tbuckley/cabot-search huggingface dataset:
Renal Failure—Imaging
Authors: Rosalyn Kutcher
Journal: JAMA (1979)

THE INDICATIONS for visualization of the kidneys in the patient with renal failure are (1) to exclude a remedial cause of renal failure (eg, hydronephrosis), (2) to evaluate renal size, (3) to determine kidney position for biopsy, and (4) to confirm a specific disease entity (eg, polycystic kidneys). <h3>Sonography</h3> Sonography is a noninvasive diagnostic imaging modality that is ideally suited for the examination of the kidneys of the patient in renal failure.<sup>1-5</sup>The procedure is applicable to all patients irrespective of the degree of renal failure, since renal function is not necessary for visualization. The technique is sufficiently accurate to be relied on as the initial and, at many times, the only diagnostic procedure. The demonstration of the anatomy is not as good as with urography but is sufficiently finite to identify accurately an obstructive uropathy as the cause of renal failure. Fine caliceal detail cannot be resolved, and
The Association of Differing Measures of Overweight and Obesity With Prevalent Atherosclerosis
Authors: Raphael See, Shuaib M. Abdullah, Darren K. McGuire, Amit Khera, Mahesh J. Patel, Jason B. Lindsey, Scott M. Grundy, James A. de Lemos
Journal: Journal of the American College of Cardiology (2007)
Residential Study and Treatment Center for Children with Intractable Asthma
Authors: Samuel C. Bukantz
Journal: JAMA (1963)

The research aspects of the treatment program at the Children's Asthma Research Institute were emphasized and illustrated by a description of two clinical studies. The first demonstrated that a daily oral dose of 6 mg of stanozolol accelerated linear growth without comparable skeletal maturation in 15 growthretarded, adrenocorticoid-treated asthmatic children. The second study made use of the Astrup pH meter in determinations of capillary blood pH and pCO2in status asthmaticus (adrenalin-resistant asthma). Data obtained in 15 cases indicated that lowered blood pH and elevated pCO2were associated with the most severe forms of status asthmaticus and that marked lowering of pH (in one case to 6.86, with survival) was an especially grave prognostic sign. Management of such clinical states requires intravenous fluids, adrenocortical steroids, aminophylline. and no sedatives.
Cytokine and chemokine receptor profile of peripheral blood mononuclear cells during treatment with infliximab in patients with active rheumatoid arthritis
Authors: R Nissinen
Journal: Annals of the Rheumatic Diseases (2004)

<b>Objectives:</b> To analyse immunological changes during treatment with a monoclonal anti-tumour necrosis factor α (TNFα) antibody, infliximab, in patients with rheumatoid arthritis (RA). <b>Methods:</b> 25 patients with RA and 5 patients with other arthritides were studied during the first 6 weeks of treatment with infliximab. At the start of treatment and after 2 and 6 weeks, spontaneous expression of CCR3 and CCR5 on peripheral blood T cells and monocytes was studied by flow cytometry. The secretion and mRNA expression of interferon γ (IFNγ), interleukin (IL)4, IL5, and TNFα from phytohaemagglutinin (PHA) stimulated peripheral blood mononuclear cells was measured with an ELISA and RT-PCR. Plasma levels of C reactive protein, serum amyloid protein A, rheumatoid factor, and antibodies to filaggrin and citrullinated cyclic peptide were measured with an ELISA. <b>Results:</b> The number of CD4 T cells and CD14 monocytes expressing CCR3 (p = 0.013, p = 0.009, respectively) and CD8 T cells expressing CCR5 (p = 0.040) as well as PHA stimulated secretion of IL4 and IFNγ (p&lt;0.05) increased during treatment in patients with RA. 15 (60%) patients with RA achieved clinical response (at least ACR20) during the first 2 weeks. The number of T cells expressing CCR3 and CCR5 was higher before treatment in non-responders than in responders (p&lt;0.05). The number of T cells increased in responders. <b>Conclusion:</b> Increase in secretion of Th1 and Th2 cytokines together with induced expression of chemokine receptors on T cells and monocytes suggest restoration of peripheral cell mediated immunity and blockade of the accumulation of inflammatory cells in joints as response to treatment.
Predictive risk factors and prevalence of malignancy in patients with iron deficiency anemia in Taiwan
Authors: Chao-Hung Ho, Wing-Keung Chau, Hui-Chi Hsu, Jyh-Pyng Gau, Jie-Yu You, Chih-Cheng Chen
Journal: American Journal of Hematology (2005)

