tbuckley/cabot-search huggingface dataset:
Dapagliflozin Improves Glycemic Control and Reduces Body Weight as Add-on Therapy to Metformin Plus Sulfonylurea: A 24-Week Randomized, Double-Blind Clinical Trial
Authors: Stephan Matthaei, Keith Bowering, Katja Rohwedder, Anke Grohl, Shamik Parikh
Journal: Diabetes Care (2015)

OBJECTIVE To evaluate the efficacy and safety of dapagliflozin in patients with type 2 diabetes inadequately controlled with metformin and sulfonylurea. RESEARCH DESIGN AND METHODS Patients with HbA1c of 7.0% (53 mmol/mol) to 10.5% (91 mmol/mol) receiving sulfonylurea and metformin were randomized to receive dapagliflozin 10 mg/day (n = 109) or placebo (n = 109) for 24 weeks. RESULTS HbA1c (baseline: dapagliflozin 8.08% [65 mmol/mol]; placebo 8.24% [67 mmol/mol]) and fasting plasma glucose (baseline: dapagliflozin 167.4 mg/dL [9.29 mmol/L]; placebo 180.5 mg/dL [10.02 mmol/L]) significantly improved from baseline with dapagliflozin (placebo-subtracted change –0.69% [–7.5 mmol/mol], P &amp;lt; 0.0001; –33.5 mg/dL [–1.86 mmol/L], P &amp;lt; 0.0001, respectively). More patients achieved a therapeutic glycemic response (HbA1c &amp;lt;7.0% [53 mmol/mol]) with dapagliflozin (31.8%) versus placebo (11.1%) (P &amp;lt; 0.0001). Body weight and systolic blood pressure were significantly reduced from baseline over 24 and 8 weeks, respectively, with dapagliflozin (placebo-subtracted change –2.1 kg, P &amp;lt; 0.0001; –3.8 mmHg, P = 0.0250). Patients receiving dapagliflozin showed placebo-subtracted increases in total, LDL, and HDL cholesterol (11.4 mg/dL, P = 0.0091; 11.4 mg/dL, P = 0.0030; 2.2 mg/dL, P = 0.0172, respectively) with no change in LDL/HDL cholesterol ratio (0.1; P = 0.2008) or triglycerides (–16.5 mg/dL; P = 0.1755). Adverse events occurred in 48.6% of patients receiving dapagliflozin and 51.4% receiving placebo. Significantly more patients with dapagliflozin compared with placebo experienced hypoglycemia (12.8 vs. 3.7%; P = 0.024) and genital infections (5.5 vs. 0%; P = 0.029). Events of urinary tract infection were reported by 6.4% of patients in both groups. CONCLUSIONS Dapagliflozin was well tolerated and effective over 24 weeks as add-on to metformin plus sulfonylurea. Adverse effects included hypoglycemia and genital infections.
Month Of Birth And Sensitization To Grass Pollen Or House Dust Mites: Is There Association?
Authors: A.C. Porto Neto, J.R. de Dias, C.M.Z. Rech, J. Pastorello, P.F. Magrin, T. Tognon, V.T. Cazarotto, L.C. Rigodanzo, A. Pasqualotti
Journal: Journal of Allergy and Clinical Immunology (2009)
Correction of ClC-1 splicing eliminates chloride channelopathy and myotonia in mouse models of myotonic dystrophy
Authors: Thurman M. Wheeler, John D. Lueck, Maurice S. Swanson, Robert T. Dirksen, Charles A. Thornton
Journal: Journal of Clinical Investigation (2007)

In myotonic dystrophy (dystrophia myotonica [DM]), an increase in the excitability of skeletal muscle leads to repetitive action potentials, stiffness, and delayed relaxation. This constellation of features, collectively known as myotonia, is associated with abnormal alternative splicing of the muscle-specific chloride channel (ClC-1) and reduced conductance of chloride ions in the sarcolemma. However, the mechanistic basis of the chloride channelopathy and its relationship to the development of myotonia are uncertain. Here we show that a morpholino antisense oligonucleotide (AON) targeting the 3' splice site of ClC-1 exon 7a reversed the defect of ClC-1 alternative splicing in 2 mouse models of DM. By repressing the inclusion of this exon, the AON restored the full-length reading frame in ClC-1 mRNA, upregulated the level of ClC-1 mRNA, increased the expression of ClC-1 protein in the surface membrane, normalized muscle ClC-1 current density and deactivation kinetics, and eliminated myotonic discharges. These observations indicate that the myotonia and chloride channelopathy observed in DM both result from abnormal alternative splicing of ClC-1 and that antisense-induced exon skipping offers a powerful method for correcting alternative splicing defects in DM.
Points from Letters: Injecting Hydroceles--an Unproved Treatment?
Authors: R. G. Apthorpe
Journal: BMJ (1973)

