tbuckley/cabot-search huggingface dataset:
Meta-analysis of Trials Comparing β-Blockers, Calcium Antagonists, and Nitrates for Stable Angina
Authors: Paul A. Heidenreich
Journal: JAMA (1999)

ContextWhich drug is most effective as a first-line treatment for stable angina is not known.ObjectiveTo compare the relative efficacy and tolerability of treatment with β-blockers, calcium antagonists, and long-acting nitrates for patients who have stable angina.Data SourcesWe identified English-language studies published between 1966 and 1997 by searching the MEDLINE and EMBASE databases and reviewing the bibliographies of identified articles to locate additional relevant studies.Study SelectionRandomized or crossover studies comparing antianginal drugs from 2 or 3 different classes (β-blockers, calcium antagonists, and long-acting nitrates) lasting at least 1 week were reviewed. Studies were selected if they reported at least 1 of the following outcomes: cardiac death, myocardial infarction, study withdrawal due to adverse events, angina frequency, nitroglycerin use, or exercise duration. Ninety (63%) of 143 identified studies met the inclusion criteria.Data ExtractionTwo independent reviewers extracted data from selected articles, settling any differences by consensus. Outcome data were extracted a third time by 1 of the investigators. We combined results using odds ratios (ORs) for discrete data and mean differences for continuous data. Studies of calcium antagonists were grouped by duration and type of drug (nifedipine vs nonnifedipine).Data SynthesisRates of cardiac death and myocardial infarction were not significantly different for treatment with β-blockers vs calcium antagonists (OR, 0.97; 95% confidence interval [CI], 0.67-1.38; P=.79). There were 0.31 (95% CI, 0.00-0.62; P=.05) fewer episodes of angina per week with β-blockers than with calcium antagonists. β-Blockers were discontinued because of adverse events less often than were calcium antagonists (OR, 0.72; 95% CI, 0.60-0.86; P<.001). The differences between β-blockers and calcium antagonists were most striking for nifedipine (OR for adverse events with β-blockers vs nifedipine, 0.60; 95% CI, 0.47-0.77). Too few trials compared nitrates with calcium antagonists or β-blockers to draw firm conclusions about relative efficacy.Conclusionsβ-Blockers provide similar clinical outcomes and are associated with fewer adverse events than calcium antagonists in randomized trials of patients who have stable angina.
Tuberculosis: who should prescribe?
Authors: A G Wardman, S E Williams, P G Curzon, R L Page, N J Cooke
Journal: BMJ (1982)

In routine clinical practice 20% of patients with pulmon- ary tuberculosis were treated with the regimen recommended by the British Thoracic Association after the British trial of short-course chemotherapy.Despite the use of several regimens that could be considered inadequate, no patient from the survey within south and west Wales appears to have relapsed yet.Deaths from pulmonary tuberculosis continue at the same rate as 10 years ago.Patient default remains a difficult problem even with modern, less toxic, short-course regimens.
Inhibition of viral replication by nitric oxide and its reversal by ferrous sulfate and tricarboxylic acid cycle metabolites.
Authors: G Karupiah, N Harris
Journal: The Journal of Experimental Medicine (1995)

IFN-gamma-induced nitric oxide (NO) in the murine macrophage-derived cell line RAW 264.7 was previously shown to inhibit replication of the poxviruses ectromelia and vaccinia (VV) and HSV-1. In the current study we demonstrate that murine macrophages activated as a consequence of VV infection express inducible nitric oxide synthase. These activated macrophages were resistant to infection with VV and efficiently blocked the replication of VV and HSV-1 in infected bystander cells of epithelial and fibroblast origin. This inhibition was arginine dependent, correlated with nitrite production in cultures, and reversible by the NOS inhibitor N omega-monomethyl-L-arginine. NO-mediated inhibition of VV replication was studied by treatment of virus-infected human 293 cells with the NO donor S-nitroso-N-acetyl-penicillamine. Using a VV-specific DNA probe, antibodies specific for temporally expressed viral proteins, and transmission electron microscopy, we have shown that NO inhibited viral late gene protein synthesis, DNA replication, and virus particle formation, but not expression of the early proteins that were analyzed. Putative enzymatic targets of NO were identified by reversing the NO-mediated inhibition of VV replication in the 293 cells with exogenous ferrous sulfate and L-cysteine. Reversal of inhibition may derive from the capacity of these reagents to protect or regenerate nonheme iron or thiol groups, respectively, which are essential for the catalytic activities of enzymes susceptible to inactivation by NO.
More on the Common Communion Cup
Authors: Maureen Brady Moran
Journal: Annals of Internal Medicine (1993)

