tbuckley/cabot-search huggingface dataset:
Intestinal permeability in patients with coeliac disease and dermatitis herpetiformis.
Authors: I Bjarnason, M N Marsh, A Price, A J Levi, T J Peters
Journal: Gut (1985)

Intestinal permeability was investigated in patients with coeliac disease and dermatitis herpetiformis by a 51Chromium-labelled ethylenediaminetetraacetate (51Cr-EDTA) absorption test and the results correlated with histomorphometric analysis and intraepithelial lymphocyte counts of jejunal biopsies. The mean (+/- SD) 24 hour urine excretion of 51Cr-EDTA in 34 healthy volunteers was 1.9 +/- 0.5% of the orally administered test dose. Patients with untreated coeliac disease (19) or untreated dermatitis herpetiformis (five) excreted significantly more 51Cr-EDTA than controls (5.9 +/- 2.7% and 4.6 +/- 2.1%, respectively, p less than 0.001) and all were outside the normal range of 1.0-2.6%. Patients with coeliac disease (42) treated for 6 months-23 years (mean 5 years) and patients with dermatitis herpetiformis (11) treated for 6 months-8 years (mean 3 years) excreted significantly more 51Cr-EDTA than controls, 4.2 +/- 2.4% p less than 0.0001 and 3.0 +/- 0.9% p less than 0.003 respectively. Eleven of 14 (79%) treated patients with coeliac disease with an entirely normal jejunal mucosae demonstrated abnormal intestinal permeability. Intestinal permeability did not correlate significantly with either the mucosal height/crypt depth ratio or intraepithelial lymphocyte counts in jejunal biopsies from patients with untreated or treated coeliac disease. The demonstration of a persistent increase in intestinal permeability in patients with both coeliac disease and dermatitis herpetiformis may suggest a common pathogenetic mechanism in both disorders. It is postulated that altered permeability may facilitate the entry of gluten or a fraction thereof into the lamina propria where it causes a cascade of immunological events.
Strong Variations of Mitochondrial Mutation Rate across Mammals--the Longevity Hypothesis
Authors: B. Nabholz, S. Glemin, N. Galtier
Journal: Molecular Biology and Evolution (2007)

Mitochondrial DNA (mtDNA) is the most popular marker of molecular diversity in animals, primarily because of its elevated mutation rate. After >20 years of intensive usage, the extent of mitochondrial evolutionary rate variations across species, their practical consequences on sequence analysis methods, and the ultimate reasons for mtDNA hypermutability are still largely unresolved issues. Using an extensive cytochrome b data set, fossil data, and taking advantage of the decoupled dynamics of synonymous and nonsynonymous substitutions, we measure the lineage-specific mitochondrial mutation rate across 1,696 mammalian species and compare it with the nuclear rate. We report an unexpected 2 orders of magnitude mitochondrial mutation rate variation between lineages: cytochrome b third codon positions are renewed every 1–2 Myr, in average, in the fastest evolving mammals, whereas it takes >100 Myr in slow-evolving lineages. This result has obvious implications in the fields of molecular phylogeny, molecular dating, and population genetics. Variations of mitochondrial substitution rate across species are partly explained by body mass, longevity, and age of female sexual maturity. The classical metabolic rate and generation time hypothesis, however, do not fully explain the observed patterns, especially a stronger effect of longevity in long-lived than in short-lived species. We propose that natural selection tends to decrease the mitochondrial mutation rate in long-lived species, in agreement with the mitochondrial theory of aging.
Ileal pouch-anal anastomosis for Crohn's disease
Authors: C M EDWARDS, B F WARREN, N A SHEPHERD
Journal: Gut (1999)

