tbuckley/cabot-search huggingface dataset:
Serum hyaluronic acid with serum ferritin accurately predicts cirrhosis and reduces the need for liver biopsy in C282Y hemochromatosis
Authors: Darrell H. G. Crawford, Therese L. Murphy, Louise E. Ramm, Linda M. Fletcher, Andrew D. Clouston, Gregory J. Anderson, V. Nathan Subramaniam, Lawrie W. Powell, Grant A. Ramm
Journal: Hepatology (2008)

Diagnosing the presence of cirrhosis is crucial for the management of patients with C282Y hereditary hemochromatosis (HH). HH patients with serum ferritin >1,000 μg/L are at risk of cirrhosis; however, the majority of these patients do not have cirrhosis. Noninvasive markers of hepatic fibrosis may assist in determining which patients with a serum ferritin >1,000 μg/L have cirrhosis and require liver biopsy. This study evaluated the utility of current diagnostic algorithms for detecting cirrhosis, including serum ferritin concentration, platelet counts, and aspartate aminotransferase (AST) levels, in combination with serum markers of fibrosis, hyaluronic acid and collagen type IV (CLIV), in predicting cirrhosis in HH patients. Stage of fibrosis, serum hyaluronic acid and CLIV levels, were measured in 56 patients with HH. No patient with a serum ferritin <1,000 μg/L had cirrhosis, but only 40% of patients with serum ferritin >1,000 μg/L were cirrhotic. A combination of platelet count (<200 × 109/L), elevated AST, and serum ferritin >1,000 μg/L did not detect 30% of cirrhotic subjects. Serum hyaluronic acid was increased in HH compared with controls (42.0 ± 9.8 ng/mL versus 19.3 ± 1.8 ng/mL; P = 0.02). A hyaluronic acid concentration >46.5 ng/mL was 100% sensitive and 100% specific in identifying patients with cirrhosis. In patients with serum ferritin >1,000 μg/L, hyaluronic acid levels were significantly elevated in patients with cirrhosis versus those without cirrhosis (137 ± 34.4 ng/mL versus 18.6 ± 1.5 ng/mL, respectively; P = 0.006). CLIV >113 ng/mL was 100% sensitive but only 56% specific for cirrhosis (area under the curve = 0.78; P = 0.01). Conclusion: In HH, the measurement of hyaluronic acid in patients with serum ferritin >1,000 μg/L is a noninvasive, accurate, and cost-effective method for the diagnosis of cirrhosis. (HEPATOLOGY 2009;49:418–425.)
Vascular Effects of Diet Supplementation With Plant Sterols
Authors: Oliver Weingärtner, Dieter Lütjohann, Shengbo Ji, Nicole Weisshoff, Franka List, Thomas Sudhop, Klaus von Bergmann, Karen Gertz, Jochem König, Hans-Joachim Schäfers, Matthias Endres, Michael Böhm, Ulrich Laufs
Journal: Journal of the American College of Cardiology (2008)
NHS Review. Streamlining management.
Authors: A. Bussey
Journal: BMJ (1989)

The proposals in the white paper Working for Patients have been described as "the most far-reaching reform of the National Health Service in its forty year history."'No one reading its hundred pages could disagree.Of the seven key measures proposed, those concerned with the governance of the NHS are as radical as any.There are differences of detail in the proposals for Scotland, Wales, and Northern Ireland but the principles are identical with those described here for England.At the top level in England a new NHS policy board, chaired and appointed by the Secretary of State, will determine the strategy, objectives, and finances of the NHS.This board will also oversee the next level-the NHS management executive, which will deal with all operational matters in the NHS (including, for the first time, family practitioner committees) and will be led by a chief executive.This structure is similar to that proposed in the first Griffiths report but never fully implemented.2The new arrangements should be welcomed for removing the confusion between policy setting and management that led to the present NHS Management Board being chaired successively by the first chief executive, ministers of state, and, latterly, the Secretary of State-to the bewilderment of the rest of the NHS.At the next level down regional health authorities are to remain but are to concentrate on setting performance criteria for and monitoring the performance of those below them and evaluating the effectiveness of the NHS.They will shed many of the support services that can better be provided by district health authorities, agencies, or the private sector.The legal, information, building, and works bureaucracies of regional health authorities are among those that will lose their monopoly position and will have to compete or die.The remit of regional health authorities will be extended to embrace family practitioner committees as well as district health authorities-bringing together for the first time at a strategic level the main arms of the NHS.
Magnified endoscopic observation with Fuji Intelligent Chromo Endoscopy of primary duodenal follicular lymphoma
Authors: D. Norimura, H. Isomoto, D. Niino, Y. Akazawa, N. Yamaguchi, K. Ohnita, S. Shikuwa, F. Takeshima, K. Nakao
Journal: Endoscopy (2010)

