tbuckley/cabot-search huggingface dataset:
Management of Stable Chronic Obstructive Pulmonary Disease: A Systematic Review for a Clinical Practice Guideline
Authors: Timothy J. Wilt, Dennis Niewoehner, Roderick MacDonald, Robert L. Kane
Journal: Annals of Internal Medicine (2007)

Background: Chronic obstructive pulmonary disease (COPD) is a common and disabling condition in adults. Information about therapeutic effectiveness and adverse effects of common treatment options and how clinical and spirometric characteristics affect outcomes is not well known but is important for clinicians caring for patients with stable COPD. Purpose: To evaluate the effectiveness of COPD management strategies. Data Sources: English-language publications in MEDLINE and the Cochrane Library through March 2007. Study Selection: Randomized, controlled trials (RCTs) and previous systematic reviews of inhaled therapies, pulmonary rehabilitation, disease management, and supplemental oxygen in adults with COPD. Data Extraction: Participant, study, and intervention characteristics; exacerbations; deaths; respiratory health status; exercise capacity; hospitalizations; and adverse effects. Data Synthesis: Eight meta-analyses and 42 RCTs examined inhaled therapies: short-acting anticholinergics (n = 7), long-acting anticholinergics (n = 10), long-acting β2-agonists (n = 22), corticosteroids (n = 14), dual D2 dopamine receptor–β2-agonist (n = 3), or short-acting β2-agonist plus ipratropium (n = 3). Evidence for nonpharmacologic therapies included 3 reviews of 39 RCTs plus 6 additional RCTs of pulmonary rehabilitation, 2 reviews of 13 RCTs plus 2 additional RCTs of disease management, and 8 RCTs of oxygen. Overall, long-acting inhaled therapies, used alone or in combination, reduced exacerbations more than placebo by 13% to 25% and had similar effectiveness to each other. Average improvements in health status scores were less than what is considered to be clinically noticeable. Inhaled monotherapy did not reduce mortality rates. Inhaled corticosteroids plus long-acting β2-agonists reduced deaths in relative terms compared with placebo (relative risk, 0.82 [95% CI, 0.69 to 0.98]) and inhaled corticosteroids alone (relative risk, 0.79 [CI, 0.67 to 0.94]) but not compared with long-acting β2-agonists alone (relative risk, 0.82 [CI, 0.52 to 1.28]). Absolute reductions were 1% or less and were not statistically significant. Pulmonary rehabilitation improved health status and dyspnea but not walking distance. Neither disease management nor ambulatory oxygen improved measured outcomes. Supplemental oxygen reduced mortality rates among symptomatic patients with resting hypoxia (relative risk, 0.61 [CI, 0.46 to 0.82]). Insufficient evidence supports using spirometry to guide therapy. Limitations: Articles were limited to those in the English language. Treatment adherence, adverse effects, and effectiveness may differ among clinical settings. Short-acting inhalers for "rescue therapy" were not evaluated. Conclusion: Long-acting inhaled therapies, supplemental oxygen, and pulmonary rehabilitation are beneficial in adults who have bothersome respiratory symptoms, especially dyspnea, and FEV1 less than 60% predicted.
Probing the size limit for nanomedicine penetration into Burkholderia multivorans and Pseudomonas aeruginosa biofilms
Authors: Katrien Forier, Anne-Sophie Messiaen, Koen Raemdonck, Hans Nelis, Stefaan De Smedt, Jo Demeester, Tom Coenye, Kevin Braeckmans
Journal: Journal of Controlled Release (2014)
UVB therapy decreases the adhesive interaction between peripheral blood mononuclear cells and dermal microvascular endothelium, and regulates the differential expression of CD54, VCAM-1, and E-selectin in psoriatic plaques
Authors: J-P. CAI, K. Harris, V. Falanga, J. R. Taylor, Y. H. Chin
Journal: British Journal of Dermatology (1996)

