tbuckley/cabot-search huggingface dataset:
QL-13 * QUALITY OF LIFE AND COGNITIVE FUNCTIONING IN THE RANDOMIZED, MULTICENTER GLARIUS TRIAL INVESTIGATING BEVACIZUMAB/IRINOTECAN VS STANDARD TEMOZOLOMIDE IN NEWLY DIAGNOSED, MGMT-NON-METHYLATED GLIOBLASTOMA PATIENTS
Authors: U. Herrlinger, N. Schafer, J. Steinbach, A. Weyerbrock, P. Hau, R. Goldbrunner, R. Kohnen, H. Urbach, W. Stummer, M. Glas
Journal: Neuro-Oncology (2014)

BACKGROUND: In the GLARIUS trial, progression-free survival was significantly prolonged and overall survival was similar in both arms. The present report focuses on quality of life (QoL), Karnofsky performance score (KPS) and cognitive functioning during first-line and postprogression therapy. METHODS: Patients (n = 170) with newly diagnosed, MGMT-non-methylated glioblastoma were randomized 2:1 for bevacizumab (BEV)/irinotecan (IRI) therapy or standard temozolomide (TMZ) therapy. Every 3 months, KPS, QoL (EORTC-QLQ C30 and BN20) and cognitive functioning (MMSE) was determined. Analysis included a longitudinal mixed model analysis and a Kaplan-Meier analysis of the time to deterioration (10 points in QoL, points, 3 points in MMSE, 20% in KPS; tumor progression not regarded as an event). RESULTS: In KPS, MMSE and all 5 prespecified dimensions of QoL (global health status, physical functioning, social functioning, motor dysfunction, communication deficit) mixed model analyses and time to first deterioration analyses did not detect differences between the treatment arms. Time to deterioration of nausea/vomiting was shorter with BEV/IRI (p = 0.024). At progression, the crossover rate in the BEV/IRI arm (to TMZ) and in the standard TMZ arm (to BEV/(IRI) was identical with 65%. Time to postprogression deterioration was significantly longer in the standard TMZ arm receiving crossover BEV/(IRI) in the majority of patients regarding 13 of 26 QoL dimensions including prespecified global health status, social functioning, motor dysfunction, communication deficit. Time to postprogression deterioration was similar for MMSE, but for KPS it tended to be prolonged in the standard arm receiving crossover BEV/(IRI) (p = 0.09). CONCLUSION: Except for IRI-induced nausea/vomiting, first-line BEV/IRI therapy was not associated with any detrimental effects on QoL, performance status or cognition as compared to TMZ standard therapy. After progression, patients pretreated with TMZ in the standard arm had a prolonged stabilization of QoL in many dimensions presumably due to a high rate of crossover BEV therapy.
Doctors must put patients’ needs ahead of their personal beliefs
Authors: Clare Dyer
Journal: BMJ (2008)

Doctors must be prepared to set aside their religious and other personal beliefs if these compromise the care of patients, according to the latest ethical guidance from the UK General Medical Council.

This could include removing a Muslim doctor’s face veil if it impedes proper communication between patient and doctor, the guidance implies.

“Some patients, for example, may find that a face veil worn by their doctor presents an obstacle to effective communication and the development of trust,” it says.

“You must be prepared to respond to a patient’s individual needs and take steps to anticipate and overcome …
Possible Protective Role for C-Reactive Protein in Atherogenesis
Authors: Sucharit Bhakdi, Michael Torzewski, Kerstin Paprotka, Steffen Schmitt, Hala Barsoom, Prapat Suriyaphol, Shan-Rui Han, Karl J. Lackner, Matthias Husmann
Journal: Circulation (2004)

Background— Previous work indicated that enzymatically remodeled LDL (E-LDL) might activate complement in atherosclerotic lesions via a C-reactive protein (CRP)–dependent and CRP-independent pathway. We sought to substantiate this contention and determine whether both pathways drive the sequence to completion. Methods and Results— E-LDL was prepared by sequential treatment of LDL with a protease and cholesteryl esterase. Trypsin, proteinase K, cathepsin H, or plasmin was used with similar results. Functional tests were used to assess total complement hemolytic activity, and immunoassays were used to demonstrate C3 cleavage and to quantify C3a, C4a, C5a, and C5b-9. E-LDL preparations activated complement to completion, independent of CRP, when present above a threshold concentration (100 to 200 μg/mL in 5% serum). Below the threshold, all E-LDL preparations activated complement in dependence of CRP, but the pathway then halted before the terminal sequence. Native LDL and oxidized LDL did not activate complement under any circumstances tested. Immunohistological analyses corroborated the concept that CRP-dependent complement activation inefficiently generates C5b-9. Conclusions— Binding of CRP to E-LDL is the first trigger for complement activation in the atherosclerotic lesion, but the terminal sequence is thereby spared. This putatively protective function of CRP is overrun at higher E-LDL concentrations, so that potentially harmful C5b-9 complexes are generated.
The Low Risk of Hepatitis B in Rural Hospitals
Authors: W. Robert Lange
Journal: JAMA (1985)

