tbuckley/cabot-search huggingface dataset:
Short-term Prognosis in Severe Adult and Adolescent Malnutrition During Famine
Authors: Steve Collins, Mark Myatt
Journal: JAMA (2000)

In the setting of famine, infection is likely to cause mortality among severely malnourished persons. Although clinical signs are likely to be useful prognostic indicators in this setting, use of a clinical assessment model has not been studied.To examine the use of clinical signs in the prediction of short-term mortality in severely malnourished adults and adolescents during famine.Retrospective cohort study.Concern Worldwide Adult Therapeutic Feeding Center in Baidoa, Somalia.Data from the clinical records of 383 adult and adolescent inpatients admitted to the center between November 1992 through March 1993 who were aged 15 years or older and had a body mass index (BMI) of 13.5 kg/m(2) or less or any signs of edematous malnutrition.Association of mortality with presence or absence of 8 clinical signs (edema, hydration, ascites, dysentery, diarrhea, anemia, chest infection, and ability to stand) and BMI at admission, and sensitivity and specificity of models including a count of clinical signs and BMI in the prediction of mortality at the center.Ninety-one patients (23.8%) died, with a median time to death of 8 days from admission. Of the 8 clinical signs, severe edema (unadjusted odds ratio [OR], 2.45; 95% confidence interval [CI], 1.41-4.27), apparent dehydration (unadjusted OR, 2. 73; 95% CI, 1.60-4.66), and inability to stand (unadjusted OR, 2.96; 95% CI, 1.40-6.26) were independently associated with mortality. The most useful clinical model was that based on the presence of any 1 of these 3 signs, with a sensitivity of 77% and a specificity of 59%. Ability of admission BMI to predict mortality was less than random.Models based on clinical signs predicted death better than BMI. Simple counts of clinical signs performed as well as more complex models based on the addition of ORs. Counting relevant clinical signs is an easy and effective prognostic tool in severe adult and adolescent malnutrition during famine; however, it is not sensitive enough for use as a screening tool. JAMA. 2000;284:621-626
Death rates in England and Wales and the United States: variation with age, sex, and race
Authors: Brian Jarman, Paul Aylin
Journal: BMJ (2004)

The variation of health outcomes between ethnic groups is not easy to determine in the UK because ethnicity is not recorded on death certificates and is poorly recorded in hospital records. To better tackle health inequalities, more health data need to be categorised by ethnic group. Data on mortality by race are available for the United States. We compared mortality data for England and Wales with those for the United States and assessed their variation with race and age group. #### The bottom line
Influence of heart rate on left ventricular diastolic transmitral flow velocity patterns assessed by pulsed Doppler and color M-mode Doppler echocardiography in patients with LV dysfunction
Authors: H. Okubo, M. Takeuchi, H. Takaoka, K. Hata, M. Yokoyama, Y. Yokota
Journal: Journal of the American College of Cardiology (1998)
VENTRICULAR ACCELERATION FOLLOWING PROCAINE AMIDE HYDROCHLORIDE THERAPY
Authors: John L. Denney
Journal: JAMA (1952)

Procaine amide ("pronestyl") hydrochloride has been recently introduced for the treatment of cardiac arrhythmias; its use has been found effective especially in rhythms of ventricular origin.<sup>1</sup>The drug appears to be relatively innocuous, and, aside from occasional mild to moderate hypotensive reactions, no serious untoward effects have been observed. It is known that cardiac depressant and antifibrillatory drugs, although effective in the elimination of ectopic rhythms, may at times induce ectopic ventricular rhythms, including ventricular fibrillation. Such cardiac effects have been observed during the course of quinidine sulfate therapy.<sup>2</sup>They have been observed with greater frequency after the administration of the potent antifibrillatory drug alpha-fagarine and related compounds.<sup>3</sup>In 55 patients with various auricular and ventricular arrhythmias, continuous electrocardiograms were made during and after the intravenous administration of procaine amide hydrochloride.<sup>1d</sup>We found no indication of drug-induced ectopic ventricular activity in this group. However, in three
Epithelial-to-Mesenchymal Transition and Integrin-Linked Kinase Mediate Sensitivity to Epidermal Growth Factor Receptor Inhibition in Human Hepatoma Cells
Authors: Bryan C. Fuchs, Tsutomu Fujii, Jon D. Dorfman, Jonathan M. Goodwin, Andrew X. Zhu, Michael Lanuti, Kenneth K. Tanabe
Journal: Cancer Research (2008)

