tbuckley/cabot-search huggingface dataset:
Two Distinct Subtypes of Hepatitis C Virus Defined by Antibodies Directed to the Putative Core Protein
Authors: Atsuhiko Machida, Hitoshi Ohnuma, Fumio Tsuda, Eisuke Munekata, Takeshi Tanaka, Yoshihiro Akahane, Hiroaki Okamoto, Shunji Mishiro
Journal: Hepatology (1992)

Four distinct genotypes of hepatitis C virus types I, II, III and IV have been identified by comparison of nucleotide sequences of isolates from different areas of the world. We examined the possibility that hepatitis C virus may have serologically definable subtypes. Enzyme-linked immunosorbent assay systems were prepared by use of two synthetic peptides deduced from the putative core protein of hepatitis C virus. The following are the two peptides that were used: (a) IPKARRPEGRTWAQPGY (subtype-1) conserved in hepatitis C virus isolates with type I and type II genotypes; and (b) IPKDRRSTGKSWGKPGY (subtype-2) conserved in type III and type IV genotypes. With the enzyme-linked immunosorbent assays, the subtype-1 antibodies were detected in 26 (68%) of 38 subjects whose hepatitis C virus RNA had been genotyped as type I or type II, whereas subtype-2 antibodies were not detected. Inversely, the subtype-2 antibodies were detected in 10 (56%) of 18 subjects with hepatitis C virus RNA genotypes III or IV, whereas subtype-1 antibodies were detected in none of them. These results suggest that hepatitis C virus has two serologically distinguishable core antigen subtypes, corresponding to either genotype I/II or genotype III/IV. Subtyping of HCV by serological methods would contribute to tracking transmission routes of the virus, especially in cases where serum samples were not stored under conditions to preserve RNA or in infected hosts who have cleared the virus and therefore have only antibodies remaining to identify the infection.
Severe Hypoglycemia Predicts Mortality in Diabetes
Authors: Philip E. Cryer
Journal: Diabetes Care (2012)

In this issue of Diabetes Care , McCoy et al. (1) report 3.4-fold higher mortality in patients with diabetes who self-reported severe hypoglycemia (that which required the assistance of another person) 5 years earlier. They suggest that patient-related outcomes such as hypoglycemia would augment risk stratification and management of patients with diabetes.

Iatrogenic hypoglycemia is the limiting factor in the glycemic management of diabetes (2). It causes recurrent morbidity in most people with type 1 diabetes and many with advanced type 2 diabetes and is sometimes fatal. It impairs defenses against subsequent hypoglycemia and, thus, causes a vicious cycle of recurrent hypoglycemia. The barrier of hypoglycemia generally precludes maintenance of euglycemia over a lifetime of diabetes and, therefore, full realization of the benefits of glycemic control.

Although it can be caused by an episode of marked absolute therapeutic hyperinsulinemia, iatrogenic hypoglycemia is typically the result of the interplay of mild-to-moderate absolute or even relative therapeutic hyperinsulinemia and compromised physiological and behavioral defenses against falling plasma glucose concentrations (2). The compromised physiological defenses include attenuated adrenomedullary epinephrine responses that, in the setting of absent insulin and glucagon responses, cause the clinical syndrome of defective glucose counterregulation with its 25-fold or greater increased risk of severe hypoglycemia during aggressive glycemic therapy. The compromised behavioral defense is the failure to ingest carbohydrates, which results from attenuated sympathoadrenal (largely sympathetic neural) responses that cause the clinical syndrome of hypoglycemia unawareness with its sixfold or greater increased risk of severe hypoglycemia during aggressive glycemic therapy. Defective glucose counterregulation and hypoglycemia unawareness are the components of hypoglycemia-associated autonomic failure (HAAF) in diabetes. HAAF is a form of …
Points: Q fever
Authors: P. M Fleiss
Journal: BMJ (1983)

