tbuckley/cabot-search huggingface dataset:
Evolution of AIDS policy in the Soviet Union. I. Serological screening 1986-7.
Authors: Z A Medvedev
Journal: BMJ (1990)

In a two-article series, a research scientist from Britain's National Institute for Medical Research reports on the Soviet Union's response to AIDS. The first article reviews Soviet policy in 1986-1987 when AIDS was regarded as a "Western" disease confined to certain risk groups that did not exist officially in the USSR. Small scale mandatory screening programs in 1986 and 1987 resulted in the deportation of HIV-positive foreigners and the apparent isolation of HIV-positive Soviets. A 1987 decree provided for mandatory HIV testing of all foreigners living in the USSR and for severe penalties for HIV carriers who placed others at risk of infection. Recent outbreaks of AIDS blamed on improperly sterilized hospital needles may convince Soviet authorities to begin an active campaign for AIDS prevention.
TREM2 sustains microglial expansion during aging and response to demyelination
Authors: Pietro Luigi Poliani, Yaming Wang, Elena Fontana, Michelle L. Robinette, Yoshinori Yamanishi, Susan Gilfillan, Marco Colonna
Journal: Journal of Clinical Investigation (2015)

Microglia contribute to development, homeostasis, and immunity of the CNS. Like other tissue-resident macrophage populations, microglia express the surface receptor triggering receptor expressed on myeloid cells 2 (TREM2), which binds polyanions, such as dextran sulphate and bacterial LPS, and activates downstream signaling cascades through the adapter DAP12. Individuals homozygous for inactivating mutations in TREM2 exhibit demyelination of subcortical white matter and a lethal early onset dementia known as Nasu-Hakola disease. How TREM2 deficiency mediates demyelination and disease is unknown. Here, we addressed the basis for this genetic association using Trem2(-/-) mice. In WT mice, microglia expanded in the corpus callosum with age, whereas aged Trem2(-/-) mice had fewer microglia with an abnormal morphology. In the cuprizone model of oligodendrocyte degeneration and demyelination, Trem2(-/-) microglia failed to amplify transcripts indicative of activation, phagocytosis, and lipid catabolism in response to myelin damage. As a result, Trem2(-/-) mice exhibited impaired myelin debris clearance, axonal dystrophy, oligodendrocyte reduction, and persistent demyelination after prolonged cuprizone treatment. Moreover, myelin-associated lipids robustly triggered TREM2 signaling in vitro, suggesting that TREM2 may directly sense lipid components exposed during myelin damage. We conclude that TREM2 is required for promoting microglial expansion during aging and microglial response to insults of the white matter.
Aminoguanidine Prevents the Decreased Myocardial Compliance Produced by Streptozotocin-Induced Diabetes Mellitus in Rats
Authors: Gavin R. Norton, Geoff Candy, Angela J. Woodiwiss
Journal: Circulation (1996)

Background A decreased cardiac compliance is a major feature of the cardiomyopathy of diabetes mellitus. Either an increase in the resistance afterload to the LV or an increase in collagen cross-linking induced by the formation of advanced glycosylation end products (AGEs) of collagen may be responsible for the stiff myocardium. To evaluate these hypotheses, we examined the effect of captopril, an afterload-reducing agent, and aminoguanidine, a nucleophilic hydrazine that prevents the accumulation of collagen AGEs, on left ventricular end-diastolic (LVED) compliance after 4 months of streptozotocin (0.26 mmol/kg)–induced diabetes mellitus in rats. Methods and Results Diabetes mellitus produced a decrease in LV chamber compliance as a result of an increased myocardial stiffness (slope of the linearized LVED stress–LVED strain relation [unitless]: diabetes mellitus, 47±4; control, 27±3; P &lt;.001) and an increase in blood pressure as a result of an elevated vascular resistance. LV end-systolic elastance was unaltered by diabetes mellitus. The stiff myocardium was not associated with changes in the myocardial collagen volume fraction or total hydroxyproline concentration but was associated with an increased myocardial collagen fluorescence (fluorescence units/μg hydroxyproline) (diabetes mellitus, 11±1.1; control, 6.6±0.7; P &lt;.01). Captopril therapy (0.22 mmol ·kg −1 ·d −1 ), despite producing a decrease in blood pressure through alterations in vascular resistance, failed to decrease myocardial stiffness in rats with diabetes mellitus. Alternatively, administration of aminoguanidine (7.35 mmol·kg −1 ·d −1 ) prevented both the enhanced myocardial collagen fluorescence (7.1±1.2) and the increased slope of the linearized LVED stress–LVED strain relation (29±2) but did not change markers of blood glucose control. Conclusions These results demonstrate that diabetes mellitus can produce a stiff myocardium before the development of myocardial fibrosis. The stiff myocardium in the early stages of the development of the cardiomyopathy of diabetes mellitus is not a consequence of an increase in ventricular resistance afterload and in these circumstances is associated with the formation of collagen AGEs.
Alcohol consumption and insulin concentrations. Role of insulin in associations of alcohol intake with high-density lipoprotein cholesterol and triglycerides.
Authors: E J Mayer, B Newman, C P Quesenberry, G D Friedman, J V Selby
Journal: Circulation (1993)

