tbuckley/cabot-search huggingface dataset:
P238 Role of naturally-acquired IgG in protection from S. pneumoniae lung infection
Authors: RJ Wilson, RJ Jose, M Barabas, H Marshall, JM Cohen, E Sapey, H Baxendale, JS Brown
Journal: Thorax (2013)

<h3></h3> Preventing <i>Streptococcus pneumoniae</i> lung infections will have substantial health benefits, yet existing polysaccharide vaccines are not effective against pneumonia. Identifying the mechanisms of naturally-acquired immunity to <i>S. pneumoniae</i> lung infections could indicate alternative preventative strategies. Human intravenous immunoglobulin (IVIG) preparations pooled from &gt;1000 donors prevent respiratory infections in patients with hypogammaglobuniaemia. IVIG therefore provides a tool to investigate the naturally-acquired antibody responses to <i>S. pneumoniae</i> within a population. We have used mouse models and <i><i>in vitro</i></i>assays to assess the efficacy of IVIG for preventing <i>S. pneumoniae</i> lung infections and to identify the immunodominant target antigens. In a mouse pneumonia model, IVIG treatment was highly protective against bacteraemia (17% septicaemia v. 100% in controls, <i>P = </i>0.015) and partially protected against lung infection (lung CFU log<sub>10</sub> 3.7 for IVIG v. 6.3 for controls, <i>P = </i>0.041) but not against nasopharyngeal colonisation. Depletion of phagocyte subsets demonstrated that IVIG-mediated protection required neutrophils and macrophages for lungs and blood respectively. Flow-cytometry assays demonstrated that IgG within IVIG preparations opsonised <i>S. pneumoniae</i> effectively. Importantly, IgG opsonisation was reduced by pre-treatment of bacteria with pronase to remove bacterial surface proteins but not by depletion of anti-capsular antibody. Furthermore, <i>in vitro</i> assays demonstrated that IVIG facilitated phagocytosis, growth impairment and bacterial agglutination of capsule-deficient <i>S. pneumoniae</i> mutants, in mice IVIG depleted of anti-capsular antibody remained protective against lung infection and septicaemia. These results demonstrate that surface proteins rather than the capsule are targets for naturally-acquired adaptive immunity to <i>S. pneumoniae</i>. The potential <i>S. pneumoniae</i> protein antigen targets in IVIG were assessed using a semi-quantitative assay against 18 recombinant pneumococcal proteins. The results demonstrated significant IgG responses to the conserved pneumococcal protein antigens PhtD, PspC, PspA and PsaA. Interestingly, antibody titres to some of these antigens were reduced in sera from elderly compared to younger subjects, potentially identifying people at higher risk of <i>S. pneumoniae</i> infection. Our data demonstrate that the accepted paradigm that naturally-acquired immunity to <i>S. pneumoniae</i> depends on anti-capsular antigen is inaccurate, and instead antibody to proteins is dominant. These data will allow better evaluation of those at risk of <i>S. pneumoniae</i> infection and improved vaccine design.
Bone marrow–derived CMPs and GMPs represent highly functional proangiogenic cells: implications for ischemic cardiovascular disease
Authors: Akm Khyrul Wara, Kevin Croce, ShiYin Foo, Xinghui Sun, Basak Icli, Yevgenia Tesmenitsky, Fehim Esen, Anthony Rosenzweig, Mark W. Feinberg
Journal: Blood (2011)
Wnt2 acts as a cell type-specific, autocrine growth factor in rat hepatic sinusoidal endothelial cells cross-stimulating the VEGF pathway
Authors: Diana Klein, Alexandra Demory, Francis Peyre, Jens Kroll, Hellmut G. Augustin, Wijnand Helfrich, Julia Kzhyshkowska, Kai Schledzewski, Bernd Arnold, Sergij Goerdt
Journal: Hepatology (2008)

