tbuckley/cabot-search huggingface dataset:
Tuberculosis is increasing in England and Wales.
Authors: P D Davies
Journal: BMJ (1993)

explains the increased sensitivity of whole cell inclusion immunofluorescence, which detects genus specific and species specific antibody.3Antigenic diversity within species has also led to a serious failure of microimmunofluorescence to detect many C psittaci infections.The specificity of microimmunofluorescence has been questioned owing to reports of cross reactivity between species4 and the demonstration of both species specific and genus specific epitopes being expressed on elementary bodies.Serological approaches are used variably by some clinicians investigating respiratory infections, highlighting the need for non-invasive diagnostic alternatives.The value of routinely used com- mercial enzyme linked immunoassays to detect chiamydia in sputum has been shown in laboratory diagnosis provided that reactive samples are confirmed with direct immunofluorescence.5Genome detection of chlamydia in sputum, although promising, is currently unsuitable for hospital laboratories.Undoubtedly, future techniques will focus on molecular approaches.It would be foolhardy to be overwhelmed by the hyperbole surrounding C pneumoniae and to ignore, within our current knowledge, the clinically more important respiratory pathogen-Cpsittaci.
Continuing Education for the Health Professions
Authors: Richard L. Egan
Journal: JAMA (1985)

This book provides a detailed and comprehensive review of the important title subject. The contents are epitomized by the book's subtitle, Developing, Managing, and Evaluating Programs for Maximum Impact on Patient Care . This work is an outgrowth of a joint project of the Veterans Administration and the Association of American Medical Colleges, designed  define the principles underlying quality continuing education and  translate them into a set of workable criteria and standards.  The four editors and 13 additional contributors have written according  their special competencies. Despite the number of contributors, there is order and consistency because of the logical organization of the contents. A foreword describes the importance of the subject and the origins of the book within the Veterans Administration. The preface states the purpose of the book as to aid everyone who has responsibility for planning and implementing continuing education in all health professions and includes
Effects of apolipoprotein E genotype on serum lipids in obstructive sleep apnoea
Authors: R. Tisko, Z. Sopkova, V. Habalova, Z. Dorkova, E. Slaba, M. Javorsky, I. Tkac, R. L. Riha, R. Tkacova
Journal: European Respiratory Journal (2013)

There is increasing evidence that intermittent hypoxia resulting from obstructive sleep apnoea (OSA) is independently associated with dyslipidaemia. Currently, no data exist on potential links between OSA-related dyslipidaemia and susceptibility genes for dyslipidaemia in such patients. Our aim was to study the effects of the apolipoprotein E (<i>APOE</i>) genotype and sleep apnoea severity on atherogenic dyslipidaemia in patients with OSA. 519 clinically stable subjects prospectively recruited at a tertiary referral teaching hospital underwent full polysomnography. <i>APOE</i> gene polymorphisms were assessed using real-time PCR. In all <i>APOE</i> genotype groups, serum triglycerides increased while high-density lipoprotein (HDL) cholesterol was reduced with increasing severity of OSA in each <i>APOE</i> genotype group, whereas the deleterious effects of OSA on serum apolipoprotein (Apo)B levels were observed in ϵ2 carriers and the ϵ3/ϵ3 genotype only. Nevertheless, the ϵ4 allele carriers had ApoB levels within the risk range, irrespective of nocturnal hypoxia. In addition, among patients with the high-risk ϵ4 genotype, those with the most severe nocturnal hypoxia had significantly higher triglyceride and lower HDL cholesterol levels compared with nonhypoxic ϵ4 subjects. <i>APOE</i> genotype and the oxygen desaturation index were both independent predictors of serum triglyceride levels (p=0.009 and p&lt;0.001, respectively; <i>R</i><sup>2</sup>=0.148) and ApoB levels (p=0.001 and p=0.003, respectively; <i>R</i><sup>2</sup>=0.104). Our findings suggest that OSA has adverse effects on several lipid parameters over and above the effects carried by <i>APOE</i> genotype. Further st1udies are needed to analyse the effects of high-risk genotypes on metabolic and cardiovascular outcomes in patients with OSA.
Coping with Blindness
Authors: DeWitt Stetten
Journal: New England Journal of Medicine (1981)

