tbuckley/cabot-search huggingface dataset:
Long-Term Evaluation of Chlorambucil plus Prednisone in the Idiopathic Nephrotic Syndrome of Childhood
Authors: S. A. Williams, Sudesh P Makker, J. R. Ingelfinger, W. E. Grupe
Journal: New England Journal of Medicine (1980)

We evaluated the long-term effects of a five to 15-week course of chlorambucil and prednisone in 59 children with idiopathic nephrotic syndrome who had previously received prednisone alone and had had frequent relapses or steroid dependency or resistance. By actuarial analysis of 65 courses of dual therapy followed up for one to 12 years (mean, 5.0), we found that 95 per cent of patients were in remission at one year and 85 per cent at four years. All but two had remissions lasting longer than those induced by steroids alone, and only eight others had one or more relapses after therapy. Life-table analysis of two dosage schedules of chlorambucil at four years showed that 91 per cent of patients on low doses and 80 per cent of those on high doses were still in remission. Although immediate complications were minimal, the potential for long-term toxicity still requires careful selection of patients who receive chlorambucil. Prolonged use of chlorambucil in daily doses above 0.3 mg per kilogram of body weight per day or cumulative doses above 14 mg per kilogram is no longer warranted. Measured in terms of both the immediate and long-term responses, chlorambucil appears to lower the frequency of relapses in idiopathic nephrotic syndrome.
Effect of intermittent stretch on immobilised muscle.
Authors: P E Williams
Journal: Annals of the Rheumatic Diseases (1988)

When muscle is immobilised in a shortened position there is a reduction in fibre length and an increase in the proportion of connective tissue. This results in reduced muscle compliance and a loss of range of joint motion. Experiments have been carried out to determine whether short periods of stretch are effective in preventing these changes. The soleus muscle of the mouse was immobilised in a shortened position for a period of 10 days by means of a plaster cast. Every two days the cast was removed and the muscle passively stretched for a 15 minute period. It was found that this treatment prevented the connective tissue changes but did not prevent the reduction in muscle fibre length, which in itself resulted in considerable loss of range of motion.
Abstract P410: Alternate Day Fasting with a High Fat Diet: Impact on Body Weight, Body Composition, and Coronary Heart Disease Risk Profile in Obese Adults
Authors: Monica C Klempel, Cynthia M Kroeger, Krista A Varady
Journal: Circulation (2013)

Background: Alternate day fasting (ADF) with a low-fat (LF) diet is effective for weight loss and cardio-protection. However, the applicability of these findings is questionable as most Americans consume a high-fat (HF) diet. This study examined if these beneficial changes in weight and coronary heart disease (CHD) risk can be reproduced if a HF diet is used in place of a LF diet during ADF. Methods: Thirty-two obese subjects were randomized to an ADF-HF (45% fat) or ADF-LF diet (25% fat), which consisted of two phases: 1) a 2-week baseline weight maintenance period, and 2) an 8-week ADF weight loss period. All food was provided to subjects. Results: Body weight was reduced (P &lt; 0.0001) by ADF-HF (5 ± 1%) and by ADF-LF (4 ± 1%). Fat mass decreased (P &lt; 0.0001) by ADF-HF (5 ± 1 kg) and ADF-LF (4 ± 1 kg). Fat free mass remained unchanged. Waist circumference decreased (P &lt; 0.001) by ADF-HF (7 ± 1 cm) and ADF-LF (7 ± 1 cm). LDL cholesterol and triacylglycerol concentrations were reduced (P &lt; 0.01) by both interventions (ADF-HF: 18 ± 5%, 14 ± 5%; ADF-LF: 24 ± 3%, 14 ± 4%). The proportion of small LDL particles decreased (P &lt; 0.05) in the ADF-HF and ADF-LF groups by 8 ± 3% and 10 ± 4%. Conclusion: Thus, an ADF-HF diet produces similar reductions in weight and CHD risk as an ADF-LF diet. These findings are important in terms of diet tolerability and long-term adherence to ADF diets.
Minimal residual disease (MRD) monitoring using rearrangement of T‐cell receptor and immunoglobulin H gene in the treatment of adult acute lymphoblastic leukemia patients
Authors: Tomomi Toubai, Junji Tanaka, Shuichi Ota, Takashi Fukuhara, Satoshi Hashino, Takeshi Kondo, Masaharu Kasai, Yasutaka Kakinoki, Nobuo Masauzi, Masanobu Morioka, Tsugumichi Kawamura, Hiroshi Iwasaki, Masahiro Asaka, Masahiro Imamura
Journal: American Journal of Hematology (2005)

