tbuckley/cabot-search huggingface dataset:
Is the Quality of Diabetes Care Better in a Diabetes Clinic or in a General Medicine Clinic?
Authors: Marion Ho, Michael Marger, Jenna Beart, Ian Yip, Paul Shekelle
Journal: Diabetes Care (1997)

OBJECTIVE To compare the quality of ambulatory diabetes care delivered by physicians in the diabetes clinic versus the general medicine clinic of a university-affiliated Veterans Administration medical center. RESEARCH DESIGN AND METHODS This is a retrospective study that involved the review of medical records against predetermined process-of-care criteria. A total of 112 patients with diabetes were randomly selected, of whom 56 were cared for in the general medicine clinic and 56 in the diabetes clinic. The following main outcome measures were examined: 1) the compliance with individual criteria; and 2) the proportion of patient visits in each clinic receiving minimally acceptable quality, defined as a blood pressure measurement, a record of type of hypoglycemic medication, a glycated hemoglobin measurement within the past year, a urinalysis within the past year, an ophthalmologist or optometrist eye examination within the past year or scheduled in the next six months, a record of change in therapeutic management, and a scheduled return visit. RESULTS The diabetes clinic performed significantly better than the general medicine clinic on the following criteria: a record of a patient's self-monitoring of blood glucose levels; a foot examination; a comprehensive eye examination; a glycated hemoglobin measurement; and a referral for diabetic education. The proportion of patient visits meeting the minimally acceptable levels of quality was better in the diabetes clinic than the general medicine clinic (73 vs. 52%, P = 0.02). CONCLUSIONS Patients cared for by physicians in the diabetes clinic receive better quality of diabetes care than do patients cared for by physicians in the general medical clinic. If patient care is to be shifted from specialists to generalists, additional attention needs to be paid to ensure that generalists have the knowledge and system resources necessary to deliver an acceptable quality of diabetes care.
Prominent pericardial and myocardial lesions in the Churg-Strauss syndrome (allergic granulomatosis and angiitis).
Authors: A G Davison, P J Thompson, J Davies, B Corrin, M Turner-Warwick
Journal: Thorax (1983)

The Churg-Strauss syndrome is a rare multisystem disease of unknown cause characterised by asthma, appreciable blood and tissue eosinophilia, angiitis, and necrotising granulomas.'The clinical features are protean but cardiac lesions received little emphasis in the largest clinical series of patients so far reported.2We report three patients with the Churg-Strauss syndrome who had prominent pericar- dial and myocardial lesions and also some previously unde- scribed clinical features. Case reports CASE 1A 33 year old non-smoking woman, who had suffered for 11 years from mild asthma controlled with inhaled sal- butamol, developed a painful rash, pericarditic chest pain, shortness of breath, left pleuritic pain, polymyalgia, and emotional lability.There was no family history of allergy.On examination she was febrile and had splinter haemo- rrhages, a raised, confluent, purplish rash on both arms, bilateral ankle oedema, and scattered wheezes.
The expression of Fas Ligand by macrophages and its upregulation by human immunodeficiency virus infection.
Authors: D H Dockrell, A D Badley, J S Villacian, C J Heppelmann, A Algeciras, S Ziesmer, H Yagita, D H Lynch, P C Roche, P J Leibson, C V Paya
Journal: Journal of Clinical Investigation (1998)

Fas/Fas Ligand (FasL) interactions play a significant role in peripheral T lymphocyte homeostasis and in certain pathological states characterized by T cell depletion. In this study, we demonstrate that antigen-presenting cells such as monocyte-derived human macrophages (MDM) but not monocyte-derived dendritic cells express basal levels of FasL. HIV infection of MDM increases FasL protein expression independent of posttranslational mechanisms, thus highlighting the virus-induced transcriptional upregulation of FasL. The in vitro relevance of these observations is confirmed in human lymphoid tissue. FasL protein expression is constitutive and restricted to tissue macrophages and not dendritic cells. Moreover, a significant increase in macrophage-associated FasL is observed in lymphoid tissue from HIV (+) individuals (P < 0.001), which is further supported by increased levels of FasL mRNA using in situ hybridization. The degree of FasL protein expression in vivo correlates with the degree of tissue apoptosis (r = 0.761, P < 0. 001), which is significantly increased in tissue from HIV-infected patients (P < 0.001). These results identify human tissue macrophages as a relevant source for FasL expression in vitro and in vivo and highlight the potential role of FasL expression in the immunopathogenesis of HIV infection.
Case in Which a Silk Handkerchief Was Swallowed by a Boy Aged Nine Years
Authors: C. R. Bree
Journal: BMJ (1850)

we effectually declare our knowledge of disease, or by which we advance in the alleviation of it.This one qualification may be worth while now to state.Some are willing to attribute considerable good from the use of colchicum.The practice of from twenty to thirty years here warrants the assertion, that in cases of acute
Acute responsiveness to calcitonin in chronic renal failure.
Authors: M Cochran, C J Hillyard, G J Dew, T J Martin
Journal: BMJ (1976)

