tbuckley/cabot-search huggingface dataset:
Severe hyperparathyroidism associated with prolonged hungry bone syndrome in a renal transplant recipient.
Authors: A M Miles, M S Markell, N Sumrani, J Hong, E A Friedman
Journal: Journal of the American Society of Nephrology (1997)

Although widely believed to resolve within 6 to 12 months of successful renal transplantation, hyperparathyroidism may persist or develop after renal transplantation and eventually require parathyroidectomy. Avid calcium retention by demineralized bones (hungry bone syndrome) is well-recognized after parathyroidectomy and usually resolves after a few weeks. This report documents the case of a renal transplant recipient with persistent hyperparathyroidism who developed a pathological fracture of the pelvis and required parathyroidectomy 1 year after transplant and then manifested severe and prolonged hungry bone syndrome lasting for more than 20 months postoperatively. The clinical features and treatment of hyperparathyroidism in renal transplant recipients are discussed, as are diagnosis, pathogenesis, and management of hungry bone syndrome. Recognition of renal transplant recipients at greater risk for severe hungry bone syndrome should permit earlier and more aggressive management of this sometimes protracted complication of parathyroid surgery.
Safety and patient satisfaction of infliximab administration in an extramural setting supervised by a rheumatology specialist nurse
Authors: Y van Eijk
Journal: Annals of the Rheumatic Diseases (2006)

After introduction of reimbursement of the cost of infliximab for the treatment of patients with active rheumatoid arthritis (RA),1 several hospitals had insufficient capacity at their hospital’s day care centre to administer the drug. Therefore, we explored the possibility of administering infliximab in an extramural setting supervised by a rheumatology specialist nurse (RSN).

A vacant room in a nursing home 5 km from the hospital was prepared as the infusion facility. Two nurses and the nursing home physician were given details of the clinical aspects of RA, with emphasis on treatment with infliximab. The hospital infliximab protocol, including the screening before each infusion, the preparation and administration of infliximab, and the safety procedure, was adapted. A form to guarantee communication between the hospital and the extramural setting was developed. Arrangements with the hospital pharmacy were made to assure punctual delivery of the exact number …
Leukocyte Migration Studies in Gastric Cancer Detection: An Approach Toward Improved Specificity and Sensitivity
Authors: M. Zöller, S. Matzku, U. Schulz
Journal: JNCI Journal of the National Cancer Institute (1977)

Peripheral blood leukocytes from patients with gastric cancer and various other malignant and nonmalignant diseases and peripheral blood leukocytes from apparently healthy volunteers were tested in the leukocyte migration inhibition test with the use of 4-5 different 3 M KCl extracts of gastric cancer tissue. An operational criterion for defining sensitization of patients' leukocytes was developed; i.e., evidence in an individual sample of leukocytes of either decreased or increased migration areas (migration index less than or equal to 0.79 and larger than or equal to 1.20, respectively) with 3 or more antigen extracts. With this as an indicator of sensitization, it was found that 91% of patients with gastric cancer (39/43), comparto 5% (5/94) and 3% (1/32) of patients with nonmalignant, nongastric diseases and normal controls, respectively, were reactive. Patients with various nongastric cancers were sensitized in 36% (49/135) of cases. Gastritis and gastric, as well as duodenal, ulcer did not influence the reactivity of patients' leukocytes, but considerable sensitization was found in patients with atrophic gastritis or intestinalization. When classified in the usual manner, i.e., by considering the reaction with individual tumor extracts, the specificity and the sensitivity of the test was markedly diminished: More false negative determinations were found in the group of gastric cancer patients, and the percentage of false positives in the group of nonmalignant diseases increased. The results gave evidence of tumor-associated antigens in gastric cancer patients, against which the host elicited a cellular immune response. The high incidence of positive reactivity of leukocytes from patients with gastric cancer, together with the considerable cross-reactivity of leukocytes from patients with nongastric cancer, pointed to the expression of antigens with organ-related and widespread specificities.
Strain Differences in the Response of Inbred Syrian Hamsters to Cigarette Smoke Inhalation2
Authors: P. Bernfeld, F. Homburqer, A. B. Russfield
Journal: JNCI Journal of the National Cancer Institute (1974)

