tbuckley/cabot-search huggingface dataset:
Association of Parvovirus B19 Genome in Children With Myocarditis and Cardiac Allograft Rejection
Authors: Kenneth O. Schowengerdt, Jiyuan Ni, Susan W. Denfield, Robert J. Gajarski, Neil E. Bowles, Geoffrey Rosenthal, Debra L. Kearney, Julia K. Price, Beverly B. Rogers, Gail M. Schauer, Richard E. Chinnock, Jeffrey A. Towbin
Journal: Circulation (1997)

Background Inflammatory diseases of the heart, including myocarditis and cardiac transplant rejection, are important causes of morbidity and mortality in children. Although viral infection may be suspected in either of these clinical conditions, the definitive etiology is often difficult to ascertain. Furthermore, the histology is identical for both disorders. Coxsackievirus has long been considered the most common cause of viral myocarditis; however, we previously demonstrated by polymerase chain reaction (PCR) analysis that many different, and sometimes unexpected, viruses may be responsible for myocarditis and cardiac rejection. In this study, we describe the association of parvovirus genome identified through PCR analysis of cardiac tissue in the clinical setting of myocarditis and cardiac allograft rejection. Methods and Results Myocardial tissue from endomyocardial biopsy, explant, or autopsy was analyzed for parvovirus B19 using primers designed to amplify a 699–base pair PCR product from the VP1 gene region. Samples tested included those obtained from patients with suspected myocarditis (n=360) or transplant rejection (n=200) or control subjects (n=250). Parvoviral genome was identified through PCR in 9 patients (3 myocarditis; 6 transplant) and no control patients. Of the 3 patients with myocarditis, 1 presented with cardiac arrest leading to death, 1 developed dilated cardiomyopathy, and the other gradually improved. Four of the 6 transplant patients had evidence of significant rejection on the basis of endomyocardial biopsy histology. All transplant patients survived the infection. Conclusions Parvovirus is associated with myocarditis in a small percentage of children and may be a potential contributor to cardiac transplant rejection. PCR may provide a rapid and sensitive method of diagnosis.
Effect of Carotid Baroceptor Stimulation upon the Forelimb Vascular Bed of the Dog
Authors: DIANA ZINGHER, FRED S. GRODINS
Journal: Circulation Research (1964)

The response of the musculocutaneous vascular bed of the dog's forelimb to carotid baroceptor stimulation was determined by measuring pressures at the level of the large artery, small artery, small vein, and large vein along with limb blood flow. In one series, limb blood flow was uncontrolled. In two other series, the limb was perfused at a constant flow rate and was also isolated from collateral flow in one of these. Elevation of carotid sinus pressure in the constant flow isolated (CFI) series produced an average fall in total limb, small vessel, and venous segment resistance of 27%, 36%, and 22% respectively but no significant change in arterial segment resistance. Since transmural pressure fell significantly in all three segments, active vasodilatation must also have occurred in all, including the arterial. This is reflected in the significant increase in compliance calculated for both the lumped arterial and lumped venous segments. In any given animal, there was a positive correlation between the percentage reduction in systemic pressure and total limb resistance, but this correlation was not evident between animals. In the series in which limb blood flow was uncontrolled, flow decreased consistently and significantly when carotid sinus pressure was elevated, the average decrease being 30%. Despite possible confusion introduced by the presence of an added fixed resistance in the limb circuit (rotameter), it is probable that this finding faithfully reflects the behavior of the intact limb.
The Role of Lens Implantation in Cataract Surgery
Authors: R A Thoft
Journal: Annual Review of Medicine (1984)

Cataract surgery results in a substantial loss of the refractive power of the eye, which may be corrected by wearing cataract glasses, by using contact lenses, or by replacing the cataractous lens with an intraocular lens implant. This chapter discusses the advantages and disadvantages of each of these methods, and emphasizes the role of lens implants. The three kinds of intraocular lens implants currently available include the iris-supported lens, the anterior chamber lens, and the posterior chamber lens. Intraocular lens implants are rapidly becoming the method of choice in many patients who require cataract operations.
Comparative genomics reveals birth and death of fragile regions in mammalian evolution
Authors: Max A Alekseyev, Pavel A Pevzner
Journal: Genome biology (2010)

