tbuckley/cabot-search huggingface dataset:
Immune-mediated complications of the graft in interferon-treated hepatitis C positive liver transplant recipients
Authors: Nazia Selzner, Maha Guindi, Eberhard L. Renner, Marina Berenguer
Journal: Journal of Hepatology (2010)

Hepatitis C virus (HCV) re-infection of the graft is universal and interferon based antiviral therapy remains at present the treatment of choice in HCV liver transplant recipients. Apart from the antiviral effects, interferon and ribavirin have both potent immunomodulatory properties resulting in a broad range of immune-related disorders including acute cellular rejection and chronic ductopenic rejection as well as de novo autoimmune hepatitis. Further complicating the picture, HCV infection per se is associated with a variety of autoimmune phenomena. We discuss here the immune-mediated complications and their relationship to chronic HCV and interferon based antiviral therapy.
Marmot says government can't afford to ignore health inequality
Authors: H. Mooney
Journal: BMJ (2010)

The cost of not tackling inequalities in health care is so great that it is “not an option,” Michael Marmot, author of the recent government commissioned report ( BMJ 2010;340:c818, doi:10.1136/bmj.c818), said at a conference in London on 12 February.

Professor Marmot told the conference, organised by the Marmot Review Group at University College London, that the economic case for improving the public’s health was clear. He said, “It is part of the government’s policy to prolong the working age [to 68], but most people won’t achieve this age disability free.”

“The cost of doing nothing is not an option as it is too large,” …
The clinical importance of adrenal insufficiency in acute hepatic dysfunction
Authors: Rachael Harry, Georg Auzinger, Julia Wendon
Journal: Hepatology (2002)

Acute liver failure and septic shock share many clinical features, including hyperdynamic cardiovascular collapse. Adrenal insufficiency may result in a similar cardiovascular syndrome. In septic shock, adrenal insufficiency, defined using the short synacthen test (SST), is associated with hemodynamic instability and poor outcome. We examined the SST, a dynamic test of adrenal function, in 45 patients with acute hepatic dysfunction (AHD) and determined the association of these results with hemodynamic profile, severity of illness, and outcomes. Abnormal SSTs were common, occurring in 62% of patients. Those who required noradrenaline (NA) for blood pressure support had a significantly lower increment (median, 161 vs. 540 nmol/L; P <.001) following synacthen compared with patients who did not. Increment and peak were lower in patients who required ventilation for the management of encephalopathy (increment, 254 vs. 616 nmol/L, P <.01; peak, 533 vs. 1,002 nmol/L, P <.01). Increment was significantly lower in those who fulfilled liver transplant criteria compared with those who did not (121 vs. 356 nmol/L; P <.01). Patients who died or underwent liver transplantation had a lower increment (148 vs. 419 nmol/L) and peak (438 vs. 764 nmol/L) than those who survived (P <.01). There was an inverse correlation between increment and severity of illness (Sequential Organ Failure Assessment, r = -0.63; P <.01). In conclusion, adrenal dysfunction assessed by the SST is common in AHD and may contribute to hemodynamic instability and mortality. It is more frequent in those with severe liver disease and correlates with severity of illness.
Care of a Diphtheria Epidemic.
Authors: Josiah S. Bowen
Journal: JAMA (1904)

Mt. Washington, Md., Dec. 7, 1904. <h3>To the Editor:</h3> —InThe JournalDec. 3, 1904, p. 1709, it is stated that diphtheria is prevalent in East Coventry and in the northern section of Chester County. I write this in order that the medical profession of that community may profit by our experience here and so be enabled to stamp out the disease. In this community of 1,400 inhabitants this terrible disease has been epidemic for the past 16 months. The disease has attacked all classes. Last winter the school in the immediate neighborhood was closed two months on account of this malady. At the beginning of this school term it was thought that the trouble might be gotten rid of by the public schools. The trustees of our school, one of whom is our most eminent physician, consulted the school board and the county commissioners and made special arrangements with
Superiority of Biphasic Over Monophasic Defibrillation Shocks Is Attributable to Less Intracellular Calcium Transient Heterogeneity
Authors: Gyo-Seung Hwang, Liang Tang, Boyoung Joung, Norishige Morita, Hideki Hayashi, Hrayr S. Karagueuzian, James N. Weiss, Shien-Fong Lin, Peng-Sheng Chen
Journal: Journal of the American College of Cardiology (2008)
Cost-Utility Analysis of Screening Intervals for Diabetic Retinopathy in Patients With Type 2 Diabetes Mellitus
Authors: Sandeep Vijan
Journal: JAMA (2000)

