tbuckley/cabot-search huggingface dataset:
Diffuse alveolar haemorrhage associated with progressive systemic sclerosis.
Authors: M T Griffin, J D Robb, J R Martin
Journal: Thorax (1990)

<h3>Objective:</h3> Report a case of immunoglobulin 4-related disease (IgG4-RD) presenting as a cerebral mass with leptomeningeal enhancement. <h3>Background:</h3> IgG4-RD is an immune-mediated disorder of unknown cause. It is frequently under-recognized and delayed treatment results in extensive fibrosis. Our case highlights the importance of identifying IgG4-RD as a cause of neurological problems as early diagnosis leads to better outcomes. <h3>Design/Methods:</h3> A 42-year-old man with a history of hypertension and atrial fibrillation came for evaluation of left brain mass manifested by five month history of progressive right hemiparesis, right hemisensory loss and focal motor seizure with secondary generalization. <h3>Results:</h3> Initial magnetic resonance imaging (MRI) of the brain at symptom onset revealed a three centimeter intra-axial left posterior parietal lobe mass with vasogenic edema. Repeat brain MRI four months later showed extensive left parietal vasogenic edema with abnormal leptomeningeal and dura enhancement in the left frontoparietal and occipital regions. Cerebrospinal fluid (CSF) analysis revealed an elevated Immunoglobulin G (IGG) index at 1.21 but otherwise was unremarkable. Computed tomography (CT) chest, abdomen, and pelvis with contrast and positron emission tomography (PET) scan were negative for malignancy. IgG subtype panel was sent which revealed a high IgG4 level (98 mg, normal value 2–96 mg/dl) and high IgG4/IgG ratio (15%, normal value 5%). Biopsy showed chronic inflammatory infiltrate composed predominantly of plasma cells and eosinophils with focal granulomatous features involving the leptomeninges and overlying dura as well as increased IgG4 plasma cells per HPF(&gt;50) with an increased IgG4/IgG ratio. Prednisone 60 mg daily was started, and one month later patient had improvement of hemiparesis, mass size, leptomeningeal enhancement, and edema. <h3>Conclusions:</h3> Although uncommon, brain parenchymal involvement and leptomeningeal enhancement is a possible manifestation of IgG4-RD. <b>Disclosure:</b> Dr. Perez-Giraldo has nothing to disclose. Dr. Durica has nothing to disclose. Dr. Chainakul has nothing to disclose. Dr. Al-Awwad has nothing to disclose. Dr. Anadani has nothing to disclose.
Molecular Characteristics of Diffuse Large-B-Cell Lymphoma
Authors: Ian Magrath
Journal: New England Journal of Medicine (2002)

The utility of disease classifications depends greatly on the tools used. The lower the resolving power, the more subjective and controversial the interpretation. As has been the case throughout the history of lymphoma taxonomy, this often leads to a plethora of classification schemes, with resultant confusion and miscommunication. Yet diagnostic precision is an essential foundation for effective therapy, since individual diseases might be expected, in general, to require individual therapeutic approaches. Unfortunately, in the field of cancer, the weaknesses inherent in a purely histologic diagnosis, the primary classification tool used for most of the 20th century, have often led to . . .
Colour of bile vomiting in intestinal obstruction in the newborn: questionnaire study
Authors: Gregor M Walker, Andrew Neilson, David Young, Peter A M Raine
Journal: BMJ (2006)

