tbuckley/cabot-search huggingface dataset:
Elevated serum IgA anticardiolipin antibody levels in adult Henoch-Schönlein purpura
Authors: T. Kawakami, H. Watabe, M. Mizoguchi, Y. Soma
Journal: British Journal of Dermatology (2006)

Background Henoch–Schönlein purpura (HSP) is a small‐vessel vasculitis characterized by palpable purpura on the lower extremities and IgA‐dominant immune complex deposition within the wall and lumen of dermal vessels in the lesions. This disorder is associated, to varying degrees, with joint, gastrointestinal and renal involvement. Antiphospholipid antibodies, including anticardiolipin antibodies (aCL Abs), are a heterogeneous group of circulating autoantibodies found in patients with autoimmune and infectious diseases. Objectives To investigate the possible role of aCL Abs in adult HSP, we measured levels of serum IgA, C‐reactive protein (CRP), aCL Abs of the IgG, IgM and IgA isotypes and anti‐β2‐glycoprotein I (β2GPI)‐dependent aCL Abs in adult patients with HSP. We evaluated the correlation between these biological parameters and the clinical manifestations. Methods Adult patients with HSP with an initial cutaneous manifestation of palpable purpura on their lower extremities seen between 2001 and 2005 in our department were retrospectively reviewed. Patients with known connective tissue diseases were not included in the study. Histological examination of all patient skin biopsy specimens revealed leucocytoclastic vasculitis in the upper and mid‐dermis. Direct immunofluorescence analysis showed prominent deposits of IgA in the capillary walls of all patients. Blood samples were taken at the time that the patient presented. Serum levels of aCL Abs and anti‐β2GPI‐dependent aCL Abs were measured by enzyme‐linked immunosorbent assay. Results Twenty adult patients with HSP (12 men and eight women), mean age 62·2 years (range 23–81) were enrolled. IgA aCL Abs were found in 15 of the 20 patients (75%). All were negative for IgG aCL Abs, IgM aCL Abs and anti‐β2GPI‐dependent aCL Abs. The elevation of serum IgA aCL Abs in the 15 patients showed a significant correlation with serum IgA and CRP levels (rs = 0·91, P = 0·0007; rs = 0·80, P = 0·0026, respectively). Levels of serum IgA aCL Abs were also significantly associated with arthralgia (P = 0·022) and proteinuria according to urinalysis (P = 0·013). Conclusions Serum levels of IgA aCL Abs are elevated in the initial active stage of adult HSP, suggesting that serum IgA aCL Abs may play some role in the onset of adult HSP. We believe that serum IgA aCL Abs might be an indicator of adult HSP activity.
Sex-associated differences in left ventricular function in aortic stenosis of the elderly.
Authors: J D Carroll, E P Carroll, T Feldman, D M Ward, R M Lang, D McGaughey, R B Karp
Journal: Circulation (1992)

BACKGROUND In aortic stenosis, the response of the left ventricle to pressure overload varies from compensated hypertrophy to overt heart failure. The determinants of left ventricular adaptation are poorly understood. METHODS AND RESULTS Left ventricular function was compared to assess the role of sex in 34 women and 29 men 60 years or older with both hemodynamic and echocardiographic data characteristic of severe aortic stenosis and no important coronary artery disease. Despite a similar degree of left ventricular outflow obstruction in women versus men (aortic valve area 0.54 +/- 0.20 versus 0.59 +/- 0.19 cm2, NS), the left ventricle of women had a greater fractional shortening (37 +/- 12 versus 25 +/- 12%, p = 0.001), achieved a smaller end-systolic chamber size (1.82 +/- 0.64 versus 2.17 +/- 0.65 cm/m2, p = 0.04), and generated more pressure (210 +/- 35 versus 182 +/- 29 mm Hg, p = 0.001) with a greater maximum positive dP/dt (2.153 +/- 794 versus 1,595 +/- 384 mm Hg/sec, p = 0.02). The men had a lower cardiac index (2.12 +/- 0.59 versus 2.49 +/- 0.63 l/min/m2, p = 0.02), higher mean pulmonary artery pressure (35 +/- 13 versus 27 +/- 10 mm Hg, p = 0.01), and shorter ejection period (340 +/- 40 versus 370 +/- 40 msec, p = 0.02). Women and men were equally symptomatic. Supernormal left ventricular ejection performance was present in 41% of the women and only 14% of the men (p = 0.002). This subgroup of women had a small, thick-walled chamber (end-diastolic radius to thickness ratio, 1.58 +/- 0.52 versus 2.45 +/- 0.51 in control women, p = 0.01) with low end-systolic wall stress. Subnormal ejection performance was present in 64% of the men and only 18% of the women (p = 0.002). This subgroup of men had an increased chamber size and high end-systolic wall stress compared with control men. Greater left ventricular mass was present in men compared with women (211 +/- 55 versus 179 +/- 55 g/m2, p = 0.03). CONCLUSIONS Sex is a factor in left ventricular adaptation to valvular aortic stenosis in adults 60 years or older.
Congenital anomalies of the vas deferens.
Authors: G T Watt
Journal: BMJ (1969)

