tbuckley/cabot-search huggingface dataset:
PWE-011 Diagnosing Abdominal Tuberculosis In The Acute Abdomen
Authors: KA Burke, K Thiruppathy, A Patel, A Jayaratnam, S Snooks
Journal: Gut (2014)

<h3>Introduction</h3> Despite recent improvements in medical treatments, the incidence of abdominal tuberculosis (ATB) in the United Kingdom has increased over the past two decades. This case series examined the difficulties encountered in correctly diagnosing this infection. <h3>Methods</h3> A retrospective study was undertaken, reviewing the records of 36 patients diagnosed with ATB from 2000 to 2012 at a district general hospital in outer East London. <h3>Results</h3> The commonest presenting feature was abdominal pain in 67 (%) of patients, and the most common sites of infection were the iliocaecal junction and peritoneum, seen in 36.1 (%) and 33.3 (%) respectively. Six patients were initially investigated for Crohn’s disease and one for ileitis. The highest disease prevalence was seen in patients born in India and Pakistan, which was 27.8 (%) and 19. 4(%) of patients respectively. Colonoscopy was performed in nine patients, and three of these reported normal findings. The other six reported visible non-specific inflammatory changes. Three patients had abdominal x-rays reported and one patient had an abdominal ultrasound, all of which were normal. An abdominal computerised topography (CT) scan was performed in 26 patients and a chest CT was undertaken in 19 patients. Varying degrees of inflammatory changes were seen in all of the patients who had CT scans. Microbiological culture was positive for mycobacterium tuberculosis or acid-fast bacilli in 71(%) of patients. <h3>Conclusion</h3> Abdominal tuberculosis can be very difficult to diagnose as symptoms are non-specific and can mimic other types of granulomatous inflammatory bowel diseases. Radiology appears largely unhelpful due to the non-specificity of any positive imaging findings, and there is a lack of diagnostic procedural and microbiological tests with high specificity and sensitivity. In view of the increasing incidence of tuberculosis in the United Kingdom, there should be a high index of suspicion for ATB in individuals from high-incidence countries who present with non-specific abdominal symptoms. <h3>References</h3> Uzunkoy A, Harma M, Harma M. Diagnosis of abdominal tuberculosis: Experience from 11 cases and review of the literature. <i>World Journal of Gastroenterology</i> 2004;10(24):3547–3549 Rai S, Thomas W M Diagnosis of abdominal tuberculosis: the importance of laparoscopy.<i> Journal of the Royal Society of Medicine</i> 2003;96:586–588 National Institute for Health and Clinical Excellence Tuberculosis. Clinical diagnosis and management of tuberculosis, and measures for its prevention and control. NICE clinical guideline 2011;117 <h3>Disclosure of Interest</h3> None Declared.
Connexin Expression in Renin-Producing Cells
Authors: Lisa Kurtz, Ulrike Janssen-Bienhold, Armin Kurtz, Charlotte Wagner
Journal: Journal of the American Society of Nephrology (2008)

Absence of connexin 40 (Cx40) leads to ectopic juxtaglomerular renin expression and abrogates recruitment of renin-expressing cells in the adult kidney but does not disturb renin expression during kidney development. To find an explanation for these observations, we aimed to analyze the expression pattern of major vascular Cxs in normal juxtaglomerular epithelioid cells, in recruited renin-expressing cells, and in fetal renin-expressing cells. We found that during kidney development, the appearance of renin-producing cells paralleled the expression of Cx40 and, to a lesser extent, Cx45 but not other Cxs. In the adult kidney, juxtaglomerular epithelioid cells expressed Cx40 and lesser amounts of Cx37 and Cx43 but not Cx45, which localized to arteriolar smooth muscle cells. Recruitment of renin-producing cells in adult kidneys in response to long-term salt deprivation of mice correlated with the reappearance of only Cx40. Cx40-null renin-producing cells did not express Cx37, Cx43, or Cx45. These findings suggest that Cx40 expression is a characteristic of renin-producing cells in the kidney, and it seems to be essential in the recruitment of renin-producing cells in the adult but not the fetal kidney.
Continuous Aortic Flow Augmentation
Authors: Leslie W. Miller
Journal: Circulation (2008)

