tbuckley/cabot-search huggingface dataset:
SOME ASPECTS OF MILITARY OPHTHALMOLOGY
Authors: S. H. McKee
Journal: BMJ (1918)

TSEPT. 28. I9I8 3 40 MElDICAL JOURNAITSP.2 01 anything like a useful number of cases, or their records, for a sufficiently long time after their evacuation from France.Except wlhen the military situation demands it, a patient is not fit for evacuation from France until he is at least fit and ready for passive movement.In conclusion I would like to call attention again to the widespread desire of surgeons serving abroad to hear more of the ultimate results of cases which pass through their lhands.Our colleagues on lhorne service are apt to forget that some of us have been in France for four years and are consequently more or less in ignorance of many facts which they may regard as common knowledge.
Effects of prolonged, repeated exposure to ozone, sulfuric acid, and their combination in healthy and asthmatic volunteers.
Authors: W S Linn, D A Shamoo, K R Anderson, R C Peng, E L Avol, J D Hackney
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

To evaluate effects of "acid summer haze" on individuals who exercise extensively outdoors, we exposed 45 adult volunteers (15 normal or atopic, 30 asthmatic) in a chamber to a mixture of 0.12 ppm ozone (O3) and approximately 100 micrograms/m3 of respirable sulfuric acid aerosol (H2SO4). On separate occasions we exposed the same subjects to O3 alone, to H2SO4 alone, and to clean air. In exposures involving H2SO4, excess acid was generated to consume ammonia released by the subjects, and the aerosol therefore contained ammonium salts in addition to H2SO4. Subjects were exposed to each atmosphere on two successive days, for 6.5 h/d, with six 50-min exercise periods at ventilation rates averaging 29 L/min. Exposures were conducted during four successive weeks, in random order. Lung function and symptoms were measured before exposure and hourly during exposure. Bronchial reactivity to inhaled methacholine was measured just after the end of each exposure. Exposure to H2SO4 alone caused no significant changes in lung function, symptoms, or bronchial reactivity relative to clean air. Exposure to O3 alone or O3 + H2SO4 caused a progressive, statistically significant (p < 0.05) decline in forced expiratory function, smaller on the second day than the first, as previously found by others for O3 exposure. Bronchial reactivity increased significantly after exposure to O3 with or without H2SO4. Changes in mean lung function and bronchial reactivity with O3 + H2SO4 exposure were modestly larger than changes with O3 exposure, but the differences were nonsignificant or marginally significant. A minority of individual asthmatic and nonasthmatic subjects showed substantially greater declines in function with exposure to O3 + H2SO4 relative to O3 alone. Repeat exposure studies of these subjects again showed an excess response to O3 + H2SO4 on the average, but there was no significant correlation between the excess responses of individual subjects in the original and repeat studies. We conclude that for typical healthy or asthmatic adults heavily exposed to acid summer haze, O3 is more important than H2SO4 as a cause of short-term respiratory irritant effects.
Effectiveness of antibiotics in preventing meningococcal disease after a case: systematic review
Authors: Bernadette Purcell, Susanne Samuelsson, Susan J M Hahné, Ingrid Ehrhard, Sigrid Heuberger, Ivonne Camaroni, André Charlett, James M Stuart
Journal: BMJ (2004)

<b>Objective</b> To summarise the evidence for the role of antibiotics in preventing further cases of meningococcal disease through chemoprophylaxis given to the index patient, household contacts, and children in day care settings after a single case. <b>Design</b> Systematic review. <b>Methods</b> Studies were identified by searching Embase (1983-2003), Medline (1965-2003), and CAB Health (1973-2003) and by contacting the World Health Organization and the European meningococcal disease surveillance network and examining references of identified papers. The review included all studies with at least 10 cases in which outcomes were compared between treated and untreated groups. <b>Main outcome measure</b> Subsequent cases of meningococcal disease 1-30 days after onset of disease in the index patient. <b>Results</b> Four observational studies and one small trial met the inclusion criteria. Meta-analysis of studies on chemoprophylaxis given to household contacts showed a significant reduction in risk (risk ratio 0.11, 95% confidence interval 0.02 to 0.58). The number needed to treat to prevent a case was estimated as 218 (121 to 1135). Primary outcome data were not available in studies of chemoprophylaxis given to the index patient: when prophylaxis had not been given, rate of carriage after discharge from hospital was estimated as 3% (0 to 6), probably an underestimate of the true rate. No studies of chemoprophylaxis in day care settings were identified that met the inclusion criteria. <b>Conclusion</b> There have been no high quality experimental trials looking at control policies for meningococcal disease. The best available evidence is from retrospective studies. The risk of meningococcal disease in household contacts of a patient can be reduced by an estimated 89% if they take antibiotics known to eradicate meningococcal carriage. Chemoprophylaxis should be recommended for the index patient and all household contacts.
Production of tumor necrosis factor/cachectin by human T cell lines and peripheral blood T lymphocytes stimulated by phorbol myristate acetate and anti-CD3 antibody.
Authors: S S Sung, J M Bjorndahl, C Y Wang, H T Kao, S M Fu
Journal: The Journal of Experimental Medicine (1988)