To the Editor.—  The conclusions reached and recommendations made by Harris et al 1 following their seroepidemiologic survey for hepatitis B virus (HBV) markers in rural hospital personnel in Washington State are worrying. The investigators reported that only 96 (4.7% ) of 2,064 employees who volunteered to be tested had positive markers and concluded that they could not currently recommend routine vaccination of these rural hospital employees, even those with extensive exposure to blood.  When assessing the risk of HBV infection for employees in a rural hospital, what constitutes the best basis for comparison? Certainly the exposure can be compared with that of employees in an urban hospital setting, but it should also be contrasted with the background frequency of HBV infection in rural areas. Even though these background rates are not specified by the investigators, it is mentioned that the incidence of HBV reporting in the seven urban counties is
Constructing a learning portfolio
Authors: D. Brigden
Journal: BMJ (1999)

A learning portfolio is far more than a curriculum vitae. It is a dynamic and tailor made document that states experience alongside future objectives. It thus provides hard evidence that learning has taken place because it documents not only your experience but also your changing career objectives. A learning portfolio should be a personal summary of the learning events in your life. It may be formal, but it may also include diverse events from outside clinical work that have contributed to your development. The entire content of the portfolio need not be displayed at all times: components may be chosen for certain events. Such a document may be an important contribution to a record of in-training assessment (RITA)1 and may encapsulate more than any other assessment document (box).

#### Items to include in a learning portfolio

The structure of your portfolio should be clear to anyone reading it, even if …
A non-MHC locus essential for autoimmune type I diabetes in the Komeda Diabetes-Prone rat.
Authors: N Yokoi, M Kanazawa, K Kitada, A Tanaka, Y Kanazawa, S Suda, H Ito, T Serikawa, K Komeda
Journal: Journal of Clinical Investigation (1997)

The Long-Evans Tokushima Lean (LETL) rat, characterized by rapid onset of insulin-dependent (type I) diabetes mellitus (IDDM), no sex difference in the incidence of IDDM, autoimmune destruction of pancreatic beta cells, and no significant T cell lymphopenia, is a desirable animal model for human IDDM. We have established a diabetes-prone substrain of the LETL rat, named Komeda Diabetes-Prone (KDP) rat, showing a 100% development of moderate to severe insulitis within 220 d of age. The cumulative frequency of IDDM was 70% at 120 d of age, and reached 82% within 220 d of age. Here, we performed the first genome-wide scan for non-MHC IDDM susceptibility genes in this strain. The analysis of three crosses has led to the revelation of a major IDDM susceptibility gene, termed Iddm/kdp1, on rat chromosome (Chr) 11. Homozygosity for the KDP allele at this locus is shown to be essential for the development of moderate to severe insulitis and the onset of IDDM. Comparative mapping suggests that the homologues of Iddm/ kdp1 are located on human Chr 3 and mouse Chr 16 and would therefore be different from previously reported IDDM susceptibility genes.
Response of the Vascular System to Norepinephrine in Man After Oral Administration of Guanethidine.
Authors: Gerhard H. Muelheims
Journal: Annals of Internal Medicine (1964)

