tbuckley/cabot-search huggingface dataset:
Contribution of antigen-presenting cell major histocompatibility complex gene products to the specificity of antigen-induced T cell activation
Authors: E Heber-Katz, RH Schwartz, LA Matis, C Hannum, T Fairwell, E Appella, D Hansburg
Journal: The Journal of Experimental Medicine (1982)

Previous studies from our laboratory showed that B 10.A mice are high responders to pigeon cytochrome c fragment 81-104, whereas B 10.A(5R) mice are low responders. In the present studies, the C-terminal cyanogen bromide cleavage fragment and homologous synthetic peptides of tobacco horn worm moth cytochrome c were shown to be immunogenic in both B10.A and B10.A(5R) mice. These strains, however, showed different patterns of cross-reactivity when immune lymph node T cells were stimulated with cytochrome c fragments from other species. To examine the two patterns of responsiveness at a clonal level, cytochrome c fragment-specific T cell hybridomas were made and found to secrete interleukin 2 in response to antigen. The patterns of cross- reactivity of these B 10.A and B 10.A(5R) clones were similar to that seen in the whole lymph node population. Surprisingly, when these clones were tested for major histocompatibility complex (MHC)-restricted antigen recognition, they were all found to respond to antigen with both B10.A and B10.A(5R) antigen-presenting cells (APC). Furthermore, the cross-reactivity pattern appeared to be largely determined by the genotype of the APC, not the genotype of the T cell clone. That is, a given T cell clone displayed a different fine specificity when assayed with B10.A or B10.A(5R) APC. This observation indicates that the APC MHC gene product and antigen interact during the stimulation of the T cell response and that as a consequence the specificity of antigen-induced T cell activation is influenced by these MHC gene products. (During the preparation of this manuscript it has come to our attention that results similar to our own, concerning the fine specificity of cytotoxic T cell clones, have been obtained by Dr. T. R. Hunig and Dr. M. J. Bevan, Massachusetts Institute of Technology, Boston, MA. T. R. Hunig and M. J. Bevan. 1981. Specificity of T-cell clones illustrates altered self hypothesis. Nature. 294:460.)
Advances in experimental medicine and biology
Authors: S. J Thompson
Journal: Annals of the Rheumatic Diseases (1996)

Why is a book never quite what you expect?The ABC of Rheumatology is targeted at general practition- ers and hospital staff who deal with rheumatological problems-a good audience as there is a need for knowledge in both quarters, and if the audience perceives the need they may fork out the required fee.The editors' and authors' aims are met, that is, they cover the major fields and the common diagnoses.This will please all MRCP candidates-I wish the ABC series had been around when I took the exam, especially this edition.The illustrations are a delight, really enhancing the text.Most of the chapters are well structured, incorporat- ing the team concept of care which has been crystallised since the patient charter.
Abstract 2600: Effect of green tea intake on pharmacokinetics of oral etoposide in cancer patients
Authors: Shunji Nagai, Yutaka Fujiwara, Naoki Ishizuka, Mikiya Ishihara, Kuniaki Itoh, Naomi Ogasawara, Hikaru Nakajima, Hiroe Fuse, Nobuaki Matsubara, Hirofumi Mukai, Takeshi Yamaguchi, Toru Mukohara, Hironobu Minami
Journal: Cancer Research (2010)

Abstract BACKGROUND: Habitual consumption of green tea has been epidemiologically correlated with low risk of cancer. Among various constituents of green tea, catechins are experimentally suggested to have benefitial activity. Especially, (-)-epigallocatechin gallate (EGCG) is the most bioactive constituent. Decreased activation of carcinogenic compounds by inhibition CYP3A4 is proposed as one of mechanisms of anticarcinogenic effect. Green tea is one of the most popular beverages in Japan and Asian countries, and patients often take drugs with green tea beverages. Co-administration of oral cancer medicine which is metabolized by CYP3A4 with green tea may cause harmful interactions. PURPOSE: We investigated the effect of green tea beverage intake on pharmacokinetics of etoposide in an open label, single-dose, randomized, two-way crossover study. METHODS: Patients with various cancers were randomly assigned to receive an etoposide 50-mg capsule either with 600mL green tea beverage or 600mL of water, separated by at least 72-hours washout period. Blood samples were collected for 24 hours. Etoposide concentrations in plasma were determined by high performance liquid chromatography. Plasma pharmacokinetic parameters, including area under the curve (AUC), maximum concentration (Cmax) and elimination half-life (t1/2) were calculated by non-compartment analysis using WinNonlin software. RESULTS: Twenty-five cancer patients (11 males, 14 females; median (range) age, 63 years (46 to 81 years)) participated in this study. Co-administration with green tea resulted in an unexpected decrease by 24.8% in the AUC (p= 0.0003) of etoposide (Table). Carry-over effect was denied. CONCLUSION: Green tea reduces rather than increases exposure to orally administered etoposide.Mean pharmacokinetic parameters of etoposideParameters Water Green teaP-valueAUC 337.61257.45P=0.0003(mg*min/ml) Cmax (mcg/ml) 2.97252.1284P=0.0004t1/2 (h) 7.43116.7696P=0.0771 Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2600.
Medicare proposes to expand payments to encourage trials of effectiveness
Authors: Janice Hopkins Tanne
Journal: BMJ (2007)

