tbuckley/cabot-search huggingface dataset:
Race, insulin resistance and hepatic steatosis in chronic hepatitis C
Authors: Hari S. Conjeevaram, David E. Kleiner, Jay E. Everhart, Jay H. Hoofnagle, Steven Zacks, Nezam H. Afdhal, Abdus S. Wahed
Journal: Hepatology (2006)

Hepatic steatosis is common in chronic hepatitis C and has been linked to concurrent obesity, insulin resistance, diabetes, disease severity, and poor response to therapy. Racial differences in rates of obesity and diabetes may contribute to racial differences in hepatic steatosis and treatment response. The aim of the present study was to compare hepatic steatosis and its associations between African American (AA) and Caucasian American (CA) patients with chronic hepatitis C, genotype 1, participating in a prospective study of peginterferon and ribavirin therapy. Liver biopsy results were available from 194 AA patients and 205 CA patients. The 2 groups were compared for anthropometric, clinical, and biochemical features and insulin resistance estimated by the homeostasis model assessment index (HOMA-IR). Sixty-one percent of the AA patients and 65% of the CA patients had hepatic steatosis ( P = 0.38). In univariable analysis, steatosis was associated with HOMA-IR, body mass index, waist circumference, serum triglycerides, aminotransferase level, and histological scores for inflammation and fibrosis. After adjusting for these features, AA patients had a lower risk of steatosis than did CA patients (OR 0.54, 95% CI 0.32-0.91, P = 0.02). Insulin resistance but not steatosis was associated with a lower rate of sustained virological response when adjusted for known factors that predict response (relative risk 0.87, 95% CI 0.77-0.99, P = 0.028). Conclusion : After adjusting for the higher prevalence of features associated with hepatic steatosis, AA patients had a lower prevalence of hepatic steatosis than did CA patients with chronic hepatitis C, genotype 1. Insulin resistance but not steatosis was independently associated with lower sustained virological response. (Hepatology 2006;45:80–87.)
Subacute Cutaneous Lupus Erythematosus Associated with Hydrochlorothiazide Therapy
Authors: BARBARA R. REED
Journal: Annals of Internal Medicine (1985)

Photosensitive eruptions with clinical and histologic features of subacute cutaneous lupus erythematosus and antibodies to SS-A(Ro) antigen occurred in five patients taking hydrochlorothiazide. After drug therapy was discontinued, the eruptions cleared. In one patient anti-SS-A antibodies disappeared after discontinuation of thiazide, and in another rechallenge with hydrochlorothiazide produced an acute dermatitis with a photodistribution. These eruptions may represent a new type of photosensitive drug reaction in which the photoactive drug may be synergistic with anti-SS-A antibody in producing cutaneous lesions of photosensitive subacute cutaneous lupus erythematosus.
Pituitary folliculo-stellate-like cells stimulate somatotropic pituitary tumor growth in nude mice
Authors: Chiaki Koyama, Hirokazu Matsumoto, Takafumi Sakai, Katsumi Wakabayashi, Akihiro Ito, Ernest F. Couch, Kinji Inoue
Journal: Endocrine Pathology (1995)
Potential Benefit From Implantable Cardioverter-Defibrillator Therapy in Patients With and Without Heart Failure
Authors: Dirk Böcker, Dietmar Bänsch, Achim Heinecke, Max Weber, Jürgen Brunn, Dieter Hammel, Martin Borggrefe, Günter Breithardt, Michael Block
Journal: Circulation (1998)