Drug treatment to reduce cholesterol to new target levels is now recommended in four moderate- to high-risk patient populations: patients who have already sustained a cardiovascular event, adult diabetic patients, individuals with low density lipoprotein cholesterol levels ≥190 mg/dL and individuals with an estimated 10-year cardiovascular risk ≥7.5%. Achieving these cholesterol target levels did not confer any additional benefit in a systematic review of 35 randomised controlled trials. Recommending cholesterol lowering treatment based on estimated cardiovascular risk fails to identify many high-risk patients and may lead to unnecessary treatment of low-risk individuals. The negative results of numerous cholesterol lowering randomised controlled trials call into question the validity of using low density lipoprotein cholesterol as a surrogate target for the prevention of cardiovascular disease.
Abstract 99: Wnt signaling promotes tumor propagation in a mouse model of lung adenocarcinoma
Authors: Tuomas Tammela, Natanya Kerper, Wen Xue, Nikhil Joshi, Pekka Katajisto, Tyler Jacks
Journal: Cancer Research (2014)

Abstract The considerable variability within tissue microenvironments as well as the multiclonality of cancers leads to heterogeneity within tumors, increasing the probablility of cellular states that promote resistance to therapy and eventually lead to reconstitution of the tumor by treatment-resistant cancer cells, which in some case have properties of normal tissue stem cells. Wnt signals are important in the maintenance of stem cells in various epithelial tissues, including in lung development and regeneration. We hypothesized that Wnt signals would also contribute to hierarchial organization of KrasG12D and KrasG12D; tp53Δ/Δ mouse lung adenocarcinomas. Indeed, rare cells with nuclear βeta-catenin were detected in mouse tumors in vivo. Stimulating KP mouse lung adenocarcinoma cells with recombinant Wnt3a promoted their spheroid-forming ability in a 3-dimensional Matrigel culture system, whereas RNAi or small-molecule inhibitors targeting Porcupine, an enzyme required for post-translational palmitoylation of Wnt, suppressed tumor initiation in vitro and in vivo. Interestingly, either the stimulation or inhibition of the Wnt signaling pathway had no effect on growth of KP lung cancer cells in standard 2-dimensional cell culture, suggesting that Wnt signaling qualitatively modulates the cellular phenotype instead of controlling cell proliferation. We propose that targeting the Wnt signaling pathway can stimulate re-differentiation of lung adenocarcinoma cells, which may render them more sensitive to conventional anti-tumor therapies. Citation Format: Tuomas Tammela, Natanya Kerper, Wen Xue, Nikhil Joshi, Pekka Katajisto, Tyler Jacks. Wnt signaling promotes tumor propagation in a mouse model of lung adenocarcinoma. [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 99. doi:10.1158/1538-7445.AM2014-99
Adverse reactions to drugs in general practice.
Authors: C R Martys
Journal: BMJ (1979)

Of 817 patients in a general-practice survey of adverse reactions to drugs, 41% were thought to have "certainly" or "probably" had a reaction to the drug prescribed. Adverse effects on the gastrointestinal and central nervous systems were the most frequently reported, and 90% of reactions had occurred by the fourth day of treatment. More patients given drugs acting on the central nervous system and antihistamines reported reactions than those in other categories. A higher incidence of adverse drug effects is shown in this general-practice survey than in other, mainly hospital-based, surveys. Further intensive surveillance for adverse effects of drugs is recommended to provide additional information on the burden of drug-induced disease in the community.
Failure of Oral Contraceptives
Authors: D. J. D. Stevenson, K. B. Hughes
Journal: BMJ (1966)

BRinsH 1483 unless one limits the operation to cases really in need of it, the patient may be made worse or at best no better.Turning to psychiatric indications, which occurred in 93 out of 100 terminations at Cambridge, one cannot help asking what good-if any-came of these operations.Personally I would agree with Dr. Myre Sim's conclusion that at present there are no psychiatric indications.As Hemphill' has written, " Depression, mania and schizo- phrenia are the only important forms of psychosis in pregnancy, which is com- paratively rare anyway. . . .Termination, although often requested, can rarely be justified on psychiatric grounds."Perhaps Professor Rhodes (7 May, p. 1168) gets nearer the mark when he wonders " if we may not be in danger of losing sight of the fact that there are other solutions than termination of pregnancy in the psychiatrically ill pregnant woman."So much rubbish has been talked and written about abortion that it is exceedingly difficult to differentiate fact from fantasy.But it is high time that there was an end to the completely mistaken idea that only the rich are in a position to obtain medical justice.Medically and psychiatrically thera- peutic abortion is seldom indicated because it is very seldom indeed that it does any medical good.In the very few cases where it does so, the patient will have no difficulty whatsoever in obtaining assistance under the National Health Service free of charge.-Iam, etc.,
Microvascular surgery to preserve a preterm infant's ischaemic arm.
Authors: C. R. Kirk, S. A. Qureshi
Journal: BMJ (1988)

