tbuckley/cabot-search huggingface dataset:
Association of class II human histocompatibility leukocyte antigens with rheumatic fever.
Authors: E M Ayoub, D J Barrett, N K Maclaren, J P Krischer
Journal: Journal of Clinical Investigation (1986)

The association of class I and II HLA antigens with rheumatic fever and its manifestations was examined in 72 patients, including 48 blacks and 24 Caucasians. No significant association was found between class I antigens and rheumatic fever. In contrast, HLA-DR2 and HLA-DR4 phenotypes were encountered in a significantly higher frequency in black and Caucasian patients with rheumatic fever, respectively, compared with the control populations (P less than 0.005). The most significant association (P less than 0.005) of these DR antigens with a major manifestation of rheumatic fever was found for mitral insufficiency. In addition, a significant association was encountered between persistent elevation of antibody to the group A streptococcal carbohydrate and HLA-DR4 in Caucasian patients (P less than 0.04) or HLA-DR2 in the black patients (P less than 0.001). The frequency of HLA-DR2/4 heterozygotes among patients with rheumatic fever did not differ significantly from controls. These findings support the concept of a genetically determined susceptibility to rheumatic fever and, particularly, to rheumatic heart disease. The association of the clinical manifestations of rheumatic fever and the immune hyperresponsiveness to a streptococcal antigen could be ascribed to a disease-associated immune-response gene which is in linkage disequilibrium with the DR2 and DR4 alleles of HLA-DR locus on chromosome six.
Regulation of surfactant phosphatidylcholine secretion from alveolar type II cells during Pneumocystis carinii pneumonia in the rat.
Authors: W R Rice, F M Singleton, M J Linke, P D Walzer
Journal: Journal of Clinical Investigation (1993)

We used an immunosuppressed rat model to test the hypothesis that normal mechanisms regulating surfactant phosphatidylcholine synthesis and secretion in alveolar type II cells are aberrant in Pneumocystis carinii pneumonia. Animal groups included: group 1, healthy controls; group 2, immunosuppressed, without pneumocystosis; group 3, immunosuppressed with pneumocystosis; group 4, immunosuppressed with well-established pneumocystosis treated with trimethoprim-sulfamethoxazole (TMP-SMX). Type II cells were isolated from rats in each group and compared for [3H]choline incorporation into phospholipid and response of the type II cells to secretagogues. Incorporation of [3H]choline into phospholipid subclasses exhibited significant differences. Incorporation into phosphatidylcholine fell from 89.3 +/- 2.2% of total incorporation in group 1 control rats to 79.6 +/- 3.1% in group 3 rats with P. carinii pneumonia, while incorporation into sphingomyelin rose from 5.6 +/- 1.2% in group 1 animals to 15.2 +/- 2.7% in group 3 rats. Incorporation of [3H]choline into phospholipid subclasses in cells from group 2 and group 4 animals was not different from incorporation for group 1 animals. Type II cells from group 1 and group 2 (immunosuppressed control) rats responded appropriately to the secretagogues ATP, TPA, and terbutaline with a marked increase in surfactant phosphatidylcholine secretion; the effect of ATP was also blocked by the lectin, concanavalin A. In contrast, type II cells from group 3 rats failed to respond to the secretagogues with a significant increase in phospholipid secretion. Although treatment of group 4 rats with TMP-SMX markedly reduced the P. carinii organism burden, type II cells from these animals also responded poorly to the secretagogues. The depressed type II cell function described here provides a mechanism for the observed decrease in surfactant phospholipids from bronchoalveolar lavage fluid of experimental animals and patients with P. carinii pneumonia. The data also suggest this defect may become irreversible with advanced disease.
More randomised controlled studies in speech and language therapy
Authors: P. Carding, R. Hillman
Journal: BMJ (2001)

Papers p 658 

Randomised controlled trials remain the most widely accepted way of evaluating new treatments. Clinical services such as speech and language therapy, however, have been particularly reluctant to produce randomised controlled trials as evidence of efficacy of treatment. 1 2 An evidence base is emerging for the efficacy of a number of speech and language therapy interventions, especially in dysphasia, stammering, laryngectomy, and dysphonia.3 Most interventions, however, have been evaluated by uncontrolled before and after comparisons. One of the first randomised controlled trials in speech and language therapy to evaluate voice therapy in dysphonia appears in this issue.4 This trial shows that it is possible to design and carry out randomised controlled trials to examine complex behavioural interventions.

