tbuckley/cabot-search huggingface dataset:
Azathioprine/allopurinol co-therapy is an effective treatment for patients with inflammatory bowel disease who exhibit no response or side-effects to thiopurines without the need for metabolite level measurements
Authors: P. Stamoulos, A. Ansari, J. Stenner, G. Mackenzie, H. McSorley
Journal: Gut (2011)

<h3>Introduction</h3> In Inflammatory bowel disease (IBD) lack of response or side effects to thiopurines (TP: azathioprine and mercaptopurine) are common (30–50%) and frequently necessitate surgery or use of biologic agents (£10 000–15 000/patient/year). It is assumed that low dose thiopurine with allopurinol co-therapy (LD TP+ALLO) requires prior measurements of metabolites. This assumption restricts the use of ALLO to a group of patients with specific metabolite profiles. The authors report a single centre outcome of using LD TP+ALLO in patients with poor response or side effects to thiopurines without prior metabolite monitoring. <h3>Methods</h3> Consecutive IBD patients with poor response or side effects were given low dose LD TP+ALLO. The TP dose was reduced to 25–33% of the thiopurine methyl transferase adjusted dose followed by conventional blood monitoring. Patients were considered as full responders if Harvey Bradshaw Score fell to or below 3 or Truelove-Witts score was normal. In addition they should be free of biologics, steroids or calcineurin inhibitors for greater than 3 months. <h3>Results</h3> 47 individuals with IBD (21 had Crohn9s disease) were identified. 31 were female and the median group age was 37 years. 25 patients had poor response to TP. The median follow-up period was 12 months (minimum 6 and maximum 18 months). Full response was seen in 73% of non-responders; in this group the median 6 thioguanine level was 425 and the median methylmercaptopurine level was 112. Of those with prior toxicity to thiopurines, 70% responded to the co-therapy, including two with dose dependent neutropenia. Three patients developed myelotoxicity after 12 weeks of ALLO treatment which was improved by simple dose reduction of the TP. <h3>Conclusion</h3> This study demonstrates that LD TP+ALLO is safe, effective and well tolerated in patients with side effects or poor response to full dose TP. Careful monitoring detects myelotoxicity. Furthermore this data suggests that metabolite level measurements are not necessary prior to initiation of co-therapy, expanding its application in IBD. This approach has the potential of improving medical and economic outcomes by reducing costs from biologics, hospitalisations and surgeries.
Symptom Trends in the Last Year of Life From 1998 to 2010
Authors: Adam E. Singer, Daniella Meeker, Joan M. Teno, Joanne Lynn, June R. Lunney, Karl A. Lorenz
Journal: Annals of Internal Medicine (2015)

Calls for improvement in end-of-life care have focused attention on the management of pain and other troubling symptoms at the end of life. To describe changes in pain intensity and symptom prevalence during the last year of life from 1998 to 2010. Observational study. The HRS (Health and Retirement Study), a nationally representative longitudinal survey of community-dwelling U.S. residents aged 51 years or older. 7204 HRS participants who died while enrolled in the study and their family respondents. Proxy-reported pain during the last year of life and other symptoms for at least 1 month during the last year of life. Trends in pain intensity and symptom prevalence were analyzed for all decedents and within the categories of sudden death, cancer, congestive heart failure or chronic lung disease, and frailty. Between 1998 and 2010, proxy reports of the prevalence of any pain increased for all decedents from 54.3% (95% CI, 51.6% to 57.1%) to 60.8% (CI, 58.2% to 63.4%), an increase of 11.9% (CI, 3.1% to 21.4%). Reported prevalences of depression and periodic confusion also increased for all decedents by 26.6% (CI, 14.5% to 40.1%) and 31.3% (CI, 18.6% to 45.1%), respectively. Individual symptoms increased in prevalence among specific decedent categories, except in cancer, which showed no significant changes. The prevalence of moderate or severe pain did not change among all decedents or in any specific decedent category. Use of proxy reports and limited information about some patient and surrogate variables. Despite national efforts to improve end-of-life care, proxy reports of pain and other alarming symptoms in the last year of life increased from 1998 to 2010. National Institute of Nursing Research.
Serum transferrin receptor as a marker of erythropoiesis suppression in patients on chronic transfusion
Authors: Jakica Tancabelic, Sujit Sheth, Myunghee Paik, Sergio Piomelli
Journal: American Journal of Hematology (1999)

