tbuckley/cabot-search huggingface dataset:
Variability Of Major Allergens In Commercially Available Peanut Extracts For Skin Prick Testing
Authors: Yong Luo, Vincent R. Bonagura, David Rosenthal
Journal: Journal of Allergy and Clinical Immunology (2014)

RATIONALE: Skin prick tests (SPT) are commonly used to screen patients with suspected IgE-mediated food reactions.During preparation of commercial extracts (CE) for SPT, labile proteins that are responsible for IgE-mediated sensitivity may be degraded or lose allergenicity.For this reason, fresh food (FF) SPT may be performed.METHODS: This is a retrospective analysis of children seen at National Jewish Health for evaluation of peanut allergy who underwent SPT using both commercial peanut extract and peanut butter diluted in buffered saline.An open oral food challenge (OFC) to peanut was performed in all subjects, and results were determined by the judgment of a physician.We sought to correlate the results of SPT using CE and FF to OFC outcomes and compare results obtained using each form of SPT.RESULTS: In 62 subjects, SPT were positive in 47% using CE and 50% using FF.The two methods were in agreement in 48 (77%) subjects.OFCs were positive in 15 (24%) subjects.The positive predictive value of SPT for the OFC was 31% using CE (95% CI[16, 51%]) and 29% using FF (95% CI [15, 48%]).The negative predictive values of SPT using CE and FF were 82% (95% CI [64, 92%]) and 81% (95% CI[62, 92%]), respectively.CONCLUSIONS: The predictive power of SPT using CE and FF in diagnosing peanut allergy is similar, though slightly better for CE.The use of SPT with FF is not superior to CE, nor is it a useful adjunct to CE in diagnosing peanut allergy.
Scene setter: the importance of taking a systems approach to person centred care
Authors: S. Leyshon, S. McAdam
Journal: BMJ (2015)

Since the end of the second world war healthcare has changed greatly. Advances in treatment mean that the average life expectancy in the UK, for example, has grown by 20 years. But this has come at a cost. Health systems are significantly more complex, with care becoming ever more subspecialised. Increasing numbers of health and social care professionals are involved in each patient’s journey through the system—reflecting the changing needs of populations that are ageing and living longer with comorbid chronic conditions. Within this complexity the service user risks getting lost as different parts of the health and social care system struggle to coordinate with each other. Too often services are delivered in ways that fit with abstract policy …
Decline in mortality in children with HIV in the UK and Ireland
Authors: D M Gibb, T Duong, P A Tookey
Journal: BMJ (2004)

Editor—Mhlongo and Maduna and Prime et al challenge the results of our study and think that we overlooked alternative reasons for the rapid fivefold decline in mortality, progression to AIDS, and hospital admission rates we reported in the CHIPS cohort of vertically HIV infected children in the United Kingdom and Ireland. We cannot agree that they provide viable alternative explanations for the dramatic reduction.

Firstly, we did not include details of management of opportunistic infections, and we agree that there is indirect evidence that cotrimoxazole prophylaxis reduces the frequency of these (particularly Pneumocystis carinii pneumonia in infancy, as previously reported in the United Kingdom1). This does not explain the magnitude or the timing of the effect we observed; cotrimoxazole prophylaxis has been widely used in HIV infected children in the United Kingdom and Ireland since the early 1990s, as evidenced by its inclusion in guidelines in 1994, which reflected established practice at that time.2 No other significant change in the management or prophylaxis of opportunistic infections occurred around the time that combination antiretroviral therapy became available.

Secondly, we do not see the relevance of including details on mode of delivery as our paper related only to HIV infected children (the authors seem unaware of the published clinical trial that compared mother to child transmission rates after elective caesarean section v vaginal delivery3).

Thirdly, although we agree that the nutritional status of children in the United Kingdom and Ireland is much better than in Africa, we were not comparing survival of children in Africa with those here. Rather, we included children in the analysis of our cohort only after they had presented to medical services in the United Kingdom or Ireland (as detailed in the methods section). If anything, there might have been a bias towards poorer prognosis for the children presenting in more recent years who were more likely to be recent arrivals from Africa with advanced symptomatic disease.