Circulation details the results of the randomized clinical trial known as the Multicenter trial of the Orqis Medical Cancion system for the ENhanced Treatment of heart failure Unresponsive to Medical therapy (MOMENTUM).The Orqis device is a new entry into the field of temporary mechanical circulatory support for severe heart failure.The authors point to the growing number of patients with this condition and the very high in-hospital and short-term mortalities that are typically associated with conventional medical or surgical therapy.Thus, new simple methods of providing temporary circulatory support to allow identification of individuals with reversible dysfunction to improve, while adequately supporting the circulation to prevent multiorgan failure and the high likelihood of death in those without improvement in cardiac function, would be a significant advance in management of this population.
Successful treatment of post-influenza pseudomembranous necrotising bronchial aspergillosis with liposomal amphotericin, inhaled amphotericin B, gamma interferon and GM-CSF
Authors: R J Boots, D L Paterson, A M Allworth, J L Faoagali
Journal: Thorax (1999)

A case of aspergillus tracheobronchitis following influenza A infection in an immunocompetent 35 year old woman is described that required prolonged mechanical ventilation for airways obstruction. Treatment included liposomal amphotericin, inhaled amphotericin, gamma interferon and GM-CSF. Liposomal amphotericin therapy was associated with reversible hepatosplenomegaly. Inhaled corticosteroids with continued antifungal therapy were used for the management of severe recurrent airway obstruction. After a prolonged course of treatment she survived with fixed airways obstruction unresponsive to corticosteroids.
Effect of terbutaline on hyperpnoea-induced bronchoconstriction and urinary Clara cell protein release in athletes
Authors: Andrew Simpson, Ellen Tufvesson, Sandra Anderson, Lee Romer, Leif Bjermer, Pascale Kippelen
Journal: European Respiratory Journal (2013)

Repeated injury of the airway epithelium caused by hyperpnoea of poorly conditioned air has been proposed as a key factor in the pathogenesis of exercise-induced bronchoconstriction (EIB) in athletes. In animals, the short-acting β2-agonist terbutaline has been shown to reduce dry airflow-induced bronchoconstriction and shedding of the airway epithelial cells. Our aim was to test the efficacy of terbutaline in attenuating hyperpnoea-induced bronchoconstriction and airway epithelial injury in athletes. Twenty-three recreational athletes with EIB participated in a randomised, double-blind, placebo controlled, cross-over study. Athletes completed an 8 min eucapnic voluntary hyperpnoea (EVH) test with dry air on two separate days 15 min after inhaling 0.5 mg terbutaline or a placebo. Forced expiratory volume in 1 sec (FEV1) and urinary concentration of the Clara cell protein CC16 (a marker of airway epithelial stress) were measured before and for up to 60 min after EVH. The maximum fall in FEV1 of 18 ± 8% (SD) on placebo was reduced to 8 ± 5% following terbutaline (P<0.001). Terbutaline gave bronchoprotection (i.e., post-EVH FEV1 fall <10%) to 18 (83%) athletes. EVH caused an increase in urinary excretion of CC16 in both conditions (P<0.001), and terbutaline significantly reduced this rise (delta pre- to post-challenge CC16 increase 416 ± 495 ρg·mmol creatinine-1 after placebo vs 315 ± 523 ρg·mmol creatinine-1 after terbutaline, P=0.016). The results suggest that inhalation of a single therapeutic dose of terbutaline offers significant protection against hyperpnoea-induced bronchoconstriction and may attenuate acute airway epithelial stress in athletes.
Cerebral palsy and intrauterine growth in single births: European collaborative study
Authors: Stephen Jarvis, Svetlana V Glinianaia, Maria-Giulia Torrioli, Mary-Jane Platt, Maria Miceli, Pierre-Simon Jouk, Ann Johnson, Jane Hutton, Karla Hemming, Gudrun Hagberg, Helen Dolk, James Chalmers
Journal: The Lancet (2003)
ON CERTAIN SPONTANEOUS CHICKEN TUMORS AS MANIFESTATIONS OF A SINGLE DISEASE
Authors: Linda B. Lange
Journal: The Journal of Experimental Medicine (1914)

The forty-third spontaneous chicken tumor received at this laboratory strikingly resembles the first and has given rise on transplantation to an entirely similar series of neoplasms. Tumors of both strains are due to a filterable agent which remains active in the dried or glycerinated tissue.
Body Fatness and Fat Distribution as Predictors of Metabolic Abnormalities and Early Carotid Atherosclerosis
Authors: Rieko Takami, Noriyuki Takeda, Makoto Hayashi, Akihiko Sasaki, Shinichi Kawachi, Koji Yoshino, Kazuhisa Takami, Kazuya Nakashima, Akifumi Akai, Noriyoshi Yamakita, Keigo Yasuda
Journal: Diabetes Care (2001)

