tbuckley/cabot-search huggingface dataset:
Pulmonary disease associated with the human immunodeficiency virus in Kigali, Rwanda. A fiberoptic bronchoscopic study of 111 cases of undetermined etiology.
Authors: J Batungwanayo, H Taelman, S Lucas, J Bogaerts, D Alard, A Kagame, P Blanche, J Clerinx, P van de Perre, S Allen
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

All human immunodeficiency virus type 1 (HIV-1) infected adult patients referred to the Division of Pulmonary Diseases of the Centre Hospitalier de Kigali, Rwanda for evaluation of a pulmonary disease of undetermined etiology (PDUE) were investigated by fiberoptic bronchoscopy using both bronchoalveolar lavage (BAL) and transbronchial biopsy (TBB). During a 10-mo period 111 HIV-1 infected patients with PDUE were examined, of whom 47 (42%) fulfilled the World Health Organization (WHO) clinical case definition for acquired immunodeficiency syndrome (AIDS) and seven (6%) had an AIDS-defining illness. Nonspecific interstitial pneumonitis was diagnosed in 42 (38%) patients, tuberculosis in 25 (23%), cryptococcosis in 14 (13%), Kaposi's sarcoma (KS) in 10 (9%), Pneumocystis carinii pneumonia (PCP) in five (5%). The diagnosis remained undetermined in 18 (16%) patients. Chest radiograph patterns were generally nonspecific. TBB and BAL had diagnostic yields of 82 and 26% of all final diagnoses, respectively. Our study on Rwandese HIV-1-infected patients with PDUE provides evidence for a large spectrum of pulmonary diseases with relative frequencies differing strikingly from those in developed countries. Detailed investigations confirm the rarity of PCP in Africa and highlight nonspecific interstitial pneumonitis as the predominant diagnosis of PDUE. Empiric antituberculosis treatment is justified in the absence of clinical manifestations suggestive of a specific diagnosis and while awaiting the results of the diagnostic procedures. Primary prophylaxis for PCP would not be appropriate in Africa.
Changes in spontaneous variability of ventricular ectopic activity as a function of time in patients with chronic arrhythmias.
Authors: M I Anastasiou-Nana, R L Menlove, J N Nanas, J L Anderson
Journal: Circulation (1988)

Previous determinations of spontaneous variability in ventricular arrhythmia have often been based on measurements from consecutive days in small patient populations, whereas clinical determinations of drug efficacy typically compare measurements at intervals of 1 week and longer to baseline. We, therefore, sought to determine whether spontaneous arrhythmia variability changes as a function of time during periods ranging from 1 day to 1 year or longer. The percent reduction in the frequency of total premature ventricular complexes (PVCs) and repetitive ventricular beats required to show true drug effect rather than spontaneous variability in PVCs was determined in 47 consecutive patients with chronic ventricular arrhythmias who underwent multiple ambulatory monitor recordings while off active drug treatment (during placebo therapy). The variability in PVC rate was determined during the intervals of 1 day, 1 week, 2 weeks, 3 weeks, 4 weeks, and 1 year or longer. The percent reductions in total PVCs required to exceed the 95% confidence limits of spontaneous variability at these intervals were 55%, 85%, 86%, 93%, 96%, and 96%, respectively. Corresponding values for repetitive beats were 75%, 95%, 92%, 95%, 94%, and 98%, respectively. The percent increase in total PVCs and repetitive beats required to establish "arrhythmia aggravation" caused by an antiarrhythmic drug with a 95% confidence limit also was calculated for this study population and was 124% and 303%, respectively, at 1-day intervals and 2,269% and 4,091%, respectively, at 1-year (or longer) intervals for the 24-hour monitor recordings. Variability was not substantially affected by underlying heart disease or ejection fraction. PVC rate showed a modest negative correlation with variability (r = 0.3). Thus, variability is substantially greater at 1 week, the usual time for clinical assessment of antiarrhythmic drug efficacy, than at 1 day (p less than 0.01). Suppression of more than 85% of total PVCs and more than 95% of repetitive beats appears to be necessary after 1-2 weeks to be confident of a true drug effect. Even greater variability is observed after 1 month and up to 1 year so that reductions of up to 95% in total PVCs and 98% in repetitive beats may represent spontaneous change.(ABSTRACT TRUNCATED AT 400 WORDS)
ANTIGENS FOR THERAPEUTIC IMMUNIZATION
Authors: T. G. Garry
Journal: BMJ (1927)

