tbuckley/cabot-search huggingface dataset:
Short treatment to patients with genotype 2 or 3
Authors: Olav Dalgard, Alessandra Mangia
Journal: Hepatology (2008)

It was with great interest that we read the article by Lagging and collaborators exploring in a randomized controlled trial (RCT) the possibility of shortening the duration of hepatitis C virus (HCV) treatment from 24 to 12 weeks for patients with genotype 2 or 3 HCV (NORDynamIC trial).1 Unfortunately, in a significant number of patients 12 weeks of treatment was insufficient; this held true even for those with undetectable HCV RNA at week 4 (rapid virological response [RVR]). In contrast, in a pilot trial and two separate RCTs we found that patients with genotype 2 or 3 and RVR are suitable for short treatment (12-14 weeks treatment).2-4 The discrepant finding relates to the much higher relapse rate observed in the NORDynamIC trial compared to what we observed. In fact, in the latter, 26% of patients with RVR relapsed after 12 weeks treatment compared to 10%, 10%, and 14%, respectively, in the short treatment groups in our three trials.2-4 In the NORDynamIC trial, 4% of patients with RVR relapsed after 24 weeks treatment; thus, the difference in relapse rate between the 12-week and 24-week treatment arm was 22% as compared to 6% and 5% difference between the short and long treatment arms in our two RCTs (Table 1). How can this striking difference be explained? It is noteworthy that both the NORDynamIC trial and one of our RCTs were conducted in Scandinavia during the same period. The mean age, genotype distribution, and viral loads were similar in the two trials, and an explanation for the different results obtained must probably be sought in a difference in the treatment administered. In the NORDynamIC trial, peginterferon-alfa 2a was used while peginterferon-alfa 2b was used in our trials. There is, however, little evidence to support the notion that one peginterferon is more effective than the other. Thus, the difference in relapse rate is more likely explained by difference in ribavirin dosing. In the NORDynamIC trial, 800 mg of ribavirin was given to all, while in our trials weight-based ribavirin doses (800-1400 mg) were given. It has previously been shown that the main benefit of ribavirin is obtained through reduction of relapse rate. We therefore believe that 12-14 weeks of treatment is a rational choice for all patients with genotype 2 or 3 and RVR, provided that ribavirin is dosed high and according to weight. Olav Dalgard*, Alessandra Mangia , * Rikshospitalet, Medical Department, Oslo, Norway, Division of Gastroenterology, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
QT Interval and QT Dispersion in Eating Disorders
Authors: Yoshiyuki Takimoto, Kazuhiro Yoshiuchi, Hiroaki Kumano, Gaku Yamanaka, Tadashi Sasaki, Hiroyuki Suematsu, Yuzo Nagakawa, Tomifusa Kuboki
Journal: Psychotherapy and Psychosomatics (2004)

&lt;i&gt;Background:&lt;/i&gt; Eating disorders are thought to be risk factors for cardiac sudden death secondary to arrhythmia. Results in previous studies on QT interval and QT dispersion, markers of fatal arrhythmia, have been inconsistent. &lt;i&gt;Methods:&lt;/i&gt; We prospectively examined 179 female eating disorder patients, being over 18 years old and diagnosed according to the DSM-IV criteria between January 1995 and December 2002, and 52 healthy women. Patients with abnormal plasma electrolytes or taking medications that might influence the electrocardiogram (ECG) were excluded from the study. QT intervals were corrected for heart rate using Bazett’s formula and the nomogram method, which is more reliable at extremely low heart rates than Bazett’s formula. QT dispersion was measured as the difference between the longest and shortest QT intervals. QT intervals and QT dispersion in each patient group were compared with those in the control group. &lt;i&gt;Results:&lt;/i&gt; The 164 eligible patients consisted of 43 patients with anorexia nervosa restricting type, 35 with anorexia nervosa binge eating/purging type, 63 with bulimia nervosa purging type, and 23 with bulimia nervosa nonpurging type. There was no significant difference in age between eating disorder patients and controls. QT interval and QT dispersion were significantly longer in all eating disorder subtypes than in the control group. QT interval and QT dispersion were significantly correlated with the rate of body weight loss in bulimia nervosa. &lt;i&gt;Conclusions:&lt;/i&gt; QT interval and QT dispersion were prolonged in both anorexia nervosa and bulimia nervosa. Examination of ECG in eating disorder patients without extremely low body weight also appears to be clinically important.
Effect of liver transplantation on inflammatory bowel disease in patients with primary sclerosing cholangitis
Authors: Igor Dvorchik, Michael Subotin, Jake A. Demetris, John J. Fung, Thomas E. Starzl, Samuel Wieand, Kareem M. Abu-Elmagd
Journal: Hepatology (2002)

