tbuckley/cabot-search huggingface dataset:
Extracorporeal Photopheresis in the Treatment of AIDS-Related Complex: A Pilot Study
Authors: Emil Bisaccia
Journal: Annals of Internal Medicine (1990)

Objective: To determine side effects of extracorporeal photopheresis in the treatment of patients with the acquired immunodeficiency syndrome (AIDS)-related complex, and to gain early evidence of efficacy of the treatment. Design: Uncontrolled trial. Setting: Tertiary referral center. Patients: Five patients with AIDS-related complex: three homosexual men and one man and one woman with histories of intravenous drug abuse. One patient, a homosexual man, withdrew from therapy after 5 months but returned for monthly clinical and laboratory evaluations. Intervention: Monthly treatments with extracorporeal photopheresis. Measurements and Main Results: Symptoms resolved in four patients. Lymphadenopathy disappeared in all five. Four patients had delayed-hypersensitivity reactions to skin testing (as defined by the Walter Reed staging classification). All showed increases in p24 and gp120 antibody levels. The CD4-cell percentage increased in four patients and declined in one after 6 months of therapy, but the absolute CD4 count decreased in two patients. At 15 months, the CD4 percentage remained at or increased over the baseline value in three patients still in the study but decreased in one. Levels of Beta2-microglobulin decreased or remained stable in four patients. All patients were culture positive for the human immunodeficiency virus (HIV) before treatment. One patient had a negative viral culture after 5 months of treatment with confirmation. Two other patients became HIV culture negative, one at 14 and one at 15 months: The former patient became positive at 15 months and the latter patient remained negative at 16 months. Conclusions: The preliminary results suggest that extracorporeal photopheresis deserves further evaluation as therapy for AIDS-related complex.
The ORION statement: a CONSORT equivalent for infection control studies- Guidelines for transparent reporting of Outbreak Reports and Intervention studies Of Nosocomial infection
Authors: S.P. Stone, B.S. Cooper, C.C. Kibbler, B.D. Cookson, J.A. Robert, G.F. Medley, G. Duckworth, R. Lai, S. Ebrahim, E.M. Brown, P.J. Wiffen, P.G. Davey
Journal: Journal of Infection (2007)
The community care chest is running out of cards
Authors: N. Hawkes
Journal: BMJ (2014)

We report the case of an adult male patient who was admitted to our hospital with a diagnosis of vivax malaria complicated with renal insufficiency and acute respiratory distress syndrome (ARDS). The patient was treated with intravenous artesunate. He was intubated and mechanically ventilated and taken up for haemodialysis in view of worsening renal parameters. He developed tachycardia a few hours later. ECG showed sinus tachycardia. Tachycardia persisted though the blood pressure was normal, there was no evidence of bleeding, and the heart was clinically normal. We tried to control the heart rate with diltiazem, adenosine and metoprolol but the tachycardia persisted. The heart rate was finally controlled with amiodarone. The patient improved, was weaned off from the ventilator and extubated. His renal functions gradually improved. Oral amiodarone was continued and there was no recurrence of tachycardia. We present this case to highlight the interesting association of vivax malaria with persistent, difficult to treat tachycardia.
The Marxist View of Medicine
Authors: ELAINE ALLEN
Journal: Annals of Internal Medicine (1980)

Letters1 April 1980The Marxist View of MedicineELAINE ALLEN, M.D.ELAINE ALLEN, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-92-4-568_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Your journal is to be congratulated for its publication of the challenging and thought-provoking article "A Marxist View of Medical Care," by Howard Waitzkin (1). This paper discusses problems that are immediate and troubling and which have been addressed in conferences, conventions, seminars, and legislative halls for many years. Despite this, the crisis in medical care is ever more acute. Waitzkin's paper presents a different, nontraditional way of looking at the problem, and therein could lie the clue to that understanding that will allow development of rational solutions. Admirable as Waitzkin's presentation and analysis are, his recommendations...Reference1. WAITZKIN H. A Marxist view of medical care. Ann Intern Med. 1978;89:264-78. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ELAINE ALLEN, M.D. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1980Volume 92, Issue 4Page: 568-568 ePublished: 1 December 2008 Issue Published: 1 April 1980 PDF downloadLoading ...
Cryptococcal polysaccharides induce L-selectin shedding and tumor necrosis factor receptor loss from the surface of human neutrophils.
Authors: Z M Dong, J W Murphy
Journal: Journal of Clinical Investigation (1996)

