tbuckley/cabot-search huggingface dataset:
Trimethoprim-Sulfamethoxazole and Folinic Acid
Authors: CHRISTOPHER STOCK
Journal: Annals of Internal Medicine (1985)

Letters and Corrections1 February 1985Trimethoprim-Sulfamethoxazole and Folinic AcidCHRISTOPHER STOCK, B.A.CHRISTOPHER STOCK, B.A.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-102-2-277_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In a recent letter Kinzie and Taylor (1) discuss their rationale for recommending the prophylactic use of folinic acid for patients receiving high doses of trimethoprim-sulfamethoxazole. Although there are legitimate concerns about hematologic toxicity from high doses of trimethoprim-sulfamethoxazole, I have reservations about the routine use of folinic acid. To date there are no well-designed studies with trimethoprim-sulfamethoxazole or other antifolates that compare treatment outcomes when using or omitting folinic acid.The inference thatPneumocystis carinii, the frequent target of high-dose trimethoprim-sulfamethoxazole, cannot utilize exogenous folinic acid is probably correct as it is generally thought that protozoa...References1. KINZIE B and TAYLOR J. Trimethoprim and folinic acid [Letter]. Ann Intern Med. 1984;101:565. LinkGoogle Scholar2. FERONE R and HITCHINGS G. Folate cofactor biosynthesis by Plasmodium berghei: comparison of folate and dihydrofolate as substrates. J Protozool. 1966;13:504-6. CrossrefMedlineGoogle Scholar3. GILES C. The treatment of Toxoplasma uveitis with pyrimethamine and folinic acid. Am J Ophthalmol. 1964;58:611-7. CrossrefMedlineGoogle Scholar4. KAHN S, FEIN S, and BRODSKY I. Effects of trimethoprim on folate metabolism in man. Clin Pharmacol Ther. 1968;9:550-9. CrossrefMedlineGoogle Scholar5. JAFFE S, AMMANN A, ABRAMS D, LEWIS B, and GOLDEN J. Complications of co-trimoxazole in treatment of AIDS-associated Pneumocystis carinii pneumonia in homosexual men. Lancet. 1983;2:1109-11. CrossrefMedlineGoogle Scholar6. KOVACS J, HIEMENZ J, and MACHER A. Pneumocystis carinii pneumonia: a comparison between patients with acquired immunodeficiency syndrome and patients with other immunodeficiencies. Ann Intern Med. 1984;100:663-71. LinkGoogle Scholar1. KINZIE B and TAYLOR J. Trimethoprim and folinic acid [Letter]. Ann Intern Med. 1984;101:565. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: CHRISTOPHER STOCK, B.A.Affiliations: University of Utah Salt Lake City, UT 81123 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byIron Deficiency and Megaloblastic Anemias 1 February 1985Volume 102, Issue 2Page: 277-277KeywordsPneumocystisToxicity ePublished: 1 December 2008 Issue Published: 1 February 1985 PDF downloadLoading ...
Clinical value of radionuclide oesophageal transit measurement.
Authors: J S de Caestecker, J N Blackwell, R D Adam, W J Hannan, J Brown, R C Heading
Journal: Gut (1986)

We have reviewed our experience of 150 patients to assess the clinical value of radionuclide oesophageal transit measurements in relation to established oesophageal motility investigations. Achalasia and conditions characterised by incoordinate oesophageal motor activity were detected with equal frequency by manometry and radionuclide transit measurement. Radionuclide transit measurements identified abnormalities not detected by manometry in 18 patients, and manometry was abnormal in 26 patients with normal radionuclide studies, including all patients with nutcracker oesophagus and most with hypertensive lower oesophageal sphincter. The overall sensitivity of radionuclide transit measurements in detecting oesophageal dysmotility was 75%, the sensitivity of manometry was 83% and that of conventional barium radiology 30%. We conclude that radionuclide transit measurement is a useful test for patients with suspected oesophageal motility disorders. Although it has limitations as a screening test, it provides additional information which complements oesophageal manometry.
Lysis of plasminogen activator-resistant platelet-rich coronary artery thrombus with combined bolus injection of recombinant tissue-type plasminogen activator and antiplatelet GPIIb/IIIa antibody
Authors: Tsunehiro Yasuda, Herman K. Gold, Robert C. Leinbach, Tomiyoshi Saito, J.Luis Guerrero, Ik-Kyung Jang, Robert Holt, John T. Fallon, Desire Collen
Journal: Journal of the American College of Cardiology (1990)
Long term treatment of severe obesity: four year follow up of results of combined behavioural modification programme.
Authors: H Bjorvell, S Rossner
Journal: BMJ (1985)