The mechanisms regulating the growth and differentiation of hepatic sinusoidal endothelial cells (HSECs) are not well defined. Because Wnt signaling has become increasingly important in developmental processes such as vascular and hepatic differentiation, we analyzed HSEC-specific Wnt signaling in detail. Using highly pure HSECs isolated by a newly developed protocol selecting against nonsinusoidal hepatic endothelial cells, we comparatively screened the multiple components of the Wnt pathway for differential expression in HSECs and lung microvascular endothelial cells (LMECs) via reverse-transcription polymerase chain reaction (RT-PCR). As confirmed via quantitative RT-PCR and northern and western blotting experiments, Wnt2 (and less so Wnt transporter wls/evi) and Wnt coreceptor Ryk were overexpressed by HSECs, whereas Wnt inhibitory factor (WIF) was strongly overexpressed by LMECs. Exogenous Wnt2 superinduced proliferation of HSECs ( P &lt; 0.05). The Wnt inhibitor secreted frizzled-related protein 1 (sFRP1) ( P &lt; 0.005) and transfection of HSECs with Wnt2 small interfering RNA (siRNA) reduced proliferation of HSECs. These effects were rescued by exogenous Wnt2. Tube formation of HSECs on matrigel was strongly inhibited by Wnt inhibitors sFRP1 and WIF ( P &lt; 0.0005). Wnt signaling in HSECs activated the canonical pathway inducing nuclear translocation of β-catenin. GST (glutathione transferase) pull-down and co-immunoprecipitation assays showed Fzd4 to be a novel Wnt2 receptor in HSECs. Gene profiling identified vascular endothelial growth factor receptor-2 (VEGFR-2) as a target of Wnt2 signaling in HSECs. Inhibition of Wnt signaling down-regulated VEGFR-2 messenger RNA and protein. Wnt2 siRNA knock-down confirmed Wnt2 specificity of VEGFR-2 regulation in HSECs. Conclusion: Wnt2 is an autocrine growth and differentiation factor specific for HSECs that synergizes with the VEGF signaling pathway to exert its effects.
Thin Needle Aspiration Biopsy and Cytological Examination of Hypofunctional, ???Cold??? Thyroid Nodules in Routine Clinical Work
Authors: G GALVAN
Journal: Clinical Nuclear Medicine (1977)

Thin needle biopsy and cytological examination of hypofunctional scintigraphically “Cold” nodules is being increasingly applied in diagnosing malignancy of the thyroid and thyroiditis. It is a well suited method of selecting patients for thyroidectomy. The procedure can be performed quickly and easily on outpatients without inconveniencing the patients. There are no complications except for occasional hemorrhage into the nodule. Cytological pattern and results in 4555 punctured patients, 1076 of these surgically proven, are discussed.
Streptococcal throat infections and exacerbation of chronic plaque psoriasis: a prospective study
Authors: J.E. Gudjonsson, A.M. Thorarinsson, B. Sigurgeirsson, K.G. Kristinsson, H. Valdimarsson
Journal: British Journal of Dermatology (2003)

Guttate psoriasis has a well-known association with streptococcal throat infections but the effects of these infections in patients with chronic psoriasis remains to be evaluated in a prospective study.To determine whether streptococcal throat infections are more common in and can cause exacerbation in patients with chronic psoriasis.Two hundred and eight patients with chronic plaque psoriasis and 116 unrelated age-matched household controls were followed for 1 year. At recruitment all patients were examined, their disease severity scored and throat swabs taken. Patients and corresponding controls were then re-examined and tested for streptococcal colonization whenever they reported sore throat or exacerbation of their psoriasis during the study period.The psoriasis patients reported sore throat significantly more often than controls (61 of 208 vs. three of 116, P < 0.0001), and beta-haemolytic streptococci of Lancefield groups A, C and G (M protein-positive streptococci) were more often cultured from the patients than the controls (19 of 208 vs. one of 116, P = 0.003). A significant exacerbation of psoriasis (P = 0.004) was observed only if streptococci were isolated and the patients were assessed 4 days or later after the onset of sore throat. No difference was observed between groups A, C or G streptococci in this respect.This study confirms anecdotal and retrospective reports that streptococcal throat infections can cause exacerbation of chronic plaque psoriasis. It is concluded that psoriasis patients should be encouraged to report sore throat to their physician and that early treatment of streptococcal throat infections might be beneficial in psoriasis. A controlled trial for assessing potential benefits of tonsillectomy in patients with severe psoriasis should also be considered.
Goodpasture's Syndrome: Normal Renal Diagnostic Findings
Authors: TIMOTHY H. MATHEW
Journal: Annals of Internal Medicine (1975)

A patient with Goodpasture's syndrome is described in whom pulmonary manifestations were dramatic, but in whom renal abnormalities were minor and only found on fluorescent and electron microscopy. His urine showed no proteinuria and no increase in cells in quantitative counts, and renal function was normal. It is suggested that there may be an indication for carrying out renal biopsies in patients with idiopathic pulmonary haemosiderosis and that this may lead to an early diagnosis of Goodpasture's syndrome.
Unusual Stress Fracture of the Scapula in a Jogger
Authors: PURUSHOTHAM VELUVOLU, HARVEY S. KOHN, GARY N. GUTEN, PURNELL M. DONAHUE, ALI T. ISITMAN, JOHN P. WHALEN, B DAVID COLLIER
Journal: Clinical Nuclear Medicine (1988)