any of the agents for periods of inhalation of longer than three hours (a few up to eight hours).Our records also show that there are no important differences when the Apgar scores of the babies whose mothers inhaled methoxyflurane for three hours or less are compared with those who did so for longer periods.-Weare, etc.,
Male rape: Support for victims
Authors: D J Brooksbank
Journal: BMJ (1993)

water including that for brushing teeth; avoided milk, cheese, yoghurt, and uncooked vegetables; reduced meat and alcohol consumption; peeled all fruits; ate at the more "hygienic" expensive restaurants, where they wiped dishes and cutlery with their own dishcloth.Unsurprisingly, they endured episodes of thirst and hunger, and expense, to comply.One of them developed infectious hepatitis, bacillary dysentery, amoebic dysentery, and repeated episodes of non-specific diarrhoea.The other developed life threatening bacillary dysentery, giardiasis, two episodes of diarrhoea, and loose stools which persisted for 30 months after returning to Britain.A diet free of pathogens can rarely be achieved while travelling, particularly on a low budget trip to a developing country.Travellers need a balanced view of the costs and benefits of advice about the prevention of traveller's diarrhoea.Scientific advice should not rest solely on descrip- tive epidemiological studies and the principles of hygiene derived from the microbiology laboratory.Randomised controlled trials of field interventions are needed to assess efficacy in the main groups of travellers, by destination.
Management of Hemangiomas
Authors: E. Eugene Covington
Journal: JAMA (1961)

To the Editor:—  In an article entitled Management of Angiomas, inThe Journal(174:872 [Oct. 15] 1960), Dr. D. J. Kindel advised very early (before the 10th day of life) treatment of almost all cutaneous angiomas, including even the small strawberry marks, by using soft and ultrasoft (grenz) x-ray therapy. He used very large doses of irradiation and said there were no complications or late skin sequelae. I would like to comment as follows: (1) The overwhelming majority of the small (less than 1 cm.) strawberry marks will disappear spontaneously before the fourth year of life; thus, no therapy is necessary.  (2) He recommended soft and ultrasoft (grenz) x-ray (700 r monthly for a total of 3,500-4,900 r). This is very large total dose of irradiation for angiomas, or any other benign skin condition, and late residual changes (i.e., atrophy, whitish scar, telangiectases, ugly pigmentation, ulceration, or even late
Reaction products of aquatic humic substances with chlorine.
Authors: J D Johnson, R F Christman, D L Norwood, D S Millington
Journal: Environmental Health Perspectives (1982)

A major concern of the chlorination of aquatic humic materials is the ubiquitous production of trihalomethanes. A large number of other chlorinated organic compounds, however, have been shown to be formed by chlorine's reaction with humic substances. In this study, humic material was concentrated from a coastal North Carolina lake and chlorinated at a chlorine to carbon mole ratio of 1.5 at pH 12. A high pH was necessary for complete dissolution of the humic material and for production of adequate quantities of oxidation and chlorination products for extraction, separation and mass spectrometric identification. After concentration in ether, samples were methylated, separated with a 50-m OV-17 glass capillary column or a 25 m SP-2100 fused-silica column and identified. A Hewlett-Packard 5710A gas chromatograph interfaced to a VG Micromass 7070F double-focusing mass spectrometer was used. Low resolution, accurate mass measurements were made with a combined EI-Cl source. The ability to do low resolution, accurate mass measurements made possible a rapid scan function necessary for capillary column gas chromatography. Accurate mass measurements allowed increased confidence in the identification of compounds, most of which are not available as standards. The products identified in these studies were chlorinated aliphatic straight-chain acids dominated by di- and trichloroacetic acid and the chlorinated dicarboxylic acids: succinic, fumaric and maleic acids. Chlorinated and unchlorinated aliphatic mono- and dicarboxylic acids and unchlorinated polycarboxylic aromatic acids comprise the remaining bulk of the compounds identified.
Whole-Body “Negative-Pressure” Ventilation: Is It Really Different?
Authors: Francesco Grasso, Doreen Engelberts, Brian Kavanagh
Journal: American Journal of Respiratory and Critical Care Medicine (2008)