A dermal lymphocytic infiltrate is a characteristic feature of psoriasis, and may be involved in the pathogenesis of the disease. We have previously shown that specialized dermal microvascular endothelial cells (DMEC) in psoriatic lesions promote the selective adherence of the CD4 CD45Ro helper T-cell subset. In this study, we examined the adhesive interaction between peripheral blood mononuclear cells and psoriatic DMEC in patients treated with ultraviolet B light (UVB), and correlated the results with the expression and function of endothelial adhesion molecules on DMEC. Seven psoriatic patients were exposed to one MED of UVB daily for 14 days, and the binding properties of their peripheral blood mononuclear cells (PBMC), and tissue specimens taken from their lesions on days 0, 2, 3, 6, 8, 11 and 14 of UVB treatment, were studied. The ability of psoriatic PBMC to adhere to non-irradiated control or UVB-treated psoriatic plaques was reduced by 70% after treatment with 2-3 MED, and complete inhibition was obtained after 8-11 MED. In contrast, exposure of psoriatic plaques to 2-3 MED had no effect on the capacity of DMEC to support normal PBMC binding, which was only reduced after 8-11 MED. In addition, psoriatic plaques which were shielded from direct UVB exposure also showed decreased PBMC binding, suggesting a systemic effect of UVB treatment. Immunoperoxidase staining revealed that CD54 (ICAM-1) and E-selectin were strongly expressed on dermal vessels in untreated psoriatic plaques. Treatment of patients with 6-8 MED significantly decreased CD54 and E-selectin expression. In contrast, VCAM-1 expression on untreated plaques was weaker than that of CD54 and E-selectin, but was markedly induced following UVB treatment. In functional blocking studies, preincubation of tissue from untreated psoriatic plaques with anti-E-selectin antibody, but not antibodies against CD54 and VCAM-1, significantly inhibited the ability to bind normal PBMC. These observations suggest that UVB treatment interferes with the adhesive properties of both psoriatic PBMC and endothelial cells, and differentially regulates the expression of endothelial adhesion molecules. The study also provided direct evidence for the involvement of E-selectin in the adhesion of circulating lymphocytes to psoriatic endothelial cells.
Inappropriate use of laboratory services: long term combined approach to modify request patterns.
Authors: D Bareford, A Hayling
Journal: BMJ (1990)

To see whether changes in request patterns for haematological tests could be influenced in the long term by information released from a haematology department.Analysis of request patterns by hospital divisions before and after intervention and of costs of intervention and savings achieved.Haematology laboratory of an inner city district general hospital.Monthly release of a comparison of clinicians' workload statistics, issue of on call guidelines, and promulgation of information (by seminars and factsheets) on appropriate use of tests.Request patterns before and after intervention.During the year after intervention requests fell by at least a fifth, and the reduction persisted over the next two years. The reduction was most pronounced in relation to inpatients within the division of medicine, for whom requests fell from an average of 4.0 per patient in the six months before intervention to 2.9 per patient in the six months after.A definite and sustained reduction in inappropriate requests for laboratory investigations may be achieved by an ongoing policy of intervention including issuing guidelines and factsheets and holding seminars, but a positive attitude among senior consultant staff is crucial.
Low-Dose Captopril Scintigraphy in the Evaluation of Renovascular Hypertension
Authors: GERMAN RAMIREZ, SCOTT SAVADER, STEVEN FARBER, POLLY A. BITTLE, LUIS TENORIO, CARL D. BRUEGGEMEYER, IAN TYSON
Journal: Clinical Nuclear Medicine (1990)

This study compared the results of renal scintigraphy with simultaneous administration of Tc-99m DTPA and 1–131 Hippuran (before and after 25 mg of oral captopril) with the results of the renal arteriogram and renal vein renins (before and after the administration of 25 mg of oral captopril) to evaluate the sensitivity and specificity of renal scintigraphy in the diagnosis of renovascular hypertension. The results of 21 consecutive patients suspected of having renovascular hypertension who under-went scintigraphy and renal arteriography were analyzed. Renal scintigraphy postcaptopril detected all the cases of renovascular hypertension (eight patients) plus two additional patients who had significant renovascular stenosis but no renin overproduction. The results indicate that the renal scintigram, before and after the administration of captopril, is an accurate and sensitive test for the detection of renovascular hypertension and should be used as a screening procedure before arteriography is considered.
Intestinal immunoglobulins in children with coeliac disease
Authors: E. Savilahti
Journal: Gut (1972)

