tbuckley/cabot-search huggingface dataset:
Sympathetic contribution to pain – need for clarification
Authors: Helmut Blumberg, Ulrike Hoffman, Mohsen Mohadjer, Rudolf Scheremet
Journal: Behavioral and Brain Sciences (1997)

Certain patients with a possible contribution of the sympathetic system to pain may not fit the definition of complex regional pain syndromes (CRPS), which raises the question of terminology for those patients. To further clarify the relationship between the sympathetic system and pain, apart from the need for placebo studies, there remains an urgent need for a satisfactory definition of the criteria for a complete sympathetic block. It also remains uncertain whether a change in the discharge pattern of sympathetic fibres underlies the changes in sympathetic organ function, often found in patients with CRPS.
Prevalence and Outcomes of Same-Day Discharge After Elective Percutaneous Coronary Intervention Among Older Patients
Authors: Sunil V. Rao, Lisa A. Kaltenbach, William S. Weintraub, Matthew T. Roe, Ralph G. Brindis, John S. Rumsfeld, Eric D. Peterson
Journal: JAMA (2011)

<h3>Context</h3>Patients undergoing elective percutaneous coronary intervention (PCI) are generally observed overnight in the hospital. The association between same-day discharge of older patients and death or readmission is unclear.<h3>Objective</h3>To evaluate the prevalence and outcomes of same-day discharge among older patients undergoing elective PCI in the United States.<h3>Design, Setting, and Participants</h3>Multicenter cohort study. Data were from 107 018 patients 65 years or older undergoing elective PCI procedures at 903 sites participating in the CathPCI Registry between November 2004 and December 2008 and were linked with Medicare Part A claims. Patients were divided into 2 groups based on their length of stay after PCI: same-day discharge or overnight stay.<h3>Main Outcome Measures</h3>Death or rehospitalization occurring within 2 days and by 30 days after PCI.<h3>Results</h3>The prevalence of same-day discharge was 1.25% (95% CI, 1.19%-1.32%; n = 1339 patients) with significant variation across facilities. Patient characteristics were similar between the 2 groups, although same-day discharge patients underwent shorter procedures with less multivessel intervention. There were no significant differences in the rates of death or rehospitalization at 2 days (same-day discharge, 0.37% [95% CI, 0.16%-0.87%] vs overnight stay, 0.50% [95% CI, 0.46%-0.54%]; P = .51) or at 30 days (same-day discharge, 9.63% [95% CI, 8.17%-11.33%] vs overnight stay, 9.70% [95% CI, 9.52%-9.88%]; P = .94). Among patients with adverse outcomes, the median time to death or rehospitalization did not differ significantly between the groups (same-day discharge, 13 days [interquartile range, 7.0-21.0] vs overnight stay, 14 days [interquartile range, 7.0-21.0]; P = .96). After adjustment for patient and procedure characteristics, same-day discharge was not significantly associated with 30-day death or rehospitalization (adjusted odds ratio, 0.95 [95% CI, 0.78-1.16]).<h3>Conclusion</h3>Among selected low-risk Medicare patients undergoing elective PCI, same-day discharge is rarely implemented but is not associated with death or rehospitalization compared with overnight observation.
Potential alternatives to COX 2 inhibitors
Authors: M M Skelly
Journal: BMJ (2002)

For many years, non-steroidal anti-inflammatory drugs were regarded as a treatment for which there was no gain in arthritis without the pain of gastroduodenal toxicity. This reflected the understanding that non-steroidal anti-inflammatory drugs (NSAIDs) were cyclo-oxygenase inhibitors that reduced prostaglandin synthesis both in inflamed joints with benefit and in the stomach with detriment (figure). Recognition that a highly inducible enzyme, cyclo-oxygenase-2, largely subserved the former and a constitutive enzyme, cyclo-oxygenase-1, the latter provided an obvious selective target. The consequent success of cyclo-oxygenase-2 (COX 2) inhibitors arises, in part, from the conceptual simplicity of this idea. The journey from concept to reality has, however, inevitably been more complex, and one controversial issue is dealt with in an accompanying editorial.1 The failure of the celecoxib long term arthritis safety study (the CLASS study) may have more to do with the design of the trial than with inadequacies of cyclo-oxygenase-2 inhibitors. Other limitations of these agents may eventually deserve more attention. In particular, it was never likely that they would go beyond the indication of pain and arthritis that characterises NSAIDs, given that the goal was to mimic their action more selectively.