In the management of patients requiring chronic transfusion, various parameters may be used to evaluate the degree of erythroid marrow suppression. The aim of our study was to assess which of these parameters provide the most useful assessment of erythropoiesis. We studied 27 chronically transfused patients, 19 with sickle cell disease (SS patients) and 8 with thalassemia. Thirty-one nonchronically transfused SS patients and 74 healthy children served as controls. We measured serum transferrin receptor levels, reticulocyte counts, hemoglobin (Hb) concentrations and erythropoietin levels. The serum transferrin receptor levels were very elevated in control SS patients and remained significantly elevated in those on transfusion therapy, but were normal in thalassemia patients, indicating a more complete suppression of erythropoiesis. The reticulocyte counts were elevated in all SS patients, even when on chronic transfusion, but were in the normal range in patients with thalassemia. Erythropoietin levels were elevated in patients with thalassemia and in all the SS patients. Hb levels negatively correlated with serum transferrin receptor and erythropoietin in all SS patients. In the transfused SS patients, a higher HbS level correlated with higher reticulocyte counts, transferrin receptor, and erythropoietin levels. In thalassemia patients, erythropoiesis was more completely suppressed, as reflected both by normal reticulocyte counts and near-normal transferrin receptor levels. Though the reticulocyte counts were not significantly different in the transfused SS patients, the serum transferrin receptor levels were less elevated than in SS patients not on transfusion. The serum transferrin receptor level appears to be the most useful marker of marrow erythropoietic activity in chronically transfused SS patients. We recommend that reticulocyte counts be integrated with periodic measurements of serum transferrin receptor levels. Am. J. Hematol. 60:121–125, 1999. © 1999 Wiley-Liss, Inc.
Diabetes in prison: can good diabetic care be achieved?
Authors: I. A. MacFarlane, G. V. Gill, E. Masson, N. H. Tucker
Journal: BMJ (1992)

To investigate the clinical characteristics and metabolic control of diabetic patients given structured diabetic care in prison.Survey of diabetic men serving prison sentences during a 22 month period in a large British prison.HM Prison, Walton, Liverpool.42 male diabetic prisoners, of whom 23 had insulin dependent and 19 non-insulin dependent diabetes.Episodes of diabetic instability, glycated haemoglobin concentrations, body mass index.No serious diabetic instability occurred. Between the initial assessment by the visiting consultant diabetologist and a second assessment 10 weeks later glycated haemoglobin concentrations had fallen from 10.8 (SD 2.9)% to 9.8 (2.4)% (p less than 0.05) in prisoners with insulin dependent diabetes and from 8.7 (1.9)% to 7.6 (1.2)% (p less than 0.05) in those with non-insulin dependent diabetes. Good glycaemic control continued, a mean glycated haemoglobin concentration of 7.6 (1.5)% being recorded in seven men remaining in prison for six to 18 months. Mean body mass index (weight (kg)/(height(m))2) did not change during the study (insulin dependent prisoners 23.3 (SD 2.1), non-insulin dependent prisoners 27.9 (3.8)).Good diabetic metabolic control is usual in prison, probably due to the rigid dietary regimen, no alcohol, and compliance with treatment. Many younger men had defaulted from their home diabetic clinics, and imprisonment allowed screening for diabetic complications and reassessment of treatment. Structured diabetic care should be offered in all prisons.
Comment: Early Detection
Authors: Philip Rubin
Journal: JAMA (1974)

EARLY detection must be distinguished from early cancer because cure is feasible only when early detection results in a diagnosis of cancer in its superficial and localized state. It is unfortunate that most malignant neoplasms are discovered in the upper portion of the alimentary tract (ie, stomach and esophagus) are advanced and remain highly lethal. The term early gastric cancer implies a 60% to 95% curability rate by means of gastric resection; the resection of a gastric cancer generally provides 20% to 40% of patients with long-term survival. As statistical studies have shown, the incidence of stomach cancer has declined, but the death rate is unaltered.<sup>1</sup>The accessibility of the upper gastrointestinal tract and the existence of techniques for evaluation of its mucosal surface make this site a unique challenge. It is time to reassess seriously the science of early detection, particularly with the achievements of the Japanese medical
TCT-669 Incidence and Correlates of Stent Thrombosis up to 10 Years After Drug-Eluting Stent Implantation in Daily Clinical Practice
Authors: Ricardo Costa, Amanda Sousa, Jose Costa, Adriana Moreira, Galo Maldonado, Manuel Cano, Bruno Palmieri, cantidio campos neto, Fausto Feres, Alexandre Abizaid, J. Eduardo Sousa
Journal: Journal of the American College of Cardiology (2012)
Quantification of muscle fatigue--an overview
Authors: Vivian H. Heyward
Journal: British Journal of Sports Medicine (1973)