Letters1 October 1993More on the Common Communion CupMaureen Brady Moran, MDMaureen Brady Moran, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-7_Part_1-199310010-00033 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Furlow and Dougherty [1] cite Gill [2] as having reported that intinction may cause the transmission of saliva between communicants. I could find no mention of such a risk in Gill's review. Furthermore, Furlow and Dougherty have not advanced our knowledge on the subject of the common communion cup; that is, they have not shown that the bacteria present on the communion cup caused inoculation, infection, or an episode of disease. They provide no new evidence to refute Gill's assertion that currently available data do not provide any support for suggesting that the practice of sharing a ...References1. Furlow TG, Dougherty MJ. Bacteria on the common communion cup (Letter). Ann Intern Med. 1993; 118:572-3. Google Scholar2. Gill ON. The hazard of infection from the shared communion cup. J Infect. 1988; 16:3-23. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1993Volume 119, Issue 7_Part_1Page: 638KeywordsBacteriaInfectious diseasesInoculationSaliva ePublished: 15 August 2000 Issue Published: 1 October 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Treatment of rheumatoid arthritis is good medicine
Authors: D. L. Scott, J. Hunter, C. Deighton, D. G. I. Scott, D. Isenberg
Journal: BMJ (2011)

In “Bad medicine: rheumatoid arthritis” Spence combines unsupported assertions with misleading interpretations of publications about the disease.1

We agree that the severity of rheumatoid arthritis is declining. Strong evidence shows that this reflects better medical management, including early intensive treatment, and improved healthcare organisation.2 3

We disagree, however, with many other points. The diagnosis of rheumatoid arthritis is not “increasingly subjective.” The objective finding of joint swelling on examination is the key component of all classification criteria; ultrasound …
Molecular Characterization of Enzalutamide-treated Bone Metastatic Castration-resistant Prostate Cancer
Authors: Eleni Efstathiou, Mark Titus, Sijin Wen, Anh Hoang, Maria Karlou, Robynne Ashe, Shi Ming Tu, Ana Aparicio, Patricia Troncoso, James Mohler, Christopher J. Logothetis
Journal: European Urology (2014)
"Misleading falsehoods" regarding assisted dying?
Authors: B. D. Williams, L. F. Reynolds
Journal: BMJ (2014)

The novel COVID-19 came under limelight few months back (December 2019) and has recently been declared a pandemic by WHO. It has resulted in serious financial implications being faced by dental practices, hospitals and healthcare workers. Dental practice currently is restricted to provision of emergency dental care whereas, many hospitals have also cancelled elective procedures to save finances for COVID-19 treatment which is expensive and unpredictable. In addition, healthcare workers are also facing financial challenges in this difficult time. Competent authorities should step in to help dental practices, hospitals and healthcare workers in order to ensure the provision of all types of healthcare efficiently in these testing times and beyond.
Persistence and Efficacy of Second Generation CAR T Cell Against the LeY Antigen in Acute Myeloid Leukemia
Authors: David S. Ritchie, Paul J. Neeson, Amit Khot, Stefan Peinert, Tsin Tai, Kellie Tainton, Karen Chen, Mandy Shin, Dominic M. Wall, Dirk Hönemann, Peter Gambell, David A. Westerman, Javier Haurat, Jennifer A. Westwood, Andrew M. Scott, Lucy Kravets, Michael Dickinson, Joseph A. Trapani, Mark J. Smyth, Phillip K. Darcy, Michael H. Kershaw, H. Miles Prince
Journal: Molecular Therapy (2013)