ContextAnnual eye screening for patients with diabetes mellitus is frequently proposed as a measure of quality of care. However, the benefit of annual vs less frequent screening intervals has not been well evaluated, especially for low-risk patients.ObjectiveTo examine the marginal cost-effectiveness of various screening intervals for eye disease in patients with type 2 diabetes, stratified by age and level of glycemic control.DesignMarkov cost-effectiveness model.Setting and ParticipantsHypothetical patients based on the US population of diabetic patients older than 40 years from the Third National Health and Nutrition Examination Survey.Main Outcome MeasuresPatient time spent blind, quality-adjusted life-years (QALYs), and costs of annual vs less frequent screening compared by age and level of hemoglobin A1c.ResultsRetinal screening in patients with type 2 diabetes is an effective intervention; however, the risk reduction varies dramatically by age and level of glycemic control. On average, a high-risk patient who is aged 45 years and has a hemoglobin A1c level of 11% gains 21 days of sight when screened annually as opposed to every third year, while a low-risk patient who is aged 65 years and has a hemoglobin A1c level of 7% gains an average of 3 days of sight. The marginal cost-effectiveness of screening annually vs every other year also varies; patients in the high-risk group cost an additional $40,530 per QALY gained, while those in the low-risk group cost an additional $211,570 per QALY gained. In the US population, retinal screening annually vs every other year for patients with type 2 diabetes costs $107,510 per QALY gained, while screening every other year vs every third year costs $49,760 per QALY gained.ConclusionsAnnual retinal screening for all patients with type 2 diabetes without previously detected retinopathy may not be warranted on the basis of cost-effectiveness, and tailoring recommendations to individual circumstances may be preferable. Organizations evaluating quality of care should consider costs and benefits carefully before setting universal standards.
Proposed classification of lymphoid neoplasms for epidemiologic research from the Pathology Working Group of the International Lymphoma Epidemiology Consortium (InterLymph)
Authors: Lindsay M. Morton, Jennifer J. Turner, James R. Cerhan, Martha S. Linet, Patrick A. Treseler, Christina A. Clarke, Andrew Jack, Wendy Cozen, Marc Maynadié, John J. Spinelli, Adele Seniori Costantini, Thomas Rüdiger, Aldo Scarpa, Tongzhang Zheng, Dennis D. Weisenburger
Journal: Blood (2007)
Creativity and the Arts in Health Care Settings
Authors: Annette Ridenour
Journal: JAMA (1998)

As a medical student, I often hear comments such as "medicine is both art and science."I rarely see the incorporation of the creative arts in daily medical practice.This issue of Pulse presents new perspectives on the value of the arts in medical therapy, healing, and recovery.Exactly how the arts improve a patient's condition has yet to be answered.Perhaps the value of art in medical practice is best gleaned from the stories of those actively incorporating it into their lives.Annette Ridenour reviews the changes in how medical institutions incorporate art into health care delivery.The goal of Patch Adams, MD, is to transform the lives of his patients through clowning.When he writes about his encounter with a young, bed-ridden Russian girl, one no longer wonders just how creative a physician can be with patients in order to relieve their suffering.Next, Pamela Cruze recounts the creation of the sculpture Night Light with artist Christiane Corbat.Recovering from breast cancer, Cruze took the process of creating a piece of art as an invitation to influence her healing process.Finally, Eric W. Ring, MD, remembers lessons from his clerkship during medical school.Ring found the act of writing about difficult situations to be therapeutic.Like Cruze, he used the creative process-in this case the act of writing a fictionalized account-to transform past events into experiences he then was able to better understand.His story and the others illustrate the power the creative arts hold for patients as well as practitioners.
A subject-specific technique for respiratory motion correction in image-guided cardiac catheterisation procedures
Authors: A.P. King, R. Boubertakh, K.S. Rhode, Y.L. Ma, P. Chinchapatnam, G. Gao, T. Tangcharoen, M. Ginks, M. Cooklin, J.S. Gill, D.J. Hawkes, R.S. Razavi, T. Schaeffter
Journal: Medical Image Analysis (2009)
HIV positive patients first presenting with an AIDS defining illness: characteristics and survival
Authors: M. C Poznansky, R. Coker, C. Skinner, A. Hill, S. Bailey, L. Whitaker, A. Renton, J. Weber
Journal: BMJ (1995)

