tbuckley/cabot-search huggingface dataset:
The Predictive Power and Cost of Screening for Chlamydia
Authors: Dean Rieger
Journal: JAMA (1988)

To the Editor.—  Drs Nettleman and Jones 1 have made two basic errors in their decision analysis purportedly determining the cost-effectiveness of screening for infection with Chlamydia trachomatis in women at moderate risk for such infection. These errors go beyond mere problems with percentages assigned to branch points and render their analysis almost useless.  First, they do not include consideration of the costs and benefits of tracing and treating current sexual contacts of their identified infected women. If they do not trace and treat these contacts, treatment will provide almost no benefits at all, because infected women will probably be reinfected immediately.  Second, and similarly, they have calculated the benefits of a single treatment as if the benefits will be lifelong, forgetting that continued sexual activity in their moderate-risk population may well result in reinfection during ensuing years. Consideration of continued screening, or of calculating benefits only for a limited
Standardization of <i>in vivo</i> and <i>in vitro</i> diagnostic procedures in food allergy
Authors: R. C. Aalberse, S. O. Stapel, R. van Ree
Journal: Allergy (1998)

For most foods, true standardization is not yet feasible because there is insufficient information on the relative importance of individual allergens and their variants. Standardization without sufficient information may easily be counterproductive because improvements are less likely to be implemented. In the analysis of natural test material, the following principles apply: 1) RAST inhibition is usually inferior to other means of allergen quantitation. 2) Immunoblot is inefficient for some "important" allergens and overefficient for some "unimportant" allergens and may therefore be deceptive. 3) Single-component assays are the only satisfactory way to describe complex mixtures. Improving the actual food-testing procedure is important, but will not alone result in a reliable diagnostic procedure. Tests for measuring "effect modifiers" will have to be developed in order to predict in vivo reactions to foods.
Therapeutic Defibrination and Heparin Therapy in the Prevention and Resolution of Experimental Venous Thrombosis
Authors: SHAHBUDIN H. RAHIMTOOLA, MAURICE J. RAPHAEL, W. ROBERT PITNEY, ECKHARDT J. G. OLSEN, MICHAEL WEBB-PEPLOE
Journal: Circulation (1970)

The application of phenol to the femoral veins of anesthetized dogs resulted in an occluding thrombus in 24 of 25 veins at 1 week. Serial venography and eventual histology showed that these veins remained occluded over a 5-week observation period, the thrombi undergoing organization. Therapeutic defibrination was achieved with administration of an enzyme from venom of the pit viper (Arvin). Arvin, administered for 1 week immediately following phenol application and before thrombus formation had occurred, prevented thrombosis in all 10 such veins, and serial venography for a further 4 weeks showed that the veins remained patent. Administration of Arvin was begun 24 hours postoperatively, when venography had demonstrated an occluding thrombus and failed to clear any of 11 veins after 3 weeks of treatment. Intravenous administration of heparin, 10,000 units, at 6, 6, and 12-hour intervals in a 24-hour period, was begun immediately after phenol application and continued for 1 week; 10 of 12 veins were blocked at 1 week. Following the same dose of heparin every 6 hours four of eight veins were blocked at 1 week. The results indicate that when the vascular endothelium is damaged, therapeutic defibrination is more effective than heparin therapy in preventing venous thrombosis. Arvin therapy has no significant thrombolytic effect even if the thrombus is less than 24 hours old.
PWE-020 Diagnosing Microscopic Colitis – Is Colonoscopy Necessary?: Abstract PWE-020 Table 1
Authors: T Chapman, A Pennefather, G MacFaul, A Abraham
Journal: Gut (2014)

