tbuckley/cabot-search huggingface dataset:
C-reactive protein: a critical update
Authors: Mark B. Pepys, Gideon M. Hirschfield
Journal: Journal of Clinical Investigation (2003)

In the mid 1990s, immunoassays for C-reactive protein (CRP), with greater sensitivity than those previously in routine use, revealed that increased CRP values, even within the range previously considered normal, strongly predict future coronary events. These findings triggered widespread interest, especially, remarkably, in the US, where the clinical use of CRP measurement had been largely ignored for about 30 years. CRP production is part of the nonspecific acute-phase response to most forms of inflammation, infection, and tissue damage and was therefore considered not to provide clinically useful information. Indeed, CRP values can never be diagnostic on their own and can only be interpreted at the bedside, in full knowledge of all other clinical and pathological results. However, they can then contribute powerfully to management, just as universal recording of the patient’s temperature, an equally nonspecific parameter, is of great clinical utility.

The present torrent of studies of CRP in cardiovascular disease and associated conditions is facilitated by the ready commercial availability of automated CRP assays and of CRP itself as a research reagent. However, unlike the earlier rejection in the US of CRP as an empirical test because of its perceived lack of specificity, the current enthusiasm over CRP in cardiovascular disease is widely characterized by failure to recognize appropriately the nonspecific nature of the acute-phase response, and by lack of critical biological judgment. Quality control of the source, purity, and structural and functional integrity of the CRP, and the relevance of experimental design before ascribing pathophysiological functions, are also often ignored.

This article provides information about CRP as a protein and an acute-phase reactant, and a knowledge-based framework for interpretation and analysis of clinical observations of CRP in relation to cardiovascular and other diseases. We also review the properties of CRP, its possible role in pathogenesis of disease, and our own observations that identify it as a possible therapeutic target.
Are Heavy Smokers Different From Light Smokers?-Reply
Authors: Joel D. Killen
Journal: JAMA (1989)

<h3>In Reply.—</h3> Dr Istvan says that we should not have concluded that heavy smokers suffered from a more severe tobacco withdrawal syndrome than light smokers and supports his assertion by citing studies that he says show precessation differences between heavy and light smokers on measures of anxiety and other mood states. However, the evidence from these reports would appear to be, at best, inconclusive. For example, in the study by Williams,<sup>1</sup>measures were obtained (<i>a</i>) after at least ten hours of self-reported abstinence and (<i>b</i>) after the smoking of a cigarette. Heavy smokers differed from light smokers on six of 15 mood scales administered<i>during a period of abstinence</i>. However, Williams found no<i>main effects</i>for smoker type (heavy-medium vs light)<i>after</i>subjects had resumed smoking. In the study by McCrae and colleagues,<sup>2</sup>heavy smokers appeared more anxious than nonsmokers. Analyses comparing heavy and light smokers, if conducted,
Informed consent from the mentally ill
Authors: F. Dilkf
Journal: BMJ (1985)

surveillance began in 1982.Among these infants, only one has been reported to have had acute cliniuall h-epatitis B in early infancy.Although the exclusion of infants of anti- HBe positive mothers from the immunisation programme has rcsulted in so little ill effect, the ability to identify a subgroup of anti- HBe positive women and to offer immunisa- tion for their infants would make it possible to prevent the rare clinical hepatitis B infection without too large an increase in numbers.However, the use of hepatitis B virus DNA hybridisation tests in place of e antigen/,antibody tests for antenatal patients must depend on assessments of cost and feasibility.
In vivo glucocorticoid modulation of guinea pig splenic macrophage Fc gamma receptors.
Authors: P Ruiz, F Gomez, M King, R Lopez, C Darby, A D Schreiber
Journal: Journal of Clinical Investigation (1991)