In the past twenty years, physical educators, physiologists and psychologists have utilized a variety of methods and techniques for the quantification of muscle fatigue.The purpose of these methods is not merely to quantify muscle fatigue, but to assess the physiological status of muscle tissue in order to facilitate a greater understanding of the physiological mechanisms underlying muscle fatigue.Force-time Curve.The force-time curve is a sigmoid shaped curve representing the static force produced by the muscle over a period of time.Information regarding the peak force, time to maximum force, and maximum rate of force production are easily obtained from the records.In addition, the area beneath the curve or integrated force-time curve provides information concerning the total force exerted for a given period of time.This parameter is useful for determining the absolute muscular endurance.
Embalming Before Autopsy
Authors: John G. Gruhn
Journal: JAMA (1964)

<h3>To the Editor:—</h3> I have published several autopsy studies which illustrate the importance of microbiological tests at autopsy. These include papers on pyogenic liver abscesses (<i>Amer J Path</i><b>44</b>:36a [June] 1964), spontaneous endogenous clostridial septicemia (<i>Chicago Med Sch Quart</i><b>24</b>:12, 1964), pseudomembranous enterocolitis (<i>Amer J Surg</i><b>106</b>:966 [Dec] 1963), myocardial abscesses (<i>Amer Heart J</i><b>66</b>:301 [Sept] 1963), and mycotic infections in leukemic patients at autopsy (<i>Cancer</i><b>16</b>:61 [Jan] 1963). Please note that in both letters the writers concede that valid bacteriological and chemical studies and certain histochemical tests cannot be done on embalmed bodies. I am not able to determine which cases will require such studies until the autopsy is in progress. Morticians are not necessarily pleased by the prospect of returning bodies to the hospital after embalming, nor are they usually pleased to send an embalmer to the hospital prior to autopsy. I agree
CHRONIC ACETANILID POISONING.REPORT OF TWO ADDITIONAL CASES.
Authors: ALFRED STENGEL
Journal: JAMA (1905)

Chronic acetanilid poisoning is probably very much more frequent than the medical profession appreciates, for the reason that the symptoms may be comparatively inconspicuous. The drug in its pure form or in various proprietary combinations is so easily obtained that its indiscriminate use has naturally resulted. A very striking case came under my observation three years ago and was reported by myself and Dr. C. Y. White; since that time two additional cases have been under my care: one, a private patient, was sent to me by a medical friend on account of obscure symptoms, which proved to be the result of chronic acetanilid poisoning; the other, a hospital patient with rather more marked symptoms, was referred to me on account of other conditions. <h3>Case 1.</h3> —Mr. W. C. H., aged 38, a merchant, consulted me in July, 1902, on account of increasing weakness, nervousness and slight shortness of breath.
A heat-killed preparation of mycobacterium obuense can reduce metastatic burden in vivo
Authors: Daniel Fowler, Angus Dalgleish, Wai Liu
Journal: Journal for ImmunoTherapy of Cancer (2014)

Meeting abstracts Immune deficiency has recently been identified as one of the hallmarks of cancer, and as such, strategies that rectify this are therapeutically attractive. A potential immunotherapy is IMM-101, which is a suspension of heat-killed Mycobacterium obuense that has recently undergone
The Problem and Sociocultural Context of Single-Cigarette Sales
Authors: Elizabeth A. Klonoff
Journal: JAMA (1994)

