tbuckley/cabot-search huggingface dataset:
Stress and exacerbations in multiple sclerosis: Whether stress triggers relapses remains a conundrum
Authors: I. Galea
Journal: BMJ (2004)

EDITOR—The front page of the BMJ of 20 September 2003 carries the title: “Relapse in multiple sclerosis: stressful life events increase exacerbations.” Buljevac et al present evidence that psychological stress is associated with a doubling in risk of relapse.1 Two issues arise.

Firstly, this study has limitations, some of which are clearly acknowledged by …
Bacterial Vaccine and Infectious Asthma
Authors: Vincent J. Fontana
Journal: JAMA (1965)

A two-year double-blind control study to determine the effectiveness of bacterial-vaccine therapy was performed on 30 children with infectious asthma. The first year, from October to April, all the children received buffered saline injections weekly. Symptom cards were kept by the family during the two year study. The second year, the children were randomly divided into two groups, one receiving a bacterial vaccine, the other a placebo solution. A reduction in the incidence of wheezing, infection, and infectious episodes associated with wheezing was observed in a larger percentage of the placebo group than in the vaccine-treated group. The amount of antiasthmatic medication administered during the first and second years was equivalent.
A comparative study of three serine proteases from <i>Dermatophagoides pteronyssinus</i> and <i>D. farinae</i>
Authors: G. A. Stewart, M. R. Kollinger, C. M. King, P. J. Thompson
Journal: Allergy (1994)

Studies have shown that the dust mites Dermatophagoides pteronyssinus and D. farinae contain several serine proteases, two of which have been shown to be allergenic, and to include trypasin and chymotrypsin, corresponding to the groups III and VI mite allergens. However, mites also contain other serine proteases, and the data reported in this study show that an elastase‐like enzyme is present in both species. This enzyme was differentiated from the other serine proteases, particularly chymotrypsin, on the basis of charge, substrate specificity, and inhibition by copper and mercury cations. Its apparent mol. mass, as judged by gel filtration, was similar to those previously described for trypsain and chymotrypsin, i.e., 30 kDa. Several isoforms were detected by isoelectric focusing, but the isoelectric points of the major forms in both D. pteronyssinus and D. farinae were 10.5 and 9.8, respectively, contrasting with the acidic mite chymotrypsins. All three serine proteases were detected in whole mite and faecally enriched extracts, but the activities of trypsin and the elastase‐like enzyme were greater in the latter type of extract. These data were similar to those obtained by quantitative immunochemical analysis of the D. farinae group III allergen in appropriate extracts, suggesting that culture conditions may modulate protease production. A monoclonal antibody affinity matrix specific for the group III allergen from D. farinae was shown to bind mite trypsin. However, a small amount of mite chymotrypsin also bound, suggesting limited immunologic cross‐reactivity, a finding consistent with known sequence data.
Tobacco: A Precipitating Factor in Angina Pectoris
Authors: WILBERT S. ARONOW
Journal: Annals of Internal Medicine (1968)

Ten patients with classical angina pectoris due to coronary artery disease were exercised in an upright position with a fixed exercise load on a bicycle ergometer until they developed the first manifestation of angina pectoris. They each performed this exercise four times in a nonsmoking state and four times after smoking a cigarette of high nicotine content for 5 min. All subjects developed angina sooner if they smoked before exercising. The average percent of shortening of the exercise period before angina developed in the smoking state as compared with the nonsmoking state was 24. All patients developed an increase in the modified tension-time index after smoking. This increase represents an increase in myocardial oxygen consumption. After exercise, patients with diseased coronary arteries who smoke may not meet the increased demand for myocardial oxygen and, therefore, may develop angina sooner.
Clouston Syndrome With Heterozygous<i>GJB6</i>Mutation p.Ala88Val and<i>GJB2</i>Variant p.Val27Ile Revealing Mild Sensorineural Hearing Loss and Photophobia
Authors: Kazumitsu Sugiura, Masaaki Teranishi, Yoshinari Matsumoto, Masashi Akiyama
Journal: JAMA Dermatology (2013)
Oncologic, Functional, and Complications Outcomes of Robot-assisted Radical Cystectomy with Totally Intracorporeal Neobladder Diversion
Authors: Stavros I. Tyritzis, Abolfazl Hosseini, Justin Collins, Tommy Nyberg, Martin N. Jonsson, Oscar Laurin, Dinyar Khazaeli, Christofer Adding, Martin Schumacher, N. Peter Wiklund
Journal: European Urology (2013)
Developing a summary hospital mortality index: retrospective analysis in English hospitals over five years
Authors: M. J. Campbell, R. M. Jacques, J. Fotheringham, R. Maheswaran, J. Nicholl
Journal: BMJ (2012)

