tbuckley/cabot-search huggingface dataset:
Incomplete hepatitis B immunization, maternal carrier status, and increased risk of liver diseases: A 20-year cohort study of 3.8 million vaccinees
Authors: Yin-Chu Chien, Chyi-Feng Jan, Chun-Ju Chiang, Hsu-Sung Kuo, San-Lin You, Chien-Jen Chen
Journal: Hepatology (2014)

Hepatitis B immunization has been documented to prevent fulminant hepatic failure (FHF) and hepatocellular carcinoma (HCC) by historical comparison studies in Taiwan. This study aimed to assess long-term risks and predictors of various liver diseases associated with incomplete immunization in 3.8 million vaccinees. Profiles of the National Hepatitis B Immunization Registry, National Cancer Registry, and National Death Certification Registry were linked to ascertain newly diagnosed cases of HCC and deaths from FHF and chronic liver diseases (CLDs) from infancy to early adulthood of 3,836,988 newborn vaccinees. Cox's proportional hazards models were used to estimate hazard ratios (HRs) for various risk predictors. There were 49 newly developed cases of HCC, 73 deaths from FHF, and 74 deaths from CLDs during the follow-up of 41,854,715 person-years. There were striking differences between unvaccinated and vaccinated newborns after the launch of a national immunization program for HCC incidence (0.293 vs. 0.117 per 100,000 person-years), FHF mortality (0.733 vs. 0.174 per 100,000 person-years), and CLD mortality (2.206 vs. 0.177 per 100,000 person-years). Among vaccinees, incomplete immunization was the most important risk predictor of HCC, FHF, and CLDs, showing an HR (95% confidence interval, P value) of 2.52 (1.25-5.05; P = 0.0094), 4.97 (3.05-8.11; P < 0.0001), and 6.27 (3.62-10.84; P < 0.0001), respectively, after adjustment for maternal hepatitis B serostatus.Hepatitis B immunization can significantly prevent the long-term risk of HCC, FHF, and CLDs from infancy to early adulthood. Incomplete immunization with hepatitis B immunoglobulin or vaccines was the most important risk predictor of the liver disease among vaccinees.
Proposed Standards for Judging the Success of the Treatment of Obesity
Authors: Richard L. Atkinson
Journal: Annals of Internal Medicine (1993)

The purpose of this report is to propose standards for the successful treatment of obesity. This process is somewhat arbitrary because obesity is a multifactorial disease and because standards need revision as diagnostic and treatment techniques improve. Weight loss, the classic standard of success, does not account for individual variability. Reduction in other measures of body size, such as body mass index, percentage of excess weight, and body fat, may be preferable. Improvement in known complications of obesity (diabetes mellitus, hypertension, hyperlipoproteinemia, sleep apnea, and psychosocial problems) are equally valid measures of success. Because obesity is a chronic disease, maintenance of weight loss is included as a standard of success. Response to obesity treatment varies, and thus criteria to define minimal, intermediate, and full success for each variable are necessary.
Cross specialty training would improve outlook for academic psychiatry, says report
Authors: Z. Kmietowicz
Journal: BMJ (2013)

Training of psychiatrists needs to be more flexible to encourage doctors to take up the specialty and pursue a career in academia, a report has said.

Without a fresh approach to training, the advances being made in science were less likely to be translated into developments in diagnosis and management, because doctors were not choosing to teach future generation of psychiatrists, said Nick Craddock, professor of psychiatry at Cardiff University’s department of psychological medicine and neurology.

He was speaking at the launch of the report from the Academy of Medical Sciences, Strengthening Academic Psychiatry in the UK .1

The number of posts in academic psychiatry in …
Tubular antigen-binding proteins repress transcription of type IV collagen in the autoimmune target epithelium of experimental interstitial nephritis.
Authors: T P Haverty, C J Kelly, J R Hoyer, R Alvarez, E G Neilson
Journal: Journal of Clinical Investigation (1992)