The US Centers for Medicare and Medicaid Services, which runs the federal Medicare health insurance plan for elderly people, last month proposed changes to how it pays for clinical trials.

If accepted, the changes would help Medicare compare existing treatments and make scientific and payment decisions that could save money while still providing effective treatment.

Under the current policy, developed in 2000, Medicare pays for certain items and services and for healthcare costs of Medicare beneficiaries who are taking part in clinical trials, but it does not pay for the “investigational” drugs, tests, and devices used in trials even when these drugs, tests, …
Toxicity of Diethyltoluamide-Containing Insect Repellents-Reply
Authors: Milton Tenenbein
Journal: JAMA (1988)

<h3>In Reply.</h3> —I am pleased that my article stimulated some research by a major manufacturer of a DEET-based mosquito repellent. However, I find the results of Davies et al difficult to interpret in light of the work of Wu et al<sup>1</sup>that they cite in their letter. The experiment of Wu et al was quite similar to that of Davies et al, but its results were quite different. The DEET dose used by Wu et al was marginally less (133 mg/kg vs 148 mg/kg). Unfortunately, only the eight-hour blood concentration was obtained; the 0.016 mmol/L (0.31 mg/dL) of DEET found is about 3½ times the average peak concentration reported by Davies et al. More importantly, this was not a peak blood concentration. Companion urinary excretion data clearly demonstrated that peak concentrations occurred in the first hour after exposure. The data of Wu et al are not complete enough to
Medical Informatics
Authors: Robert A. Greenes, Edward H. Shortliffe
Journal: JAMA (1990)

Information management constitutes a major activity of the health care professional. Currently, a number of forces are focusing attention on this function. After many years of development of information systems to support the infrastructure of medicine, greater focus on the needs of physicians and other health care managers and professionals is occurring—to support education, decision making, communication, and many other aspects of professional activity.<i>Medical informatics</i>is the field that concerns itself with the cognitive, information processing, and communication tasks of medical practice, education, and research, including the information science and the technology to support these tasks. An intrinsically interdisciplinary field, medical informatics has a highly applied focus, but also addresses a number of fundamental research problems as well as planning and policy issues. Medical informatics is now emerging as a distinct academic entity. Health care institutions are considering, and a few are making, large-scale commitments to information systems and services that will affect every aspect of their organizations' function. While academic units of medical informatics are presently established at only a few medical institutions in the United States, increasing numbers of schools are considering this activity and many traditional departments are seeking and attracting individuals with medical informatics skills. (<i>JAMA</i>. 1990;263:1114-1120)
Third Contribution to the Life-History of Contagium
Authors: P. M. Braidwood, F. Vacher
Journal: BMJ (1882)

THIS Third Contribution to the Life-History of Contagium, the issue of which has, from various causes, been delayed from time to time, is presented in a less complete form than was originally intended.The recorded investigations extended over a period of four years; but they were several times suspended for months together, owing to the pressure of other work or the increasing demands of private practice.As re.
Human Rights Abuses and Concerns About Women's Health and Human Rights in Southern Iraq
Authors: Lynn L. Amowitz
Journal: JAMA (2004)