<h3>Abstract</h3> <b>Objectives</b> To identify the colour that different groups of observers thought represented bile in a newborn9s vomit. <b>Design</b> Questionnaires displaying eight colours (pale yellow to dark green). <b>Setting</b> General practices in Glasgow, postnatal ward and level III special care baby unit in a university teaching hospital, and mother and toddler groups in Glasgow. <b>Participants</b> 47 general practitioners, 29 nurses on the baby unit, 48 midwives, and 41 mothers of babies and infants. <b>Outcome measures</b> Participants indicated which colour would represent bile in a baby9s vomit. More than one colour could be chosen. Respondents were also asked to indicate one colour that was the best match for bile. <b>Results</b> When any colour could be chosen, 12 (25%) general practitioners, 1 (3%) nurse on the baby unit, 5 (10%) postnatal midwives, and 23 (56%) parents did not consider green an appropriate colour for a baby9s vomit containing bile. Twenty three (49%) general practitioners, 7 (24%) neonatal nurses, 15 (31%) postnatal midwives, and 29 (71%) parents thought yellow was the best colour match. <b>Conclusions</b> There is little agreement about the colour of bile vomit in a newborn. It is more pertinent to ask parents about the colour of vomit rather than whether it contained bile. Many general practitioners and parents do not recognise green as an appropriate colour for bile in the vomit of newborns, which may delay surgical referral. Though yellow vomit does not exclude intestinal obstruction, the presence of green vomiting in a baby is a surgical emergency and requires expeditious referral.
Effects of dobutamine on systemic, regional and microcirculatory perfusion parameters in septic shock: a randomized, placebo-controlled, double-blind, crossover study
Authors: Glenn Hernandez, Alejandro Bruhn, Cecilia Luengo, Tomas Regueira, Eduardo Kattan, Andrea Fuentealba, Jorge Florez, Ricardo Castro, Andres Aquevedo, Ronald Pairumani, Paul McNab, Can Ince
Journal: Intensive Care Medicine (2013)
The global burden attributable to low bone mineral density
Authors: L Sànchez-Riera, E Carnahan, T Vos, L Veerman, R Norman, S S Lim, D Hoy, E Smith, N Wilson, J M Nolla, J S Chen, M Macara, N Kamalaraj, Y Li, C Kok, C Santos-Hernández, L March
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Introduction</h3> The Global Burden of Disease Study 2010 estimated the worldwide health burden of 291 diseases and injuries and 67 risk factors by calculating disability-adjusted life years (DALYs). Osteoporosis was not considered as a disease, and bone mineral density (BMD) was analysed as a risk factor for fractures, which formed part of the health burden due to falls. <h3>Objectives</h3> To calculate (1) the global distribution of BMD, (2) its population attributable fraction (PAF) for fractures and subsequently for falls, and (3) the number of DALYs due to BMD. <h3>Methods</h3> A systematic review was performed seeking population-based studies in which BMD was measured by dual-energy X-ray absorptiometry at the femoral neck in people aged 50 years and over. Age- and sex-specific mean ± SD BMD values (g/cm<sup>2</sup>) were extracted from eligible studies. Comparative risk assessment methodology was used to calculate PAFs of BMD for fractures. The theoretical minimum risk exposure distribution was estimated as the age- and sex-specific 90th centile from the Third National Health and Nutrition Examination Survey (NHANES III). Relative risks of fractures were obtained from a previous meta-analysis. Hospital data were used to calculate the fraction of the health burden of falls that was due to fractures. <h3>Results</h3> Global deaths and DALYs attributable to low BMD increased from 103 000 and 3 125 000 in 1990 to 188 000 and 5 216 000 in 2010, respectively. The percentage of low BMD in the total global burden almost doubled from 1990 (0.12%) to 2010 (0.21%). Around one-third of falls-related deaths were attributable to low BMD. <h3>Conclusions</h3> Low BMD is responsible for a growing global health burden, only partially representative of the real burden of osteoporosis.
Targeted treatment with a combination of traditional DMARDs produces excellent clinical and radiographic long-term outcomes in early rheumatoid arthritis regardless of initial infliximab. The 5-year follow-up results of a randomised clinical trial, the NEO-RACo trial
Authors: Vappu Rantalaiho, Hannu Kautiainen, Markku Korpela, Pekka Hannonen, Oili Kaipiainen-Seppänen, Timo Möttönen, Markku Kauppi, Anna Karjalainen, Kari Laiho, Leena Laasonen, Mikko Hakola, Ritva Peltomaa, Marjatta Leirisalo-Repo
Journal: Annals of the Rheumatic Diseases (2013)