Follicular lymphoma occurs rarely in the gastrointestinal tract, comprising only 1 % – 3 % of all B-cell non-Hodgkin lymphomas of the gastrointestinal tract [1]. Prior reports have described cases of follicular lymphoma by using advanced endoscopic imaging [1] [2] [3] [4]. With narrow-band imaging (NBI) and magnification, follicular lymphoma is reported to show as enhanced whitish areas within enlarged villi and with a coiled vascular pattern [1] [2]. According to a previous case report [1], the lesion was also identified as whitish small nodules in the jejunum by using Fuji Intelligent Chromo Endoscopy (FICE). However, FICE in combination with magnified endoscopy in follicular lymphoma has not been reported to date.
RCGP consultation on assisted dying was comprehensive and conclusively in favour of no change to the law
Authors: M. Baker
Journal: BMJ (2014)

Far from the Royal College of General Practitioners (RCGP) being out of touch with our members,1 our recent consultation on assisted dying was one of the most comprehensive ever undertaken, with 1700 members responding from all four nations of the UK.

The result was conclusive—77% of members who submitted responses directly to the …
The New Economics and Psychiatric Care
Authors: H. Keith Fischer
Journal: JAMA (1986)

Since current psychiatric care delivery is, like the rest of health care, dominated, controlled, and to a great extent manipulated by those who manage the money, this book on the "new economics" of it is most timely and useful. Whether the current situation is seen as a huge mess or a great revolution, as part of understanding and dealing with it (many psychiatrists would say surviving it) many aspects and points of focus need to be included to get the comprehensive picture. Therefore, the present volume, with a quasi-American Psychiatric Association base and 26 authors (11 MDs, five MDs with other degrees, two PhDs, and eight authors without specified degrees), reflects the points of view of the psychiatric profession's leadership and administration, lawyers, economists, consultants, educators, businessmen, and clinicians. The focus is on the "new economics" of psychiatric care. The book begins with about 100 pages on the new economics.
The Circulation in Cold Acclimatization
Authors: G. MALCOLM BROWN, G. S. BIRD, T. J. BOAG, L. M. BOAG, J. D. DELAHAYE, J. E. GREEN, J. D. HATCHER, JOHN PAGE
Journal: Circulation (1954)

The hand and forearm blood flow of the Eskimo has been found to be greater than that of a control group of white persons in a temperate climate both at rest at an ambient temperature of 20 C. and during acute cold exposure. Under cold stress, rectal temperature was better maintained in the Eskimos, though certain deep muscle temperatures fell more than they did in the white men because of the greater blood flow through exposed parts. The Eskimos showed an elevation of basal metabolic rate and of plasma and total red cell volume. There are similarities between the circulatory changes found in the Eskimo and those found in hyperthyroidism.
Haemophilus influenzae Infection of a Finger
Authors: I. A. Miller, D. C. Turk
Journal: BMJ (1965)

MEDBRITISHURNIn view of the late stage at which the patient came under our care, and the fact that the timing of the nausea and vomiting coincided with the period of administration of the drug, we cannot draw any firm conclusion from this case, except that Marboran appeared to irritate the gastric mucosa, so causing vomiting and lack of adequate absorption of the drug.It is true to say that the crusts started drying up and the purulent periphery subsided, but it may be that this was partly influenced by control of secondary staphylococcal infection with tetracycline.
Hypoxia Induces High-Mobility-Group Protein I(Y) and Transcription of the Cyclooxygenase-2 Gene in Human Vascular Endothelium
Authors: Yan-Shan Ji, Qing Xu, John F. Schmedtje
Journal: Circulation Research (1998)