In 1970 340 of strains were resistant to tetracycline, in 1971 46%, in 1972 54%, and in 1973 to date 35°%.It would seem there- fore that in this area, at least, there has been no fall in the level of tetracycline-resistant Strep.pyogenes over the past four years.The majority of strains isolated continue to come from throat swabs, though many also come from skin sepsis and abscesses.Group B haemolytic streptococci show an even higher prevalence of tetracycline resistance- 580% of 74 strains isolated so far this year (mainly from vaginal swabs) were resistant to this drug.Whether the difference between Dr. Robertson's findings and mine is due to differences in the usage of tetracyclines in the two areas is something on which I cannot comment, but our results illustrate how widely divergent antibiotic sensitivity patterns may 'be observed in different areas of the couniry.-Iam, etc.,
Texas hospital keeps pregnant woman on life support against family's wishes
Authors: M. McCarthy
Journal: BMJ (2014)

A Texas hospital is keeping a pregnant woman, Marlise Munoz, on life support despite her family’s pleas that she be taken off the ventilator.

The patient’s husband and parents say that she is brain dead and would not have wanted to be kept on life support. But under Texas state law the hospital can ignore their wishes because Munoz is pregnant.

Munoz, an emergency medical technician, was admitted to John Peter Smith Hospital in Fort Worth, Texas, on 26 November 2013, after she collapsed at home. At the time the 33 year old mother of one was 14 weeks pregnant.

Press reports said that her husband, Erick Munoz, who is also an emergency medical technician, found her without a pulse, called for an ambulance, and began cardiopulmonary resuscitation. She was transported to John Peter Smith Hospital, where she was put on life support.

“We were both paramedics, we’ve seen things out in the field, and we both knew we didn’t want to be put on life support,” her husband said in a television interview.

Mr Munoz …
Induction of natural killer T cell–dependent alloreactivity by administration of granulocyte colony–stimulating factor after bone marrow transplantation
Authors: Edward S Morris, Kelli P A MacDonald, Rachel D Kuns, Helen M Morris, Tatjana Banovic, Alistair L J Don, Vanessa Rowe, Yana A Wilson, Neil C Raffelt, Christian R Engwerda, Angela C Burman, Kate A Markey, Dale I Godfrey, Mark J Smyth, Geoffrey R Hill
Journal: Nature Medicine (2009)
The rationality debate as a progressive research program
Authors: Keith E. Stanovich, Richard F. West
Journal: Behavioral and Brain Sciences (2003)

We did not, as Brakel &amp; Shevrin imply, intend to classify either System 1 or System 2 as rational or irrational. Instrumental rationality is assessed at the organismic level, not at the subpersonal level. Thus, neither System 1 nor System 2 are themselves inherently rational or irrational. Also, that genetic fitness and instrumental rationality are not to be equated was a major theme in our target article. We disagree with Bringsjord &amp; Yang's point that the tasks used in the heuristics and biases literature are easy. Bringsjord &amp; Yang too readily conflate the ability to utilize a principle of rational choice with the disposition to do so. Thus, they undervalue tasks in the cognitive science literature that compellingly reveal difficulties with the latter. We agree with Newton &amp; Roberts that models at the algorithmic level of analysis are crucial, but we disagree with their implication that attention to issues of rationality at the intentional level of analysis impedes work at the algorithmic level of analysis.
Cocaine and HIV Prevalence in an Alcohol Treatment Center-Reply
Authors: Andrew L. Avins
Journal: JAMA (1994)

<h3>In Reply.</h3> —We thank Dr Epstein for his interesting comment. It is true that use of cocaine, particularly crack cocaine, has been associated with HIV infection in several studies.<sup>1,2</sup>However, our report noted that no individual drug was significantly associated with HIV infection. For cocaine specifically, there was no significant association between HIV infection and ever having used any type of cocaine (odds ratio [OR]=1.4; 95% confidence interval [CI], 0.4 to 4.7) or ever having used crack cocaine (OR=0.8; 95% CI, 0.4 to 1.7). However, the relatively small number of subjects who never used any type of cocaine (10%) or crack cocaine (18%) limits the power of these analyses, precluding a definitive conclusion. Similar studies in other populations may shed more light on the independent role of alcohol in HIV infection among polysubstance users. For example, Saxon and Calsyn<sup>3</sup>recently reported that injection drug users who also used
Persorption of metallic iron particles.
Authors: G Volkheimer, F H Schulz, A Lindenau, U Beitz
Journal: Gut (1969)