Background —Whether patients with heart failure derive a benefit from therapy with implantable cardioverter-defibrillators (ICDs) has been questioned. The purpose of this study was to investigate whether New York Heart Association (NYHA) functional class had an impact on the potential benefit from ICD therapy as assessed from data stored in the memory of ICDs. Methods and Results —Between 1989 and 1996, 603 patients (77% men; 59% with coronary artery disease and 16% with dilated cardiomyopathy; age, 57±13 years; ejection fraction, 44±18%) were treated with an ICD with extended memory function (storage of electrograms and/or RR intervals from treated episodes) in combination with endocardial lead systems. The stages of heart failure (NYHA functional class I through III) at implantation were correlated with overall mortality and the recurrence of fast ventricular tachyarrhythmias (&gt;240 bpm) during follow-up. The potential benefit of the device was estimated as the difference between overall mortality and the hypothetical death rate had the device not been implanted. The latter was based on the recurrence of fast and, without termination by the devices, presumably fatal ventricular tachyarrhythmias. In the overall group, a significant difference between hypothetical death rate and overall mortality was observed (13.9%, 23.5%, and 26.6% at 1, 3, and 5 years, respectively) that suggested a benefit from ICD implantation. In patients in NYHA class I, the estimated benefit, which increased over time, was 15.2%, 29.2%, and 35.6% after 1, 3, and 5 years, respectively. In patients in NYHA class II or III, the estimated benefit increased until the third year (21.8% and 21.9%, respectively) and then remained constant until the fifth year (22.9% and 23.8%, respectively). Even those patients in NYHA class III with a history of decompensated heart failure benefited from ICD implantation. Conclusions —Analysis of stored ECG data suggests that in patients with a history of ventricular tachycardia or ventricular fibrillation, ICD therapy may lead to a prolongation of life in NYHA classes I through III. The initial benefit is greatest in patients in NYHA class II and class III, but the estimated benefit might persist longest for patients in NYHA class I.
Catheter Ablation of Accessory Pathways, Atrioventricular Nodal Reentrant Tachycardia, and the Atrioventricular Junction
Authors: Hugh Calkins, Patrick Yong, John M. Miller, Brian Olshansky, Mark Carlson, J. Philip Saul, Shoei K. Stephen Huang, L. Bing Liem, Lawrence S. Klein, Suzan A. Moser, Daniel A. Bloch, Paul Gillette, Eric Prystowsky
Journal: Circulation (1999)

Background —The purpose of this study was to evaluate the safety and efficacy of a temperature-controlled radiofrequency catheter ablation system. Methods and Results —The patient population included 1050 patients who had undergone ablation of atrioventricular nodal reentrant tachycardia (AVNRT), an accessory pathway (AP), or the atrioventricular junction (AVJ). Ablation was successful in 996 patients. The probability of success was highest among patients who had undergone ablation of the AVJ, lowest in patients who had undergone ablation of an AP, and in between for patients who had undergone ablation of AVNRT. A major complication occurred in 32 patients. Four variables predicted ablation success (AVJ, AVNRT, or left free wall AP ablation and an experienced center). Four factors predicted arrhythmia recurrence (right free wall, posteroseptal, septal, and multiple APs). Two variables predicted development of a complication (structural heart disease and the presence of multiple targets), and 3 variables predicted an increased risk of death (heart disease, lower ejection fraction, and AVJ ablation). Conclusions —These findings may serve as a guide to clinicians considering therapeutic options in patients who are candidates for ablation.
Leukocytic function in hypogammaglobulinemia
Authors: Ira D. Mickenberg, Richard K. Root, Sheldon M. Wolff
Journal: Journal of Clinical Investigation (1970)

The phagocytic, bactericidal, and metabolic capabilities of circulating blood leukocytes from three adults (two males, one female) with hypogammaglobulinemia and recurrent pneumonia, chronic sinusitis, and intestinal giardiasis were studied. These functions were found to be normal when leukocytes from the patients were incubated in media containing normal human serum. Phagocytosis of Staphylococcus albus and polystyrene balls by both patient and normal leukocytes was diminished when the cells were incubated in hypogammaglobulinemic plasma. A similar defect in opsonization by patient plasma was also noted for pneumococci, Escherichia coli and variably with Staphylococcus aureus. Both patient and normal sera had equivalent levels of heat-labile S. albus opsonins; normal serum, however, contained heat-stable S. albus-specific absorbable opsonins in significantly greater quantities to account for its superior opsonic capacity. The addition of commercial gamma globulin or purified IgG to hypogammaglobulinemic sera restored full S. albus opsonic activity. The relevancy of these observations to the impaired host defenses in these patients will be discussed.
Angiogenesis inhibition for glioblastoma at the edge: beyond AVAGlio and RTOG 0825
Authors: M. Weller, W. K. A. Yung
Journal: Neuro-Oncology (2013)

The standard of care for patients with newly diagnosed glioblastoma was redefined in 2005 when the EORTC NCIC trial showed the superiority of concomitant and maintenance temozolomide (TMZ) and radiotherapy over radiotherapy alone. Since then, numerous efforts have been made to build on this new regimen, mostly testing the hypotheses that prolonged administration of TMZ or inhibition of angiogenesis will provide a survival benefit. The most promising anti-angiogenesis agent, bevacizumab, is a monoclonal antibody that targets vascular endothelial growth factor (VEGF). Bevacizumab produced encouraging response rates and progression-free survival data at 6-month landmark analyses. Other VEGF-targeting agents, such as cediranib or VEGF trap, have shown less convincing results in their safety, tolerability, and efficacy.