Male hamsters, 102 from each of 2 inbred hamster lines, were exposed to cigarette smoke twice a day, 5 days/week for up to 100 weeks, in a modified Walton reverse-smoking machine. Sixty sham-smoked and 60 cage-held controls were used for each strain. Smoke exposure for up to 100 weeks had no effect on mortality in either strain, but reduced body weight. Carboxyhemoglobin levels increased markedly immediately after each smoke exposure but returned to baseline levels in less than 24 hours. Serum triglyceride levels and virus profiles of smoke-exposed animals were unchanged. Chronic smoke exposure increased relative weight of the lungs and heart in both strains, but to different degrees. Over 90% of the smoke-exposed animals of both strains showed hyperplastic or neoplastic changes in the larynx. However, microinvasive cancer was nearly 5 times more frequent in 1 strain than in the other. In the inbred line more susceptible to laryngeal hyperplasia, 2 animals developed nasopharyngeal tumors, one of which was malignant. Smoke exposure induced rare benign squamous papillomas in the air passages of both strains. The strain less susceptible to laryngeal hyperplasia exhibited more pulmonary adenomatosis, but its incidence was not significantly affected by smoke exposure. Clumping of pulmonary macrophages was proof that smoke had reached the lungs; 1 strain was more susceptible to this phenomenon than the other. In neither strain did smoke exposure affect the incidence of tumors arising outside the respiratory tract or the degenerative changes characteristic of aging hamsters.
Professionalism in Psychiatryby GabbardGlen O., M.D., RobertsLaura Weiss, M.D., Crisp-HanHolly, M.D., BallValdesha, M.D., HobdayGabrielle, M.D., and RachalFunmilayo, M.D. Washington, DC, American Psychiatric Publishing, 2012, 218 pp., $60.00 (paper).
Authors: Jerald Kay
Journal: American Journal of Psychiatry (2012)
Differences in the Acute Toxic Effects of Breast Radiotherapy by Fractionation Schedule
Authors: Reshma Jagsi, Kent A. Griffith, Thomas P. Boike, Eleanor Walker, Teamour Nurushev, Inga S. Grills, Jean M. Moran, Mary Feng, James Hayman, Lori J. Pierce
Journal: JAMA Oncology (2015)

Randomized trials have established the long-term safety and efficacy of hypofractionated whole-breast radiotherapy, but little is known about the acute toxic effects experienced by patients treated with hypofractionation as compared with conventional fractionation, particularly in real-world settings and from the patient's own perspective.To evaluate prospectively collected data on acute toxic effects and patient-reported outcomes in a cohort treated with varying radiation fractionation schemes in practices collaborating in the Michigan Radiation Oncology Quality Consortium (MROQC).We compared toxic effects in patients receiving hypofractionation (HF) vs conventional fractionation (CF) during treatment (through 7 days after treatment) and in follow-up (posttreatment days 8-210), after adjustment for sociodemographic, clinical, and treatment characteristics. The MROQC includes academic and community radiation oncology practices across Michigan. All 2604 patients who received adjuvant whole-breast radiotherapy after lumpectomy for unilateral breast cancer at MROQC participating sites from October 2011 through June 2014 were registered; we analyzed 2309 for whom there was a comprehensive physician toxicity evaluation within 1 week of completion of radiotherapy and at least 1 weekly toxicity evaluation during treatment.Hypofractionation vs CF.Physicians reported dermatitis, pain, fatigue, and other common toxic effects associated with breast radiotherapy at baseline, weekly during radiotherapy, and in follow-up. Patients who consented also rated their own experiences, including breast pain, fatigue, and being bothered by symptoms.Of the 2309 evaluable patients, 578 received HF. During treatment, after adjustment for sociodemographic, clinical, and treatment factors, patients receiving CF had significantly higher maximum physician-assessed skin reaction (moist desquamation, 28.5% vs 6.6%, P < .001; grade ≥2 dermatitis, 62.6% vs 27.4%, P < .001), self-reported pain (moderate/severe pain, 41.1% vs 24.2%, P = .003), burning/stinging bother (often/always, 38.7% vs 15.7%, P = .002), hurting bother (33.5% vs 16.0%, P = .001), swelling bother (29.6% vs 15.7%, P = .03), and fatigue (29.7% vs 18.9%, P = .02) but slightly greater absence of skin induration in follow-up (84.5% vs 81.2%, P = .02). No significant differences were observed in any other measured outcomes during follow-up extending through 6 months.Hypofractionation not only improves convenience but also may reduce acute pain, fatigue, and the extent to which patients are bothered by dermatitis in patients with breast cancer undergoing whole-breast radiotherapy.
Doctors' Views on Anxiety Management in General Practice
Authors: H G Deans, P Skinner
Journal: Journal of the Royal Society of Medicine (1992)