provement has occurred in the Hospital Activity Analysis compared with previous reports, it re- mains an inadequate source of data for both clinicians and management.Critical clinical infor- mation is lacking without which assessment of, for example, length of stay becomes meaningless.A national inspectorate using this health service information will fail miserably for both the quality and quantity of this data fall a long way below the standards expected in the late 1980s.
Langerhans cell histiocytosis following acute leukemia in an adult
Authors: Rebecca Hirsh, Dilip Giri, Rogers Griffith, Richard Stone, Neal Ready
Journal: American Journal of Hematology (2009)

Langerhans cell histiocytosis following acute leukemia in an adultTo the editor: A 69-year-old man presents with cough and SOB approximately 3.5 years following diagnosis of a poorly differentiated acute lymphocytic leukemia (progenitor cell phenotype).By flow cytometry, the initial leukemia in 1998 was positive for HLA-DR, CD34, and CD45 and negative for lymphoid and myeloid markers including: CD3, CD5, CD7, CD19, CD10, CD20, CD13, CD33, CD11b, and CD14; CD1a and S-100 protein staining were not available on this sample.A pathologic diagnosis of a progenitor cell leukemia most suggestive of acute lymphocytic leukemia was made.The patient received induction therapy in November 1998 and achieved a complete remission.Consolidation therapy was discontinued after one cycle due to severe cytopenias.Maintenance therapy was discontinued after 6 months secondary to methotrexate-induced hepatoxicity.Approximately 3.5 years after the initial diagnosis, the patient presented with back pain and leg weakness and found to have a paraspinal mass with cord compression.He underwent surgical resection followed by consolidative radiation.The lesion (see Fig. 1) was composed of sheets of medium to large sized mitotically active cells with relatively abundant cytoplasm.Occasional multinucleated tumor giant cells were also identified.The cell nuclei were vesicular with irregular contour and occasional grooves.Considering the remote history of a lymphocytic leukemia and the morphologic features which raised the possibility of an epithelioid/dendritic cell neoplasm, a panel of immunohistochemical stains was used to characterize the lesion.The tumor cells were positive for vimentin, CD1a, S-100 protein, CD43 and focally for keratins, CD45, CD68, and lysozyme.Negative immunostains included EMA, Melan-A, CD3, CD20, CD21, CD35, Kappa and Lambda light chains, and MPO.Leder's histochemical stain was negative.Based on the morphology and the immunohistochemical profile, a diagnosis of a dendritic cell neoplasm most consistent with Langerhans cell sarcoma was rendered.Electron microscopic studies were not performed.Bone marrow biopsy revealed trilineage hematopoiesis with no evidence of leukemic involvement.Approximately 2 months later, he developed a similar soft tissue mass in the right upper chest extending into the right supraclavicular area.Radiation treatment resulted in a complete clinical response in the chest mass and he had no evidence of progression for 1 year.The patient then developed shortness of breath and fevers.A CXR showed a right
Eotaxin and monocyte chemotactic protein-4 mRNA expression in small airways of asthmatic and nonasthmatic individuals
Authors: Rame A. Taha, Eleanor M. Minshall, Deborah Miotto, Ayako Shimbara, Andrew Luster, James C. Hogg, Qutayba A. Hamid
Journal: Journal of Allergy and Clinical Immunology (1999)
Role of upper gastrointestinal investigations in a screening study for colorectal neoplasia.
Authors: W M Thomas, J D Hardcastle
Journal: Gut (1990)