Large, solid, undissolved food particles instantly enter the body from the intestinal lumen.We examined this phenomenon which we called 'persorption'.Such large particles are kneaded between the cells into the subepithelial region through the epithelial cell layer.Transport from the intestinal wall is via the portal system and by means of the chyle (Fig. 1).Starch granules with a diameter ranging from 5 to 100 ,u were used as models for these experiments (Volkheimer, 1964, 1968; Volk- heimer and Schulz, 1968; Volkheimer et al, 1968a, b, c, and d). MATERIAL AND METHODCarbonyl iron powder' (particle size up to 8 ) and Simetag iron powder2 (particle size up to 62 t) were used.The iron powder was fed to dogs of average weight of approximately 17 kg.Iron powder, 200 g or 250 g, was suspended in 500 g of cream and 250 g of milk and fed to the fasting dogs.
Clinician Perspectives on Potentially Avoidable Hospitalizations in Patients With Cancer
Authors: Gabriel A. Brooks, Joseph O. Jacobson, Deborah Schrag
Journal: JAMA Oncology (2015)

Acute hospitalizations in patients with cancer are a major driver of the cost of cancer care, accounting for nearly half advanced cancer spending.1 Reducing acute hospitalizations is a potentially important strategy for improving the quality, value, and patient-centeredness of cancer care. The Agency for Healthcare Research and Quality has endorsed a set of administrative measures to identify potentially avoidable hospitalizations, however these measures do not apply to patients with cancer.2 We sought to evaluate the proportion of hospitalizations in cancer patients that are viewed as potentially avoidable by clinicians directly involved in patient care.
Hemorrhage and Thrombosis: A Practical Clinical Guide
Authors: Robert T. Breckenridge
Journal: JAMA (1965)

Written by a surgeon and by a clinical pathologist, this book stresses the clinical management of hemorrhagic and thrombotic states. The breezy style makes it quite easy to read in one or two evenings.  The book has several strengths. The surgical management of the complications of hemophilia is described in greater detail than in other available texts. The discussion of blood banking techniques as applied to the treatment of thrombocytopenia and hemophilia is excellent. But where the monograph deals with the physiology of coagulation, hemostasis, and thrombosis, it is less satisfying. Nor are many of its therapeutic recommendations commonly accepted. In particular, doubts must be raised concerning the efficacy of single transfusion of plasma to patients with hemophilia.  This book will be of value to the coagulationist who is sufficiently well versed to debate in his mind controversial issues raised by the authors. It will be of lesser use to
Randomized trial of pimecrolimus cream versus triamcinolone acetonide paste in the treatment of oral lichen planus
Authors: Farzam Gorouhi, Amirreza Solhpour, Jalil Momen Beitollahi, Shahla Afshar, Parastoo Davari, Pantea Hashemi, Mansour Nassiri Kashani, Alireza Firooz
Journal: Journal of the American Academy of Dermatology (2007)
Sodium Sulphacetamide in Ocular Tissues
Authors: J. M. Robson, W. Tebrich
Journal: BMJ (1942)

SCABIESMEDITCAJSHNAL 687 the mites, a considerable number being apparently unaffected by the treatment, although almost all of them contained stain, and therefore presumably drug.There was no significant difference between the actions of benzyl benzoate and dimethylthian- threne on the eggs, both being inferior to tetraethylthiuram TABLE II.-ComparativeEffects on Eggs after Rubbing in the Drugs for 3 Minutes 24 Hours Afterwards 3 Days Afterwards Drug No. of Degen
Cardiac involvement in psittacosis.
Authors: R Coll, I Horner
Journal: BMJ (1967)