Pathways of arachidonic acid metabolism. Prostaglandins, synthesised by both constitutive cyclo-oxygenase-1 and highly inducible cyclo-oxygenase-2 can contribute to …
Chemotherapy plus Radiotherapy Compared with Radiotherapy Alone in the Treatment of Locally Advanced, Unresectable, Non-Small-Cell Lung Cancer
Authors: Robert S. Pritchard
Journal: Annals of Internal Medicine (1996)

Background: Survival of patients with locally advanced, unresectable (stage III), non-small-cell lung cancer treated with radiotherapy is poor. Trials of the addition of chemotherapy to radiotherapy have produced conflicting results. Objective: To compare chemotherapy plus radiotherapy with radiotherapy alone in patients with stage III, non-small-cell lung cancer. Data Sources: English-language journal articles published between 1987 and 1995 identified in a MEDLINE search. Study Selection: Randomized trials that reported survival after previously untreated patients received chemotherapy plus radiotherapy or radiotherapy alone were reviewed. Data Extraction: For all eligible articles, reported survival curves were used to determine the relative risk for death in each of 3 years. These data were combined to determine a pooled estimate of the relative risk for death at 1, 2, and 3 years. Data Synthesis: Fourteen articles reporting on a total of 2589 patients were reviewed. Compared with radiotherapy, the combination of chemotherapy and radiotherapy reduced the risk for death at 1 year (relative risk, 0.88 [95% CI, 0.80 to 0.96]), 2 years (relative risk, 0.87 [CI, 0.81 to 0.94]), and 3 years (relative risk, 0.83 [CI, 0.77 to 0.90]). This corresponded to a mean gain in life expectancy of about 2 months. The magnitude of the treatment effect was similar when trials of concurrently and sequentially administered chemotherapy were considered separately. Conclusion: The addition of chemotherapy to radiotherapy improves survival in patients with locally advanced, unresectable, non-small-cell lung cancer. The absolute benefit is relatively small, however, and should be balanced against the increased toxicity associated with the addition of chemotherapy.
Updated US Smoking Cessation Guideline Advises Counseling, Combining Therapies
Authors: Bridget M. Kuehn
Journal: JAMA (2008)

Chicago—Counseling and certain combinations of behavioral therapies, drug therapies, or both may increase smokers’ chances of quitting, according to an updated guideline for tobacco cessation treatment published by the US Public Health Service in May (http: //www.surgeongeneral.gov/tobacco /treating_tobacco_use08.pdf). The guideline, an update of previous versions published in 1996 and 2000, is based on a review of more than 8700 studies and reflects recent advances in cessation treatment and a greater understanding of what types of interventions are most effective. A consortium of 8 organizations—the Agency for Healthcare Research and Quality; the Centers for Disease Control and Prevention; the National Cancer Institute; the National Heart, Lung, and Blood Institute; the National Institute on Drug Abuse; the Robert Wood Johnson Foundation; the American Legacy Foundation; and the Center for Tobacco Research and Intervention at the University of Wisconsin School of Medicine and Public Health— provided funding and oversight. Carlos Roberto Jaen, MD, PhD, vice chair of the panel that completed the guidelineupdate,notedhowfartherapies for cessationhavecomesince the1980s. Physicians today have many choices of medications and counseling backed by thehighestqualityofevidence,henoted. According to the guideline, cessation counseling provided individually, in a group, or over the telephone is an effective intervention and its effectiveness increases with greater intensity. Such counseling is now widely available; every state has a tobacco “quit line,” which can be reached by dialing 1-800-QUITNOW. There also are now 7 cessation medications approved by the US Food and Drug Administration (FDA)—bupropion SR, nicotine gum, nicotine inhaler, nicotine lozenge, nicotine nasal spray, nicotine patch, and varenicline.
A Case of Bowen’s Disease and Small-Cell Lung Carcinoma: Long-Term Consequences of Chronic Arsenic Exposure in Chinese Traditional Medicine
Authors: Linda Lee, Gwyn Bebb
Journal: Environmental Health Perspectives (2004)

