tbuckley/cabot-search huggingface dataset:
Do colonic bacteria contribute to cholesterol gall-stone formation? Effects of lactulose on bile.
Authors: J R Thornton, K W Heaton
Journal: BMJ (1981)

Ten healthy middle-aged women volunteered for a study to test the effect of lactulose--a synthetic, non-absorbable disaccharide--on the colonic metabolism of bile acids and on bile lipid composition. Lactulose (60 g daily in eight cases, 39 g daily in two) was taken as a proprietary syrup for six weeks, and bile was collected by duodenal intubation before and immediately after six weeks. All subjects showed a fall in the percentage of the 7-alpha-dehydroxylated bile acid deoxycholic acid (mean 28.4 +/- SEM 3.7 to 15.6 +/- 2.4; p less than 0.002) and a rise in the percentage of the primary bile acid chenodeoxycholic acid (mean 33.2 +/- 42.9 +/- 2.9; p less than 0.001). The percentage of cholic acid rose in eight subjects but mean values did not differ significantly. Bile was initially super-saturated with cholesterol in most subjects and became less saturated with cholesterol in all but one (mean saturation index 1.40 +/- 0.11 to 1.19 +/- 0.07; p less these 0.005). These data support the theory colonic bacteria contribute to cholesterol gall-stone formation.
A comparative analysis of the cross‐reactivity in the polcalcin family including Syr v 3, a new member from lilac pollen
Authors: A. Ledesma, R. Barderas, K. Westritschnig, J. Quiralte, C. Y. Pascual, R. Valenta, M. Villalba, R. Rodríguez
Journal: Allergy (2006)

Background: Polcalcins are pollen‐specific allergens with two EF‐hand calcium‐binding sites that exhibit strong cross‐reactivity. Our objective was to isolate and express the cDNA coding of the EF‐hand calcium‐binding allergen from lilac pollen and to study cross‐reactivity with other polcalcins from related and nonrelated pollen sources with different specific antibodies and sera from two different populations. Methods: Specific cDNA was amplified by PCR, cloned and expressed in Escherichia coli . Purification was achieved by gel permeation and ion exchange chromatographies. ELISA titration and inhibition assays were performed using the recombinant forms of Syr v 3, Ole e 3, Che a 3 and Phl p 7 with sera from two Spanish regions with different sensitization profiles, as well as Phl p 7‐ and Ole e 3‐specific polyclonal rabbit antisera, and an Ole e 3‐specific monoclonal antibody. Results: Syr v 3 displays two EF‐hand consensus sites and 8863 Da of theoretical molecular mass. The allergen consists of 80 residues with identities ranging from 66 to 87% with polcalcins included in this study. Syr v 3, Ole e 3, Che a 3 and Phl p 7 showed a similar IgG‐ and IgE‐binding capacity although differences at quantitative level were observed depending on the population of patients’ sera. Conclusion: Syr v 3 is a polcalcin with structural and antigenic similarities to the members of this family. Diagnosis of polcalcin‐sensitized patients could be performed whatever polcalcin used, whereas for immunotherapy, primary sensitization to a particular allergenic source should be considered.
871 AMINO ACID SUBSTITUTIONS WITHIN A HEPATITIS C VIRUS IMMUNODOMINANT HLA-CLASS I RESTRICTED EPITOPE ARE DUE TO SELECTIVE IMMUNOLOGICAL PRESSURE
Authors: S. Benito, T. Parra-Cid, J. Miquel, E. Sanz-de-Villalobos, M. Calvino, M.L. García-Buey, F. González-Mateos, A. González-Praetorius, S. Albertos, J.R. Larrubia
Journal: Journal of Hepatology (2009)
No positive effect of postmastectomy radiotherapy on mortality at 20 years in pre menopausal women with stage II breast cancer also treated with adjuvant oral cyclophopsphamide. South Sweden Breast Cancer Group, trial SBII:I.
Authors: F Killander, H Anderson, T Möller, S Rydén, P Malmström
Journal: Cancer Research (2009)