Approximately 15 years ago, I was first told that I had macular degeneration. The diagnosis was made by an experienced ophthalmologist in the small city in which I resided at that time. It was subsequently confirmed by a senior academic ophthalmologist in New York City. When, in 1970, I moved to the National Institutes of Health (NIH) in Bethesda, Maryland, I learned that my disease was a subject of research in the National Eye Institute, and I therefore availed myself of the services of the several skilled physicians in that institute. Early during my stay in Bethesda I was seen . . .
Herpes Simplex Encephalitis: Biopsy or Treatment?
Authors: GEORGE K. YORK
Journal: Annals of Internal Medicine (1980)

Letters and Corrections1 September 1980Herpes Simplex Encephalitis: Biopsy or Treatment?GEORGE K. YORK, M.D.GEORGE K. YORK, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-93-3-506 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The article by Barza and Pauker (1) on the decision to biopsy, treat, or wait in patients with suspected herpes simplex encephalitis is a simulating guide to decision making in a difficult clinical situation. The analysis is both reasonable and correct. I believe, however, that the authors have arrived at an incorrect recommendation for patient management through inaccurate assumptions of the relative risks of brain biopsy and treatment with vidarabine. A more accurate decision may be made using the decision analysis provided by the authors by substituting more appropriate risks.As pointed out, a major obstacle in...References1. BARZAPAUKER MS. The decision to biopsy, treat, or wait in suspected herpes encephalitis. Ann Intern Med. 1980;92:641-9. LinkGoogle Scholar2. KAUFMANCATALANO HL. Diagnostic brain biopsy: a series of 50 cases and a review. Neurosurgery. 1979;4:129-36. CrossrefMedlineGoogle Scholar3. ROSSJULIABALAKRISHNAN AAC. Toxicity of adenine arabinoside in humans. J Infect Dis. 1976; 133(suppl):A 192-8. CrossrefGoogle Scholar4. LAUTERBAILEYLERNER CEA. Microbiologic assays and neurological toxicity during use of adenine arabinoside in humans. J Infect Dis. 1976;134:75-9. CrossrefMedlineGoogle Scholar1. BARZAPAUKER MS. The decision to biopsy, treat, or wait in suspected herpes encephalitis. Ann Intern Med. 1980;92:641-9. LinkGoogle Scholar2. KAUFMANCATALANO HL. Diagnostic brain biopsy: a series of 50 cases and a review. Neurosurgery. 1979;4:129-36. CrossrefMedlineGoogle Scholar1. BARZAPAUKER MS. The decision to biopsy, treat, or wait in suspected herpes encephalitis. Ann Intern Med. 1980;92:641-9. LinkGoogle Scholar2. WHITLEYSOONGDOLIN RSR. Adenine arabinoside therapy of biopsy-proved herpes simplex encephalitis: National Institute of Allergy and Infectious Disease Collaborative Antiviral Study. N Engl J Med. 1977;297:289-94. CrossrefMedlineGoogle Scholar3. CHENBEN-PORATWHITLEYKAPLAN ATRA. Purification and characterization of proteins excreted by cells infected with herpes simplex virus and their use in diagnosis. Virology. 1978;91:234-42. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByViral Diseases: Herpes Simplex Encephalitis 1 September 1980Volume 93, Issue 3Page: 506-507KeywordsBiopsyBrainDecision analysisDecision makingEncephalitisHerpes simplexRelative risk Issue Published: 1 September 1980 PDF DownloadLoading ...
The Development and Use of an Innovative Laboratory Method for Measuring Arsenic in Drinking Water from Western Bangladesh
Authors: Seth H. Frisbie, Erika J. Mitchell, Ahmad Zaki Yusuf, Mohammad Yusuf Siddiq, Raul E. Sanchez, Richard Ortega, Donald M. Maynard, Bibudhendra Sarkar
Journal: Environmental Health Perspectives (2005)