BACKGROUND The relation between alcohol intake and insulin levels may explain, in part, the reported associations of alcohol with cardiovascular disease risk factors, including high-density lipoprotein (HDL) cholesterol, triglycerides, blood pressure, and glucose levels, each of which has been recognized as a component of the insulin resistance syndrome. METHODS AND RESULTS Subjects included nondiabetic participants of the Kaiser Permanente Women Twins Study (1989 through 1990). Usual alcohol intake was assessed as part of a food frequency questionnaire. For women from twin pairs in which both twins drank (n = 338), an increment of 12 g of alcohol per day (about one drink) was associated with an 8% lower 2-hour post-glucose-load insulin (P &lt; .01) in a multiple regression analysis for twin data, adjusted for age, body mass index, waist-to-hip ratio, total caloric intake, and family history of diabetes. With genetic influences removed by matched analysis of the subset of 98 monozygotic twin pairs, an intrapair difference of 12 g of alcohol per day was associated with a 12.4% intrapair decrement in postload insulin (P &lt; .01). Inverse associations were also seen for fasting insulin. Alcohol consumption was inversely associated with postload glucose but not with fasting glucose in unmatched (P = .05) and matched (P = .005) analyses. A significant positive association of alcohol intake with high-density lipoprotein cholesterol and an inverse relation of alcohol intake with triglycerides were each independent of insulin levels (P &lt; or = .02 in the matched models). Neither systolic nor diastolic blood pressures were related to alcohol consumption in this sample, perhaps because of the rather low level of alcohol intake in the study population (median, 4 g/d). CONCLUSIONS Within the range of light to moderate drinking habits, alcohol consumption was inversely related to fasting and postload insulin levels. This relation did not explain associations of alcohol intake with lipid levels and may instead reflect an additional mechanism by which moderate alcohol consumption impacts cardiovascular disease risk.
Toxic Shock Syndrome— Additional Perspectives
Authors: Hewitt C. Goodpasture
Journal: JAMA (1982)

When Todd and colleagues<sup>1</sup>published a report of seven children suffering from acute erythroderma and shock, many physicians were skeptical that toxic shock syndrome (TSS) was a new disease. This fundamental question is not resolved. Is TSS the result of elaboration of new toxin(s); a combination of increased amounts of toxins present for many years; or toxins, new or old, dependent for clinical expression on peculiar environmental influences (ie, highly absorbent tampons and suture materials)? Answers to these questions have clinical and medicolegal implications. In this issue ofThe Journal(p 1448), Bartlett and colleagues describe another group that is susceptible to TSS: postoperative patients. Striking features of the reported illnesses were generalized toxic reactions with multisystem involvement and absence of overt wound infection. The surgery involved minor procedures ordinarily associated with a strikingly low incidence of infection. One of 13 patients died, and in two cases there was
Health for London: are we now on the right route?
Authors: Stephen Thornton
Journal: BMJ (2007)

This week sees the publication of Healthcare for London: A Framework for Action , a review of London's health service by Ara Darzi, chairman of surgery at Imperial College London and now a junior health minister (see News doi: 10.1136/bmj.39273.467697.DB). NHS London, the capital's strategic health authority, commissioned Professor Darzi to set out a vision for a world class health service for London. 

