tbuckley/cabot-search huggingface dataset:
Raynaud Phenomenon of the Nipple in Breastfeeding Mothers
Authors: Meagan E Barrett, Misha M Heller, Honor Fullerton Stone, Jenny E Murase
Journal: JAMA Dermatology (2012)

<h3>Objective</h3>To elucidate the diagnostic criteria of Raynaud phenomenon of the nipple that will aid in recognizing and treating Raynaud phenomenon in breastfeeding mothers with chronic deep nipple pain during lactation.<h3>Design</h3>Retrospective review of a patient database composed of 22 cases of breastfeeding mothers who fit the diagnostic criteria for Raynaud phenomenon of the nipple.<h3>Setting</h3>Menlo Dermatology Medical Group in Menlo Park, California, an academic-affiliated, private dermatologic referral center.<h3>Patients</h3>All patients diagnosed as having Raynaud phenomenon of the nipple evaluated from January 1, 2004, through December 31, 2010.<h3>Main Outcome Measures</h3>The rate of failed treatment for Candida mastitis, the rate of improvement of symptoms with nifedipine use, and the overall rate of improvement of symptoms with appropriate therapy involving treatment of Raynaud phenomenon.<h3>Results</h3>Among the 22 patients with Raynaud phenomenon of the nipple, previous treatment for Candida mastitis with oral or topical antifungals was ineffective in 20 (91%). Of the 12 patients who tolerated a trial of nifedipine, 10 (83%) reported decreased or resolved nipple pain. All patients experienced marked improvement of symptoms with appropriate therapy involving treatment of Raynaud phenomenon.<h3>Conclusions</h3>Most patients were treated with antifungals before presentation without resolution of nipple pain. Nifedipine appears to be an effective medication for the treatment of Raynaud phenomenon of the nipple. With appropriate management of Raynaud phenomenon, breastfeeding mothers demonstrated improvement of nipple pain. Raynaud phenomenon of the nipple should be considered in the differential diagnosis of nipple pain during lactation.
Is This Patient Taking the Treatment as Prescribed?
Authors: B J Stephenson, B H Rowe, R B Haynes, W M Macharia, G Leon
Journal: JAMA (1993)

<h3>CLINICAL SCENARIOS</h3><h3>Case 1</h3> A 28-year-old woman presents to the emergency department in acute distress with a 3-day history of worsening asthma. Her prescribed medications include an inhaled β<sub>2</sub>-agonist and an inhaled steroid. When questioned, she breathlessly admits to "occasionally" missing her medications but indicates that this is "maybe only once or twice." <h3>Case 2</h3> A 55-year-old man with posttraumatic seizure disorder has been taking phenytoin since his injury. His seizures were initially adequately controlled but he recently has been having weekly seizures. In an office visit he resentfully denies missing any of his medication. <h3>THE IMPORTANCE OF CLINICAL EXAMINATION</h3> Physicians should measure compliance for patients prescribed a self-administered treatment because noncompliance is common and physicians can help patients to improve their compliance<sup>1,2</sup>and increase the benefit they derive from therapy. Compliance with long-term self-administered medication therapy is approximately 50% for those who remain in care.<sup>3</sup>
Increased Risk of Schizophrenia From Additive Interaction Between Infant Motor Developmental Delay and Obstetric Complications: Evidence From a Population-Based Longitudinal Study
Authors: Mary C. Clarke, Antti Tanskanen, Matti Huttunen, David A. Leon, Robin M. Murray, Peter B. Jones, Mary Cannon
Journal: American Journal of Psychiatry (2011)

Obstetric complications and developmental delay are well-established risk factors for schizophrenia. The authors investigated whether these risk factors interact in an additive manner to further increase risk for schizophrenia.The study population encompassed all individuals born in Helsinki between 1962 and 1969 who had developmental records archived in the Helsinki City Archives. Through linkage between the Finnish Population Register, the Finnish Hospital Discharge Register, and the Child Health Archives, child health cards were traced for 189 individuals who had received a diagnosis of schizophrenia and 189 healthy comparison subjects, individually matched to case subjects on gender and year of birth. Child health cards from the Child Health Archives contain detailed prospective developmental data from birth as well as an indicator of fetal distress, as measured by the Apgar score. Detailed developmental data from the first year of life were extracted.Delayed attainment of milestones in infancy significantly increased the risk of later development of schizophrenia in a dose-response manner. There was no significant main effect of obstetric complications on risk for schizophrenia and no significant association between obstetric complications and subsequent developmental delay. However, the additive effect of obstetric complications and delayed attainment of developmental milestones significantly increased the risk of schizophrenia beyond that associated with each factor independently (odds ratio=4.6, 95% confidence interval=1.3-17.2).These data provide evidence that underlying neurodevelopmental vulnerability, as indexed by delayed attainment of milestones, combined with obstetric adversity significantly increases the risk of schizophrenia in adulthood.
Gastrointestinal structure and function in germ-free or gnotobiotic animals.
Authors: G R Thompson, P C Trexler
Journal: Gut (1971)

