tbuckley/cabot-search huggingface dataset:
Prognostic Factors in Cryptococcal Meningitis
Authors: RICHARD D. DIAMOND
Journal: Annals of Internal Medicine (1974)

Results of amphotericin B therapy were correlated with laboratory and clinical findings in 111 patients with cryptococcal meningitis. Compared with patients who were to be cured, patients who were to die during therapy more often had the following features on admission: lymphoreticular malignancy or corticosteroid therapy; cerebrospinal fluid with high opening pressure, a low glucose level, less than 20 leukocytes/mm3 and cryptococci seen in smear; cryptococci isolated from extraneural sites; and high titers of cryptococcal antigen in cerebrospinal fluid and serum. These last two features also characterized admission findings in the group of patients who were to be discharged with negative cultures after therapy but who later relapsed. Patients who were to relapse also had high, persistent posttreatment titers of cryptococcal antigen in serum or cerebrospinal fluid.
Hepatic basolateral sodium-dependent-bile acid transporter expression in two unusual cases of hypercholanemia and in extrahepatic biliary atresia
Authors: B L Shneider, V L Fox, K B Schwarz, C L Watson, M Ananthanarayanan, S Thevananther, D M Christie, W Hardikar, K D Setchell, G Mieli-Vergani, F J Suchy, A P Mowat
Journal: Hepatology (1997)

The recent cloning of a human sodium-dependent bile acid transporter ( NTCP ) permits analysis of its expression in human liver disease and investigation of potential primary defects in its expression. NTCP from normal human liver (NHL) was first characterized in detail. Northern blotting of RNA from NHL revealed a 1.8-kb NTCP transcript. Western blotting of crude NHL plasma membranes using a carboxyterminal antipeptide antibody showed that NTCP is a 39-kd polypeptide that is N- glycosylated to a final molecular weight of 56 kd. Indirect immunofluorescent analysis of NHL sections indicated that the NTCP protein is expressed on the basolateral surface of hepatocytes. We hypothesized that the clinical phenotype of a defect in NTCP might be hypercholanemia in the relative absence of liver disease. Accordingly, the coding region of the NTCP gene of two children with this phenotype was sequenced after reverse transcription/polymerase chain reaction (RT/PCR) amplification. No primary defects in the deduced NTCP amino acid sequence were found. Despite the extremely high serum bile salt levels (235 and 126 micromol/L) in these two patients, NTCP messenger RNA (mRNA) and protein expression were quantitatively normal, in contrast to the published observations in a rat model of cholestasis secondary to common bile duct ligation. Hepatic steady-state NTCP mRNA levels in a group of 23 pre- and postportoenterostomy biliary atresia patients were inversely related to total bilirubin, indicating that extrahepatic bile duct obstruction leads to down-regulation of NTCP mRNA levels, similar to that observed in rat common bile duct ligation. Therefore the lack of down-regulation in the two patients with hypercholanemia indicates that elevated serum bile salts are not sufficient to down-regulate NTCP expression, these two patients have abnormal responses to hypercholanemia, or these two patients have a defect in a gene other than NTCP that influences hepatic clearance of bile salts.
Emergency Medical Care Systems
Authors: Alan M. Nahum
Journal: JAMA (1971)

Improving a medical care system requires an understanding of input and output functions and how they are achieved. Changes should be preceded by the establishment of a data system that will produce accurate measurements before and after change so that evaluation is possible. An initial approach, once measurement techniques have been established, would be to conduct a pilot study on an isolatable portion of the system. This might be beneficial when dealing with large urban systems but, perhaps, unnecessary for smaller rural or suburban systems. Changes will depend upon public pressure for improvement and availability of funds to meet the costs of preserving life and good health.
The Syndrome of Methoxyflurane-Associated Hepatitis
Authors: PRAKASH H. JOSHI
Journal: Annals of Internal Medicine (1974)