Gastrointestinal (GI) tract malignancy is one of the important causes of chronic iron deficiency anemia (IDA). The present study was designed to find out the prevalence and the predictive risk factors of malignancy in the IDA patients. We performed a prospective study in 148 patients with chronic IDA. A series of examinations to explore the GI tract were performed either by radiology and/or endoscopy. A Tc-RBC GI bleeding study was also performed, and prevalence and risk factors of malignancy were calculated. Totally 148 patients were enrolled, with mean age 66.2 years; 88 were male. Eighteen patients (12.2%) were found to have malignant tumors. Ten (6.8%) had benign tumors, and 96 (64.9%) had other benign conditions. No lesions could be detected in 24 patients (16.2%). Clinical symptoms and presence of fecal occult blood could not predict malignancy or any GI lesions. Multivariate logistic regression analysis showed serum ferritin < or =10 microg/L, LDH >250 U/L, and aging as the risk factors of malignancy in the IDA patients (P = 0.003, 0.002, and 0.027; and OR = 7.614, 8.955, and 1.062, respectively). An IDA patient with both serum ferritin < or =10 microg/L and LDH >250 U/L ran a 74.33-times higher risk of malignancy than the patient without (95% CI: 7.115-776.479). Malignancy was an important cause of IDA. High LDH, low serum ferritin, and aging were the risk factors of malignancy in the IDA patients.
Dietary Intake, the First Law of Thermodynamics, and the Properties of Yoga
Authors: George V. Mann
Journal: JAMA (1986)

<h3>To the Editor.—</h3> The studies by Sacks et al<sup>1</sup>concerning the relationship of vegetarian dietary habits to levels of plasma lipoproteins raise some important questions, but these studies also contain methodological problems. It seems that the data on 116 of the 132 "strict vegetarians" came from studies performed 12 years ago. Despite this, those data were pooled with modern data—a questionable practice. Body weights of the subjects were not measured—the investigators electing to use the subjects' own estimates of weight. Nutritionists are well aware of the systematic biases introduced here. The investigators say that "quantitative records of foods eaten for five consecutive days were kept," but in the next sentence they concede that "portion sizes were estimated and recorded by the subjects." That is "quantitation" with a small "<i>q</i>"! The most astonishing revelation is in Table 1 where 75 lactovegetarians, including 32 men and 43 women, with average body
The Hound of the Baskervilles effect: natural experiment on the influence of psychological stress on timing of death
Authors: D. P Phillips, G. C Liu, K. Kwok, J. R Jarvinen, W. Zhang, I. S Abramson
Journal: BMJ (2001)

The case histories are described of four brothers who suffered attacks of transient global amnesia. The coincidence of this disorder in four siblings suggests that the causative factors in transient global amnesia may have a familial basis and that its incidence is more common than generally realised.
Bowel Visualization on Bone Scan Because of Protein Losing Enteropathy
Authors: PAUL J. ROACH, DIANE ITRATO, TED S. TREVES
Journal: Clinical Nuclear Medicine (1994)

A case of visualization of the large bowel on a Tc-99m MDP bone scan is presented. A 14-year-old girl had transit of radiotracer through the intestinal lumen in two studies performed 3 weeks apart. This was almost certainly caused by a severe protein losing enteropathy. Mechanisms and other causes of bowel visualization on bone scintigraphy are discussed.
The Accidental Tourist: Medical Emergencies in the Air
Authors: Bruce B. Dan
Journal: JAMA (1989)

Each year 550 million air travelers pass through the 25 busiest airports in the United States.<sup>1</sup>More people enplane, deplane, and transfer through Chicago's O'Hare International Airport annually than live in Australia, New Zealand, Sweden, Finland, Norway, Denmark, Switzerland, Ireland, Greece, and the Congo combined. With such large congregations of people in unusual conditions, both in the air and on the ground, one might expect some unusual occurrences of medical emergencies. In this issue ofThe Journal, Cummins and Schubach<sup>2</sup>report on their survey of emergency medical responses at one large air terminal, the Seattle-Tacoma International Airport. In the 1-year prospective study, they found that the frequency of emergency calls was relatively low, approximately 1 per 20 000 traveling passengers. This incidence is probably similar to or smaller than what is seen at a football game, rock concert, or any other large gathering of reasonably healthy people. Interestingly,
Short-term effects of simvastatin on bile acid synthesis and bile lipid secretion in human subjects
Authors: Paola Loria, Marco Bertolotti, Teresa M. Cassinadri, Michele A. Dilengite, Mara Bozzoli, Francesca Carubbi, Mauro Concari, Eugenia M. Guicciardi, Nicola Carulli
Journal: Hepatology (1994)