Finally, we did not discuss clinical trials as our paper was about a cohort study. However, among paediatricians working with HIV infected children there is a strong tradition of enrolling children in clinical trials through the Paediatric European Network for Treatment of AIDS (PENTA).
Transient Synovitis and Perthes's Disease
Authors: C. P. Monty
Journal: BMJ (1973)

Riot Control Agent SIR,-In your leading article (7 July, p. 5) it vws reported that an improvement on the riot control CS gas is on the way.It is code-named CR and, being of low toxicity but extremely irritant to skin, eyes, nose and throat, only very little would cause con- siderable pain and discomfort.In the article there was no expression of concern or disgust that oral LD 5 tests were done on animals to test the toxicity of the compound.If a dose of very low toxicity can cause such acute symptoms when applied to the skin and mucous membranes it seems quite possible that doses of high, lethal, toxicity, even when given by other routes, will cause severe pain and distress.Does medical ethics approve the use of animals in this way in testing substances which only our own folly have made necessary?-Iam, etc., J. D. WHITTALL Rye, Sussex Haemolytic-Uraemic Syndrome with Pericarditis SIR,-We were interested in the case re- ported by Drs.J. A. Utting and D. R. Shreeve (9 June, p. 591) of a patient with haemolytic-uraemic syndrome and pericarditis.Their statement that "no cases with prominent friction rubs due to the micro- angiopathy have previously been described" is not correct.In 1972 we reported1 a case of haemolytic-uraemic syndrome and nmicroan- giepathy in a woman with a hydatidiform mole who had a strong pericardial rub and who recovered with heparin therapy.This rub also was unrelated to uraemia.-Weare, etc.,
Anticoagulation by Ancrod for Haemodialysis
Authors: G. H. Hall, H. M. Holman, A. D. B. Webster
Journal: BMJ (1970)

The defibrinating agent ancrod (Arvin) was used instead of heparin for intermittent haemodialysis. It was an effective, and apparently safe, anticoagulant and reduced the deposition of fibrin and leucocytes on the Cellophane membrane. Administration was more complicated and urea dialysance was less with ancrod than with heparin.
Disseminating health information in developing countries: the role of the internet
Authors: T. T.-T. Edejer
Journal: BMJ (2000)

During a visit to India in March President Clinton watched a woman enter a village health centre, call up a web page on the computer, and get information on how to care for her baby. 1 It is possible that this baby will have better health because of the availability of information on the internet.However, this possibility is underpinned by several assumptions, and the potential of information and communication technologies still has not been harnessed systematically to bring about important improvements in the health of populations, particularly among those who are poor and isolated in developing countries.This article explores the potential of advances in information and communication technologies to disseminate information and describes the availability of access to technology in developing countries.It also discusses issues of accuracy and the relevance of content. MethodsSources for this paper were obtained by searching Medline using the term dissemination and from visits to websites and links to related organisations known to be working in the areas of health research and information and communication technologies in developing countries.Information was also provided by key informants working in international health research.
Intracellular polymerization of sickle hemoglobin. Effects of cell heterogeneity.
Authors: C T Noguchi, D A Torchia, A N Schechter
Journal: Journal of Clinical Investigation (1983)

To determine the extent to which the broad distribution in intracellular hemoglobin concentrations found in sickle erythrocytes affects the extent of intracellular polymerization of hemoglobin S, we have fractionated these cells by density using discontinuous Stractan gradients. The amount of polymer formed in the subpopulations was experimentally measured as a function of oxygen saturation using 13C nuclear magnetic resonance spectroscopy. The results for each subpopulation are in very good agreement with the theoretical predictions based on the current thermodynamic description for hemoglobin S gelation. We further demonstrate that the erythrocyte density profile for a single individual with sickle cell anemia can be used with the theory to predict the amount of polymer in unfractionated cells. We find that heterogeneity in intracellular hemoglobin concentration causes the critical oxygen saturation for formation of polymer to shift from 84 to greater than 90%; polymer is formed predominantly in the dense cells at the very high oxygen saturation values. The existence of polymer at arterial oxygen saturation values has significance for understanding the pathophysiology of sickle cell anemia. The utility of these techniques for assessing various therapeutic strategies is discussed.
Mortality and the risk of malignancy in autoimmune liver diseases: A population-based study in Canterbury, New Zealand
Authors: Mohamed I.F. Shariff, James Maggs, Michael A. Heneghan
Journal: Hepatology (2012)

