tbuckley/cabot-search huggingface dataset:
Plasmapheresis and Immunosuppressive Drug Therapy in Myasthenia Gravis
Authors: Peter C. Dau, Jon M. Lindstrom, Christine K. Cassel, Eric H. Denys, Edward E. Shev, Lynn E. Spitler
Journal: New England Journal of Medicine (1977)

Plasmapheresis combined with prednisone and azathioprine therapy produced striking clinical improvement in five patients with myasthenia gravis who still had moderate to severe disability despite thymectomy, high-dose prednisone therapy and optimal doses of cholinesterase inhibitors. Serial determinations of titers of serum antibody toward the acetylcholine receptor demonstrated a fall to 21 +/- 5 per cent (mean +/- S.D.) of the original levels concurrently with the patients' increasing strength. Clinically improved patients maintained lowered titers, whereas clinical relapses were associated with a rebound in titer. Our results suggest that plasmapheresis will find a place in the management of patients with myasthenia gravis, and they implicate antibodies to acetylcholine receptor as a pathogenic factor in this disease.
Use of Home Test Kits for HIV Is Bad Medicine
Authors: F. Edward Hébert
Journal: JAMA (1989)

<h3>To the Editor.—</h3> A great deal of scientific and media attention has focused on the issue of home test and blood collection kits for detection of infection with human immunodeficiency virus (HIV). Use of such kits and devices is contrary to the standard practice of notification of life-threatening medical diagnoses in medical settings. There are sound reasons for the recommendations made by a number of agencies that counseling accompany HIV testing.<sup>1</sup>The experience of the US Air Force with notification of HIV infection sheds light on this issue. All active-duty military personnel are periodically tested for evidence of infection with HIV. Notification of seropositivity is made in person, in a medical setting, and after a confirmatory Western blot test. Seropositive active-duty individuals are immediately referred to Wilford Hall US Air Force Medical Center, Lackland Air Force Base, Tex, for a comprehensive medical evaluation. Face-to-face counseling and education are included.
Histamine release from gut mast cells from patients with inflammatory bowel diseases.
Authors: H Nolte, N Spjeldnaes, A Kruse, B Windelborg
Journal: Gut (1990)

Inflammatory mediators from intestinal mast cells may serve as initiators of acute and delayed inflammation. Mast cell histamine release was measured in 19 patients with inflammatory bowel diseases using gut mast cells from enzymatically dispersed endoscopic forceps biopsy specimens of macroscopically inflamed and normal tissue. Mast cells and corresponding basophils were challenged with anti-IgE, anti-IgG, subclass anti-IgG4, and formyl-methionyl-leucyl-phenylalanine (FMLP) and results were compared with those from nine patient control subjects. The mast cell count in patients with ulcerative colitis was increased compared with that in control subjects and patients with Crohn9s disease, and the mast cell count obtained from inflamed tissue was greater than that of normal tissue. The study also shows the heterogeneity of the responsiveness of the histamine releasing cells to various secretagogues. Thus, mast cells released 0.4 (0.0-2.0) (median (range)) ng histamine per sample at anti-IgE challenge, and basophils were also anti-IgE responsive. In contrast, mast cells did not respond to FMLP but the corresponding basophils did. Gut mast cells released 0.3 (0.0-1.0) (median (range)) ng histamine per sample at anti-IgG4 challenge; however, the corresponding basophils did not respond to anti-IgG4. In addition, the anti-IgG4 mediated histamine release was primarily confined to patients with inflammatory bowel disease. This study substantiates previous histopathological findings that mast cells may play a functional role in the inflammatory process of inflammatory bowel diseases and provides evidence for a possible role of subclass IgG4 as a reaginic antibody.
Cell types involved in collagen and fibronectin production in normal and fibrotic human liver
Authors: Bruno Clement, Jean-Alexis Grimaud, Jean-Pierre Campion, Yves Deugnier, Andre Guillouzo
Journal: Hepatology (1986)