Abstract Abstract #5128 Purpose: To study long term loco-regional recurrence rate and survival after postmastectomy radiotherapy in combination with oral cyclophosphamide in premenopausal women with stage II breast cancer.&amp;#x2028; Study design: A three-armed randomised, multicenter, phase III trial comparing 1) Radiotherapy (RT) 2) RT+ oral cyclophosphamide for one year (RT+C) and 3) cyclophosphamide only (C).&amp;#x2028; Radiotherapy was administered with 48 Gy in 20 fractions to chest wall and locoregional lymph nodes (Arwidi Å, Acta Oncol Scand 18:273-281, 1979). Cyclophosphamide was prescribed as 12 courses of 130 mg/m2 od for14 days every 4 weeks.&amp;#x2028; Patients and methods: 367 patients from 15 departments in Southern Sweden, representing 80% of all eligible patients, were included in the trial between 1978-1983; n=124 (RT), n=118 (RT+C), n=125 (C). Median age was 47 years, median tumour size was 25 mm, and 33 % of the patients were lymph node negative. Median follow up for survival was 24 years and 21 years for other events.&amp;#x2028; Results: RT reduced the risk at twenty years for locoregional recurrence in C treated patients with 75 %, 13.9 vs 3.5 %. The risk reduction was highly significant in both N0 and N+ patients. RT did not decrease systemic disease or mortality, see table 1. Chemotherapy did not decrease mortality when added to radiotherapy, though difficult to evaluate because of lack of information on delivered doses in many cases.&amp;#x2028; &amp;#x2028; Conclusion: Postmastectomy radiotherapy reduces loco regional recurrences in this premenopausal population, but no effect was seen on mortality at 20 years. Possible explanations are 1) low number of loco regional recurrences and superior survival in comparison to other trials investigating postmastectomy radiotherapy, which might have modified the effect of RT on survival, 2) too low intensity of adjuvant, single agent chemotherapy, and 3) chance, since relatively small study with little power. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5128.
The Lone Eagle's Last Flight
Authors: Milton M. Howell
Journal: JAMA (1975)

IN 1972, a surgeon performing a routine preoperative examination found an abnormal node that proved to be a lymphoma. The event was far from routine, however, for the patient was Charles A. Lindbergh, one of the most famous heroes of all time. Thus, the Lone Eagle embarked on his last flight, taking him two years, to his death in a remote cottage on Maui in Hawaii. Though he accepted the advice and assistance of medical experts all along the way, he was at the controls at all times. Lindbergh had been promptly and honestly informed of his diagnosis, and since a supraclavicular node had also been noted, he was well aware of the prognosis. Radiation therapy produced a welcome remission for a time. He was able to travel extensively on his many conservation missions; these included the preservation of a rare species of eagle and the study of the Stone-Age
Impact of PET/CT in Comparison With Same Day Contrast Enhanced CT in Breast Cancer Management
Authors: Elena Piperkova, Barbara Raphael, Mustafa E. Altinyay, Ivan Castellon, Richard Libes, Nick Sandella, Sherif Heiba, Hussein Abdel-Dayem
Journal: Clinical Nuclear Medicine (2007)

Purpose: To evaluate the impact of F-18 fluorodeoxyglucose (FDG) positron emission tomography with fused computerized tomography (PET/CT) in comparison with same day contrast enhanced CT (CE-CT) in breast cancer management. Method: Seventy studies in 49 breast cancer patients, 17 for initial and 53 for restaging disease were included. All patients underwent PET/CT for diagnostic purposes followed by CE-CT scans of selected body regions. PET/CT was started approximately 90 minutes following IV injection of 10–15 mCi of F-18 FDG on a GE Discovery PET/CT system. Oral contrast was given before F-18 FDG injection. The CE-CT was performed according to departmental protocol. Results: Out of a total of 257 lesions, 210 were concordant between PET/CT and CE-CT. There were 47 discordant lesions, which were verified by either biopsy (35) or follow-up (12 PET positive CE-CT negative lesions). PET/CT correctly identified 25 true positive (TP). CE-CT identified 2 TP lesions missed by PET/CT which were false negatives (FNs): one liver metastasis with necrosis, which was nonavid to FDG uptake because of necrosis and a second one missed on abdominal metastatic node, which did not change staging or treatment. PET/CT incorrectly identified 2 false positive lesions while CE-CT incorrectly identified 18 false positive. TP recurrence of the disease was found by PET/CT in 44% (15/34 pts), whereas 56% (19/34 pts) were free of disease. The CE-CT described progression of the disease in 1 true negative PET/CT study and no progression in 2 TP PET/CT studies. The sensitivity, specificity, accuracy, positive productive value, and negative productive value for PET/CT were 97.8%, 93.5%, 97.3%, 99.1%, 85% and for CE-CT were 87.6%, 42%, 82.1%, 91.6%, 31.7%. Conclusion: In this study, PET/CT played a more important role than CE-CT scans alone and provided an impact on the management of breast cancer patients.
Type 1 diabetes still shortens life span, Scottish study finds
Authors: J. Wise
Journal: BMJ (2015)

Despite major medical advances over the past three decades, a 20 year old woman with type 1 diabetes can still expect to live 13 years less than someone without the condition, a large Scottish study has concluded.1 For men the estimated life expectancy loss is 11 years.