In a phase I study of autologous chimeric antigen receptor (CAR) anti-LeY T-cell therapy of acute myeloid leukemia (AML), we examined the safety and postinfusion persistence of adoptively transferred T cells. Following fludarabine-containing preconditioning, four patients received up to 1.3 × 109 total T cells, of which 14–38% expressed the CAR. Grade 3 or 4 toxicity was not observed. One patient achieved a cytogenetic remission whereas another with active leukemia had a reduction in peripheral blood (PB) blasts and a third showed a protracted remission. Using an aliquot of In111-labeled CAR T cells, we demonstrated trafficking to the bone marrow (BM) in those patients with the greatest clinical benefit. Furthermore, in a patient with leukemia cutis, CAR T cells infiltrated proven sites of disease. Serial PCR of PB and BM for the LeY transgene demonstrated that infused CAR T cells persisted for up to 10 months. Our study supports the feasibility and safety of CAR–T-cell therapy in high-risk AML, and demonstrates durable in vivo ­persistence. In a phase I study of autologous chimeric antigen receptor (CAR) anti-LeY T-cell therapy of acute myeloid leukemia (AML), we examined the safety and postinfusion persistence of adoptively transferred T cells. Following fludarabine-containing preconditioning, four patients received up to 1.3 × 109 total T cells, of which 14–38% expressed the CAR. Grade 3 or 4 toxicity was not observed. One patient achieved a cytogenetic remission whereas another with active leukemia had a reduction in peripheral blood (PB) blasts and a third showed a protracted remission. Using an aliquot of In111-labeled CAR T cells, we demonstrated trafficking to the bone marrow (BM) in those patients with the greatest clinical benefit. Furthermore, in a patient with leukemia cutis, CAR T cells infiltrated proven sites of disease. Serial PCR of PB and BM for the LeY transgene demonstrated that infused CAR T cells persisted for up to 10 months. Our study supports the feasibility and safety of CAR–T-cell therapy in high-risk AML, and demonstrates durable in vivo ­persistence.
Receiver-operating characteristic (ROC) curves: a fundamental tool for improving the clinical usefulness of in vitro IgE tests
Authors: M. Plebani, F. Borghesan, D. Basso, D. Faggian
Journal: Allergy (1996)

In order to establish the most efficient thresholds for serum allergen-specific IgE measured by the Pharmacia CAP System, a "second-generation" in vitro method, we evaluated results from 89 subjects with suspected inhalant allergies, using receiver-operating characteristic (ROC) curve analysis. Sera samples were analyzed by the Pharmacia CAP System for specific IgE, the choice of allergens to be tested being based upon the symptoms and clinical history of each patient. Results were analyzed by ROC analysis for the five most representative allergens, cat dander (e1), Dermatophagoides pteronyssinus (d1), Lolium perenne (g5), wall pellitory (W19), and wormwood (w5). The areas under the ROC curves were found to be satisfactory, ranging from 0.931 (e1) to 0.974 (g5) when we excluded w5, which had a significantly smaller area (0.81). To establish the most efficient threshold for each allergen, we calculated the clinical sensitivity, specificity, efficiency, and negative and positive predictive values. The thresholds giving a higher diagnostic efficiency were as follows: 0.40 kUa/l for d1, 0.55 kUa/l for g5, 0.50 for e1, 0.65 kUa/l for w19, and 1.00 kUa/l for w5. It is concluded that quantitative reporting of specific IgE measurement has numerous advantages, but the choice of the positive threshold seems to be a prerequisite for obtaining the optimal clinical efficiency. It is also suggested that a specific threshold should be adopted for each allergen.
Cryptococcal Meningitis after Unusual Exposures to Birds
Authors: W. Jeffrey Fessel
Journal: New England Journal of Medicine (1993)

To the Editor: Although it is well known that various birds carry cryptococci, the degree of human exposure to birds that is required for the emergence of clinical cryptococcal disease is not known. Two patients with cryptococcal meningitis had unusually intense exposures. The patients were seropositive for the human immunodeficiency virus (HIV) but had been asymptomatic until meningitis developed. The first patient, a 56-year-old man, helped dismantle an aviary, measuring 16 by 12 by 8 feet, that had been unused for about 10 years. The wooden floor of the aviary was rotten, and its removal produced clouds of dust. Demolishing . . .
Effect of methotrexate on the deoxyuridine suppression test: Results with different cell preparations
Authors: Shoichiro Kanazawa, Saori Iwasa, Toru Iseki, Keiko Okuda, Haruki Kondo, Kunio Okuda
Journal: American Journal of Hematology (1988)

Abstract Recently, the deoxyuridine suppression test was used to detect folate deficiency. Several cell preparations were used in this test, and the sensitivity of the test seems to vary with them. We used whole blood (micro‐dU test) and bone marrow cells for the deoxyuridine suppression test, and the effects of methotrexate were compared. [ 3 H]Thymidine incorporation into DNA was highest when the concentration of methotrexate was 1 μM in the whole blood culture and bone marrow culture. Methotrexate concentrations from 100 nM to 1 mM did not affect the results of the micro‐dU test. However, the bone marrow deoxyuridine test became abnormal with methotrexate, and the abnormality in test values was corrected by the addition of N 5 ‐formyltetrahydrofolate. Differences in the results between the micro‐dU test and the bone marrow deoxyuridine suppression test seem to represent specificity of each dU test.
Efficacy of Bedtime NPH Insulin With Daytime Sulfonylurea for Subpopulation of Type II Diabetic Subjects
Authors: Matthew C Riddle, Lean S Hart, Donald J Bouma, Beverley E Phillipson, Gerald Youker
Journal: Diabetes Care (1989)