A four year programme of treatment for severe obesity combining standard techniques such as behavioural modification, exercise, nutritional advice, and, in addition, readmission of patients who relapse has been developed. One hundred and seven subjects of both sexes were treated. Thirty nine had their jaws fixed from the start. After four years 104 out of 107 subjects were traced; 33 (31%) had left the programme. The mean loss of weight in the remaining 74 subjects was 11.7 kg (range -20 to 55.5): 14 had lost more than 20 kg, 35 had lost 5-20 kg, 17 had lost 0-5 kg, and eight were above their weight before treatment. The rate of dropping out in this study was lower than that generally reported. Our data suggest that combined behavioural modification used as a programme for reducing weight may result in a substantial loss of weight for several years even for severely obese subjects.
Report calls for greater US involvement in global health assistance
Authors: B. Roehr
Journal: BMJ (2009)

<h3>Rationale</h3> The relationship between cigarette smoking and acute mountain sickness (AMS) is not clear. <h3>Objective</h3> To assess AMS risk and altitude acclimatisation in relation to smoking. <h3>Methods</h3> 200 healthy non-smokers and 182 cigarette smokers were recruited from Han lowland workers. These were men without prior altitude exposure, matched for age, health status and occupation, who were transported to an altitude of 4525 masl. <h3>Measurements</h3> AMS, smoking habits, arterial saturation (SpO<sub>2</sub>), haemoglobin (Hb), lung function and mean pulmonary artery pressure (PAPm) were assessed upon arrival and after 3 and 6 months. <h3>Main results</h3> Compared with non-smokers, smokers had a lower incidence of AMS and lower AMS scores than non-smokers upon arrival; higher Hb and PAPm associated with lower SpO<sub>2</sub> at 3 and 6 months at altitude; and lower forced expiratory volume in 1 s and maximal voluntary ventilation at 3 and 6 months. <h3>Conclusions</h3> Smoking slightly decreases the risk of AMS but impairs long-term altitude acclimatisation and lung function during a prolonged stay at high altitude.
School and Work Release Evaluations
Authors: Warren Lee Holleman
Journal: JAMA (1988)

Increasingly high levels of absenteeism for minor illnesses and injuries have created serious problems for American schools and industries. Short-term absenteeism also creates serious ethical and professional dilemmas for primary care physicians who routinely perform school and work release evaluations. Through an inductive analysis of three typical cases, these problems are identified. The major ethical issues involved are discussed, including truth-telling, confidentiality, and a confusion of the professional boundaries of medicine, education, and industry. Through a deductive analysis, it is shown that the conventional approaches to school and work release evaluations fail to achieve satisfactory results. To circumvent these problems, three solutions are proposed: primary care physicians can refuse to do such evaluations, inform the patient of the purpose and rules of the encounter, or perform evaluations only in the context of treatment. (<i>JAMA</i>1988;260:3629-3634)
UK government moves to tackle lottery of cancer drugs
Authors: Katherine Burke
Journal: BMJ (2004)

Electronic prescribing is to be launched two years earlier than planned in an effort to put an end to “postcode prescribing” of newer chemotherapy drugs.

Launching a report into variations in prescribing earlier this week, health minister Lord Warner described as “unacceptable” and “unfair” the differences in the way England's 34 cancer networks use new chemotherapy drugs.

Lord Warner promised to implement all the report's recommendations, including bringing forward electronic prescribing to 2006, rather than the current launch date of 2008-10. Electronic prescribing would enable cancer networks to give doctors feedback when they prescribe chemotherapy differently from the norm. Such feedback has been shown to reduce variation.