s1 February 1964Response of the Vascular System to Norepinephrine in Man After Oral Administration of Guanethidine.Gerhard H. Muelheims, M.D., Richard W. Entrup, M.D., Donald Paiewonsky, M.D., Donald S. Mierzwiak, M.D.Gerhard H. Muelheims, M.D.Search for more papers by this author, Richard W. Entrup, M.D.Search for more papers by this author, Donald Paiewonsky, M.D.Search for more papers by this author, Donald S. Mierzwiak, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-60-2-322_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSix healthy male subjects received a constant infusion of norepinephrine bitartrate at a concentration of 2 µg/min of the base that was then increased to 4 µg/min, 8 µg/min, 15 µg/min, and 20 µg/min. Each infusion period lasted 4 minutes. The blood pressure and electrocardiogram were determined at 2 and 4 minute intervals. The subjects then received 200 mg of guanethidine by mouth on the first day and 100 mg guanethidine on each of the 2 following days. The infusion of norepinephrine was repeated on the fourth day.The preguanethidine infusion of norepinephrine elicited in all subjects a rise in... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: St. Louis, Missouri PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1964Volume 60, Issue 2_Part_1Page: 322-322KeywordsAttentionBlood pressureElectrocardiographyMouthNorepinephrineOral administration Issue Published: 1 February 1964 PDF DownloadLoading ...
A long‐lasting third complete remission after second autologous transplant followed by maintenance treatment with rituximab in a patient with diffuse large cell non‐Hodgkin's lymphoma
Authors: Selmin Ataergin, Fikret Arpaci, Murat Beyzadeoglu, Mukerrem Safali, Ahmet Ozet
Journal: American Journal of Hematology (2006)
Economic Reform and Health — Lessons from China
Authors: William C.L. Hsiao, Yuanli Liu
Journal: New England Journal of Medicine (1996)

Recent experience in China helps to answer a global question: Does economic development necessarily improve health status, nutrition, and health care? In the late 1950s, when China was a very poor nation, it developed an innovative system of medical care. Each community or town organized funds from the government, households, and communes to finance village health stations and “barefoot doctors” to deliver preventive and basic health services to more than 90 percent of the population.1 Between 1952 and 1982, China reduced the rate of infant mortality from 250 to 40 deaths per 1000 live births, decreased the prevalence of malaria . . .
Reuse of hemodialyzers. Results of nationwide surveillance for adverse effects
Authors: M. J. Alter
Journal: JAMA (1988)

In 1986, the Centers for Disease Control, in collaboration with the Health Care Financing Administration, surveyed 1350 chronic hemodialysis centers in the United States to ascertain practices associated with the reuse of disposable hemodialyzers and the frequency of pyrogenic reactions and septicemia among patients. Reuse of hemodialyzers was reported by 63% of the centers. Centers that used RenNew-D (n = 5) for reprocessing hemodialyzers, compared with centers that did not reuse (n = 495), were more likely to report pyrogenic reactions (60% vs 13%) and episodes of septicemia (100% vs 55%) among their patients. Reusing hemodialyzers more than 20 times and, in some instances, also using manual reprocessing systems was significantly associated with clustering of pyrogenic reactions regardless of the type of germicide used. To detect membrane leaks developing after multiple reuses, air-pressure-leak tests should be performed on all reprocessed hemodialyzers.
Total anomalous pulmonary venous connection and severe pulmonic stenosis in a 52-year-old man.
Authors: J O Pastore, C W Akins, L M Zir, M J Buckley, R E Dinsmore
Journal: Circulation (1977)

Total anomalous pulmonary venous connection (TAPVC) is a rare cardiac congenital abnormality which usually results in death in infancy or early childhood. We describe a 52-year-old man with TAPVC and severe calcific pulmonic stenosis. Both diagnoses were suspected clinically and from the chest X-ray. Cardiac catheterization was confirmatory, and the patient underwent surgery. His initial postoperative course has been unremarkable. The hemodynamic factors relevant to long survival and relative freedom from symptoms in TAPVC are considered based on findings in this patient.
HPV-16-related DNA sequences in Kaposi's sarcoma
Authors: Y.Q. Huang, J.J. Li, A. Nicolaides, W.G. Zhang, A.E. Friedman-Kien, M. Jacobson, A.E. Friedman-Kien, M.G. Rush, E. Coutavas, M.A. Abbott, B.J. Poiesz
Journal: The Lancet (1992)

In the USA, Kaposi's sarcoma associated with the acquired immunodeficiency syndrome (AIDS-KS) is ten times more common in homosexual or bisexual men than in heterosexual men with AIDS. One explanation for this finding is that AIDS-KS may be caused by an infectious agent. Because there is a high incidence of human papillomavirus (HPV) infection, especially HPV-16, in homosexual men, we have sought HPV DNA sequences in Kaposi's sarcoma. We used the polymerase chain reaction with a primer pair specific for the highly conserved E6 region of HPV-16 to detect HPV-16 homologous DNA fragments in tumour tissues from 97 patients with KS and in KS-derived cell cultures. HPV DNA sequences were found in 11 of 69 KS skin tumours from homosexual men with AIDS-KS, in 3 of 11 KS biopsy specimens from homosexual men who had no clinical or laboratory evidence of HIV-infection, and in 5 of 17 KS skin lesions from HIV-1-negative elderly men and women with classic KS. The same primer pair amplified HPV-16 homologous fragments from two different continuous cell cultures derived from pleural effusion fluid of patients with pulmonary AIDS-KS and two continuous cell cultures derived from KS skin lesions. The findings suggest that HPV-16-related DNA sequences are associated with different forms of KS and may have a role in the pathogenesis of this neoplasm.
Selective autoantibody production by Yaa+ B cells in autoimmune Yaa(+)-Yaa- bone marrow chimeric mice.
Authors: R Merino, L Fossati, M Lacour, S Izui
Journal: The Journal of Experimental Medicine (1991)