Although glucocorticoids are widely used in the treatment of immunohematologic disease, their relative efficacy is uncertain. We used an animal model, which has helped to elucidate the role of splenic macrophage Fc gamma receptors in the clearance of IgG-coated cells, to investigate whether each Fc gamma receptor is modulated by glucocorticoids to the same extent and to examine the relative potency of three commonly used glucocorticoids. Cortisol, prednisone, and dexamethasone all impaired the clearance of IgG-coated erythrocytes. However, dexamethasone was more effective than either prednisone or cortisol (P less than 0.001). Furthermore, splenic macrophages isolated from glucocorticoid-treated animals expressed impaired Fc gamma receptor function. This effect was greater in macrophages isolated from dexamethasone-treated animals, as compared to either cortisol- or prednisone-treated animals (P less than 0.001). To assess the effect of glucocorticoids on the two types of guinea pig splenic macrophage Fc gamma receptors, Fc gamma R1,2 and Fc gamma R2, specific immunoglobulin isotypes were used to measure macrophage binding of IgG-sensitized erythrocytes. Cortisol and prednisone primarily affected Fc gamma R2, whereas dexamethasone inhibited the function of both guinea pig Fc gamma receptors. Furthermore, dexamethasone was more effective (P less than 0.01) than either prednisone or cortisol in inhibiting the ability of both receptors to bind IgG-sensitized cells. Fluorescence-activated cell sorter analysis and fluorescence microscopy with monoclonal antibodies specific for each of these two receptors demonstrated that essentially all splenic macrophages expressed both receptors, and that these glucocorticoids decreased the level of each Fc gamma receptor protein expressed, rather than altering receptor mobility and clustering in the macrophage membrane. The effect on both Fc gamma receptors was greatest with dexamethasone and least with cortisol. These studies demonstrate the significant role of guinea pig splenic macrophage Fc gamma R2 in immune clearance and in the binding of IgG-coated cells. They demonstrate a differential effect of glucocorticoid hormones on Fc gamma receptor function and on surface receptor protein. Furthermore, they suggest that dexamethasone may be a more effective glucocorticoid than either prednisone or cortisol in inhibiting the clearance of IgG-coated cells by its effect on splenic macrophage Fc gamma receptors.
Bad medicine: gynaecological examinations
Authors: Des Spence
Journal: BMJ (2011)

My friend glanced at me anxiously. The spitting tutor was puce, veins popping out of his neck, a cartoon characterisation of anger. Odd that a small word like “why” could cause such an allergic reaction. But “why” is the most important word in medicine. So why do doctors routinely conduct gynaecological bimanual and speculum examinations? I visited the gleaming spired evidence websites for guidance, but was left scrabbling around the waste paper bins of the internet.

Consider bimanual pelvic examination. It can detect pelvic masses, but what is the chance of …
TECHNIQUE IN ENDOTRACHEAL ANAESTHESIA
Authors: I. W. Magill
Journal: BMJ (1930)

I5 90EIA ORA that thle appearance was suggestive of advanced silicosis.The patient died on September 5th, and a necropsy was performed on the next day.Macroscopjcal ,t ppea ran ces.There were denise pleural adhesions oII both sides of the chest.The right lung was almi-ost coal-black in colour; small, hard n ocdules were found alongf its anterior border and throughout its substance.Several small cavities were present at t lhe apex; they were smootlh-walled, and surrounded 'by dense fibrous tissue.The lung generally was fibrosed, and small scattered areas of broncho-pnieumonia were visible.The left ltung was voluminous, heavy, and dark grey in colouir.Small, hard.nodules were present tthrougrhiout its substance, whiichi was markedly fibrosed.At the apex were several small cavities with thiclk walls.The rest of the lung was the seat of extensive broncho-pneumonia.The bronchial glands were enlarged, black in colour, but not very lhard.The heart muscle was pale and soft, and the mitral valve was selerosed and incompetent.The liver was in thie condition of chronic passive congestion with fatty change.Mic roscopical Appr?fl r-an ccs.
Serologic Markers Do Not Predict Histologic Severity or Response to Treatment in Patients With Autoimmune Hepatitis
Authors: Vaibhav Mehendiratta, Pradnya Mitroo, Alessandro Bombonati, Victor J. Navarro, Simona Rossi, Raphael Rubin, Steven K. Herrine
Journal: Clinical Gastroenterology and Hepatology (2008)
FDA's safety reform is greeted with scepticism
Authors: Ray Moynihan
Journal: BMJ (2005)

The US consumer watchdog group Public Citizen has described the creation of a new safety body at the Food and Drug Administration as a “desperate” and “cynical” attempt to respond to public alarm about the harms of prescription drugs.

