tbuckley/cabot-search huggingface dataset:
Interferon-α with Zidovudine: Safety, Tolerance, and Clinical and Virologic Effects in Patients with Kaposi Sarcoma Associated with the Acquired Immunodeficiency Syndrome (AIDS)
Authors: Susan E. Krown
Journal: Annals of Internal Medicine (1990)

Objective: To evaluate safety, tolerance, and potential efficacy of interferon-α and zidovudine combination therapy in patients with Kaposi sarcoma and the acquired immunodeficiency syndrome (AIDS). Design: Open, phase-I study with randomization between two preparations of interferon-α. Setting: Outpatient clinic of a cancer research center. Patients: Forty-three patients with Kaposi sarcoma associated with AIDS. Interventions: Patients were treated with interferon-α 4.5, 9, or 18 million U/d, and zidovudine, 100 or 200 mg orally every 4 hours. Measurements and Main Results: Neutropenia was the major dose-limiting toxicity. Fatigue, liver enzyme elevation, anemia, and thrombocytopenia were dose-limiting in some patients. Maximum tolerated dosages for interferon-α2a with zidovudine, respectively, were 4.5 million U/d with 200 mg every 4 hours or 18 million U/d with 100 mg every 4 hours. An interferon-α dosage of 9 million U/d with zidovudine dosages of either 100 or 200 mg every 4 hours induced dose-limiting toxicity in most patients. Of 37 evaluable patients, 17 (46%; 95% CI, 30% to 62%) showed complete or partial tumor regression. Antitumor effects occurred more frequently in patients with baseline CD4 counts above 200 x 106 cells/L (65%) than in patients with lower baseline counts (30%, P = 0.05). Effects on CD4 cells were related to both initial CD4 count and interferon dose. Increased skin test reactivity and decreased serum human immunodeficiency virus (HIV) p24 antigen and virus recovery from blood cells were seen. Conclusions: Combined therapy with interferon-α and zidovudine can be safely administered to patients with AIDS and Kaposi sarcoma. The observed effects on tumor growth, HIV replication, and immune function support further studies of the combination in patients at various stages of HIV infection.
Positron Emission Tomography Helps in Excluding Distant Lesions in a Case of Mesothelioma
Authors: Aju Thomas, Amolak Singh, Bennett Greenspan
Journal: Clinical Nuclear Medicine (2004)

Malignant pleural mesothelioma (MPM) is an uncommon neoplasm (2500 cases per year in the United States) of the pleura. Computed tomography (CT) is the primary modality for diagnosis and staging of MPM. Positron emission tomography (PET) is useful for staging of malignant mesothelioma, because it can provide information regarding extrathoracic spread and lymph node metastasis. PET imaging is helpful in selecting the most appropriate site for biopsy based on the metabolic activity. The intensity of FDG uptake can predict the prognosis of MPM. A case of malignant mesothelioma encasing the entire right lung is presented here.
MULTIPLE NEURITIS.WITH REPORT OF FOUR CASES.
Authors: DAVID I. WOLFSTEIN
Journal: JAMA (1905)

The principal interest in neuritis centers in the fact that, on the one hand, it resembles mere functional affections like neuralgia, which is a disease of the sensory nerve characterized by pain in the course of the nerve, or in its end distribution; on the other hand, it may be so extreme and grave in its manifestations as to be confounded with even the most serious affection of the cord itself. The term neuritis implies that there is an inflammatory condition of the nerve affected, though the diseased condition is not necessarily inflammation in its usually accepted sense, but may also be a degeneration, though with a tendency toward repair. A neuritis, of course, may be confined to a single nerve when its symptoms will be those of the nerve affected. As a matter of experience, however, we are more interested in that form of neuritis which affects many nerves
Howard Roderick Duval John Daniel Griffiths David Eryl Meredith Hugh Stewart Kerr Sainsbury Norman Tate
Authors: R. E Shaw
Journal: BMJ (2001)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following Howard Roderick DuvalJohn Daniel GriffithsDavid Eryl MeredithHugh Stewart Kerr SainsburyNorman Tate Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Potential Role of Phosphatidylinositol 3 Kinase, rather than DNA-dependent Protein Kinase, in CpG DNA–induced Immune Activation
Authors: Ken J. Ishii, Fumihiko Takeshita, Ihsan Gursel, Mayda Gursel, Jacqueline Conover, Andre Nussenzweig, Dennis M. Klinman
Journal: The Journal of Experimental Medicine (2002)