Cardiac Involvement in Psittacosis Brit.med.7., 1967, 4, 35-36 Involvement of the heart during the course of psittacosis is extremely rare if one is to judge from the few reports in the literature.This prompted us to record the following case. CASE REPORTAn 18-year-old youth was admitted to hospital on 16 July 1965.Five years previously he had been in hospital because of typhoid.He said that he often caught and handled wild birds only to release them soon after.The last occasion on which he had done this was two weeks before taking ill.His illness began two weeks before admission with the appearance of severe headache and fever, the latter persisting till admission and varying between 37 and 380 C. Soon after taking ill he experienced pain in his throat and a burning sensation in the retrosternal area, which caused great difficulty in swallowing.In addition, he developed such severe pain in the muscles of both legs that he was unable to stand unassisted.On examination he appeared to be mildly ill and pale.Oral temperature was 38.8°C., blood pressure 110/80, and radial pulse 90 a minute and regular.The heart was normal in size.Neither cardiac murmurs nor a pericardial friction rub were heard.All peripheral pulses were palpable and equal.. Numerous white shallow ulcers were visible on the soft palate and on the fauces.A few ulcers were seen on the oropharynx.There was no lymphadenopathy.Lungs were clear to percussion and auscultation.The liver and spleen were not palpable.Hiscalf muscles were exquisitely tender on palpation and the slightest movement evoked severe pain.There were no signs of thrombophlebitis.Neurological examination was unrevealing.The erythrocyte sedimentation rate was 11 mm.an hour (Wintrobe), haemoglobin 12.0 g./100 ml.; leucocyte and platelet counts were normal.Blood urea, electrolytes, bilirubin, alkaline phosphatase, and aspartate aminotransferase were normal.Blood lactic dehydrogenase was 220 units (normal range 83-185), hydroxybutyric Electrocardiogram taken soon after admission.Negative T waves are seen in leads I, II, aVL, V,, and V6.dehydrogenase 198 units (normal range 55-150), and aldolase 4.2 units (normal range 2.3-6.4).Thymol turbidity, thymol flocculation, and Lugol's test were normal.Serum iron was 30 pg./100 ml.Plasma protein was 8.5 g./100 ml.(albumin 3.5 g., globulin 5 g); electrophoresis on starch gel showed slight hypergammaglobulinaemia.The Wassermann reaction was positive, but reverted to normal five weeks later.Psittacosis complement-fixation test was positive in a titre of 1:320 on 7 July, 1:480 on 25 July, 1:240 on 23 August, and 1: 160 on 9 September.Urinalysis was normal.The 24-hour urinary creatine excretion was 154 mg.
Tumors of the Pancreas
Authors: Robert E. Hermann
Journal: JAMA (1981)

This book focuses on tumors of the pancreas, both exocrine and endocrine, and is an excellent review and reference book on this subject for gastroenterologists, general internists, and surgeons. The book has been edited and is largely written by A. R. Moossa, MD, in collaboration with 27 colleagues from the University of Chicago and several other institutions. The early chapters provide excellent reviews of the surgical anatomy, cellular composition, and physiology of the exocrine and endocrine pancreas. The illustrations in these sections are excellent. There is a comprehensive review of experimental tumors of the pancreas by Pour and Wilson. Surgical pathology is well covered, in regard to both exocrine tumors and endocrine lesions.  Eight chapters are devoted to a review of diagnostic studies of pancreatic tumors, including standard radiological investigation, radioisotope scans, ultrasonography and computed tomography, endoscopic retrograde cholangiopancreatography, angiography, pancreatic function tests, secretory studies, and the value of serum
Unstable Methotrexate Resistance in Human Small-Cell Carcinoma Associated with Double Minute Chromosomes
Authors: Gregory A. Curt, Desmond N. Carney, Kenneth H. Cowan, Jacques Jolivet, Brenda D. Bailey, James C. Drake, Chien Song Kao-Shan, John D. Minna, Bruce A. Chabner
Journal: New England Journal of Medicine (1983)

Resistance to antineoplastic drugs may develop through a variety of mechanisms, including deletion of membrane-transport mechanisms, an increase in target-enzyme concentration, or a deletion of an essential drug-activating enzyme. One unique mechanism for mutation to drug resistance is amplification of the gene coding for a target protein, leading to elevated levels of the protein. In studies of cultured experimental tumor-cell lines, resistance to a variety of toxic substances, including cadmium1 and the antineoplastic drugs N-phosphonacetyl-L-aspartate2 and methotrexate,3 has been ascribed to gene amplification.The process of gene amplification in methotrexate-resistant mammalian cells may occur within a single chromosome, producing an . . .
Lead in Liverwurst
Authors: Ernist Epstein
Journal: JAMA (1975)