To test whether de novo synthesis of cholesterol is a limiting factor for bile acid synthesis, we studied the acute effect of simvastatin, an inhibitor of HMG-coenzyme A reductase (the limiting step of cholesterol synthesis) on bile acid synthesis and biliary lipid secretion in subjects with interrupted enterohepatic circulation. In these conditions bile acid synthesis is derepressed and is assumed to equal biliary bile acid secretion. Five cholecystectomized patients fitted with T-tubes were studied. All subjects were administered simvastatin (80 mg as a single dose) 5 days after surgery. Bile was collected in 3-hr intervals for 15 hr before and 30 hr after the administration of the drug. During the experiment we kept the enterohepatic circulation of bile acid interrupted by inflating an occludable balloon inserted, during cholecystectomy, in the common bile duct. Simvastatin induced significant decreases of plasma total and low density lipoprotein cholesterol concentrations, from 163 +/- 29 mg/dl and 97 +/- 24 mg/dl of the pretreatment value to 144 +/- 30 mg/dl and 82 +/- 22 mg/dl 18 hr after simvastatin administration, respectively. Bile flow tended to increase after simvastatin, and the mean values from the third to the 15th hour after simvastatin administration (22.1 +/- 1.9 ml/hr) were significantly greater than the mean values of the pretreatment period (19.9 +/- 2.8 ml/hr). Concomitantly biliary bile acid, cholesterol and phospholipid concentrations fell from basal values of 15.9 +/- 5.1, 2.3 +/- 0.3 and 5.5 +/- 0.3 mmol/L to mean values, after treatment, of 9.0 +/- 3.5, 1.9 +/- 0.5 and 3.0 +/- 0.9 mmol/L, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
Proteinuria Is Still Useful for the Screening and Diagnosis of Overt Diabetic Nephropathy
Authors: Themis Zelmanovitz, Jorge L Gross, Jarbas Oliveira, Mirela J De Azevedo
Journal: Diabetes Care (1998)

OBJECTIVE To assess the performance of urinary total protein measurements in timed 24-h urine collection (24-h UP) and in a diurnal random urine specimen (RUS) for the screening and diagnosis of overt diabetic nephropathy. RESEARCH DESIGN AND METHODS A total of 167 diabetic patients (20 type 1 and 147 type 2 diabetic patients; 78 women and 89 men), aged 20–84 years, collected 217 timed 24-h urine specimens. Albumin was measured by immunoturbidimetry, total protein by sulfosalicylic acid technique, and creatinine by Jaffe's method. According to the timed 24-h urinary albumin excretion rate (UAER), samples were divided into three groups: normoalbuminuric (NORMO) (UAER &amp;lt;20 μg/min; n = 84), microalbuminuric (MICRO) (UAER 20–200 μg/min; n = 78), and macroalbuminuric (MACRO) (UAER ≥200 μg=min; n = 55). Eighty-six patients also collected 105 RUSs (NORMO, n = 47; MICRO, n = 37; MACRO, n = 21), and urinary protein concentration (UPC) and urinary protein-to-creatinine ratio (UPCR) were measured. The receiver operating characteristics (ROC) curve approach was used to analyze the performance of the diagnostic tests. RESULTS Spearman's coefficient of correlation of 24-h UAER versus 24-h UP was 0.95 (P &amp;lt; 0.001), and of 24-h UAER versus UPC and UPCR were 0.77 and 0.72, respectively (P &amp;lt; 0.001). The calculated areas (±SEM) under the ROC curve for the diagnosis of overt diabetic nephropathy were 0.9987 ± 0.001 for 24-h UP, 0.9926 ± 0.006 for UPC, and 0.9751 ± 0.014 for UPCR. In the ROC curves, the first points with 100% sensitivity were 541 mg (95.7% specificity) for 24-h UP, 431 mg/1 (92.9% specificity) for UPC, and 0.2 (76.2% specificity) for UPCR. CONCLUSIONS Measurements of proteinuria presented almost perfect accuracy for the screening and diagnosis of overt diabetic nephropathy. Protein measurement in spot urine is a reliable and simple method for the screening and diagnosis of overt diabetic nephropathy.
Management of deliberate self poisoning in adults in four teaching hospitals: descriptive study
Authors: N. Kapur, A. House, F. Creed, E. Feldman, T. Friedman, E. Guthrie
Journal: BMJ (1998)