<h3>Abstract</h3> <b>Objectives</b>: To study the presentation and survival of patients who present with their first diagnosis of being HIV positive at the same time as their AIDS defining illness. <b>Design</b>: Retrospective study of patients presenting with AIDS between 1991 and 1993. <b>Setting</b>: Department of genitourinary medicine, St Mary9s Hospital, London. <b>Main outcome measures</b>: AIDS defining illness at presentation and survival after diagnosis of AIDS. <b>Results</b>: Between January 1991 and December 1993, 97 out of 436 patients (22%) presented with their first AIDS defining illness coincident with their first positive result of an HIV test (group B). The remaining 339 patients (78%) had tested positive for HIV-1 infection within the previous eight years and had consequently been followed up in clinics before developing their first AIDS defining illness (group A). The two groups of patients did not differ in age and sex distribution, risk factors for HIV-1 infection, nationality, country of origin, or haematological variables determined at the time of the AIDS defining illness. However, the defining illnesses differed between the two groups. Illnesses associated with severe immunodeficiency (the wasting syndrome, cryptosporidiosis, and cytomegalovirus infection) were seen almost exclusively in group A whereas extrapulmonary tuberculosis and Pneumocystis carinii pneumonia were more common in group B. The survival of patients in group B after the onset of AIDS was significantly longer than that of patients in group A as determined by Kaplan-Meier log rank analysis (P=0.0026). <b>Conclusions</b>: Subjects who are HIV positive and present late are a challenge to the control of the spread of HIV infection because they progress from asymptomatic HIV infection to AIDS without receiving health care. The finding that presentation with an AIDS defining illness coincident with a positive result in an HIV test did not have a detrimental effect on survival gives insights into the effects of medical intervention on disease progression after a diagnosis of AIDS.
The diaphragm: contractile properties and fatigue.
Authors: D F Rochester
Journal: Journal of Clinical Investigation (1985)

Pdi breath, mean Pdi developed in one breath; Pdi max, maximal Pdi developed during a voluntary effort against a closed airway; P0, maximal force per unit of diaphragm muscle cross-sectional area; 1/2 RT, one half relaxation time; Ti/Ttot, ratio of inspiratory to total breath duration; T/lim, time at which contractile force fails; TPT, time to peak tension; Tr, time constant of the later monoexponential phase of relaxation; TTdi, tension-time index of diaphragm; V, lung volume.
Emotional distress in junior doctors
Authors: C J Burns-Cox, K Kearsey, J B M Roberts
Journal: BMJ (1987)

immunisation.This difference was significant (p= <0 005, x2 analysis).While it is assumed that half of those women might have a live birth after numerous additional abortions, these abortions may be prevented by immunotherapy.Moreover, women who have had one spontaneous abortion who have their immune response altered by immunotherapy seem to have second subsequently successful pregnancies.(This has occurred in all five patients who have become pregnant a second time in our series.)Though such women have spontaneously successful pregnancies, however, they seem to revert to their tendency to abort afterwards.Nine patients in our series had two or more abortions after a spontaneously successful pregnancy.Only one patient had two subsequently successful pregnancies after one spontaneous abortion.We therefore consider immunotherapy to be a most effective form of treatment for women who have had missed abortions, and the results of Drs Vlaanderen and Treffers do not convince us other- wise.
Interaction of CagA with Crk plays an important role in <i>Helicobacter pylori</i>–induced loss of gastric epithelial cell adhesion
Authors: Masato Suzuki, Hitomi Mimuro, Toshihiko Suzuki, Morag Park, Tadashi Yamamoto, Chihiro Sasakawa
Journal: The Journal of Experimental Medicine (2005)

CagA protein is a major virulence factor of Helicobacter pylori, which is delivered into gastric epithelial cells and elicits growth factor–like responses. Once within the cells, CagA is tyrosine phosphorylated by Src family kinases and targets host proteins required to induce the cell responses. We show that the phosphorylated CagA binds Crk adaptor proteins (Crk-II, Crk-I, and Crk-L) and that the interaction is important for the CagA-mediated host responses during H. pylori infection. H. pylori–induced scattering of gastric epithelial cells in culture was blocked by overexpression of dominant-negative Crk and by RNA interference–mediated knockdown of endogenous Crk. H. pylori infection of the gastric epithelium induced disruption of E-cadherin/catenin–containing adherens junctions, which was also dependent on CagA/Crk signaling. Furthermore, inhibition of the SoS1/H-Ras/Raf1, C3G/Rap1/B-Raf, or Dock180/Rac1/Wiskott-Aldrich syndrome protein family verprolin homologous protein pathway, all of which are involved downstream of Crk adaptors, greatly diminished the CagA-associated host responses. Thus, CagA targeting of Crk plays a central role in inducing the pleiotropic cell responses to H. pylori infection that cause several gastric diseases, including gastric cancer.
Rheumatoid Arthritis and Epstein-Barr Virus
Authors: RICHARD P. HANDLER
Journal: Annals of Internal Medicine (1985)