Although human rights abuses have been reported in Iraq, the full scope of these abuses has not been well documented.To assess the prevalence of human rights abuses since 1991 in southern Iraq, along with attitudes about women's health and human rights and women's rights and roles in society, to inform reconstruction and humanitarian assistance efforts in Iraq.Cross-sectional, randomized survey of Iraqi men and women conducted in July 2003 using structured questionnaires.Three major cities in 3 of the 9 governorates in southern Iraq.A total of 1991 respondents representing 16 520 household members.Respondent demographics, information on human rights abuses that occurred among household members since 1991, women's health and human rights, opinions regarding women's rights and roles in society, and conditions for community health and development.Respondents were a mean age of 38 years and were mostly of Arab ethnicity (99.7% [1976/1982]) and Muslim Shi'a (96.7% [1906/1971]). Overall, 47% of those interviewed reported 1 or more of the following abuses among themselves and household members since 1991: torture, killings, disappearance, forced conscription, beating, gunshot wounds, kidnappings, being held hostage, and ear amputation, among others. Seventy percent of abuses (408/586) were reputed to have occurred in homes. Baath party regime-affiliated groups were identified most often (95% [449/475]) as the perpetrators of the abuses; 53% of the abuses occurred between 1991 and 1993, following the Shi'a uprising, and another 30% between 2000 and the first 6 months of 2003. While the majority of men and women expressed support for women's equal opportunities for education, freedom of expression, access to health care, equality in deciding marriage and the number and spacing of children, and participation in community development decisions, there was less support among both men and women for women's freedom of movement, association with people of their choosing, and rights to refuse sex. Half of women and men (54% and 50%, respectively) reported agreeing that a man has the right to beat his wife if she disobeys. Fifty-three percent of respondents reported that there were reasons to restrict educational opportunities for women at the present time and 50% reported that there were reasons to restrict work opportunities for women at the present time.Nearly half of participating households in 3 southern cities in Iraq reported human rights abuses among household members between 1991 and 2003. The households surveyed supported a government that will protect and promote human rights, including the rights of women. However, currently, neither men nor women appear to support a full range of women's human rights.
Hospitalizations for people with type 1 and type 2 diabetes compared with the nondiabetic population of Tayside, Scotland: a retrospective cohort study of resource use.
Authors: P T Donnan, G P Leese, A D Morris
Journal: Diabetes Care (2000)

OBJECTIVE: To compare the hospitalizations of people with type 1 and type 2 diabetes with those of the nondiabetic population of Tayside, Scotland. RESEARCH DESIGN AND METHODS: This was a retrospective cohort study set in Tayside, Scotland. Study subjects were eligible for inclusion if they lived in Tayside from 1 January 1995 to 31 December 1995. The primary end point was hospitalization. Comparisons between people with and without diabetes were assessed using logistic regression modeling. RESULTS: The fixed population for the year 1995 included 366,849 people registered with a Tayside general practitioner; 7,735 (2.1%) of these had diabetes. Approximately 25% of all study subjects with diabetes had at least one hospital admission, compared with 12% of the nondiabetic population. The length of stay was highest for patients with type 2 diabetes (median of 7 days). People with diabetes accounted for 8.2% of the total bed days and had approximately double the risk of admission. Type 2 diabetic patients had increased risks of myocardial infarction and stroke; both type 1 and type 2 diabetic patients were at increased risk for an endocrine/metabolic admission or renal failure. The risk of ophthalmic admissions, especially for cataract, was much higher in patients with type 1 diabetes compared with the nondiabetic population. CONCLUSIONS: Type 2 diabetes was associated with more frequent and longer admissions compared with the nondiabetic population. This was due to a higher risk of neurological, cardiovascular, renal, and ophthalmic hospitalizations compared with people without diabetes.
Precipitation of laryngeal obstruction in acute epiglottitis.
Authors: W O Tarnow-Mordi, A M Berrill, C W Darby, P Davis, J Pook
Journal: BMJ (1985)