The purpose of this study was to develop a computer-assisted diagnosis (CAD) system based on image-processing techniques and artificial neural networks for the interpretation of bone scans performed to determine the presence or absence of metastases. <b>Methods:</b> A training group of 810 consecutive patients who had undergone bone scintigraphy due to suspected metastatic disease were included in the study. Whole-body images, anterior and posterior views, were obtained after an injection of <sup>99m</sup>Tc-methylene diphosphonate. The image-processing techniques included algorithms for automatic segmentation of the skeleton and automatic detection and feature extraction of hot spots. Two sets of artificial neural networks were used to classify the images, 1 classifying each hot spot separately and the other classifying the whole bone scan. A test group of 59 patients with breast or prostate cancer was used to evaluate the CAD system. The patients in the test group were selected to reflect the spectrum of pathology found in everyday clinical work. As the gold standard for the test group, we used the final clinical assessment of each case. This assessment was based on follow-up scans and other clinical data, including the results of laboratory tests, and available diagnostic images, such as from MRI, CT, and radiography, from a mean follow-up period of 4.8 y. <b>Results:</b> The CAD system correctly identified 19 of the 21 patients with metastases in the test group, showing a sensitivity of 90%. False-positive classification of metastases was made in 4 of the 38 patients not classified as having metastases by the gold standard, resulting in a specificity of 89%. <b>Conclusion:</b> A completely automated CAD system can be used to detect metastases in bone scans. Application of the method as a clinical decision support tool appears to have significant potential.
Arginine deficiency affects early B cell maturation and lymphoid organ development in transgenic mice
Authors: Wouter J. de Jonge, Karin L. Kwikkers, Anje A. te Velde, Sander J.H. van Deventer, Martijn A. Nolte, Reina E. Mebius, Jan M. Ruijter, Marinus C. Lamers, Wouter H. Lamers
Journal: Journal of Clinical Investigation (2002)

Apart from its role in the synthesis of protein and nitric oxide (NO), and in ammonia detoxification, the amino acid arginine exerts an immunosupportive function. We have studied the role of arginine in immune defense mechanisms in the developing postnatal immune system. In suckling mice, arginine is produced in the small intestine. In F/A-2+/+ transgenic mice, which overexpress arginase in their enterocytes, circulating and tissue arginine concentrations are reduced to 30–35% of controls. In these mice, the development and composition of the T cell compartment did not reveal abnormalities. However, in peripheral lymphoid organs and the small intestine, B cell cellularity and the number and size of Peyer’s patches were drastically reduced, and serum IgM levels were significantly decreased. These phenotypes could be traced to an impaired transition from the pro– to pre–B cell stage in the bone marrow. Cytokine receptor levels in the bone marrow were normal. The development of the few peripheral B cells and their proliferative response after in vitro stimulation was normal. The disturbance in B cell maturation was dependent on decreased arginine levels, as this phenotype disappeared upon arginine supplementation and was not seen in NO synthase– or ornithine transcarbamoylase–deficient mice. We conclude that arginine deficiency impairs early B cell maturation.
Role of the physiochemical properties of mucus in the protection of the respiratory epithelium
Authors: S Girod, JM Zahm, C Plotkowski, G Beck, E Puchelle
Journal: European Respiratory Journal (1992)

The respiratory mucus is a very complex biological material, which possesses both flow and deformation rheological properties, characterized by non-linear and time-dependent viscoelasticity and physical properties of adhesiveness and wettability. Viscosity and elasticity are directly involved in the transport capacity of mucus, whereas wettability and adhesiveness contribute to the optimal interface properties between the mucus and the epithelial surface. Optimal conditions for the protective and lubricant properties of respiratory mucus are represented by high wettability, and adhesiveness high enough not to induce flow of mucus in the respiratory bronchioles under gravity but low enough to mobilize mucus by airflow during coughing. An intermediate viscoelasticity is also required for an optimal mucociliary transport. Different biochemical constituents such as glycoproteins, proteins, proteoglycans and lipids are involved in the gel properties of respiratory mucus. During bronchial infection and particularly in cystic fibrosis, the loss of water and the increase in macromolecules result in a marked increase in viscosity and adhesiveness responsible for the mucus transport impairment. The various lipids present in mucus contribute differently to the physicochemical properties. Surface-active phospholipids, such as phosphatidylcholine and phosphatidylglycerol improve the wettability of mucus, whereas neutral lipids and glycosphyngolipids contribute to the hyperviscosity of mucus during infection. Phospholipids and associated mucins are also implicated in the interaction between bacteria and epithelial cells. Therefore, the respiratory mucus needs appropriate physicochemical properties for the protection, hydration and lubrication of the underlying airway epithelium.
Kidney Function Influences Warfarin Responsiveness and Hemorrhagic Complications
Authors: Nita A Limdi, T Mark Beasley, Melissa F Baird, Joyce A Goldstein, Gerald McGwin, Donna K Arnett, Ronald T Acton, Michael Allon
Journal: Journal of the American Society of Nephrology (2009)