He added that the results of the report would be sent to all strategic health …
Total Paralysis Regime in Severe Tetanus
Authors: S. M. A. Alhady, D. P. Bowler, H. A. Reid, L. T. Scott
Journal: BMJ (1960)

The triennial reports of the [joint Bethlem Royal Hospital and Maudsley] hospital have two objects.The first is the provision of statistics relating to the medical administration of the hospital departments.The second is the provision of demographic, social, and diagnostic data on the patient population attending the hospital.While
Margaret Anne Haigh (née Mitchell)
Authors: Fiona Haigh
Journal: BMJ (2007)

<h3>Abstract</h3> <h3>Background &amp; Aims</h3> Genetic analyses of human NASH have revealed polymorphisms near the membrane bound O-acyl transferase domain containing 7 (<i>MBOAT7</i>) gene associated with worsened liver injury. NAFLD/NASH also appears to decrease MBOAT7 expression or activity independent of these polymorphisms. Thus, we hypothesized that enhancing MBOAT7 function in NASH would improve pathology. <h3>Approach &amp; Results</h3> Male C57BL6/J mice were infected with adeno-associated virus 8 (AAV8) expressing MBOAT7 under control of the hepatocyte-specific thyroid hormone-binding globulin promoter, or control virus expressing green fluorescent protein (GFP). Mice were infected after NASH induction with either choline-deficient high-fat diet or Gubra Amylin NASH diet and compared to low-fat fed control mice. Both NASH diets increased liver weights, liver triglycerides, and plasma alanine and aspartate aminotransferase (ALT and AST) markers of liver injury, which were modestly yet significantly improved by MBOAT7 overexpression. However, NASH liver histology assessed by categorical scoring was not substantially improved by MBOAT7 overexpression. MBOAT7 regulates the formation of phosphatidylinositol (PI) predominantly by arachidonoylation of lysophosphatidylinositol (LPI). Shotgun lipidomics of NASH GFP-control livers suggested decreased MBOAT7 activity in that LPI content was elevated, and both total and arachidonoylated-PI were reduced. Surprisingly, MBOAT7 overexpression did not rescue the content of most arachidonoylated PI species but did normalize or increase the abundance of several oleate and linoleate-containing PI species. Free arachidonic acid was elevated but the MBOAT7 substrate arachidonoyl-CoA was found to be low in all NASH livers compared to low-fat fed mice, likely due to decreased expression of both long-chain acyl-CoA synthetases (ACSL) 1 and 4 in NASH livers compared to controls. <h3>Conclusions</h3> These results suggest MBOAT7 overexpression fails to measurably improve NASH pathology potentially due to insufficient abundance of its arachidonoyl-CoA substrate in fatty livers.
THE TONSILS AS FOCI OF INFECTION IN STREPTOCOCCUS HEMOLYTICUS CARRIERS
Authors: H. J. NICHOLS
Journal: JAMA (1918)

carefully carried out intranasal work fails to relieve the patient from annoying headache and in cases in which there is a threatened intracranial complication.Such cases will arise only exceptionally in one's experience.Dr. James J. Pattee, Pueblo, Colo.: Frontal sinusitis, requiring operation, is a troublesome affection, and the opera- tion of choice should be determined with care.From a gen- eral survey of the published opinions there is, in my judgment, a progressive increase in the number of intranasal operations with a corresponding lessening of the external.I am in accord with this order of things.I agree with Dr. Sham- baugh that it is applicable in the vast majority of cases.In rare cases we must resort to external measures.The Killian operation fails occasionally, even in the hands of our best operators.It frequently produces much disfigurement and in some cases fails to afford ample permanent drainage, the feature on which its greatest claims are based.Dr. Ingals' statement is very true.The intranasal operation requires intimate anatomic knowledge and much experience.The narrowest part of the nose is on a plane with the canthi.The Lothrop operation has the advantage of opening the sinus very near this point, a great advantage.The Lothrop opera- tion permits of thorough work; establishes adequate drainage; affords the best vision, and offers the most direct route to the site of greatest difficulty and danger.It permits healing in the shortest time and minimizes untoward after-effects.
Role of biliary stenting in the management of bile duct stones in the elderly.
Authors: H R Dalton, R W Chapman
Journal: Gut (1995)

Leading articleRole of biliary stenting in the management of bile duct stones in the elderly Nearly a third of patients with common bile duct stones are at risk of developing recurrent cholangitis or pancreatitis.'These complications carry a significant mortality in elderly, infirm patients so that prompt intervention to clear the duct of stones (or at least establish an uninterrupted flow of bile) is, particularly important.Endoscopic sphincterotomy and basket extraction is the initial treatment of choice for a patient of any age with choledocholithiasis, which clears the bile duct of stones in up to 90%.2-4 Elderly patients in whom sphincterotomy and basket extraction is unsuccessful present a challenging clini- cal problem, as surgical exploration carries an unacceptably high mortality.56Many alternative therapeutic approaches in those few patients in whom sphincterotomy and basket extraction is unsuccessful, include:-surgical exploration, mechanical lithotripsy, extracorporeal shock wave litho- tripsy (ESWL), contact dissolution, electrohydraulic and laser lithotripsy, and stenting.Surgical exploration Surgical exploration of the common bile duct is well toler- ated by young, fit patients where the death rate is about 1% or less.7-9In elderly and infirm patients the death rate may be as high as 10% or more,7 10 which makes surgery an unattractive proposition, particularly in patients with significant concomitant cardiorespiratory disease.
Screening for prolonged incubation of HTLV-I infection in British and Jamaican relatives of British patients with tropical spastic paraparesis.
Authors: J K Cruickshank, J H Richardson, O S Morgan, J Porter, P Klenerman, J Knight, A L Newell, P Rudge, A G Dalgleish
Journal: BMJ (1990)

