tbuckley/cabot-search huggingface dataset:
Childhood secondary ALL after ALL treatment
Authors: J Zuna, H Cavé, C Eckert, T Szczepanski, C Meyer, E Mejstrikova, E Fronkova, K Muzikova, E Clappier, D Mendelova, P Boutard, A Schrauder, J Sterba, R Marschalek, J J M van Dongen, O Hrusak, J Stary, J Trka
Journal: Leukemia (2007)
The effect of cimetidine on hepatic drug elimination in cirrhosis
Authors: Donald C. Nelson, George R. Avant, K. Vincent Speeg, Anastacio M. Hoyumpa, Steven Schenker
Journal: Hepatology (1985)

Both cimetidine therapy and cirrhosis individually interfere with normal elimination of various drugs. Cimetidine is often prescribed in patients with cirrhosis but there is incomplete data on its effect on drug elimination in cirrhotics. The purpose of this study was to address this issue. Eight stable cirrhotics were studied prior to and following 7 days of cimetidine administration, (300 mg orally q.i.d.). Chlordiazepoxide (Librium®), which is eliminated by the liver after demethylation, and indocyanine green, which is removed by the liver without biotransformation, were used as probes. Consistent with the concept that cimetidine interferes with drug metabolism by inhibiting microsomal oxidation, chlordiazepoxide clearance in the cirrhotics was inhibited by cimetidine (p < 0.05), but indocyanine green clearance was unaffected. As shown by us previously (Roberts, R. K. et al., Gastroenterology 1978; 75:479–485), untreated cirrhotics had substantially lower chlordiazepoxide clearance than did controls. The inhibitory effect of cimetidine on chlordiazepoxide clearance was less in cirrhotics than in controls (p < 0.05). In all subjects, there was excellent correlation between initial clearance and magnitude of depression in clearance after cimetidine, i.e., the larger the initial clearance, the larger the change (r = 0.97, p < 0.0001). Forty-eight hours after stopping cimetidine, chlordiazepoxide clearance returned to baseline in cirrhotics and controls. Our data demonstrate that cimetidine and cirrhosis may act additively to impair drug metabolism. This effect of cimetidine on chlordiazepoxide clearance is smaller in cirrhotics than in controls, but, because of impaired initial drug elimination in cirrhosis, it may result in adverse clinical effects.
Patient-Controlled Analgesia
Authors: Todd C. Grey
Journal: JAMA (1988)

<h3>To the Editor.</h3> —In a recent article about the use of patient-controlled analgesia (PCA), Dr White<sup>1</sup>failed to mention a serious potential complication of this technology: accidental massive overdosage. The State of Utah Office of the Medical Examiner has investigated a case in which a previously healthy middle-aged woman was receiving meperidine via a PCA after uncomplicated elective surgery. The patient was discovered approximately 20 minutes after beginning PCA therapy, apneic and pulseless, with 49.5 mL of the original 60 mL of meperidine solution (10 mg/mL) missing from the PCA device. The patient was resuscitated but remained comatose until her death five days later. Toxicological analysis of blood samples drawn at the time of resuscitation revealed a meperidine level of 4.2 μg/mL, well within the fatal range of 1 to 8 μg/mL.<sup>2</sup>Autopsy revealed cerebral anoxic changes and recent surgery, with no other pathological abnormalities. The PCA device
Dynamic Proteome Changes of <i>Shigella Flexneri</i> 2a During Transition from Exponential Growth to Stationary Phase
Authors: Li Zhu, Xian-Kai Liu, Ge Zhao, Yi-Dan Zhi, Xin Bu, Tian-Yi Ying, Er-Ling Feng, Jie Wang, Xue-Min Zhang, Pei-Tang Huang, Heng-Liang Wang
Journal: Genomics Proteomics & Bioinformatics (2007)