The prospective cohort study, published in JAMA , found that even in the absence of renal complications mortality from cardiovascular disease remained significantly more in people with type 1 diabetes than in the population without diabetes.

Intensive insulin treatment is now the standard of care, and over the past 30 years significant advances have been made in insulin delivery and glucose monitoring that help in the management of type 1 diabetes. Yet for many people with type 1 diabetes glycaemic control remains suboptimal, and acute and chronic complications from diabetes persist, reducing life expectancy.

Researchers from Dundee University used a national registry of patients …
Human Infection with<i>Candidatus Rickettsia tarasevichiae</i>
Authors: Na Jia, Yuan-Chun Zheng, Jia-Fu Jiang, Lan Ma, Wu-Chun Cao
Journal: New England Journal of Medicine (2013)

325-bp ompA sequences revealed that the agent clustered with other R. sibirica subspecies and was most closely related to R. sibirica subspecies sibirica 246, which had been isolated from Dermacentor nuttalli in Russia (Fig. 1).In serum samples obtained from the patient, the titers of IgM and IgG antibodies against R. sibirica on indirect immunofluorescence assay increased from 1:32 and 1:64, respectively, in the acute phase to 1:4096 for IgM and for IgG in the convalescent phase.The study of this case was approved by the institutional review board of the Chinese Academy of Military Medical Sciences.The patient provided written informed consent.R. sibirica subspecies sibirica BJ-90 was initially isolated from D. sinicus in China in 1990, 2,3 and it was detected in D. silvarum in Russia. 4Our case shows that this organism can cause human disease.Unlike patients infected with R. sibirica and R. heilongjiangensis in the same geographic region, 5 this patient was severely ill with multiorgan dysfunction.Further investigation of the epidemiologic and clinical features of R. sibirica subspecies sibirica BJ-90 is required to distinguish it from other known tickborne infections.
Terminally ill people shouldn't have to travel abroad for assisted dying
Authors: L. McClelland
Journal: BMJ (2012)

My aunt, Geraldine McClelland (Mo), died at Dignitas in 2011. She had been diagnosed with breast cancer in 2009, aged 58, and had radical surgery, chemotherapy, and radiotherapy. Some months later Mo developed a bad cough. The formal diagnosis of metastatic disease took four months. She was breathless after walking from her sofa to her fridge and wasn’t eating. She started palliative chemotherapy and was advised that she could live for up to 18 months. She went into rapid decline and so stopped treatment.

Mo was always clear about her decision to choose a medical death in the event of a terminal diagnosis if she felt her suffering was too great and if she became dependent on others. This was simply her wish.

Mo and her friends worked tirelessly to arrange everything. She had been unaware of how stringent the process was. Dignitas doesn’t promote its services; it just provides them for the small percentage who need them. It’s expensive and involves interminable paperwork. I thought of others like Mo …
Refusing to provide a prenatal test: can it ever be ethical?
Authors: Nushan P Gunawardana
Journal: BMJ (2006)

Physical activity to prevent obesity in young children Negative outcome or protocol problem?Editor-Although the article by Reilly et al on physical activity to prevent obesity in young children emphasises that adherence to protocol was good, 1 an interview with Reilly on the Today programme (7.20 am, 6 October 2006) cited the difficulty in getting children to increase their activity as much as required-that is, not a negative outcome, but a problem in achieving sufficient increase to make the intervention effective.Which was the case?
An association between psoriasis and hereditary multiple exostoses. A clue for the mapping of a psoriasis susceptibility gene?
Authors: J.L. ROSBOTHAM, R.C. TREMBATH, M. GLOVER, J. LEIGH, J.N.W.N. BARKER
Journal: British Journal of Dermatology (1994)

Summary Chronic plaque psoriasis affects approximately 1·6% of the U.K. population. Population, family and twin studies all strongly suggest an important genetic component in the pathogenesis of the disease, although genetic linkage studies have, so far, failed to identify susceptibility genes. We describe a family in which psoriasis cosegregates through three generations with a known autosomal dominant disorder, hereditary multiple exostoses (HMK). A major locus for HMH has recently been mapped to chromosome 8q. Observations in this family may provide a mapping clue for a psoriasis susceptibility gene.
Expression and desensitisation of A2 purinoceptors on cultured bovine aortic endothelial cells
Authors: J. LUTY, J. A HUNT, P. K NOBBS, E. KELLY, M. KEEN, J. MACDERMOT
Journal: Cardiovascular Research (1989)