Bevacizumab's conditional approval by the FDA in 2009 for patients with recurrent glioblastoma was linked to future demonstrations of its efficacy in prospective trials in newly diagnosed patients. Two such trials were performed, largely in parallel—one by the RTOG (RTOG-0825) in the United States, and one by Roche (AVAGlio), mostly in Europe.1 Rather mature results from both trials were presented at the 2013 American Society of Clinical Oncology meeting in Chicago.2,3 The results from both trials provide a uniform picture: Progression-free survival was significantly prolonged, and quality of life was preserved in the AVAGlio trial, but not in RTOG-0825. Overall survival was not improved, but safety and tolerability were acceptable. The subgroup analyses available so far do not identify specific subgroups of patients who particularly benefitted from bevacizumab, and a comparison of both trials suggests no major effect of cross-over at progression.

As it stands, the overall survival data from both trials do not support the routine use of bevacizumab in the upfront treatment setting. This does not exclude the possibility that subgroup and molecular analyses will reveal a beneficial effect of bevacizumab in subgroups of patients with glioblastoma. Another important question is whether bevacizumab should remain available for patients with recurrent disease because it provides quality of life and progression-free survival benefits. Answers to other important questions are also pending. Are we sure that the gain in progression-free survival reflects a true impact on disease activity and not just altered imaging? If there is a true modification of disease biology, do some tumors become more invasive and more malignant? Is maintaining quality of life early in the course of disease worth paying the price of rapid clinical deterioration later on, possibly based on induced refractoriness to all available further lines of treatment? Answering the latter question and deriving new strategies to prevent resistance or the escape from VEGF inhibition appear to be the most promising roads to success for adding VEGF inhibitors to current treatment paradigms for glioblastoma.
Abnormal electrocardiographic activity revealed by isolated rat heart preparations at various times after experimental myocardial infarction
Authors: H A SAHYOUN, R HICKS
Journal: Cardiovascular Research (1981)

Experimental myocardial infarction has been induced in rats by isoprenaline pretreatment and progress of the lesions has been observed histologically at intervals over a period of 6 weeks. This revealed transition from extensive ischaemic degeneration to apparently complete recovery of much of the affected muscle, leaving lesser areas of necrotic cells to become replaced by dissecting collagen-fibre scars. Isolated perfused preparations of affected and normal hearts were used to give electrocardiogram records. Oscilloscope photographs were measured. Ischaemia was associated, typically, with enlarged Q waves and decreased R and S waves, plus evidence of bundle branch block. These abnormalities abated as lesions resolved, leaving residual Q enlargement and arrhythmias, consistent with persistent scarring.
What future for the Department of Health?
Authors: R Klein
Journal: BMJ (1990)

Almost from its birth the NHS has been haunted by a vision.In it, the service emerges from the tutelage of central government as an independent corporation emancipated from control by civil servants and no longer vulnerable to sudden ministerial whims or political pressures.It is an idea that has surfaced from time to time, as in the report of the 1979 Royal Commission'; it has also been considered in private ministerial ruminations about the future of the NHS.In the past it has usually been dismissed as tempting but politically naive and constitutionally irregular.Now, however, its time may have come.In 1992 the NHS Management Executive is to move to new headquarters in Leeds.The move will give even more visibility to its increasingly independent role and force into the open a debate that has already begun within the Department ofHealth: a debate about the respective roles of the executive and the department.If the management executive is the body responsible for running the NHS-a sort of protocorporation, albeit at present still embedded in central government -what is the department's future? Leadership for the NHSThe origins of the management executive, as of so much else in the NHS today, go back to the 1983 Griffiths report,2 which recommended the creation of two new boards.The first, to be chaired by the secretary of state, was to be the Health Services Supervisory Board, responsible for determining the "purpose, objectives and direction" of policy.The second, to be chaired by an outsider with managerial skill, was to be the NHS Management Board, whose role it would be to implement policy, to give leadership to the management of the NHS, to control performance, and "to achieve consistency and drive over the long term."In his report Sir Roy Griffiths explicitly recognised that this was an alternative way of achieving many of the objectives sought by the advocates of an independent corporation but without calling into question the secretary of state's constitutional position or requiring time consuming legislation to implement the change.The appointment of a general manager for the NHS to act as the secretary of state's "right hand man" would leave undisturbed the secretary of state's
Isolated noncompaction of left ventricular myocardium. A study of eight cases.
Authors: T K Chin, J K Perloff, R G Williams, K Jue, R Mohrmann
Journal: Circulation (1990)

