tbuckley/cabot-search huggingface dataset:
Impact of Intraocular Pressure Reduction on Glaucoma Progression
Authors: Paul R. Lichter
Journal: JAMA (2002)

ObjectiveTo provide the results of the Early Manifest Glaucoma Trial, which compared the effect of immediately lowering the intraocular pressure (IOP), vs no treatment or later treatment, on the progression of newly detected open-angle glaucoma.DesignRandomized clinical trial.ParticipantsTwo hundred fifty-five patients aged 50 to 80 years (median, 68 years) with early glaucoma, visual field defects (median mean deviation, −4 dB), and a median IOP of 20 mm Hg, mainly identified through a population screening. Patients with an IOP greater than 30 mm Hg or advanced visual field loss were ineligible.InterventionsPatients were randomized to either laser trabeculoplasty plus topical betaxolol hydrochloride (n = 129) or no initial treatment (n = 126). Study visits included Humphrey Full Threshold 30-2 visual field tests and tonometry every 3 months, and optic disc photography every 6 months. Decisions regarding treatment were made jointly with the patient when progression occurred and thereafter.Main Outcome MeasuresGlaucoma progression was defined by specific visual field and optic disc outcomes. Criteria for perimetric progression were computer based and defined as thesame 3 or more test point locations showing significant deterioration from baseline in glaucoma change probability maps from 3 consecutive tests. Optic disc progression was determined by masked graders using flicker chronoscopy plus side-by-side photogradings.ResultsAfter a median follow-up period of 6 years (range, 51-102 months), retention was excellent, with only 6 patients lost to follow-up for reasons other than death. On average, treatment reduced the IOP by 5.1 mm Hg or 25%, a reduction maintained throughout follow-up. Progression was less frequent in the treatment group (58/129; 45%) than in controls (78/126; 62%) (P = .007) and occurred significantly later in treated patients. Treatment effects were also evident when stratifying patients by median IOP, mean deviation, and age as well as exfoliation status. Although patients reported few systemic or ocular conditions, increases in clinical nuclear lens opacity gradings were associated with treatment (P = .002).ConclusionsThe Early Manifest Glaucoma Trial is the first adequately powered randomized trial with an untreated control arm to evaluate the effects of IOP reduction in patients with open-angle glaucoma who have elevated and normal IOP. Its intent-to-treat analysis showed considerable beneficial effects of treatment that significantly delayed progression. Whereas progression varied across patient categories, treatment effects were present in both older and younger patients, high- and normal-tension glaucoma, and eyes with less and greater visual field loss.
Factors affecting Sertoli cell function in the testis.
Authors: D J Tindall, J S Tash, A R Means
Journal: Environmental Health Perspectives (1981)

The Sertoli cell is the primary target for FSH action in the mammalian testis. These cells contain the majority of testicular plasma membrane receptors for this hormone. Receptor occupancy is directly correlated with a stimulation of adenylyl cyclase and a decrease in the activity of a cytoplasmic Ca++-sensitive cAMP phosphodiesterase. Regulation of these two enzymes allows increased intracellular accumulation of cAMP, activation of cAMP-dependent protein kinase and phosphorylation of a variety of protein substrates. All of these events occur within the first 30 min following exposure of isolated Sertoli cells to FSH. RNA and protein synthesis are also enhanced by FSH. Previous studies have suggested that this gonadotropin may augment the overall cellular synthesis of proteins. Our results reveal that protein kinase inhibitor (PKI) is selectively elevated by FSH both in vivo and in vitro. PKI thus becomes the initial intracellular protein whose synthesis is under FSH control. In addition to effects on protein synthesis, FSH also positively modulates the secretion of several specific proteins. One of the proteins in this latter category is androgen binding protein (ABP). Again, regulation can be observed both in vivo and in vitro. Elevated synthesis of PKI occurs prior to demonstrable secretion of ABP. Both of these events occur subsequent to the effects of FSH on cAMP metabolism. Indeed cAMP (or any of several nonhydrolyzable derivatives) can substitute for FSH in vitro. The temporal sequence of events subsequent to hormone binding and cAMP production are identical, but occur more rapidly. Together these data support the hypothesis that most of the biochemical steps leading to the synthesis and secretion of proteins by FSH are regulated by elevated levels of cAMP.
Endoscopic Factors Predisposing to Rebleeding Following Endoscopic Hemostasis in Bleeding Peptic Ulcers
Authors: I. Chung, E. Kim, M. Lee, H. Kim, S. Park, M. Lee, S. Kim, M. Cho, K. Hwang
Journal: Endoscopy (2001)