To study whether adding initial infliximab to remission-targeted initial combination-DMARD treatment improves the long-term outcomes in patients with early rheumatoid arthritis (RA).Ninety-nine patients with early, DMARD-naïve RA were treated with a triple combination of DMARDs, starting with methotrexate (max 25 mg/week), sulfasalazine (max 2 g/day), hydroxychloroquine (35 mg/kg/week), and with prednisolone (7.5 mg/day), and randomised to double blindly receive either infliximab (3 mg/kg; FIN-RACo+INFL) or placebo (FIN-RACo+PLA) infusions during the first 6 months. After 2 years the treatment strategies became unrestricted, but the treatment goal was strict ACR remission. At 5 years the clinical and radiographic outcomes were assessed.Ninety-one patients (92%) were followed up to 5 years, 45 in the FIN-RACo+INFL and 46 in the FIN-RACo+PLA groups. At 5 years, the respective proportions of patients in strict ACR and in disease activity score 28 remissions in the FIN-RACo+INFL and FIN-RACo+PLA groups were 60% (95% CI 44% to 74%) and 61% (95% CI 45% to 75%) (p=0.87), and 84% (95% CI 71% to 94%) and 89% (95% CI 76% to 96%) (p=0.51). The corresponding mean (SD) total Sharp/van der Heijde scores at 5 years were 4.3 (7.6), and 5.3 (7.3), while the respective mean Sharp/van der Heijde scores changes from baseline to 5 years were 1.6 (95% CI 0.0 to 3.4) and 3.7 (95% CI 2.2 to 5.8) (p=0.13).In early RA, targeted treatment with a combination of traditional DMARDs and prednisolone induces remission and minimises radiographic progression in most patients up to 5 years; adding initial infliximab for 6 months does not improve these outcomes.
Phase I to III Trials of Anti–B Cell Therapy in Non–Hodgkin's Lymphoma
Authors: Peter Martin, Richard R. Furman, Morton Coleman, John P. Leonard
Journal: Clinical Cancer Research (2007)

Led by the anti-CD20 antibody rituximab, therapeutic monoclonal antibodies have dramatically altered the treatment of patients with non-Hodgkin's lymphoma. As the understanding of the biology of this novel therapy improves, so does the potential for further progress. There are currently four monoclonal antibodies approved by the Food and Drug Administration for the treatment of B-cell malignancies and dozens more are in various stages of development. The indications for the currently available antibodies, both labeled and unlabeled, are being expanded to include first-line treatment, maintenance strategies, and combinations with chemotherapy. Newer agents are being engineered to target novel antigens, and to interact more specifically with the host immune system. These promising therapeutics face a significant challenge in evaluation and integration in the post-rituximab world.
Sudden death risk in older athletes: increasing the denominator: Table 1
Authors: D S Tunstall Pedoe
Journal: British Journal of Sports Medicine (2004)

Excluding the older athlete should be a last resort Publicity and campaigning surrounding the tragedy of sudden death in young athletes (incidence 1 in 200 000 young athletes per year)1 has rather overshadowed the mortality risk of older competitors aged >30. Population studies show that death rates during sports participation increase dramatically with age2 as the incidence of coronary heart disease increases. Is this just coincidental, or is the sport triggering the deaths? The highest overall mortality (numbers dying—"the numerator") is in recreational sports favoured by the middle aged and elderly, such as fishing and lawn bowls. This is because of the large numbers of participants and their lengthy exposure (time spent participating in the sport) ("the denominator") in assessing comparative risk. The latter will vary with different populations of participants. ![Formula][1]</img> Lack of information about the denominator means that in most sports and recreational activity the exposure risk cannot be calculated and so compared. Collecting the death statistics without the denominator is almost meaningless, and can lead to illogical deductions, for instance that recreational fishing is more dangerous than hang gliding. "His death had seriously held up play, and the ambulance had damaged the grass." Many sports have their share of older coronary prone participants. I recall visiting a golf club many years ago the day after a sudden coronary death on the 12th fairway. Members felt that it was very inconsiderate … [1]: /embed/graphic-1.gif
Translocation t(11;14) Is Associated With Adverse Outcome in Patients With Newly Diagnosed AL Amyloidosis When Treated With Bortezomib-Based Regimens
Authors: Tilmann Bochtler, Ute Hegenbart, Christina Kunz, Martin Granzow, Axel Benner, Anja Seckinger, Christoph Kimmich, Hartmut Goldschmidt, Anthony D. Ho, Dirk Hose, Anna Jauch, Stefan O. Schönland
Journal: Journal of Clinical Oncology (2015)