Letters and Corrections1 June 1985Rheumatoid Arthritis and Epstein-Barr VirusRICHARD P. HANDLER, M.D.RICHARD P. HANDLER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-102-6-865_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Perhaps Dr. Steinberg or the other participants in the recent National Institutes of Health conference (1) will comment on any experience they have had with Epstein-Barr virus infection in patients with established rheumatoid arthritis. Because this complication can occur, is it not strong evidence against the etiologic role of Epstein-Barr virus in at least certain cases of rheumatoid arthritis?One of my patients developed juvenile rheumatoid arthritis at age 8. At age 20 she had an acute febrile illness with profound tonsilitis, fatigue, atypical lymphocytosis, and a positive Monospot test. She recovered fully. Now age 37, she...Reference1. DECKERMALONEHARAOUI JDB. Rheumatoid arthritis: evolving concepts of pathogenesis and treatment. Ann Intern Med. 1984;101:810-24. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1985Volume 102, Issue 6Page: 865-865KeywordsEpstein-Barr virusFatigueRheumatoid arthritis Issue Published: 1 June 1985 PDF DownloadLoading ...
Expression of Human Tissue Factor Pathway Inhibitor on Vascular Smooth Muscle Cells Inhibits Secretion of Macrophage Migration Inhibitory Factor and Attenuates Atherosclerosis in ApoE <sup>−/−</sup> Mice
Authors: Daxin Chen, Min Xia, Claudia Hayford, El-Li Tham, Vikki Semik, Stuart Hurst, Ying Chen, Henry H. Tam, Jun Pan, Yucheng Wang, Xiaojin Tan, Hui-Yao Lan, Huahao Shen, Vijay V. Kakkar, Qingbo Xu, John H. McVey, Anthony Dorling
Journal: Circulation (2015)

Tissue factor (TF) and coagulation proteases are involved in promoting atherosclerosis, but the molecular and cellular bases for their involvement are unknown.We generated a new strain (ApX4) of apolipoprotein E-deficient mice expressing a membrane-tethered human tissue factor pathway inhibitor fusion protein on smooth muscle actin-positive cells, including vascular smooth muscle cells (SMCs). ApX4 mice developed little atherosclerosis on either a normal chow or high-fat diet. Lipid levels were similar to those in parental ApoE(-/-) mice, and there was no detectable difference in systemic (circulating) tissue factor pathway inhibitor levels or activity. The small lipid-rich lesions that developed had markedly reduced leukocyte infiltrates, and in contrast to ApoE(-/-) mice, SMCs did not express macrophage migratory inhibitory factor (MIF), including at sites distant from atheromatous lesions. Low levels of circulating MIF in ApX4 mice normalized to levels seen in ApoE(-/-) mice after injection of an inhibitory anti-human tissue factor pathway inhibitor antibody, which also led to MIF expression by tissue factor-positive medial SMCs. MIF production by SMCs in ApoE(-/-) mice in vitro and in vivo was shown to be dependent on tissue factor and protease-activated receptor signaling, which were inhibited in ApX4 mice.Our data indicate that tissue factor plays a hitherto unreported role in the generation of MIF by SMCs in atherosclerosis-prone ApoE(-/-) mice, inhibition of which significantly prevents the development of atherosclerosis, through inhibition of leukocyte recruitment. These data significantly enhance our understanding of the pathophysiology of this important pathology and suggest new potential translational strategies to prevent atheroma formation.
Screening tests III
Authors: P. Sedgwick
Journal: BMJ (2009)

The performance of digital mammography as a screening tool for breast cancer was investigated in premenopausal and perimenopausal women. Digital mammography returned a “screen positive” or “screen negative” result. Breast cancer status was diagnosed by biopsy (gold standard). Digital mammography was reported to have a sensitivity of 47%, specificity of 97%, and positive predictive value of 10%.1 Which of the following statements, if any, are true?
Experimental hypersensitivity pneumonitis. Effect of CD4 cell depletion.
Authors: M Schuyler, K Gott, B Edwards, K J Nikula
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