The numbers of immunoglobulin-containing cells in jejunal biopsy specimens of 19 children with active coeliac disease aged 0·5 to 16·5 years were studied by direct immunofluorescence. Intestinal juice immunoglobulins were measured in 14 of these patients. The number of IgA-containing cells was twice and the number of IgM-containing cells 2·5 times that of age-matched controls. There were also more IgG-, IgE-, and IgD-containing cells in the jejunal mucosa of the coeliac patients, but the absolute numbers of these cells were low. The immunoglobulin content of the intestinal juice was not altered in coeliacs. A follow-up biopsy specimen was available from seven patients kept on a strict gluten-free diet for one to four months. A significant fall in the numbers of immunoglobulin-containing cells was seen, and they did not differ at that time from the controls. Two patients were followed until full normalization of the jejunal structure and they had normal numbers of immunoglobulin-containing cells. In children with coeliac disease in contrast to adult coeliacs, the study shows that the IgA-producing system is quantitatively stimulated during gluten challenge. The rapid drop in the numbers of immunoglobulin-containing cells after gluten withdrawal suggests that there is no quantitative abnormality in the local immunoglobulin-producing system of the gut in coeliac disease.
The Vigorous Diagnostic Approach to Upper-Gastrointestinal Tract Hemorrhage
Authors: Eddy D. Palmer
Journal: JAMA (1969)

Diagnostic management of 1,400 patients with severe, active upper-gastrointestinal tract hemorrhage by immediate esophagogastroscopy and contrast roentgenography provided confident identification of the bleeding lesion in 93%. Preexamination ice-water lavage of the stomach by Ewald tube and syringe proved remarkably effective for control of active hemorrhage. Seven hundred and eleven potentially bleeding lesions that were not playing a part in the hemorrhage were discovered. Duodenal ulcer was responsible for only one fourth of the hemorrhages. Erosive esophagitis and erosive gastritis were the cause of approximately 7% and 12% of the hemorrages, respectively, with death rates of 3% and 9%, respectively. There was one endoscopic injury (perforation through Zenker's diverticulum). Emergency surgical treatment was necessary to control hemorrhage in 16.1% of the 1,400 patients. The overall mortality was 7.9%.
Percutaneous balloon valvuloplasty in patients with severe aortic stenosis and low ejection fraction. Immediate results and 1-year follow-up.
Authors: J Berland, A Cribier, T Savin, E Lefebvre, R Koning, B Letac
Journal: Circulation (1989)

The efficacy, morbidity, and 1-year follow-up of balloon aortic valvuloplasty in patients with low ejection fraction (less than 40%) were studied on a consecutive series of 55 patients (mean age, 77 years) treated from September 1985 to February 1987. Because of their age (20 patients greater than 80 years old), poor left ventricular function, and associated diseases, 45 patients were definitely not surgical candidates. Balloon dilatation with 15-23-mm diameter balloon catheters decreased the transvalvular gradient from 66 +/- 24 to 28 +/- 14 mm Hg (p less than 0.001) and increased the valve area from 0.47 +/- 0.15 to 0.83 +/- 0.27 cm2 (p less than 0.001). Immediately after dilatation, ejection fraction mildly increased from 29 +/- 7% to 34 +/- 9% (p less than 0.001) in 38 patients who had undergone a second left ventricular angiogram after dilatation. No significant change in the degree of aortic regurgitation was found after the procedure. Three patients died in hospital (femoral arterial complications in two, septicemia in one). Immediate clinical improvement was noted in 80% of the patients. During the follow-up (mean, 11 months), 22 patients died (heart failure in 15 patients, sudden death in five patients, myocardial infarction in one patient, cancer in one patient). Thirty patients survived, 21 with persistent clinical improvement. Repeat cardiac catheterization was performed at 6 months in 20 patients, of whom eight had recurrence of symptoms. Nine patients had restenosis: their hemodynamic indexes had returned to prevalvuloplasty values.(ABSTRACT TRUNCATED AT 250 WORDS)
Infarction of the Interventricular Septum
Authors: David Littmann
Journal: New England Journal of Medicine (1949)

THE electrocardiographic findings resulting from infarction of the interventricular septum were recently described by Roesler and Dressler.‡ These investigators found that when the septum was involved so extensively as to include segments of both the anterior and posterior myocardial walls a characteristic electrocardiogram was regularly obtained. This consisted of a posterior-myocardial-infarction pattern in the standard limb leads and an anteroseptal picture in the leads from the precordium. Interest in this condition led to a review of clinical and pathological material at the Veterans Administration Hospital in West Roxbury, Massachusetts.Over a period of twenty-seven months, from May, 1946, to August, . . .
415 Sustained, interferon-sensitive HCV replication in a cell-based HCV replication model using replication defective adenoviral vectors or stable cell lines expressing T7 polymerase
Authors: Y HIASA, J BLACKARD, Y KAMEGAYA, N HORIIKE, M ONJI, E SCHMIDT, R CHUNG
Journal: Hepatology (2003)