All of Bangladesh's approximately 10 million drinking-water tube wells must be periodically tested for arsenic. The magnitude of this task and the limited resources of Bangladesh have led to the use of low-cost, semiquantitative field kits that measure As to a relatively high 50 μg/L national drinking water standard. However, there is an urgent need to supplement and ultimately replace these field kits with an inexpensive laboratory method that can measure As to the more protective 10 μg/L World Health Organization (WHO) health-based drinking water guideline. Unfortunately, Bangladesh has limited access to atomic absorption spectrometers or other expensive instruments that can measure As to the WHO guideline of 10 μg/L. In response to this need, an inexpensive and highly sensitive laboratory method for measuring As has been developed. This new method is the only accurate, precise, and safe way to quantify As < 10 μg/L without expensive or highly specialized laboratory equipment. In this method, As is removed from the sample by reduction to arsine gas, collected in an absorber by oxidation to arsenic acid, colorized by a sequential reaction to arsenomolybdate, and quantified by spectrophotometry. We compared this method with the silver diethyldithiocarbamate [AgSCSN(CH2CH3)2] and graphite furnace atomic absorption spectroscopy (GFAAS) methods for measuring As. Our method is more accurate, precise, and environmentally safe than the AgSCSN(CH2CH3)2 method, and it is more accurate and affordable than GFAAS. Finally, this study suggests that Bangladeshis will readily share drinking water with their neighbors to meet the more protective WHO guideline for As of 10 μg/L.
Alterations in left ventricular diastolic twist mechanics during acute human cardiac allograft rejection.
Authors: K L Yun, M A Niczyporuk, G T Daughters, N B Ingels, E B Stinson, E L Alderman, D E Hansen, D C Miller
Journal: Circulation (1991)

BACKGROUND Contraction of obliquely oriented left ventricular (LV) fibers results in a twisting motion of the left ventricle. The purpose of this study was to assess the effects of acute human cardiac allograft rejection on LV twist pattern and the twist-volume relation. METHODS AND RESULTS Tantalum markers were implanted into the LV midwall in 15 transplant recipients to measure time-varying, three-dimensional chamber twist using computer-assisted analysis of biplane cinefluoroscopic images. Twist was defined as the mean longitudinal gradient of circumferential rotation about the LV long axis. When plotted against normalized percent ejection fraction (%EF), the resulting twist-normalized %EF relation could be divided into three phases. In systole, LV twist was linearly related to ejection of blood. In contrast, diastolic untwist was characterized by early rapid recoil with little change in LV volume, followed by more gradual untwisting when the bulk of diastolic filling occurred. During 10 acute rejection episodes in 10 patients, maximum twist, peak systolic twist rate, and the slope of the systolic twist-normalized %EF relation did not change. In contrast, the slope of the early (first 15% of filling) diastolic twist-normalized %EF relation (M(early-dia)) decreased significantly (-0.194 +/- 0.062 [prerejection] versus -0.103 +/- 0.054 rad/cm [rejection], p = 0.0003), resulting in a prolonged tau 1/2 (time required to untwist by 50% [20 +/- 5% versus 28 +/- 5% of diastole], p = 0.0003) and decrease in percent untwisting at 15% diastolic LV filling (62 +/- 11% versus 36 +/- 13%, p = 0.0003). Therefore, a greater proportion of LV untwisting occurred later in diastole during rejection, as reflected by an increase in the slope (M(mid-dia)) of the middle to late (from 15 to 90% filling) diastolic twist-normalized %EF relation (-0.018 +/- 0.009 versus -0.030 +/- 0.010 rad/cm, p = 0.0015). Peak rate of untwist was not affected. With resolution of rejection, M(early-dia) and percent untwist during early diastole returned to baseline levels (p = NS versus baseline). There was also a trend for M(mid-dia) to return toward prerejection values (p = NS versus baseline), but this change did not reach statistical significance compared with rejection values. CONCLUSION Acute cardiac allograft rejection is associated with altered diastolic twist mechanics in the absence of any demonstratable systolic abnormalities. During rejection, myocardial edema and other factors may result in intrinsic changes of the elastic properties of the myocardium, thereby leading to modification of recoil forces responsible for the early, rapid unwinding of the deformed ventricle.
Debate is needed over who provides drug treatment in attention deficit hyperactivity disorder
Authors: K. Sayal
Journal: BMJ (1998)

EDITOR—Levy's editorial on attention deficit hyperactivity disorder focuses on treatment issues in Australia and the United States, which only partially generalise to the current situation in Britain.1 Although the diagnostic criteria given in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders for attention deficit hyperactivity disorder and in the 10th revision of the International Statistical Classification of Diseases and Related Health Problems for hyperkinetic disorder are much more comparable than their predecessors …
Percutaneous Transluminal Dilatation in the Treatment of Renal Vascular Hypertension
Authors: CLARENCE E. GRIM
Journal: Annals of Internal Medicine (1981)