To develop a transparent and reproducible measure for hospitals that can indicate when deaths in hospital or within 30 days of discharge are high relative to other hospitals, given the characteristics of the patients in that hospital, and to investigate those factors that have the greatest effect in changing the rank of a hospital, whether interactions exist between those factors, and the stability of the measure over time.Retrospective cross sectional study of admissions to English hospitals.Hospital episode statistics for England from 1 April 2005 to 30 September 2010, with linked mortality data from the Office for National Statistics.36.5 million completed hospital admissions in 146 general and 72 specialist trusts.Deaths within hospital or within 30 days of discharge from hospital.The predictors that were used in the final model comprised admission diagnosis, age, sex, type of admission, and comorbidity. The percentage of people admitted who died in hospital or within 30 days of discharge was 4.2% for males and 4.5% for females. Emergency admissions comprised 75% of all admissions and 5.5% died, in contrast to 0.8% who died after an elective admission. The percentage who died with a Charlson comorbidity score of 0 was 2% in contrast with 15% who died with a score greater than 5. Given these variables, the relative standardised mortality rates of the hospitals were not noticeably changed by adjusting for the area level deprivation and number of previous emergency visits to hospital. There was little evidence that including interaction terms changed the relative values by any great amount. Using these predictors the summary hospital mortality index (SHMI) was derived. For 2007/8 the model had a C statistic of 0.911 and accounted for 81% of the variability of between hospital mortality. A random effects funnel plot was used to identify outlying hospitals. The outliers from the SHMI over the period 2005-10 have previously been identified using other mortality indicators.The SHMI is a relatively simple tool that can be used in conjunction with other information to identify hospitals that may need further investigation.
WHAT AMOUNT OF VISUAL DEFECT SHOULD DISQUALIFY IN RAILROAD SERVICE?
Authors: FRANK ALLPORT
Journal: JAMA (1900)

The title of this paper constitutes one of the unsettled points connected with the subject of the ocular and aural requirements of transportation employees. Considering the absolute lack of any such requirements whatsoever, obtaining in transportation circles, only a few years ago, it is quite surprising that so much progress has been made along these lines up to the present time. Only a few years ago, the quality of an engineer's eyes and ears was never brought into question, while now the importance of the health of these organs is a settled and incontrovertible fact. The cause of this revolution of sentiment is due to the persistent efforts of ophthalmologists, aurists and conscientious and capable railway surgeons. It must be admitted, however, that honest and sincere railroad officials have quite generally been reasonably quick to grasp the importance of the subject, and to realize the enormity of their own responsibility,
Defective innate immunity predisposes murine neonates to poor sepsis outcome but is reversed by TLR agonists
Authors: James L. Wynn, Philip O. Scumpia, Robert D. Winfield, Matthew J. Delano, Kindra Kelly-Scumpia, Tolga Barker, Ricardo Ungaro, Ofer Levy, Lyle L. Moldawer
Journal: Blood (2008)
ON THE EXISTENCE OF EPIDEMIC CEREBRO-SPINAL MENINGITIS IN CHICAGO, WITH REPORT OF A CASE WITH AUTOPSY.
Authors: JAMES B. HERRICK
Journal: JAMA (1898)

The object of this paper is to prove two facts, first that a genuine case of epidemic cerebro-spinal meningitis has occurred in Chicago, the proof resting on the clinical history and the autopsy, the latter showing the presence of the meninges of the diplococcus intracellularis meningitidis of Weichselbaum; second, that this case was not a sporadic one, but that many other cases have occurred, or in other words, that there is a mild epidemic of cerebro-spinal meningitis in this city. So far as I can learn this is the first case of this disease reported for some time in this city and the first case in which the presence of the meningococcus has been recorded as found, thus establishing the nature of the disease beyond a doubt. That many other cases have been recognized as epidemic cerebro-spinal meningitis, I am well aware from conversation with physicians. The patient was a
Increasing the intestinal resistance of rats to the invasive pathogen Salmonella enteritidis: additive effects of dietary lactulose and calcium.
Authors: I M Bovee-Oudenhoven, D S Termont, P J Heidt, R Van der Meer
Journal: Gut (1997)