Abstract We evaluate whether molecular monitoring of minimal residual disease (MRD) using TCR δ (TCRD), TCR γ (TCRG), and immunoglobulin H (IgH) gene rearrangements in the bone marrow (BM) is correlated with clinical events in ALL patients. The 14 patients enrolled in this study included 6 males and 8 females with a median age of 53 years (range, 25–79 years), and the median duration of follow‐up was 417 days (range, 57–617 days). The median WBC count was 11.3 × 10 9 /L at diagnosis. All patients had L2 type ALL. Eleven patients had a monoclonal pattern of IgH (7), TCRD (3) and TCRG (1), and 3 patients had two clonal patterns. Eleven of the 14 patients achieved the first complete remission (CR) after the first induction chemotherapy. We analyzed 9 of 11 CR patients who could be examined immediately after induction chemotherapy (including re‐induction therapy). Event‐free survival (EFS, 0%) and disease‐free survival (DFS, 0%) at 1 year in CR patients with MRD level ≥10 −3 ( n = 3) were significantly lower than those in CR patients with MRD level &lt;10 −3 ( n = 6) (log‐rank test, P = 0.013, 0.013). A lower MRD in BM value after induction chemotherapy was associated significantly with longer survival in the log‐rank test. Our data provide evidence that molecular MRD status of BM is a strong predictor of outcome in adult ALL. Am. J. Hematol. 80:181–187, 2005. © 2005 Wiley‐Liss, Inc.
Energy restriction prevents the development of type 2 diabetes in Zucker diabetic fatty rats: coordinated patterns of gene expression for energy metabolism in insulin-sensitive tissues and pancreatic islets determined by oligonucleotide microarray analysis
Authors: Michele Colombo, Mogens Kruhoeffer, Soeren Gregersen, Andreas Agger, PerBendix Jeppesen, Torben Oerntoft, Kjeld Hermansen
Journal: Metabolism (2005)
Computed Tomography in the Evaluation of Trauma
Authors: Michael S. Huckman
Journal: JAMA (1983)

This book is a concise, visually pleasing treatise on the use of computed tomography (CT) in evaluating the most common sites of occult trauma. The seven chapters discuss trauma of the head, face, larynx, spine, chest, abdomen, and pelvis. While it is a multiauthored text, the editors have written all or part of five of the seven chapters. The bulk of the illustrations are of extremely high quality. In many instances, there are two illustrations per page, which facilitates the exposition of points the authors wish to make. Most of the scans used for illustration are from the latest generation of scanners and are well selected to show a broad spectrum of injuries. They include conventional axial computed tomograms and many illustrations in which reformating techniques were essential to make the diagnosis. Each chapter is followed by an extensive bibliography that usually includes many 1982 references. The chapter on facial
Italian government sets up a stem cell trial to assuage public demands
Authors: F. Turone
Journal: BMJ (2013)

A controversial stem cell procedure that caused uproar among the Italian scientific community after it was approved for use in March 20121 will undergo a publicly funded clinical trial under the supervision of the Italian Medicines Agency, the Higher Institute of Health, and the National Centre for Transplants.

The newly elected Italian parliament decided last week that patients already enrolled in treatment …
Plasma calprotectin: A new prognostic marker of survival in alcohol-induced cirrhosis
Authors: Christian Homann, Peter Garred, Niels Graudal, Philip Hasselqvist, Michael Christiansen, Magne K. Fagerhol, Åge Christian Thomsen
Journal: Hepatology (1995)