To test the hypothesis that intra-abdominal fat plays a primary role over general adiposity for metabolic abnormalities and atherosclerosis.We cross-sectionally studied 849 Japanese men aged 50.3 +/- 8.5 years (range 20-78) with BMI 23.5 +/- 2.9 kg/m(2). Intimal-medial thickness (IMT) of the carotid artery was measured by ultrasound. General adiposity was assessed by BMI. Waist circumference and waist-to-hip ratio (WHR) were used as a surrogate measure for abdominal fat. Abdominal subcutaneous fat area (ASF) and intra-abdominal fat area (IAF) were measured by computed tomography. Correlations between these measures and carotid IMT were analyzed. The interaction of generalized adiposity (BMI) and IAF in relation to metabolic variables, such as glucose tolerance, insulin resistance, and serum lipids, was also evaluated.BMI, waist circumference, WHR, ASF, and IAF were all correlated with carotid IMT. Adjustment for BMI eliminated the associations between IMT and waist circumference, ASF, and IAF. In contrast, WHR retained a significant correlation with IMT. BMI and IAF were associated with insulin resistance, glucose tolerance, HDL cholesterol, and blood pressure independently of each other. IAF was an independent correlate for serum triglyceride, but BMI was not.The primary importance of IAF over general adiposity for carotid atherosclerosis was not confirmed. Caution is recommended when using WHR as a measure of abdominal fat. The roles of IAF for metabolic abnormalities may be more limited than conventionally thought. BMI and WHR are simple and better clinical predictors for carotid atherosclerosis versus IAF.
Naturally processed viral peptides recognized by cytotoxic T lymphocytes on cells chronically infected by human immunodeficiency virus type 1.
Authors: T J Tsomides, A Aldovini, R P Johnson, B D Walker, R A Young, H N Eisen
Journal: The Journal of Experimental Medicine (1994)

We have established long-term cultures of several cell lines stably and uniformly expressing human immunodeficiency virus type 1 (HIV-1) in order to (a) identify naturally processed HIV-1 peptides recognized by cytotoxic T lymphocytes (CTL) from HIV-1-seropositive individuals and (b) consider the hypothesis that naturally occurring epitope densities on HIV-infected cells may limit their lysis by CTL. Each of two A2-restricted CD8+ CTL specific for HIV-1 gag or reverse transcriptase (RT) recognized a single naturally processed HIV-1 peptide in trifluoroacetic acid (TFA) extracts of infected cells: gag 77-85 (SLYNTVATL) or RT 476-484 (ILKEPVHGV). Both processed peptides match the synthetic peptides that are optimally active in cytotoxicity assays and have the consensus motif described for A2-associated peptides. Their abundances were approximately 400 and approximately 12 molecules per infected Jurkat-A2 cell, respectively. Other synthetic HIV-1 peptides active at subnanomolar concentrations were not present in infected cells. Except for the antigen processing mutant line T2, HIV-infected HLA-A2+ cell lines were specifically lysed by both A2-restricted CTL, although infected Jurkat-A2 cells were lysed more poorly by RT-specific CTL than by gag-specific CTL, suggesting that low cell surface density of a natural peptide may limit the effectiveness of some HIV-specific CTL despite their vigorous activity against synthetic peptide-treated target cells.
Selective inhibition of the p38 alternative activation pathway in infiltrating T cells inhibits pancreatic cancer progression
Authors: Muhammad S Alam, Matthias M Gaida, Frank Bergmann, Felix Lasitschka, Thomas Giese, Nathalia A Giese, Thilo Hackert, Ulf Hinz, S Perwez Hussain, Serguei V Kozlov, Jonathan D Ashwell
Journal: Nature Medicine (2015)
Artificial Selection on Brain-Expressed Genes during the Domestication of Dog
Authors: Yan Li, Bridgett M. vonHoldt, Andy Reynolds, Adam R. Boyko, Robert K. Wayne, Dong-Dong Wu, Ya-Ping Zhang
Journal: Molecular Biology and Evolution (2013)