Last week the FDA announced that it will set up a new drug safety oversight board, made up of experts from government agencies, including the FDA, to “oversee the management of drug safety issues” and provide information to doctors and patients more quickly than …
Fortuitous Detection of Papillary Carcinoma of the Thyroid With F-18 FDG Positron Emission Tomography in a Patient With Non-Hodgkin Lymphoma
Authors: Connie E. Kim, Judith M. Joyce, Nimish Patel, James Lichter
Journal: Clinical Nuclear Medicine (2003)

Use of F-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET) in patients with known thyroid cancer is well documented, but the role of this imaging modality in the initial workup of a thyroid nodule has not been defined. The incidental finding of a hypermetabolic focus in the thyroid on F-18 FDG PET in patients with a variety of primary malignancies is reported. Based on the authors' literature search, this is the first documented case of a thyroid cancer resulting from papillary carcinoma detected in a patient with a history of non-Hodgkin lymphoma.
AN AID TO THE EARLY DIAGNOSIS OF MEASLES AND POSSIBLY VARIOUS OTHER ERUPTIVE DISEASES
Authors: William H. Wadsworth
Journal: JAMA (1928)

In treating a child, aged 8 years, who had recovered from measles with a complete disappearance of eruption five days before, we decided, for several reasons, to give her some general ultraviolet radiation. On exposure to the rays in a darkened room, we were surprised to see what appeared to be an ordinary generalized eruption covering the torso, face and legs. Thinking that possibly the rash of measles was followed by a small amount of pigmentation, we decided to try exposure during the preeruptive stage. In the first case so treated, a boy, aged 6 years, a brunet, the eruption showed beneath the epidermis exactly forty-eight hours before it made its appearance macroscopically. Becoming interested, we began trying this on a number of patients of various ages. In some of these cases we were called only a few hours before the eruption appeared. In our list we timed the development of
Nosocomial Respiratory Infections with Gram-Negative Bacilli
Authors: WALDEMAR G. JOHANSON
Journal: Annals of Internal Medicine (1972)

A prospective study of 213 patients admitted to a medical intensive care unit was done to determine the frequency of colonization of the respiratory tract with Gram-negative bacilli and the relation of such colonization to nosocomial infection. Ninety-five patients (45%) became colonized, 22% on the first hospital day. Associated with colonization were respiratory tract disease, coma, hypotension, tracheal intubation, acidosis, azotemia, and either leukocytosis or leukopenia. Antimicrobial therapy may have promoted colonization in some patients. Nosocomial infections developed in 26 patients (12.2%), 22 of whom were colonized with Gram-negative bacilli. Nosocomial respiratory infections occurred in 23% of colonized patients but in only 3.3% of noncolonized patients. The control of nosocomial pneumonia may require the development of methods for preventing or interrupting the colonization of hospitalized patients with Gram-negative bacilli.
TELEVISION EVIDENCE IN COURT
Authors: JAMES H. RYAN, VITO J. CASSAN
Journal: American Journal of Psychiatry (1965)

A video tape recording of a diagnostic interview was presented for the first time in a court of law during a mental incompetency proceeding. The evidence was accepted by the court, thus establishing legal precedent. Possible objections to the use of this technique are discussed, along with how each could be overcome.
Activation of the cardiac ATP-sensitive K+ channel by ER-001533, a newly synthesized vasorelaxant.
Authors: W K Shen, R T Tung, Y Kurachi
Journal: Circulation Research (1992)

Effects of ER-001533 (ER), a newly synthesized vasorelaxant, on the membrane currents were examined in single ventricular cells of guinea pigs. The patch-clamp technique was used in the "whole-cell" and "inside-out" patch configurations. In the whole-cell clamp condition, ER induced a time-independent K(+)-dominant current, which was inhibited by glibenclamide (1-3 microM), suggesting that ER activated the cardiac ATP-sensitive K+ channel (KATP). To elucidate the mechanism of ER-mediated KATP channel activation, the drug was applied to the inside-out patches before and after channel "run-down." Since nucleotide diphosphates could induce the channel openings after complete run-down, effects of the drug on the nucleotide diphosphate-induced channel openings were also examined. Before run-down, ER activated the KATP channel only in the presence of ATP. ER shifted the relation between [ATP]i and the channel activity to the right in a concentration-dependent fashion without a significant alteration of the slope. After channel run-down, ER did not affect the channel openings either in the absence or in the presence of UDP. However, ER could relieve the ATP-gamma-S inhibition of the UDP-induced channel openings. Thus, we conclude that ER antagonizes the inhibitory effect of ATP on the KATP channel in a competitive manner, thereby enhancing the channel openings.
Women over 75 with fragility fractures should have DEXA
Authors: S. H Ralston, G. de'Lara, D. J Farquhar, S. J Gallacher, J. Hannan, A. R McLellan
Journal: BMJ (2009)