Abstract Hepatocellular carcinoma (HCC) is associated with a poor prognosis due to late diagnoses and a lack of effective treatment options. Epidermal growth factor receptor (EGFR)–targeted therapies have been effective in other cancers. However, erlotinib and cetuximab have shown only modest efficacy in clinical trials of HCC. We examined epithelial-to-mesenchymal transition (EMT) as a determinant of sensitivity of HCC to EGFR inhibitors. A panel of 12 human hepatoma cell lines were classified as epithelial or mesenchymal based on their expression of E-cadherin and vimentin. The resulting classification correlated with a previous microarray analysis of human hepatoma cell lines whereby the mesenchymal cell lines were shown to have increased expression of genes involved in metastasis and invasion. Sensitivity to erlotinib, gefitinib, and cetuximab was assessed and the epithelial cell lines were found to be significantly more susceptible to all three agents. Analysis of the EGFR pathway showed that EMT status was independent of EGFR expression or downstream extracellular signal–regulated kinase activation and only the epithelial cell lines expressed ErbB3. Interestingly, mesenchymal cells resistant to EGFR inhibitors had increased AKT and signal transducer and activator of transcription-3 activation through elevated expression of integrin-linked kinase (ILK). Mesenchymal cell lines were therefore experimentally transformed with kinase-inactive ILK (KI-ILK) with a resulting decrease in ILK activity and activation of AKT. KI-ILK transformants showed increased sensitivity to EGFR inhibitors both in vitro and in an in vivo xenograft model. These data suggest that EMT predicts HCC sensitivity to EGFR-targeted therapies and that ILK is a novel target to overcome HCC resistance to EGFR inhibition. [Cancer Res 2008;68(7):2391–9]
Human Immunoglobulin (Ig)M+IgD+ Peripheral Blood B Cells Expressing the CD27 Cell Surface Antigen Carry Somatically Mutated Variable Region Genes: CD27 as a General Marker for Somatically Mutated (Memory) B Cells
Authors: Ulf Klein, Klaus Rajewsky, Ralf Küppers
Journal: The Journal of Experimental Medicine (1998)

Immunoglobulin (Ig)M+IgD+ B cells are generally assumed to represent antigen-inexperienced, naive B cells expressing variable (V) region genes without somatic mutations. We report here that human IgM+IgD+ peripheral blood (PB) B cells expressing the CD27 cell surface antigen carry mutated V genes, in contrast to CD27-negative IgM+IgD+ B cells. IgM+IgD+CD27+ B cells resemble class-switched and IgM-only memory cells in terms of cell phenotype, and comprise ∼15% of PB B lymphocytes in healthy adults. Moreover, a very small population (&amp;lt;1% of PB B cells) of highly mutated IgD-only B cells was detected, which likely represent the PB counterpart of IgD-only tonsillar germinal center and plasma cells. Overall, the B cell pool in the PB of adults consists of ∼40% mutated memory B cells and 60% unmutated, naive IgD+CD27− B cells (including CD5+ B cells). In the somatically mutated B cells, VH region genes carry a two- to threefold higher load of somatic mutation than rearranged Vκ genes. This might be due to an intrinsically lower mutation rate in κ light chain genes compared with heavy chain genes and/or result from κ light chain gene rearrangements in GC B cells. A common feature of the somatically mutated B cell subsets is the expression of the CD27 cell surface antigen which therefore may represent a general marker for memory B cells in humans.
CALCAREOUS DEGENERATION OF THE DORSAL AND LUMBAR AORTAE AS A CAUSE OF BACKACHE
Authors: JOHN RIDLON
Journal: JAMA (1923)

Within the last few years, much attention has been given to the disabilities and painful conditions of the feet as a result of disturbance of the circulation in them, which has been termed intermittent claudication. Much has also been written and said about various etiologic factors in the production of backache. Pain in the back as a result of pathologic conditions arising from disease or from traumatic factors is easily explained to the clinician, but in certain cases in which there is no evidence of pathologic change to be found in the roentgenograms of the bones and joints, it is more difficult to explain the cause of the symptoms. In most of the literature on this subject, the writers have devoted most of their time to explaining the cause of the so-called idiopathic backaches on the basis of some abnormalities within the pelvic viscera in the female and of sacro-iliac
Effects of Plasmid-Mediated Growth Hormone-Releasing Hormone in Severely Debilitated Dogs with Cancer
Authors: Ruxandra Draghia-Akli, Kevin A. Hahn, Glen K. King, Kathleen K. Cummings, Robert H. Carpenter
Journal: Molecular Therapy (2002)