Methoxyflurane, an excellent, nonexplosive, fluorinated anesthetic agent, has occasionally been reported to induce liver injury. We reviewed 24 cases of the syndrome with adequate data. Two thirds of the patients were women, frequently obese. The mean age of the patients was 51 years. Half the patients had previously been exposed to halothane or methoxyflurane. Fever, the presenting symptom in half the patients, appeared from a few hours to 14 days after surgery (mean, 4 days), and evidence of hepatitis, shortly thereafter (mean, 5.8 days). The latent period was shorter in patients who had previously received these anesthetic agents. Eosinophilia occurred in 20% of the patients. Histologic examination showed a lesion indistinguishable from viral hepatitis. Fourteen of the 24 patients died (58%). Apparent cross-sensitization and cross-precipitation of hepatitis by halothane or methoxyflurane occurred frequently. Four patients (17%) developed the methoxyflurane-induced hepatorenal syndrome.
Magnification Endoscopy: Does It Improve Mucosal Surface Analysis for the Diagnosis of Gastrointestinal Neoplasias?
Authors: R. Kiesslich, M. Jung
Journal: Endoscopy (2002)

The prognosis for patients with gastrointestinal malignancies is strictly dependent on early detection of premalignant and malignant lesions. In Western countries detection rates are low for early carcinomas; in Germany, in fact, only 5 % of all gastric cancers are diagnosed at an early stage [1]. Early cancers and adenomatous lesions can be removed endoscopically with various techniques (e. g. polypectomy, mucosal resection). The patient is cured by complete resection of such lesions. It is important to detect flat and depressed neoplasias, not only the more common polypoid type of malignant and adenomatous lesions. Hence, the goal of every routine endoscopy is detection, and if possible resection, of early cancers and premalignant lesions.
Potassium channel blocker activates extracellular signal-regulated kinases through Pyk2 and epidermal growth factor receptor in rat cardiomyocytes
Authors: Satoko Tahara, Keiichi Fukuda, Hiroaki Kodama, Takahiro Kato, Shunichiro Miyoshi, Satoshi Ogawa
Journal: Journal of the American College of Cardiology (2001)
Gonadotrophin-releasing Hormone Therapy in Hypogonadal Males with Hypothalamic or Pituitary Dysfunction
Authors: C. H. Mortimer, A. S. McNeilly, R. A. Fisher, M. A. F. Murray, G. M. Besser
Journal: BMJ (1974)

Subcutaneous self-administration of synthetic gonadotrophin-releasing hormone 500 μg eight-hourly for up to one year by 12 male patients (five prepubertal) with clinical hypogonadism due to hypothalamic or pituitary disease resulted in the synthesis and continued release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). There was a rise in circulating androgen levels in all patients. Improvements in pubertal ratings were seen in some prepubertal patients. Potency returned in the adults and spermatogenesis was induced and maintained in the four patients who had received treatment for more than four months, total counts reaching between 7·8 and 432 × 10<sup>6</sup> spermatozoa. A fall in the FSH response to the releasing hormone occurred during spermatogenesis though LH was little affected. During the initial weeks of therapy FSH secretion usually occurred before that of LH though LH secretion was greater as treatment continued. FSH secretion also persisted for longer when treatment was stopped.
Improving the management of COPD
Authors: D. M. G. Halpin
Journal: BMJ (2011)

Must start with strategies to increase the rate of diagnosis

Chronic respiratory disease was a key focus of a European Union ministerial conference in October 2010. Age standardised mortality rates from chronic obstructive pulmonary disease (COPD) in the United Kingdom are among the worst in Europe, with only a handful of countries such as Armenia, Kazakhstan, and Kyrgyzstan reporting worse figures.1 This is particularly true for women, with rates three times higher than those in France and Italy. The results may partly reflect more accurate data collection, particularly as Denmark, which has a long established national patient registry, also reports high mortality despite evidence of good care. Nevertheless, there are reasons to be concerned about the management of this disease in the UK.