High titers of cryptococcal polysaccharides in the serum and spinal fluid and the lack of cellular infiltrates in the infected tissues are hallmarks of disseminated cryptococcosis. Cryptococcal polysaccharides given intravenously to mice inhibit the influx of leukocytes into sites injected with inflammatory mediators. The purpose of this investigation was to determine if cryptococcal polysaccharides, i.e., glucuronoxylomannan (GXM), galactoxylomannan, and mannoprotein, affect expression of molecules on the surface of neutrophils that are important in extravasation. GXM in the absence of serum was shown to induce human neurophils to shed L-selectin, a molecule needed in the first step of neutrophil movement into tissues. In the presence of serum, GXM caused a further shedding of L-selectin. Shedding of L-selectin was evident by reduced amounts of L-selectin on the neutrophils treated with GXM and by increased levels of soluble L-selectin in the GXM-treated neutrophil supernatants. GXM also stimulated neutrophils to have reduced expression of TNF receptor. In contrast, GXM-treated neutrophils showed increased levels of CD15 and CD11b, and unchanged CD16 expression. In the absence of serum, galactoxylomannan and mannoprotein did not affect L-selectin, TNF receptor, CD15, CD11b, or CD16 on neutrophils but did induce loss of L-selectin in the presence of serum. Our results indicate that cryptococcal polysaccharides, especially GXM, can cause shedding of L-selectin from the surface of neutrophils, and this may prevent neutrophils from attaching to the endothelial cell surfaces. Blockage of this early step in cell migration from the vessels into tissues may be responsible in part for reduced cellular infiltration into infected tissues of individuals with disseminated cryptococcosis.
Pre-S2 and Its Antibody in Fulminant Type B Hepatitis
Authors: N. C. Tassopoulos, A. Budkowska, S. Hadziyannis
Journal: JAMA (1989)

<h3>To the Editor. —</h3> Studies to date have shown that the pre-S2-region encodedpeptide is found in the serum early in the course of uncomplicated acute type B hepatitis and is correlated well with the presence of markers of active viral replication (hepatitis B e antigen and hepatitis B virus [HBV] DNA),<sup>1</sup>while the appearance of antibodies to pre-S2 (anti—pre-S2) is followed by clearance of hepatitis B surface antigen (HBsAg) and recovery.<sup>1,2</sup>In this context, anti—pre-S2 antibodies seem to play no role in the pathogenesis of HBV-related liver damage.<sup>2</sup>Fulminant type B heptitis (FH-B) is characterized by rapid clearance of HBsAg and early appearance of anti-HBs; this enhanced immune response has been implicated in the pathogenesis of FH-B.<sup>3</sup>We studied the presence of pre-S2/anti—pre-S2 in 16 serum samples from seven adults (four men and three women) with FH-B. Their age ranged from 27 to 62 years
PREOPERATIVE LOCALIZATION OF PARATHYROID ADENOMAS BY TECHNETIUM-THALLIUM AND ULTRASOUND IMAGING
Authors: John J. Coyle, Martin A. Winston, H. Earl Gordon, William H. Blahd, David L. Geffner, Eloy A. Ituarte, Theodore J. Hahn, Jack W. Coburn
Journal: Clinical Nuclear Medicine (1984)

38 patients with biochemical evidence of primary hyperparathyroidism were studied. A 50K count image of the neck was computer acquired with a gamma camera and pinhole collimator 30 minutes after IV injection of 1 mCi of Tc-99m pertechnetate. Without patient movement, 1–2 mCi of T1–201 chloride was injected IV, and sequential 30 second images were acquired for 25 minutes. The thallium images were summed and computer subtraction of the normalized pertechnetate image was performed to identify areas of discordant radionuclide uptake. Ultrasound examination was performed using a B-mode static scanner with a 5 MHz transducer. 12 patients have had surgery to date, each of whom had a single parathyroid adenoma. Nuclear imaging successfully localized 5/12 adenomas, including 4/5 inferior or upper mediastinal adenomas and 1/7 superior adenomas. There was 1 false positive. Ultrasound identified 4/12 adenomas, each of which was located posterior to the thyroid gland, including 2/5 inferior or mediastinal adenomas and 2/7 superior adenomas. There were 3 false positives by ultrasound. The combination of techniques successfully localized 7/12 adenomas, including 5/5 inferior or upper mediastinal adenomas and 2/7 superior adenomas. Nuclear imaging appears most sensitive for parathyroid adenomas located inferiorly or in the upper mediastinum, while ultrasound is useful for identifying adenomas located posterior to the thyroid gland.
Points from Letters: The Disease of Alcoholism
Authors: J. W. Todd
Journal: BMJ (1973)

FEBRuARY 1973 scribed in the subchondral osseous plate and trabecular bone' were present in all 17 patellae.Although the treatment is problematical, promising results have been obtained with graduated quadriceps exercises and intra- muscular nandrolone propionate.-Weare, etc.,
ITAMs versus ITIMs: striking a balance during cell regulation
Authors: Daniel D. Billadeau, Paul J. Leibson
Journal: Journal of Clinical Investigation (2002)

