tbuckley/cabot-search huggingface dataset:
Changes in macrophage function after rituximab treatment in patients with rheumatoid arthritis
Authors: E Toubi, A Kessel, G Slobodin, N Boulman, E Pavlotzky, D Zisman, M Rozenbaum, I Rosner
Journal: Annals of the Rheumatic Diseases (2006)

To assess changes in macrophage phenotype and function after rituximab-induced B cell depletion in patients with rheumatoid arthritis (RA).10 patients with RA were treated with rituximab, achieving significant B cell depletion 4 months later. Clinical improvement, rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) antibodies, mRNA of B cell activating factor (BAFF), interleukin (IL) 10 and CD86 in human monocyte-derived macrophages (HMDMs) and tumour necrosis factor alpha (TNFalpha) secretion from cultured HMDMs were assessed at baseline and after the depletion.A clinical response of American College of Rheumatology (ACR) 50% improvement was noted in six patients, and another two patients responded with moderate improvement, equivalent to ACR 20-50% improvements. RF and anti-CCP antibodies were positive at baseline in seven of ten patients. RF disappeared or declined in six patients 4 months after treatment, correlating with clinical improvement. By contrast, anti-CCP remained unchanged in six patients. After rituximab treatment, and in association with clinical improvement, BAFF, IL10 and CD86 mRNA expression in HMDM were significantly upregulated compared with values at baseline. A significant decrease in TNFalpha in the supernatant of cultured HMDM was also noted.In addition to B cell depletion and attenuation in some of the specific autoantibodies, clinical improvement in rituximab-treated patients with RA occurred in association with changes in macrophage function.
Patient Willingness to Be Seen by Physician Assistants, Nurse Practitioners, and Residents in the Emergency Department: Does the Presumption of Assent Have an Empirical Basis?
Authors: Gregory L. Larkin, Roderick S. Hooker
Journal: The American Journal of Bioethics (2010)

Abstract Physician assistants (PAs), nurse practitioners (NPs), and medical residents constitute an increasingly significant part of the American health care workforce, yet patient assent to be seen by nonphysicians is only presumed and seldom sought. In order to assess the willingness of patients to receive medical care provided by nonphysicians, we administered provider preference surveys to a random sample of patients attending three emergency departments (EDs). Concurrently, a survey was sent to a random selection of ED residents and PAs. All respondents were to assume the role of patient when presented with hypothetical clinical scenarios and standardized provider definitions. Despite presumptions to the contrary, ED patients are generally unwilling to be seen by PAs, NPs, and residents. While seldom asked in practice, 79.5% of patients fully expect to see a physician regardless of acuity or potential for cost savings by seeing another provider. Patients are more willing to see residents than nonphysicians. Keywords: health care deliveryinformed consentprofessional–patient relationshipright to health care Notes *Indicates patient/resident comparison (difference of proportions), p < .05. **Indicates patient/PA comparison (difference of proportions), p < .05.
Diagnosis of Acanthamoeba infection by cutaneous manifestations in a man seropositive to HIV
Authors: Lewis Pete May, Gurdip S. Sidhu, Mary Ruth Buchness
Journal: Journal of the American Academy of Dermatology (1992)

Cutaneous aeanthamoebiasis 355is susceptible to amphotericin B, whereas Acan.thamoeba is resistant.l~Acanthamoeba is susceptible to ketoconazole in vitro but not in vivo.Sulfadiazine, flucytosine, pentamidine, and polymyxin-B may have an effect in vitro on some of the Acantharnoeba species but have not been adequately tested in patients, t ~, 12
Energy requirement for defibrillation of a markedly overweight patient.
Authors: R A DeSilva, B Lown
Journal: Circulation (1978)

Recommendations have been made recently that the energy output of present-day defibrillators be increased above the 400 wsec limit. These recommendations are based largely on experimental studies in animals. We report a case of a man weighing 190.1 kg (418.2 lb), successfully resuscitated with a single 400 wsec shock after a prolonged episode of ventricular fibrillation. The observation in this patient as well as data derived from cardiovascular experience indicates that weight is not a significant factor in the successful outcome following defibrillation in adults. Many variables primarily related to the clinical condition of the heart influence the results of countershock. There are no valid studies at present to support the claim that high-energy defibrillators are necessary. In fact, implementation of such a recommendation is premature and possibly dangerous.
Generosity after tsunami could threaten neglected crises
Authors: Peter Moszynski
Journal: BMJ (2005)

The billions of dollars pledged to help reconstruction after the tsunami shows “humanity at its very best,” said Jan Egeland, United Nations under secretary general for humanitarian affairs, in Geneva last week at the launch of the UN's annual humanitarian appeal process.

