tbuckley/cabot-search huggingface dataset:
Social predictors of adult asthma: a co-twin case-control study
Authors: E Huovinen
Journal: Thorax (2001)

<h3>BACKGROUND</h3> Environmental factors are needed to explain the observed increase in the prevalence of asthma during recent decades, despite the existence of a recognised genetic component in asthma. A co-twin case-control study was undertaken to examine possible social risk factors for asthma. <h3>METHODS</h3> Asthma diagnoses were based on register data of reimbursed asthma medication. During 17 years follow up of the Finnish twin cohort, 262 twin pairs discordant for incident asthma were identified. Conditional logistic regression for 1–1 matched data was used for risk calculation. <h3>RESULTS</h3> The atopic twin had an increased risk of asthma compared with the non-atopic co-twin (RR 2.91, 95% CI 1.81 to 4.68). The more educated twin had a decreased risk of asthma compared with his/her twin sibling with less education (RR 0.45, 95% CI 0.23 to 0.86), and the twin who participated in conditioning exercise had a decreased risk of asthma compared with the more sedentary co-twin (RR 0.55, 95% CI 0.34 to 0.88). <h3>CONCLUSIONS</h3> In addition to allergic diseases, educational level and physical activity are associated with adult onset asthma, which indicates a role for factors associated with life style.
Simulacra of Sickness
Authors: Samuel Vaisrub
Journal: JAMA (1974)

The use of actors in teaching psychiatric principles to general practitioners has been previously reported and commented on inThe Journal.<sup>1,2</sup>Coached about the kind of personalities they were to assume in teaching specific psychiatric problems, these actors were interviewed by physicians in videotaped sessions of "unrehearsed" performances. A recent editorial in the<i>British Medical Journal</i><sup>3</sup>comments on a workshop in make-believe patients conducted in London. Simulations of neurological, locomotor, and psychiatric diseases were particularly convincing. Thoracic and abdominal disorders with characteristic physical signs were also often adequately mimicked. The use of trained performers (at no negligible cost) would eliminate the embarrassments and inconveniences of bedside teaching on a reluctant patient or on one who is too ill to be disturbed. With medical education going theatrical, should we not enlarge the stage to make room for the ballet? After all, we have already a cardiac rhythm disturbance known
Diffuse cutaneous leishmaniasis responds to miltefosine but then relapses
Authors: O. Zerpa, M. Ulrich, B. Blanco, M. Polegre, A. Avila, N. Matos, I. Mendoza, F. Pratlong, C. Ravel, J. Convit
Journal: British Journal of Dermatology (2007)

Diffuse cutaneous leishmaniasis (DCL), although rare, is profoundly incapacitating. At present there is no successful treatment for this progressive protozoan infection, which is associated with the absence of specific cell-mediated immunity (CMI) to Leishmania. This disease shares features with visceral leishmaniasis (VL), including specific CMI inactivity during active disease and a heavy parasitic burden, but VL responds well to treatment. Miltefosine is the first orally administered drug which has shown efficacy in the treatment of VL; it has not been adequately evaluated in the treatment of DCL.To evaluate the efficacy of miltefosine in the treatment of DCL, using clinical, parasitological, histopathological and immunological criteria.Sixteen patients with DCL were treated with miltefosine, 2.0-2.5 mg kg(-1) daily, for variable periods of time (75-218 days). Patients were hospitalized for the first month and evaluated every 2 weeks until the termination of treatment with routine laboratory chemistry, percentage clinical improvement, presence of parasites in skin smears, growth of parasites in culture medium and in hamsters, histopathological characteristics of the granulomas, adverse side-effects, and reactivity to leishmanin skin test antigen. Further cycles of treatment were given in some of these patients, particularly after suspension of treatment was followed by relapse.Patients showed dramatic clinical improvement and reduction in the parasite burden by day 15 after the initiation of treatment, which continued while treatment was maintained. By day 45, 15 patients showed 80-90% clinical improvement. Nevertheless, suspension of treatment was followed by the development of new lesions in all but one patient. Inoculation in hamsters was observed to be the most sensitive technique to detect persisting parasites. Adverse events were very mild.Miltefosine produced a dramatic clinical and parasitological response in patients with DCL and improvement continued during drug administration, but with a single exception all patients presented new lesions after suspension of treatment. There was no histological or skin test evidence to suggest the development of CMI during treatment, which may be an indispensable criterion for the evaluation of potentially effective drugs against DCL.
Tc-99m MDP Detection of Diffuse Metastatic Involvement of the Liver by Salivary Gland Mucoepidermoid Carcinoma
Authors: G GLENN COATES, BRIAN EISENBERG, STACEY C. WONG, C THOMAS YARINGTON, VINCENT J. PICOZZI
Journal: Clinical Nuclear Medicine (1995)