Three collagen types (I, III and IV) and fibronectin were localized in normal and alcoholic human liver by light and electron microscopy using the indirect immunoperoxidase technique. In normal liver, most of the bundles of collagen fibers stained for type pro-III collagen while only a few reacted for type I. Basement membranes stainedfor type IV collagen which formed discontinuous discrete deposits in sinusoids. Only fibronectin appeared as an almost continuous layer in the space of Disse. At the intracellular level, hepatocytes were found to contain little type I collagen and large amountsof fibronectin. Fat-storing cells strongly stained for type IV collagen and expressed low amounts of types I and III collagen and fibronectin. Endothelial cells contained low amounts of all the components. Alcoholic livers were studied at three stages: steatosis, fibrosis and cirrhosis. Qualitative and quantitative differences were observed in extracellular and intracellulardistributions of matrix proteins. Increased amounts of all components were usually found in fibrotic and cirrhotic livers compared to normal liver. In two fibrotic livers which contained numerous bundles of collagen in the sinusoids, fat-storing cells stained more intensely for type III collagen. In a cryptogenic fibrotic liver, abundant type IV collagen was observed in hepatocytes. These results suggest that hepatocytes, fat-storing cells and endothelial cells are engaged in production of extracellular matrix components in normal human liver. In fibrosis, hepatocytes which normally did not synthesize types III and IV collagen mayproduce these collagens.
A 12-month, in-home exercise program delayed functional deterioration in Alzheimer disease
Authors: Calvin Hirsch
Journal: Annals of Internal Medicine (2013)

Source Citation Pitkälä KH, Pöysti MM, Laakkonen ML, et al. Effects of the Finnish Alzheimer Disease Exercise Trial (FINALEX): A randomized controlled trial. JAMA Intern Med. 2013:173:894-901. 23589097
Guidelines For Infection With the Human Immunodeficiency Virus (HIV) and Health Care Workers
Authors: ZALMEN A. ARLIN
Journal: Annals of Internal Medicine (1988)

Letters and Corrections1 June 1988Guidelines For Infection With the Human Immunodeficiency Virus (HIV) and Health Care WorkersZALMEN A. ARLIN, M.D.ZALMEN A. ARLIN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-108-6-906_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The recent recommendations in the March issue (1) are useful guidelines for health care workers and patients who must face the epidemic of the acquired immunodeficiency syndrome (AIDS). As with other guidelines, they help persons make more rational and humane medical decisions. Regrettably, some persons will interpret these guidelines as the answer to all questions raised by the epidemic. At least two issues need to be clarified.1. Are health workers who have AIDS or the AIDS-related complex at risk if they work in units with patients infected with organisms to which they might be susceptible?2....Reference1. . The acquired immunodeficiency syndrome (AIDS) and infection with the human immunodeficiency virus (HIV). Ann Intern Med. 1988;108:460-9. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New York Medical College Valhalla, NY 10595 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1988Volume 108, Issue 6Page: 906-907KeywordsAIDSAIDS related complexHIVHealth care providersPatients Issue Published: 1 June 1988 PDF downloadLoading ...
Community Hospital Experience with Intravenous Streptokinase
Authors: Harold G. Morse, William J. Epperson, Joseph M. Kovaz, John D. Ware, Stuart M. Barnes, James E. Bleckley, William W. Walker, Frederic G. Jones
Journal: Annals of Internal Medicine (1987)