Although management of warfarin is challenging for patients with chronic kidney disease (CKD), no prospective studies have compared response to warfarin among patients with minimal, moderate, and severe CKD. This secondary analysis of a prospective cohort of 578 patients evaluated the influence of kidney function on warfarin dosage, anticoagulation control, and risk for hemorrhagic complications. We adjusted all multivariable regression and proportional hazard analyses for clinical and genetic factors. Patients with severe CKD (estimated GFR <30 ml/min per 1.73 kg/m2) required significantly lower warfarin dosages (P = 0.0002), spent less time with their international normalized ratio within the target range (P = 0.049), and were at a higher risk for overanticoagulation (international normalized ratio >4; P = 0.052), compared with patients with no, mild, or moderate CKD. Patients with severe CKD had a risk for major hemorrhage more than double that of patients with lesser degrees of renal dysfunction (hazard ratio 2.4, 95% confidence interval 1.1 to 5.3). In conclusion, patients with reduced kidney function require lower dosages of warfarin, have poorer control of anticoagulation, and are at a higher risk for major hemorrhage. These observations suggest that warfarin may need to be initiated at a lower dosage and monitored more closely in patients with moderate or severe CKD compared with the general population. Diminished renal function may have implications for a larger proportion of warfarin users than previously estimated.
Spontaneous Regression of Primary Autoreactivity during Chronic Progression of Experimental Autoimmune Encephalomyelitis and Multiple Sclerosis
Authors: Vincent K. Tuohy, Min Yu, Ling Yin, Julie A. Kawczak, R. Philip Kinkel
Journal: The Journal of Experimental Medicine (1999)

Experimental autoimmune encephalomyelitis (EAE) is a widely used animal model for multiple sclerosis (MS). EAE is typically initiated by CD4+ T helper cell type 1 (Th1) autoreactivity directed against a single priming immunodominant myelin peptide determinant. Recent studies have shown that clinical progression of EAE involves the accumulation of neo-autoreactivity, commonly referred to as epitope spreading, directed against peptide determinants not involved in the priming process. This study directly addresses the relative roles of primary autoreactivity and secondary epitope spreading in the progression of both EAE and MS. To this end we serially evaluated the development of several epitope-spreading cascades in SWXJ mice primed with distinctly different encephalitogenic determinants of myelin proteolipid protein. In a series of analogous experiments, we examined the development of epitope spreading in patients with isolated monosymptomatic demyelinating syndrome as their disease progressed to clinically definite MS. Our results indicate that in both EAE and MS, primary proliferative autoreactivity associated with onset of clinical disease invariably regresses with time and is often undetectable during periods of disease progression. In contrast, the emergence of sustained secondary autoreactivity to spreading determinants is consistently associated with disease progression in both EAE and MS. Our results indicate that chronic progression of EAE and MS involves a shifting of autoreactivity from primary initiating self-determinants to defined cascades of secondary determinants that sustain the self-recognition process during disease progression.
DIAGNOSIS AND TREATMENT OF MALIGNANT MELANOMA IN BULGARIA
Authors: V. C. ANDREEV
Journal: British Journal of Dermatology (1968)