Bortezomib has become a cornerstone in the treatment of AL amyloidosis. In this study, we addressed the prognostic impact of cytogenetic aberrations for bortezomib-treated patients.We analyzed a consecutive series of 101 patients with AL amyloidosis treated with bortezomib-dexamethasone as first-line treatment by interphase fluorescence in situ hybridization (iFISH). Patients were ineligible for high-dose chemotherapy, which would put them at risk for cardiac or renal failure, and thus represented a poor-risk group.Presence of t(11;14), versus its absence, was associated with inferior hematologic event-free survival (median, 3.4 v 8.8 months, respectively; P = .002), overall survival (median, 8.7 v 40.7 months, respectively; P = .05), and remission rate (≥ very good partial remission; 23% v 47%, respectively; P = .02). In multivariable Cox regression models incorporating established hematologic and clinical risk factors, t(11;14) was an independent adverse prognostic marker for hematologic event-free survival (hazard ratio, 2.94; 95% CI, 1.37 to 6.25; P = .006) and overall survival (hazard ratio, 3.13; 95% CI, 1.16 to 8.33; P = .03), but not for remission (≥ very good partial remission). Markedly, the multiple myeloma high-risk iFISH aberrations t(4;14), t(14;16), del(17p), and gain of 1q21 conferred no adverse prognosis in this bortezomib-dexamethasone-treated group. After backward variable selection, the final multivariable model was validated in a consecutive series of 32 patients treated with bortezomib, dexamethasone, and cyclophosphamide.iFISH results are important independent prognostic factors in AL amyloidosis. In contrast to our recently published results with melphalan and dexamethasone standard therapy, bortezomib is less beneficial to patients harboring t(11;14), whereas it effectively alleviates the poor prognosis inherent to high-risk aberrations. Given the discrepant response to different treatment modalities, iFISH may help to guide therapeutic choices in these poor-risk patients requiring rapid hematologic response.
Characteristics and Superoxide-Induced Activation of Reconstituted Myocardial Mitochondrial ATP-Sensitive Potassium Channels
Authors: David X. Zhang, Ya-Fei Chen, William B. Campbell, Ai-Ping Zou, Garrett J. Gross, Pin-Lan Li
Journal: Circulation Research (2001)

Mitochondrial ATP-sensitive potassium (mitoK(ATP)) channels have been suggested as triggers and end effectors in myocardial ischemic preconditioning. However, the intracellular mechanism regulating mitoK(ATP) channels remains unclear. In the present study, mitoK(ATP) channels from bovine ventricular myocardium were reconstituted using planar lipid bilayers, and the effect of superoxide (O(2-.)) on the activity of these reconstituted channels was examined. After incorporation, a potassium-selective current was recorded. The mean conductance of this current was 56 pS at 150 mmol/L KCl, which was substantially inhibited by 1 mmol/L MgATP. 5-Hydroxydecanoate (5-HD, 10 to 100 micromol/L), a selective mitoK(ATP) antagonist, reduced the open state probability (NPo) of these channels in a concentration-dependent manner, whereas diazoxide (10 micromol/L), a selective mitoK(ATP) agonist, significantly increased channel activity. HMR-1098 (100 micromol/L), a selective sarcolemmal K(ATP) antagonist, had no effect on the activity of reconstituted channels. Addition of xanthine/xanthine oxidase (100 micromol/L per 0.038 U/mL), an O(2-.)-generating system, resulted in a marked activation of mitoK(ATP) channels; the NPo of the channels was increased from 0.60+/-0.10 to 1.94+/-0.02. This O(2)(-.)-induced channel activation was completely abolished by pretreatment with 5-HD (100 micromol/L) or a sulfhydryl alkylating compound, N-ethylmaleimide (2 mmol/L). It is concluded that myocardial mitoK(ATP) channels can be reconstituted into lipid bilayers and that O(2-.) activates these channels. The effect of O(2-.) may be associated with its direct action on the sulfhydryl groups of the channel protein.
IL-27 controls sepsis-induced impairment of lung antibacterial host defence
Authors: Ju Cao, Fang Xu, Shihui Lin, Zhixin Song, Lipin Zhang, Peng Luo, Huajian Xu, Dairong Li, Ke Zheng, Guosheng Ren, Yibing Yin
Journal: Thorax (2014)