We have been studying immune interactions with somatic cells using a tubular antigen-binding protein (ThF) secreted by helper T lymphocytes harvested from mice that have an autoimmune form of interstitial nephritis called anti-tubular basement membrane disease. This ThF, although characterized originally because of its ability to induce effector T cells, additionally recognizes the nephritogenic 3M-1 antigen expressed by its target renal tubular epithelium. We believe these proteins, in general, may modulate directly some homeostatic functions in organ-derived cells, and now report that our ThF represses specifically the cellular transcription and secretion of basement membrane type IV collagen in tubular epithelium. These in vitro findings of reduced levels of mRNA encoding type IV collagen correlate well with in situ hybridization studies performed on kidneys expressing early autoimmune lesions, and predict a progressive drop in the expression of type IV collagen in the interstitium. Such a novel and unexpected repression of transcription of type IV collagen might easily impart or facilitate permanent change in the infrastructure of kidney architecture during autoimmune injury and, perhaps, contributes to the process of tubular atrophy attendant to prolonged renal inflammation.
Medical Examiners, Coroners, and Organ Recovery in the United States
Authors: Richard E. Chinnock
Journal: JAMA (1995)

<h3>To the Editor.</h3> —Ms Shafer and colleagues<sup>1</sup>have provided the transplant community with valuable information in the constant struggle to enhance donor organ resources. The relationship between a transplant center or donor hospital and the local coroner's office must be mutually supportive. The experience of the medical examiner of San Bernardino County, California, was recently reported.<sup>2</sup>Internal organs were recovered from homicide victims, including children, without significant problems occurring during subsequent legal proceedings. Organ recoveries increased by 60%. A detailed protocol was provided that could be used as a model by other ME/C offices. Two causes of death with particular pertinence to pediatric transplantation are sudden infant death syndrome (SIDS) and deaths due to suspected child abuse. Since November 1985 we have performed 262 heart transplantation procedures for 257 pediatric patients. Of these, SIDS represented 25 donors (9.5%) and suspected child abuse accounted for an additional 32 (12.2%).
Ex vivo effects of high-density lipoprotein exposure on the lipopolysaccharide-induced inflammatory response in patients with severe cirrhosis
Authors: Arnaud Galbois, Dominique Thabut, Khalid A. Tazi, Marika Rudler, Morvarid Shir Mohammadi, Dominique Bonnefont‐Rousselot, Hind Bennani, Annie Bezeaud, Zera Tellier, Cécile Guichard, Nicolas Coant, Eric Ogier‐Denis, Richard Moreau, Didier Lebrec
Journal: Hepatology (2008)

High-density lipoproteins (HDL) are known to neutralize lipopolysaccharide (LPS). Because patients with cirrhosis have lower HDL levels, this may contribute to LPS-induced ex vivo monocyte overproduction of proinflammatory cytokines. However, the effects of HDL on cytokine production by monocytes from patients with cirrhosis have never been studied. The aim of this study was to determine the effects of HDL on LPS-induced proinflammatory cytokine production in whole blood and isolated monocytes from patients with severe cirrhosis and controls. Plasma levels of HDL and cytokines were determined. The effects of reconstituted HDL (rHDL) on LPS-induced cytokine production in whole blood were assessed by cytokine array and on tumor necrosis factor alpha (TNF-alpha) and interleukin-10 (IL-10) production in isolated monocytes. Plasma HDL levels were significantly lower in patients with cirrhosis than in controls. Plasma levels of TNF-alpha and IL-6 were significantly higher in patients with cirrhosis than in controls. Incubation of rHDL with whole blood prevented LPS-induced TNF-alpha and IL-6 overproduction in patients with cirrhosis. LPS-induced TNF-alpha production and CD14 expression were significantly more marked in cirrhotic monocytes than in control monocytes, and both decreased significantly after rHDL incubation. LPS-induced down-regulation of scavenger receptor, class B, type I (SR-BI) expression was abolished in cirrhotic monocytes.This study shows that rHDL abolishes the LPS-induced overproduction of proinflammatory cytokines in whole blood from patients with severe cirrhosis. These results were confirmed in isolated monocytes from these patients. This suggests that administration of rHDL might be a useful strategy for the treatment of cirrhosis to limit LPS-induced cytokine overproduction.
530 ALT increase after initiation of protease inhibitor (PI) containing antiretroviral therapy in HIV-HCV coinfected patients is not related to high PI plasma concentrations. ANRSCO-08 cohort
Authors: A. Gervais, E. Pereira, G. Peytavin, M.-E. Lafon, F. Al-Kayed, P. Trimoulet, P. Dellamonica, F. Raffi, G. Chêne, C. Leport
Journal: Journal of Hepatology (2006)
Trends in use of coronary angiography in subacute phase of myocardial infarction.
Authors: P Nicod, E A Gilpin, H Dittrich, H Henning, A Maisel, A R Blacky, S C Smith, F Ricou, J Ross
Journal: Circulation (1991)