Background and Study Aims: Various clinical and endoscopic factors have been proposed and used as predictors of endoscopic treatment failure in bleeding peptic ulcers. Recently, several endoscopic factors have been considered to be more significant than various clinical factors, except for shock. Detailed knowledge of which endoscopic factors can be classified as predictors of rebleeding following endoscopic hemostasis is needed. This study describes newly defined endoscopic variables and evaluates their usefulness as predictors of endoscopic treatment failure.
AB0820-HPR Success in the city: the norwich experience of a nurse led treatment escalation clinic for newly diagnosed adult rheumatoid arthritis patients.
Authors: H. Hasthorpe, A. Brooksby
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> A Nurse Led Treatment Escalation Clinic for newly diagnosed adult Rheumatoid Arthritis patients was established in late 2010 in direct response to clinical need and to deliver Treat to Target’ (T2T) recommendations of responsive early effective treatment intervention. A Service Evaluation was undertaken in 2012 of the clinic between 2011-2012. <h3>Objectives</h3> Does early intervention with treatment escalation induce clinical remission/ acceptable low disease activity, utilising patient clinical outcome measure DAS28. Is patients rheumatology experience improved by attendance of this clinic? <h3>Methods</h3> The Evaluation was divided into 2 parts: 1. A retrospective analysis of routinely collected clinical data including DAS28, treatment escalation intervention at baseline 6 weeks,3,6,12 months and referrals for biologic consideration. 2. An anonymous Patient Experience Questionnaire was distributed. <h3>Results</h3> The data retrieved from 82 patients showed a significant overall improvement in DAS28. Median disease activity scores revealed a reduction in DAS28 from 5.74 at baseline and prior to treatment, to 2.55 at 6months, so achieving clinical remission of&lt;2.6. This outcome is sustained and further improved at 12 months with DAS28 average of 2.3. 2 patients at 6 months and 3 patients at 12 months were referred timely for biologic treatment. Optimum clinical intervention would appear to be Methotrexate 20mgs weekly, with Hydroxychloroquine 200mgs b.d the drug most used in combination. Cost effectiveness is demonstrated through the early aggressive intervention with first line DMARDs escalated efficiently to control disease activity and achieve clinical remission. Patient Experience Feedback from 50 patients revealed 98% felt the clinic was an integral part of their rheumatology care, with 92% expressing that they experienced symptomatic improvement through treatment escalation. <h3>Conclusions</h3> This model of patient focussed RA care, developed in response to ‘Treat to Target’ recommendations and clinical need, delivered by the Rheumatology Specialist Nurse through responsive, rapid treatment escalation demonstrates significantly improved clinical and economic outcomes, with excellent patient experience feedback and is transferable to any chronic disease management in both primary and secondary care. <h3>References</h3> Smolen, J.S., Aletha, D., Bijlsma, J.W.J. et al. (2010a) T2T Expert Committee. ‘Treating rheumatoid arthritis to target: recommendations of an international task force. <i>Annals of the Rheumatic Diseases,</i><b>69</b> (4), pp.631-37 <h3>Disclosure of Interest</h3> None Declared
Freshly voided urine temperature: a test for factitial fever
Authors: C. Ellenbogen
Journal: JAMA (1972)

To the Editor.—  Occasionally the differential diagnosis of the condition of a patient with a fever of unknown origin will include factitial fever. 1,2 Factitial fever is an elevated thermometer reading but normal body temperature due to fraudulent manipulation of the thermometer. 3,4 Once this diagnosis is entertained, however, it may be difficult to prove. One method of proof which has been suggested many times is simultaneous determination of the oral or rectal and freshly voided urine temperature. 1-4 The purpose of this paper is to examine the accuracy and practicality of this procedure on a busy general medicine ward.  Materials and Methods.—  The general medicine ward of the 483rd USAF Hospital, Cam Ranh Bay, Vietnam, is a 33-bed open ward. Staffed by one to two nurses and three to five corpsmen (orderlies) during the day, it admits from 5 to 15 clinically ill male servicemen daily, over half of
1030-12 The Action of a Specific Natriuretic Peptide Receptor Antagonist (HS142-1) Upon Basal Coronary and Renal Vascular Resistances
Authors: Thanom Supaporn, Chi-Ming Wei, Lawrence L. Aahrus, Masahiko Kinoshita, Yuzuru Matsuda, John C. Burnett.
Journal: Journal of the American College of Cardiology (1995)
Information Theoretic Approach to Assess Diagnostic Value of Computerized Tomographic Coronary Angiography
Authors: Mustafa Kılıçkap, Ahmet Ergun Karaağaoğlu, Kerim Esenboğa, Çağlar Uzun, Çetin Atasoy, Deniz Kumbasar, Çetin Erol
Journal: Journal of the American College of Cardiology (2013)
Differential effects of left anterior descending coronary occlusion on left and right ventricular anterior wall thickening in the conscious pig
Authors: A. J Crottogini, P. Willshaw, J. G Barra, E. C Lascano, R. H Pichel
Journal: Cardiovascular Research (1992)