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People in Nagapattinam, Tamil Nadu, clamour for food aid being distributed after the tsunami

Credit: DIETER TELEMANS/PANOS

But he urged donors not to divert funds from other crises. “It would be the ultimate disappointment for us,” he said, “and tragedy for the victims in all those other areas where we are struggling to …

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Abstract 1240: Bioactive proanthocyanidins from grape seeds inhibit cigarette smoke condensate-enhanced invasion of human non-small cell lung cancer cells by targeting NADPH oxidase and epithelial-mesenchymal transition
Authors: Mudit Vaid, Santosh K. Katiyar
Journal: Cancer Research (2014)

Abstract Lung cancer is the leading cause of cancer-related deaths in the United States, and the dismal 5-year survival rate of approximately 14% has shown no improvement over the past three decades. Cigarette smoke (CS) is the cause of ∼90% of lung cancer cases, and promotes drug resistance in lung cancer patients and is even known to limit effectiveness of treatment of cancers of other organs. It is therefore important to develop more effective strategies targeting CS-induced molecular abnormalities. Cigarette smoking increases oxidative stress particularly via activation of NADPH oxidase (NOX), a key source of superoxide anion production. Here we report the inhibitory effects of bioactive phytochemicals, grape seed proanthocyanidins (GSPs), on the migration potential of human non-small cell lung cancer (NSCLC) cells (A549, H460 and H1299) and assessed whether CS-induced NOX activation is their target. Using an in vitro invasion assay, we found that treatment of NSCLC cells with CS condensate (CSC) increased the migration of NSCLC cells in a dose-dependent manner, via enhancing NOX mediated-reactive oxygen species (ROS) accumulation. Treatment of NSCLC cells with GSPs inhibited the cell migration via reduction in ROS accumulation or oxidative stress and subsequent reduction of epithelial-to-mesenchymal transition. To examine the molecular targets of GSPs, we studied the effect of GSPs on CSC-induced alterations in the levels of key NOX components, namely, p22phox and p47phox, using A549 cells. We also determined the effect of GSPs on CSC-induced interaction between p22phox and p47phox proteins, a key event in NOX activation. Our results indicate that treatment of A549 cells with GSPs not only reverse CSC-induced expression levels of p22phox and p47phox, but also inhibit CSC-induced NOX activation by decreasing the binding of p22phox and p47phox proteins. This new insight into the anti-lung cancer cell migration activity of GSPs could serve as a basis for chemoprevention or therapy of advanced stage of lung cancer in human patients. Citation Format: Mudit Vaid, Santosh K. Katiyar. Bioactive proanthocyanidins from grape seeds inhibit cigarette smoke condensate-enhanced invasion of human non-small cell lung cancer cells by targeting NADPH oxidase and epithelial-mesenchymal transition. [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 1240. doi:10.1158/1538-7445.AM2014-1240
Effects of hydralazine on coronary blood flow and myocardial energetics in congestive heart failure.
Authors: R D Magorien, G P Brown, D V Unverferth, S Nelson, H Boudoulas, D Bambach, C V Leier
Journal: Circulation (1982)