Progress reportGastrointestinal structure and function in germ-free or gnotobiotic animals A truly germ-free animal harbours no associated forms of life, including viruses.Occasionally the term 'germ-free' has been used in a more restricted sense to denote animals that are free of pathogens only.For this reason it is preferable to use the term 'axenic' or the more general term 'gnotobiotic', when referring to animals in which the composition of any associated fauna or flora (biota), if present, is fully defined.Gnotobiotic animals, unless deliberately contaminated, are bacteria free but may harbour congenitally transmitted agents such as the leukaemogenic virus, found in most strains of what are usually referred to as 'germ-free' mice.Some of the advantages of investigating animals free of associated microbes were recognized even during the pioneering days of microbiology, as shown by the first report of the rearing of such animals'.Primarily because of technical difficulties, their use was greatly restricted until simple inexpensive apparatus made ofplastic film was developed2.At present the most commonly used species in germ-free work are mice, rats, and chickens.Germ-free rats and mice are available in large numbers from both institutional and com- mercial colonies, some of which have been maintained continuously since 1954.Recently, methods for obtaining and using germ-free animals have been simplified further by the development of disposable isolation apparatus which can be used for the larger animals, including pigs and even calves3, as illustrated in Figures 1 and2.These isolators can be used to contain animals that are infected with highly contagious pathogens as well as to exclude all microorganisms.Clinically, on an experimental basis, isolators have been used for surgical procedures and in the treatment of patients with extensive burns or those who have been immunosuppressed4.It seems likely that apparatus which so effectively controls cross-infection in the laboratory can also be used to solve similar problems in the hospital.This brief review does not attempt to cover all the physiological differences between conventional and germ-free animals but focuses on those relating to gastrointestinal morphology and function.A comprehensive treatise on the germ-free animal in research has already been published5.The Germ-free Gastrointestinal Tract MORPHOLOGY OF THE SMALL INTESTINEThe small intestine of germ-free animals differs from the conventional in several important respects.The germ-free intestinal wall looks and is thinner, not only because it is less cellular, but also because it is less well hydrated.The villi of germ-free dogs are the same length as those in conventional 230 on August 20,
Health department starts to stockpile masks for clinicians to combat swine flu
Authors: A. O'Dowd
Journal: BMJ (2009)

The Department of Health is planning to stockpile huge numbers of extra facemasks for clinicians to use in preparation for a possible pandemic of swine influenza.

Keeping the public informed is also being treated as a priority as the government is putting together an information leaflet that will be sent to every household in the United Kingdom next week.

An outbreak of swine flu is thought to have killed around 159 people in Mexico, although cases officially confirmed by the World Health Organization put the death toll at seven, with confirmed cases of flu found in people in Scotland, the United …
Cloned LYT-2+ cytolytic T lymphocytes destroy allogeneic tissue in vivo.
Authors: J D Tyler, S J Galli, M E Snider, A M Dvorak, D Steinmuller
Journal: The Journal of Experimental Medicine (1984)

The long-accepted notion that alloimmune cytolytic T cells (CTL) mediate transplantation immunity has recently been called into question. In order to ascertain directly whether alloimmune CTL can mediate destruction of foreign tissue, we tested the ability of mouse CTL expanded as cloned populations in vitro to destroy allogeneic skin in vivo. The results of these studies prove unequivocally that cloned Lyt-2+ CTL can perform this task in an immunologically specific, H-2-restricted, and dose-dependent fashion.
Arterial Stiffness and Risk of Coronary Heart Disease and Stroke
Authors: Francesco U.S. Mattace-Raso, Tischa J.M. van der Cammen, Albert Hofman, Nicole M. van Popele, Michiel L. Bos, Maarten A.D.H. Schalekamp, Roland Asmar, Robert S. Reneman, Arnold P.G. Hoeks, Monique M.B. Breteler, Jacqueline C.M. Witteman
Journal: Circulation (2006)