Isolated noncompaction of left ventricular myocardium is a rare disorder of endomyocardial morphogenesis characterized by numerous, excessively prominent ventricular trabeculations and deep intertrabecular recesses. This study comprised eight cases, including three at necropsy. Ages ranged from 11 months to 22.5 years, with follow-up as long as 5 years. Gross morphological severity ranged from moderately abnormal ventricular trabeculations to profoundly abnormal, loosely compacted trabeculations. Echocardiographic images were diagnostic and corresponded to the morphological appearances at necropsy. The depths of the intertrabecular recesses were assessed by a quantitative echocardiographic X-to-Y ratio and were significantly greater than in normal control subjects (p less than 0.001). Clinical manifestations of the disorder included depressed left ventricular systolic function in five patients, ventricular arrhythmias in five, systemic embolization in three, distinctive facial dysmorphism in three, and familial recurrence in four patients. We conclude that isolated noncompaction of left ventricular myocardium is a rare if not unique disorder with characteristic morphological features that can be identified by two-dimensional echocardiography. The incidence of cardiovascular complications is high. The disorder may be associated with facial dysmorphism and familial recurrence.
Abstract 4223: Low Adiponectin Levels Are an Independent Predictor of Mixed and Non-Calcified Coronary Atherosclerotic Plaques
Authors: Uli C Broedl, Corinna Lebherz, Michael Lehrke, Renee Stark, Helmholtz Zentrum, Martin Greif, Alexander Becker, Franz von Ziegler, Janine Tittus, Maximilian Reiser, Christoph Becker, Burkhard Göke, Klaus G Parhofer, Alexander W Leber
Journal: Circulation (2008)

We sought to examine the relationship of adiponectin with coronary atherosclerotic plaque morphology in patients with stable typical or atypical chest pain. There is increasing recognition that lesion composition rather than size determines the acute complications of atherosclerotic disease. Low serum adiponectin levels are associated with coronary artery disease and future incidence of acute coronary syndrome. The impact of adiponectin on lesion composition still remains to be determined. Serum adiponectin levels were determined in 303 patients with stable typical or atypical chest pain, who underwent dual-source multi-slice CT-angiography to exclude coronary artery stenosis. Atherosclerotic plaques were classified as calcified, mixed or non-calcified plaques. In bivariate analysis adiponectin levels were inversely correlated with total coronary plaque burden (r=−0.22, p&lt;0.0001), mixed (r=−0.20, p=0.0007) and non-calcified plaques (r=−0.18, p=0.003). No correlation was seen with calcified plaques (r=−0.05, p=0.39). In a fully adjusted multivariate model containing age, sex, body mass index, hypertension, diabetes mellitus, smoking, family history of coronary artery disease, LDL-cholesterol, HDL-cholesterol, triglycerides, hsCRP levels, medication and pericardial adipose tissue volume, adiponectin levels remained predictive of total plaque burden (estimate: −0.035, 95% CI: −0.051 to −0.019, p&lt;0.0001), mixed (estimate: −0.083, 95% CI: −0.127 to −0.039, p=0.0002) and non-calcified plaques (estimate: −0.076, 95% CI: −0.114 to −0.038, p=0.0001). Since the majority of coronary plaques were calcified plaques, adiponectin levels account for only 3% of the variability in total plaque number. In contrast, adiponectin accounts for approximately 20% of the variability in mixed and non-calcified plaque burden. Adiponectin levels predict mixed and non-calcified coronary atherosclerotic plaque burden. Low adiponectin levels may contribute to coronary plaque vulnerability and may thus play a role in the pathophysiology of acute coronary syndrome.
Antibody titres to Campylobacter pylori after treatment for gastritis.
Authors: D. Vaira, J. Holton, S. R. Cairns, M. Falzon, A. Polydorou, J. F. Dowsett, P. R. Salmon
Journal: BMJ (1988)

