tbuckley/cabot-search huggingface dataset:
Endoscopic sclerosis and esophageal balloon tamponade in acute hemorrhage from esophagogastric varices: A prospective controlled randomized trial
Authors: Karl-Joseph Paquet, Hubertus Feussner
Journal: Hepatology (1985)

A prospective randomized controlled clinical trial was performed in 43 consecutive histologically proved cirrhotic patients with endoscopically proved actively bleeding esophageal varices. Twenty-two were randomly selected to have esophageal tamponade with the Sengstaken-Blakemore tube, and 21 were selected to have endoscopic sclerosis of the esophageal wall. The two groups were similar in demographic, clinical and laboratory data. Bleeding was controlled by the Sengstaken-Blakemore tube in 16 of 22 patients (73%) and by endoscopic sclerosis in 20 of 21 (95%). Among those controlled by the Sengstaken-Blakemore tube, seven (44%) rebled and three (43%) were again controlled by the Sengstaken-Blakemore tube; in the endoscopic sclerosis group, four (20%) rebled and three (75%) were controlled. Thus, hemorrhage was definitively controlled in 52% of patients and 66% of bleeding episodes in the Sengstaken-Blakemore tube group and in 90% of patients and 92% of bleeding episodes in the endoscopic sclerosis group. The definite control of hemorrhage was significantly better in the endoscopic sclerosis group (p < 0.01). The Sengstaken-Blakemore tube patients received no definitive therapy after bleeding had been controlled. Within 30 days, six patients (27%) in the Sengstaken-Blakemore tube group had died compared to 2 (10%) in the endoscopic sclerosis group which is statistically significant (p < 0.01) in favor of endoscopic sclerosis. The frequency of complications was similar in the two groups. Endoscopic sclerosis patients received serial endoscopic sclerosis after bleeding had been stopped during the whole period of follow-up. After 6 months, 11 patients in the Sengstaken-Blakemore tube group had died (55%) compared to three patients (16%) in the endoscopic sclerosis group. Cumulative survival was statistically better in the endoscopic sclerosis group after 6 months (p < 0.01) and after 3 years of follow-up (p < 0.001). Survival was related to Child classification on admission. This investigation shows that endoscopic sclerosis is effective and superior to the Sengstaken-Blakemore tube in stopping active hemorrhage from esophageal varices and highly superior to the Sengstaken-Blakemore tube in reducing short- and long-term mortality.
Assessment of Myocardial Viability in Reperfused Acute Myocardial Infarction Using 16-Slice Computed Tomography in Comparison to Magnetic Resonance Imaging
Authors: Andreas H. Mahnken, Ralf Koos, Marcus Katoh, Joachim E. Wildberger, Elmar Spuentrup, Arno Buecker, Rolf W. Günther, Harald P. Kühl
Journal: Journal of the American College of Cardiology (2005)
Letter: Adoption problems.
Authors: P Sawbridge, W McClanahan
Journal: BMJ (1973)

necrotic that cortical damage becomes notable.Sometimes part or all of the necrotic papillae are cast off, but in other cases they remain in situ.In this event, cortical damage is more severe.Indeed, we have noted that when the papilla is shed leaving a sharp line of demarcation, as in the combination of infection and diabetes or of analgesic damage and infection, cortical damage may be remarkably slight.The determinant of cortical damage appears to us to be the degree of obstruction imposed by a necrotic papilla remaining in situ or by sclerosis at the line of separation.Perhaps it is a matter of semantics, but -We are, etc.,
400 IDENTIFICATION OF AN AETIOLOGY-INDEPENDENT PANEL OF SERUM FIBROSIS MARKERS IN PATIENTS STAGED BY TRANSIENT ELASTOGRAPHY
Authors: F. Grünhage, J. Rädle, T. Rädle-Hurst, S. Weidner, T. Sauerbruch, G. Hess, F. Lammert
Journal: Journal of Hepatology (2010)
Imprinted genes as potential genetic and epigenetic toxicologic targets.
Authors: S K Murphy, R L Jirtle
Journal: Environmental Health Perspectives (2000)

Genomic imprinting is an epigenetic phenomenon in eutherian mammals that results in the differential expression of the paternally and maternally inherited alleles of a gene. Imprinted genes are necessary for normal mammalian development. This requirement has been proposed to have evolved because of an interparental genetic battle for the utilization of maternal resources during gestation and postnatally. The nonrandom requisite for monoallelic expression of a subset of genes has also resulted in the formation of susceptibility loci for neurobehavioral disorders, developmental disorders, and cancer. Since imprinting involves both cytosine methylation within CpG islands and changes in chromatin structure, imprinted genes are potential targets for dysregulation by epigenetic toxicants that modify DNA methylation and histone acetylation.
Thought for food
Authors: T. Delamothe
Journal: BMJ (2011)

