tbuckley/cabot-search huggingface dataset:
Community Child Health and Paediatrics
Authors: S. Jarvis, M. Bagott
Journal: BMJ (1995)

David Harvey, Marion Miles, Diane Smyth Butterworth-Heinemann, £125, pp 705 ISBN 0 7506 1323 8

Community Child Health and Paediatrics deals with a neglected topic: the specialised health needs of children that are the core elements of community child health practice. This does not include hospital treatment--the editors deliberately omit those “items which relate to the care of acutely ill children”--or the treatment of children …
Mobile Thromboses of the Aortic Arch Without Aortic Debris
Authors: Thierry Laperche, Claude Laurian, Raymond Roudaut, P. Gabriel Steg
Journal: Circulation (1997)

Background Atherosclerotic lesions of the aortic arch are potential sources of arterial embolism. Mobile thrombi in the aortic arch in young patients without diffuse atherosclerosis have been reported recently, but such cases remain exceptional. We describe a series of young patients with unexplained arterial embolism in whom transesophageal echocardiography detected mobile aortic arch thromboses. Methods and Results Transesophageal echocardiography files collected between 1991 and 1995 in French academic cardiology centers were reviewed to identify patients who fulfilled the following criteria: (1) an arterial embolic event in the preceding weeks; (2) a mobile pedunculated aortic arch thrombosis, defined as an echogenic mass protruding into the lumen of the aorta and inserted on the aortic arch; and (3) absence of obvious diffuse aortic atherosclerosis or of aortic debris on transesophageal echocardiography. Twenty-three cases were identified from 27 855 examinations. Thromboses were located on the horizontal aorta (n=4), near the ostium of the left subclavian artery (n=5), or on the concavity of the posterior segment of the aortic arch (in the isthmus) (n=14). The insertion site was a small atherosclerotic plaque in 21 patients. The remaining aortic wall always appeared normal or mildly atherosclerotic. The mean age of the patients was 45±8.4 years (range, 26 to 61 years). All patients were treated with intravenous heparin after the diagnosis of aortic arch thrombosis, and surgical removal of the thrombosis was performed in 10 patients in whom histological examination confirmed an atherosclerotic process at the site of insertion of the thrombosis. The prognosis was mainly influenced by embolic events. Conclusions Thromboses of the aortic arch appear to be a variant form of aortic atherosclerotic disease associated with arterial embolism in young patients.
Hypomethylation of multiple imprinted loci in individuals with transient neonatal diabetes is associated with mutations in ZFP57
Authors: Deborah J G Mackay, Jonathan L A Callaway, Sophie M Marks, Helen E White, Carlo L Acerini, Susanne E Boonen, Pinar Dayanikli, Helen V Firth, Judith A Goodship, Andreas P Haemers, Johanne M D Hahnemann, Olga Kordonouri, Ahmed F Masoud, Elsebet Oestergaard, John Storr, Sian Ellard, Andrew T Hattersley, David O Robinson, I Karen Temple
Journal: Nature Genetics (2008)
Purchasing and Providing Cost-Effective Health Care
Authors: A Szczepura
Journal: BMJ (1994)

Michael F Drummond, Alan Maynard Churchill Livingstone, £14.95, pp 260 ISBN 0-443-04946-7

Medical care is changing dramatically in all parts of the world; it is becoming more ambitious and and more effective, but also more expensive. This has led to increased emphasis on cost containment in public health systems such as the NHS. However, effective cost containment is not the same as ensuring that health care is provided in the most cost effective manner; for this the effectiveness and quality of care provided must be carefully evaluated and related to costs. The NHS, like other health care systems, is increasingly coming to …
We still need artesunate monotherapy
Authors: Elizabeth Ashley, Rose McGready, Ric Price
Journal: BMJ (2006)

EDITOR—Seen from Geneva, the World Health Organization's “ultimatum” on artemisinin monotherapy may seem a landmark in prolonging the useful therapeutic life of the artemisinin derivatives,1 but for the clinicians in the field, the matter is different.