Randomised controlled studies are difficult to apply in some areas5; the limitations of such trials in general medicine, surgery, and behavioural therapies are well documented. 2 6 7 Researchers in speech and language therapy have been reluctant to use randomised controlled designs because of the complexity and individuality of human communication …
A rather sad document.
Authors: G P McNicol
Journal: BMJ (1979)

only category of caring staff essential when active treatment  no longer possible. However eirenic, the commissioners are not afraid to speak their minds. On fluoridation they are certain that it  entirely wrong to deprive the most vulnerable section of the population of such an important public health measure for the sake of the views of a small minority of adults for whom its benefits come too late. They do not mince matters concerning the quality of, for example, recruitment into psychiatry, services for the mentally handicapped, and  urban primary care, where  National Health Service  failing dismally. They recognise the less than altruistic pressure of pharmaceutical companies on GPs and make no bones about drawing up a limited list of drugs, eliminating ineffective and unnecessarily expensive drugs. Depending on your point of view, you will accept or reject the report in part or in whole. Of course, it will be a disappoint ment to those whose favourite remedies have not been exhibited or who, unrealistically, expected the heavens to open and the NHS to be transformed by some blinding revelation. The commission  well aware that there are no magic wands to be waved. If accused of  complacency in their verdict that we need not feel ashamed of  health service, which is not suffering from a mortal disease, they could argue that their lofty view enables them to see the wood unimpeded by trees. Those of us working down among the roots may not be quite so sanguine. For me, however, the importance of the report lies in its perspective overview, presumably free from sectional interest and given in good faith. Its overall attitudes seem healthy and should stimulate ideas and action. They are right that our work can therefore be regarded only as a beginning. I hope, at a cost of ?918 000, that the exercise will prove to have been cost-effective.
Familial association of autoimmune thrombocytopenia and hyperthyroidism
Authors: Nicola Bizzaro
Journal: American Journal of Hematology (1992)

Abstract An association between thrombocytopenia and thyrotoxicosis in a single individual is well documented, and the theories for this event include a common immunologic cause or a thyrotoxic‐induced decrease in platelet survival. We report the first description of the coexistence of autoimmune thrombocytopenic purpura (AITP) and Graves' disease in several members of the same family, in which four females were thrombocytopenic and two of these were also hyperthyroid. All four patients had high titers of antiplatelet antibodies, and the two hyperthyroid cases were positive for thyroid‐stimulating immunoglobulins (TSI). The familial occurrence of two autoimmune disorders is very uncommon, and suggests a genetic etiology. The HLA phenotype was determined and the antigens B8 and DR3, which are reported with high frequency in both diseases, were present in three patients. Although the etiologic cause is still unknown, our findings further support the theory that a genetic predisposition underlies autoimmune disease.
Methyldopa Associated Hepatitis
Authors: O'Neill Barrett
Journal: JAMA (1973)

<h3>To the Editor.—</h3> Methyldopa is a widely used and effective antihypertensive agent. Although several side effects have been noted, emphasis has been on the ability of this drug to cause a positive direct Coombs reaction and, occasionally, hemolytic disease.<sup>1,2</sup>The "lupus cell" phenomenom and clinical syndromes consistent with systemic lupus erythematosus have been reported.<sup>1,3</sup>Less frequently reported is the association of methyldopa with hepatitis. This letter describes such a case. <h3>Report of a Case.—</h3> A 56-year-old white woman, seen in August 1970, complained of chest discomfort and blurred vision. Elevations of blood pressure had been noted in the past, but evaluation had failed to reveal a cause. The patient had a complex past history including a right radical mastectomy in 1944 for intraductal carcinoma, a left simple mastectomy in 1957 for fibrocystic disease, and a hemiglossectomy and right radical neck dissection for squamous cell carcinoma of the tongue
THE PATHOGENESIS OF RESPIRATORY ANOMALIES AFTER EPIDEMIC ENCEPHALITIS
Authors: M. Critchley
Journal: BMJ (1927)