OBJECTIVE--To compare the prevalence of antibody to and proviral DNA of the retrovirus HTLV-I in relatives of 11 British patients with tropical spastic paraparesis who had migrated from Jamaica before they developed symptoms, and to examine factors possibly related to transmission of HTLV-I. DESIGN--Migrant, family study. Antibody state was determined by several methods and confirmed by western blotting; the polymerase chain reaction was used to detect proviral DNA. SETTING--Britain and Jamaica. SUBJECTS--All available first degree relatives: those born and still resident in Jamaica (group 1); those born in Jamaica who migrated to Britain (group 2); and index patients9 children who were born and resident in Britain (group 3). All had been breast fed and none had had blood transfusions. RESULTS--Of the 66 living relatives, 60 were traced. Seroprevalence among those born in Jamaica (irrespective of current residence) was 22% (10/46; 95% confidence limits 9 to 34%) compared with zero among British born offspring (0/14) and was higher in group 2 at 33% (7/21; 12 to 55%) than in group 1 at 12% (3/25; 0 to 25%). (Patients in group 1 had the greatest mean age.) Proviral DNA was not detected in any subject negative for HTLV-I antibody, making prolonged viral incubation in those negative for the antibody unlikely. CONCLUSION--In this sample factors related to place of birth and early residence were more important in transmission of HTLV-I than maternal or age effects. In areas with a low to moderate prevalence policies of preventing mothers who are carriers of the virus from breast feeding would be premature.
Recurrent Pneumonitis With Hypersensitivity to Hen Litter
Authors: Donald S. Korn
Journal: JAMA (1968)

Severe recurrent pneumonitis occurred in a 6-year-old city boy who lived near a market in which live chickens were sold. His pulmonary disease improved when he was removed from the area. He was shown to have precipitins to an antigen prepared from hen litter. These antibodies decreased as he improved.
The cautionary tale of side effects of chronic Notch1 inhibition
Authors: Sandra W. Ryeom
Journal: Journal of Clinical Investigation (2011)

Aberrant Notch1 signaling is implicated in several types of cancer. Therefore, Notch signaling pathways are important anticancer targets. Pan-Notch receptor inhibition is associated with numerous complications; thus, selective Notch receptor inhibition has been pursued. Studies have shown minimal side effects with short-term blockade of either Notch1 or its ligand Delta-like 4, but long-term side effects were not investigated. In this issue of the JCI, Liu et al. use mouse models to demonstrate the consequence of long-term Notch1 inhibition. They present evidence that chronic Notch1 inhibition leads to vascular tumors in the liver and decreased survival, which suggests that Notch1 therapies should be reevaluated.
Abstract 4859: Hepatocyte growth factor activator inhibitor type 1 suppresses invasion of pancreatic adenocarcinoma cells through inhibition of matriptase/protease-activated receptor-2 axis
Authors: Yukihiro Haruyama, Jing-Jia Ye, Makiko Kawaguchi, Ai Kanemaru, Tsuyoshi Fukushima, Hiroaki Kataoka
Journal: Cancer Research (2014)