A bone scan in a patient with mucoepidermoid carcinoma of the parotid gland showed vague, subtle and diffuse activity throughout the upper abdomen, representing uptake within diffuse metastases to the liver. This is characteristic of mucinous neoplasia, which mucoepidermoid carcinoma represents.
The Gynecologic Consideration of the Sexual Act
Authors: Denslow Lewis
Journal: JAMA (1983)

MAN first seeks to live, then he seeks to make others live. The instinct that determines self-preservation is almost equaled in importance and in its control of the individual by the instinct that dictates the perpetuation of the species. Indeed, in certain instances, where there is special individualization, this instinct so far transcends all others that even life itself is worthless without the attainment of the object so ardently desired, ie, without the actual possession of a certain person of the opposite sex. It is, therefore, proper for medical men in their deliberations to take cognizance of this great factor in human life. They should know its relationship to health and happiness. They should not be deterred from its scientific investigation by false modesty or by the fear of being accused of sensationalism. They should realize its importance as a dominating force in the economy, and they should approach its
Pulmonary hypertension at exercise in COPD: does it matter?
Authors: Robert Naeije, Bart G. Boerrigter
Journal: European Respiratory Journal (2013)

Pulmonary hypertension is a common complication of chronic obstructive pulmonary disease (COPD). In these patients, the increase in pulmonary artery pressure (PAP) is usually mild, in the range of 20 to 30 mmHg mean PAP (mPAP) with little progression over the years, on average 0.4 mmHg per year, and is preventable and sometimes partially reversible with chronic oxygen therapy [1, 2]. Sharp increases in PAP may occur during sleep or episodes of acute respiratory failure, and also during exercise [1, 2]. Pulmonary hypertension in COPD is explained by the combined effects of hypoxia, inflammation, hyper-inflation of the lungs and an increase in left ventricular end-diastolic pressure [2, 3]. Increased PAP is associated with decreased survival, may be the cause of clinical right heart failure, particularly in hypoxaemic patients with associated salt and water retention, and is thought to limit exercise capacity [1, 2].

Right heart catheterisations to evaluate the pulmonary circulation used to be common practice in patients with advanced COPD. The procedure is nowadays limited to the work-up of lung transplantation or lung volume reduction surgery, or for the understanding of symptoms that appear out of proportion with the lung function impairment [2, 4]. Some rare patients with COPD, approximately 1% of those referred to expert centres, present with “out of proportion pulmonary hypertension”. This entity is defined by a particular combination of mPAP >35–40 mmHg, only moderate airflow obstruction, hypoxaemia and hypocapnia [2–5]. Whether “out of proportion pulmonary hypertension” actually represents a form of pulmonary arterial hypertension (PAH) triggered by altered blood gases or inflammation associated with COPD remains unclear [5]. But there has been no reported evidence until now that targeted therapies shown effective in the …
Effectiveness of Clopidogrel and Aspirin Versus Ticlopidine and Aspirin in Preventing Stent Thrombosis After Coronary Stent Implantation
Authors: Issam Moussa, Mathew Oetgen, Gary Roubin, Antonio Colombo, Xangdong Wang, Sriram Iyer, Roberta Maida, Michael Collins, Edward Kreps, Jeffrey W. Moses
Journal: Circulation (1999)

Ticlopidine has been shown to reduce the incidence of stent thrombosis compared with warfarin, but it may cause serious hematological side effects. Clopidogrel, a new thienopyridine derivative, may be a safe alternative to ticlopidine. The aim of this study was to compare the safety and efficacy of clopidogrel and aspirin with those of ticlopidine and aspirin in patients undergoing coronary stent implantation.The population of this study consisted of 2 groups: patients who underwent coronary stenting and were treated with ticlopidine and aspirin (TA group, n=1406), and patients who underwent coronary stenting followed by treatment with clopidogrel and aspirin (CA group, n=283). At 1-month follow-up, there was no difference in stent thrombosis (1.5% versus 1.4%, P=1.0) or major adverse cardiac events (3.1% versus 2.4%, P=0. 85) between the TA and CA groups, respectively. The probability of any side effect (neutropenia, diarrhea, rash) was significantly higher in the TA group (10.6% versus 5.3%, P=0.006; relative risk, 0. 53; CI, 0.32 to 0.86).These data suggest that clopidogrel may be an effective pharmacological regimen after coronary stent implantation. Furthermore, the simpler dosing regimen, the absence of neutropenia, and the lower frequency of other side effects make it a safe alternative to ticlopidine.
Monoclonal antibody-defined immunoregulatory cells in multiple sclerosis cerebrospinal fluid.
Authors: N Cashman, C Martin, J F Eizenbaum, J D Degos, M A Bach
Journal: Journal of Clinical Investigation (1982)