RESPIRATORY ANOMALIES AFTEB EPIDEMIO ENCEPHALITIS.InIJmtAn 273 MIedicinal Treatment.-Arsenic has long been recognized as the most useful drug, aiid the upholders of the spirochaetal theory lay emphasis oni this fact.Where possible, early cases should receive precisely the same treatment as that used in neuro- syphilis; the dose of intravenous novarsenobillon should, however, never exceed 0.6 gram.Failing initravenous iinjection, intramiiuscular preparations of arsenic or bismuth should be given.When such methods are for any reasons impracticable, Fsowler's solution should be administered by the mouth, and may be used as a variant to the intra- venous and intramuscular methods.-Pyrexial Treatment.Protein therapy has been tried during the past few years in the treatment of-thip dise-ase, and some encouraging results have been reported.A mild degree --of protein -shock may-be produced by an injection of milk.It is preferable, however, to obtain a definite rise of tempera- ture, and it has been found that the intravenous injection of typhoid vaccine produced this result.It is usual to commence with a small dose-for instancee, 25 million-and gradually increase the amount so that by the end of six or eight injections -the patient is receiving 200 millions.Within a few hours of the injection a rigor occurs,-and the temperature rapidlv rises to 1020 or more.During -this period there is, of course, general malaise and usually, .temporaryexacerbation of the symptoms, especially diplopia and spasticity.Theinjections should be given every fifth day or so, and it is best to give a small dose of novarseno- billon on the day following the inijection.This form of treat- ment should be repeated from time to time.Malaria has also been tried; reports from Vienna are not encouraging in this respect, but Dreyfus and Hanau,1' in a recent paper, express the opinion that it is more satisfactorv than typhoid vaccine treatment.Dr. F. Golla informs me that relapsing fever has replaced malaria at the Maudsley Hospital in the treatment of geiieral paralysis of the insane, and that the results are just as satisfactory as with malaria, and the risk of a fatal termination is considerably less.Relapsing fever miglht tlherefore prove more suitable than either malaria or typhoid vaccine as a pyrexial agenlt in dissemninated sclerosis.
Academic Sanction-Reply
Authors: Ralph Crawshaw
Journal: JAMA (1990)

<h3>In Reply. —</h3> Mr Susser of CHISA is uncertain if I oppose any form of academic sanction. I am in favor of academic sanction that reflects the criteria outlined in the article, including a careful judgment of the full consequences and a clear statement of the reason, nature, exceptions, and expected duration, with specifics for rescinding the sanction, salted with a measure of humility for transcultural barriers and unconditional acceptance of ongoing negotiations. This is very different from passing a resolution during an ill-attended business meeting of a scientific association. As far as the World Medical Association's announced policy with regard to academic sanction, it seems more enlightened than that of many others. That it admits the Medical Association of South Africa is another matter. Rather than seeking an evil motive in a partially good action, a policy against indiscriminate academic sanction, I think those physicians who are so vocal
Establishing the Site of Gastrointestinal Bleeding
Authors: Michael O. Blackstone
Journal: JAMA (1979)

Traditionally, aspiration of gastric contents for blood is employed as the initial step in the diagnosis of gastrointestinal (GI) bleeding.<sup>1</sup>A positive result is usually viewed as indicating a bleeding site proximal to the ligament of Treitz, while negative aspirate implies a lower (small bowel or colon) site. Despite its intuitive correctness, the clinical value of this test never has been fully established. The article by Luk and colleagues, which appears elsewhere (p 576) inThe Journal, attempts to do this. In their study the outcome in 1,190 patients who had gastric aspiration performed was analyzed as to the site of bleeding ultimately determined. All patients in the study had undergone a vigorous attempt to define the site of bleeding. Upper GI endoscopy was employed in almost all patients and was the initial procedure in those having a gastric aspirate positive for blood (gross blood or guaiac-positive material). Sigmoidoscopy,
Drug-Sensitized Zebrafish Screen Identifies Multiple Genes, Including <i>GINS3</i> , as Regulators of Myocardial Repolarization
Authors: David J. Milan, Albert M. Kim, Jeffrey R. Winterfield, Ian L. Jones, Arne Pfeufer, Serena Sanna, Dan E. Arking, Adam H. Amsterdam, Khaled M. Sabeh, John D. Mably, David S. Rosenbaum, Randall T. Peterson, Aravinda Chakravarti, Stefan Kääb, Dan M. Roden, Calum A. MacRae
Journal: Circulation (2009)