Letters and Corrections1 August 1987Community Hospital Experience with Intravenous StreptokinaseHAROLD G. MORSE, M.D., WILLIAM J. EPPERSON, M.D., JOSEPH M. KOVAZ, M.D., JOHN D. WARE, M.D., STUART M. BARNES, M.D., JAMES E. BLECKLEY, M.D., WILLIAM W. WALKER, M.D., FREDERIC G. JONES, M.D.HAROLD G. MORSE, M.D.Search for more papers by this author, WILLIAM J. EPPERSON, M.D.Search for more papers by this author, JOSEPH M. KOVAZ, M.D.Search for more papers by this author, JOHN D. WARE, M.D.Search for more papers by this author, STUART M. BARNES, M.D.Search for more papers by this author, JAMES E. BLECKLEY, M.D.Search for more papers by this author, WILLIAM W. WALKER, M.D.Search for more papers by this author, FREDERIC G. JONES, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-107-2-255 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: We read with interest the recent review and recommendations of Smith and Kennedy (1) for thrombolysis in acute myocardial infarction. Coronary thrombolysis has been shown in several multicenter randomized trials to reduce mortality when done early in the course of acute myocardial infarction (2-4). Most published series in the United States have been done in academic medical centers in conjunction with acute angiography. According to 1986 American Hospital Association statistics (5), only about 15% of hospitals in the United States have cardiac catheterization laboratories; therefore, most infarctions are treated initially in hospitals with no access to acute...References1. SMITHKENNEDY BJ. Thrombolysis in the treatment of transmural myocardiac infarction. Ann Intern Med. 1987;106:414-20. LinkGoogle Scholar2. KENNEDYRITCHIEDAVIS JJK. The Western Washington Randomized Trial of Intracoronary Streptokinase in Acute Myocardial Infarction: a twelve month follow-up. N Engl J Med. 1985;312:1073-8. CrossrefMedlineGoogle Scholar3. SIMOONSBRANDDEZWAAN MMC. Improved survival after early thrombolysis in acute myocardial infarction. Lancet. 1985;2:578-81. CrossrefMedlineGoogle Scholar4. . Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet. 1986;1:397-401. MedlineGoogle Scholar5. . Hospital Statistics. 1986; 189. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 August 1987Volume 107, Issue 2Page: 255-255KeywordsAcute myocardial infarctionAngiographyCatheterizationInfarctionMortalityRandomized trials Issue Published: 1 August 1987 PDF DownloadLoading ...
Testicular torsion and low relative humidity in a tropical country.
Authors: O A Mabogunje
Journal: BMJ (1986)

One hundred and thirty one patients with testicular torsion were reviewed retrospectively to investigate the association of testicular torsion with air temperature and low relative humidity in Zaria, Nigeria. The incidence of testicular torsion was significantly increased during the harmattan season (November to February), when relative humidity is low and temperature decreased. Relative humidity was more closely correlated with the incidence of testicular torsion than was air temperature. Testicular torsion is a major contributor to male infertility in Zaria, and further study of its causes is required.
Magnetic graphene-based nanotheranostic agent for dual-modality mapping guided photothermal therapy in regional lymph nodal metastasis of pancreatic cancer
Authors: Sheng Wang, Qin Zhang, Xian F. Luo, Ji Li, Hang He, Feng Yang, Yang Di, Chen Jin, Xin G. Jiang, Shun Shen, De L. Fu
Journal: Biomaterials (2014)
Selection bias versus allocation bias
Authors: P. Sedgwick
Journal: BMJ (2013)

The effectiveness of supported self management in reducing hospital readmissions and death in patients with chronic obstructive pulmonary disease was evaluated.1 Researchers performed a randomised controlled trial. The intervention consisted of training patients to detect and treat exacerbations promptly, with ongoing support for 12 months. Patients in the control group continued to be managed by their general practitioner, hospital based specialists, or both.

Participants were patients admitted to one of six hospitals in the west of Scotland with an acute exacerbation of chronic obstructive pulmonary disease. In total, 464 patients were recruited and allocated to the treatment group using stratified randomisation based on demographic and disease severity factors. The main outcome measures included time until first hospital readmission or death owing to chronic obstructive pulmonary disease. The researchers reported that supported self management had no effect on time to first hospital readmission or death with chronic obstructive pulmonary disease.

Which …
Quality-of-Life-Adjusted Survival Analysis of High-Dose Adjuvant Interferon Alfa-2b for High-Risk Melanoma Patients Using Intergroup Clinical Trial Data
Authors: K. L. Kilbridge
Journal: Journal of Clinical Oncology (2002)

PURPOSE: High-dose adjuvant interferon alfa-2b (IFNα2b) for high-risk melanoma is a 1-year regimen that improves relapse-free and overall survival but has significant toxicity. A quality-of-life–adjusted survival (QAS) analysis analysis of two cooperative group phase III trials, E1684 and E1690/S9111/C9190, was performed, incorporating patient values (utilities) for the toxicity of IFNα2b treatment and melanoma recurrence. PATIENTS AND METHODS: Quality-Adjusted Time Without Symptoms or Toxicity methodology was used with melanoma patient utilities and trial data to estimate the effect of IFNα2b on QAS. The increase or decrease in QAS that patients could expect from treatment was estimated based on their utilities. Eleven utility predictor questions were tested to identify patients with utilities that result in decreased QAS. RESULTS: Using E1684 data, IFNα2b would result in an increase in QAS for all sets of patient utilities. This benefit was significant (P < .05) for 16% of patients. Using E1690/S9111/C9...
RELATIONSHIP BETWEEN INSULIN RESISTANCE AND CORONARY PLAQUE VULNERABILITY ASSESSED BY OPTICAL COHERENCE TOMOGRAPHY
Authors: Tomokazu Iguchi, Takao Hasegawa, Kenichiro Otsuka, Kenji Matsumoto, Shoichi Ehara, Akihisa Hanatani, Kenei Shimada, Minoru Yoshiyama
Journal: Journal of the American College of Cardiology (2013)
SOME UNHEEDED PRINCIPLES INVOLVED IN THE DIETETIC MANAGEMENT OF INFANTS DURING HOT WEATHER.
Authors: GODFREY R. PISEK
Journal: JAMA (1906)