COPD is the fifth most common cause of death in England, killing more than 25 000 people a year. As well as its effects on people living with the disease, COPD is a challenge for health services because it is the second biggest cause of emergency admissions to hospital in England. It accounts for a considerable part of the life expectancy gap between spearhead areas (the fifth of areas with …
Liver-Spleen Scintigraphy in Glycogen Storage Disease (Glycogenoses)
Authors: SYDNEY HEYMAN
Journal: Clinical Nuclear Medicine (1985)

Some forms of glycogen storage disease (GSD) primarily affect the liver, including types I, III, IV, VI, IX and 0. Scanning with Tc-99m sulfur colloid, while not being specific, does reveal some characteristic features. Most experience is with scanning in type I disease, though there are few reports in the literature. Six patients with type I, type III, type IV, and probably type VI disease are presented in this report. GSD should be considered in infants and young children presenting with hepatomegaly and abnormal liver-spleen scans. Sequential imaging is useful in following these patients. When focal defects are present, long term follow-up is indicated to detect hepatocellular adenocarcinoma.
Hepatocyte senescence in vivo following preconditioning for liver repopulation
Authors: Maria Paola Serra, Fabio Marongiu, Marcella Sini, Ezio Laconi
Journal: Hepatology (2012)

In the retrorsine (RS)-based model of massive liver repopulation, preexposure to this naturally occurring alkaloid is sufficient to prime normal host parenchymal cells to be slowly replaced by transplanted normal hepatocytes. The basis for this striking effect is yet to be fully elucidated. In the present studies the possible involvement of cell senescence was investigated. Fischer 344 rats were treated according to the RS-based protocol for hepatocyte transplantation, i.e., two doses of RS, 2 weeks apart, and were killed at 4 or 8 weeks after treatment. Control groups were given saline. Expression of senescence-associated beta-galactosidase was greatly induced in hepatocytes exposed to RS. In addition, several other changes that have been related to cell senescence were observed: these included markers of persistent activation of a DNA damage response, an increased expression of mammalian target of rapamycin, and positive regulators of the cell cycle, together with the induction of p21 and p27 cyclin-dependent kinase inhibitors. Furthermore, RS treatment increased levels of interleukin-6 in the liver, consistent with the activation of a senescence-associated secretory phenotype. Conclusion: These findings indicate that RS induces hepatocyte senescence in vivo . We propose that cell senescence and the associated secretory phenotype can contribute to the selective growth of transplanted hepatocytes in this system. (HEPATOLOGY 2012)
DETECTION OF MICROMETASTASES IN PATIENTS WITH PRIMARY BREAST CANCER
Authors: W. Howard Redding, Paul Monaghan, SusanneF. Imrie, MichaelG. Ormerod, Jean-Claude Gazet, R. Charles Coombes, HughMcd. Clink, DavidP. Dearnaley, JohnP. Sloane, T.J. Powles, A. Munro Neville
Journal: The Lancet (1983)
Assessing deleterious ecosystem-level effects of environmental pollutants as a means of avoiding evolutionary consequences.
Authors: G A LeBlanc
Journal: Environmental Health Perspectives (1994)

Recent interest has been expressed in the possible need to develop ways to detect and quantify pollutants that affect evolution. Although environmental pollutants clearly can affect evolutionary processes, the evolutionary changes are a response to ecosystem-level toxicity elicited by the pollutant, rather than a direct effect of the pollutant on evolution. Accordingly, emphasis needs to be placed on assessing the adverse effects of environmental pollutants on ecosystem structure and function in order to avoid subsequent evolutionary consequences.
PWE-102 The use of TPMT Enzyme Testing in Managing Thiopurine Therapy
Authors: M Widlak, M Smith, J Slater, L Wood, S De Silva
Journal: Gut (2013)