of Cornell University, from 2000 to 2003.These applications pertain to three-dimensional image rendering and analysis and/or small pulmonary nodule computer-aided diagnosis from computed tomography scans.The CRF licensed certain of these technologies to General Electric starting in 2001 and has received royalties, of which a portion has been distributed to C.I.H.
Respiratory symptoms and bronchial reactivity: identification of a syndrome and its relation to asthma.
Authors: A K Mortagy, J B Howell, W E Waters
Journal: BMJ (1986)

Two postal questionnaire surveys were carried out among the adult population of Southampton aimed at clarifying the diagnostic criteria for asthma (study 1) and at testing the validity of symptoms so identified as diagnostic of bronchial hyper-reactivity (study 2). The questionnaires asked about respiratory symptoms and included three questions thought likely to disclose increased bronchial reactivity. Laboratory measurements on subsamples of respondents included spirometry and bronchial challenge with increasing doses of histamine till a concentration was reached provoking a fall of more than 20% (PC greater than 20) in forced expiratory volume in one second. In the first study no normal subject (that is, one who did not report shortness of breath or wheezing on the questionnaire) had a PC greater than 20 below 0.5 g/l. Of 51 subjects who reported shortness of breath or wheezing, or both, nine had a cluster of abnormalities consisting of one or more symptoms of bronchial irritability, nocturnal dyspnoea, and prolonged morning tightness together with PC greater than 20 values of 0.5 g/l or less. These symptoms in conjunction with a low PC greater than 20 were termed the bronchial irritability syndrome. In the second study bronchial challenge confirmed the close association of these symptoms with bronchial hyper-reactivity, all other subjects being less reactive to histamine. Only 27% of subjects with symptoms of the bronchial irritability syndrome had been diagnosed as asthmatic by their general practitioners. The bronchial irritability syndrome is a definable entity for epidemiological study and patient care.
Clinical Predictors of Plaque Progression Despite Very Low Levels of Low-Density Lipoprotein Cholesterol
Authors: Ozgur Bayturan, Samir Kapadia, Stephen J. Nicholls, E. Murat Tuzcu, Mingyuan Shao, Kiyoko Uno, Ajai Shreevatsa, Andrea J. Lavoie, Kathy Wolski, Paul Schoenhagen, Steven E. Nissen
Journal: Journal of the American College of Cardiology (2010)
Emergency doctors exceed their planned hours by 20% or more, survey finds
Authors: J. Wise
Journal: BMJ (2013)

More than nine out of 10 emergency medicine consultants in the United Kingdom work more than their normal planned hours, a survey by the College of Emergency Medicine has found.

The results are contained in a report, “Stretched to the limit,” which says that there is an urgent need to ensure that safe and sustainable working practices are created in emergency departments.1 It adds that the present situation is unacceptable and makes it more difficult to recruit and retain doctors in emergency medicine.

The college carried out a web based survey of its fellows who are currently consultants, locum consultants, and associate specialists in England, Scotland, Wales, and Northern Ireland. A total of 1077 doctors completed the survey, a response rate of …
Allogeneic hematopoietic stem cell transplantation for 27 children with juvenile myelomonocytic leukemia diagnosed based on the criteria of the International JMML Working Group
Authors: A Manabe, J Okamura, K Yumura-Yagi, Y Akiyama, M Sako, H Uchiyama, S Kojima, K Koike, T Saito, T Nakahata
Journal: Leukemia (2002)
Arthroscopy of the Knee Joint
Authors: S. Gallannaugh
Journal: BMJ (1973)

Review of the results of arthroscopy of the knee joint in a consecutive series of 112 patients showed that in 81 knees the preoperative diagnosis was confirmed, and in 24 it was found to be incorrect. In seven knees the procedure yielded no further information owing to poor visualization within the joint. Arthroscopy provides a useful means of achieving more accurate diagnosis in patients with internal derangements of the knee.
Reperfusion-induced arrhythmias. A role for washout of extracellular protons?
Authors: M Avkiran, C Ibuki
Journal: Circulation Research (1992)