Functional immune responses evolve through an exquisitely controlled process integrating signals from activating and inhibitory receptors on the immune cell surface. These complex interactions, which regulate both the quality and magnitude of the ultimate response, depend crucially on two short, loosely conserved motifs found in the intracellular domain of various signaling proteins. These motifs, termed “ITAMs” and “ITIMs” for immunoreceptor tyrosine-based activation (or inhibititory) motifs, provide the basis for two opposed signaling modules that duel for control of cellular activation within the immune system. Well over a decade ago it was observed that the subunits associated with the B cell and T cell antigen
Metabolism of 24-norlithocholic acid in the rat: Formation of hydroxyl- and carboxyl-linked glucuronides and effect on bile flow
Authors: Karen E. Shattuck, Anna Radominska-Pyrek, Piotr Zimniak, Eugene W. Adcock, Roger Lester, Jan St. Pyrek
Journal: Hepatology (1986)

24-Norlithocholic (3α-hydroxy-24-nor-5β-cholan-23-oic) acid is the lower homologue of lithocholic acid, a potent cholestatic agent. In order to characterize its cholestatic potential and metabolic fate, 3β-tritiated 24-norlithocholate was infused intravenously into adult male Sprague-Dawley rats prepared with an external biliary fistula. The results demonstrate that 24-norlithocholate does not induce cholestasis in rats when administered in doses in excess of those necessary for lithocholate to produce cholestasis. Hydroxyl- and carboxyl-linked glucuronides were identified as major metabolites secreted in the bile. Especially noteworthy is the identification of carboxyl-linked glucuronides of mono-, di- and trihydroxylated C 23 bile acids. Their total amount (25% of recovered radioactive products) is comparable to that of the hydroxyl-linked glucuronide of 24-norlithocholic acid (41%). In this study, for the first time, a bile acid diglucuronide, substituted both at 3-hydroxyl and carboxyl groups, was detected (11%).
The Matching Program
Authors: John S. Graettinger, Elliott Peranson
Journal: New England Journal of Medicine (1981)

BY the mid-1940s the number of internship positions was almost twice the number of graduates from United States medical schools. Institutions and programs that had more applicants than positions and that confidently expected to have acceptances from their most promising applicants were content to make their offers of admission late in the students' senior year of medical school. On the other hand, institutions with fewer applicants understandably sought to recruit and appoint medical students earlier in their senior year or even in their junior year. These differences in appointment dates among programs obviously placed a great premium on how well . . .
Improving Rural Health: Initiatives of an Academic Medical Center
Authors: Donald L. Madison
Journal: JAMA (1985)

During most of the 1970s, rural health, especially the rural physician shortage, was on nearly everyone's "top ten" list of health care issues. (It has since slipped from that position, owing to cutbacks in discretionary federal domestic expenditures, a ballooning of the total physician supply, and replacement of resource distribution by cost control as most favored public policy target.) The early part of the decade saw several new rural health related actions—Congress established the National Health Service Corps; the Public Health Service placed a rural priority on its community health services project grants (the "Rural Health Initiative"); several midwestern and southern states opened new "regional" medical schools in areas thought to be generally underserved; a few medical schools organized "area health education centers"; two major philanthropic foundations announced national programs in rural health; and postgraduate training in the new specialty of family medicine came of age. Perhaps less widely known
A GRK5 polymorphism that inhibits β-adrenergic receptor signaling is protective in heart failure
Authors: Stephen B Liggett, Sharon Cresci, Reagan J Kelly, Faisal M Syed, Scot J Matkovich, Harvey S Hahn, Abhinav Diwan, Jeffrey S Martini, Li Sparks, Rohan R Parekh, John A Spertus, Walter J Koch, Sharon L R Kardia, Gerald W Dorn II
Journal: Nature Medicine (2008)
We should not let families stop organ donation from their dead relatives
Authors: D. Shaw
Journal: BMJ (2012)

It has recently been suggested that patients should be kept alive using elective ventilation to facilitate the harvesting of organs for donation.1 But there is a much simpler way. Veto by the family is the main impediment to an increase in organ donation,2 with at least 10% of families refusing to donate.3 However, the family has no legal grounds for over-riding the dead person’s wishes if that person clearly wanted to donate—for example, by carrying an organ donor card.4

Clinicians who heed the veto are complicit in a family denying its loved one’s last chance to affect the world. Families often regret the veto within two days, and the regret of having denied a loved one’s last wish can last for decades.5 But at the time families are in emotional distress, and clinicians must help them make the correct decision. Clinicians may be willing to respect a veto to avoid distressing families further.2 One solution is a system of so called advance commitment, where donors designate a family member in advance to confirm their decision.2 

