tbuckley/cabot-search huggingface dataset:
Genetics of Size at Birth
Authors: David B. Dunger, Clive J. Petry, Ken K. Ong
Journal: Diabetes Care (2007)

Size at birth is strongly related to a number of maternal factors including parity, length of gestation, mother's adult size, and mother's own birth weight (1). The importance of genetic factors has come from studies of monozygous and dizygous twins, where estimates of heritability of birth weight range from 30 to 70% (2,3). Ounsted et al. (4), however, reported that there may be a stronger relationship between the birth weight of the mother and that of the offspring, particularly in infants born with a low birth weight, and that these relationships may vary with parity. These data suggest that not only fetal genes but also genes that regulate the maternal uterine environment could be important in determining size at birth.

Size at birth is the strongest determinant of perinatal survival (5), yet in most populations, mean birth weight is slightly lower than optimal for offspring survival (6). Thus, it would appear that all fetal growth is subject to some degree of restraint by the maternal uterine environment (7), perhaps reflecting the importance to the mother of restricting the nutritional demands of the fetus if it would threaten her survival in times of poor nutrition. Although maternal undernutrition may (8) or may not (9) be a less common determinant of birth weight in contemporary populations, restraint of fetal growth is still evident, particularly in first pregnancies. First babies have a lower birth weight and tend to be thinner than subsequent babies, with a preserved head circumference and length, suggesting reduced adiposity. Postnatally, these babies demonstrate rapid catch-up growth (1). Such a growth pattern is evident in infants whose intrauterine environment has been affected by poor placental function, secondary to maternal hypertension and preeclampsia, but a similar pattern is also evident in uncomplicated pregnancies, where it is predicted by maternal …
In vivo dynamics of intraepidermal CD8+ T cells and CD4+ T cells during the evolution of fixed drug eruption
Authors: Y. Mizukawa, Y. Yamazaki, T. Shiohara
Journal: British Journal of Dermatology (2008)

Although a severe form of fixed drug eruption (FDE) clinically and histologically mimics toxic epidermal necrolysis (TEN), subsequent evolution of the two conditions is quite different. It remains unknown, however, which factors determine whether these lesions resolve spontaneously or subsequently progress to TEN.Because epidermal injury in TEN can be locally reproduced in the evolving FDE lesions, we sought to investigate how epidermal damage can be induced in the evolving FDE lesions and how disease progression to TEN can be prevented, by analysing the FDE lesions induced by clinical challenge with the causative drug.We immunohistochemically investigated in vivo dynamics of T-cell trafficking and activation that occur in the evolving FDE lesions using sequential biopsy specimens obtained at multiple time points from the FDE lesions.Intraepidermal CD8+ T cells, which are resident in the lesional epidermis as a stable homogeneous population of memory T cells, transiently acquire a natural killer-like phenotype and express cytotoxic granules upon activation. The influx into the epidermis of CD4+ T cells including Foxp3+ regulatory T cells (Tregs) during the evolution serves to ameliorate epidermal damage induced by activation of the intraepidermal CD8+ T cells. Interleukin-15 derived from the lesional epidermis could maintain the survival of the intraepidermal CD8+ T cells even in the absence of antigenic stimulus over a prolonged period of time (> 4 years).Whether Tregs could migrate to the lesions upon activation of intraepidermal CD8+ T cells would determine whether the inflammation becomes resolved spontaneously or progresses to TEN.
Sore throat in primary care
Authors: P. Little
Journal: BMJ (2009)

Steroids reduce pain in the first day, but data on harms are lacking

In the linked study (doi:10.1136/bmj.b2976), Hayward and colleagues report a useful and well performed systematic review in a highly topical area.1 Clinicians and patients need information about interventions other than antibiotics for sore throat for several reasons—the benefit of antibiotics for most patients is modest2 3; the use of antibiotics should be minimised because of the danger of resistance3 4; and other effective treatments, apart from the use of analgesics, anti-inflammatory drugs,5 and possibly Echinacea , are lacking.6 This systematic review provides evidence that in the first 24 hours steroids may help resolve pain (the likelihood of resolution was increased threefold, number needed to treat (NNT) 3.7) and reduce the mean time to onset of pain relief by six hours. Furthermore, given that most patients in the included studies had antibiotics, although …
Interleukin 4 inhibits in vitro proliferation of leukemic and normal human B cell precursors.
Authors: D Pandrau, S Saeland, V Duvert, I Durand, A M Manel, M T Zabot, N Philippe, J Banchereau
Journal: Journal of Clinical Investigation (1992)