How refreshing it is to read a policy document that focuses on real health problems and makes practical suggestions about how to solve them. Not for Professor Darzi a theoretical exposition of system reform or a set of proposals for organisational change that seem remote from the delivery of health care at the coalface; instead he gives us a vision of future health care in London that simply makes sense. His work, too, heralds the welcome return of service planning—much derided by governments over the past 20 years but necessary even where providers operate in a competitive market environment, giving clear signals of long term intent to attract potential investors.

Many of London's healthcare problems have been well known for …
Unusual Features of Viral Hepatitis in Accra, Ghana
Authors: RICHARD H. MORROW
Journal: Annals of Internal Medicine (1968)

A clinical, epidemiological, and histopathological study of viral hepatitis was undertaken in Accra, Ghana, where hepatitis has become a common and severe endemic disease. One hundred thirty-six patients who were admitted to Korle Bu Hospital during a 12-month period and whose diagnosis of viral hepatitis was confirmed by liver biopsy or at postmortem were included in the study. Several unusual features and associations among patients hospitalized with hepatitis are described in this report. Histopathologic examination of liver biopsy sections from these patients revealed a distinctive pattern characterized by a "glandular" transformation of liver cells about bile canaliculi, an increased frequency of cholestasis, and a rarity of acidophilic bodies. Pregnant women had a higher complication rate for hepatitis than the nonpregnant, and they had a high fetal death rate. Patients with hepatitis had twice the frequency of erythrocyte glucose 6-phosphate dehydrogenase (G6PD) deficiency as compared with the general population, and those with the enzyme defect had a longer, more severe course. Men required a longer time to recover from equivalent degrees of liver damage than women, and older patients required a longer time than younger patients. The high acute coma and death rate was associated with immigration, shantytown residency, lower socioeconomic standing, and pregnancy. On the other hand, prolonged jaundice from hepatitis could be attributed to inherent biologic factors such as age, sex, and G6PD deficiency.
Epiphrenic Diverticulum: Potential Pitfall in Thyroid Cancer Iodine-131 Scintigraphy
Authors: Ba D. Nguyen, Michael C. Roarke
Journal: Clinical Nuclear Medicine (2005)

Unusual features of iodine-131 uptake during thyroid cancer scintigraphy may lead to a false-positive diagnosis of residual or recurrent malignancy and associated metastasis. Radiographic or cross-sectional imaging correlation should help to differentiate truly functioning thyroid lesions from physiological or artifactual tracer accumulation. The authors present a case of iodine-131 mediastinal uptake from an esophageal epiphrenic diverticulum.
MYCN haploinsufficiency is associated with reduced brain size and intestinal atresias in Feingold syndrome
Authors: Hans van Bokhoven, Jacopo Celli, Jeroen van Reeuwijk, Tuula Rinne, Bob Glaudemans, Ellen van Beusekom, Paul Rieu, Ruth A Newbury-Ecob, Chin Chiang, Han G Brunner
Journal: Nature Genetics (2005)
Speaking sign language from birth can make deaf children confident
Authors: P. Hindley, R. Parkes
Journal: BMJ (1999)

EDITOR—We were perturbed to read O'Donoghue's one sided account of the range of communication methods and languages available to deaf children.1 O'Donoghue states that any language other than spoken language “leads to lifelong linguistic and communicative deficits” and that, in the past, not enabling deaf children to develop spoken language “put these children at an unacceptable disadvantage and incurred an important societal cost.” Finally, he suggests that enabling deaf children to enter mainstream …
Shells and sore feet
Authors: R. Silva
Journal: BMJ (1999)

“When did your belly start to ache?”

“Yesterday, after lunch.”

I had examined him through the anamnesis and found fever, dehydration, diarrhoea, and abdominal pain. It looked like gastroenteritis. It would be a normal scene in an emergency room. But I was sitting on the floor of the room I would share with him and six other people in a little dormitory in a small village along the Way of St James, the legendary 1100 …
Abstract P4-10-03: Long-Term Follow-Up of SweBCG 91RT, a Randomized Trial of Breast Conservation Surgery with and without Radiotherapy from the Swedish Breast Cancer Group
Authors: P Malmström, F Killander, H Anderson, E Holmberg, D Lundstedt, JE Mattsson, L Holmberg, P. Karlsson
Journal: Cancer Research (2010)