Abstract Previously, we reported that S2-CP8 cells, a metastatic variant of SUIT-2 pancreatic adenocarcinoma cell line, showed markedly decreased expression of hepatocyte growth factor activator inhibitor type 1 (HAI-1) compared to SUIT-2 and acquired EMT phenotype. Matrigel invasion assay revealed that S2-CP8 cells show enhanced invasion compared to SUIT-2 cells in vitro and forced HAI-1 expression alleviate the invasion. Consequently, in vivo study using a nude mouse orthotopic xenograft model showed reduced spontaneous metastasis by the forced HAI-1 expression. This study aimed to clarify molecular mechanisms underlying the HAI-1-mediated suppression of invasion of S2-CP8 cells. In S2-CP8 cells, activity of matriptase, a cognate protease of HAI-1, was clearly suppressed by forced expression of HAI-1. As matriptase is known to activate protease-activated receptor-2 (PAR-2) and PAR-2 agonist enhanced migration and invasion of S2-CP8, we analyzed the role of PAR-2 in HAI-1 loss-induced enhanced invasion of S2-CP8 in vitro. The HAI-1 loss-induced enhanced migration and invasion were significantly alleviated by PAR-2 antagonist, as well as by PAR-2 silencing. Moreover, knock down of matriptase also showed similar suppressive effects on the invasion of S2-CP8 cells. These results indicated that HAI-1 may have a suppressive role in the invasion of pancreatic cancer cells through its regulatory function on matriptase/PAR-2 axis. Citation Format: Yukihiro Haruyama, Jing-Jia Ye, Makiko Kawaguchi, Ai Kanemaru, Tsuyoshi Fukushima, Hiroaki Kataoka. Hepatocyte growth factor activator inhibitor type 1 suppresses invasion of pancreatic adenocarcinoma cells through inhibition of matriptase/protease-activated receptor-2 axis. [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 4859. doi:10.1158/1538-7445.AM2014-4859
Interleukin 12 and Interleukin 4 Control T Cell Adhesion to Endothelial Selectins through Opposite Effects on α1,3-fucosyltransferase VII Gene Expression
Authors: Amy J. Wagers, Christopher M. Waters, Lloyd M. Stoolman, Geoffrey S. Kansas
Journal: The Journal of Experimental Medicine (1998)

The α1,3-fucosyltransferase, FucT-VII, is crucial for the formation of ligands for all three selectins, and its expression regulates the synthesis of these ligands. Short-term polarized T helper (Th)1, but not Th2 or naive CD4+ T cells, can home to sites of inflammation, but the molecular basis for this difference has remained unclear. Here we show that naive CD4+ T cells do not express FucT-VII and fail to bind vascular selectins. We also show that when CD4+ T cells are activated in the presence of the Th1 polarizing cytokine interleukin (IL)-12, levels of FucT-VII mRNA and binding to E- and P-selectin are significantly augmented. In contrast, activation of CD4+ T cells in the presence of IL-4, a Th2 polarizing cytokine, inhibited FucT-VII expression and binding to vascular selectins. T cell activation upregulated expression of the Core2 transferase, C2GnT, equivalently regardless of the presence or absence of polarizing cytokines. These data indicate that the selective ability of Th1 cells, as opposed to Th2 cells or naive CD4+ T cells, to recognize vascular selectins and home to sites of inflammation is controlled principally by the expression of a single gene, FucT-VII.
Alternatives to animal research in acute lung injury
Authors: D. Parekh, R. C. A. Dancer, D. R. Thickett
Journal: BMJ (2014)

Pound and Bracken suggest that all animal research is futile,1 highlighting problems with quality, validity, and reporting. Although animal research is not a perfect model of human disease, there are practical and ethical difficulties in proceeding directly to human trials of new drugs. Rather …
Infliximab therapy in patients with ankylosing spondylitis: an open label 12 month study
Authors: T I Temekonidis
Journal: Annals of the Rheumatic Diseases (2003)

To evaluate the efficacy and safety of long term infliximab therapy in patients with severe refractory ankylosing spondylitis (AS).Twenty five patients (24 male, 1 female; mean (SD) age 36.0 (10.5); disease duration 13.8 (8.5) years) with AS fulfilling the modified New York criteria for AS were investigated. Twenty two (88%) patients were HLA-B27 positive. All patients had active axial disease (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) >/=30/100) and C reactive protein (CRP) >/=10 mg/l, despite adequate treatment. Intravenous infliximab (5 mg/kg) was given at weeks 0, 2, 6, and every eight weeks thereafter for 12 months. The primary end point was the reduction of the patient's global assessment of pain (GAP) by >20% on a 100 mm visual analogue scale.GAP was reduced by >20% in 23 (92%) patients, by 50% in 21 (84%) patients, and by 70% in 13 (52%). The change in BASDAI and CRP from baseline was statistically significant. The treatment was well tolerated with minimal side effects. One patient dropped out owing to inefficacy and one stopped treatment owing to an allergic reaction.This longer length study confirms the efficacy of infliximab and the good safety profile in patients with AS.