Chronic arsenic toxicity occurs primarily through inadvertent ingestion of contaminated water and food or occupational exposure, but it can also occur through medicinal ingestion. This case features a 53-year-old lifetime nonsmoker with chronic asthma treated for 10 years in childhood with Chinese traditional medicine containing arsenic. The patient was diagnosed with Bowen's disease and developed extensive-stage small-cell carcinoma of the lung 10 years and 47 years, respectively, after the onset of arsenic exposure. Although it has a long history as a medicinal agent, arsenic is a carcinogen associated with many malignancies including those of skin and lung. It is more commonly associated with non-small-cell lung cancer, but the temporal association with Bowen's disease in the absence of other chemical or occupational exposure strongly points to a causal role for arsenic in this case of small-cell lung cancer. Individuals with documented arsenic-induced Bowen's disease should be considered for more aggressive screening for long-term complications, especially the development of subsequent malignancies.
Elevated soluble tumor necrosis factor receptor levels in seasonal allergic rhinitis patients
Authors: Masashi Kato, Yoko Kato, Izumi Nakashima, Masashi Kato, Taku Hattori, Yoshinari Matsumoto, Tetsuji Yamashita
Journal: Allergy (1999)

In this study, we examined the symptom scores and tumor necrosis factor‐alpha (TNF‐α), p55 soluble tumor necrosis factor receptor (sTNFR1), and p75 soluble tumor necrosis factor receptor (sTNFR2) levels in the sera and nasal epithelial lining fluids (ELF) of 20 patients with Japanese cedar pollinosis from the pre‐ to the postseason period, and compared the results with those of 10 nonallergic control subjects. The symptom scores of the allergic subjects were significantly ( P &lt;0.01) higher than those of the nonallergic subjects during the early stage and mid‐stage of the season. There were no statistical differences between the allergic and nonallergic subjects in the TNF‐α levels in sera and ELF from the pre‐ to the post‐season. In the allergic subjects, however, the levels of sTNFR1 and sTNFR2 in ELF were significantly elevated during the early stage ( P &lt;0.05) and mid‐stage ( P &lt;0.01) of the season, whereas those in sera did not change from the pre‐ to the post‐season period. The levels of TNF‐α in ELF were more than 10 times higher than those in sera, whereas the levels of sTNFR1 and sTNFR2 in ELF were less than half of those in sera in the allergic and nonallergic subjects. These results suggest that sTNFR1 and sTNFR2 may play a role in the pathogenesis of nasal allergic reaction.
Jasmonates: Novel Anticancer Agents Acting Directly and Selectively on Human Cancer Cell Mitochondria
Authors: Ronit Rotem, Alina Heyfets, Orit Fingrut, Dorit Blickstein, Mati Shaklai, Eliezer Flescher
Journal: Cancer Research (2005)

Abstract We reported previously that jasmonates can kill human cancer cells. Many chemotherapeutic drugs induce mitochondrial membrane permeability transition, membrane depolarization, osmotic swelling, and release of cytochrome c, involving the opening of the permeability transition pore complex (PTPC). Because jasmonates exert their cytotoxic effects independent of transcription, translation, and p53 expression, we hypothesized that these compounds may act directly on mitochondria. Mitochondrial membrane depolarization was determined by flow cytometry, and cytochrome c release by Western blotting. Mitochondria were isolated by mechanical lysis and differential centrifugation. Cytotoxicity was measured by a tetrazolium-based assay, and mitochondrial swelling by spectrophotometry. Jasmonates induced membrane depolarization and cytochrome c release in intact human cancer cell lines. Jasmonates induced swelling in mitochondria isolated from Hep 3B hepatoma cells, but not in mitochondria isolated from 3T3 nontransformed cells or from normal lymphocytes, in a PTPC-mediated manner. Methyl jasmonate induced the release of cytochrome c from mitochondria isolated from cancer cell lines in a PTPC-mediated manner, but not from mitochondria isolated from normal lymphocytes. A correlation was found between cytotoxicity of methyl jasmonate and the percentage of leukemic cells in the blood of patients with chronic lymphocytic leukemia (CLL). Jasmonates induced membrane depolarization in CLL cells, and swelling and release of cytochrome c in mitochondria isolated from these cells. In conclusion, jasmonates act directly on mitochondria derived from cancer cells in a PTPC-mediated manner, and could therefore bypass premitochondrial apoptotic blocks. Jasmonates are promising candidates for the treatment of CLL and other types of cancer.
Warfarin, Pulmonary Embolism, and Cancer
Authors: JONATHAN S. KRAUSS
Journal: Annals of Internal Medicine (1982)