Most patients do not undergo acute reperfusion after myocardial infarction, and which of these patients should undergo coronary angiography is still debated.We analyzed the 1-year clinical outcomes and rates of coronary angiography performed as late as 60 days after myocardial infarction in 3,804 patients admitted between 1979 and 1988 and followed in six different centers. Patients less than 75 years old were classified into low-, medium-, and high-risk groups using a multivariate analysis of historical and clinical variables gathered during the first 8 hospital days. Patients who underwent early reperfusion (17%, all after 1984) were analyzed separately. To analyze time trends, patients were compared before and after mid-1984. Mortalities from day 9 through 1 year were similar for the two time periods in the low- (3.3% versus 2.5%) and medium-risk (7.4% versus 5.6%) groups, but mortality was lower for the high-risk group after 1984 (31.6% versus 20.0%). The proportion of patients undergoing coronary angiography increased dramatically in each group after 1984 (low risk, 18% versus 48%; medium risk, 23% versus 49%; high risk, 10% versus 32%, before and after 1984, respectively). Furthermore, a large percentage of patients (more than 40%) in the low-risk group did not have at least one of the indications for coronary angiography recently recommended by a joint task force. Among patients undergoing coronary angiography, the proportion of patients with three-vessel coronary artery disease decreased after 1984, whereas the proportion undergoing mechanical revascularization in the year after infarction increased in all risk groups.Despite the recent development of noninvasive techniques with high sensitivity for detecting high-risk patients after myocardial infarction, coronary angiography is being performed increasingly in all patients, including those determined to be at low risk for complications based on clinical data. The economic consequences of such a trend could be considerable, and its impact requires careful analysis.
One hundred years of barbiturates and their saint
Authors: D. A Cozanitis
Journal: Journal of the Royal Society of Medicine (2004)

Soporifics were limited to alcohol and opium until 1869, when chloral hydrate was first used as a sedative and hypnotic.Urethane, bromides, chlorbutanol, sulphones, hederal and chloralose then followed.In 1863, Johan Adolf Baeyer discovered malonylurea, a substance that would become the parent compound of the barbiturates.The date of this discovery is believed to have been 4 December, and on that same day Baeyer visited a tavern frequented by artillery officers.4 December is the feast day of Saint Barbara, patron saint of artillery-men as well as tunnellers and firemen; thus he designated his malonylurea barbituric acid (Figure 1). THE SAINTSaint Barbara (Figure 2) was born in the latter part of the third century in Heliopolis in what was then Syria.Her father Dioscurus, a Greek, was a fanatical idolater.In order to shield his daughter, whose beauty drew all eyes upon her, he confined Barbara to a tower having two windows.During one of her father's travels, she secretly embraced Christianity and had a third window added through which the sun would shine and honour the Holy Trinity.When Dioscurus returned and learned of Barbara's conversion, he drew his sword to kill her but she was miraculously saved.Dioscurus offered Barbara to the pagan Roman Governor, Marcianus, who was taken by her beauty.Unable to win her to his will (for she had devoted her life to God), Marcianus ordered that the maiden be flogged and have her breasts cut
Human herpesvirus 7 detection by quantitative real time polymerase chain reaction in primary cutaneous T-cell lymphomas and healthy subjects: lack of a pathogenic role
Authors: R. Ponti, M. Bergallo, C. Costa, P. Quaglino, M.T. Fierro, A. Comessatti, E. Stroppiana, F. Sidoti, C. Merlino, M. Novelli, D. Alotto, R. Cavallo, M.G. Bernengo
Journal: British Journal of Dermatology (2008)