Domesticated dogs have many unique behaviors not found in gray wolves that have augmented their interaction and communication with humans. The genetic basis of such unique behaviors in dogs remains poorly understood. We found that genes within regions highly differentiated between outbred Chinese native dogs (CNs) and wolves show high bias for expression localized to brain tissues, particularly the prefrontal cortex, a specific region responsible for complex cognitive behaviors. In contrast, candidate genes showing high population differentiation between CNs and German Shepherd dogs (GSs) did not demonstrate significant expression bias. These observations indicate that these candidate genes highly expressed in the brain have rapidly evolved. This rapid evolution was probably driven by artificial selection during the primary transition from wolves to ancient dogs and was consistent with the evolution of dog-specific characteristics, such as behavior transformation, for thousands of years.
CLOSE GENETIC LINKAGE BETWEEN DIABETES MELLITUS AND KIDD BLOOD GROUP
Authors: SusanE Hodge, Katherine Neiswanger, M Anne Spence, MaryellenC Sparkes, PaulI Terasaki, CarolE Anderson, L Leigh Field, RobertS Sparkes, Michol Crist, DavidL Rimoin, JeromeI Rotter
Journal: The Lancet (1981)
Heart Failure With a Normal Ejection Fraction
Authors: Michael R. Zile, William H. Gaasch, John D. Carroll, Marc D. Feldman, Gerard P. Aurigemma, Gary L. Schaer, Jalal K. Ghali, Philip R. Liebson
Journal: Circulation (2001)

The diagnosis of diastolic heart failure is generally made in patients who have the signs and symptoms of heart failure and a normal left ventricular (LV) ejection fraction. Whether the diagnosis also requires an objective measurement of parameters that reflect the diastolic properties of the ventricle has not been established.We hypothesized that the vast majority of patients with heart failure and a normal ejection fraction exhibit abnormal LV diastolic function. We tested this hypothesis by prospectively identifying 63 patients with a history of heart failure and an echocardiogram suggesting LV hypertrophy and a normal ejection fraction; we then assessed LV diastolic function during cardiac catheterization. All 63 patients had standard hemodynamic measurements; 47 underwent detailed micromanometer and echocardiographic-Doppler studies. The LV end-diastolic pressure was >16 mm Hg in 58 of the 63 patients; thus, 92% had elevated end-diastolic pressure (average, 24+/-8 mm Hg). The time constant of LV relaxation (average, 51+/-15 ms) was abnormal in 79% of the patients. The E/A ratio was abnormal in 48% of the patients. The E-wave deceleration time (average, 349+/-140 ms) was abnormal in 64% of the patients. One or more of the indexes of diastolic function were abnormal in every patient.Objective measurement of LV diastolic function serves to confirm rather than establish the diagnosis of diastolic heart failure. The diagnosis of diastolic heart failure can be made without the measurement of parameters that reflect LV diastolic function.
Hypoglycemia, With or Without Insulin Therapy, Is Associated With Increased Mortality Among Hospitalized Patients
Authors: Rajesh Garg, Shelley Hurwitz, Alexander Turchin, Apoorva Trivedi
Journal: Diabetes Care (2012)

Hypoglycemia is associated with increased mortality in hospitalized patients. We investigated the relationship between spontaneous hypoglycemia versus insulin-associated hypoglycemia and mortality in hospitalized patients.Data for this retrospective cohort study were obtained from electronic databases of patients admitted between 1 April 2008 and 30 November 2010. Patients with one or more blood glucose values ≤50 mg/dL on point-of-care glucose testing were considered hypoglycemic. Patients treated with insulin were assumed to have insulin-associated hypoglycemia. Age-, sex-, and race-matched patients with all blood glucose values >70 mg/dL were selected as controls. The Charlson comorbidity index (CCI) was used to control for severity of illness.There were four groups: 1) noninsulin-treated hypoglycemia (NTH) (n = 135), 2) insulin-treated hypoglycemia (ITH) (n = 961), 3) noninsulin-treated control (NTC) (n = 1,058), and 4) insulin-treated control (ITC) (n = 736). Mortality was higher in the ITH group compared with the ITC group (20.3 vs. 4.5%, P < 0.0001), with a relatively higher CCI (1.8 vs. 1.5%, P < 0.0001), but much higher in the NTH group compared with the NTC group (34.5 vs. 1.1%, P < 0.0001), with much higher CCI (2.4 vs. 1.1%, P < 0.0001). Mortality was higher in the NTH group compared with the ITH group (P < 0.0001) but lower in the NTC group compared with the ITC group (P < 0.0001). After controlling for age, sex, CCI, and admission to the intensive care unit, insulin treatment was associated with a lower mortality among the hypoglycemic patients; hazard ratio of death in the ITH group relative to the NTH group was 0.34 (95% CI 0.25-0.47, P < 0.0001).Insulin-associated and spontaneous hypoglycemia are associated with increased mortality among hospitalized patients.
Prospects for Life Span Extension
Authors: Felipe Sierra, Evan Hadley, Richard Suzman, Richard Hodes
Journal: Annual Review of Medicine (2009)