We read with interest the recent article by Ngu et al.1 that reports a population-based study examining mortality and the risk of hepatobiliary and nonhepatobiliary malignancy in patients with autoimmune liver disease. During the 7-year study period a total of 130 autoimmune hepatitis (AIH), 70 primary biliary cirrhosis (PBC), and 81 primary sclerosing cholangitis patients were identified. Of those patients with AIH, three developed hepatocellular carcinoma (HCC), while 28 developed an extrahepatic malignancy. Although it is commented that cirrhosis was present in all AIH patients with HCC, no information on the severity of liver disease or fibrosis is given for the study cohort as a whole. We wish to draw the authors' attention to a study conducted by our institution, where 243 patients with AIH were identified and prospectively followed up between 1971 to 2007.2 In this cohort, 15 patients with AIH developed HCC, which equated to an annual incidence of 1.1%. The data demonstrated that cirrhosis was the sine qua non for the development of HCC in AIH, an association that is further supported by the data from Ngu et al. Furthermore, in their study, Ngu et al. report that the risk of HCC is 15-fold greater in AIH patients in comparison to that in a matched general population. However, as a result of the absence of information on liver disease severity it is not possible to determine the proportion of the cohort that were "at risk" of developing HCC. Indeed, the authors comment that the increased incidence of nonhepatic malignancy in the AIH study population may be the result of lead-time bias resulting from incidental diagnoses during HCC surveillance investigations without elaborating on the proportion undergoing surveillance. Similarly, the influence of liver disease severity on HCC risk may also be reflected in the risk of malignancy observed in patients with PBC. No cases of HCC were reported within their cohort during the study period. As with AIH, cirrhosis is an established risk factor for HCC in PBC,3, 4 and without knowledge of the number of patients with PBC at risk of HCC it is not possible to determine whether the study population size is sufficient to permit firm conclusions as to the incidence of hepatic malignancy in PBC. Although we commend Ngu et al. for a comprehensive study, we would have welcomed further detailed information on the severity of liver disease within their patient population, given its important and established influence on the risk of hepatobiliary malignancy in patients with autoimmune liver disease. Mohamed I.F. Shariff*, James Maggs*, Michael A. Heneghan*, * Liver Unit, Department of Medicine, Imperial College London, London, UK.
John Tracey Scales
Authors: P Hampson
Journal: BMJ (2004)

Emeritus professor of biomechanical engineering University of London (b Colchester 2 July 1920; q London 1944; OBE, FRCS, CI Mech E), d 30 January 2004.

From 1952 to 1974 John Tracey Scales was a lecturer and then became a reader at the Royal National Orthopaedic Hospital (RNOH), London and Stanmore. During this time he developed Airstrip dressings. He then started the biomedical engineering department at the RNOH, and became a professor in 1974. The department became known as the Institute of Orthopaedics, part of the University of London. John Scales designed the Stanmore range of Total Joints for hips, knees, shoulders, and elbows. He was honorary director of research at the RAFT Institute for Plastic Surgery at Mount Vernon Hospital, Northwood, producing a low air loss mattress to prevent pressure sores.
Letter: Fenfluramine and psychosis.
Authors: I Oswald
Journal: BMJ (1974)

different (t = 163, P = 0 20) and breast and bottle feeding were equally distributed between the two groups x2 = 0 054; N.S.).Though the mean duration of infusion of oxytocin in group 1 (10-8 ± 8-7 hr) was greater than in group 2 (8 0 ± 7-1 hr) the difference was not statistically significant (t = 1 49, P = 0-14).We agree with Dr. B. Alderman and Professor J. M. Beazley (7 September, p. 624) that the first and sixth days are not ideal times to detect peak neonatal bilirubin levels.However, as we pointed out in our paper, the sixth day was a time at which blood was already being taken routinely for amino-acid screening and this timing of samples avoided exposing the infants to additional blood-letting.Though the re- corded peak values in our data may be lower for this reason, any increase in neonatal hyperbilirubinaemia should still be reflected in a higher mean value on the sixth day.-We are, etc.,
Behavioral momentum and multiple stimulus control topographies
Authors: William J. McIlvane, William V. Dube
Journal: Behavioral and Brain Sciences (2000)