To determine if previously reported peripheral blood suppressor cell defects are also found in the central nervous system (CNS) of patients with multiple sclerosis (MS), we studied cerebrospinal fluid (CSF) and peripheral blood lymphocytes from 40 MS patients and 15 patients with other neurological diseases. With an indirect immunofluorescence technique using the OKT series of monoclonal antibodies (OKT4, marking helper/inducer cells, OKT5 and OKT8 marking suppressor/cytotoxic cells, and OKT3 marking all peripheral T cells) we found that MS patients tested in the first 2 wk of exacerbation had invariably diminished CSF suppressor/cytotoxic cells, which was followed by an elevation of these cells in the 3rd wk of exacerbation. Repeat studies of three patients showed that perturbations of CSF suppressor/cytotoxic cells were dependent on clinical status. These observations add to the accumulating data that suggest altered immunity in the pathogenesis of MS.
1157-47 Coronary flow velocity pattern immediately after percutaneous coronary intervention in patients with acute myocardial infarction can predict myocardial viability assessed by thallium scintigraphy at six months
Authors: Koichi Tamita, Takashi Akasaka, Atsuhhi Yamamuro, Minako Katayama, Shunichirou Kaji, Kazuaki Tanabe, Kunihiko Nagai, Tomoko Tani, Shigefumi Morioka, Tsutomu Takagi
Journal: Journal of the American College of Cardiology (2004)
The transcription factors signal transducer and activator of transcription 5A (STAT5A) and STAT5B negatively regulate cell proliferation through the activation of cyclin-dependent kinase inhibitor 2b (Cdkn2b) and Cdkn1a expression
Authors: Ji Hoon Yu, Bing-Mei Zhu, Mark Wickre, Gregory Riedlinger, Weiping Chen, Atsushi Hosui, Gertraud W. Robinson, Lothar Hennighausen
Journal: Hepatology (2010)

Although the cytokine-inducible transcription factor signal transducer and activator of transcription 5 (STAT5) promotes proliferation of a wide range of cell types, there are cell-specific and context-specific cases in which loss of STAT5 results in enhanced cell proliferation. Here, we report that loss of STAT5 from mouse embryonic fibroblasts (MEFs) leads to enhanced proliferation, which was linked to reduced levels of the cell cycle inhibitors p15(INK4B) and p21(CIP1). We further demonstrate that growth hormone, through the transcription factor STAT5, enhances expression of the Cdkn2b (cyclin-dependent kinase inhibitor 2B) gene and that STAT5A binds to interferon-gamma-activated sequence sites within the promoter. We recently demonstrated that ablation of STAT5 from liver results in hepatocellular carcinoma upon CCl₄ treatment. We now establish that STAT5, like in MEFs, activates expression of the Cdkn2b gene in liver tissue. Loss of STAT5 led to diminished p15(INK4B) and increased hepatocyte proliferation. This study for the first time demonstrates that cytokines, through STAT5, induce the expression of a key cell cycle inhibitor. These experiments therefore shed mechanistic light on the context-specific role of STAT5 as tumor suppressor.
Etretinate may work where acitretin fails
Authors: T.O. BLEIKER, J.F. BOURKE, R.A.C. GRAHAM-BROWN, P.E. HUTCHINSON
Journal: British Journal of Dermatology (1997)

Acitretin (Ro 10-1670, Neotigason), a second-generation monoaromatic retinoid, is the main acid derivative and active metabolite of etretinate (Ro 10-9359, Tigason). Three patients who were unresponsive to treatment with acitretin but who responded to etretinate are reported. Twenty-nine patients in the U.K. are currently receiving etretinate on a named-patient basis. Possible explanations for the functional discrepancy between the two drugs are discussed.
Preocclusive perfusion area as a determinant of infarct size in a canine model
Authors: K. SAKAI, H. TOMOIKE, H. OOTSUBO, Y. KIKUCHI, M. NAKAMURA
Journal: Cardiovascular Research (1982)