Objective: In humans, the left anterior descending coronary artery supplies the left ventricular wall, anterior septum and the paraseptal part of the right ventricular anterior wall. Our aim was to study the effects of acute left anterior descending coronary occlusion on wall thickening in the regions of the left and right ventricular anterior walls supplied by the artery, and in remote, non-ischaemic regions of both ventricles. Methods: Systolic wall thickening (defined as percent thickening with respect to end diastolic wall thickness) was studied in eight conscious pigs every 15 s during 1 min of acute left anterior descending coronary occlusion by a cuff occluder, and every 30 s during 4 min of reperfusion. Pigs were instrumented with ultrasonic microcrystals measuring wall thickness in the anterior walls (left anterior descending artery territory) and lateral walls (left circumflex or right coronary artery territory) of both ventricles, and a left ventricular pressure microtransducer. Results: During control and reperfusion, both anterior walls displayed similar systolic thickening. During coronary occlusion, the left ventricular anterior wall showed paradoxical systolic thinning (dyskinesia) whereas the right ventricular anterior wall showed only hypokinesia. Conclusions: In the presence of equal blood flow deprivation, the right ventricular anterior wall supplied by the left anterior descending coronary artery displays a significantly lesser degree of functional impairment than the left ventricular anterior wall supplied by the same artery. This differential effect may be due to mechanical unloading of the right ventricular anterior wall resulting from left ventricular anterior wall ischaemia. This afterload reduction due to decreased mechanical interaction between the two walls would allow the right ventricular anterior wall to express its contractile reserve in the form of systolic thickening.
The Complement System of Man
Authors: Ruddy S, Gigli I, Austen Kf
Journal: New England Journal of Medicine (1972)

Activation, Control and Products of the Reaction SequenceAlthough it is not yet possible to inter-relate fully the diverse ingredients of the humoral portion of the inflammatory response, it is now feasible to indicate some of the discrete effector pathways and to identify a number of points of interaction between them. The effector pathway of the inflammatory response to be considered primarily in this review is the complement reaction sequence. Other plasma protein systems that must also be considered because of their interactions with the complement system include portions of the clotting sequence, the fibrinolytic system, and the kinin-generating sequence. Appreciation of these . . .
Failure of Cephalosporins to Prevent Staphylococcus aureus Surgical Wound Infections
Authors: Douglas S. Kernodle
Journal: JAMA (1990)

Approximately 35,000 Staphylococcus aureus surgical wound infections occur annually in the United States. To investigate why S aureus causes infection despite the perioperative administration of cephalosporins, we compared 35 methicillin-susceptible isolates recovered from deep wound infections that complicated cefazolin prophylaxis (18 of 1650 patients) and cefamandole prophylaxis (17 of 3702 patients) with 64 colonizing isolates from presurgical patients. Compared with both colonizing and cefamandole-associated isolates, S aureus isolates from cefazolin-associated infections were more resistant to cefazolin by specialized assays. Staphylococcus aureus isolates that produced the A and C variants of staphylococcal beta-lactamase were associated with infections following cefazolin and cefamandole prophylaxis, respectively. These isolates hydrolyze the respective cephalosporins rapidly, suggesting that staphylococcal survival after perioperative prophylaxis may be mediated by in vivo degradation of the prophylactically administered cephalosporin. These data indicate that some S aureus wound infections occur because of deficiencies in antimicrobial effectiveness that are not detectable by routine susceptibility tests. This finding has important implications for the therapy and prevention of S aureus infection.
Private group wins Derbyshire GP contract
Authors: Owen Dyer
Journal: BMJ (2006)

A US healthcare company is to take over two Derbyshire general practices after beating local GPs to the contract in a bidding process led by the local primary care trust.