Cachexia is a common manifestation of late stage malignancy and is characterized by anemia, anorexia, muscle wasting, loss of adipose tissue, and fatigue. Although cachexia is disabling and can diminish the life expectancy of cancer patients, there are still no effective therapies for this condition. We have examined the feasibility of using a myogenic plasmid to express growth hormone-releasing hormone (GHRH) in severely debilitated companion dogs with naturally occurring tumors. At a median of 16 days after intramuscular delivery of the plasmid, serum concentrations of insulin-like growth factor I (IGF-I), a measure of GHRH activity, were increased in 12 of 16 dogs (P < 0.01). These increases ranged from 21 to 120% (median, 49%) of the pretreatment values and were generally sustained or higher on the final evaluation. Anemia resolved posttreatment, as indicated by significant increases in mean red blood cell count, hematocrit, and hemoglobin concentrations, and there was also a significant rise in the percentage of circulating lymphocytes. Treated dogs maintained their weights over the 56-day study and did not show any adverse effects from the GHRH gene transfer. We conclude that intramuscular injection of a GHRH-expressing plasmid is both safe and capable of stimulating the release of growth hormone and IGF-I in large animals. The observed anabolic responses to a single dose of this therapy might be beneficial in patients with cancer-associated anemia and cachexia.
Acidosis in Renal Allograft Rejection
Authors: O. S. BETTER
Journal: Annals of Internal Medicine (1970)

Letters and Comments1 February 1970Acidosis in Renal Allograft RejectionO. S. BETTER, M.D.O. S. BETTER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-72-2-288_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: AS pointed out in a paper in a recent issue of the ANNALS, acidosis may be a valuable early clue to rejection of the renal transplant (1). Observations in our laboratory support this finding (2). The suggestion that acidosis may be an indication for the intensification of immunosuppressive treatment (1) should, however, be accepted with great caution. There are probably other causes for tubular acidosis after transplantation than rejection. Acute tubular necrosis may be an important etiologic factor in the genesis of the defects in urinary acidification (3, 4) at least in the early post-transplant period. Moreover,...References1. MOOKERJEEGAULTDOSSETER BMJ: Hyperchloremic acidosis in early diagnosis of renal allograft rejection. Ann Intern Med 71:47, 1969 LinkGoogle Scholar2. BETTERCHAIMOWITZNAVEH OCY: Syndrome of incomplete renal tubular acidosis after cadaver kidney homotransplantation. Ann Intern Med 71:39, 1969 LinkGoogle Scholar3. MASSRYPREUSSMAHER SHJ: Renal tubular acidosis after cadaver kidney transplantation. Amer J Med 42:284, 1967 CrossrefMedlineGoogle Scholar4. GYORYSTEWARTGEORGE AJC: Renal tubular acidosis, acidosis due to hyperkalemia, hypercalcemia, disorder of citrate metabolism and other tubular dysfunctions following human renal transplantation. Quart J Med 38:231, 1969 MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Division of Nephrology Rambam Government Hospital Haifa, Israel PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1970Volume 72, Issue 2Page: 288-288KeywordsImmunosuppressivesNecrosisRenal transplantationResearch laboratoriesTransplantation ePublished: 1 December 2008 Issue Published: 1 February 1970 PDF downloadLoading ...
Normal Uptake of 68Ga-DOTA-TOC by the Pancreas Uncinate Process Mimicking Malignancy at Somatostatin Receptor PET
Authors: Hans Jacobsson, Patricia Larsson, Cathrine Jonsson, Emma Jussing, Per Grybäck
Journal: Clinical Nuclear Medicine (2012)