The acute effect of porcine calcitonin was tested in 17 patients undergoing chronic haemodialysis. In normal adults calcitonin has no effect on plasma calcium or phosphate levels, but in nine patients both concentrations were substantially reduced after calcitonin. This hypocalcaemic and hypophosphataemic effect was a function of the initial plasma phosphate level but was unrelated to the initial plasma calcium level. Plasma hydroxyproline levels were not significantly different in the two groups an were unaffected by calcitonin. In 11 patients fasting plasma calcitonin levels were undetectable with an assay sensitive to 0-1 mug/1. Calcitonin seems to have an acute effect in chronic renal failure which may not operate by arresting bone resorption but is dependent on the plasma phosphate concentration.
698. IL-23 Transduced Dendritic Cells Produce a Potent Tumor-Specific Immunity Against Intracranial Gliomas
Authors: Jinwei Hu, Xiangpeng Yuan, John M. Ong, Christopher J. Wheeler, Maria L. Belladonna, John S. Yu, Keith L. Black
Journal: Molecular Therapy (2005)

Top of pageAbstract
L-23 is a recently discovered cytokine consisting of a heterodimer of the IL-12 p40 subunit and a novel 19-kDa protein, termed p19. IL-23 preferentially induces proliferation of, and IFN-|[gamma]| production by, memory T cells. In the present study, we transduced freshly cultured dendritic cells (DC) with an adenoviral vector carrying the single-chain IL-23 cDNA. Message RNA and protein expression of IL-23 from the transduced DC were detected by RT-PCR and ELISA respectively. Intratumoral implanting IL-23 expressing DC into intracranial GL-26 glioma bearing C57bl/6 mice resulted in prolonged survival compared with the control mice, which were intracranial bearing GL-26 glioma implanted with empty vector transduced DC. Enhanced CD8+ T cells infiltration within the tumors were detected by immunohistochemistry in brain sections from the mice treated by IL-23 expression DC. Cytotoxic T lymphocyte (CTL) assay of the spleen cells from the IL-23 expressing DC treated mice shown that CTL activities against GL-26 glioma but not irrelevant tumors were augmented. In addition, the mice survived intracranial glioma by IL-23 expressing DC treatment were resistant to intracranial rechallenge with the same GL-26 cell line. This tumor-specific protective immunity was associated with enhanced IFN-|[gamma]| expression in the brain. Furthermore, the antitumor activities of IL-23 expressing DC was also observed in athymic nude mice but greatly impaired compared with that in C57bl/6 mice. Natural killer cells depletion for the athymic nude mice abolished the antitumor function. Taken together, these data suggest that DC as powerful antigen presenting cells can elicit tumor-specific antitumor immune responses after transduced by IL-23. T cells are crucial for the antitumor activity of the IL-23 expressing DC and natural killer cells are also involved in the process.
An unusual complication of eosinophilic esophagitis in an adolescent: intramural esophageal dissection
Authors: A. Sgrò, P. Betalli, G. Battaglia, R. Bardini, M. Crivellaro, G. Svaluto, P. Gamba
Journal: Endoscopy (2012)

Intramural esophageal dissection is a rare complication of eosinophilic esophagitis. Only three cases in adults have been described [1] [2] [3]. The residual mucosal septum could be treated with endoscopic section [4] [5]. We report on the first pediatric case to be treated conservatively for intramural esophageal dissection due to eosinophilic esophagitis.
Randomized Phase III Trial of Neoadjuvant Chemotherapy in Head and Neck Cancer: 10-Year Follow-Up
Authors: P. L. Zorat, A. Paccagnella, G. Cavaniglia, L. Loreggian, A. Gava, C. A. Mione, F. Boldrin, C. Marchiori, F. Lunghi, A. Fede, A. Bordin, M. C. Da Mosto, V. C. Sileni, A. Orlando, A. Jirillo, L. Tomio, G. L. Pappagallo, M. G. Ghi
Journal: JNCI Journal of the National Cancer Institute (2004)