Rapid washout of extracellular H+ accumulated during preceding ischemia (i.e., the abrupt restoration of extracellular pH) has been implicated as an arrhythmogenic factor during reperfusion. Therefore, we hypothesized that by limiting the rate at which extracellular pH was restored during early reperfusion it should be possible to protect against reperfusion-induced arrhythmias. To test this, we used isolated rat hearts (n = 12 per group) and a novel dual coronary perfusion cannula that permitted the induction of regional ischemia (10 minutes) and the selective reperfusion (8 minutes) of the ischemic zone with modified solutions. We examined the antiarrhythmic efficacy of 1) acidic (pH 6.6) reperfusion with stepwise restoration of extracellular pH to 7.4 (stepped pH) and 2) transient (2-minute) acidic (pH 7.1, 6.8, 6.6, or 6.4) reperfusion with subsequent abrupt restoration of extracellular pH to 7.4. Hearts in two contemporary control groups were reperfused with solution at pH 7.4 throughout. In all groups, 100% of hearts exhibited ventricular tachycardia (VT) on reperfusion. VT degenerated into ventricular fibrillation (VF) in 100% of hearts in the control group but in only 42% of hearts in the stepped-pH group (p < 0.05). In the groups subjected to transient acidic reperfusion, there was a pH-dependent prolongation of VT cycle length (measured at 15 seconds of reperfusion), which was 47.1 +/- 3.9, 51.1 +/- 5.5, 56.0 +/- 1.9, 60.4 +/- 2.8 (p < 0.05), and 68.8 +/- 5.0 (p < 0.05) msec in the pH 7.4 (control), 7.1, 6.8, 6.6, and 6.4 groups, respectively. In these groups, VT degenerated into VF in 92%, 92%, 83%, 42% (p < 0.05), and 33% (p < 0.05) of hearts, respectively. In conclusion, limiting the rate at which extracellular pH is restored during early reperfusion does not affect the rapid induction of VT but inhibits the degeneration of VT into VF and promotes spontaneous reversion to normal sinus rhythm. This is consistent with a major arrhythmogenic role, during uncontrolled reperfusion, for the rapid washout of extracellular H+.
False-Positive I-131 Accumulation in a Hepatic Hydatid Cyst
Authors: Özgür Ömür, Süha Süreyya Özbek, Ayҫsegül Akgün, Bülent Yazc, Nadide Mutlukoca, Zehra Özcan
Journal: Clinical Nuclear Medicine (2007)

In this report, a case of differentiated thyroid carcinoma having false-positive I-131 accumulation due to a large hydatid cyst in the liver is presented. Abdominal sonographic examination of a 37-year-old patient with differentiated thyroid carcinoma demonstrated an ovoid, complex cystic mass containing cystic parts as well as solid-appearing components in the right lobe of liver, which is concordant with a type CE-3 hydatid cyst. The postablative whole-body scan obtained 10 days after 100 mCi I-131 therapy displayed intense and homogeneous uptake of radioiodine in the liver. Hepatic cystic mass was removed, and postoperative histologic evaluation confirmed hydatid disease. Some cystic lesions of the kidney and liver have been previously reported as causes of false-positive radioiodine accumulation.
The future role of the Department of Health
Authors: Rudolf Klein
Journal: BMJ (2007)

Among the many papers competing for the attention of Alan Johnson, the new secretary of state for health, the one that calls out for priority is the report of a Cabinet Office team on the “capability” of the Department of Health.1 The report, one of a series of reviews ranging across Whitehall, is highly critical. The DH is not alone in attracting criticism; unsurprisingly the review of the Home Office was more scathing still, and no government department has emerged from the reviews as a flawless instrument for framing and executing ministerial policy. But the timing of the report's publication poses a challenge for Mr Johnson as he takes over as health secretary. The challenge is to decide just what kind of competence he wants his department to develop, and in turn what the department's role should be.
Endoscopic Treatment of Postsurgical External Pancreatic Fistulas
Authors: G. Costamagna, M. Mutignani, M. Ingrosso, V. Vamvakousis, P. Alevras, R. Manta, V. Perri
Journal: Endoscopy (2001)

