Lapinski, M. Rogalska-Plonska, M. Rogalska, J. Pogorzelska, R. Flisiak
Journal: Journal of Hepatology (2010)
DOES SEVERITY OF LEFT VENTRICULAR REMODELING INFLUENCE THE RELATION BETWEEN MYOCARDIAL VIABILITY AND SURVIVAL WITH MEDICAL OR SURGICAL THERAPY IN PATIENTS WITH CORONARY ARTERY DISEASE AND LEFT VENTRICULAR DYSFUNCTION?
Authors: Robert O. Bonow, Serenella Castelvecchio, Julio Panza, Daniel Berman, Eric Velazquez, Robert Michler, Lilin She, Thomas Holly, Patrice Desvigne Nickens, Dragana Kosevic, Miroslaw Rajda, Lukasz Chrzanowski, Marek Deja, Kerry Lee, Harvey White, Jae Oh, Torsten Doenst, James Hill, Jean Rouleau, Lorenzo Menicanti
Journal: Journal of the American College of Cardiology (2014)
Immunoglobulin G4+ clones identified by next-generation sequencing dominate the B cell receptor repertoire in immunoglobulin G4 associated cholangitis
Authors: Lucas J. Maillette de Buy Wenniger, Marieke E. Doorenspleet, Paul L. Klarenbeek, Joanne Verheij, Frank Baas, Ronald P. Oude Elferink, Paul P. Tak, Niek de Vries, Ulrich Beuers
Journal: Hepatology (2013)

Abstract Immunoglobulin G4 (IgG4)-associated cholangitis (IAC) is a manifestation of the recently discovered idiopathic IgG4-related disease. The majority of patients have elevated serum IgG4 levels and/or IgG4-positive B-cell and plasma cell infiltrates in the affected tissue. We hypothesized that clonally expanded, class-switched IgG4-positive B cells and plasma cells could be causal to these poorly understood phenomena. In a prospective cohort of six consecutive IAC patients, six healthy controls, and six disease controls, we used a novel next-generation sequencing approach to screen the B-cell receptor (BCR) repertoires, in blood as well as in affected tissue, for IgG4+ clones. A full repertoire analysis of the BCR heavy chain was performed using GS-FLX/454 and customized bioinformatics algorithms (&gt;10,000 sequences/sample; clones with a frequency ≥0.5% were considered dominant). We found that the most dominant clones within the IgG+ BCRheavy repertoire of the peripheral blood at baseline were IgG4+ only in IAC patients. In all IAC patients, but none of the controls, IgG4+ BCR clones were among the 10 most dominant BCR clones of any immunoglobulin isotype (IgA, IgD, IgM, and IgG) in blood. The BCR repertoires of the duodenal papilla comprised the same dominant IgG4+ clones as the paired peripheral blood samples. In all IAC patients, after 4 and 8 weeks of corticosteroid therapy the contribution of these IgG4+ clones to the IgG+ repertoire as well as to total BCR repertoire was marginalized, mirroring sharp declines in serum IgG4 titers and regression of clinical symptoms. Conclusion: The novel finding of highly abundant IgG4+ BCR clones in blood and tissue of patients with active IAC, which disappear upon corticosteroid treatment, suggests that specific B cell responses are pivotal to the pathogenesis of IAC.
Powerful Medicines: The Benefits, Risks, and Costs of Prescription Drugs
Authors: B. Robert Meyer
Journal: Annals of Internal Medicine (2005)