Before the management of infants during the heated term can be placed on a scientific basis the principles on which such management should be based must be ascertained. The normal processes and requirements of the infant during warm weather should be clearly understood and also how these processes may be deranged and the requirements met under different conditions. Specially prepared foods, special percentage mixtures, sterilization and pasteurization have been offered as the solution for summer digestive disturbances. Recently a specific organism has been held accountable and a specific serum has been suggested as a possible curative agent, but still the problem confronts us. The real progress that has been made in the treatment of summer cases has not been the result of specific medication or of specific feeding, but has come from close attention to diet and care. Kerley has shown clinically what can be done in reducing infant mortality
Medical Education Toward the 21st Century
Authors: Martin Finkel
Journal: JAMA (1985)

To the Editor.—  The article  Crisis in Medical Education 1 raises critical issues. Clinical education must compete with the demands of peer review organizations, diagnosis-related groups, and other cost constraints.  The hospital patient population and the length of hospital stay are changing, yet the goals of preparing future physicians for excellence in practice and compassion in the caring of patients remain the same. New approaches to the medical curriculum are needed. As patient care is shifted from in-hospital ward care to alternative care, we should consider teaching students in other clinical settings as well.  At Mount Sinai Medical School, there is a pilot program in teaching medical students in the setting of the attending physicians' private offices. A day center in the hospital, where patients will receive diagnostic studies during the day and then be discharged, is being evaluated. The role of students in these alternative facilities should be
Intra-aortic Balloon Pump Therapy for Acute Myocardial Infarction
Authors: Yousif Ahmad, Sayan Sen, Matthew J. Shun-Shin, Jing Ouyang, Judith A. Finegold, Rasha K. Al-Lamee, Justin E. R. Davies, Graham D. Cole, Darrel P. Francis
Journal: JAMA Internal Medicine (2015)

Intra-aortic balloon pump (IABP) therapy is a widely used intervention for acute myocardial infarction with cardiogenic shock. Guidelines, which previously strongly recommended it, have recently undergone substantial change.To assess IABP efficacy in acute myocardial infarction.Human studies found in Pubmed, Embase, and Cochrane libraries through December 2014 and in reference lists of selected articles. Search strings were "myocardial infarction" or "acute coronary syndrome" and "intra-aortic balloon pump" or "counterpulsation."Randomized clinical trials (RCTs) and observational studies comparing use of IABP with no IABP in patients with acute myocardial infarction.Two reviewers independently extracted the data, and risk of bias in RCTs was assessed using the Cochrane risk of bias tool. We conducted separate meta-analyses of the RCTs and observational studies. Data were quantitatively synthesized using random-effects meta-analysis.Thirty-day mortality.There were 12 eligible RCTs randomizing 2123 patients. In the RCTs, IABP use had no statistically significant effect on mortality (odds ratio [OR], 0.96 [95% CI, 0.74-1.24]), with no significant heterogeneity among trials (I2 = 0%; P = .52). This result was consistent when studies were stratified by the presence (OR, 0.94 [95% CI, 0.69-1.28]; P = .69, I2 = 0%) or absence (OR, 0.98 [95% CI, 0.57-1.69]; P = .95, I2 = 17%) of cardiogenic shock. There were 15 eligible observational studies totaling 15 530 patients. Their results were mutually conflicting (heterogeneity I2 = 97%; P < .001), causing wide uncertainty in the summary estimate for the association with mortality (OR, 0.96 [95% CI, 0.54-1.70]). A simple index of baseline risk marker imbalance in the observational studies appeared to explain much of the heterogeneity in the observational data (R2meta = 46.2%; P < .001).Use of IABP was not found to improve mortality among patients with acute myocardial infarction in the RCTs, regardless of whether patients had cardiogenic shock. The observational studies showed a variety of mutually contradictory associations between IABP therapy and mortality, much of which was explained by the differences between studies in the balance of risk factors between IABP and non-IABP groups.
Doctor is arrested in transit in United Arab Emirates for a 10 year old conviction passed in his absence
Authors: S. Arie
Journal: BMJ (2012)