Plasma levels of calprotectin were determined in 84 patients with alcohol-induced cirrhosis. Calprotectin is released from disintegrating neutrophils, and plasma levels seem to reflect activation and turnover of such cells. The purpose of the study was to investigate the degree of activation of neutrophils, which has been indicated to be increased and a cause of neutrophil exhaustion in these patients. Additionally, on follow-up after a median observation period of 559 days, we investigated the prognostic value of calprotectin for survival. No difference was found in calprotectin levels when comparing healthy controls with patients with compensated cirrhosis and those with decompensated cirrhosis. However, high calprotectin concentrations (>median) were a significant prognostic marker of poor survival (P = .001, log-rank test). Using a multivariate Cox proportional hazard model, the prognostic value of calprotectin seemed independent of severity of liver disease evaluated on eight clinical and biochemical variables of liver disease. Divided into groups by the median calprotectin concentration, analysis of survival was performed in the whole series of patients (n = 84) as well as in patients who were completely without signs of recent or actual infection (n = 54). In both groups, calprotectin levels (>median) showed a much higher prognostic value than albumin, prothrombin complex, bilirubin, and ascites. During follow-up, calprotectin levels (>median) were also a predictor of recurrent infection (P = .009). Thus, in patients with alcoholic cirrhosis, plasma calprotectin seems to be a new prognostic marker of survival, which seems independent of the severity of liver disease. Furthermore, high plasma calprotectin levels may characterize a group of patients with cirrhosis with recurring bacterial infections. (HEPATOLOGY 1995; 21:979–985.)
A Comparison of Care at E-visits and Physician Office Visits for Sinusitis and Urinary Tract Infection
Authors: Ateev Mehrotra, Suzanne Paone, G. Daniel Martich, Steven M. Albert, Grant J. Shevchik
Journal: JAMA Internal Medicine (2012)

Internet capabilities create the opportunity for eVisits, in which physicians and patients interact virtually instead of face-to-face. In an eVisit, a patient logs into her secure personal health record internet portal and answers a series of questions about her condition. This written information is sent to the physician, who makes a diagnosis, orders necessary care, puts a note in the patient’s electronic medical record (EMR), and replies to the patient via the secure portal within several hours. eVisits are offered by numerous health systems and are commonly reimbursed by health plans.1,2 eVisits typically focus on care for acute conditions, such as minor infections.

There are several potential advantages of eVisits, including convenience and efficiency (avoiding travel and time) and lower costs.3 Further, eVisits can be provided by the patient’s primary care physician (PCP) instead of a physician at an emergency department or urgent care center. The main concerns about eVisits center on quality issues: whether physicians can make accurate diagnoses without a face-to-face interview or physical exam,4 whether use of tests and follow-up visits is appropriate, and whether antibiotics might be overprescribed.

No studies have characterized the differences between eVisits and office visits. To fill this knowledge gap, we compared the care at eVisits and office visits for two conditions--sinusitis and urinary tract infection (UTI).
Noncardiogenic Pulmonary Edema in Marathon Runners
Authors: Arthur J. Siegel
Journal: Annals of Internal Medicine (2000)

Letters19 December 2000Noncardiogenic Pulmonary Edema in Marathon RunnersArthur J. Siegel, MDArthur J. Siegel, MDMcLean Hospital; Belmont, MA 02478-9106 (Siegel)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-133-12-200012190-00023 SectionsAboutFull Text ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Ayus and colleagues' report of hyponatremic encephalopathy with noncardiogenic pulmonary edema in marathon runners (1) demonstrates the life-threatening potential of this syndrome and its treatment. The authors' use of intravenous hypertonic sodium chloride (514 mmol/L) resulted in an increase in plasma sodium levels (10 mmol/L in 12 hours) to twice the maximal rate recommended as optimal to avoid osmotic demyelination or central pontine myelinolysis (9 mmol/L per 24 hours) (2). Was there evidence of this lesion at autopsy in the runner with the lowest sodium level (117 mmol/L) who developed brain stem herniation during treatment?Exercise-related hypovolemic ...References1. Ayus JC, Varon J, Arieff AI. Hyponatremia, cerebral edema, and noncardiogenic pulmonary edema in marathon runners. Ann Intern Med. 2000;132:711-4. LinkGoogle Scholar2. Menger H, Jorg J. Outcome of central pontine and extrapontine myelinolysis (n = 44). J Neurol. 1999;246:700-5. CrossrefMedlineGoogle Scholar3. Gozal Y, Schwarzenberger J. Rapid correction of severe hyponatremia to normal values is dangerous [Letter]. Anesth Analg. 1995;81:1319-20. MedlineGoogle Scholar4. Sterns RH. The treatment of hyponatremia: first, do no harm. Am J Med. 1990;88:557-60. CrossrefMedlineGoogle Scholar5. Adrogué HJ, Madias NE. Hyponatremia. N Engl J Med. 2000;342:1581-9. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Arthur J. Siegel, MDAffiliations: McLean Hospital; Belmont, MA 02478-9106 (Siegel) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHyponatremia, Cerebral Edema, and Noncardiogenic Pulmonary Edema in Marathon Runners J. Carlos Ayus , Joseph Varon , and Allen I. Arieff Noncardiogenic Pulmonary Edema in Marathon Runners Eelco F.M. Wijdicks Metrics Cited byExercise-Associated Hyponatremia: Why Are Athletes Still Dying? 19 December 2000Volume 133, Issue 12Page: 1010KeywordsAutopsyBlood plasmaBrainBrain diseasesEdemaHyponatremiaIsotonicityLesionsSodiumSodium chloride ePublished: 19 December 2000 Issue Published: 19 December 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.Loading ...
Latent Metastasis From Carcinoma of the Thyroid
Authors: J. Martin Miller
Journal: JAMA (1966)