Arterial stiffness has been associated with the risk of cardiovascular disease in selected groups of patients. We evaluated whether arterial stiffness is a predictor of coronary heart disease and stroke in a population-based study among apparently healthy subjects.The present study included 2835 subjects participating in the third examination phase of the Rotterdam Study. Arterial stiffness was measured as aortic pulse wave velocity and carotid distensibility. Cox proportional hazards regression analysis was performed to compute hazard ratios. During follow-up, 101 subjects developed coronary heart disease (mean follow-up period, 4.1 years), and 63 subjects developed a stroke (mean follow-up period, 3.2 years). The risk of cardiovascular disease increased with increasing aortic pulse wave velocity index. Hazard ratios and corresponding 95% CIs of coronary heart disease for subjects in the second and third tertiles of the aortic pulse wave velocity index compared with subjects in the reference category were 1.72 (0.91 to 3.24) and 2.45 (1.29 to 4.66), respectively, after adjustment for age, gender, mean arterial pressure, and heart rate. Corresponding estimates for stroke were 1.22 (0.55 to 2.70) and 2.28 (1.05 to 4.96). Estimates decreased only slightly after adjustment for cardiovascular risk factors, carotid intima-media thickness, the ankle-arm index, and pulse pressure. The aortic pulse wave velocity index provided additional predictive value above cardiovascular risk factors, measures of atherosclerosis, and pulse pressure. Carotid distensibility as measured in this study was not independently associated with cardiovascular disease.Aortic pulse wave velocity is an independent predictor of coronary heart disease and stroke in apparently healthy subjects.
A National Estimate of the Economic Costs of Asthma
Authors: DAVID H. SMITH, DANIEL C. MALONE, KENNETH A. LAWSON, LYNN J. OKAMOTO, CARMELINA BATTISTA, WILLIAM B. SAUNDERS
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

This cost of illness analysis examines national cost and resource utilization by persons with asthma using a single, comprehensive data source, the 1987 National Medical Expenditure Survey. Direct medical expenditures included payments for ambulatory care visits, hospital outpatient services, hospital inpatient stays, emergency department visits, physician and facility payments, and prescribed medicines. Indirect medical costs included costs resulting from missed work or school and days with restricted activity at work. Point estimates and 95% confidence intervals (CI) were calculated and inflated to 1994 dollars. The total estimated cost was $5.8 billion (95% CI, $3.6 to $8 billion). The estimated direct expenditures were $5.1 billion (95% CI, $3.3 to $7.0 billion), and indirect expenditures were valued at $673 million (95% CI, $271 to $1,076 million). Hospitalization accounted for more than half of all expenditures. More than 80% of resources were used by 20% of the population (defined as ‘high-cost patients'). The estimated annual per patient cost for those high-cost patients was $2,584, in contrast with $140 for the rest of the sample. Findings from this study indicate that future asthma research and intervention efforts directed at hospitalizations and high-cost patients could help to decrease health care resource use and provide cost savings.
Interleukin 12 Protects from a T Helper Type 1–mediated Autoimmune Disease, Experimental Autoimmune Uveitis, through a Mechanism Involving Interferon γ, Nitric Oxide, and Apoptosis
Authors: Teresa K. Tarrant, Phyllis B. Silver, Jennifer L. Wahlsten, Luiz V. Rizzo, Chi-Chao Chan, Barbara Wiggert, Rachel R. Caspi
Journal: The Journal of Experimental Medicine (1999)