Various guidelines have been issued to doctors concerning the treatment of anxiety in primary care and particularly on the use of benzodiazepines. Little has been reported about how this advice has influenced doctors' opinions and practice. This paper describes results of interviews with 15 general practitioners and 15 general practitioner trainees on their management of anxiety problems. Most respondents admitted prescribing benzodiazepines for anxiety but reported doing so only in cases of severe distress and for short periods of time. Trainees appeared more cautious in their use of benzodiazepines than the experienced practitioners. Most doctors agreed that counselling could be as effective as benzodiazepines in treating moderate anxiety but several respondents felt it too demanding of their time. Two-thirds of doctors were in favour of employing counsellors in general practice though many foresaw practical difficulties in doing so. Increased availability of clinical psychology services was the development which most respondents felt would improve their management of anxiety problems in primary care.
YKL-40: Novel marker for pro-inflammatory M1 macrophages
Authors: Lisette Kunz, Emily van 't Wout, Annemarie van Schadewijk, Pieter Hiemstra
Journal: European Respiratory Journal (2011)

Macrophages play a major role in the pathogenesis of COPD and comprise a heterogeneous cell population with pro- (M1) and anti-inflammatory (M2) cells. CD163 has been identified as a M2 marker, however, many M1 markers are not suitable for analysis. Cells positive for YKL-40, a chitinase-like-protein, are elevated in the lungs of smoking than non-smoking COPD patients. Dexamethasone strongly reduces YKL-40 expression in peripheral blood mononuclear cells in vitro , suggesting that inhaled steroids in COPD may decrease YKL-40 expression. We evaluated YKL-40 expression in cultured M1 and M2, and the effect of dexamethasone on its expression.

Monocytes were cultured in vitro for 7 days with GM-CSF or M-CSF (for M1 and M2, resp.) and stimulated for 24h with LPS, TNFα, oncostatin M or IL-6. Dexamethasone was added in various concentrations. IL-12 and IL-10 ELISA were used to check differentiation into M1 and M2, resp. YKL-40 ELISA was performed on supernatants; quantitative PCR (qPCR) was used to analyze YKL-40 mRNA. Differences between conditions were calculated with Wilcoxon signed rank tests.

M1 cells secreted more YKL-40 than M2, independent of stimulation (261ng/ml vs 65ng/ml, p=0.03). Compared to medium, LPS, TNFα, oncostatin M or IL-6 stimulation did not affect YKL-40 release in M1 and M2 (p>0.05). qPCR confirmed these results. Dexamethasone dose-dependently and strongly inhibited YKL-40 in both M1 and M2 (p<0.05).

In conclusion, M1 have a higher expression of YKL-40 than M2, which is unchanged by pro-inflammatory stimuli. In addition, YKL-40 release is strongly inhibited by dexamethasone in both M1 and M2. These results indicate that YKL-40 expression can be used as a marker for M1 macrophages in vitro , and possibly in vivo .
Abstract 12099: Activated Notch1 Interacting With LKB1 Reduces Myocardial Ischemic Injury via Modulating AMPK Signaling Pathway
Authors: Hui Yang, Wanqing Sun, Yina Ma, Xingchi Chen, George Techiryan, Ji Li
Journal: Circulation (2014)