A case of fracture of the right scapula in the superomedial portion with no history of direct trauma is presented. It is most likely due to jogging with weights in both hands. A brief review of scapular fractures is also reported.
Pulmonary artery tumour-embolism diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration
Authors: A.L. Blanc, C. Jardin, J.B. Faivre, O. Le Rouzic, C. Do Cao, L. Benhamed, P.P. Ramon, C. Fournier
Journal: European Respiratory Journal (2011)

To the Editors:

A 61-yr-old female was diagnosed with pulmonary embolism. She had a history of poorly differentiated thyroid cancer with follicular cell phenotype, and had first been treated in 2006 by thyroidectomy and radioactive iodine-131. Local relapse (cervical nodes) had occurred within 3 months and required five cycles of chemotherapy, consisting of cisplatin and doxorubicin, followed by cervical radiotherapy and surgical resection of residual nodes. 2 yrs later during follow-up, abnormal 18F-fluorodeoxyglucose (FDG) uptake was described on positron emission tomography (PET)/computed tomography (CT) in the left thoracic hilar regions. CT pulmonary angiography showed a filling defect in the left lower lobe pulmonary artery and at the origin of the lingular artery; no delayed embolism enhancement was observed. It was considered to be a pulmonary embolism, and anticoagulation was initiated. 6 months later, follow-up imaging showed stability of both FDG uptake and CT pulmonary angiography images, and anticoagulation was continued. 10 months later, follow-up showed a right pulmonary upper lobe nodule on CT scan associated with high FDG uptake on PET/CT, and thyroglobulin ascension. This nodule was considered to be a thyroid cancer metastasis and treated by CyberKnife radiotherapy. As FDG uptake and thyroglobulin …
Diltiazem and Hyperkalemia-Reply
Authors: Robert E. Hoyt
Journal: JAMA (1987)

In Reply.—  I appreciate the helpful comments of Dr Flicker et al from Marion Laboratories Inc. Although they are correct that there has not been a documented association between diltiazem treatment and hyperkalemia, I am unaware of a study looking at potassium levels following an oral or intravenous potassium load in a patient pretreated with diltiazem.  Dr Flicker suggests that therapy with metoprolol may have contributed to the patient's hyperkalemia, but many studies seem to disagree. Patients pretreated with propranolol but not metoprolol show a rise in serum potassium level when undergoing cardiopulmonary bypass surgery.1Also, hyperkalemia following exercise is augmented by administration of both propranolol (a nonselective β-blocker and metoprolol (a selective β1-blocker), but the return to normokalemia is much more rapid with metoprolol therapy.2Administration of metoprolol in large doses loses its cardioselectivity, but whether this is clinically important is unknown. Smith et al3attempted
The Productivity Costs of Providing or Withholding Treatment
Authors: George W. Anstadt
Journal: JAMA (1994)

To the Editor.  —Dr Eddy 1 has written yet another excellent article. To be complete, the following principle should be inserted (probably as No. 3) on his list:  Because illness-related productivity losses have the same economic impact on society as direct health care expenditures, it is also valid and appropriate to consider the productivity-related costs of providing or withholding treatment.  An optimally healthy workforce bestows a tremendous competitive advantage. This has been recognized by armies since antiquity (disease-related losses exceeded battlefield losses in most wars), by nations (the success of the British navy in part through the use of limes to prevent scurvy), and by modern corporations (which invest in the health of the workforce). While this literature is young and the measures of productivity and productive capacity are imperfect, it appears that for many if not most diseases, the lost productivity costs exceed the cost of medical treatment. 2
Pioglitazone Improves Fat Tissue Distribution and Hyperglycemia in a Case of Cockayne Syndrome With Diabetes
Authors: Aiko Hayashi, Minoru Takemoto, Mayumi Shoji, Akiko Hattori, Katsuo Sugita, Koutaro Yokote
Journal: Diabetes Care (2015)

Cockayne syndrome (CS) is autosomal recessive disorder characterized by developmental delay, pigmentary retinopathy, cutaneous photosensitivity, and cachectic dwarfism (1). Although few CS patients present with diabetes, no previous report has described a suitable treatment. Here, we report such a case where pioglitazone administration successfully improved hyperglycemia in a case of CS with diabetes.