We previously demonstrated that Thy1.2+, CD4+, Ia-T cells are responsible for transfer of adoptive murine experimental hypersensitivity pneumonitis (adoptive EHP). To characterize the cells responsible for development of pulmonary inflammation in the recipient animals, we depleted recipients of CD4+ cells using monoclonal antibody GK1.5 before administration of Micropolyspora faeni-sensitized cultured C3H/HeJ spleen cells (SC) and intratracheal (i.t.) challenge with M. faeni. We also used the same depletion technique to determine the contribution of these cells to the pulmonary response to i.t. M. faeni in animals that did not receive cultured cells (direct EHP). The nature and extent of pulmonary inflammatory changes in these animals were assayed either 4 days after i.t. challenge with M. faeni in adoptive EHP or 2 days after i.t. challenge with M. faeni in direct EHP. Cultured M. faeni-sensitized SC could transfer EHP to naive animals or those treated with an irrelevant antibody. Depletion of CD4+ cells ablated the ability of recipient animals to express adoptive EHP. Two days after i.t. M. faeni (direct EHP), there was extensive neutrophilic infiltration of the lung that was not affected by depletion of CD4+ cells. We conclude that the ability to express adoptive EHP is dependent on the presence of CD4+ cells. In contrast, the acute inflammatory response to M. faeni is not CD4+ cell dependent.
A Long-Term Follow-Up Study of 60 Adolescent Psychiatric Outpatients
Authors: JULIAN I. PICHEL
Journal: American Journal of Psychiatry (1974)

The author describes a follow-up study of 60 psychiatrically disturbed outpatients who had first been seen at least ten years earlier. His findings suggest that adult disorders can be predicted on the basis of the patient's history of earlier childhood difficulty and the nature of his adolescent symptoms. Psychotherapeutic treatment did not seem to have had an effect on the outcome for those with a poor prognosis.
STUDIES ON THE IMMUNE RESPONSE OF THE RHEUMATIC SUBJECT AND ITS RELATIONSHIP TO ACTIVITY OF THE RHEUMATIC PROCESS. VII. SPLENECTOMY IN RELATION TO THE DEVELOPMENT OF RHEUMATIC ACTIVITY 1
Authors: Alvin F. Coburn, Ruth H. Pauli
Journal: Journal of Clinical Investigation (1935)

Preceding papers have shown (1,2,3,4,5) that in the rheumatic subject one factor essential for the development of acute rheumatism is the magnitude of the immune response to hemolytic streptococcus infection.The mechanism involved in the rheumatic process is unknown.The pres- ent paper deals with an attempt to diminish the.patient's antibody production for the purpose of modifying the rheumatic process, and with ob- servations on the relation of the spleen to rheu- matic activity.A number of investigators (6, 7, 8) interested in the mechanism of immune reactions are agreed that the spleen plays a role in the fixation of antigen and in the production of antibody, and that splenectomy may inhibit antibody formation under certain conditions.Clinical observers have established the effectiveness of splenectomy in cer- tain hemorrhagic disorders.Since the tendency to hemorrhage is a common characteristic of rheu- matic activity, which occurs at the time that the immune response is evoked, it seemed possible that splenectomy might modify the responses of the rheumatic subject to infection.Splenectomy was performed on a selected group of children who have subsequently been kept under close ob- servations.The findings are discussed in this paper.PROCEDURE
Neurone-specific enolase levels in pleural effusions in patients with rheumatoid arthritis.
Authors: P. Nyberg, T. Soderblom, T. Pettersson, H. Riska, M. Klockars, L. Linko
Journal: Thorax (1996)

BACKGROUND: High pleural fluid levels of neurone-specific enolase (NSE) have been reported, not only in patients with small cell lung cancer but also in those with chronic inflammatory diseases. METHODS: NSE concentrations were determined in pleural fluid and serum from 342 patients with pleural effusions including 17 with rheumatoid arthritis. RESULTS: The median NSE concentration in pleural fluid was higher in rheumatoid effusions than in any other condition studied. The median pleural fluid:serum NSE ratio was highest in patients with rheumatoid arthritis (11.6) and about unity in all other diseases including small cell lung cancer (0.9). In patients with rheumatoid arthritis pleural fluid concentrations of NSE correlated inversely with pleural fluid glucose concentrations and the pH of the pleural fluid. CONCLUSIONS: A high pleural fluid:serum NSE ratio was found consistently in pleural effusions from patients with rheumatoid disease.