This report investigates the influence of liver transplantation and concomitant immunosuppression on the course of progression of inflammatory bowel disease (IBD) and discusses statistical methodology appropriate for such settings. The data on 303 patients who underwent liver transplantation for primary sclerosing cholangitis (PSC) were analyzed using person-time analysis and Cox regression, with the duration of IBD as the time variable and transplantation as a segmented time-dependent covariate, to take into account both posttransplant and pretransplant history of IBD. The need for colectomy and appearance of colorectal cancer were taken as outcome measures. The only significant risk factor in the multivariate model for colectomy was transplantation itself, which increased the risk of colectomy due to intractable disease (Wald statistic; P =.001). None of the variables available for analysis were found to influence the risk of colon cancer significantly. Graphs showing the dependence of the instantaneous risk of cancer on the time from onset of IBD and its independence from the latter in the case of colectomy are presented. The use of a unique statistical methodology described for the first time in this setting led us to the somewhat surprising conclusion that transplantation and concomitant use of immunosuppression accelerate the progression of IBD. At the same time, transplantation does not affect the incidence of colorectal cancer. These results confirm the findings of some recent studies and can potentially shed new light on the disease pathogenesis.
FROZEN TOXIN-ANTITOXIN REACTIONS
Authors: M. J. Rosenau
Journal: JAMA (1924)

<h3>To the Editor:</h3> —At your request, we make the following statement concerning the effort of freezing on the toxin-antitoxin mixtures in the towns of Concord and Bridgewater, Mass.: A preparation of toxin-antitoxin was used in some forty children in January; the reactions were slight and such as were to be expected. During an intense cold spell, a number of vials of the same preparation were solidly frozen. When this toxin-antitoxin was melted and used for further injections, severe local reactions and constitutional disturbance followed. This preparation, when tested in the antitoxin laboratory in Boston and in the Hygienic Laboratory in Washington, was found to produce in animals the normal reactions, but, after freezing, became toxic. Other preparations tested in Boston, New York and Washington failed to show any increase in toxicity after thorough freezing. Since this occurrence, investigation has shown that several hundreds of children have been treated with other
Abstract P5-13-12: Risk of hepatitis B virus (HBV) reactivation in hepatitis B surface antigen negative/ hepatitis B core antibody positive and/or hepatitis B surface antibody positive breast cancer patients who receive chemotherapy
Authors: M Hattori, Y Ito, S Takahashi, I Fukada, T Iwase, H Iwata, K Hatake
Journal: Cancer Research (2013)

Abstract Background: Recently, chemotherapy-induced reactivation of hepatitis B virus (HBV) has been reported not only in patients positive for hepatitis B surface antigen (HBsAg), but also in patients negative for it. Although HBV reactivation is associated with substantial morbidity and mortality in patients undergoing cancer chemotherapy, the exact frequency and risk for HBV reactivation in HBsAg-negative breast cancer patients who receive chemotherapy remains unclear. In this study, we examined the frequency and risk for HBV reactivation in Japanese breast cancer patients who have received chemotherapy. Methods: A total of 562 HBsAg-negative breast cancer patients received chemotherapy from June 2008 to May 2009 at the Cancer Institute Hospital of JFCR in Japan. Antibody to hepatitis B core antigen (anti-HBc) and antibody to hepatitis B surface antigen (anti-HBs) were screened for before chemotherapy in all patients. In patients who were positive for anti-HBc and/or anti-HBs, serum HBV-DNA levels were measured and monitored during and after chemotherapy. Results: 93 (17.4%) HBsAg-negative breast cancer patients were found to have resolved hepatitis B (HBsAg-negative, anti-HBc-positive and/or anti-HBs-positive). One patient was found to be positive for HBV DNA before the initiation of chemotherapy and received adjuvant chemotherapy with Entecavir prophylaxis. 65 patients received chemotherapy in adjuvant or neoadjuvant setting, 28 patients received it for metastatic disease. In our monitoring period (median 15.3 months), no HBsAg-negative/ anti-HBc-positive and/or anti-HBs-positive breast cancer patients developed HBV reactivation during and after their chemotherapy. Conclusions: A number of HBsAg-negative breast cancer patients have received chemotherapy with a risk for HBV reactivation; however, it has been determined that conventional chemotherapy regimens for breast cancer are unlikely to increase the risk of developing HBV reactivation in these patients. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P5-13-12.
Promoting a Culture of Safety as a Patient Safety Strategy
Authors: Sallie J. Weaver, Lisa H. Lubomksi, Renee F. Wilson, Elizabeth R. Pfoh, Kathryn A. Martinez, Sydney M. Dy
Journal: Annals of Internal Medicine (2013)