Unmethylated CpG motifs present in bacterial DNA stimulate a strong innate immune response. There is evidence that DNA-dependent protein kinase (DNA-PK) mediates CpG signaling. Specifically, wortmannin (an inhibitor of phosphatidylinositol 3 kinase [PI3]-kinases including DNA-PK) interferes with CpG-dependent cell activation, and DNA-PK knockout (KO) mice fail to respond to CpG stimulation. Current studies establish that wortmannin actually inhibits the uptake and colocalization of CpG DNA with toll-like receptor (TLR)-9 in endocytic vesicles, thereby preventing CpG-induced activation of the NF-κB signaling cascade. We find that DNA-PK is not involved in this process, since three strains of DNA-PK KO mice responded normally to CpG DNA. These results support a model in which CpG signaling is mediated through TLR-9 but not DNA-PK, and suggest that wortmannin-sensitive member(s) of the PI3-kinase family play a critical role in shuttling CpG DNA to TLR-9.
Failure of Antepartum Maternal Cultures to Predict the Infant's Risk of Exposure to Herpes Simplex Virus at Delivery
Authors: Ann M. Arvin, Paul A. Hensleigh, Charles G. Prober, Deborah S. Au, Linda L. Yasukawa, Alec E. Wittek, Paul E. Palumbo, Sharon G. Paryani, Anne S. Yeager
Journal: New England Journal of Medicine (1986)

In 414 pregnant women with a history of recurrent genital herpes simplex infection, we studied the correlation between asymptomatic viral shedding in late pregnancy and at the time of delivery. Antepartum cultures for asymptomatic reactivation of herpes simplex virus were positive in 17 of the 414 women (4.1 percent). None of these women had positive cultures at the time of delivery. Cultures of specimens obtained at delivery from 5 of 354 asymptomatic mother–infant pairs (1.4 percent) were positive for asymptomatic excretion of herpes simplex virus. None of these women had had antepartum cultures that documented asymptomatic excretion of herpes simplex virus, despite the fact that culturing was repeatedly performed during the four weeks before delivery. Asymptomatic shedding of herpes simplex virus occurred with the same frequency at delivery, whether or not any episodes of symptomatic recurrence were noted during the pregnancy (1.4 vs. 1.3 percent). We conclude that antepartum maternal cultures do not predict the infant's risk of exposure to herpes simplex virus at delivery. (N Engl J Med 1986; 315:796–800.)
Stirrups or no stirrups for routine speculum examinations?: … but we do not need to do a trial of smear quality
Authors: James A Dickinson
Journal: BMJ (2006)

Editor-The report from the chief medical officer for England has implications for all UK doctors and needs to be considered very carefully. 1Its aim is a system of medical regulation that puts patients' safety first through the early detection, and where possible, remediation, of poor performance.If the report contributes to that aim, and commands public and professional support, it should be welcomed by everyone involved in health care.The Merrison report was the collective effort of Sir William Merrison and the other 14 members of his committee of inquiry, who took both oral and written evidence. 2A different process has been followed in this case.The government, sensibly, has therefore decided on a period of consultation during which the recommendations can be properly debated, tested, and costed.We have already said that we believe that the recommendations to divorce oversight of medical education from the other regulatory functions of standards, registration, and fitness to practise are not in patients' best interests.We will now be consulting widely with our partners before we submit our considered response.It may be another 30 years before there is another opportunity such as this.We must seize it so that future generations of patients can say that we did not fail them.
Labor Pains: Modern Midwives and Home Birth
Authors: Allan G. Charles
Journal: JAMA (1988)

I wish I could say something nice about this book, avoiding the probability that the authors will assume that I am sexist and a member of the establishment that "medicalizes" obstetric care. However, try as I may, I find little to recommend<i>Labor Pains</i>for reading by either the medical or lay public. The theme seems to be that male sexism and medicalization of the birth process have given rise to the kind of consumerism that in turn is giving rise to a demand for alternative medical care for the birth process. The book seems to argue (and I emphasize<i>seems to</i>, since I am not quite sure as to whether the authors are really arguing this point) that lay midwives may represent an acceptable alternative form of obstetric care. However, there are statements like "The rest of the women were 'backed into midwifery' without having apprenticed with physicians when
Amino Acid Metabolism in McArdle's Syndrome
Authors: John Wahren, Philip Felig, Richard J. Havel, Lennart Jorfeldt, Bengt Pernow, Bengt Saltin
Journal: New England Journal of Medicine (1973)