Commodity speculation, not micronutrient deficiency, is today’s most pressing problem



I can easily visualise what the minimum recommended daily intake of food looks like: a few bowls of rice with side helping of greens and cabbage, an egg, a couple of handfuls of peanuts, a glass or two of milk. It doesn’t add up to much. Yet one billion of the world’s seven billion inhabitants can’t afford to buy this food—or cheaper equivalent amounts of protein, fats, and carbohydrates—each day.

Nevertheless, I’m having problems with the attention given to the “hidden hunger” of micronutrient deficiency, which afflicts an estimated two billion people ( BMJ 2011;342:d1086, doi:10.1136/bmj.d1086). The micronutrients in question—iron, iodine, and vitamin A—make up about 0.0005% by weight of the daily ration described above.

It’s not that I don’t believe in micronutrient deficiency—or in efforts to rectify it—it’s just that I think we should be concentrating on food you can see, and the absence thereof. In other words: take care of the big stuff and the small stuff will take care of itself. (And if the problem is, say, iron deficiency anaemia secondary to hookworm or …
Genetic polymorphism of cytochrome P450 as a biomarker of susceptibility to environmental toxicity.
Authors: J Y Hong, C S Yang
Journal: Environmental Health Perspectives (1997)

Cytochrome P450 (CYP) enzymes are responsible for the metabolism of numerous xenobiotics and endogenous compounds, including the metabolic activation of most environmental toxic chemicals and carcinogens. Both metabolic and genetic polymorphisms have been identified for human CYP enzymes. The association of CYP genetic polymorphism and human cancer risk, and susceptibility to environmental hazards, have received increasing attention. This article briefly reviews the approaches and methods currently used in CYP genetic polymorphism studies. In addition, the current status and perspectives of using CYP genetic polymorphism as a biomarker of individual susceptibility to cancer and environmental toxicity are discussed.
Novel Risk Factors for Systemic Atherosclerosis
Authors: Paul M. Ridker, Meir J. Stampfer, Nader Rifai
Journal: JAMA (2001)

ContextSeveral novel risk factors for atherosclerosis have recently been proposed, but few comparative data exist to guide clinical use of these emerging biomarkers.ObjectiveTo compare the predictive value of 11 lipid and nonlipid biomarkers as risk factors for development of symptomatic peripheral arterial disease (PAD).Design, Setting, and ParticipantsNested case-control study using plasma samples collected at baseline from a prospective cohort of 14 916 initially healthy US male physicians aged 40 to 84 years, of whom 140 subsequently developed symptomatic PAD (cases); 140 age- and smoking status–matched men who remained free of vascular disease during an average 9-year follow-up period were randomly selected as controls.Main Outcome MeasureIncident PAD, as determined by baseline total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol–HDL-C ratio, triglycerides, homocysteine, C-reactive protein (CRP), lipoprotein(a), fibrinogen, and apolipoproteins (apo) A-I and B-100.ResultsIn univariate analyses, plasma levels of total cholesterol (P&lt;.001), LDL-C (P = .001), triglycerides (P = .001), apo B-100 (P = .001), fibrinogen (P = .02), CRP (P = .006), and the total cholesterol–HDL-C ratio (P&lt;.001) were all significantly higher at baseline among men who subsequently developed PAD compared with those who did not, while levels of HDL-C (P = .009) and apo A-I (P = .05) were lower. Nonsignificant baseline elevations of lipoprotein(a) (P = .40) and homocysteine (P = .90) were observed. In multivariable analyses, the total cholesterol–HDL-C ratio was the strongest lipid predictor of risk (relative risk [RR] for those in the highest vs lowest quartile, 3.9; 95% confidence interval [CI], 1.7-8.6), while CRP was the strongest nonlipid predictor (RR for the highest vs lowest quartile, 2.8; 95% CI, 1.3-5.9). In assessing joint effects, addition of CRP to standard lipid screening significantly improved risk prediction models based on lipid screening alone (P&lt;.001).ConclusionsOf 11 atherothrombotic biomarkers assessed at baseline, the total cholesterol–HDL-C ratio and CRP were the strongest independent predictors of development of peripheral arterial disease. C-reactive protein provided additive prognostic information over standard lipid measures.
Scientific art for beginners
Authors: Livia Puljak
Journal: BMJ (2006)

