tbuckley/cabot-search huggingface dataset:
PTU-072 Outcomes Of The Use Of Infliximab And Adalimumab In Patients With Crohn’s Disease At A District General Hospital
Authors: C Lane, S Ramakrishnan, J Dougherty
Journal: Gut (2014)

<h3>Introduction</h3> Infliximab (IFX) and adalimumab (ADA) are licensed for the treatment of severe Crohn’s disease (CD). NICE recommends patients should receive these agents as a planned course of treatment for 12 months or until treatment failure. Patients should have their disease reassessed to determine if they have active disease and whether ongoing therapy is appropriate. We assessed our adherence to the NICE recommendations and present our outcomes for patients who had treatment discontinued following remission. <h3>Methods</h3> Patients who had received treatment with IFX and/or ADA from Jan 2011 to Sep 2013 were identified from a database held by our pharmacy. Data was collected from patient case notes and a database of clinic letters. A total of 49 patients were identified. Cases were assessed for adherence to NICE recommendations. <h3>Results</h3> 24 patients had been on IFX only (49%), 14 patients on ADA only (28.6%) and 11 started on IFX then switched to ADA (22.4%). 8 patients had evidence of fistulating disease. Mean age was 39 years (range 17–60). All patients (100%) had severe active CD that did not respond to conventional therapy (79.6%) or were intolerant or had contraindications (20.4%) to therapy. All patients (100%) were reassessed to determine whether ongoing treatment was still clinically appropriate. All patients (100%) were treated and reviewed by clinicians with experience in their use. Discussion regarding risks and benefits of continued treatment occurred in 77.8% of cases. 39 patients (79.6%) had been on treatment for greater than 1 year. Of these, 20 patients had treatment discontinued (51.3%); 3 were due to a reaction/intolerance, 10 were due to treatment failure, and 7 due to deep clinical remission (17.9%). 2 patients (28.6%) had disease recurrence following treatment withdrawal due to remission. Mean time to relapse following withdrawal was 9 months (range 3–15). Of all patients found to be in deep clinical remission (n = 12, 30.8%) after 12 months of treatment, 6 patients had treatment continued partly due to patient choice (66.7%). Patients who continue treatment all had their disease reassessed at least every 12 months. <h3>Conclusion</h3> There is good adherence to NICE guidelines in our cohort, however despite evidence of deep clinical remission some patients declined to have treatment discontinued partly due to anxiety of relapse. Our relapse rate following withdrawal of biological treatment appears lower than that found in the literature. <h3>References</h3> NICE Technology Appraisal Guidance 187: infliximab (review) and adalimumab for the treatment of Crohn’s disease Louis E, <i>et al</i>. Maintenance of remission among patients with Crohn’s disease on antimetabolite therapy after infliximab therapy is stopped. <i>Gastroenterology</i> 2012;142:63–70 <h3>Disclosure of Interest</h3> None Declared.
THE DISTRIBUTION OF RICKETTSIA IN THE TISSUES OF INSECTS AND ARACHNIDS
Authors: E. V. Cowdry
Journal: The Journal of Experimental Medicine (1923)

In the absence of a satisfactory definition of Rickettsia the observations herein recorded were arbitrarily limited to bacterium-like organisms which are intracellular and Gram-negative. Rickettsia of this type were found in the following species: Amblyomma americana, Amblyomma hebraeum, Boophilus decoloratus, Atomus sp., Casinaria infesta, Chrysopa oculata, Ctenocephalus canis, Dermacentor variabilis, Lepisma saccharina, Lucoppia curviseta, Margaropus annulatus, Margaropus annulatus australis, Ornithodoros turicata, Pulex irritans, Rhipicephalus sanguineus, Rhipicephalus evertsi, and Salticus scenicus. Since intracellular, Gram-negative Rickettsia have been recorded in the literature as existing in Cimex lectularius, Dermacentor venustus, Melophagus ovinus, and Pediculus humanus, the occasional occurrence of such bodies must be conceded in the following groups not closely related phylogenetically: Attidae, Trombidiidae, Argasidae, lxodidae, Cinura, Acanthiidae, Pediculidae, Hippoboscidae, Chrysopidae, Pulicidae, and Ichneumonidae. The species which harbor Rickettsia differ widely in diet and habitat. One such species is insectivorous throughout life, two are insectivorous in larval stages, becoming vegetarian in the adult condition, one is chiefly vegetarian but partakes of some animal products, and two are usually entirely vegetarian; while the remainder subsist wholly upon a diet of mammalian blood. Rickettsia are associated, in only a few cases, with diseases in mammals. The evidence at hand does not lead beyond the conclusion that the Rickettsia mentioned above are true Gram-negative microorganisms, easily distinguishable from mitochondria and all other cytoplasmic and nuclear granulations, rather completely adapted to an intracellular existence, exhibiting in some cases a remarkable degree of host specificity, and often inherited through the eggs.
Laboratory Findings in Pulmonary Embolism
Authors: JOEL MORGANROTH
Journal: Annals of Internal Medicine (1971)

