tbuckley/cabot-search huggingface dataset:
Hypertension is an independent risk factor for colorectal polyps
Authors: L. Bell, A. Johnston, S. MacKenzie, K. Sundaram, J. Mawdsley, I. G. Beveridge, C. Collins, K. J. Monahan
Journal: Gut (2011)

<h3>Introduction</h3> Components of metabolic syndrome including obesity and insulin resistance with colorectal neoplasia have been well characterised, but the association of other cardiovascular risk factors including hypertension have not been well defined. The aim of this study is to evaluate the association of other cardiovascular risk factors, and colonic polyp risk. <h3>Methods</h3> A study of 1038 patients9 colonoscopies performed between January 2009 and January 2010 was undertaken, recording polyp number, appearance and anatomical location. The risk factors evaluated in the study were as follows, hypertension, hyperlipidaemia, renal function and insulin resistance. The prospectively collected data was derived from colonoscopy reports, electronic medical records and serum blood sample results. Continuous variables were analysed using a χ<sup>2</sup> test, and risk was evaluated using odds ratios. <h3>Results</h3> A total of 1038 patients were included in the study, 32% (331 patients) were found to have one or more colonic polyp, of these patients 39 % (131 patients) had co-existing hypertension compared to 26% of the patients without colonic polyps (p valve= 0.000005 χ<sup>2</sup> test; OR 1.89 95% CI 1.43 to 2.49). 77% of polyps were left sided. Upper and lower most quartiles for serum creatinine results showed an association with renal failure and the presence of colonic polyps. The upper most quartile for serum, creatinine showed a 60% association with colonic polyps while the lowest quartile had an association of 48% (p value 0.015; χ<sup>2</sup> test). Other risk factors did not demonstrate association with risk. <h3>Conclusion</h3> Hypertension is an independent risk factor for colorectal polyps in this study. There is also an association of renal impairment with the development of polyps. The mechanism may be related to metabolic syndrome or may have an independent aetiological pathway.
Emergency doctors and police debate data sharing schemes
Authors: D. Cohen
Journal: BMJ (2009)

Sharing of data between hospitals and police forces was crucial to help fight violent crime, the Home Office minister Vernon Coaker told a meeting of doctors, police experts, and local authority representatives this week.

The meeting, called the London accident and emergency data sharing summit, was held to discuss what types of data could most usefully be shared, issues of patient confidentiality, and whether hospital doctors should be obliged to report cases of knife crime to the police.

Jonathan Shepherd, a maxillofacial surgeon from Cardiff University, who favoured the collection of anonymised rather than personalised data, …
"Railroading" in retinal vessels.
Authors: P. J. Tomlin
Journal: BMJ (1967)

Allergy to insulin was a common problem in the early days of treating diabetes mellitus (Lawrence, 1925 ;Marble, 1959), but introduction of purified preparations has made this less likely.Allergic patients can usually be treated by desensitization or by changing the type of insulin (Marble, 1959).Today many patients needing only small doses of insulin have been prescribed oral hypoglycaemic agents instead.How- ever, these may be inadequate during infections or operations, or if the diabetes becomes worse, and so insulin may be given again.A secondary immune response is then apt to occur, causing local or general allergy and sometimes fatal anaphylaxis (Hanauer and Batson, 1961 ;Michel, 1963 ;Aiken, 1964).We encountered this problem in the following case and used a different method of overcoming allergy.CASE REPORT A 49-year-old housewife developed diabetes mellitus in 1960 and was given insulin zinc suspension.A few days later she developed painful red swellings at the injection sites.As her diabetes was mild insulin was stopped and tolbutamide substituted.Five years later oral hypoglycaemic drugs failed.Isophane insulin controlled the blood-sugar level, but local allergic reactions again occurred.Soluble, globin zinc, and Actrapid insulins pro- duced similar reactions whether injected subcutaneously or intra- muscularly.After 13 days she developed a widespread urticarial rash, angioneurotic oedema, and dyspnoea.Antihistamines provided no relief, and so, as symptoms were severe and potentially dangerous, prednisone 10 mg. was given by mouth; remission occurred within one hour.After this her diabetes was controlled by soluble insulin (28 i.u.morning and 32 i.u.evening) and the allergy suppressed with prednisone by mouth 10 mg.q.d.s.However, on reducing the dose of prednisone below 20 mg.daily allergic symptoms recurred.As this dose was undesirable it was decided to inject a corticosteroid drug with the insulin.Prednisolone 2 mg.failed, but hydrocortisone 10 mg.prevented both local and systemic reactions.The blood sugar level was controlled, there being no insulin resistance, and the patient improved.Within two weeks as little as 2 mg. of hydrocortisone mixed with each injection of soluble insulin was satisfac- tory.Less than this allowed skin reactions of increasing severity to recur and the patient used 2 mg.again of her own accord.
First clinical use of penicillin.
Authors: C Fletcher
Journal: BMJ (1984)