Ileal pouch-anal anastomosis forCrohn's disease EDITOR,-In his leading article (Gut 1998;43:303-8), Mr Phillips makes a plea for realistic comparisons between outcomes for pouch surgery in Crohn's disease with other restorative procedures for this disease, rather than comparisons with restorative proctocolectomy for other diseases, specifically ulcerative colitis.We agree that like comparisons are important in scientific analysis, but point out that such comparisons are confounded by the diYculties of accurate histological diagnosis in inflammatory bowel disease.In particular we should like to highlight the diagnostic confusion and unreliability of a change in diagnosis from ulcerative colitis to Crohn's disease based on the histological examination of the defunctioned rectum in ulcerative colitis. 1 Nearly all of the inflammatory changes of Crohn's disease have been described in the defunctioned colorectum in ulcerative colitis. 2 Any change from a diagnosis of ulcerative colitis to Crohn's disease must be based on a reexamination of the colectomy specimen and placed in context with the clinical history.The misdiagnosis of diverted ulcerative colitis, as Crohn's disease, will only add further to the confusion surrounding the debate on the role of the pelvic ileal reservoir in Crohn's disease.
Coronary anatomy, stress myocardial perfusion defects, and ambulatory electrocardiographic ischemia. What is the relationship? An ACIP ancillary study
Authors: Richard M. Steingart, John J. Mahmarian, Sandra Forman, Barry L. Sharaf, MaryEllen Coglianese, D.Douglas Miller, A.David Goldberg, Marilyn F. Bloom, Sheila Byers, Laurel Dvorak
Journal: Journal of the American College of Cardiology (1996)
Chronic effects of dietary exposure to amosite and chrysotile asbestos in Syrian golden hamsters.
Authors: E E McConnell, A M Shefner, J H Rust, J A Moore
Journal: Environmental Health Perspectives (1983)

Bioassays of amosite, short-range (SR), intermediate-range (IR) or intermediate-range chrysotile asbestos in combination with the intestinal carcinogen 1,2-dimethylhydrazine dihydrochloride (DMH) were conducted with male and female Syrian golden hamsters. Amosite and both forms of chrysotile asbestos were administered at a concentration of 1% in pelleted diet for the entire lifetime of the hamsters starting with mothers of the test animals. Group sizes varied from 125-254. There was no adverse effect on body weight gain or survival by either type of asbestos or by IR chrysotile asbestos in combination with DMH. A significant increase (p less than 0.05) in adrenal cortical tumors was observed in male hamsters exposed to SR and IR chrysotile asbestos and in females treated with IR chrysotile asbestos when compared to the pooled control groups. However, statistical significance (p less than 0.05) was lost when these dosed groups were compared with temporal control groups. Neither of the male or female amosite asbestos groups showed increased neoplasia in any tissue or organ compared to the control groups. The cocarcinogen studies using IR chrysotile asbestos and 1,2-dimethylhydrazine dihydrochloride were considered inadequate because there was no increase in intestinal neoplasia in the DMH group.
Emotional Response of Students to a Political Crisis
Authors: GORIDON D. JENSEN
Journal: American Journal of Psychiatry (1971)

During the early phase of the Cambodian invasion, medical students who were tested by means of a check list showed more anxiety, hostility, and depression than college students tested at "normal" times. Two weeks later, after there had been an opportunity for constructive political activity, retesting showed significant decreases in anxiety and hostility. However, depression scores remained high. An awareness of emotionality during political crises may permit more open communication and better problem solving.
The God incarnate
Authors: Ajit Singh Kashyap, Kuldip Parkash Anand, Surekha Kashyap
Journal: BMJ (2007)

A middle aged man was admitted with type 2 diabetes and coronary artery disease. He was a Hindu religious teacher, well versed in the ancient Hindu religious texts and epics, and an ardent devotee of Hanuman, the Monkey God. To explain world events and …
Dominant Frequency Increase Rate Predicts Transition from Paroxysmal to Long-Term Persistent Atrial Fibrillation
Authors: Raphael P. Martins, Kuljeet Kaur, Elliot Hwang, Rafael J. Ramirez, B. Cicero Willis, David Filgueiras-Rama, Steven R. Ennis, Yoshio Takemoto, Daniela Ponce-Balbuena, Manuel Zarzoso, Ryan P. O’Connell, Hassan Musa, Guadalupe Guerrero-Serna, Uma Mahesh R. Avula, Michael F. Swartz, Sandesh Bhushal, Makarand Deo, Sandeep V. Pandit, Omer Berenfeld, José Jalife
Journal: Circulation (2014)