Pathogenic effector T cells in experimental autoimmune uveitis (EAU) are T helper type 1-like, and interleukin (IL)-12 is required for their generation and function. Therefore, we expected that IL-12 administration would have disease-enhancing effects. Mice were immunized with a uveitogenic regimen of the retinal antigen interphotoreceptor retinoid-binding protein, treated with IL-12 (100 ng/d for 5 d), and EAU was assessed by histopathology. Unexpectedly, IL-12 treatment failed to enhance EAU in resistant strains and downregulated disease in susceptible strains. Only treatment during the first, but not during the second, week after immunization was consistently protective. High levels of interferon gamma (IFN-gamma) were present in the serum during IL-12 treatment, but subsequent antigen-specific IFN-gamma production in protected mice was diminished, as were IL-5 production, lymph node cell proliferation, and serum antibody levels. Treated mice had fewer cells and evidence of enhanced apoptosis in the draining lymph nodes. Unlike wild-type mice, IFN-gamma-deficient, inducible nitric oxide synthase (iNOS)-deficient, and Bcl-2(lck) transgenic mice were poorly protected by IL-12, whereas IL-10-deficient mice were protected. We conclude that administration of IL-12 aborts disease by curtailing development of uveitogenic effector T cells. The data are compatible with the interpretation that IL-12 induces systemic hyperinduction of IFN-gamma, causing activation of iNOS and production of NO, which mediates protection at least in part by triggering Bcl-2 regulated apoptotic deletion of the antigen-specific T cells as they are being primed.
Imaging Tumor-Stroma Interactions during Chemotherapy Reveals Contributions of the Microenvironment to Resistance
Authors: Elizabeth S. Nakasone, Hanne A. Askautrud, Tim Kees, Jae-Hyun Park, Vicki Plaks, Andrew J. Ewald, Miriam Fein, Morten G. Rasch, Ying-Xim Tan, Jing Qiu, Juwon Park, Pranay Sinha, Mina J. Bissell, Eirik Frengen, Zena Werb, Mikala Egeblad
Journal: Cancer Cell (2012)
Ajay Kumar Rai-Chaudhuri
Authors: A. R.-C. N. Rai-Chaudhuri
Journal: BMJ (2013)

Ajay Kumar Rai-Chaudhuri (“Chau”) excelled in pathology during his studies. In 1958 he set sail on the M V Asia bound for Europe. He claimed he only brought along two items for the journey, a copy of Gray’s Anatomy and a jar of his mother’s lemon pickle to ward off seasickness. After …
A Member of the Dendritic Cell Family That Enters B Cell Follicles and Stimulates Primary Antibody Responses Identified by a Mannose Receptor Fusion Protein
Authors: Claude Berney, Suzanne Herren, Christine A. Power, Siamon Gordon, Luisa Martinez-Pomares, Marie H. Kosco-Vilbois
Journal: The Journal of Experimental Medicine (1999)

Dendritic cells (DCs) are known to activate naive T cells to become effective helper cells. In addition, recent evidence suggests that DCs may influence naive B cells during the initial priming of antibody responses. In this study, using three-color confocal microscopy and three-dimensional immunohistograms, we have observed that in the first few days after a primary immunization, cells with dendritic morphology progressively localize within primary B cell follicles. These cells were identified by their ability to bind a fusion protein consisting of the terminal cysteine-rich portion of the mouse mannose receptor and the Fc portion of human immunoglobulin (Ig)G1 (CR-Fc). In situ, these CR-Fc binding cells express major histocompatibility complex class II, sialoadhesin, and CD11c and are negative for other markers identifying the myeloid DC lineage, such as (CD11b), macrophages (F4/80), follicular DCs (FDC-M2), B cells (B220), and T cells (CD4). Using CR-Fc binding capacity and flow cytometry, the cells were purified from the draining lymph nodes of mice 24 h after immunization. When injected into naive mice, these cells were able to prime T cells as well as induce production of antigen-specific IgM and IgG1. Furthermore, they produced significantly more of the lymphocyte chemoattractant, macrophage inflammatory protein (MIP)-1alpha, than isolated interdigitating cells. Taken together, these results provide evidence that a subset of DCs enters primary follicles, armed with the capacity to attract and provide antigenic stimulation for T and B lymphocytes.
Hypocapnia Is Not a Predictor of Central Sleep Apnea in Patients with Cirrhosis
Authors: Shahrokh Javaheri, Khalid F. Almoosa, Khaled Saleh, Charles L. Mendenhall
Journal: American Journal of Respiratory and Critical Care Medicine (2005)

During sleep, maintenance of rhythmic breathing is critically dependent on the level of PCO2, such that if the prevailing spontaneous PCO2 decreases below the apneic threshold, central sleep apnea (CSA) occurs. Several studies have shown that in patients with systolic heart failure (SHF), presence of a low, awake arterial PCO2 (PaCO2) increases the likelihood of developing CSA during sleep. We therefore sought to determine if a low PaCO2 is a predictor of CSA in patients with cirrhosis of the liver and with normal left ventricular systolic function. In 13 hypocapnic (PaCO2 < 36 mm Hg, mean = 33 mm Hg) patients with SHF and a mean left ventricular ejection fraction of 23%, the mean apnea–hypopnea index, was 28/hour. CSA accounted for most of the breathing disorders. In 10 hypocapnic (PaCO2 < 36 mm Hg, mean = 32 mm Hg) patients with cirrhosis and a normal left ventricular ejection fraction (60%), the mean apnea–hypopnea index was 2/hour. The maximum central apnea index was 0.2/hour. There were no significant differences in age, demographics, pulmonary function tests, PaO2, PaCO2, minute and alveolar ventilation, and ventilatory responses to CO2 between the two groups. We conclude that, in contrast to SHF, presence of hypocapnia does not predict CSA in cirrhosis.
Assessment of bone in Ehlers Danlos syndrome by ultrasound and densitometry
Authors: A L Dolan, N K Arden, R Grahame, T D Spector
Journal: Annals of the Rheumatic Diseases (1998)