RECENT studies in normal man have suggested a central role for alanine in the metabolism of resting and exercising muscle. It has been demonstrated that synthesis and release of alanine from muscle depend not only on catabolism of muscle protein but also on the rate of formation of pyruvate from glycolysis in muscle.1 , 2 Supporting this formulation is the direct linear correlation between arterial levels of alanine and pyruvate both at rest and during exercise,2 and the finding that the augmented glycolysis induced by exercise is associated with a greatly increased output of alanine, proportional to the intensity of the work . . .
Pursuing the Goal of a Donor for Everyone in Need
Authors: Frederick R. Appelbaum
Journal: New England Journal of Medicine (2012)

Allogeneic hematopoietic stem-cell transplantation can be a lifesaving treatment for many patients with hematologic cancers. However, less than 30% of patients have an HLA-matched family member to serve as a donor, and with the shrinking size of the average family in the United States, this percentage is expected to drop. The first successful unrelated-donor transplantation for leukemia was performed in 1979, after Robert Graves contacted Dr. John Hansen at the Fred Hutchinson Cancer Research Center and asked whether a matched unrelated donor could be identified for his 10-year-old daughter, who had acute lymphocytic leukemia. Mr. Graves knew there was no . . .
Fibrinopeptide A cleavage and platelet release in whole blood in vitro. Effects of stimuli, inhibitors, and agitation.
Authors: K L Kaplan, M Drillings, G Lesznik
Journal: Journal of Clinical Investigation (1981)

The relationship between platelet release and fibrinopeptide A cleavage from fibrinogen to form fibrin I in vitro was examined in blood allowed to clot undisturbed or with gentle agitation. In undisturbed or agitated blood platelet release and fibrin I formation occurred simultaneously. When hirudin was added to undisturbed blood it prevented platelet release as well as fibrin I formation. In contrast, hirudin added to agitated blood had little effect on platelet release despite complete inhibition of fibrin I formation. Collagen added to either undisturbed or agitated blood increased platelet release and then fibrin I formation, and ADP added to undisturbed blood caused an initial burst of platelet release followed by slight acceleration of fibrinopeptide A cleavage. Prostaglandin E1 and theophylline prevented platelet release in both undisturbed and agitated blood, but did not affect fibrin I formation. The results with inhibitors in agitated blood suggest that fibrin I formation and platelet release can occur independently in the presence of the increased interactions induced by agitation. Addition of thrombin or tissue thromboplastin to undisturbed blood accelerated fibrin I formation with little effect on platelet release. Finally, initial thrombin formation in undisturbed blood appeared to be associated with the platelet surface. These relationships suggest that thrombin formation via the intrinsic system leads to thrombin generation on the platelet surface and simultaneous platelet release and fibrin I formation, while thrombin generated via tissue thromboplastin leads to thrombin formation in the plasma and fibrin I formation preceding platelet release. Activation by interaction of blood with collagen causes initial acceleration of platelet release and later acceleration of fibrin I formation.
Maternal Cigarette Smoking: Effect on Infant Birth Weight-Reply
Authors: Mary Sexton
Journal: JAMA (1985)

<h3>In Reply.—</h3> Berman and colleagues have made some thoughtful comments regarding our clinical trial. Below is a response to each of the three issues raised. We have analyzed the birth weight data within subgroups of women according to their smoking status at randomization. Within the subgroup of women who had stopped smoking by randomization, there was no statistically significant difference in mean birth weights between treatment and control groups (the mean for the control group was, in fact, slightly higher than that for the treatment group). Although the power for such subgroup analysis is not particularly high, this result supports the causal hypothesis. We are in complete agreement with the points that (1) thiocyanate does not have a particularly high level of sensitivity in determining smoking status on an individual basis and (2) the level of thiocyanate—as is true of any biochemical measure- ment—does not correlate with reported
A Saline Conductivity Method for Detection of Cardiac Shunts by Indicator-Dilution Technic
Authors: RICHARD W. BOOTH, JOSEPH M. RYAN, RICHARD S. GOODWIN
Journal: Circulation Research (1958)