BACKGROUND AND AIMS: Lactulose fermentation by the intestinal microflora acidifies the gut contents, resulting in an increased resistance to colonisation by acid sensitive pathogens. The extent of fermentation should be controlled to prevent acid induced epithelial cell damage. Considering the buffering capacity of calcium phosphate and its intestinal cytoprotective effects, whether supplemental calcium phosphate adds to the increased resistance to intestinal infections by lactulose fermentations was studied. METHODS: In a strictly controlled experiment, rats were fed a purified low calcium control diet, a low calcium/lactulose diet, or a high calcium/lactulose diet, and subsequently infected orally with Salmonella enteritidis. RESULTS: Lactulose fermentation lowered the pH and increased the lactic acid concentration of the intestinal contents, which significantly reduced excretion of this pathogen in faeces; thus it improved the resistance to colonisation. This agreed with the high sensitivity of S enteritidis to lactic acid (main metabolite of lactulose fermentation) in vitro. Calcium phosphate decreased translocation of S enteritidis to the systemic circulation, an effect independent of lactulose. The unfavourable increased cytotoxicity of faecal water caused by lactulose fermentation was more than counteracted by supplemental calcium phosphate. Moreover, calcium phosphate stimulated lactulose fermentation, as judged by the reduced lactulose excretion in faeces and increased lactic acid, ammonia, and faecal nitrogen excretion. CONCLUSION: Extra calcium phosphate added to a lactulose diet improves the resistance to colonisation and translocation of S enteritidis. This is probably mediated by a calcium induced stimulation of lactulose fermentation by the intestinal microflora and reversion of the lactulose mediated increased luminal cytotoxicity, which reduces damage inflicted on the intestinal mucosa.
Therapy of Recurrent Invasive Urinary-Tract Infections of Men
Authors: Richard Gleckman, Monique Crowley, George A. Natsios
Journal: New England Journal of Medicine (1979)

THERE has been new interest in the therapy of urinary-tract infections, and new treatment programs have evolved.1 , 2 Men with recurrent urinary-tract infections present a formidable therapeutic challenge.3 , 4 Presumably short courses of antibiotic therapy fail to eradicate foci of infection that are frequently associated with structural abnormalities within the prostatic and renal parenchyma. We undertook a randomized, double-blind, placebo-controlled study to determine whether an extended course of therapy for men with recurrent, invasive urinary-tract infections would be more effective than the conventional two-week course of therapy. We found that a six-week course of antimicrobial therapy resulted in fewer relapses than the . . .
Modern management of non-Hodgkin's lymphoma.
Authors: G M Mead, J M Whitehouse
Journal: BMJ (1986)

The non-Hodgkin's lymphomas are among the most diverse and challenging diseases treated'by physicians.A mass of clinical data has now accumulated from prospective studies begun in the 1970s.In addition, recent advances in our understanding of the pathogenesis of these diseases have provided new insights and may in the future provide opportunities for new approaches to treatment.Though the incidence rates of non-Hodgkin's lymphoma are low-3746 new cases in Britain in 1982, representing 2% of malignant tumours (excluding skin cancers)-the cur- important.'6Repeated biopsies in patients with relapsing on 12 July
Comparative analysis of subacute cutaneous lupus erythematosus and chronic cutaneous lupus erythematosus: clinical and immunological study of 270 patients
Authors: M.A. Vera-Recabarren, M. García-Carrasco, M. Ramos-Casals, C. Herrero
Journal: British Journal of Dermatology (2009)