Although these two groups of patients could benefit from the more conservative opt-in consent model, they represent a tiny minority of the patient population in England.Anecdotal evidence suggests the majority of patients are likely to prefer to have the NHS care record service established sooner rather than later and to leave the medical professionals free to spend time on those who have serious concerns about their medical information or their privacy.
Selective expression of latency-associated peptide (LAP) and IL-1 receptor type I/II (CD121a/CD121b) on activated human FOXP3+ regulatory T cells allows for their purification from expansion cultures
Authors: Dat Q. Tran, John Andersson, Donna Hardwick, Lolita Bebris, Gabor G. Illei, Ethan M. Shevach
Journal: Blood (2009)
Racket Sports
Authors: Paul F. Vinger, Daniel W. Tolpin
Journal: JAMA (1978)

Eighty-two injuries secondary to the racket sports were studied during a 15-month period. Ordinary glasses provided considerable protection in the play of tennis and badminton, but not in the play of squash and racquet ball. Plastic safety lenses (USA Standard Practice for Occupational and Educational Eye ,nd Face Protection, approved Sept 18, 1968 by the USA Standards Institute [ANSI Z87.1-1968]) mounted in a sturdy frame (industrial or athletic) or an eye protector are necessary for squash and racquet ball. Contact lenses provide no ocular protection. Males suffered more serious injuries than females, but injuries were not related to the age or experience of the players. Eye protection is recommended for the racket sports.
Which Medical Schools Produce Rural Physicians?
Authors: Roger A. Rosenblatt
Journal: JAMA (1992)

<h3>Objective.</h3> —To examine the hypothesis that medical schools vary systematically and predictably in the proportion of their graduates who enter rural practice. <h3>Design.</h3> —The December 1991 version of the American Medical Association Physician Masterfile was used to examine the rural and urban practice locations of physicians who graduated from American medical schools between 1976 and 1985. Selected characteristics of the medical schools—including location, ownership, and funding—were linked to the Physician Masterfile. <h3>Main Outcome Measures.</h3> —The percentage of the graduates from each medical school who were practicing in rural areas in December 1991, disaggregated by physician specialty. <h3>Results.</h3> —Of the practicing graduates from our study, 12.6% were located in rural counties; family physicians were much more likely than members of other specialties to select rural practice, particularly in the smallest and most isolated rural counties. Women were much less likely than men to enter rural practice. Medical schools varied greatly in the percentage of their graduates who entered rural practice, ranging from 41.2% to 2.3% of the graduating classes studied. Twelve medical schools accounted for over one quarter of the physicians entering rural practice in this time period. Four variables were strongly associated with a tendency to produce rural graduates: location in a rural state, public ownership, production of family physicians, and smaller amounts of funding from the National Institutes of Health. <h3>Discussion.</h3> —The organization, location, and mission of medical schools is closely related to the propensity of their graduates to select rural practice. Increasing policy coordination among medical schools and state and federal governmental entities would most effectively address residual problems of rural physician shortages. (<i>JAMA</i>. 1992;268:1559-1565)
Daily Mean Temperature and Clinical Kidney Stone Presentation in Five U.S. Metropolitan Areas: A Time-Series Analysis
Authors: Gregory E. Tasian, Jose E. Pulido, Antonio Gasparrini, Christopher S. Saigal, Benjamin P. Horton, J. Richard Landis, Rodger Madison, Ron Keren
Journal: Environmental Health Perspectives (2014)