<h3>Introduction</h3> Two childhood autoimmune liver diseases are recognised: "classical" autoimmune hepatitis (AIH) and AIH-sclerosing cholangitis overlap syndrome (also termed as autoimmune sclerosing cholangitis, ASC). ASC is characterised by ANA and/or SMA seropositivity, hypergammaglobulinaemia and interface hepatitis—all features typical of "classical" AIH—in conjunction with bile duct destruction. Previous studies showed that regulatory T-cells, a subset essential for immune-tolerance maintenance, are defective in both conditions. Whether different CD4 and CD8 effector T-cell responses account for the clinical spectrum of childhood autoimmune liver disease is unknown. Aims: to evaluate the frequency and phenotype of CD4 and CD8 T-cells in patients with AIH and ASC. <h3>Methods</h3> 6 patients with AIH, six patients with ASC, and six healthy subjects (HS) were studied. The frequency and phenotype of T-cells was evaluated by cytofluorimetry using monoclonal antibodies against CD3, CD4 and CD8. Expression of T-bet, RORC, IFN-g and IL-17 was determined by intracellular staining. <h3>Results</h3> The frequency of CD4<sup>pos</sup>cells within total lymphocytes was lower in ASC (36.5±3.6), compared to AIH (47.2±2.7, p=0.04) and HS (46.8±2.1, p=0.04). Conversely, ASC patients displayed higher percentage of CD8<sup>pos</sup>cells (31.8±2) than in AIH (21.8±2.5, p=0.01) and HS (22.9±1.3, p=0.03), therefore exhibiting a lower CD4:CD8 compared to AIH and HS. Within CD4<sup>pos</sup>T-cells: (a) T-bet<sup>pos</sup> and IFN-g<sup>pos</sup>cells were higher both in AIH and ASC compared to HS (T-bet: p=0.01 for AIH, p=0.05 for ASC; IFN-g: p=0.02 for AIH, p=0.03 for ASC); (b) RORC<sup>pos</sup> and IL-17<sup>pos</sup>cells were more frequent in ASC than in AIH (RORC: p=0.001; IL-17: p=0.02). Within CD8-T cells: (a) IFN-g-producing cells were higher in AIH and ASC than HS (p=0.004 for AIH, p=0.08 for ASC); b) IL-17-producing cells were higher in ASC compared to AIH (p=0.05). In ASC, frequency of CD4<sup>pos</sup> and CD8<sup>pos</sup>IL-17<sup>pos</sup>cells correlated with γ-glutamyl-transpeptidase (R=0.90, p=0.01 for CD4; R=0.84, p=0.04 for CD8), and with alkaline phosphatase levels (R=0.75, p=0.09 for CD4; R=0.80, p=0.06 for CD8). <h3>Conclusion</h3> Both AIH and ASC are associated with an increase of IFN-g-producing cells. Compared to AIH, ASC patients have more CD8 T-cells, and higher number of IL-17-producing T-cells. The correlation with cholestatic biochemical abnormalities suggests that IL-17 is involved in bile duct involvement characteristic of ASC. <h3>Competing interests</h3> None declared.
Ursodeoxycholic acid for liver disease associated with cystic fibrosis: A double-blind multicenter trial
Authors: C Colombo, P M Battezzati, M Podda, N Bettinardi, A Giunta
Journal: Hepatology (1996)