Although insulin and sulfonylureas often have additive clinical effects when used in combination for type II (non-insulin-dependent) diabetes, these results are variable and a clinical role for this approach is not yet established. This study tests the efficacy of a specific combined regimen for a subpopulation of patients with a randomized double-masked placebo-controlled crossover design and under conditions similar to those of clinical practice. Twenty subjects with limited duration (less than 15 yr) type II diabetes who were moderately obese (less than 160% ideal wt) and proved imperfectly controlled on 10 mg glyburide twice daily completed two 4-mo crossover protocols, comparing a single injection of NPH insulin in the evening plus 10 mg glyburide in the morning with insulin plus placebo. Insulin dose was adjusted by experienced endocrinologists seeking the best glycemic control consistent with safety. All subjects had glycosylated hemoglobin values less than or equal to 150% of the control mean on combined therapy, and combined therapy was superior to insulin alone (fasting plasma glucose 8.0 +/- 0.3 vs. 11.1 +/- 0.6 mM, P less than .01; glycosylated hemoglobin 9.8 +/- 0.1 vs. 10.6 +/- 0.2%, P less than .01). Despite greater weight gain on combined therapy, blood pressure and plasma lipid concentrations were the same on the two regimens. These results suggest this simple regimen offers another option, besides multiple injections of insulin, for patients of this kind who are unsuccessful with a sulfonylurea or a single injection of insulin alone.
Patients Who Leave a Public Hospital Emergency Department Without Being Seen by a Physician
Authors: David W. Baker
Journal: JAMA (1991)

To determine whether patients who sought care at a public hospital emergency department and left without being seen by a physician needed immediate medical attention and whether they obtained care after leaving.Follow-up study of patients who left without being seen and of patients who waited to be seen by a physician.A public hospital's emergency department in Torrance, Calif.All patients who registered for care and left without being seen (n = 186) and a 20% random sample of patients who waited until they were seen (n = 211) in a 2-week period during spring 1990.At time of presentation: triage nurse urgency assessment, clinical acuity rating, and self-reported health status. At follow-up: hospitalization rates.Patients who left reported that they had waited 6.4 hours before leaving; those who stayed reported a 6.2-hour wait before being seen. There were no differences between those who left and those who stayed in chief complaint, triage nurse assessment, acuity ratings, or self-reported health status. Forty-six percent of those who left were judged to need immediate medical attention, and 29% needed care within 24 to 48 hours. Eleven percent of those who left were hospitalized within the next week, and three patients required emergency surgery. Nine percent of those who waited to be seen were hospitalized. Forty-nine percent of patients who left did not see a physician during the 1-week follow-up period.Overcrowding in this public hospital's emergency department restricts access to needed ambulatory medical care for the poor and uninsured.
An Slfn2 mutation causes lymphoid and myeloid immunodeficiency due to loss of immune cell quiescence
Authors: Michael Berger, Philippe Krebs, Karine Crozat, Xiaohong Li, Ben A Croker, Owen M Siggs, Daniel Popkin, Xin Du, Brian R Lawson, Argyrios N Theofilopoulos, Yu Xia, Kevin Khovananth, Eva Marie Y Moresco, Takashi Satoh, Osamu Takeuchi, Shizuo Akira, Bruce Beutler
Journal: Nature Immunology (2010)
Preload Reduction to Unmask the Characteristic Doppler Features of Constrictive Pericarditis
Authors: Jae K. Oh, A. Jamil Tajik, Christopher P. Appleton, Liv K. Hatle, Rick A. Nishimura, James B. Seward
Journal: Circulation (1997)