The induction of mRNA synthesis and accumulation of TNF/cachectin and lymphotoxin (LT) mRNAs in T leukemic cell lines and freshly isolated T cells were studied by Northern blot analyses. Without stimulation, TNF mRNA was barely detected in four T cell lines (CEM, KE4, MT-1, and SKW-3) and not detectable in Molt-4 and Jurkat cells, while a considerable amount of TNF mRNA was observed in HSB-2 cells. When stimulated by PMA, these T cell lines accumulated varying levels of TNF mRNA. All seven T cell lines expressed LT mRNA when unstimulated and responded well to PMA by increased accumulation of LT mRNA. The calcium ionophore A23187 by itself had no effect on TNF and LT mRNA accumulations in these cell lines. The CD3+ T cell lines did not respond to anti-CD3 mAb T3-II alone. However, A23187 and mAb T3-II further elevated TNF and LT mRNA accumulations in PMA-treated T cell lines. Synergism between PMA and mAb T3-II was modest in the CD3+ cell lines. A slight difference in kinetics of TNF and LT mRNA accumulations was noted. In addition, heterogeneities in TNF and LT expressions by these cell lines in responses to PMA and other stimuli were observed. In monocyte-depleted peripheral blood T cell populations. PMA was able to induce both TNF and LT mRNA syntheses. This effect was potentiated markedly by the addition of anti-CD3 mAb T3-II. This synergistic response to anti-CD3 mAb and PMA provided further evidence that T cells were the source of TNF synthesis in these cultures. There was a difference in the kinetics of TNF mRNA accumulation and that of LT mRNA. Maximal accumulation of TNF mRNA occurred at 4 h while 8-18 h was required for maximal LT mRNA accumulation. IL-2 mRNA accumulated at an intermediate peak time of 4-8 h. Western blot analyses and cytotoxicity assays with L cells as targets indicated that these T cell lines and peripheral blood T cells secreted TNF. These results provide further evidence that human T cells are capable of making TNF as well as LT under appropriate stimulations. Their productions are an integral part of T cell response to activation signals. In addition, it appears that the production of these two closely related molecules is independently regulated.
Smad4 Inactivation Promotes Malignancy and Drug Resistance of Colon Cancer
Authors: Panagiotis Papageorgis, Kuanghung Cheng, Sait Ozturk, Yi Gong, Arthur W. Lambert, Hamid M. Abdolmaleky, Jin-Rong Zhou, Sam Thiagalingam
Journal: Cancer Research (2011)

Abstract SMAD4 is localized to chromosome 18q21, a frequent site for loss of heterozygosity in advanced stage colon cancers. Although Smad4 is regarded as a signaling mediator of the TGFβ signaling pathway, its role as a major suppressor of colorectal cancer progression and the molecular events underlying this phenomenon remain elusive. Here, we describe the establishment and use of colon cancer cell line model systems to dissect the functional roles of TGFβ and Smad4 inactivation in the manifestation of a malignant phenotype. We found that loss of function of Smad4 and retention of intact TGFβ receptors could synergistically increase the levels of VEGF, a major proangiogenic factor. Pharmacologic inhibition studies suggest that overactivation of the TGFβ-induced MEK-Erk and p38-MAPK (mitogen-activated protein kinase) auxiliary pathways are involved in the induction of VEGF expression in SMAD4 null cells. Overall, SMAD4 deficiency was responsible for the enhanced migration of colon cancer cells with a corresponding increase in matrix metalloprotease 9 enhanced hypoxia-induced GLUT1 expression, increased aerobic glycolysis, and resistance to 5′-fluoruracil–mediated apoptosis. Interestingly, Smad4 specifically interacts with hypoxia-inducible factor (HIF) 1α under hypoxic conditions providing a molecular basis for the differential regulation of target genes to suppress a malignant phenotype. In summary, our results define a molecular mechanism that explains how loss of the tumor suppressor Smad4 promotes colorectal cancer progression. These findings are also consistent with targeting TGFβ-induced auxiliary pathways, such as MEK-ERK, and p38-MAPK and the glycolytic cascade, in SMAD4-deficient tumors as attractive strategies for therapeutic intervention. Cancer Res; 71(3); 998–1008. ©2011 AACR.
Back to the '90s — The Supreme Court Immunizes Managed Care
Authors: M Gregg Bloche
Journal: New England Journal of Medicine (2004)