Our relapse rate is similar to that in a trial of nicotine patches (37% between years 1 and 3) 3 and in a study using supportive counselling and nicotine gum for 5 years (40% between years 1 and 5). 4 High relapse rates after 1 year are also common in those not attending for treatment.A large general population survey estimated a relapse rate of 35% from non-validated self reports of the duration of abstinence. 5 Success rates after 1 year or less of follow up substantially overestimate lifelong cessation after a single treatment episode.Contributors: MAHR, GS, and JAS designed the original study, which GS conducted.JAS and GS designed the long term follow up phase, which GS conducted.
Use of monoclonal anti-receptor antibodies to probe the expression of the low density lipoprotein receptor in tissues of normal and Watanabe heritable hyperlipidemic rabbits.
Authors: M Huettinger, W J Schneider, Y K Ho, J L Goldstein, M S Brown
Journal: Journal of Clinical Investigation (1984)

Watanabe Heritable Hyperlipidemic (WHHL) rabbits, like humans with familial hypercholesterolemia, have a genetic defect in the low density lipoprotein (LDL) receptor. WHHL fibroblasts produce a low molecular weight precursor form of the receptor that is not glycosylated normally and is not transported to the cell surface at a normal rate. In the current studies, we have used a monoclonal antibody that reacts with the rabbit LDL receptor to extend these findings to intact rabbits. We have made the following observations: (a) In normal rabbits the liver and adrenal glands synthesize high molecular weight mature LDL receptors like those in fibroblasts. (b) In WHHL rabbits the adrenals express only the low molecular weight receptor precursor, and the liver expresses no detectable receptors. (c) When injected intravenously, the radioiodinated anti-LDL receptor monoclonal antibody is cleared from plasma 6-10-fold faster in normal than in WHHL rabbits, with specific uptake demonstrable in livers and adrenals of normal but not WHHL rabbits. The latter finding raises the general possibility that the total number of cell surface receptors expressed by an animal or human in vivo can be estimated by measuring the rate of clearance of an intravenously injected monoclonal antibody directed against the receptor of interest.
AIDS epidemic can be ended by 2030, report says
Authors: A. Gulland
Journal: BMJ (2014)

<h3>Abstract</h3> Hepatic fibrosis (HF) is a very common condition seen in millions of patients with various liver diseases. N<sup>6</sup>-methyladenosine (m<sup>6</sup>A) plays critical roles in various biological and pathological processes. However, the role of m<sup>6</sup>A and its main methyltransferase METTL3 in HF remains obscure. Here, we reported that METTL3 expression was elevated in HSCs from CCl4 induced fibrotic liver. METTL3 knockdown in HSCs mediated by recombinant adeno-associated-virus serotype 9 packed short hairpin RNA against METTL3 alleviated liver injury and fibrosis compared to empty carrier group. Mechanistically, the decreased liver fibrosis in CCl4-treated HSC-specific <i>METTL3</i> knockdown mice was due to the increased GPR161 that is a suppressor of Hedgehog pathway, a well-known pathway to activate in liver injury and regeneration. As expect, GPR161 transferred into HSCs alleviated liver fibrosis and HSC activation. Forced GPR161 expression inhibited Gli3 activated form nuclear accumulation and subsequently suppressed fibrosis-associate gene expression. Conclusion, HSC-specific deletion of METTL3 inhibits liver fibrosis via elevated GPR161 expression, which subsequently suppressed Hedgehog pathway activation and fibrosis-associated genes expression, providing novel therapeutic targets for HF therapy. <h3>Synopsis</h3> The role of RNA m<sup>6</sup>A methyltransferase METTL3 in the progression of hepatic fibrosis is unclear. Here, we reveal that suppresses m<sup>6</sup>A modification by depletion of METTL3 in Hepatic Stellate Cells (HSCs), stabilizes the GPR161 transcripts, that involved in suppressing Hedgehog signaling pathway, through YTHDF2, thereby alleviating the fibrosis feature of CCl4-induced liver injury. Disruption of m<sup>6</sup>A methyltransferases METTL3 in HSCs alleviates liver fibrosis feature. METTL3 depletion in liver HSCs suppresses its activation by suppressing Hedgehog signaling pathway through stabilizing GPR161 transcripts in an m<sup>6</sup>A-YTHDF2 dependent manner. GPR161 activates PKA that mediates phosphorylation and degradation of full-length Gli3 (Gli3-FL) protein, then the short Gli3 (Gli3-R) translocated into the nucleus and suppresses the fibrosis associated gene transcription. The elevated METTL3 expression is attribute to its promoter H3K27ac modification.
Summary of responses
Authors: Sharon Davies
Journal: BMJ (2007)