Background Primary cutaneous T-cell lymphomas (CTCLs) are a heterogeneous group of lymphomas where the tumour population emerges within a multiple subclone pattern. Mycosis fungoides (MF) and Sézary syndrome (SS) are characterized by the expansion of clonal CD4+/CD45RO+ memory T cells. Lymphomatoid papulosis (LyP) is a chronic, lymphoproliferative disorder included in the CD30+ primary CTCL spectrum. Several studies have suggested a role of viral infection for super-antigenic activation of T lymphocytes; however, evidence of their association with CTCLs is still lacking. Human herpesvirus (HHV) 7 is a CD4+ T-lymphotropic herpesvirus; its restricted cellular tropism and the ability to induce cytokine production in infected cells could make it an important pathogenic cofactor in lymphoproliferative disorders. Objectives To investigate the presence of HHV7 DNA on CTCL and healthy skin donors (HD). Methods We used quantitative real time polymerase chain reaction to evaluate the potential pathogenic role of HHV7. Results Twenty-seven of 84 (32·1%) HD were positive for HHV7 DNA. Twenty-one of 148 (14·2%) patients with CTCLs were positive for HHV7 DNA: nine of 39 (23·1%) SS, six of 14 (42·9%) CD30+ CTCLs and six of 24 (25·0%) LyP, and HHV7 DNA was negative in all 71 patients with MF. Conclusions These results seem to exclude a pathogenic role of HHV7 in CTCLs, suggesting the possibility of skin as a latency site.
Prevention of Diabetes With Mediterranean Diets
Authors: Jordi Salas-Salvadó, Mònica Bulló, Ramón Estruch, Emilio Ros, Maria-Isabel Covas, Núria Ibarrola-Jurado, Dolores Corella, Fernando Arós, Enrique Gómez-Gracia, Valentina Ruiz-Gutiérrez, Dora Romaguera, José Lapetra, Rosa Maria Lamuela-Raventós, Lluís Serra-Majem, Xavier Pintó, Josep Basora, Miguel Angel Muñoz, José V. Sorlí, Miguel A. Martínez-González
Journal: Annals of Internal Medicine (2014)

This article has been corrected. The original version (PDF) is appended to this article as a Supplement. Background: Interventions promoting weight loss can reduce the incidence of type 2 diabetes mellitus. Whether dietary changes without calorie restriction also protect from diabetes has not been evaluated. Objective: To assess the efficacy of Mediterranean diets for the primary prevention of diabetes in the Prevención con Dieta Mediterránea trial, from October 2003 to December 2010 (median follow-up, 4.1 years). Design: Subgroup analysis of a multicenter, randomized trial. (Current Controlled Trials: ISRCTN35739639) Setting: Primary care centers in Spain. Participants: Men and women without diabetes (3541 patients aged 55 to 80 years) at high cardiovascular risk. Intervention: Participants were randomly assigned and stratified by site, sex, and age but not diabetes status to receive 1 of 3 diets: Mediterranean diet supplemented with extra-virgin olive oil (EVOO), Mediterranean diet supplemented with nuts, or a control diet (advice on a low-fat diet). No intervention to increase physical activity or lose weight was included. Measurements: Incidence of new-onset type 2 diabetes mellitus (prespecified secondary outcome). Results: During follow-up, 80, 92, and 101 new-onset cases of diabetes occurred in the Mediterranean diet supplemented with EVOO, Mediterranean diet supplemented with mixed nuts, and control diet groups, respectively, corresponding to rates of 16.0, 18.7, and 23.6 cases per 1000 person-years. Multivariate-adjusted hazard ratios were 0.60 (95% CI, 0.43 to 0.85) for the Mediterranean diet supplemented with EVOO and 0.82 (CI, 0.61 to 1.10) for the Mediterranean diet supplemented with nuts compared with the control diet. Limitations: Randomization was not stratified by diabetes status. Withdrawals were greater in the control group. Conclusion: A Mediterranean diet enriched with EVOO but without energy restrictions reduced diabetes risk among persons with high cardiovascular risk. Primary Funding Source: Instituto de Salud Carlos III.
A METHOD OF SERUM TREATMENT OF PNEUMOCOCCIC SEPTICEMIA IN RABBITS
Authors: Carroll G. Bull
Journal: The Journal of Experimental Medicine (1915)

The treatment of pneumococcic septicemia in the rabbits by large doses of immune serum is detrimental, since the serum causes the formation of large clumps of bacteria in the blood which are taken out chiefly by the vessels of the lungs in which they accumulate and impede the circulation. The large doses of serum are also detrimental when they follow upon small ones through which the small clumps formed are deposited in the spleen, liver, and other organs. In this instance, the large amount of serum leads to the destruction of the pneumococci under conditions which promote an intoxication. The precise mechanism of this action is not known. The treatment of pneumococcic septicemia in rabbits by small repeated doses of immune serum can be successfully carried out. The number of pneumococci capable of being brought to destruction through phagocytosis in the organs in this way is very great. Not all the rabbits treated with small repeated doses of the serum survive. Those that succumb do so not to a general infection but to a pneumococcus meningitis. The explanation of this phenomenon is simple. When the number of pneumococci originally inoculated is very great a small number penetrate into the subdural space. Those in this space do not come under the influence of the serum, hence they are not agglutinated and prepared for phagocytosis, whence they multiply and set up a fatal meningitis. The activity of the immune serum administered in this way against virulent pneumococci is so great that a revision of our notions in the limit of powers of the anti-infectious sera seems necessary. It is patent that the problem is not simply a relation between quantity of immune bodies and number of bacteria. It is more complex than that conception indicates. The factor of the leucocytes and the degree of their possible activities under the conditions of the experiment come into play. Hereafter, in defining the mode and power of action of anti-infectious sera the condition of cooperation of the body-forces will have to be more strictly considered.
In older patients with hypertension, newly prescribed thiazides were linked to metabolic adverse events
Authors: Syed R. Latif, William Bommer
Journal: Annals of Internal Medicine (2014)