Acute epiglottitis is a life threatening infection that is nearly always caused by Haemophilus influenzae type B. It occurs predominantly in chidren aged 2-7 years.' Most require endotracheal intubation and some need tracheostomy to prevent incipient obstruction of the larynx by the swollen epiglottis.Most textbooks emphasise the need to summon skilled help from anaesthetists and ear, nose, and throat staff; to defer examination of the throat until this help is available; and to give prompt parenteral antibiotic treatment.Few textbooks specifically recommend that injections or venepuncture be delayed until intubation or tracheostomy has been performed.We describe a case that shows the potential consequences of any routine procedure that may cause crying in a child with epiglottitis who is not intubated. Case reportAn 18 month old boy was brought to Sydenham Children's Hospital with a six hour history of increasingly difficult and noisy breathing, fever, and irritability.On examination he had coarse inspiratory stridor with inter- costal and suprasternal recession.He was distressed, cyanosed, and drooling.The axillary temperature was 38°C.Direct examination of the throat was not attempted, but a lateral x ray film of the neck confirmed the diagnosis of epiglottitis.The boy was nursed in his mother's arms to minimise his distress while senior paediatric, anaesthetic, and ear, nose, and throat staff were summoned.In accordance with departmental policy an intravenous infusion was set up so that immediate treatment with antibiotics and steroids could begin.The procedure was carried out with extreme care but caused the child to cry, leading immediately to respiratory arrest.Emergency endotracheal intubation was unsuccessful so a 16 gauge Medicut cannula was inserted through the cricothyroid membrane.Treatment with 100% oxygen and external cardiac massage was begun.Spontaneous respiration was re-established within two minutes, coinciding with the arrival of the team of consultants.When the consultant anaesthetist intubated the child with a 3-0 mm orotracheal Portex tube (subsequently replaced by a 3-5 mm nasotracheal Portex tube) a grossly enlarged epiglottis was visualised.The child was given intravenous chloramphenicol, ampicillin, and hydrocortisone; sedated with chloral hydrate; and nursed in 27% humidified oxygen.Eighteen hours after intubation his fever had resolved.He was extubated under halothane anaesthesia and direct laryngoscopy.He made an uneventful recovery. DiscussionThis child's respiratory arrest was most probably precipitated by laryngeal obstruction due to crying while an intravenous infusion
Survival in Primary Pulmonary Hypertension with Long-Term Continuous Intravenous Prostacyclin
Authors: Robyn J. Barst
Journal: Annals of Internal Medicine (1994)

Objective: To evaluate the effects of long-term intravenous infusion of prostacyclin on exercise capacity, hemodynamics, and survival in patients with primary pulmonary hypertension. Design: Open, multicenter, uncontrolled trial. Setting: Four referral centers. Patients: 18 patients with primary pulmonary hypertension: 1 New York Heart Association (NYHA) class II patient, 13 NYHA class III patients, and 4 NYHA class IV patients. Interventions: Continuous intravenous prostacyclin administered by portable infusion pumps. All patients were treated with anticoagulant agents. Measurements and Main Results: With the 6-minute walk used to evaluate exercise capacity, patients could walk on average more than 100 meters farther after prostacyclin therapy was initiated (distance at 6 months, 370 ± 119 meters compared with 264 ± 160 meters at baseline; P < 0.001; distance at 18 months, 408 ± 138 meters; P = 0.02 compared with baseline). Hemodynamics were improved at 6 months: The cardiac index increased 18% (95% CI, 0.1% to 36.7%; P = 0.02), and mean pulmonary artery pressure and total pulmonary resistance decreased 9% (CI, 1.4% to 15.7%; P = 0.03) and 26% (CI, 6.1% to 46.3%; P = 0.02), respectively, compared with baseline. The improvements in cardiac index and total pulmonary resistance were maintained at 12 months (27% increase [CI, 1.3% to 51.9%; P = 0.05] and 32% decrease [CI, 9.7% to 53.6%; P = 0.02] compared with baseline, respectively). Survival was improved in NYHA class III and IV patients who received continuous prostacyclin (n = 17; follow-up, 37 to 69 months) when compared with historical controls who received standard therapy (National Institutes of Health Primary Pulmonary Hypertension Registry, n = 31, P = 0.045). Kaplan-Meier estimates of 1-, 2-, and 3-year survival rates for the patients treated with prostacyclin were 86.9%, 72.4%, and 63.3%, respectively, compared with 77.4%, 51.6%, and 40.6% for the historical control group (hazard ratio, 2.9 [CI, 1.0 to 8.0; P = 0.045]). Serious complications attributable to the drug and delivery system included two deaths and seven episodes of nonfatal sepsis in three patients. Conclusions: Continuous intravenous prostacyclin resulted in sustained clinical and hemodynamic improvement and probably in improved survival in patients with severe primary pulmonary hypertension. Despite potentially serious complications, long-term prostacyclin may be especially helpful in seriously ill patients awaiting transplantation.
Periorbital cellulitis with breast cancer
Authors: C. Spinou, G W McGarry
Journal: Journal of the Royal Society of Medicine (2003)