Developing a culture of safety is a core element of many efforts to improve patient safety and care quality. This systematic review identifies and assesses interventions used to promote safety culture or climate in acute care settings. The authors searched MEDLINE, CINAHL, PsycINFO, Cochrane, and EMBASE to identify relevant English-language studies published from January 2000 to October 2012. They selected studies that targeted health care workers practicing in inpatient settings and included data about change in patient safety culture or climate after a targeted intervention. Two raters independently screened 3679 abstracts (which yielded 33 eligible studies in 35 articles), extracted study data, and rated study quality and strength of evidence. Eight studies included executive walk rounds or interdisciplinary rounds; 8 evaluated multicomponent, unit-based interventions; and 20 included team training or communication initiatives. Twenty-nine studies reported some improvement in safety culture or patient outcomes, but measured outcomes were highly heterogeneous. Strength of evidence was low, and most studies were pre–post evaluations of low to moderate quality. Within these limits, evidence suggests that interventions can improve perceptions of safety culture and potentially reduce patient harm.
Consultant paediatric clinics in group practice.
Authors: A R Cain, J S Clark, M R Hally, J M Langham-Hobart, T C Noble, J H Walker
Journal: BMJ (1976)

Unpublished data from the Hospital In-patient Enquiry in England, Wales, and Scotland between 1958 and 1972 show that the frequency of admissions to hospital for peptic ulcer, particularly gastric ulcer, has fallen.This seems more likely to have been due to a true fall in the incidence of ulcer than to changes in treatment.Some three times as many people are admitted to hospital with duodenal ulcer in the north as in the south, but the frequency of admissions for gastric ulcer seems to vary little.The reasons for these differences are not under- stood.
In vitro and in vivo haemolysis and potassium measurement
Authors: Abbas Ismail, Wendy Shingler, Jeff Seneviratne, Gillian Burrows
Journal: BMJ (2005)

Serum or plasma potassium concentration is one of the most commonly requested biochemical tests.Haemolysis is common, occurring in vitro in most cases-that is, during or after taking the sample.In such cases, reported potassium concentrations are clinically inaccurate, greater roughly in proportion to the degree of haemolysis. 1-3The World Health Organization recommends that laboratories do not report potassium concentrations for haemolysed samples because of this. 4 By not reporting a result, laboratories may imply to the clinical team that potassium concentration cannot be measured analytically.But in cases of in vivo haemolysis, a result may be of clinical use.We report a case of a patient with renal failure and in vivo haemolysis who subsequently died, which highlights the problems of not reporting potassium concentrations for haemolysed samples.
Incessant ventricular tachycardia in infants: Myocardial hamartomas and surgical cure
Authors: Arthur Garson, Richard T. Smith, Jeffrey P. Moak, Debra L. Kearney, Edith P. Hawkins, Jack L. Titus, Denton A. Cooley, David A. Ott
Journal: Journal of the American College of Cardiology (1987)
Cardiac Arrhythmias: Diagnosis and Treatment
Authors: David H. Spodick
Journal: JAMA (1977)