<h3>Introduction</h3> Thiopurine methyl transferase (TPMT) enzyme deficiency is associated with azathioprine-induced myelosuppression and hepatotoxicity. We aimed to assess thiopurine methyl transferase levels (TPMT) in patients with inflammatory bowel disease (IBD) and to determine how these levels impact on thiopurine dosing and further treatment. <h3>Methods</h3> Retrospective analysis of all adult IBD patients treated with azathioprine (AZA) who had TPMT levels checked in our department 2008 – 2012. Patient demographics, AZA dose, blood parameters, adverse effects and reason for discontinuation were recorded. Patients were treated to try and achieve a target dose of 2.0 – 2.5 mg/kg of AZA. Our laboratory enzyme assay defined normal TPMT level as 68–150 mU/L. <h3>Results</h3> A cohort of 135 patients receiving azathioprine were identified. Mean age was 43 years (SD 17), M:F ratio 1:1. 72 patients (53%) had Crohn’s disease, 60 (44%) ulcerative colitis and 3 (3%) indeterminate colitis. Mean starting dose of AZA 1.7 mg/kg (SD 0.6), maintenance dose 1.8 mg/kg (SD 0.5). 63 (47%) were initially dosed with ≥ 2.0 mg/kg. The mean TPMT level was 100 mU/L (SD 23); 14 patients (10%) had low levels. Patients with low TPMT levels were generally started at lower doses of AZA 1.3 mg/kg (SD 0.7) vs 1.8 mg/kg (SD 0.6). Mean length of follow up on AZA was 10.6 months (range 0.1 – 44). 50 out of 135 patients (37%) exhibited adverse effects during treatment (representing 44 of the 121 (36%) with normal TPMT levels, 6 of 14 (43%) with low TPMT). Median time to adverse effects was 3 months (range 0.1–22). Leucopenia developed in 11 (22%), deranged liver biochemistry 24 (48%), adverse symptoms 24 (48%). There was one case of pancreatitis and lymphoma respectively. Adverse effects were managed by discontinuation in 30 (60%), dose reduction 14 (28%), monitoring only 6 (12%). In the 6 patients with low TPMT levels, 4 developed deranged liver biochemistry and 2 had leucopenia; in 50% AZA was discontinued. The median time to adverse effects was 11 months (range 2–22), with 5 out of 6 patients developing adverse effects after more than 6 months of treatment. <h3>Conclusion</h3> In our cohort low TPMT enzyme activity was not associated with an early onset of adverse effects or an excess of adverse effects when compared to the normal TPMT group. We would suggest that the value of TPMT level testing prior to thiopurine therapy may be less of a priority than vigilant monitoring of blood parameters during AZA therapy in identifying serious adverse effects. <h3>Disclosure of Interest</h3> None Declared.
Role of miR-26b in carcinoma-associated fibroblasts and effect on migration and invasion of breast cancer epithelial cells
Authors: Eldo Thomas Verghese, Ruth Drury, Caroline Green, Deborah Holliday, Xiaomei Lu, Claire Nash, Valerie Speirs, James Thorne, Helene Thygesen, Alexandre Zougman, Mark A Hull, Andrew M Hanby, Thomas A Hughes
Journal: The Lancet (2014)
Dyspnea secondary to pulmonary hematopoiesis as presenting symptom of myelofibrosis with myeloid metaplasia
Authors: Elisa Rumi, Francesco Passamonti, Emanuela Boveri, Mara De Amici, Cesare Astori, Marta Braschi, Carlo Castagnola, Umberto Magrini, Mario Cazzola, Mario Lazzarino
Journal: American Journal of Hematology (2006)

We report a case of a patient with myelofibrosis with myeloid metaplasia (MMM) who presented with progressive dyspnea of unexplained origin. Splenomegaly, blood smear, and bone marrow findings allowed diagnosis of MMM. High-resolution CT chest scan revealed diffuse septal thickening, while echocardiography and electrocardiogram showed no indirect evidence of pulmonary hypertension. Finally, lung biopsy revealed irregularly distributed interstitial fibrosis with islands of erythroblasts, immature granulocytic elements, and dysplastic megakaryocytes, allowing diagnosis of pulmonary extramedullary hematopoiesis (EMH). The patient received hydroxyurea as cytoreductive agent, obtaining a good hematologic response and an improvement of dyspnea. Note that, in this patient, dyspnea was the first clinical symptom of MMM; the dyspnea was not associated with pulmonary hypertension and improved following cytoreductive treatment. This case points to the importance of suspecting pulmonary EMH when unexplained progressive dyspnea occurs in a patient with MMM. Early recognition of pulmonary EMH may prevent PH and favor a better response to therapy. Am. J. Hematol. 81:124–127, 2006. © 2006 Wiley-Liss, Inc.
Delayed Suture-Line Hemorrhage
Authors: Ira R. Tannenbaum
Journal: JAMA (1971)