Dr Stevens and his colleagues (June 2003, JRSM1) describe a complex case in which periorbital cellulitis led to diagnosis of breast cancer metastasis to the sphenoid bone and the orbit. In our opinion, the periorbital cellulitis with which the patient presented might not have been due to the metastatic tumour. The CT scan shows opacity of the ethmoid sinuses bilaterally and of the right sphenoid sinus. The patient initially had pyrexia, periorbital swelling and erythema extending to the left side of her face—a clinical picture that together with the CT scan is strongly suggestive of periorbital cellulitis due to sinusitis. The sphenoid metastasis is indeed unusual and interesting but the reason she originally came to hospital may have been ethmoid sinusitis leading to periorbital cellulitis.
Inheritance of Low Serum Immunoglobulin D
Authors: Sandra L. Dunnette, Gerald J. Gleich, Richard M. Weinshilboum
Journal: Journal of Clinical Investigation (1978)

Previous studies have shown that log IgD levels in normal individuals are distributed in a nonunimodal manner. Therefore, in this study we tested whether inheritance might play a role in determination of IgD levels. IgD levels were measured in serum or plasma from 301 randomly selected children aged 6-18 yr, 245 consecutive adult blood donors, and 134 first-degree relatives of subjects with low IgD levels. Comparison of serum and plasma from five individuals revealed no difference, so the two were used interchangeably. The distributions of log IgD levels in randomly selected populations of both adults and children were nonunimodal with nadirs at 2.15 IU/ml. In both of these randomly selected populations, 13-14% of the subjects had low IgD values (<2.15 IU/ml). In addition, there was a significant sibling-sibling correlation of log IgD values (r = 0.56, n = 72, P <0.01). Because of the nonunimodality of the frequency distribution histogram for IgD values and because of the familial aggregation of these values, the study was extended to include first-degree relatives of subjects with low plasma IgD. Blood samples from 92% of living first-degree relatives, 134 individuals, were analyzed for their level of IgD, and the results of segregation and pedigree analyses of these data were compatible with autosomal recessive inheritance of an allele for low plasma IgD levels. IgD values in plasma from siblings of probands for low IgD were also non-unimodal in distribution with a nadir at ≅2.15 IU/ml. The results suggest that there is autosomal recessive inheritance of an allele for low plasma IgD.
Steatosis and progression of fibrosis in untreated patients with chronic hepatitis C infection
Authors: Ponni Perumalswami, David E. Kleiner, Glen Lutchman, Theo Heller, Brian Borg, Yoon Park, T. Jake Liang, Jay H. Hoofnagle, Marc G. Ghany
Journal: Hepatology (2006)

Hepatic steatosis is common in patients with chronic hepatitis C (CHC) and is reported to be a risk factor for progression of fibrosis. The aims of this study were to evaluate the interactions between hepatic steatosis and fibrosis in a well-defined cohort of patients with CHC. The computerized pathology database at the National Institutes of Health Clinical Center was searched for patients with CHC who had undergone liver biopsy between 1980 and 2003. Biopsies were scored for necroinflammation using a modified histology activity index, fibrosis using the Ishak system, and steatosis as either none (<5% of cells), mild (5%-25%), or moderate-to-severe (>25%). Four hundred ninety-four patients were identified. The mean age was 44 +/- 9.8 years; 60% were male, 80% Caucasian, and 65% were infected with genotype 1. Steatosis was mild in 31% and moderate to severe in 9% of patients. In univariate analysis, steatosis was associated with increased age, body weight, body mass index (BMI), alanine aminotransferase (ALT) levels, histological necroinflammatory activity, and fibrosis. However, in multivariate analysis, steatosis was associated only with increased age, BMI, and ALT levels and not with fibrosis. One hundred thirty-six patients had 2 liver biopsies separated by 0.5 to 17 years. Worsening of fibrosis occurred in 40% of patients and correlated independently with increasing age, periportal necroinflammation, and ALT elevations but not with steatosis. In conclusion, in this cohort of patients with CHC, steatosis was associated with older age, higher BMI, and higher serum ALT levels but not with the presence of or subsequent progression of fibrosis.