Should the law let patients sue health plans for damages when plans deny coverage and bad results ensue? A June ruling by the U.S. Supreme Court has returned this question to the forefront of the nation's political agenda. The decision, in Aetna v. Davila, 1 immunized employer-sponsored health plans against damage suits for wrongful denial of coverage. It voided statutes in 10 states that expressly allowed such suits and barred courts everywhere from permitting such claims to go forward under judge-made law. Consumer advocates, congressional Democrats, and their party's presidential nominee, John Kerry, vowed legislative action to end managed care's immunity, . . .
Rate and Determinants of Association Between Advanced Retinopathy and Chronic Kidney Disease in Patients With Type 2 Diabetes
Authors: Giuseppe Penno, Anna Solini, Giacomo Zoppini, Emanuela Orsi, Gianpaolo Zerbini, Roberto Trevisan, Gabriella Gruden, Franco Cavalot, Luigi Laviola, Susanna Morano, Antonio Nicolucci, Giuseppe Pugliese
Journal: Diabetes Care (2012)

OBJECTIVE To evaluate the rate and determinants of concordance between advanced diabetic retinopathy (DR) and chronic kidney disease (CKD), as assessed by both albuminuria and estimated glomerular filtration rate (eGFR), in the large cohort of the Renal Insufficiency And Cardiovascular Events (RIACE) Italian multicenter study. RESEARCH DESIGN AND METHODS Patients with type 2 diabetes (n = 15,773) visiting consecutively 19 hospital–based diabetes clinics in years 2007 and 2008 were examined. DR was assessed by dilated fundoscopy. CKD was defined based on albuminuria and eGFR. RESULTS CKD was present in 58.64% of subjects with advanced DR, whereas advanced DR was detectable only in 15.28% of individuals with any CKD and correlated with the albuminuric CKD phenotypes more than with the nonalbuminuric phenotype. Age, male sex, diabetes duration, hemoglobin A1c, hypertension, triglycerides, previous cardiovascular disease, and, inversely, HDL-cholesterol correlated independently with the presence of any CKD in individuals with advanced DR; correlates differed according to the presence of albuminuria, reduced eGFR, or both. Conversely, factors associated with the presence of advanced DR in subjects with any CKD were diabetes treatment, previous cardiovascular disease, albuminuria, and, inversely, smoking, eGFR, and age at diagnosis. CONCLUSIONS Concordance of CKD with advanced DR is low in subjects with type 2 diabetes, and CKD without advanced DR is more frequent than isolated advanced DR, at variance with type 1 diabetes. Factors independently associated with the presence of any CKD in individuals with advanced DR differ, at least in part, from those correlating with the presence of advanced DR in subjects with any CKD and by CKD phenotype.
Managing infertility in general practice must include screening for sexual infections
Authors: A. J Winter, S. Ahmad
Journal: BMJ (1998)

EDITOR—Hargreave and Mills failed sufficiently to emphasise the importance of sexually transmitted infections in their review on investigating and managing infertility in general practice.1 Genital tract infection with Chlamydia trachomatis is a major risk factor for subsequent tubal infertility.2 Many episodes of tubal infection can be asymptomatic3; those patients who have appreciable pelvic inflammation are …
Malignant effusions and immunogenic tumour-derived exosomes
Authors: Fabrice Andre, Noel EC Schartz, Mojgan Movassagh, Caroline Flament, Patricia Pautier, Philippe Morice, Christophe Pomel, Catherine Lhomme, Bernard Escudier, Thierry Le Chevalier, Thomas Tursz, Sebastian Amigorena, Graca Raposo, Eric Angevin, Laurence Zitvogel
Journal: The Lancet (2002)
The New Medical Conversation: Media, Patients, Doctors, and the Ethics of Scientific Communication
Authors: C. Stark
Journal: BMJ (2003)