Medical Writings: Book Notes4 January 2005Powerful Medicines: The Benefits, Risks, and Costs of Prescription DrugsB. Robert Meyer, MDB. Robert Meyer, MDFrom Weill Medical College, New York, New York.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-1-200501040-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Avorn J. 448 pages. New York: Knopf; 2004. $27.50. ISBN 0375414835. Order at www.randomhouse.com.Field of medicine: Clinical pharmacology, epidemiology, public health, and internal medicine.Format: Hardcover book.Audience: Anyone interested in the issues surrounding prescription drugs in the United States, from practicing clinicians, health care administrators, health economists, and policymakers to consumers.Purpose: To provide a comprehensive overview of the problems and opportunities occasioned by the pharmaceutical revolution of the last 50 years and the consequent proliferation of pharmaceutical choices available to doctors and consumers, and to suggest directions for the future.Content: The book has 5 sections discussing ... Author, Article, and Disclosure InformationAffiliations: From Weill Medical College, New York, New York. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe Challenges and Opportunities Associated with Reimbursement for Obesity Pharmacotherapy in the USA 4 January 2005Volume 142, Issue 1Page: 80KeywordsDrug policyDrug regulationDrugsGamesHealth carePatientsPharmacoepidemiologyPharmacologyPrevention, policy, and public healthSoftware tools ePublished: 4 January 2005 Issue Published: 4 January 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
PROGNOSIS AND THERAPEUTIC INDICATIONS IN CHRONIC DISEASES OF THE HEART.
Authors: DELANCEY ROCHESTER
Journal: JAMA (1897)

For the purposes of discussion, the prognostic factors in diseases of the heart may be conveniently divided into three groups:   The condition of the cardiac valves.  The condition of the capillary and venous circulation.  The condition of the muscle of the heart and of the muscular coat of the arteries—especially of the arterioles.   Of the abnormalities of the mitral valve the obstructive lesion is more serious than that of insufficiency, provided the myocardium is in fair condition; a double mitral lesion is more serious than either single one. Obstruction at this orifice is serious in two ways; if it is due to vegetations on the free edges of the valves or on the margin of the orifice at place of attachment of the valves, these vegetations may be swept off by the blood current and form infarct of the brain with all its serious consequences; if the obstruction is due
Administration delays mandate for larger employers to provide health insurance
Authors: M. McCarthy
Journal: BMJ (2013)

The Obama administration will delay by a year implementation of the provision in the health reform law requiring larger employers to offer their employees health insurance or pay a fine.

Critics of the law said the delay was just another sign that the implementation of the health law was unraveling, but supporters said the decision demonstrates the administration’s flexibility and its willingness to work with the business community.

“This announcement means even the Obama administration knows the ‘train wreck’ will only get …
Tourette's Syndrome Hypothesis Creates Controversy Among Geneticists
Authors: Beverly Merz
Journal: JAMA (1988)

COULD A SINGLE GENE be responsible for a panoply of behavioral disorders ranging from Tourette's syndrome (TS) to attention deficit disorder to compulsive eating? The question, posed at the annual meeting of the American Society for Human Genetics in New Orleans, has not only fueled a year-old controversy over the nature of the putative TS gene, it may also rekindle the long-standing debate over the validity of the genetic interpretation of family data dealing with human behavior. The question was raised by society president David E. Comings, MD, City of Hope Hospital, Duarte, Calif. In a departure from the standard presidential address, Comings made a case for his revolutionary theory. He postulated that patients with TS often have not only the motor and vocal tics characteristic of the disorder but a number of other behavior disorders because all of the disorders are governed by one gene. Comings also challenged another
Antiretroviral therapy increases risk of heart attack
Authors: S. Gottlieb
Journal: BMJ (2003)

Combination antiretroviral therapy was independently associated with a relative increase of about a quarter in the rate of myocardial infarction per year of exposure during the first four to six years of use. The absolute risk of myocardial infarction, however, was low and must be balanced against the marked benefits from antiretroviral treatment.

In this prospective observational study, researchers from the Data Collection on Adverse Events of Anti-HIV Drugs Study Group enrolled 23 468 patients in Europe, the United States and Australia, from December 1999 to April 2001 and collected follow up data until February 2002. They collected data on infection with HIV …
Students whose behaviour causes concern: Ethical perspective
Authors: D. Bowman
Journal: BMJ (2008)

What should you do when you see a fellow student behaving inappropriately? After a group of students wrote to the <i>BMJ </i>about their experience during an elective (doi:10.1136/bmj.a2874), we sought the opinions of an ethicist, a dean (doi:10.1136/bmj.a2884), a GMC representative (doi:10.1136/bmj.a2876), and a lecturer from an African university (doi:10.1136/bmj.a2875)