Life expectancy has increased dramatically in the United States and in much of the world in recent years and decades. The factors underlying this increase are incompletely understood and are undoubtedly complex. A question that drives current research is whether life expectancy can be further extended using current knowledge of modifiable risk factors. A still more challenging research focus is on the possibility that life expectancy might be further increased through knowledge gained from studies of the basic biology of aging and its genetic and environmental modifiers.
Collagen Autoimmune Arthritis
Authors: John M. Stuart, Alexander S. Townes, Andrew H. Kang
Journal: Annual Review of Immunology (1984)

Exhausted CD8 T (Tex) cells are a distinct cell lineage that arise during chronic infections and cancers in animal models and humans. Tex cells are characterized by progressive loss of effector functions, high and sustained inhibitory receptor expression, ...Read More
Improvement of skeletal lesions in mice with mucopolysaccharidosis type vii by neonatal adenoviral gene transfer
Authors: Arihiko Kanaji, Motomichi Kosuga, Xiao-Kang Li, Yasuyuki Fukuhara, Akiko Tanabe, Yuko Kamata, Noriyuki Azuma, Masao Yamada, Toyonori Sakamaki, Yoshiaki Toyama, Torayuki Okuyama
Journal: Molecular Therapy (2003)

Neonatal gene transfer using adenovirus vectors expressing human beta-glucuronidase (AxCAhGUS) resulted in pathological improvement in multiple visceral organs of mice with mucopolysaccharidosis type VII (MPSVII). However, the therapeutic effect on skeletal deformities and growth retardation, the major clinical symptoms in MPSVII, was not fully investigated by biochemical and histopathological analyses. In this study, we injected AxCAhGUS into a murine model of MPSVII (B6/MPSVII) within 24 h of birth and evaluated the therapeutic effects on skeletal deformities and growth retardation. High levels of beta-glucuronidase (GUSB) activity (approximately threefold higher than normal GUSB activity) were observed in the articular cartilage of the mice 30 days after the treatment. Histopathological study in the knee joints showed elimination of vacuole cells in the articular cartilage and growth plate. Subchondral bone near the articular surface was almost normal in the treated MPSVII mice. Long-term observation (for 140 days after treatment) indicated that characteristic phenotypes such as flattened face, hunched stature, and shortening of bone length in the treated mice were almost normal. These results demonstrate that a single injection of adenovirus vector into neonatal MPSVII mice is sufficient for long-term normalization of skeletal deformities and effective in pathological correction of the articular cartilage and growth plate.
The sexy scalpel: unnecessary shoulder surgery on the rise
Authors: Jørgen Jevne
Journal: British Journal of Sports Medicine (2015)

While we are supposed to be living in the era of evidence-based medicine (EBM), there is still a long distance between academic research and daily clinical practice. Clinicians love to cling to their safe havens and we often cite experience as a reason to uphold the status quo of clinical management. However, clinical experience can deceive us into thinking we know best, but in the age of evidence it seems rather anachronistic to hold experience above science when our opinions are being questioned.

EBM is not just about clinical experience and scientific studies, it includes patient preference. Although patient-centred care is an indisputable hallmark of modern medicine, a recent publication in JAMA highlighted patients’ tendency to overestimate treatment benefits and underestimate harms.1 Clinicians need to educate patients sufficiently and inform them about benefits and harms based on the …
Australians set up a mental health first aid course
Authors: N. Gilbert
Journal: BMJ (2002)

Researchers in Canberra have set up a first aid course in mental health to raise public awareness of mental health issues.

“The aim is to help people recognise the early warning signals of mental illness and to know how they can help in these early stages,” explains Betty Kitchener, of the Australian National University's centre for mental health research. …