Abstract Background: Postoperative radiotherapy remains the golden standard after breast conservation surgery. However, national breast screening programmes and increased public awareness of breast cancer have resulted in earlier detection of small tumours with favourable prognosis. The Swedish SweBCG 91RT multicentre study of breast conservation with and without radiotherapy was initiated in 1991. Five year results have been published.(Malmström P et al. Eur J Cancer 39: 1690, 2003). A gene expression signature for radioresistance has also been defined from this patient material. (Niméus-Malmström E et al. Breast Cancer Res 2008, 10:R3(doi10:1186/brc1997). Increasing knowledge of genetically defined subgroups of breast cancer is likely to have an impact on breast conservation treatment. We now present outcome after 15 years of follow-up. Patients and methods: After a standardised radical sector resection 1187 patients with T1-2N0M0 breast cancer were randomised to postoperative radiotherapy or no further treatment. 1178 patients fulfilled the inclusion criteria. The two treatment groups were well balanced with respect to prognostic factors. Median tumour size was 12 mm, and 65 % of cases were detected by mammography screening. Radiotherapy with tangential MV photons, 48-54 Gy in 24-27 fractions, was administered to the remaining breast parenchyma. CT-based 3-D treatment planning was used. Adjuvant systemic therapy was prescribed according to regional treatment programmes. Nine percent received adjuvant systemic therapy. Patients were followed annually with bilateral mammography for 10 years and thereafter referred to the national Swedish breast screening programme. Results: With a median follow-up of 15 years, the addition of postoperative radiotherapy did not affect overall survival, 70.8 % with RT vs 68.2 % without RT, p=0.79. This result is based on follow-up for survival until April 2010 for all patients. However, recurrence-free survival, RFS, was significantly improved by radiotherapy, 62,6 % vs 53.7 % after 15 years, P&amp;lt;0.001. The cumulative incidence of local recurrences as first event was significantly lower in the irradiated group 11.8 % after 15 years compared to 24.3 % in the control group, P&amp;lt;0.0001. Results for RFS and local recurrences are based on prolonged follow-up of 85 % of the cases and to 1999 for the remaining. Data with more complete follow-up will be presented at the meeting as will data on treatment efficacy in predefined subgroups. Conclusions: Postoperative breast radiotherapy is indicated for the majority of patients operated with breast conservation surgery. Analysis of treatment efficacy in subgroups of patients may identify groups for which radiotherapy can be omitted in the future. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-10-03.
Thalidomide ban to be lifted in the US
Authors: Terri Rutter
Journal: BMJ (1997)

A scientific advisory committee to the Food and Drug Administration has recommended that thalidomide, which has never been licensed in the United States, should be allowed to be used to treat serious inflammatory conditions associated with leprosy.

Once approved, the drug could also be prescribed, under certain restrictions, to treat other diseases, including some forms of cancer, lupus, chronic host-graft disease, and some complications due to …
Intravascular and Mucosal Immunoglobulin A: Two Separate but Related Systems of Immune Defense?
Authors: MARY ELLEN CONLEY
Journal: Annals of Internal Medicine (1987)

Immunoglobulin A has long been referred to as the antibody of mucosal secretions. However, in the last few years there has been increased interest in serum IgA, in factors that regulate the various forms of IgA produced, and in the relationship between serum and mucosal IgA. Recent data indicate that in humans, the mucosal surfaces are neither the source nor the destination of serum IgA. By estimating the amounts of IgA produced at various sites throughout the body, we have shown that in humans more IgA is synthesized and secreted each day than IgG and IgM combined; about one third of this IgA is secreted directly into the vascular compartment and never reaches the mucosal surfaces. We also consider a possible role for serum IgA as the "discreet housekeeper," the relationship between cells that produce IgA in the serum and IgA in secretions, and factors that influence the various forms of IgA produced.
Treating Sickle Cell Pain like Cancer Pain
Authors: Daniel Brookoff, Rosemary Polomano
Journal: Annals of Internal Medicine (1992)