A frequent participant in undergraduate and postgraduate courses in electrocardiography, I am often asked to recommend a book that is not as spartan as introductory cookbookstyle texts, but not as stratospheric as the advanced, electrophysiologically oriented texts and symposia. This book fills the bill. Assisted by 11 outstanding colleagues, its distinguished editor has aimed at instructing physicians specializing in internal medicine or family practice, nurse specialists, medical students, and house officers. Many texts proclaim a comparably broad goal. This one has the necessary clarity of outline and presentation to achieve it. All the common arrhythmias and some less common but lethal conditions are illustrated and analyzed with appropriate discussions of etiology, pathogenesis, and treatment. The settings in which these rhythm disturbances occur are also described, enhancing the "real-world" flavor of this authoritative book. The hand of the editor is apparent not only in the five chapters by him, but also
English judge rules that smokers' claims are "too late"
Authors: C. Dyer
Journal: BMJ (1999)

The litigation by a group of people with lung cancer against two British tobacco companies was dealt a severe blow in the High Court last week.

The High Court ruling in nine “lead” cases probably means that 36 of the 52 plaintiffs are barred from suing Imperial Tobacco and Gallaher because they launched their claims too late,and the small numbers remaining will make it uneconomic to continue. Ironically, the ruling came only days before a smoker in California was awarded $50m (£31.25m) in punitive damages …
POISONING BY MEGALOPYGE OPERCULARIS ("PUSS CATERPILLAR")
Authors: THOMAS L. LUCAS
Journal: JAMA (1942)

A recent experience of being called to the bedside of a patient suffering from severe local and generalized symptoms after contact with a caterpillar larva has led to a search of the literature for reports on similar cases. This caterpillar larva was identified as Megalopyge opercularis, or "puss caterpillar." Only 2 cases of symptoms due to Megalopyge opercularis<sup>1</sup>were found in the literature. These 2 cases and one of symptoms due to Lagoa crispata,<sup>2</sup>a member of the same family, are reviewed in this paper, with the case which I observed. It is believed that such cases occur much more frequently than the literature indicates. The scarcity of case reports may be due to many persons not reporting to a physician for treatment, or it may be due to the etiologic factor going unrecognized. Goodwin, Krafka and Mulherin reported 2 cases in Augusta, Ga., in 1937 and mentioned
Abstract B25: The Effects of PI3K/Akt/mTOR Pathway Inhibitors on a Panel of Non Small Cell Lung Cancer (NSCLC) Cell Lines
Authors: Susan Heavey, Martin Barr, Anthony Davies, Ken O'Byrne, Kathy Gately
Journal: Clinical Cancer Research (2012)

Abstract Introduction: The purpose of this study is to investigate the effects of two PI3K pathway inhibitors on a panel of NSCLC cell lines, with a view to developing resistant cell line models, through exposure to the inhibitors over an extended period of time. The PI3K/Akt/ mTOR pathway regulates cell growth and proliferation and is often dysregulated in cancer due to mutation, amplification, deletion, methylation and posttranslational modifications. Multiple novel agents, targeting different regulators within the pathway are currently under development. GDC-0941 is a PI3K targeted inhibitor which is currently in phase Ib trials for combination treatment with bevacizumab, trastuzumab and erlotinib in metastatic NSCLC. GDC-0980 is a selective dual inhibitor of PI3K and mTOR, which is currently in phase I trials for combination treatment with bevacizumab, trastuzumab, and capecitabine in solid tumors. Methods: The effects of GDC-0941 and GDC-0980 were assessed in a panel of lung cancer cells, including normal human bronchial epithelial cells (HBECs), H460 cells (PI3KCA &amp; KRAS mutant), A549 cells (wild-type PI3KCA &amp; KRAS mutated), cisplatin resistant H460 and A549 cells and H1975 cells (PI3KCA mutant /T790M mutant EGFR TKI resistant). The effect of each inhibitor on pAkt levels was examined by Western blot. Effects of the inhibitors on apoptosis and proliferation were analyzed by high content analysis and BrdU assays respectively. IC25 values obtained from these experiments were then used to begin treating cells over an extended period of time, in order to develop a cell line model of resistance. Results: Treatment of the panel of cell lines with either GDC-0941 or GDC-0980 resulted in reduced pAkt levels as observed by Western blot, as well as dose-dependent increased apoptosis and decreased proliferation of cell lines. IC25 values are currently being used to treat cell lines over an extended period of time in order to develop models of resistance to the two inhibitors. Discussion: Both GDC-0941 and GDC-0980 were shown to inhibit the PI3K pathway, as observed by the reduced levels of pAkt present after treatment with the inhibitors. Both inhibitors increase apoptosis and decrease proliferation in a dose-dependent manner, with GDC-0980 (dual PI3K/mTOR inhibitor) showing more significantly increased apoptosis and decreased proliferation than GDC-0941 (PI3K inhibitor). Resistant cell line models are currently being developed as a result of this research which will allow biomarkers of response/resistance to the drugs to be identified in the future.
Managing Antibiotic Resistance
Authors: Richard P. Wenzel, Michael B. Edmond
Journal: New England Journal of Medicine (2000)