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A Discrepancy Between Bone Scan and MRI Concerning the Involvement of Adjacent Bone in Soft Tissue Sarcoma
Authors: E GOSHEN, M MOZES, R MERCER, M QUASTEL, I MELLER
Journal: Clinical Nuclear Medicine (1993)

The case of a patient with malignant fibrous histiocytoma is described. Emphasis is placed on the preoperative implementation of bone scintigraphy and MRI, which yielded discrepant findings. The ultimate therapeutic approach is discussed in light of the discrepancy and the conclusive pathologic result.
Sensitivity, Specificity, and Predictive Value of Body Surface Cultures in a Neonatal Intensive Care Unit
Authors: Martin E. Evans
Journal: JAMA (1988)

We analyzed 24 584 cultures obtained from 3371 infants during a three-year period to determine how frequently body surface culture isolates matched those obtained subsequently from body fluids. The sensitivity, specificity, and predictive values of surface cultures were calculated daily for the two weeks up to and including the day that a body fluid culture was obtained. Isolates from cultures of material from the ear canal, nasopharynx, axilla, umbilicus, groin, rectum, stomach, and endotracheal tube were rarely the same as those recovered from blood or fluids of the cerebrospinal, joint, pleural, pericardial, and peritoneal spaces. With a frequency of sepsis of 3.3% among patients in our neonatal intensive care unit, the optimum sensitivity, specificity, and positive predictive values of surface cultures were 56%, 82%, and 7.5%, respectively. These values did not improve substantially for any specific times of surface cultures prior to sepsis, for anatomic sites cultured, or for pathogens recovered. We conclude that surface cultures are of limited value in predicting the etiology of sepsis in neonates. (<i>JAMA</i>1988;259:248-252)
International epidemiological and microbiological study of outbreak of Salmonella agona infection from a ready to eat savoury snack--II: Israel
Authors: T. Shohat, M. S Green, D. Merom, O N. Gill, A. Reisfeld, A. Matas, D. Blau, N. Gal, P. E Slater
Journal: BMJ (1996)

To explain an increase in the incidence of salmonellosis caused by Salmonella agona in Israel between October 1994 and January 1995 in the light of an outbreak of S agona phage type 15 infection in England and Wales caused by consumption of a ready to eat savoury snack produced in Israel.Epidemiology of S agona in 1994-5 was analysed and two consecutive, case-control studies of 32 and 26 case-control pairs were performed. Phage typing and molecular methods were used to characterise strains of S agona isolated from cases and samples of the snack in Israel and England and Wales.The increase in the incidence of S agona between October 1994 and January 1995 was countrywide. Cases of infection with group B salmonella increased from 60% to 80% in children under 5 years old. In both case-control studies, cases consumed more of the snack than did controls (4.25 v 2.94 packets per week in the first study (P = 0.086) and 4.04 v 2.37 packets per week in the second study (P = 0.034)). When the two studies were combined there was a significant dose-response relation for the number of packets consumed weekly. Compared with consumption of less than two packets, the odds ratio was 1.43 for between two and six packets and 3.37 for seven or more packets (chi 2 for trend = 5.27, P = 0.02) S agona phage type 15 was isolated from a packet of the snack sold in Israel, and the strain was identical with those isolated from packets and cases in Israel and England and Wales.This outbreak of S agona was caused by the contamination of a snack produced in Israel. Even under modern operating conditions, large, widespread international outbreaks of foodborne disease can occur. The success of this investigation resulted from excellent international collaboration between public health authorities.
Women in Medicine
Authors: Katherine C. White
Journal: JAMA (1983)

To the Editor.—  As a woman physician who is currently experiencing the difficulties of balancing family and career responsibilities, I found the COMMENTARY, Women in Medicine: Two Points of View, particularly timely and thought provoking.  I agree with Dr Dimond that the rapid increase in enrollment of women in medical schools during the last decade is an indication that part of sexism and inequality is behind us, but I would caution that this may prove to be merely the tip of the iceberg. As the more tangible roadblocks to women physicians' achievement give way before the efforts of those women and of perceptive male physicians like Dr Dimond, certain pervasive, unspoken assumptions begin to loom in the foreground. Principal among these assumptions is that women are somehow inherently more competent than men to assume the predominant role in child rearing and, thus, should shoulder most of the responsibility for this