In 1986, we initiated a multicenter, randomized trial to compare induction chemotherapy with cisplatin and 5-fluorouracil followed by locoregional treatment (surgery and radiotherapy or radiotherapy alone) with locoregional treatment alone in patients with head and neck squamous cell carcinoma. Here we report the long-term results of the trial. A total of 237 patients with nonmetastatic stage III or IV head and neck carcinoma were randomly assigned to receive four cycles of neoadjuvant chemotherapy followed by locoregional treatment (group A) or locoregional treatment alone (group B). Among all patients, overall survival at 5 and 10 years was 23% (95% confidence interval [CI] = 15.3% to 30.9%) and 19% (95% CI = 11.6% to 26.4%), respectively, for those in group A and 16% (95% CI = 9.6% to 23.4%) and 9% (95% CI = 3.5% to 14.7%), respectively, for those in group B ( P = .13). Among operable patients, we observed no difference between group A and group B in overall survival at 5 and 10 years (group A, 31% [95% CI = 14.9% to 47.3%] and 22.7% [95% CI = 7.1% to 38.3%], respectively; group B, 43.3% [95% CI = 25.6% to 61.0%] and 14.2% [95% CI = 0.1% to 28.3%], respectively; P = .73). Among inoperable patients, overall survival at 5 and 10 years was 21% (95% CI = 12.3% to 30.1%) and 16% (95% CI = 7.7% to 23.9%), respectively, for group A and 8% (95% CI = 1.5% to 12.3%) and 6% (95% CI = 0.1% to 9.1%), respectively, for group B (log-rank P = .04). Four cycles of neoadjuvant chemotherapy is a promising approach for treating patients with inoperable advanced head and neck cancer but not for treating patients with operable disease.
Abstract 2471: Chemical optimization of direct and selective molecular activators of pro-apoptotic BAX for cancer therapy.
Authors: Joseph A. Bellairs, Denis Reyna, Divakaramenon Sethumadhavan, Madhavi Neelagiri, Alex Broadhead, Christopher Baccei, Brian Koss, Joseph T. Opferman, Evripidis Gavathiotis, Loren D. Walensky
Journal: Cancer Research (2013)

Abstract BAX is a pro-apoptotic BCL-2 family member that lies dormant in the cytosol until triggered by cellular stress to translocate to the mitochondria and form toxic oligomeric pores. The majority of cancer cells retain wild-type BAX and instead neutralize the death pathway by overexpressing anti-apoptotic BCL-2 family proteins. Thus, direct activation of BAX represents a pharmacologic opportunity to lower the apoptotic threshold in the setting of chemoresistance. Using a Stabilized Alpha-Helix of BCL-2 domain (SAHB) modeled after the BIM BH3 helix, we previously identified the “trigger site” for direct BAX activation at the confluence of alpha-helices 1 and 6. In silico screening for small molecule modulators of BAX led to our identification of BAX activator molecule 7 (BAM7), which selectively engages the trigger site and promotes BAX-mediated cell death (Gavathiotis et al, Nat Chem Biol, 2012). Here, we applied BAM7 to a panel of acute lymphoblastic leukemia cells and observe dose-responsive killing in the micromolar range. To improve the potency of anti-ALL activity, we undertook a systematic medicinal chemistry-based iteration of BAM7’s molecular features. A series of analogs demonstrate improved BAX binding activity based on a FITC-BIM SAHB/BAX competitive fluorescence polarization assay. The most potent binders were advanced to testing in a cellular model of anti-apoptotic protein-dependent chemoresistance. Whereas select BAM7 derivatives exhibited a potency similar to or greater than the BCL-2/BCL-XL inhibitor ABT-737 in a BCL-XL-dependent ALL cell line, the compounds significantly outperformed ABT-737 in the isogenic MCL-1-dependent ALL cells. Preliminary studies revealed favorable pharmacokinetic profiles for lead BAM7 derivatives, including oral bioavailability and central nervous system penetration. These early encouraging structure-activity relationship and pharmacokinetic data on chemically-optimized BAM7 analogs suggest that direct and selective activation of BAX may be a viable strategy for therapeutic induction of apoptosis in the context of cancer chemoresistance. Citation Format: Joseph A. Bellairs, Denis Reyna, Divakaramenon Sethumadhavan, Madhavi Neelagiri, Alex Broadhead, Christopher Baccei, Brian Koss, Joseph T. Opferman, Evripidis Gavathiotis, Loren D. Walensky. Chemical optimization of direct and selective molecular activators of pro-apoptotic BAX for cancer therapy. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 2471. doi:10.1158/1538-7445.AM2013-2471
Nonmyeloablative allogeneic transplantation with or without 90yttrium ibritumomab tiuxetan is potentially curative for relapsed follicular lymphoma: 12-year results
Authors: Issa F. Khouri, Rima M. Saliba, William D. Erwin, Barry I. Samuels, Martin Korbling, L. Jeffrey Medeiros, Rosamar Valverde, Amin M. Alousi, Paolo Anderlini, Qaiser Bashir, Stefan Ciurea, Alison M. Gulbis, Marcos de Lima, Chitra Hosing, Partow Kebriaei, Uday R. Popat, Nathan Fowler, Sattva S. Neelapu, Felipe Samaniego, Richard E. Champlin, Homer A. Macapinlac
Journal: Blood (2012)
The local immune response to Escherichia coli O and K antigen in experimental pyelonephritis.
Authors: J W Smith, B Kaijser
Journal: Journal of Clinical Investigation (1976)