An important question in genome evolution is whether there exist fragile regions (rearrangement hotspots) where chromosomal rearrangements are happening over and over again. Although nearly all recent studies supported the existence of fragile regions in mammalian genomes, the most comprehensive phylogenomic study of mammals raised some doubts about their existence.Here we demonstrate that fragile regions are subject to a birth and death process, implying that fragility has a limited evolutionary lifespan.This finding implies that fragile regions migrate to different locations in different mammals, explaining why there exist only a few chromosomal breakpoints shared between different lineages. The birth and death of fragile regions as a phenomenon reinforces the hypothesis that rearrangements are promoted by matching segmental duplications and suggests putative locations of the currently active fragile regions in the human genome.
Politics and policies: making change happen
Authors: H. Tholken
Journal: BMJ (2012)

The geopolitical consequences of climate change are real and imminent, says Hinrich Tholken , and an issue for Europe and Europe’s foreign services

The onset of climate change means that for the first time in modern human history our physical environment is no longer stable. Yet our rules for peaceful coexistence on an increasingly crowded planet have always assumed a stable environment. Geographical borders, watercourses, and coastlines have been understood as constants, but this seems no longer true.

Climate change requires us then to rethink some basic principles of geopolitical importance. We may need to revisit the laws of the sea and laws concerning natural resources. We may have to rethink the concept of national sovereignty. Adapting our geopolitics to a changing environment is a task for foreign policy.

In human history conflicts arise over access to resources and territories. Climate change will affect both. We will increasingly be short of such vital resources as fresh water, food, and clean energy. Rising sea levels and increased frequency of extreme weather events will render whole stretches of territory uninhabitable or no longer economically viable. Low lying coastal areas and islands may simply disappear.

We have no rules to clarify what will happen to the economic zones of islands and territories that have sunk into the sea. Arguments over single rocks and sand banks have erupted in the past, so it’s likely that the disappearance of such territories will lead to tensions and conflicts. Borders that follow coastlines, riverbeds, and river deltas will start shifting. Loss of territory may trigger migration and exacerbate tensions. We are …
The infusion of anti‐rho‐(D) opsonized erythrocytes may be useful in the treatment of patients, splenectomized or not, with chronic, refractory autoimmune thrombocytopenic purpura—a prospective study
Authors: Guillermo J. Ruiz‐Argüelles, Maria Guadalupe Apreza‐Molina, Beatriz Pérez‐Romano, Alejandro Ruiz‐Argüelles
Journal: American Journal of Hematology (1993)

Abstract Six patients with chronic refractory autoimmune thrombocytopenic purpura (ATP) were treated with five doses of autologous red blood cells (RBCs) opsonized ex vivo with anti‐RhO‐(D) IgG. Increases in platelet counts were observed in all cases; complete responses requiring no further treatment—for periods of 8–72 months—were recorded in four patients, three of them splenectomized. The cost of the procedure was significantly lower than other 'Fc receptor (FcR) blockade' treatments.
Clinico-pharmacological studies and clinical evaluation of flurbiprofen. A new non-steroidal antirheumatic agent.
Authors: I M Chalmers, B J Cathcart, E B Kumar, W C Dick, W W Buchanan
Journal: Annals of the Rheumatic Diseases (1972)

Flurbiprofen (BTS 18 322, 2-(2-fluoro-4-biphenylyl) propionic acid) is a member of the phenylalkanoic acid series.It differs from its predecessors (ibuprofen, ibufenac) in having a biphenyl nucleus (Fig. 1), but, like them, possesses analgesic, anti-inflammatory, and antipyretic properties.In animal experiments it has been found to be much more potent than ibupro- fen, acetylsalicylic acid, and other nonsteroidal anti-inflammatory drugs.It has been shown to be devoid of glucocorticoid activity and has no demon- strable effect on the adrenal cortex (Adams and McCullough, 1971).
Mycophenolate versus Azathioprine as Maintenance Therapy for Lupus Nephritis
Authors: Mary Anne Dooley, David Jayne, Ellen M. Ginzler, David Isenberg, Nancy J. Olsen, David Wofsy, Frank Eitner, Gerald B. Appel, Gabriel Contreras, Laura Lisk, Neil Solomons
Journal: New England Journal of Medicine (2011)