Background Respiratory variation of ≥25% in mitral E velocity is a characteristic Doppler echocardiographic feature in constrictive pericarditis. However, a subset of patients with constriction do not exhibit the typical respiratory change, most likely because of marked increase in the left atrial pressure, and preload reduction may unmask the respiratory variation. Methods and Results In 12 patients with surgically confirmed constrictive pericarditis who had &lt;25% respiratory variation in mitral E velocity during an initial preoperative examination, the Doppler study was repeated after an attempt to decrease left ventricular filling pressure. At baseline, mean mitral E velocity was similar after inspiration and expiration (0.81±0.24 and 0.84±0.21 m/s, respectively). On repeat Doppler examination, with the patient in a head-up tilt or sitting position, the decrease in mitral E velocity with inspiration (0.61±0.13 m/s) was significant ( P &lt;.004), whereas it did not change significantly with expiration. The mean percent respiratory change in E velocity was 5±7% at baseline and 32±28% with preload reduction. Eight (75%) of the 12 patients developed respiratory variation of ≥25%. Conclusions When the respiratory variation in Doppler mitral E velocity is blunted or absent during the evaluation of suspected constrictive pericarditis, repeat Doppler recording of mitral flow velocities after maneuvers to decrease preload is recommended to unmask the characteristic respiratory variation in mitral E velocity.
Comparison of single-photon emission computed tomographic (SPECT) myocardial perfusion imaging with thallium-201 and technetium-99m sestamibi in dogs
Authors: Angel R. Leon, Robert L. Eisner, Sharon E. Martin, L.Susan Schmarkey, April M. Aaron, Albert S. Boyers, Kenneth M. Burnham, Dong J. Oh, Randolph E. Patterson
Journal: Journal of the American College of Cardiology (1992)
A Long Walk Home
Authors: Mari Lloyd-Williams
Journal: BMJ (2002)

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Rachel Clark with Naomi Jefferies, John Hasler and David Pendleton 

Radcliffe Medical Press, £19.95, pp 142

ISBN 1 85775 906 0

Rating: ![Graphic][2] ![Graphic][3] ![Graphic][4] ![Graphic][5] 

Interviewing prospective medical students is a privilege. Most hopeful applicants appear to be caring, empathic young people with a genuine concern for others. All medical schools now teach communication skills as an integrated part of the curriculum. So why do so many people feel hurt and let down by doctors' attitudes when they are faced with the most frightening and worst …

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Abstract 4618: Therapeutic targeting for sphingosine kinase 1 in epithelial ovarian cancer
Authors: Jeong-Won Lee, Ji Yoon Ryu, Hye-Kyung Jeon, Young-Ae Park, Young-Jae Cho, Jung-Joo Choi, Yoo-Young Lee, Tae-Joong Kim, Chel Hun Choi, Byoung-Gie Kim, Duk-Soo Bae
Journal: Cancer Research (2014)

Abstract Purpose: Sphingosine kinase 1 (SK1) is over-expressed in various human cancers with pro-growth effects and its inhibitors has been suggested potential anti-cancer agents. This study was designed to investigate the therapeutic potential of SK1 inhibitor in epithelial ovarian carcinoma (EOC). Experimental design: The expression of SK1 protein was evaluated using immunohistochemistry in patients with EOC. EOC cell lines (A2780, SKOV3ip1, A2780-CP20, SKOV3-TR, ES2 and RMG2) were used in this study to test SK1 siRNA or inhibitors. We used two kinds of SK inhibitor including SK inhibitor (for both SK1 and 2) and FTY720 (specifically inhibiting SK1) to check cell proliferation, apoptosis, angiogenesis and invasion using MTT, FACS, ELISA and wound-healing assay, respectively. Furthermore, in vivo experiments were performed to test the FTY720 on tumor growth in orthotopic EOC mouse model. Results: The expression of SK1 protein in primary EOC tissues was strongly observed in all of patients; however, there was no expression of SK1 protein in the normal ovarian epithelium (n=5). Blocking SK1 by its siRNA or inhibitors significantly affected cell proliferation, apoptosis, angiogenesis and invasion in A2780-PAR and SKOV3ip1 cells. SK1 inhibitors led to decrease of SK enzymatic activity in cells. Furthermore, utilizing the in vivo animal model (A2780-PAR), FTY720 treatment significantly decreased the total tumor weight compared with control (P &amp;lt; 0.05). Conclusions: These results show that therapeutic targeting of SK1 with its inhibitor could have potentials of novel therapeutics for EOC. Citation Format: Jeong-Won Lee, Ji Yoon Ryu, Hye-Kyung Jeon, Young-Ae Park, Young-Jae Cho, Jung-Joo Choi, Yoo-Young Lee, Tae-Joong Kim, Chel Hun Choi, Byoung-Gie Kim, Duk-Soo Bae. Therapeutic targeting for sphingosine kinase 1 in epithelial ovarian cancer. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4618. doi:10.1158/1538-7445.AM2014-4618