Although the systemic and local immune response to the O antigen of Escherichia coli has been well characterized, little information is available on the immune response to K anigen. Experimental hematogenous pyelonephritis was produced with Escherichia coli 06 K13 H1 and the serum and local (intrarenal) antibody response to O and K antigens was determined with the enzyme-linked immunosorbent assay. Both local and serum antibody responses to the K antigen were significantly less than that to the O antigen. The K antigen induced low titer IgM and IgG antibody responses in fewer than one-half of the animals and did not induce a local IgA response in any animal. In contrast, the O antigen induced local antibody responses in each of the immunoglobulin classes in all animals from day 9 of infection. Similarly, the serum IgM and IgG antibody titers to the K antigen were significantly less than those evoked in response to the O component of the Escherichia coli. No serum IgA anti-K antibodies were detected. These observations helf clarify the roles of these two antigens in pyelonephritis. Although the K antigen of Escherichia coli functions as a virulence factor in upper urinary tract infections, this antigen does not elicit a significant immune response, whereas the O antigen does induce a significant antibody response which could be of protective or diagnostic benefit.
&lt;emph type="ital"&gt;ABCA1&lt;/emph&gt; Gene Mutations, HDL Cholesterol Levels, and Risk of Ischemic Heart Disease
Authors: Liam R. Brunham
Journal: JAMA (2008)

would not expect a change in our results. Regarding the use of self-reported data on family history, prior studies have found self-reported information on family history of cancer in first-degree relatives to be valid. Underreporting tends to be the most common source of error in family history reports. This misclassification would tend to attenuate any association of family history of colorectal cancer on patient survival. Moreover, the prevalence of family history of colorectal cancer among study participants was consistent with other studies. We agree that people who are aware of a family history of colorectal cancer might adopt a more health-conscious lifestyle and may be more likely to be diagnosed at earlier stages. However, we did not observe any significant differences in T stage (invasion through the bowel wall), N stage (number of positive lymph nodes), tumor differentiation, performance status, or postoperative serum carcinoembryonic antigen between patients with or without a family history. Furthermore, a significant association between a family history and disease-free survival persisted even after adjusting for predictors of cancer recurrence or death as well as in stratified analyses of patients according to T and N stage. Regarding preferential responsiveness to chemotherapy, all patients were randomized to standardized chemotherapy protocols, and there were no differences in survival according to treatment group. Because we did not assess family size or sex of the affected family member, we are unable to examine family history according to sex of the affected relative or personyears of exposure. However, we are unaware of data demonstrating that risk of developing colorectal cancer is influenced by the sex of an affected first-degree relative and have no reason to suspect that sex of the relative would influence survival. We did examine whether the effect of family history varied according to the age at which the firstdegree relative was diagnosed with colorectal cancer. As reported, we found no difference in the adjusted hazard ratio for disease-free survival among patients whose relative was diagnosed with colorectal cancer at an age younger than 50 years compared with 50 years or older.
Potential Areas of Future Investigation
Authors: George Porter
Journal: Annals of Internal Medicine (1983)