In 1991 on the Thai-Myanmar border we were facing the prospect of untreatable Plasmodium falciparum malaria as drug resistance emerged to standard antimalarial agents. The problem was circumvented by combining artesunate or …
Role of c-fos and E2F in the induction of cyclin A transcription and vascular smooth muscle cell proliferation.
Authors: A M Sylvester, D Chen, K Krasinski, V Andrés
Journal: Journal of Clinical Investigation (1998)

Excessive proliferation of vascular smooth muscle cells (VSMCs) contributes to vessel renarrowing after angioplasty. Here we investigated the transcriptional regulation of the cyclin A gene, a key positive regulator of S phase that is induced after angioplasty. We show that Ras-dependent mitogenic signaling is essential for the normal stimulation of cyclin A promoter activity and DNA synthesis in VSMCs. Overexpression of the AP-1 transcription factor c-fos can circumvent this requirement via interaction with the cAMP-responsive element (CRE) in the cyclin A promoter. Moreover, c-fos overexpression in serum-starved VSMCs results in the induction of cyclin A promoter activity in a CRE-dependent manner, and increased binding of endogenous c-fos protein to the cyclin A CRE precedes the onset of DNA replication in VSMCs induced by serum in vitro and by angioplasty in vivo. We also show that E2F function is essential for both serum- and c-fos-dependent induction of cyclin A expression. Taken together, these findings suggest that c-fos and E2F are important components of the signaling cascade that link Ras activity to cyclin A transcription in VSMCs. These studies illustrate a novel link between the transcriptional and cell cycle machinery that may be relevant to the pathogenesis of vascular proliferative disorders.
Possible role of imatinib in clinical pulmonary veno-occlusive disease
Authors: M. J. Overbeek, G. P. van Nieuw Amerongen, A. Boonstra, E. F. Smit, A. Vonk-Noordegraaf
Journal: European Respiratory Journal (2008)

The platelet-derived growth factor receptor inhibitor imatinib has demonstrated clinical and haemodynamical improvement in both animal models of pulmonary hypertension (PH) and patients with PH. It has been suggested that anti-proliferative effects on pulmonary vascular smooth muscle cells are responsible for these beneficial effects. The current study describes a patient with pulmonary arterial hypertension associated with a suspected pulmonary veno-occlusive disease. Treatment with imatinib resulted in rapid clinical improvement and decrease of ground-glass opacities and lobular septal thickening on high-resolution computed tomography. Based on these findings and on in vitro effects of imatinib on permeability of the endothelium, the authors hypothesise that the rapid clinical outcome is partly due to effects of imatinib on vascular integrity.
Chronic hepatitis C virus (HCV) disease burden and cost in the United States
Authors: Homie Razavi, Antoine C. ElKhoury, Elamin Elbasha, Chris Estes, Ken Pasini, Thierry Poynard, Ritesh Kumar
Journal: Hepatology (2012)

Hepatitis C virus (HCV) infection is a leading cause of cirrhosis, hepatocellular carcinoma, and liver transplantation. A better understanding of HCV disease progression and the associated cost can help the medical community manage HCV and develop treatment strategies in light of the emergence of several potent anti-HCV therapies. A system dynamic model with 36 cohorts was used to provide maximum flexibility and improved forecasting. New infections incidence of 16,020 (95% confidence interval, 13,510-19,510) was estimated in 2010. HCV viremic prevalence peaked in 1994 at 3.3 (2.8-4.0) million, but it is expected to decline by two-thirds by 2030. The prevalence of more advanced liver disease, however, is expected to increase, as well as the total cost associated with chronic HCV infection. Today, the total cost is estimated at $6.5 ($4.3-$8.4) billion and it will peak in 2024 at $9.1 ($6.4-$13.3) billion. The lifetime cost of an individual infected with HCV in 2011 was estimated at $64,490. However, this cost is significantly higher among individuals with a longer life expectancy.This analysis demonstrates that US HCV prevalence is in decline due to a lower incidence of infections. However, the prevalence of advanced liver disease will continue to increase as well as the corresponding healthcare costs. Lifetime healthcare costs for an HCV-infected person are significantly higher than for noninfected persons. In addition, it is possible to substantially reduce HCV infection through active management. (HEPATOLOGY 2013;57:2164-2170).
Long-Term Follow-up Study of Periarteritis Nodosa.
Authors: Peter P. Frohnert
Journal: Annals of Internal Medicine (1966)