<h3>Introduction</h3> Microscopic colitis is a common cause of chronic diarrhoea, particularly in older people, and the incidence is increasing. As the endoscopic appearance is typically normal, diagnosis of the two subtypes, collagenous and lymphocytic colitis, relies upon specific histology findings. When suspected, guidelines advise colonoscopy with full biopsy series due to reports of a patchy disease distribution, with false negative rates of up to 40% reported with flexible sigmoidoscopy.<sup>1</sup> However, more recent data has challenged this assumption, leaving considerable uncertainty.<sup>2</sup> We report one of the largest consecutive case series to date, examining whether flexible sigmoidoscopy alone is sufficient. <h3>Methods</h3> A retrospective review of all cases of microscopic colitis diagnosed at colonoscopy over a 12-year period (2001–2013) at our hospital was performed. Only colonoscopies with both right (proximal to splenic flexure) and left sided colonic biopsies were included. The diagnostic criteria for microscopic colitis were lymphocytic infiltration in the lamina propria and either &gt;20 intraepithelial lymphocytes per 100 epithelial cells (lymphocytic colitis) or a collagenous layer &gt;10 mm (collagenous colitis). The primary aim was to assess the proportion of patients in which microscopic colitis could be diagnosed on left sided biopsies alone. <h3>Results</h3> 84 patients were included in the study. 58 (69.0%) were female with a median age of 62 years. 44 (52.4%) had collagenous colitis and 40 (47.6%) lymphocytic colitis. 76 (90.5%) had features of microscopic colitis on both right and left sided biopsies, 7 (8.3%) right side only and 1 (1.2%) left side only. Hence a diagnosis of microscopic colitis could be made in 77 (91.7%) on left sided biopsies alone. Age, sex and histopathological subtype did not significantly alter the sensitivity of left sided biopsies. <h3>Conclusion</h3> Flexible sigmoidoscopy would have correctly diagnosed microscopic colitis in a very high proportion of patients (92%). Given that flexible sigmoidoscopy is less expensive, better tolerated, and can be combined with CT scanning to exclude a proximal malignancy, this may have important implications for the investigation of non-bloody diarrhoea. <h3>References</h3> Fernandez-Banares F <i>et al</i>. Incidence of collagenous and lymphocytic colitis: a 5-year population-based study. <i>Am J Gastroenterol</i> 1999:94:418–23 Bjørnbak C <i>et al</i>. Microscopic colitis: clinical findings, topography and persistence of histopathological subgroups. <i>Aliment Pharmacol Ther</i> 2011:34:1225–34 <h3>Disclosure of Interest</h3> None Declared.
Radionuclide Hepatobiliary Scanning in Patients with AIDS-Related Sclerosing Cholangitis
Authors: DAVID QUINN, NICHOLAS POCOCK, JUDITH FREUND, ANTHONY KELLEHER, RONALD PENNY, BRUCE BREW
Journal: Clinical Nuclear Medicine (1993)

Biliary disease, primarily manifesting as papillary stenosis or sclerosing cholangitis, is being increasingly recognized as a problem in the acquired immunodeficiency syndrome (AIDS) and may be amenable to specific treatment. Ultrasound, followed by endoscopic retrograde cholangiopancreatography (ERCP) for definitive diagnosis, is currently the prime mode of investigation of suspected hepatobiliary diseases in AIDS. There are few published reports of the use of radionuclide cholescintigraphy in the assessment of these patients. This report presents Tc-99m DISIDA cholescintigraphy data from three patients with AIDS-related hepatobiliary disease confirmed by ERCP. Radionuclide cholescintigraphy was abnormal in all three patients. In two of the subjects, there was focal duct dilation with strictures in the biliary tree. The third patient demonstrated diffuse hepatic parenchymal retention with marked delay in tracer washout. Two of the subjects, treated with specific anticryptosporidial therapy, subsequently underwent progress cholescintigraphy. In one of these patients with initial diffuse parenchymal retention, there was marked improvement in scan appearances. The second patient with initial duct dilation had no significant change in scan appearances, but quantitative analysis did demonstrate improvement in hepatobiliary tracer clearance rate. In conclusion, although ERCP remains the gold standard in the diagnosis of AIDS-related biliary disease, radionuclide cholescintigraphy may be a useful modality in these patients as a screening test before proceeding to more expensive and invasive techniques. In addition, quantitative analysis of cholescintigraphy may allow assessment of patient response to specific antimicrobial or surgical intervention.
INTRAVASCULAR ULTRASOUND ASSESSMENT OF SIDE BRANCH OSTIUM AFTER A CROSSOVER STENTING WITH FINAL KISSING BALLOON INFLATION IN CORONARY BIFURCATION LESION
Authors: Masahiro Yamawaki, Yoshinobu Murasato, Kenichi Fujii, Shinke Toshiro, Hiromasa Otake, Yoshihiro Takeda, Shinichiro Yamada, Yoshihisa Shimada, Takehiro Yamashita, Kazuhiko Yumoto, Yoshihisa Kinoshita
Journal: Journal of the American College of Cardiology (2014)
Vasopressin increases cytosolic free [Ca2+] in the neonatal rat cardiomyocyte. Evidence for V1 subtype receptors.
Authors: Y J Xu, V Gopalakrishnan
Journal: Circulation Research (1991)