Objective: To assess the effect of a structured analgesic regimen on hospital use by patients with sickle cell disease. Intervention: Intravenous and oral controlled-release morphine was used instead of intramuscular meperidine and short-acting oral opioids for the treatment of sickle cell pain. Design: Time series in which emergency and admission records for four 6-month periods before and two 6-month periods after the institution of the new analgesic protocol were reviewed. Setting: Inner-city university hospital providing care for adults with sickle cell disease. Patients: All patients (an average of 50) who used the emergency department or the inpatient medical service for treatment of sickle cell crisis during the study periods. Measurements and Main Results: The number of admissions for sickle cell pain decreased by 44%, total inpatient days by 57%, length of hospital stay by 23%, and the number of emergency department visits by 67% after initiation of the morphine protocol. Hospital use remained at these lower levels one year later. Similar declines were seen for a subset of 15 patients who had a history of frequent admissions for sickle cell pain and who used this hospital exclusively and accounted for more than half of the admissions for sickle cell disease. Conclusion: A pain-control program modeled on regimens used to treat chronic cancer pain reduced hospital use by adult patients with sickle cell pain.
FOLINIC ACID AND NON-DIALYZABLE MATERIALS IN THE NUTRITION OF MALARIA PARASITES
Authors: William Trager
Journal: The Journal of Experimental Medicine (1958)

The extracellular survival of the malaria parasite Plasmodium lophurae was favored on the 4th day of incubation in vitro by the presence in the medium of added folinic acid at a concentration of about 5 microg. per ml. The development of the human malaria parasite P. falciparum intracellularly in suspensions of human erythrocytes was better in a medium with a high than in one with a low concentration of folic acid. In the early extracellular development of P. lophurae in vitro erythrocyte extract could be partially replaced by certain yeast protein preparations and by a non-dialyzable fraction, free from hemoglobin, prepared from duck erythrocyte extract by means of starch electrophoresis.
Subcutaneous Glucagon-Like Peptide I Combined With Insulin Normalizes Postcibal Glycemic Excursions in IDDM
Authors: John Dupré, Margaret T Behme, Irene M Hramiak, Thomas J Mcdonald
Journal: Diabetes Care (1997)

OBJECTIVE To determine whether a subcutaneous injection of truncated glucagon-like peptide 1 (tGLP-I)(7–36) amide that delays gastric emptying transiently can prevent postcibal hyperglycemia in IDDM without causing hypoglycemia when administered with insulin. RESEARCH DESIGN AND METHODS The postcibal increase in plasma human pancreatic polypeptide (HPP) was used as a presumptive indicator of arrival of nutrient in the small intestine. Studies in seven normal human volunteers established the dose of tGLP-I that delayed the postcibal rise in HPP by 30 min. This dose was tested in six patients with IDDM with a range of residual endogenous insulin secretion. The patients received a standard liquid test meal with or without subcutaneous tGLP-I and their usual dose of regular insulin before the meal. Blood samples collected at timed intervals were assayed for plasma concentrations of glucose, C-peptide (CP), immunoreactive insulin (IR1), HPP, and glucagon (GLN). RESULTS In normal subjects after administration of tGLP-I, postcibal plasma glucose concentration at 20 min fell below fasting levels in a dose-dependent manner. At 10 and 20 min, transient increments in plasma CP and IRI, and decrements in GLN, occurred. Subsequently, through 60 min, the excursions of plasma HPP, CP, and IRI were negatively correlated to the dose of tGLP-I. In subjects with IDDM, the selected dose of tGLP-I given with insulin before the meal delayed the plasma HPP response for 30 min and confined excursions of plasma glucose within the range observed in normal subjects receiving saline injections, whereas administration of insulin with saline injections in IDDM was followed by supranormal increases of plasma glucose. In IDDM, this dose of subcutaneous tGLP-I had no effect on plasma CP, IRI, or GLN. CONCLUSIONS In normal subjects, transient hypoglycemia after injections of tGLP-I with a meal was associated with transient stimulation of insulin secretion and inhibition of glucagon secretion. These actions together with delayed gastric emptying may account for the hypoglycemia, but other unidentified mechanisms cannot be excluded. In the subjects with IDDM, the selected relatively low dose of tGLP-I delayed excursions of plasma HPP as in normal subjects, but did not reduce the plasma glucose below the fasting level and had no effect on plasma CP, IRI, or GLN. However, injection of tGLP-I reduced the postcibal glycemic excursion and confined it within the normal range. Thus, in IDDM, a pharmacological dose of subcutaneous tGLP-I that presumably delays gastric emptying by ∼30 min can normalize glycemic excursions after a meal when given in combination with insulin. Because this cannot be achieved with regular insulin alone without risk of hypoglycemia, this combination of glucoregulatory peptides has therapeutic potential in insulin-requiring diabetes.