s1 May 1966Long-Term Follow-up Study of Periarteritis Nodosa.Peter P. Frohnert, M.D., Sheldon G. Sheps, M.D., F.A.C.P.Peter P. Frohnert, M.D.Search for more papers by this author, Sheldon G. Sheps, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-64-5-1156_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptDuring the 16 years ending December 31, 1962, 130 patients with a histologic diagnosis of periarteritis nodosa were treated at the Mayo Clinic. The greatest incidence was in the fourth and fifth decades of life (range, 6 to 72 years). The male: female distribution was 2:1. Fever and weight loss were the most common symptoms (75% of the patients) while involvement of joints, skin, or nervous system was noted in 50 to 60%. Sixty-five patients (50%) had received adrenocorticotrophic hormone or corticosteroids before admission here, and this group appeared to have a lower incidence (13 versus 24) and a less... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Peter P. Frohnert, M.D.; Sheldon G. Sheps, M.D., F.A.C.P.Affiliations: Rochester, Minnesota PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1966Volume 64, Issue 5Page: 1156-1156KeywordsAdrenocorticotropic hormoneFeversNervous systemWeight loss ePublished: 1 December 2008 Issue Published: 1 May 1966 PDF downloadLoading ...
Choice of Treatment for Cervix Cancer
Authors: Saul B. Gusberg
Journal: JAMA (1965)

Contributions to modern radiotherapy by the radiobiologist and radiation physicist, and the rapid advancement in modern surgical adjuvents, including anesthesiology, blood banks, antibiotics, and ever increasing capacity to correct the chemical imbalance of operative stress, have brought us to an era where we have two excellent, but not perfect, modalities of treatment for carcinoma of the cervix. There is no doubt that skillful radiation or surgical therapy can attain a high rate of cure in stage I and stage II tumors.  With the peculiar adaptability of the female reproductive organs to the reception of radium, the generally radiosensitive nature of these tumors, and the relatively low morbidity associated with the radiotherapeutic treatment, one would think that this should continue to be the standard treatment for this disease. Yet, in centers where teams of physicians experienced in this area, including the cytologist, pathologist, gynecologist, and radiotherapist, pool their skills so that
Dog Food, People Food and Other Matters
Authors: Daniel S. Greenberg
Journal: New England Journal of Medicine (1976)

This being a holiday season, I solicit a gift of tolerance from editors and readers so that I may depart from the rigors of dispassionate inquiry and exposition that normally characterize writings in this journal and address myself to subjects on which personal feelings will intrude.Now, a pet peeve, so to speak, one on which I have occasionally written elsewhere without any success in evoking support, is the failure of the food industry to provide humans with a product that approximates the cost and nutritional virtue of many dog foods.Some readers are probably gagging at this expression of . . .
Ventricular Tachycardia After Synchronized Direct-Current Countershock
Authors: Walter S. Graf, Paul Etkins
Journal: JAMA (1964)

RECENT ARTICLES summarize the current status of electric countershock in the management of arryhthmias.<sup>1,2</sup>Ventricular tachycardia has been induced in a patient by synchronized directcurrent countershocks. Despite prior anticoagulant therapy, the patient also had a peripheral embolization shortly after the restoration of sinus rhythm with electric countershock. <h3>Report of a Case</h3> Rheumatic fever had been diagnosed in this 56-year-old man when he was 9 years of age. A "leakage of the heart" was observed when he was 16 years old. In 1962 he had atypical angina. At that time atrial fibrillation was noted. Protein-bound iodine and radioactive iodine (I<sup>131</sup>) uptake studies were normal. In 1963 a clearly defined mitral diastolic murmur was heard for the first time. Radiologic study disclosed a moderately enlarged left atrium. One year earlier cardiac fluoroscopy had shown no chamber enlargements. The patient's ventricular rate was controlled with 0.75 mg of gitalin (amorphous ) daily.
Incidence of Intussusception in Newcastle Children
Authors: D. Court, G. Knox
Journal: BMJ (1959)