External pancreatic fistulas (EPFs) are managed primarily by conservative treatment with a success rate of 40-90%. Failures of conservative therapy have traditionally been dealt with using surgery; however, major morbidity and mortality are associated with operative treatment. The aim of this study was to evaluate the feasibility and effectiveness of endoscopic treatment in the closure of EPF.A total of 16 consecutive patients with EPF (12 men, four women; median age 50, range 21-66) underwent an attempt at endoscopic management after failure of conservative therapy. Four patients had chronic pancreatitis. All patients had EPFs occurring after open abdominal surgery. The mean interval between the onset of the fistula and our intervention was 108 days (range 27-365 days). The mean output volume of the fistula was 205 ml/d (range 50-600 ml/ d). The aim of treatment was to lower the pancreatic duct pressure and to bypass the ductal disruption by placement of drains and/or stents to induce fistula healing.In all, 13 biliary and nine pancreatic sphincterotomies were performed in order to gain access to the pancreatic duct. Access through the minor papilla was required in one patient. Complete visualization of the main pancreatic duct as well as of the fistulous tract was obtained in 12 patients (75%). Treatment consisted of placement of a nasal pancreatic drain (NPD) across the pancreaticojejunal anastomosis in one patient after duodenopancreatectomy. In 11 of the remaining 15 patients (73%) a NPD could be placed in the pancreatic duct across the ductal leakage (n = 9) or nearby (n = 2). One patient died 24 hours after endoscopic treatment from severe sepsis and massive pulmonary embolism. Endoscopic drainage was effective in healing the EPF in all patients in whom NPDs had been successfully placed, except one. The fistula in this patient healed completely after insertion of an 8.5-Fr pancreatic stent. The mean interval between endoscopic treatment and fistula closure was 8.8 days (range 2-33 days). No complications related to the endoscopic treatment were recorded in this series. In the 12 successfully treated patients, fistulas did not recur in any of the 11 surviving patients after a mean follow-up of 24.7 months (range 3-63 months).Endoscopic pancreatic drainage, when feasible, is safe and effective for EPF and should be considered as a first-line therapy when EPFs do not respond to conservative therapy.
Beating Heart Catheter-Based Edge-to-Edge Mitral Valve Procedure in a Porcine Model
Authors: James I. Fann, Frederick G. St. Goar, Jan Komtebedde, Mehmet C. Oz, Peter C. Block, Elyse Foster, Jagdish Butany, Ted Feldman, Thomas A. Burdon
Journal: Circulation (2004)

Surgical edge-to-edge repair has been used in the treatment of mitral regurgitation. We evaluated the ability of a catheter-delivered clip (Evalve, Inc) to achieve edge-to-edge mitral valve approximation without cardiopulmonary bypass and the healing response of this technique.Twenty-one pigs underwent general anesthesia and left thoracotomy. A 10F flexible delivery catheter with a clip was placed into the left atrium. With echocardiographic and fluoroscopic guidance, the clip grasped and approximated the mid portion of the anterior and posterior leaflets. After a double orifice had been confirmed, the clip was detached and the catheter withdrawn. All animals survived and had successful clip placement. Three animals were euthanized at 4 weeks, 9 at 12 weeks, 1 at 17 weeks, 7 at 24 weeks, and 1 at 52 weeks. The clip was well positioned, with leaflet approximation in all animals except 1, in which the clip separated from the posterior leaflet at 4 weeks without affecting valve function. The clip was modified and implanted in 4 pigs; all were intact at 12 to 24 weeks. Scanning electron microscopy showed clip encapsulation with complete endothelialization. Mitral stenosis and thromboembolism did not develop. Two animals developed endocarditis (1 at 12 weeks and 1 at 17 weeks). Progressive healing occurred in all other animals.Edge-to-edge mitral valve approximation can be successfully and reliably achieved with a catheter-delivered clip without cardiopulmonary bypass, resulting in durable healing. The success of this device supports the development of a percutaneous catheter-based system for mitral valve repair.
Burning Issues in Gastrointestinal Endoscopy at the Start of the New Millenium
Authors: M. Classen
Journal: Endoscopy (2003)

Gastrointestinal endoscopy has made enormous progress during the last few years. Novel imaging modalities as well as fascinating new therapeutic options seem to rapidly become realities. It seems worthwhile to review the highlights of our journal in the past year, compared with the rest of the literature as well as with recent congress abstracts; the conclusions I draw are necessarily subjective.