Campylobacter pylorn is strongly associated with histo- logically confirmed gastritis.1The most convincing evidence for a pathogenic role of C pylori in gastritis comes from trials of treatment."We investigated the
Small ubiquitin-related modifiers: A novel and independent class of autoantigens in primary biliary cirrhosis
Authors: Caroline Janka, Carlo Selmi, M. Eric Gershwin, Hans Will, Thomas Sternsdorf
Journal: Hepatology (2005)

Serum autoantibodies against components of nuclear dots (anti-NDs), namely PML and Sp100, are specifically detected in 20% to 30% of patients with primary biliary cirrhosis (PBC). Although anti-ND antibodies are nonpathogenic, the mechanisms that lead to this unique reactivity are critical to understanding the loss of immune tolerance in PBC. Importantly, Sp100 and PML are both covalently linked to small ubiquitin-related modifiers (SUMOs). Therefore, we investigated whether SUMO proteins are independent autoantigens in PBC and studied 99 PBC sera samples for reactivity against NDs, PML, and Sp100, as well as against SUMO-2 and SUMO-1 recombinant proteins. Autoantibodies against SUMO-2 and SUMO-1 were found in 42% and 15% of anti-ND–positive PBC sera, respectively. Anti-SUMO reactivity was not observed in anti-ND–negative sera. Anti–SUMO-2 autoantibodies were found in 58% of sera containing autoantibodies against both PML and Sp100 and were detected exclusively in sera containing anti-Sp100 autoantibodies. In conclusion, SUMO proteins constitute a novel and independent class of autoantigens in PBC. Furthermore, we believe our data emphasize the post-translational modification of lysine by either lipoylation in the case of AMA or SUMOylation in the case of specific anti-ND autoantibodies as the pivotal site for autoantibody generation in PBC. (HEPATOLOGY 2005 2005;41:609–616.)
German doctors press for a national trial register
Authors: Annette Tuffs
Journal: BMJ (2005)

A task force of German epidemiologists, doctors, and consumer protection campaigners is pressing for the swifter establishment of a national register of clinical trials.

At a press conference last week in Berlin the group said that it was in the interests of patients and medical science that Germany set up a register. The task force also published an appeal in the German Medical Journal Deutsches Arzteblatt (www.aerzteblatt.de/v4/archiv/artikel.asp?id=47551).

The initiative is supported by an alliance of German medical …
Intestinal dysbiosis in inflammatory bowel disease
Authors: Nirmal Kaur, Chun-Chia Chen, Jay Luther, John Y. Kao
Journal: Gut Microbes (2011)

The worldwide incidence of inflammatory bowel disease (IBD) is increasing. Abundant literature has suggested that an imbalance between harmful and protective bacteria, or dysbiosis, of the intestine is largely responsible for the rising incidence of IBD. In this review, data supporting dysbiosis as a cause of IBD are presented. A comparison of the number of scientific publications in the US versus Europe on intestinal dysbiosis and microbiota revealed the US scientific community has a lower level of interest in studying dysbiosis and microbiota compared the research community in Europe. The rising trend of antibiotic use in the US provides further evidence of the lack of concern for the effect of dysbiosis on human health. Further research to understand the causal relationship between dysbiosis and IBD are needed to better guide clinical practice in using probiotics.
ACC/AHA/Physician Consortium 2008 Clinical Performance Measures for Adults With Nonvalvular Atrial Fibrillation or Atrial Flutter
Authors: N. A. Mark Estes, Jonathan L. Halperin, Hugh Calkins, Michael D. Ezekowitz, Paul Gitman, Alan S. Go, Robert L. McNamara, Joseph V. Messer, James L. Ritchie, Sam J.W. Romeo, Albert L. Waldo, D. George Wyse
Journal: Circulation (2008)