Background— Cardiac repolarization, the process by which cardiomyocytes return to their resting potential after each beat, is a highly regulated process that is critical for heart rhythm stability. Perturbations of cardiac repolarization increase the risk for life-threatening arrhythmias and sudden cardiac death. Although genetic studies of familial long-QT syndromes have uncovered several key genes in cardiac repolarization, the major heritable contribution to this trait remains unexplained. Identification of additional genes may lead to a better understanding of the underlying biology, aid in identification of patients at risk for sudden death, and potentially enable new treatments for susceptible individuals. Methods and Results— We extended and refined a zebrafish model of cardiac repolarization by using fluorescent reporters of transmembrane potential. We then conducted a drug-sensitized genetic screen in zebrafish, identifying 15 genes, including GINS3 , that affect cardiac repolarization. Testing these genes for human relevance in 2 concurrently completed genome-wide association studies revealed that the human GINS3 ortholog is located in the 16q21 locus, which is strongly associated with QT interval. Conclusions— This sensitized zebrafish screen identified 15 novel myocardial repolarization genes. Among these genes is GINS3 , the human ortholog of which is a major locus in 2 concurrent human genome-wide association studies of QT interval. These results reveal a novel network of genes that regulate cardiac repolarization.
Efficacy of albumin in critically ill patients
Authors: S. Finfer
Journal: BMJ (2003)

In 1998, the BMJ published a meta-analysis that compared the effects of fluids containing albumin and crystalloids on death rates in critically ill patients.1 The analysis included 24 studies involving 1419 patients. The report concluded that there was no evidence that albumin reduced mortality and a strong implication that it might increase the risk of death. The authors recommended that use of albumin in critically ill patients be reviewed urgently and that albumin should not be used outside the context of rigorously conducted randomised controlled trials. Despite the fact that the reviewers themselves advised that their results must be interpreted with caution, an accompanying editorial called for a total halt to the use of albumin in critically ill patients.2 In the following weeks, numerous editorials and letters published in the BMJ debated the various merits of using albumin, without reaching consensus.3–6

As we approach the …
Preparing for Personalized Medicine
Authors: Sameer S. Chopra
Journal: JAMA (2004)

STUDENTJAMA provides a forum for critical exchange on current issues in medical education, research, and practice. It is produced by a group of medical student editors in collaboration with the JAMA editorial staff and is published monthly. The content of STUDENTJAMA includes writing by medical students, physicians, and other researchers, as well as original medical student artwork and creative writing. The articles and viewpoints in STUDENTJAMA do not necessarily reflect the opinions of the American Medical Association or of JAMA. All submissions must be the original unpublished work of the author(s). All submitted work is subject to review and editing.
Sweat tests to diagnose cystic fibrosis in adults.
Authors: M E Hodson, I Beldon, R Power, F R Duncan, M Bamber, J C Batten
Journal: BMJ (1983)

Twenty five patients with cystic fibrosis and 25 controls were studied to define a sweat sodium concentration in adults that could be taken as diagnostic of cystic fibrosis. Some of the controls had a sweat sodium concentration of over 50 mmol(mEq)/l, and thus cystic fibrosis should be diagnosed in an adult only when two measurements of sweat sodium concentration are above 70 mmol/l. In cases in which the sweat sodium concentration was borderline a suppression test using fludrocortisone improved the accuracy of diagnosis; this test entails recording the lowest concentration reached after administration of the drug. A scatter diagram of the baseline sweat sodium concentrations plotted against the lowest concentration attained after suppression with fludrocortisone may aid the diagnosis further.
A licence to bill
Authors: Des Spence
Journal: BMJ (2012)