The accelerated autoimmune syndrome observed in BXSB/MpJ male mice is associated with the presence on the Y chromosome of an as yet unidentified mutant gene, designated Y chromosome-linked autoimmune acceleration (Yaa). To study the mechanisms by which the Yaa gene accelerates and/or induces the production of autoantibodies, we have developed double-congenic bone marrow chimeras containing B cells from autoimmune males carrying the Yaa gene, and from nonautoimmune male or female mice lacking it and differing by the Igh allotype. The analysis of the allotype of total immunoglobulins and anti-DNA antibodies in Yaa+ male-normal female (Yaa-) chimeric mice revealed that the selective activation of B cells from autoimmune Yaa+ male mice was responsible for the hypergammaglobulinemia and autoantibody production. This phenomenon was not due to an anti-HY interaction between female T helper cells and male B cells, because first, Yaa+ B cells were selectively stimulated to produce autoantibodies in Yaa+ male-Yaa- male chimeric mice; and second, normal male and female chimeras failed to develop an autoimmune syndrome. In addition, the fact that both B cell populations in Yaa(+)-Yaa- chimeras similarly responded to a foreign antigen, human IgG, argues against the possibility that the selective activation of Yaa+ B cells may be due to their hyper-responsiveness to T helper signals. We propose that a cognate interaction of T helper cells with Yaa+ B cells, because of possible T cell recognition of a Yaa-related molecule expressed on Yaa+ B cells, may be responsible for the acceleration and/or induction of autoantibodies in BXSB/MpJ mice.
NEW MODEL OF HOME-BASED TELE-ECG-MONITORED CARDIAC REHABILITATION IN PATIENTS WITH HEART FAILURE: EFFECTIVENESS, QUALITY OF LIFE, SAFETY, AND ADHERENCE
Authors: Ewa Piotrowicz, Rafał Baranowski, Maria Bilińska, Monika Stepnowska, Małgorzata Piotrowska, Tomasz Zieliński, Ryszard Piotrowicz
Journal: Journal of the American College of Cardiology (2010)
Human cytotoxic T lymphocytes evoked by group A streptococcal M proteins.
Authors: J B Dale, E H Beachey
Journal: The Journal of Experimental Medicine (1987)

Purified group A streptococcal M proteins were used to stimulate peripheral blood lymphocytes from normal adult volunteers. The activated lymphocytes were cytotoxic against cultured human heart cells, as well as liver cells, fibroblasts, and K562 cells, but showed only minimal cytotoxicity against several animal cell types. The cytotoxic activity evoked by type 5 M protein was dose and time dependent. Rabbit antisera against pep M5 that contained heart-crossreactive antibodies partially inhibited cytotoxicity against heart cells, but had no effect on other target cells, suggesting that a fraction of the effector lymphocytes may be recognizing M protein-crossreactive cell surface antigens. All of the cytotoxic activity was recovered from a CD3+ population of lymphocytes obtained from a fluorescence-activated cell sorter, and CD4+ and CD8+ cells were also cytotoxic. M protein-responsive T cell clones were generated that showed specificity for heart and K562 cells, in addition to clones that were cytotoxic against both cell lines. Our data show that streptococcal M protein evokes cytotoxic T lymphocytes against multiple human but not animal target cells. Some of the effector cells may be specific for cultured myocardial cells, but their role in the pathogenesis of rheumatic carditis will require further studies of lymphocytes from patients with acute rheumatic fever and carditis.
Cholelithiasis in a Boy of 10 Presenting as Acute Appendicitis
Authors: P. A. Walker
Journal: BMJ (1951)