However, there …
Disclosure of risks of anesthesia
Authors: V. M. O'Hern
Journal: JAMA (1975)

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Clinical Lecture on Facts Connected with the Duration and Diagnosis of Rheumatism
Authors: S. O. Habershon
Journal: BMJ (1868)

WHAT is rheumatism ?and what is the value of its statistics?From the variabilities in our English climate, rheumatism is a disease of most frequent occurrence, and not only do instances continually arise in ordinary practice, but it is almost the exception to find any person who has arrived at years of maturity who has not at one period or other suffered from rheumatic pain.Still, it is beyond the reach of our present knowledge to say precisely what rheumatism is, or to indicate the changes which take place in the organic chemistry of the system during its attack.Some affirm that peculiar metamorphoses induce a disor- dered condition of the fibroid tissues of the body, and that in some persons these changes are more easily excited than in others, consti- tuting a "rheumatic diathesis."Others advance a step further and assert, that the production of lactic acid by perverted nutritive changes constitutes the proximate cause of rheumatism.Dr. Prout suggested that this acid was the origin of the rheumatic symptoms, and Mr. Simon and Dr. Richardson have demonstrated that if introduced into the
Letting vegetative patients die.
Authors: C Crisci
Journal: BMJ (1993)

practice, who generate a high income, over health authority patients.Sophisticated bureaucratic props for the internal market such as those proposed by Clarke and McKee could spell yet another expensive diversion in the development of NHS information systems and bode ill for the health of the population.Moreover, since the NHS budget is cash limited, funds for improving purchaser and provider information systems would have to come from the resources allocated to patient care.In the United States, where spending on information systems and data analysis is high, administrative costs can be as high as 40% of provider budgets.3Nevertheless, this has not resulted in cost containment or im- proved health care.45The real questions that we have yet to address in our information systems are whether the internal market will preserve equity in health care and safeguard against implicit clinical rationing and queue jumping.
COLONIZATION OF THE MOUSE INTESTINE WITH ESCHERICHIA COLI
Authors: Rose Mushin, Rene Dubos
Journal: The Journal of Experimental Medicine (1965)

Young albino Swiss mice, of the NCS and NCS-D colonies, proved highly susceptible to the establishment of intestinal infection with an enteropathogenic strain of E. coli administered per os or by stomach tube. The period of highest susceptibility was rather short, extending from the day of birth to approximately 2 weeks of age. Adult NCS and NCS-D mice failed to become experimentally colonized with E. coli, even when large doses were administered per os on 3 consecutive days. The extent of colonization of the various parts of the gastrointestinal tract was related to the size of the infective dose. Many of the young mice died within 2 to 3 days following per os infection with large doses of enteropathogenic E. coli. However, practically all the animals which survived cleared their intestinal infection at approximately the same age. For example, in mice infected with 23 x 10(6) bacteria, colonization of the intestinal tract usually came to an abrupt end when the animals were 24 to 28 days old, irrespective of the age at which they had been infected. There is suggestive evidence that the acquisition of resistance with age, and the ability of adult animals to control the intestinal infection, are related to the development in the gastrointestinal tract of a microbiota which is antagonistic to E. coli.
Prospective randomized trial on the safety and efficacy of steroid free immunosuppression after liver transplantation. Preliminary results
Authors: X. Xiol, J. Castelloote, S. Vazquez, L. Llado, J. Figueras, C. Lama, C. Baliellas, J. Gornals, C. Lopez, T. Casanovas, J. Torras, A. Rafecas
Journal: Journal of Hepatology (2003)
European drug regulators publish their evaluation of rosiglitazone
Authors: S. Mayor
Journal: BMJ (2010)

European drug regulators have for the first time published full details of their evaluation of rosiglitazone that led to the recommendation for it to be withdrawn.

In what they describe as a major step to improve the transparency of drug regulation the European Medicines Agency (EMA), the Swedish Medical Products Agency (Lakemedelsverket), the Dutch Medicines Evaluation Board, and the Agence Francaise de Securite Sanitaire des Produits de Sante have published an article in the journal of the European Association for the Study of Diabetes, Diabetologia , that maps the life cycle of their deliberations on rosiglitazone (doi:10.1007/s00125-010-1992-5).

In a statement the regulatory bodies said, “This paper opens a new area of improved communication between health authorities and the academic world, providing an insight into the processes and decision-making concerning drugs in Europe.”

One of the authors, Eberhard Blind, head of endocrinology, metabolism, cardiovascular safety, and efficacy of medicines with the EMA in London, said, “The intention of the authors of publishing additionally in a scientific journal …