Abstract Shigella flexneri is an infectious pathogen that causes dysentery to human, which remains a serious threat to public health, particularly in developing countries. In this study, the global protein expression patterns of S. flexneri during transition from exponential growth to stationary phase in vitro were analyzed by using 2-D PAGE combined with MALDI-TOF MS. In a time-course experiment with five time points, the relative abundance of 49 protein spots varied significantly. Interestingly, a putative outer membrane protein YciD (OmpW) was almost not detected in the exponential growth phase but became one of the most abundant proteins in the whole stationary-phase proteome. Some proteins regulated by the global regulator FNR were also significantly induced (such as AnsB, AspA, FrdAB, and KatG) or repressed (such as AceEF, OmpX, SodA, and SucAB) during the growth phase transition. These proteins may be the key effectors of the bacterial cell cycle or play important roles in the cellular maintenance and stress responses. Our expression profile data provide valuable information for the study of bacterial physiology and form the basis for future proteomic analyses of this pathogen.
NUCLEIC ACID SYNTHESIS IN TYPES 4 AND 5 ADENOVIRUS-INFECTED H<scp>E</scp>L<scp>A</scp> CELLS
Authors: Harold S. Ginsberg, Mary K. Dixon
Journal: The Journal of Experimental Medicine (1961)

Type 4 adenovirus infection of HeLa cells effected a marked increase in synthesis of the saline-soluble DNA fraction, but not the host-cell DNA (the water-soluble fraction). This was demonstrated by the marked increase in specific activity of saline-soluble DNA but not water-soluble DNA when P(32)-inorganic phosphate or sodium formate-C(14) was employed. When these isotopes were used to label cells before viral infection rather than during the process of viral propagation, the saline-soluble DNA from infected cells had a specific activity of 10 to 20 per cent less than that of uninfected cells, indicating that the saline-soluble DNA was synthesized both from prelabeled precursors of the cell pools and unlabeled materials from the medium. Saline-soluble DNA began to increase between 10 to 12 hours after viral infection and 3 to 4 hours before appearance of newly propagated infectious virus. The specific activity of the acid-soluble pool of infected cells also increased between 10 to 12 hours after viral inoculation when sodium formate-C(14) was used as a radioisotope. When P(32)-inorganic phosphate was utilized, the specific activity of infected-cell RNA was increased approximately the same relative amount as when total RNA was determined chemically; i.e., 30 to 40 per cent. With type 5 adenovirus, not only did a 3- to 5-fold increase in saline-soluble DNA occur, but also an increase was measured in specific activity of RNA when P(32)-inorganic phosphate was used.
Immunoglobulin M-to-Immunoglobulin G Anti-Human Leukocyte Antigen Class II Antibody Switching in Cardiac Transplant Recipients Is Associated With an Increased Risk of Cellular Rejection and Coronary Artery Disease
Authors: Katherine Lietz, Ranjit John, Elizabeth Burke, Michael Schuster, Tyson B. Rogers, Nicole Suciu-Foca, Donna Mancini, Silviu Itescu
Journal: Circulation (2005)

Activation of T cells induces immunoglobulin (Ig)M-to-IgG B-cell isotype switching via costimulatory regulatory pathways. Because rejection of transplanted organs is preceded by alloantigen-dependent T-cell activation, we investigated whether B-cell isotype switching could predict acute cellular rejection and the subsequent development of transplantation-related coronary artery disease (TCAD) in cardiac transplant recipients.Among 267 nonsensitized heart transplant recipients, switching from IgM to IgG anti-human leukocyte antigens (HLA) antibodies directed against class II but not against class I antigens was associated with a shorter duration to high-grade rejection, defined as International Society for Heart and Lung Transplantation grade 3A or higher (P<0.001), a higher cumulative rejection frequency (P=0.002), accelerated development of TCAD (P=0.04), and decreased late survival (P=0.03). Conversely, the persistence of IgM anti-HLA antibodies against class II but not against class I antigens for >30 days and the lack of IgG isotype switching were associated with protection against both acute rejection (P=0.02) and TCAD (P=0.05). Alloisotype switching coincided with T-cell activation, as evidenced by increased serum levels of soluble CD40 ligand costimulatory molecules. Finally, a case-control study showed that reduction of cardiac allograft rejection by mycophenolic acid was accompanied by reduced CD40 ligand serum levels and the prevention of IgM-to-IgG anti-HLA class II antibody switching.T-cell-dependent B-cell isotype switching and the consequent production of IgG anti-HLA class II antibodies are strongly correlated with acute cellular rejection, a high incidence of recurrent rejections, TCAD, and poor long-term survival. Detecting this isotype switch is a clinically useful surrogate marker for in vivo T-cell activation and may provide a noninvasive approach for monitoring the efficacy of T-cell targeted immunosuppressive therapy in heart transplant recipients.
THE KOCH TREATMENT COMBINED WITH SURGICAL PROCEDURES.From the Surgical Department of the Moabit City Hospital, Berlin.
Authors: None SONNENBURG
Journal: JAMA (1891)