Ehlers Danlos syndrome (EDS) is an inherited disorder of connective tissue characterised by hyperextensible skin, joint laxity, and easy bruising. There are phenotypic similarities with osteogenesis imperfecta, but in EDS a tendency to fracture or altered bone mass has not previously been considered to be a cardinal feature.This case-control design study investigates whether 23 patients with EDS had differences in fracture rates, bone mass, and calcaneal ultrasound parameters compared with age and sex matched controls.23 cases of EDS (mean (SD) age 38.5 (15.5)) were compared with 23 controls (mean age 37.8 (14.5)). A significant reduction in bone density measured by dual energy x ray absorptiometry was found at the neck of femur by 0.9 SD, p = 0.05, and lumbar spine by 0.74 SD, p = 0.02. At the calcaneum, broad band ultrasound attenuation and speed of sound were significantly reduced compared with controls by 0.95 SD (p = 0.004) and 0.49 SD (p = 0.004) for broad band ultrasound attenuation and speed of sound respectively. Broad band ultrasound attenuation and speed of sound remained significantly reduced after adjusting for bone mineral density (BMD). After adjusting for functional status (HAQ), age and sex, hypermobility was inversely correlated with broad band ultrasound attenuation and SOS, but not BMD at hip or spine. Previous fracture was 10 times more common in EDS (p < 0.001), with 86.9% of patients reporting a total of 47 low impact fractures, compared with 8.7% of controls.This study has identified a tendency of EDS patients to fracture, have low bone mass and abnormal bone structure. The aetiology is likely to be multifactorial, with an inherited structural element, accentuated by immobility or reduced exercise. This is one of the first clinical studies to suggest ultrasound can detect structural differences in bone, independent of dual energy x ray absorptiometry.
Associations Among Visceral Fat, All-Cause Mortality, and Obesity-Related Mortality in Japanese Americans
Authors: Marguerite J. McNeely, Jane B. Shofer, Donna L. Leonetti, Wilfred Y. Fujimoto, Edward J. Boyko
Journal: Diabetes Care (2011)

The study objective was to examine the associations among visceral fat (VF), all-cause mortality, and obesity-related mortality.A total of 733 Japanese Americans were followed for 16.9 years. Hazard ratios (HRs) per interquartile range increase in VF were calculated using time-dependent Cox proportional hazard models censored at age 82 years, with age as the time axis adjusted for sex and smoking.Higher VF was associated with all-cause mortality (HR 1.39 [95% CI 1.11-1.75] 107 deaths) and obesity-related mortality (1.39 [1.04-1.85], 68 deaths from cardiovascular disease, diabetes, or obesity-related cancer). After further adjustment for waist circumference, VF remained significantly associated with all-cause mortality (1.41 [1.04-1.92]) but not with obesity-related mortality. The associations between mortality and VF were not independent of BMI.VF was associated with all-cause mortality and obesity-related mortality in Japanese Americans. VF did not significantly improve mortality risk assessment beyond that of BMI.
Stasis Thrombi Induced by Bacterial Endotoxin
Authors: DUNCAN P. THOMAS, STANFORD WESSLER
Journal: Circulation Research (1964)

1. In normal rabbits, single intravenous doses of E. coli and Salmonella endotoxin produce an immediate, transient, hypercoagulable state. Venous stasis occurring during such a state allows the formation of massive red thrombi at sites of obstructed blood flow. The duration of stasis required to produce thrombi following endotoxin administration depends in part on the preinfusion silicone clotting time of the rabbit. 2. E. coli endotoxin shortens the recalcification time of platelet-poor plasma obtained from normal subjects and from patients with heredofamilial coagulation defects of Factor XII (Hageman) and Factor IX (plasma thromboplastin component). In contrast, the recalcification time of platelet-poor plasma obtained from patients with Factor XI (plasma thromboplastin antecedent) deficiency is lengthened by endotoxin. It is suggested that the heat-labile plasma factor known to be required for the platelet-endotoxin interaction may be related to Factor XI.