Concern is growing for a 78 year old South African paediatrician who has been held in prison in the United Arab Emirates for more than six weeks, after it emerged that he had been tried and convicted in his absence over the death of a child he treated while working as a locum in the country 10 years ago.

Cyril Karabus, a paediatric haematologist and oncologist at the Red Cross War Memorial Children’s Hospital in Cape Town, was arrested on 18 August when his flight home from a family wedding in Canada stopped in Abu Dhabi.

It emerged that he had been convicted in 2003 of manslaughter and falsifying documents, sentenced to 3.5 years in jail, and ordered to pay a fine of around $100 000 (£62 000; €77 000) to the …
Sudden Death of a Carrier of X-Linked Emery-Dreifuss Muscular Dystrophy
Authors: Michael C. Fishbein
Journal: Annals of Internal Medicine (1993)

Objective: To report a sudden death in a female carrier of Emery-Dreifuss muscular dystrophy and to describe the cardiac abnormalities associated with this disease. Study Design: Case series. Setting: University hospital. Patients: A 45-year-old carrier who died suddenly and two affected men who also died of cardiac manifestations of Emery-Dreifuss muscular dystrophy. Measurements: Post-mortem gross pathologic and histopathologic study of the heart. Results: All three hearts showed a unique pattern of pathologic findings. Marked loss of atrial myocardium had occurred. Myocardium had been replaced by adipose and fibrous tissue. The conduction system showed no significant abnormalities. Varying degrees of interstitial and replacement fibrosis were present in the ventricular myocardium. Conclusions: Emery-Dreifuss muscular dystrophy is associated with characteristic pathologic changes in the heart that can cause death in female carriers and affected men. Female carriers should be identified and evaluated because of the risk for sudden cardiac death.
Outcome in 91 Consecutive Patients with Pulmonary Arterial Hypertension Receiving Epoprostenol
Authors: Karl P. Kuhn, Daniel W. Byrne, Patrick G. Arbogast, Thomas P. Doyle, James E. Loyd, Ivan M. Robbins
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

Epoprostenol has markedly improved the treatment of pulmonary arterial hypertension, although predictors of outcome with epoprostenol are not well characterized. From June 1995 through August 2001, 91 patients with pulmonary arterial hypertension were treated with epoprostenol at our institution. We analyzed the effects of long-term epoprostenol treatment to determine features associated with outcome. Predictors of worse outcome included older age of disease onset (hazard ratio 3.2, 95% confidence interval 1.32–7.76 for patients above the median age of 44 years), World Health Organization functional Class IV, either at baseline or follow-up, (3.07, 1.42–6.62 compared with functional Class I, II, and III), and scleroderma spectrum of disease (2.32, 1.08–4.99). There were no baseline or follow-up hemodynamic factors predictive of outcome. Our results indicate that treatment with epoprostenol improves survival in patients with Primary Pulmonary Hypertension compared with that predicted by the National Institutes of Health Primary Pulmonary Hypertension Registry's survival equation and that their survival is significantly better than that of patients with scleroderma spectrum of disease (p = 0.001). Older patients treated with epoprostenol have significantly shorter survival, regardless of etiology.
Scanning the Genome for Coronary Risk
Authors: Anthony Rosenzweig
Journal: New England Journal of Medicine (2007)

Coronary artery disease remains an enormous clinical problem, affecting more than 15 million people in the United States alone, where it is the most common cause of death (accounting for one in three deaths).1 The prevalence of coronary heart disease is increasing at a particularly alarming rate in developing nations, which are ill equipped to shoulder the associated economic burden.2,3 The clinical need this represents underscores the importance of understanding the causes of coronary disease and identifying persons at risk.Much progress has been made toward these goals. We now recognize many clinical risk factors — such as hyperlipidemia . . .