<h3>To the Editor.—</h3> Hemorrhage from the suture-line following gastrointestinal anastomoses is a well known phenomenon. Suture-line hemorrhage has been most frequently reported following gastrectomy, with a reported incidence of 3.4%.<sup>1</sup>This hemorrhage is most often secondary to technical failure to control vessels at the site of the anastomosis and usually manifests itself in the immediate postoperative period. Occasionally, this hemorrhage may occur on the sixth to tenth postoperative day, presumably due to sloughing of the inner layer of the anastomotic suture line.<sup>2</sup>This report describes a case of delayed sutureline hemorrhage 29 days following right colectomy and ileotransverse colostomy for carcinoma of the cecum. <h3>Report of a Case.—</h3> An 83-year-old woman underwent right colectomy and ileotransverse colostomy for carcinoma of the cecum (Duke's B classification) on Aug 7, 1970. The anastomosis was performed using a two-layer open technique. There were no intraoperative complications, and the procedure was accomplished
The Acute Abdomen for the Man on the Spot
Authors: Bernard Sigel
Journal: JAMA (1980)

The "man on the spot" for whom this pithy little book is intended is the house officer facing the patient with a possible acute abdomen. Angell begins by explaining his intent to warn, console, and advise the inexperienced surgeon responsible for management decisions often at times when backup support is minimal. The author describes common behavior patterns of both patients and house officers in an emergency setting. A few apt examples, and he has gained the reader's attention with his light-hearted spoof of how pomposity and ritual often belie the house officer's anxiety, fatigue, and lack of experience. There follows a clear and interesting series of statements that can be quickly consulted for advice on many of the problems encountered in caring for the patient with an acute abdomen. The book deals with medical illnesses that resemble the acute abdomen; the diagnosis of free fluid in the peritoneal cavity, perforated
Electrolyte Imbalance after Operation for Pituitary Tumour
Authors: E. A. W. Houghton
Journal: BMJ (1953)

Case Report A coloured houseboy aged 30, of simple, facile, cheerful, and deceitful character, came to hospital complaining of a vague respiratory illness.He had always been of small stature: height, 58+ in. (149cm.); span, 60j in. (154cm.); lower segment, 29 in. (74cm.); upper segment, 291 in.(75 cm.).His neck was markedly --:--_-; webbed (Fig. 2).There was no cubitus valgus.His muscles were ..........very
Hepcidin in human iron disorders: Therapeutic implications
Authors: Antonello Pietrangelo
Journal: Journal of Hepatology (2010)

The discovery of hepcidin has triggered a virtual explosion of studies on iron metabolism and related disorders, the results of which have profoundly changed our view of human diseases associated with excess of iron, iron deficiency or iron misdistribution. Not only has new light been shed on the pathogenesis of these disorders, but therapeutic applications from these advances are now foreseen. The notion that hepcidin excess or deficiency may contribute to the dysregulation of iron homeostasis in hereditary and acquired iron disorders raises the possibility that hepcidin-lowering or enhancing agents may be an effective strategy for curing the main consequences of hepcidinopathies, anemia or iron overload, respectively. Experimental pre-clinical and clinical studies have shown that hepcidin antibodies, agonists or antagonists, cytokine receptor antibodies and small-molecules that modify hepcidin expression also reverse iron abnormalities in vivo, in a number of disease models. While future studies addressing safety and long-term efficacy of hepcidin-targeted treatments will clarify risks and benefits, a new era has begun based on the treatment of disorders of iron homeostasis through the modulation of its regulatory hormone, hepcidin.
Herpes Zoster Vaccine and Older Adults
Authors: Michael B. Rothberg
Journal: JAMA (2011)

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CAP AND GOWN IN MOLIÈRE.
Authors: W. C. TAIT
Journal: JAMA (1906)

In the "<i>Malade Imaginaire</i>," Béralde, who is the mouthpiece of Molière, says to Argan, the imaginary invalid: "Yes, you have but to speak with a gown and cap and any gibberish becomes learning, and any nonsense sense"; and Toinette, the rollicking maid-servant, hastens to add: "There, sir, if it were only for your beard, that goes a great way already, for the beard makes more than half the physician." Béralde is attempting to persuade his brother Argan to become a physician in order to cure him of his infatuation for physic and the physician. But Argan, simple minded and credulous, imagines that in order to be a doctor it is necessary "to study, to know Latin, to understand the diseases and the remedies to apply," an idea that Béralde ridicules, assuring him that he already knows as much as the average physician, without ever having studied medicine, and that cap