A 24-year-old male came to our department for the treatment of diabetes. The medical history included growth failure and psychomotor retardation at the age of 1 year and pigmentary retinopathy at the age of 3 years. Thereafter, sensorineural deafness appeared at the age of 6, and a diagnosis of CS based on clinical conditions was made at the age of 8. He eventually developed diabetes at the age …
Fatal Mushroom Poisoning
Authors: S. K. Abul-Haj, Roger A. Ewald, Leo Kazyak
Journal: New England Journal of Medicine (1963)

FATAL mushroom poisoning is uncommon in this country. Although it was first recorded in 18711 few reports have since appeared in the American literature. Buck2 has reviewed 24 fatal cases reported since 1924. Eleven of these were due to Amanita verna and its subspecies and the American phenotypes of A. phalloides. The highly lethal toxins contained in these mushrooms of the bulb-agaric group are phalloidin, phalloin and alpha, beta and gamma amanitin. (The bulb-agaric group does not include A. muscaria, which contains the rapid-acting but less fatal toxin, muscarin.) Identification of the "amanita toxins" in human tissues has . . .
Specific IgE determinations to crude and boiled lentil (<i>Lens culinaris</i>) extracts in lentil‐sensitive children and controls
Authors: D. Ibáñez Sandín, M. Martínez San Ireneo, E. Alonso Lebrero, T. Laso Borrego, F. Marañón Lizana, E. Fernández‐Caldas
Journal: Allergy (1999)

Background : The aims of this study were to evaluate the allergenicity of boiled and crude lentil extracts and to compare specific IgE binding in tolerant and nontolerant lentil‐allergic children. Methods : Thirty‐eight children were studied and divided into three groups. Group I comprised 24 children with a positive open oral challenge, or a convincing history of anaphylaxis after the ingestion of lentils; group II comprised nine children with a history of allergic reactions in the past, but currently tolerant of lentils; and group III comprised five children allergic to other legumes, but always tolerant of the ingestion of lentils. Specific IgE determinations and ELISA inhibitions were performed with the crude and boiled lentil extracts. The allergenic profile of both extracts was evaluated by SDS–PAGE and immunoblot. Results : Mean specific IgE levels in group I were significantly higher than in groups II and III. The heating process caused a significant decrease in specific IgE binding. However, IgE‐inhibition studies showed that the boiled lentil extract had a greater inhibitory capacity than the crude extract. Immunoblots revealed no important differences in IgE‐binding patterns between the two extracts. Multiple allergens were detected in a wide range of molecular masses. Conclusions : Boiled lentil extracts maintain strong allergenicity. Patients who have developed tolerance of lentil ingestion have lower specific IgE levels than symptomatic patients.
The effect of budesonide mouthwash on oral chronic graft versus host disease
Authors: Ismail Sari, Fevzi Altuntas, İsmail Kocyigit, Yildiray Sisman, Bulent Eser, Aydin Unal, Turgay Fen, Ayten Ferahbas, Ahmet Ozturk, Ali Unal, Mustafa Cetin
Journal: American Journal of Hematology (2006)

Abstract Oral chronic graft versus host disease (cGVHD) is common and a major cause of morbidity and loss of quality of life in long term survivors. Cyclosporine with prednisone remains the first line therapy for oral manifestations of cGVHD. However, even with routine administration of systemic agents, many patients with oral manifestations of cGVHD do not have resolution of their disease and may benefit from incorporation of local therapy. Budesonide is a highly potent steroid which has minimal systemic side effects and being used for oral cGVHD. We designed a retrospective study to compare treatment results of patients with oral cGVHD who received topical budesonide in addition to systemic therapy that consists of combined prednisone and cyclosporine (Group A, n = 12), with the treatment results of patients who were administered the same systemic therapy alone (Group B, n = 11) to determine whether budesonide mouthwash had any advantage on response rates. Three mg topical budesonide/10 ml saline was used 3–4 times a day for up to 6 months in group A. Diagnosis, clinical staging, and treatment response scoring for cGVHD were performed according to National Institutes of Health (NIH) consensus criteria. At the baseline examination, there were no statistically significant differences in terms of median oral cGVHD examination scores between two groups. After treatment, there was statistically significant decrease in median oral cGVHD examination scores compared to baseline ( P &lt; 0.001 and 0.021), and significant differences were found between two groups ( P &lt; 0.032). Overall response rate was 83% and 36% for group A and B, respectively ( P = 0.036). However, no statistically significant differences were found between median pain scores of two groups before and after treatment ( P = 0.740 and P = 0.091). No major systemic side effects and oral candidiasis were observed in two groups of patients. We concluded that topical budesonide might be added to systemic therapy to obtain better response rates in patients with oral cGHVD. Am. J. Hematol., 2007. © 2006 Wiley‐Liss, Inc.
Definitive Concurrent Chemoradiation for Patients with Esophageal Squamous Cell Carcinoma. Experience at a Public Hospital in Argentina
Authors: Rosa Penayo, Maximiliano SOSA Gallardo, Guillermo Mendez, Juan O'Connor, Gerardo Vitcopp, Marcela Carballido, Mario Barugel, Ariel Aguilo, Lorena Oillataguerre, Velia Lobbe, Mabel Sardi, Catalina Pogany, Enrique Roca
Journal: Annals of Oncology (2013)
Of HMD, ICU's, CPAP and Jenner
Authors: Nicholas M. Nelson
Journal: New England Journal of Medicine (1971)