Dennis J Mazur Rowman & Littlefield Publishers Inc, £20.95, pp 187 ISBN 0742520293 Rating: ![Graphic][1]</img>![Graphic][2]</img> The relationship between doctors and their patients has changed. When discussing treatment, it was doctors who largely decided what options were likely to be appropriate, and what information should be presented to patients. Legal precedent, cultural shifts, and the internet have combined to increase patient access to information about treatment options. In the United States, direct to consumer advertising has accelerated these changes (www.fda.gov/cder/ddmac/globalsummit2003/). A series of legal decisions has increased the expectation on … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif
Neuronal Intrinsic Mechanisms of Axon Regeneration
Authors: Kai Liu, Andrea Tedeschi, Kevin Kyungsuk Park, Zhigang He
Journal: Annual Review of Neuroscience (2011)

Failure of axon regeneration after central nervous system (CNS) injuries results in permanent functional deficits. Numerous studies in the past suggested that blocking extracellular inhibitory influences alone is insufficient to allow the majority of injured axons to regenerate, pointing to the importance of revisiting the hypothesis that diminished intrinsic regenerative ability critically underlies regeneration failure. Recent studies in different species and using different injury models have started to reveal important cellular and molecular mechanisms within neurons that govern axon regeneration. This review summarizes these observations and discusses possible strategies for stimulating axon regeneration and perhaps functional recovery after CNS injury.
Predicting the Onset of Glaucoma
Authors: Robert N. Weinreb, Linda M. Zangwill, Sonia Jain, Lida M. Becerra, Keri Dirkes, Jody R. Piltz-Seymour, George A. Cioffi, Gary L. Trick, Anne L. Coleman, James D. Brandt, Jefferey M. Liebmann, Mae O. Gordon, Michael A. Kass
Journal: Ophthalmology (2010)
Neurolymphomatosis: diagnosis, management, and outcomes in patients treated with rituximab
Authors: H. K. Gan, A. Azad, L. Cher, P. L.R. Mitchell
Journal: Neuro-Oncology (2009)

Neurolymphomatosis (NL) is an uncommon syndrome of peripheral or cranial nerve root dysfunction secondary to infiltration by B-cell non-Hodgkin's lymphoma (NHL). A high index of suspicion is required as presenting symptoms are varied, conventional radiology has only modest sensitivity, and pathological diagnosis is often difficult. Treatment with chemotherapy alone has an objective response rate of 82%, although long-term outcomes are highly variable. This case series describes outcomes in four patients whose management incorporated PET scanning and the use of rituximab in combination with chemotherapy. PET scanning could often diagnose NL where other diagnostic modalities were non-diagnostic. Although combination therapy with rituximab and chemotherapy has been shown to be superior to chemotherapy alone in other forms of NHL, this does not appear to be the case in patients with NL. This may reflect the inability of rituximab to adequately penetrate into the central and peripheral nervous system. This is supported by the common finding that patients will relapse solely with NL despite on-going complete remission at sites outside the nervous system. The prognosis of these patients is poor, with the disease often following a progressive course despite treatment.
Comparison of peak oxygen consumption during cycle and treadmill exercise in severe chronic obstructive pulmonary disease.
Authors: R S Mathur, S M Revill, D D Vara, R Walton, M D Morgan
Journal: Thorax (1995)

BACKGROUND--In normal subjects treadmill exercise usually produces the greatest maximal oxygen consumption (VO2max). This may not be true for patients with severe chronic obstructive pulmonary disease (COPD) in whom bicycle exercise, which offers support for the shoulder girdle, may produce a higher oxygen consumption than treadmill exercise. The aim of this study was to determine which mode of exercise produced the greatest oxygen consumption in patients with severe COPD. METHODS--Eight patients with severe COPD (forced expiratory volume in one second (FEV1) more than three standardised residuals below predicted) exercised to a symptom limited maximum on a bicycle and on a treadmill on separate days. The workload on the bicycle wa increased by 10 watts each minute, and the treadmill gradient was increased by 2.5% alternate minutes whilst the speed remained constant. Measurements of oxygen consumption (VO2), ventilation (VE), heart rate, and oxygen saturation were made, and capillary blood gases were measured before and immediately after exercise. Lactate concentration was measured before and four minutes after exercise. RESULTS--There were no differences at peak exercise between the two forms of exercise for VO2 (median 11.7 and 12.2 ml/min/kg for bicycle and treadmill, respectively), for VE (median 26.6 and 25.0 l/min, respectively), and for heart rate (median 119 and 115 beats/min, respectively). The median lactate levels after bicycle exercise were higher than those after the treadmill (2.42 v 0.94 mmol/l). CONCLUSIONS--Although only a small number of patients was studied and individual variability was large, there was no clear difference between the two forms of exercise. Regular bicycle exercise was unfamiliar to this group of patients and generated the greatest lactate response. The results do not support the hypothesis that bicycle exercise will produce a better performance in patients with severe COPD, but the two modes of exercise cannot be used interchangeably.
Predicting Live Birth, Preterm Delivery, and Low Birth Weight in Infants Born from In Vitro Fertilisation: A Prospective Study of 144,018 Treatment Cycles
Authors: Scott M. Nelson, Debbie A. Lawlor
Journal: PLoS Medicine (2011)