The interaction between chronic hepatitis C virus (HCV) infection and bronchial asthma is of considerable interest. This study was designed to examine whether differences in airway responses to an inhaled anticholinergic agent exist between asthmatic patients with and without active HCV infection.Controlled cross-sectional analysis.University hospital.Sixteen HCV-negative asthmatic patients and 36 HCV-positive asthmatic patients.All HCV-positive patients received interferon (INF) therapy for 6 months (INF responders, 16 patients; INF nonresponders, 20 patients). No patient had received INF within 3 years of the start of the study.Airway hyperreactivity to methacholine (ie, the provocative concentration of methacholine causing a 20% fall in FEV1 [PC20]), maximal increase in FEV1, and forced expiratory flow between 25% and 75% of FVC (FEF25–75) after the administration of oxitropium bromide (200 μg) were examined. At the start of the study, the groups were well-matched with respect to age, body mass index, and baseline lung function, including methacholine PC20. The mean (SD) increase in FEV1 after oxitropium bromide administration was significantly greater in patients with active HCV (95 [7] mL) than in HCV-negative asthmatic patients (68 [12] mL) and asthmatic patients with inactive HCV infection (69 [6] mL; p < 0.001). The increase in FEF25–75 after oxitropium bromide administration was also significantly greater (250 [90] mL/s vs 170 [90] and 180 [80] mL/s, respectively; p < 0.029).In patients with asthma, active HCV infection is associated with increased bronchodilator responses to inhaled oxitropium bromide. HCV infection may modulate acetylcholine-mediated airway tone.
THE +49AG POLYMORPHISM IN EXON 1 OF THE CYTOTOXIC T-LYMPHOCYTE-ASSOCIATED PROTEIN 4 IS ASSOCIATED WITH DILATED CARDIOMYOPATHY
Authors: Volker Ruppert, Thomas Meyer, Clarissa Struwe, Jana Petersen, Andreas Perrot, Maximilian G. Posch, Cemil ö;zcelik, Anette Richter, Bernhard Maisch, Sabine Pankuweit
Journal: Journal of the American College of Cardiology (2010)
REDUCTION OF GROWTH RATE IN GIGANTISM TREATED WITH TESTOSTERONE PROPIONATE
Authors: Fred P. Currier
Journal: JAMA (1941)

During the past five years several authors have suggested that there exists an antagonistic action between certain hormones and those of the pituitary. More specifically it was suggested by von Drigalski and Diethelm<sup>1</sup>that the male sex hormone acts as a physiologic brake on the growth-producing hormone of the anterior lobe of the pituitary gland. They described the use of testosterone propionate in large doses in a case of hypophysial gigantism with rather uncertain effects of the treatment. It would seem that any decrease in the rate of growth would be due either to a decrease in the amount of growth-producing hormone of the anterior lobe of the pituitary gland or to an earlier closure of the epiphysial line. It was suggested by MacCullagh<sup>2</sup>that testosterone propionate did not increase the rate of the epiphysial closure beyond normal. The following is a report on the rate of growth in a case of
Prophylaxis against hepatitis A for travel.
Authors: P Moore, P Oakeshott, J Logan, J Law, D M Harris
Journal: BMJ (1990)

To develop a rational practice policy for prophylaxis against hepatitis A for travellers to high risk areas.18 Month prospective study of consecutive patients who requested prophylaxis against hepatitis A.Inner city general practice.104 Patients aged 15-61 (mean 30) assessed for risk factors for hepatitis A and put into groups depending on predictions from the risk factors of their immunity.All patients were screened for antibody to hepatitis A virus. Of 52 patients with no risk factors 47 had no antibody and were thus susceptible to hepatitis A. All 27 patients with major risk factors (having been brought up in an endemic area or with a history of jaundice) were immune. Of 25 patients with minor risk factors (a history of previous travel in high risk areas, drug abuse, having lived in a squat or travelled rough, or having lived with someone who had jaundice) 12 were immune (p less than 0.001, chi 2 test).All travellers requesting prophylaxis against hepatitis A should be assessed for risk factors for previous exposure to hepatitis A. Those with no risk factors could be immunised with human normal immunoglobulin without screening. The remainder should be tested for hepatitis A antibody and those found to be susceptible should be immunised.
Nifedipine reduces the incidence of myocardial infarction and transient ischemia in patients undergoing coronary bypass grafting.
Authors: R Seitelberger, W Zwölfer, S Huber, S Schwarzacher, T M Binder, F Peschl, J Spatt, C Holzinger, B Podesser, P Buxbaum
Journal: Circulation (1991)