Abstract —Cyclooxygenases catalyze a rate-limiting step in the synthesis of vascular endothelial prostaglandins. Expression of the inducible cyclooxygenase-2 (COX-2) gene is increased by hypoxia in human vascular endothelial cells via the nuclear factor (NF)-κB p65 transcription factor, which is necessary but not sufficient to fully induce COX-2 transcription in response to hypoxia. After finding that cytoplasmic NF-κB p65 and IκBα (an inhibitory protein that binds NF-κB p65 precursors) levels are not changed by hypoxia, we hypothesized that other factors might play a role in regulating the COX-2 promoter, like the high-mobility-group (HMG) I(Y) family of proteins, which features multiple A·T hooks and is associated with NF-κB–mediated transactivation. Nuclear protein obtained from human umbilical vein endothelial cells (HUVECs) was supplemented with HMG I(Y) during electrophoretic mobility shift assays using an NF-κB-3′ element probe. These data suggested that HMG I(Y) proteins interact with NF-κB p65 to induce COX-2 promoter activity. We also found that TATA-box DNA demonstrated increased electrophoretic shifting indicative of DNA binding after incubation with either hypoxic HUVEC nuclear protein or normoxic nuclear protein supplemented with HMG I(Y). Transfection of HUVECs with an expression vector containing the COX-2 promoter ligated to HMG I(Y) cDNA demonstrated positive feedback on COX-2 promoter activity in hypoxia. We confirmed that COX-2 is transcriptionally regulated by hypoxia using a nuclear runoff assay. Hypoxia increased steady-state cellular levels of HMG I(Y) mRNA as an early event, corresponding with increases in HMG I(Y) protein. Overexpression of HMG I(Y) was associated in a dose-response relationship with increasing prevalence of the COX-2 protein in hypoxic HUVECs. Furthermore, sense (and antisense) HMG I(Y) overexpression caused stimulation (or inhibition) of COX-2 promoter activity as measured by luciferase reporter gene expression. The physiological significance of these findings was demonstrated by cyclooxygenase-dependent release of prostaglandin E 2 by HUVECs in hypoxia. We concluded that hypoxia increases expression of HMG I(Y) proteins while facilitating transactivation of the COX-2 promoter. The HMG I(Y) family of proteins may therefore function as part of a hypoxia-induced enhanceosome that helps to promote transcription of COX-2.
Use of sodium hypochlorite (NaOCl) in laundering stops cross-contamination of Bacillus cereus
Authors: Yoshinobu Ohsaki, Masako Kuroki, Mineji Tachibana, Shin Koyano, Itsuro Yoshida, Yoshihisa Ito, Yoshinobu Ohsaki, Mineji Tachibana, Yoshihisa Ito, Shin Koyano, Itsuro Yoshida
Journal: Journal of Infection (2007)
First person representations need a methodology based on simulation or theory
Authors: Robert M. Gordon
Journal: Behavioral and Brain Sciences (1996)

Abstract Although their thesis is generally sound, Barresi &amp; Moore give insufficient attention to the need for a methodology, whether simulation based or theory-based, for choosing among alternative possible matches of first person and third person information. This choice must be sensitive to contextual information, including past behavior. Moreover, apart from simulation or theory, first person information would not help predict future behavior.
Enrichment of FLI1 and RUNX1 mutations in families with excessive bleeding and platelet dense granule secretion defects
Authors: Jacqueline Stockley, Neil V. Morgan, Danai Bem, Gillian C. Lowe, Marie Lordkipanidzé, Ban Dawood, Michael A. Simpson, Kirsty Macfarlane, Kevin Horner, Vincenzo C. Leo, Katherine Talks, Jayashree Motwani, Jonathan T. Wilde, Peter W. Collins, Michael Makris, Steve P. Watson, Martina E. Daly
Journal: Blood (2013)
Environmental and Occupational Medicine
Authors: Harold J. Magnuson
Journal: JAMA (1993)

In the ten years since the first edition of this textbook, there has been a dramatic increase in resources devoted to occupational and environmental health issues and a broadening scope of the issues. The late Dr Irving J. Selikoff, in his foreword to this edition, presents a succinct and perceptive analysis of the forces back of these changes. In keeping with the increased resources and number of publications, the second edition of the text has grown by 50% to almost 1500 pages and the number of contributors by a similar percentage to 160, most of whom are members of academic institutions. The considerable task of searching the pertinent literature apparently was coordinated by a project director and two assistants relying heavily on the electronic databases of the National Library of Medicine and two specialty databases maintained by the National Institute for Occupational Safety and Health. Much of the book's usefulness
EMA must improve the quality of its clinical trial reports
Authors: C. Barbui, C. Baschirotto, A. Cipriani
Journal: BMJ (2011)

<b>Corrado Barbui</b>, <b>Cinzia Baschirotto</b>, and <b>Andrea Cipriani</b> find that the results of phase III studies are poorly and inconsistently documented in the EMA’s drug assessment reports. Better reporting would make them more useful for doctors, researchers, and consumers
Oral Rehydration for Children With Diarrhea
Authors: Jeanne Smith
Journal: JAMA (1991)