Should patients with positive faecal occult blood screening tests who are free of colorectal neoplasia undergo upper gastrointestinal investigation? Altogether 16,985 faecal occult blood tests were completed in a group of 18,818 asymptomatic patients (45-75 years) offered screening at two yearly intervals. A total of 447 (2.6%) were positive and underwent large bowel investigations. No neoplastic disease was identified in 283 (63%) of them. Fourteen (5%) also underwent gastroscopy for upper gastrointestinal symptoms, benign conditions were identified in five and a gastric carcinoma in one. No further investigations were instituted in the remaining 269 subjects who have now been followed up for a median period of 5 years (2-8 years). Five have been referred for benign upper gastrointestinal conditions, but none for upper gastrointestinal malignancy. Thirty one subjects have died - one from gastric cancer (a patient who had undergone a previous partial gastrectomy for a duodenal ulcer and who had persistent upper gastrointestinal symptoms). The remaining deaths were unrelated to the upper gastrointestinal tract. Nineteen people who have left the trial area have been monitored for the development of malignant disease; none have presented with upper gastrointestinal malignancy. These data support the view that upper gastrointestinal investigations need not be performed routinely in this group of subjects, but may be reserved for those with relevant symptoms.
Wales sets up drop-in vaccination clinics to tackle measles outbreak
Authors: G. Iacobucci
Journal: BMJ (2013)

Health authorities in Wales have stepped up their drive to vaccinate more children against measles in a bid to bring the outbreak in Swansea under control.

Thousands of children have been given the combined measles, mumps, and rubella (MMR) vaccine over the past two weekends in general practices and special drop-in clinics across south Wales set up by health boards to tackle the surge in cases.

Vaccination teams have been sent out to begin a targeted MMR campaign in schools this week, beginning with five comprehensive schools in Swansea and Neath Port Talbot.

As the BMJ went to press on Tuesday, 693 cases …
Observations on neutropenia associated with haemodialysis
Authors: E. K. M. Smith, K. Jobbins
Journal: BMJ (1969)

In the first 30 minutes of haemodialysis, in patients with chronic renal failure, there is a dramatic fall in total neutrophil count in the peripheral blood. An hour after the start of dialysis this has returned to normal. We have carried out a series of experiments in an attempt to elucidate the cause of this neutropenia. Both the patient and the membranes of the dialyser appeared to be a necessary combination to produce these changes, which could not be induced by the infusion of blood or saline that had previously been in contact with the dialyser. The composition of the dialysing fluid was not related to the fall of white count, and this fall was repeated when the patient was connected to a second dialyser after recovering from the neutropenia caused by the first. It was only when reusing a kidney, by rinsing it out and resterilizing it, that the neutropenia could be modified, but this was not a constant finding.
Kaposi’s sarcoma‐like lesions and other nodules as cutaneous involvement in AIDS‐related visceral leishmaniasis
Authors: M.J. González‐Beato, B. Moyano, C. Sánchez, M.T. González‐Beato, J.A. Pérez‐Molina, P. Miralles, P. Lázaro
Journal: British Journal of Dermatology (2000)

Journal Article Kaposi's sarcoma‐like lesions and other nodules as cutaneous involvement in AIDS‐related visceral leishmaniasis Get access M.J. González‐Beato, M.J. González‐Beato Departments of Dermatology, Internal Medicine and Search for other works by this author on: Oxford Academic Google Scholar B. Moyano, B. Moyano Departments of Dermatology, Internal Medicine and Search for other works by this author on: Oxford Academic Google Scholar C. Sánchez, C. Sánchez Departments of Dermatology, Internal Medicine and Search for other works by this author on: Oxford Academic Google Scholar M.T. González‐Beato, M.T. González‐Beato Departments of Dermatology, Internal Medicine and María José González‐Beato, C/V. Macabebes 7, 2°5, 28045 Madrid, Spain. E‐mail: mgbeato@yahoo.com Search for other works by this author on: Oxford Academic Google Scholar J.A. Pérez‐Molina, J.A. Pérez‐Molina Microbiology, G.Marañón Hospital, C/Dr. Esquerdo 46, 28007 Madrid, Spain Search for other works by this author on: Oxford Academic Google Scholar P. Miralles, P. Miralles Departments of Dermatology, Internal Medicine and Search for other works by this author on: Oxford Academic Google Scholar P. Lázaro P. Lázaro Departments of Dermatology, Internal Medicine and Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 143, Issue 6, 1 December 2000, Pages 1316–1318, https://doi.org/10.1046/j.1365-2133.2000.03909.x Published: 01 December 2000
SOME OBSERVATIONS ON THE ROLE OF AN ARMY PSYCHIATRIST
Authors: SAUL L. BROWN
Journal: American Journal of Psychiatry (1953)