Letters and Comments1 July 1971Laboratory Findings in Pulmonary EmbolismJOEL MORGANROTH, M.D., ALBERT DEISSEROTH, M.D., STANLEY WINOKUR, M.D.JOEL MORGANROTH, M.D.Search for more papers by this author, ALBERT DEISSEROTH, M.D.Search for more papers by this author, STANLEY WINOKUR, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-75-1-138 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: SZUCS and co-workers in their article "Diagnostic Sensitivities of Laboratory Findings in Acute Pulmonary Embolism" in the February issue of the ANNALS, reported that all patients demonstrated to have acute pulmonary embolism by pulmonary arteriography had arterial PO2 levels less than 80 mm Hg and, therefore, that if suspected patients have arterial PO2 greater than 80 mm Hg, acute pulmonary embolism is essentially excluded.We wish to report the finding of arterial PO2levels above 80 mm Hg in two patients, one, an older, chronically ill patient and the second, representative of the young ambulatory patient group,...References1. VECCHIO T: Predictive value of a single diagnostic test in unselected populations. New Eng J Med 274:1171-1173, 1966 CrossrefMedlineGoogle Scholar2. DALEN J: Pulmonary angiography in pulmonary embolism. Bull Physiopath Resp 6:45-63, 1970 MedlineGoogle Scholar3. DALENMATHUREVANS JVH: Pulmonary angiography in experimental pulmonary embolism. Amer Heart J 72:509-520, 1966 CrossrefMedlineGoogle Scholar4. FOX J: Prospective studies defined: a comment on a report on the use of hospital data in epidemiologic research. Amer J Epidem 91:231-232, 1970 CrossrefMedlineGoogle Scholar5. MACMAHONPUGHIPSEN BTJ: Epidemiologic Methods. Boston, Little, Brown and Co., 1960 Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Department of Medicine Beth Israel Hospital Boston, Mass. 02215 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByMassive pulmonary embolism without arterial hypoxaemiaPulmonary Embolism Without Arterial HypoxemiaJOHN MILLS, M.D., DENIS DREW, B.S. 1 July 1971Volume 75, Issue 1Page: 138-140KeywordsPartial pressure of oxygenPatient advocacyPulmonary arteriographyPulmonary embolismResearch laboratories Issue Published: 1 July 1971 PDF DownloadLoading ...
Clinical trial of disodium cromoglycate in treatment of asthma in children.
Authors: J. M. Smith, G. F. Devey
Journal: BMJ (1968)

<h3>Summary</h3> Whether smoking exacerbates Coronavirus disease 2019 is still debated. <i>Ex-vivo</i> Infection of reconstituted epithelial tissues from smoker versus non-smoker donors suggested comparable susceptibility to SARS-CoV-2 in epithelia from both groups.
International scientific meetings: relation between structure and function.
Authors: D Evered, R Porter, J Nugent
Journal: BMJ (1985)

Increasing pressure is being placed on the scientific community to evaluate research activities. Scientific meetings consume a small but important fraction of the research budget. Audit of a well established series of scientific meetings showed that they met their immediate objectives in that they were international and multidisciplinary and provided a forum in which all participants actively contributed to discussion. The meetings had a positive outcome for the participants, leading in many cases to the subsequent exchange of research material (60% of participants) and to the establishment of collaborative research projects (31%). The impact of the meetings on the scientific community at large was assessed by citation analysis, which showed that the proceedings were cited early, often, and over a substantial period.
Depressed expression of Klotho and FGF receptor 1 in hyperplastic parathyroid glands from uremic patients
Authors: Hirotaka Komaba, Shunsuke Goto, Hideki Fujii, Yasuhiro Hamada, Akira Kobayashi, Koji Shibuya, Yoshihiro Tominaga, Naoki Otsuki, Ken-ichi Nibu, Kimie Nakagawa, Naoko Tsugawa, Toshio Okano, Riko Kitazawa, Masafumi Fukagawa
Journal: Kidney International (2009)
Use of changes in the epicardial QRS complex to assess interventions which modify the extent of myocardial necrosis following coronary artery occlusion.
Authors: L D Hillis, J Askenazi, E Braunwald, P Radvany, J E Muller, M C Fishbein, P R Maroko
Journal: Circulation (1976)