Twenty-six patients with renal vascular hypertension were treated with percutaneous transluminal dilatation. Twenty-one were followed for more than 1 year; 18 underwent repeat angiography. Recurrence of stenosis was shown angiographically in one of six patients with fibromuscular disease and in 12 of 12 patients with atherosclerotic disease. The procedure was more likely to result in cure of hypertension (six of 10) in patients with fibromuscular disease than in patients with atherosclerotic disease (one of 16). Although percutaneous transluminal angioplasty provides the advantages of simplicity, reduced cost, and probably reduced risk, long-term utility of the procedure remains to be established. A prospective randomized trial, establishment of a registry, or both would serve this purpose.
Persistent post-traumatic stress disorder
Authors: C. Stark, J. Lee, E. Robb, B. Kidd
Journal: BMJ (1994)

EDITOR,—Brigitta Bende and Robin M Philpott report on a patient with post-traumatic symptoms 50 years after the precipitating events who improved after appropriate treatment.1 The NHS could do a great deal to treat post-traumatic symptoms in its own workers and so ensure that as few as possible develop similar syndromes.

One study found that up to 61% of clinical staff who report assaults by patients experience symptoms of post-traumatic stress disorder, and 10% meet the criteria for …
THE BLOOD IN FILARIASIS.
Authors: W. J. CALVERT
Journal: JAMA (1902)

Since the discovery of the embryos of<i>Filaria nocturna</i>in the peripheral circulation by Lewis, in 1872, very few observers have devoted their attention to the changes in the blood associated with this disease. In 1894 Bancroft and Bancroft<sup>1</sup>noted a leucocytosis in filariasis and published the following blood counts, no differential blood counts being made: Lothrop and Pratt,<sup>2</sup>in 1900, found the whites in two cases to be about normal; their highest count was 8,000, lowest 3,500. Differential counts showed 4.6 and 3.5 per cent, of eosinophiles. G. L. Gullard<sup>3</sup>found a leucocytosis varying from 4,600 to 13,500, and an eosinophilia varying from 3 to 12 per cent. He observed the highest leucocytosis and eosinophilia when the number of embryos in the peripheral circulation was greatest; and a decrease in the leucocytes and eosinophilia accompanying the decrease of the embryos in the peripheral circulation. A few
BLACKWATER (HEMOGLOBINURIC) FEVER, WITH A REPORT OF TWO FATAL CASES OCCURRING IN THE U. S. A. MILITARY HOSPITALS AT MANILA, P. I.
Authors: JOSEPH J. CURRY
Journal: JAMA (1902)

derivatives, valerian and belladonna.The opium-bromid treatment of Fleschig, popular a few years ago, is valu- able in some cases.It consists in the administration
Pharmacological correction of neonatal lethal hepatic dysfunction in a murine model of hereditary tyrosinaemia type I
Authors: Markus Grompe, Sven Lindstedt, Muhsen Al-Dhalimy, Nancy G. Kennaway, John Papaconstantinou, Carlos A. Torres-Ramos, Ching-Nau Ou, Milton Finegold
Journal: Nature Genetics (1995)
A Review of Four Dreaded Complications of Open-heart Operations
Authors: W. J. Kolff, D. B. Effler, L. K. Groves
Journal: BMJ (1960)

Open-heart operations using total-body perfusion may be accompanied by complications that do not commonly ,occur in other types of thoracic surgery.This is a review of the most important complications : metabolic .acidosis(Ito et al., 1957), overoxygenation (Ito et al., 1958), heart-block (Olmsted et al.. 1958a) and pulmonary capillary damage (Kolff et al., 1958).Each has been discussed in separate papers with exhaustive documentation, analysis, and bibliography.The clinical analysis to be presented is based upon findings in 150 consecutive patients who underwent open-heart operations in the hospital of the Cleveland Clinic Foundation.The types of heart-lung machines used were the membrane oxygenator (Kolff et al., 1956), the Melrose (1955) oxygenator, the Bjork oxygenator (Kolff et al., 1957), and the modification of the Bjork oxygenator as described by Kay et al. (1956)1 incombination with "sigrnamotor " pumps or non- occlusive roller pumps of our own design.2In 750% of our patients the heart was stopped with potassium citrate according to Melrose's technique as previously described (Kolff et al., 1957).During the post-operative period radiographs of the %chest were made.In each patient the first was made approximately three hours post-operatively; the second -that night; and others during the days following if -necessary. AcidosisThree or more hours after completion of an operation, -when overventilat on by the anaesthetist is no longer -present, the pH of the blood occasionally falls to a level -that is incompatible with life.Whatever the underlying cause, in these patients the mechanism of death seems to be an acidosis leading to respiratory failure followed by cardiac arrest.Blood samples for the determination of pH and of 'CO., content were drawn from the inferior vena cava Commercially available from Pemco Inc., 5663,
Interferon-Gamma and Mycobacterial Infections
Authors: Alfred J. Crowle
Journal: Annals of Internal Medicine (1988)