To the Editor.—  Hankin et al (231:484, 1975), in their discussion of lead in pet foods and processed organ meats, comment on the occurrence of lead in liverwurst and state, It is likely that lead occurs  in  They analyzed seven samples of liverwurst and found significant concentrations of lead in each. Almost as an afterthought, in their last paragraph they mention analyzing 14 additional liverwurst samples and finding these 14 to be free of lead. On the basis of these data, they suggest that lead occurs sporadically in liverwurst.  That sporadically occurring lead in liverwurst would show up in all of seven consecutive samples of a first run, and in none of 14 samples of a second analysis, suggests either a statistical miracle or faulty technique.
Link Between the Angiographic Substudy and Mortality Outcomes in a Large Randomized Trial of Myocardial Reperfusion
Authors: R.J. Simes, Eric J. Topol, David R. Holmes, Harvey D. White, Wolfgang R. Rutsch, Alec Vahanian, Maarten L. Simoons, Douglas Morris, Amadeo Betriu, Robert M. Califf, Allan M. Ross
Journal: Circulation (1995)

Background The Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries (GUSTO-I) trial was designed to test whether thrombolytic strategies achieving more complete, early, sustained coronary artery patency would lead to further reductions in mortality in patients with acute myocardial infarction. An angiographic substudy within GUSTO-I provided a unique opportunity to examine the relation between mortality and degrees of patency among the regimens. Methods and Results Four thrombolytic strategies were compared in 41 021 patients in GUSTO-I: streptokinase with subcutaneous or intravenous heparin, accelerated tissue plasminogen activator (TPA) with intravenous heparin, and combination streptokinase plus TPA with intravenous heparin. Accelerated TPA was associated with lower 30-day mortality (6.3%) than the other strategies (7.2%, 7.4%, and 7.0%, respectively). Among the 1210 patients in the angiographic substudy randomized to angiography 90 minutes after starting treatment, there was improved patency, particularly Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow, with accelerated TPA over the other regimens ( P &lt;.0001). Coronary artery perfusion (TIMI grade 3) at 90 minutes was also a significant predictor of 30-day survival ( P &lt;.01). To determine whether differences in mortality among the four strategies matched differences in 90-minute patency, a model was developed for predicting mortality differences in the main trial from the angiographic substudy. The model assumed that any differences in treatment effects on 30-day mortality were mediated through differences in 90-minute patency for the four treatments. The predicted rates were then compared with observed mortality rates of the remaining patients in the main trial for each treatment group. The predicted and observed 30-day mortality rates of the four treatments were streptokinase with subcutaneous heparin, 7.46% versus 7.28%; streptokinase with intravenous heparin, 7.26% versus 7.39%; accelerated TPA, 6.31% versus 6.37%; and streptokinase plus TPA, 6.98% versus 6.96%. The correlation between predicted and observed results was .97, and the proportion of squared error explained ( R 2 ) was .92. Conclusions The close relation between the predicted and observed 30-day mortality rates supports the concept that an important mechanism for improved survival with thrombolytic therapy is achievement of early, complete perfusion. The close match provides a strong biological explanation for the mortality differences seen in GUSTO-I and a sound rationale for the additional survival advantage of the accelerated TPA regimen. Irrespective of which treatment is used, early and complete restoration of infarct artery perfusion represents an essential goal of myocardial reperfusion therapy.
Depression is the real killer, not antidepressants, say commentators
Authors: David Spurgeon
Journal: BMJ (2007)

On 2 May the US Food and Drug Administration ordered that all antidepressants must carry an expanded black box warning about an increased risk of suicidal symptoms in young adults aged between 18 and 24 years. But the requirement poses a problem for doctors, says an article published online in the New England Journal of Medicine on 7 May.

“Whether the new warning will do more good than harm is not clear,” write Richard Friedman and Andrew Leon, both of Weill Cornell Medical College, New York (http://content.nejm.org, doi: 10.1056/NEJMp078015). “The real killer in this story is untreated depression, and the possible risk from antidepressant treatment is dwarfed by that from the disease. But clinicians still need to tell their depressed patients that some people who take antidepressants have an increase in suicidal symptoms, especially early in treatment, and …
&lt;emph type="ital"&gt;A Boy and a Girl With a Cat and an Eel&lt;/emph&gt;
Authors: Thomas B. Cole
Journal: JAMA (2009)

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TRANSCATHETER AORTIC VALVE IMPLANTATION: A SINGLE CENTER COMPARISON BETWEEN COREVALVE AND EDWARD SAPIEN BIOPROSTHESES
Authors: Eyal Ben- Assa, Yigal Abramowitz, Eran Leshem-Rubinow, Maayan Konigstein, Arie Steinvil, Arie Lorin Schwartz, Ofer Havakuk, Yaron Arbel, Lior Yankelson, amir halkin, Gad Keren, Shmuel Banai, Ariel Finkelstein
Journal: Journal of the American College of Cardiology (2014)