Radioligand binding studies of the cardiac arginine vasopressin (AVP) receptor, together with studies on the AVP-evoked alterations in the [Ca2+]i levels, were undertaken using primary cultures of neonatal rat cardiomyocytes. Rapid, reversible, specific, high-affinity and low-capacity binding sites were detected for the agonist, [3H]AVP, and the V1 selective antagonist, d(CH2)5 Tyr (Me)-[3H]AVP (V1 antagonist), radioligands. The V2 selective antagonist radioligand, d(CH2)5 D-Ile des-Gly NH2-[3H]AVP, showed very little binding even at very high concentrations. [3H]AVP and [3H]V1 antagonist specific binding attained equilibrium in 10 minutes at 37 degrees C. The Kd and Bmax values (mean +/- SEM) were [3H]AVP: Kd 1.44 +/- 0.18 nM; Bmax 5,253 +/- 590 sites/cell; [3H]V1 antagonist: Kd 0.96 +/- 0.10 nM; Bmax 6,869 +/- 485 sites/cell. Ki values for a series of AVP-related peptide analogues and antagonists determined by competitive inhibition of [3H]AVP binding were consistent with the saturation data. The results suggest that these cells possess a homogeneous population of V1 subtype AVP receptors. AVP increased [Ca2+]i in a concentration-dependent manner as judged by fura-2 fluorescence. This was completely attenuated by inclusion of the V1 antagonist. The maximal increase in [Ca2+]i evoked by AVP from a resting level of 60 +/- 5 nM was less (250 +/- 35 nM) in comparison to the maximal response evoked by angiotensin II (2,337 +/- 640 nM).(ABSTRACT TRUNCATED AT 250 WORDS)
Effects of static and cyclic loading in regulating extracellular matrix synthesis by cardiovascular cells
Authors: V GUPTA, K GRANDEALLEN
Journal: Cardiovascular Research (2006)

Extracellular matrix (ECM) provides several structural and functional characteristics to tissues including cell support, mechanical integrity and biological signaling. In cardiovascular tissues, cells produce various ECM components such as collagen, elastin, proteoglycans, matrix metalloproteinases, growth factors and signaling molecules. The cardiovascular cells (cardiac fibroblasts, cardiomyocytes, endothelial cells, and vascular smooth muscle cells) sense the changes in mechanical strains applied to them, through cell-surface receptors such as integrins and ion channels, and adjust their expression and synthesis of ECM molecules in order to adapt their environment to these changes. ECM changes due to altered mechanics are evident in numerous pathological situations including hypertension, cardiac hypertrophy, myocardial infarction, myxomatous heart valve disease, and atherosclerosis. In hypertrophic conditions, for example, increased mechanical loading is involved with enhanced collagen synthesis, whereas in myxomatous and atherosclerotic conditions reduced mechanical strains are accompanied by an accumulation of proteoglycans. Therefore, investigating the effects of various strain patterns on cardiovascular cells can enhance our understanding of ECM regulation and pathologies. This review focuses on the in vitro modulation of the synthesis of various ECM molecules through static or cyclic stretching of cardiovascular cells.
Cardiac transplantation affects ventricular expression of brain natriuretic peptide
Authors: A. Ationu, M. Burch, D. Singer, P. Littleton, N. Carter
Journal: Cardiovascular Research (1993)

Objective: The aim was to examine the ventricular expression of brain natriuretic peptide (BNP) in the transplanted human heart. Methods: Serial right ventricular biopsies (n=68) and plasma samples (n=68) were obtained for measurement of BNP and atrial natriuretic peptide (ANP) from 14 orthotopic cardiac transplant recipients from 1-74 weeks after transplantation. Right ventricular specimens (n=10) were also obtained from normal hearts during necropsy as controls. Results: Mean ventricular BNP in cardiac transplant recipients was higher (p<0.05) than in normal hearts, at 13531(SEM 2244) pg·mg−1 soluble protein (range 3232 - 109448) v 56(11) pg·mg−1 (range 16-91). Ventricular BNP and ANP values were correlated (r=0.57, p<0.05). Plasma BNP concentrations were higher (p<0.05) than plasma ANP concentrations, at 202(16) pg·ml−1 (range 84-655) v 100(12) pg·ml−1 (range 8-484), and were raised (p<0.05) in comparison with normal plasma BNP concentrations of 20(1.8) pg·ml−1 (range 10-23). Mean ventricular BNP was correlated with time after transplant (r=0.72, p<0.05, n=68) and with mean plasma BNP (r=0.80, p<0.05, n=14). There was no significant relationship between BNP levels and intracardiac or systemic blood pressure, or prednisolone dose (0.1-0.3 mg·kg−1·d−1). The increase in ventricular BNP with time after transplant was not explained by cardiac rejection assessed from histology, and plasma BNP was not significantly increased during rejection episodes. Conclusions: High levels of BNP are synthesised and secreted by the transplanted human ventricle, and the transplanted ventricle may be an important source of circulating BNP. The significant positive association between ventricular BNP and time after transplant suggests a possible self compensatory mechanism or functional adaptation of the transplanted heart which may be beneficial to ventricular function. Cardiovascular Research 1993;27:188-191
Jimson-Weed Intoxication
Authors: Carl S. Rosen, Michael Lechner
Journal: New England Journal of Medicine (1962)