To characterize a commonly occurring increased uptake by the uncinate process of the pancreas at PET/CT using 68Ga-DOTA-d-Phe1-Tyr3-octreotide (68Ga-DOTA-TOC). This tracer has replaced In pentetreotide (OctreoScan®) for somatostatin receptor scintigraphy at our laboratory.Fifty of our first 74 PET/CT examinations with 68Ga-DOTA-TOC could be evaluated in retrospect. None of these patients had surgery or showed any pathology in the pancreas head at the concomitant CT.Thirty-five of the 50 examinations (70%) showed an uptake by the uncinate process sufficiently intense to be interpreted as pathologic and simulating a tumor. Mean SUVmax was 9.2. Mean SUVmean using an isoactivity cut-off of >75% and >50% was 7.8 and 6.0, respectively. Volume calculations of the uncinate process activity using these definitions gave 0.9 mL and 4.2 mL, respectively.There is a frequent physiological uptake of 68Ga-DOTA-TOC by the pancreas uncinate process. This may be caused by an accumulation of pancreatic polypeptide-containing cells expressing somatostatin receptors. If there is a normal finding at concomitant diagnostic CT, this uptake should be regarded as physiological.
Therapeutic recovery of hepatitis B virus (HBV)-induced hepatocyte-intrinsic immune defect reverses systemic adaptive immune tolerance
Authors: Peixiang Lan, Cai Zhang, Qiuju Han, Jian Zhang, Zhigang Tian
Journal: Hepatology (2013)

Abstract Hepatitis B virus (HBV) persistence aggravates hepatic immunotolerance, leading to the failure of cell-intrinsic type I interferon and antiviral response, but whether and how HBV-induced hepatocyte-intrinsic tolerance influences systemic adaptive immunity has never been reported, which is becoming the major obstacle for chronic HBV therapy. In this study, an HBV-persistent mouse, established by hydrodynamic injection of an HBV-genome-containing plasmid, exhibited not only hepatocyte-intrinsic but also systemic immunotolerance to HBV rechallenge. HBV-specific CD8 + T-cell and anti-HBs antibody generation were systemically impaired by HBV persistence in hepatocytes. Interestingly, HBV-induced hepatocyte-intrinsic immune tolerance was reversed when a dually functional vector containing both an immunostimulating single-stranded RNA (ssRNA) and an HBx-silencing short hairpin RNA (shRNA) was administered, and the systemic anti-HBV adaptive immune responses, including CD8 + T-cell and anti-HBs antibody responses, were efficiently recovered. During this process, CD8 + T cells and interferon-gamma (IFN-γ) secreted play a critical role in clearance of HBV. However, when IFN-α/β receptor was blocked or the Toll-like receptor (TLR)7 signaling pathway was inhibited, the activation of CD8 + T cells and clearance of HBV was significantly impaired. Conclusion : These results suggest that recovery of HBV-impaired hepatocyte-intrinsic innate immunity by the dually functional vector might overcome systemic adaptive immunotolerance in an IFN-α- and TLR7-dependent manner. The strategy holds promise for therapeutic intervention of chronic persistent virus infection and associated cancers. (Hepatology 2013;)
Somatic SETBP1 mutations in myeloid malignancies
Authors: Hideki Makishima, Kenichi Yoshida, Nhu Nguyen, Bartlomiej Przychodzen, Masashi Sanada, Yusuke Okuno, Kwok Peng Ng, Kristbjorn O Gudmundsson, Bandana A Vishwakarma, Andres Jerez, Ines Gomez-Segui, Mariko Takahashi, Yuichi Shiraishi, Yasunobu Nagata, Kathryn Guinta, Hiraku Mori, Mikkael A Sekeres, Kenichi Chiba, Hiroko Tanaka, Hideki Muramatsu, Hirotoshi Sakaguchi, Ronald L Paquette, Michael A McDevitt, Seiji Kojima, Yogen Saunthararajah, Satoru Miyano, Lee-Yung Shih, Yang Du, Seishi Ogawa, Jaroslaw P Maciejewski
Journal: Nature Genetics (2013)
Evaluating the Science and Ethics of Research on Humans: A Guide for IRB Members
Authors: Alice Z. Frohna
Journal: JAMA (2007)

The book Evaluating the Science and Ethics of Research on Humans: A Guide for IRB Members is an admirably comprehensive volume designed to impart the experience and wisdom of its author, Dennis J. Mazur, in the area of preparing and evaluating institutional review board (IRB) submissions.
Cholesterol lowering and mortality: the importance of considering initial level of risk.
Authors: G D Smith, F Song, T A Sheldon
Journal: BMJ (1993)