Using the HFEA database of all 144,018 live births in all IVF cycles in the UK between 2003 and 2007, Scott Nelson and Debbie Lawlor show that couple- and treatment-specific factors can be used to help predict successful outcome following IVF.
Refining Treatment Decisions in Older Patients With Breast Cancer
Authors: Lisa Flaum, William J. Gradishar
Journal: JAMA Oncology (2015)

Michaela A. Dinan, PhD; Xiaojuan Mi, PhD; Shelby D. Reed, PhD; Bradford R. Hirsch, MD, MBA; Gary H. Lyman, MD, MPH; Lesley H. Curtis, PhD
Double Y-stenting for tracheobronchial stenosis
Authors: Masahide Oki, Hideo Saka
Journal: European Respiratory Journal (2012)

The purpose of the present study was to evaluate the feasibility, efficacy and safety of the double Y-stenting technique, by which silicone Y-stents are placed on both the main carina and another peripheral carina, for patients with tracheobronchial stenosis. Under general anaesthesia, using rigid and flexible bronchoscopes, a Dumon™ Y-stent (Novatech, La Ciotat, France) was first placed on the primary right or secondary left carina followed by another Y-stent on the main carina so as to insert the bronchial limb of the stent into the first Y-stent. Patients who underwent double Y-stent placement during 3 yrs and 1 month in a single centre were retrospectively reviewed. In the study period, 93 patients underwent silicone stent placement and 12 (13%) underwent double Y-stent placement (11 for right and one for left bronchus). A combination of Y-stents, 14 × 10 × 10 mm and 16 × 13 × 13 mm in outer diameter, were most frequently used. Dyspnoea was relieved in all patients. Six out of seven patients with supplemental oxygen before stent placement could be discharged without supplemental oxygen. Median survival after stenting was 94.5 days. One pneumothorax and one granuloma formation occurred. Double Y-stent placement for patients with tracheobronchial stenosis was technically feasible, effective and acceptably safe.
Air-trapping on HRCT as a marker for patient outcome in severe asthmatics treated with azithromycin
Authors: Matthias Lavens, Guy Brusselle, Geert Verleden, Walter De Wever, Johan Coolen, Johny Verschakelen
Journal: European Respiratory Journal (2014)

Introduction : Add-on treatment with azithromycin reduces the rate of exacerbations and lower respiratory tract infections (LTRI) in specific phenotypes of severe asthma. High resolution CT (HRCT) determined air-trapping in asthmatic subjects identifies a group of individuals with a high risk of severe disease.   Objectives : Can HRCT determined air-trapping predict clinical outcome of add-on treatment with azithromycin in severe asthmatics?   Methods : 68 subjects with exacerbation prone severe asthma were randomized to placebo (n=32) or azithromycin (n=36) as add-on treatment to combination therapy of inhaled corticosteroids and long-acting β2 agonists. Two subgroups were defined according to the presence (n=43) or absence (n=25) of air-trapping on HRCT. The primary clinical outcome (PEP) is the rate of patients with severe exacerbations and LRTI requiring treatment with antibiotics during the 26-week treatment phase.   Results : In the patient group without air-trapping on HRCT, there was a 26% absolute reduction in PEP rate (66% PEP rate in the intervention group with placebo and 40% PEP rate in the intervention group with azithromycin). In the patient group with HRCT determined air-trapping, PEP rates showed no benefit from azithromycin (42% PEP rate in the intervention group with placebo and 56% PEP rate in the intervention group with azithromycin).   Conclusion : These data suggest a higher clinical response of add-on treatment with azithromycin in exacerbation prone severe asthma without air-trapping on high resolution CT.