<h3>Background</h3> Interleukin 27 (IL-27) is an important cytokine regulating host immune responses. However, its role in sepsis-induced immunosuppression remains unclear. <h3>Aim</h3> To investigate the role of IL-27 in modulating sepsis-induced immunosuppression using a murine model of caecal ligation and puncture (CLP)-induced sepsis followed by secondary challenge with <i>Pseudomonas aeruginosa</i>. <h3>Methods</h3> CLP or sham surgery was performed in wild-type (WT) and IL-27 receptor (IL-27R)/WSX-1 knockout (KO) mice, and then mice were infected with intratracheal <i>P aeruginosa</i>. <h3>Results</h3> IL-27 was upregulated in patients with sepsis and septic mice. Following sepsis and secondary intrapulmonary bacterial challenge, IL-27R KO mice had higher survival rates and improved bacterial clearance from lung and blood compared with WT mice, which was associated with early increased pulmonary cytokine/chemokine production, as well as enhanced neutrophil recruitment to airspaces. Neutralisation of IL-27 in septic mice significantly improved survival and clearance of bacteria from the lungs of septic mice infected with <i>P aeruginosa,</i> and direct application of recombinant IL-27 could increase susceptibility to <i>P aeruginosa</i> infection. The resistance of septic IL-27R KO mice to secondary <i>P aeruginosa</i> infection was abrogated by depletion of alveolar macrophages (AMs) and neutrophils. AMs from septic IL-27R KO mice had higher bacterial uptake and killing capacities, enhanced cytokine/chemokine production, and increased expression of costimulatory molecules compared with those from WT mice, while neutrophils from septic IL-27R KO mice had increased bacterial killing ability and higher expression of adhesion molecule Mac-1 compared with WT neutrophils. <h3>Conclusions</h3> IL-27 is an important mediator of sepsis-induced impairment of lung antibacterial host defence.
Fabry Disease in Mice Is Associated With Age-Dependent Susceptibility to Vascular Thrombosis
Authors: Daniel T. Eitzman, Peter F. Bodary, Yuechun Shen, Christian G. Khairallah, Susan R. Wild, Akira Abe, Jacqueline Shaffer-Hartman, James A. Shayman
Journal: Journal of the American Society of Nephrology (2003)

Fabry disease is an X-linked lysosomal storage disorder due to deficiency of alpha-galactosidase A (GLA) activity that results in the widespread accumulation of neutral glycosphingolipids. Renal failure, neuropathy, premature myocardial infarction, and stroke occur in patients with this condition primarily due to deposition of glycosphingolipids in vascular endothelial cells. The clinical consequences of Fabry disease suggest that vascular thrombosis may play a prominent role in the pathogenesis of this disease; however, the vasculopathy associated with Fabry disease has not been extensively studied. To determine if mice genetically deficient in Gla are susceptible to vascular thrombosis, a photochemical carotid injury model was used to induce occlusive thrombosis. In this model, Gla-/0 mice displayed a progressive age-dependent shortening of the time to occlusive thrombosis after vascular injury that correlated with progressive accumulation of globotriasylceramide (Gb3) in the arterial wall. Bone marrow transplantation from Gla-/0 to Gla+/0 mice and from Gla+/0 to Gla-/0 mice did not change the thrombotic phenotype of the host. These studies reveal a potent vascular prothrombotic phenotype in Gla-deficient mice and suggest that antithrombotic therapies as well as therapies designed to reduce the vascular accumulation of Gb3 may have beneficial effects on thrombotic complications in patients with Fabry disease.
Plasma Exposure to Insulin Glargine and Its Metabolites M1 and M2 After Subcutaneous Injection of Therapeutic and Supratherapeutic Doses of Glargine in Subjects With Type 1 Diabetes
Authors: Geremia B. Bolli, Annke D. Hahn, Ronald Schmidt, Tanja Eisenblaetter, Raphael Dahmen, Tim Heise, Reinhard H.A. Becker
Journal: Diabetes Care (2012)

In vivo, after subcutaneous injection, insulin glargine (21(A)-Gly-31(B)-Arg-32(B)-Arg-human insulin) is enzymatically processed into 21(A)-Gly-human insulin (metabolite 1 [M1]). 21(A)-Gly-des-30(B)-Thr-human insulin (metabolite 2 [M2]) is also found. In vitro, glargine exhibits slightly higher affinity, whereas M1 and M2 exhibit lower affinity for IGF-1 receptor, as well as mitogenic properties, versus human insulin. The aim of the study was to quantitate plasma concentrations of glargine, M1, and M2 after subcutaneous injection of glargine in male type 1 diabetic subjects.
Visual loss after cat scratch
Authors: V. Hu
Journal: Journal of the Royal Society of Medicine (2005)

lacerations (both of which had healed at one month), and one of bronchospasm.However recurrence was common: 80% of patients had a primary relapse of airway stenosis and 43% had a secondary relapse.Recurrence is the usual reason for stent insertion.Since retrieval of metallic stents can be difficult, non-metallic stents are preferred for the management of benign disease; they can be left in situ for long periods.Complications of stents include migration, granuloma formation and obstruction. 9In some cases surgical resection of the stenotic segment together with bronchoplastic reconstruction is a possibility.With the increasing incidence of TB, UK clinicians need to be sensitive to this cause of stridor, especially in groups at high risk.28