A randomized study was performed on 104 patients undergoing elective coronary artery bypass grafting to examine whether the infusion of nifedipine (n = 53) reduces the incidence of perioperative myocardial ischemia and necrosis in the early postoperative period. Continuous hemodynamic and three-channel Holter monitoring was performed for 24 hours and serial assessment of serum enzymes and 12-lead electrocardiography were performed for 36 hours postoperatively. Nifedipine (minimum dose, 10 micrograms/kg/hr for 24 hours) was applied from the onset of extracorporal circulation. The control group (n = 51) received nitroglycerin (minimum dose, 1 micrograms/kg/min for 24 hours). Using the combined analyses of electrocardiography and Holter recordings, myocardial ischemia was defined as being either a transient ischemic event (TIE), transient coronary spasm (TCS), or myocardial infarction (MI). The two groups did not differ with respect to preoperative New York Heart Association classification, age, history of myocardial infarction, extracorporal circulation and aortic cross-clamp time, number of distal anastomoses, or systemic and pulmonary hemodynamics. The incidence of perioperative myocardial ischemia was substantially lower in the nifedipine than in the nitroglycerin group [TIE: three of 53 patients (6%) versus nine of 50 patients (18%), p less than 0.001; MI: two of 53 patients (4%) versus six of 50 patients (12%), p less than 0.001; and TCS: none of 53 patients (0%) versus two of 50 patients (4%), p = NS].(ABSTRACT TRUNCATED AT 250 WORDS)
Michael James Henry Piachaud
Authors: A. Burnett, N. Piachaud, T. Piachaud, M. Kerac, S. Hollins, C. Harmer, P. Cowley, L. Barnett
Journal: BMJ (2009)

Michael James Henry Piachaud (“Jack”) devoted his career to the countless people throughout the world whose health, wellbeing, and access to proper health care are jeopardised by the effects of war, poverty, and environmental damage. His multifaceted career and voluntary activities were a reflection of his humanity and his passions.

He grew up at a time when enormous questions were being asked about the nature of our society: Who should it be for? Who is responsible for it? His life was dedicated to answering these questions. He was born in June 1948, just a month before the NHS was established, and it was to this organisation, this big idea of the time, that he would dedicate his professional life. Having studied medicine at Oxford, he became a psychiatrist, and later a consultant specialising in learning disabilities, as well as a senior lecturer at Imperial College School of Medicine, where he inspired the next generation of medical students to think about the issues which he considered profoundly important.

He worked for the most vulnerable in our society, believing that society should be for everyone. He did not see disabled or helpless people, but a disabled and helpless society that …
Inversion of chromosome 16 and eosinophilia in refractory anemia with ring sideroblasts: Report of a case
Authors: Tohru Inaba, Chihiro Shimazaki, Eiko Inaba, Toshiyuki Hirata, Eishi Ashihara, Katsunori Ohkawa, Naritoshi Oku, Hideo Goto, Satoshi Murakami, Naohisa Fujita, Shinichi Misawa, Masao Nakagawa
Journal: American Journal of Hematology (1993)

Abstract A 72‐year‐old male who was admitted to our hospital with severe anemia was diagnosed as refractory anemia with ring sideroblasts (RARS), according to the French‐American‐British (FAB) classification of myelodysplastic syndromes (MDS). The patient showed persistent eosinophilia with no definite signs of either allergy or a parasitic infection. Chromosomal analysis of bone marrow cells revealed inv(16)(p13q22), a known characteristic of M4Eo acute myeloid leukemia (AML) in the FAB classification. This patient didn't exhibit leukemic transformation during his 20‐month clinical course, nor was any found at autopsy. Therefore, this is the first case of RARS to speculate that the chromosomal characteristic inv(16)(p13q22) might be specific for eosinophilia rather than AML. © 1993 Wiley‐Liss, Inc.