We have analyzed many discrimination learning difficulties as reflecting multiple stimulus control topographies (SCTs). Nevin &amp; Grace's analysis offers new variables to consider in the design of stimulus-control shaping procedures and cross-setting generalization of newly established behavior. A multiple-SCT perspective also suggests that fixed-trial discrimination procedures may offer advantages for reconciling momentum theory and partial reinforcement extinction effects.
Total audit of preventive practices
Authors: M W Taylor, L D Ritchie, R J Taylor
Journal: BMJ (1990)

the 35 who had moved into it (excluding the six children who had moved away or had no records).Doctors who are enthusiastic immunisers in practices with a high turnover of children therefore have to work exceptionally hard, as immunised children who move away tend to be replaced by those who have not been immunised.Un- fortunately, not even enthusiasts can give preschool boosters to children who have not completed the primary course.The practice's overall uptake of the preschool booster was disappointing at 68%, well below that of the primary course, which then averaged 85% across the new contract's three immunisation groups.The uptake has since been improved to 77% and can no doubt be improved further.For many practices, however, a target of 90% seems even more unreasonable for the preschool booster than for the primary course.
Abstract LB-153: Influence of macrophages and p38α/β signaling on early metastatic dissemination of premalignant ErbB2+ mammary epithelial cells
Authors: Nina Linde, Arthur Mortha, Soledad Sosa, Miriam Merad, Julio Aguirre-Ghiso
Journal: Cancer Research (2014)

Abstract Metastases originate from tumor cells that disseminate from the primary site through a process aided by macrophages. This was proposed to occur only during late invasive stages of cancer. However, the presence of tumor cells in the bone marrow of patients with ductal carcinoma in situ (DCIS), a pre-invasive form of breast cancer, argues that these events can take place earlier. The mechanisms driving this process are poorly understood. Our lab showed that in the MMTV-ErbB2 breast cancer model, inhibition of p38 signaling accelerated disease progression and enhances early dissemination. Using this same model and knowing that macrophages are key for mammary gland development and remodeling, we investigated whether these inflammatory cells might actively participate in early dissemination. We now show that F4/80+ macrophages associate with mammary ducts in the periphery of the myoepithelial layer but are never inside the ducts in wild type or in pre-malignant 18-20 week old MMTV-ErbB2 mice mammary glands. We found that macrophages are recruited into epithelial layers of pre-malignant lesions, when the ErbB2 oncogene is amplified and p38 activity is lost. This event showed a high correlation with enhanced dissemination of ErbB2+CK8/18+ mammary epithelial cells (MECs) detected in circulation or the bone marrow. Sites where macrophages had invaded the ducts showed disruption of the myoepithelium and reduced E-Cadherin expression in MECs. Depletion of macrophages from pre-malignant MMTV-Neu mice abolished p38 driven early dissemination. Importantly, DCIS samples from patients frequently contained intra-epithelial macrophages. These data suggest that macrophages may actively aid early dissemination from pre-malignant tissue, but only in the context of p38 inhibition and ErbB2 activation. Further, in areas of macrophage infiltration, luminal ductal cells may downregulate E-cadherin, which could foster cell migration/invasion. Our data in human DCIS samples further underscores the relevance of our findings and indicates that analysis of macrophages in DCIS lesions might be useful to better identify patients at high risk of carrying disseminated disease. Citation Format: Nina Linde, Arthur Mortha, Soledad Sosa, Miriam Merad, Julio Aguirre-Ghiso. Influence of macrophages and p38α/β signaling on early metastatic dissemination of premalignant ErbB2+ mammary epithelial cells. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr LB-153. doi:10.1158/1538-7445.AM2014-LB-153
Living with AIDS
Authors: Joanna Busza
Journal: BMJ (2006)

Radio 4's Living with AIDS series focuses on disparate experiences of the HIV pandemic. In the first programme, Blood Brothers , we are reminded of the men with haemophilia who contracted HIV in the early 1980s through factor VIII. In the United Kingdom 25% of patients receiving factor VIII were infected with HIV before doctors fully understood the problem. 