A new method for cardiovascular shunt detection is described using the indicator-dilution principle applied to blood conductivity changes produced by 5 per cent saline. It possesses these distinct advantages over the Evans blue technic: (1) an unlimited number of determinations can be made without an increasing blood dye background or bluish discoloration of the patient, (2) oximetric determination of blood oxygen saturation is not interferred with, and (3) a simple modification of the carrier amplifiers of commonly used recording systems supplies most of the necessary instrumentation.
Irritability in Menopause: An Investigation of Its Relation to Menopausal, Hormonal and Physical Factors
Authors: A.C. Spyropoulou, I.M. Zervas, G. Christodoulakos, I. Lambrinoudaki, D. Rizos, K. Koundi, E. Sanida, G. Creatsas, C.R. Soldatos
Journal: Psychotherapy and Psychosomatics (2009)
Relative Bioavailability and Bioaccessibility and Speciation of Arsenic in Contaminated Soils
Authors: Karen D. Bradham, Kirk G. Scheckel, Clay M. Nelson, Paul E. Seales, Grace E. Lee, Michael F. Hughes, Bradley W. Miller, Aaron Yeow, Thomas Gilmore, Sophia M. Serda, Sharon Harper, David J. Thomas
Journal: Environmental Health Perspectives (2011)

Assessment of soil arsenic (As) bioavailability may profoundly affect the extent of remediation required at contaminated sites by improving human exposure estimates. Because small adjustments in soil As bioavailability estimates can significantly alter risk assessments and remediation goals, convenient, rapid, reliable, and inexpensive tools are needed to determine soil As bioavailability.We evaluated inexpensive methods for assessing As bioavailability in soil as a means to improve human exposure estimates and potentially reduce remediation costs.Nine soils from residential sites affected by mining or smelting activity and two National Institute of Standards and Technology standard reference materials were evaluated for As bioavailability, bioaccessibility, and speciation. Arsenic bioavailability was determined using an in vivo mouse model, and As bioaccessibility was determined using the Solubility/Bioavailability Research Consortium in vitro assay. Arsenic speciation in soil and selected soil physicochemical properties were also evaluated to determine whether these parameters could be used as predictors of As bioavailability and bioaccessibility.In the mouse assay, we compared bioavailabilities of As in soils with that for sodium arsenate. Relative bioavailabilities (RBAs) of soil As ranged from 11% to 53% (mean, 33%). In vitro soil As bioaccessibility values were strongly correlated with soil As RBAs (R² = 0.92). Among physicochemical properties, combined concentrations of iron and aluminum accounted for 80% and 62% of the variability in estimates of RBA and bioaccessibility, respectively.The multifaceted approach described here yielded congruent estimates of As bioavailability and evidence of interrelations among physicochemical properties and bioavailability estimates.
Successful endoscopic removal of a large calcified cyst impacted in the sigmoid lumen
Authors: A. Restivo, L. Zorcolo, G. D’Alia, M. Cabras, G. Casula
Journal: Endoscopy (2011)

We report an endoscopic technique used to remove a 6-cm calcific cyst stuck in the sigmoid lumen which was causing a colonic obstruction.
A Side Light on Ethics.
Authors: Robt. T. Gillmore
Journal: JAMA (1903)

<h3>To the Editor:</h3> —Apropos of the Code of Medical Ethics recently published inThe Journal, it has occurred to me that we are very foolishly shutting our eyes and closing our ears to the low standard of ethics practiced by the medical profession in America to-day. This is an age of commercialism. It has planted itself as firmly in the profession of medicine as in the department stores. This commercialism is a menace to the high standing of our medical men; it handicaps the good we might do for humanity; the reform we might accomplish; the respect we might command. Year by year the standard of ethics and ideals is lowered. At present we stand almost at the head of the list, in the eyes of the world, of professional jealousies. The musician and the medical man rank side by side in their bickering and in their enviousness. Newspaper men
Points from Letters: Who Should Do Psychotherapy?
Authors: J. R. Scott
Journal: BMJ (1970)