Background Lupus erythematosus (LE) is a chronic, autoimmune disease resulting from an interaction of genetic, environmental and hormonal factors and characterized by a spectrum of clinical forms with variable evolution from a localized cutaneous form to a life-threatening systemic form. Objective To analyse and compare the prevalence and characteristics of the main clinical and immunological manifestations of subacute cutaneous LE (SCLE) and chronic CLE (CCLE). Methods A total of 270 patients with CLE (112 patients with SCLE and 158 patients with CCLE) were studied retrospectively. The clinical and serological characteristics of all the patients were collected in a chart review. Results The patients with SCLE had a higher prevalence of annular and papulosquamous lesions, Raynaud phenomenon, mucous membrane ulcers, malar rashes, photosensitivity, vasculitis and a lower frequency of discoid lesions and alopecia compared with patients with CCLE. Patients with SCLE had a higher prevalence of arthralgias (P < 0.001), xerophthalmia (P = 0.045), arthritis (P < 0.001), nephropathy (P = 0.003) and systemic LE (SLE) (P < 0.001) compared with patients with CCLE. Patients with SCLE also had a higher frequency of laboratory and serological abnormalities than patients with CCLE. Generalized discoid LE (DLE) was associated with a higher prevalence of photosensitivity (P < 0.001), panniculitis (P = 0.009) and SLE (P = 0.003) than localized DLE. In patients with SCLE and those with CCLE, photosensitivity, arthralgias, arthritis, nephropathy and xerophthalmia were associated with SLE. In patients with SCLE, significant correlations existed between clinical and immunological data. Conclusions In our series, differences in the expression of CCLE and SCLE were found with respect to the distribution and type of lesions, systemic features and immunological findings.
Evaluation of Chlor-Trimeton Maleate in Hay Fever and a Variety of Allergic Diseases
Authors: N. E. Silbert
Journal: New England Journal of Medicine (1950)

CLINICAL reports on Chlor-Trimeton maleate, which chemically is chlorprophenpyridamine maleate, have shown that this potent antihistaminic substance benefits a large percentage of patients with hay fever to whom it is administered.1 2 3 4 The drug has also been shown to be of definite value in vasomotor rhinitis, urticaria and other allergic diseases.1 , 3 , 4 The effects of Chlor-Trimeton maleate were studied among 117 patients seen in office practice and in the outpatient departments of hospitals with which I am associated. The majority of the patients were suffering from hay fever. Other disorders treated included vasomotor rhinitis, allergic asthmatic bronchitis with and without complications such . . .
Responsibility for prescribing
Authors: J. G Ball
Journal: BMJ (1983)

with an acute rise in the serum aluminium concentration.Dr Small and others describe abnormalities on the electroencephalogram and seizures in their haemophiliac patient, and they comment that he had received large quantities of factor VIII over 14 years and that he tended to inject the concentrate too rapidly.He may thus have gradually accumulated a substantial amount of aluminium in his body and an acute further exposure to a high concentration of aluminium may then have proved sufficient to provoke seizures.
Who Wants Clinical Pharmacology!?
Authors: KENNETH L. MELMON
Journal: Annals of Internal Medicine (1971)

Editorial1 February 1971Who Wants Clinical Pharmacology!?KENNETH L. MELMON, M.D., F.A.C.P., HOWARD F. MORRELLI, M.D., F.A.C.P.KENNETH L. MELMON, M.D., F.A.C.P.Search for more papers by this author, HOWARD F. MORRELLI, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-74-2-291 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptStudies on the prescription habits of physicians have aroused worldwide concern about therapeutics as a major scientific and educational problem (1-5). The WHO Technical Report, "Clinical Pharmacology: Scope, Organization, Training" (6), sounds the alarm: patients in the 1970's are in a hazardous position because of the development of many new drugs that are poorly prescribed and because of the "galloping consumption" of drugs by the public. What should be done? The WHO report indicates that clinical pharmacologists may provide the answer and inquires why clinical pharmacologists are unavailable, despite the fiat provided by preferential funding and general acceptance by academic...References1. PALMER R: Drug misuse and physician education. Clin Pharmacol Ther 10:1-4, 1969 CrossrefMedlineGoogle Scholar2. STOLLEY P and LASAGNA L: Prescribing patterns of physicians. J Chronic Dis 22:395-405, 1969 CrossrefMedlineGoogle Scholar3. OGILVIE R and RUEDY J: Adverse drug reactions during hospitalization. Canad Med Ass J 97:1450-1457, 1967 MedlineGoogle Scholar4. MELMON K, SHEINER L, and MORRELLI H: Preventable drug reactions: causes and cures. New Eng J Med. In press, 1971 MedlineGoogle Scholar5. MELMON K and MORRELLI H: Drug reactions, in Clinical Pharmacology: Basic Principles of Therapeutics, edited by MELMON KL, MORRELLI HF. New York, The MacMillan Co. In press, 1971 Google Scholar6. : Clinical pharmacology: scope, organization, training. Report of a WHO study group. WHO Techn Rep Ser 446:1-21, 1970 Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: KENNETH L. MELMON, M.D., F.A.C.P.; HOWARD F. MORRELLI, M.D., F.A.C.P.Affiliations: Departments of Medicine and Pharmacology School of Medicine University of California Medical Center San Fracisco, Calif. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1971Volume 74, Issue 2Page: 291-292KeywordsClinical pharmacologyDrugsHabits ePublished: 1 December 2008 Issue Published: 1 February 1971 PDF downloadLoading ...
Air pollution and bronchitic symptoms in Southern California children with asthma.
Authors: R McConnell, K Berhane, F Gilliland, S J London, H Vora, E Avol, W J Gauderman, H G Margolis, F Lurmann, D C Thomas, J M Peters
Journal: Environmental Health Perspectives (1999)