Purine nucleotides and their metabolites are important mediators of vascular tone. Adenosine promotes relaxation of vascular smooth muscle, acting on the A2 subclass of purinoceptors. There is some evidence that these receptors are also present on vascular endothelial cells. We have therefore examined cultured aortic endothelial cells for adenosine (A2) sensitivity. Bovine aortic endothelial cells (AG4762) were obtained from the Institute of Aging cell repository (USA), and cultured in monolayer flasks. Adenylate cyclase activity in homogenates of AG4762 cells was increased by 5′-(N-ethylcarboxamido)-adenosine (NECA) > 2-chloroadenosine > adenosine. NECA dependent activation of adenylate cyclase was inhibited by 3-isobutyl-l-methylxanthine > theophylline > caffeine. The rank order of potency of these compounds identified the responses as mediated by A2 purinoceptors. Prolonged exposure of AG4762 cells to NECA in culture resulted in loss of A2 purinoceptor responsiveness, and purinoceptor activity could be restored to non-dividing densensitised cells by further culture in the absence of the desensitising agent. The cyclic AMP dependent phosphorylation of specific sites in endothelial cells may trigger a number of important biological events which are yet to be determined.
Psychological Changes Following Surgical Treatment of Parkinsonism
Authors: PETER HAYS, BERENICE KRIKLER, LAWRENCE SUTCLIFFE WALSH, GERALD WOOLFSON
Journal: American Journal of Psychiatry (1966)

Twenty-five patients were tested and interviewed immediately before and at varying intervals after surgical treatment for parkinsonism to determine possible psychological changes. In both interviewing and psychological testing, no support was provided for the proposition that parkinsonism and schizophrenia are mutually opposed. The finding of a general postoperative elevation of mood among the patients could not easily be attributed to placebo effect, to improved function, or to a relief of tension similar to a postleucotomy effect. The authors conclude that the postoperative elevation of mood was a specific consequence of the operation itself.
Association of low birth weight with beta cell function in the adult first degree relatives of non-insulin dependent diabetic subjects.
Authors: J T Cook, J C Levy, R C Page, J A Shaw, A T Hattersley, R C Turner
Journal: BMJ (1993)

OBJECTIVE--To examine the relation between birth weight and beta cell function in the first degree relatives of non-insulin dependent diabetic subjects. DESIGN--Cross sectional study of 101 adults of known birth weight from 47 families which had at least one member with non-insulin dependent diabetes. SUBJECTS--101 white adults aged mean 43 (SD 7) years. SETTING--Oxfordshire, England. MAIN OUTCOME MEASURES--Glucose tolerance was measured by continuous infusion glucose tolerance test. beta cell function and insulin sensitivity were calculated from the fasting plasma glucose and insulin concentrations with homeostasis model assessment. beta cell function was standardised to allow for the confounding effects of age and obesity. RESULTS--Twenty seven subjects had non-insulin dependent diabetes, 32 had impaired glucose tolerance, and 42 were normoglycaemic. Birth weight correlated with the beta cell function of the complete cohort (rs = 0.29, p = 0.005), the non-insulin dependent diabetic subjects (rs = 0.50, p = 0.023), and the non-diabetic subjects (rs = 0.29, p = 0.013). The non-insulin dependent diabetic (n = 27) and the non-diabetic (n = 74) subjects had similar mean (inter-quartile range) centile birth weight 50% (19%-91%), and 53% (30%-75%) respectively. Non-insulin dependent diabetic subjects had significantly lower beta function than the non-diabetic subjects: 69% (48%-83%) v 97% (86%-120%), p &lt; 0.001. CONCLUSIONS--The cause of the association between low birth weight and reduced beta cell function in adult life is uncertain. Impaired beta cell function in non-insulin dependent diabetic subjects was not accounted for by low birth weight, and genetic or environmental factors are likely to be necessary for development of diabetes.
Chronic reduction of carotid blood flow causes salt-sensitive hypertension in rats
Authors: Masato Nishimura, Hiroyuki Kobayashi, Tetsuya Hashimoto, Toyoshi Fukuda, Koji Okino, Noriyuki Yamamoto, Toshikazu Yoshikawa, Toshihiko Ono
Journal: Journal of the American College of Cardiology (2002)
Effects of Mental Stress on Left Ventricular and Peripheral Vascular Performance in Patients With Coronary Artery Disease
Authors: Diwakar Jain, Sheriff M Shaker, Matthew Burg, Frans J.Th Wackers, Robert Soufer, Barry L Zaret
Journal: Journal of the American College of Cardiology (1998)