Letters and Corrections1 August 1982Warfarin, Pulmonary Embolism, and CancerJONATHAN S. KRAUSS, M.D.JONATHAN S. KRAUSS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-97-2-282_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The recent article by Gore and associates (1) convincingly shows an increased incidence of cancer in patients after acute pulmonary embolism. However, a significant number of their patients (five of 19) developed cancer 3 or more years after the pulmonary embolism. Although the association of thrombosis preceding occult malignancy is well established, a delay of this magnitude might suggest another explanation. The authors' data are also compatible with prolonged anticoagulation of the pulmonary embolus group by warfarin, resulting in cancer. But evidence for a direct carcinogenic role for warfarin is scant; moreover, anticoagulation is widely believed to...References1. GORE J, APPELBAUM J, GREENE H, DEXTER L, and DALEN J. Occult cancer in patients with acute pulmonary embolism. Ann Intern Med. 1982;96:556-60. LinkGoogle Scholar2. STEVENSON R, BURTON O, FERLAUTO G, and TAYLOR F. Hazards of oral anticoagulants during pregnancy. JAMA. 1980;243:1549-51. CrossrefMedlineGoogle Scholar3. RICKLES F and EDWARDS R. Delayed hypersensitivity in man: effects of systemic anticoagulation. Science. 1978;200:541-3. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JONATHAN S. KRAUSS, M.D.Affiliations: Medical College of Georgia Augusta, GA 30912 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byRodenticidesRodenticidesRodenticidesSynthetic Organic RodenticidesWarfarin and CancerLEO R. ZACHARSKI, M.D. 1 August 1982Volume 97, Issue 2Page: 282-282KeywordsLung and intrathoracic tumorsPulmonary embolismThrombosis ePublished: 1 December 2008 Issue Published: 1 August 1982 PDF downloadLoading ...
Ratio of abdominal sagittal diameter to height is strong indicator of coronary risk
Authors: L. Kumlin, L. Dimberg, P. Marin
Journal: BMJ (1997)

Prescribing antidepressants in general practiceWhat is an effective dose?Editor-What should be the advised dosage of a tricyclic antidepressant for major depression?In his editorial Tony Kendrick quotes a recommended dose of a typical tricyclic antidepressant, amitriptyline, as 125 mg daily. 1 This dosage is at the higher end of the range of dosages quoted for all tricyclic antidepressants in the British National Formulary.If followed it would have major implications for the prescribing habits of general practitioners.The recommended dosage for amitriptyline for major depression is quoted from a consensus statement published in the BMJ in 1992. 2 The source of this recommendation is a double blind placebo controlled trial of amitriptyline among depressed patients in general practice. 3 In this trial patients given the active drug received amitriptyline 75 mg daily by the end of the first week, amitriptyline 100 mg during the second week, and amitriptyline 125-175 mg, depending on improvement, during the remaining four weeks of the study.The median dose of amitriptyline given over the six week study period was 125 mg.It is the median tolerated dose.Figure 1 in the paper by Hollyman et al clearly shows a response to treatment in the first two weeks, when the lower dose of amitriptyline was given. 3 Kendrick discusses the results of several investigations into the effectiveness of antidepressants at different dosages.Similar investigations have been used to develop the dose range of every prescribable antidepressantfor example, Kerihuel and Dreyfus reviewed 34 randomised clinical trials of lofepramine. 4 In the papers reviewed the concentration of lofepramine giving a clinical response ranged from 105 mg to 210 mg, which is equivalent to 75-150 mg amitriptyline.The principle that more severe cases of major depression require higher doses of antidepressants is also valid.It also holds true for newer selective serotonin reuptake inhibitors.For example, a study of prescribing patterns across 23 381 prescriptions shows that a prescription for higher than the initial dose was required in 6.8% of patients taking fluoxetine, 21.1% of patients taking paroxetine, and 51% of patients taking sertraline. 5
Student views on continuous assessment at Birmingham University Medical School.
Authors: J K Cruickshank, P W Barritt, F Mcbesag, N Waterhouse, L H Goldman
Journal: BMJ (1975)