The goal of this study was to determine if changes in the epicardial QRS complex after coronary artery occlusion (CAO) can be used to evaluate the efficacy of interventions designed to limit infarct size. Forty-one open-chest dogs with CAO were studied: 15 were controls, 18 received hyaluronidase and eight received propranolol starting 20 minutes after CAO. Epicardial ECGs were recorded at specific time intervals to analyze ST-segment elevation and changes in Q and R waves. Transmural specimens were obtained 24 hours after CAO from the same sites at which ECGs were recorded. Q wave development (deltaQ), R wave fall (deltaR), and their combination (deltaR + deltaQ) at 24 hours correlated with the extent of necrosis, as determined by myocardial creatine phosphokinase activity depression and histologic appearance. In the control group ST-segment elevation 15 minutes after CAO (ST15M) predicted changes in Q and R waves 24 hours later; in the treated groups, the same ST15M prior to drug administration resulted in significantly less QRS changes. Thus, 1) Q wave development and R wave fall 24 hours after CAO accurately reflect myocardial necrosis. 2) ST15M predicts subsequent changes in Q and R waves. 3) The efficacy of hyaluronidase and propranolol, agents previously shown to reduce myocardial necrosis, can be detected by less Q wave development and a smaller fall in R wave voltage.
Ultraviolet radiation exposure through window glass may be associated with localization of nonmelanoma skin cancer in organ transplant recipients: a study in France and the U.K
Authors: R. Atkar, M. Ocampo, S. Euvrard, J. McGregor, J. Kanitakis, C. Harwood
Journal: British Journal of Dermatology (2013)

Funding sources: none. Conflicts of interest: none declared. Dear Editor, Ultraviolet (UV)B radiation is a substantial risk factor for skin cancer in both immune‐competent and immunosuppressed organ transplant recipients (OTRs). In OTRs, additional exposure to UVA through drug photosensitization may contribute to their excess risk, which is well established.1 There is some evidence for preferential lateralization of photodamage and (pre)cancers, in the general population, to the side most exposed to UV radiation while driving. Moehrle et al.2 reported that left‐sided drivers receive five times more UV to the left arm than the right arm, and 20 times more UV on the left side of the face than the right. Actinic keratoses have been reported to occur more frequently on the right side of the body in Australian drivers, where drivers sit on the right side of the car. A left‐sided bias in skin cancer was observed in the U.S.A., where drivers sit on the left side of the car.3 4 5
Sex Differences in the Prognostic Importance of Diabetes in Patients With Ischemic Heart Disease Undergoing Coronary Angiography
Authors: Michelle M. Graham, William A. Ghali, Peter D. Faris, P. Diane Galbraith, Colleen M. Norris, Merril L. Knudtson
Journal: Diabetes Care (2003)

OBJECTIVE—Women with ischemic heart disease have poorer outcomes than men and are suggested to have greater risk associated with diabetes. We evaluated the prognosis associated with diabetes, in analyses stratified by sex, to determine whether similar differences are seen in a large unselected cohort of patients. RESEARCH DESIGN AND METHODS—Using the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH), a clinical data collection and follow-up initiative capturing all patients undergoing cardiac catheterization in Alberta, Canada, the relative significance of diabetes on long-term survival in 13,152 men and 4,249 women was evaluated in patients presenting with or without myocardial infarction and according to first treatment received. RESULTS—The 1-year mortality rates were 4.7% and 6.8% in men and women (P &amp;lt; 0.001), 4.1% and 7.4% in nondiabetic and diabetic men (P &amp;lt; 0.001), and 5.8% and 9.6% in nondiabetic and diabetic women, respectively (P &amp;lt; 0.001). The risk-adjusted Cox proportional hazard ratios associated with diabetes in myocardial infarction were 1.03 in men and 1.20 in women. The diabetes hazard ratios for percutaneous coronary intervention were 1.28 in men and 1.40 in women, 1.23 in men and 1.32 in women for bypass surgery, and 1.26 in men and 1.31 in women for medical therapy (P = NS for all diabetes hazard ratio comparisons between men and women). CONCLUSIONS—Hazard ratios quantifying the adverse prognosis associated with diabetes in patients undergoing angiography are consistently higher among women than men, but the differences across sexes are not statistically significant. These slight sex differences noted in the APPROACH registry are similar to previously reported findings and may be clinically important.
Arthur Thomas Marshall and Mary Louise Marshall (née Neville)
Authors: Tom Marshall
Journal: BMJ (2007)