Maintenance therapy, often with azathioprine or mycophenolate mofetil, is required to consolidate remission and prevent relapse after the initial control of lupus nephritis.
Comparison of Primary Coronary Angioplasty and Intravenous Thrombolytic Therapy for Acute Myocardial Infarction
Authors: W. Douglas Weaver
Journal: JAMA (1997)

To provide a quantitative review of the treatment effects of primary coronary angioplasty vs intravenous thrombolysis for acute myocardial infarction.Ten randomized trials were identified through computerized bibliographic search of MEDLINE from January 1985 through March 1996 and by queries of principal investigators.Single-center and multicenter randomized trials comparing primary angioplasty with intravenous thrombolytic therapy among 2606 patients were included. Four trials compared angioplasty with streptokinase, 3 compared angioplasty with a 3- to 4-hour infusion of tissue-type plasminogen activator, and 3 compared angioplasty with "accelerated" administration of tissue-type plasminogen activator over 90 minutes.Each investigator provided definitions and exact data for outcome events. Odds ratios (ORs), 95% confidence intervals (CIs), and P values were calculated using exact tests for categorical data.Mortality at 30 days or less was 4.4% for the 1290 patients treated with primary angioplasty compared with 6.5% for the 1316 patients treated with thrombolysis (34% reduction; OR, 0.66; 95% CI, 0.46-0.94; P=.02). The effect was similar among thrombolytic regimens, and no subgroup demonstrated a significant reduction in death. The rates of death or nonfatal reinfarction were 7.2% for angioplasty and 11.9% for thrombolytic therapy (OR, 0.58; 95% CI, 0.44-0.76; P<.001). Angioplasty was associated with a significant reduction in total stroke (0.7% vs 2.0%; P=.007) and hemorrhagic stroke (0.1% vs 1.1%; P<.001).Based on outcomes at hospital discharge or 30 days, primary angioplasty appears to be superior to thrombolytic therapy for treatment of patients with acute myocardial infarction, with the proviso that success rates for angioplasty are as good as those achieved in these trials. Data evaluating longer-term outcomes, operator experience, and time delay before treatment are needed before primary angioplasty can be universally recommended as the preferred treatment.
A 10-year, single-institution analysis of clinicopathologic features and sentinel lymph node biopsy in thin melanomas
Authors: Chelsea Cooper, Jeffrey D. Wayne, Elizabeth M. Damstetter, Mary Martini, Jennifer Gordon, Joan Guitart, Dennis P. West, Beatrice Nardone, Alfred Rademaker, Pedram Gerami
Journal: Journal of the American Academy of Dermatology (2013)
Retinal Vascular Changes in Pre-Diabetes and Prehypertension
Authors: Thanh Tan Nguyen, Jie Jin Wang, Tien Yin Wong
Journal: Diabetes Care (2007)

The retinal vasculature can be viewed directly and noninvasively, offering a unique and easily accessible “window” to study the health and disease of the human microcirculation in vivo. In the last decade, advances in digital retinal photography and imaging techniques have allowed precise characterization of subtle retinal vascular changes in large populations. These retinal changes can be broadly divided into four groups: 1 ) classic retinal vascular changes in diabetes and hypertension (i.e., diabetic and hypertensive retinopathy), 2 ) isolated retinopathy signs in individuals with diabetes or hypertension (e.g., microaneurysm, retinal hemorrhage, or cotton wool spot), 3 ) changes in retinal vascular caliber, and 4 ) changes in retinal vascular architecture (e.g., retinal tortuosity).

New studies in large populations now show that retinal vascular changes are common in the general population and may precede the subsequent development of overt diabetes and hypertension. A consistent pattern of associations is also emerging, showing that specific retinal vascular changes may be related differently to hyperglycemia and blood pressure.

In this review, we summarize recent studies on the retinal vascular changes seen in diabetes and hypertension and speculate on potential research and clinical implications.