THE Jimson weed, Datura stramonium, is an annual herb, growing wild in most parts of the United States. The attractive, small white flowers bloom late in the spring; the spinous capsule, which is its fruit, ripens in early fall (Fig. 1). All parts of the plant (leaves, flower, seeds and roots) contain belladonna alkaloids. The seeds contain chiefly hyoscyamine; atropine, scopolamine and hyoscine are present in varying proportions in the other parts.Ingestion of Jimson weed and the resulting toxic symptoms have been reported throughout the world. Reports in the American literature, however, are sparse. Two cases of stramonium . . .
Mammographic Parenchymal Patterns: More Controversy
Authors: Myron Moskowitz
Journal: JAMA (1982)

The article by Tabár and Dean (p 185) on mammographic parenchymal patterns for breast cancer, emanating as it does from a population-based trial with a high percentage of attendance, represents a very important piece of work. The early reports of Wolfe indicating a group of mammographically identifiable patients at extremely high risk for development of breast cancer was initially greeted with enthusiasm. However, several subsequent investigators were either unable to duplicate Wolfe's work completely or, at best, only partially reproduce it at lower levels.<sup>1-6</sup>It appears from several of the reported studies, including our own,<sup>6</sup>that of Egan and Mosteller,<sup>1</sup>and the current study in particular, that the risk of the P2/DY pattern seems to be associated mostly with the prevalence screen. In subsequent or in incidence years of screening, as is shown in the current article, the magnitude of the apparent risk drops either to insignificant
Hendersonula toruloidea and Scytalidium hyalinum infections in Tobago
Authors: V.Y. Allison, R.J. Hay, C.K. Campbell
Journal: British Journal of Dermatology (1984)

Journal Article Hendersonula toruloidea and Scytalidium hyalinum infections in Tobago Get access V.Y. Allison, V.Y. Allison Bristol Royal Infirmary Bristol BS2 8HW Search for other works by this author on: Oxford Academic Google Scholar R.J. Hay, R.J. Hay London School of Hygiene and Tropical Medicine Keppel Street, London WC1E 7HT, U.K. Search for other works by this author on: Oxford Academic Google Scholar C.K. Campbell C.K. Campbell London School of Hygiene and Tropical Medicine Keppel Street, London WC1E 7HT, U.K. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 111, Issue 3, 1 September 1984, Pages 371a–372, https://doi.org/10.1111/j.1365-2133.1984.tb04738.x Published: 01 September 1984
More studies are needed before giving magnesium sulphate for pre-eclampsia
Authors: L. Duley, J. Neilson, K. Watkins
Journal: BMJ (1999)

EDITOR—Clark et al argue that magnesium sulphate reduces the risk of eclampsia and should therefore be given to all women with severe pre-eclampsia.1 The study they refer to in support of this view has reported outcome for 685 women out of 822 randomised. A more reliable guide to clinical practice is a systematic review of all relevant trials. Four trials have now compared magnesium sulphate with placebo or no anticonvulsant,2 and the relative …
Comments on Selected Cases in Medical Practice
Authors: G. Shann
Journal: BMJ (1877)