Educated in Wolverhampton, Arthur Marshall narrowly avoided joining the Kenyan police force by winning the Frank Fletcher scholarship to Birmingham Medical School, worth £100 a year for five years. After completing house jobs he volunteered for the Royal Navy in 1939 and was working in obstetrics in Selly Oak Hospital, Birmingham, when he was called up in 1940. He served on destroyers in Portsmouth and Scapa Flow before …
ONE HUNDRED AND SEVENTEEN CASES OF INFANTILE DIARRHEA TREATED BY INTESTINAL IMPLANTATION OF THE BACILLUS LACTIS BULGARICUS AT THE BABIES' HOSPITAL OF THE CITY OF NEW YORK
Authors: RALPH OAKLEY CLOCK
Journal: JAMA (1913)

who are candidates for the fellowship.Already the founders represent every large city in America; all of the medical universities; all of the general and special surgical societies; all of the important hospitals and clinics, and a large number of independent surgeons throughout the continent.It seems that this movement is of transcendent:importance.If all of the good n'en who an; properly qualified become Fellows of the American College id' Surgeons, and those who morally and educationally are unfit to do surgery aie not accepted, it will be a crystalli- zation of the high ¡deals for which the American Medi- cal Association has always stood.Every man who expects to practice surgery as a spe- cialty should be required to act as chief assistant (o a master surgeon for at least three years, and better five.It will be objected that this is too long, but the goal is not for those who soon weary of study and protracted preparation.Apprenticeship is far more essential in surgery than in any of the arts in which it is universal.A man is obliged to act as apprentice a specified num- ber of years before he is allowed to pilot a lumber scow.Who asks.tosec the pilot's license when a surgeon is needed to pilot the frail bark of life through the treach- erous "wafers that separate the island of 'lime from the mainland of Eternity"?We need a system of requirements and a course of training, and they surely will be realized, that will make of the first youths of our land what their abilities and ambitions entitle them to he, will attract to surgery the very best material and will make of the rank and file Well-equipped and conscientious surgeons.As suggestive the following outline id.' requirements is foi undated:1.A full four-year medical course in a high-grade medical college or university, leading to the degree of M.D., after ade- quate high-schoól and the special one-year premcdical science course in college.It, is especially desirable that, in addition to thorough fundamental and laboratory training in anatomy, physiology, pathology and bacteriology, such schools provide ample, practica] instruction in dispensary and ward classes in medicine, surgery and the specialties, with practical midwifery ami post-mortem work.2. Compulsory hospital internship in a good general hos- pital, with adequate laboratory facilities, for at least one year and if possible two years.
Organic brain syndrome with psychosis as an initial manifestation of systemic lupus erythematosus in an elderly woman.
Authors: M E Mavrikakis, L G Antoniades, J B Germanides, D Sotou, A Rassidakis
Journal: Annals of the Rheumatic Diseases (1992)

This paper describes a rare case of organic brain syndrome with psychosis and clinically transverse myelopathy, as initial manifestations of systemic lupus erythematosus in an elderly woman. The identification and evaluation of antibodies to ribosome P in the serum and cerebrospinal fluid may be of help in such cases for differential diagnosis. The patient was treated successfully with 30 mg prednisone daily.
Digitalis-Induced Bundle-Branch Ventricular Tachycardia Studied by Electrode Catheter Recordings of the Specialized Conducting Tissues of the Dog
Authors: ANTHONY N. DAMATO, SUN H. LAU, GUSTAVUS A. BOBB
Journal: Circulation Research (1971)