DARTALAN E MW14LJOM have concerned patients of normal intelligence, all our patients were mentally defective.We suggest that in the genetically determined cases of mental defect, developmental abnormalities of and, in the environmentally determined cases, damage to the basal ganglia, insufficient in itself to produce signs of Parkinsonism, may considerably lower the threshold dosage of dartalan that can cause these signs to appear.As we have stated, none of these patients had previously shown any signs of Parkinsonism, nor were any of them known to have suffered from encephalitis.It is well known, however, that a clear history of encephalitis in patients developing post-encephalitic Parkinsonism is frequently absent, and it seems probable that it would be absent in our cases if, as we suggest, the resulting damage was insufficient to produce post- encephalitic Parkinsonism of its own accord. SummaryAn account is given of the development of signs of Parkinsonism in 15 of 31 male and female mentally defective patients who were under treatment with dartalan, a phenothiazine derivative, in an attempt to control their behaviour disorders.Attention is drawn to the occurrence of oculogyric crises in a pair of identical twins.A possible explanation is suggested for the very much higher incidence of this complication of treatment with dartalan in this series than in any previously reported.We thank Messrs. G. D. Searle & Co. for providing a free initial supply of dartalan and for their helpful advice on all occasions.We are grateful to Professor Golla and Dr. W. Grey Walter, of the Burden Neurological Institute, for their help with the E.E.G
Prenatal allergic sensitization to helminth antigens in offspring of parasite-infected mothers.
Authors: G J Weil, R Hussain, V Kumaraswami, S P Tripathy, K S Phillips, E A Ottesen
Journal: Journal of Clinical Investigation (1983)

Total and filaria-specific immunoglobulin E (IgE) levels were studied in cord blood from infants born in Madras, India, where filariasis and intestinal helminth infections are highly endemic. Increased total IgE levels were observed in 82% of 57 cord sera tested (geometric mean 12.6 ng/ml; range 1-1,900 ng/ml). 33 of these sera also contained IgE antibodies specific for filarial antigens as determined by solid-phase radioimmunoassay. Comparison of ratios of filaria-specific IgE to total IgE in paired maternal and cord sera suggested that cord blood IgE was derived from the fetus in most cases and not from transplacental antibody transfer. Our results suggest that prenatal allergic sensitization to helminth parasites occurs in the tropics. Such sensitization may contribute to the heterogeneity in host immune response and disease expression noted in filariasis and other helminth infections.
Leptin enhances wound re-epithelialization and constitutes a direct function of leptin in skin repair
Authors: Stefan Frank, Birgit Stallmeyer, Heiko Kämpfer, Nicole Kolb, Josef Pfeilschifter
Journal: Journal of Clinical Investigation (2000)

Wound-healing disorders are a therapeutic problem of extensive clinical importance. Leptin-deficient ob/ob mice are characterized by a severely delayed wound healing that has been explained by the mild diabetic phenotype of these animals. Here we demonstrate that systemically and topically supplemented leptin improved re-epithelialization of wounds in ob/ob mice. Leptin completely reversed the atrophied morphology of the migrating epithelial tongue observed at the wound margins of leptin-deficient animals into a well-organized hyperproliferative epithelium. Moreover, topically supplemented leptin accelerated normal wound-healing conditions in wild-type mice. As assessed by immunohistochemistry, proliferating keratinocytes located at the wound margins specifically expressed the leptin-receptor subtype ObRb during repair. Additionally, leptin mediated a mitogenic stimulus to the human keratinocyte cell line HaCaT and human primary keratinocytes in vitro. Therefore, leptin might represent an effective novel therapeutic factor to improve impaired wound-healing conditions.
Neonatal screening for congenital hypothyroidism by measurement of plasma thyroxine and thyroid stimulating hormone concentrations.
Authors: K D Griffiths, N K Virdi, P H Rayner, A Green
Journal: BMJ (1985)

Neonatal screening for congenital hypothyroidism was introduced in the City of Birmingham in 1980 by measuring concentrations of both thyroid stimulating hormone and thyroxine in plasma. Over two years 30 108 babies were tested. Thirty one babies were recalled because of thyroid stimulating hormone concentrations greater than 40 mU/l, of whom 12 were treated with replacement thyroxine. Six babies were found to have low thyroxine concentrations because of reduced thyroxine binding globulin and five raised thyroxine values because of increased thyroxine binding globulin. As a result of this study screening was continued with measurement of thyroid stimulating hormone only as the primary test for congenital hypothyroidism, the thyroxine value being measured only when the concentration of thyroid stimulating hormone exceeded 20 mU/l.
Is serum gamma-glutamyltransferase a misleading test?
Authors: R Penn, D J Worthington
Journal: BMJ (1983)