Introduction: The activation of the intrinsic AMP-activated protein kinase (AMPK) pathway plays an important role in the myocardial response to ischemia, pressure overload, and heart failure. The Notch1 signaling in the adult myocardium is activated transiently in response to myocardial injury, and it has implicated that Notch1 signaling may contribute to cardiac repair. However, the role of Notch1 signaling in myocardial infarction remain uncertain. Hypothesis: The cardioprotective AMPK signaling pathway could mediate the beneficial effects of Notch1 signaling cascade during myocardial infarction. Methods: C57BL/6J male mouse hearts were subjected in vivo to left anterior descending coronary artery ligation for 5 min, 20 min, 24 hr, 1 week and 2 weeks. Mice were treated with dibenzazepine (DBZ), a new Notch γ-secretase inhibitor (5 μmol/kg/day, i.p.) and the vehicle groups were treated with saline. Ischemic heart tissues were harvested for protein, mRNA expression and histologic analysis. Results: The Notch1 signaling was significantly activated during myocardial ischemia in vivo (p&lt;0.05 vs. sham group). Interestingly, in the ex vivo heart perfusion system, systemic administration of DBZ to hearts led to significantly increase of myocardial infarct size and apoptosis caused by myocardial ischemia (p&lt;0.05 vs. vehicle group). The immunoblotting results demonstrated that DBZ treatment significantly inhibited the AMPK activation by myocardial ischemia (p&lt;0.05 vs. ischemia alone). Further immunoprecipitation experimental data showed that activated Notch1 strongly interacts with one AMPK upstream kinase, LKB1, to form a complex that modulates cardiac AMPK activation during myocardial ischemia. Moreover, the inhibition of Notch1 by DBZ impaired AMPK activation that significantly increased inflammation response such as activation of c-Jun N-terminal protein kinase (JNK) and NF-κB signaling during myocardial ischemia. Conclusions: The activated Notch1 signaling interacts with LKB1 to trigger the activation of cardioprotective AMPK signaling during myocardial ischemia. The Notch1-LKB1-AMPK signaling cascade could be a potential pharmacologic mimic for cardioprotection of ischemic heart disease.
Few trials of laparoscopic cholecystectomy have been randomised
Authors: F. P Mcginn, C Terzi
Journal: BMJ (1996)

and two related to relief.Firstly, good information should be given to parents, schools, and children and should include the dangers of cannabis (memory impairment, the fact that it contains more carcinogens than tobacco, etc).Secondly, drugs should be eliminated.The police are on the right track in the way that they tackle big dealers, but they should be allowed to tackle street dealing as well, because it is difficult to find drugs when petty sales are reduced.'Thirdly, users should be able to gain admission to drug free institutions where they are treated with respect and encouragement so that they can regain their self respect.
Effects of recombinant human erythropoietin on porphyrin metabolism in uremic patients on hemodialysis.
Authors: A Fontanellas, J A Herrero, F Coronel, J L Santos, M J Morán, A Barrientos, R Enríquez de Salamanca
Journal: Journal of the American Society of Nephrology (1996)

Recombinant human erythropoietin (r-HuEPO) is being successfully used for the treatment of uremic anemia. Several abnormalities of heme biosynthetic pathway have been described in patients with end-stage renal failure. In this condition, the activity of erythrocyte porphobilinogen deaminase has been found to be slightly increased. If this enzyme were to be the key enzyme in erythroid heme regulation, its activity would be increased to an even greater degree during the correction of uremic anemia. To assess this hypothesis, this study followed the variations of this and other parameters of porphyrin metabolism over 12 months of erythropoietin therapy in eight patients with nephrogenic anemia who underwent hemodialysis. By the first month of therapy, an increase of the previously depressed erythrocyte activity of aminolevulinate dehydratase was already evident, in coincidence with a nonsignificant increase of the reticulocyte count. The activity of this enzyme reached its maximal level by Month 3, and did not change up to Month 10. The porphobilinogen deaminase hyperactivity normalized at Month 4. By Month 12, in coincidence with the reduction of erythropoietin doses, the maximal levels of erythrocyte protoporphyrin, and the decrease in aminolevulinate dehydratase activity, the porphobilinogen deaminase values started to increase once again. In conclusion, the administration of r-HuEPO to hemodialyzed patients induced transient normalization of the previously observed porphyrin metabolism abnormalities. However, erythrocyte porphobilinogen deaminase activity did not rise concomitantly with the increase in hematocrit or hemoglobin values, but it did diminish during treatment. Therefore, porphobilinogen deaminase did not behave as a controlling enzyme in heme synthesis during the r-HuEPO-induced correction of uremic anemia.
The Dual Origin of Noninfective Rous Sarcomas&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;&lt;xref ref-type="fn" rid="FN3"&gt;3&lt;/xref&gt;
Authors: T Shimizu, H Rubin
Journal: JNCI Journal of the National Cancer Institute (1964)