We hear from Mick, who realised that he was infected with HIV only when instructions for a special diet for people with AIDS arrived in the post. He was told he had two years to live, and recalls receiving little support or advice beyond “Go out and enjoy yourself ... but don't have sex!” …
Antenatal care and high-risk babies.
Authors: M L Chiswick
Journal: BMJ (1980)

However, it seems relevant to refer now to the incidence of vomiting in paracetamol poison- ing.In total, we have records of 392 patients who ingested analgesic overdoses which included paracetamol; 120 took paracetamol alone, 44 took Distalgesic (dextropropoxyphene and paracetamol) alone, 157 took paracetamol combined with other drugs, and 71 took Distalgesic combined with other drugs.Among these patients only 46 (11-7 %) had vomited or were vomiting at the time of admission; and of the 63 who were treated with oral methionine, vomiting occurred in only 13.Further examination of these cases shows that all vomited before the treatment began but that this symptom did not persist during treatment.Obviously further analysis of these data is required, but it is already appaient that the difference in the incidence of vomiting with this type of poisoning as reported from Edinburgh (77 %)1 and London (16 %)2 cannot be explained simply by the fact that many of the latter data are collected indirectly through the Poisons Information Service inquiries.
Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) Equation Pronouncedly Underestimates Glomerular Filtration Rate in Type 2 Diabetes
Authors: Sandra P. Silveiro, Gustavo N. Araújo, Mariana N. Ferreira, Fabíola D.S. Souza, Halley M. Yamaguchi, Eduardo G. Camargo
Journal: Diabetes Care (2011)

OBJECTIVE To evaluate the performance of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation to estimate glomerular filtration rate (GFR) in type 2 diabetic patients with GFR &amp;gt;60 mL/min/1.73 m2. RESEARCH DESIGN AND METHODS This was a cross-sectional study including 105 type 2 diabetic patients. GFR was measured by 51Cr-EDTA method and estimated by the MDRD and CKD-EPI equations. Serum creatinine was measured by the traceable Jaffe method. Bland-Altman plots were used. Bias, accuracy (P30), and precision were evaluated. RESULTS The mean age of patients was 57 ± 8 years; 53 (50%) were men and 90 (86%) were white. Forty-six (44%) patients had microalbuminuria, and 14 (13%) had macroalbuminuria. 51Cr-EDTA GFR was 103 ± 23, CKD-EPI GFR was 83 ± 15, and MDRD-GFR was 78 ± 17 mL/min/1.73 m2 (P &amp;lt; 0.001). Accuracy (95% CI) was 67% (58–74) for CKD-EPI and 64% (56–75) for MDRD. Precision was 21 and 22, respectively. CONCLUSIONS The CKD-EPI and MDRD equations pronouncedly underestimated GFR in type 2 diabetic patients.
The potential role of glutamate transporters in the pathogenesis of normal tension glaucoma
Authors: Takayuki Harada, Chikako Harada, Kazuaki Nakamura, Hun-Meng A. Quah, Akinori Okumura, Kazuhiko Namekata, Tadashiro Saeki, Makoto Aihara, Hiroshi Yoshida, Akira Mitani, Kohichi Tanaka
Journal: Journal of Clinical Investigation (2007)

Glaucoma, a progressive optic neuropathy due to retinal ganglion cell (RGC) degeneration, is one of the leading causes of irreversible blindness. Although glaucoma is often associated with elevated intraocular pressure (IOP), IOP elevation is not detected in a significant subset of glaucomas, such as normal tension glaucoma (NTG). Moreover, in some glaucoma patients, significant IOP reduction does not prevent progression of the disease. Thus, understanding IOP-independent mechanisms of RGC loss is important. Here, we show that mice deficient in the glutamate transporters GLAST or EAAC1 demonstrate spontaneous RGC and optic nerve degeneration without elevated IOP. In GLAST-deficient mice, the glutathione level in Müller glia was decreased; administration of glutamate receptor blocker prevented RGC loss. In EAAC1-deficient mice, RGCs were more vulnerable to oxidative stress. These findings suggest that glutamate transporters are necessary both to prevent excitotoxic retinal damage and to synthesize glutathione, a major cellular antioxidant and tripeptide of glutamate, cysteine, and glycine. We believe these mice are the first animal models of NTG that offer a powerful system for investigating mechanisms of neurodegeneration in NTG and developing therapies directed at IOP-independent mechanisms of RGC loss.