stuck.We have become, I am afraid, the Cinderella grade of the profession and a mi- nority group the B.M.A. can well afford to neglect.Support for this view is found in the Twelfth Review Body Report, paragraph 99, which states that the Associa- tion claimed that there should be a differential between the top of the scale of medical assistants and the bottom of the scale of consultants.Fortunately, the Review Body, in its wisdom, rejected this.
Agmatine inhibits the proliferation of rat hepatoma cells by modulation of polyamine metabolism
Authors: Giulia Gardini, Carlo Cravanzola, Riccardo Autelli, Giovanni Testore, Roberta Cesa, Laura Morando, Sandro Paolo Solinas, Giuliana Muzio, Maria Angelica Grillo, Sebastiano Colombatto
Journal: Journal of Hepatology (2003)
Rugby union should ban contested scrums
Authors: James B Bourke
Journal: BMJ (2006)

F or 30 years I have been an honorary medical officer to Nottingham Rugby Football Club. In this time I have attended about 25 games a season and on many occasions have been the “duty doctor,” either officially or unofficially. In that time four players have been removed from the field of play at Nottingham with serious neck injuries. Three of the injuries were associated with scrums, and one occurred in a tackle. All four players had initial sensory and motor impairment. Two recovered within minutes or hours; one recovered in days; and one became paraplegic. Three needed an operation for fracture. Another three Nottingham players injured their necks in scrums while playing away from home and needed to be removed from the pitch. One player needed an operation and is paraplegic. Therefore I have experience of seven serious spinal cord injuries, five of which have required an operation. Two of the players are wheelchair dependent. Six of the seven injuries were related to the scrum, and in all …
Investigation of the prevalence and clinical associations of antibodies to human fibronectin in systemic lupus erythematosus.
Authors: M S Atta, K L Lim, D A Ala'deen, R J Powell, I Todd
Journal: Annals of the Rheumatic Diseases (1995)

OBJECTIVES--To assess the prevalence of antibodies to human fibronectin (anti-Fn) in sera of patients with certain connective tissue diseases and to determine their association with disease activity and the pattern of organ involvement in patients with systemic lupus erythematosus (SLE). METHODS--A capture enzyme linked immunosorbent assay (ELISA) was developed to quantify anti-Fn antibodies in serum samples from 65 patients with well characterised SLE, 50 with rheumatoid arthritis (RA), 15 with Behçet9s disease (BD), 15 with systemic vasculitis and 36 healthy subjects. An anti-Fn antibody titre greater than mean + 3SD of the healthy control log values after back transformation to the normal scale was considered positive. Disease activity in SLE patients was scored using the British Isles Lupus Assessment Group (BILAG) Index. Erythrocyte sedimentation rate (ESR), concentrations of anti-dsDNA antibody, soluble interleukin-2 receptors (sIL-2R), C3, C4, C3 degradation products (C3dg) and immunoglobulin, and antinuclear antibody (ANA) titres were measured in blood samples from SLE patients; neopterin concentration was measured in corresponding urine samples. RESULTS--Anti-Fn antibodies were found in 22 of 65 SLE patients (33.8%), seven of 50 with RA (14%), one of 15 with BD (6.6%) and none of the 15 subjects with vasculitis. Thirty SLE patients had active disease and 35 had inactive disease; their median anti-Fn concentrations were 117 u/ml (range 47-450) and 68 u/ml (range 17-334), respectively (p = 0.0001). The presence of anti-Fn did not correlate with immunoglobulin concentrations or ANA titres in these sera. No significant difference was found between SLE patients with disease activity in one major organ system compared with multiple organ involvement, as defined by BILAG (p = 0.19). However, patients with musculoskeletal manifestations had consistently greater anti-Fn concentrations compared with patients with other clinical manifestations. There were significant correlations between amounts of anti-Fn in SLE sera and ESR (rs = 0.25, p = 0.045), sIL-2R (rs = 0.28, p = 0.024) and urine neopterin (rs = 0.3, p = 0.016) but not with serum anti-dsDNA antibody titres, plasma C3, C3dg or C4. However multiple regression analysis showed a low significant correlation only with sIL-2R and BILAG score (p = 0.047 and 0.042, respectively). CONCLUSION--Anti-Fn antibodies were detected in 34% of SLE patients and in small proportions of RA and BD patients. An association between serum anti-Fn and disease activity in SLE has been identified and most SLE patients with musculoskeletal involvement had increased anti-Fn antibody concentrations.