### Diabetic retinopathy

In individuals with diabetes, the classic primary retinal vascular complication—diabetic retinopathy—is well described (1). Diabetic retinopathy signs are broadly divided into nonproliferative and proliferative retinopathy. The prevalence of diabetic retinopathy increases with duration of diabetes. The Australian Diabetes, Obesity and Lifestyle Study (AusDiab) showed that the prevalence of diabetic retinopathy is less than 10% in those with diabetes duration of less than 5 years but more than 50% in those with 20 years or longer diabetes (2). The two major risk factors of diabetic retinopathy are hyperglycemia and hypertension, with hyperlipidemia as a possible third major risk factor. The importance of hyperglycemia has been confirmed in epidemiological studies (3), as well as two pivotal …
Effect of Histamine H2-Receptor Antagonist on the Phosphorus-Binding Abilities of Calcium Carbonate and Calcium Lactate in Hemodialysis Patients
Authors: NORIHIRO TAKAHASHI, TETSUO SHOJI, KEISUKE MATSUBARA, HIROFUMI HITOMI, MAYUKO HASHIMOTO, HIDEYASU KIYOMOTO, KOICHI UCHIDA, SHIGEHIRO MIKI, MAMORU HIROHATA, TSUTOMU ISHIZU, KENJI AKIYAMA, KATSUFUMI MIZUSHIGE, HIROHIDE MATSUO, SHIGEKAZU YUASA
Journal: Journal of the American Society of Nephrology (1999)

Abstract. The effect of histamine H2-receptor antagonist (famotidine) on the phosphorus-binding abilities of calcium carbonate and calcium lactate were examined in 13 chronic hemodialysis patients. In seven patients receiving calcium carbonate, famotidine (20 mg/d) was given because of gastroduodenal disorders, and calcium carbonate was replaced with calcium lactate as a phosphorus binder after 4 wk of treatment with famotidine. With the 4-wk administration of famotidine accompanied by calcium carbonate, the serum phosphorus level increased from 6.3 ± 0.9 to 7.1 ± 0.5 mg/dl ( P &lt; 0.05). However, with the substitution of calcium lactate, the serum phosphorus level decreased significantly when compared to that before substitution (6.3 ± 0.2 and 6.0 ± 0.9 mg/dl after 4 and 8 wk of substitution, respectively), despite continued administration of famotidine. Serum calcium, creatinine, alkaline phosphatase, high sensitive parathyroid hormone, blood urea nitrogen, arterial blood pH, and bicarbonate were not significantly altered during the trial period. In six control patients treated with calcium carbonate alone, there were no statistical changes in serum calcium and phosphorus levels after substitution of calcium lactate for calcium carbonate. These results suggest that famotidine significantly affects the phosphorus-binding ability of calcium carbonate, but not that of calcium lactate. A careful observation of changes in the serum phosphorus level should be required in hemodialysis patients receiving calcium carbonate and histamine H2-receptor antagonists. Calcium lactate may be useful as a phosphorus binder in such hemodialysis patients.
The distribution of adhesive mechanisms in the normal bronchial epithelium
Authors: S Montefort, J Baker, WR Roche, ST Holgate
Journal: European Respiratory Journal (1993)

The integrity of the bronchial epithelium is dependent on various adhesion mechanisms that serve to hold the composite structure of the epithelium together and anchor it to the underlying basement membrane. Using immunohistochemistry we wanted to map out a number of these junctional and non-junctional adhesion mechanisms in the normal human bronchial epithelium. The beta 1-associated integrin subunit alpha 2 was immunolocalized to all of the epithelial intercellular spaces, whilst alpha 6 and beta 4 were strongly evident at the basal cell layer basement membrane junction. The alpha 1 and alpha 5 integrin subunits were not detected anywhere in the epithelium. Monoclonal antibodies (MoAbs) to tight junction polypeptides and the E-cadherin, liver cell adhesion molecule (LCAM), immunolocalized to the apicolateral portions of the intercellular junctions between all neighbouring columnar cells, with LCAM extending further along the lateral cell membrane. Desmosomal protein (dp) 1 and 2 MoAbs gave a punctate pattern between all of the suprabasal cells, and exhibited the greatest intensity of staining at the junction between the columnar and basal cell layers. In conclusion, there is an organized distribution of adhesive mechanisms within the normal human bronchial epithelium, which may be targeted by the various insults which lead to epithelial shedding.
Response to methotrexate in early rheumatoid arthritis is associated with a decrease of T cell derived tumour necrosis factor alpha , increase of interleukin 10, and predicted by the initial concentration of interleukin 4
Authors: M. Rudwaleit
Journal: Annals of the Rheumatic Diseases (2000)