Background: High ambient temperatures are a risk factor for nephrolithiasis, but the precise relationship between temperature and kidney stone presentation is unknown.Objectives: Our objective was to estimate associations between mean daily temperature and kidney stone presentation according to lag time and temperatures.Methods: Using a time-series design and distributed lag nonlinear models, we estimated the relative risk (RR) of kidney stone presentation associated with mean daily temperatures, including cumulative RR for a 20-day period, and RR for individual daily lags through 20 days. Our analysis used data from the MarketScan Commercial Claims database for 60,433 patients who sought medical evaluation or treatment of kidney stones from 2005–2011 in the U.S. cities of Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Los Angeles, California; and Philadelphia, Pennsylvania.Results: Associations between mean daily temperature and kidney stone presentation were not monotonic, and there was variation in the exposure–response curve shapes and the strength of associations at different temperatures. However, in most cases RRs increased for temperatures above the reference value of 10°C. The cumulative RR for a daily mean temperature of 30°C versus 10°C was 1.38 in Atlanta (95% CI: 1.07, 1.79), 1.37 in Chicago (95% CI: 1.07, 1.76), 1.36 in Dallas (95% CI: 1.10, 1.69), 1.11 in Los Angeles (95% CI: 0.73, 1.68), and 1.47 in Philadelphia (95% CI: 1.00, 2.17). Kidney stone presentations also were positively associated with temperatures &lt; 2°C in Atlanta, and &lt; 10°C in Chicago and Philadelphia. In four cities, the strongest association between kidney stone presentation and a daily mean temperature of 30°C versus 10°C was estimated for lags of ≤ 3 days.Conclusions: In general, kidney stone presentations increased with higher daily mean temperatures, with the strongest associations estimated for lags of only a few days. These findings further support an adverse effect of high temperatures on nephrolithiasis.Citation: Tasian GE, Pulido JE, Gasparrini A, Saigal CS, Horton BP, Landis JR, Madison R, Keren R, for the Urologic Diseases in America Project. 2014. Daily mean temperature and clinical kidney stone presentation in five U.S. metropolitan areas: a time-series analysis. Environ Health Perspect 122:1081–1087; http://dx.doi.org/10.1289/ehp.1307703
636 HBV SPECIFIC IMMUNE RESPONSES IN HBV TRANSGENIC MICE CAN STRONGLY BE ENHANCED BY IMMUNIZATION WITH DENDRITIC CELLS PULSED BY HBVSVP
Authors: M.M.S. Farrag, R. Tedjokusumo, C. Flechtenmacher, T. Asen, W. Stremmel, U. Protzer, K. Weigand
Journal: Journal of Hepatology (2010)
Hypersensitivity to bacteria in eczema.
Authors: W.E. PARISH, ESTHER WELBOURN, R.H. CHAMPION
Journal: British Journal of Dermatology (1976)

The sera of persons with generalized eczema (Whitfield-type) or with disseminated nummular eczema were examined for complement-activating antibacterial antibodies to test the hypothesis that some eczematous change results from an antibody-mediated cytotoxic reaction. Bacteria dying in the stratum corneum release soluble antigens, some of which diffuse into the stratum Malpighii and become firmly adsorbed to the epidermal cells. Antibacterial antibody and complement diffusing into the epidermis react with the antigens acquired by the cells and may induce vacuolation or lysis. Phenol-extracted and freeze-press-extracted antigens (both containing teichoic acids) from Staphylococcus aureus and a micrococcus (Baird-Parker types SI and MI respectively) are adsorbed by monolayers of human skin, embryo or amnion. Cells acquiring the antigen(s) are severely damaged when treated with sera containing the appropriate antibacterial antibodies and complement. IgM complement-fixing antibody appears to be much more cytotoxic in this test than IgG. The cytotoxic activity of a serum is specific for the acquired bacterial antigen and appears to depend on a sufficient concentration of the effective antibody, and not on the presence of antibodies with special properties. Explants of full thickness skin treated with bacterial antigen extracts were unharmed by the antibodies that were cytotoxic for monolayers of skin cells treated with the same antigens. The in vitro cytotoxic test should represent a potential in vivo cytotoxic phenomenon, because skin cell monolayers from two patients adsorbed bacterial antigen prepared from cultures obtained from the same patients, and were damaged by autologous serum containing anti-staphylococcal antibody and complement. It seems probable that this may be an aggravating but not necessarily an initiating factor in many cases of eczema.
Characterization of neurogenic inflammation in the airways of two highly inbred rat strains.
Authors: P R Germonpré, G F Joos, E Everaert, J C Kips, R A Pauwels
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Tachykinins released from sensory airway nerves have been shown to increase vascular permeability and plasma-protein extravasation (PPE) in rodent airways. We previously demonstrated that in Fisher (F344) rats, tachykinins cause bronchoconstriction mainly by indirect mechanisms involving the activation of NK1 receptor and mast cells, whereas in the less responsive BDE rats tachykinins have a direct NK2 receptor-mediated effect on bronchial smooth muscle. Using Evans blue dye as an intravascular marker, we demonstrated that F344 rats are hyperresponsive for the PPE induced by substance P (SP) and capsaicin. The NK1 receptor antagonist RP 67,580 reduced the neurogenic PPE in both strains, whereas the NK2 receptor antagonist SR 48,968 had no effect, indicating that only NK1 receptors are involved in the PPE. Pretreatment with the 5-HT antagonist methysergide decreased the neurogenic PPE in F344 rats but not in BDE rats. In F344 rats depleted of mast-cell mediators with compound 48/80, the SP-induced PPE was significantly reduced. Pretreatment with the H1 antagonist mepyramine and the H2 antagonist cimetidine caused a similar reduction in SP-induced PPE in main bronchi of both strains. Pretreatment with atropine, indomethacin, or the leukotriene antagonist ICI 198,615 did not affect the SP-induced PPE. In conclusion, neurogenic PPE in rat airways involves the activation of NK1 receptors. In F344 but not in BDE rats, an additional indirect mechanism involving 5-HT release and mast-cell activation participates in the neurogenic PPE.
Synergistic Effect of Vascular Endothelial Growth Factor and Basic Fibroblast Growth Factor on Angiogenesis In Vivo
Authors: Takayuki Asahara, Christophe Bauters, Lu P. Zheng, Satoshi Takeshita, Stuart Bunting, Napoleone Ferrara, James F. Symes, Jeffrey M. Isner
Journal: Circulation (1995)