Electrode catheter recordings of the bundle of His (H), the right bundle branch (RB) and the left bundle branch (LB) were obtained in 15 dogs without thoracotomy during sinus rhythm and digitalis-induced ventricular tachycardia. During sinus rhythm an H-RB-LB sequence was recorded. This sequence was unchanged during atrial stimulation at rapid rates or during cardiac slowing by vagal stimulation. In 10 of 15 cases of digitalis-induced ventricular tachycardia the LB potential preceded the onset of ventricular depolarization (QRS), and an LB-H-RB sequence was recorded. These findings indicated that during ventricular tachycardia the pacemaker was located in the left bundle branch and the bundle of His was retrogradely depolarized. In 5 of 15 cases of digitalis-induced ventricular tachycardia the H, LB and RB potentials were recorded after the onset of ventricular depolarization. These findings suggested that the pacemaker was located in the Purkinje fibers.
Warfarin for Cancer Prevention
Authors: Christoph C. Zielinski, Michael Hejna
Journal: New England Journal of Medicine (2000)

Recently reported large series have provided clear evidence of an association between idiopathic thromboembolism and the development of cancer. The standardized incidence ratio for all cancers is as high as 6.7 within the first year after a thromboembolic event, and the risk is significantly higher among patients less than 65 years of age than among those who are 65 or older.1 Apart from polycythemia vera, in which thrombosis is a direct complication of hematologic abnormalities, the standardized incidence ratios for cancer after a thromboembolic event are particularly high for cancers of the ovary, pancreas, liver, lung, kidney, brain, and esophagus . . .
Unwanted Pregnancy: Symptom of Depressive Practice
Authors: ALBERT M. BIELE
Journal: American Journal of Psychiatry (1971)

The author studied 40 women who presented themselves for consultation concerning an unwanted pregnancy. He believes these women were victims of long-standing pathological depressive practices, of which exposure to pregnancy was a symptom. By means of a time-restricted, intense, exploratory process in which the women discussed their interpersonal relationships, the patients were able to gain some insight into their depressive practices and to learn how they had been perpetuating them.
p53-Dependent Translational Control of Senescence and Transformation via 4E-BPs
Authors: Emmanuel Petroulakis, Armen Parsyan, Ryan J.O. Dowling, Olivier LeBacquer, Yvan Martineau, Michael Bidinosti, Ola Larsson, Tommy Alain, Liwei Rong, Yaël Mamane, Marilene Paquet, Luc Furic, Ivan Topisirovic, David Shahbazian, Mark Livingstone, Mauro Costa-Mattioli, Jose G. Teodoro, Nahum Sonenberg
Journal: Cancer Cell (2009)
Soluble intercellular adhesion molecule-1 in primary biliary cirrhosis: Relationship with disease stage, immune activity and cholestasis
Authors: Guan A. Lim, Riadh P. Jazrawi, Hafez A. Ahmed, Joanne H. Levy, Massimo Zuin, Andrew C. Douds, J. Douglas, Tim C. Northfield
Journal: Hepatology (1994)

Intercellular adhesion molecule—1, strongly expressed on the interlobular and proliferating bile ducts in primary biliary cirrhosis, is important in the migration and adhesion of inflammatory cells from the circulation to these structures. A soluble form has been found to be elevated in serum in primary biliary cirrhosis. Our aim was to check on the role of soluble intercellular adhesion molecule—1 in primary biliary cirrhosis with particular reference to its specificity by comparison with other disease control groups and to assess its relationship with stage of disease activity, circulating lymphocyte activation and cholestasis. Soluble intercellular adhesion molecule—1 (enzymelinked immunosorbent assay) and liver biochemistry were measured in 41 patients with primary biliary cir rhosis, 9 with primary sclerosing cholangitis, 12 with alcoholic liver disease and 17 healthy controls. In subgroups of patients with primary biliary cirrhosis, lymphocyte activation and hepatic bile acid uptake and excretory rates were determined. Soluble intercellular adhesion molecule—1 was significantly higher in all three disease groups. Levels in primary biliary cirrhosis and primary sclerosing cholangitis were similar and significantly higher than alcoholic liver disease. Soluble intercellular adhesion molecule—1 expression was greater in late primary biliary cirrhosis than early disease and correlated with histological progression. Correlations were also found with alkaline phosphatase, γ–glutamyl transpeptidase and conjugated bilirubin. A trend toward an inverse correlation with hepatic excretory rate was found, but no correlation was detected with circulating lymphocyte interleukin–2 receptor expression. We conclude that serum soluble intercellular adhesion molecule—1 is markedly elevated in immune liver diseases characterized by chronic cholestasis. In primary biliary cirrhosis, it is a marker of stage of disease activity and cholestasis. Measurements of soluble intercellular adhesion molecule—1 may be useful in monitoring disease progression and in assessing the effects of therapy. (Hepatology 1994;20:882-888).