THE BRITISH MEDICAL 7OURNAL.5I5success.A generous diet was also enjoined, with two or three glasses daily of Burgundy or Carlowitz.This lady is now in the ninth month of utero-gestation, and is daily sensible of the vigour and activity of the foetus, whilst her own health is better than it has beer for years.These cases do not require any commentary.Of course, no positive conclusion can be drawn from any one of them; but their cumula- tive evidence is considerable, and certainly entitled to some weight in the question before us.Besides the foregoing, I have two other pa- tients in the eighth and the ninth months of pregnancy respectively, one of whom has had three premature dead children and the other two.Both these ladies, like the one last mentioned, have now passed the period of pregnancy at which labour occurred before, and both enjoy unequivocal evidence of the vitality of the fcetus.These two, with those previously related, represent all the cases in which I have employed the same treatment for the preservation of the fcetus.Let me now, in conclusion, very briefly sum up the heads of evi- dence in support of the possibility and reasonableness of foetal therapeutics.i.It is a well known fact that many diseases, e.g., syphilis, measles, small-pox, scarlatina, ague, etc., contracted by the mother subsequently to conception may be communicated to the foetus in 2itero.2. Careful investigations have demonstrated that various medicines given to a pregnant woman may reach the foetus and be found in its blood or secretions.3. Clinical observations establish the fact that therapeutical effects on the foetus in utero follow the administration of certain medicines, when given to the mother for a sufficient length of time before the accession of labour.
Arteriolar narrowing as predictor of hypertension: Authors' reply
Authors: Tien Wong, Anoop Shankar
Journal: BMJ (2004)

EDITOR—Firstly, we agree that pre-existing blood pressure is an important predictor of overt hypertension. As in the Framingham study,1 our participants whose baseline blood pressure was classified as “prehypertensive” were more likely to develop clinical hypertension than those classified as “normal” (figure 2 in our paper). This effect was …
Beyond Epicardial Reperfusion
Authors: Jan J. Piek
Journal: New England Journal of Medicine (2007)

The pathogenesis of an acute myocardial infarction consists of the rupture of atherosclerotic plaque, followed by a sudden thrombotic coronary occlusion. Pioneering studies performed more than 40 years ago, even before there was full recognition of the underlying pathobiology, showed that nonselective intracoronary fibrinolysis can restore perfusion to the jeopardized vascular territory.1 Primary percutaneous coronary intervention (PCI) has now emerged as the optimal mode of reperfusion therapy, if performed by an experienced team within 90 minutes after the first medical contact. Primary PCI results in patency of the occluded artery in almost all patients and in normalization of epicardial perfusion, . . .
Release of histamine by sympathetic nerve stimulation in the guinea pig heart and modulation of adrenergic responses. A physiological role for cardiac histamine?
Authors: S S Gross, Z G Guo, R Levi, W H Bailey, A A Chenouda
Journal: Circulation Research (1984)

Histamine has been reported to attenuate adrenergic responses in cardiovascular tissues. In guinea pig atria preloaded with [3H]norepinephrine, histamine diminishes the field stimulation-induced efflux of radioactivity; this effect has been attributed to an inhibition of norepinephrine release from nerve endings. To assess the possible physiological relevance of these findings, we have reinvestigated the effects of histamine on cardiac sympathetic responses and on the release of endogenous norepinephrine in the guinea pig heart isolated with its intact sympathetic innervation. Heart rate, left ventricular contractile force, and perfusion pressure all increased with increasing frequencies of sympathetic nerve stimulation (2-8 Hz). Histamine (3 X 10(-8) to 3 X 10(-7) M) caused dose-dependent attenuation of the responses to sympathetic stimulation. The ability of histamine to modulate nerve stimulation-induced norepinephrine overflow into the coronary effluent was dependent on whether the heart had been preloaded with norepinephrine. Whereas histamine did not cause a significant reduction in nerve stimulation-induced norepinephrine overflow in hearts from untreated animals, histamine significantly reduced stimulation-induced norepinephrine overflow in hearts from guinea pigs that had been pretreated with norepinephrine before sacrifice. Histamine also attenuated the increases in left ventricular contractile force, perfusion pressure, and heart rate, which result from the intracardiac administration of norepinephrine (0.16-microgram bolus injection). In this respect, histamine was as effective as it was in inhibiting the responses elicited by nerve stimulation. Thus, in normal animals, the negative modulatory effect of histamine on adrenergic responses can be attributed largely, if not totally, to a postjunctional mechanism. In contrast, a prejunctional action of histamine may contribute significantly to the negative modulation observed in norepinephrine-preloaded hearts. Since we have observed a large increase in the amount of endogenous histamine present in the coronary effluent after sympathetic stimulation (930 pg during the 30 seconds poststimulation vs. 240 pg during 30 seconds prestimulation), as well as a prolongation of nerve stimulation-induced cardiac responses in the presence of the H2 receptor antagonist tiotidine, we postulate that histamine plays a physiological role as a modulator of sympathetic responses in the heart.