<h3>To the Editor:—</h3> May I take polite exception to the summary conclusion of authors Reed et al? Their findings indeed support the relationship of follicular lymph node inclusions to primary carcinoma of the thyroid, but neither of his cases suggests in any way that it was of clinical significance to the patient.
Letter by Prutkin Regarding Article, “Janeway Lesions: An Old Sign Revisited”
Authors: Jordan M. Prutkin
Journal: Circulation (2013)

I read with interest the description by Khanna et al 1 of a patient, aged 20 years, with infective endocarditis and Janeway lesions.The authors, however, misattribute the eponym to Theodore Janeway, when it was his father, Edward Janeway, who first described the lesions. 2 Edward Janeway, in an 1899 article, wrote, "several times I have noted numerous small hemorrhages with slight nodular character in the palms of the hands and in the soles of the feet…in malignant endocarditis." 3Emanuel Libman of Mount Sinai Hospital created the eponym in a footnote by saying, "the lesions are of such great value for diagnosis that we have thought it proper that they should have a special designation, and that this designation should carry the name of the eminent clinician who emphasized the importance of them for diagnostic purposes." 4dward's son, Theodore Janeway, was well known for his study of blood pressure, creating the first portable sphygmomanometer and becoming the first full-time professor of medicine at Johns Hopkins University.
New Tools Ready for Chlamydia Diagnosis, Treatment, but Teens Need Education Most
Authors: Teri Randall
Journal: JAMA (1993)

TWO SIGNIFICANT advances in the diagnosis and treatment of<i>Chlamydia trachomatis</i>infection are or will soon be available to physicians, as well as screening guidelines from the Centers for Disease Control and Prevention (CDC).<i>Chlamydia</i>infection accounts for the bulk of the sexually transmitted disease (STD) epidemic in the United States—4 million new cases are expected this year (Figure), and an estimated 50000 women will be rendered sterile by the disease. For the first time, physicians will be able to use a noninvasive test on men. The test is so sensitive it can detect traces of<i>Chlamydia</i>DNA in urine. And in the treatment realm, a single, 1-g oral dose of azithromycin will suffice—expensive (costing patients almost four times as much as a 1-week regimen of doxycycline) but worth it in noncompliant patients who might otherwise continue to infect their partners, public health experts say. "The ability to do a
Patient Selection for Diagnostic Coronary Angiography and Hospital-Level Percutaneous Coronary Intervention Appropriateness
Authors: Steven M. Bradley, John A. Spertus, Kevin F. Kennedy, Brahmajee K. Nallamothu, Paul S. Chan, Manesh R. Patel, Chris L. Bryson, David J. Malenka, John S. Rumsfeld
Journal: JAMA Internal Medicine (2014)