Objectives. We sought to investigate the mechanism of a mental stress–induced fall in left ventricular ejection fraction (LVEF) in patients with coronary artery disease. Background. Mental stress induces a fall in LVEF in a significant proportion of patients with coronary artery disease. This is accompanied by an increase in heart rate, blood pressure and rate–pressure product. Whether the mental stress–induced fall in LVEF is due to myocardial ischemia, altered loading conditions or a combination of both is not clear. Methods. Left ventricular (LV) function was studied noninvasively by serial equilibrium radionuclide angiocardiography and simultaneous measurement of peak power, a relatively afterload-independent index of LV contractility, in 21 patients with coronary artery disease (17 men, 4 women) and 9 normal subjects (6 men, 3 women) at baseline, during mental stress and during exercise. Peripheral vascular resistance (PVR), cardiac output (CO), arterial and end-systolic ventricular elastance (Ea, Ees) and ventriculoarterial coupling (V/AC) were also calculated. Patients underwent two types of mental stress—mental arithmetic and anger recall—as well as symptom-limited semisupine bicycle exercise. Results. Nine patients (43%) had an absolute fall in LVEF of ≥5% (Group I) in response to at least one of the mental stressors, whereas the remaining patients did not (Group II). Group I and Group II patients were similar in terms of baseline characteristics. Both groups showed a significant but comparable increase in systolic blood pressure (15 ± 7 vs. 9 ± 10 mm Hg, p = 0.12) and a slight increase in heart rate (7 ± 4 vs. 8 ± 7 beats/min, p = 0.6) and a comparable increase in rate–presure product (2.2 ± 0.9 vs. 1.9 ± 1.2 beats/min × mm Hg, p = 0.6) with mental stress. However, PVR increased in Group I and decreased in Group II (252 ± 205 vs. −42 ± 230 dynes·s·cm−5, p = 0.006), and CO decreased in Group I and increased in Group II (−0.2 ± 0.4 vs. 0.6 ± 0.7 liters/min, p = 0.02) with mental stress. There was no difference in the change in peak power (p = 0.4) with mental stress. With exercise, an increase in systolic blood pressure, heart rate, rate–pressure product and CO and a fall in PVR were similar in both groups. Of the two mental stressors, anger recall resulted in a greater fall in LVEF and a greater increase in diastolic blood pressure. Exercise resulted in a fall in LVEF in 7 patients (33%). However, exercise-induced changes in LVEF and hemodynamic variables were not predictive of mental stress–induced changes in LVEF and hemodynamic variables. Conclusions. Abnormal PVR and Earesponses to mental stress and exercise are observed in patients with a mental stress–induced fall in LVEF. Peripheral vasoconstrictive responses to mental stress contribute significantly toward a mental stress–induced fall in LVEF.
Iatrogenic intestinal obstruction: a rare complication of capsule endoscopy in a patient with familial adenomatous polyposis
Authors: P. Pérez-Segura, I. Siso, R. Luque, H. Olivera, S. Díaz, J. Mayol, C. Bueno, J. Puente, E. Díaz-Rubio
Journal: Endoscopy (2007)

A 24-year-old woman with a history of an epidermoid cyst of the knee (resected at the age of 15) and a gluteal epidermal cyst (resected at the age of 23) was referred to our service. She underwent a complete colon examination because she was suspected to have familial adenomatous polyposis (FAP). Colonoscopy showed several sessile polyps along the colon. Multiple polypeptomy was performed and histopathological examination revealed these lesions to be tubular adenomas with mild dysplasia.
Diagonal Ear-Lobe Crease: Prevalence and Implications as a Coronary Risk Factor
Authors: Edgar Lichstein, Kul D. Chadda, Dayanand Naik, Prem K. Gupta
Journal: New England Journal of Medicine (1974)

THE diagonal ear-lobe crease described below appears more commonly in patients with coronary heart disease and should be regarded as a coronary risk factor. Although other risk factors may be present in the same patient, this crease is easily noticed and serves to identify this high-risk group.MethodDuring a three-year period from July, 1970, through June, 1973, 531 patients with acute myocardial infarction were observed in a coronary-care unit.Questionnaires were completed at the time of admission concerning the presence or absence of the diagonal ear crease, hypertension, diabetes mellitus and smoking habits. The ear crease was judged to . . .