The acute effects of oral hydralazine, 1 mg/kg, on coronary vascular resistance, coronary blood flow (estimated using the coronary sinus thermodilution technique), and myocardial oxygen consumption were evaluated in 10 patients with chronic (New York Heart Association class III and IV) nonischemic congestive heart failure. Central hemodynamic responses demonstrated a modest decrease in mean arterial pressure, pulmonary capillary wedge pressure and systemic vascular resistance (12%, 15% and 29%, respectively), while the cardiac index increased from 2.3 +/- 0.1 to 3.1 +/- 0.3 and left ventricular stroke work index from 24 +/- 3.7 to 28 +/- 3.4 (p less than 0.01). Heart rate and diastolic filling time did not change. Coronary blood flow increased approximately 50%, from 144 +/- 17 to 218 +/- 30 ml/min, and coronary vascular resistance decreased from 0.55 +/- 0.09 to 0.36 +/- 0.08 mm Hg/ml/min (both p less than 0.01). Oral hydralazine increased myocardial oxygen consumption by 33%, from 15 +/- 1.6 to 20 +/- 2.7 ml/min. Despite this moderate augmentation in myocardial oxygen consumption, the arterial-coronary sinus oxygen difference decreased from 104 +/- 6.2 to 94 +/- 7.5 and the myocardial oxygen extraction ratio decreased from 71% to 64% (both p less than 0.05). The ratio of coronary vascular resistance to systemic vascular resistance decreased with hydralazine therapy, while coronary blood flow increased from 3.5% to 4.3 % of total cardiac output. In this group of patients with nonischemic cardiomyopathy, hydralazine had a favorable effect on the coronary circulation and improved the critical myocardial oxygen supply-demand ratio.
Multiple coronary arterioventricular fistulae.
Authors: A G Rose
Journal: Circulation (1978)

A 62-year-old man who died suddenly was found at autopsy to have multiple coronary arteriosystemic fistulae involving all three major coronary arteries and both ventricles. This is the second such case reported and the first with biventricular involvement and autopsy findings. A congenital bicuspid valve was also present. Numerous small blood vessels opened onto the endocardial surface of both ventricles and there were microscopic foci of persistent embryonic spongy myocardium.
Humoral Hypercalcemia of Cancer
Authors: Jeffrey S. Flier, Lisa H. Underhill, Arthur E. Broadus, Marguerite Mangin, Kyoji Ikeda, Karl L. Insogna, Eleanor C. Weir, William J. Burtis, Andrew F. Stewart
Journal: New England Journal of Medicine (1988)

THE syndrome of humoral hypercalcemia of cancer was first described by Fuller Albright in 1941.1 When a patient's hypercalcemia and hypophosphatemia resolved after the radiation of a single bone metastasis from a renal carcinoma, Albright proposed that the tumor was secreting parathyroid hormone or a peptide with similar actions.Interest in this syndrome has persisted, and has become particularly intense during the past decade. In the past six months, three groups have isolated and partially sequenced the amino terminus of a parathyroid hormone-like peptide obtained from four different tumors associated with humoral hypercalcemia of cancer,2 3 4 5 and two groups have identified . . .
Series coupled non-contractile elements are functionally unimportant in the isolated heart
Authors: K. B Campbell, R. D Kirkpatrick, A. H Tobias, H. Taheri, S. G Shroff
Journal: Cardiovascular Research (1994)

Objective: In order to evaluate possible artefact in interpretations of contractile behaviour in isolated heart experiments, the relative elastances of series coupled non-contractile and contractile components of the left ventricle of the isolated heart were evaluated. Methods: Hearts were isolated from ferrets and rabbits and mounted on a servo-controlled volume regulation device. These hearts were made to beat isovolumetrically until a selected volume perturbation was introduced. Constant flow volume withdrawals at two flow values were performed over a period of <20 ms centred around the time of peak isovolumetric pressure. Three levels of isovolumetric pressure were produced using basal, extrasystolic, and potentiated beats. Pressure responses to volume withdrawals at two flows and three isovolumetric pressures were then analysed using a mathematical model to evaluate relative values of series coupled contractile and non-contractile elastances. To validate the analysis procedure, a non-contractile series artefact with known elastance was coupled to the left ventricle; volume perturbations were then applied to the coupled left ventricle-artefact system; responses were analysed and the estimate of series coupled non-contractile elastance was compared to the known elastance of the added artefact. Results: A wide range of isovolumetric pressures [208(SD 40) mm Hg] was produced in the ferret with basal, extrasystolic, and potentiated beats. A lesser range of isovolumetric pressures [50(15) mm Hg] was produced in the rabbit. The mathematical model fitted the data very well in both the ferret and rabbit. The elastance of the series coupled non-contractile component could be estimated only in some ferrets. When estimated in the ferret, the elastance of the series coupled non-contractile component was never less than 4× that of the contractile component. When a series artefact of sufficiently low value was coupled with the native left ventricle, the elastance of the non-contractile component could be reliably estimated in both ferrets and rabbits and the estimated value approximated that of the added artefact. This indicated that the elastance of the series coupled non-contractile component of the native left ventricle was much higher than that of the added artefact. Conclusions: The series coupled non-contractile component of the isolated heart possesses a very much higher elastance than the contractile component. In fact, the elastance of the non-contractile component is so great that it contributes very little to the dynamic behaviour of the left ventricle. Virtually all of the elastance of the left ventricle of the isolated heart is due to the contractile component. Cardiovascular Research 1994;28:242-251
Salicylate Accumulation Kinetics in Man
Authors: Gerhard Levy, Tamehiro Tsuchiya
Journal: New England Journal of Medicine (1972)