ARTICLE II.—THE SURGICAL PROCEDURES AS APPLIED TO TUBERCULOSIS OF THE GLANDS, BONES AND JOINTS. Surgeons naturally seem to be of different opinions as to the procedures which are indicated in surgery of tuberculous bones, joints and glands, when they have been subjected to the Koch treatment. I will attempt in the following, with the help of a few specially selected cases, to outline our principles in the treatment of such patients. First of all, it is absolutely necessary to have a perfect understanding of the action of the remedy, for numerous complications often arise during the course of the treatment which have the greatest influence upon the temperature curve as well as upon the wound conditions. The fever curve indicates exactly whether or not the action of the Koch remedy is free from contemporaneous influence. When the temperature rises rapidly after the injection and on the following day the fever
Sensitivity of Spirometric Measurements to Detect Airway Obstruction in Infants
Authors: Marcus H. Jones, John Howard, Stephanie Davis, Jeff Kisling, Robert S. Tepper
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

We evaluated the ability of forced expiratory flow volume curves from raised lung volumes to assess airway function among infants with differing severities of respiratory symptoms. Group 1 (n = 33) had previous respiratory symptoms but were currently asymptomatic; group 2 (n = 36) was symptomatic at the time of evaluation. As a control group, we used our previously published sample of 155 healthy infants. Flow volume curves were quantified by FVC, FEF50, FEF75, FEF25-75, FEV0.5, and FEV0.5/FVC, which were expressed as Z scores. All variables except FVC had Z scores that were significantly less than zero and distinguished groups 1 and 2 with progressively lower Z scores. The mean Z scores of the flow variables (FEF50%, FEF75%, and FEF25-75%) were more negative than the Z scores for the timed expired volumes (FEV0.5 or FEV0.5/FVC) for both groups. In general, measures of flow identified a greater number of infants with abnormal lung function than measures of timed volume; FEF50 had the highest performance in detecting abnormal lung function. In summary, forced expiratory maneuvers obtained by the raised volume rapid compression technique can discriminate among groups of infants with differing severity of respiratory symptoms, and measures of forced expiratory flows were better than timed expiratory volume in detecting abnormal airway function.
Reply to Baudet et al.
Authors: K. Tominaga, F. Shigiyama, S. Ito, T. Iida, S. Fujinuma, I. Maetani
Journal: Endoscopy (2008)

We would like to thank Baudet et al. for their interest in our case report describing ”cat scratch” lesions [1]. Red linear marks or parallel corkscrew lesions have been observed in the right side of the colon [2] [3]. These endoscopic findings are considered to be the early appearance of mucosal injury without perforation resulting from barotrauma [3]. The article by McDonnell et al. highlighted to us the importance of these endoscopic findings [4]. McDonnell et al. reported a higher proportion of collagenous colitis in patients with cat scratch colon [4]. Furthermore, in patients with collagenous colitis, mucosal tears or lacerations following endoscopic air insufflation have been considered to be mucosal injury resulting from decreased compliance of the collagen-containing mucosa [5] [6] [7]. Yarze suggested these injuries were the result of barotrauma [8]. Similar findings have also been observed in patients with diversion colitis, with or without ulcerative colitis [9] [10].
Sunburn and melanoma: how strong is the evidence?
Authors: R Marks, D Whiteman
Journal: BMJ (1994)

Melanoma - both its incidence and its mortality - has been increasing in many populations around the world recently.1 Even higher rates have been predicted as a result of the depletion of stratospheric ozone.2 Many agencies around the world are now developing programmes to prevent melanoma in the future. For example, the control of skin cancer (including melanoma) is included as one of the targets in the Health of the Nation.3

Preventing disease relies on knowing both its cause and practical and cheap ways of either avoiding the cause or blocking its effect. Most people attribute the rising incidence of melanoma to social and behavioural changes this century that have resulted in increased exposure to sunlight.4 The fashion for a suntan, associated with increasing public acceptance of decreasing proportions of the body being covered while outdoors, has led to large numbers of people being exposed to sufficient sunlight to cause sunburn during leisure hours.5