In the present study, we have investigated the effects of IL-4 on the proliferation and differentiation of leukemic and normal human B cell precursors (BCP). We have demonstrated that IL-4 significantly inhibited spontaneous [3H]thymidine ([3H]-TdR) incorporation by leukemic blasts from some B lineage acute lymphoblastic leukemia (BCP-ALL) patients (8 of 14). Furthermore, IL-4 was found to suppress the spontaneous and factor-dependent (IL-7 and IL-3) proliferation of normal BCP (CD10+ surface [s] IgM- cells) isolated from fetal bone marrow. Maximum growth inhibition of either leukemic or normal BCP was reached at low IL-4 concentrations (10 U/ml), and the effect was specifically neutralized by anti-IL-4 antibody. IL-4 was further found to induce the expression of CD20 antigen on BCP-ALL cells from a number of the cases examined (5 of 8), but in contrast to leukemic cells, IL-4 failed to induce CD20 antigen on normal BCP. Finally, IL-4 was found to induce neither the expression of cytoplasmic mu chain, nor the appearance of sIgM+ cells in cultures of normal or leukemic BCP. Our data indicate that IL-4 has the potential to inhibit cell proliferation in leukemic and normal human B lymphopoiesis but is unable to drive the transition from BCP to mature B cells.
Serum leptin in NASH correlates with hepatic steatosis but not fibrosis: A manifestation of lipotoxicity?
Authors: Shivakumar Chitturi, Geoffrey Farrell, Linda Frost, Adamandia Kriketos, Rita Lin, Christopher Liddle, Dev Samarasinghe, Jacob George
Journal: Hepatology (2002)

Nonalcoholic steatohepatitis (NASH) is a disorder characterized by hepatic steatosis, inflammation, and fibrosis. Leptin is an adipocyte-derived antiobesity hormone that in rodents prevents "lipotoxicity" by limiting triglyceride accumulation and also regulates matrix deposition (fibrosis) during wound healing. We therefore determined serum leptin levels in patients with NASH to determine whether relationships existed between leptin levels and severity of hepatic steatosis or fibrosis. We used a radioimmunoassay to determine serum [total] leptin concentrations in 27 men and 20 women with NASH and 47 controls matched for gender and body mass index (BMI; and partly for age). Serum leptin values were correlated with hepatic steatosis, fibrosis, and inflammation (each categorized semiquantitatively on liver histology), and with anthropometric indices, serum lipids, glucose, insulin, c-peptide, and alanine aminotransferase (ALT) levels. Compared with the controls, mean serum leptin levels were raised in both men and women with NASH (men 14 +/- 11 ng/mL vs. 7.2 +/- 4.1 ng/mL, P =.003; women 35 +/- 16 ng/mL vs. 15 +/- 8.2 ng/mL, P <.001). Leptin values correlated with serum c-peptide levels but not with BMI. In a multivariate analysis, serum leptin (P =.027), serum c-peptide (P =.001), and age (P =.027) were selected as independent predictors of the severity of hepatic steatosis. However, serum leptin was not an independent predictor of hepatic inflammation or fibrotic severity. In conclusion, hyperleptinemia occurs in NASH and is not explained simply by gender, obesity, or the presence of type 2 diabetes. Furthermore, leptin levels correlate directly with the severity of hepatic steatosis but not with inflammation or fibrosis. We propose that the relationship between leptin and steatosis reflects a pathogenic role of leptin in hepatic insulin resistance and/or a failure of the antisteatotic actions of leptin ("peripheral leptin resistance").
Electroencephalographic Prediction of Fatal Anoxic Brain Damage after Resuscitation from Cardiac Arrest
Authors: C. D. Binnie, P. F. Prior, D. S. L. Lloyd, D. F. Scott, J. H. Margerison
Journal: BMJ (1970)