SUMMARY. The available diagnostic procedures for malignant melanoma are critically discussed. The hazards of simple excision biopsy can be reduced by the technique of radiation or chemotherapeutic cover. Methods of treatment are reviewed and the 5 year follow-up results of the treatment of 136 patients in the author's clinic are reported. It is concluded that both radiation and surgery have a place in the treatment of this tumour.
Phase I Trial of 131I-huA33 in Patients with Advanced Colorectal Carcinoma
Authors: Geoffrey Chong, Fook Thean Lee, Wendie Hopkins, Niall Tebbutt, Jonathan S. Cebon, Angela J. Mountain, Bridget Chappell, Anthony Papenfuss, Paul Schleyer, Paul U, Roger Murphy, Veronika Wirth, Fiona E. Smyth, Nicole Potasz, Aurora Poon, Ian D. Davis, Tim Saunder, Graeme J. O'Keefe, Antony W. Burgess, Eric W. Hoffman, Lloyd J. Old, Andrew M. Scott
Journal: Clinical Cancer Research (2005)

Humanized monoclonal antibody A33 (huA33) targets the A33 antigen which is expressed on 95% of colorectal cancers. A previous study has shown excellent tumor-targeting of iodine-131 labeled huA33 (131I-huA33). Therefore, we did a phase I dose escalation trial of 131I-huA33 radioimmunotherapy.Fifteen patients with pretreated metastatic colorectal carcinoma each received two i.v. doses of 131I-huA33. The first was an outpatient trace-labeled "scout" dose for biodistribution assessment, followed by a second "therapy" dose. Three patients were treated at 20, 30, and 40 mCi/m2 dose levels, and six patients at 50 mCi/m2 to define the maximum tolerated dose.Hematologic toxicity was 131I dose-dependent, with one episode of grade 4 neutropenia and two episodes of grade 3 thrombocytopenia observed at 50 mCi/m2. The maximum tolerated dose was determined to be 40 mCi/m2. There were no acute infusion-related adverse events, and gastrointestinal toxicity was not observed despite uptake of 131I-huA33 in bowel. Seven patients developed pruritus or rash, which was not related to 131I dose. There was excellent tumor-targeting of 131I-huA33 shown in all patients. The serum T1/2beta of 131I-huA33 was (mean +/- SD) 135.2 +/- 46.9 hours. The mean absorbed tumor dose was 6.49 +/- 2.47 Gy/GBq. Four patients developed human anti-human antibodies. At restaging, 4 patients had stable disease, whereas 11 patients had progressive disease.Radioimmunotherapy using 131I-huA33 shows promise in targeting colorectal tumors, and is deliverable at a maximum tolerated dose of 40 mCi/m2. Further studies of 131I-huA33 in combination with chemotherapy are planned.
A good death
Authors: R. Smith
Journal: BMJ (2000)

<b>Objectives</b> To evaluate the outcome of drowned children with cardiac arrest and hypothermia, and to determine distinct criteria for termination of cardiopulmonary resuscitation in drowned children with hypothermia and absence of spontaneous circulation. <b>Design</b> Nationwide retrospective cohort study. <b>Setting</b> Emergency departments and paediatric intensive care units of the eight university medical centres in the Netherlands. <b>Participants</b> Children aged up to 16 with cardiac arrest and hypothermia after drowning, who presented at emergency departments and/or were admitted to intensive care. <b>Main outcome measure</b> Survival and neurological outcome one year after the drowning incident. Poor outcome was defined as death or survival in a vegetative state or with severe neurological disability (paediatric cerebral performance category (PCPC) ≥4). <b>Results</b> From 1993 to 2012, 160 children presented with cardiac arrest and hypothermia after drowning. In 98 (61%) of these children resuscitation was performed for more than 30 minutes (98/160, median duration 60 minutes), of whom 87 (89%) died (95% confidence interval 83% to 95%; 87/98). Eleven of the 98 children survived (11%, 5% to 17%), but all had a PCPC score ≥4. In the 62 (39%) children who did not require prolonged resuscitation, 17 (27%, 16% to 38%) survived with a PCPC score ≤3 after one year: 10 (6%) had a good neurological outcome (score 1), five (3%) had mild neurological disability (score 2), and two (1%) had moderate neurological disability (score 3). From the original 160 children, only 44 were alive at one year with any outcome. <b>Conclusions</b> Drowned children in whom return of spontaneous circulation is not achieved within 30 minutes of advanced life support have an extremely poor outcome. Good neurological outcome is more likely when spontaneous circulation returns within 30 minutes of advanced life support, especially when the drowning incident occurs in winter. These findings question the therapeutic value of resuscitation beyond 30 minutes in drowned children with cardiac arrest and hypothermia.
Serum Amyloid P Inhibits Fibrosis Through FcγR-Dependent Monocyte-Macrophage Regulation in Vivo
Authors: Ana P. Castaño, Shuei-Liong Lin, Teresa Surowy, Brian T. Nowlin, Swathi A. Turlapati, Tejas Patel, Ajay Singh, Shawn Li, Mark L. Lupher, Jeremy S. Duffield
Journal: Science Translational Medicine (2009)