Letters and Corrections1 October 1988Interferon-Gamma and Mycobacterial InfectionsAlfred J. Crowle, PhDAlfred J. Crowle, PhDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-109-7-595_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptMurray's recent review (1) provides a welcome discussion of the role of interferon-gamma as an immune activator of macrophages against microbial pathogens. A small section of it, however, must respectfully be challenged. Contrary to what Murray suggests, interferon-gamma apparently cannot protect against tubercle bacilli or Mycobacterium avium in humans. Knowledge of this important fact can help terminate an interpolative idea that has been contradicted by well-controlled experimental evidence.In our several years of research on many variations of an in-vitro model of human tuberculosis infection, using macrophages and virulent tubercle bacilli, we have never found interferon-gamma protective (2). In fact,...References1. Murray H. Interferon-gamma, the activated macrophage, and host defense against microbial challenge. Ann Intern Med. 1988;108:595-608. LinkGoogle Scholar2. Crowle A. The tubercle bacillus-human macrophage relationship studied in vitro. In: Bendinelli M, Friedman H, eds. Mycobacterium tuberculosis. New York: Plenum Publishing Corp.; 1988:99-135. CrossrefGoogle Scholar3. DouvasLookerVatterCrowle GDAA. Gamma interferon activates human macrophages to become tumoricidal and leishmanicidal but enhances replication of macrophage-associated mycobacteria. Infect Immun. 1985;50:1-8. CrossrefMedlineGoogle Scholar4. Rook G. Progress in the immunology of the mycobacterioses. Clin Exp Immunol. 1987;69:1-9. MedlineGoogle Scholar5. RookTaverneLevetonSteele GJCJ. The role of gamma-interferon, vitamin-D3 metabolites and tumor necrosis factor in the pathogenesis of tuberculosis. Immunology. 1987;62:229-34. MedlineGoogle Scholar6. BermudezYoung LL. Tumor necrosis factor, alone or in combination with IL-2, but not IFN-gamma, is associated with macrophage killing of Mycobacterium avium complex. J Immunol. 1988;140:3006-13. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1988Volume 109, Issue 7Page: 595-596KeywordsTuberculosis Issue Published: 1 October 1988 PDF DownloadLoading ...
143 SAFETY AND EFFICACY OF STEROID- FREE IMMUNOSUPPRESSION POST-LIVER TRANSPLANTATION: A RANDOMISED PHASE III TRIAL COMPARING TACROLIMUS MONOTHERAPY AFTER DACLIZUMAB INDUCTION VERSUS TACROLIMUS+MMF DUAL THERAPY
Authors: I. Bilbao, G. Otto, T. Becker, D. D'Amico, M. Colledan, A. Bernardos, S. Beckebaum, H. Isoniemi, J. Pirenne, J. Jaray
Journal: Journal of Hepatology (2009)
Acute Onset of Acrokeratosis Paraneoplastica (Bazex Syndrome)
Authors: Stephen R. Humphrey, Amara S. Hussain, Rekha Chandran, Barbara Wilson, Ben George
Journal: JAMA Dermatology (2015)

to the plug formation.This inflammation then leads to fibrosis and atrophy. 4It may be that TGF-β signaling may also be involved because it is known that TGF-β signaling plays an important role in wound healing and scar formation.In LDS, atrophic scars and delayed wound healing have been reported. 5Interestingly, TGFBR1 null mutations cause multiple self-healing squamous epithelioma (MSSE) 6 with subsequent atrophic scarring, which is also typical for AV.However, patients with MSSE do not have features of LDS, which is usually caused by missense mutations in the TGFBR1-or TGFBR2-kinase domain. 5Further investigations are needed to clarify the relationship between AV and LDS.In conclusion, it appears that AV should be added as a cutaneous feature of LDS, possibly more specifically TGFBR2related LDS.In view of the crucial importance of early detection and management of aortopathy in LDS, we suggest a careful evaluation for clinical features of LDS, including cardiac ultrasonography and possibly TGFBR1/2 DNA analysis in every patient presenting with AV.