ACP Journal Club21 October 2014In older patients with hypertension, newly prescribed thiazides were linked to metabolic adverse eventsSyed R. Latif, MD, William Bommer, MDSyed R. Latif, MDUC Davis Medical Center, Sacramento, California, USA (S.R.L., W.B.)Search for more papers by this author, William Bommer, MDUC Davis Medical Center, Sacramento, California, USA (S.R.L., W.B.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-161-8-201410210-02011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationMakam AN, Boscardin WJ, Miao Y, Steinman MA. Risk of thiazide-induced metabolic adverse events in older adults. J Am Geriatr Soc. 2014;62:1039-45. https://pubmed.ncbi.nlm.nih.gov/24823661Clinical Impact RatingsGIM/FP/GP: Geriatrics: References1 Ernst ME, Moser M. Use of diuretics in patients with hypertension. N Engl J Med. 2009;361:2153-64. [PMID: 19940300] Google Scholar2 Psaty BM, Lumley T, Furberg CD, et al. Health outcomes associated with various antihypertensive therapies used as first-line agents: a network meta-analysis. JAMA. 2003;289:2534-44. [PMID: 12759325] Google Scholar Author, Article, and Disclosure InformationAffiliations: UC Davis Medical Center, Sacramento, California, USA (S.R.L., W.B.)This article was published at Annals.org on 7 October 2014. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 21 October 2014Volume 161, Issue 8Page: JC11KeywordsAdverse eventsDiureticsHypertensionHyponatremiaOutpatientsPotassiumResearch laboratoriesSodium ePublished: 21 October 2014 Issue Published: 21 October 2014 CopyrightCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Effect of Rowachol on biliary lipid secretion and serum lipids in normal volunteers.
Authors: O Leiss, K von Bergmann
Journal: Gut (1985)

The effect of Rowachol (200 mg tid), an essential oil preparation, on biliary lipid secretion and serum lipids was measured in six healthy male volunteers before and after four weeks of treatment. Biliary cholesterol and phospholipid secretion increased significantly from 113 +/- 36 (SD) mumol/h to 155 +/- 52 mumol/h (p less than 0.05) and from 409 +/- 145 mumol/h to 587 +/- 185 mumol/h (p less than 0.05), respectively. Bile acid secretion increased from 1519 +/- 662 mumol/h to 2287 +/- 1175 mumol/h (p greater than 0.05 and greater than 0.10). This marked increase in biliary lipid secretion was not followed by a change in molar composition of biliary lipids and lithogenicity of bile. Serum cholesterol and triglycerides declined from 4.9 mmol/l to 4.1 mmol/l (p less than 0.05) and from 1.2 mmol/l to 0.9 mmol/l (p less than 0.05) respectively. The ratio of high-density-lipoprotein cholesterol to total cholesterol increased from 0.22 to 0.31 (p less than 0.05). Although it has been shown previously that Rowachol could dissolve cholesterol gall stones the present results indicate that Rowachol alone has only weak litholytic properties, at least in normal volunteers, but might have several advantages when combined with chenodeoxycholic or ursodeoxycholic acid.
Linking Medicare and National Survey Data
Authors: Lee A. Lillard
Journal: Annals of Internal Medicine (1997)

Administrative records from the Medicare Program of the Health Care Financing Administration provide a valuable source of information for research on medical and public policy issues. This administrative database contains information on utilization of covered medical services, diagnoses, episodes of illness, and Medicare-covered costs of health care. Combining such data with information from national surveys on health status, demographics, and socioeconomic attributes substantially expands the scope of potential research questions that can be addressed. This article discusses the benefits and difficulties of linking Medicare administrative data with survey data and provides brief summaries of five national surveys of elderly U.S. citizens. These surveys can be valuable resources for examining the health status and life experiences of the Medicare population.