The association of air pollution with the prevalence of chronic lower respiratory tract symptoms among children with a history of asthma or related symptoms was examined in a cross-sectional study. Parents of a total of 3,676 fourth, seventh, and tenth graders from classrooms in 12 communities in Southern California completed questionnaires that characterized the children's histories of respiratory illness and associated risk factors. The prevalences of bronchitis, chronic phlegm, and chronic cough were investigated among children with a history of asthma, wheeze without diagnosed asthma, and neither wheeze nor asthma. Average ambient annual exposure to ozone, particulate matter (PM(10) and PM(2.5); [less than/equal to] 10 microm and < 2.5 microm in aerodynamic diameter, respectively), acid vapor, and nitrogen dioxide (NO(2)) was estimated from monitoring stations in each community. Positive associations between air pollution and bronchitis and phlegm were observed only among children with asthma. As PM(10) increased across communities, there was a corresponding increase in the risk per interquartile range of bronchitis [odds ratio (OR) 1.4/19 microg/m(3); 95% confidence interval (CI), 1.1-1.8). Increased prevalence of phlegm was significantly associated with increasing exposure to all ambient pollutants except ozone. The strongest association was for NO(2), based on relative risk per interquartile range in the 12 communities (OR 2.7/24 ppb; CI, 1.4-5.3). The results suggest that children with a prior diagnosis of asthma are more likely to develop persistent lower respiratory tract symptoms when exposed to air pollution in Southern California.
A requiem for vagotomy.
Authors: J Alexander-Williams
Journal: BMJ (1991)

Planning Association advice for a "missed pill" should be followed,27 and wearers of soft contact lenses warned that these may be permanently stained.Itching, rashes, and gastro- intestinal reactions may also occur.Contacts must be advised of the risk of late secondary disease occurring despite prophylaxis.We advocate the use of rifampicin at a dose of 20 mg/kg a day (up to a maximum of 600 mg daily) for four days for three groups of contacts of patients with invasive Haemophilus influenzae type b disease.With the exclusion of pregnant or breastfeeding women, anyone with severely impaired hepatic function, and children aged under 3 months, prophylaxis should be offered to (a) all household members in households where there is an index case of Haemophilus influenzae type b disease, irrespective of age, and another child aged under 3 years; (b) all classroom contacts -both teachers and children - where two or more cases of the disease have occurred within 120 days-that is, where spread of the organism may have occurred within the class; and (c) all index cases of the disease before discharge from hospital.Prophylaxis should not be offered routinely to household contacts when there are no other children aged under 3 years, to non-household contacts of single cases, or to ward contacts in hospital outbreaks.When prophylaxis is given all defined contacts must be identified and treatment started as early as possible.These recommendations are consistent with and amplify those of the British Paediatric Association.28A more detailed review of H influenzae type b chemoprophylaxis may be found in the Communicable Disease Report.29
An Injury Is No Accident
Authors: Theodore C. Doege
Journal: New England Journal of Medicine (1978)

IT is time for medicine to dispose of the idea of "accident" and "accidental injury," so that recent halting steps in understanding the injury problem can continue. That such efforts merit high priority is emphasized by the fact that for persons one to 44 years old, injuries are the most common cause of death.1 A glance at an American college-level dictionary shows that an "accident" is defined as an event that is "unforeseen," "unfortunate" and "unexpected" and sometimes results in a loss or injury. There is no quarrel with this part of the definition, for without doubt, few of the . . .