DICAL JsHRNALAureomycin capsules were administered orally in dosage of 250 mg.four times daily for seven days, and then increased to 500 mg.for a further two weeks.In all, a total of 35 g. was given in three weeks.At no time was there any objective or subjective improvement in the condi- tion.The bullae continued to form (some as large as a walnut) and became increasingly widespread.No toxic side- effects were noted apart from a feeling of warmth and excessive sweating.Aureomycin was considered to have been valueless in this case, and was discontinued.The patient was then given liquor arsenicalis, 10 min.(0.6 ml.) four times daily, and within a week her general condition had improved, the erythema lessened, and no further vesicles formed.She was discharged from hospital two weeks later with the disease apparently controlled by the arsenic.
Periampullary Diverticula Predispose to Primary rather than Secondary Stones in the Common Bile Duct
Authors: R. I. Hall, C. J. H. Ingoldby, M. E. Denyer
Journal: Endoscopy (1990)

Periampullary duodenal diverticula are known to be associated with an increased incidence of common bile duct stones. The nature of the association with gallstones remains uncertain. We have examined the incidence of periampullary diverticula and stones after cholecystectomy to determine whether the stones originate primarily in the common duct or migrate from the gallbladder under the influence of abnormal biliary motility. Six hundred and forty-one patients undergoing ERCP were studied. Ninety-five patients had diverticula (14.8%). Diverticula occurred more commonly in jaundiced patients, 47/95, (48.4%) than in patients with normal bilirubin 185/546 (33.8%) (p less than 0.01). Common duct stones were associated with the presence of a diverticulum in 41/95 patients (43%), compared with only 98/546 without a diverticulum (18%) (p less than 0.001). There was no difference in the incidence of common duct stones in association with a diverticulum between those who had had a cholecystectomy 20/41, and those with intact gallbladders, 21/54 (N.S.). Thus the absence of a gallbladder did not alter the high incidence of common duct stones. We conclude that the stones in the common duct are most likely to be primary stones which have formed as a result of periampullary dysfunction.
Book Review The Illusion of Certainty: Health Benefits and Risks By Erik Rifkin and Edward Bouwer. 239 pp., illustrated. New York, Springer, 2007. $79.95 (cloth); $29.95 (paper). 978-0-387-48570-6 (cloth); 978-0-387-75165-8 (paper).
Authors: Marjo-Riitta Jarvelin
Journal: New England Journal of Medicine (2008)
Oxidant injury of caucasian glucose-6-phosphate dehydrogenase—deficient red blood cells by phagocytosing leukocytes during infection
Authors: Robert L. Baehner, David G. Nathan, William B. Castle
Journal: Journal of Clinical Investigation (1971)

Patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency of red blood cells (RBC) may develop sudden hemolytic anemia during infection. Since phagocytizing polymorphonuclear leukocytes (PMN) are known to generate hydrogen peroxide, we explored the influence of this oxidant product of PMN on juxtaposed G6PD-deficient and normal RBC. The oxidant stress induced by phagocytosis depleted G6PD-deficient RBC of reduced glutathione (GSH) and this was associated with rapid removal of these cells from the circulation by the liver and spleen. No such effect was observed on normal RBC. Phagocytizing chronic granulomatous disease (CGD) PMN which lack hydrogen peroxide generation, failed to diminish GSH level in G6PD-deficient RBC. Thus, PMN can pose as a source of oxidant damage to G6PD-deficient RBC due to hydrogen peroxide generated during phagocytosis.
CXCR2 mediates NADPH oxidase–independent neutrophil extracellular trap formation in cystic fibrosis airway inflammation
Authors: Veronica Marcos, Zhe Zhou, Ali Önder Yildirim, Alexander Bohla, Andreas Hector, Ljubomir Vitkov, Eva-Maria Wiedenbauer, Wolf Dietrich Krautgartner, Walter Stoiber, Bernd H Belohradsky, Nikolaus Rieber, Michael Kormann, Barbara Koller, Adelbert Roscher, Dirk Roos, Matthias Griese, Oliver Eickelberg, Gerd Döring, Marcus A Mall, Dominik Hartl
Journal: Nature Medicine (2010)
PROPERTIES OF PNEUMONIA VIRUS OF MICE (PVM) IN RELATION TO ITS STATE
Authors: Edward C. Curnen, Frank L. Horsfall
Journal: The Journal of Experimental Medicine (1947)

Additional evidence is presented that PVM is capable of combining firmly with lung tissue particles or erythrocytes from certain susceptible species. Release of the virus from such combination can be effected by treatment with alkali as well as by heating. Free virus expressed from infected lungs without grinding the tissues is infectious and causes hemagglutination when tested directly. The concentration of virus can be estimated more accurately by means of the hemagglutination technique than from the results of infectivity tests in mice. Present evidence indicates that PVM may occur in 4 different states and that in each state it manifests distinctive properties.