This study was performed to assess whether there is any change in the T cell cytokine pattern in early rheumatoid arthritis (RA) patients treated with methotrexate (MTX) and whether the lymphocytic cytokine pattern correlates with disease activity.Eight patients with RA (disease duration < six months) were studied serially before, after three, and after six to nine months of treatment with MTX for the cytokines tumour necrosis factor alpha (TNFalpha), interferon gamma (IFNgamma), interleukin 4 (IL4) and interleukin 10 (IL10) by intracellular staining of T cells derived from peripheral blood. Response to treatment was assessed by the modified disease activitiy score.The clincial response was accompanied by a significant decrease of TNFalpha positive CD4(+) T cells from a median of 8.53% (interquartile range 5.83-10.91%) before treatment to 6.17% (2.15-6.81%) after six to nine months of treatment (p=0.021). Inversely, IL10 positive T cells increased from a median of 0.65% (interquartile range 0.6-0.93%) to a median of 1. 3% (1.22%-1.58%) after six to nine months of treatment (p=0.009). No significant change in the percentage of INFgamma positive T cells and a small decrease of IL4 positive T cells during treatment were observed. The percentage of IL4 positive CD4(+) T cells before treatment correlated with disease activity after six to nine months (r= -0.7066; p=0.05).During treatment of RA with MTX the percentage of TNFalpha producing T cells decreases whereas that of IL10 producing T cells increases. This may affect macrophage activation and, therefore, may represent a regulatory mechanism relevant to disease remission. Furthermore, the percentage of IL4 positive CD4(+) T cells at disease onset may be a useful prognostic marker.
Conan Doyle as rheumatologist.
Authors: E D Hart
Journal: Annals of the Rheumatic Diseases (1982)

Thrombocytosis and thrombocytopenia in rheumatic diseases SIR, In their interesting abstract on platelets and rheumatoid arthritis' Farr et al. call attention to the frequent presence of an inflammation-related thrombocytosis in rheumatoid art- hritis (RA).They point out that such a finding is not specific of RA.In fact they found thrombocytosis related to disease activity also in patients affected with Crohn's disease.We reached the same conclusions by the analysis of platelet counts found in a wide series including patients with RA, juvenile chronic arthritis (JCA), Sjogren's syndrome
Will Evidence Be Enough to Promote Interactive Communication for the Benefit of Patients?
Authors: Robbie Foy
Journal: Annals of Internal Medicine (2010)

Letters20 July 2010Will Evidence Be Enough to Promote Interactive Communication for the Benefit of Patients?Robbie Foy, MBChB, PhDRobbie Foy, MBChB, PhDFrom University of Leeds, Leeds LS2 9LJ, United Kingdom.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-2-201007200-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Dr. Braillon and colleagues for their comments. We agree that implementing effective systems that can deal with the complexity of patient needs in an increasingly complex health care environment is an important challenge. Of note, our work suggests that the systems required for an effective line of interactive communication between collaborating primary care and specialist physicians need not in themselves be complex (for example, planned telephone or face-to-face contact). We would encourage further work to delineate the core “active ingredients” of collaborative interventions to inform policy initiatives to improve the continuity and outcomes of primary care.... Author, Article, and Disclosure InformationAuthors: Robbie Foy, MBChB, PhDAffiliations: From University of Leeds, Leeds LS2 9LJ, United Kingdom.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMeta-analysis: Effect of Interactive Communication Between Collaborating Primary Care Physicians and Specialists Robbie Foy , Susanne Hempel , Lisa Rubenstein , Marika Suttorp , Michelle Seelig , Roberta Shanman , and Paul G. Shekelle Will Evidence Be Enough to Promote Interactive Communication for the Benefit of Patients? Alain Braillon , Aurore Bernardy-Prud'homme , and Gerard Dubois Metrics 20 July 2010Volume 153, Issue 2Page: 131KeywordsCommunication in health careConflicts of interestHealth care ePublished: 20 July 2010 Issue Published: 20 July 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...