Tumors were induced in chickens with either high or low doses of Bryan's high-titer strain of Rous sarcoma virus (RSV). The RSV stock contained Rous-associated virus (RAV) required for maturation of this strain of RSV. The ability of the tumor cells to produce RSV in vivo and in vitro was tested at various times after infection to determine the conditions favoring the production of noninfective tumors. All tumors induced with high doses of RSV yielded high concentrations of RSV during the first few days after appearance of the tumors. Subsequently, however, the virus yield per gram of tumor sharply decreased and reached zero about 3 weeks after infection. The decrease in virus yield was accompanied first by diminished growth and then regression of the tumors. The results indicated that the disappearance of RSV from tumors previously containing high concentrations of the virus and the regression of these tumors were due to an immunological reaction by the host. Tumors induced with low doses of RSV contained little or no RSV during the first few days after appearance of the tumors. Subsequently, the virus yield from most low-dose tumors increased, reached a maximum about 1 month after infection, and then declined. Early, low-dose tumor cells, which failed to produce RSV when grown in tissue culture, produced large amounts of RSV when RAV was added to the cultures. If an excess of RAV were inoculated into chickens along with a low dose of RSV, a much higher proportion of cells from the resulting tumors produced virus in tissue culture than if no excess of RAV had been added. It is concluded that many tumors induced with low doses of RSV contain no infectious RSV because of the limited opportunity for coinfection or superinfection of the tumor cells with the helper virus RAV.
Bricanyl Turbuhaler in the treatment of asthma: a six week multi-centre study carried out in Sweden, the United Kingdom, Denmark, Norway and Finland
Authors: K Osterman, E Stahl, A Kallen
Journal: European Respiratory Journal (1991)

Two hundred and fifty eight adult patients with bronchial asthma participated in an open, parallel group study of 8 wks duration. During a 2 wk run-in period the beta 2-agonist terbutaline (0.5 mg q.i.d) was delivered via a pressurized freon aerosol, Bricanyl metered dose inhaler (MDI). During the following 6 wks, one third of the patients continued with MDI and two thirds with the same dose of terbutaline in the form of dry powder, Bricanyl Turbuhaler. There were no statistically significant differences in the increases in peak expiratory flow rate (PEFR) after inhalation between the two treatment groups. The asthma symptom scores decreased in the Turbuhaler group during the study but remained the same in the MDI group. No difference in use of extra trial medication during the day was found. During the night, the difference was statistically significant in favour of Turbuhaler (p less than 0.05). Turbuhaler was well accepted and easy to use. As compared with the MDI used during run-in, 50% of the patients in the Turbuhaler group preferred to use Turbuhaler and 26% MDI, whilst 24% had no preference. In conclusion, Turbuhaler was at least as effective as MDI during the whole Turbuhaler life-span (6 wks).
Are we giving patients enough information on how to use topical treatments? Analysis of 767 prescriptions in psoriasis
Authors: C. Pouplard, P.-A. Gourraud, N. Meyer, C.B. Livideanu, M. Lahfa, J. Mazereeuw-Hautier, P. Le Jeunne, A.-L. Sabatini, C. Paul
Journal: British Journal of Dermatology (2011)

Unclear instructions probably contribute to the suboptimal efficacy and adherence to topical agents in psoriasis.To analyse the quality of prescriptions for topical therapy in psoriasis and to determine factors associated with high-quality prescription writing.We made a systematic analysis of 767 topical prescriptions written by dermatologists and general practitioners (GPs). The following parameters were recorded: writing mode (electronic vs. hand written), indication of formulation, frequency of administration, duration of treatment, indication of areas to be treated, and indication of amount of product to be used. We considered prescriptions of high quality to be those including at least four of the five prospectively defined quality parameters.Only 35·7% of prescriptions fulfilled the definition of a high-quality prescription. Quality of prescription writing was significantly influenced by two factors: electronic writing [odds ratio (OR) 3·04, 95% confidence interval (CI) 2·2-4·21; P < 10(-4) ] and specialty of the prescriber, dermatologists writing higher quality prescriptions compared with GPs (OR 1·61, 95% CI 1·54-2·14; P < 10(-4) ).Almost two-thirds of topical prescriptions are not adequately written and do not include the required information to help patients manage their topical treatment in psoriasis correctly. The quality of topical prescriptions could be improved by making the use of electronic prescriptions widespread and by the development of aids for easy evaluation of the right amount of topical treatment to be applied according to body surface area involved.