<h3>To the Editor.</h3> — It was sad to read the Brief Report<sup>1</sup>that described the death of a 9-month-old infant whose mother was unable to afford Pedialyte for oral hydration and was given no other alternative. I practiced pediatric medicine in the Harlem area of New York City for 30 years. We didn't have Lytren, Pedialyte, or Medicaid. On a trip to Mexico, South America, and Indonesia, I discovered the following homemade formula to rehydrate infants. Even in the outpatient department, infants were fed this solution by their mothers: 1 qt water (boiled, if possible) ½ tsp salt (2g) ½ tsp potassium chloride (2 g)<i>if available</i> 2-3 tbsp sugar or Karo syrup ½ tsp sodium bicarbonate (2 g) This solution could be modified if the potassium chloride or bicarbonate was unavailable. I often used just water, sugar, and salt until the loose stools stopped. Since I used it
Helping Patients Follow Prescribed Treatment
Authors: R. Brian Haynes, Heather P. McDonald, Amit X. Garg
Journal: JAMA (2002)

Low adherence to prescribed medical regimens is a ubiquitous problem. Typical adherence rates are about 50% for medications and are much lower for lifestyle prescriptions and other more behaviorally demanding regimens. In addition, many patients with medical problems do not seek care or drop out of care prematurely. Although accurate measures of low adherence are lacking for many regimens, simple measures, such as directly asking patients and watching for appointment nonattendance and treatment nonresponse, will detect most problems. For short-term regimens (< or =2 weeks), adherence to medications is readily achieved by giving clear instructions. On the other hand, improving adherence to long-term regimens requires combinations of information about the regimen, counseling about the importance of adherence and how to organize medication taking, reminders about appointments and adherence, rewards and recognition for the patient's efforts to follow the regimen, and enlisting social support from family and friends. Successful interventions for long-term regimens are all labor-intensive but ultimately can be cost-effective.
Myocardial surface Po2 - an indicator of myocardial tissue oxygenation?
Authors: J. HOBBHAHN, P. F M CONZEN, A. GOETZ, G. SEIDL, P. GONSCHIOR, W. BRENDEL, K. PETER
Journal: Cardiovascular Research (1989)

The validity of myocardial surface tissue PO2 (PtO2) as a reliable indicator of transmural myocardial tissue oxygenation was studied in six anaesthetised, open chest pigs. Epicardial surface PtO2 was correlated with other variables of myocardial tissue oxygenation such as regional blood flow, coronary venous PO2, O2 saturation, PCO2 and regional myocardial lactate extraction. The study design was based on an experimental model in which the effects of a pacing induced tachycardia on tissue oxygenation of ischaemic and normally supplied myocardium were measured. Two platinum multiwire surface electrodes were placed on the epicardium, on the areas supplied by the left anterior descending coronary artery (LAD) and the left circumflex coronary artery (CX). The LAD was constricted to reduce mean surface PtO2 in the LAD area to about 50% of its baseline value. This did not affect surface PtO2 in the CX area. The reduction of surface PtO2 in the LAD area was associated with decreases in coronary venous PO2 and O2 saturation and with increases in coronary venous lactate and PCO2. Subendocardial regional blood flow and the subendocardial to subepicardial flow ratio were significantly lower than in the CX area. Increasing the heart rate by pacing (+45 beats.min-1) led to an increased degree of ischaemia as shown by fall in surface PtO2 in the LAD area to values around zero kPa, by marked increase in coronary venous lactate and PCO2, by reduction in total (-10%) and subendocardial (-40%) LAD flow and by deterioration of the subendocardial to subepicardial flow ratio. The increased degree of ischaemia was not accompanied by an increase in O2 extraction. The marked decrease in surface PtO2 occurred in spite of a slight increase in the subepicardial regional blood flow (+10%); thus the increase in O2 delivery was not sufficient to meet the increase in O2 demand. Total flow was increased by 27% in the CX area without changes in the subendocardial to subepicardial flow ratio and in the surface PtO2 values. When pacing was stopped, surface values of PtO2 in the LAD area returned to prepacing values, as did lactate extraction and coronary venous PCO2. Clear and close relationships with surface PtO2 were found for regional lactate extraction, coronary venous PCO2 and the normalised subendocardial RBF. Poor or no correlations were found for the normalised subepicardial regional blood flow, the coronary venous O2 saturation and the absolute values of subendocardial and subepicardial regional blood flow.(ABSTRACT TRUNCATED AT 400 WORDS)
Environment, human reproduction, menopause, and andropause.
Authors: A Vermeulen
Journal: Environmental Health Perspectives (1993)