Liver disease is increasingly recognized as a major cause of morbidity in cystic fibrosis (CF). Preliminary data suggest that ursodeoxycholic acid (UDCA) may be beneficial for treatment of this manifestation. We performed a double-blind, multicenter trial in these patients to establish efficacy and safety of UDCA in terms of the improvement of clinical and nutritional indicators besides standard liver function tests. We also intended to establish whether taurine supplementation has a beneficial effect in patients receiving UDCA. From June to December 1990, we enrolled in 12 centers 55 CF patients with liver disease (39 male subjects; median age, 13.8 years). They were randomly assigned to receive for 1 year one of the following treatments: UDCA (15 mg/kg body weight daily) plus taurine (30 mg/kg body weight daily), UDCA plus placebo, placebo plus taurine, or double placebo. Clinical and laboratory evaluations were performed every 3 months. After 1 year, deterioration of overall clinical conditions, as indicated by the Shwachman-Kulczycki score (SKS), occurred in patients who received placebo but not in those who received UDCA (P = .025). Patients treated with UDCA also showed an improvement in gamma-glutamyl transpeptidase (GGT) (P = .004) and 5'-nucleotidase (P = .006) levels. Treatment with taurine was followed by a significant increase in serum prealbumin levels (P = .053), a trend toward a reduction in fat malabsorption, and no effect on the biochemical profile. No severe side effects occurred with any treatment. Thus, we concluded that UDCA administration improves clinical and biochemical parameters in CF patients with liver disease. Taurine supplementation may be indicated in patients with severe pancreatic insufficiency and poor nutritional status.
569 Incidence and predictive factors of psychiatric Disorders before and during treatment of chronic hepatitis C (CHC) with pegylated IFN α −2a and ribavirin: Prospective study
Authors: P. Castellví, C. Díez-Quevedo, M. Miquel, R. Navinés, A. Solere, M.D. Giménez, S. Montoliu, C. Márquez, F. García, J.A. Galeras, R. Solà, R. Planase
Journal: Journal of Hepatology (2006)
Dobutamine-induced ST segment elevation in patients with recent myocardial infarction: The role of myocardial ischemia, viability and ventricular dyssynergy
Authors: R. Ricci, R. Bigi, C. Coletta, A. Galati, P. Bandini, A. Verzoni, G. Greco, C. Fiorentini, G. Occhi, N. Aspromonte, V. Ceci
Journal: Journal of the American College of Cardiology (1996)
Bone density in women receiving depot medroxyprogesterone acetate for contraception.
Authors: T Cundy, M Evans, H Roberts, D Wattie, R Ames, I R Reid
Journal: BMJ (1991)

OBJECTIVE--To determine if the use of the injectable contraceptive depot medroxyprogesterone (DMPA), which reduces ovarian oestrogen production, is associated with changes in bone density. DESIGN--Population study. DMPA users were compared with two control groups selected from larger population studies and individually matched for several putative determinants of bone density (age, race, body mass index, and years of oestrogen deficiency). Controls and DMPA users were matched without prior knowledge of their bone density measurements. SETTING--Teaching hospital and community family planning clinics. SUBJECTS--30 current users of DMPA with a minimum five years9 previous use, 30 premenopausal controls, and 30 postmenopausal controls. MAIN OUTCOME MEASURE--Lumbar spine and femoral neck bone mineral density assessed by dual energy x ray absorptiometry. RESULTS--Compared with premenopausal controls matched for age, race, and body mass index, DMPA users had significantly reduced bone density in the lumbar spine (mean difference 7.5% (95% confidence interval 1.9% to 13.1%), p = 0.002) and in the femoral neck (6.6%, (0.8% to 12.3%), p = 0.007). Compared with postmenopausal controls matched for body mass index and duration of oestrogen deficiency, DMPA users had greater bone density in the lumbar spine (8.9% (4.3% to 13.5%), p = 0.001), but in the femoral neck the difference in bone density was less (4.0% (-0.4% to 8.5%), p = 0.04). CONCLUSIONS--Women using DMPA have bone density values intermediate between those of normal premenopausal and postmenopausal controls; thus, the degree of oestrogen deficiency induced by DMPA may have an adverse effect on bone density.
Hepatic Insulin Gene Therapy Normalizes Diurnal Fluctuation of Oxidative Metabolism in Diabetic BB/Wor Rats
Authors: Darin E Olson, Adam G Campbell, Marty H Porter, Kimberly G Freeman, Emily Kelso, William P Flatt, Peter M Thulé
Journal: Molecular Therapy (2008)

Previous studies of hepatic insulin gene therapy (HIGT) focused on glycemic effects of insulin produced from hepatocytes. In this study, we extend the observations of glycemic control with metabolically regulated HIGT to include systemic responses and whole-body metabolism. An insulin transgene was administered with an adenoviral vector [Ad/(GlRE)<sub>3</sub>BP1-2xfur] to livers of BB/Wor rats made diabetic with polyinosinic polycytidilic acid (poly-I:C) (HIGT group), and results compared with nondiabetic controls (non-DM), and diabetic rats receiving different doses of continuous-release insulin implants (DM-low BG and DM-high BG). Blood glucose and growth normalized in HIGT, with lower systemic insulin levels, elevated glucagon, and increased heat production compared with non-DM. Minimal regulation of systemic insulin levels were observed with HIGT, yet the animals maintained normal switching from carbohydrate to lipid metabolism determined by respiratory quotients (RQs), and tolerated 24-hour fasts without severe hypoglycemia. HIGT did not restore serum lipids as we observed increased triglycerides (TGs) and increased free fatty acids, but reduced weight of visceral fat pads despite normal total body fat content and retroperitoneal fat depots. HIGT favorably affects blood glucose, normalizes metabolic switching in diabetic rats, and reduces intra-abdominal fat deposition.
The Urinary Concentrating Mechanism
Authors: Rex L. Jamison, Roy H. Maffly
Journal: New England Journal of Medicine (1976)