Little is known about the mechanisms underlying the transition from paroxysmal to persistent atrial fibrillation (AF). In an ovine model of long-standing persistent AF we tested the hypothesis that the rate of electric and structural remodeling, assessed by dominant frequency (DF) changes, determines the time at which AF becomes persistent.Self-sustained AF was induced by atrial tachypacing. Seven sheep were euthanized 11.5±2.3 days after the transition to persistent AF and without reversal to sinus rhythm; 7 sheep were euthanized after 341.3±16.7 days of long-standing persistent AF. Seven sham-operated animals were in sinus rhythm for 1 year. DF was monitored continuously in each group. Real-time polymerase chain reaction, Western blotting, patch clamping, and histological analyses were used to determine the changes in functional ion channel expression and structural remodeling. Atrial dilatation, mitral valve regurgitation, myocyte hypertrophy, and atrial fibrosis occurred progressively and became statistically significant after the transition to persistent AF, with no evidence for left ventricular dysfunction. DF increased progressively during the paroxysmal-to-persistent AF transition and stabilized when AF became persistent. Importantly, the rate of DF increase correlated strongly with the time to persistent AF. Significant action potential duration abbreviation, secondary to functional ion channel protein expression changes (CaV1.2, NaV1.5, and KV4.2 decrease; Kir2.3 increase), was already present at the transition and persisted for 1 year of follow up.In the sheep model of long-standing persistent AF, the rate of DF increase predicts the time at which AF stabilizes and becomes persistent, reflecting changes in action potential duration and densities of sodium, L-type calcium, and inward rectifier currents.
Comparison of Lovastatin and Gemfibrozil in Normolipidemic Patients With Hypoalphalipoproteinemia
Authors: Gloria Lena Vega
Journal: JAMA (1989)

This study compared lovastatin and gemfibrozil therapy for effects on lipid and lipoprotein levels in 22 normolipidemic patients with reduced high-density lipoprotein cholesterol levels. Most patients had coronary heart disease. A randomized, crossover design consisted of two drug phases (lovastatin and gemfibrozil) alternating with placebo. Lovastatin reduced total and low-density lipoprotein cholesterol and apolipoprotein B levels by 28%, 34%, and 24%, respectively. These were unaffected by gemfibrozil. Both drugs reduced very low-density lipoprotein and intermediate-density lipoprotein cholesterol levels by 30% to 40%. Both caused small but significant increases in high-density lipoprotein cholesterol, but not in apolipoproteins A-I or A-II. Both significantly lowered ratios of total (and low-density lipoprotein) cholesterol-to-high-density lipoprotein cholesterol, but lovastatin more than gemfibrozil. Thus, for normolipidemic patients with low levels of high-density lipoprotein cholesterol, neither drug markedly raised high-density lipoprotein levels, but lovastatin produced the better overall change in lipoprotein cholesterol and apolipoprotein B levels.
A first class service
Authors: Trisha Greenhalgh
Journal: BMJ (2005)

<h3>Background</h3> Patients with certain mutations in the gene encoding the slit diaphragm protein Nephrin fail to develop functional slit diaphragms and display severe proteinuria. Many adult-onset glomerulopathies also feature alterations in Nephrin expression and function. Nephrin signals from the podocyte slit diaphragm to the Actin cytoskeleton by recruiting proteins that can interact with C3G, a guanine nucleotide exchange factor of the small GTPase Rap1. Because Rap activity affects formation of focal adhesions, we hypothesized that Nephrin transmits signals to the Integrin receptor complex, which mediates podocyte adhesion to the extracellular matrix. <h3>Methods</h3> To investigate Nephrin’s role in transmitting signals to the Integrin receptor complex, we conducted genetic studies in Drosophila nephrocytes and validated findings from Drosophila in a cultured human podocyte model. <h3>Results</h3> Drosophila nephrocytes form a slit diaphragm–like filtration barrier and express the Nephrin ortholog Sticks and stones (Sns). A genetic screen identified <i>c3g</i> as necessary for nephrocyte function. <i>In vivo</i>, nephrocyte-specific gene silencing of <i>sns</i> or <i>c3g</i> compromised nephrocyte filtration and caused nephrocyte diaphragm defects. Nephrocytes with impaired Sns or C3G expression displayed an altered localization of Integrin and the Integrin-associated protein Talin. Furthermore, gene silencing of <i>c3g</i> partly rescued nephrocyte diaphragm defects of an <i>sns</i> overexpression phenotype, pointing to genetic interaction of <i>sns</i> and <i>c3g</i> in nephrocytes. We also found that activated Nephrin recruited phosphorylated C3G and resulted in activation of Integrin <i>β</i>1 in cultured podocytes. <h3>Conclusions</h3> Our findings suggest that Nephrin can mediate a signaling pathway that results in activation of Integrin <i>β</i>1 at focal adhesions, which may affect podocyte attachment to the extracellular matrix.
Supraventricular Tachycardia with Left Aberrant Conduction due to Retrograde Invasion into the Left Bundle Branch
Authors: H. J. J. WELLENS, D. DURRER
Journal: Circulation (1968)