Exposures sufficient to cause sunburn, particularly in childhood, have been targeted by most educational programmes as the main changeable component in the process that leads to …
American Indian Medicine
Authors: John W. Huffman
Journal: JAMA (1970)

The drama of the invasion, conquest, and settlement of the Americas and the tragedy of the subjugation, displacement, and decimation of the American Indians has obscured the fact that we have borrowed many things from them. It is an accepted reality that a conqueror imposes his culture on the conquered. However, it is also true that counter-acculturation almost invariably occurs; as a result the conqueror absorbs part of the culture of those he subjugated. The author has done a masterful job of shining new light on one facet of the problem, namely, the contribution the Indians made to modern medicine. He also has provided a basis for a new appraisal of the counter-acculturation process in North America. The book is much more than a monograph on the anthropological aspects of culture diffusion. It is a well and interestingly written essay on the medical aspects of Indian history, folklore, pharmacology, and
The advanced glycation end product Nepsilon-(carboxymethyl)lysine is increased in serum from children and adolescents with type 1 diabetes.
Authors: T J Berg, J T Clausen, P A Torjesen, K Dahl-Jørgensen, H J Bangstad, K F Hanssen
Journal: Diabetes Care (1998)

OBJECTIVE: To investigate whether children and adolescents with type 1 diabetes have increased serum levels of the glycoxidation product Nepsilon-(carboxymethyl)lysine (CML) at an early stage of the disease. RESEARCH DESIGN AND METHODS: The serum levels of CML in 38 patients with type 1 diabetes aged 14+/-3.2 (mean+/-SD) years were compared with those in 26 control subjects aged 16+/-1.7 years. The mean duration of diabetes was 5+/-4.7 years, ranging from 0.5 to 15 years. The mean levels of HbA1c were 10.3+/-2.5% in the patient group. The serum levels of CML were measured using a monoclonal anti-CML antibody in a fluoremetric immunoassay. Serum protein levels of advanced glycation end products (AGEs) were assayed using a polyclonal antibody from rabbit immunized with AGE-RNase (pAGE). RESULTS: The serum levels of CML and pAGE were significantly increased in the patient group versus the control group: 1.08 (0.45-2.97) U/ml CML (median 10-90 percentiles) vs. 0.70 (0.36-1.79) U/ml CML, P &amp;lt; 0.03, and 6.6 (5.1-9.9) U/ml pAGE vs. 5.5 (3.7-8.2) U/ml AGEs, P &amp;lt; 0.01. A significant relationship between CML and pAGE was found in the IDDM group, r = 0.76, P &amp;lt; 0.001. The CML levels were not associated with the HbAlc levels (n = 23, r = -0.02, NS), cholesterol levels (n = 21, r = 0.07, NS), age, sex, or diabetes duration. CONCLUSIONS: Serum levels of CML are increased in patients with type 1 diabetes. This increase precedes the development of micro- and macrovascular complications.
Recurrent erythema multiforme: clinical features and treatment in a large series of patients
Authors: J.K. SCHOFIELD, F.M. TATNALL, I.M. LEIGH
Journal: British Journal of Dermatology (1993)

Recurrent erythema multiforme is an uncommon disorder. We have reviewed the clinical features and treatment of 65 patients with this condition. The mean number of attacks per year was six (range 2-24), and the mean duration of the disease was 9.5 years (range 2-36) reflecting its chronicity. The majority of patients had oral mucous membrane involvement (69%). In 46 patients (71%) the condition was precipitated by a preceding herpes simplex virus infection. Acyclovir was found to be the most useful first-line treatment, with 55% of patients deriving benefit from either continuous oral acyclovir or a patient-initiated 5-day oral course at the onset of herpes simplex virus infection. Of those failing to respond to acyclovir, a small proportion responded to dapsone. The most resistant patients (11) were treated with azathioprine, with complete disease suppression in all cases.
Effectiveness of continuous glucose monitoring in pregnant women with diabetes: randomised clinical trial
Authors: H. R Murphy, G. Rayman, K. Lewis, S. Kelly, B. Johal, K. Duffield, D. Fowler, P. J Campbell, R. C Temple
Journal: BMJ (2008)