I buy an airline ticket online—simple, you might think. But automatically I am charged for a bag or travel insurance for a trip to London, or I am offered the chance to pay extra to be first in the slowly moving herd in the airport queue. Lastly, I pay an extra premium for using a credit card. Customers constantly complain; there is no sense of goodwill towards this company. My red mist descends—I feel I am being systematically and cynically ripped off. I happily pay a premium just to avoid flying with this company. Bad …
Diagnostic Procedures in Cardiology: A Clinician's Guide
Authors: David L. Abrams
Journal: JAMA (1986)

With the steady increase in invasive and noninvasive diagnostic studies available in the practice of cardiology, there also appears to be a concomitant increase in books dealing with this topic. I was pleased to have the opportunity to review such a current text. The book is intended for the noncardiologist. Its purpose is to describe specific diagnostic tests, their clinical value, and how best to use them in practice. The authors have met their aims and have done so in a concise and orderly manner.  Physicians on the faculty of the Ohio State University College of Medicine have written this book. Thus, some of the data presented and statements made reflect their particular views and experience, leading at times to an unbalanced presentation. For example, almost an entire chapter is devoted to systolic time intervals, an area of special interest at the authors' institution, while scant mention is made of
Atypical Trigeminal Neuralgia
Authors: Joseph F. Cusick
Journal: JAMA (1981)

The definition, pathogenesis, and treatment of the atypical neuralgias involving the facial region remain controversial issues. It is important to emphasize differentiating the syndrome of atypical trigeminal neuralgia and recognizing its potential causal relationship to adverse mechanical stresses applied at the level of the trigeminal nerve root. (<i>JAMA</i>1981;245:2328-2329)
Renal Dysfunction After Arteriography
Authors: Robert A. Mason
Journal: JAMA (1985)

Acute renal failure has been observed in patients undergoing angiography in which a hypertonic triiodinated contrast medium is used. To ascertain the incidence of renal dysfunction and the clinical risk factors, we did a prospective study in which creatinine clearance was measured before and immediately after 120 arteriographic procedures. Thirty-seven patients (31%) sustained a significant reduction in creatinine clearance after arteriography. No specific risk factor could be determined. Our findings, however, indicate that patients with preexisting renal insufficiency or diabetes mellitus are not at a higher risk for sustaining a fall in creatinine clearance after angiography. (<i>JAMA</i>1985;253:1001-1004)
ACNEIFORM ERUPTIONS IN INFANCY.
Authors: F. F. HELLIER
Journal: British Journal of Dermatology (1954)

Journal Article ACNEIFORM ERUPTIONS IN INFANCY. Get access F. F. HELLIER, O.B.E., M.A., M.D., F.R.C.P. F. F. HELLIER, O.B.E., M.A., M.D., F.R.C.P. Leeds Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 66, Issue 1, 1 January 1954, Pages 25–30, https://doi.org/10.1111/j.1365-2133.1954.tb12554.x Published: 01 January 1954
CARDIAC I-123 METAIODOBENZYLGUANIDINE IMAGING PREDICTS THE RISK OF CARDIAC DEATH IN PATIENTS WITH CHRONIC HEART FAILURE, IRRESPECTIVE OF THE METABOLIC SYNDROME.: A LONG TERM FOLLOW UP STUDY
Authors: Hironori Yamamoto, Takahisa Yamada, Takashi Morita, Yoshio Furukawa, Koji Tanaka, Yusuke Iwasaki, Masato Kawasaki, Yuki Kuramoto, Tadao Fujimoto, Takumi Kondo, Kentaro Ozu, Kaoruko Sengoku, Masatake Fukunami
Journal: Journal of the American College of Cardiology (2012)
Fluid Resuscitation in Acute Illness — Time to Reappraise the Basics
Authors: John A. Myburgh
Journal: New England Journal of Medicine (2011)

Fluid resuscitation is a fundamental intervention in the treatment of critically ill patients. However, there is little conclusive evidence to guide clinicians about the best type of resuscitation fluid; the appropriate timing, volume, and rate of fluid administration; and the optimal way to adequately monitor the efficacy and safety of fluid resuscitation in various clinical conditions.1 Although the complications associated with excessive volume of resuscitation fluid — such as pulmonary and interstitial edema — are well recognized, an emerging body of evidence suggests that the type of resuscitation fluid may adversely affect the outcomes in specific clinical conditions; for example, . . .