A description is given of a patient with an atrioventricular nodal tachycardia with left aberrant conduction changing into nonaberrant conduction after a ventricular premature beat. Functional left bundle-branch block by retrograde invasion into the left bundle branch is thought to be responsible for this phenomenon.
Obituary of Hamilton Naki: Author's reply
Authors: Caroline Richmond
Journal: BMJ (2005)

Junior doctors' shifts and sleep deprivation New on-call rotas do not workEditor-Clearly the editorial by Murray et al on junior doctors' shifts has struck a chord with many, as on-call rotas are something close to many doctors hearts. 1 2 To most it seems the grass is not greener on the other side.Having worked most rotas, be it a traditional one in four, with full weekends, to partial, hybrid, and full shift patterns, I am in a reasonable position to comment on what I think makes a liveable on-call rota.I was under the impression that the European Working Time Directive was set out to improve the health and safety of workers, make working conditions better, but also make life away from work better because doctors would be less tired.The directive scores a "no" against all of these.I find myself more tired at work and at home, less enthusiastic, and less motivated by what is becoming a regular chore.Instead of being on call once a week, I find myself doing an on-call shift two or three times a week (on average), being late home more often than not because fewer juniors are around, and spending less time with my young children.The "old" rota system of a 24 hour oncall, with at least six on a rota, made on-call shifts less frequent, more tolerable, and even enjoyable.It also left plenty of time for training, and so long as there were six or more on rota, it made the annual leave far more flexible and workable.Anaesthetists rarely complained, certainly compared with other specialties' rotas, and everyone knew that however busy, you were always going to go home to a full day off in the morning.Why not listen to those doing the rota, and affected family members, and respect within reason what the workers want to work.
NAEVUS SEBACEUS.
Authors: EDWARB WILSON JONES, TEO HEYL
Journal: British Journal of Dermatology (1970)

SUMMARY.— The clinical records and the histopathology of 140 cases of naevus sebaceus and related compound epidermal naevi have been studied with special reference to the incidence of secondary tumours. In 27 lesions there were areas of syringocystadenoma papilliferum, sometimes forming a large part of the naevus. In 9 lesions, basal cell epithelioma was a secondary development, but only 3 of these epitheliomata showed evidence of an aggressive growth pattern. Fourteen other naevi were found histologically to have small areas of basaloid proliferation, but these proliferations were considered to be harnartomatous rather than epitheliomatous in nature. So far, on follow-up, none of the basal cell epitheliomata has recurred after treatment. A rare complication found in a patient aged 56 was the development of a squamous cell epithelioma which, although poorly differentiated, had not recurred 4 years after excision. Other related lesions were 3 syringomata, 2 apocrine cystadenomata and 2 osteomata. Some of the naevi showed areas of unusual squamous proliferation which were difficult to categorize histologically; in 2 instances keratoacanthomata were simulated; other proliferations showed "clear cell" differentiation or pseudo-epitheliomatous hyperplasia. It was concluded from this study that there is only a small risk of a serious malignant tumour supervening in naevus sebaceus, and that simple surgical excision is usually adequate treatment.
Cough Related to Angiotensin-Converting Enzyme Inhibition-Reply
Authors: Louis-Philippe Boulet
Journal: JAMA (1989)

In Reply. —  We thank Dr Levy for his comments. Our study addressed the following question: Is captopril-related cough associated with the development of airflow obstruction or airway hyper-responsiveness? Our observations show that this is not the case. We determined airway responsiveness using the response to inhaled methacholine. We prefer to use methacholine inhalation tests because they are among the best standardized methods of measurement of nonallergic airway responsiveness and because the degree of response to histamine/methacholine tests is closely correlated to the presence of variable airflow obstruction, the severity of asthma symptoms, and medication needs. 1 Furthermore, a direct relationship has been established between the degree of bronchial response to many chemical or physical nonallergic stimuli and methacholine/histamine.  As we mentioned in our article, 3 of 15 subjects had a mild reduction in the provocative concentration of methacholine that resulted in a 20% fall in forced expiratory volume in
Surgeon who referred girlfriend to gynaecologist has suspension revoked
Authors: C. Dyer
Journal: BMJ (2014)