Disorders of the urinary concentrating mechanism vary widely in their clinical importance. At one extreme, they may simply represent an inconvenience to the patient who has to arise several times each night to urinate. At the other extreme, they cause life-threatening fluid losses: in one memorable instance, a patient with diabetes insipidus was reported to excrete 47 liters in one day. Between these extremes, impaired urinary concentration may be the first clue to the presence of a systemic disturbance, such as hypercalcemia, Sjögren's syndrome or amyloidosis.The factors responsible for the kidney's remarkable ability to regulate daily water output from . . .
Gene profiling reveals specific molecular pathways in the pathogenesis of atherosclerosis and cardiovascular disease in antiphospholipid syndrome, systemic lupus erythematosus and antiphospholipid syndrome with lupus
Authors: Carlos Perez-Sanchez, Nuria Barbarroja, Sebastiano Messineo, Patricia Ruiz-Limon, Antonio Rodriguez-Ariza, Yolanda Jimenez-Gomez, Munther A Khamashta, Eduardo Collantes-Estevez, Mª Jose Cuadrado, Mª Angeles Aguirre, Chary Lopez-Pedrera
Journal: Annals of the Rheumatic Diseases (2014)

Objective To identify shared and differential molecular pathways involved in the pathogenesis of atherosclerosis (AT) and cardiovascular disease (CVD) in systemic lupus erythematosus (SLE), primary antiphospholipid syndrome (APS) and APS associated with SLE (APS plus SLE). Methods 129 patients (42 APS, 31 APS plus SLE and 56 SLE) and 61 healthy donors were included. Microarray expression profiling was performed in monocytes. RT-PCR of selected genes and western blot were used to validate microarray data. Clinical and inflammatory parameters were also analysed. Results Compared with controls, 555, 1224 and 518 genes were differentially expressed in monocytes from SLE, APS plus SLE and APS patients, respectively. Approximately 25–30% of differentially expressed genes were related to AT and CVD. Each disease displayed a specific AT/CVD/Inflammation-related gene signature. Compared with SLE, APS showed alterations in mitochondria biogenesis and function and oxidative stress. Besides the interferon signature, found in APS plus SLE and SLE patients, various genes mediating atherosclerotic/inflammatory signalling were also differentially expressed in APS plus SLE. IgG-anticardiolipin (aCL) titres independently predicted both atherosclerotic and thrombosis in APS plus SLE. Moreover, a significant correlation of IgG-aCL titres with mRNA levels of certain inflammatory molecules in monocytes was further noticed. In vitro treatment of monocytes with IgG-aCL promoted an increase in the expression of the genes most significantly changed in APS plus SLE versus healthy donors. Conclusions Gene expression profiling allows the segregation of APS, APS plus SLE and SLE, with specific signatures explaining the pro-atherosclerotic and pro-thrombotic alterations in these highly related autoimmune diseases.
Chemically Modified Adrenocortical Steroids
Authors: Edward W. Boland
Journal: JAMA (1960)

The desired antirheumatic effects can be obtained equally well from prednisone, prednisolone, methylprednisolone, triamcinolone, dexamethasone, and fluprednisolone provided they are given in effective dosages. With each drug, however, it is necessary to consider the ratio of the effective dosage to the dosage that will cause its own characteristic undesirable side-effects. This ratio (therapeutic index) is about the same for prednisone, prednisolone, and methylprednisolone, all of which are superior in this respect to cortisone and hydrocortisone and are preferred for routine use in rheumatoid patients requiring steroid administration. Triamcinolone and dexamethasone are considered special-purpose steroids, and fluprednisolone, on the basis of preliminary data, is believed to be a satisfactory antirheumatic agent free from salt-retention effects.
Tumor necrosis factor participates in the pathogenesis of acute immune complex alveolitis in the rat.
Authors: J S Warren, K R Yabroff, D G Remick, S L Kunkel, S W Chensue, R G Kunkel, K J Johnson, P A Ward
Journal: Journal of Clinical Investigation (1989)