Ninety-three electroencephalograms (E.E.G.s) were recorded within a week of cardiac resuscitation from 41 patients in whom the subsequent outcome was known to be either recovery of cerebral function or death with associated pathological evidence of gross anoxic brain damage. A statistical analysis of observations on these E.E.G.s yielded a discriminant function for predicting death or survival. Predictions based on each of the 93 individual E.E.G.s would have been correct in 92 and at a confidence level better than 99%. The same discriminant function was found to be applicable to a further 19 patients who died but did not undergo neuropathological studies and to 33 others in whom the clinical picture was complicated by such factors as uraemia or head injury. Thus it seems that the presence or absence of fatal brain damage after cardiac arrest can be reliably predicted from E.E.G.s taken within a week of resuscitation. An estimate of the probability of survival is now routinely included in the clinical report on each E.E.G. taken after cardiac arrest.
Problems of Chance in Medicine
Authors: L. J. A. Loewenthal, W. A. Wilson
Journal: BMJ (1939)

<h3>Background</h3> Ultrasound-guided techniques improve outcomes in regional anesthesia when compared with traditional techniques; however, this assertion has not been studied with novices. The primary objective of this study was to compare sensory and motor block after axillary brachial plexus block when performed by novice trainees allocated to an ultrasound- or nerve–stimulator-guided group. A secondary objective was to compare the rates of skill acquisition between the 2 groups. <h3>Methods</h3> This study was a prospective, randomized, observer-blinded, 2-arm controlled trial. Anesthesia trainees participating in this trial were novices to axillary brachial plexus block and sonography. All trainee participants underwent a standardized training program. The primary outcome was combined sensory and motor block in the relevant territories 30 minutes after completion of block. A global rating scale was used to assess trainee block performance. <h3>Results</h3> The study was ceased after 12 trainees completed 153 blocks. There was no difference between groups in combined motor-sensory score (<i>P</i> = 0.28) or as a function of block number (<i>P</i> = 0.38). There was no difference in onset between groups (<i>P</i> = 0.38). In both groups, there was an increase in the global rating scale score (<i>P</i> &lt; 0.0001) and reduced preblock survey and block performance times (<i>P</i> = 0.001) with experience. <h3>Conclusions</h3> We were unable to demonstrate a difference in the efficacy of axillary brachial plexus block performed by novices when ultrasound guidance was compared with a nerve stimulator technique. There was evidence of similarly improved clinical performance of novices in both groups.
Report details how to slash administrative costs in US healthcare
Authors: B. Roehr
Journal: BMJ (2012)

US healthcare administrative costs could be cut by at least a quarter, or $40bn (£26bn; €32bn), a year through integration, coordination, and leadership, according to a report by a pair of Harvard economists and a hospital doctor with close ties to the Obama administration.

“The most common occupation in healthcare [in the US] is office support,” which is an indictment of the scope of the problem, said senior author David Cutler. He was speaking at a forum on 11 June in Washington, DC, at the think tank Center for American Progress, where the report was released.

“If you look at other industries, they are all much more efficient …
Pharmacogenetics of abacavir hypersensitivity: A systematic review and meta-analysis of the association with HLA-B*57:01
Authors: Bernardo Sousa-Pinto, João Pinto-Ramos, Cláudia Correia, Gustavo Gonçalves-Costa, Lídia Gomes, Sara Gil-Mata, Luís Araújo, Luís Delgado
Journal: Journal of Allergy and Clinical Immunology (2015)
Radiographic abnormalities in tuberculosis and risk of coexisting human immunodeficiency virus infection. Methods and preliminary results from Bujumbura, Burundi.
Authors: N Mlika-Cabanne, M Brauner, G Kamanfu, P Grenier, E Nikoyagize, P Aubry, B Larouzé, J F Murray
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

We evaluated the age profile and chest radiographic abnormalities in 158 patients from Bujumbura, Burundi, with new-onset intrathoracic tuberculosis (pulmonary, pleural, or hilar/mediastinal adenopathy), to identify features that were associated with and would allow prediction of HIV seropositivity or seronegativity. Using agreed-upon criteria and prepared reporting forms, initial chest radiographs were reviewed by three readers, first independently and then at a consensus conference. Of the 158 patients, 105 (66%) were HIV seropositive and 53 patients were seronegative. Seropositive subjects (mean age, 35.8 yr) were older (p = 0.001) than seronegative subjects (mean age, 29.4 yr). Significant or borderline differences between HIV-seropositive and -seronegative patients included the frequency of small nodular lesions (p = 0.03), upper lobe cavitation (p = 0.05), and lymphadenopathy (p = 0.12), and the location of parenchymal abnormalities (p = 0.0006). Stepwise logistic regression revealed four important variables: age, small lesions, location, and lymphadenopathy; these were then used to derive an equation to calculate the probability that a given tuberculosis patient was HIV seropositive. Our mathematical model fit the observed data and the equation predicted serologic findings reasonably well. We conclude that it is possible to determine with useful probability a Burundian tuberculosis patient's HIV serologic status.
Trends in obesity
Authors: G. B. Gori
Journal: Journal of the Royal Society of Medicine (2006)