Although it is now 30 years since the discovery of y-glutamyl transferase (EC 2.3.2.2.), the clinical relevance of a raised activity of the enzyme in serum remains controversial. The use of the enzyme as a potential diagnostic aid did not emerge until the early 1960s, when it was introduced as a new test of liver function.1 2 Further work since then suggests that serum y glutamyltransferase activity may be a sensitive index of hepato biliary dysfunction,3 and the early prediction that measurement of y-glutamyltransferase activity would be established in the laboratory repertoire seems to have been fulfilled.4 The associa? tion between excessive alcohol consumption and raised activities of serum y-glutamyltransferase, particularly in the absence of other abnormal results of biochemical tests of liver function, was made in the early 1970s, and a serum y-glutamyltransferase estimation has been included in many screening programmes to detect an excessive intake of alcohol.5 6 It is rare, however, to find a biochemical test that is both tissue specific and disease specific, and y-glutamyltransferase activity appears to be no exception. The serum activity of the enzyme has been shown to be affected by several factors and to rise in various clinical conditions. Also its induction by a wide variety of drugs, including alcohol, makes interpretation of test results difficult. Consequently, the claimed advantage of its sensitivity is marred by its lack of specificity. Recently, doubts
Newer systems for bacterial resistances to toxic heavy metals.
Authors: S Silver, G Ji
Journal: Environmental Health Perspectives (1994)

Bacterial plasmids contain specific genes for resistances to toxic heavy metal ions including Ag+, AsO2-, AsO4(3-), Cd2+, Co2+, CrO4(2-), Cu2+, Hg2+, Ni2+, Pb2+, Sb3+, and Zn2+. Recent progress with plasmid copper-resistance systems in Escherichia coli and Pseudomonas syringae show a system of four gene products, an inner membrane protein (PcoD), an outer membrane protein (PcoB), and two periplasmic Cu(2+)-binding proteins (PcoA and PcoC). Synthesis of this system is governed by two regulatory proteins (the membrane sensor PcoS and the soluble responder PcoR, probably a DNA-binding protein), homologous to other bacterial two-component regulatory systems. Chromosomally encoded Cu2+ P-type ATPases have recently been recognized in Enterococcus hirae and these are closely homologous to the bacterial cadmium efflux ATPase and the human copper-deficiency disease Menkes gene product. The Cd(2+)-efflux ATPase of gram-positive bacteria is a large P-type ATPase, homologous to the muscle Ca2+ ATPase and the Na+/K+ ATPases of animals. The arsenic-resistance system of gram-negative bacteria functions as an oxyanion efflux ATPase for arsenite and presumably antimonite. However, the structure of the arsenic ATPase is fundamentally different from that of P-type ATPases. The absence of the arsA gene (for the ATPase subunit) in gram-positive bacteria raises questions of energy-coupling for arsenite efflux. The ArsC protein product of the arsenic-resistance operons of both gram-positive and gram-negative bacteria is an intracellular enzyme that reduces arsenate [As(V)] to arsenite [As(III)], the substrate for the transport pump. Newly studied cation efflux systems for Cd2+, Zn2+, and Co2+ (Czc) or Co2+ and Ni2+ resistance (Cnr) lack ATPase motifs in their predicted polypeptide sequences. Therefore, not all plasmid-resistance systems that function through toxic ion efflux are ATPases. The first well-defined bacterial metallothionein was found in the cyanobacterium Synechococcus. Bacterial metallothionein is encoded by the smtA gene and contains 56 amino acids, including nine cysteine residues (fewer than animal metallothioneins). The synthesis of Synechococcus metallothionein is regulated by a repressor protein, the product of the adjacent but separately transcribed smtB gene. Regulation of metallothionein synthesis occurs at different levels; quickly by derepression of repressor activity, or over a longer time by deletion of the repressor gene at fixed positions and by amplification of the metallothionein DNA region leading to multiple copies of the gene.
Deaths associated with new designer drug 5-IT
Authors: L. N. Seetohul, P. D. Maskell, G. De Paoli, D. J. Pounder
Journal: BMJ (2012)

5-IT or 5-API is the common name for a newly emerging designer drug. 1 It is a positional isomer of the tryptamine drug α-methyltryptamine and has the chemical structure (1H-indol-5-yl)propan-2-amine.Currently not controlled in Europe, it is covered, however, by the federal analogue acts in the USA 2 and Australia. 3 Very little is known about the acute or chronic effects of 5-IT.An oral dose of 20 milligrams is said to produce long lived stimulant effects, including increased heart rate, anorexia, diuresis, and slight hyperthermia for about 12 hours.