Background Recent studies have suggested that vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) may have synergistic effects on the induction of angiogenesis in vitro. Therefore, we investigated the hypothesis that the simultaneous administration of VEGF and bFGF, each having been previously shown to independently enhance collateral development in an animal model of hind limb ischemia, could have a synergistic effect in vivo. Methods and Results Ten days after surgical induction of unilateral hind limb ischemia, New Zealand White rabbits were randomized to receive either VEGF 500 μg alone (n=6), bFGF 10 μg alone (n=7), VEGF 500 μg, immediately followed by 10 μg bFGF (n=7), or vehicle only (control animals, n=8) in each case administered intra-arterially via a catheter in the internal iliac artery of the ischemic limb. BP ratio (BPR, ischemic/healthy limb) at day 10 for the VEGF+bFGF group was 0.82±0.01, much superior ( P &lt;.0005) to that of either the VEGF group (0.52±0.02) or the bFGF group (0.57±0.02). This outcome persisted at day 30: BPR in the VEGF+bFGF group (0.91±0.02) exceeded that of the control group (0.49±0.05, P &lt;.0001), the VEGF group (0.65±0.03, P &lt;.0005), or the bFGF group (0.66±0.03, P &lt;.0005). Serial angiography demonstrated a progressive increase in luminal diameter of the stem collateral artery and the number of opacified collaterals in the thigh of the ischemic limbs in all groups. Stem artery diameter with VEGF+bFGF (1.34±0.07 mm) on day 30 was significantly ( P &lt;.05) greater than with either VEGF (1.09±0.09) or bFGF (1.18±0.06) alone. Capillary density was significantly greater ( P &lt;.05) in VEGF+bFGF animals (275±20 mm 2 ) compared with VEGF (201±8) or bFGF (209±15). Conclusions Combined administration of VEGF and bFGF stimulates significantly greater and more rapid augmentation of collateral circulation, resulting in superior hemodynamic improvement compared with either VEGF or bFGF alone. This synergism of two angiogenic mitogens with different target cell specificities may have important implications for the treatment of severe arterial insufficiency in patients whose disease is not amenable to direct revascularization.
Podiatry and the sports physician--an evaluation of orthoses.
Authors: P. N. Sperryn, L. Restan
Journal: British Journal of Sports Medicine (1983)

Fifty athletes with resistant symptoms, were jointly assessed by physician and podiatrist. Commonest symptoms were foot pains (38%), anterior knee pain (34%), ankle pains including chronic sprains (30%) and Achilles pain (16%). Simple clinical examinations were made for gait pattern, in which overpronation was specifically noted in 46%, posture, leg length and configuration, rearfoot and forefoot alignment. The commonest abnormalities were calcaneal inversion (varus) in 42%, forefoot malalignment (varus 24%, valgus 14%), tibial varus (12%) and leg length discrepancies (16%). Individually casted orthotic corrections were made using rigid (60%) or soft (32%) orthoses, both (6%) or a simple shoe-raise (2%). Results up to 3 1/2 years' follow-up show symptom relief in 56% and improvement in 8%. No change was reported in 14%, while 6% could not tolerate appliances and 16% were lost to follow-up. 54% were still using orthoses, 26% had abandoned them and 20% were lost to follow-up. Orthoses now cost up to pounds 90 stg. in UK. If only about two thirds of patients benefit from them and half continue their long term use, critical selection of cases is required in both clinical and economic grounds.