UnitedHealth Europe, a subsidiary of the Minnesota based United Health Group, was awarded the contract by North Eastern Derbyshire Primary Care Trust, ahead of 17 other bidders. It will operate general practices in Normanton (a ward of Derby) and Cresswell, a former mining village, both of which are considered deprived areas with inadequate services. The practices' previous …
Problems in Treating Experimentally Induced Acute Hepatic Failure by Hemoperfusion or Cross Circulation
Authors: Robert A. F. M. Chamuleau, Robert J. Popken, Ellen C. Beyerbacht, Henk W. M. De Koning
Journal: Hepatology (1983)

Acute hepatic failure was induced in rats by galactosamine injection intraperitoneally (1 gm per kg). Twenty-four hours later rats were treated by hemoperfusion (HP) over encapsulated sorbents: cellulose acetate-coated charcoal, polyelectrolyte-coated XAD4, a combination of both, or cross circulation with a healthy donor. Compared with control treatment (prevention of hypoglycemia by glucose infusion), the survival rate was not improved by HP or cross circulation: controls 19% vs. treated animals 0 to 17%. Extension of duration or increased frequency of HP gave the same survival rates. Computer simulation based on zero-order introduction of a possible toxin into a two-compartment model shows that HP up to 5 hr per day is not able to clear the body effectively from the assumed toxin if its partition coefficient exceeds a value of 50.
Inhibition of hedgehog signalling prevents experimental fibrosis and induces regression of established fibrosis
Authors: Angelika Horn, Trayana Kireva, Katrin Palumbo-Zerr, Clara Dees, Michal Tomcik, Cinzia Cordazzo, Pawel Zerr, Alfiya Akhmetshina, Martial Ruat, Oliver Distler, Christian Beyer, Georg Schett, Jörg H W Distler
Journal: Annals of the Rheumatic Diseases (2012)

Objectives Tissue fibrosis is a leading cause of death in patients with systemic sclerosis (SSc). Effective antifibrotic treatments are not available. Here, the authors investigated inhibition of hedgehog signalling by targeting Smoothened (Smo) as a novel antifibrotic approach. Methods The activation status of the hedgehog pathway was assessed by immunohistochemistry for Gli transcription factors and by quantification of hedgehog target genes. Hedgehog signalling was inhibited by the selective inhibitor LDE223 and by small interfering RNA against Smo in the models of bleomycin-induced dermal fibrosis and in tight-skin-1 mice. Results Hedgehog signalling is activated in SSc and in murine models of SSc. Inhibition of Smo either by LDE223 or by small interfering RNA prevented dermal thickening, myofibroblast differentiation and accumulation of collagen upon challenge with bleomycin. Targeting Smo also exerted potent antifibrotic effects in tight-skin-1 mice and did prevent progression of fibrosis and induced regression of pre-established fibrosis. Conclusions Inhibition of hedgehog signalling exerted potent antifibrotic effects in preclinical models of SSc in both preventive and therapeutic settings. These findings might have direct translational implications because inhibitors of Smo are already available and yielded promising results in initial clinical trials.
A NEW ALKALINE SOLUTION OF IODIN FOR USE IN THE GRAM STAIN
Authors: ROBERT A. KILDUFFE
Journal: JAMA (1923)

The method of differential staining first described by Gram in 1884 has become an important means of classifying bacteria and, as in the case of the gonococcus, forms an important factor in their morphologic recognition.  The exact reaction or conditions governing the retention or loss of the violet dye, as a result of which bacteria are classed as gram positive or gram negative, is not entirely clear, nor is it definitely known whether the bacterial protein (protoplasm) or the bacterial cell wall is mainly concerned in the retention of the dye.  According to Wells, 1 the gram positive reaction is due to the formation of an iodin-pararosanilic-protein compound not easily dissociated by water, and he suggests that the cell wall of gram positive organisms is impermeable to the action of decolorizing agents.  The fact that the disintegration of gram positive organisms renders them gram negative, as shown by Benians, and
Intravenous Arteriography Using Digital Subtraction Techniques
Authors: W. R. Brody, D. R. Enzmann, D. C. Miller, D. F. Guthaner, N. J. Pelc, G. S. Keyes, Stephen J Riederer
Journal: JAMA (1982)