Abstract The plateau level of salicylate in the body attained by repetitive administration of fixed doses of aspirin or sodium salicylate at constant intervals increases more than proportionately with increasing dosages. The time required to attain the plateau increases with increasing dose. These unusual accumulation characteristics account for the pronounced effects of relatively small changes in maintenance dosage on salicylate concentrations in body fluids and on the pharmacologic effects of this drug. It is thus important to make upward adjustments of dosage cautiously, allowing sufficient time for body levels to reach the new steady state before the dosage is increased still further.
Prevention of coronary artery reocclusion and reduction in late coronary artery stenosis after thrombolytic therapy in patients with acute myocardial infarction. A randomized study of maintenance infusion of recombinant human tissue-type plasminogen activator.
Authors: J A Johns, H K Gold, R C Leinbach, T Yasuda, L W Gimple, W Werner, D Finkelstein, J Newell, A A Ziskind, D Collen
Journal: Circulation (1988)

Sixty-eight patients with acute "transmural" myocardial infarction presenting within 6 hours (range, 1.3-5.8 hours) of onset of chest pain were given intravenous recombinant tissue-type plasminogen activator (rt-PA) at a dosage of 1 mg/kg during 90 minutes. Coronary angiography at 90 minutes revealed a patent infarct-related coronary artery in 52 patients (76%). These patients were randomized either to treatment by continuous infusion of heparin alone (27 patients) or to treatment by heparin and a maintenance infusion of rt-PA at a dosage of 0.8 mg/kg during 4 hours (25 patients). Coronary angiography was repeated 60 minutes after the start of the maintenance infusion and again after 8-14 days. Acute symptomatic reocclusion of the infarct-related artery occurred during the 1-hour observation period in five (19%) patients treated with heparin alone but in none of the patients treated with rt-PA (p = 0.05). The measured residual stenosis of the patent infarct-related coronary artery was similar in the heparin-treated and the rt-PA-treated groups at 90 minutes infusion: 66 +/- 14% versus 68 +/- 13% diameter stenosis, respectively (mean +/- SD) and 1.1 +/- 1.1 mm2 versus 0.82 +/- 0.7 mm2 area (p = 0.35). At 8-14 days after infusion, residual stenosis was unchanged in the heparin-treated group, but it improved to 55 +/- 17% (p = 0.001) and 1.6 +/- 1.2 mm2 (p = 0.003) in the rt-PA-treated group. At 90 minutes of infusion, residual intraluminal thrombus was observed in 29 of the 52 patients (56%) with a comparably measured distribution in the two groups (p = 0.43). At 150 minutes, however, the extent of intraluminal thrombus was significantly reduced in the rt-PA-treated group as compared with the heparin-treated group (p = 0.03). In-hospital ischemic events (symptomatic reocclusion, unstable angina, or cardiovascular death) occurred in 12 patients of the heparin-treated group but only in three patients of the rt-PA-treated group (p = 0.03). Fibrinogen levels decreased to 65 +/- 21% of baseline at 90 minutes of rt-PA infusion. During the rt-PA maintenance infusion, fibrinogen fell slightly from 63 +/- 26 to 57 +/- 28% (p = 0.18). This study shows that after successful reperfusion with 1 mg/kg rt-PA during 90 minutes, a maintenance infusion of 0.8 mg/kg rt-PA during 4 hours prevents acute symptomatic coronary artery reocclusion, and it reduces the frequency of ischemic events and the severity of residual coronary artery stenosis at hospital discharge.
Jack Stanley Gibson
Authors: S C Kohli, Andrew Gibb
Journal: BMJ (2005)

The Irish surgeon Jack Gibson believed in the power of the mind above all else and pioneered the use of hypnosis in surgery for over 40 years. He claimed to have performed more than 4000 procedures without anaesthesia (www.drjackgibson.com/biography.html) and he inspired several generations of doctors to take up the practice of hypnosis, both in surgery and in treating psychosomatic disorders or disease. He also claimed to have cured himself of basal cell cancer and chronic varicose veins through self hypnosis.