We have examined the role of intrapulmonary TNF in a rat model of acute immune complex-triggered alveolitis. Intratracheal instillation of IgG anti-bovine serum albumin (anti-BSA) followed by intravenous infusion of BSA results in acute alveolitis. Over the 4-h course of evolving lung injury, a 10-fold increase in TNF activity occurred in bronchoalveolar lavage (BAL) fluid. Immunohistochemical analysis of lung sections and BAL cells revealed that alveolar macrophages are the chief source of TNF. Antibodies that specifically neutralize rat TNF activity were raised in rabbits immunized with recombinant mouse TNF alpha. When administered into the lungs with anti-BSA, anti-TNF resulted in a marked reduction (up to 61%) in lung injury. Intratracheal instillation of exogenous TNF alone, or in combination with anti-BSA, resulted in an increase in lung injury compared to controls. Morphometric analysis and measurements of myeloperoxidase activities in whole lung extracts from rats treated with anti-TNF revealed a marked reduction in neutrophils compared to positive controls. The anti-TNF antibody preparation did not inhibit in vitro complement activation or diminish neutrophil chemotactic activity present in activated rat serum. These data indicate that intrapulmonary TNF activity is required for the full development of acute immune complex-triggered alveolitis, that alveolar macrophages are the primary source of this cytokine, and that TNF participates in the pathogenesis of immune complex alveolitis through a mechanism involving neutrophil recruitment.
1073-147 Detection of coronary restenosis by serial doppler echocardiographic assessment of coronary flow velocity reserve after percutaneous coronary intervention
Authors: Duk-Hyun Kang, Seung-Hwan Lee, Jae-Hyung Park, Soo-Jin Kang, Sung-Joo Oh, Jong-Min Song, Myeong-Ki Hong, Jae-Kwan Song, Seung-Jung Park
Journal: Journal of the American College of Cardiology (2004)
IMPACT OF DAILY GLUCOSE FLUCTUATION ON CORONARY PLAQUE VULNERABILITY IN PATIENTS PRETREATED WITH LIPID LOWERING THERAPY
Authors: Masaru Kuroda, Toshiro Shinke, Kazuhiko Sakaguchi, Hiromasa Otake, Yushi Hirota, Tomofumi Takaya, Masayuki Nakagawa, Hirotoshi Hariki, Tsuyoshi Osue, Yu Taniguchi, Masamichi Iwasaki, Ryo Nishio, Hiroto Kinutani, Akihide Konishi, Hachidai Takahashi, Daisuke Terashita, Ken-ichi Hirata
Journal: Journal of the American College of Cardiology (2014)
Thallium-201 uptake in variant angina: probable demonstration of myocardial reactive hyperemia in man.
Authors: M W Kronenberg, R M Robertson, M L Born, R A Steckley, D Robertson, G C Friesinger
Journal: Circulation (1982)

Myocardial thallium scintigraphy was performed in four subjects with variant angina and in one subject with isolated, fixed coronary obstruction. Three subjects with variant angina had short episodes of ischemic ST-segment elevation that lasted 20--100 seconds. Thallium scintigrams demonstrated excess uptake in regions judged to be ischemic by angiographic and electrocardiographic criteria. Two subjects, one with variant angina and the other with a fixed coronary lesion, had prolonged episodes of ischemia that lasted 390--900 seconds. Both had reduced thallium uptake in the ischemic regions. We conclude that myocardial reactive hyperemia is the cause of excess thallium uptake in patients with variant angina who have short episodes of myocardial ischemia.
Source of surgical instruments should be checked, BMA says
Authors: Deborah Cohen
Journal: BMJ (2008)

Doctors should encourage their hospitals or practices to ensure that the surgical instruments they purchase are “ethically procured,” a BMA report has said.

Each month the NHS buys millions of pounds’ worth of surgical instruments, with a considerable majority manufactured in Sialkot, Pakistan. Each year 100 million surgical instruments are produced in Sialkot, with a product range of more than 10 000 items worth about $191m (£98m; €124m).

But working conditions in factories are “unhealthy, unsafe, and unfair,” with exposure to toxic and corrosive chemicals, metal dust, noise, and dangerous machinery on the list …
Prevalence of ECG abnormalities in an international survey of patients with suspected or confirmed heart failure at death or discharge
Authors: Nasrin K. Khan, Kevin M. Goode, John G.F. Cleland, Alan S. Rigby, Nick Freemantle, Joanne Eastaugh, Andrew L. Clark, Ramesh de Silva, Melanie J. Calvert, Karl Swedberg, Michael Komajda, VIu Mareev, Ferenc Follath
Journal: European Journal of Heart Failure (2007)