The writer has attempted to spotlight some of the problems facing the recently trained psychiatrist who may be serving a period of active duty in the military forces. He has noted such problems as the authoritarian structure of the military service, the ambivalence that may arise within the psychiatrist in having to fulfill a significant role in such an environment, the need for the psychiatrist to comprehend the cultural framework in which he is operating, and the problem of limited communication in the authoritarian culture. He has also taken note of certain of the sources of frustration presenting themselves to the psychiatrist in the Army, as well as some of the areas for personal growth and further study.
No ACE Up Their Sleeve
Authors: Rebecca Voelker
Journal: JAMA (1998)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
ROENTGEN-RAY OBSERVATIONS IN ASTHMA
Authors: WILLIS F. MANGES
Journal: JAMA (1927)

There is probably no other disease associated with tissue changes that can be demonstrated roentgeno-graphically that has received so little attention by the roentgenologist as asthma. The roentgenologist is not responsible, except that as a specialist he has not made an aggressive effort to get cases for study. As an example of this lack of interest or opportunity one may note that Wessler and Jaches 1 have not even mentioned asthma in their work on clinical roentgenology of diseases of the chest, and yet they do describe many relatively rare conditions.  There is really very little roentgenologic literature on the diagnosis of asthma and its complications. Strangely enough, on the other hand, there are many excellent papers on the roentgen-ray treatment of asthma; and, too, it is worthy of note that in all of them excellent results are reported.  We do not at this time want to deal with the
Management of women with mild and moderate cervical dyskaryosis
Authors: G Flannelly, D Anderson, H C Kitchener, E M F Mann, M Campbell, P Fisher, F Walker, A A Templeton
Journal: BMJ (1994)

To compare the outcomes in women with mild and moderate dyskaryosis after increasing periods of surveillance and thereby to define a rational protocol for managing such women.Prospective study with randomisation of women to one of four treatment groups, each with a different period of surveillance; one group in which the women were given immediate treatment and three other groups in which the women were under surveillance for six, 12, and 24 months.A dedicated colposcopy clinic in Aberdeen, Scotland.902 women who presented with a mildly or moderately dyskaryotic smear for the first time.Cytological and colposcopic examinations at intervals of six months until the allocated period of surveillance was completed, at which time biopsy was performed. Women with severe dyskaryosis were withdrawn from surveillance and a biopsy was performed.The histological findings after punch biopsy or large loop excision of the transformation zone, and the trends in cytological appearances of serial cervical smears.793 women completed the study. In all, 769 women had an adequate final smear, of which 197 were normal cytologically, 328 were still mildly or moderately dyskaryotic, and 244 were severely dyskaryotic. Seventeen of the 67 (25%) women with one repeat smear showing non-dyskaryosis had cervical intraepithelial neoplasia grade III compared with only one of the 31 (3%) women with no dyskaryosis in four repeat cervical smears (P < 0.0001). None of the women had invasive cancer. Of 158 women whose index smear showed mild dyskaryosis and who were allocated to the group under surveillance for two years, only 40 had not defaulted or still had dyskaryotic smears by the end of the two years.Cytological surveillance, although safe, is not an efficient strategy for managing women with mildly abnormal smears. Women with any degree of dyskaryosis in a smear should be referred for colposcopy.
Cerebral Metastases from Bronchial Carcinomata
Authors: G. Flavell
Journal: BMJ (1949)

JOURNALand before resorting to surgery in the future the effects of this drug should be tried.SummaryA case record is presented of tuberculosis of the breast and underlying costo-chondral junction.The patient gave a history of old tuberculous peritonitis and tuberculous cervical adenitis.Tubercle bacilli were isolated from the discharging sinus.The general features of the disease, the symptomatology, and the differential diagnosis are described, and special emphasis is laid on the importance of differentiating carcinoma.Attention is called to the association of tuberculosis and carcinoma in the same breast.The treatment is described for various types of case.I wish to thank Dr. J. H. 0. Earle for studying the pathology of the specimen, and Dr.