<b>Background</b> EMPHASIS10 is a novel, easy to use quality of life questionnaire designed for patients with pulmonary hypertension (PH) <b><sup><i>1</i></sup></b>. We report our experience in using this score and its relation to markers of disease severity. <b>Methods and Results</b> In total, n=174 patients completed the EMPHASIS10; patients with learning difficulties were excluded. Median age [interquartile range] was 47[38-58] years and 122(70%) were female. PH diagnosis included 20(11%) patients with iPAH or heritable PAH, 97(56%) with PAH related to CHD, 22(13%) patients with PAH due to connective tissue disease and 35(20%) with other types of PH. EMPHASIS10 consists of 10 questions, each graded on a semantic differential six-point scale (0 to 5), for a maximum achievable (worse possible) score of 50. Median EMPHASIS10 score was 23[12-33]. No significant association with gender or oxygen saturation was seen. In contrast, patients in higher WHO functional class had significantly worse score (13.0[5.0-23.5] in FC I-II vs 31[22-37] in FC III-IV, p&lt;0.001). Also, a strong correlation between EMPHASIS10 score and 6MWT distance (R=0.58, p&lt;0.001) was observed. <b>Conclusion:</b> The EMPHASIS10 score is significantly associated with established predictors of exercise intolerance and prognosis. Further studies are needed to provide cut-offs which can be used to introduce or escalate disease specific therapies in PH. Yorke J et al.ERJ2014;43,1106-1113.
PERFORMANCE OF XIENCE V EVEROLIMUS-ELUTING VS. TAXUS EXPRESS PACLITAXEL-ELUTING CORONARY STENTS IN SMALL VESSELS: POOLED RESULTS OF THE SPIRIT III AND SPIRIT IV CLINICAL TRIALS
Authors: James Bernard Hermiller, Robert Applegate, Julie Dootzadeh, Wesley Pierson, Aakar Shah, John Peterson, Krishnankutty Sudhir, Gregg Stone
Journal: Journal of the American College of Cardiology (2010)
Peri-operative blood transfusion in gastric cancer surgery: prognostic or confounding factor?
Authors: Stefano Rausei, Laura Ruspi, Federica Galli, Fabio Tirotta, Davide Inversini, Francesco Frattini, Corrado Chiappa, Francesca Rovera, Luigi Boni, Gianlorenzo Dionigi, Renzo Dionigi
Journal: International Journal of Surgery (2013)
Consulting the public about health service priorities
Authors: C. Bowie, A. Richardson, W. Sykes
Journal: BMJ (1995)

Consulting the public is an important component of commissioning health services. Somerset Health Authority has devised a method of consultation using eight focus groups meeting three times a year. Each group consists of 12 people, and together the groups are demographically representative of Somerset's population. The groups are asked about issues that are concerning the health authority, and their views have influenced health authority decisions. Each group is given some background information before the meeting, together with more information at the meeting. The discussions are tape recorded and analysed for qualitative information, but the groups are also asked to score certain priorities. The groups have been found to be representative, valid, and focused on community rather than individual values. Health authorities wanting to know the values people attach to health services should adopt this qualitative approach to consultation.
Regular review: Improving the care of patients with genital herpes
Authors: S. Drake
Journal: BMJ (2000)

Clinical experience suggests that many doctors view genital herpes as an uncommon minor illness for which there is little effective treatment. Yet the converse is true. More than 28 000 cases of genital herpes were reported from clinics dealing with sexually transmitted diseases in England in 1998, and seroprevalence studies suggest that there are many more unrecognised infections. Patients often present having had frequent painful attacks of genital ulceration for many years, although effective antiviral drugs are available that dramatically reduce morbidity if used appropriately. In addition patients often believe that they are infectious only during symptomatic episodes, despite evidence that most transmission occurs from asymptomatic shedding of the virus.1 This poor understanding may result in unnecessary morbidity for patients and their partners and inhibits efforts to reduce the spread of genital herpes.

#### Summary points

Up to 50% of first episode genital herpes in the United Kingdom is attributable to herpes simplex type 1 virus, although recurrences are far more likely after infection with herpes simplex type 2 virus

Many patients and clinicians are unaware that oral sex is a common route of transmission of genital herpes infections

Transmission from asymptomatic individuals in monogamous relationships can occur after several years, causing severe psychological distress

The majority of patients with genital herpes simplex virus infections have symptoms and signs unrecognised by either themselves or their clinicians

Oral antiviral treatment should be given for primary or first episode genital herpes, and long term oral suppressive antiviral treatment is highly effective in reducing recurrences of symptoms in selected patients

Acquisition of a new herpes simplex virus type in the third trimester of pregnancy can have serious implications for the neonate and requires specialist intervention

We have concentrated on the clinical management of genital herpes. Sources of information included the UK national guidelines,2 relevant …