One hundred years ago, the three major causes of death in the United States were tuberculosis, pneumonia, and gastrointestinal infections. Subsequently, the advent of antibiotics resulted in a major decline in the incidence of life-threatening infections in the developed world. By the end of the 20th century, only lower respiratory tract infections still ranked among the top 10 causes of death. As we approach January 2001, however, the unforgiving rise in the frequency of multidrug resistance among leading pathogens should cause great concern and incite a commitment to act responsibly.The pneumococcus is arguably the most important cause of community-acquired . . .
No physical signs
Authors: T. Greenhalgh
Journal: BMJ (1996)

When I was a student, a good outpatient clinic was one in which we heard a systolic murmur and were bought a bun by the consultant. A brilliant clinic was one in which we heard a diastolic murmur, saw retinal haemorrhages, and felt a spleen. Three of my postgraduate qualifications were won largely on the basis of my ability at the time to elicit and interpret physical signs such as these.

There is a patient on my list who thinks I am the best doctor in the world. This is despite the fact that, try as I might, I have never heard …
Mediators of vasopressin induced natriuresis in cirrhosis--possible role of atrial natriuretic factor.
Authors: A L Gerbes
Journal: Gut (1989)

reasons which the authors state.I do hope that their results will not reverse this trend.It has been suggested that perhaps patients in the younger age group do not respond so well to this type of manage- ment but this has not been our experience or those of others using the same type of dilator.' Csendes and colleagues state that the procedure is painful but this is not something our patients have complained of when the procedure is carried out under diazepam sedation which they do not use.The main danger of pneumatic dilatation, which the authors rightly emphasise, is perforation of the oesophagus.This complication can nearly always be managed conservatively but it must be emphasised that in this gastrointestinal procedure as in many others medicosurgical collaboration is important.Lastly, the authors emphasise the problem of individuality of the different dilatation methods and the consequent difficulty of comparing these.This observation may be correct but I do not think it should be considered an impossible task.There are enough Units carrying out the procedure for such a project to at least be considered.
1108. Ad5 Penton Base Recombinant Protein: Intracellular Trafficking &amp; Implications for Gene Delivery
Authors: Altan Rentsendorj, Jiansong Xie, Michelle MacVeigh, Hasmik Agadjanian, Sarah F. Hamm-Alvarez, Lali K. Medina-Kauwe
Journal: Molecular Therapy (2005)

A growing interest in utilizing viral capsid proteins for non-viral delivery has led us to investigate how these proteins contribute to viral trafficking. For example, we and others have developed recombinant adenovirus (Ad) capsid proteins, such as the penton base, into non-viral vectors. The penton base facilitates viral infection by binding cell surface integrins and triggering receptor-mediated endocytosis. Previous studies have shown that Ad serotype 5 (Ad5) escapes the endosome at an early stage of cell entry, and hijacks dynein motors to translocate along intact microtubules for trans-cytoplasmic migration toward the nuclear periphery. Those findings suggest that one or all of the three major Ad5 capsid proteins (penton base, fiber, and/or hexon) interact with the cytoskeletal machinery to mediate intracellular trafficking of the virus during the early stages of infection.
Patient and Hospital Characteristics Associated With Inappropriate Percutaneous Coronary Interventions
Authors: Paul S. Chan, Sunil V. Rao, Deepak L. Bhatt, John S. Rumsfeld, Hitinder S. Gurm, Brahmajee K. Nallamothu, Matthew A. Cavender, Kevin F. Kennedy, John A. Spertus
Journal: Journal of the American College of Cardiology (2013)