To provide data on the sale of single cigarettes to adults and minors and to examine the sociocultural context in which these sales occur.A naturalistic observation study using repeated measures. Two hundred six stores in a convenience sample were visited by one minor and one adult who each attempted to purchase a single cigarette.Single-cigarette sales to an adult and/or minor. Data were obtained on type of store and, if a sale occurred, on the price, brand, and packaging of the cigarette. The ethnic composition of the neighborhood surrounding each store was determined.One hundred one (49.1%) of the stores sold single cigarettes. Singles were sold significantly more often to minors than to adults, and when both could make a purchase, minors paid more for these singles than did adults. Singles were least likely to be sold in white neighborhoods, more likely to be sold in integrated neighborhoods, and most likely to be sold in minority neighborhoods. Minors were able to purchase single cigarettes during 34.4% of the visits to white neighborhoods but could do so during 71.2% of the visits to minority neighborhoods; adults were able to make similar purchases during 24% of the visits to white neighborhoods and 37.3% of the visits to minority neighborhoods.The illegal sale of single cigarettes involves complex sociocultural factors heretofore unexamined. An understanding of such factors may be useful in planning merchant education programs and drafting policy to control illegal sales.
Diffuse pigmented villonodular synovitis: non-surgical management.
Authors: J M Gumpel, D J Shawe
Journal: Annals of the Rheumatic Diseases (1991)

Pigmented villonodular synovitis is a condition rarely seen by rheumatologists, and then almost always at the invitation of their surgical colleagues. At one time, referral was only after failure of one or more surgical synovectomies, but the increasing use of arthroscopy and early diagnosis by arthroscopic biopsy has resulted in referral of early cases
THE ROLE OF THE RENIN-ANGIOTENSIN SYSTEM IN THE CONTROL OF ALDOSTERONE SECRETION*
Authors: James O. Davis, Phyllis M. Hartroft, Elwood O. Titus, Charles C. J. Carpenter, Carlos R. Ayers, Herbert E. Spiegel
Journal: Journal of Clinical Investigation (1962)

Within the last year, evidence (1-4) has ac- cumulated to show that the kidney secretes a hor- mone which is a prime regulator of aldosterone secretion.The renal origin of an aldosteronestimulating hormone (ASH) has been demon- strated following acute blood loss (1-3), during chronic thoracic caval constriction (4), and dur- ing chronic Na depletion (4).Nephrectomizedhypophysectomized dogs failed to respond to acute hemorrhage with an increase in aldosterone secretion, and acute bilateral nephrectomy of hypophysectomized caval and hypophysectomized Na- depleted dogs resulted in a marked drop in aldosterone secretion.Furthermore, crude saline extracts of kidney produced a striking increase in aldosterone secretion (1-5).In malignant ex- perimental renal hypertension, hyperaldosteronism was consistently present (6).These findings and the reports that renin preparations (6) and syn- thetic angiotensin II (6-8) increase the rate of aldosterone production suggest the possibility that ASH is renin.The present experiments were undertaken to determine the chemical nature of this ASH by fractionation of crude kidney extracts for aldo- sterone-stimulating and pressor activity.The renin content of kidneys from dogs with thoracic caval constriction and secondary hyperaldosteronism and from normal dogs has been compared.Since dogs with thoracic caval constriction and Na-depleted dogs do not have hypertension, the response in blood pressure to synthetic angiotensin
Differential gene expression during multistage carcinogenesis.
Authors: G T Bowden, P Krieg
Journal: Environmental Health Perspectives (1991)

The use of the mouse skin multistage model of carcinogenesis has aided our understanding of critical target genes in chemical carcinogenesis. The mutagenic activation of the Harvey-ras proto-oncogene has been found to be an early event associated with the initiation of mouse skin tumors by the polycyclic aromatic hydrocarbon 7,12 dimethylbenz[alpha]anthracene and the pure initiator ethyl carbamate (urethane). In contrast to chemical initiation of mouse skin tumors, ionizing radiation-initiated malignant skin tumors have been shown to possess distinct non-ras transforming gene(s). Differential screening of cDNA libraries made from chemically initiated malignant skin tumors has been used to identify a number of cellular gene transcripts that are overexpressed during mouse skin tumor progression. These differentially expressed genes include beta-actin, ubiquitin, a hyperproliferative keratin (K6), a gene whose product is a member of a fatty acid or lipid-binding protein family, and a gene called transin or stromelysin. The overexpression of the stromelysin gene, which encodes a metalloproteinase that degrades proteins in the basement membrane, is hypothesized to play a functional role in malignant tumor cell invasion and metastasis. We believe that the cloning, identification, and characterization of gene sequences that are differentially expressed during tumor progression could lead to the discovery of gene products that either play functional roles in skin tumor progression or in the maintenance of various progressive tumor phenotypes.
Solitary Splenic Metastasis in a Patient With a Malignant Melanoma Diagnosed With F-18-FDG PET Scanning
Authors: Henriette M. E. Quarles van Ufford, Peter J. C. Zoon, Paul F. G. M. van Waes, Gerard van Herk, John M. H. de Klerk
Journal: Clinical Nuclear Medicine (2005)