Diagnostic coronary angiography in asymptomatic patients may lead to inappropriate percutaneous coronary intervention (PCI) due to a diagnostic-therapeutic cascade. Understanding the association between patient selection for coronary angiography and PCI appropriateness may inform strategies to minimize inappropriate procedures.To determine if hospitals that frequently perform coronary angiography in asymptomatic patients, a clinical scenario in which the benefit of angiography is less clear, are more likely to perform inappropriate PCI.Multicenter observational study of 544 hospitals participating in the CathPCI Registry between July 1, 2009, and September 30, 2013.Hospital proportion of asymptomatic patients at diagnostic coronary angiography and hospital rate of inappropriate PCI as defined by 2012 appropriate use criteria for coronary revascularization.Of 1 225 562 patients who underwent elective coronary angiography, 308 083 (25.1%) were asymptomatic. The hospital proportion of angiography among asymptomatic patients ranged from 1.0% to 73.6% (median, 24.7%; interquartile range, 15.9%-35.9%). By hospital quartile of asymptomatic patients at angiography, hospitals with higher rates of asymptomatic patients at angiography had higher median rates of inappropriate PCI (14.8% vs 20.2% vs 24.0 vs 29.4% from lowest to highest quartile, P < .001 for trend). This outcome was attributable to more frequent use of inappropriate PCI in asymptomatic patients at hospitals with higher rates of angiography in asymptomatic patients (5.4% vs 9.9% vs 14.7% vs 21.6% from lowest to highest quartile, P < .001 for trend). Hospitals with higher rates of asymptomatic patients at angiography also had lower rates of appropriate PCI (38.7% vs 33.0% vs 32.3% vs 32.9% from lowest to highest quartile, P < .001 for trend).In a national sample of hospitals, performance of coronary angiography in asymptomatic patients was associated with higher rates of inappropriate PCI and lower rates of appropriate PCI. Improving preprocedural risk stratification and thresholds for coronary angiography may be one strategy to improve the appropriateness of PCI.
Evaluation of muscle damage after a rugby match with special reference to tackle plays
Authors: Y Takarada
Journal: British Journal of Sports Medicine (2003)

To investigate blood indices of muscle damage after a competitive rugby match.Fifteen elite amateur rugby players volunteered to participate (mean (SE) age 26.6 (0.7) years, height 179.8 (1.0) cm, weight 87.4 (2.2) kg, and VO2MAX 58.5 (1.2) ml/kg/min). The study was conducted after two competitive matches during the 1999-2000 season. Plasma concentrations of lactate, potassium (K+), sodium (Na+), and myoglobin, and the activity of creatine kinase were measured before and after the matches. In addition, the number of tackles by and on each subject and the average duration of the work and rest periods were analysed using video recordings of the matches.Myoglobin concentration and creatine kinase activity showed appreciable transient increases after the match. Peak values for myoglobin concentration (980 (166) microg/l) and creatine kinase activity (1081 (159) U/l) were observed 45 minutes and 24 hours after the match respectively. Positive and significant correlations were observed between the number of tackles and both peak myoglobin concentration (r=0.85, p<0.01; n=14) and peak creatine kinase activity (r=0.92, p<0.01; n=14). Plasma lactate and K+ concentrations also showed appreciable increases after the match, whereas plasma Na+ concentration showed a gradual decrease. The mean duration of the work and rest periods were 21.5 (2.2) and 24.3 (3.1) seconds respectively.The rugby matches resulted in serious structural damage to the muscles, the extent of which was highly dependent on the number of tackles.
Picking up the tab for erythropoietin.
Authors: R Gabriel
Journal: BMJ (1991)

model ofagent, host, and environment.28Research that allows for interplay among these factors is likely to be most productive.29We already know much about the environments in which multiple sclerosis is common and about relevant host factors (including those with a genetic basis).The agent(s) remains a mystery, although an infectious agent has long been suspected.More than 20 viruses have been linked with multiple sclerosis over the years, but in no case has the association proved causal.30Recent reports implicating a retrovirus have not been confirmed.3'"33Alter et al suggested that multiple sclerosis might be an age dependent host response to measles and other childhood infections.3435Another lesson from the history of epidemiology is that diseases may be preventable before their causes are properly understood.Thus the Royal Navy knew how to prevent scurvy more than a century before the discovery of vitamins, and John Snow's work led to steps to control cholera long before the cholera vibrio was identified.28Some optimists hope that the vaccination programmes against measles will lead to a decline in multiple sclerosis.That remains to be seen, but the search for environmental factors should continue.