<b>Objective</b> To evaluate the effectiveness of continuous glucose monitoring during pregnancy on maternal glycaemic control, infant birth weight, and risk of macrosomia in women with type 1 and type 2 diabetes. <b>Design</b> Prospective, open label randomised controlled trial. <b>Setting</b> Two secondary care multidisciplinary obstetric clinics for diabetes in the United Kingdom. <b>Participants</b> 71 women with type 1 diabetes (n=46) or type 2 diabetes (n=25) allocated to antenatal care plus continuous glucose monitoring (n=38) or to standard antenatal care (n=33). <b>Intervention</b> Continuous glucose monitoring was used as an educational tool to inform shared decision making and future therapeutic changes at intervals of 4-6 weeks during pregnancy. All other aspects of antenatal care were equal between the groups. <b>Main outcome measures</b> The primary outcome was maternal glycaemic control during the second and third trimesters from measurements of HbA<sub>1c</sub> levels every four weeks. Secondary outcomes were birth weight and risk of macrosomia using birthweight standard deviation scores and customised birthweight centiles. Statistical analyses were done on an intention to treat basis. <b>Results</b> Women randomised to continuous glucose monitoring had lower mean HbA<sub>1c</sub> levels from 32 to 36 weeks' gestation compared with women randomised to standard antenatal care: 5.8% (SD 0.6) <i>v</i> 6.4% (SD 0.7). Compared with infants of mothers in the control arm those of mothers in the intervention arm had decreased mean birthweight standard deviation scores (0.9 <i>v</i> 1.6; effect size 0.7 SD, 95% confidence interval 0.0 to 1.3), decreased median customised birthweight centiles (69% <i>v</i> 93%), and a reduced risk of macrosomia (odds ratio 0.36, 95% confidence interval 0.13 to 0.98). <b>Conclusion</b> Continuous glucose monitoring during pregnancy is associated with improved glycaemic control in the third trimester, lower birth weight, and reduced risk of macrosomia. <b>Trial registration</b> Current Controlled Trials ISRCTN84461581.
Electrocardiography In Athletes
Authors: George A. Sheehan
Journal: JAMA (1973)

<h3>To the Editor.—</h3> Few professionals in medical care will be dissuaded from routine electrocardiography of athletes by Dr. Gordon Cumming's argument that it is unrealistic both by cost benefit and subject benefit criteria. We physicians know that no decisions today are based on costs or benefit to the patient. In an affluent society, where health is concerned, there can be no economy. I would like to suggest what I consider a more compelling argument against routine electrocardiography— harm to the athlete, the harm specifically being disqualification from sports for alarming, but innocuous variants on the electrocardiogram. This past year I had occasion to review the ECGs of an entire pro football squad. At least 10% of the tracings would have been judged as pathological by inexperienced readers and perhaps even veteran readers not cognizant that such changes can be normal in athletes. One player had previously been subjected to coronary
Does This Patient Have Abdominal Aortic Aneurysm?
Authors: Frank A. Lederle
Journal: JAMA (1999)

In the physical examination of abdominal aortic aneurysm (AAA), the only maneuver of demonstrated value is abdominal palpation to detect abnormal widening of the aortic pulsation. Palpation of AAA appears to be safe and has not been reported to precipitate rupture. The best evidence on the accuracy of abdominal palpation comes from 15 studies of patients not previously known to have AAA who were screened with both abdominal palpation and ultrasound. When results from these studies are pooled, the sensitivity of abdominal palpation increases significantly with AAA diameter (P<.001), ranging from 29% for AAAs of 3.0 to 3.9 cm to 50% for AAAs of 4.0 to 4.9 cm and 76% for AAAs of 5.0 cm or greater. Positive and negative likelihood ratios with 95% confidence intervals (CIs) using a cutoff point for AAAs of 3.0 cm or greater are 12.0 (95% CI, 7.4-19.5) and 0.72 (95% CI, 0.65-0.81), respectively, and for AAAs of 4.0 cm or greater are 15.6 (95% CI, 8.6-28.5) and 0.51 (95% CI, 0.38-0.67). The positive predictive value of palpation for AAA of 3.0 cm or greater in these studies was 43%. Limited data suggest that abdominal obesity decreases the sensitivity of palpation. Abdominal palpation specifically directed at measuring aortic width has moderate sensitivity for detecting an AAA that would be large enough to be referred for surgery but cannot be relied on to exclude AAA, especially if rupture is a possibility.