Journal Article Preocclusive perfusion area as a determinant of infarct size in a canine model Get access KIKUO SAKAI, KIKUO SAKAI From the Research Institute ofAngiocardiology and Cardiovascular Clinic, Faculty of Medicine, Kyushu University, 3–1–1 Maidashi, Higashi-ku Fukuoka 812, Japan *Address for reprints: Hitonobu Tomoike, MD, Research Institute of Angiocardiology and Cardiovascular Clinic, Faculty of Medicine, Kyushu University, 3–1–1 Maidashi, Higashi-ku, Fukuoka 812, Japan. Search for other works by this author on: Oxford Academic PubMed Google Scholar HITONOBU TOMOIKE, HITONOBU TOMOIKE From the Research Institute ofAngiocardiology and Cardiovascular Clinic, Faculty of Medicine, Kyushu University, 3–1–1 Maidashi, Higashi-ku Fukuoka 812, Japan Search for other works by this author on: Oxford Academic PubMed Google Scholar HISATSUNE OOTSUBO, HISATSUNE OOTSUBO From the Research Institute ofAngiocardiology and Cardiovascular Clinic, Faculty of Medicine, Kyushu University, 3–1–1 Maidashi, Higashi-ku Fukuoka 812, Japan Search for other works by this author on: Oxford Academic PubMed Google Scholar YUTAKA KIKUCHI, YUTAKA KIKUCHI From the Research Institute ofAngiocardiology and Cardiovascular Clinic, Faculty of Medicine, Kyushu University, 3–1–1 Maidashi, Higashi-ku Fukuoka 812, Japan Search for other works by this author on: Oxford Academic PubMed Google Scholar MOTOOMI NAKAMURA MOTOOMI NAKAMURA From the Research Institute ofAngiocardiology and Cardiovascular Clinic, Faculty of Medicine, Kyushu University, 3–1–1 Maidashi, Higashi-ku Fukuoka 812, Japan Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 16, Issue 7, July 1982, Pages 408–416, https://doi.org/10.1093/cvr/16.7.408 Published: 01 July 1982
Potential for organ donation in the United Kingdom: audit of intensive care records
Authors: Kerri Barber, Sue Falvey, Claire Hamilton, Dave Collett, Chris Rudge
Journal: BMJ (2006)

<h3>Abstract</h3> <b>Objectives</b> To determine the true potential for solid organ donation from deceased heartbeating donors and the reasons for non-donation from potential donors. <b>Design</b> An audit of all deaths in intensive care units, 1 April 2003 to 31 March 2005. The study was hierarchic, in that information was sought on whether or not brain stem testing was carried out; if so, whether or not organ donation was considered; if so whether or not the next of kin were approached; if so, whether or not consent was given; if so, whether or not organ donation took place. <b>Setting</b> 341 intensive care units in 284 hospitals in the United Kingdom. <b>Participants</b> 46 801 dead patients, leading to 2740 potential heartbeating solid organ donors and 1244 actual donors. <b>Main outcome measures</b> Proportion of potential deceased heartbeating donors considered for organ donation, proportion of families who denied consent, and proportion of potential donors who became organ donors. <b>Results</b> Over the two years of the study, 41% of the families of potential donors denied consent. The refusal rate for families of potential donors from ethnic minorities was twice that for white potential donors, but the age and sex of the potential donor did not affect the refusal rate. In 15% of families of potential donors there was no record of the next of kin being approached for permission for organ donation. <b>Conclusions</b> Intensive care units are extremely good in considering possible organ donation from suitable patients. The biggest obstacle to improving the organ donation rate is the high proportion of relatives who deny consent.
CCR2 recruits an inflammatory macrophage subpopulation critical for angiogenesis in tissue repair
Authors: Sebastian Willenborg, Tina Lucas, Geert van Loo, Johanna A. Knipper, Thomas Krieg, Ingo Haase, Bent Brachvogel, Matthias Hammerschmidt, Andras Nagy, Napoleone Ferrara, Manolis Pasparakis, Sabine A. Eming
Journal: Blood (2012)
Overcrowding in psychiatric hospitals.
Authors: J. C. Barker
Journal: BMJ (1968)