Jack produced a series of gramophone records, cassette tapes, and CDs from 1965 onwards, dealing with psychosomatic disorders and based on self hypnosis. One of these, How to Stop Smoking, became the best selling LP in Ireland in 1971. He also produced a video entitled The Power of the Subconscious, showing himself performing eye surgery under hypnosis in the 1960s, and he published three books: The Life and Times of an Irish Hypnotherapist ( 1989), Relax and Live ( 1992), and Memoirs of an Irish Surgeon—An Enchanted Life ( 1999).

Jack Gibson was a short, balding dynamo of a man, once a James Mason lookalike, but latterly closer to Nelson Mandela with Ghandi's beautiful smile. He was a walking contradiction who was the bane of many a hospital hierarchy or high court judge: he was alternative yet conventional, a rebellious yet establishment figure, informal yet intense, self mocking yet proud.

After qualifying in 1933 and becoming a fellow of the Royal College of Surgeons of Ireland in 1934, he did locums in Aden, Malawi, and South Africa. In 1939 he became dean of the Medical Aids School (later known as the Durban Medical School). During the second world war Jack worked for the Emergency Medical Service in Newcastle, Liverpool, and Weymouth, treating soldiers wounded at Dunkirk and during D Day.

Jack returned to South Africa, working at the Brakepan Hospital and as a general practitioner in 1946-9, and then came back north to Guernsey in 1950. He returned to Africa as a surgeon at the Haile Selassie Hospital, Ethiopia, in 1959, and finally returned to his native Ireland as resident surgical officer at Dr Steeven's Hospital, in Dublin, later that year. He also had a long career as an expert medical witness.

He leaves two grandchildren and two great grandchildren.

Jack Stanley Gibson, surgeon and hypnotherapist Naas, County Kildare, Ireland (b 1909; q 1933; FRCSI, DTM&H), d 2 April 2005.
Withdrawing performance indicators: retrospective analysis of general practice performance under UK Quality and Outcomes Framework
Authors: E. Kontopantelis, D. Springate, D. Reeves, D. M. Ashcroft, J. M. Valderas, T. Doran
Journal: BMJ (2014)

<b>Objectives</b> To investigate the effect of withdrawing incentives on recorded quality of care, in the context of the UK Quality and Outcomes Framework pay for performance scheme. <b>Design</b> Retrospective longitudinal study. <b>Setting</b> Data for 644 general practices, from 2004/05 to 2011/12, extracted from the Clinical Practice Research Datalink. <b>Participants</b> All patients registered with any of the practices over the study period—13 772 992 in total. <b>Intervention</b> Removal of financial incentives for aspects of care for patients with asthma, coronary heart disease, diabetes, stroke, and psychosis. <b>Main outcome measures</b> Performance on eight clinical quality indicators withdrawn from a national incentive scheme: influenza immunisation (asthma) and lithium treatment monitoring (psychosis), removed in April 2006; blood pressure monitoring (coronary heart disease, diabetes, stroke), cholesterol concentration monitoring (coronary heart disease, diabetes), and blood glucose monitoring (diabetes), removed in April 2011. Multilevel mixed effects multiple linear regression models were used to quantify the effect of incentive withdrawal. <b>Results</b> Mean levels of performance were generally stable after the removal of the incentives, in both the short and long term. For the two indicators removed in April 2006, levels in 2011/12 were very close to 2005/06 levels, although a small but statistically significant drop was estimated for influenza immunisation. For five of the six indicators withdrawn from April 2011, no significant effect on performance was seen following removal and differences between predicted and observed scores were small. Performance on related outcome indicators retained in the scheme (such as blood pressure control) was generally unaffected. <b>Conclusions</b> Following the removal of incentives, levels of performance across a range of clinical activities generally remained stable. This indicates that health benefits from incentive schemes can potentially be increased by periodically replacing existing indicators with new indicators relating to alternative aspects of care. However, all aspects of care investigated remained indirectly or partly incentivised in other indicators, and further work is needed to assess the generalisability of the findings when incentives are fully withdrawn.