OBJECTIVE--To investigate the level of risk of death from coronary heart disease above which cholesterol lowering treatment produces net benefits. DESIGN--Meta-analysis of results of randomised controlled trials of cholesterol lowering treatments. METHODS--Published and unpublished data from all identified randomised controlled trials of cholesterol lowering treatments with six months or more follow up and with at least one death were included in the meta-analysis. The analyses were stratified by the rate of death from coronary heart disease in the control arms of the trials. MAIN OUTCOME MEASURES--Death from all causes, from coronary heart disease, and from causes other than coronary heart disease. RESULTS--In the pooled analysis, net benefit in terms of total mortality from cholesterol lowering was seen only for trials including patients at very high initial risk of coronary heart disease (odds ratio 0.74; 95% confidence interval 0.60 to 0.92). In a medium risk group no net effect was seen, and in the low risk group there were adverse treatment effects (1.22; 1.06 to 1.42). In a weighted regression analysis a significant (p &lt; 0.001) trend of increasing benefit with increasing initial risk of coronary heart disease was shown. Raised mortality from causes other than coronary heart disease was seen in trials of drug treatment (1.21; 1.05 to 1.39) but not in the trials of non-drug treatments (1.02; 0.88 to 1.19). Cumulative meta-analysis showed that these results seem to have been stable as new trials appeared. CONCLUSION--Currently evaluated cholesterol lowering drugs seem to produce mortality benefits in only a small proportion of patients at very high risk of death from coronary heart disease. Population cholesterol screening could waste resources and even result in net harm in substantial groups of patients. Overall risk of coronary heart disease should be the main focus of clinical guidelines, and a cautious approach to the use of cholesterol lowering drugs should be advocated. Future trials should aim to clarify the level of risk above which treatment is of net benefit.
Down's Anomaly
Authors: Robert A. Goyer
Journal: JAMA (1967)

The title of this monograph, Down's Anomaly , gives credit to Langden Down, a London physician, who in 1866 recognized a distinct clinical entity which he named Mongolian idiocy. Professor Penrose's long interest in this syndrome and his many personal contributions to its understanding are reflected in the completeness with which the subject is presented: 25 pages of references form the last section of the monograph. In this book the authors present, in essence, an organized abstract of the world's literature on mongolism. It is difficult to be critical of what is said, but we can, perhaps, question the manner in which it is presented. In general the text reads well, but the reviewer found the continuous insertion of authors' names a frequent source of distraction—a relatively minor complaint of a very scholarly work.  The contents include historical background, physical signs, biochemistry, and cytogenetics. The section on dermatoglyphics is very detailed
Aeromonas hydrophila Sepsis in a Patient Undergoing Hemodialysis Therapy
Authors: Allan M. Ramsay
Journal: JAMA (1978)

Aeromonas hydrophila septicemia complicated by a generalized cutaneous vasculitis developed in a patient receiving home hemodialysis therapy. Because the Aeromonas organism is found in many natural water sources, the possibility that this patient's hemodialysis system became contaminated was explored. Although cultures from the patient's home environment showed no Aeromonas sp, the possibility still exists that the site of contamination was in the dialysis system.
Controlled trial comparing two types of enteral nutrition in treatment of active Crohn's disease: elemental versus polymeric diet.
Authors: D Rigaud, J Cosnes, Y Le Quintrec, E Rene, J P Gendre, M Mignon
Journal: Gut (1991)

To determine whether an elemental diet or a polymeric defined formula diet would be more effective for treating active Crohn's disease, we conducted a prospective randomised clinical trial in 30 patients with active Crohn's disease unresponsive to steroids and/or complicated by malnutrition. They received a four to six week enteral nutrition course with either an elemental diet or a polymeric diet. Clinical remission occurred in 10 of the 15 patients on elemental diet compared with 11 of the 15 patients assigned to polymeric diet. Both groups showed similar improvements in nutritional status, biological inflammation, alpha 1 antitrypsin clearance, and colonoscopic lesions (diminished in 17 out of 24 patients). Most patients relapsed during the year after discharge. We conclude that enteral nutrition, whatever the diet, is an efficient primary therapy for active Crohn's disease but does not influence the long term outcome.