Ezzati et al. (May 2006 JRSM 1 ) misplace their confidence by a wide margin in claiming to have reached the first 'unbiased' estimates of state and national levels and trends of obesity in the USA.To do so, they claim to have calculated rates of self-reporting biases using data from the NHANES (National Health and Nutrition Examination Survey) and Behavioral Risk Factor Surveillance System (BRFSS) surveys of the US Center for Disease Control and Prevention, which were assumed to be representative of the USA population on the basis of the original sampling design.In reality the assumption is questionable, the response rates being about 80% for NHANES and 45% for BRFSS.If nothing else, such a discrepancy sets a distance between what the two surveys may represent, also considering that the surveys represent different samples.In a crucial decision, Ezzati et al. excluded subjects who did not participate in both surveys-an exclusion that inevitably invalidates any claim that the bias estimates reached could be representative of the USA population or of individual state populations.Such elementary flaws lead to ask how scarce resources could be approved for such a wanting study design.
Valproic acid and fetal abnormality.
Authors: C J Bailey, R W Pool, E M Poskitt, F Harris
Journal: BMJ (1983)

dose 54 units/day).All 10 patients had been issued with a further appoint- ment.Three were subsequently admitted as emergencies, and seven returned to the clinic.Eleven patients (eight men, three women; age range 40-71, mean 56) were under the supervision of their general practitioner, who did not know why they had ceased to attend.Seven patients were on a diet, all but one were also receiving tablets.The remaining four were being treated with insulin (mean dose 38 units/day); none were aged under 30 and three were in the range 30-50.Nine patients were issued with a further appointment.Four were contacted through the district nurse, who took blood samples for estimation of haemoglobin A1 (HbA,) (upper limit of normal 8-5 g/dl).One patient, whose HbA, concentration was 5-6 g/dl said he had been told by the doctor not to return to the clinic.Two patients (with HbA, concentrations of 9.9 g/dl and 7-5 g/dl) said they did not attend unless they felt unwell.The fourth patient (HbA, 14-9 g/dl) thought everything was under control.The remaining three non-attenders (one man, two women; age range 36-55, mean 46) were under no supervision, and their general practitioner did not know why they had ceased to attend.One was on a diet and two were being treated with tablets.Two had been given another appointment.
Serum Cholesterol and Colon Cancer
Authors: Albert B. Lowenfels
Journal: JAMA (1981)

To the Editor.—  It is difficult to explain the intriguing negative correlation between serum cholesterol level and colon cancer as noted by Williams and co-workers (1981;245:247). One possibility might be that for some persons, low serum cholesterol level is associated with excess cholesterol excretion that could act as a promoter for colon cancer, as suggested by Cruse et al. 1 The World Health Organization clofibrate study tends to support this hypothesis, since pharmacologic lowering of serum cholesterol level increased the risk of bowel cancer. 2 The presumption is that cholesterol excretion was also increased, since there was a definite increase in gallstone-related disease. It would be most interesting to find out if there is any relation between gallstones, serum cholesterol level, and colon cancer in the Framingham group of patients.
Comparison of Drug-Eluting Stents and Coronary Artery Bypass Surgery for the Treatment of Multivessel Coronary Disease
Authors: Yan Li, Zhe Zheng, Bo Xu, Shiju Zhang, Wei Li, Runlin Gao, Shengshou Hu
Journal: Circulation (2009)