Student opinion on the system of continuous assessment used at Birmingham Medical School was sampled by distributing questionnaires to 621 students in the first four years of the course; 482 questionnaires (78%) were returned. Many comments and criticisms of the system were received but the vast majority of students (92%) said they preferred the present style of assessment to conventional final examinations. These criticisms are discussed and recommendations are made to improve the existing scheme.
Hodgkin's Disease and the ABVD Regimen
Authors: RAYMOND B. WEISS
Journal: Annals of Internal Medicine (1982)

Letters and Corrections1 June 1982Hodgkin's Disease and the ABVD RegimenRAYMOND B. WEISS, M.D.RAYMOND B. WEISS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-96-6-784_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Santoro and colleagues (1) have reported a 59% complete response rate using the ABVD regimen (doxorubicin, bleomycin, vinblastine, and decarbazine) in patients with Hodgkin's disease resistant to MOPP chemotherapy (mechlorethamine, vincristine, procarbazine, and prednisone). For uncertain reasons other investigators (2-4) using approximately the same regimen and dose schedule have not achieved a similarly favorable rate of complete remission. One possible reason for this difference is that Santoro and associates state that 11 of their 54 evaluable patients had irradiation as "consolidation therapy" after receiving ABVD treatment. Either some of these 11 patients did not achieve a complete...References1. SANTOROBONFANTEBONADONNA AVG. Salvage chemotherapy with ABVD in MOPP-resistant Hodgkin's disease. Ann Intern Med. 1982;96:139-43. LinkGoogle Scholar2. CASEYOUNGLEE DCB. Combination chemotherapy of MOPP-resistant Hodgkin's disease with adriamycin, bleomycin, dacarbazine and vinblastine (ABVD). Cancer. 1979;39:1382-6. CrossrefGoogle Scholar3. KRIKORIANPORTLOCKROSENBERG JCS. Treatment of advanced Hodgkin's disease with adriamycin, bleomycin, vinblastine, and imidazole carboxamide (ABVD) after failure of MOPP therapy. Cancer. 1978;41:2107-11. CrossrefMedlineGoogle Scholar4. SUTCLIFFEWRIGLEYSTANSFELDMALPAS SPAJ. Adriamycin, bleomycin, vinblastine and imidazole carboxamide (ABVD) therapy for advanced Hodgkin's disease resistant to mustine, vinblastine, procarbazine and prednisolone (MVPP). Cancer Chemother Pharmacol. 1979;2:209-13. CrossrefMedlineGoogle Scholar1. GOLDIECOLDMAN JA. A mathematical model for relating the drug sensitivity of tumors to their spontaneous mutation rate. Cancer Treat Rep. 1979;63:1727-33. MedlineGoogle Scholar2. GOLDIECOLDMANGUDANSKAS JAG. Rationale for the use of alternating non-cross resistant chemotherapy. Cancer Treat Rep. 1982; 66:439-49. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: RAYMOND B. WEISS, M.D.Affiliations: Uniformed Services University of the Health Sciences Walter Reed Army Medical Center Washington, DC 20012 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1982Volume 96, Issue 6_Part_1Page: 784-784KeywordsChemotherapyHodgkin lymphomaMechlorethamineProcarbazine ePublished: 1 December 2008 Issue Published: 1 June 1982 PDF downloadLoading ...
Serratia marcescens. Biochemical characteristics, antibiotic susceptibility patterns, and clinical significance
Authors: C. J. Wilkowske
Journal: JAMA (1970)

Serratia marcescens isolation can be accomplished more frequently when biochemical criteria are used to identify the Enterobacteriaceae. During a 14-month period, 176 strains of S marcescens were isolated, predominantly from hospitalized patients. Generally, these organisms were resistant to many antibiotics. Underlying factors were preceding antibiotic or inhalation therapy and surgery and instrumentation of the urinary tract. Most strains confined to urine or sputum samples caused infections of low morbidity, but when there was associated wound or blood-stream infection the death rates were high. The isolation of S marcescens should not be ignored because it is a life-threatening complication for certain hospitalized patients.