New therapies that target chronic inflammation with fibrosis are urgently required. Increasing evidence points to innate activation of inflammatory cells in driving chronic organ fibrosis. Serum amyloid P is a naturally circulating soluble pattern recognition receptor, a member of the family of pentraxin proteins. It links danger-associated molecular pattern recognition to Fc gamma receptor-mediated phagocytosis. Here we show that fibrosis progression in the mouse kidney is significantly inhibited by therapeutic administration of human serum amyloid P, regulated by activating Fc gamma receptors, and dependent on inflammatory monocytes and macrophages, but not fibrocytes. Human serum amyloid P-mediated inhibition of mouse kidney fibrosis correlated with specific binding of human serum amyloid P to cell debris and with subsequent suppression of inflammatory monocytes and kidney macrophages in vitro and in vivo, and was dependent on regulated binding to activating Fc gamma receptors and interleukin-10 expression. These studies uncover previously unidentified roles for Fc gamma receptors in sterile inflammation and highlight serum amyloid P as a potential antifibrotic therapy through local generation of interleukin-10.
The Sorrows of the Septum
Authors: W. J. Horne
Journal: BMJ (1926)

BEOTIO O-LMINOLLOQY AND OTOLOGfI -t{J; laryngocele; the neck had been traced through the thyro- hyoid membrane, and therefore it must be outside the larynx, and, of course, a pharyngocele, to which group Godlee rightly assigned it.Mention had been made of his omission to include the artificial enlargement of the pyriform fossa with the aid of leaden discs by natives of India and South Africa for depositing stolen coins and precious stones; he had been dealing eexclusively with hernias and diverticular sinuses, not with mere artificial enlargements of natural cavities-with pouches, not with pouchings-and therefore had rightly excluded from illustration and consideration tho interesting specimen in St. Bartholomew's museum.
THE CANFIELD OPERATION
Authors: J. A. Gibb
Journal: BMJ (1931)

<h3>Objectives</h3> Having more information about the biopsychosocial functioning of their geriatric patients might help physicians better balance medical interventions according to patients’ needs. For this reason, we aimed to develop an easy-to-handle International Classification of Functioning, Disability and Health (ICF) Core Set for community-dwelling geriatric patients aged 75 and older in primary care. In this empirical study, we describe the functioning and health of community-dwelling patients aged 75 and older in primary care in Germany and identify the most common problems encountered by these individuals when using the ICF. <h3>Design</h3> In this exploratory, cross-sectional study, a health professional conducted semi-structured interviews. <h3>Setting</h3> Community-dwelling older adults aged 75 and older in Germany. <h3>Participants</h3> 65 participants (mean age=80.2, SD=3.6). <h3>Outcome measures</h3> Extended ICF Checklist V.2.1a, patients prioritised chapters of the ‘activities and participation’ component. <h3>Results</h3> The three most common impairments for ‘body functions’ were <i>visual system functions</i> (ICF-code <i>b210</i>; 89%), <i>blood pressure functions</i> (<i>b420</i>; 80%) and <i>sensations associated with hearing and vestibular functions</i> (<i>b240; 59%</i>). For ‘body structures’, they were <i>eyes, ears and related structures</i> (<i>s2</i>; 81%), <i>structure of mouth</i> (<i>s320</i>; 74%) and <i>structures related to the digestive, metabolic and endocrine systems</i> (<i>s5</i>; 49%). For the ‘activities and participation’ component, adequate aids compensated for activity limitations to a certain degree. Still, after having adequate aids, the category in which the participants had the most difficulty was <i>walking</i> (<i>d450;</i> 35%). Participants rated the ‘mobility’ chapter as the most important of all chapters. ‘Environmental factors’ were facilitators of participants’ functioning. <h3>Conclusions</h3> This empirical study provides a list of ICF categories relevant to older adults from the clinical perspective. Along with lists from the other three preparatory studies, it will form the basis for the development of an ICF Core Set for community-dwelling older adults in primary care. <h3>Trial registration details</h3> The trial is registered in ClinicalTrials.gov (NCT03384732).