Nearly 10 years of immense supportive effort directed to the infant suffering from moderate to severe hyaline-membrane disease (HMD) had, until recently, brought us from expected overall mortalities of worse than 60 per cent down to about 30 per cent. In the babies with the highest degree of arterial desaturation (severe right-to-left shunting of blood is a hallmark of the disease), mortality still verged on 85 per cent, even after the introduction of fluid and alkali therapy in the attempt to repair acidosis.1 Painful and prolonged efforts by many at respirator support next brought us to the position in 1968 . . .
Discontinuing Antiepileptic Medication in Children with Epilepsy after Two Years without Seizures
Authors: Shlomo Shinnar, Eileen P.G. Vining, E. David Mellits, Bernard J. D'Souza, Kenton Holden, Rosemary A. Baumgardner, John M. Freeman
Journal: New England Journal of Medicine (1985)

Antiepileptic medications were discontinued in 88 children with epilepsy of various causes who had been free of seizures for two to four years. The subjects were then followed for six months to five years (mean, 22 months). Sixty-six (75 per cent) remained free of seizures. Electroencephalographic characteristics, type of seizure, and age at onset were important in predicting outcome. Specific electroencephalographic features (such as the presence or absence of slowing or spikes) were more predictive than simple classification of an electroencephalogram as normal or abnormal. A history of complex partial seizures that had been controlled for two years carried a relatively favorable prognosis (P<0.05), whereas a history of atypical febrile seizures carried a poor prognosis (P<0.05). The variable of a younger age at onset was also associated with a better outcome (P<0.05), but only if accompanied by electroencephalographic slowing. Altogether, six variables (the interaction of age at onset with electroencephalographic slowing, electroencephalographic spikes, atypical febrile seizures, complex partial seizures, electroencephalographic slowing, and electroencephalographic change) were statistically significant (P<0.05) in predicting outcome. We conclude that in most children with epilepsy who have been free of seizures for two or more years, antiepileptic medications can safely be discontinued, and that it is possible to predict reasonably well which children will remain free of seizures. (N Engl J Med 1985; 313:976–80.)
A Course for Medical Students in the Psychology of Sex: Training in Sociocultural Sensitivity
Authors: SHERWYN M. WOODS
Journal: American Journal of Psychiatry (1969)

Teaching sexual psychology to medical students must take into consideration their high degree of anxiety and conflict, common obsessive compulsive personality structure, lack of factual knowledge, and lack of awareness of the social class influences on sexual attitudes and behavior. A small group teaching method is presented that encourages the acquisition of knowledge and assists the student to reduce his own anxieties, increase his ease of communication, and broaden his sociocultural sensitivity.
Case of Gross Overdosage of Soluble Phenytoin
Authors: T. N. Nauth-Misir
Journal: BMJ (1948)

Soluble phenytoin is an anticonvulsant now widely used in the treatment of idiopathic epilepsy.The exact site of its action has not been elucidated, although it is generally appreciated that it acts differently from phenobarbitone.Toxic effects due to overdosage have been classified by Blair ( 1939) into (a) nervous symptoms consisting of giddi- ness, blurring of vision, diplopia, clonic spasm, tremors, muscular irritability, ataxia, and nystagmus; (b) mental symptoms consisting of euphoria, excitement, irritability, confusion, delusions, hallucinations, dullness, and depres- sion; (c) cutaneous eruptions, varying from a slight erythema to a scarlatiniform or morbilliform rash; and (d) gastro-intestinal symptoms such as nausea and anorexia.Other toxic effects include fever and swelling and tender- ness of the gums.These toxic effects have been noted in the course of therapeutic usage of the drug and are quickly relieved by reduction of the dose or temporary withdrawal of the drug.The following case of gross overdosage (self-adminis-