As the hypothalamic gonadotropin-releasing hormone (GnRH) pulse generator is an integrator of hormonal, metabolic, and neural signals, it is not surprising that the function of the hypothalamogonadal axis is subject to the influence of a large array of environmental factors. Before puberty, the central nervous system (CNS) restrains the GnRH pulse generator. Undernutrition, low socioeconomic status, stress, and emotional deprivation, all delay puberty. During reproductive life, among peripheral factors that effect the reproductive system, stress plays an important role. Stress, via the release of corticotropin-releasing factor (CRF), eventually triggered by interleukin 1, inhibits GnRH release, resulting in hypogonadism. Effects of CRF are probably mediated by the opioid system. Food restriction and underweight (anorexia nervosa), obesity, smoking, and alcohol all have negative effects on the GnRH pulse generator and gonadal function. Age and diet are important determinants of fertility in both men and women. The age-associated decrease in fertility in women has as a major determinant chromosomal abnormalities of the oocyte, with uterine factors playing a subsidiary role. Age at menopause, determined by ovarian oocyte depletion, is influenced by occupation, age at menarche, parity, age at last pregnancy, altitude, smoking, and use of oral contraceptives. Smoking, however, appears to be the major determinant. Premature menopause is most frequently attributable to mosaicism for Turner Syndrome, mumps ovaritis, and, above all, total hysterectomy, which has a prevalence of about 12-15% in women 50 years old. Premature ovarian failure with presence of immature follicles is most frequently caused by autoimmune diseases or is the consequence of irradiation or chemotherapy with alkylating cytostatics. Plasma estrogens have a physiological role in the prevention of osteoporosis. Obese women have osteoporosis less frequently than women who are not overweight. Early menopause, suppression of adrenal function (corticoids), and thyroid hormone treatment all increase the frequency of osteoporosis. Aging in men is accompanied by decreased Leydig cell and Sertoli cell function, which has a predominantly primary testicular origin, although changes also occur at the hypothalamopituitary level. Plasma testosterone levels, sperm production, and sperm quality decrease, but fertility, although declining, is preserved until senescence. Stress and disease states accelerate the decline on Leydig cell function. Many occupational noxious agents have a negative effect on fertility.(ABSTRACT TRUNCATED AT 400 WORDS)
Exhaled leukotrienes and prostaglandins in COPD
Authors: P Montuschi
Journal: Thorax (2003)

The role of eicosanoids, including leukotrienes (LTs) and prostaglandins (PGs), in chronic obstructive pulmonary disease (COPD) is uncertain. The aim of this study was to investigate whether eicosanoids are measurable in exhaled breath condensate (EBC), a non-invasive method of collecting airway secretions, in patients with stable mild to moderate COPD, and to show possible differences in their concentrations compared with control subjects.LTB(4), LTE(4), PGE(2), PGD(2)-methoxime, PGF(2alpha), and thromboxane B(2) (TxB(2)) were measured in EBC in 15 healthy ex-smokers, 20 steroid naïve patients with COPD who were ex-smokers, and in 25 patients with COPD who were ex-smokers and who were treated with inhaled corticosteroids. The study was of cross sectional design and all subjects were matched for age and smoking habit.LTB(4) and PGE(2) concentrations were increased in steroid naïve (LTB(4): median 100.6 (range 73.5-145.0) pg/ml, p<0.001; PGE(2): 98.0 (range 57.0-128.4) pg/ml, p<0.001) and steroid treated patients with COPD (LTB(4): 99.0 (range 57.9-170.5) pg/ml, p<0.001; PGE(2): 93.6 (range 52.8-157.0) pg/ml, p<0.001) compared with control subjects (LTB(4): 38.1 (range 31.2-53.6) pg/ml; PGE(2): 44.3 (range 30.2-52.1) pg/ml). Both groups of patients had similar concentrations of exhaled LTB(4) (p=0.43) and PGE(2) (p=0.59). When measurable, LTE(4) and PGD(2)-methoxime concentrations were similar in COPD patients and controls, whereas PGF(2alpha) concentrations were increased in the former. TxB(2)-LI was undetectable in any of the subjects.There is a selective increase in exhaled LTB(4) and PGE(2) in patients with COPD which may be relatively resistant to inhaled corticosteroid therapy.