The recent NICE guidance on osteoporosis has generated much controversy and the publication of “alternative” guidelines.1 An aspect which has escaped attention is the advice that bone density scanning by dual energy x ray absorptiometry (DEXA) may not be required in women aged ≥75 who have had a fragility fracture. This has been incorporated into the osteoporosis direct enhanced service agreement …
Seborrheic keratosis: Reflectance confocal microscopy features and correlation with dermoscopy
Authors: Verena Ahlgrimm-Siess, Theresa Cao, Margaret Oliviero, Martin Laimer, Rainer Hofmann-Wellenhof, Harold S. Rabinovitz, Alon Scope
Journal: Journal of the American Academy of Dermatology (2013)
PREDICTIVE VALUE OF 2D AND 3D DEFORMATION PARAMETERS AND WALL MOTION SCORE TO IDENTIFY TRANSMURAL MYOCARDIAL NECROSIS IN STEMI PATIENTS: A COMPARATIVE STUDY AGAINST CMR
Authors: Luigi P. Badano, Denisa Muraru, Giacomo Zoppellaro, Umberto Cucchini, Davide Ermacora, Manuel De Lazzari, Diletta Peluso, Martina Perazzolo-Marra, Sabino Iliceto
Journal: Journal of the American College of Cardiology (2013)
Combined topical use of difluoromethyl ornithine and methylglyoxal bis (guanylhydrazone) in UV-irradiated mouse skin
Authors: K. KAPYAHO, J. LAUHARANTA, J. JANNE
Journal: British Journal of Dermatology (1982)

Journal Article Combined topical use of difluoromethyl ornithine and methylglyoxal bis (guanylhydrazone) in UV‐irradiated mouse skin Get access K. KÄPYAHO, K. KÄPYAHO Department of Biochemistry, University of Helsinki and Department of Dermatology, University Central Hospital, Helsinki, Finland Search for other works by this author on: Oxford Academic Google Scholar J. LAUHARANTA, J. LAUHARANTA Department of Biochemistry, University of Helsinki and Department of Dermatology, University Central Hospital, Helsinki, Finland Search for other works by this author on: Oxford Academic Google Scholar J. JÄNNE J. JÄNNE Department of Biochemistry, University of Helsinki and Department of Dermatology, University Central Hospital, Helsinki, Finland Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 107, Issue 4, 1 October 1982, Pages 415–422, https://doi.org/10.1111/j.1365-2133.1982.tb00384.x Published: 01 October 1982 Article history Accepted: 31 March 1982 Published: 01 October 1982
Last Word on Hiccups
Authors: Barry Blum
Journal: JAMA (1968)

<h3>To the Editor:—</h3> Permit me to offer a simpler remedy for hiccups than Dr. Perlman's (<b>202</b>:245, 1967). It is used by Peace Corps volunteers in Thailand, with seemingly excellent results. To quote from the Peace Corps medical pamphlet: Check with your friends for a local village remedy. That's usually as good as anything we can offer. If they can't help, try this: Hold your breath and drink a glass of water (boiled, of course). While still holding your breath, rub the left side of your neck with your right hand for about 15 seconds. You should be sitting down when you do this.
Interferon-γ increases IL-12 mRNA expression and attentuates allergic late-onset airway responses in the Brown Norway rat
Authors: S. Isogai, Q. Hamid, E Minshall, S Miyake, Y Yoshizawa, R Taha, M Toda, J.g Martin, A Watanabe
Journal: European Respiratory Journal (2000)

Interferon gamma is a T-helper cell (Th)-1-type cytokine that has been suggested to inhibit the development of an atopic Th2-type profile of cytokine expression. The aim of this study was to investigated the effect of exogenous rat interferon gamma on antigen-induced airway responses, and on Th1 and Th2-type cytokine messenger ribonucleic acid (mRNA) expression in the Brown Norway rat. Rats were actively sensitized to ovalbumin and 14 days later underwent an aerosolized ovalbumin challenge. Animals were intratracheally administered either interferon gamma (3,000 U) or control solvent 30 min prior to, and 2 and 4 h following, antigen challenge. Lung resistance was monitored over an 8-h time period. Using in situ hybridization and immunocytochemistry, the levels of Th1- (interleukin-12) and Th2-type (interleukin4 and -5) cytokine mRNA, and major basic protein expression in the bronchoalveolar lavage fluid of these rats 8 h after ovalbumin challenge were also determined. Administration of interferon gamma attenuated the development of the late-onset airways response in ovalbumin-sensitized antigen-challenged rats (p<0,05). The expression of interleukin-4 and -5 mRNA in the bronchoalveolar lavage fluid of interferon gamma treated rats was significantly attenuated compared to ovalbumin-challenged saline-treated controls (p<0.001). This was accompanied by a significant increase in the expression of interleukin-12 mRNA, and a reduction in eosinophil numbers. Intratracheal administration of interferon gamma modulates the allergic late-onset airways response in rats, and this is associated with a reduction in the expression of T-helper cell 2-type cytokines and an increase in interleukin-12 messenger ribonucleic acid expression within the airways. The present results support a role for interferon gamma in the pathophysiology of acute allergic airway responses, possibly by virtue of its ability to modulate T-helper cell 1- 2-type cytokine expression within the lungs.
PERIPHERAL COLLAGEN MARKERS PREDICT ALL-CAUSE MORTALITY AND CARDIOVASCULAR HOSPITALISATION IN PATIENTS WITH HEART FAILURE AND PRESERVED EJECTION FRACTION: RESULTS OF THE I-PRESERVE COLLAGEN SUB-STUDY
Authors: Henry Krum, Maros Elsik, Hans G. Schneider, Agata Ptaszynska, Marion Black, Peter Carson, Barry Massie
Journal: Journal of the American College of Cardiology (2010)
Role of alveolar macrophages in precipitation of mineral elements inhaled as soluble aerosols.
Authors: P Galle, J P Berry, C Galle
Journal: Environmental Health Perspectives (1992)