A 71-year-old woman with a history of stage III melanoma was hospitalized for evaluating fever of unknown origin and severe left upper quadrant abdominal pain. A computed tomography scan of the abdomen revealed a solitary lesion in the spleen, 10.5 × 10.4 × 10.1-cm, causing splenomegaly. Fused F-18 FDG PET/CT images revealed a solitary splenic metastasis and a focus of increased uptake in the region of the previously removed melanoma at the right scapula. Based on the clinical findings and CT and PET scans, malignant melanoma (stage IV) was diagnosed. Splenectomy was performed subsequently. The histopathologic finding was consistent with a metastasis of a melanoma.
Asystolic episodes during pacemaker implantation.
Authors: E A Astrinsky, S Furman, J Florio
Journal: Circulation (1981)

During normal rate programming of a pulse generator from slower to more rapid rates, intervals of output impulse suppression lasting 2 seconds plus the newly programmed interval to a maximum of 3.935 seconds are possible, and are a result of the pulse interval control system. These occur if programming falls within the susceptible window (the period between the existing interval and the new one) but will not take place if the programming command is given immediately after an output pulse. Four incidents with resulting ventricular asystole of up to 2.8 seconds are documented and explained. No significant clinical complications were observed.
Magnified Observation of Elevated Borderline Lesions (Adenoma) of the Stomach Based on Dissecting Microscopy and Magnifying Fiberoptic Endoscopy
Authors: M. Nishizawa, T. Okada
Journal: Endoscopy (1981)

We have established a system of classification for interpreting the magnified images of elevated lesions of the stomach (see Table 1). Working with a large sample, we isolated what we call borderline lesions of the stomach (adenoma), defined them, and then devised a way of interpreting magnified images to help endoscopists identify them.
Hereditary hypertension caused by chimaeric gene duplications and ectopic expression of aldosterone synthase
Authors: Richard P. Lifton, Robert G. Dluhy, Michael Powers, Glenn M. Rich, Michael Gutkin, Francesco Fallo, John R. Gill, Leonard Feld, Arunabha Ganguly, Jack C. Laidlaw, D.J. Murnaghan, Chris Kaufman, Jan R. Stockigt, Stanley Ulick, Jean-Marc Lalouel
Journal: Nature Genetics (1992)
Further clinical observations on the pulmonary effects of paraquat ingestion.
Authors: T Higenbottam, P Crome, C Parkinson, J Nunn
Journal: Thorax (1979)

Five patients are reported who developed evidence of acute lung damage after proved ingestion of paraquat. In two the lung changes resolved; in one an aspiration pneumonia occurred, which was successfully treated, while two developed fatal pulmonary oedema. These pulmonary complications after paraquat intoxication appear more common than the progressive pulmonary fibrosis previously described. It is suggested that acute pulmonary oedema is a response to large doses, usually of Gramoxone, that subclinical lung changes result from small doses, usually of Weedol, and that pulmonary fibrosis occurs after intermediate doses. Preliminary data on plasma paraquat concentrations suggest that these are of value in prognosis.
Cimetidine and Ranitidine
Authors: Cyrus E. Rubin
Journal: JAMA (1984)

<h3>To the Editor.—</h3> Most physicians would agree that the development of H<sub>2</sub>-inhibitor drugs for peptic ulcer is a major advance in the treatment of this common disease. Furthermore, the physiological research stimulated by their availability has increased our understanding of ulcer pathogenesis. For years, cimetidine has been the only H<sub>2</sub>-inhibitor drug available in the United States, but now ranitidine has been approved by the Food and Drug Administration. Thus, it is appropriate that<i>JAMA</i>, a journal that many physicians turn to for objective guidance in drug therapy, publish an evaluation of this new member of the H<sub>2</sub>-inhibitor family. The article, "Ranitidine," by Williamson Strum,<sup>1</sup>unfortunately implies that ranitidine "is almost completely free" of side effects seen with cimetidine. The truth of the matter is that both cimetidine and ranitidine are excellent drugs for ulcer treatment and that undesirable side effects are rare in