The application of digital computers to electronic x-ray imaging devices has rejuvenated interest in the field of intravenous arteriography. By utilizing computer image subtraction techniques, digital roentgenographic systems based on fluoroscopy or computed tomography (scanned projection radiography) provide significantly improved vascular imaging compared with conventional film subtraction methods. Digital subtraction angiography schemes isolate contrast media in the vessel by detecting differences in images obtained before and after the injection of contrast medium or changes in the relative attenuation of contrast media at different x-ray energies. Present applications include carotid and peripheral arteriography, thoracic and abdominal aortography, pulmonary arteriography, and ventriculography. Future applications may include intracerebral and coronary arteriography. These systems should provide low-risk outpatient screening arteriography.
Expression of adhesion molecules on synovial fluid and peripheral blood monocytes in patients with inflammatory joint disease and osteoarthritis
Authors: M Koller, M Aringer, H Kiener, L Erlacher, K Machold, G Eberl, A Studnicka-Benke, W Graninger, J Smolen
Journal: Annals of the Rheumatic Diseases (1999)

<h3>OBJECTIVE</h3> To determine the presence of adhesion molecules on monocytes/macrophages (Mφ) from peripheral blood (PB) and synovial fluid (SF) in patients with osteoarthritis (OA) and inflammatory joint diseases (rheumatoid (RA) and reactive arthritis (ReA)) in order to improve our understanding of the possible mechanisms underlying the inflammatory process. <h3>METHODS</h3> Whole blood and SF cells were stained with monoclonal antibodies against CD11a (LFA-1), CD15 s (sialyl-Lewis X), CD44, CD54, VLA-4, and HLA-DR counterstained with anti-CD14 antibodies as a Mφ marker for dual fluorescence analysis by flowcytometry. <h3>RESULTS</h3> On PB-Mφ, CD15s was markedly increased in both RA as well as ReA compared with OA. Furthermore, in the PB LFA-1, CD44, and HLA-DR showed a higher surface density on Mφ in ReA than in OA. Comparison between SF and PB showed significantly higher CD44 and CD54 expression on SF-Mφ. These molecules play an important part in lymphocyte-Mφ interaction. <h3>CONCLUSION</h3> In PB from patients with inflammatory joint diseases, Mφ are activated, allowing recruitment into the synovial compartment. These disorders, in contrast with OA seem to be "systemic" in nature. Within the SF, different adhesion molecules are expressed on CD14<sup>+</sup> Mφ as compared with PB.
The abnormal cervical smear.
Authors: A Singer
Journal: BMJ (1986)

The relative ineffectiveness of the screening programme in the United Kingdom seems to be related to two factors: the lack of an initial call system coupled with inadequacy of record and recall systems for women with abnormal findings and the fact that most smears are performed on relatively low risk young women. There has been a dramatic increase in the number of the precancerous lesions found, especially in young women, with an associated increase in deaths in this group, and this is imposing a great strain on the cytology screening system.2
Treatment of Chancroid
Authors: James E. Fitzpatrick
Journal: JAMA (1981)

Thirty-five men with chancroid were randomly treated with oral sulfisoxazole, sulfisoxazole and tetracycline, sulfamethoxazole-trimethoprim, or intramuscular streptomycin. The highest rate of cures were obtained in 13 of 13 patients treated with streptomycin and in ten of ten patients treated with sulfamethoxazole-trimethoprim. Only seven of nine patients treated with sulfisoxazole and five of eight treated with sulfisoxazole and tetracycline were cured. We conclude that the sulfamethoxazole-trimethoprim combination is as efficacious as streptomycin and probably superior to sulfisoxazole and tetracycline in the treatment of chancroid. (<i>JAMA</i>1981;246:1804-1805)
1042. Creation of Tolerogenic Dendritic Cells by Non Viral Gene Transfer with Immunoliposomes
Authors: Peng H. Tan, Sven C. Beutelspacher, Giovanna Lombardi, Andrew J.T. George
Journal: Molecular Therapy (2005)

Dendritic cells (DCs) have the ability both to stimulate immune responses, and also to induce anergy in T cells. We have investigated two approaches to inducing tolerogenic DCs. These have potential for the treatment of autoimmune disease, allergy and in preventing transplant rejection.