DWIALJOUWALthese thousands of problems together rather than separately.These days there is a bitter competition among psychiatrists to discharge more and more long-stay patients, but very little thought has been given to the other side of the story: the community tolerance, its costs, and its limitations.Physical discharge of a patient is no substitute for cure.The criterion is that he should be happier and more useful in the community than in the hospital.I believe there is a case for moder- ating our enthusiasm to empty the mental hospitals with some research on discharged 'patients by individuals working exclusively in the community.-Iam, etc.,
The Cost-Effectiveness of Sofosbuvir-Based Regimens for Treatment of Hepatitis C Virus Genotype 2 or 3 Infection
Authors: Benjamin P. Linas, Devra M. Barter, Jake R. Morgan, Mai T. Pho, Jared A. Leff, Bruce R. Schackman, C. Robert Horsburgh, Sabrina A. Assoumou, Joshua A. Salomon, Milton C. Weinstein, Kenneth A. Freedberg, Arthur Y. Kim
Journal: Annals of Internal Medicine (2015)

Background: Chronic infection with hepatitis C virus (HCV) genotype 2 or 3 can be treated with sofosbuvir without interferon. Because sofosbuvir is costly, its benefits should be compared with the additional resources used. Objective: To estimate the cost-effectiveness of sofosbuvir-based treatments for HCV genotype 2 or 3 infection in the United States. Design: Monte Carlo simulation, including deterministic and probabilistic sensitivity analyses. Data Sources: Randomized trials, observational cohorts, and national health care spending surveys. Target Population: 8 patient types defined by HCV genotype (2 vs. 3), treatment history (naive vs. experienced), and cirrhosis status (noncirrhotic vs. cirrhotic). Time Horizon: Lifetime. Perspective: Payer. Intervention: Sofosbuvir-based therapies, pegylated interferon–ribavirin, and no therapy. Outcome Measures: Discounted quality-adjusted life-years (QALYs), costs, and incremental cost-effectiveness ratios (ICERs). Results of Base-Case Analysis: The ICER of sofosbuvir-based treatment was less than $100 000 per QALY in cirrhotic patients (genotype 2 or 3 and treatment-naive or treatment-experienced) and in treatment-experienced noncirrhotic patients but was greater than $200 000 per QALY in treatment-naive noncirrhotic patients. Results of Sensitivity Analysis: The ICER of sofosbuvir-based therapy for treatment-naive noncirrhotic patients with genotype 2 or 3 infection was less than $100 000 per QALY when the cost of sofosbuvir was reduced by approximately 40% and 60%, respectively. In probabilistic sensitivity analyses, cost-effectiveness conclusions were robust to uncertainty in treatment efficacy. Limitation: The analysis did not consider possible benefits of preventing HCV transmission. Conclusion: Sofosbuvir provides good value for money for treatment-experienced patients with HCV genotype 2 or 3 infection and those with cirrhosis. At their current cost, sofosbuvir-based regimens for treatment-naive noncirrhotic patients exceed willingness-to-pay thresholds commonly cited in the United States. Primary Funding Source: National Institute on Drug Abuse and National Institute of Allergy and Infectious Diseases.
Role of different pathways of the complement cascade in experimental bullous pemphigoid
Authors: Kelly C. Nelson, Minglang Zhao, Pamela R. Schroeder, Ning Li, Rick A. Wetsel, Luis A. Diaz, Zhi Liu
Journal: Journal of Clinical Investigation (2006)

Bullous pemphigoid (BP) is an autoimmune subepidermal blistering disease associated with autoantibodies directed against the hemidesmosomal proteins BP180 and BP230 and inflammation. Passive transfer of antibodies to the murine BP180 (mBP180) induces a skin disease that closely resembles human BP. In the present study, we defined the roles of the different complement activation pathways in this model system. Mice deficient in the alternative pathway component factor B (Fb) and injected with pathogenic anti-mBP180 IgG developed delayed and less intense subepidermal blisters. Mice deficient in the classical pathway component complement component 4 (C4) and WT mice pretreated with neutralizing antibody against the first component of the classical pathway, C1q, were resistant to experimental BP. These mice exhibited a significantly reduced level of mast cell degranulation and polymorphonuclear neutrophil (PMN) infiltration in the skin. Intradermal administration of compound 48/80, a mast cell degranulating agent, restored BP disease in C4(-/-) mice. Furthermore, C4(-/-) mice became susceptible to experimental BP after local injection of PMN chemoattractant IL-8 or local reconstitution with PMNs. These findings provide the first direct evidence to our knowledge that complement activation via the classical and alternative pathways is crucial in subepidermal blister formation in experimental BP.