Dialogue Summaries1 May 1983Potential Areas of Future InvestigationGeorge Porter, M.D.George Porter, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-98-5-881_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSeveral questions for which investigative protocols could be designed were suggested. These questions included: What is the prevalence in the adult population of salt-sensitive hypertension? Can a predictor of the prehypertensive phase of salt-sensitive hypertension be identified, and would it be cost effective as a screening device? How effective is moderate salt restriction in treating salt-sensitive hypertension? Must salt restriction be coupled with caloric restriction to be effective in reducing elevated blood pressure? Are the manipulations of the dietary salt content without risk? Have all dietary nutrients that may contribute to hypertension been evaluated? Can the food industry develop a... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: University of Oregon Health Sciences Center PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1983Volume 98, Issue 5_Part_2Page: 881-882KeywordsAdultsBlood pressureFoodForecastingHypertensionNutrientsSalts Issue Published: 1 May 1983 PDF downloadLoading ...
Local ventromedial hypothalamus glucose perfusion blocks counterregulation during systemic hypoglycemia in awake rats.
Authors: M A Borg, R S Sherwin, W P Borg, W V Tamborlane, G I Shulman
Journal: Journal of Clinical Investigation (1997)

The ventromedial hypothalamic nucleus (VMH) is necessary for the integrated hormonal response to hypoglycemia. To determine the role of the VMH as a glucose sensor, we performed experiments designed to specifically prevent glucopenia in the VMH, while producing hypoglycemia elsewhere. We used awake chronically catheterized rats, in which local VMH glucose perfusion (100 mM or 15 mM of D-glucose) was combined with a sequential euglycemic-hypoglycemic clamp. In two control groups the VMH was perfused either with (a) an iso-osmotic solution lacking glucose, or with (b) nonmetabolizable L-glucose (100 mM). During systemic hypoglycemia glucagon and catecholamine concentrations promptly increased in the control animals perfused with either 100 mM L-glucose or the iso-osmotic solution lacking glucose. In contrast, glucagon, epinephrine and norepinephrine release was inhibited in the animals in which the VMH was perfused with D-glucose; hormonal secretion was partially suppressed by the VMH perfusion with 15 mM D-glucose and suppressed by approximately 85% when the VMH was perfused with 100 mM D-glucose, as compared with the control groups. We conclude that the VMH must sense hypoglycemia for full activation of catecholamine and glucagon secretion and that it is a key glucose sensor for hypoglycemic counterregulation.
AUTORADIOGRAPHIC STUDIES ON THE PROLIFERATION OF ANTIBODY-PRODUCING CELLS IN VITRO
Authors: T. Hünig, A. Schimpl, E. Wecker
Journal: The Journal of Experimental Medicine (1974)

A rapid and reliable autoradiographic technique for plaque-forming cells (PFCs) using (14)C rather than tritiated thymidine is described. Its application to PFCs developing in vitro shows that (a) practically all PFCs derive from precursors dividing steadily during the culture period, (b) PFC precursors divide in the absence of T-cell helper function, and (c) at least some PFCs may continue to divide.
Chondrocalcinosis and Hypomagnesemia
Authors: Michael H Ellman
Journal: New England Journal of Medicine (2008)

A 50-year-old woman presented with a several-year history of acute and chronic joint pain. Her serum magnesium level was 0.9 mg per deciliter (0.4 mmol per liter) (normal range, 1.6 to 2.5 [0.7 to 1.0]), and the total daily urinary excretion of magnesium and the fractional clearance of magnesium were elevated. Radiography revealed chondrocalcinosis in the knee (Panel A, arrow), outlining the articular cartilage and especially the lateral meniscus, and calcifications in the wrist (Panel B) that were deposited on the triangular cartilage (arrow) as well as the radial-carpal and intercarpal cartilage. Chondrocalcinosis is the presence of linear, stippled calcification . . .
THE FALLACIES OF X-RAY PICTURES.
Authors: EDWARD A. TRACY
Journal: JAMA (1897)

Roentgen's marvelous work on the properties of the X-rays (their nature is as yet unknown) has already been productive of much good in surgery and medicine—almost entirely in the field of diagnosis. The application of his discovery necessitates the rewriting of the text-books on fractures and dislocations. Facts, heretofore "smothered in surmise" are clearly set forth by the radiographs. For example, no writer, of which I am aware, on fractures, suspected the frequency with which fracture of the ulnar styloid process accompanies Colles' fracture; yet this frequency has been demonstrated by radiographs of Colles' fractures. While much has been gained in accuracy of diagnosis by the aid of X-ray pictures, there is one branch of practical medicine where harm is threatened by their employment. I refer to medical jurisprudence. X-ray pictures have been already admitted as evidence in some courts. Their indiscriminate admission will hurt the cause of justice—because they