Background— Numerous studies have compared the outcomes of coronary artery bypass grafting (CABG) surgery and coronary stenting for the treatment of multivessel coronary disease. In 2003, drug-eluting stents were introduced with the hope of reducing restenosis. However, limited information exists on the comparison of drug-eluting stents and CABG surgery. The long-term outcome of drug-eluting stents compared with that of CABG surgery is also unclear. Methods and Results— We identified 3720 consecutive patients with multivessel disease who underwent isolated CABG surgery or received drug-eluting stents between April 1, 2004, and December 31, 2005, and we compared safety (total mortality, myocardial infarction, and stroke) and efficacy (target-vessel revascularization) during a 3-year follow-up. These outcomes were compared after adjustment for differences in baseline risk factors. Patients who underwent CABG (n=1886) were older and had more comorbidities than patients who received drug-eluting stents (n=1834). Patients receiving drug-eluting stents had considerably higher 3-year rates of target-vessel revascularization. Drug-eluting stents were also associated with higher rates of death (adjusted hazard ratio, 1.62; 95% confidence interval, 1.07 to 2.47) and myocardial infarction (adjusted hazard ratio, 1.65; 95% confidence interval, 1.15 to 2.44). The risk adjusted rate of stroke was similar in the 2 groups (hazard ratio, 0.92; 95% confidence interval, 0.69 to 1.51). Conclusions— In a cohort of patients with multivessel disease, CABG was associated with lower rates of death, myocardial infarction, and target-vessel revascularization than drug-eluting stents.
Hevein-like domain IV in wheat germ agglutinin (WGA) is responsible for the majority of IgE cross-reactivity between WGA and hevein (Hev b 6.02)
Authors: P. Karisola, H. Alenius, K. Turjanmaa, T. Reunala, N. Kalkkinen, T. Palosuo, M. Kulomaa
Journal: Journal of Allergy and Clinical Immunology (2003)
Intradermal immunization with rabies vaccine. Inactivated Wistar strain cultivated in human diploid cells
Authors: N. Ajjan
Journal: JAMA (1980)

We report a comparative study of the Mérieux Institute's inactivated rabies vaccine administered intradermally or subcutaneously. Vaccine safety was satisfactory, with only minor local and generalized reactions. Serological effectiveness was outstanding: all of those who had been seronegative became seropositive following either two intradermal or subcutaneous injections given one month apart. A comparison of the intradermal and subcutaneous routes demonstrated several important points. Antibody titers developing after subcutaneous immunization were greater than after intradermal immunization. The kinetics of antibody development during primary immunization were parallel in the two immunization protocols. Eleven months after primary immunization, subcutaneous administration of a booster dose of vaccine resulted in a titer elevation 1.86-fold greater than that in intradermal administration. Each of these levels indicated good serological response.
A Prospective Assessment of Reports of Drinking to Self-medicate Mood Symptoms With the Incidence and Persistence of Alcohol Dependence
Authors: Rosa M. Crum, Ramin Mojtabai, Samuel Lazareck, James M. Bolton, Jennifer Robinson, Jitender Sareen, Kerry M. Green, Elizabeth A. Stuart, Lareina La Flair, Anika A. H. Alvanzo, Carla L. Storr
Journal: JAMA Psychiatry (2013)

Mood disorders and alcohol dependence frequently co-occur. Etiologic theories concerning the comorbidity often focus on drinking to self-medicate or cope with affective symptoms. However, there have been few, if any, prospective studies in population-based samples of alcohol self-medication of mood symptoms with the occurrence of alcohol dependence. Furthermore, it is not known whether these associations are affected by treatment or symptom severity.To evaluate the hypothesis that alcohol self-medication of mood symptoms increases the probability of subsequent onset and the persistence or chronicity of alcohol dependence.Prospective study using face-to-face interviews-the National Epidemiologic Survey on Alcohol and Related Conditions.Nationally representative survey of the US population.Drinkers at risk for alcohol dependence among the 43 093 adults surveyed in 2001 and 2002 (wave 1); 34 653 of whom were reinterviewed in 2004 and 2005 (wave 2).Association of alcohol self-medication of mood symptoms with incident and persistent DSM-IV alcohol dependence using logistic regression and the propensity score method of inverse probability of treatment weighting.The report of alcohol self-medication of mood symptoms was associated with an increased odds of incident alcohol dependence at follow-up (adjusted odds ratio [AOR], 3.10; 95% CI, 1.55-6.19; P = .002) and persistence of dependence (AOR, 3.45; 95% CI, 2.35-5.08; P < .001). The population-attributable fraction was 11.9% (95% CI, 6.7%-16.9%) for incident dependence and 30.6% (95% CI, 24.8%-36.0%) for persistent dependence. Stratified analyses were conducted by age, sex, race/ethnicity, mood symptom severity, and treatment history for mood symptoms.Drinking to alleviate mood symptoms is associated with the development of alcohol dependence and its persistence once dependence develops. These associations occur among individuals with subthreshold mood symptoms, with DSM-IV affective disorders, and for those who have received treatment. Drinking to self-medicate mood symptoms may be a potential target for prevention and early intervention efforts aimed at reducing the occurrence of alcohol dependence.