The lysosomes of several varieties of cells such as the tubular proximal cell of the kidney and the alveolar macrophage have the ability to concentrate and precipitate several elements inhaled in water-soluble form, usually as phosphate. The mechanism involved is attributed to the high acid phosphatase activity of lysosomes and can be considered as an in vivo Gomori reaction. Among the elements studied, most of them are chemotoxic or radiotoxic (Cr; group IIIA: Al, Ga, In; rare earths: La, Ce, Tm; actinides: Th, U). In the lung macrophage, this mechanism of intralysosomal concentration and precipitation may prevent the diffusion of these toxic elements through the alveolar membrane.
Effects of Ambient Air Pollution on Hemostasis and Inflammation
Authors: Goran Rudež, Nicole A.H. Janssen, Evren Kilinc, Frank W.G. Leebeek, Miriam E. Gerlofs-Nijland, Henri M.H. Spronk, Hugo ten Cate, Flemming R. Cassee, Moniek P.M. de Maat
Journal: Environmental Health Perspectives (2009)

BackgroundAir pollution has consistently been associated with increased morbidity and mortality due to respiratory and cardiovascular disease. Underlying biological mechanisms are not entirely clear, and hemostasis and inflammation are suggested to be involved.ObjectivesOur aim was to study the association of the variation in local concentrations of airborne particulate matter (PM) with aerodynamic diameter < 10 μm, carbon monoxide, nitrogen monoxide, nitrogen dioxide, and ozone with platelet aggregation, thrombin generation, fibrinogen, and C-reactive protein (CRP) levels in healthy individuals.MethodsFrom 40 healthy volunteers, we collected 13 consecutive blood samples within a 1-year period and measured light-transmittance platelet aggregometry, thrombin generation, fibrinogen, and CRP. We performed regression analysis using generalized additive models to study the association between the hemostatic and inflammatory variables, and local environmental concentrations of air pollutants for time lags within 24 hr before blood sampling or 24–96 hr before blood sampling.ResultsIn general, air pollutants were associated with platelet aggregation [average, +8% per interquartile range (IQR), p < 0.01] and thrombin generation (average, +1% per IQR, p < 0.05). Platelet aggregation was not affected by in vitro incubation of plasma with PM. We observed no relationship between any of the air pollutants and fibrinogen or CRP levels.ConclusionsAir pollution increased platelet aggregation as well as coagulation activity but had no clear effect on systemic inflammation. These prothrombotic effects may partly explain the relationship between air pollution and the risk of ischemic cardiovascular disease.
The appropriateness of tympanostomy tubes for children
Authors: S. T. Dana
Journal: JAMA (1995)

To the Editor.  —As chairman of the American Academy of Otolaryngology—Head and Neck Surgery Quality Improvement Committee, I feel obligated to share my observations regarding the article by Dr Kleinman and colleagues. 1   Before the April 27, 1994, issue of JAMA , no attempt was made by VHS or its insurance company clients to disseminate their criteria among the very physicians they now criticize. As one can easily see in their Table 2, there are 64 scenarios with 43 inappropriate choices, 15 equivocal choices, and only six appropriate choices. It seems miraculous that only 23% of the proposed surgeries were found to be inappropriate! Dr Kleinman and associates have set themselves up as judges in a kangaroo court, and I find that professionally and morally offensive.  The methods permitted the authors to change a rating from appropriate to equivocal arbitrarily. One could have rated more of the equivocal in the appropriate